PMID- 1613491
TI  - Purification and lectin-binding properties of s-laminin, a synaptic isoform of
      the laminin B1 chain.
AB  - The extracellular matrix (ECM) at the vertebrate neuromuscular junction is a
      repository of functionally important molecules, some of which can regulate the
      formation of synapses during regeneration. One candidate molecule is s-laminin, a
      185-kDa homologue of the laminin B1 chain. Whereas several members of the laminin
      family are present throughout the ECM ensheathing muscle fibers, immunoreactivity
      for s-laminin is found selectively at synaptic sites in adult and embryonic rats,
      and is detectable at a time when synaptogenesis is taking place during
      development. We have reported previously that a rat schwannoma cell line, D6P2T,
      produces and releases large amounts of s-laminin in culture. We have now purified
      s-laminin from medium conditioned by these cells by using a simple three-step
      procedure. Serum-free, conditioned medium is separated by ion-exchange
      chromatography on DEAE-Sephacel, followed by size-exclusion chromatography on 500
      HR-Sephacryl. Finally, s-laminin is dissociated from other ECM components by
      agarose gel electrophoresis under reducing conditions and recovered in solution
      by extracting slices of agarose gel. The purified preparation displays one silver
      stained band that is recognized by three monoclonal antibodies known to bind to
      different epitopes on s-laminin. Lectin-binding studies demonstrate that s
      laminin is a glycoprotein and bears many of the carbohydrate moieties present on
      the B1 and B2 chains of laminin. Thus, the three 185-220-kDa members of the
      laminin family are related in both their protein and carbohydrate domains.

PMID- 1613492
TI  - Adult rat retina interneurons synthesize GD3: GD3 expression by these cells is
      regulated by cell-cell interactions.
AB  - GD3, a ganglioside of the lactosyl series, is prevalent in rat retina neuronal
      cells. We studied here whether rat retina neurons synthesize their own surface
      GD3 or if they acquire it from Muller glia cells. We analyzed the activity of GD3
      synthase and the in vivo labeling of gangliosides from N-[3H]acetylmannosamine in
      adult rat retinas after selective destruction of Muller glia cells with the
      gliotoxic alpha-D,L-aminoadipate (AAA). Immunostaining of rat retina sections and
      western blot analysis with an antivimentin antibody confirmed the gliotoxic
      effect of AAA. Neither GD3 synthase activity nor the in vivo labeling of GD3 and
      other gangliosides was significantly affected by AAA, indicating that neuronal
      cells synthesize their own GD3. We next analyzed the regulation of the expression
      of GD3 by these neurons in culture. About 80% of freshly dissociated cells from
      retina of 4-day-old rats (R4) immunoexpress surface GD3. After 3 days in
      dispersed cell culture conditions, GD3 expression was under the limit of
      detection in 80% of neuronal cells, indicating a failure of these cells to
      maintain the expression of surface GD3 in these experimental conditions. Most
      flat Muller glia-derived cells present in these cultures were GD3 positive.
      Surface GD3 was detected in approximately 60% of neuronal cells dissociated from
      R4 tissue that was developed in vitro as an organ culture for 3 days. Likewise,
      approximately 50% of neurites that had grown out from R4 retinal explants within
      3 days in culture and whose neuronal character was indicated by immunoexpression
      of growth-associated protein GAP-43 were GD3 positive. These findings suggest
      that the tissue organization and/or specific interactions modulate GD3 expression
      in neuronal cells. Under dispersed-cell culture conditions, c-pathway
      gangliosides (GQ1c and GT1c), which are built up from the sialylation of GD3 and
      later completion of the oligosaccharide backbone, were detected in approximately
      60% of neuronal cells, suggesting a maintenance of production of GD3 as an
      intermediate for gangliotetraosyl gangliosides.

PMID- 1613493
TI  - Toxic effects of iron for cultured mesencephalic dopaminergic neurons derived
      from rat embryonic brains.
AB  - Iron, a transition metal possibly involved in the pathogenesis of Parkinson's
      disease, was tested for its toxic effects toward cultures of dissociated rat
      mesencephalic cells. When cultures were switched for 24 h to serum-free
      conditions, the effective concentrations of ferrous iron (Fe2+) producing a loss
      of 50% of dopaminergic neurons, as quantified by tyrosine hydroxylase (TH)
      immunocytochemistry, TH mRNA in situ hybridization, and measurement of TH
      activity, were on the order of 200 microM. High-affinity dopamine (DA) uptake,
      which reflects integrity and function of dopaminergic nerve terminals, was
      impaired at significantly lower concentrations (EC50 = 67 microM). Toxic effects
      were not restricted to dopaminergic neurons inasmuch as trypan blue dye exclusion
      index and gamma-aminobutyric acid uptake, two parameters used to assess survival
      of other types of cells present in these cultures, were also affected. Protection
      against iron cytotoxicity was afforded by desferrioxamine and apotransferrin, two
      ferric iron-chelating agents. Normal supplementation of the culture medium by
      serum proteins during treatment was also effective, presumably via nonspecific
      sequestration. Potential interactions with DA were also investigated. Fe2+ at
      subtoxic concentrations and desferrioxamine in the absence of exogenous iron
      added to the cultures failed to potentiate or reduce DA cytotoxicity for
      mesencephalic cells, respectively. Transferrin, the glycoprotein responsible for
      intracellular delivery of iron, was ineffective in initiating selective cytotoxic
      effects toward dopaminergic neurons preloaded with DA. Altogether, these results
      suggest (a) that ferrous iron is a potent neurotoxin for dopaminergic neurons as
      well as for other cell types in dissociated mesencephalic cultures, acting likely
      via autoxidation into its ferric form, and (b) that the presence of intra- and
      extracellular DA is not required for the observed toxic effects.

PMID- 1613494
TI  - Mapping of histamine H1 receptors in the human brain using [11C]pyrilamine and
      positron emission tomography.
AB  - We have studied the characteristics of carbon-11 labeled pyrilamine as a
      radioligand for investigating histamine H1 receptors in human brain with positron
      emission tomography (PET). [11C]Pyrilamine is distributed evenly in proportion to
      cerebral blood flow at initial PET images. Later (after 45-60 min), 11C
      radioactivity was observed at high concentrations in the frontal and temporal
      cortex, hippocampus, and thalamus, and at low concentrations in the cerebellum
      and pons. The regional distribution of the carbon-11 labeled compound in the
      brain corresponded well with that of the histamine H1 receptors determined in
      vitro in autopsied materials. In six controls, the frontal and temporal
      cortices/cerebellum ratio increased during the first 60 min to reach a value of
      1.22 +/- 0.071. Intravenous administration of d-chlorpheniramine (5 mg)
      completely abolished the specific binding in vivo in the frontal cortex and
      temporal cortex (cortex/cerebellum ratio, 0.955 +/- 0.015). The availability of
      this method for measuring histamine H1 receptors in vivo in humans will
      facilitate studies on neurological and psychiatric disorders in which histamine
      H1 receptors are thought to be abnormal.

PMID- 1613495
TI  - Glucocorticoids exacerbate hypoxic and hypoglycemic hippocampal injury in vitro:
      biochemical correlates and a role for astrocytes.
AB  - The acute secretion of glucocorticoids is critical for responding to
      physiological stress. Under normal circumstances these hormones do not cause
      acute neuronal injury, but they have been shown to enhance ischemic and seizure
      induced neuronal injury in the rat brain. Using fetal rat hippocampal cultures,
      we asked whether hypoxic and hypoglycemic cell damage in vitro could be
      exacerbated by direct exposure to corticosterone (CORT). Each of these insults
      alone damaged neuronal cells, whereas 4-6 h of hypoxic treatment could damage age
      matched astrocytes if glucose was reduced or omitted. Ischemic-like injury to
      both cell types could be attenuated by pretreatment with high (30 mM) glucose.
      Exposure to 100 nM CORT did not affect cell viability under control conditions
      but enhanced both hypoxic and hypoglycemic neuronal injury. In both cases,
      pretreatment with high glucose abolished this CORT-mediated synergy. In astrocyte
      cultures, CORT exacerbated both hypoxic and hypoglycemic injury and this effect
      was also attenuated by high-glucose pretreatment. Identical 24-h CORT treatment
      caused a 13% reduction in glucose uptake in astrocytes and a 38% reduction in
      glycogen content, without affecting the level of intracellular glucose. Thus,
      CORT could endanger both neurons and astrocytes in mixed hippocampal cultures and
      this effect emerged only under conditions of substrate depletion. The metabolic
      disruption in astrocytes by CORT further suggests that the ability of CORT to
      exacerbate neuronal injury may be due in part to impaired glial cell function.

PMID- 1613496
TI  - Ethanol-induced increase in endogenous dopamine release may involve endogenous
      opiates.
AB  - The effect of opiate peptides on basal and potassium-stimulated endogenous
      dopamine (DA) release from striatal slices was studied in vitro. Dual stimulation
      of the striatal slices gave a reproducible increase in DA release that was
      calcium dependent. Addition of the delta-opiate receptor agonists Met5
      enkephalin, [D-Ala2,D-Leu5]enkephalin (DADLE), and [D-Ser2]Leu-enkephalin-Thr
      (DSLET), increased the basal DA release without affecting potassium-stimulated
      release in a dose-dependent manner. The effect of DADLE was antagonized by the
      addition of naloxone. In contrast, the mu-opioid receptor agonist [D-Ala2,N
      MePhe4,Gly-ol5]enkephalin (DAGO) and the epsilon-opioid agonist beta-endorphin
      inhibited the stimulated DA release without changing the basal release. The
      inhibitory effect of DAGO on potassium-stimulated release was antagonized by
      naloxone. The addition of ethanol (75 mM) to the incubation media produced a
      delayed increase of both the basal and stimulated DA release. There was no change
      in stimulated DA release when the change in basal release was subtracted,
      suggesting that ethanol produced a dose-dependent, selective increase in basal DA
      release. Naloxone and the selective delta-opiate antagonist ICI 174864 inhibited
      the ethanol-induced increase in basal DA release. Naloxone and ICI 174864 added
      alone did not alter either basal or stimulated DA release. We therefore suggest
      that the ethanol-induced increase in basal DA release is an indirect effect
      involving an endogenous delta-opiate agonist.

PMID- 1613497
TI  - Temporal profiles of nerve growth factor beta-subunit level in rat brain regions
      after transient ischemia.
AB  - To determine the role of nerve growth factor (NGF) in ischemic brain damage, we
      measured the temporal and regional changes in the level of NGF in the hippocampal
      subfields, the cerebral cortex, the striatum, and the septum at 1, 2, 7, and 30
      days after transient forebrain ischemia using a highly sensitive sandwich-type
      enzyme immunoassay system for the beta-subunit of mouse 7S NGF (beta-NGF). We
      also analyzed glial fibrillary acidic protein immunoreactivity in the hippocampus
      to ascertain the contribution of reactive astrocytes to NGF production after an
      ischemic insult. In the CA1 subfield of the hippocampus, the level of beta-NGF
      decreased slightly 2 days after ischemia (not significant), at which time CA1
      pyramidal cell loss began to occur, and increased by 40% 30 days after ischemia
      (p less than 0.05). A marked increase in glial fibrillary acidic protein-positive
      astrocytes in the CA1 subfield 2-30 days after ischemia suggests that the
      reactive astrocytes participated in a gradual increase in the level of beta-NGF
      after recirculation. The level of beta-NGF in the dentate gyrus decreased
      transiently 2 days (p less than 0.05) and 7 days (p less than 0.01) after
      ischemia, followed by recovery to the level of control animals 30 days after
      ischemia. The level of beta-NGF in the septum gradually decreased 7 days (-27%, p
      less than 0.05) and 30 days (-43%, p less than 0.01) after ischemia. The levels
      of beta-NGF in the cerebral cortex and striatum remained unaltered throughout the
      observation period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613498
TI  - Biochemical and autoradiographical determination of protein synthesis in
      experimental brain tumors of rats.
AB  - The rate of leucine incorporation into brain proteins was studied in rats with
      experimental brain tumors produced by intracerebral transplantation of the glioma
      clone F98. Incorporation was measured with [14C]leucine using a controlled
      infusion technique for maintaining constant specific activity of [14C]leucine in
      plasma, followed by quantitative autoradiography and biochemical tissue analysis.
      After 45 min the specific activity of free [14C]leucine in plasma was 2.5-3 times
      higher than in brain and brain tumor, indicating that the precursor pool for
      protein synthesis was fueled both by exogenous (plasma-derived) and endogenous
      (proteolysis-derived) amino acids. Endogenous recycling of amino acids amounted
      to 73% of total free leucine pool in brain tumors and to 60-70% in normal brain.
      Taking endogenous amino acid recycling into account, leucine incorporation was
      78.7 +/- 16.0 nmol/g of tissue/min in brain tumor, and 17.2 +/- 4.2 and 9.7 +/-
      3.3 nmol/g/min in normal frontal cortex and striatum, respectively. Leucine
      incorporation within tumor tissue was markedly heterogeneous, depending on the
      local pattern of tumor proliferation and necrosis. Our results demonstrate that
      quantitative measurement of leucine incorporation into brain proteins requires
      estimation of recycling of amino acids derived from proteolysis and, in
      consequence, biochemical determination of the free amino acid precursor pool in
      tissue samples. With the present approach such measurements are possible and
      provide the quantitative basis for the evaluation of therapeutic interventions.

PMID- 1613499
TI  - Muscarinic receptor stimulated GTPase activity in synaptic membranes from bovine
      retina.
AB  - GTPase activity has been measured in synaptic membranes from bovine retina, with
      and without muscarinic receptor stimulation. Maximal stimulation above basal
      levels was achieved with 5 microM oxotremorine and 100 microM carbachol. (4
      Hydroxy-2-butynyl)-1-trimethylammonium m-chlorocarbanilate chloride, which is
      selective for the M1 muscarinic receptor, failed to stimulate GTPase activity. 4
      Diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP) inhibition of oxotremorine
      stimulation demonstrated the presence of two populations of receptors, a low
      affinity site (IC50 +/- SEM, 0.63 +/- 0.18 microM) which accounted for 63% of the
      inhibition and a high-affinity site (IC50 less than 1 nM) which accounted for the
      remaining 37%. When carbachol-stimulated GTPase activity was assayed, a single 4
      DAMP inhibitory site was apparent (IC50 +/- SEM, 2.0 +/- 0.9 microM). Pirenzepine
      inhibited GTPase activity at a single site (IC50 values +/- SEM, 46.9 +/- 11 and
      25.4 +/- 6.5 microM against oxotremorine and carbachol, respectively).
      Methoctramine was equipotent against carbachol and oxotremorine stimulation (IC50
      values, 4.2 +/- 1.8 and 6.2 +/- 1.5 microM). Inhibition of maximal carbachol and
      oxotremorine stimulation by muscarinic antagonists at the major site had a rank
      order of potency of 4-DAMP = methoctramine greater than pirenzepine. Thus, the
      major site for muscarinic stimulation of GTPase activity in bovine retinal
      membranes is pharmacologically similar to M2 receptors.

PMID- 1613500
TI  - Effect of intracellular glutamine on the uptake of large neutral amino acids in
      astrocytes: concentrative Na(+)-independent transport exhibits metastability.
AB  - To examine whether the concentration gradient of glutamine (Gln) drives
      concentrative Na(+)-independent uptake of neutral amino acids (NAA) in mouse
      cerebral astrocytes, uptake was compared in "Gln-depleted" and "Gln-replete"
      cultures. Uptake (30 min in Na(+)-free buffer) of histidine, kynurenine, leucine,
      tyrosine, and a model substrate for System L transport was 70-150% greater in Gln
      replete cultures. Phenylalanine uptake was not affected. All of these NAA trans
      stimulated the export of Gln from astrocytes. However, the increase in NAA uptake
      was sustained even though the Gln content of Gln-replete cultures declined. Also,
      uptake of Gln itself was enhanced in Gln-replete cultures. Thus, countertransport
      of Gln was insufficient to explain the enhancement of NAA uptake. Enhanced uptake
      was restored, and could be magnified, by reloading Gln-depleted cultures either
      with Gln or with histidine. It is suggested that substrate-induced asymmetry and
      molecular hysteresis in the Na(+)-independent carrier could account for the
      sustained enhancement of NAA uptake. Only histidine and kynurenine were
      concentrated comparably to Gln (15- to 29-fold at 1 mM in Na(+)-free buffer). The
      other NAA were four to six times less concentrated. At least two Na(+)-dependent
      transport systems also supported the concentration gradient of Gln in regular
      buffer.

PMID- 1613501
TI  - Phosphoethanolamine enhances high-affinity choline uptake and acetylcholine
      synthesis in dissociated cell cultures of the rat septal nucleus.
AB  - Dissociated rat septal nucleus cells cultured in defined medium exhibited twofold
      increases in the maximal rates of sodium-dependent, high-affinity choline uptake
      and acetylcholine formation when grown in the presence of phosphoethanolamine.
      The effect was concentration-dependent (EC50 = 15 microM) and appeared to be
      associated with in vitro maturation of cholinergic neurons rather than with
      enhanced survival. Choline acetyltransferase, acetylcholinesterase, and choline
      kinase activities were unaffected by this treatment. The effect of
      phosphoethanolamine was specific for cholinergic neurons, because treatment with
      this compound did not alter the kinetic constants for high-affinity neuronal
      uptake of gamma-aminobutyric acid or dopamine. The action appeared to be mediated
      primarily through activation of the sodium-dependent, high-affinity transport
      mechanism for choline as opposed to alterations in the storage and release of
      acetylcholine.

PMID- 1613502
TI  - Differences in dopamine clearance and diffusion in rat striatum and nucleus
      accumbens following systemic cocaine administration.
AB  - Acute cocaine administration preferentially increases extracellular dopamine
      levels in nucleus accumbens as compared with striatum. To investigate whether a
      differential effect of cocaine on dopamine uptake could explain this observation,
      we used in vivo electrochemical recordings in anesthetized rats in conjunction
      with a paradigm that measures dopamine clearance and diffusion without the
      confounding effects of release. When a finite amount of dopamine was pressure
      ejected at 5-min intervals from a micropipette adjacent to the electrode,
      transient and reproducible increases in dopamine levels were detected. In
      response to 15 mg/kg of cocaine-HCl (i.p.), these signals increased in nucleus
      accumbens, indicating significant inhibition of the dopamine transporter. The
      time course of the dopamine signal increase paralleled that of behavioral changes
      in unanesthetized rats receiving the same dose of cocaine. In contrast, no change
      in the dopamine signal was detected in dorsal striatum; however, when the dose of
      cocaine was increased to 20 mg/kg, enhancement of the dopamine signal occurred in
      both brain areas. Quantitative autoradiography with [3H]mazindol revealed that
      the affinity of the dopamine transporter for cocaine was similar in both brain
      areas but that the density of [3H]mazindol binding sites in nucleus accumbens was
      60% lower than in dorsal striatum. Tissue dopamine levels in nucleus accumbens
      were 44% lower. Our results suggest that a difference in dopamine uptake may
      explain the greater sensitivity of nucleus accumbens to cocaine as compared with
      dorsal striatum. Furthermore, this difference may be due to fewer dopamine
      transporter molecules in nucleus accumbens for cocaine to inhibit, rather than to
      a higher affinity of the transporter for cocaine.

PMID- 1613503
TI  - Prohormone thiol protease and enkephalin precursor processing: cleavage at
      dibasic and monobasic sites.
AB  - Production of active enkephalin peptides requires proteolytic processing of
      proenkephalin at dibasic Lys-Arg, Arg-Arg, and Lys-Lys sites, as well as cleavage
      at a monobasic arginine site. A novel "prohormone thiol protease" (PTP) has been
      demonstrated to be involved in enkephalin precursor processing. To find if PTP is
      capable of cleaving all the putative cleavage sites needed for proenkephalin
      processing, its ability to cleave the dibasic and the monobasic sites within the
      enkephalin-containing peptides, peptide E and BAM-22P (bovine adrenal medulla
      docosapeptide), was examined in this study. Cleavage products were separated by
      HPLC and subjected to microsequencing to determine their identity. PTP cleaved
      BAM-22P at the Lys-Arg site between the two basic residues. The Arg-Arg site of
      both peptide E and BAM-22P was cleaved at the NH2-terminal side of the paired
      basic residues to generate [Met]-enkephalin. Furthermore, the monobasic arginine
      site was cleaved at its NH2-terminal side by PTP. These findings, together with
      previous results showing PTP cleavage at the Lys-Lys site of peptide F,
      demonstrate that PTP possesses the necessary specificity for all the dibasic and
      monobasic cleavage sites required for proenkephalin processing. In addition, the
      unique specificity of PTP for cleavage at the NH2-terminal side of arginine at
      dibasic or monobasic sites distinguishes it from many other putative prohormone
      processing enzymes, providing further evidence that PTP appears to be a novel
      prohormone processing enzyme.

PMID- 1613504
TI  - Nerve growth factor-induced changes in the structure of sulfated proteoglycans in
      PC12 pheochromocytoma cells.
AB  - Structural changes in proteoglycans (PGs) were examined during the neuritogenesis
      of PC12 cells induced by nerve growth factor (NGF). (1) A heparan sulfate (HS) PG
      and a chondroitin sulfate (CS) PG were synthesized by PC12 cells, irrespective of
      the presence of NGF or the duration of culture. PGs released from PC12 cells into
      the culture medium were mostly CSPGs. (2) In the absence of NGF, the apparent
      molecular mass of HSPG prepared from PC12 cells after 3 days of culture was in
      the range of 90-190 kDa for the intact form (Kav = 0.38 on Sepharose CL-6B), 12
      kDa for HS, and 61 kDa for the core protein. In the presence of NGF, these values
      were 90-190 kDa, 10 kDa, and 51 kDa and 61 kDa, respectively. The intact forms of
      cell-associated CSPG had apparent molecular mass ranges of 120-150 kDa and 120
      190 kDa (Kav = 0.38 and 0.34), with CSs of 15 kDa and 20 kDa in the presence and
      absence of NGF, respectively. The apparent molecular mass of the core protein of
      cell-associated CSPG was 92 kDa, irrespective of the presence of NGF. The
      molecular sizes of cell-associated PGs and their glycosaminoglycans remained
      unchanged during culture. (3) CSPGs released by PC12 cells into the culture
      medium were separated into two peaks (I and II) by column chromatography on DEAE
      cellulose. The peak II fraction prepared from the medium with NGF after 3 days of
      culture consisted of CSPG with Kav = 0.22 on Sephacryl S-300 [40-84 kDa by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)].(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1613505
TI  - Uptake and distribution of iron and transferrin in the adult rat brain.
AB  - Brain uptake of iron-59 and iodine-125-labelled transferrin from blood in the
      adult rat has been investigated using graphical analysis to determine the blood
      brain barrier permeability to these tracers in experiments that lasted between 5
      min and 8 days. The blood-brain barrier permeability (K(in)) to 59Fe was 89 x 10(
      5) ml/min/g compared to the value of 7 x 10(-5) ml/min/g for 125I-transferrin,
      which is similar to that of albumin, a plasma marker. The autoradiographic
      distribution of these tracers in brain was also studied to determine any regional
      variation in brain uptake after the tracers had been administered either
      systemically or applied in vitro. No regional uptake was seen for 125I
      transferrin even after 24 h of circulation. In contrast, 59Fe showed selective
      regional uptake by the choroid plexus and extra-blood-brain barrier structures 4
      h after administration. After 24 h of circulation, 59Fe distribution in brain was
      similar to the transferrin receptor distribution, as determined in vitro, but was
      unlike the distribution of nonhaem iron determined histochemically. The data
      suggest that brain iron uptake does not involve any significant transcytotic
      pathway of transferrin-bound iron into brain. It is proposed that the uptake of
      iron into brain involves the entry of iron-loaded transferrin to the cerebral
      capillaries, deposition of iron within the endothelial cells, followed by
      recycling of apotransferrin to the circulation. The deposited iron is then
      delivered to brain-derived transferrin for extracellular transport within the
      brain, and subsequently taken up via transferrin receptors on neurones and glia
      for usage or storage.

PMID- 1613506
TI  - A novel glial growth inhibitory factor, gliostatin, derived from neurofibroma.
AB  - Neurofibroma tissue was investigated for the presence of glial growth modulators
      that would suppress the proliferation of glial cells. A novel endogenous
      polypeptide inhibitor of proliferation and DNA synthesis in glial cells,
      gliostatin, was purified from the extracts of neurofibroma by a procedure
      comprising dye and anion-exchange column chromatography, and HPLC. A monoclonal
      antibody raised against partially purified gliostatin showed no cross-reactivity
      with known cytokines, but adsorbed the growth inhibitory activity of gliostatin
      and immunochemically visualized the putative gliostatin bands on western blot
      analyses. Although the product showed an apparent M(r) of 100,000 accompanied by
      an inhibitory activity on gel filtration column chromatography, it migrated at a
      lower apparent M(r) of 50,000 under the reducing conditions on western blotting,
      indicating that a homodimeric structure of native gliostatin consisted of 50-kDa
      subcomponents. Gliostatin was a potent growth inhibitor acting at nanomolar
      concentrations against all glial tumor cells and glia maturation factor
      stimulated astroblasts, but not neuronal cells.

PMID- 1613507
TI  - Changing fatty acid content of growth cone lipids prior to synaptogenesis.
AB  - The developing mouse was used to assess biochemical changes in membrane lipids
      during the period when nerve growth cones become synapses. Growth cone particles
      and synaptosomes were simultaneously obtained from common brain homogenates.
      Incorporation of the essential fatty acid, docosahexaenoic acid (22:6 omega-3),
      was correlated with the developmental changes in endogenous fatty acid content of
      growth cones and synaptosomes. Analysis of endogenous lipid content indicated
      that, at all ages studied, the growth cones contained more arachidonoyl acyl
      chains (20:4 omega-6) than did synaptosomes. Before the onset of synaptogenesis,
      levels of arachidonoyl chains increased and levels of 22:6, oleoyl and linoleoyl
      chains decreased in synaptosomes. Although stearoyl and palmitoyl (16:0) remained
      stable in synaptosomes, 16:0 decreased in growth cones. With the exception of
      16:0 and 20:4, endogenous fatty acyl content of growth cones and synaptosomes
      became similar by postnatal day 10, which coincides with the onset of
      synaptogenesis. When 5-day-old mouse pups were injected intraperitoneally with
      [3H]22:6, the incorporation into growth cone and synaptosome phospholipids was
      greatest in phosphatidylethanolamine, followed by phosphatidylserine and
      phosphatidylcholine. Nominal labeling was present in phosphatidic acid and
      phosphatidylinositol. Labeling in neutral lipids was less than that of
      phospholipids, with triacylglycerol incorporating most of the neutral lipid
      label, followed by diacylglycerol and free 22:6. Only the growth cone fraction
      contained detectable amounts of 22:6-labeled cholesterol esters. The distribution
      of 22:6 label in plasma 72 h after injection indicated that approximately 60% of
      the label was in phospholipids with approximately 40% in neutral lipids and less
      than 5% in free fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613508
TI  - Metabolism of lactate in the rat brain during the early neonatal period.
AB  - The metabolism of lactate in isolated cells from early neonatal rat brain has
      been studied. In these circumstances, lactate was mainly oxidized to CO2,
      although a significant portion was incorporated into lipids (78% sterols, 4%
      phosphatidylcholine, 2% phosphatidylethanolamine, and 1% phosphatidylserine). The
      rate of lactate incorporation into CO2 and lipids was higher than those found for
      glucose and 3-hydroxybutyrate. Lactate strongly inhibited glucose oxidation
      through the pyruvate dehydrogenase-catalyzed reaction and the tricarboxylic acid
      cycle while scarcely affecting glucose utilization by the pentose phosphate
      pathway. Lipogenesis from glucose was strongly inhibited by lactate without
      relevant changes in the rate of glycerol phosphate synthesis. These results
      suggest that lactate inhibits glucose utilization at the level of the pyruvate
      dehydrogenase-catalyzed reaction, which may be a mechanism to spare glucose for
      glycerol and NADPH synthesis. The effect of 3-hydroxybutyrate inhibiting lactate
      utilization only at high concentrations of 3-hydroxybutyrate suggests that before
      ketogenesis becomes active, lactate may be the major fuel for the neonatal brain.
      (-)-Hydroxycitrate and aminooxyacetate markedly inhibited lipogenesis from
      lactate, suggesting that the transfer of lactate carbons through the
      mitochondrial membrane is accomplished by the translocation of both citrate and N
      acetylaspartate.

PMID- 1613509
TI  - Extracellular concentrations of dopamine and metabolites in the rat caudate after
      oral administration of a novel catechol-O-methyltransferase inhibitor Ro 40-7592.
AB  - The effect of the systemic administration of a novel, orally active, catechol-O
      methyltransferase (COMT) inhibitor, Ro 40-7592, on the in vivo extracellular
      concentrations of dopamine (DA) and its metabolites, dihydroxyphenylacetic acid
      (DOPAC) and homovanillic acid (HVA), was studied by transcerebral microdialysis
      in the dorsal caudate of freely moving rats. Ro 40-7592 (at doses of 3.0, 7.5,
      and 30 mg/kg p.o.) elicited a marked and long-lasting reduction of HVA, and at
      doses of 7.5 and 30 mg/kg, an increase of DOPAC output, but it failed to increase
      DA output. The administration of L-beta-3,4-dihydroxyphenylalanine (L-DOPA, 20
      and 50 mg/kg p.o.) with a DOPA decarboxylase inhibitor (benserazide) increased
      both HVA and DOPAC output, but failed to modify significantly extracellular DA
      concentrations in dialysates; in contrast, combined administration of L
      DOPA+benserazide with Ro 40-7592 (30 mg/kg p.o.) resulted in a significant
      increase in DA output. Ro 40-7592 prevented the L-DOPA-induced increase in HVA
      output and markedly potentiated the increase in DOPAC output. To investigate to
      what extent the increase in extracellular DA concentrations was related to an
      exocitotic release, tetrodotoxin (TTX) sensitivity was tested. Addition of TTX to
      Ringer, although abolishing DA output in the absence of L-DOPA, partially reduced
      it in the presence of L-DOPA+Ro 40-7592 and even more so after L-DOPA without the
      COMT inhibitor. The results of the present study suggest that metabolism through
      COMT regulates extracellular concentrations of DA formed from exogenously
      administered L-DOPA but not of endogenous DA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613510
TI  - Enhancement by cytidine of membrane phospholipid synthesis.
AB  - Cytidine, as cytidine 5'-diphosphate choline, is a major precursor in the
      synthesis of phosphatidylcholine in cell membranes. In the present study, we
      examined the relationships between extracellular levels of cytidine, the
      conversion of [14C]choline to [14C]phosphatidylcholine, and the net syntheses of
      phosphatidylcholine and phosphatidylethanolamine by PC12 cells. The rate at which
      cytidine (as [3H]cytidine) was incorporated into the PC12 cells followed normal
      Michaelis-Menten kinetics (Km = 5 microM; Vmax = 12 x 10(-3) mmol/mg of
      protein/min) when the cytidine concentrations in the medium were below 50 microM;
      at higher concentrations, intracellular [3H]cytidine nucleotide levels increased
      linearly. Once inside the cell, cytidine was converted mainly into cytidine
      triphosphate. In pulse-chase experiments, addition of cytidine to the medium
      caused a time- and dose-dependent increase (by up to 30%) in the incorporation of
      [14C]choline into membrane [14C]-phosphatidylcholine. When the PC12 cells were
      supplemented with both cytidine and choline for 14 h, small but significant
      elevations (p less than 0.05) were observed in their absolute contents of
      membrane phosphatidylcholine, phosphatidylethanolamine, and phosphatidylserine,
      all increasing by 10-15% relative to their levels in cells incubated with choline
      alone. Exogenous cytidine, acting via cytidine triphosphate, can thus affect the
      synthesis and levels of cell membrane phospholipids.

PMID- 1613511
TI  - Cell swelling, blebbing, and death are dependent on ATP depletion and independent
      of calcium during chemical hypoxia in a glial cell line (ROC-1).
AB  - The morphological and biochemical changes that occur during chemical hypoxic
      injury in a neural cell line were studied in the presence and absence of calcium.
      Oligodendroglial-glioma hybrid cells (ROC-1) were subjected to inhibitors of
      glycolytic and oxidative ATP synthesis (chemical hypoxia). Complete respiratory
      inhibition depleted [ATP] to less than 5% of control by 4 min. Blebs appeared on
      the cell surfaces and cells began to swell within a few minutes of ATP depletion.
      A 200% increase in cell volume and bleb coalescence preceded irreversible cell
      injury (lactate dehydrogenase release) which began at approximately 20 min with
      50% cell death by 40 min. In energized cells an equivalent degree of osmotic
      swelling induced by ouabain inhibition of the Na+, K(+)-ATPase pump did not
      produce blebbing or cell death. Partial inhibition of respiration decreased [ATP]
      to approximately 10% of control by 40 min. Blebbing and swelling began at 40 min
      and bleb coalescence preceded plasma membrane disruption which began at
      approximately 55 min. ATP depletion, blebbing, swelling, and death followed
      similar time courses in the presence or absence of extracellular calcium
      ([Ca2+]e). Intracellular calcium ([Ca2+]i) was measured using fura-2. In calcium
      containing medium metabolic inhibition caused a transient increase in resting
      [Ca2+]i (100 +/- 17 nM) followed by a low steady-state level preceding plasma
      membrane disruption. Following deenergization in calcium-free medium, [Ca2+]i
      remained below 60 nM throughout injury and death. These data suggest that
      decreased ATP initiates a sequence of events including bleb formation and cell
      swelling that lead to irreversible cell injury in the absence of large increases
      in [Ca2+]i.

PMID- 1613512
TI  - Avian brain epinephrine and 5-hydroxytryptamine: is it still a matter of
      controversy?

PMID- 1613513
TI  - Specific expression of N-acetylaspartate in neurons, oligodendrocyte-type-2
      astrocyte progenitors, and immature oligodendrocytes in vitro.
AB  - To test the specificity of N-acetylaspartate (NAA) as a neuronal marker for
      proton nuclear magnetic resonance (1H NMR) spectroscopy, purified and
      characterized cultured cells were analyzed for their NAA content using both 1H
      NMR and HPLC. Cell types studied included cerebellar granule neurons, type-1
      astrocytes, meningeal cells, oligodendrocyte-type-2 astrocyte (O-2A) progenitor
      cells, and oligodendrocytes. A high concentration of NAA was found in extracts of
      cerebellar granule neurons (approximately 12 nmol/mg of protein), whereas NAA
      remained undetectable in purified type-1 astrocytes, meningeal cells, and mature
      oligodendrocytes. However, twice the neuronal level of NAA was found in O-2A
      progenitors grown in vitro. In addition significant levels of NAA were also
      detected in cultures of immature oligodendrocytes. Our data partly support
      previous suggestions that NAA may be a useful neuronal marker for 1H NMR
      spectroscopic examination of the adult brain. However, they also raise the
      further possibility that alterations of NAA associated with some specific brain
      disorders, particularly disorders seen in newborn and young children, may reflect
      abnormalities in the development of oligodendroglia or their precursors.

PMID- 1613514
TI  - Reduced neuropeptide Y concentrations in suicide brain.
AB  - Neuropeptide Y (NPY) was measured in postmortem brain tissue from victims of
      suicide and from individuals dying a sudden natural or accidental death
      (controls). Concentrations of NPY-immunoreactivity were measured by
      radioimmunoassay in frontal cortex (BA 10), temporal cortex (BA 22), caudate
      nucleus, and cerebellum. Concentrations of NPY-immunoreactivity were
      significantly lower in postmortem frontal cortex (-14%) and caudate nucleus (
      27%) from suicide victims compared with age-matched controls. A subgroup of
      suicides with evidence of a history of depression revealed more robust reductions
      in concentrations of NPY-immunoreactivity in frontal cortex and caudate nucleus,
      as did four individuals who died from natural causes and also were described as
      having a possible history of depression. Concentrations of NPY-immunoreactivity
      in temporal cortex and cerebellum from victims of suicide or from the subgroup of
      subjects with a possible history of depression were not significantly different
      from those of age-matched controls. We suggest there is a deficit in the brain
      NPY system leading to region-specific reductions in peptide concentrations in
      subjects who have a history of depression.

PMID- 1613515
TI  - Brain-derived neurotrophic factor protects dopamine neurons against 6
      hydroxydopamine and N-methyl-4-phenylpyridinium ion toxicity: involvement of the
      glutathione system.
AB  - Brain-derived neurotrophic factor (BDNF) has recently been shown to enhance the
      survival of dopamine neurons in cultures derived from the embryonic rat
      mesencephalon. We now extend this study by demonstrating that, in addition to the
      effect of sustaining survival of dopaminergic neurons, BDNF also confers
      protection against the neurotoxic effects of 6-hydroxydopamine (6-OHDA) and N
      methyl-4-phenylpyridinium ion (MPP+). Exposure of mesencephalic cultures to
      either 6-OHDA or MPP+ resulted in a loss of 70-80% of dopaminergic neurons, as
      determined by tyrosine hydroxylase (TH) immunocytochemistry. In BDNF-treated
      cultures, loss of TH-positive cells after exposure to either toxin was reduced to
      only 30%. To facilitate biochemical measurements, we studied SH-SY5Y dopaminergic
      neuroblastoma cells. BDNF was found to protect these cells from the dopaminergic
      neurotoxins, 6-OHDA and MPP+. Indicative of oxidative stress, treatment of SH
      SY5Y cells with 10 microM 6-OHDA for 24 h caused a fivefold increase in the
      levels of oxidized glutathione (GSSG). Pretreatment with BDNF for 24 h completely
      prevented the rise in GSSG. Further examination revealed that BDNF increased the
      activity of the protective enzyme, glutathione reductase, by 100%. In contrast,
      BDNF had no effect on the activity of catalase. These results add further impetus
      to exploring the therapeutic potential of BDNF in animal models of Parkinson's
      disease.

PMID- 1613516
TI  - Bone graft and total hip arthroplasty. A review.
AB  - The success of total hip arthroplasty has been well documented. Aseptic loosening
      remains the major long-term problem that can lead to significant bone loss and
      structural deficits. Bone graft has been used with increasing frequency to
      reconstruct these difficult cases. In this review, the authors detail the
      biology, biomechanics, and banking of bone grafts. A summary of currently
      available data on the clinical result of autograft and allograft in
      reconstructive hip surgery is presented.

PMID- 1613517
TI  - Measurement accuracy in acetabular cup migration. A comparison of four radiologic
      methods versus roentgen stereophotogrammetric analysis.
AB  - Four different methods of radiologic evaluation of the acetabular component
      migration following total hip arthroplasty have been compared with roentgen
      stereophotogrammetry, a proven highly accurate method for studying early
      migration. In the Sutherland and Wetherell method the implant's position is
      measured with a pencil and a ruler from an ordinary pelvis radiograph. New
      reference lines of the Wetherell method are thought to be more accurate. The
      Sulzer and EBRA methods are computerized. In the Sulzer method prominent bone
      markers are digitized and used as reference points. In the EBRA method a system
      of tangents on prominent pelvis structure is digitized and used to detect
      radiographs with similar projection. The implant's position is calculated as the
      mean position of similar radiographs. The Sutherland, Wetherell, and Sulzer
      methods had almost the same accuracy, whereas the EBRA method was more accurate
      and could be used for pro- and retrospective studies in a large number of
      patients.

PMID- 1613518
TI  - Treatment of fractures about hip prostheses with compression plating.
AB  - Between 1984 and 1986, 10 patients who sustained a femur fracture about a hip
      prosthesis were treated with open reduction and internal fixation using
      compression plating. Nine of the 10 fractures healed in an average time of 5
      months. Other than one nonunion, no significant complications were noted. Follow
      up study, ranging from 13 to 44 months (average, 26 months), was obtained on all
      10 patients. One had a loose femoral component, which was attributed to
      inadequate stem size. None of the other patients had either clinical or
      radiographic evidence of loosening. Based on Harris hip scores, there was no
      indication that plating significantly interfered with hip function. The authors
      believe that these results demonstrate that plating can be an effective method of
      treating femoral fractures about hip prostheses.

PMID- 1613519
TI  - Cementless total knee arthroplasty in unselected cases of osteoarthritis and
      rheumatoid arthritis. A 3-year follow-up study of 103 cases.
AB  - The authors reviewed 103 cementless AGC 2000 total knee arthroplasties in
      unselected cases of osteoarthritis and rheumatoid arthritis with a follow-up
      period of 3 years. Excellent or good clinical results were obtained in 96%. The
      median maximal flexion was 110 degrees. Two aseptic loosenings of the tibial
      components had been revised prior to this evaluation. Two other patients showed
      radiographic signs of tibial loosening but were asymptomatic. Undersizing of the
      tibial component predisposes to subsidence and loosening. One had septic tibial
      loosening planned for revision. Four had nonprogressive lucent lines beneath the
      tibial tray but were asymptomatic. No patellar or femoral component loosening was
      revealed. Undercorrection of preoperative varus deformity did not dispose to
      tibial loosening or radiolucency, nor influence the clinical result. In terms of
      survival of the prosthesis the cumulative success rate was 97.1%. When pain and
      radiographic loosening was also considered, the success rate was 90.7%. These
      results encourage uncemented use of this prosthesis, but emphasize the importance
      of good primary prosthetic fit at the tibial side.

PMID- 1613520
TI  - Knee arthroplasty rating.
AB  - A number of rating systems used to evaluate the results of total knee
      arthroplasty exist. Many of these systems are based on different concepts, and
      might be expected to give divergent results. To see if this was so, the authors
      examined a consecutive series of 235 posterior stabilized knee arthroplasties
      recording the results according to five rating systems: HSS (The Hospital for
      Special Surgery), Brigham, Freeman, BOA (British Orthopaedic Association), and
      the VENN diagram. In spite of their apparent differences, all point systems and
      the BOA gave almost identical results, while the VENN diagram proved to be the
      most stringent. The authors suggest that any of the current point systems may be
      used to "score" arthroplasties, but the results should also be rated with the
      VENN diagram in order to see the quality of the arthroplasty and a comparison
      between the different series.

PMID- 1613521
TI  - Dislocation in low-friction arthroplasty.
AB  - In a series of 2,050 low-friction arthroplasties, 61 cases (2.97%) of dislocation
      were analyzed. The mechanism of production was malposition of the components
      (group 1, 33%), deficiency of the abductor mechanism (group 2, 34%), or the
      association of both (group 3, 26%). Failure to find a cause was even more rare
      (group 4, 7%). The best treatment is prevention by careful surgical technique,
      since good results with different procedures have only been attained in 51% of
      dislocated hips.

PMID- 1613522
TI  - Pasteurella multocida infection in total knee arthroplasty. Case report and
      literature review.
AB  - Pasteurella multocida, a small gram-negative bacterium, is part of the normal
      mouth flora of many animals, including domestic cats and dogs. While commonly
      associated with infections in animals, it is a rare cause of human disease. The
      majority of Pasteurella infections in humans occur with percutaneous inoculation
      of the organism following a bite by a cat or dog, although disease without
      antecedent animal exposure or with causal animal contact does occur. The spectrum
      of disease produced ranges from localized, including abscess, cellulitis,
      lymphadenopathy, and osteomyelitis, to systemic, with septicemia, septic
      arthritis, respiratory, and central nervous system involvement. Altered host
      defenses and underlying chronic disease, such as rheumatoid arthritis,
      corticosteroid therapy, and severe hepatic or renal disease, may predispose to
      more serious systemic manifestations of infection. The authors report a case of
      P. multocida infection in a total knee arthroplasty as a result of a dog scratch
      and review the literature reporting P. multocida infections in total knee
      arthroplasty.

PMID- 1613523
TI  - Subluxation of the posterior stabilized total knee arthroplasty. A report of two
      cases.
AB  - There has been only one previous report of dislocation of a posteriorly
      stabilized total knee arthroplasty. The authors present two further cases of
      subluxation of this prosthesis and report a method of accomplishing reduction
      that could not otherwise be achieved by conventional techniques. The current
      design of this prosthesis enabled revision of the polyethylene tibial component
      to be undertaken without removal of the cemented metal-backing tray, an advantage
      not previously appreciated.

PMID- 1613524
TI  - The effect of polymerization of methylmethacrylate on metal-backed and non-metal
      backed acetabular components.
AB  - Aseptic loosening of the acetabular component has been identified as the main
      cause of failure of cemented total hip arthroplasty in the long term. Wear of the
      high-density polyethylene has been implicated as a major contributory factor to
      loosening. The etiology of wear is multifactorial. The exothermic phase of
      polymerization of polymethylmethacrylate is associated with a 5.9% volume
      expansion. Using double-exposure holographic interferometry, the authors examined
      the influence of polymerization of cement on the internal geometry of a metal
      backed cup and two non-metal-backed cups (Charnley 22 mm, Muller 32 mm). The non
      metal-backed cups exhibited marked heat concentration points and disrupted fringe
      patterns, indicating distortion of the internal geometry of the cup. In
      contradistinction, the metal-backed cup showed good heat dissipation and regular
      fringe patterns, indicating minimal internal distortion. The differences were not
      quantified but were visually dramatic. The authors believe this may be an
      important contributory factor to cup wear in cemented total hip arthroplasty.

PMID- 1613525
TI  - The effect of extracorporeal shock wave lithotripsy on the prosthesis interface
      in cementless arthroplasty. Evaluation in a rabbit model.
AB  - The effect of extracorporeal shock wave lithotripsy on interfacial strength
      between prosthesis and bone in cementless arthroplasty was examined using a
      rabbit model. Paired femora, each implanted with fiber mesh porous coated
      titanium implants, were harvested from rabbits 15 weeks after implantation. In
      group I, one femur from each pair was exposed to lithotripsy treatment consisting
      of 2,000 shocks at 20 kV. In group II, one femur from each pair was exposed to
      2,000 shocks at 26 kV. Contralateral femora from each pair served as controls in
      both groups. Mechanical pushout tests were conducted on the implants using a 1321
      Instron testing machine at a constant rate of 1 mm/minute. Shock waves generated
      at 20 kV were found to have no significant decrease on either the prosthesis/bone
      interfacial strength or energy to failure of cementless implants. Shock waves
      generated at 26 kV produced a mean 17.45% decrease in the prosthesis/bone
      interfacial strength, which approached statistical significance (P = .062), and a
      7.84% mean decrease in the energy to failure (P = .268). However, in four of the
      seven group II specimens, cortical fractures occurred. These findings suggest
      that lithotripsy will not aid in the removal of uncemented porous coated devices
      and lithotripsy inadvertently focused at an uncemented device will not disrupt
      significantly the prosthesis-bone interface.

PMID- 1613526
TI  - A pseudometallosis cyst associated with a Moore prosthesis. A case report.
AB  - A Moore prosthesis that had been in place for 28 years was revised. Apparent
      metallosis resulted from contact between the collar and the calcar. A supra
      acetabular cyst was found packed with black stained debris. Metallurgical
      examination failed to reveal any metallic debris in the cyst material. This case
      indicates that all black staining in and of itself is not necessarily indicative
      of metallosis.

PMID- 1613527
TI  - Life expectancy after total hip arthroplasty.
AB  - The 6-year survival rate was investigated in 646 patients undergoing total hip
      arthroplasty for osteoarthritis, rheumatoid arthritis, or complications following
      femoral neck fracture between 1978 and 1982. A comparison of mortality was done
      between patients treated by osteosynthesis for fresh femoral neck fracture and a
      matched general population. The mortality was lower than that of the matched
      general population after total hip arthroplasty and even lower for patients
      treated for fresh femoral neck fracture. Patients undergoing total hip
      arthroplasty for osteoarthritis had the highest survival rate, followed by
      patients with rheumatoid arthritis and complications after femoral neck
      fractures.

PMID- 1613528
TI  - Diagnosis of deep venous thrombosis by compression ultrasound in knee
      arthroplasty patients.
AB  - A prospective study of 62 knee arthroplasty limbs from 60 patients was undertaken
      to evaluate the effectiveness of compression ultrasound when compared to
      venography in detecting deep venous thrombosis (DVT). The study was conducted in
      a double-blind nature. Compression ultrasound and venographic examinations were
      conducted on the same day within 5-8 days postoperatively. Compression ultrasound
      had a sensitivity of 85.7%, a specificity of 94.5%, and an accuracy of 93.5% when
      venography was considered as the gold standard or 100% correct. Positive and
      negative predictive values were 66.6% and 98.1%, respectively. Eight patients
      were diagnosed with acute DVT. Five patients presented with calf DVT, one patient
      had calf DVT extending into the popliteal space, and two patients developed thigh
      DVT. The authors conclude that compression ultrasound is an efficacious method to
      evaluate knee arthroplasty patients for deep vein thrombosis.

PMID- 1613529
TI  - Retained distal femoral osteophyte. An infrequent cause of postoperative pain
      following total knee arthroplasty.
AB  - Persistent postoperative pain following total knee arthroplasty is infrequent.
      This case report describes an unusual cause of pain, crepitus, and effusion
      following total knee arthroplasty due to a retained distal femoral osteophyte.
      Osteophyte removal resulted in total alleviation of this patient's discomfort and
      swelling.

PMID- 1613530
TI  - Subsidence of porous coated noncemented femoral components in total hip
      arthroplasty. A roentgen stereophotogrammetric analysis.
AB  - Roentgen stereophotogrammetric analysis was used in the evaluation of subsidence
      in nine noncemented femoral components of the Biomet Taperloc prosthesis. After 2
      years three components had subsided 0.7-0.9 mm. No distinct symptoms related to
      the micromotion appeared. The subsidence in this investigation was smaller than
      the reported subsidence of other noncemented prostheses.

PMID- 1613531
TI  - Disassembly of the osteonics bipolar ring when used with a Howmedica femoral
      head. A report of four cases.
AB  - In 1980 Osteonics marketed their universal head replacement (UHR) as a universal
      head to fit 32 mm heads. The authors present four cases of ring disassociation in
      the Osteonics UHR when combined with Howmedica femoral heads.

PMID- 1613532
TI  - Postoperative blood retrieval and transfusion in cementless total knee
      arthroplasty.
AB  - Postoperative wound drainage was aspirated, collected, and transfused in 197
      patients undergoing unilateral or bilateral cementless knee arthroplasty using
      the Solcotrans or the Constavac Blood Conservation blood-retrieval devices.
      Operative technique, method of hemostasis, and postoperative management were
      identical in all patients. Drainage-tube suction pressure was minimized, and the
      duration of drainage collection was less than 8 hours in all patients. In the 153
      patients who underwent unilateral total knee arthroplasty (TKA), the amount of
      blood retrieved and transfused averaged 829 cm3 (59% of total blood lost). For
      the 44 patients who underwent bilateral procedures, 1,131 cm3 of blood was
      salvaged (56% of total blood lost). Transfused banked blood averaged 1.7 units
      (25% homologous) in unilateral cases, while bilateral procedures required 3.0
      units (35% homologous). Complications (4%) included wound hematomata in five
      patients and deep venous thrombosis in two. Transient chills, fever, or
      tachycardia were seen in four patients at the time of transfusion. Transfusion
      requirements of banked blood appeared to be significantly reduced, especially in
      simultaneous bilateral knee arthroplasty, when compared to previous experience in
      patients who did not undergo postoperative blood retrieval.

PMID- 1613533
TI  - Angled bearing inserts in total knee arthroplasty. A brief technical note.
AB  - Malalignment of total knee prosthetic components may lead to premature wear,
      loosening of components, or patellar instability. Unfortunately, removal of
      securely cemented or ingrown components is difficult and may be extremely
      destructive to the available bone stock. Angled bearing inserts provide a means
      to compensate for malpositioned components and should be considered an
      alternative to component removal in certain cases.

PMID- 1613534
TI  - Removal of well-fixed cementless metal-backed patellar components.
AB  - Removal of well-fixed, cementless metal-backed patellar components can be
      difficult due to lack of easy surgical access to the anchoring pegs. Five cases
      of total knee arthroplasty with failed metal-backed cementless patellar
      components with ingrown anchoring pegs are presented. A technique of removal of
      these components is described that preserves remaining patellar bone and provides
      easy access to the well-ingrown anchoring pegs, lessening the risk of fracture
      during patellar component extraction.

PMID- 1613535
TI  - The MTT assay for chemosensitivity testing of human tumors of the central nervous
      system. Part I: Evaluation of test-specific variables.
AB  - The aim of this study was to optimize the experimental conditions of the MTT
      assay for primary cultures of human brain tumors. This assay is based on the
      mitochondrial reduction of MTT-(3-(4,5-dimethylthiazol-2-yl)-2,5
      diphenyltetrazolium bromide) salt to formazan crystals by living cells. Formazan
      can be quantified spectrophotometrically. This assay measures the antimetabolic
      and, by using an adequate recovery period for the cells, also the
      antiproliferative effects of cytotoxic drugs. Our results suggest the following
      experimental design for its application as an chemosensitivity assay for human
      brain tumors: 1-h drug exposure followed by a seven days recovery period without
      drugs. Then tumor cells are incubated 4 hours with 1 mg MTT/ml and final
      absorbance readings are performed at 550 nm and 630 nm as test and reference
      wavelengths respectively. In this way, the assay seems to be a reliable and
      simple method for rapid chemosensitivity testing in human brain tumors.

PMID- 1613536
TI  - The MTT assay for chemosensitivity testing of human tumors of the central nervous
      system. Part II: Evaluation of patient- and drug-specific variables.
AB  - In this study we assessed the influence of patient- and drug-specific parameters
      in the short-term MTT-chemosensitivity assay in 150 primary cell cultures derived
      from human brain tumors. In 45 patients the MTT assay was directly compared with
      the CFA (Colony Forming Assay). Resistance was 10-20% higher in the MTT assay
      than in the CFA, but there was a good agreement in both assays, that more
      malignant gliomas had a higher in vitro chemosensitivity against ACNU and BCNU.
      Overall the results demonstrate, that there is no uniform correlation between the
      in vitro chemosensitivity and the histopathological classification of the tumors,
      which corresponds well to the clinical situation. On the basis of this study we
      suggest prospective clinical trials with the MTT assay in human brain tumors.

PMID- 1613537
TI  - Systemic treatment with murine recombinant interleukin-1 beta inhibits the growth
      and progression of malignant glioma in the rat.
AB  - We investigated the effects of daily subcutaneous (SC) injections of 100, 200, or
      400 micrograms/kg murine recombinant interleukin-1 beta (rIL-1 beta) or its
      excipient on normal Fischer 344 rats and ones harboring a malignant RT-2 glioma.
      The tumor model has a predictable course with animals dying on days 14-17
      following an intracerebral inoculation of 10(4) RT-2 glioma cells. Treatments
      with rIL-1 beta or excipient began on day seven post-tumor inoculation and
      continued for 7 days. We observed no significant effect on core body temperatures
      although there was a significant (p less than 0.05) decrease in body weight in
      all rIL-1 beta treated animals. When tumor-bearing animals became moribund, they
      received an intraperitoneal injection of bromodeoxyuridine (BUdr) and were
      sacrificed two hours later. Blood samples were obtained prior to their sacrifice
      by transcardiac perfusion with a buffered aldehyde solution. Recombinant IL-1
      beta affected blood differentials; causing neutrophilia, lymphopenia, and slight
      thrombocythemia. The BUdr labeling index of glioma cells did not significantly
      differ between treatment groups, although tumors differed histologically at the
      time of necropsy. Tumors of rIL-1 beta treated animals had more extensive
      necrosis and a greater degree of leukocyte infiltration. Survival studies were
      conducted in which rats were given continuous daily SC injections of rIL-1 beta
      until day of death. Overall survival between the two groups differed
      significantly in studies using 100 micrograms/kg/d (p less than 0.05); rIL-1 beta
      treated rats had a mean survival time of 22 (+/- 3.0) days while excipient
      controls had a mean survival time of 17 (+/- 0.5) days. Similarly, at a dose of
      200 micrograms rIL-1 beta/kg/d, mean survival was significantly (p less than
      0.05) increased as compared to excipient controls (18.75 +/- 1.5 vs. 15.25 +/-
      1.7 days, respectively). Daily injections of 400 micrograms/kg did not
      significantly increase the survival of glioma bearing animals, possibly as a
      consequence of rIL-1 beta toxicity at this dose.

PMID- 1613538
TI  - Primary intraosseous meningioma: case report.
AB  - A case of 72-year-old Japanese woman with a rare intraosseous meningioma is
      presented. The tumor was located in the right frontoparietal region, involving
      the coronal suture. The tumor was excised totally and the pathological diagnosis
      was meningioma. Similar cases reported in the past literature are reviewed and
      the possible histogenetic mechanism of the tumor is discussed.

PMID- 1613539
TI  - Meningitis with Burkitt like B-cell lymphoma in HIV infection.
AB  - Malignant lymphoma with meningeal involvement was detected in 7 patients with
      stage IV HIV infection. The diagnosis of lymphoma was made at a maximum of four
      months before discovery of meningeal involvement. In our seven cases the lymphoma
      was B-cell type, one case expressed Kappa chains, four cases demonstrated Lambda
      chains and in two cases differentiation was not possible. A review of findings in
      all HIV positive patients treated in the same period revealed 10 non-Hodgkin
      lymphomas of the B-cell type, though meningeal and cerebral involvement was
      observed only in B-cell lymphoma of the Burkitt type.

PMID- 1613540
TI  - Diagnosis and treatment of patients with meningeal carcinomatosis.
AB  - The records of thirty-four patients with meningeal carcinomatosis treated at our
      hospital between 1984 and 1990 were reviewed. The sources, histologies,
      metastatic lesions outside the central nervous system, the history of the
      treatment of primary lesions and intraparenchymal of metastatic brain tumors and
      the period from the diagnosis of primary lesions and the treatment of
      intraparenchymal metastatic brain tumors to the diagnosis of meningeal
      carcinomatosis were investigated. Meningeal carcinomatosis was diagnosed and by
      neurological signs, CSF cytology, CT scan and MRI. Each patient was given a 5 mg
      single dose of methotrexate (MTX) alone or combined with 20 mg cytosine
      arabinoside (Ara-C) administered by intrathecal injection via an Ommaya reservoir
      and standard lumbar puncture with or without radiotherapy. Following intrathecal
      chemotherapy 22 of 29 patients showed symptomatic improvement of meningeal
      irritation and in 10 of 29 patients with cranial nerve impairment amelioration of
      symptoms was also observed. Moreover, CSF cytology became negative in 10 of 29
      patients after a full course of intrathecal chemotherapy. Neurotoxicity
      Leukoencephalopathy, a neurotoxic effect of intrathecal chemotherapy was not
      observed in any of the patients. From these results, MTX in small doses is
      recommended for intrathecal chemotherapy of meningeal carcinomatosis to prevent
      neurotoxicity.

PMID- 1613542
TI  - Disparity sensitivity of neurons in monkey extrastriate area MST.
AB  - We tested the disparity sensitivity of neurons from the medial superior temporal
      area (MST) in awake behaving monkeys. While the monkey looked at a fixation spot
      on a screen in front of it, random dot stimuli moved in the preferred direction
      of the cell under study, and the disparity of the dots made the stimuli appear to
      move in a frontoparallel plane in front of, on, or behind the screen. Over 90% of
      the 272 neurons studied were sensitive to the disparity of the visual stimulus.
      Of those disparity-sensitive cells, 95% were most responsive either to near
      stimuli (stimuli with crossed disparities appearing to move in front of the
      screen) or to far stimuli (stimuli with uncrossed disparities appearing to move
      behind the screen). In a smaller sample of the disparity-sensitive cells, we
      found cells whose preferred direction of stimulus motion reversed as the
      disparity of the stimulus reversed. For example, a cell that responded best to
      rightward motion for near stimuli responded best to leftward motion for far
      stimuli. We found that 40% of the disparity-sensitive cells had this disparity
      dependent direction selectivity. This disparity-dependent direction selectivity
      was maintained over the entire range of speeds tested (6-56 degrees/sec). We
      tested whether the disparity sensitivity of the neurons indicated the distance of
      the stimulus from the screen where the monkey was fixating (relative depth) or
      the distance of the stimulus from the monkey (absolute depth) by having the
      monkey fixate at different depths in front of or behind the screen. For most MST
      neurons, the changes in vergence did not alter the disparity response, indicating
      that the disparity sensitivity of these neurons conveyed information on depth
      relative to the plane of fixation. We conclude that the disparity characteristics
      of cells in the dorsomedial MST are those expected of a system serving primarily
      coarse rather than fine stereopsis. The correlation between disparity selectivity
      and direction selectivity in these neurons, as well as their other properties,
      suggests a role in signaling the direction of self-motion of the observer through
      the environment.

PMID- 1613541
TI  - Cerebral infection complicating systemic aspergillosis in acute leukemia:
      clinical and radiographic presentation.
AB  - Cerebral fungal infection is becoming an increasingly recognized entity in
      immunocompromised patients on post-mortem examination. In order to determine the
      frequency of clinically significant cerebral fungal infection and define its
      clinical characteristics in a cohort of immunocompromised patients at high risk
      of fungal infection, the records of 118 patients with acute leukemia were
      examined for 57 clinical and laboratory features. The characteristics of 26
      patients with systemic aspergillosis and acute leukemia were compared to 92
      patients with acute leukemia in a control group. Eight of 118 patients (7%) had
      cerebral infection (seven Aspergillus, on Candida). Patients with systemic
      aspergillosis were more likely than patients in the control group to have focal
      neurologic findings (p = 0.02), confusion (p = 0.04), and abnormal computerized
      tomography (CT) of the brain characterized by single or multiple, enhancing or
      non-enhancing hypodense lesions (p = 0.02). Patients with systemic aspergillosis
      were more likely to die in complete remission than patients in the control group
      (p = 0.003); three of six patients with aspergillosis who died in remission
      expired as a consequence of cerebral infection. Cerebral infection complicated
      systemic Aspergillus infection in seven of 26 patients (27%), versus one of 16
      patients with systemic Candida infection (6%) (p = NS). The authors conclude,
      therefore, that systemic aspergillosis complicating acute leukemia is more likely
      to be associated with confusion, focal neurologic findings, and abnormal CT scan
      of the brain, and that these findings suggest the presence of cerebral infection.
      In addition, cerebral infection commonly complicates the course of systemic
      aspergillosis, and is a significant cause of morbidity and mortality in patients
      with acute leukemia. A high index of suspicion is needed to insure early
      diagnosis and appropriate therapy, particularly in those who achieve remission of
      their leukemia.

PMID- 1613543
TI  - Sensory tuning beyond the sensory system: an initial analysis of auditory
      response properties of neurons in the lateral amygdaloid nucleus and overlying
      areas of the striatum.
AB  - The lateral amygdaloid nucleus (AL) is anatomically connected with sensory
      processing structures in the thalamus and cortex and is believed to be critically
      involved in emotional processing by virtue of these connections. In order to
      understand further how auditory projections to AL contribute to emotional
      processing, acoustic response properties of single AL neurons were characterized
      in rats. Recordings were also made in the posterior striatum dorsal to AL. Many
      cells in AL and the striatum could be driven by broad-band auditory stimulation
      with white noise or clicks. Initial onset latencies were typically between 12 and
      25 msec. Most cells also had later responses (60-150 msec), and a few only had
      late responses. In frequency receptive field tests, different classes of cells
      were identified. One group had relatively clear frequency preferences. Thresholds
      for these relatively tuned cells tended to be somewhat higher in AL than in the
      striatum. Frequency preferences for AL cells were always above 10 kHz. Although
      most striatal cells had preferences for frequencies above 10 kHz, some cells were
      found with frequencies below 10 kHz as well. A second group of acoustically
      responsive neurons, much more common in AL than in the striatum, showed no
      frequency specificity (untuned cells). These responded to a wide range of
      frequencies, even at intensities near threshold. A third group, found mainly in
      AL (approximately 60% of the total population of cells examined in AL), exhibited
      rapid habituation to auditory stimuli. These tended to have high thresholds (80
      100 dB). Because these cells habituated so quickly, frequency specificity could
      not be determined. Responses in AL and the striatum were compared with responses
      in the "specific" auditory relay nucleus of the thalamus, the ventral division of
      the medial geniculate body, where cells had shorter onset latencies, narrower
      tuning functions, and lower-intensity thresholds than cells in AL and striatal
      areas. These findings show that cells in AL exhibit a wide range of auditory
      tuning properties and suggest that information processing in the amygdala might
      be fruitfully studied as a direct extension of processing in sensory afferent
      structures.

PMID- 1613544
TI  - A nonphotic stimulus causes instantaneous phase advances of the light-entrainable
      circadian oscillator of the Syrian hamster but does not induce the expression of
      c-fos in the suprachiasmatic nuclei.
AB  - The study investigated whether nonphotic cues that alter the phase of overt
      circadian rhythms do so by causing instantaneous shifts in the underlying, light
      sensitive clock. Wheel-running activity in Syrian hamsters was studied under free
      running conditions of constant dim red light as an overt marker of circadian
      phase, the daily onset of activity being defined as circadian time 12 (CT 12).
      Exposure to a 15 min pulse of bright light at CT 12.20 caused a phase delay in
      activity onset, whereas pulses delivered at CT 11.20 had no effect upon the overt
      rhythm. Correlated with their effect on behavior, light pulses delivered at CT
      12.20 induced expression of c-fos-like immunoreactivity in the retinorecipient
      regions of the suprachiasmatic nuclei of the hypothalamus (SCN), whereas pulses
      delivered at CT 11.20 had no effect upon the expression of c-fos. Expression of
      this immediate-early gene therefore provided a second marker of circadian phase,
      because its induction by light is closely correlated with the onset of subjective
      night (CT 12). To establish a suitable protocol for nonphotic shifts of the
      activity rhythm, animals were handled and received a subcutaneous injection of
      saline at different circadian phases. Injections at CT 8 or CT10 caused an
      immediate bout of wheel-running activity, and a consequent phase advance in the
      activity rhythm as assessed by the earlier onsets of activity in successive days.
      Handling and injections at other circadian phases were without effect. Despite
      shifting the overt rhythm, these procedures at CT 10 did not lead to the
      expression of c-fos in the SCN.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613545
TI  - In vitro neurogenesis by neuronal precursor cells derived from the adult songbird
      brain.
AB  - The vocal control nucleus of the adult songbird forebrain, HVc, exhibits de novo
      neurogenesis in adulthood, with the production of new neurons from precursor
      cells located in the overlying ventricular zone (Goldman and Nottebohm, 1983). We
      previously established that explants derived from neurogenic regions of the adult
      canary forebrain could be maintained in vitro, under conditions that permitted
      the migration and differentiation of those new neurons previously generated in
      vivo (Goldman, 1990). However, we found no evidence for continued neuronal
      mitogenesis in these cultures, which were raised in high concentrations of serum.
      In the present study, we investigated the permissive conditions for in vitro
      neurogenesis by these adult forebrain-derived ventricular zone explants. When HVc
      explants derived from adult zebra finches were maintained in low-serum medium, in
      vitro neurogenesis could be demonstrated by 3H-thymidine uptake as long as 5 days
      after explantation. Immunocytochemistry for microtubule-associated protein-2
      followed by autoradiography confirmed the neuronal identity of these 3H-thymidine
      incorporating cells. In vitro neuronal production occurred in an inverse relation
      to the serum concentration: Over the range of 2.5-25% fetal bovine serum,
      neuronal 3H-thymidine labeling was most frequent in those cultures exposed to the
      lowest serum levels. This facilitation of in vitro neuronal mitogenesis by serum
      depletion suggests that fetal serum may contain factors that inhibit the division
      of adult-derived neuronal precursor cells, either directly or by agents released
      by serum-stimulated glial or ependymal cells.

PMID- 1613546
TI  - Functional anatomy of human procedural learning determined with regional cerebral
      blood flow and PET.
AB  - The functional anatomy of motor skill acquisition was investigated in six normal
      human subjects who learned to perform a pursuit rotor task with their dominant
      right hand during serial positron emission tomography (PET) imaging of relative
      cerebral blood flow (relCBF). The effect of motor execution, rather than
      learning, was identified by a comparison of four motor performance scans with two
      control scans (eye movements only). Motor execution was associated with
      activation of a distributed network involving cortical, striatonigral, and
      cerebellar sites. Second, the effect of early motor learning was examined.
      Performance improved from 17% to 66% mean time on target across the four PET
      scans obtained during pursuit rotor performance. Across the same scans,
      significant longitudinal increases of relCBF were located in the left primary
      motor cortex, the left supplementary motor area, and the left pulvinar thalamus.
      The results demonstrate that changes of regional cerebral activity associated
      with early learning of skilled movements occur in sites that are a subset of a
      more widely distributed network that is active during motor execution.

PMID- 1613547
TI  - Estradiol mediates fluctuation in hippocampal synapse density during the estrous
      cycle in the adult rat.
AB  - We have found that the density of synapses in the stratum radiatum of the
      hippocampal CA1 region in the adult female rat is sensitive to estradiol
      manipulation and fluctuates naturally as the levels of ovarian steroids vary
      during the 5 d estrous cycle. In both cases, low levels of estradiol are
      correlated with lower synapse density, while high estradiol levels are correlated
      with a higher density of synapses. These synaptic changes occur very rapidly in
      that within approximately 24 hr between the proestrus and estrus stages of the
      estrous cycle, we observe a 32% decrease in the density of hippocampal synapses.
      Synapse density then appears to cycle back to proestrus values over a period of
      several days. To our knowledge, this is the first demonstration of such short
      term steroid-mediated synaptic plasticity occurring naturally in the adult
      mammalian brain.

PMID- 1613548
TI  - Gene regulation in an ascending nociceptive pathway: inflammation-induced
      increase in preprotachykinin mRNA in rat lamina I spinal projection neurons.
AB  - Tachykinin peptides are distributed widely in the nervous system and have been
      shown to play a prominent role in nociceptive pathways in the spinal cord and
      dorsal root ganglia. This study investigated the inflammation-induced response of
      dorsal horn projection neurons and local circuit neurons expressing
      preprotachykinin (PPT) mRNA using RNA blot analysis and in situ hybridization
      histochemistry. To identify projection neurons, fluorogold was injected into the
      parabrachial area of the brainstem. In laminae I, II and V/VI ipsilateral to
      inflammation, there was a differential increase in the number of neurons
      exhibiting PPT mRNA. In lamina I, the number of spinal projection neurons
      containing PPT mRNA showed a greater than 200% increase. The identification of
      spinal projection neurons with inflammation-induced increases in PPT mRNA
      suggests that tachykinin peptides may act as neurotransmitters in nociceptive CNS
      projection pathways.

PMID- 1613549
TI  - Enduring memory impairment in monkeys after ischemic damage to the hippocampus.
AB  - Patient RB became amnesic following an episode of global ischemia that resulted
      in a bilateral lesion of the CA1 field of the hippocampus. This finding suggested
      that damage restricted to the hippocampus is sufficient to produce clinically
      significant memory impairment. To evaluate further the effect of ischemic brain
      damage on memory, we have developed an animal model of cerebral ischemia in the
      monkey. Monkeys were subjected to 15 min of reversible ischemia, using a
      noninvasive technique involving carotid occlusion and pharmacologically induced
      hypotension. These monkeys sustained significant loss of pyramidal cells in the
      CA1 and CA2 fields of the hippocampus, as well as loss of somatostatin
      immunoreactive cells in the hilar region of the dentate gyrus. Cell loss occurred
      bilaterally throughout the rostrocaudal extent of the hippocampus but was greater
      in the caudal portion. Except for patchy loss of cerebellar Purkinje cells,
      significant damage was not detected in areas outside the hippocampus, including
      adjacent cortical regions, that is, entorhinal, perirhinal, and parahippocampal
      cortex, and other regions that have been implicated in memory function. On
      behavioral tests, the ischemic monkeys exhibited significant and enduring memory
      impairment. On the delayed nonmatching to sample task, the ischemic monkeys were
      as impaired as monkeys with lesions of the hippocampal formation and adjacent
      parahippocampal cortex (the H+ lesion). On two other memory tasks, the ischemic
      monkeys were less impaired than monkeys with the H+ lesion. In neuropathological
      evaluations, it has always been difficult to rule out the possibility that
      significant areas of neuronal dysfunction have gone undetected. The finding that
      ischemic lesions produced overall less memory impairment than H+ lesions
      indicates that the ischemic monkeys (and by extension, patient RB) are unlikely
      to have widespread neuronal dysfunction affecting memory that was undetected by
      histological examination. These results provide additional evidence that the
      hippocampus is a focal site of pathological change in cerebral ischemia, and that
      damage limited to the hippocampus is sufficient to impair memory.

PMID- 1613550
TI  - A cell-surface heparan sulfate proteoglycan mediates neural cell adhesion and
      spreading on a defined sequence from the C-terminal cell and heparin binding
      domain of fibronectin, FN-C/H II.
AB  - FN-C/H II is a heparin binding synthetic peptide from the C-terminal cell and
      heparin binding domain of fibronectin (FN) that mediates neuronal cell adhesion,
      spreading, and neurite outgrowth. Cellular interactions with FN-C/H II are
      inhibited by soluble heparin, suggesting that a cell-surface proteoglycan may
      mediate interactions with FN-C/H II (Haugen et al., 1990). To test this
      hypothesis further, heparan sulfate (HS) or chondroitin sulfate (CS) was removed
      from the cell surface by enzyme treatment. Heparitinase but not chondroitinase
      treatment of cells inhibited rat B104 neuroblastoma cell adhesion and spreading
      on FN-C/H II. Additionally, heparitinase treatment decreased the spreading of
      cells on the 33/66 kDa fragments containing the C-terminal heparin binding domain
      of FN. Furthermore, antibodies generated against a mouse melanoma HS proteoglycan
      (HSPG) inhibited B104 cell adhesion to FN-C/H II and the 33/66 kDa FN fragments.
      35S-HSPG isolated from B104 cells directly bound to FN-C/H II both in solid phase
      assays and by affinity chromatography, but failed to bind to a control peptide
      from this region, CS1. The binding of 35S-HSPG was predominantly mediated by the
      HS and not the core protein of the HSPG. SDS-PAGE of iodinated HSPG demonstrated
      a single 78 kDa core protein following heparitinase digestion, which migrated at
      51 kDa under nonreducing conditions. Anti-HSPG antibodies recognized the 78 kDa
      core protein by immunoblotting, and stained the surface of rat B104 neuroblastoma
      cells and cells of the primary neonatal rat nervous system. These results
      identify a cell-surface HSPG that likely mediates neuronal cell binding
      interactions with FN-C/H II.

PMID- 1613551
TI  - Dynamic regulation of NGFI-A (zif268, egr1) gene expression in the striatum.
AB  - The expression of immediate-early genes of the fos/jun leucine zipper family can
      be regulated in striatal neurons by stimuli affecting the dopaminergic
      nigrostriatal system. The regulatory effects are gene specific, region specific,
      and striatal compartment specific. In the experiments reported here, we have
      explored the possibility that dopaminergic stimulation might also affect striatal
      expression of NGFI-A, a member of the zinc finger family of immediate-early
      genes. We treated healthy adult rats with amphetamine or cocaine and monitored
      the acute response of striatal neurons by in situ hybridization with
      oligonucleotide probes for NGFI-A mRNA. Both drugs evoked rapid, anatomically
      patterned increases in NGFI-A mRNA expression in the dorsal striatum
      (caudoputamen) and in the ventral striatum (nucleus accumbens, olfactory
      tubercle). The main response to each drug was in medium-sized neurons, known to
      be the projection neurons of the striatum. At every dose of amphetamine eliciting
      a response, the increased NGFI-A mRNA expression was preferentially concentrated
      in striosomes of the rostral caudoputamen, whereas cocaine at each dose given
      induced expression of NGFI-A mRNA in both striosomes and matrix at these striatal
      levels. The two indirect agonists evoked NGFI-A expression in both striatal
      compartments farther caudally, especially in the central and medial caudoputamen.
      Activation by both drugs was blocked by pretreatment with the D1-selective
      dopamine receptor antagonist SCH23390. These patterns of NGFI-A activation are
      remarkably similar to those found for Fos-like immunoreactivity following acute
      amphetamine and cocaine treatments, suggesting that coordinate activation of
      members of at least two immediate-early gene families occurs in the striatum
      following catecholaminergic stimulation. Such patterns of induction strongly
      support the view that the genomic responsiveness of the striosome and of the
      matrix compartments of the rostral striatum are distinct at the level of early
      response gene expression. These findings raise the interesting possibility that
      some of the well-known effects of dopaminergic stimulation on neuropeptide and
      neurotransmitter expression in the striatum may reflect particular combinatorial
      patterns of immediate-early gene activation.

PMID- 1613552
TI  - Three-dimensional structure of dendritic spines and synapses in rat hippocampus
      (CA1) at postnatal day 15 and adult ages: implications for the maturation of
      synaptic physiology and long-term potentiation.
AB  - It has long been hypothesized that changes in dendritic spine structure may
      modify the physiological properties of synapses located on them. Due to their
      small size, large number, and highly variable shapes, standard light microscopy
      of Golgi impregnations and electron microscopy (EM) of single thin sections have
      not proved adequate to identify most spines in a sample or to quantify their
      structural dimensions and composition. Here we describe a new approach, the
      series sample, that was developed to classify by shape and subcellular
      composition all of the spines and synapses in a sample of neuropil by viewing
      them through serial EM sections. Spines in each class are then randomly selected
      for serial reconstruction and measurement in three dimensions. This approach was
      used to assess whether structural changes in hippocampal CA1 spines could
      contribute to the enhanced synaptic transmission and the greater endurance of
      long-term potentiation (LTP) that occur with maturation. Our results show a near
      doubling in the total density of synapses in the neuropil and along reconstructed
      dendrites between postnatal day 15 (PND 15) and adult ages. However, this
      doubling does not occur uniformly across all spine and synapse morphologies. Thin
      spines, mushroom spines containing perforated postsynaptic densities (PSDs) and
      spine apparatuses, and branched spines increase by about four-fold in density
      between PND 15 and adult ages. In contrast, stubby spines decrease by more than
      half and no change occurs in mushroom spines with macular PSDs or in dendritic
      shaft synapses. The stubby spines that remain are smaller in adults than at PND
      15 and the mushroom spines are larger, while no change occurs in the three
      dimensional structure of thin spines. Only a few spine necks at either age are
      constricted or long enough to attenuate charge transfer; therefore, the doubling
      in synapses should mediate the enhancement of synaptic transmission that occurs
      with maturation. In addition, LTP is not likely to be mediated by widening of
      spine necks at either age. However, the constricted spine necks could serve to
      concentrate specific molecules at activated synapses, thereby enhancing the
      specificity and endurance of LTP with maturation. These results demonstrate that
      the new series sample method combined with three-dimensional reconstruction
      reveals quantitative changes in the frequency and structure of spines and
      synapses that are not discernable by other methods and are likely to have
      dramatic effects on synaptic physiology and plasticity.

PMID- 1613553
TI  - Presynaptic control of modulatory fibers by their neural network targets.
AB  - Numerous modulatory fibers control the output of the pyloric and gastric mill
      neural networks in the crustacean stomatogastric ganglion (STG). We now describe
      the first results of intracellular recordings from the axon of one of these input
      neurons, stomatogastric nerve axon 1 (SNAX 1), close to where it enters the STG.
      SNAX 1 excites both the pyloric and gastric mill rhythms and is identified on the
      basis of its synaptic interactions with identified STG neurons. SNAX 1 receives
      synaptic input from several sources within the STG. As a result of these synaptic
      inputs, SNAX 1 fires bursts of action potentials that are time-locked to both the
      pyloric and gastric mill rhythms. The synaptic connections made onto the SNAX
      axon terminals are likely to play important roles in shaping the impulse activity
      patterns in these modulatory inputs. Thus, the fibers that modulate the pattern
      generating networks in the STG are themselves influenced by elements in these
      networks, and modulation is a dynamic interaction between input fibers and STG
      neurons.

PMID- 1613554
TI  - Prostaglandin E2 exerts an awaking effect in the posterior hypothalamus at a site
      distinct from that mediating its febrile action in the anterior hypothalamus.
AB  - The precise sites for prostaglandin E2 (PGE2)-related activity responsible for
      the promotion of wakefulness and elevation of brain temperature were determined
      in several regions of the monkey brain. PGE2 was administered through a
      microdialysis probe into 11 brain loci mainly in the preoptic area/anterior
      hypothalamic region (POA/AH) and the tuberomammillary region in the posterior
      hypothalamus (TuM-PH). Administration of PGE2 into the POA/AH resulted in a
      marked and dose-dependent febrile response. When a low dose (15 pmol/min) of PGE2
      was administered into the POA/AH, brain temperature increased significantly up to
      a 0.6 degrees C rise, but sleep behavior and amounts of time in wakefulness, slow
      wave sleep (SWS), and REM sleep during the administration period were not
      significantly different from those of the control monkeys. Dose of PGE2 above 150
      pmol/min elevated the brain temperature and heart rate more markedly and
      suppressed sleep. The degree of inhibition of sleep by PGE2 was closely
      correlated with the changes in these autonomic responses. On the other hand, when
      a low dose of PGE2 was administered into the TuM-PH, the time spent awake during
      the administration period increased up to 3.5-fold and the amount of time spent
      in SWS decreased to 50% of that of the control level, with negligible changes in
      brain temperature and heart rate. The awaking response of PGE2 in the TuM-PH was
      also dose dependent, but was not correlated with the change in brain temperature.
      Among 11 brain regions tested, the hyperthermic effect of PGE2 was most potent in
      the POA, while its awaking effect was most pronounced in the TuM-PH close to the
      mammillary complex. These findings demonstrate that the site of action of PGE2
      for the regulation of sleep-wakefulness is clearly distinct from that for the
      temperature regulation. PGE2 may be involved in the neurochemical mechanism of
      wakefulness mediated in a specific site in the PH.

PMID- 1613555
TI  - The period gene encodes a predominantly nuclear protein in adult Drosophila.
AB  - The period gene of Drosophila melanogaster (per) is important for the generation
      and maintenance of biological rhythms. Previous light microscopic observations
      indicated that per is expressed in a variety of tissues and cell types and
      suggested that the per protein (PER) may be present in different subcellular
      compartments. To understand how PER influences circadian rhythms, it is important
      to define its subcellular location, especially in adult flies where inducible
      promoter experiments suggested that it is most relevant to circadian locomotor
      activity rhythms. To this end, we report the results of an immunoelectron
      microscopic analysis of wild-type flies and per-beta-galactosidase (beta-gal)
      fusion gene transgenics using a polyclonal anti-PER antibody or an anti-beta-gal
      antibody, respectively. Most of the PER antigen and the fusion gene product were
      located within nuclei, suggesting that PER acts in that subcellular compartment
      to affect circadian rhythms. The results are discussed in terms of per's possible
      biochemical functions.

PMID- 1613556
TI  - Astrocyte precursors in neonatal rat spinal cord cultures.
AB  - Cultures of newborn rat spinal cord contain multiple types of astrocytes. By
      using a combination of cultures enriched for glial precursors and clonal
      analysis, we have identified a particular astrocyte precursor that gives rise to
      morphologically distinct classes of astrocytes. This astrocyte precursor labels
      with the monoclonal antibody A2B5, is highly migratory, proliferates in response
      to serum and platelet-derived growth factor, and differentiates into process
      bearing astrocytes, many of which subsequently assume a "pancake"-shaped
      morphology. A2B5+ astrocyte precursors share antigenic and migratory
      characteristics with previously described O2A progenitor cells but differ in
      their response to regulatory factors, including serum and coculture with type 1
      astrocytes. More importantly, these astrocyte precursors do not give rise to
      oligodendrocytes. In their proliferative response to serum and their capacity to
      differentiate into astrocytes, these glial precursors resemble type 1 astrocyte
      precursors from optic nerve. However, unlike type 1 astrocyte precursors, these
      cells are A2B5+, highly migratory, and do not give rise to fibroblast-like
      astrocytes. Neonatal rat spinal cord cultures contain approximately twice the
      number of the A2B5+ astrocyte precursors than O2A progenitor cells. By contrast,
      the majority of A2B5+ cells in postnatal day 7 optic nerve cultures are O2A
      progenitors. The presence of large numbers of A2B5+ astrocyte precursors in rat
      spinal cord cultures may reflect the more complex cytoarchitecture of the spinal
      cord compared to the optic nerve.

PMID- 1613557
TI  - Nicotine binding and nicotinic receptor subunit RNA after chronic nicotine
      treatment.
AB  - DBA mice were chronically treated with nicotine by continuous intravenous
      infusion of 4.0 mg/kg/hr for 10 d. Drug-treated mice were tolerant to the acute
      effects of nicotine on locomotor activity and body temperature. The effect of
      chronic treatment on the amount of L-3H-nicotine binding and RNA encoding for
      alpha 4, the most widely expressed nicotinic alpha-subunit, was measured in three
      brain regions. Chronic treatment increased L-3H-nicotine binding in cortex and
      midbrain but had no effect in cerebellum. In contrast, chronic treatment had no
      effect on the levels of mRNA encoding for alpha 4 in any of the three brain
      regions. Subsequently brains were sectioned and L-3H-nicotine binding was
      measured using quantitative autoradiographic methods. In addition, the relative
      amounts of mRNA for the major nicotinic receptor subunits (alpha 4 and beta 2),
      as well as for three additional minor subunits (alpha 2, alpha 3, and alpha 5),
      were determined by in situ hybridization histochemistry followed by quantitation
      of image intensity. Chronic nicotine treatment resulted in increases in the
      amount of L-3H-nicotine binding in many but not all brain areas measured. In
      contrast, chronic treatment had little effect on the intensity of the
      hybridization signal for the nicotinic subunit mRNA. The results suggest that
      chronic treatment with nicotine under conditions resulting in maximal steady
      state increases in L-3H-nicotine binding has little effect on RNA levels encoding
      any of four nicotinic alpha-subunits and the beta 2-subunit.

PMID- 1613558
TI  - Multiple axonal spike initiation zones in a motor neuron: serotonin activation.
AB  - The lateral gastric (LG) motor neuron of the stomatogastric nervous system of the
      crab Cancer borealis has a large soma in the stomatogastric ganglion (STG). The
      LG motor neuron makes inhibitory synaptic connections within the neuropil of the
      STG, and also projects to the periphery, where it innervates a series of muscles
      that control the movements of the lateral teeth of the gastric mill. The LG motor
      neuron has a spike initiation zone close to its neuropilar integrative regions,
      from which spikes propagate orthodromically to the muscles. Additionally, under
      certain conditions, the LG neuron can initiate spikes at peripheral axonal sites
      that can be 0.5-2.0 cm from the STG. Peripherally initiated spikes propagate
      antidromically into the STG and also propagate to the muscle. The peripheral
      spike initiation zones are often active in combined preparations in which the
      muscles are left attached. When the muscles are removed, depolarization of the LG
      soma together with 5-HT applied to the motor nerve also evokes peripheral spike
      initiation. At a given 5-HT concentration, the duration of the trains of
      antidromic spikes can be controlled by current injection into the soma,
      suggesting the presence of a slow voltage-dependent conductance in the LG axon.
      The antidromic spikes contribute to lengthening of the duration of contraction in
      some of the muscles innervated by the LG, but do not evoke IPSPs onto LG follower
      neurons. Thus, the LG neuron can send different signals to its peripheral and
      central targets.

PMID- 1613559
TI  - Spontaneous locomotor hyperactivity in a mouse mutant with a deletion including
      the Snap gene on chromosome 2.
AB  - The gene encoding the synaptosomal-associated protein--25 kDa (SNAP-25) was
      mapped by analysis of somatic cell hybrids and an intersubspecies backcross to
      mouse Chromosome 2. To identify potential mutants for SNAP-25, mice bearing
      mutations mapping to this region of Chromosome 2 were screened for Snap gene
      abnormalities. Mice heterozygous for the semidominant mutation coloboma (Cm/+)
      were identified that carried a deletion of Snap gene sequence. Analysis of
      genomic DNA revealed that the Snap gene dosage in Cm/+ mice was 50% lower than
      control littermates. Additionally, SNAP-25 mRNA and protein expression were 50%
      lower in coloboma mice than control littermates. The coloboma mouse phenotype is
      characterized by small eyes and head bobbing; in addition, we observed that these
      mice were extremely hyperactive with spontaneous locomotor activity exceeding
      three times control mouse activity. The localization of the genetic abnormality
      in coloboma mice using the Snap gene marker will provide a powerful tool for
      studying the biologic basis of locomotor hyperactivity.

PMID- 1613560
TI  - Rapid development of dopaminergic supersensitivity in reserpine-treated rats
      demonstrated with 14C-2-deoxyglucose autoradiography.
AB  - Dopaminergic denervation supersensitivity has been implicated in the pathogenesis
      of levodopa-induced dyskinesias, the most common and limiting side effect in the
      drug treatment of Parkinson's disease, yet the mechanisms that mediate altered
      drug sensitivity remain poorly understood. In animals models, one key component
      of denervation supersensitivity is the enhanced efficacy of selective D1 agonists
      to stimulate locomotion. In rats with chronic dopamine depletion induced by 6
      hydroxydopamine nigral lesion, the increased ability of D1 agonists to stimulate
      regional cerebral glucose utilization (RCGU) in the substantia nigra pars
      reticulata (SNr) has provided a metabolic correlate to the heightened motor
      response. In this study, we used the stimulation of RCGU in the SNr as a
      sensitive in vivo assay of D1 agonist effect to examine the time course of
      development of supersensitivity in rats following acute dopamine depletion with
      single doses of reserpine (5.0 mg/kg, i.p.) and alpha-methyl-p-tyrosine (AMPT;
      100 mg/kg, i.p.). The stimulatory effect of the D1 agonist SKF 38393 (30 mg/kg)
      on RCGU in the SNr was first enhanced 6 hr after reserpine/AMPT injection and was
      maximally enhanced at 12-24 hr (relative 2-deoxyglucose uptake increased 32-51%;
      P less than 0.05). The response to SKF 38393 returned to control values 5 d after
      reserpine/AMPT injection. The single reserpine/AMPT injections depleted striatal
      dopamine to 1-2% of control values from 3-48 hr postinjection, whereas D1 and D2
      dopamine receptor densities were unchanged at 24 hr.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1613561
TI  - Euglycemic hyperinsulinemic clamp and oral glucose load in stimulating myocardial
      glucose utilization during positron emission tomography.
AB  - To enable assessment of myocardial viability, myocardial glucose utilization has
      commonly been stimulated by oral glucose loading. To compare the effects of
      glucose loading and insulin and glucose infusion (insulin clamp) on PET
      fluorodeoxyglucose ([18F]FDG) myocardial scan image quality and regional
      myocardial glucose utilization rate (rMGU), eight patients with angiographically
      documented coronary artery disease and previous myocardial Q-wave infarction were
      studied twice, once during insulin clamp and once 1 hr after oral glucose
      loading. The rMGU rates were derived by graphic Patlak analysis in 33 normal, 10
      scar and 6 "hot spot" myocardial segments. Infusion of insulin and glucose gave
      stable plasma-glucose and serum-insulin levels during imaging. In contrast,
      glucose loading caused marked changes in plasma-glucose and insulin
      concentrations. The image quality was clearly superior and the fractional
      utilization rates of [18F]FDG were twice as high during insulin clamp than after
      glucose loading (p less than 0.0001). Due to the higher plasma-glucose levels
      after glucose loading, the calculated rMGU in normal, scar and hot spot
      myocardial segments was comparable between the two protocols. The insulin clamp
      technique makes it possible to adjust and maintain a metabolic steady state
      during the PET study. It does not alter [18F]FDG uptake patterns in different
      myocardial areas when compared to the standard glucose loading protocol, but this
      technique results in superior image quality and permits the use of smaller [18F]
      FDG patient doses.

PMID- 1613562
TI  - Euglycemic hyperinsulinemic clamp and oral glucose load in stimulating myocardial
      glucose utilization during positron emission tomography.

PMID- 1613563
TI  - Myocardial FDG PET studies with the fasting, oral glucose-loading or insulin
      clamp methods.

PMID- 1613564
TI  - Metabolic cardiac imaging in severe coronary disease: assessment of viability
      with iodine-123-iodophenylpentadecanoic acid and multicrystal gamma camera, and
      correlation with biopsy.
AB  - Fifteen patients with coronary disease and resting left ventricular ejection
      fractions of less than or equal to 0.35 underwent resting metabolic cardiac
      imaging utilizing 1 mCi [123I]iodophenylpentadecanoic acid (IPPA) intravenously
      and a multicrystal gamma camera. Parametric images of regional rates of IPPA
      clearance and accumulation were generated. Forty-two vascular territories (22
      infarcted) were evaluated by metabolic imaging as well as transmural myocardial
      biopsy. Despite resting akinesis or dyskinesis in 20/22 (91%) infarcted
      territories, 16/22 (73%) of these territories were metabolically viable.
      Transmural myocardial biopsies in all patients (43 sites, 42 vascular
      territories) during coronary bypass surgery confirmed IPPA results in 39/43
      patients (91%). When compared to biopsy, scan sensitivity for viability was 33/36
      (92%) with a specificity of 6/7 (86%). Eighty percent of bypassed, infarcted but
      IPPA viable segments demonstrated improved regional systolic wall motion
      postoperatively as assessed by exercise radionuclide angiography. We conclude
      resting IPPA imaging identifies viable myocardium, thereby providing a safe, cost
      effective technique for myocardial viability assessment.

PMID- 1613565
TI  - Noninvasive in-vivo measurement of hepatic and cardiac iron.
AB  - This study describes a new noninvasive in-vivo method of appraising human iron
      stores by nuclear resonance scattering (NRS). Manganese-56 is used as a source of
      847 keV gamma rays which scatter resonantly from the iron in the liver and heart
      of patients with Cooley's anemia (thalassemia major). These patients have heavy
      iron overload that may lead to cardiac and other organ failure. The NRS iron
      quantitation of the liver compared favorably, in a linear fashion, with the iron
      in the liver biopsies. Above initial value, the hepatic iron correlates with the
      cardiac NRS signal. There is no correlation, however, between liver enzymes and
      degree of iron load. NRS appears to be a reliable method for measuring cardiac
      and hepatic iron. It may be repeated as needed to determine the effectiveness,
      selectivity and compliance to therapy and prognosis.

PMID- 1613566
TI  - Gastric emptying and intragastric distribution of oil in the presence of a liquid
      or a solid meal.
AB  - There is little information about gastric emptying of extracellular fat. A marker
      for liquid fat, 99mTc-(V)-thiocyanate, was used to compare gastric emptying and
      intragastric distribution of oil to that of aqueous liquid and solid meal
      components. Eight volunteers consumed 60 ml of 99mTc-labeled oil and 290 ml of
      113m-In-labeled soup (total 505 kcal) on one day and 280 g 113mIn-minced beef
      (500 kcal), 60 ml 99mTc-labeled oil and 290 ml nonlabeled soup (505 kcal) on
      another day. In the oil/soup meal, gastric emptying of oil was slower than soup
      (50% emptying time 139.1 +/- 16.5 min versus 47.9 +/- 4.5 min, p less than 0.01).
      There was retention of oil in the proximal stomach (p less than 0.01) and
      retrograde movement of oil from distal into proximal stomach. In the
      oil/soup/beef meal, there was no difference in emptying of oil and beef from the
      total stomach (retention at 180 min 71.4% +/- 3.4% versus 58.3% +/- 7.6%, ns),
      but more oil was retained in the proximal stomach and more beef was retained in
      the distal stomach (p less than 0.01). The emptying rate of oil in the oil/soup
      meal was about twice that for oil consumed in the other meal. There was no
      difference between the two meals in the number of calories emptied in the first
      180 min. These results demonstrate major differences in the intragastric
      distribution of oil compared to solid and aqueous liquid meals.

PMID- 1613567
TI  - Simultaneous assessment of bolus transport and contraction parameters in multiple
      swallow investigations.
AB  - A better understanding of scintigraphic findings may lead to a wider acceptance
      of esophageal transit studies. The purpose of this study, therefore, was to
      correlate standard manometric parameters with the quantitative and qualitative
      characteristics of liquid and semi-solid bolus transport. Twenty-nine patients
      were simultaneously investigated with esophageal scintigraphy and manometry.
      Single-swallow and sum-image data of six consecutive swallows were analyzed. No
      significant relationship between transit time and the velocity of the peristaltic
      wave could be identified, which suggests that factors other than peristaltic
      velocity (e.g., pharyngeal pump) essentially modulate esophageal transit. There
      was also no linear correlation between esophageal emptying and peristaltic
      amplitudes. Emptying was normal in patients with amplitudes greater than 30 mmHg
      and reduced in those with amplitudes less than 30 mmHg. This suggests that a
      threshold pressure greater than 30 mmHg is necessary to propel a test bolus
      adequately. Patterns in condensed images have been shown to specifically reflect
      the events in corresponding manometric recordings. Normal and different
      pathologic types of peristalsis presented analogous findings in both modalities.
      Thus, an analysis of the relationship between bolus transport and contraction
      parameters in simultaneous studies increases understanding of quantitative and
      qualitative scintigraphic results.

PMID- 1613568
TI  - Petition would ease strictures on outpatient nuclear medicine therapy.

PMID- 1613569
TI  - Esophageal disorders and scintigraphy: one clinician's perspective.

PMID- 1613570
TI  - Clinical comparison of technetium-99m-teboroxime and thallium-201 utilizing a
      continuous SPECT imaging protocol.
AB  - To examine the advantages of a 99mTc-labeled cardiac perfusion agent, teboroxime
      or SQ30,217 (Squibb Diagnostics), a prospective study was undertaken comparing it
      to 201Tl stress testing in 17 patients suspected or known of having coronary
      artery disease (CAD). All patients were studied utilizing a single-detector SPECT
      camera with a continuous acquisition imaging protocol. Testing was performed on a
      treadmill to comparable levels with both agents within a 2-wk period. Concordance
      between the two studies on a patient by patient basis was seen in 16/17 (94%)
      patients, and discordance was seen in 1/17 (6%) patients. Comparison of findings
      between 201Tl and 99mTc-teboroxime on a segment by segment basis showed
      concordance in 107/119 (90%) segments, and 12/119 (10%) were discordant. Both
      examinations independently detected an equal number of normal (77) and abnormal
      (42) segments. There was no significant difference between the two agents in
      classifying lesions as ischemic, although there were significant differences
      between thallium and teboroxime in classifying infarct and infarct/ischemia.
      Technetium-99m-teboroxime SPECT imaging is a clinically useful method for
      detecting CAD, with a major advantage being the shorter examination time per
      individual patient study. The mean total examination time for completion of the
      99mTc-teboroxime study was 2.5 hr versus 4.0 hr for 201Tl.

PMID- 1613572
TI  - Dose estimation in strontium-89 radiotherapy of metastatic prostatic carcinoma.
AB  - Strontium-89 radiotherapy is becoming an important treatment in the palliation of
      bone pain from osteoblastic metastases. The absorbed dose delivered to bone
      metastases during 89Sr radiotherapy has been estimated in four patients with
      metastatic prostatic carcinoma. Patients were injected with a tracer dose of 85Sr
      chloride. Blood and urine samples were obtained during the week following
      injection. Strontium-85 scintigrams of metastases and normal bone were obtained
      up to 8 wk postinjection. Half of the patients showed elevated whole-body
      retention; plasma-strontium concentrations were decreased from normal values.
      Uptake of strontium in metastases was 2-25 times that in normal bone but rates of
      washout of strontium from metastases were similar to those from normal bone.
      Absorbed doses delivered in infinite time to the metastases by 89Sr ranged from
      21 +/- 4 to 231 +/- 56 cGy/MBq with a median value of 68 cGy/MBq. Doses to red
      marrow were less by a factor of 2 to 50. These absorbed doses are sufficiently
      large to be expected to produce a therapeutic benefit.

PMID- 1613571
TI  - A comparison of brain perfusion SPECT in cocaine abuse and AIDS dementia complex.
AB  - Intravenous drug use is a major risk factor for HIV-1 infection. Since both AIDS
      dementia complex (ADC) and cocaine have been associated with abnormal brain
      perfusion imaging, we compared the scintigraphic patterns of ADC patients and
      cocaine polydrug users with normal control subjects using 99mTc-HMPAO SPECT. We
      found a high incidence of cortical defects in both ADC (100%) and cocaine
      dependent (90%) subjects. In the cocaine and ADC patients, cortical defects were
      most frequent in the frontal, temporal and parietal lobes and occurred with
      similar frequency in the two populations. In both groups, the number of cortical
      defects per subject was higher than normal subjects (10.0 +/- 5.0 for ADC, 10.1
      +/- 5.2 for cocaine and 0.7 +/- 1.5 for normal), background activity was high (a
      65% and 60% incidence for ADC and cocaine, respectively), and basal ganglia
      involvement was frequent (40% and 65% for ADC and cocaine). We conclude that the
      brain perfusion pattern, while a sensitive indicator of ADC, cannot be
      distinguished from chronic cocaine polydrug use and caution should therefore be
      applied before entertaining a specific diagnosis.

PMID- 1613573
TI  - Factors influencing serial measurements of cardiac volumes by count-based
      methods: effects of elevated catecholamines, position, and exercise on technetium
      99m-blood radioactivity concentration.
AB  - Most radionuclide methods for measuring cardiac volume require a determination of
      the blood radioactivity concentration. Thus, changes in blood radioactivity over
      time or during interventions might lead to spurious volume estimates unless blood
      radioactivity is serially measured. The effects of elevated epinephrine, posture
      and exercise on 99mTc-labeled blood radioactivity concentration were studied in
      15 young (mean age = 28 yr) and 14 older (mean age = 68 yr) healthy males. An
      epinephrine infusion of 50 ng/kg/min resulted in a 4.1% +/- 1.0% increase in
      99mTc-blood radioactivity (p less than or equal to 0.001) compared to baseline.
      Sitting increased blood radioactivity concentration by 12.3% +/- 3.0% (p less
      than 0.0002) compared to the supine position and peak supine bicycle exercise
      caused an 11.0% +/- 1.7% increase (p less than or equal to 0.0001) compared to
      supine rest. There was a significantly greater increase during peak supine
      exercise in the young compared to the older subjects (15.0% +/- 2.3% versus 6.3%
      +/- 2.0%, p less than or equal to 0.01). The mechanism of the increase in blood
      radioactivity concentration is uncertain, but presumably reflects the addition of
      hemoconcentrated red blood cells from the spleen and/or the loss of plasma
      volume. Failure to correct for the increased blood radioactivity concentration
      during exercise or pharmacological interventions will result in a significant
      error in serial measurements of cardiac volumes by methods requiring RBC
      radioactivity measurements.

PMID- 1613574
TI  - Evaluation of infectious diabetic foot complications with indium-111-labeled
      human nonspecific immunoglobulin G.
AB  - Osteomyelitis of the foot is a well-known complication of diabetes mellitus. In
      this study, the validity of 111In-labeled human nonspecific immunoglobulin G
      (IgG) scintigraphy was studied in 16 diabetic patients with foot ulcers, gangrene
      or painful Charcot joints. In all patients, plain radiographs, conventional bone
      scan images and 111In-IgG images were recorded. The results were verified by
      histologic examination of surgical specimens in patients who did not respond to
      antibiotic treatment within 2-3 wk (10 lesions) or long-term clinical follow-up
      of at least 6-mo (16 lesions). On the bone scans, all seven osteomyelitic foci
      were detected. However, 19 additional foci not due to osteomyelitis were seen.
      The absence of true-negative bone scans in this study resulted in a specificity
      of 0%. On the plain radiographs, four of seven osteomyelitis foci were detected;
      for 111In-IgG scintigraphy, six of seven (sensitivity 57% and 86%, respectively).
      Plain radiographs correctly ruled out osteomyelitis in 15 of 19 lesions, 111In
      IgG scintigraphy in 16 of 19 (specificity 79% and 84%, respectively). All imaging
      procedures gave false-positive results in penetrating ulcers over the calcaneus
      in two patients and in one patient with a Charcot joint, most likely due to
      recent fractures. A false-negative 111In-IgG study was observed in a patient with
      severe arterial angiopathy. Accurate estimation of probable osteomyelitis was not
      possible from the results of soft-tissue cultures, since in only 6 of 12 positive
      cultures, osteomyelitic foci could be proven. Indium-111-IgG scintigraphy can
      contribute to adequate evaluation of osteomyelitis in diabetic foot complications
      because it improves specificity when compared to bone scan and radiographic
      findings and improves sensitivity in comparison to plain radiographs.

PMID- 1613575
TI  - Diagnostic imaging of the liver.

PMID- 1613576
TI  - The relationship between myocardial blood flow and glucose uptake in ischemic
      canine myocardium determined with fluorine-18-deoxyglucose.
AB  - The relationship between myocardial blood flow as a marker of severity of
      ischemia and exogenous glucose utilization was examined following occlusion of
      the left anterior descending coronary artery in 10 fasted, anesthetized, open
      chest dogs. Fluorine-18-fluorodeoxyglucose (FDG) was injected 10 min after the
      onset of ischemia and serial blood samples were obtained to measure FDG in
      plasma. Tracer-labeled microspheres, used to measure myocardial blood flow (MBF),
      were injected 10 and 40 min postocclusion. After the last microsphere injection,
      the heart was arrested and removed rapidly. Tissue samples of the left ventricle
      were obtained, weighed and FDG counts were determined. Two days later, the same
      samples were assayed for radioactivity from the tracer-labeled microspheres and
      blood flow was calculated. Thus, FDG uptake and MBF measurements were made in the
      same tissue samples. When normalized for variations in blood flow, there were no
      significant differences in FDG uptake between the subendocardial and
      subepicardial halves of the tissue samples. FDG uptake was relatively high and
      uniform in normal myocardium, paralleling the pattern of MBF. In ischemic
      myocardium, however, FDG uptake and MBF did not vary in parallel. In tissue
      samples with MBF reduced by up to 80% from control levels, relative FDG uptake
      increased such that absolute FDG uptake remained at normal or near normal levels.
      In samples with more severe ischemia, FDG uptake decreased precipitously with
      additional decrements in MBF. We propose that sufficient glycolytic flux may be
      sustained to maintain cellular viability when perfusion is above the threshold
      value. Below the threshold, however, irreversible changes may be initiated.

PMID- 1613577
TI  - Myocardial blood flow, deoxyglucose uptake, and myocyte viability in ischemia.

PMID- 1613578
TI  - Interspecies variation in biodistribution of technetium (2-carbomethoxy-2
      isocyanopropane)6+.
AB  - The cationic complex technetium (2-carbomethoxy-2-isocyanopropane)6+ (99mTc-CPI)
      contains terminal ester groups that were included to provide a pathway for in
      vivo metabolism of this compound, thereby enhancing its performance as a
      myocardial perfusion agent. Biodistribution studies of the compound demonstrated
      myocardial accumulation in rabbit, guinea pig, and chick, but not in rat and
      mouse. Radiochemical analysis by HPLC after in-vitro incubation of 99mTc-CPI in
      blood plasma from the various species confirmed enzymatic hydrolysis to numerous
      new compounds. Rat and mouse serum produced complete hydrolysis of this agent
      after incubation for less than 5 sec at 25 degrees C or rates greater than 500
      times those observed in human, rabbit, guinea pig and chick serum. Chemical
      synthesis and isolation of the monohydrolyzed species with subsequent
      biodistribution studies in guinea pig and rabbit confirmed that this neutral
      lipophilic complex did not accumulate in heart tissue. It is concluded that
      varying rates of enzymatic in-vivo hydrolysis produce the interspecies
      biodistribution differences and may account for the moderate myocardial clearance
      relative to other isonitrile complexes.

PMID- 1613579
TI  - Establishment and characterization of monoclonal antibodies against an octahedral
      gallium chelate suitable for immunoscintigraphy with PET.
AB  - As a prerequisite for preparing bispecific antibody conjugates containing anti
      tumor and anti-metal chelate binding sites that can be used for pretargeted
      immunoscintigraphy, monoclonal antibodies (Mabs) have been raised against an
      octahedral metal chelate synthetized from gallium (Ga) and the hexadentate ligand
      N,N'bis[2-hydroxy 5-(ethylene beta carboxy) benzyl] ethylenediamine N,N' diacetic
      acid (Ga-HBED-CC). With use of the Farr assay, binding studies with the 67Ga
      labeled chelate and three clones of anti-chelate Mabs showed that none of the
      Mabs were able to precipitate more than 50% of the Ga-chelate, suggesting an
      enatiomerism of the Ga-chelate and a sensitivity of the Mabs to either one or the
      other chelate enantiomer. This could be confirmed by comparing the circular
      dichroism spectra of the Ga-chelate fractions that passed affinity columns
      containing the Mabs immobilized on sepharose without retention. With use of a Ga
      HBED-CC enantiomer, whole-body retention in mice, preinjected with the
      corresponding anti-metal chelate Mab of ca. 70% ID, was measured compared to 2.1%
      retention in mice not preinjected with the Mab. Due to the high affinity of
      chelate-to-Mab binding in vivo, bispecific antibody conjugates prepared from the
      fragments of the anti-Ga-chelate Mab might be suitable for pretargeted
      immunoscintigraphy with the short-lived positron-emitter 68Ga.

PMID- 1613580
TI  - In-vivo identification of tumor multidrug resistance with 3H-colchicine
      [corrected].
AB  - Multidrug resistance (MDR) is a major obstacle in the clinical treatment of
      cancer with natural-product anticancer agents. Identification of MDR in vivo
      could be important in the design of chemotherapeutic regimens. As a first step in
      developing radiolabeled drugs to detect MDR, we measured the in vivo distribution
      of radiolabel from [ring C, methoxy-3H]-colchicine ([3H]-CHC) in immunosuppressed
      mice bearing xenografts of colchicine-resistant and sensitive tumor cell lines.
      Experiments were done at trace (1 microgram/kg) and LD50 (4 mg/kg) dose levels.
      Activity concentration/injected dose was more than twice as great in sensitive as
      in resistant tumors (p less than 0.01) at 60 min following retroorbital injection
      of [3H]-CHC. There was no significant difference in activity distribution between
      trace- and high-dose injections for any of the tissues sampled. Chromatographic
      analysis of plasma and tumor extracts demonstrated extensive extravascular
      metabolic degradation of [3H]-CHC. The ratio of [3H]-CHC concentration of
      injected dose between sensitive and resistant tumors was 3:1 (p less than 0.05),
      due primarily to protein-bound [3H]-CHC. This preliminary study demonstrates that
      it is possible to distinguish multidrug resistant from sensitive tumors in vivo
      on the basis of radiolabel uptake from an injected MDR drug. Colchicine, labeled
      with 11C at the [ring C]-methoxy group, may be useful as a radiopharmaceutical
      for quantitative identification of MDR in human tumors using PET.

PMID- 1613581
TI  - Effect of carbohydrate modification on the localization of human polyclonal IgG
      at focal sites of bacterial infection.
AB  - Radiolabeled human polyclonal IgG localizes at focal sites of
      infection/inflammation. Previous studies have sought to identify the mechanism of
      localization, but the relative importance of specific antigen recognition by
      individual antibody molecules, binding to Fc receptors on inflammatory cells and
      nonspecific processes such as increased tissue permeability remains uncertain.
      This study was performed to evaluate the specific role of Fc receptor binding as
      a mechanism of localization. The Fc region of IgG was modified by endoglycosidase
      F digestion and periodate oxidation to reduce the binding of IgG to Fc receptors.
      In-vitro binding was tested in an Fc receptor binding assay using the human
      monocyte-like cell line, U937. The in-vivo ability of the modified antibodies to
      localize at focal sites of E. coli infection was tested by biodistribution
      studied with the 111In-labeled proteins. Modification of the carbohydrate moiety
      of the Fc region of IgG resulted in a marked decrease in Fc receptor binding in
      vitro; with antibody concentrations of 1 micrograms/ml (which is presumed to
      exist at infected sites) showing no binding for endoglycosidase modified IgG and
      50% binding for periodate modified IgG. In contrast, in-vivo infection
      localization as measured by level of accumulation or target-to-background ratio
      was not significantly effected by carbohydrate modification. These studies
      suggest that the contribution of Fc receptor binding to IgG localization at sites
      of infection is minimal.

PMID- 1613582
TI  - Delayed L-phenylalanine infusion allows for simultaneous kinetic analysis and
      improved evaluation of specific-to-nonspecific fluorine-18-dopa uptake in brain.
AB  - The accumulation of 3-O-methyl-6-[18F]fluoro-L-DOPA (18F-30M-DOPA) in the brain
      from the circulation is responsible for most of the nonspecific background during
      18F-DOPA positron emission tomography scanning. To increase the sensitivity of
      18F-DOPA for imaging presynaptic dopamine systems, we took advantage of 18F-30M
      DOPA's rapid clearance from the brain (T1/2 approximately 15-20 min). The
      infusion of the unlabeled amino acid L-phenylalanine, starting 75 min after 18F
      DOPA administration, prevents 18F-30M-DOPA entrance into the brain through
      competition at the large amino acid transport system of the blood brain barrier.
      This method produces high specific-to-nonspecific contrast images of 18F
      accumulation beginning 15-30 min after onset of amino acid infusion and better
      sensitivity to small changes in 18F-DOPA uptake while still allowing for kinetic
      analysis of the data in the early time points. Kinetic and anatomical data were
      found to be strongly correlated.

PMID- 1613583
TI  - Technetium-99m-medronate uptake in hepatic necrosis associated with Budd-Chiari
      syndrome.
AB  - A 99mTc-MDP bone scan performed on a 52-yr-old female for possible bone
      metastasis revealed prominent hepatic uptake. Subsequently, a 99mTc-SC scan
      revealed tracer uptake in the caudate lobe with diminished uptake in the
      remainder of the liver. Further imaging with Doppler ultrasound and hepatic
      venography confirmed a diagnosis of Budd-Chiari syndrome. Hepatic necrosis,
      demonstrated on CT imaging, was secondary to Budd-Chiari syndrome and was felt to
      be the cause of 99mTc-MDP hepatic uptake in this patient.

PMID- 1613584
TI  - Comparison of technetium-99m-MIBI and thallium-201-chloride uptake in primary
      thyroid lymphoma.
AB  - A case of primary thyroid lymphoma demonstrating uptake of 99mTc-hexakis-2
      methoxy isobutyl isonitrile (MIBI) is presented. The 99mTc-MIBI image more
      clearly delineated the extent of tumor as demonstrated on CT compared to 201Tl
      chloride and [99mTc]pertechnetate images. Following two courses of chemotherapy,
      repeat radionuclide studies and CT scan showed complete resolution of the thyroid
      tumor. Technetium-99m-MIBI may be useful in the assessment of disease activity
      and monitoring response to treatment in patients with lymphoma.

PMID- 1613585
TI  - Radiation safety considerations for post-iodine-131 thyroid cancer therapy.
AB  - The purpose of this study was to develop guidelines based on direct patient
      measurements as to when 131I-treated thyroid cancer patients may resume close
      personal contact after release from the hospital. External exposure rates were
      measured on 27 patients using a calibrated ionization survey meter. The patients'
      exposure rates were measured at the time of release from the hospital and 2-7
      days post-hospital discharge. Measurements were taken at 1, 0.6 and 0.3 meters
      from the patient's upright body axis (stomach to thyroid). Vertical movement of
      the survey instrument was utilized to obtain the maximum reading each time. All
      patients had exposure rates less than 2 mR/hr at 1 meter at 2-4 days post
      hospital discharge. Eight-eight percent (21/24) had exposure rates less than 2
      mR/hr at 0.6 meter at 2-4 days post-hospital discharge. Guidelines can be
      prepared specifically for thyroid cancer therapy patients that are rational and
      consistent with existing radiologic health standards.

PMID- 1613586
TI  - Optimization of follow-up measurements of bone mass.
AB  - In bone densitometry, the precision of the instrument, the number of measurements
      and the time-points of the measurements are important criteria for monitoring
      bone mass changes. The most appropriate follow-up procedure can be determined by
      numerical comparison of various combinations of these three criteria. This can be
      done by computing the confidence interval of changes in bone mass. We developed a
      model to estimate the length of a confidence interval for the observed changes in
      individual patients. With specific instrument precision, a specified number of
      measurements and, assuming a linear rate of bone mass changes, the best estimate
      of the actual changes in bone mass is obtained by measurements at the end of an
      observation period. With the current precision of bone densitometers, follow-up
      of patients with yearly duplicate measurements is recommended. A shorter scan
      time interval offers no additional information unless very rapid bone loss is
      expected.

PMID- 1613587
TI  - Left ventricular perfusion and performance from a single radiopharmaceutical and
      one camera.
AB  - To test the hypothesis that a small field of view portable multicrystal
      scintillation camera can perform stress/rest combined LV function by first-pass
      and perfusion studies using 99mTc-teboroxime, 26 patients with positive stress
      thallium studies within 2 wk and 8 healthy volunteers were studied. A 241Am point
      source marker over the sternum was used for motion correction. Dynamic dual
      isotope (99mTc/241Am) acquisition was performed following injection of 15.6 +/-
      2.3 mCi of 99mTc-teboroxime at peak treadmill exercise. Two minutes later (blood
      pool clearance), while still standing on the flat treadmill, 3-4 40-sec planar
      images were acquired. One hour later patients were reinjected with 22.7 +/- 3.4
      mCi of 99mTc-teboroxime while standing in front of the camera and the same
      dynamic/static acquisition protocol repeated. The planar images were interpolated
      from a 20 x 20 matrix to a 160 x 160 matrix, a sharpening filter and an
      interpolative background subtraction algorithm applied. The scans were divided
      into segments, each scored as normal, reversible and fixed. The agreement with
      thallium imaging for identifying an abnormal scan was 24/26 (92%) and for
      identifying abnormal vascular territories was 43/52, (83%). Fourteen patients had
      exercise LVEF less than 50% and all had either prior myocardial infarction,
      myocardial infarction plus ischemia or LAD ischemia. Diagnostic planar perfusion
      images and exercise LVEF can be acquired in less than 4 min using 99mTc
      teboroxime and a portable multicrystal scintillation camera.

PMID- 1613589
TI  - Lung scan interpretation: a physiologic, user-friendly approach.

PMID- 1613588
TI  - Lung scan interpretation: a physiologic, user-friendly approach.
AB  - A physiologically-oriented, user-friendly algorithm for interpretation of
      ventilation-perfusion (V/P) lung scans was compared to the widely used Biello
      criteria. The physiologic algorithm relies primarily on the observer's degree of
      certainty that a V/P mismatch is present rather than on the size (relative to a
      whole segment) and number of V/P mismatches. One hundred five patients who had
      undergone a ventilation study with 133Xe gas, a perfusion study with 99mTc-MAA
      and pulmonary angiography were reviewed. Each V/P lung scan was interpreted once
      with the physiologic algorithm and once with the Biello criteria by two
      observers. Fifty-nine percent of the 105 studies were classified as indeterminate
      with the physiologic algorithm versus 62% with the Biello criteria. The
      prevalence of pulmonary embolism in the high probability, indeterminate, low
      probability and normal categories for the physiologic algorithm were 60%, 26%, 7%
      and 0%, respectively; and for the Biello criteria were 50%, 31%, 11% and 0%,
      respectively. Analysis of the data with receiver-operating-characteristic curves
      indicated that the physiologic algorithm performed better than the Biello
      criteria (p less than 0.05). In addition, the physiologic algorithm has the
      advantages of being more intuitive and easier to remember. We conclude that
      further evaluation of the physiologic approach for the interpretation of V/P lung
      scans is warranted.

PMID- 1613590
TI  - Blunted response of myocardial perfusion to dipyridamole in older adults.

PMID- 1613591
TI  - Marrow scintigraphic changes after hormonal therapy.

PMID- 1613592
TI  - The localization of indium-111-leukocytes, gallium-67-polyclonal IgG and other
      radioactive agents in acute focal inflammatory lesions.

PMID- 1613593
TI  - Standardized tests of PET performance.

PMID- 1613594
TI  - Patterns of dementia in Alzheimer's disease.

PMID- 1613595
TI  - Berson-Yalow Award winners shedding light on FDG uptake in tumors.

PMID- 1613596
TI  - Radiopharmaceutical chemist receives Hevesy Nuclear Medicine Pioneer Award.

PMID- 1613597
TI  - Certification for nursing staff development educators.

PMID- 1613598
TI  - A creative recruitment program. Future nurses' camp.
AB  - Attracting high school students into nursing is a concern of staff development
      educators. "Future Nurses' Camp" was a creative, cost-effective program developed
      by a hospital education department. A 2-week, fun-filled, informative camp that
      included the use of high-tech equipment and patient-care decision games promoted
      a positive image of nursing. Experiencing nurses' roles reinforced the students'
      desire to enter nursing.

PMID- 1613599
TI  - Education centers. What features are best?
AB  - Nurse educators in the 1990s need to conserve resources, decrease duplication in
      staff training efforts, maintain educational quality, and provide a flexible
      learning environment. Educators at the University of Minnesota Hospital and
      Clinic in Minneapolis find these goals easier to achieve since they designed an
      education center in 1986. Orientation, continuing education, inservice, and
      skills fairs are some activities that take place in the center. In this article,
      the authors describe the center and give useful tips for readers interested in
      developing a similar facility.

PMID- 1613600
TI  - A nursing update course. Service and education collaborate.
AB  - This article describes the planning, development, implementation and evaluation
      of a nursing update course. It identifies collaboration between a hospital and
      college as the key element in the program's success. Evaluation showed the
      program was effective in recruiting and educating students; it helped alleviate a
      local nursing shortage and brought nursing practice and education together, and
      87% of the course participants either returned to practice or entered formal
      education programs to continue their professional development.

PMID- 1613601
TI  - Education day. The evolution of a learning experience.
AB  - Education Day in our hospital was created as a way of increasing attendance at
      annual mandatory inservices. Since beginning the program, compliance with
      mandatory inservice has increased from 50% to 97%. The Education Day format
      consolidates resources and provides consistency in the delivery of required
      information. The format is also flexible; it responds to changes and specialized
      educational needs of the nursing staff.

PMID- 1613602
TI  - Self-learning packages in staff development.
AB  - Potential uses for self-learning packages in the nursing staff development
      setting include orientation programs, mandatory education programs, developmental
      programs, and review of infrequently used skills. The staff development educator
      can use pretest and posttest results obtained from the use of self-learning
      packages to document intervention with the learner. Benefits for both learners
      and staff development educators when this teaching strategy is used are
      described.

PMID- 1613603
TI  - A guide to competency-based orientation. Develop your own program.
AB  - Nursing orientation should provide the requisite knowledge and skills to enable a
      nurse to perform competently in a new work environment. This article provides a
      step-by-step guide to the development of a competency-based orientation program
      that is supported by well-developed preceptors. It is written in a "how-to"
      format, providing the guidance and tools necessary for a nurse educator to
      develop a program that is institution specific.

PMID- 1613604
TI  - Implementing self-learning.

PMID- 1613605
TI  - A theory-based computer training program.
AB  - Using Kolb's learning theory resulted in an effective method of implementing a
      computer training program. The variety of teaching strategies provided an
      environment for nurses and other health care providers with different learning
      styles to understand and use the computer system successfully. The comprehensive
      training program was critical to the successful conversion to a new computer
      system in this large public teaching hospital. This project reinforces the need
      for nursing education and research departments to use teaching strategies that
      accommodate a variety of learning styles in a heterogenous group. The results of
      this project suggest one approach to stimulate adult learning and facilitate an
      effective learning environment. Nurses and other computer users have demonstrated
      effectiveness of this training program through successful activation of the new
      computer system.

PMID- 1613606
TI  - Assessing learning outcomes.

PMID- 1613607
TI  - Patterns of syphilis testing in the elderly.
AB  - OBJECTIVE: To evaluate the frequency of inconsistencies in the use of laboratory
      tests for syphilis among the elderly in an acute care setting. DESIGN:
      Retrospective medical record review. SETTING: Academic medical center.
      PATIENTS/PARTICIPANTS: All patients 60 years of age and older who had: 1)
      positive tests for syphilis and no lumbar puncture performed (n = 71), 2) lumbar
      punctures performed and no positive test for syphilis (n = 68), and 3) positive
      tests for syphilis and lumbar punctures performed (n = 8). INTERVENTIONS: None.
      MEASUREMENTS AND MAIN RESULTS: The chronology and results of syphilis tests were
      abstracted from the medical records. Documentation of signs and symptoms of
      neurosyphilis, including dementia and depression, were abstracted from the
      medical records by a second reviewer. Most patients had inadequate evaluations;
      51 had no follow-up of positive syphilis tests and 43 had cerebrospinal fluid
      syphilis tests in the absence of positive blood tests for syphilis or signs and
      symptoms of neurosyphilis. CONCLUSIONS: The inconsistent pattern of serologic
      testing in this study suggests that the testing was done as a routine procedure
      and not for a specific purpose. For a majority of the tested individuals, the
      results did not provide a public health benefit or contribute to the individual's
      well-being.

PMID- 1613608
TI  - Fatigue in primary care: prevalence, psychiatric comorbidity, illness behavior,
      and outcome.
AB  - OBJECTIVES: To identify the prevalence, psychiatric comorbidity, illness
      behavior, and outcome of patients with a presenting complaint of fatigue in a
      primary care setting. METHODS: 686 patients attending two family medicine clinics
      on a self-initiated visit completed structured interviews for presenting
      complaints, self-report measures of symptoms and hypochondriasis, and the
      Diagnostic Interview Schedule (DIS). Fatigue was identified as a primary or
      secondary complaint from patient reports and questionnaires completed by
      physicians. RESULTS: Of the 686 patients, 93 (13.6%) presented with a complaint
      of fatigue. Fatigue was the major reason for consultation of 46 patients (6.7%).
      Patients with fatigue were more likely to be working full or part time and to be
      French Canadian, but did not differ from the other clinic patients on any other
      sociodemographic characteristic or in health care utilization. Patients with
      fatigue received a lifetime diagnosis of depression or anxiety disorder more
      frequently than did other clinic patients (45.2% vs. 28.2%). Current psychiatric
      diagnoses, as indicted by the DIS, were limited to major depression, diagnosed
      for 16 (17.2%) fatigue patients. Patients with fatigue reported more medically
      unexplained physical symptoms, greater perceived stress, more pathologic symptom
      attributions, and greater worries about having emotional problems than did other
      patients. However, only those fatigue patients with coexisting depressive
      symptoms differed significantly from nonfatigue patients. Patients with fatigue
      lasting six months or longer compared with patients with more recent fatigue had
      lower family incomes and greater hypochondriacal worry. Duration of fatigue was
      not related to rate of current or lifetime psychiatric disorder. One half to two
      thirds of fatigue patients were still fatigued one year later. CONCLUSIONS: In a
      primary care setting, only those fatigue patients who have coexisting
      psychological distress exhibit patterns of abnormal illness cognition and
      behavior. Regardless of the physical illnesses associated with fatigue,
      psychiatric disorders and somatic amplification may contribute to complaints of
      fatigue in less than 50% of cases presented to primary care.

PMID- 1613610
TI  - The medical problems of homeless clinic patients: a comparative study.
AB  - OBJECTIVE: To compare the prevalence of major medical problems in homeless and
      nonhomeless patients. PATIENTS: All 475 persons seeking care at an ambulatory
      clinic serving the medically indigent for one calendar year. INTERVENTION: None.
      MEASUREMENTS AND MAIN RESULTS: Demographic and clinical data were collected by
      structured interviews and medical record reviews for all patients seeking care at
      the clinic between March 1989 and April 1990. Comparisons were made between
      homeless patients, those patients with unstable housing, and those with stable
      housing. There was no significant between-group difference in age, gender,
      ethnicity, and health insurance coverage. Homeless patients were more likely to
      be unemployed (p less than 0.001) and were found to have higher prevalence of
      alcohol abuse, injuries/fractures, and dental and gynecologic problems (p less
      than 0.05). CONCLUSIONS: There were more similarities than differences in the
      prevalences of major medical problems in homeless vs. nonhomeless community
      clinic patients. Where differences did exist, homeless persons consistently had a
      higher prevalence of illness than did the nonhomeless.

PMID- 1613609
TI  - Natural history of symptoms of depression and anxiety during inpatient treatment
      on general medicine wards.
AB  - OBJECTIVE: To establish the frequency of criteria-based depression and anxiety in
      newly admitted medical inpatients and to determine the natural history of
      depressive and anxiety symptoms during hospitalization. DESIGN: Prospective
      structured assessment of criteria-based depression and anxiety diagnoses within
      24 hours of hospitalization with routine follow-up depression and anxiety
      questionnaires until discharge. SETTING: A tertiary care university hospital and
      an affiliated Veterans Administration hospital. PATIENTS: One hundred twenty
      eight adult patients admitted to internal medicine inpatient units between May
      1990 and August 1990. MAIN RESULTS: On admission, 43 of the 128 patients inducted
      met the DSM-III criteria for major depression, while an additional six met the
      criteria for adjustment disorder with depressed mood. Only six patients met the
      criteria for panic disorder, generalized anxiety disorder, or adjustment disorder
      with anxious mood at the time of admission to the study. Patients with high
      symptom scores on the anxiety and depression scales showed significant decreases
      in these scores without specific psychiatric intervention. Those who remained in
      the hospital 20 days or longer showed initial improvement and subsequently
      returned to baseline symptom levels of depression and anxiety. In approximately
      9% of patients, symptoms of depression persisted or worsened. CONCLUSIONS: Major
      depression occurs more commonly than anxiety disorder in newly admitted medical
      inpatients but both resolve spontaneously in the majority during the course of
      hospitalization without specific psychiatric intervention unless the
      hospitalization is prolonged. One in ten will continue to show symptoms of
      depression.

PMID- 1613611
TI  - A physician-completed patient registry system: pilot results for unstable angina
      in the elderly. The Northern New England Cardiovascular Disease Study Group and
      the Dartmouth Primary Care COOP.
AB  - OBJECTIVE: For many common conditions, such as unstable angina pectoris (UAP) in
      the elderly, the course of the disease and the influence of treatments on outcome
      need to be better described. In this report the authors demonstrate how a simple
      pocket-sized card system can be used by busy clinicians to identify patient
      cohorts and follow the courses of their illnesses. DESIGN AND SETTING: Twelve
      university-based and 12 rural clinicians enrolled consecutive patients over the
      age of 64 with UAP. One week and six weeks after patient enrollment the
      physicians described treatments, diagnoses, and patient outcomes. RESULTS: The
      median age of the 76 patients was 73 years. Within one week of enrollment for
      UAP, ten (13%) suffered myocardial infarctions or died; by six weeks this adverse
      event rate was 26%. The presence of three or more clinical criteria for UAP (odds
      ratio 9.9; 95% CI 2.4-41.5) and "ST changes" by electrocardiography (odds ratio
      9.5; 95% CI 2.5-35.6) were strongly associated with death or myocardial
      infarction within a week after enrollment. CONCLUSION: These findings suggest
      that the use of a clinician-completed patient registry will allow designation of
      clinically important high- and low-risk UAP. A registry system such as that
      described here may be useful for the initial evaluation of treatment and outcomes
      of illness.

PMID- 1613613
TI  - Variation in physician opinion about scheduling of return visits for common
      ambulatory care conditions.
AB  - OBJECTIVE: To determine whether there is consensus about intervals between visits
      for adult general medicine patients with common ambulatory care conditions.
      DESIGN: Survey of practicing physicians and residents. SETTING: Ambulatory care
      at a hospital clinic, a group practice, and a physician office. PARTICIPANTS: 153
      physicians, including residents, fellows, and staff from The University of Iowa
      Hospitals and Clinics, internists and family practitioners from three Iowa towns,
      and internists from Atlantic City, New Jersey. INTERVENTIONS: None. MEASUREMENTS
      AND MAIN RESULTS: There was wide variation in responses, with greater consensus
      for more acute conditions than for chronic conditions or preventive care.
      CONCLUSIONS: 1) Wide variation exists in proposed intervals between visits for
      care of patients with common ambulatory conditions. 2) Variation occurs within
      the same geographic area and is unassociated with year of graduation from medical
      school, year in training, or academic appointment 3) Further study is needed to
      assess the significance of this variation.

PMID- 1613612
TI  - Diagnostic judgments of nurse practitioners providing primary gynecologic care: a
      quantitative analysis.
AB  - OBJECTIVES: To determine the accuracy of experienced nurse practitioners'
      judgments of the probability of chlamydial infection of the cervix, to identify
      the clinical factors ("cues") related to the judgments, and to discern likely
      sources of judgment error. DESIGN: Cross-sectional study with prospective data
      collection. SETTING: Urban hospital-based clinic. PATIENTS: 492 nonpregnant women
      receiving primary gynecologic care. INTERVENTIONS: Four nurse practitioners
      recorded clinical data, tested women for chlamydial infection, and judged the
      probability of chlamydial infection using six categories: less than 1%, 1-4%, 5
      9%, 10-24%, 25-50%, and greater than 50%. MEASUREMENTS AND MAIN RESULTS:
      Chlamydial infection was detected by immunofluorescent assay in 31 (6%) of the
      492 women. Although the median probability judgment was 5-9%, judgments were only
      weakly related (p = 0.08) to actual rates of infection. In a multivariate
      analysis, eight clinical cues were independently (p less than 0.05) related to
      nurse practitioners' probability judgments: age less than 20 years; past
      chlamydial or gonococcal infection; new sex partner; partner with suspected
      genital infection; genito-urinary symptoms; cervicitis, purulent vaginal
      discharge; and malodorous vaginal discharge. A linear model based on the eight
      cues, weighted according to their regression coefficients, predicted chlamydial
      infection more accurately than did the nurse practitioners' actual judgments (ROC
      curve areas 0.69 vs. 0.58, respectively; p less than 0.05). However, only two of
      the eight cues (age less than 20 years and purulent vaginal discharge) were
      actually related to chlamydial infection in a second multivariate model; this
      model bad accuracy similar to that of an empirically derived prediction rule (ROC
      curve areas 0.77 and 0.80, p = 0.27). CONCLUSIONS: Nurse practitioners were often
      inaccurate in their diagnostic judgments. Our analyses suggest that this
      inaccuracy stemmed from both the inconsistent use of clinical cues and the use of
      cues that were not related to chlamydial infection. Therefore, interventions such
      as algorithms that promote consistency and accuracy in diagnostic use of relevant
      cues would be likely to improve their diagnostic judgments.

PMID- 1613614
TI  - Cardiovascular risk modification in the college student: knowledge, attitudes,
      and behaviors.
AB  - STUDY OBJECTIVES: To study knowledge, attitudes, and behaviors regarding
      cardiovascular risk in college students, and to delineate preferred modes of
      gaining further information. DESIGN: Cross-sectional survey. SETTING: Four-year
      public liberal arts college. PARTICIPANTS: 1,503 students returning a
      questionnaire (response rate of 60.4%). RESULTS: Over 91% of respondents knew
      hypertension was a major cardiovascular risk factor. In addition, 90% identified
      smoking, 86.7% identified cholesterol level, and 72% identified exercise as
      additional factors. Under 16% reported that they smoked cigarettes, but only
      33.5% exercised regularly. Only 32.9% had had cholesterol levels checked, with
      19.2% knowing their values. Over 94% named doctors and nurses as desired sources
      of further information, yet only 23% said doctors had previously discussed
      prevention of heart disease with them. CONCLUSIONS: General knowledge of cardiac
      risk factors is high among college students, yet actual behavior does not
      necessarily reflect assimilation of these concepts. Students seek health
      information from traditional sources. Primary care physicians have a unique
      opportunity to address these issues, especially in the pre-college physical
      examination.

PMID- 1613615
TI  - Quality of emergency room triage of medical inpatients to an acute care clinic or
      chronic health care facilities.
AB  - OBJECTIVE: To evaluate the accuracy of emergency room triage by general
      internists assigning medical patients to four different health care settings.
      DESIGN: Prospective trial. SETTING: Medical emergency room of a university
      hospital providing primary and referral care. PATIENTS: 974 consecutive patients
      admitted for acute medical care, excluding patients admitted to intensive care
      units. INTERVENTION AND MEASUREMENTS: After primary evaluation patients were
      assigned to one of four groups: A) acutely ill requiring acute care in a general
      medical ward (n = 598); B) acutely ill requiring acute care limited to two to
      three days (n = 201); C) chronically ill with realistic chances for
      rehabilitation (n = 77); and D) chronically ill requiring definite referral to
      skilled nursing home care (n = 98). Nine months later, outcome and placement
      after index hospitalization were evaluated in surviving patients. MAIN RESULTS:
      159 (16%) patients died; three (1%) were lost to follow-up. Evolution confirmed
      the appropriateness of the initial triage of 90% of the remaining 812 patients
      (83%). Allocations were correct in 96%, 95%, and 91% of cases in groups A, B, and
      C, respectively. In group D, only 44% were definitely transferred to nursing
      homes; 56% were rehabilitated and returned to their previous social settings or
      entered homes for the aged. CONCLUSIONS: Clinical judgment of general internists
      in an emergency room adequately identifies patients requiring acute care of
      regular or short duration and chronically ill patients with realistic prospects
      for rehabilitation. But the need for nursing home placement is overestimated. To
      avoid patient misplacement the authors propose direct access to a specialized
      geriatric assessment facility.

PMID- 1613616
TI  - Painful shoulder syndromes: diagnosis and management.
AB  - Painful shoulder conditions are common primary care problems. Providers should
      learn the topographical landmarks about the shoulder and understand shoulder
      mechanics. A careful clinical evaluation will usually provide a likely diagnosis.
      In unclear cases with marked pain, weakness, and reduced mobility, or with a
      suspected rotator cuff tear or rupture, arthrography or MRI will usually
      establish a diagnosis. Therapy of bursitis/tendinitis consists of a steroid
      injection into the inflamed subacromial area or a 14-day trial of an NSAID.
      Therapy of bicipital tendinitis, largely empiric because definitive studies are
      unavailable for any specific treatment, includes judicious peritendinous steroid
      injections and avoiding aggravating activities. In the management of patients
      with suspected tendon tears or rupture, primary care practitioners can confirm
      the diagnosis by ordering MRI or arthrography before referring these patients to
      an orthopedist for definitive surgical therapy. Optimal management of adhesive
      capsulitis remains unclear, but an intraarticular steroid injection appears
      beneficial at least in temporarily diminishing pain. Pendular motion exercising
      is also an integral part of therapy. Deleterious effects of peribursal or
      intraarticular steroid infiltration appear minimal; but injections into the
      tendon or frequent, repetitive injections are contraindicated. Each shoulder
      condition has a variable course, depending on the structure(s) and extent of
      involvement.

PMID- 1613618
TI  - Clinical activities and satisfaction of general internists, cardiologists, and
      ophthalmologists.
AB  - To define factors that affect the levels of practice satisfaction of different
      specialities, an observer recorded the activities of 15 physicians in practice
      (nine general internists, three cardiologists, and three ophthalmologists) as
      they examined 304 clinic patients. General internists reported less satisfaction
      with their clinics than did the other physicians and attributed their
      satisfaction primarily to successful social interaction in 54% of visits, while
      cardiologists most often derived satisfaction from intellectual stimulation (50%)
      and ophthalmologists from medical success (81%). The general internists whom the
      authors observed are less satisfied with clinical encounters than are
      cardiologists and ophthalmologists and derive satisfaction mostly from social
      interaction, not biomedical aspects of care.

PMID- 1613619
TI  - Adult-onset Still's disease with a significant rheumatoid factor: examining
      proper use of diagnostic and classification criteria.
AB  - A case is presented of a 32-year-old man with classic clinical adult-onset
      Still's disease, who had an initially elevated (1:320) but not persistently high
      rheumatoid factor. Since lack of a high rheumatoid factor is one feature in the
      proposed classification criteria for adult-onset Still's disease, the patient was
      given a diagnosis of rheumatoid arthritis. The faulty reasoning behind this
      diagnosis of rheumatoid arthritis is discussed, focusing on the inappropriate use
      of classification criteria for individual clinical diagnosis, as well as the
      occasional need for longitudinal diagnosis.

PMID- 1613620
TI  - "Optimal" cost-effectiveness analyses?

PMID- 1613621
TI  - When is hospitalization necessary?

PMID- 1613622
TI  - Characterization of the intrinsic properties of the anterior cruciate and medial
      collateral ligament cells: an in vitro cell culture study.
AB  - The poor healing abilities of the anterior cruciate ligament (ACL) in contrast to
      those of the medial collateral ligament (MCL) are well known. Different intrinsic
      properties of the constituent cells of these ligaments have been proposed to be
      one of the factors in the differential repair mechanisms. To examine this
      hypothesis, we have established primary cell lines of ACL and MCL from the tissue
      explants of approximately similar dimensions and have studied their behavior in
      vitro. The outgrowth of cells from ACL explants was slower than from MCL
      explants, as shown by the size of the surrounding clusters of cells. Both ACL and
      MCL cultures exhibited typical fibroblastic morphology. No significant
      differences were observed in either attachment or growth of cells from the
      attached explants derived from various segments of ACL and MCL. Growth curves of
      ACL and MCL cultures at both passage numbers 2 and 6 showed a slower rate of
      proliferation of ACL cells than MCL cells (p less than 0.005). DNA synthesis
      measured in terms of [3H]thymidine incorporation (CPM/10(3) cells) of both log
      phase (ACL = 607.5 +/- 5.4 vs. MCL = 1356.4 +/- 11.3) and confluent (ACL = 83.0
      +/- 3.6 vs. MCL = 189.8 +/- 5.4) cultures, supports the conclusion that
      differential proliferation rates of these cells exist in culture. FITC-phalloidin
      staining (for actin) of later passage cultures (P3-P5) showed a spread-out
      appearance of ACL cells and an elongated appearance of MCL cells. Relatively more
      stress fibers were seen within ACL cells. SDS-PAGE and Western blot analysis of
      cellular proteins revealed higher actin (43 kDa) content in ACL cells than in MCL
      cells. In vitro wound closure assay was performed by creating a uniform wound of
      0.6 mm width in the confluent layer of ACL and MCL cultures. By 48 h
      postwounding, cell-free zones created in ACL cultures were occupied partially by
      single cells in a nonconfluent fashion. In contrast, the wounded zone in the MCL
      cultures was almost completely covered by the cells. Results presented in this
      report demonstrate a lower proliferation and migration potential of ACL cells in
      comparison with MCL cells. These differences in intrinsic properties of ACL and
      MCL cells that were observed in vitro might contribute to the differential
      healing potentials of these ligaments in vivo.

PMID- 1613617
TI  - Medical care of the elderly in the nursing home.

PMID- 1613624
TI  - Healing of the medial collateral ligament following a triad injury: a
      biomechanical and histological study of the knee in rabbits.
AB  - The effect of a partial medial meniscectomy and anterior cruciate ligament (ACL)
      transection on medial collateral ligament (MCL) healing was studied in skeletally
      mature rabbits. Two groups of animals, group I (isolated MCL rupture) and group
      II (MCL rupture with ACL transection and partial medial meniscectomy), were
      examined. At 6 and 12 weeks postoperatively, histological examination of the
      healing MCL and biomechanical evaluation of the varus-valgus (V-V) knee rotation
      and tensile properties of the femur-MCL-tibia complex (FMTC) were performed.
      Group II animals experienced substantial joint degeneration by 6 weeks.
      Progressive osteophyte formation was observed adjacent to the MCL insertions
      along with proximal migration of the MCL tibial insertion between 6 and 12 weeks.
      Histologic examination of the healing MCL substance from both groups showed
      disorganized collagen, inflammation, and fibroblast proliferation that decreased
      over time. For group II knees, the V-V knee rotation was found to be
      significantly elevated (4.7 to 5.2 times the contralateral control), and did not
      decrease with time. In contrast, the V-V knee rotations of the group I specimens
      were 1.8 times greater than control immediately following injury, and approached
      control values by 12 weeks. Tensile testing of the FMTCs revealed that the
      ultimate load increased with time for both groups, but group I had significantly
      higher values than group II. The linear stiffness in group I was not different
      than that group II and did not increase with time. For the mechanical (material)
      properties of the healed MCL substance, the modulus of the healing tissue for
      group II was only 40% that of group I. The structural properties of the FMTC and
      the mechanical properties of the MCL substance from both groups at 6 and 12 weeks
      were significantly different from the contralateral controls. We further
      demonstrated that immediately after ACL reconstruction, the V-V rotation of group
      II knees could be restored to group I levels. Recent clinical studies of MCL
      healing following isolated complete ligament tears have suggested that
      nonoperative management without immobilization leads to excellent treatment
      outcome. However, in more severe injuries involving additional tissues, poor
      quality of the healed ligament tissue and articular degeneration are observed.
      Our results demonstrate the deleterious effects of an untreated triad injury on
      the healing of the MCL substance and its insertions. Examination of the MCL
      substance suggests that a much larger healing mass is formed following a triad
      injury, which partially compensates for inferior ligament mechanical
      properties.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1613623
TI  - Primary and coupled motions in the intact and the ACL-deficient knee: an in vitro
      study in the goat model.
AB  - Quadrupeds are commonly used as animal models to study healing of anterior
      cruciate ligament (ACL) reconstructions. While rabbits, dogs, goats, and sheep
      have been used, goats and sheep are increasingly being employed because of the
      larger joint size that facilitates surgery, ease of availability, and lower
      expense to maintain in the farm environment. In spite of this, little is known
      about the function of the ACL in controlling primary and coupled motions in the
      quadruped. We report here on the measurements of these motions in goats, with the
      application of anterior-posterior forces, varus-valgus moments, and internal
      external moments in the intact and ACL-deficient knee. Sectioning the ACL caused
      significant increases in primary anterior translation, and in varus-valgus and
      internal rotations. The increases in anterior translation were similar in amount
      and dependence on flexion angle to those seen in human knees. The increase in
      varus averaged 7 degrees and did not depend on flexion angle, whereas the
      increase in valgus was significant only in the flexed knee. The increases in
      internal tibial rotation were greatest in extension, whereas the increases in
      external rotation were small and independent of flexion angle. When the ACL was
      cut, coupled internal rotation increased with an anterior force as well as a
      valgus moment. Large increases were seen in coupled anterior translation with the
      application of varus and valgus moments, whereas smaller increases were seen with
      internal and external moments. These findings demonstrate that the ACL restrains
      multiple motions in the goat knee. This study also provides baseline data for
      future studies of ACL reconstruction.

PMID- 1613626
TI  - Quantitation of in situ contact areas at the glenohumeral joint: a biomechanical
      study.
AB  - Glenohumeral arthritis may result from abnormal articular mechanics, and shoulder
      reconstructive procedures often rely implicitly on the belief that the
      restoration of normal articular mechanics is required to obtain satisfactory
      clinical results. Despite this, limited knowledge of normal or pathologic
      glenohumeral joint articular mechanics and contact is available. This study uses
      a stereophotogrammetry technique to determine contact areas in normal cadaver
      glenohumeral joints with intact ligaments and capsule through a large range of
      motion using simulated forces of the four rotator cuff muscles and three deltoid
      heads. All shoulders were first elevated to their maximum elevation in the
      scapular plane at an external rotation (starting rotation = 40 +/- 8 degrees),
      which allowed each shoulder to attain its maximal elevation in the scapular
      plane, and then repeated at 20 degrees internal to this rotation. Contact areas
      consistently increased with increasing elevation until 120 degrees to an average
      of 5.07 cm2 before decreasing with further increased elevation to an average of
      2.59 cm2 at 180 degrees of total arm elevation. At 20 degrees internal to the
      starting rotation, contact areas reached high values 60 degrees earlier (averaged
      4.56 cm2 at 60 degrees of total arm elevation) and then remained fairly constant
      through 120 degrees before decreasing with further increased elevation to 2.51
      cm2 at 180 degrees total arm elevation. With increasing elevation in the external
      starting rotation, humeral head contact dramatically migrates from an inferior
      region to a superocentral-posterior region while glenoid contact shifts
      posteriorly. When the humeral shaft is positioned 20 degrees internal to the
      starting rotation, humeral head contact shifts from inferocentral-anterior to
      superocentral-posterior regions. Simultaneously, a similar posterior shift in
      glenoid contact is observed. Furthermore, whereas only a small portion of the
      humeral head surface area is in contact in any given position, contact on the
      glenoid surface is much more uniformly distributed over its entire articulating
      surface.

PMID- 1613625
TI  - Development of vascularization in the chondroepiphysis of the rabbit.
AB  - Although numerous studies have addressed the presence of cartilage canals within
      developing epiphyses, the chronology of their appearance and their vascular
      contribution to the developing chondroepiphysis remain to be studied. We have
      selected a model, similar to the developing human skeletal system, in which
      extensive cartilage canal development precedes the subsequent secondary
      ossification process. In the rabbit proximal tibia, both chondroepiphyseal and
      vascular (cartilage canals) development were quantified from the first evidence
      of vessels until the formation of the secondary center of ossification. The
      volume of hyaline cartilage increased 25 times after intraepiphyseal vessels were
      initially observed. The blood supply, measured in cartilage canal volume,
      increased 400-fold over the same period. Three distinct cartilage canal
      morphologies were identifiable before the formation of the secondary center of
      ossification: (a) an early phase, in which the canals appeared as infoldings
      derived from the perichondrium; (b) a reactive phase, occurring simultaneously
      with chondrocyte hypertrophy and characterized by a very large increase in
      mesenchymal cells within the cartilage canal; and (c) a vascular phase,
      coincident with mineralization of the matrix, in which the familiar, unitary
      canal morphology was replaced by that of a vascular plexus. While matrix
      mineralization and the formation of bone seem dependent on critical cellular
      events, notably chondrocyte hypertrophy, the role that the vascular supply plays
      in developing sufficient biological inertia for the ossifying transition must not
      be underestimated.

PMID- 1613627
TI  - Contact characteristics of the subtalar joint: load distribution between the
      anterior and posterior facets.
AB  - The pressure distribution properties of the normal talocalcaneal joint were
      studied in 13 fresh cadaver specimens using pressure-sensitive film. The film was
      inserted into the joint through a posterior approach for the posterior facet and
      an anteromedial approach for the anterior/middle facet. Specimens, comprising the
      distal half of the tibia and fibula and the intact ankle and foot, were
      positioned in neutral in the sagittal plane. In the coronal plane, specimens were
      positioned in neutral, inversion, or eversion, and the contact characteristics
      were determined in varying positions, with and without loading the fibula, under
      axial loads of 350 N, 700 N, 1,050 N, and 1,400 N. The transducers were video
      imaged for quantitative analysis of area and pressure. The contact/joint area
      ratio increased significantly with applied load in the posterior facet [e.g., in
      eversion from 0.336 (SD = 0.195) at 350 N to 0.631 (SD = 0.225) at 700 N], as did
      the proportion of the contact area greater than 6 MPa, indicating an increase in
      contact pressure. The contact/joint area ratio was significantly lower in
      inversion than in any other position of the foot; however, high-pressure zones
      were similar, indicating that higher pressures occur in inversion. In the
      anterior/middle facets both contact/joint area ratio and high pressure/contact
      area ratios increased significantly to 700 N, but not with further load increase.
      At 350 N the anterior/middle facet contact area was 31% that of the posterior
      facet, yet it carried 63.3% of the load of the posterior facet, so its mean
      contact pressure was 1.44 MPa compared with 0.93 MPa for the posterior
      facet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613628
TI  - Contact characteristics of the subtalar joint: the effect of talar neck
      misalignment.
AB  - In this study we determined the effects of misalignment of the talar neck on the
      contact characteristics of the subtalar joint. Each of seven fresh cadaver lower
      extremities was mounted in a loading jig and a vertical load was applied, 90% of
      which was directed through the tibia and 10% through the fibula. The foot was
      allowed to displace freely in the horizontal plane so that relative rotations,
      known to occur in the subtalar joint, would not be prevented. Pressure-sensitive
      film, inserted into the posterior and anterior/middle articulations, was used to
      quantify changes in contact characteristics. After testing in the normal
      condition, the talar neck was osteotomized and stabilized with internal and
      external skeletal fixation. Contact characteristics were then determined in each
      of the following stages: anatomic realignment, or with 2-mm displacement of the
      talar neck either dorsally, medially, laterally, or complex (dorsal and varus)
      with respect to the body of the talus. Measurements showed no significant changes
      in overall contact area or high pressure area in the posterior facet, although
      four of the seven specimens demonstrated increased localization of the contact
      area into two discrete regions. The combined anterior/middle facet, on the other
      hand, was significantly unloaded by all but medial displacement of the talar
      neck. An extraarticular load path and/or increased loading directly on the
      talonavicular joint was presumed to account for the loss of load transfer in the
      talocalcaneal joint.

PMID- 1613629
TI  - Correlating magnetic resonance imaging with the biochemical content of the normal
      human intervertebral disc.
AB  - Magnetic resonance imaging was used to determine the T2 relaxation times of
      prepared proteoglycan solutions and of normal human intervertebral disc tissue
      from the annulus fibrosus (AF) and nucleus pulposus (NP). The collagen,
      proteoglycan, and water contents of the disc tissue samples were determined by
      biochemical assays after they were scanned. Correlations among 1/T2, collagen,
      proteoglycan, and water contents of the tissue samples and among 1/T2, water, and
      proteoglycan contents of the proteoglycan solutions were calculated. A moderate
      negative correlation between 1/T2 and water content was noted for the tissue
      samples, and a very high negative correlation was found between 1/T2 and water
      content for the proteoglycan solutions. The very high positive correlation
      between 1/T2 and proteoglycan content of the proteoglycan solutions is probably
      due to this negative correlation between 1/T2 and water content. There was no
      significant correlation between 1/T2 and proteoglycan content of the tissues. The
      moderate positive correlation between 1/T2 and collagen content is probably due
      to the high negative correlation between collagen content and water content. No
      significant correlation was found between the collagen and proteoglycan contents
      of the tissues. Thus it appears that the data confirm previous reports in the
      literature that the collagen of the disc tissue functions to control its water
      content.

PMID- 1613630
TI  - Fibrillar collagen-biphasic calcium phosphate composite as a bone graft
      substitute for spinal fusion.
AB  - The osteoconductive capacity of fibrillar collagen-biphasic calcium phosphate
      composition was compared to autogenous bone in a canine spinal fusion model. All
      animals underwent a standard intervertebral body fusion (L2-L4) with rigid
      internal fixation and received either autogenous bone alone or a mixture of the
      ceramic and autogenous bone (3:1) as the graft material. Animals were followed
      for 12 months and the quality of fusion in each animal assessed by biomechanical
      testing and histological analysis. The fused L2-L4 segment of each dog was
      embedded in bone cement and mounted in a specially designed mechanical tester for
      testing in flexion, extension, and side bending. Overall, the mean rigidity of
      the fusion mass was not significantly different between the two groups [10.5 +/-
      4.1 (SD) for autogenous bone vs. 11.3 +/- 1.7 for the ceramic plus autogenous
      bone, p greater than 0.05]. Similar findings were obtained for mean bending
      moment, compressive load, angular deformation, and energy absorbed for the two
      groups. Histological analysis was performed on transverse nondecalcified
      specimens. Quantitation of bone ingrowth using back-scattered electron imaging
      disclosed no significant differences in the amount of new bone formed at the
      graft site between autogenous bone and the ceramic plus autogenous bone
      recipients (23.4 +/- 10% vs. 25.8 +/- 8.8%) when correction for the autogenous
      bone volumes was performed. Light microscopic analysis of toluidine blue-stained
      transverse sections demonstrated new bone growth around and through the ceramic
      bone graft material. These results suggest that use of a collagen-biphasic
      calcium phosphate ceramic and autogenous bone mixture (3:1) provides a suitable
      osteoconductive alternative to the use of autogenous bone and results in the
      formation of a mechanically competent fusion mass not significantly different
      from that obtained with autogenous bone alone.

PMID- 1613631
TI  - Three-dimensional mechanical properties of the thoracolumbar junction.
AB  - The thoracolumbar junction region is a frequent site of spinal trauma. Accurate
      knowledge of the normal mechanical behavior of the intervertebral joints in this
      region is of importance to the clinician in treating the spinal injuries. The
      present study documented the complete three-dimensional motions of levels T11-T12
      and T12-L1 in the thoracolumbar region. Pure moments of flexion/extension,
      bilateral axial torque, and bilateral lateral bending were applied to 11 three
      vertebrae human cadaveric specimens (T11-L1) to a maximum of 7.5 Nm.
      Intervertebral motions were calculated using stereophotogrammetry and presented
      in the form of load-displacement curves, each containing three rotations and
      three translations at one intervertebral level. Average +/- SD flexion,
      extension, axial rotation, and lateral bending ranges of motion to one side were
      2.7 +/- 1.3 degrees, 2.4 +/- 1.3 degrees, 1.8 +/- 0.7 degrees, and 3.5 +/- 1.1
      degrees, respectively, at level T11-T12. The same ranges of motion at T12-L1 were
      2.9 +/- 1.4 degrees, 3.9 +/- 1.4 degrees, 1.2 +/- 0.7 degrees, and 3.7 +/- 1.1
      degrees, respectively. The extension and axial rotation ranges of motion at level
      T11-T12 were found to be significantly different than the same motions at T12-L1.
      The different geometry in the facet joints explains these observed differences in
      the mechanical behavior of T11-T12 and T12-L1.

PMID- 1613632
TI  - The effects of fluoridated water on bone strength.
AB  - Fluoride from fluoridated water accumulates not only in the enamel of teeth but
      also in the skeleton. The effects of fluoridated water on the skeleton are not
      well understood, yet there is some evidence that fluoridated water consumption
      increases the incidence of fractures. In the present study, femoral bending
      strength was measured in rats on fluoride intakes that ranged from low levels to
      levels well above natural high fluoride drinking water. Bone strength followed a
      biphasic relationship with bone fluoride content. Fluoride had a positive effect
      on bone strength for lower fluoride intakes and a negative influence on bone
      strength for higher fluoride intakes. The vertebral fluoride content at which
      femoral strength was maximum was between 1,100 and 1,500 ppm. The increase in
      femoral strength at this fluoride level was not accompanied by an increase in
      femoral bone density. The optimal fluoride content is within the range of bone
      fluoride contents found in persons living in regions with fluoridated water (1
      ppm) for greater than 10 years.

PMID- 1613633
TI  - Effect of controlled local release of sodium fluoride on trabecular bone.
AB  - Systemic sodium fluoride has been used in the treatment of osteoporosis. Recent
      studies have shown that it has a positive risk/benefit ratio for use in
      increasing spinal trabecular bone density. However, thinning of the cortices of
      the long bones with a resulting increase in fracture incidence has been observed.
      This study was designed to determine the response of bone to sodium fluoride
      released from a biodegradable polymer matrix, a technique which could potentially
      deliver it locally to a site of need in the skeleton which has a positive
      response to fluoride. In one group of mature New Zealand white rabbits,
      cylindrical poly(D,L-lactic acid) (PLA) implants, with or without impregnated
      sodium fluoride, were implanted into the contralateral femoral trochanters and
      tibial metaphyses. In a second group, similar implants were placed in adjacent
      vertebrae. Four weeks postimplantation, the femora, tibiae, and vertebrae were
      removed, sectioned, cleaned of all but mineralized tissue, and the surfaces of
      the sections stained. The stained surfaces were imaged and analyzed for
      morphometric properties of the trabeculae. Comparing contralateral vertebrae,
      those exposed to sodium fluoride had significantly thickened trabeculae, with
      decreased spacing between them and a greater bone fraction. A similar increase in
      trabecular width was found in the subchondral bone of the proximal tibiae exposed
      to local release fluoride. Femoral sections showed no difference, possibly due to
      the lack of extensive trabecular bone in the region chosen for study.

PMID- 1613634
TI  - Nursing assessment of the elderly patient.
AB  - Assessment, the first phase of the nursing process, is the key factor in
      identifying a patient's health care needs. This article addresses the special
      needs of the elderly population and discusses the application of the assessment
      process to the planning and implementation of patient care.

PMID- 1613635
TI  - Intravenous therapy for the elder patient: implications for the intravenous
      nurse.

PMID- 1613636
TI  - Lost in the system.
AB  - Today's health care system is not well suited to the needs of the elder patient.
      The author discusses the dilemmas confronting this patient population, the
      increase in the size of the elder population, and the changing lifestyles of
      elders. It is important for all health care practitioners to recognize and
      understand these issues and assist the elder patient in obtaining quality health
      care.

PMID- 1613637
TI  - The role of the nurse as a patient advocate: a call to action.

PMID- 1613638
TI  - The physiology of aging.

PMID- 1613639
TI  - Use of deacetylated gellan gum (Gelrite) for the production of sulphamethizole
      containing beads.
AB  - Deacetylated gellan gum (Gelrite) was used to produce a bead formulation
      containing sulphamethizole by a hot extrusion process into chilled ethylacetate.
      The spherical dried beads recovered had a porous surface which could be reduced
      in porosity by increasing the Gelrite concentration. Energy dispersive analysis
      showed the drug to be uniformly distributed throughout the beads. Dissolution
      studies confirmed that the drug was slowly released from the beads, the
      retardation of which could be extended by the use of increasing Gelrite
      concentration or by post-treatment of dried beads with either a waxy sealant or
      gamma irradiation. In-vivo studies in dogs confirmed that dried beads prepared by
      extruding a suspension of 10 per cent w/w sulphamethizole in 3 per cent aqueous
      Gelrite dispersion had effective sustained properties on oral dosing in
      comparison to a conventional capsule formulation but had a possible small loss in
      relative bioavailability.

PMID- 1613640
TI  - Influence of the surface properties of low contact angle surfactants on the body
      distribution of 14C-poly(methyl methacrylate) nanoparticles.
AB  - The body distribution of surfactant-coated and non-coated poly(methyl
      methacrylate) nanoparticles with a size of 131 +/- 30 nm after intravenous
      injection into rats was investigated. The coating materials were poloxamine 904,
      poloxamine 908, poloxamine 1508, poloxamer 338, and Brij 35. These materials were
      preselected by the method of contact angle measurement. No overall valid relation
      between contact angles and the modification of body distribution could be found.
      However, the classification of surfactants by determination of the contact angles
      of the surfactant solution on the polymer material seems to be a very helpful
      method for preselection of poloxamers and poloxamines. Another parameter for
      preselection could be molecular weights of the poloxamines. Poloxamine 1508 was
      the most efficient coating material in reducing the liver uptake and increasing
      the blood levels of poly(methyl methacrylate) nanoparticles.

PMID- 1613641
TI  - Influence of drug loading level on drug release and dynamic swelling of
      crosslinked gelatin microspheres.
AB  - The effect of drug loading level both on dynamic swelling and drug release was
      evaluated using crosslinked gelatin microspheres. Owing to water penetration the
      microsphere diameter went first to a maximum value, which was not affected by the
      payload; the diameter gradually approached to an equilibrium swollen value, which
      was affected by drug loading level. Water absorption increases and drug diffusion
      decreases the microsphere diameter. Obviously, the diameter variation depends on
      the factor (water absorption or drug diffusion) predominating in the process. As
      the payload affected only the equilibrium swollen value it is reasonable to
      hypothesize that drug loading level has a greater effect on drug diffusion than
      on polymer relaxation. This rationale could explain the increase of the diffusion
      component of the drug release process as the payload increased.

PMID- 1613642
TI  - Coating charcoal with polyacrylate-polymethacrylate copolymer for haemoperfusion.
      I: Fabrication and evaluation.
AB  - A potential haemoperfusion system has been developed using activated charcoal
      encapsulated with a polyacrylate-polymethacrylate copolymer. The film forms a
      coating of great mechanical strength around the charcoal particles, which is
      readily permeable to water and certain dissolved substances. The charcoal
      granules were coated with various membrane thicknesses consisting of a 2-10 per
      cent (by weight) film coat, using the modified method of non-solvent addition of
      Benita et al. (1985). The effect of various encapsulation variables such as
      stirring rate, rate of addition of non-solvent, percentage of coating polymer and
      concentration of a non-wall-forming polymer (PIB) in the non-solvent phase on
      adsorptivity, as well as the release of fine particles, were determined. The
      effect of coating thickness on the adsorption rate of the coated charcoal was
      investigated by constructing Higuchi diffusion model plots using methylene blue
      as a model adsorbate. It was found that the membrane permeability can be adjusted
      by changing experimental conditions to obtain high adsorption capacity along with
      a low level of released particles. Further, the effect of presoaking of the
      coated charcoal in purified water, normal saline, and 0.067 M phosphate buffer pH
      7.4 (for 24 h at 37 degrees C) on the rate of adsorption of methylene blue was
      also evaluated.

PMID- 1613643
TI  - Plasticizers and their effects on microencapsulation process by spray-drying in
      an aqueous system.
AB  - Microencapsulated theophylline particles were prepared by an aqueous spray-drying
      process using hydroxypropylmethylcellulose. The effect of different plasticizers,
      triethylcitrate, polyethylene glycol, propylene glycol, glycerin and citric acid,
      was investigated. Triethylcitrate, a water-insoluble plasticizer, produced a
      porous honeycomb-like microcapsule wall resulting in rapid drug release. The
      presence of the plasticizers also influenced crystallization of the drug. The
      formation of a solid drug dispersion was observed with the addition of citric
      acid or glycerin. Changes in the pH of liquid feed caused by the plasticizer had
      an effect on the product dissolution profile, but this was not a major factor.
      Formation of pores due to leaching of plasticizers during dissolution enhanced
      drug release. Flow property measurements indicated that the plasticizers also
      affect the cohesiveness of the spray-dried products. Compared to the
      microcapsules formed without any plasticizers, propylene glycol, glycerin and
      citric acid appeared to be beneficial to the microcapsule wall formation, with
      microcapsules containing citric acid having the slowest drug release.

PMID- 1613644
TI  - Microencapsulation of propranolol hydrochloride by the solvent evaporation
      technique.
AB  - Propranolol hydrochloride microcapsules were prepared by the coacervation-phase
      separation induced by solvent evaporation technique. The cellulose acetate
      phthalate was employed as coating material alone and in combination with ethyl
      cellulose. The prepared microcapsules were evaluated for their drug content,
      particle size distribution (microscopic method), flow properties, bulk density,
      in vitro dissolution and drug release kinetics.

PMID- 1613645
TI  - A new approach to encapsulating non-steroidal anti-inflammatory drugs. V.
      Biopharmaceutical study of microcapsules of azapropazone coated with pectin and
      rutin.
AB  - Azapropazone was encapsulated with pectin-rutin mixture using the fluidized bed
      technique. The encapsulated particles showed higher dissolution rate and
      bioavailability but lower ulcerogenic activity as compared with the drug alone.

PMID- 1613646
TI  - Polymers for biodegradable medical devices. IX: Microencapsulation studies;
      effects of polymer composition and process parameters on poly-hydroxybutyrate
      hydroxyvalerate microcapsule morphology.
AB  - Reservoir-type microcapsules were prepared using a double emulsion solvent
      evaporation technique from a series of nine different poly-beta-hydroxybutyrate
      (PHB)-based polymers in which both molecular weight and hydroxyvalerate content
      were varied. Particles prepared from a low molecular weight (MW 43,000)
      homopolymer had a shrivelled appearance, but were not porous. When the molecular
      weight of the fabricating homopolymer was increased to 540,000, however, these
      features disappeared and non-wrinkled particles with microporous surfaces were
      observed. Microcapsules prepared from a high molecular weight copolymer of PHB
      with 10.8 per cent hydroxyvalerate (HV) had a similar appearance, but particles
      prepared from a high molecular weight 20.1 per cent HV copolymer had much
      smoother and less porous surfaces. Lowering the molecular weight of the copolymer
      had the effect of producing particles that were generally distorted in shape and
      had highly irregular, macroporous, surface morphologies. Increasing the double
      emulsion temperature to 40 degrees C at 2 min after phase combination typically
      generated smoother and/or less porous particles and improved the batch yield. The
      numerous factors potentially responsible for the development of morphological
      characteristics of the products are discussed in the light of these observations.

PMID- 1613647
TI  - Process and formulation variables in the preparation of wax microparticles by a
      melt dispersion technique. I. Oil-in-water technique for water-insoluble drugs.
AB  - Ibuprofen-wax (carnauba, paraffin, beeswax, and the semisynthetic glyceryl esters
      -Gelucire 64/02 and Precirol ATO5) microparticles were prepared without organic
      solvents as an alternative to polymeric microparticles. In the melt dispersion
      technique, the drug-wax melt was emulsified into a heated aqueous phase followed
      by cooling to form the microparticles. The microparticles were characterized with
      respect to their drug loading, and morphological and release properties. They
      were spherical and non-agglomerated and drug loading close to 60 per cent were
      achieved. The more hydrophilic waxes (Gelucire 64/02 or Precirol ATO5) could be
      prepared without the use of surfactants. With the other waxes, increasing amounts
      of sodium lauryl sulphate in the external aqueous phase decreased the drug
      loading because of drug solubilization when compared to the polymeric stabilizer,
      poly(vinyl alcohol). The type of wax, the rate of cooling, and the temperature of
      the aqueous phase had no significant effect on the drug loading because of the
      low solubility of the drug in the external aqueous phase. The drug release was
      controlled by the hydrophobicity of the wax. Besides ibuprofen, other water
      soluble drugs (ketoprofen, indomethacin, hydrocortisone) were also encapsulated
      by this method. The wax microparticles could be formulated into an aqueous
      sustained-release oral suspension dosage form.

PMID- 1613648
TI  - An analysis of first-order release kinetics from albumin microspheres.
AB  - Release rates from BSA microspheres prepared from various conditions are analysed
      using a previously reported equation expressing the first-order release rate
      constant. The permeability constants calculated applying the equation on
      experimental release rates are in good agreement with the constants measured from
      permeation studies using planar membrane, for various preparation conditions. It
      is shown that the equation expressing the first-order release rate constant is
      valid more extensively. The permeability constant varies depending on the
      preparation conditions, and the reason for variation is shown clearly to be the
      difference in degree of swelling of the polymer. It was found from regression
      analysis that there is relatively simple correlation between unknown parameters
      of the equation and the preparation conditions. Release rate constants can be
      calculated applying the equation on the known parameters and the estimated values
      of the unknown parameters from the correlation. Good agreement was found between
      the calculated values and experimental ones; therefore, at least as far as we
      examined here, the release rate constant of the microsphere can be estimated from
      the preparation conditions.

PMID- 1613649
TI  - Process and formulation variables in the preparation of wax microparticles by a
      melt dispersion technique. II. W/O/W multiple emulsion technique for water
      soluble drugs.
AB  - Pseudoephedrine HCl-carnauba wax microparticles were prepared by a multiple
      emulsion-melt dispersion technique. A heated aqueous drug solution was emulsified
      into the wax melt (W/O emulsion), followed by emulsification of this primary
      emulsion into a heated external aqueous phase (W/O/W emulsion). The drug
      containing microparticles were formed after cooling and congealing of the wax
      phase. The encapsulation efficiencies were above 80 per cent and actual drug
      loadings close to 50 per cent were achieved. The surface of the microparticles
      had submicron pores and drug crystals were visible on cross-sections. The drug
      loading depended on the rate of cooling and the volume of the internal aqueous
      phase but was insensitive to the volume of the continuous phase. The drug release
      was much faster when compared to the release from polymeric microspheres.

PMID- 1613650
TI  - Psychodiagnosis of personality structure: psychotic personality organization.
AB  - Recent developments in Rorschach psychology, including nomothetic approaches
      focused on scores, ratios, and indices and idiographic approaches focused on
      content emerging from psychoanalytic theory, offer the Rorschach clinician a rich
      and potent interpretive methodology. This article examines the structural
      diagnosis of personality organization with a focus on psychotic personality
      structure. Rorschach approaches to the differential diagnosis of psychotic
      personality organization are presented. The Rorschach is viewed as indispensible
      in the differential diagnosis of personality organization, especially in the so
      called "borderline" cases.

PMID- 1613651
TI  - A psychotic gynemimetic: I just had a pregnant thought.
AB  - Nomothetic and idiographic content analytic approaches to the Rorschach are used
      in complementary fashion to explore the psychotic personality structure and
      primitive interpersonal models in a 37-year-old biologically normal male, who was
      a gynemimetic, that is, a transvestite who aspired to have the genetalia of a
      woman. The Rorschach was riddled with psychotic verbalizations and imagery
      suggesting inadequate differentiation from the original symbiosis, inadequate
      symbiosis anxiety, and significant separation anxiety--a constellation
      culminating in the transsexual fantasy of fusion with the mother.

PMID- 1613652
TI  - A psychotic (sexual) psychopath: "I just had a violent thought ...".
AB  - The case of a 33-year-old White male with a history of sexual assault is
      presented. His Rorschach is analyzed and interpreted using both psychostructural
      (Exner, 1986) and psychodynamic (Cooper & Arnow, 1986; Kwawer, 1980; Meloy &
      Gacono, in press-b) methodologies. Findings are used to understand the presence
      and interaction of both psychopathic character and psychotic personality
      organization in this mentally ill, sadistic, and sexually predatory young man.

PMID- 1613653
TI  - Toward a synthetic approach to the Rorschach: the case of a psychotic child.
AB  - Much Rorschach research on case material focuses on the utility of a single
      scoring system, set of variables, or scale in isolation from other systems,
      scales, or perspectives. This approach fails to acknowledge the complexity of the
      Rorschach and to reflect the manner in which sophisticated clinicians select and
      synthesize various perspectives during the clinical inference and decision-making
      process. A case of a psychotic child is presented to illustrate the utility of a
      synthetic approach to the Rorschach. The strengths and weaknesses of various
      Rorschach perspectives in addressing specific diagnostic issues is explored
      through the case material.

PMID- 1613654
TI  - Affective differences among empirically derived subgroups of headache patients.
AB  - We (Kinder, Curtiss, & Kalichman, 1991) reported four distinct subgroups of male
      and female headache patients based on the results of a cluster analysis of the
      Minnesota Multiphasic Personality Inventory (MMPI). We extended these results by
      providing further descriptive information of the subgroups. The MMPIs of 229 (52
      males and 177 females), composing the second cohort in our (Kinder et al., 1991)
      study of headache patients, were reclassified into subgroups. Differences between
      subgroups on independent measures of anxiety, anger, anger expression, and
      depression were investigated. Significant differences were found among the
      empirically derived subgroups. Results are discussed in the context of previous
      research on headache and back pain patients.

PMID- 1613655
TI  - Form E of the 16PF and adults with mental retardation: internal consistency and
      validity.
AB  - Form E of the Sixteen Personality Factors Questionnaire (16PF-E) was administered
      to 70 adults (45 men and 25 women) who resided in a public facility for mentally
      retarded persons. Alpha coefficients were computed for each of 16 primary trait
      scales. The Intelligence (B), Ego Strength (C), Dominance (E), Superego Strength
      (G), Parmia (H), Protension (L), Autia (M), Shrewdness (N), Guilt Proneness (O),
      and Self-Sentiment (Q3) scales exhibited low internal consistency, whereas
      Premsia (I) and Self-Sufficiency (Q2) evidence relatively higher levels.
      Personality traits of subjects were also assessed by staff ratings. Ratings were
      compared to 16PF-E primary and secondary trait scores via correlation
      coefficients. Results provided virtually no support for the validity of the 16PF
      E primary scales and the Exvia, Anxiety, and Cortertia secondary factors as
      applied to the subject population. Limited support for the validity of the
      Independence secondary factor was found.

PMID- 1613656
TI  - Establishing a Placement Index for behaviorally disturbed children using the Hand
      Test.
AB  - Hand Test variables were evaluated to see if they would empirically discern
      varying levels of behavioral and social maladjustment in severely behaviorally
      handicapped children. Hand Test protocols of 6- to 18-year-old students (N = 100)
      were gathered. Twenty protocols from each of three levels of special education
      placement were obtained in addition to 40 protocols of students enrolled in
      regular educational classrooms. A stepwise discriminant analysis yielded both
      pathology (PATH) and aggression (AGG) as significant discriminators (p less than
      .05). Cutoff scores and a weighted equation consisting of nine variables was
      derived using proper placement in group setting as the criteria. The assignment
      of children to correct placement levels was 64% or 79%, depending on the
      stringency of criteria. These findings reinforce the utility of the Hand Test as
      a valuable tool in the psychologist's testing armament for assisting with
      placement decisions and support the strength of integrating multiple variables to
      aid with these decisions. Replication of this study for the purpose of cross
      validation of the Placement Index is strongly encouraged.

PMID- 1613657
TI  - Revisiting the Rorschach of Sirhan Sirhan.
AB  - The published Rorschach (Kaiser, 1970) of Sirhan Sirhan, the man who assassinated
      presidential aspirant Robert F. Kennedy in 1968, was studied. Psychostructural
      and psychodynamic analyses were conducted using reliable and valid methodology
      that was unavailable at the time of examination. In contrast to the defense
      experts at trial who diagnosed paranoid schizophrenia, the data suggest a
      depressed and suicidal individual organized at a borderline level of personality.
      Character pathology is hysterical, paranoid, and dependent. When the Rorschach
      findings are compared to the development history of Sirhan and the behavior
      around the time of the assassination, the data are somewhat consistent with the
      theme of psychic trauma, are very consistent with the theme of recurrent loss and
      pathological mourning, and validate a characterological distrust and hatred of,
      yet hysterical dependence on, the object world. Rorschach indices of predatory
      violence (Meloy, 1988a) in relation to the planned and purposeful assassination
      are also discussed.

PMID- 1613658
TI  - A conceptual validation study of the texture response on the Rorschach.
AB  - This study addresses the Rorschach texture response (T). The authors proposed a
      developmental line incorporating tactile self-soothing functions and tactile
      aspects of interpersonal closeness and related it to T. It was hypothesized that
      T would be linearly related to one's reliance on tactile cues cognitively by
      categorizing objects according to texture and behaviorally by touching and
      stroking. Subjects were 81 women, between the ages of 18 and 30. The results
      confirm the notion that T is related to both cognitive and behavioral reliance on
      tactile cues. It was also hypothesized that high T subjects, more than others,
      would increase their use of tactile cues and touching when stressed, but this
      hypothesis was not supported. The results were considered to be consistent with
      the proposed developmental line but not for differential regression along the
      line. They also supported T as being related to a tactile mode of information
      processing.

PMID- 1613659
TI  - Concordance of the MCMI-II, the MMPI, and Axis I discharge diagnosis in
      psychiatric inpatients.
AB  - Discriminant functions of the MMPI and the MCMI-II were compared in a sample of
      166 hospitalized psychiatric patients with discharge diagnoses of affective
      disorder (63), schizophrenia (26), substance abuse (35), and other disorders
      (42). Of special interest was the comparative diagnostic utility of the two
      instruments in regards to DSM-III-R Axis I diagnoses. Both tests performed
      reasonably well in the discriminant function analyses; however, the MCMI-II
      achieved a somewhat superior overall hit rate with this sample of inpatients (79%
      to 68%). This difference was tied to greater accuracy of the MCMI-II for
      identifying the affective disorders group.

PMID- 1613660
TI  - Clinical validity of a Personality Inventory for Children (PIC) profile typology.
AB  - We evaluated the validity of a profile typology for the Personality Inventory for
      Children (PIC), a parent-informant measure of child psychiatric status. For
      referred children, we studied (a) the convergence of PIC profile types with
      diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders
      (3rd ed., American Psychiatric Association, 1980) and (b) the incremental
      validity of the PIC over diagnoses in the prediction of symptom ratings completed
      by teachers and clinicians. We found a high diagnosis-PIC correspondence only for
      developmentally disordered children; the overlap for children with emotional
      conduct problems was poor. For the latter group, however, the correlation of
      diagnoses with symptom ratings was low, but the incremental validity of the PIC
      over diagnoses was high. We discuss the use of this profile typology in the
      clinical evaluation of children and present a case example.

PMID- 1613661
TI  - The impact of theory on psychological testing: how psychoanalytic theory makes
      diagnostic testing more enjoyable and rewarding.
AB  - Systematically applying psychoanalytic theory to psychological testing cultivates
      a practical, useful, and enjoyable experience of test administration, test
      scoring, and test interpretation. Furthermore, by grounding psychological testing
      in psychoanalytic theory, testing becomes rewarding because there is a lively
      clinical interplay between testing and psychotherapy. These potential sources of
      enjoyment and skill for the psychological examiner are explored, and several
      clinical examples are given for illustrative purposes. The need to appreciate the
      impact of a given theoretical frame of reference is highlighted.

PMID- 1613662
TI  - Infection of cynomolgus monkeys with a chimeric HIV-1/SIVmac virus that expresses
      the HIV-1 envelope glycoproteins.
AB  - Replication competent chimeric viruses that express the gag and pol proteins of
      SIVmac and the env proteins of HIV-1 were made. One such chimeric virus, SHIV-4,
      that expresses the vif, vpx, vpr, and nef regulatory genes of SIV and the tat and
      rev regulatory genes of HIV-1 replicated efficiently in cynomolgus monkeys. This
      model system can be used to evaluate the efficacy of anti-HIV-1 vaccines directed
      at the envelope glycoproteins, anti-HIV-1 envelope glycoprotein antiserum or
      monoclonal antibodies, and anti-HIV-1 drugs designed to inhibit the tat, rev, or
      env functions.

PMID- 1613663
TI  - CD4-mimicking antibodies in HIV-positive and normal human sera.
AB  - An earlier study showed that approximately 5% of HIV-seropositive human sera
      contain gp120 antibodies that mimic CD4, seen as anti-idiotypic to the CD4
      monoclonal T4.2. The present study shows the existence of a second type of CD4
      mimicking gp120 antibody, which specifically binds to the CD4 monoclonal, OKT4A.
      This anti-idiotypic antibody to OKT4A is less frequent than the antibody reacting
      with T4.2. In two patients studied, this OKT4A binding antibody seems to appear
      as early during infection as the anti-idiotypic antibody to T4.2; however, the
      concentration varies more with time. In order to evaluate the possible clinical
      relevance of these CD4-mimicking antibodies, sera from 208 HIV-seropositive and
      204 healthy seronegative individuals were screened. There was a significantly
      higher frequency of anti-idiotypic antibodies to T4.2 among HIV-positive
      individuals compared to healthy controls (p = 0.05). However, no correlation was
      found between the presence of CD4-mimicking antibodies and clinical
      classification of HIV-infected individuals.

PMID- 1613664
TI  - Cytokine activation of human macrophages infected with HIV-1 to inhibit
      intracellular protozoa.
AB  - Peripheral blood mononuclear cells (PBMCs) from HIV-seronegative donors were
      infected in vitro with HIV-1. Infection was monitored by cytopathology,
      supernatant p24 antigen, and by immunocytochemical staining. After 14 days in
      culture, approximately 70-90% of the cells became infected with HIV, as indicated
      by cell fusion and immunostaining for virus. At this time, recombinant HuIFN
      gamma was added to the cultures, followed by infection 24 h later with the
      intracellular protozoan parasites Toxoplasma gondii, Trypanosoma cruzi, or
      Leishmania chagasi. Percentages of intracellular parasites were determined at
      various points thereafter. Using a system capable of detecting both virus and
      parasite infection, we determined that (a) cells infected with HIV were capable
      of ingesting and/or being infected by each of these parasitic protozoa, (b) HIV
      infected macrophages could be activated to inhibit the replication of all three
      parasites following treatment with IFN-gamma, and (c) cultures of HIV-infected
      macrophages could respond to IFN-gamma with increased oxidative burst activity.
      The degree of parasite infection or inhibition observed in infected cells was not
      significantly different from that observed in non-HIV-infected cells. From these
      observations, we concluded that HIV-1 infection does not render macrophages
      unresponsive to IFN-gamma activation for microbicidal activity.

PMID- 1613665
TI  - One-year follow-up of vaccine therapy in HIV-infected immune-deficient
      individuals: a new strategy.
AB  - Immunization of AIDS/ARC patients with autologous cells expressing HIV antigens,
      although providing clinical and biological benefits, fails to restore cellular
      immunity. The latter result is due partly to the antiproliferative effect of HIV
      1 on activated T-cells (immune suppression), which leads to blockade of specific
      immune reactions. To overcome immune suppression, a new vaccine strategy was
      designed consisting of an immunization against HIV-1 combined with components of
      the T-cell-suppressive (antiproliferative) network. This new vaccine treatment
      proved to be innocuous in mice, monkeys, and two non-HIV-infected humans. A Phase
      I clinical trial was performed in six patients previously under cellular
      immunotherapy and still presenting a cellular immune defect. Preliminary results
      confirmed, after a 1-year follow-up of the patients, the safety of the new
      vaccine, which also partially restored the cellular immune response, including
      anti-HIV HLA-restricted cell-mediated cytotoxicity, delayed hypersensitivity to
      recall antigens, and proliferation of T-cells specifically activated by recall
      antigens.

PMID- 1613667
TI  - Premature mortality related to HIV infection in California 1981-1993.
AB  - The number of years of potential life lost (YPLL) before age 65 was used to
      compare the effects of HIV on premature mortality versus other causes of death in
      California from 1981 to 1993. Using California AIDS case surveillance data, YPLL
      associated with HIV rose from 629 in 1981 to 120,721 in 1989, and is projected to
      reach 188,000 in 1993 (plausible range, 155,000-285,000). In 1989, HIV ranked
      fourth in YPLL behind all malignant neoplasms, traffic-related motor vehicle
      accidents, and all heart diseases. By 1993, if current mortality trends continue,
      HIV is projected to be the leading single cause of YPLL in California ahead of
      all malignant neoplasms (184,597 in 1989), motor vehicle-related YPLL (163,038 in
      1989), and all heart diseases.

PMID- 1613666
TI  - A comparison of younger and older gay men's HIV risk-taking behaviors: the
      Communication Technologies 1989 Cross-Sectional Survey.
AB  - Data from the 1989 Communication Technologies cross-sectional survey of gay men
      in San Francisco indicate that both levels and correlates of sexual risk are
      different between younger and older gay men. Gay men under the age of 30 report
      higher risk behavior for human immunodeficiency virus (HIV) infection than do gay
      men who are 30 years of age or older. Further, the set of correlates of
      unprotected anal intercourse are different between younger and older gay men.
      Both young and old gay men report that having a primary partner and a lower
      perceived impact of the AIDS epidemic on their sexual behavior are associated
      with risk. However, among young gay men, reporting a lower attributed risk for
      HIV infection to unprotected anal intercourse, higher concern about AIDS risks,
      and shorter length of residence in San Francisco are positively correlated with
      risk-taking behavior. These associations were not statistically significant among
      gay men 30 years of age or older. It appears that the circumstances and/or
      reasons for taking sexual risk are different between older and younger gay men.
      Prevention programs must be designed so that they are sensitive to the needs of
      each generation of gay men.

PMID- 1613668
TI  - Prognostic indicators for development of AIDS among intravenous drug users.
AB  - A cohort of 544 human immunodeficiency virus-1 (HIV-1) seropositive intravenous
      drug users (IVDUs) was recruited in 1988 and early 1989; data on laboratory
      markers, clinical symptoms, intravenous drug use, and demographics were
      collected. Forty-one IVDUs developed AIDS within 2 years of enrollment. Data were
      analyzed using methods of survival analysis. None of the individuals reported use
      of antiviral agents or Pneumocystis carinii prophylaxis at baseline. A very
      strong (p less than 0.001) dose-response relationship was identified between CD4
      cell count at baseline and the subsequent development of AIDS. In multivariate
      analysis, both the presence of more than one clinical HIV-1-related symptom and
      serum neopterin greater than 12 nmol/L showed significant associations with the
      relative hazard (95% confidence interval) of AIDS after controlling for CD4 of
      2.9 (1.6, 5.6) and 2.0 (1.0, 3.7), respectively. In these IVDUs, serum beta 2
      microglobulin did not add predictive power for progression to AIDS. The effect of
      clinical symptoms was stronger for high CD4 cell counts, indicating the need to
      monitor HIV seropositive IVDUs with both laboratory studies and clinical
      evaluation.

PMID- 1613669
TI  - A model predicting dentists' willingness to treat HIV-positive patients.
AB  - Data for this study of dentists' willingness to treat HIV-positive (HIV+)
      individuals were derived from a survey of a probability sample of American
      general practitioner dentists (GPD). Data were received from 1,351 active GPD,
      which represented an 88% response rate. Because the outcome measure--willingness
      to treat HIV+ patients--is dichotomous, i.e., yes/no, logistic regression was
      selected as the statistical technique to be used for the creation of a predictive
      model. Seventeen independent variables were initially considered. The final and
      most parsimonious model contains six independent variables, of which perceived
      safety in treating HIV+ patients has the most predictive power. Fear of
      consequences for the practice, if HIV+ patients were seen, was also a powerful
      predictor, with a sense of ethical responsibility and a past history of treating
      HIV+ patients also being important predictive variables. Knowledge level about
      transmission of HIV and concern about risks associated with treating homosexuals
      were also significant.

PMID- 1613670
TI  - Human immunodeficiency virus DNA copies as a virologic marker in a clinical trial
      with beta-interferon.
AB  - The number of human immunodeficiency virus (HIV) DNA copies in peripheral blood
      mononuclear cells (PBMC) was quantitated by the polymerase chain reaction (PCR)
      and used as a virologic marker in a clinical trial with beta-interferon (beta
      IFN) (6 x 10(6) IU/day administered intravenously for 4 weeks). In 11 HIV
      infected patients who were clinically stable, the number ranged from 10 to 1,063
      copies per 10(5) PBMC. However, percent change of the number in the individual
      untreated patients stayed between -46.2% and 203.0% of the basal level by one
      month interval. In six patients who were treated with beta-IFN, changes in the
      number were not significant before and after the trial.

PMID- 1613671
TI  - Physicians' attitudes toward assisted suicide in AIDS.
AB  - We investigated factors influencing attitudes and practices among San Francisco
      physicians toward physician-assisted suicide in the context of AIDS. To explore
      this topic a questionnaire was developed for use in comparing two physician
      groups. This self-administered instrument was completed by 69 physician members
      of the San Francisco County Community Consortium (CCC), a community-based
      clinical research organization whose members care for persons with human
      immunodeficiency virus (HIV) disease. A comparison group consisted of 86 randomly
      sampled San Francisco physicians recruited from the California Medical
      Association mailing list. Anonymity of respondents was maintained. Chi-squares
      and t-tests were conducted to compare physician groups with regard to
      demographics and experiences with AIDS. Factor analytic techniques and
      correlational analyses were used to identify attitudinal and behavioral
      predictors of willingness to assist in a patient suicide. Twenty-three percent of
      the total sample would be likely to grant the patient's initial request for
      assistance in committing suicide. When faced with an adamant request, CCC members
      would be more likely to assist than comparison group physicians. Ethical beliefs
      were the strongest predictor of physicians' intention to assist. Identification
      with the AIDS patient also had significant predictive value.

PMID- 1613672
TI  - B-cell activation and differentiation by HIV-1 antigens among volunteers
      vaccinated with VaxSyn HIV-1.
AB  - The generation of memory B cells in response to vaccination with a baculovirus
      derived recombinant gp160 candidate AIDS vaccine, VaxSyn HIV-1, was investigated
      in 12 healthy human volunteers who were immunized with VaxSyn HIV-1, hepatitis B
      vaccine, or alum adjuvant alone on days 1, 28, 180, and 540. Peripheral blood
      mononuclear cells were collected pre- and post-immunization and cultured
      unstimulated or with pokeweed mitogen (PWM), VaxSyn HIV-1 (rgp160), or HIV-1
      lysate (iHIV-1) for 7 days before polyclonal and HIV-1-specific IgG production in
      culture supernatants (SNs) were measured. No differences were seen in the
      spontaneous or PWM-induced IgG production in SN from vaccinees and controls. Only
      vaccinee SN contained higher-than-normal levels of polyclonal IgG after
      stimulation with either rgp160 or iHIV-1, especially after the second and third
      booster immunizations on days 180 and 540, respectively. There were also
      contemporaneous increases in HIV-1-specific antibody in SN of all vaccinees,
      albeit at different time points throughout the study. We conclude that VaxSyn HIV
      1 induces antigen-specific B-cell responses with the generation of memory B cells
      in vivo that can be reactivated in vitro to deliver an anamnestic response.

PMID- 1613673
TI  - Adjunctive corticosteroid therapy for Pneumocystis carinii pneumonia in AIDS: a
      randomized European multicenter open label study.
AB  - Fifty-nine human immunodeficiency virus type-1-infected patients with a
      microscopically proven first episode of moderate to severe Pneumocystis carinii
      pneumonia (PCP) were enrolled into a randomized European multicenter study. The
      effect of adjunctive corticosteroid (CS) therapy was assessed on (a) survival to
      discharge, (b) need for mechanical ventilation, and (c) survival at day 90. CS
      was given within 24 h of standard therapy as intravenous methylprednisolone 2
      mg/kg body weight daily for 10 days. All patients received cotrimoxazole as
      standard treatment. Inclusion criteria were a PaO2 less than 9.0 kPa (67.5 mm Hg)
      and/or a PaCO2 less than 4.0 kPa (30.0 mm Hg) while breathing room air. During
      the acute episode of PCP, 9 (31%) of the 29 control patients died versus 3 (10%)
      of the 30 CS patients; p = 0.01. Mechanical ventilation was necessary in 15
      patients; 12 (41%) in the control group and 3 (10%) in the CS group; p = 0.01.
      The 90-day survival was 69% in controls versus 87% in CS patients; p = 0.07.
      Based on these data we conclude that adjunctive CS therapy for moderate to severe
      PCP in AIDS patients reduces the acute mortality and the need for mechanical
      ventilation.

PMID- 1613674
TI  - Influence of treatment with zidovudine (ZDV) on the long-term survival of AIDS
      patients.
AB  - The influence of treatment with zidovudine (ZDV) and other factors on long-term
      survival of AIDS patients was analyzed in a cohort of 629 adults. A total of 434
      (69%) were diagnosed before ZDV became routinely available in Spain (December
      1987) or refused the drug, while the remaining 195 (31%) received ZDV (starting
      at a dose of 750-1,200 mg/day). A total of 412 (65.5%) were parenteral drug
      addicts and 217 (34.5%) male homosexuals. Two hundred thirty-two (36.9%)
      presented with a tuberculosis, 303 (48.2%) with other opportunistic infections,
      69 (11%) with Kaposi's sarcoma, and the remaining 25 (4%) with a lymphoma. By
      December 1990, 251 (39.9%) of the 629 have already died with a cumulative
      survival probability of 50.6% after 2 years (45.3-55.9%; 95% confidence
      interval). When patients receiving ZDV were compared with those untreated, the
      estimated survival probability was significantly (p less than 0.0001) higher (89%
      vs. 59% after 1 year, 69% vs. 48% after 2 years, and 55% vs. 40% after 3 years).
      Moreover, treatment with ZDV (p less than 0.0001) together with being less than
      45 years old (p less than 0.0001), being a parenteral drug addict (p = 0.016),
      and presenting with tuberculosis (p less than 0.0001) were the factors selected
      by the multivariate analysis as independently improving the prognosis. In
      conclusion, adult AIDS patients (homosexual or drug addicts) may benefit from
      treatment with ZDV, at least during 3 years.

PMID- 1613675
TI  - HTLV-I and HTLV-II infection in Uruguay.

PMID- 1613676
TI  - Clinical characteristics of male homosexual/bisexual HIV-infected prison inmates.

PMID- 1613677
TI  - Influence of gender, age, and transmission category on the progression from HIV
      seroconversion to AIDS.

PMID- 1613678
TI  - Nimodipine in acute alcohol withdrawal state.
AB  - The effect of the calcium channel blocker, nimodipine, in acute alcohol
      withdrawal was investigated in a randomized, placebo controlled, double blind
      study. Thirty-two male patients with a history of alcohol dependence according to
      DSM-III criteria, but no other substance abuse, were included. A new rating
      instrument which fulfilled theoretical test criteria was applied to determine the
      severity of the alcohol withdrawal state. The patients received nimodipine or a
      placebo on four separate occasions (4 x 60 mg) and, in addition, clomethiazole,
      according to a standardized procedure. Our investigation has shown that, in the
      first 48-72 h of alcohol withdrawal, both groups consumed similar amounts of
      additional clomethiazole medication. Thus, no significant effect of nimodipine on
      the acute alcohol withdrawal state could be demonstrated. There was some tendency
      for nimodipine to ameliorate psychosensory dysfunction.

PMID- 1613679
TI  - Leukocytosis, monocytosis and neutrophilia: hallmarks of severe depression.
AB  - To date, there has been a small number of reports that severe depression is
      accompanied by disturbances in total white blood cell (i.e. leukocytosis) and
      leukocyte subset (i.e. neutrophilia, monocytosis, lymphopenia) counts. These
      results, however, have not yet been validated in a large-scale, well-controlled
      study. To this end, we have counted the number of leukocytes, monocytes,
      lymphocytes and granulocytes (neutrophils, eosinophils, basophils) in 22 healthy
      controls and in 109 depressed inpatients. We noted leukocytosis in major
      depressed patients compared with normal subjects, whilst minor depressives
      manifested intermediate findings. Leukocytosis was significantly more pronounced
      in major depressed males compared with major depressed females. Major depression
      related leukocytosis appears to be characterized by neutrophilia and monocytosis.
      There was a significant positive relationship between the overall severity of
      illness on one hand, and the degrees of leukocytosis, neutrophilia and
      monocytosis on the other. The total number of both phagocytic cell populations
      (i.e. monocytes and neutrophils) was significantly and positively related. Our
      results might point to the existence of an inflammatory process in major
      depressed subjects, particularly in males.

PMID- 1613680
TI  - Ascertaining psychiatric diagnoses with the family history method in a substance
      abuse population.
AB  - Research investigating patterns of familial aggregation of psychiatric disorders
      has used the family history method in which a single family member reports on the
      psychiatric history of their relatives. This method is more efficient and less
      costly than the family study method, in which direct interviews are performed on
      as many family members as possible. The family history method has been shown to
      have good specificity, in family studies of depression, but sensitivity has been
      less acceptable. The present study is the first study to report on the
      sensitivity and specificity of five psychiatric diagnoses made in a substance
      abusing population using the family history method. Among substance abusers and
      their family members, substance abuse is the most accurately diagnosed disorder.
      However, among family members only, the accuracy of diagnosing substance abuse
      declines significantly. Spouses and offspring are better informants than parents
      or siblings, and female relatives are better informants than male relatives. When
      more than one informant is available and positive diagnoses are determined by any
      positive family report, sensitivity for most disorders increases significantly.
      The results are discussed in terms of increasing the accuracy of the family
      history method.

PMID- 1613681
TI  - Behavioral contagion in sibships.
AB  - A behavior is "contagious" if one person is more likely to exhibit it when a
      relevant other person has already done so. In this sense, behavioral contagion is
      commonly thought to contribute to many social problems, such as drug abuse and
      teenage promiscuity. In this paper we focus on behavioral contagion in sibships.
      Borrowing a model from the theory of contagious diseases, we show that contagion
      will cause prevalence to increase with sibship size. This model also allows us to
      estimate the magnitude of the contagious factor relative to non-contagious
      factors. Finally, we develop two statistical tests for the presence of contagion.
      Results are presented for participation in a skill-development program and four
      child-psychiatric conditions: neurosis, hyperactivity, somatization, and conduct
      disorder. Evidence is presented that program participation is probably contagious
      and conduct disorder possibly so. The other three child-psychiatric conditions
      are shown not to be contagious. Implications for research and practice are
      discussed.

PMID- 1613682
TI  - Midazolam shortens seizure duration following electroconvulsive therapy.
AB  - In an open, prospective clinical trial, midazolam anaesthesia was compared with
      thiopental (plus suxamethonium chloride as a muscle relaxant) to clinically
      evaluate the former as an anaesthetic and a muscle relaxant during
      electroconvulsive therapy (ECT). Twelve depressed patients underwent a course of
      ECT, receiving midazolam or thiopental anaesthesia alternatively. Significant
      differences were found in seizure duration between the two anaesthetics.
      Midazolam shortened the seizures to a duration that was not therapeutically
      desirable. There were no differences in stimulus parameters between the two
      groups. The muscle relaxant effect of midazolam failed to provide optimal
      paralysis. Thus, midazolam anaesthesia offers no advantage over standard
      anaesthetic agents for ECT.

PMID- 1613683
TI  - Therapy through art. Facilitating treatment of sexual abuse.
AB  - 1. Infants and preverbal children encode memory through visual and sensorimotor
      channels, and there is evidence that at times of intense stress and terror, the
      cognitive memory system may be bypassed in all age groups. 2. Art therapy offers
      visual and sensorimotor media that may more easily allow repressed traumatic
      memories to surface. 3. Art therapy is often used with children and adolescents
      to overcome resistance, build trust, reduce tension, and stimulate memory. It may
      also be useful in working with adults, because the repression occurred at a much
      earlier developmental stage, the adult may also have a child's concept of the
      traumatic event.

PMID- 1613684
TI  - Normal pressure hydrocephalus. A potentially reversible form of dementia.
AB  - 1. Normal pressure hydrocephalus (NPH) is a rare but potentially treatable form
      of dementia. Shunting will improve functioning in 40% to 50% of patients. 2. The
      classic symptoms of NPH are dementia characterized by mild memory impairment and
      apathy, ataxic gait, and urinary hesitancy or incontinence. 3. The patient with
      NPH may present with psychiatric symptoms of depression, paranoia, visual
      hallucinations, irrational hostility, and aggression or mania. 4. Patients with
      NPH are indifferent about activities of daily living and personal safety and
      require close supervision.

PMID- 1613685
TI  - Traumatic war. Stress & schizophrenia.
AB  - 1. An examination of the effects of the Lebanese war on the citizens found that
      traumatic war events can be regarded as of primary importance for risk factors
      triggering the onset of schizophrenia. 2. The overall findings indicate an
      increase in the rate of admission for men diagnosed with schizophrenia throughout
      the 12 years of the war. The most significant increases occurred either following
      intensive fighting episodes or months later due to the additive effect of stress.
      3. How soon individuals are affected by environmentally induced war stress may be
      related to their level of vulnerability to the disorder.

PMID- 1613686
TI  - Xanax: pros and cons.

PMID- 1613687
TI  - Confessions of a geriatric nurse researcher.

PMID- 1613688
TI  - Bottom line.

PMID- 1613689
TI  - Where assault begins.

PMID- 1613690
TI  - Psychiatric triage: a cost-effective approach to quality management in mental
      health.
AB  - As seen from this trial program, psychiatric triage in the ED is potentially a
      very effective tool for improving the quality of mental health patient care. For
      a minimal investment in personnel, there is a potential for a major improvement
      in patient care, patient record documentation, interdepartmental relations, and
      financial reimbursement to the institution.

PMID- 1613691
TI  - How to reduce the risk of HIV infection for the seriously mentally ill.
AB  - 1. The professional literature increasingly indicates the need to educate persons
      with serious mental illness regarding HIV/AIDS. 2. Community-based organizations
      currently responding to the AIDS epidemic are poorly equipped to respond to the
      special needs of persons with serious mental illness. 3. Persons with serious
      mental illness are concerned by HIV/AIDS. Some, however, will incorporate
      education into their pathology via delusional systems or misunderstandings. 4.
      Effective programs for this population can be developed following community
      health nursing principles.

PMID- 1613692
TI  - Steroids in rheumatoid arthritis: the honeymoon revisited.

PMID- 1613693
TI  - Microfocal radiography with macroradiographs in osteoarthritis--does it hit the
      spot and show the big picture?

PMID- 1613694
TI  - Why everything (or nothing) seems to work in the treatment of scleroderma.

PMID- 1613695
TI  - Inhibition of type II collagen induced arthritis in mice by an immunosuppressive
      extract of Tripterygium wilfordii Hook f.
AB  - The effects of Tripterygium wilfordii Hook f (TWHf), a Chinese herbal remedy, on
      type II collagen induced arthritis (CIA) in DBA/1LacJ mice were determined. Mice
      were divided into 4 groups receiving oral treatment for 63 days: Group A, sham
      feedings; Group B, TWHf (78 mg/day); Group C, TWHf (140 mg/day); Group D, TWHf
      (140 mg/day) starting 21 days after collagen immunization. Arthritis incidence
      was reduced and day of onset delayed in Groups B and C compared with A. Arthritic
      joint counts, arthritic severity scores, and anticollagen antibody titers were
      decreased in Groups B, C, and D compared with A. Histopathology revealed
      destructive arthritis only in Group A. Our results indicate that TWHf is a potent
      immunosuppressive inhibitor of CIA, even when treatment is begun 3 weeks after
      immunization.

PMID- 1613696
TI  - Polyamine levels in synovial tissues and synovial fluids of patients with
      rheumatoid arthritis.
AB  - We determined the polyamine contents of the synovial tissues from 11 patients
      with rheumatoid arthritis (RA), and the free putrescine levels in the synovial
      fluids (SF) from 10 patients with RA, 7 with osteoarthritis (OA), 5 with
      posttraumatic arthritis, and 3 with infectious arthritis. Putrescine levels in
      the synovial tissues correlated with serum C reactive protein concentration in
      patients with RA. Free putrescine levels in SF were significantly elevated in
      patients with infectious arthritis, compared with those found in RA, OA, and
      posttraumatic arthritis. Free putrescine levels in SF from patients with RA were
      significantly higher than in those with OA. Our findings suggest that polyamines
      may play an important role in RA.

PMID- 1613697
TI  - c-myc mRNA expression in minor salivary glands of patients with Sjogren's
      syndrome.
AB  - c-myc protooncogene is implicated in the pathogenesis of B cell lymphoid
      malignancies and high levels of c-myc mRNA expression are observed in activated
      blood mononuclear cells. Sjogren's syndrome (SS) is characterized by lymphocytic
      infiltrates of exocrine glands, remarkable B cell hyperreactivity and a strong
      predisposition to B cell neoplasia. In this study, c-myc protooncogene mRNA
      expression in 29 labial minor salivary gland biopsies from patients with primary
      SS and 15 controls was examined using in situ hybridization histochemistry. Two
      40mer oligonucleotides from the 1st and the 2nd exon of the c-myc gene, labeled
      with 35S, were used as probes. To detect the origin of the cell hybridized with a
      c-myc probe, a combined immunochemistry in situ hybridization histochemistry
      technique was used. High c-myc mRNA expression was detected on acinar epithelial
      cells. c-myc did not correlate with c-fos and c-jun protein expression. Stronger
      c-myc mRNA expression was detected in labial salivary glands of patients with
      longer disease duration (p less than or equal to 0.002) and more intense T
      lymphocyte infiltrates (p less than 0.05) although these patients revealed no
      hypergammaglobulinemia. No correlation was observed between c-myc mRNA and B
      lymphocyte monoclonicity or lymphoma. In conclusion, strong c-myc mRNA expression
      was observed on epithelial cells of labial salivary glands from patients with
      primary SS. Our findings may indicate the presence of a reactivated virus hosted
      in these cells.

PMID- 1613698
TI  - Life table analysis of 879 treatment episodes with slow acting antirheumatic
      drugs in community rheumatology practice.
AB  - In 596 patients with RA managed over a decade in a community practice setting,
      879 slow acting antirheumatic drug (SAARD) treatment episodes were analyzed using
      5-year life tables. The probability of continuation of therapy was 50% by 9-24
      months for all drugs except for methotrexate (MTX), which was 62% by 5 years
      [corrected]. MTX treatments were of significantly longer duration than those of
      all other SAARD (p less than 0.001); terminations for both inefficacy (p less
      than 0.001) and toxicity (NS) were less likely. These findings concur with recent
      evidence suggesting that MTX is a superior SAARD in this setting.

PMID- 1613699
TI  - Illness intrusiveness in rheumatoid arthritis: differential impact on depressive
      symptoms over the adult lifespan.
AB  - Depressive symptoms in rheumatoid arthritis (RA) were hypothesized to derive from
      illness intrusiveness--illness-induced lifestyle disruptions. Differences over
      the adult lifespan were also investigated in 110 outpatients with RA, aged 24-78
      years who completed standardized psychological tests. A significant Age x Illness
      Intrusiveness interaction indicated that depressive symptoms intensified more
      sharply among comparatively younger vs older individuals as the intrusiveness of
      RA increased. We conclude illness intrusiveness is an important determinant of
      depressive symptoms in RA. However, its impact may vary over the course of adult
      psychological development.

PMID- 1613700
TI  - A double blind placebo controlled trial of recombinant tissue plasminogen
      activator in the treatment of digital ischemia in systemic sclerosis.
AB  - The treatment of digital ischemia in systemic sclerosis remains inadequate. We
      report a double blind, placebo controlled trial of recombinant tissue plasminogen
      activator (rtPA), a potent thrombolytic agent. Ten patients received rtPA. A
      potent, acute fibrinolytic effect was observed. During the infusion of rtPA,
      improvements in skin blood flow were seen. These improvements were shortlived.

PMID- 1613701
TI  - Hypersensitivity vasculitis and Henoch-Schonlein purpura: a comparison between
      the 2 disorders.
AB  - Leukocytoclastic vasculitis of small vessels and predominant involvement of the
      skin are common features of both hypersensitivity vasculitis (HV) and Henoch
      Schonlein purpura. In a study comparing 93 patients with HV and 85 patients with
      Henoch-Schonlein purpura we found major differences with respect to frequencies
      and type of organ involvement (gastrointestinal tract, kidneys, skin and joints)
      which were present in both younger and older patients when analyzed separately.
      To investigate which clinical criteria best differentiate between these 2
      vasculitides, 2 methodologies were employed. A rule requiring 3 or more criteria
      to be present from a list of 6 yielded 87.1% of correctly classified Henoch
      Schonlein purpura cases; and 2 or fewer criteria from the same list of 6
      correctly classified 74.2% of HV cases. A classification tree was associated with
      respective values of 83.5 and 84.9%. The results indicate that HV and Henoch
      Schonlein purpura are similar but separable clinical syndromes.

PMID- 1613702
TI  - The absence of factor B activation products in scleroderma.
AB  - Previous investigators have reported the presence of complement activation
      products in scleroderma. Using an assay consisting of isoelectric focussing
      followed by immunofixation (IEF/IF) for alternative pathway activation product
      Ba, and an ELISA for C3d that we developed for evaluating lupus plasmas, we
      assayed 48 plasmas from patients with diffuse cutaneous scleroderma, 16 patients
      with the limited CREST variant, 2 patients with mixed connective tissue disease
      (MCTD) and 4 patients with Raynaud's disease. Ba was not detected in any
      patient's plasma. Only one plasma from a patient with CREST contained elevated
      levels of C3d. We cannot reconcile the absence of B activation products in our
      patients with scleroderma with the results of the previous report, and conclude
      that further studies are necessary.

PMID- 1613703
TI  - Brain pathology in systemic lupus erythematosus.
AB  - Brain pathology was documented in 10 patients with systemic lupus erythematosus
      (SLE), 7 of whom had clinical neuropsychiatric SLE prior to death. This was
      manifested by seizures (5 patients), organic brain syndrome (3 patients) and
      psychosis (2 patients). Multifocal cerebral cortical microinfarcts, associated
      with microvascular injury, were documented in 4 patients and in our study
      constituted the predominant histopathologic abnormality attributable to SLE.
      Changes of a healed vasculitis in medium sized leptomeningeal vessels were seen
      in 1 case. Agreement between the clinical and pathologic classification of
      neuropsychiatric SLE was observed in 7/10 (70%) cases and the strongest
      association was between the presence of cerebral microinfarcts and seizures (4/5
      patients, p less than 0.05). No correlation was observed with anticardiolipin,
      anti-P, lymphocytotoxic and antineuronal antibodies.

PMID- 1613704
TI  - Bone marrow IgA and IgA subclass synthesis in ankylosing spondylitis.
AB  - To investigate the source of increased production causing elevation of serum
      immunoglobulin A (IgA) in ankylosing spondylitis (AS) we studied the production
      of IgA and IgA subclasses in cultures of bone marrow cells as well as the
      relative numbers of IgA and IgA subclass containing bone marrow cells obtained
      from 24 patients with AS and 22 healthy control individuals. In patients with AS
      serum levels of IgA, IgA, and IgA2 were significantly higher compared to
      controls. The IgA1 subclass in patient's serum contributed significantly less to
      the total IgA compared to controls. In bone marrow cultures of patients with AS
      and controls the production of IgA, IgA1 and IgA2 were in the same range as were
      the relative numbers of bone marrow cells containing IgA and IgA subclasses.
      However, the immunoglobulin synthesis by bone marrow cells of patients with AS
      showed a significant shift towards IgA1 compared to controls. Our findings
      indicate that the regulatory abnormalities of IgA production in AS involve both
      the IgA1 and IgA2 subclass and suggest that an abnormal mucosal immune response
      could be responsible for chronic overproduction of IgA and the elevation of serum
      IgA in patients with AS.

PMID- 1613705
TI  - Combination of cyclosporine A and calcitriol in the treatment of adjuvant
      arthritis.
AB  - We investigated combination treatment with cyclosporine A (CsA) and calcitriol
      (CT), 2 immunomodulatory agents, in vivo in the adjuvant arthritis (AA) model in
      rats. Treatment initiated at priming with complete Freund's adjuvant consisted of
      daily administration of CsA and CT during the prearthritic phase (14 days). CsA
      given alone delayed the onset of the disease, whereas the severity was either not
      affected or paradoxically enhanced. Injection of CT alone reduced the severity of
      arthritis. The association of low doses of CsA (5 mg/kg) and CT (0.2
      micrograms/kg) further delayed the onset of AA and abolished the aggravating
      effect. Our findings suggest that low doses of CsA and CT in association exhibit
      the additive beneficial effects of either agent alone.

PMID- 1613706
TI  - Transient migratory osteoporosis: a variant of reflex sympathetic dystrophy?
      Report of 3 cases and literature review.
AB  - Three cases of transient migratory osteoporosis treated with sympathetic blocks
      are described. Review of the literature in conjunction with the presentation and
      treatment of these 3 cases led to the formulation of a hypothesis of a common
      mechanism (mediated through the sympathetic nervous system) responsible for the
      profound osteoporosis and pain of reflex sympathetic dystrophy and transient
      migratory osteoporosis. Arguments are presented supporting transient migratory
      osteoporosis as a variant of the classical reflex sympathetic dystrophy.

PMID- 1613707
TI  - von Willebrand factor antigen in hypertrophic osteoarthropathy.
AB  - Recent evidence suggests that a key feature in the pathogenesis of hypertrophic
      osteoarthropathy (HOA) is an enhanced local platelet vessel wall interaction in
      the affected extremities. In our investigation we measured plasma levels of von
      Willebrand Factor Antigen (vWF:Ag; ELISA assay), a marker of platelet and/or
      endothelial activation, in 5 patients with the primary form of HOA and in 6
      patients with the secondary form (due to cyanotic heart disease). Seven subjects
      matched for sex and age were used as controls. Patients showed statistically
      significantly higher levels of vWF:Ag in the primary (163.8 +/- 13.9%) and
      secondary form (152.6 +/- 9.6%, p less than 0.001 for both) when compared to
      controls (100.4 +/- 6.3%). Our results support the notion that platelet
      endothelial cell interaction may play a key role in the development of HOA.

PMID- 1613708
TI  - Control and "fibrositic" tenderness: comparison of two dolorimeters.
AB  - It can be as important to quantify lack of tenderness, as tenderness. Palpation
      detects tenderness only; dolorimeters with a limited scale restrict ability to
      assess variations in thresholds at clinically nontender sites. Such variations
      must be measured if we are to evaluate generally acting factors affecting
      tenderness. We measured thresholds at "fibrositic" and control sites in 8
      subjects, using 2 observers and 2 different dolorimeters. The traditional
      Chatillon dolorimeter yielded twice as many readings off the 9 kg scale (17 of 96
      versus 8 of 96) as the Fischer instrument, with a scale of 11 kg [continuity
      corrected (chi 2 = 3.725, p = 0.086)/bd. The Fischer instrument also used a
      footplate with a smaller diameter, and results using the 2 instruments were not
      parallel. Median values were the same (5.1 kg), but the Fischer instrument gave
      lower readings at tender sites (10th percentile 2.4 versus 2.9 kg) and higher
      values at nontender sites. Thresholds at fibrositic and control sites were
      significantly correlated, reinforcing evidence of generally acting factors
      affecting tenderness.

PMID- 1613709
TI  - Tidal irrigation versus conservative medical management in patients with
      osteoarthritis of the knee: a prospective randomized study. Tidal Irrigation
      Cooperating Group.
AB  - To determine the efficacy of tidal knee irrigation for knee pain due to
      osteoarthritis (OA), we conducted a randomized, single blind, 14-week prospective
      trial comparing medical management with tidal knee irrigation in 77 patients with
      non-end stage OA of the knee and unilateral pain refractory to standard medical
      treatment. Fifty-seven patients completed the study. Statistically significant
      differences (p less than 0.05) favoring tidal knee irrigation over medical
      management were pain after 50' walk, pain after 4-stair climb, most intense pain
      in previous day, frequency of knee stiffness with inactivity, days of morning
      knee stiffness in previous week, physician assessment of knee tenderness and
      overall assessments of therapy effectiveness by both patient and physician. Tidal
      knee irrigation results in more favorable improvement of pain due to OA than can
      be accomplished with traditional medical management.

PMID- 1613710
TI  - A comparison of five preparations of synthetic monosodium urate monohydrate
      crystals.
AB  - We conducted preliminary crystallographic investigations and biologic studies on
      5 synthetically grown preparations of monosodium urate monohydrate (MSUM)
      crystals including one preparation of urate spherulites. The 5 crystal
      preparations exhibited wide variations in morphology, size, surface area, and
      ultrastructure, but only a few changes in their biologic effects. When injected
      intraarticularly, urate spherulites were less phlogistic than most acicular
      forms. Since crystal-cell interactions and inflammatory responses are influenced
      by crystal size, morphology, and surface characteristics, standardization of
      methods of preparing MSUM crystals is, therefore, important, particularly when
      analyzing and comparing results from different research laboratories.

PMID- 1613711
TI  - Relationship between joint space width and subchondral sclerosis in the
      osteoarthritic hand: a quantitative microfocal radiographic study.
AB  - Measurement of joint space width and subchondral sclerosis from x 5
      macroradiographic examination of 32 patients with osteoarthritis (OA) of the hand
      over an 18-month period showed that joint space loss was symmetrical in both
      hands. Its change showed that over a period of time narrowing progressed
      proximally from distal interphalangeal to proximal interphalangeal,
      metacarpalphalangeal and wrist joints. Sclerosis was greatest in those joints at
      which the largest forces were exerted across the hand in precision, power and
      pulp-pinch grip, respectively. Our findings suggest that constitutional factors
      determine the onset of cartilage changes in OA which in turn result in
      subchondral sclerosis, the extent of which is determined by the pattern of normal
      forces within the hand.

PMID- 1613712
TI  - POEMS syndrome in systemic lupus erythematosus.
AB  - POEMS syndrome [plasma cell dyscrasia with polyneuropathy, organomegaly,
      endocrinopathy, monoclonal (M) protein, skin changes] although mimicking the
      connective tissue diseases in several ways has not been reported in a patient who
      also meets criteria for the diagnosis of systemic lupus erythematosus (SLE). We
      describe a patient with POEMS syndrome and SLE and review the similarities and
      differences between POEMS syndrome and other connective tissue disorders.

PMID- 1613713
TI  - Trimethoprim-sulfamethoxasole induced meningitis in systemic lupus erythematosus.
AB  - Most reports of drug induced meningitis in systemic lupus erythematosus (SLE)
      have implicated ibuprofen. We describe a 46-year-old woman with SLE who developed
      aseptic meningitis abruptly after ingesting trimethoprim-sulfamethoxasole (TMP
      SMX). This patient had received TMP-SMX twice before; each was associated with
      increasingly severe reactions, whose relationship with the use of TMP-SMX became
      apparent only in retrospect. A history of medication use should be sought in all
      patients with meningitis who have an underlying autoimmune disorder.

PMID- 1613714
TI  - Multiple complications of the antiphospholipid syndrome with apparent response to
      aspirin therapy.
AB  - We describe a patient with antiphospholipid antibodies who presented with a rapid
      progression of hemolytic anemia, thrombocytopenia, central retinal vein
      thrombosis, 2 cerebral thromboses and pulmonary hemorrhage. She was treated with
      high dose prednisolone, plasma exchange, high dose intravenous immunoglobulin and
      began taking cyclophosphamide without evidence of control of disease. However,
      the anemia and thrombocytopenia appeared to respond rapidly to low dose aspirin
      and she made a complete recovery without any further complications.

PMID- 1613715
TI  - Fever, hepatitis and acute interstitial nephritis in a patient with rheumatoid
      arthritis. Concurrent manifestations of azathioprine hypersensitivity.
AB  - We describe a patient with rheumatoid arthritis (RA) who developed
      hypersensitivity after 3 weeks of therapy with azathioprine with fever, jaundice
      and renal insufficiency. A percutaneous liver biopsy was compatible with
      hypersensitivity hepatitis. During azathioprine rechallenge, the symptoms
      recurred within a few days, consistent with the diagnosis of an acute
      hypersensitivity reaction. This report is the first to describe the association
      of an azathioprine induced hypersensitivity simultaneously involving the liver
      and the kidneys, in the same patient with RA, with resurgence after rechallenge.

PMID- 1613716
TI  - A patient with Werner's syndrome and osteosarcoma presenting as scleroderma.
AB  - Werner's syndrome (WS) is often mistaken for scleroderma. We describe a patient
      with WS who presented with an enlarging, painful mass of the right knee that
      proved to be a juxtaarticular osteosarcoma of the distal femur. Recognition of WS
      and prompt investigation of any painful, enlarging masses to exclude sarcomatous
      degeneration will benefit these patients.

PMID- 1613717
TI  - Concurrent Sweet's syndrome and erythema nodosum: a report, world literature
      review and mechanism of pathogenesis.
AB  - Sweet's syndrome (acute febrile neutrophilic dermatosis) and erythema nodosum are
      reactive dermatoses whose pathogenesis is currently undefined. Although there are
      several associated conditions that both of these disorders have in common, the
      appearance of Sweet's syndrome and erythema nodosum in the same person is rare.
      Only 8 individuals with biopsy confirmed lesions of both dermatoses were
      described in the world literature. We describe a 30-year-old woman with biopsy
      confirmed lesions of Sweet's syndrome on her hand and erythema nodosum on her
      legs. She had been taking an oral contraceptive and an appetite suppressant
      during the 5 months before these dermatoses appeared. Both cutaneous lesions
      rapidly responded to topical corticosteroid ointment and have not recurred since
      her medications were discontinued. The association of Sweet's syndrome and
      erythema nodosum is reviewed, their similarities discussed, and a pathogenesis is
      proposed.

PMID- 1613718
TI  - A rare case of bronchial stenosis in Wegener's granulomatosis. Dramatic response
      to intravenous cyclophosphamide and oral cotrimoxazole.
AB  - We describe a patient with Wegener's granulomatosis (WG) who developed as the
      only pulmonary manifestation a severe proximal bronchial stenosis despite
      conventional treatment with steroids and oral cyclophosphamide. The patient
      subsequently responded to a combined therapy with intravenous (IV)
      cyclophosphamide and oral cotrimoxazole. We stress the rarity of bronchial
      involvement in WG and discuss the role of IV cyclophosphamide and cotrimoxazole
      in the management of this disease.

PMID- 1613719
TI  - Cryoglobulins, anticardiolipin antibodies and livedo reticularis.

PMID- 1613720
TI  - Accelerated hypertension in a patient with mixed connective tissue disease.

PMID- 1613721
TI  - The association of plasma exchange synchronized with intravenous gamma globulin
      therapy in severe intractable polymyositis.

PMID- 1613722
TI  - Response to intravenous cyclophosphamide treatment in lupus myelopathy.

PMID- 1613723
TI  - Fibromyalgia and sex hormones.

PMID- 1613724
TI  - Articular indices for use in clinical trials of rheumatoid arthritis.

PMID- 1613725
TI  - Who's sign?

PMID- 1613726
TI  - Western blotting for the diagnosis of Borrelia burgdorferi infection in patients
      with sacroiliitis.

PMID- 1613727
TI  - Rheumatoid arthritis: current concepts and future directions. Proceedings of the
      4th Edward Dunlop International Symposium. Montreal, Canada, May 23-25, 1991.

PMID- 1613728
TI  - Mechanisms of action of disease modifying antirheumatic drugs.
AB  - The relationship between the biologic activities of disease modifying
      antirheumatic drugs (DMARD) and their therapeutic effects are complex. Some DMARD
      are prodrugs, e.g., azathioprine; others may act in combination with endogenous
      substances, e.g., D-penicillamine and copper salts. Gold compounds,
      antimalarials, sulfasalazine, azathioprine and methotrexate affect various
      phagocytic cell functions. Most DMARD inhibit the immune responses of monocytes
      and of T and B lymphocytes. Gold, sulfasalazine, D-penicillamine also affect
      fibroblast and/or endothelial cell proliferation. Many DMARD inhibit responses
      to, or production of, cytokines. Several DMARD have overlapping biologic effects
      but differ in their therapeutic efficacy in individual patients for unknown
      reasons.

PMID- 1613729
TI  - What a rheumatologist needs to know about T cell receptor structure and function.
AB  - By understanding normal immune response, it has been possible to develop
      therapeutic strategies toward the treatment of autoimmune disease. The
      association of autoimmune disease with the major histocompatibility complex (MHC)
      class II gene products suggests that the inductive events in which the putative
      autoantigen is presented on the surface of antigen presenting cells in the
      context of the MHC class II gene products and is recognized by CD4(+) helper or
      inducer T cells form an interesting target for immunotherapeutic intervention. By
      understanding the structure/function relationships of T cell receptors for
      antigen, it might be possible to develop novel immunotherapeutic strategies for
      the treatment of seropositive rheumatoid arthritis. Studies described below
      review recent progress in understanding the components of the ternary complex and
      suggest possible areas of immunotherapeutic intervention.

PMID- 1613730
TI  - Excitement in synovium: the rapid evolution of understanding of rheumatoid
      arthritis and expectations for therapy.
AB  - Multiple events give rise to rheumatoid arthritis (RA) and many different
      elements create an overall pathological effect. It is highly unlikely that a
      single cause for RA will be identified. A greater appreciation of the multiple
      events that lead to the development of RA is opening up a number of promising
      points of intervention which may serve as potential alternatives to the broader
      based and often toxic drugs used in RA therapy today.

PMID- 1613731
TI  - Rheumatoid factors: historical perspective, origins and possible role in disease.
AB  - The recognition of antibodies by the immune system is more complex than
      previously believed. Rheumatoid factor (RF), a family of autoantibodies against
      gammaglobulin, has long been recognized as an important biologic marker for
      rheumatoid arthritis (RA). When RF contributes to the generation of the
      inflammatory aspects of RA, it probably does so by forming immune complexes that
      are themselves able to bring about the inflammatory response. Contrary to the
      widely accepted belief that RF somehow is triggered by recognition of self IgG,
      antibodies to viral Fc receptors may provide the initial stimulus for RF
      production in RA.

PMID- 1613732
TI  - Rheumatoid factors in the pathogenesis of rheumatoid arthritis.
AB  - Rheumatoid factors (RF) participate in the pathogenesis of rheumatoid arthritis
      by formation of immune complexes. IgM-RF form complement activating immune
      complexes with IgG-containing antigen-antibody complexes. IgG-RF form unique
      immune complexes without the presence of separate antigen molecules. The
      specificities of RF in rheumatoid arthritis have subtle differences from RF
      formed by B cell neoplasms. Immune deposits in rheumatoid articular cartilage
      have high potential for generating inflammation and contain RF. The immune
      deposits in articular cartilage need to be characterized further, and the
      mechanisms that initiate and perpetuate RF production in patients with rheumatoid
      arthritis should be elucidated.

PMID- 1613733
TI  - IgM rheumatoid factors in patients with rheumatoid arthritis derive from a
      diverse array of germline immunoglobulin genes and display little evidence of
      somatic variation.
AB  - Rheumatoid factors (RF) are present in the plasma of patients with rheumatoid
      arthritis (RA) although the site of synthesis of most of these antibodies is
      within the synovium. This report primary concerns RF of the IgM isotype. While a
      few of the RF derive from patients with systemic lupus erythematosus or from
      normal individuals, the remaining derive from the inflamed synovial tissue of
      patients with RA. Two RF are encoded by members of the VH1 gene family, 8 from
      the VH3 family and 2 from the VH4 family. Two polyreactive antibodies derive from
      the VH3 family and 2 come from the VH4 family. This distribution is not
      fundamentally different from the distributions seen in a large array of
      autoantibodies and antibodies to external antigens. Similarly, the light chains
      derive from most of the known kappa and lambda VL families. It is hard to escape
      the preliminary conclusion that gene segments from virtually any light chain
      variable region can contribute to RF or polyreactive antibody structures. Most
      IgM RF and polyreactive antibodies are direct copies of germline genes in one of
      their polypeptide chains or at most are 2 nucleotides away in one of their chains
      from a known germline gene.

PMID- 1613734
TI  - Binding characteristics of human hybridoma IgG and IgM rheumatoid factors:
      influence of IgG isotype and carbohydrate content.
AB  - The interaction of human monoclonal rheumatoid factors (RF) with the Fc portion
      of IgG is complex. We have investigated the influence of the nature of the
      antigen (Fc) on the binding of hybridoma-generated RF derived from patients with
      rheumatoid arthritis or systemic lupus erythematosus. For IgM RF, the interaction
      is strongly influenced by the primary structure of the Fc with little or no
      effect of the carbohydrate, which is positioned at amino acid 297 in the gamma-2
      domain. In contrast, our preliminary data suggest that IgG RF binding is affected
      both by the primary structure and the nature of the carbohydrate of the Fc. These
      results suggest that the antigen selection events which lead to the induction and
      production of IgG RF are likely to be different from those that induce IgM RF
      production.

PMID- 1613735
TI  - Proteinases in rheumatoid arthritis.
AB  - The role of proteinases in the extracellular breakdown of the connective tissue
      matrix during disease processes is outlined. Focussing on the matrix
      metalloproteinases, we present an overview of the mechanisms regulating their
      activity. Methods of assessing their role in disease processes is exemplified by
      new data on stromelysin activity in remodelling joint tissues in both model
      systems and human disease.

PMID- 1613736
TI  - Epidemiologic studies of rheumatoid arthritis: future directions.
AB  - We (1) review the current status of epidemiologic studies of rheumatoid arthritis
      (RA); (2) consider the strengths and weaknesses of such studies and (3) offer
      suggestions regarding directions which future work might take. We will not
      examine any particular studies in great detail, but, instead, will focus on those
      broad aspects of epidemiologic work concerning RA which seem most important. In
      this process, it may be useful to draw comparisons with cancer epidemiology,
      since etiologic possibilities in cancer often resemble those seen in RA and
      similar methodologic issues are involved.

PMID- 1613737
TI  - Practice based evaluation of the longterm benefit of second line agents in
      rheumatoid arthritis.
AB  - A hypothetical practice based consortium to evaluate treatment of early
      rheumatoid arthritis (RA) is discussed. It would consist of a coordinating center
      and many practicing rheumatologists. Patients with RA within 3 to 12 months of
      disease onset who met strict entry criteria would be offered enrollment in their
      choice from a menu of protocols that includes standard and aggressive treatment
      options and would be followed for a long time. Standard efficacy assessments
      would be carried out at fairly long intervals, with emphasis on erosive changes
      in wrist, hands and feet x-rays. Analysis would be done across drug protocols
      within homogeneous subgroups of patients who have been stratified by comparable
      entry characteristics, using those who develop erosions during treatment with
      nonsteroidal antiinflammatory drugs only as the standard for comparison. This
      approach can be used to identify risk factors that predict subsequent erosive
      joint damage, and to select a few promising drugs, combinations and therapeutic
      strategies for subsequent definitive studies.

PMID- 1613738
TI  - Biological agents in rheumatoid arthritis.
AB  - New potential therapies using molecular biology technology are under development.
      The initial trials in rheumatoid arthritis (RA) with interferon gamma were
      disappointing. Cytokine inhibitors such as interleukin-1 receptor antagonist are
      beginning clinical trials. Growth factors have been used to treat isolated
      complications associated with RA. Monoclonal antibodies to target active cell
      lines or receptors are also under study with preliminary results available from
      several studies. This technology offers a hope lf more selective interventions
      for many systemic rheumatic diseases.

PMID- 1613739
TI  - Immunopathogenesis and treatment of rheumatoid arthritis.
AB  - Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology.
      Recent advances have suggested that T cells play a critical role in the
      immunopathogenesis of RA. A variety of clinical trials using a number of
      monoclonal antibodies have confirmed the hypothesis that CD4+ T cells play a
      central role in propagating the disease. Moreover, these trials have suggested
      rational approaches for the treatment of RA in the future. Despite a
      comprehensive view of the immunopathogenic processes causing the manifestations
      of the disease, the underlying cause of RA remains unknown. Critical aspects of
      RA that might be important in the early diagnosis and prognosis of the disease
      remain to be delineated. These include the precise role of the association with
      gene products of the major histocompatibility complex and possibly the role of
      other genetic elements. In addition, there is no information concerning potential
      etiologic agents. Delineation of these issues should provide additional insight
      into RA and potential approaches to treatment and prevention.

PMID- 1613740
TI  - From aspirin to biologics: therapeutic implications for rheumatoid arthritis.
AB  - As effective antiinflammatory agents have been added to our armamentarium, 2
      major treatment strategies for the treatment of rheumatoid arthritis have
      developed. The traditional pyramid strategy is based on initial, conservative
      measures, followed by more aggressive therapy as the disease progresses. The step
      down bridge approach is an alternative, more aggressive strategy that favors
      earlier use of more potent agents. The longterm effects of disease modifying
      antirheumatic drugs (DMARD) and combination second line therapy on disease
      progression remain unclear. Advances in the development of more specific DMARD
      and in human recombinant proteins offer promising future therapies.

PMID- 1613741
TI  - Nonsteroidal antiinflammatory drugs: benefit/risk evaluation in rheumatic
      diseases.
AB  - Side effects of nonsteroidal antiinflammatory drug (NSAID) therapy are attributed
      to direct damage by the acidic compounds and to the secondary effects of
      prostaglandin inhibition. In general, gastrointestinal, skin and central nervous
      system effects predominate, followed by general adverse hepatic and renal events.
      Advanced age, female gender, history of gastrointestinal disorders and renal
      impairment increase the risk of NSAID induced side effects. Pharmacologic
      modifications that may help minimize side effects include lowered cyclooxygenase
      inhibitor activity, more stable plasma/tissue concentrations, decreased
      lipophilicity, avoidance of biliary excretion and renal excretion in inactive
      form. Prescribing NSAID according to their differing pharmacokinetic profiles may
      help maximize clinical efficacy and reduce side effects.

PMID- 1613742
TI  - 3D database searching in drug design.

PMID- 1613743
TI  - Orally active aldose reductase inhibitors: indazoleacetic, oxopyridazineacetic,
      and oxopyridopyridazineacetic acid derivatives.
AB  - Benzothiazole side chains featured in zopolrestat (1a) and its congeners were
      incorporated into oxophthalazineacetic acid replacements, including indazole,
      pyridazinone, and pyridopyridazinone with a pendant acetic acid moiety. Potent
      aldose reductase inhibition activity among resulting compounds is as widespread
      as it is in the earlier zopolrestat series, thus lending further support to our
      hypothesis that there is a binding site on the aldose reductase enzyme with
      strong affinity for benzothiazoles. Representative new compounds 1-[(5,7-difluoro
      2-benzothiazolyl)-methyl]-1H-indazoleacetic acid (62), [6-[[5
      (trifluoromethyl)benzothiazol-2-yl]methyl]-8-oxo- 6H-pyrido[2,3-d]-pyridazin-5
      yl]acetic acid (70), 3,4-dihydro-4-oxo-5,6-dimethyl-3-[(5,7-difluorobenzothiazol
      2-yl) methyl]-1-pyridazineacetic acid (79), and 3,4-dihydro-4-oxo-5,6-cyclohexano
      3-[[5-(trifluoromethyl) benzothiazol-2-yl]-methyl]-1-pyridazineacetic acid (82)
      are potent aldose reductase inhibitors with IC50s of 30, 2.1, 5, and 52.2 nM,
      respectively. The best of these compounds, 79 and 82, also inhibit accumulation
      of sorbitol in rat sciatic nerve in a model of diabetic complications, when
      administered orally at 10 mg/kg. The inhibition values are 76 and 61%,
      respectively. In addition to benzothiazole, we have examined its surrogates
      effective in potentiating aldose reductase inhibition activity, including
      benzoxazole and aryl[1,2,4]oxadiazole. Structure-activity relationships emerging
      from this program are also discussed.

PMID- 1613744
TI  - Hydantoin bioisosteres. In vivo active spiro hydroxy acetic acid aldose reductase
      inhibitors.
AB  - The hypothesis that clinical side effects of the aldose reductase inhibitor (ARI)
      sorbinil were related to its hydantoin ring led to a bioisosteric analysis and
      replacement of the hydantoin by a spiro hydroxy acetic acid moiety as in 40.
      These hydroxy acids, compared to hydantoins, showed a similar potency increase on
      chroman 2-methyl substitution, a similar orthogonal relationship of acidic to
      aromatic moieties, and similar ARI enantioselectivity. In this series the six
      membered spiro hydroxy acetic acid anion array is a bioisostere for a spiro
      hydantoin anion and leads to ARIs with excellent in vivo activity. In vitro and
      in vivo activity was improved over 40 by chroman cis 2-methylation as in 4 and by
      aromatic 6,7-halogen substitution. Compounds with the best acute in vivo activity
      in rats were compared for chronic in vivo activity. The highest tissue levels and
      best chronic in vivo activities were found in the racemic 6,7-dichloro and 6
      fluoro-7-chloro analogues 18 and 23. ARI activity was enantioselective for 58 and
      60, the 2R,4R-enantiomers of 18 and 23. 7-Chloro-6-fluoro-cis-4-hydroxy-2(R)
      methyl-chroman-4-acetic acid (60) was selected for phase 1 clinical trials and
      did not exhibit sorbinil-like hypersensitivity side effects.

PMID- 1613745
TI  - Synthesis of carbon-11 labeled iodinated cocaine derivatives and their
      distribution in baboon brain measured using positron emission tomography.
AB  - Three iodine-substituted derivatives of cocaine, methyl esters of 3-[(2'-, 3'-,
      and 4'-iodobenzoyl)oxy]-8-methyl-[1R-(exo,exo)]-8- azabicyclo[3.2.1]octane-2
      carboxylic acid (2a-c), were synthesized and subjected to N-demethylation to give
      the corresponding noriodococaines 3-[(2'-,3'-, and 4'-iodobenzoyl)oxy]-[1R
      (exo,exo)]-8- azabicyclo[3.2.1]-octane-2-carboxylic acid (3a-c). These were
      remethylated with [11C]CH3I to give the [N-11C-methyl]iodococaines 4a-c which
      were examined in baboon brain in vivo using positron emission tomography (PET).
      Compared to [N-11C]cocaine itself the regional distributions were changed from a
      highly specific localization in the corpus striatum to more diffuse patterns
      which included the cerebellum and cortex. Peak brain uptakes and clearance
      kinetics were also changed. [N-11C]-o-Iodococaine (4a) had a peak uptake in the
      striatum at 4-5 min after injection of only 17% that of cocaine in the same
      animal. The peak uptake of [N-11C]-p-iodococaine (4c) was 60% of that of [N
      11C]cocaine and a clearance half-time of approximately 55 min, twice that of [N
      11C]cocaine. [N-11C]-m-Iodococaine (4b) displayed half the uptake of [N
      11C]cocaine, buts its clearance was similar to that of the parent molecule. The
      fractions of unmetabolized tracer in blood plasma at 1-30 min were higher for 4a
      c than for [N-11C]cocaine. Plasma protein binding experiments showed 10%, 0.3%,
      1.6%, and 6% as the free fraction for cocaine and o-, m-, and p-iodococaines
      respectively, consistent with the low brain uptake observed for the ortho isomer,
      and implicated alpha 1-acid glycoprotein as responsible for the low free fraction
      of o-iodococaine. The potencies of 2a-c to displace tritiated cocaine from
      striatal membranes were p-iodo approximately cocaine greater than m-iodo
      approximately o-iodo.

PMID- 1613746
TI  - Synthesis and muscarinic receptor activity of ester derivatives of 2-substituted
      2-azabicyclo[2.2.1]heptan-5-ol and -6-ol.
AB  - Radioligand binding affinities of four new muscarinic antagonists and six
      potential muscarinic agonists which possess the 2-alkyl-2
      azabicyclo[2.2.1]heptane ring system have been determined in rat heart, rat
      brain, and m1- or m3-transfected CHO cell membrane preparations to examine the
      selectivity for subtypes of muscarinic receptor. The efficacies of the potential
      muscarinic agonists were determined by the ratio of binding affinities against
      [3H]QNB and [3H]Oxo-M. Four muscarinic antagonists which have the 2,2
      diphenylpropionate side chain at either the C5 (5-endo or 5-exo) or the C6 (6
      endo or 6-exo) positions did not discriminate between the subtypes of muscarinic
      receptors. The 2,2-diphenylpropionate 5-endo substituted compound was the most
      potent, showing affinities between 4.23 x 10(-10) and 1.18 x 10(-9) M in rat
      heart, rat brain, and m1- or m3-transfected CHO cell membrane preparations. The
      rank order of ester potency was 5-endo greater than 5-exo greater than 6-endo
      greater than 6-exo. A molecular modeling study based on the pharmacophore
      developed for azaprophen was used to account for the relative potency of these
      antagonists. Six potential muscarinic agonists which have acetoxy groups in the
      C5 or C6 position with an N-methyl or N-benzyl substituent did not discriminate
      subtypes of muscarinic receptors and had affinities between 6.63 x 10(-6) and
      4.76 x 10(-5) M in rat heart, rat brain, and m1- or m3-transfected CHO cell
      membrane preparations. exo-2-Methyl-5-acetoxy-2-azabicyclo[2.2.1]heptane was the
      most efficacious partial agonist.

PMID- 1613747
TI  - Synthesis and aromatase inhibition of 3-cycloalkyl-substituted 3-(4
      aminophenyl)piperidine-2,6-diones.
AB  - The synthesis of 3-cycloalkyl-substituted 3-(4-aminophenyl)piperidine-2,6-diones
      is described [cyclopentyl (1), cyclohexyl (2)]. The enantiomers of 2 were
      separated either by using HPLC on optically active sorbent or by crystallization
      of the brucine salt of the phthalamic acid of 2. The absolute configuration of
      the (+)- and (-)-enantiomers of 2 were assigned as S and R, respectively, by
      comparing the CD spectra to those of the enantiomers of aminoglutethimide (AG, 3
      (4-aminophenyl)-3-ethylpiperidine-2,6-dione). The compounds were tested in vitro
      for inhibition of human placental aromatase, the cytochrome P450-dependent enzyme
      which is responsible for the conversion of androgens to estrogens. Compounds 1
      and 2 inhibited aromatase by 50% at 1.2 and 0.3 microM, respectively (IC50 AG =
      37 microM). According to the findings with AG, the (+)-enantiomer of 2 was
      responsible for the inhibitory activity, being a 240-fold more potent aromatase
      inhibitor in vitro than racemic AG. On the other hand, (+)-2 displayed a strongly
      reduced inhibition of desmolase (cholesterol side-chain cleavage enzyme) compared
      to AG (relative activity = 0.3). Thus (+)-2 is of interest as a potential drug
      for the treatment of estrogen-dependent diseases, e.g. mammary tumors.

PMID- 1613748
TI  - Iodoaminopotentidine and related compounds: a new class of ligands with high
      affinity and selectivity for the histamine H2 receptor.
AB  - The synthesis and biological evaluation of a new class of histamine H2
      antagonists with N-cyano-N'-[omega-[3-(1-piperidinylmethyl)phenoxy]
      alkyl]guanidine partial structure are described as part of an extensive research
      program to find model compounds for the development of new radioligands with high
      H2 affinity and specific activity. High receptor affinity is achieved by an
      additional (substituted) aromatic ring, which is connected with the third
      guanidine N by a carbon chain spacer and an amine, carboxamide, ester, or
      sulfonamide link ("polar group"). In functional studies for H2 antagonistic
      activity and other pharmacological actions [e.g. H1 antihistaminic,
      antimuscarinic, antiadrenergic (alpha 1, beta 1), 5-HT2 blocking activity] in the
      isolated guinea pig atrium and ileum and rat aorta and tail artery, the compounds
      proved to be highly potent and selective histamine H2 receptor antagonists. The
      H2 antagonistic activity is mainly depending on the length of both the N'-alkyl
      chain (chain A) and the N"-spacer (chain B). Compounds with a C3 chain A and a C2
      chain B are most potent in the preferred group of substances, i.e., the
      carboxamide series. A wide variety of substituents at the aromatic ring is
      tolerated, among them iodine, amino, and azido groups. These compounds are up to
      32 times more potent than cimetidine in the isolated guinea pig right atrium. The
      replacement of the carboxamide by an ester group (44c) is well tolerated, while
      replacement of the cyanoguanidine by an urea group results in nearly 100-fold
      decrease in activity (46c,e). The iodinated benzamides are among the most potent
      H2 antagonists known so far. The [125I]-labeled form of 31f
      ([125I]iodoaminopotentidine, [125I]-N-[2-(4-amino-3-iodobenzamido) ethyl]-N'
      cyano-N"-[3-[3-(1-piperidinylmethyl) phenoxy]propyl]guanidine) and its
      photolabile analogue 31h ([125I]iodoazidopotentidine, [125I]-N-[2-(4-azido-3-
      iodobenzamido)ethyl]-N'-cyano-N"-[3-[3-(1-piperidinyl-methyl)pheno xy]
      propyl]guanidine) proved to be useful probes for reversible and irreversible
      labeling of the histamine H2 receptor. Radioligand binding studies in guinea pig
      cerebral membranes revealed considerably higher H2 receptor affinity for 31f (pKi
      = 9.15), 31h (pKi = 8.58), and some analogues than functional experiments (guinea
      pig atrium), presumably reflecting an easier access to the H2 receptors in
      membranes.

PMID- 1613749
TI  - Active conformation of a tumor promoter, teleocidin. A molecular dynamics study.
AB  - Telecidins are potent tumor promoters, having a nine-membered lactam structure.
      Teleocidins and their small-molecular-sized active congeners (indolactams) are
      known to exist in an equilibrium between at least two conformational states, the
      twist and the sofa form. Molecular dynamics (MD) calculations were performed on
      four indolactams, in order to examine the relationships between preferred ring
      conformations and the biological activities. It was shown that the tumor
      promoting activities are closely related with the existence ratio of the sofa
      form among 10 possible conformations. This implies that the sofa form is the
      active ring conformation, which is compatible with the previous result obtained
      independently from the superposition of teleocidin and phorbol ester. The
      predicted ratios of conformers for each indolactam were in good agreement with
      those observed by NMR spectral analysis. The high-temperature MD method proved to
      be very useful for predicting the preferred structures of these cyclic compounds,
      in which the overall stabilities are strongly influenced by the conformations of
      substituent groups on the ring.

PMID- 1613750
TI  - Nucleosides and nucleotides. 107. 2-(cycloalkylalkynyl)adenosines: adenosine A2
      receptor agonists with potent antihypertensive effects.
AB  - Adenosine receptor-binding profiles in rat brain tissues and antihypertensive
      effects in spontaneously hypertensive rats (SHR) of a series of 2
      (cycloalkylalkynyl)adenosines (2-CAAs) and their congeners are described. The
      structure-activity relationship of this series of compounds is discussed,
      focusing on the length of the alkynyl side chain and bulkiness of the terminal
      cycloalkyl substituents in terms of binding activity and cardiovascular effects.
      All the 2-CAAs had a preferential affinity for A2 receptors. Of these
      derivatives, 2-(3-cyclopentyl-1-propyn-1-yl)adenosine (10b) exhibited the most
      selective affinity for A2 receptors (Ki ratio: A1/A2 = 70) on the basis of
      receptor binding. In the C-2 binding region of adenosine, compounds often have
      potent and/or selective A2 activity from introduction of an acetylenic group at
      the C-2 position followed by one methylene residue further followed by a
      hydrophobic substituent such as a cycloalkyl ring at the terminal position of the
      alkynyl side chain. Intravenous injection of 10b up to 100 micrograms/kg had a
      potent hypotensive effect without a marked decrease in heart rate in anesthetized
      SHR. Compounds 10j-s, with a hydroxyl group in the C-3" position of the alkynyl
      side chain, had a potent affinity for both A1 and A2 receptors, but they were not
      highly selective for A2 receptors. These compounds caused a marked bradycardia
      upon intravenous administration in anesthetized SHR. Oral administration of 10b
      (0.1-1 mg/kg) had a potent and long-lasting antihypertensive effect in conscious
      SHR.

PMID- 1613751
TI  - Novel functional M1 selective muscarinic agonists. Synthesis and structure
      activity relationships of 3-(1,2,5-thiadiazolyl)-1,2,5,6-tetrahydro-1
      methylpyridines .
AB  - A series of novel 3-(3-substituted-1,2,5-thiadiazol-4-yl)-1,2,5,6-tetrahydro- 1
      methylpyridines (substituted-TZTP; 5a-l, 7a-h, 8, 9c-n, 11, 13j) were synthesized
      and tested for central muscarinic cholinergic receptor affinity by using [3H]
      oxotremorine-M (Oxo-M) and [3H]-pirenzepine (Pz) as ligands. The potency and
      efficacy of the compounds for the pharmacological defined M1 and M2 muscarinic
      receptors were determined on isolated electrically stimulated rabbit vas deferens
      and on spontaneously beating isolated guinea pig atria, respectively. Selected
      compounds were also tested for M3 activity in the isolated guinea pig ileum. The
      C1-8 alkoxy-TZTP 5a-l analogues all displaced [3H]-Oxo-M and [3H]-Pz with low
      nanomolar affinity. Depicting chain length against Oxo-M binding and against Pz
      binding the unbranched C1-8 alkoxy-TZTP (5a-h) derivatives produced U-shaped
      curves with butoxy- (5d) and (pentyloxy)-TZTP (5e) as the optimum chain length,
      respectively. This U-shaped curve was also seen in the ability of the compounds
      5a-h to inhibit the twitch height in the vas deferens preparation. The
      (pentyloxy)- (5e) and the (hexyloxy)-TZTP (5f) analogues produced an over 90%
      inhibition of the twitch height with IC50 values in the low picomolar range. In
      both the atria and in the ileum preparations 5f had low efficacy and potency.
      With the (alkylthio)-TZTP (7a-h) analogues the structure-activity relationship
      was similar to the one observed with the alkoxy (5a-h) analogues, but generally
      7a-h had higher receptor affinity and was more potent than the corresponding 5a
      h. However, the C3-8 alkyl-TZTP (9c,e,g,h) analogues had 10-100 times lower
      affinity for the central muscarinic receptors than the corresponding alkoxy and
      alkylthio derivatives, and their efficacy in the vas deferens preparation was too
      low to obtain IC50 values. The unsubstituted TZTP (11) compound was a potent but
      nonselective muscarinic agonist. The two 3-(3-butoxy/(hexyloxy)-1,2,5-oxadiazol-4
      yl)-1,2,5,6-tetrahy dro-1- methylpyridines (butoxy/hexyloxy)-OZTP; 19a/b) were
      also synthesized and tested. Both 19a and 19b had much lower affinity for the
      central muscarinic receptors than 5d and 5f, and the efficacy of 19a,b was too
      low to give IC50 values in the vas deferens preparation. Therefore, the C5-6
      (alkyloxy)/(alkylthio)-TZTP's represent a unique series of potent functional M1
      selective muscarinic agonists.

PMID- 1613752
TI  - Nucleic acid related compounds. 74. Synthesis and biological activity of 2'(and
      3')-deoxy-2'(and 3')-methylenenucleoside analogues that function as mechanism
      based inhibitors of S-adenosyl-L-homocysteine hydrolase and/or ribonucleotide
      reductase.
AB  - Treatment of 2-amino-6-chloro-9-(beta-D-ribofuranosyl)purine (21) with TBDMS
      chloride/imidazole/DMF gave a separable mixture of 5'-O, 2',5'-bis-O (22), 3',5'
      bis-O (23), and 2',3',5'-tris-O-TBDMS derivatives. Oxidation of 22 and 23 with
      CrO3/pyridine/Ac2O, treatment of the respective ketonucleosides with
      methylenetriphenylphosphorane, and deprotection gave 2-amino-6-chloro-9-[3(and 2)
      deoxy-3(and 2)-methylene- beta-D-erythro-pentofuranosyl]purines (28 and 37) that
      were converted into other 2-amino-6-substituted-purine analogues. Tubercidin was
      converted into 2'-deoxy-2'-methylenetubercidin (49) by an analogous route.
      Inactivation of S-adenosyl-L-homocysteine hydrolase by 2'- and 3'
      methyleneadenosine analogues was investigated. Mechanism-based inhibition of S
      adenosyl-L-homocysteine hydrolase and anticancer and antiviral activities of
      2'(and 3')-deoxy-2'(and 3')-methylenenucleoside analogues are discussed.

PMID- 1613753
TI  - Synthesis and evaluation of analogues of (Z)-1-(4-methoxyphenyl)-2-(3,4,5
      trimethoxyphenyl)ethene as potential cytotoxic and antimitotic agents.
AB  - A series of stilbenes has been prepared and tested for cytotoxicity in the five
      human cancer cell lines A-549 non-small cell lung, MCF-7 breast, HT-29 colon,
      SKMEL-5 melanoma, and MLM melanoma. The cis stilbenes 6a-f proved to be cytotoxic
      in all five cell lines, with potencies comparable to that of combretastatin A-4.
      These cytotoxic compounds were all potent inhibitors of tubulin polymerization.
      The corresponding trans stilbenes 7b-f were inactive as tubulin polymerization
      inhibitors and were significantly less cytotoxic in the five cancer cell lines.
      In the dihydro series, 8b, 8c, and 8f were inactive as tubulin polymerization
      inhibitors, while 8a, 8d, and 8e were less active than the corresponding cis
      compounds 6a, 6d, and 6e. The lack of tubulin polymerization inhibitory activity
      and cytotoxicity displayed by the phenanthrene 23b, which was synthesized as a
      conformationally rigid analogue of the lead compound 1, indicates that the
      activity of the stilbenes is not due to a totally planar conformation. Similarly,
      inactivity of the conformationally restricted analogue 26 suggests that the
      biologically active conformation of 1a resembles that of the cis alkene 1.
      Additional inactive compounds prepared include the benzylisoquinoline series 28
      32 as well as the protoberberines 38 and 39. Shortening the two-carbon bridge of
      1a to a one-carbon bridge in the diphenylmethane 20 resulted in a decrease in
      cytotoxicity and tubulin polymerization inhibitory activity. Although the
      corresponding benzophenone 18 was as active as 1a as a tubulin polymerization
      inhibitor, it was less cytotoxic than 1a, and the benzhydrol 19 was essentially
      inactive. With the exception of the amide 15c, which displayed low antitubulin
      activity, all of the phenylcinnamic acid derivatives 14a-c and 15a-f were
      inactive in the tubulin polymerization inhibition assay. The acid 14b and the
      ester 15a were cytotoxic in several of the cancer cell cultures in spite of their
      inactivity as tubulin polymerization inhibitors.

PMID- 1613754
TI  - Structural studies on bio-active compounds. 20. Molecular modeling and
      crystallographic studies on methylbenzoprim, a potent inhibitor of dihydrofolate
      reductase.
AB  - Methylbenzoprim (MBP) is a potent inhibitor of dihydrofolate reductase, which is
      more selective for mammalian than bacterial enzymes. Crystal-structure studies on
      the free base of MBP, with two independent molecules, and the ethanesulfonate
      salt, have demonstrated three significantly different conformations for MBP. With
      the MOPAC optimized MBP cation as starting point, the COSMIC energy was monitored
      as torsion angles were changed in 5 degrees increments. The barrier to rotation
      about C(5)-C(11) can create two slowly interconverting rotamers, in agreement
      with NMR studies. Two conformations of the cation that fit the human DHFR
      structure from the Brookhaven Protein Data Bank have been found. They differ
      chiefly by a half-turn about C(5)-C(11), positioning the nitro group on opposite
      sides but allowing the central and benzylic rings to find hydrophobic
      surroundings. The central ring is close enough to the predicted position of the
      cofactor NADPH to make competition likely. Kinetic studies with rat liver DHFR
      show that MBP is an inhibitor that competes with NADPH as well as dihydrofolate.

PMID- 1613755
TI  - Quinazoline antifolate thymidylate synthase inhibitors: difluoro-substituted
      benzene ring analogues.
AB  - The synthesis of a series of new C2-methyl-N10-alkylquinazoline-based thymidylate
      synthase (TS) inhibitors containing difluroinated p-aminobenzoate rings is
      described. Derivatives of the N10-propargyl and N10-methylquinazoline antifolates
      were prepared with 2',3'-, 2',5'-, and 2',6'-difluoro substitution. The synthesis
      of the 2',5'-difluoro analogues involved oxidation of the difluoronitrotoluene to
      2,5-difluoro-4-nitrobenzoic acid followed by glutamation, reduction, and
      alkylation (propargyl bromide or MeI) to the diethyl N-(4-(alkylamino)-2,5
      difluorobenzoyl)-L-glutamates. For the synthesis of the 2',3'- and 2',6'-difluoro
      compounds a new route was devised starting from methyl 4-((tert
      butoxycarbonyl)amino)-2,6-difluorobenzoate and its 2,3-substituted counterpart.
      Treatment with NaH and then an alkyl halide introduced the N10-substituent. The
      methyl ester was hydrolyzed and the resulting acid was condensed with diethyl L
      glutamate. The secondary amine was liberated using CF3CO2H and coupled with 6
      (bromo-methyl)-3,4-dihydro-2-methyl-4-oxoquinazoline to yield the antifolate
      diesters. Final deprotection with mild alkali completed the synthesis in each
      case. The target compounds were tested as inhibitors of partially purified L1210
      TS and also examined for their inhibition of the growth of L1210 cells in
      culture. Compared to their nonfluorinated parent compounds all the difluoro
      analogues were poorer inhibitors of TS. The greatest loss of enzyme activity was
      seen in the N10-propargyl analogues which contained one of the fluorine atoms
      ortho to the amine substituent. This loss was less apparent in the N10-methyl
      derivatives. Despite this lower inhibition of TS the majority of new compounds
      have equivalent cytotoxicity to their nonfluorinated predecessors.

PMID- 1613756
TI  - Structure-activity studies of potassium channel opening in pinacidil-type
      cyanoguanidines, nitroethenediamines, thioureas, and ureas.
AB  - Potassium channel opening activity for pinacidil-type cyanoguanidines,
      nitroethenediamines, thioureas, and ureas, has been assessed through simultaneous
      measurement of spontaneous contractile activity and stimulation of 86Rb+ efflux
      from rat portal veins loaded with 86Rb+. The good correlation between these two
      effects suggests that the vasodilator activity of the compounds is directly
      attributable to an increased opening of potassium channels. The resulting
      quantitative in vitro data has been used to analyze the structure-activity
      relationships for potassium channel opening, allowing the biological activity to
      be rationalized in terms of a pharmacophore involving a hydrogen-bond-acceptor
      element, a hydrogen-bond-donor element, and a lipophilic binding group. A model
      for the binding of pinacidil-related compounds to their potassium channel
      receptor has been developed, and compounds designed to test this model have been
      synthesized and tested. Prototropic equilibria are implicated as playing a
      fundamental role in determining the hydrogen-bonding ability of the compounds,
      and conformational changes in the receptor are invoked to explain disparities in
      the chiral recognition of lipophilic groups in different compounds.

PMID- 1613757
TI  - 7-Oxabicycloheptylprostanoic acids: potent, time-dependent cyclooxygenase
      inhibitors that induce a conformational change in the prostaglandin endoperoxide
      synthase protein.

PMID- 1613758
TI  - (E)-1,3-dialkyl-7-methyl-8-(3,4,5-trimethoxystyryl)xanthines: potent and
      selective adenosine A2 antagonists.

PMID- 1613759
TI  - Estimates of the frequency of chromosome abnormalities detectable in unselected
      newborns using moderate levels of banding.
AB  - Data on structural chromosome abnormalities identified during prenatal diagnosis
      were used to estimate the number of such abnormalities that would be detectable
      in an unselected series of newborns using moderate levels of banding (400 to 500
      bands). These estimates were compared with the rates detected in nonbanded
      surveys of newborns. Between 1976 and 1990 prenatal diagnosis using banding
      techniques was carried out in our laboratory on 14,677 women aged 35 and over.
      Among these, we detected 112 structural rearrangements, 32 unbalanced and 80
      balanced. These figures were adjusted by two methods to give an estimate of the
      frequency of structural abnormalities in the newborn. Our data suggest that the
      use of moderate levels of banding increases the frequency of unbalanced
      structural abnormalities from 0.052 to 0.061% and of balanced structural
      abnormalities from 0.212 to 0.522%. Thus, the total number of chromosome
      abnormalities detectable in the newborn is increased from 0.60% in unbanded
      preparations to 0.92% in banded preparations.

PMID- 1613760
TI  - Cyclophosphamide increases the frequency of sister chromatid exchange in direct
      preparations of human chorionic villi in the absence of supplementary enzymatic
      activation systems.
AB  - A study was performed to evaluate the effect on the frequency of sister chromatid
      exchange in first trimester chorionic villi of two chemical compounds, mitomycin
      C and cyclophosphamide. Mitomycin C is generally known to induce an increase in
      sister chromatid exchange both in vivo and in vitro standard conditions.
      Cyclophosphamide is a compound requiring additional enzymatic enrichment of the
      culture medium to express its mutagenic activity under in vitro conditions. We
      exposed chorionic villi samples to these chemicals without the use of
      conventional cell cultures and without adding enzymatic extracts to the medium.
      The results indicate a statistically significant increase in the frequency of
      sister chromatid exchange after exposure to both compounds and also at lower
      dosages.

PMID- 1613761
TI  - The clinicopathological features of three babies with osteogenesis imperfecta
      resulting from the substitution of glycine by valine in the pro alpha 1 (I) chain
      of type I procollagen.
AB  - The features of three babies with perinatal lethal osteogenesis imperfecta (OI
      II) resulting from substitutions of glycine by valine in the triple helical
      domain of the alpha 1(I) chain of type I collagen were studied. The babies were
      heterozygous for this substitution at residue 1006 in case 1 (OI35), 973 in case
      2 (OI59), and 256 in case 3 (OI7B). OI35 had the most severe clinical form, OI
      IIC, with premature rupture of membranes, severe antepartum haemorrhage,
      stillbirth, severe short limbed dwarfism, and extreme osteoporosis. OI59 was a
      better formed baby but was also born prematurely as a result of premature rupture
      of membranes and severe antepartum haemorrhage. She had the radiographic features
      of OI IIA. OI7B was born at term and also had the radiographic features of OI
      IIA. Pathological examination of the skeletons of OI35 and OI59 showed grossly
      deficient intramembranous and endochondral ossification. Trabecular bone was
      sparse in the long bones and vertebrae. The trabeculae contained a cartilage core
      and an overlying layer of woven bone or osteoid. The diaphyses lacked cortical
      bone. The periosteal fibroblasts of OI35 contained grossly distended rough
      endoplasmic reticulum consistent with the 53% reduction in collagen secretion by
      cultured dermal fibroblasts. The aorta, skin, and lungs were hypoplastic in OI35
      and OI59. The findings in this study show that glycine substitutions by valine in
      Gly-X-Y triplets, from glycine 256 to glycine 1006, of the triple helical domain
      of alpha 1(I) chains produce the OI II phenotype. The phenotype was most severe
      in the baby with the most carboxy-terminal substitution.

PMID- 1613763
TI  - Recurrence of neural tube defect in a group of at risk women: a 10 year study of
      Pregnavite Forte F.

PMID- 1613762
TI  - Screening for mutations in the muscle promoter region and for exonic deletions in
      a series of 115 DMD and BMD patients.
AB  - Mutations in the muscle promoter region and exonic deletions were screened in a
      series of 115 unrelated DMD and BMD patients from north-east Italy. No gross
      mutations of the promoter region were found. In three cases in which dystrophin
      of normal size was expressed at low levels, the analysis of DNA sequences of the
      promoter region failed to detect abnormalities. The majority of deletions in
      coding sequences, detected by cDNA probes, occur in the deletion hot spot
      identified by the probe P20. Intrafamilial variability in the severity of the
      disease is reported and discussed.

PMID- 1613764
TI  - Unusual T cell clones in a patient with Nijmegen breakage syndrome.
AB  - The rare autosomal recessive Nijmegen breakage syndrome is characterised by
      severe immunodeficiency, microcephaly associated with mental retardation, and
      typical chromosomal rearrangements in peripheral T lymphocytes. This syndrome,
      though similar to ataxia telangiectasia, does not exhibit the neurological and
      cutaneous signs of this disorder. We report here the first patient with Nijmegen
      breakage syndrome ascertained in France. Chromosome analysis detected, in
      addition to the specific aberrations, two clonal T cell proliferations which do
      not involve the usual bands 14q11.2 and 14q32.1.

PMID- 1613765
TI  - Meckel syndrome and neural tube defects in Kuwait.

PMID- 1613766
TI  - Sociocultural problems in genetic counselling.

PMID- 1613767
TI  - Maxillonasal dysplasia (Binder's syndrome) and chondrodysplasia punctata.

PMID- 1613768
TI  - Marfan syndrome: a mystery solved.

PMID- 1613769
TI  - A linkage map of 10 loci flanking the Marfan syndrome locus on 15q: results of an
      International Consortium study.
AB  - Members of an International Consortium for Linkage Analysis of the Marfan
      Syndrome (MFS1) have pooled data for joint analysis in an attempt to determine
      the precise location of the MFS1 gene and the order of 10 DNA markers on 15q.
      Five laboratories performed a total of 2111 genotypes in 22 families consisting
      of 225 affected and 248 normal subjects. For each marker a mean of 98 meioses was
      informative. D15S48 and D15S1 were identified as the closest linked markers with
      99% upper confidence intervals of 12% and 13% respectively. We have used the CRI
      MAP program to construct the most likely order as: D15S24-D15S25-D15S1-MFS1
      D15S48-D15S49+ ++-(D15S45/S51)-(D15S29/S38). Placement of D15S2 in relation to 
      D15S1-D15S48- cannot be determined with certainty. The genetic map of these
      markers extends 53.6 cM in males and 65.0 cM in females with a sex averaged map
      of 60.7 cM. The sex difference was statistically significant (p = 0.005). Linkage
      heterogeneity between 22 MFS1 families was documented (p = 0.009) necessitating
      the exclusion of one family from the analysis. However, comparison of the
      remaining 21 families for two point and multipoint lod scores showed no evidence
      for linkage heterogeneity of the MFS1 locus.

PMID- 1613770
TI  - Marfan syndrome in a large family: response of family members to a screening
      programme.
AB  - Reaction to medical, social, and genetic implications of Marfan syndrome was
      evaluated by means of two questionnaires, the first after various tests before
      discussion of the diagnosis, the second after full discussion of the patient's
      diagnosis. Thirty-seven members of a family known to be at risk for Marfan
      syndrome attended for both questionnaires. All patients claimed to be satisfied
      with the way they were informed of the results of screening; 41% of patients were
      more worried about their health and 48% were more worried about the future after
      diagnosis. Apart from 50% of the smokers reducing or stopping their intake of
      cigarettes there were only very minor changes in lifestyle over the first month
      despite the increased level of expressed anxiety. If a definitive screening test
      was available, 96% of patients claimed they would have chosen it, 45% felt it
      would have an influence on their future plans, and 78% would choose to use a
      method of prenatal diagnosis for Marfan syndrome if it were available.

PMID- 1613771
TI  - Sensorineural deafness inherited as a tissue specific mitochondrial disorder.
AB  - We present here a large Israeli-Arab kindred with hereditary deafness. In this
      family 55 deaf subjects (29M, 26F), who are otherwise healthy, have been
      identified and traced back five generations to one common female ancestor. The
      deafness is progressive in nature, usually presenting in infancy and childhood.
      Audiometry on six deaf and seven unaffected subjects was consistent with severe
      to profound sensorineural hearing loss. Based on formal family segregation
      analysis, the inheritance of deafness in this family closely fits the expectation
      of a two locus model owing to the simultaneous mutation of a mitochondrial gene
      and an autosomal recessive gene. Thus, this disorder appears to have the unusual
      features of being an inherited tissue specific mitochondrial disease and
      apparently requiring the homozygous presence of a nuclear gene for clinical
      expression. Most importantly, this disorder presents a unique opportunity to
      investigate the molecular basis of hereditary non-syndromic deafness and normal
      hearing.

PMID- 1613772
TI  - Fetal hydrops.
AB  - Seventy-two fetuses or neonates with non-immune hydrops were examined between
      1983 and 1988. The commonest association was chromosome abnormality; 11 fetuses
      had a 45,X karyotype and 11 autosomal trisomy. Chromosome abnormality was
      suspected in a further 20 on necropsy findings but chromosome culture was not
      possible or unsuccessful. In 11 cases there was histological evidence of
      infection; seven babies had major structural anomalies and six affected fetuses
      were twins. In six (8%) the cause of hydrops was not determined compared with
      eight (16%) of cases examined between 1976 and 1982. Hydrops was diagnosed more
      frequently while the fetus was alive, before 20 weeks' gestation, and associated
      with chromosome anomaly than found previously.

PMID- 1613773
TI  - Chromosome in situ suppression hybridisation in human male meiosis.
AB  - Chromosome in situ suppression hybridisation with biotinylated whole chromosome
      libraries permits the unequivocable identification of specific human somatic
      chromosomes in numerous situations. We have now used this so called 'chromosome
      painting' technique in meiotically dividing cells, isolated from human testicular
      biopsy. It is shown that the method allows identification of target homologues,
      bivalents, and sister chromatids throughout the relevant stages of meiosis. Thus,
      a more accurate study of meiosis per se is now available to increase our
      understanding of such processes as first meiotic synapsis of homologues and
      chiasma formation/meiotic crossing over, which are still outstanding biological
      enigmas. The new technology also makes it possible, for the first time, (1) to
      obtain direct numerical data in first meiotic non-disjunction for individual
      chromosomes, and (2) to quantify segregation in male carriers of structural
      rearrangements. We exemplify the use of the chromosome painting technique for a
      first meiotic segregation analysis of an insertional translocation carrier.

PMID- 1613774
TI  - Rapid identification of Legionella species from a single colony by gas-liquid
      chromatography with trimethylsulphonium hydroxide for transesterification.
AB  - Transesterification of bacterial fatty acids to methyl esters with
      trimethylsulphonium hydroxide (TMSH) was compared with a conventional method for
      the identification of Legionella species by capillary gas chromatography. There
      was an extensive coincidence in the gas chromatographic profiles of bacterial
      fatty acid methyl esters (FAMEs) obtained by the two methods. However, the TMSH
      procedure needs less initial material and is much more simple and rapid. The
      chromatographic pattern of FAMEs obtained from a single colony is sufficient for
      the identification of the genus Legionella, and L. pneumophila can be clearly
      distinguished from other Legionella species.

PMID- 1613775
TI  - Dissemination and proliferation of Salmonella typhimurium in genetically
      resistant and susceptible mice.
AB  - Genetically resistant A/J and CBA mice were inoculated intraperitoneally with
      either 10(3) or 10(4) organisms of a virulent strain of Salmonella typhimurium;
      susceptible C57BL/6J and BALB/c mice were inoculated with either 10(2) or 10(3)
      organisms. Except with the smaller dose in resistant mice, fatal infection
      ensued. Bacteraemia occurred within 1 h after inoculation, except that it was not
      detectable during the first 6 h in the susceptible mice inoculated with 10(2)
      organisms. From day 2, the circulating bacterial population continued to increase
      in all infected mice, except that it remained under control in the resistant mice
      inoculated with the lower dose (10(3) organisms). The pathogen proliferated
      logarithmically in the liver from day 2, and a bacterial count of c. 10(8) cfu/g
      of tissue was reached when the animals died at 5-7 days; again, the resistant
      mice inoculated with 10(3) organisms were an exception in which the hepatic
      bacterial population was kept under control and the mice survived.

PMID- 1613776
TI  - Application of biochemical fingerprinting to the investigation of clonal groups
      of Salmonella of serotype Havana.
AB  - A computerised typing method based on biochemical fingerprinting was used to
      investigate biochemical phenotypes (BPTs) among 70 strains of Salmonella of
      serotype Havana isolated from human cases of gastroenteritis in Iran and other
      parts of the world. A total of 16 BPTs comprising five common and 11 single
      phenotypes was identified. The most frequently found BPT contained 24 isolates
      from Iran and nine from other countries. Three common BPTs with two, seven and 15
      isolates were found among Iranian strains only and one common BPT with two
      isolates was found among non-Iranian strains only. Antibiotic-resistance patterns
      and virulence properties of strains from these common BPTs suggested that they
      might be unique clones. Forty-two Iranian isolates shared multi-resistance to
      between three and seven antibiotics. In contrast, none of the isolates from other
      countries was resistant to antibiotics. Furthermore, 43 Iranian isolates showed
      mannose-resistant adhesion to HeLa cells and 24 of them possessed an aerobactin
      mediated iron-uptake system, whereas none of the isolates from other countries
      possessed any of these virulence properties. These findings suggest that four
      unique clones of Salmonella Havana with different BPTs and virulence properties
      are common in Iran; two particular clones were responsible for a majority of
      Havana infections there. However, the most prevalent BPT found among Iranian
      strains was also common in strains from other countries. It is concluded that
      biochemical fingerprinting, as used in this study, is a reliable method for
      identifying clonal groups of Havana strains. The method is reproducible, easy to
      perform and can be used alone, or in combination with other typing methods, in
      epidemiological studies of serotype Havana.

PMID- 1613777
TI  - In-vitro and in-vivo characteristics of TnphoA mutant strains of Salmonella
      serotype Gallinarum not invasive for tissue culture cells.
AB  - Insertion mutants of a strain of Salmonella serotype Gallinarum, the cause of
      fowl typhoid, were produced with transposon TnphoA. Eight mutants were identified
      as being less invasive in cell culture than the parent strain. Neither the parent
      strain nor the mutants showed mannose-sensitive haemagglutination of various red
      blood cell species. Although two mutants gave mannose-resistant (MR)
      haemagglutination of red cells of different animal species these MR activities
      could not be correlated with other characteristics in vitro or in vivo. The
      mutant strains were divisible into three classes by their patterns of
      invasiveness and adhesiveness in vitro and by changes in membrane proteins.
      Strains of classes 1 and 2 had single transposon insertions, detected by Southern
      hybridisation, of 8.9 and 2.4 kb EcoRV-digested chromosomal-fragments,
      respectively, and were slightly less invasive than the parent strain. They were
      no less virulent for chickens by the oral route than a mutant strain shown to be
      as invasive in vitro as the parent strain. The class-2 mutant was also less
      adhesive than the other strains. The single mutant strain of class 3 which
      contained insertions in several chromosomal fragments, was non-invasive in Vero
      cells (less than log10 1.0 cfu/ml recovered compared with log10 2.88 for the
      parent strain) and showed reduced virulence by both oral and intramuscular
      routes. The mutant strains of all classes were taken up equally rapidly from the
      blood by the spleen. Intramuscular immunisation of chickens with the class-3
      mutant strain gave complete protection against oral challenge 3 weeks later with
      1000 oral LD50 doses of the virulent parent strain.

PMID- 1613778
TI  - Comparison of rapid methods for detection of heat-labile (LT) and heat-stable
      (ST) enterotoxin in Escherichia coli.
AB  - Oxoid VET-RPLA, ST-EIA and Pharmacia Phadebact ETEC-LT enterotoxin tests were
      compared to find a simple but reliable method for detecting enterotoxigenic
      Escherichia coli (ETEC) in Hungary. In the Oxoid tests, all six reference LT- or
      ST-producing strains, except one ST-producer, gave positive results. Of 11
      reference porcine enterotoxigenic strains, all four LT-producers gave positive
      reactions for LT but three of 10 ST-producers gave negative reactions for ST.
      Thirteen of 50 strains from culture collections of H. Steinruck (Germany) were
      LT+ and nine of 33 were ST+. When 31 isolates were tested simultaneously with the
      Oxoid and the Pharmacia LT tests, 12 strains were LT+ by the Oxoid LT test but by
      the Phadebact LT test only seven of these strains were LT+ and, of the remainder,
      three gave uncertain results and two gave negative results. Of 69 porcine
      strains, seven were LT+ and three ST+. Of 901 human strains isolated in Hungary,
      10 were LT+ and one of 24 tested was ST+. In two cases, ETEC strains were
      isolated from contacts of travellers returning from Mongolia and Bangladesh.
      Results of comparative studies with reference strains corresponded well to those
      of the classical toxin detection tests. The Oxoid test was rapid, sensitive,
      specific and easy to perform and is recommended for use in screening ETEC
      isolates.

PMID- 1613779
TI  - Adhesion of Shigella dysenteriae type 1 and Shigella flexneri to guinea-pig
      colonic epithelial cells in vitro.
AB  - Adhesion of bacteria to guinea-pig colonic epithelial cells in vitro was
      inhibited by fucose with all the four strains tested (two of Shigella dysenteriae
      type 1 and two of S. flexneri). N-acetyl neuraminic acid and N-acetyl mannosamine
      also caused inhibition, suggesting a multiplicity of receptors on the epithelial
      cell. Congo-red binding of the strains correlated with their adhesive ability,
      whereas haemagglutination of rabbit erythrocytes by the bacteria did not.

PMID- 1613780
TI  - Mechanism of persistent infection associated with peritoneal implants.
AB  - The ability of rabbits to clear an intraperitoneal injection of Pseudomonas
      aeruginosa in the presence or absence of a surgically implanted peritoneal device
      was investigated. Sham-operated rabbits without an implant eliminated a P.
      aeruginosa challenge of 5 x 10(6) cfu/ml; lavage fluid and peritoneal tissues
      became culture-negative within 96 h. However, peritonitis developed in rabbits
      that were given the same number of bacteria in the presence of an implant; high
      bacterial counts were recovered from the lavage fluid and the device itself.
      Scanning and transmission electronmicroscopy revealed bacterial biofilms on the
      surface of the device. Insertion of pre-colonised devices demonstrated a rapid
      multiplication of sessile organisms within the resulting bacterial biofilm.
      Counts reached a plateau of about 1 x 10(7) cfu/cm2 of Silastic by day 16 and
      fluctuated around this level until the end of the study. Pre-immunisation with
      formalin-killed whole cells of P. aeruginosa did not reduce this bacterial growth
      despite high levels of specific IgG. The results confirm the failure of
      peritoneal defences to clear an infection in the presence of an implant following
      either challenge with planktonic bacteria or insertion of a pre-colonised device,
      and demonstrate the rapid development of bacterial biofilms on the surface of the
      implant which appear to protect the bacteria from host defences, even when primed
      by pre-immunisation.

PMID- 1613781
TI  - Ribotyping of coagulase-negative staphylococci.
AB  - The discriminative capacity of ribotyping was initially assessed without
      knowledge of results obtained for the same isolates by use of more established
      typing methods. Forty-eight isolates of coagulase-negative staphylococci (CNS)
      from peritoneal fluids were studied. They were collected prospectively during 31
      consecutive episodes of infection associated with peritoneal dialysis in 17
      patients. DNA was digested by the restriction endonucleases EcoRI or HindIII and
      ribotyped by means of a biotinylated cDNA probe to 16S + 23S staphylococcal
      ribosomal RNA gene sequences. These methods in combination produced a total of 27
      types which compared well with numbers of groups distinguished by other typing
      methods: limited biotype-antibiotic resistogram (ARB; 28), antibiotic resistogram
      alone (25), API-Staph (12), phage typing (9) and plasmid analysis (22).
      Ribotyping was highly reproducible and typed all isolates, including those that
      were not phage-typable (35) or did not contain plasmids (4). When used in a
      hierarchical manner with ARB, ribotyping results produced 13 additional types in
      comparison with the other three methods. When used hierarchically with all other
      typing systems, a further five types were found among isolates from two patients.
      However, some of the differences observed as a result of ribotyping could have
      been due to subtle changes produced by mutation, lysogenisation or gene
      transposition. Since the method requires additional time, expense and technical
      expertise, it is likely to be useful only when answers to specific
      epidemiological problems are required or as an initial screen before using other
      methods of genetic analysis.

PMID- 1613782
TI  - An ultrastructural study of Helicobacter mustelae and evidence of a specific
      association with gastric mucosa.
AB  - The ultrastructure of Helicobacter mustelae, a natural inhabitant of the ferret
      stomach, has been studied and compared with the human gastroduodenal pathogen H.
      pylori. H. mustelae is a short, slightly curved rod, 2 microns x 0.5 micron, with
      four or more sheathed flagella. The most common flagellar configuration is a
      single flagellum at one terminus, bipolar arrangement at the other end and a
      lateral flagellum. Dense inclusion bodies were observed below the flagellar
      insertion sites. It is suggested that this configuration is a specialised
      adaptation to motility in a viscous environment. On examination of the ferret
      gastric mucosa, similarities to H. pylori were observed such as adherence to
      gastric tissue and the formation of adhesion pedestals. However, unlike H.
      pylori, significant numbers of bacteria were intracellular. Furthermore, a much
      greater proportion of H. mustelae were attached to the mucosa with few bacteria
      lying free in the mucus, as is seen with H. pylori. It is concluded that the
      ferret is an important model for the study of adherence of bacteria to gastric
      mucosa and their possible role in peptic ulceration.

PMID- 1613783
TI  - Virulence and adhesive properties of serotypes A and B of Candida albicans
      isolated from paediatric burn patients.
AB  - The virulence and adhesive properties of 50 isolates of Candida albicans
      serotypes A and B collected over 6 years from 48 paediatric burn patients were
      examined to provide more detailed information about candidal pathogenesis in burn
      patients and to examine the relevance of the commonly used epithelial cell
      adhesion assay for determining fungal virulence. The isolates represented a fair
      distribution of serotypes (29 isolates were serotype A and 21 isolates were
      serotype B) and a total of 28 serotype-biotype combinations were found; 32% of
      the serotype-biotype combinations appeared only once, while 44% of the isolates
      showed similar biotype tests for two of three digits. Adhesion of the isolates to
      plastic and to buccal epithelial cells (BECs) was examined and compared after
      growth in a chemically defined medium. There were significant differences in the
      adhesion of individual isolates to plastic or BECs, but no correlation was found
      between biotype and adhesiveness. Serotype B isolates were found to be more
      adhesive to BECs (p less than 0.05) but not to plastic. There was no apparent
      correlation between candidal adhesiveness and site of isolation from these
      patients (autografts, blood, faeces, throat swabs, tracheal aspirates, wounds and
      intravenous catheters), although isolates from catheters were generally less
      adhesive to epithelial cells. Virulence in a systemic infection mouse model
      revealed that there were significant differences in virulence between isolates,
      but no correlation was found between virulence and the biotype, serotype or site
      of isolation. Similarly, no correlation was found between virulence and
      adhesiveness or cell-surface hydrophobicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613784
TI  - Quantitative analysis of immunoglobulin G subclass responses to Pseudomonas
      aeruginosa antigens in cystic fibrosis.
AB  - The four subclasses of IgG have different structures, functions and implications
      in the antibody response. IgG subclass reactions to individual Pseudomonas
      aeruginosa structural antigens in 22 adolescents and young adults with cystic
      fibrosis (CF) were studied qualitatively and quantitatively by densitometric
      analysis of Western blot assays. These patients had been infected by P.
      aeruginosa for 7 years or longer and were divided into two groups according to
      their pulmonary status: Group 1 comprised 11 patients with relatively good
      pulmonary status; Group 2 consisted of 11 patients with poor pulmonary status.
      There was a relative decrease of IgG1 and a relative increase of IgG2 and,
      especially, of IgG3 and IgG4 antibodies against P. aeruginosa antigens in the CF
      patients. Comparison of the two CF patient groups showed a significant increase
      in the proportion of IgG3 in the Group 2 patients. This could be a potential
      cause or effect in the deterioration of their pulmonary function. Densitometric
      analysis of Western blots revealed more than 24 P. aeruginosa antigens and
      indicated those that were the targets of the isotype antibody response(s) that
      were apparently most harmful. Thus, there was a significant increase of IgG2 or
      IgG3 reactivity (or of both) against proteins F, H (H1 and H2), and I in the
      Group 2 patients. One other striking observation of this study was the high
      reactivity of IgG4 antibodies to protein H. IgG4 was the major antibody to this
      protein in seven of the 11 Group 1 patients compared to two of the 11 in Group 2.
      We hypothesise that IgG4 antibodies may antagonise IgG2 antibodies, helping to
      preserve stable pulmonary function.

PMID- 1613785
TI  - Ophthalmic laser surgery: therapeutic implications for the primary physician.
AB  - This paper represents the results of a retrospective study on the diagnosis and
      treatment of 102 consecutive patients who received laser surgery in a general
      ophthalmic practice during the period of August 1989 to September 1991. The
      purpose of the study is to document and interpret the type of eye disorders that
      lend themselves to definitive laser treatment. The goal of this article is to
      enhance the awareness of non-ophthalmologists in their pivotal and vital role in
      referring patients to an ophthalmologist for evaluation of the basic disease
      processes which, left untreated, can lead to vision impairment or blindness.

PMID- 1613786
TI  - Topological analysis of the hepatitis B virus core particle by cysteine-cysteine
      cross-linking.
AB  - The nucleocapsid, or core particle, of hepatitis B virus is formed by 180
      subunits of the core protein, which contains Cys at positions 48, 61, 107 and
      183, the latter constituting the C terminus. Upon adventitious oxidation, some or
      all of these cysteine residues participate in the formation of disulphide
      bridges, leading to polymerization of the subunits within the particle. To
      utilize the cysteine residues as topological probes, we reduced the number of
      possible intersubunit crosslinks by replacing these residues individually, or in
      all combinations, by serine. A corresponding set of variants was constructed
      within the context of an assembly-competent core protein variant that lacks the
      highly basic C-terminal region. Analysis, by polyacrylamide gel electrophoresis
      under non-reducing conditions, of the oxidative crosslinking products formed by
      the wild-type and mutant proteins expressed in Escherichia coli, revealed a clear
      distinction between the three N-proximal, and the C-terminal Cys: N-proximal Cys
      formed intermolecular disulphide bonds only with other N-proximal cysteine
      residues, leading to dimerization. Cys48 and Cys61, in contrast to Cys107, could
      be crosslinked to the homologous cysteine residues in a second subunit, and are
      therefore located at the dimer interface. Cys 183 predominantly formed disulphide
      bonds with Cys183 in subunits other than those crosslinked by the N-proximal
      cysteine residues. Hence, the polymers generated by oxidation of the wild-type
      protein are S-S-linked dimeric N-terminal domains interconnected via
      Cys183/Cys183 disulphide bonds. The intermolecular crosslinks between the N
      proximal cysteine residues were apparently the same in the C-terminally truncated
      and in the full-length proteins, corroborating the model in which the N-terminal
      domain and the C terminus of the HBV core protein form two distinct and
      structurally independent entities. The strong tendency of the N-terminal domain
      for dimeric interactions suggests that core protein dimers are the major
      intermediates in hepatitis B virus nucleocapsid assembly.

PMID- 1613787
TI  - Purification and crystallization of glycogen phosphorylase from Saccharomyces
      cerevisiae.
AB  - Glycogen phosphorylase from Saccharomyces cerevisiae is activated by the covalent
      phosphorylation of a single threonine residue in the N terminus of the protein.
      We have hypothesized that the structural features that effect activation must be
      distinct from those characterized in rabbit muscle phosphorylase because the two
      enzymes have unrelated phosphorylation sites located in dissimilar protein
      contexts. To understand this potentially novel mechanism of activation by
      phosphorylation, we require information at atomic resolution of the
      phosphorylated and unphosphorylated forms of the enzyme. To this end, we have
      purified, characterized and crystallized glycogen phosphorylase from S.
      cerevisiae. The enzyme was isolated from a phosphorylase-deficient strain
      harboring a multicopy plasmid containing the phosphorylase gene under the control
      of its own promoter. One liter of cultured cells yields 12 mg of crystallizable
      material. The purified protein was not phosphorylated and had an activity of 4.7
      units/mg in the presence of saturating amounts of substrate. Yeast phosphorylase
      was crystallized in four different crystal forms, only one of which is suitable
      for diffraction studies at high resolution. The latter belongs to space group
      P4(1)2(1)2 with unit cell constants of a = 161.1 A and c = 175.5 A Based on the
      density of the crystals, the solvent content is 49.7%, indicating that the
      asymmetric unit contains the functional dimer of yeast phosphorylase.

PMID- 1613788
TI  - Aromatic-aromatic interactions in the zinc finger motif. Analysis of the two
      dimensional nuclear magnetic resonance structure of a mutant domain.
AB  - The folding and stability of globular proteins are determined by a variety of
      chemical mechanisms, including hydrogen bonds, salt bridges and the hydrophobic
      effect. Of particular interest are weakly polar interactions involving aromatic
      rings, which are proposed to regulate the geometry of closely packed protein
      interiors. Such interactions reflect the electrostatic contribution of pi
      electrons and, unlike van der Waals' interactions and the hydrophobic effect,
      may, in principle, introduce a directional force in a protein's hydrophobic core.
      Although the weakly polar hypothesis is supported by a statistical analysis of
      protein structures, the general importance of such contributions to protein
      folding and stability is unclear. Here, we show the presence of alternative
      aromatic-aromatic interactions in the two-dimensional nuclear magnetic resonance
      structure of a mutant Zn finger. Changes in aromatic packing lead in turn to
      local and non-local differences between the structures of a wild-type and mutant
      domain. The results provide insight into the evolution of Zn finger sequences and
      have implications for understanding how geometric relationships may be chemically
      encoded in a simple sequence template.

PMID- 1613789
TI  - Hybrid system for protein secondary structure prediction.
AB  - We have developed a hybrid system to predict the secondary structures (alpha
      helix, beta-sheet and coil) of proteins and achieved 66.4% accuracy, with
      correlation coefficients of C(coil) = 0.429, C alpha = 0.470 and C beta = 0.387.
      This system contains three subsystems ("experts"): a neural network module, a
      statistical module and a memory-based reasoning module. First, the three experts
      independently learn the mapping between amino acid sequences and secondary
      structures from the known protein structures, then a Combiner learns to combine
      automatically the outputs of the experts to make final predictions. The hybrid
      system was tested with 107 protein structures through k-way cross-validation. Its
      performance was better than each expert and all previously reported methods with
      greater than 0.99 statistical significance. It was observed that for 20% of the
      residues, all three experts produced the same but wrong predictions. This may
      suggest an upper bound on the accuracy of secondary structure predictions based
      on local information from the currently available protein structures, and
      indicate places where non-local interactions may play a dominant role in
      conformation. For 64% of the residues, at least two experts were the same and
      correct, which shows that the Combiner performed better than majority vote. For
      77% of the residues, at least one expert was correct, thus there may still be
      room for improvement in this hybrid approach. Rigorous evaluation procedures were
      used in testing the hybrid system, and statistical significance measures were
      developed in analyzing the differences among different methods. When measured in
      terms of the number of secondary structures (rather than the number of residues)
      that were predicted correctly, the prediction produced by the hybrid system was
      also better than those of individual experts.

PMID- 1613790
TI  - Electron microscopy of decorated crystals for the determination of
      crystallographic rotation and translation parameters in large protein complexes.
AB  - The lumazine synthase/riboflavin synthase complex of Bacillus subtilis consists
      of an icosahedral capsid of 60 beta subunits enclosing a core of 3 alpha
      subunits. The preparation of reconstituted hollow capsids consisting of 60 beta
      subunits and their crystallization in a hexagonal (space group P6(3)22) and in a
      monoclinic (space group C2) modification have been described. The rotational and
      translational parameters of the protein molecules in both crystal forms were
      studied by electron microscopy of freeze-etch replicas and by Patterson
      correlation techniques. Decoration with silver and image processing provided
      images with the positions of the 3-fold and 5-fold molecular axes being labelled
      by metal clusters. This allowed the unequivocal determination of the orientation
      and translational position of the protein molecules with respect to the
      crystallographic axes in the hexagonal modification. From inspection of the
      decoration images it was immediately obvious that the hexagonal crystal forms of
      alpha 3 beta 60 and of beta 60 are isomorphous. In the monoclinic crystals, a
      local icosahedral 2-fold coincides with the crystallographic 2-fold axis. The
      exact solution of the particle orientation was determined by interpretation of
      Patterson self-rotation functions for the icosahedral symmetry axes. Rotational
      and translational parameters for the monoclinic modification are given. A
      rational procedure for the efficient application of freeze-etching techniques in
      order to elucidate the packing in crystals of large proteins is described.

PMID- 1613791
TI  - Solution conformations and aggregational properties of synthetic amyloid beta
      peptides of Alzheimer's disease. Analysis of circular dichroism spectra.
AB  - The A4 or beta-peptide (39 to 43 amino acid residues) is the principal
      proteinaceous component of amyloid deposits in Alzheimer's disease. Using
      circular dichroism (c.d.), we have studied the secondary structures and
      aggregational properties in solution of 4 synthetic amyloid beta-peptides: beta
      (1-28), beta-(1-39), beta-(1-42) and beta-(29-42). The natural components of
      cerebrovascular deposits and extracellular amyloid plaques are beta-(1-39) and
      beta-(1-42), while beta-(1-28) and beta-(29-42) are unnatural fragments. The beta
      (1-28), beta-(1-39) and beta-(1-42) peptides adopt mixtures of beta-sheet, alpha
      helix and random coil structures, with the relative proportions of each secondary
      structure being strongly dependent upon the solution conditions. In aqueous
      solution, beta-sheet structure is favored for the beta-(1-39) and beta-(1-42)
      peptides, while in aqueous solution containing trifluoroethanol (TFE) or
      hexafluoroisopropanol (HFIP), alpha-helical structure is favored for all 3
      peptides. The alpha-helical structure unfolds with increasing temperature and is
      favored at pH 1 to 4 and pH 7 to 10; the beta-sheet conformation is temperature
      insensitive and is favored at pH 4 to 7. Peptide concentration studies showed
      that the beta-sheet conformation is oligomeric (intermolecular), whereas the
      alpha-helical conformation is monomeric (intramolecular). The rate of aggregation
      to the oligomeric beta-sheet structure (alpha-helix----random coil----beta-sheet)
      is also dependent upon the solution conditions such as the pH and peptide
      concentration; maximum beta-sheet formation occurs at pH 5.4. These results
      suggest that beta-peptide is not an intrinsically insoluble peptide. Thus,
      solution abnormalities, together with localized high peptide concentrations,
      which may occur in Alzheimer's disease, may contribute to the formation of
      amyloid plaques. The hydrophobic beta-(29-42) peptide adopts exclusively an
      intermolecular beta-sheet conformation in aqueous solution despite changes in
      temperature or pH. Therefore, this segment may be the first region of the beta
      peptide to aggregate and may direct the folding of the complete beta-peptide to
      produce the beta-pleated sheet structure found in amyloid deposits. Differences
      between the solution conformations of the beta-(1-39) and beta-(1-42) peptides
      suggests that the last 3 C-terminal amino acids are crucial to amyloid
      deposition.

PMID- 1613792
TI  - Three-dimensional structure of a recombinant variant of human pancreatic
      secretory trypsin inhibitor (Kazal type).
AB  - A modified version of the human pancreatic trypsin inhibitor (PSTI), generated in
      a protein-design project, has been crystallized in spacegroup P4(3) with lattice
      constants a = 40.15 A, c = 33.91 A. The structure has been solved by molecular
      replacement. Refinement of the structure by simulated annealing and conventional
      restrained least-squares yielded for 8.0 to 2.3 A data a final R-value of 19.1%.
      Differences to the known structures of porcine PSTI complexed with trypsinogen
      and modified human PSTI complexed with chymotrypsinogen occur at the flexible N
      terminal part of the molecule. These differences are influenced by crystal
      packing, as are low temperature factors for the binding loop. The geometry of the
      binding loop is similar to the complexed structures.

PMID- 1613793
TI  - Co-operative binding of the globular domain of histone H5 to DNA.
AB  - The globular domain of histone H5 (GH5) was prepared by trypsin digestion of H5
      that was extracted from chicken erythrocyte nuclei with NaCl. Electron
      microscopy, sucrose gradient centrifugation, native agarose gel electrophoresis
      and equilibrium density gradient ultracentrifugation show that GH5 binds co
      operatively to double-stranded DNA. The electron microscopic images suggest that
      the GH5-DNA complexes are very similar in structure to co-operative complexes of
      intact histone H1 (or its variants) with double-stranded DNA, studied previously,
      which have been proposed to consist of two parallel DNA double helices
      sandwiching a polymer of the protein. For complexes with GH5 or with intact H1,
      naked DNA co-sediments with the protein-DNA complexes through sucrose gradients,
      and DNA also appears to protrude from the ends and sides of the complexes;
      measurements of the protein-DNA stoichiometry in fractionated samples may not
      reflect the stoichiometry in the complexes. An estimate of the stoichiometry
      obtained from the buoyant density of fixed GH5-DNA complexes in CsCl suggests
      that sufficient GH5 is present in the complexes for the GH5s to be in direct
      contact, as required by a simple molecular mechanism for the co-operative
      binding. Chemical crosslinking demonstrates that GH5s are in close proximity in
      the complexes. In the absence of DNA, GH5-GH5 interactions are weak or non
      existent.

PMID- 1613794
TI  - Crystallization and preliminary X-ray studies of the liganded lysine, arginine,
      ornithine-binding protein from Salmonella typhimurium.
AB  - The periplasmic binding protein LAO from Salmonella typhimurium, which is
      involved in lysine, arginine and ornithine transport, has been crystallized
      together with one of its ligands, arginine (LAO-Arg). Preliminary X-ray
      diffraction studies of LAO-Arg crystal show that it belongs to the orthorhombic
      space group P2(1)2(1)2(1) and has the unit cell dimensions of a = 37.65 A, b =
      59.45 A, c = 115.91 A. Crystals of the LAO-Arg complex diffract beyond 2.0 A
      resolution.

PMID- 1613795
TI  - Crystallization and preliminary X-ray studies on the co-repressor binding domain
      of the Escherichia coli purine repressor.
AB  - The purine repressor is a putative helix-turn-helix DNA-binding protein that
      regulates several genetic loci important in purine and pyrimidine metabolism in
      Escherichia coli. The protein is composed of two domains, an N-terminal DNA
      binding domain and a C-terminal core that binds the purine co-repressors, guanine
      and hypoxanthine. The co-repressor binding domain (residues 53 to 341) has been
      crystallized from polyethylene glycol 600-MgCl2 solutions. They are of the
      monoclinic form, space group P2(1), with a = 38.2 A, b = 125.7 A, c = 61.8 A and
      beta = 100.2 degrees. They diffract to a resolution of at least 2.2 A and contain
      two monomers per asymmetric unit. The importance of the structural determination
      of this domain is underscored by the high degree of sequence homology displayed
      within the effector binding sites among a sub-class of helix-turn-helix proteins,
      of which LacI and GalR are members. The structure of the PurR co-repressor
      binding domain will provide a high resolution view of one such domain and could
      serve as a possible model for future effector site structural determinations.
      Perhaps more important will be this structure's contribution to the further
      understanding of how protein-DNA interactions are modulated.

PMID- 1613796
TI  - Crystallization and preliminary crystallographic study of neuraminidase from
      Micromonospora viridifaciens.
AB  - Single crystals of neuraminidase from the bacterium Micromonospora viridifaciens
      were obtained using the hanging drop vapour diffusion method and polyethylene
      glycol as precipitant at pH 5.0 or 5.5. The crystals belong to the orthorhombic
      space group P2(1)2(1)2(1), with unit cell dimensions a = 48.14 A, b = 82.73 A, c
      = 84.75 A and with one molecule in the asymmetric unit. Diffraction extends to at
      least 1.7 A.

PMID- 1613797
TI  - Initiating a crystallographic study of a class II fructose-1,6-bisphosphate
      aldolase.
AB  - We have reproducibly crystallized the metal-dependent Class II fructose-1,6
      bisphosphate aldolase from Escherichia coli. Crystals in the shape of truncated
      hexagonal bipyramids have unit cell dimensions of a = b = 78.4 A, c = 290.6 A and
      are suitable for a detailed structural analysis. The space group has been
      identified as P6(1)22 or enantiomorph. Data sets to approximately 2.9 A
      resolution have been recorded using both the Rigaku R-AXIS IIc image plate area
      detector coupled to a copper target rotating anode X-ray source and using the MAR
      image plate systems with synchrotron radiation at the EMBL outstation DESY in
      Hamburg, and at S.R.S. Daresbury. Diffraction beyond 2.5 A has been observed when
      large freshly grown crystals are used with the synchrotron beam. A data set to
      this resolution has been collected. Several putative heavy-atom derivative data
      sets have also been measured using synchrotron radiation facilities and analysis
      of these data sets is in progress.

PMID- 1613798
TI  - De novo design, synthesis and study of albebetin, a polypeptide with a
      predetermined three-dimensional structure. Probing the structure at the nanogram
      level.
AB  - The de novo polypeptide named albebetin was designed to form the tertiary fold
      that has not yet been observed in natural proteins. The design was based on the
      molecular theory of protein structures. The gene coding for this polypeptide was
      chemically synthesized. For the initial characterization of a protein structure,
      a new approach has been developed that uses only nanogram amounts of a
      polypeptide without its previous purification. This approach includes the
      biosynthesis of radiolabeled protein in a cell-free translation system with
      subsequent analysis of its compactness and structure by size-exclusion
      chromatography, urea-gradient electrophoresis and limited proteolysis. According
      to all tests used, albebetin has a compact stable structure.

PMID- 1613799
TI  - Thermodynamic consequences of the removal of a disulphide bridge from hen
      lysozyme.
AB  - Differential scanning calorimetry experiments as a function of pH have been
      carried out for native hen egg white lysozyme and a three-disulphide derivative
      (CM6,127-lysozyme). The results indicate that the enthalpy (delta H298) and heat
      capacity changes (delta Cp) for unfolding are closely similar for the two
      proteins. This shows that the substantial reduction (25 degrees C at pH 3.8) in
      Tm resulting from removal of the 6-127 disulphide bond can, to a good
      approximation, be attributed totally to an increase in the entropy difference
      between the native and denatured states. The significance of this result for
      understanding the factors influencing the stability of folded proteins is
      discussed.

PMID- 1613800
TI  - Co-optimization of ribozyme substrate stacking and L-arginine binding.
AB  - A model of the Tetrahymena catalytic site predicts that nucleotide 262 (nt262)
      caps an RNA pocket in which nucleoside substrates and arginine-like competitive
      inhibitors reside. Here we show that substituted RNAs behave as if nt262 stacks
      on nucleoside substrates, supporting the model. The more frequent an nt262 is in
      natural sequences, the more reactive the corresponding Tetrahymena RNA is for
      both cognate and non-cognate nucleoside substrates. These more reactive RNAs with
      the majority nt262 also bind arginine more strongly, stereoselect more strongly
      in favor of L-arginine, and make a greater distinction between the somewhat
      similar side-chains of L-arginine and L-lysine. These parallel changes in
      interaction with nucleosides and arginine analogs seem best explained by stacking
      of the arginine's guanidino group under the nt262 base. One consequence is that
      selection for improved Tetrahymena catalysis with nucleosides should also yield
      an improved arginine site.

PMID- 1613801
TI  - Telomere end-replication problem and cell aging.
AB  - Since DNA polymerase requires a labile primer to initiate unidirectional 5'-3'
      synthesis, some bases at the 3' end of each template strand are not copied unless
      special mechanisms bypass this "end-replication" problem. Immortal eukaryotic
      cells, including transformed human cells, apparently use telomerase, an enzyme
      that elongates telomeres, to overcome incomplete end-replication. However,
      telomerase has not been detected in normal somatic cells, and these cells lose
      telomeres with age. Therefore, to better understand the consequences of
      incomplete replication, we modeled this process for a population of dividing
      cells. The analysis suggests four things. First, if single-stranded overhangs
      generated by incomplete replication are not degraded, then mean telomere length
      decreases by 0.25 of a deletion event per generation. If overhangs are degraded,
      the rate doubles. Data showing a decrease of about 50 base-pairs per generation
      in fibroblasts suggest that a full deletion event is 100 to 200 base-pairs.
      Second, if cells senesce after 80 doublings in vitro, mean telomere length
      decreases about 4000 base-pairs, but one or more telomeres in each cell will lose
      significantly more telomeric DNA. A checkpoint for regulation of cell growth may
      be signalled at that point. Third, variation in telomere length predicted by the
      model is consistent with the abrupt decline in dividing cells at senescence.
      Finally, variation in length of terminal restriction fragments is not fully
      explained by incomplete replication, suggesting significant interchromosomal
      variation in the length of telomeric or subtelomeric repeats. This analysis,
      together with assumptions allowing dominance of telomerase inactivation, suggests
      that telomere loss could explain cell cycle exit in human fibroblasts.

PMID- 1613802
TI  - Genomic organization and context of a trypanosome variant surface glycoprotein
      gene family.
AB  - We have defined the genomic organization and genomic context of a Trypanosoma
      brucei brucei gene family encoding variant surface glycoproteins (VSGs). This
      gene family is neither tandemly repeated nor closely linked in the genome, and is
      not located on small or intermediate size chromosomes. Two dispersed repeated
      sequence elements, RIME-ingi and the upstream repeat sequence, are linked to
      members of this gene family; however, the upstream repeat sequences are closely
      linked only to the basic copy. In other isolates of T.b. brucei this gene family
      appears conserved with some variation; a restriction fragment length polymorphism
      found among these isolates suggests the hypothesis that VSG genes may
      occasionally be diploid. A model accounting for both the generation of dispersed
      families of VSG genes, and for the interstrain variability of VSG genes, is
      proposed.

PMID- 1613804
TI  - Papers from the Ninth Annual Neurotrauma Society Meeting. New Orleans, Louisiana,
      November 9-10, 1991. Proceedings.

PMID- 1613803
TI  - Sequence divergence among members of a trypanosome variant surface glycoprotein
      gene family.
AB  - We have used analysis of DNA sequence data from four members of a Trypanosoma
      brucei variant surface glycoprotein gene family to investigate the molecular
      basis of the generation of antigenic diversity in African trypanosomes. Among
      these four sequences we find the greatest similarity in the untranslated
      sequences immediately upstream from the coding region. A complex pattern of
      nucleic acid and predicted amino acid sequence divergence appears starting at the
      coding sequence. Two related but highly divergent hydrophobic leaders are
      associated with different members of this gene family; both forms of these
      hydrophobic leaders appear to exist in other isolates of T. b. brucei. We find
      conservative replacements in the first 120 predicted amino acid residues of the
      mature protein; the following 80 predicted residues show less conservative
      replacements, and we suggest that this region may be hypervariable and exposed to
      the aqueous environment.

PMID- 1613805
TI  - Biochemistry and pharmacology of lipid antioxidants in acute brain and spinal
      cord injury.
AB  - Oxygen radical-mediated lipid peroxidation (LP) has been suggested increasingly
      to be an important factor in posttraumatic neuronal degeneration. Thus, numerous
      studies have evaluated the neuroprotective efficacy of pharmacological agents
      with lipid antioxidant activity in models of spinal cord and brain injury.
      Intensive pretreatment of animals with the endogenous lipid peroxyl radical
      scavenger vitamin E (i.e., alpha-tocopherol) has been shown to decrease
      posttraumatic spinal cord ischemia and to enhance chronic neurological recovery.
      However, the slow CNS tissue uptake of vitamin E requires chronic dosing, making
      it an impractical agent for treatment of acute neural injury. The glucocorticoid
      steroid, methyl-prednisolone (MP), has been shown to possess significant
      antioxidant efficacy and, when administered to animals or humans in antioxidant
      doses, improves chronic neurological recovery after spinal cord injury. This
      activity of MP is independent of the steroid's glucocorticoid receptor-mediated
      actions, as evidenced by the efficacy of the novel antioxidant 21-aminosteroids,
      which are devoid of glucocorticoid activity but have greater antioxidant efficacy
      than MP. One of these, tirilazad mesylate (U-74006F), has been shown to be
      effective in animal models of brain and spinal cord injury and is currently the
      subject of phase II clinical trials. Recently, compounds that combine the amino
      functionality of the 21-amino-steroids with the peroxyl radical scavenging
      chromanol portion of vitamin E (i.e., 2-methylaminochromans) also have shown
      promise as neuroprotective agents. The consistent benefit afforded by antioxidant
      compounds further supports the concept that LP is an important therapeutic target
      for acute pharmacological neuroprotection.

PMID- 1613806
TI  - The role of glutamate antagonists for the treatment of CNS injury.
AB  - Ischemic damage, chiefly of the focal type, and axonal disruption (diffuse axonal
      injury) are the major factors causing brain damage after human head injury. About
      one third of this damage may be delayed hours or days after the injury. Evidence
      from four animal models, each relevant to different aspects of human head injury,
      has shown that excitatory amino acid-induced changes are responsible for a
      proportion of the posttraumatic sequelae and that these effects can be blocked by
      EAA antagonists. This evidence is reviewed, and the implications for the conduct
      of human trials with EAA antagonists are discussed.

PMID- 1613807
TI  - The importance of brain temperature in cerebral injury.
AB  - The recent finding that small variations in brain temperature can critically
      determine the extent of histopathological injury in animal models of brain injury
      has generated renewed interest in hypothermic brain protection. Whereas mild
      hypothermia protects the brain from ischemic and traumatic brain injury, mild
      hyperthermia worsens ischemic outcome. Selective brain cooling has many
      advantages over whole body cooling, including the elimination of harmful side
      effects, such as cardiac arrhythmias. In addition to the clinical issue of brain
      protection, manipulating brain temperature has become a powerful tool with which
      to investigate the pathophysiology of ischemic and traumatic brain injury. The
      purpose of this article is to review and discuss recent findings demonstrating
      the importance of brain temperature in ischemic and traumatic brain injury.
      Potential mechanisms by which mild hypothermia may attenuate and mild
      hyperthermia accentuate the detrimental consequences of brain injury are
      reviewed.

PMID- 1613808
TI  - Systemic hypothermia in treatment of brain injury.
AB  - An extensive literature suggests that there are minimal complications of systemic
      hypothermia in humans at and above 30 degrees C for periods of several days.
      Intracranial hemorrhage has been found to complicate profound hypothermia (10-15
      degrees C), and ventricular arrhythmias occur at temperatures below 30 degrees C.
      Our initial clinical studies were with 21 patients undergoing elective craniotomy
      cooled to 30-32 degrees C for 1-8 h (mean 4 h). Hypothermia was induced by
      surface cooling with water blankets. No complications were found. Among 11
      patients with severe brain injury, cooling to levels below 32 degrees C was
      associated with ventricular arrhythmias in 1 patient and atrioventricular block
      in 1 patient. Asymptomatic hypokalemia was found routinely and treated with
      potassium replacement. No intracranial hemorrhage or other complications were
      found. With surface cooling, intravascular temperature dropped at 1.6 degrees
      C/h. Based on the safety of surface cooling to a core temperature of 32 degrees C
      for 48 h, we are conducting a randomized study of this level of hypothermia in
      patients with severe brain injury, cooled within 6 h of injury.

PMID- 1613809
TI  - Hypothermia in spinal cord injury.
AB  - Early investigations involving central nervous system (CNS) temperature lowering
      to protect against the detrimental effects of hypoxia and ischemia were based on
      the observation that hypothermia reduces brain metabolism and energy consumption.
      The protective effects of hypothermia have been demonstrated in numerous
      experimental models of cerebral ischemia and recently in models of brain trauma.
      These observations also led to the application of hypothermia, in the form of
      local spinal cord cooling (LSCC), in animal models of experimental spinal cord
      injury (SCI). Although some investigators have reported negative results in
      studies of LSCC following traumatic SCI, the majority of studies have noted
      beneficial effects. The favorable results in animal experimentation led to a
      limited number of cases where LSCC was used in the treatment of human SCI.
      However, results are difficult to interpret because (1) most investigators report
      only a small number of cases, (2) the studies lack a control population, (3) the
      time interval from injury to the application of cooling has been highly variable,
      and (4) several investigators combined drug treatments with LSCC. In these
      experiments, LSCC was achieved via perfusion with a cold solution or an epidural
      heat exchanger and the aim was to lower cord temperatures significantly (about 10
      degrees C). The application of the technique itself is fraught with difficulties.
      It requires acute surgery in a traumatized patient, a wide multilevel
      laminectomy, and minimizing the time interval between injury and the application
      of spinal cord cooling. Recent studies in experimental brain ischemia strongly
      suggest that a drastic lowering of CNS temperature may be unnecessary to lessen
      the degree of tissue damage occurring following an ischemic brain
      injury.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613810
TI  - Monosialogangliosides, neuroprotection, and neuronal repair processes.
AB  - Gangliosides play important roles in the physiologic operations of the nervous
      system, in particular that of the brain. Changes in ganglioside composition occur
      in the mammalian brain not only during development, but also in aging and in
      several neuropathologic situations. Gangliosides may modulate the ability of the
      brain to modify its response to signals from the surrounding environment. For
      example, cultured neurons respond to exogenous gangliosides with changes
      characteristic of differentiation; these sialoglycosphingolipids also amplify the
      response of neurons to neurotrophic factors. Additional in vitro studies have
      shown that monosialogangliosides like GM1 protect against excitatory amino acid
      related neurotoxicity by limiting the downstream consequences of receptor
      overstimulation. Systemic administration of GM1 is efficacious in reducing acute
      nerve cell damage and in facilitating medium- and long-term functional recovery
      following various types of injury to the adult mammalian central nervous system.
      The GM1 protective effects in the acute injury phase likely result, at least in
      part, from attenuation of excitotoxicity, while long-term functional recovery may
      reflect GM1 potentiation of neurotrophic factors. The potential therapeutic
      efficacy of GM1 is encouraged by recent positive clinical findings in acute human
      stroke, subarachnoid hemorrhage, and spinal cord injury.

PMID- 1613811
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- 1613812
TI  - A randomized trial of nimodipine in severe head injury: HIT I. British/Finnish Co
      operative Head Injury Trial Group.
AB  - We studied the efficacy of nimodipine in severely head-injured patients in a
      randomized study. Of 176 patients who received nimodipine, 2 mg/h iv for 2 day,
      53% had a favorable outcome (moderate or good recovery). Of 175 control patients,
      49% had a favorable outcome. This difference was not statistically significant
      but does not exclude the possibility that a study of a larger number of patients
      could show a clinically useful benefit.

PMID- 1613813
TI  - Intracellular acidosis in human and experimental brain injury.
AB  - Brain tissue acidosis is considered to play a role in the complex sequence of
      events following traumatic brain injury. This report reviews the experimental and
      clinical research conducted at the Medical College of Virginia to help clarify
      the extent of metabolic derangement that occurs and to evaluate the effect of
      treatment. Experimental injury models in ventilated animals showed that trauma
      produces a mild brain tissue acidosis that recovers within hours of injury.
      Hypoxia combined with trauma produces a relative ischemia and exacerbates the
      acidosis, which eventually resolves with resuscitation. Other studies revealed
      that CSF lactate measurements should be interpreted with caution, particularly in
      patients with subarachnoid hemorrhage. The results of two randomized clinical
      trials testing therapeutic effects of sustained hyperventilation and treatment
      with tromethamine (THAM) are discussed.

PMID- 1613814
TI  - Therapeutic potential for adenosine receptor activation in ischemic brain injury.
AB  - The present report reviews the biochemical and physiological responses to
      adenosine receptor activation and how these responses underlie the ability of
      adenosine to couple energy demand with energy supply. In addition, activation of
      adenosine receptors pharmacologically is shown to initiate various reactions
      which could be responsible for the observed adenosine-mediated attenuation of the
      neuropathological consequences of brain ischemia. Also reported is the extent to
      which side effects such as hypothermia can contribute to the observed efficacy of
      adenosine agonist administration in the small animal model of ischemia. Data from
      various in vitro and in vivo ischemia studies is presented showing that
      neuroprotection can be achieved following pharmacological activation of adenosine
      receptors either through agonists with high affinity for A1 adenosine receptors
      or drugs which potentiate endogenous adenosine levels. In general the data
      support utilization of adenosine receptor activation as a means of attenuating
      ischemic brain damage.

PMID- 1613815
TI  - Blood flow and metabolic therapy in CNS injury.
AB  - A hypermetabolic state, consisting of increased resting energy expenditure,
      excessive protein wasting, and hyperglycemia, occurs in patients with a severe
      head injury. The hypermetabolism can affect survival by rapidly resulting in
      protein-calorie malnutrition (increased energy expenditure and protein wasting)
      and may adversely affect neurological recovery by altering the microenvironment
      of the injured brain (hyperglycemia).

PMID- 1613816
TI  - Nicotinic and muscarinic subtypes in the human brain: changes with aging and
      dementia.
AB  - Different effects of normal aging on muscarinic and nicotinic receptor subtypes
      were observed in postmortem brain tissue from different regions of the human
      brain. A significant decrease in M1 and M2 receptors was found in cerebral
      cortex, while the M1 and especially the M2 receptors increased with age in the
      thalamus. A similar pattern of changes was also observed when using (-)3H
      nicotine as ligand for nicotinic receptors in the cortex and thalamus. No
      significant changes in nicotinic receptor binding were observed with age in the
      cortex or thalamus when using 3H-acetylcholine as ligand. Nicotinic and
      muscarinic receptors in the brain are not equally affected in dementia disorders.
      A marked loss of high affinity nicotinic receptors was observed in cortical
      tissue from patients with Alzheimer's disease and with multi-infarct dementia
      (MID). The muscarinic receptors were (both M1 and M2) increased in Alzheimer
      cortical tissue while they were decreased in MID.

PMID- 1613817
TI  - MPTP-induced parkinsonism: acceleration of biochemical and behavioral recovery by
      GM1 ganglioside treatment.
AB  - The effects of GM1 ganglioside administration on functional recovery and recovery
      of caudate nucleus dopamine levels have been assessed in cats made parkinsonian
      by administration of the dopaminergic neurotoxin 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine (MPTP). Cats made severely parkinsonian by MPTP administration
      began to show spontaneous functional recovery by the third week after MPTP, as
      had been observed in previous studies with this model. In contrast, cats with
      similar initial impairment but which received 3 weeks of GM1 ganglioside
      treatment (30 mg/kg, i.p. daily) showed an accelerated behavioral recovery,
      showing significant functional improvement after the first week of GM1 treatment
      and almost normal function by the end of the third week of treatment. The GM1
      treated cats had caudate nucleus dopamine, 3,4-dihydroxyphenylacetic acid
      (DOPAC), and HVA levels significantly increased above levels measured in saline
      treated MPTP control cats. A second group of cats received MPTP only until the
      first signs of parkinsonism were observed and thus overall had a less severe
      initial syndrome than the cats described previously. Again, while all cats showed
      functional recovery over time, the recovery process was accelerated in GM1
      treated cats. GM1 treatment also caused a significant increase in caudate
      dopamine levels in these cats. These results suggest that GM1 ganglioside
      administration can result in increased dopamine levels even in the heavily
      denervated striatum and accelerate functional recovery after an MPTP-induced
      lesion of the nigrostriatal dopamine system in the cat. This suggests that GM1 or
      other trophic factor therapies may be fruitful treatment strategies for a
      disorder of nigrostriatal function such as Parkinson's disease.

PMID- 1613818
TI  - The structural integrity of glial scar tissue associated with a chronic spinal
      cord lesion can be altered by transplanted fetal spinal cord tissue.
AB  - The potential for fetal spinal cord (FSC) tissue transplants to modify an
      established glial scar or to restrict the reformation of a scar following
      surgical manipulation of a chronic lesion site was studied in the injured rat
      spinal cord. Six to eight weeks after preparation of a hemisection lesion cavity,
      glial scar tissue was left intact in one group, whereas in a second group it was
      excised prior to transplantation of a suspension of FSC tissue. From the first
      group, examination of serial sections through the graft-host interface that had
      been immunoreacted for glial fibrillary acidic protein (GFAP) demonstrated that
      in many cases the glial scar no longer was a continuous wall separating the two
      tissues. Quantitation of the area occupied by these discrete gaps in the scar
      provided an Index of Fusion, indicating the extent of direct contact between the
      transplant and host spinal cord. In some animals this constituted as much as 60%
      of the interface, while in others there were no breaks in the scar (0% fusion).
      Reinjury of the spinal cord lead to a rapid astrocytic response culminating in
      the reestablishment of a dense matrix of glial cells and processes covered by a
      basal lamina. This reformed scar effectively isolated the spinal cord from the
      external environment of the cavity. When FSC tissue was transplanted after first
      removing scar tissue the continuity of reformed glial scarring at the graft-host
      interface was altered. Distinct gaps in the scar appeared randomly along the
      interface. The mean Index of Fusion for animals receiving a moderate reinjury
      (removal of scar tissue only) was not as high as for those animals in which a
      more severe reinjury (expansion of the cavity by 0.5 mm) was performed before
      transplantation. The extent of graft-host fusion was not significantly improved
      when scar tissue was removed prior to transplantation. These findings support the
      hypothesis that the presence of FSC tissue will have an effect on the persistence
      of glial scar tissue in a chronic lesion site as well as limit the extent to
      which a new scar is formed in response to a second injury to the spinal cord.

PMID- 1613819
TI  - Collagen IV is present in the developing CNS during Drosophila neurogenesis.
AB  - By means of immunocytochemistry with a battery of specific antibodies, we
      describe the expression of the collagen IV chain produced by the gene DCg1 during
      the two phases of Drosophila neurogenesis. DgC1 was not expressed in neuronal
      tissues as shown by in situ hybridization, but the onset of its expression in
      cells of mesodermal origin was concomitant with the appearance of collagen IV on
      early axon pathways and peripheral nerve roots in the embryonic developing CNS. A
      similar situation was found during imaginal CNS development at metamorphosis,
      when collagen IV immunoreactivity was detected on centrifugal and centripetal
      nerve pathways, and specially on retinula axons that develop from the eye
      imaginal disc towards the lamina anlage in the brain optic lobe. Our results
      strongly suggest that collagen IV could be involved, together with other
      informative molecules of basement membranes, in a dynamic process of cell-matrix
      interactions during the establishment of initial axon pathways and neurite
      outgrowth in vivo.

PMID- 1613820
TI  - Application of a fluorescent dye to study connectivity between third ventricular
      preoptic area grafts and host hypothalamus.
AB  - The mutant hypogonadal (hpg) mouse lacks a functioning gene for the neurohormone
      gonadotropin releasing hormone (GnRH). Previous studies from our laboratory had
      indicated that the initiation and maintenance of reproductive function in these
      mice could be brought about by the implantation of normal fetal grafts into adult
      hosts. Testicular or ovarian growth and other indicators of normal neurosecretory
      output were always accompanied by survival of GnRH neurons and growth of GnRH
      axons into the host median eminence where such axons terminate on the hypophysial
      portal capillaries. To determine if other connections exist between graft and the
      host hypothalamus, small crystals of the carbocyanine dye, 1,1'-dioctadecyl
      3,3,3',3'-tetramethyl-indocarbocyanine perchlorate (DiI) were applied to either
      graft or host after fixation of the brain. Tissue sections were analyzed for
      retrograde and and anterograde movement of the dye. When crystals were placed on
      the graft, labeled axons were found in the host median eminence or in the host
      hypothalamus taking an arching trajectory toward the median eminence.
      Retrogradely labeled neurons in the host were few in number and largely confined
      to the host arcuate nucleus. With DiI crystals applied to the basal hypothalamus,
      labeled axons were distributed widely in the host but much sparser in the graft.
      Axons appeared to enter primarily at sites where the graft and host interface
      lacked an ependymal lining. Small numbers of retrogradely labeled neurons were
      also seen in the graft. Most were cells of very simple morphology and were
      distributed randomly in the graft. When double label experiments were carried out
      most DiI positive cells in the graft contained GnRH. These results indicate the
      connectivity between host hypothalamus and the third ventricular preoptic area
      grafts exists but is limited in nature.

PMID- 1613821
TI  - CG-4, a new bipotential glial cell line from rat brain, is capable of
      differentiating in vitro into either mature oligodendrocytes or type-2
      astrocytes.
AB  - We have established a permanent cell line (CG-4) of rat central nervous system
      glial precursors from primary cultures of bipotential oligodendrocyte-type 2
      astrocyte (O-2A) progenitor cells, which were kept proliferating with the
      mitogen(s) secreted by the neuronal B104 cell line. The CG-4 cells have a normal
      karyotype and display the properties of normal O-2A cells. CG-4 cells can be
      propagated in serum-free culture medium supplemented with medium conditioned by
      B104 cells for unrestricted periods of time as O-2A cells, characterized by the
      presence of the A2B5 surface marker and the absence of markers specific for
      oligodendrocytes (galactocerebroside, myelin basic protein) or type 2-astrocytes
      (glial acidic fibrillary protein). bFGF and PDGF are potent mitogens for CG-4
      cells and their combination can substitute for the B104-derived mitogen(s). CG-4
      cells are capable of differentiating into either oligodendrocytes or type 2
      astrocytes. Differentiation into oligodendrocytes occurs after withdrawal of the
      mitogen. Replacement of the mitogen with fetal calf serum (20%), in contrast,
      induces 50% of the CG-4 cells to differentiate into type 2-astrocytes. Pure
      cultures of oligodendrocytes or type 2-astrocytes can be generated in substantial
      amounts from CG-4 cells and maintained for several weeks in medium containing 5%
      fetal calf serum.

PMID- 1613822
TI  - Long-term survival of mouse corpus callosum grafts in neonatal rat recipients,
      and the effect of host sensitization.
AB  - Previous studies have suggested that the incidence of spontaneous rejection among
      immunogenetically mismatched neural transplants in neonatal recipients varies
      significantly depending on the cellular composition of the graft material. For
      example, neuron-rich grafts of embryonic mouse retina generally survive for
      extended periods without showing signs of rejection after implantation into
      neonatal rats, whereas cortical xenografts, which contain abundant glial and
      endothelial cells as well as neurons, typically undergo rejection 4-6 weeks after
      implantation. To determine whether the presence of donor glia is responsible for
      this high incidence of spontaneous rejection, we examined the fate of a non
      neuronal graft material composed predominantly of xenogeneic glial cells (post
      natal day 3, PD3, CD-1 mouse corpus callosum) implanted into the mesencephalon of
      PD1 Sprague-Dawley rats. The distribution and survival of donor astrocytes were
      assessed using a monoclonal antibody specific for a mouse astrocyte surface
      antigen, M2. Thirteen of 16 animals sacrificed within 2 months of implantation
      had detectable transplants. In these animals, M2-positive cells frequently
      migrated well away from body of the graft, clustering in large numbers in several
      characteristic regions of the host brain. Unlike cortical grafts of similar age,
      the vast majority (93%) of callosal transplants showed no histological signs of
      rejection or major histocompatibility complex antigen expression in and around
      the transplant-derived cells. As previously noted in the neonatal retinal
      transplant paradigm, however, well-integrated 1-month-old corpus callosum grafts
      could be induced to reject by appropriate sensitization of the host immune
      system, implying that the host was not immunologically tolerant to the foreign
      neural graft. With longer survival times in unsensitized hosts, a progressively
      smaller percentage of animals had detectable donor astrocytes (5 of 10 animals at
      3 months postimplantation and 4 of 16 animals at 4 months); in those 9 animals
      with surviving grafts, only small numbers of M2-positive cells were seen within
      the graft bed and surrounding host brain. However, only 2 of the 26 "long-term"
      animals showed evidence of graft rejection. These results indicate that mouse
      astrocytes show characteristic patterns of migration into the host brain when
      implanted into neonatal rats; however, these xenogeneic cells have a limited
      duration of survival. The infrequency with which even subtle signs of spontaneous
      rejection were detected in animals that had received corpus callosum xenografts
      suggests that an immune-mediated process is unlikely to be responsible for the
      time-dependent elimination of the donor astrocytes.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1613823
TI  - A histochemical study of iron, transferrin, and ferritin in Alzheimer's diseased
      brains.
AB  - Immunohistochemical and histochemical staining were performed on Alzheimer's
      diseased brain tissue obtained at autopsy. The iron-regulatory proteins
      transferrin and ferritin as well as iron are, in general, found predominantly in
      oligodendrocytes similar to that previously reported for normal brain tissue.
      However, in the vicinity of senile plaques, the staining pattern is altered for
      both proteins and iron. Transferrin is homogenously distributed around the senile
      plaques and is apparently extracellular. In addition, transferrin is found in
      astrocytes in the cerebral cortical white matter of the Alzheimer's tissue rather
      than its normal distribution in oligodendrocytes. A robust ferritin
      immunoreaction accompanies senile plaques and many blood vessels in the
      Alzheimer's brain tissue. Although many ferritin-positive oligodendrocytes are
      present in the Alzheimer's tissue, most of the ferritin-containing cells
      associated with senile plaques and blood vessels are microglia. Iron can also be
      demonstrated in the senile plaques. The iron reaction product is observed both
      diffusely in proximity of the plaques and in cells associated with the plaques.
      These data strongly suggest a disruption in brain iron homeostasis in Alzheimer's
      disease as demonstrated by alterations in the normal cellular distribution of
      iron and the proteins responsible for iron regulation. These data will contribute
      to understanding both the potential for oxidative damage and the potential for
      metal neurotoxicity in Alzheimer's disease.

PMID- 1613824
TI  - Calmodulin antagonists chlorpromazine and W-7 inhibit exogenous cholesterol
      esterification and sphingomyelinase activity in human skin fibroblast cultures.
      Similarities between drug-induced and Niemann-Pick type C lipidoses.
AB  - In this report we showed that calmodulin antagonists chlorpromazine (CPZ) and W-7
      (N-[6-aminohexyl]-5-chloro-1-naphtalenesulfonamide), when added to fibroblast
      cell cultures, gave rise to a time- and dose-dependent decrease of
      sphingomyelinase activity. CPZ and W-7 also significantly inhibited LDL- and non
      LDL-dependent cholesterol esterification. Addition of these drugs to cell culture
      medium mimicked what is observed in the genetic disease Niemann-Pick type C. H-7
      (1-[5-isoquinonylsulfonyl]-2-methylpiperazine), an inhibitor of protein kinase C
      and cyclic nucleotide-dependent kinases, had no effect on sphingomyelinase and
      cholesterol ester formation. Thus the possibility of a modulation of cell
      sphingomyelin and cholesterol esters by a calmodulin-dependent second messenger
      system must be considered.

PMID- 1613825
TI  - Calbindin-D28K and ischemic damage of pyramidal cells in rat hippocampus.
AB  - An antibody against rat calbindin-D28K, a calcium-binding protein present at high
      concentration in certain neurons of the central and peripheral nervous systems,
      was used to determine the progression of the pathological events in the rat
      hippocampus following experimental cerebral ischemia. Calbindin-D28K
      immunoreactivity is present in dentate granule cells and in the CA1-CA2 pyramidal
      cells. CA1 subfield contains a higher proportion of calbindin-D28K-positive
      pyramidal cells than does the CA2 subfield and CA1 cells are more immunoreactive
      than the CA2 cells. The pyramidal cells of the CA1 and CA2 subfields are
      vulnerable to ischemia. The cells in the CA1 became necrotic within 3-4 days
      after ischemia while those of the CA2 became necrotic within 2 days. There was a
      concomitant decrease in calbindin-D28K immunoreactivity in the whole hippocampal
      regio superior after ischemia which peaked 3 days postischemia. The difference in
      CA2 and CA1 vulnerability seemed to be inversely correlated with the calbindin
      D28K contents of the CA2 and CA1 pyramidal cells. The decrease in the calbindin
      D28K contents of these neurons was accompanied by cell damage. We therefore
      suggest that calbindin-D28K is an important factor for the survival of pyramidal
      cells in the hippocampal formation after ischemia.

PMID- 1613826
TI  - Prevention of hand injuries in cycle accidents.
AB  - More than one fifth of patients in a group involved in cycle crashes sustained
      hand injuries. The average time off work as a result of the hand injury in our
      study was 17.6 days. The number and severity of hand injuries would be reduced by
      the wearing of proper gloves and this is recommended. The gloves currently sold
      as "cycling" gloves are not adequate.

PMID- 1613827
TI  - Tumor necrosis factor and cardiac function.
AB  - The direct effect of tumor necrosis factor (TNF), a product of activated
      macrophages, on myocardial performance was determined using an isolated papillary
      muscle technique and a modified Langendorff preparation. Papillary muscle was
      obtained from male adult rats 4-5 hours after they received either 100 ng/kg TNF
      (group A), or 100 micrograms/kg TNF (group B) or saline (control). Group B
      animals exhibited significantly greater peak tension development and velocity of
      contraction compared with controls (p less than 0.05). In group A animals these
      variables were not significantly different from those of the controls (p greater
      than 0.05). Electrophysiologic measurements revealed a significant decrease in
      resting membrane potential in both group A and group B animals compared with the
      controls (p less than 0.05). Whole hearts perfused with serum from animals
      treated with TNF 18-22 hours earlier exhibited significant impairment of
      contractility, decreased rate of systolic pressure development, and decreased
      rate of relaxation compared with the controls (p less than 0.05). Coronary flow
      and myocardial water content were similar for both groups of perfused hearts.
      These data suggest that tumor necrosis factor stimulates an early beneficial
      effect on myocardial function, which 18-22 hours later is associated with
      impairment of myocardial performance. This effect appears to be serum
      transferable.

PMID- 1613828
TI  - Long-term follow-up of vascularized bone grafts for the reconstruction of tibial
      nonunion: evaluation with computed tomographic scanning.
AB  - Ten cases of reconstruction of the tibia with vascularized bone grafts were
      evaluated by computed tomographic (CT) scanning. In all cases the grafts were
      placed because of pseudarthrosis. The patients ranged in age from 20 to 64 years.
      The duration of follow-up was 1-9 years. In six cases fibular grafts were used to
      bridge the defect and in four cases iliac crest grafts were used. No additional
      bone grafts were placed after the initial operation. The pseudarthroses were
      classified into three types: type N--no bony defect (4 cases); type P--partial
      bony defect (3 cases); and type C--complete segmental bone loss (3 cases). Our
      evaluation showed that the grafts used to treat the type N and type P
      pseudarthroses were the same shape and size as at the time of placement. The
      grafts used to treat the type C pseudarthroses were hypertrophied, although the
      medullary canal of the graft remained the same size as at the time of placement.
      Hypertrophy was a result of an extraperiosteal reaction. The fibular grafts were
      square rather than triangular in cross section. It was concluded that mechanical
      loading is important in promoting hypertrophy of the graft.

PMID- 1613829
TI  - Effect of recombinant human growth hormone on catabolic hormones and free fatty
      acids following thermal injury.
AB  - Severe burn injury elicits the release of catabolic hormones that contribute to
      negative nitrogen balance, protein wasting, and impaired wound healing. Previous
      studies have shown that burn patients receiving recombinant human growth hormone
      (rhGH) therapy have an increase in the rate of skin donor site healing and a
      shorter hospital stay. The mechanism by which rhGH exerts its effects, however,
      is not clearly understood. This study examines the effects of rhGH on circulating
      levels of catabolic hormones and nonesterified fatty acids in pediatric burn
      patients. Patients with greater than 40% total body surface area burn were
      randomly assigned to receive placebo (n = 8) or 0.2 mg/kg/day rhGH (n = 6)
      throughout their hospitalization. All patients had early morning blood samples
      assessed for catecholamines (CAT), cortisol, insulin, glucagon, and free fatty
      acid (FFA) levels during a period of hypermetabolism. No differences could be
      demonstrated in age, burn size, postburn day of evaluation, resting energy
      expenditure per kilogram, respiratory rate, heart rate, respiratory quotient,
      serum cortisol, and serum glucose between placebo- and rhGH-treated patients. The
      rhGH-treated group did show a significant elevation (p less than 0.05) in insulin
      like growth factor-1 (55.9 +/- 14.5 vs. 168 +/- 23.7 mU/mL), total catecholamines
      (1,817 +/- 177 vs. 1,117 +/- 137 pg/mL), norepinephrine (1,257 +/- 121 vs. 867 +/
      113 pg/mL), epinephrine (385 +/- 175 vs. 147 +/- 36 pg/mL), insulin (32.8 +/-
      3.3 vs. 25.0 +/- 3.0 mU/mL), glucagon (215 +/- 18 vs. 158 +/- 22 pg/mL), and free
      fatty acids (0.74 +/- 0.01 vs. 0.59 +/- 0.04 mEq/L) compared with the placebo
      group (data expressed as mean +/- SE).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613830
TI  - Hemorrhagic hypotension after brain injury causes an early and sustained
      reduction in cerebral oxygen delivery despite normalization of systemic oxygen
      delivery.
AB  - Morbidity and mortality are doubled when hemorrhagic hypotension (HEM)
      accompanies a traumatic brain injury (TBI). Hemorrhagic hypotension initiates a
      "secondary" injury (SI) that has been attributed to ischemia, but this has not
      been confirmed in the laboratory. All previous studies have been of relatively
      short duration (less than 6 hours), allowing insufficient time to study the
      pathophysiology of SI, since maximal intracranial pressure (ICP) elevations may
      occur 16 to 20 hours after injury. We hypothesized that HEM combined with TBI
      would reduce cerebral oxygen delivery (cO2del) and cerebral metabolic rate for
      oxygen (cMRO2) to a greater degree than would occur with TBI alone. In a porcine
      model of TBI and HEM we recorded systemic oxygen delivery (sO2del), ICP, cerebral
      blood flow (CBF), cO2del, cMRO2, brain oxygen extraction ratio (cO2ER), and
      cortical water content (CWC) over a 24-hour study period. Controls (n = 7) were
      instrumented only, group 1 (n = 14) received a focal cryogenic lesion only, group
      2 (n = 21) received a cryogenic lesion plus hemorrhage to 50 mm Hg for 45
      minutes. Animals were resuscitated with crystalloid solutions; shed blood in
      group 2 animals was returned after one hour. Hemorrhagic hypotension following
      TBI produced a significant and sustained reduction in cO2del associated with a
      lower cMRO2 and cO2ER, and higher ICP and CWC, than seen with lesion alone. This
      occurred despite adequate early restoration of sO2del. This confirms that
      cerebral ischemia is ongoing despite restoration of systemic hemodynamics.

PMID- 1613831
TI  - Simultaneous liver and lung injury following gut ischemia is mediated by xanthine
      oxidase.
AB  - We have previously shown that gut ischemia/reperfusion (I/R) causes simultaneous
      liver and lung dysfunction and that neutrophils play a critical role in this
      process. The purpose of this study was to ascertain whether xanthine oxidase (XO)
      was likewise operational. Normal and XO-inactivated rats (given a tungsten
      enriched, molybdenum-depleted diet for 3 weeks) underwent 45 minutes of occlusion
      of the superior mesenteric artery, and control rats were subjected to a sham
      laparotomy. After zero and six hours of reperfusion, blood was sampled and livers
      and lungs harvested. Iodine-125-labeled albumin leak was used as a marker for
      pulmonary and liver capillary permeability barrier function, and serum
      acetoacetate/3-hydroxybutyrate (AcAc/3-OHB) levels as an index of hepatic
      mitochondrial redox state. Gut ischemia/six hours of reperfusion (I/R) increased
      the 125I albumin lung/blood ratio and the 125I albumin liver/blood ratio; AcAc/3
      OHB levels decreased significantly. Xanthine oxidase activation eliminated the
      observed lung and liver capillary leak as well as the hepatic metabolic
      derangement induced by gut I/R. In conclusion, the simultaneous lung and liver
      dysfunction produced by gut I/R is mediated by XO.

PMID- 1613832
TI  - Can adult trauma surgeons care for injured children?
AB  - Large urban trauma centers care for injured children as well as adults in many
      areas of the country, but the quality of care in these hospitals has not been
      evaluated versus that available at pediatric trauma centers. The recent
      validation of TRISS methodology in pediatric populations allowed us to evaluate
      the quality of pediatric trauma care being provided in a level I trauma center
      treating injured patients of all ages. We reviewed the records of 353 injured
      children (aged 0-17 years) who were admitted to our trauma center over a 30-month
      period for the following data: demographics, mechanism of injury, initial
      physiologic status (RTS), surgical procedures required, need for intensive care,
      nature and severity of the injuries (ISS), and outcome. TRISS analysis allowed us
      to compare our population with the Major Trauma Outcome Study. Only two of the 21
      total deaths (overall mortality, 6%) were unexpected, and there were seven
      unexpected survivors. One hundred twenty-one patients underwent emergency
      surgical procedures and 63 required admission to the intensive care unit. The Z
      scores ranged from +0.32 for the children aged less than 2 years to +3.98 for the
      older age group (14-17 years). We conclude that the quality of care for pediatric
      trauma patients admitted to trauma centers that care for patients of all ages
      compares favorably with national standards. In most areas of the country,
      improvements in pediatric trauma care will likely come from addressing the
      special needs of injured children in general trauma centers rather than from
      developing separate pediatric facilities.

PMID- 1613833
TI  - Vascular injuries in a rural state: a review of 978 patients from a state trauma
      registry.
AB  - The demographics, etiology, and outcome of 1148 vascular injuries suffered by 978
      patients reported from eight trauma centers in a largely rural state to a trauma
      registry (NCTR) data base containing 26,617 patients entered over a 39-month time
      interval were analyzed. Vascular injury patients were more frequently transferred
      by helicopter (18%), referred from other hospitals (45%), transfused more blood
      (8 units mean/24 hours), had higher mean ISS values (14 vs. 9), had lower
      systolic blood pressures on admission (113 vs. 128 mm Hg), had higher emergency
      department mortality (3.3%), and required immediate surgery more often (79%) when
      compared with nonvascular injury NCTR patients (p = 0.0001). Vascular injury
      patients had significantly longer hospital stays (13 vs. 10 days), longer ICU
      stays (5 vs. 4 days), and greater hospital costs ($22,500 vs. $12,300) while
      incurring more serious AIS values for the regions of the chest, abdomen, and
      extremities. One hundred twenty-nine (13.1%) died, 97 after admission compared
      with a 6.2% mortality for NCTR nonvascular injury victims. Forty-seven percent of
      vascular injuries were extremity lesions; the amputation rate was 1.3%; and
      management was most often by simple repair (41.9%) or patching (22.2%). Rural
      vascular injury patients had a high incidence of blunt trauma (43.4%) and were
      older (average, 51 years); they were transported by helicopter more often (30.3%)
      and were frequently referred from another hospital (77.8%); they had longer ICU,
      ventilator, and hospital stays and greater hospital charges; and they had higher
      mortality (14.2%) compared with urban vascular trauma victims. The data suggest a
      need for the trauma care system to focus on earlier recognition, stabilization,
      and rapid transportation of this most seriously injured group of patients.

PMID- 1613834
TI  - Prospective comparison of clinical judgment and APACHE II score in predicting the
      outcome in critically ill surgical patients.
AB  - Prospective identification of patients who will not survive has been proposed as
      a means of limiting utilization of medical resources including critical care.
      This study prospectively compared prediction of outcome for surgical ICU patients
      by clinical assessment and the APACHE II score. Five hundred seventy-eight
      patients were assessed within 24 hours of admission by the ICU attending
      physician and predicted to live or die. An APACHE II score was calculated in that
      same time period. All data were stored in a data base and compared with actual
      SICU outcome. There were 40 deaths in 578 patients (6.9%). The clinical
      assessment had an overall accuracy of 95.2% vs. 90.9% for APACHE II. The Pearson
      correlation coefficients for the two methods of prediction were 0.59 for clinical
      assessment and 0.44 for APACHE II. Predictive power was not greatly improved by
      combining both prediction methods. Over 40% of patients predicted to die by both
      methods actually survived. This study demonstrates that clinical assessment is
      superior to APACHE II in predicting outcome in this group of surgical patients,
      although the difference is small. In addition, this study suggests that neither
      clinical assessment nor the APACHE II score, when obtained within 24 hours of
      admission, is very reliable at predicting which surgical ICU patients will die.

PMID- 1613835
TI  - Neurologic consequences of cerebrovascular injury.
AB  - Because of ongoing controversy, the issue of vascular repair or ligation for
      patients with cerebrovascular injuries and preoperative central neurologic
      deficits is frequently debated. A total of 133 patients with penetrating
      cerebrovascular injuries were analyzed. The frequency of preoperative neurologic
      deficit was 20% (27 patients). The common carotid and internal carotid arteries
      were the most frequently injured structures, with a 29% and 15% incidence of
      preoperative neurologic deficits, respectively. The results of carotid repair in
      all patients whose preoperative deficit was limited to weakness or paralysis were
      favorable (seven patients normal or improved, two patients unchanged). The
      results of repair in patients whose preoperative deficit was characterized by
      obtundation were variable (four patients improved, four patients worsened or
      died). The results of carotid ligation were also variable (one improved, one
      unchanged, three worsened or died). Limited numbers of patients with preoperative
      neurologic deficits and the retrospective nature of this review prohibit definite
      conclusions. Therefore a multicenter, prospective, randomized trial of ligation
      or vascular repair for comatose patients with cerebrovascular injuries is
      proposed.

PMID- 1613836
TI  - The use of transesophageal echocardiography in the evaluation of chest trauma.
AB  - Transesophageal echocardiography (TEE) has been used over the last 10 years (1982
      1992) to study the heart and thoracic aorta. We set out to evaluate the
      diagnostic applications of TEE in patients with thoracic trauma. Specifically,
      TEE was performed on patients suspected of having either a cardiac contusion or
      an injury of the thoracic aorta. Fifty-eight patients admitted with thoracic
      trauma underwent TEE. Fifty of those patients suspected of having a cardiac
      contusion also underwent transthoracic echocardiography (TTE). The two diagnostic
      modalities were compared. In 21 of these patients a wide mediastinum was apparent
      on admission chest x-ray films. Nineteen of this latter group underwent thoracic
      angiography in addition to TEE. Two patients underwent post-mortem examination.
      Of the 50 patients undergoing both TEE and TTE, a cardiac contusion was detected
      by TEE in 26 patients. Transthoracic echocardiography detected only six
      contusions in this group. Of the 21 patients with a wide mediastinum, TEE
      detected three obvious aortic disruptions. These findings were confirmed in each
      case by angiography. In 16 cases TEE showed the aorta to be normal. This was
      confirmed on the angiogram in 14 cases and by autopsy in two cases.
      Transesophageal echocardiography revealed an aortic intimal irregularity distal
      to the left subclavian artery in two cases. The results of aortography were
      normal in these last two cases. As a diagnostic modality, TEE more accurately
      detected cardiac contusions than TTE (p less than 0.001) and was a very sensitive
      screening tool in the early evaluation of patients with a wide mediastinum.

PMID- 1613837
TI  - Oxygen extraction ratio: a valid indicator of transfusion need in limited
      coronary vascular reserve?
AB  - We have described whole body oxygen (O2) extraction ratio (ER) as a reliable
      indicator of transfusion need in acute normovolemic anemia. In normal hearts,
      myocardial lactate production (-LACT), indicating anaerobic metabolism, does not
      occur until the ER greater than 50% and Hct less than 10%. It is not known if the
      ER is valid in the setting of limited coronary vascular reserve. This study
      assesses the effect of a critical left anterior descending (LAD) coronary
      stenosis on the compensation to acute blood loss anemia. Adult dogs were
      anesthetized, paralyzed, and mechanically ventilated. A critical LAD stenosis was
      created in seven animals (STEN). There were seven controls (CON). Animals
      underwent isovolemic exchange transfusion with 6% HES until cardiac failure (CF).
      Catheters were placed in the aorta, pulmonary artery, and anterior
      interventricular coronary vein. Cardiac failure occurred at Hct = 8.6% +/- 0.4%
      in the CON and 17.0% +/- 0.5% in the STEN animals. Cardiac output increased in
      the CON, but not in the STEN animals. Blood flow in the LAD increased in the CON
      but not the STEN animals. -LACT began in the CON and STEN animals at Hct less
      than 20% and coincided with an ER greater than 50% in both groups. We conclude
      that CF occurs at a higher hematocrit with a critical LAD stenosis. The whole
      body ER greater than 50% remains a valid indicator of myocardial metabolism in
      anemia in the presence of limited coronary vascular reserve. The ER may be a
      useful guide to transfusion therapy.

PMID- 1613838
TI  - Emergency center thoracotomy: impact of prehospital resuscitation.
AB  - Emergency center thoracotomy was performed at our facility on 389 patients from
      1984 through 1989. There were no patients excluded from the study, and survival
      for all patients was 8.3% with survival rates of 15.2% and 7.3% for stab and
      gunshot wounds, respectively. Emergency center thoracotomy was performed on 42
      patients suffering from isolated extrathoracic injuries with 7% survival. There
      were no survivors of blunt trauma in this study. Fifty-three percent of the
      patients arrived with cardiopulmonary resuscitation (CPR) in progress. The
      average time of prehospital CPR for survivors was 5.1 minutes compared with 9.1
      minutes for nonsurvivors. Of the survivors, prehospital endotracheal intubation
      prolonged successful toleration of CPR to 9.4 minutes compared with 4.2 minutes
      for nonintubated surviving patients (p less than 0.001). Emergency center
      thoracotomy is useful in the resuscitation of victims dying of penetrating
      truncal trauma. Prehospital endotracheal intubation significantly lengthened the
      time of successful CPR.

PMID- 1613839
TI  - Emergency thoracotomy: survival correlates with physiologic status.
AB  - Emergency thoracotomy is a standard procedure in the management of cardiac arrest
      in patients sustaining severe trauma. We examined the records of 463 moribund
      trauma patients treated at our institution from 1980 to 1990 to refine
      indications for emergency thoracotomy. Patients underwent thoracotomy either in
      the emergency department (ED) (n = 424) or in the operating room (OR) (n = 39) as
      a component of continuing resuscitation after hospital arrival. The survival rate
      was 13% (61 of 463) overall, 2% (3 of 193) for blunt, 22% (58 of 269) for all
      penetrating, 8% (10 of 131) for gunshot, 34% (48 of 141) for stab-wound patients,
      and 54% (21 of 39) for patients who underwent emergency thoracotomy in the OR.
      Survival correlated with the physiologic status of patients both on initial
      evaluation in the field by paramedics and on arrival at the ED. Patients with
      penetrating trauma and in profound shock (BP less than 60 mm Hg) or mild shock
      (BP 60-90 mm Hg) with subsequent cardiac arrest had survival rates of 64% (27 of
      42) and 56% (30 of 54), respectively. None of the patients with absent signs of
      life, defined as full cardiopulmonary arrest with absent reflexes (n = 215), on
      initial assessment by paramedics in the field, survived. We conclude that (1) no
      emergency thoracotomy should be performed if no signs of life are present on the
      initial prehospital field assessment; (2) emergency thoracotomy is an indicated
      procedure in most patients sustaining penetrating trauma; (3) blunt traumatic
      cardiac arrest is a relative contraindication to emergency thoracotomy.

PMID- 1613840
TI  - Dorsal carpometacarpal dislocation of the index finger: a report of three cases
      and a review of the English-language literature.
AB  - Isolated dorsal carpometacarpal dislocation of the index finger is a rare injury.
      We treated three patients with such an injury; two cases by delayed open
      reduction and internal fixation, and one case by direct closed reduction and
      internal fixation. Satisfactory functional results were obtained in two of the
      three cases (follow-up of 4 and 2 years, respectively). Anatomic factors, the
      mechanisms of injury, and management as discussed in the English-language
      literature are reviewed.

PMID- 1613841
TI  - Technical note: modifications and improvements of the Milch technique for the
      reduction of anterior dislocation of the shoulder without premedication.
AB  - A method for the reduction of anterior dislocations of the shoulder based on the
      Milch technique is presented. We have been using this method for the last 2 years
      (75 dislocations) with excellent results. The reduction is easy, produces minimal
      pain and discomfort for the patient, and the success rate is as high as 94.5%.
      The modified Milch technique is less troublesome for the patient and the
      physician and we strongly recommend it.

PMID- 1613842
TI  - Acute epiglottitis: historical highlights and perspectives for future research.
AB  - Acute epiglottitis was classified under more than 35 headings before 1960. It is
      the purpose of this article to review and examine the crucial events that have
      marked, but also often impeded, the conceptualization of this disease. As is the
      case for other diseases, the history of acute epiglottitis depended upon the
      evolution of technology in medicine. From this review the author has produced a
      "catalogue raisonne" of material snatched from the immensity of obsolete
      publications. It can be considered as an overview of the historical highlights of
      this very peculiar disease, acute epiglottitis. It also stresses areas of
      potential research, as our medical forefathers had imagination but lacked the
      technical capabilities which are now at our disposal. Finally, it gives the
      reader a unique opportunity to glance at the making of otolaryngology.

PMID- 1613843
TI  - Quantitative light microscopy in urological oncology.

PMID- 1613844
TI  - Choice of gastroepiploic vessels for gastrocystoplasty.
AB  - Use of vascularized gastric segments for augmentation cystoplasty and for
      construction of a continent urinary diversion depends on adequate blood supply
      via the right or left gastroepiploic vessels. Inadequate gastroepiploic vessels
      on 1 side may not be apparent without intraoperative testing for their patency.
      We recommend routine testing for the patency of the left and right gastroepiploic
      vessels before selecting the side to be used as a pedicle for the gastric
      segment.

PMID- 1613845
TI  - Improved pump placement with infrapubic penile prosthetic implantation.
AB  - A common problem with implantation of an inflatable penile prosthesis is
      inadequate placement and/or fixation of the pump mechanism. We report on a total
      of 45 of our most recent patients who underwent penile prosthesis implantation
      for erectile dysfunction. In all cases the implants were placed with an
      infrapubic approach in conjunction with a penoscrotal counterincision for
      improved pump placement and fixation. One patient (2.2%) had an infectious
      complication requiring revision. When we compared this infection rate with the
      infectious complication rates reported in the literature, we found that adding a
      penoscrotal counterincision did not increase the risk of infectious complication
      to the patient.

PMID- 1613846
TI  - Detrusor function with lesions of the conus medullaris.
AB  - Conventional urodynamic evaluation is unable to distinguish between a pure conus
      lesion and one with concomitant cauda equina involvement. Lumbosacral evoked
      potentials to tibial nerve stimulation assesses the sensory root and dorsal horn
      interneurons of the L5 to S2 spinal cord segments. This allows for the diagnosis
      of a pure lesion of the conus medullaris with preservation of the sensory root
      response (R wave) with absence of the dorsal horn gray matter response (S wave).
      Urodynamic evaluation in 5 patients with a conus lesion showed a variety of
      detrusor responses ranging from hyperreflexia through areflexia with decreased
      compliance to areflexia with normal compliance. The ability to diagnose a pure
      conus lesion may have prognostic significance as newer modalities of treatment
      emerge, all of which require intact gray matter of the spinal cord.

PMID- 1613847
TI  - The influence of anterior root stimulation (S2) in deafferented spinal cord
      injury men on cavernous electrical activity.
AB  - Registration of cavernous electrical activity (single potential analysis of
      cavernous electrical activity) was recently suggested for the diagnosis of
      autonomic cavernous dysfunction. For validation of this method the effect of
      sacral neurostimulation on cavernous electrical activity was examined. In 3 male
      patients with a complete spinal cord lesion (T3, T4 and T12, respectively),
      deafferentation was done at the S2 to S5 levels. Around the anterior roots of S2
      to S5 electrodes for neurostimulation were placed. Cavernous electrical activity
      was recorded with an intracavernous needle electrode and with surface electrodes
      in the flaccid as well as in the erect states induced by neurostimulation (at 7,
      8, 12, 18, 20, 30 and 45 Hz., 30 v. and 0.4 msec). In all patients similar
      potentials compared to the normal values, as well as additional pathological
      potentials were recorded during flaccidity. During neurostimulation all patients
      achieved full erection with no or markedly decreased cavernous electrical
      activity to frequencies of 12, 18, 20 and 30 Hz., while to 7, 8 and, more
      pronounced, 45 Hz. only partial erection with ongoing cavernous electrical
      activity was found. Our study strongly suggests that cavernous electrical
      activity and, subsequently, the cavernous smooth muscle tone are dependent on
      autonomic input. This finding supports the hypothesis that single potential
      analysis of cavernous electrical activity may be valid in the diagnosis of
      cavernous autonomic dysfunction. Furthermore, our results suggest a possible role
      for single potential analysis of cavernous electrical activity in the fine tuning
      of erection inducing neurostimulators.

PMID- 1613848
TI  - Continent appendicocolostomy: a variation of the Mitrofanoff principle in
      pediatric urinary tract reconstruction.
AB  - There are numerous options for continent urinary reconstruction in children. If
      the appendix is available and the bladder capacity is satisfactory, a Mitrofanoff
      procedure may be performed using the appendix as a catheterizable tube implanted
      into the bladder. However, in many patients the bladder is absent or too small
      for this type of reconstruction. An alternative technique, termed
      appendicocolostomy, is to implant the appendix under the tenia of a detubularized
      patch of cecum or sigmoid colon, which becomes part of a continent neobladder or
      is attached to the bladder itself. This procedure has been used in 12 children
      and 1 adult undergoing continent reconstruction. Urological diseases included
      bladder exstrophy (10 patients) and a neuropathic bladder (3). Two patients
      underwent undiversion of a sigmoid conduit, while in 7 of the remaining patients
      the bladder was included in the reservoir. In 1 patient histological examination
      of the tip of the appendix revealed an incidental invasive carcinoid tumor
      necessitating appendectomy and revision of the reconstruction. Otherwise, no
      complications have occurred. Three adults were scheduled for this procedure but
      the appendix was diseased and an alternative form of diversion was necessary.
      Followup ranged from 2 months to 4 years. All patients are totally dry with a
      capacity of 300 to 750 cc (mean 475 cc). The appendicocolostomy is a superior
      form of conduit reconstruction that should be considered when the appendix is
      available during continent reconstruction. However, in adults the appendix may be
      fibrotic, precluding its use. Because most boys with exstrophy and a small
      bladder capacity requiring augmentation cystoplasty must perform intermittent
      catheterization, attachment of the appendix to the reservoir is an alternative
      that allows for easier and less painful intermittent catheterization than
      catheterization of the reconstructed epispadiac penis.

PMID- 1613849
TI  - Contrast-induced central nervous system toxicity after radiographic evaluation of
      the lower urinary tract in myelodysplastic patients with ventriculoperitoneal
      shunts.
AB  - Routine urological evaluation of children with myelomeningocele helps to identify
      those at risk for upper urinary tract deterioration. We report on 2 patients with
      ventriculoperitoneal shunts who had intraperitoneal rupture of the bladder.
      Reflux of contrast media via or around the ventriculoperitoneal shunt into the
      cerebral ventricles occurred in both patients, resulting in severe neurological
      insult.

PMID- 1613850
TI  - The predictive value of ultrasonography in evaluation of infants with posterior
      urethral valves.
AB  - Between 1981 and 1989, 28 infants less than 6 months old with posterior urethral
      valves underwent ultrasound evaluation as part of the initial evaluation at our
      hospital. The single ultrasound feature that correlated with subsequent renal
      function was the status of corticomedullary differentiation. The presence of
      corticomedullary junctions in at least 1 kidney in 17 infants was always
      associated with a serum creatinine level of 0.8 mg./dl. or less in long-term
      followup. Of 11 patients with absent corticomedullary differentiation 7 had
      eventual creatinine levels of greater than 0.8 mg./dl. with 5 of them suffering
      clinically significant renal insufficiency. An association between vesicoureteral
      reflux and absent corticomedullary junctions was also found.

PMID- 1613851
TI  - Prognosis for patients with prenatally diagnosed posterior urethral valves.
AB  - Children in whom posterior urethral valves are diagnosed shortly after birth are
      at higher risk for renal failure than children in whom posterior urethral valves
      are diagnosed later in life. The influence of prenatal diagnosis of posterior
      urethral valves on clinical outcome has not been established. We collected data
      on children with posterior urethral valves treated since birth at our hospital
      between 1975 and 1990. The clinical outcomes for 8 patients diagnosed prenatally
      and 15 diagnosed neonatally were compared. Of the 8 patients in the prenatal
      group 5 (64%) had renal failure compared to 5 of 15 (33%) in the neonatal group
      (p greater than 0.05). Nadir creatinine of more than 1.2 mg./dl. correlated with
      the development of renal failure in all patients in the neonatal and prenatal
      groups. There was 1 death in the prenatal group. In our experience prenatal
      diagnosis of posterior urethral valves has grave implications, including a 64%
      incidence of progressive renal failure and a 64% incidence of transient pulmonary
      failure. Oligohydramnios and postnatal pulmonary insufficiency are predictive of
      progressive renal failure. Earlier diagnosis and treatment of children with
      posterior urethral valves did not improve the clinical prognosis.

PMID- 1613852
TI  - The treatment of urinary incontinence in children using glutaraldehyde cross
      linked collagen.
AB  - Periurethral injection of polytetrafluoroethylene (PolyTef) paste has been used
      to correct urinary incontinence for 2 decades. The controversy over distant
      migration of the paste has led to an interest in alternative materials
      particularly for the pediatric patient. Glutaraldehyde cross-linked collagen,
      derived from bovine dermal collagen, is effective in treating urinary
      incontinence in adults. Eight children with structural urinary incontinence
      underwent glutaraldehyde cross-linked collagen injection. Fluorourodynamic
      studies preceded and followed the injections. An average of 10.9 cc
      glutaraldehyde cross-linked collagen was injected per treatment (range 2.5 to
      20). The number of injections per child ranged from 1 to 6 (mean 2.1) and
      followup averaged 13.75 months (range 6 to 33). Overall, 88% of the patients were
      cured or improved: 5 (63%) became continent, 2 were improved and 1 had no effect.

PMID- 1613853
TI  - Primary endodermal sinus tumor of the penis: a case report.
AB  - We report a case of primary extragonadal germ cell tumor of the penis in a 2-year
      old child with elevated serum alpha-fetoprotein. The patient responded well to a
      combination of bleomycin, etoposide and cisplatin, achieving a complete response
      within 3 cycles. He was alive and disease-free 8 months after diagnosis. To our
      knowledge this is the first case of an endodermal sinus tumor of the penis
      reported in the literature. The possible histogenesis of this tumor at such a
      rare site is discussed.

PMID- 1613854
TI  - Acute bilateral testicular torsion in the adolescent.
AB  - A case of acute bilateral testicular torsion in the adolescent is reported. This
      case reaffirms the need to perform bilateral scrotal exploration in cases of
      suspected torsion. Although it represents an extreme rarity, delay in exploration
      may have resulted in bilateral orchiectomy. The case also appears to be another
      example of intermittent testicular pain as a harbinger of impending torsion in a
      patient with the bell clapper deformity. Perhaps a more aggressive approach
      should be taken to explore patients surgically who present with intermittent
      scrotal pain.

PMID- 1613855
TI  - Bilateral primary neuroblastomas in the inguinal canal.
AB  - The incidental finding of a nodular mass in the inguinal canal in children
      usually occurs during surgical exploration for an inguinal hernia. We report an
      unusual occurrence of neuroblastomas bilaterally and simultaneously in the
      inguinal canals of an infant with no evidence of metastatic disease.

PMID- 1613856
TI  - Spontaneous regression of metastases in a case of bilateral renal cell carcinoma.
AB  - A patient is described who had undergone bilateral nephrectomy for renal cell
      carcinoma and who had been maintained on hemodialysis for the last 2 years. A
      total of 3 months after acceptance into the program he was found histologically
      to have metastatic pleural lesions, which had regressed spontaneously 1 1/2 years
      ago. Repeat clinical and radiological assessment has shown no tumor recurrence.

PMID- 1613857
TI  - Fast magnetic resonance imaging in the evaluation of tumoral obstructions of the
      inferior vena cava.
AB  - A prospective study was conducted on 9 patients with suspected obstruction of the
      inferior vena cava on ultrasonography, dynamic computerized tomography and/or
      inferior venacavography during the course of a retroperitonal tumor to assess the
      value of magnetic resonance imaging with gradient echo sequences. The findings on
      gradient echo magnetic resonance imaging were compared with the other imaging
      modalities and surgical or necropsy results. Our results suggest that gradient
      echo magnetic resonance imaging is the most appropriate imaging modality to
      diagnose and delineate the extent of inferior vena caval obstruction.

PMID- 1613858
TI  - Inflammatory pseudotumor of the bladder.
AB  - Inflammatory pseudotumor of the bladder is an unusual benign lesion arising from
      the bladder submucosa. We present 2 cases and describe the clinical presentation,
      and radiographic and histological findings. This benign lesion must be
      differentiated histologically from several malignant lesions of the bladder.
      Complete surgical excision, either by transurethral resection or partial
      cystectomy, appears to be curative.

PMID- 1613859
TI  - Restenosis of the urethra despite indwelling Wallstent.
AB  - Of 5 patients with recurrent urethral strictures were treated with a self
      expandable permanently implanted urethral stent 2 had stenosis within the stent
      2.5 and 9 months after placement of the stent, respectively.

PMID- 1613860
TI  - False diagnoses of venous leak impotence.
AB  - Tests for erectile dysfunction using intracavernous injections of vasoactive
      drugs are currently popular and have resulted in frequent diagnoses of venous
      leak impotence. Tests used to make this diagnosis, however, have not been
      validated by study in control subjects. We present 2 cases of false diagnoses of
      venous leak impotence. Anxiety mediated through the sympathetic nervous system
      may block the action of intracavernous smooth muscle relaxants. The resulting
      incidence of false diagnoses of venous leak impotence is unknown.

PMID- 1613861
TI  - Three cases of didmoad or Wolfram's syndrome: urological aspects.
AB  - We report on 3 patients with the rare syndrome of diabetes insipidus, diabetes
      mellitus, optic atrophy, neurosensory deafness, atony of the urinary tract and
      other abnormalities (DIDMOAD or Wolfram's syndrome). All 3 patients had diabetes
      mellitus, optic atrophy, deafness and dilatation of the urinary tract. In 2
      patients there was diabetes insipidus. The possibility of anatomical outlet
      obstruction or a neurogenic bladder was eliminated radiologically and
      urodynamically, and dilatation of the urinary tract was considered to be either a
      consequence of high diuresis associated with diabetes insipidus or a degenerative
      process affecting the central and peripheral nervous system, which can explain
      all of the manifestations of the syndrome except diabetes mellitus. A significant
      improvement in bilateral urinary tract distention was achieved by bladder
      drainage in the first 2 cases, while desmopressin therapy dramatically decreased
      the daily urinary output.

PMID- 1613862
TI  - The presence of an antibacterial glycoprotein in a spectrum of transitional gel
      carcinomas.
AB  - The mucin lining of the bladder is thought to serve as a primary defense
      mechanism against bacterial colonization, and has recently been implicated in the
      urothelial resistance to carcinogenic insult. We have isolated a unique
      glycoprotein fraction (GP1) of this lining from the normal rabbit bladder which
      may have a function in preventing bacterial adherence and colonization in the
      urinary tract. This glycoprotein has been shown to bind to a wide range of
      uropathic bacteria. The present study examines changes in the bladder's
      antibacterial defense mechanisms as measured by GP1 expression in the neoplastic
      state. Using an anti-GP1 serum, immunohistochemical staining was performed on 20
      paraffinized and fresh frozen transitional cell carcinomas ranging from low
      grade, superficial tumors to high grade, invasive tumors. The presence of GP1 was
      seen throughout the mucosal layer in normal specimens with increased amounts
      noted towards the mucosal surface. Progressively decreased expression was noted
      with increasing grades of all transitional carcinoma specimens. Mucosal field
      changes in GP1 expression were not noted in any of the patients. Intestinal
      mucosal controls failed to detect the presence of GP1. These studies suggest that
      the expression of GP1 decreases with tumor dedifferentiation and that bladder
      tumorogenesis may serve a role in handicapping the bladder's primary
      antibacterial defense mechanism.

PMID- 1613863
TI  - Effect of outlet obstruction on 3H-thymidine uptake: a biochemical and
      radioautographic study.
AB  - Experimental outlet obstruction in the rabbit is characterized by a rapid and
      substantial increase in urinary bladder mass. Although it is clear that both the
      smooth muscle and connective tissue compartments are increasing in mass, there is
      little information on the mechanisms by which this increase in mass occurs. As an
      initial investigation in this process, urinary bladders from normal and
      obstructed NZW rabbits were exposed in vitro to tritiated thymidine (3H-TdR) in
      order to determine which populations of cells are induced to synthesize DNA
      following outlet obstruction, and when, after obstruction, such synthesis occurs.
      Biochemical analysis of nucleic acids was performed on each specimen to determine
      total and radioactive DNA. These analyses showed a marked increase in DNA
      synthesis at 24 hours following obstruction which remained relatively high
      through seven days after obstruction. There was a decline in labelling at 14
      days. Incorporation of radioactive label peaked at three days and declined to
      control levels by 14 days. Samples of tissue were taken from each subject and
      processed for radioautography. At 24 hours after obstruction, significant numbers
      of cells of the basal cell layer of the urothelium are observed to be actively
      involved in DNA synthesis, while the other two tissue compartments (muscularis
      and connective tissue) show no significant changes when compared to normal
      specimens. Connective tissue, on the other hand, showed significantly increased
      levels of labelling above control level from three to 14 days after obstruction.
      Smooth muscle cells were observed to be frequently labelled in only one of the
      experimental bladders observed three days after obstruction.

PMID- 1613864
TI  - Characterization of bovine bladder mucin fractions that inhibit Escherichia coli
      adherence to the mucin deficient rabbit bladder.
AB  - We have previously shown that a dialyzed, lyophilized saline extract from bovine
      urothelium can restore the antiadherence activity of the rabbit bladder following
      mucin removal with 50% acetone. This report describes results of initial
      purification of antiadherence factor(s) from bovine bladder mucin and describes
      results of biochemical analysis in an attempt to elucidate possible mechanism of
      this antiadherence activity. Separation performed by gel filtration (Spectra gel
      AcA 34, 20-350 KD range) results in three fractions. Only the low molecular
      weight fraction had a statistically significant inhibitory effect on bacterial
      adherence to the mucin deficient rabbit bladder. After overnight dialysis against
      running deionized water and lyophilization, the crude extract contained 60%
      protein while gel filtration fractions 1-3 contained 35%, 90% and 15% by weight
      respectively. The first fraction (apparent high molecular weight, greater than
      350 kD) did not appear to enter SDS polyacrylamide electrophoresis gels (SDS
      PAGE, 3-12%) or agarose gels (0.5%) to any significant extent. In the fractions
      that displayed antiadherence activity (the crude extract, fractions 2 and 3) SDS
      PAGE bands were seen corresponding to an apparent molecular weight of 78 kD in
      addition to bands co-migrating with bovine serum albumin (BSA). BSA itself
      slightly increases bacterial adherence in this model. Most of the albumin of the
      crude extract was found in the second fraction (60%). On the other hand most of
      the sulfate and sugar of the crude extract was found in the third, low molecular
      weight fraction. Since sulfated polysaccharides such as heparin and dextran
      sulfate are very effective antiadherence agents in this rabbit bladder model, it
      is conceivable that the sulfated sugar content of the third fraction is
      responsible for its antiadherence effect on the mucin deficient rabbit bladder.

PMID- 1613865
TI  - A pharmacological in vitro study of the mouse urinary bladder at the time of
      acute change in bladder reservoir function after irradiation.
AB  - Mouse urinary bladder strips were investigated as to whether the acute change in
      bladder reservoir function seen after irradiation might be due to major changes
      in basic nerve and smooth muscle functions. The release mechanism of
      acetylcholine, cholinergic and non-cholinergic nerve activation explored by
      indomethacin and potassium channel activation were investigated. It was concluded
      that the normal mouse bladder is partly cholinergically and partly non
      cholinergically innervated. The role of acetylcholine is of the same importance
      as in other rodents. However, it was not possible to distinguish any difference
      between normal and irradiated mouse bladders in respect to nerve and smooth
      muscle function.

PMID- 1613866
TI  - Extracorporeal shock wave lithotripsy for patients with calcified ipsilateral
      renal arterial or abdominal aortic aneurysms.
AB  - A total of 4 patients with renal or upper ureteral calculi associated with
      ipsilateral calcified renal arterial or abdominal aortic aneurysms underwent
      extracorporeal shock wave lithotripsy. One patient with a renal artery aneurysm
      had a solitary kidney. Linear distance from the calcified aneurysm to the stone,
      calculated by computerized and plain tomography, ranged between 4.6 and 6.5 cm.
      (mean 5.3). Treatment was accomplished on an unmodified Dornier HM3 lithotriptor
      using 900 to 2,400 shock waves (mean 1,575) at 18 kv. There were no complications
      of treatment and all 4 patients were discharged from the hospital within 24
      hours, at which time radiographic examination revealed excellent stone
      comminution without change in the calcified aneurysm. With followup as long as 30
      months, no adverse effects of therapy have become evident. We conclude that the
      presence of an ipsilateral calcified aneurysm may not necessarily preclude
      treatment of renal or upper ureteral calculi with extracorporeal shock wave
      lithotripsy, although further studies are required to help define the potential
      limits of such therapy in this setting.

PMID- 1613867
TI  - Cystometry in mice--influence of bladder filling rate and circadian variations in
      bladder compliance.
AB  - Meaningful interpretation of cystometric measurements in experimental animals
      requires detailed analysis of factors that could affect the results. In the
      present study, the effect of catheter size and bladder filling rate were studied
      in detail; in addition, the influence of (day) time on bladder compliance was
      assessed by cystometry in mice. Bladder reservoir function was independent of the
      catheter size, when i.v. cannulae with outer diameters of 0.6 and 0.8 mm. were
      used, but leakage pressure and leakage volume were increased with the larger
      catheter. Neither the storage capacity nor the bladder wall resistance showed
      dependence on filling rates above 0.1 ml./min. Below this rate, bladder capacity
      increased and wall resistance decreased with decreasing filling rate.
      Furthermore, leakage eventually occurred below 20 mm. Hg with the lower filling
      rates. Marked diurnal variations in bladder compliance and wall resistance were
      observed. Maximum storage capacity was observed at 7 p.m. and the reservoir
      function subsequently decreased to a plateau between 1 a.m. and 1 p.m.

PMID- 1613868
TI  - Implantable penile venous compression device: initial experience in the acute
      canine model.
AB  - We have designed a venous compression device implantable at the base of the penis
      outside the tunica albuginea. Because it does not require exposure of individual
      veins for ligation, the risk to the cavernous nerve is practically nil. It
      occludes the venous return only temporarily, and thus collaterals are less likely
      to occur. In this preliminary acute study in dogs (N = 13), the penile venous
      compression device was shown to be effective and safe in controlling penile
      venous drainage and maintaining rigid erection.

PMID- 1613869
TI  - A comparison of stone damage caused by different modes of shock wave generation.
AB  - A standard stone phantom was used to compare stone damage after extracorporeal
      shock wave administration from electrohydraulic, electromagnetic and
      piezoelectric lithotripters. For each machine, a low and high shock wave
      intensity setting was chosen: 18 & 24 kV for electrohydraulic; 16 & 19 kV for
      electromagnetic; power levels 1 and 4 for piezoelectric. The shock wave was
      focused either at the front (surface facing the wave source) or back surface of
      the stone and 50, 100, 200 or 400 shocks were delivered to different stone
      groups. Effects of varying physical properties in the stone phantom were also
      investigated. Stone damage was described in terms of volume loss and both depth
      and width of the resulting damage crater. At the lower intensity settings, all
      three machines produced stone volume loss which was linearly related to the
      number of shock delivered. At higher intensity settings, volume loss increased
      rapidly as the number of shocks increased. With the same number of shocks, stone
      volume loss was greatest with the electrohydraulic machine, followed by
      electromagnetic and piezoelectric lithotripters for both low and high intensity
      settings. Damage craters from the piezoelectric device were narrow and deep;
      those from the electromagnetic machine were of the shape of a right angle
      circular cone; whereas those from the electrohydraulic lithotripter were shallow
      and wide. At the high intensity settings, damage from the piezoelectric and
      electrohydraulic lithotripters appeared to depend upon the position of the focal
      point with a higher volume loss when the shock waves were targeted at the front
      surface of the stone. For the electromagnetic device, a higher volume loss was
      found when we positioned the focal point at the back surface of the stone
      phantom. Stone phantoms with lower mechanical strength and acoustic impedance
      were more easily damaged than those with higher values. Finally, a computer
      regression model was developed to express volume loss in terms of the intensity
      setting, focal position and number of shocks for each lithotripter.

PMID- 1613871
TI  - Entubulization repair of severed cavernous nerves in the rat resulting in return
      of erectile function.
AB  - Erectile dysfunction is a significant complication of radical pelvic surgery in
      men. Using the rat as an experimental model, we investigated the feasibility of
      repairing surgically ablated cavernous nerves utilizing silastic tube nerve
      growth conduits filled with nerve growth enhancing media. Known fertile male
      Sprague-Dawley rats were randomly divided into four surgical groups consisting of
      nerve ablation, immediate nerve reconstruction utilizing the entubulization
      technique (two groups) and control. The nerve ablation group had five mm.
      sections of the cavernosal nerve excised bilaterally. The entubulization nerve
      graft group had five mm. sections of the cavernous nerve excised bilaterally,
      followed by immediate microsurgical reconstruction with a silastic nerve tube
      conduit filled with either Matrigel and heparin (MA) or Matrigel and heparin plus
      acidic fibroblast growth factor (MA/aFGF), interposed between the severed
      cavernous nerve stumps bilaterally. The control group underwent sham operations
      with the cavernous nerves being exposed only. Erectile function was evaluated at
      one, two, and four months postoperatively. Return of erectile function was
      defined as tumescence of the corporal bodies with application of direct
      electrical stimulation (four volts of five millisecond pulses at 20 Hertz) to the
      proximal cavernous nerves. The two and four month electrical stimulation studies
      resulted in tumescence from 50% and 58% of the entubulization nerve reconstructed
      nerves with MA/aFGF versus 29% and 30% for the MA only group and only 5% and 11%
      for the ablated group, respectively. We conclude that in this experimental model
      immediate nerve graft repair utilizing entubulization techniques with the
      addition of nerve growth enhancing media appears to be a successful method of
      salvaging erectile function when the cavernous nerves have been divided.

PMID- 1613870
TI  - Studies on the afferent and efferent renal nerves following autotransplantation
      of the canine kidney.
AB  - The presence of both afferent and efferent renal nerves following renal
      transplantation was investigated in a canine autotransplant model. The efferent
      postganglionic sympathetic renal nerves were studied using the glyoxylic acid
      histofluorescence technique to identify renal tissue adrenergic amines (Grade 0
      4). The afferent sensory renal nerves were studied by the systemic blood pressure
      response to renal arterial injection of capsaicin. In 8 control dogs with native
      innervated kidneys (Group I), intrarenal injection of capsaicin significantly
      increased the systemic blood pressure from baseline by 32.4 +/- 6.3 mm. Hg (p
      less than 0.01). This response was equivalent to the blood pressure increase
      following injection of capsaicin into the mesenteric artery which was 37.3 +/-
      9.8 mm. Hg. The renal tissue histofluorescence grade in this group was 4. Six
      dogs were studied two to three weeks after autotransplantation of a solitary
      kidney (Group II). Intrarenal injection of capsaicin did not increase the
      systemic blood pressure in these animals. Three dogs in this group had no
      evidence of renal tissue adrenergic amines by histofluorescence (Grade 0); the
      remaining two animals had renal tissue histofluorescence grades of 1 and 2. Eight
      dogs were studied 12 to 35 months after autotransplantation of a solitary kidney
      (Group III). Intrarenal injection of capsaicin in these animals significantly
      increased the systemic blood pressure from baseline by 10 +/- 1.4 mm. Hg (p less
      than 0.001). The renal tissue histofluorescence grade in this group ranged from 1
      to 3. These data support the presence of both afferent and efferent renal nerves
      in the kidney at greater than or equal to one year post-transplant.

PMID- 1613872
TI  - Comparative autonomic responses of the cat and rabbit bladder and urethra.
AB  - The cat and the rabbit have both been utilized extensively in the study of lower
      urinary tract function. Previous studies have demonstrated that although both the
      cat and rabbit bladder are approximately the same weight, the in-vitro cat
      bladder can generate over 6 times the intravesical pressure of the rabbit
      bladder. The current study was designed to compare the ability of the isolated
      bladder to generate pressure with the pressures required to maintain flow through
      the isolated urethra for both the cat and the rabbit. The results can be
      summarized as follows. 1) The cat bladder is visibly much thicker than the rabbit
      bladder, and in vitro cystometry demonstrates that it is far less compliant than
      the rabbit bladder. 2) Over 20 cm.H2O pressure is required to begin flow through
      the isolated cat urethra preparation, whereas 5 cm.H2O begins flow through the
      rabbit urethra. 3) Increasing the flow rate (up to 7-fold) through both the
      isolated cat and rabbit urethra increases intraurethral pressure only slightly.
      4) Both the isolated cat and rabbit urethra respond strongly to field stimulation
      and alpha-adrenergic stimulation (relative to the opening pressure required to
      begin flow), but not to cholinergic stimulation. 5) Field stimulation following
      pre-stimulation by methoxamine induces a strong relaxation of the pre-stimulated
      cat urethra, but an additive contraction in the pre-stimulated rabbit urethra.
      These studies demonstrate that in order for the cat to empty its bladder, it must
      generate a comparatively high intravesical pressure, whereas the rabbit is
      required to generate a relatively low intravesical pressure.

PMID- 1613873
TI  - Optimal parameters for CO2 laser reconstruction of urethral tissue using a
      protein solder.
AB  - This study was designed to determine the optimal laser parameters for welding
      urethral tissue and to develop further understanding of the welding process. A
      partial transection of the pendulous rat urethra was repaired using laser powers
      of 80, 120, and 160 milliwatts with shutter speeds of 50 milliseconds, 100
      milliseconds, and in a continuous wave mode. Repairs were made using the laser
      alone and the laser plus a protein solder. Measurements of intraluminal bursting
      strength, percentage stricture and histology were performed. The highest bursting
      strength with the least amount of tissue damage was achieved using a power of 120
      milliwatts with 100 milliseconds pulses and the addition of a protein solder. The
      average percentage stricture was lowest with the laser plus solder repair (4.2%)
      when compared to laser only repair (14%). Intraluminal bursting strength was
      similar in both types of repairs. Histology demonstrated marked changes in
      collagen organization after laser application in all models.

PMID- 1613874
TI  - Conservative surgery of renal cell tumors in 140 patients: 21 years of
      experience.
AB  - Operative method, course and complications were analyzed retrospectively in 140
      patients who underwent a conservative operation for renal tumor between June 1969
      and December 1990. In 53 patients (20 women and 33 men, mean age 61.2 years,
      range 38 to 77 years, with 49 renal cell carcinomas and 4 benign renal tumors)
      there was an imperative indication for an organ preserving operation because
      nephrectomy would have made dialysis obligatory. In 87 patients (29 women and 58
      men, mean age 53.7 years, range 27 to 74 years, with 72 renal cell carcinomas and
      15 benign renal tumors) the tumor was conservatively resected in the presence of
      a normal contralateral unit (elective indication) and 68 of these patients (78%)
      were symptom-free. In the imperative group 32 of 49 patients (65.3%) with renal
      cell carcinoma had no evidence of disease after a mean followup of 4.6 years.
      Known metastases were present in 4 of 7 patients who died of the tumors in this
      group. In 3 patients with an imperative indication for conservative surgery a
      second tumor occurred in the kidney: 2 were treated with further parenchyma
      sparing operations, while in 1 with poor physical condition no further measures
      were possible. Of 72 patients with renal cell carcinoma who underwent an elective
      operation 68 (94.4%) had no signs of tumor progression after a mean followup of
      3.3 years. One patient died of tumor metastases, and 2 (2.7%) had tumor
      recurrence in the kidney requiring nephrectomy and enucleation, respectively. The
      5-year cause-specific survival rates for the imperative and elective groups were
      84% and 96%, respectively. Patients with a local stage T3 tumor were
      characterized by a significantly worse survival curve than those with a stage T1
      or T2 tumor but no significant difference was noted among the various grades of
      differentiation.

PMID- 1613875
TI  - Transitional cell carcinoma of the renal pelvis and ureter: prognostic relevance
      of nuclear deoxyribonucleic acid ploidy studied by slide cytometry: an 8-year
      survival time study.
AB  - In 72 patients with urothelial carcinoma of the renal pelvis or ureter the
      ploidy, deoxyribonucleic acid (DNA) heterogeneity and counts of cell cycle phases
      in the tumor were analyzed by means of single cell DNA cytophotometry with the
      intention of finding new prognostic factors in addition to those already known
      (stage and grade). Followup ranged from 1 to 8 years. The results of the DNA
      analyses were related to the tumor categories, histopathological grading of the
      tumors and clinical course. Malignancy grade 1 tumors showed DNA frequency peaks
      in the diploid range, while tumors assessed as malignancy grade 2 showed
      heterogeneous DNA distribution patterns. Malignancy grade 3 tumors exhibited 71%
      aneuploid and 29% tetraploid DNA values. The proliferation rate of the tumor
      cells was statistically significantly higher in malignancy grades 2 and 3 than in
      malignancy grade 1. The prognosis for grade 1 tumors is good, whereas it is
      unfavorable in the case of grade 3 tumors. For these 2 groups (patients with
      grades 1 and 3 tumors) DNA ploidy affords no additional prognostic information.
      Grade 2 tumors, on the other hand, are heterogeneous in respect to DNA ploidy
      although they exhibit the same histomorphological degree of differentiation.
      These tumors can be subclassified as aneuploid (biologically aggressive) and
      diploid or tetraploid (biologically less aggressive) tumors. There was also a
      positive correlation between T category and DNA ploidy. The cell lines were
      aneuploid in 38% of the patients with stage T1 tumors, 56% with stage T2 tumors
      and almost 85% with stage T3, N+ tumors. A significant correlation was found
      between the results of DNA cytophotometry and the clinical course of the disease.
      Patients with diploid tumor cell nuclei had no metastases and no local tumor
      progression for up to 8 years, whereas patients with aneuploid tumor cell nuclei
      suffered metastasis and local tumor progression within 24 to 36 months. The
      patients died of the tumor 36 months after primary diagnosis on the average. The
      determination of DNA ploidy, tumor heterogeneity and tumor cell proliferation by
      means of DNA cytophotometry affords valuable clues as to prognosis.

PMID- 1613876
TI  - Complications following unstented parallel incision extravesical
      ureteroneocystostomy in 1,000 kidney transplants.
AB  - Between May 10, 1982 and September 1, 1990, 1,000 kidney transplant recipients
      underwent parallel incision extravesical ureteroneocystostomy for urinary tract
      reconstruction. Complications attributed to this surgical technique that required
      reoperation occurred in 2.1% of the recipients. These complications included
      urinary extravasation in 9 patients, ureteral necrosis in 3, ureteral obstruction
      in 3, ureteral bleeding in 3, ureteral implantation into thickened folds of
      peritoneum in 2 on chronic ambulatory peritoneal dialysis and ureteral
      implantation into an ovarian cyst in 1. Vesicoureteral reflux occurred in 0.4% of
      the ureteroneocystostomies, none of which was revised. No allografts were lost as
      a result of these complications. The principles of the technique are sound. One
      should be careful if the patient has a small, defunctionalized or scarred
      bladder, has undergone multiple pelvic operations or has had pelvic inflammatory
      disease.

PMID- 1613877
TI  - The frequency of histopathological abnormalities in incidental appendectomy in
      urological patients: the implications for incorporation of the appendix in
      urinary tract reconstruction.
AB  - In 1980 Mitrofanoff described the use of the isolated appendix as an intermittent
      catheterization route to empty a continent urinary reservoir. The procedure was
      popularized and numerous variations on the same principle were reported. Presence
      of histopathological abnormalities in the appendix may limit its suitability for
      reconstructive purposes. We studied the frequency of incidental histopathological
      abnormalities in appendixes removed electively in 122 urological patients during
      a radical pelvic operation. The implications for incorporation of the appendix in
      urinary tract reconstruction are evaluated. A total of 38 patients (31.1%) had
      notable histological abnormalities of the appendix: 35 had fibrous obliteration
      of the lumen, 2 had carcinoid tumor and 1 had a mucocele of the appendix. The
      rate of abnormal appendixes was significantly higher in elderly patients (more
      than 70 years old). Incidental pathology of the appendix is a frequent finding
      that may affect the immediate results and the late outcome of urinary tract
      reconstruction using the appendix. When such strategy of urinary tract
      reconstruction is considered, potential histopathological abnormalities should be
      anticipated. The patients should be informed and aware of possible unexpected
      changes in the preplanned procedure, while the surgeon must be familiar with
      these alternative reconstructive methods.

PMID- 1613878
TI  - Cytogenetic studies of carcinoma in situ of the bladder: prognostic implications.
AB  - Carcinoma in situ of the bladder has traditionally been considered a lethal
      disease by most urologists and as such it has been treated most frequently in an
      aggressive manner. Recent investigations have suggested that carcinoma in situ of
      the bladder may, in fact, be a complex of diseases that exists in at least 2
      distinct disease forms, 1 aggressive and 1 relatively nonaggressive. We studied
      the cytogenetics of 17 patients diagnosed clinically and pathologically to have
      carcinoma in situ, and found a positive correlation of karyotype complexity
      (numerical and structural changes) with disease course. Superficial tumors with
      normal karyotypes remained superficial throughout the study and continued to
      exhibit a nonaggressive course, while patients whose tumors had an abnormal
      karyotype at diagnosis expressed a much more aggressive course that ultimately
      developed into invasive disease. Nonrandom chromosomal changes involving
      chromosomes 1, 5, 8 and 11 were observed in these tumors. Therefore, cytogenetic
      evaluation may prove to be an important guide in helping to determine an
      appropriate treatment course for patients with carcinoma in situ of the bladder.

PMID- 1613879
TI  - Deoxyribonucleic acid flow cytometry in invasive bladder carcinoma: a possible
      predictor for successful bladder preservation following transurethral surgery and
      chemotherapy-radiotherapy.
AB  - Tumor deoxyribonucleic acid (DNA) ploidy was evaluated as an objective parameter
      that may correlate better with the responsiveness of bladder cancer to
      chemotherapy plus radiotherapy than do clinical features or histopathological
      subtypes. A total of 40 patients with localized muscle-invading bladder cancer
      (clinical stages T2 to T4) underwent prospective treatment on a potential bladder
      preserving protocol. Tumors of 37 of the 40 patients were analyzed by DNA flow
      cytometry of multiple paraffin embedded specimens. Transurethral resection,
      neoadjuvant chemotherapy and 40 Gy. radiotherapy plus cisplatin were followed by
      urological reevaluation of the tumor (a complete response required a negative
      biopsy and a negative urine cytology study). A total of 7 noncomplete response
      patients underwent immediate radical cystectomy whereas the full bladder sparing
      treatment (radiotherapy to 64.80 Gy. plus cisplatin) was given to 23 complete
      response patients and 7 noncomplete response patients who were unsuited for
      surgery. Of the tumors 22 (59%) were purely aneuploid and 10 (27%) were purely
      diploid. Five tumors contained aneuploid and diploid patterns in different tumor
      specimens (partly diploid). Current status with a 30-month median followup in
      surviving patients includes an 82% overall survival rate in the aneuploid group
      versus 47% in the diploid/partly diploid group. Of all the patients 68% are free
      of invasive tumor: 82% in the aneuploid group versus 47% in the diploid/partly
      diploid group. By multivariate analysis pure aneuploidy was significantly (p =
      0.05) correlated with freedom from invasive tumor in the bladder (either as
      persistence or as recurrence) and approached significance (p = 0.08) in
      correlation with overall patient survival. A longer observation time will be
      required to confirm this unexpectedly good outcome for patients with pure
      aneuploid tumors. We hypothesize that pretreatment DNA ploidy status may become a
      clinically useful prognostic factor in selecting patients for successful
      treatment with transurethral surgery and neoadjuvant chemotherapy plus
      radiotherapy.

PMID- 1613880
TI  - Combination cisplatin and dichloromethotrexate in patients with advanced bladder
      cancer. Phase 2. A Southwest Oncology Group study.
AB  - The combination of cisplatin and dichloromethotrexate is a pharmacologically
      rational strategy designed to avoid the nephrotoxicity associated with the
      systemic chemotherapy of bladder cancer. Of 97 patients with metastatic bladder
      cancer entered into this study 73 with good renal function received cisplatin and
      dichloromethotrexate, while 24 with impaired renal function received
      dichloromethotrexate alone. No responses were noted in the latter group. A 42%
      response rate (95% exact confidence interval 30.0 to 55.2%), including 9 patients
      (14%) who achieved a complete response, was observed in the combination group.
      The toxicity patterns in both groups of patients were consistent with the
      hypothesis that renal toxicity would be ameliorated with the use of the
      methotrexate analogue. However, the failure to achieve a higher overall response
      rate despite near maximum tolerated doses of dichloromethotrexate discourages
      future studies with this agent. New agents for metastatic bladder cancer should
      be tested as first line therapy.

PMID- 1613881
TI  - Modified vascularized pedicled scrotal flap for complex hypospadias.
AB  - Surgical correction of complex hypospadias defects is a problem. A 1-stage
      technique using a scrotal septum pedicled skin flap was used in 7 patients with
      inadequate preputial skin and scarred ventral penile skin unsuitable for
      satisfactory repair. The results were satisfactory in 5 patients. Distal urethral
      stricture developed in the remaining 2 patients and 1 of them had a subcoronal
      urethrocutaneous fistula. Minor hair growth was noted in 1 patient. The pedicled
      scrotal septum flap is recommended in selected cases of complex hypospadias,
      particularly when other methods fail.

PMID- 1613882
TI  - Congenital defect in sinusoidal smooth muscles: a cause of organic impotence.
AB  - We report 2 cases of primary impotence due to a congenital defect in the
      compliance of the sinusoidal spaces secondary to fibrosis and atrophy of the
      smooth muscles. Both patients were young adults at presentation. Diagnosis of
      this rare entity was achieved by penile Doppler ultrasound and
      cavernosometry/cavernosography of the cavernous bodies. Both patients underwent
      placement of a penile prosthesis, during which biopsy samples of the cavernous
      tissue were obtained, and diagnosis was confirmed by light and electron
      microscopy.

PMID- 1613883
TI  - The combined intracavernous injection and stimulation test: diagnostic accuracy.
AB  - A retrospective review was done of the results of the combined intracavernous
      injection and stimulation test, an office based functional test for impotence. In
      this procedure the quality of erection is assessed 15 minutes after injection of
      a vasoactive drug. In our series 90 patients did not achieve full rigidity and
      were instructed to perform genital self-stimulation for 5 minutes before
      reevaluation. Of the 90 patients 67 (74%) improved with stimulation and 23 (26%)
      showed no improvement. At 5 minutes after stimulation a decrease in the quality
      of the erection was found in 25 patients--a finding suggestive of venogenic
      impotence. When cavernosometry and cavernosography were performed 21 patients
      (84%) had moderate to severe venous leakage and 4 (16%) showed none. Self
      stimulation after diagnostic injection of intracavernous agents can improve
      patient response, and may better predict the potential success of a therapeutic
      self-injection program and the diagnosis of suspected venogenic impotence.

PMID- 1613884
TI  - Penile pharmacological duplex ultrasonography: a dose-effect study comparing
      papaverine, papaverine/phentolamine and prostaglandin E1.
AB  - Alternations of penile blood flow are believed to be the most frequent organic
      cause of erectile dysfunction. Penile duplex ultrasonography following
      intracavernous injection of a vasoactive agent is an accepted method for
      diagnosis of penile vascular dysfunction. To determine the diagnostic efficacy of
      commonly used vasoactive drugs we studied the hemodynamic effects of different
      dosages of papaverine, the combination of papaverine and phentolamine, and
      prostaglandin E1 in men with erectile dysfunction and men with normal erectile
      potency using color duplex ultrasonography. We concluded that 12.5 mg. papaverine
      and 10 micrograms. prostaglandin E1 are the drugs of choice to be used in
      conjunction with penile duplex ultrasonography because of optimal effects on
      cavernous arterial dilatation and low risk of prolonged erection. However, low
      dose papaverine or prostaglandin E1 has a limited value in evaluating veno
      occlusive function.

PMID- 1613885
TI  - Cancer metastatic to the penis: treatment with hyperthermia and radiation therapy
      and review of the literature.
AB  - Metastatic cancer to the penis is rare, its optimum treatment remains poorly
      defined and the outcome of patients with such metastases is poor. Hyperthermia in
      conjunction with radiation therapy has been shown to be an effective modality in
      the treatment of locally advanced or recurrent cancer and hyperthermia alone is
      under evaluation in treating benign disorders, such as hypertrophy of the
      prostate. Recently, 4 patients with symptomatic metastatic lesions to the penis
      (3 had primary prostatic cancer and 1 had rectal cancer) were treated with
      radiation therapy and hyperthermia. Treatment was well tolerated except for pain
      during hyperthermia, which limited the temperatures that could be obtained. All
      of the patients improved symptomatically, 1 achieved a complete response and 2
      had partial responses. No significant complications were noted. Symptomatic
      control was maintained in all patients for the duration of their survival. This
      limited series suggests the possible role of local hyperthermia as an adjunct to
      radiation therapy in the treatment of metastases to the penis.

PMID- 1613886
TI  - Globotriaosyl ceramide glycolipid in seminoma: its clinicopathological importance
      in differentiation from testicular malignant lymphoma.
AB  - Glycolipids were biochemically extracted from 14 specimens of seminoma, 2 of
      testicular malignant lymphoma (both of which were difficult to differentiate from
      seminoma with a high mitotic index) and 4 of normal testicle. The pattern of
      their expression was compared. Marked accumulation of globotriaosyl ceramide was
      observed in seminoma but it was present in a small amount in testicular malignant
      lymphoma. Differentiation between seminoma and malignant lymphoma is sometimes
      difficult by histopathological findings but it is considered to be greatly
      facilitated by examination of the pattern of glycolipid expression.

PMID- 1613887
TI  - Prostatic abscess: diagnosis and treatment.
AB  - We present a series of 25 men with prostatic abscesses studied during an 11-year
      interval in whom prostatic fluctuation upon digital rectal examination was the
      most characteristic sign. Transrectal ultrasound was the most reliable method for
      diagnosis and transurethral drainage under antibiotic coverage was the ideal
      treatment for this disease.

PMID- 1613888
TI  - Correlation of prostate cancer nuclear deoxyribonucleic acid, size, shape and
      Gleason grade with pathological stage at radical prostatectomy.
AB  - Using image cytometry and a video planimetry unit, various deoxyribonucleic acid
      (DNA) measurements, nuclear size and shape factors, and Gleason grade were
      correlated with capsular penetration, seminal vesicle invasion and lymph node
      involvement in 113 radical prostatectomy specimens. Percentage of nondiploid
      cells was the best DNA measurement and standard deviation of nuclear area was the
      best size measurement correlating with capsular penetration. However, stepwise
      regression analysis demonstrated that Gleason grade was the only independent
      predictor of capsular penetration. The only parameter that independently
      predicted seminal vesicle invasion in a stepwise regression analysis was
      percentage of tetraploid cells. The mode of optical density was the best DNA
      measurement for predicting lymph node involvement, although stepwise regression
      analysis found that Gleason grade was the only independent predictor. DNA ploidy
      was not as predictive of pathological stage. In summary, DNA measurements and
      nuclear morphometry performed on smears offered relatively little additional
      prediction of pathological stage over that of Gleason grade.

PMID- 1613889
TI  - Early continence after radical prostatectomy.
AB  - A prospective evaluation of urinary continence in 60 consecutive patients
      undergoing radical prostatectomy with incorporation of the fascia posterior to
      the urethra into the vesicourethral anastomosis is described. With this technique
      complete continence without the need for pads has been achieved in 88% of the
      patients, with stress incontinence in 10% and total incontinence in 2%.
      Continence was achieved within 1 to 16 weeks, with 13% of the patients dry during
      week 1, 55% dry at 6 weeks and 83% dry at 3 months. The median interval to
      achieve continence was 5 weeks. Median age of the continent patients was
      significantly lower than that of incontinent patients (65 versus 69 years).
      Neither the number of neurovascular bundles resected nor the need to reconstruct
      the vesical neck affected the rate of continence. While the exact mechanism of
      continence after radical prostatectomy remains unknown, incorporation of the
      fascia posterior to the urethra into the vesicourethral anastomosis results in
      earlier continence and thereby lessens the morbidity of this procedure.

PMID- 1613890
TI  - A new procedure for biopsy of a solid renal mass: transurethral approach under
      fluoroscopic control.
AB  - Cystoscopically placed, fluoroscopically guided catheters were used to biopsy 3
      solid renal tumors. One kidney had a renal cell carcinoma and 2 had transitional
      cell carcinoma invading the renal parenchyma, including 1 that had undergone
      various ureteroscopic biopsy techniques that failed to yield a diagnosis. The
      transurethral technique offers an alternative to open, laparoscopic or
      percutaneous biopsy in selected patients.

PMID- 1613891
TI  - Traffic death toll may be declining, but experts not ready to celebrate.

PMID- 1613892
TI  - Defining, counting traffic injuries no easy task as nation assesses toll from
      this violence.

PMID- 1613893
TI  - For three quarters of century, safety experts work to keep trains, vehicles from
      colliding.

PMID- 1613894
TI  - Simulator designed for advanced traffic research.

PMID- 1613895
TI  - Driving while under influence of alcohol remains major cause of traffic violence.

PMID- 1613896
TI  - Association dedicated to crash injury control.

PMID- 1613897
TI  - Seven years before centennial of first US traffic death, toll already has reached
      nearly 2.8 million.

PMID- 1613898
TI  - High-speed chases to high-powered squirters, moving traffic violations pose
      variety of threats.

PMID- 1613899
TI  - As nation grows older, traffic safety officials confront questions of who should
      drive.

PMID- 1613901
TI  - Highway fund threat is no easy ride for motorcycle helmet law opponents.

PMID- 1613900
TI  - Campaigns focus on helmets as safety experts warn bicycle riders to use--and
      preserve--heads.

PMID- 1613902
TI  - From the Centers for Disease Control. Trends in alcohol-related traffic
      fatalities, by sex--United States.

PMID- 1613903
TI  - From the Centers for Disease Control. Safety-belt and helmet use among high
      school students--United States, 1990.

PMID- 1613904
TI  - From the Centers for Disease Control. Table reporting alcohol involvement in
      fatal motor-vehicle crashes.

PMID- 1613905
TI  - From the Centers for Disease Control. Increased safety-belt use--United States,
      1991.

PMID- 1613906
TI  - Contempo '92.

PMID- 1613907
TI  - Addiction medicine.

PMID- 1613908
TI  - Administrative medicine.

PMID- 1613909
TI  - Adolescent medicine.

PMID- 1613910
TI  - Anesthesiology.

PMID- 1613911
TI  - Cardiothoracic surgery.

PMID- 1613912
TI  - Cardiovascular disease.

PMID- 1613913
TI  - Critical care medicine.

PMID- 1613914
TI  - Economics.

PMID- 1613915
TI  - Emergency medicine.

PMID- 1613916
TI  - Endocrinology.

PMID- 1613917
TI  - Ethics.

PMID- 1613918
TI  - Family medicine.

PMID- 1613919
TI  - General internal medicine.

PMID- 1613920
TI  - Geriatric medicine.

PMID- 1613921
TI  - Government.

PMID- 1613922
TI  - Infectious diseases.

PMID- 1613923
TI  - Medical genetics.

PMID- 1613924
TI  - Medical toxicology.

PMID- 1613925
TI  - Neonatology.

PMID- 1613926
TI  - Neurological surgery.

PMID- 1613927
TI  - Neurology.

PMID- 1613928
TI  - Nutrition.

PMID- 1613929
TI  - Occupational and environmental medicine.

PMID- 1613930
TI  - Oncology.

PMID- 1613931
TI  - Ophthalmology.

PMID- 1613932
TI  - Otolaryngology-head and neck surgery.

PMID- 1613933
TI  - Pathology and laboratory medicine.

PMID- 1613934
TI  - Pediatrics.

PMID- 1613935
TI  - Preventive medicine and public health.

PMID- 1613936
TI  - Psychiatry.

PMID- 1613937
TI  - Pulmonary medicine.

PMID- 1613938
TI  - Quality in health care.

PMID- 1613939
TI  - Radiology.

PMID- 1613941
TI  - Surgery.

PMID- 1613940
TI  - Sports medicine.

PMID- 1613942
TI  - [Combined therapy with prostaglandin E1 ointment and lumbar sympathetic ganglion
      block on intractable skin ulcers accompanied by Burger's disease].
AB  - For the 2 patients with intractable skin ulcers and pain accompanied by
      thromboangiitis obliterans (Burger's disease), we applied combined therapy with
      lumbar sympathetic block, continuous epidural block and prostaglandin E1
      ointment. Prostaglandin E1 (PGE1) was prepared as a topical ointment by mixing
      with Plastibase (polyethylene resin, 5%, liquid paraffin, 95%) at a concentration
      of 10 micrograms.g-1. The ointment was kept in a refrigerator until use.
      Following debridement and washing of the surface of ulcers as required, the
      ointment was applied evenly onto the surrounding and over the surface of each
      ulcer 2 times daily after sterilization. With this therapy the ulcers were cured
      completely in 10 days after the start of treatment. No side effect was observed
      both locally and systemically. Although the combined therapy we used with
      prostaglandin E1 ointment was a noninvasive method, a remarkable shortening of
      the period of treatment was achieved.

PMID- 1613943
TI  - [A series of anesthesia for a child with Lowe's syndrome].
AB  - A series of anesthesia for a child with Lowe's syndrome was reported. The boy
      underwent general anesthesia for 6 times for ophthalmic and dermatologic
      surgeries in approximately eight years since the age of only four months when the
      first anesthesia had been given. From the third to the fifth episodes of
      anesthesia, marked metabolic acidosis was noted, but at the first and second
      anesthesia, metabolic acidosis had not been recognized. Such acidosis was
      corrected each time by 7% NaHCO3 infusion at the early stage of anesthesia, and
      afterwards uneventful courses were seen. In the last anesthesia, acidosis was not
      found, though disturbance of renal functions were suspected because of abnormal
      urinary NAG and beta 2-microglobulin value in blood. Attention should be paid to
      possible anesthetic hazards in Lowe's syndrome patients such as metabolic
      acidosis due to the renal-tubular dysfunction, the risk of convulsion, glaucoma,
      the fragility of the bone structures, and so forth.

PMID- 1613944
TI  - [Anesthetic problems in patients with Forestier's disease].
AB  - We have studied common problems associated with the anesthetic management of
      Forestier's disease in 8 patients undergoing neurosurgery. This disease is a
      systemic degenerative disorder and is characterized by osteo-spur formation at
      anterior spinal body. In two of eight patients the trachea was intubated with
      great difficulty even by well-trained anesthesiologist. Its cause could be found
      not only in limited cervical mobility but also in constrained epiglottic
      elevation, suggesting that Forestier's disease requires special anesthetic
      considerations. It is thus important to predict the possibility of difficult
      tracheal intubation on both physical examination and the preoperative X-ray
      photography.

PMID- 1613945
TI  - [Studies of emergency cardiopulmonary bypass (ECPB) for cardiopulmonary-cerebral
      resuscitation; (1) Introduction of a portable-percutaneous ECPB system].
AB  - The authors have developed an ECPB system, which can be applied quickly, safely
      and easily under an emergency condition requiring cardiac massage and artificial
      ventilation. Fundamentally, the ECPB system consists of 3 parts; a portable ECPB
      apparatus, a pair of percutaneous cannulae and a short circuit connecting an
      oxygenator with the cannulae. The ECPB apparatus is assembled with commercially
      available components (i.e., a centrifugal pump, a battery pack, a temperature
      controller, a compact membrane oxygenator with a heat exchanger, etc) and they
      are placed on a mobile cart. The circuit is primed with 300 ml of lactated Ringer
      solution. The priming can be done within 15 minutes via a reservoir. It is also
      possible to keep the primed circuit to be ready for emergency use at least for a
      week. The cannulae are placed intravascularly through the femoral artery and vein
      by using the Seldinger's percutaneous method. In an emergency situation, the
      arterial and venous cannulations are carried out separately on the both inguinal
      regions to save time. The tip of the venous cannula is adjusted to be placed near
      the right atrium under fluoroscopy. Initiation of ECPB via the femoro-femoral V-A
      cannulae assures instant and stable supply of oxygenated blood to all of the
      vital organs. At the present time, nothing is more important than a quick supply
      of oxygenated blood to the brain to ameliorate the post-ischemic brain damage.

PMID- 1613946
TI  - [Effect of prostaglandin E1 on arterial ketone body ratio during gastrectomy].
AB  - We evaluated the effect of prostaglandin E1 (PGE1) on arterial ketone body ratio
      (AKBR), which is a parameter to indicate the function of the liver cells, in the
      patients undergoing total or subtotal gastrectomy. Twenty patients were divided
      into two groups: continuous intravenous administration of PGE1 (0.02
      micrograms.kg-1.min-1) was started from 30 minutes after the beginning of the
      operation in 10 patients, and the remainders did not receive PGE1. AKBR levels at
      30 minutes after the beginning of the operation (during the resection of stomach)
      were significantly lower than those after the resection of stomach in both
      groups. A significant increase in AKBR caused by the administration of PGE1 was
      observed during the resection of the stomach in PGE1 group. However, almost no
      change was observed in AKBR during the resection of the stomach in control group.
      These findings suggest that the administration of PGE1 has a protective effect on
      liver which is due mainly to the increase in hepatic blood flow during the
      resection of stomach.

PMID- 1613947
TI  - [The effects of prostaglandin E1 infusion on the viscosity and pH of gastric
      fluid during general anesthesia].
AB  - We studied the protective effect of prostaglandin E1 (PGE1)-induced hypotensive
      anesthesia on gastric mucosa in 30 elective surgical patients. Three groups, each
      composed of 10 patients, received PGE1, nitroglycerin or none during general
      anesthesia. Then we measured the viscosity and pH of gastric fluid continuously
      in each group. In the PGE1 group the viscosity and pH increased significantly and
      rapidly (P less than 0.05) as compared with the other groups. This suggests that
      PGE1 offers prophylactic effect against postoperative acute gastric mucosal
      lesion (AGML).

PMID- 1613948
TI  - [Usefulness of a disposable nasogastric tube with a pH sensor--comparison with a
      class pH electrode].
AB  - We evaluated a disposable nasogastric tube with a pH sensor in comparison with an
      external glass pH electrode with aspiration of gastric contents, continuously.
      The mean pH value determined by pH sensor was 3.01, and 2.99 by glass pH
      electrode. There was a good correlation between the two methods (r = 0.91). The
      agreement between the two methods was especially good when pH less than 5.0.
      There was a wide scattering in the data when pH greater than 5.1. When the glass
      pH electrode data were above 5.1, the pH sensor tended to show lower pH values
      than glass pH electrode.

PMID- 1613949
TI  - [A new preoperative evaluation of platelet aggregation--Part II].
AB  - With the new platelet function test which we reported in the first paper, the
      platelet aggregation was evaluated in 50 patients, and the comparison with the
      results of bleeding time was made in 20 cases. There was no statistical
      correlation between the bleeding time and the platelet aggregation. The bleeding
      time has been considered as an indicator of platelet function and is included in
      a preoperative check list. However, its result depends on the amount of platelets
      and the endothelial factor, and the reliability of bleeding time on platelet
      function is considered small, especially in patients medicated with antiplatelet
      drugs. For such patients, the platelet aggregation test is essential. The present
      study demonstrated that the patient belonging to grade-1 were resistant to
      hemostasis during the operation. Taking into the surgical and anesthetic
      depression on the platelet function into consideration, the patients below grade
      2 are risky for the surgery.

PMID- 1613950
TI  - [Evaluation of efficacy of maximum surgical blood order schedule (MSBOS) in the
      operating room].
AB  - We evaluated efficacy of maximum surgical blood order schedule (MSBOS) using
      analysis of cross-match to transfusion ratio (C/T ratio) during 1 year after
      applying MSBOS to operations in our operating room. The MSBOS used was based on
      our trial reported in 1990. Compared with preoperative prepared blood units
      before application of MSBOS, C/T ratio decreased from 4.76 to 3.44, and cross
      matched blood units decrease from 476 units to 344 units (about 72%) per 100
      packs of transfused blood. We conclude that application of MSBOS is effective and
      useful for saving preoperative prepared blood. Analysis with C/T ratio was very
      useful to recognize the present status of preparations of blood for surgery
      preoperatively. MSBOS should be re-evaluated regularly because of changes of
      operative environment such as surgeon, operative method, preoperative condition
      of patients, and so on.

PMID- 1613951
TI  - [Serum catecholamine concentrations and hemodynamics during operations on 23
      children with neuroblastoma].
AB  - The purpose of the present report is to reveal the relation between hemodynamic
      changes and serum catecholamine concentrations during operation of 23
      neuroblastoma patients. The patients were aged from 6 months to 7 years (mean 1.2
      year), and 20 patients (86%) were under 1 year of age. All the patients were in
      early stage of tumor development because they were diagnosed as neuroblastoma
      mainly by mass screening test for VMA and HVA in urine utilizing HPLC. This
      urinary mass screening test for infants is performed routinely in Japan.
      Operative manipulation of tumor provoked the significant elevation of blood
      pressure, and the increasing tendency of heart rate and rectal temperature. The
      mean concentrations of three kinds of serum catecholamine, epinephrine,
      norepinephrine and dopamine, were all very high during manipulation of tumor.
      Especially, the norepinephrine concentration was 90.2 times higher than the
      preoperative value. The children who showed high blood pressure, over 70% of the
      control level, showed high urinary VMA and VMA/HVA ratio preoperatively and a
      high norepinephrine secretion during operation. We conclude that for the
      anesthetic management of neuroblastoma, it is necessary to control the elevation
      of blood pressure even in small children, especially in the patients who have
      showed high values of urinary VMA and VMA/HVA ratio preoperatively.

PMID- 1613952
TI  - [Measurement of functional residual capacity by sulfur hexafluoride washout].
AB  - An open circuit tracer gas washout method for measurement of functional residual
      capacity (FRC) during mechanical ventilation is described and tested. The system
      employed a piezo-valve for dispensing sulfur hexafluoride (SF6) gas, a fast
      response infrared SF6 analyzer, Servo 900-C ventilator and a computer. The piezo
      valve unit delivers SF6 into the airway in proportion to instantaneous
      inspiratory flow so that inspiratory SF6 concentration was held constant
      regardless of the inspiratory flow pattern. The washin concentration was
      approximately 0.6% which was so low that the supply of other gases was hardly
      influenced. The amount of SF6 at the end of a washin was calculated during
      washout by signals of expired SF6 concentration and expired flow. The results
      obtained in model lungs were accurate and reproducible; mean difference (limits
      of agreements) was 14 +/- 48ml (M +/- 2SD) in the range between 0.5 and 3.0
      liters. Comparison with helium dilution methods in 24 healthy subjects gave a
      regression equation: y = 0.98x + 56, r = 0.98. The mean difference of the values
      between the two methods was 21 +/- 142 ml (M +/- 2SD). The authors conclude that
      the system is quite useful in determining FRC of the patients under mechanical
      ventilation.

PMID- 1613953
TI  - [The influence of lung volume and body position on pulmonary blood flow under
      hypoxic exposure].
AB  - We examined the changes in the electromagnetically measured left lower lobe blood
      flow (QLLL) when the left lower lobe (LLL) was exposed to alveolar hypoxia
      selectively under two different positions (supine and right lateral position in
      18 dogs. QLLL/CO, Qs/Qt and other cardiopulmonary parameters were obtained during
      the following experimental sequence; 1) the whole lung ventilated with 100% O2
      (control), 2) LLL collapsed and the remainder ventilated with 100% O2, 3) N2
      expansion of LLL (N2 CPAP) and the remainder ventilated with 100% O2, 4) O2
      expansion of LLL (O2 CPAP) and the remainder ventilated with 100% O2, and 5) The
      whole lung ventilated with 100% O2. In the supine position group (n = 9), both
      selective collapse and N2 CPAP of LLL caused QLLL/CO to decrease significantly (P
      less than 0.02) from control values (14.9 +/- 1.7%) to 10.6 +/- 0.9% and 11.9 +/-
      1.6%, respectively. But there was no difference in QLLL/CO between collapse and
      N2 CPAP of LLL. In the right lateral position group (n = 9), hypoxic exposure of
      LLL caused no decrease in QLLL/CO from control values. But QLLL/CO during N2 CPAP
      (8.5 +/- 1.1%) decreased significantly than that during collapse (10.8 +/- 1.5%)
      (P less than 0.02). Qs/Qt during N2 CPAP (15.6 +/- 1.4%) also decreased
      significantly (P less than 0.05) from that during collapse (18.5 +/- 2.2%). We
      conclude that the difference of the changes in QLLL/CO under hypoxic exposure
      between supine and right lateral position was caused by hydrostatic pressure
      which influenced more during lateral position than during supine position.

PMID- 1613954
TI  - [The effect of age and gender on the effect of midazolam as intramuscular
      premedicant].
AB  - This study was designed to quantify the appropriate dose of midazolam relating to
      age and gender for intramuscular premedication. Three hundred and eighty-six
      consecutive patients (15-83 years) received midazolam (2.5-5.5 mg) with atropine
      30 minutes prior to surgery. The perioperative effects of midazolam on arterial
      pressure as well as heart rate, SpO2 and amnesic effects of regional anesthesia
      were evaluated in patients divided to 10-year age intervals. Reduction of
      arterial pressure correlated with preanesthetic values (r = 0.515, P less than
      0.01). Especially in those over 60 years, we observed significant reductions.
      Besides, compared with the males, the reduction was smaller in females. On the
      arrival at the operating room, this reduction recovered slightly, but
      preanesthetic hypertension was still attenuated effectively. After age 70, the
      SpO2 was lower, while the amnesic effect during regional anesthesia was
      significantly prominent. Amnesic effect correlated more with the dose than the
      dosage determined by body weight. Younger female patients required larger dosage
      determined by body weight than the corresponding male. As age increases, dose
      adjustment should be made mostly on the basis of age, and its adjustment on the
      basis of body weight should be made with great caution. In this study, we
      determined the appropriate dose of midazolam, 5 mg for those males younger than
      60 years and females below 50 years, and 3-3.5 mg for those older than 80 years.

PMID- 1613955
TI  - [An experimental study on the appropriate proportion of dopamine and dobutamine
      for mixed infusion to treat cardiopulmonary dysfunction].
AB  - This study was aimed to investigate appropriate proportion for combined use of
      dopamine (DA) and dobutamine (DB) to treat cardiopulmonary dysfunction. The total
      dose of 10 micrograms.kg-1.min-1 with several different proportions in steps of 2
      micrograms.kg-1.min-1 of DA and DB was administered to mongrel dogs with intact
      lung and with cardiopulmonary dysfunction caused by lung edema induced by oleic
      acid instillation. The hemodynamic variables during and after the infusion with
      the combined dosages of both agents were compared with that of baseline values.
      In dogs with intact lung, cardiac index (CI) increased significantly in all
      proportions of both agents. The levels of CI tend to increase prominently when
      the proportion of DB in the mixture was increased. Heart rates showed a tendency
      to increase with higher proportion of DB. Increasing proportions of DA caused a
      more increase of arterial pressure than by increasing that of DB. In dogs with
      pulmonary edema, these hemodynamic characteristics with the proportional changes
      of both drugs were demonstrated more significantly than in normal dogs. From
      these results, it was concluded that the appropriate combined preparation of both
      agents to increase CI without extreme tachycardia in dogs with cardiopulmonary
      dysfunction was the mixed solution of DA 2-4 micrograms.kg-1.min-1 and DB 6-8
      micrograms.kg-1.min-1.

PMID- 1613956
TI  - [Serum and urinary inorganic fluoride levels after prolonged inhalation of
      sevoflurane in man].
AB  - The serum and urinary concentrations of inorganic fluoride were measured before
      and after sevoflurane anesthesia in ten patients without renal disease, who
      underwent surgeries lasting for 13.4 +/- 0.9 hours. The mean concentration of
      serum inorganic fluoride reached a maximal value of 42.5 +/- SE mumol.liter-1 at
      the end of anesthesia. However, the serum inorganic fluoride concentration
      increased over 50 mumol.liter-1 which is called "nephrotoxic threshold" in five
      of ten patients. A positive correlation was found between serum inorganic
      fluoride concentration and anesthetic dose. The largest urinary excretion of
      inorganic fluoride was 1804 +/- SE mumol.day-1 in the first postoperative day and
      the excretion decreased rapidly thereafter. We conclude that while nephrotoxicity
      was not demonstrated from biochemical data in this study, prolonged inhalation of
      sevoflurane (13.4 +/- 0.9 hours) increases serum inorganic fluoride concentration
      during and after the inhalation which may influence renal function.

PMID- 1613957
TI  - [Clinical study on total intravenous anesthesia with droperidol, fentanyl and
      ketamine. 14. Effect on epidural pressure].
AB  - We studied effect of total intravenous anesthesia using ketamine, fentanyl and
      droperidol (DFK) on epidural pressure as an index for cerebrospinal fluid
      pressure in six surgical patients who underwent gastrectomy. The epidural
      catheter was inserted on the previous day. The epidural puncture was made at Th7
      12 and the tip of the catheter was located 5 cm cephalad. The epidural pressure
      was measured before, just after and 30 minutes after the induction. The induction
      dose of fentanyl was 5 micrograms.kg-1 and that of ketamine was 1 mg.kg-1. The
      epidural pressure at the induction decreased in significantly by 19% as compared
      with that before the induction. The result suggested that DFK would not increase
      cerebrospinal fluid pressure when the doses of ketamine and fentanyl were
      changed.

PMID- 1613958
TI  - [Clinical study on total intravenous anesthesia with droperidol, pentazocine and
      ketamine].
AB  - Fifty patients underwent various surgical procedures including abdominal,
      orthopedic, plastic and gynecological operations under total intravenous
      anesthesia with ketamine, pentazocine and droperidol. Neither nitrous oxide,
      inhaled anesthetics nor narcotics such as fentanyl were administered to the
      patients. Intraoperative muscle relaxation was achieved with vecuronium and the
      patients were ventilated manually throughout the surgical procedures. Thirty
      percent of the patients developed hypertension and tachycardia, but they were
      easily overcome with administration of calcium ion channel blocker. Their
      peripheral circulation as well as urine output was well maintained. No adverse
      effects on the liver and kidney were observed post-operatively. Their post
      operative sedation and analgesia were evaluated excellent. A few patients had
      strange dream as if they might have missed their way into the "pink" tunnel. The
      data above described suggest that this anesthetic method would deserve further
      detailed clinical study.

PMID- 1613959
TI  - [Valve injury: a new complication of internal jugular vein cannulation].
AB  - Although internal jugular vein cannulation is performed commonly, most physicians
      are not aware of existence of the internal jugular venous valve. This is the only
      valve between the right atrium of the heart and the brain, and it has an
      important role of preventing retrograde blood flow and increased back pressure to
      the brain. In this study, anatomic appearance of human internal jugular valves is
      described, and the competence of these valves is assessed. We examined also a
      safe approach to percutaneous cannulation of the internal jugular vein to avoid
      this complication. In the cadaveric subjects, the internal jugular vein with its
      valve was removed at the time of autopsy. In the living subjects, to examine the
      movement of this valve, endoscopic visualization utilizing the superfine
      fiberscope, and ultrasound techniques were applied. Next, to detect the
      competence of the jugular venous valve, transvalvular pressure gradients were
      measured. Nineteen internal jugular valves were obtained from 20 cadaveric
      subjects. These valves were situated directly above the termination of the
      internal jugular vein into the inferior bulb. The opening and closing of the
      valve were easily visualized with both superfine fiberscope and real-time
      ultrasound technique. Patients with competent valves showed transvalvular
      pressure gradients of 50-100 mmHg during cough-induced high intrathoracic
      pressure. Internal jugular venous valve is located 0.5-2.0 cm above the union of
      the subclavian and internal jugular veins, and the central approach performed at
      the summit of the cervical triangle has been shown to have a risk of injuring the
      internal jugular venous valve.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613960
TI  - [Usefulness of 0.02 percent epinephrine solution to widen the nasal cavity].
AB  - There are many reports describing how to use epinephrine solution before nasal
      intubation, but there are few reports showing how much of the nasal cavity is
      widened by using epinephrine solution. The purpose of this study is to examine
      the usefulness of epinephrine solution to widen the nasal cavity before nasal
      intubation by measuring the decrease of the nasal concha. Twenty patients who
      were scheduled for nasal intubation were divided into two groups: 0.02 percent
      (1:5000) epinephrine solution (0.02 group, n = 10). 0.033 percent (1:3000)
      epinephrine solution (0.033 group, n = 10). The solutions were instilled on long
      cotton-tipped applicators that were slowly inserted until they reached posterior
      wall of the nasopharynx. We examined the area of the inferior nasal concha on X-P
      before and after inserting applicators in two groups. The area of the inferior
      nasal concha on X-P decreased 25 percent and 27 percent after using epinephrine
      solution in 0.02 group and 0.033 group, respectively and the decreases of the
      area were significant. But there was no significant difference between two
      groups. We conclude that 0.02 percent epinephrine solution is useful and adequate
      to widen the nasal cavity before nasal intubation.

PMID- 1613961
TI  - [Troubled endotracheal intubation: an adult case of anomalous tracheal bronchus].
AB  - We experienced troubled endotracheal intubation in an adult patient with
      asymptomatic tracheal bronchus. The breath sounds of the right upper lobe were
      found to be absent right after the placement of a tracheal tube. An anomalous
      tracheal bronchus (displaced right upper lobar bronchus originating about 1 cm
      above carina) was found by fiberoptic bronchoscopy. The length of trachea of the
      patient was about 6 cm shorter than that of the normal value of adult male, which
      significantly reduced the safe range of positioning a tracheal tube. In a patient
      with this anomaly, who is otherwise healthy, a placement of a tracheal tube may
      cause pulmonary complications. Thus, as a diminished breath sound is found to be
      located at the upper right lobe after endotracheal intubation, we have to think
      of tracheal bronchus as one of the possible causes.

PMID- 1613962
TI  - [A case report of a 63-year-old patient with malignant hyperthermia].
AB  - We have experienced a case of fulminant malignant hyperthermia who was a 63-year
      old female weighing 44 kg. There was no particular past history nor family
      history. She underwent right mastoidectomy because of chronic otitis media. Her
      preoperative physical status was ASA I. She was premedicated with diazepam 10 mg
      and loxatigine 75 mg P.O. The induction was done with thiamylal 200 mg IV and
      fentanyl 0.1 mg IV followed by vecuronium 6 mg IV for endotracheal intubation.
      Intubation was easy and uneventful. Anesthesia was maintained with nitrous oxide
      3 l.min-1, oxygen 3 l.min-1 and enflurane 2.0%. Seventy min after the induction
      of anesthesia, arterial blood gas analysis showed severe respiratory acidosis
      (PCO2: 63.2 mmHg, pH: 7.27) and it was improved with manual hyperventilation at
      that time. Pulse rate increased from 80 to 115 b.p.m. 20 minutes later. Then, the
      patient was ventilated with 100% oxygen, and anesthetic circuits and machine were
      exchanged for new units. Surgery was postponed. Muscle stiffness of upper
      extremities was observed and her temperature increased to a maximum of 38.9
      degrees C. Surface cooling was started and dantrolene sodium 60 mg and furosemide
      20 mg were given intravenously. The patient was transferred to the intensive care
      unit, and clinical signs improved gradually within one hour. Serum enzymes; CPK,
      LDH, GOT and GPT increased on the first postoperative day. On the 11 th
      postoperative day skeletal muscle biopsy was done under local anesthesia with 1%
      procaine and Ca-induced Ca-release rate test revealed positive for enflurane.
      This is the oldest patient of malignant hyperthermia reported in Japan.

PMID- 1613963
TI  - [The catecholamine concentrations of collected autologous blood during
      adrenalectomy for pheochromocytoma].
AB  - We have studied the concentrations of catecholamines in collected autologous
      blood. The measured levels of the blood samples from Cell-stat collecting chamber
      were epinephrine 4.74 ng.ml-1 and norepinephrine 2.39 ng.ml-1. First wash of
      collected blood with 700 ml of saline diluted the catecholamine concentrations to
      epinephrine 3.13 ng.ml-1 and norepinephrine 1.6 ng.ml-1. The concentrations of
      catecholamines after second wash were epinephrine 2.19 ng.ml-1 and norepinephrine
      1.11 ng.ml-1. These values were three to twenty folds of normal ranges even after
      the second wash, and still the same levels as intraoperative plasma catecholamine
      (the measured values; epinephrine 0.81-2.81 ng.ml-1 and norepinephrine 0.96-3.15
      ng.ml-1). Since platelets actively concentrate catecholamines during their life
      span, the destruction of platelets by suction or centrifugation may probably play
      the most important role in the elevation of catecholamine concentrations in the
      collected autologous blood. We concluded that intraoperative autotransfusion in
      the resection of pheochromocytoma is likely to result in the elevation of
      systemic blood pressure by catecholamines of the transfused blood.

PMID- 1613964
TI  - [Hemodilutional and blood salvaging autotransfusions in a case of aplastic
      anemia].
AB  - A 28-year-old female, weighing 46 kg, 155 cm in height, with aplastic anemia
      underwent implantation of iliac bone to the head of the femur. A combined
      technique of hemodilution and intraoperative blood salvaging was applied to
      supplement the blood loss during the operation. Intraoperative monitoring
      included continuous arterial pressure, heart rate, electrocardiograph, SVO2,
      bleeding time, prothrombin time (PT), activated thromboplastin time (APTT), and
      thromboelastography. A total of 900 ml of blood was drawn and the same volume of
      5% albumin solution was infused over half an hour before the beginning of the
      surgery. During the operation, 2100 ml of blood was lost, and 1260 ml of
      autologous blood, 400 ml of homogeneous red blood cells and 5 units of fresh
      platelet were infused. The values of PT, APTT, bleeding time were within normal
      ranges after the surgery. Only 3 units of fresh platelet was infused in 2 weeks
      after the surgery. It was suggested that hemodilution and salvaging
      autotransfusion is safely performed and beneficial to minimize homogeneous blood
      transfusion even in a case of aplastic anemia.

PMID- 1613965
TI  - [Therapeutic evaluation of imipenem/cilastatin sodium for bacterial infections in
      patients with hematological diseases].
AB  - 1. To evaluate the efficacy and tolerance of imipenem/cilastatin sodium (IPM/CS)
      in severe infections associated with hematopoietic disorders, IPM/CS was
      administered to a total of 105 patients. 2. Out of 96 patients evaluable for
      efficacy, clinical responses were excellent in 23 patients, good in 30, fair in
      15, poor in 19 and unknown in 9, and the overall response rate was 60.9%. 3. The
      most common underlying hematopoietic disease was acute non-lymphocytic leukemia
      and the most common infections were sepsis and suspected sepsis. 4. Daily dose,
      severity of infection and neutrophil count had effects on the clinical response.
      5. The overall eradication rate of bacteria was 83.7%. 6. Side effects were
      observed in 10 patients (9.5%) and abnormal laboratory test results in 12
      (11.4%). From the above findings, we have concluded that IPM/CS is very useful
      for the treatment of severe infections in compromised patients with hematopoietic
      diseases.

PMID- 1613966
TI  - [Free concentration and protein binding of ceftriaxone].
AB  - Ceftriaxone (CTRX) was administered in dose of 1 g 30 minutes intravenous drip
      infusion to 5 healthy volunteers. Cefpiramide (CPM) and cefotetan (CTT) were
      administered as control antibiotics. The serum concentrations of total and free
      drugs, using ultrafiltration, were assayed by bioassay and HPLC. Protein binding
      rates and pharmacokinetic parameters were calculated. Free concentration of
      antibiotics were following orders in each sampling time: CTRX greater than CTT
      greater than CPM. Mean free concentrations of CTRX at 0 hour and at 8 hours after
      intravenous drip infusion was more than 20 micrograms/ml and more than 2
      micrograms/ml. Even at 24 hours after intravenous drip infusion free
      concentrations of CTRX were detectable. Mean half life in beta phase by HPLC was
      following orders: CTRX (7.5 hours) greater than CPM (5.4 hours) greater than CTT
      (4.7 hours). Mean protein binding rates were following orders: CPM (98%) greater
      than CTT (94%) greater than CTRX (92%). CONCLUSIONS: Characteristic of CTRX is
      high free drug concentration and long half life.

PMID- 1613967
TI  - [A study on in vitro antibacterial activity and clinical usefulness in
      respiratory tract infections of panipenem/betamipron, a newly synthesized
      carbapenem antibiotic].
AB  - Panipenem/betamipron (PAPM/BP) is a combination drug of PAPM, a new parenteral
      carbapenem antibiotic and BP, an amino acid derivative at a weight ratio of 1:1.
      Its in vitro antibacterial activities against clinically isolated respiratory
      pathogenic bacteria were determined. It was superior to imipenem (IPM) in the in
      vitro antibacterial activities against Haemophilus influenzae, Haemophilus
      parainfluenzae, Branhamella catarrhalis, Staphylococcus aureus including MRSA,
      Klebsiella pneumoniae, Serratia marcescens and Escherichia coli. PAPM had
      antibacterial activities almost equal to those of IPM against Streptococcus
      pneumoniae and Enterococcus spp. Against Pseudomonas aeruginosa, however, its
      antibacterial activity was about 1/4 that of IPM. The clinical usefulness of
      PAPM/BP was studied by dissolving it in a solution containing lactate and
      administering the solution by intravenous drip infusion to 12 cases of
      respiratory tract infections. Out of 11 cases with respiratory tract infections
      excluding cytomegalovirus pneumonia, the efficacy rate was 90.9%, with 4 cases of
      excellent and 6 cases of good responses. In terms of its bacteriological
      efficacies, eradication of pathogenic bacteria including super-infection were
      observed in 2 out of 4 strains, but 2 strains of P. aeruginosa remained
      unchanged. Six strains appeared as superinfected bacteria during and after
      administration of this preparation substituting original pathogens. Side-effects
      were not observed in the 12 cases, and in laboratory tests, slight transient
      increases of S-GOT and S-GPT were found in 1 case. In conclusion, PAPM/BP is a
      very useful parenteral antibiotic against respiratory tract infections and can be
      one of the drugs of the first choice.

PMID- 1613968
TI  - [Investigation of panipenem/betamipron levels in sera and various tissues in
      patients of orthopedic surgery].
AB  - Panipenem/betamipron (PAPM/BP), a new parenteral carbapenem antibiotic, was
      investigated with regard to their levels in sera and various tissues collected
      from patients under orthopedic surgery. The subjects were 17 patients,
      complaining low back pain and hospitalized for surgical operations. PAPM/BP was
      administered by intravenous drip infusion for 30 minutes of a dose of 500 mg/500
      mg. Serum and cerebrospinal fluid (CSF) specimens were taken from 8 patients at
      15-70 minutes after administration and assayed for PAPM and BP levels. Serum,
      bone, and joint capsule samples where taken from the other 9 cases at 25-127
      minutes after administration and assayed. PAPM levels in CSF were considerably
      lower than those in serum. They were 23.74-1.11 micrograms/ml in sera, 0.31-0.05
      micrograms/ml in CSF's during 15 to 70 minutes after administration. PAPM levels
      were 27.85-2.97 micrograms/ml in sera, 2.54-0.20 micrograms/g in bones, 5.63 and
      1.67 micrograms/g in joint capsules during 25 to 127 minutes after
      administration. BP levels in sera and various tissues were low compared to those
      of PAPM. These results showed that PAPM was detected at higher levels than 0.2
      microgram/g in various tissues, except CSF during 20 to 120 minutes after drip
      infusion of PAPM/BP 500 mg/500 mg for 30 minutes.

PMID- 1613969
TI  - [A clinical study on panipenem/betamipron in chronic respiratory tract
      infections].
AB  - Panipenem/betamipron (CS-976, PAPM/BP), a new carbapenem antibiotic, was
      administered a single dose of 500 mg or 750 mg via intravenous drip infusion
      twice a day for treatment of chronic respiratory infection to study its clinical
      efficacy, bacteriological efficacy and safety. Twenty nine cases were studied for
      the efficacy evaluation. Only the safety evaluation was made in 6 cases which
      were judged to be unsuitable, because in some of them pneumonia and other
      diseases were not specified as the subject diseases, of serious illness in some
      the conditions were too serious, and in the other cases the duration of
      administration was insufficient since administration had to be discontinued due
      to side-effects. The duration of administration was 6 to 18 days with 1 g divided
      into 2 doses daily or 4 to 15 days with 1.5 g in 2 divided doses daily. When
      clinical efficacies were classified according to different diseases, this
      preparation was effective in 11 cases and slightly effective in 1 case of 12
      cases of chronic bronchitis with an efficacy rate of 91.7%. It was effective in
      10 cases, slightly effective in 1 case and ineffective in 1 case of 12 cases of
      bronchiectasis with an efficacy rate of 83.3%. It was slightly effective in 2 and
      ineffective in 1 out of 3 cases of diffuse panbronchiolitis, and was effective in
      2 cases of pulmonary emphysema with infections. PAPM/BP was given at a dose level
      of 1 g in 2 divided doses daily to 17 cases and that of 1.5 g in 2 divided doses
      daily to 10 cases. For the remaining 2 cases, changes in the dose level were made
      in middle course of treatment. The efficacy rate in the 1 g regimen was 76.5% and
      that with the 1.5 g regimen was 90%. The overall results in the 29 cases included
      23 effective, 4 slightly effective and 2 ineffective cases, thus the overall
      efficacy rate was 79.3%. As pathogens, 11 species including 24 strains were
      isolated and identified from 19 cases. They were Gram-positive cocci including 2
      strains each of Staphylococcus aureus and Streptococcus pneumoniae, 1 strain each
      of Staphylococcus epidermidis, Streptococcus sanguis, and Streptococcus viridans
      and a strain of Streptococcus spp., and Gram-negative rods including 9 strains of
      Pseudomonas aeruginosa, 4 strains of Haemophilus influenzae and 1 strain each of
      Klebsiella pneumoniae, Enterobacter cloacae and Pseudomonas spp.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1613970
TI  - [Clinical evaluation of panipenem/betamipron in severe infections complicating
      hematological disorders].
AB  - Forty-three patients with severe infections which were complicating hematological
      disorders were treated with panipenem/betamipron, and the efficacy and the safety
      of the drug were evaluated. The results obtained are summarized below. 1. Out of
      40 patients in whom efficacies are evaluable, the clinical responses were
      excellent in 17 patients, good in 4, fair in 7 and poor in 12, and the total
      clinical efficacy rate was 52.5%. 2. The efficacy rate in 7 patients who had
      failed to respond to prior treatment with other antibiotics was 57.1%. Thus, no
      significant difference was observed in efficacy rates between the patients who
      had failed to respond to prior treatment with other antibiotics and the patients
      who received no preceding antibiotics therapy. 3. Out of the 43 patients in whom
      the safety was evaluable, no side effects nor abnormal laboratory findings were
      found.

PMID- 1613971
TI  - [Clinical study of panipenem/betamipron for burn infections in the domain of
      plastic and reconstructive surgery].
AB  - The effectiveness and the safety of panipenem/betamipron, new antibiotics of the
      carbapenems for burn infections, were studied and the following results were
      obtained: 1. The preparation, 0.5 g/0.5 g, was administered by intravenous drip
      infusion twice a day to 11 cases of patients with burn infections. In 10 cases
      for which clinical effects were evaluable, results were rated as "excellent" in 2
      cases, "good" in 2 cases and "fair" in 6 cases, with an efficacy rate of 40%. 2.
      Penetration to the affected tissue was studied in 2 cases. The tissue level of
      panipenem was 0.20 micrograms/g immediately after the end of drip infusion and
      6.86 micrograms/g 60 minutes thereafter. 3. As for the safety, a slight increase
      in GOT, GPT and Al-P was noted in 1 case; a slight increase in GPT, NAG and beta
      2MG was found in 1 case; and a slight increase in GOT, GPT, Al-P and LAP was
      noted in 1 case, as abnormal variations in laboratory test results.

PMID- 1613972
TI  - [Studies on the efficacy and safety of panipenem/betamipron in infections in
      surgical domain and the safety when mixed with lactate containing infusion].
AB  - Studies were done on the effectiveness and safety of panipenem/betamipron, a new
      carbapenem antibiotic, in infections in the surgical domain and its safety when
      dissolved in infusions containing lactate. The obtained results are summarized as
      follows. The preparation, 0.5 g/0.5 g or 1.0 g/1.0 g, was administered by
      intravenous drip infusion 2 to 3 times a day to 31 cases of patients with
      infections in the surgical domain. A physiological saline solution was used as
      the solvent in 21 cases (group A) of them and Solita T3, an infusion containing
      lactate, was used as the solvent in the 10 remaining cases (group B). As for its
      clinical effects, results were rated as "excellent" in 20, "good" in 7, "fair" in
      3 and "no response" in 1 out of the 31 cases, and the efficacy rate was 87.1%.
      Regarding its bacteriological effects, results were rated as "disappeared" in 22,
      "decreased" in 2, "unchanged" in 1 and "unknown" in 1 out of 26 cases from which
      bacteria were isolated, hence the bacteria-clearance rate was 88.0%. As for side
      effects, skin rash was seen in 1 case and slight increases of GOT and GPT were
      noted as abnormal changes in laboratory data in 2 cases. These side effects were
      all observed among the cases in group A but not at all in group B where a lactate
      containing infusion was used as the solvent.

PMID- 1613973
TI  - [A multicenter study on panipenem/betamipron in dermatology].
AB  - Panipenem/betamipron (PAPM/BP), a new carbapenem, was studied in dermatology.
      PAPM/BP was used clinically in the treatment of skin and skin structure
      infections in a multicenter trial. Fifty three patients were enrolled in the
      trial. Clinical evaluations were made in 50 patients. Most patients received
      intravenous infusion of PAPM/BP in a dose of 500 mg twice daily. Other dosages
      were used in some patients. The overall clinical efficacy rate was 78%. When 15
      cases of secondary infections were excluded, the rate was 85.7%. Adverse
      responses were nausea and/or vomiting in 3 patients, redness with itching in 1
      patient, headache or head heaviness in 2 patients and diarrhea in 1 patient. The
      patient with redness and itching had also nausea and vomiting. This occurred 1
      hour after the start of the first infusion of this drug. After the
      discontinuation of the treatment the symptoms went away on the next day.
      Abnormalities in laboratory test results were observed in 7 out of 53 patients.
      One patient with liver cirrhosis and hepatocellular carcinoma developed anemia
      (RBC 372 x 10(4)/mm3----275 x 10(4)/mm3, Hb 11.9 g/dl----8.8 g/dl, 35.1%---
      26.0%). Other abnormalities were all mild. Penetration of the drug into skin
      tissues after intravenous infusion of 500 mg of this drug in skin surgery
      patients was studied. Skin/serum concentration ratios ranged from 0.20 to 0.97.
      Skin concentrations were higher than the concentration of PAPM inhibiting 80% of
      clinical isolates over a period of 6 hours. In rats, skin concentrations were
      much lower than serum concentrations probably due to the difference in in vivo
      metabolism of PAPM. A few resistant strains of Staphylococcus aureus against PAPM
      and imipenem (IPM) were isolated. However, PAPM and IPM showed good antibacterial
      activities compared to other drugs tested. In conclusion, PAPM/BP is considered
      to be a useful drug in the treatment of skin and skin structure infections.

PMID- 1613974
TI  - [Shape change in human megakaryoblastic leukemia cells, MEG-01].
AB  - We investigated the intracellular processes of the shape change in the human
      megakaryoblastic leukemia cell, MEG-01, by platelet agonists. Thrombin induced
      the formation of many pseudopods. This shape change was also induced by TPA and
      A23187, but not by ADP, collagen, or epinephrine. Electron microscopy and FITC
      labeled phalloidin staining revealed thick submembranous microfilament bundles in
      the pseudopods of the shape-changed cells induced by thrombin. Shape change was
      inhibited by cytochalasin B. Protein kinase C (RKC) inhibitor, H-7, markedly
      inhibited thrombin-induced shape change, while the myosin light chain kinase
      (MLCK) inhibitor, ML-9 did not. These results suggest that thrombin-induced
      reorganization of microfilaments and shape change of MEG-01 cells are mediated by
      PKC but not by MLCK.

PMID- 1613975
TI  - [Role of GTP-binding proteins in phospholipid metabolism in human platelets].
AB  - Phosphoinositide-specific phospholipase C (PLC) catalyzes the hydrolysis of
      phosphatidylinositol 4,5-bisphosphate (PIP2) to inositol 1,4,5-trisphosphate
      (IP3) and diacylglycerol (DG), which act as second messengers. Substantial
      evidence has strongly suggested that a putative G-protein (s), Gp, regulates PLC
      activity in human platelets. Recently, the molecular mechanism of PLC activity
      regulation was clarified as to two types of enzymes, PLC-gamma and PLC-beta. In
      this chapter, the regulatory mechanisms of the PLCs via a Gp or tyrosine kinase
      is summarized, and the involvement of some G-protein in the regulation of other
      phospholipases, phosphatidylcholine-specific PLC, phospholipase A2 and
      phospholipase D, is also discussed.

PMID- 1613976
TI  - [Small GTP-binding protein and platelet function].
AB  - In platelets, nearly ten small GTP-binding proteins (G proteins) are identified.
      Among these small G proteins, smg p21 is the most abundant. The C terminus of smg
      p21 is processed by three post-translational modifications: geranylgeranylation,
      removal of three amino acids and carboxyl methylation. There are two regulatory
      proteins for smg p21, smg p21 GTPase activating protein (GAP) and smg GDP
      dissociation stimulator (GDS). Moreover, smg p21 is phosphorylated by A-Kinase
      and this phosphorylation stimulates the action of smg GDS. C-Kinase and Ca2+
      induce platelet activation, while A-Kinase antagonizes this activation. Since smg
      p21 is the substrate of A-Kinase, it is possible that smg p21 mediates the A
      Kinase action and inhibits the platelet function, such as aggregation and
      secretion. The mode of action of and the possible function of smg p21 in
      platelets are discussed.

PMID- 1613977
TI  - [Platelet membrane glycoproteins and the molecular mechanisms of hereditary
      platelet dysfunction].
AB  - Glycoproteins, present on the outer surface of platelets, function in the
      aggregating and releasing reactions of these cells. Some of the hereditary
      diseases of platelet dysfunction, such as, thrombasthenia and Bernard-Soulier
      syndrome, have been shown to result from defects in some of these glycoproteins.
      Recent advances in molecular biology have enabled us to analyze the genes which
      encode the defective glycoproteins in these patients. The information from these
      studies also helps us to understand in detail the function of the glycoproteins.
      At present, the major glycoproteins, GP II b/IIIa and GP I b/IX, have been
      studied extensively and we know the details of the mechanisms through which they
      function. However, as to the minor glycoproteins, GP I a/II a, GP IV and GP VI,
      details remain to be elucidated.

PMID- 1613978
TI  - [Effect of protein kinase C activation on platelet Na+/H+ exchanger].
AB  - Protein kinase C activation in human platelets has a modulatory role in
      maintaining intracellular pH (pHi), by adjusting pHi at a particular value (pH
      7.22). Changes in pHi induced by protein kinase C appeared to depend upon
      differences between H+ efflux catalyzed by Na+/H+ exchanger and H+ production.
      The pHi recovery after acid loading was significantly facilitated by protein
      kinase C activation. Analysis of the rate constant for pHi recovery suggested
      that the turnover rate or the apparent affinity of the Na+/H+ exchanger for H+
      was increased. Protein kinase C also decreased the Km value of the Na+/H+
      exchanger for extracellular Na+. It is suggested that the role of protein kinase
      C in platelet pHi regulation is dual, adjusting the pHi value at a certain set
      point, on the one hand, and increasing the rate constant of the Na+/H+, on the
      other.

PMID- 1613979
TI  - [Molecular structure and regulation of cyclooxygenase].
AB  - Prostaglandin (PG) endoperoxide synthase is a bifunctional enzyme with fatty acid
      cyclooxygenase activity (arachidonic acid----PGG2) and PG hydroperoxidase
      activity (PGG2----PGH2). The primary structure of the enzyme was determined
      recently by cloning and sequencing the cDNAs for sheep and mouse enzymes and the
      genomic DNA for the human enzyme. Aspirin selectively inhibits the fatty acid
      cyclooxygenase activity but not the PG hydroperoxidase activity by acetylating
      the serine #506. Several lines of evidence suggest that cyclooxygenase enzyme is
      inducible by several biofactors, such as EGF, TGF-beta, IL-1, and epinephrine.
      Furthermore, it has been recently suggested that glucocorticoids inhibit the
      synthesis of the enzyme by the conversion of cyclooxygenase mRNA into a cryptic,
      untranslatable form.

PMID- 1613980
TI  - [Protein-tyrosine phosphorylation of human platelets and its function].
AB  - Addition of ionophore A23187 to washed human platelets caused a time- and dose
      dependent increase in the phosphotyrosyl content of 135, 124 and 76 kDa proteins.
      Platelets loaded with intracellular Ca2+ chelator 5,5'-demethyl-bis-(o
      aminophenoxy)-ethane-N,N,N',N'-tetraacetic acid before addition of A23187
      exhibited no protein-tyrosine phosphorylation. Replenishment of such platelets
      with extracellular CaCl2 restored A23187-induced protein-tyrosine
      phosphorylation. Upon stimulation with A23187, both aspirin and ADP scavengers
      treated platelets exhibited protein-tyrosine phosphorylation without
      phosphoinositide hydrolysis or protein kinase C activation. Its protein-tyrosine
      phosphorylation was not inhibited by ML-9, a selective inhibitor of myosin light
      chain kinase. Genistein, a selective inhibitor of protein-tyrosine kinase,
      inhibited A23187-induced platelet aggregation but not secretion. These data show
      (a) that A23187 stimulates protein-tyrosine phosphorylation by elevation of
      intracellular Ca2+, (b) that A23187-induced protein-tyrosine phosphorylation is
      independent of formation of endoperoxides/thromboxane A2, released ADP,
      phosphoinositide hydrolysis, protein kinase C activation, fibrinogen binding and
      myosin light chain kinase, and (c) that A23187-induced protein-tyrosine
      phosphorylation may be involved in platelet aggregation but not in secretion.
      Furthermore, a synergistic effect of A23187 and protein kinase C activators in
      stimulating protein-tyrosine phosphorylation is suggested.

PMID- 1613981
TI  - [Intracellular Ca2+ behavior and activation of calpain-I in activated platelets].
AB  - A relationship between intracellular Ca2+ concentration ([Ca2+]i) and calpain-I
      activation and change in subcellular localization of the enzyme in activated
      platelets were investigated. The [Ca2+]i exhibited a biphasic response after
      stimulation with thrombin. Activation of calpain-I was measured by determination
      of the appearance of active 76 and 78 kDa forms accompanying the disappearance of
      the 80 kDa form, the inactive form, on immunoblots. Calpain-I was activated
      dependent on the extent of the initial elevation of [Ca2+]i. For maximum
      activation (60%) 300-500 nM [Ca2+]i was required and half-maximal activation
      occurred at 160-220 nM [Ca2+]i. The active 76 kDa form was observed only in the
      fraction containing subcellular organelles and plasma membrane of activated
      platelets. It was demonstrated that the localization of calpain-I was changed
      from the cytosol to the membrane and calpain-I was activated on the membrane by
      Ca2+, elevated through the initial elevation after activation of platelets.

PMID- 1613982
TI  - [Amplification and inhibition of platelet function by serum lipoproteins].
AB  - Low-density lipoprotein (LDL) at a concentration of 100 micrograms/mL, which is
      near the dissociation constant (Kd) of LDL-binding, had a maximal stimulatory
      effect on agonist-induced platelet aggregation. Anti-LDL receptor monoclonal
      antibody (C-7), like native LDL, induces a transient increase in intracellular
      Ca2+ and a shape change of human platelets. On the other hand, high-density
      lipoprotein (HDL) inhibited platelet function. ApoE-rich HDL, as well as,
      apoE.DMPC potently inhibited platelet aggregation in a dose-dependent manner.
      ApoE.DMPC stimulated the release of cholesterol into the supernatant, suggesting
      that apoE plays a major role in the inhibitory effect of apoE-rich HDL in
      platelet function, presumably due to the release of cholesterol from the plasma
      membrane.

PMID- 1613983
TI  - [Study on fibrinolysis and platelet function].
AB  - The aim of this study is to evaluate the relationship between tissue plasminogen
      activator (tPA)/PA inhibitor (PAI) complex and PAI, and platelet in the
      circulating blood. tPA/PAI complex and active PAI (act PAI; Teijin Co., Japan),
      and PAI antigen (PAI ant; Biopool AB, Sweden) were assayed by enzyme immunoassay
      (EIA). The mean concentrations (ng/10(9) platelets) in supernatant from lysate of
      platelet rich plasma (PRP) and washed platelets were 27.1 +/- 9.2, 1.5 +/- 1.2 in
      tPA/PAI complex, 188.7 +/- 46.1, 83.3 +/- 7.5 in act PAI and 236.2 +/- 41.6,
      191.9 +/- 45.1 in PAI ant, respectively. PRP was mixed with ADP (10(-5), 10(-4),
      10(-3) M), for 3 min and the supernatant after centrifugation then was provided
      for assay of PAI and tPA/PAI complex. Concentrations of act PAI, PAI ant and
      tPA/PAI complex dose-dependently increased with ADP. Almost the same results were
      obtained, when collagen and other agents were used instead of ADP. This study
      revealed that platelets contained quantities PAI (as free PAI) and released PAI
      during aggregation, and that a part of the PAI immediately formed a complex with
      tPA. Those findings suggested that platelets may play an important role on the
      formation of thrombus, in the way of anti-fibrinolysis, in addition to novel
      platelet functions, such as aggregation.

PMID- 1613984
TI  - [Arterial intimal thickening].
AB  - Disturbances in the integrity of the arterial endothelium are considered to be a
      primary event in the pathogenesis of atherosclerosis. Platelets do not adhere to
      the intact endothelium but with removal of the endothelium, a thrombotic response
      to the exposed thrombotic subendothelium occurs. With time, proliferation of
      smooth muscle cells occurs in the inner-most part of the media beneath the
      thrombus, and the proliferated smooth muscle cells migrate beyond the internal
      elastic lamina to invade the thrombus and organize it. A growth factor released
      from activated platelets (PDGF) stimulates smooth muscle cell proliferation. At
      the same time, the endothelium, adjacent to the thrombus, proliferates and covers
      the organizing thrombus from its margin. Thus, localized flat or raised intimal
      thickenings are formed from organization of mural thrombus or repair of intimal
      injury. There is much evidence that the release of platelet constituents can
      damage the vessel wall. Our study clearly demonstrated that material released
      from situ platelet-rich mural thrombi into the arterial circulation can cause
      endothelial damage and promote the proliferation of smooth muscle cells in the
      intima, downstream, and in remote segments of the arterial wall, without apparent
      endothelial denudation. PDGF, together with other growth factors, is also
      considered to be involved in smooth muscle cell proliferation in this case.

PMID- 1613985
TI  - [Inhibition of serotonin-induced platelet aggregation by endothelins].
AB  - Endothelins are a family of three peptides that act as local hormones in all
      mammalian species. They were found to inhibit rabbit and dog platelet aggregation
      in vivo, whereas no effect was observed in vitro. In order to investigate the
      possible interaction between endothelins and human platelet serotonergic
      receptors, their effect on the platelet aggregation, induced by serotonin, was
      studied. Endothelin-1, -2 and -3 had a dual action for platelet aggregation
      induced by serotonin. When added simultaneously to serotonin endothelins
      aggregatory response to this amine was potentiated. On the contrary,
      preincubation of platelet suspension with endothelins resulted in a concentration
      dependent inhibition of serotonin-promoted platelet response. Moreover,
      endothelin-1 inhibited serotonergic amplification of epinephrine-induced
      aggregation of platelets. It is proposed that endothelins bind to the platelet
      membrane and interact with serotonergic receptors and/or G proteins. The diverse
      effect of eodothelins on serotonin-induced aggregation of platelets may be due to
      stimulation of protein kinase C.

PMID- 1613986
TI  - [Arachidonic acid metabolism affected by cellular interactions regulating
      leukocyte adherence].
AB  - Increased leukocyte adherence to endothelium is recognized to be the first step
      following the development of unstable angina and cerebrovascular disease. In this
      paper, the methods to determine leukocyte adherence and the conditions which
      influence the result of the assay are discussed. We administered aspirin, TxA2
      synthetase inhibitor or TxA2 receptor antagonist to healthy volunteers. Leukocyte
      adherence was inhibited following the administration of these antiplatelet
      agents. The effect on leukocytes may prevent thrombosis formation. Although the
      role of the leukocyte adherence in the pathogenesis of thrombosis has not been
      fully elucidated. Several forms of stimuli may cause expression of adhesive
      glycoproteins, which have a RGD sequence, on the surface of leukocyte and thus
      lead to thrombotic formation.

PMID- 1613987
TI  - [Platelet membrane glycoprotein V and clinical significance of plasma GPVf 1
      level].
AB  - Thrombin hydrolyzes platelet membrane glycoprotein V (GPV) which has leucine rich
      repetitive modules specifically, and releases GPVf1 (fragment of N terminal in
      GPV). The GPV related antigen level in plasma will thus reflect activation of
      platelet in vivo. The ELISA assay to measure the concentration of GPV and GPVf1
      in plasma using polyclonal anti-GPV antibody, was established. The concentration
      of GPV and GPVf1 in plasma by using polyclonal anti-GPV antibody was established.
      The concentration of GPV related antigen in plasma is significantly higher in
      patients with thrombosis and correlated well with thrombotic episodes. It was
      suggested that the measurement of plasma-GPV-related antigen level is a useful
      marker for the diagnosis of thrombosis or prethrombotic states.

PMID- 1613988
TI  - [Platelet-derived microparticles].
AB  - The presence of platelet fragments or platelet-derived microparticles (MP) in
      blood is of great interest, because it could be used as a marker for increased
      destruction or activation of platelets followed by their aggregation and
      vesiculation. In addition to early electronmicroscopic observations, a variety of
      methods to detect MP in plasma and serum have been developed, including
      immunoelectrophoresis, radioimmunoassay and the immunofluorescence test using
      flow cytometric analysis. In these techniques, monoclonal antibodies directed
      against platelet membrane specific antigens, such as glycoprotein (GP) IIb/IIIa
      or GP I b, have been used to distinguish platelet microparticles from other
      components. From basic and clinical investigations, MP has proved to be increased
      in some physiological and pathological conditions, including blood clotting,
      thrombin and collagen-induced activation of platelets, mechanical trauma of
      platelets, and immune-mediated platelet destruction. Furthermore, it has been
      shown that a significant part of platelet procoagulant activity resides on these
      small vesicles (MP), released from the platelet plasma membrane, on activation.

PMID- 1613989
TI  - [11-Dehydro-TXB2 and 2,3-dinor-TXB2 as new parameters of TXA2 generation].
AB  - Artifactual formation of thromboxane (TX) B2 during blood collection falsifies
      real value of TXB2 in plasma. A part (29.3%) of TXB2 is metabolized to 11-dehydro
      (DH)-TXB2 in several organs. 11-DH-TXB2 was not generated during blood collection
      or during serum formation. The peak amount of 11-DH-TXB2 after intravenous
      injection of TXB2 to rabbits was lower than that of TXB2, but the level of 11-DH
      TXB2 was kept 2-3 times higher than that of TXB2 even after more than 5 min. A
      half life of 11-DH-TXB2 is 45-60 min in the human. Large species differences were
      found. In human urine, 11-DH-TXB2 was excreted 1.5-5.8 times more than 2,3-dinor
      TXB2. Patients with ARDS and DIC, who received platelet transfusion, excreted
      increased amounts of 2,3-dinor-TXB2 and 11-DH-TXB2 in urine. 11-DH-TXB2 may be a
      useful parameter of TXA2 formation in pathological states.

PMID- 1613990
TI  - [Hemostatic control in platelet dysfunction and abnormality by DDAVP].
AB  - DDAVP infusion shortens the bleeding time in patients with some types of platelet
      dysfunction and may be useful for hemostatic control. In order to clarify the
      mechanism of DDAVP to correct or bypass the release defect, we examined the
      effect in 17 patients with prolonged bleeding time, i.e., 11 with various kinds
      of platelet dysfunction, 4 with idiopathic thrombocytopenic purpura (ITP), 1 with
      chronic myelocytic leukemia (CML), and in an aspirin-ingested volunteer. DDAVP
      shortened the bleeding time in 9 patients with platelet dysfunctions, one with
      ITP, and the one aspirin ingested volunteer. No improvement was found in the
      aggregability and the retention rates, and no signs of activation occurred in the
      platelet shape. The RCof was elevated in all of the patients after the infusion.
      Our data suggests that DDAVP improves the hemostasis through primary aggregation
      and release of dense bodies, and not directly through an increase of RCof.

PMID- 1613991
TI  - [Detection of soluble forms of platelet membrane glycoproteins and its clinical
      significance].
AB  - Soluble forms of surface membrane glycoproteins of various cell types have been
      identified as makers for in vivo or in vitro cellular events, in which the
      receptors are involved. Using mouse monoclonal antibodies, sandwich ELISA systems
      to quantitate plasma concentrations of two platelet glycoproteins in soluble form
      were set up: one is glycocalicin (GC), a proteolytic fragment of GP Ib alpha
      chain and the other is GMP-140 or CD62 (GMP) known as a target for leukocyte
      recruitment at vascular injury sites. As in vivo markers, GC is said to reflect
      platelet turnover. High levels of plasma GMP were detected in patients with
      thrombotic thrombocytopenic purpura, being presumably indicative of
      microcirculation disorder. During storage of platelet concentrates, plasma levels
      of both markers were increased in a time-dependent fashion over 10 days. This
      correlated with a decrease in the surface expression of the glycoproteins on
      platelets, suggesting that the soluble glycoproteins entering the supernatants by
      proteolysis would be an useful indicator for in vitro alteration of stored
      platelets surface.

PMID- 1613992
TI  - [Pharmacological aspects of a novel antiplatelet drug, E5510].
AB  - E5510 is an antiplatelet agent, recently synthesized in Japan. It inhibited human
      platelet aggregation ex-vivo induced by collagen, arachidonic acid, ADP, PAF,
      epinephrine and thrombin. In addition, it inhibited platelet adhesion and release
      reaction. In animal models of thrombosis, oral administration of a low dose of
      E5510 inhibited thrombus formation. Studies on its mode of action suggest that
      E5510 blocks multiple pathways of platelet activation: inhibition of arachidonic
      acid release, cyclooxygenase and PDE. Using healthy volunteers, inhibition of
      platelet aggregation was demonstrated with 1 hour after a single dose of E5510
      and continued for more than 8 hours. No inhibition was observed 24 hours after
      administration. E5510 is currently under clinical evaluations in patients with
      various thrombotic diseases. This paper also describes the results of its
      clinical trials regarding the efficacy and safety using the patients with
      essential thrombocythemia.

PMID- 1613993
TI  - [Antiplatelet effect of clopidogrel].
AB  - Clopidogrel is a new thieno-pyridine derivative and has a more potent inhibitory
      effect on platelet aggregation, dependent on ADP rather than ticlopidine. In a
      phase I study performed in Japan, significant inhibition of ADP-induced platelet
      aggregation and prolongation of bleeding time was observed in the dose range of
      25, 50 and 75 mg. These effects were comparable to 200 or 300 mg of ticlopidine.
      Antithrombotic effects have also been shown in experimental animal models.
      Clopidogrel is expected to reduce the incidence of neutropenia since smaller
      doses are sufficient to suppress platelet aggregation compared to ticlopidine.
      Clopidogrel has been proven to be a potent and well-tolerated antiplatelet agent
      for atherosclerosis patients at risk of thrombosis, in Europe.

PMID- 1613994
TI  - [Clinical and preclinical pharmacology of KC-764, a novel antiplatelet agent].
AB  - Preclinical pharmacological studies showed that KC-764 was more potent and more
      selective in inhibiting platelet aggregation than aspirin. The concentration of
      KC-764 for inhibiting PGI2 production in the aorta was 70 times higher than that
      for inhibiting TXA2 in platelets. Antiplatelet action of KC-764 was augmented by
      plasma components. This augmentation by plasma may lead to selective antiplatelet
      activity. KC-764 has been investigated for platelet function in patients with
      chronic cerebral infarction. KC-764 at 10, 20 and 40 mg b i d, inhibited platelet
      aggregation induced by arachidonic acid, collagen, and ADP, and its potency was
      almost equal to aspirin at 100-330 mg daily. Plasma TXB2 levels were markedly
      depressed by KC-764 but plasma 6-keto-PGF1 alpha levels were not influenced. On
      the contrary, aspirin depressed both plasma prostanoids. These findings suggest
      that KC-764 can overcome the 'aspirin dilemma'.

PMID- 1613995
TI  - [Strategies for antiplatelet therapy-drug-fixed method and suppression-fixed
      method].
AB  - The strategies for antiplatelet therapy and recent trends in the research field
      are reviewed. In addition to the approach to finding new drugs, basic research on
      the function of the platelet which should be suppressed and on how drugs should
      be used, is required for the improvement of the efficacy of antiplatelet therapy.
      Our approach to suppression-fixed antiplatelet therapy which is in contrast with
      the previous drug-fixed method and is based on a principle that aggregation and
      release are strongly suppressed by the use of aspirin plus ticlopidine close to
      the limit, found observations on primary platelet dysfunction is described.
      Preliminary results of this on the prevention of stroke indicate that recurrence
      was 0.88% per year in contrast with the 4.3% in a group with normal platelet
      function and 5-15% in groups without antithrombotic therapy in Japan.

PMID- 1613996
TI  - [Benefits and risks of antiplatelet therapy. A retrospective study].
AB  - Seven hundred and forty-six patients with cerebral infarction (except those with
      cardiogenic embolism) were retrospectively studied to determine the effect of
      antiplatelet agents on the prevention of recurrence and the incidence of cerebral
      hemorrhage, as an adverse effect of the drugs. The average follow-up period was
      26.5 months for the fatal cases and 41.3 months for the survivors. Cerebral
      infarction recurred in 41 patients (3.1%/year) during the period of
      administration of antiplatelet agents, while it occurred in 66 (5.4%/year)
      untreated patients (p less than 0.01). Cerebral hemorrhage occurred 14 times in
      14 patients; 7 (0.5%/year) during the antiplatelet treatment and 7 (0.6%/year)
      during the period without antiplatelet agents. No evidence was found that
      cerebral hemorrhage was promoted by antiplatelet agents.

PMID- 1613997
TI  - [Antiplatelet therapy in cardiac diseases].
AB  - 1) Myocardial infarction (MI): Aspirin (160-300 mg/day) therapy started
      immediately after the onset, with or without simultaneous coronary arterial
      thrombolytic therapy, reduces the mortality rate in vascular diseases, including
      MI, and prevents reinfarction. Maintenance therapy with the same dosage is also
      recommended. 2) Angina pectoris: In unstable angina, aspirin in a dose of 300
      mg/day for 2 years reduces the mortality and the incidence of MI. Ticlopidine
      decreases anginal attacks in a few cases of angina at rest. 3) Coronary artery
      bypass grafting (CABG): Long-term administration of 325 mg aspirin/day should be
      started on the day of surgery and combined with 200-400 mg dipyridamole/day
      administered from 2 days before to 1 week after the surgery. 4) Percutaneous
      transluminal coronary angioplasty (PTCA): Current antiplatelet drugs prevent post
      procedural acute coronary occlusion but not late restenosis.

PMID- 1613999
TI  - [Inhibitory effect of activated protein C and heparin on arterial thrombosis].
AB  - Activated protein C (APC) exerts an anticoagulant effect by inactivating
      coagulation factors Va and VIIIa, preferentially on the surface of the cell
      membrane, and may enhance fibrinolysis by inhibiting PAI-1. APC inhibits venous
      and microvascular thrombosis, as well as, platelet-rich thrombus formation on the
      Dacron graft inserted in the arteriovenous shunt. We examined the effect of APC
      and heparin on arterial thrombosis using small mesenteric arteries of the rat, in
      which platelet-rich thrombus formation was induced by segmental deep vessel
      injury and the changes were monitored using a video-microscope system. Both APC
      (0.9 and 3.0 mg/kg, iv) and heparin (300 and 1000 U/kg) inhibited thrombus
      formation similarly. APC did not prolong APTT compared with heparin. APC may
      inhibit arterial thrombosis after vascular damage without serious bleeding side
      effects.

PMID- 1613998
TI  - [Anti-thrombotic and anti-atherogenic action of eicosapentaenoic acid].
AB  - Epidemiological studies performed in Greenland Eskimos and Japanese indicated
      that ingestion of fish meat rich in omega-3 polyunsaturated fatty acids, such as
      eicosapentaenoic acid (EPA), reduces the incidence of cerebro- and cardiovascular
      thrombotic diseases. Therefore, the effect of administration of purified EPA,
      derived from sardine oil, on hemorrheological properties and serum lipids in
      patients with thrombotic disorders was studied. Dietary supplementation of EPA
      resulted in decrease in platelet aggregability with reduction of TXA2 production,
      prolongation of bleeding time, decrease of platelet adhesiveness, increase of red
      cell deformability, and improvement of serum lipid concentration. Decrease in
      platelet TXA2 production may be ascribed to the decrease in arachidonate (AA)
      content of platelet membrane, inhibition of AA release from platelet membrane and
      competitive inhibition of AA metabolism at the level of cyclo-oxygenase, by EPA.
      Administration of EPA increased PGI2 production in the rat thoracic aorta and co
      culture of rat aorta smooth muscle cell with EPA also increased PGI2 production,
      but suppressed smooth muscle cell proliferation. This may be explained by a EPA
      derived peroxide stimulation of cyclo-oxygenase activity. Administration of EPA
      decreased platelet-derived growth factor (PDGF) production in rat peritoneal
      macrophages. In EPA-rich peritoneal macrophages from rat given EPA, incorporation
      of acetyl LDL and accumulation of cholesterol in macrophages decreased. This may
      indicate that dietary supplementation of EPA suppress foam cell formation. An
      interesting finding is that EPA-rich LDL obtained from rabbits given EPA is less
      susceptible to Cu(2+)-catalyzed oxidative modification. This seems to indicate
      that EPA may also suppress lipid peroxidation of lipoprotein.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1614000
TI  - The aging of the aged: challenges for gerontology & geriatrics in the United
      States.
AB  - It comes as no surprise that global graying will be one of the most pressing
      issues of the coming century. The most rapidly growing age group in all developed
      countries is the one with persons aged 85 and older. Often referred to as the
      "oldest old", the aging of the aged reflects a universal concern being
      experienced in the United States as well as in other industrialized countries,
      such as Japan. This paper addresses the challenges that such changes present for
      gerontology and geriatrics. Contextual projections of population trends and of
      life expectancy, as well as actual health care costs and estimated government
      health care expenditures will be compared for the United States and for Japan.
      Among the geriatric challenges being confronted are (1) the need to separate
      aging from disease, (2) the need for more geriatric centers and available
      geriatricians to serve the aged, (3) the introduction of health care strategies
      of prevention and case management, (4) responses to the notion of health care
      rationing, and (5) the ultimate importance of research ranging from the
      biological and molecular to the behavioral, social, and health service delivery.
      Global aging presents a gerontological imperative that may best be understood by
      examining policy recommendations and future policy decisions.

PMID- 1614001
TI  - [Studies on atherosclerosis with an animal model].
AB  - Atherosclerosis is a fundamental cause of life-threatening disorders, such as
      ischemic heart disease or stroke. Therefore, prevention and treatment of
      atherosclerosis is a matter of importance. In atherosclerotic lesions, there are
      many foam cells which contain large amounts of cholesteryl ester. In particular,
      most of these foam cells in the early stage of atherosclerosis derive from
      monocytes/macrophages. Today, foam cell transformation of macrophages in
      subendothelial space is considered to occur by a mechanism in which macrophages
      take up oxidized low density lipoprotein. We have already discovered that
      atherosclerosis of Watanabe heritable hyperlipidemic rabbits, an animal model for
      hereditary hyperlipidemia and severe atherosclerosis, could be prevented by
      probucol. This drug was originally developed as an antioxidant, and the mechanism
      of prevention of atherogenesis with this drug is considered that it prevents
      oxidative modification of LDL. On the other hand, probucol also causes regression
      of xanthoma in patients with familial hypercholesterolemia. This effect implies
      that probucol can be effective for treatment of atheromatous lesions, because
      xanthoma is a lesion which consists of macrophage-derived foam cells. However,
      the precise mechanism of probucol in causing regression of xanthoma has not been
      clarified. Considering these observations, we paid special attention to the
      oxidative modification of high density lipoprotein (HDL). HDL makes contact with
      foam cells in subendothelial space and stimulates efflux of cholesterol. This is
      the very place where oxidative modification of LDL is considered to occur.
      Therefore, it is rational to attempt to determine what would happen when HDL is
      oxidized and whether probucol could prevent oxidative modification of
      HDL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614002
TI  - [Pathophysiology of osteoporosis from animal experimental point of view].

PMID- 1614004
TI  - [The search for an animal model for the study of dementia].

PMID- 1614003
TI  - [Clinical aspects of bone mineral content in osteoporosis].

PMID- 1614005
TI  - [Assessment and treatment of patients with dementia of the Alzheimer type].
AB  - Recently more than a dozen clinical trials for dementia of the Alzheimer type
      (DAT) have been conducted in Japan using almost the same diagnostic criteria and
      assessment procedures. Cholinomimetic drugs such as AChE or M1 agonist are the
      most common in the current clinical drug trials. DSM-IIIR and NINCDS-ADRDA are
      usually employed as diagnostic criteria. In the recent report on the sensitivity
      and specificity of these diagnostic criteria, it has been indicated that the
      clinician or researcher who wishes to ensure that patients classified as DAT are
      more likely DAT should choose DSM-III, whereas the investigator who wishes to
      include the greatest number or DAT cases, seldom assigning a diagnosis of no DAT
      to a true case, should choose NINCDS-ADRAD. Also, development of exclusion
      criteria for DAT would be essential to improve interrater reliability of these
      diagnostic criteria. In the recent clinical trials outside Japan, a dual
      assessment procedure consisting of objective psychometric test(s) to assess
      cognitive impairment and global clinical impression of change is a standard
      method to evaluate the clinical efficacy of drugs for DAT. In psychometric tests,
      Alzheimer's Disease Assessment Scale (ADAS) is the most common in the US and
      Hasegawa's Dementia Scale (HDS) in Japan. A Japanese version of ADAS-cog. has
      been already developed for use in clinical trials in Japan. Also, HDS has
      recently been revised to improve the sensitivity of the test. In addition,
      Clinical Dementia Rating (CDR) that is one of the common measures staging
      severity of dementia in Japan might be a better alternative to the conventional
      Clinical Global Impression of Change (CGIC) in the US.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1614006
TI  - [Quantitative X-ray CT analysis of calcification of the abdominal aorta and its
      relationship to obesity].
AB  - Quantitative analysis of abdominal aorta calcification by X-ray CT is a useful
      method for non-invasive diagnosis of atherosclerosis. We recently examined the
      relationship between the X-ray CT measurement of abdominal aorta calcification
      and the degree of obesity. For this purpose, the body mass index (BMI) and the
      subcutaneous fat thickness (determined by X-ray CT at the umbilical level) were
      analyzed in relation to the abdominal aorta calcification index (ACI) in 845
      patients (453 males and 392 females aged 40-79 years). Patients with BMI under 20
      were classified as "lean", those with BMI between 20-26 as "normal" and those
      with BMI over 26 as "obese". 1. Among males, the ACI was highest in lean
      individuals and lowest in obese individuals. The difference in ACI between lean
      and obese males was significant in the middle aged group (40-65 years). Among
      females, no relationship was observed between the degree of obesity and ACI. 2.
      Among males, ACI was higher in individuals with low subcutaneous fat thickness
      and lower in individuals with greater subcutaneous fat thickness. The difference
      was significant in the middle aged group. Among females, no relationship was
      observed between the two parameters. 3. When the visceral fat to subcutaneous fat
      ratio (V/S) in 85 males and females aged 60-69 years was analyzed in relation to
      ACI, ACI tended to decrease as the V/S increased, in both males and females. 4.
      Relationships between BMI and subcutaneous fat thickness, between BMI and lipids
      and between lipids and ACI were also analyzed.

PMID- 1614007
TI  - [Guanidino compounds in the elderly].
AB  - To examine the metabolism of guanidino compounds in the elderly, we measured the
      serum concentrations of urea nitrogen, creatinine (Cr), guanidinoacetic acid
      (GAA) and creatine (CR) in middle-aged and elderly subjects. We also measured
      muscle mass in the elderly. The elderly subjects tended to have lower serum GAA
      concentrations than middle-aged subjects. On the contrary, CR concentrations of
      elderly subjects were higher than those of middle-aged subjects. Bedridden
      elderly subjects tended to have lower serum GAA concentrations and lighter muscle
      mass than ambulatory elderly subjects. On the contrary, serum CR concentrations
      of bedridden subjects were higher than those of ambulatory subjects. CR is an
      essential substance for muscle energy metabolism. These results indicate that
      high serum CR concentrations due to low CR metabolism in skeletal muscle might
      suppress glycine amidinotransferase (GAT) activity, resulting in decreased GAA
      production in the elderly.

PMID- 1614008
TI  - [A statistical analysis of factors influencing standing balance, activity of
      daily living and ambulation in hemiplegic patients].
AB  - This study was undertaken to investigate several factors influencing standing
      balance, activity of daily living and ambulation in hemiplegic patients after
      cerebro-vascular diseases. A statistical analysis of 121 hemiplegic patients with
      unilateral supratentorial lesions showed that age, severity of muscle weakness of
      involved or uninvolved extremities, unilateral spatial neglect and the sense of
      toe position had influence on standing balance, activity of daily living or
      ambulation. The patients were divided into five groups based on the degree of
      unilateral spatial neglect, evaluated by their copies of two daisies who omitted
      more than three quarters, three quarters, half, one quarter and none of the
      figures were defined as the USN-4, USN-3, USN-2, USN-1 and no involvement groups,
      respectively. Those who belonged to the USN-2 group had significantly lower
      scores for activity of daily living than those who belonged to the no involvement
      group. In the USN-2 group, 7 of the 8 patients could not keep standing for 50
      seconds, while in the no involvement group, this was the case in only 1 of the 15
      patients. Activity of daily living scores or sway area during standing showed no
      statistically significant differences between the USN-1 and no involvement
      groups. These results suggested that severe or moderate unilateral spatial
      neglect is one of the most important factors influencing standing balance and
      activity of daily living.

PMID- 1614009
TI  - [Electrocardiographic criteria for the diagnosis of the left septal fascicular
      block and its frequency among primarily elderly hospitalized patients].
AB  - Characteristic electrocardiographic findings of the left septal fascicular block
      consist of a prominent anterior QRS force. Therefore, the following criteria were
      proposed for the diagnosis of left septal fascicular block, based on the normal
      limits of the R and S waves and R/S of V1 and V2. (1) Right ventricular
      hypertrophy, complete right bundle branch block, preexcitation (Type A), high
      posterior infarction, hypertrophic cardiomyopathy and abnormality of the thorax
      or intrathoracic tissues which might cause marked counterclockwise rotation
      around the longitudinal axis of the heart, should be excluded. (2) One of the
      following two criteria should be satisfied. (i) R/Sv1 greater than 2, and Rv1
      greater than or equal to 5 mm, (ii) R/Sv2 greater than 2, and Rv2 greater than or
      equal to 15 mm, or Sv2 less than 5 mm. The frequency of left septal fascicular
      block diagnosed by these criteria was 3.5% among all patients of a hospital
      mainly consisting of elderly patients. This frequency was less than that of the
      left anterior fascicular block or complete right bundle branch block, but it was
      higher than that of the complete left bundle branch block or bilateral bundle
      branch block.

PMID- 1614010
TI  - [Contributing factors to intellectual impairment in patients with multiple
      lacunar infarctions].
AB  - The author investigated factors leading to intellectual impairment in patients
      with multiple lacunar infarctions. The subjects consisted of 40 patients with
      multi-infarct dementia (MID) and 17 nondemented patients with multiple
      infarctions (MI) who showed multiple lacunar infarctions in the deep penetrating
      arterial territory on CT. MID patients showed more marked and extensive
      periventricular lucency (PVL), a higher degree of ventricular index (VI) measured
      on CT, and were of a higher age, and had poorer activity of daily living (ADL)
      compared with MI patients. There were significant correlations between the PVL
      score, VI, ADL score, age and Hasegawa's dementia rating score (HDS). However, no
      significant differences in sex, site of infarct, and the count of low density
      areas reflected lacunar infarction on CT, and vascular risk factors were shown
      between MID and MI patients. Multiple regression analysis demonstrated that the
      PVL score and VI showed the highest partial correlations for HDS, and that the
      ADL score and age were also independently contributing factors. Our results
      suggest that deep white matter lesions observed as PVL on CT and ventricular
      enlargement were the most important factors contributing to intellectual
      impairment in patients with multiple lacunar infarcts, and that physical factors
      such as ADL and age can be considered to be related to the development of
      dementia.

PMID- 1614011
TI  - [Isolated splenic tuberculosis].
AB  - A case of splenic tuberculosis is reported. The patient was a 79-year-old man who
      was admitted to the Tokyo Metropolitan Geriatric Hospital because of high fever
      and loss of body weight. Several finger-tip sized superficial lymph nodes were
      palpable in bilateral inguinal regions. The intermediate PPD skin test was
      positive. However, there was no evidences of active tuberculosis on the chest
      roentgenogram. The computed tomogram of the abdomen showed moderate enlargement
      of the spleen with multiple low density areas and several swollen lymph nodes in
      the para-aortic region. Although a lymph node of the inguinal region was resected
      for the pathologic examination, it showed no specific changes. In order to obtain
      a final diagnosis, laparotomy was performed. The spleen was markedly enlarged and
      nodular in appearance. No abnormal findings were observed in the other abdominal
      organs. Splenectomy was carried out. Numerous yellowish nodules, varying from 0.1
      to 5 cm in diameter, were observed on the cut surface of the resected spleen (20
      x 20 x 8 cm, 700 g). The bacteriologic examination revealed acid-fast bacilli.
      The fever subsided after splenectomy and following antituberculous therapy.
      Recently, isolated tuberculosis of the spleen has become very rare. Since 1965,
      only six cases in five reports can be found in the English, French and German
      literature. The present case is considered to be one such very rare cases of
      tuberculosis. Although splenic tuberculosis is rare at the present time, splenic
      tuberculosis should be included in the differential diagnosis of fever of unknown
      origin with splenomegaly.

PMID- 1614012
TI  - [Progressive changes in the coronary arteries in patients with ischemic heart
      disease after aortocoronary bypass].
AB  - To examine the time course of changes in the coronary arteries in patients with
      coronary heart disease after aortocoronary bypass (ACB), the authors studied 2
      groups of patients: (1) 23 who had conservative treatment and (2) 23 who were
      selected for ACB. Repeated angiography was performed 14.6 +/- 2.5 months after
      the initiation of the study. Following ACB, changes in lesions were observed in
      17 coronary artery segments in 39.1% of the patients. Grafted artery stenoses
      largely proximal to the site of transplantation became progressive. There was a
      relationship between the changes in coronary arteries to graft patency. In Group
      1, the time course of coronary atherosclerosis was found in 8 segments in 26% of
      the cases. Atherosclerosis progressed in all artery segments virtually in a
      steady way. Application of vein grafts may change intracoronary hemodynamics,
      creating conditions for more rapid and common progression of coronary artery
      lesions.

PMID- 1614013
TI  - [Arteriosclerosis of the right gastro-omental artery].
AB  - The right gastroepiploic artery is most frequently used for direct myocardial
      revascularization. In this connection, its histological study was performed to
      reveal the atherosclerosis incidence in persons from different age groups who had
      apparent signs of coronary atherosclerosis. Twenty one arteries taken from adult
      cadavers at the age of 35-85 years were examined. The arteries with normal were
      28.6%, those with Degree I alterations were 52.4%, those with Degree II
      alterations were 19%. Degrees III and IV alterations were not detected.
      Morphological studies indicated that hemodynamically significant right
      gastroepiploic artery lesions were found in 19% of cases, mainly in subjects
      above 60 years. The artery may be used in coronary surgery as a shunt with a good
      prognosis of its performance.

PMID- 1614014
TI  - [Changes in lipid metabolism in patients with arteriosclerosis obliterans after
      charcoal hemoperfusion and hypolipidemic therapy in the preoperative period].
AB  - The paper analyzes the results of the treatment of 26 patients with
      atherosclerosis obliterans of the lower extremities, which has been performed to
      make an intensive hypolipidemic preparation for an operation. The comprehensive
      approach based on the combination of medication (nicotinic acid, and its
      derivatives, cholestyramine, and SKH -2K charcoal hemoperfusion ) and efferent
      therapy reduced the plasma levels of total cholesterol by 27%, triglycerides to
      48%, low density lipoprotein cholesterol to 40%, and increased high density
      lipoprotein cholesterol up to 72%. The similar course therapy may be repeatedly
      used in a follow-up of this group of patients.

PMID- 1614015
TI  - [Study of the role of adrenergic vasoconstriction in the development of dynamic
      coronary obstruction in patients with stress-induced stenocardia].
AB  - The aim of the present investigation was to evaluate sympathetic vasoconstrictor
      influence and to define its role in the formation of coronary occlusion in
      patients with effort angina. The investigation covered 22 patients with
      Functional Class II-III stable effort angina. To detect vasoconstrictor responses
      on exercise and to identify their adrenergic component, pair bicycle tests were
      performed before and after administration of nitroglycerin and pratsiol. Repeated
      bicycle tests were conducted twice a day: at 10-11 a.m. and at 3-4 p.m. to study
      spontaneous exercise tolerance variations confirming the presence of dynamic
      coronary occlusion. The examinations indicated that in 18 patients the exercise
      resulted in functional major artery narrowing, aggravating the organic stenosis.
      Activation of smooth muscle alpha-adrenoreceptors is of a definite significance
      in the genesis of dynamic coronary occlusion in 50% of all the examinees.

PMID- 1614016
TI  - [Prognostic significance of various qualitative and quantitative indicators of
      coronary angiography in patients with unstable stenocardia].
AB  - The coronary bed was qualitatively and quantitatively examined in 41 patients
      with unstable angina pectoris. The patients were divided into two groups: (1)
      those with uncomplicated angina and (2) those with complicated angina in relation
      of follow-up (mean 3.1 +/- 0.8 years) findings. In patients with a poor coronary
      heart disease outcome a symptom-related lesion was more frequently located mainly
      in the left coronary trunk during clinical manifestations of unstable angina
      pectoris, along with more severe overall lesion in the coronary bed. They had
      also higher incidence rates of complicated lesions and higher values of three
      quantitative parameters (stenosis extent, the mean and proper diameters of a
      stenotic segment in the symptom-related vessel) determined by semiautomatic
      stenosis configuration analysis.

PMID- 1614017
TI  - [Differential methods of physical training of patients with ischemic heart
      disease in early periods after aortocoronary bypass and their effect on the
      indicators of central hemodynamics].
AB  - Seventy two patients with coronary heart disease who had undergone aortocoronary
      bypass grafting were followed up. In the early postoperative periods (on day 16)
      the patients had ergometer exercise testing along with chest massage. In patients
      with complete myocardial revascularization and without complications, the
      exercise was 50% of the individual threshold capacity, followed by its correction
      every 7 days after control bicycle ergometry. In patients with incomplete
      myocardial revascularization or with intra- and postoperative complications,
      exercises with steady capacity (50% of the threshold capacity) were performed, by
      enhancing its exposition in a gradual manner. A course of physical training (15
      18 studies 5 times a week) resulted in improvement of the patients' clinical
      condition, and caused a training effect and positive alterations in central
      hemodynamic parameters in patients with both hyper- and hypokinetic hemodynamic
      baselines.

PMID- 1614018
TI  - [Use of an implanted spinal neurostimulator in treatment-resistant stenocardia].

PMID- 1614019
TI  - [Effect of acetylsalicylic acid on the indicators of thrombocytic hemostasis in
      patients with myocardial infarction].
AB  - The examination of 50 patients with acute myocardial infarction indicated that
      enhanced platelet functional activity was a prognostically unfavourable sign and
      associated with a higher risk for myocardial infarction complications. The
      application of aspirin, 250 mg daily, in patients with high platelet functional
      activity in the acute period of the disease failed to produce a beneficial
      antiaggregatory effect.

PMID- 1614020
TI  - [Differential selection of anti-anginal drugs in stable stenocardia in relation
      to the data of central and intracardiac hemodynamics].
AB  - Rheography and echocardiography were used to study central and intracardiac
      hemodynamic parameters in 196 patients with Functional Classes I-II from the
      screening of the main antianginal drugs during an acute pharmacological test
      under bicycle ergometric monitoring. It was established that the hemodynamic type
      of circulation and left ventricular end-diastolic and end-systolic volumes may be
      used as criteria for the differential choice of antianginal agents. The values of
      these parameters are given for sustac, propranolol, verapamil, nifedipine and
      sustac plus propranolol.

PMID- 1614021
TI  - [Changes in plasma lipid and apoprotein levels in patients with ischemic heart
      disease after hemosorption].
AB  - All the patients who had undergone a course of non-specific hemosorption (HS) for
      clinical indications showed lower plasma lipid levels and largely lower
      triglyceride concentrations. The patients with hypercholesterolemia alone
      simultaneously displayed decreased levels of cholesterol, high density
      lipoproteins, and apoprotein A-I. Apoprotein B levels reduced in patients having
      normal lipid values and in those with isolated hypercholesterolemia. The changes
      in the levels of lipids and apoproteins were different for 2 weeks after
      hemosorption in relation to the baseline lipid spectrum. The patients with
      coronary heart disease with hyperlipidemias had positive trends in lipid spectral
      changes: the parameters of atherogenic classes of lipids tended to decrease,
      whereas those of antiatherogenic lipid classes tended to show a slight increase.
      There was a negative direction in the dynamics of the studied parameters in renal
      patients, in those who had normal baseline lipid values, and in those with
      isolated hypo-alpha-cholesterolemia, i. e. higher plasma cholesterol and
      triglyceride, low density lipoprotein cholesterol and apoprotein B levels.

PMID- 1614022
TI  - [Interaction of hyperbaric oxygenation with nifedipine and propranolol at the
      level of autonomic regulation of the heart in patients with angina pectoris].
AB  - Thirty three males suffering from coronary heart disease, Functional Classes II
      III exercise-induced angina pectoris were examined for changes occurred in
      autonomic cardiac regulatory parameters under the influence of a normobaric
      oxygenation session (control), a hyperbaric oxygenation session (oxygen pressure
      1.5 atm, duration 40 min), and combined normo- and hyperbaric oxygenation with
      nifedipine (oral corinfar, 20 mg, n = 18), and propranolol (oral inderal, 40 mg,
      n = 15) sessions. Variation of pulse and statistical analysis of cardiac rhythm
      were used in the study. The baseline autonomic tone and autonomic provision
      isometric exercise were evaluated. A single hyperbaric oxygenation session in
      this mode during isometric exercise was shown to diminish the sympathetic
      activation and increased heart rate which had been caused by nifedipine, by
      decreasing its central sympathetic effect and increasing neuroeffector
      cholinergic activity. The hyperbaric oxygenation session in combination with
      propranolol induced a supplementary reduction in sympathetic activity and its
      effects on cardiac rhythm via the humoral regulatory pathway by potentiating the
      negative chronotropic effect of the drug.

PMID- 1614023
TI  - [Physical activity and physical work capacity of patients with initial
      manifestations of cerebrovascular disorders in arterial hypertension].
AB  - The routine protocol of general and neurological examinations and some special
      questionnaires were used to examine physical activity (FA) and physical working
      capacity (FWC) in a random population from one of the Moscow districts which
      included 1200 persons (males and females aged 30-64 years). The majority of the
      examinees were those who had slight and moderate exercises, mainly sitting work,
      did few or no physical exercises. The proportion of persons with low physical
      activity increased with age both among males and females. The ratios generally
      remained despite the presence of early signs of abnormal blood supply. Bicycle
      ergometer testings showed a significant reduction in the physical working
      capacity of the patients with abnormal brain blood supply, in a greater extent,
      in arterial hypertension. Decreased functional activity and functional working
      capacity may regarded as one of the risk factors for cerebrovascular disorders,
      in arterial hypertension in particular, and should be borne in mind in
      implementing preventive measures.

PMID- 1614024
TI  - [Pathogenesis of angina pain (concerning the article by V.S. Volkov "The role of
      spasm in the pathogenesis of stenocardia")].

PMID- 1614025
TI  - ["The role of spasm in the pathogenesis of stenocardia"].

PMID- 1614026
TI  - [Isoptin in cardiologic practice].

PMID- 1614027
TI  - [X syndrome].

PMID- 1614028
TI  - [Hypertensive crisis].

PMID- 1614029
TI  - [Early intravital diagnosis of pericardial mesothelioma].

PMID- 1614030
TI  - Axial heterogeneity of adenosine transport and metabolism in the rabbit proximal
      tubule.
AB  - Transport and metabolism of adenosine were studied in the S1, S2, and S3 segments
      of the rabbit proximal renal tubule. Isolated segments were perfused in vitro
      with uniformly labelled 14C-adenosine to measure the lumen-to-bath flux of
      adenosine. This flux rate was measured by the disappearance of 14C from the
      luminal fluid (JD) and simultaneously by the appearance of 14C in the bathing
      solution (JA), expressed as femtomoles per minute per millimeter of tubule length
      (fmol.min-1.mm-1). At a perfused concentration of 83.3 microM adenosine, when
      corrected for metabolism, the JDs for adenosine in the S1, S2, and S3 segments
      were 735, 212, and 273, respectively. JAs, corrected for metabolism, were 0, 0,
      and 4.8 fmol.min-1.mm-1 for the S1, S2, and S3 segments, indicating that very
      little or no 14C-adenosine moved across the basolateral membrane. To correct for
      metabolism of 14C-adenosine, the perfusion fluid, collected fluid, tubular
      extract, and bathing fluid, from three tubules of each segment type, were
      analyzed by high-performance liquid chromatography to identify 14C-adenosine and
      its 14C-metabolites. At 83.3 microM, all segments metabolized adenosine
      extensively. Consequently, adenosine-5'-monophosphate (AMP) and inosine were
      found in tubule cells of all segments. Inosine also appeared in the collected
      fluid, but AMP did not. In S1 and S2 segments, none of the 14C in the bathing
      solutions could be identified and no adenosine was found. Of the small amounts of
      14C found in bathing solutions from S3 segments, about 27% appeared to be
      adenosine, the rest were inosine and hypoxanthine or unidentified
      metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614031
TI  - Response of cortical collecting ducts from remnant kidneys to arginine
      vasopressin.
AB  - Chronic renal failure is associated with impaired urine concentration. Previous
      studies have demonstrated that cortical collecting ducts (CCD) from uremic
      rabbits (with remnant kidneys) have an impaired response to arginine vasopressin
      (AVP). To determine whether this defect is an early, integral component of
      compensatory renal growth by the remnant kidney, we studied the response of CCD
      derived from rabbits one week after 75% nephrectomy. At one week, hypertrophy and
      adaptation in sodium transport are fully developed, but azotemia and interstitial
      fibrosis are absent. The animals with remnant kidneys failed to respond normally
      to water deprivation and dDAVP (maximum urine osmolality 738 +/- 29.1 mOsm/kg
      compared to 1378 +/- 207 in sham operated). However, in isolated, perfused CCD
      from remnant kidneys, AVP stimulated hydraulic water permeability to the same
      extent as in normal CCD or CCD from sham operated animals. AVP-induced cAMP
      generation per mm tubule length was significantly higher in the CCD from remnant
      kidneys (137.4 +/- 14.5 fmol/mm) than in the control group (82.4 +/- 11.9
      fmol/mm), but not different when expressed per micrograms protein. These studies
      demonstrate that one week after reduction in renal mass there is no defect in the
      response of CCD to AVP, suggesting that the mechanisms responsible for the
      hyposthenuria after loss of renal mass are not related to any intrinsic cellular
      changes that occur in CCD early during compensatory renal growth.

PMID- 1614032
TI  - Interactions of LDL and modified LDL with mesangial cells and matrix.
AB  - Hyperlipidemia may play a role in the progression of diabetic and other renal
      diseases. Low density lipoprotein (LDL) and other proteins including
      extracellular matrix components undergo nonenzymatic glycation in vivo. We
      examined the effects of glycation of LDL as occurs in diabetes (4 to 8%) on
      binding and uptake by mesangial cells and their proliferation. The glycation of
      LDL (g-LDL) significantly decreased its binding and uptake by mesangial cells by
      15 to 20%, indicating that glycated LDL binds to the LDL receptor, but with lower
      affinity than LDL. Both LDL and g-LDL modestly stimulated [3H] thymidine
      incorporation into mesangial cells at 5 to 10 micrograms/ml. Native, oxidized (Ox
      LDL) and glycated LDL all bound to the extracellular matrix generated by rat
      mesangial cells in culture. The binding of LDL, Ox-LDL and g-LDL to mesangial
      matrix was two to four times higher than to mesangial cells. Binding of LDL and g
      LDL was significantly higher to glycolaldehyde modified matrix, which serves as
      an in vitro model for nonenzymatic glycation end-product cross-linking of matrix
      which occurs in long-standing diabetes. Based on these findings, we propose that
      glycation of LDL decreases its binding and uptake by the LDL receptor of
      mesangial cells and may slow its catabolism. Furthermore, LDL bound to
      extracellular mesangial matrix can undergo oxidation and generate cytotoxic LDL
      components. This process may be further enhanced by advanced glycation of the
      mesangial matrix in diabetes, contributing to glomerular pathology.

PMID- 1614033
TI  - Chronic neutral phosphate supplementation induces sustained, renal metabolic
      alkalosis.
AB  - The aim of the present study was to test whether intravenous neutral phosphate
      supplementation, recently shown in our laboratory to acutely stimulate proton
      secretion in the distal nephron, was able to induce a sustained metabolic
      alkalosis. Neutral Na and K phosphate supplementation for seven days, with
      equivalent reduction in chloride supply and unchanged intake of sodium and
      potassium, in ADX rats receiving fixed physiological doses of aldosterone and
      dexamethasone (group 1, N = 7), was responsible for a severe metabolic alkalosis
      (MA; delta [HCO3] 11 +/- 1.3 mM, and delta pH 0.11 +/- 0.06 unit). Metabolic
      alkalosis was at least in part of renal origin, since net acid excretion (NAE)
      transiently increased, principally due to an increment in titratable acid
      excretion rate. Balances were equilibrated for sodium and negative for chloride
      and potassium, which may have contributed to the severity of the MA. Chronic i.v.
      neutral Na phosphate, without change in potassium and chloride supply, in ADX
      rats receiving the same doses of steroids (group 2, N = 5), was responsible for a
      less severe MA (delta [HCO3] 7.5 +/- 0.9 mM, and delta pH 0.07 +/- 0.01 unit),
      also of renal origin. In this group, balances were positive for chloride and
      sodium and equilibrated for potassium. Finally, neutral Na and K phosphate
      supplementation with reduction in chloride supply in intact rats (group 3, N = 4)
      was also able to induce a MA (delta [HCO3] 5.5 +/- 1.8 mM, and delta pH 0.06 +/-
      0.01 unit) of renal origin, with balances negative for chloride and equilibrated
      for potassium and sodium. In all groups, the generation and maintenance of MA
      probably resulted from stimulated proton secretion in the distal nephron, as
      suggested by the observed increase of PCO2 over HCO3 concentration ratio in the
      urine and a fall in urine pH despite augmented urinary buffer content throughout
      the phosphate infusion period. Glomerular filtration rate did not significantly
      vary in any group. In conclusion, chronic supplementation of neutral phosphate
      appears to stimulate per se proton secretion in the distal nephron, independently
      of sodium, chloride, and potassium balances, and adrenal steroid secretion. Thus
      neutral phosphate supplementation should be added to the previously known factors
      able to induce MA.

PMID- 1614034
TI  - Experimental model of lead nephropathy. I. Continuous high-dose lead
      administration.
AB  - This study followed the progression of lead nephropathy in male Sprague-Dawley
      rats (E) administered lead acetate (0.5%) continuously in drinking water for
      periods ranging from 1 to 12 months. Control animals (C) were pair-fed.
      Observations included renal pathology by light and electron microscopy, wet and
      dry kidney weights, and glomerular filtration rate (GFR) to assess renal
      function. Urinary excretion of lead, the enzymes N-acetyl-beta-D-glucosaminidase
      (NAG) and glutathione-S-transferase (GST), and brush border antigens (BB50, CG9,
      and HF5) were utilized to explore possible markers of kidney injury. GFR was
      increased significantly after three months of lead exposure, but was decreased
      significantly after 12 months. Kidney wet weights were significantly greater in E
      than C from three months on. Kidney dry weight/wet weight ratio was constant up
      to three months, but decreased in E at 12 months. Glomerular diameters were
      normal at all time periods; the nephromegaly was related primarily to hypertrophy
      of proximal tubules. Lead inclusion bodies were found in nuclei of proximal
      convoluted tubules and pars recta at all times. Tubular atrophy and interstitial
      fibrosis first appeared at six months, and increased in severity thereafter.
      Brush borders of proximal tubules were disrupted at one and three months, but
      recovered thereafter. Focal and segmental glomerulosclerosis was observed in 2 of
      10 rats at 12 months. Arteries and arterioles remained normal at all time
      periods. Urinary NAG was elevated in E above C after three months of lead
      exposure. However, urinary NAG in C also increased with age, obscuring changes in
      the 12 month E rats. GST was elevated after three months of lead administration
      in E, not without an attendant age-related increase in C rats. In three-month E
      rats, urinary brush border antigens were increased above C, but were decreased at
      six and 12 months, correlating with the morphologic changes in brush border. We
      conclude that a high dose of lead in rats may initially stimulate both renal
      cortical hypertrophy and an increase in GFR. Later, the adverse effects of lead
      on the tubulointerstitium predominate, and GFR falls. The urinary marker, NAG,
      was abnormal in the early stages of the disease, but age-related changes obscured
      its utility at later stages; urinary GST appeared to be a more consistent marker
      of injury.

PMID- 1614035
TI  - Renal localization of the constitutive 73-kDa heat-shock protein in normal and
      PAN rats.
AB  - We purified the constitutive 73-kDa heat-shock protein (HSP73) from the bovine
      brain, and produced a specific antibody against the protein in a rabbit. On
      immunoblotting, the antibody cross reacted only with a protein band with a
      molecular mass of 73 kDa in a crude extract from normal rat kidneys, which was
      regarded as rat renal HSP73. The intrarenal immunohistochemical distribution of
      HSP73 was examined by using this antibody, on both normal rat kidneys and kidneys
      with puromycin aminonucleoside nephrosis. HSP73 was predominantly present in
      epithelial cells of the glomeruli and the tubules. In normal kidneys, HSP73 was
      generally localized in both the cytoplasm and the nucleus of these epithelial
      cells, except for proximal tubular epithelial cells. On the other hand, in
      kidneys with puromycin aminonucleoside nephrosis, HSP73 accumulated in the
      cytoplasm at a level higher than in the nucleus in association with the severity
      of renal dysfunction and proteinuria. These findings indicate that HSP73 is
      mainly expressed in glomerular and tubular epithelial cells in the kidney under a
      physiological condition, and that its expression changes from the nucleus to the
      cytoplasm under pathological conditions such as a protein overload to these
      epithelial cells.

PMID- 1614036
TI  - Production of extracellular matrix by glomerular epithelial cells is regulated by
      transforming growth factor-beta 1.
AB  - Transforming growth factor-beta (TGF-beta) has widespread effects on
      extracellular matrix production by many cultured cell lines and appears to play a
      role in the pathological accumulation of extracellular matrix that accompanies
      inflammatory and fibrotic diseases such as glomerulonephritis. Earlier
      experiments have shown that mesangial cells respond to TGF-beta 1 with a marked
      increase in the production of two chondroitin/dermatan sulfate proteoglycans,
      decorin and biglycan, but their production of other matrix components elevated in
      glomerulonephritis is not substantially affected by TGF-beta 1. Since the
      glomerular epithelial cells are also thought to contribute to matrix production
      in the glomerulus, we examined the ability of these cells to produce some of the
      nonproteoglycan matrix components in response to TGF-beta 1. Exposure of
      glomerular epithelial cells to TGF-beta 1 increased the production of fibronectin
      and type IV collagen, in addition to biglycan. Enhancement of the cell layer
      accumulation of laminin was also observed. These results show that TGF-beta 1 has
      a differential effect on extracellular matrix production by epithelial and
      mesangial cells from glomeruli. TGF-beta 1 released in the glomerulus secondary
      to injury could thus affect both cell types and lead to increased intraglomerular
      production of proteoglycans, whereas the increased fibronectin, type IV collagen,
      and laminin may primarily originate from the epithelial cells.

PMID- 1614037
TI  - Free cadmium activity in renal epithelial cells is enhanced by Mg2+ depletion.
AB  - Free Cd2+ uptake was determined by fluorescence techniques with the use of mag
      fura-2 in single epithelial MDCK cells. Cytosolic Cd2+ increased in a time
      dependent and concentration-dependent manner following the addition of cadmium to
      the external solution. The increment in cytosolic Cd2+ was greater in magnesium
      depleted cells relative to normal cells. Uptake in normal and magnesium-depleted
      cells was inhibited by the channel antagonist, verapamil, and increased with the
      agonist, Bay K 8644. These studies indicate that free Cd2+ may exist in the cell
      cytosol and Cd2+ uptake is greater following magnesium-depletion. These data
      support the notion that magnesium may provide a cytoprotective effect in cadmium
      toxicity.

PMID- 1614038
TI  - Essential fatty acid deficiency normalizes function and histology in rat
      nephrotoxic nephritis.
AB  - The central lipid abnormality in essential fatty acid deficiency (EFAD) is the
      lack of availability of arachidonic acid. To examine the role of total
      eicosanoid's biosyntheses in the pathology and pathophysiology of
      glomerulonephritis, EFAD was induced in weanling rats, which were then subjected
      to antiglomerular basement membrane antibody (NTS)-induced injury in adulthood.
      Glomerular dynamics (as assessed by micropuncture), quantitative histology, and
      eicosanoid generation rates were measured at two hours and two weeks post-NTS,
      and compared to those of standard diet-fed (STD) controls. Two hours post-NTS,
      and despite the occurrence of proteinuria in both EFAD and STD animals,
      glomerular dynamics were essentially normal in EFAD rats, whereas STD animals had
      reduced values for glomerular filtration rate (GFR) and renal plasma flow rate
      (RPF). At two weeks, severe histologic changes were observed in STD animals
      including mesangial and stalk hypercellularity, moderate sclerosis, and
      interstitial nephritis, coupled with heavy proteinuria and reduced GFR and RPF.
      In dramatic contrast, EFAD rats displayed totally normal glomerular structures
      and functions. In parallel, glomerular generation rates of prostaglandin E2 and
      thromboxane A2 were suppressed markedly in EFAD rats. Thus, EFAD confers complete
      protection against the histopathologic and functional sequelae of immune
      initiated injury in the glomerulus. The data suggest that the initial wave of
      complement-induced neutrophil infiltration (with resultant proteinuria) is not
      sufficient to perpetuate injury into the more destructive chronic phases. The
      results provide strong impetus for the design of more specific interventional
      therapies targeting the various enzymes and products of arachidonic acid
      metabolism in the attempts to control glomerular inflammation.

PMID- 1614039
TI  - Interactions of hypercholesterolemia and hypertension in initiation of glomerular
      injury.
AB  - In the Dahl S rat (DS), salt induces systemic and glomerular capillary
      hypertension associated with progressive glomerulosclerosis, while Dahl R rats
      (DR) remain normotensive, without glomerular abnormalities. Studies in
      experimental models have suggested that hypercholesterolemia may play a role in
      the development of glomerulosclerosis; however, it is unclear whether
      hypercholesterolemia alone, in the absence of hypertension, can initiate injury.
      To answer this question we induced hypercholesterolemia in salt-supplemented DS
      (DSC) and DR (DRC) by feeding a high cholesterol (4%) chow. Control rats (DS, DR)
      received high-salt, normal cholesterol chow. After eight weeks, DS and DSC
      developed equivalent hypertension (161 +/- 3 vs. 153 +/- 3 mm Hg, respectively, P
      = NS), while DR and DRC remained normotensive (138 +/- 5 vs. 131 +/- 5 mm Hg, P =
      NS; P less than 0.05 vs. DS and DSC). Cholesterol fed rats developed marked and
      equivalent hypercholesterolemia compared to controls (DS vs. DSC, 71 +/- 3 vs.
      289 +/- 91 mg/dl, P less than 0.05; DR vs. DRC, 52 +/- 2 vs. 327 +/- 54 mg/dl, P
      less than 0.05). Hypertensive rats (DS, DSC) developed worse proteinuria and
      glomerular injury than normotensive rats (DR, DRC), but hypercholesterolemia
      exacerbated proteinuria and glomerulosclerosis only in DSC and not in DRC.
      Proteinuria significantly correlated with serum cholesterol in hypertensive rats
      (DS, DSC, P less than 0.05), but not normotensive rats (DR, DRC, P = NS).
      Furthermore, DSC had increased renal vascular resistance compared to DS, while no
      differences were found between DRC and DR. Thus, in the Dahl rat,
      hypercholesterolemia alone does not initiate glomerular injury. In this model,
      hypercholesterolemia is a pathogenetic factor in glomerular injury only when it
      coexists with systemic hypertension.

PMID- 1614040
TI  - Modulation of glomerular proteoglycans by insulin-like growth factor-1.
AB  - Effect of insulin-like growth factor-1 (IGF) on the synthesis of glomerular
      proteoglycans (PGs) in an ex vivo recirculating organ perfusion system was
      investigated. Kidneys were perfused with a medium (approximately 80 ml)
      containing [35S]-sulfate (250 microCi/ml) and IGF (62.5 to 625 ng/ml). After
      radiolabeling, a small cortical piece was saved for tissue autoradiography, and
      the remaining kidney and the perfusion medium were utilized for biochemical
      studies. The glomeruli were isolated; their PGs extracted and characterized. A
      two- to threefold increase of the total radioactivities in tissue and media
      fractions was observed with the exposure to IGF. By Sepharose CL-6B
      chromatography, the tissue PGs eluted as two peaks (A and B) with Kav = 0.24 and
      0.48, and the majority of the radioactivity was confined to peak A. This peak
      contained intact PGs while peak B included glycosaminoglycan (GAG) chains.
      Elution profiles of the glomerular PGs were similar in the control and IGF
      groups. However, there was a disproportionate increase of chondroitin/dermatan
      sulfate in the IGF group. The media fractions also had two peaks, and most of the
      radioactivity was associated with peak B containing GAG chains. A remarkable
      accentuation of peak B along with significant increase in the
      chondroitin/dermatan sulfate were observed in the IGF group. By DEAE-Sephacel
      chromatography, the PGs/GAGs of IGF group eluted at a relatively lower salt
      concentration as compared to the control. Autoradiography revealed a relatively
      high concentration of radioactivity over the mesangium as compared to the other
      cell types of the glomerulus. [35S]-methionine studies revealed a generalized
      increase of protein synthesis in the IGF group, but comparatively much less than
      that of PGs/GAGs. These results indicate that IGF enhances the biosynthesis of
      PGs/GAGs by various cell types of the renal glomerulus, especially that of the
      mesangial cell, as reflected by the selective increase of chondroitin/dermatan
      sulfate.

PMID- 1614041
TI  - Contrast nephropathy in patients with impaired renal function: high versus low
      osmolar media.
AB  - Prescription of low osmolar contrast to prevent nephrotoxicity in subjects with
      pre-existing renal impairment is costly and has not been clearly shown to be
      effective. We entered 249 subjects with a pre-contrast serum creatinine greater
      than 120 mumol/liter (1.35 mg/dl) having cardiac catheterization or intravenous
      contrast into a randomized controlled trial comparing high and low osmolar
      contrast. The outcome assessed was a rise in serum creatinine repeated 48 to 72
      hours after contrast. A further 117 patients entered the non-randomized
      prospective arm of the study. In the randomized study the serum creatinine rose
      by at least 25% after contrast in 8 of 117 (6.8%) given high and in 5 of 132
      (3.8%) given low osmolar contrast (P greater than 0.05, one-tailed 95% confidence
      interval for the difference 3 to 7.8%). More severe renal failure (greater than
      50% increase in serum creatinine) after contrast was uncommon (3.4% with high and
      1.5% with low osmolar contrast). A rise in serum creatinine after contrast was
      significantly associated with the severity of the pre-contrast renal impairment
      and the presence of diabetes mellitus, but not with type of contrast. Diabetics
      with a serum creatinine greater than 200 mumol/liter (2.25 mg/dl) pre-contrast
      had a highest risk of deterioration in renal function after contrast. We conclude
      that in patients with pre-existing renal impairment the incidence of contrast
      nephropathy was not significantly different comparing high osmolar and nonionic
      contrast. The potential benefit of nonionic contrast in moderate renal impairment
      is likely to be small, but trials in diabetics with severe renal impairment
      should be undertaken urgently.

PMID- 1614042
TI  - Toxicity of osmotic solutes on human mesothelial cells in vitro.
AB  - We evaluated the effect of the various osmotic solutes on the growth rate of
      human mesothelial cells (HMC) in an in vitro culture. Glucose inhibited
      proliferation of HMC in a dose dependent way. At high glucose concentrations (60
      mM, 90 mM) the effect was instant but at lower concentration (30 mM) decrease in
      the mesothelial cell proliferation was significant only after five days of
      incubation. Reversibility of the glucose effect was inversely proportional to
      exposure time to this solute. Mannitol and glycerol studied in similar
      concentrations as glucose decreased proliferation of the mesothelial cells less
      than glucose, whereas amino acid glycine had a similar effect to glucose.
      However, all osmotic solutes caused similar injury to mesothelial cells membrane
      as measured by release of LDH. These results suggest that the toxic effect of the
      osmotic solutes on proliferation of the mesothelial cells depends not only on the
      hyperosmolality but also on some metabolic effect(s). In an in vitro culture, HMC
      may provide a suitable model for the study of the toxic effect of dialysis fluid
      on peritoneal mesothelium.

PMID- 1614043
TI  - Survival as an index of adequacy of dialysis.
AB  - To examine how patient survival substantiates dialysis adequacy, 20-year
      actuarial survival experience was calculated for 445 unselected hemodialysis (HD)
      patients (97 patients accepted on a temporary basis--and usually kept on their
      regular dialysis scheme--were left out). The dose of dialysis has been the same
      and unchanged for all patients since beginning: 24 square meter hours of Kiil
      dialysis (cuprophane) per week with acetate buffered dialysate. KT/V mean (SD)
      was 1.67 (0.41). Six months after starting dialysis, 98% of patients were
      normotensive and off all blood pressure (BP) medication. The mean population
      hematocrit, excluding the only 6 patients receiving erythropoietin
      supplementation, was 28%. Survival rate was 87% at 5 years, 75% at 10 years, 55%
      at 15 years, and 43% at 20 years of HD. The satisfactory control of BP without
      using potentially toxic BP drugs and the higher than usual dose of dialysis are
      two possible explanations for survival data better than usually reported. We
      suggest that patient survival should be considered as the best overall index of
      adequacy of dialysis.

PMID- 1614044
TI  - Fistula dysfunction: effect on rapid hemodialysis.
AB  - Rapid hemodialysis (Qb 400 to 500 ml/min) places considerable demands on
      hemodialysis vascular access. This six-month prospective study enrolled 52
      patients and evaluated urea recirculation as a means of detecting fistula
      dysfunction. It evaluated the effects of fistula location and dialysis blood flow
      on urea recirculation during rapid hemodialysis and assessed the effect of rapid
      dialysis on fistula thrombosis. Urea recirculation increased as Qb increased from
      300 to 400 ml/min (8 +/- 3% to 16 +/- 3%, P less than 0.05). The extent of urea
      recirculation was also fistula site dependent (radial fistulas 18 +/- 4%, upper
      arm fistulas 11 +/- 3%, Qb 400 ml/min, P less than 0.05). Site and blood flow
      dependent urea recirculations were an indicator of venous stenoses. When venous
      stenoses were corrected, urea recirculation rates improved (36 +/- 3% to 21 +/-
      3%, P less than 0.05). There were no differences between methods of determining
      urea recirculation early in dialysis (contralateral arm venepuncture vs. stop
      flow technique; 30 to 60 min). However, at 120 minutes urea recirculation was
      significantly greater with the contralateral arm venepuncture technique. Venous
      dialysis pressure at Qb 400 ml/min had limited use as a predictor of venous
      stenoses unlike its value at lower Qb. Fistula thrombosis (0.26/patient year of
      dialysis) and fistula replacement (0.09/patient year of dialysis) were similar to
      our observations in a conventional hemodialysis facility where prospective
      correction of fistula dysfunction was also used.

PMID- 1614045
TI  - Renal hemodynamics and reduction of proteinuria by a vasodilating beta blocker
      versus an ACE inhibitor.
AB  - The effects of a nonselective beta-adrenergic blocking drug with beta-2 agonist
      activity (dilevalol 200 mg) on proteinuria and renal hemodynamics were evaluated
      in a double-blind crossover study versus an ACE inhibitor (enalapril 5 mg) in
      eight patients with glomerulonephritis, moderate renal function impairment and
      proteinuria greater than 1 g/24 hr. Patients were studied after a one week
      placebo phase while off all other medications, except steroids in a few cases,
      and after three weeks of treatment. A 10-day placebo washout perod was included
      between the various drug treatments. During each period renal hemodynamics were
      measured by clearance techniques, and urinary protein excretion as well as
      fractional clearance of albumin and IgG were determined. Both drugs reduced mean
      arterial pressure and proteinuria to a similar extent [mean arterial pressure:
      placebo 108 +/- 13 mm Hg; dilevalol 103 +/- 11 mm Hg (P less than 0.05);
      enalapril 103 +/- 12 mm Hg (P less than 0.05); protein excretion: placebo 5.1 +/-
      4.2 g/day; dilevalol 3.3 +/- 3.0 g/day (P less than 0.05); enalapril 2.8 +/- 2.8
      g/day (P less than 0.05)]. The antiproteinuric effect was greater with enalapril
      than dilevalol. Dilevalol reduced GFR [baseline inulin clearance: 73.3 +/- 38
      ml/min/1.73 m2; after dilevalol: 63.3 +/- 28 ml/min/1.73 m2 (P less than 0.05)]
      and the decrease of proteinuria correlated positively with the reduction of GFR.
      Enalapril did not significantly lower the GFR (inulin clearance during enalapril
      66.8 +/- 23 ml/min/1.73 m2) and the reduction of proteinuria did not correlate
      with the lowering of the GFR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614046
TI  - Factors affecting the progression of renal disease in autosomal-dominant
      polycystic kidney disease.
AB  - Autosomal-dominant polycystic kidney disease results in renal failure at a
      varying age from childhood to old age. We postulated that factors other than the
      culprit gene alone contribute to the course of progression of the renal failure.
      We studied 580 subjects with autosomal-dominant polycystic kidney disease and 194
      unaffected family members. We calculated survival curves to end-stage renal
      failure or death and developed a linear model for testing the effects of single
      or multiple variables on the progression of renal failure as estimated from the
      reciprocal of serum creatinine. Fifty-two subjects died and 94 reached end-stage
      renal failure during the period of observation, yielding functional survivals of
      71% at age 50 years, 53% at 58 years and 23% at 70 years. The following variables
      were independently associated with worse mean renal function at a given age (P
      value less than 0.01): the PKD1 gene, younger age at diagnosis, male gender,
      hypertension, increased left ventricular mass, hepatic cysts in women, three or
      more pregnancies, gross hematuria, urinary tract infections in men and renal size
      expressed as renal volume. The following were not associated significantly with
      the course of renal function: gender of affected parent, mitral valve prolapse,
      intracranial aneurysms, any pregnancy, hepatic cysts in men and urinary tract
      infections in women. The identification of unalterable maleficent factors such as
      the PKD1 gene and male gender permit more informed counseling while the
      identification of alterable factors such as hypertension, number of pregnancies
      and recurrent urinary tract infections provides the clinician with the
      opportunity to modify these factors and improve the management of patients with
      autosomal-dominant polycystic kidney disease.

PMID- 1614047
TI  - A quantitative description of solute and fluid transport during peritoneal
      dialysis.
AB  - To investigate the relationship between dialysate glucose concentration and
      peritoneal fluid and solute transport parameters, 41 six-hour single dwell
      studies with standard glucose-based dialysis fluids containing 1.36% (N = 9),
      2.27% (N = 9) and 3.86% (N = 23) anhydrous glucose were carried out in 33
      clinically-stable continuous ambulatory peritoneal dialysis (CAPD) patients.
      Intraperitoneal dialysate volumes (VD) were determined from the dilution of 131I
      albumin with a correction applied for its elimination from the peritoneal cavity
      (KE, ml/min). Diffusive mass transport coefficients (KBD) were calculated from
      aqueous solute concentrations (with a correction applied for the plasma protein
      concentration and, for electrolytes, also for the Donnan factor) during a period
      of dialysate isovolemia. The intraperitoneal amount calculated to be transported
      by diffusion was subtracted from the measured total amount of solutes in the
      dialysate, yielding an estimate of non-diffusive solute transport. The
      intraperitoneal dialysate volume over time curve was characterized by: initial
      net ultrafiltration (lasting on average 92 min, 160 min and 197 min and with
      maximum mean net ultrafiltration rates 6 ml/min, 8 ml/min and 14 ml/min,
      respectively, for the 1.36%, 2.27% and 3.86% solutions); dialysate isovolemia
      (lasting about 120 min for all three solutions) and fluid reabsorption (rate
      about 1 ml/min for all three solutions). KBD for glucose, potassium, creatinine,
      urea and total protein did not differ between the three solutions and the
      fractional absorption of glucose was almost identical for the three glucose
      solutions, indicating that the diffusive transport properties of the peritoneum
      is not influenced by the initial concentration of glucose or the ultrafiltration
      flow rate. About 50% of the total absorption of glucose occurred during the first
      90 minutes of the dwell. The mean percentage of the initial amount of glucose
      which had been absorbed (%GA) at time t during the dwell could be described (r =
      0.999) for all three solutions using the experimental formula %GA = 85 - 75.7 * e
      0.005*t. After 360 minutes, about 75% of the initial intraperitoneal glucose
      amount had been absorbed corresponding to a mean (+/- SD) energy supply of 75 +/-
      6 kcal, 131 +/- 18 kcal and 211 +/- 26 kcal for the three solutions. Non
      diffusive (that is, mainly convective) transport was almost negligible for the
      less hypertonic solutions while it was estimated to account for 30 to 40% of the
      total peritoneal transport of urea, creatinine and potassium during the first 60
      minutes of the 3.86% exchange.

PMID- 1614048
TI  - Effect of fluoride on aluminum-induced bone disease in rats with renal failure.
AB  - Aluminum (Al) accumulation in renal failure is an etiological factor in the
      pathogenesis of low turnover bone disease. Aluminum-induced impairment of
      mineralization has been related to a reduced extent of active bone-forming
      surface. The present study investigated the effect of fluoride, a potent
      stimulator of osteoblast number, on the toxicity of aluminum in rats with renal
      failure (Nx). Following a large parenteral aluminum load (3.2 mg/kg x day) over a
      period of nine weeks, bone histomorphometry of vertebral cancellous bone revealed
      a severe low-turnover osteodystrophy as evidenced by a fall in osteoblastic
      osteoid surfaces and mineral apposition rates. Concurrent administration of
      fluoride [20 mg/liter (F20) or 40 mg/liter (F40) supplied with the drinking
      water] resulted in a significant increase in the number of osteoblasts (Nx+Al+F40
      vs. Nx+Al, 33.75 +/- 2.83 vs. 1.81 +/- 0.43 mm-1, P less than 0.001) together
      with an overall reduced deposition of aluminum in bone (469.3 +/- 24.6 vs. 592.2
      +/- 28.3 micrograms/g, P less than 0.01). However, there was an increase in the
      fraction of osteoid surface exhibiting stainable aluminum at the bone-osteoid
      interface (70.7 +/- 7.1 vs. 44.3 +/- 6.0%, P less than 0.005). Fluoride-exposed
      rats accumulated a significantly larger osteoid volume, suggesting an
      exacerbation of the osteomalacic lesion, and furthermore, dynamic
      histomorphometric parameters remained depressed. These results indicate that
      fluoride has a distinct effect on the pattern of aluminum deposition in bone. In
      addition, fluoride antagonizes the aluminum-induced reduction in osteoblast
      number but provides no amelioration of the impaired mineralization in aluminum
      intoxicated rats. Thus, in this model a decrease in the extent of osteoblast
      surface does not account for the development of aluminum-related bone
      disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614049
TI  - Single kidney function: early and late changes in urate transport after
      nephrectomy.
AB  - Renal urate transport was studied by means of pyrazinamide (PZA) and probenecid
      (PB): (a) before and at 2, 6, 24 weeks (24 patients), (b) 1 to 30 years after
      uninephrectomy in 27 and 12 patients with Ccr greater than 80 and 30 to 70
      ml/min, respectively. Uninephrectomy was followed by important tubular urate
      transport modifications during at least two weeks, which lead to a marked
      uricosuria as indicated by significant increase in FEur (mean value +/- SD, 0.228
      +/- 0.059 vs. 0.097 +/- 0.014 and 0.099 +/- 0.019 in normals and chronically
      diseased solitary kidneys). Reduced response to PZA and PB suggests a diminished
      reabsorptive capacity for urate mainly at the presecretory site which persisted
      after FENa normalization. Tubular compensations were presumably complete at six
      weeks, since pattern of urate transport returned to normal with an almost
      complete reabsorption of filtered urate load (99%) and a percentage of
      postsecretory reabsorption (80%) very close to those seen in normal subjects with
      a pair of kidneys. The adjustment in urate excretion in solitary kidneys was
      achieved by a significant increase of secreted urate as compared with 50% of pre
      uninephrectomy values. Thus, increased urate secretion by the remaining intact
      organ is sufficient to maintain urate balance with a normal serum level.

PMID- 1614050
TI  - The pathobiology of subclinical pyelonephritis--an experimental evaluation.
AB  - Clinical studies have demonstrated a poor correlation between localization tests,
      which are designed to determine the site of urinary tract infection, and symptoms
      of upper urinary tract infection. One explanation is that microorganisms may be
      present in the kidney but not initiate an inflammatory response with associated
      symptoms. An animal model has been developed to obtain quantitative information
      on the comparative pathobiology of lesion-inducing and non-lesion-inducing
      infections. In this model, non-manipulated kidneys had acquired a persistent
      microbial flora within 48 hours of the lower urinary tract becoming infected.
      This bacterial invasion was not associated with gross or histologic changes
      within the renal parenchyma, but minor foci of inflammatory cells were seen
      beneath the epithelium lining the calyces. Ureteric urines from such kidneys
      contained many leukocytes and high numbers of bacteria. These results showed that
      the kidneys were infected, rather than colonized, and the term "subclinical"
      infection was appropriate. Antimicrobial agents were variably successful at
      eradicating the infection. These experimental observations support the concept of
      subclinical pyelonephritis and may explain the absence of symptoms in the
      clinically equivalent situation in humans.

PMID- 1614051
TI  - A model of the volumetrically-controlled hemodialysis circuit.
AB  - We developed a model that predicts the hemodynamics of the volumetrically
      controlled circuit used to administer high flux hemodialysis. The equations
      simulate the entire blood side of the circuit so that blood and dialysate
      pressures can be predicted from a knowledge of circuit component and patient
      characteristics. An alternative method of computation has also been devised which
      permits measured circuit pressures to be used to predict patient blood access
      pressure, dialyzer resistance to flow and membrane hydraulic conductivity.
      Success of the model was evaluated by measuring both circuit pressure and
      component characteristics. The model successfully predicted circuit pressures
      when measured component characteristics were employed as model inputs.
      Conversely, the model accurately predicted circuit component characteristics when
      measured pressures were employed as inputs (8 patients, 30 dialyses). Specific
      predictions of the model include the following. Elevations of patient blood
      access pressure will cause blood and dialysate pressures to rise equivalently
      without affecting the rate of back-filtration or location of pressure equilibrium
      along the dialyzer axis. Elevated hematocrit is predicted to increase circuit
      pressures to a degree that is similar to a poorly functioning blood access,
      however, high hematocrit markedly augments back-filtration and moves the point of
      pressure equilibrium toward the dialyzer entrance. We conclude that the model
      provides a predictive tool that can be used to optimize circuit design.
      Alternatively, the model can be used to separate the influence of a poorly
      functioning patient access from other factors which can elevate circuit
      pressures.

PMID- 1614052
TI  - Non-invasive prediction of aluminum bone disease in hemo- and peritoneal dialysis
      patients.
AB  - Between October 1987 and October of 1989, we conducted a prospective study to
      evaluate non-invasive test strategies for predicting aluminum bone disease (ABD)
      in a group of largely unselected dialysis patients based on their deferoxamine
      (DFO) test alone, or the combined results of their DFO test and intact 1-84
      parathyroid hormone (PTH) levels. These test parameters were evaluated against
      the pathological diagnosis of ABD based on bone biopsy ("gold standard"). A total
      of 445 patients in three dialysis centers in Toronto were serially followed for
      their clinical, laboratory and risk parameters for renal osteodystrophy during
      the study, and 259 (142 PD and 117 HD) patients underwent a series of
      investigations which included the DFO test, measurement of intact 1-84 PTH
      levels, and an iliac crest bone biopsy. Serum aluminum ([Al]) level greater than
      or equal to 3700 nM (or 100 micrograms/liter) had a positive predictive value
      (PPV) of 75% for ABD in our PD and 88% in our HD patients, but its sensitivity
      was low (10 and 37%). Delta [Al] (that is, incremental rise of serum [Al] from
      baseline post-DFO) was useful in predicting ABD in our PD but not HD patients.
      Test combination based on delta [Al] greater than or equal to 5550 nM (or 150
      microgram/liter) and PTH levels less than 20 pM (or 200 pg/ml) yielded the best
      PPV greater than or equal to 95% for ABD in both PD and HD patients. This test
      cut-off would remain highly predictive of ABD even if the prevalence of ABD
      decreases to as low as 5% for the PD patients and 10% for the HD
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614053
TI  - A new scintigraphic method to characterize ultrafiltration in hollow fiber
      dialyzers.
AB  - Ultrafiltration and pressure profiles in hollow fiber dialyzers with different
      hydraulic permeabilities have been investigated with a new scintigraphic method.
      Radiolabelled albumin macroaggregates, used as a nondiffusible marker molecule,
      were added to the blood in an in vitro circuit and circulated through cuprophan
      and polysulphon dialyzers. Since the marker molecule was too big to cross the
      dialysis membrane, its changes in concentration were assumed to occur in response
      to the variation of the blood water content (filtration or back-filtration).
      These changes in concentration, recorded by a gamma camera, were evaluated to
      establish the cumulative values of filtration and back-filtration and their
      relevant profiles along the length of the dialyzer. The achieved data were
      compared with the experimental values of ultrafiltration empirically measured and
      with the theoretical values predicted by a classic linear method. Two conditions
      were analyzed: A) the minimal filtration rate necessary to avoid back-filtration
      (critical filtration); and B) the condition of zero net filtration in which
      filtration equals back-filtration. The nuclear method proved to be extremely
      precise in predicting the ultrafiltration values and significantly more precise
      than the linear method, especially for the highly permeable dialyzer. The reason
      for that probably depends on the non-linear pressure and ultrafiltration profile
      observed with the scintigraphic pattern of the dialyzer. Viscosity changes and
      local variations in blood flow may in fact interfere with the pressure drop
      inside the hollow fibers and result in such a complex behavior. The other
      interesting aspect of this method is the possibility of accurate measurement of
      the amount of back-filtration that wouldn't be possible with simple calculations.
      In conclusion, the complex nature of the phenomena regulating the water fluxes in
      hollow fiber dialyzers requires more complex calculation than a simple linear
      model to achieve an accurate range of predictability.

PMID- 1614054
TI  - Lipoprotein abnormalities in hyperlipidemic and normolipidemic men on
      hemodialysis with chronic renal failure.
AB  - Lipids, lipoproteins, apolipoproteins (apo) and apo E polymorphism were
      determined in 101 men with chronic renal failure (CRF) were were on hemodialysis
      and 101 healthy controls matched for age and sex. Patients with CRF on
      hemodialysis had significantly higher levels of serum triglycerides, very-low
      density lipoprotein (VLDL) cholesterol, intermediate-density lipoproteins (IDL),
      and lower levels of low- and high-density lipoproteins (LDL and HDL,
      respectively) than controls. Regarding apolipoproteins, serum apo B
      concentrations were decreased. Apo C-III concentrations in sera and in VLDL and
      HDL fractions were significantly increased in 35 hemodialysis patients compared
      with 32 controls. Seventy-eight of the 101 CRF patients had normal serum
      cholesterol and triglycerides (less than 5.2 mmol/liter and less than 2.3
      mmol/liter, respectively). However, this subgroup also showed a significant
      increase in VLDL-triglycerides and serum apo E concentration in addition to
      changes observed in the group as a whole. Apo E polymorphism in our study
      population did not differ from that reported for other European populations.
      According to the different apo E phenotypes, lipids and lipoprotein composition
      showed no significant differences in controls or patients. We conclude that
      accumulation of triglyceride-rich lipoproteins in patients with CRF on
      hemodialysis may thus be at least in part related to the enrichment of apo C-III
      in VLDL and HDL fractions. Lipoprotein profile in hemodialysis patients,
      including those with normal serum cholesterol and triglyceride levels, is
      consistent with high cardiovascular risk.

PMID- 1614055
TI  - Removal of aluminoxamine and ferrioxamine by charcoal hemoperfusion and
      hemodialysis.
AB  - We studied the removal of aluminoxamine (AlO) and ferrioxamine (FO) by (i)
      hemoperfusion/hemodialysis using an AluKart in combination with either a
      Cuprophan F-120 or a Hemophan FH-160 membrane, or (ii) hemodialysis with a high
      flux F-60 polysulfone membrane. The same six dialysis patients underwent in a
      random order dialysis by the three set-ups after i.v. infusion of 30 mg/kg of
      desferrioxamine (DFO) during the last half an hour of the preceding dialysis
      session. The mean +/- SD plasma AlO and FO clearances of the AluKart combined
      with either a F-120 or FH-160 membrane were 194.3 +/- 25.8 ml/min (AlO) and 164.2
      +/- 41.3 ml (FO) at the start of dialysis declining to respectively 76.6 +/- 27.3
      and 68.5 +/- 42.6 ml/min at the end of dialysis. With a high-flux dialysis
      membrane the intra-dialytic plasma clearance remained constant at 81.5 +/- 6.8
      ml/min for AlO and 60.0 +/- 2.8 ml/min for FO. In the presence of an AluKart
      combined with a FH-160 up to 84 +/- 27% and 84 +/- 19% of the available AlO and
      FO could be removed during a four-hour hemoperfusion/hemodialysis session. During
      the first hour of dialysis, respectively 59 and 58% of the total amount of AlO
      and FO extracted by the AluKart was removed compared to only 9 and 16% during the
      last hour.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614056
TI  - Radiocontrast-induced nephropathy in humans: role of renal vasoconstriction.
AB  - Radiocontrast-induced nephropathy (RCIN) is a common cause of acute renal failure
      in hospitalized patients. Renal vasoconstriction figures prominently in the
      proposed pathogenesis of RCIN based on animal experiments. Prior human studies
      examining renal hemodynamic changes after contrast medium (CM) injection are
      inconclusive. No previous study of animals or humans has established a
      relationship between CM-associated renal hemodynamic changes and the subsequent
      development of RCIN. In the present study, we examined the renal hemodynamic
      effects of CM in patients at high risk of RCIN. In addition, we related those
      effects to the subsequent development of RCIN. Using renal vein thermodilution
      catheters, we measured renal blood flow (RBF) in 12 patients with chronic renal
      failure [serum creatinine (SCr) greater than or equal to 159 mumol/liter] during
      ionic CM injection for cardiac catheterization. We made measurements at the start
      of the procedure (t = 0), before the ventriculogram (t = 5), after the
      ventriculogram (t = 15), and after the coronary angiogram (t = 65). We measured
      SCr at t = 0 and again 24 and 48 hours later. Mean RBF for the group tended to
      increase after the ventriculogram, and increased significantly by t = 65 (P less
      than 0.005 vs. t = 0). When examined by individual patient, RBF fell below
      baseline in three patients (30%) at t = 15, but rose above baseline again by t =
      65. Only one patient (8.3%) had a fall in RBF below baseline at t = 65. RCIN
      (defined as an increase in SCr greater than or equal to 25% above baseline)
      developed in six patients (50%) within 48 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614057
TI  - Dialysis-related amyloidosis.

PMID- 1614058
TI  - Effects of chronic felodipine treatment on renal function and morphology in SHR.
AB  - To investigate if blood pressure reduction per se may prevent progressive renal
      disease in aging spontaneously hypertensive rats (SHR), 15-month-old SHR were
      treated with the calcium antagonist felodipine, with the beta-blocker metoprolol
      or with the combination for six months. The combined regimen caused the greatest
      blood pressure reduction over time, metoprolol caused the least, while felodipine
      had an intermediate effect. At the end of treatment, urinary protein excretion
      and endogenous creatinine clearance were determined in rats kept in individual
      metabolic cages. At autopsy, the kidneys were histologically examined and indices
      of chronic progressive nephrosis and glomerular sclerosis were determined. A
      positive correlation was found between urinary protein excretion and glomerular
      sclerosis. Glomerular sclerosis was low in the groups of rats with high
      endogenous creatinine clearance. In both groups treated with felodipine,
      glomerular sclerosis and urinary protein excretion were significantly reduced
      compared to untreated controls. These results illustrate that the calcium
      antagonist felodipine attenuates proteinuria and glomerular sclerosis in aging
      SHR. The blood pressure reduction may be of major importance in this respect,
      although a direct action on the sclerotic process within the glomeruli may also
      contribute.

PMID- 1614059
TI  - Acute renal effects of felodipine in hypertensive patients with kidney disease.
AB  - In contrast to other types of directly acting vasodilators, calcium antagonists
      promote sodium excretion. It is not well established, however, whether these
      drugs also induce natriuresis in hypertensive patients with renal disease.
      Therefore, we studied the acute effects of the dihydropyridine calcium antagonist
      felodipine in nine such patients (CCr 68 +/- 19 ml/min) and 12 healthy
      normotensive subjects. In both the hypertensive patients and the normotensive
      subjects total and fractional sodium excretion rose during the first 40 minutes
      of intravenous felodipine infusion; in the hypertensive patients this rise of
      sodium excretion was positively correlated to the initial glomerular filtration
      rate (GFR) (r = 0.87, P less than 0.01). In the patients, during ongoing
      felodipine infusion, natriuresis was attenuated in the setting of a large
      continuing decrease of blood pressure. In contrast, in the normotensive subjects,
      in whom blood pressure did not fall any further, a steady rise of sodium
      excretion was observed. In both the hypertensive patients and the normotensive
      subjects GFR remained unchanged and renal vascular resistance decreased, whereas
      renal plasma flow increased only in the latter group. Changes in sodium excretion
      were not correlated to changes in renal hemodynamic parameters. It is concluded,
      that also in hypertensive patients with diminished renal function felodipine
      exerts a potentially advantageous natriuretic effect. However, this natriuretic
      effect is possibly less at lower GFR and seems to be attenuated by blood pressure
      reduction. The mechanism of this natriuretic effect as well as its contribution
      to the antihypertensive effect of felodipine still has to be clarified.

PMID- 1614060
TI  - Long-term effects of felodipine in patients with reduced renal function.
AB  - To characterize the long-term effects of calcium antagonists on renal function in
      hypertension felodipine was used to treat 14 patients with severe uncontrolled
      hypertension associated with renal functional impairment: six patients had renal
      parenchymal hypertension, six had essential hypertension and two had renovascular
      hypertension. Mean blood pressure was 197 +/- 2/115 +/- 3 mm Hg despite treatment
      with three or more antihypertensive drugs. Mean glomerular filtration rate (GFR)
      was 39 +/- 6 ml/min (Cr-EDTA clearance) before initiation of felodipine
      treatment. All patients experienced a blood pressure reduction after starting
      felodipine treatment, which persisted during long-term therapy in combination
      with previous medication except former vasodilating drugs. Blood pressure after
      12 and 24 months was 152 +/- 7/89 +/- 2 and 157 +/- 5/90 +/- 2 mm Hg,
      respectively. Patients with moderately impaired GFR and absence of progressive
      renal disease (N = 8) manifested an increase in GFR after 6 and 12 months on
      felodipine (59 +/- 10 to 63 +/- 7 and 70 +/- 6 ml/min, respectively, P less than
      0.05). Renal plasma flow (PAH clearance) exhibited only a slight increase (315 +/
      68 to 340 +/- 63 and 314 +/- 69 ml/min) with a consequent increase in filtration
      fraction (18 +/- 1 to 21 +/- 1 and 20 +/- 1%, NS). At follow-up after six to
      eight years patients with initial GFR greater than or equal to 50 ml/min had a
      maintained renal function. In five patients a progressive deterioration of renal
      function had been documented.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614061
TI  - Are calcium antagonists of value in ameliorating the course of chronic renal
      disease?
AB  - Renal protection is defined as an attenuation or significant slowing of the
      irrevocable decrease in renal function over time, which occurs subsequent to
      renal dysfunction. Control of systemic hypertension by whatever means exerts a
      renal protective effect. Evidence suggesting a specific action of individual
      antihypertensive agents is less certain. Calcium antagonists may exert a specific
      renal protective effect. Experiments in rats with reduced renal mass,
      desoxycorticosterone-induced hypertension, chronic angiotensin II infusion, and
      in spontaneously hypertensive rats support such a view. In three crossover
      trials, calcium antagonists reduced proteinuria in patients with type 2 diabetes
      mellitus. Preliminary data from a single prospective trial in patients with renal
      insufficiency offer additional support; however, definitive conclusions cannot be
      reached without further trials. In particular, comparative trials of different
      classes of antihypertensive agents with equal blood pressure control are needed.
      Thus far, only reducing systemic blood pressure per se has been shown to be of
      value in attenuating hypertension-induced renal dysfunction in humans.

PMID- 1614062
TI  - Growth factors and glomerular sclerosis.
AB  - Progress has been made over the last decade in our understanding of the
      pathophysiology of progressive chronic renal failure (CRF) and the underlying
      glomerular sclerosis. Although these advances have been made in experimental
      animals and have so far had little impact on the management of CRF in humans,
      they nevertheless identify pathways through which glomerular sclerosis takes
      place. They also identify the cells involved in this process and the role of
      cytokines/growth-promoting peptides in the communication between these cells. It
      is the purpose of this review to detail the contribution of cytokines to
      glomerular scarring.

PMID- 1614063
TI  - Role of calcium in the progression of renal disease: experimental evidence.
AB  - Intracellular calcium mediates a wide array of cell functions in mesenchymal as
      well as in epithelial and endothelial cells. These comprise regulation of
      vascular tone, cell proliferation and synthesis of prostanoids and cytokines.
      Therefore, it is not surprising that a substantial body of evidence has emerged
      to suggest a crucial role of calcium in the initiation and perpetuation of renal
      disease. Increased deposition of calcium was found in the renal cortex of rats
      with remnant kidney and in kidney tissue of patients with end-stage renal
      failure. Calcium plays an important role in altered intrarenal and glomerular
      hemodynamics with increased glomerular wall tension as well as in cellular
      proliferation and in recurrent ischemic events leading to glomerulosclerosis and
      interstitial fibrosis. Besides hemodynamic mechanisms, additional calcium
      dependent mechanisms must be considered for glomerular hypertrophy and/or
      mesangial proliferation to develop, namely the role of growth factors,
      prostanoids and cytokines. Their signals include receptor-regulated production of
      inositol-trisphosphate and diacylglycerol and the consecutive stimulation of
      protein kinase C and the Na/H-antiport. Full activation of this antiport, which
      raises intracellular pH and thereby stimulates protooncogenes, again requires the
      presence of calcium. Recurrent focal glomerular ischemia may result in cellular
      and mitochondrial calcium overload that may interfere with cellular energy
      metabolism. Calcium also activates proteinases and the production of oxidants to
      enhance neutrophil-mediated cell injury. These deleterious effects of calcium may
      initiate and perpetuate the progression of renal disease and eventually lead to
      end-stage renal failure.

PMID- 1614064
TI  - Means of clinical evaluation of renal disease progression.

PMID- 1614065
TI  - Does essential hypertension cause end-stage renal disease?
AB  - The number of patients developing end-stage renal disease (ESRD) as a consequence
      of hypertension is increasing and accounts for 25% of new cases of ESRD in the
      United States. However, the diagnosis of hypertensive ESRD is one of exclusion
      and no pathologic data corroborate this classification. Undoubtedly, these
      patients suffer from a variety of diseases, including accelerated hypertension
      and atherosclerotic disease of the large arteries. Also included are patients
      with an undiagnosed primary renal disease. The prevalence of these conditions in
      the hypertensive population is unknown. It is also proposed that mild to moderate
      hypertension can lead to ESRD. In support of this view, early investigators noted
      that nephrosclerosis was correlated with hypertension and/or left ventricular
      hypertrophy. More recently, in the Hypertension Detection and Follow-up Program,
      renal function was found to decline in some patients despite treatment. Data from
      the Baltimore Longitudinal Study of Aging indicate that the rate at which
      creatinine clearance declines with aging is correlated with blood pressure. A
      recent retrospective study reported that serum creatinine increased significantly
      in approximately 15% of treated hypertensive patients. However, in none of these
      studies was the presence of intrinsic renal disease definitively excluded.
      Furthermore, although an increase in serum creatinine or decline in clearance has
      been reported, progression to end-stage renal disease has not been documented.
      Therefore, additional studies are necessary to determine the frequency with which
      essential hypertension leads to end-stage renal disease.

PMID- 1614066
TI  - Determinants of progressive renal disease in diabetes mellitus.
AB  - The prognosis for the patient with diabetic nephropathy has improved considerably
      during the last decade. This is due to identification and treatment of different
      risk factors. Elevated blood pressure has turned out to be a major risk factor in
      established diabetic nephropathy. The impact of metabolic control has also been
      demonstrated. Lipid abnormalities have recently been identified as a possible
      factor that accelerates loss of renal function. The role of renal hemodynamic
      alterations is probably also important. Their contribution can indirectly be
      assessed by studying the effects of pharmacologic therapy. Angiotension
      converting enzyme inhibitors reduce proteinuria by a mechanism independent of
      systemic blood pressure and there is suggestive evidence that they preserve renal
      function to a greater degree than other antihypertensive agents.

PMID- 1614067
TI  - Effects of calcium antagonists on renal hemodynamics and glomerular function.
AB  - Cytosolic [Ca2+] can be increased by influx of the ion from the extracellular
      compartment, Ca2+ release from intracellular storage sites, and/or a reduced
      activity of active transport processes for Ca2+ extrusion or sequestration.
      Organic calcium antagonists block transmembrane calcium entry and, therefore, can
      be utilized to evaluate the importance of calcium influx in the regulation of
      renal hemodynamics. Recent studies indicate that calcium antagonists selectively
      vasodilate preglomerular arterioles, leading to increases in renal blood flow
      (RBF), glomerular filtration rate (GFR) and glomerular pressure. In contrast with
      angiotensin converting enzyme inhibitors and other vasodilator agents, calcium
      antagonists primarily influence the component of renal vascular resistance
      responsible for autoregulation, potently attenuating autoregulatory efficiency.
      Calcium antagonists also block the afferent arteriolar vasoconstriction elicited
      by angiotensin II, while not influencing the efferent arteriolar vasoconstriction
      evoked by this peptide. Tubuloglomerular feedback (TGF)-mediated vasoconstrictor
      responses are also abolished by calcium antagonists, indicating that the TGF
      effector mechanism may require transmembrane calcium influx into the smooth
      muscle cells of the afferent arterioles. These observations provide compelling
      evidence that calcium influx, through pathways which are influenced by organic
      calcium antagonists, is an integral component of the afferent arteriolar
      vasoconstriction elicited by a variety of stimuli, while efferent arteriolar
      vasoconstriction appears to depend on other calcium access pathways.

PMID- 1614068
TI  - Renal tubular effects of calcium antagonists.
AB  - Calcium channel blockers have diuretic and natriuretic properties in normal
      animals and humans. The renal mechanism by which this natriuresis is produced has
      not yet been completely defined although dihydropyridine derivatives evoke it in
      experimental animals independently of any effects on renal blood flow or on the
      glomerular filtration rate. Injections or infusions into the renal artery
      indicate that the renal excretory effect is secondary to a direct action on renal
      tubular water and solute reabsorption but not to renal hemodynamic changes.
      Studies undertaken to localize the site of action of dihydropyridine calcium
      antagonists on renal tubules by renal clearance and micropuncture techniques
      suggest that both proximal and distal tubular sites are involved. Primary sites
      of action in distal convoluted tubules and in the collecting duct have been
      identified for felodipine and nisoldipine during sodium infusion, whereas sites
      for nitrendipine in proximal tubules have been demonstrated in strict hydropenia.
      Both changes in the tubuloglomerular feedback setting and suppression of
      aldosterone secretion have been proposed to explain some of these effects. The
      changes do not, however, seem to be dependent on renal innervation. In normal
      humans, the degree and duration of natriuresis and diuresis correlate with the
      dose of dihydropyridine derivatives and the extent of systemic pressure
      reduction. Clearance studies of normal subjects indicate an effect of different
      dihydropyridine derivatives on tubular fluid and electrolyte reabsorption.
      Nicardipine and nifedipine are reported to exert proximal tubular actions based
      either on urate and phosphate excretion or water and lithium clearance. The
      measurement of tubular indices following felodipine administration suggests a
      proximal tubular site of action.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614069
TI  - Renal effects of felodipine--a review.
AB  - Felodipine is a dihydropyridine calcium antagonist which lowers total peripheral
      resistance and blood pressure in doses which have no effect on cardiac conduction
      and contractility. It increases the urinary excretion of sodium and water due to
      decreased renal tubular reabsorption from the glomerular ultrafiltrate. This is
      observed at low doses which do not affect blood pressure, renal blood flow (RBF)
      or glomerular filtration rate (GFR). Felodipine decreases total renal vascular
      resistance and causes a transient increase in RBF in patients with normal RBF. In
      patients with low pretreatment values, RBF is increased during chronic treatment.
      Felodipine does not affect normal GFR. Thus filtration fraction may decrease. In
      patients with severe hypertension and reduced GFR, felodipine treatment results
      in good blood pressure control and increased GFR. In animal models of progressive
      renal disease due to hyperfiltration, felodipine has no negative effect on GFR,
      glomerulosclerosis or survival although proteinuria may increase. In salt
      sensitive rats given high salt diet, resulting in hypertension, hypoperfused
      kidneys and progressive renal damage, felodipine treatment results in reduced
      blood pressure, increased RBF and GFR, and reduced proteinuria and
      glomerulosclerosis. In patients with previously refractory hypertension and
      progressive impairment of renal function, felodipine treatment results in good
      blood pressure control and a reduced rate of progression. In animals, felodipine
      limits the extent of renal damage after ischemia and reperfusion.

PMID- 1614070
TI  - Progression of renal disease: current concepts and therapeutic approaches.
AB  - The pathogenesis of progressive renal disease includes systemic hypertension and
      intrarenal factors that may be hemodynamic or metabolic in origin and involve
      mediators of inflammation. Most current information derives from experiments in
      rodents. In other species (rabbit, dog, baboon) subjected to renal mass
      reduction, a greater variety of pathologic changes is apparent than in rats.
      Clinical trials at controlling progression of renal disease are compounded by
      numerous factors; and it is not evident that extrapolation can safely be made
      from results of animal studies to human disease. The mechanism(s) of renal
      disease progression in humans, therefore, remain largely unknown. Current
      therapeutic recommendations in patients with chronic renal disease include
      limitation of phosphorus absorption, correction of lipid abnormalities and
      control of systemic blood pressure. The latter can be achieved with a variety of
      agents some of which, like angiotensin converting enzyme inhibitors and calcium
      antagonists, may be preferred because of specific intrarenal effects.

PMID- 1614071
TI  - Calcium antagonists and the kidney: implications for renal protection.
AB  - During the past decade, attention has focused on the effects of calcium
      antagonists on renal function. When administered in vitro to the isolated
      perfused kidney, calcium antagonists exhibit consistent actions permitting
      characterization of their renal effects. Calcium antagonists do not affect the
      vasodilated isolated perfused kidney, but they do dramatically alter the response
      of this preparation to vasoconstrictor agents. Our recent studies using the
      isolated perfused hydronephrotic rat kidney model, which permits direct
      visualization of afferent and efferent arterioles, have demonstrated that the
      preferential augmentation of glomerular filtration rate observed in the isolated
      perfused kidney is attributable to preferential vasodilatation of preglomerular
      vessels. Although the clinical implications of such observations have not been
      fully delineated, the results of recent studies indicate that calcium antagonists
      exert salutary effects on renal function in patients with impaired renal
      hemodynamics. Such disorders include radiocontrast-induced nephrotoxicity and
      transplant-associated acute renal insufficiency. It is apparent, however, that
      the effects of calcium antagonists on renal blood flow commend their use in the
      management of essential hypertension.

PMID- 1614072
TI  - Hemodynamic comparisons of enalapril and felodipine and their combination.
AB  - Thirty-six patients (33 male, 3 female) with a mean age of 67 years and a
      diastolic blood pressure between 95 and 115 mm Hg, after a four-week placebo run
      in period entered a double-blind crossover study comparing felodipine 5 and 10 mg
      with enalapril 5 and 10 mg and their combination (enalapril 5 mg + felodipine 5
      mg). Combined therapy caused a fall in blood pressure of 24/16 mm Hg at trough
      level that was greater than the falls with the higher doses of monotherapy. The
      fall with felodipine was greater than with enalapril. Similar patients responded
      to felodipine and enalapril but more patients achieved blood pressure control
      with felodipine. When patients not controlled with enalapril 5 mg had felodipine
      5 mg or enalapril 5 mg added, felodipine was more effective at lowering blood
      pressure than the increase in enalapril dosage. A similar effect occurred in
      those not controlled with felodipine 5 mg. Adverse effects occurred in 22
      patients on felodipine, 14 patients on enalapril and 8 on combined therapy. The
      lipoprotein profile was not altered significantly. Glomerular filtration rates as
      assessed by 24-hour creatinine clearance were 90 ml/min at randomization, 125
      ml/min on felodipine, 108 ml/min on enalapril and 120 ml/min on the combination.
      Felodipine and enalapril in low doses are effective antihypertensive agents in
      elderly people. Felodipine monotherapy is more effective than enalapril
      monotherapy but a greater blood pressure lowering effect can be obtained with the
      combination of low doses of enalapril and felodipine. This has the advantage that
      the number of side effects is less.

PMID- 1614073
TI  - Glomerular hemodynamics in progressive renal disease.
AB  - A descriptive survey of renal hemodynamics in the major experimental models of
      progressive renal disorders (primary loss of renal tissue, primary glomerular
      injury and primary hypertension) is given. Although the pathogenesis in the
      different models differs in several respects, increases in glomerular capillary
      pressure and renal growth factors are important for the development of
      progressive renal disorders. In primary glomerular disorders, interstitial immune
      reactions seem to be critical. In glomerular nephritis with increased capillary
      wall thickness, the increase in glomerular capillary pressure may be of less
      importance than in other models. A third important factor for progression of
      renal disorders is a gradual breakdown of autoregulation of renal blood flow and
      glomerular filtration rate exposing the glomerulus to the variations in systemic
      blood pressure.

PMID- 1614074
TI  - Interaction between cyclosporine and felodipine in renal transplant recipients.
AB  - The nephrotoxic adverse effect of cyclosporine in renal transplantation may be
      counteracted by calcium antagonists. The effect of a single oral dose of 10 mg of
      the calcium antagonist felodipine or placebo was studied in ten cyclosporine
      treated renal transplant recipients before, during, and after an acute
      intravenous infusion of cyclosporine in a randomized, single-blind crossover
      study. Glomerular filtration rate, and renal plasma flow, and tubular function
      evaluated by the lithium clearance technique were determined. Both glomerular
      filtration rate, renal plasma flow, urinary sodium excretion, fractional
      excretion of sodium, and lithium clearance increased after felodipine, whereas
      proximal and distal fractional reabsorption and blood pressure were reduced.
      Intravenous infusion of cyclosporine per se did not influence any of the
      parameters. It is concluded that a single dose of felodipine in cyclosporine
      treated renal transplant recipients has beneficial effects on renal hemodynamics,
      tubular function and blood pressure. It is suggested that these effects result
      from a direct vasodilatation and an effect on tubular function, and that
      felodipine given intravenously seems to antagonize at least some of the
      nephrotoxic effects of cyclosporine.

PMID- 1614075
TI  - Evaluation of the efficacy of felodipine in two models of acute renal failure in
      dogs.
AB  - Acute renal failure was induced in pentobarbital anesthetized dogs either by
      withdrawal of the blood and/or by acute renal artery occlusion and efficacy of
      felodipine in preserving renal function was evaluated. In Wiggers' model of
      hemorrhagic shock, animals were allowed to bleed into a reservoir and after
      maintaining a hypotensive state (40-45 mm Hg) for 150 minutes, blood was
      reinfused and recovery in the renal function was evaluated. In a separate series,
      a renal artery was completely occluded for 45 minutes and after release of the
      occlusion recoveries in various markers of renal function were monitored.
      Felodipine 0.01 mumol/kg i.v. or the vehicle was administered ten minutes before
      hemorrhage or ten minutes prior to initiation of renal artery occlusion.
      Comparison of the data between the vehicle-treated dogs from the two models show
      that although renal blood flow (RBF) was restored to similar levels, recoveries
      in glomerular filtration rate (GFR), urine volume (UV), urinary excretion of
      sodium (UNa V) and potassium (UK V) were severely depressed in shock model (15 to
      25% of the basal value) and consistently lower than the recoveries in the renal
      artery occlusion model (30-50%). These data could suggest that the extent of
      renal impairment is more severe in hemorrhagic shock. Nevertheless, felodipine
      pretreatment provided significant protection to renal function from ischemic
      damage in both the models; the drug-treated groups were characterized by
      significant recoveries in GFR, UNa V and UK V (60-100%) and by prompt and full
      restoration of RBF and UV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614076
TI  - [Neonatal BCG vaccination: as a routine measure or only in special indications?].

PMID- 1614077
TI  - [Severe gastroenteritis after HiB preventive vaccination?].

PMID- 1614079
TI  - [Legal liability problems of the physician].

PMID- 1614078
TI  - [Simultaneous infection with Borrelia burgdorferi--FSME virus].

PMID- 1614080
TI  - [The physician as an accident witness: emergency treatment and the problem of
      failure to treat].
AB  - As a witness of an accident the physician has always the duty to render first
      aid. At least he has to examine carefully whether his help is not or no more
      necessary. On account of his professional abilities the duty to first aid may
      concern him as the only person also among several participants, and he must
      always care to take the best possible measures for the prevention of dangers. In
      the other case he exposes himself the danger of culpability for not having
      performed first aid. Apart from a penal verdict also the possibility of a verdict
      by a professional court of justice for the same offence can be added. In the
      process before the professional court of justice is examined, whether or not the
      physician failed in his professional duty to protect and restore health as well
      as to reduce complaints (section 1, number 2 MBO).

PMID- 1614081
TI  - [Mucoviscidosis in adulthood. An overview of the research on the psychosocial
      aspects].
AB  - Cystic fibrosis patients do have fairly improved life-expectancies today.
      Therefore, they are confronted with the obstacles and stresses of adult life. The
      author reviews studies concerning the following aspects of adult cf-patients:
      psychosocial functioning, separation from home, coping and compliance. Finally,
      beneficial modes of psychosocial interventions are discussed.

PMID- 1614082
TI  - [Homosexuality in childhood and adolescence].
AB  - Every second homosexual man has a presentiment of his own homosexuality during
      childhood. 86 percent of the homosexual men feel it till eighteen. The
      selfrecognition is a way full of conflicts between ignoration and acceptance;
      sometimes it ends in deformation of the personality or even in suicide. For well
      advice of homosexual children and adolescents we indicate: firstly an early
      sexual education in the school including information on homosexuality and
      secondly the academic and postgradual education of physicians, psychologists and
      pedagogues on natural variants of human sexuality.

PMID- 1614083
TI  - [Contribution to hypochondrogenesis].
AB  - Hypochondrogenesis is one of non-viable skeleton dysplasiae which recently has
      been delimited as an entity of its own and with its classification between
      spondylo-epiphysary dysplasia and achondrogenesis. An accurate differential
      diagnosis requires specialised histo-pathological investigations of the patient's
      cartilage tissue. Five new observations compared to a classical case of dysplasia
      spondylo-epiphysaria congenita are added to the references made in literature.

PMID- 1614084
TI  - [Role of the school in vaccination and prevention of infection].
AB  - 628 pupils from both the northern and southern parts of West Germany (Baden
      Wurttemberg, Bavaria, Lower Saxony, Schleswig-Holstein) were interviewed via an
      "infectious diseases" questionnaire: 44 questions dealt with vaccination
      (vaccination history, opinions of efficiency of different vaccines), 38 with
      problems concerning AIDS/HIV. The results indicated significant lack in the
      acceptance of most of the common immunisations. Improvement of AIDS/HIV
      information, especially on HIV-transmission and psychosocial, economical and
      political consequences seems to be necessary. Possibilities of future health
      education for pupils are discussed.

PMID- 1614085
TI  - [Corneal ulcer. Current analysis from specialized ambulatory care of a clinic].
AB  - A review of 115 cases of ulcerative keratitis that were diagnosed and treated at
      the specialized ambulatory care center for infectious eye diseases at the 2.
      Department of Ophthalmology over a period of eight years (January 1983-April
      1991) is presented. In the analysis of the etiology nearly half (47.7%) were
      observed following a trauma to the epithelium, 38 (= 33.0%) were associated with
      contact lens wear and the third largest group (10.4%) was associated with lid
      problems. It is apparent that over the course of the last years the spectrum of
      microorganisms associated with this localized inflammation has shifted: the
      prevalence of Staphylococci (1983-1986 = 65%) has decreased, whereas the
      incidence of gram-negative rods increased (1987-1990 = 49%). In 19% Pseudomonas
      aeruginosa could be isolated, mostly associated with soft contact lens wear. A
      total of 37.5% of the staphylococci isolates were found to be resistant to
      gentamicin, most probably as a consequence of the widespread, indiscriminate use
      of this antibiotic. An updated treatment schedule is presented.

PMID- 1614086
TI  - [Choroid melanoma. A retrospective randomized comparative study of ruthenium
      irradiation vs enucleation].
AB  - A randomized retrospective study concerning survival of Ruthenium treatment and
      enucleation in melanoma patients has been performed. For 112 patients from
      Hamburg who underwent Ruthenium therapy individual match partners were selected
      in Copenhagen where during the same period of time enucleation was the standard
      procedure. Selection took place concerning patient's age and sex at the time of
      treatment, initial tumor volume and the time of treatment. The present status of
      the patients was not known during the selection process. During the observation
      time of 12 years there was a survival rate after irradiation of 77.9% and after
      enucleation of 78.6%. Cox' regression disclosed a coefficient of 0.049 with a
      standard aviation of 0.293 and a P-value of 0.867. All parameters were showing no
      statistical difference between Ruthenium treated and enucleated patients. The
      survival rate in males was 69.2%, female patients 87.2%. For male patients there
      was a 2,4-fold higher risk to develop metastasis compared with female patients.
      Patient's age at the time of treatment correlated significantly with the
      prognosis. There was an increase in mortality risk by factor 1.4 per decade.

PMID- 1614087
TI  - [Value of corticosteroids in after-care of patients after cataract extraction and
      lens implantation].
AB  - In two double-blind controlled trials the anti-inflammatory effects of
      dexamethasone were examined in post-cataract extraction eyes after lens
      implantation in 321 patients. In the first trial, 103 patients were included. 49
      eyes received eye-drops with 0.1% dexamethasone and antibiotics, the control
      group of 54 eyes received the same antibiotics without any steroids. The follow
      up was 2 months. In the case of unexpected complications, the patients dropped
      out. This was the case in 48% of the steroid-group and in 79% of the control
      group. The main reason for this statistically significant difference were
      inflammatory complications in the control-group, which are difficult to quantify.
      The incidence of fibrinous reactions was not significantly different in the two
      groups, probably because of small numbers. In the second trial, we looked for
      fibrinous reactions. The follow-up was 3 weeks, 218 patients participated. They
      were divided into three groups: 71 patients received eyedrops with 0.1%
      dexamethasone 4x daily, 77 patients received the same drops 4x daily up to the
      fifth postoperative day, from then on 1x daily. 70 patients received the same
      drops 1x daily. A mild fibrinous reaction was seen in 10% of the high-dose-group,
      in 6% of the medium-dose-group and in 21% of the low-dose-group. Only the
      difference between the last two groups is statistically significant. We conclude
      that the therapy with corticosteroids after cataract extraction and lens
      implantation may be reduced early in the postoperative course.

PMID- 1614089
TI  - [Heterotopic fundus. An easily missed abnormality].
AB  - This study demonstrates 12 patients with "tilted disc syndrome" which includes an
      inferior conus and inversion of the optic disc, sectorial ectasia of the fundus,
      and refractive scotoma. Knowledge of the anomaly can help to prevent the patient
      from repeated neurologic and neuroradiologic examinations to exclude a cerebral
      tumor.

PMID- 1614088
TI  - [Epiretinal membrane formation after pars plana vitrectomy in proliferative
      diabetic retinopathy].
AB  - Recurrent epiretinal membranes are a major contributing factor to functional and
      visual failures after pars plana vitrectomy for proliferative vitreoretinal
      disorders. In this study 222 consecutive eyes that have had pars plana vitrectomy
      for proliferative diabetic retinopathy (operated in 1986 und 1987) were evaluated
      retrospectively. The study focuses on a subgroup of 108 consecutive eyes all with
      preoperative tractional retinal detachment and all operated with primary silicone
      oil injection. A minimum follow up of six months was present in 90% of these
      cases. Permanent visual success was observed in 40% of the eyes, most of which
      had dense vitreous hemorrhage preoperatively. Multivariant analysis revealed that
      among several potential risk factors recurrent epiretinal membranes as well as
      silicone oil were significantly associated with visual failure. Because of the
      high incidence of recurrent epiretinal membranes associated with poor functional
      results silicone oil injection following pars plana vitrectomy should be employed
      restrictively in patients with proliferative diabetic retinopathy.

PMID- 1614090
TI  - [Effect of histological criteria (TpNM classification, degree of differentiation)
      on mortality of patients with retinoblastoma].
AB  - 153 patients suffering from retinoblastoma and treated between 1960 and 1980 were
      analysed retrospectively. Median follow-up was 11.2 years. 13 patients (8.5%)
      died from retinoblastoma. 3 patients died from a secondary osteosarcoma. The
      survival rates from patients with differentiated retinoblastomas did not differ
      from those with undifferentiated tumor cells. Optic nerve invasion decreased
      significantly the survival rate and involvement of the sectional line led to a
      survival rate after 5 years of only 22.2%. Due to 3 cases of death from secondary
      osteosarcoma, the survival rate of 91.14% after 5 years deteriorated to 87.64%
      after 10 to 14 years.

PMID- 1614091
TI  - [Importance of standardized photos for planimetry].
AB  - In a series of 30 patients we compared the optic disc measurements. Disc
      photographs were either taken centric or excentric. Pictures with excentric discs
      showed significantly smaller measurements. However, the C/D-ratio demonstrated a
      good correlation (r = 0.95). For follow-up studies even not standardized photos
      can be useful, especially if the same examinator makes all the measurements.

PMID- 1614093
TI  - [Orbital teratoma--microsurgical therapy possibilities].
AB  - Microsurgical removal of a large congenital orbital teratoma is reported with
      successful preservation of visual function. The importance of interdisciplinary
      work-up including neuroradiology, ophthalmology, maxillo-facial surgery and
      histopathology is demonstrated. During the postoperative period closed follow-up
      to control refraction and to treat amblyopia is mandatory to gain optimal
      results.

PMID- 1614092
TI  - [Esthesioneuroblastoma with orbital invasion].
AB  - The authors report on an 83-years-old woman with esthesioneuroblastoma (ENB). The
      first clinical manifestation was an invasion of the suborbital and orbital
      region. ENB are local destructive tumours which seldom metastasize. Complete
      surgical excision, supplemented by irradiation therapy offers the highest cure
      rate. Relapses should be treated with individualized afterloading radiotherapy.

PMID- 1614094
TI  - [Metastatic eyelid tumors--description of clinical aspects and histology based on
      three cases].
AB  - Clinical findings and histology of secondary lid tumors are described by example
      of three cases. The rare lid metastases appear mainly in three different
      patterns. Except cytology, which depends on the primary tumor, their morphology
      is quite uniform. Lid metastases of a cutaneous melanoma, a contralateral uveal
      melanoma and, probably reported for the second time, a leiomyosarcoma are
      presented.

PMID- 1614095
TI  - [The Excimer laser. I. The Lucerne evaluation procedure for Excimer therapy].
AB  - The Excimer laser has been available for clinical applications in the Lucerne Eye
      Hospital since September 1990. Excimer laser keratectomy as a refractive therapy
      option is meeting with widespread interest among patients. As this is an invasive
      method whose complications cannot be neglected and for which long-term experience
      is so far lacking, this interest has to be balanced by extremely strict and
      responsible diagnosis by those offering the therapy. The authors present their
      evaluation concept here. The figures below document the reticence exercised in
      diagnosis: 1100 information leaflets dispatched are contrasted in the final
      analysis with only 34 laser treatments in a period of 10 months. 50 of the 200
      patients admitted (referred by specialists) for preliminary examinations were
      definitively excluded from treatment in Lucerne as early as the administrative
      stage, and 61 during the clinical evaluation proper.

PMID- 1614096
TI  - [The Excimer laser. II. Initial experiences with the Excimer laser in Lucerne].
AB  - In the period between September 1990 and July 1991, 35 patients (46 eyes) were
      treated with the Excimer Laser. In 25 patients (34 eyes), a Myopia-Laser-Shaping
      was performed, one patient was treated for both myopia and astigmatism. In eight
      patients (10 eyes) correction of astigmatism was carried out. Two patients with
      recurrent erosions and one patient with superficial scarring of the cornea were
      treated. The authors review their initial experience with the Excimer Laser. The
      decision to initiate treatment must not be undertaken lightly, because the
      possibility of serious complications may not be neglected. This method shows
      promise in selected patients with light to medium degrees of myopia. In cases of
      severe myopia, our experience is encouraging. Subjectively, the patients are
      satisfied with the results, which do not fall short of their expectations.
      Further research and clinical experience in this area is urgently required.

PMID- 1614097
TI  - [Autoregulation in the choroid].
AB  - The cerebral perfusion is continuously and highly sensitively dependent on
      arterial pCO2. Does the ocular perfusion behave in a similar manner? To answer
      this question, the authors measured the following parameters before and after the
      inhalation of 10% CO2: a) the increase of capillary pCO2, using a transcutaneous
      sensor, and b) the redness (pallor) of the retinal tissue, an expression of its
      hemoglobin content, was measured at two retinal locations with the Ocular
      Photometer (OPM). Initial results from young test-volunteers and patients with
      documented carotis stenoses show that the choroid is able to maintain constant
      its blood-volume even under changing loads.

PMID- 1614098
TI  - [Familial occlusion of central veins associated with type II familial
      hyperlipoproteinemia].
AB  - We report, for the first time to the best of our knowledge, about a family in
      which 3 members (two of which were under 40 years of age) of two successive
      generations presented central retinal vein occlusions in relation to a type II
      hyperlipoproteinaemia. On the basis of the reported cases, it can be postulated
      that hyperlipoproteinaemia seems to be a serious potential risk factor for
      central retinal vein occlusion. The particular aspects of central vein occlusion
      in relation to hyperlipoproteinaemia are the elevated frequency of recurrences,
      the poor visual prognosis secondary to severity of veinous obstruction, and the
      increased incidence of these occlusions in younger patients. The discovery of a
      hyperlipoproteinaemia in young patients with central retinal vein occlusion
      should therefore incite prompt examination of other family members in order to
      initiate prophylactic hypolipaemic treatment.

PMID- 1614099
TI  - [Systemic corticosteroid therapy in non-arteritic anterior ischemic optic
      neuropathy].
AB  - A non-arteritic anterior ischemic optic neuropathy has usually a poor prognosis.
      Spontaneous remissions are extremely rare. In contrast to arteritic anterior
      ischemic neuropathy, systemic corticosteroids are generally accepted to be
      ineffective. Two cases of bilateral severe non-arteritic anterior ischemic optic
      neuropathy are reported who underwent full remission of their visual function
      directly related to high-dose systemic corticosteroids. It is hypothesized that,
      in acute phases of non-arteritic anterior ischemic optic neuropathy a significant
      reduction of tissue swelling and consecutive prelaminar reperfusion can be
      achieved with high-dose corticosteroids.

PMID- 1614100
TI  - [Anti-inflammatory effect of topical diclofenac sodium (Voltarene Ophta) after
      argon laser trabeculoplasty: preliminary results of a prospective double-blind
      method].
AB  - Using the laser flare-cell meter (LFMC), we have previously determined the
      intensity and pattern of post-ALT ocular inflammation. Inflammation peak occurs
      48 hours after ALT and clinically relevant inflammation is seen in 100% of
      pigmentary glaucomas (PIG), 75% of pseudoexfoliative glaucomas (PEXG) but only in
      25% of primary open angle glaucomas (POAG). We also showed that topical
      diclofenac reduced inflammation in all 17 treated patients. Prostaglandins are
      thought to play a major role in ALT-inflammation and it is therefore logical to
      assume that NSAID are effective in that situation and will probably
      advantageously replace corticosteroids. In order to assess the anti-inflammatory
      effect of diclofenac drops (Voltaren Ophtha) we included a total of 37 PIG or
      PEXG (19 in the diclofenac and 18 in the placebo group) scheduled for ALT in
      prospective randomized placebo-controlled study. Visual acuity, tonometry, and
      LFCM flare measure were performed before, 3, 6 hours, 1, 2, 4, 7, 14 days after
      ALT. Topical diclofenac or placebo was given before and after ALT and then QID
      for a total of 4 days. Mean maximal flare increase was significantly less in the
      diclofenac group than in the placebo group (4.6 +/- 3.8 ph/msec v. 17.4 +/- 19
      ph/msec; p less than 0.01). Flare increase compared to pre-ALT values was
      significant at 1 and 2 days after ALT in the placebo group only (p less than
      0.02; p less than 0.05); no significant flare increase occurred in the diclofenac
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614101
TI  - [Diclofenac-dexamethasone combination in treatment of postoperative inflammation:
      prospective double-blind study].
AB  - In a prospective randomized double masked study including 40 patients we
      evaluated the anti-inflammatory effect of a combination of dexamethasone acetate
      0.1% + diclofenac 0.1% drops compared to dexamethasone acetate 0.1% + placebo
      drops, after ECCE + posterior chamber lens implantation. Anterior chamber (AC)
      flare and cells were measured with the laser flare-cell meter Kowa FC-1000. The
      group receiving the dexamethasone-diclofenac combination showed a more rapid
      decrease of AC flare which was significant at days D3 (P less than 0.003) and D12
      (p less than 0.028). The reduction of AC cells was comparable in both groups,
      showing however a strong tendency toward a lower cell count in the group
      receiving diclofenac at days D12 and D30 (p less than 0.08). Tolerance of
      diclofenac was good and comparable to the placebo.

PMID- 1614102
TI  - [Differential treatment of postoperative and uveitis-induced inflammatory cystoid
      macular edema].
AB  - Twenty-five eyes (23 patients) with inflammatory cystoid macular edema (CME) (11
      after cataract surgery and 14 eyes (12 patients) with uveitis) were followed in a
      prospective open study. The aim was to determine the efficiency of a combined
      treatment of Diamox (acetazolamide), Voltaren Ophtha (diclofenac, a NSAID) and
      Ultracortenol (prednisolone acetate) and in the case of treatment failure, the
      usefulness of posterior subtenon's injections of corticosteroids (Kenacort 40 mg
      (triamcinolone)). Seven eyes (all pseudophakic CMEs) responded successfully to
      the initial therapy. Their mean visual acuity improved from 0.31 +/- 0.13 to 0.93
      +/- 0.08 after 18 +/- 5 days (p less than or equal to 0.001). Of the sixteen of
      18 evaluable eyes that were additionally treated with a mean of 3.28 +/- 1.07
      three-weekly posterior subtenon's injections, 15 eyes including all uveitis CME
      responded to treatment. Their mean visual acuity improved from 0.49 +/- 0.20 to
      0.96 +/- 0.31 (p less than or equal to 0.001). Two patients were excluded; in
      22/23 eyes the sequential treatment was successful with an overall success rate
      of 95% of cases (improvement of five lines on the Snellen chart or final visual
      acuity of 0.8 or better). Initial angiographic cystoid macular edema was
      comparable and significantly improved after therapy in the two treatment groups.
      No mean intraocular pressure rise was noted after steroid injections. Measurement
      of anterior chamber inflammation with the laser flare-cell meter (Kowa FC-1000)
      showed elevated flare in all cases which significantly decreased in both
      treatment groups and represented a good follow-up parameter for the effect of
      antiinflammatory treatment and restoration of blood-ocular barrier.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1614103
TI  - [Perimetry findings before and after surgical removal of epimacular membranes].
AB  - The visual acuity and the central visual field (Octopus program M1) were analyzed
      before and after peeling of epimacular membranes (EMM) in 18 eyes. The EMM were
      classified according to their etiology as idiopathic, secondary nonvascular and
      secondary vascular. A large variability of initial visual field indices was found
      pre- and postoperatively (table 1). The least functional improvement was found
      following peeling of EMM with a history of more than 12 months as well as of
      idiopathic EMM with an initial mean defect (MD) of greater than 3 dB (fig. 8 und
      9). The best success rate was achieved for eyes with idiopathic EMM and MD less
      than or equal to 3 dB and for eyes with secondary nonvascular EMM (fig. 6 and 7).
      The visual acuity but not the MD improved postoperatively in the 3 eyes with
      vascular EMM which had developed after a retinal vascular branch occlusion.

PMID- 1614104
TI  - [Chronic uveitis: course after vitrectomy].
AB  - Vitrectomy is an acknowledged method in the therapy of chronic uveitis and its
      complications. We analysed the functional results after vitrectomy of 106
      patients (121 eyes). In more than 61% of the patients, the visual acuity improved
      more than one line. There is less glare, and stereoscopic vision is better. In
      10% of the patients, the follow-up was complicated by a retinal detachment; in
      contrast, a primary retinal detachment was the indication for the vitrectomy in
      19%. Our study shows that vitrectomy helps reducing the frequency of recurrence
      of uveitis and the intensity of drug therapy.

PMID- 1614105
TI  - [Uveitis complicating posterior segment neovascularization. Six cases].
AB  - Subretinal or preretinal neovascularisation may be occasionally observed during
      the evolution of certain forms of uveitis. Subretinal neovascularisation commonly
      begins at the level of the chorioretinal uveitic scars. Consequently, the
      alteration of the retinal pigment epithelium-Bruch's membrane-choriocapillaris
      complex is the apparent cause. Laser photocoagulation of the neovascular front,
      when indicated, is the treatment of choice. In contrast, preretinal
      neovascularisation is observed at the active stage of uveitis. Fluorescein
      angiography findings suggest that it is probably correlated with the importance
      of inflammation since in most of the cases there is no retinal ischemia.
      Therefore, in order to obtain a regression of the neovascular tufts the treatment
      should be directed against the inflammatory process. In this study the authors
      report five cases of subretinal neovascularisation which developed at the level
      of chorioretinal post-inflammatory scars and one case of papillary
      neovascularisation which occurred during the active stage of an unilateral
      intermediate uveitis and in which new vessels regressed completely following
      systemic steroid treatment.

PMID- 1614106
TI  - [Treatment of recurrent corneal erosion by puncture of Bowman's membrane].
AB  - 16 patients (18 eyes) with a recurrent corneal erosion have been treated with
      anterior stromal punctures. The pain disappeared in 15 patients and remained
      unchanged for one patient. No recurrence was observed over a 18 months follow-up
      period (maximum 39 months) and no patient was complaining of glare. The technique
      is simple, effective, cheap and easily performed without special instrumentation.

PMID- 1614107
TI  - [The fate of corneal transplants from the Zurich eye bank].
AB  - In a retrospective study, we investigated the survival of transplanted corneal
      material, which had been sent between 1988 and 1989 from the Zurich Eye Bank to
      both domestic and foreign physicians and clinics. A questionnaire was used to
      determine diagnosis, transplant survival, cause of any opacification, the
      occurrence of problems of epithelialisation, loosening of sutures, as well as
      vascularization of the host cornea. Of a total of 416 corneas, 327 or 79% could
      be evaluated. The mean follow-up periods of the various diagnostic groups ranged
      from 11 to 20 months, with a range of 1 to 35 months. After 18 months, the rate
      of clear transplants was 96% in the keratokonus group. This rate was
      significantly better than that of the bullous keratopathy group (77%, p less than
      0.013) or that of all other diagnosis groups (72%, p less than 0.001). The
      difference to the 81% survival rate of the group with Fuchs' endothelial
      dystrophy was not significant. The most frequent cause of transplant
      opacification was primary transplant failure. Analysis of possible risk factors
      further confirmed that transplant opacification occurs more frequent in the
      presence of vascularization of the host cornea.

PMID- 1614108
TI  - [Prerequisites for the use of preserved donor tissue in perforating and lamellar
      keratoplasty].
AB  - The longterm tissue culture is performed at the University Eye-Hospital of
      Hamburg since 1985 with a standardized procedure. The number of donor material
      and operations in the first 7 months of 1991 are reported. Preparation, storing
      and HLA-typing of the tissue are considered. The technical working up of the
      stored tissue for penetrating and lamellar keratoplasties will be explained.

PMID- 1614109
TI  - [Short and long-term advantages and disadvantages of prolene monofilament sutures
      in penetrating keratoplasty].
AB  - The authors have studied the short and long-term advantages and inconveniences of
      Prolene monofilament sutures employed in perforating keratoplastic surgery.
      Contrary to Nylon, Prolene has the advantage of no structural or tensional
      modifications, postoperative measurements of corneal astigmatism thus remaining
      more stable with the time. Accordingly, where very little or no astigmatism is
      noted, the slight or no change in corneal refraction with time is an obvious
      advantage ot the patient. However, the use of Prolene in the beginning can cause
      some problems with continuous suture tension, either excessive or insufficient,
      which can result in serious complications. With training, these difficulties can
      be overcome and excellent results obtained.

PMID- 1614110
TI  - [Long-term results of congenital glaucoma microsurgery--retrospective study].
AB  - Medium and long term results of trabeculotomy and goniotomy operations for
      primary congenital glaucomas treated in Lausanne between 1965 and 1990 were
      studied retrospectively. Parameters evaluated were intraocular pressure (IOP) and
      final visual acuity (VA). Data on IOP were available for 38 eyes. 66% underwent
      trabeculotomy and/or goniotomy (first group) the others needed further surgical
      or medical treatment (second group). IOP was equal or inferior to 19 mmHg in 88%
      of the first group and 62% of the second group at the end of the study (mean
      follow-up 13.1 years). Data on VA were available for 32 eyes. In the first group,
      65% showed a VA of more than 0.5 compared to 33% for the second group. Therefore,
      we can consider trabeculotomy and goniotomy as early operations as advisable in
      first intention treatment of primary congenital glaucoma.

PMID- 1614111
TI  - [Comparison of the effects of trabeculoplasty using the Nd-YAG laser and the
      argon laser].
AB  - We compared the effect of Argon Laser trabeculoplasty (ALT) and Nd-YAG-Laser
      trabeculoplasty (YLT) on inflammation and intraocular pressure (IOP). Twenty-two
      patients scheduled for bilateral trabeculoplasty were treated with an Argon laser
      in one eye and with Nd-YAG laser in the controlateral eye. Visual acuity, IOP and
      anterior chamber inflammation (measured with the laser flare-cell meter) were
      controlled at 0, 3, 6, 18 hours, 2, 4, 7, 14, 30, 90 and 180 days after
      trabeculoplasty. Our results showed a similar pressure lowering effect in both
      groups (-24.5 +/- 23% after YLT versus -32.9 +/- 16.3% after ALT at 90 days post
      laser; p = 0.26). The anterior chamber inflammation was delayed and more
      important in the ALT-group (inflammation peaked at 24.8 hours after YLT versus
      44.5 hours after ALT; p = 0.034) (maximal mean flare increase: 19.4 +/- 12
      pH/msec. after ALT, versus 16.1 +/- 11.4 ph/msec. after YLT). All eyes with
      inflammation were successfully treated with topical diclofenac QID (Voltaren
      Ophtha), a nonsteroidal anti-inflammatory agent. YLT is a safe and effective
      alternative technique to perform laser trabeculoplasty, which is especially
      useful in poorly pigmented angles where ALT is known to be less effective.

PMID- 1614112
TI  - [Effect of naftidrofuryl (Praxilene) in primary open angle glaucoma: prospective
      double-blind study].
AB  - The positive effect of Naftidrofuryl (Praxilene), a specific serotonine-S2
      receptor antagonist, has already been described in the treatment of normal
      pressure glaucoma. Despite the fact that in POAG intraocular pressure (IOP) is
      the primary ethiopathogenic mechanism, vascular factors could also influence the
      progression of the disease, especially in old patients with cardiovascular risk
      factors. We have studied the effect of Naftidrofuryl versus placebo in a
      randomised double-blind study on 42 POAG patients. Visual acuity, IOP, Visual
      field (Octopus program G1), Arterial pressure, Plasma viscosity have been
      recorded at 0, 12 and 24 weeks. Our results showed no difference between the
      Naftidrofuryl and the Placebo group for each studied parameter except a decrease
      of CLV at 12 weeks in the Naftidrofuryl group (p = 0.012). This suggests that
      Naftidrofuryl is not as effective in POAG as it is in normal tension glaucoma.
      Other studies with a greater patient - collective and the use of other vasoactive
      substances will be necessary in the future.

PMID- 1614113
TI  - [Comparison of five methods for subjective assessment of ocular cyclodeviation].
AB  - METHODS: 1. simple Maddox rod (Franceschetti) 2. set of scaled large diameter
      Maddox rods 3. synoptophore 4. synoptometer (Cuppers) 5. dark red glass in front
      of the Harms tangent scale (Kolling). Whereas the first two methods allow to
      measure in primary position only, the other three also permit secondary and
      tertiary position measurements. Thirty normal subjects underwent comparative
      measurements by means of the above techniques in monocular and binocular
      condition. The median values indicate that all these methods are reliable but
      that certain specific differences influence the results. For this reason, pre-
      and postoperative measurements of ocular torsion should always be performed by
      the same method. The most appropriate techniques have shown to be: the set of
      scaled Maddox rods for measurements in primary position only, the dark red glass
      in front of the Harms tangent screen for measuring also in secondary and tertiary
      positions.

PMID- 1614114
TI  - [Length-tension measurement of oblique eye muscles in strabismus operations for
      differentiating trochlear paralysis and strabismus sursoadductorius].
AB  - In a group of patients with a motility typical of a superior oblique palsy (a
      hypertropia increasing in adduction, in down-gaze and on head-tilt, a V-pattern
      and an excyclotropia), we recorded length-tension diagrams of oblique eye muscles
      during strabismus surgery. In 14 cases a length-tension recording was made during
      surgery in general anaesthesia, before and after intravenous administration of
      succinylcholine, that produces a fierce contraction of eye muscles. Among 14
      patients that had eye motilities compatible with a superior oblique muscle palsy,
      7 indeed had a non-contracting superior oblique muscle, but others had oblique
      muscles that contracted vividly. We also made length-tension diagrams of oblique
      eye muscles during strabismus surgery with local, tetracain eye-drop anaesthesia.
      Here, the recording was made three times, while the patient looked ahead, into
      the field of action of the muscle and out of the field of action of the muscle.
      Some patients indeed had a non-contracting superior oblique muscle and a stiff
      inferior oblique muscle, but others had superior oblique muscles that contracted
      vividly, despite an eye motility typical of a superior oblique palsy, with a
      positive Bielschowsky head-tilt test. This finding confirms the assumption of
      Kaufmann, Kolling and others that these cases have a non-paretic motility
      disorder. Viirre et al. found in normal monkeys that disruption of fusion by one
      week of occlusion of one eye allowed abberrations of conjugate horizontal and
      vertical eye movement like upshoot-in-adduction to become manifest.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1614115
TI  - [Strabismus induced by peripheral vestibular lesions].
AB  - Little attention has been paid in the ophthalmological literature to strabismus
      resulting from lesions located in the peripheral vestibular system. However, this
      phenomenon is commonly encountered in clinical practice. As a rule, this kind of
      strabismus shows a prominent vertical component. It is generally combined with a
      change in perception of verticality, conjugate cyclotorsion of the eyes, and head
      tilt. This association is known as "ocular tilt reaction". It occurs in a number
      of clinical settings which are believed to be related with alteration in the
      otolithical and/or vertical semicircular canal pathways. Strabismus occurring as
      a feature of ocular tilt reaction might result from different mechanisms
      according to the location of the lesion, e.g. in the utricles, in the midbrain
      tegmentum, and in the dorso-lateral medulla oblongata. This phenomenon is
      illustrated here with the report of a patient suffering from Meniere disease, who
      underwent selective vestibular neurectomy. Methods of ophthalmological evaluation
      in such cases is described.

PMID- 1614116
TI  - [Review of 114 cases of malignant tumors of the eyelids treated surgically].
AB  - The results of the surgical treatment of 114 malignant eyelid tumors, performed
      by one surgeon, are reported. The localization, histology and evolution of the
      tumors, and the significance of surgery in treatment of these lesions, are
      discussed.

PMID- 1614117
TI  - [Orbitoplasty in patients with artificial eyes].
AB  - The typical signs of the postenucleation socket syndrome consist of enopthalmos,
      shallow lower fornix, lower lid laxity and entropion, and ptosis. It causes
      discomfort and can render the bearing of a prosthesis uncomfortable or
      impossible. The signs must be corrected in single or combined procedures. The
      lower fornix and the lids can be corrected with good success, enophthalmos is
      difficult to correct, however.

PMID- 1614118
TI  - [Uveal melanomas in patients less than 20 years of age].
AB  - During the past 15 years we observed 21 uveal tumors in patients aged 20 years
      and younger. Four of them were younger than 10 years, 4 were 11 to 15 years' old,
      4 ranged from 16-17 years and 9 from 18-20 years. An accelerated beam irradiation
      was applied in 11 cases, a surgical excision was carried out in 4 cases, and a 60
      CO-applicator used for 3 patients. Three enucleations were carried out straight
      away. In this study we present the clinical characteristics of melanomas of young
      people, the therapy used, as well as the systematic analysis of the vital
      prognosis of the patients and of the functional prognosis of the eyes under
      treatment.

PMID- 1614119
TI  - [Retinoma and phtisis bulbi: benign expression of retinoblastoma].
AB  - Systematic investigation of families of children suffering from retinoblastoma
      reveals more and more cases of retinoma or phthisis bulbi, cases which used to be
      called "spontaneous regression". Between 1975 and 1991, we have in this way
      discovered 11 cases (7%) certain to be carrying retinoma or phthisis bulbi, and a
      further 5 cases where the same diagnosis is highly probable. Of the 11 certain
      cases, 5 are unilateral, 6 bilateral, and 8 present family history of the
      disease. Of the total number of 17 eyes, 16 present retinoma, 1 phthisis bulbi.
      On clinical examination, all (100%) showed characteristic lesions in the form of
      greyish homogenous elevated masses in the vitreous cavity. 11 presented
      calcifications (69%) and in 14 disturbance of the pigment epithelium occurred
      (87%). The average follow-up is 4 years. Of the 11 patients, 8 are of procreating
      age and have up to now 25 offsprings. Amongst these, 15 have retinoblastoma
      (60%), 2 retinoma and phthisis bulbi (8%). All except one of the retinoblastoma
      cases are bilateral. This study would appear to show that retinoma occurs with a
      higher frequency than that which is usually given. The figures show clearly that
      retinoblastoma and retinoma derive from the same genetic disturbances, possibly
      at different times during cell maturation, and consequently require the same
      investigation and follow-up.

PMID- 1614120
TI  - [Discrete media clouding and its effect of contrast transfer coefficients, the
      pattern ERG and contrast sensitivity].
AB  - As a model for our study we selected 11 pseudophacic patients with secondary
      cataracts who experienced good postoperative visual acuity after extracapsular
      cataract extraction. Besides best visual acuity and contrast sensitivity Pattern
      ERG (PERG) and Contrast-Transfer-Ratio (CTR) were measured before and after YAG
      Kapsulotomy was performed. Visual acuity and contrast sensitivity increased in
      all patients after treatment, whereas CTR increased in eight patients. PERG was
      measured in five patients, in two cases its amplitudes were higher, the other
      measurements revealed unchanged or lower amplitudes. Our model shows that in
      addition to the usual psychophysic tests, with CTR and PERG there are objective
      methods available to measure discrete opacities of the visual system.

PMID- 1614121
TI  - [Phacoemulsification: technical initiation at what price?].
AB  - Phacoemulsification of the cataract is perhaps technically superior which is
      considered "classic". This technic consists however of a number of difficulties
      that may be mastered during an apprentiship. Considerable complications may arise
      during this initiation periods; imposing this surgical method on patients is thus
      an ethical problem. If the risks encountered during the apprentiship of
      phacoemulsification appear comparable to those during the classic extracapsular
      technique, phacoemulsification may be recommended with less reservation. We have
      compared 250 initial cases of classic extracapsular extraction with 250 "initial
      cases" of phacoemulsification, taking into account operative and post-operative
      complications and final functional results.

PMID- 1614122
TI  - [Pars plana lensectomy in pediatric cataract].
AB  - The pars plana approach to cataract extraction in the pediatric age has several
      advantages. We report of 9 eyes with congenital cataract and discuss the
      advantages of the pars plana technic. In all cases a single surgical approach was
      sufficient. There were no complications postoperatively which made either
      surgical or medical treatment necessary. Postoperatively aphakia was corrected
      with contact lenses. During pars plana-lensectomie the central part of the
      anterior and posterior capsule is removed and an anterior vitrectomie is
      performed. With this procedure secondary cataract formation could always be
      prevented.

PMID- 1614123
TI  - [Results of conventional detachment surgery. I. Study planning, patients and
      vision results].
AB  - A consecutive series of patients with retinal detachment were examined. All
      patients were treated primarily with buckling procedure. Patients with
      redetachment, bilateral detachment, vitrectomy or history of strabismus or
      amblyopia were excluded. Of these 155 patients, 117 could be examined. 97% of
      patients without macula detachment are able to keep or improve their visual
      acuity. 85% of those patients with macula detachment showed an improvement of
      visual acuity. The most important prognostic factor for the visual outcome is the
      duration of macula detachment. In cases of more than four days duration a visual
      acuity of 20/40 or more could not be expected.

PMID- 1614124
TI  - [Results of conventional retinal detachment surgery. II. Changes in refraction].
AB  - In a comparative study we examined the refractive changes in 117 patients
      following conventional buckling retinal detachment surgery. Of these, 54 had a
      segmental scleral buckle, 18, an encircling buckle, and 45, a combination of both
      methods. Comprising about 2D, the changes in spherical equivalent were most
      marked in the patients who had combined operations. A correlation exists between
      buckle height and extent of refractive change (p = 0.0297).

PMID- 1614125
TI  - [Results of conventional retinal detachment surgery. III. Orthoptic results].
AB  - In a comparative study we examined orthoptic side effects in 117 patients
      following conventional retinal detachment surgery. Of these, 54 had had a
      segmental scleral buckle, 18 a simple encircling band and 45 encircling band
      combined with a radial buckle. Persistent diplopia was found in 6% of cases
      following segmental buckles, in 11% following simple encircling procedures and in
      20% following combined operations with encircling bands and segmental buckles.
      The incidence of diplopia was more than 30% in cases with high encircling
      buckles.

PMID- 1614126
TI  - [Peeling of epiretinal macular membranes. Results and conclusions of the Geneva
      Clinic].
AB  - Epiretinal macular membranes can cause a lowering of visual acuity and may even
      lead to a total loss of foveal function in the absence of surgical procedure. The
      only surgical treatment is vitreo-retinal surgery with peeling of the membrane.
      In Geneva, we studied 23 patients, all of whom were operated for epiretinal
      membrane even though visual acuity was greater as 0.2, 10 membranes were
      idiopathic et 13 secondary. Six patients from this second group had recently
      undergone cataract surgery. The results were good: 83% of the patients showed an
      improvement in post-operative visual acuity and 60% gained 2 or more lines on the
      Snellen scale. The main factors for prognosis were preoperative macular cystoid
      edema and duration before surgery. The principal post-operative complication
      encountered was a secondary opacification of the lens with, to a lesser extent,
      cystoid edema of the macula.

PMID- 1614127
TI  - [Pars plana vitrectomy in uveitis].
AB  - A vitrectomy was performed in 30 eyes suffering from different forms of uveitis.
      An improvement of visual acuity was obtained in 29 cases and was explained by
      removal of vitreous haze and/or of the cataract, but not by the improvement of
      the inflammatory process.

PMID- 1614128
TI  - [Vitrectomy in Terson syndrome. Report of 18 cases].
AB  - A vitrectomy was performed in 18 eyes (15 patients) with vitreous hemorrhages due
      to Terson's syndrome. The average age of the patients was 46.5 +/- 14.4 years.
      The mean interval between the acute event of an intracranial hemorrhage and the
      vitrectomy was 6.8 +/- 4.9 months. The vitreous hemorrhage was associated with
      epiretinal membranes in 3, PVR in 2, and retinal breaks and/or rhegmatogenous
      retinal detachment in 3 eyes. The vitrectomy had to be combined with membrane
      peeling in 2, encircling procedures or exoplants in 4, cryotherapy in 5,
      endolaser in 1, and air/SF6 gas filling in 3 eyes. A missing or incomplete
      posterior vitreous detachment in 8 eyes was associated with a higher risk of PVR
      and retinal detachment. Two eyes with this condition needed 3 secondary
      operations. The mean follow-up duration was 32 (1 to 126) months. Two patients
      died 4 and 11 months after the operation. The visual acuity improved
      significantly following vitrectomy in all 18 eyes. The final visual acuity was
      better than 20/40 in 73% and 20/25 to 20/20 in 56%. The initial postoperative
      visual acuity decreased later on due to nuclear cataract in 7 of 10 eyes of
      patients over 45 years of age. A complicated cataract developed in only 1 of 8
      eyes of younger patients who maintained a mean visual acuity of 20/25. Vitrectomy
      for Terson's syndrome is recommended in bilateral cases without spontaneous
      clearing of the vitreous within 3 months, as well as in cases with PVR and
      imminent retinal detachment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614129
TI  - [Unilateral eyebrow suspension in severe unilateral congenital ptosis].
AB  - The result of unilateral brow suspension in severe unilateral ptosis is said to
      be cosmetically and functionally not satisfactory. For the reason of symmetry,
      the myectomy of the levator muscle on the healthy side and the bilateral brow
      suspension have been recommended (Beard's law). However, we have successfully
      operated the affected side only in several patients without this far-reaching
      supplement.

PMID- 1614130
TI  - ["Blow-out" orbital trauma and diplopia. Conservative or surgical approach?].
AB  - The treatment of orbital fractures, type blow-out, has always been discussed
      about. One hundred-twenty patients, subdivided in four groups were examined.
      Incarceration of the peri-muscular structures or not. Surgical or conservative
      treatment. These four groups have been studied with the purpose of establishing a
      treatment plan, which implicated the different time of healing up to a complete
      and functional recovery. Our purpose is to explain why we suggest a conservative
      attitude and the necessity of proceeding with radiological screening along with
      an examination of the binocular eyesight.

PMID- 1614131
TI  - [Modification of the visual field during temporary interruption of miotic
      treatment].
AB  - The visual field of 27 eyes with chronic open angle glaucoma was examined with
      the "Octopus 1-2-3" automatic perimeter. The visual fields with and without
      miotics were compared using the "mean defect" (MD) as parameter. The MD decreases
      significatively (p = 0.003) after interruption of the miotic treatment. As
      presumed, the IOP and the pupillary diameter increased significantly (p less than
      0.001). The CLV insignificatively decreased. The short term modifications of the
      pupillary diameter seem to be a more important factor than this of IOP.

PMID- 1614132
TI  - [Unexpected changes in the vitreous body after posterior detachment].
AB  - After changing the position of the eye, intravitreal structures demonstrate a
      gravitary position at rest. As an exception the detached vitreous shows an
      irreversible position at rest. The vitreous tractions on retinal adhesions are
      therefore irregular. This could explain the asymmetric distribution of retinal
      tears and has to be considered for the operation techniques.

PMID- 1614133
TI  - [Regeneration of the optic nerve of Xenopus laevis after argon laser injury].
AB  - Following mechanical lesion of the optic nerve (ON), lower vertebrates are
      capable of regeneration of the ON and regain visual function. We have studied, by
      light and electron microscopy, regeneration of the larval ON of Xenopus laevis
      after treatment with the argon laser. The laser energy is absorbed by the
      neurothelial pigment and provokes a burned crater and vesiculation in the
      interior of the ON. In contrast to the mechanically induced process, axons
      regenerate, after laser treatment, within the nerve and do not sprout into the
      neighboring tissue. The regenerating ON is not vascularized. Immediately after
      laser treatment, a loss of myelin, hypertrophy, phagocytic activity, and local
      rearrangement of glial cells are observed. After four weeks, myelination is still
      irregular. Glial cells have regained their normal aspect.

PMID- 1614134
TI  - [Sources of error in planimetry of the optic nerve].
AB  - No matter how "sophisticated" they may seem to have become, contemporary methods
      for bioplanimetry of the optic disc vary in precision; easily overlooked or
      neglected optical influences must, indeed, be taken into consideration; and, of
      greatest detriment to the meaningfulness of any and all such results is the fact
      that even "experts" have difficulty in uniformly and reproducibly indicating
      where the boundaries of the optic disc and its excavation actually lie.

PMID- 1614135
TI  - [Degeneration of retinal cells of the rat in pressure-induced ischemia
      reperfusion damage: an electron microscopy study].
AB  - An ischaemia-reperfusion insult to the retina was produced in one eye of 29 rats
      by transitory elevation of the intraocular pressure. The ultrastructural
      morphology of the degenerating retinal cells was studied at several time points
      after the insult. Three morphologically distinct types of cell death could be
      individualized. Type I exhibited progressive karyolysis and cytolysis and was
      consistent with necrosis. Type II was characterized by progressive shrinkage and
      condensation of the nucleus and cytoplasm followed by heterophagic elimination,
      thus resembling apoptosis. The main features of type III cell death were
      homogenization of the nucleoplasm and cytoplasm and dilatation of the perinuclear
      cisternae; thus, they were evocative of "non-lysosomal vesiculate" cell death.
      Transitional stages were observed as well.

PMID- 1614136
TI  - [Profile of pO2. I. Profile of transretinal pO2 in hypoxia].
AB  - Transretinal PO2 measurements during systemic hypoxia, made during variations of
      the PO2 by steps of 10 mmHg between 120 and 30 mmHg, have shown that the PO2
      values measured at the inner-retina up to half the thickness of the retina
      remained stable. On the other hand, those measured at the choroid and at the
      outer-retina decreased in a linear manner according to the variations of PaO2.
      These results suggest a regulation in the retinal blood flow, allowing the PO2 to
      remain stable for the different steps of hypoxia studied. On the other hand, the
      values measured at the choroid and at the outer-retina showed the absence of
      regulation in the choroidal blood flow during hypoxia. Systemic hypoxia may
      affect the metabolism of the photoreceptors and the pigmentary epithelium.

PMID- 1614137
TI  - [Profile of pO2. Regulation of papillary pO2].
AB  - PO2 measurements using a double barelled recess type microelectrodes were
      measured in the optic nerve head of miniature pigs during systemic hyperoxia
      (100% oxygen breathing) and variations of the systemic blood pressure by
      intravenous injection of Adrenaline or trinitrine. During either systemic
      hyperoxia, or progressive variations of blood pressure, the intervascular PO2
      remained stable. These results suggest a regulation of the tissue PO2 of the
      optic nerve head, as the retina does, at constant values.

PMID- 1614138
TI  - [Metabolic factors of vasomotor regulation of the inner retina].
AB  - Lactic acid, the end metabolic product of anaerobic glycolysis is probably the
      mediator of the hypoxia induced vasodilation on retinal arterioles. In this study
      we explored the mechanisms of the retinal vasomotor effect of this metabolite by
      performing preretinal juxtaarteriolar pulsatile pressure microinjections on the
      intact eye of anesthetized and artificially ventilated miniature pigs.
      Microinjections of the levorotatory isomer L-lactic acid (pH: 2) induced a local
      maximal dilation of retinal arterioles. This vasodilator effect, like that of
      systemic hypoxia, was not mediated by the release of prostaglandins. Preretinal
      pulsatile pressure juxtaarteriolar microinjections of neutral-pH solution of L
      lactic acid also induced a segmental retinal arteriolar dilation. In contrast,
      microinjections of the dextrorotatory isomer D-lactic acid (pH: 2, solution),
      which is not produced by the retina, did not affect significantly the arteriolar
      diameter. Consequently, the vasodilator effect of lactic acid does not depend on
      periarteriolar pH modification and probably interferes with retinal metabolism
      since only the natural levorotatory metabolite is recognized.

PMID- 1614139
TI  - [Hemostatic effect of the Nd:YAG laser in cw function].
AB  - The Nd:YAG laser may be effectively employed to induce blood flow stasis and
      vessel closure in rabbits. The mechanism by which these effects are achieved
      depends upon the nature of the primary absorbing structures in the irradiated
      tissue, as well as upon the energy level of radiation. Vascular wall damage
      occasioned in consequence of energy absorption in melanin granules triggers blood
      flow stasis according to the classic clotting cascade, defects in the endothelial
      cell wall being closed by aggregated platelets. In tissue lacking melanin
      pigmentation, energy is absorbed primarily by the haemoglobin of erythrocytes,
      and blood flow is arrested by coagulation of plasma proteins, platelets being
      absent from the impact centre. The portent of these different haemostatic
      mechanisms upon repair of the endothelial cell wall and neovascularization have
      yet to be determined.

PMID- 1614140
TI  - [Anterior high frequency capsulotomy. I. Experimental study].
AB  - Basing on the bipolar-coaxial wetfield-diathermy, introduced in microsurgery 1974
      by the author, an anterior capsulotomy instrument using a modulated RF-current
      was published in 1984. In the meantime several patients have been operated
      successfully with this technique. However, further experimental studies allowed a
      refining of the instrument, an improvement of the electronic control device and a
      perfection of the surgical technique. Today, this technique has four considerable
      advantages compared with other methods: the size of the capsulotomy opening is
      not casual but determined by the surgeon, the presence of a viscous substance in
      the anterior chamber definitely facilitates the optical control of the surgical
      procedure, the border of the capsulotomy is astonishingly resistant to mechanical
      forces, therefore the risk of radial capsular tears is highly reduced, the border
      of the capsulotomy is well defined by a tiny grayish coagulation line which
      facilitates the implantation. The experimental results are demonstrated. The
      clinical and surgical results are presented in the same journal by Coester et al.

PMID- 1614141
TI  - [Anterior high frequency capsulotomy. II. Clinico-surgical experiences].
AB  - Using an instrument developed by Kloti, the author performed anterior capsulotomy
      by means of a radio-frequency current in 21 cases of extracapsular cataract
      extraction. This group is compared with 21 control cases. The advantages and
      limits of this technique are discussed. The procedure was found to be simple and
      very helpful to the surgeon. There was no evidence of any damage to structures in
      the patient's eye.

PMID- 1614142
TI  - [Anatomic, histologic, and morphometric studies of the ocular rectus muscles and
      their relation to the eye globe and Tenon's capsule].
AB  - After having been the subject of several studies during the first half of the
      20th century, the anatomical and morphological measurements of the ocular rectus
      muscles have recently been reinvestigated (e.g. L. Apt). At the Anatomy Institute
      in Geneva, similar measurements were performed on 25 human orbits as well as the
      depth of the subtenon space. The results show a large variation from one
      individual to another, although the "Tillaux spiral" was always respected. We
      have also shown that the ratio of the arc between each pair of opposed rectus
      muscles is a constant equal to 1 (0.997 +/- SD = 0.031). The subtenon space was
      defined morphometrically and confirmed histologically. All these measurements are
      important for practical aspects involved in the surgery of strabismus.

PMID- 1614143
TI  - [Regulation of papillary pO2].
AB  - PO2 measurements using a double barelled recess type microelectrodes were
      measured in the optic nerve head of miniature pigs during systemic hyperoxia
      (100% oxygen breathing) and variations of the systemic blood pressure by
      intravenous injection of Adrenaline or trinitrine. During either systemic
      hyperoxia, or progressive variations of blood pressure, the intervascular PO2
      remained stable. These results suggest a regulation of the tissue PO2 of the
      optic nerve head, as the retina does, at constant values.

PMID- 1614144
TI  - [Acute anterior uveitis: para-infectious hypothesis in predisposed individuals].
AB  - The etiology and the physiopathology of acute anterior uveitis (AAU) is not well
      understood yet. However, two major predisposing factors have been identified: a
      bacterial infection especially with gram negative organisms (functioning as a
      trigger) and a genetic background, in particular the expression of HLA B-27
      tissue antigen. We report the case of a young woman returning from travel to the
      Far East with her partner. Both presented simultaneously a gastrointestinal
      infection with fever and diarrhea. Despite extensive investigations, the
      infectious agent was never identified because of early empirical antibiotic
      therapy. A few days later, the patient developed AAU of a moderate grade in both
      eyes. HLA B-27 testing was positive for her, but not for her partner.
      Experimental research, based on a animal model such as endotoxin-induced uveitis
      (EIU), gives us some insight into the possible pathogenic mechanisms of AAU.
      Footpad injection of endotoxin (lipopolysaccharide component of the wall of gram
      negative), produce an acute anterior uveitis in rats. Extensive histologic
      analysis of other organs shows that the anterior segment of the eye is the only
      structure involved. Intensity of inflammation varies in different rat strains,
      stressing the importance of the genetic background. The similarity of the animal
      model to AAU will contribute to orient clinical research towards identifying more
      thoroughly the possible infectious agent at the origin of AAU and possibly to
      develop a prophylactic therapy.

PMID- 1614145
TI  - [Ocular toxocara canis in a 30-year-old adult].
AB  - Pars plana vitrectomy was performed in a 30-year-old patient who presented a
      posterior traction detachment due to an inflammatory granuloma. The granuloma
      removed in toto during surgery revealed characteristic features of toxocariasis
      lesion (first case described in the literature). An ELISA test performed on a
      vitreous sample was strongly positive. Retinotomy around the granuloma was
      necessary to re-attach the retina and silicone oil was used as a tamponade for 4
      months. VA improved from HM to 15/200 after silicone removal.

PMID- 1614146
TI  - [Optic neuritis in non-Hodgkin's lymphoma].
AB  - Optic neuropathy during non-Hodgkin lymphoma is a late central nervous system
      complication of unfavourable prognosis. It appears especially with involvement of
      the bone marrow. A normal cerebrospinal fluid, lack of any beneficial effect of
      the chemo-corticotherapy and absence of papilledema suggest paraneoplastic, or
      iatrogenic (radio and (or) chemotherapeutic) neuropathy with conclusive
      histopathological proof only at autopsy. More frequently, cerebrospinal fluid
      containing malignant cells, papilledema and a beneficial effect of the
      chemocortico-therapy suggests malignant infiltration of the optic nerve as occurs
      in our case. Optic neuropathy during non-Hodgkin lymphoma may exceptionally
      precede the systemic disease by several years. Early oculomotor involvement
      suggests meningeal malignant infiltration as found in meningeal carcinomatosis.

PMID- 1614147
TI  - [Recurrent eyelid tumor in necrotizing panniculitis].
AB  - To our knowledge, necrotizing lid tumors occurring in the context of a
      necrotizing lobular panniculitis have not yet been described in the literature.
      Our patient, a 75-year-old male, presented with indolent, nonmoveable
      subcutaneous lumps that were centrally ulcerating. They appeared first on his
      upper lid, then on his lower lid and thereafter on the neck, back, upper
      extremity and abdomen, especially in the area of his cholecystectomy scar. A
      thorough work-up, which included repeated histopathological examinations
      performed by several laboratories, led to the diagnosis of an idiopathic
      necrotizing lobular panniculitis. A serum level determination performed later
      revealed no alpha 1-antitrypsin deficiency. As the eye-lid's subcutaneous tissue
      lacks fat, the association between the necrotizing lid tumors and the necrotizing
      panniculitis appears to be a paradox. In spite of the normal alpha 1-antitrypsin
      serum levels--determined when the patient's lesions had long ago healed--we think
      in retrospect that the differential diagnosis should have included the
      possibility of a decreased alpha 1-antitrypsin serum level (e.g. heterozygous MZ
      phenotype). An alpha 1-antitrypsin level deficiency--with resulting decreased
      inhibition of collagenase and elastase--could account for the necrotizing process
      that also occurred in the eyelid's subcutaneous tissue. In the Van Gieson stain
      of this patient's eyelid biopsy, fragmentation of all visible collagen and
      elastic fibers was noted. In our opinion, the differential diagnosis does include
      lid involvement with secondary panniculitis caused by partially decreased alpha 1
      antitrypsin serum levels and--by exclusion--idiopathic necrotizing lobular
      panniculitis. Therapeutic possibilities are briefly discussed.

PMID- 1614148
TI  - [Orbitocranial plasmacytoma: a case report].
AB  - A female patient aged 79 years suffered from a unilateral, slowly progressive and
      painless exophthalmus. The investigations lead to the diagnosis of a voluminous
      plasma cell tumor involving the fossa infratemporalis, a part of the lateral
      orbit, as well as the middle and anterior cerebral fossae. This rare case is
      described and placed in its clinico-pathological context.

PMID- 1614149
TI  - [Spontaneous regression of an acquired arterial macroaneurysm of the retina].
AB  - We report on a case of partially occluded macroaneurysm with central circinate
      retinopathy which showed an impressive, nearly complete, spontaneous regression
      after one year. Complications of macroaneurysms and indications to therapy are
      discussed.

PMID- 1614150
TI  - [Pepper and salt fundus and family anamnesis in congenital syphilis].
AB  - Recognizing congenital syphilis in pediatric patients is of utmost importance
      with regard to therapy. The case of a 5-year-old girl with salt and pepper fundus
      demonstrates the importance of a thorough family history which led towards the
      diagnosis of congenital syphilis. This paper stresses the importance of family
      history in pigmented lesions of the fundus.

PMID- 1614151
TI  - [Primary antibiotic treatment of corneal ulcers in contact lens patients].
AB  - Two patient histories show that the therapy of contact lens corneal ulcers is
      complicated by bacterial resistance and mixed infection. To start an effective
      therapy against pseudomonas, gram-negative as well as gram-positive germs, a
      primary combination of tobramycin with fusidic acid seems to us as reasonable.
      Because of possible resistance to these antibiotics a smear should be taken from
      the ulcer and the contact lens case before therapy is begun and the clinical
      evolution must be controlled. In the choice of the antibiotics, the actual state
      of resistance and commercial availability was taken into account.

PMID- 1614152
TI  - [Tumorous eyelid changes in systemic diseases].
AB  - Lid tumors appear to invite the physician to make a diagnosis at first glance.
      This poster displays examples of lid tumors that occur in the context of
      malignancies, inflammatory and metabolic diseases and phacomatoses. The most
      frequent primary sites in metastatic eyelid tumors are the breast, the lung and
      cutaneous melanoma. Because of their comparatively low incidence and variable
      appearance these lid tumors are, at least in the beginning, often misinterpreted.
      Careful differential diagnosis may help in avoiding the diagnostic pitfalls of
      the masquerade syndromes. Lid tumors associated with sarcoidosis, lupus
      erythematosus discoides, lupus vulgaris, syphilis are briefly mentioned.
      Xanthelasmas occur more frequently in diabetics than in the normal population.
      About 5% of patients with xanthelasma suffer from hyperlipidemia. Neurofibromas
      and cavernous hemangiomas of the lid may accompany von Recklinghausen's and
      Sturge-Weber's diseases.

PMID- 1614153
TI  - [Lyme disease in Switzerland: ocular involvement].
AB  - Lyme disease is a multisystem disorder caused by the spirochete Borrelia
      burgdorferi, which is transmitted by a tick (Ixodes Ricinus). Lyme disease is
      divided into three stages (infection, dissemination and immunological reactions).
      Ocular manifestations are rare except for conjunctivitis and facial nerve palsy.
      Switzerland is an endemic zone for Lyme disease; the presence of an atypical pars
      planitis should prompt a search for Lyme disease.

PMID- 1614154
TI  - [Anterior ischemia of the optic nerve and anemic retinopathy].
AB  - We report on the case of a 59-year-old man with the association of an anterior
      ischemic optic neuropathy on the left eye and a bilateral anemic retinopathy
      following an extreme and prolonged post-operative anemia, because the patient had
      refused blood-transfusion. After one year of follow-up, the visual acuity did
      improve on the left eye. This association is rare, and only few cases have been
      reported.

PMID- 1614155
TI  - [Ocular complications of AIDS. Diagnostic problems].
AB  - Presentation is made of the ocular complications of AIDS which were observed in
      the ophthalmologic clinic of the University Hospital in Zurich from 1986 to 1991.
      Besides cotton-wool spots, CMV-retinitis is the most frequent and best known
      infectious complication. In all other infections, diagnosis is most difficult,
      because it could never be supported by histological examination. Presentation is
      made of some cases of acute retinal necrosis, toxoplasmosis, cryptococcosis,
      candida, and of some cases of uveitis with unknown etiology. Furthermore we
      present one intraocular non-Hodgkin lymphoma, some suspicions of Kaposi's sarcoma
      and some neurologic disturbances of central origin.

PMID- 1614156
TI  - [Pseudotumor cerebri, clinical parameters and therapeutic modalities].
AB  - Pseudotumor cerebri is a central nervous disorder with elevated intracranial
      pressure that is most common among young obese women. It presents with headache,
      transient visual obscurations and loss of central vision. Papilledema and visual
      field defects are frequent. Acetazolamid can be used for treatment. If medical
      treatment is not successful, optic nerve sheath decompression is recommended.
      Three patients were treated medically and there were treated surgically. Both
      methods stabilized or improved visual fields and central vision.

PMID- 1614157
TI  - [Pathogenesis and treatment of primary closed-angle glaucoma].
AB  - With an incidence of about 1/1000, primary angle-closure glaucoma is 4 to 5 times
      less frequent than primary open-angle glaucoma. It occurs most frequently due to
      pupillary block, itself both due to anatomical configuration and to either
      physiological or pathological changes in the anterior chamber. Pupillary block
      causes an increase of pressure in the posterior chamber, which leads to anterior
      displacement of the iris and, finally, to angle closure. The treatment of choice 
      dictated by the pathogenesis - consists of diminishing the posterior chamber
      pressure by means of hyperosmotic agents such as glycerin per os or mannitol iv.
      After reduction of the posterior-chamber pressure has been attained, a mild
      miotic, i.e. one which causes neither a strong miosis nor a flattening of the
      anterior chamber, is administered. If it is an acute attack, the application of
      these principles will permit normalization of pressure within about one hour.
      Several therapeutic guidelines are proposed, adapted to certain classical
      situations as well as to some less classical.

PMID- 1614158
TI  - [Experiences with secondary implantation of anterior chamber lenses].
AB  - Between 1984-1990 80 secondary implantations of an anterior chamber lens in
      aphakic eyes have been completed. The average follow-up period was 3.1 years,
      some of the patients checked on during the last 6 years. The most relevant
      complications to mention being retinal detachment (2), as well as cystoid macular
      edema (1). These complications appeared in patients in whom a vitrectomy had to
      be performed simultaneously. Other complications like corneal dystrophy, glaucoma
      or lens dislocations were not observed. The risk is increased when there is the
      need to perform a vitrectomy simultaneously. In cases without vitrectomy the risk
      is slight.

PMID- 1614159
TI  - [Long-term results of secondary implantation of anterior chamber lenses].
AB  - Long-term follow-up of secondary implanted anterior chamber intraocular lenses.
      The long-term results after secondary implantation of an anterior chamber IOL in
      aphakic patients are illustrated. After a mean period of 7 years after uneventful
      intracapsular cataract extraction 45 eyes underwent secondary implantation of an
      anterior chamber IOL of Symflex-Type. The mean follow-up was 40 months. During
      this time we observed following complications: minimal pupillary deformation (12
      cases), worsening of the best corrected visual acuity (8 cases), progredient
      pupillary deformation (3), retinal detachment (2), pupillary block glaucoma (2),
      CME (1) and formation of peripheral anterior synechia (1). We discuss the
      alternative possibility to correct aphkia by secondary implantation of a
      transscleral fixated posterior chamber IOL or by epikeratophakia.

PMID- 1614160
TI  - [An approach to diabetic retinopathy].
AB  - Presentation of ophthalmological taking in charge program of the diabetic
      patients, program elaborated during a symposium in London under the supervision
      of the World's Health Organisation and the International Federation of Diabetes.
      A calendar of the necessary controls is worked out. A scheme of the proposed
      treatment is decided. This program has to be known and followed by the patients,
      the general doctors and Swiss ophthalmologists.

PMID- 1614161
TI  - [Prognosis of penetrating keratoplasty in secondary endothelial atrophy of
      diverse etiology].
AB  - Endothelial atrophy following cataract extraction is an increasingly important
      indication for perforating keratoplasty (PK). Other significant indications for
      PK are the treatment of endothelial atrophy following vitreous/retinal surgery
      for perforating injuries or primary retinal pathology. We evaluated the first
      year post-operative course of fourteen patients that underwent PK: 7 patients
      with silicon-oil induced keratopathy (group I), and 7 patients with endothelial
      atrophy following anterior segment surgical procedures (group II). On follow-up,
      group II exhibited a significant improvement of visual acuity. In group I,
      despite the clarity of the graft, there was no improvement of vision because of
      the development of retrocorneal membranes, or pre-existing or progressive retinal
      changes.

PMID- 1614162
TI  - [Correction of astigmatism after penetrating keratoplasty].
AB  - Nine patients had a surgical correction of high astigmatism following perforating
      keratoplasty. In seven of them the reason for the perforating keratoplasty was
      keratoconus, in two of them Fuchs' endothelial dystrophy. The correction was
      performed in the seven 31-69 yrs old keratoconus patients 4-19 years (median 10
      yrs) after the transplant, in the patients with Fuchs' dystrophy 13 month and 1
      year following corneal transplant. In eight cases two circular shaped relaxing
      incisions of 60 degrees were performed in the steeper meridian, seven times
      combined with sutures in the opposite meridian. Once a wedge resection was
      performed. The astigmatism before correcting surgery was 8-19 dpt (median 13
      dpt), 3-24 month (median 11 month) 1.75-13 dpt (median 8 dpt). The reduction of
      astigmatism was 3-10 dpt (median 8 dpt). In 5 of 9 patients the astigmatism could
      be corrected by spectacles, in two more patients no spectacles were prescribed
      because of cataract. After this series of astigmatic correction we think that
      incisions without sutures are superior. This method could replace rekeratoplsty
      in the future.

PMID- 1614163
TI  - [Video documentation of disordered ocular motility disorders].
AB  - Demonstration of monitoring of pathological eye movements by standardized Video
      Documentation. The Patient is positioned in front of a circle (diameter 80
      degrees or 60 degrees) with individual fixation bulbs in the secondary and
      tertiary gaze directions. Tapes and immediately printable freeze-pictures make
      precise follow-ups and therapy control possible.

PMID- 1614164
TI  - [Cataract Eye Camp in India, Xerophthalmia Project. Experiences last January
      within the scope of the Combat Blindness Foundation at the Sitapur Ophthalmology
      Hospital in India].
AB  - In India are approximately 4 million blind people by advanced or mature cataract.
      For only 10 US$ one patient can be operated in eye camps in the villages by an
      intracapsular cataract cryoextraction an + 12.00 dptr. aphakia glasses. Also
      estimated four million people are blind by xerophthalmia. The project is to
      examine all the babies and little children in the villages and to give them for 2
      years each month vitamin-A-medication. On the other side the parents of children
      suffering from xerophthalmia are instructed to plant vegetables rich in vitamin
      A. The goal of both projects is to make a cataract and xerophthalmia free zone in
      Uttar Pradesh, which should spread over the entire country. Both projects are
      sponsored by Combat Blindness Foundation, P.O. Box 5, 332 Madison Wisconsin 53705
      USA, Professor Suresh Chandra, chairman.

PMID- 1614165
TI  - [Fluorescence angiography in ophthalmologic practice].

PMID- 1614166
TI  - [Evaluating visual function with visual display graphics on the Macintosh II
      computer].
AB  - A collection of programs has been developed on the Macintosh II computer to
      generate visual tests for an ophthalmological practice. The large number of
      available colours makes it possible to emulate most of the available tests and
      also to develop new ones. The system allows testing of the following visual
      functions: Visual acuity, Stereopsis, Aniseikonia, Phoria, Cyclophoria, Colour
      Vision and Contrast sensitivity.

PMID- 1614167
TI  - [Development and concept of a new operatory chair].
AB  - We present a novel type of operatory chair which directs an operation microscope
      by remote control using infrared beams: XV, zoom, focal and accessories. The
      advantage of this system is the absence of transmission cables, and consequently
      represents an important improvement in terms of flexibility. It is a vast
      improvement as well for maintaining sterile conditions in the operation room. The
      ergonomics of this chair was especially designed for microsurgery. The adjustment
      and stability of the forearm has been considerably improved.

PMID- 1614168
TI  - [The eye as an art form: the ocular prosthesis].
AB  - The technique of fabricating an ocular prosthesis out of glass is a rare art
      originating from Thuringen (formerly DDR). This technique is still practised by a
      few artists. A close collaboration between the ocularist and surgeon is
      indispensible towards achieving an optimal adaptation. We present several rules
      of plastic surgery enabling the cavity to receive the prosthesis after
      enucleation. The realization and adaptation of such a prosthesis has been filmed
      and will be presented.

PMID- 1614169
TI  - [Treatment of dyslexia with occlusion or prisms].
AB  - In the German speaking part of Switzerland in the last few years there have been
      two singular trends in orthoptic and surgical treatment of dyslexia. Professor
      Otto performs occlusion to achieve dominance in one eye. Of 300 cases treated he
      has operated on 147 for an exodeviation. Dr. Pestalozzi prescribes prismes based
      on the Polatest to reach perfect binocular vision. In 175 cases he operated on 43
      dyslectic children for an esodeviation. Both treatments are critically analysed
      and refused.

PMID- 1614170
TI  - [Are prism glasses a sensible measure in treatment of dyslexia?].
AB  - A short summary of the characteristics of speaking, reading and writing is given,
      followed by the respective anatomical, physiological and neuropsychological
      counterparts, which are to be described as the "Hor-Denk-Sprech-Seh-Schreib
      Organismus" (H-D-S-S-SCH-O). Various disorders occurring in the H-D-S-S-SCH-O as
      well as health problems and psychological and/or sociological factors may
      negatively contribute to the ability of speaking, reading and writing. In each
      case medical and non-medical specialists should thoroughly assess the cause of
      the problem in order to select the most effective treatment method. An agreement
      was made between Dr. Pestalozzi (Olten) and the author, to asses logopedically
      from 1987 until 1990 at the Speech Therapy Clinic (Abteilung Klinische Logopadie,
      ORL-Klinik, Universitatsspital Zurich) 20 dyslexic children, aged 7 to 13 years,
      designated by Dr. Pestalozzi to the wearing of prism-glasses in order to cure
      their dyslexias. The results of this logopedic study are described and discussed.

PMID- 1614171
TI  - [Orthoptic treatment of dyslexia].
AB  - It is assumed that dyslexia is due to a brain-organic syndrome, either congenital
      or acquired in infancy, with specific gnostic deficiencies and faulty controlled
      binocular vision. The latter is expressed by an intermittent alternating central
      scotoma which is thought to be responsible for impaired visual perception during
      reading. The aim of the orthoptic treatment of dyslexia must therefore be to
      eliminate the alternating central scotoma by stabilizing the binocular vision,
      and thus to improve reading ability by achieving unimpaired visual perception.

PMID- 1614172
TI  - [Further observations of dyslexia patients with prism correction].
AB  - Report on 370 dyslexics, whereof 281 can be evaluated. The heterophoric cases
      were all corrected by Haase's method of prismatic binocular full correction.
      There are mainly esophorias but only little exophorias and strabisms. 3% are
      orthophoric. Visual acuity improved as well as sensory adaptations. The latter
      were mainly fixation disparities II. 82 operated cases resulted in a residual
      angle of 3+/-3 prism-diopters measured by Polatest. The influence on dyslexia is
      very good in 11%, good in 60%. 17% showed no influence on dyslexia but got rid of
      asthenopic symptoms. Only 12% failed. Good results are seen already after three
      months up to one year and in some cases even after 2 or 3 years. As optical and
      surgical corrections do not heal the dyslexia, it is discussed how to explain the
      obtained good results. The author's opinion is that prismatic corrections may
      save energy as the patients have no longer to compensate their heterophoria
      themselves. Thus they dispose on more energy e.g. for understanding of the text
      they are reading.

PMID- 1614173
TI  - [Diagnostic imaging of the brain of blind and visually handicapped young
      children].
AB  - In infants with delayed or absent visual maturation a neuroradiological
      investigation of the brain is commonly performed in addition to
      neurophysiological examinations. We report our preliminary experience with
      magnetic resonance imaging (MRI). MRI allows a detailed anatomical assessment and
      an evaluation of the myelination, including the optic radiation. Following severe
      perinatal hypoxic-ischemic injury periventricular leukomalacia in the parieto
      occipital region was a common finding. The findings in infants with or without
      ocular abnormalities were heterogeneous, including normal findings, nonspecific
      delays of cerebral myelination as well as several malformations (such as corpus
      callosum hypoplasia, Aicardi syndrome, septo-optic dysplasia, migration
      disorders). In the individual case the neuroradiological findings do not allow to
      draw conclusions to the visual function and prognosis. In children with Leber
      congenital retinal amaurosis we have observed a normal myelination of the optic
      radiation. In many cases, particularly if a syndromic diagnosis is reached, neuro
      imaging gives useful information for prognostic and genetic counselling.

PMID- 1614174
TI  - [Congenital oculomotor apraxia. Presentation--developmental problems-
      differential diagnosis].
AB  - Congenital oculomotor apraxia (COMA) was initially defined by Cogan in 1952. In
      this condition voluntary horizontal saccades cannot be generated, while slow
      horizontal pursuit movements and vertical eye movements are intact. Affected
      infants usually present with delayed visual and/or psychomotor development or may
      even appear to be blind. In the second half of the first year "compensatory" head
      thrust movements become apparent. While the oculomotor abnormalities tend to
      improve with increasing age most affected children have delayed motor and speech
      development. The cognitive development is commonly impaired and many children
      require a special scholastic education. In our personal series of 9 children we
      have found variable and nonspecific neuroradiological findings, including
      cerebellar hypoplasia, hypoplasia of corpus callosum and grey matter
      heterotopias. COMA has to be differentiated from acquired forms of ocular apraxia
      as seen in Morbus Gaucher type 3, ataxia teleangiectasia and Morbus Leigh.

PMID- 1614175
TI  - [Visual milestones and child development].
AB  - Frequently, the milestones of visual development are the only available parameter
      of visual functions in newborns and small infants. The subscale eye-hand
      coordination of Griffith's Developmental Test and some single items of visuo
      motor functions were assessed concerning their first occurrence in healthy AGA
      term and preterm infants. Term and preterm infants differed constantly, but not
      significantly, in favour of the term children. No sex differences could be
      documented. Neurologic optimality score showed significant correlations with
      development of visual milestones. The Griffiths subscore at 9 and 24 months
      showed good correlations with later cognitive functions.

PMID- 1614176
TI  - [Longitudinal physical development of healthy children 0 to 18 years of age. Body
      length/height, body weight and growth velocity].
AB  - In addition to the Dortmunder longitudinal growth study we investigated
      development of height, weight and height velocity in 213 healthy boys and girls
      15-18 years old. Number of children decreased in the age group of 17 and 18 years
      old to 143. The study was performed in a longitudinal way, the measurements were
      taken in an one year distance. The median height gain in boys between 15 and 18
      years amounted to 9.3 cm, in girls to 2.1 cm, respectively. 18 years old boys are
      180.1 cm tall, girls 167.9 cm. The median increment of body weight in boys from
      15-18 years amounted to 7.3 kg, in girls 4.4 kg, respectively. Median weight in
      18 years old boys amounted to 65.2 kg, in girls to 58.0 kg. International
      comparison with other longitudinal growth studies shows a trend of somewhat
      higher weight, height and height velocity of the children from our study.

PMID- 1614177
TI  - [Treatment of disseminated intravascular coagulation with antithrombin III
      concentrate in children with verified infection].
AB  - Consumption coagulopathy in childhood is still a serious problem. Besides
      treatment of the underlying diseases therapy of consumption coagulopathy was
      performed with heparin and nowadays with substitution of coagulation factors,
      especially antithrombin III concentrate, alone or in combination with heparin. We
      performed administration of AT III concentrates only, without additional heparin
      treatment in children with proven septicaemia (preterm infants n = 21, children
      beyond the newborn period n = 18). Antithrombin III, platelet count, fibrinogen,
      PT, aPTT and TT were assayed. These coagulation parameters turned to be normal 48
      hours after normalisation of the antithrombin III plasma level-AT III increased
      to normal values within 24 hours after the initial substitution in all children.
      Lethal outcome was not observed after sole administration of AT III as well as no
      other side effects have been seen. In summary, these data indicate that
      consumption coagulopathy in childhood can be managed successfully with early
      substitution of AT III concentrate.

PMID- 1614178
TI  - [Thrombotic occlusion of the abdominal aorta in the neonatal period--successful
      thrombolytic treatment].
AB  - Aortic thrombosis during neonatal period is rare and usually related to an
      umbilical artery catheter. In an infant (birth weight 3110 gm) with complete
      thrombosis of the abdominal aorta distal to the renal arteries of unknown
      etiology we started a fibrinolytic therapy with streptokinase at the age of 12
      days (streptokinase intravenously with an initial loading dose of 3000 U/kg,
      maintenance 1000 U/kg/hr for 2 days). This was followed by a heparinisation
      (10,000 U/m2/d, 24 hours later 200 U/kg/d). 72 hours after onset of therapy there
      was no blood pressure difference between upper and lower limbs. Side-effects of
      therapy did not occur; the success of medical treatment continued after
      termination of the heparinisation.

PMID- 1614179
TI  - [Pregnancy and labor in mucoviscidosis--results of a study in Germany].
AB  - Thirty-one pregnancies in 27 women suffering from mucoviscidosis have been
      studied in Germany, in the period from 1980 to 1991. This analysis is the largest
      collection of data to date relating to pregnancy and birth with mucoviscidosis
      after the American-Canadian study of 1980. The German study demonstrated that
      only women with few weak symptoms became pregnant: typically the pregnant women's
      mucoviscidosis was diagnosed at an average age of 9.2 years, and 96.5% of the
      women had a satisfactory pregravid Shwachman-Kulczicki-Score. Only minor
      complications were observed in these pregnancies, in particular pulmonary
      exacerbations (in 18 pregnancies) and an insufficient weight gain (average of 7.2
      kg). Abortions were induced in five pregnancies and no spontaneous were observed.
      There were of maternal deaths during pregnancy or childbirth. More than one
      quarter of the newborns were premature. All the children had normal sweat
      chloride test results. 21 women could breast-feed successfully. In fifteen cases
      the mother's state of health deteriorated after pregnancy however only to a minor
      (ten cases) or moderate degree (four cases). It is noteworthy that of the twenty
      six infants twenty one were male. In this study we obtained the unexpected result
      that unaffected heterocygous children of women with mucoviscidosis are mainly
      male.

PMID- 1614180
TI  - [Serum prolactin after cerebral and psychogenic seizures in childhood and
      adolescence--an additional useful method for differentiating the two forms of
      seizure].
AB  - Prolactin levels were measured immediately after the seizure in some, and 15 to
      20 minutes later in all of 67 children aged between 6 months and 17 years. Values
      were determined after grand mal, complex partial and petit mal seizures and
      psychogen seizures. A more than 2 to 3 fold prolactin increase over the baseline
      value occurred almost always after grand mal and regularly after complex partial
      seizures. No hyperprolactinaemia was observed after petit mal seizures. Also
      after psychogenic seizures a rise in serum prolactin failed. The
      neurophysiological basis underlying this phenomenon is a decrease of gaba- und
      dopaminergic systems associated with the seizure. The described method is useful
      in the differential diagnosis of epileptogenic versus psychogenic seizures.

PMID- 1614181
TI  - [Clinical importance of hepatitis B virus DNA detection in serum of children with
      chronic hepatitis B].
AB  - 206 sera from 172 children with chronic hepatitis B infection were tested for HBV
      DNA by dot blot hybridization. 111 were positive and 95 negative for HBV DNA. 103
      (78.6%) of the positive patients had HBeAg and 5 (7.7%) anti-HBe. In 60 (92.3%)
      of the anti-HBe positive sera no HBV DNA could be detected. Children with
      elevated liver enzymes had HBV DNA in 80.1%, whereas in 71.6% of the chronic
      HBsAg carriers with normal liver enzymes no HBV DNA was found. In 87 of the 95
      dot blot negative patients polymerase chain reaction was performed. 73 (83.9%)
      children of this group were HBV DNA positive. All HBeAg positive patients and
      those with elevated aminotransferases had HBV DNA in their serum. 56 anti-HBe
      positive HBsAg carriers were also positive; 14 were negative for HBV DNA. Our
      results demonstrate that viral sequences can be found in all HBeAg positive and
      in most of the anti-HBe positive children. Patients with ongoing virus
      replication have to be considered infectious and recommendation for vaccination
      of close relatives of these patients must be stressed.

PMID- 1614182
TI  - [Pilot study of amiloride inhalation in children with cystic fibrosis].
AB  - Bronchial clearance is impaired in cystic fibrosis (CF). Respiratory secretions
      contain less sodium and chlorid, resulting in reduced airway water content.
      Aerosolized amiloride, a sodium transport blocker, was shown to normalize the
      amount of sodium in bronchial mucus, leading to an improvement in mucociliary
      clearance. In a controlled, double blind crossover study on nine CF children we
      tried to assess the efficacy of twice daily inhaled amiloride (10(-3)M) on sputum
      weight, consistency of sputum and lung function (FEF1, FVC, FEF50, FEF25, PEF).
      Each treatment period (amiloride versus 0.9% saline) lasted for two months. We
      could show that inhaled amiloride was able to increase mean sputum weight per day
      from 11.75 g (+/- 5.96) up to 18.5 g (+/- 10.34). This was equal to an increase
      of 57%. Some children felt that sputum expectoration lasted longer while using
      amiloride and that even for some hours after inhalation they expectorated a
      sputum-like fluid. We were able to detect, at least in some patients, that their
      sputum consisted of two parts, one showing more solid contents, the other more
      fluid-like contents. This was, however, not a consistent feature. No significant
      or clinical important differences were found for pulmonary function test data.
      There were no pulmonary or extra pulmonary side effects from treatment with
      amiloride. Further studies should be undertaken to assess the efficacy of longer
      lasting amiloride inhalation on the course of the disease in CF patients.

PMID- 1614183
TI  - [Meningitis in 154 children of a pediatric clinic in Germany: clinical and
      epidemiologic aspects].
AB  - In a retrospective study, the histories of the non-neonates treated for primary
      meningitis in the Pediatric Department of Mainz University Hospital between 1986
      and 1989 were analyzed with regard to etiological, diagnostic, clinical and
      epidemiological criteria. In the period studied there were 37 cases of infectious
      meningitis (11 Neisseria meningitidis (29.7%), 7 H. influenzae (18.9%), 3 S.
      pneumoniae (8.1%), 16 other (43.2%)), and 117 cases of acute aseptic meningitis
      syndrome (12 mumps virus (10.3%), 3 Borrelia burgdorferi (7.7%), 3 FSME (2.6%), 2
      herpes simplex virus, 91 other (77.8%)). Sixty-six percent of the patients were
      male. Of the infants with infectious meningitis, 68% were under 5 years old. In
      contrast, 69% of the children with noninfectious meningitis were aged 5 or older.
      While 70% of the infectious meningitis cases occurred in fall and winter, 64% of
      the cases of acute aseptic meningitis syndrome occurred in spring and summer. In
      differential diagnosis between infectious and acute aseptic meningitis syndrome
      maximal sensitivity was a CRP value exceeding 0.5 mg/dl, a CSF lactate value of
      over 3 mmol/l and a CSF cell count of over 2000/3 cells. In none of the cases did
      a second or third lumbar puncture furnish information additional to that which
      could have been deduced from physical examination and course of temperature. A
      second lumbar puncture failed to produce unexpected results, or have consequences
      for therapy, in any of the 14 cases with noninfectious meningitis. Of 37 infants
      with infectious disease, one (2.7%) died from the sequelae of pneumococcal
      meningitis. Recovery was partial in 8 (22.2%) of the 36 surviving
      infants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614184
TI  - [Opitz-trigonocephaly syndrome--a characteristic dysmorphia-retardation syndrome
      of unclear origin].
AB  - Report on a patient with Opitz-Trigonocephaly-Syndrome who was diagnosed at the
      age of ten months. He had a trigonocephaly and multiple other stigmata including
      oblique orbital fissures, internal strabism, high and narrow palate with broad
      alveolar ridges, microstomia, large dysplastic ears, nuchal cutis laxa, broad
      clumsy fingers. Additionally he had a ventricular septal defect, was dystrophic
      and developmentally retarded. Chromosomal analysis was normal. A sister that was
      recently born showed no dysmorphic signs. So far, 24 cases have been reported in
      the literature. This is the 5th patient in Germany.

PMID- 1614185
TI  - [Craniometaphyseal dysplasia--characteristic roentgen findings].
AB  - Craniometaphyseal dysplasia is a rare disorder of bone remodeling, which is
      characterized by hyperostosis or sclerosis of the skull combined with metaphyseal
      flaring of the long tubular bones. Diagnosis is only possible on the basis of the
      characteristic radiographic findings, these are shown in a case report of a 2 1/2
      year old boy. There is no therapy of craniometaphyseal dysplasia.

PMID- 1614186
TI  - [Effect of psychotherapeutic interventions on weight reduction and personality
      development of a 13-year-old boy with Prader-Willi syndrome].
AB  - A 12.10-year old boy (actual weight 88.8 kg, actual height 131.2 cm; 228%
      overweight) with Prader-Willi-syndrome achieved, after repeated ineffective
      therapy attempts over a period of 10 years, a weight reduction of 11.8 kg (185%
      overweight) during a 9-week in-patient treatment. In the following out-patient
      phase of therapy a further weight reduction of 20 kg (109% overweight) was
      achieved over a period of 16 months. Apart from the usual modes of action of
      therapy (reduced energy intake, physical exercise, behaviour modification),
      family therapeutic and special education interventions were used. These achieved
      an improvement of the patient's self-esteem, an increase in his competence to act
      and in his autonomy concerning his diet management, as well as a positive
      experience of his own abilities and social acceptance by other children and the
      stabilisation of the dysfunctional family system. It may be assumed that this
      therapeutic success is dependent on consequent compliance with the system model.

PMID- 1614187
TI  - The renin-angiotensin system and diabetic retinopathy.
AB  - The importance of the renin-angiotensin system in the eye has not been clearly
      established, nor is it known whether it is of importance in the evolution of
      diabetic retinopathy. Circulating renin is produced in the kidney and other
      tissues; its main importance is in the control of blood pressure. Elevated levels
      have been found in diabetic patients with microvascular complications. There is
      also some suggestion that the prorenin content is elevated in diabetics and that
      this is an indicator of the development of microvascular complications in the
      next few years. Angiotensin-converting enzyme (ACE) inhibitors have been found to
      reduce the leakage in early diabetic retinopathy, but it is possible that this
      was only due to a reduction of blood pressure. Angiotensin II was found to induce
      neovascularisation in corneal pocket experiments, and the replication of aortic
      endothelial cells has been reported. We were unable to find any increased
      replication of retinal endothelial cells treated with angiotensin II. It is
      possible that the main function of the renin-angiotensin system in the eye is the
      regulation of local blood flow.

PMID- 1614188
TI  - [Diabetic nephropathy in type 2 diabetes--epidemiology, early diagnosis and
      therapeutic strategies].
AB  - Diabetic nephropathy now accounts for approximately one-third of all patients who
      develop end-stage renal disease. The realization that half of these individuals
      suffer from non-insulin-dependent (type-2) diabetes mellitus has sparked
      increased interest attempts to understand the epidemiology and pathophysiology.
      In particular, early diagnosis, prevention and intervention in type-2 diabetic
      patients with micro-albuminuria and incipient diabetic nephropathy is urgently
      needed, since an early mortality due to cardiovascular complications is well
      documented in these patients. This review article summarizes most of the new data
      concerning epidemiology, pathophysiology, early diagnosis and the very few
      intervention studies in diabetic nephropathy of type-2 diabetic patients.

PMID- 1614189
TI  - [Diabetic cardiopathy. Pathophysiologic concepts and therapeutic approaches].
AB  - Epidemiological data reviewed suggest that diabetes itself increases the cardiac
      risk of diabetics (types I and II), independently from the development of
      coronary heart disease and in addition to other risk factors (hypertension,
      hypercholesterolemia, hypertriglyceridemia, smoking and others), presumably by a
      specific myocardial disease called "diabetic cardiopathy", or according to the
      recommendations of the WHO, "diabetic heart muscle disease." Disturbances of the
      left and right ventricular function as well as the autonomic function of the
      heart can be understood as signs of this specific cardiopathy. The
      pathophysiological mechanisms underlying this disease are not yet fully known;
      however, recent evidence is presented that diabetes leads to a facet of metabolic
      dysfunctions regarding glucose and energy metabolism, calcium homeostasis and the
      expression of specific proteins that diminish the ability of the heart to respond
      to increased workload and increase the vulnerability of the heart in diabetes.
      Since preliminary experimental data indicate that inhibitors of the angiotensin
      converting enzyme can protect the heart in diabetes, it is intriguing to suggest
      that increased release of angiotensin II plays a significant role in the change
      from reduced adaptability to irreversible damage of the heart in diabetes.

PMID- 1614190
TI  - Influence of dietary factors on the renal renin-angiotensin system.
AB  - Protein meals and infusion of amino acids cause an increase of glomerular
      filtration rate in humans and animals with normal renal function despite the
      circulating renin concentration remaining unchanged. The renal hemodynamic
      response is not altered by angiotensin converting enzyme inhibitors, but it is
      obliterated by cyclooxygenase inhibitors. By contrast, chronic exposure to high
      protein diets raises circulating renin and increases messenger RNA of renin (but
      not of angiotensinogen) in kidney tissue. Chronically high protein intake raises
      the glomerular filtration rate and reduces glomerular permselectivity; the
      reverse is seen with low protein intake. In patients with renal failure, acute
      amino acid infusion or protein meals cause a paradoxical drop in glomerular
      filtration rate which is not influenced by converting enzyme inhibitors.

PMID- 1614191
TI  - [ACE inhibitor effects on structure and function of the glomerular basement
      membrane].
AB  - Metabolism of proteins which compose capillary basement membrane is altered in
      diabetic patients. In the kidney, this leads to an impaired permselectivity of
      glomerular basement membrane and consequently to onset of proteinuria.
      Proteinuria which is often increased by hemodynamic factors, initiates and
      promotes the development of diabetic glomerusclerosis. Aside from near-normal
      metabolic control, special antihypertensive treatment can reduce proteinuria and
      retard loss of kidney function in proteinuric diabetic patients. The beneficial
      effect of ACE-inhibitors on course of diabetic nephropathy is generally thought
      to be a consequence of decreased systemic and intraglomerular pressure. However,
      recent longterm studies in Type I and Type II diabetic patients with nephropathy
      showed that ACE-inhibition can reduce proteinuria independent from their
      hemodynamic effects and, thus, improves the filtration properties of glomerular
      basement membrane. This may be due to an influence of ACE-inhibition on
      metabolism of basement membrane proteins.

PMID- 1614192
TI  - [Angiotensin II and its effects on vascular structure].
AB  - The peptide vasoconstrictor angiotensin II (Ang II), originally described as
      deriving exclusively from the plasma renin angiotensin system, has now been
      demonstrated to be produced independently of such sources. Local tissue
      angiotensin-generating systems are well documented. There is increasing evidence
      that these locally produced vasoconstrictor peptides may contribute to blood
      vessel homeostasis, as well as the development of vascular pathologies. Results
      obtained from pharmaceutical intervention in these systems in humans and animals
      strongly support this hypothesis. In addition to its vasoconstrictor properties,
      Ang II acts as a potent biological effector. In vitro both vasoconstrictor
      peptides appear to modulate the activity of autocrine feedback loops in vascular
      smooth muscle cells. The activity of these feedback loops in vivo may represent a
      central mechanism for regulation and phenotypic differentiation of this cell
      type. The most well-established autocrine feedback loops of vascular smooth
      muscle cells are constituted by platelet-derived growth factor and transforming
      growth factor-beta, both of which are influenced by the action of angiotensin II.
      The effects of the peptide vasoconstrictors on the (auto) regulated feedback
      loops are of long-term structural importance since both vasoconstrictors (via
      autocrine growth modulators) may influence the composition of the extracellular
      matrix of vascular smooth muscle cells. This includes effects on the synthesis
      and secretion of thrombospondin, fibronectin, tenascin, etc.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1614193
TI  - [Clinical sequelae of hyperinsulinemia in diabetes mellitus].
AB  - Surprisingly enough, insulin has recently been suspected of promoting
      cardiovascular complications, provided it becomes effective in excess
      concentrations at the vascular walls. This applies to both endogenous
      hyperinsulinemia and insulin substitution performed exogenously with high insulin
      doses. Several large population studies in non-diabetics - carried out in
      Helsinki, Busselton and Paris - have proved recently that serum insulin
      concentration is an independent risk predictor for the occurrence of coronary
      heart disease. According to in vitro trials, insulin stimulates the proliferation
      of the smooth muscle cells in vascular media and the lipid synthesis, as well as
      lipid incorporation into the vascular wall. Very recent large-scale population
      studies in randomly selected type II diabetics (the Schwabing Study and one
      performed at Oxford) have revealed a close association between an endogenous
      insulin requirement, on the one hand, and the risk of macroangiopathy or coronary
      heart disease on the other.

PMID- 1614194
TI  - Statement of the AATS/STS Joint Committee on Thoracoscopy and Video Assisted
      Thoracic Surgery.

PMID- 1614195
TI  - Effect of skin temperature on platelet function in patients undergoing
      extracorporeal bypass.
AB  - Thirty-seven patients undergoing cardiopulmonary bypass operations were studied
      to assess the effect of skin temperature on platelet function. Differences in
      skin temperature between the two arms were created during bypass, at the
      completion of bypass, and at 2 and 24 hours after the completion of bypass. In
      each of 37 patients the temperature of one arm was increased with a water-filled
      blanket set at 40 degrees C. In 11 of these patients the other arm was allowed to
      equilibrate with the environment, and in the other 26 patients the arm was cooled
      with ice. Except for the differences in local skin temperature between the two
      arms, all factors known to affect the patient's bleeding time were similar.
      Measurements were made of bleeding times and the levels of thromboxane B2 and 6
      keto-prostaglandin F1 alpha in shed blood obtained at the template bleeding time
      site. In the 33 patients not treated with aspirin, local hypothermia produced an
      increased bleeding time and a significant reduction in the thromboxane B2 level
      at the bleeding time site, but no reduction in 6-keto-prostaglandin F1 alpha
      level. Local rewarming produced a significant increase in the shed blood
      thromboxane B2 level. In the four patients treated with aspirin, local
      hypothermia produced no differences in bleeding times or shed blood levels of
      thromboxane B2 or 6-keto-prostaglandin F1 alpha. These data show the benefits of
      rewarming patients with hypothermia who have nonsurgical blood loss to restore to
      normal both core and peripheral temperatures before resorting to the transfusion
      of homologous blood products.

PMID- 1614196
TI  - Does desmopressin acetate prophylaxis reduce blood loss after valvular heart
      operations? A randomized, double-blind study.
AB  - The effectiveness of prophylactic desmopressin acetate in reducing hemorrhage
      after cardiopulmonary bypass operations is controversial. We conducted a
      prospective, randomized, placebo-controlled, double-blind trial to determine its
      effectiveness and safety in such patients. Eighty-three evaluable patients
      undergoing valvular heart operations were randomized to receive desmopressin (0.3
      microgram/kg) (41) or placebo (42) after cardiac bypass. Demographic
      characteristics were similar in both groups. There was no significant difference
      in total 24-hour blood loss between groups (desmopressin 1064.8 +/- 647.1 ml
      versus placebo 844.4 +/- 507.6 ml; p greater than 0.05), or in the requirement
      for red blood cell, platelet, or fresh frozen plasma transfusion, or for
      reexploration for control of hemorrhage. Neither was there a difference in the
      occurrence of thrombotic complications between groups. Analysis of factor VIII
      activity, von Willebrand factor, or von Willebrand factor multimers failed to
      show significant correlations with blood loss or differences between groups
      except for factor VIII activity, which was significantly higher in the
      desmopressin group 1 hour after operation than in the placebo group. A detailed
      comparative analysis of similar trials to determine the reasons for different
      outcomes suggests that desmopressin should not be used routinely as a
      prophylactic agent to reduce postsurgical hemorrhage, but that it may be
      beneficial when used in patients who already manifest excessive bleeding
      postoperatively.

PMID- 1614197
TI  - Plasma thromboxane and pulmonary artery pressure in neonates treated with
      extracorporeal membrane oxygenation.
AB  - To examine whether neonates with persistent pulmonary hypertension are subject to
      a thromboxane-mediated exacerbation of their pulmonary hypertension during
      extracorporeal membrane oxygenator therapy (a form of partial cardiopulmonary
      bypass), we performed serial measurements of plasma thromboxane B2 and pulmonary
      artery pressure before, during, and after extracorporeal membrane oxygenation.
      Pulmonary artery pressure was high before extracorporeal membrane oxygenation,
      did not increase after the start of this therapy, but began to decrease after 48
      hours of extracorporeal membrane oxygenation. During the course of extracorporeal
      membrane oxygenation, mean pulmonary artery pressure decreased by 50% and mean
      plasma thromboxane B2 levels decreased by 70%. In addition, serial plasma
      thromboxane B2 levels were significantly correlated with pulmonary artery
      pressures in individual infants with a primary diagnosis of meconium aspiration
      (r = 0.965 to 0.723). We speculate that the decrease in pulmonary artery pressure
      and plasma thromboxane B2 levels over time may reflect resolution of acute lung
      injury and that thromboxane B2 may play a role in regulating pulmonary artery
      pressure in infants with meconium aspiration.

PMID- 1614198
TI  - Aortic valve replacement. Aortic root versus coronary sinus perfusion with blood
      cardioplegic solution.
AB  - The role of retrograde coronary sinus cardioplegia in patients undergoing aortic
      valve replacement for aortic stenosis alone or in combination with myocardial
      revascularization has not been fully defined. Sixty-three patients undergoing
      elective aortic valve replacement received cold potassium blood cardioplegic
      solution via either the aortic root (36 patients) or the coronary sinus (27
      patients). The patients were similar with respect to age, degree of aortic
      stenosis, ventricular function, severity of coronary artery disease, crossclamp
      time, completeness of revascularization, and mean volume and temperature of the
      infusion solution. The mean septal temperature and the release of myocardium
      specific isoenzyme in the first 2 hours after crossclamp removal was higher in
      the retrograde group (p less than 0.008). Right and left ventricular function was
      preserved equally in the two groups, and volume-loading studies suggested
      improved diastolic performance in patients having retrograde cardioplegia. There
      were no differences between the two groups with respect to clinical outcome. We
      conclude that coronary sinus cardioplegia is as safe as aortic root perfusion for
      myocardial preservation in patients undergoing elective aortic valve replacement.

PMID- 1614199
TI  - Successful long-term preservation of the neonatal heart with a modified
      intracellular solution.
AB  - Current methods of myocardial preservation for transplantation are suboptimal. A
      newly developed intracellular cardioplegic and storage solution (modified
      University of Wisconsin solution, group 1) was compared in a randomized, blinded
      fashion with our present clinical protocol, Stanford cardioplegic solution and
      saline storage (group 2) in an isolated neonatal pig model. After arrest and
      storage for 12 hours at 4 degrees C, biopsy specimens were taken from six group 1
      hearts and five group 2 hearts for examination under an electron microscope and
      assessment of high-energy phosphate levels and water content. The remainder
      (group 1, n = 7; group 2, n = 6) were reperfused with blood for 50 minutes, after
      which function curves were obtained at left ventricular end-diastolic pressures
      of 3 to 12 mm Hg and biopsy tissue was taken. Eight control hearts (group 3) were
      cannulated in situ and perfused on the circuit without arrest or intervening
      ischemia. Stroke and minute work index curves were approximately threefold and
      fivefold higher for group 1 (modified University of Wisconsin solution) than for
      group 2 (Stanford), respectively (p less than 0.01). The hearts preserved with
      University of Wisconsin solution did not differ in function from unpreserved
      control hearts (group 3). High-energy phosphate levels were better maintained in
      group 1 than group 2 (p less than 0.05), and water content was lower (p less than
      0.01). Semiquantitative grading of electron micrographs paralleled the functional
      and biochemical results. CONCLUSION: Modified University of Wisconsin
      intracellular solution provides markedly better heart preservation than
      conventionally used cardioplegic and storage solutions.

PMID- 1614200
TI  - New aspects of the degeneration of bioprosthetic heart valves after long-term
      implantation.
AB  - Bioprosthetic heart valves removed 76 to 150 months after implantation were
      morphologically investigated to correlate structural alterations with clinical
      failure modes. Traditional morphologic methods of evaluating valvular
      heterografts, such as microradiography and electron microscopy, were complemented
      by undecalcified ground sections, a new technique for analyzing the distribution
      of mineral deposits. Apart from well-investigated mechanisms that accelerate
      tissue degeneration, our observations point to additional facts: (1) phagocytosis
      of collagen fibrils and elastic material by macrophages and foreign body giant
      cells in areas near tears and perforations and (2) initial calcification
      indicated by delicate crystals in the intercellular space arranged in close
      relation to the periodicity of the cross-striation pattern of collagen fibrils.
      The present report not only calls attention to degenerative changes that are
      enhanced by mechanical stress but also underlines phagocytosis as an important
      mechanism in the destruction of bioprosthetic heart valves.

PMID- 1614201
TI  - Exogenous adenosine accelerates recovery of cardiac function and improves
      coronary flow after long-term hypothermic storage and transplantation.
AB  - Impaired coronary flow during postischemic reperfusion may limit functional
      recovery. In the present studies we used the heterotopically transplanted rat
      heart and the isolated working rat heart to assess whether adenosine, given
      during reperfusion, could improve either the rate or the extent of postischemic
      recovery. Hearts were arrested (2 minutes at 4 degrees C) with the St. Thomas'
      Hospital cardioplegic solution and stored by immersion in the same solution for 8
      hours at 4 degrees C. Hearts were then transplanted into the abdomen of
      homozygous recipients. Immediately before reperfusion, adenosine (0.5 ml of a 1
      mumol/L solution, equivalent to 0.13 micrograms) was injected into the left
      ventricle (control rats received an equivalent amount of saline). Hearts were
      reperfused in vivo for 30 minutes or 24 hours, after which they were excised and
      perfused (Langendorff) for 20 minutes for the assessment of function. They were
      then freeze clamped and taken for metabolic analysis. After 50 minutes of
      reperfusion, left ventricular developed pressure was 75 +/- 5 mm Hg (4 mm Hg end
      diastolic pressure) in the adenosine group versus 61 +/- 4 mm Hg in the control
      group (p less than 0.05); however, after 24 hours function was identical in the
      two groups (52 +/- 4 versus 52 +/- 3 mm Hg). After 50 minutes of reperfusion
      coronary flow was greater in the adenosine group (11.0 +/- 0.4 versus 9.7 +/- 0.4
      ml/min in control rats; p less than 0.05), a difference that was sustained for 24
      hours (12.8 +/- 0.3 versus 11.4 +/- 0.4 ml/min in control rats; p less than
      0.05). Adenosine triphosphate and creatine phosphate contents recovered to
      similar extents in control and adenosine groups after both 50 minutes and 24
      hours of reperfusion. In further studies with an identical storage protocol (8
      hours at 4 degrees C), hearts were not transplanted but were reperfused with
      crystalloid medium in the Langendorff mode for 15 minutes (creatine kinase
      leakage measured) and in the working mode for 180 minutes. In an attempt to mimic
      the heterotopic transplant protocol, adenosine (1 mumol/L) was included in the
      perfusion fluid for the first 2 minutes of reperfusion. Similar results to those
      of the transplant studies were obtained, with coronary flow being consistently
      improved in the adenosine group; however, this benefit was lost after only 2
      hours of reperfusion.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1614202
TI  - Effect of oxygen tension and cardiovascular operations on the myocardial
      antioxidant enzyme activities in patients with tetralogy of Fallot and aorta
      coronary bypass.
AB  - Since the chronically cyanotic myocardium appears to be more susceptible to
      reperfusion injury after cardiac operations than the noncyanotic myocardium, we
      studied the association between the preoperative arterial oxygen tension and the
      myocardial superoxide dismutase, catalase, and glutathione peroxidase activities.
      Fourteen patients with tetralogy of Fallot scheduled for elective operations had
      baseline arterial blood gas measurements done before operation. During the
      operation right ventricular biopsy specimens were taken for enzyme analysis
      immediately before cold blood cardioplegic arrest and 20 minutes after crossclamp
      removal. The tissue antioxidant enzyme activities of the patients with tetralogy
      of Fallot were compared with the myocardial results in 15 adults with stable
      angina pectoris having elective aorta-coronary artery bypass graft operations.
      Myocardial tissues removed from two patients with hypertrophic obstructive
      cardiomyopathy who had corrective operations were analyzed for antioxidant
      activities. There were no changes in myocardial antioxidant enzyme activities
      during the operation in the patients with tetralogy of Fallot and coronary artery
      bypass graft. The myocardial superoxide dismutase, catalase, and glutathione
      peroxidase activities correlated (0.82, 0.68, and 0.89, respectively)
      significantly (p values were less than 0.01, 0.05, and 0.01, respectively) with
      the preoperative arterial oxygen tensions in the patients with tetralogy of
      Fallot. The myocardial glutathione peroxidase activities were at least four times
      higher in the myocardium of patients with coronary artery bypass graft and
      hypertrophic obstructive cardiomyopathy than in that of those with tetralogy of
      Fallot. This study provides putative evidence that the myocardium of patients
      with tetralogy of Fallot is a risk of oxygen-derived free radical injury during
      and immediately after corrective cardiovascular operations.

PMID- 1614203
TI  - Age-related differences in cardiac susceptibility to ischemia/reperfusion injury.
      Response to deferoxamine.
AB  - Age-related differences in susceptibility to ischemia/reperfusion injury and the
      response to the iron chelator deferoxamine during reperfusion were studied in
      isolated nonworking rabbit hearts subjected to 30 or 40 minutes of ischemia at 37
      degrees C followed by 30 minutes of reperfusion. In the experimental group,
      hearts received a bolus of deferoxamine just before the moment of reflow,
      followed by a continuous infusion during the first 10 minutes of reperfusion.
      Isovolumic systolic (peak developed pressure) and diastolic (diastolic pressure
      versus balloon volume relationship) function was assessed with an intracavity
      balloon and incremental volume changes. In separate groups of hearts, adenine
      nucleotide content (adenosine triphosphate, diphosphate, and monophosphate) was
      measured before ischemia, at end-ischemia, and 30 minutes after reperfusion. The
      cardiac function measurements showed that after 30 minutes of ischemia and 30
      minutes of reperfusion, peak developed pressure in newborn hearts recovered to
      89% +/- 5% of preischemic levels; this recovery was significantly better than
      that of adult hearts, which exhibited 67% +/- 6% (p less than 0.01) recovery.
      Deferoxamine significantly improved cardiac function only in adult hearts (p less
      than 0.01). However, after 40 minutes of ischemia and 30 minutes of reperfusion,
      peak developed pressure in newborn hearts was reduced to 61% +/- 3% and was not
      significantly better than that of adult hearts (54% +/- 5%). Deferoxamine
      significantly improved systolic function in both newborn and adult hearts (p less
      than 0.01) exposed to 40 minutes of ischemia. Myocardial adenosine triphosphate
      content fell markedly by the end of 30 and 40 minutes of ischemia in both groups.
      After 30 minutes of ischemia, newborn but not adult hearts were able to
      completely recover adenosine triphosphate content by 30 minutes of reperfusion.
      This advantage was lost after 40 minutes of ischemia. Deferoxamine had no effect
      on recovery of adenosine triphosphate content in any group. We conclude that (1)
      newborn hearts recover postischemic function and metabolism faster than adult
      hearts after shorter periods of ischemia; (2) this advantage is lost as the
      ischemic period is prolonged; (3) deferoxamine improved postischemic cardiac
      function after longer ischemic periods, in both age groups, but failed to improve
      the recovery of myocardial adenosine triphosphate content.

PMID- 1614204
TI  - Management of the left atrioventricular valve in the repair of complete
      atrioventricular septal defects.
AB  - Left atrioventricular valve regurgitation in atrioventricular canal defects is
      usually due to malalignment of the edges of the cleft or to annular dilatation.
      Intraoperative assessment and correction of left atrioventricular valve
      incompetence is critical for successful outcome in the surgical management of
      complete atrioventricular canal defects. Although some have elected not to suture
      the cleft in the setting of minimal incompetence, we have found that this often
      results in significant left atrioventricular valve insufficiency, necessitating
      reoperation. From January 1982 through December 1990, 105 patients with complete
      atrioventricular canal underwent definitive repair. Repair was performed with a
      single pericardial patch technique in 86 patients (82%). Intraoperative
      assessment of left atrioventricular valve competence was performed in all cases.
      Ninety-six patients (91%) required suturing of the cleft and 63 (60%) required
      annuloplasty to establish satisfactory competence of the left atrioventricular
      valve. The overall early mortality rate was 10.5% (11/105 patients). From 1986 to
      1990, the early mortality rate decreased to 7.7% (6/78 patients). In a mean
      follow-up of 39 months (range 1 to 106 months), late survival was 96% (90/94
      operative or early survivors). Reoperation was performed on eleven (11.5%)
      patients; six (6.3%) for failure of the atrioventricular valve repair, three for
      patch dehiscence, and two for residual ventricular septal defects. These data
      demonstrate that routine approximation of the cleft and aggressive use of left
      atrioventricular valve annuloplasty is safe and results in an excellent outcome
      with a low incidence of reoperation for failure of left atrioventricular valve
      repair.

PMID- 1614205
TI  - Dissolution of the Liaison Committee--rebirth of the Thoracic Surgery Directors
      Association.

PMID- 1614206
TI  - Invited letter concerning: concomitant arch repair in acute type A aortic
      dissection.

PMID- 1614207
TI  - Treatment of postoperative chylothorax by fibrin glue application under
      thoracoscopic view with use of local anesthesia.

PMID- 1614208
TI  - The dangers of gathering data.

PMID- 1614209
TI  - Report of neoaortic valve replacement in a ten-year-old girl after an arterial
      switch procedure for transposition.

PMID- 1614210
TI  - A fractured and detached right atrial myxoma: an unusual and threatening
      condition detected by intraoperative transesophageal echocardiography.

PMID- 1614211
TI  - The five-year evaluation of a mechanical heart valve without anticoagulation in
      goats.
AB  - Two 5-year observations of goats with microporous surfaced Bjork-Shiley Monostrut
      mitral heart valves without anticoagulation show the important point that one
      went through four the other two normal pregnancies with delivery of fourteen
      kids. Furthermore, the local findings on the valves suggest that the porous
      surface should be used only to invite a thin, endothelialized neointima over a
      preferably carbon-coated suture ring to continue over the groove and to the
      adjacent part of the valve flange. The vertical or central part of the ring and
      the struts, in the control material with a polished surface, have never been the
      origin of a thrombus and should therefore be polished.

PMID- 1614212
TI  - Left ventricular mechanics and energetics in the dilated canine heart: acute
      versus chronic mitral regurgitation.
AB  - The effects of volume overload associated with mitral regurgitation on left
      ventricular systolic mechanics, energetics, mechanical to external stroke work
      efficiency, and ventriculoarterial coupling were examined in 11 conscious, closed
      chest dogs. Miniature radiopaque tantalum markers were implanted into the
      myocardium to measure left ventricular volume, and biplane cinefluoroscopic
      images were obtained 1 week and 3 months after creation of mitral regurgitation.
      Echocardiographically determined left ventricular mass increased from 116 +/- 28
      to 152 +/- 29 gm (p less than 0.001). Left ventricular end-diastolic and end
      ejection volumes increased by 24% and 27%, respectively. Global left ventricular
      systolic performance was assessed by the slopes (linear regression) of the end
      systolic pressure-volume and end-systolic stress-volume relationships corrected
      for change in end-diastolic volume; normalized end-systolic pressure-volume
      relationships fell by 36% (p less than 0.001), and normalized end-systolic stress
      volume relationships declined by 21% (p less than 0.005). The normalized end
      systolic volume at 100 mm Hg end-systolic left ventricular pressure increased
      from 0.63 to 0.75 (p less than 0.05). Similar results were observed based on a
      nonlinear (quadratic) fit of the end-systolic pressure-volume data. In terms of
      energetics, the slopes of the stroke volume-end-diastolic volume and pressure
      volume area-end-diastolic volume relationships fell significantly, indicating
      reduced external stroke work and mechanical energy at any given level of preload.
      Additionally, the efficiency of energy transfer from pressure-volume area to
      external pressure-volume work at matched end-diastolic volume was 25% lower (p =
      0.006) at 3 months compared with the 1-week measurements. While overall effective
      arterial (or total vascular) elastance tended to decrease after a period of time,
      the effective ventriculovascular coupling ratio increased from 1.6 +/- 0.6 to 2.7
      +/- 1.1 (p less than 0.005), indicating a greater degree of mismatch between the
      left ventricle and the total (forward and regurgitant) vascular load. Therefore
      the low pressure-volume overload of mitral regurgitation not only resulted in
      depressed left ventricular systolic mechanics but also was associated with
      deterioration of global left ventricular energetics and efficiency and
      exacerbated mismatch in coupling between the left ventricle and the systemic
      arterial bed and left atrium.

PMID- 1614213
TI  - Effects of coronary artery bypass grafting on global and regional myocardial
      function. An intraoperative echocardiographic assessment.
AB  - The immediate effect of coronary artery bypass grafting on global and regional
      myocardial function was studied by means of epicardial two-dimensional
      echocardiography during operations in 20 patients. Echocardiograms were recorded
      before cardiopulmonary bypass and 5 and 30 minutes after bypass. Global left
      ventricular function was expressed as percent short-axis area change and regional
      function as percent fractional area change. Segments were classified according to
      their baseline function as normal (percent fractional area change greater than
      40%), moderately hypokinetic (percent fractional area change 21% to 40%), or
      severely dysfunctional (percent fractional area change less than 20%). Percent
      short-axis area change was significantly reduced immediately after
      cardiopulmonary bypass (from 42.0% +/- 4.6% to 34.9% +/- 3.0%, p less than 0.05)
      but had returned to baseline 30 minutes after bypass (42.6% +/- 4.0%). Similarly,
      function of normal and moderately hypokinetic segments decreased significantly
      immediately after cardiopulmonary bypass (normal segments: percent fractional
      area change 56% +/- 0.9% before bypass to 42.3% +/- 1.5% after bypass, p less
      than 0.0001; moderately hypokinetic segments: 31.0% +/- 0.9% to 25.1% +/- 1.4%, p
      less than 0.002). Both normal and moderately hypokinetic areas regained baseline
      function by 30 minutes after bypass (normal segments: 53.4% +/- 1.6%; moderately
      hypokinetic segments: 35.4% +/- 2.0%). In contrast, severely dysfunctional
      segments were found to be significantly improved immediately after bypass (14.7%
      +/- 0.9% before bypass to 27.7% +/- 2.1% after bypass, p less than 0.0001). This
      improvement was maintained 30 minutes after bypass (22.8% +/- 1.5%, p less than
      0.001). We conclude that coronary revascularization exhibits an immediate
      beneficial effect on chronically underperfused myocardium having severely
      depressed baseline function. However, in normal and moderately hypokinetic areas,
      the depressant effects of global ischemia and reperfusion prevail in the
      immediate postbypass period, leading to a global depression of cardiac function.

PMID- 1614214
TI  - Surgery for acute dissection of ascending aorta. Should the arch be included?
AB  - Thirty-day and 1-, 5-, 10-, and 20-year overall survivorships among 82 patients
      undergoing replacement of the ascending aorta with or without the arch for acute
      aortic dissection between 1968 and May 1989 were 79%, 66%, 56%, 46%, and 30%,
      respectively. The multivariably determined risk factors for death were the
      inclusion of the arch in the replacement, the year of the operation, the
      predissection New York Heart Association functional class, diabetes, and
      concomitant coronary artery bypass grafting. The current 30-day survivorship
      predicted by the multivariable equation when the operation involves only the
      ascending aorta is 97%, and the 10- and 20-year predicted survivorships are 61%
      and 39%, respectively. When the current era the replacement involves the arch as
      well as the ascending aorta, the predicted 30-day survivorship is 84%, and the 10
      and 20-year ones are 48% and 31%. In 1990 sixteen additional patients (one
      hospital death) underwent ascending aortic replacement, and six (no hospital
      deaths) ascending aorta and arch replacement. The predictions for 1990 from the
      multivariable equation were similar to these actual experiences (Ps for
      differences were 0.6 and 0.4). Seventy percent of surviving patients with DeBakey
      type I dissection were free of a second aortic operation for aneurysmal dilation
      of the distal false channel, but this occurred in none of nine patients in whom
      an intimal tear in the transverse arch was included in the resection.

PMID- 1614215
TI  - More than ten years' follow-up of the Hancock porcine bioprosthesis in Japan.
AB  - From February 1975 through October 1981, 256 Hancock porcine bioprostheses
      (Johnson & Johnson Cardiovascular, King of Prussia, Pa.) (60 aortic, 169 mitral,
      and 27 pulmonary/tricuspid position) were implanted in 220 patients (104 male and
      116 female, aged 9 to 67 years; mean 43.3) at Kyushu University Hospital in
      Japan. The procedures include 41 aortic valve replacements, 121 mitral valve
      replacements, 4 pulmonary valve replacements, 6 tricuspid valve replacements, and
      48 combined valve replacements (31 aortic plus mitral, 13 mitral plus tricuspid,
      and 4 aortic plus mitral plus tricuspid). Hospital mortality was 6.4%. Follow-up
      was 98% during 8 to 14 (mean 10.5) years. Cumulative follow-up was 1836 patient
      years and 2078 valve-years. At 10 years the overall actuarial survival rate,
      including hospital morality, was 70% +/- 3%, and freedom from valve-related
      mortality with sudden death was 87% +/- 3%. More than half of the current
      survivors required no anticoagulant therapy. Freedom from thromboembolism or
      anticoagulant-related hemorrhage (or both) and prosthetic valve endocarditis was
      common. Freedom from structural valve failure and reoperation declined more than
      9 years after replacement of left-sided heart valves but not after replacement of
      right-sided heart valves. Sixty-seven patients underwent 68 repeat operations,
      and there were four deaths (5.9%). The rate of freedom from overall valve-related
      complications at 10 years was 62% +/- 8% for aortic valve replacement, 53% +/- 5%
      for mitral valve replacement, 80% +/- 13% for pulmonary/tricuspid valve
      replacement, and 42% +/- 9% for combined valve replacement. There was a
      significant difference between pulmonary/tricuspid valve replacement and combined
      valve replacement (p less than 0.05). The Hancock bioprosthesis is suitable for
      the replacement of valves in the right side of the heart but not for combined
      valve replacement.

PMID- 1614216
TI  - Triple sequential grafts using the internal mammary artery. An angiographic and
      short-term follow-up study.
AB  - Between December 1984 and December 1988, coronary artery bypass operations,
      involving the use of 119 sequential internal mammary artery grafts with three or
      more anastomoses per conduit, were performed in 116 patients. Patients included
      14 women and 102 men, with a mean age of 60 years. They received a total of 629
      anastomoses; 373 anastomoses were used in multiple sequential arterial bypass
      grafts; 116 sequential left and three right internal mammary artery jump grafts
      were performed. There were 27 patients with bilateral internal mammary artery
      grafts, but only 17 had completely arterial revascularizations. Perioperative
      infarction occurred in 3.4% of the patients; 1.7% of infarctions were related to
      sequential internal mammary artery grafts. There were no hospital deaths. Control
      angiography was performed within a month of the operation in 72 patients (with
      371 anastomoses, of which 229 were in sequential arterial bypass grafts). The
      overall patency rate was 94.6%, and for the internal mammary artery sequential
      graft with three or more anastomoses it was 96.1%. The mean follow-up period was
      13 months; 110 patients were in New York Heart Association class I; there was one
      non-cardiac-related death, and three patients (2.6%) had a late myocardial
      infarction. One was related to the area revascularized by the sequential internal
      mammary artery graft. Multiple sequential internal mammary artery bypass grafts
      in coronary artery disease are feasible, with a high short-term patency and a low
      perioperative morbidity and mortality.

PMID- 1614217
TI  - Platelet activating factor antagonist enhances lung preservation in a canine
      model of single lung allotransplantation.
AB  - Optimal techniques for lung preservation are yet to be defined. Platelet
      activating factor is a phospholipid released by a variety of cells and produces
      pulmonary abnormalities similar to posttransplantation pulmonary dysfunction. We
      investigated the strength of the effect of the platelet activating factor
      antagonist BN 52021 as compared with that of deferoxamine, an iron chelator
      previously shown to improve lung preservation. Differential lung function and
      pulmonary hemodynamics were used to assess preservation after a 6-hour period of
      cold ischemic storage in a modified canine model of left lung
      allotransplantation. Thirty size- and weight-matched mongrel male dogs were used
      for 15 transplant procedures randomized to one of three preservation techniques.
      The University of Wisconsin solution was used as the basic flush solution for all
      experimental animals. BN 52021 was added to the flush solution in one group (10
      mg/kg, n = 5) and deferoxime in another group (10 mg/kg, n = 5). No additives
      were used for the control animals (n = 5). BN 52021 and deferoxime were
      administered to respective donor animals 30 minutes before organ harvesting (10
      mg/kg) and to recipient animals 30 minutes before reperfusion (10 mg/kg). The
      pulmonary artery flush solution was administered (40 ml/kg) over 4 minutes.
      Recipient animals received double-lumen endotracheal tubes and were monitored
      with balloon-tipped, flow-directed catheters in both pulmonary arteries and dual
      angle ultrasonic flow probes around each pulmonary artery. Solid-state high
      fidelity micromanometers were used to measure pressures in the pulmonary artery,
      the left atrium, and the left ventricle. Systemic arterial, right and left
      pulmonary venous, and mixed venous blood samples were analyzed at 1, 2, 4, and 6
      hours after transplantation. Pulmonary venous oxygen tension of the transplanted
      lung for the control group was 202 +/- 81 mm Hg versus 282 +/- 53 mm Hg for the
      BN 52021 group 6 hours after transplantation (p less than 0.05). Pulmonary
      vascular resistance of the transplanted lung for the control group was 319 +/- 54
      dynes.sec.cm-5 versus 149 +/- 71 dynes.sec.cm-5 for the BN 52021 group (p less
      than 0.05). Proton magnetic resonance spectroscopy was performed on segments of
      upper and lower lobes of the native and transplanted lung from recipient animals
      to determine total lung water content. The BN 52021 group had a total lung water
      content of 57.3% as compared with 51.9% for the deferoxime group (p = not
      significant) and 88.6% for the control group (p less than 0.05).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1614218
TI  - Successful twenty-four-hour lung preservation with donor core cooling and
      leukocyte depletion in an orthotopic double lung transplantation model.
AB  - Donor core cooling with cardiopulmonary bypass is a valid method of clinical lung
      preservation. However, organ ischemia with this method is still limited to short
      term intervals. Since circulating leukocytes participate in postischemic injury
      through the release of oxygen-derived free radicals, we examined whether
      leukocyte depletion by mechanical filtration could extend ischemic tolerance of
      the lung during preservation and subsequent double lung transplantation. Bovine
      donor lungs were preserved by donor core cooling (10 degrees to 15 degrees C)
      with cardiopulmonary bypass. Donor lungs were removed, stored in 4 degrees C
      donor blood for 24 hours, and transplanted. Graft function was studied for 6
      hours after transplantation. Group 1 animals (n = 6) underwent standard
      cardiopulmonary bypass with whole blood for donor and recipient procedures. In
      group 2 (n = 6), leukocyte filters were incorporated into the cardiopulmonary
      bypass circuit in both donor and recipient operations. In group 2 recipient
      animals leukocyte counts decreased to 3% of mean baseline values and remained low
      during the experiment. Postischemic lung function (assessed by systemic arterial
      oxygenation, pulmonary artery pressure, pulmonary vascular resistance, airway
      pressure, lung water content, and end-point histologic characteristics) was
      significantly better preserved in the animals with leukocyte depletion. Leukocyte
      depletion by mechanical filtration in both donor and recipient improves the
      ischemic tolerance of the lung beyond that provided by donor core cooling alone,
      resulting in excellent lung function after 24 hours of ischemia.

PMID- 1614219
TI  - Futility of yearly heart biopsies in patients undergoing heart transplantation.
AB  - Three hundred thirty-eight endomyocardial biopsies, performed as part of the
      routine annual evaluation at 1 or more years after transplantation in 211
      patients, were reviewed. In only two instances (0.6%) were the histologic
      findings suggestive, but not pathognomonic, of acute rejection. Both patients
      were treated for rejection and are doing well at 4 and 6 years postoperatively.
      On the basis of the results of this study, we believe that routine yearly heart
      biopsies in asymptomatic patients are not necessary for long-term care of
      patients after heart transplantation, and we believe they should be performed
      only if there is clinical suspicion of rejection or as part of a research
      protocol.

PMID- 1614220
TI  - Hematologic changes during and after cardiopulmonary bypass and their
      relationship to the bleeding time and nonsurgical blood loss.
AB  - The hemostatic dysfunction induced by cardiopulmonary bypass is due, in part, to
      a platelet dysfunction evidenced by a postoperative extension of the bleeding
      time; it leads to increased postoperative blood loss and morbidity. This study,
      which was conducted in 85 patients undergoing cardiopulmonary bypass, was
      designed to characterize the hematologic changes during and after cardiopulmonary
      bypass and to elucidate the relationships between these changes, the extension of
      the bleeding time, and the magnitude of the postoperative nonsurgical blood loss.
      Variables were measured before, during, and 2, 24, 48, and 72 hours after
      cardiopulmonary bypass. Univariate and multivariate analyses were performed with
      either the 2-hour postbypass bleeding time or the 4-hour postbypass blood loss as
      the dependent variables. The reversal of the extension of the bleeding time in
      the postoperative period was accompanied by a significant increase in the mean
      platelet volume and by a significant increase in the level of thromboxane B2
      measured in the blood shed from the site of the bleeding time determination. The
      postoperative bleeding time correlated with the postoperative blood loss, and
      both parameters were dependent on the duration of cardiopulmonary bypass. In
      addition, the postoperative bleeding time correlated with the skin temperature
      and the plasma level of D-dimer, while the postoperative blood loss also
      correlated with temperature and the plasma levels of C3. These data establish a
      direct relationship between the postoperative bleeding time, the postoperative
      blood loss, and temperature. They indicate that the reversal of the postoperative
      extension of the bleeding time is due in part to rewarming and to the release of
      larger platelets into the circulation, and they suggest that hyperfibrinolysis
      and complement activation may play an important role in the cardiopulmonary
      bypass-induced platelet dysfunction.

PMID- 1614221
TI  - Pulmonary function and resting breathing pattern in myotonic dystrophy.
AB  - In 17 patients with myotonic dystrophy, spirometric, flow-volume, and maximal
      mouth occlusion variables were obtained and compared with 8 normal subjects.
      Ventilatory CO2 response was measured by the estimation of the steady-state
      effect of a sufficiently large serial dead space. Variability of resting
      breathing pattern was expressed by the variation coefficients of respiratory
      cycle time and tidal volume. The group means of the total lung capacity (TLC),
      vital capacity (VC), forced expiratory volume in 1 sec (FEV)1 and forced
      inspiratory volume in 1 sec (FIV)1 showed a restrictive pattern. Only maximal
      static mouth pressure (Pi,max), measured at residual volume (RV) level, showed a
      significant positive correlation with both VC (p = 0.03) and FIV1 (p = 0.02),
      suggesting inspiratory muscle weakness as a determinant of the restriction.
      Although the differences were just not significant, both variation coefficients
      of the respiratory cycle time and tidal volume were larger in the group with a
      CO2 sensitivity below the lower limit of normal compared to those with a normal
      ventilatory response to CO2. In 3 patients, fluctuations in FRC were also
      present. We hypothesize that, in addition to the already documented FRC
      fluctuations by uncoordinated spontaneous intercostal muscle action, a defect of
      integration of afferent neural input and chemical drive in the medullary region
      may also be present in these patients.

PMID- 1614222
TI  - Neopterin in tuberculous and neoplastic pleural fluids.
AB  - Neopterin is derived from guanosine-triphosphate, produced by stimulated
      macrophages under the influence of gamma interferon of lymphocyte origin. It has
      been suggested as an excellent marker for activation of the monocyte/macrophage
      axis in some clinical situations. We evaluated its concentration in the pleural
      effusions of 25 individuals (10 tuberculous and 15 neoplastic) as well as in the
      blood of 22 of them (8 tuberculous and 14 neoplastic), comparing these levels
      with those of a control group in 99 normal individuals. The concentration of
      neopterin was determined by radioimmunologic assay. This showed a significant
      increase (p less than 0.001) of neopterin levels in the tuberculous pleural
      fluid, compared to the neoplastic group (42 +/- 23/17 +/- 9 nmol/L). In the
      blood, values were nearly identical to the pleural fluid (41.3 +/- 25/15.8 +/-
      6.9 nmol/L), although with significant differences between them and in relation
      to the control group (p less than 0.001), which had a normal serum value (5.11 +/
      1.92 nmol/L). We emphasize the influence of the neopterin levels in the pleural
      fluid on the diagnosis of causes of pleurisy and its importance as a marker of
      immunologic cellular activity.

PMID- 1614223
TI  - Changes in the migratory ability of human lung and skin fibroblasts during in
      vitro aging and in vivo cellular senescence.
AB  - The migration of human lung and skin fibroblasts was determined during in vitro
      aging and in vivo cellular senescence by measuring their migration from the edge
      of a denuded area of a monolayer. The migration of human fetal lung fibroblasts
      (TIG-1 and TIG-3) decreased only very slightly with increasing passage, whereas
      the migration of human fetal skin fibroblasts (TIG-3S) declined gradually: the
      difference in cell migratory ability between early and late passages was
      significant (P less than 0.05). The migratory patterns of skin fibroblasts from
      adult and elderly donors were also similar to that of fetal skin fibroblasts.
      Next, the migratory abilities of fibroblast lines from adult and elderly donor
      groups were compared, using relatively early passaged cells. The migratory
      ability of the elderly-donor skin fibroblast lines was significantly lower (P
      less than 0.05) than that of the adult-donor skin fibroblast lines. Addition of
      suramin and monensin suppressed the migration of fibroblasts from fetal, adult
      and elderly donors, which implies that fibroblast migration is regulated by
      growth factors and matrix substances. The relationships between the age-dependent
      decline of migratory ability, growth factors and the extracellular matrix are
      discussed.

PMID- 1614224
TI  - Lifespan shortening of the nematode Caenorhabditis elegans under higher
      concentrations of oxygen.
AB  - The effects of higher concentrations of atmospheric oxygen on the lifespans of
      wild type and a temperature-sensitive zyg-9(b244) mutant of the nematode
      Caenorhabditis elegans were examined. Their mean and maximum lifespans decreased
      with increasing oxygen concentration. The mean and maximum lifespans of the wild
      type under 60, 75, and 90% oxygen shrunk by 17 and 10, 31 and 31, and 40 and 41%,
      respectively, as compared with those under 21% oxygen (normal air). The mean and
      maximum lifespan of the zyg-9(b244) mutant under 60 and 90% oxygen shrunk by 18
      and 22%, and 38 and 39%, respectively, as compared with those under 21% oxygen.
      The Gompertz analysis of the survival data of the wild type revealed that the
      exponential Gompertz component, the rate of acceleration of mortality, increased
      with increasing oxygen concentration: i.e. the ageing was accelerated under
      higher concentrations of oxygen. Oxygen acts as a lifespan determinant of the
      nematode. When the animals were exposed to a high concentration of oxygen at the
      early phase of lifespan, the oxygen-induced lifespan shortening was not observed.
      This means that oxygen-induced damage leading to lifespan shortening is repaired
      under 21% oxygen and that the oxygen-induced lifespan shortening does not result
      from any alteration in development and/or mutation.

PMID- 1614225
TI  - Age-related modifications of leucine uptake in brush-border membrane vesicles
      from rat jejunum.
AB  - Leucine uptake in brush-border membrane vesicles purified from rat jejunum is
      sodium-dependent, sensitive to the membrane electrical potential difference and
      enhanced by the intravesicular presence of potassium. This last effect is not
      mediated by the genesis of an electrical potential difference, since potassium
      activation and electrical potential effects are additive. Sodium-dependent
      leucine Vmax (1568 +/- 91 pmol/mg per 3 s, is higher in young rats than in adult
      and old animals. The diffusion component of leucine transport decreases with
      increasing age. Preloading the vesicles with 100 mM KCl increases leucine Vmax
      200% in young animals, 100% in adult and 44% in old animals. The potassium
      activation is a saturation function of the cation concentration. Leucine uptake
      in brush border membrane from old animals is less sensitive to the electrical
      potential difference than in membranes from adult and young animals.

PMID- 1614226
TI  - Differential effects of swimming and running on microsomal metabolism in middle
      aged and aged Fischer 344 rats.
AB  - Cytochrome P-450 (P-450) content as well as p-nitroanisole (pNA) O-demethylase
      and UDP-glucuronyltransferase (UDPGT) activities were determined in livers of
      middle-aged (MA; 12 or 18 months) and aged (24-26 months) rats exercised by
      either treadmill running or swimming. In addition, aniline hydroxylase activity
      was measured in MA runners and aged swimmers and compared to respective sham and
      non-handled controls. Treadmill exercise consisted of running aged and MA rats on
      a motorized treadmill for 16 and 20 m/min respectively, 60 min/day and 4 times
      per week, for 8 weeks. Sham rats were placed on the treadmill twice per week for
      5 min at 8 m/min. No differences were found in any parameter comparing sham rats
      to non-handled controls. Running did not affect body weight or hepatic microsomal
      protein during the 8-week study. A 33-35% decline in microsomal P-450 content in
      treadmill exercised MA and aged rats was found. PNA O-demethylase activity was
      decreased 30% in MA and 45% in aged runners and aniline metabolism was inhibited
      21% in MA rats. UDPGT activity was not affected by running in MA or aged rats.
      Swimming exercise was accomplished by placing the rats in a tank of water (32-33
      degrees C) filled to a depth of 2 ft. Swim time was 60 min twice daily, 5 times
      per week. The aged and MA rats were trained for 6 months and 1 year,
      respectively. Two control groups, non-swimming sedentary (dry control) and 1 min
      swim/day sham (wet control), were utilized. MA and aged wet controls and swimmers
      weighted 8% and 15% less respectively, than MA and aged sedentary rats.
      Microsomal protein was significantly increased in MA swimmers compared to
      sedentary (20%) and wet control (35%) but no change was found with swimming in
      the aged rats. The results of the enzymatic studies were variable in the MA rats.
      Increases in P-450 content were found in wet controls (16%) and swimmers (27%) of
      the MA group, but only the swimming change was significant. No significant change
      was determined for pNA metabolism between swimmers and wet (22%) or dry (17%)
      controls. Aged swimmers and wet controls were more consistent, with no change in
      any of the parameters except aniline metabolism which was significantly increased
      in wet controls (25%) and swimmers (28%) as compared to dry controls. No
      significant change in UDPGT activity was measured in either age group of
      swimmers.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1614227
TI  - The effect of age on mitogen responsive T cell precursors in human beings is
      completely restored by interleukin-2.
AB  - It is well known that the function of T lymphocytes is significantly impaired by
      advancing age. In the present study, attempts have been made to further
      characterize the T cell impairment of elderly subjects. Thus, we have performed
      limiting dilution microculture analysis to evaluate the precursor frequency of T
      lymphocytes responding to a mitogenic stimulus in old and young subjects.
      Furthermore we have evaluated the activity of recombinant interleukin-2 (rIL-2)
      on these cells. The results demonstrate that in older subjects the frequency of
      these precursors is significantly decreased. The in vitro treatment with rIL-2
      increased the frequency of mitogen responsive T lymphocyte precursors in both
      groups so that the difference between the two groups was not significant. Thus
      present results extend the findings demonstrating that older subjects display an
      impairment of T cell functions and that IL-2 treatment may correct these
      alterations. In particular, they confirm the hypothesis that age-associated
      functional changes are more likely due to diminished numbers of reactive cells,
      than to a decline in the activity of all cells.

PMID- 1614228
TI  - Appropriateness of care. A comparison of global and outcome methods to set
      standards.
AB  - The RAND-UCLA Health Services Utilization Study previously analyzed the
      appropriateness of use of carotid endarterectomy based on a literature review and
      global expert judgments. In this study, for 45 of the same clinical indications
      used in the RAND-UCLA Study, the authors compare the appropriateness judgments
      based on the global judgment method to appropriateness ratings based on
      probability estimates of specific outcomes that were provided by the same panel
      of experts. The authors asked these experts to estimate, for each clinical
      indication, the likelihood of important medical outcomes (i.e. stroke within a
      year) in the presence and absence of endarterectomy. Using decision analysis, the
      appropriateness of endarterectomy for these 45 indications was then calculated.
      For only two of the eight physicians were the Spearman rank-order correlations
      between these two methods of judging appropriateness significant and positive.
      (Correlations for the eight physicians ranged from 0.45 to -0.38). This result
      was produced by: 1) the tendency of the experts to estimate relatively poor
      outcomes for seriously ill patients whether or not endarterectomy was performed;
      and 2) a far less consistent effect of clinical factors on outcome estimates than
      on global judgments. Better methods for incorporating probability estimates into
      a global rating process must be developed. The authors found excellent agreement
      between the panelists' relative outcome estimates for common endarterectomy
      indications and the observed stroke rate for these same indications, suggesting
      that one promising method is to use specific outcome data to "anchor" expert
      judgments.

PMID- 1614229
TI  - Falling, health status, and the use of health services by older adults. A
      prospective study.
AB  - In this study, data from the Longitudinal Study on Aging were used to
      prospectively assess the relationship between repetitive falling or falling only
      once in the year before baseline and changes in health status and the use of
      health services. Multiple and logistic regression were used to control for a
      variety of known covariates, in addition to the baseline values of the target
      outcomes. Repetitive falling was associated with decreased health status,
      measured by various activities of daily living and disability indices, at both 2-
      and 4-year follow-ups. One fall, however, was never associated with deteriorating
      health status. Similarly, repetitive falling was related to a decreased
      likelihood of visiting a physician (at the first follow-up, only), but to an
      increased likelihood of hospitalization, nursing home placement, and death (at
      both follow-ups). Falling just one time, however, was only associated with an
      increased likelihood of nursing home placement. Based on outcome trajectories,
      two subpopulations of repetitive fallers were identified. One subpopulation was
      consistent with the rapid deterioration hypothesized by the "spiral" response to
      falling, and includes about 35% of the repetitive fallers (i.e., those who die
      within 4 years of baseline). The other subpopulation was consistent with the
      initial decline and subsequent stabilization hypothesized by the "drop
      stabilization" response.

PMID- 1614230
TI  - The dynamics of health insurance among the near elderly.
AB  - Data from the Longitudinal Survey of Income and Program Participation were used
      to examine the dynamics of health insurance among persons 55 to 64 years of age.
      Persons in this age range are especially vulnerable to incurring high health care
      costs. Between the summer of 1983 and early 1986, 21% of persons 55 to 64 years
      of age experienced some time without health insurance. Approximately one fifth
      were continuously uninsured (4%) while the rest spent only part of the time
      without coverage, typically 4 months or less. Women were particularly vulnerable
      to periods without insurance, accounting for approximately twice as many of them
      as did men. Unlike younger cohorts, the coverage lost among the near elderly
      tended not to be employer coverage. Instead, most uninsured spells were ones in
      which individually purchased coverage was lost. Most spell beginnings were
      unrelated to changes in household employment, yet most spells ended when
      employment within the household increased. Some currently proposed reforms to
      expand health insurance, such as an all-employer mandate, a "pay-or-play"
      mandate, and extending Medicaid to persons in poverty, are less effective in
      reaching this medically high-risk population than in reaching younger persons who
      are uninsured.

PMID- 1614231
TI  - Hospital and patient characteristics associated with death after surgery. A study
      of adverse occurrence and failure to rescue.
AB  - We asked if the factors that predict overall mortality following two common
      surgical procedures are different from those that predict adverse occurrences
      (complications) during the hospitalization or death after an adverse occurrence,
      which we refer to as "failure to rescue." We examined 5,972 Medicare patients
      undergoing elective cholecystectomy or transurethral prostatectomy using three
      outcome measures: 1) the death rate (number of deaths/number of patients); 2) the
      adverse occurrence rate (number of patients who developed an adverse
      occurrence/number of patients); and 3) the failure rate (number of deaths in
      patients who developed an adverse occurrence/number of patients with an adverse
      occurrence). The death rate was associated with both hospital and patient
      characteristics. The adverse occurrence rate was associated primarily with
      patient characteristics. In contrast, failure to rescue was associated more with
      hospital characteristics, and was less influenced by patient admission severity
      of illness as measured by the MedisGroups score. We concluded that factors
      associated with hospital failure to rescue are different from factors associated
      with adverse occurrences or death. Understanding the reasons behind variation in
      mortality rates across hospitals should improve our ability to use mortality
      statistics to help hospitals upgrade the quality of care.

PMID- 1614232
TI  - Physician charges in the hospital. Exploring episodes of care for controlling
      volume growth.
AB  - Medicare physician payments are growing rapidly. At least 40% of the annual
      growth is due to volume increases. Reforms passed in 1989 include volume
      performance standards that attempt to control volume by linking future physician
      fee increases to volume growth. There is concern that defining the entire nation
      as the risk pool will result in an unworkable volume performance standard. One
      way to improve incentives is to create a separate volume performance standard for
      in-hospital physician services, define bundles of services related to the
      hospital stay, and place the medical staff of the hospital at risk for volume
      growth. To forestall the unbundling of services outside the stay, windows could
      be defined around the stay. This study reports physician services during the stay
      and in windows around the stay. In so doing, the study creates the knowledge base
      necessary to design better volume control policies and judge among alternative
      window definitions. Using 1987 data, this study presents average physician
      charges by type of service during: 1) the hospital stay; and 2) 1-month windows
      before and after the stay. For all admissions, 85% of charges occur during the
      stay and 15% occur during the windows (windows for surgical admissions and
      medical admissions are 9% and 23%, respectively). Pre- and postwindows are
      roughly symmetrical and average charges per day gradually increase before the
      admission and decline after discharge. A small physician panel commented on the
      clinical appropriateness of the one month windows. The panel indicates that
      defining in-hospital episodes of physician care is feasible.

PMID- 1614233
TI  - The impact of clinical pharmacists' consultations on physicians' geriatric drug
      prescribing. A randomized controlled trial.
AB  - The impact of clinical pharmacists' consultations on geriatric drug prescribing
      was studied in a prospective randomized controlled trial of patients 65 years of
      age and over discharged on 3 or more medications for chronic conditions from a
      450-bed community hospital. The pharmacists provided consultation to experimental
      patients and their physicians at hospital discharge and at periodic intervals for
      3 months postdischarge. Using a standardized tool, a physician-pharmacist panel,
      blinded to study group assignment of patients, evaluated the appropriateness of
      prescribing for a random sample of 236 patients. Eighty-eight percent had at
      least one or more clinically significant drug problems, and 22% had at least one
      potentially serious and life-threatening problem. Drug-therapy problems were
      divided into six categories: 1) inappropriate choice of therapy; 2) dosage; 3)
      schedule; 4) drug-drug interactions; 5) therapeutic duplication; and 6) allergy.
      Experimental patients were less likely to have one or more prescribing problems
      in any of the categories (P = 0.05) or in the appropriateness (P = 0.02) or
      dosage (P = 0.05) categories. A summary score, measuring the appropriateness of
      the patient's total drug regimen, indicated that experimental patients' regimens
      were more appropriate than those of controls (P = 0.01). Results of this trial
      reveal that clinical pharmacists can improve the appropriateness of geriatric
      drug prescribing in outpatient settings.

PMID- 1614234
TI  - Inflammation and the allergic response.
AB  - The atopic diseases--allergic rhinitis, asthma, and atopic dermatitis--are
      chronic inflammatory diseases characterized by an exacerbating and remitting
      course and can only rarely be associated causally with allergen exposure. The
      challenge to ascribe an allergic basis to these diseases is derived from the
      apparent inability to reconcile these chronic inflammatory features with a
      process thought to be initiated by the rapid release of mediators after the
      interaction of allergen with IgE-coated mast cells. The traditional understanding
      has been that mast cell activation results in the release of a series of
      preformed and rapidly synthesized substances that mediate the immediate onset of
      vasodilatation, vascular leakage, smooth muscle contraction, and irritant nerve
      receptor stimulation. These mediators, however, are rapidly degraded and are not
      thought to be associated with a significant inflammatory component. Recent
      studies, however, have established that the interaction of allergen with the
      immune system is, in fact, far more complex (Fig. 4). In addition to mast cell
      activation, allergen can interact with and activate T-lymphocytes and mononuclear
      phagocytic cells, leading to the secretion of cytokines and other inflammatory
      substances. Furthermore, the interaction of allergen with the mast cell may be
      far more complex, with the potential to stimulate the delayed release of newly
      synthesized cytokines. The interaction of allergen with the immune system also
      promotes the secondary release of inflammatory neuropeptides. Thus, the known
      spectrum of mediators released after allergen exposure has vastly been expanded.
      These include numerous still uncharacterized chemotactic and activating peptides;
      eicosanoids such as 5-HETE, 12-HETE, and leukotriene B4; platelet-activating
      factor; several proteases; neuropeptides and, most importantly, the cytokines.
      These mediators recruit and activate neutrophils, monocytes, basophils, and
      eosinophils, attract additional lymphocytes and mononuclear phagocytic cells, and
      induce mast cell proliferation with further mast cell degranulation. A vicious
      cycle subsequently develops, with further inflammation and tissue destruction.
      Thus, the interaction of allergen with the immune system has become a complex
      cascade capable of producing the chronic inflammatory changes characteristic of
      allergic diseases.

PMID- 1614235
TI  - Urticaria and angioedema.
AB  - Urticaria and angioedema are usually the clinical consequence of vasoactive
      mediators derived from mast cells in the skin or mucosal tissues. Efforts to
      classify mast cell-mediated causes of urticaria and angioedema have generally
      been frustrated by their diverse pathogenesis and clinical course. The term acute
      is typically used to describe fleeting lesions whose recurrence does not extend
      beyond 6 weeks. Chronic is the term used to describe lesions that persist for
      more than a few hours but usually less than a day, and recurrences extend for
      more than 6 weeks. These definitions do not take histology into account. Skin
      biopsies of fleeting lesions demonstrate a paucity of inflammatory cells, whereas
      more persistent lesions display a spectrum of perivascular cuffing by
      predominantly T cells and monocytes. The presence of leukocytoclastic vasculitis
      in persistent lesions indicates an underlying immune complex disease. Many of the
      physical urticarias have fleeting lesions that can be induced with the
      appropriate stimulus for years. This review article has emphasized the clinical
      course and histology of urticaria and angioedema lesions in an effort to provide
      a more complete understanding of the pathogenesis and appropriate treatment.
      Clearly, avoidance of an identifiable inciting stimulus is optimum management,
      although most patients have no etiology defined or the cause is not realistically
      avoidable. At present, treatment options for these patients rely on
      antihistamines to control the immediate consequence of mast cell degranulation.
      Corticosteroids are reserved for the treatment of patients whose urticaria or
      angioedema lesions persist, reflecting the increasing involvement of mononuclear
      cells in the disease process. For leukocytoclastic vasculitis, corticosteroids
      are indicated, and cytotoxic drugs may be required for adequate treatment. Future
      treatments of urticaria and angioedema will evolve based on elucidation of the
      relevant cells and soluble mediators and will include counterregulatory or
      antagonistic peptides and drugs. C1 esterase inhibitor deficiency is a relatively
      uncommon cause of angioedema but is important to understand because of its
      ability to clinically mimic mast cell-mediated angioedemas and its unique
      pathogenesis and treatment. HAE can be divided into two serologic subtypes that
      simply reflect the location of the defect in one of the codominantly expressed C1
      INH genes on chromosome 11. AAE can be divided into two serologic subtypes. AAE
      type I is due to massive consumption of C1-INH, presumably by tumor-related
      immune complexes. AAE type II is due to an anti-C1-INH autoantibody.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1614236
TI  - Anaphylaxis.
AB  - The syndrome of anaphylaxis is a life-threatening event in which the potential
      for patient morbidity and mortality is high. An understanding of the
      pathophysiology of anaphylaxis, the most serious of the allergic disorders, is
      paramount for its diagnosis. In addition to these elements, this article
      discusses newly recognized causes of anaphylaxis and reviews its treatment.

PMID- 1614237
TI  - Drug allergy.
AB  - Although allergic drug reactions are just one type of adverse reaction to
      medications, they are clinically very important because of the morbidity and
      mortality they cause. An ever-expanding pharmacopeia increases the potential for
      allergic drug reactions. An understanding of the types of allergic drug
      reactions, their immunopathologic mechanisms, and the most likely medications
      involved; an approach to determine the drug responsible for the reaction; and
      ways to prevent future allergic drug reactions are important features in
      minimizing patient morbidity.

PMID- 1614238
TI  - Stinging insect allergy.
AB  - Insect sting anaphylaxis is a relatively common problem estimated to affect at
      least 0.4% of the population and is responsible for at least 40 deaths per year
      in the United States. The allergic reactions are mediated by IgE antibodies
      directed at constituents in honeybee, yellow jacket, hornet, and wasp venoms. In
      addition, increasing numbers of reactions occur from fire ant stings, non-winged
      Hymenoptera present in the Southeastern United States. The anaphylactic symptoms
      are typical of those occurring from any cause. Most reactions in children are
      mild, frequently involving dermal manifestations (hives, edema) only. The more
      severe reactions, such as shock and loss of consciousness, can occur at any age
      but are relatively more common in adults. Following sting anaphylaxis,
      approximately 50% of unselected patients will continue to have allergic reactions
      to subsequent stings. The natural history of the disease process is influenced by
      the severity of the anaphylactic symptoms. Children with dermal reactions only
      have a benign course and are unlikely to have recurrent reactions. Patients with
      more severe reactions are at risk for repeat anaphylaxis. Patients with a history
      of insect sting anaphylaxis and positive venom skin tests should have epinephrine
      available and are candidates for subsequent venom immunotherapy, which provides
      almost 100% protection against subsequent re-sting reactions. Recommendations for
      the duration of immunotherapy are evolving. Venom therapy can be stopped if skin
      test reactions become negative. For most patients, 3 years of therapy appears
      adequate, despite persistence of positive venom skin tests.

PMID- 1614239
TI  - Respiratory infections and asthma.
AB  - Airway responsiveness is increased during respiratory virus infections, both in
      subjects with asthma and without underlying pulmonary disease. Furthermore, the
      airway hyperresponsiveness is altered for a prolonged period of time, weeks or
      months after the viral illness has subsided. This article reviews the possible
      mechanisms of virus-associated airway hyperresponsiveness, including the complex
      interplay of IgE-dependent reactions, changes in autonomic nervous system
      function and inflammation, epithelial damage, effects of viruses on the cellular
      immune response, and enhanced late-phase response.

PMID- 1614240
TI  - Occupational asthma.
AB  - Occupational asthma is recognized as the most common form of occupational lung
      disease. Over 200 causative substances have been described. Major cases of
      occupational asthma are discussed along with valuable diagnostic approaches.
      Early diagnosis and removal of the patient from workplace exposure to the
      causative substance can prevent progression to severe asthma.

PMID- 1614241
TI  - Environmental control of indoor air pollution.
AB  - Indoor air pollution is becoming an increasing problem in industrialized
      countries. Most people spend their time indoors which results in chronic exposure
      to indoor allergens and irritants. New products have been introduced to the
      environment to which humans are not immunologically adapted. This article
      describes the main sources of indoor air pollution and the best ways to control
      exposure to indoor air pollutants.

PMID- 1614242
TI  - Allergen immunotherapy. Review of efficacy and current practice.
AB  - The modern use of allergen immunotherapy is described. Evidence for efficacy in
      inhalant allergy and insect sting allergy is reviewed. Current indications for
      allergen immunotherapy are discussed.

PMID- 1614243
TI  - Avulsion of the anomalous facial nerve at stapedectomy.
AB  - Injury to the facial nerve in an anomalous location overlying the oval window at
      the time of stapedectomy has rarely been reported. The authors recently have
      encountered three patients with such injuries. The facial nerve was found at the
      time of reexploration to run directly over the oval window. A fourth patient was
      explored primarily for a conductive hearing loss and the same anomalous course
      was discovered. The purpose of this report is to alert the otologic surgeon to
      this rare but potentially catastrophic anomaly and to review the pertinent
      embryology and management of these malformations.

PMID- 1614244
TI  - S-100 protein in human inner ear: use of a novel immunohistochemical technique on
      routinely processed, celloidin-embedded human temporal bone sections.
AB  - The authors recently developed a new antigen retrieval technique which allows
      immunohistochemical detection of proteins in routinely processed, celloidin
      embedded human temporal bone sections. This technique was used in the present
      study, which reports the occurrence of S-100 protein in the human inner ear.
      Fifteen celloidin-embedded human temporal bone sections, obtained from the
      Eastern Temporal Bone Bank at the Massachusetts Eye and Ear Infirmary, were
      tested with the monoclonal antibody to S-100. This protein was found in the
      spiral ligament, in Reissner's membrane, in the spiral limbus, and in the
      basement membrane of the cochlea. S-100-positive, thin fibers could be seen as
      supporting elements in the acoustic nerve and the facial nerve. This protein was
      localized along the surface of vestibular wall. The new technique provides an
      immunohistochemical approach to studying routinely processed human temporal bone
      sections and may prove useful in the field of immuno-otopathology.

PMID- 1614245
TI  - Tracheoesophageal complications of thyroid disease.
AB  - Fine needle aspiration (FNA) biopsy in thyroid diagnosis has significantly
      reduced the need for diagnostic thyroidectomy. The relative proportion of
      therapeutic thyroid surgery is therefore increasing and, since a significant
      number of therapeutic procedures are indicated to alleviate tracheoesophageal
      complications, surgeons are likely to be confronted with an increasing percentage
      of potentially challenging cases in the face of declining thyroidectomy
      caseloads. All thyroidectomies done at the authors' institution from 1987 through
      1990 were studied in order to assess the potential impact of FNA on thyroid
      surgery and to specifically analyze the management of those cases accompanied by
      tracheoesophageal complications. It is concluded that 18% of the 87
      thyroidectomies in this series could possibly have been avoided had FNA been
      obtained routinely. The clinical manifestations and surgical management of those
      cases associated with tracheoesophageal complications are presented. General
      therapeutic strategies for such cases are also summarized.

PMID- 1614246
TI  - Facial electroneurography: analysis of techniques and correlation with
      degenerating motoneurons.
AB  - Facial electroneurography is the one electrophysiologic test that quantifies the
      degree of nerve degeneration. This two-part study establishes electroneurography
      (ENoG) as a reliable and valid system of measurement. Part I examines three
      different ENoG techniques in normal subjects and in patients with advanced
      paralysis. Myogenic compound action potential (CAP) absolute amplitudes differ
      according to methodology, site, and gender. Analyses of side-to-side and test
      retest CAP differences demonstrate optimized and standardized recording lead
      techniques to be comparable and consistent when CAPs are recorded in the midface.
      The most significant variable is time, i.e., the inconsistency of test-retest
      results. The coefficient of reliability increases when averaging results of test
      sessions repeated at a similar point in time. Part II, an animal model, supports
      the correlation between ENoG predictions following facial nerve injury and the
      level of motoneuron degeneration, as assessed by retrograde transport of horse
      radish peroxidase to the somata of the facial motor nucleus and by peripheral
      axon counts.

PMID- 1614247
TI  - Intraoperative measurement of the elastic modulus of the vocal fold. Part 1.
      Device development.
AB  - Although the concept of manipulating laryngeal biomechanics to improve vocal
      function is not new, there has been a recent proliferation in surgical techniques
      used to affect laryngeal function. These include methods which increase the
      stiffness of the vocal folds, medialize the vocal folds, alter the pitch by
      changing the tension of the vocal folds, and augment the tissues using injection
      of alloplastic materials. Despite these new and possibly revolutionary methods,
      no means are presently available to surgeons to intraoperatively evaluate and
      optimize results of a surgical intervention. This study involved the development
      of a device to measure the in vivo elastic modulus of the vocal folds.

PMID- 1614248
TI  - Intraoperative measurement of the elastic modulus of the vocal fold. Part 2.
      Preliminary results.
AB  - This paper presents initial clinical experience using a device capable of
      measuring the transverse elastic modulus of the vocal fold. These initial results
      indicated that the device may be useful in determining stiffness inequalities
      between the vocal folds.

PMID- 1614249
TI  - Hearing preservation in acoustic neuroma surgery: a continuing study.
AB  - Hearing preservation in acoustic neuroma surgery is possible in a limited number
      of cases. Although there have been many articles published about hearing
      preservation, there have been few studies of long-term hearing results, nor is it
      known if there is an increased rate of tumor recurrence when hearing preservation
      is attempted. Twenty-two patients who underwent a hearing preservation procedure
      via the retrosigmoid approach were selected from 80 consecutive patients with
      cerebellopontine angle tumors operated on from February 1984 to November 1987.
      Useful hearing was retained in 11 cases as reported in a previously published
      study. Seven patients continue to have useful hearing after 3 to 5 years; 3 have
      shown a gradual but slight decline. There has been no tumor recurrence in these
      patients, but 2 patients, operated on early in the series and who had lost
      hearing, had recurrent tumor.

PMID- 1614251
TI  - Granular cell tumors of the trachea.
AB  - In contrast to the relative frequency of granular cell tumors (GCT) in the larynx
      and bronchi, the occurrence of these tumors in the trachea is rare. A 50-year
      review of the English-language literature disclosed only 24 described cases of
      tracheal GCT. This report reviews the clinicopathologic data from those 24 cases,
      along with the data from 2 cases obtained via a personal communication and the
      data from 4 previously unpublished cases obtained from a 30-year review of the
      Armed Forces Institute of Pathology archives. Tracheal resection was the
      predominant mode of therapy and often was performed as a salvage procedure for
      failed endoscopic excisions. Recommendations for a more uniform approach to
      surgical management are provided.

PMID- 1614250
TI  - Study of the performance of four prelinguistically or perilinguistically deaf
      patients with a multi-electrode, intracochlear implant.
AB  - Individuals who are born deaf or become deaf in early childhood and are implanted
      as adults (or in late adolescence) with a multi-electrode, intracochlear implant
      often cannot understand speech by audition alone. Test results of four implanted
      patients were analyzed to determine 1. if there was a difference in performance
      between patients; 2. if there was a relation between performance and history of
      auditory stimulation; and 3. which tests revealed performance differences. On
      audition-only and audition-plus-vision tests, overall performance was rank
      ordered from lowest to highest for patients 1, 2, 3, and 4, respectively. Patient
      4 recognized a few words audition-only. Patients 1 and 2 had long periods of no
      auditory stimulation; patients 3 and 4 had long periods of auditory stimulation
      with hearing aids prior to implantation. Tests not revealing differences in
      performance were identified.

PMID- 1614252
TI  - Promontory electrical stimulation in postoperative acoustic tumor patients.
AB  - Complete deafness can follow acoustic tumor surgery and results from labyrinthine
      injury, auditory nerve trauma, and/or vascular compromise. A central auditory
      prosthesis is one potential rehabilitative strategy in such patients. Anatomical
      studies suggest that some spiral ganglion cells may survive after vascular
      occlusion, and we have demonstrated responses to electrical stimulation in
      patients after labyrinthectomy. It was thus hypothesized that patients deafened
      after a hearing conservation attempt, but maintaining an intact auditory nerve,
      could utilize an intracochlear implant. To investigate this possibility,
      promontory electrical stimulation was performed on three patients who had tumors
      less than 2 cm and who had serviceable preoperative hearing, but no responses
      postoperatively. Behavioral responses and electrically evoked auditory brainstem
      and middle latency responses were obtained from two patients, one of whom was 6
      years postsurgery. These data indicate that a cochlear implant may be possible
      after acoustic tumor surgery.

PMID- 1614253
TI  - Comparison of vasoconstrictors for functional endoscopic sinus surgery in
      children.
AB  - Three different vasoconstricting agents were evaluated during functional
      endoscopic sinus surgery (FESS) in 57 children. Oxymetazoline hydrochloride
      0.05%, phenylephrine hydrochloride 0.25%, or cocaine 4% was applied to the nasal
      mucosa in a prospective, randomized, double-blind fashion. Heart rate and blood
      pressure changes were recorded 5 and 10 minutes after application of the study
      vasoconstrictor to each nostril. The surgeon's subjective impressions of bleeding
      and visualization were recorded for each side of the nose, as were total blood
      loss and anesthesia time. Although all three vasoconstrictors were tolerated well
      by the children, there was a suggestion that heart rate decreased more at 5
      minutes with phenylephrine than with oxymetazoline or cocaine (P = .08) and that
      blood pressure increased more at 10 minutes with phenylephrine than with
      oxymetazoline or cocaine (P = .1). No arrhythmias were noted. Subjective scoring
      for bleeding showed that children receiving oxymetazoline were less likely to
      receive scores of "more" bleeding than usual (3/38 vs. 10/34 for phenylephrine
      and 10/35 for cocaine, P less than .02). Subjective scoring for visualization
      showed that children receiving oxymetazoline were also less likely to receive
      scores of "worse" visualization than usual (3/38 vs. 12/38 for phenylephrine and
      9/35 for cocaine, P less than .01). There was no difference in surgical bleeding
      or visualization between children receiving phenylephrine and children receiving
      cocaine. In our institution, 0.05% oxymetazoline is the preferred vasoconstrictor
      for FESS in children.

PMID- 1614254
TI  - Reduction of hypertrophic earlobes.

PMID- 1614255
TI  - Surgical anatomy of the vertebral artery at the skull base.

PMID- 1614256
TI  - V-wedge crura resection in nasal tip surgery.

PMID- 1614257
TI  - A new simple technique for tracheoesophageal puncture.

PMID- 1614258
TI  - Tissue response following CO2 laser application in apical surgery: light
      microscopic assessment in dogs.
AB  - The potential advantages of CO2 laser in apical surgery have not been established
      histologically. Therefore, the long-term effects of CO2 laser on the apical and
      periapical tissues were examined histologically in dogs 6 months after apical
      surgery. Lased specimens and unlased controls showed periapical inflammatory and
      osteogenic reactions. Lased root surfaces revealed craters with a superficial
      charred layer closely associated with new cementum-like matrix. The subjacent
      dentin appeared tubule-free and eosinophilic. Lased bone trabeculae showed a
      charred layer with a deeper osteocyte-free zone. The charred layer was covered by
      new bone. Detached charred segments in the marrow space and periapical
      inflammatory infiltrate were intimately associated with multinucleated giant
      cells, some containing minute char particles. Such cells were absent from the
      root and trabecular char linings. In addition, the charred surfaces were free of
      hard tissue resorption. These results suggest that CO2 laser does not hinder
      healing when applied in apical surgery.

PMID- 1614259
TI  - Holmium:YAG laser recanalization.

PMID- 1614260
TI  - "Photodynamic therapy in gastrointestinal cancer".

PMID- 1614261
TI  - Detection of calcified atherosclerotic plaque by laser-induced plasma emission.
AB  - The use of fluorescence spectroscopy to discriminate atherosclerotic from normal
      tissue is limited by a lower sensitivity for calcified than noncalcified
      atherosclerotic plaque (65% vs. 93%, respectively). To evaluate plasma emission
      as a means to detect calcified plaque, 325 normal and atherosclerotic cadaveric
      aortic sites were irradiated through a 100-micron silica fiber in blood by a
      pulsed holmium laser (lambda = 2.1 microns, fluence = 4 J/mm2). A photodiode
      positioned near the proximal end of the fiber detected plasma emission during a
      laser pulse. Plasma emission was detected at 0% (0/110) of normal, 0% (0/107) of
      noncalcified atherosclerotic tissue, and 91% (98/108) of calcified
      atherosclerotic sites. Spectroscopic analysis confirmed the presence of calcium
      lines in the plasma emission from calcified atherosclerotic plaque. Although
      ablative fluences (greater than 3 J/mm2) were required for plasma generation, a
      single laser pulse ablated only to a depth of 67 +/- 16 microns in normal tissue.
      In an additional 10 calcified atherosclerotic sites, laser ablation was continued
      as long as plasma emission was detected. In all cases, plaque ablation was
      terminated before arterial perforation. Furthermore, the adjunctive use of plasma
      detection improved the accuracy of fluorescence spectroscopic classification of
      normal and atherosclerotic tissue. In conclusion, plasma detection has a high
      sensitivity (91%) and specificity (100%) for calcified atherosclerotic plaque and
      may be a useful adjunct for laser angioplasty guidance. Furthermore, plasma
      detection can be implemented both simply and inexpensively.

PMID- 1614262
TI  - Monitoring myocardial reperfusion injury with NADH fluorometry.
AB  - Using NADH fluorometry to monitor myocardial metabolism, the mechanism of
      reperfusion injury was investigated after the delivery of an experimental
      reperfusate. Using an isolated working heart preparation, rat hearts underwent 15
      min of global ischemia at 37 degrees C. Following the ischemic insult, an
      oxygenated enriched reperfusion solution was given for 5 min. The hearts were
      then returned to a working state and aortic flow recorded to evaluate recovery.
      NADH levels were monitored throughout the experiment with a fluorometer and
      glycogen, AMP, ADP, and ATP were measured biochemically pre- and postischemia,
      after reperfusion and after recovery. In this study, reperfusion injury was best
      abated by an enriched reperfusate. Our results indicate the mechanism for this
      amelioration is not high-energy phosphate replenishment. Rather, as indicated by
      NADH fluorescence, the hearts attain an intermediate level of metabolism that
      permits glycogen to be restored and functional recovery to be improved.

PMID- 1614263
TI  - Transurethral laser prostatectomy in the canine model.
AB  - A technique for performing transurethral prostatectomy was devised using a
      Neodymium:Yttrium Aluminum Garnet laser in a canine model. Six dogs underwent
      transurethral laser prostatectomy following establishment of a perineal
      urethrostomy. The efficacy of the prostatectomies was judged by retrograde
      urethrography, transrectal prostate ultrasonography, cystoscopy, and histologic
      examination. The method of applying laser energy while holding the tip of the
      fiberoptic light guide 2-3 mm away from the prostate was ineffective; with power
      ranging from 40 to 70 watts, this technique resulted mainly in coagulation
      necrosis and removal of only a small amount of tissue. However, placing the tip
      of the light guide in direct contact with the prostate and using power from 70 to
      100 watts produced impressively large prostatectomy defects by tissue
      vaporization. We conclude that this newly devised technique for transurethral
      prostatectomy in the canine model can be performed safely and effectively using a
      Neodymium:Yttrium Aluminum Garnet laser (Neodymium:YAG).

PMID- 1614264
TI  - Microbeam laser-injured neurons increase in vitro astrocytic gap junctional
      communication as measured by fluorescence recovery after laser photobleaching.
AB  - An important aspect of the neuronal-astrocyte relationship is the interaction of
      reactive astrocytes with injured and/or dying neurons. Few studies have focused
      on the signaling of astrocytes by injured neurons or on the possibility that
      neurons can alter astrocytic gap junctional communication. The purpose of this
      study was to determine whether the presence of injured neurons could alter
      astrocytic gap junctional coupling by establishing an in vitro method of
      microbeam laser neuronal injury and coculturing these neurons with astrocytes.
      Neurons from two rat neuronal clonal cell lines were injured using a 20-W argon
      laser operating on the ultraviolet (UV) multiline (351-361 nm) directed through a
      X40 objective of an inverted microscope. After laser injury, the glass slide with
      the injured neurons was sandwiched with a slide on which primary rat astrocytes
      were grown. Although the neurons and astrocytes were bathed in the same medium,
      they were not in direct contact during the coculture period (24, 48, or 72 hr).
      Astrocytic gap junctional dye coupling was examined using the fluorescence
      recovery after laser photobleaching (gap-FRAP) analysis technique. Astrocytes
      cocultured with the injured neurons for 24 to 48 hr did not show a significant
      difference in fluorescence recovery when compared to control values. After 72 hr
      of coculture, there was a significant increase in the gap junctional dye
      coupling. These results indicate that injured neurons influence in vitro
      astrocytic gap junctional conductance after 72 hr of coculture as measured by dye
      coupling.

PMID- 1614265
TI  - Ultraviolet laser-induced fluorescence of colonic tissue: basic biology and
      diagnostic potential.
AB  - Laser-induced fluorescence (LIF) of colonic tissue was examined both in vitro and
      in vivo to assess the ability of the technique to distinguish neoplastic from
      hyperplastic and normal tissue and to relate the LIF spectra to specific
      constituents of the colon. Spectra from 86 normal colonic sites, 35 hyperplastic
      polyps, 49 adenomatous polyps, and 7 adenocarcinomas were recorded both in vivo
      and in vitro. With 337-nm excitation, the fluorescence spectra all had peaks at
      390 and 460 nm, believed to arise from collagen and NADH, and a minimum at 425
      nm, consistent with absorption attributable to hemoglobin. The spectra of colonic
      tissue recorded both in vivo and in vitro are different, primarily in the NADH
      fluorescence component, which decays exponentially with time after resection.
      When normal colonic tissue is compared to hyperplastic or adenomatous polyps, the
      predominant changes in the fluorescence spectra are a decrease in collagen
      fluorescence and a slight increase in hemoglobin reabsorption. A multivariate
      linear regression (MVLR) analysis was used to distinguish neoplastic tissue from
      non-neoplastic tissue with a sensitivity, specificity, predictive value positive,
      and predictive value negative toward neoplastic tissue of 80%, 92%, 82%, and 91%,
      respectively. When the MVLR technique was used to distinguish neoplastic polyps
      from non-neoplastic polyps, values of 86%, 77%, 86%, and 77% respectively, were
      obtained. The data suggest that the LIF measurements sense changes in polyp
      morphology, rather than changes in fluorophores specific to polyps, and it is
      this change in morphology that leads indirectly to discrimination of polyps.

PMID- 1614266
TI  - Preliminary results of intraoperative excimer laser angioplasty: phase 1: an
      adjunct to coronary artery bypass surgery.
AB  - The excimer laser underwent phase I clinical trials at three centers to determine
      its safety for intraoperative coronary laser angioplasty as an adjunct to
      coronary artery bypass grafting. A 308-nm Xenon-Chloride, pulsed-wave excimer
      laser was used to perform angioplasty in 30 patients undergoing coronary artery
      bypass surgery. Forty vessels (30 patients) were treated, in which the extent of
      occlusion ranged from 30% to 100%, with complete occlusion in 40% of all vessels.
      Improvement in vessel luminal caliber was achieved in 33 (79%) vessels, with
      perforations occurring in 4 (12%) vessels, 2 of which required surgical repair.
      The lumens of the remaining 8 (19%) vessels were not enlarged, and 2 (5%) of
      these vessels were perforated. Luminal enlargement was most often achieved in
      totalled occluded vessels in which 16/17 (94%) were recanalized. No patients died
      within 30 days postoperatively. Five patients demonstrated biochemical and
      electrocardiographic evidence of myocardial injury 48 hr postoperatively, and one
      patient died of cardiac arrest 139 days postoperatively. On the basis of these
      results, we believe that excimer laser angioplasty can be performed safely to
      improve coronary luminal patency, even in totally occluded vessels, in an
      operative setting. The long-term value of this procedure remains to be
      elucidated.

PMID- 1614267
TI  - Bone ablation with Er:YAG and CO2 laser: study of thermal and acoustic effects.
AB  - A pulsed Er:YAG laser at 2.94 microns and a superpulsed CO2 laser at 10.6 microns
      are used to investigate bone ablation applications in otolaryngology.
      Quantitative measurements of mass removal and the ablation depth of cat skull
      bone and rat femur are presented with the Er:YAG laser at fluences of 9-117
      J/cm2. Histological results show that the minimal thermal injury zone from the
      edge of the lesion is 5-10 microns. Comparison of the photoacoustic and thermal
      effects during the ablation process indicates that the temperature rise from the
      10.6-microns light was higher than that from the 2.94-microns light but that the
      photoacoustic wave amplitude produced with the Er:YAG laser was higher than that
      with the CO2 laser. The fluence used for the efficient ablation of bone tissues
      produces a photoacoustic wave ranging from 100 to 120 dB. The ear can tolerate
      this level for a short time period. Results of this study suggest that the Er:YAG
      laser can be an important surgical tool in otolaryngology.

PMID- 1614268
TI  - Holmium:YAG laser ablation of human intervertebral disc: preliminary evaluation.
AB  - Percutaneous discetomy has become a viable alternative in the treatment of
      herniated intervertebral disc. This study determined the effectiveness of
      holmium: YAG laser for ablation of human disc tissue. Human cadaveric
      intervertebral disc was harvested and stored in cold saline-soaked gauze for
      evaluation within 24 hr of removal. Using a specially designed apparatus, a 600
      microns diameter fiber was advanced perpendicular through the annulus fibrosis at
      a controlled force of 0.098 Newtons (10 g). Samples were lased in air (n = 17)
      and in room temperature saline (n = 32). The laser energy was delivered at 5 Hz,
      250 microseconds pulsewidth, and from 50 mJ/mm2 to 1,100 mJ/mm2 fluence. Three to
      six holes were lased using identical parameters in each tissue specimen and were
      evaluated histologically and by morphometric analysis. The maximum zone of
      thermal necrosis and thermal denaturation occurred at 700-1,100 mJ/mm2; 140
      microns and 590 microns in air and 80 microns and 730 microns in saline,
      respectively. At fluences between 200 and 700 mJ/mm2, the thermal necrosis ranged
      from 20 to 60 microns in air and from 10 to 50 microns in saline, the zone of
      denaturation also being less. The holes created with the 600 microns fiber were
      circular in shape, with a mean diameter of 500 microns (n = 3). The etch rates
      (penetration/pulse) appeared to increase with increasing fluences. In saline, the
      etch rate ranged from 7 to 53 microns/pulse (r = 0.57, P less than or equal to
      0.10), and, in air, the values ranged from 7 to 65 microns/pulse (r = 0.79, P
      less than or equal to 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614269
TI  - Techniques for pharmacological and toxicological studies with isolated hepatocyte
      suspensions.
AB  - Since its introduction in 1969, the high-yield preparation of isolated
      hepatocytes has become a frequently used tool for the study of hepatic uptake,
      excretion, metabolism and toxicity of drugs and other xenobiotics. Basic
      preparative methods are now firmly established involving perfusion of the liver
      with a balanced-saline solution containing collagenase. Satisfactory procedures
      are available for determining cell yields, for expressing cellular activities and
      for establishing optimal incubation conditions. Gross cellular damage can be
      detected by means of trypan blue or by measuring enzyme leakage, and damaged
      cells can be removed from the preparation. Specialized techniques are available
      for preparing hepatocyte couplets and suspensions enriched with periportal or
      perivenous hepatocytes. The isolated hepatocyte preparation is particularly
      convenient for the study of the kinetics of hepatic drug uptake and excretion
      because the cells can be rapidly separated from the incubation medium. Isolated
      liver cells have also proved valuable for investigating drug metabolism since
      they show many of the features of the intact liver. However, they also show
      important differences such as losses of membrane specialization, some degree of
      cell polarity and the capacity to form bile. The many consequences of the hepatic
      toxicity of xenobiotics including lipid peroxidation, free radical formation,
      glutathione depletion, and covalent binding to macromolecules are also readily
      studied with the isolated liver cell preparation. A particular advantage is the
      ease with which morphological changes as a result of drug exposure can be
      observed in isolated hepatocytes. However, it must be remembered that the
      isolation procedure inevitably introduces changes that may make the cells more
      susceptible than the normal liver to damage by xenobiotic agents. Despite its
      limitations, the isolated hepatocyte preparation is now firmly established in the
      armamentarium of the investigator examining the interaction of the liver with
      xenobiotics.

PMID- 1614270
TI  - Stimulation of melanin synthesis of B16-F10 mouse melanoma cells by bufalin.
AB  - Bufalin, which is one of prominent components of Chinese toad venom, was found to
      decrease the rate of cell proliferation of mouse melanoma clone B16-F10 cells and
      a concomitant stimulation of expression of its melanotic phenotype. The effect of
      bufalin on melanogenesis included stimulation of tyrosinase activity and increase
      of cellular melanin content. These effects became apparent after 48 hr exposure
      to 10(-4) M bufalin and increased thereafter. Other cardiotonic steroids, such as
      cinobufagin and ouabain, at the concentration of 10(-4) M for 6 days, also showed
      the stimulatory effect on melanin synthesis of B16-F10 cells, but not
      digitoxigenin.

PMID- 1614271
TI  - Studies on lidocaine-induced kindling.
AB  - Lidocaine HCl, injected 5 times weekly, produces pharmacological kindling in
      rats. The aims of the present study were to: 1) approximate the threshold dose
      for the effect in mice and 2) determine if injections given less frequently than
      5 times weekly produces kindling. Mice were injected (IP) either 5 times weekly
      for 4 weeks or 2 times weekly for 10 weeks, with doses ranging from 30 to 50
      mg/kg. Kindling was defined as the appearance of convulsions on each of 5
      consecutive injections. The estimated threshold dose for kindling was
      approximately 40 mg/kg, as suggested by the observation that 2 of 8 and 8 of 8
      mice were kindled at 40 and 50 mg/kg respectively when injected 5 times each
      week. Whether mice were injected (50 mg/kg) 5 times weekly, or, only twice
      weekly, 80% of them were kindled by the fifteenth injection. Thus, it would
      appear that pharmacological kindling might be as much a function of number of
      injections as it is of frequency of injections.

PMID- 1614272
TI  - Intraperitoneal injection of chloral hydrate causes intra-abdominal adhesions and
      unilateral testicular atrophy in golden Syrian hamsters.
AB  - We investigated the reason for the high mortality we had observed in
      hypophysectomized-orchidectomized Golden Syrian hamsters that were anesthetized
      with intraperitoneal (i.p.) injections of chloral hydrate (CH). Intact male
      Golden Syrian hamsters were injected intraperitoneally with 0.1cc/100g BW of a
      35% solution of CH, a 35% solution of sodium chloride, or double-distilled water.
      Equal numbers of hamsters in each group were injected on the right or left side
      of the abdomen. Within 10 days, 35% of the CH-injected hamsters were dead or had
      to be euthanized. Autopsy revealed severe peritonitis and adynamic ileus. CH
      injected hamsters that survived gained weight at a rate similar to that of the
      controls. All surviving hamsters were killed 18 days after the injections. Among
      the surviving CH-injected hamsters, 84.6% had intra-abdominal adhesions, 61.5%
      had unilateral testicular atrophy, and 53.8% had a yellowish necrotic mass in the
      epididymal fat pad (EFP). All the lesions occurred on the side that was injected.
      The atrophied testes had been rendered cryptorchid due to involvement with intra
      abdominal adhesions. In the water-treated controls, there were no abnormalities;
      whereas, in the saline controls, 75% had a mass in the EFP. Histology of the EFP
      mass was similar in hamsters injected with CH or hypertonic saline and suggested
      a diagnosis of fat necrosis. The results suggest that the mortality, the intra
      abdominal adhesions, and the unilateral cryptorchidism were caused by a single
      i.p. injection of CH, but the fat necrosis in the EFP was probably caused by high
      concentrations of salt. The results further suggest that high concentrations of
      CH should not be injected intraperitoneally for anesthesia in chronic studies,
      particularly of the male reproductive system.

PMID- 1614273
TI  - Identification of hydropathically complementary putative contact sequences within
      epidermal growth factor (EGF) and the EGF receptor.
AB  - Hydropathic complementariness (HC) has been proposed as a novel molecular
      recognition code for how two proteins can recognize one other and thus form a
      reversible complex. If a protein contains a segment of a few amino acid residues
      that is surface-exposed, plus in extended conformation, plus composed of residues
      whose hydropathy pattern is opposite to that of a correspondingly sized segment
      on the respective other protein, this protein may bind to the other one through
      such a segment of HC (1). In order to identify in a pair of proteins sequences of
      HC we have developed the program PUTATIVE SITES SEARCHER (PSS-1) (2), a name that
      alludes to the possibility that such a segment of HC could represent a putative
      contact "site". Here we describe the application of PSS-1 to the study of human
      epidermal growth factor (EGF) and human EGF receptor (EGF-R). Six segments of HC
      were identified, two of which, designated a and b, fall exactly into
      experimentally verified contact regions on EGF as well as on EGF-R. Site a
      consists of residues 25.AEIYMCV.19 of EGF ("half site" aEGF) and of residues
      331.NIKHFKN.337 of the EGF-R ("half site" aEGF-R); site b consists of residues
      34.VCNCAY.29 of EGF and residues 365.PQELDI.370 of the EGF-R. Most interestingly,
      both half sites aEGF and bEGF localize in loop B of hEGF which is recognized as
      being essential for receptor binding. Similar is true for the half sites aEGF-R
      and bEGF-R that localize in subdomain III (residues 314-445) of the extracellular
      part of the EGF-R, also identified to be responsible for EGF binding. Thus, each
      of the two theoretically predicted sites is composed of half sites whose
      functional importance is experimentally verified. This correspondence supports
      the principal suitability of PSS-1 and suggests that EGF binds to EGF-R at least
      in part by means of HC contacts besides using, most probably, also "classical"
      (i.e. non-HC-type) contacts (e.g. charge interactions or hydrophobic bonds).

PMID- 1614274
TI  - Reversible, amine--selective effects of acute and chronic brofaromine treatment
      in the rat.
AB  - The effects of brofaromine, clorgyline (reversible and irreversible type A MAO
      inhibitors, respectively) and tranylcypromine (non-selective MAO inhibitor) on
      rat striatal levels of phenylethylamine, tryptamine, m-tyramine and p-tyramine
      were determined. Brofaromine and clorgyline increased m- and p-tyramine levels,
      but not phenylethylamine levels. Brofaromine given at a dose of 100 mg/kg did
      increase tryptamine levels. Tranylcypromine increased the levels of all four
      amines greatly. The effects of chronic treatment with brofaromine on amine levels
      were not different from those following acute treatment. By contrast, chronic
      treatment with clorgyline caused greater increases in striatal m- and p-tyramine
      levels than did acute clorgyline. These data show that changes in the rat
      striatal levels of m-tyramine and p-tyramine may be used as in vivo indicators of
      the selectivity and reversiblity of inhibition of type A MAO, while tryptamine
      levels reflect non-selective inhibition of both types of MAO.

PMID- 1614275
TI  - Pharmacological evaluation of GS-389, a novel tetrahydroisoquinoline analog
      related to higenamine, on vascular smooth muscle.
AB  - The effects of GS-389, a novel tetrahydroisoquinoline analog, on isolated rat and
      mouse thoracic aorta rings, were investigated. Both GS-389 and papaverine induced
      endothelium-independent, concentration-dependent relaxations of the rat and mouse
      aortae precontracted with phenylephrine (PE). The GS-389-induced inhibition of
      the contractile response to PE was noncompetitive. The initial phasic contraction
      to PE elicited in Ca(2+)-free media was also attenuated by pretreatment with GS
      389, indicating that GS-389 may interfere with the release of intracellular Ca2+
      and/or the effects of intracellular Ca2+ release. GS-389 potentiated the
      vasodilatory effects of isoproterenol and sodium nitroprusside in rat and mouse
      aortae. GS-389 significantly increased cGMP levels in the rat aorta and inhibited
      cGMP phosphodiesterase from the rabbit brain. Methylene blue, but not
      propranolol, inhibited the vasodilatory effect of GS-389. These results suggest
      that the vasorelaxant effect of GS-389 may be due, at least in part, to
      inhibition of cGMP metabolism.

PMID- 1614276
TI  - Effects of concomitant cholinergic and adrenergic stimulation on learning and
      memory performance by primates.
AB  - Physostigmine and other centrally-acting acetylcholinesterase inhibitors are
      currently being examined for their potential in the treatment of Alzheimer's
      Disease. The ability to employ this class of agents is limited by the potential
      for debilitating and dangerous side effects. Clonidine and related drugs have
      recently been demonstrated to enhance memory performance in monkeys. Clonidine
      also inhibits the function of cholinergic neurons in specific brain regions and
      reduces certain side effects of physostigmine. Seven adult macaque monkeys
      performing a delayed matching-to-sample (DMTS) task received regimens of
      increasing doses of clonidine and physostigmine on separate occasions to
      determine the 'best dose' of each agent in terms of enhanced memory performance.
      The best doses were combined as a single administration and performance compared
      to that using the two drugs alone. The combination regimen of clonidine and
      physostigmine was more effective than either drug alone in enhancing memory
      performance. Part of the benefit may have been due to the ability to employ
      significantly higher doses of physostigmine in the combination regimen. A single
      injection of the combination resulted in enhanced performance both on the day of
      administration as well as on the following day. These results are consistent with
      the ability of clonidine to limit the expression or intensity of certain
      physostigmine-induced autonomic side effects, while allowing the cognitive
      beneficial effects of the cholinesterase inhibitor.

PMID- 1614277
TI  - Digitalis-like compounds in the toad Bufo viridis: tissue and plasma levels and
      significance in osmotic stress.
AB  - Digitalis-like compounds (DLC), constituents of animal tissues, are possible
      regulators of the Na+, K(+)-ATPase implicated in water and salt homeostasis. The
      distribution of DLC in the toad (Bufo viridis) was determined following methanol
      extraction and partial purification. DLC highest levels were found in the skin
      but it was also detected in the plasma and many internal organs. Short term
      (hours) exposure of the toad to hypertonic shock (1.5% NaCl) induced an increase
      in plasma osmolarity due to an increase in Na+ and Cl- levels. This treatment
      induced a transient, three fold, increase of DLC levels in the brain and
      transient reduction of its levels in the ventral skin. Acclimation of the toads
      to burrowing conditions for six weeks resulted in an increase in plasma
      osmolarity due to a large increase in plasma urea with a small increase in ion
      concentrations. Under these conditions DLC levels in the dorsal skin increased by
      100% without alteration of its levels in the plasma, brain and ventral skin. DLC
      levels in the toad brain of control animals, showed a significant dependence on
      season, being highest in the summer and lowest in the winter. DLC levels in the
      skin peaked in May while the levels in the plasma were season independent. The
      changes in DLC levels induced by the short- as well as long-term perturbations in
      the animal environmental salinity together with the seasonal differences suggest
      that DLC in the toad is involved in water and salt homeostasis of these animals,
      but may also participate in other unknown functions.

PMID- 1614278
TI  - Changes in hepatic lipid composition after infection by LP-BM5 murine leukemia
      virus causing murine AIDS.
AB  - The severe hepatic disorders in patients with acquired immune deficiency syndrome
      (AIDS) is often attributed to a variety of other factors which could affect
      hepatic function. To evaluate the mechanism of liver damage in murine AIDS
      induced immune-suppressed animal, a murine model of AIDS (MAIDS), caused by
      infection with LP-BM5 murine leukemia virus was used at a late stage of the
      disease. Retroviral infection significantly increased hepatic cholesterol,
      triacylgycerol and the cholesterol/phospholipid ratio. Similarly, the proportions
      of palmitic, palmitoleic, linoleic, ratios of linoleic to arachidonic and
      saturated to unsaturated fatty acids were significantly lower while the
      proportion of oleic, docosatetraenoic and docosahexenoic fatty acids were
      significantly increased in the retrovirus infected mice. Hepatic dysfunction as
      evidence by increased serum transaminase levels were also observed in the
      retrovirus infected animals. The data suggest that the liver damage in murine
      AIDS is induced by retroviral infection and the desaturase enzymes system
      necessary to maintain regular balance of the fatty acids in the cells may be
      affected during retroviral infection.

PMID- 1614279
TI  - Characterization of the heredity of kininogen deficiency in brown Norway
      Katholiek strain rats.
AB  - Brown Norway rat strain has been studied for mode of inheritance of its
      congenital deficiency in plasma high molecular weight (HMW)-kininogen and low
      molecular weight (LMW)-kininogen, and low plasma level of prekallikrein. We
      examined the genetics of the deficiency by performing a mixed breeding experiment
      between B/N-Katholiek (B/N-Ka, deficient) and B/N-Kitasato (B/N-Ki, normal)
      strains. Incidence of the deficiency was judged by the plasma level of HMW
      kininogen. Plasma level of HMW-kininogen was around 50% of the normal level in
      all F1 generations of the hybrid between male B/N-Ka and female B/N-Ki (Exp. 1),
      and between female B/N-Ka and male B/N-Ki (Exp. 2). Incidence of deficiency
      (plasma HMW-kininogen level less than 5%) in Exp. 1 was 23.8% in male F2 and
      20.0% in female F2 generations. By Exp. 2 also the incidence was 25.0% in male
      and 30.0% in female F2 generations. There was no significant difference of the
      incidence between the two experiments or sexes. These results indicate the
      inheritance of the kininogen-deficiency to be Mendelian autosomal recessive, the
      same as for the reported cases of human kininogen deficiency. Gel filtration
      study suggests that prekallikrein in the B/N-Ka plasma may be free form, while
      that in the B/N-Ki plasma may form complex with HMW-kininogen.

PMID- 1614280
TI  - Erythropoietin induced transmembrane calcium influx in essential hypertension.
AB  - The effects of erythropoietin (EPO) on cytosolic free calcium concentration
      ([Ca2+]i) in platelets of 20 essential hypertensive patients (HT) and of 25
      normotensive subjects (NT) were investigated using the fura2 technique. In
      resting platelets [Ca2+]i were not significantly higher in HT compared to NT
      (74.3 +/- 7.8 nM vs 59.8 +/- 7.0 nM, mean +/- SEM). Addition of EPO significantly
      increased [Ca2+]i in HT compared to NT (13.8 +/- 5.3 nM vs 0.9 +/- 1.9 nM, p less
      than 0.01). EPO increased the amount of calcium in intracellular stores. This was
      confirmed independently using thrombin-induced changes of [Ca2+]i in a calcium
      free medium and using chlorotetracycline as a marker of stored calcium. After
      preincubation with EPO thrombin-induced changes of [Ca2+]i were significantly
      lower in HT compared to NT (306.1 +/- 30.0 nM vs 407.7 +/- 35.7 nM, p less than
      0.05). In a calcium-free medium after preincubation with EPO thrombin-induced
      changes of [Ca2+]i were significantly lower in HT compared to NT (54.7 +/- 11.8
      nM vs 100.9 +/- 10.5 nM, p less than 0.05) indicating lower storage capacity in
      HT. It is concluded that elevated response to EPO may provide a powerful tool to
      evaluate diagnosis and underlying pathophysiological mechanisms in essential
      hypertension.

PMID- 1614281
TI  - 4-Iodotomoxetine: a novel ligand for serotonin uptake sites.
AB  - The tomoxetine analog, R-4-iodotomoxetine, binds in vitro to a single site of rat
      cortical membranes with high affinity (Kd = 0.03 +/- 0.01 nM, n = 4) and can be
      blocked by a selective serotonin reuptake site inhibitor, paroxetine. The [125I]R
      4-iodotomoxetine binding at equilibrium is saturable and is temperature- and
      Na(+)-dependent. The number of specific [125I]R-4-iodotomoxetine binding sites
      (Bmax = 356 +/- 20 fmol/mg protein) is similar to that of [3H]citalopram (329 +/-
      30 fmol/mg protein), a known serotonin uptake inhibitor. The binding of [125I]R-4
      iodotomoxetine is selectively inhibited by several serotonin uptake blockers, and
      a good correlation is demonstrated between the potency of various drugs to
      inhibit in vitro binding of [125I]R-4-iodotomoxetine and [3H]citalopram. In
      addition, lesions performed with the neurotoxin p-chloroamphetamine, which
      destroys monoamine neurons, including serotonergic neuronal system, result in a
      90% reduction of [125I]R-4-iodotomoxetine binding when compared to sham controls.
      These results indicate that the binding sites labeled by [125I]R-4-iodotomoxetine
      are associated with the neuronal serotonin uptake sites. However, the in vivo and
      ex vivo results do not show regional localization corresponding to the
      distribution of serotonin uptake sites. The nonspecific uptake may be related to
      this compound's high lipophilicity (octanol-buffer partition coefficient = 1100 -
      1400 at pH 7). Although the in vivo properties of [125I]R-4-iodotomoxetine make
      it an unlikely candidate for mapping serotonin uptake sites with SPECT, the high
      affinity and selectivity should make it a useful tool for in vitro studies of the
      serotonin uptake sites.

PMID- 1614282
TI  - Carbamazepine produces nonspecific effects on cocaine self-administration in
      rats.
AB  - Anecdotal evidence in humans suggest that carbamazepine suppresses cocaine
      induced rush and craving. Such claims are unsupported in controlled trials using
      a placebo control. In the present study, rats were trained to self-administer
      i.v. cocaine in daily 2-hr sessions in which every tenth lever press delivered 1
      mg/kg cocaine. After responding was stable, they were injected before each
      session with the vehicle for 2 days followed by carbamazepine for 2 days. At a 7
      mg/kg dose, carbamazepine was without effect, whereas 15 mg/kg suppressed
      responding for cocaine only on the second (day 4) day of carbamazepine treatment.
      With 4 consecutive days of treatment, carbamazepine (15 mg/kg) reduced cocaine
      maintained responding slightly, but significantly. In another group of animals
      trained to lever-press for food reinforcement, carbamazepine (15 mg/kg) also
      significantly decreased the rate of responding, suggesting that the suppression
      of responding was not specific to cocaine-reinforced behavior.

PMID- 1614283
TI  - Quantitative analytical mass spectrometry of endogenous neuropeptides in human
      pituitaries.
AB  - This manuscript reviews state-of-the-art mass spectrometric (MS) methodology for
      the qualitative (amino acid sequence determination) and quantitative analysis of
      opioid neuropeptides in human pituitary tissue. Those analytical data are
      required for the elucidation of the basic molecular mechanisms involved in tumor
      formation and to test the hypothesis that metabolic defects in neuropeptidergic
      system processing is a contributing factor to human anterior pituitary tumor
      formation. Several different neuropeptide products that derive metabolically from
      the proenkephalin A and proopiomelanocortin (POMC) precursors have been analyzed
      separately and together in human pituitaries, including post-mortem controls and
      post-surgical tumors. The quantification, with optimal molecular specificity, of
      a peptide in a tissue is an important measurement because the amount of an
      endogenous peptide reflects the ratio of its synthesis to its degradation and
      thus, any defects in those processes may be reflected in the amount of a peptide.

PMID- 1614284
TI  - An EEG analysis of drug effects after mild head injury in mice.
AB  - An electroencephalographic (EEG) and behavioral model of head injury in
      unanesthetized, free moving mice has been used to test the effects of TRH and
      GM1. In our experimental conditions a mechanical head injury capable of inducing
      loss of righting reflex for 2 to 60 sec, also induces a consistent decrease of
      the total power of the spectrum of EEG and a decrease of the power of fast beta
      band (20-40 Hz) for at least 120 min. TRH, injected after trauma in dose of 10
      mg/kg, caused improvement of EEG total power of the spectrum. GM1 in high (30
      mg/kg) but not in low dose (5 mg/kg) caused more rapid restoration of both the
      total power and fast as well as slow beta band power. These results suggest that
      GM1 has favorable effects on post-concussive neurophysiological symptoms in head
      injured animals.

PMID- 1614285
TI  - Comparative effects of Des Leu Angiotensin I and Angiotensin II on AVP secretion
      from the hypothalamoneurohypophysis and pituitary of the rat.
AB  - In the present study we compared the effects of Des Leu Angiotensin I (Des Leu
      AI) with Angiotensin II (AII) on the secretion of vasopressin (AVP) from the
      isolated hypothalamoneurohypophyseal system (HNS) and isolated posterior
      pituitary gland of the rat. Administration of 10(-6)M, 10(-5) M and 10(-4) M Des
      Leu AI was without significant effect on AVP secretion from the HNS. A similar
      phenomenon was seen in the posterior pituitary with 10(-6) M and 10(-5) M Des Leu
      AI, although 10(-4) M significantly increased AVP release. Administration of 10(
      6) M AII was without significant effect in either preparation, although 10(-5) M
      and 10(-4) M AII caused significant dose-dependent increases in AVP secretion
      over control release that were similar in both the HNS and posterior pituitary
      gland. These results suggest that Des Leu AI is not a physiologically relevant
      stimulus of AVP secretion when restricted to this area of the rat brain. They are
      also consistent with the presence of receptors sensitive to AII in the pituitary
      gland of the rat.

PMID- 1614286
TI  - The role of cyclo-oxygenase and lipoxygenase in the interleukin-1-induced
      activation of the HPA axis: dependence on the route of injection.
AB  - Interleukin-1 (IL-1) has been shown to activate the hypothalamic-pituitary
      adrenal (HPA) axis, and to elevate cerebral concentrations of tryptophan and the
      norepinephrine catabolite, 3-methoxy,4-hydroxyphenylethyleneglycol (MHPG).
      Eicosanoids have been shown to be involved in a number of the effects of IL-1,
      but their role in the activation of the HPA axis is controversial. We studied the
      effects of various cyclo- and lipoxygenase inhibitors on the neurochemical and
      HPA responses to IL-1. Pretreatment of mice with the cyclo-oxygenase inhibitors,
      indomethacin (10-25 mg/kg) or ibuprofen (10 mg/kg) failed to prevent the
      elevations of plasma corticosterone, or hypothalamic MHPG or tryptophan that
      followed intraperitoneally (IP) administered IL-1. Similar results were obtained
      with the nonspecific oxygenase inhibitor, BW 755C, and the lipoxygenase
      inhibitor, BW A4C. However, the cyclo-oxygenase inhibitor, diclofenac, did
      attenuate the IL-1-induced elevation of plasma corticosterone and the
      neurochemical changes. To resolve the conflicting data on the effect of
      indomethacin on the IL-1-induced elevation of plasma concentration, we studied
      the effects of indomethacin on the response to IL-1 injected intravenously (IV).
      By contrast with the response to IP IL-1, that to IV IL-1 was attenuated by
      indomethacin. Time course of the HPA response to IL-1 is more rapid following IP
      injections than IV, therefore we assessed the effects of IV IL-1, earlier than
      that to IP IL-1. Forty min following IP IL-1, the corticosterone response to IL-1
      was markedly attenuated. This suggests that more than one mechanism is involved
      in the HPA response to IL-1. The more rapid one, predominant in the case of IV
      injections, is sensitive to cyclo-oxygenase inhibitors, whereas the slower one is
      not.

PMID- 1614287
TI  - Changes in plasma free and sulfoconjugated catecholamines before and after acute
      physical exercise: experimental and clinical studies.
AB  - To elucidate whether sulfoconjugated catecholamines in plasma, especially
      dopamine, serve as a source of free catecholamines, we examined the change in
      afterload on the deconjugating activity of catecholamines in isolated Langendorff
      perfused rat hearts. Dopamine-sulfate was administered under ordinary or high
      work-load conditions. Free dopamine in the effluent was increased by the high
      work-load of the hearts, whereas conjugated dopamine showed an apparent decrease.
      These results indicate the possibility that deconjugation of sulfoconjugated
      catecholamines is accelerated by a high-work-load. To obtain further evidence in
      humans, we also examined the changes in the plasma levels of free and
      sulfoconjugated catecholamines in healthy volunteers before and after marathon
      running. Free dopamine increased 1.99-fold from the baseline value after
      exercise, whereas conjugated dopamine decreased by 12%. Similarly, the plasma
      levels of free noradrenaline and adrenaline increased after exercise to 2.45- and
      1.51-fold their respective baseline values, while conjugated noradrenaline and
      adrenaline both decreased. These clinical results, as well as those of the
      experimental studies, suggest that the increase in plasma free catecholamines
      after exercise is due not only to increased release from the sympathoadrenal
      system but also to accelerated conversion from sulfoconjugated catecholamines in
      the plasma.

PMID- 1614288
TI  - Blockers of potassium current and resting membrane potential in rat muscle
      fibers.
AB  - Rat diaphragm fibers were equilibrated for several hours in 150 mM KCl; when they
      were returned to 5 mM KCl the resting potential went back to its original level
      with a half time of 17 min. This repolarization was blocked by 5 mM BaCl2, a
      blocker of the inward rectifier K channel. On the other hand, 0.1 mM apamin and
      0.02 mM glibenclamide which block the Ca-dependent and ATP sensitive K channels,
      respectively, and 0.1 mM 9-AC a blocker of the Cl- channel did not affect the
      repolarization. 5 mM barium decreased the K conductance measured under current
      clamp conditions in diaphragm muscle fibers. The possible role of the inward
      rectifier system in the repolarization following return to normal [K]o is
      discussed.

PMID- 1614289
TI  - Antimony and Cleopatra.

PMID- 1614290
TI  - Endogenous ouabain: implications for cardiovascular disease diagnosis and
      therapy.

PMID- 1614291
TI  - The role of ionized cytosolic calcium ([Ca2+]i) in injury and recovery from
      anoxia and ischemia.

PMID- 1614292
TI  - The supportive care unit--inpatient geriatric rehabilitation: preliminary data.

PMID- 1614293
TI  - Unusual articular manifestations in chronic renal disease.

PMID- 1614294
TI  - Hemoglobin as oxygen carrier in cell-free fluids.
AB  - The University of Maryland is studying the oxygen needs of internal organs and
      how these needs can be met by oxygen carriers in cell-free fluids. Once
      developed, cell-free oxygen carriers will have a large variety of applications
      including hemodilution, transfusion therapy, organ preservation, and cancer
      therapy.

PMID- 1614295
TI  - A new concept of hemorrhagic shock: implications for therapy.

PMID- 1614296
TI  - The importance of measuring microalbumin.

PMID- 1614297
TI  - Violence in the Accident and Emergency Department.
AB  - Crimes of violence are recorded increasingly frequently, including those
      involving health professionals. We reviewed records of violent incidents kept for
      a major Accident and Emergency Department over a ten-year period. Details were
      recorded in a Violent Incident Book by all grades of A/E staff, and separate
      records were kept by hospital security officers. A total of 407 incidents were
      recorded. Numbers, rank and sex of staff assaulted, types of assault, injuries
      received, weapons used and characteristics and disposal of perpetrators were
      recorded. Many were young males who had been drinking: others were regular
      attenders, of whom three subsequently died and one convicted of murder. Nurses
      and male doctors appeared to be at the greatest risk of assault and receptionists
      at the least risk. Recording of violent incidents and subsequent prosecution
      seemed inconsistent, and may have reflected the lack of a code of practice in
      this area. Suggestions are made about preventing, predicting and dealing with
      violence, and its aftermath, in the A and E department, including the use of
      security officers and closed circuit television, waiting room design, the
      recognition of body language and signs of alcohol or substance intoxication. The
      importance of staff support after an assault is emphasized, including immediate
      and long-term counselling, provision of legal advice, criminal or civil court
      action, victim support schemes and the workings of the Criminal Injuries
      Compensation Board. Free legal advice for staff assaulted at work should be
      included in the terms of service of NHS staff.

PMID- 1614298
TI  - Injuries due to violent crimes.
AB  - This is a study of police reported assaults during 1979, 1982 and 1985 in the
      County of Kopparberg. Criminological and odontological variables of 1,870 cases
      of assaults reported to the police during these three separate one-year periods
      were collected and analysed. Most of the cases were from densely populated areas.
      There was an increase in cases from 1979 to 1985, particularly of violence in
      residences. No differences in the type or kind of assault could be found. The
      proportion of women victims increased markedly and, to a lesser extent, so did
      the proportion of women offenders. One third of the victims were not injured by
      the assault, one third suffered haematomas or swellings and one third suffered
      wounds. 6.5 per cent of the total had fractures. The left side of the face was
      the most common site of soft-tissue injuries and zygomatico-orbital fractures. No
      aggravation of the violence or the resultant injuries could be found during these
      periods.

PMID- 1614299
TI  - Common poisons in Singapore--past and present.
AB  - A study on past toxicological activities in Singapore enabled us to capture the
      trends of poisons abused in this country over the last 108 years. Until the early
      sixties, corrosive alkali and acids, alcohol (poisoning cases), inorganic
      chemicals, heavy metals and plant alkaloids were the mainstay of poisons
      principally used. The seventies and eighties saw a swing towards pharmaceuticals.
      The 1988-89 data gave alcohol (poisoning cases), pharmaceuticals, household items
      such as detergents, hypochlorite and antiseptic, carbon monoxide, paraquat,
      malathion, organic solvents (toluene and xylenes) and narcotics as the mainstay
      of poisons encountered. The last two classes of poisons reflect the continuing
      problems of glue sniffing and narcotics abuse facing Singapore.

PMID- 1614300
TI  - Fatal self-induced hyperinsulinaemia: a delayed post-mortem analytical detection.
AB  - The inconspicuous number of cases of self-induced hyperinsulinaemia reported in
      the literature may suggest that many are obscure enough to escape their
      detection. A case of fatal suicidal hyperinsulinaemia in a non-diabetic is
      reported here, and in whom only a retrospective biochemical analysis provided an
      explanatory cause of death. A quantitative radioimmuno assay (RIA) estimation of
      the refrigerated postmortem blood sample stored at 4 degrees C for three weeks
      gave a positive insulin yield. It reiterates the need, in forensic cases, for a
      very low threshold of suspicion and a good back-up for the appropriate body fluid
      analysis or tissue microexamination, especially when full details of the
      circumstances surrounding the death are not available at the autopsy. A brief
      resume on insulin is presented as a background to the current forensic interest
      in the apparent increase in sudden deaths in young diabetics amidst the
      controversy about the bio-designed 'human' insulin and subjective unawareness of
      severe hypoglycaemia.

PMID- 1614301
TI  - Epilepsy and criminal law.
AB  - Automatic episodes of aggressive or violent behaviour may occur during or after
      an epileptic fit. Epileptic automatisms are regarded by the law as 'insane
      automatisms'. A person who commits a crime during the course of a seizure is
      therefore legally insane and must be committed to a psychiatric hospital. The law
      of insanity is inappropriate when applied to epileptic automatisms. A change in
      the law is therefore necessary to remove epileptic offenders from the legal ambit
      of insanity, and to save them the threat of detention in a mental hospital as a
      consequence of their crime.

PMID- 1614302
TI  - Setting up psychiatric liaison schemes to magistrates' courts: problems and
      practicalities.
AB  - Guidelines are set out to aid those wishing to establish psychiatric liaison
      services to magistrates' courts, as recommended by the Home Office. The account
      is based upon 20 months' experience of running such a scheme at Clerkenwell
      magistrates' court in inner London. The practical problems in initiating such a
      service are explored together with difficulties likely to be encountered in its
      running. These include questions of personnel, interviewing facilities, relations
      with other disciplines, legal issues concerning the Mental Health Act and
      problems encountered in negotiating with catchment area services. Suggestions are
      given as to how difficulties may be overcome. The future of liaison schemes to
      magistrates' courts is discussed.

PMID- 1614303
TI  - Sleepwalking and indecent exposure.

PMID- 1614304
TI  - 'How dangerous is it that this man goes loose!' (Hamlet Act 4 Scene III)

PMID- 1614305
TI  - The right of silence.

PMID- 1614306
TI  - Causes celebres. The Thomas Lund Lecture, delivered to the British Academy of
      Forensic Sciences on Tuesday 22 October 1991.

PMID- 1614307
TI  - Correlations between in vivo 31P MRS measurements, tumor size, cell survival, and
      hypoxic fraction in the murine EMT6 tumor.
AB  - Phosphorus metabolite ratios were measured using 31P magnetic resonance
      spectroscopy shortly before measurement of cell survival and radiobiologic
      hypoxic fraction (HF) in EMT6/SF tumors, transplanted into a hindlimb of Balb/c
      mice. A total of 58 tumors with a volume range of 180 to 1250 mm3 were examined
      in experiments entailing no anesthesia. Postirradiation tumor cell viability was
      measured using an in vitro clonogenic assay. Correlations between tumor volume,
      surviving fraction (SF), HF, phosphorus metabolite ratios, and intracellular pH
      were computed. Both SF and HF increased significantly with tumor volume as did
      the metabolite ratios of inorganic phosphorus and phosphomonoesters to nucleoside
      triphosphates (Pi/NTP and PME/NTP, respectively), as well as Pi to
      phosphocreatine (Pi/PCr). In comparison to HF, the ratios of Pi/NTP, Pi/PCr, and
      PME/NTP each yielded significant positive correlations (Kendall correlation
      coefficients(tau) = 0.25 to 0.33). However, these were not significantly stronger
      than the correlation between HF and volume (tau = 0.21). Apparent values of tumor
      pH did not correlate with any other measured parameter. While these results
      indicate a statistical relationship between HF and the measured metabolite
      ratios, the widely scattered data, as reflected by magnitude of tau less than
      0.35, made metabolite ratios poor predictors of HF in individual tumors.

PMID- 1614308
TI  - Analysis of encoding efficiency in MR imaging of velocity magnitude and
      direction.
AB  - The efficiency of balanced versus unbalanced techniques for phase-angle-based
      velocity magnitude and direction imaging is investigated. Methods having balanced
      flow-encoding gradients (gradients in positive and negative directions with a
      zero center of gravity) are compared with unbalanced methods. For three
      dimensional imaging, a currently used balanced method is the six-point technique
      having opposed gradients pairs for each orthogonal direction. A currently used
      unbalanced method is a four-point null technique which has three orthogonal
      gradients and an additional acquisition having no specific flow encoding to
      correct the baseline (null) phase. In the gradient-limited case of slow flow and
      perfusion, the balanced method is predicted to have higher velocity magnitude-to
      noise ratio per time (SNRV) by a factor of 1.63, with similar results for
      velocity direction. In the wraparound-limited case of faster flows and motions,
      similar results are found when a null acquisition is added to the balanced
      method. This results in a seven-point balanced method having an SNRV 1.51 times
      that of the four-point unbalanced method. If null phases are within the [
      pi/2,pi/2] interval, this additional null acquisition is unnecessary. Other four
      point methods are also considered. These results indicate that, in general,
      balanced methods have advantages over unbalanced methods for velocity imaging.

PMID- 1614309
TI  - Application of self-refocusing band selective RF pulses for spectroscopic
      localization.
AB  - A new self-refocusing slice selection 90 degrees pulse is presented and its
      incorporation in the SPACE localization sequence described. Experimental
      comparisons are made with the self-refocusing pulse reported by Geen (H. Geen, S.
      Wimperis and R. Freeman, J. Magn. Reson. 85, 620 (1990)). The main source of
      localization error in the SPACE sequence is traced to the hard pi/2 pulse and the
      development of a shaped-pulse version of the sequence is described. This required
      the calculation of a slice-selective pulse capable of rotating coherent
      transverse magnetization to the z-axis. The RF power requirements for these
      experiments are also discussed.

PMID- 1614310
TI  - Metabolic response of the human heart to inotropic stimulation: in vivo
      phosphorus-31 studies of normal and cardiomyopathic myocardium.
AB  - In order to determine if an increase in myocardial oxygen consumption is
      accompanied by changes in high energy phosphates in normal subjects and patients
      with dilated cardiomyopathy, phosphorus-31 spectra were acquired under resting
      conditions and during dobutamine infusion. In seven normal subjects, dobutamine
      raised the rate-pressure product to 226% of control. The ratio of PCr/ATP was
      1.86 +/- 0.17 (mean +/- SE) under resting conditions and 1.90 +/- 0.22 (P = 0.44)
      with dobutamine infusion. In eight patients with dilated cardiomyopathy,
      dobutamine raised the rate-pressure product to 161% of control. As in the normal
      subjects, the ratio of PCr/ATP under resting conditions (1.63 +/- 0.24) was
      unchanged during dobutamine infusion (1.57 +/- 0.24, P = 0.38). These data
      indicate that increases in cardiac work do not have a major effect on high energy
      phosphate concentrations in normal subjects or in patients with clinically
      compensated dilated cardiomyopathy.

PMID- 1614311
TI  - NMR studies of erythrocytes immobilized in agarose and alginate gels.
AB  - 31P and 13C NMR were used to study the energy metabolism in perfused, human
      erythrocytes. The erythrocytes were immobilized in agarose threads, Ca- or Ba
      alginate beads, and Ba-alginate-coated agarose threads. Erythrocytes were easily
      washed out from the agarose threads, but not from alginate-containing gels.
      Various small molecules, such as hypophosphite, dimethyl methylphosphonate, and
      methylphosphonate, were taken up from the perfusion medium in a normal manner. In
      addition, the 2,3-bisphosphoglycerate (2,3-DPG) chemical shifts were sensitive to
      the oxygen partial pressure suggesting that O2 molecules were diffusing through
      the gel and modifying the binding of 2,3-DPG to hemoglobin. A combination of
      inosine and pyruvate stimulated the synthesis of 2,3-DPG, but only if inorganic
      phosphate was present in the perfusion medium. Inosine only resulted in a
      dramatic rise in the intracellular sugarphosphate concentrations. Furthermore, [2
      13C]glucose was converted to [2-13C]lactate by immobilized cells at a rate which
      was comparable to that in a control suspension. In summary, immobilization in Ba
      alginate-coated agarose threads was an efficient way of trapping human
      erythrocytes for whole cell NMR investigations.

PMID- 1614312
TI  - Chemical shift imaging with phase-encoding RF pulses.
AB  - An inherent problem of conventional chemical shift imaging is signal
      contamination into adjacent voxels. This is especially severe in proton
      spectroscopy of the central nervous system, where the lipid signal from the skull
      is several orders of magnitude higher than the metabolite resonances from the
      brain. The reason for the contamination lies in the fact that the distribution of
      spins does not coincide with the discrete sampling matrix of the discrete Fourier
      transformation if a continuous phase-encoding scheme using magnetic field
      gradients is being used. This problem can be overcome if phase encoding is
      performed by appropriately phase-modulated RF pulses. It is demonstrated that
      contamination free spectra can be acquired from voxels immediately adjacent to
      the skull. Using small voxels of 1 x 1 x 2-ml regional variations of N-acetyl
      aspartate in the cerebellum of patients with oligopontine cerebellar atrophy
      could be observed.

PMID- 1614313
TI  - Elimination of oblique flow artifacts in magnetic resonance imaging.
AB  - We present an analysis of how flow oblique to the frequency-encoding direction
      generates displacement artifacts in MR imaging and show that for flow which has
      constant velocity between the start of the phase encoding and the center of the
      echo it is possible to eliminate these artifacts by gradient moment nulling in
      the phase-encoding direction. However, unlike the standard moment nulling
      calculations for flow compensating the frequency-encode and slice-selection
      gradients, the phase-encoding first moment must be nulled specifically with
      respect to the echo center. Limitations of this method imposed by finite gradient
      strengths are analyzed. In 3D volume acquisitions with two axes phase encoded it
      is possible to correct for oblique flow in all directions, and this is
      demonstrated in images of a human volunteer. Correction for oblique flow
      displacement artifacts may be particularly useful in quantitative flow and
      angiographic applications.

PMID- 1614314
TI  - In vivo 7Li NMR imaging and localized spectroscopy of rat brain.
AB  - Lithium-7 in vivo NMR spectroscopy and imaging techniques have been developed at
      4.7 T for rat head. The pharmacokinetics of lithium (Li) uptake in rat head has
      been measured using STEAM localized spectroscopy for the whole brain, which
      showed relatively rapid uptake of Li and a steady level of Li from about 5 to 20
      h. Localized spectroscopy on brain sections revealed no differences in Li
      concentration among the front, middle, and rear of the brain. The spin-lattice
      relaxation time showed a single exponential decay for the head. The spin-spin
      relaxation time for head showed a biexponential behavior. Using a 1H-7Li double
      coil assembly, 7Li images were generated for rat head, as was the corresponding
      1H image for anatomic localization. The 7Li image (7-mm slice thickness, 4-mm in
      plane resolution) recorded after the last dose in a multiple ip dose protocol
      shows the Li distribution in the head and neck. Based on 7Li images, the Li level
      in muscle was about twice that in the brain. Variations of 7Li intensity level
      across the brain were typically small.

PMID- 1614315
TI  - Deblurring for non-2D Fourier transform magnetic resonance imaging.
AB  - For several non-2D Fourier transform imaging methods, off-resonant reconstruction
      does not just cause geometric distortion, but changes the shape of the point
      spread function and causes blurring. This effect is well known for projection
      reconstruction and spiral k-space scanning sequences. We introduce here a method
      that automatically removes blur introduced by magnetic field inhomogeneity and
      susceptibility without using a resonant frequency map, making these imaging
      methods more useful. In this method, the raw data are modulated to several
      different frequencies and reconstructed to create a series of base images.
      Determination of degree of blur is done by calculating a focusing measure for
      each point in each base image and a composite image is then constructed using
      only the unblurred regions from each base image. This method has been
      successfully applied to phantom and in vivo images using projection
      reconstruction and spiral-scan sequences.

PMID- 1614316
TI  - Improving resolution in MRI by interleaving data acquisition for increased
      digitization rates.
AB  - In certain situations in magnetic resonance imaging the digital resolution in the
      frequency encode direction may be compromised by hardware limits on data
      digitization rates. We demonstrate a method of overcoming this restriction,
      without hardware modifications, by interleaving data from several acquisitions to
      produce a higher resolution composite data set.

PMID- 1614317
TI  - Experimental analysis of T1 imaging with a single-scan, multiple-point, inversion
      recovery technique.
AB  - Look and Locker's single-scan, multiple-point, T1 determination technique
      modified for imaging applications was evaluated experimentally for its accuracy
      and reliability with respect to the pulse sequence parameters, in particular, to
      the interpulse delay, tD, and the tip angle, alpha. T1 imaging experiments were
      performed with a 0.5-T imaging system on a phantom which consisted of an array of
      vials containing 2% agarose gels doped with various amount of Mn2+ using
      different combinations of the parameter set (tD, alpha). T1 results obtained with
      this technique were compared with those measured by a conventional inversion
      recovery procedure using the same spectrometer. Strategic choice of pulse
      sequence parameters to minimize experimental errors and the criteria for these
      choices will be discussed.

PMID- 1614318
TI  - MR imaging of brain surface using steady-state free precession.
AB  - We present an imaging technique that affords direct and noninvasive visualization
      of brain surface structure. This technique utilizes the signal before the rf
      pulse in steady-state free precession. This signal highly reflects the spin-spin
      relaxation time T2 as was studied in our laboratory (Matsui et al. J. Magn.
      Reson. 62, 12, 1985). Therefore the cerebrospinal fluid (CSF), having a long T2,
      is depicted as high intensity. The CSF permeates cerebral sulci and fissures. The
      imaging time with this technique is less than 1 min.

PMID- 1614319
TI  - Hadamard spectroscopic imaging technique as applied to study human calf muscles.
AB  - In vivo results obtained by the B1 insensitive Hadamard spectroscopic imaging
      multivolume technique used with a surface coil are shown. The functional behavior
      of different human calf muscles during exercise was determined and the Pi/PCr
      ratio in each calf muscle, during steady-state conditions, was measured as a
      function of work level. Different levels of metabolic and physical activity were
      observed at the three calf muscles.

PMID- 1614320
TI  - 31P NMR studies of resting zone cartilage from growth plate.
AB  - 31P NMR of superfused resting cartilage demonstrated the presence of
      phosphocreatine in chondrocytes. Changes in pH and in the NTP level were followed
      during carbon source starvation. From 31P spectra of perchloric acid extracts,
      phosphoethanolamine, phosphocholine, and the corresponding glycerol diesters were
      identified as the major phosphomonoester and phosphodiester components.

PMID- 1614321
TI  - Measurement of brain perfusion by volume-localized NMR spectroscopy using
      inversion of arterial water spins: accounting for transit time and cross
      relaxation.
AB  - The theoretical model for perfusion measurement by NMR using arterial labeling of
      endogenous water is extended to include the effects of transit time and cross
      relaxation of tissue water with macromolecules. Water magnetization in rat brain
      is monitored using the STEAM method to simultaneously determine the transit time,
      magnetization transfer rate constant, and perfusion. The results show that the
      transit time in rat brain is quite short, and thus its effect on perfusion
      measurement is small. It is also demonstrated both theoretically and
      experimentally that the steady-state effects of cross-relaxation with
      macromolecules on perfusion measurement are accounted for by a proper control
      experiment.

PMID- 1614322
TI  - Magnetization transfer time-of-flight magnetic resonance angiography.
AB  - Time-of-flight (TOF) angiography based on inflow enhancement is limited by the
      steady-state signal differences between blood and the surrounding stationary
      tissues. We present a new TOF sequence in which magnetization transfer contrast
      is used to supplement wash-in effects. Angiograms demonstrating the superior
      performance of this technique are presented.

PMID- 1614323
TI  - An aqueous gastrointestinal contrast agent for use in echo-planar MR imaging.
AB  - Four volunteers were imaged with echo-planar imaging before and after ingesting a
      dilute barium preparation. The contrast material improved bowel visibility by
      increasing lumen signal intensity, without increasing noise. Long T2
      gastrointestinal contrast material can be used in T2-weighted imaging when motion
      artifacts are suppressed by ultrashort acquisitions.

PMID- 1614324
TI  - Time course EPI of human brain function during task activation.
AB  - Using gradient-echo echo-planar MRI, a local signal increase of 4.3 +/- 0.3% is
      observed in the human brain during task activation, suggesting a local decrease
      in blood deoxyhemoglobin concentration and an increase in blood oxygenation.
      Images highlighting areas of signal enhancement temporally correlated to the task
      are created.

PMID- 1614325
TI  - Contribution of cytoplasmic polypeptides to the 1H NMR spectrum of developing rat
      cerebral cortex.
AB  - In the present study the contribution of cytoplasmic polypeptides thymosins beta
      4 and beta 10 to the 1H NMR spectrum during the maturation of the rat cerebral
      cortex was assessed. In the proton spectrum intense broad peaks at 0.9, 1.22, and
      1.40 ppm from thymosins decreased in size relative to the signal at 2.02 ppm in
      parallel to the reciprocal increase in the concentration of N-acetyl aspartate.
      Levels of thymosins beta 4 and beta 10 were under developmental regulation. It is
      concluded that peaks from thymosins may provide extended information for an NMR
      spectroscopist and thus they have to be taken into account in the interpretation
      of the newborn cerebral 1H NMR spectrum.

PMID- 1614326
TI  - Noise correlation exists for independent rf coils.

PMID- 1614327
TI  - The difference in the lcrV sequences between Y. pestis and Y. pseudotuberculosis
      and its application for characterization of Y. pseudotuberculosis strains.
AB  - We have sequenced the lcrGVH operon from Y. pseudotuberculosis plasmid pYV995 and
      compared its sequence with that of Y. pestis. The sequences were highly
      homological, however, six base pair substitutions were found in one short 14 bp
      region termed variable sequence. Two oligonucleotides corresponding to variable
      sequence of Y. pestis (pes-V) or Y. pseudotuberculosis (ptb-V) were synthesized
      and were used as molecular probes in hybridization experiments with sets of Y.
      pestis and Y. pseudotuberculosis strains. All 17 Y. pestis strains tested were
      positive only with the pes-V probe, 18 of 21 Y. pseudotuberculosis strains were
      positive with the ptb-V probe, while three Y. pseudotuberculosis strains reacted
      with the pes-V probe but not the ptb-V probe. The 200 bp fragment including
      variable sequence was sequenced in seven Y. pseudotuberculosis strains. The Y.
      pseudotuberculosis strains which were positive with the pes-V probe possessed the
      200 bp fragment sequence almost identical with that from Y. pestis. No
      correlation between the Y. pestis-like lcrV sequence and virulence was found for
      these strains. Moreover, the Y. pseudotuberculosis strains with Y. pestis-like
      sequences in contrast to Y. pestis possessed unaltered yadA gene. However, we
      have found the yadA frameshift mutation characteristic for Y. pestis in one Y.
      pseudotuberculosis strain 312.

PMID- 1614328
TI  - Analysis of Yersinia pestis chromosomal determinants Pgm+ and Psts associated
      with virulence.
AB  - The ability to absorb exogenous pigments (Pgm+) has, until now, been considered
      an established virulence factor of Yersinia pestis, the causative agent of
      plague. This property correlates with the sensitivity to the bacteriocin pesticin
      (Psts). Both functions are chromosomally encoded. In the present study, using Hfr
      donors and isogenic Pgm-Psts and Pgm-Pstr mutants, these functions were shown to
      be determined by discrete but closely linked genes. These markers designated pgm
      and psn, respectively, were preliminarily located within a linkage group
      including 11 loci. It was also found that pigmentation is not essential for mouse
      virulence but is necessary for survival of Y. pestis in the flea, the plague
      vector. At the same time, conversion of an avirulent Pstr mutant to pesticin
      sensitivity restored some degree of virulence.

PMID- 1614329
TI  - Isolation and replication in human fibroblast cells (MRC-5) of a microsporidian
      from an AIDS patient.
AB  - Many parasitic opportunistic infections occur in AIDS patients. In a young female
      drug abuser, HIV-positive at the IV stage, a microsporidian was detected and
      identified in urine by cell culture in fibroblast monolayers (MRC-5) and formally
      recognized by electron microscopy. This parasite has been involved in hepatitis,
      myositis and malabsorption syndromes in AIDS patients. Its diagnosis is difficult
      and this is the first time that its replication has been reported in human
      diploid cells in vitro.

PMID- 1614330
TI  - Activated mouse macrophages kill Entamoeba histolytica trophozoites by releasing
      reactive nitrogen intermediates.
AB  - Mouse macrophages activated by gamma interferon (IFN-gamma) and bacterial
      lipopolysaccharide (LPS) are highly cytotoxic for the enteric protozoan parasite
      Entamoeba histolytica. Herein, we show that this killing by activated macrophages
      is L-arginine dependent, inasmuch as it was blocked by exogenous arginase or NG
      monomethyl-L-arginine. These two inhibitors had no effect on E. histolytica
      cytolytic activity against L929 fibroblasts. Also, macrophage killing of E.
      histolytica always correlated with nitrite presence in the supernatant fluids.
      Finally, it was shown that addition of excess iron or the reductant sodium
      dithionite to activated macrophages blocked their ability to kill E. histolytica.
      Overall, this suggests that killing of E. histolytica by activated macrophages
      depends on the production of reactive nitrogen intermediates which leads to
      critical iron loss and protozoan parasite death.

PMID- 1614331
TI  - Lipoteichoic acid and M protein: dual adhesins of group A streptococci.
AB  - The roles of lipoteichoic acid (LTA) and M protein in the adherence of group A
      streptococci to human cells were investigated. Both M+ and M- streptococci bound
      to pharyngeal and buccal epithelial cells in similar numbers. Streptococcal
      attachment was inhibited by LTA, but not by the pepsin-extracted, amino-terminal
      half of M protein (pep M), suggesting that M protein does not mediate attachment
      to these cells. However, a purified, recombinant, intact M protein did block
      attachment of streptococci to buccal cells. Using synthetic peptides, the
      inhibitory domain was localized to a region of intact M protein that is within or
      near the bacterial cell wall. Evidence is presented to suggest that on the
      surface of streptococci this region of the M protein is probably not accessible
      for interactions with host cell receptors and that M protein does not mediate
      attachment to buccal or pharyngeal cells. In contrast, approximately 10-times
      more M+ streptococci bound to Hep-2 cells than did M- streptococci and pep M
      protein blocked binding of streptococci to Hep-2 cells. The data suggest that at
      least two streptococcal adhesins, LTA and M protein, are involved in the
      adherence of streptococci to certain cells and that the relative contributions of
      these adhesins to the attachment process depends on the type of host cells used
      to study adherence.

PMID- 1614332
TI  - Plasmid-mediated serum resistance in Salmonella enterica.
AB  - The ability of Salmonella enterica to survive an incubation of 2 h in fresh,
      pooled guinea-pig serum was determined comparing strain sets of serovariants
      Dublin and Typhimurium, harbouring or lacking the virulence plasmid. All strains
      showed marked serum resistance, which was slightly decreased among cured strains
      of Typhimurium. However, when introduced into a rough Escherichia coli strain,
      all Typhimurium plasmids substantially increased the resistance of the host
      strain to guinea-pig serum, whereas the Dublin plasmid did not. The traT gene,
      previously shown to affect serum resistance, was identified on all Typhimurium
      plasmids, but not on the Dublin plasmid. Mutational inactivation of the traT gene
      on the Typhimurium plasmids eliminated the serum resistance mediated by the
      plasmids.

PMID- 1614333
TI  - Both adenylate cyclase and hemolytic activities are required by Bordetella
      pertussis to initiate infection.
AB  - Among virulence factors synthesized and secreted by Bordetella pertussis,
      pertussis toxin (PTX) and the bifunctional adenylate cyclase-hemolysin (AC-Hly)
      are able to invade mammalian cells and to impair intracellular functions.
      Moreover, both proteins are protective antigens in murine intracerebral and
      respiratory models. In order to study their in vivo properties, different B.
      pertussis mutants, deficient in AC-Hly expression or secretion, or producing
      modified AC-Hly devoid of either adenylate cyclase or hemolytic activities, were
      constructed and examined. The in vivo properties of the mutants were compared to
      PTX deficient strains, using the murine respiratory model. We show that lack of
      PTX as well as adenylate cyclase or hemolytic activities results in avirulence.
      Furthermore, we show that mutants lacking adenylate cyclase or hemolytic
      activities were unable to multiply as fast as the parental strains and PTX
      mutants during the first 5 days following infection. Thus, both adenylate cyclase
      and hemolytic activities are required by B. pertussis to initiate infection.

PMID- 1614334
TI  - Role of elastase as a virulence factor in experimental Pseudomonas aeruginosa
      infection in mice.
AB  - The role of elastase and alkaline protease in the pathogenesis of fatal
      infections caused by Pseudomonas aeruginosa was determined in mice treated with
      calcium chloride. Mortality increased significantly when solutions containing
      elastase were injected together with non-lethal inocula of strain PA 103, which
      does not produce proteolytic enzyme. In contrast, solutions containing alkaline
      protease did not increase mortality. In mice injected intramuscularly with strain
      PA 103 and calcium chloride, the organisms grew rapidly in the injected muscle
      but not in the liver. However, when elastase was injected together with strain PA
      103 and calcium chloride, viable bacteria were also found in the liver. Moreover,
      the survival rate of mice challenged with elastase-producing strain 5 and calcium
      chloride was enhanced, and colonization of the liver prevented, by immunization
      with elastase toxoid. These results suggest that elastase contributes to the
      invasiveness of the organism.

PMID- 1614335
TI  - MSMS reimbursement roundup.

PMID- 1614336
TI  - Public health issues.
AB  - In a recent MSMS survey, MSMS members ranked public health as one the top five
      issues of major concern to Michigan physicians. Tobacco use, chronic illness, and
      HIV-infected health care workers comprise some of the major public health issues
      facing physicians and patients in Michigan. Following is a brief examination of
      each of these issues. Also included is a brief discussion of medical doctors as
      public health directors. Should all public health directors be medical doctors?
      This question is addressed in this cover story.

PMID- 1614337
TI  - Medicaid managed care comes of age.

PMID- 1614338
TI  - PRO update. Transition from the third to fourth scope of work.
AB  - The Health Care Financing Administration (HCFA) began implementation of the
      transition from the Third Peer Review Organization (PRO) Scope of Work to the
      Fourth PRO Scope of Work on October 1, 1991. PROs in 11 states are currently
      implementing newly-established medical review requirements under the "Scope of
      Work," the contract by which PROs are obligated to carry out their statutorily
      mandated duties of determining the medical necessity, appropriateness and quality
      of care delivered to Medicare beneficiaries. Michigan's PRO (MPRO) is scheduled
      to implement requirements outlined in the Fourth Scope of Work beginning April 1,
      1992. This article discusses the American Medical Association's (AMA)
      relationship to the PRO program and the transition from the Third to the Fourth
      Scope of Work including the status of the Uniform Clinical Data Set.

PMID- 1614340
TI  - The need for a new paradigm for health.

PMID- 1614339
TI  - Gov. Engler deserves recognition, respect for his strong stand on liability
      reform.

PMID- 1614341
TI  - Health promotion and disease prevention.
AB  - Health promotion and disease prevention programmes improve the health status of
      populations, preserve freedom, and empower individuals. Yet, despite important
      advances in many countries, including a more health-conscious public, it would be
      beneficial in the United States and in other countries to have a comprehensive
      plan to make health promotion and disease prevention personal and societal
      priorities. I have called this climate a 'culture of character', a climate of
      individual responsibility to encourage healthy behaviour. I want to encourage the
      readers of Medical Education to participate in the formulation of plans to
      implement greater health promotion and disease prevention efforts. Such a climate
      of personal responsibility could be created if doctors, educators and policy
      makers agreed on some workable, positive goals and steps that would help meet
      realistic national goals over a defined period of time. If there were such
      agreement, then doctors could more clearly focus their own efforts with their
      patients, in concert with other health professionals, and with policy-makers who
      have the same goal--healthier people.

PMID- 1614342
TI  - Evaluation of teaching medical ethics by an assessment of moral reasoning.
AB  - This study assessed the hypothesis that the formal teaching of medical ethics
      promotes a significant increase in the growth and development of moral reasoning
      in medical students. Results indicated a statistically significant increase (P
      less than or equal to 0.0005) in the level of moral reasoning of students exposed
      to a medical ethics course compared to the control group that was not exposed to
      the medical ethics course. When the posttest scores were adjusted by subtracting
      the pretest scores, the differences were even more significant (P less than or
      equal to 0.0002). This study confirmed similar findings of another study using a
      different instrument of assessment. Brief discussion is given of the fundamental
      premise that the appropriate function of teaching medical ethics in our modern
      pluralistic society is to improve students' moral reasoning about value issues
      regardless of what their particular set of moral values happens to be.

PMID- 1614343
TI  - Teaching of medical ethics in Sri Lanka.
AB  - Medical ethics as taught by members of the Department of Forensic Medicine in
      three of five medical colleges in Sri Lanka is a 'rule ethic' ('normative ethic')
      based on 'traditional' or 'classical' ethics. Instruction includes the teaching
      of moral principles, illustrated with examples. Also included are aspects
      concerning the functions of the Sri Lanka Medical Council. The topic is evaluated
      in the essay, multiple choice question and oral components of the third MBBS
      (Part II) examination (end of fourth year). As presently taught the syllabus is
      thoroughly inadequate for dealing with modern (medical) ethical issues. The
      shortcomings and limitations in the present programme are pointed out and
      requisite improvements suggested. A case is made for an eclectic view of ethics,
      in which a 'situation ethic' would play a part. Finally, the training of a highly
      moral responsible medical professional is emphasized.

PMID- 1614344
TI  - From traditional to problem-based learning: a case report of complete curriculum
      reform.
AB  - The Sherbrooke School of Medicine, Quebec, has restructured its entire curriculum
      to make problem-based learning (PBL) the main instructional format. This complete
      reform is explained both in terms of process and content. The curriculum problems
      were clearly identified and overcome by a major structural shift-over following
      the stages of a strategic planning of change. Implementation over a period of 7
      years is described according to a four-stage framework: need for change;
      selection of the PBL solution; planning for implementation; and the full-scale
      adoption of the PBL method. The programme is described in relation to the
      congruence of goals, learning and evaluation activities. Initial impact on
      student learning and evaluation, attracting better quality students, academic
      staff roles, and on financing the operation are discussed. Changing the
      undergraduate programme has become an institutional project directed by the
      Office of the Dean.

PMID- 1614345
TI  - Teaching medicine with cases: student and teacher opinion.
AB  - In a second-year family medicine course taught using simulated patients the
      students commented most favourably on the clinical relevance of the topics, the
      enthusiasm of teachers, and the opportunity to interview simulated patients with
      their fellow students, in contrast to their basic science courses, which did not
      give them patient contact. They felt most confident about skills acquired in
      relation to diseases with a limited number of key symptoms, signs and treatments
      (meningitis, otitis) and less confident about diseases with many symptoms and
      treatments (diabetes, trauma, arrhythmias). They made few comments about
      alternative cases which might have been selected. Their adverse comments were
      about the workload. During tutor meetings over 4 years, a key concern which
      emerged was to find cases with a level of complexity suitable to the students.
      The tutors emphasized these principles of case selection: the cases should be
      based on real life and include most of the signs and symptoms of the disease;
      contain one or at most two foci; have nodal decision-making points; emphasize
      clinical reasoning; reinforce prior knowledge; permit the transfer of knowledge
      to other cases; and permit the assessment of associated technical skills.

PMID- 1614346
TI  - Assessment of blood pressure measuring techniques.
AB  - The recommended techniques to measure blood pressure for assessment of
      hypertension are seldom followed in the ambulatory care setting. This study has
      found that interns and first-year family practice residents have significant
      deficits in their knowledge and use of the recommended techniques to measure
      blood pressure. The results suggest that inadequacies exist in the teaching of
      blood pressure measuring techniques in our medical schools, the consequences of
      which are misdiagnosis and improper treatment of high blood pressure.

PMID- 1614347
TI  - Practical medical education in general practice.
AB  - The Medical Faculty of the University of Limburg in Maastricht, The Netherlands
      pays special attention to extramural care. The extramural profile of the Medical
      Faculty also manifests itself in the curriculum. Since 1978, a 12-week clerkship
      in practical medical training in general practice (PMT-GP) has been offered to
      fifth-year students. The general aim is to acquaint students with general medical
      aspects as well as specific primary care aspects of health care. The programme
      started in the autumn of 1978 with 24 students and 24 GP teachers. At present
      more than 100 GP teachers, working in about 70 practices, train 120-130 students
      a year. The model of the PMT-GP system is characterized by six features: a ratio
      of one GP teacher to one student; autonomous examination by the student of at
      least 15 patients a week; daily follow-up discussion on the basis of patient
      records prepared by the student; opportunities for self-study by the student; one
      tutorial day a week at the Medical Faculty; intensive contacts between the
      Faculty and GP teachers. Key activities of the PMT-GP include autonomous contacts
      with patients, written records and daily follow-up discussions with the GP
      teacher.

PMID- 1614348
TI  - Measuring the quality of junior hospital doctors in general medicine.
AB  - During the course of a larger study aimed at relating staffing levels of junior
      doctors in general medicine to the safety of the care provided, it became clear
      that consultant doctors considered the quality of their junior staff as being at
      least as important as the quantity. This paper describes several attempts to
      develop a feasible and valid method of measuring the quality of senior house
      officers (SHOs) and registrars using routinely available data. Having rejected
      three methods and had difficulties with three other methods, a modified Delphi
      survey was used to explore the extent to which consultants agreed on the key
      attributes of a high quality SHO or registrar. Sixty-seven (60%) of all
      consultants in the South-West Thames and Trent regions responded to two rounds of
      questionnaires which revealed communication skills as being consistently the most
      significant factor. This was confirmed in a second, anonymous survey of 198 (78%)
      SHO and registrar posts in the North-West Thames region. It also became clear
      that consultants viewed the quality of their own SHOs and registrars as generally
      high. This being so it is argued that the requirement to adjust for quality, when
      comparing SHO and registrar levels between hospitals, is of minor importance.
      These results also suggest that the explicit teaching of communication skills
      should have a high priority in undergraduate and postgraduate education.

PMID- 1614349
TI  - Allocation of junior hospital doctors to pre-registration posts: does Britain
      need a national matching scheme?
AB  - The attitudes of British postgraduate deans and senior medical students to the
      introduction of a national pre-registration house officer allocation scheme were
      investigated by postal questionnaire. Several postgraduate deans expressed
      interest, but most were not in favour of the proposal. Students held similar
      views. The advantages and disadvantages of a national scheme are discussed.

PMID- 1614350
TI  - Performance evaluation of graduates from a community-based curriculum: the
      housemanship period at Gezira.
AB  - The housemanship performance of the first two classes of the University of Gezira
      Medical School was assessed on 107 occasions by using a questionnaire
      administered to the senior doctors (consultants) in the units in which they
      worked and the data, which covered 32% of all housemanship rotations taken by
      these graduates, were analysed. On a 5-point scale (poor to excellent) the rating
      of performance for 26 questions was average and above (S = 3: + S = 4: + S = 5)
      in 95% of instances. The good and excellent rating (S = 4 + S = 5) for the same
      questions was about 80%. The grand mean for rating of questions in the cognitive,
      psychomotor and attitudes domain was 4.1, 3.9 and 4.2 out of 5 respectively. The
      graduates were found to be better off (45%), comparable to (50%) and less than
      (5%) when compared to other graduates who worked with the same consultants in the
      past. Results of three general questions inquiring about graduates' practice
      safety, overall standing and consultants' preference for Gezira graduates had a
      95% positive rating. It is concluded that these results provide significant
      positive answers for some basic questions concerning credibility which are often
      raised about Gezira and similar schools with innovative medical curricula.

PMID- 1614351
TI  - Improving presentation skills of family medicine residents: a randomized
      controlled study.
AB  - A randomized controlled time series design was used to evaluate the influence of
      an educational intervention designed to improve the presentation skills of family
      medicine residents. Each resident gave three presentations, with the educational
      intervention occurring between the first and second presentations in the
      experimental group, and between the second and third presentations in the control
      group. The presentations were evaluated using a standardized format. The
      experimental group, in contrast to the control group, showed significant
      improvement in scores for all major criteria after receiving the educational
      intervention between presentations 1 and 2. This improvement continued with
      repetition between presentations 2 and 3. After receiving the educational
      intervention between presentations 2 and 3, the control group also demonstrated
      significant improvement in several key areas. We conclude that an educational
      intervention can improve the presentation skills of family medicine residents.
      Education coupled with repeated opportunities for presentation will produce a
      greater improvement in resident performance than repeated presentations alone.

PMID- 1614352
TI  - Continuing medical education and the education allowance: variation in credits
      obtained by general practitioners.
AB  - The educational credits obtained by general practitioners for the postgraduate
      education allowance were examined. With over 3 months of the qualifying period
      remaining, 68.4% had reached the requirement. The educational day attainments
      show almost a normal distribution, with 4.2% of doctors completing more than
      double the requirement.

PMID- 1614353
TI  - Medical education in Thailand.
AB  - In order to make training more relevant to community needs, medical educators
      throughout Thailand have been attempting to address issues concerning the
      training of their undergraduates. Support for a reorientation of medical
      education and acceptance of the frame-work put forward by the World Health
      Organization are evident in national health plans and in national medical
      education conferences. This paper outlines some of the basic problems faced by
      health policy makers in Thailand and presents a brief chronology of recent events
      in the history of medical education in Thailand.

PMID- 1614354
TI  - Alzheimer's disease and metal-containing glia.
AB  - Considerable evidence suggests that in Alzheimer's disease, olfactory bulb damage
      may be a primary factor, causing degeneration and neurofibrillary tangles
      primarily in neurons connected with this brain area. Also, deposits of amyloid
      may involve an improper regulation of the cleavage of a precursor protein by
      glia. Finally, toxic effects of aluminium may be an etiological factor. This
      review proposes that all these seemingly unrelated aspects of Alzheimer's disease
      could be related to a disturbed function of metal-containing glia. Such a
      disturbance, initiated by or aggravating toxic effects of aluminum, may underlie
      initial damage in the olfactory bulb and/or other brain areas with a weakened
      blood-brain barrier and may be responsible for amyloid deposition.

PMID- 1614355
TI  - Eliminating human immunodeficiency virus (HIV) from infected individuals and
      cells: is it possible?
AB  - The literature from 1984 to 1991 has been searched for reports of patients who
      have eliminated human immunodeficiency virus (HIV) from their system. While such
      reports are scarce, it appears that a small number of HIV-positive patients have
      reverted to a negative state either spontaneously or following radical
      immunosuppressive regimens for neoplastic disease. Although no carefully planned
      animal experiments or clinical trials have been reported, it would appear that
      bone marrow ablation and replacement may eliminate HIV from healthy, asymptomatic
      HIV-positive individuals. Although much of the clinical experience to date
      suggests that radical immunosuppression is not indicated in advanced AIDS
      patients in whom the virus has likely spread beyond the immune system, such cases
      do not represent evidence that immunosuppression is not indicated in healthy, HIV
      positive individuals.

PMID- 1614356
TI  - Early impressions concerning actinomycetal infections that may play a role in the
      pathogenesis of eosinophilia-myalgia syndrome (EMS) and other 'new illnesses'.
AB  - Actinomycetal infections by Actinomyces, Nocardia, and Streptomyces appear to be
      increasing in incidence. Clinical and laboratory data from twelve patients
      believed to have subclinical actinomycete-streptomycete infections (ASI)* are
      presented. It is proposed that the recent epidemic of eosinophilia-myalgia
      syndrome (EMS) may have been caused by pre-existing host ASI that generated toxic
      agents when individuals ingested supplemental L-tryptophan (LT). LT is the
      substrate used by streptomycetes to synthesize actinomycins, extremely cytotoxic
      metabolites that could have accounted for symptoms seen in EMS. Actinomycins
      inhibit CoA activity and interfere with the synthesis and utilization of amino
      acids. LT also provides streptomycetes with additional NAD, a substance of great
      importance to their DNA synthesis and metabolic activity. With increased
      activity, streptomycin, chloramphenicol, adriamycin or any one of the many
      secondary metabolites (antibiotics) produced by Streptomyces could be
      endogenously generated in greater quantities. The clinical result would be
      increased host toxicity. A contaminant that has been isolated from case
      associated lots of LT may have simply provided additional tryptophan for an ASI.
      It is also possible that a nucleotide or similar substance in the case associated
      LT products caused increased activation of tryptophan-2,3-dioxygenase, the rate
      limiting enzyme required for the production of NAD and/or actinomycin. Potential
      reasons for ASI, atypical forms of actinomycete-streptomycete micro-organisms,
      and the possibility of involvement in other diseases are discussed.

PMID- 1614357
TI  - Degenerative and inflammatory diseases may result from defects in
      antimineralization mechanisms afforded by glycosaminolglycans.
AB  - Many human cellular and tissue compartments are supersaturated with respect to
      calcium oxyanion salts. In order to prevent the formation of injurious crystals
      efficient anti-crystallization protective mechanisms must be necessary. We
      suggest that depletion of such systems, particularly in ageing organisms and
      under conditions of oxidative stress, plays an important role in degenerative and
      inflammatory diseases, including cancer.

PMID- 1614358
TI  - The puzzle of Alzheimer's disease (AD).
AB  - A compromised defensive system of brain cells against aluminium, together with
      local defects in glucose metabolism, causes AD. Lack of citrate is a driving
      force and free cis-aconitate or glutamate are potential carriers, which enable
      the exotoxin to cross lipid membranes. Only a few aluminium ions replace
      magnesium in key positions. They block the reversibility of phosphorylation
      reactions, which are important for short term memory: sensitization of the
      insulin receptor and protein phosphorylations. Due to disturbed phosphorylation
      of the cytoskeleton, protein synthesis runs out of balance. Efforts to restore
      the disturbed reactions result in AD specific deposits. Aluminium ions are the
      common cause for the induction of AD pathogenesis in patients with genetic
      defects, with mechanical brain lesions or with minor infarcts, as well as with
      changes in the relation between numbers of neurons and neuron nursing glia cells
      due to age.

PMID- 1614359
TI  - Magnetic influences on fetus and infant as reason for sudden infant death
      syndrome: a new testable hypothesis.
AB  - The hypothesis is based upon: a) My observed clustering of Sudden Infant Death
      Syndrome (SIDS) cases at places with abnormal geomagnetic fields (GMF) and/or
      electromagnetic fields (EMF); b) recorded GMF with pulsations matching the
      breathing frequencies of infants; c) the reported immature development of
      increased dendritic spine density in the brain stem of SIDS cases and; d) the
      increased dendrite arborization in the brains of rats exposed to magnetic fields
      (MF). The hypothesis consists of two parts: 1. A disturbed GMF in the residence
      or surroundings of a pregnant woman may interrupt the normal development of the
      central organ which controls respiration (brain stem) of the fetus. This is
      termed the 'Selection Factor'. 2. If such an infant with a functional disturbance
      of the control organ is then exposed to a GMF or EMF with pulsations similar to
      his own breathing frequency, but inverted in phase, value, form etc then the
      vital nerve impulses from the respiration control organ to the breathing organs
      may be disturbed or blocked with fatal effect. This is termed the 'Trigger
      Factor'. The elements of the 'Selection Factor' and the 'Trigger Factor' together
      produce SIDS. A program to test such a supposed 'Trigger Factor' is included.

PMID- 1614360
TI  - A new role for an old hormone: is gastrin a cofactor for dietary metal ion
      uptake?
AB  - It is proposed that gastrin promotes the uptake of divalent and trivalent metal
      ions from the gastrointestinal lumen by catalyzing the binding of metal ions to
      luminal albumin and transferrin respectively. The following observations are
      consistent with this hypothesis: 1. Gastrin binds both divalent and trivalent
      metal ions. 2. Gastrin binds to both albumin and apotransferrin. 3. Binding of
      gastrin to albumin is enhanced by divalent metal ions. 4. Gastrin, albumin and
      transferrin are all present in gastric juice. 5. Surgical removal of the gastric
      mucosa results in iron deficiency.

PMID- 1614361
TI  - Deficiency of copper can cause neuronal degeneration.
AB  - The aim of this article is to emphasize the important role that copper plays in
      the function of nerve cells. We are reporting preliminary data which suggest that
      the swelling of axons which we produce in rats by iminodipropionitrile, IDPN, is
      due to its chelating action on copper, and how conversely supplementation with
      copper abolishes both symptoms and lesions. The copper values we obtained by
      atomic absorption spectrophotometry of the spinal cord and brain from the animals
      fully support this contention. In comparing these results with the diseases that
      are known to be due to copper deficiency, namely Menkes disease in man, swayback
      in lambs and several neurological mutant mice, we find not only similar axonal
      swellings, but also amelioration of symptoms and lesions by early administration
      of copper. Considering the main forms in which copper is present, we discuss the
      cuproproteins, i.e. ceruloplasmin and metallothionein, and their role in
      transport and delivery of copper to various organs. Further, the many
      cuproenzymes i.e. superoxide dismutase, tryptophan-2,3-dioxygenase, lysine
      oxidase, cytochrome oxidase, monoamine oxidases, tyrosinase, dopamine-beta
      hydroxylase and d-amino levulinate dehydratase are noted for their roles in the
      nervous system. Finally, we suggest that neuronal copper deficiency should be
      more fully investigated as a possible etiological factor in the more common
      neurodegenerative diseases, such as Alzheimer's disease and amyotrophic lateral
      sclerosis, ALS.

PMID- 1614362
TI  - Prevention of gallstone migration from the gallbladder into the cystic duct.
AB  - Biliary colic is caused by an increased pressure within the gallbladder lumen due
      to gallbladder contraction against an impacted stone in the cystic duct. It
      should be possible to prevent the passage of stones into the cystic duct by
      avoiding those body positions (mostly the supine position) in which the neck of
      the gallbladder is located in the downward position.

PMID- 1614363
TI  - Concept of the development of the mammalian cerebellum based on physical rotation
      forces.
AB  - In pre-mammalian forms the cerebellum (rhombencephalon) has no rhombic lip and it
      develops in the median region between the two auricles above the front end of the
      fourth ventricle. In mammals, cells in the superior rhombic lip and dorsal part
      of the dorsal lamina of the metencephalon are said to proliferate to form two
      rounded swellings, the rudiments of the cerebellum. This assumption does not
      explain many peculiarities of the mammalian cerebellum, 11 of which have been
      described. The crux of the present hypothesis is that the mammalian cerebellar
      hemispheres and vermis develop from the median cerebellar element seen in the pre
      mammalian forms and that the vermis does not develop as a confluence of the two
      hemispheric tissues.

PMID- 1614364
TI  - The impact origin of genetic material.
AB  - It is proposed that high velocity asteroidal impacts with the Earth created
      polymeric nucleotide sequences out of monomeric nucleotides via direct
      compressive forces. The developed model describes the simultaneous formation of
      histone-equivalent proteins and RNA/DNA-equivalent template structures as a
      natural and expected consequence of bolide impactions with organic material
      accumulating on the crustal surface of the Earth approximately 3.8-3.5 billion
      years ago. It is shown that literally billions of different gene-equivalent
      nucleotide sequences, each one having a set of surface-complementary histone
      equivalent proteins, might be created in such a manner. It is hypothesized that
      it is this process that gave rise to the chemical substrate upon which Darwinian
      selective forces have acted ever since.

PMID- 1614365
TI  - [Renin inhibitors for lowering blood pressure].

PMID- 1614366
TI  - [Preventive tuberculosis vaccination--pro and contra].

PMID- 1614367
TI  - Ticlopidine for prevention of stroke.

PMID- 1614368
TI  - [The disease or the patient--priorities in education and internal medicine
      general practice].

PMID- 1614369
TI  - [Local excision of rectal tumors. Indications, preoperative diagnosis, surgical
      technique and results].
AB  - Between January 1986 and October 1991 255 patients with rectal tumors were
      treated by local excision. In 239 patients local excision was performed by
      transanal endoscopic microsurgery, 16 tumors were removed with the retractor
      developed by Parks. Operative mortality was 1% in 189 local removed adenomas,
      complications were observed in two patients (2.1%), local recurrences in seven
      patients (3.7%). 66 rectal carcinomas were treated by local excision (operative
      mortality 1%, complication rate 3%). In one of 28 local excised "low risk" T1
      carcinomas a recurrence was observed. Five of eleven local treated patients with
      "high risk" tumors developed a recurrence. Endosonography was of utmost
      importance in preoperative staging of rectal tumors. Between June 1987 and
      October 1991 204 patients with rectal tumors (92 sessile adenomas, 30 T1
      carcinomas and 82 advanced carcinomas) were examined preoperatively by
      endosonography. The diagnosis of an adenoma or a T1-carcinoma was made with a
      sensitivity of 0.9, although no differentiation was possible between adenomas and
      T1-carcinomas. Results of digital examination were comparable to endosonography,
      under condition that digital examination was complete. Insufficient information
      was obtained from the endosonographic detection of lymph-node metastatic spread.

PMID- 1614370
TI  - [Chronic diarrhea, steatorrhea and protein deficiency in a 27-year-old patient].

PMID- 1614371
TI  - [Intensive care of patients with obstructive lung diseases].

PMID- 1614372
TI  - [Pathogenesis and therapy of gallstone disease].

PMID- 1614373
TI  - [Principles and concepts of immunosuppressive therapy of glomerulonephritis].

PMID- 1614374
TI  - [The best possible preparation for coloscopy].

PMID- 1614375
TI  - [Communicating medicine--luxury or necessity?].

PMID- 1614377
TI  - [Inflammatory muscle diseases. International symposium "Inflammatory myopathies",
      Munich 26 September 1991].

PMID- 1614376
TI  - [Use of amrinone in terminal dialysis-dependent renal failure].

PMID- 1614378
TI  - [Haemophilus endocarditis].

PMID- 1614379
TI  - The changing profile of the elderly: effects on future long-term care needs and
      financing.
AB  - Simulation techniques are used to analyze the changing profile of the elderly
      from 1990 to 2030. The results show that the future demand for long-term care
      services is likely to be greater than many realize. Increases in the number of
      elderly who are 85 years of age and older, who have health limitations, or who
      live alone are likely to outpace the general increase in the elderly population.
      Although there will be a very large group of elderly at risk, their economic
      status will be better than that of today's elderly population. The percentage of
      elderly who can afford insurance premiums for broad long-term care coverage will
      increase in the future, but most older Americans probably will not be able to
      afford insurance. Although policies that reduce the cost and encourage the
      purchase of long-term care insurance could help to expand coverage, a large long
      term care financing gap is likely to remain for the future elderly population.

PMID- 1614380
TI  - Public and private responsibility for financing nursing-home care: the effect of
      Medicaid asset spend-down.
AB  - Data from a nationally representative sample of nursing-home residents at the
      beginning of 1987 are used to assess the interaction of Medicaid asset spend
      down, the distribution of nursing-home days by payment source, and the effect of
      proposed changes in public financing of nursing-home care. Three out of five
      nursing-home residents were covered by Medicaid in January 1987; nearly all of
      the remainder were private-pay. Most Medicaid recipients were covered by Medicaid
      when they entered the care facility at the start of an episode, but 18 percent
      had spent down and were originally admitted as private-pay. A universal nursing
      home benefit that insured the first six months of each nursing-home episode would
      cover 16 percent of the people in nursing homes on a given day,
      disproportionately those who are private-pay. A universal benefit with a 24-month
      waiting period would cover 56 percent of nursing-home residents on a given day,
      and would tend to favor those financed by Medicaid.

PMID- 1614381
TI  - Competition for altruism: bone and organ procurement in the United States.
AB  - The number of "units" of human bone used during surgical procedures has grown to
      almost a quarter of a million. Medical demand for such bone is expanding rapidly
      and the nation's bone-banking system is struggling to grow apace. Unfortunately,
      because of this growth, bone banks must compete with organ banks for access both
      to hospitals and to potential donors. This conflict can, and may already be,
      negatively affecting the supply of transplantable tissues and organs. The nature
      of this conflict is affected by current law and public policy, but those effects
      are little understood and perhaps not intended.

PMID- 1614382
TI  - Federal budgetary costs of blindness.
AB  - Federal expenditures for blindness-related disability among Americans are
      examined. The government, rather than the private sector, frequently bears the
      economic consequences of visual disability through entitlement and public
      assistance programs. Findings suggest an average $11,896 federal cost of a person
      year of blindness for a working-aged American, which includes income assistance
      programs (SSDI/SSI), health insurance programs (Medicare/Medicaid), and tax
      losses resulting from reduced potential earnings. Almost 97 percent of the
      aggregate annual federal costs of blindness in 1990, which totaled approximately
      $4 billion, is accounted for by working-aged adults, who represent less than one
      third of the total blind population. Approximately 25 percent of all blindness is
      attributed to preventable causes.

PMID- 1614383
TI  - Health policy and the distribution of lifetime income.
AB  - A number of health policies have implications for, and in turn can be influenced
      by, the distribution of income. However, current discussions define the
      distribution in current, not lifetime, income. This study describes a method of
      estimating gender and race differences in the distribution of lifetime incomes
      that account for mortality differences. When cohort lifetime incomes of living
      and deceased persons are compared, black men are found to be much worse off,
      whereas white women are found to be better off than existing estimates using
      annual income suggest. The mortality and lifetime income advantage of white
      women, however, is offset if, as some argue, white women have higher morbidity
      rates than white men of the same age. The authors use the concept of lifetime
      income to draw implications for health policy debates on cigarette and beer
      taxes, occupational safety and health, Medicaid versus Medicare spending,
      educational health promotion programs, and general investments in education.

PMID- 1614384
TI  - The case of the disappearing generalist: does it need to be solved?
AB  - The proportion of generalist physicians in the United States has declined
      steadily over 50 years, bringing it to the lowest percentage of trained primary
      care physicians of any developed country; the trend toward subspecialization is
      accelerating. Many analysts believe this imbalance between generalists and
      subspecialists to be a major cause of America's high health care costs, heavy
      dependence on biotechnology, and consumer dissatisfaction. Others argue that sub
      specialists can provide excellent primary care services, and the decrease in the
      number of generalists is not a problem. Three contrasting views on the
      implications of this trend state that today's generalists are an important and
      scarce resource that must be bolstered; that subspecialists can replace
      generalists as providers of primary care; and that the free market will determine
      the best manpower mix. A final view, on the marketplace option, posits that
      generalism will not recover until it creates a vital, and unique, role in
      handling the primary care challenges of the twenty-first century. These competing
      viewpoints are used to clarify assumptions underlying our major policy options in
      the arena of health manpower.

PMID- 1614385
TI  - Missing: a national medical manpower policy.

PMID- 1614386
TI  - Accessibility of cigarettes to youths aged 12-17 years--United States, 1989.
AB  - Rates of tobacco-related diseases are higher for persons who initiate smoking at
      younger ages than for those who begin at older ages (1). Restricted access to
      tobacco products may delay or prevent the decision by adolescents to initiate
      tobacco use (1,2). This report summarizes findings from the Teenage Attitudes and
      Practices Survey (TAPS) regarding minors' access to cigarettes during
      1989.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614387
TI  - Scalping incidents involving hay balers--New York.
AB  - In August 1991, the Agricultural Health Nurse Program (AHNP) of New York received
      a report of a woman who was scalped (i.e., traumatic avulsing of the scalp) when
      her hair became entangled in a hay baler. Subsequent investigations by the AHNP
      identified three similar incidents. One was identified through a rehabilitation
      service and one by a machinery dealer; one of these women identified the third
      person. In all four cases, the injuries resulted from entanglements with rotating
      secondary drivelines, shielded from above by three-sided guards, on hay-baling
      equipment. This report summarizes the four incidents and discusses strategies for
      prevention of similar incidents related to operation of farm machinery.

PMID- 1614388
TI  - Spina bifida incidence at birth--United States, 1983-1990.
AB  - Spina bifida, a birth defect of the spinal column that can cause varying degrees
      of paralysis, is a major contributor to serious developmental disabilities in the
      United States. To determine the incidence and descriptive epidemiology of spina
      bifida, CDC analyzed reports from 16 states with population-based birth defects
      surveillance systems (Table 1). This report summarizes findings from this
      analysis for 1983-1990.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614389
TI  - Recommendations regarding penicillin-resistant pneumococcal disease--Spain.

PMID- 1614390
TI  - [A study on a postoperative change of beta-2-microglobulin in surgical patients].
AB  - Various renal tubular functions were monitored perioperatively in 42 surgical
      patients and the validity of beta-2-microglobulin (BMG) was evaluated. NAG index
      (urine NAG titer/urine creatinine), the absolute value of free water clearance
      and fractional excretion of sodium were worse at 3 to 5 hours after the beginning
      of operation, indicating the latent renal tubular damage took place during
      operation. On the other hand, fractional excretion of BMG (FE-BMG; BMG
      clearance/creatinine clearance) slowly elevated after operation and reached a
      peak on the 2nd postoperative day. The postoperative change of C-reactive protein
      (CRP), was similar with that of FE-BMG, showing a significant correlation (r =
      0.716, p less than 0.001). The close relationship between CRP and FE BMG was
      confirmed in 26 patients with or without abnormal liver function who underwent
      abdominal operation. The peak value of FE BMG was significantly (p less than
      0.01) lower in 5 patients with ICG 15' greater than 25% than in 21 patients with
      ICG 15' less than 20%. Similarly, the peak value of CRP tended to be lower in the
      former group. In conclusion, FE BMG can not be employed as an indicator of renal
      tubular function during postoperative period. It reacts as an acute phase
      reactant like CRP and is probably produced in the liver.

PMID- 1614391
TI  - [Experimental study of lymph node metastasis in thoracic esophageal carcinoma-
      regarding lymph node metastasis and changes in lymphatic flow by ultrafine
      charcoal in rabbit esophageal carcinoma model].
AB  - Esophageal carcinoma models were created by transplanting VX2 cells to rabbit
      esophagus endoscopically. By injecting finely divided activated charcoal into
      normal rabbit esophagus and tumor sites of esophageal carcinoma model, lymph flow
      was observed directly. Existence of lymph node metastasis was studied in detailed
      pathology. In 30 rabbits with upper esophageal carcinoma, lymph node metastasis
      was seen in 77%. Metastasis to bilateral intrathoracic paratracheal lymph node
      was seen in 50%, and also concentration of lymphatic flows from tumor site was
      seen. However, there were no metastasis and no lymph flow to abdominal lymph
      nodes. While, metastasis to cervical lymph nodes showed around 13%. Esophageal
      lymphatic flows were also seen reaching the cervical area along the esophagus. In
      40 models with mid lower esophageal carcinoma, lymph node metastasis were seen in
      88%. Metastasis to right and left thoracic paratracheal lymph nodes was 75% and
      53%, respectively, and 25% of metastasis went to cardia lymph nodes. The lymph
      flows were going up and down around these lymph nodes, and reaching to lymph
      nodes at upper highest mediastinum or left gastric artery. The metastatic rate to
      the cervical lymph nodes was about 5%. There were no significant differences in
      lymphatic metastasis between right and left mediastinum. These findings suggest
      the necessity of radical dissection for both sides of the mediastinum.

PMID- 1614392
TI  - [Combined resection of respiratory tract for thoracic esophageal carcinoma].
AB  - Thirty seven patients with thoracic esophageal carcinoma underwent esophagectomy
      combined with resection of respiratory tract. In 5 patients who received
      resection with the trachea or bronchus, 1 patient survived more than two years.
      His status of lymph node metastasis was n2 positive, and surgical margin was free
      of cancer. These findings show that negative surgical margin and certain lymph
      adenectomy are required to obtain good prognosis. A half of 32 patients who
      received combined resection of the lung had no invasion into the lung tissue
      pathologically. Five-year survival rate of 32 patients was 22.9%. We concluded
      that combined resection of the lung was safe procedure and showed satisfactory
      outcome.

PMID- 1614393
TI  - [Enhancement of anti-tumor effect of adriamycin by verapamil in a intrahepatic
      arterial infusion in the rats].
AB  - In a intrahepatic arterial infusion, the enhancement of cytotoxicity of
      adriamycin (ADR) by verapamil (VER), a calcium antagonist was investigated in
      male Wistar rat with liver tumor of Walker 256 carcinosarcoma. The accumulation
      of ADR in tumor tissue at 2 hrs after a bolus intrahepatic arterial injection of
      ADR with VER (4 mg/kg) was 1.9-fold more than without VER. But VER did not
      enhance it in normal liver tissue and heart tissue. In the continuous
      intrahepatic arterial infusion therapy (cia) of ADR and VER (1.5 mg/kg/day) for 6
      days, tumor weight and the accumulation of ADR in tumor tissue, normal liver
      tissue and heart tissue were assessed. Tumor weight of ADR-cia+VER-cia group was
      significantly less than ADR-cia group (p less than 0.05). And the accumulation of
      ADR in tumor tissue of ADR-cia+VER-cia group was significantly higher than ADR
      cia group (p less than 0.05). But VER did not enhance it in normal tissue. The
      administration of VER in a intrahepatic arterial infusion is shown to be able to
      enhance the cytotoxicity of ADR in tumor tissue but not to enhance in normal
      tissue. The continuous intrahepatic arterial infusion of VER enhanced
      cytotoxicity of ADR at clinical dose and it suggests the clinical applicability
      of VER in cancer chemotherapy.

PMID- 1614394
TI  - [Biological effect of estrogen metabolites in human breast cancer].
AB  - In order to investigate the estrogen metabolism in human breast cancer, the
      estradiol 2- and 16 alpha-hydroxylase (2-, 16 alpha-OHase) activities were
      determined in the microsomal fractions of human breast tissues by using reverse
      phase HPLC. The effects of estrogen metabolites on the cell proliferation were
      also examined by employing two human breast cancer cell lines. The 2-OHase
      activity was detected in most cancerous and noncancerous tissues, but the value
      in cancerous tissues was significantly lower than that in noncancerous tissues (p
      less than 0.05). Patients without lymph node metastases showed relatively higher
      activity than those with metastases (0.05 less than p less than 0.1). The 16
      alpha-OHase activity was, however, found in only 23% of cancerous tissues. Among
      those, the activity was present in 52% of ER positive cancerous tissues, but
      almost absent in ER negative ones. The growth ER positive cell line, MCF-7, was
      suppressed with 2-hydroxyestrone and stimulated with 16 alpha-hydroxyestrone. The
      cell proliferation stimulated with 16 alpha-hydroxyestrone was not inhibited by
      the addition of tamoxifen, a strong antagonist of estradiol. Two metabolites had
      no effect on the growth of ER negative cell line, MDA-MB-231. These results
      suggest that estrogen metabolites influence the proliferation of human breast
      cancer cells as the endogenous regulatory factors and should be considered for
      the future endocrine therapy.

PMID- 1614395
TI  - [Abdominal complications of the pedicled omental flap in chest surgery].
AB  - The incidence of abdominal complications and the gastrointestinal function after
      omental pedicle wrapping (Group I: n = 13) were compared with those after right
      pneumonectomy (Group II: n = 9) and cholecystectomy (Group III: n = 22).
      Indications of the omentopexy were as follows: 1) prophylaxis for the bronchial
      complication after chest surgery (4 cases), 2) treatment of thoracic empyema (2
      cases) and 3) postoperative bronchopleural fistula (7 cases). Poor intestinal
      movement necessitating fast after surgery persisted significantly longer in Group
      I than in Group II (p less than 0.05), but no significant difference was observed
      between Group I and Group III. Abdominal complications were observed frequently
      in Group I when oral feeding was initiated; abdominal distension in 7 of 13 cases
      (54%), epigastric discomfort in 3 (23%) and dehiscence of the abdominal wound in
      4 (31%). Abdominal wound dehiscences were most frequently encountered after
      surgical treatment with the omentopexy for empyema thoracic (2/2, 100%) and for
      bronchopleural fistula (2/7, 28%). Upper GI examination was performed in seven
      cases, four of which (57%) showed the deformity of antral region of the stomach.
      Since this finding was not always accompanied with the symptom of gastric
      retention, it was likely that gastric retention following the omentopexy was
      caused by dissection of right gastroepiploic nerves rather than the anatomical
      deformity of the stomach.

PMID- 1614396
TI  - [Morphological and functional studies on implanted arterial graft].
AB  - Early morphological and functional changes in arterial graft were studied.
      Autologous free graft of dog femoral artery or vein was implanted in the arterial
      system and the changes of endothelial cell by scanning electron microscope and
      prostacyclin levels were observed. In arterial graft, endothelial cell detachment
      after the implantation was rarely observed except the site with mechanical damage
      around the anastomosis. The site of cell detachment regenerated by 21 days after
      the implantation. The prostacyclin level was 2.5 pg/mg in venous graft or 35.9
      pg/mg in arterial graft. The level in venous graft decreased after the
      implantation and it increased according to the cell regeneration, while the level
      was stable in arterial graft. The prostacyclin level of internal thoracic artery
      or gastroepiploic artery in clinical use was 54.5 pg/mg or 50.1 pg/mg,
      respectively. However the level in saphenous vein (SV) was 17.3 pg/mg and there
      were significant differences between the levels of arterial grafts and one of SV.
      Conclusively the arterial graft was superior to venous graft in early
      morphological and functional changes after the implantation and the superiority
      in early period after graft implantation may be one of the factor to contribute
      good graft patency in long term period.

PMID- 1614397
TI  - [Primary malignant lymphoma of the esophagus--a case report].
AB  - We report a rare case of primary malignant lymphoma of the esophagus without
      extraesophageal involvement. A 69-year-old woman was referred to our hospital
      because of dysphagia. Esophagogram revealed an irregularly marginal ulceration
      with stenosis at the abdominal esophagus. Endoscopic study showed an ulcerative
      lesion at the level of 30 cm from the incisor teeth. Esophagocardiectomy was
      performed. Resected specimen showed a shallow depressed ulceration, 6.5 x 6.0 cm
      in size, at the lower esophagus. Microscopic examination revealed malignant
      lymphoma of diffuse, large cell type. No evidence of involvement was found in the
      dissected lymph nodes and the bone marrow biopsy specimens. She has been well for
      4 years and 6 months postoperatively.

PMID- 1614398
TI  - [A case of intrahepatic cholesterol stone complicated with atrophy of the
      anterior superior ventral and anterior superior lateral subsegments (S8ab) of the
      liver].
AB  - A 61-year-old male patient with intrahepatic cholesterol stone is reported.
      Stones were detected in the anterior superior lateral subsegment (S8ab) of the
      right lobe with bile duct stenosis, the lateral anterior segment (S3) of the left
      lobe, and the left caudate lobe (S11). Partial hepatectomy including S8ab, S3 and
      S11 was performed to remove all stones. Atrophy of S8ab was diagnosed by CT, and
      PTP clarified the patency of the subsegmental portal vein (P8ab). This is a rare
      case with cholesterol intrahepatic stone with regional bile duct stenosis and
      subsegmental atrophy of S8ab of the liver.

PMID- 1614399
TI  - [Local recurrence of differentiated thyroid carcinoma effectively treated by
      local injection of OK-432].
AB  - Local recurrence of differentiated thyroid carcinoma in a 67-year-old woman was
      treated by topical injection of OK-432 every 2-4 weeks. Recurrent tumors turned
      into small scar-like tissues after 9 months of OK-432 administration. The
      bleeding from the tumor was well controlled. Secondary recurrent tumors were also
      effectively treated in the same manner. About 2 years have passed since the start
      of the treatment and the local recurrence is well controlled. We conclude that
      topical injection of OK-432 might be a good modality of treatment for the local
      recurrence of thyroid carcinoma.

PMID- 1614400
TI  - [A case of pheochromocytoma in pregnancy].
AB  - A 29-year-old woman was referred to our hospital at the 34th week of her first
      pregnancy with a diagnosis of severe pregnancy-induced hypertension. A diagnosis
      of pheochromocytoma was made by elevated values of serum and urinary
      noradrenaline. Ultrasonography and computed tomography revealed a left adrenal
      tumor. Caesarean section combined with removal of the tumor at the 36th week of
      gestation was performed with a satisfactory result obtaining a healthy mother and
      an infant. Current management of patients with a pheochromocytoma during
      pregnancy is discussed.

PMID- 1614401
TI  - [Modulation by recombinant alpha-2a-interfer on the activity and site of action
      of 5-fluorouracil on xenografted human colon cancer in nude mice: preliminary
      report].

PMID- 1614402
TI  - [Pancreatic mitochondrial fragility and impaired pancreatic energy metabolism
      induced by cyclosporin A in rats; preliminary report].

PMID- 1614403
TI  - [A metastatic model of human gastric cancers using orthotopic tissue implantation
      in nude mice: preliminary report].

PMID- 1614404
TI  - [The effect of duodenal reflux on esophageal carcinogenesis in rats: preliminary
      report].

PMID- 1614405
TI  - [Adsorption of natural antibodies with acetone-treated tissue powder: preliminary
      report].

PMID- 1614406
TI  - Increased glucocorticoid receptor gene promoter activity after antidepressant
      treatment.
AB  - We have tested the hypothesis that antidepressants affect the expression of the
      glucocorticoid receptor gene, by looking at glucocorticoid receptor gene promoter
      activity, glucocorticoid receptor mRNA levels, and glucocorticoid-binding
      activity after treatment of different cell lines with desipramine. Treatment of
      LTK- cells or Neuro 2A cells with desipramine produced a 50-200% increase in
      chloramphenicol acetyltransferase activity transcribed from a 2.7-kilobase
      glucocorticoid receptor gene promoter region. In cell lines derived from both
      neuronal and non-neuronal sources, glucocorticoid receptor mRNA concentration
      doubled after desipramine treatment, and this was associated with a 2-fold higher
      functional glucocorticoid binding capacity and increased glucocorticoid
      sensitivity, as measured with the reporter plasmid pMMTVCAT. Antidepressant
      induced increases in glucocorticoid receptor gene promoter activity,
      glucocorticoid receptor mRNA levels, and functional glucocorticoid binding
      activity suggest a novel mechanism of action for these drugs on the hypothalamic
      pituitary-adrenal axis.

PMID- 1614407
TI  - Overcoming of vinblastine resistance by isoquinolinesulfonamide compounds in
      adriamycin-resistant leukemia cells.
AB  - We investigated the effects of seven isoquinoline derivatives in overcoming
      resistance to vinblastine in Adriamycin-resistant mouse leukemia P388/ADR cells
      and human myelogeneous leukemia K562/ADR cells. N-(2-Methylpiperazyl)-5
      isoquinoline-sulfonamide (H-7), N-[2-(methylamino)ethyl]-5
      isoquinolinesulfonamide (H-8), and N-(2-aminoethyl)-5-isoquinolinesulfonamide (H
      9) did not reverse resistance to vinblastine in these resistant cells. N-[2-[N-[3
      (4-Chlorophenyl)-2-propenyl]amino]ethyl]-5- isoquinolinesulfonamide (H-86) and N
      [2-[N-[3-(4-chlorophenyl)-1-methyl-2-propenyl]- amino]ethyl]-5
      isoquinolinesulfonamide (H-87) caused significant accumulation of intracellular
      vinblastine and marked reversal of the resistance to vinblastine in both
      resistant cell lines. Addition of a formyl group at the terminal amino group of H
      86 (H-85) or addition of an aminoethyl group to the nitrogen atom at the
      sulfonamide group of H-86 (W-66) reduced those activities. The activity on
      vinblastine accumulation seems to correlated with the hydrophobicity of the
      compounds. The compounds that effectively reversed resistance to vinblastine
      inhibited [3H]vinblastine efflux and photoaffinity labeling of P-glycoprotein
      with a photosensitive analogue of vinblastine, N-(p-azido-(3-[125I]iodo)-salicyl)
      N'-beta-aminoethylvindesine. Although these isoquinoline derivatives inhibited
      protein kinase A and protein kinase C with various potencies, these inhibitory
      activities did not correlate with the reversal of drug resistance. These results
      indicate that hydrophobic isoquinoline derivatives reverse multidrug resistance
      due to the suppression of drug binding to P-glycoprotein, without involvement of
      their activities on protein kinase A and protein kinase C.

PMID- 1614408
TI  - Distribution of cytochrome P450 1A1 and NADPH-cytochrome P450 reductase in lungs
      of rabbits treated with 2,3,7,8-tetrachlorodibenzo-p-dioxin: ultrastructural
      immunolocalization and in situ hybridization.
AB  - Induction of cytochrome P450 1A1 (P450 1A1) in a variety of tissues is a well
      established consequence of exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)
      and related compounds. Although localization of the induced protein within the
      lung has been described, the precise intracellular distribution of the enzyme is
      not clear. Analysis of tissue sections, microsomal proteins, and mRNA from lungs
      of treated and untreated rabbits established that P450 1A1 had been induced by
      treatment with TCDD. Rabbit lungs from animals treated with TCDD were examined
      with immunocytochemistry and in situ hybridization, to identify the cell types
      that contain P450 1A1 and those that contain mRNA encoding P450 1A1. Endothelial
      cells of the entire vascular bed of rabbit lung reacted markedly with anti-P450
      1A1. Likewise, cells lining both arteries and veins, as well as capillary
      endothelial cells, reacted strongly with the cDNA probe for mRNA encoding P450
      1A1. Clara cells at all levels of airway labeled prominently for both P-450 1A1
      and P450 1A1 mRNA. In addition, type 2 cells, alveolar macrophages, and to a
      lesser degree, ciliated cells reacted with the cDNA probe. P450 reductase, which
      is required for P450 activity, has previously been identified in Clara cells,
      type 2 cells, and alveolar macrophages, but not in endothelium of rabbit lung. We
      have now obtained similar results for the localization of mRNA encoding P-450
      reductase. This finding brings into question the function of P450 1A1 in
      endothelium.

PMID- 1614409
TI  - Effect of corticosteroids on the expression of cytochromes P450 and on
      cyclosporin A oxidase activity in primary cultures of human hepatocytes.
AB  - Prednisone, prednisolone, and methylprednisolone are currently administered in
      association with cyclosporin A in the postoperative treatment of transplant
      patients. The aim of this work was to evaluate the effects of these
      corticosteroids on the expression of several forms of cytochromes P450 (P450),
      including P450 1A2, 2D6, 2E1, and 3A, and on cyclosporin A oxidase activity in
      human liver. For this purpose, human hepatocytes prepared from lobectomies were
      maintained in culture in a serum-free medium, in collagen-coated dishes, for 96
      144 hr, in the absence or presence of 50-100 microM corticosteroids, rifampicin,
      or dexamethasone. To mimic more closely the current clinical protocol, hepatocyte
      cultures were also co-treated with corticosteroids and cyclosporin A or
      ketoconazole (a selective inhibitor of P450 3A). Cyclosporin A oxidase activity,
      intracellular retention of cyclosporin A oxidized metabolites within hepatocytes,
      accumulation of P450 proteins and corresponding messages, and de novo synthesis
      and half-lives of these P450 were measured in parallel in these cultures. Our
      results, obtained from seven different hepatocyte cultures, showed that 1)
      dexamethasone and prednisone, but not prednisolone or methylprednisolone, were
      inducers of P450 3A, at the level of protein and mRNA accumulation, as well as of
      cyclosporin A oxidase activity, known to be predominantly catalyzed by these
      P450; 2) although corticosteroids are known to be metabolized in human liver,
      notably by P450 3A, partial or total inhibition of this P450 by cyclosporin or
      ketoconazole, respectively, did not affect the inducing efficiency of these
      molecules; 3) corticosteroids did not affect the half-life of P450 3A or the
      accumulation of other forms of P450, including 1A2, 2D6, and 2E1; 4) chronic
      treatment of cells with cyclosporin did not affect P450 3A accumulation; 5)
      corticosteroids were all competitive inhibitors of cyclosporin A oxidase in human
      liver microsomes, with Ki values of 61 +/- 12, 125 +/- 25, 190 +/- 38, and 210 +/
      42 microM for dexamethasone, prednisolone, prednisone, and methylprednisolone,
      respectively; and 6) chronic treatment of cells with corticosteroids did not
      influence the excretion of oxidized metabolites of cyclosporin from the cells.
      These results support most of clinical reports dealing with mutual interactions
      between cyclosporin A and corticosteroids.

PMID- 1614410
TI  - Different types of receptor interaction of peptide and nonpeptide angiotensin II
      antagonists revealed by receptor binding and functional studies.
AB  - The pharmacological effects of angiotensin II (AII) are potently inhibited by
      several peptide and recently synthesized nonpeptide AII receptor antagonists. The
      interaction of sarcosine1, isoleucine8-AII (sarile), sarcosine1,O-methyltyrosine4
      AII (sarmesin), and the nonpeptide AII antagonists 2-n-butyl-4-chloro-5-
      hydroxymethyl-1-[(2'-(1H-tetrazole-5-yl)biphenyl-4-yl)- methyl]imidazole (DuP
      753, Losartan potassium) and its metabolite 2-n-butyl-4-chloro-1-[(2'-(1H
      tetrazole-5-yl)biphenyl-4-yl)methyl]imidaz ole - 5-carboxylic acid (EXP3174) with
      AII binding sites was investigated in radioligand binding and functional studies.
      Sarile, sarmesin, DuP 753, and EXP3174 inhibited 125I-AII binding to rat lung
      tissue, with Ki values of 3.5, 16.1, 23.7, and 10.4 nM, respectively. The Hill
      coefficients of all displacement curves, except for sarile (nH, 1.45), were not
      significantly different from unity. In functional experiments using rabbit aorta,
      sarmesin and DuP 753 competitively inhibited the contractile response to AII,
      with pA2 values of 6.75 and 8.01, respectively. Sarile, in contrast, revealed
      noncompetitive antagonism, i.e., the maximum contractile force and the slope of
      the concentration-contractile force curve were significantly and concentration
      dependently depressed. The concentration-contractile response curve for AII was
      shifted to the right in a parallel fashion in the presence of EXP3174 (3 nM to 1
      microM); however, the maximum contractile force was significantly decreased, by
      24%. The marked noncompetitive antagonism of sarile (3 nM) was reversed in the
      presence of increasing concentrations of sarmesin (30 nM to 30 microM) or DuP 753
      (10 nM to 1 microM), whereas in the presence of increasing concentrations of
      EXP3174 (3-300 nM) a 25% depression in maximum contractile force persisted.
      Moreover, the reduction of the maximum contractile force by EXP3174 (10 nM) was
      concentration-dependently restored in the presence of increasing concentrations
      of DuP 753 (10 nM to 1 microM), indicating interaction with the same binding
      site. Whereas sarile (0.3-10 nM) did not affect the 125I-AII binding capacity in
      radioligand saturation experiments, a 54% reduction of Bmax was observed in the
      presence of 100 nM EXP3174. The data provide evidence that all antagonists
      inhibit the functional response to AII by interacting with a common binding site
      at the receptor. The noncompetitive behavior of sarile seems to be due to slow
      dissociation from this receptor site. An additional mechanism must be postulated
      for EXP3174. An allosteric interaction with the receptor, as suggested by the
      reduction in Bmax, may be, at least in part, responsible for the nonclassical
      antagonism of this compound.

PMID- 1614411
TI  - [3H]pBC 264, a suitable probe for studying cholecystokinin-B receptors: binding
      characteristics in rodent brains and comparison with [3H]SNF 8702.
AB  - [3H]Propionyl-Tyr-(SO3H)-gNle-mGly-Trp-(NMe)Nle-Asp-Phe-NH2 ([3H]pBC 264) (98-100
      Ci/mmol), a new peptidase-resistant cholecystokinin (CCK) agonist that is 1000
      fold more potent for CCK-B than for CCK-A receptors, interacts, with a similar
      subnanomolar affinity, with a single class of binding sites (Kd, 0.15-0.2 nM) in
      brain membranes of mouse, rat, guinea pig, and cat, in Tris and Krebs buffers.
      The concentration of CCK-A receptors in rodent brain was estimated to be 8-10
      fmol/mg of protein, by measurement of the Bmax values of the nonselective agonist
      [3H] propionyl-CCK8, with or without 10 nM pBC 264 to saturate CCK-B sites. In
      guinea pig and mouse brain, specific [3H]pBC 264 binding was not affected by NaCl
      and/or guanyl-5'-yl-imidodiphosphate. In contrast, in rat brain the affinity of
      [3H]pBC 264 was decreased and the maximal number of binding sites was increased
      by NaCl and the guanyl nucleotide or by alkaline treatment, suggesting that a
      proportion of CCK-B receptors are linked to guanine nucleotide-binding proteins.
      The Bmax of a CCK8 analog, [3H]SNF 8702, was higher (57 fmol/mg of protein) than
      that of [3H]pBC 264 (40 fmol/mg of protein) in guinea pig brain cortex but not in
      mouse brain. The relative potencies of various analogs differed among species.
      The CCK-B antagonist L365,260 was 18-, 30-, and 64-fold less potent than [3H]pBC
      264 in guinea pig, mouse, and rat, respectively. PD 134308, a CCK-B antagonist,
      was 20-fold less potent in rat brain than in guinea pig brain. Likewise, the
      cyclic analog BC 254 displayed a 30- and 60-fold lower affinity for mouse and rat
      than for guinea pig brain preparations. Together, these results suggest the
      presence of CCK-B receptor subtypes. In all tissues, the specific binding of
      [3H]pBC 264 at its Kd values was very high (75-90%) and higher than that of the
      hydrophobic CCK-B probe [3H]SNF 8702 (approximately 50%). Therefore, unlike
      [3H]SNF 8702, [3H]pBC 264 can be used to study preparations with low receptor
      concentrations, such as rat brain, making this radiolabeled molecule the most
      appropriate ligand available to date for CCK-B receptor studies.

PMID- 1614412
TI  - Photoactivatable agonist of the nicotinic acetylcholine receptor: potential probe
      to characterize the structural transitions of the acetylcholine binding site in
      different states of the receptor.
AB  - The nicotinic acetylcholine receptor exhibits at least four different affinity
      states for agonists such as acetylcholine. In order to identify the structural
      changes occurring at or near the agonist binding site during the allosteric
      transitions, three photoactivatable compounds designed to display agonist
      activity were synthesized. Inhibition constants of these compounds for the
      cholinergic and the noncompetitive blocker binding sites were determined for the
      resting and the desensitized states of the receptor. Among these probes, two
      ligands, AC5 and AC7, displayed a high affinity for the agonist binding site and
      were poorly recognized by the binding site for noncompetitive blockers.
      Electrophysiological experiments revealed that these ligands behaved as agonists
      at low concentrations. We used these two compounds in photolabeling experiments
      and observed that they were able to inactivate the agonist binding site. Up to
      50% of these sites were irreversibly inhibited, depending on the ligand, the
      irradiation conditions, and the selected receptor state. The compound with the
      most interesting properties (high affinity and selectivity for the acetylcholine
      binding site, as well as agonist activity and high photolabeling yield) is AC5, a
      structural analogue of the fluorescent agonist dansyl-C6-choline, which has been
      previously used to characterize the different states of the nicotinic receptor.
      After radioactive synthesis, [3H]AC5 was shown to label all four receptor
      subunits, in a protectable manner. This radioligand, thus, appears suitable for
      investigation of the dynamics of allosteric transitions occurring at the
      activated acetylcholine binding site.

PMID- 1614413
TI  - Stimulation of monooxygenation and conjugation after liver transplantation in the
      rat: involvement of Kupffer cells.
AB  - The success rate of liver transplantation has improved markedly during the last
      few years and, although this patient population receives multiple drug therapies,
      the effect of liver transplantation on drug metabolism has been studied very
      little. Therefore, the purpose of this study was to assess the metabolism of
      model drug substrates after liver transplantation in the rat. Rat livers were
      stored for 4 hr in cold Euro-Collins solution, transplanted orthotopically, and
      then perfused 2 hr later with oxygenated Krebs-Henseleit buffer, using a
      nonrecirculating system. Rates of monooxygenation of the model compound p
      nitroanisole, conjugation of p-nitrophenol, and uptake of oxygen were measured.
      All parameters studied were elevated significantly, by nearly 2-fold, by
      transplantation. Specifically, monooxygenation was increased from 2.9 +/- 0.2 to
      5.1 +/- 0.4 mumol/g/hr, conjugation was elevated from 3.3 +/- 0.6 to 7.7 +/- 0.1
      mumol/g/hr, and O2 uptake was stimulated from basal values of 114 to 197
      mumol/g/hr. Transplantation did not, however, alter rates of monooxygenation and
      conjugation in isolated microsomes supplemented with excess cofactor. When donor
      rats were pretreated with the Kupffer cell toxicant gadolinium chloride (10
      mg/kg, intravenously) 30 hr before liver storage, the elevation after
      transplantation in all parameters studied was prevented. Depletion of
      carbohydrate reserves by fasting of donor rats did not prevent stimulation of
      monooxygenation and conjugation. On the other hand, urea synthesis from ammonium
      chloride, a process dependent on mitochondrial NADPH, was increased and
      monooxygenation was diminished after transplantation, suggesting the involvement
      of mitochondria in this phenomenon. Indeed, mitochondria isolated 2 hr
      postoperatively exhibited significantly elevated respiratory control ratios and
      higher state 3 rates of respiration. Taken together, these data support the
      hypothesis that Kupffer cells, activated by transplantation, release mediators
      that stimulate mitochondria in parenchymal cells and enhance drug metabolism by
      increasing cofactor supply (e.g., NADPH for monooxygenation and UDP-glucuronic
      acid for glucuronidation).

PMID- 1614414
TI  - Effects of vitamin E on the killing of cultured hepatocytes by tert-butyl
      hydroperoxide.
AB  - The disposition of vitamin E was examined in cultured rat hepatocytes intoxicated
      with tert-butyl hydroperoxide (TBHP). Culturing of the cells overnight (18-20 hr)
      with approximately 60 nM alpha-tocopherol (alpha-T) equivalents [Williams' E
      medium, 18 nM tocopherol phosphate (alpha-TP), 9% fetal calf serum, 43 nM alpha
      T] resulted in a content of alpha-T that was 16% of the concentration of vitamin
      E measured in freshly isolated hepatocytes. Supplementation of the medium with 1
      microM alpha-TP maintained the alpha-T concentration of the cultured cells at the
      level of freshly isolated hepatocytes. Supplemented hepatocytes exposed to TBHP
      showed decreased lipid peroxidation and delayed cell killing, compared with
      hepatocytes not cultured overnight with alpha-TP. Killing of the supplemented
      cells by TBHP was accompanied by a loss of alpha-T. Pretreatment of supplemented
      hepatocytes with the iron chelator deferoxamine prevented much of the loss of
      alpha-T. At the same time, deferoxamine inhibited both the lipid peroxidation and
      cell killing. The antioxidant N,N'-diphenyl-1,4-phenylenediamine reduced the loss
      of alpha-T and significantly decreased lipid peroxidation. In the presence of
      N,N'-diphenyl-1,4-phenylenediamine, cell killing was delayed by 15 min and
      reduced in extent. Overnight supplementation of hepatocytes with nonesterified
      alpha-T, or vitamin E esters other than alpha-TP, similarly rendered the cells
      less sensitive to TBHP. The nonesterified alpha-T produced a higher cell
      associated vitamin E concentration than did the esters; however, nonesterified
      alpha-T did not result in greater protection against TBHP. These data indicate
      that the mechanisms of the cell killing by TBHP are the same in cultured
      hepatocytes that contain low or physiological concentrations of vitamin E.

PMID- 1614415
TI  - Helicase inhibition by anthracycline anticancer agents.
AB  - Helicases are essential to both DNA replication and transcription because they
      separate double-stranded DNA, preparing the single strands for replication or
      transcription. Because the anti-cancer anthracycline antibiotics stabilize double
      stranded DNA primarily by their intercalative binding, we expected the
      intercalated antibiotics to interfere with helicase action. We examined
      anthracycline antibiotic effects on SV40 large T antigen helicase activity, using
      a duplex DNA helicase substrate of 32P-labeled 17-mer annealed to complementary
      M13mp19(+) circular single-stranded DNA. The T antigen helicase activity was
      potently inhibited by the anthracycline antibiotics. The T antigen helicase IC50
      values for the anthracycline antibiotics were as follows: nogalamycin, 2 x 10(-7)
      M; daunorubicin, 4 x 10(-7) M; doxorubicin, 4 x 10(-7) M; idarubicin, 1.8 x 10(
      6) M; 4'-epidoxorubicin, 2 x 10(-6) M; aclacinomycin, 4 x 10(-6) M; and
      menogaril, 6 x 10(-6) M. Partially purified helicases from HeLa cells and murine
      mammary carcinoma FM3A cells also were potently inhibited by doxorubicin, with
      IC50 values of 4 x 10(-7) M and 9 x 10(-7) M, respectively. Because the
      abundance, specificities, and types of helicases vary in the cell, this site of
      action for anthracycline antibiotics may help explain anthracycline potency, drug
      specificity for DNA or RNA inhibition, and some types of cellular resistance to
      these drugs.

PMID- 1614416
TI  - Transfection of human 5-hydroxytryptamine1A receptors in NIH-3T3 fibroblasts:
      effects of increasing receptor density on the coupling of 5-hydroxytryptamine1A
      receptors to adenylyl cyclase.
AB  - Human serotonin [5-hydroxytryptamine (5-HT)1A] receptors have been transfected in
      NIH-3T3 cells, and their pharmacology and coupling to adenylyl cyclase have been
      analyzed. Three cellular preparations were used, 1) monoclonal cell lines (clones
      6, 2B, and 4B), expressing 45, 280, and 500 fmol of 5-HT1A receptors/mg of
      protein, respectively; 2) clones 6, 2B, and 4B in which the concentration of 5
      HT1A receptors was increased after stimulation of the glucocorticoid-inducible
      promoter with dexamethasone; and 3) polyclonal cell lines that expressed an
      increasing amount of 5-HT1A receptor as a function of cell passage. The
      transfected 5-HT1A receptors inhibited basal, forskolin-stimulated, and
      isoproterenol-stimulated adenylyl cyclase. The inhibition was dependent on the
      receptor density expressed, increasing from 60% at low density (45 fmol/mg) to
      90% at a density higher than 280 fmol/mg. The pharmacology of the 5-HT1A receptor
      was studied, with particular attention being paid to the behavior of some
      agonists. These pharmacological characteristics are similar to those of 5-HT1A
      receptors in hippocampus but different from those of 5-HT1A in cerebral cortex.
      Analysis of the potencies and efficacies of the full agonist 5-HT and the partial
      agonist ipsapirone, as a function of receptor density in the three cellular
      populations used, revealed that 1) the efficacies of the full and partial
      agonists increased with the receptor density; 2) the EC50 values of the full and
      partial agonists were not shifted to the left when the receptor density was
      increased (based on the increase in efficacy and considering the classical
      pharmacological models of receptor-drug action, a 9-10-fold shift was expected);
      and 3) the ratio between the efficacies of the full agonist 5-HT and the partial
      agonist ipsapirone was not modified when the receptor concentration was increased
      or when the GTP-binding protein availability was decreased. The results indicate
      that neither the classical nor the operational model of drug-receptor action can
      be used to describe the coupling of 5-HT1A receptors to adenylyl cyclase in
      transfected NIH-3T3 cells. One of the explanations could be that 5-HT1A receptors
      and GTP-binding proteins are coupled in functional domains (almost precoupled),
      rather than distributed in homogeneous compartments in which they are free to
      diffuse.

PMID- 1614417
TI  - Molecular mechanism of RU 486 action: a review.

PMID- 1614418
TI  - Polyamines in liver and their influence on chromatin condensation after 17-beta
      estradiol treatment of Atlantic salmon.
AB  - Atlantic salmon (Salmo salar) were treated with 17-beta estradiol to induce
      vitellogenin synthesis in liver. This led to an increase in liver wet weight and
      total DNA. After incubation with micrococcal nuclease (EC 3.1.31.1) less soluble
      chromatin was obtained from nuclei of the estradiol treated than the control
      fish, but active gene regions were solubilized by the nuclease. Thus, in the
      estradiol treated fish soluble mononucleosomes contained hybridizable
      vitellogenin gene sequences. As a result of estradiol treatment the content in
      total liver of putrescine rose 3-fold, that of spermidine 2-fold, while spermine
      was unchanged. In muscle no significant changes were observed. The regulatory
      functions of polyamines during gene expression were investigated by binding
      (14C)spermine to isolated liver nuclei depleted of endogenous polyamines. The
      number of binding sites was higher in nuclei of estradiol treated than control
      fish. (14C)spermine associated preferentially with micrococcal nuclease
      insensitive chromatin. Thus, the high content of putrescine and spermidine in
      liver supported the view of polyamine accumulation in proliferating tissues. The
      preferential binding to condensed chromatin indicated a stabilizing effect of
      polyamines on the organization of inactive chromatin structures.

PMID- 1614419
TI  - Trypanosoma cruzi glycoprotein 72: immunological analysis and cellular
      localization.
AB  - Two monoclonal antibodies were used to biochemically characterize glycoprotein 72
      (GP72) from Trypanosoma cruzi and to localize the protein in live and fixed
      parasites by indirect immunofluorescence and in thin section of parasites by
      immunogold electron microscopy. GP72 was shown in immunoblots to be specific for
      the epimastigote stage; the protein could not be detected in trypomastigotes.
      Each antibody reacted with a different epitope on the glycoprotein and
      deglycosylation of GP72 ablated reactivity with one of the antibodies. Indirect
      immunofluorescence and electron microscopic evaluation of parasite associated
      gold particles showed the presence of GP72 in the cell surface membrane including
      the flagellar pocket and the cytostome. In addition, cytoplasmic membrane
      vesicles of the endosomal-lysosomal system stained intensely.

PMID- 1614420
TI  - Heparin releasable and nonreleasable forms of heparan sulfate proteoglycan are
      found on the surfaces of cultured porcine aortic endothelial cells.
AB  - Evidence suggests that endothelial cell layer heparan sulfate proteoglycans
      include a variety of different sized molecules which most likely contain
      different protein cores. In the present report, approximately half of endothelial
      cell surface associated heparan sulfate proteoglycan is shown to be releasable
      with soluble heparin. The remaining cell surface heparan sulfate proteoglycan, as
      well as extracellular matrix heparan sulfate proteoglycan, cannot be removed from
      the cells with heparin. The heparin nonreleasable cell surface proteoglycan can
      be released by membrane disrupting agents and is able to intercalate into
      liposomes. When the heparin releasable and nonreleasable cell surface heparan
      sulfate proteoglycans are compared, differences in proteoglycan size are also
      evident. Furthermore, the intact heparin releasable heparan sulfate proteoglycan
      is closer in size to proteoglycans isolated from the extracellular matrix and
      from growth medium than to that which is heparin nonreleasable. These data
      indicate that cultured porcine aortic endothelial cells contain at least two
      distinct types of cell surface heparan sulfate proteoglycans, one of which
      appears to be associated with the cells through its glycosaminoglycan chains. The
      other (which is more tightly associated) is probably linked via a membrane
      intercalated protein core.

PMID- 1614421
TI  - Stimulation of insulin release by isosmolar addition of permeant molecules.
AB  - Pancreatic beta-cells are known to respond to hyposmolar stress by releasing
      insulin. It was evident from perifusion studies using islet cells from ob/ob-mice
      mixed with polyacrylamide beads that a similar type of secretory response can be
      obtained by isosmolar addition of 10-25 mM of the rapidly penetrating urea
      molecule. There was no effect with hyperosmolar addition of urea. The urea
      induced insulin release differed from the ordinary stimulation of secretion in
      not disappearing but being more pronounced after previous heating to 45 degrees C
      or removal of extracellular Ca2+. Isosmolar urea was exceptional as an insulin
      secretagogue in being effective also in the presence of the alpha 2-adrenergic
      agonist clonidine or when lowering the temperature to 24 degrees C. Further
      support for the idea that isosmolar addition of rapidly penetrating molecules
      induces insulin release was obtained by testing non-metabolizable glucose
      analogues. Whereas 25 mM 3-O-methyl-D-glucose doubled the secretory rate within 4
      min, the non-permeant L-glucose had only a slight initial action. When not
      compensating for the alterations of the medium osmolarity 3-O-methyl-D-glucose
      was without effect. Although expansion of beta-cells cannot explain the existence
      of a pronounced initial secretory response to D-glucose it may under certain
      conditions contribute to the stimulatory effects of the sugar.

PMID- 1614422
TI  - Changes in lipid content and composition during the development of N
      nitrosodiethylamine induced hepatocarcinoma.
AB  - Alterations in lipid content and composition in the N-nitrosodiethylamine-induced
      hepatocarcinoma were investigated. Rats were administered with N
      nitrosodiethylamine in the drinking water for 12 weeks followed by normal tap
      water for another 6 weeks. The cholesterol content in the liver was increased
      shortly after the administration of N-nitrosodiethylamine and remained elevated
      after the removal of the nitrosoamine from the water. The
      phosphatidylethanolamine level was elevated during N-nitrosodiethylamine
      administration with a concomitant reduction in phosphatidylcholine level.
      Lysophosphatidylcholine and sphingomyelin levels were increased during the last
      four weeks of the study. The level of phosphatidylinositol was substantially
      reduced after eight weeks of N-nitrosodiethylamine treatment, and remained low
      during the post-treatment period. We postulate that changes in
      lysophosphatidylcholine and sphingomyelin may be a compensatory mechanism for
      maintaining the asymmetrical distribution of choline-containing lipids in the
      outer leaflet of the membrane. The elevated level of cholesterol may be a useful
      indicator for the early detection of N-nitrosodiethylamine-induced
      hepatocarcinoma.

PMID- 1614424
TI  - Keys to regeneration. Proceedings of the European Conference on Tissue and Post
      Traumatic Regeneration. Geneva, September 3-7, 1990.

PMID- 1614425
TI  - The foundations of contemporary regeneration research: historical perspectives.

PMID- 1614426
TI  - Axonal release of transferrin in peripheral nerves of axolotls during
      regeneration.

PMID- 1614423
TI  - Dipyridamole stimulates types II cAMP-dependent protein kinase in vitro.
AB  - Dipyridamole activates in vitro type II cAMP-dependent protein kinase. This agent
      stimulates the autophosphorylation of the regulatory subunit in the presence of
      cAMP but not so in the absence of the cyclic nucleotide. The activation was also
      observed with exogenous substrates such as casein, histone 2A and MAP2. This
      stimulation did not seem to be related to the cAMP binding to the R II subunit of
      the enzyme. Competition binding experiments showed that dipyridamole does not
      compete with adenosine for the A1 receptor. The results suggest that the reported
      regulatory properties of dipyridamole on lipid metabolism (Gonzalez-Nicolas et
      al. Int J Biochem 21: 883-888, 1989) might be mediated through a direct action-
      an activation--on the catalytic subunit of a cAMP-dependent protein kinase.

PMID- 1614427
TI  - Characterization of fibroblast growth factor binding in regenerating limb
      blastemas of axolotls.

PMID- 1614428
TI  - Extraction of the WE3 antigen and comparison of reactivities of mAbs WE3 and WE4
      in adult newt regenerate epithelium and body tissues.

PMID- 1614429
TI  - Activation of genes coding for gamma-crystallins during lens regeneration in the
      newt.

PMID- 1614430
TI  - Pattern perturbation in Xenopus laevis forelimb regenerates following treatment
      with retinoic acid and carrier media.

PMID- 1614431
TI  - Observations on digit regeneration in the amphibian Triturus cristatus after 180
      degrees rotation of digit blastemata.

PMID- 1614432
TI  - On the completeness of skin regeneration and reorganization of scars in warm
      blooded animals.

PMID- 1614433
TI  - Properties of the donor muscle determine the characteristics of regenerated avian
      skeletal muscle.

PMID- 1614434
TI  - Muscle regeneration and aging.

PMID- 1614435
TI  - Regeneration of connective tissue in different organs of xenogeneic mouse
      radiation chimeras.

PMID- 1614436
TI  - Regeneration of hemopoietic and connective tissues.

PMID- 1614437
TI  - Lymphoid cell-derived humoral factors as possible mediators in regeneration
      information transfer.

PMID- 1614439
TI  - Aluminium concentration in nuclei of regenerating rat liver cells. A study by
      analytical ion microscopy.

PMID- 1614438
TI  - A model of hepatic regeneration and carcinogenesis due to total liver cell injury
      induced by dipin and partial hepatectomy.

PMID- 1614440
TI  - Regeneration of the aquapharyngeal complex in the holothurian Eupentacta
      fraudatrix (Holothuroidea, Dendrochirota).

PMID- 1614441
TI  - Regeneration of digestive tube in holothurians Stichopus japonicus and Eupentacta
      fraudatrix.

PMID- 1614442
TI  - The fish fin regenerate.

PMID- 1614443
TI  - Effects of amputation through primary forelimb regenerates and delayed
      denervation of the secondary blastemata on the continuation of regeneration in
      adult newts.

PMID- 1614444
TI  - [Surfactant homeostasis--principles for surfactant substitution therapy].

PMID- 1614445
TI  - [Pediatric tracheostomy care].
AB  - Long term tracheostomy has become a rare caregiving problem in Paediatrics, but
      remains the only therapeutic strategy for a spectrum of complex anomalies of the
      paediatric airway. The present state-of-the-art article describes the practical
      routine of tracheostomy care as developed in the Paediatric Department of Graz.
      Commencing with indications for tracheostomy and a brief comment on relevant
      operations, it discusses routine and special tracheostomy tubes, valves, and
      other accessory devices. One chapter on specialised care is focussed on the
      paediatric airway, another more general one is concerned with the tracheostomized
      child. Then follows teaching tracheostomy care to parents; the article ends with
      a discussion of control investigations and decannulation.

PMID- 1614447
TI  - [Pachygyria and laminar heterotopic tissue. A rare case of unique expression of a
      neuronal migration disorder in twins].
AB  - We report of 16 year old twinsisters with a neuronal migration disorder, twin I
      with mental retardation and focal epileptic seizures on MRI showed general
      pachygyria, laminar subcortical heterotopia and mildly dilated lateral
      ventricles, whereas twin II whose first symptom was a cerebral seizure only
      showed a focal pachygyria and laminar subcortical heterotopia; the location of
      pachygyria corresponded to the epileptogenic focus. The morphological expression
      seems to correspond with the severeness of the clinical features. Genetic as well
      as exogenic factors must be assumed to be causative for the migration anomalies.

PMID- 1614446
TI  - [48,XXYY syndrome in a boy with essential tremor. Comparison with 120 cases from
      the literature].
AB  - We report on a 14 year-old boy with 48,XXYY karyotype, presenting with essential
      tremor and a slight retardation of psychomotor development. In contrast to other
      cases with 48,XXYY syndrome, this pubertal patient has testicles of normal size,
      has small stature and shows no behavioural disturbances. We compared our patient
      with 120 other published cases.

PMID- 1614448
TI  - [Growth hormone therapy in STH deficiency with immunologic deficiency and
      chromosome fragility].
AB  - A 8 year old boy with short stature, low height velocity, mental retardation,
      cutaneous abnormalities, common variable immunodeficiency and increased
      chromosomal instability is described. In this patient growth hormone deficiency
      could be demonstrated by several stimulation tests. Growth hormone treatment
      increased growth rate from 4 cm/year before therapy to 7.8 cm in the first and
      7.1 cm in the second year of treatment. Under therapy no effect on the
      immunological reactivity could be observed.

PMID- 1614449
TI  - [Mucociliary clearance in childhood].
AB  - AIM OF THE STUDY: A new, nearly monodisperse human serum albumin particle
      produced by air-pressure-nebulization was inhaled by children and lung-transplant
      patients. METHOD: After inhalation of the particles obtained with an air-pressure
      nebulizer, the initial deposition pattern showed a marked tracheobronchial
      deposition which could be reproducibly obtained without a special breathing
      technique, the alveolar deposition being not higher than 10%. With the use of
      99mTc, the radiation exposure is limited to a level which is low enough for
      children, but images can be taken up to 24 hrs later. Further parameters for in
      vivo characterization of the mucociliary function are the 24 h retention pattern
      and the velocity of particle motion in the trachea. RESULTS: Within the first 45
      minutes, the global clearance rate was 51% in healthy children, which is rather
      high in comparison with the literature, most likely due to size of particles and
      the selection of patients with a mean age of 10.7 years. In ciliary dysfunction,
      the initial clearance rate was 16% and 46% within 24 h. CONCLUSIONS: With
      simplification of the preparation, application, and examination technique, this
      method is to be used in children, so that a wider use can be anticipated. The
      normally fast initial elimination of particles allows quick differentiation of
      normal and impaired ciliary function.

PMID- 1614450
TI  - [Cerebral Doppler measurements in risk newborn infants do not have a prognostic
      value].
AB  - PROBLEM: The prognostic value of cerebral doppler for the neonatal and the
      developmental prognosis was studied. METHODS: A prospective longitudinal study on
      175 newborns at risk was performed. The blood flow velocities were recorded
      transcranially in the middle cerebral, posterior cerebral and internal carotid
      artery on day 1, 3-5 and 8-10 of life. Neonatal mortality and cerebral sonography
      gave the criteria for neonatal prognosis. Developmental prognosis was determined
      at a corrected age of 9 months by neurological examination and Griffth's test.
      RESULTS: In 60 neonates abnormal flow velocities were obtained at least at one
      recording. Ultrasound revealed cerebral hemorrhage in 20, hypoxic-ischemic
      encephalopathy in 5 children. 14 infants died during the neonatal period, 5 in
      the following months. Premature babies with birth weights below 1501 g and
      abnormal flow velocities presented more cerebral hemorrhages and deaths than
      those with normal flow velocities. At the age of 9 months a slight handicap was
      observed in 10, a severe handicap in 6 of the surviving 156 infants. The majority
      of infants with abnormal neonatal doppler-recording had a normal
      neurodevelopmental status. CONSEQUENCE: Cerebral doppler seems to be of little
      value to determine the prognosis of newborns at risk.

PMID- 1614451
TI  - [Is the Crede eye disease prevention with silver nitrate still necessary.
      Position of the German-Austrian Society of Neonatology and Pediatric Intensive
      Care].

PMID- 1614452
TI  - [In memory of Arvo H. Ylppo].

PMID- 1614453
TI  - [Diagnosis and therapy of anemia in childhood. Part 1. Differential diagnosis,
      hypoplastic anemia, thalassemia].

PMID- 1614454
TI  - [Kawasaki syndrome. Association with exposure to carpet shampoo and successful
      therapy with immunoglobulins in the second week of the illness].
AB  - A male infant and a three year old girl, both with acute febrile illness, were
      admitted to our hospital for suspected meningitis/sepsis and
      gastroenteritis/severe viral infection, respectively. Both showed all six
      principal features of Kawasaki syndrome and revealed several other symptoms and
      laboratory findings commonly associated with the disease. The infant had multiple
      coronary aneurysms. The girl developed ascites, pancreatitis and iritis, all of
      which are seldomly recognized symptoms of the Kawasaki syndrome. The prompt and
      satisfactory therapeutic responses of both patients to the combined therapy
      consisting of oral acetylsalicylic acid (50-100 mg/kg b.w./d) and intravenous
      gamma-globuline (400 mg/kg b.w./d) at the eight and even eleventh day of illness
      support the use of gamma-globuline therapy beyond the first week of the disease.
      Prior to their illnesses both children had been exposed to carpet shampoo, an
      agent which has been repeatedly associated with an increased risk of Kawasaki
      syndrome.

PMID- 1614455
TI  - [Pyromania and enuresis. Multifactorial causes require multidimensional treatment
      concepts].
AB  - The abilities to control the voiding of the bladder and to act competently in
      dealing with fire are important factors of the normal development of children.
      Unfavourable conditional constellations in the socio-emotional, cognitive, or
      physical realm can cause developmental defects which manifest themselves in
      certain target symptoms, for instance Pyromania and Enuresis. The importance of
      multifactorial etiological models will be illustrated by a case report of a boy
      displaying symptoms of Pyromania and Enuresis nocturna. The analysis of the
      specific conditions of the case studied results in the appropriate
      multidimensional treatment concept.

PMID- 1614456
TI  - [Neonatal variant of Bartter syndrome].
AB  - A male preterm infant of 32 weeks of gestation with history of severe
      polyhydramnios during pregnancy presented soon after birth with polyuria with
      initial sodium chloride loss subsequently followed by increasing potassium loss.
      After manifestation of hypokalaemia, hypochloraemia, alkalosis and high urinary
      prostaglandin concentrations, the diagnosis of the neonatal variant of Bartter's
      syndrome was made. The treatment consisted of administered of large amounts of
      fluid with sodium chloride and potassium supplementation and indomethacin (1.5 to
      2 mg/kg per day).

PMID- 1614457
TI  - [Tumors of the adrenal gland and lumbar sympathetic chain. Differential
      ultrasound diagnosis in childhood].
AB  - In a retrospective study from 1979 to 1989 17 tumors of the sympathic chain and
      the adrenal gland were analysed according to typical sonographic patterns. 13
      tumors (10 neuroblastomas, 2 pheochromocytomas, 1 adenoma of the adrenal gland)
      were localized within the abdomen, 4 tumors (3 neuroblastomas, 1 ganglioneuroma)
      originated from the mediastinum. Neuroblastomas usually were great suprarenal
      masses with bad delineation and inhomogenous increased echogenicity in comparison
      with the liver. In more than 50% calcifications occurred, whereas cysts (15%)
      could rarely be found. The upper pole of the ipsilateral kidney usually was
      compressed and displaced caudally and laterally. The great intraabdominal vessels
      were usually displaced anteriorly and to the opposite side. The disturbed flow
      within the compressed intraabdominal vessels could reliably be shown by colour
      Doppler sonography as well as tumor vascularity. The 2 pheochromocytomas as well
      as the ganglioneuroma and the adenoma of the adrenal gland were round or oval,
      well delineated nodules with homogeneous liver like echogenicity. According to
      their typical sonographic patterns tumors of adrenal gland and sympathic chain
      can be differentiated from each other as well as from kidney tumors.

PMID- 1614458
TI  - [Determination of hydrogen in expiratory air of premature infants in suspected
      necrotizing enterocolitis].
AB  - BACKGROUND: Breath hydrogen (H2) analysis has been recommended for the
      differential diagnosis between necrotizing enterocolitis and transient feeding
      intolerance. METHODS: We performed 360 breath H2 analyses in 32 unselected
      premature babies by use of an electrochemical method. RESULTS: All babies on oral
      feedings excreted H2. The concentration of H2 in expired air was extremely
      variable and often high even in well premature babies. Antibiotic medication
      (other than penicillin G alone) inhibited breath hydrogen excretion. CONCLUSIONS:
      Breath hydrogen analysis can be used as a diagnostic tool for necrotizing
      enterocolitis if performed in a symptomatic child on oral feedings prior to the
      initiation of antibiotic therapy.

PMID- 1614459
TI  - [Reference values for IgE concentration in serum of children. Method: ImmunoCAP
      FEIA system].
AB  - Age specific IgE reference values were determined in serum of 224 children by the
      aid of the ImmunoCAP fluorescence enzyme immunoassay method. RESULTS: Cord blood:
      less than 0.35 kU/l; Till 0.5 year: less than 2.0 kU/l; 0.5-2 years: up to 3.8
      kU/l; 2-5 years: up to 16.0 kU/l; 5-8 years: up to 26.2 kU/l; 8-12 years: up to
      34.6 kU/l; 12-16 years: up to 26.3 kU/l. These IgE reference values can be used
      for the diagnosis of pathological elevated IgE concentrations in serum of
      children.

PMID- 1614460
TI  - [Endocrinologic disorders in deletion of chromosome 18].
AB  - Patients suffering from deletions of chromosome 18 (p-, q-) show regularly short
      stature. Endocrinological investigations were performed to prove if short stature
      is due to pituitary insufficiency. In three female patients with deletions of
      chromosome 18 and retarded bone age serum growth hormone was investigated after
      insulin induced hypoglycemia, after glucagon-propranolol and after stimulation
      with growth hormone releasing hormone. Thyroid function, gonadal function and
      adrenal function were investigated too. All three patients showed growth hormone
      deficiency. In one patient there were found in addition hypothyroidism and
      gonadotrophine deficiency as well. In conclusion growth failure in some patients
      with deletions of chromosome 18 seems to due to pituitary insufficiency. In these
      patients treatment with recombinant growth hormone may increase growth velocity.

PMID- 1614461
TI  - [Juvenile chronic leukemia and chronic myelomonocytic leukemia. Experiences with
      bone marrow transplantation in childhood in 5 cases].
AB  - Chronic leukemias of early childhood (JCML/CMML) are rare malignant diseases for
      which effective regimens of chemotherapy have not been established. However, some
      of these patients may be cured by BMT. We report on 4 children with JCML and one
      child with CMML undergoing BMT from HLA-identical siblings and from matched
      unrelated donors. 3 of 5 patients are disease-free 9 to 37 months post BMT.
      According to our observations an effective reduction of blastic cells before BMT
      seems to be necessary for a sustained remission of these diseases. This reduction
      can be reached by intensive chemotherapy and by splenectomy before BMT. Moreover,
      we stress the need for total body irradiation (TBI) during BMT in order to
      eradicate residual malignant cells.

PMID- 1614462
TI  - Intravenous immune globulin for the prevention of nosocomial infection in low
      birth-weight neonates. The Multicenter Group for the Study of Immune Globulin in
      Neonates.
AB  - BACKGROUND: Nosocomial infection is a major risk for premature infants with very
      low birth weights. One reason for their susceptibility to infection may be
      antibody deficiency, since there is little transfer of maternal IgG to the fetus
      before 32 weeks' gestation. METHODS: We conducted a multicenter, double-blind
      study of neonates weighing 500 to 1750 g at birth. A total of 588 neonates were
      randomly assigned, with stratification for birth weight, to receive periodic
      intravenous infusions of either immune globulin (500 mg per kilogram of body
      weight per day) or a placebo. Mortality, morbidity, and nosocomial infection
      during the next 56 days were assessed. RESULTS: The infusions were well
      tolerated; mild, reversible adverse reactions occurred in five infants in each
      group. There was a significant reduction in the risk of a first nosocomial
      infection in the recipients of immune globulin as compared with the placebo
      recipients (relative risk, 0.7; 95 percent confidence interval, 0.5 to 0.9).
      About 85 percent of the nosocomial infections were bacterial; the majority of
      these were caused by coagulase-negative staphylococci or Staphylococcus aureus.
      The neonates who received immune globulin had fewer mean days of hospitalization
      than the controls (62 vs. 68, P = 0.15); among the infants with infections, the
      difference in the mean length of the hospital stay was even greater (80 days vs.
      101 days, P = 0.02). CONCLUSIONS: For premature infants weighing between 500 and
      1750 g at birth, treatment with intravenous infusions of immune globulin is safe
      and reduces the risk of nosocomial infection.

PMID- 1614463
TI  - Preserved insulin secretion and insulin independence in recipients of islet
      autografts.
AB  - BACKGROUND: Transplantation of pancreatic islets, rather than whole pancreas, has
      been introduced as a treatment for diabetes mellitus. We studied five patients
      ranging in age from 12 to 37 years who had severe chronic pancreatitis for which
      they underwent total pancreatectomy followed by isolation and hepatic
      transplantation of their own islets. METHODS: All patients had remained insulin
      independent for 1 to 7 1/2 years after transplantation. The numbers of islets
      transplanted ranged from 110,000 to 412,000. Islet function was assessed by
      measuring the plasma insulin responses to intravenous glucose and arginine and
      the plasma glucagon responses to hypoglycemia and arginine. In one patient, islet
      function was studied during catheterization of the hepatic vein, portal vein, and
      splenic artery and by analysis of a liver-biopsy specimen. RESULTS: After
      transplantation, the mean (+/- SD) fasting plasma glucose concentration was 122
      +/- 47 mg per deciliter (6.8 +/- 2.6 mmol per liter) and the hemoglobin A1c
      concentration was 6.0 +/- 0.8 percent in the five patients. The values were most
      abnormal--214 mg per deciliter (11.9 mmol per liter) and 7.3 percent,
      respectively--in the patient who received only 110,000 islets. The acute plasma
      insulin responses to glucose and to arginine in the five patients were 23 +/- 13
      and 26 +/- 10 microU per milliliter (168 +/- 94 and 184 +/- 70 pmol per liter),
      respectively, as compared with 58 +/- 6 and 37 +/- 8 microU per milliliter (416
      +/- 44 and 267 +/- 61 pmol per liter) in the normal subjects. The peak plasma
      glucagon responses to insulin and arginine were 21 +/- 4 and 65 +/- 36 pg per
      milliliter, respectively, as compared with 125 +/- 28 and 156 +/- 99 pg per
      milliliter in the normal subjects. All five patients had plasma epinephrine but
      not pancreatic polypeptide responses to hypoglycemia. The results of the hepatic
      vein catheterization in one patient indicated that the transplanted islets
      released insulin and glucagon in response to arginine. Immunoperoxidase staining
      of this patient's liver-biopsy specimen showed that the islets contained insulin,
      glucagon, and somatostatin but not pancreatic polypeptide. CONCLUSIONS:
      Intrahepatic transplantation of as few as 265,000 islets can result in the
      release of insulin and glucagon at appropriate times and in prolonged periods of
      insulin independence.

PMID- 1614465
TI  - Cumulative meta-analysis of therapeutic trials for myocardial infarction.
AB  - BACKGROUND: The large volume of published randomized, controlled trials has led
      to a need for meta-analyses to track therapeutic advances. Performing a new meta
      analysis whenever the results of a new trial of a particular therapy are
      published permits the study of trends in efficacy and makes it possible to
      determine when a new treatment appears to be significantly effective or
      deleterious. We describe the use of such a procedure, cumulative meta-analysis,
      to assess therapeutic trials among patients with myocardial infarction. METHODS:
      We performed cumulative meta-analyses of clinical trials that evaluated 15
      treatments and preventive measures for acute myocardial infarction. RESULTS: An
      example of this method is its application to the use of intravenous streptokinase
      as thrombolytic therapy for acute infarction. Thirty-three trials evaluating this
      therapy were performed between 1959 and 1988. We found that a consistent,
      statistically significant reduction in total mortality (odds ratios, 0.74; 95
      percent confidence interval, 0.59 to 0.92) was achieved in 1973, after only eight
      trials involving 2432 patients had been completed. The results of the 25
      subsequent trials, which enrolled an additional 34,542 patients through 1988, had
      little or no effect on the odds ratio establishing efficacy, but simply narrowed
      the 95 percent confidence interval. In particular, two very large trials, the
      Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico trial
      in 1986 (11,712 patients) and the Second International Study of Infarct Survival
      trial in 1988 (17,187 patients) did not modify the already established evidence
      of efficacy. We used a similar approach to study the accumulating evidence of
      efficacy (or lack of efficacy) of 14 other therapies and preventive measures for
      myocardial infarction. CONCLUSIONS: Cumulative meta-analysis of therapeutic
      trials facilitates the determination of clinical efficacy and harm and may be
      helpful in tracking trials, planning future trials, and making clinical
      recommendations for therapy.

PMID- 1614466
TI  - Moricizine.

PMID- 1614464
TI  - Prophylactic intravenous administration of standard immune globulin as compared
      with core-lipopolysaccharide immune globulin in patients at high risk of
      postsurgical infection.
AB  - BACKGROUND: Infections and their sequelae are a major cause of death among
      patients admitted to the surgical intensive care unit (ICU). Studies of passive
      immunotherapy with standard intravenous immune globulin and hyperimmune globulin
      directed against gram-negative core lipopolysaccharide to prevent gram-negative
      infections and their serious systemic complications have had equivocal results in
      such patients. METHODS: We performed a double-blind study to assess the efficacy
      of standard immune globulin and core-lipopolysaccharide hyperimmune globulin in
      preventing infections in surgical patients at high risk. The patients received
      standard immune globulin (400 mg per kilogram of body weight), hyperimmune
      globulin (400 mg per kilogram), or placebo (25 percent albumin, 8 ml per
      kilogram) weekly, for a maximum of four doses while in the ICU. RESULTS: A total
      of 352 patients were enrolled, and 329 could be evaluated. The number of patients
      in whom infections developed was significantly lower in the group receiving
      standard immune globulin than in the placebo group (36 of 109 vs. 53 of 112
      patients, P = 0.03), as was the incidence of pneumonia (15 vs. 30 cases, P =
      0.04), especially pneumonia due to gram-negative bacteria (5 vs. 16 cases, P =
      0.02). The number of days spent in the ICU and the total days spent in the
      hospital were lower in the standard immune globulin group (medians of 2 and 7.5
      days fewer; P = 0.02 and 0.06, respectively). In contrast, the hyperimmune
      globulin had no detectable prophylactic effect on infections (50 of 108 patients,
      with 25 cases of pneumonia). The rate of systemic infections and shock was
      similar in the three study groups, and hospital mortality did not differ
      significantly among them. CONCLUSIONS: Intravenous immune globulin given
      prophylactically to selected high-risk patients in the surgical ICU can reduce
      the incidence of infection. Core-lipopolysaccharide hyperimmune globulin is not
      effective in preventing gram-negative infections and their systemic
      complications.

PMID- 1614467
TI  - Case records of the Massachusetts General Hospital. Case 30-1992. Progressive
      neurodegenerative disease in a young boy.

PMID- 1614468
TI  - Immune globulin to prevent nosocomial infections.

PMID- 1614469
TI  - Perspectives in pancreatic and islet transplantation.

PMID- 1614470
TI  - Clinical trials and meta-analysis. What do they do for us?

PMID- 1614472
TI  - Dyslexia.

PMID- 1614471
TI  - Underinsurance in America.

PMID- 1614474
TI  - Dyslexia.

PMID- 1614473
TI  - Dyslexia.

PMID- 1614475
TI  - Dyslexia.

PMID- 1614476
TI  - Corticosteroids in the treatment of optic neuritis.

PMID- 1614477
TI  - Corticosteroids in the treatment of optic neuritis.

PMID- 1614478
TI  - Corticosteroids in the treatment of optic neuritis.

PMID- 1614479
TI  - Glucocorticoid therapy and pituitary-adrenal responses to corticotropin-releasing
      hormone.

PMID- 1614480
TI  - Glucocorticoid therapy and pituitary-adrenal responses to corticotropin-releasing
      hormone.

PMID- 1614481
TI  - Glucocorticoid therapy and pituitary-adrenal responses to corticotropin-releasing
      hormone.

PMID- 1614482
TI  - Calcitriol or calcium for postmenopausal osteoporosis.

PMID- 1614483
TI  - Calcitriol or calcium for postmenopausal osteoporosis.

PMID- 1614484
TI  - Prednisolone in severe alcoholic hepatitis.

PMID- 1614485
TI  - Aspirin to prevent stroke in nonrheumatic atrial fibrillation. The Stroke
      Prevention in Atrial Fibrillation Investigators.

PMID- 1614486
TI  - Gestational versus genetic mothers.

PMID- 1614487
TI  - Gestational versus genetic mothers.

PMID- 1614488
TI  - Gestational versus genetic mothers.

PMID- 1614489
TI  - Gestational versus genetic mothers.

PMID- 1614490
TI  - Neutrons give improved results in selected tumour types.

PMID- 1614491
TI  - Which headache? Migraine: a start in a series on some of the most common headache
      conditions.

PMID- 1614492
TI  - Drug interactions involving antibiotics.

PMID- 1614493
TI  - Primary care obstetrics in South Africa.

PMID- 1614494
TI  - Setting priorities in nursing research.

PMID- 1614495
TI  - Can simulation replace practica?

PMID- 1614496
TI  - Systemic and other factors that affect wound healing.

PMID- 1614497
TI  - Leeds disunited.

PMID- 1614498
TI  - US company's gene therapy trial is first to bypass RAC for approval.

PMID- 1614499
TI  - House vote to kill SSC reflects squeeze that budget deficit puts on all research.

PMID- 1614500
TI  - Japan 'finds' money for research.

PMID- 1614501
TI  - Clinical research damaged by UK health service reforms.

PMID- 1614502
TI  - FBI attaches strings to its DNA database.

PMID- 1614503
TI  - Lab death blamed on gas build-up.

PMID- 1614504
TI  - Large, oil-soaked endowment helps state universities weather current hard times.

PMID- 1614505
TI  - Biotechnology leads the way as state moves beyond ground-based economy.

PMID- 1614506
TI  - SW medical center, famous and favoured, is thriving.

PMID- 1614507
TI  - Houston breeds biotechnology hot shots.

PMID- 1614508
TI  - New biotechnology institute at Rice promotes interdisciplinary studies.

PMID- 1614509
TI  - San Antonio fills research park by making offers that scientists cannot refuse.

PMID- 1614510
TI  - Texas A&M struggles to gain the respect that its researchers have already won.

PMID- 1614511
TI  - Space science in Texas means basic research as well as support for manned
      flights.

PMID- 1614512
TI  - San Antonio aims for spot on high-technology map.

PMID- 1614513
TI  - Malaria. Asexual deviants take over.

PMID- 1614514
TI  - Rhizobium--plant signal exchange.
AB  - Initial stages in the Rhizobium-legume symbiosis can be thought of as a
      reciprocal molecular conversation: transmission of a gene inducer from legume
      host to bacterium, with ensuing bacterial synthesis of a morphogen that is
      transmitted to the plant, switching the developmental fate of the legume root.
      These signal molecules have a key role in determining bacterium-host specificity
      and the purified Nod factor compounds provide useful new tools to probe plant
      cell function.

PMID- 1614515
TI  - Rapid switching to multiple antigenic and adhesive phenotypes in malaria.
AB  - Adhesion of parasitized erythrocytes to post-capillary venular endothelium or
      uninfected red cells is strongly implicated in the pathogenesis of severe
      Plasmodium falciparum malaria. Neoantigens at the infected red-cell surface
      adhere to a variety of host receptors, demonstrate serological diversity in field
      isolates and may also be a target of the host-protective immune response. Here we
      use sequential cloning of P. falciparum by micromanipulation to investigate the
      ability of a parasite to switch antigenic and cytoadherence phenotypes. Our data
      show that antigens at the parasitized cell surface undergo clonal variation in
      vitro in the absence of immune pressure at the rate of 2% per generation with
      concomitant modulations of the adhesive phenotype. A clone has the potential to
      switch at high frequency to a variety of antigenic and adhesive phenotypes,
      including a new type of cytoadherence behaviour, 'auto-agglutination' of infected
      erythrocytes. This rapid appearance of antigenic and functional heterogeneity has
      important implications for pathogenesis and acquired immunity.

PMID- 1614516
TI  - Alterations in a yeast protein resembling HIV Tat-binding protein relieve
      requirement for an acidic activation domain in GAL4.
AB  - The acidic transcriptional activation motif functions in all eukaryotes, which
      suggests that it makes contact with some universal component of the
      transcriptional apparatus. Transcriptional activation by the yeast regulatory
      protein GAL4 requires an acidic region at its carboxyl terminus. Here we
      implement a selection scheme to determine whether GAL4 can still function when
      this C-terminal domain has been deleted. It can, when accompanied by a mutation
      in the SUG1 gene which is an essential gene in yeast. Analysis of mutant SUG1 in
      combination with various alleles of GAL4 indicates that SUG1 acts through a
      transcriptional pathway that depends on GAL4, but requires a region of GAL4 other
      than the C-terminal acidic activation domain. The predicted amino-acid sequence
      of SUG1 closely resembles that of two human proteins, TBP1 and MSS1, which
      modulate expression mediated by the human immunodeficiency virus tat gene.

PMID- 1614517
TI  - Processing pathways for presentation of cytosolic antigen to MHC class II
      restricted T cells.
AB  - Antigens presented to CD4+ T cells derive primarily from exogenous proteins that
      are processed into peptides capable of binding to class II major
      histocompatibility complex (MHC) molecules in an endocytic compartment. In
      contrast, antigens presented to CD8+ T cells derive mostly from proteins
      processed in the cytosol, and peptide loading onto class I MHC molecules in an
      early exocytic compartment is dependent on a transporter for antigen presentation
      encoded in the class II MHC region. Endogenous cytosolic antigen can also be
      presented by class II molecules. Here we show that, unlike class I-restricted
      recognition of antigen, HLA-DR1-restricted recognition of cytosolic antigen
      occurs in mutant cells without a transporter for antigen presentation. In
      contrast, DR1-restricted recognition of a short cytosolic peptide is dependent on
      such a transporter. Thus helper T-cell epitopes can be generated from cytosolic
      antigens by several mechanisms, one of which is distinct from the classical class
      I pathway.

PMID- 1614518
TI  - Too many trinucleotide repeats.

PMID- 1614519
TI  - Human insulin.

PMID- 1614520
TI  - Why cheat?

PMID- 1614521
TI  - Media make AIDS wishes come true.

PMID- 1614522
TI  - Cancer. p53, guardian of the genome.

PMID- 1614523
TI  - Let the French sue.

PMID- 1614524
TI  - Immunology. A sense of something missing.

PMID- 1614525
TI  - Blood substitutes and infection.

PMID- 1614526
TI  - Robert Gallo forced off NIH stage after HHS vetoes public briefing.

PMID- 1614527
TI  - Quantification of the disorder in network-modified silicate glasses.
AB  - Local order in silicate glasses has been observed by many experimental techniques
      to be similar to that in crystalline materials. Details of the intermediate-range
      order are more elusive, but essential for understanding the lack of long-range
      symmetry in glasses and the effect of composition on glass structure. Two
      dimensional 17O dynamic-angle-spinning nuclear magnetic resonance experiments
      reveal intermediate-range order in the distribution of inter-tetrahedral (Si-O
      Si) bond angles and a high degree of order in the disposition of oxygen atoms
      around the network-modifying cations.

PMID- 1614528
TI  - Group asks NIH to stop growth hormone trials.

PMID- 1614529
TI  - NIH makes room for the unconventional after Congress mandates new programme.

PMID- 1614530
TI  - Panel trims NSF budget.

PMID- 1614531
TI  - French AIDS scandal goes to court.

PMID- 1614532
TI  - Japan moves gingerly towards guidelines on gene therapy.

PMID- 1614533
TI  - MHC class I alloantigen specificity of Ly-49+ IL-2-activated natural killer
      cells.
AB  - The molecular basis of target cell recognition by CD3- natural killer (NK) cells
      is poorly understood, despite the ability of NK cells to lyse specific tumour
      cells. In general, target cell major histocompatibility complex (MHC) class I
      antigen expression correlates with resistance to NK cell-mediated lysis, possibly
      because NK cell-surface molecules engage MHC class I antigens and consequently
      deliver inhibitory signals. Natural killer cell allospecificity involves the MHC
      class I peptide-binding cleft, and further understanding of this allospecificity
      should provide insight into the molecular mechanisms of NK cell recognition. The
      Ly-49 cell surface molecular mechanisms of NK cell recognition. The Ly-49 cell
      surface molecule is expressed by 20% of CD3- NK cells in C57BL/6 mice (H-2b).
      Here we show that C57BL/6-derived, interleukin-2-activated NK cells expressing Ly
      49 do not lyse target cells displaying H-2d or H-2k despite efficient spontaneous
      lysis by Ly-49- effector cells. This preferential resistance correlates with
      expression of target cell MHC class I antigens. Transfection and expression of H
      2Dd, but not H-2Kd or H-2Ld, renders a susceptible target (H-2b) resistant to Ly
      49+ effector cells. The transfected resistance is abrogated by monoclonal
      antibodies directed against Ly-49 or the alpha 1/alpha 2 domains of H-2Dd,
      suggesting that Ly-49 specifically interacts with the peptide-binding domains of
      the MHC class I alloantigen, H-2Dd. Inasmuch as Ly-49+ effector cells cannot be
      stimulated to lyse H-2Dd targets, our results indicate that NK cells may possess
      inhibitory receptors that specifically recognize MHC class I antigens.

PMID- 1614534
TI  - Ban on primate trade seen as threat to animals.

PMID- 1614535
TI  - Rapamycin selectively inhibits interleukin-2 activation of p70 S6 kinase.
AB  - The macrolide rapamycin induces cell cycle G1 arrest in yeast and in mammalian
      cells, which suggests that an evolutionarily conserved, rapamycin-sensitive
      pathway may regulate entry into S phase. In mammals, rapamycin inhibits
      interleukin-2 receptor-induced S phase entry and subsequent T-cell proliferation,
      resulting in immunosuppression. Here we show that interleukin-2 selectively
      stimulates the phosphorylation and activation of p70 S6 kinase but not the erk
      encoded MAP kinases and rsk-encoded S6 kinases. Rapamycin completely and rapidly
      inhibits interleukin-2-induced phosphorylation and activation of p70 S6 kinase at
      concentrations comparable to those blocking S phase entry of T cells (0.05-0.2
      nM). The structurally related macrolide FK506 competitively antagonizes the
      actions of rapamycin, indicating that these effects are mediated by FKBP, which
      binds the transition-state mimic structure common to both rapamycin and FK506
      (refs 4, 6, 9-11). The selective blockade of the p70 S6 kinase activation cascade
      by the rapamycin-FKBP complex implicates this signalling pathway in the
      regulation of T cell entry into S phase.

PMID- 1614536
TI  - Antibody and HIV-1 gp120 recognition of CD4 undermines the concept of mimicry
      between antibodies and receptors.
AB  - It has been proposed that antibodies can mimic the binding of a receptor to its
      ligand and that anti-idiotype antibodies raised against such antibodies can be
      used to identify the receptor. A large number of antibodies have been raised
      against CD4, the receptor on T cells for the envelope glycoprotein gp120 of the
      human immunodeficiency virus, and the site at which gp120 binds to CD4 has been
      delineated. It has therefore become possible to contrast the fine specificities
      of a natural ligand (gp120) and antibodies that interact with the receptor at the
      same site. Here we report that out of a panel of 225 anti-CD4 antibodies, only
      one showed fine binding specificity that was broadly like that of gp120, but the
      evidence was against this being an exact mimic. Thus the data indicate that the
      production of antibody mimics will occur very rarely or not at all and that the
      anti-idiotype approach is unlikely to be useful. This contention is supported by
      a review of the results of attempts to use this approach. Taking strict criteria
      for success, there is no example for which the anti-idiotype approach has led to
      the discovery of a previously undescribed receptor or other protein of interest.

PMID- 1614537
TI  - Amplification of a gene encoding a p53-associated protein in human sarcomas.
AB  - Despite extensive data linking mutations in the p53 gene to human tumorigenesis,
      little is known about the cellular regulators and mediators of p53 function. MDM2
      is a strong candidate for one such cellular protein; the MDM2 gene was originally
      identified by virtue of its amplification in a spontaneously transformed
      derivative of mouse BALB/c cells and the MDM2 protein subsequently shown to bind
      to p53 in rat cells transfected with p53 genes. To determine whether MDM2 plays a
      role in human cancer, we have cloned the human MDM2 gene. Here we show that
      recombinant-derived human MDM2 protein binds human p53 in vitro, and we use MDM2
      clones to localize the human MDM2 gene to chromosome 12q13-14. Because this
      chromosomal position appears to be altered in many sarcomas, we looked for
      changes in human MDM2 in such cancers. The gene was amplified in over a third of
      47 sarcomas, including common bone and soft tissue forms. These results are
      consistent with the hypothesis that MDM2 binds to p53, and that amplification of
      MDM2 in sarcomas leads to escape from p53-regulated growth control. This
      mechanism of tumorigenesis parallels that for virally-induced tumours, in which
      viral oncogene products bind to and functionally inactivate p53.

PMID- 1614538
TI  - Wild-type p53 activates transcription in vitro.
AB  - The p53 protein is an important determinant in human cancer and regulates the
      growth of cells in culture. It is known to be a sequence-specific DNA-binding
      protein with a powerful activation domain, but it has not been established
      whether it regulates transcription directly. Here we show that intact purified
      wild-type human and murine p53 proteins strongly activate transcription in vitro.
      This activation depends on the ability of p53 to bind to a template bearing a p53
      binding sequence. By contrast, tumour-derived mutant p53 proteins cannot activate
      transcription from the template at all, and when complexed to wild-type p53,
      these mutants block transcriptional activation by the wild-type protein.
      Moreover, the simian virus 40 large T antigen inhibits wild-type p53 from
      activating transcription. Our results support a model in which p53 directly
      activates transcription but this activity can be inhibited by mutant p53 and SV40
      large T antigen through interaction with wild-type p53.

PMID- 1614539
TI  - A new approach to protein fold recognition.
AB  - The prediction of protein tertiary structure from sequence using molecular energy
      calculations has not yet been successful; an alternative strategy of recognizing
      known motifs or folds in sequences looks more promising. We present here a new
      approach to fold recognition, whereby sequences are fitted directly onto the
      backbone coordinates of known protein structures. Our method for protein fold
      recognition involves automatic modelling of protein structures using a given
      sequence, and is based on the frameworks of known protein folds. The plausibility
      of each model, and hence the degree of compatibility between the sequence and the
      proposed structure, is evaluated by means of a set of empirical potentials
      derived from proteins of known structure. The novel aspect of our approach is
      that the matching of sequences to backbone coordinates is performed in full three
      dimensional space, incorporating specific pair interactions explicitly.

PMID- 1614540
TI  - Head of drug company takes Serbian post.

PMID- 1614541
TI  - Long-range correlations within DNA.

PMID- 1614542
TI  - Molecular biology. Chlamydomonas surrenders.

PMID- 1614543
TI  - Dopamine receptors. Which D4 do you have?

PMID- 1614544
TI  - Vertebrate development. Induction and all that.

PMID- 1614545
TI  - Proto-vav and gene expression.

PMID- 1614546
TI  - Queen activation of lazy workers in colonies of the eusocial naked mole-rat.
AB  - Evolutionary conflicts of interest are expected to arise in genetically diverse
      social groups. In eusocial insect societies, a potential conflict exists between
      the queen and her workers over how active the workers should be, and evidence
      exists that queen aggression increases activity levels of her lazier workers.
      Here I provide evidence that queen aggression (shoving) in laboratory colonies of
      the eusocial mammal, the naked mole-rat (Heterocephalus glaber), is a
      convergently evolved manifestation of queen-worker conflict over worker activity.
      Queen-initiated shoves activate inherently lazy workers, which tend to be larger
      and/or less related to the queen than are infrequently shoved, industrious
      workers. In addition, queen removal selectively depresses the activity of workers
      that are larger and less related to her. Finally, queen shoving and worker
      inactivity are pronounced when colonies are satiated but not when colonies are
      hungry, indicating that the underlying 'work-conflict' is highly context
      specific.

PMID- 1614547
TI  - Objective analysis of the topological organization of the primate cortical visual
      system.
AB  - The primate cortical visual system is composed of many structurally and
      functionally distinct areas, each receiving and sending about 10 projections from
      and to other cortical areas. The visual cortex is thus served by many cortico
      cortical connections to form a network of considerable complexity. Thus the gross
      organization of this cortical processing system presents a formidable topological
      problem: although the spatial position of the areas in the brain is reasonably
      well established, the gross 'processing architecture' defined by the connections,
      is less well understood. Here I report an optimization approach that gives both
      qualitative and quantitative insight into the connectional topology of the
      primate cortical visual system. This approach supports suggestions that the
      system is divided into a dorsal 'stream' and a ventral 'stream' with limited
      cross-talk, that these two streams reconverge in the region of the principal
      sulcus (area 46) and in the superior temporal polysensory areas, that the system
      is hierarchically organized, and that the majority of the connections are from
      'nearest-neighbour' and 'next-door-but-one' areas.

PMID- 1614548
TI  - Shigella flexneri induces apoptosis in infected macrophages.
AB  - The Gram-negative bacterial pathogen Shigella flexneri causes dysentery by
      invading the human colonic mucosa. Bacteria are phagocytosed by enterocytes,
      escape from the phagosome into the cytoplasm and spread to adjacent cells. After
      crossing the epithelium, Shigella reaches the lamina propria of intestinal villi,
      the first line of defence. This tissue is densely populated with phagocytes that
      are killed in great numbers, resulting in abscesses. The genes required for cell
      invasion and macrophage killing are located on a 220-kilobase plasmid. We report
      here on the mechanism of cytotoxicity used by S. flexneri to kill macrophages.
      Each of four different strains was tested for its capacity to induce cell death.
      An invasive strain induced programmed cell death (apoptosis), whereas its non
      invasive, plasmidcured isogenic strain was not toxic; neither was a mutant in ipa
      B (ref. 10) (invasion protein antigen), a gene necessary for entry. A non
      invasive strain expressing the haemolysin operon of Escherichia coli induced
      accidental cell death (necrosis), demonstrating that other bacterial cytotoxic
      mechanisms do not lead to apoptosis. This is the first evidence that an invasive
      bacterial pathogen can induce suicide in its host cells.

PMID- 1614550
TI  - US muddles policy on fetal tissue.

PMID- 1614549
TI  - Hsp90 chaperones protein folding in vitro.
AB  - The heat-shock protein Hsp90 is the most abundant constitutively expressed stress
      protein in the cytosol of eukaryotic cells, where it participates in the
      maturation of other proteins, modulation of protein activity in the case of
      hormone-free steroid receptors, and intracellular transport of some newly
      synthesized kinases. A feature of all these processes could be their dependence
      on the formation of protein structure. If Hsp90 is a molecular chaperone involved
      in maintaining a certain subset of cellular proteins in an inactive form, it
      should also be able to recognize and bind non-native proteins, thereby
      influencing their folding to the native state. Here we investigate whether Hsp90
      can influence protein folding in vitro and show that Hsp90 suppresses the
      formation of protein aggregates by binding to the target proteins at a
      stoichiometry of one Hsp90 dimer to one or two substrate molecule(s).
      Furthermore, the yield of correctly folded and functional protein is increased
      significantly. The action of Hsp90 does not depend on the presence of nucleoside
      triphosphates, so it may be that Hsp90 uses a novel molecular mechanism to assist
      protein folding in vivo.

PMID- 1614551
TI  - Controversial NIH genome researcher leaves for new $70-million institute.

PMID- 1614553
TI  - Genentech's stance on biodiversity riles staff.

PMID- 1614552
TI  - Search for contaminant in EMS outbreak goes slowly.

PMID- 1614554
TI  - Delays, confusion over rules hinder EC research projects.

PMID- 1614555
TI  - Solving the U.S. health care dilemma.

PMID- 1614556
TI  - Solving the U.S. health care dilemma.

PMID- 1614557
TI  - Chronic fatigue syndrome. A practical approach.

PMID- 1614559
TI  - Providing services in nursing homes. A physician's legal obligations.

PMID- 1614558
TI  - Status epilepticus. Latest approaches in management.
AB  - Status epilepticus--convulsive or non-convulsive--is a major neurological
      emergency. Vital neurons are lost with every moment of delay. Every physician
      should approach status epilepticus in a manner analogous to cardiopulmonary
      arrest: a structured series of interventions following a defined protocol to
      produce better results than a haphazard approach. In both situations, speedy
      intervention is essential to prevent irreversible damage.

PMID- 1614560
TI  - Geriatric peer-counseling. Pilot project provides support for the homebound
      elderly.

PMID- 1614561
TI  - Elegy for a way of life. A physician laments the changes in American medicine;
      with comment from deans at the state's four medical schools.

PMID- 1614562
TI  - Alexander Fleming and penicillin. The chance of a lifetime?

PMID- 1614563
TI  - [An overlooked lymphoma of the stomach can sometimes have serious consequences].

PMID- 1614564
TI  - [Prevention and treatment of osteoporosis].
AB  - Despite the fact that osteoporosis is a common disease and an important cause of
      morbidity and mortality, that screening tests are available which are safe and
      acceptable to patients, and that effective therapy is possible, osteoporosis
      remains a controversial subject. The Dutch Health Advisory Board
      (Gezondheidsraad) recently submitted to the Ministry of Health a balanced and
      comprehensive report to remedy this controversial situation. As often in a
      consensus report made by a variety of experts, completeness is assured but the
      necessary relevance of the statements and the feasibility of the therapeutic
      recommendations are not always clear. Based on personal experience, clinical
      practice and research in osteoporosis, the author formulates a number of messages
      which complement the report. The following messages are elaborated: osteoporosis
      is a silent thief; backache during the menopause is not always osteoporosis;
      detection of the patient at risk for osteoporotic fractures is possible; primary
      osteoarthrosis protects against osteoporosis; bone densitometry has given
      osteoporosis a scientific cachet; bones are not stones, effective prevention and
      treatment are possible, there are alternatives to calcium and hormone replacement
      therapies. There is still much to learn about osteoporosis and its treatment.
      Nevertheless, there is a great deal that is known and we need to give the best
      advice we can in the light of this knowledge.

PMID- 1614565
TI  - [Bone densitometry and osteoporosis].

PMID- 1614566
TI  - [Postmenopausal estrogen substitution and the risk of atherosclerotic heart and
      vascular diseases].

PMID- 1614567
TI  - [Non-Hodgkin lymphoma of the stomach as an entity. Concept formation and current
      developments].

PMID- 1614568
TI  - [Revision consensus osteoporosis].
AB  - Several years ago a consensus guideline conference was organised both in the
      United States (1984) and in the Netherlands (1985) on case finding, prevention
      and treatment of osteoporosis. The most important conclusion of both conferences
      was that oestrogen substitution can significantly reduce the incidence of
      fractures in postmenopausal women. This statement has not changed in the revised
      guidelines on osteoporosis of 1991. As far as the effect of hormonal substitution
      of oestrogens with or without progestagens in relation to cardiovascular disease
      and breast and endometrial carcinoma is concerned, insights have hardly changed
      in the last 5 years. The value of other drugs in the treatment of osteoporosis,
      however, has become better known. Both diphosphonates and anabolic steroids have
      recently made a comeback.

PMID- 1614569
TI  - [Good 10-year results following cemented total knee arthroplasty].
AB  - The results of primary total knee arthroplasty in patients with a follow-up of 4
      10 years are presented. The study population consisted of osteoarthritis as well
      as rheumatoid arthritis patients. Both groups were analyzed separately for
      postoperative pain reduction at rest and during activity, as well as for
      improvement of some daily activities (walking distance, stair climbing). Pain
      reduction at rest and during activity was maintained during the follow-up period
      of 4-10 years. The walking distance and the ability to climb stairs improved
      during the first few postoperative years, but declined in the later postoperative
      years. Survival curve analysis of the total knee arthroplasty showed good results
      for osteoarthritis as well as rheumatoid arthritis (estimated probability of
      survival of the prosthesis at 10 years' follow-up was 94%).

PMID- 1614570
TI  - [Rhabdomyolysis, disseminated intravascular coagulation and multiple organ
      failure in a patient with cocaine and heroine poisoning].
AB  - A 19-year-old female patient with cocaine and heroin intoxication is described in
      whom several life threatening complications such as hypovolemic shock,
      cardiopulmonary insufficiency, rhabdomyolysis, diffuse intravascular coagulation
      and multiple organ failure occurred. The patient survived the intoxication after
      quick intensive treatment.

PMID- 1614571
TI  - [The patient's question: important determinant for quality of medical actions].

PMID- 1614572
TI  - [Dry-bed training and nocturnal enuresis].

PMID- 1614573
TI  - [Diagnostic management in suspected pulmonary embolism: results of a survey among
      Dutch internists and pulmonologists].

PMID- 1614574
TI  - [Insulinoma and octreotide].

PMID- 1614575
TI  - [Neuropathic pain; causes and treatment].

PMID- 1614576
TI  - AIDS & the physician.

PMID- 1614577
TI  - Comments on functional endoscopic sinus surgery.
AB  - A brief comment on functional endoscopic sinus surgery with the result of 208
      cases were presented. It was stressed that all sinus patients must have very
      intensive conservative management, much longer than previously thought, before
      functional endoscopic sinus surgery should be employed. Functional endoscopic
      sinus surgery is a vastly superior method of surgically treating the paranasal
      sinuses. It is based on the principles of reestablishing normal physiology of the
      sinus mucosa. It affords an excellent basis for removal of disease, establishing
      natural drainage, aeration and restoration of normal physiology.

PMID- 1614578
TI  - The practice of medicine in Nebraska prior to statehood.

PMID- 1614579
TI  - "Autonomy and the art of medicine".

PMID- 1614580
TI  - Exposures during pregnancy and lactation.

PMID- 1614581
TI  - The role of stereotactic biopsy in the management of HIV-related focal brain
      lesions.
AB  - The criteria for brain biopsy in patients with acquired immunodeficiency syndrome
      (AIDS) remain unclear and without universal acceptance. In order to shed more
      light on this issue, the authors reviewed the records of 25 AIDS patients with
      focal cerebral lesions who consecutively underwent stereotactic biopsy between
      November 1988 and October 1990. The most frequently occurring diagnoses were
      lymphoma (36%), progressive multifocal leukoencephalopathy (24%), and
      toxoplasmosis (8%). Patients whose central nervous system disease resulted in
      their initial presentation (approximately 40%) survived a median of 37 weeks, as
      opposed to 6 weeks for those who had previous AIDS-related infections. The
      proportion of biopsies of contrast-enhancing lesions that were diagnostic and
      thereby contributed to the patients' therapeutic management was 87.5%. On the
      other hand, only 67% of the biopsies of nonenhancing lesions were diagnostic, and
      none of these lesions were treatable. All of the lymphoma patients had had AIDS
      for some time and, despite a reasonable preoperative Karnofsky score and
      postoperative radiation therapy, their median survival was only 6 weeks; however,
      biopsy was critical to their therapeutic management. Early brain biopsy, rather
      than empiric antitoxoplasmosis therapy, appears indicated for aggressive therapy
      of contrast-enhancing lesions in patients who have had previous manifestations of
      AIDS. The role for biopsy of nonenhancing lesions is less clear, but it may
      provide prognostic information.

PMID- 1614582
TI  - Postoperative low-dose heparin decreases thromboembolic complications in
      neurosurgical patients.
AB  - Thromboembolic complications are a major cause of postoperative morbidity and
      mortality in the neurosurgical patient. Prophylaxis with lower extremity
      pneumatic compression boots (PCBs) reduces the incidence of lower extremity deep
      vein thrombosis (DVT) but has not been shown to affect the incidence of pulmonary
      embolism (PE). Prophylaxis with low-dose heparin has consistently reduced the
      incidence of both DVT and PE in studies on general surgical patients but has not
      been adopted for use in neurosurgery primarily for fear of causing catastrophic
      hemorrhage. We report on a series of 138 consecutive adult patients who underwent
      major neurosurgical procedures on a general neurosurgical service at our
      institution. Patients were treated with intraoperative PCBs and, starting on the
      morning of the first postoperative day, with a regimen of 5000 U of heparin
      administered subcutaneously twice daily. This treatment was continued until
      patients were fully ambulatory. PCBs were discontinued 24 hours after the first
      administration of heparin. None of the heparin-treated patients suffered
      postoperative hemorrhage. We compared this series with a control group of 473
      adult patients who had previously undergone major neurosurgical procedures on the
      same neurosurgical service. These patients had been treated with intraoperative
      and postoperative PCBs alone. The control group had a 3.2% incidence of
      thromboembolic complications (15 of 473; eight DVT, seven PE). Prophylaxis with
      PCBs plus heparin significantly (P = 0.020) reduced the incidence of
      thromboembolic complications: no PCBs/heparin-treated patient exhibited clinical
      evidence of PE or DVT (0%, 0/138). We conclude that a combination of
      intraoperative PCBs and postoperative low-dose heparin is a safe and effective
      method by which to reduce thromboembolic complications in the neurosurgical
      patient.

PMID- 1614583
TI  - Essential hypertension associated with neurovascular compression: angiographic
      findings.
AB  - According to the hypothesis of Jannetta, an arterial compression of the left root
      entry zone (REZ) of cranial nerves IX and X by looping arteries could play an
      important role in the pathogenesis of essential hypertension. In an initial
      anatomical study, the positions of the left vagus and glossopharyngeal nerves in
      the skull were radiographically determined in 10 cadavers. By using a pattern of
      REZ topography developed from this information, the angiographic findings in 107
      hypertensive and 100 normotensive patients were then compared retrospectively. In
      80% of the angiograms of the hypertensive patients that could be evaluated, an
      artery crossed the left REZ of cranial nerves IX and X. Most frequently, this was
      the posterior inferior cerebellar artery (35.3% of cases), followed by the
      vertebral artery (29.4% of cases) and the anterior inferior artery (19.1% of
      cases). In 9 cases (13%), both the posterior inferior cerebellar artery and the
      vertebral artery appeared in the REZ. Frequently, a larger diameter of the left
      vertebral artery was found. The angiograms of normotensive patients that could be
      evaluated revealed an artery in the REZ in only 34.5% of cases. Our results
      support the hypothesis that essential hypertension may be associated with
      neurovascular compression of the left REZ of cranial nerves IX and X.

PMID- 1614584
TI  - Computerized electroencephalographic monitoring and selective shunting: influence
      on intraoperative administration of phenylephrine and myocardial infarction after
      general anesthesia for carotid endarterectomy.
AB  - During carotid endarterectomy (CEA), phenylephrine infusions are commonly used to
      induce hypertension during carotid clamping in an attempt to increase collateral
      cerebral blood flow and prevent cerebral ischemia. Although this practice appears
      to increase the incidence of intraoperative myocardial ischemia during CEA when
      general anesthesia is employed, whether the limited use of phenylephrine
      infusions in specific instances of cerebral ischemia, as shown on an electro
      encephalogram, results in low perioperative rates of both myocardial infarction
      (MI) and cerebral infarction remains unclear. We studied 171 CEAs done under
      general anesthesia performed with selective shunting based on the identification
      of cerebral ischemia by a two-channel computerized electroencephalographic
      monitor. The use of a phenylephrine infusion was restricted to the following
      instances of cerebral ischemia: 1) ischemia associated with hypotension that did
      not resolve within 2 minutes of decreases in anesthetic administration and
      treatment with fluid and/or colloid; 2) ischemia poorly or slowly responsive to
      shunt placement, accompanied by either hypo- or normotension; and 3) ischemia
      poorly or slowly responsive to removal of the carotid clamp, accompanied by
      either hypo- or normotension. Two non-Q wave MIs (1.2%) occurred, both nonfatal.
      There were two cerebral infarctions (1.2%) and three deaths not related to MI
      (1.8%). Based on these findings, in order to decrease the incidence of both MI
      and cerebral infarction after general anesthesia for CEA, we recommend the
      restrictive use of phenylephrine-induced hypertension for specific instances of
      slowly or poorly reversible cerebral ischemia, as shown on the
      electroencephalogram.

PMID- 1614585
TI  - Preoperative risks predict neurological outcome of carotid endarterectomy related
      stroke.
AB  - The aim of this study was to determine if preoperative risk factors are
      predictors of poor stroke outcome after carotid endarterectomy. In addition, the
      effect of other stroke risk factors on stroke severity was determined. A
      retrospective review of carotid endarterectomy results spanning 10 years,
      encompassing 561 patients, and reporting the combined results of all surgeons at
      our institution was performed. Patients were assigned to one of four groups.
      There were 227 patients with no preoperative risks (Group 1), 61 with
      angiographic risks (Group 2), 196 with medical risks with or without angiographic
      risks (Group 3), and 77 with neurological risks with or without
      medical/angiographic risks (Group 4). Other risks associated with stroke
      occurrence were recorded including: intraoperative risks (cross-clamp time, use
      of shunt, use of glucose solutions), surgical complications (carotid
      occlusion/thrombus or ligation), and medical complications (hypoxia, myocardial
      infarct). Stroke incidence was 5% with 2% (11 patients) and 3.4% (19 patients)
      having good and poor outcomes, respectively. Stroke incidence was highest in
      Groups 2 and 4 (10 and 14%, respectively), and Group 4 had the highest incidence
      of poor-outcome stroke (12%). Cross-clamp time, intraoperative shunt placement,
      and intraoperative glucose administration were similar among preoperative risk
      groups and were not primary determinants of stroke severity. The most common
      medical complication was myocardial infarction, which had the highest incidence
      in Groups 3 and 4 (6.1 and 5%, respectively). The highest incidence of surgical
      complications occurred in Groups 2 and 4, carotid thrombosis being the most
      common event (16 patients). Surgical complications were more commonly associated
      with stroke than were medical complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614586
TI  - Differentiation of pituitary adenoma and meningioma: visualization with positron
      emission tomography and [11C]-L-deprenyl.
AB  - Seven patients with clinically nonsecreting pituitary adenoma and 5 patients with
      meningioma were examined with positron emission tomography using [11C]-LL
      deprenyl and [11C]-LL-methionine. The dynamics of the uptake of [11C]-L-deprenyl
      in the pituitary adenomas demonstrated a rapid and high uptake immediately after
      the injection, and, later, an almost constant level was observed that was equal
      to or higher than that observed in normal brain tissue. In the meningiomas,
      however, the initially high uptake was followed by a marked decrease with time,
      reaching a level that was approximately half that observed in brain tissue. The
      study demonstrated high binding of [11C]-L-deprenyl to monoamine oxidase B in
      pituitary adenomas, whereas the binding in meningiomas was very low. This fact
      can be used in the differential diagnosis of pituitary adenoma and parasellar
      meningioma. Operative samples from 10 patients with meningioma and from 5
      patients with pituitary adenoma were analyzed biochemically for activity of
      monoamine oxidase B, using [14C]-phenyl-ethylamine as substrate. The nonsecreting
      pituitary adenomas demonstrated high enzyme activity, the secreting adenomas
      about one-tenth of that of the nonsecreting, and the meningiomas one-thirtieth of
      that of nonsecreting adenomas.

PMID- 1614587
TI  - Outcome analysis in 654 surgically treated lumbar disc herniations.
AB  - This article reports the outcomes of 654 consecutive patients treated during a
      4.5-year period. Patients had a microdiscectomy, a laminectomy plus
      microdiscectomy, or a decompressive laminectomy with a microdiscectomy. The
      causes of ruptured discs were lifting (31.4%), falls (10.2%), and sports (10.0%).
      Almost all patients had complained of leg pain (99%), and 79% had radicular pain
      in a dermatomal distribution. Thirty-three percent of the patients had been
      involved in industrial accidents, and 6% had legal claims pending during the
      surgical period. Almost 11% of the patients had complications, and there was one
      death caused by abdominal arterial bleeding. Patients were also rated according
      to the Prolo Functional-Economic Outcome Rating Scale to improve the ability to
      compare series in the future. Almost 80% of the patients had good outcomes as
      defined by scores on this scale of 8 (16.2%), 9 (33.2%), and 10 (26.9%). Several
      conclusions can be drawn from the results of this series: 1) most patients had
      good outcomes; 2) patients with nonindustrial injuries had better outcomes than
      did patients with industrial injuries; 3) professionals with legal concerns and
      laborers with industrial insurance had good outcomes; and 4) the Functional
      Economic Outcome Rating Scale appears to be a useful tool for comparing different
      procedures more objectively and for comparing the outcomes across series.

PMID- 1614588
TI  - The subarachnoid spaces in craniosynostosis.
AB  - A review of 85 patients with various forms of craniosynostosis showed predictable
      patterns of dilatation of the subarachnoid spaces in regions of compensatory
      skull growth. The characteristic pattern in sagittal synostosis (43 patients)
      included dilatation of the frontal and occipital subarachnoid spaces associated
      with the elongation of the anteroposterior dimension of the skull and widening of
      the interhemispheric fissure. In 11 patients with unilateral coronal synostosis,
      dilatations of the subarachnoid spaces over the contralateral frontal lobe, the
      sylvian regions, and the ipsilateral temporal lobe tip were consistent with the
      skull changes of contralateral frontal bossing, increased bitemporal dimension,
      and elevation of the sphenoid wing, respectively. Four patients with bilateral
      coronal synostosis also had enlarged subarachnoid spaces high over the
      convexities of the brain consistent with the towering configuration of the skull.
      Four patients with true lambdoid synostosis had dilatation of the subarachnoid
      space only over the ipsilateral frontal lobe associated with compensatory bossing
      of the frontal bone. Ten of 14 patients with lambdoid deformities had bilateral
      enlargement of the subarachnoid spaces suggesting brain atrophy and an underlying
      motor delay accounting for the position-induced skull changes. The findings
      suggest that focal hydrodynamic mechanisms are involved in the compensatory skull
      changes seen in craniosynostosis.

PMID- 1614589
TI  - Failure of conventionally fractionated radiotherapy to decrease the risk of
      hemorrhage in inoperable arteriovenous malformations.
AB  - Twenty-six patients with arteriovenous malformations (AVMs) were treated between
      1965 and 1986 with conventional fractionated radiotherapy at the Royal Marsden
      Hospital. There were 14 male patients and 12 female, aged 11 to 57 years (median,
      24 yr). Twenty-five patients completed radiotherapy with a localized treatment
      target volume of a dose of 40 to 54 Gy. The median follow-up was 14.5 years.
      Eleven patients had an additional hemorrhage. The actuarial annual risk of
      bleeding was 2.3%, which is similar to that found in untreated patients. Follow
      up angiograms were performed in 11 patients, and 10 showed persistence of AVM.
      The results suggest that fractionated radiotherapy in conventional doses does not
      make a large impact on the risk of hemorrhage in patients with inoperable AVMs,
      and, where possible, stereotactic external beam radiotherapy/radiosurgery should
      be employed.

PMID- 1614590
TI  - Single intracisternal bolus of recombinant tissue plasminogen activator in
      patients with aneurysmal subarachnoid hemorrhage: preliminary assessment of
      efficacy and safety in an open clinical study.
AB  - Intracisternal thrombolysis with recombinant tissue plasminogen activator (rtPA)
      was performed in 20 patients with aneurysmal subarachnoid hemorrhage. All
      patients had blood accumulations in the basal cisterns according to Fisher's
      Grade III, thus being at a high risk for the development of posthemorrhagic
      delayed ischemic deficits (DID). All patients underwent an operation within 72
      hours after aneurysm rupture. After the aneurysm had been excluded from the
      cerebral circulation, a single bolus of 10 mg of rtPA was injected into the basal
      cisterns. Postoperatively, serial computed tomographic examinations demonstrated
      radical blood clot removal in all patients. Daily transcranial Doppler
      examinations revealed accelerated blood flow velocities in 16 of 20 patients. The
      postoperative results according to the Glasgow Outcome Scale were as follows: 16
      patients were Grades I and II, 2 patients were Grade III. Two patients died
      postoperatively, 1 because of a bowel perforation, and 1 from DID attributable to
      the development of a cerebral vasospasm. No postoperative bleeding complications
      occurred. It is concluded that pharmacological removal of subarachnoid blood
      accumulations can be achieved in a safe and effective way by an intrathecal
      single bolus of 10 mg of rtPA instilled into the basal cisterns after aneurysm
      clipping. The acceleration of blood flow velocities in a number of patients
      indicated that posthemorrhagic arterial narrowing was not completely prevented by
      this treatment, but this remained asymptomatic in 19 of 20 patients. Although
      extensive blood clot removal can be achieved by a single bolus of rtPA, more
      radical or complete blood removal probably requires the use of higher drug
      concentrations or additional postoperative intracisternal or intraventricular
      rtPA injections, for which further studies are needed.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1614591
TI  - Blood-brain barrier permeability changes after experimental subarachnoid
      hemorrhage.
AB  - Basic mechanisms underlying cerebrovascular permeability responses to
      subarachnoid hemorrhage (SAH) are still to be defined in detail. Previous
      investigations examining the occurrence of blood-brain barrier (BBB) breakdown
      after SAH in the experimental setting have yielded conflicting results. In a rat
      model of SAH, we assessed BBB changes by means of the quantitative [14C]-alpha
      aminoisobutyric acid technique. Experiments were carried out on the second day
      post-SAH. In blood-injected rats [14C]-alpha-aminoisobutyric acid transport
      across the BBB increased significantly in cerebral cortices and cerebellar gray
      matter, averaging 1.3 to 1.5 times control values. The present data indicate that
      SAH induces well-defined changes in BBB function, possibly involved in the
      pathogenesis of post-SAH cerebral dysfunction in humans. Results reported here
      have also potential clinical implications for the management of aneurysm
      patients.

PMID- 1614592
TI  - Transient elevation of the intracranial pressure increases the infarct size and
      perifocal edema after subsequent middle cerebral artery occlusion in the rat.
AB  - The objective of this study was to mimic in a simple experiment the two major
      brain insults sustained by the patient with a subarachnoid hemorrhage, that is,
      the ictus and the subsequent delayed reduction of focal cerebral blood flow
      caused by vasospasm without the interference of subarachnoid blood, to test the
      hypothesis that ictal events not related to the presence of blood in the
      subarachnoid space per se may be important for the development of ischemic
      deficits and cerebral infarction when vasospasm develops. Groups of rats were
      subjected to a sudden transient elevation of the intracranial pressure to a level
      causing a brief period of complete global ischemia by infusion of mock
      cerebrospinal fluid into the cisterna magna (this manipulation was designed to
      allow survival of the animal and recovery of consciousness). Two and one-half
      hours later, a focal ischemic insult was induced by occlusion of the middle
      cerebral artery. Rats subjected to middle cerebral artery occlusion alone and
      sham operation served as controls. The infarct size was used as the end point and
      was calculated on brain slices stained with 2,3,5-triphenyltetrazolium chloride.
      The study demonstrates that a brief sudden elevation in intracranial pressure, in
      itself consistent with survival and recovery, increased the vulnerability of the
      brain to a subsequent focal ischemic insult. Thus the combination of insults
      resulted in significantly (P less than 0.05) larger infarcts than did middle
      cerebral artery occlusion alone. Further, this combination of insults resulted in
      a disproportionate enlargement of the affected hemisphere, which could not be
      explained by the increased infarct size alone.

PMID- 1614593
TI  - Inflammatory cell infiltrates vary in experimental primary and metastatic brain
      tumors.
AB  - We have studied the cellular immune response that accompanies primary and
      metastatic brain cancers induced experimentally in rats by inoculation of RG-2
      glioma and Walker 256 (W256) carcinoma cells, respectively. The inflammatory cell
      infiltrates were characterized with lectin histochemistry to visualize microglial
      cells and macrophages and with immunohistochemistry, using a panel of monoclonal
      antibodies, to detect major histocompatibility complex (MHC), lymphocytic, and
      macrophage antigens. The metastatic tumor was composed of a loose stroma with
      multiple, often large, necrotic areas, whereas the RG-2 glioma was composed of a
      dense collection of tumor cells showing only rare necrotic foci. Both tumor types
      were heavily infiltrated with microglia and/or macrophages, and these were
      positive for MHC Class II (Ia) antigens. Expression of MHC Class I antigens was
      absent from RG-2 glioma cells, but it was present in W256 metastatic carcinoma
      cells. The metastatic tumor was also characterized by a much heavier infiltrate
      of lymphocytes, as shown by the presence of cells positive for CD4, CD8, and
      leukocyte common antigens. These lymphocytic markers were absent from reactive
      microglia in the W256 carcinoma, whereas they were present in the RG-2 glioma.
      Polymorphonuclear leukocytes were seen only in the metastatic tumor. Our study
      delineates differences between the inflammatory cell infiltrates found in
      metastatic brain tumors and those found in primary brain tumors. The differences
      in cell composition and immunophenotype may indicate a more effective antitumor
      response in the metastatic tumor that could account for the observed tissue
      destruction.

PMID- 1614594
TI  - Localization of sensorimotor cortex: the influence of Sherrington and Cushing on
      the modern concept.
AB  - According to Penfield, the work of Charles Sherrington's laboratory forced a
      change from the long-held concept of a broad, overlapping sensorimotor cortex to
      the concept of a narrow, discrete pre-Rolandic motor cortex separate from the
      post-Rolandic sensory strip. Harvey Cushing, one of the founders of modern
      neurosurgery, coined the term narrow motor strip. Cushing also appears to have
      been the first to color the precentral gyrus in a mosaic pattern and to use red
      coloring for the motor cortex and blue for the sensory cortex. Cushing's red and
      blue color coding is still used in textbooks, nearly 100 years later. In this
      article, we review the historical evolution of and the evidence for the concept
      of narrow and discrete motor and sensory strips anterior and posterior to the
      Rolandic cortex. A review of the historical development of the concept and recent
      physiological studies reaffirms the proposition that the motor and sensory areas
      are much broader and more complex than they were thought to be in the classic
      teaching that originated with Sherrington and Cushing.

PMID- 1614595
TI  - Synovial cyst at the C1-C2 junction.
AB  - Intraspinal synovial or ganglion cysts of the cervical spine are rare. We present
      the third reported case of a degenerative articular cyst of the upper cervical
      spine, involving the quadrate ligament of the odontoid process. Magnetic
      resonance examination reveals typical images. A new, more general terminology is
      proposed.

PMID- 1614597
TI  - Malignant astrocytoma six years after the resection of a cerebral metastatic
      cardiac myxoma: case report.
AB  - We describe a woman who had a total resection of a cardiac myxoma followed 8
      months later by a hemorrhage in the right frontal lobe secondary to extravascular
      metastasis of the myxoma. Six years later, after an asymptomatic follow-up, she
      developed a recurrence of left-sided seizures and an enhancing mass in the same
      location as the previous tumor. At operation, a malignant astrocytoma was
      demonstrated. Cardiac myxoma is a true neoplasm with benign histology, which may
      be associated with heart failure, systemic illness, or peripheral embolization.
      The neurological manifestations of embolization may include no symptoms, acute or
      delayed infarction, and intravascular proliferation with aneurysmal dilatation
      and potential for hemorrhage. The development of extravascular metastatic tumor
      deposits has been reported previously in only three histologically verified
      cases. Once the integrity of the blood vessel wall is destroyed by the tumor, a
      portal of entry is established for tumor cell proliferation in the brain
      parenchyma. There is no known association between a metastatic cardiac myxoma and
      a malignant glioma in the literature. Several possibilities for the occurrence of
      these two neoplasms are discussed.

PMID- 1614596
TI  - Painful tic convulsif caused by a brain tumor: case report and review of the
      literature.
AB  - Patient with painful tic convulsif caused by a brain tumor is presented. The
      patient was admitted with right trigeminal neuralgia and ipsilateral facial
      spasm, i.e., painful tic convulsif. Preoperative computed tomography scans showed
      no apparent abnormalities; however, surgery revealed that these symptoms were
      associated with a pearly tumor located in the cerebellopontine angle. Subtotal
      resection for the decompression of the right trigeminal and facial nerves was
      performed and resulted in complete relief of the symptoms. Histological
      examination demonstrated the tumor to be an epidermoid cyst.

PMID- 1614598
TI  - Aneurysmal peroneal nerve compression.
AB  - Vascular compression syndromes of the peroneal nerve are rare. The case history
      of a patient with a peroneal nerve compression caused by a true anterior tibial
      artery aneurysm is reported. The surgical excision of the aneurysm resulted in
      marked improvement.

PMID- 1614599
TI  - Intracranial osteolytic malignant meningiomas appearing as extracranial soft
      tissue masses.
AB  - Malignancy is rare in intracranial meningiomas. Although the topic is widely
      discussed, there is little agreement in the literature as to the histological and
      radiological features that warrant the diagnosis of malignant meningioma. Three
      patients are described who had soft-tissue masses and underlying osteolytic
      lesions on computed tomography. All three patients also had a large intracranial
      component that proved to be a malignant meningioma. Rarely do meningiomas have
      all three of these features. We propose that a meningioma causing osteolysis and
      soft-tissue extension should be considered malignant until proven otherwise.

PMID- 1614600
TI  - Cystic meningioma: report of three patients.
AB  - Three patients with cystic meningioma are reported. The computed tomographic
      scans or magnetic resonance images of these tumors resembled those of a glial or
      metastatic tumor with cystic or necrotic changes. There is no definitive method
      for preoperatively differentiating cystic meningiomas from the more common
      malignant glioma. Angiographic evaluation and collaboration with a
      neuropathologist are important for the recognition of these potentially curable
      neoplasms.

PMID- 1614601
TI  - Bilateral arteriovenous malformations: case report.
AB  - The authors describe a case of supratentorial bilateral arteriovenous
      malformations in a patient who suffered an intracerebral hemorrhage. It was
      radiologically demonstrated that the arteriovenous malformations were separate
      and bilateral, located in the temporal lobes. They were removed in two operations
      with preoperative embolization of one. The patient did well with no neurological
      damage.

PMID- 1614602
TI  - Intracerebral hemorrhage after combined anticoagulant-thrombolytic therapy for
      myocardial infarction: two case reports and a short review.
AB  - Intracerebral hemorrhage complicating anticoagulant-thrombolytic therapy for
      myocardial infarction is infrequent but is associated with grave prognostic
      implications. We report two cases and review current management recommendations.

PMID- 1614603
TI  - Sacral agenesis occurring in siblings: case report.
AB  - We report a rare incidence of sacral agenesis occurring in siblings. One of our
      patients had a low-lying conus, and untethering of the cord in the area of the
      filum terminale led to improvement in urinary symptoms. The need for aggressive
      investigation of patients with sacral agenesis and static neurological deficits
      is discussed.

PMID- 1614604
TI  - Intraoperative angiography and temporary balloon occlusion of the basilar artery
      as an adjunct to surgical clipping: technical note.
AB  - The direct surgical treatment of intracranial aneurysms is not always possible,
      especially in posterior circulation aneurysms. This is usually because of their
      complex anatomy and location next to the skull base and brain stem, where
      proximal vascular control is usually not attainable. Four patients at our
      institution underwent intraoperative transfemoral catheterization of the basilar
      artery with a nondetectable endovascular balloon for proximal control of the
      basilar artery. The flow control in the basilar artery was excellent and
      facilitated the surgery. Before surgery, each patient underwent the placement of
      a 10-cm 8-French femoral introducer sheath and were taken to the operating room
      where they were placed in a supine position and a subtemporal or pterional
      craniotomy was performed. After the initial exposure and before aneurysm
      manipulation, a nondetachable silicone balloon catheter was passed through an
      introducer catheter and was placed into the rostral basilar artery, using flow
      direction, microguidewires, and angiographic "road-mapping" techniques. In two
      patients, temporary basilar occlusion was used to collapse the aneurysm and to
      facilitate clip placement. In the third patient, intraoperative aneurysm rupture
      occurred and was controlled by temporary basilar artery occlusion. Using
      intraoperative angiography, complete aneurysm obliteration and vessel patency was
      confirmed in all four patients. All patients made a complete recovery except for
      initial postoperative third nerve palsies in three patients. This technique
      achieves intraoperative control of the basilar artery proximal to an aneurysm by
      the use of a nondetachable occlusive balloon in the basilar artery. An added
      benefit is the ease with which intraoperative angiography can be obtained in this
      context.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614605
TI  - Modified supraorbital craniotomy: technical note.
AB  - The authors present a surgical approach that incorporates the frontal sinus and
      extends a supraorbital craniotomy to include the lateral orbital rim and zygoma.
      The craniotomy provides wide exposure of the anterior fossa, orbit, ipsilateral
      middle fossa, and cavernous sinus. The procedure can be performed easily, and the
      bone flaps can be secured rapidly back into the anatomical position at the time
      of closure. This modified supraorbital craniotomy is ideal for large benign
      lesions originating along the sphenoid wing or orbit that expand into the
      anterior fossa.

PMID- 1614606
TI  - A temporal transsylvian approach to anterior circulation aneurysms.
AB  - Operative management of cerebral aneurysms remains a technically challenging
      problem in modern neurosurgery despite major advances in microsurgical
      techniques. This is largely caused by the difficulty of exposing and handling
      these aneurysms, which are located around the circle of Willis at the base of the
      brain. Large cranial windows, generous brain retraction, and local brain
      resection have, at times, been employed to overcome these difficulties. In the
      present report, an exclusively temporal approach to the anterior aspect of the
      circle of Willis for surgical treatment of aneurysms arising from the anterior
      circulation is described. This approach limits the surgical preparation and the
      craniotomy to the temporal area, protects the temporal branch of the facial nerve
      from injury, and provides a superior cosmetic appearance soon after surgery. It
      provides a lateral transsylvian exposure to the base of the brain and thus
      permits the safe dissection and exposure of the aneurysms using microsurgical
      techniques with minimal, if any, retraction of the frontal lobe. The need for
      routine resection of the gyrus rectus for exposure of anterior communicating
      artery aneurysms is alleviated. This approach can be considered in patients
      harboring large or small incidental or acutely ruptured anterior circulation
      aneurysms. The outcome of 96 consecutive patients who underwent this procedure is
      described to illustrate its safety and effectiveness.

PMID- 1614607
TI  - Vestibular schwannoma (acoustic neuroma). Consensus development conference.

PMID- 1614608
TI  - Definition of contemporary surgical management in cisternal and parenchymatous
      cysticercosis cerebri.

PMID- 1614609
TI  - Pregnancy in patients with cerebrospinal fluid shunts: report of a series and
      review of the literature.

PMID- 1614610
TI  - Neurophysiological assessment outcomes of nonacquired immunodeficiency syndrome
      patients with primary central nervous system lymphoma before and after blood
      brain disruption chemotherapy.

PMID- 1614611
TI  - Afferent and efferent connections of cortical transplants implanted into the
      damaged sensorimotor area of the cerebral cortex of adult rats.

PMID- 1614612
TI  - Monosynaptic connections in the central nervous system of the edible snail:
      receptive fields of presynaptic neurons.

PMID- 1614613
TI  - Role of the lateral and medial hypothalamus in the reproduction of the motoric
      reaction which is a signal during the development of classical conditioned
      reflexes.
AB  - It has been demonstrated in experiments on three dogs that test
      electrostimulation of the lateral hypothalamus reproduces the motoric reaction
      which is the signal stimulus during the development of classical alimentary CR
      (83%) and does not reproduce it during the development of classical defensive CR
      (93%). The test electrostimulation of the medial divisions of the hypothalamus,
      like the electrostimulation of the LH, reproduces the "signal" motoric reaction,
      but in a smaller percent of cases (62%), during the development of classical
      alimentary CR, and does not reproduce it during the development of classical
      defensive CR. The reproduction of the signal motoric reaction during the
      electrostimulation of the LH is associated with the activation of a backward
      conditioned connection from the motivational structures of the hypothalamus to
      the representation of the signal stimulus in the motor cortex.

PMID- 1614614
TI  - Functional role of the neurospecific S-100 protein in the processes of memory.
AB  - The change in the content of S-100 protein in the brain in the presence of
      learning and an amnestic influence (administration of an M-cholinolytic), taking
      interhemispheric asymmetry into account, was studied in experiments on white
      rats. The action of S-100 protein and of an antiserum to this protein on the
      learned behavior of the rats were also investigated. It was established that the
      level of S-100 protein increases in the left and right hemispheres in the process
      of the development of an alimentary conditioned reflex. The disruption induced by
      the cholinolytic of the processes of the development of conditioned reflexes is
      accompanied by a decrease in the content of S-100 protein in the brain.
      Intracisternal administration of an M-cholinolytic and an antiserum to S-100
      protein mutually potentiates their amnestic effect.

PMID- 1614615
TI  - Organization of network properties of cells in local and distributed neuronal
      networks of the brain of cats.
AB  - The network properties of neurons of the visual and motor cortex and of the
      lateral nucleus of the hypothalamus were investigated on the basis of identified
      interneuronal interactions, using the cross-correlation method of analysis, in
      cats with developed alimentary conditioned instrumental reflexes to light. The
      varied organization of the network properties of cortical neurons in the
      organization of local and distributed neuronal networks was demonstrated, namely:
      the predominance of divergent properties over convergent properties for large
      cells in local networks and the leveling out of these relationships in
      distributed networks. The neurons of the lateral nucleus of the hypothalamus had
      an equal representation of convergent and divergent properties in the
      organization of local and distributed networks. The network properties of neurons
      of the cortical and subcortical structures were manifested in the background,
      following the development of conditioned reflexes, and during extinction. Only
      the small cells of the visual cortex were functionally dependent and changed the
      relationship of network properties in local networks during the extinction of
      conditioned reflexes.

PMID- 1614616
TI  - Change in neuronal excitability in hippocampal sections of rats isolated after
      the destruction of the medial septal area.
AB  - The influence of chronic destruction of the medial septal area (MSA) on focal
      potentials (FP) of field CA1 evoked by stimulation of Schaffer collaterals was
      studied in experiments on viable sections of the hippocampus of rats. The
      preparation, incubation, and pickup of FP of the sections of the control and
      experimental groups were carried out in identical conditions using traditional
      methods. The amplitude-temporal of population EPSP and population spikes, their
      interdependence, and their dependence on the strength of the stimulating current
      were assessed using automated data analysis. It was demonstrated that coagulation
      of the MSA is accompanied by an increase in the excitability of neuronal
      complexes of the lateral portion of field CA1 which is manifested by the
      generation of multiple rhythmic discharges and the development of spike activity
      of the cells at a lower intensity of the synaptic inflow. It is hypothesized that
      destruction of the MSA leads to a relative attenuation of inhibitory control in
      the neuronal systems of field CA1, the elements of which are depolarized with
      anomalous synchronicity and generate rhythmic impulse trains.

PMID- 1614617
TI  - Features of the establishment of the spontaneous activity of neurons of the
      trigeminal sensory nuclei of viable sections of the rat brainstem in postnatal
      ontogenesis.
AB  - An attempt was made to characterize the features of the development of the
      neurons of the sensory trigeminal nuclei, a basic structure of the sensory
      support of alimentary behavior, in the late stages of postnatal ontogenesis. A
      technique involving viable sections of the brainstem of infant rats at the ages
      of two, four, and eight weeks was utilized. An increase with age in the number of
      neurons possessing spontaneous activity (44% at two weeks; 69% at eight weeks),
      an increase in the frequency of discharges, the appearance by the fourth week of
      a population of cells with high-frequency spontaneous activity, and an increase
      in the number of such neurons by the eighth week. Three types of background
      active neurons were distinguished: episodic, continuous, and group; and the
      dynamics of the change in the ratios of these types with age was demonstrated.
      Significant changes with age were not found in resting potentials, although a
      tendency to its increase takes place between the second and eighth weeks of
      postnatal development.

PMID- 1614618
TI  - Phosphorylation of the proteins of synaptic membranes during the emergence of
      prolonged dissociated states induced by carbacholine.

PMID- 1614619
TI  - Influence of superficial polarization of the cerebral cortex of the dog on
      extinctive inhibition.

PMID- 1614620
TI  - Morphometric analysis of synaptic contacts in the anterior limbic cortex in the
      endogenous psychoses.

PMID- 1614621
TI  - Synthesis of proteins in the critical periods of early postnatal ontogenesis: its
      role in the formation of intraspecies aggressive behavior of rats.
AB  - The significance of the synthesis of the protein in the brain for the formation
      of intraspecies aggressive behavior of isolated males in early postnatal
      ontogenesis, under the influence of social contacts, was revealed in experiments
      on 200 mongrel rats. Chronic administration of cycloheximide (0.5 mg/kg;
      intraperitoneally), a protein synthesis blocker at the stage of translation, to
      infant rats from the 15th to the 30th postnatal days, prior to daily three-hour
      sessions of contacts between them, disrupted the formation of intraspecies
      aggressive behavior. This was manifested at adult age by their hyperaggressivity
      and by changes in the proportions of various reactions in the integral act of
      aggressive behavior.

PMID- 1614622
TI  - Results of clinical and enzymatic immunoassay study of a neurospecific leucine
      aminopeptidase in neurological patients.

PMID- 1614624
TI  - A method for the diagnosis of interhemispheric brain asymmetry.

PMID- 1614623
TI  - Participation of glutamatergic and dopaminergic systems of the neostriatum in the
      organization of alimentary conditioned reflexes.
AB  - In this study the results of behavioral, neurophysiological, and morphological
      investigations in relation to the participation of the corticostriatonigral
      system in the organization of conditioned reflexes are presented. It was
      demonstrated in experiments on dogs that blockade of N-methyl-D-aspartate
      receptors of the caudate nucleus disrupts the realization of consolidated
      conditioned reflexes and renders their development more difficult. The blockade
      of quisqualate receptors facilitates the process of differentiation. Switching
      off of the dopaminergic input makes the development of positive conditioned
      reflexes more difficult. The reversible switching off of the substantia nigra
      leads to the reorganization of the neuronal activity of the caudate nucleus in
      response to the presentation of the conditional signal. Inhibitory nigral
      influences are directed primarily to the ventromedial divisions of the nucleus,
      while activating influences are directed to its dorsal segments. The topically
      organized connections of the motor regions of the cortex with the dorsal region
      of the caudate nucleus, and of the limbic regions with its ventromedial divisions
      were studied in morphological investigations on cats. A certain distinctiveness
      was identified of the spatial organization of the nigrostriatal projections. The
      data obtained are discussed from the point of view from the systemic organization
      of behavior.

PMID- 1614625
TI  - Beyond our borders.

PMID- 1614626
TI  - We made the list, but...

PMID- 1614627
TI  - Rethinking women's services.

PMID- 1614628
TI  - We're building peace. An interview with Licensatura Rosa Rodriguez Deras,
      Director, School of Medical Technology, National University of El Salvador.
      Interview by Patricia Moccia.

PMID- 1614629
TI  - We're building peace. An interview with Yolanda de Landos, Director of Nursing,
      School of Medical Technology, National University of El Salvador. Interview by
      Patricia Moccia.

PMID- 1614631
TI  - The decade for natural disaster reduction: the role of health care workers.
AB  - Disasters are occurring more frequently these days. Pickens, a Geneva-based
      journalist, examines how the World Health Organization suggests to cope with
      disasters.

PMID- 1614630
TI  - Karoshi: death from overwork--a nursing problem in Japan?
AB  - Japanese Nurses are overworked and underpaid; many of them leave the profession
      at about age 25 and get married. Will working conditions change so that more
      nurses remain nurses?

PMID- 1614632
TI  - Medical disaster relief in Switzerland: a brief overview.

PMID- 1614633
TI  - Health for all by the year 2000: where is it now?. Interview by Craig Little.

PMID- 1614635
TI  - Health care in Canada: the presumption of care.

PMID- 1614634
TI  - Comparison of national health care systems (as of 18 July 1991).

PMID- 1614636
TI  - Health and nutritional consequences of the 1991 Bangladesh cyclone.

PMID- 1614637
TI  - Unproven nutritional remedies and cancer.

PMID- 1614638
TI  - Buthionine sulfoximine, an experimental tool to induce glutathione deficiency:
      elucidation of glutathione and ascorbate in their role as antioxidants.
AB  - The development of buthionine sulfoximine, a selective inhibitor of glutathione
      biosynthesis, is an important new tool to elucidate the in vivo role of
      glutathione. Recent investigations have shown that ascorbic acid can serve as an
      essential antioxidant in the presence of severe glutathione deficiency.

PMID- 1614639
TI  - Choline: a conditionally essential nutrient for humans.
AB  - Tissue concentrations of choline decreased significantly while serum alanine
      aminotransferase activity, a marker of liver injury, increased sharply (by 50%)
      when healthy young adult men received a choline-free semisynthetic diet for three
      weeks. This study suggests that choline is an essential nutrient for humans when
      excess methionine and folate are not available in the diet.

PMID- 1614640
TI  - Gender differences in immune competence during copper deficiency.
AB  - Restriction of copper intake during lactation and postlactation periods reduced T
      cells and increased interleukin-2 receptors in isolated splenocytes from male,
      but not female, rats. However, a reduced in vitro proliferative response to
      phytohemagglutin (PHA) was seen in both male and female Cu-deficient rats. These
      findings suggest that Cu deficiency may inhibit proliferation at a step between
      early activation and DNA synthesis.

PMID- 1614641
TI  - Interspecies differences in folate metabolism.
AB  - The primary form of folate in the plasma of pigs is tetrahydrofolate. In
      contrast, 5-methyl-tetrahydrofolate comprises most of all of the plasma folate in
      humans and other animal species examined. High-affinity folate-binding proteins
      may be involved in governing this distribution of plasma folates.

PMID- 1614642
TI  - The new reference daily intakes: for better or for worse?
AB  - The introduction of the RDIs was well intentioned. However, there are scientific
      uncertainties and reasons for concerns about the proposed new nutrition
      standards. Adoption of the RDIs will inevitably lead to reduced intakes of
      critically important vitamins and minerals, will make it more difficult for
      members of nutritionally vulnerable groups to meet their nutrient needs, and will
      have undesirable effects on the health of the most needy by altering nutrition
      priorities and programs in this country. National nutrition standards remain with
      us for a long time. The U.S. RDAs have been in place for 18 years; any new
      standards need to be sound enough and safe enough to last as long. The proposed
      RDIs are clearly not of this caliber.

PMID- 1614643
TI  - Energy requirements in the elderly.
AB  - The major components of daily energy expenditure may change during aging. A
      review of current estimates of energy requirements leads to the conclusion that
      direct estimates of daily energy expenditure are desirable to confirm the
      validity of the present recommendations. A more extensive examination of the
      metabolic and nutritional significance of the major food fuel sources is
      necessary to further define human energy needs.

PMID- 1614644
TI  - The bat killer.

PMID- 1614645
TI  - Applying an abduction pillow correctly.

PMID- 1614646
TI  - How H.I.V. affects the eye.

PMID- 1614647
TI  - Assessing fibrin-split products.

PMID- 1614648
TI  - Responding to carbamate poisoning.

PMID- 1614649
TI  - Preventing a peripheral i.v. infection.

PMID- 1614651
TI  - The gift of life.

PMID- 1614650
TI  - Peak levels for vancomycin.

PMID- 1614652
TI  - From coma to discharge. The story of a roller coaster recovery.

PMID- 1614653
TI  - Exploring misconceptions about breast cancer.

PMID- 1614654
TI  - Caring for the patient with a pigtail drainage catheter.

PMID- 1614655
TI  - Charting the future of emergency drug protocols.

PMID- 1614656
TI  - What you need to know about advance directives.

PMID- 1614657
TI  - S.I.A.D.H. Is your patient at risk?

PMID- 1614658
TI  - Just a minute.

PMID- 1614659
TI  - Death with dignity.

PMID- 1614660
TI  - Managing cardiovascular conditions.

PMID- 1614661
TI  - Transtracheal catheter tips.

PMID- 1614662
TI  - Myths & facts ... about depression.

PMID- 1614663
TI  - Learning to say no.

PMID- 1614664
TI  - Back to school. A guide for easing the pain.

PMID- 1614665
TI  - Intensive care for the elderly: should the gates remain open?

PMID- 1614666
TI  - Osseous sarcoidosis, radiologic imaging, and physician interaction.

PMID- 1614667
TI  - Impact of do-not-resuscitate legislation on the use of cardiopulmonary
      resuscitation in three teaching hospitals.
AB  - Under New York State's unique do-not-resuscitate law, patients admitted to a
      hospital are assumed to consent to cardiopulmonary resuscitation unless a do-not
      resuscitate order has been written in accordance with specific stipulations. This
      study was undertaken to determine if the law would significantly change the use
      of cardiopulmonary resuscitation. The charts of 952 patients who died on the
      medical services of Bellevue, New York University, and New York Veterans
      hospitals during the 12-month periods before and after the law went into effect
      were reviewed. The proportion of patients undergoing cardiopulmonary
      resuscitation was determined. To take into account the effects of potential
      confounders (ie, hospital, sex, race or ethnic group, age, diagnosis), a multiple
      logistic regression analysis was performed. The relative risk for cardiopulmonary
      resuscitation was found to be 0.81, (95% confidence interval: 0.59-1.10) after
      the law as compared with before, which was not statistically significant.
      Although patients with chronic or potentially reversible illness were much more
      likely than those with hopeless illness to undergo cardiopulmonary resuscitation
      (relative risk of 7.08 [3.23-15.54] and 12.89 [8.71-19.07], respectively), the
      data failed to show that the law had an impact on the use of cardiopulmonary
      resuscitation in any of the disease categories. Total use of formal do-not
      resuscitate orders increased from 32.7% to 83.9% (p less than .0001), although at
      Bellevue, where documentation was high before the law, no further increase
      occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614668
TI  - Contact investigation and isoniazid chemoprophylaxis in New York City, 1979-1987.
AB  - The Bureau of Tuberculosis of the New York City Department of Health has carried
      out investigations of contacts to active cases of tuberculosis for many years. In
      addition, the Bureau has undertaken tuberculosis screening, with tuberculin
      testing and by radiography where indicated, of persons for employment purposes,
      school attendance, and for various other reasons. In 1969, the Bureau began
      providing isoniazid chemoprophylaxis; since then, more than 150,000 persons have
      been given isoniazid. Several isoniazid chemoprophylaxis effectiveness trials of
      chemoprophylaxis are achieved, the frequency of developing tuberculosis in one's
      lifetime would be reduced by 50%-70% by the time treatment is completed,
      according to several studies. On the basis of the beneficial results of these
      trials, the Bureau of Tuberculosis introduced the use of isoniazid
      chemoprophylaxis. This study was undertaken to assess the acceptability of
      isoniazid chemoprophylaxis and the success of contact investigation under both
      regular clinical conditions and uncontrolled conditions.

PMID- 1614669
TI  - Pigeons as a remedy (segulah) for jaundice.

PMID- 1614670
TI  - Pulmonary cavitary disease.

PMID- 1614671
TI  - The story of Lassa fever. Part I: Discovering the disease.

PMID- 1614672
TI  - A history of the Women's Medical Society of New York State.

PMID- 1614673
TI  - Lytic osseous destruction in vertebral sarcoidosis.

PMID- 1614674
TI  - Clavicular resection in the exposure and resection of malignant tumors.

PMID- 1614675
TI  - Renal angiomyolipoma presenting as a retroperitoneal mass following thrombolytic
      therapy for acute myocardial infarction.

PMID- 1614676
TI  - Neutropenia induced by low-dose captopril.

PMID- 1614677
TI  - Hyperbilirubinemia in the term infant.

PMID- 1614678
TI  - Exercise and pregnancy: a review of maternal and fetal effects.

PMID- 1614679
TI  - Energy requirements in pregnancy: a review.
AB  - The traditional estimates of the additional energy requirements during pregnancy
      are approximately 300 calories per day or 80,000 calories for a full-term
      pregnancy. Recently these estimates have been challenged as being excessive,
      especially for non-Western populations. In light of recent studies and advances
      in methodology, the purpose of this paper is to review 1) the components of
      energy expenditure, 2) the different methods of assessing energy expenditure, 3)
      various factors that may affect energy expenditure during gestation, and 4) the
      recent literature on energy expenditure in pregnancy. The available data suggest
      that the energy requirements in pregnancy are varied and depend on the population
      being examined. Furthermore, additional studies are needed in order to clarify
      these issues in various normal populations as well as in populations at risk for
      fetal growth abnormalities.

PMID- 1614680
TI  - Hormonal replacement therapy in postmenopausal women and cardiovascular disease:
      an overview.

PMID- 1614681
TI  - Engineers encourage universities to emphasize safety in curriculum.

PMID- 1614682
TI  - Ergonomics at UAW-Ford.

PMID- 1614683
TI  - Personal experience on horizontal glottectomy. Critical evaluation of long-term
      results.

PMID- 1614684
TI  - Elective radiotherapy of the neck in patients with squamous cell carcinoma of the
      head and neck.
AB  - A prospectively recorded 5-year series of 254 patients receiving elective neck
      irradiation is evaluated. All had clinically negative necks and initial control
      at the primary site. Forty-seven percent of the patients had T3-4 tumours.
      Radiotherapy was delivered from a megavolt source at 2 Gy/day 5 days a week to a
      total dose of 46-50 Gy. All but 3 patients completed the treatment as planned.
      Neither tumour stage nor site of the primary tumour was related to the incidence
      of regional recurrences. Of 30 patients receiving 46-49 Gy, 5 died from neck node
      recurrences. Of 221 patients treated to 50 Gy or more, 16 (7.2%) developed
      regional recurrences. Two of these recurrences were avoided, giving a regional
      failure rate of 6.3%. As a whole, 7.8% died from regional, 11.4% from local, and
      3.1% from distant recurrences.

PMID- 1614685
TI  - Vestibular disturbance after myelography. Contrast media in the internal auditory
      canal.
AB  - Two cases of vestibular disturbance caused by residual oily contrast medium in
      the internal auditory canals after myelography are reported. Nystagmus towards
      the affected side and normal caloric responses were observed; therefore, contrast
      media are considered to act as irritants to the vestibular nerve.

PMID- 1614686
TI  - Sensorineural hearing loss associated with otitis media with effusion.
AB  - The clinical records of 1,372 cases of otitis media with effusion (OME) treated
      during the past 10 years were reviewed in search of associations with
      sensorineural hearing loss (SNHL). In 14 cases (1.0%), the development of SNHL
      was considered to be etiologically related to OME. These 14 cases were classified
      into two groups. In group A, which consisted of 5 cases, the clinical feature was
      acute onset of SNHL and gradual improvement. In group B of 9 cases, SNHL
      progressed gradually or insidiously and did not improve. Different
      pathophysiology may be assumed to underlie these two groups. The results of this
      study demonstrate that we have to pay attention to a possible development of SNHL
      during the course of OME.

PMID- 1614687
TI  - Idiopathic sudden hearing loss and disturbance of iron metabolism. A clinical
      survey of 426 cases.
AB  - The role of disturbances of the iron metabolism (DIM) in idiopathic sudden
      hearing loss (ISHL) was investigated in 426 patients with ISHL who received iron
      therapy, anti-DIM medication, vitamins, and a combined regimen in a randomized
      study which was stratified by stages and groups. Low concentrations of
      haemoglobin, serum iron, serum ferritin, and red cell basic ferritin as well as
      abnormal circadian variations in the serum iron level were observed. The results
      were significantly better in patients receiving iron therapy than in those
      receiving anti-DIM medication, vitamins, and the combined regimen. Hearing
      improvement was achieved in 53.26% of the patients whose treatment started later
      than 3 months after the onset of the disease. The clinical association of DIM and
      ISHL is discussed.

PMID- 1614688
TI  - Electronystagmographic features in some peripheral and central vestibular
      disorders: application of multiple discriminant analysis of
      electronystagmographic parameters.
AB  - In routine clinical electronystagmographic (ENG) tests (postrotatory,
      optokinetic, caloric and tracking tests), eye movement signals were analyzed and
      a multiple discriminant analysis was carried out with the aid of a microcomputer.
      Six parameters were selected and, based on these, two functions for
      discriminating between peripheral and central disorders were established.
      Discrimination between 35 patients with peripheral lesions and 15 patients with
      central lesions was made with a correct classification rate of 97.1 and 86.7%,
      respectively. These rates are significantly higher than that of any single ENG
      test analysis. Our results indicate that the clinical application of ENG can be
      improved by searching for more sensitive ENG parameters and adopting the
      comprehensive analysis approach.

PMID- 1614689
TI  - Functional study of the eustachian tube with sequential scintigraphy.
AB  - The authors investigated the tubal function by means of sequential scintigraphy
      in 16 patients affected by chronic otitis media and in 3 patients with
      posttraumatic perforation of the tympanic membrane. Evaluated parameters were:
      appearance time (AT), radioactivity peak time, rise time in the tympanic cavity,
      eustachian tube and rhinopharynx, and radioactivity percent values passed in the
      rhinopharynx. The tubal pressure-equilibrating function was determined by means
      of the manometer pump section of the impedance meter. A significant relationship
      between the pressure-equilibrating function and the tubal scintigraphy parameters
      has been detected. The variability of the AT in the tube and the almost constant
      time needed by the radioactive tracer to go through the tube and reach the
      rhinopharynx could indicate that a major role in the tympanic cavity drainage is
      played by the tympanic ostium and the surrounding mucosa.

PMID- 1614690
TI  - Culture and cryopreservation of chondrocytes from human cartilage: relevance for
      cartilage allografting in otolaryngology.
AB  - One of the reasons for failure of cartilage allografts is the impaired condition
      of the transplant during storage. In this paper we describe methods for the
      isolation and culture of viable chondrocytes obtained from nasal septum
      cartilage. Furthermore, we evaluate the possibility of growing such specific
      chondrocytes under culture conditions and storing them in a frozen state. Age
      dependent differences were observed in the growth rate of the cultured cells. Our
      results confirm that chondrocytes survive freezing and remain able to
      proliferate. Knowledge gained from this study may be applied to the culture and
      freezing of viable intact cartilage for use in reconstructive surgery in
      otolaryngology.

PMID- 1614691
TI  - Immunohistochemical study of the fourth cell type in the olfactory epithelium in
      guinea pigs and in a patient.
AB  - The mammalian olfactory epithelium consists of supporting cells, olfactory
      receptor cells, basal cells and a fourth cell type, which has recently been
      discovered. In this study we examine this fourth cell type using
      immunohistochemical techniques. Anti-Purkinje-specific spot-35 protein (S-35),
      anti-S-100 protein (S-100), anti-neuron-specific enolase (NSE), antichromogranin
      A and antisynaptophysin antisera were used for the immunostaining. The fourth
      cell type immunoreacted only to anti-S-35 antiserum and did not react to other
      antisera in guinea pigs. On the other hand, in the human S-100 immunoreactivity
      was seen in the fourth cell type as well as weak reactivity to S-35. NSE
      immunoreactivity was found only in the olfactory receptor cells of guinea pigs
      and the human. From these results it is assumed that this fourth cell type is a
      second chemoreceptor different from the olfactory receptor cells because S-35 and
      S-100 are Ca(++)-binding proteins.

PMID- 1614692
TI  - Empty sella syndrome, diagnosed as allergic rhinitis.
AB  - Unilateral cerebrospinal fluid (CSF) rhinorrhea as the only manifestation of the
      primary empty sella syndrome is a rare event. A case of a middle-aged male
      patient complaining for intermittent unilateral rhinorrhea, which started 5
      months earlier, is reported. The persistence of this state was attributed to an
      allergic rhinitis. The initial work-up excluded the above diagnosis and an
      erroneous radiological diagnosis led to a puncture of the left maxillary sinus. A
      lateral X-ray of the skull and CT scan led to the diagnosis of empty sella
      syndrome, possibly due to an adenoma or a meningocele.

PMID- 1614693
TI  - Phlegmonous and abscess-forming ENT infections: comparative efficacy of
      ceftriaxone versus amoxicillin-clavulanic acid.
AB  - In this randomized trial, 100 patients received ceftriaxone or amoxicillin
      clavulanic acid in phlegmonous or abscess-forming ENT infections. Clinical and
      bacteriological results confirm that both antibiotics are equally effective, the
      advantage of ceftriaxone being one administration a day. Drainage surgery is
      necessary when an abscess has already formed. In 4 cases (ceftriaxone: 3;
      amoxicillin-clavulanic acid: 1), no positive response could be observed. Systemic
      and local tolerance was, as a general rule, excellent, and side effects were
      reported in 3 cases of the ceftriaxone group and in 3 cases of the amoxicillin
      clavulanic acid group.

PMID- 1614694
TI  - Continuously improving patient care: practical lessons and an assessment tool
      from the National ICU Study.
AB  - Pressure for hospitals to maintain quality while lowering cost or provide greater
      quality at a given level of cost is particularly critical in intensive care
      services for which it is increasingly difficult to match revenues with costs,
      given reimbursement limits. At the same time, twofold to threefold differences in
      intensive care unit risk-adjusted mortality have been reported. This article
      provides a model for thinking about continuous improvement of intensive care
      services, draws on the National ICU Study to identify fundamental organizational
      and managerial processes associated with better performance, and offers a
      validated assessment instrument to be used as a tool for continuous improvement.

PMID- 1614695
TI  - The Achilles' heel of quality management: the human quotient.

PMID- 1614696
TI  - Cross-functional, integrative team decision making: essential for effective QI in
      health care.
AB  - Quality improvement methods first developed in industry can be applied in health
      care, but major adjustments in the traditional health care organization are
      needed for continuous improvement processes to work. One change is establishing
      cross-functional or multidisciplinary teams to carry out integrative decision
      making in the place of departmental hierarchical decision making within the
      functional areas and disciplines. This article cites examples from experience
      with one service process--delivery of care to newborns--and examines techniques
      from the group behavior and conflict resolution literature which could enhance
      the success of cross-functional teams in health care organizations.

PMID- 1614697
TI  - A consumer guide for marketing medical services: one institution's experience.
AB  - This paper describes the Cleveland Clinic Foundation's experience with the
      development and implementation of a 20-page quality indicator consumer guide for
      patients with or at risk of developing coronary artery disease. The guide, which
      provides six "quality indicators," was designed to enable patients to evaluate
      and compare quality-related information when choosing a provider. Design elements
      for the guide included a user-friendly format to offset the amount of information
      consumers are asked to absorb. Data on inquiries showed that the majority were
      women (53%) and adults under the age of 65 years (57%). Although the media
      criticized the guide as a marketing tool, it represents an effort to educate
      consumers about the importance of research when choosing a provider.

PMID- 1614698
TI  - [Extrahepatic cholestasis in infancy and childhood: the role of ultrasonography].
AB  - Of 23 children with extrahepatic cholestatic syndromes, who were studied with
      sonography, there were found to have biliary atresia, choledochal cyst,
      cholelithiasis, stenosis of bile duct, gallbladder duplication, cholecystitis.
      Ultrasonography is the most useful initial investigation of choice, and in most
      of the cases the only investigation.

PMID- 1614699
TI  - [Diagnosis of chronic myeloproliferative diseases based on bone marrow biopsy].
AB  - The bone marrow biopsies and laboratory data of 248 patients with untreated
      chronic myeloproliferative disorders have been evaluated according to the
      Hannover Classification. 47.6 per cent of the cases were classed as primary or
      basic diseases, including chronic myeloid leukaemia common type, chronic myeloid
      leukaemia megakaryocytic type, chronic megakaryocytic-granulocytic myelosis,
      polycythaemia vera and essential thrombocythaemia. In 52.4 per cent of the
      biopsies the advanced stages of the primary diseases like increase of fibers and
      loss of differentiation were noted; the increase of fibers in myeloid leukaemia
      megakaryocytic type and in chronic megakaryocytic-granulocytic myelosis, and loss
      of differentiation in chronic myeloid leukaemia common type were frequently
      noted. In 14.1 per cent of the cases the advanced myelofibrosis and blast cell
      accumulations obscured the histological features of the primary disease,
      therefore these cases were placed in the unclassifiable group. The cases without
      increase of fibers and loss of differentiation accounted for only 4 per cent of
      the unclassifiable category. Leucocyte and platelet count as well as haematocrit
      values showed considerable overlapping and scattering and were generally lower in
      cases which developed myelofibrosis.

PMID- 1614700
TI  - [Long-term phenytoin (Diphedan) therapy leading to IgA nephropathy].
AB  - A single case of IgA nephropathy with a concomitant tubulointerstitial nephritis,
      developing during a long-term phenytoin therapy is reported. The prolonged
      phenytoin therapy did neither prevent the transitional increases of serum IgA
      level nor ward off deterioration of the histological alterations. This case
      suggests that acute tubulointerstitial nephritis may have played a role in the
      mesangial trapping of IgA immunocomplexes.

PMID- 1614701
TI  - [Treatment of cholelithiasis. Professional recommendation--1992].

PMID- 1614702
TI  - [Jozsef Szentgyorgyi (1765-1832].

PMID- 1614703
TI  - [Jeno Jendrassik and the beginning of experimental physiology in Hungary].

PMID- 1614704
TI  - [Cosmetic aspects of dentistry at the beginning of the 19th century].

PMID- 1614706
TI  - [Comment on the article discussing the system of family medicine and laboratory
      diagnosis, by Maria Nemeth, published in Orvosi Hetilap vol.135, p. 575].

PMID- 1614705
TI  - [Waldenstrom's macroglobulinemia?].

PMID- 1614708
TI  - Painting with too broad a brush?

PMID- 1614707
TI  - [Parasystole?].

PMID- 1614709
TI  - Understanding advance directives and amendments to guardianship law.
AB  - In April, Pennsylvania became one of the last states in the country to
      statutorily recognize living wills. In addition, Pennsylvania guardianship
      statutes have been amended. This article describes those changes and informs
      physicians of their responsibilities when patients have executed living wills or
      when guardians have been appointed by the courts.

PMID- 1614710
TI  - Plans proceed to publish physician-specific data.
AB  - Physicians should be aware that the release of physician-specific information by
      the Pennsylvania Health Care Cost Containment Council (PHC4) may have a
      significant impact on decisions made by patients or potential patients. This
      article, which outlines PHC4's proposed Research Plan about coronary artery
      bypass graft (CABG) surgery and related issues, is a follow-up to "First Report
      Card for Physicians Due This Summer" [Pennsylvania Medicine, May 1992]

PMID- 1614711
TI  - Health views from the Senate: Part Two. Interview by Maria T. Montesano.

PMID- 1614712
TI  - An update on Lyme disease in Pennsylvania.

PMID- 1614713
TI  - How does KePRO compare?

PMID- 1614714
TI  - Dealing with stress in the physician's marriage.
AB  - Practicing medicine in the 1990s brings a high-stress lifestyle, and no one knows
      that better than the spouse of a physician. While television and cinema have
      portrayed the medical family as an all-American ideal, the reality can be very
      different.

PMID- 1614715
TI  - Motivating employees to be team players. The Health Care Group.

PMID- 1614716
TI  - New antibiotics for skin and skin structure infections.

PMID- 1614717
TI  - Pedicle screw fixation in the management of unstable thoracolumbar spine
      injuries.
AB  - Pedicle screw fixation provides rigid segmental stabilization of the
      thoracolumbar spine. A wide range of conditions that can cause instability of the
      thoracolumbar spine can be treated using this technique. The increasing
      popularity of pedicle screw fixation has resulted in new knowledge concerning
      pedicle anatomy and the biomechanics of this method of fixation. The preliminary
      results have clarified both the indications and the limitations of this
      procedure. Successful results using pedicle screws require prudent patient
      selection, thorough preoperative preparation, and a high level of surgical
      expertise.

PMID- 1614718
TI  - Basic principles and clinical uses of screws and bolts.
AB  - The orthopaedic surgeon uses screws for interfragmentary fixation, fastening soft
      tissue to bone, or holding plates or nails to bone. The most common function of
      screws is to fix bone to bone. This article reviews the design parameters and
      types of screws used in orthopaedic surgery.

PMID- 1614719
TI  - Review of treatment results for Kienbock's disease.
AB  - A review of the literature reveals that Kienbock's disease has been treated in
      many different ways. Excision of the lunate, with or without replacement
      arthroplasty, and joint-leveling procedures (radial shortening or ulnar
      lengthening) are the most popular procedures, but other methods of treatment
      (nonoperative, wrist denervation, lunate revascularization, intercarpal
      arthrodesis and proximal-row carpectomy) have also been performed. Based on our
      current understanding of the etiology, a joint-leveling procedure seems to make
      the most sense when surgery is indicated. However, other procedures have yielded
      a high success rate as well.

PMID- 1614720
TI  - The effects of fibular and talar displacement on joint contact areas about the
      ankle.
AB  - The purpose of this study was to advance prior techniques and studies regarding
      the effects of fibular and talar displacement of contact areas of the tibio-talar
      joint. Type IV supination external rotation injuries were experimentally created
      on five fresh cadaveric specimens. Tibio-talar contact and peak pressures were
      measured using Fuji pressure-sensitive film with the talus in a neutral position
      and then displaced 1, 3, 4, 5, and 8 mm laterally as well as a repeat measurement
      following reduction and plate fixation. Results demonstrated a 50% reduction in
      contact area with only 1 mm of talar displacement along with a linear increase in
      average peak pressures. Reapproximation of the fibular osteotomy with a plate and
      rereduction of the talus allowed for return to normal pretesting contact areas.
      This study confirms prior studies demonstrating the significance of 1 mm of talar
      displacement in regards to marked reduction in contact area of the tibio-talar
      joints. In addition, restoration of the normal anatomy and fixation of the
      osteotomy allows for return of normal contact areas.

PMID- 1614721
TI  - Gait analysis in pediatric lower extremity amputees.
AB  - Walking function in 56 children with lower extremity amputations was assessed
      using a questionnaire and gait analysis. Children with prosthetic lower
      extremities can be very functional in society, often participating in sports.
      Limitations are proportional to the extent of the missing limbs. As a group,
      pediatric amputees walk more slowly than their normal peers with a slower cadence
      and a longer stride length. Pediatric amputees have higher heart rates when
      walking than normal children, but they seem willing to pay a higher physiologic
      price for ambulation.

PMID- 1614722
TI  - Lower spinal mobility and external immobilization in the normal and pathologic
      condition.
AB  - The study presented here used lateral flexion and extension roentgenograms to
      determine lumbosacral motion in healthy persons and in patients with
      spondylolisthesis. The lumbosacral corset, Jewett extension brace, and plastic
      thoracolumbosacral orthosis (TLSO) were then placed and repeat roentgenograms
      were done to see if effective immobilization could be obtained. Although
      individual variation existed, there appeared to be no significant difference in
      lower lumbar motion between the two groups studied, and the orthotics acted in a
      similar fashion on both the volunteers and the patients. The lumbosacral corset
      was unable to immobilize the L3-S1 levels. There was a statistically significant
      decrease in the average lateral disk space motion at L3-4 and L4-5 with the use
      of the Jewett brace and the TLSO (P less than .01); however, the motion was never
      completely eliminated. No brace could adequately immobilize the L5-S1 level, and
      some people demonstrated increased motion at this level while wearing the
      orthotics.

PMID- 1614723
TI  - Superficial temporal artery laceration. A complication of skull tong traction.
AB  - Complications associated with the use of skull tongs are not uncommon. We report
      a case of superficial temporal artery injury as a complication of Gardner-Wells
      tong application. Chronic recurrent episodes of pulsatile bleeding from the pin
      site necessitated arterial ligation to control the bleeding.

PMID- 1614724
TI  - Imaging rounds. Bilateral condensing osteitis of the clavicles.
AB  - The following case illustrates the roentgenographic and clinical findings of a
      condition of interest to the orthopaedic surgeon. The initial history, physical
      findings, and roentgenographic examinations are found on the first two pages. The
      following pages present the final clinical and roentgenographic differential
      diagnosis.

PMID- 1614725
TI  - A method for removal of broken vertebral screws.
AB  - A method for removal of a broken vertebral screw is described using an easily
      obtained 5/64-inch tungsten drill bit and a #1 screw extractor. It allows removal
      of the screw while retaining pedicle integrity and also minimizes potential nerve
      root compromise.

PMID- 1614726
TI  - Inserting distal screws into interlocking IM nails.
AB  - The use of interlocking IM nails is commonplace in major trauma centers.
      Currently, an accurate guide for inserting the distal screws is not available.
      Most centers use the "free-hand" technique. Every surgeon must be familiar with
      this method to insert the screws. We describe our protocol for inserting the
      distal screws into interlocking IM nails.

PMID- 1614727
TI  - Drill sleeve for pedicle screw fixation.
AB  - Pedicle screw fixation is a popular method of fixation of the spine. Placement of
      screw and prevention of injury are surgeon dependent. We describe an easily made
      drill sleeve and depth gauge to assist in the preparation of the vertebral
      pedicle for pedicle screw application. Use of this device will help prevent soft
      tissue injury and overpenetration of the drill in the vertebral body.

PMID- 1614729
TI  - The laboratory maintenance of Sanguinicola inermis Plehn, 1905 (Digenea:
      Sanguinicolidae).
AB  - Methodology is described for the laboratory maintenance of the life-cycle of
      Sanguinicola inermis, using common carp (Cyprinus carpio) as the definitive host
      and Lymnaea peregra as the intermediate host. Lymnaea auricularia was also
      infected but is not considered to be a suitable laboratory host. Tench (Tinca
      tinca) were susceptible to infection at high cercarial doses but subsequent
      infection rates were low. Goldfish (Carassius auratus) and Lymnaea stagnalis were
      refractory to laboratory infection.

PMID- 1614728
TI  - Identification and characterization of two repetitive non-variable antigens from
      African trypanosomes which are recognized early during infection.
AB  - The present paper describes two repetitive proteins representing common antigens
      of African trypanosomes which are non-variant and which are recognized early in
      infection by the host immune system. These antigens were identified by their
      ability to immunoreact with bovine serum taken during the early phase of a cyclic
      trypanosomal infection. Screening of a cDNA library from T. b. gambiense with
      such early infection serum identified a protein which contains a repetitive motif
      consisting of 68 amino acid repeat units (GM6). Immunofluorescence and immunogold
      electron microscopy revealed that GM6 is located on fibres which connect the
      microtubules of the membrane skeleton with the flagellum. A second repetitive
      antigen detected by this serum is MARP1 (microtubule-associated repetitive
      protein 1), a protein previously characterized in this laboratory as a high
      molecular weight component of the membrane skeleton, which consists of more than
      50 tandemly repeated, near-identical 38 amino acid repeat units. Beta
      galactosidase fusion products of both proteins demonstrated a strong
      immunoreactivity with sera from T. b. brucei and T. congolense-infected cattle.
      The result from this preliminary immunological evaluation indicates a high
      immunodiagnostic sensitivity (90%) of the two recombinant antigens which make
      them interesting candidates for immunodiagnosis of trypanosomiasis in cattle.

PMID- 1614730
TI  - Developmental changes of Echinococcus multilocularis metacestodes revealed by
      tegumental ultrastructure and lectin-binding sites.
AB  - Ultrastructural investigations (SEM, TEM) combined with lectin-binding analysis,
      have revealed concurrent modifications in tegumentary structure and surface
      glycoconjugates during the establishment and differentiation of Echinococcus
      multilocularis metacestodes in jirds. The laminated layer, which is amorphous and
      rich in polysaccharides when initially secreted by the young cyst, takes on a
      different appearance and has a different glycoconjugate composition according to
      whether the cyst becomes fertile or sterile. The laminated layer of fertile cysts
      transforms into a microfibrillar matrix, the protein content of which may
      increase while sugar content decreases during protoscolex differentiation.
      Independently of this structure, brood capsules, from which arise protoscoleces,
      are formed by invagination of the cyst tegument. The intense secretion of
      glycoconjugates from the brood capsule wall during invagination may serve to
      interact with host factors passing through the laminated layer. The combined use
      of ultrastructural study and lectin labelling has allowed the demonstration of an
      ultrastructural and biochemical gradient of differentiation of the protoscolex.
      Seven stages of differentiation have been described. The possibility that the
      excreted-secreted tegumentary glycoconjugates, revealed by lectin labelling
      during protoscolex differentiation, might be the gradual biochemical expression
      of one or several stimuli implicated in the phenomenon of protoscolex maturation,
      is discussed.

PMID- 1614731
TI  - Immunoepidemiology of Ascaris lumbricoides: relationships between antibody
      specificities, exposure and infection in a human community.
AB  - The serum antibody responses of 124 people naturally exposed to Ascaris
      lumbricoides infection were analysed by immunoprecipitation of radio-isotope
      labelled 3rd- and 4th-stage larval Ascaris suum excretory and secretory antigens
      (L3/4 ES). Profiles of antigens recognized were visualized by polyacrylamide gel
      electrophoresis (SDS-PAGE), and the band intensities of the 12 major precipitated
      antigens were individually scored. Most subjects were seropositive, but
      considerable variation was observed in the amount of total and individual ES
      antigens precipitated. The sex- and age-related profiles of antibody levels
      followed similar patterns to those of egg output. In addition, total antibody
      scores of individuals were closely correlated (r = 0.47-0.52) with their eggs per
      gram of faeces (e.p.g.) collected 4 months after blood samples were taken. These
      findings suggest that antibody levels against larval ES antigens reflect recent
      exposure and are consistent with the hypothesis that establishment of adult worms
      is proportional to the number of larvae that recently migrated through the lung.

PMID- 1614732
TI  - Segregation and co-occurrence of larval cestodes in freshwater fishes in the
      Bothnian Bay, Finland.
AB  - Two autogenic (Triaenophorus crassus and T. nodulosus) and four allogenic
      (Diphyllobothrium latum, D. dendriticum, D. ditremum and Schistocephalus solidus)
      larval cestode species were found in 13 out of 31 fish species studied from the
      Bothnian Bay, NE Baltic. Gasterosteus aculeatus was the most heavily infected
      fish with 4 larval cestode species; for two of them (D. ditremum and S. solidus)
      the three-spined stickleback was found to be the required fish intermediate host.
      Among allogenic cestode species, those restricted to different definitive host
      species segregated their larval population in relation to the fish host, while,
      for example, D. ditremum and S. solidus, both maturing in fish-eating birds, had
      the highest percentage of co-occurrences. D. dendriticum, which had the widest
      range of definitive hosts, was found in the greatest number (8) of fish species
      and co-occurred with all other species found except T. crassus. The two autogenic
      species totally segregated their larval population from each other although they
      both require pike as definitive host. The ecological and evolutionary
      relationships behind the patterns found for larval cestodes are discussed.

PMID- 1614733
TI  - Sequential development of the immune response in rainbow trout [Oncorhynchus
      mykiss (Walbaum, 1792)] to experimental plerocercoid infections of
      Diphyllobothrium dendriticum (Nitzsch, 1824).
AB  - Development of the inflammatory response of rainbow trout to experimental
      infections with Diphyllobothrium dendriticum plerocercoids is described using
      light and electron microscopy. The cellular response to plerocercoids occurred
      within 2 weeks post-infection (p.i.). This was followed by an increase in
      leucocyte numbers during weeks 3-6 p.i., with full encapsulation of plerocercoids
      by week 6 p.i. Neutrophils were the first leucocytes to engage the developing
      plerocercoid, followed by large influxes of macrophages which transformed into
      epithelioid cells. With longer times p.i. the accumulation of different leucocyte
      types increased, and a blood vascular network developed. Full development of the
      composite cyst was characterized by fibroplasia, particularly at the periphery of
      the cyst, and the subsequent deposition of a collagenous tissue matrix. Enzyme
      linked immunosorbent assay (ELISA) examination of serum samples taken over the 20
      week period showed that specific anti-D. dendriticum antibody titres were first
      detected at 5 weeks p.i. and increased to a maximum by 11 weeks p.i.

PMID- 1614734
TI  - Experimental population dynamics of Rhabdias bufonis (Nematoda) in toads (Bufo
      bufo): density-dependence in the primary infection.
AB  - Density-dependence in worm establishment, numbers, biomass and larval production
      were examined in primary infections of 0, 10, 40, 80 and 160 larvae of the lung
      nematode, Rhabdias bufonis in the common toad, Bufo bufo. The infection procedure
      established 4 non-overlapping levels of infection which persisted until 6 weeks
      post-infection (p.i.), after which there was an overall decline up to 12 weeks
      p.i. Worm numbers had no direct effect on adult worm survival but temporal
      changes in worm weight were density-dependent. Adult worm establishment in the
      lungs declined significantly as the numbers of worms in the lungs increased. At
      the lowest exposure dose, 86% of the larvae administered reached maturity in the
      lungs while at the highest, only 37% did so. Also, the numbers of immature larvae
      outside the lungs increased as adult worm numbers increased. Both features
      provide evidence for a threshold limit to the numbers of worms maturing in the
      lungs. Worm numbers also affected larval output per host and per capita
      fecundity. A significant positive relationship between per capita fecundity and
      per capita worm weight suggested that density-dependence acted primarily to
      constrain the growth of individual worms. Finally, the constraints imposed on
      worm growth and fecundity were apparently relaxed when worm density decreased,
      providing evidence for density-dependent flexibility in per capita fecundity.
      Density-dependence in worm establishment and per capita fecundity are mechanisms
      which may potentially regulate this host-parasite interaction in the field. Both
      mechanisms may be functionally related to physical space limitations in the
      lungs, within which worms must compete for finite nutrients.

PMID- 1614735
TI  - Species richness in helminth communities: the importance of multiple congeners.
AB  - Using data sets derived from published literature, the contribution of congeneric
      species to helminth component community richness is evaluated. Consideration of
      the frequency distribution of congeners in relation to host and parasite groups
      reveals that the distributions are unimodal, that singletons are the commonest
      class and that the frequency of occurrence of congeners decreases with increasing
      number of species per genus. Congeners may be found in any group of hosts or
      parasites, but are more common amongst cestodes of aquatic birds. Two patterns of
      occurrence of congeneric species are recognized: one in which from a few to
      multiple congeners are found within a single helminth genus, exemplified by
      dactylogyrid monogeneans and cloacinid nematodes, and the other in which there is
      a simultaneous occurrence of congenerics and confamilials such that there are
      several genera involved, but each represented by fewer species, exemplified by
      strongyles in horses. The question of whether these patterns can be considered
      examples of species flocks is discussed. We conclude that multiple congeners and
      species flocks are interesting phenomena but, except in isolated cases, they make
      insignificant contributions to community richness.

PMID- 1614736
TI  - Studies on a murine model of congenital toxoplasmosis: vertical disease
      transmission only occurs in BALB/c mice infected for the first time during
      pregnancy.
AB  - The incidence of congenital toxoplasmosis was determined by an ELISA in the
      litters of BALB/c mice which had been infected 8 weeks before mating, on day 12
      of pregnancy, or on both these occasions. Of those mice given the infection for
      the first time on day 12 of pregnancy, 5 out of 6 gave birth to infected litters
      with approximately 50% of the individuals in each litter being infected. BALB/c
      mice which had been infected 8 weeks before mating did not give birth to infected
      litters, even if they were reinfected on day 12 of pregnancy. Following infection
      BALB/c mice were found to harbour significantly fewer tissue cysts than the
      congenic H-2 derivative BALB/K strain. However, chronically infected BALB/K mice
      also failed to produce infected litters, indicating that tissue cyst burden in
      the dam did not influence congenital infection at least on the BALB background.
      This study demonstrates that BALB/c dams chronically infected with Toxoplasma
      gondii, have immunity capable of protecting their embryos from congenital
      infection, even if the dams are reinfected during pregnancy. Our results
      demonstrate that the BALB/c mouse can be used as a model of human or ovine
      congenital T. gondii infection suitable for testing putative vaccines.

PMID- 1614737
TI  - A monoclonal-based IgM capture ELISA for detection of antibodies to 22 and 41 kDa
      membrane antigens of Toxoplasma gondii.
AB  - A murine monoclonal antibody which reacts to 22 and 41 kDa Toxoplasma gondii
      surface antigens was employed in an IgM capture enzyme-linked immunosorbent assay
      (ELISA). A total of 125 patients' sera were tested in the monoclonal-based assay.
      When compared with a commercial ELISA test (Abbott Toxo-M EIA) which uses
      polyclonal anti-T. gondii antibodies, good correlation (Pearsons coefficient r =
      0.91) was observed. The specificity of the assay was studied by testing a panel
      of control sera obtained from healthy individuals and blood transfusion donors;
      all sera gave negative results. Serum samples positive for T. gondii antibodies
      were treated with 2-mercaptoethanol (2-ME) to demonstrate the specificity of the
      test for IgM antibodies. Reactivity of these sera was lost after the treatment.
      The test is not subject to interference by rheumatoid factor as sera positive for
      rheumatoid factor were negative in the assay. Reproducibility was good with the
      coefficients of variation for within-day tests below 10% and not exceeding 18%
      for day-to-day tests. The monoclonal-based assay is simple to perform and appears
      to be a viable test for diagnosis of T. gondii infection.

PMID- 1614738
TI  - Modulation of the activity of the internal defence system of the pond snail
      Lymnaea stagnalis by the avian schistosome Trichobilharzia ocellata.
AB  - Effects of infection with the avian schistosome Trichobilharzia ocellata on the
      activity of the internal defence system of the intermediate snail host Lymnaea
      stagnalis were studied, utilizing an in vitro phagocytosis assay for determining
      haemocyte activity. A distinction was made between plasma- and cell-associated
      effects. The period immediately after penetration of the parasite into the snail
      host (1.5-72 h post-exposure (p.e.)) was extensively studied. In addition,
      several time-points coinciding with the later-successive-stages of parasite
      development (2, 4, 6, 8 and 10 weeks p.e.) were investigated. Plasma-associated
      enhancement of defence activity was found between 1.5 and 6 h p.e., followed by
      plasma-associated suppression between 12 and 72 h p.e. A cell-associated
      activation was found between 1.5 and 6 h p.e. and also at 8 and 10 weeks p.e. How
      these effects on the defence system may be related to phenomena observed in
      infected snails at these time-points is discussed.

PMID- 1614739
TI  - The in vitro transformation of the miracidium to the mother sporocyst of
      Schistosoma margrebowiei; changes in the parasite surface and implications for
      interactions with snail plasma factors.
AB  - The in vitro transformation of the miracidium to the mother sporocyst of
      Schistosoma margrebowiei was initiated by placing the miracidium in mammalian
      physiological saline. The transformation occurs in stages: the cilia cease
      beating; the ciliated plates become detached from the intercellular ridges and
      underlying muscle layers; the intercellular ridges spread over the body surface
      eventually forming a new tegument; the sporocyst changes from an ovoid to a
      tubular shape in about 48 h at room temperature. The surfaces of the miracidium,
      sporocyst and cercaria of S. margrebowiei display stage-specific carbohydrates on
      their surfaces as indicated by lectin staining. Ricin120 stains the cilia alone
      of the miracidium whereas peanut agglutinin stains the larval surface except for
      the cilia. The intercellular ridges of the miracidium stain with concanavalin A
      and wheat germ agglutinin, and these lectins stain the entire surface of the
      mature mother sporocyst. The cercaria is the only larval stage which stains
      positively with asparagus pea lectin. Bulinus nasutus is incompatible with
      Schistosoma margrebowiei; the haemolymph of this snail contains an agglutinin
      which agglutinates a wide variety of mammalian erythrocytes including those of
      human ABO blood groups. The haemagglutinin titre of B. nasutus plasma is reduced
      after incubation with miracidia of S. margrebowiei indicating that the agglutinin
      is absorbed onto the surface of this larval stage but not that of the mother
      sporocyst or cercaria. The possible roles of agglutinins in host-parasite
      interactions together with the significance of the differences in the surface
      carbohydrates of the larval stages are discussed.

PMID- 1614740
TI  - Relocation of Schistosoma mansoni in the lungs and resistance to reinfection in
      Rattus rattus.
AB  - The localization of adult Schistosoma mansoni originating from Guadeloupe (West
      Indies) was analysed in the natural host Rattus rattus in experimental and
      natural infections. A transfer of schistosomes from the porto-mesenteric system
      to the lungs occurs between the 4th and the 20th weeks post-infection, with a
      peak between 4 and 8 weeks; it should be noted that the worms start laying eggs
      at 4 weeks post-infection. In both experimentally and naturally infected R.
      rattus the relocation of schistosomes in the lungs is correlated with the total
      worm burden. Between 6 and 12 weeks post-infection some adult worms and numerous
      eggs are trapped in the liver. A high mortality in the worm population coincides
      with the migration of the parasites from the porto-mesenteric veins to the lungs.
      In re-infected R. rattus a relationship appears between the presence of
      schistosomes in the lungs and resistance to reinfection. It is concluded that, as
      already postulated previously in mice, resistance to re-infection in the natural
      host R. rattus is at least partly correlated with the hepatic pathology caused by
      the schistosomes of the primary infection.

PMID- 1614741
TI  - Praziquantel: physiological evidence for its site(s) of action in magnesium
      paralysed Schistosoma mansoni.
AB  - The mechanism whereby praziquantel produces a contraction and subsequent flaccid
      paralysis (a loss of sensitivity to subsequent stimuli) of Schistosoma mansoni in
      a medium containing an elevated Mg2+:Ca2+ ratio was investigated. In RPMI,
      praziquantel produced a concentration-dependent tonic contraction of the parasite
      with an EC50 of 200 nM. Magnesium inhibited the contraction in such a manner as
      to convert the tonic contraction to a phasic one without altering the peak force
      generated. The Mg(2+)-dependent block was non-competitive with praziquantel but
      was competitive with extracellular Ca2+, ratios of 7.5:1;Mg2+:Ca2+ being needed
      to inhibit the tonic contraction and to induce flaccid paralysis. Flaccid
      paralysis was associated with a reduced ability of the parasite to take up 45Ca2+
      from the bath compared to parasites that had not entered into flaccid paralysis
      and flaccid paralysis was reversible. Recovery from flaccid paralysis was
      accelerated by treatments that are expected to increase Ca2+ uptake by the
      parasite. At a concentration of 500 nM, praziquantel produced 2 distinct phasic
      contractions in intact parasites incubated in an elevated [Mg2+] medium but only
      1 phasic contraction in parasites lacking their surface tegumental membranes. In
      zero Ca2+ I-RPMI, 10 microM praziquantel produced a phasic contraction of intact
      parasites but did not stimulate contraction of detegumented parasites until Ca2+
      was reintroduced into the bath. These results indicate that praziquantel
      interacts with specific Ca(2+)-permeable sites in the tegumental and sarcoplasmic
      membranes of the parasite and that under these conditions of elevated Mg2+:Ca2+
      ratios, these sites become blocked by Mg2+, leading to flaccid paralysis of the
      parasite.

PMID- 1614742
TI  - Numerical taxonomy of Trypanozoon based on polymorphisms in a reduced range of
      enzymes.
AB  - Numerical analyses of Trypanozoon taxonomy are presented, based on the isoenzyme
      data of Stevens et al. (1992). The previous study used a reduced range of enzymes
      compared with earlier work; the analyses indicate the value of this rationalized
      system. Both recently isolated trypanosome stocks and previously studied
      populations were included, allowing detailed comparison with earlier studies.
      Relationships between zymodemes were calculated with an improved similarity
      coefficient program, using Jaccard's coefficient (1908), and by Nei's method
      (1972). Dendrograms were constructed from the matrices produced with the group
      average method. The groupings produced by both numerical methods were in close
      agreement, and the clusters of related principal zymodemes largely matched the
      species, subspecies and strain groups proposed by previous workers. Trypanozoon
      biochemical taxonomy is reviewed and the groupings reinforced by this study are:
      the mainly East African strain groups, busoga, zambezi, kakumbi, kiboko and
      sindo; T.b. gambiense and the bouafle strain group from West Africa, and T.
      evansi; an intermediate bouafle/busoga group was also recognized.

PMID- 1614743
TI  - Trypanosoma cruzi glutathione-binding proteins: immunogenicity during human and
      experimental Chagas' disease.
AB  - Following purification by affinity chromatography, three glutathione-binding
      proteins (TcGBP) of 45, 30, and 25 kDa were co-purified from Trypanosoma cruzi
      epimastigotes. Using 1-chloro-2,4 dinitrobenzene as substrate, a glutathione S
      transferase activity of 70 nmol/min/mg of proteins was detected in the GSH
      binding fraction. An increased expression of TcGBP and total GST activity was
      observed upon incubation of parasites with phenobarbital, which is an inducer of
      GST synthesis. Immunofluorescence and electron microscopic experiments
      demonstrated that TcGBP were expressed by all developmental stages of the
      parasite, including infective forms. The expression of these proteins by
      intracellular dividing amastigotes could be in favour of a potential defensive
      role of these molecules against host attack. Results obtained by
      immunoprecipitation of in vitro translation products using anti-TcGBP antisera
      suggested that these three polypeptides are not glycosylated. In addition,
      antibodies directed against the TcGBP were found in a high proportion of T. cruzi
      infected chronic chagasic patients' sera and in sera of chronically infected
      BALB/c mice. In contrast, acute chagasic patients' sera and acute-phase mouse
      sera were found to be poorly reactive with these proteins. Our results identify a
      new class of potential target antigens, which may be essential for the
      development of T. cruzi in its host. Their protective role in experimental models
      deserves to be investigated.

PMID- 1614744
TI  - Genetic variation in Trypanosoma brucei and the epidemiology of sleeping sickness
      in the Lambwe Valley, Kenya.
AB  - A contingency table approach was used to explore the influence of location, host
      species and time on the genetic composition of a Trypanosoma brucei population in
      Lambwe Valley, Kenya. Significant differences in zymodeme frequencies were
      noticed over comparatively short geographical distances suggesting that
      transmission of T. brucei is somewhat localized. A significant association was
      observed between zymodeme and the mammalian host from which T. brucei was
      derived. The association was consistent in different localities in Lambwe valley
      and remained stable for at least 32 months. These observations indicate that
      zymodemes are adapted to different host species and that genetic exchange has not
      disrupted host associations over this time-scale. A major change in the
      composition of the T. brucei population during a sleeping sickness outbreak in
      1980 was confirmed. But while new zymodemes emerged, a decline in overall
      diversity was noted during times of high sleeping sickness incidence. The results
      can be explained by selection of T. brucei zymodemes for particular transmission
      cycles. Although it is not necessary to invoke genetic exchange, sex may help T.
      brucei to adapt to changes in selection pressures. Such a hypothesis helps to
      explain why T. brucei appears largely clonal in the short term, even though
      population studies indicate that sex is responsible for much genetic diversity in
      the long term. It also explains why neighbouring populations of T. brucei are
      composed of a different range of zymodemes formed from the same alleles. Such a
      view implies that genetic exchange has an important role in the microevolution of
      T. brucei populations.

PMID- 1614746
TI  - Respiratory mechanics in mechanically ventilated newborns: a comparison between
      passive inflation and occlusion methods.
AB  - A passive inflation method was described for measuring total respiratory
      elastance and resistance during mechanical ventilation in adult patients (Rossi
      et al., J Appl Physiol 58:1849, 1985). We applied this method to preterm and full
      term mechanically ventilated newborn infants and we compared the results with
      those obtained by the occlusion method. We performed 37 tests in 16 newborn
      infants (B.W. 880-4,500 g; G.A. 28-42 weeks), between 1 and 45 days of postnatal
      age, ventilated with a Servo Ventilator 900C, set in controlled-volume mode. Flow
      was measured through a pneumotachograph inserted between the endotracheal tube
      (ETT) and the breathing circuit, tidal volume by integration of flow and airway
      pressure directly at the airway opening. Flow, volume, and pressure were recorded
      on an X/Y plotter to obtain pressure-volume (P/V), flow-volume (V/V) loops, and
      pressure-time curves. Occlusion was performed by using the end-inspiratory and
      the end-expiratory pause buttons of the ventilator. Analysis of P/V and V/V loops
      provided respiratory system compliance (Crs, infl.), resistance (Rrs, infl.), and
      "intrinsic positive end-expiratory pressure" (PEEPi, infl.). These values were
      compared with Crs, occl., Rrs, occl., and PEEPi, occl. measured by the occlusion
      method. The measurements were well correlated (Crs, infl./Crs, occl.: r = 0.90;
      Rrs, infl./Rrs, occl.: r = 0.91; PEEPi, infl./PEEPi, occl.: r = 0.91). Rrs,
      infl./Rrs, occl. and PEEPi, infl./PEEPi, occl. did not differ significantly.
      However, Crs, occl. was 15% higher than Crs, infl. (P less than 0.01). The
      passive inflation method is simple to use and well tolerated in preterm and full
      term ventilated newborn infants, it provides accurate results, and can be a good
      alternative to occlusion methods. It requires, however, a constant inflation flow
      and adaptation to the ventilator.

PMID- 1614745
TI  - Is there room for another pediatric bronchoscope?

PMID- 1614747
TI  - Changes in the CA 19-9 antigen and Lewis blood group with pulmonary disease
      severity in cystic fibrosis.
AB  - The altered carbohydrate structure of sputum from patients with cystic fibrosis
      (CF) has been thought to be due to the inflammatory airway response.
      Carcinoembryonic antigen (CEA) and CA 19-9 detect sialosylated carbohydrates in
      mucus. The epitope of CA 19-9 is part of the Lewis A (Le(a)) blood group antigen.
      Serum concentrations of CEA and CA 19-9 were determined by radioimmunoassay in 41
      CF patients, aged 6-34 years; 16 were asymptomatic Outpatients, and 25 had been
      admitted for pulmonary exacerbations. There was no difference in CEA between
      groups. The CA 19-9 serum concentration was elevated in 90% of patients who had
      at least one of the two Lewis antigens. The CA 19-9 concentration of Inpatients
      with exacerbations was 2.7 times that of stable Outpatients (263 +/- 44 versus 99
      +/- 13 U/mL; P less than 0.02). CA 19-9 correlated significantly with age (r =
      0.35, P less than 0.05), Brasfield score (r = 0.39, P less than 0.015), pulmonary
      function tests, cough severity (r = 0.50, P less than 0.001) and NIH clinical
      score (r = 0.57, P less than 0.001). CA 19-9 concentration of Inpatients
      decreased by 44% from admission to discharge (302 +/- 45 to 169 +/- 39, P less
      than 0.02). Fourteen of 25 (56%) of the Inpatients were Le(a) positive versus
      only 3/15 (20%) of Outpatients who had milder lung disease (P less than 0.002).
      Of the Inpatients, 25% with more advanced lung disease were Le(a+b+), a rare
      blood group in the normal population, and one not observed in the Outpatients
      with milder disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614748
TI  - Effect of posture on regional ventilation in children.
AB  - Little information has been published concerning the pattern of regional
      ventilation in children, yet many differences in lung and chest wall mechanics in
      childhood, supported by clinical observation, have led to the hypothesis that the
      pattern of regional ventilation seen in children may not be the same as in
      adults. Forty-three children and 16 adult volunteers underwent Krypton (Kr) 81m
      radionuclide ventilation lung scans in the supine and right and left decubitus
      postures. In children aged 2-10 years mean fractional ventilation to the right
      lung (VfR) was 46.1%. This fell to 36% when dependent and rose to 56.1% in the
      uppermost position. Redistribution of ventilation away from the dependent towards
      the uppermost lung was seen in all children. In children aged 10-18 years VfR was
      57.2% (supine), 48.0% (dependent), and 62.9% (uppermost). An identical pattern
      was seen in children with normal or abnormal pulmonary function tests (peak
      expiratory flow rate, and FEV1: FVC ratio). In subjects over 18 years of age a
      different pattern was seen: mean VfR was 52.4% (supine), rising to 53.4%
      (dependent), and falling to 48.9% (uppermost). Postural redistribution of
      ventilation, as assessed by Kr81m ventilation imaging, changes late in the second
      decade of life. This will have clinical consequences in the management of
      children with unilateral lung disease.

PMID- 1614749
TI  - New peripherally inserted midline catheter: a better alternative for intravenous
      antibiotic therapy in patients with cystic fibrosis.
AB  - A study was performed on outpatients with cystic fibrosis (CF) to evaluate the
      performance of an over-the-needle peripherally inserted midline catheter for the
      delivery of 2-week courses of antibiotic therapy. The midline is a 7-inch
      catheter inserted in the antecubital region with the tip located in the axillary
      region. It is made of a newly developed biomaterial that softens and expands upon
      contact with body fluids. The hypotheses for the study were that the midline
      catheter: 1) is useful for intermediate-length therapies; 2) can prevent multiple
      3-day conventional peripheral catheter restarts; 3) can prevent or delay the use
      of more invasive central devices; 4) is comfortable for patients; and 5) is
      economical. A total of 41 midlines were inserted in 27 patients with an average
      age and weight of 22 years and 109 pounds, respectively. Prior to this study
      implanted ports and primarily conventional short peripheral catheters were used
      to administer I.V. therapy to these patients; fifty percent of these short
      peripheral catheters failed within 2.6 days. At 2 weeks of dwell, 80% of the
      midline catheters placed in these patients were still indwelling. Also, 80% of
      all midline catheter removals were for non-catheter-related reasons. There were
      no cases of midline catheter phlebitis. In contrast, the phlebitis rates
      published for peripherally inserted central catheters (PICCs) and conventional
      short peripheral catheters at 7 days of dwell are 20% and greater than 51%
      respectively. The midline catheters were comfortable and well liked by most
      patients and became more economical than conventional peripheral catheters for
      therapies lasting approximately 6 days through 1 to 2 months.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1614750
TI  - Technique and use of transbronchial biopsy in children and adolescents.
AB  - Since July 1988, a total of 92 transbronchial biopsies (TBB) have been performed
      in 18 patients (aged 3-16 years). Twelve patients (67%) were heart-lung
      transplant (HLT) recipients undergoing surveillance for pulmonary graft rejection
      and infection. The remainder included immunocompromised patients at risk of
      opportunistic infections (n = 4), patients with fibrosing alveolitis (n = 1) and
      a collagen vascular disorder with suspected lung involvement (n = 1). TBB was
      performed through either a fiberoptic (n = 50) or a rigid (n = 41) bronchoscope,
      all under general anesthesia. On one occasion a cardiac bioptome was used through
      an endotracheal stent. The sensitivity of TBB for diagnosing acute and chronic
      rejection in HLT patients was 88% and 60%, respectively (specificity, 91% and
      100%). Definitive diagnoses were made in 4 (67%) of the non-HLT group.
      Bronchoalveolar lavage (BAL) was performed during each procedure for
      microbiological and cytological examination. Thirty-four pathogenic organisms
      including Pseudomonas aeruginosa (16/34), Staphylococcus aureus (8/34), and
      Candida albicans (5/34) were isolated from BAL culture. Complications included
      pneumothorax (8%), transient pyrexia (7%), and dyspnea (2%).

PMID- 1614751
TI  - Optimal electrode location for monitoring the ECG and breathing in neonates.
AB  - Continuous monitoring of breathing in infants is commonly performed using
      transthoracic impedance. This method employs skin surface electrodes measuring
      changes in electrical impedance and relates these changes to respiratory events.
      Typically, two electrodes on the infant's chest monitor both the ECG and
      breathing. We have attempted to identify separate electrode locations that give
      the best signal for breathing and ECG, and a single location that optimizes both
      of these signals. Thirty-seven infants were studied by placing 12 electrodes on
      the infant's chest and abdomen, and serially sampling pairwise combinations of
      electrodes. The optimal signal for breathing was obtained when electrodes spanned
      the diaphragm. Optimal ECG signal was seen with one electrode at the right mid
      clavicle and one at the xyphoid. Clinicians should be aware of these locations in
      order to provide the best signal available.

PMID- 1614752
TI  - Correcting for the Bernoulli effect in lateral pressure measurements.
AB  - Measurement of airway pressure is essential in the study of respiratory
      mechanics, and is usually done via a lateral tap in the conduit (e.g.,
      endotracheal tube, cannula, or mouthpiece) leading into the subject's airway.
      Such pressure measurements, however, may be severely affected by the Bernoulli
      effect if the diameter of the conduit is small and the gas flow through it
      sufficiently high. We present in this note a simple method of assessing whether
      or not the Bernoulli effect is important in any particular situation. The
      technique involves comparing the pressure-flow relationships of the conduit
      obtained both by blowing air through it from one end and sucking air in the
      reverse direction by applying negative pressure at the same end. If the
      resistance of the conduit is the same for gas flow in both directions, then half
      the magnitude of the difference between the two pressure-flow relationships gives
      the magnitude of the Bernoulli effect pressure. We give results of an
      experimental situation in which this was the case. We also show that those
      conditions under which the Bernoulli effect is likely to be a problem are also
      those under which the velocity profile is likely to be approximately flat,
      thereby permitting the magnitude of the Bernoulli effect to be easily calculated.

PMID- 1614754
TI  - Treatment of infants with acute diarrhea: what's recommended and what's
      practiced.
AB  - In 1985, the American Academy of Pediatrics (AAP) published a policy statement on
      the treatment of infants with acute diarrhea complicated by mild to moderate
      dehydration. To determine how closely physicians in the United States follow the
      AAP's treatment guidelines, a questionnaire was sent to 457 pediatricians and 360
      family practitioners. The questionnaire presented a hypothetical infant with
      acute diarrhea complicated by mild to moderate dehydration and included questions
      regarding the number of such patients seen yearly, length of time used to
      rehydrate the infant, and how formula or solids are introduced following
      rehydration. Complete responses were received from 53% of pediatricians and 40%
      of family practitioners. The number of patients with acute diarrhea seen per year
      did not affect physician's treatment. Pediatricians and family practitioners
      responded similarly to most questions. Contrary to the AAP's guidelines to
      rehydrate in 4 to 6 hours, 62% of responding physicians extend the rehydration
      period to 12 to 24 hours. Also contrary to the AAP's recommendations, 62% of
      pediatricians and family practitioners use a lactose-free formula. The majority
      of responding physicians do follow the AAP's treatment guidelines to initiate
      feedings with diluted formula. Significantly more pediatricians than family
      practitioners advance to a full-strength formula within 1 day (P = .011). Fewer
      than 50% of physicians polled started solids within 24 hours as suggested by the
      AAP. Overall, the findings suggest that very few pediatricians and family
      practitioners follow all aspects of the AAP's treatment guidelines for infants
      with acute diarrhea complicated by mild to moderate dehydration.

PMID- 1614753
TI  - Allergic alveolitis in a 12-year-old boy: treatment with budesonide nebulizing
      solution.
AB  - Allergic alveolitis due to bird antigens was diagnosed in a 12-year-old boy. He
      suffered from cough, dyspnea, easy fatigue, anorexia, and severe weight loss. The
      diagnosis was verified by a gradual improvement when he was removed from the
      birds, exacerbation upon re-exposure, and the demonstration of serum
      precipitating antibodies against bird antigens. The patient recovered completely
      after a short course of oral prednisolone, treatment with inhaled nebulized
      budesonide for 3 months, and removal of the birds from his home.

PMID- 1614755
TI  - Recurrent ovarian cysts in childhood: diagnosis of McCune-Albright syndrome by
      bone scan.

PMID- 1614756
TI  - Lichen striatus: simultaneous occurrence in siblings.

PMID- 1614757
TI  - Retained spur following a rooster attack.

PMID- 1614758
TI  - Systemic reaction to human growth hormone treated with acute desensitization.

PMID- 1614759
TI  - Bias and 'overcall' in interpreting chest radiographs in young febrile children.
AB  - Few studies have examined the diagnostic validity of the examination physician's
      interpretation of chest radiographs in young febrile children, and none (to our
      knowledge) the extent to which the "official" (ie, the radiologist's) reading may
      be biased by access to the examining physician's reading and to other clinical
      information. The authors studied 287 consecutive chest radiographs obtained in
      286 febrile children 3 to 24 months of age without chronic cardiopulmonary
      disease or known asthma who presented to a children's hospital emergency
      department between March 1989 and August 1990. The readings by treating
      pediatricians, official pediatric radiologists, and a "blind" pediatric
      radiologist were compared. Official radiologists had access to the treating
      pediatricians' readings and the clinical information provided on the radiography
      requisition. The blind radiologist knew only that each child was 3 to 24 months
      of age and febrile, and he was asked to judge the presence or absence of
      pneumonia. Using the blind radiologist's reading as the "gold standard" for
      judging validity of the treating physicians' and official radiologists' readings,
      sensitivity (.677 vs .647), specificity (.828 vs .849), positive predictive value
      (PPV, .537 vs .571), and kappa index (kappa, .462 vs .475) were quite similar. By
      contrast, agreement by the treating physicians was considerably higher with the
      official radiologists' readings as gold standard: sensitivity = .756, specificity
      = .922, PPV = .795, and kappa = .688. When the treating physician's reading was
      positive, the official radiologists' positivity rate was much higher than the
      blind radiologist's (74.4% vs 51.8%, P less than .005), sensitivity was high
      (.884) but specificity was low (.436), PPV was .663, and kappa was .326.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1614760
TI  - Causation of kwashiorkor: toward a multifactorial consensus.

PMID- 1614761
TI  - We have the solution: now what's the problem?

PMID- 1614762
TI  - Sudden infant death syndrome and sleeping position.

PMID- 1614763
TI  - American Academy of Pediatrics Committee on Infectious Disease: Acellular
      pertussis vaccines: recommendations for use as the fourth and fifth doses.

PMID- 1614764
TI  - American Academy of Pediatrics Committee on Children with Disabilities: American
      Association for Pediatric Ophthalmology and Strabismus, and American Academy of
      Ophthalmology: Learning disabilities, dyslexia, and vision.
AB  - Dyslexia and other related learning disabilities are serious problems. The
      American Academy of Pediatrics, through its Committee on Children with
      Disabilities and the Section on Ophthalmology, the American Academy of
      Ophthalmology, and the American Association for Pediatric Ophthalmology and
      Strabismus strongly support the need for early diagnosis and educational
      remediation. There is no known eye or visual cause for dyslexia and learning
      disabilities, and no effective visual treatment. Multidisciplinary evaluation and
      management must be based on proven procedures demonstrated by valid research.

PMID- 1614765
TI  - ECMO and sepsis.

PMID- 1614766
TI  - ECMO for infection.

PMID- 1614767
TI  - ECMO and sepsis. If differences could be due to chance alone, are trends worth
      discussing?

PMID- 1614768
TI  - Neonatal screening for dependents of active-duty military personnel.

PMID- 1614769
TI  - Would breast-feeding decrease risks of lead intoxication?

PMID- 1614770
TI  - The bilirubin debate.

PMID- 1614771
TI  - The crying of infants with colic: a controlled empirical description.
AB  - To obtain a controlled empirical description of some of the measurable clinical
      features of colic in a naturalistic context, 38 infants whose mothers considered
      crying a problem ("colic") and 38 pair-matched control infants were observed and
      videotaped at home 10 minutes before and after an evening feed. The parents kept
      a diary of infant behaviors (including crying and fussing) for 7 days following
      the visit. Following Wessel et al (Pediatrics. 1954;14:421-434), each "colic"
      infant was classified according to the number of days per week that crying and
      fussing duration was greater than 3 h/d. The distribution of infants with colic
      suggested that there were two subgroups: Wessel's colic infants, with 3 days or
      more per week of more than 3 hours of crying and fussing per day; and non
      Wessel's colic infants, with fewer such days. Maternal measures of total daily
      crying/fussing duration, crying/fussing bout length, and infant temperament and
      objective analyses of facial activity showed a consistent pattern of differences
      in which Wessel's colic infants differed from both non-Wessel's colic and control
      infants, who in turn did not differ from each other. Both colic groups differed
      from control infants only in the perception of postfeed cries as being more "sick
      sounding." The results imply that the complaint of colic represents two (or more)
      groups and that there may be meaningfully distinct colic syndromes. They also
      provide the first independent empirical support for Wessel and colleagues'
      clinical distinction between "fussy" and "contented" babies.

PMID- 1614772
TI  - Back transporting infants from neonatal intensive care units to community
      hospitals for recovery care: effect on total hospital charges.
AB  - Many neonates are referred to neonatal intensive care units (NICUs) for
      specialized care far from their parents' residence. This distance can add to the
      stress of the parents and reduce the contact of the parents with their newborn.
      Small studies have found that back transporting these neonates to hospitals
      closer to their homes is safe and cost-effective. Despite these findings, the
      reluctance of many insurers to pay for back transports prevents or delays many
      back transports. Insurers may not consider the findings of the previous studies
      to be conclusive, given that the comparisons were between small numbers of
      neonates back transported and neonates who remained in tertiary care, and the
      potential for differences in severity of illness between the groups is
      significant. In this study the effect on hospital charges of back transports was
      examined by comparing the charges for care in community hospitals with what these
      charges would have been in a tertiary care center. The advantage of this method
      is that it avoids case-mix differences between the groups and thus minimizes the
      potential for small-sample bias. Data were collected for all back transports from
      a NICU to non-tertiary care centers (n = 90) for a 9-month period. We were able
      to obtain the itemized bills for the care at community hospitals for 42 of these
      patients. Each bill was recalculated using the charges for the NICU to determine
      potential for savings. The average charges for recovery care were about $6200
      lower at the community hospital than they would have been at the NICU.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1614773
TI  - On-lap travel: still a problem in motor vehicles.
AB  - National observational studies indicate that infants who are not restrained in
      child safety seats (CSSs) in motor vehicles are usually riding on the lap of
      another occupant. This study was undertaken to determine the conditions under
      which children travel on-lap. The extent to which injuries would be reduced if
      these children were restrained in CSSs was also examined. Data were taken from a
      multihospital monitoring system for pediatric occupant injuries and from the
      coroner's office in a single urban county (1980 through 1989). One hundred ten
      children younger than 1 year of age evaluated in the monitored emergency
      departments after involvement in a crash had been traveling on-lap. On-lap travel
      did not appear to result from overcrowding. Eighty-eight percent were riding in
      vehicles with five or fewer occupants; 83% were in the front seat; 58% sustained
      injury; 22% of those evaluated were hospitalized; and 15% sustained intracranial
      injury. A 30% reduction in overall injury, a 75% reduction in hospitalization,
      and a 69% reduction in intracranial injury were projected for those riding on
      lap, had they been restrained in CSSs. Applying national rates of on-lap travel
      (16.8%) to National Highway Traffic Safety Administration estimates of the number
      of infants injured in crashes each year indicates that approximately 2218 of
      these children would be on the lap of another passenger. Substantial savings in
      terms of injury and associated costs can be realized if children traveling on-lap
      were in CSSs. Parent education as well as strict enforcement of CSS laws must be
      implemented.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614774
TI  - A new perspective on the natural history of vesicoureteric reflux.
AB  - Vesicoureteric reflux is most commonly recognized in girls after urinary tract
      infection. Increasing recognition of vesicoureteric reflux in neonates, detected
      after an abnormal prenatal sonogram, shows a marked male predominance: 80% boys.
      Vesicoureteric reflux in children may be both a congenital abnormality, more
      common in boys, and an acquired abnormality, more common in girls with voiding
      dysfunction.

PMID- 1614775
TI  - A role for prostacyclin in bruising symptomatology.
AB  - The relationship between bleeding and bruising and the production of prostacyclin
      and thromboxane was assessed in children who were to have a tonsillectomy and/or
      an adenoidectomy. Eicosanoids in the blood oozing from the bleeding time incision
      were measured and correlated with the reported frequency of bruising and
      epistaxis. A striking association (P = .0003) between prostacyclin production and
      the frequency of bruising was found; children reporting bleeding at least
      biweekly had the highest prostacyclin synthesis. Successively lower levels of the
      prostacyclin metabolite, 6-keto-prostaglandin F1 alpha, were found in children
      reporting less frequent bruising. Prostacyclin production in bleeding time blood
      was also correlated inversely with systolic blood pressure and hemoglobin level,
      although neither of these variables could explain the association between
      prostacyclin production and bruising. There was no correlation between
      thromboxane formation, systolic blood pressure, hemoglobin level, age, or
      bleeding time and the frequency of bruising. The ratio of thromboxane B2 to 6
      keto-prostaglandin F1 alpha was correlated inversely with the length of the
      bleeding time (P = .016). It is concluded that vascular prostacyclin production
      may have a role in bruising symptomatology. It is suggested that prostacyclin
      formed at the injured vessel surface collects within the first few seconds after
      injury inside the tissue space at the site of the bruise and, by influencing the
      formation of the platelet/fibrin plug and/or the leakage of blood from the
      vessels, plays a significant role in modifying the development of bruising.

PMID- 1614776
TI  - Primary hemochromatosis in children: report of three newly diagnosed cases and
      review of the pediatric literature.
AB  - Hereditary hemochromatosis was diagnosed in three asymptomatic siblings following
      the unexpected finding of elevated serum iron concentrations. This diagnosis was
      confirmed by hepatic biopsy. Repeated phlebotomies resulted in a significant
      decline of serum iron and ferritin concentrations and a decrease of hepatic iron
      content. This report and a review of the literature indicate that the diagnosis
      of hereditary hemochromatosis must be considered more frequently in childhood.
      Organ dysfunction from iron overload may be minimized in children by the early
      commencement of regular phlebotomy.

PMID- 1614777
TI  - Diabetic gastroparesis due to postprandial antral hypomotility in childhood.
AB  - Nausea, vomiting, chronic abdominal pain, and constipation developed in three
      children with insulin-dependent diabetes mellitus beginning 1 to 7 years after
      the onset of diabetes. All three had considerable difficulty in achieving
      satisfactory glycemic control. All had delayed gastric emptying of solids and
      postprandial antral hypomotility. Diabetic autonomic neuropathy must be
      considered in the differential diagnosis of gastrointestinal symptoms even in the
      young diabetic patient.

PMID- 1614778
TI  - Umbilical morphology: normal values for neonatal periumbilical skin length.
AB  - Malformations of the umbilicus are a feature of many dysmorphic syndromes
      including Rieger syndrome, Robinow syndrome, and Aarskog syndrome. The
      characteristic umbilical malformation in Rieger syndrome consists of redundant
      periumbilical skin which extends along the cord for an excessive distance.
      Although the measurement of umbilical skin length plays an important role in the
      neonatal diagnosis of Rieger syndrome, normal values for this measurement in
      healthy neonates have not been established. Umbilical skin length was measured in
      104 healthy neonates. The length to which the umbilical skin extended along the
      cranial aspect of cord (mean 11.53 mm, SD 3.58) was significantly longer than the
      umbilical skin length along the caudal aspect (mean 8.71 mm, SD 2.89) (P less
      than .05). Multiple regression analysis revealed a significant association
      between age and umbilical skin length. Birth weight, length, and gestational age
      were not significantly associated with umbilical skin length when adjusted for
      the other three variables. No significant differences in umbilical skin length
      were observed between male and female groups. The above normal values should aid
      in the neonatal diagnosis of Rieger syndrome, and furthermore it is recommended
      that cranial umbilical skin length measurement be included in the examination of
      the dysmorphic child.

PMID- 1614779
TI  - Spectrum and frequency of pediatric illness presenting to a general community
      hospital emergency department.
AB  - Knowledge of the range of pediatric illness presenting to a general emergency
      department (ED) is needed to optimize the quality of care delivered there. It was
      hypothesized that the pediatric population treated at a general ED exhibited a
      broad range of medical complaints, while differing significantly from children
      seen in a pediatric ED. General ED records from 1 week each season were reviewed,
      and patient age, chief complaint, diagnosis, time of arrival, season, and
      disposition were recorded. Data on 874 patients were analyzed and compared with
      pediatric ED data. General ED patient age affected chief complaint, diagnosis,
      and admission rate (9.5% less than or equal to 1 year admitted vs 2.6% greater
      than 1 year, P less than .001). General ED patients were older (7.9 vs 6.0 years,
      P less than .001) and admitted less frequently (3.8% vs 11%, P less than .001).
      Admission rates varied by arrival time only at the general ED, where minor trauma
      was more common (41% vs 22%, P less than .001). It is concluded that a wide range
      of pediatric illness is treated in a general ED, supporting the decision to have
      pediatric emergency physicians on staff, and that significant differences exist
      in the spectrum and frequency of pediatric illness seen in a general ED and
      pediatric ED.

PMID- 1614780
TI  - The changing role and responsibilities of chairmen in clinical academic
      departments: the transition from autocracy.
AB  - There is considerable literature dealing with the responsibilities of clinical
      department chairmen, which primarily emphasizes the importance of developing a
      sound and facilitating administration. This is dependent on the hiring of
      appropriate support personnel, developing a representative committee structure,
      being available to the faculty for their needs, and establishing departmental
      guidelines, procedures, and policies that apply equally to everyone. Nascent
      chairmen have an extensive literature available to them concerning academic
      administration, but a chairman's success is primarily dependent on the possession
      or development of certain interpersonal skills. Developing a concern and interest
      in the faculty and staff will come naturally to some and may have to be learned
      by others. A chairman can attempt to create an excellent esprit de corps by
      introducing a departmental philosophy that is perceived by the faculty to be
      supportive. Qualities of the chairman that convey this philosophy are fairness,
      integrity, compassion, confidentiality, effectiveness, judiciousness, and the
      willingness to exert considerable effort and time in obtaining recognition and
      rewards for the faculty. Some of the most difficult tasks for a chairman are (1)
      the prioritization of his or her responsibilities and activities, (2)
      representing both the university and the department when their goals appear to
      conflict, (3) recognizing that an autocratic chairman may administer the
      department with less difficulty and even appear to have more respect than a
      democratic chairman, (4) learning to expect less accolades and appreciation from
      faculty than the clinical chairmen of yesteryear, and (5) resisting the
      commitment of valuable time to negotiations or battles that cannot be won or to
      activities that do not benefit the department or the university.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1614781
TI  - Effect of inclusion of beans in a mixed diet for the treatment of Peruvian
      children with acute watery diarrhea.
AB  - A double-masked clinical trial was conducted to assess the effects of inclusion
      of beans in a mixed diet for young Peruvian children with acute diarrhea. Dietary
      treatment consisted of either rice, beans, and vegetable oil (group RB, n = 25)
      or rice, soy-protein isolate, corn syrup solids, and vegetable oil (group RS, n =
      21), each given in amounts up to 150 kcal/kg body weight per day immediately
      following rehydration therapy. The groups were generally similar at the time of
      admission, and there were no differences in the rates of treatment failure (8% in
      group RB, 14% in group RS; P = .65). Mean stool outputs were 83 +/- 46 (SD) g/kg
      body weight in group RB and 71 +/- 43 g/kg body weight in group RS on day 1, and
      these outputs consistently ranged from 25% to 40% greater in group RB than in
      group RS (P = .058). By contrast, the median duration of liquid stool excretion
      was substantially less in group RB than in group RS (60 vs 121 hours, P = .01).
      The fractional absorption of carbohydrate, fat, and total energy was
      significantly greater by children in group RS, but there were no differences in
      net apparent absorption of these nutrients because the children in group RB
      consumed significantly more of their assigned diet. Children in group RS gained
      significantly more weight during the whole period of observation (194 g vs 1 g, P
      = .047), but these differences could be entirely explained by the weight (and
      presumably fluid) changes on day 1. There were no consistent differences by
      dietary group in any of the other anthropometric indicators.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1614782
TI  - Are poor families satisfied with the medical care their children receive?
AB  - While access to care has been shown to be worse for poor populations, few studies
      have examined the quality of care received by the poor vs the nonpoor.
      Furthermore, serious concerns have been raised about the impact of cost
      containment efforts on the quality of health care for both the poor and nonpoor.
      The authors examine the interpersonal quality of medical care received by
      children from poor and nonpoor families by assessing parental satisfaction with
      physician-patient communication in a telephone survey of a nationally
      representative sample of households containing 2182 children and adolescents 17
      years or younger. The majority of parents were satisfied with many aspects of
      their interactions with physicians. However, poor families were more likely to be
      not completely satisfied with the medical care their children received at their
      last health visit than nonpoor families (27% vs 12%, P less than .001). With
      regard to specific aspects of the physician-patient communication, poor families
      were more likely to be not satisfied with the physician's provision of
      information about the illness (40% vs 21%, P greater than .001); the physician's
      discussion of examination findings (21% vs 9%, P less than .001); and the
      opportunity provided by the physician to express their concerns (12% vs 6%, P
      less than .001). Logistic regression demonstrated that poor patients were
      approximately twice as likely to be not satisfied with the medical encounter and
      with various aspects of their communication with the physician. It is concluded
      that the parents of poor children are less satisfied with their care. Both policy
      and educational interventions may be needed to address this problem.

PMID- 1614783
TI  - Referral patterns for children with chronic diseases.
AB  - A sample of 1377 physicians were surveyed by mailed questionnaire to study to
      what extent primary care physicians are involved in the long-term care of
      children with chronic disorders. The sample included all pediatricians practicing
      in the province of Quebec and a stratified random sample of general practitioners
      (10% sample in urban areas and 25% sample in rural areas). A response rate of 81%
      was achieved. Referral patterns were studied for asthma, congenital heart
      disease, and diabetes. Although pediatricians referred their patients less
      frequently than general practitioners, referral patterns depended mainly on the
      clinical condition. "No routine referral" was the most popular management
      strategy for asthma, whereas for congenital heart disease and diabetes more than
      20% of physicians referred their patients for all aspects of care. Rural
      physicians tended to assume patient care to a greater extent than did urban
      physicians. Most pediatricians referred patients directly to subspecialists
      practicing in tertiary care centers, whereas general practitioners often sent
      patients to pediatricians practicing elsewhere, or to other specialists. These
      data suggest that the availability of medical resources in the community and
      accessibility to tertiary care centers also influence physicians' involvement in
      the long-term care of these children.

PMID- 1614784
TI  - Television viewing and pediatric hypercholesterolemia.
AB  - Cholesterol screening for children is recommended currently only for those with a
      family history of premature coronary heart disease or hyperlipidemia. The authors
      report on a pediatric-office-based cholesterol screening program where the
      predictive values of family history indicators were evaluated along with reported
      television viewing, physical activity, and dietary habits in 1081 children (aged
      2 to 20 years, mean 7.4 +/- 3.6 [SD] years). Eight percent of these children had
      a total cholesterol value of 200 mg/dL or higher; 53% of such children reported
      watching 2 or more hours of television daily compared with 34% of children with
      lower cholesterol levels. Multivariate analyses revealed that excessive
      television viewing was the strongest predictor for a child to have a cholesterol
      value of 200 mg/dL or higher, with relative risks of 2.2 for 2 to 4 hours of
      television viewing per day (P less than .01) and 4.8 for children watching more
      than 4 hours/day, when compared to those watching less than 2 hours/day (P less
      than .01). In contrast, a positive family history of a high cholesterol level was
      only modestly associated with an increased probability of having a high
      cholesterol level (relative risk = 1.6, P less than .05), and a history of
      premature myocardial infarction in a parent or grandparent was not associated
      with a child's cholesterol level. Excessive television viewing was found to be
      associated with certain dietary and physical activity habits and may prove to be
      a useful, global marker for several life-style factors predisposing children to
      hypercholesterolemia.

PMID- 1614785
TI  - Tracking of serum cholesterol levels in a multiracial sample of preschool
      children.
AB  - The relation of an initial measurement of serum total cholesterol to subsequent
      levels over a (mean) 13-month interval was examined in a multiracial (white,
      Hispanic, American Indian, and black) sample of 1680 one- to four-year-olds.
      Although the relation of the initial level to the final measurement (r = .54) did
      not vary by race, sex, relative weight, or changes in relative weight, the
      association increased with age at the time of the initial measurement (eg, r =
      .64 among 4-year-olds). Based on the initial and final total cholesterol
      determinations, the within-person standard deviation was 21 mg/dL and the
      coefficient of variation was 13%. Although the final total cholesterol level was
      within 5 mg/dL of the initial level for 18% of the children, the two
      determinations differed by greater than or equal to 25 mg/dL for about 35% of the
      children and by greater than or equal to 50 mg/dL for about 8%. Of the 149
      children who had an initial cholesterol level greater than or equal to 200 mg/dL,
      34% (about five times the expected number) had a follow-up level that was
      similarly elevated whereas 25% had a subsequent measurement below 170 mg/dL. The
      results indicate that although an initial cholesterol level in early life is
      moderately predictive of subsequent levels, it may be difficult to interpret a
      single total cholesterol determination because of substantial within-person
      variability.

PMID- 1614787
TI  - Syringe caps: an aspiration hazard.

PMID- 1614786
TI  - The occurrence of high levels of acute behavioral distress in children and
      adolescents undergoing routine venipunctures.
AB  - While there is no question that children dislike needles, there are very little
      data available on the occurrence of high levels of distress experienced by
      children undergoing routine venipunctures. To provide some insight into this
      problem, trained observers evaluated distress in 223 different children and
      adolescents undergoing this procedure. An observational distress scale of 1 to 5
      was developed; 1 = calm, 2 = timid/nervous, 3 = serious distress, but still under
      control, 4 = serious distress with loss of control, and 5 = panic. We observed a
      strong relation between distress and age but not between distress and gender.
      During the actual venipuncture, half the subjects (113/223) were scored as having
      high levels of distress (3 or more). Our subjects were also grouped into three
      age ranges: toddlers; 2 1/2 to 6 years, N = 70; preadolescents; 7 to 12 years, N
      = 55; and adolescents; 12 years and older, N = 98. The percent of subjects
      experiencing high levels of distress for each age group were: 83%, 51%, and 28%,
      respectively. We conclude that for venipunctures: 1) high levels of distress are
      common, and 2) age and not gender correlates with distress. Other correlations
      are discussed. Toddlers and pre-adolescents should be the targets for new
      interventions to reduce distress.

PMID- 1614788
TI  - Hypercalcemia in association with subcutaneous fat necrosis of the newborn:
      studies of calcium-regulating hormones.

PMID- 1614789
TI  - Stroke in an early adolescent with systemic lupus erythematosus and coexistent
      antiphospholipid antibodies.

PMID- 1614790
TI  - Decreased thymus size on chest radiography: a sign of pediatric human
      immunodeficiency virus infection?

PMID- 1614791
TI  - [Clinico-epidemiological studies of anomalies of the central nervous system in
      children in evaluation of the effectiveness of their prevention by fetal
      ultrasonography and genetic monitoring].
AB  - A study was made of the prevalence, structure and risk factors of congenital
      developmental abnormalities (CDAs) of the CNS seen over the recent 17 years in
      the newborn (217,000 births) and 7845 children of different age, who died during
      the same period. The stage I work involved a retrospective analysis of the
      medical documentation up to a broad-scale introduction of ultrasonography of CDAs
      in the fetus; stage II was concerned, with an analysis of the genetic monitoring
      after this method was introduced into public health practice, with the coverage
      of the pregnant amounting to 98%. The recent years have witnessed a stable
      tendency toward a decrease of both the total incidence of CDAs of the CNS in the
      newborn and dead children and of the incidence of certain CDAs, namely
      anencephaly + and hydrocephalus, most accurately diagnosed on ultrasonography.
      The ratio of pregnancy (the 4th and subsequent ones), pregnancy pathologies
      (gestosis, infectious diseases), prematurity, intrauterine hypotrophy, previous
      exposure to ionizing radiation of the future child's mother and father
      (radiotherapy, industrial hazards, and so forth) are significant risk factors of
      CDAs of the CNS in the fetus.

PMID- 1614792
TI  - [Nezelof syndrome in a newborn infant].

PMID- 1614793
TI  - [A case of dystonia musculorum deformans in a patient with type I
      trichorhinophalangeal dysplasia].

PMID- 1614794
TI  - [Indicators of lipid metabolism in newborn infants from the Angara region].

PMID- 1614795
TI  - [Pulmonary surfactant: its relation to the type of pneumonia and adrenal gland
      function in children in their first year of life].

PMID- 1614796
TI  - [Prenatal risk factors and the status of local defense of the intestines in
      premature newborn infants].
AB  - A randomized study was made to examine certain characteristics of local immunity
      of the intestine (immunoglobulins in coprofiltrates, microbiocenosis) and the
      immunoglobulin composition of the milk of mothers to 108 premature breast-fed
      children of the first month of life. It has been established that toward the end
      of the second week of life, there was a remarkable decrease in the
      characteristics of secretory IgA (SIgA) in coprofiltrates of the newborn whose
      mothers suffered from gestosis (group 2) and in children born to mothers with
      infectious pathology (group 3) as compared to conventionally healthy premature
      children (group 1). The group 3 neonates showed a significantly less amount of
      IgG. According to the examinations made over time, the deficiency of secretory
      antibodies rose in group 2, declined in group 3, whereas the group 1 children
      manifested an increase in SIgA. The group 2 and 3 children demonstrated more
      profound dysbiotic disturbances, characterized by long persistence of
      opportunistic microorganisms and by the appearance in some cases of pathogenic
      microorganisms in the intestine. All this requires distinguishing risk groups and
      carrying out additional preventive and treatment measures in such children.

PMID- 1614797
TI  - [Clinico-metabolic status of fetuses and newborn infants with fetal macrosomia].
AB  - A study was made of the development of large fetuses during pregnancy with regard
      to the clinical picture, ultrasound screening of the placenta and fetuses,
      biochemical and immunological monitoring of blood of pregnant women, fetuses and
      neonates. 172 pregnant women were placed under observation. Of these, large
      fetuses (the main group) were born in 70 cases, whereas in 102 cases, the fetuses
      were of medium body weight (the control group). The comparison of the data
      obtained allows a conclusion that macrosomia gives rise to the acceleration of
      maturation of the fetal organs and systems, to the intensification of metabolism
      within the system mother--placenta--fetus.

PMID- 1614798
TI  - [Processes of absorption and utilization of glucose in newborn infants with
      intrauterine hypotrophy].
AB  - Overall 75 neonates with intrauterine hypotrophy (IH) and 19 healthy children
      were examined for glucose absorption and utilization according to the glucose
      tolerance test data. IH neonates were revealed to have and increase of glucose
      absorption and retardation of its utilization. The high blood glucose
      concentrations seen 2 hours after the test support functional insufficiency of
      the pancreas in IH.

PMID- 1614799
TI  - [Characteristics of central and peripheral hemodynamics in infants with hemolytic
      disease of newborn].
AB  - Overall 82 full-term neonates (52 children with hemolytic disease and 30 healthy
      neonates) were examined. The general circulation was investigated over time (on
      days 1, 3.5-7 of life). Use was made of echocardiography and monitor studies of
      arterial pressure and heart rate; lability of arterial pressure and general
      peripheral vascular resistance were computed. As a result of the studies and
      correlations, it has been revealed that neonates with hemolytic disease manifest
      appreciable disorders of the cardiovascular system, correlating with the disease
      gravity. Earlier times of the closure of fetal communications were established as
      were the hyperkinetic type of +cardiac hemodynamics, arterial hypotension
      accompanied by arterial pressure instability and a decrease of the general
      peripheral vascular resistance which should be taken into consideration in
      choosing therapeutic measures.

PMID- 1614800
TI  - [Liver function in newborn infants with conjugation hyperbilirubinemia after
      exchange transfusion and hemosorption].
AB  - Overall 40 neonates with conjugation jaundice were examined. A study was made
      over time (after 1 and 5 days) of the content of bilirubin, cholesterol, total
      protein, cholyl glycine, cholinesterase, and alanine aminotransferase before and
      after surgical treatment (substitution transfusion and hemoperfusion). It has
      been established that substitution transfusion inhibits protein synthesizing
      liver function and raises the content of cholyl glycine. In the authors, opinion,
      this reduces the bilirubin-binding capacity of albumin and increases hepatocyte
      membrane permeability. Extracorporeal detoxication makes protein synthesizing
      liver function return to normal, minimizes the content of cholyl glycine,
      promoting the growth of the bilirubin-binding capacity of albumin.

PMID- 1614801
TI  - [Problem of infection in fetuses and newborn infants].
AB  - Overall 76 histories of births, case reports of neonates and protocols of
      autopsies of the dead because of infection were analyzed. It has been established
      that the overwhelming majority of the children had contracted infection
      antenatally or during birth, with the ascending pathway of infection being
      predominant. Attention is drawn to the clinical and postnatal diagnosis with the
      aid of the screening tests.

PMID- 1614802
TI  - [The course and outcome of chronic hepatitis B in children].
AB  - Overall 98 children aged 1 to 14 years suffering from chronic hepatitis B (CHB)
      were followed up clinically for 1 to 6 years. CHB was diagnosed on the basis of
      the clinical and laboratory data. In the majority of the children, the diagnosis
      was verified by the results of a histological study of liver biopsy specimens.
      Chronic active hepatitis (CAH), was revealed in 27 children, chronic persistent
      hepatitis (CPH) in 31. CHB was marked by the presence of HBe-antigenemia in 89
      patients (90.8%). The studies have demonstrated that CHB associated with HBe
      antigenemia runs its course with insignificant clinical manifestations and
      enzymic exacerbations without jaundice. In the presence of persistent HBs
      antigenemia, the natural course of CHB (in CAH and CPH) is characterized by
      seroconversion (from HBeAg to anti-HBe) with a simultaneous decrease and
      normalization of aminotransferase activity and a reduction of the pathological
      process activity in the liver (transformation of CAH to CPH). Seroconversion and
      clinico-biochemical amelioration supervene at different observation periods
      (after 1-6 years) and do not depend on the initial activity of hepatitis. As the
      observation period increases, the rate of anti-HBe appearance in the blood rises,
      amounting to 90% with the observation period exceeding 5 years. The conclusion is
      made that CHB patients do not need active drug therapy but require long and
      permanent observation.

PMID- 1614803
TI  - [Frequency of detection of hepatitis B markers in various chronic diseases in
      children].
AB  - Overall 995 children with different somatic chronic diseases were examined for
      viral hepatitis B markers demonstration using up-to-date highly sensitive methods
      (hemagglutination inhibition test, EIA). In the control group (children with
      acute intestinal infections), HBV-infection markers were discovered in 4.3%.
      Children with diabetes mellitus (13.1%), chronic renal diseases (18.9%),
      pulmonary diseases (32.8%), bronchial asthma (33.3%) and hemophilia (85.2%) are
      attributed to the group at greater risk for HBV infection. As a rule, the rate of
      HBV-infection markers demonstration in chronic somatic diseases was higher in
      considerable duration of the underlying illness. The overwhelming majority of the
      children examined had suffered subclinical forms of HBV-infection as shown by the
      disease history, whereupon they manifested antibodies against HBV antigens. HBs
      antigenemia, that persisted for a long time (chronic HBV-infection) was
      demonstrable far less frequently. The authors provide evidence for the necessity
      of carrying out a broad-scale screening of HBV-infection markers in the indicated
      risk groups and vaccination against hepatitis B in children without HBsAG and
      without immunity to viral hepatitis B. The importance of measures aimed at
      preventing infections transmitted via blood is emphasized.

PMID- 1614804
TI  - [Effectiveness of using recombinant interferon alfa2 (reaferon) combined with
      antioxidants in children with acute hepatitis B].
AB  - The authors describe the results of the first experience gained with the use of
      recombinant alpha 2-interferon in children with acute viral hepatitis B. The drug
      was administered rectally in combination with antioxidants (tocopherol). The
      study was carried out by the double blind method with randomization and two
      control groups (given tocopherol alone or placebo alone). 73 children with acute
      viral hepatitis B were examined. The therapeutic combination reaferon plus
      tocopherol was established to favour more rapid elimination of dyspeptic and
      abdominal phenomena, to shorten the time of the liver and spleen size increase,
      duration of hyperfermentemia, to provide for an accelerated reduction of HBsAg
      titers, elimination of HBeAg and seroconversion, to stimulate alpha-interferon
      production by leukocytes, and to activate the system of mononuclear phagocytes.

PMID- 1614806
TI  - [Development and morbidity during the first year of life of children breast fed
      from the first 1.5 hr. after birth].

PMID- 1614805
TI  - [Clinical and diagnostic value of complex examination of the bronchoalveolar
      lavage fluid in nonspecific inflammatory lung diseases in children].
AB  - A study was made of the results of cytological, cytochemical (determination of
      the ratio of ethidium bromide extinction and NTB test) and microbiological
      studies of bronchoalveolar lavage fluid in 125 children with acute pneumonia and
      347 with chronic nonspecific inflammatory pulmonary diseases. It has been
      revealed that all-round studies permit defining the type and activity of
      endobronchitis together with the status of the ventilated alveolar tissue. Acute
      pneumonia is marked by catarrhal process with highly active inflammation of
      bacterial nature, whereas chronic nonspecific inflammatory diseases by purulent
      endobronchitis. In localized forms of nonspecific inflammatory pulmonary
      diseases, streptococci and pneumococci may be regarded as the dominant
      microflora.

PMID- 1614807
TI  - [Prospects of reducing perinatal mortality].
AB  - The paper is concerned with an analysis of the causes of the perinatal lethality,
      carried out on a material of 2106 autopsies of fetuses and neonates. The authors
      describe the structure of the perinatal lethality and the relationship between
      the character of fetal and neonatal pathology and the mother's health status,
      pregnancy and delivery.

PMID- 1614808
TI  - [Effect of eleutherococc extract and dibazole on general and intracellular
      adaptive reactions in children aged 4-14 years with acute pneumonia].

PMID- 1614809
TI  - [Oral administration of a complex immunoglobulin preparation in the treatment of
      children with acute intestinal infections].

PMID- 1614811
TI  - [Experience with the treatment of nonspecific ulcerative colitis in children and
      adolescents].

PMID- 1614810
TI  - [Use of anti-allergic immunoglobulin in children with allergic diseases].

PMID- 1614812
TI  - [Pathogenetic substantiation of rational antioxidant treatment of children with
      kidney diseases].

PMID- 1614813
TI  - [Objectives and standards of professional advanced training of pediatricians].

PMID- 1614814
TI  - [Principles of conducting immunological rehabilitation of children with secondary
      immunologic deficiency conditions].

PMID- 1614815
TI  - Altered cell volume regulation in ras oncogene expressing NIH fibroblasts.
AB  - Expression of the Ha-ras oncogene has been reported to stimulate the
      dimethylamiloride sensitive Na+/H+ exchanger and Na+,K+,2Cl- cotransport, both
      transport systems which are involved in cell volume regulation. The present study
      has been performed to test for an influence of ras oncogene expression on cell
      volume regulation in NIH 3T3 fibroblasts expressing the Ha-ras oncogene (+ ras).
      As controls served NIH 3T3 fibroblasts not expressing the ras oncogene (-ras). In
      isotonic extracellular fluid, the cell volume of + ras cells (2.70 +/- 0.08 pl)
      is significantly greater than the cell volume of -ras cells (2.04 +/- 0.10 pl).
      Both, + ras and -ras cells exhibit a regulatory cell volume increase in
      hypertonic extracellular fluid and a regulatory cell volume decrease in hypotonic
      extracellular fluid. The regulatory cell volume decrease is inhibited by 1 mmol/l
      quinidine and barium, the regulatory cell volume increase is inhibited in -ras
      and +ras cells by dimethyl-amiloride (100 mumol/l) and, only in +ras cells, by
      furosemide (100 mumol/l) and bumetanide (10 mumol/l). In conclusion, expression
      of the ras oncogene leads to a shift of the set point for cell volume regulation
      to greater cell volumes, which may contribute to the activation of the Na+/H+
      exchanger and Na+,K+,2Cl- cotransport.

PMID- 1614816
TI  - Slow-to-fast transformation of denervated soleus muscle of the rat, in the
      presence of an antifibrillatory drug.
AB  - The myofibrillar changes of rat denervated soleus muscle were studied in the
      presence and in the absence of an antifibrillatory drug. After bilateral
      sciaticotomy, a concentrated solution of procainamide hydrochloride was steadily
      released, by way of a miniosmotic pump, in the space between the soleus and the
      gastrocnemius muscles of one leg. Fibrillation activity of soleus muscles was
      checked electromyografically at 3- to 5-day intervals. On the 21st day following
      denervation the muscles were excised, stained for adenosine triphosphatase
      activity and analysed for myosin heavy chain (MHC) isoforms. In the denervated
      procainamide-treated muscles fibrillation was consistently (-75% on average)
      depressed in comparison to the contralateral denervated muscles. Type 1 (slow)
      fibres and MHC isoform were also significantly reduced, to the advantage of type
      2A (fast) fibres and MHC isoform. The results support the view that denervation
      inactivity, like other kinds of muscle inactivity, favours the expression of fast
      type myofibrillar isoforms, and that this effect is counteracted, at least
      partially, by the spontaneous activity of the denervated muscle.

PMID- 1614817
TI  - Voltage-dependent currents in isolated cells of the turtle retinal pigment
      epithelium.
AB  - The electrophysiological properties of isolated turtle retinal pigment epithelial
      cells (RPE cells) were investigated using the whole-cell patch-clamp technique.
      Most RPE cells exhibited a voltage-dependent outward current activated by
      depolarization beyond about -43 mV that inactivated during a 500-ms voltage step.
      Tail current measurements indicated that the conductance underlying this current
      was potassium selective. This current inactivated with prolonged depolarization
      and was abolished or reduced by extracellular quinidine, barium,
      tetraethylammonium (TEA) and 4-aminopyridine (4-AP). Steady-state inactivation of
      the voltage-dependent outward current revealed a time-independent outwardly
      rectifying current/voltage relationship in many cells. In addition, many cells
      had an outward current that activated slowly upon depolarization beyond about +40
      mV and appeared to reverse near 0 mV in both 3 mM KCl and 30 mM KCl external
      solutions. This current was often observed in the presence of potassium channel
      blockers. Hyperpolarizing pulses commonly evoked inward currents that activated
      slowly and did not inactivate. These currents were commonly observed when
      fluoride was absent from the pipette, and only occasionally when fluoride was the
      major pipette anion. Tail current measurements indicated that this current was
      somewhat anion selective. These currents may play important roles in the
      homeostatic and phagocytic functions of RPE cells in their interactions with the
      neural retina.

PMID- 1614818
TI  - Ca-dependent K channels in smooth muscle cells permeabilized by beta-escin
      recorded using the cell-attached patch-clamp technique.
AB  - Using the cell-attached patch-clamp technique, the activity of single, Ca
      dependent K channels was recorded in single smooth muscle cells permeabilized by
      beta-escin. The conductance and the relationship between the open probability of
      the channels and pCa recorded in permeabilized cells were very similar to those
      obtained in excised inside-out patches. At pCa 7, application of 30 microM
      acetylcholine (ACh) or 0.1 microM substance P (SP) together with 1 mM guanosine
      5'-trisphosphate to permeabilized cells elicited transient bursts of channel
      openings similar to those which occur in intact cells. Transient activation was
      also observed when 2-30 microM inositol trisphosphate (IP3) was applied to
      permeabilized cells. This single channel activity was inhibited by pretreatment
      with low-molecular-weight heparin at 50-100 micrograms/ml. Channel activity at
      pCa 7.0 was greatly enhanced by 200 microM cyclic adenosine monophosphate. These
      results provide direct evidence that single Ca-dependent K channel activity is
      regulated by the transmitters ACh and SP, as well as a second messenger, IP3, via
      the release of intracellular Ca from intracellular sites which are blocked by
      heparin. This novel approach is valuable in elucidating second messenger
      mechanisms involved in the regulation of single channel activity by transmitters
      and autocoids, since permeabilization by beta-escin preserves the entire system
      of receptor-operated signal transduction and allows intracellular application of
      second messengers at fixed concentrations.

PMID- 1614820
TI  - Desensitization of acetylcholine receptors in BC3H-1 cells.
AB  - We studied desensitization of nicotinic acetylcholine (ACh) receptor channels in
      the clonal BC3H-1 cell line. We measured the current response to rapid perfusion
      of outside-out patches with 1 microM to 5 mM ACh, carbamylcholine and
      suberyldicholine. After binding to the receptors and opening the ion channels,
      all agonists induce a rapid, concentration-dependent decay of channel activity.
      The time constant of the current decay ranged from several seconds at low agonist
      concentrations to about 50 ms at saturating concentrations. The decay rate at
      saturating concentrations was independent of voltage. The ratio of steady-state
      to peak current ranged from 0.5 at low agonist concentrations to 0.02 or less at
      high concentrations. The rate of recovery from desensitization after removal of
      agonist was also measured. For ACh, the recovery time constant was 320 ms;
      recovery from desensitization by carbamylcholine was twice as fast. A linear
      kinetic results. The data are consistent with a cyclic model, although, it is not
      possible to uniquely determine all of the rate constants in this scheme. The
      results are compared with competitive binding and single channel studies of
      desensitization in BC3H-1 cells.

PMID- 1614819
TI  - Inactivation of the Ba2+ current in dissociated Helix neurons: voltage dependence
      and the role of phosphorylation.
AB  - The rate of inactivation of the voltage-dependent Ba2+ current in dissociated
      neurons from the snail Helix aspersa was found to be modulated by
      phosphorylation. Conditions were chosen such that the most likely mechanism of
      inactivation of the Ba2+ current was a voltage-dependent/calcium-independent
      inactivation process. If adenosine-triphosphate (ATP) was not included in the
      patch electrode filling solution, or if alkaline phosphatase was added, the Ba2+
      current rapidly ran down and the rate of inactivation greatly increased with
      time. Dialysis with either ATP gamma S or the phosphatase inhibitor okadaic acid
      (OA) either enhanced the amplitude or greatly reduced the rate of run-down of the
      Ba2+ current (depending upon the presence of ATP), as well as reducing the rate
      of inactivation. However, dialysis with either the catalytic subunit of the
      cyclic-adenosine-mono-phosphate-dependent protein kinase (cAMP-PK), a synthetic
      peptide inhibitor of this enzyme, or staurosporine (a potent inhibitor of protein
      kinase C), did not have any significant effect on the amplitude or kinetics of
      the Ba2+ current. Surprisingly, dialysis with a peptide inhibitor (CKIP) of the
      Ca2+/calmodulin-dependent protein kinase II (Ca(2+)-CaM-PK) significantly reduced
      the rate of inactivation of this current. These results suggest that
      phosphorylation may exert its effect by modulating the gating properties of the
      Ca2+ channels.

PMID- 1614821
TI  - Neurotransmitters inhibit the omega-conotoxin-sensitive component of Ca current
      in neuroblastoma x glioma hybrid (NG 108-15) cells, not the nifedipine-sensitive
      component.
AB  - Voltage-dependent calcium currents (ICa) in NG 108-15 cells consisted of three
      pharmacologically distinct components: a transient low-voltage-activated (LVA)
      current, sensitive to Ni2+; a high-voltage-activated (HVA) current sensitive to
      the dihydropyridine antagonist, nifedipine and a HVA current sensitive to omega
      conotoxin GVIA (CgTx). The voltage sensitivities and decay kinetics of the two
      HVA currents were indistinguishable. The neurotransmitters acetylcholine (ACh)
      and noradrenaline inhibited ICa. This inhibition was not occluded by Ni2+ or
      nifedipine, but was abolished by CgTx. It is therefore concluded that the
      neurotransmitter-sensitive component of ICa is restricted to that component of
      HVA current inhibitable by omega-conotoxin.

PMID- 1614823
TI  - Cortical temperature and EEG slow-wave activity in the rat: analysis of vigilance
      state related changes.
AB  - Vigilance states, cortical temperature (TCRT), and electroencephalograph (EEG)
      slow-wave-activity (SWA, mean power density in the 0.75-4.0 Hz range) of ten rats
      were recorded continuously during a baseline day, and two recovery days (Recovery
      1 and 2) after 24 h of sleep deprivation (SD). The short term changes of TCRT
      were analysed within episodes of nonrapid eye movement sleep (NREMS), REM sleep
      (REMS) and waking (W), and at transitions between vigilance states. SWA was
      analysed within NREMS episodes and at W to NREMS (WN) transitions. TCRT increased
      during episodes of W and REMS, and decreased during NREMS episodes. These changes
      were a function of episode duration, and, for W and NREMS, of TCRT at episode
      onset. In Recovery 1 the increase in TCRT at NREMS to REMS (NR) and NREMS to W
      (NW) transitions tended to be attenuated. SWA within NREMS episodes was enhanced
      after SD. Over all experimental days, the increase of SWA and the decrease of
      TCRT in NREMS episodes were not correlated. It is concluded that during recovery
      from SD the changes in TCRT at state transitions were little affected. The lack
      of a relationship between changes in TCRT and SWA indicates that separate
      mechanisms underlie the regulation of brain temperature and sleep intensity.

PMID- 1614822
TI  - Na(+)-Ca2+ exchange in the isolated cochlear outer hair cells of the guinea-pig
      studied by fluorescence image microscopy.
AB  - The outer hair cell isolated from the guinea-pig was superfused in vitro and the
      cytosolic calcium concentration ([Ca2+]i) and sodium concentration ([Na+]i) were
      measured using fluorescence indicators. Under the resting condition, [Ca2+]i and
      [Na+]i were 91 +/- 9 nM (n = 51) and 110 +/- 5 mM (n = 12), respectively. Removal
      of external Na+ by replacing with N-methyl-D-glucamine (NMDG+) increased [Ca2+]i
      by 270 +/- 79% (n = 27) and decreased [Na+]i by 23 +/- 4 mM (n = 6). Both changes
      in [Ca2+]i and [Na+]i were totally reversible on returning external Na+ to the
      initial value and were inhibited by addition of 0.1 mM La3+ or 100 microM
      amiloride 5-(N,N-dimethyl) hydrochloride. Elevation of external Ca2+ ions to 20
      mM reversibly decreased [Na+]i by 8 +/- 6 mM (n = 5). Moreover, the chelation of
      the intracellular Ca2+ with 1,2-bis (2-aminophenoxy) ethane-N,N,N',N'-tetraacetic
      acid (BAPTA) exerted an inhibitory action on the NMDG(+)-induced reduction in
      [Na+]i. Exposure to 5 mM NaCN for 2 min significantly and reversibly increased
      [Ca2+]i by 290 +/- 37% (n = 5), but did not affect the [Ca2+]i elevation induced
      by the NMDG+ solution. The rise in [Ca2+]i induced by the NMDG+ solution was not
      enhanced by ouabain pretreatment. Addition of ouabain did not alter the [Na+]i.
      The present results are best explained by the presence of an Na(+)-Ca2+ exchanger
      in cell membrane and indicate that the activity of Na+/K+ pump is poor in outer
      hair cells.

PMID- 1614824
TI  - Endothelin-1 blunts transepithelial transport and differentiation of Madin-Darby
      canine kidney cells.
AB  - We investigated the effects of endothelin-1 (ET-1) on Madin-Darby canine kidney
      (MDCK) cells, a cell line originating from the renal collecting duct. The
      activity of transepithelial transport was assessed as the rate of dome formation
      in monolayers grown on solid support. The pH value of the dome fluid (dome pH)
      was measured by means of pH-selective microelectrodes. Differentiation of
      monolayer cells was estimated as the peanut-lectin(PNA)-binding capacity of the
      apical membrane. Confluent monolayers were incubated for 12-72 h in serum-free
      medium at various concentrations of ET-1. Exposure to 1 nmol/l ET-1 reduced dome
      formation by a maximum of 41 +/- 8% (n = 4; P less than 0.02) after 24 h. ET-1
      (10 nmol/l; 24 h) decreased dome pH from 7.52 +/- 0.02 (n = 53) to 7.36 +/- 0.03
      (n = 51; P less than 0.02). Apical application of amiloride (1 mmol/l) reduced
      dome pH in both ET-1-treated and non-treated domes to essentially the same level,
      7.25 +/- 0.03 (n = 19) and 7.23 +/- 0.03 (n = 17) respectively. ET-1 (10 nmol/l;
      24 h) reduced PNA-binding capacity by 19 +/- 3% (n = 5; P less than 0.02).
      Moreover, ET-1 prevented the increase in PNA binding (+ 53 +/- 7%; n = 5) induced
      by 0.1 mumol/l aldosterone. We conclude that ET-1 inhibits transepithelial
      transport and PNA binding via inhibition of apical Na+/H+ exchange, thus
      antagonizing aldosterone action in MDCK cells.

PMID- 1614826
TI  - Regulation of oxygen radical production of human polymorphonuclear leukocytes by
      adenosine: the role of calcium.
AB  - In polymorphonuclear leukocytes (PMNL) adenosine is a potent inhibitor of
      stimulus/response coupling, as demonstrated by its adverse action on
      phagocytosis, degranulation and oxygen radical production. Because this
      nucleoside can reduce several cell functions by counteracting intracellular
      calcium ions (Ca2+), the present study investigates the effect of adenosine on
      oxygen radical production in human PMNL stimulated by N-formylmethionyl-leucyl
      phenylalanine (fMet-Leu-Phe), zymosan-activated serum (ZAS) and ionophore A 23187
      in a Ca(2+)-dependent manner, and stimulated by phorbol myristate acetate (PMA)
      and latex in a Ca(2+)-independent manner. The results demonstrate that all the
      Ca(2+)-dependent stimuli were concentration-dependently inhibited by adenosine.
      In contrast, leukocyte stimulation by the Ca(2+)-independent activator PMA was
      not affected by adenosine. Surprisingly, radical formation stimulated by latex
      beads was concentration-dependently reduced by adenosine. When intracellular Ca2+
      was modified by the ionophore clamping technique or the Ca(2+)-buffering capacity
      of quin-2, latex-induced radical formation could be separated into two parts, one
      showing Ca(2+)-dependent and the other Ca(2+)-independent activation. In the
      presence of intracellular Ca2+, adenosine exerted a strong inhibition on the
      latex-induced cell activation but failed to inhibit in the Ca(2+)-depleted state.
      In order to elucidate a direct reduction of Ca2+ as the underlying mechanism of
      adenosine-mediated inhibition, intracellular Ca2+ was measured in PMNL by quin-2
      fluorescence. When PMNL were activated by latex, fMet-Leu-Phe and ionophore A
      23187, adenosine significantly reduced the stimulated rise in intracellular
      Ca2+.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614825
TI  - AlF4- and vanadate stimulate chloride secretion in rabbit colon by a Ca(2+)
      dependent mechanism.
AB  - Stripped rabbit descending colon mucosae were studied in vitro in modified Ussing
      chambers to determine the effects of AlF4- and vanadate on Cl- transport. Serosal
      additions of AlF4- and vanadate increase short circuit current (Isc) and tissue
      conductance, while luminal addition of the agents is ineffective. Addition of
      aluminium potentiates the effect of NaF on Isc. AlF4- and vanadate increase
      serosal-to-mucosal flux of 36Cl without affecting mucosal-to-serosal flux. The
      effects of these agents on Isc are markedly inhibited by serosal addition of
      bumetanide and depend on the presence of Na+ in the serosal bathing solution. The
      effects of AlF4- and vanadate on Isc are dependent on the presence of Ca2+ in the
      bathing solution, and are completely inhibited by indomethacin, but the effect of
      forskolin is not affected by the removal of Ca2+ from the bathing solution and
      the addition of indomethacin. AlF4- and vanadate significantly increase the level
      of inositol phosphate metabolites. The results indicate that AlF4- and vanadate
      increase Cl- secretion in the rabbit colon via an increase in prostaglandin
      synthesis which is mediated by the increase of intracellular Ca2+ concentrations.

PMID- 1614827
TI  - A loudspeaker-driven system for rapid and multiple solution exchanges in patch
      clamp experiments.
AB  - A new and inexpensive system allowing rapid and synchronized changes of solutions
      around a membrane patch or a cell under voltage-clamp conditions is described.
      Four plastic capillary tubings (OD 640 microns; ID 430 microns) were glued
      together horizontally and attached to a coil of a commercially available
      loudspeaker. Servo-control of the position of the coil allowed the mouth of any
      of the capillaries to be positioned near the pipette tip within 6 ms. A high flow
      speed of the test solution was crucial to achieve rapid solution exchange. At a
      flow speed of 5 cm/s, complete exchange of the external environment of a frog
      ventricular cell was achieved within 20-30 ms. The time course of solution change
      was found to be 3-5 times faster at the tip of an open patch pipette. To preserve
      the physical integrity of the cell, the cell was usually perfused by a control
      capillary at a slow velocity (0.2-0.4 cm/s) and test solutions flowing out of
      adjacent capillaries at high velocity (4-5 cm/s) were applied to the cell only
      for short periods. Determination of the three-dimensional contamination profile
      around the mouth of the control capillary allowed the optimal conditions for the
      use of the system to be established and possible sources of contamination to be
      avoided between adjacent capillaries with unmatched flow speeds. Successive and
      multiple changes in external solutions could be easily synchronized with voltage
      clamp depolarizations to examine the time course of the effect of drugs on
      voltage-operated ion channels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614828
TI  - Endogenous and exogenous agonist-induced changes in the coupling between [Ca2+]i
      and force in rat resistance arteries.
AB  - The relationship between isometric tension and free cytoplasmic calcium, [Ca2+]i,
      was investigated in rat isolated resistance arteries using fura-2. Depolarisation
      with 125 mM K+ induced a tonic contraction, while [Ca2+]i increased transiently
      but stabilised above resting [Ca2+]i. Furthermore, the tension/[Ca2+]i ratio was
      lower during activation with 125 mM K+ if the effect of endogenous noradrenaline
      (NA) was inhibited. Concentration/response curves with NA and K+ indicated that
      NA increased the sensitivity to [Ca2+]i. Calcium concentration/response curves in
      the presence of 10 microM NA or 125 mM K+ showed that NA could induce force at or
      below resting [Ca2+]i, while for any given bath calcium concentration, [Ca2+]i
      was similar in the presence of NA or K+. Addition of NA or vasopressin (AVP) to
      vessels depolarised with 125 mM K+ caused force development but no increase in
      [Ca2+]i, suggesting that agonists increase the efficacy of [Ca2+]i. However,
      during activation with AVP the efficacy of [Ca2+]i decreased time-dependently.
      The results suggest that in resistance arteries [Ca2+]i plays a crucial role in
      excitation-contraction coupling, but the tension/[Ca2+]i relationship can be
      modified by exogenous and endogenous agonists.

PMID- 1614829
TI  - Phosphate transport in isolated rat inner medullary collecting duct.
AB  - Phosphate transport by the inner medullary collecting duct of normal rats was
      studied using an in vitro microperfusion technique. Net (Jnet), lumen-to-bath
      (Jlb) and bath-to-lumen (Jbl) phosphate fluxes were measured using 32PO4 as
      tracer, in the absence of net water absorption. A net absorption of phosphate
      (22.3 +/- 3.3 pmol cm-2 s-1) was observed by direct determination, and was
      similar to the difference between the Jlb and Jbl (57.7 +/- 8.2 and 32.2 +/- 1.5
      pmol cm-2 s-1 respectively). The addition of amiloride (10 microM) to the
      perfusate did not change the Jlb of phosphate but blocked the efflux of sodium.
      Also, the withdrawal of sodium from the bath and perfusion solution did not
      change the Jlb of phosphate. In parallel, the addition of ouabain (10 mM) to the
      bath fluid decreased the Jlb of sodium more (37%) than the Jlb of phosphate (12%)
      and did not change the Jbl of phosphate. The addition of arsenate (10 microM) to
      the perfusate both in the presence and in the absence of sodium caused a decrease
      in Jlb, but Jbl remained unchanged, and parathyroid hormone (10 U) added to the
      bath did not change the Jlb. The increase in pH of the bath and perfusion fluid
      was associated with an increase in the Jlb of phosphate, and the decrease in pH
      was similarly followed by a decrease in phosphate efflux. The Jbl did not change
      with the pH alterations. These data demonstrate that a net phosphate absorption
      takes place in rat inner medullary collecting duct perfused in vitro and that
      this transport appears to be independent of sodium absorption and the action of
      parathyroid hormone. Moreover, a decrease in luminal and bath pH induces a
      decrease in phosphate efflux.

PMID- 1614830
TI  - Mechanism of Cl- transport in eel intestinal brush-border membrane vesicles.
AB  - Cl- transport was studied in a preparation of brush-border membrane vesicles
      (BBMV) from seawater eel intestine. 36Cl- uptake appeared to be stimulated by a
      positive inside membrane diffusion potential generated (a) by a concentration
      gradient of salts, the cations of which are more permeable than the anions, (b)
      by a K+ diffusion potential obtained by imposing a K+ concentration gradient
      (Cout greater than Cin) in the presence of valinomycin, (c) an inwardly directed
      H+ ion concentration gradient. The membrane-potential-driven Cl- transport was
      inhibited by 1 mM 5-nitro-2-(4-phenylpropyl-amino)-benzoic acid. Arachidonic acid
      also inhibited Cl- uptake in eel intestinal BBMV, but the effect appeared to be
      unspecific, as the unsaturated fatty acid also affected the Na+ dependent D
      glucose uptake. The effect of arachidonic acid was reversed in the presence of
      bovine serum albumin. Cl- influx was the same in the presence of inwardly
      directed gradients of Li+, Na+ or K+, arguing against the presence of Na(+)-Cl-,
      as well as K(+)-Cl- cotransport. The absence of a significant contribution of the
      Na(+)-K(+)-2Cl- cotransport mechanism to the Cl- uptake in seawater eel
      intestinal BBMV was indicated from the observations that Cl- uptake was not
      stimulated by the simultaneous presence of inwardly directed Na+ and K+
      gradients, and that it was nearly insensitive to 1 mM bumetanide in the presence
      of extravesicular Na+ and K+. Furthermore, no evidence for the dependence of Cl-
      uptake on the Na+ gradient was obtained under a short-circuited membrane
      diffusion potential, i.e. in the presence of equilibrated K+ and
      valinomycin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614831
TI  - Role of Na+/Ca2+ exchange in transcellular Ca2+ transport across primary cultures
      of rabbit kidney collecting system.
AB  - Cells from connecting tubule and cortical collecting duct of rabbit kidney were
      isolated by immunodissection with mAb R2G9 and cultured on permeable filters.
      Confluent monolayers developed an amiloride-sensitive transepithelial potential
      difference of -50 +/- 1 mV (lumen negative) and a transepithelial resistance of
      507 +/- 18 omega cm2. Transepithelial Ca2+ transport increased dose-dependently
      with apical [Ca2+] and, in solutions containing 1 mM Ca2+, the active
      transcellular Ca2+ transport rate was 92 +/- 2 nmol h-1 cm-2. Transcellular Ca2+
      transport was dependent on basolateral Na+ (Nab+). Isoosmotic substitution of
      Nab+ for N-methylglucamine resulted in a concentration-dependent decrease in Ca2+
      absorption, with maximal inhibition of 67 +/- 5%. A Hill plot of the Na(+)
      dependence yielded a coefficient of 1.9 +/- 0.4, indicating more than one Na+
      site on a Na(+)-dependent Ca2+ transport system. In addition, the absence of
      Cab2+ resulted in a significant increase in Ca2+ transport both in the presence
      and absence of Nab+. Added basolaterally, ouabain (0.1 mM) inhibited Ca2+
      transport to the same extent as did Na(+)-free solutions, while bepridil (0.1
      mM), an inhibitor of Na+/Ca2+ exchange, reduced Ca2+ transport by 32 +/- 6%.
      Methoxyverapamil, felodipine, flunarizine and diltiazem (10 microM) were without
      effect. Depolarisation of the basolateral membrane, by raising [K+]b to 60 mM,
      significantly decreased transcellular Ca2+ transport, which is indicative of
      electrogenic Na+/Ca2+ exchange. In conclusion, active Ca2+ transport in the
      collecting system of rabbit kidney is largely driven by basolateral Na+/Ca2+
      exchange. However, a residual Ca2+ absorption of about 30% was always observed,
      suggesting that other Ca2+ transport mechanisms, presumably a Ca(2+)-ATPase,
      participate as well.

PMID- 1614832
TI  - A fast perfusion system for single cell physiology optimized for microscopes with
      water immersion objectives.
AB  - A perfusion system was constructed which allows the fast application of different
      solutes underneath a water immersion objective. The perfusion system is mounted
      into the immersion objective by milling a slot into the frontal metal plate of
      the lens holder. It consists of a five-channel pipette fixed to the objective and
      solution reservoirs gated by computer controlled magnetic valves. Up to five
      different solutions can be applied to the specimen under study. The solution
      between objective and specimen is completely exchanged after 1-2 s as determined
      from fluorescence measurements. This arrangement is optimized for [Ca2+]
      measurements with a fluorescence measurement system in tissue slices, where
      upright microscopes are required. It offers the advantage of saving a
      micromanipulator for the perfusion pipette and facilitates a fast, reproducible
      and precise positioning of the perfusion system.

PMID- 1614833
TI  - A comparison of isometric force, maximum power and isometric heat rate as a
      function of sarcomere length in mouse skeletal muscle.
AB  - The isometric force, maximum power and isometric heat rate have been measured at
      different sarcomere lengths (SL) between 1.40 and 3.63 microns in two types of
      mouse muscle, soleus and omohyoideus, at 25 degrees C. The SL force relationship
      is different in the two muscles. At a SL above optimum filament overlap, 2.44
      microns in omohyoideus muscles, maximum power declined while isometric force
      remained high. In soleus muscles this occurred above a SL of 2.33 microns. In
      parallel experiments, the isometric heat rate declined linearly with increasing
      SL above 2.33 microns in soleus muscles, while isometric force remained closer to
      its maximum. At short SL, between 2.33-1.75 microns in soleus and 2.44-2.15
      microns in omohyoideus, maximum power remained at or near its maximum value as
      did heat rate (soleus) while isometric force fell. In both muscles at SL greater
      than optimum for force development maximum power output (unlike force) is
      proportional to filament overlap. The variation in heat rate over this SL range
      can be described as the sum of constant rate and a rate proportional to filament
      overlap. These observations are compatible with the idea that maximum power and
      heat rate are less affected by non-uniformities in SL than is force.

PMID- 1614834
TI  - Bicarbonate-dependent changes of intracellular sodium and pH in identified leech
      glial cells.
AB  - A new triple-barrelled ion-sensitive microelectrode was used to investigate the
      importance of bicarbonate for the regulation of intracellular Na+ and pH (Nai and
      pHi, respectively) of neuropile glial cells in the central nervous system of the
      leech Hirudo medicinalis. Addition of CO2/HCO3- produced an increase of the Nai
      activity and an intracellular alkalinization, indicating bicarbonate accumulation
      in the glial cells. Changes of external pH (from 7.4 to 7.0 and 7.8) produced
      large and rapid shifts of pHi and Nai and of the membrane potential in the
      presence, but not in the absence, of bicarbonate. Thus, acid/base transport and
      Na+ movements across the glial membrane into and out of the cells were
      accelerated severalfold in CO2/HCO3(-)-buffered saline as compared to a CO2/HCO3(
      )-free, HEPES-buffered saline. The results suggest that the electrogenic,
      reversible, cotransport of Na+ and HCO3- in the glial cell membrane [3,9] can
      produce significant changes in intraglial pH and Na activity, and can carry a
      significant fraction of the total Na+ flux across the cell membrane.

PMID- 1614835
TI  - Comparison of two types of Na+ currents with low-voltage-activated T-type Ca2+
      current in newborn rat dorsal root ganglia.
AB  - Na+ currents and the low-voltage-activated T-type Ca2+ current (T-ICa) were
      recorded from neurons of rat dorsal root ganglia under similar ionic environments
      using the whole-cell patch-clamp technique. Two types of Na+ currents were
      identified on the basis of their sensitivity to tetrodotoxin (TTX) and channel
      kinetics. One type was blocked by 1 nM TTX and had a faster activation and
      inactivation time courses (F-INa), while the other type was insensitive to 100
      microM TTX and had a much slower channel kinetics (S-INa). Activation thresholds
      were -60, -40 and -70 mV for F-INa, S-INa and T-ICa, respectively. Peak
      amplitudes were obtained in respective current/voltage curves at -30 mV (F-INa),
      0 mV (S-INa) and -50 mV (T-ICa). The time to peak and the decay time constant
      measured at potential levels giving peak amplitudes were 0.5 and 1.5 ms for F
      INa, 1.4 and 2.9 ms for S-INa and 8.1 and 17 ms for T-ICa, respectively. Cd2+ in
      a concentration of 50 microM totally blocked T-ICa, whereas it had no effect on
      either type of Na+ current. T-INa was found in 18 out of 25 cells which possessed
      F-INs, whereas it was found in only 2 cells among 15 which lacked F-INa. These
      three types of inward currents having different kinetic and pharmacological
      properties may mediate diverse functional roles in processing sensory signals.

PMID- 1614836
TI  - Intracellular ion imaging using fluorescent dyes: artefacts and limits to
      resolution.
AB  - Development of highly efficient fluorescent ratio indicators has made imaging of
      ion concentrations within individual cells possible (Grynkiewicz et al. 1985;
      Tsien and Poenie 1986). Ion imaging is a complex technique and is therefore prone
      to artefacts. In this paper we investigate the limits of the technique and its
      potential pitfalls. The spatial resolution of an imaging system is determined for
      different cell geometries. We describe a technique to increase the time
      resolution of existing systems by using a single excitation wavelength to measure
      changes in ion concentration. We demonstrate examples of potential artefacts
      arising from hardware limitations, image processing and fundamental optics.
      Methods for recognition and minimization of these problems are discussed.

PMID- 1614837
TI  - Design and use of an "optrode" for optical recordings of cardiac action
      potentials.
AB  - An optical method was used to measure action potentials from frog ventricle, in
      vitro, under normal physiological conditions with 0.5-1 mM Ca2+ Ringer's
      solution. The approach presented in this paper involves a portable fluorimeter
      coupled to a multimode optical fiber running into a glass pipette ("optrode") to
      carry both excitation light to and fluorescence from the ventricle stained with
      the voltage sensitive dye di-4-ANEPPS. A suction technique was used to stabilize
      the optrode-tissue interface, significantly reducing motion artifacts from the
      beating ventricle. The typical fractional change in fluorescence intensity for an
      action potential was -9%. The optical recordings faithfully reproduced membrane
      action potentials as measured with microelectrode recordings. To confirm further
      the validity of our method we studied the effect of an increasing stimulation
      rate on the optical action potential. The amplitude of the action potential did
      not increase, and the change in action potential duration was similar to
      published results obtained with microelectrode recordings, suggesting that our
      optical action potentials are relatively free of motion artifacts. Finally, our
      optical recordings suggest that during anodal and cathodal point stimulation, the
      time course of membrane potential differs from that predicted simply by a passive
      cable model.

PMID- 1614838
TI  - A method for exceptionally low noise single channel recordings.
AB  - We present a method whereby, with integrating electronics, quartz patch
      electrodes and a novel use of silicone oil, background noise levels as low as
      .083 pA RMS in a 5 kHz bandwidth (4-pole Butterworth filter) have been achieved
      in single channel patch clamp recordings. These approaches result in much higher
      signal to noise ratios for single channel recording than have previously been
      reported and should allow many investigators to significantly reduce noise at a
      constant bandwidth or to increase their recording bandwidths by several kHz.

PMID- 1614839
TI  - [Real forensic difficulties in dental treatment].

PMID- 1614840
TI  - Module II.1. Fetal effects of maternal alcohol and drug use.

PMID- 1614841
TI  - Module II.2. Impaired practice by health professionals.

PMID- 1614842
TI  - Module II.3. Addictions: nursing diagnosis and treatment.

PMID- 1614843
TI  - Module II.4. Nursing care in acute intoxication.

PMID- 1614844
TI  - Module II.5. Nursing care in withdrawal.

PMID- 1614845
TI  - Module II.6. Drug misuse and dependence in the elderly.

PMID- 1614846
TI  - Module II.7. Drug and alcohol problems in special populations.

PMID- 1614847
TI  - Module II.8. Nursing care of drug and alcohol problems in special populations.

PMID- 1614848
TI  - State-approved schools of nursing R.N. 1992.

PMID- 1614850
TI  - Binding of TFIIIA to derivatives of 5S RNA containing sequence substitutions or
      deletions defines a minimal TFIIIA binding site.
AB  - The repetitive zinc finger domain of transcription factor IIIA binds 5S DNA and
      5S RNA with similar affinity. Site directed mutagenesis of the Xenopus borealis
      somatic 5S RNA gene has been used to produce a series of derivatives of 5S RNA
      containing local sequence substitutions or sequence deletions. Gel mobility shift
      analyses of the binding of TFIIIA to these altered 5S RNAs revealed that all
      three of the helical stems of the 5S RNA secondary structure are required for
      binding. TFIIIA was observed to bind with normal affinity to RNAs lacking 12
      nucleotides at either the loop c or loop e/helix V regions of 5S RNA, as well as
      to a double mutant containing both deletions. The secondary structure of the
      resulting 96-nucleotide RNA, studied using structure-specific ribonucleases, was
      found to resemble the central portion of 5S RNA.

PMID- 1614849
TI  - How are tRNAs and mRNA arranged in the ribosome? An attempt to correlate the
      stereochemistry of the tRNA-mRNA interaction with constraints imposed by the
      ribosomal topography.
AB  - Two tRNA molecules at the ribosomal A- and P-sites, with a relatively small angle
      between the planes of the L-shaped molecules, can be arranged in two mutually
      exclusive orientations. In one (the 'R'-configuration), the T-loop of the A-site
      tRNA faces the D-loop of the P-site tRNA, whereas in the other (the 'S'
      configuration) the D-loop of the A-site tRNA faces the T-loop of the P-site tRNA.
      A number of stereochemical arguments, based on the crystal structure of 'free'
      tRNA, favour the R-configuration. In the ribosome, the CCA-ends of the tRNA
      molecules are 'fixed' at the base of the central protuberance (the peptidyl
      transferase centre) of the 50S subunit, and the anticodon loops lie in the neck
      region (the decoding site) of the 30S subunit. The translocation step is
      essentially a rotational movement of the tRNA from the A- to the P-site, and
      there is convincing evidence that the A-site must be located nearest to the
      L7/L12 protuberance of the 50S subunit. The mRNA in the two codon-anticodon
      duplexes lies on the 'inside' of the 'elbows' of the tRNA molecules (in both the
      S-type and R-type configurations), and runs up between the two molecules from the
      A- to the P-site in the 3' to 5'-direction. These considerations have the
      consequence that in the S-configuration the mRNA in the codon-anticodon duplexes
      is directed towards the 50S subunit, whereas in the R-configuration it is
      directed towards the 30S subunit. The results of site-directed cross-linking
      experiments, in particular cross-links to mRNA at positions within or very close
      to the codons interacting with A- or P-site tRNA, favour the latter situation.
      This conclusion is in direct contradiction to other current models for the
      arrangement of mRNA and tRNA on the ribosome.

PMID- 1614851
TI  - The weak, fine-tuned binding of ubiquitous transcription factors to the Il-2
      enhancer contributes to its T cell-restricted activity.
AB  - The T lymphocyte-specific enhancers of the murine and human Interleukin 2 (Il-2)
      genes harbour several binding sites for ubiquitous transcription factors. All
      these sites for the binding of AP-1, NF-kB or Oct-1 are non-canonical sites, i.e.
      they differ in one or a few base pairs from consensus sequences for the optimal
      binding of these factors. Although the factors bind weakly to these sites, the
      latter are functionally important because their mutation to non-binding sites
      results in a decrease of inducible activity of the Il-2 enhancer. Conversion of
      three sites to canonical binding sites of Octamer factors, AP-1 and NF-kB results
      in a drastic increase in enhancer activity and the induction of the Il-2 enhancer
      in non-T cells, such as B cell lines, murine L cells and human HeLa cells. The
      introduction of two or three canonical sites into the enhancer leads to a further
      increase of its activity. Il-2 enhancer induction is also observed in B cells
      when the concentration of AP-1 and Oct factors increases as a result of
      cotransfections with FosB and Octamer expression plasmids. When Il-2 enhancer
      constructs carrying canonical factor binding sites were injected into Xenopus
      oocytes the strong binding of ubiquitous factors substantially overcomes the
      silencing effect of negatively acting factors present in resting primary T
      lymphocytes. These results suggest a fine-tuned interplay between ubiquitous and
      lymphoid-specific factors binding to and transactivating the Il-2 enhancer and
      show that the binding affinity of ubiquitous factors to the enhancer contributes
      to its cell-type specific activity. Moreover, we believe that a dramatic increase
      of transcriptional activity brought about by single point mutations at strategic
      important factor binding sites may also have relevance to the activation of
      nuclear oncogenes.

PMID- 1614852
TI  - An African swine fever virus gene with homology to DNA ligases.
AB  - Sequence analysis of the SalI g region of the genome of a virulent isolate of
      ASFV (Malawi Lil 20/1) has revealed an open reading frame with the potential to
      encode a 48 kilodalton (kD) polypeptide which has significant homology with
      eukaryotic and prokaryotic DNA ligases. This ASFV encoded gene also contains the
      putative active site region of DNA ligases including the lysine residue which is
      necessary for enzyme-adenylate adduct formation, but lacks the C-terminal basic
      region conserved in other eukaryotic DNA ligases. A novel [32P]-labelled
      potential DNA ligase-adenylate adduct of M(r) 45 kD was observed upon incubation
      of ASFV infected cell cytoplasmic extracts with alpha-[32P]-ATP and subsequent
      analysis of products by SDS/PAGE. These data together suggest that ASFV encodes
      its own DNA ligase.

PMID- 1614853
TI  - Two nucleotides next to the anticodon of cytoplasmic rat tRNA(Asp) are likely
      generated by RNA editing.
AB  - The nucleotide sequences of major cytoplasmic tRNA(Asp) from rat liver and rat
      ascites hepatoma comprise a U32 and C33 next to the anticodon as was confirmed by
      different procedures. Additionally we identified a tRNA(Asp) with C32 and U33 in
      a minor proportion. We have shown earlier that the tRNA(Asp) gene is part of a
      cluster of tRNA genes which is amplified at least ten times in the rat nuclear
      genome. Six independent isolated clones display identical sequences in the coding
      region of the tRNA(Asp) gene which differ from tRNA(Asp) in having C32 and T33.
      Using a combination of single-strand conformation polymorphism (SSCP) analyses
      and direct sequencing of polymerase chain reaction (PCR) products we have now
      demonstrated that no variant allele of the tRNA(Asp) gene with T32 and C33 exists
      in the rat genome. Together with the RNA sequencing data these findings strongly
      indicate that major rat tRNA(Asp) is generated by post-transcriptional pyrimidine
      transitions at positions 32 and 33 and that the minor tRNA(Asp) is its unedited
      precursor.

PMID- 1614854
TI  - A single amino acid substitution reduces the superhelicity requirement of a
      replication initiator protein.
AB  - The origin of rolling circle replication in filamentous coliphage consists of a
      core origin that is absolutely required and an adjacent replication enhancer
      sequence that increases in vivo replication 30 to 100-fold. The core origin binds
      the initiator protein (gpII) which either nicks or relaxes negatively
      superhelical replicative form DNA (RFI). Nicking at the origin, but not
      relaxation, leads to initiation of DNA replication. Our results indicate that the
      ratio of nicking to relaxation (nicking-closing) in vitro depends on the
      superhelical density of the substrate. We have studied the effect of a single
      amino acid substitution in gpII, which allows wild-type levels of replication in
      the absence of the enhancer, on origin nicking and binding. The enhancer
      independent mutation yields more nicking and less relaxation of RFI, compared to
      the wild-type protein. The mutant gpII also shows a reduced requirement for
      superhelicity of the substrate in the nicking reaction. At the same time, the
      mutant gpII increases the cooperativity of protein-protein interactions in origin
      binding. We propose that the relaxation activity of gpII negatively regulates
      replication initiation, and that both increase in the negative superhelicity of
      the substrate and action of the replication enhancer may antagonize the
      relaxation activity.

PMID- 1614855
TI  - Targeted alterations in yeast artificial chromosomes for inter-species gene
      transfer.
AB  - In order to facilitate alterations of large DNA molecules for their introduction
      into mammalian cells we have characterised the mechanism of site-specific
      modifications in yeast artificial chromosomes (YACs). Newly developed yeast
      integration vectors with dominant selectable marker genes allow targeted
      integration into left (centromeric) and right (non-centromeric) YAC arms as well
      as alterations to the human derived insert DNA. In transformation experiments,
      integration proceeds exclusively by homologous recombination although yeast
      prefers linear ends of homology for predefined insertions. Targeted regions can
      be rescued which expedite the cloning of internal human sequences and the
      identification of 5' and 3' YAC/insert borders. Integration of the neomycin
      resistance gene into various parts of the YAC allowed the transfer and stable
      integration of large DNA molecules into a variety of mammalian cells including
      embryonic stem cells.

PMID- 1614856
TI  - Serum, AP-1 and Ets-1 stimulate the human ets-1 promoter.
AB  - The ets-1 proto-oncogene codes for a transcription factor. In order to understand
      how ets-1 is regulated, we have cloned its promoter. We show that the promoter is
      inducible by serum and expression of c-Fos and c-Jun, and it is positively auto
      regulated by its gene product. A 50 base-pair sequence is sufficient to confer c
      Fos + c-Jun and c-Ets-1 responsiveness to a heterologous promoter. This element
      contains two AP1 and one Ets-1 like motifs. Striking, AP-1 and Ets-1 motifs are
      found in oncogene responsive units (ORU's) of other promoters, suggesting that
      combining these motifs is a common mechanism for generating mitogen responsive
      transcription elements.

PMID- 1614857
TI  - Structural and functional features of cis-acting sequences in the basic replicon
      of plasmid ColIb-P9.
AB  - We have structurally and functionally analyzed the cis-elements essential for
      ColIb-P9 plasmid DNA replication. The putative oriV region encompassed a region
      of 172 base pairs (bp) located 152 bp downstream of the repZ gene. A typical dnaA
      box found in this region proved nonessential for the DNA replication of ColIb-P9.
      The ssi signal of ColIb-P9 is a homologue of the G-sites of R1 and R100 plasmids.
      Deletion of the G-site led to 1.5-fold reduction of the copy number, suggesting
      that although this G-site is not essential, it is important for efficient ColIb
      P9 DNA replication. In addition, the ColIb-P9 replicon is highly and extensively
      homologous with the P307 (RepFIC) replicon, and highly homologous with the R100
      (RepFIIA) replicon around the G-site region. These facts imply a common ancestry
      from which the plasmids have evolved.

PMID- 1614859
TI  - Computer methods for locating kinetoplastid cryptogenes.
AB  - RNA editing in the mitochondria of kinetoplastid protoza involves the insertion
      and/or deletion of precise numbers of uridine residues at precise locations in
      the numbers of uridine residues at precise locations in the transcribed RNA of
      certain genes. These genes are known as cryptogenes. In this paper we study
      computational algorithms to search for unknown cryptogenes and for the associated
      templates for insertion of uridines, gRNA sequences. The pairwise similarity
      search algorithm of Smith and Waterman (1) is modified to study this problem. The
      algorithm searches for unknown gRNAs given the cryptogene sequence. The method is
      tested on 4 known cryptogenes from L.tarentolae which are known to have 7
      associated gRNAs. The statistical distribution of the longest gRNA when comparing
      random sequences is derived. Finally we develop an algorithm to search for
      cryptogenes using amino acid sequences from related proteins.

PMID- 1614858
TI  - A DNA polymerase from the archaeon Sulfolobus solfataricus shows sequence
      similarity to family B DNA polymerases.
AB  - The gene encoding the thermostable DNA polymerase from the archaeon Sulfolobus
      solfataricus (strain MT 4) was isolated by means of two degenerate
      oligonucleotide probes. They were designed on the basis of partial enzyme amino
      acid sequences. The gene was found to encode a 882 residues polypeptide chain
      with a deduced molecular mass of about 100 kDa. By comparison with other archaeal
      genes, putative regulatory sites were identified in the gene-flanking regions. By
      computer-assisted homology search, several sequence similarities among S.
      solfataricus and family B DNA polymerases were found. In addition, conserved
      sequence motifs, implicated in the 3'-5' exonuclease activity of E. coli DNA
      polymerase I and shared by various family A and B DNA polymerases, were also
      identified. This result suggests that the proofreading domains of all these
      enzymes are evolutionarily related.

PMID- 1614860
TI  - Uranyl photofootprinting of triple helical DNA.
AB  - Two triple helix structures (15-mers containing only T.A-T triplets or containing
      mixed T.A-T and C.G-C triplets) have been studied by uranyl mediated DNA
      photocleavage to probe the accessibility of the phosphates of the DNA backbone.
      Whereas the phosphates of the pyrimidine strand are at least as accessible as in
      double stranded DNA, in the phosphates of the purine strand are partly shielded
      and more so at the 5'-end of the strand. With the homo A/T target increased
      cleavage is observed towards the 3'-end on the pyrimidine strand. These results
      show that the third strand is asymmetrically positioned along the groove with the
      tightest triple strand double strand interactions at the 5'-end of the third
      strand. The results also indicate that homo-A versus mixed A/G 'Hoogsteen-triple
      helices' have different structures.

PMID- 1614861
TI  - Corruption of genomic databases with anomalous sequence.
AB  - We describe evidence that DNA sequences from vectors used for cloning and
      sequencing have been incorporated accidentally into eukaryotic entries in the
      GenBank database. These incorporations were not restricted to one type of vector
      or to a single mechanism. Many minor instances may have been the result of simple
      editing errors, but some entries contained large blocks of vector sequence that
      had been incorporated by contamination or other accidents during cloning. Some
      cases involved unusual rearrangements and areas of vector distant from the normal
      insertion sites. Matches to vector were found in 0.23% of 20,000 sequences
      analyzed in GenBank Release 63. Although the possibility of anomalous sequence
      incorporation has been recognized since the inception of GenBank and should be
      easy to avoid, recent evidence suggests that this problem is increasing more
      quickly than the database itself. The presence of anomalous sequence may have
      serious consequences for the interpretation and use of database entries, and will
      have an impact on issues of database management. The incorporated vector
      fragments described here may also be useful for a crude estimate of the fidelity
      of sequence information in the database. In alignments with well-defined ends,
      the matching sequences showed 96.8% identity to vector; when poorer matches with
      arbitrary limits were included, the aggregate identity to vector sequence was
      94.8%.

PMID- 1614862
TI  - Two distinct pathways of interferon induction as revealed by 2-aminopurine.
AB  - Activation and repression of IFN gene expression are controlled primarily at the
      transcriptional level. In order to elucidate some aspects of the induction
      mechanism of the IFN genes, we examined the effects of different treatments on
      IFN production in L929 cells, a well-characterized system, and in primary spleen
      cells. Our results indicate that 2-Aminopurine (2-AP) inhibits type I IFN (IFN
      alpha and IFN-beta) induction in L929 cells but not in spleen cells. In L929
      cells, 2-AP inhibited the induction of the MuIFN-beta promoter and of promoters
      containing tetrahexamer and PRDII sequences linked to a reporter gene. Inhibition
      of activation of the inducible factors binding to the MuIFN-beta promoter and sub
      elements was also observed. In contrast, factors binding to the MuIFN-beta
      promoter are present constitutively in spleen cell nuclei and their activity is
      not inhibited by 2-AP. These results suggest that 2-AP inhibits IFN-beta gene
      induction in L929 cells through blocking of activation of the inducible DNA
      binding factors which interact with the IFN-beta promoter.

PMID- 1614863
TI  - Synergistic induction of promoters containing metal- and glucocorticoid
      responsive elements.
AB  - We have shown that it is possible to synergistically activate gene transcription
      when several glucocorticoid responsive elements (GREs) and metal responsive
      elements (MREs) that coexist within the same promoter are induced simultaneously.
      To demonstrate this, additional GREs were introduced into a human metallothionein
      IIA (hMT-IIA) promoter in which some constitutive elements had been deleted. The
      transcriptional strength and inducibility of the modified hMT-IIA promoters were
      studied in transient expression experiments using the CAT gene as a reporter. As
      a result of synergistic activation of transcription by CdCl2 and dexamethasone,
      the induced expression levels of the modified promoters were significantly higher
      than those obtained with wild-type hMT-IIA. Since the increase in inducible
      expression was not accompanied by a concominant increase in basal levels, the
      inducibility of the modified MT promoters was up to 6-fold higher. The degree of
      transcriptional synergism was shown to depend on the position and the number of
      GREs introduced. Thus, the engineering of synthetic promoters that include both
      GREs and MREs should offer the opportunity to develop a new series of improved
      inducible mammalian expression vectors.

PMID- 1614864
TI  - Heterologous activation of the actinorhodin biosynthetic pathway in Streptomyces
      lividans.
AB  - A DNA fragment of Streptomyces fradiae is able to activate the antibiotic
      actinorhodin biosynthetic pathway when cloned in Streptomyces lividans. The
      activator DNA region has been sequenced and its transcription initiation and
      termination sites accurately mapped in vivo. This DNA encodes a 132 nucleotides
      long transcript which is apparently responsible for the actinorhodin production
      phenotype, possibly acting as an antisense RNA. The sequence of the activator
      gene revealed no homology with any other known Streptomyces coelicolor genes
      concerned with actinorhodin biosynthesis or its pleiotropic regulation.

PMID- 1614865
TI  - The influence of single base triplet changes on the stability of a pur.pur.pyr
      triple helix determined by affinity cleaving.
AB  - The influence of sixteen base triplet changes at a single position within a
      pur.pur.pyr triple helix was examined by affinity cleaving. For the 15 base pair
      target site studied here, G.GC, A.AT and T.AT triplets stabilize a triple helix
      to a greater extent than the other 13 natural triplets (pH = 7.4, 25 degrees C).
      Weaker interactions were detected for the C.AT, A.GC and T.CG triplets. The
      absence of specific, highly stabilizing interactions between third strand bases
      and the CG or TA base pairs demonstrates a current sequence limitation to
      formation of this structure. Models for the two dimensional base triplet
      interactions for all possible 16 natural triplets are presented.

PMID- 1614866
TI  - Stable fluorescent complexes of double-stranded DNA with bis-intercalating
      asymmetric cyanine dyes: properties and applications.
AB  - The synthesis, proof of structure, and the absorption and fluorescence properties
      of two new unsymmetrical cyanine dyes, thiazole orange dimer (TOTO; 1,1'-(4,4,7,7
      tetramethyl-4,7- diazaundecamethylene)-bis-4-[3-methyl-2,3-dihydro-(benzo-1,3
      thiaz ole)-2- methylidene]-quinolinium tetraiodide) and oxazole yellow dimer
      (YOYO; an analogue of TOTO with a benzo-1,3-oxazole in place of the benzo-1,3
      thiazole) are reported. TOTO and YOYO are virtually non-fluorescent in solution,
      but form highly fluorescent complexes with double-stranded DNA (dsDNA), up to a
      maximum dye to DNA bp ratio of 1:4, with greater than 1000-fold fluorescence
      enhancement. The dsDNA-TOTO (lambda max 513 nm; lambda maxF 532 nm) and dsDNA
      YOYO (lambda max 489 nm; lambda maxF 509 nm) complexes are completely stable to
      electrophoresis on agarose and acrylamide gels. Mixtures of restriction fragments
      pre-labeled with ethidium dimer (EthD; lambda maxF 616 nm) and those pre-labeled
      with either TOTO or YOYO were separated by electrophoresis. Laser excitation at
      488 nm and simultaneous confocal fluorescence detection at 620-750 nm (dsDNA-EthD
      emission) and 500-565 nm (dsDNA-TOTO or dsDNA-YOYO emission) allowed sensitive
      detection, quantitation, and accurate sizing of restriction fragments ranging
      from 600 to 24,000 bp. The limit of detection of dsDNA-TOTO and YOYO complexes
      with a laser-excited confocal fluorescence gel scanner for a band 5-mm wide on a
      1-mm thick agarose gel was 4 picograms, about 500-fold lower than attainable by
      conventional staining with ethidium bromide.

PMID- 1614867
TI  - Promoter specificity of the two transcriptional activation functions of the human
      oestrogen receptor in yeast.
AB  - We have previously demonstrated that the human oestrogen receptor (hER) contains
      two transcriptional activation functions located in the N-terminal region (TAF-1)
      and in the hormone binding domain (TAF-2), which can act both independently and
      synergistically in a promoter- and cell-specific manner in animal cells. We have
      also demonstrated that hER can activate transcription from chimaeric oestrogen
      responsive GAL1 promoters in yeast, and shown that transcriptional activation was
      due to TAF-1, whereas TAF-2 showed little, if any, transcriptional activity on
      these promoters. By using a more complex promoter derived from the URA3 gene, we
      now show that TAF-2 is also active in yeast, and that the activities of TAF-1 and
      TAF-2 are promoter-context-specific in yeast. We also confirm that the agonistic
      activity of 4-hydroxytamoxifen (OHT) can be ascribed to the activity of TAF-1.

PMID- 1614868
TI  - Tissue- and cell-specific expression of human sn-glycerol-3-phosphate
      dehydrogenase in transgenic mice.
AB  - Comparison of the promoter sequence for the sn-glycerol-3-phosphate dehydrogenase
      (GPDH, EC 1.1.1.8) genes in mice and humans showed that there were three promoter
      domains conserved in evolution (1). To study the functional organization of the
      GPDH promoter, we generated transgenic mice carrying the complete human gene,
      GPD1. The level of human and mouse GPDH activity was measured in each tissue and
      the amount of human-mouse GPDH heterodimer was used as a sensitive indicator of
      cell-specific expression of GPD1. During postnatal development and in adult
      tissues of the transgenic mice, human GPDH was expressed at levels that
      corresponded closely to the expression of the endogenous mouse gene, Gdc-1.
      Surprisingly, deletion of the evolutionarily conserved fat-specific elements
      (FSE) in the proximal promoter region failed to reveal any alterations in GPD1
      expression that were specific for either white or brown adipose tissue.

PMID- 1614869
TI  - Zfp-37, a new murine zinc finger encoding gene, is expressed in a developmentally
      regulated pattern in the male germ line.
AB  - To begin to examine the function in the mouse testis of genes containing the zinc
      finger motif, we have screened an adult mouse total testis cDNA library with
      probes to a conserved region of zinc fingers. We have isolated cDNAs for a new
      murine zinc finger encoding gene that has been designated Zfp-37. Northern blot
      hybridization analysis revealed Zfp-37 transcripts at high levels in the testis,
      the only adult tissue in which Zfp-37 expression was observed. Zfp-37 was also
      expressed at lower levels in the mid-gestation embryo and placenta. The major
      testicular transcripts are 2.3 and 2.6 kb. A 4.0 kb transcript was detected at
      lower levels in the testis as well as in embryo and placenta. Northern blot and
      in situ hybridization analysis revealed that expression of Zfp-37 was most
      abundant in germ cells which have completed meiosis and are undergoing the
      complex morphogenetic changes of spermiogenesis. The pattern of expression of Zfp
      37 and the presence of the zinc finger domain suggest that Zfp-37 may have a role
      in regulating spermiogenesis.

PMID- 1614870
TI  - Identification of an enhancer involved in the melanoma-specific expression of the
      tumor antigen melanotransferrin gene.
AB  - Melanotransferrin (MTf) is a tumor associated antigen found in abundance on the
      surface of melanoma cells. It is a transferrin-like protein found in low amount
      in most adult tissues and whose gene is reminiscent of house-keeping genes. With
      the goal of understanding the regulatory mechanisms which might explain the
      enhancement of expression in tumor cells, we report here the characterization of
      a regulatory element located 2 kbp upstream from the promoter and whose deletion
      specifically impairs gene expression in melanoma cells; we show that this element
      is part of an enhancer composed of two modules which are each the target for the
      AP1 transcription factor. The two modules present a synergistic mode of action
      specific for melanoma cells which requires both of the 130 bp away AP1 sites.
      Furthermore, we show that the enhancer behaves differently according to the
      promoter context.

PMID- 1614871
TI  - RNP-1, an RNA-binding motif is conserved in the DNA-binding cold shock domain.
AB  - Sequence analysis has shown that there is a short motif of 8 amino acids,
      corresponding to the RNP-1 motif found in canonical RNA-binding domains, which is
      common to two families of apparently unrelated proteins. Many RNA-binding
      proteins contain the RNP-1 and RNP-2 motifs in an RNA-binding domain. The cold
      shock domain (CSD) family of proteins, which includes several transcription
      factors which have been shown to bind to DNA, has now been identified to contain
      a motif similar to RNP-1. A non-redundant protein sequence database was searched
      with regular expressions and with a weight/residue position matrix of the RNP-1
      motif resulting in the identification of numerous known members of the RNA
      binding family of proteins. In addition, the search identified that the CSD
      containing family of proteins includes a motif which is almost identical to the
      RNP-1 motif. A determination of the statistical significance of this analysis
      showed that the RNP-1 motifs from these two families of proteins are indeed
      similar.

PMID- 1614872
TI  - Characterization of the human rod transducin alpha-subunit gene.
AB  - The human rod transducin alpha subunit (Tr alpha) gene has been cloned. A cDNA
      clone, HG14, contained a 1.1 kb insertion when compared with the human Tr alpha
      cDNA published by Van Dop et al. (1). Based on two overlapping clones isolated
      from a human genomic library, the human Tr alpha gene is 4.9 kb in length and
      consists of nine exons interrupted by eight introns. Northern blots of human
      retina total RNA showed that the gene is transcribed by rod photoreceptors into
      two species of mRNA, 1.3 kb and 2.4 kb in size. Apparently, this is the result of
      alternative splicing. Two putative transcription initiation sites were determined
      by primer extension and S1 nuclease protection assays. The putative promoter
      regions of the human and mouse Tr alpha genes have an identity of 78.1%. As found
      in the mouse gene (2), no TATA consensus sequence is present in the human gene.

PMID- 1614873
TI  - WORDUP: an efficient algorithm for discovering statistically significant patterns
      in DNA sequences.
AB  - We present here a fast and sensitive method designed to isolate short nucleotide
      sequences which have non-random statistical properties and may thus be
      biologically active. It is based on a first order Markov analysis and allows us
      to detect statistically significant sequence motifs from six to ten nucleotides
      long which are significantly shared (or avoided) in the sequences under
      investigation. This method has been tested on a set of 521 sequences extracted
      from the Eukaryotic Promoter Database (2). Our results demonstrate the accuracy
      and the efficiency of the method in that the sequence motifs which are known to
      act as eukaryotic promoters, such as the TATA-box and the CAAT-box, were clearly
      identified. In addition we have found other statistically significant motifs, the
      biological roles of which are yet to be clarified.

PMID- 1614876
TI  - ApoI, a unique restriction endonuclease from Arthrobacter protophormiae which
      recognizes 5' RAATTY 3'.

PMID- 1614874
TI  - Distinct activation of murine interferon-alpha promoter region by IRF-1/ISFG-2
      and virus infection.
AB  - Virus infection in mouse L929 cells activates expression of interferon-alpha 4
      (IFN-alpha 4), but not IFN-alpha 6. The integrity of a symmetrical sequence,
      GTAAAGAAAGT (alpha F1 site); (-103 to -93), present in the 35 nucleotide (nt)
      long inducible element (IE) (-109 to -75) of the alpha 4 promoter region is
      essential for the virus-induced expression. In the present study, we have shown
      that the interferon regulatory factor 1 (IRF-1) can induce expression of both IFN
      alpha 4 and -alpha 6 in a transient expression assay. Virus infection cooperates
      with IRF-1 and further enhances transcription from the alpha 4 promoter, but
      inhibits the IRF-1-mediated expression from the alpha 6 promoter. The virus
      mediated induction is determined by both IRF-1 and alpha F1 sites, while
      activation by IRF-1 in a cotransfection assay is not greatly influenced by the
      alpha F1 sequence. The activation of IFN-alpha gene promoters by IRF-1 was
      limited to the transient expression assay. The integrated alpha 4 promoter or the
      endogenous IFN-alpha genes could not be induced by transfection with IRF-1
      expressing plasmid and IRF-1 did not up-regulate expression of the endogenous IRF
      1 gene. However, expression of IRF-1 alone was sufficient to up-regulate the
      expression of two IFN stimulated genes, 2',5' oligoadenylate synthetase (OAS) and
      interferon stimulated (ISG)-15 gene. These results suggest that induction of IFN
      alpha gene expression by virus infection requires cooperation between IRF-1 and
      another factor(s) that binds to the alpha F1 sequence.

PMID- 1614875
TI  - A conserved family of genes related to the testis determining gene, SRY.

PMID- 1614877
TI  - MfoAI, a novel isoschizomer of HaeIII from Mycobacterium fortuitum recognizing 5'
      GG/CC-3'.

PMID- 1614878
TI  - MhaAI, a novel isoschizomer of PstI from Mycobacterium habana recognizing 5'
      CTGCA/G-3'.

PMID- 1614879
TI  - Bovine sequences in rodent DNA.

PMID- 1614880
TI  - Nucleotide sequence of a cDNA encoding another Trypanosoma cruzi acidic ribosomal
      P2 type protein (TcP2b).

PMID- 1614881
TI  - Nucleotide sequence of a cDNA encoding a Trypanosoma cruzi acidic ribosomal PO
      protein: a novel C-terminal domain in T. cruzi ribosomal P proteins.

PMID- 1614882
TI  - B region variant of the estrogen receptor gene.

PMID- 1614883
TI  - Characterisation of BciBII, an isoschizomer of BstNI from a strain of Bacillus
      circulans B.

PMID- 1614884
TI  - BavAI, a restriction endonuclease from Bacillus alvei.

PMID- 1614885
TI  - Isolation and characterisation of restriction endonuclease BcuAI from Bacillus
      cereus A.

PMID- 1614886
TI  - Chemical cross linking subtraction (CCLS): a new method for the generation of
      subtractive hybridisation probes.

PMID- 1614887
TI  - A random-PCR method (rPCR) to construct whole cDNA library from low amounts of
      RNA.

PMID- 1614888
TI  - Electroporation in 'intracellular' buffer increases cell survival.

PMID- 1614889
TI  - A novel PCR method for amplifying exons (or genes) over intragenic (or
      intergenic) regions in the genome.

PMID- 1614892
TI  - Making a difference in health policy.

PMID- 1614891
TI  - Where and when does change begin?

PMID- 1614893
TI  - Health promotion and disease prevention: toward excellence in nursing practice
      and education.

PMID- 1614894
TI  - A nursing view of the United States-Iraq war: psychosocial health consequences.

PMID- 1614896
TI  - Nursing education in modern Turkey.

PMID- 1614895
TI  - Developing community leadership in healthy cities: the Indiana model.

PMID- 1614890
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1614897
TI  - 'Will universal precautions protect me?' A look at staff nurses' attitudes.

PMID- 1614898
TI  - Empowering nurses for professional practice.

PMID- 1614899
TI  - High-flow sheaths for pediatric fluid resuscitation: a comparison of flow rates
      with standard pediatric catheters.
AB  - We evaluated high-flow intravenous devices designed specifically for fluid
      resuscitation of infants and children. Fluid flow rates with 4-, 5-, and 6-Fr
      high-flow sheaths and 18-, 20-, and 22-gauge catheters were measured and
      compared. Flow rate is significantly faster with the 4-Fr sheath (P less than
      0.0001) than with the 18-, 20-, or 22-gauge catheter. The high flow rates
      possible with the sheaths make them ideal for use in patients who require rapid
      fluid resuscitation.

PMID- 1614900
TI  - Diagnosing abdominal pain in a pediatric emergency department.
AB  - We undertook a prospective study of 377 children (two to 16 years old) presenting
      with abdominal pain to determine: 1) common discharge diagnoses; 2) what signs
      and symptoms are associated with appendicitis; and 3) follow-up of patients
      discharged from the emergency department (ED). Nine diagnoses accounted for 86%
      of all diagnoses made. The most common final diagnosis was "abdominal pain"
      (36%). The following findings were significantly associated with appendicitis:
      vomiting, right lower quadrant(RLQ) pain, tenderness, and guarding (all P less
      than 0.001). Ninety-seven percent (28/29) of patients with appendicitis had at
      least two of these four signs and symptoms, as did 28% (96/348) of patients
      without appendicitis. The sensitivity of the model is 0.96, and the specificity
      is 0.72 (positive predictive value = 0.24; negative predictive value = 0.99). Of
      the patients contacted within one week of the visit (237), 75% reported that the
      pain had resolved (mean contact time, 2.6 days). We conclude that 1) patients
      presenting to the ED with abdominal pain often leave with the diagnosis of
      abdominal pain; 2) of the patients contacted, the majority reported that their
      pain has resolved; and 3) a diagnosis of appendicitis should be considered in any
      patient with any two of the following signs or symptoms: vomiting, guarding,
      tenderness, or RLQ pain. Such patients should be evaluated and observed carefully
      for the possible diagnosis of appendicitis.

PMID- 1614901
TI  - A one-year series of pediatric ED water-related injuries: the Hawaii EMS-C
      project.
AB  - During a 12-month period ending on November 30, 1988, data on 133 pediatric
      patients visiting a pediatric emergency department with water-related injuries
      were collected. Of these patients, 70% were male. There were 13 submersions,
      seven cases of head trauma, three cases of neck trauma, 88 cases of external
      injury, and 34 other injuries. Incidents took place at beaches (75%) in public
      pools (12%), in friends' pools (4%), and in home pools (4%). Eighty-six percent
      of the cohort knew how to swim. Swimming, playing, and surfing activity accounted
      for most of the injuries. Measures for prevention are described.

PMID- 1614902
TI  - Metal detectors: an alternative approach to the evaluation of coin ingestions in
      children?
AB  - Foreign body ingestions constitute a common problem in pediatric emergency
      medicine. Recent data indicate that, despite current recommendations, most
      children who ingest coins do not undergo radiologic evaluation. The purpose of
      this study was to determine the accuracy of a metal detector in locating coins in
      a model simulating coin ingestions in children. Initially, the distance between
      the anterior chest wall (ACW) and the esophagus was measured on 17 chest computed
      tomograms obtained on children between the ages of three months and six years.
      Subsequently, a distance equal to the mean ACW-to-gastroesophageal junction
      measurement was marked across the investigator's forearm. A second investigator
      then attempted to detect the presence of the coin through the forearm by using a
      Super Scanner (Garrett Security Systems, Inc, Garland, TX) metal detector. The
      study was conducted in a blinded manner and consisted of 50 attempts equally
      divided among pennies, nickels, dimes, quarters, and controls (no coin). The
      accuracy of the metal detector in identifying the presence or absence of coins in
      our model was 100%. We conclude that the metal detector evaluated by us is highly
      accurate in identifying coins through human tissues and that it should become a
      valuable and practical tool in the evaluation of children following a coin
      ingestion.

PMID- 1614903
TI  - Pulmonary aspiration of activated charcoal: a complication of its misuse in
      overdose management.

PMID- 1614904
TI  - An unsuspected alkaline battery foreign body presenting as malignant otitis
      externa.
AB  - We describe a case of an unsuspected button battery foreign body in the ear canal
      causing symptoms that mimic malignant otitis externa in a previously healthy 13
      year old. Button batteries in the ear canal may cause extensive liquefactive
      necrosis of the surrounding tissue by leaking an alkaline electrolyte solution.
      Suspicion of a foreign body should be maintained in any child presenting with a
      complicated otitis externa. Prompt evaluation and removal of button batteries are
      necessary to prevent tissue destruction.

PMID- 1614905
TI  - Vitamin K deficiency, intracranial hemorrhage, and a subgaleal hematoma: a fatal
      combination.
AB  - An exclusively breast-fed infant, who did not receive vitamin K prophylaxis at
      birth, presented with signs of raised intracranial pressure. Her clinical course
      was compounded by a lumbar puncture, which revealed blood in the cerebrospinal
      fluid, and a large subgaleal hematoma, which developed at the puncture site of an
      attempted scalp vein catheterization, resulting in coning, hypovolemic shock, and
      death. A major coagulopathy was present, probably caused by vitamin K deficiency.
      The necessity for vitamin K prophylaxis in all newborns and the timing of lumbar
      puncture in the critically ill child are discussed.

PMID- 1614906
TI  - Postprandial hypoglycemia in an infant associated with propranolol.

PMID- 1614907
TI  - Measurement of severity for nonhospitalized injuries in the pediatric age group.
AB  - To better classify minor injuries in the pediatric outpatient population, we
      empirically developed a scale to predict functional impairment, one week and one
      month postinjury, based on data available at the time of care. A sample of 857
      injured children aged five to 19 years was randomly split into two subsamples.
      Using logistic regression techniques, predictive models were developed and
      confirmed on the subsamples and then applied to the full sample. Age, location of
      injury, and type of injury were predictive of impairment one week post-injury;
      however, type of injury was the only consistently significant predictor. Type of
      injury, specifically fracture, dislocation, and sprain, and location of injury
      (lower extremity) were significant predictors of functional impairment one month
      postinjury; however, once again, the type of injury was the only variable
      consistently significant across all models. Other than the type of injury, the
      variables available at the time of care were too uniform between disabled and
      nondisabled patients to be useful in developing a severity scale for minor
      injuries. We conclude that other outcome measurements or scale development
      techniques should be explored to develop a useful classification scheme for minor
      injuries.

PMID- 1614908
TI  - Interfacing with police in the pediatric emergency department.
AB  - In summary, ED staff and local police departments should make a concerted effort
      to work together. The ED director should develop management protocols in
      conjunction with local police chiefs to plan strategies in advance. It is helpful
      to provide "orientation sessions," so that each group of professionals knows what
      to expect of the other. It may also be helpful to arrange tours of the ED so that
      police know where to go when they are called to the ED. All of these efforts
      should foster better care of children in the ED and will reduce tensions between
      the dedicated groups who work with such children.

PMID- 1614909
TI  - Acute pancreatitis in children.
AB  - Acute pancreatitis in childhood is not a rare condition, and it should be
      considered in all children presenting with acute abdominal complaints. A complete
      history should be obtained, with emphasis on recent trauma or infection, current
      medications, and the presence of any chronic diseases. After a thorough physical
      examination, simple ancillary studies including noninvasive imaging techniques
      will confirm the clinical suspicion. Appropriate aggressive treatment, instituted
      early, will help to reduce the associated morbidity and mortality. Most children
      with acute pancreatitis will recover with conservative management and suffer no
      significant long-term sequelae.

PMID- 1614910
TI  - Interpretive electrocardiographs.

PMID- 1614911
TI  - Management of asthma.

PMID- 1614912
TI  - A fatal case of colic.
AB  - The potential causes of excessive, prolonged crying in early infancy represent a
      broad range of conditions. The underlying etiology causing an acute episode of
      crying may not be recognized in a single emergency department encounter. An
      adverse outcome may result when an infant with unexplained crying is discharged
      with a diagnosis of colic.

PMID- 1614913
TI  - Asymptomatic subclavian steal syndrome in children following cardiac surgery: a
      potential hazard with re-operation?
AB  - We describe a case of fatal hypoxic-ischemic encephalopathy, leading to brain
      death following the modified Fontan procedure in a child with asymptomatic
      subclavian steal syndrome (SSS). This patient's brain death was most likely
      multifactorial in view of his postoperative course. However, we believe that the
      presence of the SSS contributed to the abnormal cerebral circulation during
      surgery and postoperatively, leading to brain death. The presence of SSS in
      patients undergoing an open-heart procedure may be a risk factor for cerebral
      ischemia or brain death.

PMID- 1614915
TI  - Pulsed wave and color Doppler findings in congenital pulmonary vein stenosis.
AB  - A premature infant presented at 8 weeks of age with respiratory failure and
      pulmonary hypertension. Two-dimensional echocardiography was not diagnostic but
      color flow imaging and pulsed Doppler examination revealed turbulent and
      continuous pulmonary venous flow. Differing patterns of disturbed flow suggested
      varying severity of obstruction in individual pulmonary veins. The Doppler
      findings are compared to the angiographic and autopsy data.

PMID- 1614914
TI  - Hypertrophic cardiomyopathy in mucopolysaccharidoses: regression after bone
      marrow transplantation.
AB  - Mucopolysaccharide storage disease (MPS) presents clinically with a broad
      spectrum of abnormalities, among which cardiovascular involvement has been
      described. The echocardiographic findings have recently been reported for the
      various types of MPS. Among these, asymmetric septal hypertrophy (ASH) has been
      documented. We present a case of a 9-year-old girl suffering from type I MPS,
      atypical variant, with echocardiographic signs of ASH. She was given a bone
      marrow transplant after which the hypertrophic cardiomyopathy regressed.

PMID- 1614916
TI  - Supraventricular tachyarrhythmias, congenital heart disease, and sudden cardiac
      death.
AB  - The etiologies of sudden cardiac death following the surgical treatment of
      congenital heart defects remain uncertain. A young patient with prior repair of
      partial anomalous pulmonary venous return is presented, in whom brief episodes of
      a supraventricular tachyarrhythmia (rate 170/min) were documented to result in
      ventricular fibrillation. This unusual sequence may represent a basis for
      unexplained sudden cardiac death in other patients following atrial surgical
      procedures for the treatment of congenital heart disease.

PMID- 1614918
TI  - Absence of an aortic valve cusp, a cause of severe aortic regurgitation in
      infancy.
AB  - Congenital aortic regurgitation is an extremely rare cardiac lesion. This is a
      case report of an infant with a severe degree of valve regurgitation due to
      absence of the noncoronary aortic cusp. We show the echocardiographic,
      angiographic, and surgical aspects of the case, emphasizing the importance of a
      precise anatomical diagnosis and the problems of early valve replacement.

PMID- 1614917
TI  - Scimitar syndrome with absence of the right pulmonary artery: a case with volume
      induced, reversible, left-sided pulmonary hypertension.
AB  - An infant with scimitar syndrome, absent right pulmonary artery, and systemic
      blood supply to the right lung presented in severe cardiac failure. Cardiac
      catheterization revealed suprasystemic pressure of the left pulmonary artery and
      a high pulmonary vascular resistance. Right-sided pneumonectomy abolished cardiac
      failure and normalized both pulmonary artery pressure and resistance. Pure volume
      load affecting one lung--as in this case through absence of the right pulmonary
      artery plus additional left-to-right shunt from a systemic collateral--can lead
      to pulmonary hypertension. Early operative intervention can reverse this process
      and prevent pulmonary vascular disease.

PMID- 1614919
TI  - Cor triatriatum associated with total anomalous pulmonary venous drainage in the
      setting of mitral atresia and a restrictive interatrial communication.
AB  - A rare variant of cor triatriatum is described in which the proximal "accessory"
      chamber received all four pulmonary veins and drained into the levoatriocardinal
      vein and then into the innominate vein. The distal "true" chamber contained the
      left atrial appendage. The left atrioventricular valve was atretic and the
      interatrial septum was restrictive.

PMID- 1614920
TI  - Gaucher's disease with mitral valve calcification.

PMID- 1614921
TI  - Cardiomyopathy in infancy: observations in an epidemiologic study.
AB  - Cardiomyopathy (Cm), a rare form of cardiac disease in infancy, is receiving
      increasing attention stimulated by the availability of endocardial biopsy and new
      forms of therapy. Population-based information on frequency of occurrence, types,
      and maternal and infant characteristics of this diverse group of heart muscle
      disorders has been obtained in the course of an etiologic study on cardiovascular
      disease in infancy. The Baltimore-Washington Infant Study (BWIS) enrolled 2659
      infants with heart disease and 2801 control infants between January 1, 1981 and
      March 31, 1987, a 6-year prevalence of 4.46/1000 live births. Fifty-six infants
      had cardiomyopathy, in the absence of a structural defect (prevalence 1/10,000).
      The cases were classified clinicopathologically as follows: dilated Cm (n = 17),
      hypertrophic Cm (n = 26), tumor (n = 5), endocardial fibroelastosis (n = 5),
      glycogen storage (n = 1), mucocutaneous lymph node syndrome (n = 1), and
      infarction (n = 1). Eleven syndromic associations and six metabolic disturbances
      indicate genetic risk factors. Some of the same syndromes occurred in other
      infants who had structural cardiac abnormalities. This overlap suggests that
      embryonic myocardial disease might sometimes be responsible for altered cardiac
      structures, possibly secondary to hemodynamic changes. Familial myocardial
      disease occurred in two infants with hypertrophic Cm. The Cm group did not differ
      by race and sex from controls, but the mothers were of lower educational and
      occupational status with less private care and with later registration for
      pregnancy care. The descriptive epidemiology of this population-based case group
      provides evidence of greater etiologic heterogeneity than has been shown in
      clinical reports.

PMID- 1614922
TI  - Grading the severity of congestive heart failure in infants.
AB  - To determine which variables most accurately define congestive heart failure
      (CHF) in infants, 41 patients (median age 2.5 months) were graded by four
      pediatric cardiologists for the presence and severity of CHF based on the
      following variables: amount of formula consumed per feeding, feeding time,
      history of diaphoresis or tachypnea, growth parameters, respiratory and heart
      rates, respiratory pattern, perfusion, presence of edema, diastolic filling
      sounds, and hepatomegaly. There were 19 patients graded as having no CHF, nine as
      mild, seven moderate, and six severe CHF. The most sensitive and specific
      variables (p less than 0.0001) for the presence of CHF were a history of less
      than 3.5 oz/feed, respiratory rate greater than 50/min, an abnormal respiratory
      pattern, diastolic filling sounds, and hepatomegaly. Moderate to severe CHF was
      present when patients took less than 3 oz/feed or greater than 40 min/feed, had
      an abnormal respiratory pattern with a resting respiratory rate greater than
      60/min, and had a diastolic filling sound and moderate hepatomegaly. Severe CHF
      was accompanied by a heart rate greater than 170/min, decreased perfusion, and
      severe hepatomegaly. Thus, the grading of the severity of CHF in infants should
      include an accurate description of these historical and clinical variables.

PMID- 1614924
TI  - Cor triatriatum sinistrum: one institution's 28-year experience.
AB  - Twelve patients with cor triatriatum sinistrum were treated over a 28-year
      period. Their ages ranged from 1 month to 7.5 years. Congestive heart failure was
      the most common presentation. Cardiac catheterization was performed on six of the
      12 patients and a correct diagnosis of cor triatriatum was made on angiography in
      only four of the six. Of the remaining six patients, three were diagnosed as
      having cor triatriatum by echocardiography and three by autopsy. Echocardiography
      is now considered to be the diagnostic modality of choice in our institution.
      Seven patients were operated on and five died prior to diagnosis or treatment
      Associated cardiac anomalies included persistent left superior vena cava, atrial
      septal defects, coarctation of the aorta, and total anomalous pulmonary venous
      drainage. A right atrial, transseptal approach to the common pulmonary chamber
      and excision of the left atrial membrane was found to be the treatment of choice
      and was used in six of the seven patients operated on. One patient died in the
      postoperative period. Thus, cor triatriatum sinistrum, a rare and potentially
      lethal congenital cardiac anomaly, can be diagnosed by echocardiography and
      successfully treated surgically with a low operative mortality.

PMID- 1614923
TI  - A survey of pediatric management of dyslipidemias in New England.
AB  - We recently surveyed physicians attending the New England Pediatric Preventive
      Cardiology Society. Sixteen physicians who actively evaluated children with
      dyslipidemia completed questionnaires; at least one representative from six of
      the seven medical schools in New England was included. The survey elicited
      responses to five hypothetical cases of childhood dyslipidemia which were
      representative of the types of lipid problems commonly referred to pediatric
      lipid specialists. Diet modification was the initial treatment of choice of all
      participants. For any set of lipid values, postpubertal age increased the
      proportion of respondents who would have prescribed medication. When
      pharmacologic intervention was elected, resin binders (cholestyramine or
      cholestipol) and niacin were most commonly prescribed. The responses of the
      physicians showed considerable variation in the threshold for beginning
      medications. In summary, this survey suggests substantial variation in the
      approach to pharmacologic management of pediatric dyslipidemias in the New
      England region.

PMID- 1614925
TI  - Juvenile autoimmune thyroiditis and mitral valve prolapse.
AB  - An increased incidence of mitral valve prolapse (MVP) has been reported in adult
      patients with autoimmune thyroid disease. The aim of this study was to assess the
      incidence of MVP in children and adolescents with juvenile autoimmune thyroiditis
      (JAT). Cardiac echo studies using M-mode, 2D, and Doppler examinations were
      performed on 23 patients (21 females, 2 males). The patients were studied at a
      median age of 12 years (range 5-20 years). Only one patient was found to have
      evidence suggestive of MVP, an incidence (4.3%) similar to that seen in the
      normal pediatric population. We, therefore, conclude that the incidence of MVP in
      children and adolescence with JAT is not increased.

PMID- 1614926
TI  - Anomalous left coronary artery from the main pulmonary trunk: physiologic and
      clinical importance of its association with persistent ductus arteriosus.
AB  - Anomalous left coronary artery (ALCA) from the pulmonary trunk presents in early
      infancy with a clinical picture of failure to thrive, congestive heart failure
      (CHF), angina-like episodes, and mitral insufficiency. These manifestations which
      are due to myocardial ischemia may change in the presence of an associated
      lesion. We present a case and review two previous reports of a patent ductus
      arteriosus (PDA) associated with this anomaly. Although signs and symptoms are
      not as clear due to the less impaired coronary perfusion and the presence of a
      PDA, the presence of mitral insufficiency should raise the possibility of an
      anomalous coronary artery and, therefore, a cardiac catheterization and
      angiocardiography are recommended in anticipation of reparative surgery.

PMID- 1614927
TI  - Care with an indwelling urinary catheter. Tips for avoiding problems in
      independent and institutionalized patients.
AB  - Ideally, no patient would have an indwelling urethral catheter. However, certain
      circumstances require long-term catheterization. In these patients, bacterial
      colonization is to be expected. Morbidity and mortality related to long-term
      catheterization can be minimized by attention to the details of catheter care,
      prompt treatment of often minimally symptomatic catheter-related infections, and
      attentiveness to changes in patient condition or alternative treatments that may
      permit catheter removal.

PMID- 1614929
TI  - Medical implications of obesity. Losing pounds, gaining years.
AB  - Through thousands of years of starvation and poor nutrition, the human body has
      become adept at storing scarce nutrients. Today, in the United States and Canada
      particularly, the combination of sedentary habits and excessive intake of
      calories is imposing a dual burden on a physiologic system that is ill-equipped
      to handle it. Unable to rid itself of calories, the body's only defense is to
      store them all. The end result is obesity, with all its deleterious effects on
      health and longevity.

PMID- 1614928
TI  - Animal bites. Guidelines to current management.
AB  - Several factors need to be considered when evaluating animal bites. These include
      type of animal involved, specific nature of the wound, circumstances of the
      attack, interval between injury and treatment, and location of the bite. Of
      concern are direct destruction of tissue and risk of infection. Use of antibiotic
      prophylaxis is controversial, but most authorities agree that it is needed for
      hand wounds, puncture wounds, or "dirty" wounds of any type in any location. The
      choice of antibiotic is also controversial, but initial empirical treatment
      generally relies on broad-spectrum coverage. Rabies prophylaxis is indicated for
      bites by carnivorous wild animals, bats, and unvaccinated domestic animals.
      Review of the patient's tetanus status is mandatory.

PMID- 1614930
TI  - Aspiration pneumonia. A threat when deglutition is compromised.
AB  - Aspiration results from abnormal structure or from dysfunction during the oral,
      pharyngeal, or esophageal stage of deglutition. Chemically induced inflammation
      of the lungs and obstruction of the airways may ensue. Feeding and swallowing
      problems may occur at any age, but they are particularly prevalent in the
      elderly, and the morbidity and mortality that result from impaired oral intake
      are now recognized as a major geriatric problem. Aspiration pneumonitis and/or
      pneumonia has a high morbidity and mortality rate. Medical management is mainly
      aimed at supportive care with the hope of resolution over time. Complications
      demand aggressive measures. Prevention of aspiration is apt to be more rewarding
      than treatment of consequences. All predisposing factors should be carefully
      assessed by the physician and modified whenever possible.

PMID- 1614931
TI  - Follow the rules. But tell us if the feds target you unfairly!

PMID- 1614932
TI  - Exercise for patients with diabetes. Benefits, risks, precautions.
AB  - Exercise is beneficial in both prevention and control of non-insulin-dependent
      (type II) diabetes. Whether a patient has insulin-dependent or type II diabetes,
      a regular exercise program can produce positive changes in the lipid profile,
      reduce blood pressure and weight, and improve other cardiovascular risk factors.
      The risks of an exercise program include precipitation of cardiovascular events,
      damage to the soft tissue and joints of the feet, visual loss, early and delayed
      hypoglycemia, and hyperglycemia and ketosis. Consequently, a comprehensive
      clinical assessment to identify potentially harmful diabetic complications and to
      determine the patient's fitness level is needed before a suitable exercise
      program can be prescribed. With careful manipulation of insulin doses and home
      monitoring of blood glucose levels, exercise need not adversely affect glycemic
      control. Moreover, the metabolic and cardiovascular benefits that result from a
      sensible exercise program can greatly improve the quality of life for most
      diabetic patients.

PMID- 1614933
TI  - Acute myocardial infarction. An updated protocol for thrombolytic therapy.
AB  - Only a small percentage of patients who have acute myocardial infarction receive
      the benefit of intravenous thrombolytic therapy, often because logistics result
      in unnecessary pre-hospital and in-hospital delays. Dr Selig therefore recommends
      that a streamlined protocol be available and that it be updated at regular
      intervals to ensure that this time-dependent therapy is more routinely utilized.

PMID- 1614934
TI  - The hypertensive patient. Not just a number.
AB  - Treatment of both systolic-diastolic and isolated systolic hypertension in
      patients over age 65 has been shown to decrease subsequent cardiovascular
      morbidity and mortality. In the European Working Party on High Blood Pressure in
      the Elderly study, the number of morbid and mortal cardiovascular events
      prevented in the treatment group was 29/1,000 person-years, whereas in the
      Systolic Hypertension in the Elderly Program, the number was 55/1,000 person
      years. This magnitude of reduction is substantial, but in the case of primary
      prevention in the elderly, a large number of patients must be treated to benefit
      relatively few. Better strategies of targeting treatment based on risk over and
      above that of high blood pressure are needed. Certainly, patients with more than
      one cardiovascular risk factor or evidence of end-organ damage should be treated
      more aggressively.

PMID- 1614935
TI  - Post-polio syndrome. An emerging threat to polio survivors.
AB  - The manifestations of post-polio syndrome typically occur 20 to 40 years after an
      acute episode of poliomyelitis and are confined to previously affected muscles.
      Because of motor unit remodeling and direct mechanical damage, weakness increases
      in individual muscles until it exceeds their narrow margin of reserve and becomes
      clinically apparent. Although the exact cause is not clear, generalized weakness
      often occurs when several muscles are affected and various postural limb
      strategies used by the patient are no longer able to compensate for the loss of
      muscle strength. The mainstays of treatment are life-style changes to avoid
      overexertion and use of light-weight orthoses and assistive aids to unload the
      extremities. Exercise and surgery have a limited role in management.

PMID- 1614936
TI  - How useful are implantable cardioverter-defibrillators?
AB  - When use of an implantable cardioverter-defibrillator (ICD) is being considered
      for a patient with life-threatening ventricular arrhythmias, the potential risks
      and benefits must be carefully weighed. The risks of implantation of an ICD
      should be minimal; however, a low risk is highly dependent on patient selection
      and other factors, and perioperative risk varies significantly from center to
      center. The referring physician should not hesitate to ask for perioperative
      mortality statistics from the referral center. The difficulty in successfully
      documenting the usefulness of the ICD is especially important today. As the ICD
      becomes more like the pacemaker, there will be a natural tendency to expand the
      use of this new technology to patients in lower-risk groups. Suboptimal methods
      were adequate to document the benefit of the ICD in high-risk patients, but
      similar methods may not be adequate for low-risk patients. Fortunately, the
      importance of performing adequate studies has been recognized, as evidenced by
      the several randomized controlled trials that have been undertaken to study the
      efficacy of the ICD in these new groups of patients.

PMID- 1614937
TI  - Shortage of primary care physicians.

PMID- 1614938
TI  - Readers respond to CLIA.

PMID- 1614939
TI  - Readers respond to CLIA.

PMID- 1614940
TI  - Wheat middlings as an alternative feedstuff for laying hens.
AB  - Three long-term experiments were conducted to evaluate the possibility of using
      wheat middlings (WM) for laying hens and to study the responses of six strains of
      commercial laying hens fed WM diet. In Experiment 1,320 layers maintained in
      floor pens were fed diets containing 45% WM with .25 or .75% salt, or 89% WM with
      .25% or 1.5% salt. Salt supplementation did not show any beneficial effect on egg
      production. Hen-day egg production by hens fed the 45% WM diet was significantly
      higher for hens fed 45% WM than for those fed the 89% WM diet (79 versus 67.5%,
      44-wk period). Feed, limestone, and water intakes were increased by the 89% WM
      diet. Yolk color, Haugh units, hen livability, and reproductive parameters were
      not different among the dietary treatments. In Experiments 2 and 3, laying hens
      from six commercial strains (four strains each experiment, 240 hens per strain)
      were maintained in laying cages in each year, and fed either a corn and soybean
      meal (CSM) or a 25% WM diet. Results show that neither diet nor strain had
      effects on hen-day egg production; however, egg weights from Strains A, C, and F
      were heavier than those from Strains B, D, and E. Feed intakes and feed
      utilizations were similar among the s trains. The 25% WM diet increased egg
      weight, feed intake, and feed utilization compared with the CSM diet. Livability
      of hens was 93.8 to 97.5% and was not affected by either strain or diet. It is
      concluded that commercial strains of laying hens can be fed diets containing 25
      to 45% WM and still have normal hen-day egg production although feed utilization
      will be poorer.

PMID- 1614941
TI  - Glucagon-induced desensitization of broiler adipocyte lipolysis.
AB  - Continuous exposure of cells to a hormonal stimulus results in attenuation of the
      hormone's effects on the cell; a process known as desensitization. The present
      study was undertaken to determine whether glucagon (GLU) induces desensitization
      of its lipolytic effect in adipocytes isolated from the abdominal fat of market
      age broilers. Preincubation of adipocytes with 10 to 100 ng/mL of porcine GLU
      (pGLU) or chicken GLU (cGLU) for 24 h reduced (P less than .05) GLU-stimulated
      lipolysis. However, pGLU decreased (P less than .05) lipolysis to a greater
      extent than cGLU. Maximal lipolysis was reduced 70% by pGLU and 55% by cGLU.
      Chicken GLU also exhibited lower biological potency for acutely stimulating
      lipolysis from control and cGLU-treated adipocytes. Glycerol release from control
      adipocytes incubated for 1 h with .3 ng/mL of cGLU or pGLU was 26 and 42 nmol/h
      per 3% cells, respectively. The GLU-induced decrease in lipolysis occurred
      rapidly and was partially reversible. The results of the present study indicated
      that GLU induced desensitization of its lipolytic effect in broiler adipocytes.

PMID- 1614942
TI  - Effect of inorganic phosphate source and dietary phosphorus level on laying hen
      performance and eggshell quality.
AB  - Two experiments were conducted to evaluate laying hen performance when fed two
      sources of inorganic phosphorus. In Experiment 1, a regular and a coarse form of
      defluorinated phosphate and one source of dicalcium phosphate were used in diets
      calculated to contain either .4 or .5% total phosphorus (.2 or .3% nonphytate
      phosphorus). In Experiment 2, either the regular form of defluorinated phosphate
      or the dicalcium phosphate source was fed in diets calculated to contain either
      .4, .5, .6, or .7% total phosphorus (.2, .3, .4, or .5% nonphytate phosphorus).
      In Experiment 1, hens fed .5% total dietary phosphorus consumed more feed and
      produced heavier eggs (P less than or equal to .05). Hens fed the .4% dietary
      phosphorus level lost more weight during the experiment (P less than or equal to
      .05). No differences among dietary treatments existed for egg specific gravity. A
      significant source by level interaction occurred for the farm classification of
      thin-shelled, cracked, or broken eggs and for the total of these classifications.
      In Experiment 2, egg production, feed consumption, egg weight, and egg mass were
      depressed (P less than or equal to .05) at the .4% total dietary phosphorus
      level. Hens fed the .4 and .7% total dietary phosphorus level laid eggs with the
      highest and lowest egg specific gravity, respectively. This trend was inverse to
      the effect of these phosphorus levels on egg weights. A significant source by
      level interaction occurred for the farm classification of thin shell and for the
      total percentage of eggs with exterior defects. At the .4% total phosphorus
      level, the regular form of defluorinated phosphate produced eggs with a
      significantly greater thin shell classification than the dicalcium phosphate
      source. Hens fed the dicalcium phosphate source produced a higher percentage of
      compressed-sided and misshapen eggs.

PMID- 1614943
TI  - Effect of feeding palmitic, oleic, and linoleic acids to Japanese quail hens
      (Coturnix coturnix japonica). 2. Maternal diets and stage of incubation on the
      lipid metabolism of quail embryos.
AB  - An experiment was conducted to evaluate the effects of diets containing 3% of
      either palmitic acid (Diet PA), oleic acid (Diet OA), or linoleic acid (Diet LA)
      and three stages of development (Days 11, 13, and 15 of incubation) on 1) weights
      of yolk plus yolk sac membrane (TY), yolk sac membrane (YSM), yolk, liver, and
      extrahepatic tissue (ET); and 2) the fatty acid composition of phospholipid,
      triglyceride, and cholesterol ester fractions of YSM and ET of quail embryos.
      Embryos from birds fed Diet LA had the highest (P less than .05) weights of TY
      and yolk followed by those from birds fed Diet OA and Diet PA. The weight of ET
      was highest (P less than .05) in embryos from birds fed Diet PA followed by those
      from birds fed Diet LA and Diet OA. The weights of YSM and liver were not
      affected by the maternal diet (P greater than .05). The weight of TY decreased
      whereas the weights of liver and ET increased as incubation progressed (P less
      than .05). The weight of YSM was maximum at Day 13 of incubation. In the
      phospholipid, triglyceride, and cholesterol ester fractions of both YSM and ET of
      embryos, the fatty acid present at the highest level, except palmitic acid, was
      the one added to the maternal diet. In phospholipids of both YSM and ET the oleic
      acid content decreased and linoleic acid increased as incubation progressed. In
      triglycerides and cholesterol esters of both YSM and ET, the levels of palmitic
      acid increased, but oleic and linoleic acids decreased, with advancing embryonic
      development. The results of the present study indicate that embryos from birds
      fed Diet PA mobilize more yolk material and produce heavier ET than embryos from
      birds fed Diet OA and Diet LA. The fatty acid profiles of phospholipid,
      triglyceride, and cholesterol esters of embryonic tissues are consistently
      influenced by dietary fatty acid and the stage of development.

PMID- 1614944
TI  - Mineral balance and urinary and fecal mineral excretion profile of broilers
      housed in thermoneutral and heat-distressed environments.
AB  - Two experiments were conducted utilizing 4- to 7-wk posthatching Vantress x Arbor
      Acres male broilers to evaluate heat distress effects on mineral balance
      partitioned into urinary and fecal loss. In the first study, 8 colostomized and
      14 intact birds were allotted to two environmental chambers maintained at either
      a thermoneutral temperature (24 C) or a cycling temperature heat distress (24 to
      35 C) in a switch-back design. Birds were precision-fed 2% of body weight thrice
      daily to equalize consumption prior to and over each 48-h experimental period.
      Feces and urine for colostomized birds and total excrement for intact birds were
      collected and analyzed for mineral content. Averaging across surgical
      classification, heat distress increased (P less than .05) excretion of K, P, S,
      Mg, Cu, Mo, and Zn. Despite little heat distress effect on urine production,
      minerals disproportionately excreted in urine included K, Mg, P, and S; Cu and Mg
      were lost primarily in feces. In the second study 42 colostomized birds were used
      to expand the urinary excretion data with the period of heat distress held at 35
      C for 36 h. Heat distress increased (P less than .05) urine output from 52.3 +/-
      5.3 to 109.9 +/- 4.5 mL/12 h and also increased total urinary K, P, S, Na, Mg,
      Ca, and Mn excretion. The present data provide evidence that heat distress
      adversely impacts bird mineral balance and that the excretion route for this
      effect varies with the specific mineral and possibly, heat distress severity.

PMID- 1614945
TI  - Changes in plasma catecholamine, free fatty acid, and glucose concentrations, and
      plasma monoamine oxidase activity before and after feeding in laying hens.
AB  - In order to better understand the relationship of free fatty acid (FFA)
      concentrations to feed intake in laying hens, plasma levels of catecholamine,
      glucose, and FFA and plasma monoamine oxidase activity were measured. Blood
      samples were taken in the morning before and after the start of feeding via
      chronic brachial vein catheters. Plasma concentrations of epinephrine and
      norepinephrine were analyzed by modified HPLC with an electrochemical detection
      method. Plasma concentrations of FFA and glucose were not significantly different
      before and after the start of feeding, however a negative correlation (r = -.763,
      r2 = .582, P less than .01) between these parameters was observed. No significant
      correlations between the plasma concentration of FFA and plasma concentrations of
      epinephrine or norepinephrine before and after the start of feeding were
      observed. However these were significantly correlated (r = .444, r2 = .197, P
      less than .05 for FFA and epinephrine; r = .787, r2 = .619, P less than .01 for
      FFA and norepinephrine) when the behavioral activity of hens was low, such as in
      resting or feeding. Plasma activity of monoamine oxidase was not different before
      and after the start of feeding, and no relationship was observed between plasma
      monoamine oxidase activity and plasma epinephrine or norepinephrine
      concentration. It is suggested that the increase in plasma FFA concentration
      before feeding would be elicited by the increase in the circulating epinephrine
      and norepinephrine concentrations. Plasma FFA concentration was not affected by
      the increase in circulating epinephrine and norepinephrine concentrations during
      active behavior such as pacing and egg call before and after oviposition.

PMID- 1614946
TI  - Response to angiotensin II after selective lesioning of brain regions believed to
      be involved in water intake regulation.
AB  - The subfornical organ (SFO) and organum vasculosum lamina terminalis (OVLT) are
      regions of the brain that border the third ventricle (outside the blood-brain
      barrier) and have been implicated in the control of water intake elicited by
      angiotensin II (ANGII). Studies were conducted in which the response to injected
      ANGII following lesions of the SFO (LSFO) or OVLT (LOVLT) in broiler chicks was
      observed. Three groups of birds were used for each trial: lesioned and ANGII
      injected (LI); not lesioned and ANGII-injected (NLI); and not lesioned and saline
      injected (NLC). In Experiment 1, water intake of LISFO was decreased through 3 h
      postinjection (P less than .01). Intakes of LISFO and NLCSFO were not
      significantly different through 1 h postinjection. The OVLT did not have an
      effect on cumulative water intake in response to intramuscular ANGII. Water
      intakes of LIOVLT and NLIOVLT did not differ from each other, but were
      significantly higher than NLCOVLT (P less than .05) at .5 and 1 h postinjection.
      Feed intake was unaltered by SFO or OVLT lesions. Feed intake was suppressed and
      water intake increased by ANGII injection. The present study indicates that the
      SFO, but not the OVLT, plays a role in ANGII-induced water intake in broiler
      chicks.

PMID- 1614947
TI  - Research note: effect of 2,4-dinitrophenol on growth and body composition of
      broilers.
AB  - The effects of 2,4-dinitrophenol (DNP) on growth, feed efficiency, fattening, and
      mitochondrial functions of liver and skeletal muscle were studied in broilers.
      The DNP was added at levels of 100, 200, and 400 mg/kg of diet. Feed intake was
      not changed with administration of DNP except at 100 mg/kg of diet. Body weight
      was significantly decreased by administration of DNP at 400 mg/kg of diet
      compared with those at 0 and 100 mg/kg of diet. Feed efficiency was significantly
      reduced by administration of DNP at 400 mg/kg of diet. Abdominal fat and carcass
      fat contents, expressed either as absolute values or relative percentages of body
      weight, were significantly decreased with increasing dietary DNP concentration
      above 200 mg/kg of diet. These results showed that administration of DNP reduced
      body fat, which may be associated with the change in feed efficiency. No
      reduction in adenosine triphosphate:oxygen ratio with increasing DNP
      concentration was observed in hepatic and skeletal muscle mitochondria isolated
      from broilers fed experimental diets containing DNP.

PMID- 1614948
TI  - Research note: broiler acclimation to heat distress and feed intake effects on
      body temperature in birds exposed to thermoneutral and high ambient temperatures.
AB  - Relationships between ambient temperature, bird acclimation to cycling
      temperature, heat distress, and feed consumption were evaluated in two
      experiments. In the first experiment, birds previously acclimated to cycling
      temperature heat distress (24 to 35 C) for two 24-h cycles were observed to have
      24% lower (P less than .01) feed consumption than birds previously housed at 24 C
      and experiencing their first heat distress exposure. A significant (P less than
      .01) acclimation history by ambient temperature interaction was detected, with
      acclimated birds having a higher rectal temperature (42.3 versus 41.2 C) when
      housed at 24 C and a lower rectal temperature (44.2 versus 44.6 C) when exposed
      to 35 C than did the unacclimated controls. In the second experiment, feed intake
      and acclimation effects were separated by precision-feeding birds 0, 5, and 10%
      of body weight. Rectal temperature in the 24 C and 35 C environments increased
      linearly (P less than .01) as feeding level increased for both acclimated and
      unacclimated birds. Similar to the first experiment, an ambient temperature by
      acclimation history interaction was detected (P less than .01), with acclimated
      birds exhibiting increased body temperature when housed in thermoneutral
      environments and lower body temperature when exposed to high ambient temperature
      distress.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614949
TI  - Effect of light intensity level during prelay light restriction on subsequent
      reproductive performance of turkey breeder hens.
AB  - Two trials were conducted to determine whether light intensity levels during the
      prelay (light restriction) and the lay (egg production) periods influenced
      subsequent photoinduced reproductive performance of turkey breeder hens. The
      light intensity levels were 22 and 270 lx and each was provided during the prelay
      and lay periods in a factorial arrangement. Each of the period light intensity
      levels were applied to half of the hens from each prelay treatment group. Data
      were collected for BW, rate of reproductive development, egg production,
      fertility, hatchability, egg weight, and poult weight. There were no interactions
      between the prelay and lay period treatments, nor a consistent prelay light
      intensity effect on rate of initiation of lay or duration of time to achieve 50%
      production. In addition, prelay and lay light intensity levels had no consistent
      effects on rate of lay, percentage of fertility and hatchability, egg weight, and
      poult weight. It was concluded that there was no advantage to the use of high
      intensity light during short-day light restriction of the prelay period on
      subsequent reproductive performance.

PMID- 1614951
TI  - Effect of periodic feeding and photoperiod on anticipation of feed withdrawal.
AB  - Broiler chicks obtained from a commercial hatchery were reared on litter in
      environmental chambers. The rearing temperature was 32 C initially, and reduced
      2,8 C/wk until 24 C was reached. Water was available for ad libitum intake. The
      treatments began at 7 days in Trial 1 and at 8 days in Trial 2, during which feed
      and water consumption were recorded by computer every 30 min and summarized for 2
      and 24-h periods until each trial was completed. In Trial 1, the treatments
      were: 1) continuous light with feed available 12 h/day; and 2) 12 h light (L):12
      h dark (D) with feed available for ad libitum consumption for 1 wk and
      unavailable thereafter during darkness. In Trial 2, the treatments were 1)
      14L:10D; 2) 10L:14D; and 3) continuous light. During the treatments, no feed was
      provided during darkness and only for 12 h/day during continuous light. At 29
      days, feeding and lighting were again continuously provided until the trial ended
      at 33 days. Broilers were able to anticipate the period of feed unavailability
      when it coincided with darkness. They were unable to anticipate the period when
      feed was unavailable if they were in continuous light. Continuously lighted
      broilers consumed more feed at the onset of the feeding period than did the
      broilers in light:dark cycles. Periodically lighted broilers consumed more feed
      at the end than at the onset of the feeding period. Resumption of continuous
      feeding occurred more quickly for continuously lighted broilers than for those
      previously on light:dark cycles. The data indicate that the internal clock that
      permits broilers to anticipate recurring periods of feed unavailability depends
      on a daily period of darkness.

PMID- 1614950
TI  - Laying hen performance as affected by diet and caging density.
AB  - Two trials were conducted to investigate the effects of caging density and diet
      on the performance of caged layers. Diets were formulated contain .775, .725, and
      .675% lysine. The TSAA content was formulated to be 85% of the lysine content of
      each diet. Pullets were caged in 25.4 cm wide x 40.0 cm deep cages at three, two,
      or one bird per cage. Production data were collected for 112 days in Trial 1 and
      168 days in Trial 2. As dietary protein, lysine, and TSAA increased, hen-day egg
      production, egg weight, and feed conversion improved (P less than .05) . Feed
      consumption and feed per dozen eggs were not consistently affected by diet.
      Caging density had no consistent effects on any of the production parameters. No
      interactions were detected between dietary treatments and cage density in either
      trial.

PMID- 1614952
TI  - Barley inclusion and avoparcin supplementation in broiler diets. 1. Effect on
      small intestinal bacterial flora and performance.
AB  - Diets based on barley or corn without avoparcin supplementation were associated
      with high counts of Clostridium perfringens in the contents of the small
      intestine of the birds at the age of 2 to 4 wk. The weight gain of birds younger
      than 2 wk and the body weight of 4-wk-old birds were significantly lower, and the
      feed conversion ratio at slaughter was significantly higher, in birds on barley
      diets than in birds on corn diets. The frequency of birds with sticky droppings
      on Day 21 was significantly higher for barley diets. The number of C.
      perfringens, and the feed conversion ratio at slaughter were significantly lower
      but the number of coliform bacteria, weight gain during the 3rd wk, and body
      weight of 4-wk-old chickens were significantly higher when the diets were
      supplemented with 7.5 mg avoparcin/kg feed. The effect of avoparcin on the feed
      conversion ratio was statistically significant only on a barley diet.

PMID- 1614953
TI  - Effect of monensin on ultrastructure and cellular invasion by the turkey coccidia
      Eimeria adenoeides and Eimeria meleagrimitis.
AB  - Freshly excysted sporozoites (SZ) of the turkey coccidia Eimeria meleagrimitis
      and Eimeria adenoeides were incubated at 41 C in concentrations of monensin from
      .01 to 1.0 microgram/mL, washed free of the drug, and either processed for phase,
      fluorescence, and transmission electron microscopy or inoculated into cultures of
      turkey kidney cells. Phase microscopy indicated that after 1.5 h incubation in
      1.0 micrograms/mL monensin, about 60% of the SZ of E. meleagrimitis had become
      notably rounded or displayed localized protrusions. These alterations were
      accompanied by ultrastructural abnormalities (in 90% of the SZ) including
      vacuoles in the cytoplasm, bulging and separation of plasma membrane layers, and
      dense bands in the refractile bodies that extended toward the periphery of the
      refractile body. Similar morphological and ultrastructural changes were observed
      in over half of the E. adenoeides SZ after 2 h incubation in 1.0 micrograms/mL
      monensin. Additionally, some specimens contained a pycnotic nucleus that was
      usually surrounded by a large vacuole. After 4 h incubation, almost all of the SZ
      displayed some degree of ultrastructural damage. Indirect fluorescent antibody
      labeling with parasite-specific monoclonal antibodies demonstrated clouds of
      antigen surrounding the monensin-treated but not the untreated SZ, suggesting an
      increase in permeability with incubation in monensin. With both E. meleagrimitis
      and E. adenoeides, the structural changes were reflected in a significant
      inhibition of cellular invasion. The inhibitory activity of monensin was
      concentration- and time-dependent in that the greatest inhibition of invasion was
      observed in SZ incubated for 4 h in 1.0 micrograms/mL of monensin; shorter
      incubation times or lower concentrations of monensin having less effect.

PMID- 1614954
TI  - Comparison of heat-shock-induced and lipopolysaccharide-induced protein changes
      and tumoricidal activity in a chicken mononuclear cell line.
AB  - The functions of a chicken mononuclear phagocytic cell line MQ-NCSU were examined
      after exposure to nonthermal (lipopolysaccharide, LPS) and thermal (heat shock,
      HS) treatments. The protein profiles and tumoricidal factor activity of MQ-NCSU
      cells exposed to 15 micrograms LPS under control (41 C) temperatures expressed
      enhanced synthesis of classical 23-, 70-, and 90-kDa HS proteins (HSP), a heat
      inducible 32-kDa protein (P32), and a novel LPS-induced 120-kDa protein (P120).
      In comparison to LPS treatment, MQ-NCSU cells exposed to 45 C (HS) expressed
      HSP23, HSP70, HSP90, and P32 but not P120. Combined exposure of MQ-NCSU cells to
      HS (45 C) and LPS (15 micrograms) induced an alteration in the initial and
      optimal expression and duration of synthesis of the HSP and the LPS-induced P120.
      The tumoricidal activity of supernatants from LPS-treated and untreated MQ-NCSU
      cells cultured at 45 C was significantly depressed as compared with the controls
      (cultured at 41 C). The supernatants collected from LPS-treated and untreated MQ
      NCSU cultures maintained at 41 C were exposed to 45 C temperature for up to 48 h.
      The tumoricidal potential of these supernatants was not affected. The present
      study demonstrates that LPS exposure induces several "stress" proteins in
      macrophages, some of which have molecular similarity with the classical HSP. In
      addition, LPS induces a unique 120-kDa protein not produced following HS alone,
      which may serve as a differential protein associated with activated or
      tumoricidal phenotype of macrophages. Heat shock suppresses the tumoricidal
      potential of LPS-treated MQ-NCSU cells in a regulatory manner that does not
      appear to be a result of thermal denaturation of the tumoricidal factor secreted
      in the culture supernatant.

PMID- 1614955
TI  - Heat-shock protein synthesis in chicken macrophages: influence of in vivo and in
      vitro heat shock, lead acetate, and lipopolysaccharide.
AB  - Synthesis of heat-shock proteins (HSP) in chicken macrophages, in response to
      thermal and nonthermal stressors, was determined. Cornell K-strain 6-wk-old White
      Leghorn females were injected with Sephadex and approximately 42 h later
      subjected to elevated temperatures in order to achieve a core body temperature
      (CBT) of 44 C. Peritoneal macrophages were isolated at 30 and 60 min after heat
      treatment. A parallel group of chickens, maintained at the normal CBT of 41 C,
      was used as controls and peritoneal macrophages were isolated after 60 min of
      treatment. For in vitro study of HSP response, cells of a chicken macrophage cell
      line (MQ-NCSU) were subjected to 45 C ambient temperature to produce heat shock
      (HS, thermal stress), lipopolysaccharide (LPS, 15 micrograms), and lead acetate
      (nonthermal stress) exposure for varying time periods. The HSP profiles of
      macrophages following various treatments were determined by one- and two
      dimensional gel electrophoresis. The results showed that macrophages isolated
      from the 44 C CBT group synthesized HSP90, HSP70, HSP23, and a heat-inducible P32
      protein. This HSP synthesis profile was similar to the HSP expression by MQ-NCSU
      cells exposed in vitro to 45 C conditions. Exposure to MQ-NCSU cells to lead
      acetate induced the same four proteins previously expressed by macrophages after
      in vivo or in vitro heat treatment. Two-dimensional analysis of lysates from
      cells treated with LPS, HS, or LPS plus HS treatments revealed a doublet protein
      molecule (70a and 70b) with identical molecular mass of 70 kDa. However, the pI
      value (isoelectric point) of 70b was higher (5.1) than that of 70a, which, along
      with HSP90 and HSP23, focused more toward the acidic side with a pI value of less
      than 4.6. The present study is the first to report pI profiles of chicken
      macrophage HSP. The in vitro and in vivo studies suggest that chicken macrophages
      respond to thermal and nonthermal stressors by producing similar kinds of "stress
      proteins".

PMID- 1614956
TI  - 81st annual meeting of the Poultry Science Association, Inc., Fayetteville,
      Arkansas, August 3-6, 1992 and 13th annual meeting of the Southern Poultry
      Science Society, Atlanta, Georgia, January 20-21, 1992. Abstracts.

PMID- 1614957
TI  - Hydrogels: swelling, drug loading, and release.
AB  - Hydrogels have been used by many investigators in controlled-release drug
      delivery systems because of their good tissue compatibility and easy manipulation
      of swelling level and, thereby, solute permeability. The desired kinetics,
      duration, and rate of solute release from hydrogels are limited to specific
      conditions, such as hydrogel properties, amount of incorporated drug, drug
      solubility, and drug-polymer interactions. This review summarizes the
      compositional and structural effects of polymers on swelling, loading, and
      release and approaches to characterize solute release behavior in a dynamic
      state. A new approach is introduced to compensate drug effects (solubility and
      loading) with the release kinetics by varying the structure of heterogeneous
      polymers. Modulated or pulsatile drug delivery using functional hydrogels is a
      recent trend in hydrogel drug delivery.

PMID- 1614958
TI  - Pharmacokinetic/dynamic correlation of pulmonary and cardiac effects of fenoterol
      in asthmatic patients after different routes of administration.
AB  - Pulmonary and cardiac effects of the beta 2-adrenergic drug fenoterol were
      studied in 27 asthmatic patients using an integrated pharmacokinetic/dynamic
      (PK/PD) approach. Airway resistance (Rf), intrathoracic gas volume (IGV), heart
      rate, and plasma levels were monitored after placebo, injection (12.5 and 25
      micrograms), nasal instillation (400 micrograms), inhalation (200 and 400
      micrograms), and infusion (200 micrograms/180 min with or without loading dose).
      The pharmacokinetics were best described by an open three-compartment model with
      a terminal half-life of 200 min (gamma = 0.23 +/- 0.08 L/hr), a volume of
      distribution at steady state of 1.9 +/- 0.8 L/kg, and a clearance of 0.86 +/-
      0.32 L/hr/kg, with 14 and 9% absorbed after nasal and pulmonary administration,
      respectively. For the noninhalation regimens, a PK/PD correlation linked the
      concentration in the shallow pharmacokinetic compartment to the investigated
      effects via an Emax relationship, resulting in three to five times higher EC50
      values (concentration necessary to achieve half-maximal effect) for the heart
      rate than for the beta 2-mediated effects on IGV and Rf. In contrast, pulmonary
      effects after inhalation could not be incorporated into the correlation,
      indicating that these effects are induced locally after inhalation. Intrapatient
      variability for EC50 and Emax was approximately 90%.

PMID- 1614959
TI  - The bilayer floating capsule: a stomach-directed drug delivery system for
      misoprostol.
AB  - A bilayer floating dosage unit is proposed to achieve local delivery of
      misoprostol, a prostaglandin E1 analogue, at the gastric mucosa level. The system
      is a capsule consisting of a floating layer maintaining the dosage unit buoyant
      upon the gastric content and a drug layer formulated to act as a sustained
      delivery system. The differential design of the two layers allows the
      optimization of both floating capability and drug release profile. The layers are
      both composed of a hydrophilic matrix based upon hydroxypropylmethyl cellulose
      (HPMC). Parameters influencing the release profiles are described. The use of a
      large capsule increases the gastric residence time (GRT), as it impedes passage
      through the pylorus opening. gamma-Scintigraphic studies were performed to
      visualize cohesion of the two layers in vivo and to determine GRT as a function
      of meal regimen. The average GRTs were 199 +/- 69 min after a single meal
      (breakfast) and 618 +/- 208 min after a succession of meals.

PMID- 1614960
TI  - Cutaneous metabolism of nitroglycerin in vitro. II. Effects of skin condition and
      penetration enhancement.
AB  - The effects of skin storage, skin preparation, skin pretreatment with a
      penetration enhancer, and skin barrier removal by adhesive tape-stripping on the
      concurrent cutaneous transport and metabolism of nitroglycerin (GTN) have been
      studied in vitro using hairless mouse skin. Storing the skin for 10 days at 4
      degrees C did not alter barrier function to total nitrate flux [GTN + 1,2
      glyceryl dinitrate (1,2-GDN) + 1,3-glyceryl dinitrate (1,3-GDN)]. However,
      metabolic function was significantly impaired and suggested at least fivefold
      loss of enzyme activity. Heating skin to 100 degrees C for 5 min appreciably
      damaged hairless mouse skin barrier function. The ability to hydrolyze GTN was
      still present, however, and remained constant over the 10-hr experimental period,
      in contrast to the "control," which showed progressively decreasing enzymatic
      function with time. Pretreatment of hairless mouse skin in vivo (prior to animal
      sacrifice, tissue excision, and in vitro transport/metabolism studies) with 1
      dodecylazacycloheptan-2-one (Azone), a putative penetration enhancer,
      significantly lowered the skin barrier to nitrate flux (relative to the
      appropriate control). Again, barrier perturbation resulted in essentially
      constant metabolic activity over the observation period. The ratio of metabolites
      formed (1,2-GDN/1,3-GDN) was increased from less than unity to slightly above 1
      by the Azone treatment. Adhesive tape-stripping gradually destroyed skin barrier
      function by removal of the stratum corneum. The effects of 15 tape-strips were
      identical to those of Azone pretreatment: a greatly enhanced flux, a constant
      percentage formation of metabolites over 10 hr (once again), and an increase in
      the 1,2-GDN/1,3 GDN ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614961
TI  - Rotating-disk dissolution kinetics of nitrofurantoin anhydrate and monohydrate at
      various temperatures.
AB  - The dissolution behavior of nitrofurantoin anhydrate and monohydrate in JP XI,
      second fluid (pH 6.8) was investigated at various temperatures using a dispersed
      amount method and a rotating-disk method. The initial dissolution process of the
      monohydrate obtained by the rotating-disk method followed the Noyes-Whitney
      Nernst equation, but that of the anhydrate did not. The initial dissolution
      process of the anhydrate was analyzed by a dissolution kinetics equation
      involving the phase transformation process from anhydrate to monohydrate. The
      maximal concentration, the dissolution rate constant, and the rate constant of
      the phase transition process were estimated. The thermodynamic parameters for the
      dissolution processes of the anhydrate and monohydrate were obtained from van't
      Hoff plots and Arrhenius plots, respectively. The results of the intrinsic
      solubility and dissolution parameters of anhydrate and monohydrate suggest the
      possibility that the difference in the dissolution rates of the anhydrate and
      monohydrate affect the bioavailability of nitrofurantoin preparation. Information
      on the dissolution behavior of nitrofurantoin pseudopolymorphs is therefore
      useful for designing high-quality preparations.

PMID- 1614962
TI  - An electrically modulated drug delivery device. III. Factors affecting drug
      stability during electrophoresis.
AB  - A number of factors affecting the stability of propranolol HCl during
      electrophoretic control were investigated. It was found that significant
      degradation of propranolol HCl and hydrolysis of water occurred when a current of
      15 mA was used with platinized electrodes. This degradation was thought to be due
      to decomposition of propranolol HCl at the electrodes. Degradation could be
      significantly reduced by using uncoated platinum electrodes and currents in the
      range of 0 to 2.5 mA, while still allowing control of drug delivery rates.
      Electrode reaction processes were found at high ionic strengths and high drug
      concentrations but were not thought to be associated with drug decomposition.

PMID- 1614963
TI  - Simultaneous in vitro measurement of intestinal tissue permeability and
      transepithelial electrical resistance (TEER) using Sweetana-Grass diffusion
      cells.
AB  - A simple modification of the commercially available Sweetana-Grass (S-G) side-by
      side diffusion cells, allowing the simultaneous measurement of tissue
      permeability and transepithelial electrical resistance (TEER), has been described
      and validated for rat excised, muscle-free intestinal tissue. The TEER-lowering
      effects of a series of acylcarnitines were shown to be correlated with previously
      reported in vitro (i.e., membrane perturbation) and in vivo (i.e., absorption
      enhancement) activity. The TEER-lowering effect of palmitoyl carnitine chloride
      (PCC) was also shown to be reversible. The effects of PCC on TEER and the
      permeability of poorly absorbed compounds (cefoxitin and lucifer yellow) were
      simultaneously determined. Compared to controls (mannitol-treated), PCC
      immediately produced a rapid drop in colon TEER. By 5 min post-PCC addition,
      colon TEER was 50% of control; by 10 min post-PCC addition, colon TEER was 17% of
      control. After a lag of about 5-10 min post-PCC addition, the cefoxitin or
      lucifer yellow permeability coefficient increased more than 20-fold. The modified
      S-G cells provide a simple and reproducible method whereby flux and TEER can be
      simultaneously determined, providing a valuable link between the effect of
      absorption enhancers on TEER measurements and the increased permeability of
      poorly absorbed compounds.

PMID- 1614964
TI  - Intestinal absorption of peptides and peptide analogues: implications of fasting
      pancreatic serine protease levels and pH on the extent of oral absorption in dogs
      and humans.
AB  - In order to describe and predict the impact of intestinal metabolism on peptide
      absorption, intestinal chymotrypsin activity, flow rate, and pH were
      characterized in fasted, duodenally fistulated dogs as a function of
      gastrointestinal (GI) motility phase. GI motility was classified as either active
      or quiescent. Cumulative volume, F(t), and volumetric flow rate, Q(t), curves
      were constructed and the data were sorted according to motility phase. The mean
      +/- SE active phase pH was 6.4 +/- 0.3, whereas the quiescent phase pH was 7.3 +/
      0.3. The difference between the mean active and the mean quiescent phase pH
      values was significant. The active and quiescent phase flow rates (ml/min) were
      also significantly different, at values of 1.2 +/- 0.2 and 0.28 +/- 0.07,
      respectively. The active phase flow rates were consistent among the dogs studied;
      however, the quiescent phase flow rates were highly variable among the dogs. The
      variability of the quiescent phase flow rates was expected since phase II of the
      GI motility cycle is characterized by intermediate, irregular spike activity. The
      mean active and quiescent phase chymotrypsin activities were 1.87 x 10(-5) +/-
      0.53 x 10(-5) and 1.56 x 10(-5) +/- 0.65 x 10(-5) M, respectively. The active
      phase values were not statistically different among dogs, however, the quiescent
      phase values were found to be highly variable among dogs. The difference between
      the active and the quiescent phase chymotrypsin mean levels, however, was not
      statistically significant. The chymotrypsin levels determined in dogs were found
      to be approximately 10 times greater than those reported in humans.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1614965
TI  - Mechanism and site dependency of intestinal mucosal transport and metabolism of
      thymidine analogues.
AB  - This study has been undertaken to investigate the mechanisms of intestinal
      mucosal transport and metabolism of thymidine analogues and to identify any
      optimal site(s) of the rat intestine particularly involved in the absorption of
      thymidine analogues. The intestinal absorption of 3'-azido-3'-deoxythymidine
      (AZT) was studied at three initial concentrations in four segments of the rat
      intestine using an in situ recirculating perfusion technique. Disappearance of
      AZT followed first-order kinetics throughout the gastrointestinal (GI) tract at
      all tested concentrations. The apparent first-order rate constants were found to
      be relatively invariant over a broad range of concentrations from 0.01 to 1.0 mM.
      Corrected for the length of each segment, the apparent permeability (Papp) of AZT
      was 3.01 +/- 0.32 x 10(-5) cm/sec (mean +/- SE) in the duodenum, 2.06 +/- 0.24 x
      10(-5) cm/sec in the upper jejunum, 0.76 +/- 0.13 x 10(-5) cm/sec in the combined
      lower jejunum and ileum, and 0.32 +/- 0.10 x 10(-5) cm/sec in the colon, which
      indicated that intrinsic absorptivity was greater in the upper GI tract than in
      the lower portions possibly due to the differences in surface area for
      absorption. No AZT metabolite appeared in any part of the GI tract. On the other
      hand, thymidine and other analogues, i.e., 5-iodo-2'-deoxyuridine and 2'
      deoxyuridine, were rapidly metabolized into nucleobase and sugar in the upper GI
      tract, whereas in the colon no metabolite appeared. A free 3'-OH group appears to
      be necessary for the metabolism (catabolism) of thymidine analogues in the rat
      intestine mainly by pyrimidine nucleoside phosphorylase.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1614966
TI  - Analysis of zidovudine distribution to specific regions in rabbit brain using
      microdialysis.
AB  - The distribution of zidovudine (3'-azido-3'-deoxythymidine; AZT) into two regions
      of rabbit brain was investigated in crossover using microdialysis. Six rabbits
      had guide cannulas surgically implanted in the lateral ventricle and thalamus by
      stereotaxic placement. After recovery, microdialysis probes were positioned and
      i.v. bolus doses of 5, 10, 20, and 30 mg/kg were administered to each animal over
      a period of 2 weeks. Blood was drawn via a marginal ear vein catheter for 8 hr.
      Brain dialysate was collected at 3 microliters/min from ventricle and thalamus
      dialysis probes every 10 min. Simulated cerebrospinal fluid (CSF), to which 3'
      azido-2',3'-dideoxyuridine (AZdU) was added, was used as perfusate. AZdU loss,
      which was measured during simultaneous retrodialysis, served as a marker for in
      vivo recovery of AZT. AZT concentrations in plasma, as well as in ventricle and
      thalamus dialysate, were determined using a sensitive HPLC assay, and AZdU was
      simultaneously analyzed in the dialysates. Calculation of in vivo recovery of AZT
      was based on loss of AZdU from the perfusate during retrodialysis and was used to
      estimate the concentration of drug at both sites in the brain. In vitro loss of
      AZdU and recovery of AZT showed good agreement, demonstrating a bivariate
      regression slope of 0.99. The half-lives and AUCs (normalized to dose) achieved
      in the plasma, ventricle, or thalamus were not significantly different for the
      four doses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614967
TI  - Uptake and stereoselective binding of the enantiomers of MK-927, a potent
      carbonic anhydrase inhibitor, by human erythrocytes in vitro.
AB  - MK-927 [5,6-dihydro-4H-4(isobutylamino)thieno(2,3-B)thiopyran -2-sulfonamide-7.7
      dioxide], a potent carbonic anhydrase inhibitor, contains a chiral center and
      exists as a racemate. In order to understand the kinetic behavior of the
      enantiomers of MK-927 in the body, the uptake and binding of these compounds were
      studied in human erythrocytes in vitro. Since no degradation or metabolism of the
      enantiomers occurred during incubation in blood, one can describe the
      equilibration of the drugs between plasma and erythrocytes by a closed two
      compartment system. Erythrocytes were considered as a compartment composed of two
      parts: one in which free drug is exchangeable to plasma and the other in which
      drug is tightly bound to carbonic anhydrase in a Michaelis-Menten type binding.
      After the addition of the enantiomers individually to fresh blood, they were
      taken up by erythrocytes rapidly in a concentration-dependent manner. The time to
      achieve equilibrium decreased as the concentration increased, suggesting
      saturation of binding sites. With the assumption of simple diffusion, the binding
      and transfer kinetics were determined simultaneously by computer fitting. There
      were no stereoselective differences in the transfer process of the enantiomers
      across the erythrocyte membrane, while binding of the enantiomers exhibited
      stereoselectivity. The penetration of the unbound enantiomer across the
      erythrocyte cell membrane was rapid, with a mean transit time of about 3 sec. The
      S-(+)-enantiomer was bound to the high-affinity carbonic anhydrase isoenzyme more
      strongly than the R-(-)-enantiomer by approximately 10-fold. For the low-affinity
      isoenzyme, the R-(-)-enantiomer was bound more strongly than the S-(+)
      enantiomer.

PMID- 1614968
TI  - Use of a pharmacokinetic model incorporating discontinuous gastrointestinal
      absorption to examine the occurrence of double peaks in oral concentration-time
      profiles.
AB  - Double peaks in the plasma concentration-time profile following oral
      administration have been reported for several compounds. A pharmacokinetic model
      incorporating discontinuous absorption was developed to simulate concentration
      time profiles with double peaks. The gastrointestinal (GI) tract was divided into
      N compartments, with absorption occurring only from the second and Nth
      compartments. A two-compartment model was used to describe systemic drug
      disposition. The effect of gastric emptying and GI transit rate constants (Kl and
      K1, respectively), number of hypothetical gut compartments, and absorption rate
      constant at each site (Ka1, Ka2) on the time of occurrence of each peak (Tp1,
      Tp2), the theoretical fraction of the dose absorbed at each site (phi 1, phi 2),
      and the contribution of the second site to systemic drug exposure (expressed as
      phi 2rel) were examined. Simulated concentration-time profiles demonstrated that
      Tp2 was determined by Kt and N, while Tp1 was determined by K1 and Kt. Changes in
      Ka1 and Ka2 had no effect on Tp1 or Tp2. phi 1, phi 2, and phi 2rel were
      determined by Ka1, Ka2, and Kt, and simulations indicated that a secondary peak
      in the concentration-time profile will be evident only when phi 2rel is
      substantial. In addition, concentration-time data for ranitidine and cimetidine,
      which displayed double peaks, were fit with the model. The present model
      described both data sets well, and realistic pharmacokinetic and physiologic
      parameters (absorption rate constants, systemic bioavailabilities, GI residence
      times) were obtained.

PMID- 1614969
TI  - Bacterial monitoring in vials using a spectrophotometric assimilation method.
AB  - Aseptic-filling processes are often used with fragile parenteral products that
      might be destroyed by terminal autoclaving. However, aseptic filling is not as
      effective as autoclaving in reducing contamination. As a result, time-consuming
      microbiological methods and turbidimetry are employed currently as product
      inspection techniques, but these processes can destroy the product and might not
      detect low levels of contamination. Thus, near-infrared (IR) light scattering was
      evaluated in this study as a new method for determining low levels of
      contamination noninvasively and nondestructively. A new parallel mathematical
      technique was used in conjunction with near-IR spectrophotometry to detect
      successfully contamination by several species of bacteria through intact glass
      vials. Using the near-IR method, products can be evaluated without introducing
      contamination, preserving the sample vial for dispensing or evaluation by another
      method.

PMID- 1614970
TI  - New water-soluble pilocarpine derivatives with enhanced and sustained muscarinic
      activity.
AB  - The synthesis of an homologous series of new water-soluble derivatives of
      pilocarpine is described. The new compounds, referred to as soft quaternary
      salts, are water soluble by virtue of a cationic ammonium head and their
      lipophilicity can be modulated by manipulating the size and the nature of the
      substituent in the inactive portion of the molecule. The miotic activity of the
      compounds was evaluated after administration to normotensive New Zealand White
      rabbits. Changes in pupil size indicated a substantial cholinergic effect on the
      iridal sphincter musculature. The best candidate, compound 20, which has a 16
      carbon side chain, was evaluated for reduction of the intraocular pressure in
      genetically glaucomatous Beagles. Compound 20 is superior to pilocarpine in both
      tests, with a potency 10 to 20 times that of the parent compound and a longer
      duration of action. It is suggested that the new compounds are prodrug forms of
      pilocarpine which greatly enhance the corneal bioavailability of the parent
      compound.

PMID- 1614971
TI  - The anomalous hydrolytic behavior of 1-phenylvinyl phosphate.
AB  - The kinetics of hydrolysis of 1-phenylvinyl phosphate, 1, were studied over a pH
      range of 1 to 8.3 and over a pD range of 1 to 5.6 at 25 degrees C and mu = 0.5 M
      with sodium chloride. The hydrolytic behavior of 1 was found to differ, in many
      respects, from that of alkyl and aryl phosphomonoesters. First, the rates of
      hydrolysis of 1 were extremely rapid and, in the hydronium ion-catalyzed region,
      gave a solvent deuterium isotope effect (kH/kD) of 3.20. Also, the 1H-NMR
      spectrum of acetophenone formed upon complete hydrolysis of 1 in D2O (pD 1.2)
      revealed that only one deuterium atom was incorporated into the methyl group.
      Hence, the evidence was consistent with a rate-limiting and nonreversible proton
      transfer from the solvent to 1. In addition, using an H2 18O labeling study in
      conjunction with 31P-NMR analysis, the hydrolytic mechanism appeared to involve
      nucleophilic attack by water at both the alpha-carbon and the phosphorus atom
      with concurrent C-O and P-O bond fission. Second, in the pH region where the
      monoanionic species of 1 predominated, buffers had a pronounced catalytic effect
      on the hydrolysis rate; there appeared to be a normal solvent deuterium isotope
      effect; and the rate constant, k' o, showed a positive deviation from the
      established Bronsted relationship. The dissimilarities between 1 and alkyl and
      aryl phosphomonoesters supported the involvement of an alternate
      dephosphorylation pathway.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1614972
TI  - Evaluation of the Poisson distribution for estimating the quality of drug/diluent
      random powder mixtures. I. High particle size of the drug constituent.
AB  - Use of the Poisson distribution to estimate the quality of random mixtures was
      evaluated as a measure of the highest attainable degree of dose uniformity of
      tablets. Ingredient A was assumed to have a large particle size as compared to
      diluent B. In contrast to the more precise binomial distribution, for the simple
      Poisson approach no experiments are necessary to investigate the mean proportions
      of the apparent volume, av and bv, which A and B assume within the powder samples
      in the die. The range of volume ratios was defined where the Poisson distribution
      is valid. Accepting an error of 5% of the random content variation of A per
      sample, av may amount to up to 0.1 (10%). In terms of the proportion by mass of
      A, a, this range is wider, and commonly of the order of 0.2 or higher. This
      approach was tested with tablets prepared from mixtures of coarse sucrose A and a
      fine Avicel/talc diluent B at A:B (m:m) ratios from 10:90 to 50:50. Even with the
      30:70 tablets, the variations of the sucrose content were still in good agreement
      with the content variations of the random mixtures as estimated from the Poisson
      distribution. Estimates of the 50:50 ratio, however, deviated from the Poisson
      distribution.

PMID- 1614973
TI  - Optimized formulation of magnetic chitosan microspheres containing the anticancer
      agent, oxantrazole.
AB  - A combined emulsion/polymer cross-linking/solvent evaporation technique was used
      to prepare magnetic chitosan microspheres (MCM) containing the anticancer drug,
      oxantrazole. A central composite experimental design was used to simultaneously
      evaluate a variety of formulation factors on a number of response variables, such
      as the percentage of oxantrazole entrapped in the MCM. In association with the
      study design, statistical optimization procedures indicated the factors that
      significantly influence MCM preparation and what levels of the factors are needed
      to produce optimum MCM. Entrapment of anticancer agents into biodegradable
      microspheres is difficult because of low aqueous drug solubility and porosity of
      the particles. The latter effect was circumvented by a chitosan cross-linking
      step that resulted in approximately 3% (w/w) oxantrazole entrapment in the MCM
      via the optimization procedures. The combined formulation and statistical
      optimization strategy provide a basis to develop other microparticulate systems
      and led to a dosage form that can be used for future in vivo investigations.

PMID- 1614974
TI  - Mechanisms to control drug release from pellets coated with a silicone elastomer
      aqueous dispersion.
AB  - The mass transport of two different compounds through polydimethylsiloxane (PDMS)
      silica films was investigated to demonstrate qualitatively how this coating
      system can alter the release of various compounds. Various ratios of PDMS
      elastomer and silica were used to coat monodisperse particle-sized pellets
      layered with an ionizable compound (tartrazine) and a nonionized compound
      (acetaminophen). The 2:1 PDMS-silica composition containing the polyethylene
      glycol (PEG) 8000 pore former allowed mainly pore transport through void spaces
      in the PDMS films. Both compounds rapidly diffused through the film as a result
      of the solubilization and subsequent removal of the PEG 8000 from the film
      matrix. As the PDMS-silica ratios in the films changed from a 1:1 to a 2:1 to a
      4:1 (all without polyethylene glycol 8000) coating formulation, the differences
      in release rate between acetaminophen and tartrazine changed. The lower ratio of
      PDMS-silica allowed much faster tartrazine diffusion compared to acetaminophen.
      As the ratio increased from 1:1 to 2:1, the two compounds were released at
      similar rates. When the ratio reached 4:1, acetaminophen was released
      significantly faster than tartrazine. Explanations for these differences and the
      mechanisms controlling the drug release are discussed in the text. In some
      circumstances, osmolality and pH affected drug release from dosage forms coated
      with this polymer system. This study demonstrated that utilization of this
      polymer system offers a useful tool for the formulation scientist to modify
      release rates of ionic and nonionic drug substances.

PMID- 1614975
TI  - Effect of surfactant phase in perfluorocarbon emulsification efficiency.
AB  - The effect of preparation temperature on the emulsification efficiency of
      perfluoro-3-butyltetrahydrofuran (FC-75) was investigated. Polyoxyethylene (POE)
      oleyl ether surfactants were used as the emulsifier(s) in a range of HLB values
      of 7.5 to 9.5. The emulsions were prepared by paddle mixing as a method of low
      shear emulsification. After centrifugation of the resulting O/W emulsions, the
      volume of FC-75 which separated was utilized as a measure of the emulsification
      efficiency. In general, emulsions prepared at temperatures where the surfactant
      was in a lamellar-to-isotropic surfactant solution transition, L alpha----L3,
      displayed a better emulsification efficiency than those prepared with other
      surfactant phases.

PMID- 1614976
TI  - A novel method for determination of sterility of microcapsules and measurement of
      viability of encapsulated organisms.
AB  - A method of determining the viability of microencapsulated microorganisms
      (Bacillus Calmette Guerin) is reported. This method was also used to measure the
      effectiveness of aseptic production of microcapsules in maintaining the interior
      of the microcapsules free from contamination by microorganisms. This method is
      advantageous over conventional plating methodology, as plating can only determine
      external contamination of microcapsules and similar devices. It involves the
      detection of 14CO2, which is generated by the metabolism of 14C-labeled fatty
      acid in the growth medium by encapsulated microorganisms. The method depends on
      the semipermeable nature of the microcapsule walls, which allows passage of 14C
      palmitic acid and 14CO2. BCG organisms encapsulated within an alginate-polylysine
      alginate microcapsule (5-15 microns) (1) were shown to be viable, and no
      contaminating organism(s) was present. Methods suitable for the aseptic
      production and freeze drying of alginate-polylysine-alginate BCG microcapsules,
      which retain the viability of the organisms, are reported.

PMID- 1614977
TI  - Application of curdlan to controlled drug delivery. I. The preparation and
      evaluation of theophylline-containing curdlan tablets.
AB  - To study the use of curdlan, a natural beta-1,3-glucan, in drug delivery, in
      vitro release studies were carried out with curdlan tablets containing
      theophylline. Tablets were readily prepared by compressing three different
      curdlan and theophylline mixtures, namely, a physical mixture, spray-dried
      curdlan particles with theophylline powder, and spray-dried particles of
      curdlan/theophylline solution. Drug release from the tablets prepared from spray
      dried particles of curdlan/theophylline was lowest. The release rate was constant
      from 1 to 8 hr, and 59% cumulative release was obtained at 8 hr. Drug release
      from curdlan tablets was unaffected by pH or various ions; these curdlan tablets
      might also control drug release in vivo after oral administration. Application of
      Higuchi's equation indicated that drug release from curdlan tablets was diffusion
      controlled. The release profiles of the curdlan tablets were compared to those of
      a commercial theophylline sustained-release tablet.

PMID- 1614978
TI  - The disposition of a human relaxin (hRlx-2) in pregnant and nonpregnant rats.
AB  - The pharmacokinetics and tissue distribution of a human relaxin were investigated
      after intravenous (iv) bolus administration to pregnant or nonpregnant rats.
      Human gene-2 relaxin (hRlx-2) serum concentrations after iv bolus administration
      were described as the sum of three exponentials. The pharmacokinetics were
      comparable in pregnant and nonpregnant rats. The serum clearance (CL) was 7.4
      10.2 ml/min/kg at doses of 46-93 micrograms/kg and was linear in this range. The
      half-lives were 1.1-2.0, 15.1-16.4, and 53.7-67.9 min, respectively. The volume
      of the central compartment (Vc) was 48-79 ml/kg and the volume of distribution at
      steady state (Vss) was 271-336 ml/kg. Increasing the dose to 463 micrograms/kg
      increased the dose-corrected area under the serum concentration-time curve and
      significantly decreased CL and Vss. The distribution of radioactivity in the
      tissues of pregnant rats was followed after iv bolus dosing with hRlx-2
      internally labeled with 35S-cysteine. Comparison of the extent of organ uptake of
      radiolabel after 35S-hRlx-2 or 35S-cysteine administration suggested that the
      kidneys were the principal site of uptake; the liver was of secondary importance.
      In perfusion experiments utilizing livers isolated from pregnant or nonpregnant
      rats, 36-52% of the dose of hRlx-2 was cleared from the perfusate in 2 hr. These
      studies showed that the pharmacokinetics of hRlx-2 in rats appeared to be
      unaffected by pregnancy and suggested that the kidneys and liver both play a role
      in the elimination of hRlx-2.

PMID- 1614979
TI  - Sustained delivery of interleukin-2 from a poloxamer 407 gel matrix following
      intraperitoneal injection in mice.
AB  - Parenteral delivery of recombinant biologic response modifiers (BRMs) remains a
      challenge because of the brief intravascular half-life of most recombinant
      proteins and their associated rapid clearance from the circulation. Recombinant
      derived interleukin-2 (rIL-2) was formulated with Pluronic F-127, N.F. (poloxamer
      407, N.F.) and the biological activity determined vs time at 4, 22, and 37
      degrees C. As assessed by rIL-2-induced peripheral blood lymphocyte (PBL) uptake
      of [3H]thymidine, storage of rIL-2/poloxamer 407 (33% w/w) for 72 hr at 4 and 22
      degrees C did not result in an overall negative slope of the [3H]thymidine vs
      time profiles. However, storage of an rIL-2/poloxamer formulation at 37 degrees C
      for 72 hr resulted in an approximate 15% reduction in the biological activity as
      assessed by [3H]thymidine incorporation. As assessed by bioassay ([3H]thymidine
      uptake), the cumulative percentage rIL-2 released in vitro at 22 degrees C after
      8 hr from rIL-2/poloxamer 407 matrices containing either 30% (w/w) or 35% (w/w)
      poloxamer 407 was 81.8 +/- 1.7 and 82.1 +/- 4.7%, respectively. When ELISA was
      used to determine the amount of rIL-2 released vs time, the corresponding values
      for the cumulative percentage rIL-2 released were 82.6 +/- 10.1 and 40.9 +/-
      8.8%. Cytotoxicity of rIL-2 stimulated PBLs cultured with poloxamer 407 (0.17%,
      w/w) toward malignant Daudi cells was significantly (P less than 0.05) enhanced
      compared to controls. Finally, mice injected with the rIL-2/poloxamer 407
      formulation (1 x 10(5) U/inj. q.d. x 3 days) demonstrated a bioequivalent effect
      of rIL-2-induced natural killer (NK) cell activity in vitro toward malignant
      murine YAC-1 cells at one-half the standard exogenously administered dose of rIL
      2 known to generate enhanced NK lytic activity in mice (1 x 10(5) U/inj. b.i.d. x
      3 days). No untoward systemic side effects were observed for mice injected i.p.
      with polymer vehicle alone (30%, w/w) (0.15 ml q.d. x 3 days), pH 7 phosphate
      buffered saline (PBS) (0.15 ml q.d. x 3 days), rIL-2 formulated with poloxamer
      407 (30%, w/w) (1 x 10(5) U/0.15 ml q.d. x 3 days and 0.5 x 10(5) U/0.15 ml q.d.
      x 3 days), or rIL-2 dissolved in PBS (1 x 10(5) U/0.15 ml b.i.d. x 3
      days).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1614980
TI  - The influence of peptide structure on transport across Caco-2 cells. II. Peptide
      bond modification which results in improved permeability.
AB  - In order to study the influence of hydrogen bonding in the amide backbone of a
      peptide on permeability across a cell membrane, a series of tetrapeptide
      analogues was prepared from D-phenylalanine. The amide nitrogens in the parent
      oligomer were sequentially methylated to give a series containing from one to
      four methyl groups. The transport of these peptides was examined across confluent
      monolayers of Caco-2 cells as a model of the intestinal mucosa. The results of
      these studies showed a substantial increase in transport with each methyl group
      added. Only slight difference in the octanol-water partition coefficient
      accompanied this alkylation, suggesting that the increase in permeability is not
      due to lipophilicity considerations. These observations are, however, consistent
      with a model in which hydrogen bonding in the backbone is a principal determinant
      of transport. Methylation is seen to reduce the overall hydrogen bond potential
      of the peptide and increases flux by this mechanism. These results suggest that
      alkylation of the amides in the peptide chain is an effective way to improve the
      passive absorption potential for this class of compounds.

PMID- 1614981
TI  - Prenatal diagnosis of alpha-1-antitrypsin deficiency by PCR of linked
      polymorphisms: a study of 17 cases.
AB  - We describe our experiences of prenatal diagnosis of alpha-1-antitrypsin
      deficiency using closely linked polymorphisms detected by Southern blotting and
      the polymerase chain reaction. Prenatal diagnosis was carried out for 17
      pregnancies from 15 couples.

PMID- 1614982
TI  - Rapid prenatal diagnosis of trisomy 18 and triploidy in interphase nuclei of
      uncultured amniocytes by non-radioactive in situ hybridization.
AB  - Two biotinylated chromosome-specific DNA probes were used to quantify the number
      of chromosomes 18 and 1 in uncultured amniocytes. Thirty-three samples of
      uncultured amniocytes were hybridized with a chromosome 18-specific DNA probe.
      Uncultured cells from two of the 33 samples were also hybridized with a
      chromosome 1-specific probe. Thirty of the samples were disomic with respect to
      chromosome 18; two samples were trisomic with respect to chromosome 18, and one
      sample was trisomic with respect to chromosomes 1 and 18. The two cases of
      trisomy 18 and the single case of triploidy were identified on uncultured cells
      within 48-72 h after amniocentesis. They were found among five samples from
      pregnant women who had amniocentesis because of an ultrasonographically
      identified fetal malformation. A trisomic karyotype could be diagnosed with
      certainty in uncultured amniocytes because the majority of the responding nuclei
      exhibited three hybridization signals. In normal cells, the majority of nuclei
      exhibited two signals. In no cases was there discordance between the genotype as
      predicted by in situ hybridization and that determined by cytogenetic analysis.

PMID- 1614983
TI  - Evaluation of prenatal diagnosis by a registry of congenital anomalies.
AB  - Prenatal diagnosis performed by fetal karyotype and ultrasound scan is now a
      routine part of antenatal care in many countries. How many fetal anomalies are
      actually detected by these procedures? We have used our registry of congenital
      malformations to answer this question. In our region, prenatal diagnosis was
      performed in 23.1 per cent of fetuses with a chromosomal aberration and in 20.1
      per cent of fetuses with non-chromosomal anomalies. Only 6.9 per cent of the
      pregnancies with fetuses with non-chromosomal anomalies were terminated. The
      sensitivity of prenatal diagnosis by ultrasonographic examination was much lower
      for isolated malformations (fetuses with only one anomaly) than for multiple
      malformed children, 15.3 and 48.3 per cent respectively, chromosomal anomalies
      excluded.

PMID- 1614984
TI  - Cardiotocographic and sonographic findings in two cases of antenatally diagnosed
      intrauterine fetal brain death.
AB  - Intrauterine fetal brain death is a rare cause of a fixed fetal heart rate
      pattern. Seven cases have been previously reported in the literature, but only
      two of them were diagnosed prenatally and all the newborns died soon after
      delivery. Two additional cases of antepartum diagnosis of intrauterine fetal
      brain death, managed expectantly, are reported. We had the unique opportunity to
      document progressive sonographic cerebral changes during the follow-up period,
      following the neurological event, while the fetus continued life and growth in
      utero. The cardiographic and sonographic findings suggesting intrauterine fetal
      brain death were a prolonged fixed fetal heart rate, even following a
      vibroacoustic and contraction stress test; an atonic fetus without breathing and
      body movement; and the appearance of hydramnios and the development of
      ventriculomegaly.

PMID- 1614985
TI  - Genetic amniocentesis at 7-14 weeks of gestation.
AB  - Genetic amniocentesis performed at 7-14 weeks of gestation was studied in a
      series of 138 patients of whom 50 wanted termination of pregnancy (less than or
      equal to 12 weeks). The material for analysis consisted of 132 samples due to two
      sampling failures and four samples being handled incorrectly. Forty-eight samples
      (36 per cent) were taken at 7-12 weeks of gestation, mainly transvaginally
      (36/48: 75 per cent). The success rate of culture and karyotyping increased with
      the duration of pregnancy, but was only satisfactory from week 11 onwards. The
      time until harvest was then 14-15 days. The transvaginal approach is easy to
      perform and was accepted by the women, but we experienced bacterial or fungal
      overgrowth in 17 per cent of these samples, whereas no infection occurred in the
      samples taken transabdominally (n = 96). We conclude that genetic amniocentesis
      is feasible from week 11, but further studies concerning side effects, especially
      focusing on the procedure-related abortion risk, should be carried out before
      early amniocentesis is routinely applied.

PMID- 1614986
TI  - Clues and pitfalls in the early prenatal diagnosis of 'late onset' infantile
      polycystic kidney.
AB  - Infantile polycystic kidney disease (IPKD) is an autosomal recessive inherited
      disorder, IPKD has been previously diagnosed by us as early as the 14th week of
      gestation. 'Late onset' (third trimester) IPKD has been previously described by
      several authors. We present here a case of intrauterine detection of 'late onset'
      IPKD, suggesting that elongated hyperechogenic kidneys (with normal transverse
      and anteroposterior diameters) should be considered as an early sign of 'late
      onset' presenting IPKD.

PMID- 1614988
TI  - Chang medium raises the chromatin instability of pericentromeric areas of
      chromosome 1 in amniotic fluid cells.

PMID- 1614987
TI  - Prenatal diagnosis of Fryns' syndrome.
AB  - We report on a new case of ultrasonographic prenatal diagnosis of Fryns' syndrome
      during the second pregnancy of a young woman whose first child died 90 min after
      birth and was diagnosed as having this autosomal recessive condition. The
      feasibility of diagnosis in utero and timing in the phenotypic expression of this
      multimalformation syndrome are discussed.

PMID- 1614989
TI  - Mosaic tetrasomy 12p: a new case.

PMID- 1614990
TI  - Correlates of maintenance of a low-fat diet among women in the Women's Health
      Trial.
AB  - BACKGROUND: The Women's Health Trial (WHT) was a feasibility study for a
      randomized controlled trial designed to test the hypothesis that a reduction in
      dietary fat reduces breast cancer incidence among women age 45 to 69. Between
      1984 and 1988, 2,064 women participated in its two phases. METHODS: A follow-up
      study of 525 women who were randomized to receive the WHT dietary intervention
      program was conducted to assess maintenance of the diet 1 year on average after
      the trial ended. Among 448 participants, the mean percentage of energy from fat
      as measured by a food frequency questionnaire was 40.0% at baseline, 26.3% at the
      end of the trial, and 27.7% at follow-up. Based on 408 women with complete data,
      a recursive model was estimated, describing the influence of baseline
      characteristics of the women on attendance at intervention program sessions,
      adherence to the diet during the trial, and long-term maintenance of the diet
      after the trial ended. The effects of women's experiences during the trial on
      adherence and long-term maintenance were investigated as well. RESULTS:
      Attendance at the educational sessions was strongly related to adherence to the
      diet during the trial (P less than 0.001), and adherence was the most important
      predictor of long-term maintenance (P less than 0.001). The percentage of energy
      from dietary fat at baseline was an important correlate of both adherence (P less
      than 0.001) and long-term maintenance (P less than 0.001). College-educated women
      were more likely to adhere to the diet during the trial (P less than 0.001).
      Feelings of deprivation adversely affected long-term maintenance (P less than
      0.01), primarily through their effect on adherence during the trial (P = 0.01).
      Costliness of the diet in time and money negatively influenced long-term
      maintenance (P less than 0.05). Development of a distaste for fat encouraged
      adherence (P = 0.06). CONCLUSIONS: The low-fat dietary pattern established during
      the WHT was maintained for as long as 20 months after the trial ended. A
      recursive model was useful in analyzing the process and correlates of long-term
      maintenance of dietary behavior change. Both predisposing variables and women's
      experiences while on a low-fat diet were associated with long-term maintenance.
      The results suggest that feelings of deprivation should be avoided, perhaps by
      use of low-fat substitutes, by those attempting to lower their dietary fat and
      that more research is needed on the development of a distaste for fat among
      individuals who adopt low-fat diets.

PMID- 1614992
TI  - Sun exposure and sunscreen use following a community skin cancer screening.
AB  - BACKGROUND: In May 1988, a community skin cancer screening was held, and of the
      251 individuals who attended, 214 (85%) completed a follow-up questionnaire. The
      objective of this study was to examine the associations among attitudes,
      knowledge, and behavior in those who had attended the screening. RESULTS:
      Analysis showed that females were twice as likely to have false positive
      screening diagnoses as males (odds ratio 2.2; P = 0.06). Attitudes toward tanning
      were not correlated with knowledge about the harmful effects of excess sun
      exposure (rp = -0.02; P = 0.67) or with behaviors such as reported sun exposure
      (for positive attitude versus "poor" attitude, linear trend P less than 0.11) and
      sunscreen use (linear trend P = 0.70). Behavior, defined as reported sunscreen
      use, was highly correlated with knowledge, both of the harmful effects of the sun
      and of the definition of SPF (linear trend P less than 0.001). Sunscreen use was
      also associated with the younger age group (those less than 59, P less than
      0.05), female sex (P less than 0.001), higher education (P less than 0.05), and
      perceived risk for melanoma (P less than 0.05). CONCLUSIONS: We conclude that
      more targeted education in the domain of knowledge would benefit males and those
      over the age of 59.

PMID- 1614991
TI  - Body mass and acute myocardial infarction. GISSI-EFRIM Investigators.
AB  - BACKGROUND: The relation between body mass index and acute myocardial infarction
      was analyzed using data from a multicentric case-control study conducted in Italy
      between September 1988 and June 1989 within the framework of the GISSI-2 trial.
      METHODS: Subjects were 916 patients with acute myocardial infarction and no
      history of cardiovascular disease and 1,106 controls hospitalized for acute
      conditions not related to known or suspected risk factors for ischaemic heart
      disease. RESULTS: Relative to the lowest quintile of the Quetelet Index
      (weight/height2) the estimated risks for subsequent quintiles were 1.2 (95%
      confidence intervals, (CI): 0.9 to 1.6), 1.7 (95% CI: 1.2 to 2.2), 1.8 (95% CI:
      1.4 to 2.4), and 2.2 (95% CI: 1.7 to 3.0) when adjustment was made for age, sex,
      education, and smoking habits by means of logistic regression. The association
      was consistent across strata of sex, education, and smoking status, but not age.
      The estimated risk for subjects in the fifth quintile of the Quetelet Index
      relative to those in the first was 4.1 under 55 years of age, but only 1.7
      between 55 and 64 years and 1.5 above age 65. CONCLUSION: The relation between
      body mass and myocardial infarction was explained, at least in part, by higher
      serum cholesterol levels and the prevalence of diabetes and hypertension among
      fatter subjects. This does not, however, totally eclipse a possible causal
      relation between body mass and risk of myocardial infarction, since these
      conditions are a consequence, rather than a confounder, of overweight.

PMID- 1614993
TI  - Characteristics of heavy smokers.
AB  - BACKGROUND: Heavy smokers (those who smoke greater than or equal to 25 or more
      cigarettes a day) are a subgroup who place themselves and others at risk for
      harmful health consequences and also are those least likely to achieve cessation.
      Despite this, heavy smokers are not well described as a segment of the smoking
      population. METHODS: We used representative population data on 1,048 smokers to
      examine differences between heavy and lighter smokers (less than or equal to 24
      cigarettes per day). RESULTS: Heavy smokers constituted 26.7% of all cigarette
      smokers. Compared with lighter smokers, heavy smokers were significantly more
      likely to be male, to be age 30 years or older, to smoke their first cigarette of
      the day within 30 min of waking, to perceive quitting as very difficult, to have
      little confidence in their ability to quit, to be less likely to report variation
      in their rate of smoking between work and leisure days, and to be less likely to
      be employed. CONCLUSIONS: Public health strategies which may particularly assist
      heavy smokers include stronger restrictions on smoking in public places, nicotine
      replacement therapies, and the use of segmentation research to more carefully
      target campaign messages to influence quit attempts and confidence.

PMID- 1614995
TI  - Green tea composition, consumption, and polyphenol chemistry.
AB  - Tea is grown in about 30 countries but is consumed worldwide, although at greatly
      varying levels. It is the most widely consumed beverage aside from water with a
      per capita worldwide consumption of approximately 0.12 liter per year. Tea is
      manufactured in three basic forms. Green tea is prepared in such a way as to
      preclude the oxidation of green leaf polyphenols. During black tea production
      oxidation is promoted so that most of these substances are oxidized. Oolong tea
      is a partially oxidized product. Of the approximately 2.5 million metric tons of
      dried tea manufactured, only 20% is green tea and less than 2% is oolong tea.
      Green tea is consumed primarily in China, Japan, and a few countries in North
      Africa and the Middle East. Fresh tea leaf is unusually rich in the flavanol
      group of polyphenols known as catechins which may constitute up to 30% of the dry
      leaf weight. Other polyphenols include flavanols and their glycosides, and
      depsides such as chlorogenic acid, coumarylquinic acid, and one unique to tea,
      theogallin (3-galloylquinic acid). Caffeine is present at an average level of 3%
      along with very small amounts of the other common methylxanthines, theobromine
      and theophylline. The amino acid theanine (5-N-ethylglutamine) is also unique to
      tea. Tea accumulates aluminum and manganese. In addition to the normal complement
      of plant cell enzymes, tea leaf contains an active polyphenol oxidase which
      catalyzes the aerobic oxidation of the catechins when the leaf cell structure is
      disrupted during black tea manufacture. The various quinones produced by the
      enzymatic oxidations undergo condensation reactions which result in a series of
      compounds, including bisflavanols, theaflavins, epitheaflavic acids, and
      thearubigens, which impart the characteristic taste and color properties of black
      tea. Most of these compounds readily form complexes with caffeine. There is no
      tannic acid in tea. Thearubigens constitute the largest mass of the extractable
      matter in black tea but their composition is not well known. Proanthocyanidins
      make up part of the complex. Tea peroxidase may be involved in their generation.
      The catechin quinones also initiate the formation of many of the hundreds of
      volatile compounds found in the black tea aroma fraction. Green tea composition
      is very similar to that of the fresh leaf except for a few enzymatically
      catalyzed changes which occur extremely rapidly following plucking. New volatile
      substances are produced during the drying stage. Oolong tea is intermediate in
      composition between green and black teas.

PMID- 1614994
TI  - Availability of cigarettes to underage youth in three communities.
AB  - BACKGROUND: Underage youth report that they primarily obtain cigarettes from
      commercial sources. Thus policies that effectively prevent purchase by minors
      could have an effect on the prevalence of young people's cigarette use. METHODS:
      In this study, 12- to 15-year-old male and female confederates attempted to
      purchase cigarettes from all cigarette outlets in three communities. RESULTS: A
      success rate of 53% over the counter and 79% from vending machines was achieved.
      These results show that minors can purchase cigarettes in all types of
      businesses, even those characterized as "adult" locations. Boys in this study had
      more difficulty than girls in purchasing cigarettes over the counter, and younger
      individuals had more difficulty than 15-year-olds. However, these differences
      were not found in vending machine sales. Similarly, over-the-counter sales of
      cigarettes were significantly reduced following a state-wide increase in the
      penalty for tobacco sales to minors, but vending machine sales were not affected.
      CONCLUSIONS: These results support stringent and universal controls over the sale
      of cigarettes as an essential part of any tobacco use prevention strategy.

PMID- 1614996
TI  - Tea components: antimutagenic and anticarcinogenic effects.
AB  - BACKGROUND: Tea from the Camellia sinensis species of the Theaceae family is one
      of the most ancient and, next to water, the most widely consumed beverage in the
      world. Since tea contains several polyphenols and since several other naturally
      occurring dietary polyphenols have shown antimutagenic effects in bacteria and
      anticarcinogenic effects in animal bioassay systems, we studied whether
      polyphenols extracted from Chinese green tea (GTP) also possess antimutagenic and
      anticarcinogenic effects. RESULTS: GTP and its constituent epicatechin
      derivatives were found to interact with hepatic cytochrome P450 (P450) and
      inhibited the P450-dependent mixed-function oxidase enzymes in skin and liver.
      GTP and its epicatechin derivatives exhibited antimutagenic effects in several
      test systems. GTP showed substantial anti-skin-tumor-initiating and anti-skin
      tumor-promoting activities when assessed in murine skin tumorigenesis bioassay
      systems. In these model systems polyaromatic hydrocarbons, benzo[a]pyrene (BP), 3
      methyl-cholanthrene, 7,12-dimethylbenz[a]anthracene, and (+)-7 beta,8 alpha
      dihydroxy-9 alpha,10 alpha-epoxy-7,8,9,10- tetrahydrobenzo[a]pyrene (an ultimate
      carcinogenic metabolite of BP) were used as model skin carcinogens. The feeding
      of GTP in drinking water to SKH-1 hairless mice also afforded significant
      protection against ultraviolet-B-radiation-induced skin photocarcinogenesis.
      CONCLUSIONS: These data suggest that tea components possess antimutagenic and
      anticarcinogenic effects, and that they could protect humans against the risk of
      cancer by environmental agents.

PMID- 1614998
TI  - Suppression of genotoxicity of carcinogens by (-)-epigallocatechin gallate.
AB  - Epidemiological evidence shows that green tea may be a factor in lowering cancer
      risk. We have investigated the possibility that (-)-epigallocatechin gallate
      (EGCG), a major polyphenol in green tea, might be an antimutagenic substance. In
      the Ames Salmonella test, EGCG suppressed the direct-acting mutagenicity of 3
      hydroxyamino-1-methyl-5H-pyrido-[4,3-b]indole (Trp-P-2(NHOH)) and 2-hydroxyamino
      6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1(NHOH)), the activated forms of
      food-derived carcinogens 3-amino-1-methyl-5H-pyrido[4,3-b]indole and 2-amino-6
      methyldipyrido[1,2-a:3',2'-d]imidazole. EGCG was also effective in reducing the
      mutagenicity of Trp-P-2(NHOH) in mouse FM3A cells in culture. Furthermore, EGCG
      demonstrated a suppressive effect in the in vivo Drosophila mutation assays,
      i.e., the wing spot test, and the DNA repair test, on several carcinogens. EGCG
      was also effective in inhibiting DNA single-strand breaks in vitro caused by Glu
      P-1(NHOH). We conclude that the mechanism of inhibition may not have resulted
      from direct interaction between EGCG and the mutagens, but rather from indirect
      interception of mutagen action by EGCG.

PMID- 1614999
TI  - Teas and tea components as inhibitors of carcinogen formation in model systems
      and man.
AB  - BACKGROUND: Epidemiological evidence points to a cancer protective role of green
      yellow-orange vegetables and fruits. The involvement of teas as a protective
      factor in carcinogenesis has not received the attention it seems to merit. To
      gain relevant information, attempts were made to stimulate in vitro those
      conditions to which human groups are actually exposed. METHODS: The inhibitory
      effects of infusions of Chinese, Japanese, and Ceylonese teas were examined by
      adding them to a nitrosation mixture consisting of 0.8 mg sodium nitrite and 340
      mg equivalent of a widely consumed salt-preserved fish (Pak Wik) and estimating
      the frequency of mutants in TA 1535 strain of Salmonella typhimurium. RESULTS:
      The tea samples exhibited a strong inhibitory effect at concentrations that are
      actually ingested by man. A comparable inhibition was obtained by several tea
      phenolics. A second series of experiments dealt with the formation of
      nitrosoproline (NPRO) which can be strongly inhibited in vitro by the tea
      infusions and tea phenolics. The effects of the tea infusions and caffeic acid on
      the endogeneous formation of NPRO in man were examined by having volunteers
      ingest 300 mg sodium nitrate and 30 min later 300 mg proline, collecting urine
      samples over a 24-hr period, and estimating the excreted NPRO. The tested teas,
      at doses regularly consumed, again exerted a strong inhibitory effect on
      endogeneous NPRO formation in humans. Comparable inhibitory effects were obtained
      by ingesting caffeic acid, chlorogenic acid, or ferulic acid with the nitrosation
      mixture. CONCLUSIONS: These results indicate that the simultaneous intake of teas
      with food products that are being nitrosated within the stomach of human subjects
      should exert a protective, beneficial effect.

PMID- 1615000
TI  - The effects of Chinese tea on the occurrence of esophageal tumors induced by N
      nitrosomethylbenzylamine in rats.
AB  - BACKGROUND: Based on previous studies on the blocking effect of Chinese tea in
      the formation of N-nitroso compounds in rats and humans, experiments were carried
      out to study the effects of Chinese tea on the occurrence of esophageal tumors
      induced by N-nitrosomethylbenzylamine (NMBzA) in rats. METHODS: In the first
      experiment, rats were given two precursors of NMBzA, i.e., sodium nitrite and
      methyl benzylamine, p.o. After 12 weeks, the incidence of esophageal tumors was
      95%. However, in the five groups of tea (green tea, jasmine tea, black tea, and
      oolong tea)-treated rats, the incidences were only 5-19%. In the second
      experiment, preformed NMBzA was administered to rats. RESULTS: The incidences of
      esophageal tumors in the five tea-treated groups were 42-67%, while in the
      positive control group, without tea, the incidence was 90%. Histopathological
      examination showed the same protective effects of tea treatment. In a separate
      study, a significant reduction of O6-methylguanine (MeG) and the ratio of O6-MeG
      to N7-MeG was observed in rats treated with oolong tea and jasmine tea.

PMID- 1614997
TI  - Inhibitory effect of green tea on tumorigenesis by chemicals and ultraviolet
      light.
AB  - Topical application of a green tea polyphenol fraction inhibited 12-O
      tetradecanoyl-phorbol-13-acetate-induced tumor promotion in CD-1 mice previously
      initiated with 7,12-dimethylbenz[a]anthracene (DMBA). Oral administration of a
      green tea infusion as the sole source of liquid sustenance to SKH-1 mice
      inhibited ultraviolet B light (UVB)-induced sunburn lesions, UVB-induced
      initiation of skin tumors, UVB-induced formation of skin tumors in mice
      previously initiated with DMBA, and nitrosodiethylamine-induced forestomach and
      lung tumors in A/J mice. In addition to inhibiting UVB-induced formation of skin
      tumors in DMBA-initiated mice, oral administration of green tea markedly
      decreased tumor size.

PMID- 1615001
TI  - [Does the sinu-bronchial syndrome exist?].

PMID- 1615002
TI  - [In vitro studies of cellular immunity in chronic bronchitis with and without
      corticosteroid medication].
AB  - In 29 patients with chronic bronchitis, 17 of whom were receiving systemic
      prednisolone, parameters of cellular and humoral immunity from the blood were
      evaluated and compared with a control group. Serum concentrations of
      immunoglobulins IgG, A and M, IgG subclasses, lymphocyte subsets and lymphocyte
      response to mitogenes (PHA, ConA, PWM), antibodies (anti-CD3) and tetanus antigen
      were determined. Whereas T cell subsets did not show any difference between all
      groups, the relative proportion of B lymphocytes was lower in the patient group
      without corticosteroids. Both patient groups showed a decreased lymphocyte
      response. As expected, serum IgG was lower in the steroid group, which could not
      be explained by additional cellular findings. Our data indicate that patients
      suffering from chronic bronchitis may show signs of a decreased cellular
      immunity.

PMID- 1615003
TI  - [Comparison of two different methods for measuring interoception of obstructions
      in asthma patients].
AB  - For measuring the interoception of airway resistance, bronchial obstructions are
      often simulated by flow-resistive loads applied externally (i.e. outside the
      body) into the respiratory flow. However, it is open to doubt whether
      interoception characteristics obtained in this manner are really related to the
      clinical pattern of complaints of asthmatic patients. Possibly such externally
      applied resistance simulates merely an aspect of the physics of apnoea but not a
      clinical and hence also psychological aspect of the same. To estimate the
      significance of these aspects for the perception of obstructions, this ability
      was measured in 25 asthmatic patients first by means of external added loads;
      this test was then repeated by noting the subjective assessment of bronchial
      obstructions caused during a routine histamine provocation test. Both
      interoception parameters correlated only slightly (rxy = 0.31) which is discussed
      as a pointer to the assumption that, among other parameters, psychological
      factors may considerably modify the perception of flow resistivity. No
      correlations were seen between the characteristic interoception value obtained by
      means of mesh resistivities and the different variables of the clinical pattern
      of symptoms. On the other hand, the interoception parameter measured on the basis
      of bronchial obstructions revealed significant connections with several clinical
      variables: the greatly increased incidence of respiratory distress at night or
      during certain external conditions, coping medication, physical exercise and
      style. It is concluded that only such parameters of perception of obstructions
      are clinically relevant for patients suffering from asthma, which consider not
      only the somaticophysical but also the psychic component of asthmatic respiratory
      distress.

PMID- 1615004
TI  - [Revascularization of heterotopic isotransplants of the rat trachea using an
      omentum flap].
AB  - Donor airway ischemia remains a significant problem following lung
      transplantation. An acceleration of local bronchial revascularization would be
      advantageous for bronchial healing. In the present study, the quantitative
      effects of omentopexy on tracheal revascularization and epithelial regeneration
      were investigated in a heterotopic rat tracheal isograft model. Tracheal segments
      were harvested from donor rats and heterotopically implanted into the omentum of
      syngeneic recipient rats. Tracheal segments were wrapped for 2 days (group 2), 7
      days (group 3) or 14 days (group 4). Tracheal segments in group 1 were harvested
      and not re-implanted. Following sacrifice of the animals after 2, 7 or 14 days,
      the vascularity of the tracheas and the tracheal epithelial morphology were
      assessed histologically using morphometric image analysis. The vascularity of
      tracheal segments was significantly higher in group 1 (native tracheas) compared
      to all other groups. Vascularity in group 4 segments (omental wrap for 14 days)
      was significantly greater than in group 3 segments (omental wrap for 7 days).
      Tracheal epithelial morphology was characterized by non-confluent single
      epithelial cells at day 2, a confluent multilayered nonciliated epithelium after
      7 days of omental wrap and a morphologically normal epithelium after 14 days of
      omental wrap. Our new heterotopic rat tracheal isograft model allows histologic
      assessment and quantification of local revascularization and epithelial
      regeneration of tracheal segments by omentopexy.

PMID- 1615005
TI  - [Emissions of airborne substances from stalls of domestic animals].
AB  - There is concern on recent reports indicating an increase of respiratory
      affections in humans in areas with high livestock production. A survey is
      presented on airborne emissions from livestock buildings. About 136 gaseous
      compounds are analysed in animal house air of which 22 are quantified, only. The
      most environment-related compounds are ammonia and methane. It is assumed that
      German animal husbandry emits more than 350,000 t ammonia per year. The content
      of airborne microorganisms in livestock buildings is between some 100 and several
      1000 per liter. The greatest part, more than 80%, are Staphylococcae and
      Streptococcae. Fungi, moulds and yeasts can form more than 1%, and coli-like
      bacteria about 0.5% of the total amount. Moulds like Penicillium, Aspergillus,
      Cladosporium and Alternaria were identified which are known to have allergic
      properties. The average concentrations of dust in animal barns vary between 0.5
      and 20 mg/m3. The dust contains high amounts of protein and carries endotoxins
      which both have an allergic potential. Preliminary results show that the germ
      content of the surrounding air in areas with high animal densities seems to be
      distinctly higher than in non-livestock regions.

PMID- 1615006
TI  - [Esophago-thoracic fistula after pneumonectomy and long-term main bronchus stump
      fistula].
AB  - A woman patient admitted for treatment, who had reached the age of 65 years, had
      a previous history of an open pulmonary tuberculosis in 1946 that had been
      treated at that time by means of collapsotherapy and phrenico-exeresis.
      Pleuropneumonectomy was performed in 1976 because of a residual cavity of a
      thoracic empyema. Since 1978 the patient suffered from a fistula of the bronchus
      treated by postural therapy without achieving a cure. In 1989 a fistula formed
      between oesophagus and pneumonectomy cavity. Clinically this was associated with
      an increasing reduction of performance and a suddenly ineffective postural
      drainage, resulting in triphasic and eventually fatal aspiration. Histology
      revealed a suppurative inflammation in the fistular channel and a slight
      superficial Candida colonisation of the pneumonectomy cavity, of the fistular
      channel and of adjacent mucous glands of the oesophagus. Formation of the fistula
      was probably due to a small traction diverticulum followed by perforation because
      of obstructed oesophageal passage due to scarified distortions.

PMID- 1615007
TI  - Vitamin A status: relationship to immunity and the antibody response.

PMID- 1615008
TI  - Comparison of copper binding components in dog serum with those in other species.
AB  - The copper content of dog serum and its distribution to copper binding proteins
      was compared with that of rat and mouse. Total serum Cu concentrations of dogs
      and mice were one third those of the rat. Plasma ceruloplasmin, determined by
      azide-inhibitable oxidase activity with two substrates, was 8-fold less in the
      dog and 9- to 20-fold less in the mouse than in the rat, and, in both dogs and
      mice, there was 70-75% less ceruloplasmin Cu, determined by atomic absorption
      after gel filtration. In the dog, the largest proportion of total and
      exchangeable serum Cu was with the transcuprein fraction. Only one third as much
      Cu was with albumin in the dog (and mouse) versus the rat, and this was released
      much more readily through dialysis. In dogs and mice, the exchangeable
      (nonceruloplasmin) serum copper pool was half the size of that in rats and
      humans. Especially in the mouse (but also in rats and dogs), a small proportion
      of the exchangeable pool appeared bound to ferroxidase II. We conclude that the
      dog may rely more on transcuprein and low molecular weight complexes and less on
      albumin and ceruloplasmin for transport of copper to cells.

PMID- 1615009
TI  - Enhanced growth restriction of Legionella pneumophila in endotoxin-treated
      macrophages.
AB  - Macrophages from A/J mice are permissive for growth of Legionella pneumophila, an
      intracellular opportunistic pathogen that grows preferentially in macrophages.
      Macrophages from other mouse strains are highly resistant to growth of
      Legionella. In the present study, it was found that macrophages from A/J mice are
      readily activated by pretreatment with lipopolysaccharide (LPS), so that the
      cells do not permit Legionella to replicate in vitro, as occurs when untreated
      macrophages from A/J mice are cultured with these organisms for 48 hr. The
      augmentation of Legionella growth inhibition by LPS-activated macrophages from
      nonpermissive BDF1 mice also occurred. After in vitro infection, there was a 1000
      fold increase in the number of Legionella in A/J macrophages and approximately a
      10-fold increase in BDF1 macrophages, but LPS treatment of macrophages from
      either strain resulted in marked growth restrictions. This suppression was both
      dose dependent as well as dependent upon the time of addition of the LPS to the
      macrophages. Furthermore, the lipid A component of LPS was found to be as
      effective as the intact LPS in activating macrophages to inhibit the
      intracellular growth of Legionella. Further studies concerning the mechanisms
      involved are clearly warranted and in progress.

PMID- 1615010
TI  - Effect of triacontanol on numbers and functions of cells involved in inflammatory
      responses.
AB  - A preparation of a triacontanol-containing compound was studied for its effect on
      cells involved in the inflammatory response. C57BL/6 mice were injected
      intraperitoneally with various concentrations of this compound and investigated
      for total body weight, wet weight of thymus tissue, number of thymus cells and
      splenocytes, interleukin 1 production of spleen monocytes, and response of
      splenocytes to the T cell mitogen, phytohemagglutinin. Mice treated with the
      triacontanol preparation exhibited decreased total body weight, 24% reduction in
      thymus weights, 39% decrease in the number of thymus cells, and 21% depression in
      total splenocytes. Splenic monocytes of these animals produced a significantly
      reduced amount of interleukin 1 and splenocytes had a significantly depressed
      response to phytohemagglutinin. It is concluded that triacontanol has an
      inhibitory effect on at least some of the cells responsible for inflammation.

PMID- 1615011
TI  - Impaired febrile response with age: role of thermogenesis in brown adipose
      tissue.
AB  - We demonstrated previously that in Escherichia coli-infected rats, the heat
      necessary for the febrile response is a result of thermogenesis in brown adipose
      tissue (BAT). To investigate whether senescent rats have an impaired febrile
      response to infection and whether such an impairment is a result of attenuated
      sympathetically activated thermogenesis in BAT, we assessed body temperature and
      the increase in mitochondrial guanosine 5'-diphosphate (GDP) binding sites in
      interscapular BAT in response to E. coli administration in young and senescent
      male F-344 rats. There was a significant delay of 2 hr in the onset of fever in
      the older animals. In addition, in senescent rats, the peak fever (1.0 +/- 0.1
      delta degrees C vs 2.2 +/- 0.1) and the cumulative fever (383 +/- 43 delta
      degrees C.min vs 775 +/- 69) were significantly less than in the young rats (P
      less than 0.005). Baseline levels of GDP binding were the same in young and old
      rats. In young rats, during the rising phase of the fever, E. coli infection
      resulted in a 50% increase in the density of GDP binding sites in BAT
      mitochondria. In contrast, there was no increase in GDP binding in the older rats
      following infection. The failure to increase GDP binding may be a result of a
      reduced ability to unmask reserve GDP binding sites. Alternatively, there may be
      fewer total GDP binding sites (masked and unmasked) in senescent rats and these
      sites may already be unmasked. Collectively, these data suggest that the impaired
      febrile response with age is due to reduced thermogenesis in BAT.

PMID- 1615012
TI  - Viscoelastic influence on wall and baroreceptors of rabbit carotid sinus.
AB  - This study examined multifiber baroreceptor nerve activity (BNA) as a function of
      carotid sinus wall distension in 19 rabbits. Analysis estimated mechanical or
      viscoelastic properties of the sinus wall and their influence on BNA. In six
      sinuses, properties were altered by treatment with the enzyme protease to remove
      the endothelium and with nifedipine to passively relax smooth muscle. Properties
      were estimated from dynamic and steady state wall response to a 45 mm Hg step
      increase and decrease in intrasinus pressure (ISP) of 20 min. Control wall
      response had fast and slow (creep) portions with a viscosity increase from 1,370
      N(s)/m to 17,864 N(s)/m during step-up in ISP. Wall elasticity averaged 77 N/m;
      which estimated the relationship of force and change in steady state response.
      Control BNA response also had fast and slow (resetting) portions. A BNA and wall
      response relationship (BNA/m) was defined as transduction-gain (T-G) with
      proportional and dynamic components. In the subgroup, wall creep and baroreceptor
      resetting were abolished by protease treatment, suggesting an endothelial
      mediator which influenced sinus smooth muscle. Histology data indicated enzyme
      damage was limited to tunica intima tissues, and nifedipine did not block Ca2+
      channels on neural structures. By comparison of responses before and after
      treatments the proportional component of T-G was equated to an elastic influence
      (1/E), with E = 7.5 x 10(-6) m/BNA, while the dynamic component was equated to a
      viscous influence (1/V), with V = 1.53 x 10(-4) m(s)/BNA. A simple but
      fundamental relationship for baroreceptor-tissue linkages was estimated by BNA/m
      = 1/(Vs + E), a first-order transfer function.

PMID- 1615013
TI  - Blood flow measurements by the reference sample method with microsphere injection
      in to the aorta: an accurate and easy approach.
AB  - The validity of hemodynamic measurements by the reference sample method with
      microspheres injection into the aorta, via a carotid artery catheter, was
      evaluated in rats and compared with the results obtained after left ventricle
      injection. In the aorta injection group, a good mix of microspheres was observed
      in 83% of the animals. Moreover, a symmetrical distribution of microspheres was
      observed in 10 out of 12 rats (83%). An excellent correlation between right and
      left kidney-testes blood flows was observed (r = 0.93 and 0.96, respectively; P
      less than 0.01). Mean arterial pressure was not modified during microspheres
      injection into the aorta. Cardiac output (104 +/- 26 vs 101 +/- 23 ml/min, NS)
      and portal blood flow (14.2 +/- 3.3 vs 13.5 +/- 2.2 ml/min, NS) were similar
      after aorta and left ventricle injections series, respectively. Our results
      indicate that the injection of microspheres into the aorta is an adequate and
      easy approach to systemic and splanchnic hemodynamic measurements. This approach
      could be a good alternative to left ventricle injection of microspheres in
      experimental studies in rats.

PMID- 1615014
TI  - Renal actions of endothelin during mannitol and saline expansion.
AB  - We evaluated the effects of volume expansion with saline (0.5 ml kg-1 min-1, n =
      13) and with 10% mannitol in saline (0.5 ml kg-1 min-1, n = 13) on the
      cardiorenal actions of endothelin-1 (ET) in rats anesthetized with sodium
      pentobarbital. We also evaluated to what extent the calcium channel antagonist,
      verapamil (0.02 mg kg-1 min-1), altered the cardiorenal actions of endothelin in
      volume-expanded rats (n = 10 with saline and n = 10 with mannitol). In five rats
      from each group, renal blood flow was measured with an electromagnetic flow
      probe. Sixty minutes after surgery, control clearances were collected, ET (110 ng
      kg-1 min-1) was then infused for 30 min, and recovery clearances were collected
      for 60 min. ET caused a similar increase in mean arterial blood pressure and
      decrease in renal blood flow and the glomerular filtration rate in the saline and
      mannitol groups. Verapamil significantly attenuated but did not abolish the ET
      induced increase in mean arterial blood pressure in both saline- and mannitol
      treated rats. By contrast, the calcium channel antagonist had no effect on the ET
      induced decrease in either the glomerular filtration rate or renal blood flow in
      saline-treated rats, but significantly attenuated these responses to ET in
      mannitol-expanded animals. These data demonstrate that (i) the systemic and renal
      responses to ET are not affected by expansion with saline or mannitol and (ii)
      the renal vasoconstriction prompted by endothelin is not affected by verapamil in
      saline-expanded rats, but is attenuated by the Ca2+ channel antagonist during
      expansion with mannitol. These data suggest that during volume expansion with
      mannitol, but not with saline, the ET-induced renal vasoconstriction occurs
      primarily at intrarenal resistance sites that are dependent upon extracellular
      Ca2+.

PMID- 1615015
TI  - Circadian rhythm of ornithine decarboxylase activity in small intestine of fasted
      rats.
AB  - The aim of this study was to determine whether the circadian changes in ornithine
      decarboxylase (ODC) activity of different segments of the small intestine were
      governed by factors other than food intake. First, the effects of fasting on
      mucosal ODC activity were examined. The results indicate that mucosal ODC
      activity in 24 hr and 48 hr fasted rats decreased significantly compared with ad
      libitum-fed rats. Second, the circadian rhythm of mucosal ODC activity was
      characterized by measuring mucosal ODC activity in fasted rats at four time
      points (09:00, 15:00, 21:00, and 03:00 hr; light period: 06:00-18:00 hr). The
      results from this study indicate that there is a detectable baseline ODC activity
      in different segments of fasting intestine. In duodenum, mucosal ODC activity was
      highest at 15:00 hr (light period), a time at which the rat was normally not
      eating. In jejunum and ileum, mucosal ODC activity increased between 21:00 and
      03:00 hr (dark period). The observation that small intestine exhibits a distinct
      circadian rhythm of ODC activity in fasted rats suggests that not only food but
      also intrinsic factors can modulate physiologic oscillations in mucosal ODC
      activity.

PMID- 1615016
TI  - Human beta-interferon incubated with muscle homogenate is protected by albumin
      but not by proteinase inhibitors.
AB  - The scarce bioavailability of beta-interferon (IFN-beta) after intramuscular
      administration is probably due either to the binding of IFN-beta to interstitial
      matrix, or to lymphatic absorption and/or to local breakdown by lysosomal
      proteinases from muscle. In this work, we first showed that after intramuscular
      injection, the apparent bioavailability of natural human IFN-beta is about 10% of
      that of recombinant IFN-alpha 2 and then we evaluated the effects of proteinase
      inhibitors and albumin on IFN-beta incubated at 37 degrees C with muscle
      homogenate. IFN biological activity decreased spontaneously by about 20% after
      incubation for 6 hr at 37 degrees C in Hanks' solution, but it was almost
      completely lost after incubation with muscle homogenate. Proteinase inhibitors
      (alpha 1-antitrypsin, alpha 2-macroglobulin, aprotinin, soybean trypsin
      inhibitor, leupeptin, EP-459, and EP-475) failed to block the inactivation of IFN
      beta by muscle proteinases, whereas albumin exerted a partial but consistent
      protection.

PMID- 1615017
TI  - Effects of H-2 and vitamin A on micrognathia in congenic mice.
AB  - Pregnant mice congenic with C57BL/10 (B10.A, B10.BR, B10.D2, B10.A(2R),
      B10.A(5R), B10.A(15R), B10.A(1R), B10.A(18R), and B10.OL) were fed Purina Mouse
      Chow or the same diet plus 200 IU of vitamin A daily. The pregnant dams were
      sacrificed on the eighteenth day of gestation, and the fetuses were sexed and
      examined for defects in mandibular development. On average, micrognathia occurred
      five times more frequently in female (1.5%) than male (0.3%) fetuses. The
      addition of vitamin A to the diet affected only females, reducing the frequency
      of this defect to that observed in males from dams fed the control diet.
      Micrognathia was strongly associated with micro- or anophthalmia, but not with
      defects of the palate. C57BL/10 fetuses had the highest frequency of micrognathia
      (3.2%) and B10.D2 and B10.A(5R) fetuses had the lowest (0.1%). The results
      suggest that a locus distal to C4 and perhaps proximal to Qa-1 may exert a
      moderate influence on mandibular development and a second locus proximal to E
      beta may have a weak effect.

PMID- 1615018
TI  - Stromal cells derived from spleen or bone marrow support the proliferation of rat
      natural killer cells in long-term culture.
AB  - Rat nylon wool nonadherent bone marrow cells were propagated for up to 75 days in
      co-culture with stromal cells derived from either spleen or bone marrow.
      Interleukin (IL) 1 enhanced the ability of spleen stroma to support the long-term
      culture of natural killer (NK) cells, ostensibly by inducing these support cells
      to synthesize other cytokines. Flow cytometry studies indicated that the nylon
      wool separation procedure enriched the concentrations of mature NK cells from
      7.9% to 38.1% for splenocytes and from 3.8% to 19.5% for bone marrow cells.
      Analyses of the adherent zones of suspended nylon screen NK cell cultures
      revealed substantial numbers of large granular lymphocytes that expressed NK
      323+/MOM/3F12/F2- phenotypes. The presence of both mature and immature cells of
      the NK lineage in this matrix was inferred by the presence of both IL-2 receptor
      (IL-2R) positive and IL-2R negative, and OX-8+ and OX-8- NK 323+ cells over the
      greater than 4-month experimental period. Suspended nylon screen cultures
      displayed a greater potential for producing cytolytic cells than either co
      cultures of bone marrow nonadherent cells on stroma monolayers or suspension
      cultures. The large granular lymphocytes produced in suspended nylon screen
      cultures could be transformed into active killers of YAC-1 targets by IL-2. In
      contrast to bone marrow nonadherent cells, more splenic nylon-wool-passed cells
      displayed a mature NK phenotype, but their proliferative potential and ability to
      be transformed into cytolytic cells by IL-2 decreased rapidly in culture. In the
      suspended nylon screen culture system, NK cells migrate from the underlying
      stroma in stages as they mature, retain their cytolytic potential, and manifest a
      capacity for self-renewal. Cultured cells were routinely dissociated into single
      cell suspensions via enzyme treatment and were reinoculated onto "fresh" nylon
      screen/stromal cell templates after passage through nylon wool columns. These co
      cultures continued to generate cytolytic cells in numbers greater than those of
      the initial inoculum.

PMID- 1615019
TI  - [The pharmacology of superoxide dismutase].

PMID- 1615020
TI  - [PAF-antagonists with phospholipid structure. 4. Alkylcarbamoylphospholipids with
      heteroarene and heterocyclase head groups and variation of the P-N-distance;
      synthesis, characterization and structure-activity relationship].
AB  - A series of 11 PAF-analogues, structurally modified in position 1
      (alkylcarbamoyloxy), position 2 (n-propyl), and position 3 (polar head group)
      were synthesized, and the inhibitory potencies on human blood platelets in vitro
      was evaluated. Investigations of structure-activity relationships revealed, that
      the PAF antagonist activity is strongly influenced by the chain length of the
      alkylcarbamoyl residue and the structure of the polar head group. Derivatives
      with pentadecyl and octadecylcarbamoyl structure emerged effective inhibitors.
      The best activity was observed by dimethylaminopyridinium, analogues with a P-N
      distance of 3 or 4 methylene groups and pentadecyl or octadecylcarbamoyl
      structure (IC50 = 1.0-1.6 mumol/l).

PMID- 1615021
TI  - Nonsteroidal antiinflammatory agents. Part 21: optically active stereoisomers of
      p-trifluoromethylphenyl- and p-thioanisyl-biphenylyl- hydroxypropionic acids.
AB  - The synthesis, diastereomeric separation, assignment to erythro- and threo
      configuration by 1HNMR, and optical resolution of 3-(p-trifluoromethyl-phenyl)-
      and (p-thioanisyl)-2-biphenylyl-3-hydroxypropionic acids are described. The
      enantiomers were submitted to a preliminary assay to determine antiinflammatory
      activity.

PMID- 1615022
TI  - Synthesis of some N-substituted indole derivatives and their biological
      activities.
AB  - Acylation of 2,3-diphenyl-5-methoxy-indole using ethyl chloroformate or
      chloroacetyl chloride in dimethylformamide and sodium hydride yielded the N
      substituted derivatives 1 and 2, respectively. While Friedel-Crafts acylation
      using chloroacetyl chloride afforded di-4,6-chloroacetyl derivative 3, the
      reaction of the N-chloroacetyl derivative 2 with amines, hydrazines, urea,
      semicarbazide hydrochloride, thiophenol, benzimidazole-2-thiol,
      thiosemicarbazide, 2-mercaptoethanol and thioglycolic acid was studied. Several
      of the compounds were tested for their effect on arterial blood pressure,
      antiinflammatory and ulcerogenic activities.

PMID- 1615023
TI  - [Synthesis and antimicrobial activity of chlorobenzyl benzylidene
      imidazolidinedione derivatives and substituted thiazolidinediones].
AB  - The synthesis of five chlorobenzyl benzylidene imidazolidinediones and four
      fluorobenzyl benzylidene thiazolidinediones is described. In order to investigate
      their antimicrobial activity they are evaluated against microorganism such as
      Candida albicans, Neurospora crassa, Staphylococcus aureus, Mycobacterium
      smegmatis and Escherichia coli.

PMID- 1615024
TI  - [Potential cardiotonics. 13. Crystal structure, charge distribution and molecular
      electrostatic potential of 3-cyano-2-(3-diethyl-aminopropylamino)-5-(4
      pyridinyl)pyridine (AWD 122-60)].
AB  - The crystal and molecular structure of the potential cardiotonic agent AWD 122-60
      have been determined by X-ray structure analysis. Based on the molecular
      structure charge distribution and molecular electrostatic potential were
      evaluated. The results are discussed in comparison with those of other
      cardiotonic 3,4'-bipyridines.

PMID- 1615025
TI  - [The use of bead cellulose for controlled drug liberation. 5. Kinetics of
      liberation of bonded drugs from bead cellulose and bead cellulose derivatives].
AB  - Examination of in vitro liberation of prazosin hydrochloride and benzocaine from
      formulations of matrix type with bead cellulose and bead cellulose derivatives
      shows deviations from first order kinetics owing to competition of several
      processes: dissociation of ionic bonds or cleavage of covalent bonds between
      drugs and bead cellulose, pore diffusion, dissolution of the drugs and swelling
      of cellulose matrix. Suitable combinations of different bonded portions of the
      drug on bead celluloses let these complexes seem to be successful in the use for
      controlled and retarded liberation of drugs.

PMID- 1615026
TI  - [Rheology and extensiometry of ophthalmic preparations with a vegetable oil
      base].
AB  - The physical characteristics of ophthalmic preparations based on vegetable oils
      destined for hot climates was studied in part by determining their rheological
      properties and also by measuring their extensibility. The results obtained showed
      that the thixotropy of the formulations studied was a favorable property which
      would permit their uniform application to the surface of the eye.

PMID- 1615027
TI  - Liposomes as a potential drug carrier for citicoline (CDP-choline) and the effect
      of formulation conditions on encapsulation efficiency.
AB  - In this paper we report the investigation of the potential of liposomes as drug
      carrier for citicoline (1; CDP-choline). The aim of our work is to improve the
      pharmacokinetic and pharmacodynamic parameters of the drug to facilitate the
      overcoming of the blood-brain barrier. The thermotropic behaviour of hydrated
      dispersions of various phospholipids and their mixtures containing 1 have been
      investigated by differential scanning calorimetry (DSC) to have a clear view of
      the interaction between the drug and the liposome phospholipids. By the values of
      transition peak temperature (Tm) and transition enthalpy (delta H) we note a
      strong interaction between 1 and the polar heads of L-alpha
      dipalmitoylphosphatidic acid (DPPA) and L-alpha-dipalmitoylphosphatidylserine
      (DPPS), whereas there is not any considerable interaction between the drug and L
      alpha-dipalmitoylphosphatidylcholine (DPPC) or L-alpha
      dimyristoylphosphatidylcholine (DMPC); in any case no interaction occurs between
      1 and the hydrophobic part of the phospholipid. So we conclude that all the drug
      is fitted into the aqueous spaces. The results of the encapsulation efficiency
      experiments demonstrate how the encapsulation capacity increase with using
      charged phospholipids, reaching the top with DPPA. Moreover, it was noted that
      the presence of Cholesterol (Chol) enhances the encapsulation capacity (EC) and
      drug content (DC) values of DPPC, a neutral phospholipid. The size of the
      liposomes was determined by light scattering (LS).

PMID- 1615028
TI  - Study of the gastrointestinal diffusion system (GDS): influence of acacia gum on
      mechanical and chemical properties in free cellulose acetate films.
AB  - In this work a study of free cellulose acetate films was carried out in the
      presence and absence of acacia gum at high concentrations (50 and 75%). The
      mechanical toughness and the aspect were influenced by operatory conditions and
      by the relative air humidity. The increase of relative humidity from about 0% to
      75% decreased the mechanical toughness and the color film changed from a clear to
      opaque white. The presence of acacia gum decreased the mechanical toughness and
      the water vapour transmission rate and increased the film water solubility.

PMID- 1615029
TI  - Pharmacokinetics of isometronidazole. Basic model and estimation of the kinetic
      parameters from experimental data.
AB  - For the optimal timing of application of radiosensitizers in a course of
      radiotherapy it is important to know the sensitizer concentration at the time of
      irradiation. We have studied the pharmacokinetics of the hypoxic cell sensitizer
      isometronidazole in man and mouse and analyzed the data on the basis of an open
      two-compartment model after extravasal application. The parameter estimation is
      performed directly to avoid estimation biasing and data points from blood and
      tissue compartments are approximated simultaneously. The values obtained differ
      significantly from the estimations calculated by other authors for the same data.

PMID- 1615030
TI  - [Antitussive action of extracts and polysaccharides of marsh mallow (Althea
      officinalis L., var. robusta)].
AB  - The complex extract and the polysaccharide isolated from the roots of marsh
      mallow were tested for antitussive activity in unanaesthetized cats of both
      sexes. Cough was elicited by mechanical stimulation of laryngopharyngeal and
      tracheobronchial mucous area of the respiratory system with a Nylon fibre
      (diameter 0.35 mm). Cough was evaluated on the basis of the changes in lateral
      tracheal pressure. The polysaccharide and the complex extract were administered
      p.o. in a dose of 50 and 100 mg/kg b.w., respectively. The efficiency of the
      mentioned compounds was compared with the cough-suppressing effect of drugs
      belonging to the non-narcotic antitussics. The results of the experiments showed
      that administration of the polysaccharide led to a statistically significant
      decrease of the number of cough efforts both from laryngopharyngeal and
      tracheobronchial areas of the the respiratory system. The polysaccharide in a
      dose of 50 mg/kg b.w. was as effective in inhibition of the cough reflex as
      Sirupus Althaeae in a dose of 1000 mg/kg b.w. and more effective than
      prenoxdiazine in a dose of 30 mg/kg b.w. However, the cough-suppressing effect of
      the polysaccharide was lower than that of dropropizine. The extract was less
      effective than the polysaccharide.

PMID- 1615031
TI  - [Tyrosine splitting aminopeptidases on cultivated anterior hypophyseal and
      vascular endothelial cells].
AB  - Activities of aminopeptidases for a tyrosine peptide hydrolysis were
      characterized with Tyrosyl-7-amino-4-methyl-coumarin as substrate on in vitro
      cultivated anterior pituitary cells, respectively, on aortic endothelial cells.
      Furthermore the corresponding activities were measured in different fractions of
      the cells. The activities of the enzymes in soluble fractions of the cell
      homogenates are comparable with aminopeptidases of cytosolic compartments of
      other tissue samples. On the other hand remarkable differences exist between Km-
      and IC50-values of the membrane preparations of both cell types. Furthermore, the
      substrate degradation on intact cells by provable membrane bound ectoenzymes is
      identically for both cell types and this degradation is insensitive for
      amastatin. Our results are discussed with special respect for the importance of
      the degradation of biological active peptides with N-terminal tyrosine by
      aminopeptidases on their physiological targets.

PMID- 1615032
TI  - HPLC quantification of a tricomponent psychiatric formulation containing
      chlorpromazine, trifluoperazine and trihexyphenidyl.

PMID- 1615033
TI  - In vitro and in situ absorption of ethamsylate. Part 1: A simple
      spectrophotometric method for in situ intestinal absorption using phenol red as
      volume marker.

PMID- 1615034
TI  - The timing control of geminate and single stop consonants in Japanese: a
      challenge for nonnative speakers.
AB  - The stop closure durations and voice onset time of geminate and single voiceless
      stops in Japanese were examined with two groups of subjects: native Japanese and
      fluent Americans. The two groups were found to have different manners of timing
      control of these segments. The results indicated that the 10 native speakers
      distinguished between the geminate and single stops by controlling the closure
      durations in the mean ratio of 2.8:1.0, while the 4 fluent Americans pronounced
      the same tokens in diverse and random manners. The timing control of geminate and
      single stop consonants is a challenge for nonnative speakers who may either miss
      the contrast, or may pronounce geminate and single stops with the ratio of
      approximately 2.0:1.0.

PMID- 1615035
TI  - Speaking fundamental frequency patterns of Japanese women.
AB  - The purpose of this research was to obtain information on the speaking
      fundamental frequency (SFF) mean levels, variability and patterns of Japanese
      females and contrast them with those of Caucasian speakers of American English.
      To this end, 56 young women--32 Japanese and 24 Americans--read standard passages
      in either or both the Japanese and English languages. It was found that the
      Japanese exhibited higher fundamental frequencies than did the Americans for all
      speaking conditions, and this contrast was statistically significant.
      Additionally--and unlike the American speakers--most Japanese women exhibited
      bimodal SFF distribution patterns. It is judged that the observed differences in
      level and distribution result primarily from differences in the structure of the
      two languages.

PMID- 1615036
TI  - Stops in the world's languages.
AB  - This account of the great variety of stops in the world's languages shows that,
      apart from their place of articulation, these sounds can be described principally
      in terms of the activities that occur at three phases: onset, closure, and
      release. Other potentially contrastive features discussed include length, and the
      use of the glottalic airstream mechanism (other airstream mechanisms are not
      considered here). Phonologically only two phases--closure and release--are
      exploited; independent distinctions of features such as phonation type or
      articulatory manner cannot be found in the onset phase. We examine the
      combinatorial possibilities of the features that are used and discuss
      implications for phonological feature systems.

PMID- 1615037
TI  - Spatial learning ability of rats undernourished during early postnatal life.
AB  - Experiments to determine whether undernutrition during early life results in
      deficits in spatial learning behavior has produced conflicting results. It was
      hypothesized that this may be due to the differing degrees of undernutrition used
      in the various studies, and/or to the timing of the testing procedures with
      respect to the period of food deprivation. These possibilities were tested by
      undernourishing rats between birth and 30 days of age to two different levels
      (i.e., level-1 and level-2). The degree of undernutrition was greater at level-2
      than level-1. Behavioral testing of these rats and well-fed controls was carried
      out in the Morris water maze when they were between either 35 and 65 or 170 and
      200 days of age. Statistical analyses of the escape latency data from these
      experiments revealed that rats tested almost immediately after the period of
      undernutrition have alterations in their spatial learning behavior compared with
      controls. However, even a short period of nutritional rehabilitation removed any
      differences between control and previously undernourished groups, irrespective of
      the level of undernutrition.

PMID- 1615038
TI  - Parametric manipulations and fixed-interval self-stimulation.
AB  - Three experiments investigated hypothalamic self-stimulation under a fixed
      interval (FI) reinforcement schedule. An FI 20-s schedule was chosen to reduce
      stimulation density in order to minimize the influence of priming effects or
      stimulation aftereffects that can affect responding under other schedules of
      reinforcement. The first experiment showed that the influence of train duration
      is greatest at levels up to 1 s and thereafter level off over a wide range of
      train durations (1-32 s). The second experiment showed that altering frequency,
      current, or pulse width produced almost identical changes in FI responding. These
      findings show that the neutral network subserving hypothalamic self-stimulation
      simply integrates the amount of charge over time. It is relatively insensitive to
      the combination of stimulation parameters that make up a given waveform. In the
      third experiment, the chronaxies from the strength-duration curves indicate the
      neural substrate supporting self-stimulation has a great current-integrating
      capacity. Together, these experiments show that varying the amount of brain
      stimulation produce large and consistent changes in a number of FI response
      measures. These measures effectively describe different attributes of FI
      performance and include response rate, the postreinforcement pause, interresponse
      times of short duration and the temporal distribution of responses within the
      interval.

PMID- 1615039
TI  - Autonomic nervous system response patterns correlate with mental imagery.
AB  - New findings related to autonomic nervous system (ANS) functions may reveal some
      brain functions, since they can be observed by real time analysis. ANS parameters
      (skin potential and resistance, skin temperature and blood flow, instantaneous
      heart rate) and instantaneous respiratory frequency are quantified by original
      techniques and indices. Results show that ANS responses correlate with mental
      imagery. Imagery contents influence autonomic responses, thus making it
      comparable to real activity. Therefore, by using two shooting events as models,
      the almost identical nature of the ANS response is evidenced during real shooting
      and in mental concentration before shooting. Next, shooting activity imagery can
      be distinguished from neutral imagery but is comparable to the activity itself as
      far as ANS responses are concerned.

PMID- 1615040
TI  - Smooth muscle sensitization and neuromuscular depression induced by chronic
      administration of antimalarial drugs.
AB  - The functional effects on chick smooth and skeletal muscle of chronic
      administration of 60 mg kg-1 chloroquine or quinacrine given as daily
      intraperitoneal injections for 70 days have been investigated. Noradrenaline and
      potassium chloride (KCl) contracted the normal expansor secundariorum muscle, a
      smooth muscle from the wing of chicks wholly innervated by noradrenergic nerves.
      The muscle was unresponsive to acetylcholine and histamine. Chronic
      administration of chloroquine or quinacrine induced supersensitivity of expansor
      muscles to KCl and the muscles were contracted by acetylcholine and histamine.
      These actions were more pronounced in quinacrine-treated chicks and could be due
      to direct smooth muscle sensitization that may result in postjunctional changes.
      The oesophagus is a smooth muscle that is predominantly under parasympathetic
      control. The oesophagus from chronically-treated chicks was more sensitive to
      acetylcholine and KCl than the control muscles. This sensitization was more
      marked for chloroquine than quinacrine. Chronic administration of chloroquine and
      quinacrine depressed skeletal muscle contractions evoked by acetylcholine and
      potassium chloride. These findings indicate that chronic chloroquine and
      quinacrine administration sensitise smooth muscle to agonist drugs but depress
      neuromuscular transmission.

PMID- 1615041
TI  - Interstrain aggression in hypertensive and/or hyperactive rats: SHR, WKY, WKHA,
      WKHT.
AB  - Four inbred rat strains, all derived from Wistar-Kyoto (WKY) rats, express
      hypertension and hyperactivity in all combinations: SHRs have both traits, WKYs
      have neither, WKHAs are hyperactive/normotensive, and WKHTs are
      hypertensive/normoactive. Rats of the four strains were tested for aggression, at
      one time only, by pairing subjects of same sex, same age, but different strain,
      in a novel arena, i.e., on neutral ground, for three consecutive, 5-min
      observation periods. Total aggression scores were highest in females, highest in
      the first 5-min period, and lower at 7-9 months than at younger ages.
      Allogrooming was more frequently observed than other types of aggression, such as
      attacks, mounts, aggressive postures, and blocks. Allogrooming scores were
      significantly elevated in the hypertensive strains, especially WKHT, and very low
      in the hyperactive strains, especially WKHA. The other forms of aggression were
      significantly higher in females with hyperactivity. It was concluded that
      interstrain aggression, as seen in SHRs and WKYs, is differentially expressed by
      two new strains genetically derived from them. Furthermore, no one strain among
      these four expresses all components of the behavioral responses seen in this form
      of aggression.

PMID- 1615042
TI  - Genotype, uterine position, and testosterone sensitivity in older female mice.
AB  - CF-1 and CK (C57BL/6J x AKr) female mice that developed in utero between two
      males (2M), adjacent to one male (1M), or between two females (0M) were tested
      for their sensitivity to the aggression-promoting property of testosterone (T)
      beginning at 9 months of age. Comparisons between the strains showed that a
      higher proportion of CF-1 females fought in response to T and that the period of
      hormone exposure required to induce aggression also was shorter in this strain.
      Within each of the genotypes, there were no systematic differences in
      responsiveness to T related to contiguity to males during fetal development.
      While the results provide further evidence for genotype as a major influence on
      neural sensitivity to androgen, they do not support uterine position of females
      relative to males as a source of phenotypic variation in responsiveness.

PMID- 1615043
TI  - The performance of WKY rats on three tests of emotional behavior.
AB  - The behavior of Wistar, Fischer-344, and WKY male rats was observed on three
      tests of emotional behavior. These included the defensive-withdrawal test, the
      elevated plus maze, and the conditioned defensive-burying test. Rats were
      subsequently exposed to the water-restraint ulcerogenic procedure. Fischer-344
      rats were more active in the defensive-withdrawal tests, but other behavioral
      measures in this test did not discriminate between the three strains. Scores
      reflecting anxiety in the elevated plus maze were lowest for Fischer-344 rats and
      highest for WKY rats, but the anxiety scores of WKY rats did not differ
      significantly from Wistar rats. The behavior of WKY rats was significantly
      different from the other two strains in the conditioned defensive burying test.
      While the degree of anxiety is measured by burying behavior, elicited by the
      novelty of prod shock, immobility was the prevalent response of WKY rats. WKY
      rats also revealed significantly higher ulcer severity scores when exposed to
      water-restraint stress after each behavioral test procedure. We propose that WKY
      rats are hyperresponsive to stress and that novelty stress elicits depression
      like behavior, which is the prevalent behavioral stress response in WKY rats.

PMID- 1615044
TI  - Cholecystokinin antagonist and lipid intake as a function of caloric density and
      familiarity.
AB  - The effect of treatment with the cholecystokinin antagonist L364,718 on intake of
      different dilutions of corn oil emulsion was tested under two levels of
      familiarity with the oil emulsion. No increase in intake was observed. To see if
      the CCK antagonist was effective under our conditions, exogenous CCK was
      administered under the same conditions. A complete suppression of the large
      reduction produced by CCK on intake was found.

PMID- 1615045
TI  - Amiloride reduces intensity responses of human fungiform papillae.
AB  - Microdrop stimulation of human fungiform papillae was used to confirm that the
      drug amiloride reportedly reduces the taste response to NaCl and sucrose.
      Amiloride caused magnitude reductions of saltiness in most subjects and of
      sweetness for some but not all subjects. More of the subjects showed a reduction
      in response to NaCl than a reduction to sucrose and there were individual
      differences in the strength of the reduction of magnitude.

PMID- 1615046
TI  - Human psychophysical studies of saltiness suppression by amiloride.
AB  - Two studies were performed to assess the effects of amiloride on the saltiness of
      NaCl. In the first study, four highly trained subjects were asked to report the
      first appearance of saltiness as NaCl microdrops were rapidly applied to an
      increasing number of fungiform papillae along the front, dorsal surface of the
      tongue. For two subjects, amiloride, a sodium channel blocker, caused a large and
      significant increase in the number of papillae needed to report a salty taste.
      The other two subjects were unaffected, as measured by this procedure. In the
      second study, four different subjects were trained in the same procedure as in
      the previous study. For testing, however, they were stimulated on a fixed number
      of papillae, which was two times the number self-selected during training as
      sufficient for perception of saltiness with NaCl, and sourness with citric acid.
      They reported the quality of the experience as salty, sour, or neither, with and
      without amiloride treatment of the papillae set. Two of the four subjects had a
      loss of saltiness of NaCl, but not sourness of citric acid, when the papillae set
      was treated with amiloride.

PMID- 1615047
TI  - Rats can discriminate between the urine odors of genetically identical mice
      maintained on different diets.
AB  - Male Long-Evans hooded rats were tested in a habituation-dishabituation procedure
      for their ability to discriminate between the urine odors of male C57BL/6J mice
      maintained on two different diets. There were discriminable differences between
      the urinary odors of two individual mice maintained on different diets. The rats
      did not dishabituate when presented with urine odors from two individuals on the
      same diet or two odor samples from the same individual. These results indicate
      that individual urinary odors of genetically identical mice are influenced by
      diet. We discuss the hypothesis that diet may act together with genetic
      differences, commensal bacteria, and hormonal changes to convey olfactory
      information used for individual recognition.

PMID- 1615048
TI  - Photoperiod and gonadal hormones influence odor preferences of the male meadow
      vole, Microtus pennsylvanicus.
AB  - Male meadow voles housed in a long photoperiod (14 h light/day, LP) preferred
      female to male odors, whereas males maintained in a short photoperiod (10 h
      light/day, SP) did not display preferences for odors of either sex. These odor
      preference patterns matched those of free-living males during spring and autumn,
      respectively. The preference of LP male voles for female over male odors was
      eliminated by gonadectomy and reinstated by treatment with testosterone. In SP
      males, although gonadectomy did not affect odor choices, a preference for female
      odors was induced by testosterone treatment. Treatment with estradiol did not
      alter odor preferences of LP or SP males. In conjunction with previous result,
      the present findings suggest that hormonal responsiveness of neural substrates
      that control odor preferences are sexually dimorphic and may reflect sex
      differences in reproductive strategies.

PMID- 1615049
TI  - Circadian patterns of drinking and eating in pygmy goats.
AB  - The eating and drinking patterns of pygmy goats fed ad lib and kept on a 12 h
      light/12 h dark cycle were recorded and analyzed. Eighty-four percent of drafts
      (drinking bouts) were associated with meals (feeding bouts). Only 42% of meals
      were associated with drafts. In the light phase meals associated with drafts were
      significantly larger than meals not associated with drafts, suggesting that meal
      size is increased by water intake around meals. Cumulative food intake was
      positively correlated with cumulative water intake, but the correlation was
      weaker during the dark phase than during the light phase. The results demonstrate
      that water intake in ruminants is associated with food intake, but the link
      between water and food intake seems to be more pronounced during the light phase
      than during the dark phase.

PMID- 1615050
TI  - Effects of chronic dietary choline on temporal discrimination of BN and WAG rats.
AB  - Using rats of the inbred BN and WAG strain, we tested the hypothesis that chronic
      dietary choline supplementation would especially affect the timing behavior of BN
      rats because of their lower cholinergic activity and their poor performance in
      aversively motivated learning and memory tasks. An apparent effect of chronic
      choline supplementation (2.5 mg choline chloride per ml water) on DRL-8"
      responding was not confirmed in a second experiment when the choline
      concentration was doubled. WAG rats treated chronically with choline showed a
      poorer temporal discrimination performance on a DRL-16" schedule than untreated
      WAG rats. In contrast, choline supplementation never had an effect on the
      performance of BN rats. The results of the DRL-16" experiment provide partial
      support for a hypothesis proposed by Church and Meck that the remembered time of
      reinforcement is inversely related to the functional activity of brain
      cholinergic activity: acetylcholine precursor treatment increases memory storage
      speed, which results in an overestimation of the time elapsed. An alternative
      explanation, which takes into account the aberrant EEG activities of WAG rats, is
      also discussed.

PMID- 1615052
TI  - Comparison of preference thresholds for NaCl solution in rats of the Sprague
      Dawley and Long-Evans strains.
AB  - Rats of the Sprague-Dawley and Long-Evans strains were compared with respect to
      their preference threshold and preference maximum concentrations for NaCl
      solution in a two-bottle choice paradigm. The preference threshold for NaCl in
      rats of the Sprague-Dawley strain occurred when the concentration of NaCl
      presented was 0.030 M. The preference maximum concentration was 0.10 M. In the
      case of rats of the Long-Evans strain, a preference threshold concentration was
      not clearly manifested although the preference maximum concentration was also
      0.10 M. Thus, the previously reported lack of an appetite for isotonic NaCl
      solution in rats of the Long-Evans strain compared to those of the Sprague-Dawley
      strain is most likely related to the failure of rats of the former strain to
      discriminate between water and NaCl solution until the concentration of NaCl
      exceeds 0.15 M. However, at this concentration, both strains rejected NaCl
      solution in favor of water. In contrast to the results with NaCl solution, rats
      of the Long-Evans strain appear to have a greater appetite for 5% glucose
      solution than do those of the Sprague-Dawley strain. Whether this is related to a
      reduced preference threshold concentration for glucose remains to be tested.

PMID- 1615051
TI  - Learned preference for the limiting amino acid in rats fed a threonine-deficient
      diet.
AB  - Preference for an odor associated with protein is only seen in protein-deprived
      rats. We hypothesized that rats depleted of the amino acid threonine (THR) would
      prefer a flavored solution paired with a THR replete diet. Rats were given a
      flavored drink paired with THR-deficient (DEV) diet followed by a second flavor
      paired with a corrected (COR) diet. In choice testing, the animals clearly
      selected the COR-paired flavor, while control rats preferred the other flavor.
      This did not, however, differentiate between aversion to the DEV-paired flavor
      and learned preference for the COR-paired flavor. In subsequent tests, an
      unpaired flavor was given rather than the DEV-paired flavor. The COR-paired
      flavor was included in the test as before. In the second and third trials, using
      either DEV or a less profoundly deficient diet, animals depleted of THR selected
      the COR-paired flavor to a greater extent than control rats. We conclude that
      animals deficient in the essential amino acid, THR, show a learned preference for
      the flavor paired with repletion.

PMID- 1615053
TI  - Influence of anterior subdiaphragmatic vagotomy and TPN on rat feeding behavior.
AB  - Total parenteral nutrition (TPN) inhibits food intake and feeding behavior.
      Whether caloric sensory function of the liver contributes to this food intake and
      feeding behavior regulation via vagal-afferent innervation was tested after
      performing anterior hepatic vagotomy or sham operation in rats infused with a TPN
      solution providing 100% of daily energy needs, given continuously for 4 days.
      Food intake, meal number, size, duration, meal and intermeal sniffs, and eating
      activity were measured using an automated computerized rat eater meter (ACREM).
      TPN infusion resulted in a significant decrease of food intake and feeding
      indexes in both groups. The vagotomized rats showed a significantly higher food
      consumption, achieved by greater meal frequency, larger meal size, and longer
      meal duration. Thus, vagotomized rats consumed more than their controls by eating
      larger meals more often and of longer duration. Data suggest that anterior
      hepatic vagotomy interrupts hepatic caloric sensory feedback loop, diminishing
      inhibitory vagal effects on food intake with TPN, leading to an overall increase
      in food intake.

PMID- 1615054
TI  - Lesions of the medial amygdala produce severe impairment of copulatory behavior
      in sexually inexperienced male rats.
AB  - The effects of amygdaloid lesions on masculine copulatory behavior were examined
      in male rats. Sexually inexperienced male rats were castrated and subjected to
      bilateral lesions in one of the following areas: the medial amygdala, the
      cortical amygdala, or the basolateral amygdala. Three weeks later, all rats
      received implantation of silastic capsules containing testosterone. Then, four
      observations of copulatory behavior were carried out every 5 days following the
      implantation of testosterone. Rats with medial amygdala lesions showed a severe
      deficit of copulatory behavior, whereas rats with basolateral amygdala lesions
      showed no change in the performance of copulation. As for rats with cortical
      amygdala lesions, although their copulatory behavior was impaired, the effect was
      confined to a deficit in intromission and ejaculation responses. These findings
      suggest that the medial amygdala plays a critical role in regulating masculine
      sexual behavior in the rat.

PMID- 1615055
TI  - Habituation and dishabituation of human salivary response.
AB  - Habituation may be relevant for understanding how sensory stimuli influence
      factors related to ingestive behavior. In the first of three experiments in
      humans we showed that salivation and hedonic ratings to lemon or lime juice
      habituated within 10 presentations, and dishabituation of the salivation and
      hedonic ratings to the original juice were observed after a new juice was
      presented. Experiment 2 replicated the habituation and decrease in hedonics to
      lemon juice, and showed both dishabituation and a relative increase in hedonics
      when chocolate taste, rather than another juice, served as the dishabituating
      stimulus. In a third experiment we showed a video game, a nontaste stimulus,
      could serve as a distractor to prevent the development of habituation, as well as
      a dishabituator after habituation had occurred.

PMID- 1615056
TI  - Effects of 2-deoxy-D-glucose on food intake of rats are affected by diet
      composition.
AB  - The effect of various doses of 2-deoxy-D-glucose (2-DG) on food intake in rats
      fed either a medium fat diet with a moderate carbohydrate content (MF-rats) or a
      carbohydrate-free high fat diet (HF-rats) was tested. Injections were given
      intraperitoneally either in the middle of the bright phase or 1 h after onset of
      the dark phase. During the light phase 2-DG induced a transient hyperphagia in
      both HF- and MF-rats, but the hyperphagia was somewhat less pronounced in HF
      rats. During the dark phase 2-DG produced a hyperphagia in the MF-rats and a long
      term hypophagia in the HF-rats. Since 2-DG elicited feeding in HF-rats during the
      light phase, the feeding response to 2-DG not only reflects hunger for
      carbohydrate as previously suggested but also seems to produce hunger for energy.

PMID- 1615057
TI  - Intrauterine positions and testosterone levels of adult male gerbils are
      correlated.
AB  - Those male Mongolian gerbils (Meriones unguiculatus) that developed in
      intrauterine positions between two male fetuses had significantly higher levels
      of serum testosterone, as adults, than did those adult male gerbils that
      developed in intrauterine positions between two female fetuses. The endogenous
      testosterone levels of adult male gerbils were significantly positively
      correlated with both the sizes of their ventral scent glands and their
      frequencies of scent marking. We found no evidence of pulsatile release of
      testosterone in adult male gerbils.

PMID- 1615058
TI  - Plasma catecholamines and social behavior in male vervet monkeys (Cercopithecus
      aethiops sabaeus).
AB  - Many investigations in humans indicate that epinephrine, norepinephrine and their
      ratio may correlate with such traits as social competence, academic achievement,
      and aggression. However, the socioeconomic, dietary, and environmental confounds
      accompanying most human studies complicate their interpretation. Social status,
      aggression, and other social behaviors can be reliably assessed in nonhuman
      primates under conditions controlling for crucial environmental factors. If
      interpretation of human studies is correct, dominant and subordinate male vervet
      monkeys should exhibit distinctive patterns of catecholamine secretion. To test
      this possibility, seventeen adult male monkeys living in six stable social groups
      were observed for 6 months. Based on their success in agonistic events, subjects
      were categorized as dominant or subordinate. Alpha scores were calculated from
      empirically derived factors to provide a noncategorical measure of dominant
      behavioral style. Plasma epinephrine and norepinephrine samples obtained from
      anesthetized subjects did not differ between dominant and subordinate males.
      Alpha scores, however, distinguished high from low norepinephrine/epinephrine
      ratio groups. These findings are consistent with studies in humans linking high
      epinephrine, low norepinephrine, and social competence.

PMID- 1615059
TI  - Senescence-accelerated mouse (SAM): age-related reduced anxiety-like behavior in
      the SAM-P/8 strain.
AB  - Age-related behavioral changes in the passive avoidance, food neophobia, elevated
      plus-maze, and water-lick conflict tests were studied using substrains of
      senescence-accelerated mouse (SAM-P/8 and SAM-R/1) at 2 to 20 months of age. SAM
      P/8 mice exhibited a significant impairment of acquisition of passive avoidance
      compared with SAM-R/1 mice when they were trained repeatedly, and the acquired
      response in SAM-P/8 mice rapidly diminished in contrast to good retention in SAM
      R/1 mice. SAM-P/8 mice showed an age-related decrease in the latency to eat novel
      food after a 24-h food deprivation as compared with SAM-R/1 mice at 2 to 12
      months of age, despite no significant difference in latency to eat familiar food
      between the two strains. In the elevated plus-maze test, SAM-P/8 mice had
      apparent increases in the number of entries into open arms and time spent on open
      arms in comparison to SAM-R/1 mice at 4 through 12 months of age; this difference
      became obvious with aging, implying age-associated reduced anxiety in the SAM-P/8
      strain. In addition, SAM-P/8 mice exhibited a significant increase in punished
      water drinking compared to SAM-R/1 mice in the water-lick conflict test, although
      unpunished water intake in SAM-P/8 mice did not differ from that in the SAM-R/1
      control. Aged SAM-R/1 mice, 20 months old, exhibited low anxiety-like behavior in
      the food neophobia and elevated plus-maze tests such as was seen in SAM-P/8 mice,
      when compared with young (4-month-old) SAM-R/1 mice.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1615060
TI  - Maternal influences on body temperature in the infant primate.
AB  - The following study investigated the diurnal variation in body temperature of the
      young monkey infant and assessed the role that the mother plays in the
      development of the temperature rhythm. Using an implantable biotelemetry system,
      core body temperature and motoric activity were evaluated in maternally-reared
      and hand-reared rhesus monkey infants across the first several months of life.
      Our results indicated that the nocturnal temperatures of hand-reared infants are
      lower than those of mother-reared infants at one month of age, and that there are
      persistent differences in the orientation and shape of the diurnal temperature
      rhythm. The initial thermal challenge and the prolonged rhythm shift may have
      implications for the normal development of several physiological systems in the
      hand-reared infant monkey.

PMID- 1615061
TI  - Dietary self-selection vs. complete diet: body weight gain and meal pattern in
      rats.
AB  - Food intake and body weight gain of male adult Wistar rats were examined in two
      groups of animals. One group (n = 14) was allowed to select its diet from
      separate sources of protein (casein, 3.1 kcal/g), fat (lard and sunflower oil,
      7.9 kcal/g) and carbohydrate (CHO, starch and sucrose, 3.3 kcal/g). Another group
      (n = 10) received a nutritionally complete diet (3.3 kcal/g). After 2 weeks of
      adaptation to the diets, body weights and meal patterns were recorded for at
      least 4 days. The total caloric intake was nearly identical for the two groups of
      rats. Rats given dietary choice gained less weight over 4 days than rats fed chow
      and showed reduced feed efficiency. During the 24-h period, self-selecting rats
      consumed 20.8% of calories as proteins, 21% as fats and 58.2% as CHO. Self
      selecting rats ate significantly less calories during the day than did rats given
      chow. The chow diet consisting of 17.3% calories as protein, 7.6% as fat and
      75.1% as CHO. When comparing the self-selecting group nutrient intakes to those
      of chow-fed group it was observed that 24-h protein calorie intakes were
      identical in both groups. Fat intake was significantly higher and CHO reduced as
      compared to chow-fed rats. During the day, CHO intake was higher in self
      selecting rats, and fat intake was not significantly reduced. During the night,
      protein and fat intakes were significantly higher in self-selecting rats, while
      CHO intake was significantly decreased, particularly in the last periods of the
      night.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615062
TI  - A staphylococcal multidrug resistance gene product is a member of a new protein
      family.
AB  - The complete nucleotide sequence (321 bp) of smr (staphylococcal multidrug
      resistance), a gene coding for efflux-mediated multidrug resistance of
      Staphylococcus aureus, was determined by using two different plasmids as DNA
      templates. The smr gene product (identical to products of ebr and qacC/D genes)
      was shown to be homologous to a new family of small membrane proteins found in
      Escherichia coli, Pseudomonas aeruginosa, Agrobacterium tumefaciens, and Proteus
      vulgaris. The smr gene was subcloned and expressed in S. aureus and E. coli and
      its ability to confer the multidrug resistant phenotype was demonstrated for two
      different lipophilic cation classes: phosphonium derivatives and quarternary
      amines. Expression of smr gene leads to the efflux of tetraphenylphosphonium and
      to a net decrease in the uptake of lipophilic cations. The deduced polypeptide
      sequence (107 amino acid residues, 11,665 kDa) has 46% hydrophobic residues (Phe,
      Ile, Leu, and Val) and 20% hydroxylic residues (Ser and Thr). Four transmembrane
      segments are predicted for smr gene product. Of the charged amino acid residues,
      only Glu 13 is located in a transmembrane segment. This Glu 13 is conserved in
      all members of the family of small membrane proteins. We propose a mechanism
      whereby exchange of protons at the Glu 13 is a key in the efflux of the
      lipophilic cation. This mechanism includes the idea that protons are transported
      to the Glu 13 via an appropriate chain of hydroxylic residues in the
      transmembrane segments of Smr.

PMID- 1615063
TI  - Cloning and DNA sequence of the Mycobacterium fortuitum var fortuitum plasmid
      pAL5000.
AB  - The complete nucleotide sequence of the Mycobacterium fortuitum var fortuitum
      plasmid pAL5000 has been determined. Computer analysis of this 4821-bp plasmid
      for protein coding regions, based on mycobacterial codon usage preferences,
      reveals the presence of two putative protein coding regions immediately
      downstream from typical mycobacterial promoter and ribosome binding sites. Both
      open reading frames, ORF1 and ORF2, produced proteins with the predicted
      respective sizes previously shown in minicell expression experiments [A. Labidi
      et al. (1985) FEMS Microbiol. Lett. 30, 221-225]. ORF1 encodes a putative 20-kDa
      basic protein with characteristics of a DNA binding protein involved in plasmid
      DNA replication. ORF2 encodes a 67-kDa protein with an amino-terminal sequence
      suggestive of a transported protein and a possible transmembrane anchor near its
      carboxyl-terminal. The current sequence and its analysis are more consistent with
      the minicell expression experiments than the previously published sequence of the
      pAL5000 plasmid [J. Rauzier et al. (1988) Gene 71, 315-321].

PMID- 1615064
TI  - Heterologous gene expression in Bacteroides fragilis.
AB  - Bacteroides fragilis and other gastrointestinal tract Bacteroides are unusual
      gram-negative eubacteria in that genes from other gram-negative eubacteria are
      not expressed when introduced into these organisms. To analyze gene expression in
      Bacteroides, expression vector and promoter probe (detection) vector systems were
      developed. The essential feature of the expression vector was the incorporation
      of a Bacteroides insertion sequence element, IS4351, which possesses promoter
      activity directed outward from its ends. Genes inserted into the multiple cloning
      site downstream from an IS4351 DNA fragment were readily expressed in B.
      fragilis. The chloramphenicol acetyltransferase (cat) structural gene from Tn9
      was tested and conferred chloramphenicol resistance on B. fragilis. Both
      chloramphenicol resistance and CAT activity were shown to be dependent on the
      IS4351 promoters. Similar results were obtained with the Escherichia coli beta
      glucuronidase gene (uidA) but activity was just 30% of the levels seen with cat.
      Two tetracycline resistance determinants, tetM from Streptococcus agalactiae and
      tetC from E. coli, also were examined. tetC did not result in detectable
      tetracycline resistance but the gram-positive tetM gene conferred high-level
      resistance to tetracycline and minocycline in Bacteroides hosts. Based on the cat
      results, promoter probe vectors containing the promoterless cat gene were
      constructed. These vectors were used to clone random B. fragilis promoters from
      partial genomic libraries and the recombinants displayed a range of CAT
      activities and chloramphenicol MICs in B. fragilis hosts. In addition, known E.
      coli promoters (Ptet, Ptac, Ptrc, Psyn, and P1P2rrnB) were tested for activity in
      B. fragilis. No chloramphenicol resistance or CAT activity was observed in B.
      fragilis with these promoters.

PMID- 1615065
TI  - Mobilization of recombinant plasmids from Staphylococcus aureus into coagulase
      negative Staphylococcus species.
AB  - pC221, a small nonconjugative staphylococcal plasmid, can be mobilized between
      staphylococci by pG01, a larger conjugative plasmid. pC221 carries the two
      transacting genes, mobA and mobB, which are needed for its mobilization. The
      products of these genes create a site-specific single-stranded nick (mobA) and
      then facilitate DNA transfer (mobB). Several useful Escherichia coli
      staphylococcal shuttle plasmids containing the cloned single-stranded nick site
      were created and successfully mobilized into Staphylococcus aureus and two
      coagulase-negative staphylococci, S. epidermidis and S. saprophyticus, by
      providing mob genes (pC221) and conjugative transfer genes (pG01) in trans in the
      donor. These vectors may offer a genetic system for the introduction of
      recombinant plasmids into coagulase negative staphylococci.

PMID- 1615066
TI  - cis-inhibitory elements in the pT181 replication system.
AB  - We report here the existence of a pair of sequence elements in plasmid
      cointegrates that together block the function of pT181 plasmid replication
      origins in cis. The study is an outgrowth of the use of plasmid pE194 as a vector
      for the analysis of the pT181 replication system. We have observed that whereas
      the isolated pT181 replication origin is fully functional when cloned to pE194,
      it is inactive when the entire pT181 plasmid genome is cloned. This cis
      inhibition is relieved by deletion of all or part of the pE194 palA element or of
      the pT181 countertranscript promoter. The inhibitory effect of pE194 palA is
      independent of distance and orientation, whereas the inhibitory effect of the
      countertranscript promoter is lost when the promoter is moved to a distance of
      1.5 kb from the replication origin or inverted in situ. We found that the cis
      inhibited pT181 origin expresses origin-specific (Inc3B) incompatibility, which
      involves competition for the initiator protein. This finding suggests that the
      cis-inhibited origin binds the initiator protein and therefore that the
      inhibition affects a step in the initiation process subsequent to initiator
      binding.

PMID- 1615067
TI  - Composite rhytidectomy.
AB  - Signs of aging in the face reflect the change in position of deep anatomic
      elements, which are the platysma muscle, cheek fat, and the orbicularis oculi
      muscle. These changes occur from progressive ptosis of these elements, which
      continue to keep their intimate relationship with each other throughout the aging
      process. Conventional face lift procedures disrupt this normal relationship by
      separating the skin from these elements. All SMAS techniques reposition only the
      platysma muscle without repositioning the cheek fat and orbicularis muscle. This
      composite rhytidectomy allows elevation of a composite musculocutaneous flap
      containing all three elements for repositioning while maintaining their intimate
      relationship with each other and with the skin. One-hundred and sixty-seven
      composite rhytidectomies have been done with impressive results and minimal
      complications.

PMID- 1615068
TI  - Improved salvage of complicated microvascular transplants monitored with
      quantitative fluorometry.
AB  - Quantitative fluorometry has been used to monitor circulation in transplanted
      toes and cutaneous flaps in our unit since 1982. Analysis of 177 uncomplicated
      transplants monitored by quantitative fluorometry shows that this technique has
      low false indication rates for arterial occlusion (0.6 percent of patients) and
      venous occlusion (6.2 percent of patients). None of these patients was reexplored
      because of a false monitor reading, and except for single abnormal sequences,
      monitoring appropriately indicated intact circulation throughout the
      postoperative period. Quantitative fluorometry has correctly indicated vascular
      complications in 21 (91.3 percent) of 23 transplants over an 8-year period. The
      salvage rate (85.7 percent) of the fluorescein-monitored reexplored transplants
      was significantly higher than the salvage rates of similar reexplored transplants
      not monitored with fluorescein and of reexplored muscle flaps (which cannot be
      monitored with the fluorometer used at this unit). These clinical data indicate
      that quantitative fluorometry is a valid and useful postoperative monitor for
      transplanted toes and cutaneous flaps.

PMID- 1615069
TI  - Human pressure perception values for constant and moving one- and two-point
      discrimination.
AB  - Despite the need to evaluate sensibility for accurate diagnosis and the need to
      record the degree of sensation achieved in the postoperative period, the
      clinician has been without the ability to measure human pressure perception
      accurately. Traditionally, the Semmes-Weinstein monofilaments were used to
      measure the static one-point discrimination threshold. A new sensory testing
      instrument, the Pressure-Specifying Sensory Device, was used to obtain normative
      data from the index and little finger of the dominant hand in 35 people ranging
      in age from 16 to 83 with no known neurologic impairment. Pressure perceptions
      for static one- and two-point discrimination (s1PD, s2PD) and moving one- and two
      point discrimination (m1PD, m2PD) were recorded. The mean values (+/- SD) were
      0.13 +/- 0.06, 0.24 +/- 0.12, 0.22 +/- 0.10, and 0.26 +/- 0.13 gm/mm2 for s1PD,
      s2PD, m1PD, and m2PD, respectively, on the index finger and 0.07 +/- 0.05, 0.16
      +/- 0.12, 0.17 +/- 0.07, and 0.21 +/- 0.14 gm/mm2 for s1PD, s2PD, m1PD, and m2PD,
      respectively, for the little finger. The little finger was significantly more
      sensitive than the index finger (p less than 0.001). There was no significant
      change in pressure perception with increasing age.

PMID- 1615070
TI  - What will historians say?

PMID- 1615071
TI  - Who's first on first?

PMID- 1615072
TI  - Cancer recurrence following Mohs micrographic surgery: a mechanism of tumor
      persistence.
AB  - Recurrence of basal cell carcinomas after Mohs micrographic surgery is rare but
      known to occur. This report describes the recurrence of a basal cell carcinoma of
      the forehead after Mohs surgery in order to illustrate a previously undescribed
      mechanism of tumor persistence and recurrence despite thorough microscopic
      evaluation of all surgical margins. The value of the surgeon's reviewing all
      prior histologic sections before performing micrographic surgery, the importance
      of resecting all scar tissue from a previous surgical site prior to determination
      of tumor-free margins, and the potential usefulness of a three-tiered closure
      after excision of a cutaneous malignancy that involves the muscular layer are
      discussed.

PMID- 1615073
TI  - Facial midline and symmetry: modified face bow.
AB  - A facial "cone" can be drawn inside the head. The apex of the cone is the
      midpoint of the line that connects both ear canals, point C, and the face is the
      base. A modified face bow is designed with holes through which a Steinmann pin is
      passed, meeting at the apex of the facial cone. After the ear bolts are
      symmetrically fixed, the Steinmann pin through the central hole follows the
      midline of the face as the bow rotates from the forehead to the chin. The right
      and left facial bony protrusions can be evaluated by two Steinmann pins
      projecting through the corresponding holes on the face bow. This device is
      utilized to determine the facial midline and facial symmetry during surgery. It
      also can be used as a tool for anthropologic studies.

PMID- 1615074
TI  - Rhinoplasty: the retractable roof.

PMID- 1615075
TI  - Teeth in the line of a mandible fracture: which should be performed first,
      extraction or fixation?

PMID- 1615076
TI  - Secondary healing.

PMID- 1615077
TI  - Effect of epinephrine on blood loss during liposuction.

PMID- 1615078
TI  - A report of anatomic variation in the rat femoral vein.

PMID- 1615080
TI  - Faulty planning in plastic surgery.

PMID- 1615079
TI  - Sterility of bone pencils.

PMID- 1615081
TI  - Repositioning the orbicularis oculi muscle in the composite rhytidectomy.
AB  - While blepharoplasties are routinely done with face lift procedures, the
      improvement is accomplished by removing excess orbital fat with eyelid skin and
      muscle along the incisional line. The orbicularis oculi muscle remains intact as
      its inferior border, which has become ptotic and redundant with aging, and
      actually remains in the same position following a conventional lower lid
      blepharoplasty and rhytidectomy. However, by elevating the orbicularis oculi with
      the cheek fat and platysma in a composite face lift flap, and by excising the
      redundant inferior border of the orbicularis muscle, a total rejuvenation of the
      malar area is accomplished. The descent of the orbicularis oculi muscle is in an
      inferolateral vector, whereas the vector of facial aging is inferomedial. Thus,
      repositioning the orbicularis oculi is in a superomedial vector and is obligatory
      in a composite rhytidectomy.

PMID- 1615082
TI  - Health care for Americans.

PMID- 1615084
TI  - An easy method of tunneling pedicle flaps.

PMID- 1615083
TI  - Avoiding needle sticks in the operating room.

PMID- 1615085
TI  - MRI and capsular contracture.

PMID- 1615086
TI  - Locating tissue expander injection ports with a metal detector.

PMID- 1615087
TI  - Avoidance of a double digital nerve graft as a secondary procedure in
      revascularization patients.

PMID- 1615088
TI  - Neuroblastoma presenting as a craniofacial deformity.

PMID- 1615089
TI  - Alar rim raising.
AB  - The relationship of the alar rim to columella visibility and nostril proportion
      is crucial to a good aesthetic result. The alar rim has been a neglected part of
      the nose in primary and secondary rhinoplasty procedures for want of a natural
      contouring operation. Results of directly excising the alar rim and its
      indications are presented with adequate follow-up. Indications for the procedure
      include (1) recontouring of the cleft lip nose with anterior webbing, (2)
      equalizing asymmetrical nostrils, (3) enlarging small nostrils, (4) correcting a
      hanging (sigmoid) ala, and (5) converting round to oval nostrils.

PMID- 1615090
TI  - Arterial supply of the anterior ear.
AB  - Twenty cadaver auricles were injected with a latex solution to define the
      arterial supply of the anteroauricular surface. Two arterial networks exist, the
      network of the triangular fossa-scapha and the network of the concha. Both
      eventually communicate on the anthelix. The triangular fossa-scapha network
      originates from one subbranch of the upper auricular branch of the superficial
      temporal artery and from branches of the posterior auricular artery that come
      through the earlobe and triangular fossa and over the helical margin. The conchal
      network is provided by two to four perforators that come from the posterior
      auricular artery, piercing the conchal floor. Auricular branches of the
      superficial temporal artery in the preauricular region and their communications
      with the posterior auricular artery also were confirmed. We believe that a
      greater understanding of the detailed arterial anatomy in this area allows one to
      develop safely a variety of surgical techniques for reconstruction of the ear.

PMID- 1615091
TI  - Patch esophagoplasty with free forearm flap for focal stricture of the
      pharyngoesophageal junction and the cervical esophagus.
AB  - Focal stricture of the cervical esophagus can be caused by corrosive injury or
      irradiation or following esophageal reconstruction. For severe stricture that
      cannot be relieved by bougie dilatation, surgical correction should be done.
      Among the operations performed, the myocutaneous flap is considered the first
      choice. Patch esophagoplasty with a free flap is indicated in the following
      situations: (1) when the patient is a young woman, (2) when the patient is obese,
      and (3) following irradiation that renders myocutaneous flaps unreliable. For
      correction of focal stricture of the cervical esophagus, six patients underwent
      esophagoplasty with a patch of free forearm flap. In comparison with other
      methods, this approach is associated with less morbidity and a better aesthetic
      result. The patients started oral intake at 1 month. Only one patient had minor
      leakage, and this healed after conservative treatment. The skin patch inserted in
      the esophageal wall caused no problem in motility, and the patients could eat
      smoothly after surgery.

PMID- 1615092
TI  - Congenital malignant melanoma.
AB  - The diagnosis and management of a 3-day-old infant with an exophytic pigmented
      growth on her back and chest are discussed. At 3 days of age, the child underwent
      a complete surgical excision of this lesion with immediate coverage by partial
      thickness skin grafts. Pathologically, the lesion proved to be a thoracolumbar
      congenital melanocytic nevus with multiple focal areas of malignant melanoma. The
      child is now 3 years past surgery and shows no evidence of recurrence or distant
      metastases. The importance of this case lies in the presence of overt malignant
      melanoma at birth within a giant congenital nevocytic nevus.

PMID- 1615093
TI  - The impact of stress on the clinical presentation of melanoma.
AB  - The impact of major life events on the clinical presentation of melanoma was
      determined in a retrospective case-control analysis. There was a significantly
      higher occurrence of divorce or marital separation and a significantly higher
      occurrence of bankruptcy or unemployment in the 5 years prior to the clinical
      presentation of 56 melanoma patients relative to an age- and sex-matched control
      group of 56 general surgical patients (p less than 0.01). There was also a higher
      occurrence of death of a spouse or immediate family member, although this
      difference was not statistically significant. Overall, 26 (46 percent) of the
      melanoma patients had major life crises in the 5 years prior to clinical
      presentation, and this was highly significant (p less than 0.01). We believe that
      major life stress has an impact on the clinical presentation of melanoma.
      Potential reasons for this difference are reviewed.

PMID- 1615094
TI  - Reduction mammaplasty with a circular folded pedicle technique.
AB  - A personal technique for breast reduction utilizing a circular dermal-breast
      pedicle is presented. After a cutaneous glandular excision in the inferior pole
      and glandular excision in a discoid shape under the central area, the pedicle is
      folded on itself to produce a direct elevation of the nipple-areola complex into
      its new position, to enhance projection, and to act as a central support. A
      rational economy of scars is obtained by a central convergence of the breast
      tissue that stretches the breast periphery and by sutures finishing in the
      inferoareolar area. There the skin excess is removed to avoid scar lengthening in
      both the caudal and cranial directions. Evaluation of long-term results reveals
      maintenance of breast projection, preservation of the inframammary fold to
      inferior areola distance, and minimal residual scarring.

PMID- 1615095
TI  - The biomechanical and histopathologic effects of surface texturing with silicone
      and polyurethane in tissue implantation and expansion.
AB  - There has been considerable interest in determining the effect of morphologic
      alterations of prosthetic surfaces on capsule response in breast surgery. The
      purpose of this study was to provide a precise, three-dimensional evaluation of
      soft-tissue response to surface modifications in both implantation and expansion.
      Expandable 100-cc prostheses were designed with one of three surfaces: textured
      silicone (Biocell), standard smooth silicone, or polyurethane (Natural-Y, Meme).
      A new submuscular implantation site in the rabbit was developed. Each animal
      randomly received a smooth-surface device on one side and either a textured
      silicone or polyurethane device on the other. In one group of animals, the
      prostheses were expanded monthly. Capsular response was evaluated monthly in vivo
      using standardized techniques as well as biomechanical methods for up to 6 months
      in the expander group (n = 7 to 16) and 8 months in the implant group (n = 7 to
      15). Analysis of biomechanical and histologic data revealed that prosthetic
      surface morphology can specifically alter capsular response. Polyurethane was the
      only effective surface in preventing capsular contracture in implantation. In
      expansion, both textured silicone and polyurethane surfaces resulted in
      significantly less capsular contracture and less resistance to expansion than
      comparable smooth-surfaced controls. Statistical comparisons reveal that the
      biomechanical methods utilized in this study provide the most precise and
      objective method of defining overall soft-tissue contracture around implanted
      biomaterials.

PMID- 1615096
TI  - Free flaps in the elderly.
AB  - Microsurgical transfer of tissue has become a primary tool of the reconstructive
      surgeon. The elderly, as a growing segment of our society, are requiring free
      tissue transfers in proportion to their numbers. To investigate the potential
      morbidity of free-tissue transfers in the elderly, we studied consecutive
      populations of 31 patients above the age of 65 years and 90 patients below the
      age of 65 years. Complication rates were 65 and 49 percent, respectively.
      Premorbid medical conditions were present in 87 percent of patients 65 years and
      older and in 72 percent of those under 65 years. Medically related complications
      in free-tissue transfers, previously unreported in the literature, were 35
      percent in the elderly group and 10 percent in the younger group. Wound-healing
      complications were seen in equal proportions between groups. The rates of wound
      and medically related complications observed in the elderly group were nearly
      double those observed in the younger group; however, after correction for the
      presence of preexisting medical conditions, no significant differences were seen
      between the two groups. These observations suggest that age alone is not a
      variable in risk for free-tissue transfers. Elective microsurgery can be
      performed in the elderly patient with a high expectation of success.

PMID- 1615097
TI  - Microcirculatory disturbances following the passage of emboli in an experimental
      free-flap model.
AB  - Following completion of arterial repair in an experimental free-flap model,
      platelet emboli have been observed passing through the microcirculation
      downstream. The purpose of this experimental study was to observe and quantitate
      changes in capillary perfusion occurring subsequent to these events. The isolated
      rat cremaster model was used. For 6 hours subsequent to surgical injury of the
      main artery in this model, the number of emboli and the number of perfused
      capillaries downstream were counted. In eight rats having an intentional arterial
      wall injury, emboli were consistently seen during the first hour of reflow. In
      the nine control animals having no arterial injury, no emboli were seen. The
      presence of emboli in the cremaster muscle, resulting from the arterial injury,
      was associated with a significant reduction in the number of perfused
      capillaries. We suggest that the observed decrease in capillary perfusion was
      associated with microemboli that produced an adverse effect for several hours
      after their initial presence in the circulation.

PMID- 1615098
TI  - Will schizophrenia become a graveyard for molecular geneticists?

PMID- 1615099
TI  - Genetics and developmental stability: an integrative conjecture on aetiology and
      neurobiology of schizophrenia.

PMID- 1615100
TI  - Lasegue's editorial riposte to Gull's contributions on anorexia nervosa.
AB  - One week after Sir William Gull read his seminal report on anorexia nervosa to
      the Clinical Society of London, a brief account was published (Anonymous, 1873).
      In Paris, Charles Lasegue, editor of Archives Generales de Medecine read the
      report and printed an immediate editorial riposte, parts of which will be quoted
      in this communication.

PMID- 1615101
TI  - Subjective response to neuroleptics and outcome in schizophrenia: a re
      examination comparing two measures.
AB  - The schizophrenic patient's early psychological response to neuroleptic treatment
      has been demonstrated to be a significant predictor of treatment response. The
      validity of the construct of subjective response is evaluated by comparison of
      two measures. Fifty-five recently admitted and unmedicated schizophrenic patients
      were randomly allocated to chlorpromazine or haloperidol. Subjective responses at
      24 and 48 hours as assessed by two different scales, the Van Putten & May scale
      and the self-administered Drug Attitude Inventory, were strongly correlated with
      outcome at three weeks. Early emergence of extrapyramidal symptoms was not
      related to subjective response, but dysphoric patients had a greater incidence of
      EPS by the end of treatment than did non-dysphoric patients. The two measures
      showed high concordance in identification of early drug dysphoria.

PMID- 1615102
TI  - Frontal and non-frontal lobe neuropsychological test performance and clinical
      symptomatology in schizophrenia.
AB  - Schizophrenic subjects performed significantly worse on neuropsychological tests
      of frontal lobe function but not on tests of non-frontal lobe function when
      compared to a matched group of normal subjects. Correlations expected between
      frontal lobe neuropsychological test performance and negative symptoms were not
      found.

PMID- 1615103
TI  - Comparison of negative symptoms in schizophrenic and poor outcome bipolar
      patients.
AB  - Using the Scale for the Assessment of Negative Symptoms (SANS), affective
      blunting, alogia, and attentional impairment were assessed in 30 manic patients
      with chronic impairment of inter-episode instrumental functioning and 85 chronic
      schizophrenic patients. The schizophrenic patients had markedly higher ratings on
      all three negative symptom dimensions. When negative symptoms were examined
      categorically, no manic patient was rated to show prominent affective flattening
      or alogia. This relative specificity may not apply to attentional impairment
      which was rated as prominent in 17% of the manic patients and in 55% of the
      schizophrenic patients.

PMID- 1615104
TI  - Diagnostic concordance in functional psychosis revisited: a study of inter
      relationships between alternative concepts of psychotic disorder.
AB  - More than a decade ago, a series of retrospective studies examined the
      concordance between proliferating definitions of severe psychiatric disorder. The
      European response has been a poly-diagnostic one, which has attempted to maintain
      interest in a broad range of psychiatric phenomena in the psychoses. In North
      America a more convergent approach has emerged, resulting in a series of
      operational definitions evolving from one another, and a correspondingly limited
      capacity to allow alternative perspectives to co-exist. The present study uses a
      prospective design as well as recent improvements in the clinical validity of
      psychopathology assessment to re-evaluate the relationships between competing
      concepts of psychotic illness in a broad sample (N = 176) of recent-onset
      psychotic patients. In the schizophrenic group, concordance was predictably
      highest among recent North American 'cousins', and lowest among various
      historical concepts. There was a moderately high concordance between selected
      schizoaffective and atypical psychosis definitions, indicating that this
      component is an important area for further studies of descriptive validity. These
      interrelationships may be used as a starting point to explore latent classes
      underlying the phenomena of functional psychosis.

PMID- 1615105
TI  - Comorbidity of substance abuse and schizophrenia: the role of pre-morbid
      adjustment.
AB  - Co-morbid substance use and abuse is common in schizophrenic patients, and the
      role of substance abuse in initiating and maintaining psychosis has important
      definitional and aetiological implications. We investigated the issue in a cohort
      of 131 schizophrenic patients. We found non-users (N = 67) were similar to
      pathological users (N = 64) in current symptomatology and clinical history. The
      pathological users did, however, have better pre-morbid adjustment levels. Only
      alcohol use and to some extent cannabis use contributed to this effect; use of
      stimulants or hallucinogens did not. These results indicate the importance of
      evaluating the various types of substance used when attempting to explore the
      significance of co-morbidity. The results also suggest that co-morbidity of
      substance abuse and schizophrenia may be explained by a common factor antecedent
      to both: better pre-morbid adjustment. A two-stage model is proposed to explain
      these findings: increased sociability increases exposure to opportunities of
      substance use in a subset of patients; subsequent onset of psychotic illness
      accelerates the use to a pathological level as the individual attempts to cope
      with the stress of the developing mental illness.

PMID- 1615106
TI  - Cognitive deficit and the prediction of rehabilitation success in a chronic
      psychiatric group.
AB  - This paper describes the second stage (years 4, 5 and 6) of a prospective follow
      up of a sample of chronic patients which was designed to investigate the in
      service use. It also tested the relative predictive power of variables which
      included demographic, symptomatic and behavioural factors as well as a novel
      reaction time variable which reflects response processing time. During the six
      years of the study 91% of the patients in the sample changed either the degree of
      their day and/or night care. Many moved to more independence but, a number did
      also become more dependent on psychiatric services. There were no differences in
      outcome between a schizophrenic group and patients with other diagnoses. These
      results suggest a level of flexibility in outcome even in a severely disabled
      chronic group. The main predictor of future service use at each stage of the
      follow-up for the whole group was chronicity at entry to the study. But, when the
      group was divided into schizophrenic patients and 'others', the response
      processing measure was a significant predictor of service use in the
      schizophrenic group and accounted for between 17% and 30% of the variance. For
      the 'other' diagnostic group, the age of the patient seemed to be the major
      determinant of care. The reaction time variable seems to be an extra class
      correlate of a strict diagnosis of schizophrenia. It may also be a stable or
      episodic vulnerability factor, but as well as these promising hypotheses, which
      have yet to be justified, this measure does seem to have pragmatic value in
      predicting outcome in a rehabilitation network.

PMID- 1615107
TI  - Autobiographical memory and problem-solving strategies of parasuicide patients.
AB  - Recent research has noted the tendency of parasuicide patients to retrieve over
      general autobiographical memories. Separate studies suggest problem-solving
      deficits within this group. The present study was concerned first with
      replicating these findings and, secondly, with developing a model of the
      relationship between over-general memory recall and poor problem-solving
      abilities in parasuicide patients. Anger and hopelessness were measured as
      markers for mood. In line with the hypotheses, the parasuicide group (N = 12)
      produced significantly over-general memories in contrast to a matched control
      group (N = 12). This occurred significantly in relation to positive cues, and
      latency to first responses was significantly delayed in the parasuicide group.
      The parasuicide group also provided fewer and less-effective problem-solving
      strategies than the control group, and a significant association was found
      between low effectiveness of problem-solving strategies and over-general memory
      recall in the parasuicide group. Anger and hopelessness levels were significantly
      higher within the parasuicide group in line with previous findings. The clinical
      implications of these findings are discussed.

PMID- 1615108
TI  - Railway suicide: the psychological effects on drivers.
AB  - People have jumped (or fallen) in front of trains on the London Underground
      system in increasing numbers throughout the twentieth century. During the past
      decade there have been about 100 such incidents each year, of which around 90
      would involve the train driver witnessing his train strike the person on the
      track. Most are suicides or attempts at suicide. They represent major unexpected
      and violent events in the lives of the train drivers and it might be expected
      that some of them would respond by developing a post-traumatic stress reaction of
      the type identified by Horowitz (1976) or other adverse psychological reactions
      or both. The research reported in this paper was designed to characterize the
      range of responses of drivers to the experiences of killing or injuring members
      of the public during the course of their daily work. It was found that 16.3% of
      the drivers involved in incidents did develop post-traumatic stress disorder and
      that other diagnoses, e.g. depression and phobic states, were present in 39.5% of
      drivers when interviewed one month after the incident.

PMID- 1615109
TI  - Psychosocial correlates of clinical depression after psychiatric in-patient
      treatment: methodological issues and baseline differences between recovered and
      non-recovered patients.
AB  - General methodological and design issues in research on psychosocial outcome
      predictors of clinical depression are discussed, and the first stage of a study
      of discharged depressed in-patients is presented. It involved 115 recovered and
      75 non-recovered such patients who were compared regarding stress factors, social
      support, personality and coping styles. While there were few differences between
      recovered and non-recovered patients with respect to stable personality traits,
      recovered patients were less likely to have had severe long-term life
      difficulties, and their coping style differed: it was characterized by more
      negative appraisals of stressful situations, greater problem avoidance, less
      palliative activities, and a lesser inclination to solicit social support.
      Whereas among women without partners, as well as men, non-recovery was also
      associated with less support from friends, in particular psychological-emotional
      support in crises, non-recovered women with partners had much more such support.
      The results are discussed with reference to the existing literature on outcome
      correlates of clinical depression.

PMID- 1615110
TI  - Environmental risk factors for Alzheimer's disease: their relationship to age of
      onset and to familial or sporadic types.
AB  - Data from a case-control study of Alzheimer's disease (AD) were analysed in
      relation to age of onset and familial/sporadic status. The analyses were
      restricted to environmental exposures which might injure the brain. Later-onset
      AD was found to be positively associated with starvation/malnutrition and with
      nose-picking and negatively with analgesics, while earlier-onset was associated
      with physical underactivity and nervous breakdown more than 10 years before.
      Sporadic AD was associated with starvation/malnutrition and with head injury.
      These analyses merit replication in other large case-control studies of AD.

PMID- 1615111
TI  - Longitudinal analysis of a two-component model of the memory deficit in
      Alzheimer's disease.
AB  - The memory deficit in Alzheimer's disease (AD) has been characterized as
      consisting of multiple components. The purpose of this study was to confirm the
      utility of a two-process model, and to examine changes in the nature and extent
      of the neuropsychological deficits after a one-year interval. The results
      replicate the initial observation that the memory loss in AD can be described as
      consisting of a focal amnesic syndrome and a dysexecutive syndrome characterized
      by failure of rapid information processing and search of both episodic and
      semantic memory. One year after the initial observation, all dysexecutive
      patients and the majority of the amnesic patients had become non-focal. No
      patient developed a dysexecutive syndrome, but 18 patients developed amnesic
      syndromes. These results suggest that, like other aspects of the cognitive
      deficits of AD, the memory loss is multifactorial. These results have
      implications for understanding the pathophysiology of AD, and for designing
      pharmacotherapeutic intervention.

PMID- 1615112
TI  - Coping strategies and breast disorders/cancer.

PMID- 1615113
TI  - Measuring psychiatric disorder in the recent past: the use of the Psychiatric
      Assessment Schedule retrospectively.
AB  - Ninety-four patients were asked about the presence of psychiatric symptoms on
      admission to hospital using the revised Psychiatric Assessment Schedule. Three
      months later they were asked to recall their symptoms at admission using the same
      instrument retrospectively. The results of the initial and retrospective
      interviews showed good rates of agreement in terms of PAS score, ID level,
      psychiatric 'caseness' and both CATEGO and DSM-III-R diagnoses. The study
      demonstrates that it is possible to make reliable measurements of the mental
      status of three months previously, simultaneously with assessments of current
      mental status. The uses of such a measuring instrument are discussed.

PMID- 1615114
TI  - Measuring psychiatric disorder in the community: a standardized assessment for
      use by lay interviewers.
AB  - Many of the standardized interviews currently used in psychiatry require the
      interviewer to use expert psychiatric judgements in deciding upon the presence or
      absence of psychopathology. However, when case definitions are standardized it is
      customary for clinical judgements to be replaced with rules. The Clinical
      Interview Schedule was therefore revised, in order to increase standardization,
      and to make it suitable for use by 'lay' interviewers in assessing minor
      psychiatric disorder in community, general hospital, occupational and primary
      care research. Two reliability studies of the revised Clinical Interview Schedule
      (CIS-R) were conducted in primary health care clinics in London and Santiago,
      Chile. Both studies compared psychiatrically trained interviewer(s) with lay
      interviewer(s). Estimates of the reliability of the CIS-R compared favourably
      with the results of studies of other standardized interviews. In addition, the
      lay interviewers were as reliable as the psychiatrists and did not show any bias
      in their use of the CIS-R. Confirmatory factor analysis models were also used to
      estimate the reliabilities of the CIS-R and self-administered questionnaires and
      indicated that traditional measures of reliability are probably overestimates.

PMID- 1615115
TI  - Why people with probable minor psychiatric morbidity consult a doctor.
AB  - This epidemiological investigation examines factors determining medical
      consultation in people with probable minor psychiatric morbidity. About 54% of
      people with probable minor psychiatric morbidity and about 23% of the
      (numerically much greater) remainder with lower probability of psychiatric
      morbidity consulted a doctor, usually a primary care physician, in the two weeks
      prior to a research interview. Medical consultation rates were higher in females
      than in males. The dominant finding was that in people with probable minor
      psychiatric morbidity physical illness was strongly associated with medical
      consultation. Almost 89% of males and 97% of females with probable minor
      psychiatric morbidity and physical illness consulted a doctor in the two weeks
      prior to interview. Logistic regression modelling was used to investigate the
      joint effects on medical consultation of physical illness and six socio
      demographic variables, and physical illness emerged as the major single
      determinant of medical consultation in women and, in men, it exerted its effect
      through an interaction with lower educational level.

PMID- 1615116
TI  - The Mental Impairment and Evaluation Treatment Service: staff attitudes and staff
      client interactions.
AB  - This study describes and evaluates a new short-term residential service for
      adults with mild learning difficulties and challenging behaviour, the Mental
      Impairment Evaluation and Treatment Service. The study examines staff attitudes
      towards management practices, towards the potential achievement of individuals
      with learning difficulties, the staff's perceived involvement in decision making,
      and also the nature of their interaction with the clients, in two different
      settings on the Unit. The Unit's management practices were found to be client
      orientated in nature and staff were more in agreement with client-orientated than
      institution-orientated management practices. Staff were generally optimistic
      about clients' potential and felt involved in decision making. Correlations
      between certain staff characteristics, attitudes and interactions are discussed.
      The study extends the range of services that have been evaluated in this way, and
      provides a description of the service in its early stages, which will provide an
      important comparison point for it when it is more permanently established.

PMID- 1615117
TI  - Rapid development of hyponatraemic seizures in a psychotic patient.
AB  - A 60-year-old woman with a history of recurrent psychotic illness developed
      severe hyponatraemia after a short period of compulsive water drinking. The case
      provides a rare illustration of the rapidity of development of dangerously low
      levels of serum sodium. On discovery of mild hyponatraemia it is essential to
      repeat measurement of the serum sodium level should the patient's clinical
      condition change, in order to detect any further deterioration of serum
      osmolality which may result in severe and possibly fatal cerebral symptoms.

PMID- 1615118
TI  - Structural brain imaging abnormalities associated with schizophrenia and partial
      trisomy of chromosome 5.
AB  - Chromosomal abnormalities occurring in association with mental illness provide a
      unique opportunity to study the interaction of genetic abnormalities and the
      brain in mental illness. Four individuals from a family in which schizophrenia
      was found to cosegregate with a partial trisomy of chromosome 5 were studied with
      computed tomography and magnetic resonance imaging. Temporal lobe atrophy was
      found in the two trisomic males and in the asymptomatic balanced translocation
      female. In addition, a large cavum septum pellucidum and a cavum vergae were
      found in the older trisomic individual. Scans from the normal male were free of
      abnormalities. These results suggest that molecular studies of the translocation
      breakpoints in this chromosomal abnormality may be of interest, and encourage
      further studies of brain structure in other chromosomal abnormalities associated
      with psychosis.

PMID- 1615119
TI  - Behavioral screening for cognition enhancers: from indiscriminate to valid
      testing: Part I.
AB  - Preclinical efforts to detect and characterize potential cognition enhancers
      appear to have been dominated by a strategy of demonstrating a wide variety of
      apparently beneficial behavioral effects with little attention given to the
      specific psychological mechanisms underlying behavioral enhancement. In
      particular, the question of whether or not behavioral facilitation is based on
      relevant mnemonic mechanisms and is independent of the stimulus properties and/or
      the motivational and attentional components of a task is not often considered. As
      a result, an overwhelming number of compounds have failed to produce the clinical
      effects predicted for them on the basis of preclinical research. The available
      data suggest that a more successful approach requires deductive research
      strategies rather than the indiscriminate accumulation of apparently beneficial
      effects in a variety of behavioral tasks and animal models. The first step
      towards such an approach is a systematic and rigorous evaluation of the different
      aspects of validity for the models most frequently used in preclinical research.
      It is concluded that a combination of good construct validity and good face
      validity represents a necessary condition for screening tests with predictive
      validity, and that the most popular paradigms fail to fulfil these criteria.
      Future screening programs for cognition enhancers will probably be characterized
      by a depreciation of "fast and dirty tests" in favor of approaches focussing on
      the validity of the effects of potential cognition enhancers.

PMID- 1615121
TI  - Pavlovian conditioning of L-dopa induced movement.
AB  - Using the unilateral 6-hydroxydopamine (6-OHDA) substantia nigra pars compacta
      (SNC) lesion rat model and a Pavlovian conditioning protocol, the present
      investigation determined that the contralateral rotation response induced by the
      antiparkinsonian dopaminergic drug L-dopa can become conditioned to exteroceptive
      test environment stimuli. Two non-drug conditioning tests indicated that
      contralateral rotation was elicited by the test environment without the presence
      of L-dopa. This conditioned response had a rotation diameter profile that was
      qualitatively the same as the L-dopa induced contralateral rotation response.
      Additionally, drug tests with the combined dopaminergic receptor antagonists, SCH
      23390 (0.1 mg/kg) and haloperidol (0.5 mg/kg), at doses sufficient to block
      spontaneous behavior and L-dopa (20 mg/kg)-induced rotation, revealed that the
      conditioned contralateral rotation response, unlike L-dopa-induced contralateral
      rotation, is not affected by D1/D2 receptor blockade. Thus, the conditioned
      stimuli of the test environment can elicit the contralateral rotation response
      even in animals rendered akinetic by D1/D2 antagonists. This activation of a
      conditioned dopaminergic drug response by the situational stimuli, independent of
      dopaminergic mechanisms, may, therefore, contribute to the untoward
      overstimulation clinical effects of L-dopa through summation of conditioned and
      drug-induced effects. Furthermore, the use of conditioning procedures to elicit
      movement in akinetic animals may provide a new research methodology to
      investigate the phenomenon of paradoxical kinesia.

PMID- 1615122
TI  - Behavioral economics of drug self-administration. IV. The effects of response
      requirement on the consumption of and interaction between concurrently available
      coffee and cigarettes.
AB  - In behavioral economics, consumption of a reinforcer is determined by its price
      and by the price of other available reinforcers. This study examined the effects
      of price manipulations on the consumption of concurrently available coffee and
      cigarettes. During fifteen 4-h sessions, coffee and cigarettes were concurrently
      available according to fixed-ratio (FR) schedules of reinforcement. After
      consumption stabilized under a fixed ratio 100 for both reinforcers, the response
      requirement for each reinforcer was varied separately (i.e., FR 100, 1000 and
      2500), while the response requirement for the other reinforcer was kept at 100.
      Increasing the FR value decreased coffee and cigarette consumption to a similar
      degree. Also, as the price for cigarettes increased (and consumption decreased),
      coffee consumption decreased; however, as the price of coffee increased,
      cigarette consumption did not change. These results indicate that for this
      setting the reinforcing effects of cigarettes and coffee were comparable but
      interacted asymmetrically. These findings when analyzed and quantified via
      economic concepts of own-price and cross-price elasticity illustrate the
      viability of using behavioral economics to examine drug self-administration in a
      choice paradigm.

PMID- 1615120
TI  - Complex motor and sensorimotor functions of striatal and accumbens dopamine:
      involvement in instrumental behavior processes.
AB  - The suggestions that dopamine (DA) systems are involved in "motor control" and
      "reward" represent the classic working hypotheses on the behavioral functions of
      these systems. The research generated by these hypotheses has yielded results
      that are far more complicated than the simplest form of either hypothesis would
      indicate. Pharmacological or lesion-induced interference with DA function does
      not suppress all aspects of movement control, nor all aspects of reward, nor all
      aspects of motivation. The deficits produced by interference with DA systems are
      selective and dissociative in nature, affecting some aspects of motor or
      motivational function, but leaving others basically intact. In some sense the
      hypotheses that DA is involved in "motor" or "reward" or "motivational" processes
      are partly correct, but the processes to which these terms refer are too broad to
      offer an accurate and detailed description of the behavioral functions of brain
      DA. A review of the literature on the behavioral pharmacology of DA suggests that
      the behaviors most easily disrupted by DA antagonists are highly activated and
      complex learned instrumental responses that are elicited or supported by mild
      conditioned stimuli, and maintained for considerable periods of time. It is
      proposed that DA in accumbens and striatum modulates the ability of neocortical
      and limbic areas involved in sensory, associative, and affective processes to
      influence complex aspects of motor function, and also modulates the execution of
      complex motor acts organized by the neocortex. Thus, interference with DA systems
      produces a "subcortical apraxia", which dissociates complex stimulus processes
      from complex motor processes, but leaves aspects of those processes intact.

PMID- 1615123
TI  - Ontogeny of cocaine hyperactivity and conditioned place preference in mice.
AB  - Conditioned place preference (CPP) procedures using jointly visual and tactile
      cues (white compartment with a wide-mesh metal floor versus black compartment
      with a narrow-mesh floor) were employed to assess the ontogenetic pattern of
      cocaine reinforcing properties in outbred CD1 mice. A classical 11-day-long
      schedule, in which the drug experience occurred in the initially less-preferred
      compartment ("biased" procedure, Spyraki 1988), served to study cocaine (0, 1, 5,
      or 25 mg/kg IP repeated four times at 48 h intervals) during the early
      postweaning stage (21-32 days). The result was a fully-fledged CPP at all cocaine
      doses. A subsequent experiment used a shortened (4-day) "unbiased" CPP schedule
      (animals assigned at random to drug experience in one or the other compartment);
      this enabled an assessment of the ontogenetic pattern of the drug action (single
      treatment, same dose range) in pups of both sexes at three different
      developmental ages (14-17, 21-24, or 28-31 days). At the 25 mg/kg dose, CPP
      developed in animals of all ages, while the 5 mg/kg dose was effective only in 21
      24 day pups and the 1 mg/kg dose was ineffective. No significant sex differences
      were found, but the use of the unbiased procedure enabled a demonstration of an
      interaction between treatment, age, and type of CS. At the preweaning stage, CPP
      was due mainly to an increased preference for the black/narrow-mesh compartment,
      while at the early postweaning stage it consisted mainly of an increased
      preference for the white/wide-mesh compartment; at the late postweaning stage the
      cue and the treatment factor did not interact.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615124
TI  - Comparison of error patterns produced by scopolamine and MK-801 on repeated
      acquisition and transition baselines.
AB  - An understanding of the differential role of cholinergic and glutaminergic
      systems may be limited by the failure to move the analysis of learning
      impairments beyond an assessment of changes in overall accuracy. This paper
      reports the results of two studies in which the effects in rats of scopolamine
      (0.5-3.0 mg/kg IP), a cholinergic antagonist, and MK-801 (0.05-0.3 mg/kg IP), an
      NMDA-receptor antagonist, were compared in two different repeated learning
      procedures and the nature of the underlying error patterns produced by each was
      evaluated. The first study examined drug effects upon a repeated sequence
      acquisition procedure and found that while both drugs decreased overall accuracy
      in a dose-dependent manner, the predominant error pattern varied significantly
      with drug; scopolamine primarily produced skipping errors within the sequence,
      whereas MK-801 more prominently increased perseveration on the first and second
      members of the sequence. In the second study, which used a repeated transition
      procedure, both drugs again significantly decreased overall accuracy in a dose
      dependent manner, but no consistent differences in error patterning produced by
      the drugs were observed. Thus, while both cholinergic and NMDA systems play a
      role in learning, the behavioral processes underlying the changes in overall
      accuracy may differ, as indicated by the differential patterns of errors produced
      by scopolamine and MK-801 in the repeated acquisition baseline. Furthermore, the
      observed differences in the underlying behavioral processes of scopolamine and MK
      801 in the repeated acquisition but not on the repeated transition procedure
      suggest that each of the two drugs may affect more than one of the variables
      controlling behavior, with the relative impact of drug-related changes in
      controlling variables depending upon the operative contingencies of the learning
      task.

PMID- 1615125
TI  - Behavioral microanalysis of spatial delayed alternation performance: rehearsal
      through overt behavior, and effects of scopolamine and chlordiazepoxide.
AB  - Rats were trained in an operant spatial delayed alternation task utilizing
      retention intervals from 2 to 32 s. In addition to response accuracy, operations
      of the levers during the retention intervals were recorded and analyzed. Animals
      were tested following the administration of the muscarinic antagonists
      scopolamine hydrobromide and methylbromide, and the benzodiazepine receptor
      agonist chlordiazepoxide. In vehicle-treated animals, the relative number of
      correct responses and correct rehearsal operations (operation of the forthcoming
      correct lever during retention intervals) varied with the length of the retention
      intervals, and these measures were correlated. The response rate for rehearsal
      operations increased with the length of the retention intervals. It is speculated
      that the delay-dependent increase in response rate reflects an effect of delayed
      reward that was also associated with a delay-dependent increase in the tendency
      to alternate between levers. The effects of delay on the accuracy of rehearsal
      operations may have contributed to the delay-dependent correct responding.
      Scopolamine hydrobromide (0.01, 0.03, 0.1, 0.3 mg/kg) and methylbromide (0.1, 0.3
      mg/kg) impaired correct responding, but did not seem to interfere with the
      relative number of correct rehearsal operations. As only the presentation of the
      panel light indicated trial onset, it is speculated that the cholinergic receptor
      blockade resulted in an increase in the probability of a repositioning response
      that was triggered by light onset. Chlordiazepoxide (1, 3, 5, 10 mg/kg) did not
      affect behavioral performance. These results suggest that in tasks that allow the
      development of rehearsal operations, delay-dependent response accuracy does not
      represent a sufficient condition for conclusions on task demands on
      memory.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615126
TI  - Preexposure to amphetamine and nicotine predisposes rats to self-administer a low
      dose of cocaine.
AB  - The acquisition of low-dose (0.25 mg/kg/infusion) intravenous cocaine self
      administration was measured in rats that had received nine daily injections of
      amphetamine (1.0 mg/kg, IP), nicotine (0.6 mg/kg base weight, SC) or vehicle. For
      control rats, the acquisition of self-administration was gradual with the number
      of responses per 2 h daily test session increasing between days 3 and 9. By
      comparison, rats preexposed with amphetamine and nicotine demonstrated elevated
      response means during the early days of testing, suggesting more rapid
      acquisition. All groups eventually reached similar asymptotic levels of
      responding. The enhanced responding observed during the early days of testing in
      the rats preexposed with amphetamine and nicotine was due to an increased number
      of subjects that reliably self-administered cocaine. Thus, the rats preexposed
      with amphetamine and nicotine seemed predisposed to the reinforcing effects of
      cocaine. In contrast to the self-administration data, preexposure to nicotine
      failed to sensitize rats to the locomotor activating effects of cocaine. In fact,
      the same preexposure regimen appeared to produce tolerance to this effect of
      cocaine. These data give evidence that different mechanisms may mediate
      sensitization to the reinforcing and locomotor activating effects of cocaine.

PMID- 1615127
TI  - The mesolimbic dopaminergic system is implicated in the reinforcing effects of
      nicotine.
AB  - Rats were trained to self-administer nicotine on a fixed-ratio schedule of
      reinforcement. Infusion of the nicotinic antagonist chlorisondamine into the
      cerebral ventricles produced a sustained reduction in nicotine self
      administration compared to vehicle-treated controls. Lesions of the mesolimbic
      dopamine system were produced by microinfusion of 6-hydroxydopamine into the
      nucleus accumbens. Following production of the lesions, nicotine self
      administration was markedly reduced for the 3-week test period; motor impairment
      did not appear to be responsible. Post mortem analysis of brain tissue showed
      that the lesion produced a pronounced decrease in dopamine content of the nucleus
      accumbens and the olfactory tubercle, and a small depletion in the striatum.
      These data demonstrate that the reinforcing effects of nicotine occur within the
      central nervous system, and that the mesolimbic dopamine projection plays an
      important role in these effects.

PMID- 1615128
TI  - Sensitization to haloperidol-induced suppression of milk intake: effect of
      interdose interval.
AB  - The purpose of this study was to determine the effect of manipulating the
      interdose interval (IDI) on the suppression of milk intake induced by haloperidol
      (HAL). Groups of rats were given chronic injections of either HAL (0.625 mg/kg)
      or saline at IDIs of 1, 2, 7, or 14 days. Dose-response curves were determined at
      the conclusion of the chronic phase. The results indicated that injections of HAL
      given at IDIs of 1 or 2 days produced neither tolerance nor sensitization,
      whereas injections given at intervals of 7 or 14 days produced sensitization.
      Sensitization was also observed in the control groups, perhaps as a result of the
      intermittent schedule of HAL injections given during the dose-response tests.
      Sensitization to HAL was not accompanied by changes in sensitivity to
      amphetamine. The results of this experiment are consistent with those of other
      studies in showing that the behavioral effects of neuroleptics are strongly
      influenced by the schedule of injections. In addition, evidence is presented that
      sensitization to HAL-induced hypophagia is contingent on behavioral experience
      under the drug.

PMID- 1615129
TI  - Heightened aggressive behavior during morphine withdrawal: effects of d
      amphetamine.
AB  - The morphine withdrawal syndrome is composed of profound short- and long-term
      changes in autonomic, somato-motor and affective functions. In mice, morphine
      withdrawal produces heightened aggressive behavior and alterations in motor
      behavior; however, it is unclear whether these changes in behavior occur in
      unison and are dependent on a common mechanism or occur independently. In order
      to characterize the morphine withdrawal syndrome in mice, male Swiss-Webster mice
      were housed with female partners for 3-4 weeks before being implanted
      subcutaneously with morphine or placebo pellets. The pellets were removed 72 h
      after implantation and behavioral measurements were conducted 5, 48 and 96 h
      after pellet removal. During these tests, mice received d-amphetamine (0.3-10
      mg/kg) or saline after which they were assessed for changes in motor behavior and
      for changes in aggressive behavior while confronting a group-housed male
      "intruder". In morphine-withdrawn mice, frequency of attack behavior was
      increased by approximately 30% and this effect persisted for at least 4 days. In
      contrast, explosive jumping was increased and walking and rearing were greatly
      decreased at the onset of the withdrawal period but declined within the first 24
      h and returned to control levels within 48 h of pellet removal. d-Amphetamine
      maintained the elevated level of aggressive behavior and sharply increased
      locomotion in morphine-withdrawn mice; in placebo-pelleted mice, d-amphetamine
      dose-dependently decreased aggressive behaviors while increasing locomotion. The
      differential time course and the differential modification by d-amphetamine
      suggest that heightened aggressive behavior is a long-lasting consequence of
      morphine-withdrawal based on separate mechanisms than the short-lived alterations
      in motor activity.

PMID- 1615130
TI  - A comparison of the effects of sibutramine hydrochloride, bupropion and
      methamphetamine on dopaminergic function: evidence that dopamine is not a
      pharmacological target for sibutramine.
AB  - Sibutramine hydrochloride, a novel monoamine reuptake inhibitor antidepressant,
      has been studied to determine whether it alters dopaminergic function in the
      brain. Its effects have been compared with bupropion, a dopamine reuptake
      inhibitor, and methamphetamine, a dopamine reuptake inhibitor and releasing
      agent. Sibutramine (0.1-3 mg/kg PO) and methamphetamine (0.3-30 mg/kg PO) both
      prevented reserpine (0.75 mg/kg IV) ptosis in rats with ED50 values of 0.6 mg/kg
      and 4.2 mg/kg, respectively. Bupropion (10-100 mg/kg PO) was ineffective against
      reserpine ptosis. The efflux of [3H]-dopamine from preloaded rat striatal slices
      was not altered by 10(-7)-10(-5) M concentrations of sibutramine, BTS 54,354, BTS
      54,505 (secondary and primary amine metabolites, respectively) or bupropion. In
      contrast, methamphetamine (10(-8)-10(-4) M) caused a significant concentration
      dependent increase in [3H]-dopamine release. Sibutramine (3 mg/kg IP or 6 mg/kg
      PO) and bupropion (10 mg/kg IP or 30 mg/kg PO) did not alter 3-methoxytyramine (3
      MT) levels in rat striatum. Striatal 3-MT concentrations were, however, dose
      dependently increased by methamphetamine (0.3-10 mg/kg IP or 0.42-4.2 mg/kg PO).
      Sibutramine (6 mg/kg PO) did not induce circling in rats with unilateral 6
      hydroxydopamine lesions of the nigrostriatal dopaminergic neuronal tract.
      Bupropion (10-100 mg/kg PO) did not induce circling at the lowest dose, but
      caused increasing ipsilateral rotation at higher doses. Methamphetamine (0.42 or
      4.2 mg/kg PO) induced ipsilateral circling with marked effects at the higher
      dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615131
TI  - Reinforcing effects of enantiomers of N,N-dimethylamphetamine in squirrel
      monkeys.
AB  - Reinforcing effects of the (+)- and (-)-enantiomers of N,N-dimethylamphetamine, a
      drug that is abused in humans, were studied in squirrel monkeys (Siamiri
      sciureus) trained under schedules of intermittent cocaine reinforcement. During
      training, each 30th response produced an injection of cocaine (fixed-ratio
      schedule), which was followed by a 1-min period during which lights were out and
      responses had no scheduled consequences (timeout). Sessions in which cocaine
      injections were scheduled alternated in an irregular sequence with sessions in
      which saline injections were scheduled. After training, response rates were well
      maintained by cocaine (response rates approximated 1.4 responses per second) but
      occurred relatively infrequently during sessions in which saline was injected
      (response rates approximated 0.3 responses per second). Doses of 10 to 56
      micrograms/kg/injection of (+)-N,N-dimethylamphetamine maintained rates of
      responding significantly higher than those maintained by saline. The (-)
      enantiomer did not maintain rates of responding that were higher than those
      maintained by saline when tested at doses up to 100 micrograms/kg/injection.
      These findings support previous results indicating that N,N-dimethylamphetamine
      will function as a reinforcer in laboratory animals. Further, they suggest that
      the significant reinforcing activity of this drug is restricted to the (+)
      enantiomer.

PMID- 1615132
TI  - Subjective and behavioral responses to intravenous fentanyl in healthy
      volunteers.
AB  - Fentanyl is a mu opiate agonist which is occasionally abused by medical personnel
      who have ready access to the drug. We examined in healthy volunteers (N = 13) the
      subjective and psychomotor-impairing effects of intravenous fentanyl (0-100
      micrograms/70 kg). A randomized, placebo-controlled, crossover design was used in
      which subjects were injected with 0, 25 (N = 6), 50 and 100 micrograms/70 kg
      fentanyl in a double-blind fashion. Subjects completed several questionnaires
      commonly used in abuse liability testing studies before drug injection and at
      periodic intervals for up to 3 h after drug injection. Subjects also completed
      several psychomotor tests at these times. Some aspects of psychomotor functioning
      (e.g., eye-hand coordination) were impaired by fentanyl. Fentanyl produced dose
      related increases in ratings of "high" and "sedated," but also tended to produce
      dysphoria and somatic symptomatology. Most subjects reported liking the effects
      of the two higher doses of fentanyl for at least a brief time after injection,
      but they varied widely in their linking ratings across the 3-h post-drug
      injection period. Despite the transient increases in liking ratings, fentanyl did
      not increase scores on a widely-used measure of drug-induced euphoria (morphine
      benzedrine group scale of the Addiction Research Center Inventory). The present
      results suggest that some medical personnel who experiment with fentanyl may like
      it, and thus be at increased risk for abusing the drug in the future.

PMID- 1615133
TI  - Effects of fenfluramine and para-chloroamphetamine on sexual behavior of male
      rats.
AB  - The present studies have evaluated the effects of pharmacologically induced
      release serotonin on sexual responses of male rats during exposure to a sexually
      receptive female rat. Following acute administration of fenfluramine or para
      chloroamphetamine (PCA), significant dose-related decreases in copulatory rate
      and copulatory efficiency, and increases in ejaculatory latency were observed.
      These effects were not observed when the animals were pretreated with LY53857, a
      5-HT1c/2 antagonist. These studies indicate that acute release of serotonin
      evoked by these releasing agents has inhibitory effects on sexual sexual drive,
      capacity to achieve erection and threshold for ejaculation, and these effects are
      mediated by either the 5-HT1c or 5-HT2 receptor.

PMID- 1615134
TI  - Amphetamine or haloperidol 2 weeks earlier antagonized the plasma corticosterone
      response to amphetamine; evidence for the stressful/foreign nature of drugs.
AB  - We inquired whether a single exposure to amphetamine (AM) or haloperidol (HALO)
      could modify the plasma corticosterone (CORT) response to a second injection of
      AM 2 weeks later. Male rats were injected with 4 mg/kg d-AM sulfate and tested
      for water intake for 5 h before sacrifice. Overall, AM induced water intake but
      none of the pretreatments altered this effect. By contrast, preexposure to AM,
      HALO or its vehicle 2 weeks earlier prevented the elevation of plasma CORT
      obtained when AM was administered without pretreatment. A combined pretreatment
      of HALO or its vehicle with AM produced an even greater blockade of AM-induced
      CORT elevation. Manipulations which prevented AM-induced drinking reduced the
      effectiveness of AM pretreatment in attenuating AM-induced elevation in CORT,
      suggesting that the pretreatment may have been sensitizing the effectiveness of a
      coping response--drinking--in reducing the CORT effect. Our findings also
      indicate that a dopamine agonist (AM), a dopamine antagonist (HALO) and a
      nonspecific stressor (acidic vehicle) can all induce the same, long-lasting
      action on CORT. This strongly suggests that the effects of AM and HALO in this
      instance cannot be explained in terms of their pharmacological actions, which are
      opposite to one another, but instead relate to their properties as
      stressful/foreign agents to the organism.

PMID- 1615135
TI  - Effect of taurine on ethanol-induced changes in open-field locomotor activity.
AB  - In the present investigation we questioned whether taurine antagonized the
      effects of ethanol on motor activity measured in the open field. Ten minutes
      following simultaneous administration (IP) of ethanol (1.0, 1.5, 2.0 and 2.5
      g/kg) or saline and taurine (30, 45 and 60 mg/kg) or saline, mice were placed in
      open field chambers and locomotor activity was measured during a 10 min testing
      period. A significant interaction was found between taurine and ethanol. Taurine
      treated mice displayed lower motor excitation with the 1.0 g/kg dose of ethanol
      than the saline group treated with the same dose of ethanol. However at the 2.0
      g/kg ethanol dose, taurine-treated mice demonstrated higher motor activity than
      the saline treated mice, once again, treated with the same dose of ethanol. No
      differences in blood ethanol levels were observed between the two groups. In a
      second study, taurine administration (30, 45 and 60 mg/kg) did not show any
      effect on d-amphetamine-induced enhancement of locomotor activity (1, 2, and 3
      mg/kg). Data from this study demonstrated an interaction between taurine and
      ethanol in their effect on locomotor activity in the open field.

PMID- 1615136
TI  - Rate of increase of plasma drug level influences subjective response in humans.
AB  - This study addressed the commonly held, but seldom tested, notion that faster
      rates of increase of drug effects are associated with more positive subjective
      effects. Sodium pentobarbital was administered to normal healthy volunteers in
      either a single oral dose or in a series of divided, cumulating doses, and
      subjective responses were monitored. Twelve subjects participated in three weekly
      sessions, during which they received capsules containing placebo, 150 mg
      pentobarbital in a single dose (SIN) or 180 mg pentobarbital administered in six
      divided doses (DIV) of 30 mg every 30 min. Doses of pentobarbital in the SIN and
      DIV were selected to produce similar peak plasma levels. Blood samples were
      obtained at regular intervals for plasma drug level determinations, and
      throughout the session subjects completed self-report mood questionnaires (e.g.,
      Profile of Mood States, visual analog ratings of drug liking and drug "high") and
      psychomotor performance tests (e.g., Digit Symbol Substitution Test). As
      expected, the SIN and DIV conditions yielded similar peak levels of
      pentobarbital, but the peak was attained more rapidly in the SIN condition.
      Despite the similarity in peak plasma levels, subjects reached greater peaks in
      ratings of "high" and wanted more of the drug when they were in the SIN
      condition. On an end-of-session liking questionnaire they also reported
      significantly greater liking of the drug in the SIN condition. On other measures
      of drug effects (e.g., sedation and psychomotor impairment) no significant
      differences were observed between the conditions. Thus, the rate of increase of
      the drug's effects specifically influenced subjects' ratings on subjective
      measures (e.g., "high" and liking) that may be associated with risk for
      abuse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615137
TI  - Partial reversal of fluoxetine anorexia by the 5-HT antagonist metergoline.
AB  - Experiment 1 showed that the reduction of intake produced by 5 or 10 mg/kg
      fluoxetine in rats eating either a solid or a liquid meal was partially
      antagonised by 1 mg/kg of the 5HT1/5HT2 antagonist metergoline but not by 1 mg/kg
      of the 5HT2 antagonist ketanserin. Experiment 2 examined the meal patterning of
      rats given 5 mg/kg fluoxetine and 1 mg/kg metergoline. Fluoxetine alone increased
      the latency to feed, reduced meal size and shifted the inter-pellet interval
      (IPI) distribution to the right. Metergoline alone had little immediate effect on
      food intake or other feeding parameters but partially reversed the reduction of
      food intake produced by fluoxetine. There was a complete reversal of the
      increased latency to feed and a partial reversal of the depression of meal size.
      However, the rightward shift of the IPI distribution caused by fluoxetine, which
      indicated a depression of feeding rate, was more pronounced after combined
      treatment. We conclude that fluoxetine reduces food intake by enhancing satiety
      through a serotonergic dependent mechanism but reduces feeding rate through a
      separate mechanism, whose neurochemical basis remains to be established.

PMID- 1615138
TI  - Sodium pentobarbital: sensory and associative effects in classical conditioning
      of the rabbit nictitating membrane response.
AB  - Four experiments were conducted to determine the effects of sodium pentobarbital
      (0, 3, 9, and 15 mg/kg) on the acquisition of the rabbit's classically
      conditioned nictitating membrane response (NMR) and to determine the locus of the
      drug's effects on sensory, motor, associative, and nonassociative processes. In
      experiment 1, classical conditioning of the NMR was accomplished by pairing tone
      and light conditioned stimuli (CSs) with paraorbital shock as the unconditioned
      stimulus (US). The experiment revealed that pentobarbital retarded the
      acquisition of conditioned responses (CRs) to both tone and light CSs. Experiment
      2, employing unpaired CS, UCS presentations, indicated small but significant drug
      effects on NMR base rate and nonassociative NMRs to the CS. Experiment 3 revealed
      no significant drug effect on the psychophysical functions relating UCS intensity
      to UCR frequency or amplitude, nor on the UCS intensity threshold for eliciting
      UCRs. On the other hand, in experiment 4, the drug significantly impaired CR
      frequency over an extended range of CS intensities and raised CS intensity
      threshold. It was concluded that pentobarbital's attenuation of CS intensity also
      operated to impair CR acquisition.

PMID- 1615139
TI  - L-dopa withdrawal in Parkinson's disease selectively impairs cognitive
      performance in tests sensitive to frontal lobe dysfunction.
AB  - A group of ten patients with idiopathic Parkinson's disease (PD) was tested on a
      series of automated tests of learning, memory, planning and attention whilst
      either on or off L-dopa medication. Controlled withdrawal of L-dopa interfered
      with aspects of performance on three of the tests that had previously been shown
      to be sensitive to frontal lobe dysfunction; a spatial working memory task, the
      Tower of London planning test, and a visual discrimination paradigm that also
      included intra- and extra-dimensional shift tests of selective attention. More
      specifically, errors were increased in the spatial working memory test, and both
      the accuracy and latency of thinking were impaired. Thinking time was
      significantly slowed following L-dopa withdrawal, even though the possible
      contaminating effects on motor slowing were fully controlled by a yoked control
      procedure. Nine out of ten patients reached a further stage of the visual
      discrimination, set-shifting paradigm when on, rather than off, L-dopa
      medication. Spatial span was also impaired off medication, but there were no
      effects of L-dopa withdrawal on tests of pattern and spatial recognition memory,
      simultaneous and delayed matching to sample or visuospatial conditional
      associative learning. Comparisons with a large control group confirmed previous
      findings that PD is associated with deficits on the majority of these tests. The
      results are discussed in terms of the fronto-striatal, dopamine dependent nature
      of some of the cognitive deficits found in PD, but the apparent dopamine
      independent nature of deficits in other aspects of cognitive functioning, notably
      in tests of visual recognition memory and associative learning.

PMID- 1615140
TI  - Abolition of latent inhibition by a single 5 mg dose of d-amphetamine in man.
AB  - The performance of healthy volunteer subjects on an auditory latent inhibition
      (LI) paradigm was assessed following administration of a single oral dose of d
      amphetamine or placebo. It was predicted that a low (5 mg), but not a high (10
      mg), dose of d-amphetamine would disrupt LI. The prediction was supported with
      left ear presentation of the preexposed stimulus only. When the preexposed
      stimulus was presented to the right ear the predicted pattern of findings was not
      obtained. It is concluded that the dopaminergic system is involved in the
      mediation of LI in man and it is speculated that the interaction between
      amphetamine dose and ear of presentation of the preexposed stimulus may reflect
      normally occurring dopaminergic hemisphere asymmetry.

PMID- 1615141
TI  - Hypersensitivity to scopolamine in the elderly.
AB  - Scopolamine hydrobromide, 0.43 mg/70 kg, was administered by subcutaneous
      injection to ten young and ten elderly subjects. A comprehensive
      neuropsychological test battery was used to assess the effects of scopolamine, as
      compared to placebo, on cognitive function. As previously reported for this group
      of young subjects, scopolamine significantly impaired performance on tests of
      recent memory and visuospatial praxis. The same effects were observed in the
      elderly subjects, but the magnitude of the effects was much larger. The
      scopolamine injections produced significant psychomotor slowing in the elderly,
      whereas higher doses of the drug are required to produce this effect in young
      subjects. In both young and old subjects scopolamine failed to affect immediate
      memory, language function, object sorting, and the frequency of intrusion errors
      (although trends toward an effect were more apparent in the elderly). Remote
      memory, tested in the elderly only, was also unaffected. The results suggest that
      scopolamine's cognitive effects are quantitatively more pronounced in elderly
      subjects than young subjects, but that they are qualitatively similar and do not
      constitute a valid model for the cognitive dysfunction associated with
      Alzheimer's disease.

PMID- 1615142
TI  - Suppression of alcohol and saccharin preference in rats by a novel Ca2+ channel
      inhibitor, Goe 5438.
AB  - The effect of the novel 1,4-dihydronaphthyridine Ca2+ channel inhibitor Goe 5438
      (CI-951) on voluntary ethanol consumption was examined in selectively bred
      alcohol-preferring (P) rats in a free choice two bottle preference test versus
      water. Intraperitoneally injected Goe 5438 dose-dependently (5, 10 or 20
      mumol/kg, twice daily) inhibited ethanol and increased water intake over the 24 h
      period (injection day). The drug decreased ethanol preference, originally above
      90%, by 6%, 19% and 45% at respective doses, on the injection day. That
      inhibitory effect of the highest dose of Goe 5438 on ethanol preference remained
      significant also on days 2 and 3 after injections (-51% and -18%, respectively).
      Goe 5438, in the highest dose, also tended to decrease granulated chow
      consumption during the injection day only. To further test whether the inhibition
      of ethanol preference is secondary to decrease in reinforcing properties of
      ethanol and not due to interference with satiety mechanisms, we compared the
      effect of two higher doses (10 and 20 mumol/kg, intraperitoneally, twice daily)
      of Goe 5438 on spontaneous preference for a non-caloric 0.04% saccharin solution
      in Sprague-Dawley rats. We observed a dose-dependent suppression of preference
      (by 44% and 58%, respectively) during the injection day, but not the subsequent
      24 h period. However, Goe 5438 also significantly alleviated food pellet intake
      on the injection day. In conclusion, Goe 5438 produces potent and long-lasting
      inhibition of voluntary ethanol consumption, which may be secondary to
      attenuation of reinforcing properties of ethanol.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1615143
TI  - Haloperidol reduces ethanol-induced motor activity stimulation but not
      conditioned place preference.
AB  - This experiment examined the impact of a dopamine receptor blocker on ethanol's
      rewarding effect in a place conditioning paradigm. DBA/2J mice received four
      pairings of a tactile stimulus with ethanol (2 g/kg, IP), haloperidol (0.1 mg/kg,
      IP)+ethanol, or haloperidol alone. A different stimulus was paired with saline.
      Ethanol produced increases in locomotor activity that were reduced by
      haloperidol. However, conditioned preference for the ethanol-paired stimulus was
      not affected by haloperidol. Haloperidol alone decreased locomotor activity
      during conditioning and produced a place aversion. These results indicate a
      dissociation of ethanol's activating and rewarding effects. Moreover, they
      suggest that ethanol's ability to induce conditioned place preference is mediated
      by nondopaminergic mechanisms.

PMID- 1615144
TI  - Opposite effects of pentylenetetrazol on self-defensive and submissive postures
      in the rat.
AB  - In a previous work, using the resident-intruder situation, we have shown that a
      benzodiazepine inverse agonist could exert a "fear-promoting" effect, in
      decreasing self-defensive behaviours while increasing submissive postures. To
      further test this hypothesis, the effects of pentylenetetrazol on different forms
      of defensive behaviour were examined in male intruder rats confronted with
      offensive residents. Administration of pentylenetetrazol (10 and 20 mg/kg, IP)
      increased submissive postures such as immobility and on-the-back, but reduced
      self-defensive postures. Other active behaviours were not reduced, thus excluding
      a non-specific behavioural suppression. These results suggest that self-defensive
      and submissive behaviours can be dissociated and that anxiogenic compounds are
      more likely to increase submissive behaviours than self-defensive ones.

PMID- 1615145
TI  - [Arcos system--rational procedures for optimization of conical crown adhesion].

PMID- 1615146
TI  - [Individual baking procedure--system or accident?].

PMID- 1615147
TI  - [Powder metallurgical preparation procedures of Degusint in dental laboratory and
      clinical application--an overview].

PMID- 1615148
TI  - [Incorrect decisions in personnel management].

PMID- 1615149
TI  - [Spiral block connection].

PMID- 1615150
TI  - [10 year register. Volumes 21-30, 1981-1991].

PMID- 1615151
TI  - [Frontier research on mesoderm induction in the early amphibian embryos].

PMID- 1615152
TI  - [Pathophysiology of cerebral ischemia].

PMID- 1615153
TI  - [Structure and activity of lipase].

PMID- 1615154
TI  - [Ligament: a natural composite material to open the shells of bivalves].

PMID- 1615155
TI  - [Dynamic fluorescence methods and their applications to biochemistry].

PMID- 1615157
TI  - Sexual dysfunction.

PMID- 1615156
TI  - Sexual dysfunction in perspectives: an introduction.

PMID- 1615158
TI  - Sexual issues in the medically ill and aging.

PMID- 1615159
TI  - Prescription drugs and sexual function.

PMID- 1615160
TI  - The five-factor model of personality and sexual functioning in outpatient men and
      women.
AB  - 454 adults seeking evaluation at a sexual behaviors consultation clinic were
      evaluated for the major dimensions of personality as measured by the NEO
      Personality Inventory and various aspects of sexual attitudes and experiences via
      the Derogatis Sexual Functioning Inventory. The results showed that elevated
      Neuroticism was correlated with dysphoric symptoms, negative body image and
      lowered satisfaction. More extraverted individuals reported increased drive, more
      sexual experience, positive body image, and more positive affects. Agreeableness
      was unrelated to sexual drive and satisfaction but was negatively related to
      symptomatology. Openness was positively associated with amount of Information,
      range of sexual experiences, liberal attitudes toward sex, sexual drive and
      fantasy and appears to broadly impact upon sexual functioning. The more
      conscientious subjects had lowered sexual drive, but fewer dysphoric symptoms and
      a better body image. Women showed a similar pattern of personality correlates
      with the exception that personality was unrelated to females' sexual experiences
      and sexual satisfaction. The present findings support and expand previous
      research and contribute to our understanding of how personality dispositions
      influence the experience and expression of sexual functioning in male and female
      clinical samples.

PMID- 1615161
TI  - Normal aging and the evaluation of sexual dysfunction.

PMID- 1615162
TI  - Critique of the DSM-III-R nosology of sexual dysfunctions.

PMID- 1615163
TI  - Changes in terminology for sexual disorders in DSM-IV.

PMID- 1615164
TI  - Sexual and intimacy dysfunction among homosexual men and women.
AB  - Homosexually active men and women are no more immune than anyone else from
      various types of sexual dysfunction and underlying psychopathology. Intimacy
      fears and conflicts, ignorance, alcohol and drug dependence and relationship
      issues exemplify the type of issues influencing dysfunction regardless of sexual
      orientation, although membership of a stigmatized minority sexuality may
      exacerbate causes of sexual dysfunction. The effects of discordant lifestyle and
      identity, homosexual identity formation, dysphoria and internalized homophobia on
      sexual functioning are three examples of these factors of specific relevance to
      being homosexual in this culture. The effects of AIDS, difficulties arising from
      the mechanics of safer sex and the psychosexual effects of oppression on healthy
      sexual functioning all indicate how factors important to (but not caused by)
      minority sexuality status may influence sexuality functioning. The importance of
      neither perceiving homosexuality solely in terms of pathology on the one hand,
      nor refusing to recognize unhealthy sexual functioning on the other, is
      emphasized throughout. Models of sexuality must be inclusive, positive and
      communicated to the client if future sexual dysfunction is to be limited.
      Finally, the role of the therapist in community development, as well as
      individual intervention, is addressed. Primary health care interventions are
      required not only to address the specific issues affecting homosexual men and
      women, but also to promote a more positive approach to sexuality for all.

PMID- 1615165
TI  - Sexual aversion versus hypoactive sexual desire: a diagnostic challenge.
AB  - Our work with women with sexual aversion documents the presence of marked sexual
      avoidance behaviors as specified in the DSM-III-R1 diagnostic criteria for this
      disorder. At the same time, we demonstrate the presence of normal sexual desire
      and capacity for orgasm in these women. These two findings offer support for a
      valid diagnostic differentiation between sexual aversion disorder and hypoactive
      sexual desire disorder. Inherent in the diagnosis and treatment of sexual
      aversion disorder is an appreciation by the clinician of the tremendous approach
      avoidance conflict that exists in these patients. The behavioral and cognitive
      avoidance features, therefore, need to be elicited actively by the clinician
      during all phases of assessment and treatment. These features are not always
      offered readily by the patients for fear of having to relinquish these strategies
      and their related sense of control over the overwhelming anxiety that sexual
      intimacy can produce. Consequently, treatment is not always straightforward and
      successful.

PMID- 1615166
TI  - The early phase of treatment: an object relations approach.

PMID- 1615167
TI  - Does attention modulate the perception of luminance changes?
AB  - In a previous study assessing the modulation of visual processing by attention,
      Bonnel, Possami, and Schmitt showed that, when discriminating line-length,
      subjects precisely shared processing resources between two pairs of lines
      presented to the left and right of fixation. In a close replication requiring the
      detection of luminance increments instead of line-length differences, subjects
      were unable to follow the instructions and to allocate attention differentially,
      thus supporting the claim that light detection is fundamentally different from
      shape discrimination. In a subsequent experiment, we tested and rejected the
      possibility that luminance perception was not open to modulation by attention due
      to its physical nature. Replacing brightness detection by brightness
      identification allowed voluntary control on the quality of processing to be
      evidenced. The similarity between the latter results and the data from line
      length discrimination suggests that task requirements may be crucial in
      determining the distribution of attention.

PMID- 1615168
TI  - Privileged access by irrelevant speech to short-term memory: the role of changing
      state.
AB  - Memory for visually presented items is impaired by speech that is played as an
      irrelevant background. The paper presents the view that changing state of the
      auditory material is an important prerequisite for this disruption. Four
      experiments studied the effects of sounds varying in complexity in an attempt to
      establish which features of changing state in the auditory signal lead to
      diminished recall. Simple unvarying or repetitive speech sounds were not
      sufficient to induce the irrelevant speech effect (Experiment 1): in addition,
      simple analogues of speech, possessing regular or irregular envelopes and using a
      range of carriers, failed to imitate the action of speech (Experiment 2).
      Variability of between-utterance phonology in the irrelevant stream (Experiment
      3) emerged as a crucial factor. Moreover, predictability of the syllable sequence
      did not reduce the degree of disruption (Experiment 4) suggesting that supra
      syllabic characteristics of the speech are of little importance. The results
      broadly support the idea that disruption of short-term memory only occurs when
      the speech stream changes in state. It is argued that disruption occurs in memory
      when cues to serial order based on phonological representations of heard material
      interfere with the phonological codes of visual origin. It is suggested that cues
      to changing state of the speech input contaminate those associated with items of
      visual origin, which are already in a phonological store.

PMID- 1615169
TI  - Towards an exemplar model of face processing: the effects of race and
      distinctiveness.
AB  - Valentine (1991a, 1991b) described a theoretical framework for face recognition
      in which faces are encoded as locations in a multidimensional space. It was
      argued that this approach could provide a unified account of the effects of
      distinctiveness, inversion, and race on face recognition. In this paper we
      evaluate the ability of this theoretical framework to account for the effects of
      distinctiveness and race in four experiments in which white British and Japanese
      faces served as stimuli and both white British and Japanese students acted as
      subjects. In a recognition memory experiment the expected "own-race bias" was
      observed as a Race of Subject x Race of Face interaction. Distinctive faces were
      recognized more accurately than typical faces, but the effect of distinctiveness
      did not interact with the race of face or the race of subject. Typical faces were
      classified faster than distinctive faces in a task in which intact faces had to
      be distinguished from jumbled faces, as found in earlier work, and the effect of
      distinctiveness did not interact with the race of face or race of subject. In
      contrast, a task in which subjects classified faces according to their race did
      show a greater effect of distinctiveness for own-race faces. The results are
      discussed in relation to the two specific models within the multidimensional
      space framework identified by Valentine (1991a): a purely exemplar-based model
      and a norm-based coding model. It is argued that these results are more easily
      accommodated in terms of a purely exemplar-based model. Some conceptual problems
      in applying the norm-based coding model to the effect of race are discussed.

PMID- 1615170
TI  - Against relative timing invariance in movement kinematics.
AB  - The kinematics of stair climbing were examined to test the assertion that
      relative timing is an invariant feature of human gait. Six male and four female
      subjects were video-recorded (at 60 Hz) while they climbed a flight of stairs 10
      times at each of three speeds. Each gait cycle was divided into three segments by
      the maximum and minimum angular displacement of the left knee and left foot
      contact. Gentner's (1987) analysis methods were applied to the individual subject
      data to determine whether the duration of the segments remained a fixed
      proportion of gait cycle duration across changes in stair-climbing speed. A
      similar analysis was performed using knee velocity maxima to partition the gait
      cycle. Regardless of how the gait cycle was divided, relative timing was not
      found to remain strictly invariant across changes in speed. This conclusion is
      contrary to previous studies of relative timing that involved less conservative
      analysis but is consistent with the wider gait literature. Strict invariant
      relative timing may not be a fundamental feature of movement kinematics.

PMID- 1615171
TI  - The locus of repetition priming of spoken word production.
AB  - Naming of a pictured object is substantially facilitated when the name has
      recently been produced in response to a definition or read aloud. The first
      experiment shows this to be so when over one hundred trials have intervened, and
      when the subjects can name the pictures quickly and accurately in the absence of
      priming. The locus of the effect must be in lexicalization processes subsequent
      to picture identification and is unlikely to be mediated by recovery of an
      episodic trace. Two further experiments show that prior production of a homophone
      of the object's name is not an effective prime, (although slower responses are
      somewhat facilitated when the homophones are spelled the same). Hence the
      facilitation observed for repeated production of the same word cannot be
      associated with the repetition of the phonological form per se. We conclude that
      the facilitation must be associated with retrieval of the semantic specification
      or the process of mapping of that specification to its associated phonological
      representation.

PMID- 1615172
TI  - Repetition of lexicalization across languages: a further test of the locus of
      priming.
AB  - Wheeldon and Monsell (this issue) found that production of a word in response to
      a definition had a large and long-lasting facilitatory effect on latency for
      later production of the same word to name a pictured object, and that this
      priming effect was not due to repeated production of the phonological word-form
      per se. This paper reports a further test of the locus of the effect. Welsh
      English bilinguals named pictured objects in Welsh. Half the words were primed
      either by their earlier production in Welsh in response to Welsh definitions or
      by production of their equivalents in English in response to English definitions.
      Substantial facilitation resulted from prior production in the same language,
      none from prior production in the other language--provided that the equivalents
      differed in phonological form. Given that priming results neither from repeated
      activation of a meaning when different phonological forms are produced, nor from
      repetition of the same phonological form in response to different meanings, the
      priming effect must be localized in the connection between a word's meaning and
      its phonological form. We also put forward an account of bilingual lexicalization
      that accommodates this result together with some evidence indicating that
      production of words in one language is not wholly insulated from the
      "availability" of words in the other.

PMID- 1615173
TI  - Blood eosinophil count as risk factor for relapse in acute asthma.
AB  - In this retrospective investigation comprising 54 adult patients included in two
      studies of the treatment of acute asthma, the risk of relapse was studied. The
      set of variables that best predicted the length of time before a new asthmatic
      attack comprised blood eosinophil count (P less than 0.001), FEV1 on arrival (P
      less than 0.001) and increased medication on discharge (P less than 0.01). The
      set of variables that best predicted the number of new attacks during a period of
      1 yr consisted of eosinophil count (P less than 0.001), FEV1 (P less than 0.001),
      increased medication on discharge, age and breathing rate on arrival (P less than
      0.05). Patients with an eosinophil count of more than 500 x 10(6) l-1 and a FEV1
      of less tha 1.0 l ran a six-fold greater risk of returning with a new attack
      within 1 month than patients with lower eosinophil count and higher FEV1. No
      significant correlation was found between post-treatment PEF variation and
      relapse in acute asthma.

PMID- 1615174
TI  - High dose nebulized steroid in the treatment of chronic steroid-dependent asthma.
AB  - Despite the dramatic success of inhaled steroids in controlling asthma symptoms
      there remains a small number of patients in whom asthma can only be treated with
      continuous oral steroids. Eighteen such patients, aged 19-62 years (seven males,
      11 females) were followed in an open trial of nebulized budesonide over 12-18
      months. All had required at least 7.5 mg or more daily prednisolone to control
      their symptoms over the preceeding 2 or more years and were taking 1200
      micrograms beclomethasone dipropionate or 1600 micrograms budesonide daily. With
      a daily dose ranging between 4 and 8 mg nebulized budesonide, 14 patients
      successfully stopped oral steroids while in three the dose was reduced; only one
      patient failed to benefit. There was an increase in the mean FEV1 from 1.9 (+/-
      0.9) to 2.2 (+/- 0.9) l, and in the mean morning PEFR, from 238 (+/- 119) to 286
      (+/- 130) l min-1. There was also a significant decrease in the mean number of
      hospital admissions for acute severe asthma, from 1.5 (+/- 1.8) to 0.9 (+/- 1.1)
      per year. These findings should encourage a careful and controlled evaluation of
      nebulized steroids as a substitute for oral steroids in this difficult group of
      asthmatics.

PMID- 1615175
TI  - Humidification as an adjunct to chest physiotherapy in aiding tracheo-bronchial
      clearance in patients with bronchiectasis.
AB  - Humidification of inspired air or oxygen is frequently utilized by respiratory
      physiotherapists to relieve sputum retention. Cold water, jet nebulizing
      humidifiers are in widespread use but there has been no previous attempt to
      investigate the efficacy of this treatment. We have performed a single-blind,
      cross-over study to quantify the effect of humidification as an adjunct to chest
      physiotherapy. Seven patients with bronchiectasis completed the trial, with a
      mean (range) age of 51 years (41-64 years) and mean (range) percent of predicted
      FEV1 of 46% (29-76%). On 2 days, separated by 1 week, subjects were randomly
      allocated to humidification or no humidification as a precursor to an optimal
      chest physiotherapy regimen. A radio-aerosol of human serum albumin
      millimicrospheres labelled with 99mTechnetium was used to measure sputum
      clearance by serial gamma camera images. Serial measurements of sputum weight and
      FEV1 were also recorded. Humidification (30 min) was followed by postural
      drainage (20 min) with the subject using the forced expiration technique to
      assist clearance. When humidification was combined with physiotherapy there was a
      significant increase in total wet weight of sputum (P less than 0.05) with a
      median (range) increase of 6 g (-9-15.5 g); and a significant increase in total
      radiolabel clearance (P less than 0.05) with a median (range) increase of 8.7% (1
      13%), compared to physiotherapy alone. This study demonstrates that the use of
      cold water, jet nebulizing humidifiers significantly increases tracheo-bronchial
      clearance above that of an optimal physiotherapy regimen alone in
      bronchiectasis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615176
TI  - Predictors of mortality in silicosis.
AB  - The mortality of a cohort of 1487 male patients with silicosis in a population
      based register followed up from 1980 to 1986 was evaluated with reference to the
      mortality rates of the general male population. A striking excess of deaths from
      all causes (observed 368, standardized mortality ratio, SMR 3.00) was noted.
      Seventy-four percent of the deaths were due to respiratory conditions and
      complications directly or indirectly related to silicosis. The risk of death was
      especially higher than expected in younger patients under 45 years of age.
      Patients with simple silicosis of profusion category 1 did not appear to be at
      any increased risk of death relative to the general population, but increasing
      excesses of death were associated with greater extent of simple and conglomerate
      disease. These increased mortality risks were observed in tuberculosis-free
      patients as well as in those who never smoked. For the same extent of silicotic
      disease, the risk of death was higher if tuberculosis occurred. There was no
      evidence, however, that patients who smoked were more likely to suffer a worse
      mortality outcome than those who did not. Age at diagnosis, extent of silicotic
      disease and the occurrence of tuberculosis were therefore strong predictors of
      mortality in patients with silicosis.

PMID- 1615177
TI  - Inhaled steroids in patients with bronchiectasis.
AB  - The effect of inhaled beclomethasone diproprionate (1500 micrograms day-1) on
      symptoms, pulmonary function and sputum production was examined in a double
      blind, placebo-controlled, cross-over study in 20 patients with bronchiectasis.
      An 18% reduction in daily sputum production (P less than 0.003) was observed on
      treatment with inhaled steroid compared to placebo. A small, significant,
      improvement in morning peak expiratory flow rate (P less than 0.03) and forced
      expiratory volume in 1 s (P less than 0.03) was seen but the absolute changes are
      unlikely to be of clinical importance. Symptom scores for cough improved
      significantly (P less than 0.02). Inhaled steroids may have a role in the
      management of bronchiectasis by reducing cough and sputum production.

PMID- 1615178
TI  - The effect of high-frequency ventilation on non-Newtonian properties of bronchial
      mucus.
AB  - We have investigated the changes in the non-Newtonian properties of human
      bronchial mucus brought about by in vitro high frequency ventilation. This type
      of ventilation brought about changes in viscous properties, measured during creep
      and oscillation of the mucus, which would be expected to reduce mucus clearance
      in vivo. We suggest that any beneficial effects of clinical high-frequency
      ventilation on respiratory mucus clearance in patients are not brought about by
      long-term (more than a few seconds) changes in the viscous properties of the
      mucus itself.

PMID- 1615179
TI  - Inhaled sodium cromoglycate for pre-term children with respiratory symptoms at
      follow-up.
AB  - Children born prematurely frequently have recurrent respiratory symptoms at
      follow-up and benefit from bronchodilator therapy. We have assessed if regular
      inhaled sodium cromoglycate would reduce this respiratory morbidity and need for
      bronchodilator therapy. Sixteen symptomatic children (median gestational age 29
      weeks, post-natal age 15 months) were entered into a randomized double-blind,
      placebo-controlled trial. In two 3-week periods, the patients received either
      placebo or sodium cromoglycate (5 mg) as one puff q.d.s. from an inhaler via a
      coffee cup. Parents recorded their child's symptoms and need for bronchodilator
      therapy throughout and lung function was assessed by measurement of functional
      residual capacity (FRC) at the beginning and end of each 3-week period. The
      symptom score was reduced by 49% in the active compared to the placebo period (P
      less than 0.01) and bronchodilator was taken on a mean of 2.9 days per infant in
      the active period compared to 7.9 days in the placebo period (P less than 0.01).
      There was a significant improvement in FRC in ten of 16 patients over the active
      period but only in two infants over the placebo period (P less than 0.01). We
      conclude regular inhaled sodium cromoglycate is useful prophylaxis for
      symptomatic pre-term children.

PMID- 1615180
TI  - Extrinsic allergic alveolitis: problems in diagnosis and a potential use for
      computed tomography.
AB  - Bird fancier's lung, the most common form of extrinsic allergic alveolitis in
      Britain, can be a difficult diagnostic problem. The symptoms are non-specific,
      often insidious in onset and frequently misdiagnosed as influenza or a viral or
      bacterial pneumonia. Frequently there is a delay in eliciting the history of
      exposure to the antigen. The chest radiograph is often less impressive than the
      clinical presentation and may be normal despite severe symptoms, impaired
      respiratory function and florid pathological changes. We present three cases
      demonstrating these diagnostic problem. In two cases, high resolution computed
      tomography demonstrated the typical 'ground glass' opacification seen in active
      alveolitis. This allowed targeting of transbronchial biopsies which revealed an
      inflammatory infiltrate of the interstitium with granuloma formation and
      inflammatory cells in some alveoli. The problems in diagnosis and the potential
      role of high resolution computed tomography are discussed.

PMID- 1615181
TI  - Persistent cough and sputum: prevalence and clinical characteristics in south
      east England.
AB  - In order to measure the prevalence of chronic respiratory symptoms in the
      population and to identify subjects for a case-referent study of aetiologic
      factors, 10,000 persons registered with general practices in south east England
      were surveyed. Responses to an initial postal questionnaire were validated by
      telephone interview; clinical interviews and simple spirometry were subsequently
      carried out on a sample of persons aged 5-54 years, reporting persistent sputum
      production. Results indicated that the postal questionnaire was an effective and
      sensitive method of surveying respiratory symptoms in the population. Comparison
      with earlier surveys suggests that the prevalence of chronic cough and sputum in
      Great Britain has fallen in males but not in females. Of those adults reporting
      persistent sputum production, high proportions reported associated symptoms of
      wheezing (54%), breathlessness (45%) or upper respiratory tract symptoms (54%).
      Thirty percent recalled a serious respiratory infection in childhood and 52% were
      current cigarette smokers although 34% reported that they had never been regular
      smokers. Overall there was little evidence of serious airflow obstruction in this
      group.

PMID- 1615182
TI  - Effect of bromhexeine on sputum amoxycillin levels in lower respiratory
      infections.
AB  - Bromhexeine has been widely used as an adjunct in the management of lower
      respiratory infections and is useful in altering the physical characteristics of
      sputum. Its effect on the sputum penetration of an antibiotic has been sparsely
      studied. The present study highlights the improvement in sputum amoxycillin
      (amoxy) levels when a combination tablet, amoxy 500 mg plus bromhexeine 8 mg, is
      administered as compared to plain amoxy 500 mg. Sputum amoxy levels were
      significantly higher in the combination group (0.674 +/- 0.588 micrograms ml-1)
      as compared to 0.272 +/- 0.19 micrograms ml-1 in the amoxy group (P = 0.028). The
      clinical responses assessed by the physician as well as the patient were
      significantly better in the amoxy plus bromhexeine group as compared to the amoxy
      group. The radiological and bacteriological responses were similar in both
      groups. There was no increase in the side-effects due to bromhexeine and,
      overall, its use can be recommended in the treatment of acute lower respiratory
      infections.

PMID- 1615183
TI  - Spontaneous arrest of growth of a plasma cell granuloma.

PMID- 1615184
TI  - 'Smoke-bomb' pneumonitis.

PMID- 1615185
TI  - A radiographer's asthma.

PMID- 1615186
TI  - Audit of tuberculosis contact tracing procedures in South Gwent.

PMID- 1615187
TI  - Epidemiological differences in pulmonary tuberculosis non-compliance and relapse.

PMID- 1615188
TI  - The value of routine microbial investigation in community-acquired pneumonia.

PMID- 1615189
TI  - N-acetylcysteine by metered dose inhaler in the treatment of chronic bronchitis:
      a multi-centre study.
AB  - Sixty-five patients with chronic bronchitis were studied at five different
      centres in a double-blind, randomized trial. Two parallel groups were treated
      with either N-acetylcysteine or placebo by metered dose inhalers for 16 weeks.
      Following a 1-week run-in period, each patient recorded subjective impressions of
      the drug action on their bronchitic symptoms in a diary once a week. In addition,
      exacerbations were registered. Lung function testing and adverse effects were
      evaluated by four visits to the chest clinics during the 16 weeks. We could not
      demonstrate that N-acetylcysteine by metered dose inhalers had any significant
      effect on patients' feeling of well-being, sensation of dyspnoea, intensity of
      coughing, mucus production, or expectoration or lung function. Its effect in
      reducing exacerbations could not be estimated because of a very low number of
      exacerbations reported. N-acetylcysteine inhalation was safe when used over a 16
      week period.

PMID- 1615190
TI  - The effect of inhaled terbutaline on FEV1, FVC, dyspnoea and walking distance in
      patients with chronic obstructive lung disease.
AB  - This double-blind, placebo-controlled, crossover study was performed to evaluate
      the effect of terbutaline administered by a turbuhaler on spirometry, walking
      distance and dyspnoea during exercise in patients with chronic obstructive lung
      disease (COLD) and to evaluate relationships between changes in spirometry and
      working indices. The patients had a maximum reversibility in FEV1 of 15%
      predicted, and to ensure the option of studying correlations between changes in
      spirometry and working indices in patients with COLD a wide range of
      reversibility in FVC was ensured. Eighteen patients (M, 12; F, 6; mean age 68.5
      years) were included in the trial. Mean baseline FEV1 was 0.921 and FVC 2.081.
      Six minutes unpaced walking distance on flat ground (WD) and Brog dyspnoea index
      scale (BS) were used as working indices. Baseline mean WD was 467.9 m, and median
      BS 3.2. No significant difference was found in the effect of terbutaline compared
      to placebo on the spirometry findings or WD. However, BS during exercise improved
      significantly on the terbutaline day. No significant correlation was found
      between changes in working indices and change in spirometry. Thus, the use of
      exercise testing and dyspnoea-scoring may reveal patients who benefit from acute
      bronchodilation without significant improvement in lung function.

PMID- 1615191
TI  - Neonatal respiratory support and lung function abnormalities at follow-up.
AB  - We have investigated if respiratory distress syndrome (RDS) treated by an
      increased inspired oxygen concentration, rather than mechanical ventilation, was
      associated with impaired lung function at follow-up and/or an increase in
      respiratory symptoms. Thoracic gas volume (TGV) and airways resistance (RAW) were
      measured in eight pre-term infants (median gestational age 29 weeks) at 6 and 12
      months of age. The infants had suffered from RDS but had not required mechanical
      ventilation. Their results were compared to 16 other infants, matched for
      gestational age; eight who had required ventilation in the neonatal period and
      eight who had had no RDS. In all three groups the occurrence of respiratory
      symptoms was recorded. The lung function of the infants requiring oxygen in the
      neonatal period was similar to those who had not suffered from RDS, but their
      airways resistance was significantly lower at 6 but not 12 months than that of
      infants ventilated in the neonatal period (P less than 0.05). There was no
      significant difference in recurrent respiratory symptoms between the three groups
      although a greater proportion of the infants ventilated in the neonatal period
      were symptomatic in the first 6 months of life. These results suggest that oxygen
      therapy alone does not result in an impairment of lung function which is
      independent of the effect of prematurity.

PMID- 1615192
TI  - [Pneumologists against smoking].

PMID- 1615193
TI  - [Primary malignant germinal tumors of the mediastinum].

PMID- 1615194
TI  - [Primary malignant germinal tumors of the mediastinum. Results from a national
      retrospective survey].
AB  - The object of this enquiry was to group together a series of patients with a
      mediastinal germ cell tumour who were diagnosed and treated between 1983-1990 to
      specify their clinical characters and their prognostic factors and to evaluate
      the current therapeutic strategies. Out of a total of 87 cases that were analysed
      23 had seminomas and 64 malignant dysembryomas. Amongst the 23 patients suffering
      from seminomas, 8 had first been treated by surgery, 13 by chemotherapy and 2 by
      radiotherapy. At the end of treatment 22 made a complete response and 4 patients
      relapsed after 4-13 months following a complete response. 3 patients had
      metastases at the outset and were alive and in complete response at 1,4 and 7
      years respectively. The survival level at 2 years for seminomas was 84%. Of 64
      patients suffering from a malignant dysembryoma, 19 were first treated with
      surgery (10 by complete resection) followed by chemotherapy in 17 cases. At the
      end of treatment 12 patients were in complete remission. Only one of these
      patients had a subsequent relapse. 45 patients were first treated by chemotherapy
      (10 complete responses, 26 partial responses) then secondary surgery was
      performed in 22 cases, allowing a complete remission in 21. Seven malignant
      dysembryomas relapsed after an initial complete remission. The patients treated
      for pure choriocarcinoma were 7 in number: 6 of these received primary
      chemotherapy. One patient underwent a secondary resection and was living at 26
      months. The other 5 died rapidly. The 2 year survival for malignant dysembryomas
      was 52%. The median survival was 28 months. There was a significant difference in
      surviyal between dysembryomas in complete remission and those in partial
      remission.

PMID- 1615195
TI  - [Mediastinal seminoma. Is it an entity to be treated differently?].
AB  - The evolution of the therapeutic concepts of non seminomatous tumours (T) has
      chemotherapy as the preponderant treatment, and has also led to a different
      approach for mediastinal seminomas. In effect the traditional attitude for as
      complete an excision as possible followed by radiotherapy is in the process of
      changing. Certainly in 20% of cases a complete excision is possible. Post
      operative radiotherapy (30-50 grays) does not seem to change the survival and may
      be questioned in the management of invasive T. The radical debulking surgery of
      varying degrees no longer has a place. The standard treatment of inoperable T has
      remained for some time radiotherapy (35-40 grays). The survival at 5 years for
      these patients is around 60%, very close to the stage IIB seminoma of the
      testicles. If the seminoma seems to be radiosensitive it is also chemo-sensitive
      with an RC less than 80% in advance seminomas and of 90% in mediastinal
      seminomas. Thus there appears to be a contradictory debate; in the absence of
      precise staging of "thymic type" tumour and of randomised trials made difficult
      by the small number of cases one can envisage the following option: In the case
      of an inoperable T radiotherapy alone, excepting in the very bulky forms
      (diameter greater than 50% of the chest) or metastases where primary chemotherapy
      (CT) (4 cycles of VP16-platine) has a place: The treatment of the residual mass
      after CT depends on the size of the latter: less than 3 or equal to 3 cm by
      complementary treatment and greater than 3 cm by secondary surgery and if the
      seminoma is active complementary.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615196
TI  - [Germinal tumors of the mediastinum. Therapeutic strategy, prognosis, biology].
AB  - Mediastinal germ cell tumors have a poor prognosis. Cisplatin containing
      chemotherapy combined with either primary or post-chemotherapy exeresis of the
      disease can induce a 50% cure rate. Acute leukemia is often associated with these
      tumors. In these cases, a clonal evolution from the germ cell tumor has been
      demonstrated.

PMID- 1615197
TI  - [Primary malignant germinal tumors of the mediastinum. Surgical aspects].
AB  - Surgery retains an important place in the treatment of malignant germ cell
      tumours of the mediastinum though in order to achieve complete excision the
      appropriate moment for surgery needs to be chosen carefully. Complete excision,
      which is the great benefit of surgery, is rarely possible as first treatment
      because of the large volume of these tumours and their extension into mediastinal
      vascular structures. Considerable surgical experience is essential in order to
      allow extended incision involving the lung and the large vessels which might
      involve prosthetic replacements. Excepting in situations of great urgency surgery
      usually follows chemotherapy and is used as follows: in patients who appear to be
      in complete remission but who have residual lesions which require eradication,
      and those with malignant tissue which is persisting or more often of a mature
      teratoma which may have a risk of progressing. The return of tumour markers to
      normal values does not guarantee the absence of some residual cancer, in some
      patients with a partial remission complementary surgery may allow a further 20%
      to achieve a complete response, in the absence of a response to chemotherapy,
      surgical excision should be attempted without too long a delay and then followed
      by a different chemotherapy regime.

PMID- 1615198
TI  - [Plasma extravasation in the tracheo-bronchial airways. Mechanisms and
      physiopathological consequences in asthma].
AB  - Plasma extravasation (EP) is an important phenomenon during the course of
      inflammation. In asthmatic subjects, EP is produced not only in the walls of the
      airways, but also in the lumen. This has consequences for the bronchial calibre
      and the qualitative and quantitative characteristics of the secretions. Numerous
      experimental methods have been developed in animals in order to study EP induced
      in the airways by different stimuli. For the most part these are inapplicable in
      man where EP is generally validated in an indirect fashion by measuring the
      quantity of certain plasma proteins, such as albumin in the secretions or the
      bronchoalveolar lavage. EP is linked to an increase in the permeability of the
      vessels, notably this is situated in the subepithelial zone. It is influenced by
      the appearance of disruption between the endothelial cells and possibly amplified
      by an increased blood flow linked to vasodilatation. It is the association of
      these phenomena of epithelial hyperpermeability which favours the appearance of
      EP in the lumen. In experimental systems the greater part of the mediators
      implicated in the pathophysiology of asthma are capable of inducing EP in the
      airways. The perfecting of reliable and non-invasive methods of study is,
      however, necessary to achieve a perfect understanding of the role of EP in the
      pathophysiology of asthma or other inflammatory diseases of the bronchi and to
      assess the efficacy of this parameter of different therapeutic techniques.

PMID- 1615199
TI  - [Inhaled corticosteroids in the treatment of childhood asthma].
AB  - During the last fifteen years, inhaled corticosteroids were increasingly used for
      prophylaxis in childhood asthma. The development of inhaled corticosteroids with
      a high ratio of topical vs systemic potency, now makes possible their use in
      large doses which are needed to control the most severe forms of the disease, in
      order to avoid long term oral corticosteroid treatment for these patients. The
      efficacy of inhaled corticosteroids depends on an optimal pulmonary deposition of
      the drug which is obtained with children by inhaling the drug via a large volume
      spacer. Beyond their beneficial effects on the clinical condition of the patients
      and on pulmonary function, inhaled corticosteroids should improve the long term
      prognosis of asthma, by reducing chronic inflammation in the airways and the
      associated bronchial hyperreactivity. At usual dosages, inhaled corticosteroids
      are free of harmful side effects. However, caution and close observation of
      adrenal function and growth development are required when prescribing inhaled
      corticosteroids at high dosages for a long period. Nevertheless, inhaled
      corticosteroids present very few serious side effects compared with those induced
      by long term oral corticosteroid treatment.

PMID- 1615201
TI  - [Exercise tests in pneumology. C.R.E.D.O].
AB  - Exercise tests have proved very useful in numerous areas such as sports medicine,
      research, clinical medicine and rehabilitation to exercise and therapeutic
      trials. It is not always easy for a pneumologist to decide what sort of effort
      and which protocol to use. There is also the question of which parameter to use
      and the relationship between parameters and which are the most pertinent as a
      function of the aim of the research. Above all the exercise test should be
      adaptable in view of the diversity of the objectives. In routine pneumology the
      exercise test using a bicycle ergometer and a triangular type of protocol are
      recommended for numerous reasons. The usual parameters (ventilation, oxygen
      consumption, production of carbonic dioxide, cardiac rate and blood gases) and
      their derivatives all have a value in the domain of cardiorespiratory physiology.
      It is important in clinical practice not to give too great an emphasis to the
      exact relationship expressed as a function of the workload, because the
      cycloergometer is practically never calibrated or even checked by the user.
      Dyspnoea was the major symptom leading the patient to seek a consultation and it
      is of primary importance that all effort tests include an estimation of the
      sensation of breathlessness.

PMID- 1615200
TI  - [Hyperventilation syndrome: current advances].
AB  - The hyperventilation syndrome has been described for half a century but clearly
      remains underdiagnosed. Its acute manifestation is easily diagnosed ("the tip of
      the iceberg") but its recognition in numerous subtle forms requires a particular
      degree of alertness on the part of the clinician ("the hidden part of the
      iceberg"). The incidence of this syndrome in the general population varies
      according to different authors as between 6-11% and may mimic diverse organic
      disorders. The physiological consequences of hyperventilation are reviewed as
      well as their contribution in the clinical picture. The aetiology of the syndrome
      and its links with organic pathology or psychiatric disturbances continues to be
      debated. Is hyperventilation the expression of abnormal respiratory function or a
      preferred manifestation of anxiety? This article discusses and reviews the
      variety of tests which enable the presumptive diagnosis to be confirmed. The
      response to the proposed treatments is generally excellent when one takes account
      of the numerous possible options. These include comportmental therapies such as
      respiratory re-education, the utilisation of betablockers and psychotrophic drugs
      or psychotherapy.

PMID- 1615202
TI  - [Clinical characteristics and etiology in hemoptysis in a pneumology service. 291
      cases].
AB  - The aim of this work is to determine the clinical characteristics of haemoptysis
      and their principal aetiologies in a retrospective study of 291 cases collected
      over 5 years and occurring in adults who were hospitalised in a pneumology
      service. The annual incidence of haemoptysis was 8.8% of the in-patient
      population. The mean age of the patients was 46 and 47% were less than 50. The
      males were most frequent (69.4%) and haemoptysis was the presenting feature in
      35.4%; it was minimal in 71.1% of average quantity in 26.8% and severe in 2.1%.
      The thoracic radiograph was judged abnormal in all cases and the abnormalities
      noted were suggestive of a particular aetiology in 70.8% of cases. The
      aetiological cause was dominated by bronchial cancer and of active pulmonary
      tuberculosis or its sequalae with levels of 34.4% and 18.9% respectively. For the
      other causes bronchial dilatation was important with 15.1% and hydatic cysts
      another 9.3%. Other aetiologies were represented by bacterial pneumonias with or
      without abscesses 7.2%, pulmonary aspergilloma 6.9%, chronic bronchitis with or
      without emphysema 3.5% and by rare causes in 4 cases. The cause for the
      haemoptysis was not found in 3.1%. This study brings out the preponderant place
      of bronchial cancer as a cause of haemoptysis in a country which still has a high
      prevalence of tuberculosis. Nevertheless the existence of tuberculosis services
      where the greater part of tuberculosis patients are hospitalised explains in part
      the predominance of bronchial cancer increasing very rapidly in our service.

PMID- 1615203
TI  - [Continuous oxygen therapy at home. Observations of oxygen users after an
      instruction program].
AB  - The benefit of continuous domiciliary oxygen therapy (OCD) directly depends on
      the number of hours the oxygen is used daily. The observance of a correct regime
      is rarely met at present. For this reason we have done a prospective study for 24
      months, assessing the compliance of 64 patients from 28 to 82 years of age. All
      these patients received a systematic and personal programme of education for 2
      days in hospital. We subsequently measured, without the knowledge, either of the
      patient or the person caring from them, the quarterly oxygen usage. The mean
      duration of oxygen therapy was 14.7 +/- 3.6 hours. It remained stable during the
      2 years of observation: 51% of the patients achieved a treatment of 15 hours or
      more and 10%, 10 hours or less. We did not find a significant correlation between
      the hours of compliance and the age, sex, FEV1, FVC and PaO2 or haemoglobin
      saturation. A significant statistical correlation with the PaCO2 was obtained.
      The more educated patients had better compliance levels than those of lesser
      education. The results obtained were better than those found in the literature at
      the present time. Perhaps it is explained by the level of education given. It
      cannot be excluded, however, that our severe criteria for the prescription of OCD
      has selected a population which was more susceptible to achieving good
      compliance. However, these results encourage the initiation of another
      prospective study using a control group to make a better assessment of the impact
      of education on the patient and his carers by the improved compliance in OCD.

PMID- 1615204
TI  - [Value of high resolution tomodensitometry in pulmonary histiocytosis X.
      Radiological, clinical and functional correlations].
AB  - Histiocytosis is a rare cause of diffuse interstitial pneumonia. Its aetiology is
      not known and the outcome is often unsatisfactory. In 10 subjects in whom the
      diagnosis of histiocytosis X was established at CHU in Grenoble, 7 could be
      followed up. We report the clinical, functional, radiological and high resolution
      tomographic data on these 7 subjects suffering from histiocytosis X and followed
      up for a period between 3 and 13 years (8 +/- 3 years). All the subjects were
      symptomatic at the time of diagnosis. The clinical outcome amongst the 10
      subjects included 2 patients who died, 2 who stabilised, 1 worsened and there
      were 4 clinical cures, 1 patient was lost to follow up. The respiratory function
      tests of the 7 subjects who were followed up was characterised by the appearance
      of airflow obstruction and a significant fall in the DLCO/VA (KCO) of 68 +/- 17%
      of the predicted value to 43 +/- 13%. An analysis comparing the initial pulmonary
      radiography to the current films showed that the reticular nodular lesions tended
      to progress to a diminution in size, while there was an increase in the
      reticulation. The high resolution computed tomography was confirmed as better
      technique than pulmonary radiography in detailing the cystic and nodular lesions.
      This was the only examination which correlated with DLCO/VA (R: 0.8; p: 0.018). A
      progressive model for computed tomographic lesions is proposed. Computed
      tomography appears to be the key examination, orientating the diagnosis based on
      the association of the nodules and cysts and enabling a better appreciation of
      the severity of the pulmonary disease taking account of its excellent correlation
      with diffusion.

PMID- 1615205
TI  - [Treatment of empyema and pyopneumothorax of infectious origin and chronic
      evolution by drainage-lavage with iodized polyvinylpyrrolidone].
AB  - Thirty five patients, twenty nine men and six women with a mean age of twenty six
      and suffering from a pyothorax 23% or a pyopneumothorax 77% of whom 41% had a
      bronchopleural fistula on chronic evolution (greater than one month before
      drainage), had been treated using drainage and lavage with iodised
      polyvinylpyrrolidine without local or general antibiotics. This treatment enabled
      thirty four patients to be cured with some moderate radiological sequelae, a 50%
      restitution "ad integrum". The importance of the sequelae was correlated with
      increased aged (P less than 0.001), a delay before drainage (P less than 0.001)
      and a prolonged duration of drainage (P less than 0.01), to multiple organisms (P
      less than 0.01) and the presence of a pneumothorax (P less than 0.02) and to a
      tuberculous origin of the effusion (P less than 0.01). These two latter factors
      were the cause of a prolongation of the duration of drainage (P less than 0.01).
      Tuberculous patients who on average were older (P less than 0.05) and had a
      prolonged period of drainage (P less than 0.01) presented with major immediate
      radiological sequelae (P less than 0.01). In conclusion the technique of drainage
      using iodised polyvinylpyrrolidine gave excellent results in cases of non
      tuberculous pyothorax in young subjects, but gave less impressive results in
      subjects suffering from tuberculosis, because of the significant radiological
      sequelae.

PMID- 1615206
TI  - [Use of intravenous adrenalin in severe acute asthma].
AB  - The efficacy of and tolerance to intravenous Adrenaline (IV) have been assessed
      in cases of acute severe asthma (AAG). From January 1983 to March 1990 there were
      56 episodes of AAG treated by intravenous Adrenaline using an average dose of
      0.33 microgram per kilogramme per minute, in association with intravenous steroid
      therapy and Aminophylline (0.6 mg/kg per hour). A group of 12 patients were
      ventilated before admission and were excluded from the study. Two groups were
      defined on the basis of their admission PaCO2: Group A with 30 episodes of AAG
      and a PaCO2 above 45 mm of mercury, Group B with 14 episodes of AAG and a PaCO2
      of less than 45 mm of mercury. The clinical improvement was equally rapid in both
      groups on average 8.7 (plus or minus 8.2) hours in Group A and 14.6 (plus or
      minus 15.7) hours in Group B. Artificial ventilation was only required in 2.3% of
      cases (7% in Group A and none in Group B). Treatment using intravenous Adrenaline
      is well tolerated as is shown by the absence of any worsening of the tachycardia,
      the significant fall in blood pressure after correcting the PaCO2 in Group A and
      the absence of any raised blood pressure in Group B. In conclusion, treatment
      with intravenous Adrenaline associated with IV Theophylline and IV
      corticosteroids based on the fact of its rapid action and that it is well
      tolerated, means that this drug should be considered as part of the therapeutic
      arsenal during acute severe asthmatic attacks in patients who are breathing
      spontaneously.

PMID- 1615207
TI  - [Follicular bronchiolitis: a pediatric case report].
AB  - A case of bronchiolitis of insidious evolution appearing in an unweened infant
      aged six months is reported. Initially an acute episode of bronchial obstruction
      was followed by respiratory failure with failure to thrive. The total inefficacy
      of conventional treatment (corticosteroids, nebulised and oral bronchodilators)
      led to assisted ventilation for three weeks, four months after the onset of
      symptoms. All investigations aimed at achieving a diagnosis were negative and
      this led to an open lung biopsy. This showed characteristic lesions of
      bronchiolitis and follicular bronchitis without other parenchymatous disease.
      With continuous antibiotics and physiotherapy the respiratory status improved,
      both clinically and radiologically. Amongst the explanations of the
      pathophysiology of follicular bronchitis they also discussed the existence of
      heterozygous delta F 508 in their observation to explain the chronicity of the
      problems. They stress the need to look for a mutation of delta F 508 in infants
      who present with unexplained obstructive bronchial pathology.

PMID- 1615208
TI  - [A case of congenital pulmonary varices].
AB  - Pulmonary varices are rare disorders (only 72 published cases), and are most
      often congenital in origin, asymptomatic and have a benign outcome. In some cases
      the appearance of varices is favoured by pulmonary venous hypertension which is
      most often related to mitral valve disease, or it is associated with other
      vascular or bronchial malformations. We present a new case of isolated pulmonary
      varices occurring in an asymptomatic young woman aged 20. The pulmonary
      radiological abnormality was confirmed using computed tomography which showed
      that the abnormality was both of vascular origin and of venous composition.
      Digital subtraction angiography during the venous phased confirmed the diagnosis.
      There was no associated cardiomyopathy, nor any bronchial or vascular
      malformation. No surgical intervention was taken, nor was there any clinical or
      radiological change observed during follow-up over one year. The diagnosis of
      pulmonary varices is an important one to make, particularly to avoid an
      unnecessary thoracotomy, but there should always be a systemic search for
      associated anomalies.

PMID- 1615209
TI  - [Diagnosis of an unusual thoracic opacity].

PMID- 1615210
TI  - [A dyspnea of unusual cause in a chronic bronchitis patient].

PMID- 1615212
TI  - [Pneumology Society of French Language. List of members 1992].

PMID- 1615211
TI  - [A historical case of disseminated tuberculosis].

PMID- 1615213
TI  - Peptides in oncology I. LH-RH agonists and antagonists.

PMID- 1615214
TI  - Gonadotropin-releasing hormone: physiological and endocrinological aspects.

PMID- 1615215
TI  - LH-RH antagonists: state of the art and future perspectives.

PMID- 1615216
TI  - Treatment of uterine leiomyomata by LH-RH agonists.

PMID- 1615217
TI  - On the management of metastatic prostate cancer with LH-RH analogs.

PMID- 1615218
TI  - Combination therapy with flutamide and castration (orchiectomy or LH-RH agonist)
      in untreated patients with advanced prostate cancer.

PMID- 1615220
TI  - Treatment of endometrial cancer with GnRH analogs.
AB  - Given the small number of side effects, GnRH may be a useful and ideal drug for
      new therapeutic hormonal approaches in many cases of both invasive and
      noninvasive endometrial cancer. The hypoestrogenic state thus induced as well as
      a local effect may lead to pronounced regression of the tumor. Any future therapy
      should, however, always be tailored to meet individual needs. The use of GnRH
      agonists may be advocated in the following circumstances: 1. In pronounced
      endometrial hyperplasia and adenomatous hyperplasia (particularly relevant in
      those cases where hysterectomy is not desirable, e.g., in young patients who have
      not yet completed their families). 2. In patients with endometrial cancer where
      surgery is contraindicated or refused. 3. In addition to or as a substitute for
      radium treatment preoperatively to reduce uterine volume (myomas) to make surgery
      technically easier; to devitalize the tumor, stop menorrhagia, and improve
      anemia. 4. In advanced cases as an adjunct to radiotherapy and gestagens. It is
      possible that this will produce synergistic effects. 5. As adjuvant treatment
      (replacing gestagens?) in primary stages. 6. In relapses of endometrial cancer,
      refractory to conventional therapy, and in pulmonary metastases.

PMID- 1615219
TI  - LH-RH agonists in the treatment of ovarian cancer.

PMID- 1615221
TI  - Direct antitumor effects of LH-RH analogs.

PMID- 1615222
TI  - LH-RH agonists in the treatment of metastatic breast cancer: ten years'
      experience.

PMID- 1615223
TI  - LH-RH agonists in the treatment of premenopausal patients with advanced breast
      cancer.

PMID- 1615224
TI  - Modelling steady state pulmonary elimination of He, SF6 and CO2: effect of
      morphometry.
AB  - We studied the influence of acinar morphometry on the shape of simulated
      expirograms computed from a single path convection-diffusion model that includes
      a source term for gas evolution from the blood (Scherer et al., J. Appl. Physiol.
      64: 1022-1029, 1988). Acinar structure was obtained from published data of 3
      different lung morphometries. The simulations were performed over a range of
      tidal volumes (VT) and breathing frequencies (f) comparable to those observed in
      a previously reported human study. Airways dead space (VDaw) increased with VT in
      all the morphometric models tested and in the experimental data. The increase in
      VDaw with VT was inversely related to the diffusivity of the evolving gas and to
      the rate of increase in airway cross-section of the most mouthward (proximal)
      alveolated generations of the models. Normalized phase III slope for all the
      gases decreased with increasing VT in all the models as was previously reported
      for healthy human subjects. In the model simulations, the greatest sensitivity of
      phase III slope to VT was seen with the least diffusible gas using the airway
      morphometry with the smallest cross-sectional areas in the proximal alveolated
      generations. We conclude that both VDaw and phase III slope of an evolving gas
      are sensitive to the geometry of the proximal acinar airways and that this is
      manifest by their dependence on tidal volume, breathing frequency, molecular
      diffusivity and alveolar/blood source emission rate. The model simulations
      indicate that heterogeneity of gas washout is not required to explain the
      magnitude of the phase III slope in healthy human subjects.

PMID- 1615225
TI  - The effect of vagal stimulation on the distribution of inspired gas in the lungs.
AB  - We investigated the direct effects of efferent vagal activity on the distribution
      of inspired gas by stimulating the vagus nerve of one lung and measuring the
      topographic distribution of a radioactive tracer (133Xe) to both lungs. The
      distribution of inspired (133Xe) boli was measured with NaI scintillation
      detectors placed apex-base over each posterior lung of intubated, paralyzed,
      anesthetized dogs. In 7 supine dogs vagal stimulation reduced the distribution of
      rapidly insufflated 133Xe boli (flow greater than 2.5 L/s) to the test lung (P
      less than 0.02), but not when boli were insufflated slowly (flow less than 0.5
      L/s), suggesting that vagal stimulation affects pulmonary gas distribution
      primarily by increasing airway resistance and not through changes in lung
      compliance. The effect of vagal stimulation on the regional apex-base
      distribution of inspired gas (greater than 2.5 L/s) was measured in 7 supine and
      5 upright dogs. In the supine position, vagal stimulation did not change the
      uniform apex-base bolus distribution, whereas in the upright position less of the
      bolus was distributed to the middle and lower lung regions (P less than 0.043),
      compared to control measurements. This indicates that the regional effects of
      vagal stimulation on the distribution of inspired gas are uniform in the supine
      position, but that vagal stimulation alters the distribution of inspired gas when
      the apex-base pleural pressure gradient is increased.

PMID- 1615226
TI  - Spike trains from single motor units in human parasternal intercostal muscles.
AB  - Recordings of single motor unit activity were obtained from parasternal
      intercostal muscles of normal humans during quiet breathing. Spike trains from 52
      individual motor units were analyzed. All these units were low threshold ones,
      recruited at low inspired volumes and therefore at low tension thresholds. Mean
      frequency of firing at onset was 7.8 Hz and mean increase in frequency through
      the breath was 3.6 Hz. Onset and peak frequencies were positively correlated with
      inspiratory flow rate. Alternation of interspike intervals between long and short
      was found in the spike trains of 6 of 13 units tested and this occurred at
      frequencies of 6-12/s. Doublet discharges at the beginnings of spike trains were
      seen during voluntary neck flexion but never in quiet breathing or voluntary deep
      breaths. The pattern of activity in these human intercostal motor units was
      similar to that reported for low threshold, slow twitch units in other mammalian
      skeletal muscles, including respiratory muscles.

PMID- 1615227
TI  - Effects of different levels of end-tidal PO2 on ventilation during isocapnia in
      humans.
AB  - The purpose of this investigation was to examine how the ventilatory decline
      observed during sustained, eucapnic hypoxia (HVD) is affected by different levels
      of hypoxia. Six subjects were each studied 3-6 times at each of 5 different
      levels of isocapnic hypoxia (end-tidal PO2 equal to 45, 50, 55, 65 and 75 Torr)
      in random order. The following variables were linearly related to saturation: (1)
      the rapid increase in ventilation at the onset of hypoxia; (2) the decline in
      ventilation over the period of hypoxia; and (3) the undershoot in ventilation
      below the pre-hypoxic control values at the relief of hypoxia. The rapid decrease
      in ventilation at the relief of hypoxia, however, was not linearly related to
      saturation. The mean time to peak ventilation was 2.13 +/- 0.07 min (+/- SE) at
      the onset of hypoxia, which was significantly longer (P less than 0.05) than the
      time to minimum ventilation at the relief of hypoxia of 1.23 +/- 0.18 min. The
      recovery from the undershoot in ventilation was 95% +/- 3% complete after 5 min,
      whereas the recovery in sensitivity to hypoxia was only 35% +/- 13% complete
      after 5 min of euoxia.

PMID- 1615228
TI  - The chaotic behaviour of resting human respiration.
AB  - The study of non-linear mathematics has led to the concept of an attractor that
      can confine to within certain boundaries the path traced out in multidimensional
      space when a variable is plotted against itself delayed by various lag times. The
      type of attractor present can be determined by monitoring the exponential rate
      (called a Lyapunov exponent) at which almost identical values within a time
      series become dissimilar. Lyapunov exponents estimated from data collected during
      the normal resting breathing of eight adults were all positive, end-tidal PCO2
      had the lowest Lyapunov exponent (0.06 +/- 0.01 bits/s; Mean +/- SE), breath and
      expiratory duration had the highest exponents (0.23 bits/s). The results indicate
      that resting respiration is chaotic. This chaotic behaviour may allow fast and
      flexible responses to sudden changes, allow if necessary complete readjustment of
      the control parameters, and may be involved in the phase locking of respiration
      to external stimuli.

PMID- 1615229
TI  - Properties of postganglionic sympathetic neurons with axons in phrenic nerve.
AB  - The aim of the study was to test the reflex and resting properties of
      postganglionic sympathetic neurons with axons located in the right phrenic nerve.
      The experiments have been performed on chloralose-anesthetized cats with both
      vago-aortic nerves cut. The somata or the postganglionic sympathetic neurons were
      located in the stellate ganglion. Axons of these neurons passed through the upper
      and lower phrenic nerve roots and through the phrenic nerve itself. The presence
      of cardiac and respiratory rhythmicities was detected in the activity of the
      phrenic postganglionic sympathetic neurons. Hyperventilation, which abolished
      burst discharges of the phrenic nerve, decreased the sympathetic activity by 14%.
      Systemic hypoxia (ventilating the animals for 2 min with 8% O2 in N2) increased
      the sympathetic activity threefold. The results of our experiments suggest that
      axons of the sympathetic neurons located in the right phrenic nerve could
      possibly be diaphragmatic muscle vasoconstrictors.

PMID- 1615230
TI  - The effect of blood flow and left atrial pressure on the DLCO in lambs and sheep.
AB  - Previous studies suggest that pulmonary capillary distensibility and recruitment
      may differ in lambs and sheep. To study the effect of pulmonary blood flow (PBF)
      and vascular pressure on capillary hemodynamics in lambs and sheep we measured
      the diffusing capacity for carbon monoxide (DLCO) as an index of pulmonary
      capillary blood volume during a baseline period, after increasing PBF, and during
      left atrial hypertension. In the lamb, DLCO did not change significantly either
      with a 65% increase in PBF or with an increase in left atrial pressure (Pla) of
      1.33 kPa at constant PBF. In the sheep on the other hand, doubling PBF led to a
      28% increase in DLCO (P less than 0.02), and an increase in Pla of 1.87 kPa at
      constant PBF led to a 19% increase in DLCO (P less than 0.01). These results
      suggest that the neonatal lamb has a nearly fully recruited and relatively non
      compliant pulmonary capillary bed at rest, unlike the adult sheep which can
      respond to hemodynamic changes with distension and recruitment of the pulmonary
      capillary bed.

PMID- 1615231
TI  - Effects of muscle temperature on the VO2 kinetics at the onset of exercise in
      man.
AB  - The kinetics (i.e. the rate of readjustment) of O2 uptake (VO2) at the mouth of
      muscle blood flow in the vastus lateralis muscle (Qm), and the net accumulation
      of lactate in the rest-to-exercise transient (early lactate) were assessed in 6
      untrained men (age 31 +/- 8 (SD) yrs) during constant-load 5-min duration
      exercises on the cyclo ergometer of 75 and 125 W, performed at muscle
      temperatures (Tm) of 35.5 +/- 0.9 degrees C (N) and of 28.0 +/- 1.65 degrees C
      (C). VO2 was measured breath-by-breath; Qm was assessed from 133Xe clearance;
      early lactate was calculated as the difference between the venous lactate
      concentrations observed after and before exercise. At both work loads, steady
      state VO2 was slightly higher in N than in C (P less than 0.05 at 75 W; NS at 125
      W). The half-times of VO2 kinetics were: in N, 36.2 +/- 6.7 s at 75 W and 41.6 +/
      8.6 s at 125 W; in C, 41.4 +/- 10.0 at 75 W and 43.8 +/- 14.0 at 125 W (NS).
      Mean steady state Qm was 8.5 ml.min-1.100 g-1 in C, and 13.4 in N at 75 W (NS);
      at 125 W, Qm was 18.3 ml.min-1.100 g-1 in C vs. 25.0 in N (NS). The half-times of
      the Qm kinetics tended to be slower in C than in N (NS). At both work loads,
      early lactate was slightly greater in C than in N (NS). It is concluded that, at
      submaximal exercise, (a) steady state VO2 and the VO2 kinetics are not affected
      by Tm, and (b) at the onset of exercise Qm does not affect VO2 kinetics.

PMID- 1615232
TI  - Acclimatization to hypoxia alters cerebral convective and diffusive O2 delivery.
AB  - Ventilatory acclimatization (VA) to hypoxia alters cerebrovascular responses to
      arterial blood gas perturbations. For example, after VA, cerebral blood flow
      (CBF) is elevated, at a given arterial CO2 tension (PaCO2), compared to CBF
      before VA. This experiment examined the effects of VA to 72 h of normobaric
      hypoxia [arterial O2 tension (PaO2) approx. 40 mmHg, O2 saturation in arterial
      blood approx. 50%] on total and regional cerebrovascular resistance (CVR and
      rCVR) and cerebral O2 extraction fraction (OEF) in 32 conscious sheep. Four
      different O2-CO2 gas combinations were sequentially administered to each sheep
      before and after VA. CVR and rCVR were calculated from CBF (radiolabeled
      microspheres) and arterial and cerebral downstream pressures; OEF was calculated
      from arterial and cerebral venous O2 contents. After VA, during hyperoxia, CVR
      and rCVR tended to be lower during both hypocapnia and hypercapnia. During
      hypoxia, although CVR and rCVR were slightly less during hypocapnia, CVR and rCVR
      during hypercapnia were surprisingly increased. The post-VA increases in mean CVR
      and mean rCVR during hypoxic gas combinations differed from the post-VA decreases
      during hyperoxic gas combinations (0.04 less than or equal to P less than or
      equal to 0.11). In contrast, although VA decreased OEF during three of four gas
      combinations (P less than or equal to 0.003), there was a greater mean post-VA
      decrease in OEF during hypercapnic gas combinations than during hypocapnic gas
      combinations (P = 0.025); decreases in OEF were correlated with decreases in
      cerebral O2 consumption. The post-VA CVR responses may reflect altered
      neurocirculatory control by the arterial chemoreflex; the OEF responses suggest
      relative cerebral hyperperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615233
TI  - Cardiovascular responses to hypoxia in the hagfish, Eptatretus cirrhatus.
AB  - Simultaneous measurements of cardiac output (Q), blood pressures and blood gases
      were made in the hagfish, Eptatretus cirrhatus, during exposure to hypoxia. The
      partial pressure of oxygen in the medium (PIO2) was reduced from 20.7 kPa to 8.0
      kPa and then lowered to 5.3 kPa. At a PIO2 of 5.3 kPa there was a 40% increase in
      Q. Part of the increase may have been due to the increased activity of the animal
      at low PIO2. In recovery, when the animals were inactive, Q continued to rise to
      160% of the control values. At 5.3 kPa, oxygen consumption (as determined by the
      Fick principle) fell to 29% of the normoxic value and was associated with
      increased branchial vascular resistance (Rg) and an increased diffusion
      limitation of the gills (Ldiff). Adrenaline increased heart rate and aortic blood
      pressures. Increased Rg and Ldiff could be provoked in normoxia by the injection
      of the beta-adrenergic blocking drug propranolol. We suggest that catecholamines
      may be involved in the tonic control of gill vasomotor tone.

PMID- 1615234
TI  - The human immunodeficiency virus, type 1: the virus and its role in neurologic
      disease.

PMID- 1615235
TI  - Epidemiology of human immunodeficiency virus infection and the neurologic
      complications of the infection.

PMID- 1615236
TI  - Human immunodeficiency virus-related cognitive impairment and the acquired
      immunodeficiency syndrome dementia complex.

PMID- 1615237
TI  - Management of neurologic opportunistic disorders in human immunodeficiency virus
      infection.

PMID- 1615238
TI  - Neuromuscular complications of human immunodeficiency virus infection.
AB  - As the lifespan of patients with HIV infection is prolonged with more effective
      antiviral therapies, the prevalence of neuromuscular disorders is likely to
      increase. The understanding of the pathogenesis and optimal therapy of these
      illnesses has advanced during the past 5 years. However, there are still
      significant gaps in our knowledge. It is important that neurologists remain at
      the forefront of investigation and treatment of these complex disorders.

PMID- 1615239
TI  - Syphilis and human immunodeficiency virus infection.

PMID- 1615240
TI  - Neurologic manifestations of pediatric acquired immunodeficiency syndrome:
      clinical features and therapeutic approaches.

PMID- 1615241
TI  - Brain imaging in human immunodeficiency virus infection.

PMID- 1615242
TI  - "A common geography of the mind": physicians in AIDS literature.

PMID- 1615243
TI  - Doctor vector.

PMID- 1615244
TI  - Pretransplant evaluation and outcome.

PMID- 1615245
TI  - Need, demand, and supply in kidney transplantation: a review of the data, an
      examination of the issues, and projections through the year 2000.

PMID- 1615246
TI  - Pancreas transplantation.

PMID- 1615247
TI  - Trends and concepts in the prescription and delivery of dialysis in the United
      States.

PMID- 1615248
TI  - Commonly measured laboratory variables in hemodialysis patients: relationships
      among them and to death risk.

PMID- 1615249
TI  - Comparison of treatment costs between dialysis and transplantation.

PMID- 1615250
TI  - Extrarenal manifestations of autosomal dominant polycystic kidney disease.

PMID- 1615251
TI  - Fluid replacement during exercise in the heat. Review and recommendations.

PMID- 1615252
TI  - Physiological adaptations to velocity-controlled resistance training.
AB  - The force-velocity characteristics of skeletal muscle are such that maximal force
      is inversely related to the velocity of shortening. This relationship has been
      observed using isolated muscle preparations and intact muscle groups (e.g. knee
      extensors). Isokinetic dynamometry has revealed some specific physiological
      adaptations to different velocities of training: an increase in torque and power
      that are greater at or near the velocity of training; a transfer of torque gains
      to slower and faster angular velocities after intermediate velocity resistance
      training; increases in maximal oxygen consumption and cardiac output in response
      to circuit training; increases in anaerobic power output; changes in skeletal
      muscle size and changes in myofibrillar ATPase activity; and new applications for
      rehabilitation of muscular and ligamentous injuries, and post-coronary patients.

PMID- 1615254
TI  - Softball injuries. Aetiology and prevention.
AB  - Over 40 million individuals nationally participate in organised softball leagues,
      playing an estimated 23 million games per year in the United States. It has also
      been estimated that softball causes more injuries leading to emergency room
      visits in the United States than any other sport. Between 1983 and 1989, over 2.6
      million injuries were documented through selected emergency rooms throughout the
      United States. In addition, the potential costs of these injuries can be
      staggering, therefore, prevention is of utmost importance. Prior to
      implementation of any preventative measures, the aetiology and distribution of
      injuries must be ascertained. Softball-related injuries can be grouped into 3
      categories: (a) sliding-related injuries--the most common injury scenario; (b)
      collision-related injuries; and (c) falls sustained by the player. Various
      preventative approaches have been utilised to reduce the incidence of these
      recreational sports injuries and the associated health care costs. In regard to
      sliding-related injuries, breakaway bases have been utilised and have been found
      to reduce sliding-related injuries by approximately 98%. In reference to
      collision injuries, deformable walls and padded back stops and field maintenance
      have been found to prevent the majority of injuries secondary to collisions and
      falls. In addition, better coaching techniques as well as stretching and
      conditioning programmes have all been found to benefit players in the prevention
      of their injuries. As physicians, trainers and individuals involved with sporting
      activities, it is imperative that we turn and focus our attention on prevention.
      The cornerstone to diminished injuries and subsequent prevention of an injury is
      a safer environment for the recreational softball player to participate in.

PMID- 1615255
TI  - Return-to-work evaluation after coronary events. Special emphasis on simulated
      work activity.

PMID- 1615253
TI  - Body fat assessment in women. Special considerations.
AB  - Methods of in vivo body fat estimation are based on simple assumptions about body
      composition which work reasonably well for men, while estimations in women have
      been largely extrapolated from the male studies so that women are treated as men
      with just more of the same fat. Compared to men, fat regulation in women is
      considerably more elaborate, with more and different sites for storage and a
      larger proportion of fat distributed to the extremities and in subcutaneous
      locations. Thus, a ratio of waist-to-hips girth which reflects increasing fatness
      in men only specifies 2 different extremes of a broader spectrum of possibilities
      for fat distribution in women. This complicates anthropometric prediction of
      total fatness and clearly limits the generalisability of any female equations.
      Anthropometric methods are further confounded by difficulties in the criterion
      methods against which they are developed. For example, the validity of
      assumptions about the fractional contributions of bone mineral and body water to
      fat-free mass and density may not hold through the reproductive cycles. Women
      athletes involved in weight-bearing or strength training may increase bone
      mineral content above average values but if they become amenorrhoeic, bone
      mineral density may fall significantly below average values. Fit premenopausal
      women distribute fat differently and have a higher bone mineral content than
      unfit postmenopausal women. Genetic factors which also affect criterion method
      assumptions in men are superimposed on these additional complications in women.
      Body fat in female athletes extends across almost the entire range of female
      fatness, with some of the lowest measurements in distance runners and body
      builders which fall into the normal male range, but also with some relatively
      high values in swimmers and strength athletes, which would classify these women
      as obese by male standards. Thus, total body fat reflects a more complex
      regulation and has a different meaning to health and performance in women than it
      does for men. Predictive equations for women athletes should be developed with a
      view to the specific group and ultimate purpose to which they will be applied.

PMID- 1615256
TI  - Biomechanics of sprint running. A review.
AB  - Understanding of biomechanical factors in sprint running is useful because of
      their critical value to performance. Some variables measured in distance running
      are also important in sprint running. Significant factors include: reaction time,
      technique, electromyographic (EMG) activity, force production, neural factors and
      muscle structure. Although various methodologies have been used, results are
      clear and conclusions can be made. The reaction time of good athletes is short,
      but it does not correlate with performance levels. Sprint technique has been well
      analysed during acceleration, constant velocity and deceleration of the velocity
      curve. At the beginning of the sprint run, it is important to produce great
      force/power and generate high velocity in the block and acceleration phases.
      During the constant-speed phase, the events immediately before and during the
      braking phase are important in increasing explosive force/power and efficiency of
      movement in the propulsion phase. There are no research results available
      regarding force production in the sprint-deceleration phase. The EMG activity
      pattern of the main sprint muscles is described in the literature, but there is a
      need for research with highly skilled sprinters to better understand the
      simultaneous operation of many muscles. Skeletal muscle fibre characteristics are
      related to the selection of talent and the training-induced effects in sprint
      running. Efficient sprint running requires an optimal combination between the
      examined biomechanical variables and external factors such as footwear, ground
      and air resistance. Further research work is needed especially in the area of
      nervous system, muscles and force and power production during sprint running.
      Combining these with the measurements of sprinting economy and efficiency more
      knowledge can be achieved in the near future.

PMID- 1615258
TI  - Factors related to the incidence of running injuries. A review.
AB  - The term incidence is interpreted in many different ways in the literature.
      Running injury epidemiology should include denominator-based incidence rates, in
      which the number of new injuries observed during 1 year is related to the
      population of runners at risk. In 10 studies with denominator-based incidences
      selected from the literature, the annual incidence rates of injured runners vary
      from 24 to 65%. Comparison of denominator-based incidence rates from different
      studies requires a discussion of the denominator and of the numerator; i.e. the
      study population and the definition of running injury. Injury definitions differ
      from one study to another. Study populations are particular subgroups of the
      total running population and they differ from one study to another. Subgroups may
      differ in origin: volunteers, runners from a mailing list or entrants of a road
      race. Incidence rates are higher among supervised volunteers than among listed
      runners, and higher among both these groups than among race-entrants. The choice
      from the universe of the running population and the used injury definition are
      methodological issues. Incidence is dependently associated with the prevalence of
      predisposing running injury factors. There is consistent epidemiological support
      for the role of a few aetiological factors; i.e. higher mileage per week,
      previous running injury, higher running speed and lesser running experience.
      Higher mileage per week is probably the strongest predictor. In the selected
      injury studies, mileage per week differs from one study population to another.
      Differences in mileage per week do not explain differences in incidence rate
      between these studies. In conclusion, caution must be taken when comparing annual
      incidence rates of different studies. Methodological issues are at least as
      important as aetiological factors. Study populations may refer to different
      selections of the universe of the running population. The lengths of observation
      periods and 'running injury' definitions may differ from one study to another.

PMID- 1615259
TI  - Meniscal injury in the anterior cruciate-deficient knee. A rationale for clinical
      decision-making.
AB  - Meniscal injury is common in acute or chronic anterior cruciate ligament
      insufficiency. The patterns of meniscal lesions are predictable in the acute and
      chronically unstable knee. The early incidence of meniscal injury is high and
      increases with time. Meniscal repair has become increasingly successful.
      Techniques for anterior cruciate ligament reconstruction have also improved, and
      with more progressive rehabilitation programmes, this has become a more tolerable
      procedure for both patients of highly athletic lifestyles and more moderate
      recreational athletes. The decision-making process for the sports medicine
      physician requires an overall assessment of many variables. A delicate balance of
      factors such as age, sex, joint laxity, activity level, individual motivation,
      social circumstances, associated meniscal, collateral ligament and/or chondral
      damage may sway the surgeon towards a nonoperative or operative decision. At the
      present time, a 'cook book' answer to each case presented is not available. As in
      all of medicine, each patient is an entity that requires an individual evaluation
      and a specific course of treatment. This review aims to help in this decision
      making process. Future prospective studies investigating the many variables
      mentioned will hopefully objectively delineate guidelines for the choice of the
      most effective therapeutic regimen.

PMID- 1615260
TI  - Tumor registrar's role in TNM staging.
AB  - The role of the tumor registrar in TNM staging has not been clearly defined. This
      paper shows how this can be clarified in individual hospital cancer programs and
      how the tumor registrar serves as a key member of the cancer team in implementing
      physician TNM staging.

PMID- 1615257
TI  - Effects of physical activity on some components of the skeletal system.
AB  - Sporting activities impose on the skeletal system forces of a high intensity and
      frequency. Ligaments, bone and tendons behave in a time-dependent load-extension
      fashion, and it is important for both scientists and clinicians to consider, for
      example, the alterations in failure properties shown by ligaments, tendons and
      bone at different rates of deformation. Whether the ability of the skeletal
      system to withstand stress can be improved with appropriate training is still
      controversial. The effects of physical exercise depend on the modality, intensity
      and duration with which the exercise itself is performed. Moreover, genetic
      factors, also influencing growth and hormonal status, may exert a significant
      influence on the response of a given tissue to an external load. Overloading may
      cause a lesion, and this may decrease or annihilate performance capability. The
      skeletal system may not be resistant enough, and so it may prove limiting to
      intensive physical activity. In vitro studies on resistance of a single tissue
      have not taken into consideration the specific resistance of that structure in
      vivo, and the results so obtained cannot be readily extrapolated to sporting
      activities, as in vivo muscles, joints, tendons, ligaments and cartilage act as
      one. This article reviews some of the possible beneficial and detrimental effects
      of intense exercise on various components of the skeletal system, focusing on its
      ability to withstand and adapt to stresses and allow maximal performance.

PMID- 1615262
TI  - Cancer staging.

PMID- 1615261
TI  - Cancer staging: future directions for the TNM classification.
AB  - The major accomplishment of the 1987 edition of the TNM classification was the
      unification of criteria for all site classifications, namely, the elimination of
      all variations that had developed over the years. The main directions that TNM is
      taking for the future are 1) verification of published classifications, 2)
      classification of new sites and tumor types, 3) addressing the integration of
      nonanatomic factors with TNM to achieve prognostic grading, and 4) application of
      TNM beyond pure clinical-pathological aspects to assess methods of early
      detection, quality of care, and population trends.

PMID- 1615263
TI  - Cancer staging.

PMID- 1615264
TI  - Survival results depend on the staging system.
AB  - The results of expressing patient outcome are compared using two staging systems:
      localized, regional, and distant (LRD) and the TNM of the American Joint
      Committee on Cancer (AJCC). Expressing patient outcome depends on the staging
      system used. There is overlap between the stage definitions of the LRD and the
      TNM. A single stage in the LRD may include more than one stage grouping of the
      TNM and vice versa. For most sites, "localized" provides lower survival rates
      than stage I of the TNM. The TNM provides more precise information about
      prognosis because its definitions reflect the latest survival information and
      diagnostic technology. Time trends can be measured only with the LRD because of
      its stability over the years. The precision of the TNM has been achieved at the
      expense of time trend analysis. The LRD is usually not an acceptable end point
      for the assessment of early cancer detection.

PMID- 1615265
TI  - Staging patterns and early cancer detection.
AB  - There is a great deal of indirect, nonexperimental evidence that a pattern of
      earlier-stage disease at diagnosis has a better outcome. Increased early
      detection activities can change, these stage patterns while various biases and
      the question of generalizability need to be kept in mind in their interpretation.
      The indirect evidences of possible benefit from early detection activities
      includes an increase in the number of cases detected, a pattern of more early-
      and less advanced-stage cases, an increase in the overall site-specific survival
      rate, and a decrease in the case fatality rate. Unless these intermediate markers
      are favorable, it is unlikely that early detection will reduce mortality. In
      addition, one should also differentiate a reduced incidence or a change in
      treatment as a cause for reduced mortality.

PMID- 1615266
TI  - Staging of head and neck cancer.
AB  - Revised staging systems for cancers of the upper aerodigestive tract, the major
      salivary glands, and the thyroid are presented. The staging has been accepted by
      both the American Joint Committee on Cancer and the International Union Against
      Cancer and is gaining worldwide acceptance.

PMID- 1615267
TI  - Role and extent of lymphadenectomy for early breast cancer.
AB  - A better understanding of the locoregional and systemic approaches to breast
      cancer over the past decade and one-half has altered the perspective on surgical
      management of the axilla. An increased awareness of the importance of early
      diagnosis and appropriate staging has focused further attention on the extent of
      resection of axillary lymph nodes. Examined here are the anatomy and physiology
      of the axillary lymph nodes, their clinical evaluation, the significance of
      histologic evaluation, a discussion of the procedure's role in staging and
      therapy, and a presentation of the complications of axillary lymph node
      dissection. It is in this light that we discuss the extent of axillary
      lymphadenectomy in early diagnosis of breast cancer.

PMID- 1615268
TI  - How staging directs treatment for esophageal and lung cancer.
AB  - While staging systems may seem complicated and cumbersome at times, they are
      designed to stratify patients into groups by prognosis and treatment. This
      article reviews the staging of lung cancer and esophageal cancer, and it shows
      how this classification translates into different treatment plans based upon this
      staging.

PMID- 1615269
TI  - Staging of colorectal cancer.
AB  - A chronological overview of the various staging systems for colorectal cancer is
      presented in an effort to demonstrate the reason for the current state of
      confusion. The Dukes 1932 system is considered to be the gold standard because of
      its simplicity and accuracy and is the system most often referred to in the
      literature. Number of positive nodes and depth of invasion are two variables that
      have been found to be predictors of survival. In the future, other prognostic
      factors such as nuclear morphology, flow cytometric characteristics, histological
      grade, and vascular or lymphatic invasion may also be entered into the staging
      equation. Use of the TNM system at this time is recommended since it most
      completely describes appropriate prognostic factors and allows conversion of
      other staging systems into a common format. Future modifications could logically
      evolve from the TNM system.

PMID- 1615270
TI  - Sarcoma management based on a standardized TNM classification.
AB  - The proper management of soft tissue sarcomas, that offering the highest cure
      rate while attempting limb sparing should the extremities be involved, requires a
      standard approach best achieved with the TNM classification. Such staging of the
      sarcomatous lesion is based primarily on the histologic grade, followed by size
      and finally histologic classification. The definitive approach is surgical, with
      muscle group dissection employed at all sites, including the extremities, trunk,
      and head and neck region. Radiation therapy alone or in combination with
      chemotherapy improves survival in all high-grade lesions at risk for recurrence.
      Evaluation of the primary and recurrent lesion by computed tomography, magnetic
      resonance when necessary, and angiography offers the best approach for evaluation
      of the lesion in treatment planning.

PMID- 1615271
TI  - [Chorionic villi sampling and prenatal diagnosis].
AB  - The authors report their experience of 790 villous specimens taken either early
      (for 430 cases) or late (360 cases) between 10 and 37 weeks of amenorrhea (WA)
      using a transabdominal syringe. In the early choriocentesis cases, they conclude
      that use of the transabdominal route after 12.5 WA, regardless of the position of
      the chorion, makes it possible significantly to reduce the rate of fetal loss
      which becomes similar to that for amniocentesis. Placentocentesis has been used
      at later stages, either for high-risk couples as an alternative to amniocentesis
      (183 cases), or in cases of ultrasound abnormalities (177 cases) as an
      alternative to amniocentesis or cordocentesis. Placentocentesis makes it possible
      to obtain the fetal karyotype very rapidly within 1 to 2 days.

PMID- 1615272
TI  - [Induction in the scarred uterus].
AB  - Labor was induced in 41 women with uterine scarring and a fetus in the cephalic
      presentation and normal pelvis size. Due to various problems, these patients
      would have had to undergo cesarean section if this alternative had not been
      attempted. The use of prostaglandins E2 to increase maturation of the cervix, of
      Syntocinon and peridural analgesia made it possible to obtain delivery through
      the genital tract in 24 cases with the same level of fetal morbidity as for the
      babies delivered by cesarean.

PMID- 1615273
TI  - [Perineal rehabilitation of female urinary incontinence. Long term results].
AB  - The results of perineal rehabilitation in 101 women with urinary incontinence are
      evaluated with a follow-up of 18 months (9-37 months). The authors try to precise
      the clinicals and urodynamicals initials factors of a bad pronostic.

PMID- 1615274
TI  - [Menopause and cardiovascular risk factors. Influence of treatments].
AB  - Along with menopause goes an increase of cardiovascular heart disease risk, and
      at the same time a change in certain risk factors. Those risk factor changes are
      analysed. The most obvious change is cholesterol increase, mostly on its LDL
      fraction linked to a decrease of its regular epuration. Today, the influence of
      replacement therapy on cardiovascular heart disease risk is not well known, and
      this is due mostly to the fact that there are no randomized studies. Thus exists
      a selection of women with low risk levels, either at the beginning or during
      follow-up. As a consequence results are necessarily optimized. It is possible to
      extrapolate the risk factor evolution under treatment only if its mechanism is
      known. Thus, when estradiol is given not the oral route, lipidic balance is
      brought back to its premenopausal state, without any noticeable influence on
      other known risk factors. It is thus reasonable to see there a favorable
      influence. When estradiol or any other similar molecule is given the oral route,
      one can notice, depending on the dose and the molecule, similar changes, along
      however with other variations which actual consequences remain unknown, like the
      increase of certain coagulation factors, of angiotensinogen, of triglycerides on
      HDL cholesterol. In particular, one does not know if those last pharmacological
      changes do not have a negative effect on predisposed patients.

PMID- 1615275
TI  - [Management of the scarred uterus].
AB  - On the basis of 899 cases of uterine scarring following cesarean section, the
      authors carried out a prophylactic cesarean in 42% of cases. Labor ended in
      childbirth by the genital tract in 44% of cases. The very low incidence of
      uterine rupture since segmental hysterotomy has become widespread and the
      improved fetal and maternal prognosis are all reasons to prefer delivery by the
      genital tract. One of the factors in choosing the method of childbirth is
      radiopelvimetry and estimation of the fetal weight; however, the suspicion of a
      threshold pelvis is not a contraindication to the labor test which was successful
      in 70% of the authors cases. On condition that strict obstetrical monitoring is
      possible, oxytocic drugs can be used to induce labor or correct hypokinesia and
      to administer a peridural analgesic. Routine extraction is no longer necessary
      during the expulsion phase but the authors remain faithful to uterine revision.
      In general, the labor test should be suggested as often as possible and should
      receive the same monitoring and treatment methods as for an intact uterus.

PMID- 1615276
TI  - [Hydrops fetalis of non-immunological origin. Study of 24 cases and review of the
      literature].
AB  - Twenty-four cases of Schriddes' disease of non-immunological origin were observed
      between 1973 and 1990 in the Gynecology-Obstetrics Service at Angers (France).
      These cases are analyzed and the results are compared with those published in the
      literature. This disorder must be diagnosed before birth. Three examinations are
      currently essential for foetal assessment: obstetrical ultrasound, ultrasonic
      cardiography and amniocentesis. As a result of improved antenatal diagnosis, the
      question of the indications for in-utero treatment and medical termination of
      pregnancy now arises. Despite progress in neonatal resuscitation, the prognosis
      generally remains very poor.

PMID- 1615277
TI  - [Ruptured tubal pregnancy associated with an evolving uterine pregnancy. Case
      report and review of the literature].

PMID- 1615278
TI  - [The combined pregnancy. Review of the literature with regard to a case report].

PMID- 1615279
TI  - [Associated rectal and genital prolapse: value of Delorme's operation. A case
      report].
AB  - Rectal prolapse is a rare disorder, which usually affects patients suffering from
      genital prolapse (rectal prolapse is associated with genital prolapse in 50% of
      cases). On the basis of a study of the literature and with regard to one case
      history, the authors set out to explore the simplest and most effective way of
      treating these two disorders simultaneously. The treatment remains surgical and
      should combine treatment of the genital prolapse by vaginal route with treatment
      of the rectal prolapse by means of the Delorme operation. The mortality and
      morbidity rates are zero if this operation is used and the relapse rate is only 8
      to 11% for the rectal prolapse. It would appear that the two approaches are
      rarely associated by the authors and would seem to be interesting to reconsider
      this question by indicating mixed treatment of the two prolapses whenever
      possible.

PMID- 1615280
TI  - Binding of a bacterial acylpoly(1,3)galactoside to human blood leucocytes.
AB  - The binding of a 34-kDa (mol. wt.) acylpoly(1,3)galactoside (APG) extracted from
      a membrane proteoglycan of Klebsiella pneumoniae to human blood leucocytes was
      investigated. APG is made of a long poly(1,3)galactose chain, a core-like region
      and a lipid moiety which comprises two glucosamine residues bound to a phosphate
      group and two beta OH myristic acids. Fluoresceinated APG was shown to bind
      preferentially to monocytes and to a lesser extent to polymorphonuclear
      neutrophils, as determined by flow cytometry. Binding of fluoresceinated APG was
      inhibited by unlabelled APG; it was concentration dependent, but not saturable,
      with rapid kinetics. It occurred at +4 degrees C but was markedly increased at 37
      degrees C. It involved trypsin-sensitive molecules on the membrane of monocytes.
      Neither the parent proteoglycan nor lipopolysaccharide from K. pneumoniae or
      Salmonella minnesota competed for APG binding. A minor non-specific binding to
      lymphocytes, occurring predominantly on B cells, was observed. Unlike that of
      lipopolysaccharide, the APG binding was not blocked by polymyxin B sulphate.
      Interaction between the galactose chain of APG and the galactose receptor does
      not account for the binding of APG to monocytes because the galactose receptor
      (Mac-2) is expressed at high density on activated macrophages but not on
      monocytes. Despite its strong binding to human blood monocytes, APG displayed a
      much weaker activity than K. pneumoniae membrane proteoglycan with respect to
      induction of monocyte cytokine synthesis. When administered as a Technetium 99
      conjugate, APG was shown to label inflammatory foci in experimental animals, and
      its property as a marker of macrophages is currently being evaluated in clinical
      trials.

PMID- 1615281
TI  - Common variable immunodeficiency with increased surface IgM-positive double
      bearing B cells.
AB  - We report a case of common variable immunodeficiency (CVI) that shows low levels
      of IgG and IgA, but a normal quantitative or qualitative level of IgM. T-cell
      functions were not disturbed. Increased numbers of surface IgM (sIgM) and sIgD,
      sIgM and sIgG, sIgM and sIgA double-bearing B cells were observed as compared
      with a control. No IgG and IgA induction upon stimulation with Staphylococcus
      aureus Cowan I (SAC) and recombinant interleukin-2 (rIL-2), or pokeweed mitogen
      (PWM) and rIL-4 or rIL-6 was observed, although there was proliferation. Although
      mu mRNA was expressed as much as in a healthy control, transcription of gamma
      mRNA and alpha mRNA was very low. Furthermore, no enhanced effects of gamma mRNA
      and alpha mRNA were recognized upon stimulation with rIL-4 and rIL-6. These
      results suggest that the patient's B cells might be defective at the switching
      process from mu, mu and delta, mu and gamma to gamma or mu and alpha to alpha.

PMID- 1615282
TI  - Association of the mycobacterial 30-kDa region proteins with the cutaneous
      infiltrates of leprosy lesions. Evidence for the involvement of the major
      mycobacterial secreted proteins in the local immune response of leprosy.
AB  - The granulomatous skin lesions of human leprosy are known to be due to the
      cutaneous immune reaction to various mycobacterial antigens. In the present
      study, by immunohistochemical analysis using a previously characterized
      monoclonal antibody (MoAb) 3A8 we have demonstrated a selective expression of the
      3A8 epitope of mycobacterial 30-kDa proteins, the major secreted proteins of
      mycobacteria, in various forms of leprosy lesions across the clinical spectrum.
      The localization of MoAb 3A8 staining is confined to the areas of cellular
      infiltrates of the lesions. In tuberculoid lesions the intense 3A8 staining was
      seen mostly in association with the membrane of the dermal cellular infiltrates
      whereas in highly bacilliferous lepromatous lesions the staining seems to be
      diffused with granular appearance but not in the form of bacteria. In patients
      with reversal reaction the staining was specifically extended to cells
      infiltrating the epidermis. MoAb 3A8 did not show any reactivity with
      inflammatory skin lesions of patients other than those with leprosy. Since the
      3A8 epitope of 30-kDa proteins has been shown to be present in all cellular
      compartments of the mycobacteria and in the actively secreted BCG 85 antigen
      complex, MoAb 3A8 reactive protein(s) in leprosy lesions may be derived either
      from degraded somatic mycobacterial products or from antigens actively secreted
      by live bacilli. The latter could be true in the cases of untreated lepromatous
      lesions with high bacterial load since live M. leprae has also been considered to
      secrete corresponding 30-kDa proteins similar to other closely related
      mycobacteria. By double immunoenzyme staining we clearly demonstrate the
      expression of 3A8 epitope on CD68+ macrophages in the granulomas of tuberculoid
      leprosy, whereas in highly bacilliferous lepromatous lesions most of the double
      staining was seen in a diffuse pattern within the interstitial space of the
      cellular infiltrate as well as in the cytoplasm of CD68+ macrophages. In lesions
      from reversal reaction the 3A8 epitope is more strongly expressed on CDla+
      dendritic Langerhans cells (LC) both in the epidermis and in the dermis as
      compared with other types of leprosy. This provides evidence for the involvement
      of LC in handling of mycobacterial antigenic epitopes in leprosy lesions.
      Further, immunoenzyme double staining revealed that the expression of this
      mycobacterial 3A8 epitope on antigen presenting cells such as CD68+ macrophages
      and CDla+ LC is present in juxtaposition with CD3+ T cells including the alpha
      beta and gamma delta receptor-bearing T cells in the granuloma.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1615283
TI  - Adjuvant composition determines the induction of type II collagen-induced
      arthritis.
AB  - In this study we have investigated the influence of adjuvant composition on the
      development of collagen-induced arthritis and of anti-collagen type II specific B
      and T-cell responses following immunization with type II collagen. DBA/l mice
      immunized with bovine collagen type II emulsified in complete Freund's adjuvant
      (CFA) containing Mycobacterium tuberculosis strain H37Ra developed footpad
      swelling indicative of arthritis. Animals immunized with collagen type II plus
      CFA containing Mycobacterium butyricum, or incomplete Freund's adjuvant showed no
      significant increase in footpad width. Induction of anti-CII specific T-cell
      proliferation was also dependent upon immunization with CII plus CFA containing
      M. tb H37RA. In contrast, ovalbumin-reactive T-cell proliferation was unaffected
      by the species of mycobacteria, indicating that the difference in adjuvant
      activity of the mycobacterial species is specific for anti-collagen type II T
      cell responses. Antibody response to collagen type II, unlike T-cell responses,
      was not significantly different using the two adjuvants. This study therefore
      demonstrates that murine collagen-induced arthritis requires immunization with
      collagen type II together with complete Freund's adjuvant containing
      Mycobacterium tuberculosis H37RA. Since only this combination of antigen and
      adjuvant induces detectable arthritis and T-cell responses against collagen type
      II, while antibody synthesis does not have such stringent adjuvant requirements,
      this suggests that the development of the full pattern of the collagen-induced
      arthritis disease requires synergistic activation of both humoral and cell
      mediated responses.

PMID- 1615284
TI  - Immunoglobulin G, A, and M light chain ratios in some humoral immunological
      disorders.
AB  - The total kappa/lambda immunoglobulin light chain ratio and the kappa/lambda
      ratios within each of the serum immunoglobulin classes G, A, and M were measured
      in thirteen patients with humoral immunological disorders. Of those patients,
      eight had common variable immunodeficiency whereas five patients had other forms
      of humoral immunological deficiencies. Eleven patients had abnormal antibody
      response in vivo. All but three of the thirteen patients had clearly abnormal
      light chain ratios in one or more of the immunoglobulin classes. We conclude that
      humoral immunological disorders, usually characterized by abnormal heavy chain
      production and a disturbed antibody response, may frequently have a concomitant
      abnormal synthesis of the light chains resulting in an abnormal kappa/lambda
      light chain ratio.

PMID- 1615285
TI  - The implications of the failure to generate autoantibody-producing hybridomas
      from rat erythrocyte-immunized mice.
AB  - Injection of mice with rat erythrocytes (RRBC) has long been thought to provide
      an experimental model in which suppressor T cells (Ts) control autoimmunity. The
      basis of this is that whilst mice immunized with RRBC produce an antibody
      response, of which a proportion cross-reacts with autologous red cells, the RRBC
      immunized recipients of RRBC-primed spleen cells make no, or little,
      autoantibody, and secondly because the transfer of this autoantibody-specific
      suppression can be abrogated by T-cell depletion of transferred spleen cells.
      Here an alternative explanation of these phenomena is described.

PMID- 1615286
TI  - Affinity purification of antigen-specific serum immunoglobulin from the European
      eel (Anguilla anguilla).
AB  - Immunization of specimens of the European eel with a hapten-carrier conjugate
      resulted in a significant rise in anti-hapten titres. Antigen-specific
      immunoglobulin was purified on a matrix onto which the hapten-carrier conjugate
      had been immobilized. Rabbit antisera raised against the product of the affinity
      purification recognized two molecular moieties. The first was eel immunoglobulin
      as inferred by the polypeptide composition, i.e. disulphide-linked heavy and
      light chains of 72 kDa and 25 kDa respectively. The second was a 110-kDa protein.
      A 800-kDa and a 400-kDa molecular form of eel immunoglobulin were disclosed by a
      combination of gel filtration and immunoelectrophoretic detection. The latter was
      the more abundant serum form. The 110-kDa protein was found non-covalently
      associated with the 400-kDa immunoglobulin. Both molecular forms of
      immunoglobulin from immune sera exhibited antigenic specificity and reactivity.

PMID- 1615287
TI  - Recombinant vaccine vector-induced protection of athymic, nude mice from
      influenza A virus infection. Analysis of protective mechanisms.
AB  - Athymic, nude mice, which normally succumb to virus infection, can resolve
      infection with recombinant vaccinia virus (rVV) engineered to express IL-2. We
      have demonstrated that interferon-gamma (IFN-gamma) produced by natural killer
      (NK) cells and other immunocytes in response to the virus-encoded interleukin-2
      (IL-2) is crucial to recovery. Here, we extend this work to show that nude mice,
      when primed intravenously with rVV co-expressing both IL-2 and an influenza virus
      haemagglutinin (HA) gene, are also protected following challenge with a lethal
      dose of homologous influenza virus. A substantial increase in the number of
      influenza virus-reactive antibody-secreting cells producing antibody of the IgM
      isotype, but not of the IgG or IgA isotypes, was found in spleens and lungs of
      the protected mice. Treatment with monoclonal antibodies to IFN-gamma or to the
      NK marker, as GM1, at challenge and thereafter, led to their death however,
      though the specific IgM antibody response was unaffected. These data suggest that
      both specific antibody and non-specific antiviral reactivity are important
      elements of the protective response and show that this immunization strategy may
      be used to protect severely immunocompromised individuals.

PMID- 1615288
TI  - Mortality among workers engaged in the development or manufacture of styrene
      based products--an update.
AB  - Mortality was updated another 11 years through 1986 for a previously studied
      cohort of 2904 male chemical workers who were potentially exposed to styrene and
      related materials for a year or more between 1937 and 1971. Substantial deficits
      in mortality from all causes and total cancer were observed in the cohort when it
      was compared with white males in the United States, and also other chemical
      workers who were unexposed to styrene-based products. Mortality from leukemia was
      slightly less than expected during the updated period, in contrast to an excess
      of lymphatic leukemia observed in the original period. Yet small elevations in
      risk of other types of lymphatic cancer, particularly multiple myeloma,
      persisted. The risk of these cancers did not increase with estimated intensity or
      duration of styrene exposure. The findings are discussed in context with those of
      studies of similarly exposed workers in related industries.

PMID- 1615289
TI  - Mortality of workers employed at organochlorine pesticide manufacturing plants-
      an update.
AB  - A previous mortality study among four organochlorine pesticide manufacturers was
      updated through 1987. The organochlorine pesticides included chlordane;
      heptachlor and endrin; aldrin, dieldrin and endrin; and
      dichlorodiphenyltrichloroethane. The mortality for all causes and all malignant
      neoplasms at each of the plants was lower than expected. There was a
      statistically significant increase in liver and biliary tract cancer among
      workers at plant 3 (5 observed, standardized mortality ratio 393, 95% confidence
      interval 1.27-9.20). These results are somewhat consistent with experimental
      animal findings showing benign and malignant tumors of the liver after exposure
      to aldrin and dieldrin. However, the deaths were due to a mixture of intra- and
      extra-hepatic tumors, and the dose-response analysis was limited because of the
      small number of deaths and lack of exposure data. Additional study of this group
      should include continued follow-up of the total cohort and a case-referent
      analysis of the deaths from liver and biliary tract cancer.

PMID- 1615290
TI  - Mortality among workers in a thorium-processing plant--a second follow-up.
AB  - A second follow-up of mortality was carried out for workers employed in a thorium
      processing plant between 1915 and 1973. The study group comprised 3796 workers
      (3119 men and 677 women). Of the whole group, 926 (761 men and 165 women) were
      deceased and 2620 (2161 men and 459 women) were still alive, while 250 (6.6%)
      were lost to follow-up. For the male workers, the standardized mortality ratio
      (SMR) for all causes of death was 1.12 with a 95% confidence interval (95% CI) of
      1.05-1.21. The SMR for the male workers was also significantly increased for all
      cancers (SMR 1.23, 95% CI 1.04-1.43) and lung cancer (SMR 1.36, 95% CI 1.02
      1.78). For the female workers, the SMR was 0.74 (95% CI 0.63-0.86) for all causes
      and 0.53 (95% CI 0.35-0.78) for all cancers. The results of a Poisson regression
      analysis showed that there was no significant effect of the selected factors on
      lung cancer mortality.

PMID- 1615291
TI  - Adverse pregnancy outcome and childhood malignancy with reference to paternal
      welding exposure.
AB  - Welding may deteriorate spermatogenesis and increase reproductive failures. This
      study examines reproductive end points in a Danish cohort of 10,059 metalworkers
      who fathered 3,569 children in 1973 through 1986. Occupational histories were
      gathered by postal questionnaires. Information on pregnancy outcomes and
      offspring was obtained by record linkage to medical registers. The occurrence of
      reduced birthweight, preterm delivery, infant mortality, and congenital
      malformation was not increased among children at risk from paternal welding
      exposure in comparison with children not at risk. The overall incidence of
      childhood malignancies among 23,264 children born in 1968 through 1986 with a
      total of 259,113 person-years of follow-up was equal to national rates (relative
      risk 0.97, 95% confidence interval 0.63-1.42). However, pregnancies preceding a
      birth at risk from paternal exposure to stainless steel welding were more often
      terminated by spontaneous abortion (odds ratio 1.9, 95% confidence interval 1.1
      3.2). This finding needs cautious interpretation and should be further
      investigated in future studies.

PMID- 1615292
TI  - Differences in the incidence of myocardial infarction among occupational groups.
AB  - An inverse relationship between social class and coronary heart disease has been
      observed in several countries, but few studies have investigated the incidence of
      this disease over different occupational groups. A case-referent study was
      carried out to estimate the relative risk of a first myocardial infarction in
      various occupational groups. Cases of myocardial infarction (N = 36,602) were
      identified from both hospital discharge and death records. Two referents for each
      case were randomly selected from the study base. Information about occupation was
      obtained from two consecutive censuses. An increased incidence, compared with
      that of others employed, was found for persons in some occupations in production
      work, transport work (men), and service work (women). Low relative risk were
      found mainly for persons in occupations demanding a high education. The relative
      risks ranged from 0.3 to 2.8. Several factors, occupational as well as
      nonoccupational, may be of importance in explaining the findings.

PMID- 1615293
TI  - Design of check-out systems including laser scanners for sitting work posture.
AB  - Forty-six laser scanner operators were compared with 106 cashiers operating
      conventional cash registers. The influence of job rotation on the two groups was
      evaluated, and several design features were examined. For this purpose the
      prevalence of musculoskeletal disorders was determined by means of a
      questionnaire and a physical examination. In addition, a three-dimensional
      movement analysis system was employed. Work postures were analyzed with the Ovako
      working analysis system. The results indicate that a beneficial effect on the
      musculoskeletal system is achieved by combining the operation of a laser scanner
      with job rotation. The study also points out the need for better equipment,
      including flat scanners and smaller keyboards, and a change in the angle between
      the scanner and the take-off belt running up to the cashier.

PMID- 1615294
TI  - Effects of perceived job stress on depressive symptoms in blue-collar workers of
      an electrical factory in Japan.
AB  - This three-year prospective study on the effects of job stress on depressive
      symptoms over time was conducted among male blue-collar workers in an electrical
      factory in Japan. Data were collected at yearly intervals by means of postal
      questionnaires. Initially ten job stress variables, five major covariates, and
      depressive symptoms (Zung Self-Rating Depression Scale) were measured. In the
      yearly examinations, depressive symptoms were measured for a total of 468
      respondents. The results indicated that job unsuitability was a significant
      predictor of depressive symptoms in the second and third year, after control for
      the initial covariates and depressive symptoms. Lack of control over workplace
      and poor human relations at the workplace were significantly associated with
      depressive symptoms after one and two years, respectively. Job unsuitability and
      poor human relations at the workplace seem to be risk factors for long-lasting
      depressive symptoms in Japanese blue-collar workers.

PMID- 1615295
TI  - Cancer mortality among licensed herbicide applicators.
AB  - This retrospective cohort study investigated the cancer mortality of 1341
      herbicide applicators licensed before 1 January 1980. The cohort was followed for
      mortality until 1 January 1988 by means of the Dutch system of population
      registers. For the subjects who died before 1 January 1988 the cause of death was
      obtained from the Central Bureau of Statistics. The cause of death was obtained
      for 98.4% of the deceased subjects. The total mortality was lower than expected
      according to mortality rates of the total male Dutch population. The total number
      of deaths from cancer was however slightly higher than expected [standardized
      mortality ratio (SMR) 114]. Mortality from several subtypes of cancer was also
      higher than expected, that for multiple myeloma being statistically significantly
      higher than unity (SMR 815, 95% confidence interval 164-2382). Occupational
      exposure to herbicides appears to increase the risk for multiple myeloma and
      possibly other malignant neoplasms.

PMID- 1615296
TI  - [Cerebral trypanosomiasis: epidemiology, clinical aspects, therapy and illness
      course].
AB  - More than 20,000 people are infected with one of the two forms of African
      trypanosomiasis each year. Without treatment the outcome is almost always fatal.
      There are, however, problems involved in drug treatment. Reactive encephalitis is
      recorded in up to 18% of all cases treated for cerebral trypanosomiasis. Recently
      a lack of response to treatment has been reported with increasing frequency from
      endemic areas. Relapses occur in up to 10% of cases. Reasons for relapses include
      insufficient treatment due to poor compliance or lack of drugs, reinfection in
      endemic areas, pharmacokinetic problems, the parasite's evasive mechanisms, and
      primary and/or secondary drug resistance.

PMID- 1615297
TI  - Cerebral malaria.
AB  - Cerebral malaria is the most important manifestation of severe Plasmodium
      falciparum infection. The clinical picture in South East Asian adults differs
      from that in African children. The children are more likely to have abnormal
      brain stem reflexes, signs suggestive of cerebral herniation, and raised CSF
      opening pressure, and to suffer persistent neurological sequelae. The mortality
      remains high at about 20%. The diagnosis must be considered in all patients with
      fever and impaired consciousness who may have been exposed to the infection. The
      pathophysiology of cerebral malaria may involve mechanical obstruction of the
      cerebral circulation by parasitized erythrocytes which have adhered to the
      vascular endothelium. Cytokines such as tumor necrosis factor may also
      contribute. The most important element of treatment is early, optimal
      chemotherapy with quinine, but artemisinine derivatives may prove even more
      effective.

PMID- 1615298
TI  - [Spongiform encephalopathies with special reference to bovine spongiform
      encephalopathy].
AB  - In Switzerland bovine spongiform encephalopathy (BSE) was detected for the first
      time in November 1990. It is a transmissible disease of the central nervous
      system similar to Creutzfeldt-Jakob disease (CJD), Gerstmann-Straussler-Scheinker
      syndrome (GSS) and kuru in man, and, in animals, scrapie in sheep and goats,
      chronic wasting disease (CWD) in captive mule deer and elk of North America and
      transmissible mink encephalopathy (TME) of farm reared mink. The infectious agent
      of the spongiform encephalopathies (SEs) is extremely small (greater than 100
      microns) and very resistant against physical and chemical disinfectants. The
      infectiousness is closely linked to the so-called prion proteins, the biological
      and genetic properties of which are not yet fully understood. The first outbreak
      of BSE occurred in England, and the disease spread rapidly all over Great
      Britain. The source of infection proved to be bone and meat meal obtained from
      scrapie-infected slaughter wastes. So far we have diagnosed 17 cases of BSE in
      our country. The risk of humans contracting CJD by ingestion of meat, milk and
      their products contaminated with BSE is probably minimal.

PMID- 1615299
TI  - Neurocysticercosis. An introduction with special emphasis on new developments in
      pharmacotherapy.
AB  - Neurocysticercosis is the most important parasitic infection of the nervous
      system in countries of the third world. The disease is caused by the cystic
      larval stage of Taenia solium, the pork tape worm. The clinical picture of
      neurocysticercosis is due to the parasite itself and/or an inflammatory reaction
      around degenerating cysts in the central nervous system. It may cause epilepsy,
      chronic meningitis and hydrocephalus. The diagnosis is greatly facilitated by the
      use of computer tomography, magnetic resonance imaging and serological tests.
      Praziquantel and albendazole now offer a reasonable treatment for
      neurocysticercosis. However, the effect of praziquantel is largely dependent on
      its bioavailability, which is decreased by the use of antiepileptics and,
      possibly, dexamethasone. Albendazole is associated with side effects on bone
      marrow and liver, and it has teratogenic and mutagenic properties. Both drugs act
      poorly on intraventricular cysts. Coadministration of cimetidine with
      praziquantel leads to a significant two-and-a-half times' increase of the latter
      drug's bioavailability. This resulted in a good clinical response to treatment
      for 12 patients with various forms of neurocysticercosis. Although
      neurocysticercosis is no longer endemic in many Western European countries, its
      incidence is likely to increase due to increased travel to, and immigration from,
      endemic countries.

PMID- 1615300
TI  - [Strongyloidiasis under immunosuppressive therapy].
AB  - Strongyloidiasis is a parasitic disease of tropical regions and to some extent of
      the South of Europe. In immunocompromised patients, particularly under steroid
      medication, infestation by this nematode may sometimes lead to life-threatening
      hyper-infestation. Diagnosis is often difficult because of a polymorphic clinical
      picture and usually low larvae excretion in the stool. The case is reported of a
      Yugoslavian patient who under corticosteroid therapy suffered from severe
      diarrhea and dehydration due to hyperinfestation by nematode larvae. Several
      attempts at treatment were necessary to eradicate the infestation.

PMID- 1615301
TI  - [The use of echocardiography in intensive care medicine].
AB  - Transthoracic echocardiography is an easily accessible, non-invasive imaging
      procedure for evaluation and follow-up of critically ill patients. It is
      particularly helpful in evaluating patients with thoracic pain, low-output
      syndrome or heart murmur, and has prognostic value in acute myocardial
      infarction. It makes a diagnostic contribution in 60 to 90% of cases, and has
      therapeutic implications in 50 to 65%. New ultrasound technics are briefly
      discussed.

PMID- 1615302
TI  - [Vasculitic skin lesions caused by nonsteroidal anti-inflammatory agents].
AB  - Today, non-steroidal anti-inflammatory drugs are very frequently prescribed
      agents. These drugs are responsible for side effects which are rarely recognized
      and poorly understood. One of these side effects is leukocytoclastic vasculitis
      with or without skin ulcerations. Rheumatoid arthritis and other mixed connective
      tissue diseases may also lead to vasculitis ulcerations, which explains the
      difficulty of correct diagnosis in each case. In addition, disease-modifying
      drugs such as methotrexate, frequently used in the above-mentioned syndromes,
      further complicate the situation because these agents may also produce
      vasculitis. In the present case study we analyze and discuss the diagnosis and
      follow-up in three of our patients with vasculitis skin ulcerations. In two of
      them, the vasculitis was attributed to the use of naproxen. Despite thorough
      examination and documentation of all three cases, etiologic evaluation was
      difficult and complex.

PMID- 1615303
TI  - [Anemia-inducing colonic diverticular hemorrhages].
AB  - 20 patients with massive lower gastrointestinal bleeding caused by segmental or
      total colonic diverticular disease are presented. The bleeding source was
      localized by colonoscopy, angiography and intraoperatively in 5, 5 and 2 patients
      respectively. The hemorrhage occurred in the right colon in 9 patients and in the
      left colon in 3 patients. Due to ongoing bleeding 9 patients needed immediate
      surgery (7 right hemicolectomies, 1 left hemicolectomy, 1 sigmoidectomy). The
      median transfusion requirement of operated individuals was 14 units of blood. 2
      (22%) patients died from postoperative complications. The remaining 7 patients
      had no recurrent bleeding during a median follow-up of 3.5 years (0.5-9 years).
      11 patients with arrested bleeding (median transfusion requirement 3 units of
      blood) were treated conservatively. During a mean follow-up of 4.5 years (1.5-10
      years) only one (9%) of the conservatively treated patients complained of
      recurrent bleeding requiring sigmoidectomy. We conclude that massive and ongoing
      hemorrhage (greater than 6 units of blood) occurs predominantly in right-sided
      colonic diverticula and requires immediate surgery. Arrested bleeding
      (transfusion requirements less than 6 units of blood) from colonic diverticula
      can be treated conservatively since operative mortality is high and recurrent
      bleeding is rare.

PMID- 1615304
TI  - [Age- and sex-specific standard values of colonic transit time in healthy
      subjects].
AB  - Use of radiopaque markers with a plain X-ray of the abdomen is a simple technique
      to measure mean segmental and total colonic transit time. We evaluated 128
      healthy volunteers with a mean age of 40 years (range 20-81 years) from three
      different parts of Switzerland to assess age and sex specific normal transit
      times. In men and women colonic transit time was not influenced by age. The mean
      transit time was significantly shorter in men than in women (30 +/- 2 hours
      versus 41 +/- 3 hours: p less than 0.05). In men the transit time was also
      influenced by smoking. Non-smoking men had a significantly shorter transit time
      than smokers (26 +/- 2 hours versus 40 +/- 5 hours: p less than 0.05). In women,
      neither smoking nor the menstrual cycle influenced transit time. For normal
      colonic transit time we recommend up to 66 hours for smoking men, up to 44 hours
      for non-smoking men and up to 70 hours in general for women.

PMID- 1615305
TI  - [Liposarcoma of the laryngeal region. Case report and literature review].
AB  - The case is reported of a 64-year-old man in whom a pedunculated tumor of the
      Vallecula epiglottica occurred and was excised. Histologically it proved to be a
      dedifferentiated liposarcoma. The patient is well and free of disease 18 months
      later. The literature is reviewed and 20 other cases of liposarcoma in the
      laryngeal region are discussed.

PMID- 1615306
TI  - Accumulation of copper, lead, manganese and iron by field populations of
      Hydrodictyon reticulatum (Linn.) Lagerheim.
AB  - The potential of 'water-net' Hydrodictyon reticulatum to accumulate copper, lead,
      manganese and iron was determined in seven polluted water bodies having different
      physicochemical characteristics. The lead accumulation was linearly related with
      ambient concentration whereas in case of copper, manganese and iron it was
      maximum at lowest ambient level of metals. Investigations on response of alga to
      various concentrations of test metals under single metal treatments revealed that
      the algal cells are saturated at high equilibrium concentration of greater than
      0.5 (lead), greater than 2.5 (copper and iron) and greater than 5.0 (manganese)
      mg/l. Alkaline pH favoured accumulation of these metals under field conditions.
      Alga showed high concentration factor (Cf) for all the metals both under field
      and laboratory conditions. However, Cf value was higher in case of manganese and
      iron in natural populations. Results indicate the possibility of using this alga
      in waste water treatment programmes.

PMID- 1615307
TI  - Aerosols characterization in a forested site in Quebec, Canada.
AB  - Three AERAS low pressure 11 stage cascade impactors with rotatable collecting
      plates (LPCR) were installed at the Duchesnay forest station near Quebec City and
      four low pressure inertial collectors (LPIC) were installed in the forest. The
      analysis of the aerosol deposits was performed by static fast atom beam mass
      spectroscopy (FABMS); SIMS and ESCA analyses were also made. The morphological
      characterization and the elemental volumetric composition of the aerosols were
      established by a scanning electron microscope equipped with an X-ray dispersive
      energy analyser. Micro-weighting of the aluminium substrate before and after the
      sampling by the AERAS impactor enabled the study of the mass-size-distribution of
      the aerosols according to their aerodynamic equivalent diameter. Example of the
      results obtained are presented in relation to air parcels' trajectories. This
      study has shown that it is possible to characterize the aerosols according to the
      origin and trajectories of the air mass with which they travel; sources along the
      tracks have been shown to contribute to the aerosol loading of the air masses.

PMID- 1615308
TI  - Geochemical prospection of cadmium in a high incidence area of prostate cancer,
      Sierra de Gata, Salamanca, Spain.
AB  - A high incidence of prostate cancer was observed in some areas of Salamanca
      province, Spain. After excluding the most common etiological factors as the
      cause, it is concluded that the only possible risk factor must be due to the
      presence of some environmental carcinogen. In view of the etiological
      relationship between Cd and the pathological state, a study was carried out on
      the geochemistry of this element in the area. Anomalous amounts of Cd were found
      in stream sediments. This anomaly does not correspond to human activity, but
      rather to high regional amounts of cadmium in the substrate. Thus, the contents
      of Cd in soils developed over substrates containing naturally-occurring anomalous
      amounts of cadmium and the concentration in underground waters should be
      considered as a risk factor in this area.

PMID- 1615309
TI  - Lead concentration and delta-aminolevulinic acid dehydratase activity in the
      blood of the general population of Tarragona Province, Spain.
AB  - Blood samples were collected from 488 people living in an industrial and an
      agricultural area of Tarragona Province, Spain. The samples were subjected to
      blood lead analyses by atomic absorption spectrophotometry. Although in the
      industrial area men had higher blood lead levels than women, this difference was
      not statistically significant. Blood lead concentrations were related to a range
      of factors such as age, smoking and drinking habits. Both smoking and drinking
      habits were associated with a dose-dependent increase in blood lead levels,
      especially in men. On the other hand, delta-aminolevulinic acid dehydratase (ALA
      D, EC 4.2.1.24) activity was determined in blood from 186 people of Tarragona
      Province. The results obtained were within the normal limit values (NLV) as
      defined by the WHO. The present data concerning Tarragona Province show that in
      relation to environmental health there is not a serious problem from lead
      contamination.

PMID- 1615310
TI  - Geographical and temporal patterns of air-borne and personal 1,1,1
      trichloroethane exposure in Piedmont region (Italy).
AB  - During the summer of 1989 and the winter 1989-1990, we initiated measurements of
      1,1,1-trichloroethane concentrations in indoor, outdoor, and 'personal' air, in
      urban and rural sites. In the Piedmont region (North-Western Italy) we have
      carried out an atmospheric monitoring study: in the centre of Turin city (urban
      site), in Cuorgne (rural site), and in Banchetta (remote site). First results
      confirm a higher winter contamination (11.67 vs. 2.79 micrograms/m3) and a higher
      contamination at the urban site, compared to rural and remote sites. Excluding
      Cuorgne in the summer, all indoor/outdoor ratios are greater than 1 and, in all
      cases, the 'personal' air shows higher 1,1,1-trichloroethane levels than indoor
      and outdoor air. In Turin the relationships between winter and summer all show a
      higher winter contamination, while, in Cuorgne no differences are proven.

PMID- 1615311
TI  - Predictive relationships for sidestream smoke cigarette yields.
AB  - Relationships have been sought for smoking machine generated sidestream smoke
      yields of cigarettes for particulate matter (water and nicotine free) (PMWNF) and
      nicotine. Comparisons have been made with the corresponding mainstream smoke
      yields, other readily measurable factors in machine smoking and with the physical
      characteristics of cigarettes. The sidestream smoke yields have been found to be
      related to the puff count during machine smoking multiplied by the cross
      sectional area of a cigarette or to the total weight of cigarette tobacco burnt
      during machine smoking. For the brands retailed in the U.K. these relationships
      permit calculation of the sidestream smoke contributions of PMWNF and nicotine to
      environmental tobacco smoke. From the data used to derive these relationships,
      and based on 31 cigarette brands representing 71% of cigarette sales in the U.K.,
      the sales weighted sidestream PMWNF yield is 27.1 mg/cigarette and that for
      nicotine is 5.12 mg/cigarette.

PMID- 1615312
TI  - Polycyclic aromatic hydrocarbons, nickel and vanadium in air particulate matter
      in Bahrain during the burning of oil fields in Kuwait.
AB  - Inhalable air particulate matter (APM) was collected in Bahrain from July 31,
      1991 to August 4, 1991, during the burning of the oil fields in Kuwait. The
      filters collected were black and the levels of APM ranged from 139 to 673
      micrograms m-3 with an average value of 199 micrograms m-3. APM were analysed for
      their contents of PAHs, Ni and V. Analysis was carried out for 32 PAHs and total
      PAHs ranged from 3.1 to 9.1 ng m-3 and averaged 5.3 ng m-3. The highest
      individual PAH levels were benzo[ghi]perylene, benzo[b]fluoranthene,
      benzo[a]pyrene and indeno[1,2,3-cd]pyrene. The concentration of Ni and V ranged
      from 7 to 42 and 11 to 42 ng m-3, with an average value of 22 and 26 ng m-3,
      respectively. A strong correlation was found between Ni and V (r = 0.98, P less
      than 0.01). The results show that the smoke from burning oil wells in Kuwait has
      contributed to the concentrations of particulate matter, PAHs, Ni and V in APM in
      Bahrain.

PMID- 1615313
TI  - Increased radon concentrations in classrooms used for pottery workshops.
AB  - In a pilot study of nine schools the radon (Rn) concentrations were measured
      systematically. The mean radon concentrations in the classrooms on the ground
      floor and on higher floors was 52 Bq/m3, which is equivalent to the mean values
      in Central Europe. Several of the basement rooms used for handicraft lessons had
      significantly increased Rn levels with a mean concentration of 617 Bq/m3. In all
      other parts of the basement Rn levels were clearly lower with a mean
      concentration of 136 Bq/m3. In the rooms used for handicraft lessons numerous
      articles of pottery were on display. After removing these the Rn in air
      concentration was reduced to a mean value of 83 Bq/m3.

PMID- 1615314
TI  - Fetal tissue research.

PMID- 1615315
TI  - The safety of foods developed by biotechnology.

PMID- 1615317
TI  - New plant institute recommended.

PMID- 1615316
TI  - Lightning strikes the SSC.

PMID- 1615318
TI  - Budget ax lops off entire departments at San Diego.

PMID- 1615319
TI  - Motor molecules on the move.

PMID- 1615320
TI  - A new discipline probes suicide's multiple causes.

PMID- 1615321
TI  - Chaos breaks out at NIH, but order may come of it.

PMID- 1615322
TI  - A new blueprint for water's architecture.

PMID- 1615323
TI  - The role of solvent viscosity in the dynamics of protein conformational changes.
AB  - Nanosecond lasers were used to measure the rate of conformational changes in
      myoglobin after ligand dissociation at ambient temperatures. At low solvent
      viscosities the rate is independent of viscosity, but at high viscosities it
      depends on approximately the inverse first power of the viscosity. Kramers theory
      for unimolecular rate processes can be used to explain this result if the
      friction term is modified to include protein as well as solvent friction. The
      theory and experiment suggest that the dominant factor in markedly reducing the
      rate of conformational changes in myoglobin at low temperatures (less than 200 K)
      is the very high viscosity (greater than 10(7) centipoise) of the glycerol-water
      solvent. That is, at low temperatures conformational substates may not be
      "frozen" so much as "stuck."

PMID- 1615324
TI  - Probing protein stability with unnatural amino acids.
AB  - Unnatural amino acid mutagenesis, in combination with molecular modeling and
      simulation techniques, was used to probe the effect of side chain structure on
      protein stability. Specific replacements at position 133 in T4 lysozyme included
      (i) leucine (wt), norvaline, ethylglycine, and alanine to measure the cost of
      stepwise removal of methyl groups from the hydrophobic core, (ii) norvaline and O
      methyl serine to evaluate the effects of side chain solvation, and (iii) leucine,
      S,S-2-amino-4-methylhexanoic acid, and S-2-amino-3-cyclopentylpropanoic acid to
      measure the influence of packing density and side chain conformational entropy on
      protein stability. All of these factors (hydrophobicity, packing, conformational
      entropy, and cavity formation) significantly influence protein stability and must
      be considered when analyzing any structural change to proteins.

PMID- 1615325
TI  - Nuclear localization of Agrobacterium VirE2 protein in plant cells.
AB  - The Agrobacterium single-stranded DNA (ssDNA) intermediate T-strand is likely
      transferred to the plant cell nucleus as a complex with a single VirD2 molecule
      at its 5' end and multiple VirE2 molecules along its length. VirD2 contains a
      nuclear localization signal (NLS); however, because the T-strand is principally
      coated with VirE2 molecules, VirE2 also might assist in nuclear uptake. Indeed,
      VirE2 fused to a reporter protein localizes to plant cell nuclei, a process
      mediated by two amino acid sequences with homology to the bipartite NLS of
      Xenopus nucleoplasmin. Moreover, tumorigenicity of an avirulent virE2 mutant is
      restored when inoculated on transgenic plants expressing VirE2, supporting in
      planta function of VirE2.

PMID- 1615326
TI  - Stage-specific adhesion of Leishmania promastigotes to the sandfly midgut.
AB  - Although leishmaniasis is transmitted to humans almost exclusively by the bite of
      infected phlebotomine sandflies, little is known about the molecules controlling
      the survival and development of Leishmania parasites in their insect vectors.
      Adhesion of Leishmania promastigotes to the midgut epithelial cells of the
      sandfly was found to be an inherent property of noninfective-stage promastigotes,
      which was lost during their transformation to metacyclic forms, thus permitting
      the selective release of infective-stage parasites for subsequent transmission by
      bite. Midgut attachment and release was found to be controlled by specific
      developmental modifications in terminally exposed saccharides on
      lipophosphoglycan, the major surface molecule on Leishmania promastigotes.

PMID- 1615327
TI  - Reversal of the orientation of an integral protein of the mitochondrial outer
      membrane.
AB  - The NH2-terminus of the signal-anchor sequence of an integral, bitopic protein of
      the outer mitochondrial membrane was extended both in amino acid length (from 11
      to 38 amino acids) and net charge (from +4 to +8)--changes that confer on the NH2
      terminus characteristics of a strong matrix-targeting signal. The protein was
      inserted into the outer membrane but in an inverted orientation (Ncyto-Cin).
      These findings suggest that, in common with other membrane systems, the
      orientation of a protein in the outer mitochondrial membrane can be determined by
      a signal that causes retention of the NH2-terminus on the cytosolic side of the
      membrane.

PMID- 1615328
TI  - Recent advances in bone marrow transplantation. Introduction.

PMID- 1615329
TI  - Results of allogeneic bone marrow transplantation with unrelated or mismatched
      donors.
AB  - As most patients are not fortunate enough to have an HLA-matched sibling to use
      as a bone marrow donor, attention has focused on the use of either HLA-matched
      but unrelated donors or HLA-mismatched family members. With the maturation of the
      field of histocompatibility testing, it is now possible to quantitate with
      relative precision the degree of disparity between patient and donor. In general,
      it appears that with respect to histocompatibility differences between donors
      other than HLA-matched siblings, there is an increased incidence of acute graft
      versus-host disease, with the risk correlated with the degree of
      histoincompatibility. However, the overall disease-free survival is not always
      adversely affected, as a graft-versus-leukemia effect may counterbalance the
      increased death rate from graft-versus-host disease. To find donors for most
      patients, efforts are under way to recruit a large number of unrelated volunteers
      into the National Marrow Donor Program.

PMID- 1615330
TI  - Role of colony-stimulating factors in bone marrow transplantation.

PMID- 1615331
TI  - Bone marrow transplantation: past experiences and future prospects.

PMID- 1615332
TI  - The role of autologous bone marrow transplantation in the treatment of solid
      tumors.
AB  - Until effective new agents can be developed, increasing dose intensity may be the
      best way to improve therapy for patients who fail conventional treatment.
      Alkylating agents, including radiation, are likely candidates for use in dose
      intensive combinations. Past phase I clinical trials of single agents have
      redefined the maximum tolerated doses when marrow transplantation attenuates the
      myelosuppression. High-dose combinations of more than two agents are only
      possible with significant dose reductions from single-agent maximum tolerated
      doses. Multiple courses of therapy might permit the use of more than two agents
      without dose reduction. A multidrug and/or multicourse approach will probably be
      needed to effect curative therapy.

PMID- 1615333
TI  - Management of anemia in oncology. Introduction.

PMID- 1615334
TI  - The therapeutic role of recombinant erythropoietin in anemic patients with intact
      endogenous production of erythropoietin.
AB  - Recombinant human erythropoietin (r-HuEPO) has been shown to be remarkably
      effective in raising the hemoglobin concentrations and improving the quality of
      life of patients with chronic renal disease. It is currently under investigation
      for treatment of patients with nonrenal anemias associated with cancer
      chemotherapy, acquired immunodeficiency syndrome, rheumatoid arthritis, and other
      chronic illnesses. To date, investigators have shown that patients with mild
      anemia and low endogenous erythropoietin (EPO) production may be good candidates
      for such treatment. Conversely, studies have shown that patients with severe
      anemia and serum EPO concentrations of above 500 mU/mL apparently do not respond
      to doses used for patients with mild anemia or chronic renal disease. Large doses
      of r-HuEPO may be of use in such patients, and clinical trials are in progress to
      determine if it is at least possible to make these patients transfusion
      independent.

PMID- 1615335
TI  - Toward bloodless surgery: erythropoietin therapy in the surgical setting.
AB  - Issues related to blood safety and blood inventory have recently led to a much
      greater interest in blood conservation measures. Some of these measures have
      included using lower transfusion triggers (hematocrit values), directed donor
      programs, and autologous blood transfusions. When possible, autologous blood
      donation is the preferable alternative because it represents the safest blood,
      conserves blood inventories, and has a salutary effect on physician transfusion
      behavior. Indeed, homologous blood requirements are lowered in patients who
      donate autologous blood before elective surgery. However, autologous blood
      donation can be limited by physician underordering and an insufficient
      erythropoietic response to serial phlebotomy. Continuing medical education can be
      effectively used to alter physician behavior regarding underordering. Early
      clinical trials have suggested that recombinant human erythropoietin (r-HuEPO)
      can be effectively used to increase the volume of autologous blood obtained
      before surgery and to prevent the anemia caused by serial phlebotomy. Determining
      the optimal dose, route, and interval of administration of r-HuEPO is currently
      the object of ongoing investigations.

PMID- 1615336
TI  - The application of recombinant erythropoietin in anemic patients with cancer.
AB  - Recombinant human erythropoietin (r-HuEPO) has been shown to correct anemia and
      alleviate transfusion dependency in patients with end-stage renal disease, to
      ameliorate anemia and reduce transfusion requirements in anemic patients with
      acquired immunodeficiency syndrome, to correct anemia in patients with rheumatoid
      arthritis, and to facilitate predeposit autologous blood donation. Cancer is
      frequently complicated by anemia, and a survey of serum erythropoietin
      concentrations in anemic cancer patients showed inappropriately low
      concentrations for the degree of anemia. Initial clinical trials suggest that r
      HuEPO can correct the anemia associated with malignancy, but the exact role of
      the recombinant hormone in this situation remains to be defined.

PMID- 1615337
TI  - Use of recombinant human erythropoietin in the treatment of anemia in patients
      who have cancer.
AB  - Mild to moderate anemia associated with malignant disease can contribute to the
      overall morbidity in patients with cancer. Because this anemia has been linked to
      a blunted erythropoietin response, recombinant human erythropoietin (r-HuEPO) was
      assessed as a means to correct it and provide some degree of palliation. Three
      different patient populations were studied: one population not administered
      chemotherapy, a second population administered chemotherapy that did not include
      cisplatin, and a third population administered chemotherapy that included
      cisplatin. In all patient populations, r-HuEPO increased hematocrit values
      compare with placebo. In the two chemotherapy-treated populations, r-HuEPO
      decreased blood transfusion requirements after the first month of therapy.
      Patient-rated energy levels, ability to engage in daily activity, and overall
      quality of life improved in patients who responded to r-HuEPO therapy with an
      increase in hematocrit values of 6 percentage points or more. Thus, it appears
      that r-HuEPO may be a useful adjunct for palliation and treatment of anemia in
      patients with cancer.

PMID- 1615338
TI  - Changing patterns of care in the management of anemia.
AB  - There exists a potential for change in the approach to the management of the
      patient with chronic disease, specifically, the anemia of chronic disease (ACD).
      One of the components in the pathophysiology of ACD is inadequate erythropoietin
      response. Normally, as anemia develops, the erythropoietin level does not begin
      to increase until the hematocrit level decreases below 35%. However, the increase
      in the erythropoietin level is blunted in ACD. Increasing the hematocrit level by
      transfusion or recombinant human erythropoietin (r-HuEPO) treatment can
      subjectively and objectively improve the ACD patient's symptoms and performance.
      Although objective data in support of blood transfusions do exist, this treatment
      can carry risks of acute and chronic reactions, infection, and possibly
      immunosuppression. Treatment with r-HuEPO is a safer, nontransfusion means of
      increasing the hematocrit level of the patient with ACD symptoms.

PMID- 1615339
TI  - Biomodulation of chemotherapy-induced myelosuppression.
AB  - Growth factors, or cytokines, that have a broad spectrum of actions on lymphoid
      and myeloid cell lineages recently have been introduced into clinical practice.
      Erythropoietin, granulocyte-colony stimulating factor, and granulocyte-macrophage
      colony stimulating factor were the first to be introduced and to receive approval
      from the Food and Drug Administration. A number of interleukins and other
      cytokines presently are being developed. If a clinician is to use these potent
      biologicals appropriately, it is important that he or she understand the basic
      concepts of their biological actions and physiological effects. This article
      outlines features of production, cellular action, synergistic interactions,
      action on neoplastic cells, and clinical utility of these growth factors, all
      relating to their potential use in states of chemotherapy-induced
      myelosuppression.

PMID- 1615340
TI  - Control of G(0) phase of human bone marrow stem cells.

PMID- 1615341
TI  - T-cell depletion and allogeneic bone marrow transplantation.

PMID- 1615342
TI  - T-cell depletion in unrelated bone marrow transplantation.

PMID- 1615343
TI  - [Use of the terms "incidence" and "prevalence" in epidemiological studies].

PMID- 1615344
TI  - [Perspectives of research and action in the field of infectious diseases in
      Mexico].

PMID- 1615345
TI  - [Factors of Salmonella typhi virulence in relation to the development of new
      vaccines].
AB  - Although many vaccines against typhoid fever have been developed, none have been
      adapted for their further application on developing countries. In order to get
      better vaccines, the virulence factors of both S. typhi and S. typhimurium have
      been studied. Thus, some protection assays have been made using surface antigens
      involved on virulence or using live attenuated vaccines of bacteria mutated on
      virulence genes. Here we present a brief review about virulence factors studied
      so far for the development of new vaccines.

PMID- 1615346
TI  - [Vaccines against Haemophilus influenzae B: present, past and future].
AB  - Haemophilus influenzae type b (Hinb) is the main etiologic agent of severe
      pediatric illnesses, such as meningitis, epiglottitis and pneumonia. Countries
      most affected by this pathogen are localized in the American, European and
      African continents. While this organism was originally isolated 100 years ago,
      the first field trial using a whole killed vaccine was performed until 1959.
      Since then, further controlled clinical trials have mainly been conducted in the
      North American and European continents. Under appropriate safety and efficacy
      evaluation tests performed by the Federal Drug Administration Agency (FDA), five
      vaccines were licensed: one single and four conjugated preparations. Worldwide
      and regional epidemiologic data concerning serious diseases produced by this
      organism have shown their outstanding impact in the public health of developed
      countries. Unfortunately, in developing countries similar epidemiological indexes
      are lacking for lethal and disabling diseases, such as meningitis. In order to
      decrease high morbidity and mortality rates of this meningeal disease and its
      neurological sequelae, immunoprophylactic preventive measures have been
      recommended. Furthermore, some risk factors of this infant illness can also be
      reduced. New strategies regarding conjugate Hib-vaccines are reviewed. Finally,
      promising virulence factors or self Hib-structures for the production of vaccines
      are suggested, such as outer membrane proteins (OMP), lipooligosaccharides,
      fimbriae or pili.

PMID- 1615347
TI  - [Use of molecular biology in the epidemiological characterization of Neisseria
      gonorrhoeae].
AB  - This paper describes current methods useful to define molecular markers from a
      collection of Neisseria gonorrhoeae strains. The procedures of auxotyping,
      serotyping and plasmid profiling led to the obtention of 10 auxotypes, 19
      serotypes and five plasmid types (including beta-lactamase plasmids) among 41
      gonococci studied. Twelve patterns of antimicrobial resistance were determined as
      well, through in vitro susceptibility testing by agar dilution. These tools in
      conjunction, offer the possibility to study gonorrhea in a dynamic fashion from
      an epidemiologic perspective. Furthermore, they have allowed us to establish a
      gonococcal reference laboratory in our institution.

PMID- 1615348
TI  - [Prevalence of cervicovaginal infections caused by Chlamydia trachomatis among
      female population of the city of Cuernavaca, Morelos].
AB  - The chlamydiae are a genetically diverse group of bacteria with a unique
      intracellular development cycle. The spectrum of clinical manifestations of
      Chlamydia trachomatis infections in the female includes cervicitis, acute
      urethral syndrome, pelvic inflammatory disease, salpingitis and the risk of
      exposure of infants born through an infected birth canal who may develop
      inclusion conjunctivitis and/or pneumonia. In order to determine the prevalence
      of cervicovaginal infections caused by C. trachomatis in female population in
      Cuernavaca, Morelos, we studied 2,407 sexually active women from a suburban area.
      Genital specimens were collected from each woman and cultured in McCoy cell
      monolayers. Detection of the bacteria was done by staining with fluorescein
      conjugated monoclonal antibodies (Syva Microtrak, Palo Alto CA). 97 of them were
      culture-positive for C. trachomatis, with and overall prevalence of 4.02 per
      cent. The most important clinical symptom observed in 47 of the infected patients
      was an increased or altered vaginal discharge.

PMID- 1615349
TI  - [Epidemiology of rubella in Mexico].
AB  - An analysis of the transmission dynamics of rubella in Mexico based upon notified
      cases during 1983-1990 is presented. It is observed, for the first time, that the
      force of infection in the age-group of 15-44 years old and the average age of the
      infection at the national level show a slight increase simultaneously. The
      theoretical estimates of the interepidemic period coincide with the observed
      ones. The annual proportion of susceptible individuals is practically constant
      during 1983-1990. The intrinsic reproductive rate of rubella at national level
      and for the different age-groups is assessed. The annual estimates of Ro are
      small and they are practically unchanged for all age-groups, excepting the group
      of 15-44 years. The herd immunity of rubella for the different age-groups is
      evaluated and it is concluded that the best strategy for preventing congenital
      rubella in Mexico is to continue with the no vaccination policy against rubella.
      Nonetheless, the continuous monitoring of this policy is necessary.

PMID- 1615350
TI  - [Seroepidemiology of rubella in Mexico: data and theory].
AB  - The pattern of seropositivity of rubella obtained through the National
      Seroepidemiological Survey (NSS) of 1987-1988 is compared with the observed
      annual patterns of morbidity and with theoretical serological profiles based upon
      the age-distribution of cases. In spite of a lack of direct correspondence among
      the NSS results and the ones obtained from morbidity data, a relationship among
      the patterns and trends is observed. The theoretical methods used for inferring
      the proportion of seropositives as a function of age provide an inexpensive and
      fast alternative in order to monitor the current policy of no vaccination against
      rubella in Mexico.

PMID- 1615351
TI  - [Entamoeba histolytica: a standing threat].
AB  - The importance and limitations of microscopic differential diagnosis of Entamoeba
      histolytica in asymptomatic carriers is reviewed. The possibility that some
      nonpathogenic strains of E. histolytica could be Entamoeba hartmanni is
      discussed. The imperative necessity to encourage research in epidemiology and
      diagnosis is emphasized. The need to know the prevalence in Mexico and
      distinguish E. histolytica from E. hartmanni is also discussed. This differential
      diagnosis is fundamental in the treatment of carriers and in epidemiological
      studies. Treatment must be directed only to acute and chronic patients and
      asymptomatic carries who prepare food. Appropriate drugs are still metronidazole
      and quinolines.

PMID- 1615352
TI  - [Infectious agents and autoimmune diseases].
AB  - In this paper the molecular aspects of the relationships between infectious
      agents and autoimmune diseases, the mechanisms of immune response to infectious
      agents, and the more recent hypotheses regarding the cause of autoimmune diseases
      are discussed. The antigens are processed and selected by their immunogenicity,
      and presented by HLA molecules to the T cell receptor. These events initiate the
      immune response with the activation and proliferation of T-lymphocytes. Although
      there are several hypotheses regarding the cause of autoimmune diseases and too
      many findings against and in favor of them, there is still no conclusive data.
      All these hypothesis and findings are discussed in the context of the more recent
      advances.

PMID- 1615353
TI  - [Infectious diseases in the era of the global village].
AB  - This paper discusses the situation of infectious diseases in an era of the global
      village. Emphasis is placed on three themes: 1) the blurring of geographical
      borders of infectious diseases; 2) the role of technology in the combat against
      infectious diseases, and 3) the need for international collaboration for the
      control of the main infectious problems.

PMID- 1615354
TI  - [The omnipresence of helminthiasis].
AB  - This article presents a reflexion on the role of helminthic diseases in the
      world. Emphasis is made on the fact that in spite of its enormous diversity,
      helminthic parasites have similar epidemiologic behaviours and share high
      endemicity. Mathematical model design is crucial not only for a better
      understanding of their transmission mechanisms, but to evaluate different
      intervention strategies. Nonetheless, control of this serious endemic diseases
      will be achieved only through the joint effort of governments, funding agencies
      and researchers.

PMID- 1615355
TI  - [Transmission of cholera by flies. 1897].

PMID- 1615356
TI  - Occupational lung disease.

PMID- 1615357
TI  - Rights and realities: a critical review of the accessibility of information on
      hazardous chemicals.
AB  - The importance of workers' right-to-know about current hazards in the workplace
      and the importance of notification about risks associated with past exposures
      would seem self-evident. Some of the methods for achieving the goal of an
      informed work force can be found in the existing right-to-know laws and
      notification programs. This article reviews right-to-know legislation and
      describes the current state of implementation of these regulations and some of
      the barriers that impair workers from receiving information and from being able
      to act to protect themselves.

PMID- 1615358
TI  - Pneumoconioses in the United States: highlights of surveillance data from NIOSH
      and other federal sources.

PMID- 1615359
TI  - Surveillance for lung disease. Quality assurance using computers and a team
      approach.
AB  - An occupational pulmonary surveillance program will detect the lung diseases that
      affect about 20% of the general population: asthma, chronic bronchitis,
      emphysema, restrictive disorders, and lung cancer. Annual spirometry testing and
      standardized respiratory questionnaires are useful components of all programs,
      but because many problems with spirometry testing and interpretation occur, a
      team approach is indicated. In order to minimize the false-positive rate, an
      expert in pulmonary surveillance should be included to help choose a good
      spirometry system, train technicians, monitor the quality of their work, and
      interpret the results. Interpretation of annual change in pulmonary function
      enhances the ability to detect lung disease early but requires knowledge of the
      test-retest reproducibility of the FEV1 of your own surveillance program.

PMID- 1615360
TI  - Inherited predisposition to lung cancer.
AB  - This chapter summarizes data from epidemiologic and animal model studies which
      demonstrate that an inherited predisposition influences the incidence of lung
      cancer. The authors review the cell biologic events that contribute to neoplastic
      transformation and the biologic processes that influence tumor progression. They
      describe how host mechanisms may limit the genesis and progression of tumors and
      discuss how information about mechanisms of carcinogenesis may be applied to
      estimating the risk of lung cancer in individuals exposed to environmental
      carcinogens.

PMID- 1615361
TI  - Pulmonary imaging techniques in the diagnosis of occupational interstitial lung
      disease.
AB  - The chest radiograph is extensively used in evaluating workers at risk for
      developing occupational lung disease. Other pulmonary imaging techniques used in
      conjunction with the initial chest radiograph include conventional computed
      tomography, high resolution computed tomography, and gallium scintigraphy. This
      chapter evaluates the use of these techniques and their appropriate applications
      in the pneumoconioses, hypersensitivity pneumonitis, berylliosis, and hard metal
      diseases.

PMID- 1615362
TI  - Environmental monitoring: correlating air measurements of substances with immune
      response.
AB  - In summary, data from animal models would suggest that air measurements of
      substances can be correlated with immune response, be it immunodepression or
      either of the two forms of immunostimulation-autoantibody formation or specific
      immunologic sensitization. However, became immunodepression and autoantibody
      formation are not specific for a given substance, and because they can be induced
      by a variety of other factors such as drugs and intercurrent viral infections, it
      would seem unlikely that correlations between air measurements and measurements
      of immunodepression or autoantibody formation could be very useful. In contrast,
      specific immunologic sensitization is a response that can only be induced by
      exposure to a specific agent. The major problem confronting investigators
      attempting to perform concentration-response studies in humans is accurate
      measurement of workplace exposures. If exposures could be reliably quantified, it
      is likely that concentration-response correlations could be determined for worker
      groups. This could prove useful for estimating exposure of groups based on
      aggregate immune response. It would be most useful, however, for determining
      threshold concentrations below which a very low proportion of workers--perhaps 1
      in 100 or even 1 in 1000--would become sensitized. These threshold concentration
      levels of sensitizing substances could be used to develop permissible exposure
      levels in the workplace. Reducing workplace sensitization and diseases such as
      occupational asthma and hypersensitivity pneumonitis would be of obvious benefit
      to workers, management, government, and society at large.

PMID- 1615363
TI  - Water-related lung diseases.
AB  - A variety of water sources can act as reservoirs and vectors for contaminants
      associated with acute and chronic lung diseases. Inhalation of contaminated
      aerosols is the most important route of exposure leading to water-related lung
      disease. However, dermal absorption, disseminated marine-acquired wound
      infections, and ingestion or aspiration of water containing harmful contaminants
      have been associated with pulmonary disease as well. This article discusses these
      routes of infection and describes the infectious and noninfectious lung diseases
      associated with exposure to water.

PMID- 1615364
TI  - Acquired airway hyperresponsiveness from nonimmunogenic irritant exposure.
AB  - The question of whether nonallergic airway hyperresponsiveness is an acquired or
      an inherent phenomenon is important in the understanding of occupational lung
      disease, as it has implications for the management and prevention of occupational
      disease. This chapter reviews the evidence suggesting that airway
      hyperresponsiveness may be acquired as a result of exposure to irritants in the
      workplace.

PMID- 1615365
TI  - Isocyanates and lung disease: experimental approaches to molecular mechanisms.
AB  - Isocyanates are reactive compounds that have commercial applications in the
      synthesis of a variety of products, including paints, coatings, elastomers, and
      foams. The correlation between isocyanates and a spectrum of respiratory disease
      has been established, primarily at the clinical level. The focus of this article
      is to bridge the gap of understanding from clinical symptoms to molecular
      reactivity, with emphasis on experimental approaches that serve to complement
      clinical and epidemiologic data.

PMID- 1615366
TI  - Occupational and environmental respiratory diseases: a medicolegal primer for
      physicians.
AB  - This article is an introduction to medicine and the law with specific reference
      to occupational and environmental respiratory diseases. It provides an initial
      orientation for practicing physicians and includes basic definitions, practices
      and procedures, and helpful hints. Basic information about impairment and
      disability evaluations are reviewed.

PMID- 1615367
TI  - Don't just "do spirometry"--closing the loop in workplace spirometry programs.
AB  - The authors acknowledge that surveillance is a word that often causes eyes to
      glaze over and recognize that spirometry is often a casualty of a routine
      approach to surveillance. This article describes how to use spirometry as an
      active part of an on-site workplace occupational health program whose emphasis is
      avoiding trouble by knowing where and how to look for signs of occupational lung
      disease.

PMID- 1615368
TI  - Central diabetes insipidus resulting from a nonneoplastic tiny mass lesion
      localized in the neurohypophyseal system.
AB  - With the advent of magnetic resonance imaging (MRI), the neurohypophyseal system
      can be clearly delineated and its functional integrity can be predicted. The
      authors describe seven cases of central diabetes insipidus (DI) that occurred
      spontaneously. MRI revealed that the normal hyperintensity of the pituitary
      posterior lobe, which has been thought to be the neurosecretory material
      containing antidiuretic hormone, was absent in all cases. In addition,
      enlargement of a part of the neurohypophyseal system was recognized in five of
      seven cases on MRI. Three of the five patients with enlargement of a part of the
      neurohypophyseal tract underwent biopsy and were demonstrated to have chronic
      inflammation of the neurohypophyseal system. It was demonstrated that the
      enlarged parts of the neurohypophyseal system had shrunk either spontaneously or
      after the biopsy in four of the five cases. All patients are alive and have not
      experienced progression or remission of the disease. This study indicates that
      some cases of idiopathic DI result from a tiny mass lesion, usually
      nonneoplastic, localized in the neurohypophyseal system.

PMID- 1615369
TI  - Primary tumors of the cervical spine: surgical experience with 38 cases.
AB  - Thirty-eight primary tumors of the cervical spine were operated on in the Section
      of Neurosurgery, Department of Neurological Sciences, "La Sapienza" University of
      Rome between 1954 and 1988. Of these, 23 were malignant and 15 benign. The aims
      of surgical treatment in every case were tumor removal, decompression of the
      spinal cord, and conservation or restoration of vertebral stability. In no case
      was surgery confined to biopsy. Surgical stabilization was performed in 12
      patients. Bone fusion was obtained with autologous bone (iliac crest, fibula) in
      benign tumors, whereas synthetic material (acrylic and metal) was used in
      malignant tumors. Past experience and greater awareness of the concrete
      possibilities of treating these tumors have led us to evolve the following
      strategy: 1. For aggressive benign tumors (osteoblastoma, giant cell tumors) and
      for malignancies in patients with fair life expectancy (solitary myeloma,
      chordoma): radical removal. 2. For benign tumors with low neoplastic potential
      and for malignant tumors in patients with poor life expectancy: conservative
      removal. Long-term results were gratifying in all benign lesions and low-grade
      malignancies even though two patients with chordomas needed reoperations.
      Sarcomas had relatively poor results.

PMID- 1615370
TI  - Direct surgery for giant aneurysm exhibiting progressive enlargement after
      intraaneurysmal balloon embolization.
AB  - A case of giant intracranial carotid artery aneurysm exhibiting progressive
      enlargement after incomplete intraaneurysmal balloon embolization is presented.
      The patient was successfully treated by the trapping and decompression of the
      aneurysm with a superficial temporal artery-middle cerebral artery anastomosis.
      The thrombus surrounding the intraluminal balloons was very soft and poorly
      organized. Either direct surgery with extracranial-intracranial arterial bypass
      or complete intravascular surgery should be performed for giant aneurysms when
      direct clipping is impossible.

PMID- 1615371
TI  - Primary solitary intracranial melanoma: case report and review of the literature.
AB  - Among CNS tumors, intracranial melanomas represent a subject of interest for
      neurooncologists and neurosurgeons because clinical and radiological patterns of
      these tumors can mimic the presence of meningiomas, and in spite of their
      malignant behavior they can be satisfactorily treated. In the present report we
      describe a new case of primary intracranial melanoma that displayed some
      radiological features of meningioma; we review the clinical features of 80
      previously well-documented cases. The importance of neuroradiological and
      histochemical (S-100 protein, antimelanin antibodies, proliferating cell nuclear
      antigen staining) methods and of flow cytometry in helping with histopathological
      examination is stressed. Review of the clinical histories demonstrates that
      surgical excision is recommended in most cases, depending on tumor location, and
      that if total removal is performed, long-term disease-free periods can be
      attained.

PMID- 1615372
TI  - Periventricular neurocytoma: a pathological entity.
AB  - Three cases of periventricular neurocytomas are presented. All patients had a
      large but well-circumscribed, hyperdense tumor with insignificant contrast
      enhancement in the lateral and third ventricle, causing hydrocephalus.
      Calcification was present in one patient. Angiography revealed a blush tumor
      enhancement in two cases. Surgical removal was complete in two patients and
      incomplete in one. Light microscopy showed a cell pattern that resembled either
      ependymoma or oligodendroglioma. However, in all cases the tumor was confirmed to
      be a neurocytoma by immunocytochemical analysis that showed reactivity for
      synaptophysin and/or neuron-specific enolase in a high percentage of neoplastic
      cells. With respect to the literature it is concluded that neurocytomas represent
      an individual pathological entity of supratentorial midline tumors. Complete
      surgical removal without irradiation is the recommended treatment.

PMID- 1615374
TI  - Occult spinal pseudomeningocele following a trivial injury successfully treated
      with a lumboperitoneal shunt: a case report.
AB  - A patient with a traumatic occult spinal pseudomeningocele is presented. The
      possible etiology and the use of a lumboperitoneal shunt in this situation are
      discussed.

PMID- 1615373
TI  - Posterior inferior cerebellar artery (PICA) aneurysm presenting with SAH and
      contralateral crural monoparesis: a case report.
AB  - A patient with contralateral monoparesis of the leg due to subarachnoid
      hemorrhage (SAH) from an aneurysm of the first posterior inferior cerebellar
      artery (PICA) segment is reported. The monoparesis may well be associated with
      the close anatomical relationships between the site of the aneurysm and the PICA
      blood supply of the corticospinal fibers to the contralateral leg.

PMID- 1615375
TI  - Endovascular coil embolization of a recurrent giant internal carotid artery
      aneurysm via the posterior communicating artery after cervical carotid ligation:
      case report.
AB  - The case of a 29-year-old man with a giant fusiform aneurysm of the left internal
      carotid artery (ICA) is presented. The aneurysm, treated by cervical ICA ligation
      and extracranial-intracranial bypass, recurred 4 years later owing to recruitment
      of the posterior communicating artery (PCoA). Because of the previous bypass
      surgery a direct surgical approach was excluded. After an initial failure with
      balloon embolization, the aneurysm was embolized successfully with occlusive
      platinum microcoils through the microcatheter navigated into the aneurysm via the
      enlarged PCoA. Endovascular coil embolization may be useful in the treatment of
      cerebral aneurysms not amenable to direct surgery or balloon embolization.

PMID- 1615376
TI  - Symptomatic cerebral vasospasm after intraventricular hemorrhage from ruptured
      arteriovenous malformation.
AB  - We present a rare case showing symptomatic vasospasm after intraventricular
      hemorrhage from a ruptured arteriovenous malformation. No significant
      subarachnoid hemorrhage in the basal cisterns was observed on computed tomography
      in the entire course of illness. Although most cases showing vasospasm are
      associated with the deposition of blood in the basal cisterns, this case suggests
      the possibility of some other important factor in causing the subsequent
      development of vasospasm.

PMID- 1615377
TI  - Cranial fasciitis of childhood: a case report.
AB  - Cranial fasciitis of childhood is very rare, only 17 cases having been reported
      in the literature. We report an additional case of this rare disease. The patient
      was a 5-year-old boy who complained of left exophthalmos and double vision.
      Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large
      epidural mass in the left frontal region that had invaded into the underlying
      anterior skull base. The tumor showed homogeneous, low density with
      nonhomogeneous contrast enhancement on the CT scans, and low intensity on the T1
      weighted and high intensity on the T2-weighted MRI images. A whitish-pink,
      elastic, hard tumor was revealed in the epidural space in the left anterior
      cranial fossa, which was totally excised with curettage of the affected anterior
      skull base. The origin of the tumor was suspected to be the fibrous connective
      tissue of the sphenofrontal suture. The histological diagnosis was that of
      cranial fasciitis. There was no evidence of recurrence 1 year postoperatively.

PMID- 1615378
TI  - Nicardipine in the prevention of spasm-induced neurological deficits after
      subarachnoid hemorrhage: a dose-ranging study.
AB  - The tolerability of four doses of intravenous nicardipine (0.03, 0.08, 0.11, and
      0.15 mg/kg/h) was assessed in this randomized multicenter, parallel-group study.
      Fifty-two patients with Hunt and Hess grade I-III aneurysmal subarachnoid
      hemorrhage were treated with intravenous nicardipine beginning within 4 days of
      bleeding, for a mean duration of 12.6 days; this treatment was followed by
      administration of oral nicardipine 90-120 mg until day 30. Hypotension was the
      main side effect, and it occurred only in the two groups that received the
      highest doses. However, it was possible to continue nicardipine in all cases at
      lower doses or even without modification, and hypotension was never responsible
      for any deleterious clinical effect.

PMID- 1615379
TI  - Can laser angioplasty replace carotid endarterectomy in the management of
      nonstenotic atheromatous disease of the carotid bifurcation?

PMID- 1615380
TI  - Discovery of the arachnoid membrane.

PMID- 1615382
TI  - [Medical technology in primary school].

PMID- 1615381
TI  - [History--a life in the forefront. Interview by Ole Sohn].

PMID- 1615383
TI  - [ICN--solidarity with colleagues in Ghana].

PMID- 1615384
TI  - [Education. Philosophy for nurses].

PMID- 1615385
TI  - [Work environment. Work Inspection wants to inspect all hospitals].

PMID- 1615386
TI  - [AIDS--Noah's Ark].

PMID- 1615388
TI  - [Outpatient childbirth. Lack of milk].

PMID- 1615387
TI  - [Outpatient childbirth. Restraint with success].

PMID- 1615389
TI  - [Health policy--pictures of the future. Interview by Kirsten Bjornsson].

PMID- 1615390
TI  - [Taxes--nurses' 1991 income tax returns].

PMID- 1615391
TI  - [Needed--continuing education].

PMID- 1615392
TI  - [Home care nursing--challenge and frustration].

PMID- 1615393
TI  - [Team work. Health visitors are needed when children are hospitalized].

PMID- 1615394
TI  - [Nutrition. Standard diet--a bad idea].

PMID- 1615395
TI  - [Nursing home--fellowship group as a form of nursing].

PMID- 1615396
TI  - [Outpatient--the form of surgery for the future].

PMID- 1615397
TI  - [Clinical nursing. The pouch-free system].

PMID- 1615398
TI  - [Spiritual care].

PMID- 1615399
TI  - [Executive Board--afraid at work].

PMID- 1615400
TI  - [Executive Board--standardization is not included in assignments].

PMID- 1615401
TI  - [Kuwait--new professional horizons].

PMID- 1615402
TI  - [Physician's on-call roster. Children, trifles and drug addicts].

PMID- 1615403
TI  - [Physician's on-call roster. A pampered generation].

PMID- 1615404
TI  - [Physician's on-call roster. The psychological support bandage].

PMID- 1615405
TI  - [Physician's on-call roster. Shorter on-call hours, more patients].

PMID- 1615406
TI  - [Physician's on-call roster. The new arrangement].

PMID- 1615407
TI  - [Good and bad working days].

PMID- 1615409
TI  - [Romania--Danish behind the new education system].

PMID- 1615408
TI  - [Education on the spot].

PMID- 1615410
TI  - [Professional nursing guidelines. Bridge between theory and practice].

PMID- 1615411
TI  - [Physician's on-call roster and nurses].

PMID- 1615412
TI  - [Physician's on-call roster. Weekend on-call in medical practice].

PMID- 1615413
TI  - [Physician's on-call roster. Entire family involved in on-call activities].

PMID- 1615414
TI  - [Everyday with diagnosis].

PMID- 1615415
TI  - [Documentation--support enthusiastic minds].

PMID- 1615416
TI  - [EEC will influence health system].

PMID- 1615417
TI  - [Report on health legislation--shortages and goal-setting].

PMID- 1615418
TI  - [France--sit-in cleared away].

PMID- 1615419
TI  - [France--5 percent organized].

PMID- 1615420
TI  - [France--we will create a new professional organization].

PMID- 1615421
TI  - Comments on "Target tissue specificity of retinoic acid-induced stress proteins
      and malformations in mice".

PMID- 1615422
TI  - The "maternal arterial space" in the center of rats' placenta may be venous, not
      arterial.

PMID- 1615423
TI  - The interaction between dysmorphology and epidemiology: methodologic issues of
      lumping and splitting.

PMID- 1615424
TI  - Distal phocomelia of the forearm in a thirteenth-century skeleton from Poland.
AB  - The skeleton of a 35- to 40-year-old male (A.D. 1250 to 1300) with distal
      phocomelia (intercalary transverse) of the right forearm and severe (90-100
      degrees) right-sided scoliosis is examined. Congenital malformation of the the
      right forearm resulted in absence of the radius and ulna, and attachment of the
      upper arm and hand to the trunk. Lesser abnormalities consist of a-hypoplastic
      right scapula and misshapened ribs and sternum. This rare deformity reflects the
      variability and antiquity of congenital malformations of the upper limb.

PMID- 1615425
TI  - Cardiovascular anomalies in chick embryos produced by bis-diamine in
      dimethylsulfoxide.
AB  - N,N'-bis(dichloroacetyl)-1,8-octamethylenediamine(bis-diamin e) (100 micrograms)
      dissolved in dimethylsulfoxide (DMSO) was administered to early developing chick
      embryos (Hamburger-Hamilton stage 9-21) in order to clarify the teratogenic
      effects on the cardiovascular system and to determine whether bis-diamine
      interferes with the migration of neural crest cells. Of 346 cases, 154 (44.5%)
      survived. The incidence of cardiovascular anomalies was 149 out of 154 cases
      (96.8%). Infundibular ventricular septal defect, double outlet right ventricle,
      and persistent truncus arteriosus were the primary cardiac anomalies observed in
      this study. A high percentage of these anomalies were accompanied by hypoplasia
      of the right 6th aortic arch artery and persistent left 4th aortic arch artery.
      Particularly, administration of bis-diamine to chick embryos at stage 13 resulted
      in a high incidence of persistent truncus arteriosus (64.3%). Bis-diamine has
      been suspected to inhibiting the migration of neural crest cells. However, neural
      crest cells were observed in the tunica media of the great arteries and the
      truncal valves of persistent truncus arteriosus produced by bis-diamine in
      chimeric embryos at stage 13. Morphological changes such as cell death were not
      observed.

PMID- 1615426
TI  - Effects of 4-hydroperoxycyclophosphamide (4-OOH-CP) and 4
      hydroperoxydechlorocyclophosphamide (4-OOH-deCICP) on the cell cycle of post
      implantation rat embryos.
AB  - In this study, we used preactivated forms of cyclophosphamide (CP) and
      dechlorocyclophosphamide (deClCP) to examine the effects of phosphoramide mustard
      (PM) and acrolein, respectively, on the cell cycle of postimplantation rat
      embryos. The percentage distribution of cells in the G1/G0, S, and G2/M phases of
      the cell cycle was determined by flow-cytometric analysis. At embryotoxic
      concentrations, 4-OOH-CP (PM) induced major cell cycle perturbations whereas 4
      OOH-deClCP (acrolein) caused no major perturbation of the cell cycle. These data
      support the hypothesis that the mechanism of the embryotoxic action of PM
      involves alkylation of DNA, whereas the mechanism of action of acrolein does not.
      The primary effect of PM on the cell cycle was an initial delay in the S phase
      followed by a G2/M arrest. At low embryotoxic concentrations of 4-OOH-CP, there
      was apparent reversal of the G2/M arrest; at higher embryotoxic concentrations
      there was little recovery from the G2/M arrest. The high level of cell death
      found at higher drug concentrations suggests that prolonged G2/M arrest leads to
      cell death. Using radiolabeled CP and cell sorting, it was determined that PM
      predominantly alkylated DNA in the S phase of the cell cycle. Overall, the data
      from this study support the hypothesis that DNA cross-links, induced by the
      alkylation of DNA by PM, induce cell cycle perturbations. Furthermore, these cell
      cycle alterations may be one of the early steps in the mechanism leading to the
      embryotoxicity of PM.

PMID- 1615428
TI  - The use of dysmorphology in birth defects epidemiology.
AB  - Most human teratogens have been identified by the clinical recognition of
      characteristic patterns of congenital anomalies among children whose mothers were
      exposed to a particular agent during pregnancy. Although this dysmorphologic
      method has been valuable, it is criticized because it is not easily amenable to
      statistical evaluation. Conventional birth defects epidemiological studies are
      designed to permit rigorous statistical assessment, but such investigations
      usually classify congenital anomalies without adequate consideration of their
      known etiological heterogeneity. It is possible to combine the best aspects of
      these two approaches to identifying human teratogens in a "dysmorphologic
      case/control study." Instead of including all available cases with a given
      defect, only individuals having the anomaly in the context of a multiple
      congenital anomaly pattern without a recognizable cause would be selected for
      inclusion among the case group. The frequency of exposure to the putative
      teratogen would be determined among these selected cases and among appropriately
      chosen controls; conventional statistical analysis would then be performed.
      Although this design reduces the size of the case group compared to a
      conventional case/control study, the statistical power is unchanged or increased.
      In addition, biological plausibility is increased by concentrating upon a group
      of cases that is more likely to have a teratogenic cause.

PMID- 1615427
TI  - Retinamides: hydrolytic conversion of retinoylglycine to retinoic acid in
      pregnant mice contributes to teratogenicity.
AB  - Retinamides are prominent among synthetic vitamin A derivatives (retinoids) which
      can prevent or reduce the incidence of certain carcinogen-induced neoplasms in
      animals. They also possess lower toxicity toward adult and developmental systems
      than natural retinoids, presumably because of the presence of an amide endgroup
      which resists ready hydrolysis. In this investigation, we compared the
      developmental toxicities in mice of N-(4-hydroxyphenyl)retinamide(4-HPR), N
      ethylretinamide (ER) and two retinoylamino acids, N-(all-trans-retinoyl)glycine
      (RG) and N-(all-trans-retinoyl)-DL-leucine (RL), which are formed from retinoic
      acid and the alpha-amino acids; RG and RL were shown in a previous study to
      differ from each other and from retinoic acid in certain toxicity bioassays. We
      found that while 4-HPR, ER, and RL were only minimally embryotoxic, RG was
      uniquely active as a teratogen with potency equivalent to that of retinol, the
      precursor of retinoic acid. Since binding to cytoplasmic proteins and nuclear
      receptors is a function of the presence of an acidic endgroup in the retinoid
      molecule, we investigated if RG given to pregnant mice was converted to retinoic
      acid (RA) and if teratologically significant amounts were detectable in the
      embryo. A single 100 mg/kg dose of RG in oil vehicle was given orally to ICR mice
      on day 11 of gestation (plug day = day 0). Extraction and quantification by HPLC
      of the retinoids in the maternal plasma and in whole embryos were performed at
      hourly intervals for the first 10 h after dosing and at 26 h. RG was absorbed
      rapidly reaching peak levels in the maternal plasma at 1 h after the dose and
      maintained a level of 15 micrograms/mL for up to 4 h, before starting a decline.
      RG also transferred to the embryo reaching peak levels greater than 0.75
      micrograms/g wet weight between 2 and 4 h after the dose. All-trans RA was
      detected in the maternal plasma and the embryo at 1 h after the dose, reaching
      peak levels at 2 h in both compartments (0.43 micrograms/mL or g), before
      starting a decline. Small quantities of 13-cis RG (a contaminant in the original
      solution comprising 2-3% by weight) and 13-cis RA were also detected in both
      compartments, but their amounts in the embryo were considered insufficient to
      contribute to teratogenicity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1615429
TI  - The role of the visceral yolk sac in hyperglycemia-induced embryopathies in mouse
      embryos in vitro.
AB  - The adverse developmental effects of hyperglycemia to rodent embryos have been
      shown using whole embryo culture. Although, a mechanism by which hyperglycemia
      induced effects occur is unknown, recent work has focused on the visceral yolk
      sac as a potential target tissue. Therefore, we have evaluated the developmental
      effects of hyperglycemia in early head fold stage mouse embryos in vitro and
      assessed the histiotrophic function of the visceral yolk sac. As has been
      previously shown in rodents, hyperglycemia produced neural tube closure defects
      in a concentration dependent manner at 33, 50, and 67 mM glucose using a 44 h
      exposure period. However, exposure times between 6 and 12 h were sufficient to
      alter embryonic development when the glucose concentration was 50 or 67 mM. In
      contrast, early somite stage embryos (4-6 somite stage) appear to be less
      sensitive to dysmorphogenesis and a 48 h exposure to 67 mM glucose but not 33 or
      50 mM also produced neural tube defects. Hyperglycemia (67 mM) did not alter the
      uptake of 35S-methionine and 35S-cysteine-labeled hemoglobin (35S-Hb) in the
      visceral yolk sac (VYS) in early headfold staged embryos. However, the
      accumulation of 35S in the embryo was reduced by 16-18% at glucose concentrations
      of 50 or 67 mM during the last 12 h of a 44 h exposure period. No effect on VYS
      uptake or embryonic accumulation of 35S-labeled products was observed at shorter
      exposure periods (12-24 and 24-36 h).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615430
TI  - Maternal methionine supplementation promotes the remediation of axial defects in
      Axd mouse neural tube mutants.
AB  - The Axd (axial defects) mouse model system (Essien et al., Teratology 42:183-194,
      '90) is characterized by a dominant mutation which causes posterior open neural
      tube defects (NTD) and a variety of tail anomalies (curly tails, or CT). Repeated
      backcrosses to BALB/cByJ mice have resulted in a 50% increase in Axd penetrance
      among neonates of heterozygous matings and loss of a correlation with maternal
      tail phenotype. Analysis of D12-D18 embryos from Axd/+ x Axd/+ matings indicates
      that soft tissues can superficially heal over some lesions from open NTD and that
      some curly tails can straighten (macroscopically) as gestation proceeds.
      Similarly, in embryos of Axd/+ x BALB crosses, there is remediation of
      approximately 33% of the tail flexion defects by birth. Numerous studies show
      that maternal nutritional status can affect the development of the neural tube
      and related axial structures. One nutrient of special interest is methionine,
      which is required for neurulation in cultured rat embryos (Coelho et al., J.
      Nutr. 119:1716, '89). Thus, the major question addressed by this study was
      whether supplemental methionine administered to Axd/+ dams crossed to Axd/+ males
      would alter the prenatal expression of the gene. When given IP (70 mg/kg) on D8
      and D9, methionine resulted in a 41% reduction (from 29% to 17%) in the incidence
      of NTD in D 14 embryos (P less than 0.01).

PMID- 1615431
TI  - Morphological changes in long bone development in fetal akinesia deformation
      sequence: an experimental study in curarized rat fetuses.
AB  - In order to investigate the transverse growth of the long bones during
      intrauterine development in the fetal akinesia deformation sequence (FADS), we
      studied curarized rat fetuses. Curarization was performed by daily subcutaneous
      administration of D-Tubocurarine from day 17 of gestation until term.
      Experimental fetuses were compared with a sham-operated control group. The total
      area and perimeter, the absolute and relative amount of periosteum and bone
      trabeculae, the major and minor axes, and the elongation factor were measured
      from histological cross-sections of the femoral metaphysis and diaphysis using an
      IBAS 1 image analysis system. Curarized rat fetuses showed growth retardation, a
      short umbilical cord, and multiple articular contractures, a phenotype consistent
      with FADS. Alterations in femoral shape and transverse growth that affected the
      diaphysis were noted in these fetuses. These included a decrease of total cross
      section area and reduction of the absolute and relative amounts of bone
      trabeculae with marked thinning of the periosteum. Femoral cross-sections was
      rounder than controls. These results evidenced an impairment of the membraneous
      (periosteal) ossification of long bones produced by immobilization and/or
      decrease of muscular strength, and support our previous clinical findings of bone
      hypoplasia and osteopenia in FADS.

PMID- 1615432
TI  - Inositol deficiency increases the susceptibility to neural tube defects of
      genetically predisposed (curly tail) mouse embryos in vitro.
AB  - Curly tail (ct/ct) mouse embryos, which have a genetic predisposition for neural
      tube defects (NTD), were grown in culture from the 2-5 somite stage, before the
      initiation of neurulation, up to the 22-24 somite stage, when closure of the
      anterior neural tube is normally complete. The embryos were cultured in whole rat
      serum or in extensively dialysed serum supplemented with glucose, amino acids,
      and vitamins, with inositol omitted or added at concentrations of 2, 10, 20, and
      50 mg/l. Two strains were used as controls; CBA mice, which are related to curly
      tails, and an unrelated PO stock. It was found that ct/ct embryos were
      particularly sensitive to inositol deficiency; both they and the CBA embryos
      showed a similar high incidence of cranial NTD after culture in inositol
      deficient medium (12/17 and 11/18, respectively). Furthermore, the lowest dose of
      inositol had no effect on the frequency of head defects in ct/ct mice, though it
      halved the incidence in CBA embryos. With higher inositol concentrations, the
      majority of ct/ct embryos completed head closure normally, and their development
      was generally similar to that obtained in whole serum. PO embryos showed a lower
      proportion (5/19) of cranial NTD in the inositol deficient medium than the other
      two strains, and this was further reduced by even the lowest inositol dose.

PMID- 1615433
TI  - Could a national health system really be worse?

PMID- 1615434
TI  - Insurance plan for Texas physicians makes major changes in HIV/AIDS coverages.

PMID- 1615435
TI  - Here's help in understanding Medicare's new claim form.

PMID- 1615436
TI  - Important dates loom for compliance with CLIA regulations.

PMID- 1615437
TI  - Rio Grande Valley physicians call for tort reform.

PMID- 1615438
TI  - New health reform plan maintains free-market system.

PMID- 1615439
TI  - Researchers seek new class of AIDS drugs.

PMID- 1615440
TI  - Student loan program revisions stall in Congress.

PMID- 1615442
TI  - Physicians have a place to take concerns under new UR rules.

PMID- 1615441
TI  - Training employees required under OSHA regulations.

PMID- 1615443
TI  - Neglecting informed consent is fuel for malpractice suits.

PMID- 1615444
TI  - TB waging attack on HIV-positive patients and jail inmates.

PMID- 1615445
TI  - Doctors join "Way Cool" adolescent health program.

PMID- 1615446
TI  - Reducing teen pregnancy rates is goal of summit.

PMID- 1615447
TI  - Agenda on AIDS.

PMID- 1615448
TI  - The cost of cancer in Texas.
AB  - Direct and indirect costs of cancer for Texas are estimated for 1988 and are
      compared to costs for 1980. The distribution of these costs by age group and type
      of cancer is presented and discussed. Conceptual and methodological issues
      underlying the estimates are explained to assist the reader in interpretation.
      The authors conclude that future collection of more specific data at the state
      level would greatly assist policymakers dealing with cancer issues.

PMID- 1615449
TI  - Selective posterior rhizotomy to treat spasticity associated with cerebral palsy:
      a critical review.
AB  - Selective posterior rhizotomy for the treatment of spasticity has become a widely
      used procedure. The historical evolution of this procedure is reviewed with an
      emphasis on the physiological basis for the procedure. The proper screening and
      selection criteria, perioperative management, operative technique, and
      postoperative therapy are discussed. Results from a series of 25 patients are
      reviewed. Ten of these patients were operated on for a goal of improved ease in
      caretaking and this was achieved. In seven patients, the goal was to improve
      independent functioning (ambulation was not considered possible) and this was
      achieved. Eight patients underwent the procedure to improve ambulation and this
      was achieved.

PMID- 1615450
TI  - "If the government would just leave us alone...".

PMID- 1615452
TI  - No easy solution for homicide rate.

PMID- 1615451
TI  - Physician defends rural health clinics.

PMID- 1615453
TI  - [Common cold: diagnostic steps? Antibiotics?].
AB  - The common cold is caused by more than 100 virus types. However, the clinical
      manifestation is always similar with rhinorrhea, stuffiness, sneezing,
      pharyngitis, laryngitis and cough. The local inflammatory reactions are not due
      to the presence of virus but caused by locally produced inflammatory mediators.
      Bacterial superinfections may cause otitis or sinusitis. Bacterial
      nasopharyngitis has been described in children. This entity possibly exists also
      in adults. Traditional viral cultures are rarely positive and are not recommended
      in the daily routine. In children, antigen detection for adenovirus, respiratory
      syncytial virus, parainfluenza and influenza virus are recommended to confirm the
      viral etiology or for epidemiological surveillance. The presence of group-A
      streptococci must be proven by culture or antigen detection before treatment with
      penicillin. Antiviral treatment is limited to interferon or ribavirin. New
      antiviral substances are in development. Today, treatment of common cold is
      limited to symptomatic measures, and antibiotic treatment is not justified.

PMID- 1615454
TI  - [Infectious sinusitis and otitis].
AB  - Insight into the pathogenesis and knowledge of the microbial flora provide the
      basis for the treatment of sinus and ear infections. Reduced oxygen tension and
      impaired mucociliary transport are important factors that influence the
      pathogenesis of both acute and chronic sinusitis and otitis. Therefore, topical
      decongestion and antibiotic regimens belong to the main therapeutic principles.
      The choice of an antibiotic for treatment of acute infections is usually empiric;
      however, in chronic and recurrent infections identification of the microbiology
      by fluid aspiration from the sinus or middle ear is desirable before long-term
      antibiotic therapy is initiated. It is also important to recognize underlying
      predisposing conditions such as nasal polyps, anatomic deformities or tooth
      abscesses which should be corrected to prevent further recurrences. External
      otitis is a painful condition seen most frequently in the swimming season
      (swimmer's ear) and is often associated with the use of cotton swabs. Repeated
      removal of debris from of the external canal and ototopical antibiotics are
      mostly successful; however, in severe cases like in necrotizing external otitis
      antibiotic therapy is indicated.

PMID- 1615455
TI  - [Group A streptococci 1992--a challenge for general practice, hospital and
      research].
AB  - Group A streptococci continue to frequently cause a wide array of infectious
      diseases. Prompt and reliable diagnosis of such patients and their adequate
      management are often complex and require substantial degree of both knowledge and
      suspicion. Modern aspects concerning acute streptococcal pharyngitis, invasive
      infections, and rheumatic fever represent important challenges for medical
      doctors working in private praxis, hospital and research. Major achievements in
      better understanding streptococcal infection include the complex pathogenicity of
      M-proteins, the perplexing results of uncritically performed throat cultures, the
      questionable therapeutic dominance of penicillin, and the prospect for active
      immunization. These changes certainly imply relevant adaption in managing group A
      streptococcal infections.

PMID- 1615456
TI  - [Acute and chronic bronchitis].
AB  - Acute bronchitis and exacerbations of chronic bronchitis are important problems
      in clinical practice. Acute bronchitis is frequently caused by viruses, and
      rarely by Mycoplasma or Chlamydia pneumoniae. Antimicrobial therapy is generally
      not indicated. The causes of exacerbations in patients with chronic bronchitis
      are often not clear. Beside environmental irritants and hypersensitivity with
      acute bronchospasm, viral infections are important. The role of bacterial
      infections is not established. Nevertheless, early antibiotic treatment seems to
      be beneficial, particularly in reducing the incidence of respiratory
      deterioration, and therefore decreasing cost and morbidity.

PMID- 1615457
TI  - [Pneumonia: etiologic diagnosis and therapy in general practice].
AB  - The majority of community-acquired pneumonias are not hospitalized, have a good
      prognosis and a low mortality rate. In the nonimmunocompromised adult patient,
      pneumonias are caused by a broad array of microorganisms of which the so-called
      'atypical' agents (mycoplasma, chlamydiae, viruses) are as frequently found as
      classical bacteria such as pneumococci and haemophilus. Generally, the mode of
      acquisition and the clinical picture will not allow to deduct the etiology with
      certainty, and the laboratory results are often nonconclusive (sputum
      examination) or delayed (serology). Empirical therapy should be initiated based
      on epidemiological grounds and on the characteristics of the patient. For
      patients without underlying conditions, immunosuppression or advanced age, a
      macrolide (erythromycin or a new macrolide) appears to constitute a good choice
      because of its broad spectrum of activity, comprising the classical bacterial
      agents of pneumonia, mycoplasma, chlamydiae, and legionella.

PMID- 1615458
TI  - [Urinary tract infections in general practice].
AB  - Urinary tract infections are a frequent problem in ambulatory practices.
      According to the localization of the infection and to complicating factors we
      differentiate between various syndromes with different clinical presentations.
      Relevant diagnostic criteria are a bacteriuria of greater than or equal to 100
      organisms par millilitre or a pyuria of greater than or equal to 5 leukocytes per
      high power field. For acute cystitis, a treatment for three days is recommended.
      Cotrimoxazole or quinolones are effective drugs, which are more and more
      recommended for the treatment of acute pyelonephritis, too.

PMID- 1615459
TI  - [Bacterial gastrointestinal infections: acute gastroenteritis].
AB  - The diagnosis of bacterial gastrointestinal infections is based on anamnesis,
      clinical signs and simple examinations of feces (fecal leucocytes, occult blood).
      Thereby it can be decided, whether a microbial identification by culture or an
      antibiotic therapy is indicated. In case of noninvasive infections mediated by
      enterotoxins, an oral substitution of liquid will suffice. An antibiotic therapy
      is indicated in case of severe, febrile dysentery, shigellosis, cholera, typhoid
      fever as well as severe infections by salmonella and clostridium difficile.

PMID- 1615460
TI  - [Localized bacterial skin infections and dermatologic manifestations of systemic
      infections].
AB  - Localized bacterial skin infections are frequent. In furunculosis, a local
      treatment is usually sufficient. In case of frequent recurrence a possible
      staphylococcus aureus colonization should be looked for and eliminated. Erysipela
      is treated by systemic antibiotics in order to avoid complications such as
      streptococcal gangrena or parainfectious glomerulonephritis. Anaerobic cellulitis
      and gas gangrena are postoperative or posttraumatic infections of the soft
      tissues which require a combined surgical and antibiotic treatment. Systemic
      infections may be recognized by characteristic skin lesions. These skin lesions
      are the consequence of bacterial emboli, vasculitis, intravascular coagulation or
      toxins, respectively. Examples for such manifestations are lesions in
      endocarditis, purpura fulminans, ekthyma gangrenosum, disseminated candidemia and
      toxic shock syndrome.

PMID- 1615461
TI  - [Suspected Lyme borreliosis: how to diagnose, whom to treat?].
AB  - Lyme Borreliosis is diagnosed or presumed primarily on a clinical basis.
      Serological tests may help to increase the diagnostic certainty. Type and
      duration of antibiotic therapy depend on the stage of the disease.

PMID- 1615462
TI  - [Fever without a recognizable cause in general practice: what should be done?].
AB  - Fever is one of the most common presenting symptoms for consultation in general
      practice. For the vast majority of cases, a specific cause is never found, and
      the fever disappears spontaneously. We present an algorithm for the management of
      a febrile adult patient with the aim to help recognize early a potentially
      dangerous infection and to avoid unjustified blind antibiotic therapy.

PMID- 1615463
TI  - The amount of plasminogen, tissue-type plasminogen activator and plasminogen
      activator inhibitor type 1 in human thrombi and the relation to ex-vivo
      lysibility.
AB  - Thrombolytic therapy successfully reopens obstructed blood vessels in the
      majority of cases. However, it is not known why a substantial amount of thrombi
      are resistant to lysis by a fibrinolytic agent. In vitro studies have
      demonstrated that tissue-type plasminogen activator (t-PA) and plasminogen
      incorporated in the clot (during formation) increase lysibility. To test whether
      lysibility of in vivo formed human thrombi is related to their composition, we
      studied 25 venous thrombi obtained at autopsy and 21 arterial thrombi obtained
      during embolectomy. Plasminogen activator inhibitor-1 (PAI-1) antigen was
      measured in a phosphate-buffered saline (PBS) extract of each thrombus; t-PA
      antigen and plasminogen antigen were determined in a 6 M urea extract of the
      thrombus, representing bound proteins. Lysibility was measured as weight
      reduction during 8 h of incubation in PBS containing streptokinase (SK) 100 U/ml,
      corrected for spontaneous lysis, reflected by weight loss in PBS without SK. In
      addition, lysibility in SK was compared with lysibility in urokinase (UK) 100
      U/ml and in t-PA 200 U/ml. Spontaneous lysis amounted to 29 +/- 5% (mean +/- SEM)
      and 33 +/- 5% in venous and arterial thrombi, respectively, and inversely
      correlated with the PAI-1 content of thrombi (r = -0.43, p less than
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615464
TI  - Effect of plasminogen activator inhibitor-1 on tissue-type plasminogen activator
      induced fibrinolysis.
AB  - The effect of fibrin on the interaction of human recombinant single-chain tissue
      plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) was
      studied in normal rabbit plasma and in plasma with high levels of native PAI-1. t
      PA was added to diluted plasma containing calcium (10 mM) and 125I-fibrinogen at
      37 degrees C. Clotting was initiated with human thrombin, and lysis was monitored
      both turbidimetrically and by release of 125I-fibrin degradation products (fdp).
      The activity of t-PA (50 IU/ml) was rapidly reduced to 15% of the initial value
      in plasma containing PAI-1 (23 AU/ml). When thrombin and t-PA were added
      simultaneously to the plasma, more than 70% of the activity was retained through
      incorporation of t-PA into the fibrin clot. t-PA-induced fibrinolysis in PAI-1
      enriched plasma was further delayed when the temperature was reduced from 37 to
      25 degrees C. Turbidimetric and 125I-fdp release data provided complementary
      information. The former technique traced fiber dissolution, while the latter
      reflected network integrity. These results indicate that t-PA-induced
      fibrinolysis in PAI-1 enriched plasma is modulated by the presence of fibrin and
      by temperature.

PMID- 1615465
TI  - No evidence for short-term regulation of plasminogen activator inhibitor activity
      by insulin in man.
AB  - In cross-sectional studies a positive correlation has been found between
      circulating insulin, triglycerides and plasminogen activator inhibitor (PAI-1)
      activity. To directly examine the effect of insulin on PAI-1 activity in vivo, we
      determined the response of PAI-1 activity in 17 normal subjects to acute
      hyperinsulinemia (serum free insulin 92 +/- 8 mU/l) during maintenance of
      normoglycemia (plasma glucose 5.1 +/- 0.1 mmol/l). In 12 matched control subjects
      PAI-1 activity was measured during infusion of saline (serum free insulin 3.6 +/-
      0.3 mU/l, plasma glucose 5.2 +/- 0.1 mmol/l). Plasma PAI-1 activity decreased
      during the insulin infusion from 9.0 +/- 1.4 to 5.6 +/- 0.8 U/ml (p less than
      0.01), and during saline infusion from 7.0 +/- 1.4 to 4.3 +/- 0.6 U/ml (p less
      than 0.05). Serum triglyceride concentrations decreased from 1.09 +/- 0.20 to
      0.76 +/- 0.09 mmol/l (p less than 0.001) during hyperinsulinemia but remained
      unchanged during the saline infusion (1.04 +/- 0.11 vs. 1.02 +/- 0.12 mmol/l,
      NS). We conclude that insulin does not acutely change plasma PAI-1 activity, and
      that acute insulin-induced changes in serum triglycerides occur independently
      from those of PAI-1 activity.

PMID- 1615466
TI  - Transport of anti-glycoprotein IIb/IIIa-antibodies into the alpha-granules of
      unstimulated human blood platelets.
AB  - The redistribution of the antibody-glycoprotein (GP) IIb/IIIa complex was
      investigated with the immuno-gold labeling technique in order to trace its
      transport in resting platelets. Washed platelets were incubated in the presence
      of aspirin and a prostacyclin analogue (iloprost) with three different monoclonal
      antibodies (Gi3, J15 and P2) against GPIIb/IIIa. The examination of ultrathin
      serial sections showed that the surface labeling was internalized into the
      surface connected membrane system (SCS). Labels were found within the alpha
      granules after 40 min and the number of labels increased during longer incubation
      periods (max. 120 min). The transport possibly involved coated membranes. The
      alpha-granules were neither found to be altered during this process nor were any
      morphological signs of platelet activation detectable. The anti-GPIIb/IIIa
      complex remained membrane-associated during the transfer. These observations
      indicate that the membrane-GPIIb/IIIa complex was stable and transported from the
      surface into the alpha-granules of resting platelets. Since this transport was
      not influenced by iloprost or by aspirin it may be interpreted as constitutive
      endocytosis.

PMID- 1615467
TI  - Reaction of acetaldehyde with human platelets.
AB  - Platelet function defects observed in chronic alcoholics are not wholly explained
      by the inhibitory action of ethanol on platelet aggregation; they are not
      completely reproduced either in vivo by short-term ethanol perfusion into
      volunteers or in vitro by the addition of ethanol to platelet-rich plasma. As
      acetaldehyde (AcH) binds to many proteins and impairs cellular activities, we
      investigated the effect of this early degradation product of ethanol on
      platelets. AcH formed adducts with human platelets at neutral pH at 37 degrees C
      which were stable to extensive washing, trichloracetic acid hydrolysis and
      heating at 100 degrees C, and were not reduced by sodium borohydride. The amount
      of platelet adducts formed was a function of the incubation time and of the
      concentration of AcH in the reaction medium. At low AcH concentrations (less than
      0.2 mM), platelet bound AcH was directly proportional to the concentration of AcH
      in the reaction medium. At higher concentrations (greater than or equal to 0.2
      mM), AcH uptake by platelets tended to reach a plateau. The amount of adducts was
      also proportional to the number of exposures of platelets to pulses of 20 microM
      AcH. AcH adducts formation severely impaired platelet aggregation and shape
      change induced by ADP, collagen and thrombin. A positive correlation was
      established between platelet-bound AcH and inhibition of aggregation. SDS-PAGE
      analysis of AcH adducts at neutral pH demonstrated the binding of
      [14C]acetaldehyde to many platelet proteins. AcH adduct formation with membrane
      glycoproteins, cytoskeleton and enzymes might interfere with several steps of
      platelet activation and impair platelet aggregation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1615468
TI  - Effective reversal of warfarin-induced excessive anticoagulation with low dose
      vitamin K1.
AB  - Reversal of the anticoagulant effect of warfarin in patients with no active
      haemorrhage can be achieved by administration of intravenous vitamin K1.
      Currently recommended doses of intravenous vitamin K1, for this purpose often
      result in subsequent difficulties in anticoagulation. We observed the response to
      low dose intravenous vitamin K1 in patients requiring reversal of anticoagulant
      therapy. Ten consecutive patients received 1 mg and 21 further patients received
      0.5 mg of intravenous vitamin K1. In 50% of the patients who received 1 mg of
      vitamin K1 the INR (International Normalised Ratio) fell below 2 at 24 h whereas
      in patients who received 0.5 mg the INR fell below 5.5 in all subjects after 24 h
      and in none did it fall below 2.0. No patient had any thrombotic or haemorrhagic
      complications and no difficulty was encountered in re-establishing anticoagulant
      control after 24 h. We recommend 0.5 mg of vitamin K1 as an effective and
      convenient method of predictable and fine control of oral anticoagulant therapy.

PMID- 1615469
TI  - Rapid isolation of human endothelial cells from whole blood using S-Endo1
      monoclonal antibody coupled to immuno-magnetic beads: demonstration of
      endothelial injury after angioplasty.
AB  - The presence in whole blood of circulating endothelial cells (EC) has been a
      subject of debate for many years. It could represent a good marker of vessel
      injury. We demonstrate here that human endothelial cells can be directly isolated
      and identified in circulating blood by means of an endothelial cell specific
      monoclonal antibody, S-Endo1, coupled to micromagnetic beads. The specificity and
      efficacy of the assay were established using normal blood samples with cultured
      EC added. Specific rosettes formed between EC and beads could subsequently be
      isolated with a magnet. The rosetted cells were recovered with a yield greater
      than 80%. Their endothelial origin was confirmed by the positive labelling of von
      Willebrand factor and thrombomodulin, as well as the presence of Weibel-Palade
      bodies. We applied this method to demonstrate significantly increased levels of
      EC in venous and arterial human blood samples in patients undergoing heart
      catheterization. This new whole blood immuno-separation method may be useful in
      determining endothelial cell injury in vascular disorders.

PMID- 1615470
TI  - Processing and characterization of recombinant von Willebrand factor expressed in
      different cell types using a vaccinia virus vector.
AB  - The cloning of the cDNA encoding von Willebrand factor (vWF) has revealed that it
      is synthesized as a large precursor (pre-pro-vWF) molecule and it is now clear
      that the prosequence or vWAgII is responsible for the intracellular
      multimerization of vWF. We have cloned the complete vWF cDNA and expressed it
      using a recombinant vaccinia virus as vector. We have characterized the structure
      and function of the recombinant vWF (rvWF) secreted from five different cell
      types: baby hamster kidney (BHK), Chinese hamster ovary (CHO), human fibroblasts
      (143B), mouse fibroblasts (L) and primary embryonic chicken cells. Forty-eight
      hours after infection, the quantity of vWF antigen found in the cell supernatant
      varied from 3 to 12 U/dl depending on the cell type. By SDS-agarose gel
      electrophoresis, the percentage of high molecular weight forms of vWF varied from
      39 to 49% relative to normal plasma for BHK, CHO, 143B and chicken cells but was
      less than 10% for L cells. In all cell types, the two anodic subbands of each
      multimer were missing. The two cathodic subbands were easily detected only in BHK
      and L cells. By SDS-PAGE of reduced samples, pro-vWF was present in similar
      quantity to the fully processed vWF subunit in L cells, present in moderate
      amounts in BHK and CHO and in very low amounts in 143B and chicken
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615471
TI  - Hereditary cerebral hemorrhage with amyloidosis-Dutch type: a study of
      fibrinolysis.
AB  - In view of reported associations between increased bleeding tendency and
      systemically decreased alpha 2-antiplasmin in patients with systemic amyloid
      deposition we studied alpha 2-antiplasmin, fibrinogen, C-reactive protein and
      blood levels of locally produced endothelial hemostasis factors in the acute and
      quiescent phase in 16 patients with hereditary cerebral hemorrhage with
      amyloidosis-Dutch type (HCHWA-D). None of the factors measured in the quiescent
      phase of the disease was abnormal. In the acute phase, shortly after a stroke,
      only factor VIII:Ag was evidently elevated. We concluded that systemic
      abnormalities in the part of the fibrinolysis system studied are not likely to be
      responsible for multifocal and recurrent cerebral hemorrhages in HCHWA-D. The
      role of an elevated factor VIII:Ag level in the acute phase is unclear.

PMID- 1615472
TI  - von Willebrand factor in plasma and urine of men with premature coronary artery
      disease.
AB  - Plasma and urine samples from 17 men who had suffered a myocardial infarction
      before the age of 45 years were quantitatively and qualitatively analyzed for von
      Willebrand factor antigen (vWF), and compared with samples obtained from
      controls. The levels of vWF in plasma and its characteristic multimeric
      composition in the patient samples were not different from those of the controls.
      However, when analyzed for lower molecular weight components, plasma samples from
      some patients contained more degraded material than those of the controls as
      indicated by the presence of an extra protein band of vWF related material having
      a molecular weight of about 200 kDa. The levels in urine of vWF and the molecular
      weight of the fragments excreted did not differ between patients and controls. A
      relative increase in excretion of lower molecular fragments was, however,
      observed in the patient group. In a second group of 97 consecutive post
      infarction patients under the age of 45 years the extra 200 kDa vWF band was
      found in 46% of the patients, whereas it was not detected in control plasmas.
      Taken together these findings suggest that degraded forms of vWF occur in normal
      plasma and that a more extensive degradation may occur in patients with coronary
      atherosclerosis, which could account for the relative increase in the excretion
      of lower molecular weight fragments observed in these patients.

PMID- 1615473
TI  - The venous antithrombotic effect of LF 1351 in the rat following oral
      administration.
AB  - The venous antithrombotic effects of a novel chemical entity, LF 1351, were
      investigated in rats following single oral administration, in comparison with
      i.v. administered heparin. LF 1351 demonstrated a dose-related antithrombotic
      effect in three models of venous thrombosis. The compound was approximately
      equipotent in two models involving complete stasis of the vena cava and
      administration of factor Xa or porcine serum, giving respective ED50 values of
      48.7 mg/kg and 36.7 mg/kg. LF 1351 was less effective in a model involving
      partial stasis in the presence of an endothelial lesion. In this case, the
      antithrombotic effect did not exceed 60-65%, the ED50 being 150 mg/kg. Heparin
      (50-300 micrograms/kg; 7.5-45.0 U/kg) was effective in all three models. At the
      approximate ED80 value against factor Xa-induced thrombosis (75 mg/kg) the
      antithrombotic effect of LF 1351 persisted for 6 h. The antithrombotic effect of
      LF 1351 (300 mg/kg) occurred without significant changes in APTT or thrombin
      time.

PMID- 1615474
TI  - Cytoplasmic localization of aequorin loaded into human platelets by a new method.

PMID- 1615475
TI  - Subunit composition of plasma von Willebrand factor (vWF) in two uremic patients
      with acquired vWF abnormalities.

PMID- 1615476
TI  - Prevention of hepatitis C virus infection in children with haemophilia A and B
      and von Willebrand's disease.

PMID- 1615477
TI  - The effect of DDAVP and placebo on platelet function and prolonged bleeding time
      induced by oral acetyl salicylic acid intake in healthy volunteers.

PMID- 1615478
TI  - Treatment of hemophilia A with a highly purified factor VIII concentrate prepared
      by anti-FVIIIc immunoaffinity chromatography.
AB  - To reduce the risk of pathogenic virus transmission associated with the
      therapeutic administration of plasma-derived anti-hemophilic factor (FVIIIc), a
      process utilizing anti-FVIIIc immunoaffinity chromatography to isolate FVIIIc has
      been developed. In addition, the starting cryoprecipitate solution has been
      treated with an organic solvent/detergent mixture to inactivate lipid-enveloped
      viruses. A final ion exchange chromatography step is used to further remove
      contaminants, e.g., anti-FVIIIc antibody, potentially leached with FVIIIc during
      the immunoaffinity step. The purified FVIII is stabilized for lyophilization and
      storage by the addition of human albumin. The monoclonal anti-FVIIIc antibody
      used in the immunoaffinity step of the process is not detectable in the final
      preparation. Viral reduction studies performed at specific steps of the process
      demonstrate that 11 logs of human immunodeficiency virus (HIV) and greater than 4
      5 logs of other lipid-enveloped viruses are inactivated within the first 30 s of
      exposure to the solvent/detergent mixture and 4-5 logs of various model viruses,
      e.g. Endomyocarditis virus (EMC), are physically removed during washing of the
      immunoaffinity column. The lyophilized product is reconstituted using sterile
      water in a matter of seconds. The pharmacokinetics of Hemofil M were compared to
      those obtained using a standard heat-treated concentrate (Hemofil CT) in five
      severe factor VIII deficient hemophiliacs in a randomized, cross-over study. No
      statistically significant differences were observed in mean half life (p greater
      than 0.6) or median recovery (p = 0.4) between the two preparations. No
      clinically significant adverse effects were observed in patients receiving either
      FVIII preparation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615479
TI  - Prevention of deep vein thrombosis following total hip replacement by low
      molecular weight heparinoid.
AB  - We assessed the safety and efficacy of the novel low molecular weight heparinoid
      Lomoparan (Org 10172) for the prevention of deep-vein thrombosis in patients
      undergoing elective total hip replacement in a randomized, placebo-controlled,
      double-blind trial in 197 consecutive patients. The heparinoid (750 anti-factor
      Xa-units, s.c., b.i.d.) was administered to 97 patients and 99 patients received
      placebo. Study medication was started preoperatively and continued for 10 days.
      Efficacy was assessed by bilateral phlebography at day 10, postoperatively. The
      incidence of deep-vein thrombosis was 56.6% and 15.5% respectively in the placebo
      and heparinoid treated patients (incidence reduction: 74%; P less than 0.001).
      This reduction was observed both for proximal-vein thrombosis (25% to 8%; P less
      than 0.005) and isolated calf-vein thrombosis (31% to 7%; P less than 0.001). No
      major hemorrhage was observed. The number of red-cell units transfused and drain
      fluid loss were comparable for the two study groups. Six patients in the
      heparinoid group and none in the control group developed minor wound hematomas (P
      less than 0.05). During an 8-week post-discharge follow-up period three patients
      with a normal venogram at day 10 developed clinically apparent venous
      thromboembolism, which was confirmed by objective testing. All three patients
      belonged to the heparinoid-treated group. We conclude that 750 anti-factor Xa
      units Org 10172 s.c. twice daily starting preoperatively is safe and effectively
      reduces early deep-vein thrombosis following elective total hip replacement.
      Further studies on the incidence of post-discharge thromboembolism are required.

PMID- 1615480
TI  - Deep vein thrombosis in obstetric patients: diagnosis and risk factors.
AB  - This study was performed to assess the prevalence of deep vein thrombosis (DVT)
      in consecutive obstetric patients with clinical symptoms of DVT, using impedance
      plethysmography (IPG) as the diagnostic method and to establish the safety of
      withholding anticoagulant therapy in patients with a repeatedly normal IPG. In
      addition, in patients with DVT the prevalence of coagulation and fibrinolytic
      disorders, which may explain the occurrence of venous thrombosis was
      investigated. Of the 77 obstetric patients with symptoms of DVT, 32 (42%) had an
      abnormal IPG. The remaining 45 patients had a repeatedly normal IPG and showed no
      venous thromboembolism during a 6 months follow-up period. Twenty percent (six
      patients) of the patients with an abnormal IPG had a coagulation or fibrinolytic
      abnormality. These observations suggest that serial IPG can be used effectively
      in the management of obstetric patients with clinically suspected DVT and that
      hemostatic abnormalities are frequently found in those patients with DVT.

PMID- 1615481
TI  - Recombinant tissue factor as substitute for conventional thromboplastin in the
      prothrombin time test.
AB  - Relipidated recombinant tissue factor (r-TF) has been assessed in comparison with
      conventional rabbit brain thromboplastin (Manchester Reagent) for its suitability
      for measurement of prothrombin time (PT). The International Sensitivity Index
      (ISI) of r-TF calibrated against the International Reference Preparation BCT/253
      (human plain) was found to be 0.96 and 1.12 with instrumental and manual
      techniques. Our study of plasmas from patients with congenital deficiencies of
      clotting factors covering a wide range of severity demonstrates that r-TF is able
      to detect even minor deficiencies of factors involved in the extrinsic and common
      coagulation pathways. Patients with liver diseases were correctly diagnosed with
      a prevalence of abnormal results comparable for both reagents. Between-assay
      reproducibility expressed as coefficient of variation was 2.3% and 3.9% at normal
      and abnormal PT levels. In conclusion, our evaluation shows that relipidated r-TF
      possesses the necessary requisites of sensitivity, diagnostic accuracy and
      reproducibility which make it a suitable candidate for PT determination both for
      monitoring oral anticoagulant therapy and diagnosing congenital and acquired
      clotting factor deficiencies. Moreover, being a highly defined reagent it may
      constitute a step forward in the standardization of PT testing.

PMID- 1615482
TI  - A novel functional assay of protein C in human plasma and its comparison with
      amidolytic and anticoagulant assays.
AB  - A simple and fast method for the quantitative determination of protein C activity
      in plasma is here described. The first step consists in the conversion of protein
      C in the test sample into activated protein C by means of an activator isolated
      from Southern Copperhead venom. Subsequently, the degradation of factor Va, in
      presence of protein C-deficient plasma, is measured by the prolongation of the
      prothrombin time which is proportional to the amount of protein C in the sample.
      The dose-response curve showed a linear relationship from 6 to 150% protein C
      activity and the inter- and intra-assay reproducibility was 3.5% and 5.6%
      respectively. In normal subjects, a mean of protein C level of 98 +/- 15% of
      normal pooled plasma was found. Comparison with the anticoagulant assay in
      samples of patients with oral anticoagulant, liver cirrhosis, disseminated
      intravascular coagulation and severe preeclampsia revealed an excellent
      correlation (r = 0.94, p less than 0.001). Also, a similar correlation (r = 0.93,
      p less than 0.001) existed between amidolytic assay and the method here proposed
      for all the samples studied without including the oral anticoagulant group. These
      results allowed us to infer that this method evaluates the ability of protein C
      to interact with protein S, phospholipids, calcium ions and factor Va.

PMID- 1615483
TI  - In vivo characterization of a new synthetic thrombin inhibitor.
AB  - We have examined the in vivo pharmacology of DuP 714 (Ac-[D]-Phe-Pro
      boroArginine), a representative of a new series of synthetic thrombin inhibitors
      which contain a boronic acid derivative of arginine. Intravenous bolus injections
      of DuP 714 in anesthetized rats and conscious rabbits produced transient
      elevations of clotting times. Clinically relevant prolongations of the APTT were
      also observed in rabbits after i.v. infusion of less than 0.1 mg kg-1 h-1.
      Efficacy against venous thrombosis was demonstrated in a rabbit model of stasis
      induced thrombosis. Clots formed in 100% of control animals and only 33% of
      animals treated with 0.5 mg/kg DuP 714, and were less severe in treated animals.
      In a rabbit arterial-venous shunt model mimicking arterial thrombosis, occlusion
      occurred within 30 min in 72% of control animals vs. 11% of animals treated with
      0.1 mg kg-1 h-1 DuP 714. Results indicate that DuP 714 is a highly effective
      anticoagulant which should be useful for the prevention of both venous and
      arterial thrombotic diseases.

PMID- 1615484
TI  - Presence and possible origin of epsilon(gamma-glutamyl)lysine isodipeptide in
      human plasma.
AB  - epsilon(gamma-glutamyl)lysine isodipeptide has been detected in normal human
      plasma by a sensitive HPLC technique in a concentration of 1.9-3.6 mumol/l.
      Incubation of in vitro clotted plasma at 37 degrees C for 12 h resulted in an
      increased amount of isodipeptide, and there was no further significant change
      when streptokinase was also present. Increased in vivo isodipeptide
      concentrations were also observed in hypercoagulable states and during
      fibrinolytic therapy.

PMID- 1615485
TI  - Characterization of the original Christmas disease mutation (cysteine 206---
      serine): from clinical recognition to molecular pathogenesis.
AB  - Christmas disease was first reported as a distinct clinical entity in two
      manuscripts published in 1952. The eponym associated with this disorder, is the
      surname of the first patient examined in detail and reported by Biggs and
      colleagues in a paper describing the clinical and laboratory features of seven
      affected individuals. This patient has severe factor IX coagulant deficiency
      (less than 0.01 units/ml) and no detectable circulating factor IX antigen (less
      than 0.01 units/ml). Coding sequence and splice junctions of the factor IX gene
      from this patient have been amplified in vitro through the polymerase chain
      reaction (PCR). One nucleotide substitution was identified at nucleotide 30,070
      where a guanine was replaced by a cytosine. This mutation alters the amino acid
      encoded at position 206 in the factor IX protein from cysteine to serine. The non
      conservative nature of this substitution, the absence of this change in more than
      200 previously sequenced factor IX genes and the fact that the remainder of the
      coding region of this gene was normal, all provide strong circumstantial evidence
      in favour of this change being the causative mutation in this patient. The
      molecular characterization of this novel mutation in the index case of Christmas
      disease, contributes to the rapidly expanding body of knowledge pertaining to
      Christmas disease pathogenesis.

PMID- 1615486
TI  - Haplotype analysis of identical factor IX mutants using PCR.
AB  - We have detected the mutations in the factor IX genes from all of the haemophilia
      B patients registered at Malmo haemophilia centre and are currently examining the
      entire UK haemophilia B population. From these studies we have found 13 base
      substitutions which have recurred in 1-6 other, presumably unrelated, patients.
      In order to determine the minimum number of independent repeats of each mutation
      we have used PCR to examine the five factor IX polymorphisms forming the most
      informative combinations and we have characterised the haplotype of each patient.
      Patients with different haplotypes are assumed to be unrelated and thus to carry
      independent mutations. All but one of the 13 mutations occur in at least 2
      haplotypes thus pinpointing 12 mutational hotspots and mutations that can be
      clearly considered detrimental. Two of the 13 substitutions occur at non-CpG
      sites.

PMID- 1615487
TI  - On the intraindividual and gender variability of haemostatic components.
AB  - The intraindividual variability in terms of coagulation analyses was explored in
      10-16 samples collected from each of 15 women during one menstrual cycle. For
      comparison, six men were sampled six times during a period of 30 days. The
      following variables were analysed: FVII, FVIII, FX, vWF:Ag, vWF:ristocetin
      cofactor, fibrinogen, antithrombin, plasminogen and anti-plasmin. The results
      demonstrated mean coefficients of variation ranging between 4.5 (plasminogen) and
      20.7 (vWF:Ag). In certain individuals, the intraindividual variability amounted
      to nearly 40%, in particular in the assays of FVIII and vWF:Ag. No direct
      relation between these two factors and oestradiol, progesterone or testosterone
      levels could be observed in our individuals. The implications of these variations
      are discussed in terms of disease prediction and diagnosis of coagulation
      disorders.

PMID- 1615488
TI  - Daytime fluctuations of plasminogen activator inhibitor 1 (PAI-1) in populations
      with high PAI-1 levels.
AB  - The mechanism underlying diurnal variations in PAI-1 as well as the cellular
      origin of PAI-1 in subjects with high PAI-1 levels are unknown. We evaluated
      diurnal changes (8:00 am vs 4:00 pm) in PAI-1 (functional and immunological
      assays), t-PA Ag and t-PA/PAI-1 complex levels in controls and subjects with high
      PAI-1 levels. Three test groups were recruited among obese hyperinsulinemic
      subjects, emergency care unit patients with inflammatory syndrome or infection
      and pregnant women. The classical afternoon decrease of PAI-1 level was observed
      in controls and obese subjects but its amplitude was greater in the latter. The
      decrease in t-PA Ag and t-PA/PAI-1 complex levels was the same in controls and in
      obese. As, in previous studies, elevated PAI-1 levels have been correlated with
      insulin resistance and a decrease in insulin sensibility has been described in
      the early morning, it is proposed that this "dawn phenomenon" could be implicated
      in the circadian variations of PAI-1 in controls and could be amplified in obese
      subjects. Great variability in PAI-1, t-PA Ag or t-PA/PAI-1 complex levels was
      observed in patients with acute inflammatory syndrome or infection for whom
      classical biorhythms are suppressed. No diurnal changes in PAI-1 and other
      fibrinolytic parameters were observed in patients with inflammatory syndrome or
      in pregnant women suggesting that other sources and/or other regulatory
      mechanisms of PAI-1 production are involved.

PMID- 1615489
TI  - Contrast venography, the gold standard for the diagnosis of deep-vein thrombosis:
      improvement in observer agreement.
AB  - To determine whether the Rabinov-Paulin or the long-leg venography technique
      should be preferred in the diagnostic management of patients with clinically
      suspected deep-vein thrombosis, two independent experienced radiologists blindly
      assessed two different series of venograms of consecutive outpatients with
      clinically suspected deep-vein thrombosis. Venograms were obtained from two
      outpatient clinics of primary referral centres. In one centre the venograms were
      performed according to the technique of Rabinov and Paulin with the use of 100 ml
      of radiographic material and spot films of the calf, popliteal and more proximal
      veins. In the other centre, long-leg films were obtained after the administration
      of 150 ml of contrast material. The percentage venograms adjudicated as
      inadequate by at least one radiologist and inter-observer disagreement for both
      series were used as the main study outcome measures. Prior to the study, both
      radiologists agreed on the standardized criteria for a normal, abnormal and
      inadequate test result using a separate set of films. An inadequacy rate of 20%
      was found for the Rabinov-Paulin venography series (n = 123), whereas only 2% of
      the 126 long-leg films were inadequate for interpretation (p less than 0.001).
      The inter-observer diagreement for inadequacy, presence or absence of deep-vein
      thrombosis was 21% for the Rabinov and Paulin venograms and 4% for the long-leg
      films (kappa, 0.65 and 0.92; 95% confidence intervals: 0.53 to 0.77 and 0.84 to
      0.99, respectively; p less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615490
TI  - Liver blood flow as a major determinant of the clearance of recombinant human
      tissue-type plasminogen activator.
AB  - The influence of changes in liver blood flow on the clearance of rt-PA was
      studied both in healthy subjects and in a perfused rat liver model. Liver blood
      flow in healthy subjects was documented indirectly by the clearance of
      indocyanine green (ICG). Exercise reduced liver blood flow on average by 57% with
      a 95% confidence interval (95% CI) ranging from 51% to 62% (n = 5) and increased
      plasma levels of rt-PA activity (after an i.v. infusion of 18 mg of rt-PA over
      120 min) by 119% (95% CI, 58%-203%) and rt-PA antigen by 91% (95% CI, 30%-140%).
      In the perfused rat liver model it was shown that halving or doubling of the
      physiological flow rate of a perfusate, containing rt-PA caused a proportional
      change in the clearance of rt-PA, while the extraction of rt-PA by the liver
      remained similar. In conclusion, liver blood flow is a major determinant of the
      clearance of rt-PA. This may have important implications for dosage of rt-PA in
      patients with myocardial infarction.

PMID- 1615491
TI  - Markers of coagulation and fibrinolysis after fractures of the lower extremities.
AB  - The study was performed to detect activation of coagulation and fibrinolysis in
      terms of prothrombin fragment 1 and 2 (F1 + 2), thrombin-antithrombin III complex
      (TAT), fibrin degradation products (FbDP), fibrinogen degradation products
      (FgDP), and soluble fibrin monomers (FM) in plasma from 39 patients with
      fractures of the lower extremities. We found substantially elevated levels of the
      molecular markers at admission and on the day after admission (Day 1) compared
      with control levels. Admission levels of F1 + 2, TAT, FbDP and FgDP were
      significantly higher compared with levels on day 1, whereas levels of FM were not
      significantly different between the two days. Generally there were good
      correlations between all markers of coagulation and fibrinolysis at admission
      whereas correlations were weaker or absent on day 1. In conclusion we found
      substantial haemostatic activation as a immediate response to trauma. Increased
      levels of F1 + 2, TAT, FM, FbDP and FgDP appear to be a normal physiological
      reaction after fractures of the lower extremities.

PMID- 1615492
TI  - Effect of exercise intensity on 6-keto-PGF1 alpha, TXB2, and 6-keto-PGF1
      alpha/TXB2 ratios.
AB  - Six men (X = 27.3 yr) ran at 60%, 70% and 80% of maximal oxygen consumption on
      separate days for 30 minutes to determine exercise intensity effects on 6-keto
      PGF1 alpha, TXB2, and 6-keto-PGF1 alpha/TXB2 ratios. At rest, 6-keto-PGF1 alpha
      was 384 +/- 68.3 pg/ml; TXB2 was 147 +/- 55.6 pg/ml; and the 6-keto-PGF1
      alpha/TXB2 ratio was 4.63 +/- 1.3. After exercise at 60%, 70%, and 80% TXB2
      increased to 523.2 +/- 117.5, 611.7 +/- 155.4*, and 643.8 +/- 121.7* pg/ml,
      respectively (*p less than .05). Post-exercise ratios tended to be inversely
      related to exercise intensity; however, no statistically significant differences
      were found between these values. These data suggest that exercise-induced
      increases in TXB2 may be related to intensity.

PMID- 1615493
TI  - Hereditary heparin cofactor II deficiency and coronary artery disease.
AB  - We here present a Japanese family with type I hereditary heparin cofactor II (HC
      II) deficiency. The propositus (a 61-year-old man) suffered from angina pectoris
      and coronary artery disease was confirmed by coronary angiography. He underwent
      percutaneous transluminal coronary angioplasty (PTCA) four times in one year.
      Combined use of heparin, aspirin, and nitrates could not prevent the return of
      his symptoms and restenosis of segment 6 of the left anterior descending artery.
      His HC II activity and antigen levels were 49% and 50%, respectively, and his
      daughter also showed similar low levels. Cerebral infarction had occurred in two
      family members. Argatroban, a selective potent thrombin inhibitor, was
      administered after the fourth PTCA for the purpose of preventing reocclusion and
      achieved a successful outcome. A relationship between HC II deficiency and
      thrombosis has not yet been established. Our case suggests that standard heparin
      therapy is not effective in preventing restenosis in such individuals, in whom
      the process is accelerated by thrombin generation at the site where PTCA produces
      rupture of the atherosclerotic plaque. Argatroban may be more effective under low
      HC II conditions because of its potent inhibition of thrombin activity at sites
      of vascular wall damage.

PMID- 1615494
TI  - Procoagulant activity in bronchoalveolar fluids: no relationship with tissue
      factor pathway inhibitor activity.
AB  - Abnormalities in local coagulation may explain alveolar fibrin deposition which
      often accompanies human lung injuries. The purpose of this study was to
      investigate the generation of procoagulant activity (PCA) and tissue factor
      pathway inhibitor (TFPI) in selected bronchoalveolar lavage fluids (BAL) from
      controls (n = 7) and from patients with interstitial lung diseases (n = 9),
      Pneumocystis carinii (PCP) pneumonia (n = 11) and bacterial pneumonia (n = 8). As
      compared with controls a significant increase of PCA was observed in the three
      groups with lung diseases. PCA in BAL from patients with untreated interstitial
      lung diseases (PC Units mean of 162 +/- 48) was significantly higher than PCA of
      treated patients (PC Units 36 +/- 10; p less than 0.05). Increases of PCA
      paralleled protein levels in BAL and the protein/albumin ratios were comparable
      in the four groups. TFPI was significantly increased in PCP (p less than 0.02)
      and bacterial pneumonia (p less than 0.03), but only marginally increased in
      interstitial lung diseases when compared with controls. No correlation was found
      between TFPI and PCA in any of the four groups. These data indicate that
      increased procoagulant activity observed in various lung diseases is not
      counterbalanced by TFPI.

PMID- 1615495
TI  - Guanosine 5'-0-(3-thiotriphosphate) induced calcium release in human platelets is
      mediated by inositol 1,4,5-triphosphate.
AB  - Guanosine 5'-triphosphate (GTP) and its nonhydrolyzable analogs, such as
      guanosine 5'-0-(3-thiotriphosphate) (GTP gamma S), induce several responses in
      platelets including secretion, production of inositol 1,4,5-triphosphate (IP3)
      and mobilization of Ca2+ from intracellular sites. Because IP3 is well
      established as a second messenger in mobilizing Ca2+ from intracellular stores it
      has been generally assumed that Ca2+ release by GTP/GTP gamma S in platelets is
      mediated by IP3. However, studies in neuronal, hepatic and smooth muscle cells
      have suggested that IP3 and GTP/GTP gamma S activate Ca2+ release by distinct
      mechanisms and that IP3-independent mechanisms mediate GTP/GTP gamma S-induced
      Ca2+ release. In several tissues heparin inhibits binding of IP3 and blocks IP3
      stimulated Ca2+ release in a competitive and specific manner. In the present
      studies, IP3 and GTP gamma S induced Ca2+ release and their relationship was
      examined in human platelets using heparin as a probe. In saponin permeabilized
      platelets, IP3 (0.05-5 microM) induced a prompt, dose-dependent release of Ca2+
      (EC50 0.5 microM). GTP gamma S (1-50 microM) released Ca2+ in a dose-dependent
      manner with EC50 of 2 microM but with a time lag of 30-90 seconds. Exposure of
      platelets to 1 microM IP3 following a submaximal response with GTP gamma S (1
      microM) resulted in a further increase in Ca2+ release but no further increase
      was noted on adding 1 microM IP3 following a maximal response with GTP gamma S
      (10 microM); similar findings were noted on reversing the order of addition of
      GTP gamma S and IP3 suggesting that these effectors release Ca2+ from the same
      source. IP3 (0.5 microM) induced Ca2+ release was blocked by low molecular weight
      (4000-6000) heparin (IC50 30 micrograms/ml). More importantly, heparin abolished
      GTP gamma S (2.5 microM) induced Ca2+ release (IC50 10 micrograms/ml). These
      results indicate that, in contrast to the findings in some other cells, in human
      platelets GTP gamma S-induced Ca2+ release is mediated largely by a mechanism
      involving IP3.

PMID- 1615496
TI  - Ticlopidine and platelet function in healthy volunteers.
AB  - The influence of a 4-weeks therapy with 500 mg ticlopidine daily on platelet
      function parameters was examined in 10 male healthy volunteers aged 20-33 years
      in order to extend the knowledge on the antiplatelet activity of this substance.
      Ticlopidine significantly (p less than 0.01) affected ex-vivo platelet
      aggregation induced by ADP and increased platelet sensitivity to the
      antiaggregatory action of PGI2. Generation of TXB2 from endogenous substrate
      during spontaneous clotting of blood (serum-TXB2), conversion of exogenous
      radiolabelled arachidonic acid into TXB2 and MDA-formation in isolated platelets
      were unaffected by the treatment. The TXB2-level in plasma of volunteers,
      however, was decreased, after administration of the drug. The diminished alpha
      granule content liberation (beta-thromboglobulin: p less than 0.01; PDGF: p less
      than 0.01; PF4 not significant) indicates that ticlopidine induces a decrease in
      platelet activity. The beneficial effect on release reaction is not associated
      with a decrease in TXA2-formation. Our results demonstrate that ticlopidine
      inhibits platelet activity, especially the PDGF-release. These results confirm
      the value of this drug in the prevention of atherosclerosis and its
      thromboembolic complications.

PMID- 1615497
TI  - Measurement of the zeta potential of human platelets by the use of laser-light
      scattering.
AB  - An instrument was developed to detect the shift in scattering of laser light that
      occurs when particles in suspension move in a chamber with an electrical load.
      The instrument measures the zeta potential of particles. We applied the
      instrument to study human blood cells. Platelet-rich plasma was used because of
      the stability of the suspension, without the sedimentation or autoaggregation
      that is often seen with red or white blood cells. The reproducibility of the
      measurements was satisfactory when there were enough platelets in the suspension.
      Platelets from healthy controls (n = 136) had a potential of -14.20 +/- 1.64 mV
      at the detection angle of 17.1 degrees. Platelets from patients with essential
      thrombocytosis (n = 16) or polycythemia vera (n = 8) had higher potentials than
      the healthy controls.

PMID- 1615498
TI  - The bleeding time in normal subjects is mainly determined by platelet von
      Willebrand factor and is independent from blood group.
AB  - Bleeding time (BT) is the most important test "in vivo" evaluating the primary
      hemostasis. No relationship between plasma von Willebrand factor (vWF) and BT has
      been found in normal subjects, whereas no data are available on the relationship
      between platelet vWF and blood group or BT in normal subjects. To clarify the
      reciprocal relationship between blood group, vWF and BT, we studied 177 normal
      subjects. The influence of blood group on BT was analyzed in 116 subjects and the
      distribution of platelet and plasma vWF between different blood groups in 111
      subjects. Furthermore, in a subgroup of 50 subjects, a multivariate regression
      model, including age, platelet count, plasma and platelet vWF:Ag and Ristocetin
      Cofactor (RiCof), hematocrit, sex and O or non-O blood group was used to assess
      the joint influence of these variables on BT. BT was similar in O and non-O group
      (P = 0.310) and, although plasma vWF was significantly lower in O group (P less
      than 0.0001), platelet vWF content was similarly distributed (P = 0.873 vWF:Ag
      and P = 0.322 RiCof). Furthermore, platelet vWF was not correlated with plasma
      vWF (r = 0.06, P = 0.526). In the multivariate regression analysis, only platelet
      vWF, age and platelet count showed a significant, inverse correlation with BT (P
      = 0.004), explaining 25% of the total variation of this test. Platelet vWF
      resulted therefore the main determinant of BT.

PMID- 1615499
TI  - Platelet hypoaggregability in rats exposed to SART stress (repeated cold stress).
AB  - A prolongation of bleeding time accompanied by thrombocytopenia and abnormalities
      in coagulation-fibrinolysis systems has been observed in laboratory animals
      exposed to a chronic form of environmental stress induced by severe fluctuations
      of air temperature, known as SART (specific alternation of rhythm in temperature)
      stress. In order to clarify the hemostatic profile under SART stress in more
      detail, the present study examined platelet aggregability in vitro as well as in
      vivo in stressed rats. During exposure to stress, thrombocytopenia developed from
      day 5, and remained up to at least day 14. In vitro aggregation of platelets
      stimulated by ADP or collagen was markedly decreased in stressed rats, compared
      with unstressed rats. Furthermore, stressed rats exhibited in vivo
      hypoaggregability of platelets, as estimated by the magnitude of the drop in
      circulating platelet counts following intravenous injection of ADP and collagen.
      Protein and cholesterol content in platelets remained constant after stress
      exposure. These results indicate that SART-stressed rats exhibit platelet
      dysfunctions in addition to thrombocytopenia. Considering the previous findings,
      the hemostatic system under SART stress appears to show a general tendency toward
      hemorrhage.

PMID- 1615500
TI  - Significance and quantitative analysis of von Willebrand factor in human
      platelets.
AB  - The von Willebrand factor (vWF) is found in plasma and in platelets. The
      concentration and multimeric composition of the vWF in platelets of 160 patients
      with bleeding tendency were examined since very little is known about the
      platelet vWF. For quantitative analysis of the platelet vWF, a modified ELISA was
      established. A reference range from 70%-130% of platelet vWF concentration
      considered normal was established by examining 80 healthy blood donors. 16.9% of
      the 160 patients showed a decreased vWF concentration in platelets only, while
      all the other coagulation parameters were normal. 3 of our patients belong to the
      same family and suggesting an autosomal dominant genetic transmission for the von
      Willebrand disease type 1-3. The data also suggests, that a quantitative and
      qualitative analysis of the vWF in plasma and platelets is required for an exact
      diagnosis of the von Willebrand disease.

PMID- 1615502
TI  - Statistically evaluated chromogenic rate assay of zymogen activation via
      spectrophotometer-computer interface.

PMID- 1615501
TI  - Serotonin is involved in some effects of erythropoietin.

PMID- 1615503
TI  - [Drug therapy of rheumatoid arthritis--a status quo?].

PMID- 1615504
TI  - [Programmed cell death--significance for cancer etiology and treatment].

PMID- 1615505
TI  - [Functional dyspepsia].

PMID- 1615506
TI  - [Pathogenetic aspects of sarcoidosis. Importance of local complement synthesis in
      alveolar macrophages].
AB  - Sarcoidosis is a multisystem granulomatous disorder of unknown etiology. Markers
      of activity include elevated serum ACE levels, interleukin 2-receptors,
      hypercalcemia, hypercalciuria, intrathoracic uptake of radioactive gallium,
      retinal vascular leakage, and an increased T4/T8 ratio in bronchoalveolar lavage
      fluid. The three main pathological features of sarcoidosis are alveolitis,
      granuloma formation and fibrosis. The cells harvested by bronchoalveolar lavage
      in sarcoidosis are representative of the local inflammatory reaction seen in the
      lung. Alveolar macrophages have the potential to synthesize the components of the
      functional alternative and terminal pathways of complement. The alveolar
      macrophages from sarcoidosis patients produce more complement than their healthy
      counterparts. Complement participates in the normal metabolism of immune
      complexes and has the ability to modulate immune responses via complement
      receptors present on virtually all cell types. On the other hand, through
      enhanced levels of complement factors, an increased number of activated
      macrophages in the lung may contribute to a changed immune response, which may be
      of significance for the granulomatous inflammation seen in sarcoidosis and may
      also contribute to the tissue damage seen in sarcoid fibrosis.

PMID- 1615508
TI  - [Bronchial carcinoid].
AB  - A total of seven patients with bronchial carcinoids were treated at our hospital
      during the period from 1975 to 1991. Debut of symptoms varied from eight months
      to ten years before diagnosis. Cough, copious mucus, hemoptysis and recurrent
      lobar pneumonias were common. Six tumours were identified by chest X-ray. All
      tumours were visualised bronchoscopically; five showed as cherry-red polypoid
      tumours, one as a necrotising tumour and one as a stenosis of the bronchus. One
      patient underwent pneumonectomy, three lobectomy, one bilobectomy, one segment
      resection and one sleeve resection and lobectomy combined. Two cases were
      complicated by empyema and one was not radically operated due to impaired
      cardiopulmonary function. None showed carcinoid syndrome. All patients are still
      alive, and no recurrences or metastases have appeared.

PMID- 1615507
TI  - [Myasthenia gravis].
AB  - Myasthenia gravis, first described in 1672 by Sir Thomas Willis and named by
      Jolly in 1895, is clinically characterized by muscular weakness relieved by rest.
      The incidence rate is about 4/million/year, the prevalence in Norway is about
      100/million. Anticholinesterase drugs, introduced by Mary Walker in 1934, are
      still the primary therapeutics. Since about 1960 the disease has been recognized
      as autoimmune. Circulating antibodies to the acetylcholine receptor of the
      neuromuscular synapse are detectable in greater than or equal to 85% of the
      patients. Hence thymectomy, plasmapheresis and immunosuppressant drugs are
      useful. The thymus is recognizably pathological in 75-80% of the cases. The
      thymic hormone thymopoietin stimulates thymocytes and T-cells, and directly
      blocks the acetylcholine receptor.

PMID- 1615509
TI  - [Primary suture of the posterior cruciate ligament].
AB  - 23 acute midsubstance ruptures of the posterior cruciate ligament were treated by
      primary suture. 20 patients returned for follow-up. Four of them had an isolated
      rupture of the PCL. The remaining 16 patients had sustained combined injuries to
      ligaments, including eight total ruptures of the anterior cruciate ligament. All
      ruptured ligaments were sutured. At follow-up (median = 5.5, range 3-10 years)
      median knee score according to Lysholm was 81 (range 53-100). Five were rated
      excellent, six good, three fair and six poor. KT-1000 arthrometer measurements
      revealed a posterior instability of between 5 and 10 mm in five patients and
      below 5 mm in 14 patients. Thus, in most patients, some instability remained in
      spite of operative treatment.

PMID- 1615510
TI  - [Urinary excretion of cannabis metabolites].
AB  - Urine testing is increasingly used to detect drug abuse, most commonly by easily
      performed immunological tests. There is large interpersonal variation in the
      excretion time of cannabinoids. Excretion times of up to 11 weeks have been
      demonstrated. In cases with a long excretion time a negative test result may be
      followed by a positive result without concomitant abuse. We describe a case where
      cannabinoid metabolites in urine were detected by a routine immunological method
      (Abbotts ADx) after 95 days of supervised abstinence. It is important that
      personnel evaluating test results have a thorough knowledge of possible pitfalls.

PMID- 1615511
TI  - [Burns].
AB  - Extensive burns are severe, life-threatening injuries. Cutaneous burns are often
      accompanied by injury to inhalation, leading to severe pulmonary problems with a
      high rate of mortality. Published reports on series of burn patients state that
      in 2-5% of all (burn) cases, cutaneous thermal injury was accompanied by
      mechanical injuries such as fractures, closed head injuries, or blunt injuries to
      chest and abdomen. The care of the burn is often made difficult by concomitant
      orthopaedic injury, and in a multiple trauma victim, the burn itself often
      complicates diagnosis and treatment. It is important to recognize all injuries as
      soon as possible. The article briefly discusses practical considerations when
      treating patients with multiple injuries including cutaneous burns and/or
      inhalation injury. After initial resuscitation and stabilization these patients
      should be transferred to a specialized treatment facility for burns. As a rule,
      open surgical reduction and fixation of fractures should be carried out no later
      than 48 hours after the injury.

PMID- 1615512
TI  - [Gunshot wounds and explosion injuries].
AB  - The severity of injury inflicted by a missile is determined by the structure hit
      and retardation of the missile and thus the energy dissipated to the tissue. The
      injury to tissue depends on the kinetic energy and the construction of the
      missile, and the density and resilience of the tissue. Devastating, heavily
      contaminated wounds are inflicted by close-range shotguns and high-energy
      missiles, and thorough wound debridement and delayed primary closure are required
      after about four days. In general, it is not necessary to remove the missile
      unless this can be done easily. Explosions in air can cause burns, shrapnel
      wounds, acceleration and deceleration injuries. The shock wave dissipates energy
      on the border between air and fluid. This injuries primarily hollow organs such
      as lungs and intestines. Casualties from blasts may exhibit no external symptoms
      or signs of lung or intraabdominal injury. It is necessary to perform serial
      physical examinations, blood gas analyses, chest X-ray or CT scan.

PMID- 1615513
TI  - [Apoptosis and cytostatic agents].
AB  - There are two distinct modes of cell death: necrosis and apoptosis. Apoptosis is
      an active process that may require gene expression and protein synthesis, and for
      this reason apoptosis has been called programmed cell death. Cancer cells in
      culture exposed to several anticancer drugs show morphological and biochemical
      characteristics consistent with apoptosis. This observation has possible impact
      on chemotherapeutic treatment of cancer. In this article we survey apoptosis,
      with emphasis on the relationship between apoptosis and anticancer drugs.

PMID- 1615514
TI  - [Preventive low dosage treatment and pre-eclampsia].
AB  - Pregnancy-induced hypertension and pre-eclampsia occur in 10% of pregnancies and
      are recognised as important and prevalent sources of risk to both mother and
      foetus. Although the exact cause of the disease is unknown, several mechanisms
      have been suggested, including enhanced sensitivity to vasopressors and imbalance
      in the production of prostaglandins. This may lead to vasoconstriction of small
      arteries, activation of platelets and uteroplacental insufficiency. Since
      thromboxane A2 and prostacyclin are derived from arachidonic acid through the
      action of cyclooxygenase, low dose aspirin selectively inhibits the synthesis of
      platelet thromboxane A2 without affecting production of endothelium-derived
      prostacyclin. Data available from clinical trials suggest that, when given to
      high risk patients, low dose aspirin reduces risk of preeclampsia and
      intrauterine growth retardation by 50%, with no observed risk of adverse effects
      to either mother or foetus.

PMID- 1615515
TI  - [Endocavitary radiotherapy of rectal cancer].
AB  - Most patients with rectal carcinomas undergo surgery, either a resection with
      anastomosis or Miles' operation with permanent colostomy. Endocavitary
      radiotherapy is an alternative to surgery in patients with small carcinomas
      (Dukes' A) or adenovillous adenomas. The treatment is cheap, simple, gives good
      local tumour control, has low morbidity and does not require hospitalization. The
      Norwegian Radium Hospital has recently started to use this method in selected
      cases of rectal carcinomas.

PMID- 1615516
TI  - [Gastric and duodenal probe].

PMID- 1615517
TI  - [Functional dyspepsia--a stress disease].
AB  - Because non-ulcer dyspepsia is associated with stress and motility disturbances
      it is now called functional dyspepsia. Compared with healthy persons, patients
      with functional dyspepsia are characterized by poor vagal tone, wider gastric
      antrum both fasting and postprandially, lack of stress-related repression of
      antral motility and meal-induced dyspeptic symptoms. Postprandial discomfort is
      related to antral distension. Poor vagal tone may cause antral distension and
      dysmotility as well as symptoms in these patients. Treatment programmes or drugs
      which improve vagal tone may be beneficial.

PMID- 1615518
TI  - [Use and disposal of drugs at home. Experiences of a community campaign for drug
      collection].
AB  - We carried out a campaign to encourage return of medicines stored in private
      homes. 248 out of 1,512 households in our district returned average ten
      containers of drugs. 90% of these had been opened before return. Three out of
      four containers were outdated. A questionnaire was sent to all 1,512 households.
      33% responded. All but six households kept medicines at home. An average of nine
      products were stored in each home. Half of the products were non-prescription
      drugs. Half of the households had medicine cabinets. The kitchen was the room
      most often used to store medicines. We discuss various efforts to achieve more
      simple return of unwanted drugs. We must emphasize the need to store medicines at
      home in a safe place.

PMID- 1615520
TI  - [The superpill which prevents myocardial infarction].

PMID- 1615519
TI  - [Risk factors and mortality of myocardial infarction in Kristiansund, Alesund and
      Molde].
AB  - We have examined mortality from ischaemic heart disease, prevalence of self
      reported coronary heart disease and risk factor levels in three towns
      (Kristiansund, Alesund and Molde) in the county of More og Romsdal. The results
      for mortality were based on vital statistics for the age group 40-69 years, for
      the periods 1966-76 and 1977-87. Risk factor data and data on self-reported
      coronary heart disease for the age groups 40-42 years and 65-67 years were
      obtained from a health screening survey conducted in the county in 1990.
      According to the official statistics, the towns share important socio-economic
      characteristics, but Kristiansund is thought to have stronger roots in the
      coastal culture, with a historically economic basis in fishery and shipbuilding.
      We observed substantial differences between the three towns, both as regards risk
      factor levels and mortality from ischaemic heart disease. By far the highest
      mortality rates were found in Kristiansund, both for men and for women. A similar
      gradient existed for the levels of main risk factors, including serum
      cholesterol, systolic blood pressure and prevalence of smokers. We discuss the
      implications of these findings for prevention strategies.

PMID- 1615521
TI  - [HIV infection and professional secrecy].

PMID- 1615522
TI  - [Doubts about atenolol in the treatment of hypertension].

PMID- 1615523
TI  - [Should HIV-positive persons selling sex be protected?].

PMID- 1615524
TI  - [People and biotechnology--hearing statement of the Medical Society].

PMID- 1615525
TI  - [Emergency helicopters--a health service in the grey zone?].

PMID- 1615527
TI  - [Limitations of social insurance--beginning of the end of the social democratic
      welfare state?].

PMID- 1615526
TI  - [A valuable search program for Medline].

PMID- 1615528
TI  - [New signals in the medico-ethical thinking?].

PMID- 1615529
TI  - [Various experiences with the use of the quantitative buffy coat analyzer (QBC)
      in the horse].
AB  - Usability, repeatability and accuracy of the quantitative buffy coat analyser,
      QBC2, have been tested for the horse. The analyser provided reasonable results.
      The correlation between the data obtained with the QBC2 and those obtained with
      conventional techniques was found to be good.

PMID- 1615530
TI  - [Probiotics].
AB  - Probiotics, living cultures of micro-organisms, are currently of great interest
      as counterparts to antibiotics. The idea behind the use of probiotics is that the
      development and stability of intestinal microflora can be enhanced. The
      protection against infections is increased, resulting in fewer health problems
      and increased productivity. The mechanism of action of probiotics is not yet
      known, although there are several hypotheses. There is increasing evidence to
      suggest that probiotics act by stimulating the host's immune systems. The only
      accepted example of effective protection against infections provided by living
      micro-organism is the 'Nurmi concept', whereby one-day-old chicks acquire an
      enhanced protection against Salmonella infections when they are administered the
      complex intestinal flora of older chicks. The effects of probiotics on the
      growth, feed conversion or production of farm animals are, even in specific
      situations, not consistent enough to consider their use out of economic
      considerations. Probiotics are used to (re)establish the intestinal flora of
      patients or persons with lactose intolerance. The claims that probiotics have
      cholesterol-lowering and anti-tumour actions are based on animal experiments and
      require further investigations.

PMID- 1615531
TI  - Regional differences in rat brain lipids during global ischemia.
AB  - BACKGROUND AND PURPOSE: Membrane lipid degradation plays an important role in the
      pathogenesis of ischemic brain damage, but there is little information on changes
      in cerebrosides, sulfatides, and sphingomyelin. We studied regional changes in
      the quantities of these lipids during complete global brain ischemia in rats.
      METHODS: Nitrous oxide-anesthetized rats were subjected to ischemia by a high
      pressure neck cuff and arterial hypotension for 0 (control), 3, 10, or 30 minutes
      (n = 5 at each time). Brain temperature was allowed to fall spontaneously during
      ischemia, and the brain was frozen in situ with liquid N2 without recirculation.
      The frontal cortex, hippocampus, and basal ganglia were dissected at -15 degrees
      C. The lipids were separated by column and high-performance thin-layer
      chromatography and quantified by charring and densitometry. RESULTS: Total lipid
      content was higher (p less than 0.01) in the hippocampus (72.6 +/- 2.8 mg/g wet
      wt, mean +/- SD) than in the frontal cortex and basal ganglia (57.7 +/- 2.1 and
      62.6 +/- 1.5 mg/g wet wt, respectively). Ischemic changes occurred only in the
      frontal cortex, where total lipid content fell (p less than 0.01) by 11% after 30
      minutes of ischemia because sulfatide and cerebroside contents fell by 44% and
      38%, respectively. CONCLUSIONS: Despite a marked accumulation of free fatty acids
      during complete global brain ischemia in rats, the only detectable changes in
      brain lipids were in the amounts of cerebrosides and sulfatides in the frontal
      cortex.

PMID- 1615532
TI  - Transesophageal echocardiographic detection of aortic arch disease in patients
      with cerebral infarction.
AB  - BACKGROUND AND PURPOSE: Ulcerated plaques in the aortic arch are frequent autopsy
      findings in patients with cerebral infarctions, particularly those of unknown
      cause. It has been suggested that they could be a source of cerebral emboli.
      Using transesophageal echocardiography, we prospectively studied 12 consecutive
      patients with cerebral infarction of undetermined cause after noninvasive workup
      to evaluate the frequency of aortic plaques or mural thrombi that could embolize
      in cerebral arteries. SUMMARY OF REVIEW: Six patients (50%) had an intraluminal
      echogenic mass of the aortic arch, mainly located at the junction of the
      ascending aorta and arch. This material was pedunculated (in one patient) or
      broad based (in five patients) with a markedly irregular surface and intraluminal
      extension from 3 to 15 mm. In addition, we found cholesterol emboli in two of the
      four patients who underwent quadriceps biopsy. CONCLUSIONS: These results show
      that transesophageal echocardiography has capabilities in detecting such lesions
      and point to the aortic arch as a possible source of cerebral emboli in patients
      with cerebral infarction of unknown cause.

PMID- 1615533
TI  - Early recurrent ischemic stroke. A case-control study.
AB  - BACKGROUND AND PURPOSE: Data concerning potentially treatable risk factors for
      early recurrent stroke are limited. Therefore, we carried out a retrospective
      case-control study to identify factors predisposing to early reinfarction.
      SUMMARY OF REVIEW: We identified all patients admitted to Duke University
      Hospital or the Durham Veterans Administration Medical Center during 1 year
      having two documented ischemic strokes within 90 days (n = 12 of 273). Twelve
      randomly selected patients matched for age, sex, and race but having only a
      single stroke served as controls. There were no significant differences between
      the groups with respect to a variety of factors including the presence of
      hypertension, diabetes, a history of transient ischemic attack, a history of
      stroke, cerebral site of the index stroke, and subtype of the index stroke. A
      potential cardioembolic source was more frequently identified in the patients
      with early recurrent stroke (seven of the 12 case-control pairs were discordant
      for a potential cardioembolic source; McNemar's chi 2 test, p less than or equal
      to 0.02). CONCLUSIONS: Of the variables examined, the presence of a potential
      cardioembolic source was the single statistically significant factor associated
      with reinfarction within the first 90 days after ischemic stroke. The limitations
      and possible therapeutic implications of these results are discussed.

PMID- 1615534
TI  - Increased plasma endothelin-1 in acute ischemic stroke.
AB  - BACKGROUND AND PURPOSE: Endothelins are a recently discovered group of most
      powerful vasoconstrictor peptides. Endothelin-1 is produced by endothelial cells,
      and endothelin-3 is derived from neuronal tissue. Theoretically, endothelin
      mediated vasoconstriction may enhance ischemic neuronal damage. This study aimed
      to measure plasma levels of both endothelins in patients with acute
      nonhemorrhagic cerebral infarction. SUMMARY OF REPORT: Plasma levels of
      endothelin-1 and endothelin-3 were measured by radioimmunoassay in 16 consecutive
      patients within the first 72 hours after the onset of nonhemorrhagic cerebral
      infarct, as diagnosed clinically and by computed tomography. There was a marked
      (fourfold) elevation in plasma endothelin-1 levels in the patients (median, 11.7
      pg/ml; 25th and 75th centiles, 5.4 and 13.2 pg/ml) compared with those in a
      control group of 13 age-matched subjects (median, 2.56 pg/ml; 25th and 75th
      centiles, 2.4 and 3.0 pg/ml; p less than 0.0001). The first 24 hours after stroke
      onset were associated with higher endothelin-1 levels, and there was a trend to
      elevated levels with more severe neurological deficits. In all patients and
      controls endothelin-3 levels were below 0.5 pg/ml. CONCLUSIONS: Ischemic stroke
      is associated with acute and marked increases in plasma levels of endothelin-1.
      This may reflect enhanced production by damaged endothelial cells within the
      infarcted tissue. Local leakage of endothelin-1 may induce severe and prolonged
      constriction of collateral vessels and may therefore have a deleterious role in
      the pathogenesis and final outcome of cerebral infarction.

PMID- 1615535
TI  - Critical carotid and vertebral arterial occlusive disease and cough syncope.
AB  - BACKGROUND AND PURPOSE: Cough syncope typically occurs in patients with known
      chronic lung disease. The mechanism usually involves a combination of decreased
      venous return, increased cerebrospinal fluid pressure, and secondary hypocapnia,
      all resulting in cerebral arterial vasoconstriction. Cough syncope has not in the
      past been associated with occlusive cerebrovascular disease. CASE DESCRIPTION: We
      describe a 50-year-old man with a 6-month history of episodes of loss of
      consciousness during paroxysms of coughing. Physical examination showed
      asymmetrical upper extremity blood pressures and carotid and subclavian artery
      bruits. Pulmonary function studies were normal. Ultrasound and angiography showed
      total occlusion of the left common carotid artery, right internal carotid artery,
      and right vertebral artery; tight stenosis of the right subclavian artery; and a
      hypoplastic left vertebral artery. The patient had a left subclavian-to-left
      common carotid artery bypass and has had no syncope since that time. CONCLUSIONS:
      To our knowledge, this is the first reported case of cough syncope and severe
      cerebrovascular disease in which surgery led to amelioration of symptoms.
      Cerebrovascular occlusive disease may contribute to cough syncope.

PMID- 1615536
TI  - Spontaneous vertebral artery dissection initially mimicking myocardial
      infarction.
AB  - BACKGROUND AND PURPOSE: Vertebral and carotid artery dissections may present with
      very different signs and symptoms, making early recognition difficult. However,
      diagnosis should be established as soon as possible to prevent unnecessary
      diagnostic investigations and to institute adequate treatment. CASE DESCRIPTION:
      A 46-year-old man presented with severe intermittent pain of his left upper arm
      and general discomfort. During extensive cardiological evaluation for suspected
      myocardial infarction, a severe brain stem syndrome occurred. Ultrasound Doppler
      studies detected vertebral artery dissection, which was confirmed by angiography.
      CONCLUSIONS: The unusual initial presentation of vertebral artery dissection
      delayed an early diagnosis and adequate treatment. Because noninvasive methods
      are available today, their applications are recommended in similarly
      uncharacteristic circumstances.

PMID- 1615537
TI  - Familial intracranial aneurysms. A review.
AB  - BACKGROUND: A familial occurrence of intracranial aneurysms is defined by the
      presence of such aneurysms in two or more first to third-degree family members.
      Families with two affected members may represent accidental aggregation. Other
      families show a frequency compatible with an autosomal dominant mode of
      inheritance. A genetic basis is also suggested by the younger average age of
      familial cases with a ruptured intracranial aneurysm (42.3 years versus an age
      range of 50-54 years for nonfamilial cases), occurrence at the same site or a
      mirror site in sibling pairs, occurrence in identical twins, and the association
      of intracranial aneurysms with genetically transmitted disorders. SUMMARY OF
      REVIEW: No reliable data are available about the occurrence of familial
      intracranial aneurysms among all patients with ruptured aneurysms; a frequency of
      6.7% has been reported from a retrospective study, but a large part of the
      "familial" occurrence can be explained by fortuitous aggregation. The
      pathogenesis of familial intracranial aneurysms is not fully explained; a
      (partial) deficiency of type III collagen has been reported in sporadic, but not
      in familial, cases. Clinical decision analysis shows how the risk of harboring an
      intracranial aneurysm and the age of the patient are the main determinants for
      elective screening; lifetime risk of rupture (and therefore age) and surgical
      risks are the determinants for neurosurgical treatment. CONCLUSIONS: Surgical
      treatment is recommended for patients aged less than 70 years with a moderate or
      low surgical risk, and screening (preferably by intra-arterial digital
      subtraction angiography) is recommended only for relatives aged 35-65 years.
      Magnetic resonance angiography may develop into a useful alternative for
      screening, but the risks of diagnostic procedures play only a minor role in the
      decision analysis.

PMID- 1615538
TI  - Confusion over the terminology of subcortical infarcts visible on computed
      tomography is widespread.

PMID- 1615539
TI  - Do not resuscitate orders for cerebrovascular accident patients.

PMID- 1615540
TI  - Surgical treatment of cerebellar infarction.

PMID- 1615541
TI  - Coronary artery disease and cardiac events with asymptomatic and symptomatic
      cerebrovascular disease.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the prevalence
      of coronary artery disease and coronary events during follow-up in patients with
      asymptomatic carotid stenosis, transient ischemic attacks, or small strokes.
      METHODS: We prospectively studied 60 consecutive patients with thallium-201
      scintigraphy followed by coronary arteriography according to an established
      protocol. RESULTS: The 201Tl testing was abnormal in seven of 15 patients (47%)
      with asymptomatic carotid stenosis and in 19 of 44 patients (43%) with transient
      ischemic attacks or small strokes (p greater than 0.05). In 33 patients with no
      history of coronary artery disease, 11 (33%) had reversible 201Tl defects. In 26
      patients with a history of coronary artery disease, 15 (58%) had reversible
      and/or fixed defects (p = 0.054 compared with patients with no history). A
      history of peripheral vascular disease was the only risk factor significantly
      associated with an abnormal 201Tl test (p = 0.032). Coronary artery stenosis of
      greater than 50% was identified in one or more vessels in 14 of 15 patients
      undergoing coronary arteriography. Over a mean follow-up period of 311 days, four
      patients (7%) developed new onset of angina. There were four coronary events
      among 14 patients (29%) with both a reversible area on the 201Tl and abnormal
      coronary arteriography. In comparison, there were only four coronary events among
      46 patients (9%) without reversible defects on the 201Tl studies (p = 0.055).
      CONCLUSIONS: Our study demonstrates that one third of patients with no history of
      coronary artery disease had an abnormal 201Tl test and that nearly one half of
      patients with either symptomatic or asymptomatic cerebrovascular disease had
      abnormal 201Tl tests. Patients with a reversible 201Tl defect and significant
      stenosis by coronary arteriography were at higher risk for subsequent cardiac
      events. These findings demonstrate the utility of screening patients with
      asymptomatic and symptomatic cerebrovascular disease for cardiac disease.

PMID- 1615542
TI  - Progression of carotid atherosclerosis in Japanese patients with coronary artery
      disease.
AB  - BACKGROUND AND PURPOSE: Along with the recent changes in lifestyle in Japan, the
      incidence of coronary artery disease has increased while the incidence of stroke
      appears to be decreasing. We investigated the relation between the progression of
      carotid atherosclerosis and the severity of coronary artery disease in the
      Japanese population. METHODS: The 2-year change in extracranial carotid
      atherosclerosis in 50 Japanese patients who underwent coronary angiography was
      evaluated using carotid echotomography. To quantify the extent of carotid
      atherosclerosis, the maximal thickness measurements of all plaques were summed
      for an individual plaque score, except for new plaques found on reexamination.
      Carotid disease progression was evaluated by the sum of plaque score change and
      the thickness of the new plaque found on reexamination. RESULTS: The plaque score
      changed by -3.2 to 10.1 mm (mean +/- SD, 1.06 +/- 2.42 mm). The extent of
      coronary atherosclerosis (p less than 0.02) and serum total cholesterol level (p
      less than 0.01) were different between the progressing (n = 17) and the
      nonprogressing (n = 30) groups of carotid atherosclerosis when the progressing
      group included the patients with a delta plaque score of greater than or equal to
      1.0 mm. Neither age, serum triglyceride level, serum high-density lipoprotein
      cholesterol level, pack-years of smoking, percentage of smokers, percentage of
      hypertensive patients, nor percentage of diabetic patients was different between
      the two groups. Carotid disease progression was significantly higher in patients
      with three-vessel coronary disease than in patients without significant coronary
      artery disease (p less than 0.005). There was a significant positive linear
      correlation between carotid disease progression and Gensini's coronary artery
      disease score (R = 0.411, p less than 0.005). CONCLUSIONS: Our data showed that
      severe coronary artery disease and a high serum total cholesterol level were
      strong predictors for carotid disease progression in Japanese patients with high
      rates of coronary artery disease.

PMID- 1615543
TI  - Ultrasonic measurement of the elastic modulus of the common carotid artery. The
      Atherosclerosis Risk in Communities (ARIC) Study.
AB  - BACKGROUND AND PURPOSE: The Atherosclerosis Risk in Communities Study is a
      prospective investigation of the etiology and natural history of atherosclerosis
      and the etiology of clinical disease in four US communities. METHODS: Noninvasive
      ultrasonic methods were used to determine mean wall thickness (WT), radius (R),
      and circumferential arterial strain (CAS) in the left common carotid artery of
      3,321 white male and female study participants between the ages of 45 and 64
      years. The mean and standard deviation of Young's elastic modulus (Y) in 5-year
      age groups were determined for each sex by combining the ultrasonic data with
      concurrent noninvasive measurements of pulse pressure (PP) in the right brachial
      artery using the equation Y = (R/WT) x (PP/CAS). RESULTS: Significant (p =
      0.0001) age group differences in Y were observed in both sexes, with the mean
      value increasing from 701 kPa in women and 771 kPa in men in the 45-49-year-old
      age group to 965 and 983 kPa, respectively, in the 60-64-year-old age group.
      Significant (p = 0.0001) age group differences were also observed for WT, the
      WT/R ratio, PP, CAS, and the PP/CAS ratio in both sexes. A sex difference in Y
      was detected (male greater than female, p = 0.0006) only in the 45-49-year-old
      age group. Significant (p less than 0.0001) sex differences were found, with men
      having a greater lumen diameter calculated as 2 x (R - WT), a greater WT, and a
      greater 2R in all age groups. The WT/R ratio did not differ in both sexes in all
      age groups. CONCLUSIONS: Knowledge of the arterial wall elastic modulus and the
      parameters required for its determination can provide important insight into
      structural changes occurring within the arterial wall with age and sex, and
      possibly with the onset of very early arterial disease.

PMID- 1615544
TI  - Treatment of cerebellar infarction by decompressive suboccipital craniectomy.
AB  - BACKGROUND AND PURPOSE: We present an anecdotal series of 11 patients without
      past history of stroke with progressive neurological deterioration while on
      medical therapy for large cerebellar infarctions. Clinical signs of brain stem
      compression developed in these patients. Computerized tomography of the head
      confirmed mass effect from brain edema. It was the clinical judgment of the
      neurologists and neurosurgeons that each of these 11 patients would expire
      without surgical intervention. METHODS: All 11 patients (seven men, four women;
      mean age, 54 years) were treated with suboccipital craniectomy for decompression
      and temporary ventriculostomy for cerebrospinal fluid pressure monitoring and
      drainage. RESULTS: Seven patients demonstrated neurological improvement on the
      first postoperative day. Two patients returned to their previous jobs 3 months
      after surgery. The Barthel Index indicated that six individuals were functioning
      with minimal assistance within a follow-up period of 16-60 months. The remaining
      three were functionally dependent. No mortality was noted in this series.
      CONCLUSIONS: These results suggest that decompressive suboccipital craniectomy
      may be an effective, lifesaving procedure for malignant cerebellar edema after a
      large infarction.

PMID- 1615545
TI  - Doppler CO2 test as an indicator of cerebral vasoreactivity and prognosis in
      severe intracranial hemorrhages.
AB  - BACKGROUND AND PURPOSE: Transcranial Doppler ultrasonography is a noninvasive,
      reproducible technique that allows the assessment of CO2-induced cerebral
      vasomotor reactivity. We investigated the effect of CO2 changes on cerebral blood
      flow velocity in patients with severe intracranial hemorrhage and evaluated the
      relation between CO2 reactivity, intracranial pressure, and outcome. METHODS:
      Transcranial Doppler parameters, intracranial pressure, arterial blood pressure,
      and PaCO2 were measured simultaneously in 40 patients. To determine CO2
      reactivity, the initial PaCO2 of each patient was lowered by at least 6 mm Hg by
      controlled hyperventilation. Relative CO2 reactivity was defined as the percent
      change in mean flow velocity per mm Hg PaCO2 (averaged during 20 heart cycles
      before and after approximately 15 minutes of increased hyperventilation).
      RESULTS: A significantly reduced relative CO2 reactivity was observed in the
      patient group compared with a healthy, age-matched control group. Relative CO2
      reactivity was maintained significantly better in patients with moderate
      intracranial pressure than in patients with markedly increased intracranial
      pressure. An indirect correlation was found between intracranial pressure and
      relative CO2 reactivity (r = -0.89; p less than 0.001). Clinical outcome was
      significantly related to the initial relative CO2 reactivity. Whereas the
      patients with good recovery had shown a largely preserved reactivity (mean +/-
      SD, 3.4 +/- 0.7%) that did not differ significantly from the control group, there
      was a continuous decrease up to the patients who died (0.8 +/- 0.3%).
      CONCLUSIONS: Transcranial Doppler CO2 testing in patients with severe cerebral
      disease and elevated intracranial pressure provides useful information regarding
      hemodynamic state, prognosis, and determination of beneficial effects of specific
      therapy.

PMID- 1615546
TI  - Treatment of acute cerebral hemorrhage with intravenous glycerol. A double-blind,
      placebo-controlled, randomized trial.
AB  - BACKGROUND AND PURPOSE: Hitherto, treatment of acute cerebral hemorrhage with
      intravenous glycerol has not been evaluated in rigorous clinical studies with
      sufficient patient numbers. METHODS: We undertook a double-blind, stratified and
      randomized, placebo-controlled clinical trial. Only patients with a first stroke
      admitted to the hospital within 24 hours after onset of symptoms were recruited,
      provided computed tomography confirmed hemorrhage and informed consent was
      obtained. After stratification into alert, semicoma, and coma subgroups using the
      Glasgow Coma Scale, 107 patients received active treatment (500 ml of 10%
      glycerol in saline by intravenous infusion over 4 hours on 6 consecutive days)
      and 109 were given corresponding saline treatment. Using a variety of objective
      scoring systems, patients were followed up for up to 6 months. RESULTS: At follow
      up, all measures of outcome in the treated and control groups were very similar.
      At 6 months, respective mortality rates were 37 of 107 and 33 of 109.
      Corresponding mean +/- SD improvements in Scandinavian Stroke Study Group scores
      were 8.35 +/- 16.9 versus 11.55 +/- 15.6 (long-term) and 0.64 +/- 7.3 versus 2.40
      +/- 6.9 (prognostic), and improvements in the Barthel Index ratings were 10.72 +/
      24.7 versus 13.95 +/- 23.3, respectively. Glasgow Coma Scale score improvements
      in the survivors were 0.81 +/- 1.5 and 1.16 +/- 1.7 in the treated and control
      groups, respectively. Hemolysis (generally subclinical) was the only adverse
      effect of glycerol noted. CONCLUSIONS: In the absence of any clinically or
      statistically significant difference in outcome between the treated and control
      groups, this trial provides no justification for glycerol therapy following acute
      cerebral hemorrhage.

PMID- 1615548
TI  - Discharge outcome after stroke rehabilitation.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to examine the relations
      between host characteristics (age and side of body affected) and program
      variables (lengths of stay in acute care and rehabilitation, levels of functional
      ability at admission and discharge, and rates of community discharge). METHODS: A
      sample of 7,905 patients was drawn from medical rehabilitation facilities
      enrolled in the Uniform Data System for Medical Rehabilitation who were admitted
      and discharged for the first time between January 1988 and June 1989. Data were
      analyzed using either chi 2 tests or z normal tests of proportions, and analyses
      of variance (ANOVA) and/or t tests. Significance was set at p less than 0.05, and
      statistically significant F ratios were examined using Student-Newman-Keuls
      tests. RESULTS: The average age of patients was 70.7 years (24% less than 65
      years, 53% 65-79 years, and 23% greater than 79 years). Lengths of stay in acute
      care and rehabilitation, admission and discharge functional independence ratings,
      and rates of community discharge were generally inversely related to patient age.
      Patients with bilateral paresis had lower rates of community discharge than those
      with unilateral paresis, although this distinction was not evident in the older
      group. CONCLUSIONS: Results showed that older age and bilateral paresis are
      negatively associated with levels of independence at admission and discharge and
      with rates of community discharge.

PMID- 1615547
TI  - Emergency reversal of anticoagulation after intracerebral hemorrhage.
AB  - BACKGROUND AND PURPOSE: Although intracerebral hemorrhage is one of the most
      serious complications during oral anticoagulant therapy, there are no guidelines
      on emergency treatment with respect to reversal of anticoagulation effect in
      these patients. METHODS: We retrospectively compared laboratory data and clinical
      features in 17 cases of anticoagulant-related intracerebral hemorrhage treated
      with prothrombin complex concentrate (n = 10) or fresh-frozen plasma (n = 7).
      RESULTS: In the group of patients treated with prothrombin complex concentrate,
      the mean prothrombin time decreased from 2.83 to 1.22 International Normalized
      Ratio within 4.8 hours, compared with a decrease from 2.97 to 1.74 within 7.3
      hours in those given fresh-frozen plasma (i.e., four to five times more rapidly
      after treatment with prothrombin complex concentrate) (p less than 0.001).
      Symptoms and signs of intracerebral hemorrhage, measured on an eight-graded
      Reaction Level Scale, progressed on average 0.2 grades in patients given
      prothrombin complex concentrate compared with 1.9 grades in those given fresh
      frozen plasma (p less than 0.05). In patients with prothrombin values above 1.46,
      clinical progression within 12 hours occurred in five of six cases. CONCLUSIONS:
      Treatment with prothrombin complex concentrate reverses anticoagulation more
      rapidly than fresh-frozen plasma, which might be of importance for the prevention
      of further bleeding.

PMID- 1615549
TI  - Pure sensory stroke. Clinical-radiological correlates of 21 cases.
AB  - BACKGROUND: Although pure sensory stroke is a relatively common lacunar syndrome,
      the responsible lesions are often unidentified because of their small size. I
      reported 21 cases of pure sensory stroke in which the lesions could be identified
      by head computed tomography and/or magnetic resonance imaging and correlated the
      clinical findings with the radiological lesions. SUMMARY OF REPORT: Eleven
      patients had thalamic strokes. Lacunes confined to the posterolateral part of the
      thalamus were found in nine cases, and hemorrhages of relatively large size were
      found in two. Five patients showed a loss of all sensory modalities, but six with
      very small lacunes showed minor or restricted sensory changes. Seven patients
      with lacunes or hemorrhages in the lenticulocapsular region or corona radiata
      showed abnormalities of spinothalamic tract sensation. Two patients with a small
      lacune and a hemorrhage in the pontine tegmentum showed a selective sensory
      deficit of the medial lemniscal type. One patient with a small cortical infarct
      showed a cortical sensory loss that was preceded by cortical sensory transient
      ischemic attacks. CONCLUSIONS: Pure sensory stroke can occur with lesions in
      various areas of the somatosensory system. Hemisensory deficits of all modalities
      usually are associated with a relatively large lacune or hemorrhage in the
      lateral thalamus, whereas tract-specific or restricted sensory changes suggest
      very small strokes in the sensory pathway from the pons to the parietal cortex.

PMID- 1615551
TI  - Cerebral plasminogen activator activity in spontaneously hypertensive stroke
      prone rats.
AB  - BACKGROUND AND PURPOSE: In the spontaneously hypertensive stroke-prone rat, it is
      unclear whether plasminogen activator plays a role in the development of stroke.
      The present study was undertaken to investigate brain levels of plasminogen
      activator activity in spontaneously hypertensive stroke-prone rats and Wistar
      Kyoto rats. METHODS: Plasminogen activator was purified from the brains of rats
      of both strains. The purification involved used ammonium sulfate precipitation,
      gel filtration, a zinc chelate-Sepharose column, and a concanavalin A-Sepharose
      column. Fraction I (0.15 M KCl-soluble fraction) and fraction II (2 M KCl plus 6
      M urea-soluble fraction) were purified from both strains. RESULTS: Total
      plasminogen activator activity in the original homogenates for fractions I and II
      derived from spontaneously hypertensive stroke-prone rats was increased to twice
      the level found in Wistar-Kyoto rats. The final product purified from fractions I
      and II in both strains of rats revealed single bands of plasminogen activator
      activity on enzymatic analysis with a molecular weight of 72,000. The purified
      product had stronger S-2288 amidolytic activity than S-2444 amidolytic activity,
      and it also displayed fibrin-binding ability. CONCLUSIONS: The study demonstrated
      that there is an increased content of plasminogen activator in the brains of
      spontaneously hypertensive stroke-prone rats that might be related to the
      development of stroke.

PMID- 1615550
TI  - Pressure-flow relations in canine collateral-dependent cerebrum.
AB  - BACKGROUND AND PURPOSE: The pressure-flow relation has been characterized in
      normal cerebrum, but it has not been studied in cerebrum dependent on collateral
      flow. The purpose of this investigation was to examine the relation between
      systemic pressure, regional cerebral blood flow, and middle cerebral artery
      branch pressure in collateral-dependent and normal brain. METHODS: In 10
      anesthetized dogs, we cannulated a branch of the middle cerebral artery and
      identified collateral-dependent tissues using the shadow flow technique. We
      measured pressure in normal and cannulated branches of the middle cerebral artery
      and regional cerebral blood flow. The common carotid arteries were occluded, and
      hemorrhage reduced mean arterial pressure to 50 and 25 mm Hg. RESULTS: When
      aortic pressure was 25 mm Hg, blood flow to the collateral-dependent zone
      decreased from a baseline of 87 +/- 5 to 6 +/- 1 ml/100 g per minute (mean +/-
      SE), and pressure in the cannulated branch of the middle cerebral artery
      decreased from 49 +/- 4 to 2 +/- 0.4 mm Hg (p less than 0.05). Small-vessel
      resistance in the collateral-dependent region decreased from 0.56 +/- 0.09 to
      0.38 +/- 0.04 mm Hg/ml/100 g per minute (p less than 0.05) after carotid
      occlusion but did not change significantly during hypotension. In normal brain,
      however, small-vessel resistance continued to decrease as systemic pressure was
      reduced. CONCLUSIONS: This study provides pressure-flow relations in normal and
      collateral-dependent cerebrum during carotid occlusion and progressive
      hypotension. In collateral-dependent tissue, concurrent occlusion of middle
      cerebral and carotid arteries produces autoregulatory dilatation of small
      vessels, resistance fails to decrease as mean arterial pressure is reduced to 25
      mm Hg, and profound focal hypoperfusion is produced.

PMID- 1615552
TI  - [Association of dentists of Winterthur (VWZ). Foundation and development].

PMID- 1615553
TI  - [Differential diagnosis of epulis-type changes in the mouth].
AB  - Various tumorlike reactions of the oral mucous membranes under the term Epulis
      are summarized. These histologically different benign or malignant neoplasms of
      the gingiva are not very frequent. The differential diagnosis on a clinical basis
      like symptoms and macroscopic appearance is not easy. Sometimes under these
      harmless appearing lesions highly aggressive and malignant tumors may be hidden;
      as there are carcinomas, sarcomas, metastases, tumors of the salivary glands or
      malignant lymphomas. The therapy of choice is the complete removal including the
      underlaying periosteum. Occasionally the adjacent bone and tooth have also to be
      resected. Because of the harmless clinical appearance a histological examination
      is always required. Some clinical and pathohistological impressive examples are
      presented.

PMID- 1615554
TI  - [Frequency of chromosome aberrations in peripheral blood lymphocytes of children
      living in regions with various radio-ecologic situations].
AB  - First results of cytogenetic monitoring of children, living in contaminated
      regions of the Ukraine show statistically significant increase in quantity of
      chromosome aberrations, that is positively correlated with environmental
      situation. The effect found shows that damage of genome stability must be
      accounted as an indicator of increased possibility of gene-based pathology in
      studied groups as compared to control.

PMID- 1615555
TI  - [Heterophilic granulocytes of rats during irradiation].
AB  - The bone marrow eosinophils of rats subjected to irradiation are capable of
      secreting a peroxidase system obtained by neutrophils and endotheliocytes. As a
      result, there appear heterophil granulocytes in the peripheral blood.

PMID- 1615556
TI  - [Analysis of the genetic predisposition to cancer in families of patients with
      multiple primary malignant neoplasms].
AB  - Clinical-genetic examination of 305 patients with multiple primary tumors aimed
      at determining the rate of genetic burden to their development and community of
      joint accumulation of tumors in families of these patients has revealed a
      significant genetic community of inheritance of breast cancer, carcinomas of
      colon, endometrium, ovaries and stomach in the families of patients with multiple
      primary tumors. Comparative analysis of genetic correlations has shown the
      greatest genetic burden in families of patients with multiple primary tumours as
      against the families of patients with solitary cancer.

PMID- 1615557
TI  - [Genetic markers of individual predisposition to lung cancer].
AB  - The investigation concerning the dependence of cancer incidence on genetic HLA
      markers and character of dermatoglyphs was carried out. The use of the pattern
      recognition method for multifactorial estimation of the above markers as well as
      the elimination of the main non-genetic oncogenic risk factors allowed obtaining
      the proof of the existence of the genetic predisposition to lung cancer. It was
      estimated that the character of dermatoglyphic prints is the most adequate marker
      for the investigated predisposition, and the reliable prediction of the genetic
      risk of the lung cancer development can be given as based on the joint evaluation
      of both markers.

PMID- 1615558
TI  - [Genetic polymorphism of hemoglobin, protein systems, blood enzymes and their
      relationship to reproducibility].
AB  - The genetic polymorphism of haemoglobin, transferrin, amylase, alkaline
      phosphatase, ceruloplasmin, beta-lactoglobulins and casein were studied. The
      relationship between the level of the heterozygosity of the blood polymorphic
      protein and enzyme systems was determined.

PMID- 1615559
TI  - [Mutagenic activity of the plant preparation KAC-81].
AB  - Mutagenic activity of vegetative preparation KAC-81 containing extracts of common
      wormwood and pine buds using crepis root seedlings, unicellular green alga of
      Chlorella indicator strains of Salmonellas TA 100, TA 1534, TA 1537, TA 50 and TA
      98 as well as white mice and white rats has been studied. It is shown that the
      preparation caused a weak mutagenic effect on Crepis seedlings and Chlorella and
      no mutagenic effects on the indicator strains of salmonellas, in sex and somatic
      cells of mammals under single peroral action in maximally endured doses.

PMID- 1615560
TI  - [Retrospective study of the development of basic trends in human cytogenetics for
      1981-1988].

PMID- 1615561
TI  - [Spectacular advances in cardiology: molecular biology promises more to come.
      Interview by Robert Henry].

PMID- 1615562
TI  - [Pneumococcal vaccine and the independently living elderly].

PMID- 1615563
TI  - [Anxiety disorders in children: incidence, comorbidity and risk factors].
AB  - According to epidemiological studies, prevalence of children's anxiety disorders
      is about 10%. Among children who suffer from anxiety disorders, a majority also
      presents one or more anxiety or mood disorders. The children's sex and age are
      likely to influence anxiety disorders. As well as the children's personality:
      studies about 'temperament' indeed pointed up this notion. Low socio-economic
      level of family could be a risk-factor, the importance of which varies according
      to anxiety disorders subtypes. Current and/or history of parental anxiety
      disorders, presenting or not with mood disorders, increase the risk for their
      children to suffer from anxiety disorders.

PMID- 1615564
TI  - [A diabetic patient presenting unduly precocious retinopathy and nephropathy].

PMID- 1615566
TI  - [Angina: beware of apparent benignity].

PMID- 1615567
TI  - [Angina: a unique research protocol in Quebec].

PMID- 1615565
TI  - [Anatomo-clinical conference at the Hotel-Dieu de Montreal. A 34-year-old man
      with fever and hemoptysis].

PMID- 1615568
TI  - Renal cystic disease in multisystem conditions.
AB  - Five renal cystic diseases have significant extrarenal manifestations: autosomal
      dominant polycystic kidney disease (ADPCK), autosomal recessive polycystic kidney
      disease (ARDCK), tuberous sclerosis (TS), von Hippel-Lindau Syndrome (VHL), and
      medullary cystic disease (MCD). Knowledge of these extrarenal manifestations is
      important since they may precede, present simultaneously, or follow the onset of
      the renal cystic disease. This article discusses the most significant extrarenal
      manifestations of these five renal cystic diseases: (1) ADPCK: hepatic cysts and
      cardiovascular abnormalities; (2) ARDCK: portal hypertension; (3) TS: hamartoma
      like tumors of other organs; (4) VHL: central nervous system hemangioblastomas
      and paragangliomas; and (5) MCD: congenital hepatic fibrosis. Detecting
      extrarenal manifestations may be helpful (1) in confirming the renal cystic
      disease; (2) in thoroughly evaluating the patient with known renal cystic
      disease, and (3) if they antedate the renal cystic disease, their presence will
      alert the radiologist to evaluate the kidneys.

PMID- 1615569
TI  - Imaging the urethra in men and women.
AB  - This review describes and illustrates the radiologic techniques, normal anatomy,
      and common congenital and acquired lesions of the urethra in men and women.
      Voiding cystourethrography and retrograde urethrography are the most common
      imaging modalities employed in the diagnosis of anatomic lesions of the urethra.
      The appearance of the urethra may then dictate the need for further functional
      evaluation with urodynamic studies. Congenital lesions in men include posterior
      and anterior urethral valves and duplicated urethra. In women, ectopic insertion
      of the ureter into the urethra is the usual congenital lesion. Acquired urethral
      lesions include benign prostatic hypertrophy in men and strictures and
      diverticula in both men and women.

PMID- 1615570
TI  - In utero sonography of genitourinary anomalies.
AB  - Congenital anomalies of the genitourinary system represent the commonest fetal
      anomaly. The sonographic findings in hydronephrosis, multicystic kidney
      (dysplastic kidney), polycystic kidney, and renal agenesis are reviewed.

PMID- 1615571
TI  - Multimodality approach to staging renal cell carcinoma.
AB  - Renal imaging has dramatically improved since the introduction of ultrasound
      (US), computed tomography (CT), and most recently magnetic resonance (MR)
      imaging. US and MR imaging are ideal for patients with compromised renal function
      preventing administration of iodinated contrast material or those who have
      experienced reactions to contrast. Staging errors occur due to limitations in
      assessing microscopic tumor invasion of the renal capsule and perinephric fat,
      detecting metastatic deposits in normal sized lymph nodes and differentiating
      inflammatory hyperplastic lymph nodes from neoplastic ones. These limitations are
      shared by US, CT, and MR imaging. Vascular invasion by tumor can be evaluated by
      all imaging modalities including venography. The advantages and limitations of
      each examination will be presented.

PMID- 1615572
TI  - The dilated urinary tract in children.
AB  - Dilatation of the urinary tract is detected in a number of settings throughout
      childhood. Children may be asymptomatic or present with urinary tract infection,
      hematuria, or voiding symptoms. Evaluation of the affected urinary tract may
      require standard radiographic techniques (VCUG, EU) complemented by ultrasound
      and nuclear medicine studies. The goal of imaging is to differentiate
      hydronephrosis (HN) from hydroureteronephrosis (HUN) and to provide the correct
      diagnosis so that appropriate treatment can be given. This article reviews and
      demonstrates the findings in some common and uncommon causes of HN and HUN.

PMID- 1615573
TI  - Renal transplantation: use of sonography.

PMID- 1615574
TI  - Diverticula of the male urethra: a review of 61 cases.
AB  - Sixty-one cases of diverticulum of the male urethra were reviewed. This group
      included 10 patients with congenital and 51 with acquired diverticula. The
      etiology of the acquired variety, the radiological findings, and the frequency of
      appearance in both congenital and acquired diverticula of the urethra during a 30
      year period are described.

PMID- 1615575
TI  - Digital radiography in urologic imaging: radiation dose reduction on
      urethrocystography.
AB  - Digital luminescent radiography (DLR) is a new form of digital radiographic
      technology which can be used as an alternative to conventional radiologic
      systems; it replaces conventional screen-film systems by photostimulable
      phosphorus. Due to the linear dynamic range of photostimulable phosphorus, x-ray
      examinations can be performed with significantly lower radiation exposure. In
      this study radiation dose was reduced by about 90% using DLR for
      urethrocystography.

PMID- 1615576
TI  - Intracavernosal injection of prostaglandin E1 as an alternative for papaverine in
      penile angiography.
AB  - Arteriography of the penile vasculature was performed after intracavernous
      injection of prostaglandin E1 in five patients. Penile tumescence was obtained in
      three patients with a dose of 10 micrograms and in the other two patients with a
      dose of 20 micrograms. Mean duration of penile tumescence was 1 h 36 min.
      Visualization of the penile vasculature was adequate in all patients. Local pain
      was a minor side effect in one patient. These preliminary results suggest that
      prostaglandin E1 might represent an alternative for papaverine in the
      angiographic study of male impotence.

PMID- 1615577
TI  - Inguinal mass in a 66-year-old man.

PMID- 1615578
TI  - Contemporary concepts for imaging urinary tract obstruction.
AB  - Ultrasound is an integral tool in the contemporary assessment of urinary tract
      obstruction. Pulsed and color Doppler have eliminated many previous false
      positives due to blood vessels or non-obstructive hydronephrosis. Limitations of
      the ultrasound technique still exist and on occasion necessitate the utilization
      of intravenous urography.

PMID- 1615579
TI  - Interleukin-2-induced growth inhibition of prostatic adenocarcinoma (Dunning
      R3327) in rats.
AB  - The present study was designed to evaluate the effect of a biological response
      modifier, interleukin-2 (IL-2), on the growth in rats of Dunning (R3327, androgen
      sensitive) prostatic adenocarcinoma. IL-2 was given to one group of tumour
      bearing rats by subcutaneous infusion (Alzet micro-osmotic pump 2002, 14 days) of
      424,286 IU/kg per day during 4 weeks. Another group was sham-operated and served
      as control. Tumour growth was calculated by weekly measurement of tumour volume.
      IL-2 treatment caused a significant growth delay without any significant
      toxicity. Plasma testosterone concentrations were similar in both groups and
      ventral prostatic weights did not differ. Morphometric analyses of epithelial
      cells, stroma, luminal compartment in tumour tissue and calculation of the number
      of intratumoral lymphocytes did not show any differences between the two groups.
      It is suggested that IL-2 treatment can decrease prostatic tumour growth without
      apparently affecting the testosterone metabolism. Further studies with special
      interest on the mechanism of action are justified.

PMID- 1615581
TI  - BCG treatment and the importance of an inflammatory response.
AB  - A prospective study was performed on patients with superficial bladder tumour
      treated with bacillus Calmette-Guerin (BCG). The kinetics of interleukin-6 (IL-6)
      titres were monitored in urine collected at regular intervals for 24 h during 14
      BCG treatments, each consisting of six weekly intravesical instillations. IL-6
      titres were quantified with an ELISA system and compared with a bioassay
      (biologically active IL-6) system. After instillation, urinary IL-6 titres
      transiently increased, reaching maximum levels between 2 and 6 h after
      instillation. IL-6 titres appeared to be significantly correlated with an
      increase of total cells retrieved by bladder washout 3 h after instillation. The
      kinetics of the weekly maximum biologically active IL-6 titres indicate that
      three types of BCG-induced response occur: an "early" response starting at the
      first instillation; a "late" response after the third instillation; or no IL-6
      response. The "early" response appeared to be associated, but not strictly
      correlated, with an IL-2 response. The results suggest that the effectiveness of
      BCG treatment is determined by two processes, an inflammatory one, followed by a
      delayed type of hypersensitivity response.

PMID- 1615580
TI  - Differential sensitivity of hormone-responsive and unresponsive human prostate
      cancer cells (LNCaP) to tumor necrosis factor.
AB  - Two sublines, the hormone-sensitive LNCaP-FGC and the insensitive LNCaP-r
      (resistant) carcinoma cell lines, originating from the parental human prostatic
      carcinoma cell line LNCaP were tested for sensitivity to human tumor necrosis
      factor-alpha (TNF) using the MTT assay. Irrespective of the culture conditions,
      i.e., whether FGC cell growth was hormone stimulated or hormone deprived, a clear
      dose-related response was observed between the concentration of TNF (range: 5
      5000 U/ml) in the culture medium and the percentage of growth inhibition. In
      medium containing androgen-depleted serum, in which FGC cells showed reduced
      proliferative activity, the percentage of inhibition by a concentration of 100
      U/ml TNF was substantially higher than that found in hormone-stimulated cells
      (90% and 60%, respectively). In contrast to the FGC cells, the hormone
      insensitive LNCaP-r cells were almost completely resistant to the action of TNF.
      Growth of the FGC cells was almost completely inhibited, whereas growth of the
      LNCaP-r cells was retarded with only 20% at dosages up to 5000 U/ml. This
      substantial difference in TNF responsiveness could not be ascribed to differences
      in TNF-binding capacity, as both the FGC and LNCaP-r cells were found to contain
      identical numbers of TNF-receptors (approximately 1000 sites/cell). A possible
      association between hormone responsiveness and TNF sensitivity is suggested for
      these LNCaP sublines.

PMID- 1615582
TI  - Regulatory effects of interleukin-7 on renal tumor infiltrating lymphocytes.
AB  - Biological therapy using a combination of lymphokine and tumor infiltrating
      lymphocytes (TILs) is a new approach to the treatment of patients with advanced
      cancer. To improve the potency of TILs, new cytokines with T-cell stimulatory
      effects used alone or in combination with interleukin-2 (IL-2) are currently
      being investigated. We have studied the effect of interleukin-7 (IL-7) on TILs
      derived from renal cell carcinoma. Our data demonstrated that five of ten TILs
      proliferated in response to IL-7 alone. This proliferative response was 73-90%
      less than that obtained with IL-2 alone. The use of IL-7 plus IL-2 resulted in a
      1.2- to 4.7-fold increase in proliferation of six of ten TILs compared with IL-2
      alone. IL-7-driven TIL growth was consistently blocked by anti-IL-2, anti-IL-2R
      and anti-IL-7 antibodies (37.2%, 41.6% and 82.2% suppression, respectively). The
      expression of IL-2 receptors was also significantly increased in the presence of
      IL-7 or IL-7 phytohemagglutinin (40.6 + 3.8 and 72.5 + 1.5). In comparison with
      IL-2, IL-7 treatment was associated with a decrease in CD56 (46.3% +/- 19 vs 10%
      +/- 4.9) and increase in CD3 (29.3% +/- 12 vs 73% +/- 6.4) and CD4 (19.3% +/- 15
      vs 58% +/- 10). These studies suggest that in some renal TILs, IL-7 and IL-2 can
      have a synergistic proliferative effect. The IL-7 stimulatory effect appears to
      be mediated via both an IL-2 pathway and an IL-7-independent pathway.

PMID- 1615583
TI  - Cytostatic effect of different strains of Bacillus Calmette-Guerin on human
      bladder cancer cells in vitro alone and in combination with mitomycin C and
      interferon-alpha.
AB  - The cytostatic activity of five Bacillus Calmette-Guerin (BCG) strains (Pasteur,
      Evans, Tice, RIVM and Connaught) on human transitional cell cancer T24 cells was
      examined. A striking effect was noted even in 2-day cultures, and the effect was
      more pronounced when the cells were incubated for 5 days with different BCG
      strains alone. The concentrations needed were about the same as those used in
      clinical practice (10(9) colony-forming units of Pasteur strain in 100 ml
      buffered saline solution). Combination with mitomycin C or interferon-alpha-2b
      potentiated the cytostatic effect. A slight difference in cytostatic activity
      between different BCG strains was found.

PMID- 1615584
TI  - Morphological aspects of the interaction of Bacillus Calmette-Guerin with
      urothelial bladder cells in vivo and in vitro: relevance for antitumor activity?
AB  - Intravesical administration of Bacillus Calmette-Guerin (BCG) has been shown to
      be effective in the treatment of patients with superficial bladder cancer. For a
      better understanding of the mechanism of this antitumor activity, scanning and
      transmission electron microscope (SEM, TEM) studies were carried out to
      investigate morphological aspects of the interaction of BCG with the bladder wall
      in vivo and in vitro. Adherence of BCG to the bladder wall in vivo was studied 1
      and 24 h after single or multiple (6x) BCG instillations in intact and in
      electrocauterized guinea pig bladders. Despite extensive search with SEM for its
      presence, virtually no BCG was found on the intact urothelium, and BCG was only
      occasionally observed in the coagulation lesions. SEM and TEM studies revealed
      adherence and phagocytosis of BCG by the T24 human bladder carcinoma cell line in
      vitro. Time sequence studies on the phagocytosis and fate of BCG showed that T24
      cells are capable of progressively degrading the mycobacteria in phagolysosomes.
      However, BCG did not alter MHC class II antigen expression on T24 cells in vitro.
      In contrast, 54 urine sediments and bladder washings of 11 bladder cancer
      patients, taken prior to or after several intravesical BCG instillations, failed
      to demonstrate urothelial (tumor) cells showing evidence of BCG phagocytosis (682
      cells screened by TEM), while BCG was phagocytized avidly by leukocytes. These
      data suggest that a direct interaction of BCG with urothelial bladder cells in
      vivo can be called in question.

PMID- 1615585
TI  - Dimethylsulfoxide enhances the absorption of chemotherapeutic drug instilled into
      the bladder.
AB  - We examined the effect of dimethylsulfoxide (DMSO) on the absorption of a
      chemotherapeutic drug instilled into the bladder. Female Wistar rats with bladder
      tumors underwent intravesical instillation of normal saline (S group) or 50% DMSO
      (D group) prior to the administration of pirarubicin (tetrahydropyranyl
      Adriamycin). The absorption of pirarubicin was estimated histologically by
      observing its fluorescence. In the S group, fluorescence of pirarubicin was
      observed only in the epithelial layer of normal or hyperplastic regions and in
      the cells of superficial layers of the tumor. In the D group fluorescence was
      observed in the entire bladder wall of normal or hyperplastic regions and
      extended to deeper regions of the tumors than in the S group. These findings
      indicate enhancement of the absorption of pirarubicin by pretreatment with DMSO.

PMID- 1615586
TI  - Responses of tumour cell lines implanted onto the chorioallantoic membrane of
      chick embryo to anticancer agents in combination with hyperthermia.
AB  - The chorioallantoic membrane of chick embryos was used to examine the responses
      of three tumour cell lines to anticancer agents, alone and in combination with
      hyperthermia. Fifteen minutes of hyperthermia at 42.5 degrees C produced the most
      favourable anticancer effect in the B16-F10 grafts. The use of Adriamycin (ADM)
      alone and the combined use of hyperthermia and either cisplatin (CDDP),
      cyclophosphamide (CY) or ADM resulted in a significantly higher rate of tumour
      regression in the B16-F10 grafts from a murine melanoma. In the KK-47 grafts
      derived from a transitional cell carcinoma of the bladder, the use of CY alone
      and the combination of CY and hyperthermia produced a significant tumour
      regression rate. In the T24 grafts neither the use of CY or CDDP alone, nor the
      combination of these drugs with hyperthermia demonstrated any significant effect.
      This method of screening anticancer agents was found to be rapid, simple to
      perform and inexpensive.

PMID- 1615587
TI  - Surgical treatment of the atonic bladder ("vesical cap").
AB  - As demonstrated in animal experiments and in five patients with atonic bladders,
      "vesical cap" surgery causally solves detrusor impairment by functionally
      reinforcing it with a vital muscle layer from an ileal seromuscular flap. All
      other genuine components of the bladder are kept intact, which is very beneficial
      for bladder function.

PMID- 1615588
TI  - Ureterorectal diversion with rectal augmentation. Morphological and manometric
      study in the dog.
AB  - Uretersigmoidostomy in the adult has progressively been abandoned because of its
      high complication rate (both metabolic and functional). We have studied the
      feasibility of a new model of ureterorectal diversion in 12 Beagle dogs, with the
      aim of increasing rectal capacity and decreasing rectal pressure. A segment of
      the ileum was isolated and opened along its antimesenteric border to obtain a
      patch into which the right ureter was implanted, the left ureter being left
      intact to allow comparison of the kidneys postoperatively. The patch was then
      sutured to the edges of a large anterior rectotomy. Modifications of rectal
      physiology were studied by recording the rectal pressure after distension by a
      latex balloon both preoperatively and 3 months postoperatively, so that it was
      possible to evaluate the elasticity of the rectal wall. Radiographic studies and
      examination of autopsy specimens after 3 months yielded the impression of a
      reservoir added to the rectal space. Intrarectal pressure was significantly
      decreased (50% of the preoperative value) for a given distension volume following
      rectal augmentation (P less than 0.01). The elasticity of the rectal wall was not
      modified but the capacity of the reservoir was increased. The ureteroileal
      implantation was patent in two of the five evaluable dogs out of seven
      implantations performed. In these cases, signs of pyelonephritis were found in
      the right kidneys. In the remaining cases the implantation became obstructed for
      reasons mainly related to canine anatomy and experimental conditions. These
      technical difficulties in the dog make it impossible to assess the quality of
      this reimplantation technique in this model.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615589
TI  - [Systemic chemotherapy of urothelial cancer].

PMID- 1615590
TI  - [Urologic characteristics of 7 patients over 100 years of age].
AB  - In the last few decades the old old have increased continuously in numbers.
      Diseases of the genitourinary organs are a frequent part of the multiple
      morbidity we are familiar with in such patients. In the 9th decade of life the
      renal parenchyma is reduced by 30-50%. The decreased glomerular filtration
      combined with tubular insufficiency leads to disturbances of the electrolyte,
      water and acid-base balance. In contrast to these involutionary changes in the
      kidneys, the prostate increases in size owing to varying degrees of hyperplasia,
      and the incidence of malignant growth increases progressively. A total of 575
      patients over the age of 100 years were observed at the Medical Policlinic of
      Wurzburg University, and 7 of these who had pronounced urological disorders are
      described in detail. The variations in the ageing process are considerable.
      Urological illnesses in the course of the multiple morbidity usual in this group
      have a particularly unfavourable influence in the terminal phase of these old old
      patients.

PMID- 1615591
TI  - [Is ultrasound imaging of the urethra an alternative to radiologic urethral
      imaging and urethroscopy?].
AB  - Ultrasonographic examinations have been widely accepted in urology for a variety
      of indications. Stimulated by reports on the usefulness of sonourethrography and
      the idea of reducing radiation exposure, we examined 145 male urethrae during
      retrograde instillation of sterile saline solution. In addition, 8 patients were
      examined during spontaneous micturition. We found this procedure to be painless,
      quick, cheap and to have nearly the same diagnostic value as conventional
      methods.

PMID- 1615592
TI  - [Separation of urologic tumors cells from Cell Saver blood using a membrane
      filter. A new method in autotransfusion?].
AB  - Tumor cells of three urological longterm cell lines have been labelled with 35[S]
      Methionin and added to red cell concentrates. Red cell concentrates rich in tumor
      cells were passed through a cell saver and two special membranfilters under
      standard conditions. The 35[S]-Methionin labelled tumor cells were detected by
      liquid scintillation counting. On an average, only 0.027% of the radioactivity
      was left after passing through the cell saver and the membran filters in the 12
      experiments. If investigations in clinical use of cell-saver and membran filter
      confirm these results, there will be significant consequences in urological tumor
      surgery by the possibility of transfusing the salvaged autologous blood.

PMID- 1615593
TI  - [Correlation of vesico-ureteral reflux and recurrent urinary tract infections
      with increased bacterial adherence].
AB  - Unimpeded urinary flow and voiding of the bladder without residual urine are
      essential for the prevention of urinary tract infections. Therefore, recurrent
      urinary tract infections are most commonly found in patients with functional and
      anatomic disorders of the urinary tract. Children suffering from vesico-ureteral
      reflux are especially susceptible to recurrent urinary tract infections. The
      interaction between germ and target cell, i.e. between antigen and receptor, is
      another important factor in the development of urinary tract infections. This so
      called bacterial adherence is variable and depends upon receptor density as well
      as the affinity of the germ to the receptor. However, our study showed that this
      bacterial adherence plays a minor role in the development of recurrent urinary
      tract infections secondary to vesico-ureteral reflux.

PMID- 1615594
TI  - Management of type III stress urinary incontinence using artificial urinary
      sphincter.
AB  - Type III stress urinary incontinence due to severe intrinsic urethral weakness
      without significant urethrovesical descensus may be treated by periurethral
      injection, sling cystourethropexy, bladder neck reconstruction, or artificial
      urinary sphincter implantation. The rationale for procedure selection depends on
      a number of patient factors and the surgeon's experience. We herein report on 25
      women who were identified as having such incontinence by evaluation which
      included videourodynamic study and lateral voiding cystography and who were
      managed by the implantation of an artificial urinary sphincter. The etiology of
      the severe intrinsic urethral weakness in most patients was multiple prior failed
      cystourethropexies. Postoperatively, 1 patient died of a cerebral vascular
      accident. The remaining 24 women had significantly improved continence and were
      completely satisfied at latest follow-up. No revisions have been required for
      patients receiving an artificial sphincter after 1983. No sphincter erosions or
      infections have occurred. Our experience and review of the literature shows that
      the artificial sphincter provides an excellent first option for women with type
      III urinary stress incontinence due to intrinsic urethral weakness of various
      etiologies.

PMID- 1615595
TI  - Transurethral incision and posterior resection of prostate (TUI-PRP) for selected
      patients with benign obstructive prostatic disease.
AB  - Transurethral incision and posterior resection of the prostate (TUI-PRP) is
      described and used to overcome my three concerns in performing transurethral
      incision of the prostate (TUIP). The favorable result from TUI-PRP is presented.

PMID- 1615597
TI  - Late metastases in seminoma: incidence, localization, and therapeutic
      implications.
AB  - Late metastases of seminoma testis were found in 2 patients thirty and nine years
      after orchiectomy and radiotherapy. Metastases involved retroperitoneal lymph
      nodes and lung in 1 case and obstruction of the sigmoid colon and left ureter in
      the other. Cases of late, atypically localized metastases of seminoma described
      in the literature are reviewed. Therapy includes surgical removal of the
      metastases, radiation therapy, and systemic chemotherapy. Therapeutic
      considerations must include toxicity of preceding radiotherapy.

PMID- 1615596
TI  - Safety of transrectal prostatic biopsy through double-glove technique without
      antibiotic prophylaxis.
AB  - We studied 143 men who underwent transrectal prostatic biopsies using the double
      glove technique. No patient received any antimicrobial therapy before the
      procedure. Clean catch urine cultures were obtained at admission and two, four,
      and twenty-four hours, and two weeks after biopsy. Aerobic and anaerobic blood
      cultures were performed at admission, and at thirty minutes and four hours after
      the procedure. In addition, clinical parameters were monitored closely in the
      hospital for twenty-four hours after the biopsy. A total of 132 patients were
      considered evaluable. Temperatures of 37.6 degrees C or higher occurred in 3.8
      percent of the patients. In no case was rigors recorded. In 4 of the patients
      studied (3%) post-biopsy urine cultures were infected with Escherichia coli. All
      post-biopsy blood cultures, both aerobic and anaerobic, were negative. Our data
      indicate that with the use of the double-glove technique, prophylactic
      administration of antibiotics is not necessary to prevent the infectious
      complications following transrectal biopsy of the prostate.

PMID- 1615598
TI  - Renal cell carcinoma: incidental diagnosis and natural history: review of 235
      cases.
AB  - Two hundred thirty-five cases of histologically proved renal cell carcinoma (1976
      1987) were reviewed to determine the impact of incidental tumor detection on the
      natural history of this cancer. One hundred sixty-eight patients (71.5%)
      presented with clinical signs and/or symptoms of renal pathology. Of these, 25
      (18%) were investigated without consideration of renal cell carcinoma in the
      differential diagnosis. Sixty-seven cases (28.5%) were diagnosed as an incidental
      finding on diagnostic imaging for extrarenal symptomatology. Approximately 30
      percent of patients were found to have metastatic disease on initial presentation
      regardless of incidental, or suspected discovery of these tumors. Stages A and B
      tumors were encountered with equal frequency in patient groups with both
      suspected and incidental diagnosis. Intravenous pyelography was the diagnostic
      modality used to detect the diagnosis in 83 percent of cases. While incidental
      detection of renal cell carcinoma has become more frequent than in previous
      years, it appears to have impacted minimally on the discovery of earlier stage
      tumors than those with presenting clinical symptoms. In contrast to prior
      reports, our data show that the natural history of renal cell carcinoma is not
      significantly altered by the incidental detection of tumor.

PMID- 1615599
TI  - Ophthalmologic manifestations of genitourinary diseases.
AB  - There are several urologic disorders which also involve the eye and orbit. We
      have compiled examples of these and reviewed the literature. Metastasis from
      genitourinary malignancy (including neuroblastoma), Wilms tumor, Reiter syndrome,
      tuberous sclerosis, von Hippel-Lindau disease, and oxalosis may all have
      ophthalmologic manifestations. Urologists need to be aware of these and obtain
      appropriate consultation in order to fully care for patients with these diseases.

PMID- 1615600
TI  - Clinical trial of a simplified vacuum erection device for impotence treatment.
AB  - Thirty-one men participated in a clinical trial of a simplified vacuum erection
      device (Catalyst) in which the pump and penile cylinder have been combined to
      facilitate the pumping required to induce a vacuum. Of the 28 men who completed
      the three-month trial, 26 (93%) reported overall satisfaction with the device and
      an intention to continue its use, and 2 men were unable to maintain a
      satisfactory erection. Episodes of mild bruising or development of petechiae
      occurred in 9 men. None of the complications required treatment or prevented safe
      use of the device. Our experience with this new vacuum device indicates a high
      degree of patient satisfaction and minimal complications. On average, patients
      rated ease of use high at all follow-up visits.

PMID- 1615601
TI  - Influence of shock waves on fracture healing.
AB  - During the last decades the influence of physical factors on fracture healing has
      been widely described. With the use of shock waves for the treatment of
      urolithiasis, a new mechanical medium has been introduced into medicine. For the
      first time the influence of shock waves on fracture healing was studied in rats.
      With fractioned shock-wave treatment (5 times 100 shock waves at 14 or 18 kV) an
      enhancement in healing could be achieved.

PMID- 1615603
TI  - Duplicated urethra: an anomaly best repaired.
AB  - Three cases of urethral duplication are described--two complete and one
      incomplete. The surgical approaches used in 2 of the 3 cases are described, the
      third not having come to definitive surgery as yet. In the patient with an
      incomplete urethral duplication the accessory urethra and associated ventral
      preputial hood were excised. A repair of the complete duplication was devised in
      which an end-to-side urethrourethrostomy and penile plastic revision were
      accomplished. The literature is reviewed and a new classification system for
      urethral duplication is proposed.

PMID- 1615602
TI  - Percutaneous pyeloplasty (endopyelotomy) for congenital ureteropelvic junction
      obstruction.
AB  - Endopyelotomy was performed in 30 patients with congenital primary ureteropelvic
      junction obstruction; 4 patients had high insertion of the ureter and 8 patients
      had caliceal stones. Clinical and radiologic success was achieved in 25 patients.
      There were five failures, all of whom subsequently had successful open
      pyeloplasty. The theoretical and experimental foundations of the procedure and
      fine points of the operative technique are presented. Endopyelotomy appears to be
      valuable for primary ureteropelvic junction obstruction just as it is for
      secondary obstruction.

PMID- 1615604
TI  - Polyorchidism discovered as testicular torsion.
AB  - We report on a case of polyorchidism that presented as testicular torsion. A
      brief history and review of the literature is also presented. Of the 47 cases
      reported, this patient is the youngest.

PMID- 1615605
TI  - Method for correcting meatal stenosis after hypospadias repair.
AB  - Meatal stenosis is uncommon after hypospadias surgery even when the meatus is
      placed at the tip of the glans. However, when it occurs, such stenosis can be
      quite troublesome. A conventional meatotomy done in the presence of inflammation
      is often attended by recurrent stenosis. In such situations we therefore advocate
      placing a tourniquet around the base of the penis and raising a V-shaped flap of
      glans with the point of the V at the dorsum of the meatus. The stenosis is then
      incised along the back wall of the urethra down into non-inflamed tissues. The
      tip of the flap is sutured to this point and additional absorbable sutures are
      used to anchor the flap in place so that healthy tissue crosses the stenotic
      area. Recurrent stenosis after this maneuver is unusual.

PMID- 1615606
TI  - Simultaneous presence of schistosomiasis and advanced cancer in prostate.
AB  - A forty-nine-year-old patient was found to have Schistosoma eggs inside his
      prostatic cancer. At the time of diagnosis, the patient already had spread of
      metastatic disease in lumbar spine. Review of the literature revealed this to be
      the first such case published in English literature. Despite advanced stage of
      disease (Stage D2), the patient responded well to immediate orchiectomy and
      regional irradiation. Two years after diagnosis was established, the patient was
      without clinical evidence of disease, when he suddenly died. The cause of death
      was not established because the family declined an autopsy.

PMID- 1615607
TI  - Filling defect in ureter after ileal conduit surgery.
AB  - Two cases with a filling defect in the distal part of the ureter after operation
      with a nippled ureteroileal anastomosis are presented. The filling defects were
      due to an inversion of the nipple.

PMID- 1615608
TI  - Use of silicone medical grade tubing for microsurgical vasovasostomy training.

PMID- 1615609
TI  - Flow cytometric and genetic study of familial gonadal tumors.
AB  - Three cases of familial gonadal tumors are reported. Genetic studies were
      conducted in 2 cases: a brother and sister with embryonal carcinoma and a benign
      cystic teratoma, respectively, and a father and son with embryonal carcinoma. DNA
      flow cytometry of paraffin-embedded tumors and constitutional karyotyping were
      performed. Further genetic studies are emphasized.

PMID- 1615610
TI  - Simple cysts of testis.
AB  - Three cases of benign intraparenchymal cysts of the testis are described. A nine
      month-old infant and a forty-two-year-old man were seen with painless testicular
      enlargement and underwent orchiectomy and cyst excision, respectively. The third
      patient, a sixty-eight-year-old man, was asymptomatic with the cyst discovered
      following orchiectomy for prostatic carcinoma. In each case the cyst was
      multilocular and lined with a simple cuboidal epithelium. In 1 case special and
      immunohistochemical stains were performed. Review of the literature in
      conjunction with the cysts' staining characteristics are strongly supportive of
      its derivation from ectopic epithelium.

PMID- 1615611
TI  - Renal scintigraphy in initial evaluation of renal colic.
AB  - To determine the role of renal scintigraphy (RS) in patients with suspected acute
      urinary tract obstruction, a prospective study was performed comparing RS with
      emergency intravenous excretory urography (IVU) in 36 examinations. Thirty
      patients were diagnosed as having renal colic: 28 had dilation of the urinary
      tracts with (89%) or without (11%) visualized stone; 2 patients with stones did
      not have stasis at the IVU. An abnormal RS was found in 28 patients with abnormal
      IVU, while it was normal in the 2 nonobstructed patients (sensitivity = 93%). The
      radiopaque stones in these 2 patients were seen on plain x-ray film of the
      abdomen. The results of this study support the use of RS combined with a plain
      film of the abdomen in the initial evaluation of renal colic.

PMID- 1615613
TI  - Varicocelectomy: incidence of external spermatic vein involvement in the clinical
      varicocele.
AB  - The vascular anatomy of the clinical varicocele, and the incidence of involvement
      of the external spermatic vein were studied. Dilation of the external spermatic
      vein (4 mm) was found in 49.5 percent of 93 varicoceles in 67 patients. The
      location of this vein, its potential involvement in a varicocele, and its
      management were reviewed.

PMID- 1615612
TI  - A seventy-eight-year-old man with flank pain.

PMID- 1615614
TI  - Experience with weekly doxorubicin (adriamycin) in hormone-refractory stage D2
      prostate cancer.
AB  - One hundred eleven patients with endocrine-refractory Stage D prostate cancer
      were treated with weekly administration of 20 mg/m2 body surface area of
      doxorubicin hydrochloride (Adriamycin). Fifty-seven were part of a randomized
      study comparing doxorubicin and prednisone to prednisone alone. There were
      significantly more subjective responders in the doxorubicin group than in the
      prednisone group (p less than 0.01). The number of patients with evidence of
      stable disease was also higher during the chemotherapy arm compared with
      prednisone alone (p = 0.02). Patients taking doxorubicin had a slightly longer
      period of stable disease than did those taking prednisone (p = 0.08). Overall
      survival, however, was not prolonged (p = 0.26). Fifty-four patients took part in
      an open trial and 69 percent responded to treatment. All of these had clinical
      improvement. Side effects were minimal with cardiotoxicity noted in less than 15
      percent among patients with side effects. Over 35 percent had no side effects.
      Thus single agent, weekly doxorubicin therapy as evaluated in our experience,
      while well tolerated and of subjective benefit, does not provide the patient with
      a significant longer progression-free survival or improved overall survival.

PMID- 1615615
TI  - Antibiotic prophylaxis following lower urinary tract instrumentation.
AB  - The value of routine antibiotic prophylaxis was assessed in 362 women undergoing
      lower urinary tract instrumentation. A three-day course of a once-a-day dose of 1
      g of cefadroxil was compared with a three-day course of 100 mg of nitrofurantoin
      three times a day, in a randomized investigator blinded placebo controlled study.
      Both study drugs were significantly more effective in preventing
      postinstrumentation urinary tract infections than placebo (p less than 0.003).
      Differences in efficacy between the two test drugs were not significant; however,
      side effects in the nitrofurantoin group were more frequent and severe than those
      in the cefadroxil group. Cefadroxil also offered the advantage of a once-daily
      dosing schedule.

PMID- 1615616
TI  - Subsistence insecurity and ill feeling in domiciliary care.
AB  - The purpose of this study was to analyse the relationship between the feeling of
      subsistence security and well feeling. For the study 129 patients in Helsinki
      domiciliary care were interviewed. Relationships between subsistence security and
      well feeling have been demonstrated by chi-square test. According to the findings
      physical, mental and social well feeling decreased when financial difficulties
      increased. Experienced improvement in health was less for those patients who had
      financial difficulties than for those who had not. The subsistence security was
      the main predictor of the variances of the sumvariables 'physical well-ill
      feeling' and 'mental and social well-ill feeling'. It can be suggested that for
      indigent people in domiciliary care it is not sufficient that a variety of
      services is available. It is therefore an important task of the nurses to
      strengthen the indigent patients' ability to utilize the different opportunities
      available in order to improve their well feeling and ability to cope at home.

PMID- 1615617
TI  - [Gender variables in nursing theories. A text analysis of 5 theories].
AB  - During individual care planning in the education of nurses, the students learns
      to plan, carry out and assess care on the basis of nursing theory. Neutral terms
      such as patient, client, individual and person commonly occur in planning. The
      level of personalization can not, however, be considered satisfactory if no
      attention is paid to gender related variables and if differences in the reaction
      of men and women to problems and illnesses are not underlined. The aim of the
      study was to investigate if and how gender related aspects appear in nursing
      theories. The book "Nursing theories--the base for professional nursing practice"
      was used as the primary source for the choice of theorists. From the initial
      selection (n = 12) the five most quoted theorists according to Nursing citation
      index 1988-1989 (Orem, Rogers, Roy, Nightingale och Peplau), were studied. The
      result shows that little attention is paid to the gender perspective of patients.
      Consequently needs of differentiation between women and men are imperfectly
      observed in individual care planning.

PMID- 1615618
TI  - [Delimitation of the biomedical models and its consequences for the holistic
      viewpoint in nursing, and for quality research].
AB  - Medicine is dominated today by the so called biomedical model of sickness. This
      model ontologically reduces Man to biochemistry and every kind of sickness to
      disease, and therefore expresses an ontologically reductionistic view of Man.
      This view is logically incompatible with the humanistic view of Man, and a
      holistic concept of health. Given the distinction between disease and illness,
      the model is in most cases necessary and sufficient for the treatment of disease
      but for certain kinds of illness it might be neither necessary nor sufficient. In
      order to be a fruitful model it should be radically changed so that it can be
      supplemented by models based on a humanistic view of Man and a holistic concept
      of health. A complementary model would have positive effects on medical praxis,
      health care in general and on the Science of Health Care.

PMID- 1615619
TI  - The models of nursing activity in the basic care of demented patients living in
      institutions.
AB  - The chief concern of this article is the basic care of demented patients living
      in institutions. The data for the study were collected by observing basic care
      situations and interviewing practising nurses. The analysis was based on
      continuous comparative analysis. Five models of nursing activity were identified:
      rejective, routinized, robot-like, cassette-like, and skillful. Nurses
      concentrated more on obligatory daily activities than on the individual needs of
      demented patients, on the special characteristics of dementia, or on encouraging
      spontaneous activity among demented patients. The nurses tended to look at
      demented patients chiefly in terms of the abilities they had lost and the
      disturbance they caused; less attention was given to their remaining facilities,
      such as their sense of humor and their ability to enjoy things and to establish
      contact through gestures and physical touching.

PMID- 1615620
TI  - Subjective loneliness--a comparison between elderly and relatives.
AB  - The survey was aimed at examining the differences between the elderly's
      subjectively experienced loneliness and relatives' appraisal of the situation.
      The interviews contained structured questions about relatives' knowledge of the
      elderly's loneliness and their social contacts with the elderly. In total, 178
      relatives took part in the interviews. The Cognitive-impaired group included 66
      pairs elderly/relatives, where the elderly persons were cognitively impaired, and
      the Cognitive-intact group 112 pairs, where the elderly persons had normal
      cognitive function. There were differences between relatives' appraisal of
      loneliness and the elderly's own experience. The elderly with cognitive deficits
      seemed to feel loneliness more often than persons with intact cognitive ability.
      Relatives tended to overestimate the elderly's loneliness, especially among
      persons with cognitive difficulties. These elderly more often had short frequent
      visits, while persons in the Cognitive-intact group had longer, but not so
      frequent visits.

PMID- 1615621
TI  - Invited article: Richard D. Turk Memorial Lecture--parasites' progress.
AB  - The College of Veterinary Medicine at Texas A & M University celebrated its 75th
      anniversary in September 1991. As a part of this celebration, Professor Lord
      Soulsby was invited by the faculty of the Department of Veterinary Pathobiology
      to deliver the annual Turk Memorial Lecture. The following is Professor Lord
      Soulsby's presentation.

PMID- 1615622
TI  - A survey of ovine parasite control practices in Tennessee.
AB  - A sample of 126 sheep producers in Tennessee was randomly selected from the
      members of a statewide organization of sheep producers. Data about the
      participants' farms, sheep, parasite control practices and sources of information
      regarding ovine parasite control were obtained by a telephone survey. The
      response rate was 99%. The typical respondent kept 20 lambs, 20 ewes and 2 rams
      on three pastures totalling 20 acres. In order of decreasing frequency,
      anthelmintics were given according to a regular schedule, to coincide with
      breeding management procedures, or to treat clinical signs of parasitism.
      Proportions of producers deworming the various classes of sheep zero, one, two,
      three, four or more than four times annually were as follows: lambs--3, 28, 40,
      16, 9 and 8%, respectively; ewes--3, 8, 20, 16, 34 and 22%, respectively; rams-
      1, 9, 19, 15, 38 and 19%, respectively. The majority of respondents planned to
      deworm lambs (89%) and ewes (82%) the same number of times in the following year.
      Of the producers who dewormed sheep two or more times during 1989, 39-49% (ranges
      include different proportions for lambs, ewes and rams) used the same
      anthelmintic exclusively, and 51-61% used two or more drug classes. Of the owners
      using a single anthelmintic exclusively, most (39-66%) used ivermectin, followed
      by levamisole (19-33%) and benzimidazoles (13-24%). One hundred and three of 124
      (83%) producers intended to use the same anthelmintics in the future. Sixty-four
      of 124 (52%) producers had discontinued using at least one ovine anthelmintic.
      The most common reasons for discontinuance were dissatisfaction with the clinical
      response after treatment and inconvenience of administration. Sheep-oriented
      publications, other sheep producers and veterinarians were considered the most
      important sources of information about deworming programs and choice of
      anthelmintics.

PMID- 1615623
TI  - Laboratory and field observations on anti-tick properties of the plant
      Gynandropsis gynandra (L.) Brig.
AB  - A shrubby plant, abundant in east Kenya, Gynandropsis gynandra (L.) Brig., was
      shown to exhibit repellent and acaricidal properties to larvae, nymphs and adult
      Rhipicephalus appendiculatus and Amblyomma variegatum ticks. All stages of ticks
      avoided the leaves of the plant and a high percentage of the ticks which were
      continuously exposed to its leaves died; surviving ticks were weak and inactive
      but regained activity when exposed to fresh air. The effectiveness of the plant's
      leaves as a repellent and acaricide was most pronounced on nymphs and least
      pronounced on adults. Field investigations indicated that ticks were not found up
      to 2-5 m from the plant in areas where the plant was predominant. The potential
      of using the plant for tick control within an integrated tick management system
      in the resource-poor farming context in Africa was highlighted.

PMID- 1615624
TI  - Analytical determination of the distribution of flumethrin on the body surface of
      cattle following topical pour-on application.
AB  - By means of chemical analysis, the distribution behaviour of flumethrin was
      determined in the hair coat of cattle following topical pour-on application.
      Flumethrin was applied at 1 mg active ingredient (a.i.) kg-1 body weight along
      the backline of cattle. It was demonstrated that this compound could be recovered
      from all hair samples taken on Day 1 following application from dorsal, lateral,
      ventral and distal body regions in concentrations ranging from 670 to 1
      micrograms a.i. g-1 hair, depending on the distance from the site of application.
      On Days 3, 5 and 10 after treatment, the corresponding concentrations were 125.0
      1.5, 23.0-1.0, and 44.0-0.9 micrograms a.i. g-1 hair, respectively. When
      correlating these values to the body surface of cattle, it is evident that on all
      sample days and body regions, a concentration of more than 0.01 microgram a.i. cm
      2 body surface was present. This amount of active substance is sufficient for
      effective acaricidal action, as shown by laboratory and field data.

PMID- 1615625
TI  - Development of an enzyme-linked immunosorbent assay (ELISA) for the detection of
      antibody to the parasitic dinoflagellate Amyloodinium ocellatum in Oreochromis
      aureus.
AB  - An enzyme-linked immunosorbent assay (ELISA) using antibody to affinity-purified
      Oreochromis aureus immunoglobulin and antigens from the parasitic dinoflagellate
      amyloodinium ocellatum was developed. The ELISA was then used to evaluate the
      immune response of the tilapine fish to immunization with the parasite. Fish
      immunized with antigens of the dinospore stage, either live or sonicated,
      produced a specific immune response that was detectable by this ELISA.
      Combinations of serial dilutions of A. ocellatum antigen and fish anti-A.
      ocellatum serum were examined to determine which dilutions provided optimal
      differentiation of seropositive from seronegative fish. Fresh and heat
      inactivated serum from both seropositive and seronegative fish produced similar
      results.

PMID- 1615626
TI  - Adrenal and thyroid dysfunctions in experimental Trypanosoma congolense infection
      in cattle.
AB  - Severe pathological changes were observed in the adrenal and thyroid glands of
      Zebu (Bos indicus) heifers infected with Trypanosoma congolense. In the adrenal
      glands, severe inflammatory changes characterised by mononuclear cellular
      infiltration in the subcapsular areas, zona glomerulosa, zona fasciculata and
      zona reticularis were observed. In addition, there were hyperaemia, haemorrhage
      and hyperplasia resulting in increased adrenal weight in the two heifers
      slaughtered on Days 50 and 70 post-infection (p.i.). In the medullary areas of
      these two heifers, there was only mononuclear cellular infiltration. In the two
      heifers slaughtered on Day 113, localised mononuclear cellular infiltration was
      observed in addition to cortical cell depletion and fibrosis, resulting in
      reduced adrenal weight when compared with the controls. In the thyroid glands of
      the infected heifers, gross enlargement of the follicles filled with pale
      staining colloids were observed in association with squamous metaplasia of the
      follicular epithelium and fibroplasia. Serum cortisol concentrations showed an
      appreciable but non-significant increase (P less than 0.05) between Weeks 2 and 6
      p.i. in the infected heifers (5.6 +/- 0.86 ng ml-1 vs. 4.4 +/- 0.34 ng ml-1) when
      compared with the uninfected controls or the pre-infection level. Thereafter,
      cortisol levels declined though non-significantly throughout the rest of the
      study. However, there was a steady increase towards normal levels from Week 12
      p.i. until the end of the experiment. Changes in the basal serum concentrations
      of thyroxine (T4) were also measured weekly. There was a progressive decrease in
      the levels of T4 from the third until the 11th week p.i., when the decrease
      became significant (P less than 0.05) and remained so until the 16th week when
      the experiment ended.

PMID- 1615627
TI  - Seasonal variation of oribatid mite (Acarina) populations and their relationship
      to sheep cestodiasis in Argentina.
AB  - Samples of soil were collected monthly from two ranches in the zone of Puan,
      Province of Buenos Aires, Argentina. The monthly distribution of males, females
      without eggs and females with eggs for the dominant species of oribatid mites
      were studied. The dominant species were Zygoribatula lata in Ranch A, and
      Zygoribatula elongata in Ranch B. Both species are hosts of Moniezia expansa
      Rudolphi, 1810 and Helictometra giardi Baer, 1927. Based on the data presented,
      the factors associated with transmission of these cestodes, including the role
      played by oribatid mites, are discussed.

PMID- 1615628
TI  - Seasonal variations in the numbers of trichostrongylid nematode eggs and their
      larvae in the faeces of farmed goats in Malaysia.
AB  - Faecal worm egg counts of goats from two farms in Penang Island, West Malaysia,
      were monitored over a period of 14 months. The faecal egg count pattern followed
      that of total rainfall. The humid tropical environment was favourable for the
      development of various species of trichostrongylid nematodes, namely Haemonchus
      contortus, Trichostrongylus spp., Oesophagostomum spp. and Cooperia spp.
      Generally, H. contortus was observed to be the predominant species, more so in
      the monsoon months of the year.

PMID- 1615629
TI  - In vitro multiplication of Cryptosporidium parvum in mouse peritoneal
      macrophages.
AB  - Cryptosporidium parvum of bovine origin was developed in vitro in unsensitized
      mouse peritoneal macrophages. Macrophages growing in RPMI medium were infected
      with sporozoites or with oocysts, and after staining infections were studied by
      light microscopy. A high parasitic index was obtained with multiple infections
      occurring commonly. This is a simple method for the study of Cryptosporidium
      biology, and for in vitro assays of pharmacological activity.

PMID- 1615630
TI  - Lipid metabolism and Sarcocystis miescheriana infection in growing swine.
AB  - Sixteen 2-month-old pigs were divided into four equal groups and infected with
      either 500,000, 1,000,000 or 3,000,000 sporocysts of Sarcocystis miescheriana.
      Four pigs served as uninfected controls. Pigs were bled weekly and serum was
      collected beginning 14 days prior to infection and continuing until 63 days after
      infection. Body fat composition, as measured by the specific gravity of the
      carcass, was not affected by infection. There were no significant effects of
      infection on serum concentrations of glucose, insulin, triglycerides, and total,
      high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol. A
      slight depression in HDL cholesterol occurred during the acute phase of
      infection. Tumor necrosis factor (TNF) was not detected in serum from infected
      swine when assayed by a cytotoxicity assay using TNF-sensitive WEHI 164 clone 13
      cells. Attempts to stimulate TNF production in RAW 264.7 cells with parasitic
      lysates gave mixed results. This study suggests that the disruption of lipid
      metabolism is not the primary cause of growth retardation in growing swine
      infected with S. miescheriana.

PMID- 1615631
TI  - The efficacy of ivermectin against Thelazia rhodesii (Desmarest, 1828) in the
      eyes of cattle.
AB  - One hundred cattle with confirmed natural infections of Thelazia rhodesii were
      included in three studies to evaluate the efficacy of ivermectin for the
      treatment of eyeworm infection. Thelazia rhodesii were counted in situ in each
      eye of each animal on Day 0 (prior to treatment) and the cattle were paired by
      the number of worms, within categories of sex, age or number of infected eyes.
      Within each pair, one animal was randomly assigned to serve as an untreated
      control, while the other was treated subcutaneously with ivermectin at 200
      micrograms kg-1 body weight. Eight days later, parasites were recovered from each
      eye separately, identified and counted. In each study, significantly (P less than
      0.01) fewer T. rhodesii were collected on Day 8 from ivermectin-treated cattle
      than from controls. Overall, the reduction in numbers of T. rhodesii collected
      from treated cattle was greater than 99% (P less than 0.05) relative to controls,
      with reductions of 100% being recorded in two of the three studies.

PMID- 1615632
TI  - Epidemiology and effects of nematode infections on beef cow-calf systems of
      Argentina's western pampas.
AB  - The epidemiology and the effects of nematode infections on cow-calf systems were
      followed from 3 weeks before calving to 7 months afterwards. Two groups, each of
      15 cow-calf pairs grazed on separate lucerne pastures. Group I (GI) were treated
      monthly with oxfendazole (4.5 mg kg-1), cows being dosed from calving and calves
      starting 45 days later. Animals in Group II (GII) were not treated. The egg
      output of the cows was very low. An increase was recorded 2 months after
      parturition, consisting mainly of Ostertagia spp. The egg output and worm burdens
      of calves remained low until late summer and reached a peak in autumn.
      Ostertagia, Cooperia and Haemonchus were the main genera recovered from
      slaughtered calves. The pasture contamination and tracer calf worm counts
      remained consistently low until autumn when they began to increase. Inhibited
      early fourth stage larvae of Ostertagia were recovered during spring. After
      calving, the live-weight gains (LWG) of treated GI cows were significantly higher
      (P less than 0.004) than those of GII cows, whereas the LWG of GI calves were
      significantly higher during December (P less than 0.037) and March (P less than
      0.029) than those of GII calves. There were significant (P less than 0.04)
      cumulative LWG responses between GI and GII calves with no differences in cow
      cumulative LWG at the end of the trial. For spring-born calves, these results
      suggest that strategic deworming programs in cow-calf systems may produce
      benefits.

PMID- 1615633
TI  - Immune responses of pony foals during repeated infections of Strongylus vulgaris
      and regular ivermectin treatments.
AB  - Ten helminth-free pony foals divided into three groups were used in this study.
      Eight foals were each experimentally infected per os with 50 Strongylus vulgaris
      infective larvae weekly for 4 weeks, at which time one foal died of acute
      verminous arteritis. The remaining seven foals subsequently received 50 S.
      vulgaris infective larvae every 2 weeks for an additional 20 weeks. Four of the
      infected foals remained untreated (Group 1) and three of the infected foals were
      given ivermectin at 8, 16 and 24 weeks post initial infection (Group 2). Two
      foals served as controls (Group 3). Foals in Group 1 developed eosinophilia,
      which was sustained throughout the course of infection. A mild eosinophilia also
      developed in Group 2 foals; however, the eosinophil numbers were markedly reduced
      for 3 weeks after each ivermectin treatment. Only foals in Group 1 developed
      significant (P less than 0.05) hyperproteinemia, hyperbetaglobulinemia and a
      reversal of the albumin/globulin (A/G) ratio 4 weeks after initial infection.
      Significant (P less than 0.05) IgG anti-S. vulgaris ELISA titers developed in
      foals in Groups 1 and 2 3 weeks after infection and were sustained for the
      duration of the experiment. Western blot analysis of soluble somatic antigens of
      S. vulgaris adult female and male worms probed with sera from foals in Groups 1
      and 2 revealed only subtle differences between these animals. The blastogenic
      reactivity of peripheral blood mononuclear cells (PBMC) to phytohemagglutinin and
      concanavalin A was not significantly different between groups. Peripheral blood
      mononuclear cells from foals in Groups 1 and 2 developed significant (P less than
      0.05) blastogenic reactivity to S. vulgaris soluble adult somatic antigen when
      examined at 25 weeks after infection. Mesenteric lymph node cells from foals in
      Group 2, although not statistically significant, were more reactive to antigen
      than were the mesenteric lymph node cells from foals in Group 1 when examined at
      27 weeks after infection. These results suggest that significant alterations in
      the immune response of ponies to S. vulgaris does not occur after intravascular
      killing of larvae by ivermectin treatments.

PMID- 1615634
TI  - An attempt to define the host range for African horse sickness virus (Orbivirus,
      Reoviridae) in east Africa, by a serological survey in some Equidae, Camelidae,
      Loxodontidae and Carnivore.
AB  - A survey was carried out in horse, zebra, elephant, camel, sheep and goat and
      wild carnivore sera for virus-serum neutralising antibody to the nine type
      strains of African horse sickness virus. Antibody was found amongst the horse,
      zebra and elephant sera to all nine different strains. No antibody was detected
      in any sera from camels, sheep and goats. None was found in sera from hyaena and
      jackals in this series but had been detected earlier.

PMID- 1615635
TI  - Serodiagnosis of leptospirosis in pigs using an axial filament enzyme-linked
      immunosorbent assay.
AB  - The axial filament (AF) from Leptospira interrogans serovar canicola was isolated
      by cesium chloride density gradient centrifugation of 2% sarcosyl treated whole
      cells. Isolation of AF was confirmed by electron microscopic examination, by
      protein-A immunogold labelling, sodium dodecyl sulphate polyacrylamide gel
      electrophoresis (SDS-PAGE), and immunoblotting. Analysis by SDS-PAGE of the
      purified preparation showed relatively weak bands of molecular size 41 kDa and 21
      kDa, and strong bands of 35 kDa and 34.5 kDa. Immunoblot analysis using antiserum
      to the AF against sonicated leptospires of a variety of serovars showed prominent
      reaction against the 41, 35, and 34.5 kDa protein bands, as well as against minor
      bands of molecular weight 43, 39, and 37 kDa. Antisera prepared against
      leptospiral serovars also identified minor bands at 33 and 32 kDa. Immunoblots
      with antiserum to whole cells of serovar bratislava detected the 35 and 34.5 kDa
      AF bands of Borrelia burgdorferi moderately and of Treponema hyodysenteriae only
      slightly in comparison to leptospiral AF. Antibody to B. burgdorferi did not
      detect the leptospiral AF antigen. Immunoblots with antiserum to T.
      hyodysenteriae showed a marked reaction with a 41 kDa band of B. burgdorferi but
      only a very minor reaction with leptospiral AF. The AF was tested in an AF-ELISA
      against sera from 260 pigs, many of which reacted in the microscopic
      agglutination test (MAT) against one or more leptospiral serovars. A sensitivity
      of 97.1% and a specificity of 93.1% was determined in comparison to the MAT. Only
      moderate correlation was observed between titres detected in the AF-ELISA and the
      MAT (r = 0.4). When sonicated whole cells (WC) of serovar canicola were used in
      an ELISA (WC-ELISA), high correlation was observed between AF-ELISA and WC-ELISA
      (r = 0.97). These findings show that the AF-ELISA can be used effectively as a
      species-specific antigen for the serological diagnosis of leptospirosis in swine
      and that sonicated whole cells can substitute excellently for purified AF as the
      antigen source. These findings may be extrapolated to the use of AF in
      immunodiagnosis of leptospirosis in other species.

PMID- 1615637
TI  - The effect of oxytetracycline treatment on immunity induced by Anaplasma
      centrale.
AB  - Calves vaccinated with Anaplasma centrale were treated with 20 mg/kg of long
      acting oxytetracycline (OTC/LA) before or simultaneously with vaccination or up
      to seven months later. Of 40 animals given one or two of OTC/LA from 3 to 13 days
      before vaccination, 23 become patent after vaccination, with an average prepatent
      period almost twice as long as that in non-treated vaccinated controls. Upon
      challenge with 2 x 10(8) A. centrale per dose all 17 previously non-patent calves
      showed average maximum parasitemias of 2 to 3.8%. Out of 30 calves treated with
      two to four doses of OTC/LA from one to four weeks after vaccination, 29 remained
      negative for A. centrale and reacted to challenge infection with average maximum
      parasitemias of 6.9-7.8%. Five out of 10 calves receiving OTC/LA simultaneously
      with the vaccination, and all of a separate group of 10 calves treated with a
      single dose seven days after vaccination, become patent an average of 51.6 and
      63.5 d, respectively, after vaccination. Upon challenge, the five previously non
      patent calves showed an average of 5.2% maximum parasitemia. In all groups, only
      rare parasites were seen in previously patent calves after challenge. Thirty
      calves treated with 2-4 doses of OTC/LA about six months after vaccination showed
      no or only a few parasites upon challenge. The above results show that treatment
      with single or multiple doses of OTC/LA a few weeks before or after
      administration of live A. centrale vaccine can interfere with elaboration of
      immunity.

PMID- 1615636
TI  - A field evaluation of serological and cellular diagnostic tests for bovine
      tuberculosis.
AB  - This paper describes the field evaluation of a serological test and a new in
      vitro assay for cell-mediated reactivity for the diagnosis of bovine
      tuberculosis. The use of a Mycobacterium bovis-specific antigen (MPB-70) in an
      ELISA to test the serological response to tuberculosis infection resulted in a
      specificity of 96.4% and a sensitivity of 18.1%. The most favourable results were
      obtained with the interferon gamma (IFN-gamma) assay which had a sensitivity of
      81.8% and a specificity of 99.1%. Respective figures for the single intradermal
      tuberculin test were 68.1% and 96.7%. The use of MPB-70 as the antigen in the IFN
      gamma assay reduced the sensitivity of this assay, without producing any useful
      increase in specificity. The IFN-gamma assay was also demonstrated to be a
      practical diagnostic test for use with large groups of cattle.

PMID- 1615639
TI  - OSHA rules on bloodborne pathogens.

PMID- 1615638
TI  - Development of double sandwich ELISA for Clostridium perfringens beta and epsilon
      toxins.
AB  - Specific, double-sandwich ELISAs for beta and epsilon toxins were developed by
      coating wells of microplates with specific sheep antitoxin IgG and using specific
      rabbit antitoxin IgG as detecting antibodies. The assay for beta toxin detected a
      minimum level of 8 ng/ml of purified toxin. The assay for epsilon toxin was
      capable of detecting 2 ng/ml of purified toxin. When applied to detect the toxin
      in intestinal contents using 50% fetal bovine serum as diluent the lowest amounts
      detected were about at least 30 ng/ml for beta toxin and 4 ng/ml for epsilon
      toxin. Clear differences in ELISA readings of both assays have been found between
      culture filtrates from toxin and non-toxin producing strains. These results
      suggested that both assays described in this study could detect their respective
      toxin in buffers, culture supernatants or in intestinal contents.

PMID- 1615640
TI  - The supply of mammography resources in West Virginia.
AB  - The distribution of mammography machines and related resources in West Virginia,
      along with the distribution of breast cancer screen-eligible women, are examined
      using county-specific data. This data placed on a state map shows that it is not
      necessary to cross more than one county line anywhere within West Virginia in
      order to visit a mammography facility. The overall density of these machines is
      20 per 100,000 women over 45, almost double the capacity needed for screening
      mammography. After taking into account the projected demand for mammography, the
      current average cost per exam is around $65-$100. If mammography machines were
      placed in all the counties without machines, the cost in those countries would be
      around $140 per exam. It would be cheaper to provide a travel allowance to women
      in rural counties than to install machines in these areas. Machines that are
      accredited by the American College of Radiologists, the most available indicator
      of quality mammography, are located only in densely populated areas of the state.

PMID- 1615641
TI  - Critical incident stress in prehospital emergency care.
AB  - In addition to the routine pressures associated with their demanding roles,
      prehospital emergency responders can suffer severe stress as a result of exposure
      to a critical incident. Such an event overwhelms the individual's ability to
      emotionally adjust, and can lead to symptoms which cause suffering in emergency
      personnel, their families and their patients. A Critical Incident Stress
      Management (CISM) Team has been established in southern West Virginia to address
      this occupational hazard. This group was formed as a cooperative arrangement
      between the Charleston Division of the West Virginia University Health Sciences
      Center and emergency personnel in the Greater Kanawaha Valley. This article
      offers an explanation of the team's functioning and specific information
      regarding its activation.

PMID- 1615643
TI  - The family.

PMID- 1615642
TI  - A patient with eosinophilia, hypoalbuminemia and abdominal pain.
AB  - Strongyloides stercoralis infections frequently present with eosinophilia and
      abdominal pain. Since the gastrointestinal symptoms are non-specific, only 15
      percent of these patients are correctly considered to have an infectious
      enteritis or intestinal parasite. In fact, the initial diagnosis is peptic ulcer
      disease in most patients. The clinical course may be indolent, or patients may
      develop a sudden catastrophic illness, particularly following the administration
      of corticosteroids.

PMID- 1615644
TI  - Autonomy versus do no harm.

PMID- 1615645
TI  - Anxiety among Cambodian refugee adolescents in transit and in resettlement.

PMID- 1615646
TI  - Self-efficacy and social support in self-management of epilepsy.

PMID- 1615647
TI  - Using NCAST instruments with urban American Indians.

PMID- 1615648
TI  - How married couples make decisions.

PMID- 1615649
TI  - Construing benefit from a negative experience of incest.

PMID- 1615650
TI  - Measuring circadian rhythms. Actigraph Versus Activation Checklist.

PMID- 1615651
TI  - Nurse moral reasoning using the Nursing Dilemma Test.

PMID- 1615652
TI  - Ethical considerations for quality assurance versus scientific research.
AB  - There is increasing evidence to support the contention that the boundaries
      between QA and scientific clinical research are blurred. This blurring is of
      particular concern in relation to the protection of human subjects rights (Brett
      & Grodin, 1991). The article thus concludes that it is essential that proposals
      for QA programs undergo periodic appraisal by an institutionally responsible,
      disinterested review panel. It further concludes that it is essential to submit
      proposals for all prospective QA projects, potentially scientifically meritorious
      QA projects, and all scientific clinical research projects to an institutional
      review board (IRB) to render decisions about the protection of human subject's
      rights before accessing data. Doing so protects the subject's rights, protects
      the investigator from unwittingly rendering harm rather than good, and enhances
      the ethical credibility of the projects. It also protects the investigator from
      embarrassing and potentially litigious situations. It is also incumbent on IRBs
      to develop efficient, effective, and expeditious review processes that encourage
      rather than discourage the a priori review process.

PMID- 1615653
TI  - Design and measurement challenges in family research.
AB  - Closing the chasm between family theory, nursing practice, and family research
      requires design and methods that foster the study of families as dynamic,
      holistic entities. This article has outlined several strategies for capturing
      morphostasis and morphogenesis and for studying the family as a unit of analysis.

PMID- 1615654
TI  - Clinical training in human immunodeficiency virus disease for community
      physicians. The Los Angeles experience.
AB  - In the past decade, the increased number of persons being treated for infection
      with the human immunodeficiency virus (HIV) has placed an enormous burden on
      specialty clinics. This is especially true in Los Angeles, where care of patients
      with the acquired immunodeficiency syndrome (AIDS) has been termed a "crisis"
      situation. Especially in its early stages, HIV disease can be appropriately
      managed by primary care physicians who provide patients with medical and
      psychological counseling and refer them to specialists when major AIDS-related
      complications develop. Physicians completing their training as recently as 5
      years ago, however, received little systematic preparation in the care of HIV
      infected patients and thus may lack important skills such as the ability to
      recognize opportunistic infections early in their course. By means of a 1-week
      intensive preceptorship in a high-volume AIDS clinic, we are preparing community
      physicians to assume a more active role in providing care for this growing
      patient population. In the preceptorship, participants receive one-on-one
      training from specialists in infectious diseases, pulmonary diseases, and
      hematology and oncology, as well as from internists and family physicians.
      Evaluation of the clinical experience demonstrated a greater level of confidence
      on the part of program participants in treating HIV-infected patients and showed
      that participants screen and test high-risk patients in their practices and
      devote a substantial proportion of their practices to caring for HIV-infected
      patients.

PMID- 1615655
TI  - Adolescent health care in a large multispecialty prepaid group practice. Who
      provides it and how well are they doing?
AB  - Adolescents are at risk for pregnancy, sexually transmitted diseases, suicide,
      homicide, accidents, and substance abuse. Adolescent medicine involves an overlap
      of many skills needed to provide routine medical care, as well as care for those
      conditions that require psychosocial assessment. We report the results of a mail
      survey covering care of this age group by practitioners of pediatrics, internal
      medicine, obstetrics and gynecology, family practice, and adolescent medicine in
      a large, multispecialty, prepaid group practice. The mail survey covered 10 areas
      of adolescent care. Adolescent medicine physicians expressed the highest level of
      perceived knowledge and competence in these areas, with family practitioners
      ranked second. More than 50% of internists and pediatricians felt only fair to
      poor competence for a variety of adolescent conditions, whereas a third of
      internists and pediatricians reported that they liked to care for adolescents.
      Physicians in all 4 of the primary care specialties reported a need for a teen
      health center for both consultation and education. These results are similar to
      those reported for pediatricians and primary care physicians in private practice
      and for residents in internal medicine.

PMID- 1615656
TI  - Drug dosing guidelines in patients with renal failure.
AB  - The metabolism and excretion of many drugs and their pharmacologically active
      metabolites depend on normal renal function. Accumulation and toxicity can
      develop rapidly if dosages are not adjusted in patients with impaired renal
      function. In addition, many drugs that are not dependent on the kidneys for
      elimination may exert untoward effects in the uremic milieu of advanced renal
      disease. A familiarity with basic pharmacologic principles and a systematic
      approach are necessary when adjusting drug dosages in patients with abnormal
      kidney function. The distinct steps involve calculating the patient's glomerular
      filtration rate, choosing and administering a loading dose, determining a
      maintenance dose, and a decision regarding monitoring of drug concentrations. If
      done properly, therapy in renal patients should achieve the desired pharmacologic
      effects while avoiding drug toxicity. Physicians must not oversimplify the
      pharmacologic complexities presented by patients with renal failure by relying
      excessively on nomograms and "cookbook" equations. In addition to a reduced
      glomerular filtration rate, patients with renal disease often have alterations in
      pharmacokinetics such as bioavailability, protein binding, hepatic
      biotransformation, and volume of distribution. An awareness of biologically
      active or toxic metabolites of parent compounds that accumulate when the
      glomerular filtration rate is reduced is also necessary to avoid toxicity. The
      effects of dialysis on drug elimination and the need for supplemental dosing are
      additional considerations in patients undergoing renal replacement therapy.

PMID- 1615657
TI  - Diabetes mellitus in pregnancy.
AB  - The Council on Scientific Affairs of the California Medical Association presents
      the following inventory of items of progress in obstetrics and gynecology. 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 obstetrics and gynecology 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 Obstetrics and Gynecology of the California
      Medical Association, and the summaries were prepared under its direction.

PMID- 1615658
TI  - RU 486 (mifepristone).

PMID- 1615659
TI  - Management of hirsutism.

PMID- 1615661
TI  - Substance abuse in pregnancy.

PMID- 1615662
TI  - Premenstrual syndrome.

PMID- 1615660
TI  - Who is a candidate for Norplant?

PMID- 1615663
TI  - Genetic predisposition to ovarian cancer.

PMID- 1615664
TI  - Ovarian cancer screening.

PMID- 1615665
TI  - Secondary syphilis presenting as nephrotic syndrome.

PMID- 1615666
TI  - Seat belt use during pregnancy.

PMID- 1615667
TI  - Reexpansion pulmonary edema in AIDS.

PMID- 1615668
TI  - Drug company marketing in the groves of academe.

PMID- 1615669
TI  - Noninvasive monitoring of oxygenation and ventilation. 40 years in development.

PMID- 1615670
TI  - Practical therapeutics in patients with renal impairment.

PMID- 1615671
TI  - Autoimmune disease and the nervous system.

PMID- 1615672
TI  - Tic or dystonia?

PMID- 1615673
TI  - Nintendo elbow.

PMID- 1615675
TI  - [The male climacteric from the practical viewpoint].
AB  - A transient physiologic period similar to that in women leads from full sexuality
      to senium in the life of men, too. This phase may involve the complex of male
      climacteric symptoms. The diminished testosterone secretion of the testes as
      endocrine "primum movens", together with an increased level of the carrier
      protein (SHBG), results in a reduced androgen supply of the organism, as
      reflected in a low free andorgenic index. The diagnosis of male climacteric is
      made on the basis of an enhanced serum LH level. With regard to the differential
      diagnosis, atherosclerosis, diabetes mellitus, chronic alcoholic liver damage,
      malignant tumors and prostatic complaints are particularly to be considered. The
      hormonal treatment consists of low-dose testosterone medication; for the
      prevention of osteoporosis, however, testosterone preparations may be replaced by
      anabolic steroids. As for women, the concomitant vegetative phenomena of the
      climacteric syndrome should be alleviated symptomatically.

PMID- 1615674
TI  - Primary care professionals' attitudes regarding compulsory HIV testing.

PMID- 1615676
TI  - [Psychological disorders of menopause: on the topic of multifactorial origin].
AB  - Interdisciplinary scientific research is an unjustly neglected discipline in the
      investigation of etiology and therapeutic potential regarding the symptoms of pre
      , peri- and postmenopause. Thus the aim of this paper is: 1) the description of
      psychological disturbances occurring before, during and after menopause, 2) a
      representation of the etiological interaction between endocrinological,
      vegetative, psychodynamic and psychosocial factors of influence, and 3) to
      summarize the possible psychiatric and psychotherapeutic measures which can be
      taken.

PMID- 1615678
TI  - [Contraception in climacteric].
AB  - The problems of an adequate contraception around the age of 40 are not yet solved
      in our time. On one hand the women are afraid of unexpected pregnancies during
      this life period, at the other hand the hormonal contraceptives are not anymore
      optimal at this time. The various contraceptive methods with its positive and
      negative effects during this period are discussed in this paper.

PMID- 1615677
TI  - [The atheroprotective importance of estrogen substitution from the social
      medicine viewpoint].
AB  - Due to the increasing life expectancy most women nowadays suffer from menopausal
      problems. These include not only menopausal symptoms, but also osteoporosis and
      atherosclerosis. Hormone replacement therapy therefore is a measure for keeping
      physiological standards. It has both preventive and therapeutic importance, for
      the individual as well as for the public. In the following we give an overview to
      these aspects, focusing on prevention of atherosclerosis.

PMID- 1615679
TI  - [Gyneco-urologic problems in climacteric].
AB  - In climacteric women stress and urge incontinence often occur as a consequence of
      estrogen deficiency. Urinary incontinence is defined as involuntary discharge of
      urine associated with psychologic and hygienic problems. Of 3,248 women
      investigated between 1986 and 1990 at our Clinic for Climacteric Dysfunctions,
      Vienna, 1,039 women (32%) reported symptoms such as vaginal dryness, incontinence
      and problems with regard to cohabitation. Indications for estrogen replacement
      therapy in and/or after the climacteric period are urinary stress incontinence
      degree I, urge incontinence (pollakisuria, nycturia), atrophic urethritis as well
      as preoperative estrogen replacement. For therapeutic management both conjugated
      estrogens and estradiol as well as estriol preparations may be employed, taking
      the contraindications into account. Postmenopausal estrogen replacement is highly
      indicated with dysfunctions in the area of urethra and urinary bladder.

PMID- 1615680
TI  - [A main symptom of the climacteric manifestation complex: arthropathia
      climacteria].
AB  - In the last few years several studies have been published raising the question
      whether hormonal factors are co-responsible for the female prevalence of certain
      joint diseases. From our own clinical experience we know that more than half of
      the women seen at our outpatients department because of disorders of the post
      menopausal syndrome complain about arthralgies (especially of the PIP-joints). We
      have introduced the term "arthropathia climacterica" for it. Moreover the
      positive results of two clinical studies on which effects hormone replacement
      therapy had on these complaints indicate a relation between estrogens and joints.

PMID- 1615681
TI  - [Differentiated therapy of the climacteric syndrome].
AB  - The replacement therapy is postmenopausal women is seen to be for transformation
      of the oestrogen-stimulated endometrium only, which does not apply to
      hysterectomised women. Because of the influence of estrane on lipids, one often
      advises against a replacement therapy with progestogens in hysterectomised women.
      With increasing knowledge of encountered extragenital functions of sexual
      steroids, the latter is questionable, if natural progesterone is given, which is
      (said to be) lipid-neutral, performing the function of the progestogens, which is
      quite more than reproduction only, more efficiently than estrane or gonane. Due
      to the competitive blocking of aldosterone the effect of progesterone is sodium
      diuretic and diuretic, being as important as the therapy of climacteric
      complaints, as well as the consequence, which is the result of the physiological
      connection between progesterone and encephalics. Moreover, the effect of the
      progestogens is to tonicise the vascular system and is linked to a number of
      intestinal hormones in order to adjust their function. Therefore, progesterone
      seems to perform a great variety of extragenital functions. Menopausal women
      should not be deprived of the benefits of these functions within the framework of
      a replacement therapy.

PMID- 1615682
TI  - [The osteoprotective effect of ovarian hormones].
AB  - Osteoporosis is regarded as a disease of the systems controlling bone evolution.
      Estrogen modulates such a control system; without estrogen 50% of bone is not
      formed to the peak bone mass or may be lost lateron. Substitution with estrogen
      can be interpreted as a natural right of the women in our society. Estrogen
      modulates by dynamic hormonal system the genexpression in bone and determines its
      three-dimensional architecture. Substitution with estrogen has to consider the
      individual genetic situation of each women and its biographic and health
      situation. Individual estrogen substitution is not fully realized yet but
      estrogen substitution prevents osteoporosis effectively. We question if senile
      osteoporosis exists at all if there were no estrogen deficiency.

PMID- 1615683
TI  - [Bone density screening in females in climacteric].
AB  - Bonestability is not only determined by the content but also by the construction
      of the mineral part and the biochemical structure. In addition the organic parts
      are important, too. Result of the measurements shows only the bone-quantity. The
      development of several measurement techniques (highquality quantitative
      computertomography [QCT]) allow us diagnoses concerning the bone quality. Single
      photon absorptionsdensitometry (SPA), DPA (dual photon absorptiometry), DEXA
      (dual energy X-ray absorptiometry) and QCT (quantitative computertomography,
      peripher and central) are todays measurement techniques. In the meantime SPA
      looses the importance, also DPA-method is displaced by DEXA.

PMID- 1615684
TI  - [Hormone substitution in climacteric and postmenopause. Consensus report of the
      Austrian Menopause Society].

PMID- 1615685
TI  - [Menopausal bone density in healthy females of Voralberg. Lack of relation to
      anamnesis].
AB  - Bone density was evaluated in 182 healthy climacteric women. Women were recruted
      from a general prevention program. The results show deviation from 58.2 to 218.6-
      mean value 128.28, SD 30.91 mg/ccm K2HPO4. 28% of bone density values are under
      the fracture risk level citated in literature. No statistical relationship was
      found between bone density and anamnestic data--only the age at hysterectomy
      shows statistical correlation. The follow up after one year shows no predictive
      value of anamnestic data to the lost of bone mineral density.

PMID- 1615686
TI  - Introduction: research directed to improving women's occupational health.
AB  - This paper reviews briefly recent developments in research on women's
      occupational health and safety in five areas: documenting the unexpectedly heavy
      physical and mental workload involved in occupations traditionally assigned to
      women; showing the consequences for women's health of their precarious
      relationship to the work force; demonstrating the health effects of the double
      workday; studying the effects of work on those aspects of biology that are sex
      specific; suggesting ways to remove ergonomic barriers to women entering non
      traditional jobs which have been designed in relation to the typical male body.
      Suggestions are made for future research in these areas, in response to the needs
      of working women. This paper serves as an introduction to the volume of Women and
      Health dealing with women's occupational health and safety.

PMID- 1615687
TI  - Impact of the participation of women in science: on rethinking the place of women
      especially in occupational health.
AB  - Recently, women have become scientists in increasing numbers. The present article
      uses a perspective drawn from the sociology of knowledge to examine the impact of
      this participation on science, especially the study of occupational health and
      safety. Five evolutionary stages are described: (1) Inclusion of women as
      scientific workers; (2) Inclusion of women as subjects of scientific research;
      (3) Inclusion of variables relevant to women, rather than merely applying to
      women the factors used to explain men's situations; (4) Using new methodologies
      to reveal the complexity and the specificity of women's life situations, in
      addition to those tools developed while studying male populations; (5)
      Questioning the values on which traditional science has been based, and orienting
      research according to feminist values. Examples from the study of women's
      occupational health illustrate these five stages. It is suggested that scientific
      research oriented toward the well-being of women workers will not only yield a
      better understanding of women's conditions but also lead to a rethinking of
      standard practices for research on men's conditions.

PMID- 1615688
TI  - Heat exposure standards and women's work: equitable or debatable?
AB  - Although there is an abundant literature on the health effects of occupational
      heat exposure, very few authors have addressed the question of the effects of
      heat stress on women workers. Knowledge about the effects of work in hot
      environments is mainly derived from the study of "heavy" muscular activity and
      current heat exposure standards are based on an energy criterion according to
      metabolic load. Metabolic load does not reflect cardiac strain associated with
      sedentary, repetitive work, involving static effort. The research presented here
      was conducted in an industrial laundry with 11 women mangle operators exposed to
      moderate heat stress during the summer months and whose work activity is
      classified as light on the basis of energy expenditure. Physiological and
      symptomatological responses, work activity and ambient temperature were assessed
      over 3 complete work days in summer and in winter. Recorded and perceived
      temperature, discomfort, feelings of fatigue and symptoms of thermal stress were
      significantly higher in summer than in winter. Symptoms of drowsiness and musculo
      skeletal aches were reported equally in both seasons. Heart rate was high in both
      seasons, as were calculated indices of cardiac strain. Recommended limits for
      cardiac strain were surpassed significantly more often in summer than in winter.
      It is suggested that threshold levels should be redefined to include the
      prevention of cardiac strain resulting from cumulative effects of heat stress and
      sedentary, repetitive activity, typical of many women's job with low energy
      requirement.

PMID- 1615690
TI  - Health problems of women employed in jobs involving psychological and ergonomic
      stressors: the case of garment workers in Quebec.
AB  - Health problems of women whose jobs involved intense time pressure were evaluated
      in a study of 800 sewing-machine operators employed in Quebec between 1976 and
      1985. Information on workers' occupational characteristics were obtained from
      public records. Symptoms of anxiety and depression, use of medication and
      disability status were determined by interview. Garment workers had an increased
      prevalence of slight, moderate and severe disability and higher levels of
      symptoms of anxiety and depression when compared to workers in other occupations.
      Garment workers paid piecework rates took medication for stomach problems in
      greater proportion than workers paid an hourly wage. Furthermore, workers who
      spend 5-9, 10-14, 15-19 and 20 or more years in piecework had an increased
      prevalence of severe disability compared to the baseline category 0-4 years, with
      adjusted risk ratios of 2.2 (95% CI = 1.14-4.6), 3.3 (95% CI = 1.5-6.9), 3.6 (95%
      CI = 1.5-8.4 and 2.3 (95% CI = 0.8-6.6) respectively, independent of age, smoking
      habits, education, type of task and total length of employment. These findings
      suggest that short-term, non-disabling conditions associated with time pressure
      by previous authors may have more important long-term sequelae then had been
      previously documented.

PMID- 1615689
TI  - Stability of psychological impairment: two year follow-up of former
      microelectronics workers' affective and personality disturbance.
AB  - For the past twenty years women's complaints in the microelectronics industry
      have often been diagnosed as mass psychogenic illness, despite evidence of
      potential exposure to organic solvents, which have been associated with affect
      and mood changes. In the present study, the standard version of the Minnesota
      Multiphasic Personality Inventory (MMPI) was used to evaluate affective and
      personality disturbance among 63 former microelectronics workers (56 women and 7
      men) over a two-year period of time. In both 1986 and 1988, the former workers
      obtained mean scale score elevations beyond two standard deviations above the
      normative sample (T = greater than 70) on the MMPI clinical scales of
      schizophrenia, hypochondriasis, psychasthenia, depression and hysteria. For most
      scales, 86-88 mean score differences did not attain the 0.05 significance level
      (two-tailed paired t-test) and no significant differences were observed for 86-88
      comparison scale scores = greater than 70 (McNemar paired statistic). Although
      there were too few men to perform gender comparisons, men scored higher than
      women on 5 scales and all of the men had scores = greater than 70 on
      hypochondriasis, depression, hysteria, psychasthenia and schizophrenia. These
      findings reveal that these former microelectronics workers manifested affective
      and personality disturbances, consistent with organic solvent toxicity, which
      persisted over a two year period, indicating that they were not reactive,
      transient hysterical neurosis.

PMID- 1615691
TI  - Ergonomic analysis of work activity of data entry clerks in the computerized
      service sector can reveal unrecognized skills.
AB  - Women are highly represented in those computer service jobs which are supposed to
      require the lowest level of qualification. The complexity of the activities which
      contribute to accomplishing such tasks in real life is usually unrecognized, as
      are the skills needed to perform these activities. The requirements of one such
      job, held by 7 women in a university administration, have been documented by
      ergonomic analysis. According to the supervisors, little mental effort was
      required, and "the employees do the job without even thinking about it." However,
      study of the real tasks involved revealed that the job required a great deal of
      innovative thinking, all of it unrecognized by the employer, and some of it
      actually forbidden. However, because the knowledge was not arrived at through
      systematic training, it is fragmentary and does not permit the employee to be
      fully autonomous or to transfer her skills to other jobs.

PMID- 1615692
TI  - How pregnant workers see their work, its risks and the right to precautionary
      leave in Quebec.
AB  - In 1981, the Quebec government passed a law providing "precautionary leave" or
      reassignment to other jobs for pregnant workers exposed to a risk for their
      health or that of their fetus. This measure was much more popular than expected,
      with about 30% of pregnant workers taking leave in 1987. Uncertainty about what
      constitutes a risk for pregnancy, conflicts between views of pregnancy as a
      social or private act, and differing ideas on employers' responsibility for
      protection of pregnant workers have combined with worries about cost to stimulate
      debate on this law. Since 1986, there has been pressure on the government to
      restrict access to precautionary leave. This article describes research designed
      to answer some of the questions raised during the debate. Data banks of the
      Health and Safety Commission and responses of 2500 women workers were examined to
      characterize the jobs of women who did and those who did not take leave. Leave
      was usually taken by those who worked in sectors traditionally associated with
      risks, and women who applied for precautionary leave more often reported their
      working conditions to be difficult. Women taking leave accorded more importance
      to their maternal and domestic roles, but equal value to their roles in the
      workplace. The article concludes that the popularity of the measure is not due to
      laziness or lack of responsibility on the part of women workers, but to poor
      conditions in women's traditional jobs. It is suggested that more emphasis be
      placed on improving conditions rather than on early leave from work.

PMID- 1615693
TI  - Integration of women into traditionally masculine jobs.
AB  - Jobs are often allocated according to sex, although this distribution is not
      always justified by biological differences between men and women. Ergonomic
      analysis of sex-typed jobs in a clothing factory and in a plastics factory
      revealed that the total weight lifted in women's jobs exceeded that in a typical
      male laborer's job. The characteristics of work organization and work rhythm also
      differed according to the sex to whom jobs were assigned: Muscular exertion was
      intense but sporadic with the men's jobs, moderate but continuous with the
      women's. Scientific study has not related characteristics of sex-typed jobs to
      differences between the sexes in average size and shape. However, analysis of two
      cases showed that average-sized women entering traditional men's jobs may be
      disadvantaged, if no thought is given to adjusting tools, equipment and work
      stations. Trying to do a job designed for larger, heavier people may cause health
      and safety problems. Any improvement in the conditions of these jobs to take into
      account a wider range of physical characteristics will benefit men as well as
      women.

PMID- 1615694
TI  - The status of the health care financing crisis in Wisconsin 'medicina nusquam non
      est' (medicine is universal): X.

PMID- 1615695
TI  - WIPRO and the justification of existence.

PMID- 1615696
TI  - A moral response to the problems of the medical care system.

PMID- 1615697
TI  - Patient satisfaction with breast reconstruction.
AB  - Thirty-two women were surveyed to assess their satisfaction with breast
      reconstruction after mastectomy for cancer. Most reconstructions consisted of a
      submuscular implant, and were performed after an average interval of 11.3 months.
      The procedures averaged 2.4 per individual, and nearly half of the women reported
      requiring an operation on the opposite breast to attain symmetry. Despite the
      fact that 60% of the reconstructions resulted in a complication or complaint,
      women reported that they felt more balanced and whole and less depressed, and all
      were glad that they had breast reconstruction.

PMID- 1615698
TI  - Acute confusional migraine: case series and review of literature.
AB  - Acute confusional state (ACS) as a manifestation of migraine in the pediatric age
      group was initially described by Gascon and Barlow. The characteristics and
      natural history of acute confusional migraine (ACM) have been elaborated on by
      other authors. The diagnosis of ACM is, however, easily overlooked in clinical
      practice, due to its peculiar presentation. We describe three children who had
      acute onset of confusion. The differential diagnosis of acute confusional state
      and the clinical features and management of ACM are discussed.

PMID- 1615699
TI  - A rationale for universal screening for childhood lead poisoning.

PMID- 1615700
TI  - Reductive metabolism of the anticonvulsant agent zonisamide, a 1,2-benzisoxazole
      derivative.
AB  - 1. The metabolism of zonisamide in vitro was characterized through aerobic and
      anaerobic incubations with rat liver subcellular fractions and cultured
      gastrointestinal microflora. 2. Zonisamide reacted with rat hepatic microsomal
      cytochrome P-450 and exhibited a Type I binding spectrum. 3. Metabolism of
      zonisamide in vitro by hepatic subcellular fractions and cultured
      gastrointestinal flora produced a single metabolite, 2-(sulphamoylacetyl)-phenol
      (2-SMAP), by reductive cleavage of the 1,2-benzisoxazole ring. 4. The reductive
      metabolism of zonisamide was primarily mediated by microsomal cytochrome P-450.
      The soluble fraction enhanced reduction when combined with the microsomal
      fraction but itself possessed only weak reductive activity. 5. Reduction of
      zonisamide by the most enzymically active liver fractions required NADPH, was
      stimulated by FMN and SKF-525A, and was inhibited by CO or air, as well as by n
      octylamine. 6. Unlike their involvement in the reduction of numerous nitro, azo,
      and N-oxide compounds, cultured aerobic and anaerobic intestinal flora were not
      principally involved in the reduction of zonisamide.

PMID- 1615701
TI  - Propofol metabolism in man during the anhepatic and reperfusion phases of liver
      transplantation.
AB  - 1. An i.v. dose of 14C-propofol (0.53 mg/kg) was administered to three male and
      three female patients during the anhepatic phase of liver transplantation, which
      lasted 30-56 min after dosing. Arterial and venous blood samples, bile (T-tube
      drainage) and urine were collected at various times afterwards and submitted to
      h.p.l.c. and radioassay or specific fluorescence detection for the unchanged
      drug. 2. Extrahepatic metabolism was apparent during the anhepatic phase, since
      at 30 min post-dose, unchanged propofol comprised only 42-89% of the blood
      radioactivity. 3. Examination of the plasma radioactivity during the anhepatic
      phase in two subjects showed evidence of propofol glucuronide and 4-quinol
      sulphate, confirming extrahepatic metabolism of the drug. Quinol glucuronides
      were only detected in the liver reperfusion phase. 4. There was no evidence that
      the lungs contribute to the extrahepatic metabolism of propofol, since drug
      concentrations in the arterial blood were not less than in central venous
      samples. 5. During the first 24 h period, urine collected from five patients
      contained 7-74% dose, whilst the bile contained 0.1-0.9%. In three patients with
      normal renal function recovery in urine was 66-74% dose. Examination of urinary
      radioactivity in one subject showed the main component to be propofol glucuronide
      during the anhepatic phase.

PMID- 1615702
TI  - Effects of methimazole on the kinetics of netobimin metabolites in cattle.
AB  - 1. The effects of methimazole (MTZ) on the pharmacokinetic behaviour of netobimin
      (NTB) and its albendazole (ABZ) metabolites were studied in calves. NTB trisamine
      salt solution was given by subcutaneous (12.5 mg/kg) and oral (20 mg/kg) routes,
      either alone or co-administered with MTZ (1.5 mg/kg, intramuscularly). 2. NTB
      parent drug was detected only after s.c. treatments, showing rapid absorption,
      early Cmax and fast disposition. ABZ was not found in plasma at any time after
      either s.c. or oral treatments. 3. Concomitant treatment with MTZ significantly
      increased the albendazole sulphoxide (ABZSO) elimination half-life (t1/2 beta)
      (321%) and mean residence time (MRT) (170%) from the values obtained after s.c.
      treatment with NTB alone. 4. Oral treatment resulted in an ABZSO pharmacokinetic
      profile with an AUC 27% higher, a significantly longer t1/2 beta (151%) and MRT
      (124%) in the presence of MTZ. 5. We conclude that when co-administered with NTB
      in cattle, MTZ induces significant changes in the disposition kinetics of the
      anthelmintically active ABZSO metabolite.

PMID- 1615703
TI  - Biotransformation of the hexachlorobutadiene metabolites 1-(glutathion-S-yl)
      pentachlorobutadiene and 1-(cystein-S-yl)-pentachlorobutadiene in the isolated
      perfused rat liver.
AB  - 1. The first step in the bioactivation of the nephrotoxin hexachlorobutadiene is
      the biosynthesis of 1-(glutathion-S-yl)-1,2,3,4,4-pentachloro-1,3-butadiene
      (GPCB). GPCB formed in the liver is secreted into bile, may be reabsorbed in the
      gut, intact or after hydrolysis to 1-(cystein-S-yl)-1,2,3,4,4-pentachloro-1,3
      butadiene (CPCB), and undergo enterohepatic circulation or translocation to the
      kidney. Hepatic uptake and metabolism of GPCB and CPCB may thus influence the
      disposition of these S-conjugates. We therefore studied the metabolism and uptake
      of CPCB and GPCB in the isolated perfused rat liver. 2. Dose-dependent uptake of
      GPCB and CPCB from the perfusion medium by isolated perfused liver was
      demonstrated; CPCB is cleared from the perfusion medium to a much higher extent
      than GPCB. 3. GPCB and CPCB are intensively biotransformed to biliary
      metabolites. These metabolites were identified by thermospray mass spectrometry
      as products of the conjugation reaction of GPCB and CPCB with glutathione and
      subsequent hydrolysis of the glutathione moieties. 4. Hepatic biosynthesis of 1
      (N-acetyl-L-cystein-S-yl)-1,2,3,4,4-pentachloro- 1,3-butadiene from CPCB was only
      a very minor pathway in GPCB and CPCB metabolism in liver. 5. The results
      indicate that hepatic biosynthesis of mercapturic acids may not contribute to the
      disposition of S-conjugates formed from hexachlorobutadiene in vivo and that GPCB
      may be, at least in part, delivered intact to the kidney.

PMID- 1615704
TI  - Inhibition of human and rabbit liver steroid and xenobiotic UDP
      glucuronosyltransferases by tertiary amine drugs--implications for adverse drug
      reactions.
AB  - 1. To investigate the hypothesis that disruption of glucuronidation of endogenous
      compounds by drugs represents a potential mechanism for pathogenesis of adverse
      drug reactions, the effects of a range of tertiary amine and amide drugs (many
      with effects on sex hormone function) on steroid hormone and xenobiotic UDP
      glucuronosyltransferase activities in human and rabbit liver microsomes were
      studied in vitro. 2. Chlorpromazine, amitriptyline, imipramine, promethazine and
      cyproheptadine were consistently the most potent inhibitors of the
      glucuronidation of testosterone, androsterone, oestriol and 1-naphthol, the
      steroid activities being more susceptible to inhibition (up to 90%). 3.
      Carbamazepine, diphenhydramine, sulphadimethoxine, dimenhydrinate and (+/-)
      chlorpheniramine had little effect on the UDPGT activities measured. 4. The
      structural features within this group of compounds required for inhibitory
      potency were the presence of a rigid tricyclic ring (e.g. phenothiazine) and
      either a dimethylaminopropyl or a methylpiperidine side-chain. 5. The
      implications of these data for involvement of disruption of the normal cellular
      function of glucuronidation in the pathogenesis of frequently observed adverse
      side-effects associated with these compounds are discussed.

PMID- 1615705
TI  - The effects of cobalt chloride, SKF-525A, and N-(3,5-dichlorophenyl)succinimide
      on in vivo hepatic mixed function oxidase activity as determined by single-sample
      plasma clearances.
AB  - 1. Four drugs--antipyrine, theophylline, quinidine, and ethosuximide--were used
      as probes of in vivo hepatic mixed function oxidase (MFO) activity. Functional
      MFO activity was evaluated by estimating probe clearances subsequent to
      pretreatment of rats with either cobalt chloride, SKF-525A, or N-(3,5
      dichlorophenyl) succiminide (NDPS). 2. Clearances of each probe were estimated
      from single plasma concentration measurements. Each pretreatment altered the
      clearances of this panel of probes in a different way. NDPS pretreatment
      increased theophylline clearance while slowing quinidine and ethosuximide
      clearances. SKF-525A slowed all probe clearances except for ethosuximide. Cobalt
      chloride slowed all probe clearances except for theophylline. 3. The use of
      multiple probes as substrates for the hepatic cytochrome P-450 system can provide
      some insight into the functional consequences of xenobiotic exposures on that
      system. Moreover, xenobiotic-induced functional changes on hepatic MFO when
      assessed in vivo appear to be modest relative to changes in in vitro activity or
      hepatic cytochrome P-450 content. This minimally invasive multiprobe method may
      be useful for assessing xenobiotic influences on human hepatic MFO in vivo.

PMID- 1615706
TI  - Metabolism of (-)-6(S)-hydroxy-4(R)-(1-hydroxy-1-methylethyl)-1- cyclohexene-1
      ethanol in rat and dog.
AB  - 1. The metabolism of a new mucoactive drug, chemically (-)-6(S)-hydroxy-4(R)- (1
      hydroxy-1-methylethyl)-1-cyclohexene-1-ethanol (CO/1408), has been studied in rat
      and dog after a single oral dose; eight metabolites were identified. 2. Oxidation
      of the primary and secondary alcohol groups, hydroxylation in allylic positions
      and conjugation with glucuronic acid occurred in both species. Products of
      oxidation on the double bond have not been identified. 3. Using reversed-phase
      h.p.l.c. and beta-cyclodextrin in the eluent it was found that the glucuronide
      metabolites varied with species and with the biological fluid examined.

PMID- 1615707
TI  - Effects of hypophysectomy and testosterone treatment on the urinary excretion of
      zenarestat in rats.
AB  - 1. The effects of hypophysectomy and androgen treatment on the urinary excretion
      of zenarestat were investigated in Sprague-Dawley rats. 2. Hypophysectomized male
      rats and normal female rats has similar urinary excretion of zenarestat which was
      much greater than that of normal male rats. 3. Treatment of male and female
      hypophysectomized rats with testosterone resulted in the urinary excretion of
      zenarestat characteristic of intact adult male rats. 4. Urinary secretion of
      zenarestat in rats is independent of pituitary hormone and is suppressed only by
      androgen.

PMID- 1615708
TI  - Absorption, distribution and excretion of zenarestat, a new aldose reductase
      inhibitor, in rats and dogs.
AB  - 1. The absorption, distribution and excretion of zenarestat have been studied in
      male rats and dogs after i.v. and oral administration of 14C-zenarestat. 2. The
      bioavailability of zenarestat was 93% in rats and 65% in dogs. A major proportion
      of the plasma 14C in rats and dogs was due to unchanged drug. The terminal
      elimination half-life of zenarestat in plasma was 6 h in rats and dogs. 3. Except
      for organs associated with absorption and elimination, tissue 14C levels were
      lower than plasma levels in rats. The distribution to, and elimination from
      sciatic nerve were slower than those of other tissues. 4. Most of the 14C from
      14C-zenarestat administered orally and i.v. to rats and dogs was excreted in the
      faeces. After i.v. dosing to bile duct-cannulated rats, 96% of the radioactive
      dose was excreted in the bile.

PMID- 1615709
TI  - Biological fate of sulphur mustard (1,1'-thio-bis(2-chloroethane)): urinary and
      faecal excretion of 35S by rat after injection or cutaneous application of 35S
      labelled sulphur mustard.
AB  - 1. A technique for the quantitative cutaneous application of sulphur mustard
      vapour is described. The maximum rate of uptake of the agent vapour by shaved rat
      skin in vivo was estimated as 7 micrograms/cm2 per min. 2. The major route of
      excretion was through the kidneys: greater than 70% of the radioactivity of all
      doses was excreted in 3 days after either i.v. or i.p. injections of 35S-labelled
      sulphur mustard, but less (50-70% depending on dose) was excreted in the same
      time following cutaneous application. 3. This urinary excretion of 35S had a half
      life of 1.4 days, and the decreased proportion of the applied dose excreted
      following cutaneous application may be accounted for by retention of
      radioactivity in the skin. 4. The contribution of faecal excretion was greater
      following cutaneous application.

PMID- 1615710
TI  - Metabolism of phenol in the terrestrial snail Cepaea nemoralis L.
AB  - 1. The metabolism of phenol in the terrestrial snail Cepaea nemoralis was studied
      after injection into the haemocoel of the dorsolateral foot region. 2. Excreted
      metabolites, and metabolites extracted from the body, were analysed by h.p.l.c.
      In addition to phenyl beta-D-glucoside, arbutine (quinol beta-D-glucoside), a new
      conjugate of phenol, was detected.

PMID- 1615711
TI  - Cytochromes P-450 in rats: structures, functions, properties and relevant human
      forms.

PMID- 1615712
TI  - [Sonography in gallbladder diseases].

PMID- 1615713
TI  - [Ultrasound diagnosis of the gastrointestinal tract without (native) and with
      water filling (hydrosonography)].

PMID- 1615714
TI  - [Endoscopic retrograde cholangiopancreatography (ERCP). An assessment of its
      status].

PMID- 1615715
TI  - [Extracorporeal shockwave lithotripsy (ESWL) of gallbladder calculi in
      combination with oral litholysis. Results of the first 180 patients of the
      Charite Internal Medicine University Clinic].

PMID- 1615716
TI  - [Bacterial colonization of gallstones].

PMID- 1615717
TI  - [Hepatic encephalopathy: long-term therapy with neomycin is problematic].

PMID- 1615718
TI  - [Adrenergic beta blockade in liver cirrhosis with portal hypertension? Doppler
      ultrasound measurement of the short-term effect of propranolol on the portal
      system].

PMID- 1615719
TI  - [Follow-up of chronic hepatitis B in patients with kidney transplantation:
      comparison between kidney transplant patients and hemodialysis patients].

PMID- 1615720
TI  - [Selected aspects of therapy of systemic lupus erythematosus].

PMID- 1615721
TI  - [Antihypertensive combination therapy with ACE inhibitors].

PMID- 1615722
TI  - [Diagnostic bronchoalveolar lavage].

PMID- 1615723
TI  - [Screening for bronchial cancer. A case-control study].

PMID- 1615725
TI  - [Secondary malignant neoplasms following postoperative radiotherapy of breast
      cancer].

PMID- 1615724
TI  - [Prognostic factors in lymph node negative breast cancer patients].

PMID- 1615726
TI  - [Surgery of intestinal arteries. 1: Acute intestinal ischemia syndrome].

PMID- 1615727
TI  - [Sudden cardiac death: can individual risk be predicted?].
AB  - Only 30-40% of all victims of sudden cardiac death could so far be classified as
      risk patients during their lifetime. Risk factors for sudden death have little
      predictive value in an asymptomatic population: for example, the typical risk
      profile for the presence of coronary heart disease and changes in the surface-ECG
      at rest and especially in the surface-ECG under stress. Usually, the victims of
      sudden cardiac death among top performance athletes have been suffering from a
      heart disease of which they knew nothing beforehand: below 40 years of age,
      mostly from hypertrophic cardiomyopathy; beyond 40, predominantly from coronary
      heart disease. Among the heart diseases, sudden cardiac death is the cause of
      death most often in hypertrophic cardiomyopathy, in dilatative cardiomyopathy and
      in certain types of coronary heart disease. Notwithstanding the employment of
      fully update cardiological diagnostics the risk patients cannot be identified
      with reliable precision among those suffering from these diseases. It is only
      clinically manifest persistent ventricular tachycardia or successful reanimation
      in case of ventricular fibrillation that will definitely pinpoint the patient as
      being at risk of sudden cardiac death also in the future.

PMID- 1615728
TI  - [Anti-arrhythmic drug prevention of sudden cardiac death--the status after the
      CAST study].
AB  - Sudden cardiac death is caused by ventricular tachyarrhythmias. Therefore,
      antiarrhythmic drugs have been widely used in the prophylaxis of this lethal
      event. However, all studies using "classical" antiarrhythmic drugs (class 1) for
      this purpose have shown an enhanced mortality in the patients treated. One of the
      major causes for these disappointing results are probably proarrhythmic effects,
      which are especially observed in patients with reduced left ventricular function.
      Obviously a normal Holter ECG during the titration phase cannot exclude
      proarrhythmic events during long-term follow-up. In addition, the suppression of
      ventricular premature beats by an antiarrhythmic agent seems not to be an useful
      criterium as far as the prophylaxis of sudden death is concerned. The crucial
      prerequisit for the induction of the lethal arrhythmia is the "arrhythmogenic
      substrate" which clinically can only incompletely analysed by recording of late
      potentials or programmed ventricular stimulation. From the therapeutical point of
      view we need drugs which can modulate this arrhythmogenic substrate i.e.
      antifibrillatory acting drugs and not antiarrhythmic drugs in the classical
      sense. Beta blockers and class 3 drugs are the first step in this direction.

PMID- 1615729
TI  - [Which patient with sustained ventricular tachycardia is suited for long-term
      therapy with anti-arrhythmia drugs?].
AB  - Therapy of patients with a history of sustained ventricular tachycardia
      essentially depends on the type and extent of underlying cardiac disease. This
      survey presents older and newer results regarding the outcome of this arrhythmia
      in relation to QRS morphology and underlying disease: monomorphic ventricular
      tachycardia without underlying cardiac disease; monomorphic ventricular
      tachycardia on the basis of right ventricular dysplasia; monomorphic ventricular
      tachycardia in coronary artery disease or dilated cardiomyopathy; polymorphic
      ventricular tachycardia with/without QT prolongation. Apart from complete
      hemodynamic evaluation of all cases with documented sustained ventricular
      tachycardia, programmed ventricular stimulation should be performed. Because of
      the excellent long-term outcome and the regularly benign clinical symptomatology,
      antiarrhythmic drugs are and will remain the therapy of first choice in patients
      without underlying cardiac disease. In exercise-induced arrhythmias, beta
      blocking agents are to be used in the first place. As an exception to the general
      rule, special forms of ventricular tachycardia without underlying cardiac disease
      respond to verapamil. The clinical symptomatology during ventricular tachycardia
      on the basis of coronary artery disease or dilated cardiomyopathy is typically
      severe with a guarded outcome. Long-term therapy with antiarrhythmic drugs should
      be performed only when the efficacy was proved by serial electrophysiologic drug
      testing (suppression of inducibility of the arrhythmia). Regarding drug testing,
      the class III antiarrhythmic drugs sotalol and amiodarone seem to be more
      effective than the class I antiarrhythmic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615730
TI  - [Catheter ablation of ventricular tachycardia].
AB  - Catheter ablation of ventricular tachycardias was performed in a total of 80
      patients whose tachycardias were considered as drug refractory and who were not
      considered to be candidates for antitachycardic surgery or implantation of an
      automatic cardioverter defibrillator. After careful endocardial catheter mapping
      including pacing interventions, either direct-current (DC) (n = 61) or
      radiofrequency current (RF) (n = 13) or both (n = 6) were applied of the "site of
      origin" of ventricular tachycardia or the "zone of slow conduction". 42 of 51
      patients with coronary heart disease were discharged; ventricular tachycardia
      recurred in 8 cases, and 2 patients died suddenly. In the remaining 32 patients,
      there were no recurrences of ventricular tachycardia during a mean follow-up
      period of 12 month. Three patients died perioperatively. In 21 of 29 patients
      without coronary artery disease, no recurrences of ventricular tachycardia were
      observed (mean duration of follow-up 17 months) whereas 8 cases had a recurrence
      of ventricular tachycardia.

PMID- 1615731
TI  - [Implantable defibrillators].
AB  - Automatic implantable defibrillator therapy has changed the approach to life
      threatening ventricular tachycardia completely and essentially improved survival
      after aborted sudden cardiac death. Since the first implantation of a
      defibrillator in 1980, 20,000 patients have received such a device. Nonetheless,
      in Germany still too many patients die of sudden cardiac death because
      defibrillator therapy fails to be known enough and keeps not being made use of
      (no more than 1,000 implants to date). In this group of patients characterized by
      poor ventricular function, antiarrhythmic drug therapy proved to be unreliable or
      even dangerous in many cases, while electrophysiologically-guided surgical
      interventions use to be impossible. The introduction of the implantable
      defibrillator enabled the incidence of sudden cardiac death to be reduced to
      about 2% during the first year after implant, and to 5% in the third year,
      respectively. In most centers with more extensive experience in defibrillator
      implantations, operative mortality is about 2-3%. Long-term results with
      defibrillator patients are controlled by the course of the underlying disease,
      which is coronary artery disease with large scars due to infarction in some 75%
      of cases. In a large group of about 10,000 patients, total mortality has been
      calculated to be 15% after three years. Defibrillator systems of the latest
      generation offer multiple programmability of tachycardia identification
      parameters and permit differentiated modification of therapeutic intervention.
      Defibrillator therapy has now been improved essentially by the introduction of
      endocardial lead systems and, in addition, by the defibrillator being combined
      with an antitachycardia pacing system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615732
TI  - [Electrophysiologic operations. Surgical treatment of life-threatening
      tachycardia: indications, surgical possibilities, results].
AB  - Electrophysiologic operations, which mean electrophysiologically (= mapping)
      guided direct operations for life-threatening tachyarrhythmias have been
      elaborated and popularized during the decade of 1980-1990. They are predominantly
      related to patients with supraventricular tachycardias on the basis of accessory
      atrioventricular bypass tracts (Wolff-Parkinson-White syndrome) and individuals
      with malignant ventricular tachycardias in the setting of coronary artery
      disease. The concept of these operations is to identify the tachycardia
      underlying morphologic substrates at time of surgery utilizing intraoperative
      electrophysiologic mapping techniques and to ablate those arrhythmogenic tissues
      surgically. In comparison to the natural (= non-surgical) history of the
      mentioned disorders their mortality and morbidity prognosis is significantly
      improved through direct antitachycardiac operations. Possibly the spectrum,
      indications and applications of those electrophysiologic operations will change
      through the next decade since the meantime a variety of rhythm disorders are
      successfully approached by interventional cardiologic measures.

PMID- 1615733
TI  - [Familial primary generalized epilepsy and drug (anticonvulsant)-induced systemic
      lupus erythematosus--a family study].
AB  - We report a 12-year study of a family with high mortality rate due to primary
      generalized epilepsy. During indicated and non-indicated therapy with
      anticonvulsive drugs (succinimides and hydantoines) there developed symptoms of
      systematic lupus erythematosus. The value of controlled immunological and genetic
      markers is discussed.

PMID- 1615734
TI  - [Systemic lupus erythematosus and pregnancy].
AB  - Our study strengthens the view that successful pregnancy outcome can be achieved
      in most patients with SLE, although premature delivery and pregnancy-related
      complications are common. For the differential diagnosis of preeclampsia and
      lupus flare in pregnancy, levels of anti-DNA antibodies and complement C3 are
      valuable parameters. In patients with antibodies to phospholipids, no major
      clinical problems occurred provided that patients were treated with
      corticosteroids and low-dose aspirin. However, none of our patients with renal
      involvement of SLE had an uncomplicated pregnancy course.

PMID- 1615736
TI  - Arrhythmias in the natural history of mitral stenosis.
AB  - Mitral stenosis with or without regurgitation is the most common form of valve
      disease associated with arrhythmias, as atrial fibrillation (AF) is the most
      frequent complication of mitral stenosis. AF may occur as transient episodes with
      the patients reporting a history of palpitation, paroxysmal dyspnea or
      tachycardia or as sustained arrhythmia.

PMID- 1615735
TI  - [Enzyme immunoassay for the detection of autoantibodies to nRNP and Sm: a rapid
      and sensitive alternative to current procedures].
AB  - Antinuclear antibodies are of major importance in the diagnosis of inflammatory
      rheumatic diseases. Sm and nRNP antibodies can be found in sera from patients
      with systemic lupus erythematosus and mixed connective tissue disease. Usually,
      these antibodies have been detected with one of the following methods:
      Ouchterlony immunodiffusion, passive hemagglutination or
      counterimmunoelectrophoresis (CIE). In this work results obtained by Ouchterlony
      and CIE techniques were compared with those obtained by ELISA. Purified proteins
      from cellular extracts (HeLa) were used as antigens for Sm- and nRNP-ELISA: D
      polypeptide for Sm-ELISA and the 68 kD, A, C, B,B' and D polypeptides for nRNP
      ELISA. Compared with the other two techniques, ELISA was less time consuming and
      showed greater sensitivity. Quantitative titration proved to be of advantage in
      monitoring the course of the diseases mentioned above.

PMID- 1615737
TI  - Features of patients with severe mitral stenosis with respect to atrial rhythm.
      Atrial fibrillation in predominant and tight mitral stenosis.
AB  - The aim of this study was to assess the features of patients with severe mitral
      stenosis in relation to atrial rhythm. Six hundred and fifty patients (pts) with
      severe mitral stenosis (MS) (valve area less than or equal to 1.5 cm2) who
      underwent percutaneous balloon commissurotomy (n = 600) or surgery (n = 50) were
      classified into 3 groups according to their atrial rhythm (AR): group A: sinus
      rhythm (SR) (n = 379), group B: SR with episodes of transient atrial fibrillation
      (AF) (n = 65), group C: permanent AF (n = 206). Uni- and multivariate analysis of
      clinical, echocardiographic and hemodynamic parameters with respect to the atrial
      rhythm was performed. Some parameters were comparable in all 3 groups: sex,
      pulmonary, right and left atrial pressures, mitral valve area, incidence of
      associated aortic valve disease. Nine parameters were different: mean age, NYHA
      class III or IV, previous commissurotomy, previous embolism, cardiac index,
      mitral regurgitation, tricuspid regurgitation, left atrium diameter, mitral
      calcification. Multivariate analysis, identified age, left atrial diameter and
      presence of mitral calcification as independent predictors of atrial
      fibrillation. Transoesophageal echocardiography was performed in 167 cases. A
      spontaneous echo contrast was recorded in 106 cases (63.5%) and was significantly
      correlated with a history of embolism and or left atrial thrombi detected by
      echocardiography. Atrial fibrillation, size of left atrium, severity of mitral
      stenosis and cardiac index were found to be independent predictive factors of
      spontaneous echo contrast.

PMID- 1615738
TI  - Ventricular arrhythmias and mitral valve prolapse.

PMID- 1615739
TI  - Arrhythmias in the natural history of aortic stenosis.
AB  - In aortic stenosis, severe ventricular arrhythmias may be linked to left
      ventricular dysfunction and are a factor to be considered when a surgical
      decision is to be made. Conduction disturbances are frequent, sometimes not
      related to the severity of the stenosis and may endanger patient's life.

PMID- 1615740
TI  - Arrhythmias in aortic regurgitation: incidence, consequences and treatment.

PMID- 1615741
TI  - Ventricular arrhythmias in aortic valve disease before and after aortic valve
      replacement.
AB  - In order to evaluate the effect of aortic valve replacement on the incidence of
      ventricular arrhythmias in patients with aortic valve disease, 24-hour ambulatory
      electrocardiographic recordings were obtained before surgery in 96 patients
      without coronary artery disease (aortic stenosis n = 50, combined aortic stenosis
      and regurgitation n = 19 and aortic regurgitation n = 27). Following aortic valve
      replacement, repeat recordings were obtained after 13 +/- 4 days and 18 +/- 7
      months. Ventricular arrhythmias were in all cases classified according to Lown
      and were compared with clinical, echocardiographic and hemodynamic data.
      Preoperatively, ventricular premature beats were observed in 85 patients (89%)
      and were frequent (greater than 30 ventricular premature beats/hour) in 20 (21%).
      Multiformity was found in 27 (28%), couplets in 18 (19%) and ventricular
      tachycardia in 11 (11.5%). The occurrence of ventricular arrhythmias was not
      related to the type or severity of valve lesions. Patients with severe
      ventricular arrhythmias (Lown class 3 or 4: 37%) had a greater thickness of their
      interventricular septum 13.9 +/- 2.5 mm, vs 11.7 +/- 2.6 (p less than 0.05); a
      higher LV mass 176 +/- 34 g/m2, vs 134 +/- 39 (p less than 0.05) and a lower left
      ventricular ejection fraction 47 +/- 12%, vs 57 +/- 11, (p less than 0.01). Two
      weeks postoperatively, the incidence and severity of ventricular arrhythmias had
      increased: ventricular premature beats were noted in 92% and were severe in 50%.
      No correlation was found between ventricular arrhythmias and preoperative or
      operative data. Eighteen months after surgery, ventricular premature beats were
      still observed in 81% of patients but remained frequent in 7% only. Severe
      ventricular arrhythmias were noted in 27%. Patients with severe ventricular
      arrhythmias had at the time of this late recording a lower radionuclide left
      ventricular ejection fraction 57 +/- 14%, vs 73 +/- 9 (p less than 0.02) and a
      higher enddiastolic diameter 63 +/- 15 mm, vs 48 +/- 7, (p less than 0.01). This
      study indicates that ventricular arrhythmias are common in patients with aortic
      valve disease. The severity of arrhythmias is influenced by the LV consequences
      of valve lesion both pre- and late postoperatively. The frequency and severity of
      ventricular arrhythmias increase early after surgery and do not correlate with
      preoperative or operative data.

PMID- 1615742
TI  - Permanent cardiac pacing for prolonged second and third degree atrioventricular
      block complicating cardiac valve replacement.

PMID- 1615743
TI  - Preoperative ventricular arrhythmias in mitral regurgitation. French Working
      Group on Valvular Heart Disease.

PMID- 1615744
TI  - Perioperative arrhythmias in valvular heart disease.

PMID- 1615745
TI  - Arrhythmias and valvular heart diseases. European Society of Cardiology Working
      Group on Valvular Heart Diseases. Namur, Belgium, 24-25 May 1991. Proceedings.

PMID- 1615746
TI  - Possible mechanisms of arrhythmias in valvular heart disease.

PMID- 1615747
TI  - [Prognosis in chronic myeloid leukemia].
AB  - The clinical course of patients with chronic myelogenous leukaemia (CML) is very
      heterogenous. Survival is determined by the timing of disease transformation. A
      patient's risk of transformation can be defined, but the time when it will occur
      can not be predicted. A number of features recorded at the time of diagnosis
      correlate significantly with survival and can serve as prognostic parameters.
      Conventional therapy has not achieved a substantial delay in the universally
      fatal outcome of the disease. Allogenic or syngenic bone marrow transplantation
      to individuals with CML is at present the only treatment with a curative
      potential.

PMID- 1615748
TI  - [Immunologic phenotype of lymphocytes in chronic B-cell lymphocytic leukemia. I.
      B- and T-lymphocytes in chronic lymphocytic leukemia].
AB  - This article contains the review and the critical discussion of studies of T and
      B lymphocytes in chronic B-cell lymphocytic leukaemia. It is not explicitly known
      now, which stage of differentiation of lympho-haemopoietic cells undergoes
      malignant transformation in CLL-B. Basing on VDJ recombination activity it is
      supposed that some cases derive from the stem cell, others--from B lineage cells.

PMID- 1615749
TI  - [Immunologic phenotype of lymphocytes in chronic B-cell lymphocytic leukemia. II.
      Studies of immunologic phenotype of peripheral blood and lymph node lymphocytes
      in patients with chronic lymphocytic leukemia or leukemic forms of
      lymphoplasmacytoid lymphoma].
AB  - In a group of 16 patients with chronic lymphocytic leukaemia and leukaemic forms
      of the lymphoma lymphoplasmocytoides immunophenotypes of peripheral blood and
      lymph node lymphocytes were studied. CONCLUSIONS: 1) immunophenotype
      heterogeneity observed in a minority of patients in lymph-nodes or peripheral
      blood seems to be connected with the co-existence of leukaemic and normal
      reactive B-cells, 2) SIgG+ cells seem to represent activated B lymphocytes
      producing and secreting autoantibodies, 3) circulating peripheral T lymphocytes
      do not reflect the distribution of T cell subpopulations in lymph-nodes.

PMID- 1615751
TI  - [Results of serological tests for syphilis used in preventive examinations].
AB  - Results of serological tests for syphilis performed on donors and patients at the
      Institute of Haematology over the last two years are summarized. The results of
      tests performed by cardiolipins ++ USR and VDRL antigens, and later confirmed
      using FTA-ABS and TPHA methods were evaluated. They indicate that the recently
      produced USR antigen is more sensitive and more specific than VDRL antigen.
      Similarly, TPHA proves to be more sensitive than FTA-ABS test in these
      prophylactic assays.

PMID- 1615750
TI  - [Second cessation of therapy in children with acute lymphoblastic leukemia].
AB  - In the group of 63 children in whom a relapse of ALL after first suspension of
      treatment occurred, and in whom a repeated cessation of therapy had place, 46.2%
      of patients had probability of a prolonged symptomless survival. The children
      with an isolated extramedullary relapse had a greater chance for a DFS of 7
      years, than those with a relapse in the bone marrow (p = 0.05). The patients with
      a relapse occurring after the first cessation of treatment of ALL should be
      treated as intensively as newly diagnosed cases, because they have a real
      possibility for a prolonged survival during remission phase of disease.

PMID- 1615752
TI  - [Indications for bone marrow transplantation in failure of the hematopoietic
      system].

PMID- 1615753
TI  - Antileukemic effects of recombinant human tumor necrosis factor alpha (rh-TNF
      alpha) with cyclophosphamide or methotrexate on leukemia L1210 and leukemia P388
      in mice.
AB  - We investigated the influence of recombinant human tumor necrosis factor alpha
      (rh-TNF alpha) administered as a single agent or in combination with
      cyclophosphamide (CY) or methotrexate (MTX) on the survival time of mice
      inoculated with lymphoblastic leukemia L1210 or lymphatic leukemia P388. The
      median survival time of leukemia L1210 bearing mice treated with rh-TNF alpha at
      doses ranging from 200 to 275 g/kg in daily i.p. injections was longer than that
      of control animals. Groups of mice with leukemia L1210 receiving rh-TNF alpha
      combined with either MTX or CY lived longer than animals treated with these
      agents individually. We observed only slight prolongation of life of animals
      inoculated with this tumor and treated with rh-TNF alpha at dose of 800
      micrograms/kg in four injections on 2, 4, 6 and 8 day of experiment, and no
      effect when rh-TNF alpha was administered at dose of 200 or 400 micrograms/kg at
      the same treatment regime. In contrast no significant differences in lifetime
      were obtained from either simultaneous or sequential treatment of mice bearing
      leukemia P388. Groups of mice with this tumor treated with rh-TNF alpha in
      conjunction with either MTX or CY lived longer than controls, or rh-TNF alpha
      singly treated mice, but their survivals were not significantly prolonged
      compared with mice receiving cytostatics alone.

PMID- 1615754
TI  - Haemolytic crises caused by Hoya carnosa in a patient with G6PD deficiency.
AB  - Haemolytic crises caused by contact with Hoya carnosa were observed in a 45-years
      old woman. The investigation of erythrocyte enzymes displayed both G6PD
      deficiency and its diminished affinity to G-6-P. Some properties of
      dehydrogenases isolated from erythrocytes of the patient's brother and son were
      also changed although clinical signs of haemolysis were absent.

PMID- 1615755
TI  - Interleukin-6: an osteotropic factor?

PMID- 1615756
TI  - Intermittent administration of bovine PTH-(1-34) increases serum 1,25
      dihydroxyvitamin D concentrations and spinal bone density in senile (23 month)
      rats.
AB  - We examined the effect of intermittent administration of bovine parathyroid
      hormone (1-34) (bPTH) on spinal bone mineral content (BMC) and bone mineral
      density (BMD), serum 1,25-dihydroxyvitamin D concentrations, and serum markers of
      osteoblast function in senile male and female rats (23 and 24 months of age,
      respectively). Sexually mature young (3 month) male rats were similarly treated
      for comparison. bPTH administration increased serum osteocalcin concentrations
      without changing serum inorganic phosphate or calcium concentrations in either
      group of old animals. In young animals, PTH administration increased the serum
      calcium and inorganic phosphate concentrations significantly (p less than 0.05),
      although values remained within the normal range. In the vehicle-treated male
      rats, serum 1,25-dihydroxyvitamin D concentrations were lower in the senile than
      in the young animals (18 +/- 5 versus 47 +/- 6 pg/ml, p less than 0.05). PTH
      administration resulted in significantly increased serum 1,25-dihydroxyvitamin D
      concentrations in the senile and young male animals (both, p less than 0.05) and
      the final mean serum 1,25-dihydroxyvitamin D concentrations were not
      statistically different (68 +/- 9 versus 85 +/- 6 pg/ml respectively; p = NS).
      Serum 1,25-dihydroxyvitamin D concentrations were significantly (p less than
      0.05) higher in the PTH-treated senile female rats than the sex-matched, vehicle
      treated controls. The pretreatment spinal BMC and BMD as assessed by dual-energy
      x-ray absorptiometry (DEXA) were significantly higher in the senile male animals
      than in the young animals. Spinal BMC and BMD decreased in the vehicle-treated
      senile male rats (p less than 0.05) over the 3 weeks of the study despite a gain
      in weight.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615757
TI  - Evidence for P2-purinoceptors on human osteoblast-like cells.
AB  - ATP released from damaged cells or by controlled secretion could be an important
      factor in the formation or remodeling of bone. In a variety of other tissues ATP
      has been shown to control cellular processes by acting on P2-purinoceptors and
      activating the calcium signaling pathway. Here we demonstrate for the first time
      that extracellular ATP increases the intracellular free calcium [Ca2+]i
      concentration in normal human osteoblasts and in SaOS-2 cells, a human
      osteosarcoma-derived cell line, but not in ROS 17/2.8 cells. The ATP-induced
      increase in [Ca2+]i was dose dependent, and the concentrations of ATP required
      were similar to those reported to regulate cellular functions in other cell
      types. Although ATP is metabolized rapidly by bone cells, the effects on [Ca2+]i
      appeared to be mediated directly by ATP rather than one of its metabolites.
      Adenosine 3-thiotriphosphate, a nonhydrolyzable analog of ATP, induced similar
      changes in [Ca2+]i. This indicates that P2-purinoceptors are present on
      osteoblast-like cells and that extracellular ATP from various sources might be an
      important factor in the regulation of osteoblast functions.

PMID- 1615758
TI  - Developmental regulation of creatine kinase activity in cells of the epiphyseal
      growth cartilage.
AB  - During the process of endochondral bone formation, the maturing chondrocyte
      exhibits profound changes in energy metabolism. To explore the mechanism of
      energy conservation in cartilage we examined the expression of creatine kinase,
      an enzyme that catalyzes the formation of ATP in tissues under oxygen stress.
      Measurement of creatine kinase activity and cytochemical assessment of enzyme
      distribution clearly showed that the level of enzyme activity was related to
      chondrocyte maturation. Thus, as the cells hypertrophied, there was a progressive
      increase in creatine kinase activity. Similarly, an elevation in creatine kinase
      activity was noted in chondrocyte cultures as the cells assumed an hypertrophic
      state. When cartilage calcification was disturbed by rickets, there was a
      decrease in enzyme activity in the hypertrophic region. Studies were performed to
      examine the creatine kinase isozyme profile of cells of the epiphysis. In resting
      and proliferating cartilage, the isoform was MM. In hypertrophic cartilage, the
      predominant isoforms were MB and BB. In terms of the creatine phosphate content,
      the highest values were seen in the proliferative region; lower amounts were
      present in hypertrophic and resting cartilage; and no creatine phosphate was
      detected in calcified cartilage. These data suggest that turnover of creatine
      phosphate is greatest in the mineralized region of the epiphysis. The results of
      these investigations point to creatine kinase as being under developmental
      control. The activity of the enzyme in cartilage cells should serve as a marker
      of developmental events associated with chondrocyte proliferation, hypertrophy,
      and mineralization.

PMID- 1615760
TI  - Retention of etidronate in human, dog, and rat.
AB  - The retention of radioactivity in human, rat, and dog following a single injected
      dose of radiolabeled etidronate disodium (EHDP) is shown to follow power-law
      decay curves with similar slopes for times up to 4, 60, and 80 days,
      respectively. During this period retention declines with time according to a weak
      inverse power of the time since dosing, with an exponent ranging from -0.05 (dog)
      to -0.09 (human and rat). Direct analyses of dog bones either 90 days after a
      single dose or 365 days after cessation of chronic dosing indicate a more rapid
      bone clearance of EHDP than predicted by the initial power law. Direct skeletal
      analysis also shows a more rapid loss of radioactivity in the rat between 60 and
      365 days, indicative of either a second power law or a terminal exponential phase
      in the retention function occurring after 60 days. These data are used to
      estimate the minimum and maximum amounts of drug that would remain in the body
      following long-term treatment in humans. For the intermittent cyclic EHDP
      treatment (ICT) regimen for osteoporosis (repeated cycles of 14 daily doses of
      400 mg orally followed by 76 days drug free), the projected retention of EHDP
      after 3 years of treatment is 25-50 times the daily absorbed dose. Thus, for a 60
      kg woman with a daily absorbed dose of 12 mg, the retained mass of EHDP would be
      about 300-600 mg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615759
TI  - Identification of proteins secreted by human osteoblastic cells in culture.
AB  - To better understand the biochemistry of matrix-forming cells, we developed a
      simple and reproducible procedure for the isolation and identification by N
      terminal sequencing of proteins secreted by cells into culture medium and applied
      this procedure to the analysis of the major Coomassie blue-staining proteins
      under 100 kD that are secreted from three different human osteoblastic cell
      cultures. The major proteins secreted by normal human osteoblasts from adult
      trabecular bone were identified by N-terminal sequencing to be gelatinase,
      osteonectin, the C-terminal propeptides of the alpha 1 and alpha 2 chains of type
      I collagen, tissue inhibitor of metalloproteinase 1 (TIMP-1), and beta 2
      microglobulin. The amounts of each of these proteins secreted into medium over a
      24 h interval did not change over the 7 consecutive days of culture under serum
      free conditions, which indicates that this pattern of protein secretion is not
      significantly affected by the serum-free conditions needed for protein
      identification by this method. In addition, radioimmunoassay for bone gla protein
      (BGP), a marker for osteoblast phenotype, revealed that BGP secretion remained
      high over 7 days of culture under serum-free conditions and was comparable to the
      rate of BGP secretion in control cultures with 10% serum. The major proteins
      secreted by MG-63 cells were identified by N-terminal sequencing to be
      gelatinase, a novel 40 kD human bone protein we termed YKL-40, TIMP-1, the
      recently discovered TIMP-2, and beta 2-microglobulin. Further studies revealed
      that YKL-40 is the only protein detectable by Coomassie staining of SDS gels of
      MG-63 media proteins that is induced by extended time at confluence or by
      treatment with 1,25-(OH)2D3. The apparent absence of detectable Coomassie-stained
      bands corresponding to the C-terminal propeptides of collagen in the medium of MG
      63 cells suggests that these transformed cells may not be a good model for bone
      matrix formation. The major proteins secreted by normal fetal osteoblastic cells
      were identified by N-terminal sequencing to be osteonectin and the C-terminal
      propeptides of the alpha 1 and alpha 2 chains of type I collagen. Gelatinase and
      TIMP could not be detected among the conditioned medium proteins by these
      methods. These observations indicate that fetal osteoblasts primarily express
      proteins that are matrix constituents and adult human osteoblasts secrete, in
      addition to these, proteins that could function in matrix turnover.

PMID- 1615761
TI  - Bone mineral density in elderly men and women: results from the Framingham
      osteoporosis study.
AB  - Our study investigated bone mineral density of the proximal femur and ultradistal
      and proximal radius in a population of elderly men and women. The Framingham
      study started in 1948, following a population-based sample for evaluation of
      cardiovascular risk factors and events. During the 20th biennial Framingham
      examination (1988-89) we conducted the Framingham osteoporosis study, measuring
      bone mineral density in the proximal femur and distal and proximal radius for
      1154 study participants. Ages ranged from 68 to 98 years, with a mean age of 76
      years. Bone mineral density was measured using Lunar SP2 and DP3 densitometers.
      This cross-sectional study evaluates mean bone mineral density measurements at
      each site by 5 year age intervals for men and women, testing for trends in bone
      density with age. Analyses were repeated adjusting for weight and height. Among
      the 446 and 708 women, bone mineral density of the femur and bone mineral content
      of the proximal radius were inversely and significantly related to age in both
      sexes and were considerably higher in men than women at all sites. The linear
      decline with age group in our cross-sectional study remained after multivariate
      adjustment for height and weight. The ultradistal radius showed no significant
      correlation with age for either sex. There were significant correlations between
      the bone measurements made at different sites for both men and women (range in r
      = 0.27-0.89). Cross-sectional curves of bone mineral density with age showed no
      significant differences in slope between males and females.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1615762
TI  - Prostaglandin E2 promotes osteoclast formation in murine hematopoietic cultures
      through an action on hematopoietic cells.
AB  - Osteoclastic differentiation is induced from hematopoietic cells in the presence
      of 1,25-(OH)2D3 by stromal cells that are present in bone but not in
      hematopoietic spleen. Recent evidence suggests that prostaglandins (PGs) are
      essential for this process. In this communication we describe experiments in
      which we have examined further the role of PGE2 in osteoclast formation. We found
      a marked reduction in basal, 1,25-(OH)2D3, and IL-3-induced production of
      calcitonin receptor (CTR)-positive cells and bone resorption by cyclooxygenase
      inhibitors, which was restored by PGE2 addition. Although some stromal cell types
      (ST2 cells) that support osteoclast formation from spleen cells produced PGs in
      response to 1,25-(OH)2D3, others (ts8 and calvarial cells) did not, either alone
      or in combination with spleen cells. On the other hand, both bone marrow and
      spleen cells produced amounts of PGE2 in response to 1,25-(OH)2D3 that were
      sufficient to account for osteoclast formation. Osteoclast-inductive ts8 cells
      were able to support osteoclast formation from spleen cells in the presence of
      1,25-(OH)2D3 or PGE2 even if devitalized. Incubation of ts8 cells in these agents
      before devitalization did not avoid the requirement for the presence of PGE2 or
      1,25-(OH)2D3 during subsequent incubation with spleen cells. Thus, hematopoietic
      cells produce sufficient PGE2 for osteoclast formation, and the PGE2 thus
      produced acts on hematopoietic precursors, which can be induced in the presence
      of PGE2 to express CTR and resorb bone on contact with osteoclast-inductive
      stromal cells. The ability of osteoclast-inductive cells to support osteoclast
      formation appears not to rest on their ability to produce, induce, or respond to
      PGE2.

PMID- 1615763
TI  - Risk of fractures in patients with pernicious anemia.
AB  - In a series of postmenopausal women previously studied by our group, pernicious
      anemia was associated with reduced bone mineral density of the spine and with
      vertebral fractures. To determine whether osteoporotic fractures represent an
      important clinical problem for such patients, we conducted a population-based
      retrospective cohort study of all Rochester, Minnesota residents newly diagnosed
      with pernicious anemia from 1950 through 1979. These 131 individuals were
      followed through the inpatient and outpatient records of all medical care
      providers in the community for 1550 person-years. In comparison with fracture
      rates from the general community, patients with pernicious anemia had a 1.9-fold
      increase in proximal femur fractures, a 1.8-fold increase in vertebral fractures,
      and a 2.9-fold increase in distal forearm fractures (all p less than 0.05).
      Increases in the risk of proximal humerus and pelvis fractures were not
      statistically significant. Clinicians should be aware that pernicious anemia is
      associated with an increased risk of osteoporotic fractures, but the mechanism is
      unknown.

PMID- 1615764
TI  - HLA antigens and intracranial aneurysms.
AB  - The frequencies of the HLA-A, -B and -DR were determined in a group of 59
      transplant donors who died from subarachnoid haemorrhage within three days
      following the rupture of intracranial aneurysm (the SAH group) and compared with
      those of a control group consisting of 389 donors who died from other causes. The
      only significant difference was in the increased frequency in the SAH group of
      non-typed ("empty")-DR loci in association with the DR7 phenotype. The most
      probable explanation of this finding is that in the SAH group the frequency of
      DR7 homozygotes is several times higher than in the general population, and that
      bearing the DR7 allele in homozygotic form is associated with a very high risk of
      developing potentially fatal intracranial aneurysmal haemorrhage.

PMID- 1615766
TI  - Plasma osmolality, osmoregulation and prognosis after head injury.
AB  - 108 Patients with severe brain damage were examined for the course of plasma
      osmolality. In addition plasma values of Na+, K+, glucose and blood urea nitrogen
      (BUN) were measured simultaneously by auto-analyzer. The clinical status was
      registered daily by using a modified Glasgow coma scale. Outcome of the injured
      patients was registered by using the Glasgow outcome scale. 60 patients survived,
      48 died, 39 of brain damage and 9 of secondary diseases, such as infection or
      embolism. Sustained severe brain damage is generally followed by disturbances of
      metabolic regulation. Quite often the osmotic regulation is disturbed. In most
      cases these disturbances are of hyperosmolar nature, their extent and duration
      being correlated to the prognosis. Hyposmolar deregulation occurs less
      frequently, and occasionally lead to peracute brain oedema (e.g. SIADH-syndrome).
      These dysregulations are interpreted as disturbances of the central function of
      the diencephalon, in lethal cases even as "hypothalamic death". Blood osmolality
      measurements should therefore be made early in states of acute cerebral disease
      to help establish a prognosis, control the treatment of water imbalance and to
      determine contra-indications to osmotherapy.

PMID- 1615765
TI  - Stereotactic diagnosis and treatment of pineal region tumours and vascular
      malformations.
AB  - Diagnosis and treatment of tumours and vascular malformations in the region of
      the pineal gland continue to challenge the neurosurgeon's skill. Due to vital
      vascular and brain structures in the region, microsurgical removal of such masses
      is often impossible. During the past nine years, we have managed 47 patients with
      pineal region mass lesions using stereotactic techniques for diagnosis and
      treatment. In order to determine further therapeutic options, 15 patients
      underwent stereotactic biopsy of pineal region tumours. In all patients, the
      histologic diagnosis obtained served to direct further therapy. Thirty-two
      patients were treated with stereotactic radio-surgery for pineal region tumours
      or vascular malformations. During the follow-up period, one patient underwent
      delayed microsurgical resection of a midbrain angiographically occult vascular
      malformation. No other patient required microsurgical intervention after a
      stereotactic procedure. In all 47 patients, no significant morbidity or mortality
      occurred after stereotactic biopsy or radiosurgery. Empiric treatment of pineal
      region tumours with fractionated radiation therapy is no longer warranted. Image
      guided stereotactic technology provides a safe method to accurately diagnose and
      effectively treat selected pineal region masses. After definitive histologic
      diagnosis is established, proper treatment may be instituted. Options for
      treatment include stereotactic radiosurgery for selected tumours and vascular
      malformations, microsurgical resection of benign tumours or fractionated external
      beam radiation therapy for malignant germ cell and glial tumours. Stereotactic
      surgery should be the first option in the diagnosis and therapy of pineal region
      masses.

PMID- 1615767
TI  - Isoflurane in the management of status epilepticus after surgery for lesion
      around the motor area.
AB  - When conventional treatment for status epilepticus fails, general anaesthesia is
      recommended. We present our experience with isoflurane, an inhalational
      anaesthetic, in the management of four patients with status epilepticus which
      occurred soon after surgery for motor area lesion. The seizures were controlled
      with relatively small concentrations of isoflurane. Hypotension, the only adverse
      effect of isoflurane, was managed easily with the use of dopamine in
      physiological saline. Although status epilepticus occurring soon after surgery is
      transient, it carries a risk of persistent brain damage if active treatment is
      not instituted promptly. Isoflurane general anaesthesia may be recommended to
      control it in the intensive neurosurgical care.

PMID- 1615768
TI  - Diagnosis of cervical disc disease. MRI versus cervical myelography.
AB  - In a prospective study of 63 surgical patients cervical myelography was compared
      with MRI to establish the relative value of the 2 diagnostic procedures in
      patient selection for surgery of ruptured cervical discs and bony nerve root
      compression. While MRI in the T1-weighted and gradient echo modes matched the
      diagnostic accuracy of invasive myelography (95%), T1 and T2-weighted MRI images
      alone were associated with an error rate of 10%. In patients with medial
      protrusion myelography did not always show the true extent of compression,
      whereas MRI tended to miss small laterally protruding disc fragments. Cervical
      myelography continues to have a place in the diagnosis of cervical disc disease,
      whenever clinical signs and symptoms do not agree with MRI data.

PMID- 1615769
TI  - Thoracic disc herniation. Analysis of 14 cases and review of the literature.
AB  - Fourteen cases of thoracic intervertebral disc prolapse are reported and
      analysed. Eleven were women, 3 men, and the peak incidence was in the 5th decade.
      No trauma was reported in our cases. The T8/9 interspace was the most frequently
      involved. A sensory level was noticed in 6 cases and in four a clear cut sensory
      level at T10 was observed. Results of surgical treatment show that using
      microsurgical techniques costotransversectomy and its modifications are equally
      effective; laminectomy is contraindicated.

PMID- 1615770
TI  - Near-anatomical reduction and stabilization of burst fractures of the lower
      thoracic or lumbar spine.
AB  - Thirty-one consecutive symptomatic patients with burst fractures of the lower
      thoracic or lumbar spine (T 11-L4) were treated by early surgery in a 36-month
      period, with near-anatomical reduction being achieved via the postero-lateral
      route. Fusion and reconstruction of the vertebral body was done by using
      autologous or processed bovine bone. Correction of the kyphotic deformity was
      obtained by using distraction rods or transpedicular devices. The post-operative
      mean degree of kyphosis, percent vertebral height, and percent canal stenosis
      showed statistically significant differences, compared with the corresponding pre
      operative mean values. All but one of the 25 patients with incomplete paraplegia
      exhibited neurological improvement, with complete recovery occurring in 20 cases
      (median follow-up: 16 months) irrespective of the location of the lesion at the
      thoraco-lumbar junction (T 11-L1) or the lower lumbar segment (L2-L4). Out of the
      6 patients with pre-operative complete paraplegia, useful motor power returned in
      one case with a lesion below L1. The results confirm the suitability of the
      postero-lateral route and are consistent with the assumption that early near
      anatomical reduction and stabilization favours maximum neurological recovery in
      symptomatic patients.

PMID- 1615771
TI  - Cognitive deficits after rupture and early repair of anterior communicating
      artery aneurysms.
AB  - In a retrospective follow-up study covering a time period of four years 18
      patients operated upon early for an aneurysm of the anterior communicating artery
      (ACoA) and a control group of 21 patients with aneurysmal subarachnoid
      haemorrhage (SAH) from other sources than ACoA aneurysm and 9 patients with SAH
      of nonaneurysmal origin were subjected to neuropsychological examination. Both
      groups were comparable in their neurological condition on admission and in the
      severity of bleeding seen on CT-scan. Testing included memory functions,
      concentration, logical and spatial thinking, a Stroop-test, an aphasia screening
      test and a complex choice reaction task. Patients with SAH of a ruptured ACoA
      aneurysm did not differ significantly from the control group in any of the tests
      used. But there was a trend for the ACoA patients to have more memory problems
      than the patients with SAH of other origins. On the other hand the patients in
      the control group with aneurysmal SAH of other locations and with non-aneurysmal
      SAH had not significantly more problems with concentration and aphasia than the
      patients with ruptured ACoA aneurysm. These results, which differ from the common
      opinion of frequent occurrence of memory deficits in ACoA aneurysms are
      interpreted as a consequence of the changes in improved pre-, intra- and
      postoperative management in modern neurosurgery.

PMID- 1615772
TI  - Significant lateralisation of supratentorial ICP after blunt head trauma.
AB  - After blunt head trauma simultaneous left and right hemispheric intracranial
      pressure (ICP) monitoring revealed a pressure gradient of about 30 mmHg
      persisting until the 5th day after the accident equilibrating thereafter. ICP was
      elevated over the radiologically more compressed hemisphere. The supratentorial
      space seems to allow considerable interhemispheric pressure gradients. As a
      consequence epidural ICP monitoring should be performed over the hemisphere with
      signs of greater compression.

PMID- 1615773
TI  - Late posttraumatic nonvascular pulsating eye.
AB  - A patient is reported with unilateral intermittent pulsating eye caused by the
      combination of an orbital encephalocele and hydrocephalus, thirty four years
      after a head injury. Treatment of the hydrocephalus resulted in disappearance of
      the eye pulsations and encephalocele, as well as in improvement of the gait.

PMID- 1615774
TI  - Cardiac rehabilitation and elderly patients.

PMID- 1615775
TI  - A longitudinal study of the occurrence of joint complaints in elderly people.
AB  - Joint complaints were studied in two cohorts longitudinally followed at 4-5 year
      intervals between the ages of 70 and 79, representative of the elderly population
      of Goteborg, Sweden. Joint complaints were reported by 30-43% of the women and by
      15-25% of the men. A significant increase of joint complaints was found in both
      sexes between the ages of 70 and 75 but not thereafter. The knee joints were the
      most common site of complaints in both sexes. Complaints were not consistently
      reported by the probands at all examinations, however, and a 'disappearance' of
      complaints with age was found. Complaints on all three occasions were reported by
      15% of the women and 3% of the men. An association was observed between
      repeatedly reported complaints and radiographic osteoarthritis as well as with
      self-reported rheumatoid arthritis.

PMID- 1615776
TI  - Practical problems with eye-drops among elderly ophthalmology outpatients.
AB  - Many elderly patients have eye-drops prescribed. We have examined the abilities
      in eye drop application of 43 consecutive outpatients aged 75 years or more who
      completed a questionnaire and demonstrated their technique in eye-drop
      application. Less than one-third of patients applied drops themselves, the rest
      relying on others; one-third of this group lived alone. The majority of patients
      experienced some difficulty with the application of their drops and it was
      estimated that half of those who usually applied their own treatment were
      unlikely to succeed in instilling a drop into the conjunctival sac. Few patients
      had been prescribed aids or appliances to improve their eye-drop application
      technique.

PMID- 1615777
TI  - Quantitative vibration perception testing in elderly people: an assessment of
      variability.
AB  - The variability of vibration perception threshold measured by the Biothesiometer
      for three consecutive readings on a single occasion and 18 sequential readings
      over 7 days was assessed in 20 elderly convalescent subjects. The coefficient of
      variation for three consecutive readings at the great toe was high [right great
      toe: median (range) 15 (6-260%]. The median coefficients of variation for
      sequential readings were higher than those for consecutive readings at both toes
      [right great toe: median (range) 26 (5-71)% versus 15 (6-26)%, p = 0.0001]. Thus
      quantitative tests of sensory function are not reliable in elderly people, even
      when the subjects have no acute medical problem. Screening for neuropathy in
      elderly patients should probably rely on clinical examination or
      electrophysiological tests.

PMID- 1615778
TI  - Glycosylated haemoglobin in the diagnosis of diabetes mellitus in elderly people.
AB  - An oral glucose tolerance test (OGTT, 75 g WHO criteria) was applied to healthy
      elderly subjects (mean age 76 years) within a week of measurement of random blood
      glucose and glycosylated haemoglobin (HbA1). The 'Corning' method was used to
      assay HbA1 (established normal range for our laboratory 5-8%). Sixty-five
      subjects (38 women) of whom 54 were not diabetic on WHO criteria for OGTT
      participated in the study. Five of the 54 patients with non-diabetic OGTT results
      had abnormal HbA1 (greater than 8%). These five subjects had no evidence of
      impaired glucose tolerance. Eleven subjects had diabetic OGTT results of whom
      only four had raised HbA1 assay results. Seven subjects had normal HbA1 in spite
      of diabetic OGTT. The mean HbA1 in the group of subjects with normal OGTT (n =
      52) was 6.7% (SD 1.05, range 4.6-8.7%). It appears from our study that the normal
      range of HbA1 in elderly subjects is not markedly different from established
      normal values. The poor sensitivity (36%) and predictive value (44%) of abnormal
      HbA1 in detecting diabetes, as shown in our study, would not permit its use for
      screening purposes nor as a confirmatory test for diabetes in elderly subjects.

PMID- 1615779
TI  - Elderly patients and their medication: a post-discharge follow-up study.
AB  - Fifty-six elderly patients (age range 65-98 years) discharged from a geriatric
      unit were visited at home on or after the 5th post-discharge day (median day 8)
      and their medication assessed. By the day of the visit, 15 of the 56 had not had
      a new prescription issued (27%) and 27 patients (48%) had old prescribed
      medication at home. Forty-one new scripts, issued by general practitioners,
      should have contained 128 medications if the general practitioners wished to
      continue unchanged the medication given on hospital discharge. Fourteen drugs
      (11%) had been added and 17 drugs (13%) omitted. The number of prescriptions
      issued unchanged was 26/41 (63%). Inaccurately labelled containers and/or changed
      drug names were found in 28%. Contrary to hospital advice, 47% of medications
      were issued in childproof containers. Poor communication between hospital and
      general practitioners is only part of the problem. Methods to expedite the
      delivery of new prescriptions should be developed.

PMID- 1615781
TI  - Reduced axial rotation in the spouses of sufferers from clinical idiopathic
      parkinsonism.
AB  - Axial rotation during recumbency was used to quantify the tendency towards
      parkinsonism with respect to one cardinal sign, brady/hypokinesia. Twenty-four
      elderly sufferers from idiopathic parkinsonism, their spouses, and 40 control
      subjects were studied. Significant differences in total angular displacement over
      7 h were found between sufferers and their spouses (83% of grand mean) and
      between spouses of sufferers and controls (31%). These differences could not be
      accounted for by age or cognitive function. Moreover, the total angular
      displacement of the spouses was independent of whether they shared a bed with the
      sufferer. Neither the sufferers and their spouses, nor the 20 couples who
      constituted the control group, showed any relationship between partners with
      respect to angular displacement. These findings do not favour learned behaviour,
      or selective mating as an explanation of reduced movement in spouses of
      sufferers. Significantly more of the control couples had a single cardinal sign
      in both partners than expected on the basis of the frequency of a single sign in
      one partner. Environmental factors operating in adult life could be involved in
      the pathogenesis of parkinsonism.

PMID- 1615780
TI  - Immunogenicity of inactivated influenza vaccine in residential homes for elderly
      people.
AB  - One hundred and seventy residents of 11 Leicester City Council homes for the
      elderly, with a total of 515 beds, were studied during a 30-week period from
      September 1988 to March 1989 to determine the use of influenza vaccine, the
      levels of influenza antibody, the incidence of influenza, and the protection
      afforded by vaccination. The study group of 133 women and 37 men had a mean age
      of 85 years and 59% had one or more chronic medical conditions. The immunization
      rates by home for the 170 symptomatic residents ranged from 8% to 90% (mean 45%).
      Seventy-one sera, 36 from vaccinated and 35 from non-vaccinated residents were
      collected between 1 December 1988 and 24 March 1989 and were assayed for antibody
      to A/Taiwan/1/86 (H1N1), A Sichuan/2/87 (H3N2) and B/Beijing/1/87. Analysis
      revealed no statistically significant differences between the antibody profiles
      of vaccinated and unvaccinated subjects. Six influenza A and 6 influenza B
      infections were confirmed among the 170 subjects with upper respiratory tract
      infections. Influenza vaccination was not associated with significant levels of
      protection against influenza A or B. Studies of the haemagglutinins of the
      vaccine strains and influenza isolates during 1988/89 showed that they were
      closely related.

PMID- 1615782
TI  - Characteristics of urinary incontinence in elderly patients studied by 24-hour
      monitoring and urodynamic testing.
AB  - Characteristics of urinary incontinence have been studied in 100 elderly
      incontinent patients using invasive video-urodynamics and noninvasive 24-h
      monitoring of incontinence, fluid intake, voiding and residual urine.
      Incontinence was of the urge type in 51 patients, including 24 with reduced
      bladder sensation. Noninvasive 24-h monitoring showed satisfactory
      reproducibility and high sensitivity (88%) for detecting urine loss.
      Urodynamically proven urge incontinence, especially in combination with reduced
      sensation, and recent bacteriuria were associated with severe urine loss on 24-h
      monitoring. On 24-h monitoring, urine output was significantly larger at night
      and nocturia was common. In urge incontinence urine loss was predominantly
      nocturnal and the amount depended significantly on the previous evening's fluid
      intake and on nocturia. Noninvasive 24-h monitoring showed that post-void
      residual was common and was often largest in the early morning. It also yielded
      many free-voiding flow curves. Normal flow curves with small residual urine make
      dysfunction of voiding itself unlikely. Thus noninvasive monitoring provides
      information about incontinence and voiding that is suitable for designing
      intervention and management strategies. Invasive testing may be necessary however
      to confirm the urodynamic type of incontinence or suspected voiding dysfunction.

PMID- 1615783
TI  - Use of cisplatin for elderly patients.
AB  - The ageing of the population has resulted in a greater emphasis on cancer
      treatment effects in elderly patients. This population has often had arbitrary
      dose modification of chemotherapy owing to fear of excessive side-effects. A
      review was undertaken to evaluate cisplatin toxicity in patients of 70 years of
      age or older. Thirty-four patients were evaluated. Their mean age was 72.8 years
      and 85.3% were women. Fourteen of 34 (41%) patients completed the planned
      therapy. Treatment was terminated because of disease progression (35%), renal
      toxicity (9%) and non-renal toxicity (15%). Our conclusion is that cisplatin can
      safely be administered to elderly patients. Arbitrary dose modification or
      elimination of cisplatin from a treatment programme on the grounds of patient age
      alone is not justified.

PMID- 1615784
TI  - Dementia in Melton Mowbray--a validation of earlier findings.
AB  - In 1981 a survey of elderly persons aged 75 years and over who belonged to a
      general practice in Melton Mowbray, Leicestershire found a prevalence of moderate
      cognitive impairment of 4.7%. The criterion which determined the impairment was a
      score of 7 or under on the CAPE Information/Orientation (IO) sub-test. The
      prevalence rate has been considered to be much lower than in some key studies,
      notably the 13% reported in 1970 from Newcastle upon Tyne. Although rates based
      on cognitive scales are likely to give different results from those based on
      diagnostic assessment, the suggestion is that the IO sub-test is an insensitive
      screening instrument for dementia. Using results on the sensitivity and
      specificity of the CAPE IO sub-test (cut-point 8/9) to detect moderate or severe
      dementia as defined by clinical diagnosis using the Cambridge Mental Disorders of
      the Elderly (CAMDEX) schedule, the adjusted prevalence rates of moderate or
      severe dementia were found to be 3.4% in 1981 and 5.2% in 1988. Both these
      figures were lower than the observed rates scoring 8 or under on the IO sub-test,
      confirming that insensitivity of the IO sub-test was not the reason for the
      supposed low rate in Melton Mowbray in 1981. As the prevalence of dementia in
      those aged 75 years and over has been reported by other studies to range from 3%
      to 24%, it is more likely that high rates are due to screening instruments with
      low specificity.

PMID- 1615785
TI  - Urinary and faecal incontinence in community-residing elderly women.
AB  - The prevalence of urinary and faecal incontinence was investigated in a sample of
      1049 women aged 60 years and over in the municipality of Amstelveen, the
      Netherlands; 719 postal histories were completed. The overall prevalence of
      urinary incontinence was 23.5%. Daily urine loss was reported by 14.0% of all
      women. In women aged 60 to 84 years and 85 years and over 4.2% and 16.9% were
      faecally incontinent, respectively. In all age groups poor mobility and frequency
      were associated with urinary incontinence. Urgency was independently associated
      in women aged 60-85 years as was nocturia in women aged 85 years and over.

PMID- 1615786
TI  - Bacterial meningitis in elderly patients: clinical picture and course.
AB  - We reviewed the case records of 48 patients aged 60 years and older with a
      diagnosis of acute bacterial meningitis made during the period 1976-88.
      Predisposing conditions were present in 26 patients (54%) and concurrent
      infections in 24 patients (50%). Streptococcus pneumoniae accounted for 41% of
      all isolates and 56% were Gram-positive organisms. The most common symptoms were
      fever (79%), meningism (54%) and change in mental status (69%). Sixty-three per
      cent of the patients survived. Increased fatality was associated with absence of
      typical symptoms and signs and was presumably due to a delay in diagnosis. Other
      clinical and biochemical variables and antimicrobial therapy before admission to
      hospital and the presence of underlying disease were not associated with outcome.

PMID- 1615787
TI  - Hypothesis: age-associated changes in gait represent, in part, a tendency towards
      parkinsonism.
AB  - In 144 healthy, active, asymptomatic volunteers (aged 30-88 years), age explained
      33% of the variance in free walking speed. This could not be ascribed simply to
      differences in physique at maturity, since height had a more important effect on
      speed (p less than 0.0001) than did leg length (p less than 0.01). Multiple
      linear regression was used to fit models for speed, by selection from four sets
      of variables: common physical, body sway, functional anatomy of spine and lower
      limbs, and psychometric. The best model (which included age) explained little
      more of the variance (41%) than did age alone. Moreover, incorporation of age
      into the alternative model, built in its absence, still contributed significantly
      (p less than 0.0001) to the variance explained. The effect of age on gait
      appeared to be complex, with an increment in double support time disproportionate
      to the reduction in speed. We formulate by exclusion, the hypothesis that age
      associated changes in gait represent, in part, a tendency towards parkinsonism.

PMID- 1615788
TI  - 'Eye tests' and elderly people.

PMID- 1615789
TI  - Medications, fallers and non-fallers.

PMID- 1615790
TI  - Management and immediate outcome of patients with intracoronary thrombus during
      percutaneous transluminal coronary angioplasty.
AB  - A retrospective analysis of our experience with intraprocedural thrombus
      complicating percutaneous transluminal coronary angioplasty (PTCA) was
      undertaken. Of 983 PTCA procedures reviewed, 62 (6.3%) were complicated by
      thrombus. Patients were managed conservatively (group I, n = 18), with redilation
      (group II, n = 17), or with intracoronary urokinase and redilation (group III, n
      = 27). The three groups did not differ with respect to demographic or baseline
      angiographic variables, but complications, defined as death, myocardial
      infarction, bypass surgery, or threatened occlusion requiring emergency stenting,
      occurred in 11% of patients in group I, 24% in group II, and 48% in group III.
      Occlusive thrombus behavior was observed in 80% of these 62 patients. Patients
      with complications were less likely to have received antecedent antiplatelet
      therapy (79% vs 95% of patients without complications), had more complex baseline
      lesion morphology, more often had thrombus present at baseline (42% vs 19%), and
      more often had a low activated clotting time at the start of PTCA (53% vs 8%).
      Thrombi that led to complications more frequently exhibited occlusive behavior
      before therapy was begun (95% vs 71%) and more often occurred in the setting of
      intimal dissection (42% vs 14%). Patients undergoing PTCA at the time of
      diagnostic catheterization were more likely to have complications than those in
      whom PTCA was delayed. A successful outcome was more likely (83% vs 27%, p =
      0.03) in group III if at least 140,000 U of urokinase were administered within 50
      minutes of the appearance of thrombus. Thus intracoronary thrombus formation
      during PTCA remains a significant source of morbidity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1615791
TI  - Effects of acute and prolonged administration of propafenone on internal
      defibrillation in the pig.
AB  - Some antiarrhythmic sodium channel blocking drugs have been found to increase the
      energy necessary for internal defibrillation. Propafenone is a new drug that has
      been shown to be efficacious in the therapy of supraventricular and ventricular
      arrhythmias, and is of potential use in patients with defibrillators. The effects
      of short-term and prolonged propafenone administration on the internal
      defibrillation threshold (DFT) were determined in 43 pigs randomized to one of
      four groups: saline infusion (n = 10); propafenone infusion (n = 10); placebo
      administration for 8 days (n = 10); or propafenone administration for 8 days (n =
      13). Two mesh electrodes were sutured on the right lateral and left lateral
      epicardial surface and current was delivered from the right electrode to the left
      electrode. Triplicate DFTs were obtained before and at 40 and 80 minutes after
      infusion of drug or placebo. In pigs receiving long-term administration, after
      baseline DFTs were obtained the electrodes were removed and the chest was closed.
      Following 8 days of drug or placebo administration, DFTs were redetermined. No
      changes were observed in the short- or long-term control groups. DFTs were lower
      after propafenone administration: either short-term infusion (20 +/- 6.2 joules
      at baseline; 15.6 +/- 5 joules at 40 minutes, p less than 0.05; 10.2 +/- 6 joules
      at 80 minutes, p less than 0.001) or long-term administration (17.8 +/- 2.6
      joules at baseline versus 12 +/- 3.2 joules on drug, p less than 0.002).
      Decreased ventricular cycle lengths were found with acute administration of
      propafenone. Three pigs died during long-term administration of
      propafenone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615792
TI  - Flecainide single oral dose for management of paroxysmal supraventricular
      tachycardia in children and young adults.
AB  - The efficacy of a single oral dose of flecainide to terminate paroxysmal
      supraventricular tachycardia (PSVT) was evaluated in 25 children and young
      adults. The subjects were selected from a group of 35 patients with recurrent
      attacks of PSVT evaluated by means of electrophysiologic study and intravenous
      electropharmacologic testing with flecainide. In all 25 patients the induced PSVT
      was stopped by intravenous flecainide and was then no longer inducible or
      nonsustained. All patients had normal hearts. At least 48 hours after acute
      intravenous testing, 25 patients underwent electrophysiologic study with a
      transesophageal catheter and PSVT was induced in all of them: atrioventricular
      reentrant tachycardia in 16 and atrioventricular nodal reentrant tachycardia in
      nine. During stable tachycardia, a single oral dose of flecainide (2.9 +/- 0.3
      mg/kg; 2.5 to 3.3 mg/kg) was administered. This approach was effective for
      termination of PSVT in 22 patients. The mean plasma level of flecainide at
      cessation of tachycardia was 277 +/- 92 ng/ml (150 to 500 mg/ml). All 22 patients
      who responded were given a single oral dose of flecainide for recurrences of PSVT
      during follow-up. During a period of 12 +/- 7 months (2 to 27 months) a total of
      134 spontaneous episodes of PSVT were reported, and 127 of these episodes were
      terminated with periodic management. Thus oral periodic flecainide seems useful
      for management of PSVT in selected patients.

PMID- 1615793
TI  - Risk assessment in nonischemic ventricular arrhythmia by left and right
      ventriculography.
AB  - Ventricular fibrillation and sudden death are rare phenomena in nonischemic
      ventricular arrhythmia, particularly in arrhythmogenic right ventricular
      cardiomyopathy. In most instances electrophysiologic studies help to assess the
      risk of sudden death, but sometimes programmed ventricular stimulation is
      unsuccessful. Among 48 patients with ventricular fibrillation (n = 9) and
      sustained (n = 25) and nonsustained (n = 19) ventricular tachycardia, invasive
      and noninvasive diagnostic tests (coronary angiography, biventricular
      angiography, programmed ventricular stimulation, and echocardiography) were
      performed to obtain more information about the underlying heart disease. In 43
      patients (90%) arrhythmogenic right ventricular cardiomyopathy was diagnosed with
      segmental hypokinesia (n = 31) and diffuse hypokinesia (n = 12) of the right
      ventricle. In patients with documented ventricular fibrillation, the right
      ventricular ejection fraction was lower (30.8% vs 47.8% and 45.9%, respectively)
      and multisegmental contraction impairment of the right ventricle was
      significantly more frequent (p less than 0.001). Additional left ventricular
      abnormalities and right ventricular dilatation were not significant parameters
      for identifying high-risk patients. In addition to programmed ventricular
      stimulation, quantitative analysis of the results of right and left ventricular
      angiography contributes to risk assessment in patients with nonischemic
      ventricular arrhythmia.

PMID- 1615794
TI  - Significance of aborted cardiac arrest and sustained ventricular tachycardia in
      patients referred for treatment therapy of advanced heart failure.
AB  - Cardiac arrest in patients with heart failure may be the result of remediable
      factors such as pulmonary edema, drug toxicity, or electrolyte abnormalities, or
      it may be due to primary arrhythmias. The relation of prior aborted cardiac
      arrest or sustained ventricular tachycardia to subsequent prognosis was assessed
      in 458 consecutive patients referred for management of advanced heart failure
      (left ventricular ejection fraction 0.2 +/- 0.07). All patients received tailored
      vasodilator and diuretic therapy and were then followed as outpatients. Patients
      were divided into four groups: 388 patients (85%) with no prior cardiac arrest or
      sustained ventricular tachycardia, 31 patients (7%) with a primary arrhythmia
      cardiac arrest, 22 patients (5%) with a secondary cardiac arrest, and 17 patients
      (4%) with sustained ventricular tachycardia without cardiac arrest. Patients with
      cardiac arrest resulting from a primary arrhythmia were usually treated with
      antiarrhythmic drugs (25 patients), and five patients received an implantable
      defibrillator. After hospital discharge actuarial 1-year sudden death risk (17%)
      and total mortality (24%) rates for the group with primary arrhythmia were
      similar to corresponding values in patients with no history of cardiac arrest or
      sustained ventricular tachycardia (17% and 30%, respectively). In patients with a
      secondary cardiac arrest as a result of exacerbation of heart failure (11
      patients), torsade de pointes (10 patients), or hypokalemia (one patient),
      therapy focused on removal of aggravating factors. Actuarial 1-year sudden death
      (39%) and total mortality (54%) rates for the group with secondary arrest were
      higher than for patients without a history of cardiac arrest (p = 0.003 and
      0.005, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615795
TI  - Coronary angioplasty in patients eighty years of age or older.
AB  - Percutaneous transluminal coronary angioplasty (PTCA) was performed on 58 lesions
      in 53 patients 80 years of age or older with unstable angina. Most patients had
      previous myocardial infarction, abnormal left ventricular contraction patterns,
      and multivessel coronary disease. In most (48) patients only one vessel was
      dilated. PTCA was successful in 48 (82.8%) lesions, but complications were
      frequent. Eight patients died, six after anatomically successful PTCA (three with
      cardiac complications, two with noncardiac complications, and one with both
      cardiac and noncardiac complications). Two patients died after unsuccessful PTCA
      (one of cardiac complications and one of noncardiac complications), and 11
      patients with PTCA were alive with significant complications (all noncardiac).
      Twenty-nine patients had successful PTCA with no complications; 40 (74.5%)
      patients were discharged with clinically successful PTCA. It is concluded that
      PTCA is feasible in patients 80 years of age or older but that both cardiac and
      noncardiac complications are common in this group of very fragile patients.

PMID- 1615796
TI  - Determinants of the renal response to ACE inhibition in patients with congestive
      heart failure.
AB  - The objective of the present study was to determine whether pretreatment
      neurohormonal and renal hemodynamic parameters predict the change in renal
      function with the administration of quinapril, a new angiotensin-converting
      enzyme (ACE) inhibitor. Twenty patients with New York Heart Association (NYHA)
      class III and IV heart failure were evaluated. Following pretreatment
      determination of renal function and plasma neurohormones, patients were treated
      daily with 10 mg of quinapril. Measurements of glomerular filtration rate (GFR)
      and renal plasma flow (RPF) were repeated after 7 weeks to assess changes in
      function (delta GFR and delta RPF). Mean GFR increased from 49 +/- 6 to 56 +/- 7
      ml/min/1.73 m2 (p = 0.10), but decreased in five patients. Mean RPF increased
      from 235 +/- 23 to 252 +/- 23 ml/min/1.73 m2 (p = 0.08), but decreased in five
      patients. There was no relation between delta GFR and baseline determinations of
      GFR, RPF, plasma renin activity, plasma angiotensin II, or serum Na. Only a high
      filtration fraction (GFR/RPF) predicted a decreased GFR (r = 0.61, p less than
      0.005). In contrast, no baseline renal hemodynamic parameter correlated with
      delta RPF. We conclude that poor renal function does not increase the risk of
      renal deterioration with quinapril. However, dependence of renal function upon
      the renin-angiotensin system may be predicted by a high filtration fraction.

PMID- 1615798
TI  - Abnormalities of diastolic filling of the left ventricle associated with aging
      are less pronounced in exercise-trained individuals.
AB  - To determine whether exercise training has an effect on left ventricular
      diastolic dysfunction associated with the normal aging process, we studied a
      group of 20 normal healthy adult distance runners (mean miles currently run per
      week was 45 for an average of 15 years) and 20 normal healthy sedentary
      individuals (who currently walk less than 1 mile per day and are not involved in
      a regular exercise program) matched for age and systolic and diastolic blood
      pressure with the runners. Doppler echocardiographic indices of left ventricular
      diastolic filling were significantly different between the two groups. The
      exercise group when compared with the sedentary group had significantly decreased
      late diastolic peak filling velocity (0.51 +/- 0.11 m/sec versus 0.66 +/- 0.20
      m/sec; p = 0.003), late diastolic velocity-time integral (5.2 +/- 1.5 cm versus
      6.6 +/- 2.2 cm; p = 0.02), increased early-to-late peak filling velocity ratio
      (1.29 +/- 0.38 versus 0.96 +/- 0.24; p = 0.001), and early-to-late velocity-time
      integral ratio (2.08 +/- 0.51 versus 1.42 +/- 0.47; p less than 0.001). We
      conclude that the left ventricular diastolic dysfunction associated with "normal"
      aging is less pronounced in those persons who are exercise-trained.

PMID- 1615797
TI  - Reduced pulmonary microvascular permeability in severe chronic left heart
      failure.
AB  - Pulmonary edema is a serious complication of heart failure, but often patients
      with chronic heart failure resist pulmonary edema despite elevated pulmonary
      venous pressures. This protection might be a result of decreased pulmonary
      microvascular permeability. Double-isotope scintigraphy with 113mindium-labeled
      transferrin and 99mtechnetium-labeled erythrocytes allows noninvasive estimation
      of pulmonary microvascular permeability; an index of transferrin accumulation is
      calculated that reflects microvascular permeability. Fourteen patients with
      severe chronic left ventricular dysfunction were compared with a control group of
      15 patients with mild coronary artery disease. In the control group the
      transferrin accumulation index was 0.35 (range -0.3 to 1.0) x 10(-3)/min, and in
      patients with heart failure the index was 0.0 (range -1.0 to 0.7) x 10(-3)/min,
      which was significantly lower (p less than 0.01). The reduction in the
      transferrin accumulation index correlated weakly with the duration of heart
      failure (R = -0.5, p less than 0.02). These data indicate reduced protein efflux
      consistent with a decrease in pulmonary microvascular permeability in patients
      with severe chronic heart failure. Similar changes have been observed in severe
      mitral stenosis and may reflect a generalized adaptation to chronic pulmonary
      venous hypertension.

PMID- 1615799
TI  - Risk factors for systemic embolism in patients with paroxysmal atrial
      fibrillation.
AB  - The purpose of this study was to define the risk factors for systemic embolism in
      patients with recently diagnosed paroxysmal atrial fibrillation. We therefore
      studied 63 consecutive patients with symptomatic nonvalvular paroxysmal atrial
      fibrillation and performed a clinical and noninvasive cardiac, peripheral
      vascular, and neurologic evaluation that included two-dimensional
      echocardiography, 24-hour Holter monitoring, and computed tomographic brain scan.
      Patients with predisposing clinical conditions for systemic embolism (valvular
      heart or coronary artery disease) or paroxysmal atrial fibrillation (sick sinus
      disease, preexcitation, or thyroid dysfunction) were excluded. At entry 34
      patients had idiopathic paroxysmal atrial fibrillation and 29 had hypertension.
      Fourteen patients had a recent systemic embolic complication: nine had a recent
      occlusive nonlacunar cerebrovascular accident, two had transient ischemic
      attacks, and three had peripheral systemic emboli that required surgery. In
      addition, five patients had evidence of old cerebrovascular accident on the
      computed tomographic scan (group 1). Forty-four patients had no systemic embolism
      (group 2). Results of univariate analysis showed that patients in group 1 were
      older (72 +/- 9 vs 63 +/- 13 years, p less than 0.05), had a higher incidence of
      hypertension (70% vs 35%, p less than 0.01), and had an increased left atrial
      diameter (4.1 +/- 0.7 vs 3.6 +/- 0.5 cm, p less than 0.05). Multiple stepwise
      logistic regression analysis showed that a history of hypertension and left
      atrial enlargement on two-dimensional echocardiography were significant
      independent risk factors for systemic embolism in patients with symptomatic
      nonvalvular paroxysmal atrial fibrillation.

PMID- 1615800
TI  - Ten-year experience with mitral valve replacement in the elderly.
AB  - Limited data are available on mitral valve replacement in the elderly patient.
      Therefore we report our 10-year experience including predictors of perioperative
      mortality and subsequent long-term cardiac mortality in elderly patients with
      mitral valve replacement compared to younger patients. Of the 126 consecutive
      patients with mitral valve replacement, 26 were older (77 +/- 4, group 1) and 100
      were younger (62 +/- 9, group 2) than 70 years. Bioprostheses were used more
      frequently in patients in group 1 (65% vs 7%, p less than 0.0001). Of the 21
      clinical, ECG, hemodynamic, and angiographic variables studied, patients in group
      1 had higher pulmonary artery systolic pressure (57 +/- 15 vs 48 +/- 19, p less
      than 0.05), fascicular block on ECGs (70% vs 33%, p less than 0.005), and greater
      pump time on cardiopulmonary bypass (160 +/- 75 vs 120 +/- 50 minutes, p less
      than 0.025). A trend toward a higher perioperative mortality rate was also seen
      in group 1 (27% vs 12%, p = 0.058). Predictors of perioperative mortality by
      multivariate analysis were the presence of aortic calcification and prolonged
      pump time on cardiopulmonary bypass in group 1 and coronary artery disease,
      female sex, elevated mean pulmonary artery pressure, and postoperative complete
      atrioventricular block in group 2. During a mean 4-year follow-up period, cardiac
      mortality and total mortality rates were 42% and 54%, respectively, for group 1
      compared to 24% and 35%, respectively, for group 2.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1615801
TI  - Factors influencing immediate results, complications, and short-term follow-up
      status after Inoue balloon mitral valvotomy: a North American multicenter study.
AB  - Clinical trials with the Inoue mitral valvotomy balloon have recently begun in
      the United States. We assessed the effects of 17 demographic, echocardiographic,
      procedural, and hemodynamic variables on the immediate results, complications,
      and short-term follow-up of 200 patients in 15 centers undergoing valvotomy with
      this device. The study population had a mean age +/- SD of 53 +/- 15 years, and
      the total echocardiographic score was 7.2 +/- 2.4. Valvotomy was technically
      successful in 96.5% of procedures and increased the mean mitral valve area from
      1.0 +/- 0.3 to 1.8 +/- 0.7 cm2 (p less than 0.001); 72% had an increase in valve
      area greater than or equal to 50%, and 67% had a final area greater than or equal
      to 1.5 cm2. Major procedural complications included cardiac tamponade during
      transseptal puncture (1.0%), systemic embolism (1.5%), and severe mitral
      regurgitation (2.4%); there were no procedural deaths and one hospital death.
      Multivariate analysis identified the absence of prior surgical commissurotomy and
      younger age as significant predictors of the gain in mitral valve area, but the
      correlation coefficients were low. Although the absence of subvalvular disease on
      echocardiograms was a predictor of a final valve area greater than or equal to
      1.5 cm2, the total echocardiographic score did not correlate well with the
      immediate outcome (r = 0.01, p = NS). No variable was identified as predictive of
      restenosis, which occurred according to echocardiographic criteria in 14 of 66
      (21%) patients evaluated 6 months after valvotomy. Good hemodynamic results with
      valvotomy were achieved in the majority of patients with low complication rates
      by many investigators with the use of the Inoue balloon device.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1615802
TI  - Echocardiographic estimation of balloon-stretched diameter of secundum atrial
      septal defect for transcatheter occlusion.
AB  - Stretched diameter of the atrial septal defect (ASD), determined by balloon
      sizing at cardiac catheterization, is commonly used to select the sizes of the
      devices used for transcatheter closure of the secundum ASD. We have previously
      evaluated the utility of pulmonary/systemic flow ratio and angiographic and
      echocardiographic (echo) sizes of the ASD in estimating stretched ASD diameter in
      a group of 16 patients and determined that echo diameter had the best correlation
      with stretched diameter (r = 0.82; p less than 0.001). The stretched diameter can
      be estimated: 1.05 x echo diameter in millimeters + 5.49. In this study we have
      prospectively evaluated this formula in estimating the stretched ASD diameter by
      two-dimensional echo measurements obtained in two (long and short-axis) subcostal
      views in another group of 21 patients aged 2.5 to 29 years (median 4.5 years).
      The echo size of the ASD was 9.7 +/- 3.0 mm, whereas the measured stretched
      diameter was 15.3 +/- 4.0 mm. The predicted stretched ASD diameter was calculated
      according to the above formula and was 15.7 +/- 3.1 mm, not significantly
      different (p greater than 0.1) from the measured stretched diameter. The
      correlation between predicted and measured stretched ASD sizes was excellent (r =
      0.9; p less than 0.001). The mean squared error was 2.4. The differences between
      measured and predicted values were within 2 mm in all but three patients. It is
      concluded that stretched ASD diameter can be estimated accurately by two
      dimensional subcostal echo measurements, which in turn could be used for
      selection of device size for occlusion of the ASD.

PMID- 1615803
TI  - Noninvasive evaluation of interventricular pressure gradient across ventricular
      septal defect: a simultaneous study of Doppler echocardiography and cardiac
      catheterization.
AB  - Simultaneous continuous-wave Doppler echocardiography and left- and right-sided
      cardiac pressure measurements were performed during cardiac catheterization in 64
      patients with a congenital ventricular septal defect (VSD). The peak-to-peak
      pressure gradient across the VSD on cardiac catheterization ranged from 0 to 109
      mm Hg (61 +/- 31.7 mm Hg). The peak shunt velocity and peak pressure gradient
      across the VSD on Doppler ultrasound imaging ranged from 0.96 to 5.21 m/sec (3.75
      +/- 1.16 m/sec) and from 4 to 105 mm Hg (62 +/- 29.8 mm Hg), respectively.
      Doppler measurements of the peak interventricular pressure gradient correlated
      well with measurements obtained by cardiac catheterization (r = 0.98, standard
      error of estimate = 6.3 mm Hg, p less than 0.001). Doppler ultrasound imaging
      yielded information comparable to that obtained by catheterization and provided
      an accurate method of measuring the pressure gradient across the VSD, which is a
      useful parameter for the assessment of pulmonary artery systolic pressure in
      patients with a VSD, without a left or right ventricular outflow tract
      obstruction.

PMID- 1615804
TI  - Recurrent myocardial ischemia following thrombolytic therapy: guidelines for
      practicing clinicians.
AB  - The natural history of patients with acute myocardial infarction treated with
      thrombolytic therapy includes two distinct phases: the initial or acute phase is
      characterized pathologically by atheromatous plaque rupture and thrombotic
      coronary arterial occlusion, and clinically by the abrupt onset of symptoms.
      Prompt restoration of coronary blood flow and myocardial reperfusion during this
      phase, achieved in a majority of patients given thrombolytic therapy, limits
      myocardial necrosis, preserves ventricular function, and lowers mortality.
      Although the thrombus can be pharmacologically removed, an unstable anatomic
      substrate persists. Therefore following thrombolytic therapy, a subacute phase
      occurs, during which patients are at risk for recurrent ischemic events. More
      than a theoretical concept, experience has shown that recurrent ischemia and
      reinfarction develop in 20% to 30% and 5% of patients, respectively. Morbidity
      and mortality are elevated considerably in these patients, dictating an
      aggressive diagnostic and treatment approach.

PMID- 1615805
TI  - Significance of preinfarction angina for preservation of left ventricular
      function in acute myocardial infarction.
AB  - The effect of preinfarction angina on the preservation of left ventricular
      function was evaluated with the use of cineventriculography in 37 patients who
      had either total or subtotal occlusion of the proximal left anterior descending
      coronary artery during the convalescent period of myocardial infarction. In 15
      patients who had preinfarction angina more than 1 week before the onset of acute
      myocardial infarction (group A), the global left ventricular ejection fraction
      was 54 +/- 3% (SEM) and regional wall motion in the infarct area was 10 +/- 3%.
      In 10 patients who had preinfarction angina occurred within 1 week before the
      onset of acute myocardial infarction (group B), the left ventricular ejection
      fraction and regional wall motion in the infarct area were 42 +/- 3% and 1 +/-
      2%, respectively. In 12 patients without preinfarction angina (group C), the left
      ventricular ejection fraction and regional wall motion in the infarct area were
      38 +/- 3% and -1 +/- 2%, respectively. In groups B and C, both the left
      ventricular ejection fraction and regional wall motion in the infarct area were
      lower than those in group A (p less than 0.05). The collateral circulation at the
      onset of acute myocardial infarction was better in group A compared with groups B
      and C (p less than 0.05). Thus the collateral circulation, promoted by repetitive
      anginal episodes indicative of myocardial ischemia, causes the preservation of
      myocardial function.

PMID- 1615806
TI  - Atherosclerotic saphenous vein grafts treated with different interventional
      procedures assessed by intravascular ultrasound.
AB  - Intravascular ultrasound imaging of saphenous vein grafts may enhance the
      angiographic interpretation of results following transcatheter interventions. We
      used intravascular ultrasound to study 18 patients with stenotic vein grafts
      following balloon angioplasty, atherectomy, or stent placement. In real-time
      imaging the three-layer appearance was rarely seen, calcification was infrequent
      (11% of patients), and atheroma were usually mildly echogenic ("soft"). Despite
      excellent angiographic results (reduction in percent diameter stenosis from 90 +/
      8% to 17 +/- 8%) and concordant improvement in lumen area by ultrasound
      regardless of the intervention, there was usually significant retained atheroma
      at the treatment site. Following balloon angioplasty, ultrasound showed multiple
      superficial fissures and fractures without discrete dissections. Atherectomy
      caused a smooth lumen surface without deep dissections or resections, but
      significant retained atheroma was observed with each one of the atherectomy
      procedures. Endovascular stents were concentric in the vein with reflective
      struts above compressed atheroma and an outer echogenic adventitia. Stent
      expansion was asymmetric axially and longitudinally and evidence of stent recoil
      was present. Thus intravascular ultrasound may be an important adjunct to
      angiography in characterizing postintervention results in saphenous vein grafts.

PMID- 1615807
TI  - The white blood cell count and risk for coronary heart disease.
AB  - In conclusion, the WBC count has been demonstrated in several epidemiologic
      studies to be a strong independent predictor of future coronary heart disease.
      Although it is not possible at this point in time to be certain that the elevated
      WBC count is a cause rather than a consequence of ischemic heart disease, recent
      pathophysiologic studies suggest that the white blood cell, in particular the
      neutrophil, is instrumental in the pathogenesis of myocardial ischemia. It is
      conceivable that patients who develop acute myocardial ischemia have abnormal
      leukocyte function before the onset of the acute event, which provides a
      pathophysiologic milieu for the progression of the atherosclerotic process.
      Future research must focus on further elucidation of the properties of WBCs and
      clarification of the role of the activated neutrophil in the process of vascular
      injury. Quantitative and qualitative changes in leukocyte function may have
      important implications in the development of CHD.

PMID- 1615808
TI  - Combined rotational and directional atherectomy guided by intravascular
      ultrasound in an occluded vein graft.

PMID- 1615809
TI  - Angioplasty in a child with Kawasaki disease.

PMID- 1615810
TI  - Coronary heart disease in young age associated with essential thrombocythemia.

PMID- 1615811
TI  - Anomalous origin of the left coronary artery from the pulmonary artery: report of
      an adult with ventricular fibrillation as the presenting symptom.

PMID- 1615812
TI  - The ligamentum arteriosum: an unreported origin of peripheral emboli diagnosed by
      transesophageal echocardiography.

PMID- 1615813
TI  - Aortic endocarditis after percutaneous balloon valvuloplasty: the role of
      transesophageal echocardiography in early detection and follow-up.

PMID- 1615814
TI  - Unruptured sinus of Valsalva aneurysm diagnosed by transesophageal
      echocardiography.

PMID- 1615815
TI  - Primary malignant mesothelioma of the pericardium.

PMID- 1615816
TI  - Low-dose calcium pretreatment to prevent verapamil-induced hypotension.

PMID- 1615817
TI  - Cocaine-induced bradyarrhythmias.

PMID- 1615818
TI  - Peaks of QTc lengthening measured in Holter recordings as a marker of life
      threatening arrhythmias in postmyocardial infarction patients.

PMID- 1615819
TI  - QT prolongation with torsade de pointes in pheochromocytoma.

PMID- 1615820
TI  - Multiple emboli from a large aortic arch thrombus in a patient with thrombotic
      diathesis.

PMID- 1615821
TI  - Serial documentation of changes in a mitral valve vegetation progressing to
      abscess rupture and fistula formation by transesophageal echocardiography.

PMID- 1615822
TI  - Congenital isolated pulmonary valve incompetence: neonatal presentation and early
      natural history.

PMID- 1615823
TI  - The role of exercise testing for evaluating patients with unstable angina.

PMID- 1615824
TI  - Cardiac emergencies at a major international airport: a prospective observational
      study.

PMID- 1615825
TI  - Statistical analysis of clinical risk factors for coronary artery spasm:
      identification of the most important determinant.
AB  - Coronary artery spasm plays an important role in acute ischemic events, and it
      has a close relationship with coronary atherosclerosis. Thus we attempted to
      determine the most significant risk factor for coronary artery spasm. Among 3000
      consecutive patients who underwent coronary cineangiography with ergonovine
      maleate testing, 330 with typical angina pectoris (group 1) and 294 with old
      myocardial infarction (group 2) were studied. We divided each group into three or
      four subgroups according to the presence of fixed organic stenosis (FOS+) or a
      positive reaction to ergonovine maleate (coronary artery spasm [CAS]+). We
      examined the relationship between coronary artery spasm and eight coronary risk
      factors: age, sex, hypertension, diabetes mellitus, smoking, and serum
      cholesterol, uric acid, and high-density lipoprotein cholesterol levels. The
      proportion of smokers in the subgroups with CAS(+) was significantly higher than
      in the subgroups with CAS(-)(p less than 0.01). There was no correlation between
      smoking and fixed organic stenosis. According to the results of multiple
      regression analysis, there was a positive correlation between smoking and CAS(+)
      and between serum high-density lipoprotein cholesterol levels and CAS(+)(p less
      than 0.01). Thus we concluded that smoking is the most significant risk factor in
      discriminating between patients with and without coronary artery spasm.

PMID- 1615826
TI  - Induction of coronary artery spasm by intracoronary acetylcholine: comparison
      with intracoronary ergonovine.
AB  - To investigate the mechanism of coronary spasm, we compared the action of
      acetylcholine with that of ergonovine in 11 patients with vasospastic angina
      (group 1) and in 15 patients with chest pain (group 2). Coronary arteriography
      was performed immediately after the patients received intracoronary injections of
      titrated increments of each agent. In the patients in group 1 occlusive or near
      occlusive (99% luminal narrowing) coronary spasm associated with angina and
      ischemic electrocardiographic ST changes was noted in nine of 11 patients
      receiving acetylcholine and in all 11 patients receiving ergonovine. The region
      and the degree of the most severe coronary spasm on coronary arteriograms evoked
      by the two agents were the same in nine of the 11 patients in group 1. In the
      other two patients in group 1, spontaneous focal coronary spastic stenosis in the
      baseline coronary arteriogram was relieved by the intracoronary injection of
      acetylcholine, and a focal coronary occlusive spasm in the same region was
      induced repeatedly by the subsequent intracoronary injection of ergonovine
      (paradoxic phenomenon). In contrast, occlusive or near-occlusive coronary spasm
      was not induced by either agent in any patient in group 2. These results suggest
      that the two provocative tests for coronary spasm that involve acetylcholine and
      ergonovine are clinically useful in the diagnosis of vasospastic angina, but
      testing with intracoronary ergonovine is needed when a spontaneous focal coronary
      spasm is relieved by the intracoronary injection of acetylcholine. The results
      also indicate that in many patients with vasospastic angina, nonspecific
      hypersensitivity to acetylcholine or ergonovine in a definite region of the
      coronary arteries generally plays an important role in the induction of coronary
      spasm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615827
TI  - Coronary collaterals reduce the duration of exercise-induced ischemia by allowing
      a faster recovery.
AB  - The role of collaterals in influencing postischemic recovery after exercise
      testing has not been investigated previously. We studied 54 patients (mean age 59
      +/- 6 years) with effort-induced angina and documented coronary disease who
      underwent exercise testing and thallium-201 myocardial scintigraphy. On
      angiography, 30 patients (group A) exhibited visible collaterals (grade 2 to 3,
      Cohen and Rentrop classification) perfusing the ischemic zone, whereas the other
      24 (group B) did not. Patients with collaterals had more severe coronary artery
      disease (Gensini score 46.9 +/- 16 vs 28.6 +/- 18; p less than 0.001) and more
      severe impairment of coronary flow reserve (time and rate-pressure product to 1
      mm ST segment depression 3.5 +/- 0.8 vs 4.8 +/- 0.6 minutes, p less than 0.01;
      14,189 +/- 2451 vs 16,081 +/- 2215 beats/min x mm Hg, p less than 0.04,
      respectively). However, in these patients the ECG returned to baseline more
      rapidly after exercise (5.5 +/- 1.6 vs 11.7 +/- 3.3 minutes; p less than 0.001).
      Therefore, although collaterals do not apparently prevent or delay the
      development of exercise-induced ischemia, they can limit its duration by allowing
      a faster recovery.

PMID- 1615828
TI  - Effects of intracoronary dipyridamole infusion on regional myocardial blood flow
      and intrinsic thallium-201 washout in dogs with a critical coronary stenosis.
AB  - Intravenous dipyridamole (DP) infusion produces a significant endocardial-to
      epicardial flow gradient distal to a critical coronary stenosis, resulting in
      diminished regional thallium-201 (Tl-201) uptake and washout. Intravenous DP can
      also produce a significant decrease in arterial blood pressure and therefore in
      coronary perfusion pressure. We determined to further clarify the mechanism of
      this transmural coronary "steal" employing intracoronary DP administration,
      thereby avoiding systemic hypotension. In five of eight dogs with a critical left
      anterior descending (LAD) stenosis, intracoronary DP caused no significant fall
      in systemic arterial pressure, a rise in epicardial flow from 1.15 +/- 0.2 to
      1.75 +/- 0.2 ml/min/gm, and a slight fall in subendocardial flow from 1.15 +/-
      0.2 to 1.03 +/- 0.5 ml/min/gm. Intracoronary DP caused no prolongation of the
      intrinsic Tl-201 washout rate. In three dogs that developed systemic hypotension
      after intracoronary DP, endocardial flow fell from 1.14 to 0.63 ml/min/gm, the
      epicardial/endocardial flow ratio fell to 0.35, and Tl-201 washout became more
      prolonged. Thus intracoronary DP in the setting of a critical LAD stenosis caused
      minimal endocardial-to-epicardial steal and had no effect on the intrinsic Tl-201
      washout rate unless it was accompanied by a fall in systemic arterial pressure.
      The magnitude of the transmural steal was substantially less than reported in our
      previous experiments utilizing intravenous DP infusion. This study provides a
      further insight into the mechanism of DP-induced subendocardial ischemia and
      suggests that systemic hemodynamic alterations play an important role in the
      effects of the vasodilator on myocardial blood flow and Tl-201 kinetics.

PMID- 1615829
TI  - Analysis of thallium-201 single-photon emission computed tomography after
      intravenous dipyridamole using different quantitative measures of coronary
      stenosis severity and receiver operator characteristic curves.
AB  - The presence of significant coronary artery disease in individual vessels was
      assessed using thallium-201 single-photon emission computed tomography (SPECT)
      after intravenous dipyridamole. Coronary angiograms were analyzed using
      quantitative computer-assisted techniques in 81 men patients. Eleven men with a
      less than 3% probability of coronary artery disease were used as a control
      population. Three definitions of a hemodynamically significant coronary stenosis
      were studied independently: (1) a greater than 50% luminal diameter narrowing;
      (2) an absolute cross-sectional area less than or equal to 2.0 mm2; or (3) a
      greater than or equal to 70% cross-sectional area obstruction. Myocardial
      perfusion after dipyridamole was analyzed using the quantitative (polar map)
      method in 213 regions from the group with known coronary anatomy and using 33
      regions from the group with a low likelihood of disease. Receiver operating
      characteristic curves were used to define the best cut-off point for the
      discrimination between normal and abnormal perfusion. When related to each of the
      three quantitative angiographic criteria, the optimum balance between sensitivity
      and specificity occurred at a defect size of greater than or equal to 8% for the
      left anterior descending artery, greater than or equal to 4% for the circumflex
      artery, and greater than 0% for the right coronary artery. Using a luminal
      diameter narrowing of greater than 50% to define the presence of significant
      coronary artery disease, these corresponded to respective sensitivities and
      specificities of 0.82 and 0.76 for the left anterior descending artery, 0.71 and
      0.71 for the circumflex artery, and 0.76 and 0.82 for the right coronary artery.
      Thus analysis of receiver operator characteristic curves provides a means to
      define abnormalities for the SPECT polar map program after dipyridamole stress.
      Different definitions of coronary stenosis significance as determined by
      quantitative angiography did not substantially alter the results of the thallium
      imaging data and thus suggest that these definitions are functionally similar.

PMID- 1615830
TI  - Relationship between exercise echocardiography and perfusion single-photon
      emission computed tomography in patients with single-vessel coronary artery
      disease.
AB  - The aim of this study was to assess the relative value of exercise
      echocardiography and perfusion single-photon emission computed tomography (SPECT)
      in identifying the presence and severity of coronary artery stenosis.
      Accordingly, 44 consecutive patients with stenosis in one vessel performed
      simultaneous postexercise echocardiography and perfusion SPECT (with either
      thallium-201 [n = 19] or 99m-Tc-methoxyisobutyl isonitrile [n = 25]) in
      conjunction with symptom-limited bicycle exercise testing. Positive test results
      were based on the presence of new or worsened exercise-induced wall motion
      abnormalities and transient perfusion defects, respectively. Moreover, an
      "ischemic" score index was derived for semiquantitative assessment of both
      echocardiography (with a 14-segment model of left ventricular wall on a 4-point
      scale) and SPECT (47-segment model on a 5-point scale). All patients underwent
      correlative coronary arteriography, assessed by digital caliper. Significant
      coronary artery disease (diameter stenosis greater than or equal to 50%) was
      present in 30 patients. There was a good overall concordance between the two
      tests in terms of result (79%); compared with patients with positive results of
      both tests, in the seven patients with positive SPECT and negative
      echocardiography the time of recording echocardiographic images was longer (p =
      0.05). When analyzing patients according to the percent diameter stenosis
      (greater than 70%, 50% to 70%, and less than 50%) for both echocardiography and
      SPECT, the prevalence of an ischemic response was directly related to the
      severity of the coronary stenosis (p less than 0.001); moreover, a negative test
      result was highly predictive of a diameter coronary stenosis less than
      70%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615831
TI  - Ventricular tachycardia after infarction: sources of coronary blood flow to the
      infarct zone.
AB  - The purpose of this study was to determine the sources of coronary blood flow to
      infarct scars in patients with sustained ventricular tachycardia occurring late
      after myocardial infarction, which is necessary for transcoronary sclerosis or
      embolization. Angiograms of 32 consecutive patients (age 63 +/- 8 years, ejection
      fraction 0.30 +/- 0.10) were reviewed. Sources of blood flow to the infarct zone
      were identified as coming from a recanalized infarct-related artery, side branch,
      collateral, or coronary bypass graft. Eighty-four percent of patients in the
      study had an identifiable blood supply to the area of previous infarction. More
      than one source of blood flow to anterior infarct locations were observed more
      often than to inferior infarct locations (53% vs 17%, p = 0.03). Transcoronary
      mapping for possible chemical ablation should be technically feasible in the
      majority of patients with ventricular tachycardia. Infarct zone blood flow arises
      from any of several sources and varies somewhat depending on infarct location.

PMID- 1615832
TI  - Prognostic significance of programmed ventricular stimulation in patients
      surviving complicated acute myocardial infarction: a prospective study.
AB  - In survivors of complicated myocardial infarction, the inducibility of sustained
      ventricular tachycardia may help identify a subset that is at increased risk for
      subsequent sudden cardiac death or spontaneous sustained ventricular tachycardia.
      We performed prehospital discharge programmed ventricular stimulation in 86
      survivors of acute myocardial infarction complicated by heart failure, angina
      pectoris, or nonsustained ventricular tachycardia. These patients also underwent
      cardiac catheterization with coronary angiography and 24-hour ambulatory ECG
      recording. Programmed ventricular stimulation induced sustained ventricular
      tachycardia in 19 patients (22%) and ventricular fibrillation in six (7%) and did
      not induce these arrhythmias in 61 patients (71%). During an average follow-up of
      18 +/- 13 months, 11 patients had arrhythmic events (seven sudden death and four
      nonfatal spontaneous sustained ventricular tachycardia) and 10 patients had
      nonsudden cardiac death. The total cardiac mortality rate was 20%. Arrhythmic
      events occurred in 32% of the 19 patients with inducible sustained ventricular
      tachycardia compared with 7% of the remaining 67 patients (p less than 0.003). By
      multivariate analysis the occurrence of arrhythmic events was independently
      predicted by both inducible sustained ventricular tachycardia and Killip class
      III or IV heart failure. The risk of arrhythmic events was 4.4% in the absence of
      both variables versus 38.4% (p less than 0.001) when both variables were present.
      The total cardiac mortality rate was best predicted by low left ventricular
      ejection fraction (less than 30%). Thus programmed ventricular stimulation is
      useful in risk stratification of survivors of complicated acute myocardial
      infarction. The prognostic utility appears to be particularly high in patients
      with infarction complicated by Killip class III or IV heart failure.

PMID- 1615833
TI  - Multivessel and single-vessel coronary angioplasty: a comparative study.
AB  - To determine the efficacy of multivessel coronary angioplasty, 569 consecutive
      patients undergoing multivessel angioplasty were compared with 569 age- and sex
      matched control patients undergoing single-vessel angioplasty. Baseline variables
      were similar except for number of diseased vessels and greater left ventricular
      dysfunction in the multivessel group. Major in-hospital complication rates
      (death, 0% vs 0.5%; Q wave myocardial infarction, 0.5% vs 0.9%; emergency bypass
      surgery, 2.5% vs 3.2%) were similar for multivessel and single-vessel
      angioplasty. The 5-year actuarial survival rate was 93% for multivessel
      angioplasty and 92% for single-vessel angioplasty. Event-free survival was
      similar except that patients undergoing multivessel angioplasty had an 8% higher
      incidence of repeat coronary angioplasty in the first year of follow-up (p =
      0.03). Multivessel coronary angioplasty can be performed with results comparable
      to those of single-vessel angioplasty with the exception of a higher incidence of
      repeat angioplasty.

PMID- 1615834
TI  - Biphasic versus sequential pulse defibrillation: a direct comparison in pigs.
AB  - It has recently been demonstrated that both biphasic and sequential pulse
      defibrillation shocks are superior to monophasic defibrillation shocks in animals
      and humans. There is little information directly comparing these two waveforms
      when pulse characteristics, subject, and total electrode surface area are kept
      constant. Pigs were randomized in a cross-over design for triplicate
      determinations of defibrillation threshold using biphasic and sequential pulse
      shocks and both large and small epicardial electrodes. Anesthetized pigs weighing
      18 to 28 kg had sets of defibrillating electrodes (TX-7) with total surface areas
      of 13 cm2 (group 1, n = 16) and 26 cm2 (group 2, n = 16), respectively, attached
      to the heart. Leading edge delivered voltage, current, and energy were
      significantly lower with sequential pulse shocks than with biphasic shocks for
      both electrode sets (delivered energy means +/- standard error of the mean: 13.3
      +/- 1.6 versus 22.4 +/- 3.0 joules, and 9.9 +/- 1.5 versus 14.2 +/- 1.6 joules,
      respectively). In addition, six of the pigs could not be defibrillated with 900
      stored V using biphasic shocks, although all pigs were defibrillated with less
      than 800 stored V using sequential pulse defibrillation. We conclude that
      sequential pulse defibrillation using three defibrillating electrodes provides an
      important current delivery system not matched by biphasic shocks using two
      electrodes when subject, waveform characteristics, and total electrode surface
      area are kept constant.

PMID- 1615835
TI  - Who needs the apothecary system?

PMID- 1615836
TI  - Use of stationary automated blood pressure devices in pharmacies.

PMID- 1615837
TI  - Conducting at-home medication reviews.

PMID- 1615838
TI  - Fostering professional growth in young pharmacists.

PMID- 1615839
TI  - The 'little, round, white pill' problem.

PMID- 1615840
TI  - Leaflets reinforce counseling.

PMID- 1615841
TI  - Use sensitivity in providing drug literature.

PMID- 1615842
TI  - Xanax can lead to dependency.

PMID- 1615843
TI  - Use of ACE inhibitors in the treatment of cardiovascular disease.
AB  - ACE inhibitors have been available by prescription since the marketing of
      captopril in the early 1980s. Since that time, six additional ACE inhibitors have
      been marketed, four of which received approval from the Food and Drug Association
      in 1991. All but one of the new ACE inhibitors are carboxylic-acid compounds, and
      all of them maintain a pro-drug metabolic pathway. Initially, ACE inhibitors were
      approved only for the control of high blood pressure. More recently, captopril
      and enalapril have been approved for use in congestive heart failure. In 1988,
      ACE inhibitors were one of the recommended first-line therapies for mild-to
      moderate hypertension. Their use in patients with hypertension has steadily
      increased, most likely because of their minimal effect on coexistent
      cardiovascular risk factors. In CHF, ACE inhibitors are the only single drug
      class that has been shown to reduce mortality and hospitalizations due to the
      disease without concomitant administration of another drug. ACE inhibitors are
      clearly drugs that should be used early in the treatment of most patients with
      CHF. Differences between ACE inhibitors are often difficult to define. As
      information regarding the clinical utility of tissue ACE inhibition is unveiled,
      the ability to use a selected ACE inhibitor based on individual patient
      characteristics may increase. The future for ACE inhibition looks promising and
      the cumulative clinical value of ACE inhibition appears to be just beginning.

PMID- 1615844
TI  - Eyedrop comparison.

PMID- 1615845
TI  - 'No' to single-entry doctor's degree.

PMID- 1615846
TI  - Gemfibrozil-lovastatin therapy for primary hyperlipoproteinemias.
AB  - The specific aim of this retrospective, observational study was to assess safety
      and efficacy of long-term (21 months/patient), open-label, gemfibrozil-lovastatin
      treatment in 80 patients with primary mixed hyperlipidemia (68% of whom had
      atherosclerotic vascular disease). Because ideal lipid targets were not reached
      (low-density lipoprotein (LDL) cholesterol less than 130 mg/dl, high-density
      lipoprotein (HDL) cholesterol greater than 35 mg/dl, or total cholesterol/HDL
      cholesterol less than 4.5 mg/dl) with diet plus a single drug, gemfibrozil (1.2
      g/day)-lovastatin (primarily 20 or 40 mg) treatment was given. Follow-up visits
      were scheduled with 2-drug therapy every 6 to 8 weeks, an average of 10.3 visits
      per patient, with 741 batteries of 6 liver function tests and 714 creatine
      phosphokinase levels measured. Only 1 of the 4,446 liver function tests (0.02%),
      a gamma glutamyl transferase, was greater than or equal to 3 times the upper
      normal limit. Of the 714 creatine phosphokinase levels, 9% were high; only 1
      (0.1%) was greater than or equal to 3 times the upper normal limit. With 2-drug
      therapy, mean total cholesterol decreased 22% from 255 to 200 mg/dl, triglyceride
      levels decreased 35% from 236 to 154 mg/dl, LDL cholesterol decreased 26% from
      176 to 131 mg/dl, and the total cholesterol/HDL cholesterol ratio decreased 24%
      from 7.1 to 5.4, all p less than or equal to 0.0001. Myositis, attributable to
      the drug combination and symptomatic enough to discontinue it, occurred in 3% of
      patients, and in 1% with concurrent high creatine phosphokinase (769 U/liter); no
      patients had rhabdomyolysis or myoglobinuria.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615847
TI  - Comparison of delay times to hospital presentation for physicians and
      nonphysicians with acute myocardial infarction.
AB  - To evaluate whether patients who recognize the symptoms of myocardial ischemia
      and have easy access to medical care have shortened time delays between onset of
      symptoms and hospital presentation, the total time interval between symptom onset
      and hospital arrival for 258 U.S. male physicians experiencing a first acute
      myocardial infarction (AMI) in the Physicians' Health Study (PHS) was compared
      with that of a comparable group of 240 men enrolled in the U.S. component of the
      Second International Study of Infarct Survival (ISIS-2), as well as with those of
      previously published series of patients with AMI. For patients presenting for
      medical care within 24 hours of symptom onset, the median time delay from onset
      of symptoms to presentation for medical care was 1.8 hours in the PHS, and 4.9
      hours in the U.S. component of ISIS-2 (p less than 0.001). Furthermore, 56% of
      participants in the PHS presented for medical care within 2 hours and 72% within
      4 hours of symptom onset compared with 20% (p less than 0.001) and 44% (p less
      than 0.001), respectively, for ISIS-2 participants. In previously published
      series, the average time to presentation was comparable to that in the ISIS-2
      trial, with variation depending on country of origin and on local population
      density. The median time to medical presentation in any previous series was not
      shorter than that in the PHS. Thus, physicians in the PHS had significantly
      shorter time delays between onset of symptoms and presentation for medical care.
      This difference may help explain the far lower than expected cardiovascular
      mortality rates among physician participants in the PHS.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1615848
TI  - Aggravation of arrhythmia by antiarrhythmic drugs, and the important role of
      underlying ischemia.

PMID- 1615849
TI  - Reduction of QT-interval imprecision and variance by measuring the JT interval.

PMID- 1615850
TI  - Stenting for elastic recoil during coronary angioplasty of the left main coronary
      artery.

PMID- 1615851
TI  - Aspiration thrombectomy for removal of coronary thrombus.

PMID- 1615852
TI  - Disparate serum lipid changes between normotensive and hypertensive women during
      the menstrual cycle.

PMID- 1615853
TI  - Atrial and ventricular approaches for radiofrequency catheter ablation of left
      sided accessory pathways.

PMID- 1615854
TI  - Doppler detection of valvular regurgitation after radiofrequency ablation of
      accessory connections.

PMID- 1615855
TI  - Safety of percutaneous transvenous balloon mitral commissurotomy in patients with
      mitral stenosis and thrombus in the left atrial appendage.

PMID- 1615856
TI  - The four subtypes of anomalous origin of the left main coronary artery from the
      right aortic sinus (or from the right coronary artery).

PMID- 1615857
TI  - Congenital hypoplasia of both right and left circumflex coronary arteries.

PMID- 1615858
TI  - Frequency of thromboembolic stroke in persons greater than or equal to 60 years
      of age with extracranial carotid arterial disease and/or mitral annular calcium.

PMID- 1615859
TI  - Echocardiographic frequency and severity of aortic regurgitation after ultrasonic
      aortic valve debridement for aortic stenosis in persons aged greater than 65
      years.

PMID- 1615861
TI  - Intraventricular muscle band mimicking asymmetric ventricular septal hypertrophy
      and hypertrophic cardiomyopathy.

PMID- 1615860
TI  - Sinus node artery occlusion for treatment of chronic nonparoxysmal sinus
      tachycardia.

PMID- 1615862
TI  - Less money for doctors in the future?

PMID- 1615863
TI  - Noninvasive identification of severe coronary artery disease using exercise
      tomographic thallium-201 imaging.
AB  - The ability of exercise thallium-201 tomographic imaging to predict the presence
      of left main or 3-vessel coronary artery disease (CAD) was examined in 688
      patients who underwent both exercise thallium-201 testing and coronary
      angiography. Significant differences existed for multiple variables between
      patients with (n = 196) and without (n = 492) severe left main or 3-vessel CAD.
      Logistic regression analysis identified 4 variables as independently predictive
      of left main or 3-vessel CAD. These variables were the magnitude of ST-segment
      depression with exercise, the number of visually abnormal short-axis thallium-201
      segments, the presence or absence of diabetes mellitus, and the change in
      systolic blood pressure with exercise. Using these variables, patients were
      classified by nomograms into low-, intermediate- and high-probability groups.
      Patients at high probability (n = 205) had a 52% prevalence of 3-vessel or left
      main CAD, whereas those at low probability (n = 170) had only a 12% prevalence.
      Only 53 patients (29%) with 3-vessel or left main CAD had perfusion abnormalities
      in all 3 coronary territories. Clinical and exercise parameters provide important
      independent information in the identification of left main or 3-vessel CAD by
      exercise thallium-201 tomographic imaging, because thallium scintigraphy alone is
      suggestive of extensive CAD in few patients.

PMID- 1615864
TI  - Effect of thrombolytic therapy on the predictive value of signal-averaged
      electrocardiography after acute myocardial infarction.
AB  - Standard time domain variables from signal-averaged electrocardiography were
      examined in a population of 331 survivors of acute myocardial infarction. Of
      these subjects, 130 received early (less than 24 hours) thrombolytic therapy.
      During a follow-up of greater than or equal to 10 months, there were 17
      arrhythmic events (8.5%) (sudden death or sustained symptomatic ventricular
      tachycardia) in the group without thrombolysis and 8 (6.2%) in those with
      thrombolysis. Statistically, highly significant differences between the signal
      averaged electrocardiographic variables of patients with and without arrhythmic
      events were found in the group without thrombolysis, whereas only root-mean
      square voltage of the terminal 40 ms of the signal-averaged QRS complex was
      statistically associated with outcome (the differences in the other 2 indexes
      being not significant) in patients with thrombolysis. When using 2 previously
      published categoric criteria for the diagnosis of abnormal signal-averaged
      electrocardiography, the performance of these criteria in predicting arrhythmic
      events was substantially better in the group without thrombolysis than in those
      with thrombolysis (positive predictive accuracy greater than 3 times lower).
      Retrospectively adjusted receiver-operator characteristics showed that for a
      sensitivity of 30%, the maximum achievable positive predictive accuracy of signal
      averaged electrocardiography for arrhythmic events was 100% in the group without
      thrombolysis, but only 27% in those with thrombolysis. It is concluded that
      standard signal-averaged electrocardiography after acute myocardial infarction is
      less informative in patients who receive thrombolytic treatment.

PMID- 1615865
TI  - Six-year survival after coronary thrombolysis and early revascularization for
      acute myocardial infarction.
AB  - Six-year follow-up was conducted in a consecutive series of 192 patients
      receiving thrombolytic therapy for acute myocardial infarction (AMI) with ST
      segment elevation. Cardiac catheterization was performed within a day, and
      patients with an open infarct artery routinely had early revascularization: 99
      (67%) underwent coronary bypass surgery and 18 (12%) coronary angioplasty. With
      this treatment strategy, 6-year cardiac mortality was 14.5%, 6% (12 patients) in
      hospital and 9% (16 patients) for survivors of hospitalization. Multivariate
      analysis showed that predictors of cardiac death among survivors of
      hospitalization were a closed infarct artery at catheterization (p less than
      0.01), diabetes (p less than 0.01) and anterior myocardial infarction (p = 0.01).
      A subset of 146 patients underwent radionuclide angiography before hospital
      discharge; for them, predictors of mortality were a closed infarct artery at
      catheterization (p less than 0.01), anterior wall AMI (p = 0.02), and Killip
      class III to IV on admission (p less than 0.06). Left ventricular ejection
      fraction was not a significant predictor of mortality for this subset of
      patients.

PMID- 1615866
TI  - Value of negative predischarge exercise testing in identifying patients at low
      risk after acute myocardial infarction treated by systemic thrombolysis.
AB  - Although thrombolytic therapy reduces mortality in patients with acute myocardial
      infarction (AMI), it is associated with a greater incidence of successive
      coronary events, and there is still no ideal diagnostic and therapeutic strategy
      for such patients. The present study verifies the value of negative predischarge
      exercise testing in identifying low-risk patients treated with thrombolysis after
      AMI. One hundred fifty-seven consecutive patients with an uncomplicated clinical
      course underwent maximal or symptom-limited exercise testing (Bruce treadmill
      protocol) within 15 days of AMI in the absence of therapy. The location of the
      AMI was anterior in 51 patients, inferior in 85 and non-Q-wave in 21. All of the
      patients were followed for 6 months. Death and nonfatal reinfarction were
      considered as major coronary events, and the recurrence of angina as a minor
      event. Exercise test results were negative in 105 patients (group 1) and positive
      for angina or ST depression greater than or equal to 0.1 mV in 52 (group 2). No
      deaths occurred during follow-up; there were 3 reinfarctions (3%) and 7 cases
      (7%) of postinfarction angina in group 1, and 2 reinfarctions (4%) and 21 cases
      (40%) of postinfarction angina in group 2. By the end of follow-up, 90% of the
      patients with negative exercise test results were event-free (97% in the case of
      major events). These results show that thrombolytic therapy does not affect the
      value of negative postinfarction exercise testing in identifying low-risk
      patients.

PMID- 1615867
TI  - Magnetic resonance imaging during dobutamine stress in coronary artery disease.
AB  - Cine magnetic resonance imaging (MRI) provides a tomographic method of assessing
      regional ventricular function in any desired plane. It has not been possible to
      obtain adequate images during dynamic exercise, and this has limited its value in
      patients with coronary artery disease (CAD). Therefore, an infusion of dobutamine
      was used to study 25 patients with exertional chest pain and abnormal exercise
      electrocardiograms. Areas of abnormal wall motion were compared with areas of
      abnormal myocardial perfusion imaged by dobutamine thallium emission tomography
      and with coronary arteriography. Twenty-two patients had significant CAD. Twenty
      one (96%) of these patients had reversible myocardial ischemia shown by
      dobutamine thallium tomography, and 20 (91%) had reversible wall motion
      abnormalities shown by dobutamine MRI. Comparison of abnormal segments of
      perfusion and wall motion showed 96% agreement at rest, 90% agreement during
      stress, and 91% agreement for the assessment of functional reversibility. The
      normalized magnetic resonance signal intensity of the ischemic segments showed a
      small but significant reduction when compared with that of normal segments (-67
      units [9.2%]; p less than 0.05). Dobutamine infusion was well-tolerated, despite
      causing chest discomfort in 24 patients (96%). Nine patients (36%) developed a
      minor dysrhythmia that was usually ventricular premature complexes, but this did
      not limit infusion, and other side effects were mild. The short plasma half-life
      of dobutamine makes it ideal as a stress agent for imaging techniques (such as
      MRI), and these results suggest that it is more effective in the provocation of
      wall motion abnormalities than is dipyridamole in patients with CAD.

PMID- 1615868
TI  - Enhanced sensitivity for detection of coronary artery disease by addition of
      atropine to dobutamine stress echocardiography.
AB  - Patients undergoing dobutamine stress echocardiography often take beta
      antagonists which limit heart rate response and sensitivity in the test for
      detection of coronary artery disease. The aim of this study was to assess the
      effect of the addition of atropine to dobutamine stress echocardiography on
      clinical, electrocardiographic and echocardiographic outcomes. Dobutamine stress
      echocardiography was performed starting at and increasing every 3 minutes with 10
      micrograms/kg/min to a maximum of 40 micrograms/kg/min (stage 4), which was
      continued for 6 minutes. In patients not achieving 85% predicted maximal exercise
      heart rate and in whom the test was not judged positive on echocardiographic or
      electrocardiographic criteria, atropine (0.25 mg intravenously, repeated up to a
      maximum of 1 mg if necessary) was added and dobutamine continued for up to a
      further 5 minutes, or until an adequate heart rate was achieved or the test was
      stopped because of chest pain or electrocardiographic changes. Of 80 consecutive
      patients undergoing dobutamine stress echocardiography within 2 weeks of coronary
      angiography, 49 required atropine (group A) and 31 required only dobutamine
      (group B). After dobutamine alone, heart rate (mean +/- SD) was higher in group B
      than in group A: 129 +/- 20 vs 90 +/- 18 beats/min, p less than 0.0001; but after
      the addition of atropine, heart rate in group A increased to 120 +/- 20
      beats/min. Overall sensitivity for the detection of coronary disease was 70%, 95%
      confidence interval (CI) 55 to 83%; after the addition of atropine, sensitivity
      for group A was 65%, 95% CI 45 to 81%; in group B, sensitivity was 81%, 95% CI 54
      to 96%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615869
TI  - Initial management and long-term clinical outcome of restenosis after initially
      successful percutaneous transluminal coronary angioplasty.
AB  - Restenosis remains a critical limitation after percutaneous transluminal coronary
      angioplasty (PTCA). The clinical experience with restenosis was reviewed in 1,490
      patients who had restenosis of at least 1 site within 1 year of their PTCA. The
      source of data was the clinical database at Emory University. Patients who had
      previous coronary bypass surgery or PTCA and patients who underwent PTCA in the
      setting of acute myocardial infarction were excluded. When restenosis was
      angiographically documented, 363 were treated medically, 1,051 with repeat PTCA,
      and 76 with coronary bypass surgery. In the repeat PTCA group there were 778
      patients who originally had 1-vessel disease and 273 with multiple vessel
      disease. Re-dilatation of restenotic sites was performed in 95%. Angiographic
      success of all lesions dilated was achieved in 99%. Coronary bypass surgery was
      required in 2.5% of patients with restenosis first treated with repeat PTCA. One
      patient with multiple vessel disease died. Coronary bypass surgery was performed
      in fewer patients aged greater than or equal to 65 years, but more patients with
      multiple vessel disease. Two (2.6%) of the coronary bypass surgery patients had Q
      wave myocardial infarction and there were no deaths. In the PTCA group, 5-year
      actuarial survival was 95%, and cardiac survival 96%. Freedom from cardiac events
      or further revascularization procedures was 51% at 5 years. Patients treated with
      PTCA and medically treated patients had similar cardiac survival rates. The most
      important correlates of cardiac survival were age and the presence of diabetes
      mellitus. At 5 years, cardiac survival without diabetes was 97 and 83% with
      diabetes (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615870
TI  - Usefulness of a postoperative exercise test for predicting cardiac events after
      coronary artery bypass grafting.
AB  - The predictive value of a postoperative exercise test in terms of cardiac events
      after coronary artery bypass grafting (CABG) was prospectively studied in 231
      consecutive patients. During a 5-year follow-up there were 28 cardiac events
      (12%), of which 15 were cardiac deaths (13 sudden), and 13 were nonfatal
      myocardial infarctions. There was no difference in the rate of graft patency
      between groups with and without cardiac events, but ejection fraction was lower
      in patients with than without events (51 +/- 16% vs 58 +/- 10%; p less than
      0.05). Duration of the exercise test was shorter, and maximal work load was lower
      in patients with cardiac events (p less than 0.05 for both). The prevalence of
      greater than or equal to 1 mm ST-segment depression was 22% (symptomatic in 25%,
      and silent in 75%) and did not differ between groups with and without cardiac
      events. After adjustment for prognostic variables using the proportional hazards
      method, diuretic treatment (p = 0.007) and a low postoperative ejection fraction
      (p = 0.04) remained significant for predicting the risk of cardiac events within
      5 years of CABG, but exercise duration and work load did not have any significant
      predictive value. Thus, the predictive value of a postoperative exercise test is
      limited, and signs of impaired left ventricular function are of greater
      significance for the 5-year prognosis after CABG than are those of myocardial
      ischemia.

PMID- 1615871
TI  - Comparison of patient-reported outcomes after elective coronary artery bypass
      grafting in patients aged greater than or equal to and less than 65 years.
AB  - Older patients represent a growing proportion of patients undergoing coronary
      artery bypass grafting (CABG). Although functional benefits after CABG have been
      demonstrated, most assessments of outcomes have involved patients aged less than
      65 years. Therefore, little is known concerning the impact of CABG on older
      patients compared with that on younger ones. A number of postsurgical (6 months)
      health-related quality-of-life outcomes (e.g., symptoms, cardiac functional
      class, instrumental activities of daily living, and emotional and social
      functioning) reported by patients aged less than 65 (n = 169) and greater than or
      equal to 65 (n = 99) years who underwent elective CABG at 4 major teaching
      hospitals in Massachusetts and California were compared. The proportion of
      patients reporting cardiac-related symptoms after surgery did not vary by age,
      and quality-of-life outcome scores of younger and older patients did not differ
      even after adjustment for clinical and demographic characteristics. The exception
      to this was mental health status, an outcome for which older patients reported
      better functioning than did younger ones. On average, patients in the 2 age
      groups reported equivalent improvement over preadmission status in instrumental
      activities of daily living, and emotional and social functioning. The independent
      relation of clinical and sociodemographic factors to quality-of-life outcomes was
      also investigated. Patients who functioned better before admission, those with
      less severe co-morbid disease, and married patients reported better functioning
      after discharge. In general, older patients who underwent elective CABG reported
      functional benefits similar to those reported by younger ones, and the factors
      associated with better functioning did not vary by age group.

PMID- 1615872
TI  - Increased onset of sudden cardiac death in the first three hours after awakening.
AB  - A circadian variation of sudden cardiac death has been documented, but its
      relation to individual time of awakening and possible triggering events has not
      been studied in the general population. By monitoring of mortality records in 4
      cities and towns in Massachusetts, 148 potential cases of sudden cardiac death
      were identified. In 94 cases, the informants listed on the death certificates
      were contacted, the diagnosis of sudden cardiac death was established, and a
      telephone interview was completed within a mean of 19 days (range 8 to 28) after
      the death. The time of day of all 94 cases of sudden cardiac death (mean age 61
      +/- 9 years, 74% men) demonstrated a circadian variation (p less than 0.05) with
      a peak from 9:00 A.M. to 12:00 noon. An analysis of time of death adjusted for
      individual wake-times of the decedents demonstrated an increased onset of sudden
      cardiac death during the initial 3-hour interval after awakening with a relative
      risk of 2.6 (95% confidence interval 1.6, 4.2) compared with other times of the
      day. The increased risk of sudden cardiac death soon after awakening suggests
      specific triggering factors or mechanisms that are particularly likely to occur
      during this time. The narrowing of the time interval during which the risk of
      sudden cardiac death is increased should facilitate the study of possible
      pathogenetic mechanisms and triggering factors of the disease and may aid in the
      design of more effective preventive strategies.

PMID- 1615873
TI  - Effectiveness of loading oral flecainide for converting recent-onset atrial
      fibrillation to sinus rhythm in patients without organic heart disease or with
      only systemic hypertension.
AB  - Sixty-two patients with recent-onset (less than or equal to 1 week) atrial
      fibrillation (New York Heart Association functional class 1 and 2) were
      randomized in a single-blind study to 1 of the following treatment groups: (1)
      flecainide (300 mg) as a single oral loading dose; or (2) amiodarone (5 mg/kg) as
      an intravenous bolus, followed by 1.8 g/day; or (3) placebo for the first 8
      hours. Twenty-four-hour Holter recording was performed, and conversion to sinus
      rhythm at 3, 8, 12 and 24 hours was considered as the criterion of efficacy.
      Conversion to sinus rhythm was achieved within 8 hours (placebo-controlled
      period) in 20 of 22 patients (91%) treated with flecainide, 7 of 19 (37%) treated
      with amiodarone (p less than 0.001 vs flecainide), and 10 of 21 (48%) treated
      with placebo (p less than 0.01 vs flecainide). Resumption of sinus rhythm within
      24 hours occurred in 21 of 22 patients (95%) with flecainide and in 17 of 19
      (89%) with amiodarone (p = not significant). Mean conversion times were shorter
      for flecainide (190 +/- 147 minutes) than for amiodarone (705 +/- 418; p less
      than 0.001). No major side effects occurred. At Holter monitoring, a pause of 9.3
      seconds was observed in 1 asymptomatic patient treated with flecainide. Phases of
      atrial flutter with a ventricular rate less than or equal to 150 beats/min were
      detected before sinus conversion in 1 patient receiving placebo and in 2
      receiving flecainide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615874
TI  - Electrocardiographic changes and arrhythmias after cancer therapy in children and
      young adults.
AB  - Transient electrocardiographic changes and arrhythmias are known to be acute
      manifestations of cardiotoxicity secondary to cancer therapy with anthracyclines
      or cardiac irradiation. However, despite the known risk of late cardiac
      dysfunction in survivors of childhood cancer therapy, the risk of clinically
      important electrocardiographic abnormalities and arrhythmias after treatment is
      unknown. Standard 12-lead and 24-hour ambulatory electrocardiograms were recorded
      in 73 patients who received anthracyclines alone, 24 who received cardiac
      irradiation alone, and 27 who received both anthracyclines and cardiac
      irradiation. The mean age of the patients was 15 years. Mean cumulative
      anthracycline dose was 282 mg/m2 in patients who received anthracyclines alone
      and 244 mg/m2 in patients who received both anthracyclines and cardiac
      irradiation. Analysis of the 12-lead and 24-hour electrocardiograms demonstrated
      increased frequency of QTc prolongation, supraventricular premature complexes,
      supraventricular tachycardia, ventricular premature complexes, couplets and
      ventricular tachycardia (all p less than 0.001) when compared with an age-matched
      healthy population. Most patients had abnormalities limited to single
      supraventricular or ventricular premature complexes; however, potentially serious
      ventricular ectopy, including ventricular pairs and ventricular tachycardia, were
      noted in patients with cumulative doses greater than 200 mg/m2.
      Electrocardiographic abnormalities and arrhythmias are not limited to the acute
      phase of treatment with anthracyclines and cardiac irradiation. Survivors of
      childhood malignancy who received anthracyclines or cardiac irradiation, or both,
      probably should undergo ambulatory electrocardiographic monitoring as part of
      their follow-up to detect potentially life-threatening arrhythmias.

PMID- 1615875
TI  - Silent myocardial ischemia in men with systemic hypertension and without clinical
      evidence of coronary artery disease.
AB  - The prevalence, characteristics and circadian pattern of silent myocardial
      ischemia, and its association with ventricular arrhythmias was studied in
      hypertensive men aged 35 to 70 years (mean 61) without clinical cardiac disease.
      Participants were withdrawn from diuretic treatment and received 1 month of oral
      electrolyte repletion with 40 mmol of potassium chloride, and 400 mg of magnesium
      oxide daily. Twenty-four-hour Holter monitoring was then performed. Episodes of
      silent myocardial ischemia occurred in 50 of 186 men (27%) and lasted from 2 to
      289 minutes (mean 30 and median 18). Statistical analysis comparing the interval
      from midnight to 6 A.M. with each of the other three 6-hour time intervals
      revealed that participants were less likely to have silent myocardial ischemia in
      this period (p less than 0.01 for each comparison) than at other times of the
      day. There was little difference in the proportion of men with a frequent or
      complex ventricular arrhythmia during the entire day or within 1 hour of the
      silent myocardial ischemic episode (or during a comparable time period) comparing
      those with to those without silent myocardial ischemia. These findings indicate
      that silent myocardial ischemia occurs in approximately 25% of an older
      population of hypertensive men without history of symptomatic cardiac disease.
      The circadian pattern of frequency of silent ischemic events in men free of
      clinical cardiac disease is similar to that reported for patients with cardiac
      disease and coincides with that reported for sudden death. There was no
      significant association between silent myocardial ischemia and ventricular
      arrhythmias.

PMID- 1615876
TI  - Effects of combined hydrochlorothiazide and amiloride versus single drug on
      changes in salt taste and intake.
AB  - Hydrochlorothiazide stimulates salt intake without altering salivary or gustatory
      function. Amiloride reportedly reduces salivary sodium levels and salt taste. It
      was hypothesized that these unintended drug actions would be attenuated by
      concurrent use of these 2 diuretics. Normotensive adults (n = 23) were
      administered placebo for 2 weeks, active combination drug Moduretic for 4 weeks,
      and placebo again for 2 weeks in a double-blind protocol. Salivary flow,
      gustatory function and sodium intake were monitored at the end of each period,
      together with selected physiologic measures (i.e., plasma aldosterone, plasma
      renin activity, body composition, blood pressure and heart rate). No significant
      changes were observed for salivary flow, salt taste or sodium intake. These
      findings indicate that amiloride and hydrochlorothiazide used in combination can
      reduce drug effects that may compromise the efficacy of either drug when used
      alone.

PMID- 1615877
TI  - Improvement of automated electrocardiographic diagnosis by combination of
      computer interpretations of the electrocardiogram and vectorcardiogram.
AB  - In the international project "Common Standards for Quantitative
      Electrocardiography" (CSE), diagnostic results of different computer programs for
      the interpretation of the electrocardiogram (ECG) and of the vectorcardiogram
      (VCG) were combined, and it was shown that the "combined program" performs better
      than each program separately. Because the program MEANS (Modular ECG Analysis
      System) comprises 2 different classification programs--one for the ECG, the other
      for the VCG--this allowed investigation of whether the combined interpretations
      would yield a better diagnostic result than either one separately. This approach
      requires that a VCG always be recorded in addition to the ECG. To circumvent this
      complication, the VCG was reconstructed from the simultaneously recorded ECG
      leads. This reconstructed VCG was then interpreted by the VCG classification
      program, whereupon the diagnostic interpretations of the ECG and the
      reconstructed VCG were combined. For the validation, the CSE database of
      documented ECGs and VCGs (n = 1,220) was used. The combination of the ECG and VCG
      interpretations yielded a better diagnostic result than each interpretation
      program separately (total accuracy 74.2% (ECG + VCG) vs 69.8% (ECG) and 70.2%
      (VCG), p less than 0.001 in both cases). The results for the reconstructed VCG
      (total accuracy 70.5%) are comparable to those for the ECG and the VCG (p greater
      than 0.10 in both cases). The performance of the combined interpretations of ECG
      and reconstructed VCG (total accuracy 73.6%) is approximately the same as that of
      the combined ECG and VCG (p greater than 0.10). Thus, the performance of an ECG
      computer program can be improved by incorporating both ECG and VCG classificatory
      knowledge, using only the ECG itself.

PMID- 1615878
TI  - Effect of low-calorie diets on the sympathetic nervous system, body weight, and
      plasma insulin in overweight hypertension.
AB  - When weight reduction was found to decrease blood pressure in the overweight
      hypertensive patient, it was hailed as the causative factor. A growing number of
      recent studies indicate that this association may be secondary to a correlation
      between diet-associated metabolic change and the sympathetic nervous system. A
      select group such as overweight hypertensive patients may have a genetic
      predisposition for such a correlation. In overweight hypertensive patients, low
      calorie diet and especially very-low-calorie diet, correlate with improved
      glucose metabolism, a decrease in plasma insulin concentration, and altered
      norepinephrine concentrations and thus sympathetic nervous system activity.
      Several of these studies also show a lack of effect of salt intake on blood
      pressure. Thus, it seems that metabolic changes caused by the decrease in caloric
      intake are responsible for the decrease in blood pressure. These must be
      investigated to understand the effect of the different diets on blood pressure.
      Very low-calorie diets were found very useful in breaking the vicious circle of
      severe nonresponsive hypertension to medication.

PMID- 1615879
TI  - Insulin sensitivity during very-low-calorie diets assessed by minimal modeling.
AB  - The time course of plasma glucose, insulin, and C-peptide after intravenous
      glucose (300 mg/kg body wt) injection was analyzed with minimal model approach in
      nine normal females and seven obese females. Glucose tolerance, estimated by
      glucose assimilation coefficient (KG), was positively correlated with glucose
      effectiveness (SG), but not correlated with peripheral insulin sensitivity (SI)
      in obese females as well as normal females. These factors were estimated before
      and after weight loss with 1.8-MJ (420-kcal) very-low-calorie diets (VLCDs) or
      with 2.5-3.3-MJ (600-800-kcal) low-calorie diets in two obese subjects. KG and
      glucose effectiveness decreased after acute weight loss with VLCD, although
      insulin sensitivity increased. Weight loss with low calorie diets resulted in
      improvement of KG and glucose effectiveness. These results suggest that a
      significant amount of glucose is taken up through insulin-independent mechanisms
      during the intravenous glucose tolerance test (ivGTT) in these subjects. This
      insulin-independent glucose uptake may be an important determinant of the fate of
      glucose in obese females as well as normal females.

PMID- 1615880
TI  - Effect of very-low-calorie diets with weight loss on obstructive sleep apnea.
AB  - To determine the effect of very-low-calorie diets (VLCDs) with weight loss on
      obstructive sleep apnea (OSA), we studied eight obese subjects with OSA, five
      males and three females. Subjects consumed a VLCD of 1760 kJ (420 kcal) (67%
      protein, 4% fat, 29% carbohydrate) or 3350 kJ (800 cal) (20% protein, 30% fat,
      50% carbohydrate) with 100% of the recommended daily allowance of vitamins and
      minerals. Mean (+/- SD) values of weight and respiration before and after weight
      loss were, for weight, 153 +/- 37 and 132 +/- 29 kg (P less than 0.05); for BMI
      (kg/m2), 54 +/- 13 and 46 +/- 10 (P less than 0.05); for desaturations/h sleep,
      106 +/- 50 and 52 +/- 45 (P less than 0.05); for apneas + hypopneas/h sleep, 90
      +/- 32 and 62 +/- 49; for Pco2, 48 +/- 10 and 42 +/- 4 torr (P less than 0.05).
      Desaturation episodes/h and apnea + hypopneas/h improved in six patients. The
      most obese subject (female, BMI 81) who lost the most weight (47 kg) did not
      improve, nor did the subject who lost the least weight, 7 kg. The number of
      movements + arousals from sleep decreased in all patients (P less than 0.05). We
      conclude that VLCD with weight loss can produce improvement in OSA; subjects who
      lose a small amount of weight or subjects who are extraordinarily obese before
      and after weight loss may not improve.

PMID- 1615881
TI  - Psychological aspects of obesity and very-low-calorie diets.
AB  - This paper selectively reviews available evidence concerning psychological
      characteristics associated with obesity, psychological changes accompanying very
      low-calorie diets (VLCDs), and the influence of certain psychological factors on
      response to VLCD treatment. The obese population as a whole does not show an
      elevated incidence of psychopathology. Treatment-seeking obese do show more
      psychiatric disturbance, at a level comparable to other medical/surgical
      patients. There appear to be no global personality traits or profiles that are
      associated with obesity. However, obese people differ from non-obese groups on
      psychological and behavioral variables related to weight and eating and more
      frequently display perceptual and emotional body image anomalies. Binge eating
      appears rather common among obese groups. VLCDs have generally neutral to
      positive effects on hunger, depression, and anxiety. New data on body image
      suggest that VLCDs are associated with post-treatment underestimation of body
      size. Finally, recent data on possible psychological and behavioral correlates of
      VLCDs outcome are presented.

PMID- 1615882
TI  - Exercise during and after very-low-calorie dieting.
AB  - Neither diet nor exercise are effective as single modes of intervention in the
      treatment of obesity. Although it is logical that they be combined in the context
      of multidisciplinary treatment, restrictions in calorie or protein intakes while
      dieting may impair short-term or long-term function. The limited evidence
      available indicates that properly constituted very-low-calorie diets can
      effectively preserve physical function across major weight loss, but long-term
      preservation of this weight loss is strongly influenced by postdiet exercise
      habits. In summary, counseling on and initiation of safe and effective exercise
      practices during dietary treatment of obesity are appropriate, but the ultimate
      goal should be to direct the patient towards lifelong exercise behaviors that
      will contribute to sustained weight maintenance.

PMID- 1615883
TI  - Drug therapy after very-low-calorie diets.
AB  - Very-low-calorie diets (VLCDs) are effective at reducing weight, even in patients
      who have often failed with conventional diets. Maintaining weight lost by means
      of a VLCD remains a clinical challenge. Attempts to prevent weight regain by
      dietary reeducation or by more formal behavior-modification techniques are not
      easily applicable to large numbers of patients and are not always successful; the
      use of drugs to maintain and improve upon initial VLCD success could be of real
      clinical value. Pharmacological treatment of obesity has evolved in recent years
      with the development and licensing of potent serotonin agonists, such as
      dexfenfluramine (dF), acting as nonstimulant anorectic agents. Thermogenic drugs
      are not yet as advanced in clinical development and evaluation but offer the
      prospect of increasing energy output in the reduced obese patient. Drugs used to
      treat obesity need to be effective, to be safe, not to exhibit drug tolerance,
      and ideally, to be shown to reduce morbidity or mortality from obesity,
      particularly because treatment will need to be prolonged. Such requirements are
      not unique for treating obesity, they are similar for drugs used to treat other
      metabolic diseases such as hypercholesterolemia or diabetes. VLCD followed by dF
      has been shown to be effective. A double-blind trial randomized 45 patients who
      had successfully completed 8 wk of treatment on the Cambridge diet to either
      placebo or dF 15 mg twice daily for 26 wk. Patients continued on a diet giving 60
      75% of daily energy needs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615884
TI  - Combination of very-low-calorie diet and behavior modification in the treatment
      of obesity.
AB  - Very-low-calorie diets (VLCDs) cause rapid weight loss. However, weight regain is
      rapid upon discontinuing the VLCD unless lifestyle is altered. The addition of a
      behavioral-modification (BMOD) program improves the long-term outcome. The major
      components of a BMOD program to alter lifestyle are education about nutrition and
      eating habits with alteration of amount and patterns of eating, institution of an
      aerobic activity program designed to increase energy expenditure, training in
      self-awareness and assertiveness, and training in coping techniques for long-term
      alteration of lifestyle. By retrospective chart review, we evaluated two VLCD
      programs at the same institution. One program gave 12 wk of BMOD before a 12-wk
      course of VLCD (Program 1), then scheduled individual visits regularly
      thereafter. The other program used simultaneous VLCD and BMOD in a 26-wk
      treatment course (Program 2), consisting of 2 wk of stabilization on 5020 kJ/d
      (1200 kcal/d), 12 wk of VLCD, and 12 wk of transition to a low-calorie solid food
      diet. Follow-up was obtained at 1 y in both groups. Maximum weight loss was
      similar, but subjects in Program 2 regained about one-third of the lost weight
      versus approximately 10% in Program 2. A third program of preceding BMOD followed
      by a low-calorie diet (Program 3) gave similar weight maintenance at 1 y as
      Program 1. Prospective studies are needed to determine if BMOD simultaneously
      with or preceding VLCD promotes better long-term weight maintenance. These data
      confirm the benefits of long-term follow-up for maintaining weight loss.

PMID- 1615885
TI  - Relationship of dieting history to resting metabolic rate, body composition,
      eating behavior, and subsequent weight loss.
AB  - This study examined the relationship of dieting history to resting metabolic
      rate, body composition, and subsequent weight loss in 50 obese women. A
      preliminary study showed that the women were able to report with satisfactory
      reliability the number of diets in which they had engaged (mean = 4.9 +/- 0.5),
      as well as the total weight loss resulting from these diets (mean = 55.9 +/- 6.0
      kg). We found no evidence that weight cycling, as measured by either of these
      variables, was associated at baseline with a reduced resting metabolic rate or an
      increased percentage of body fat. Nor did we find that weight cycling was
      associated with smaller weight losses in a prospective trial in which subjects
      were treated by very-low-calorie diet and behavior therapy. The clinical
      implications of these findings are discussed, as are the methodological problems
      encountered in conducting research on this topic.

PMID- 1615886
TI  - Effects of weight cycling on body composition.
AB  - It is frequently claimed that weight cycling, or "yo-yo" dieting, causes an
      inappropriate and permanent loss of lean body mass (LBM). Data are presented from
      a rural African population that undergoes profound weight cycling caused by an
      annual hungry season. No detrimental effect on LBM was observed. Data are also
      presented from an 18-wk prospective study of moderately obese British women who
      underwent three cycles of VLCD-induced weight loss and subsequent relapse. The
      proportion of weight lost as LBM was no greater than predicted. A review of the
      published results from experimental weight cycling in small animals also shows a
      high level of consensus that cycling does not significantly alter body
      composition. We conclude that, although weight cycling may affect growth of young
      animals, metabolic efficiency, and health, these effects are not mediated through
      permanent alterations in body composition.

PMID- 1615887
TI  - Factors influencing body composition during very-low-calorie diets.
AB  - Apparent body composition changes with weight loss on very-low-calorie diet
      (VLCD) can depend on the method of fat-free mass estimation. In this report the
      implications of differences in measurement by direct versus indirect methods are
      examined. The nitrogen sparing and protein economy associated with ketosis is
      relevant and results of clinical trials with diets of varying composition are
      presented. The analytical findings of a multicenter, multimethod long-term VLCD
      study illustrate protein and metabolic conservation during VLCD. Protein losses,
      by total body nitrogen, over 10 wk dieting, independent of body mass index, were
      4.75% of weight lost, as conservatively expected from obesity tissue reduction
      with no degradation of total energy expenditure. The implications of utilization
      of glycogen (water and potassium release) in interpretation of diet success and
      of body compositional change is evaluated. Evidence is presented that ultimate
      compositional changes with weight change may be individually specific and that
      body composition may be predicted from weight considerations alone.

PMID- 1615888
TI  - Factors determining energy expenditure during very-low-calorie diets.
AB  - There is an important variability in short- and long-term weight loss success
      among obese subjects, regardless of the strategy used. It is still unclear
      whether this variability is a therapy-specific or a patient-specific problem.
      Changes in energy expenditure are probably a key factor in the phenomena of
      weight loss or weight regain. Factors influencing resting metabolic rate (RMR)
      and diet-induced thermogenesis (DIT) in obese patients are considered: age, fat
      mass, fat-free mass (FFM), sex and thyroid hormones are all related to the
      components of energy expenditure. Fat distribution estimates [expressed by waist
      to-hip ratio (WHR)] seem to be related to DIT rather than to RMR. Short- and long
      term effects of very-low-calorie diets (VLCDs) on RMR and DIT were investigated.
      Short-term weight loss by VLCD induced a significant (P less than 0.001) decrease
      of FFM with a concomitant decline of RMR values. A nonsignificant decreasing
      trend exists for thermogenesis. No further decrease of FFM was found after long
      term weight loss without differences in RMR/FFM or thermogenesis. Changes in FFM
      are known to be the major component of changes in RMR, but other factors may be
      involved. Also some other factors may account for the possible changes in diet
      induced thermogenesis during VLCD. Candidates for this include total fat mass,
      FFM, sex hormones, insulin concentrations, and fat distribution, of which insulin
      concentrations seem to determine RMR changes to an important extent. Fat
      distribution patterns per se or changes in WHR seem to account consistently (P
      less than or equal to 0.05) for changes in DIT during VLCD.

PMID- 1615889
TI  - Liver and gallbladder disease before and after very-low-calorie diets.
AB  - Hepatobiliary characteristics of untreated obese patients and those of patients
      reducing weight through very-low-calorie diets (VLCDs) are reviewed. In untreated
      obesity, hepatobiliary abnormalities are prevalent. Fatty change is common and
      may be related to insulin resistance. Moreover, portal inflammation and fibrosis
      are prevalent findings, also in the absence of alcohol abuse. The liver plays a
      key role in the hyperinsulinism and hyperlipidemia, and hepatic drug metabolism
      is influenced by enhanced glucuronidation and sulphatation. Predisposition to
      gallstone formation can be ascribed to increased biliary cholesterol secretion in
      concert with changed nucleating factors and altered gallbladder motility. Weight
      loss by VLCD reduces fatty change but may induce slight portal inflammation and
      fibrosis. Insulin resistance and pharmacokinetic abnormalities regress. During
      VLCD the risk of gallstone formation is markedly increased. The deleterious
      effects described of a rapid weight loss should draw some attention to the liver
      and biliary tract during VLCD treatment.

PMID- 1615890
TI  - The role of very-low-calorie diets in obesity.
AB  - The popularity of very-low-calorie diets (VLCDs) is enormous, but questions
      persist about their safety and their long-term efficacy. This article addresses
      the following questions: who should be placed on a VLCD? when should a patient go
      on a VLCD? how much should an individual lose? where should a VLCD program be
      carried out and by whom? It stresses the importance of evaluating VLCD programs
      by their long-term goals and long-term results. Also, a few of the unanswered
      questions in VLCD treatment are addressed. Finally, worrisome financial-ethical
      questions of the business of VLCDs is discussed.

PMID- 1615891
TI  - Weight loss and 2-y follow-up for 80 morbidly obese patients treated with
      intensive very-low-calorie diet and an education program.
AB  - Eighty morbidly obese individuals consecutively enrolled in a comprehensive very
      low-calorie diet (VLCD) program were evaluated. Patients' mean initial body mass
      index was 45.5 kg/m2 and they lost 35.3 kg in 26 wk. Serum total cholesterol, low
      density-lipoprotein cholesterol, and triglycerides decreased by 15.0%, 17.0%, and
      14%, respectively. Systolic and diastolic blood pressure decreased by 8.7% and
      10.0%, respectively. The 46 individuals completing 2-y follow-up were maintaining
      48.0 +/- 7.6% (means +/- SE) of their weight loss. Morbidly obese persons lost
      substantial amounts of weight using a comprehensive VLCD program, reduced risk
      factors associated with obesity, and had encouraging long-term results, with 48%
      of weight loss maintained at 2 y of follow-up.

PMID- 1615892
TI  - Weight loss by very-low-calorie diets: effects on substrate oxidation, energy
      expenditure, and insulin sensitivity in obese subjects.
AB  - Weight reduction improves glucose utilization, but it is not known whether this
      occurs primarily through the oxidative or nonoxidative pathways of glucose
      metabolism. We studied this question in 12 obese subjects [whose body mass index
      (BMI) was 33.4 +/- 1.1 kg/m2)] before and after 6 wk on a very-low-calorie diet
      of 1680 kJ/d with the euglycemic insulin clamp technique in combination with
      indirect calorimetry. The mean body weight decreased from 105.3 +/- 4.6 to 94.1
      +/- 4.0 kg (P less than 0.001). This was mainly due to a reduction in fat mass
      from 47.2 +/- 3.6 to 37.7 +/- 3.0 kg (P less than 0.001), whereas lean body mass
      decreased only slightly (from 58.0 +/- 2.0 to 56.4 +/- 1.8 kg). The basal energy
      expenditure decreased with weight loss by 10.7%. This was associated with a
      reduced rate of lipid oxidation (P less than 0.05). Weight loss increased glucose
      utilization by 26%, primarily by enhancing insulin-stimulated glucose oxidation
      (P less than 0.05), whereas the effect on nonoxidative glucose metabolism was
      less pronounced (P greater than 0.05). Substantial weight loss increases glucose
      utilization by enhancing glucose oxidation.

PMID- 1615893
TI  - Protein metabolism in obese subjects during a very-low-energy diet.
AB  - We postulated that the return to nitrogen equilibrium after 3 wk of a negative
      balance during a very-low-calorie diet (VLCD) providing low-quality protein in
      obese subjects was due to availability of endogenously originating amino acids
      from a "pool" that, when depleted, would result in worsening balance. This should
      be reflected in altered kinetics of protein metabolism with the requirement for
      increased breakdown to maintain synthesis constant. Seven female obese subjects
      [body mass index (BMI) = 34.4 +/- 1.8 kg/m2] were given a 1.7-MJ/d all-protein
      diet (16.8 g N) derived from hydrolyzed gelatin (supplemented with tryptophan and
      methionine) that provides 18% of its amino acids as essential, a multivitamin
      mineral supplement, and 16 mmol KCl for 42 d. At baseline (7-d isocaloric diet),
      and weeks 4 and 6 of VLCD, amino nitrogen flux rate was calculated from the 15N
      abundance in urinary urea using the oral 15N-glycine method and rates of
      synthesis (S) and breakdown (B) inferred from N flux. Whole-body N flux did not
      change from baseline to weeks 4 and 6 (39.5 +/- 2.0 vs 37.4 +/- 2.0 vs 39.2 +/-
      1.9 g N/d). By contrast, S and B decreased at weeks 4 and 6 with S decreasing
      more so that net protein synthesis (S-B) was less positive at week 4 than at
      baseline (2.2 +/- 0.2 and 0.9 +/- 0.3 g N/d; P less than 0.05) and became
      negative at week 6 (-0.9 +/- 0.2 g N/d; P less than 0.05). Concurrently, N
      equilibrium was achieved by week 4 but returned to negative balance by week
      6.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615894
TI  - Cholelithiasis in patients treated with a very-low-calorie diet.
AB  - One hundred seventy-nine obese patients (mean body mass index = 36.3) were
      retrospectively evaluated for the development of cholelithiasis associated with
      the use of a 2530-kJ/d (605-kcal) very-low-calorie diet (VLCD). Nine percent of
      patients had preexisting gallstones and 11% of patients developed gallstones
      either during or within 6 mo of completing the diet. Six percent had subsequent
      cholecystectomy. Ursodeoxycholic acid administered to one patient resulted in
      spontaneous stone dissolution whereas spontaneous dissolution occurred in three
      patients. Surveys of patients at three other programs using the same diet yielded
      similar incidence of gallstones. We conclude that rapid weight loss associated
      with the use of VLCD is associated with a significant incidence of gallstone
      formation. VLCD should be physician supervised because resolution of
      cholelithiasis spontaneously, with stone passage, or dissolution with
      ursodeoxycholic acid therapy may reduce the need for cholecystectomy.

PMID- 1615895
TI  - Dependence of weight loss during very-low-calorie diets on total energy
      expenditure rather than on resting metabolic rate, which is associated with fat
      free mass.
AB  - The assumption that total energy expended is related to resting metabolic rate
      (RMR) has not been validated. Intuitively, weight lost should be determined by
      the difference between the total energy consumed and the total energy expended.
      The ratio of actual daily energy usage to RMR by subjects dieting for 11 wk on a
      1695-kJ (405-kcal) very-low-calorie diet (VLCD) was variable 1.9 +/- 0.3 (range
      1.47-2.36). Weight loss correlated with total energy expenditure measured by 2H2
      18O and not RMR, body mass index or body composition. Although RMR may be a
      reliable indicator of fat-free mass, there is little evidence that subjects with
      similar RMR will lose comparable weight or have comparable difficulty in weight
      maintenance.

PMID- 1615896
TI  - Changes in total body nitrogen during weight reduction by very-low-calorie diets.
AB  - Body composition measurements, including total body nitrogen (TBN) by in vivo
      neutron activation analysis, were made on 11 female volunteers before and after
      an 11-wk very-low-calorie diet (VLCD) [1695 kJ (405 kcal) 6.7 g N]. Mean body
      mass index (BMI) changed from 32.1 to 26.2 kg/m2, corresponding to a mean weight
      loss of 16.2 +/- 2.4 (SD) kg. The mean loss of TBN was 125 +/- 57 g, equivalent
      to 781 +/- 356 g protein. The fat-free mass (FFM) component of the weight loss
      was calculated by two different methods as 23.5% (+/- 3% SEM) and 22.8% (+/- 2.7%
      SEM), respectively, thereby demonstrating the improved protein sparing of
      ketogenic VLCDs. FFM loss was not clearly related to BMI.

PMID- 1615897
TI  - Altered calcium homeostasis accompanying changes of regional bone mineral during
      a very-low-calorie diet.
AB  - Calcium homeostasis during a very-low-calorie diet (VLCD) was examined. During
      the treatment, intact parathyroid hormone tended to decrease initially, bone Gla
      protein increased significantly in the third week, and tartrate-resistant acid
      phosphatase decreased during the entire treatment. Serum ketone bodies showed
      significant correlations with intact parathyroid hormone and bone Gla-protein in
      some cases. Regarding bone mineral content, bone mineral content of the head
      increased while that of the legs decreased, resulting in no significant changes
      in total bone mineral content. These results suggest that VLCD treatment alters
      calcium homeostasis, which may cause regional bone mineral changes.

PMID- 1615898
TI  - Lipid, lipoprotein, and apolipoprotein assessment during an 8-wk very-low-calorie
      diet.
AB  - The influence of a very-low-calorie diet (VLCD) on lipid pattern is
      controversial. To evaluate the long-term effect of semistarvation on lipid
      patterns, a group of severely obese patients [aged 37 +/- 12 y, body mass index
      (BMI) 40.0 +/- 0.9] underwent a VLCD for 8 wk. Total cholesterol (TC), LDL
      cholesterol (LDL-C), and HDL cholesterol (HDL-C), triglycerides (TGs),
      apolipoproteins A1 (apo A1) and B (apo B) were analyzed every week. TC (6.07 +/-
      0.23 vs 5.53 +/- 0.25 mmol/L, P less than 0.0008), HDL-C (mmol/L 1.26 +/- 0.06 vs
      1.04 +/- 0.05 mmol/L, P less than 0.0001), TGs (1.46 +/- 0.19 vs 1.06 +/- 0.10
      mmol/L, P less than 0.0008), and apo A1 (1.57 +/- 0.06 vs 1.32 +/- 0.06 g/L, P
      less than 0.0002) decreased, whereas LDL-C and apo B showed a biphasic behavior:
      they significantly fell during the first 3 wk, but during the last weeks returned
      to their initial values.

PMID- 1615899
TI  - Clinical correlates of short- and long-term weight loss.
AB  - This study was designed to identify psychological, behavioral, and physiological
      correlates of short- and long-term weight loss. Measures of psychological
      functioning, body composition, fat cell size and number, and attendance were
      evaluated in 76 obese women for their relationship to weight loss at the end of
      treatment and at a 1-y follow-up evaluation. Losing more weight during the first
      month of treatment and attending a higher percentage of treatment sessions were
      strongly associated with greater weight loss at the end of treatment and at 1-y
      follow-up. In addition, patients with the highest initial weights lost the most
      weight both at the end of treatment and at 1-y follow-up. Easily obtained
      measures are as successful in predicting weight loss as are more expensive and
      complicated measures.

PMID- 1615900
TI  - Comparison of clinical usefulness of very-low-calorie diet and supplemental low
      calorie diet.
AB  - Forty-five overweight patients (12 male, 33 female) were prescribed a very-low
      calorie diet (VLCD) or a supplemental low-calorie diet (LCD), randomly, at an
      outpatient clinic. Twenty obese patients [31.6 +/- 13.1 y; body mass index (BMI)
      32.9 +/- 6.1] were treated with a VLCD of 1757 kJ/d for 1-2 mo (five packages of
      Optifast 70/d; Sandoz Nutrition, Minneapolis). Another 25 patients (35.3 +/- 11.7
      y; BMI 31.9 +/- 4.4) were treated by a supplemental LCD of 3515-5021 kJ/d for 1-2
      months, which consisted of two to three packages of Optifast 70 and 2678-3682 kJ
      of conventional balanced meals. By the fourth week, the weight reduction obtained
      by the VLCD was significantly greater than that achieved by the supplemental LCD
      (P less than 0.01). At the eighth week, however, effect of the VLCD and the
      supplemental LCD in terms of weight reduction did not differ significantly. No
      serious side effects were observed in either treatment group. However, remarkable
      elevation of serum uric acid concentration was detected in seven patients on the
      VLCD. The treatment period of the VLCD is limited to less than or equal to 3 mo.
      On the other hand, obese patients can be treated with the supplemental LCD for
      greater than 3 mo. Therefore, the supplemental LCD is considered to be useful in
      the treatment of moderately obese Japanese patients on an outpatient basis.

PMID- 1615901
TI  - Across-the-day monitoring of mood and energy intake before, during, and after a
      very-low-calorie diet.
AB  - Mood, hunger, and energy intake were monitored in eight obese women before,
      during, and after 2 wk on a very-low-calorie diet (VLCD). Energy intake was
      significantly lower by approximately 30% in the week after the VLCD compared with
      the prediet week, both from food diaries and at a controlled ad libitum test
      meal. There was a gradual reduction in hunger, irritability, and urge to eat
      after 1 wk on the VLCD, which persisted through the postdiet week. Hunger and
      discontent were greatest in the evening during the first few days of the VLCD but
      diminished as the duration of the VLCD increased.

PMID- 1615902
TI  - Long-term outcome of a self-help very-low-calorie-diet weight-loss program.
AB  - This paper presents 90-wk data on five seriously overweight subjects originally
      brought together for 1-2 wk in simple residential accommodation to share the
      experience of beginning a program of very-low-calorie dieting. All subjects have
      remained well below their starting weight; four of the five subjects have
      continued to lose weight (weight losses 33.7-66.8 kg), now weighing less than at
      the end of the first 26 wk previously reported (1). It is proposed that this self
      help group model, incorporating a very-low-calorie diet, is valuable for the long
      term management of obesity.

PMID- 1615903
TI  - Effect of 4-wk treatment of obesity by very-low-calorie diet on anthropometric,
      metabolic, and hormonal indexes.
AB  - One-month treatment of obese patients (body mass index, 39.44 +/- 0.94, measured
      in kg/m2) with a very-low-calorie diet (VLCD) resulted in a significant weight
      loss, which was higher in men than in women. In contrast, the decrease of percent
      fat content was higher in gynoid obese women than in men or women with android
      fat distribution. In females fat mobilization was depressed at the thigh region
      where a substantially lower percent decrement of thigh skinfold thickness was
      demonstrated in comparison with males. VLCD treatment positively affected blood
      pressure and concentrations of total cholesterol, triglyceride, insulin, and
      cortisol. Total cholesterol-high-density-lipoprotein (HDL) cholesterol ratio
      remained unchanged and HDL cholesterol in serum significantly declined. Indexes
      of body fat distribution were not significantly influenced by the short-term
      treatment by VLCD except waist-hip ratio, which declined in android obese
      females. VLCD does not decrease a tolerance of physical exercise, as the
      metabolic response to submaximal workload on a cycle ergometer as well as the
      responses of cortisol, growth hormone, and prolactin remained unchanged after the
      treatment.

PMID- 1615904
TI  - Body-fat distribution and serum lipids during the long-term follow-up of obese
      patients treated initially with a very-low-calorie diet.
AB  - To evaluate a long-term efficacy of very-low-calorie-diet (VLCD) treatment, 42
      obese patients were reexamined 1 y after the initiation of the weight reduction
      by VLCD treatment for 1 mo. All the subjects participating in the long-term
      outpatient weight-reduction regime were divided into weight losers and regainers
      according to the weight change achieved at the end of 1-y follow-up. A final body
      weight decrease in weight losers was followed by a significant decline of total
      cholesterol-high-density-lipoprotein (HDL) cholesterol ratio together with
      significant rise of serum HDL cholesterol whereas almost all skinfold thicknesses
      declined. In weight regainers the sum of 10 skinfold thicknesses was the same at
      the end of follow-up as at the beginning of VLCD treatment, but body fat
      distribution was shifted towards the gynoid type when individual skinfold
      thicknesses were assessed. However, among the generally employed indexes of body
      fat distribution only waist-thigh ratio significantly decreased in weight losers.
      Nonsignificant differences in serum concentrations of total cholesterol, HDL
      cholesterol, and triglycerides between weight regainers and weight losers at the
      end of long-term follow-up suggest that some kind of adherence to weight
      reduction regime including physical exercise may favorably affect the lipid
      profile as well as body fat distribution independently on the body weight
      regained.

PMID- 1615905
TI  - Body composition and weight maintenance with a very-low-calorie diet for the
      treatment of moderate obesity.
AB  - We report body composition in 11 moderately obese patients (mean BMI less than
      30) treated for 8 wk with a 2530-kJ/d (605-Kcal) diet. Mean weight loss was 9.4
      kg. Fat-free mass (FFM) loss of 2.3 kg was 23% of total weight loss and
      essentially equal to loss of total body water (2.5 L). Body composition was
      measured by the Futrex-5000 near-infrared technique. We conclude there is no
      excess loss of FFM in moderately obese patients treated with MNP 70/70, a 70-g
      protein, 70-g carbohydrate dietary supplement for 8 wk.

PMID- 1615906
TI  - Repeated use of the very-low-calorie diet in a structured multidisciplinary
      weight-management program.
AB  - Forty-eight obese patients (mean body mass index = 36.4) were retreated with a
      very-low-calorie diet (VLCD) at a mean of 104-wk after first VLCD. Mean weight
      regain was 23 kg or 86% regain of initial loss. Retreatment with VLCD required
      weekly physician monitoring and indepth psychotherapy group attendance. Five
      patients (10%) lost an average of 4.55 kg and withdrew within the first 4 wk
      (group AO. Thirteen patients (27%) lost 13.8 kg over 11.5 wk, an average weight
      loss of 1.2 kg/wk and enrolled in maintenance (group B). Thirty patients (63%)
      lost 10.2 kg over 20 wk, an average weight loss of 0.5 kg/wk and did not enroll
      in the maintenance program (group C). Although weight loss occurs in patients
      retreated with the VLCD, adherence to the VLCD and commitment to the maintenance
      program are not optimal.

PMID- 1615907
TI  - Comparative weight loss in obese patients restarting a supplemented very-low
      calorie diet.
AB  - Successive weight losses were compared for 21 patients restarting a very-low
      calorie diet (VLCD) after weight regain. Patients broke VLCD2 sooner (3.8 vs 9.8
      wk) and lost less (9.4 vs 19.1 kg), but weight-loss rates did not differ
      significantly (0.83 vs 0.71 kg/wk). Net loss post-VLCD2 was 12.0 kg. Restart
      patients had difficulty adhering to the repeat VLCD, which resulted in lower
      losses. However, similar weight-loss rates and significant net weight loss
      suggest repeat VLCDs can be effective.

PMID- 1615908
TI  - Glycogen storage: illusions of easy weight loss, excessive weight regain, and
      distortions in estimates of body composition.
AB  - Glycogen is stored in the liver, muscles, and fat cells in hydrated form (three
      to four parts water) associated with potassium (0.45 mmol K/g glycogen). Total
      body potassium (TBK) changes early in very-low-calorie diets (VLCDs) primarily
      reflect glycogen storage. Potassium released from glycogen can distort estimates
      of body composition during dieting. TBK changes due to glycogen mobilization were
      measured in 11 subjects after 4 d dieting with a VLCD. The influence of water
      laden glycogen on weight fluctuations during the dieting process, the exaggerated
      regain if carbohydrate loading occurs, and the implications for weight control
      programs and overestimation of nitrogen losses with dieting are discussed.

PMID- 1615909
TI  - Outcome of a multicenter outpatient weight-management program including very-low
      calorie diet and exercise.
AB  - A 12-wk weight-management program was conducted to test the effectiveness of a
      combined very-low-calorie diet (VLCD) [2.0 MJ/d (470 kcal/d)] (week 1-5) and
      exercise (E) program supervised by each patient's general practitioner and
      dietitian. Throughout the program, patients [body mass index measured in kg/m2
      (BMI) 27-35] were encouraged to take part in an individually graded E program of
      walking (W), cycling (C), running (R), or swimming (S) (Van Baak and Binkhorst
      1981). Ninety-four patients (65 female and 29 male, weight: 87.7 kg, BMI: 30.7,
      age: 39.8 y) completed the program (delta: -10.6 kg). At the start, 46% were not
      involved in any type of physical exercise. After 12 wk only 8% were inactive
      (Drop out group (n = 14): 47%). Weight loss over 12 wk was significantly (P less
      than 0.01) related to participation rate in the E program. Also, 24-wk follow-up
      showed a significantly better (P less than 0.05) weight maintenance for patients
      who continued the E program (+0.4 vs +1.8 kg). These data demonstrate the
      effectiveness of a weight-management program including exercise in primary health
      care.

PMID- 1615910
TI  - High-density-lipoprotein metabolism during a very-low-calorie diet.
AB  - We examined the changes in high-density-lipoprotein (HDL) metabolism in eight
      female obese patients undergoing a very-low-calorie diet (VLCD). In the first
      half of the study, HDL cholesterol (HDL-C), apolipoprotein A-I (apo A-I), and apo
      A-II showed a parallel decrease. Although lipoprotein lipase (LPL) and hepatic
      lipase (HTGL) did not change, lecithin: cholesterol acyltransferase (LCAT)
      decreased. In the latter half of the protocol, HDL-C and apo A-I increased
      whereas apo A-II decreased, resulting in increased apo A-I-A-II ratios. There was
      no change in LPL, HTGL, or LCAT. LCAT and apolipoprotein composition may be
      important in HDL-C changes after VLCD.

PMID- 1615912
TI  - Perilous times in pathology education.

PMID- 1615911
TI  - Very-low-calorie-diet therapy in severe obesity.
AB  - This study investigated the effects of very-low-calorie-diet (VLCD) therapy on
      body weight, plasma glucose, and lipid metabolism in severely obese patients.
      Ninety-one patients were subjected to VLCD therapy for 4-24 wk. Reduction of body
      weight was remarkable during the first 4 wk, then leveled off despite continuous
      treatment. Fasting plasma glucose, triglyceride, and 75-g oral glucose-tolerance
      test showed a significant improvement. Total cholesterol fell in the early stages
      but then increased more than the pretreatment level during VLCD. VLCD therapy is
      useful for the treatment of severe obesity.

PMID- 1615913
TI  - Quantitation of estrogen and progesterone receptors by immunocytochemical and
      image analyses.
AB  - Compared to other techniques, the ability to detect estrogen and progesterone
      receptors by immunocytochemical analysis in formalin-fixed, paraffin-embedded
      sections has clear advantages, including the ability to assay small biopsy
      specimens, fine-needle aspirate samples, and archival material. Twenty-two cases
      of breast carcinoma were evaluated for estrogen and progesterone receptors by
      immunocytochemical analysis and enzyme immunoassay. Using a true color-based
      image analysis system, histograms of area versus the optical density of the
      positive staining nuclei were generated. A binary decision algorithm was derived
      from these histogram parameters by the CART computer program. Estimates generated
      by the algorithm for image analysis/immunocytochemical analysis had a 90%
      concordance with the enzyme immunoassay values. It is concluded that quantitative
      immunocytochemical results for estrogen and progesterone receptor content in
      formalin-fixed, paraffin-embedded tissue can be generated using image analysis.

PMID- 1615914
TI  - Multiple microcarcinoids arising in chronic ulcerative colitis.
AB  - A 50-year-old man who had chronic ulcerative colitis with dysplasia and two
      synchronous carcinomas had a total colectomy. Microscopic examination of the
      resected specimen revealed multiple microcarcinoids that were all smaller than 2
      mm in diameter and not visible with gross examination. Histologic examination
      revealed that they were similar to microcarcinoids of the stomach encountered in
      patients with pernicious anemia. In this patient, however, there was no
      associated endocrine cell hyperplasia in the overlying mucosa, and the carcinoids
      may have arisen from dysplastic stem cells in the colonic crypts.

PMID- 1615916
TI  - Processing and evaluation of breast excision specimens. A clinically oriented
      approach.

PMID- 1615915
TI  - Positive immunoglobulin gene rearrangement study by the polymerase chain reaction
      in a colonic adenocarcinoma.
AB  - The detection of clonal rearrangements of the immunoglobulin heavy chain gene by
      the polymerase chain reaction provides a rapid method to differentiate monoclonal
      from polyclonal B-lymphocyte proliferations. It has been shown to be highly
      specific and so far, no false-positive results have been described. A case of a
      poorly differentiated colonic adenocarcinoma that showed a "false positive"
      clonal immunoglobulin heavy chain gene rearrangement by the polymerase chain
      reaction technique is reported. DNA contamination was unlikely because of the
      strict adherence to the laboratory polymerase chain reaction protocol and also
      the repeated demonstration of the same amplified band in a separate experiment
      using DNA extracted from another piece of tumor tissue. The apparent monoclonal
      immunoglobulin heavy chain gene rearrangement in the first polymerase chain
      reaction may be related to a combination of the paucity of lymphoid cells in the
      tissue sample and the presence within this small number of lymphocytes of a
      clonal reactive cell population. It is, therefore, important to correlate the
      routine microscopic and immunohistochemical findings in the interpretation of
      polymerase chain reaction results, especially when working with nonlymphoid
      tumors and lymphocyte-poor lesions.

PMID- 1615917
TI  - Detection of Pneumocystis carinii. Comparative study of monoclonal antibody and
      silver staining.
AB  - The sensitivity of Pneumocystis carinii detection using silver stain (Grocott
      method) was compared to that using the avidin-biotin-complex immunoperoxidase
      (IP) staining method with anti-P. carinii monoclonal antibody. Silver stain
      detected only cyst wall, whereas IP stained both cyst wall and trophozoites.
      Serial sections of formalin-fixed, paraffin-embedded autopsy lung specimens from
      41 acquired immune deficiency syndrome patients in three disease categories were
      stained: I--premortem or autopsy diagnosis of P. carinii pneumonia (13 cases); II
      -history of treated P. carinii pneumonia but no P. carinii detected in autopsy
      tissue specimens (15 cases); and III--no clinical or autopsy evidence of P.
      carinii pneumonia (13 cases). Smears from 7 bronchoalveolar lavages (3 positive)
      and 11 induced sputa (1 positive) also were stained. All cases of P. carinii in
      category I were detected with equal sensitivity. P. carinii undetected by silver
      stain in category II and III cases and in bronchoalveolar lavages and induced
      sputa were not revealed by IP. Detection of trophozoites by IP did not improve
      sensitivity because the staining pattern was amorphous or focally granular, and
      thus easily confused with nonspecific staining of mucin or intracellular or free
      particulate material. Reliable identification of trophozoites could be made only
      with coexisting cyst structures. Silver staining was more advantageous because it
      also identified fungal infections and was faster and more cost effective than IP.

PMID- 1615918
TI  - Antibodies reactive with T cells in paraffin sections.

PMID- 1615919
TI  - Small blastoid cells in bone marrow.

PMID- 1615920
TI  - Frequency of gastric intestinal-type and diffuse-type adenocarcinoma in Mexico.

PMID- 1615921
TI  - Increased free phenytoin concentrations in predialysis serum compared to
      postdialysis serum in patients with uremia treated with hemodialysis. Role of
      uremic compounds.
AB  - Patients with uremia are reported to have elevated concentrations of free
      phenytoin as a result of decreases in protein binding. This appears to be related
      to the presence of uremic compounds. To determine the dialyzability of these
      compounds, the in vitro protein binding levels of phenytoin in pre- and
      postdialysis serum (supplemented with phenytoin) of 12 patients with uremia were
      compared. For these patients, the concentrations of free phenytoin were
      significantly greater in predialysis serum (lower protein binding) compared to
      postdialysis serum, although the concentrations of total phenytoin did not vary.
      Low levels of protein binding of phenytoin in predialysis serum also were
      observed in two hemodialysis patients receiving phenytoin. Several serum pools,
      prepared from both normal volunteers and the predialysis sera of uremic patients,
      were dialyzed (in vitro equilibrium dialysis). Then both undialyzed and dialyzed
      sera were supplemented with phenytoin and analyzed to determine free and total
      phenytoin concentrations. The free phenytoin concentrations were increased in
      equilibrium-dialyzed normal serum pools compared to undialyzed original pools
      because of decreases in albumin concentrations after equilibrium dialysis. In
      contrast, free phenytoin concentrations were decreased in the equilibrium
      dialyzed uremic serum pools, thereby indicating an attenuation of the albumin
      dilution effect on free phenytoin concentration, probably by the preexisting
      uremic compounds. These compounds can be removed completely by treating sera with
      activated charcoal at pH 3. The results obtained from charcoal treatment
      experiments, in combination with other results, indicate that these uremic
      compounds can be removed partially by in vivo hemodialysis and by in vitro
      equilibrium dialysis.

PMID- 1615922
TI  - Hairy cell leukemia. Diagnosis of bone marrow involvement in paraffin-embedded
      sections with monoclonal antibody DBA.44.
AB  - The new monoclonal antibody DBA.44 recognizes an unknown fixation-resistant B
      cell differentiation antigen expressed by mantle zone lymphocytes, reactive
      immunoblasts, monocytoid B cells, and a small proportion of high- and low-grade
      lymphomas. Among node-based lymphomas, the strongest membrane staining was
      observed in centroblastic, immunoblastic, and monocytoid B-cell lymphomas. In
      studying bone marrow biopsy specimens from 166 patients with hairy cell leukemia,
      strong positive staining of surface membrane 'hairy' features of leukemic cells
      was observed in routinely fixed and decalcified bone marrow biopsy specimens of
      nearly all cases. The antibody distinguished hairy cell leukemia from the more
      common B-cell chronic lymphocytic leukemia and bone marrow infiltrates of typical
      lymph node-based lymphomas by immunomorphologic criteria. DBA.44 was valuable to
      (1) confirm the diagnosis of hairy cell leukemia, (2) estimate the bone marrow
      density of hairy cell leukemia before and after treatment, and (3) make the
      diagnosis of hairy cell leukemia in ambiguous cases, which are all properties
      that indicate its usefulness in the practice of diagnostic hematopathology.

PMID- 1615923
TI  - The prognostic significance of proerythroblasts in acute erythroleukemia.
AB  - Erythroleukemia is a heterogeneous disorder that can have an excess of
      myeloblasts or proerythroblasts in the setting of dyserythropoiesis. The French
      American-British classification, established in 1976 and subsequently revised,
      allows only for the diagnosis of erythroleukemias whose immature elements are
      predominated by myeloid blasts, previously described as DiGuglielmo's syndrome.
      However, there is another form of erythroleukemia, in which the predominant
      immature elements are proerythroblasts, called DiGuglielmo's disease. To clarify
      this issue, 23 cases of erythroleukemia were reviewed and classified: 10 with a
      myeloblast predominance and 13 with a proerythroblastic predominance. These two
      forms of erythroleukemia can be distinguished on the basis of quantitative and
      qualitative morphologic features. When there were 30% or more proerythroblasts,
      calculated by dividing the total erythroid component into the proerythroblasts,
      there were few to no myeloblasts, no Auer rods, and increased cytoplasmic
      vacuoles; and myeloperoxidase staining was negative. The malignant
      proerythroblasts had increased block and blush periodic acid-Schiff positivity.
      The most frequent chromosomal abnormalities involved chromosomes 5 and 7. The
      patients with DiGuglielmo's disease had a median survival time of 2 months
      (range, 0.06 to 9 months), compared to a median of 16 months (range, 2 to 48
      months), in patients with DiGuglielmo's syndrome. The erythroleukemia with the
      preponderance of proerythroblasts had a worse prognosis because many of the
      individuals did not survive long enough to respond to the therapy initiated.
      Erythroleukemia with 30% or more proerythroblasts should be included in the
      French-American-British classification because it behaves clinically and appears
      morphologically as an acute leukemia rather than a myelodysplastic syndrome.

PMID- 1615924
TI  - Acute monocytic leukemia with chloroacetate esterase positivity. FAB M4 or M5?
AB  - French-American-British criteria for the diagnosis of acute monocytic leukemia
      (M5) require that 80% of nonerythroid bone marrow cells consist of monoblasts,
      promonocytes, and/or monocytes. Monocytic differentiation is demonstrated by
      fluoride-sensitive nonspecific esterase positivity. Chloroacetate esterase
      positivity is accepted as a marker of granulocytic differentiation. Three cases
      fulfilling French-American-British criteria for M5 showed fluoride-sensitive
      nonspecific esterase positivity in up to 100% of nonerythroid marrow cells but
      also exhibited strong chloroacetate esterase positivity in 20% to 90% of the same
      population. Less than 5% of blasts stained for Sudan black B and peroxidase.
      These cases may be viewed as chloroacetic esterase-positive acute monocytic
      leukemia or as acute myelomonocytic leukemia. The authors favor the former
      because the cases were myeloperoxidase negative; however, these cases indicate
      that chloroacetate esterase may not be a specific marker for granulocytic
      differentiation.

PMID- 1615925
TI  - DNA analysis to aid in the diagnosis of chronic myeloproliferative disorders.
AB  - Diagnosing chronic myeloproliferative disorders (CMPD) can be difficult because
      of overlap and possible transitions between the different conditions and their
      similarity to reactive myeloproliferations. DNA analysis was applied to improve
      differentiation of CMPDs. All subtypes of CMPD analyzed, including chronic
      myeloid leukemia, agnogenic myeloid metaplasia, polycythemia vera, and essential
      thrombocythemia, had in common that granulocytes and bone marrow cells were
      clonal in origin, as shown by X chromosome-linked DNA polymorphism in conjunction
      with methylation patterns (n = 32). Reactive myeloproliferations, by contrast,
      showed polyclonal inactivation patterns. Clonality could not distinguish CMPD
      from cases of myelodysplastic syndrome because the latter (n = 7) also exhibited
      clonal hematopoiesis. Because of their clonal origin, peripheral granulocytes
      were used in all cases (n = 201) to detect bcr gene rearrangement. Despite
      possible morphologic overlap between different types of CMPD, bcr gene
      rearrangement was specific for chronic myeloid leukemia and could be applied to
      differentiate chronic myeloid leukemia from other CMPDs in cases of equivocal
      morphologic diagnosis. Chronic myeloproliferative disorders represent clonal
      hemopoietic diseases that probably have specific underlying genetic defects. Thus
      DNA analysis can aid substantially in the differential diagnosis of CMPD.

PMID- 1615926
TI  - Barrett's esophagus. A preneoplastic disorder.

PMID- 1615927
TI  - Acute megakaryoblastic leukemia simulating carcinoma.
AB  - Acute megakaryoblastic leukemia has emerged as an important subset of early
      childhood leukemia. It often presents a diagnostic dilemma because of its many
      morphologic manifestations and propensity to mimic metastatic carcinoma. An
      abdominal mass was identified by sonographic and computed tomographic scans in a
      10-month-old girl, who had anemia and thrombocytopenia. An open biopsy of the 3
      cm, peripancreatic mass showed cohesive nests and sheets of tumor cells with
      focal spindling and desmoplasia. Although the diagnosis of acute megakaryoblastic
      leukemia was established from a bone marrow aspirate using immunocytochemical
      techniques and karyotype analysis, a coexistent abdominal epithelial malignant
      neoplasm could not be excluded entirely by light microscopic examination alone.
      The megakaryoblastic nature of the abdominal tumor was established by
      immunocytochemical stains for glycoprotein IIIa on paraffin-embedded tissue.

PMID- 1615928
TI  - Mucin histochemical analysis in the interpretation of Barrett's esophagus.
      Results of a multicenter study. The Operative Group for the Study of Esophageal
      Precancer.
AB  - A multicentric study of Barrett's esophagus (BE) was started in November 1987 to
      evaluate (1) the prevalence of BE among subjects undergoing upper
      gastrointestinal endoscopic examination; (2) the pathologic features of BE; and
      (3) the correlation between BE and early malignant changes. In 157 of 330
      patients who underwent multiple standardized biopsies, BE was confirmed with
      histologic evaluation. Specialized intestinal-type BE was observed in 84
      patients. By applying Alcian blue (pH 2.5)-periodate oxidation-Schiff, high-iron
      diamine-Alcian blue (pH 2.5), and periodate borohydride-saponification-periodate
      oxidation-Schiff techniques, the intestinal type of BE was subclassified into
      colonic and ileal types, both complete and incomplete. Fifty cases had incomplete
      colonic metaplasia with sulphomucins in the columnar cells and 64 had complete
      colonic intestinal metaplasia, 49 of them containing O-acetylated sialomucins in
      the goblet cells. These patients are being included in a short-term follow-up.
      Dysplasia (six low grade, two high grade) was observed in eight patients in areas
      of intestinal colonic-type epithelium; in these patients, a complete loss of O
      acetylated sialomucins in the dysplastic areas and a remarkable reduction of
      these mucins in the surrounding tissue were observed. The reduction of O
      acetylated sialomucins might indicate relative tissue immaturity, which could
      represent an early sign of neoplastic dedifferentiation. Therefore, the relevance
      of O-acetylated sialomucin content in BE, first demonstrated in intestinal type,
      is now evident, although its biologic importance is being studied.

PMID- 1615929
TI  - Expression of blood group-related antigens, ABH, Lewis(a), Lewis(b), Lewis(x),
      Lewis(y), CA19-9, and CSLEX1 in early cancer, intestinal metaplasia, and
      uninvolved mucosa of the stomach.
AB  - The expression of blood group-related antigens, A, B, H type 2, Lewis type 1
      (Lewis(a) [Le(a)] and Lewis(b) [Le(b)]), Lewis type 2 (Lewis(x) [Le(x)] and
      Lewis(y) [Le(y)]), sialylated Le(a) (CA19-9), and sialylated Le(x) (CSLEX1), was
      analyzed sequentially with immunohistochemical methods in early gastric cancer,
      intestinal metaplasia, and uninvolved gastric mucosa obtained from 35 surgical
      specimens of patients who underwent gastrectomy. The high incidence of the
      inappropriate expression of Lewis type 1 antigens and the deletion of H and Lewis
      type 2 antigens was observed similarly in patients with cancer and intestinal
      metaplasia. The acquisition of CA19-9 and CSLEX1 and the deletion of B antigen
      frequently were found in intestinal-type cancer and all types of intestinal
      metaplasia. The simultaneous deletion of A antigen was detected only in the
      combination of intestinal-type cancer and incomplete-type intestinal metaplasia.
      Thus the present study shows that similar changes of tissue antigenicities exist
      in early gastric cancer and intestinal metaplasia.

PMID- 1615930
TI  - Expression of E-cadherin in normal, benign, and malignant tissues of female
      genital organs.
AB  - The expression of human E-cadherin in normal tissues and in benign and malignant
      tumors of female genital organs was examined immunohistochemically with a
      monoclonal antibody, HECD-1, specific for human E-cadherin. The normal tissues
      included the ovary, fallopian tube, uterine endometrium, uterine cervix, and
      vagina. E-cadherin was detected clearly in the cell-to-cell boundaries of both
      normal glandular and squamous epithelia obtained from those tissues. The tumor
      tissues consisted of 9 ovarian, 7 endometrial, and 4 cervical adenocarcinomas, 12
      squamous cell carcinomas of the cervix, including 3 cervical intraepithelial
      neoplasms, and 5 mesenchymal tumors. E-cadherin also was detected in the cell-to
      cell borders of all the epithelial tumors tested, with some reactivity in the
      cytoplasm of malignant cells, whereas mesenchymal tumors showed no expression. It
      is noteworthy that poorly differentiated areas of both the adenocarcinomas and
      squamous cell carcinomas showed less expression of E-cadherin. No difference in
      the expression of E-cadherin between the primary and metastatic lesions was
      detected in 10 sets of malignant tumors. E-cadherin may be an important factor
      among a variety of biologic events that occur during the process of metastasis.
      However, further studies are needed to clarify this.

PMID- 1615931
TI  - p53 expression in neoplasms of the uterine corpus.
AB  - It has been recognized that mutations in tumor suppressor genes may have an
      important oncogenic role. Although abnormalities of the p53 tumor suppressor gene
      have been reported in tumors from various organ systems, p53 expression has not
      been studied in neoplasms of the uterine corpus. Using a monoclonal antibody to
      the p53 product, frozen sections of 56 uterine tumors (40 endometrioid
      endometrial adenocarcinomas, 7 serous endometrial carcinomas, 4 mixed Mullerian
      tumors, 2 endometrial stromal sarcomas, 1 leiomyosarcoma, 2 leiomyomas) and 2
      normal endometria were stained using the immunoperoxidase technique. Staining was
      evaluated by light microscopic examination; in carcinomas with strong/diffuse
      reactivity, evaluation was by digitized image analysis. p53 staining of
      adenocarcinomas was compared statistically to the histologic type, grade,
      surgical stage, and clinical follow-up. Specific staining was present in the
      nucleus of malignant tumor cells only. Benign cells did not stain. Strong/diffuse
      staining was seen in 14 adenocarcinomas and in 2 mixed Mullerian tumors.
      Weak/focal staining was observed in 14 adenocarcinomas. Serous carcinomas showed
      strong positivity more frequently than endometrioid endometrial carcinomas.
      Staining patterns correlated with histologic grade and stage. Image analysis of
      immunostained p53 correlated with type of adenocarcinoma, but not with grade or
      stage in the cases measured. p53 was expressed strongly in tumors of five of
      eight patients who died of adenocarcinoma but in none of five patients with no
      evidence of disease and a minimum follow-up of 24 months. In addition, 3 of 12
      patients with persistent or recurrent disease showed tumors that strongly
      expressed p53. It is concluded that abnormal expression of p53 occurs frequently
      in malignant uterine tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1615932
TI  - Neuroendocrine phenotype in lung cancers. Comparison of immunohistochemistry with
      biochemical determination of enolase isoenzymes.
AB  - The authors evaluated methods of recognition of neuroendocrine differentiation in
      lung cancer because this is thought to bear prognostic value. One hundred forty
      lung tumors were divided by immunohistochemical analysis using neuroendocrine
      markers (neuron-specific enolase, Leu7, chromogranin, neural cell adhesion
      molecules, SL11/14, and Leu19) into two groups of 51 neuroendocrine tumors
      positive for three neuroendocrine markers and 89 non-neuroendocrine tumors.
      Biochemical determination of enolase activity and isoenzyme distribution showed
      that the level of total enolase activity was similar between neuroendocrine and
      non-neuroendocrine tumors. alpha gamma and gamma gamma enolase isoenzyme
      percentages were higher in neuroendocrine tumors. A cut-off of gamma enolase %
      (alpha gamma/2 + gamma gamma) at 14% gave a sensitivity rate of 84% and
      specificity rate of 97% in separating neuroendocrine and non-neuroendocrine
      tumors, whereas immunohistochemical analysis using anti-gamma enolase had low
      specificity (68%) and immunohistochemical analysis with Leu 7 and chromogranin
      had high specificity (97%) and low sensitivity (37% and 60%) levels for
      neuroendocrine tumors. The best prediction of neuroendocrine differentiation was
      obtained using immunohistochemical analysis against neural cell adhesion
      molecules combined with biochemical estimation of enolase using gamma enolase of
      14% and a gamma gamma isoenzyme more than 3%.

PMID- 1615933
TI  - Optimization of DNA extraction from formalin-fixed tissue and its clinical
      application in Duchenne muscular dystrophy.
AB  - The authors report a case of Duchenne muscular dystrophy in which a deletion was
      determined by multiplex polymerase chain reaction using postmortem tissue from a
      proband who died in 1985, 2 years before the cloning of the dystrophin gene.
      Several extraction methods were analyzed to determine optimal conditions for
      recovery of DNA from fixed tissue. Variables examined were tissue lysis times and
      temperatures, a simple salting-out procedure for purification of DNA, polymerase
      chain reaction amplification of crude lysate versus purified DNA, and lysis of
      different tissues and tissue quantities. Extracted DNA was analyzed
      spectrophotometrically, electrophoretically, and by its suitability for
      polymerase chain reaction amplification using exon flanking primers of the
      dystrophin gene. Lysis at 37 degrees C for less than 24 hours led to the recovery
      of predominantly low-molecular-weight DNA, which was unsuitable for polymerase
      chain reaction in this experience. Lysis at 54 degrees C consistently yielded
      visible, spoolable quantities of high-molecular-weight DNA in as little as 24
      hours. Direct amplification of crude, unpurified lysates was unsuccessful.
      However, purified samples yielded consistent amplification products. The
      purification step was simplified by substituting a rapid salting-out procedure
      for organic extractions.

PMID- 1615934
TI  - The high mortality of gastrointestinal bleeding in HIV-seropositive patients: a
      multivariate analysis of risk factors and warning signs of mortality in 50
      consecutive patients.
AB  - The patterns of which human immunodeficiency virus (HIV)-seropositive patients
      underwent endoscopy for gastrointestinal bleeding at a university hospital were
      analyzed in 50 consecutive patients admitted from July 1984 through December
      1989, and criteria were developed as to which patients are most likely to benefit
      from endoscopy. Analyzed patient data included the medical records, follow-up
      until July 1990 obtained by telephone questionnaire in 46 patients, and autopsy
      findings in the 11 patients undergoing autopsy. Thirty-seven percent of the
      patients did not undergo endoscopic or radiographic examinations indicated to
      determine the cause of bleeding. The adequacy of the evaluation was not related
      to race, intravenous drug abuse, homosexuality, hemophilia, the diagnosis of
      known AIDS, or being a public patient. In 21 of the 28 cases in which the cause
      of bleeding was determined, the diagnosed lesions had a specific, effective
      therapy. The mortality from gastrointestinal bleeding was 39.0%, compared with
      8.3% in 48 controls without known HIV infection (p less than 0.001 by Fisher's
      exact test, odds ratio = 7.0, odds ratio confidence interval = 5.0-9.7).
      Statistically significant independent predictors of mortality included
      leukocytosis, concurrent major diseases, intravenous drug abuse, transfusion of 5
      or more units of packed erythrocytes, and the presence of a bloody nasogastric
      aspirate or hematemesis (Wilk's lambda statistic = 0.369, p less than 0.0001). In
      particular, 10 of 11 patients (89%) with two or more concurrent major diseases
      died, whereas only three of 24 patients (13%) with no concurrent diseases died
      during the hospitalization. We conclude a large percentage of HIV-seropositive
      patients did not undergo a diagnostic evaluation for gastrointestinal bleeding at
      a university hospital, and there was no discernible rational pattern as to which
      patients underwent endoscopy. Endoscopy is an important and indicated procedure
      in HIV-seropositive patients with no or one concomitant major illness. HIV
      seropositive patients with gastrointestinal bleeding and two or more concomitant
      major illnesses have an exceedingly poor prognosis, and are less likely to
      benefit from invasive diagnostic tests and aggressive therapy.

PMID- 1615935
TI  - Long-term clinical and manometric follow-up of patients with nonspecific
      esophageal motor disorders.
AB  - In the manometric evaluation of patients complaining of chest pain, a nonspecific
      esophageal motor disorder is commonly identified. Yet, the clinical
      characteristics of these patients and stability of the manometric pattern with
      time have not been previously described. This study reports a 3.2-yr clinical and
      manometric follow-up of 23 patients with nonspecific esophageal motor disorder.
      These subjects were most commonly middle-aged women with long-standing,
      persistent, and debilitating clinical symptoms. Ninety-six percent (22/23) of our
      patients complained of chest pain; 65% (15/23) had dysphagia. In addition, 15
      (65%) had evidence of reflux during ambulatory pH studies. Symptoms caused such
      concern that the patients frequently sought medical assistance to exclude serious
      diseases. Although the symptoms tended to persist, the motility patterns changed
      in some patients. Follow-up manometric studies were normal in 29%, and
      nonspecific esophageal motor disorder persisted in 57% of the patients. In three
      patients (14%), the pattern evolved into diffuse esophageal spasm. When symptoms
      were compared with these changes in follow-up manometric patterns, the
      correlation was poor. This observation suggests that additional mechanism(s)
      other than disturbed esophageal motility may be responsible for the symptoms seen
      in these individuals.

PMID- 1615936
TI  - Ischemic hepatitis: widening horizons.
AB  - Ischemic hepatitis is not an uncommon complication of reversible severe
      hypotension or cardiac failure. The prognosis usually is determined by the cause
      of the initial hypotension or cardiac failure, rather than the subsequent hepatic
      dysfunction. We report a retrospective analysis of nine patients with ischemic
      hepatitis in which previously unreported clinical and biochemical abnormalities
      are noted. The clinical and biochemical course of the patients were reviewed
      until recovery or death from ischemic hepatitis. All the patients had a rapid
      striking elevation of aspartate aminotransferase, and lactic dehydrogenase, with
      an equally rapid resolution of these parameters. Abnormal serum glucose levels
      occurred in six patients (none of whom had a prior carbohydrate intolerance).
      Insulin therapy was given to three patients for a limited period. Renal
      impairment was manifest in all nine patients, and it resolved spontaneously
      within 10 days. Altered mental status was detected in six patients; the changes
      reverted to normal within 7 days of their onset. A preexisting anemia (hemoglobin
      less than 11.0 g/dl) was noted on admission in four patients, and it did not
      appear to potentiate the manifestations of the hepatic ischemia. We conclude that
      ischemic hepatitis should be anticipated in all patients with a recent history of
      systemic hypotension. It should be considered in the differential diagnosis of
      patients with unexplained hepatitis; the early massive rise in lactic
      dehydrogenase, the rapid fall in transaminases, and the early mild/moderate renal
      failure strongly suggest ischemic hepatitis. Patients with ischemic hepatitis can
      manifest reversible renal failure, mental confusion, and hyperglycemia which may
      require insulin for its control.

PMID- 1615937
TI  - Effect of injection sclerosis with alcohol on the rebleeding rate of
      gastroduodenal peptic ulcers with nonbleeding visible vessels: a prospective,
      controlled trial.
AB  - To assess the efficacy of injection therapy with alcohol on prevent rebleeding
      and emergency surgery in patients with gastroduodenal ulcers and nonbleeding
      visible vessels, we have performed a prospective controlled trial involving 39
      patients who were classified into two groups according to the time of the day on
      which emergency endoscopy was performed: group 1 (25 patients) in which
      endoscopic hemostasis with absolute alcohol was performed, and group 2 (14
      patients) in which conventional therapy was applied (blood transfusions,
      antacids, and ranitidine). The two groups were comparable with regard to age,
      sex, and type of bleeding. The rebleeding rate/emergency surgery rate of 8%/4%,
      respectively, for group 1 was lower than the 57%/50% for group 2 (p less than
      0.001). Our results suggest that endoscopic hemostasis with alcohol should be
      considered as the initial treatment of choice in patients who present with major
      upper gastrointestinal hemorrhage and are found to have an ulcer with a
      nonbleeding visible vessel.

PMID- 1615938
TI  - Fecal protein markers of colorectal cancer.
AB  - To identify fecal proteins that might prove useful in the early detection of
      colorectal cancer, we used sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) and protein immunoblotting to compare the fecal
      protein patterns of stool supernatants from 10 patients with colorectal cancer
      with those of 12 controls. SDS-PAGE followed by Coomassie blue staining revealed
      two heavily stained bands in the majority of cancer stools that were not present
      in control stools. These bands proved to be human hemoglobin and human albumin by
      protein immunoblotting. No other consistent differences between the cancer and
      control stools were observed on the stained gels. The stool supernatants were
      probed for several other blood proteins by protein immunoblotting. Carbonic
      anhydrases I and II were more abundant in the cancer stools; alpha 1-antitrypsin
      appeared equally in cancer and control stools. Further work is needed to
      determine whether measurement of fecal carbonic anhydrase can be useful for early
      detection of colorectal cancer.

PMID- 1615939
TI  - Correlates of constipation in an ambulatory elderly population.
AB  - Constipation is a common and often perplexing problem for elderly people. The
      prevalence of self-reported constipation and factors associated with constipation
      were investigated in 3,166 people over age 65. Twenty-six percent of women and
      15.8% of men reported recurrent constipation (p less than 0.0001). There was a
      significant increase in reported constipation with increasing age (p less than
      0.0001). Multiple factors were found to correlate with self-reported
      constipation. A logistic regression model revealed 13 factors of significance in
      predicting constipation. The most important factors were age, sex, total number
      of drugs taken, pain in the abdomen, and hemorrhoids (p less than 0.0001).
      Specific drugs do not appear to be important factors in constipation in the
      elderly. Elderly people who report the use of multiple drugs, pain in the
      abdomen, and hemorrhoids are at increased risk for constipation.

PMID- 1615941
TI  - Significance of pleural effusion in patients with acute pancreatitis.
AB  - We retrospectively reviewed the charts of all patients with acute pancreatitis
      admitted to our hospital between July 1987 and June 1991 to determine the
      relationship of a pleural effusion in patients with acute pancreatitis with the
      severity of the disease, the etiology of the pancreatitis, pseudocyst formation,
      and triglyceride levels. Eleven (13.4%) of the 82 patients with acute
      pancreatitis had evidence of pleural effusion. Eight of 42 patients with
      alcoholic pancreatitis developed an effusion, compared with one of 33 patients
      with biliary pancreatitis, indicating that an alcoholic etiology may be a risk
      factor. Seven (63%) of the 11 patients had associated pseudocysts. Patients with
      severe disease had a greater incidence of pleural effusion. The effusion was on
      the left side in six, bilateral in four, and on the right side in one patient.
      Hypertriglyceridemia did not appear to be an independent risk factor associated
      with pleural effusions. Diagnostic thoracentesis was performed in three patients
      because of the presence of fever. Pleural fluid amylase was normal in one case
      and mildly elevated in the other two. All effusions resolved spontaneously
      without the need for any therapeutic intervention.

PMID- 1615940
TI  - Receptor index via hepatic asialoglycoprotein receptor imaging: correlation with
      chronic hepatocellular damage.
AB  - Galactosyl human serum albumin is a newly developed receptor-binding agent,
      specific for the asialoglycoprotein receptor, which resides exclusively on the
      plasma membrane of mammalian hepatocytes. The receptor-binding agent was
      synthesized by the covalent coupling of carbohydrate units to human serum
      albumin. The clinical utility of technetium-99m-labeled galactosyl human serum
      albumin was evaluated in six control subjects with normal livers and in 50
      patients with chronic liver disease. The parameter, receptor index, was derived
      from liver and heart time-activity data and is the ratio of radioactivity of the
      liver over the radioactivity of the liver plus the heart at 15 min after the
      intravenous injection of 3 mg of labeled ligand. Values for the receptor index in
      the control subjects and in patients with mild, moderate, and severe liver
      disease were 0.936 +/- 0.015, 0.909 +/- 0.034, 0.848 +/- 0.070, and 0.669 +/-
      0.085, respectively. Good correlations were obtained between the receptor index
      and conventional liver function tests, such as the Child-Turcotte criteria score
      (rs = -0.776, p = 0.0001), prothrombin time (r = 0.736, p = 0.0001), and the
      plasma disappearance rate of indocyanine green (r = 0.805, p = 0.0001). These
      significantly high correlations of the receptor index with classical indicators
      of hepatic functional reserve suggest that the receptor index is a potentially
      practical and reliable diagnostic method for estimating the functioning
      hepatocyte mass and for assessing liver function.

PMID- 1615942
TI  - Primary gastric plasmacytoma: a morphological and immunohistochemical study of
      five cases.
AB  - Five cases of primary gastric plasmacytoma were studied histopathologically and
      immunohistochemically. Plasmacytoid cells proliferated diffusely in the propria
      mucosa, almost preserving the structure of gastric glands. Occasionally,
      intranuclear inclusions, giant cells, and needle-shaped crystalline inclusions
      were observed. The neoplastic nature could be suspected on the basis of these
      histological findings. Immunohistochemically, three cases were positive for IgM
      and two for IgA. IgM positivity was more commonly observed in the gastric
      plasmacytoma than in multiple myeloma. Another immunohistochemical study
      demonstrated that LN-1 negativity and anti-EMA antibody positivity might be an
      indicator to differentiate gastric plasmacytoma from other types of gastric
      lymphoma. Four cases of early-stage gastric plasmacytoma have been followed for 5
      12 yr. No recurrence has been observed so far. These cases suggest that gastric
      plasmacytoma has a relatively good prognosis.

PMID- 1615943
TI  - Increased intracranial pressure and hepatic encephalopathy in chronic liver
      disease.
AB  - Increased intracranial pressure is present in more than 80% of patients with
      fulminant hepatic failure. However, patients with encephalopathy secondary to
      chronic liver disease are thought not to develop elevated intracranial pressure.
      We report two patients with chronic liver disease in hepatic coma with raised
      intracranial pressure documented by an epidural intracranial pressure monitor.
      One patient rapidly deteriorated to coma over a period of 4 h. The other patient
      progressively worsened following intravenous sedation administered during upper
      endoscopy. Both patients had generalized tonic-clonic seizures, and one
      demonstrated decerebrate posturing and papilledema. Although all metabolic and
      structural abnormalities should be excluded in patients with hepatic
      encephalopathy, if the etiology remains in question, the possibility of increased
      intracranial pressure should be considered in patients with chronic liver
      disease.

PMID- 1615944
TI  - Fungemia with Torulopsis glabrata after endoscopic biliary stent replacement.
AB  - We report a patient with disseminated cholangiocarcinoma who developed systemic
      fungemia subsequent to endoscopic retrograde cholangiopancreatography (ERCP) and
      stent replacement. Despite intensive systemic antifungal therapy with iv
      amphotericin B, the patient developed multiple complications and eventually
      succumbed to her underlying disease. Cultures of the removed stent and blood were
      positive for the same organism, Torulopsis glabrata. In an immunocompromised host
      during ERCP manipulation, fungal pathogens should be considered in post-stent
      septicemia.

PMID- 1615945
TI  - Aminophylline suppository-induced acute proctitis.
AB  - A 9-yr-old boy revealed anal hemorrhage after administration of an aminophylline
      suppository. Proctosigmoidoscopy demonstrated edema of the rectal mucosa with
      hyperemia and petechiae. We performed a provocation test and obtained the
      diagnosis of aminophylline suppository-induced acute hemorrhagic proctitis. One
      should recognize that acute hemorrhagic proctitis is a rare but important side
      effect of aminophylline suppositories, because they are commonly used for
      asthmatic children.

PMID- 1615946
TI  - Long-term hepatic memory for hypersensitivity to nitrofurantoin.
AB  - Nitrofurantoin-induced hepatic injury has been established unequivocally as an
      entity by rechallenge experiences. We reviewed 12 previously reported cases in
      which rechallenge was described. The longest reported interval between initial
      injury and rechallenge-provoked injury was 4 yr. We report a 56-yr-old woman who
      experienced severe hepatocellular injury with brief low-dose administration of
      nitrofurantoin 17 yr after an initial hepatitis-like illness associated with
      ingestion of the drug. Despite a temporal relationship to nitrofurantoin
      administration and histologic features compatible with drug-induced hepatitis,
      the initial bout of hepatitis had been termed "infectious." Our case appears
      remarkable for the long interval between initial injury and rechallenge-induced
      injury. The severity of the hepatic injury seen on rechallenge underscores the
      concept that the inadvertent rechallenge can be dangerous. Failure to identify
      the first bout of hepatitis as nitrofurantoin-related, and failure to inform the
      patient about the possible relationship to nitrofurantoin, raises important risk
      management concerns, because hepatic memory of nitrofurantoin hypersensitivity
      appears to be of long duration.

PMID- 1615947
TI  - Primary intestinal lymphoma in Crohn's disease: minute tumor with a fatal
      outcome.
AB  - A 54-yr-old man with a 22-yr history of Crohn's disease was found to have a
      microscopic focus of immunoblastic lymphoma within a segment of small bowel
      resected to relieve intestinal obstruction. There was no other clinically evident
      disease. Thirty months later, he developed axillary adenopathy with recurrent
      lymphoma of the same immunophenotype (IgA lambda) and was given combination
      chemotherapy, with complete clinical response. Lymphoma recurred 6 months later
      in the axilla and progressed rapidly over the next 3 months, despite
      chemotherapy. He developed extensive mediastinal, mesenteric, and retroperitoneal
      disease with malignant ascites and died 39 months after diagnosis of the
      incidentally discovered bowel mucosal primary tumor.

PMID- 1615949
TI  - Hepatic lymphangiomatosis: report of two cases, with an immunohistochemical
      study.
AB  - Two cases of hepatic lymphangiomatosis were examined. One tumor was noted
      incidentally at autopsy, and the other tumor was removed by operation. These
      liver tumors could not be detected by the naked eye, but ill-defined lace-like
      areas were seen. Microscopically, small cystic spaces were irregularly aggregated
      in the hepatic parenchyma and, in part, in the portal tracts. Faintly stained
      lymph-like material without any erythrocytes was found in the spaces. The silver
      impregnation method confirmed that most of the cystic lumina were dilated Disse's
      spaces. Also, some of them were directly connected with lymph vessels in the
      portal tracts. Thin lining cells along the internal surface of these cystic
      channels could not be positively stained by Ulex europaens 1 or factor 8-related
      antigen, both of which were present in the endothelium of the blood vessels in
      the portal tracts. We describe herein this rare lymphangiomatosis of the liver,
      with special reference to its immunohistochemistry.

PMID- 1615948
TI  - Acute colonic diverticular perforation presenting as left ear pain and facial
      swelling due to cervical subcutaneous emphysema in a patient administered
      corticosteroids.
AB  - A 56-yr-old white female administered corticosteroids presented with left ear
      pain and facial swelling due to cervical subcutaneous emphysema from a
      diverticular perforation of the sigmoid colon. This case demonstrates that
      localized signs of a bowel perforation may be absent in patients administered
      corticosteroids, that these patients may present with unusual, remote findings,
      and that bowel perforation can produce cervical subcutaneous emphysema.

PMID- 1615950
TI  - Adenocarcinoma in Meckel's diverticulum: report of a case and review of 30 cases
      in the English and Japanese literature.
AB  - A 54-yr-old man who complained of abdominal pain was found to have an
      adenocarcinoma arising in Meckel's diverticulum, as preoperatively diagnosed with
      99mTc-pertechnetate scintigraphy. Angiography of the superior mesenteric artery
      revealed multiple branched arteries and tumor stain, but the vitelline artery was
      not clearly identified. Surgery revealed that the tumor had invaded the urinary
      bladder and the ileum, including the diverticulum, and the bladder had to be
      partially resected. Histopathological examination of the lesion revealed a
      diverticulum containing normal small bowel mucosa, ectopic normal gastric tissue,
      and adenocarcinoma. In a review of 30 cases of adenocarcinoma in Meckel's
      diverticulum in the English and Japanese literature, our case was the first to be
      diagnosed preoperatively.

PMID- 1615951
TI  - Tuberous sclerosis complex: review of the gastrointestinal manifestations and
      report of an unusual case.
AB  - Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that can
      affect any organ of the body. We report the first case of advanced colonic
      adenocarcinoma in a patient with well-documented TSC, offer rationales for the
      association of this lesion with TSC, and review the literature pertaining to
      gastrointestinal involvement of this complex.

PMID- 1615952
TI  - MEGX: from bench to bedside.

PMID- 1615953
TI  - Beta-blockers in portal hypertension: variation on a theme.

PMID- 1615954
TI  - Application of the medical decision-making model to esophageal reflux disease:
      commentary on a study by Breumelhof and Smout.

PMID- 1615955
TI  - Enteral feeding: PEG or nasoenteric.

PMID- 1615956
TI  - Clinical application of the study on sphincter of Oddi motor activity in patients
      with anomalous pancreaticobiliary junction.

PMID- 1615957
TI  - Hidradenitis suppurativa and Crohn's disease in two families: a significant
      association?

PMID- 1615958
TI  - Long-term microscopic findings after colon esophagoplasty.

PMID- 1615959
TI  - Esophageal tuberculosis.

PMID- 1615960
TI  - A case of constitutional indocyanine green excretory defect with abnormal
      retention of sulfobromophthalein: a new functional disorder?

PMID- 1615961
TI  - Lack of tumor response to interferon in a malignant ECL cell carcinoid of the
      stomach.

PMID- 1615962
TI  - Hematoma of the liver caused by self-inflicted trauma mimicking hepatic abscess.

PMID- 1615963
TI  - Association of intrahepatic portal venous obstruction with intrahepatic calculi
      formation.

PMID- 1615964
TI  - Pseudoterranova decipiens larva infection mimicking a chronic peptic ulcer.

PMID- 1615965
TI  - Folly, woodenheadedness, and the alluvial mind.

PMID- 1615966
TI  - Therapeutic donor insemination: a prospective randomized trial of fresh versus
      frozen sperm.
AB  - OBJECTIVE: We evaluated the efficacy of fresh versus frozen sperm in therapeutic
      donor insemination. STUDY DESIGN: Fifty-seven women underwent 72 courses of
      treatment (a maximum of six therapeutic donor insemination cycles--three fresh
      and three frozen) totaling 198 cycles. Each woman served as her own control and
      was prospectively randomized to receive a single, timed insemination of either
      fresh or frozen sperm. RESULTS: Fecundity was 20.6% for fresh sperm cycles and
      9.4% for frozen (p less than 0.03, by chi 2 analysis). Fresh cervical cap
      insemination fecundity was 20.3%; frozen was 7.8% (p less than 0.03, by chi 2
      analysis). Fresh intrauterine insemination fecundity was 21.2%; frozen was 15.8%
      (p = 0.63, by chi 2 analysis). Fresh 3-month life-table pregnancy rates were 48%
      +/- 10%; frozen rates were 22% +/- 8% (p = 0.05 by Breslow analysis). Survival
      analysis with fixed covariates showed a positive association with the use of
      fresh sperm (p = 0.04). CONCLUSION: Cycle fecundity was significantly greater
      with fresh sperm in women undergoing cervical cap insemination or intrauterine
      insemination and in women undergoing only cervical cap insemination. These
      results have important implications for contemporary management of patients
      undergoing therapeutic donor insemination with frozen sperm.

PMID- 1615967
TI  - Effect of controlled ovarian hyperstimulation on pregnancy rates after
      intrauterine insemination.
AB  - OBJECTIVE: Our objective was to evaluate the effect of controlled ovarian
      hyperstimulation on pregnancy rates after intrauterine insemination of washed
      husband's sperm. STUDY DESIGN: In a private practice setting at the Infertility,
      Gynecology, and Obstetrics Medical Group in San Diego, 79 treatment programs
      included intrauterine insemination during natural cycles, 195 included clomiphene
      stimulation, and 53 had human menopausal gonadotropin stimulation. Pregnancy
      rates and monthly fecundabilities were calculated by life-table analysis and
      compared by the Z test. RESULTS: By life-table analysis the cumulative
      probability of pregnancy after intrauterine insemination with no ovulation
      induction is 21.0% after six cycles with a monthly fecundability of 3.4%. With
      clomiphene the pregnancy rate is 32.7% with a monthly fecundability of 6.1%, and
      with human menopausal gonadotropin the pregnancy rate is 60.7% with a monthly
      fecundability of 13.0%. The human menopausal gonadotropin group had a
      significantly higher pregnancy rate and monthly fecundability as compared with
      the other two groups. There were no differences between the no-stimulation and
      the clomiphene groups. CONCLUSIONS: Human menopausal gonadotropin stimulation
      results in a significantly higher pregnancy rate and monthly fecundability after
      intrauterine insemination as compared with no stimulation or clomiphene use.

PMID- 1615968
TI  - Percutaneous umbilical blood sampling: results from a multicenter collaborative
      registry. The Western Collaborative Perinatal Group.
AB  - Percutaneous umbilical blood sampling has become an important diagnostic tool in
      the evaluation of fetal health. Although recent reports have established the
      safety of this procedure, most have arisen from single centers with extensive
      experience. The Western Perinatal Collaborative Group has maintained a continuous
      registry of percutaneous umbilical blood sampling performed at the 13 member
      institutions for the years 1986 through 1990. During this period 302 procedures
      were performed. Primary indications for percutaneous umbilical blood sampling
      included Rh and non-Rh isoimmunization, intrauterine growth retardation,
      nonimmune hydrops, fetal anomalies, immune thrombocytopenia purpura, and rapid
      fetal chromosome analysis. Percutaneous umbilical blood sampling was successfully
      performed in 93.7% of cases with a sample withdrawn by a single puncture in 80.5%
      of attempts. In the majority of cases a 22-gauge needle was used. Postprocedural
      fetal death resulted in six cases (2.1%) and was most often associated with fetal
      anomalies or an abnormal karyotype. In conclusion, evaluation of the fetal state
      by percutaneous umbilical blood sampling is a safe and easily performed
      procedure, as demonstrated by a collaborative multicenter study.

PMID- 1615969
TI  - Hysteroscopic myometrial biopsy: its use in diagnosing adenomyosis and its
      clinical application.
AB  - OBJECTIVE: The purpose of this study was to develop and clinically evaluate a
      hysteroscopic myometrial biopsy for diagnosing adenomyosis. STUDY DESIGN: Ninety
      patients with menorrhagia had myometrial biopsies. The depth of adenomyosis was
      correlated with the severity of menorrhagia. RESULTS: Of the 90 patients studied,
      50 had hysteroscopically normal appearing cavities (i.e., without polyps or
      submucous myomas). Of those 50, 33 (66%) had significant adenomyosis (greater
      than 1 mm) as compared with controls (0.8 mm). A statistically significant
      correlation between the depth of adenomyosis and the severity of menorrhagia was
      found, (p = 0.05). CONCLUSION: A myometrial biopsy can diagnose adenomyosis.
      Minimal adenomyosis can be treated definitively by endometrial ablation. Deep
      adenomyosis should be treated with a hysterectomy. Endometrial glands left under
      a scar could not only bleed and cause pain but also have malignancy potential.
      The scar may delay bleeding and the diagnosis of endometrial cancer. Routine
      myometrial biopsy at the time of operative hysteroscopy should be added to our
      diagnostic armamentarium.

PMID- 1615970
TI  - Neonatal morbidity according to gestational age and birth weight from five
      tertiary care centers in the United States, 1983 through 1986.
AB  - OBJECTIVES: This study details the incidence, by gestational age and birth
      weight, of specific neonatal morbidities in singleton neonates without major
      congenital anomalies. STUDY DESIGN: Data were prospectively collected on all
      deliveries at five tertiary centers in the United States during the years 1983
      through 1986. Pregnancies were meticulously dated and the gestational ages of the
      neonates at delivery were confirmed by Dubowitz score. RESULTS: The incidence of
      respiratory distress syndrome gradually decreases with increasing gestational age
      until 36 weeks. A marked decrease in the incidence of necrotizing enterocolitis,
      patent ductus arteriosus, intraventricular hemorrhage, and sepsis occurs after 32
      completed weeks. The number of days of mechanical ventilation for respiratory
      distress syndrome and newborn stay in the tertiary care facility also were
      significantly reduced after 32 weeks. CONCLUSIONS: The incidence of both
      respiratory distress syndrome and patent ductus arteriosus is markedly decreased
      by both increasing gestational age and birth weight. The incidence of grade III
      and IV intraventricular hemorrhage, necrotizing enterocolitis, and sepsis
      virtually vanishes after 34 weeks. These data relating neonatal morbidities to
      gestational age are important to the obstetrician in the critical decision
      regarding the timing of delivery and to the parents, who can benefit from a
      realistic prediction of the neonatal course.

PMID- 1615971
TI  - Deoxyribonucleic acid analysis by flow cytometry of uterine leiomyosarcomas and
      smooth muscle tumors of uncertain malignant potential.
AB  - OBJECTIVES: The histologic distinction of uterine benign leiomyomas from
      leiomyosarcomas is difficult. Ploidy analysis and measurement of the
      proliferative rate were examined to determine if they could distinguish malignant
      from benign tumors and if they were independent prognostic factors. STUDY DESIGN:
      Paraffin-embedded blocks were recut and prepared for flow cytometry with the
      technique of Hedley. Mitotic counts and tumor grading were performed on an
      adjacent hematoxylin and eosin-stained section. Statistical analysis was carried
      out with chi 2 life-table, and Cox model analysis. RESULTS: There were 33
      patients with deoxyribonucleic acid histograms that were acceptable for analysis.
      Fourteen tumors were diploid and 19 were aneuploid. There were no significant
      differences in the clinical characteristics between the patients with diploid
      tumors and those with aneuploid tumors. Aneuploid tumors were more likely to have
      cellular atypia (p = 0.085). There was a strong correlation between the
      percentage of cells in the S phase and the mitotic count (p = 0.0001). Increasing
      mitotic count, increasing S phase, presence of extrauterine disease, and
      postmenopausal status were all adverse prognostic factors. However, when
      multivariant analysis with a Cox model was used, only S phase and presence of
      extrauterine disease were adverse factors. Diploid tumors have a better overall
      survival (p = 0.0658) but a similar disease-free survival. In those patients who
      ultimately have relapses, diploid tumors have a significantly longer interval
      from relapse to death (p = 0.0045). CONCLUSIONS: Neither ploidy analysis nor
      measurement of the proliferative rate will distinguish a benign from a malignant
      course in an individual patient; however, ploidy is predictive of survival from
      time of disease progression and proliferative rate is the strongest predictor of
      overall survival. The time-proven reliability of mitotic count in the diagnosis
      of smooth muscle tumors reflects its ability to predict proliferative rate.

PMID- 1615972
TI  - The utility of immunocytochemistry in invasive adenocarcinoma of the cervix.
AB  - OBJECTIVES: The purpose of the study was to evaluate the utility of
      immunocytochemistry in the management of cervical adenocarcinoma. Patterns of
      reactivity to various immunocytochemical markers were correlated with clinically
      known risk factors for recurrence. STUDY DESIGN: A retrospective evaluation of 55
      patients with invasive cervical adenocarcinoma was conducted. Monoclonal
      antibodies were generated against various human intermediate filament proteins
      and tested on fixed, paraffin-embedded tissue by the avidin-biotin complex
      immunoperoxidase method. Dako V9 antivimentin antibodies and two anticytokeratin
      antibodies, 35 beta H11 and 34 beta E12, were used. Polyclonal antibodies to
      carcinoembryonic antigen and antibodies to epithelial membrane antigen were used.
      RESULTS: Of 55 patients, 50 (91%) had positive epithelial membrane antigen
      antibodies in tumor cells. Tissue from patients with cervical adenocarcinoma
      demonstrated positivity for 35 beta H11 antibodies in 46 of 53 patients (87%) and
      positivity for 34 beta E12 antibodies in 15 of 54 patients (28%). Vimentin
      antibodies were negative in all except one patient. Carcinoembryonic antigen
      positive antibodies were detected in 37 of 55 patients (67%). This study also
      demonstrated consistent negative expression of vimentin in invasive cervical
      adenocarcinoma. Carcinoembryonic antigen expression rates were 50% and 75% for
      patients with small tumors (less than or equal to 2 cm) and large tumors (greater
      than 2 cm), respectively (p less than 0.01). Patients with carcinoembryonic
      antigen expression are at increased risk for recurrence and also sustain reduced
      survival potential. CONCLUSIONS: Patients with cervical adenocarcinoma and
      carcinoembryonic antigen expression are at increased risk for recurrence. We
      speculate that immunocytochemistry may detect lymph node micrometastases
      otherwise unsuspected by conventional microscopy.

PMID- 1615973
TI  - Advanced epithelial ovarian carcinoma: long-term survival experience at the
      community hospital.
AB  - OBJECTIVE: The purpose of this study was to determine prognostic factors that
      could be altered to increase survival of patients with advanced ovarian cancer
      treated at the community hospital. STUDY DESIGN: This study is a retrospective
      analysis of 101 patients with stage III and IV epithelial ovarian carcinoma who
      underwent primary surgery at two private hospitals from 1970 to 1990. RESULTS:
      Primary laparotomy was done by a general surgeon in 54 cases. The tumors in 23%
      of stage IIIC cases were debulked to less than or equal to 2 cm residuum. The
      survival rate decreased as stage or postoperative tumor residual increased.
      Patients with stage IIIA and IIIB disease had similar survival rates,
      significantly better than those with stage IIIC disease. Cytoreduction of stages
      IIIB and IIIC to microscopic disease resulted in a survival curve equal to the
      "natural optimal" stage IIIA. Patients with cytoreduction of stage IIIC disease
      to less than or equal to 2 cm did not obtain survival rates equal to those with
      stage IIIB disease with visible tumor remaining. Patients with stage IIIC disease
      achieved a significant increase in survival rate if their tumors were cytoreduced
      to microscopic disease. Platinum-based combination chemotherapy compared with
      alkylating agents improved survival in patients with stage IIIC disease who had
      greater than 2 cm tumor residual. Seven patients survived greater than 5 years,
      with three patients currently free of disease. Three prognostic categories
      predict decreasing survival: (1) stage IIIC if tumor is cytoreduced to no visible
      residual, stage IIIA or stage IIIB; (2) stage IIIC with visible tumor residual;
      (3) stage IV. CONCLUSION: Survival of community hospital-treated advanced ovarian
      carcinoma patients can be improved by early diagnosis, adjuvant platinum-based
      combination chemotherapy, and surgical cytoreduction to minimal disease. This
      treatment requires a team approach and education of the medical staff, including
      nongynecologists.

PMID- 1615974
TI  - Modified retropubic cystourethropexy. II.
AB  - In 1986 we published a preliminary report describing a modification for bladder
      neck suspension in the treatment of urinary stress incontinence. From 1982
      through 1989 135 surgical procedures were performed. Long-term follow-up of these
      patients is now presented. Of the 135 patients in this study, 118 were available
      for follow-up at the time of this report; 108 (91.5%) of the 118 reported no
      urinary leakage. Of the 10 patients who reported continued urinary leakage, only
      2 had persistent or recurrent urinary stress incontinence; they were reoperated
      on with favorable results. The other eight patients reporting urinary leakage
      were patients with mixed-cause urgency incontinence. The adjusted success rate
      for the treatment of genuine stress incontinence was therefore 98%.

PMID- 1615975
TI  - The physiologic mechanisms of variable decelerations.
AB  - OBJECTIVES: The purpose of this study was to determine the cause and physiologic
      consequences of variable decelerations. STUDY DESIGN: Previous studies of heart
      rate changes in human and experimental animals were critically reviewed with
      respect to the autonomic nervous system component, the cause of the increased
      vagal activity, and the role of cord compression or other stimuli in these heart
      rate changes. RESULTS: There is abundant evidence from experimental and human
      studies that variable decelerations can be reproduced by either cord compression
      or head compression. The vagal reflex produced is probably caused by a
      combination of chemoreflex (earlier in the deceleration) and baroreflex (later).
      The variable deceleration is accompanied by an acidosis, primarily respiratory,
      and probably hypoxemia. Cord compression results in decreased umbilical blood
      flow. CONCLUSIONS: Recent Doppler velocimetry studies suggest that even though
      the variable decelerations may be similar in duration and depth, the reduction of
      umbilical blood flow may be greater when the prime cause is cord compression than
      when the prime cause is vagal reflex from another source.

PMID- 1615976
TI  - Elective induction versus spontaneous labor: a retrospective study of
      complications and outcome.
AB  - OBJECTIVE: This retrospective study was undertaken to identify whether electively
      induced labor places the mother or her fetus at increased risk as compared with
      her spontaneous labor cohort. STUDY DESIGN: This study compares the labor,
      delivery, and fetal outcome of 253 parturients in which labor was electively
      induced with 253 matched controls who began labor spontaneously. All patients
      were delivered at Huntington Memorial Hospital in Pasadena, California, during
      the calendar year 1990. The patients were between 37 and 41 weeks' gestation and
      had no medical or obstetric conditions necessitating induction. The cases and
      controls were matched for age group, parity, gestational age, and delivering
      obstetrician. RESULTS: Epidural anesthesia was used in 83.8% of patients in the
      induction group versus 55.7% in the spontaneous group. Patients with labor
      induced had a shorter first stage of labor. Meconium staining was found
      significantly more often in the spontaneous group than in the induced group
      (16.2% vs 6.7%). This contributed to a greater rate of neonatal consultations in
      the spontaneous labor group. Although cesarean section rates between the two
      groups were similar, nulliparous patients in the induction group with an
      estimated Bishop score of less than or equal to 5 had a 50% cesarean section
      rate. Iatrogenic prematurity was not encountered. No differences existed between
      the two groups with respect to intrapartum maternal complications, fetal
      complications, or postpartum complications. CONCLUSIONS: When compared with
      spontaneous labor, elective induction of labor at term does not appear to pose an
      increased risk to the mother or her fetus in a carefully selected patient
      population. However, elective induction of labor in a nulliparous patient with an
      unfavorable cervix should be discouraged.

PMID- 1615977
TI  - Tubal sterilization and risk of subsequent hospital admission for menstrual
      disorders.
AB  - OBJECTIVE: Our objective was to investigate tubal sterilization and subsequent
      hospitalization for menstrual disorders. STUDY DESIGN: Automated discharge data
      were used in a population-based cohort study of 7253 women aged 20 to 49 years
      with tubal sterilization (1968 through 1983) at Group Health Cooperative of Puget
      Sound. Comparisons were with an age-matched cohort of 25,448 nonsterilized women
      and a nonmatched cohort of 5283 spouses of men with vasectomies. RESULTS: In the
      sterilization cohort, 282 had hospitalization for menstrual disorders (curettage,
      n = 191; hysterectomy, n = 66; nonsurgical, n = 25). Risk of hospitalization for
      menstrual disorders was 2.4 times greater after tubal sterilization (95%
      confidence interval 2.0 to 2.9). This risk was 6.1 times greater for sterilized
      women aged 20 to 24 years (95% confidence interval 0.72 to 3.2). Compared with
      the risk for nonsterilized women whose spouses had a vasectomy, the risk was 1.6
      times greater (95% confidence interval 1.3 to 2.1). Hospitalization for menstrual
      disorders was not more common after unipolar sterilization than after other
      methods, as might have been expected if the menstrual disorder was related to
      impaired uteroovarian circulation. CONCLUSIONS: Tubal sterilization is associated
      with a greater risk of hospitalization for menstrual disorders. A biologic
      association is not supported by these results.

PMID- 1615978
TI  - Early amniocentesis: outcome, risks, and technical problems at less than or equal
      to 12.8 weeks.
AB  - OBJECTIVE: It is the purpose of this report to evaluate our experience with
      amniocentesis at less than or equal to 12 weeks' gestation. STUDY DESIGN: Medical
      records of 936 patients at less than or equal to 12.8 weeks' gestation undergoing
      genetic amniocentesis between Oct. 1, 1986, and June 30, 1990, were evaluated for
      gestational age, indication, frequency of needle insertion, amniocentesis
      complications, and pregnancy outcome. RESULTS: There were seven miscarriages
      within 2 weeks of amniocentesis (0.7%), 21 miscarriages before 28 weeks (2.2%),
      and four stillbirths or neonatal deaths (0.4%), resulting in a total
      postprocedural loss rate of 3.4%. There were 26 chromosomally abnormal fetuses
      (2.8%). The spontaneous abortion rate in ultrasonographically normal pregnancies
      at less than 14 weeks, not undergoing amniocentesis, has been estimated at 2.1%
      to 3.2%. CONCLUSION: Amniocentesis at 12 weeks is a viable option for patients
      desiring earlier prenatal genetic diagnostic information.

PMID- 1615979
TI  - Suffer the little children.

PMID- 1615980
TI  - Anatomic aspects of vaginal eversion after hysterectomy.
AB  - OBJECTIVE: Our aim was to understand how vaginal eversion after hysterectomy
      differs from other forms of prolapse. STUDY DESIGN: The role of individual
      structures involved in vaginal support was studied by pelvic dissection of 61
      cadavers. Serial cross sections from 13 additional cadavers were examined.
      RESULTS: The upper third of the vagina (level I) is suspended from the pelvic
      walls by vertical fibers of the paracolpium, which is a continuation of the
      cardinal ligament. In the middle third of the vagina (level II) the paracolpium
      attaches the vagina laterally to the arcus tendineus and fascia of the levator
      ani muscles. The vagina's lower third fuses with the perineal membrane, levator
      ani muscles, and perineal body (level III). Dissection reveals that the
      paracolpium's vertical fibers in level I prevented prolapse of the vaginal apex
      and vaginal eversion. CONCLUSIONS: The paracolpium in level I forms the critical
      factor that differentiates vaginal eversion from posthysterectomy cystocele
      rectocele or enterocele in which the vaginal apex remains well suspended.

PMID- 1615981
TI  - Receiver-operator characteristic, efficiency analysis, and predictive value of
      serum progesterone concentration as a test for abnormal gestations.
AB  - OBJECTIVE: Our objective was to determine if a discriminatory progesterone
      concentration could be established that confidently predicted abnormal early
      gestations. STUDY DESIGN: We analyzed differences in progesterone concentrations
      between normal (n = 40) and abnormal (n = 34) pregnancies during the first 49
      days of gestation. The receiver-operator characteristic curve, test efficiency,
      and predictive value of serum progesterone to discriminate between an abnormal
      and normal first-trimester gestation were calculated for progesterone
      concentrations between 5 and 25 ng/ml. RESULTS: Receiver-operator characteristic
      curve analysis indicated that the best discriminatory progesterone concentration
      was 10 ng/ml. Test efficiency was maximum between serum progesterone
      concentration of 9 to 14 ng/ml (80%). When progesterone was less than 10 ng/ml,
      the predictive value of the abnormal test result was greater than 90%.
      CONCLUSION: Receiver-operator characteristic analysis, test efficiency, and the
      predictive value of an abnormal test result suggest that the best progesterone
      cut off point that predicts abnormal early pregnancies is 10 ng/ml.

PMID- 1615982
TI  - Prevalence of out-of-phase endometrial biopsy specimens.
AB  - OBJECTIVE: We attempted to determine the prevalence of out-of-phase endometrial
      biopsy specimens among fertile and infertile women and women with recurrent
      pregnancy loss, histologic dating of biopsies was compared with four reference
      points for expected ovulation. These reference points included last menstrual
      period, next menstrual period, luteinizing hormone testing, and ultrasonographic
      documentation of ovulation. STUDY DESIGN: Four hundred eighty-five endometrial
      biopsies were performed 7 days after documented ovulation-based ultrasonographic
      evidence for follicle collapse. The histologic dating was referenced to the last
      menstrual period, next menstrual period, and ultrasonographic documentation of
      ovulation. One hundred thirty-two of these women also performed urinary
      luteinizing hormone surge testing before ovulation and serum progesterone
      determinations. A comparison of the prevalence of out-of-phase biopsy specimens
      among groups was determined with the chi 2 test and Fisher's exact test. RESULTS:
      The prevalence of out-of-phase endometrial biopsy specimens ranged from 42% when
      last menstrual period was used to 26% with next menstrual period, to 21% with
      luteinizing hormone testing, and to 4% with ultrasonographic documentation of
      ovulation. Serum progesterone values among women with a diagnosis of out-of-phase
      biopsy specimens by any of the reference dates progesterone were similar to those
      with in-phase biopsy specimens. CONCLUSION: The accuracy of histologic
      endometrial dating was best determined by ultrasonographic monitoring rather than
      by last menstrual period, next menstrual period, or luteinizing hormone testing
      in infertile populations and in those with recurrent pregnancy loss.
      Additionally, because no significant difference in out-of-phase biopsy specimens
      exists between fertile and infertile patients and recurrent pregnancy loss, those
      with the role of this procedure is called into question.

PMID- 1615983
TI  - Drug use or inadequate prenatal care? Adverse pregnancy outcome in an urban
      setting.
AB  - OBJECTIVE: This study analyzed the relationships between illicit drug use, low
      birth weight, adequacy of prenatal care, and perinatal mortality. STUDY DESIGN:
      Perinatal outcome parameters in 23,926 deliveries between 1983 and 1990 were
      analyzed. Statistical analysis (chi 2 analysis) was applied for each year of
      study to separate the effects of inadequate prenatal care from illicit drug use.
      RESULTS: Patients with drug use had a two to three times higher incidence of low
      birth weight and perinatal death. Drug use with more than five prenatal visits
      had a minimal effect on outcome; drug use with inadequate care was associated
      with a three times higher incidence of perinatal death and low birth weight.
      CONCLUSION: Adequacy of prenatal care is a marker of "social chaos" and affects
      outcome more than drug use itself.

PMID- 1615984
TI  - Eclampsia. VII. Pregnancy outcome after eclampsia and long-term prognosis.
AB  - OBJECTIVES: Our goal was to report pregnancy outcome and long-term prognosis
      after eclampsia. STUDY DESIGN: Women whose pregnancies were managed at the E.H.
      Crump Women's Hospital between August 1977 and April 1989 were studied. A total
      of 223 women with eclampsia underwent follow-up for an average of 7.2 years.
      Thirteen had preexisting hypertension and 210 were normotensive (31 were
      multiparous and 179 were nulliparous). RESULTS: Among these women 23 who were
      multiparous and 159 who were nulliparous had 366 subsequent pregnancies: 22% of
      pregnancies were complicated by preeclampsia, 1.9% by eclampsia, and 2.5% by
      abruptio placentae; 2.7% resulted in perinatal death. Within the nulliparous
      group, women who had eclampsia before 37 weeks' gestation in the index pregnancy
      had significantly higher incidences of preeclampsia and poor perinatal outcome in
      subsequent pregnancies as compared with those who had eclampsia at greater than
      or equal to 37 weeks' gestation; the highest incidence of obstetric complications
      occurred in those having eclampsia at less than or equal to 30 weeks. Twenty of
      the 210 normotensive women (9.5%) had chronic hypertension on follow-up; the
      highest incidence (17.9%) being in those with eclampsia at less than or equal to
      30 weeks and the lowest incidence (4.8%) in those having eclampsia at greater
      than or equal to 37 weeks. Women with eclampsia who had preeclampsia in
      subsequent pregnancies had a higher incidence of chronic hypertension as compared
      with those who were normotensive in subsequent pregnancies (25% vs 2%, p less
      than 0.0001). Long-term maternal complications included dialysis required in one
      patient and one case of cardiomyopathy in women with chronic hypertension; there
      was one maternal death in a women with chronic hypertension. None of the women
      had evidence of neurologic deficit or seizures during follow-up. CONCLUSIONS:
      These findings should be used in counseling women who have had eclampsia and are
      considering future pregnancies.

PMID- 1615985
TI  - Preoperative and postoperative analysis of site-specific pelvic support defects
      in 81 women treated with sacrospinous ligament suspension and pelvic
      reconstruction.
AB  - OBJECTIVES: The objectives of this study were to identify factors that predict
      long-term success, defined as the absence of anatomic defects, in women
      undergoing pelvic reconstruction and to identify which defects most frequently
      persist or recur. STUDY DESIGN: Eighty-one women treated by sacrospinous ligament
      suspension and pelvic reconstruction between 1984 and 1990 had site-specific
      analysis performed preoperatively and at consecutive postoperative visits. The
      findings at the 6-week postoperative visit and subsequent visits were compared
      for each of five sites: urethra, bladder, cuff, cul-de-sac, and rectum. RESULTS:
      The Fisher exact test showed that patients with no support defects at the 6-week
      visit were less likely to require subsequent repair than patients who had any
      defect at that visit (p = 0.003). Thirteen patients with subsequent or persistent
      cystoceles had no bladder repair performed at the time of the study procedure.
      However, even with repair the bladder was the most likely site for persistence or
      recurrence. CONCLUSION: Absence of any pelvic support defect at the 6-week
      postoperative visit is associated with a 3% likelihood that the patient will
      require subsequent reconstructive surgery within 2 to 5 years. The anterior
      segment provides the greatest challenge to restoration of normal anatomy.

PMID- 1615986
TI  - Cervical cytology: a randomized comparison of four sampling methods.
AB  - OBJECTIVE: The purpose of this study was to compare smear quality and
      endocervical cell recovery of four cervical smear sampling devices. STUDY DESIGN:
      Two thousand fifteen patients undergoing routine cervical smears at the
      University of Tennessee Obstetrics and Gynecology clinics were randomly assigned
      to a cotton swab-spatula, Cytobrush-spatula, Cervex-Brush, or Bayne Pap Brush.
      The cytopathology laboratory, blind to method, used specific criteria to grade
      smears as being optimal, adequate, marginal, or inadequate. Statistical analysis
      was by the chi 2 and analysis of variance tests. RESULTS: No statistical
      differences occurred among the groups for nonpregnant patients. For pregnant
      patients smear quality was improved with both Cytobrush-spatula and Bayne Pap
      Brush versus cotton swab-spatula (p = 0.0301 and 0.0004, respectively); cotton
      swab-spatula had fewer endocervical cells than the Cytobrush-spatula (p =
      0.0001), Cervex-Brush (p = 0.0288), and Bayne Pap Brush (p = 0.0081).
      CONCLUSIONS: The cotton swab-spatula and Cytobrush-spatula appear to be the most
      effective screening methods for nonpregnant and pregnant patients, respectively.

PMID- 1615987
TI  - Interlaboratory variation in antiphospholipid antibody testing.
AB  - OBJECTIVE: Because of the widespread use of antiphospholipid antibody testing in
      the evaluation of patients with recurrent pregnancy loss, we evaluated the
      consistency of results among laboratories testing for anticardiolipin antibody
      and the lupus anticoagulant. STUDY DESIGN: A questionnaire regarding methods used
      and samples of blood from 20 patients were sent to five university-based and five
      commercial facilities for antiphospholipid antibody testing. RESULTS: The
      responses of the participating laboratories to the questionnaires revealed
      significant differences in methods, standardization, and units of reporting. For
      anticardiolipin antibody, the number of specimens found to be positive for any
      isotype (immunoglobulin G, M, or A) varied considerably among laboratories, with
      a range of 5 to 13. All laboratories were in agreement (i.e., at least one
      isotype was present or all were absent) for only 5 of 20 specimens (25%). In
      contrast, lupus anticoagulant results were more reproducible, although one
      facility reported results markedly discordant from the other four laboratories.
      CONCLUSION: These observations suggest that significant interlaboratory variation
      exists in antiphospholipid antibody, and particularly anticardiolipin antibody,
      testing and might lead to unnecessary therapeutic interventions.

PMID- 1615988
TI  - Reproductive outcome in women with recurrent spontaneous abortions of alloimmune
      and autoimmune causes: preconception versus postconception treatment.
AB  - OBJECTIVES: The null hypothesis is that treatment of women with recurrent
      spontaneous abortions with anticoagulation and immunosuppression will not
      increase the reproductive outcome if it is started preconceptionally. STUDY
      DESIGN: Ninety-four women with recurrent spontaneous abortion with autoimmune
      abnormalities comprised the study group. Group I began autoimmune therapy 48
      hours after ovulation: heparin 5000 U twice daily, aspirin 80 mg daily, and
      prednisone 5 mg twice daily, with an increase to 10 mg twice daily when pregnant.
      Group II started the same medication after a positive pregnancy test. Group III
      received no medication. Controls were 19 women with no autoimmune abnormalities.
      The frequency of reproductive outcome was subject to multiple comparison by the
      Duncan test. RESULTS: The percentages of live-born children in groups I, II, and
      III were 74%, 44%, and 11%, respectively. CONCLUSIONS: Preconception diagnostic
      work-up and treatment of autoimmune abnormalities in women with histories of
      recurrent spontaneous abortion is advocated.

PMID- 1615989
TI  - The Green Bay cesarean section study. II. The physician factor as a determinant
      of cesarean birth rates for failed labor.
AB  - OBJECTIVE: Our study was designed to develop a profile of specific labor
      management characteristics generally used by physicians with low versus those
      with high rates of cesarean sections in the care of nonprogressive labor in
      nulliparous patients. STUDY DESIGN: A 4-year retrospective data set was used to
      analyze all patients with nonprogressive labor cared for by 11 board-certified
      obstetricians and gynecologists practicing full-time at two Green Bay hospitals.
      Variations in labor management are analyzed and tested for their effect on the
      rate of cesarean section for failure of labor to progress. RESULTS: Cesarean
      section in nulliparous women for nonprogressive labor varied from 4.3% of all
      deliveries in the low group to 12.3% in the high group. Through multivariate
      analysis we developed a profile of specific labor management characteristics used
      by physicians with low versus those with high rates of cesarean section.
      CONCLUSION: These techniques can be used to definitively identify management
      strategies that result in a decrease in cesarean rates for nonprogressive labor.

PMID- 1615990
TI  - Vaginal birth after cesarean delivery: are there useful and valid predictors of
      success or failure?
AB  - OBJECTIVE: Before parturition are there useful and valid predictors of successful
      or unsuccessful vaginal birth after previous cesarean birth that could be used to
      enhance the obstetric care of a patient and her pregnancy? STUDY DESIGN: The
      clinical course and outcome of all patients who attempted vaginal birth after
      cesarean delivery at one level III center during 1989 were evaluated to identify
      factors prognostic of a successful or unsuccessful patient group; use of this
      information in stepwise logistic regression and cluster analysis was
      disappointing. RESULTS: No single criterion or optimal clusters of factors were
      found and no equation achieved greater than 75% predictability of outcome with
      acceptable sensitivity and specificity. CONCLUSIONS: Before parturition
      prediction of outcome of vaginal birth after cesarean delivery is tenuous
      regardless of past obstetric history or recent clinical parameters. Thus it seems
      appropriate to encourage a trial of labor in almost all patients with a prior low
      segment uterine incision (transverse or vertical) unless there is a strong
      physician or patient-derived contraindication to such an undertaking.

PMID- 1615991
TI  - Comparison of dynamic image and pulsed Doppler ultrasonography for the diagnosis
      of the small-for-gestational-age fetus.
AB  - OBJECTIVE: Because poor fetal growth is a significant cause of perinatal
      morbidity and mortality, a prospective study was undertaken to evaluate the
      ability of real-time ultrasonography and Doppler velocimetry to detect the small
      for-gestational-age fetus. STUDY DESIGN: A prospective study of 136 women at risk
      for fetal growth abnormalities was conducted. Patients were delivered within 3
      weeks and had live-born, nonanomalous, singleton infants. The relative estimated
      fetal weight (estimated fetal weight divided by the median birth weight for
      gestational age) and the systolic/diastolic ratio were measured and compared with
      receiver-operator characteristic curves. In this method the area under the curve
      is the index of performance. RESULTS: Forty-six infants were small for
      gestational age. Although both relative estimated fetal weight (area under the
      curve = 0.923) and systolic/diastolic ratio (area under the curve = 0.837) were
      significantly associated with the small for gestational age fetus, the former was
      more strongly correlated, p = 0.021. CONCLUSION: Relative estimated weight is
      more sensitive and specific and should be the preferred parameter when
      gestational age is known.

PMID- 1615992
TI  - Prediction of respiratory distress syndrome by a new colorimetric assay.
AB  - OBJECTIVE: The purpose of this study was to evaluate the clinical performance of
      a new, simple, and rapid colorimetric assay for predicting respiratory distress
      syndrome. STUDY DESIGN: Ninety-four specimens obtained within 3 days of delivery
      were assayed with the new test. For 78 of these specimens, the
      lecithin/sphingomyelin ratio was also determined. Significant differences were
      calculated with chi 2 analysis. Cutoff points were selected by maximizing the
      corresponding sums of sensitivity and specificity and from receiver-operator
      characteristic curves. RESULTS: The specificity of the new colorimetric test was
      better than 89%, and it yielded more than 86% correct diagnoses. Furthermore, the
      test had a significantly (p less than 0.05) lower percentage of false-immature
      results than that obtained with the lecithin/sphingomyelin ratio. Moreover, the
      new test performed relatively well in analyses of patients between 27 weeks and
      36 weeks' gestation. CONCLUSION: We concluded that the new assay is reliable and
      that it can serve as a useful alternative to current methods for predicting
      respiratory distress syndrome.

PMID- 1615993
TI  - Urinary incontinence: correlation of history and brief office evaluation with
      multichannel urodynamic testing.
AB  - OBJECTIVE: Patients' histories of urinary incontinence and the results of several
      standard clinical tests were correlated with final diagnoses obtained by
      multichannel urodynamic testing. We used a combination of clinical test results
      to predict the final diagnoses. STUDY DESIGN: Ninety consecutive women with a
      primary complaint of urinary incontinence completed a standardized questionnaire
      and underwent a structured clinical examination consisting of several standard
      clinical tests. Each patient later underwent multichannel urodynamic testing to
      obtain a final diagnosis. RESULTS: Although the symptoms of stress incontinence
      were significantly associated with genuine stress incontinence and mixed
      incontinence, overlap in patients with detrusor instability did not allow the
      histories to be useful diagnostically. The only clinical tests showing
      significant association with the final diagnoses of incontinence were the cough
      stress test and single-channel medium-fill cystometry. Reliable prediction of the
      urodynamic diagnosis of incontinence could not be achieved with either of these
      two tests or with a combination of variables obtained by discriminant analysis.
      CONCLUSIONS: Women with complaints of urinary incontinence, especially those for
      whom surgery is contemplated, should undergo complete urodynamic evaluation when
      it is available.

PMID- 1615994
TI  - Mechanism of recurrent spontaneous abortion. I. Ultrasonographic findings.
AB  - OBJECTIVES: Our objective was to study the mechanisms of early pregnancy loss
      with ultrasonographic findings in pregnancies that terminated in repeat abortion
      in women with recurrent spontaneous abortion compared with patients with
      spontaneous abortion with no previous spontaneous abortion and with women with
      recurrent spontaneous abortion who had viable pregnancies. STUDY DESIGN: A
      prospective, unselected study of 83 pregnancies followed from 4 to 12 weeks of
      gestation. Weekly transvaginal ultrasonography.among 43 pregnancies terminating
      in abortion were compared with 40 pregnancies ending in live birth with the
      Fisher exact test with a p value of significance assigned at less than 0.05.
      RESULT: A significant difference in the presence of fetal heart activity was
      observed at 6 weeks +/- 5 days among women who subsequently aborted when
      recurrent spontaneous abortions were compared with no history of abortion (55%
      and 14%, p less than 0.02). Fetal pole size was small in 86% of pregnancies lost
      after fetal heart activity. CONCLUSION: Ultrasonographic examination at 6 weeks
      can diagnose impending abortion with a sensitivity of 85%, specificity of 93%,
      positive predictive value of 92%, and negative predictive value of 87% among
      women with recurrent spontaneous abortion.

PMID- 1615995
TI  - Acute childbirth morbidity: its measurement using hospital charges.
AB  - OBJECTIVES: An analytic descriptive analysis of acute childbirth morbidity was
      carried out at Duke University Medical Center, comparing patients delivered by
      primary cesarean section with those delivered vaginally. STUDY DESIGN: All
      primary cesarean deliveries and vaginal deliveries from July 1, 1981, through
      June 30, 1986, were combined with maternal and infant charge data. A total of
      7256 patients were analyzed. A description of the charges for the associated
      diagnoses was carried out. A morbidity index was used to identify differences in
      predicted median hospital charges with 95% confidence intervals. RESULTS: The
      ratio of mean primary cesarean delivery to mean vaginal delivery total charges
      was 2.5:1. The magnitude of the mean hospital charges was inversely related to
      the frequency of the indication with the lowest charges associated with dystocia
      and the highest with multiple pregnancy. Antepartum risk factors (increased
      maternal age, patient referral) were associated with increases in maternal and
      infant morbidity as measured by the morbidity index. Chronic maternal
      hypertension resulted in decreased maternal morbidity but increased infant
      morbidity when primary cesarean delivery was used. Although preterm delivery was
      associated with large increases in charges, it was not significantly altered by
      using primary cesarean delivery. Risk factors associated with the management of
      abnormalities of labor were associated with decreases in maternal and infant
      morbidity when primary cesarean delivery was used. CONCLUSION: Analysis of acute
      childbirth morbidity, as measured by hospital charges, showed marked variation of
      diagnosis and risk-specific charges for patients delivered by primary cesarean
      section.

PMID- 1615996
TI  - Treatment of fetal supraventricular tachycardia with flecainide acetate after
      digoxin failure.

PMID- 1615997
TI  - Amniotic fluid glucose and intraamniotic infection: sensitivity, specificity, and
      predictive values.

PMID- 1615998
TI  - Ureaplasma urealyticum resistance to erythromycin: confirmed by clinical trial.

PMID- 1615999
TI  - Steroids receptors in the endometrium during clomiphene citrate treatment.

PMID- 1616000
TI  - The tip of the iceberg and the best fit in ultrasonographic dating of pregnancy.

PMID- 1616001
TI  - Hydroxyurea and pregnancy.

PMID- 1616002
TI  - Gangliosides as modulators of cell function.
AB  - Gangliosides, sialic acid-containing glycosphingolipids, are found in the outer
      leaflet of the plasma membrane of all vertebrate tissues and species. This report
      presents a brief introduction to the gangliosides and reviews the chemistry and
      topography of their biosynthesis. It also presents an overview of the present
      evidence supporting a physiological significance for the gangliosides in a
      variety of experimental systems. This includes consideration of their potential
      roles in development and cell adhesion. In addition, experimental examples in
      which gangliosides appear to influence signal transduction processes through
      their interactions with plasma membrane proteins are discussed.

PMID- 1616003
TI  - Ca2+/calmodulin regulation of putrescine uptake in cultured gastrointestinal
      epithelial cells.
AB  - Regulation of putrescine uptake in a small intestinal crypt cell line, IEC-6
      cells, was examined. Uptake of [14C]putrescine was measured throughout a normal
      growth curve and was found to be inversely related to growth. Kinetic analysis at
      low and high cell density revealed the inhibition of uptake in confluent cells
      was due to a five-fold reduction in Vmax of uptake, 199.5 vs. 43.1 pmol.10(5)
      cells-1.h-1, respectively. Three gastrointestinal hormones, gastrin, secretin,
      and cholecystokinin, produced partial inhibition of [14C]putrescine uptake.
      Conversely, treatment of quiescent cells with 5% fetal bovine serum to stimulate
      growth did not affect uptake. Influence of putrescine uptake on free ionized
      intracellular Ca2+ ([Ca2+]i) was measured by microspectrofluorometry using the
      Ca(2+)-sensitive fluoroprobe fura-2. Basal [Ca2+]i was calculated to be 112 nM
      and increased rapidly to 313 nM upon addition of 10 microM putrescine. Preventing
      the rise in [Ca2+]i using an intracellular Ca2+ buffer, 1,2-bis(2
      aminophenoxy)ethane-N,N,N',N'-tetraacetic acid acetoxymethyl ester, decreased
      [14C]putrescine uptake to 29.5 +/- 5.3% of control values. 45Ca2+ flux
      experiments and measurement of transport in 0 Ca2+ and 0.5 mM EDTA suggested an
      intracellular source of calcium was mobilized during putrescine uptake. Finally,
      use of the putative calmodulin antagonist N-(6-aminohexyl)-5-chloro-l
      naphthalenesulfonamide caused a dose-dependent inhibition of [14C]putrescine
      uptake with 50% inhibitory concentration of approximately 7 microM. These data
      suggest that putrescine uptake in IEC-6 cells may be regulated by a
      Ca2+/calmodulin-dependent mechanism.

PMID- 1616004
TI  - Norepinephrine-induced phosphatidylcholine hydrolysis by phospholipases D and C
      in rat tail artery.
AB  - Rat tail arterial segments were incubated with [3H]choline to selectively label
      endogenous phosphatidylcholine. Norepinephrine (NE; 10(-5) M) addition for
      periods of 10 s to 30 min significantly increased the concentration of
      extracellular phosphatidylcholine metabolites, [3H]choline, and
      [3H]phosphocholine. The release of [3H]choline and [3H]phosphocholine from the
      segments was NE dose dependent (10(-6)-10(-3) M). NE also increased the formation
      of [3H]phosphatidylethanol in [3H]myristate-labeled tail artery in the presence
      of ethanol, characteristic of phospholipase D activity. NE-induced
      phosphatidylcholine hydrolysis was blocked by pretreatment with prazosin (10(-5)
      M) and was unchanged by pretreatment with propranolol (10(-5) M). 4 beta-phorbol
      12,13-dibutyrate (PDBu, 10(-6) M) stimulated the release of [3H]choline, which
      was inhibited by pretreatment with staurosporine (10(-5) M). The stimulatory
      effect of NE on phosphatidylcholine metabolism was not altered by either
      pretreatment with staurosporine (10(-5) M) or calcium-free buffer. In summary, we
      have demonstrated NE-stimulated phosphatidylcholine hydrolysis by phospholipase D
      and C in intact vascular smooth muscle. This effect of NE was dose dependent and
      was mediated through the alpha 1-adrenergic receptor. Norepinephrine and PDBu
      stimulated phosphatidylcholine hydrolysis through different mechanism(s), and the
      stimulatory effect of NE did not seem to require protein kinase C and calcium
      influx.

PMID- 1616005
TI  - Differential sensitivity of AS-30D rat hepatoma cells and normal hepatocytes to
      anoxic cell damage.
AB  - A substantial fraction of cells present within hard tumors experience extremely
      hypoxic and hypoglycemic conditions that can lead to phenotypic alterations such
      as increased metastatic potential and chemotherapeutic drug resistance. Little is
      known regarding the influence of anoxic aglycemia on tumor cell energy metabolism
      and viability, and no direct comparisons have been made between the effects of
      this form of metabolic stress on tumor cells and their tissue of origin. In this
      study, the effects of in vitro aglycemic incubation under N2 (with or without
      iodoacetate) on trypan blue exclusion, lactate dehydrogenase release, cell
      surface blebbing, ATP levels, and mitochondrial respiratory capacity of rat AS
      30D ascites hepatoma cells and normal hepatocytes were measured. Under anoxic
      aglycemic conditions, the period of incubation during which 50% viability was
      lost was 2 h for hepatocytes and 6-8 h for AS-30D cells. In contrast, the rate of
      anoxia-induced loss of ATP was comparable for the two cell types, and
      mitochondrial damage was actually accelerated in the tumor cells. These findings
      suggest that tumor cells are more resistant to anoxic cell death because of their
      greater ability to withstand deenergization and subcellular injury.

PMID- 1616006
TI  - Secretion of K and Cl across colonic epithelium: cellular localization using
      electron microprobe analysis.
AB  - Electron microprobe analysis of quick-frozen distal colonic epithelium from
      guinea pig was used to locate the cells responding to secretory stimuli.
      Concentrations of Na, K, and Cl were similar for cells of surface and crypt in
      the unstimulated state, 8, 149, and 46 mmol/kg wet weight, respectively.
      Stimulation of either K and Cl secretion with prostaglandin E2 or K secretion
      alone with epinephrine increased Na to approximately 12 mmol/kg wet weight in
      crypt cells but not in surface cells or cells in the crypt neck. This result
      supports the location of ion secretory cells in the lower two-thirds of the
      crypt. In the vacuoles of crypt columnar cells, stimulation of KCl secretion
      decreased K, S, Mg, and Ca and increased Na and Cl, indicative of the concomitant
      release of vacuole contents. Mucin granules in crypt goblet cells contained more
      S and Mg than granules in surface goblet cells. These findings support the
      concept of differentiation in ion and macromolecular secretory function along the
      axis from crypt to surface epithelium.

PMID- 1616007
TI  - Epithelial permeability factor: a serum protein that condenses actin and opens
      tight junctions.
AB  - An epithelial permeability factor (EPF) in human serum lowered, within 1 h, the
      transepithelial electrical resistance and opened the tight junctions of a
      cultured kidney epithelium (Madin-Darby canine kidney) when it came in contact
      with the basolateral surface of the kidney epithelium. Size-exclusion
      chromatography of serum or heat-inactivated serum resolved seven peaks of EPF
      activity (approximately 15, approximately 30, approximately 45, approximately 60,
      approximately 120, and approximately 240 kDa and greater than 240 kDa) with 65%
      of the activity at approximately 45, approximately 60, and approximately 120 kDa.
      Heat inactivation, which had no effect on total activity, caused a significant
      decrease in the activity at 120 kDa and an equivalent rise in activity at 45 kDa.
      Although acid charcoal extraction or lectin affinity chromatography did not
      remove activity, EPF activity was eliminated by pepsin. Heat-inactivated serum or
      fractions containing EPF had no effect on ZO-1 localization but did cause a dose
      dependent focal condensation of the perijunctional actin ring at sites where
      three or more cells were in contact. These data suggest that EPF is a protein
      that appears to form multimers that interact with the basolateral surface of the
      epithelium and cause constriction of the cytoskeleton and an increase in
      permeability at specific sites along the tight junction.

PMID- 1616008
TI  - Flow-induced calcium transients in single endothelial cells: spatial and temporal
      analysis.
AB  - Endothelial cells (EC) are uniquely situated to respond to hemodynamic forces.
      Because flow-mediated release of endothelial-derived relaxing factors is
      associated with increased EC intracellular calcium ([Ca2+]i), we sought to
      determine the effects of fluid shear stress on EC [Ca2+]i. Cells were subjected
      to flow in parallel-plate flow chambers and glass capillary tubes, and single
      cell [Ca2+]i was measured using fura-2. Upon initiation of flow (shear stress of
      30 dyn/cm2), [Ca2+]i increased within 30 s to a peak value (approximately 4 times
      basal) and then decreased slowly to a plateau (approximately 2 times basal) that
      persisted for greater than 5 min. A striking finding was that the increases in
      [Ca2+]i were nonhomogeneous; the nuclear region and a periplasma membrane region
      were higher than the cytosol. After flow cessation, the increase in [Ca2+]i could
      be elicited repeatedly by resumption of flow. Removing extracellular Ca2+ did not
      eliminate the response. In contrast to EC, rat aortic smooth muscle cells showed
      no flow-mediated increase in [Ca2+]i. The complexity of EC [Ca2+]i response to
      flow suggests regulation of [Ca2+]i by several mechanisms that may serve a role
      in both short- and long-term EC responses to flow.

PMID- 1616009
TI  - Magnetic field influence on acetylcholine release at the neuromuscular junction.
AB  - The effects of a static magnetic field on the frequency of miniature end-plate
      potentials (MEPPs), recorded from the murine phrenic nerve-diaphragm preparation,
      were studied. In the presence of a 1,200-G field, statistically significant
      changes in MEPP frequency were observed. There was a modest increase in frequency
      at temperatures at and below 34 degrees C and a prominent decrease in frequency
      at temperatures above 35 degrees C. This temperature-dependent phenomenon was not
      seen in the absence of calcium in the perfusate. These results suggest that, at
      its phase transition temperature, the diamagnetic anisotropy of the presynaptic
      membrane is sufficient to influence neurotransmitter release by altering the
      function of the transmembrane calcium transfer mechanism.

PMID- 1616010
TI  - Maxi K+ channel in apical membrane of vestibular dark cells.
AB  - Recordings were made on excised apical membrane patches from vestibular dark
      cells from the semicircular canal of gerbils to determine if ion channels could
      be involved in the process of K+ secretion. Both nonselective cation channels
      [Am. J. Physiol. 262 (Cell Physiol. 31): C1430-C1436, 1992] and K(+)-selective
      channels were found. The K+ channels occurred in only 0.7% of the patches. In
      symmetrical 145 mM KCl solutions, the current-voltage (I-V) relation of the K(+)
      selective channel was linear, indicating the absence of rectification, and the
      conductance was 240 +/- 8 pS (n = 8). The Goldman-Hodgkin-Katz equation for
      current carried solely by K+ could be fitted to the I-V relation in asymmetrical
      K+ and Na+ solutions and yielded a K+ permeability of 5.78 x 10(-13) cm3/s (n =
      12). The channel was shown to be impermeable to Li+, NH4+, N-methyl-D-glucamine,
      and Cl-. Channel activity increased with depolarization and with increasing free
      [Ca2+]; for voltages between +40 and -60 mV, the strongest regulation occurred in
      the range 10(-6) to 10(-5) M Ca2+. Tetraethylammonium (2 x 10(-2) M) had from the
      cytosolic side no effect on the open probability (Po) but completely inhibited
      activity from the extracellular side. Po was reduced by Ba2+ (5 x 10(-3) M),
      verapamil (10(-4) M), quinine (10(-4) M), and quinidine (10(-4) and 10(-3) M),
      while lidocaine (5 x 10(-3) M) had no measurable effect on Po but decreased the
      amplitude. Rb+ and Cs+ were either poorly permeable or partially blocked the
      channel in a voltage-dependent manner.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616011
TI  - Glucocorticoid-induced skeletal muscle atrophy in vitro is attenuated by
      mechanical stimulation.
AB  - Glucocorticoids induce rapid atrophy of fast skeletal myofibers in vivo, and
      either weight lifting or endurance exercise reduces this atrophy by unknown
      mechanisms. We examined the effects of the synthetic glucocorticoid dexamethasone
      (Dex) on protein turnover in tissue-cultured avian fast skeletal myofibers and
      determined whether repetitive mechanical stretch altered the myofiber response to
      Dex. In static cultures after 3-5 days, 10(-8) M Dex decreased total protein
      content 42-74%, total protein synthesis rates 38-56%, mean myofiber diameter 35%,
      myosin heavy chain (MHC) content 86%, MHC synthesis rate 44%, and fibronectin
      synthesis rate 29%. Repetitive 10% stretch-relaxations of the cultured myofibers
      for 60 s every 5 min for 3-4 days prevented 52% of the Dex-induced decrease in
      protein content, 42% of the decrease in total protein synthesis rate, 77% of the
      decrease in MHC content, 42% of the decrease in MHC synthesis rate, and 67% of
      the decrease in fibronectin synthesis rate. This in vitro model system will
      complement in vivo studies in understanding the mechanism by which mechanical
      activity and glucocorticoids interact to regulate skeletal muscle growth.

PMID- 1616012
TI  - Muscle fatigue in frog semitendinosus: role of intracellular pH.
AB  - The purpose of this study was to utilize glass microelectrodes to characterize
      the intracellular pH (pHi) before and during recovery from fatigue in the frog
      semitendinosus (ST) muscle. A second objective was to evaluate the relationship
      between pHi and contractile function. The frog ST muscle (22 degrees C) was
      fatigued by direct electrical stimulation with 100-ms 150-Hz trains at 1/s for 5
      min. Peak tetanic force (Po) was reduced to 8.5% of initial force and recovered
      in a biphasic manner, returning to the resting value by 40 min. Resting pHi was
      7.00 +/- 0.02 (n = 37) and declined with fatigue to an average value of 6.42 at 3
      min of recovery. During recovery pHi significantly increased and by 25 min had
      returned to the prefatigue value. The pHi recovery was highly correlated to the
      slow phase of Po recovery (r = 0.98, P less than 0.001). The mean resting
      membrane potential was -78 +/- 1.0 mV (n = 42) and at 3 min of recovery was
      depolarized to -67 +/- 4 mV. Both the peak rate of twitch force development
      (+dP/dt) (r = 0.99, P less than 0.001) and decline (-dP/dt) (r = 0.94, P less
      than 0.014) were highly correlated to pHi during the slow phase of recovery.
      Contraction time (CT) and one-half relaxation time (1/2RT) increased
      significantly and recovered exponentially. The recovery of CT and 1/2RT were both
      significantly correlated to pHi (r = -0.93, P less than 0.001 and r = -0.86, P
      less than 0.001 for CT and 1/2RT, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616013
TI  - Mechanism of heptanol-induced uncoupling of cardiac gap junctions: a perforated
      patch-clamp study.
AB  - The influence of heptanol on gap junctional and non-junctional membrane currents
      was studied in cultured neonatal rat heart cells using both the whole cell and
      perforated patch voltage-clamp method. With both methods, exposure to heptanol
      produced a dose-dependent decrease in the junctional current (dissociation
      constant = 0.54 and 1.20 mM for whole cell and perforated patch experiments,
      respectively). Heptanol-induced uncoupling was reversible. In the same
      concentration range, heptanol reduced all nonjunctional membrane ionic currents
      examined. This suggests that heptanol does not act specifically on gap junction
      channels but rather on the structure of the lipid membrane. This hypothesis is
      strengthened by the observation that in monolayer cultures of neonatal rat heart
      cells fluorescence steady-state anisotropy decreased proportional with increasing
      the heptanol concentration in the bath. Single-channel conductances (gamma j)
      were identical with both recording methods (21 and 40-45 pS); heptanol did not
      alter gamma j. Under conditions of reduced junctional coupling induced by
      heptanol, junctional conductance (gj) displayed voltage sensitivity at values of
      gj at which no voltage sensitivity could be observed under control conditions.
      These results suggest that heptanol-dependent uncoupling was caused by a decrease
      in open probability of the gap junction channels.

PMID- 1616014
TI  - Interactions between ANG II, sympathetic nervous system, and baroreceptor
      reflexes in regulation of blood pressure.
AB  - The renin-angiotensin system plays an important role in the regulation of
      arterial blood pressure and in the development of some forms of clinical and
      experimental hypertension. It is an important blood pressure control system in
      its own right but also interacts extensively with other blood pressure control
      systems, including the sympathetic nervous system and the baroreceptor reflexes.
      Angiotensin (ANG) II exerts several actions on the sympathetic nervous system.
      These include a central action to increase sympathetic outflow, stimulatory
      effects on sympathetic ganglia and the adrenal medulla, and actions at
      sympathetic nerve endings that serve to facilitate sympathetic neurotransmission.
      ANG II also interacts with baroreceptor reflexes. For example, it acts centrally
      to modulate the baroreflex control of heart rate, and this accounts for its
      ability to increase blood pressure without causing a reflex bradycardia. The
      physiological significance of these actions of ANG II is not fully understood.
      Most evidence indicates that the actions of ANG to enhance sympathetic activity
      do not contribute significantly to the pressor response to exogenous ANG II. On
      the other hand, there is considerable evidence that the actions of endogenous ANG
      II on the sympathetic nervous system enhance the cardiovascular responses
      elicited by activation of the sympathetic nervous system.

PMID- 1616015
TI  - Theory of production rate calculations in steady and non-steady states and its
      application to glucose metabolism.
AB  - I present a review and synthesis of the basic theory, steady state, and non
      steady state for the calculation of metabolite production rates for systems that
      have a central well-mixed compartment that is the site of tracer input and
      sampling. The theory is then applied to the calculation of glucose production. If
      the only inputs are into the central compartment, an experimental design that
      involves varying tracer infusion rates to maintain constant specific activity in
      the central compartment and the same constant specific activity in the peripheral
      compartments allows calculation of the endogenous production. That holds even if
      the models are unidentifiable. The correct equation and Steele's pool fraction
      approximation reduce to the same result for this experimental design. However,
      that does not justify the use of Steele's equation when there are deviations from
      the exact experimental design. When the specific activity in the central
      compartment is not constant, model-dependent correction terms to Steele's
      equation are needed.

PMID- 1616016
TI  - Oscillations of lactate released from islets of Langerhans: evidence for
      oscillatory glycolysis in beta-cells.
AB  - Oscillations in the glycolytic process have been demonstrated in a number of
      different biological systems. However, their presence has never been demonstrated
      in insulin-secreting beta-cells. We used lactate as a marker for glycolysis and
      measured lactate and insulin concentrations in the effluent of isolated perifused
      rat islets of Langerhans. Sustained regular oscillations in lactate
      concentrations with an average period of 16-20 min were observed in islets that
      were perifused with medium containing 5.5 or 16.7 mM glucose. Sustained
      oscillations of insulin concentrations secreted by the islets were also observed
      in these experiments, and the average period of oscillation was 14.6 +/- 2.3 min
      at 16.7 mM glucose. Mean insulin concentrations at 5.5 mM glucose were too low to
      permit analysis of oscillations. Spectral analysis confirmed the regularity of
      the lactate and insulin oscillations and showed peaks that were consistent with
      the average periods obtained using the Clifton program. Moreover, spectral
      analysis demonstrated marked similarity between the patterns of lactate and
      insulin oscillation during perifusion with 16.7 mM glucose. Cross-correlation
      analysis found these oscillations not to be consistently in phase. In conclusion,
      sustained oscillations in lactate released from islets of Langerhans suggest that
      the glycolytic process in beta-cells also oscillates. The similarity of the
      periods of lactate and insulin raises the possibility that oscillations in
      glycolysis may provide a mechanism for pulsatile insulin secretion.

PMID- 1616017
TI  - Epinephrine augments cortisol secretion from isolated perfused adrenal glands of
      guinea pigs.
AB  - To determine direct effects of epinephrine on adrenal cortisol secretion,
      bilateral adrenal glands were isolated from guinea pigs, together with bilateral
      kidneys, aorta, and inferior caval vein for influent and effluent routes. The
      preparation was perfused with oxygenated Krebs-Ringer bicarbonate solution (pH
      7.4) containing 10 mM glucose, 0.2% bovine serum albumin, and 4.6% dextran. The
      perfusate cortisol level was elevated by the addition of epinephrine in a dose
      dependent manner at concentrations greater than 100 pg/ml and increased eightfold
      as high as the basal level at 1 micrograms/ml epinephrine. The stimulatory effect
      of epinephrine on cortisol secretion was completely abolished by phentolamine, an
      alpha-adrenergic antagonist but was not affected by propranolol, a beta
      adrenergic antagonist. These results demonstrate that epinephrine has a direct
      stimulatory effect on adrenal cortisol secretion via an alpha-adrenergic
      mechanism and also suggest that not only adrenocorticotropin but also epinephrine
      is a most important factor for the regulation of cortisol secretion.

PMID- 1616018
TI  - Effects of infused amino acids on glucose production and utilization in healthy
      human subjects.
AB  - Amino acids have been reported to increase endogenous glucose production in
      normal human subjects during hyperinsulinemia: however, controversy exists as to
      whether insulin-mediated glucose disposal is inhibited under these conditions.
      The effect of an amino acid infusion on glucose oxidation rate has so far not
      been determined. Substrate oxidation rates, endogenous glucose production, and
      [13C]glucose synthesis from [13C]bicarbonate were measured in six normal human
      subjects during sequential infusions of exogenous glucose and exogenous glucose
      with (n = 5) or without (n = 5) exogenous amino acids. Amino acids increased
      endogenous glucose production by 84% and [13C]glucose synthesis by 235%. Glucose
      oxidation estimated from indirect calorimetry decreased slightly after amino
      acids, but glucose oxidation estimated from [13C]glucose-13CO2 data was increased
      by 14%. It is concluded that gluconeogenesis is the major pathway of amino acid
      degradation. During amino acid administration, indirect calorimetry
      underestimates the true rate of glucose oxidation, whereas glucose oxidation
      calculated from the 13C enrichment of expired CO2 during [U-13C]glucose infusion
      does not. A slight stimulation of glucose oxidation during amino acid infusion,
      concomitant with an increased plasma insulin concentration, indicates that amino
      acids do not inhibit glucose oxidation.

PMID- 1616019
TI  - Intensity of lactation modulates renal 1 alpha-hydroxylase and serum 1,25(OH)2D
      in rats.
AB  - Renal 25-hydroxyvitamin D-1 alpha-hydroxylase (1 alpha-hydroxylase) activity and
      serum 1,25-dihydroxyvitamin D [1,25(OH)2D] concentration were measured in
      lactating rats suckling litters of 3, 6, or 12 pups to determine the effect of
      increasing lactational intensity on the biosynthesis of 1,25(OH)2D. Serum Ca2+,
      total Ca, Pi, and immunoreactive parathyroid hormone were also determined. The
      average daily litter weight gain for each litter size was calculated from the
      gain over the last 4-6 days of each of three experiments and was used as an index
      of lactational intensity. Highly significant correlation coefficients were found
      between 1 alpha-hydroxylase and average daily litter weight gain (rs = 0.63, n =
      53, P less than 0.001), serum 1,25(OH)2D and average daily litter weight gain (rs
      = 0.62, n = 50, P less than 0.001), 1 alpha-hydroxylase and serum total Ca (rs = 
      0.52, n = 53, P less than 0.001), and average daily litter weight gain and total
      Ca (rs = -0.52, n = 53, P less than 0.001). Neither serum phosphorus nor
      immunoreactive parathyroid hormone correlated significantly with 1 alpha
      hydroxylase. In addition, construction of regression models using a stepwise
      forward variable selection procedure revealed serum total Ca concentration to be
      a significant predictor for both serum 1,25(OH)2D and renal 1 alpha-hydroxylase
      in lactating rats. These data support the hypothesis that increasing lactational
      intensity leads to decreasing serum Ca concentration, resulting in stimulation of
      1 alpha-hydroxylase activity and a rise in the serum 1,25(OH)2D level.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1616020
TI  - Effects of short-term testosterone exposure on insulin sensitivity of muscles in
      female rats.
AB  - The effects of testosterone on insulin sensitivity were studied in
      oophorectomized female rats. Euglycemic, hyperinsulinemic clamp measurement
      showed a marked decrease of insulin sensitivity after 48 but not 24 h of
      testosterone exposure, which was overcome at high insulin concentrations. Insulin
      stimulation of 2-deoxyglucose uptake as well as glycogen synthesis was measured
      in the white and red parts of the gastrocnemius, the extensor digitorum longus,
      and soleus muscles as well as in the liver (only glycogen synthesis). After 24 h
      of treatment, inhibition of both 2-deoxyglucose uptake and glycogen synthesis was
      found in the most insulin-sensitive muscles. After 48 h of insulin stimulation,
      glycogen synthesis was inhibited in all examined individual muscles (white and
      red parts of gastrocnemius, extensor digitorum longus, and soleus) as was the
      activity of the insulin-sensitive part of glycogen synthase in muscle. Inhibition
      of insulin-stimulated 2-deoxyglucose uptake again affected the most insulin
      sensitive muscles. There was a slight but significant change of muscle fiber
      composition toward less long-chain myosin and more short-chain myosin-containing
      fibers. Serum cortisol, plasma free fatty acids, and blood glycerol did not
      change. It is concluded that testosterone administration in moderate doses to
      oophorectomized female rats is followed by a rapid deterioration of insulin
      sensitivity in muscle, mediated mainly by perturbations of the insulin receptor
      glycogen synthesis systems apparently coinciding with changes in muscle
      morphology.

PMID- 1616021
TI  - Regulation of glycogen metabolism in canine myocardium: effects of insulin and
      epinephrine in vivo.
AB  - Myocardial glycogen synthesis and glucose, lactate, and oxygen extraction were
      measured in the hearts of anesthetized dogs during infusions of insulin and
      epinephrine. Glycogen was monitored in vivo using 13C-nuclear magnetic resonance
      during an infusion of [1-13C]glucose into the left anterior descending artery.
      Glycogen synthesis was observed during a venous infusion of insulin (1.8
      microU.min-1.kg-1), and this newly synthesized glycogen was neither broken down
      nor was more glycogen synthesized during a subsequent epinephrine infusion (0.5
      micrograms.min-1.kg-1). During recovery from epinephrine, glycogen synthesis
      occurred at 2.1 times the rate seen in the control period. Glycogen synthesis was
      not stimulated in the absence of epinephrine by control infusions of saline.
      Glucose uptake was increased by insulin during the control period (from 0.09 to
      0.39 mumol.min-1.g-1), so that the combined extraction of glucose and lactate
      exceeded the requirement for oxidizable substrate calculated from oxygen
      consumption. The "excess" glucose (0.15 mumol.min-1.g wet wt-1) is presumably
      available for glycogen synthesis. During recovery from epinephrine, lactate
      uptake was increased over threefold. Because this additional lactate supplies
      most of the fuel required for oxidation, the excess glucose available for
      glycogen synthesis during this period was two times that seen before epinephrine
      (an average of 0.32 mumol.min-1.g wet wt-1 between 20 and 40 min
      postepinephrine). These data are consistent with the notion that glycogen
      synthesis can be activated in the heart without an accompanying increase in
      glucose uptake by providing an alternative substrate (i.e., lactate) for
      oxidation.

PMID- 1616022
TI  - Caffeine ingestion and muscle metabolism during prolonged exercise in humans.
AB  - We examined the effects of a high-caffeine dose on endurance performance and
      muscle acetyl group metabolism during prolonged exercise. Eight subjects cycled
      to exhaustion at approximately 80% maximal oxygen uptake (VO2max) 1 h after
      ingestion of 9 mg/kg body wt dextrose (Pl) or caffeine (Caf). In the Pl trial,
      muscle biopsies were taken at rest (1 h postingestion) and at 15 min and
      exhaustion during exercise. The Caf trial followed the same protocol 1 wk later,
      with an additional biopsy at the time corresponding to Pl exhaustion. The
      subjects cycled significantly longer during the Caf trial (96.2 +/- 8.8 min) than
      in the Pl trial (75.8 +/- 4.8 min). Net glycogenolysis during the initial 15 min
      of cycling was reduced in the Caf vs. Pl trial (4.7 +/- 1.5 vs. 10.6 +/- 1.3
      mmol.kg dry muscle-1.min-1; P less than 0.05). Muscle citrate concentration was
      increased at rest with Caf (0.59 +/- 0.07 vs. 0.37 +/- 0.05 mmol/kg dry muscle; P
      less than 0.05) but increased to similar values in both trials during cycling.
      Caf elevated the acetyl-CoA/CoA-SH ratio at rest (0.316 +/- 0.046 vs. 0.201 +/-
      0.023; P less than 0.05) but had no effect on the increases in muscle acetyl-CoA
      and acetylcarnitine during exercise. The results indicate that Caf before
      exercise decreased muscle glycogenolysis by approximately 55% over the first 15
      min of exercise at approximately 80% VO2max. This "spared glycogen" was available
      late in exercise and coincided with a prolonged time to exhaustion. Increased
      utilization of intramuscular triacylglycerol and/or extramuscular free fatty
      acids after caffeine ingestion may inhibit carbohydrate use at rest and early
      during exercise via elevations in muscle citrate and the acetyl-CoA/CoA-SH ratio.
      Muscle acetyl-CoA and acetylcarnitine were maintained above resting contents even
      at exhaustion when muscle glycogen was depleted.

PMID- 1616023
TI  - Hepatic metabolism during fasting-refeeding transition in conscious pregnant
      rabbits.
AB  - The aim of the present study was to determine changes induced by pregnancy in the
      hepatic handling of nutrients during the fasting-refeeding transition. Net
      hepatic and gut substrate fluxes were determined by the Fick principle in
      conscious pregnant (day 30) and nonpregnant rabbits in the 2 h after consumption
      of a mixed meal. Hepatic glucose production was suppressed by approximately 50%
      in both groups from 15 to 90 min. Pregnant rabbits returned to control levels at
      120 min. Pregnant females displayed a larger gut glucose output and a greater
      arterial hyperglycemia. The hepatic and gut balance of lactate as well as the
      arterial level was almost unchanged. In pregnant females the hepatic uptake and
      arterial concentration of free fatty acids (FFA) remained almost unchanged,
      whereas these measures decreased in nonpregnant females by approximately 55 and
      approximately 80%, respectively, at 120 min. The decline in hepatic output of
      beta-hydroxybutyrate was similar in both groups. In pregnant rabbits arterial
      levels of beta-hydroxybutyrate did not parallel changes in the hepatic release as
      in nonpregnant females. Pregnant females displayed a greater hyperinsulinemia
      both in the portal vein and the artery over the first hour. It is concluded that,
      in pregnant rabbits fed a mixed meal, the ability of the liver to handle glucose
      is impaired because of insulin resistance. The latter brings about a greater and
      prolonged arterial hyperglycemia, which is reinforced by peripheral insulin
      resistance. Furthermore, the higher level of FFA may also contribute to the
      hyperglycemia. As a result, a greater amount of glucose is diverted to other
      sites, presumably the uterus.

PMID- 1616024
TI  - Kinetics of 1,25-dihydroxyvitamin D metabolism in the aging rat.
AB  - To determine whether postmaturational aging influences the kinetics of 1,25
      dihydroxyvitamin D [1,25(OH)2D] metabolism in the rat, we measured the metabolic
      clearance (MCR) and production (PR) rates of 1,25(OH)2D in 6-, 12-, 18-, and 24
      mo-old Fischer 344 rats using the constant infusion method. Plasma calcium,
      phosphorus, and parathyroid hormone (PTH), urinary calcium and phosphorus, and
      glomerular filtration rate (GFR) were also measured. MCR and PR increased 57 and
      91%, respectively (when expressed per rat), and 32 and 39%, respectively (when
      expressed per kg body wt), between 6 and 24 mo of age, with the greatest increase
      occurring between 18 and 24 mo. The plasma concentration of 1,25(OH)2D remained
      unchanged. Plasma PTH, when compared with 6-mo-old animals, was significantly
      elevated at 18 mo (147%) and even higher at 24 mo (240%). GFR (51Cr-labeled EDTA
      clearance) remained unchanged through 18 mo but tended to be reduced at 24 mo.
      Plasma phosphorus tended to decrease with age, whereas plasma calcium, urinary
      calcium, and urinary phosphorus did not differ among the age groups. These data
      indicate that both clearance and production of 1,25(OH)2D increase with
      postmaturational aging in the rat. They also suggest that the early age-related
      rise in plasma PTH is neither a consequence of low plasma calcium nor of renal
      insufficiency.

PMID- 1616025
TI  - Role of leucine and other amino acids in regulating protein metabolism in vivo.
AB  - The present study examines the independent effects of amino acids and leucine in
      modulating insulin's effect on leucine kinetics in 24-h fasted conscious dogs
      during an experimental period where insulin was infused at 600 mU.kg-1.h-1. Group
      I (n = 7) received saline, group II (n = 10) received sequential infusions of L
      leucine at 0, 1, 3, and 1 mumol.kg-1.min-1 each lasting for 90 min, and group III
      (n = 6) received L-amino acids with doses of L-leucine matching those of group
      II. Plasma leucine (mumol/l) was 120 +/- 5 basally and 135 +/- 23 and 129 +/- 12
      during the infusion of 3.0 mumol.kg-1.min-1 in groups II and III compared with 40
      +/- 3 in group I. Leucine rate of appearance (mumol.kg-1.min-1) was 3.5 +/- 0.3
      during the basal period and was suppressed 80% in both groups II and III as
      compared with 40% in group I (P less than 0.01). Leucine oxidation (basal = 0.7
      +/- 0.15 mumol.kg-1.min-1) dropped 20% in group I but increased to threefold
      basal in group II and twofold in group III (P less than 0.05). Nonoxidative rate
      of disposal (basal = 2.6 +/- 0.2 mumol.kg-1.min-1) dropped 25% in group I and 55%
      in group II but did not change in group III. These data show that, in addition to
      insulin, amino acids and particularly leucine cause a marked suppression of
      proteolysis. Availability of all amino acids to prevent hypoaminoacidemia is
      necessary to sustain basal rates of protein synthesis. The infusion of leucine
      alone resulted in significant stimulation of leucine oxidation.

PMID- 1616026
TI  - Linear bone growth of oMT1a-oGH transgenic male mice.
AB  - Linear bone growth was studied in male mice possessing a controlled ovine
      metallothionein 1a promoter-ovine growth hormone (oMT1a-oGH) transgene. Transgene
      expression was activated at weaning by the addition of 25 mM zinc sulfate to
      drinking water; transgenic and control mice received the zinc supplementation.
      The ulna, humerus, and tibia were excised at 10-day intervals until 130 days from
      control and from mice hemizygous for oMT1a-oGH. Bones from mice overexpressing
      growth hormone (GH) were 11-20% longer than those from controls (P less than
      0.01) at 130 days. Transgenic mice exhibited both an enhanced rate of bone growth
      and a growth period of greater duration, i.e., the ulna, tibia, and humerus from
      oMT1a-oGH mice grew at an accelerated rate for an additional 20-40 days relative
      to the same bones from control mice. The bones from both groups were
      characterized by isometric growth patterns. Genetic size scaling revealed that
      the observed differences in bone growth were directly related to the mature size
      of the bone, suggesting that the bones possess an inherent growth pattern that is
      followed even in the presence of elevated GH.

PMID- 1616027
TI  - NMR-invisible ATP in heart: fact or fiction?
AB  - 31P-nuclear magnetic resonance (31P-NMR) spectroscopy is widely used to monitor
      sequential changes in the nucleoside triphosphate (NTP) pool in intact tissues.
      Recently, the validity of this technique to quantitate incremental changes in ATP
      in heart has been challenged. Accordingly, we compared NTP measured by 31P-NMR
      and by chemical techniques in isolated isovolumic rat hearts at 16 and 56 min of
      oxygenated perfusion and in hearts subjected to 28 min of hypoxia, with or
      without 28 min of reoxygenation, and 12 or 28 min of ischemia, with or without 28
      min of reperfusion. NTP content was calculated from 31P-NMR spectra using an
      external standard. At the end of each protocol the heart was freeze-clamped, and
      NTP and ATP contents were determined by chemical assay. After 16 min of normoxic
      perfusion the values for NTP and ATP contents measured by both methods in the
      same hearts were indistinguishable. Results from all seven experimental
      conditions show no significant difference between methods (P = 0.262). Thus both
      methods detect the same incremental change in NTP and ATP.

PMID- 1616028
TI  - Roles of paraventricular catecholamines in feeding-associated corticosterone
      rhythm in rats.
AB  - Effects of local destruction of the brain catecholaminergic neurons were examined
      on the light- and feeding-associated circadian rhythms in plasma corticosterone
      in rats. 6-Hydroxydopamine (6-OHDA), a selective and long-lasting neurotoxin of
      the catecholaminergic neurons, was microinjected into the following discrete
      areas of the brain: the paraventricular nucleus (PVN), median eminence (ME),
      suprachiasmatic nucleus (SCN), ventromedial hypothalamic nucleus (VMH), lateral
      hypothalamic nucleus (LH), and the ascending bundle of noradrenergic neurons
      (NAB). And the feeding-associated as well as the light-associated circadian
      rhythms in plasma corticosterone were determined. The light-associated circadian
      rhythm was assayed under a 24-h light-dark cycle with free access to food,
      whereas the feeding-associated circadian rhythm was measured under restricted
      daily feeding in which rats had free access to food at a fixed time of day. 6
      OHDA reduced the norepinephrine concentrations in respective regions to 10-30% of
      the control value, except for the LH. The light-associated circadian rhythm was
      not affected by 6-OHDA into the SCN or PVN. By contrast, 6-OHDA into the PVN or
      ventral NAB suppressed the feeding-associated circadian peak. 6-OHDA into the VMH
      and LH showed some effects on plasma corticosterone level but not on the feeding
      associated circadian rhythm. 6-OHDA had no systematic effect on plasma
      corticosterone level when injected into the SCN, ME, and dorsal NAB. These
      findings indicate that the catecholaminergic neurons projecting to the PVN are
      involved in the feeding-associated but not in the light-associated circadian
      rhythms.

PMID- 1616029
TI  - Kidney IGF-I and renal hypertrophy in GH-deficient diabetic dwarf rats.
AB  - Insulin-like growth factor I (IGF-I) has been proposed as a renotropic factor in
      initial diabetic kidney growth. To examine the effects of an isolated growth
      hormone (GH) and IGF-I deficiency on diabetic renal hypertrophy, dwarf rats were
      made diabetic and studied over a period of 7 days. Diabetic dwarf rats treated
      with human GH (hGH) or insulin and diabetic rats with intact pituitary were used
      as controls. In diabetic control animals kidney weight had increased by day 2 (P
      less than 0.01), and the increase amounted to 27% after 7 days, whereas untreated
      diabetic dwarf rats had a slower and lesser degree of kidney weight increase,
      reaching significance on day 7 only, amounting to 8%. hGH administration in
      diabetic dwarf rats increased the kidney weight on day 7 when compared with
      untreated diabetic dwarf rats (P less than 0.05) and was 19% over that of insulin
      treated diabetic dwarf rats. The glomerular volume had increased by 43% in
      untreated diabetic control rats at day 7, compared with a 29% increase in
      untreated diabetic dwarf rats (P less than 0.05). hGH administration in diabetic
      dwarf rats increased the glomerular volume by 46%, comparable to the increase
      seen in diabetic control animals. Kidney IGF-I was increased on day 2 by 51 and
      46% in saline- and hGH-injected diabetic dwarf rats, respectively, but a
      significantly higher increase in kidney IGF-I amounting to 96% was seen in
      diabetic control rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616030
TI  - Tracer-to-tracee ratio for analysis of stable isotope tracer data: link with
      radioactive kinetic formalism.
AB  - A kinetic formalism for the analysis of stable isotope transient tracer data is
      developed by establishing the link with the formalism available for radioactive
      tracer data. The crucial variable is the tracer-to-tracee ratio. By expressing
      the measurements in terms of this ratio, the conventional kinetic formalism used
      for radioactive data can be applied to estimate noncompartmental parameters using
      stable isotope tracer data. The tracer-to-tracee ratio also plays an important
      role in compartmental modeling. By considering the tracer masses in the
      compartments as state variables the system-experiment model can be written in a
      format analogous to that usually adopted for the radioactive tracer. Finally, it
      is shown that the tracer-to-tracee ratio also plays a role in a test of the
      endogenous steady-state assumption.

PMID- 1616031
TI  - Increased apolipoprotein A-IV in rat mesenteric lymph after lipid meal acts as a
      physiological signal for satiation.
AB  - Chylomicron transport and apolipoprotein A-IV (apo A-IV) output in mesenteric
      lymph increases significantly after a lipid meal. Mesenteric lymph collected from
      lymph-fistula rats after lipid infusion exerted an anorectic effect on 24 h
      fasted rats after administration through chronically indwelling right atrial
      catheter. Lymph before lipid infusion and lymph collected from a rat fed lipid
      plus Pluronic L-81 (a potent inhibitor of chylomicron formation) had no anorectic
      effect. Chylomicron and apo A-IV-rich lymph lost its anorectic effect after
      specific immunoprecipitation of apo A-IV by a monospecific antibody. Intravenous
      infusion of the same amount of purified apo A-IV as in chylous lymph 6-8 h after
      a lipid meal suppressed food intake. This unique physiological function of apo A
      IV is not shared by apolipoprotein A-I. It is proposed that apo A-IV is a
      circulating signal released in response to fat feeding and that it is likely to
      mediate the anorectic effect of a lipid meal.

PMID- 1616032
TI  - Release of reactive oxygen by hepatocytes on reoxygenation: three phases and role
      of mitochondria.
AB  - Reoxygenation of isolated hepatocytes in primary culture resulted in a three
      phase response in the release of reactive oxygen species (ROS) as determined by
      peroxidase-dependent luminol chemiluminescence. Release of ROS within the first
      and second phase correlated well with the extent of reoxygenation injury, both
      being most significant after approximately 4 h of hypoxic incubation. During the
      third phase, some of the ROS were released by already nonviable cells. Both
      antimycin A and rotenone significantly increased release of ROS, indicating
      severe alterations of the mitochondrial respiratory chain caused by hypoxia and
      suggesting that the altered mitochondrial respiratory chain represents an
      important source for the release of ROS on reoxygenation. Generation of ROS rose
      sharply when the O2 content was increased from 0 to 2%, whereas a further
      increase in the O2 content, of up to 95%, resulted in only small but steady
      increases in the formation of ROS. The latter suggests that, in addition to
      enzymatic sources such as the mitochondrial respiratory chain, nonenzymatic
      reactions may also contribute to the formation of ROS on reoxygenation.

PMID- 1616033
TI  - Macromolecular transport by rat gastric mucosa.
AB  - We previously demonstrated that the stomach is capable of mounting a type I
      hypersensitivity reaction to luminal antigen challenge. These findings imply that
      antigenically intact macromolecules cross the gastric mucosa. To test this
      hypothesis, rat gastric mucosa was mounted in Ussing chambers, and bovine serum
      albumin (BSA, 0.5 mg/ml) and 125I-labeled BSA (10 microCi) were added to mucosal
      fluids. After equilibration, serosal fluids were sampled for two 30-min periods,
      and fluxes of immunologically intact BSA (determined by an enzyme-linked
      immunosorbent assay) and total BSA (125I-BSA) were calculated under basal
      conditions and in the presence of NaF and colchicine, and at 4 degrees C.
      Additional experiments examined macromolecular permeability in sensitized
      challenged tissues. Immunologically intact BSA (21.3 +/- 4.5 ng.30 min-1.cm-2)
      crossed the gastric mucosa as approximately one-fourth of the total BSA flux
      (78.2 +/- 7.5 ng.30 min-1.cm-2). The uptake of immunologically intact BSA was
      significantly reduced by NaF, an inhibitor of ATP production and endocytosis;
      colchicine, which inhibits polymerization of cytoskeletal microtubules; and at 4
      degrees C, a general metabolic inhibitor. The transmural passage of antigen was
      not significantly altered by immunoglobulin E-mediated anaphylaxis. These
      findings indicate that intact protein antigens cross the gastric mucosa by an
      active, energy-dependent mechanism that uses the microtubular network.

PMID- 1616034
TI  - Inflammation causes hyperplasia and hypertrophy in smooth muscle of rat small
      intestine.
AB  - Inflammation of the rat jejunum with Trichinella spiralis causes altered smooth
      muscle contractility by day 6 postinfection (PI). We investigated the association
      of structural change in the smooth muscle layers with inflammation. By day 6 PI,
      smooth muscle area in cross sections of jejunum increased (P less than 0.05) in
      longitudinal (LM) and circular (CM) muscle layers. Nuclei counting in cross
      sections showed that cell number increased two- to threefold in CM and LM, and
      this increase was not reversed on day 23 PI. Estimation of cell size showed
      significant hypertrophy by day 6 PI in both muscle layers. [3H]thymidine
      autoradiography showed that the labeling index (LI) of jejunal LM and CM
      increased sharply on day 4 PI and peaked on day 6 PI (10- to 15-fold increase).
      The noninflamed ileum showed a smaller trophic response, with no significant
      change in area or nuclei number, the LI was increased only on day 6 PI in the
      ileal CM and was unchanged in LM. Thus extensive hyperplasia and hypertrophy of
      smooth muscle cells are associated with intestinal inflammation.

PMID- 1616035
TI  - Effect of diet on glucose transporter site density along the intestinal crypt
      villus axis.
AB  - High-carbohydrate diets stimulate intestinal brush-border glucose uptake and
      increase the number of glucose-protectable phlorizin binding sites, but it has
      been unknown where along the crypt-villus axis these effects are expressed. We
      attacked this problem by three methods. First, by measuring phlorizin binding to
      isolated mouse enterocytes fractionated along the crypt-villus axis by the Weiser
      method, we identified a high-affinity binding site predominating from villus tip
      to midvillus and a site of possibly lower affinity predominating in the crypts. A
      high-carbohydrate diet increased by severalfold the density of the villus sites
      and probably also of the crypt sites, without changing their binding constants.
      Second, autoradiography revealed increased glucose-protectable phlorizin binding
      along the whole crypt-villus axis on a high-carbohydrate diet. Finally, a
      polyclonal antibody against the Na(+)-glucose cotransporter recognized a protein
      in the brush-border membrane of villus cells. Hence, substrate-dependent
      upregulation of intestinal glucose transport involves increased numbers of
      transporters along the crypt-villus axis.

PMID- 1616036
TI  - Crypt-villus site of glucose transporter induction by dietary carbohydrate in
      mouse intestine.
AB  - Intestinal brush-border glucose uptake rate is regulated by dietary carbohydrate
      level. However, this uptake response takes a day or more after a change in
      dietary carbohydrate level. Is this dietary signal perceived in the crypts, and
      is the glucose transporter activity of enterocytes irreversibly programmed there?
      If so, this time lag could reflect cell migration times along the crypt-villus
      axis, since glucose transport is not fully expressed until cells reach the
      midvillus. Alternatively, however, the time lag could arise from the induction
      process itself, if glucose transporter activity in mature villus enterocytes can
      be reversibly reprogrammed by dietary carbohydrate levels. Hence, we measured
      glucose-protectable phlorizin binding (as a measure of glucose transporter site
      density) in mouse enterocytes fractionated along the crypt-villus axis by the
      Weiser method, as a function of time after an abrupt switch in dietary
      carbohydrate level. For an increase or decrease in dietary carbohydrate, an
      increase or decrease in phlorizin binding site density first appeared in the
      crypts and marched over the course of several days to the villus tips. Hence, the
      signal for glucose transporter regulation is perceived in the crypts, and the
      observed lag in uptake is due largely to cell migration times.

PMID- 1616037
TI  - Patch-clamp recording in myenteric neurons of guinea pig small intestine.
AB  - The results of our research established the feasibility of applying patch-clamp
      methods in the study of the cellular neurophysiology of myenteric neurons
      enzymatically dissociated from adult guinea pig small intestine. Recording in
      current-clamp mode revealed two populations of neurons. One population discharged
      repetitively during depolarizing current pulses and displayed anodal-break
      excitation reminiscent of S/type 1 myenteric neurons. In the second population,
      spike discharge was limited to one or two spikes at the onset of depolarizing
      pulses and was similar to the behavior of AH/type 2 neurons. Recording in voltage
      clamp mode revealed a complex of overlapping inward and outward whole cell
      currents. Fast and slow components of inward current were interpreted as sodium
      and calcium currents, respectively. Outward currents were blocked by cesium and
      consisted of components with properties of delayed rectifier current and A-type
      potassium current.

PMID- 1616038
TI  - Hormonal regulation of paracellular permeability in isolated rat hepatocyte
      couplets.
AB  - Many hormones and drugs exert their effects on cells by increasing cytosolic Ca2+
      (Cai2+) and activating protein kinase C (PKC). Each of these actions results in
      cholestasis in the isolated perfused rat liver, but the responsible mechanisms
      are unclear. We used isolated rat hepatocyte couplets to observe the direct
      effects of increased Cai2+ and PKC activation on permeability of the hepatocyte
      tight junction and canalicular volume, two possible determinants of hepatocyte
      bile secretion. Couplets were stimulated with the Ca2+ agonist vasopressin (10(
      8) M) in the absence and presence of the Ca2+ influx antagonist Ni2+ (5 x 10(-3)
      M) or with the PKC activator phorbol dibutyrate (10(-6) M). Cai2+ was determined
      by ratio microspectrofluorometry of indo-1, permeability of the couplet tight
      junctions was assessed by exclusion of horseradish peroxidase from the
      canalicular space, and changes in canalicular volume over time were measured
      directly by optical planimetry. Canalicular volume increased by 1.6 +/- 2.5%/min
      (mean +/- SD) under basal conditions. In response to vasopressin, there was a
      rapid 15-fold increase in Cai2+, followed first by an increase in paracellular
      permeability, then by canalicular collapse (15.9 +/- 5.9%/min). Pretreatment with
      Ni2+ markedly decreased the vasopressin-induced increase in Cai2+ and abolished
      both the increase in paracellular permeability and the canalicular collapse.
      Phorbol dibutyrate also increased paracellular permeability but resulted in
      neither increased Cai2+ nor canalicular collapse. The PKC inhibitor H-7 reversed
      the effects of both vasopressin and phorbol dibutyrate on tight junction
      permeability. Bile secretory pressure, measured in isolated perfused rat liver
      preparations, was acutely increased by vasopressin, but the increase was
      augmented rather than inhibited by Ni2+.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616039
TI  - Vagus-dependent disruption of interdigestive canine motility by gastric
      distension.
AB  - The purpose of this study was to determine the effect of proximal gastric
      distension on interdigestive patterns of canine gastrointestinal motility and to
      examine the role of extrinsic nerves in regulating such an effect. Serosal
      electrodes were placed on the antrum, duodenum, and jejunum. Animals were studied
      before and after transthoracic vagotomy or after neural isolation of the entire
      jejunoileum (extrinsic denervation). Proximal gastric distension for 5 h was
      provided by inflating with air a thin complaint bag placed into the proximal
      stomach after the onset of phase III of the migrating motor complex (MMC). Four
      volumes (0, 1.5, 12.5, and 25 ml/kg) were each tested four times in each animal.
      In neurally intact animals, gastric distension with volumes of 12.5 and 25 ml/kg
      consistently abolished the MMC in the antrum (100%), duodenum (96%), and proximal
      jejunum (greater than or equal to 62%), but less often in distal jejunum (greater
      than or equal to 25%). After vagotomy, gastric distension did not inhibit cycling
      of the MMC in the antrum, duodenum, or proximal or distal jejunum. After
      extrinsic denervation of the jejunoileum, gastric distension inhibited the MMC in
      the antrum and the duodenum but had no effect in the proximal or distal jejunum.
      These findings suggest that nonnutrient proximal gastric distension may
      contribute to postprandial changes in patterns of myoelectric activity in the
      upper gastrointestinal tract and that this effect is mediated by the vagus
      nerves.

PMID- 1616040
TI  - Hepatic uptake of 3,5,3'-triiodothyronine: electrochemical driving forces.
AB  - We used the multiple indicator dilution technique to assess the electrochemical
      forces driving uptake of 3,5,3'-triiodo-L-thyronine (T3) across the basolateral
      plasma membrane in the single-pass perfused rat liver. With the use of 4 g/dl
      albumin solutions, the influx and efflux clearances were 0.020 +/- 0.005 and
      0.0049 +/- 0.0017 (SE) ml.s-1.g liver-1, respectively, indicating that the total
      T3 concentration at equilibrium should be about four times greater in cytoplasm
      than in plasma. However, when the influx and efflux clearances were divided by
      the unbound (free) T3 concentration in the perfusate and cytosol, they were not
      different (3.76 +/- 0.26 vs. 4.30 +/- 0.38 ml.s-1.g liver-1), indicating that the
      uptake process does not generate a gradient of unbound T3 across the plasma
      membrane. To further test whether T3 uptake is driven by the electrical potential
      difference across the plasma membrane, liver cells were depolarized by isosmotic
      replacement of perfusate chloride with gluconate. There was no effect on uptake
      or efflux. To test whether uptake is coupled to influx of sodium, perfusate
      sodium was replaced with choline. Although there was a modest decline in both the
      influx and efflux clearances, there was no change in their ratio, as would be
      expected for sodium-coupled active transport. These results indicate that uptake
      of T3 across the basolateral hepatocyte membrane occurs by passive diffusion. We
      found no evidence to support concentrative, active transport by either
      electrogenic or sodium-coupled mechanisms.

PMID- 1616041
TI  - Both CCK-A and CCK-B/gastrin receptors mediate pepsinogen release in guinea pig
      gastric glands.
AB  - We evaluated the affinity of cholecystokinin octapeptide (CCK-8), gastrin, and
      subtype-selective CCK agonists for CCK/gastrin receptors and compared it with the
      ability of these peptides to stimulate phosphoinositide (PI) hydrolysis and
      pepsinogen release in guinea pig gastric glands. Competitive binding studies
      using 125I-labeled Bolton-Hunter-CCK-8 and 125I-gastrin showed the presence of
      CCK-B/gastrin receptors in gastric glands and dispersed chief cells. In contrast,
      the potency of peptides in stimulating PI hydrolysis in both gastric glands and
      dispersed chief cells displayed a profile similar to CCK-A receptors found in
      pancreatic acini, i.e., CCK-8 = A 71378 greater than A 71623 greater than A 70874
      much greater than A 72962 = CCK-8 (desulfated) greater than gastrin II greater
      than gastrin I. In general, the rank order of potency of peptides for stimulation
      of PI hydrolysis correlated well with their ability to stimulate pepsinogen
      release. At concentrations greater than 10 microM, efficacies of gastrin I and II
      in stimulating pepsinogen release from gastric glands were near 90% of the
      maximal activity of CCK-8. The inhibitory potency of MK-329, a selective CCK-A
      receptor antagonist, was similar against either CCK-8 (10 nM) or gastrin I (10
      microM), except that a minor portion (approximately 30-40%) of gastrin I-induced
      pepsinogen release was insensitive to MK-329. The MK-329-insensitive component
      was inhibited by CI-988, a potent and selective CCK-B/gastrin receptor
      antagonist.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616042
TI  - On the design and interpretation of experiments to elucidate albumin-dependent
      hepatic uptake.
AB  - The liver's apparently anomalous extraction of organic anions tightly bound to
      albumin continues to provoke controversy and confusion. Decisive experiments have
      proved difficult to design, and mathematical models have usually been constructed
      to defend one or another putative mechanism to the exclusion of others. To
      stimulate more decisive experiments and as an aid to interpreting those already
      reported, we discuss a general formulation of the problem that predicts the
      clearance pattern to be expected when facilitated dissociation and codiffusion
      are joint determinants of the uptake flux. The results provide an approach to
      modeling the various mechanisms by which the concentration of bound ligand at the
      cell surface could be a driving force for uptake. Further we present new
      calculations to clarify the interpretation of net ligand clearance when the
      removal of free ligand is the result of bidirectional fluxes into and out of an
      unstirred sink. Applied to a previously published comparison of the uptake
      performances of hepatocytes and polyethylene, the new calculations support the
      inference that facilitated dissociation of albumin-palmitate complexes occurs at
      or near the hepatocyte surface.

PMID- 1616043
TI  - Nitric oxide modulates epithelial permeability in the feline small intestine.
AB  - The objective of this study was to assess whether inhibition of nitric oxide
      production leads to increased epithelial permeability in feline small intestine.
      Local intra-arterial infusion of the nitric oxide synthesis inhibitor NG-nitro-L
      arginine-methyl ester (L-NAME; 0.025 mumol.ml-1.min-1) was performed in
      autoperfused segments of cat ileum for 90 min. An exogenous source of nitric
      oxide, sodium nitroprusside (SNP) was infused (0.025 mumol.ml-1.min-1) for the
      last 30 min of the 90-min L-NAME infusion. Epithelial permeability was
      quantitated by measuring blood-to-lumen clearance of 51Cr-labeled EDTA throughout
      the experiment. An increase of approximately sixfold in mucosal permeability was
      observed within 30 min of L-NAME infusion and this effect was completely reversed
      by infusion of either SNP or L-arginine (0.125 mumol.ml-1.min-1). NG-nitro-D
      arginine-methyl ester (D-NAME) had no effect on mucosal permeability. The
      increase in epithelial permeability was sufficiently large that rhodamine-dextran
      (mol wt = 17,200) clearance from interstitium to lumen was increased.
      Pretreatment with IB4, a monoclonal antibody directed against the leukocyte
      adhesive glycoprotein complex (CD11/CD18) did not prevent the L-NAME-induced
      increase in epithelial permeability. These data suggest that inhibition of nitric
      oxide production leads to a reversible circulating leukocyte-independent increase
      in epithelial permeability.

PMID- 1616044
TI  - Dietary control of the lactase mRNA distribution along the rat small intestine.
AB  - At weaning, the lactase-phlorizin hydrolase (LPH) mRNA was shown to disappear
      specifically from the distal part of ileum while remaining abundant in the more
      proximal segments of the small intestine. The purpose of this study was to
      analyze the longitudinal distribution of this transcript in rats whose intestinal
      lumen content was modified before and after weaning. Preweaned animals force-fed
      with an artificial diet retained a high amount of LPH mRNA in the jejunum,
      whereas this transcript precociously decreased in the distal ileum. Conversely,
      prolonged nursing delayed the specific decay of the LPH mRNA in the latter
      segment. Food deprivation in preweaned animals did not alter the longitudinal
      distribution of this transcript in that it remained abundant in the distal ileum.
      In adult rats, rearranging the order of the small intestinal segments with regard
      to the intraluminal flow of nutrients did not modify the typical distribution of
      the LPH mRNA. These results suggest that switching over from milk to the adult
      type diet at weaning contributes to the modification of the longitudinal
      distribution of the LPH mRNA that normally occurs at this stage. However, once
      the adult pattern of expression of this transcript is established, it cannot be
      significantly altered by changing the position of each intestinal segment as well
      as its luminal content.

PMID- 1616045
TI  - Electric and motor patterns associated with canine jejunal transit of liquids and
      solids.
AB  - Our hypothesis was that the direction of liquid transit through the canine
      jejunum is determined by the direction that single jejunal pressure waves spread,
      while the direction of solid transit depends on the direction of spread of both
      single waves and clustered waves. In six dogs, 80-cm jejunal Vella loops were
      made and fitted with manometric catheters and serosal electrodes. After recovery,
      transit of liquids (Ringer lactate) and solids (2.4-mm nylon spheres) placed into
      the center of the loop was determined in the conscious animals while pacing the
      loop in a forward direction or in a backward direction. Under fasting and fed
      conditions, single pressure waves followed the direction of pacing, while the
      direction of migration of clustered waves was not determined by the direction of
      pacing. Liquid transit always followed the direction of single pressure waves. In
      contrast, solids moved distally regardless of the direction of pacing, except
      when liquids were also present in the lumen, in which case solids moved in the
      same direction as the single pressure waves.

PMID- 1616046
TI  - Relative potency of endothelin analogues on changes in gastric vascular
      resistance.
AB  - The purpose of this study was to examine the effects of several endothelin
      analogues on the gastric microcirculation. We measured changes in vascular
      resistance of an ex vivo gastric segment of chloralose-anesthetized dogs. Changes
      in luminal pressure were used to quantitate contractile force. Graded doses of
      endothelin-2 (ET-2), endothelin-3 (ET-3), [Ala3,11]endothelin (Ala-ET), and the
      COOH-terminal hexapeptide (ET-C) were infused intra-arterially to the stomach. ET
      2 and Ala-ET produced dose-related sustained increases in vascular resistance
      (10(-10) to 10(-8) M), with Ala-ET less potent than ET-2. In contrast, ET-3 was a
      weak vasoconstrictor while ET-C had no significant effects. There were no
      detectable changes in filtration with any of these analogues. However, the force
      of gastric contractions was significantly attenuated by both ET-2 and Ala-ET in a
      dose-dependent manner. We found that endothelin analogues produced sustained
      vasoconstriction of the gastric segment with a potency order of ET-2 greater than
      Ala-ET-3 much greater than ET-C. Our results suggest that endothelin analogues
      are potent vasoconstrictors but have little effect on filtration across the
      gastric vasculature.

PMID- 1616047
TI  - Altered regulation of regional sucrase-isomaltase expression in diabetic rat
      intestine.
AB  - Increased sucrase-isomaltase (SI) expression is a prominent feature of adaptive
      changes observed in the small intestine of streptozocin-treated chronically
      diabetic (CD) rats. In this study, we examine the cellular and molecular basis of
      increased SI expression in CD rats by determining SI specific activities and mRNA
      abundance in sequentially isolated enterocytes along the villus-to-crypt axis of
      proximal jejunum and distal ileum. In all regions, two- to fourfold increases in
      sucrase activity in diabetic rat enterocytes were paralleled by increases in SI
      mRNA. However, analogous to nondiabetic rat intestine, no differences in SI mRNA
      abundance were observed between corresponding enterocyte fractions from ileum and
      jejunum of diabetic rat intestine. By nuclear run-on assays, differences in rates
      of SI gene transcription were not observed in diabetic and nondiabetic intestinal
      tissues. We conclude that diabetes induces increased total and specific
      activities and mRNA abundance of intestinal SI, largely through the stabilization
      of SI mRNA. Furthermore, analogous to nondiabetic small intestine, differences in
      proximal-to-distal SI expression appear to be determined at the translational or
      posttranslational level.

PMID- 1616048
TI  - Convective movement of Ca2+ across guinea pig gallbladder epithelium.
AB  - Recently, much interest has developed in biliary calcium because of its
      importance in the pathogenesis and composition of gallstones. While much progress
      has been made in understanding the thermodynamic factors that control biliary
      calcium concentrations, little is known about the kinetic factors that control
      the movement of calcium across the gallbladder epithelium. These studies measure
      guinea pig gallbladder epithelial permeability to Ca2+ during in vivo convective
      water movement across the membrane. Water movement, ranging from -15.2
      (absorption) to 6.3 microliters.min-1.cm-2 (water entry), was induced by placing
      hypotonic, isotonic, and hypertonic solutions into the gallbladder lumen. Calcium
      movement was found to be directly and linearly related to water flow, indicating
      that Ca2+ moved with the convective water flow, presumably across paracellular
      channels. The slope of this relationship (0.602), representing the concentration
      of calcium in the fluid translocated across the gallbladder epithelium, was only
      about half that of plasma or luminal contents, indicating that calcium movement
      across the membrane was restricted. The mean sieving coefficient (1 - r) of
      guinea pig gallbladder, calculated from this slope, was approximately 0.5,
      indicating that the epithelium is only moderately permeable to Ca2+. The results
      suggest that intraluminal chelation of Ca2+ for the possible prevention and/or
      treatment of calcium-containing gallstones is a potentially feasible therapeutic
      modality.

PMID- 1616049
TI  - In vitro hyporeactivity to methoxamine in portal hypertensive rats: reversal by
      nitric oxide blockade.
AB  - The endothelial cell plays an important role in the local control of vascular
      smooth muscle tone. Portal hypertension is accompanied by systemic vasodilatation
      and a decreased response to vasoconstrictors, changes especially evident in the
      superior mesenteric arterial bed. To evaluate a possible effect of the locally
      released endothelium-derived relaxing factor nitric oxide (NO), we tested the
      effect of NO blockade in in vitro perfused superior mesenteric arterial beds of
      normal (sham) and portal hypertensive (PVL) rats, induced by partial portal vein
      ligation. A significant (n = 7/group; P = 0.02) hyporeactivity to the
      vasoconstrictive properties of the alpha-adrenoceptor agonist methoxamine (3 x
      10(-6) to 3 x 10(-4) M) was prevented by blocking NO formation in PVL compared
      with sham rats, using the stereospecific biosynthesis antagonist N omega-nitro-L
      arginine (10(-4) M, n = 7/group; NS for all methoxamine concentrations tested).
      This effect was reversed by the NO precursor L-arginine (10(-3) M, n = 5/group).
      In conclusion, these in vitro results in mesenteric vessels demonstrate that 1)
      portal hypertension is accompanied by a hyporeactivity to the vasopressor
      methoxamine and 2) locally released NO in this preparation is responsible for the
      decreased vasoconstrictive response.

PMID- 1616050
TI  - Structure, function, and regulation of cellular tight junctions.
AB  - The tight junction (TJ) is a dynamic structure that is controlled, in part, by
      the activity of the cytoskeleton. It has become abundantly clear that, in the
      presence of Ca2+, assembly of the TJ is the result of cellular interactions that
      trigger a complex cascade of biochemical events that ultimately lead to the
      formation of an organized network of TJ elements, the composition of which
      remains unknown. The TJ functions both as a barrier between two fluid
      compartments and, to a lesser extent, as a fence between apical and basolateral
      membrane domains. To meet the many physiological and pathological challenges to
      which epithelia and endothelia are subjected, the TJ must be capable of a rapid
      and coordinated response, which depends on complex regulatory mechanisms. The
      precise characterization of the mechanisms involved in the assembly and
      regulation of the TJ is an area of current active investigation. However, until
      the biochemical composition of this structure has been defined and its gene
      identified, the TJ will continue to be an elusive yet tantalizing challenge to
      the cell biologist.

PMID- 1616051
TI  - Rabbit lung surfactant protein A gene: identification of a lung-specific DNase I
      hypersensitive site.
AB  - Expression of the gene encoding pulmonary surfactant protein A, SP-A, is lung
      specific and developmentally and hormonally regulated. Previously, we observed
      that SP-A gene transcription is initiated in fetal rabbit lung after day 21 of
      gestation and reaches maximal levels by day 28. In the present study, a cDNA
      specific for rabbit SP-A was used to isolate the SP-A gene from a rabbit genomic
      library. A 7.6-kb fragment containing the entire structural gene and
      approximately 380 bp of 5'-flanking DNA was isolated and characterized. The
      transcription initiation site, mapped by primer extension analysis, was localized
      23 bp downstream of a putative TATA element. The structural gene is composed of
      five exons and four introns. The first exon encodes the 5'-untranslated region of
      the mRNA; the translation initiation site is in exon II, and exon V contains the
      two polyadenylation sites that give rise to the 2.0- and 3.0-kb species of SP-A
      mRNA. A potential adenosine 3',5'-cyclic monophosphate (cAMP)-regulatory element
      (CRE) was identified at -261 bp, and sequences with homology to glucocorticoid
      regulatory element (GRE) half-sites were found at -150 and -190 bp upstream of
      the transcription initiation site and within the first intron. A DNase I
      hypersensitive site was identified in genomic DNA isolated from 21- and 28-day
      fetal and adult rabbit lung tissues. This site was mapped within the 5'-flanking
      region of the SP-A gene, at approximately -80 to -180 bp upstream of the
      transcription initiation site. The absence of this hypersensitive site in genomic
      DNA of liver, kidney, and heart tissues suggests that altered chromatin structure
      may serve a role in lung-specific SP-A gene expression. The presence of this
      tissue-specific DNase I hypersensitive site in lung nuclei from 21-day
      gestational age fetal rabbits suggests that the SP-A gene may exist in an
      accessible conformation prior to the time of transcription initiation.

PMID- 1616052
TI  - Effects of TNF-alpha and phorbol ester on human surfactant protein and MnSOD gene
      transcription in vitro.
AB  - Tumor necrosis factor-alpha (TNF-alpha) and the phorbol ester, 12-O-tetradecanoyl
      phorbol-13-acetate (TPA) decrease the synthesis of surfactant proteins
      association with decreased SP-A and SP-B mRNA. Nuclear run-on assays were
      utilized to test whether the inhibitory effects of TNF-alpha and TPA were
      associated with changes in surfactant protein gene transcription. SP-A gene
      transcription was inhibited by both TNF-alpha and TPA as assessed by nuclear run
      on assays. Inhibitory effects of both agents on SP-A gene transcription were
      readily detected within 6 h after exposure and persisted for 24 h. While TNF
      alpha and TPA decreased cellular SP-B mRNA content, transcription of the SP-B
      gene was not influenced by these agents. In contrast to the inhibitory effects of
      TPA and TNF-alpha on SP-A and SP-B mRNAs, steady-state mRNA and rate of
      transcription of human manganese superoxide dismutase (MnSOD) were increased by
      both agents. The time course and extent of increased MnSOD gene transcription by
      TNF-alpha and TPA were distinct. Transcription of the human beta-actin gene was
      not altered by either agent. The inhibitory effects of TPA and TNF-alpha on SP-A
      expression in pulmonary adenocarcinoma cells are associated with the inhibition
      of SP-A gene transcription. Loss of SP-B mRNA was not accompanied by decreased SP
      B gene transcription. Actinomycin D blocked the inhibitory effects of TNF-alpha
      and TPA on SP-A and SP-B mRNA, supporting a role for posttranscriptional events
      in the modulation of the expression of the surfactant proteins SP-A and SP-B.

PMID- 1616053
TI  - Arachidonic acid increases cholinergic secretory responsiveness of ferret
      tracheal glands.
AB  - The purpose of this study was to determine if arachidonic acid could alter ferret
      tracheal gland secretory responsiveness to a cholinergic agonist. We prepared
      glandular explants and incubated the explants in medium containing
      [3H]glucosamine. Secretory responsiveness was expressed as the percent change in
      basal secretion of acid-precipitable [3H]glucosamine-labeled glycoconjugates
      induced by the addition of agonist with and without arachidonic acid [mean +/- SE
      (n)]. Addition of 10(-3) M arachidonic acid caused a significant increase in
      secretion [28 +/- 6% (n = 6)] compared with untreated control tissues [-10 +/- 4%
      (n = 7), P less than or equal to 0.05]. Carbachol (10(-7) M) increased secretion
      39 +/- 9% (n = 7). The combination of 10(-3) M arachidonic acid and 10(-7) M
      carbachol elicited a significantly greater change in secretion compared with
      either agent alone [173 +/- 50% (n = 5)]. The addition of nordihydroguaiaretic
      acid (10(-6) M) or indomethacin (10(-6) M) partially attenuated the arachidonic
      acid-enhanced secretory responsiveness to carbachol. Treatment with both blockers
      completely inhibited the arachidonic acid-enhanced secretory responsiveness to
      carbachol. The effect of arachidonic acid on cholinergic stimulation was also
      abolished by treating the explant cultures with tetrodotoxin (10(-7) M). This
      hypersecretory state is most likely mediated by eicosanoid-induced release of
      neurotransmitters from nerve terminals.

PMID- 1616054
TI  - Binding, uptake, and localization of surfactant protein B in isolated rat
      alveolar type II cells.
AB  - This study reports the ability of rat alveolar type II cells to internalize
      mature bovine surfactant protein B (SP-B) in vitro. Isolated type II cells were
      incubated with labeled SP-B, and binding and internalization were studied
      biochemically and morphologically. Biochemical analyses demonstrated a time
      dependent association of 125I-labeled SP-B with type II cells; binding steadily
      increased through 4 h and then remained constant through 20 h of incubation. The
      association of [3H]SP-B with type II cells was characterized via light and
      electron microscopic autoradiography. Significant quantities of [3H]SP-B were
      found at the plasma membrane, in the endocytic pathway, and in lamellar bodies.
      The pathway of SP-B internalization was not altered by the presence of whole rat
      surfactant; however, the quantity of SP-B internalized into lamellar bodies was
      increased. 3[H]SP-B was not associated with coated pits and colocalized with
      horseradish peroxidase (HRP), consistent with receptor-independent
      internalization. Cell-associated SP-B was not degraded and was detected in
      lamellar bodies undergoing exocytosis. These results suggest that SP-B may follow
      a recycling pathway similar to that previously reported for surfactant
      phospholipids.

PMID- 1616055
TI  - Release of reactive oxygen species by guinea pig tracheal epithelial cells in
      vitro.
AB  - Regulatory and stimulatory mechanisms of H2O2 release from guinea pig tracheal
      epithelial cells were investigated. Cells in primary culture maintained in a
      previously described air-liquid interface system released H2O2 to the
      extracellular space only from the apical side of the cells. The rate of release
      was 0.044 +/- 0.003 nmol.min-1.mg protein-1. H2O2 release could be stimulated
      significantly during a 30-min incubation period with phorbol myristate acetate
      (PMA) and platelet-activating factor (PAF). A stimulatory effect of PAF was
      achieved at concentrations greater than 100 nM and with PMA at concentrations
      greater than 10 ng (16 nM). When protein kinase C was inactivated with
      staurosporine, the responses to both PAF and PMA were abolished, whereas the
      cyclooxygenase inhibitor, indomethacin, did not affect H2O2 generation. When
      guinea pig tracheal epithelial cells were exposed to sublethal concentrations of
      extracellular H2O2 (30 microM), H2O2 was detoxified from both apical and basal
      sides, H2O2 removal being significantly more rapid from the apical side of the
      cells. These results suggest that tracheal epithelial cells can be stimulated to
      generate reactive oxygen species into the airway lumen and that this occurs in
      response to inflammatory mediators that act through protein kinase C. Luminal
      H2O2 release may have developed as a defense mechanism against microbes, and,
      similarly, luminal detoxification of H2O2 could represent an important mechanism
      of modulation of airway inflammation in response to oxidant stress.

PMID- 1616056
TI  - Differentiated structure and function of cultures from human tracheal epithelium.
AB  - Here we describe the conditions which allow cultured human tracheal epithelial
      cells to retain the ion transport properties and ultrastructure of the original
      tissue. The order of potency of growth supports and media additives in elevating
      baseline short-circuit current (Isc) and responses to mediators were vitrogen gel
      (VIT) greater than extracellular matrix from bovine corneal endothelial cells
      (ECM) greater than human placental collagen (HPC), and 2% Ultroser G serum
      substitute (USG) greater than 5% fetal calf serum (FCS) greater than defined
      growth factors (GF). For all combinations of medium and growth supports, an air
      interface (AIR) gave better electrical properties than immersion feeding (IMM).
      As opposed to our earlier conditions (HPC/FCS/IMM), the best new combination
      (VIT/USG/AIR) produced higher baseline Isc (58.0 +/- 10.6 vs. 5.1 +/- 1.0
      microA/cm2) and increased Isc responses to isoproterenol (6.1 +/- 1.5 vs. 0.8 +/-
      0.3 microA/cm2) and bradykinin (9.6 +/- 2.0 vs. 1.0 +/- 0.2 microA/cm2), while
      retaining high transepithelial resistance (227 +/- 5 omega.cm2). VIT/USG/AIR led
      to the appearance of cilia, an increase in the depth of the cell sheets (50 vs.
      10 microns), longer and more frequent apical microvilli, and increased
      interdigitations of the basolateral membrane. Protein and DNA content were also
      significantly increased. Secretory granules were present which stained with
      antibody to goblet cells, but not to serous or mucous gland cells. CF cells grown
      in VIT/USG/AIR showed high baseline Isc (69 +/- 18 microA/cm2) and a
      proportionately larger inhibition of Isc by amiloride (70 +/- 10 vs. 34 +/- 3%).
      Isc did not respond to isoproterenol, and the response to bradykinin was 22%
      normal.

PMID- 1616058
TI  - A stable O2-resistant cell line: role of lipid peroxidation byproducts in O2
      mediated injury.
AB  - HA-1 hamster fibroblasts receiving fresh media every 24 h were continuously
      passaged in progressively increasing O2 concentrations for 18 mo (designated
      O2R95). These cells were significantly more resistant than parental HA-1 to
      clonogenic inactivation mediated by 95% O2 without media replacement. The O2R95
      cell line exhibited increases in the activities of catalase (CAT), Mn superoxide
      dismutase (MnSOD), Cu,Zn superoxide dismutase (Cu,Zn SOD), and glutathione
      peroxidase (GPx). O2R95 cells demonstrated uniformly distributed increased
      staining for CAT, MnSOD, Cu,Zn SOD, and GPx proteins, as determined by
      immunohistochemistry. Cellular resistance to and metabolism of 4-hydroxy-2
      nonenal (4HNE), a toxic byproduct of lipid peroxidation implicated in mechanisms
      of O2 toxicity, was examined in HA-1 and O2R95 cell lines. O2R95 cells were
      significantly more resistant to 4HNE cytotoxicity, which was accompanied by a
      significant increase in 4HNE metabolism. O2R95 cells also demonstrated an
      increase in total glutathione (GSH) and glutathione S-transferase (GST) activity,
      an enzymatic system believed to be involved with 4HNE metabolism. Furthermore,
      homogenates from O2R95 cells consumed greater quantities of 4HNE in the presence
      of NADPH (but not NADH, NAD+, or NADP+), suggesting that an enzyme(s) utilizing
      NADPH contributes to 4HNE metabolism, resistance to 95% O2 and 4HNE as well as
      increased total GSH, antioxidant enzyme activities, and NADPH-dependent
      metabolism of 4HNE, persisted in O2R95 cells for 75 days of growth in 21% O2.
      These findings are compatible with the hypothesis that aldehydic byproducts of
      lipid peroxidation contribute to mechanisms of O2 toxicity and the selective
      pressure exerted by exposure of cells to hyperoxia.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1616057
TI  - Effects of surfactant apolipoproteins on liposome structure: implications for
      tubular myelin formation.
AB  - Tubular myelin is one of several forms of lung surfactant and may play an
      important role in its surface activity. To determine possible mechanisms of
      tubular myelin formation, we studied the effects of purified surfactant proteins
      (SP-A, SP-B, and SP-C) on large unilamellar dipalmitoylphosphatidylcholine-egg
      phosphatidylglycerol (7/3; wt/wt) liposomes. We studied different types of
      membrane interaction induced by the apolipoproteins and correlated these with the
      observed changes in ultrastructure. Aggregation was assessed by measurement of
      light absorbance, lysis, and fusion by measurement of the fluorescence emitted by
      water-soluble and lipid-soluble probes, respectively. Mixtures of the
      apolipoproteins and liposomes were examined in ultrastructural studies by
      negative staining and by thin sectioning. We found that each protein had a
      pronounced and distinct effect on liposome structure. SP-A caused aggregation,
      whereas SP-B and SP-C also caused extensive leakage of liposome contents (lysis)
      and some degree of lipid mixing (fusion). The disruptive effects of SP-B and to a
      lesser extent those of SP-C were correlated by negative staining with the
      appearance of bilayer disks, which tended to aggregate into large sheets. There
      was a marked synergy between SP-A and SP-B in the process of membrane fusion in
      the presence of calcium, which correlated with an early (10 min) and extensive
      rearrangement of the structures seen by electron microscopy followed by a delayed
      (24 h) appearance of small amounts of tubular myelin.

PMID- 1616059
TI  - Surfactant protein A metabolism in preterm ventilated lambs.
AB  - Surfactant protein A (SP-A) metabolism was studied in vivo in 33 preterm
      ventilated lambs at 138 +/- 1 days gestational age by measuring recoveries of
      exogenously administered surfactant containing both radiolabeled SP-A and labeled
      saturated phosphatidylcholine (Sat PC) given via the trachea at birth.
      Endogenously secreted SP-A was also labeled with [35S]methionine and followed
      over 24 h. The exogenously labeled SP-A left the alveolar pool more rapidly than
      did Sat PC over the first 5 h of life (P less than 0.05), and both exogenously
      labeled SP-A and Sat PC were detected within lamellar bodies by 2 h, indicating
      uptake from the airspaces. The quantity of SP-A in alveolar washes increased
      about twofold from birth to 5 h of age, whereas alveolar Sat PC pools were
      constant over 24 h. The SP-A endogenously labeled with [35S]methionine was
      recovered at highest specific activities in the alveolar washes at 10 and 45 min
      after birth with no labeled SP-A detectable in lamellar body fractions until 2 h.
      The curve for endogenous SP-A labeling of lamellar bodies was similar to that for
      exogenous labeling, indicating that SP-A was initially secreted by a pathway
      independent of lamellar bodies with subsequent SP-A labeling of lamellar bodies.
      The kinetics of SP-A metabolism were very different than for Sat PC in preterm
      lambs.

PMID- 1616060
TI  - Differential extraction for the rapid purification of bovine surfactant protein
      B.
AB  - Surfactant protein B (SP-B), a peptide found in organic solvent extracts of
      mammalian surfactant, has been isolated from surfactant previously by column
      chromatography and/or preparative sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS/PAGE). We have developed a method for isolation of SP-B from
      bovine surfactant utilizing differential organic extraction. Dried surfactant,
      isolated from lavage of excised cow lungs, was delipidated by extraction with
      diisopropyl ether-butanol (3:2). The aqueous layer, containing surfactant
      proteins, was dried and then was sequentially extracted with diethyl ether
      ethanol (3:1) and CHCl3:MeOH:HCl (3:2:0.005 N). SP-B partitioned into chloroform
      methanol, which was evaporated under N2. Purified SP-B, quantitated by Coomassie
      dye binding, represented 1% (wt/wt) of the original surfactant with a final
      phospholipid-to-protein ratio less than 1. Silver-stained SDS/PAGE of the SP-B
      extract revealed a single band at 9 kDa (reduced) and 18 kDa (nonreduced), which
      by immunoblotting reacted strongly with monospecific anti-SP-B antibody. Amino
      acid sequence analysis confirmed the presence of NH2 and N-1 terminal sequences
      of bovine SP-B. This procedure offers a rapid, reliable method for isolation of
      purified SP-B from whole surfactant.

PMID- 1616061
TI  - Relationship between personality type and achievement in an undergraduate
      physiology course.
AB  - The Myers-Briggs type indicator (MBTI) was given to 163 students in an
      undergraduate Human Physiology course at a large state university. Selected MBTI
      personality types were compared for achievement in the course using a t test to
      compare total points earned. High grades were earned by students stronger in the
      traits of introversion (I) and judgment (J), whereas the extraverted (E) and
      perceptive (P) types had the lowest grades and dropped out of the course in the
      largest numbers. When combinations of MBTI types were compared, the highest
      grades were earned as follows: SJ greater than ST greater than IN greater than IJ
      greater than IS (S, sensing; T, thinking; N, intuitive). This ranking indicates
      that a sensing personality also has a strong relationship to achievement in this
      Human Physiology course when it is combined with judgment, thinking, or
      introversion. Instructors and students need to be aware of the relationship
      between personality and learning so they can modify their teaching style and
      learning behavior to enhance academic achievement.

PMID- 1616062
TI  - Physiology course for secondary school biology teachers.
AB  - The Department of Physiology at the Medical College of Virginia/Virginia
      Commonwealth University offered a human physiology course to middle school and
      high school science teachers in the Richmond, VA, area. It was a three-credit
      course, team taught, and given at a location convenient to many area teachers.
      This course served the community by contributing to the continuing education
      efforts of teachers and concurrently enhanced our recruitment program by
      advertising "physiology" to teachers who will influence college-bound students
      for years to come. In addition, we established ties between teachers and
      physiology faculty such that continuing interactions (e.g., collaborative
      research during the summer) should be facilitated. The success of the course
      suggests that this is an effective way to serve local communities, enhance
      efforts to recruit graduate students into the basic sciences, and at the same
      time help reverse the educational crisis in the US by bolstering the backgrounds
      of secondary school teachers.

PMID- 1616063
TI  - A student apparatus for recording action potentials in cockroach legs.
AB  - A comparatively simple apparatus allows even beginning students to observe action
      potentials in the cockroach leg. The recordings are made extracellularly by
      impaling the leg on two insect pins. Deflection of large spines on the leg, which
      are each innervated by one sensory neuron, initiates the action potentials. Using
      this technique, students observe the all-or-nothing nature of action potentials,
      their coding of information by frequency, and sensory adaptation.

PMID- 1616064
TI  - Keeping community college faculty current in physiology through utilization of
      health science center expertise.
AB  - The maintenance of current knowledge in physiology in community colleges is very
      difficult to accomplish. The absence of a research environment, limited library
      facilities, and heavy teaching loads often result in the instructor utilizing the
      teaching textbook as the primary source of information. A cooperative program
      between The University of Texas Health Science Center at San Antonio and San
      Antonio Community College has been developed in which the Health Science Center
      faculty present updated seminars in physiology topics for the community college
      faculty. This program has been in existence for three years and has proved to be
      very effective in improving the quality of the physiology curriculum at the
      community college.

PMID- 1616066
TI  - Computer software for physiology education.

PMID- 1616065
TI  - Breath hydrogen testing as a physiology laboratory exercise for medical students.
AB  - Breath hydrogen testing (BHT) is a simple and reliable method for identifying
      impaired carbohydrate absorption. We describe a laboratory exercise in physiology
      for medical students using BHT as the teaching tool. The students collect fasting
      samples of expired air from each other using a simple nasal prong technique. They
      then drink one of several different aqueous carbohydrate solutions. Additional
      samples of expired air are collected by the students at 90 and 120 min after
      substrate ingestion and are analyzed by gas chromatography. Between sampling
      periods, discussions of digestive physiology are provided by the faculty.
      Students tabulate their BHT results as well as recording any symptoms using a
      standard scoring system. A total of 460 students have participated. We found that
      the percentage of students who malabsorbed a given substrate was similar each
      year. The results obtained in these student exercises closely parallel those
      reported in the literature. We conclude that BHT is an excellent teaching tool
      for illustrating carbohydrate digestion and absorption, even when performed by
      minimally trained subjects.

PMID- 1616067
TI  - Interactive videodisc calorimetry simulations for exercise physiology
      laboratories.
AB  - Six interactive videodisc lessons for college-level exercise physiology classes
      were developed. The six lessons were written using TenCore for the IBM M-Motion
      technology. The focus of the laboratories is on exercise metabolism measured by
      indirect calorimetry. The six lessons are as follows. 1) Environmental measures:
      determines whether conditions are favorable for exercise. Dry bulb, wet bulb, and
      black globe temperatures are obtained to calculate relative humidity, STPD gas
      volumes, and the wet bulb-globe temperature index. 2) Basal metabolism:
      emphasizes the mechanics of calculating energy expenditure through indirect
      calorimetry. Lying, sitting, and exercise metabolism are compared. 3) Submaximal
      metabolism: compares the energy cost of walking a mile and running a mile. Steady
      state exercise, oxygen debt, and oxygen deficit are explored. 4) Maximal
      metabolism: assesses maximal oxygen consumption using the Bruce protocol. 5)
      Hormonal responses to prolonged exercise: demonstrates the effect of hormonal
      levels on %fat and %carbohydrate utilization during 1 h of exercise. 6) Metabolic
      responses to supramaximal exercise: estimates anaerobic power using the Wingate
      test.

PMID- 1616068
TI  - Behavior as a window on physiology: a simple apparatus for recording caterpillar
      feeding.
AB  - Regulation of feeding is a fundamental element of homeostasis. This is reflected
      in the similarity of control mechanisms in a wide range of animals, including
      insects and humans. A close examination of feeding behavior can illuminate the
      physiological processes driving regulation. A simple, inexpensive method for
      recording fine details of feeding by caterpillars is described. Possible
      experiments, interpretation of the data, and the relationship of observations to
      the underlying physiology, are outlined.

PMID- 1616069
TI  - [Incidence of Borrelia burgdorferi infection in isolated facial paralysis. A
      prospective study].
AB  - Between the causes of facial paralysis, similar to Bell's palsy, recently are
      included those due to some families of spirochaeta (Borrelia burgdorferi)
      transmitted through tick-bite. These bacteria, besides de facial palsy, may
      produce several degrees of lymphocytic meningitis and subsequently the paralysis
      of the face, sometimes clumsy or recurrent. The treatment being the antibiotic
      drugs, never the corticoids. In the paper are explained prospectively the
      incidence of this disease in the AA's environment.

PMID- 1616070
TI  - [Idiopathic cerebral hernia in the middle ear].
AB  - Idiopathic brain herniation into the middle ear and the mastoid process is an
      infrequent condition. There are only 29 cases reported in the world literature
      covering the last 40 years. The paper inform on one of those cases, a man, of
      spontaneous encephalocele and deals with the pathogenesis, the clinical features
      and the suitable surgical approach.

PMID- 1616071
TI  - [Alloplastic materials in otological surgery. An update].
AB  - Alloplastic materials have been employer as replacement of the ossicular chain,
      in the reconstruction of the posterior wall of the outer ear and even in filling
      up the mastoid process. But owing to the restrictive laws in some countries
      relative to the transplantations of homologous ossicles and first of all for fear
      of viral transmissions through the procedures a new light is shed in this field
      of the ear surgery. In the paper the AA, make a critical revision of replacement
      alloplastic prosthesis considering the lately introduced materials. The majority
      of the prosthesis, specially those in plastic, give not, either in short or long
      term, worthy results. Autologous tissues are, as always have been, the first
      choice in the reconstructive management of the anatomy of the middle ear.
      Alloplastic materials being the second chance, by virtue of its recognized
      intolerance at long terms.

PMID- 1616072
TI  - [2 cases of esophageal perforation by foreign bodies].
AB  - The AA. present 2 cases of esophageal perforation due to foreign bodies among 179
      esophagoscopies done for removal of other intruders, which required the
      endoscopic procedure, during a lapse of 4 years. Considerations regarding the
      treatment and the evolutive course.

PMID- 1616073
TI  - [Informatics program in the study of patients with Meniere's vertigo].
AB  - Meniere's Vertigo is a process of long evolution applying for several clinical
      variables during many periodical controls. The A. of the paper present an
      informatics program aiming to compile each patient data regarding these items: 1.
      a quick knowledge of the evolutive course both clinic and therapeutical
      experienced by the patient during years; 2. control of the efficacy of the
      treatments done; and 3. the comparison of own results with those of other
      authors. In the article are expose the practical development of the program and
      the data gained with.

PMID- 1616074
TI  - [Choristoma of the salivary gland and dermoid cyst of the middle ear in a 3-year
      old girl. Apropos of a case].
AB  - We studied a rare instance of salivary gland choristoma and dermoid cyst of
      middle ear in a 3 years old girl. There are only thirteen cases of salivary
      choristoma reported and ours is the only one combining choristoma and dermoid
      cyst of the middle ear published, as far as we know.

PMID- 1616075
TI  - [Mandibular osteoradionecrosis caused by radiotherapy of lip cancer. Differential
      diagnosis with tumor recurrence].
AB  - The onset of the bone radionecrosis is a relatively unusual problem which should
      be considered in the differential diagnosis of recurrences of irradiated tumors
      showing a high degree of aggressiveness. The AA. present a case report of a re
      operated lower lip carcinoma which underwent further radiation therapy. A bony
      mandibular lesion was then observed, which led to the diagnosis of tumoral
      invasion at the mandible, and a partial mandibulectomy was then performed. The
      histopathological examination revealed a bone necrosis, probably due to
      radiotherapy. The clinical features and therapeutic management of mandibular
      osteoradionecrosis are commented.

PMID- 1616076
TI  - Expanding school health services to serve families in the 21st century.

PMID- 1616077
TI  - Roles and responsibilities for nursing continuing education and staff development
      across all settings. American Nurses Association. Council on Continuing Education
      and Staff Development.

PMID- 1616078
TI  - Compendium of HIV/AIDS positions, policies and documents. April 1992.

PMID- 1616079
TI  - Persuasion in clinical practice: rational decision or intuitive belief?

PMID- 1616080
TI  - Patient-controlled analgesia: a double-blind study in burn patients.
AB  - A double-blind controlled study was performed to assess the efficacy and safety
      of patient-controlled analgesia in burn patients. This method was compared with
      conventional analgesic therapy consisting of intermittent intravenous morphine
      injections. Twenty-four adult patients hospitalised for burn injuries
      participated in the study. The McGill Pain Questionnaire, visual analogue scales
      and verbal-numeric scales were administered at regular intervals to measure
      various components of the patients' pain experience, degree of pain relief,
      anxiety levels, adverse side effects and overall treatment efficacy. Although
      statistical significance was found in only one measure, the results suggested
      better pain control in patients who were administered morphine by patient
      controlled analgesia as compared with intermittent injections. Analysis of the
      side effects showed no difference between the groups. The amount of morphine
      administered over the trial period was also similar for the two groups but
      considerable interpatient variability was seen. Although further research is
      needed to determine the conditions for optimal use of patient-controlled
      analgesia, it is concluded that it is a safe, effective and improved method for
      controlling pain in selected burn patients.

PMID- 1616081
TI  - Admixture of propofol and alfentanil. Use for intravenous sedation and analgesia
      during transvaginal oocyte retrieval.
AB  - An admixture of propofol and alfentanil provides adequate sedation and analgesia
      during transvaginal oocyte retrieval in the absence of a paracervical block. In
      100 patients the technique provided haemodynamic stability, sedation which was
      easily controlled, rapid recovery and universal patient acceptance.

PMID- 1616082
TI  - Anaesthesia for bullectomy. Use of propofol, high frequency jet ventilation and
      extradural blockade.
AB  - A patient with a single large bulla occupying 50% of the right hemithorax was
      anaesthetised successfully with a combination of techniques not previously
      described. The technique consisted of extradural analgesia and intravenous
      infusion of propofol, while ventilation was maintained with high frequency jet
      ventilation through a single lumen tracheal tube. The advantages of this
      technique are a reduced risk of barotrauma, good operating conditions and good
      analgesia.

PMID- 1616083
TI  - Anaesthesia for intraperitoneal hyperthermic perfusion.
AB  - Intraperitoneal hyperthermic perfusion is a method of regional chemotherapy shown
      to be effective in the prevention and treatment of peritoneal metastases. General
      anaesthesia for a patient who required this procedure is described. Guidelines
      for management are suggested, with particular emphasis on temperature control,
      fluid and electrolyte balance and postoperative care.

PMID- 1616084
TI  - Fibreoptic intubation in cicatricial membranes of the pharynx.
AB  - Two patients presented with almost total obliteration of the pharynx. In one, a
      membrane developed after corrosive poisoning; in the other, the oropharynx was
      filled with a dense cicatrix in the sclerosing phase of rhinoscleroma. In both
      patients, a single opening in the membrane provided access to both the larynx and
      oesophagus. Fibreoptic intubation allowed both a thorough assessment of the
      pathology and subsequently the passage of a cuffed tracheal tube to secure the
      airway. To overcome the problem of respiratory obstruction while the fibrescope
      passed through the opening in the membrane, either rapid intubation, or a
      technique using pre-oxygenation and voluntary hyperventilation followed by breath
      holding during bronchoscopy, was used. The thin calibre and manoeuvrability of
      the flexible fibreoptic bronchoscope makes fibreoptic intubation an excellent
      technique of airway management in cicatricial membranes of the pharynx.

PMID- 1616085
TI  - Hypotension following valve replacement surgery in carcinoid heart disease.
AB  - We report the use of adrenaline in a 62-year-old woman with carcinoid heart
      disease who underwent double valve replacement. She was given an intravenous
      infusion of octreotide throughout the peri-operative period. Following the
      termination of cardiopulmonary bypass she developed profound hypotension which
      proved to be refractory to various therapies but responded to adrenaline.
      Adrenaline is said to be contraindicated in carcinoid syndrome, but we would
      suggest the consideration of its use in such cases where the hypotension may
      result from myocardial depression rather than from a carcinoid crisis.

PMID- 1616086
TI  - Caudal blockade in the management of aortic thrombosis following umbilical artery
      catheterisation.
AB  - A neonate, with a postconceptual age of 29 weeks, suffered thrombosis of the
      aorta as a consequence of umbilical artery catheterisation. This resulted in
      ischaemic lesions of the lower limbs and buttocks. Part of the management
      consisted of the insertion of an extradural catheter, via the caudal route, which
      provided good pain relief and may have improved lower limb blood flow.

PMID- 1616087
TI  - Thoracic epidural anaesthesia and primary pulmonary hypertension.
AB  - Patients with primary pulmonary hypertension occasionally present for surgery.
      Anaesthesia requires continuous cardiovascular monitoring and maintenance of
      stable pulmonary and systemic haemodynamics. The management of a patient with
      severe pulmonary hypertension, undergoing open lung biopsy under a combination of
      general anaesthesia and thoracic epidural analgesia is reported and the problems
      of primary pulmonary hypertension are discussed.

PMID- 1616088
TI  - Functionally crossed pipelines. An intermittent condition by a faulty ventilator.
AB  - Unexpectedly high blood oxygen tension in intensive care patients occurring over
      a 5-year period were found to have been caused by an apparently normally
      functioning ventilator which was intermittently acting as a conduit between the
      oxygen and air pipelines. Responses to a circular letter sent to Quality Control
      Pharmacists in England and Wales suggest that similar faults may have occurred at
      least five times in the past 10 years. Recommendations are given for the
      prevention of this problem, including monitoring of gas pipeline composition.

PMID- 1616089
TI  - Spinal epidural anaesthesia. A new combination system.
AB  - We present our experience with a new combined spinal epidural system through
      which regional anaesthesia was performed in 30 male patients undergoing
      suprapubic prostatectomy. The technique consists of two needles, a 17 G Tuohy
      needle with a hole in its distal curve (back eye) and a 29 G spinal needle which
      is passed through the back eye before being introduced into the subarachnoid
      space. We found the back eye combined spinal-epidural system effective and simple
      to use. The Tuohy needle with its back eye did not impede insertion of the
      epidural catheter and was a suitable introducer for the thin 29 G spinal needle.

PMID- 1616090
TI  - Modification to the Sprotte spinal needle.
AB  - The large lateral hole of the Sprotte needle is claimed to aid cerebrospinal
      fluid efflux during the performance of spinal anaesthesia. Using theoretical
      calculations and practical measurement we have shown that reducing the area of
      the lateral hole to that of the cross sectional area of the needle does not
      affect the flow rate. We suggest this modified Sprotte needle is an improved
      design which has the potential advantages of reducing the incidence of inadequate
      spinal anaesthesia and strengthening the needle tip.

PMID- 1616091
TI  - Magnetic resonance for the anaesthetist. Part II: Anaesthesia and monitoring in
      MR units.
AB  - Anaesthetists are increasingly involved in patient care during magnetic resonance
      imaging and spectroscopy. This paper describes a system which has been developed
      for the management of critically ill patients and the conduct of anaesthesia in a
      magnetic resonance unit with a 1.6 tesla whole body magnet. Difficulties which
      arise from working in a confined space in a high magnetic field are highlighted.
      Different approaches to anaesthesia, sedation and the modification of equipment
      for use in this environment are reviewed. The problems associated with patient
      monitoring within a magnetic field are discussed and some solutions are
      suggested. A transport system for critically ill patients is described and a
      protocol for management is outlined.

PMID- 1616092
TI  - Pre-registration house surgeons. A questionnaire study of anaesthesia-related
      knowledge and approach to pre-operative investigations.
AB  - A group of newly qualified pre-registration House Officers completed a
      questionnaire relating to their knowledge of anaesthetic drugs and to their
      appreciation of complications which may, in whole or in part, have required some
      knowledge of anaesthesia. Considerable gaps in knowledge were demonstrable, not
      only in matters that might arguably be regarded as strictly within the province
      of anaesthesia, but also in respect of basic pharmacology. The same House
      Officers were also questioned as to the necessity for various basic pre-operative
      investigations prior to six everyday surgical procedures. This demonstrated a
      marked propensity for House Officers to overinvestigate patients as compared to
      the requirements of practising anaesthetists. The discrepancy was most marked
      with respect to pre-operative chest X rays. However, considerable disparity was
      also demonstrable amongst a group of experienced anaesthetists as to their
      requirements for pre-operative investigations. Permitting students greater
      exposure to anaesthesia in the undergraduate curriculum could go a long way
      towards improving this situation.

PMID- 1616093
TI  - Isosorbide dinitrate spray. Attenuation of cardiovascular responses to
      laryngoscopy and intubation.
AB  - We evaluated the efficacy of isosorbide dinitrate buccal spray (Isomack) in
      attenuating the cardiovascular response to laryngoscopy and tracheal intubation
      in 60 patients undergoing elective surgery under general anaesthesia. Patients
      were allocated to one of three groups of 20 patients each. Group 1 patients were
      administered placebo buccal spray 90 s before induction of anaesthesia. Groups 2
      and 3 had isosorbide dinitrate spray 30 and 90 s before induction of anaesthesia.
      Systolic, diastolic and mean arterial pressures and heart rate were monitored.
      After the spray, group 3 patients had a significant decrease in systolic arterial
      pressure (p less than 0.01). At 1 min after intubation, systolic, diastolic and
      mean arterial pressures showed a significant increase in group 1 patients (24.9
      mmHg, 14.2 mmHg and 18.7 mmHg respectively). In contrast, groups 2 and 3 showed a
      significant decrease in these parameters (p less than 0.01). Although significant
      tachycardia was present following intubation in all the three groups, the degree
      of tachycardia was greater in groups 2 and 3 (p less than 0.01).

PMID- 1616094
TI  - The laryngeal mask--a modification in its use and design.

PMID- 1616095
TI  - Use of the laryngeal mask airway in the presence of a bleeding diathesis.

PMID- 1616096
TI  - Laryngeal mask misplacement--causes, consequences and solutions.

PMID- 1616097
TI  - Use of the laryngeal mask airway during magnetic resonance imaging.

PMID- 1616098
TI  - Is clonidine an anaesthetic in man?

PMID- 1616099
TI  - Psychogenic seizures after general anaesthesia.

PMID- 1616100
TI  - A possible complication with a sheath introducer.

PMID- 1616101
TI  - The Oxford Miniature Vaporizer at high temperatures--evaluation of an external
      bypass.

PMID- 1616102
TI  - Secondary transfer of patients.

PMID- 1616103
TI  - A serious complication of minitracheotomy.

PMID- 1616104
TI  - Expiratory obstruction from coincidence of sizing.

PMID- 1616105
TI  - Anaesthetic techniques and trainee anaesthetists.

PMID- 1616106
TI  - Pain relief following dental extraction.

PMID- 1616107
TI  - Craniotomy and PEEP.

PMID- 1616108
TI  - Propofol and abreaction.

PMID- 1616109
TI  - Airway maintenance for short ophthalmological procedures in children.

PMID- 1616110
TI  - VCO2 following tourniquet deflation.

PMID- 1616111
TI  - A case of malignant hyperthermia?

PMID- 1616112
TI  - Red rubber Robertshaw tubes.

PMID- 1616113
TI  - [Speaking for myself].

PMID- 1616114
TI  - [The effect of muscle relaxants on masseter tone. An experimental study in an MH
      susceptible swine model].
AB  - Malignant hyperthermia (MH) may occur, when a genetically predisposed individual
      or pig (MHS) is exposed to triggering agents. The increase in free, ionized
      sarcoplasmic calcium inducing the vicious circle of MH is believed to result from
      calcium-induced release with volatile anaesthetics, and from depolarization
      induced calcium release with succinylcholine (SCH). The administration of SCH to
      susceptible humans or pigs frequently produces an increase in masticatory muscle
      tone. This hitherto ill-defined phenomenon is referred to as "masseter spasm"
      (MS). We have attempted to elucidate the pathophysiology of MS in a porcine
      model. METHODS. After the protocol had been approved by the state authorities, 6
      MHS pigs were investigated. The pigs were mixed breeds (German Landrace and Dutch
      Pietrain) and were 9 +/- 1 weeks old with an average body weight of 25.5 kg.
      Premedication consisted of intramuscular injection of azaperone, 7.5 mg.kg-1.
      Anaesthesia was induced with piritramide, 1.2 mg.kg-1, administered via a
      cannulated ear vein. Subsequent to laryngoscopic endotracheal intubation,
      neuromuscular blockade was achieved with 4 mg pancuronium. Ventilation was set at
      12 breaths per minute and adjusted to maintain an end-tidal CO2 concentration of
      4.7% by adapting the tidal volume (PhysioFlex). Anaesthesia was maintained with
      piritramide, 2.25 mg.kg-1.h-1, pancuronium, 0.4 mg.kg-1.h-1, and N2O (60% in O2).
      Instrumentation included an arterial line, a central venous line, and a
      fiberoptic pulmonary artery catheter (Oximetrix). Masticatory muscle tone (MMT)
      was assessed with an intermolar balloon, connected to a pressure transducer and
      calibrated to zero prior to SCH administration. As a reference variable for
      effects produced by SCH, intraocular pressure (IOP) was measured manometrically
      in the anterior chamber. After stabilization of haemodynamic variables, the
      neuromuscular blockade was allowed to wear off. After recovery of the evoked
      masseter electromyogram, a paralyzing dose of pancuronium was administered (0.5
      mg.kg-1). When paralysis was complete, SCH was administered (1.5 mg.kg-1),
      followed a few minutes later by dantrolene infusion (5 mg.kg-1 over 10 min).
      RESULTS. The administration of SCH was followed by clinically unequivocal MH
      episodes in all pigs, indicated by an increase in oxygen uptake (VO2; PhysioFlex;
      Fig. 1) and end-tidal CO2 concentration and a decrease in oxygen saturation of
      mixed venous blood (svO2; Fig. 2). Despite complete neuromuscular blockade
      (monitored with EMG), SCH produced an increase in MMT in all pigs which was
      reversed by dantrolene (Fig. 3). The time course of MMT paralleled that of IOP,
      suggesting a similar underlying mechanism. DISCUSSION. Succinylcholine is a
      trigger of MH in susceptible individuals; onset of the syndrome may be associated
      with "masseter spasm". SCH increases extraocular muscle tone, probably by means
      of stimulating multiply innervated fibers; the resulting IOP increase is not
      prevented by competitive neuromuscular blockade. The existence of multiple
      innervated fibers has also been shown in muscle spindles in the deep layers of
      the masseter, with their stimulation resulting in elevation of the jaw. We
      speculate that the increases in MMT and IOP observed in this study reflect the
      same process, i.e. a motor response, initiated by SCH-induced stimulation of the
      intramyocellular contractile system of multiply innervated muscle fibers, that is
      independent of neuromuscular transmission. Triggering of MH with SCH despite
      complete neuromuscular blockage suggests a mechanism other than depolarization
      induced calcium increase. And, for the semantics, according to neurological
      terminology MS should be referred to as contracture not as spasm.

PMID- 1616115
TI  - [Droperidol versus metoclopramide. Prevention of emesis following strabismus
      surgery in children].
AB  - Vomiting after strabismus surgery is a major problem that remains as yet
      unsolved, especially in children. Droperidol and metoclopramide, both known as
      powerful antiemetic drugs, were compared in this study. METHODS. One hundred ASA
      class I and II children ranging from 3 to 10 years of age were studied in a
      double-blind, randomised fashion. They were assigned to three groups: group D (n
      = 33) received 0.075 mg/kg droperidol, group M (n = 33) 0.15 mg/kg
      metoclopramide, and group N (n = 34) 0.1 ml/kg NaCl i.v. upon arrival in the post
      anaesthesia recovery room (PARR). After oral premedication with 0.4 mg/kg
      midazolam, anaesthesia was induced via a face mask by inhalation of halothane,
      nitrous oxide, and oxygen. Barbiturates, atropine, and succinylcholine were not
      used; 0.05 mg/kg vecuronium was given to facilitate intubation. Gastric contents
      were aspirated by a gastric tube at the end of the operation. Vomiting and
      retching were recorded for 24 h; recovery from anaesthesia was assessed by a
      modified Steward score. RESULTS. The three groups were comparable regarding age,
      body weight, duration of anaesthesia, number of repaired eye muscles, and
      occurrence of the oculocardiac reflex (OCR). During the first 24 h
      postoperatively 21/33 (64%) patients of group D vomited, 24/33 (73%) of group M,
      and 33/34 (97%) of group N. The differences between groups D and N and between M
      and N were significant (P less than 0.01); comparison of groups D and M showed no
      statistical significance. Droperidol was more effective in reducing severe
      vomiting. Of the group N children, 47% vomited more than 6 times in 24 h compared
      to 18% of group M and 0% of group D. Age, sex, duration of anaesthesia, number of
      repaired eye muscles, and occurrence of the OCR had no influence on postoperative
      vomiting. Despite being administered at the end of the operation, droperidol did
      not prolong the patients' stay in the PARR. The post-anaesthetic scores for group
      D children were only slightly lower compared to groups M and N. CONCLUSIONS.
      Droperidol (0.075 mg/kg) and metoclopramide (0.15 mg/kg) both reduce
      postoperative vomiting after strabismus surgery. Droperidol seems to be more
      effective in reducing severe vomiting. Postoperative sedation after droperidol
      was not a major problem in our experience.

PMID- 1616116
TI  - [The integration of thoracic epidural anesthesia into anesthesia for intra
      abdominal surgery].
AB  - Upper abdominal and thoracic surgeries require efficient pain management. The
      complications of postoperative analgesia include respiratory depression and--when
      choosing the epidural route--possible damage to the spinal cord by infection,
      trauma, or bleeding. Therefore, thoracic epidural analgesia may appear to be too
      risky and is frequently cancelled although many studies have shown its excellent
      efficacy. Controlled studies comparing thoracic epidural analgesia to lumbar
      epidural analgesia or intravenous analgetic regimens with special regard to the
      patient's outcome are contradictory. To make the preoperative decision on the
      method of pain control more rational, we studied catheter-related complications
      from 2056 thoracic epidural catheters used for intra- and postoperative analgesia
      retrospectively (n = 1002) and prospectively (n = 1054) over a 5 1/2-year period.
      In all patients the thoracic epidural catheter was inserted preoperatively using
      local anaesthesia, in most cases by the paramedian approach between level T 5/6
      and T 8/9. During the clinical course of all patients there were no clinical
      signs of any epidural bleeding or infection. Neurological complications caused by
      the epidural catheter did not occur. Seven patients (0.035%) experienced
      radicular pain that disappeared after removal of the catheter or interruption of
      the puncture, respectively. A primary perforation of the dura mater was noticed
      in 0.5% of cases retrospectively and 1.23% prospectively. Respiratory depression
      following epidural application of 0.3 mg buprenorphine was seen in 1 patient
      (0.05%). Continuous analgesia with local anaesthetics and/or opioids applied
      epidurally by a thoracic catheter was performed on the peripheral ward (n = 829,
      40%) if close monitoring of the neurological status as well as rapid diagnosis of
      any painful paraesthesia or paraplegia was possible.

PMID- 1616117
TI  - [A noncardiac pulmonary edema following aortocoronary bypass surgery. Diagnosis
      and therapy based on a case report].
AB  - Noncardiac pulmonary edema can occur not only after cardiac surgery with
      cardiopulmonary bypass but also after noncardiac operations. This so-called
      transfusion-related acute lung injury (TRALI) has been attributed to the
      transfusion of homologous blood and plasma. In the presence of normal left
      ventricular function an acute increase in pulmonary capillary permeability leads
      to massive protein-rich pulmonary edema, reduced pulmonary function, and
      intravascular hypovolemia. This may be caused by leukocyte antibodies. Signs and
      diagnostic and therapeutic procedures are discussed with reference to a case
      report.

PMID- 1616118
TI  - [Subdural and epidural hematomas following epidural anesthesia. A literature
      review].
AB  - Of 434 cases of epidural, subdural, and intracranial haematomas published in the
      last 2-3 decades, 61 had developed following spinal, epidural or caudal
      anaesthetic procedures; 29 haematomas were around the spinal cord and 32, within
      the cranium. The most frequent secondary cause of this complication was pre-,
      intra-, or postoperative administration of drugs influencing blood coagulation.
      Simultaneous traumatic and haemorrhagic punctures may favour the development of a
      haematoma. The most common primary symptom of lumbothoracic haematomas was back
      pain with and without radicular symptoms, while intracranial haematomas were
      predominantly accompanied by persistent headache. Continuous postoperative follow
      up of such patients is essential. Postoperative results of laminectomies for
      lumbothoracic haematomas has been found to on the time interval between the first
      symptoms and the start of surgery. If surgery is performed within 8 h after the
      onset of paraplegia the prognosis is relatively good. Compared with the frequency
      of spinal, epidural, and caudal anaesthetic procedures throughout the world,
      haematomas of the lumbothoracic or cranial region are extremely rare
      complications.

PMID- 1616119
TI  - [Total spinal anesthesia. A complication of lumbar catheter peridural anesthesia
      for postoperative analgesia].
AB  - A case of secondary subarachnoidal dislocation of a lumbar epidural catheter is
      reported. A 76-year-old female underwent resection of the sigmoid colon. In order
      to provide postoperative analgesia, an epidural catheter was inserted between the
      3rd and 4th lumbar interspaces prior to induction of anaesthesia. Aspiration
      tests were negative twice and a test dose of 4 ml 0.5% bupivacaine produced no
      signs of anaesthesia. Thereafter, the operation was performed under balanced
      general anaesthesia. Prior to the end of surgery a total of 14 ml bupivacaine
      0.5% was administered without significant cardiovascular depression. At the time
      of extubation the patient was awake and free of pain. There was no sign of
      respiratory depression or paralysis of the upper extremities. Three hours later
      in the recovery room the patient complained of pain. After a negative aspiration
      test 14 ml bupivacaine 0.25% was injected. Thirty minutes after injection apnea
      and cardiac arrest occurred. Resuscitation was immediately started, resulting in
      quick restoration of circulation and restitutio ad integrum. Aspiration at this
      time showed cerebrospinal fluid. The latency of the onset of total spinal
      anaesthesia and the rapid restoration of stable vital functions, was astonishing.
      It is essential to observe the common precautions such as an aspiration test
      without a filter, administration of a test dose, and titration of the injected
      amount each time the anaesthetic agent is applied via an epidural catheter.

PMID- 1616120
TI  - [Ambulatory epidural analgesia in patients with tumors. An outmoded technique?].
AB  - In 35 of 316 patients suffering from severe cancer pain, an epidural catheter was
      placed for continuous morphine application. Indications for epidural opiates
      included failure of pain relief with oral morphine, severe side effects with oral
      administration, and contraindications for oral morphine, e.g., ileus. METHODS.
      The epidural catheter was inserted in the lumbar, thoracic or cervical region,
      according to the main localization of pain. A silicon catheter with a Dacron cuff
      (4.2 F Broviac Davol, Cranston, R.I.) was connected and tunneled subcutaneously
      to a distant exit on the lateral chest wall (Fig. 2). A portable morphine pump
      (CADD-PCA Pharmacia Deltec) was connected to the externalized catheter. The
      morphine was infused continuously at a basic rate. It could be increased to a
      programmed limit by additional boli determined by the patients themselves. Thirty
      patients were treated as outpatients. RESULTS. The mean duration of treatment was
      101 (10-333) days. The daily dose of morphine ranged from 9 to 200 (33) mg at the
      beginning of therapy, and from 20 to 288 (88) mg at the end of treatment. In 27
      patients (77%) epidural morphine administration proved to be a valuable method of
      pain control (Fig. 3). Even in most cases of tolerance to oral morphine,
      especially in patients suffering from pain of neuropathic origin, pain control
      was adequate. There were no cases of continuous loss of effectiveness of
      continuous loss of effectiveness or development of tolerance (Fig. 5). The
      epidural morphine dosage depended on the character and intensity of pain and its
      responsiveness to epidural opiates. Technical complications were noticed in 6
      patients (17%), and fairly mild side effects of epidural morphine occurred in 20%
      of the patients for a limited time. CONCLUSIONS. The technique described is a
      simple and convenient method for long-term treatment of cancer patients with
      epidural morphine. There was no need for more invasive procedures, such as
      intrathecal or intraventricular morphine administration, in this group of
      patients in whom no pain relief had been achieved with oral morphine
      administration.

PMID- 1616121
TI  - [The usefulness of the laryngeal mask in ambulatory anesthesia. An evaluation of
      200 cases of ambulatory anesthesia].
AB  - We studied the value of Brain's laryngeal mask on 200 patients undergoing
      ambulatory operations under general anaesthesia using propofol and alfentanil.
      Continuous registration of maximal airway pressure and pulse oximetry were
      carried out. The operations were performed mainly in the following four
      specialities: urology, general surgery, gynaecology, and ophthalmology. The mean
      operation time was 39 min (6-82 min). All patients belonged to ASA groups I-III.
      No patient was premedicated. We encountered no difficulties in introducing the
      mask using the technique described by Brain except in one 6-year-old boy with
      hypertrophic tonsils in whom it was impossible. Insufficient sealing of the
      trachea occurred in a 29-year-old woman with thyroid hypertrophy. In most
      patients (70%) the oxygen saturation (spO2) could be maintained above 95%; only 6
      (2%) showed an spO2 value of less than 90%. Peak inspiratory pressures--a measure
      of tight fitting of the mask--are shown in Table 2. Laryngospasm occurred in 2
      children who had inhalation inductions with halothane. This complication was
      never seen after induction with propofol. The most important positive finding was
      that relaxant drugs became largely unnecessary after we started working with the
      mask, which reduced postoperative recovery time as well as costs. CONCLUSION. We
      consider the laryngeal mask to be not only an important new technique, but in
      combination with propofol and alfentanil the method of choice for ambulatory
      anaesthesia in day-case surgery.

PMID- 1616122
TI  - [Transfusion related lung injury--hypothesis or clinical reality? Comments on the
      article by U. Schirmer et al. A noncardiac pulmonary edema following
      aortocoronary bypass surgery].

PMID- 1616123
TI  - [Paralysis due to carbohydrates. The role of hypernatremia].

PMID- 1616124
TI  - Determination of human serum alcohol dehydrogenase using isozyme-specific
      fluorescent substrates.
AB  - Both class I and class II alcohol dehydrogenase (ADH) activities are present in
      human serum. The contribution of each class can be measured using two class
      specific, fluorogenic substrates, 4-methoxy-1-naphthaldehyde and 6-methoxy-2
      naphthaldehyde. The former is highly selective for class I isozymes, especially
      those containing alpha or gamma subunits, whereas class II (pi) ADH
      preferentially reduces the latter. Selective inhibition of class I ADH by 4
      methylpyrazole further increases the specificity. Specificity, accuracy, and
      precision of the assay for serum measurements have been determined. The activity
      of class I ADH in normal human serum is below the limit of detection of this
      method, i.e., less than 1.0 nM/min. The activity of class II ADH in normal
      individuals is 15 +/- 5 nM/min. In some patients values as high as 2100 nM/min
      are observed for class I, but in all instances, the amount of class II found was
      higher than that of class I ADH.

PMID- 1616125
TI  - Instrumentation for the breath-by-breath determination of oxygen and carbon
      dioxide based on nondispersive absorption measurements.
AB  - This paper describes the development and evaluation of instrumentation for the
      breath-by-breath determination of oxygen and carbon dioxide in respiratory gases.
      The method is based on nondispersive absorption and uses the 145-nm absorption
      band for detection of oxygen and the 4.3-micron band for detection of carbon
      dioxide. A xenon discharge lamp with a sharp band at 147 nm was chosen as the
      source for the determination of oxygen, and a carbon dioxide discharge lamp with
      a sharp band at 4.3 micron was chosen for determination of carbon dioxide. A
      vacuum photodiode was used as the detector for oxygen, and a photoconductive cell
      with a built-in interference filter was used for detection of carbon dioxide.
      Plots of absorbance (A) vs concentration (C, %) were linear for oxygen and were
      nonlinear for carbon dioxide. Typical least-squares calibration equations were A
      = 0.020C + 0.02 for oxygen (0-100%) and A = 0.0012C2 + 0.050C + 0.008 for carbon
      dioxide (0-8%). Comparisons of computed (y) vs prepared (x) values for the
      concentrations given above were linear for both gases, yielding y = (1.00 +/-
      0.01)x - 0.13 +/- 0.73 for oxygen and y = (1.07 +/- 0.02)x - 0.04 +/- 0.06 for
      carbon dioxide. The standard deviations were 1.2% at 50% oxygen and 1.5% at 4%
      carbon dioxide. Records are presented to illustrate breath-by-breath monitoring
      of these gases in a healthy subject.

PMID- 1616126
TI  - Separation of fluoride from fluoroelastomers by diffusion in test tubes.
AB  - The conventional procedure for separation of fluoride as trimethylfluorosilane in
      Conway diffusion cells involves the use of grease for sealing the cell and also
      for closing the hole in the lid drilled for introduction of hexamethyldisiloxane.
      We have developed a simpler procedure in which diffusion is carried out in 5-mL
      test tubes without the use of grease. Results of analysis of fluoride following
      diffusion from water, urine, and bone samples are in excellent agreement with
      those obtained by other procedures not involving diffusion. Separation of
      fluoride from partly and fully cured fluoroelastomers is achieved by first
      grinding the samples in a liquid nitrogen mill and then using methyl ethyl ketone
      as an adjuvant to perchloric acid employed in the diffusion procedure.

PMID- 1616127
TI  - Determination of phospholipids from pulmonary surfactant using an on-line coupled
      silica/reversed-phase high-performance liquid chromatography system.
AB  - A basic normal-phase HPLC separation of phospholipids can be improved by
      introducing a limited contribution of solvophobic retention. For this purpose,
      the effect of an additional alkylsilica (C18) column of variable length coupled
      in series with a silica column was investigated. With increasing percentage of
      reversed phase in this system, the retention of phosphatidylglycerol increased.
      Phosphatidylinositol and phosphatidylserine were separated into molecular
      species. The "selective retention" defined in this study permits an evaluation of
      the solvophobic retention of phospholipids in the coupled system. An alternative
      column switching procedure is used for specific applications of the biphasic
      separation on chosen phospholipids. With this system, determination of
      phosphatidylglycerol and six other phospholipids from pulmonary surfactant could
      be performed.

PMID- 1616129
TI  - Empirical procedure that uses molecular structure to predict enantioselectivity
      of chiral stationary phases.
AB  - A total of 121 racemic compounds were separated in the normal-phase mode on a (S)
      (1-naphthylethyl)carbamoylated beta-cyclodextrin (S-NEC-beta-CD) bonded phase and
      74 on the R equivalent (R-NEC) chiral stationary phase (CSP). All compounds are
      of the type that have four substituents on a stereogenic center, rather than an
      "axis of chirality". It is shown that the binary solvent pair used as the mobile
      phase has a significant influence on chiral recognition. However, the proportions
      of the components of a specific pair have little effect. From the results, the
      individual contributions to chiral recognition by these CSPs were estimated for
      81 different substituents of the stereogenic center. Varying the arrangement of
      these 81 substituents could produce over 1.6 million compounds. Hydrogen was
      chosen as the reference substituent and was assigned a 0 cal/mol free energy. The
      chiral recognition increased when sp2-hybridized carbons were connected to the
      stereogenic center. Conversely, sp3-hybridized carbons decreased the
      enantioselectivity. Amido groups increased the chiral recognition, especially
      when associated with pi-acid (3,5-dinitrobenzoyl) or pi-basic (naphthyl) groups.
      This approach does not allow one to know which enantiomer elutes first. However,
      the "substituent energy" list for chiral compounds can be used to obtain an
      estimated value for the enantioselectivity of a compound by adding the energy
      contributions of the four substituents connected to the stereogenic center. In
      this way one can predict a priori whether or not a compound will separate on a
      CSP and estimate its separation factor (alpha). Theoretically, this approach can
      be used for most CSPs, provided a sufficient data base is generated on them.

PMID- 1616128
TI  - Effects of analyte velocity modulation on the electroosmotic flow in capillary
      electrophoresis.
AB  - Modulation of the electroosmotic flow in capillary zone electrophoresis by
      modulation of the driving voltage gives rise to a flow profile that changes
      between laminar and flat profiles. The changing flow profile induces a radial
      movement of sample species to and from the capillary surface. The induced sample
      concentration gradient can be monitored by carefully probing the capillary
      surface. The resulting signal is a derivative of the normal-shaped peak.
      Derivative-shaped peaks can be observed with cations, but not with anions. Anions
      are unable to approach the double-layer region and therefore are unaffected by
      the modulation process.

PMID- 1616130
TI  - Preconcentration of dopamine by uphill transport across an ion-exchange membrane.
AB  - The transport of dopamine from samples in which it is in the cationic form across
      a cation-exchange membrane into a receiver electrolyte occurred against its
      concentration gradient under two conditions. With receiver electrolytes at pH
      values below the pKA1 of dopamine, the transport was by Donnan dialysis. With the
      pH above the pKA1, the neutralization of protonated dopamine at the membrane
      receiver interface sustained the diffusion gradient of the dopamine cation across
      the membrane phase, thereby allowing the analytical concentration of this species
      to increase above that of its concentration in the sample. When 0.25 M RbCl, 0.5
      mM LaCl3 mixtures in the pH range 3.0-7.0 comprised the receivers,
      preconcentration factors of 20 were achieved with a 15-min dialysis across a
      tubular cation-exchange membrane. Under identical conditions except with a pH 10
      receiver, the preconcentration factor was 22. The former condition results in
      Donnan dialysis whereas the transport mechanism at pH 10 is sustained passive
      diffusion. In contrast to Donnan dialysis, transport rates under sustained
      passive diffusion conditions are independent of ionic strength over a wide range;
      for example they are constant for samples containing up to 0.17 M KH2PO4 at pH
      4.6.

PMID- 1616131
TI  - Homogeneous mechanism of ascorbic acid interference in hydrogen peroxide
      detection at enzyme-modified electrodes.

PMID- 1616132
TI  - An anatomical investigation of the muscles of the pelvic outlet in iguanas
      (Iguanidae Iguana iguana) and varanus (Varanidae Varanus (dumerillii)) with
      special reference to their nerve supply.
AB  - Five pelvic halves from three male iguanas (Iguanidae Iguana iguana) and two
      pelvic halves from one male varanus (Varanidae Varanus (dumerillii)), were
      dissected in order to obtain detailed data on the relationship of the lumbosacral
      plexus and the muscles of the pelvic outlet. According to the positions of the
      passage of the metazonal nerves, the nerves can be divided into three groups: 1)
      the nerves passing dorsal to the caudofemoralis muscle, 2) the nerves passing
      between the caudofemoralis and the caudoischiadicus major, 3) the nerves passing
      ventral to the caudoischiadicus major. In consideration of the sites of origin
      from the lumbosacral plexus, a stratificational analysis can be proposed; group 1
      arises craniodorsal to group 2, and group 3 caudoventral to group 2. It is
      suggested that the pelvic outlet muscles (caudofemoralis, quadratus caudae,
      obliquus cloacae, transversus cloacae profundus, retractor penis,
      caudoischiadicus major, and the caudoischiadicus minor) are derived from the
      ventral muscles of the posterior limb, and have moved caudally concomitant with
      the caudal migration of the cloaca.

PMID- 1616133
TI  - Neurochemical anatomy of the mammalian spinal cord: functional implications.

PMID- 1616134
TI  - Anesthesia and myocardial ischemia: the gains of the past have largely come from
      control of myocardial oxygen demand; the breakthroughs of the future will involve
      optimizing myocardial oxygen supply.

PMID- 1616135
TI  - Effect of chloride transport blockade on the MAC of halothane in the rat.
AB  - There is a growing evidence that central nervous system chloride transport via
      gamma-aminobutyric acid (GABAA) related Cl- conductance or Cl-/HCO3- exchange
      affects anesthetic requirements. To delineate the effects of GABAA-related Cl-
      conductance blockade versus Cl-/HCO3- exchange inhibition, we determined the
      change in minimum alveolar anesthetic concentration (MAC) of halothane in rats
      after intracisternal infusion of 4,4'-diisothiocyano-2,2'-disulfonic acid
      stilbene (DIDS). DIDS inhibits Cl-/HCO3- exchange transport in concentrations
      greater than 1 microM and in GABAA-related Cl- channels in concentrations greater
      than 0.1 mM. After control MAC determination, rats were given intracisternal mock
      cerebrospinal fluid (n = 6), 1.0 microM DIDS (n = 8), or 1 mM DIDS (n = 8) at a
      rate of 2 microL/min for 30 min. Mock cerebrospinal fluid did not change the MAC
      of halothane. The MAC of halothane increased significantly (P less than 0.001)
      from 0.96% +/- 0.02% to 1.11% +/- 0.03% (mean value +/- SEM) with 1 microM DIDS
      and from 0.94% +/- 0.02% to 1.16% +/- 0.04% with 1 mM DIDS. The increases in MAC
      with 1 microM and 1 mM DIDS were not statistically different. This suggests that
      Cl-/HCO3- exchange inhibition increases halothane requirements, whereas GABAA
      related Cl- channel blockade does not.

PMID- 1616136
TI  - Isoflurane anesthesia prevents unconscious learning.
AB  - We investigated whether greater than or equal to 0.6 minimum alveolar
      concentration (MAC) of isoflurane suppresses learning of information presented
      verbally. Preoperatively, we asked 45 healthy patients (aged 23-58 yr) undergoing
      elective surgery 15 general knowledge questions designed to arouse their
      curiosity. They were told that they would be given the answers during anesthesia.
      Anesthesia was induced with isoflurane and nitrous oxide (25 subjects also
      received 1.1 +/- 0.6 mg/kg of propofol). The trachea was intubated with the aid
      of vecuronium (0.07 mg/kg IV). Isoflurane in oxygen was given to provide 0.6 MAC
      before and 1.0 and 1.4 MAC during surgery. After 10 min at each of two of the
      three MAC levels, the answers were given to five of the questions. At the
      remaining concentration, patients received a message to either touch an ear (n =
      30) or keep their arms still (n = 15) during the postoperative interview. Twenty
      four hours later, patients were asked whether they recalled intraoperative
      events. They were then asked to answer the 15 questions, choosing from five
      possible answers to each, one of which was correct. The number of times each
      patient touched an ear during this interview was noted. No patient consciously
      recalled events during anesthesia. The number of questions answered correctly
      postoperatively did not differ according to whether the answers had been provided
      during anesthesia (at any isoflurane concentration) or had not been provided
      (control questions). The number of ear-touches postoperatively did not differ
      between those who had and had not received the intraoperative message encouraging
      ear-touching.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616137
TI  - Oxygen consumption and carbon dioxide elimination after release of unilateral
      lower limb pneumatic tourniquets.
AB  - Oxygen consumption (VO2), carbon dioxide elimination (VCO2), and respiratory
      exchange ratio (RQ) were continuously measured in 15 male and 15 female adults
      during knee surgery, with the leg exsanguinated by an inflatable tourniquet
      around the thigh. Arterial blood was also intermittently sampled for blood gas
      analysis, electrolytes, and lactate content before and after tourniquet
      deflation. There was a significant increase in VO2 and VCO2 after tourniquet
      deflation, which was more pronounced in the male (aged 29.5 +/- 14.8 yr, mean +/-
      SD) than the female (aged 56.9 +/- 15.6 yr) patients, both in terms of maximal
      increase (P less than 0.001) and percent of increase from values before deflation
      (P less than 0.001 and P = 0.01). The body weights and tourniquet inflation times
      were not significantly different between the male and female patients. Excess VO2
      (O2 debt) and excess VCO2 over 12 min after deflation of the tourniquet were also
      significantly higher for male (593.5 +/- 222.9 mL and 714.9 +/- 463.8 mL,
      respectively) than for female patients (302 +/- 73.3 mL and 196 +/- 162.22 mL,
      respectively; P less than 0.01). There was no correlation between the duration of
      tourniquet inflation time and peak increase in VO2, peak increase in VCO2, and O2
      debt over 12 min after deflation of the tourniquet; however, tourniquet time was
      weakly correlated with excess VCO2 over 12 min after tourniquet deflation (r =
      0.55, P = 0.002). There was a significant decrease in pHa (P less than 0.001)
      from release of PaCO2 and lactate after tourniquet deflation. Plasma potassium
      levels also increased significantly after tourniquet release (P less than
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616138
TI  - Coagulopathy after reinfusion of autologous scavenged red blood cells.

PMID- 1616139
TI  - Accidental overdose of systemic morphine during intended refill of intrathecal
      infusion device.

PMID- 1616140
TI  - Unsuccessful interpleural analgesia in a patient with mesothelioma.

PMID- 1616141
TI  - Upper airway obstruction and infant botulism.

PMID- 1616142
TI  - Job's syndrome: an unusual response to a common drug.

PMID- 1616143
TI  - Mass spectrometers and infrared gas analyzers interpret bronchodilator
      propellants as anesthetic gases.

PMID- 1616145
TI  - Isolated masseter muscle spasm versus generalized rigidity?

PMID- 1616144
TI  - Masseter muscle spasm and the diagnosis of malignant hyperthermia susceptibility.

PMID- 1616146
TI  - Ventilatory effects of clonidine.

PMID- 1616147
TI  - An unusual cause of nasogastric tube obstruction.

PMID- 1616148
TI  - Relief of pain by ketorolac or alcohol?

PMID- 1616149
TI  - Effects of adenosine after coronary artery bypass surgery.

PMID- 1616150
TI  - Venous air embolism during spinal instrumentation and fusion in the prone
      position.

PMID- 1616151
TI  - Venous air embolism during spinal instrumentation and fusion in the prone
      position.

PMID- 1616152
TI  - An aid to oral intubation in patients with potential cervical spine injuries.

PMID- 1616153
TI  - Not all E cylinders were created equal.

PMID- 1616155
TI  - Peer-reviewed anesthesiology journals and research.

PMID- 1616154
TI  - Anesthetic drugs and the emergency department: one teaching institution's
      response.

PMID- 1616156
TI  - Mechanisms of renal hemodynamic impairment during infrarenal aortic cross
      clamping.
AB  - Infrarenal aortic cross-clamping is associated with impairment of renal
      hemodynamics due to vasoconstriction, the mechanism of which remains under
      debate. To assess the renal effect of two potent renal vasodilators (enalapril, a
      converting enzyme inhibitor, and nicardipine, a calcium antagonist), 24 patients
      scheduled for reconstructive aortic surgery were randomly allocated to one of
      three treatment groups (n = 8 each) and received either a placebo, nicardipine,
      or enalapril. Anesthesia consisted of flunitrazepam, fentanyl, pancuronium, and,
      occasionally, droperidol. Although aortic cross-clamping was associated with no
      change in mean arterial blood pressure, decreased cardiac output and increased
      systemic vascular resistance occurred in control patients (33% and 43%,
      respectively, both P less than 0.05 versus baseline) and nicardipine-treated
      patients (51.7% and 67.7%, respectively, both P less than 0.05 versus baseline);
      however, changes in cardiac output and systemic vascular resistance failed to
      reach significance in enalapril-treated patients. Glomerular filtration rate
      (technetium 99-diethylenetriaminepentacetic acid clearance) and effective renal
      plasma flow (iodo-Hippuran 131 clearance) decreased for the duration of aortic
      cross-clamping in control patients (42.9% and 18.5%, respectively, both P less
      than 0.05 versus baseline) and enalapril-treated patients (34.0% and 38.1%,
      respectively, both P less than 0.05 versus baseline), but no change was observed
      in nicardipine-treated patients. These results suggest that the reninangiotensin
      system is not an important determinant of the renal vasoconstriction associated
      with aortic cross-clamping. In contrast, renal dysfunction may be alleviated by
      the dihydropyridine derivative nicardipine, which probably acts at the level of
      the preglomerular resistance vessels.

PMID- 1616157
TI  - Effects of fentanyl on alpha-aminoisobutyric acid transfer across the blood-brain
      barrier.
AB  - The effect of fentanyl on the transfer of small hydrophilic molecules across the
      blood-brain barrier was studied in rats by measuring the blood-brain transfer
      coefficient (Ki) and the regional cerebral blood flow (rCBF) and by calculating
      the capillary permeability-surface area product. In the control group (n = 14),
      after a femoral artery and vein were catheterized under isoflurane anesthesia,
      the rats were allowed to remain awake for 1.5 h before measuring Ki (n = 8) using
      intravenous 14C-alpha-aminoisobutyric acid or rCBF (n = 6) using 14C
      iodoantipyrine. In the fentanyl groups, rats were injected with 25 micrograms/kg
      (low (n = 6) or 100 micrograms/kg (high dose) of fentanyl (n = 14), followed by a
      continuous infusion at a rate of 50 or 200 micrograms.kg-1.h-1, respectively.
      Their lungs were mechanically ventilated. The Ki (low dose, n = 6; high dose, n =
      8) and rCBF (high dose, n = 6) were measured 1 h after fentanyl infusion. The Ki
      was lower in 9 of 13 brain regions in the low-dose fentanyl group and in 7 of 13
      brain regions in the high-dose fentanyl group than in the control animals. The
      average value of Ki in all the brain regions was 8.6 +/- 4.6 microL.g-1.min-1 in
      the control group, 5.2 +/- 2.9 microL.g-1.min-1 in the low-dose fentanyl group,
      and 5.7 +/- 2.9 microL.g-1.min-1 in the high-dose fentanyl group. High-dose
      fentanyl did not significantly affect rCBF in any brain region studied. The value
      of the regional permeability-surface area product was similar to the
      corresponding regional Ki in the groups studied. In conclusion, fentanyl
      decreased the transfer of small hydrophilic molecules across the blood-brain
      barrier, as demonstrated by a decreased Ki and permeability-surface area product,
      without significant changes in rCBF.

PMID- 1616158
TI  - Evaluation of the endotracheal intubating conditions of rocuronium (ORG 9426) and
      succinylcholine in outpatient surgery.
AB  - The time-course of action and tracheal intubating conditions of rocuronium and
      succinylcholine under intravenous anesthesia with propofol, alfentanil, and
      nitrous oxide were studied in 30 patients undergoing outpatient surgery. The
      neuromuscular effects of both drugs were quantified by recording the indirectly
      evoked twitch response of the adductor pollicis muscle after ulnar nerve
      stimulation (0.1 Hz, 0.2 ms supramaximal stimuli). Patients were given either 0.6
      mg/kg rocuronium (n = 20) or 1 mg/kg succinylcholine (n = 10) intravenously.
      Sixty seconds after the administration of the muscle relaxant, the trachea was
      intubated and the intubating conditions were scored by a "blinded" assessor.
      Intubating conditions were not different (P = 0.34) between the rocuronium and
      succinylcholine groups. The onset and duration of neuromuscular blockade were
      shorter with succinylcholine than with rocuronium. The depression of the twitch
      response to 5% of control value occurred in 0.8 +/- 0.1 min with 1 mg/kg
      succinylcholine and 1.2 +/- 0.5 min with 0.6 mg/kg rocuronium (P less than 0.01).
      The recovery of the twitch response to 25%, 75%, and 90% of its control value was
      shorter after succinylcholine (P less than 0.001) and occurred at 8.1 +/- 2.6,
      10.3 +/- 3.9, 11.3 +/- 4.6 and 25.3 +/- 5.0, 33.1 +/- 5.9, 36.1 +/- 6.3 min after
      succinylcholine and rocuronium, respectively. Also the time required for
      spontaneous recovery from 25% to 75% of the control twitch response was
      significantly shorter (P less than 0.001) after succinylcholine (2.2 +/- 1.4 min)
      than after rocuronium (7.8 +/- 2.1 min). It is concluded that in spite of the
      pharmacodynamic differences between succinylcholine and rocuronium, the
      intubating conditions after administration of both compounds are similar and
      develop at the same rate.

PMID- 1616159
TI  - Halothane relaxes previously constricted human epicardial coronary artery
      segments more than isoflurane.
AB  - To compare the vasodilatory effects of isoflurane versus halothane on coronary
      arteries in vitro, we studied the capacity of isoflurane and halothane to relax
      resting and previously constricted human coronary artery segments with use of in
      vitro tension recording. Human epicardial coronary artery segments (1.5-2.0 mm
      outside diameter) were obtained from hearts excised from recipient patients at
      time of heart transplantation. The effects of 0.5%, 1.0%, 2.0%, and 3.0%
      isoflurane or halothane on resting coronary artery segments stretched to their
      optimal resting tension were determined. Next, after removal of anesthetic from
      the bathing solution, the segments were constricted with K+ (60 mM), and this
      contraction was allowed to plateau. The arteries were then again exposed to
      isoflurane or halothane at 0.5%, 1.0%, 2.0%, and 3.0% concentrations. Isoflurane
      and halothane had no effect on noncontracted coronary artery segments stretched
      to their optimal resting tension. Halothane caused significant relaxation of K(+)
      induced (60 mM) contractions at 2.0% and 3.0% but not at lower concentrations.
      Isoflurane did not cause significant relaxation of K(+)-induced (60 mM)
      contractions at any concentration studied. Our studies indicate that under the
      conditions studied, isoflurane at clinically relevant concentrations is not a
      significant coronary dilator.

PMID- 1616160
TI  - Intraoperative patient-controlled analgesia: an alternative to physician
      administration during outpatient monitored anesthesia care.
AB  - Outpatients undergoing minor diagnostic and therapeutic procedures associated
      with intermittent discomfort are frequently given bolus injections of intravenous
      opioid analgesics. In a group of 80 healthy women undergoing vaginal ovum pickup
      procedures, we evaluated patient-controlled administration of alfentanil using a
      patient-controlled analgesia device (with a lockout interval of 3 min) as an
      alternative to conventional physician-controlled administration. The two
      alfentanil administration techniques were equally effective in providing
      intraoperative analgesia. The average alfentanil dosage requirements were 1.49 +/
      0.50 and 1.46 +/- 0.55 micrograms.kg-1.min-1 (mean +/- SD) in the physician- and
      patient-controlled groups, respectively. The incidence of postoperative nausea
      was the same in both treatment groups (8%). Even with the mandatory lockout
      interval, intraoperative patient-controlled administration of alfentanil was
      comparable to physician-controlled administration with respect to patient comfort
      and satisfaction during vaginal ovum pickup procedures.

PMID- 1616161
TI  - Efficacy of the FEF colorimetric end-tidal carbon dioxide detector in children.
AB  - Direct laryngoscopy and observation of endotracheal tube (ETT) passage between
      the vocal cords remain the criterion standard for verifying endotracheal
      intubation. Detection of end-tidal carbon dioxide (ETCO2) serves as an invaluable
      adjunct to confirm endotracheal intubation, detect inadvertent esophageal
      intubation, and monitor for accidental tracheal extubation. Capnography, however,
      is often unavailable outside the operating suite. A commercially available,
      disposable, colorimetric ETCO2 detector (FEF, Fenem, Inc., New York, N.Y.), in
      which color changes using a numerical scale semiquantitatively measure percent
      carbon dioxide in exhaled gases, has proved effective in confirming endotracheal
      intubation in adults, but has not been thoroughly investigated in children. We
      studied 20 otherwise healthy children, aged 6 mo to 8 yr, with simultaneous
      infrared and colorimetric ETCO2 measurements during elective general anesthesia
      to evaluate the efficacy of the colorimetric detector. Two hundred of 200
      tracheally intubated positive-pressure breaths and 198 of 200 breaths under
      spontaneous mask ventilation demonstrated a yellow color change (color level 5 or
      6), signifying an ETCO2 greater than or equal to 15 mm Hg (2.0 kPa). Repeated
      measures analysis of variance revealed no significant differences in infrared
      ETCO2 values between the two yellow color levels throughout the study period. The
      associations among color level, infrared ETCO2 determinations, ETT size, and ETT
      "leak" pressures estimated by Spearman rank correlation analysis were significant
      only for higher infrared ETCO2 values with higher ETT leak pressures (P less than
      0.05). No complications were observed. The Fenem disposable colorimetric ETCO2
      detector effectively confirms clinical signs of endotracheal intubation in
      children when capnography is unavailable.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616162
TI  - Oral midazolam in children: effect of time and adjunctive therapy.
AB  - The purpose of this study was to determine the influence of timing and
      concomitant administration of atropine and/or meperidine on the perioperative
      effects of oral midazolam in children. In 154 healthy children, 1-8 yr old, we
      studied six oral preanesthetic medication regimens according to a randomized,
      double-blind protocol. Group A (placebo) received 5 mL of apple juice. The other
      five groups received medication with apple juice to a total volume of 5 mL, 20-60
      min before induction of anesthesia. Group B received atropine (0.02 mg/kg); group
      C received midazolam (0.5 mg/kg); group D received midazolam (0.5 mg/kg) and
      atropine (0.02 mg/kg); group E received meperidine (1.5 mg/kg) and atropine (0.02
      mg/kg); and group F received meperidine (1.5 mg/kg), atropine (0.02 mg/kg), and
      midazolam (0.5 mg/kg). The sedative effect of midazolam was maximal 30 min after
      oral administration. Ninety-five percent of the children who were separated from
      their parents within 45 min after oral midazolam administration (with or without
      atropine) had satisfactory separation scores (vs 66% of those separated after 45
      min; P less than 0.02). Midazolam-treated patients were more cooperative with a
      mask induction of anesthesia compared with non-midazolam-treated children (83% vs
      56%). Neither atropine nor meperidine appeared to significantly improve the
      effectiveness of oral midazolam. No preoperative changes in heart rate,
      respiratory rate, or hemoglobin oxygen saturation were noted in any of the
      treatment groups. Finally, oral midazolam did not prolong recovery even after
      outpatient procedures lasting less than 30 min. In conclusion, midazolam (0.5
      mg/kg) given orally 30-45 min before induction of anesthesia is safe and
      effective without delaying recovery after ambulatory surgery.

PMID- 1616164
TI  - Combination of low-dose epidural morphine and intramuscular diclofenac sodium in
      postcesarean analgesia.
AB  - Epidural morphine is used for postcesarean analgesia, and nonsteroidal
      antiinflammatory drugs are frequently administered to relieve uterine cramps
      after vaginal delivery. To assess the efficacy of a combination of low-dose
      epidural morphine and intramuscular diclofenac sodium in postcesarean analgesia,
      a double-blind, randomized study was conducted. Epidural anesthesia was given to
      120 parturients who were randomly allocated into four treatment groups: group A
      received normal saline solution, 10 mL epidurally and 3 mL intramuscularly (IM);
      group B received 10 mL of epidural saline solution and 75 mg (3 mL) of diclofenac
      IM; group C received 2 mg of morphine in 10 mL of epidural saline solution and 3
      mL of saline solution IM; and group D received 2 mg of morphine in 10 mL of
      epidural saline solution and 75 mg of diclofenac IM. Epidural injections were
      given after delivery of the placenta, and IM injections were given on arrival in
      the recovery room. Verbal analogue pain scores were recorded at 2, 4, 8, 12, 18,
      and 24 h after epidural injection. Subjective scores of overall pain relief were
      also recorded at 24 h. Results showed that scores of overall pain relief were
      significantly better in group D compared with group A, B, or C (P less than
      0.05). Groups A and B required more supplemental meperidine than groups C and D.
      None of the subjects in group D requested supplemental analgesia. Compared with
      the other three groups, group D experienced a better analgesic effect for both
      wound pain and uterine cramping pain from 4 to 18 h (P less than 0.05). Incidence
      of nausea or vomiting, or both, and pruritus occurred more frequently in groups C
      and D compared with group A or B (P less than 0.05). No bradypnea was observed
      during the study period. Diclofenac alone was not effective in postcesarean
      analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616163
TI  - Vasopressor therapy for hypotension during epidural anesthesia for cesarean
      section: effects on maternal and fetal flow velocity ratios.
AB  - The purpose of this study was to identify the influence of hypotension as a
      result of epidural anesthesia and of its treatment with either ephedrine or
      methoxamine on uteroplacental and umbilical flow velocity ratios and fetal acid
      base status. Fifty healthy women with an uncomplicated full-term pregnancy were
      studied during elective cesarean section under epidural anesthesia. A method of
      continuously recording flow velocity waveforms was used that allowed the
      identification of simultaneous values of maternal and fetal Doppler indices
      related to events during the induction of anesthesia. In 15 patients in whom
      arterial blood pressure did not decrease, the uteroplacental pulsatility index
      (UtPI) did not change, but the umbilical pulsatility index (UmPI) decreased from
      a mean (95% confidence interval) of 0.98 (0.88-1.09) to 0.91 (0.82-0.99) (P less
      than 0.05). In 32 patients who experienced hypotension of at least 15%, the UtPI
      increased from 0.82 (0.76-0.89) to 1.04 (0.92-1.17) (P less than 0.01). Treatment
      with ephedrine had no influence on either the UtPI or UmPI, but treatment with
      methoxamine resulted in brief increases in the UtPI of 0.47 (0.24-0.69) during
      the first 5 min after its administration; the increases were brief and resolved
      within 2 min. The choice of vasopressor drug had no influence on the UtPI
      recorded just before surgery commenced (final UtPI), but those patients who
      experienced hypotension had significantly larger final UtPIs (1.02 (0.91-1.10))
      than those who never became hypotensive (0.86 (0.72-0.99)), and this was
      associated with significantly increased placental hydrogen ion gradients. The
      choice of vasopressor drug appears to be of minor importance compared with the
      avoidance of hypotension.

PMID- 1616165
TI  - Comparison between clonidine and epinephrine admixture to lidocaine in brachial
      plexus block.
AB  - The admixture of clonidine or epinephrine to lidocaine for brachial plexus block
      was studied with regard to duration of block, postoperative analgesia, and plasma
      concentrations of lidocaine. Thirty-three patients of ASA physical status I and
      II received an admixture of either clonidine (150 micrograms; n = 15) or
      epinephrine (200 micrograms; n = 18) to 40 mL of 1% lidocaine in a randomized,
      double-blind fashion. Bone surgery predominated in those patients receiving
      clonidine and soft-tissue surgery in those receiving epinephrine (P less than
      0.05). Onset and duration of block were not different between the groups. With
      the admixture of clonidine, fewer patients were completely pain free for greater
      than 12 h (13.3%) and pain scores (visual analogue scale 0-10) were higher 6 h
      after the block (median 4; range 0-6) than with epinephrine (61.1%; median 2;
      range 0-7, respectively; P less than 0.05). In patients who had received
      clonidine, peak plasma concentrations of lidocaine were higher (10.29 +/- 2.96
      mumol/L) and occurred earlier (23.7 +/- 9.3 min; mean +/- SD) than in those
      treated with epinephrine (6.9 +/- 1.71 mumol/L; 72.5 +/- 56.2 min; P less than
      0.05). This indicates the absence of a local vasoconstrictor effect of clonidine
      and implies a reduced margin of safety with regard to local anesthetic toxicity.
      Although clonidine does not offer advantages compared with epinephrine, it may be
      a useful adjunct to local anesthetics in those patients in whom the
      administration of epinephrine is contraindicated.

PMID- 1616166
TI  - Clinical pharmacokinetics of R(+)- and S(-)-mepivacaine after high doses of
      racemic mepivacaine with epinephrine in the combined psoas compartment/sciatic
      nerve block.
AB  - The purpose of this study was to investigate the pharmacokinetics of R(+)- and S(
      )-mepivacaine in 10 male patients after injection of a high dose (731 mg) of
      racemic R,S-mepivacaine for a combined psoas compartment/sciatic nerve block.
      Arterial blood samples were taken, and the plasma concentrations of the
      stereoisomers R(+)- and S(-)-mepivacaine were measured by means of high
      performance liquid chromatography (HPLC) with a Chiral AGP column. The S(-)
      isomer reached higher plasma concentrations than the R(+) isomer. The maximal
      plasma concentration (Cmax) of R(+) was 1.54 +/- 0.34 micrograms/mL, whereas that
      of the S(-) isomer was 2.34 +/- 0.51 micrograms/mL (P = 0.00050). The time at
      which Cmax was reached (Tmax) was identical for both isomers. The area under the
      plasma concentration-time curve from t = 0 to infinity (AUC infinity) of S(-)
      mepivacaine was almost double that of R(+)-mepivacaine. The elimination half-life
      (T1/2) was identical for both isomers (3 h), which means that the calculated
      total body clearance and the calculated steady-state volume of the distribution
      of R(+) are, respectively, 1.7 and 1.5 times larger than that of the S(-) isomer.
      We conclude that the plasma concentrations of the S(-)-mepivacaine isomer were
      higher than those of the R(+) isomer because of a smaller volume of distribution
      and a slower total body clearance.

PMID- 1616167
TI  - Antinociceptive effects of phenobarbital in "tail-flick" test and deafferentation
      pain.
AB  - Deafferentation pain has been related to abnormal electrical hyperactivity in the
      neurons of the sensory relays in the central nervous system. This electrical
      activity resembles the epileptoid pattern observed in experimental epileptoid
      foci. With the aim of preventing this hyperactivity, rats were given long-term
      treatment with phenobarbital after sciatic transection and dorsal cervical
      rhizotomy. Daily intramuscular injections of saline solution or 5 and 10 mg/kg of
      phenobarbital were administered for 20 days, starting 10 days before surgery.
      Larger doses of phenobarbital delayed the onset and reduced the severity of
      autotomy. In a test of acute pain, the effect of intraperitoneal (1-16 mg) and
      intrathecal (100-500 micrograms) phenobarbital was studied by measuring the "tail
      flick" response latency. Intraperitoneal phenobarbital did not modify acute pain,
      but 500 micrograms of intrathecal phenobarbital increased the threshold of pain.
      These results indicate that (a) phenobarbital, a drug with anticonvulsant
      activity, reduces deafferentation behavior in rats, and (b) intrathecal
      phenobarbital has an antinociceptive action in acute experimental pain.

PMID- 1616168
TI  - Effects of single-dose intravenous omeprazole and ranitidine on gastric pH during
      general anesthesia.
AB  - We conducted a comparative trial of the gastric proton pump inhibitor omeprazole
      and the H2-receptor antagonist ranitidine on gastric pH in 50 adult patients
      scheduled for elective gynecologic surgery. The drugs were administered
      intravenously in random fashion after induction of general anesthesia and
      placement of a gastric electrode for continuous pH monitoring. The two drugs
      caused significant increases in gastric pH that did not differ significantly when
      compared with one another, yet there were significant differences from the
      control group, which did not receive either of the two drugs. A gastric pH of 2.5
      was reached within median 34 and 26 min after administration of omeprazole (40
      and 80 mg, respectively) and within median 32 and 26 min after administration of
      ranitidine (50 and 100 mg, respectively). After injection of omeprazole, a
      gastric pH of 3.5 was reached after median 41 and 34 min; injection of ranitidine
      (50 and 100 mg) produced a pH of 3.5 after median 43 and 48 min, respectively. We
      conclude that the intravenous administration of a single dose of omeprazole or
      ranitidine causes a similar increase, both in magnitude and time of onset, in
      gastric pH during general anesthesia.

PMID- 1616169
TI  - Ketorolac does not decrease the MAC of halothane or depress ventilation in rats.
AB  - To determine the effects of intravenous (IV) ketorolac on anesthesia and the
      mechanisms involved, we evaluated its effects on minimum alveolar anesthetic
      concentration (MAC) and ventilation in halothane-anesthetized rats. Ketorolac in
      clinical (0.2 and 2 mg/kg) and large (20 and 40 mg/kg) IV doses did not affect
      the MAC of halothane (0.82% +/- 0.02%). Resting end-tidal CO2 tension (5.1% +/-
      0.1%) and the slope of the CO2 response curves (70 +/- 6 mL.min-1.%-1) were also
      unaffected by IV ketorolac. The mean arterial blood pressure did not
      significantly change after ketorolac in doses of 0.2, 2, or 20 mg/kg but
      decreased significantly (P less than 0.05) after 40 mg/kg (placebo 99 +/- 8 mm
      Hg; ketorolac 87 +/- 6 mm Hg). This study demonstrates that MAC, ventilation, and
      mean arterial blood pressure are unaffected by clinical doses of IV ketorolac.
      Furthermore, the lack of effect on MAC and ventilation from larger doses suggests
      that ketorolac does not have mechanisms of action in the central nervous system.

PMID- 1616170
TI  - Psychological science around the world.

PMID- 1616171
TI  - Ethnic differences in adolescent achievement. An ecological perspective.
AB  - Using data collected from a large sample of high school students, the authors
      challenge three widely held explanations for the superior school performance of
      Asian-American adolescents, and the inferior performance of African- and Hispanic
      American adolescents: group differences in (a) parenting practices, (b) familial
      values about education, and (c) youngsters' beliefs about the occupational
      rewards of academic success. They found that White youngsters benefit from the
      combination of authoritative parenting and peer support for achievement, whereas
      Hispanic youngsters suffer from a combination of parental authoritarianism and
      low peer support. Among Asian-American students, peer support for academic
      excellence offsets the negative consequences of authoritarian parenting. Among
      African-American youngsters, the absence of peer support for achievement
      undermines the positive influence of authoritative parenting.

PMID- 1616172
TI  - The mental health system and older adults in the 1990s.
AB  - Trends in mental health services for older adults during the past decade were
      used to predict salient issues for the current decade. These include overreliance
      on inpatient treatment, increased use of general hospitals as treatment sites,
      inadequate integration with the nursing-home industry, and insufficient mental
      health referrals from general medical providers. In the decade ahead, the mental
      health needs of older adults are unlikely to be an identified focus; rather the
      issues will overlap with other priorities (e.g., biomedical research on brain
      functioning, alternative treatment programs for the chronically mentally ill, and
      containing health care costs). Advocates for the elderly will be successful to
      the extent that they cast aging services within the context of these other
      concerns.

PMID- 1616173
TI  - Is the unconscious smart or dumb?
AB  - How sophisticated is unconscious cognition? This is one of the most fundamental
      questions about the unconscious that has been posed by research psychologists
      over the past century. Anthony Greenwald takes a contemporary look at this
      classical problem and concludes that unconscious cognition is severely limited in
      its analytic capability. In response, other leading scholars agree that the
      reality of unconscious processes is no longer questionable. Although there is
      some disagreement about just how sophisticated these processes are, the consensus
      is that exciting times are ahead for both research and theory concerning the
      mental processes involved in unconscious cognition.

PMID- 1616174
TI  - New look 3. Unconscious cognition reclaimed.
AB  - Recent research has established several empirical results that are widely agreed
      to merit description in terms of unconscious cognition. These findings come from
      experiments that use indirect tests for immediate or long-term residues of barely
      perceptible-but-unattended, or attended-but-forgotten events. Importantly, these
      well-established phenomena--insofar as they occur without initially involving
      focal attention--are limited to relatively minor cognitive feats. Unconscious
      cognition is now solidly established in empirical research, but it appears to be
      intellectually much simpler than the sophisticated agency portrayed in
      psychoanalytic theory. The strengthened position of unconscious cognitive
      phenomena can be related to their fit with the developing neural network
      (connectionist) theoretical framework in psychology.

PMID- 1616175
TI  - Another look at New Look I.

PMID- 1616176
TI  - Psychodynamics and the unconscious.

PMID- 1616177
TI  - The psychological unconscious. Found, lost, and regained.
AB  - In response to Greenwald's article on contemporary research on unconscious mental
      processes, the authors address three issues: (a) the independence of much recent
      research and theory from psychodynamic formulations; (b) the broad sweep of the
      psychological unconscious, including implicit perception, memory, thought,
      learning, and emotion; and (c) the possibility that the analytic power of
      unconscious processing may depend both on the manner in which mental contents are
      rendered unconscious and the manner in which they are to be processed.

PMID- 1616178
TI  - Perception without awareness. Critical issues.

PMID- 1616179
TI  - Nonconscious acquisition of information.
AB  - The authors review and summarize evidence for the process of acquisition of
      information outside of conscious awareness (covariations, nonconscious indirect
      and interactive inferences, self-perpetuation of procedural knowledge). Data
      indicate that as compared with consciously controlled cognition, the nonconscious
      information-acquisition processes are not only much faster but are also
      structurally more sophisticated, in that they are capable of efficient processing
      of multidimensional and interactive relations between variables. Those mechanisms
      of nonconscious acquisition of information provide a major channel for the
      development of procedural knowledge that is indispensable for such important
      aspects of cognitive functioning as encoding and interpretation of stimuli and
      the triggering of emotional reactions.

PMID- 1616180
TI  - Unconscious influences revealed. Attention, awareness, and control.
AB  - Recent findings of dissociations between direct and indirect tests of memory and
      perception have renewed enthusiasm for the study of unconscious processing. The
      authors argue that such findings are heir to the same problems of interpretation
      as are earlier evidence of unconscious influences--namely, one cannot eliminate
      the possibility that conscious processes contaminated the measure of unconscious
      processes. To solve this problem, the authors define unconscious influences in
      terms of lack of conscious control and then describe a process dissociation
      procedure that yields separate quantitative estimates of the concurrent
      contributions of unconscious and consciously controlled processing to task
      performance. This technique allows one to go beyond demonstrating the existence
      of unconscious processes to examine factors that determine their magnitude.

PMID- 1616181
TI  - Postsplenectomy leukocystosis: physiologic or an indicator of infection?
AB  - The records of 42 patients who underwent splenectomy following blunt abdominal
      trauma were reviewed to determine whether white blood cell (WBC) count is a
      useful indicator of acute infection in the postoperative period. Patients,
      ranging in age from 14 to 54 years, were divided into two groups: 1) infected (n
      = 18) and 2) noninfected (n = 24). Group average daily WBC counts (thousands/mm3)
      and differential counts (polymorphonuclear leukocyte/bands) were evaluated for
      the first 14 postoperative days. The infected group had a mean WBC of 21.2 and a
      mean differential count of 73/8. The average daily WBC count began to rise on Day
      4 (WBC = 10.8) and peaked on Day 7 at 27.8. There were 30 episodes of infection:
      14 pneumonias and 16 others, including sinusitis, empyema, subphrenic abscess,
      urinary tract infection, and bacteremias. The noninfected group had a mean WBC
      count of 14.2 and a mean differential of 73/5. For this group, the average WBC
      peaked by the postoperative Day 2 (WBC = 15.9), then the trend was downward.
      Thus, for patients with traumatic splenic injuries, WBC count may predict
      infection in the postsplenectomy period. In the noninfected group, the authors
      observed no average daily WBC count above 16; whereas, in the infected group, no
      average daily WBC count less than 16 was observed. The differential counts were
      not significantly different between the two groups.

PMID- 1616182
TI  - Portable ultrasonography in critical care.
AB  - A 2-year retrospective analysis of portable ultrasound examinations in the
      intensive care unit was conducted to evaluate the indications and efficacy of
      portable sonography. A total of 86 examinations were performed on 79 patients. Of
      these, 22 per cent of the examinations supported the suspected diagnosis and
      contributed to treatment. Seventy per cent of the examinations excluded the
      suspected diagnosis. There was a 9 per cent incidence that yielded unsuspected
      information that contributed to treatment. Only 8 per cent of the examinations
      were misleading or proven false. The authors found that with an overall
      sensitivity of 79 per cent and specificity of 97 per cent, portable
      ultrasonography is a valuable, relatively inexpensive test in the critical care
      setting.

PMID- 1616183
TI  - Hepatic enzyme response and hyperpyrexia after severe liver injury.
AB  - A multi-center experience with 210 severe liver injuries was reviewed to define
      postoperative changes in hepatic enzyme levels and body temperature profile. The
      129 patients who survived initial operation comprised the data base. Serum
      glutamic oxaloacetic transaminase (SGOT) and lactate dehydrogenase (LDH) peaked
      within 24 hours (750 +/- 92 IU/L, 870 +/- 120 IU/L) and decreased rapidly during
      the first 4 days. Serum bilirubin was maximal at 7 days, while alkaline
      phosphatase rose slowly throughout 14 days. Hepatic enzyme elevations were more
      dramatic after blunt trauma, reflecting greater hepatocellular disruption.
      Maximum daily temperatures exceeding 38.0 degrees C and 39.0 degrees C were
      recorded for the first 3 postoperative days in 82 (64%) patients and 14 (11%)
      patients, respectively. No infectious source was evident in 13 (93%) of 14
      patients with severe hyperpyrexia, implicating release of inflammatory mediators
      associated with major hepatic trauma. Convalescence from severe hepatic injury is
      marked by release of SGOT and LDH, as well as fever, which may be anticipated
      during the first 4 days postinjury.

PMID- 1616184
TI  - Giant, benign, mucinous cystadenoma of the ovary: case study and literature
      review.
AB  - Benign, mucinous cystadenomas account for 15 per cent of all ovarian neoplasms.
      Of these, the giant variant occurs rarely. A morbidly obese, 52-year-old, white
      woman was seen for acute abdominal pain and diagnosed using computerized
      tomography as having a giant, benign, mucinous cystadenoma. At laparotomy, 21-kg
      cystic mass attached to the right ovary was removed. Total abdominal hysterectomy
      and bilateral salpingo-oophorectomy were performed. In such patients, special
      consideration must be given to hemodynamic and ventilatory monitoring and
      intraoperative fluid management. Recognition and subsequent surgical management
      of this and other large abdominal masses can be optimized by thoughtful,
      preoperative evaluation and careful planning of the operative approach.

PMID- 1616185
TI  - Transareolar dye-injection microdochectomy.
AB  - Single-duct microdochectomy is described for use in patients with bloody or
      serosanguinous nipple discharge arising from a single duct in the breast. Because
      most such cases are caused by benign, intraductal papillomata, the technique used
      in removing the offending ductal system should be fully diagnostic, adequately
      therapeutic, and cosmetically acceptable. A technique is described that is used
      in 40 consecutive patients with good diagnostic, therapeutic, and cosmetic
      result. The procedure itself combines techniques and principles of plastic and
      reconstructive surgery such as minimal tissue trauma, use of anatomical tissue
      planes, bloodless-field surgery, and microdissection.

PMID- 1616186
TI  - The significance of breast complaints as correlated with age and breast cancer.
AB  - A review is presented of 2,000 consecutive new, patients with breast complaints.
      Emphasis is placed on the specific complaint as correlated with patient age and
      the incidence of breast cancer. The initial complaints were a lump (50%), an
      abnormal mammogram (32%), other complaints (8%), breast pain (6%), and nipple
      discharge (4%). Follow-up information was available for 1,889 patients. The
      majority of the patients (68%) were under 50 years of age. Of 831 patients to
      whom a biopsy was recommended, 720 ultimately had a biopsy and 147 cancers were
      identified. Sixty-five per cent of the cancers were in women aged 50 years or
      greater. Of the patients aged 50 years or older, 16.1 per cent had breast cancer,
      while only 4.0 per cent of the patients less than 50 years and 0.8 per cent of
      the patients less than 30 years of age had breast cancer. The author concludes
      that the overwhelming majority of patients (92%) referred to a breast surgery
      practice do not have malignancy. Thus, primary physicians undoubtedly see even a
      smaller per cent of breast complaints ultimately result in the diagnosis of
      breast cancer. There is a need to better inform the public as to the significance
      of breast complaints and to establish more specific criteria for biopsy,
      particularly in the young, professional, liability threats not withstanding.

PMID- 1616187
TI  - Primary malignant melanoma of the small bowel: a case study.
AB  - Malignant melanoma involving the gastrointestinal (GI) tract is diagnosed
      premortem in only 4 per cent of patients with the disease, even though in autopsy
      series 60 per cent of patients who died of malignant melanoma have GI metastases.
      Usually, these GI lesions are metastatic. However, a few cases of primary GI
      malignant melanoma have been reported. Such a case is reported and discussed,
      including the clinical presentation, pathophysiology, treatment, and prognosis of
      this disease.

PMID- 1616188
TI  - Preoperative irradiation and surgery for initially unresectable adenocarcinoma of
      the rectum.
AB  - Forty-two patients with initially unresectable rectal adenocarcinoma were treated
      with preoperative irradiation and surgery between March 1970 and March 1986 at
      the University of Florida (Gainesville, FL). No patient received adjuvant
      chemotherapy. All patients had follow-up for at least 5 years; 23 (55%) had
      follow-up for 10 years or more. Five patients (12%) underwent an exploratory
      laparotomy before irradiation; the remaining 37 patients were clinically thought
      to have unresectable disease. Eighteen patients had tumor fixation to one
      structure, and 24 patients (57%) had fixation to two or more structures. Lesions
      that exhibited impaired mobility but not complete fixation were considered to be
      clinically resectable and are not included in this series. The dose of
      preoperative irradiation ranged from 3,500 to 6,000 cGy at 180 cGy per fraction;
      30 of 42 patients received 4,500 to 5,000 cGy and only 4 patients received less
      than 4,000 cGy. Forty-one patients were operated on 1 to 11 (mean 4.6) weeks
      after the completion of radiotherapy; 1 patient died of aspiration pneumonia
      after completing irradiation but before the planned resection. Resection of the
      rectal cancer was accomplished in 37 patients. Four patients were found to have
      extensive unresectable disease at laparotomy. Twenty-one patients had a complete
      resection: 11 were stage B2, and 10 were stage C2. Twenty patients had incomplete
      resection due to positive margins (8 patients), distant metastases with or
      without positive margins (8 patients), or no resection due to extensive disease
      (4 patients). Two patients died after the operation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1616189
TI  - Selective nonoperative management of solid breast masses.
AB  - A prospective study evaluated the hypothesis that, following consistent clinical
      and mammographic guidelines, many women with breast masses can be nonoperatively
      managed. One hundred eighty women with solid breast masses were assigned both a
      clinical and mammographic diagnosis by each a surgeon and radiologist. Immediate
      biopsy (n = 78) was recommended when either clinician thought that the mass was
      malignant (52 cancers). The remainder were offered a trial of observation, with
      interval biopsy performed upon patient preference or for increased
      clinical/mammographic concern. Of the 89 who consented to this, 70 received long
      term follow-up (X = 22 months) with improvement in the characteristics of the
      mass. The diagnosis of invasive cancer was delayed in two women initially
      observed, with no apparent impact on survival. It is concluded that many women
      with solid breast masses can be safely observed. Biopsy remains warranted for any
      mass suspicious for malignancy on clinical/mammographic grounds, or if follow-up
      cannot be assured.

PMID- 1616190
TI  - [Chronic rhinitis].

PMID- 1616191
TI  - [Alcohol consumption in children: polling the parents].
AB  - Alcoholism is a major health problem in Spain. Frequently, the first drink is
      offered in the home. We report the results of a poll in which parents were asked
      when they offer alcohol to their children. We found that 76.1% offered alcohol
      anytime. Furthermore, 15% of the mothers answered that this may be of benefit to
      their children. Drinks with a higher level of alcohol (brandy, punch, anis) were
      offered more frequently after seven years of age and to those children whose
      mother had offered the first alcoholic beverage at an earlier age.

PMID- 1616192
TI  - [Redistribution of fetal cardiac output in intrauterine growth retardation].
AB  - One hundred and thirty-one fetuses with a gestational age between 29 and 41 weeks
      have been studied by Doppler-Echocardiography. The cases include normal
      pregnancies and those with a risk for congenital heart disease. We compared the
      cardiac output distribution, calculated by Pulsed Doppler-Echocardiography,
      between the intrauterine growth retardation cases and those with normal growth.
      The normal and relative dominance of the right versus the left ventricle is
      demonstrated in normal pregnancies and normal growth fetuses. This ratio is
      clearly inverted in the growth-retarded cases. This redistribution of blood flow
      may be a response to chronic hypoxia allowing preferential flow of the blood to
      the brain.

PMID- 1616193
TI  - [Dermoid cyst of the anterior fontanelle in children: clinical significance and
      differentiation from encephalocele].
AB  - Dermoid cysts of the anterior fontanel present as a tumor lesion that tenses up
      when the child cries or strains. Their midline position in the skull, the fact
      that some of these cysts contain clear fluid and the presence of an underlying
      bone defect, lead the clinician to the erroneous diagnosis of encephalocele, for
      which they are sent for consultation. We report a series of five of these cysts
      (3 dermoid and 2 epidermoid) located over the anterior fontanel, remark on their
      clinical significance, and stress their differential diagnosis from encephalocele
      and from other tumor lesions of the anterior fontanel.

PMID- 1616194
TI  - [Comparison of treatment of acute asthma attacks in children with salbutamol
      dispensed by the Volumatic dispenser or by a nebulizer].
AB  - Eighteen children with acute asthma were administered equal doses of Salbutamol
      either through a nebulizer and face mask or a dose-metered inhaler, spacer
      (Volumatic) and tidal breathing mechanism. Consecutive doses at twenty minute
      intervals were administered until either no significant improvement in pulmonary
      function was observed or until a cumulative dose of 0.15 mg/Kg (maximum of 5 mgs)
      had been given. All subjects finally received a dose of 0.15 mg/Kg (maximum of 5
      mgs) of nebulized Salbutamol at the end of the study. No difference in
      bronchodilation was obvious between the methods of treatment. No significant side
      effect was observed in any patient. Treatment of acute asthma in children with
      Salbutamol via a pressurized inhaler, spacer and tidal breathing mechanism may be
      an efficacious, safe and readily available method, but further work is needed
      before it can be recommended for routine home management of asthma attacks.

PMID- 1616195
TI  - [Pulmonary mechanism in preterm neonates without respiratory problems].
AB  - Pulmonary function was measured by computerized pneumotacography in 26 preterm
      newborn infants without respiratory problems. Mean (+/- SD) for birth weight,
      gestation and postnatal age were 2,034 +/- 412 g, 34.1 +/- 1.7 weeks, and 2.2 +/-
      1.6 days, respectively. An esophageal balloon, a differential transducer and
      nasal prongs were used to measure pressure and flow. The following parameters
      were measured in each respiration by the mean squares method: Dynamic compliance
      (Cdyn), total respiratory resistance (RRt) and work (WRt), respiratory time
      constant (KTt), rate (f) and maximal inspiratory and expiratory flows (PIF, PEF).
      Replication of the method was found to be good, as the differences between two
      determinations were not significant (p less than 0.05). The mean differences were
      less than 6.26%. The mean (+/- SD) and the 3rd and 97th percentiles for each
      parameter were the following: f: 52 +/- 7 (39-66) r.p.m., Tv: 6.6 +/- 1.1 (4.5
      8.7) ml/kg, Vmin: 342 +/- 82 (128-502) ml/min, Cdin: 3.7 +/- 1.1 (1.5-6) ml/cm,
      RRt: 83 +/- 47 (37-204) cm/L/sec, TRt: 27 +/- 15 (2-57.1) g/cm/kg, PIF: 2.2 +/-
      0.5 (1.1-3.2) L/min and PEF: 1.9 +/- 0.6 (0.7-3) L/min.

PMID- 1616196
TI  - [Importance of maternity routines in the success of maternal breast feeding].
AB  - Many of the problems that are associated with breast-feeding appear to be caused
      by various postnatal care procedures that take place in the majority of our
      hospitals. In order to identify these obstacles, a survey was carried out on a
      sample of 400 mothers whose children were born in Mostoles in 1989. The results
      were as follows: 1) The average duration of breast-feeding was 2.43 months (SD =
      2.19 months). 2) The lower the baby's birth weight and the longer that he was
      kept in the hospital, the shorter the time that he was breast-fed. Two basic
      procedures in the hospital "norms" appear to contribute to the failure of breast
      feeding. First, the provision of glucose water or formula bottles and second, a
      ridged feeding schedule. If the newborn was fed on demand in the hospital it
      tended to be continued once at home. In both the hospital and in the home, on
      demand feeding was strongly associate with successful breast-feeding. Some simple
      modifications to the Maternity departments are recommended.

PMID- 1616197
TI  - [Phenylalanine metabolites in hyperphenylalaninemic children].
AB  - Phenylalanine and its organic acid derivatives, phenylacetate, mandelic, o
      hydroxy-phenylacetate, phenyllactate and phenylpyruvate are increased due to the
      enzymatic block in the normal pathway of phenylalanine metabolism in
      phenylketonuric and hyperphenylalaninemic patients. These organic acids are
      neurotoxic and whether they are responsible for behavior and learning problems in
      hyperphenylalaninemic children remains to be seen. The purpose of the present
      study was to evaluate: 1) variations of the organic acid derivatives of
      phenylalanine during dietary treatment and 2) the usefulness of its determination
      to further adjust the phenylketonuric diet. Twenty-eight children, ages 4 months
      to 16 years, were studied. On the same day, the level of phenylalanine in the
      plasma and phenylalanine metabolites in freshly collected urine samples were
      tested. Phenylalanine metabolites were detected in some patients with blood
      phenylalanine levels below 242 microM/L and they rose as levels of blood
      phenylalanine increased with the phenylpyruvic acid being the highest when blood
      phenylalanine levels were greater than 424 microM/L. These compounds are usually
      not detected in normal urine. However, we have or learning problems, thus we do
      not make further adjustments in the PKU diet on the basis of phenylalanine
      metabolites.

PMID- 1616198
TI  - [Treatment of preterm neonates with severe respiratory distress syndrome using
      exogenous natural surfactants of porcine origin].
AB  - From September 1989 to September 1990, a total of 25 newborn infants with severe
      RDS (on mechanical ventilation and with a FiO2 above 0.6) were treated with
      porcine surfactant (Curosurf), since its efficacy has been demonstrated in a
      prior clinical trial (Pediatrics 1988; 82: 683-91). The mean birth weight and
      gestational age were 1,327 +/- 566 g and 29.5 +/- 3.8 weeks, respectively. Twenty
      four percent of the babies had an arterial pH below 7.1. At a mean postnatal age
      of 9.1 +/- 10.7 hours, a dose of 200 mg/Kg of Curosurf was given by the tracheal
      route. Mean paO2 rose from 47 +/- 14 mm Hg to 166 +/- 64 mm Hg (p less than
      0.001). The paO2 increased in 24 of the 25 cases and in 20 (80%) the post
      treatment paO2 was a least two times higher than the pre-treatment value. An hour
      after surfactant treatment, the paCO2 decreased from 58 +/- 21 mm Hg to 45 +/- 16
      mm Hg (p less than 0.01) and the pH increased from 7.19 +/- 0.15 to 7.28 less
      than 0.11 (p less than 0.001). The following complications were observed:
      pulmonary interstitial emphysema (16%), pneumothorax (8%), patent ductus
      arteriosus (36%), intraventricular hemorrhage (28%) and bronchopulmonary
      dysplasia (24%). The neonatal survival rate and the survival rate after discharge
      from the hospital were 76% and 64%, respectively. The combined survival and
      absence of DBP was 32%. Nonsurvivors had lower birth weights and gestation ages,
      as well as lower paO2 5 min after treatment and higher FiO2 24 hours after
      surfactant treatment than did the survivors.

PMID- 1616199
TI  - [Factors influencing election and duration of maternal breast feeding].

PMID- 1616200
TI  - [Mortality caused by accidental suffocation during the first year of life].
AB  - We have analyzed the mortality due to accidental choking and suffocation during
      the first year of life that occurred in Spain from 1970 to 1980. The annual
      mortality rate due to choking caused by foodstuffs increased considerably from
      1970 (5.7 deaths per 100,000) to 1977 (34.47 deaths per 100,000) and then
      declined slightly. Overall, mortality from this cause increased by a factory of
      five throughout the decade. This surprising evolution and its causes at a time
      when infant mortality is declining are discussed.

PMID- 1616201
TI  - Pseudosubluxation of C2-C3 in childhood: a frequent clinico-radiological
      diagnostic error.
AB  - Although serious cervical injuries in pediatric patients are very infrequent, the
      may occur occasionally as a result of a strong blow to the head. Clinical records
      and radiological pictures, and in some cases computer tomography, help to provide
      the correct diagnosis. During childhood there are several normal radiological
      variants that may be interpreted as pathological findings, of which
      pseudosubluxation C2-C3 is the most frequent. We present two such cases and
      discuss the clinical and radiological criteria for the differential diagnosis
      between normal variants and injuries to the cervical spine in pediatric patients.

PMID- 1616202
TI  - [Recurrent infections in glycogenosis type Ib].

PMID- 1616203
TI  - [Neonatal sepsis and meningitis caused by Haemophilus influenzae].

PMID- 1616204
TI  - [Atypical measles with hepatic involvement].

PMID- 1616205
TI  - [Prenatal diagnosis of neuroblastoma].

PMID- 1616206
TI  - [Administration of immunotherapy with allergens: importance of measuring the
      maximal expiratory flow rate].

PMID- 1616207
TI  - [And they still want more?].

PMID- 1616208
TI  - [Pancreatic heterotopy as a cause of intestinal invagination].

PMID- 1616209
TI  - [Pediatric emergencies].

PMID- 1616210
TI  - [Recurrent condyloma acuminatum in an infant].

PMID- 1616211
TI  - An outbreak of tuberculosis caused by multiple-drug-resistant tubercle bacilli
      among patients with HIV infection.
AB  - OBJECTIVE: To evaluate a nosocomial outbreak of tuberculosis caused by multiple
      drug-resistant bacilli among patients with tuberculosis and HIV infection.
      DESIGN: A case-control study. PATIENTS: Patients with HIV infection and culture
      proven tuberculosis. MEASUREMENTS: Patient characteristics, date of diagnoses of
      HIV infection and disease, date of diagnosis of tuberculosis, Mycobacterium
      tuberculosis susceptibility results, and medical center contact. RESULTS: Sixty
      two patients who had tuberculosis caused by multiple-drug-resistant bacilli
      (cases) and 55 patients who had tuberculosis caused by susceptible or single-drug
      resistant bacilli (controls) were identified. Controls were more likely to be
      black (odds ratio, 0.4; 95% CI, 0.2 to 0.9) or Haitian (odds ratio, 0.2; CI, 0.1
      to 0.6) compared with cases, who were more likely to be homosexual men (odds
      ratio, 2.9; CI, 1.3 to 6.4). Forty-four cases (71%) had previous contact with an
      HIV clinic compared with 15 controls (27%) (P less than 0.0001). Cases were more
      likely to have had AIDS (odds ratio, 7.7; CI, 1.5 to 53.7), to have been
      hospitalized on an HIV ward (odds ratio, 8.3; CI, 2.3 to 29.7), to have been seen
      in an HIV clinic (odds ratio, 7.8; CI, 3.4 to 18.1), to have received intravenous
      therapy in an HIV clinic (odds ratio, 13.0; CI, 4.6 to 37.0), or to have received
      inhalation pentamidine in an HIV clinic before a diagnosis of tuberculosis was
      made. Multiple logistic regression analysis showed that a diagnosis of AIDS (odds
      ratio, 11.2; CI, 3.1 to 40.6) and HIV clinic visits (odds ratio, 13.0; CI, 2.7 to
      63.7) before a diagnosis of tuberculosis were significantly associated with
      tuberculosis caused by multiple-drug-resistant bacilli. Using susceptibility
      patterns and appointment dates, we found that 22 cases had previous contact with
      a person who had tuberculosis caused by multiple-drug-resistant bacilli in the
      HIV clinic. CONCLUSIONS: Nosocomial transmission of M. tuberculosis from other
      HIV-infected patients with tuberculosis caused by multiple-drug-resistant bacilli
      can occur. These findings have serious public health implications and demand
      strict adherence to acid-fast bacilli isolation precautions.

PMID- 1616212
TI  - Clinical presentation and outcome of patients with HIV infection and tuberculosis
      caused by multiple-drug-resistant bacilli.
AB  - OBJECTIVE: To determine the clinical manifestations of patients with human
      immunodeficiency virus (HIV) infection and tuberculosis caused by multiple-drug
      resistant bacilli compared with those with single-drug-resistant or susceptible
      bacilli. DESIGN: Descriptive, case-control, and cohort studies. SETTING: A large
      urban teaching hospital. PATIENTS: Sixty-two patients with tuberculosis caused by
      multiple-drug-resistant bacilli (cases) and 55 patients with tuberculosis caused
      by single-drug-resistant or susceptible bacilli (controls). MEASUREMENTS:
      Characteristics of clinical presentation, radiographs, pathologic abnormalities,
      antituberculosis treatment, and clinical course. RESULTS: Twenty cases (32%) had
      concomitant pulmonary and extrapulmonary disease at presentation compared with 9
      controls (16%; odds ratio, 2.4; 95% CI, 1.0 to 5.9). More cases had alveolar
      infiltrates (76%; odds ratio, 3.6; CI, 1.2 to 11.4), interstitial infiltrates
      with a reticular pattern (67%; odds ratio, 7.8; CI, 1.0 to 83.5), and cavitations
      (18%; odds ratio, 6.6; CI, 0.8 to 315.3) on initial chest radiographs compared
      with controls (49%, 19%, and 3%, respectively). Pathologic specimens from cases
      showed extensive necrosis, poor granuloma formation, marked inflammatory changes
      with a predominance of neutrophils, and abundant acid-fast bacilli. Twenty-five
      cases received two or more effective antituberculosis drugs for more than 2
      months. Only 2 cases had three consecutive negative cultures for Mycobacterium
      tuberculosis; one patient died within 1 day of the last negative culture, and the
      other had positive cultures 496 days later. The remaining 23 cases had
      persistently or intermittently positive cultures despite therapy. The clinical
      course of these cases suggested overwhelming miliary tuberculosis with
      involvement of the lungs (77%), pleura (15%), stool (34%), meninges (13%), bone
      marrow (16%), blood (10%), lymph nodes (10%), and skin (8%). The median survival
      time was 2.1 months for cases compared with 14.6 months for controls (P = 0.001,
      log-rank test). CONCLUSIONS: Tuberculosis caused by multiple-drug-resistant
      bacilli in patients with HIV infection is associated with widely disseminated
      disease, poor treatment response with an inability to eradicate the organism, and
      substantial mortality.

PMID- 1616213
TI  - Rapid suppression of spontaneous ventricular arrhythmias during oral amiodarone
      loading.
AB  - OBJECTIVE: To determine the time course of effects of amiodarone during an oral
      loading period. DESIGN: A prospective, nonrandomized study. SETTING: Arrhythmia
      referral center at a university hospital. PATIENTS: Fifty patients with
      refractory sustained ventricular tachycardia (n = 44) or ventricular fibrillation
      (n = 6) and frequent (greater than or equal to 30/h) ventricular premature
      complexes. INTERVENTION: Oral amiodarone, 1200 mg/d for 14 days and 400 mg/d
      thereafter. MEASUREMENTS: Ambulatory electrocardiographic monitorings, 12-lead
      electrocardiograms, and amiodarone blood levels on days 3, 5, 7, 9, 11, 13, and
      28. RESULTS: Dramatic reductions of ventricular arrhythmias were noted during the
      first 72 hours of the therapy. Average ventricular premature complexes/h,
      couplets/h, and nonsustained ventricular tachycardias/24 h were 524 +/- 1224/h,
      16 +/- 61/h, and 167 +/- 611/24 h, respectively, at baseline, and reduced to 140
      +/- 243/h, 11 +/- 50/h, and 33 +/- 117/24 h, respectively, on day 3 (P less than
      0.05 for all). Subsequent reductions of ventricular arrhythmias from day 3 to day
      13 were more gradual but were still significant (P less than 0.05). A significant
      reduction of ventricular arrhythmias (greater than or equal to 70% reduction of
      ventricular premature complexes and greater than or equal to 90% reduction of
      nonsustained ventricular tachycardias) was noted in 50% of patients on day 3, in
      65% on day 7, and in 83% on day 13. Prolongation of the QT interval exhibited a
      similar time course. There were no further differences in reduction of
      ventricular premature complexes or QT intervals between day 13 and day 28.
      CONCLUSIONS: Oral amiodarone given in loading doses produces rapid and dramatic
      reductions in spontaneous ventricular arrhythmias within 72 hours. Subsequent
      reductions of spontaneous arrhythmia were gradual and less dramatic.

PMID- 1616214
TI  - Empiric treatment of acute diarrheal disease with norfloxacin. A randomized,
      placebo-controlled study. Swedish Study Group.
AB  - OBJECTIVE: To evaluate the clinical and microbiologic efficacy and safety of
      norfloxacin for acute diarrhea. DESIGN: Double-blind, placebo-controlled,
      randomized clinical multicenter trial. SETTING: Six departments of infectious
      disease. PARTICIPANTS: Patients 12 years of age or older with a history of acute
      diarrhea lasting 5 or fewer days. Eighty-five percent of patients (511/598) were
      evaluable for efficacy. Of these evaluable patients, 70% had traveled abroad
      within the previous 6 weeks. INTERVENTIONS: Patients received either norfloxacin,
      400 mg, or placebo twice daily for 5 days. MEASUREMENTS: Enteric pathogens were
      isolated in 51% of the evaluable patients: Campylobacter species in 29%,
      Salmonella species in 16%, Shigella species in 3.5%, and other pathogens in 2.6%.
      RESULTS: Norfloxacin had a favorable overall effect compared with placebo (cure
      rate, 63% compared with 51%; P = 0.003). There were statistically favorable
      effects in culture-positive patients, patients with salmonellosis, and severely
      ill patients but not in culture-negative patients or patients with
      campylobacteriosis or shigellosis. A significant difference was noted between
      norfloxacin and placebo in median time to cure among all evaluable patients (3
      compared with 4 days, P = 0.02) and in patients with campylobacteriosis (3
      compared with 5 days, P = 0.05) but not in patients. Culture-positive, but not
      culture-negative patients, in the norfloxacin group had significantly fewer loose
      stools per day compared with patients in the placebo group from day 2 onward (P
      less than or equal to 0.01). Norfloxacin was significantly less effective than
      placebo in eliminating Salmonella species on days 12 to 17 (18% compared with
      49%, P = 0.006), whereas the opposite was true for Campylobacter species (70%
      compared with 50%, P = 0.03). In six of nine patients tested, norfloxacin
      resistant Campylobacter species (MIC, greater than or equal to 32 micrograms/mL)
      appeared after norfloxacin treatment. CONCLUSION: Empiric treatment reduced the
      intensity and, to some extent, the duration of symptoms of acute diarrhea. The
      effect was restricted to patients who had bacterial enteropathogens or who were
      severely ill. The clinical usefulness of this treatment is limited by the fact
      that norfloxacin seems to delay the elimination of salmonella and to induce
      resistance in campylobacter.

PMID- 1616215
TI  - The serum-ascites albumin gradient is superior to the exudate-transudate concept
      in the differential diagnosis of ascites.
AB  - OBJECTIVE: To compare the serum-ascites albumin gradient to the exudate
      transudate concept in the classification of ascites. DESIGN: Prospective
      collection of ascitic fluid data from patients with well-characterized causes of
      ascites. SETTING: Hepatology inpatient and outpatient ward and consult service of
      a large, urban hospital. PATIENTS: A total of 901 paired serum and ascitic fluid
      samples were collected from consecutive patients with all forms of ascites.
      INTERVENTIONS: None. MAIN OUTCOME MEASURES: The utility of the serum-ascites
      albumin gradient and the old exudate-transudate concept (as defined by ascitic
      fluid total protein concentration [AFTP]) were compared for their ability in
      discriminating the cause for ascites formation. RESULTS: The albumin gradient
      correctly differentiated causes of ascites due to portal hypertension from those
      that were not due to portal hypertension 96.7% of the time. The AFTP, when used
      as defined in the old exudate-transudate concept, classified the causes of
      ascites correctly only 55.6% of the time. This resulted in part because the AFTP
      of most spontaneously infected samples (traditionally expected to be exudates)
      was low, and the AFTP of most cardiac ascites samples (traditionally expected to
      be transudates) was high. CONCLUSIONS: The exudate-transudate concept should be
      discarded in the classification of ascites. The serum-ascites albumin gradient is
      far more useful than the AFTP as a marker for portal hypertension, but the latter
      remains a useful adjunct in the differential diagnosis of ascites.

PMID- 1616216
TI  - Fabry disease: an unusual cause of severe coronary disease in a young man.

PMID- 1616217
TI  - The treatment of diabetic retinopathy: a view for the internist.
AB  - PURPOSE: To review the status of surgical and medical therapy for diabetic
      retinopathy from the perspective of the non-ophthalmologist. DATA SOURCES:
      Relevant English-language articles published from January 1981 to July 1991 were
      identified through MEDLINE. Other relevant articles were obtained from the
      authors' personal database. STUDY SELECTION: For the review of surgical
      treatment, large randomized, controlled trials were selected. For the review of
      medical treatment, randomized studies comparing intensive insulin treatment with
      conventional insulin therapy were selected, as were double-blind, randomized,
      controlled trials of aldose-reductase inhibitor therapy and antiplatelet therapy
      in patients with diabetic retinopathy. DATA EXTRACTION: Emphasis is on findings
      from large, multicenter, randomized, controlled studies. DATA SYNTHESIS: Surgery
      is effective in three clinical situations: Panretinal (scatter) photocoagulation
      is effective treatment for proliferative retinopathy that is likely to progress
      to severe visual loss, with such therapy resulting in a 50% to 60% decrease in
      the main outcome (visual acuity of 5/200 or less; focal photocoagulation
      decreases the incidence of deterioration of visual acuity by 60% in patients with
      clinically significant macular edema, but no benefit of photocoagulation has been
      shown in patients with mild-to-moderate background diabetic retinopathy; and
      vitrectomy is effective in improving visual acuity only in patients with severe,
      complicated proliferative retinopathy. Intensive insulin therapy has not been
      consistently effective in short-term studies with small numbers of subjects.
      Results of the Diabetes Control and Complications Trial should show whether
      intensive insulin therapy affects the course of diabetic complications. Aldose
      reductase inhibitors have not shown efficacy in changing the course of diabetic
      retinopathy. Results of trials using antiplatelet agents are controversial.
      CONCLUSIONS: Current therapy of diabetic retinopathy is based on detection and
      surgical treatment of advanced lesions. Medical interventions that effectively
      halt the progression or prevent the development of diabetic retinopathy are
      needed.

PMID- 1616218
TI  - Cough and angioneurotic edema associated with angiotensin-converting enzyme
      inhibitor therapy. A review of the literature and pathophysiology.
AB  - OBJECTIVE: To review available information on cough and angioneurotic edema
      associated with angiotensin-converting enzyme (ACE) inhibitors. DATA SOURCES: All
      relevant articles from 1966 through 1991 were identified mainly through MEDLINE
      search and article bibliographies. STUDY SELECTION: More than 400 articles were
      identified; 200 reporting incidence or possible mechanisms for the side effects
      or both were selected. DATA EXTRACTION AND SYNTHESIS: All pertinent information,
      including incidence and mechanisms of ACE inhibitor-induced cough and angioedema,
      was reviewed and collated. CONCLUSIONS: Cough occurs in 5% to 20% of patients
      treated with ACE inhibitors, recurring with reintroduction of the same or another
      ACE inhibitor. It is more common in women. The mechanism may involve accumulation
      of prostaglandins, kinins (such as bradykinin), or substance P (neurotransmitter
      present in respiratory tract C-fibers); both bradykinin and substance P are
      degraded by ACE. A 4-day trial of withdrawal of the ACE inhibitor or temporary
      substitution of another class of antihypertensive agent inexpensively and easily
      ascertains if the ACE inhibitor caused the cough. Change to another ACE inhibitor
      or additive therapy with nonsteroidal anti-inflammatory drugs is not recommended.
      Prompt recognition of ACE inhibitor-related cough can prevent unnecessary
      diagnostic testing and treatment. Angioedema occurs in 0.1% to 0.2% of patients
      receiving ACE inhibitors. The onset usually occurs within hours or, at most, 1
      week after starting therapy. The mechanism may involve autoantibodies,
      bradykinin, or complement-system components. Treatment involves first protecting
      the airway, followed by epinephrine, antihistamines, and corticosteroids if
      needed. Therapy is then resumed with an alternate class of antihypertensive
      agent.

PMID- 1616219
TI  - National Study of Internal Medicine Manpower: XIX. Trends in internal medicine
      residency training programs.
AB  - The National Study of Internal Medicine Manpower (NaSIMM) reports on the results
      of its 1989-1990 census of residency programs. The results are integrated into an
      organizational model identifying inputs, process, outputs, and environment of
      medical training programs. The number of residents entering internal medicine
      continues to grow at a relatively rapid pace. This growth is largely accounted
      for by foreign citizens who are graduates of foreign medical schools (AFMGs).
      Residents are spending an increasing proportion of their time in ambulatory care
      settings, but, thus far, this ambulatory care training has occurred primarily in
      hospital clinics and emergency rooms. The proportion of a program's residents
      entering general internal medicine was found in a multiple regression analysis to
      be negatively associated with the number of subspecialty programs located in the
      training hospital, the percent of AFMG residents in the program, and the presence
      of a preliminary track in the program.

PMID- 1616220
TI  - A leap of faith. What can we do to curtail intrainstitutional transmission of
      tuberculosis?
AB  - Large-scale, epidemic transmission of tuberculosis to patients, nonprofessional
      staff, nurses, and physicians has been documented recently in hospitals, clinics,
      acquired immunodeficiency syndrome (AIDS) residencies, and correctional
      facilities. Prominent factors in these outbreaks have included human
      immunodeficiency virus (HIV) infection and AIDS, delayed diagnosis of
      tuberculosis, multidrug-resistant strains of tuberculosis that resulted in
      protracted shedding of mycobacteria, and ventilation patterns in buildings that
      resulted in the accumulation of infectious particles. Multiple deaths from
      tuberculosis have resulted. Various strategies, including vaccines, masks,
      augmented ventilation, air filters, and ultraviolet irradiation have been
      proposed to control this situation. Although no well-controlled studies exist to
      document the utility of any of these modalities, ultraviolet germicidal
      irradiation seems both the best theoretical model and the most practical tactic.
      Ultraviolet systems should be widely deployed throughout high-risk institutions.

PMID- 1616221
TI  - Disconnecting a ventilator at the request of a patient who knows he will then
      die: the doctor's anguish.

PMID- 1616222
TI  - Activism in academic internal medicine.

PMID- 1616223
TI  - Treating sickle cell pain like cancer pain.

PMID- 1616224
TI  - Subcutaneous compared with intravenous heparin for deep vein thrombosis.

PMID- 1616225
TI  - Subcutaneous compared with intravenous heparin for deep vein thrombosis.

PMID- 1616226
TI  - Subcutaneous compared with intravenous heparin for deep vein thrombosis.

PMID- 1616227
TI  - Subcutaneous compared with intravenous heparin for deep vein thrombosis.

PMID- 1616228
TI  - TIPS and variceal bleeding.

PMID- 1616229
TI  - Alpha-interferon-induced nodular rheumatoid arthritis in renal cell carcinoma.

PMID- 1616230
TI  - HIV infection in the workplace: protecting the vulnerable.

PMID- 1616231
TI  - Covering for impaired residents.

PMID- 1616232
TI  - ACP practice guidelines.

PMID- 1616233
TI  - Medical use of marijuana.

PMID- 1616234
TI  - Medical use of marijuana.

PMID- 1616235
TI  - [Current techniques for investigating exocrine pancreatic function in children].
AB  - The exocrine pancreas produces many of the enzymes responsible for the digestion
      of food. Severe alterations in exocrine pancreas function cause malabsorption
      which predominantly affects fats. Unfortunately, because it is a deep organ the
      pancreas is a difficult target for investigations. A large number of diagnostic
      tests have been developed to gather information on pancreatic function with
      minimal invasiveness. Although helpful in everyday practice, each of these
      methods investigates only one of the multiple components of pancreatic secretory
      function and all are relatively insensitive, i.e., detect only severe secretion
      deficiencies. Furthermore, none of these tests can evaluate water and electrolyte
      secretion. Consequently, invasive duodenal juice studies with stimulation remain
      the "gold standard" for evaluating exocrine pancreas function.

PMID- 1616236
TI  - [Outcome of children of alcoholic mothers (study of 105 cases followed to adult
      age) and various prophylactic findings].
AB  - Thirty years after recognition of the fetal alcohol syndrome, a study of 105
      affected individuals who reached adulthood provides insight into the long-term
      outcome of this condition. The typical facial dysmorphism undergoes odd changes,
      often with a long face and a bulky nose and chin, in contrast to the appearance
      of affected infants. The growth failure becomes slightly less marked. The
      malformations, which occur in 3/4 of severe forms, increase the disability
      although function is sometimes better than expected. In contrast, the
      microcephaly becomes more pronounced. This explains the psychic disorders which
      are the main prognostic factor: mental retardation in the most severely affected
      patients or severe learning disabilities and, in every case, behavior disorders
      and marked instability. Similar disorders are often found in siblings with no
      apparent dysmorphism underlining the extent of the problem and the urgent need
      for prophylaxis. Some of the observations made in adults, confronted to
      embryologic data, lead to useful inferences with respect to prophylaxis.

PMID- 1616237
TI  - [Value of accelerated hyposensitization with mixed allergens in severe childhood
      asthma].
AB  - The value (in terms of decreased numbers of attacks and of hospitalizations for
      attacks, decreased need for asthma medications, and improved tolerance to
      allergens) of rush immunotherapy to a mixture of allergens was studied in
      children with multiple sensitizations and severe asthma (as evaluated on the
      number of attacks, number of hospitalizations, and dependence on corticosteroids)
      already receiving optimal medical therapy. Because syndromic reactions are
      common, rush immunotherapy should be performed in the hospital and premedication
      with corticosteroids may be warranted in the most severe cases.

PMID- 1616238
TI  - [Dopa-sensitive muscular dystonia. Segawa's syndrome. A case report].
AB  - A four-year-old girl developed difficulty in walking due to dystonia of the right
      then left foot, rest tremor in both hands, and rigidity. These symptoms worsened
      upon exertion and in the evening and were remarkably responsive to L. dopa,
      suggesting the diagnosis of fluctuating muscular dystonia or Segawa syndrome.

PMID- 1616239
TI  - [Tracheal compression by an aberrant brachiocephalic trunk: diagnosis by magnetic
      resonance].
AB  - In a full-term infant who underwent surgery for type III esophageal atresia,
      attempts to remove the tracheal tube postoperatively failed. Bronchoscopy
      disclosed external compression of the trachea in the chest. Selection of the
      investigations most likely to provide the etiologic diagnosis was discussed.
      Because of the patient's poor general condition, MRI of the mediastinal area was
      performed first and showed an abnormal origin of the brachiocephalic trunk which
      was the cause of tracheal compression. No attempt at corrective surgery was made
      and the patient was successfully extubated at four months of age.

PMID- 1616240
TI  - [Skin manifestations revealing monocytic leukemia. A case report].
AB  - A three-month-old developed a deep nodule over the elbow, then two weeks later
      additional nodules over the trunk with enlargement of the liver and spleen.
      Examination of the bone marrow established the diagnosis of monocytic leukemia.
      Acute monocytic leukemia is the most common leukemia in infants. Skin lesions,
      visible as red, brown or purple nodules ("blueberry muffin lesions") and
      confluent areas of purpura are common and may occur as the first manifestations
      of the disease. These skin lesions are not specific of leukemia and other
      diagnoses should be considered including histiocytosis, neuroblastoma, and skin
      erythropoiesis (in Torch syndrome, hemolytic disease of the newborn, hereditary
      spherocytosis, and twin-to-twin transfusion syndrome).

PMID- 1616241
TI  - [Case report of skin manifestations in infantile Mediterranean kala-azar].
AB  - The case of a 19-month-old girl with visceral leishmaniasis and unusual skin
      manifestations is reported. Emphasis is put on the fact that such manifestations
      are unusual in Mediterranean infantile leishmaniasis. The clinical features,
      parasitology, histology, and course of these skin lesions are discussed.

PMID- 1616242
TI  - [Association of Hbo Arab/beta-thalassemia discovered fortuitously in 2 brothers].
AB  - A four-year-old boy admitted for fever and a skin rash was diagnosed as having a
      rickettsial infection. Regenerative microcytic anemia and enlargement of the
      spleen were also found. Hemoglobin electrophoresis and a family study disclosed a
      combination of two heterozygous hemoglobinopathies, i.e., HbO Arab and beta
      thalassemia. A male sibling had the same anomalies as the index patient and was
      free of symptoms.

PMID- 1616243
TI  - [X-ray findings in pulmonary tuberculosis in children and its complications].
AB  - Pulmonary tuberculosis is still a common disease in children, especially those of
      immigrant families. Prevention and diagnosis rest on the plain chest film which
      should remain the first step of the work-up. Apart from cerebromeningeal
      complication, CT scan is also useful for evaluating chest lesions including
      mediastinal lymphadenopathies and lung parenchyma involvement. CT scan combined
      with endoscopy ensures detection of complications including bronchogenic
      dissemination. With a few cases as illustrations, the role of roentgenographic
      investigations in the management of pediatric tuberculosis is outlined.

PMID- 1616244
TI  - [A retrospective study of preadoption x-ray findings in young children at the
      Social Child Aid: value and limitations].
AB  - French law requires that children awaiting adoption undergo full medical
      evaluation to detect anomalies which may influence decisions concerning adoption.
      As part of this evaluation, all infants admitted to the Saint-Vincent-de-Paul
      Preadoption Center in Paris undergo roentgenographic evaluation including frontal
      and lateral films of the skull, a frontal chest film, a frontal view of the
      pelvis, and frontal films of one upper limb and one lower limb. A study of the
      one hundred most recent evaluations, carried out in infants aged 1 to 14 months,
      disclosed 16 roentgenographic anomalies. Five of these anomalies were already
      known prior to the evaluation, 2 did not give rise to additional investigations,
      and 9 led to additional tests, a change of therapy or subsequent radioclinical
      monitoring. Among the six films taken in each patient, only the frontal views of
      the chest and pelvis proved informative. Screening using these two roentgenograms
      only is recommended, with other roentgenograms being performed if called for on
      the basis of clinical findings.

PMID- 1616245
TI  - [Spa treatment in pediatric pneumo-allergology and ENT].
AB  - Each year in France, 42,000 children receive spa therapy, which is covered by the
      national health care insurance system. In over three cases out of four, the
      treatment is ordered by the child's physician for respiratory tract disease which
      fails to respond adequately to conventional therapy. Asthma, recurrent
      bronchitis, and spasmodic cough are the main indications in pneumo-allergology;
      seromucous otitis media, naso-sinusitis and refractory pharyngitis are the most
      common pediatric ENT diseases treated in spa centers. The two main types of
      mineral water used are sulfur-rich waters in patients with prominent infection
      and chloride and bicarbonate-rich waters when allergy is the main problem.
      Experimental studies point to the fact that these waters have immunomodulating
      effects. However, other therapeutic interventions in spa centers, including
      rehabilitation and health education, also play a role. Evaluations of spa therapy
      for respiratory tract diseases carried out by government agencies have
      demonstrated decreases in school absenteeism and above all in the use of drugs in
      treated patients. The future of pediatric spa therapy will likely depend on the
      development of preventive interventions in spa centers.

PMID- 1616246
TI  - [Respiratory infections: germs sensitive to cefaclor].

PMID- 1616247
TI  - [Cerebral arteriovenous malformations in a probable familial form of Rendu-Osler
      disease].
AB  - Cerebral arteriovenous malformations with neonatal manifestations are infrequent
      and virtually always fatal. Heart failure with an intracranial bruit is the most
      common presentation. Exceptionally, the aneurysm is a manifestation of Rendu
      Osler-Weber syndrome which is inherited on an autosomal dominant basis.
      Development of cerebral arteriovenous malformations occurs very early as
      demonstrated by the discovery of two aneurysms with major repercussions on the
      cerebral parenchyma in a female with severe prematurity. Pregnant women with
      suspected Rendu-Osler-Weber syndrome should undergo ultrasound studies targeted
      at identifying untreatable cerebral lesions antenatally.

PMID- 1616248
TI  - [Imerslund-Najman-Grasbeck anemia. Apropos of a case].
AB  - Imerslund-Najman-Grasbeck anemia is an infrequent disease with an autosomal
      recessive pattern of inheritance. The characteristic anomaly is selective
      malabsorption of vitamin B12 by the ileal mucosa. Diagnosis rests on a positive
      family history and on the demonstration of megaloblastic anemia with proteinuria.
      The proteinuria is due to glomerular dysfunction with mesangial proliferation.
      Management rests on lifelong parenteral administration of vitamin B12. A case of
      Imerslund anemia with a favorable outcome under vitamin B12 treatment is
      reported.

PMID- 1616249
TI  - [Tumoral calcinosis. Apropos of a further case in a child].
AB  - Tumor-like calcinosis is an infrequent condition whose etiology is poorly
      understood. Calcifications develop in the subcutaneous tissue neighboring the
      large joints. All age groups can be affected, although the disease is more common
      before the age of twenty years. A new case of tumor-like calcinosis in an eight
      year-old girl is reported here. A huge mass in the right hip region and a smaller
      mass around the right elbow were found. Biologic studies revealed increased serum
      phosphorus levels with normal serum calcium levels. Roentgenograms confirmed the
      diagnosis of tumor-like calcinosis by showing calcified masses independent from
      the bones of the neighboring joint. Management consisted in complete removal of
      both masses. Outcome was favorable. In this patient's family, the disease appears
      to be inherited according to a dominant pattern, although recessive autosomal
      transmission is believed to be more common.

PMID- 1616251
TI  - [School physician and rhythms of schoolchildren's life].
AB  - The common occurrence of chronic fatigue among schoolchildren raises questions
      concerning sleep requirements and desirable daytime activity schedules in growing
      children. Several practical situations including inadequate sleep time, irregular
      sleeping hours, and lack of synchronization of activities and daytime biological
      periodicity are described. The inadequate attention given to these needs by
      families and society require widespread repeated diffusion of clear, short
      educational messages in order to improve the well-being of children.

PMID- 1616250
TI  - [Mobius syndrome and bilateral chorioretinal coloboma].
AB  - A child with palsy of the right facial nerve and bilateral palsy of the VIth,
      IXth and XIIth cranial nerves, dysfunction of the VIIIth cranial nerve, facial
      malformations and bilateral equinovarus was diagnosed on the basis of these
      features as having Moebius syndrome. Ocular studies disclosed congenital cataract
      and chorioretinal coloboma in both eyes. These ocular abnormalities have not
      previously been described in Moebius syndrome. This paper discusses whether the
      coexistence of these two types of anomalies may be due to occurrence of a break
      in the primitive internal carotid and trigeminal arteries between the fourth and
      fifth postconceptional weeks, causing maldevelopment of the choriocapillary and
      impairing neuron differentiation in cranial nerve nuclei.

PMID- 1616252
TI  - [Medical language and communication with children: psycho-ethical aspects].

PMID- 1616253
TI  - [Therapeutic evaluation of Mormoiron attapulgite in acute diarrheas of infants
      and children. A multicenter study in controlled liberal practice versus placebo
      in 113 patients].
AB  - A placebo-controlled multicenter study was carried out to evaluate the
      effectiveness and safety of Actapulgite in infants and children with acute
      diarrhea. One hundred and thirteen patients, with a mean age of 28 months, were
      enrolled by pediatricians in the office. As recommended during acute diarrhea,
      the dosage of Actapulgite was doubled during the first three treatment days (2 to
      4 packets a day according to the patient's weight), and reduced by half
      thereafter. The main effectiveness criteria was passage of the first normally
      formed stool, which denotes normalization of intestinal transit time. The first
      normally formed stool was recorded after two days of treatment with Actapulgite
      and was followed, on the next day, by a second normal stool, denoting complete
      recovery. The greater effectiveness of Actapulgite as compared with the placebo
      was demonstrated by the fact that both the first and the second normally formed
      stools were passed one day earlier with the active treatment (p = 0.01 and p =
      0.002, respectively). In addition, resumption of a normal diet occurred
      significantly earlier with Actapulgite (4.4 days) than with the placebo (5.1
      days). In addition to being effective, the study drug proved remarkably well
      tolerated. This study is especially valuable because of its office setting and
      the use of exclusively clinical criteria with a strict methodology.

PMID- 1616254
TI  - Palpation of peripheral pulses: a difficult art.

PMID- 1616255
TI  - An insight into Dupuytren's contracture.
AB  - Dupuytren's contracture is a deforming, fibrotic condition of the palmar fascia
      which has confounded clinicians and scientists since the early descriptions by
      Guillaume Dupuytren in 1831. It predominantly affects elderly, male caucasians,
      has a hereditary predisposition and has strong associations with diabetes,
      alcohol consumption, cigarette smoking and HIV infection. The major morphological
      features are an increase in fibroblasts, particularly around narrowed
      fibroblasts; a finding consistent with localised ischaemia. During ischaemia,
      adenosine triphosphate (ATP) is converted to hypoxanthine and xanthine, and
      endothelial xanthine dehydrogenase to xanthine oxidase (alcohol also mediates
      this change, a finding of particular relevance given the association of
      Dupuytren's contracture with alcohol intake). Xanthine oxidase catalyses the
      oxidation of hypoxanthine to xanthine and uric acid with the release of
      superoxide free radicals (O2-), hydrogen peroxide (H2O2) and hydroxyl radicals
      (OH.). These free radicals are highly reactive, with half-lives in the order of
      milliseconds and are toxic in high concentrations. A potential for free radical
      generation in Dupuytren's contracture was elicited by finding a sixfold increase
      in hypoxanthine concentrations in Dupuytren's contracture compared with control
      palmar fascia. In vitro studies affirmed the toxic effects of oxygen free
      radicals to Dupuytren's contracture fibroblasts, but also showed that, at lower
      concentrations (concentrations similar to those likely to occur in Dupuytren's
      contracture), free radicals had a stimulatory effect on fibroblast proliferation.
      Cultured fibroblasts were found to release their own O2-. These endogenously
      released free radicals were also found to be important in fibroblast
      proliferation. The collagen changes of Dupuytren's contracture were examined. The
      results established that fibroblast origin was unimportant, but that inhibition
      of type I collagen production at high fibroblast density accounted for the
      increase in type III/I collagen ratios observed by previous investigators. These
      biochemical and morphological observations throw new light on Dupuytren's
      contracture. They suggest that age, genetic and environmental factors may
      contribute to micro vessel narrowing with consequent localised ischaemia and free
      radical generation. Endothelial xanthine oxidase derived free radicals may both
      damage the surrounding stroma and stimulate fibroblasts to proliferate.
      Proliferating fibroblasts lay down and contract collagen in lines of
      stress.Progressive fibroblast proliferation and deposition of collagen is likely
      to encourage further microvessel narrowing with a positive feedback effect
      consistent with the progressive nature of the condition.

PMID- 1616256
TI  - Hand surgery requirements in an average sized district general hospital.
AB  - To estimate the overt need for hand surgery in an average sized district general
      hospital and to assess the resources required to meet this need, data were
      collected prospectively on all new trauma and elective patients presenting from 1
      June to 30 November 1989 to the Derby Hand Unit, Derbyshire Royal Infirmary,
      Derby. In all, 1740 new patients with hand disorders (1082 trauma and 658
      elective) were seen. All were followed up for 6 months or until discharge. Based
      on the Derby Hand Unit practice, the overt need for hand surgery in an average
      sized district general hospital was estimated and the resources required to
      satisfy this need were defined. Such a hospital serving a population of 250,000
      should expect about 23 new trauma patients and 17 new elective patients each
      week. To service this demand requires between three and six outpatient clinics,
      between three and eight inpatient beds and three operating sessions each week.
      The net annual cost of such a service in 1989-1990 would be 318,753 pounds.

PMID- 1616257
TI  - Should we palpate foot pulses?
AB  - Palpation of foot pulses is traditionally used to evaluate patients with arterial
      disease. This study investigated observer variation in assessment of pedal
      vessels by pulse palpation and Doppler auscultation. A series of 33 claudicant
      patients and five controls were examined by a consultant, registrar, SHO and
      nurse. Dorsalis pedis (DP) and posterior tibial (PT) pulses were palpated and
      were then examined by Doppler with measurement of systolic pressures. CONTROL
      GROUP: No disagreement in DP pulses. However, all observers agreed on the
      presence of a PT pulse in only 70% of limbs. Claudicants: There was better
      agreement in palpation of the DP pulse (all observers agreed in 67% of limbs),
      than the PT pulse (all agreed in 53%). This suggests that the DP pulse is easier
      to palpate than the PT (P less than 0.05). By contrast there was better agreement
      on Doppler signals from the PT artery, all agreed in 78% of limbs; compared with
      the DP artery, all agreed in 58% (P less than 0.01). Pressure measurements by the
      observers agreed to within +/- 0.15 in 88% of claudicant and 100% of control
      limbs. Pedal pulse palpation in patients with arterial disease is subject to
      substantial observer error. Doppler pressure measurement is preferable unless
      pulses are bounding.

PMID- 1616258
TI  - Peripheral pulse palpation: an unreliable physical sign.
AB  - Fifty observers, including two fully trained vascular surgeons, were asked to
      determine the presence or absence of the femoral and distal pulses of four
      patients with peripheral vascular disease and one asymptomatic subject (50 pulses
      assessed). Pulses felt by both vascular surgeons were deemed to be palpable.
      Among the other observers, the sensitivity of palpation was 95% or over for the
      femoral pulse, but 33% to 60% for observers of varying experience feeling for the
      posterior tibial pulse. Up to 20% false-positive observations were reported.
      Disease was diagnosed in over 10% of examinations of healthy limbs and was missed
      in over 10% of symptomatic limbs. The accuracy of pulse palpation was strongly
      correlated with the systolic blood pressure in the underlying artery. Accuracy
      was greater among more experienced observers, suggesting that careful teaching of
      this skill is likely to be beneficial. Even so, pulse palpation alone is an
      unreliable physical sign and should only be used in combination with objective
      measurements as a guide to clinical management.

PMID- 1616259
TI  - The prognostic value of nucleolar organiser regions in colorectal cancer: a 5
      year follow-up study.
AB  - Nucleolar organiser regions (AgNORs) are loops of ribosomal DNA which reflect the
      cellular activity or malignant potential of the cell and are identified by a
      specific staining technique. The purpose of this study was to assess the
      prognostic value of AgNORs in colorectal cancer and to compare it with other
      accepted prognostic methods. We studied 164 patients who were surgically staged
      for colorectal cancer and who had complete follow-up data available for 5 years.
      Using a highly specific silver staining and counting technique each patient was
      given an AgNOR score. There were 5 Dukes' C tumours, 108 were Dukes' B and 5 were
      Dukes' A. No cancer deaths occurred in patients with Dukes' A tumours. The
      incidence of well-differentiated, moderately-differentiated and poorly
      differentiated tumours was 37.2%, 53.7% and 9.1%, respectively. Non-survivors had
      significantly higher AgNOR scores compared with survivors (mean value +/- SD,
      14.2 +/- 0.9 vs 8.2 +/- 0.6, P less than 0.0001). In a regression analysis model
      AgNOR score was the most significant individual variable for predicting survival
      (chi 2 = 15, P less than 0.01) when compared with Dukes' classification,
      histological grade, tumour depth or vascular invasion.

PMID- 1616260
TI  - Does surgical experience influence mastectomy complications?
AB  - Mastectomy remains the most commonly performed surgical procedure for breast
      cancer, and complications such as infection or wound breakdown (which may relate
      to the experience of the operator) could expensively prolong hospital stay and
      retard the administration of additional therapy. We examined the complications,
      hospital stay and cost of therapy of total mastectomy and axillary node clearance
      in 164 women, comparing these between four grades of surgeon: registrar (67
      operations), senior registrar (58), part-time consultant (21) and professor (18).
      Our policy, for local reasons, was to perform mastectomy whenever possible rather
      than select lesser surgical or non-surgical management options. There was no
      significant difference between operators when the percentage of seromas requiring
      aspiration (9, 3, 5, 6), infection (16, 7, 23, 11), or wound breakdown (7, 3, 5,
      6) were compared. Neither the length of hospital stay (9.3 +/- 6.9, 8.2 +/- 4.7,
      9 +/- 7.3, 9.2 +/- 11.2 days), nor cost (2005, 1939, 1966, 1927 rands) differed.
      Surgical experience did not significantly influence mastectomy complications.

PMID- 1616261
TI  - Non-specific abdominal pain: the resource implications.
AB  - Non-specific abdominal pain (NSAP) is responsible for a significant proportion of
      emergency surgical admissions with resultant resource implications. The extent of
      the problem was assessed in a consecutive group of 100 patients, aged between 15
      and 35 years, admitted with lower abdominal pain to one general surgical firm. No
      less than 67 of these patients (67%) were diagnosed as having NSAP (13.29% of all
      general surgical admissions), most (75%) being female and having a mean hospital
      stay of 4.1 days. Only 11 patients (11%) had appendicitis and the remaining 22
      had miscellaneous gynaecological, urological or gastrointestinal problems.
      Detailed analysis of the resources used revealed that the mean cost to the NHS of
      each case of NSAP was 807 pounds, the bulk of which was attributable to the
      hospital stay. Wider assessment of the problem (by means of postal questionnaire)
      suggests that the cost to the NHS in Wales is in the region of 6 million pounds
      per year and may be over 100 million pounds per year in the UK as a whole.

PMID- 1616262
TI  - Carcinoma of the major salivary glands.
AB  - The results of a prospective survey of planned management of 28 primary
      carcinomas of the parotid, and five primary carcinomas of the submandibular gland
      over a period of 22 years are discussed. High- and low-grade carcinomas are
      distinguished and less radical treatment for the latter appears justified.

PMID- 1616263
TI  - Use of disposable skin staplers for bowel anastomosis to reduce laparotomy time
      in war.
AB  - Laparotomy for penetrating wounds to the abdomen is demanding in terms of time,
      skill and resources. Any modification of existing techniques that will lessen
      these demands will be of benefit at surgery in forward areas in war. A previous
      paper (1) compared a method of small bowel anastomosis using disposable skin
      staplers with a two-layer handsewn anastomosis using fresh pig ileum. The stapled
      method was both significantly faster to perform and mechanically superior. In two
      further studies on a total of 12 pigs the stapled method has been compared with a
      single-layer and a double-layer handsewn small bowel anastomosis. All 12 pigs
      recovered from laparotomy without complication. Construction times were recorded.
      The quality of healing of the anastomoses was assessed by clinical observation,
      post-mortem and histological examination, and tensiometry. The skill required to
      perform the stapled anastomoses was estimated subjectively. The stapled technique
      was consistently faster than the handsewn methods. A Kolmogorov two-sample test
      showed an improvement in times when comparing the stapled method with the single
      layer, with a significance of P = 0.05. An improvement was also seen when the
      stapled method was compared with the double layer, with a significance of P =
      0.01. There was no statistically significant difference between the construction
      times for the two handsewn methods. There was no evidence of anastomotic failure
      or haematoma at post-mortem and no adverse reaction to the metal staples. No
      features were identified on histology to indicate impaired healing with the
      stapled method. Tensiometry of the anastomoses showed that the stapled
      anastomosis is as mechanically reliable as the handsewn anastomosis. The level of
      skill required to perform the stapled anastomosisis judged to be within the
      capabilities of relatively junior surgeons once the technique has been mastered
      in an anastomosis workshop.

PMID- 1616264
TI  - Audit of 200 consecutive aortic aneurysm repairs carried out by a single surgeon
      in a district hospital: results of surgery and factors affecting outcome.
AB  - It has been suggested that surgery for abdominal aortic aneurysm (AAA) be
      confined to designated centres. A prospective audit of 200 consecutive AAA
      repairs at a district general hospital was performed between 1981 and 1990. The
      30-day mortality rates for elective, symptomatic and ruptured aneurysm repair
      were 1.4%, 3.5% and 30%, respectively. The major factor affecting outcome after
      the mode of presentation was the age of the patient, with 30-day mortality rates
      for emergency treatment increasing from 21% (age range 60-69 years) to 42% (age
      range 70-79 years). This mortality rate for ruptured aneurysms is an
      underestimate, with two-thirds of patients with rupture dying before reaching
      hospital and some patients dying in hospital undiagnosed. The major contribution
      to improved overall mortality would therefore be detection before rupture
      (usually by ultrasound) and improved diagnostic accuracy. Many patients with
      ruptured aneurysms had symptoms for only a short period before presentation (42%
      for less than 6 h) and required urgent surgery (26% reached theatre within 1 h).
      These two factors make long-distance transfer of these patients an unrealistic
      option. The concentration of this type of surgery in relatively few centres will
      distance the patient from their relatives and reduce the opportunity for the
      majority of junior doctors to acquire an understanding of the presentation,
      natural history and management of aortic aneurysms. This understanding when
      combined with a screening programme is likely to have a far greater impact on the
      overall mortality from AAA than restricting the centres for surgical treatment.

PMID- 1616265
TI  - Care of road traffic accident victims in a district general hospital.
AB  - It has been suggested that 20-33% of trauma related deaths are preventable. The
      Accident and Emergency Department of Luton and Dunstable Hospital, therefore, set
      out to examine its own performance and to attempt to highlight areas of possible
      improvement. The department sees 65,851 new patients per annum, 3936 of these
      were victims of road traffic accidents (RTA). There were 184 patients admitted
      and six died. One death was considered preventable; shortcomings were noted with
      delay in availability of services. It is recommended that early assessment by
      experienced clinicians and easy access to theatre facilities and diagnostic
      imaging be available in district general hospitals to improve the quality of care
      for trauma victims.

PMID- 1616266
TI  - Six hundred patients with gallstones.
AB  - A total of 610 patients with gallstones were treated over an 8-year period in a
      single surgical unit. Of these patients, 384 had cholecystectomy, 86 surgical
      duct exploration and 140 endoscopic sphincterotomy. Four patients died after
      cholecystectomy (1%), but there were no deaths after the treatment of duct
      stones. The proportion of patients with duct stones having endoscopic
      sphincterotomy with the gallbladder in situ rose considerably during the 8-year
      period, from about 20% to 75%. Gallstones tend to present in the elderly as duct
      stones, and in the young as gallbladder stones. The majority of patients over 75
      years of age had endoscopic sphincterotomy, whereas the younger patients were
      usually treated surgically.

PMID- 1616267
TI  - Primary carcinoma of the gallbladder: a 10-year experience.
AB  - New developments in the management of gallstone disease, and particularly
      percutaneous and extracorporeal treatments that leave the mucosa intact, have
      renewed interest in the relationship between cholelithiasis and carcinoma. These
      treatments are both available in our hospital and to examine this question we
      studied the patients presenting between 1980 and 1990 with gallbladder cancer.
      The study comprised 21 patients with histologically proven carcinoma. The M:F
      ratio was 1:4 with a mean age of 76 years. Gallstones were present in 18 patients
      (85.7%). Ten patients remain alive today and in the 11 who died the median
      survival was 4 months. A preoperative diagnosis was made by ultrasound in only
      two patients. The lack of a preoperative diagnosis in the majority of patients is
      clearly a cause for concern and while our figures, like other series, do not
      establish a causal relationship with gallbladder carcinoma, it is vital to be
      diligent in the follow-up of high-risk patients (stones greater than 3 cm) with
      intact gallbladder mucosa after the treatment of stone disease.

PMID- 1616268
TI  - Assessment of burn injury in the accident and emergency department: a review of
      100 referrals to a regional burns unit.

PMID- 1616269
TI  - Control of presacral bleeding in rectal surgery.

PMID- 1616270
TI  - Application of the laryngeal mask airway to thyroid surgery and the preservation
      of the recurrent laryngeal nerve.

PMID- 1616271
TI  - Application of the laryngeal mask airway to thyroid surgery and the preservation
      of the recurrent laryngeal nerve.

PMID- 1616272
TI  - Prevention of occupational transmission of HIV in the ENT clinic.

PMID- 1616273
TI  - Contamination of underwater seal drainage systems in thoracic surgery.

PMID- 1616274
TI  - Assessment of the use of disposable skin staplers to reduce laparotomy time in
      penetrating ballistic injury of the abdomen.

PMID- 1616276
TI  - Coloproctology--a specialty in transition.

PMID- 1616275
TI  - Dilemmas in providing a vascular surgical service.

PMID- 1616277
TI  - Should surgical services be ringfenced?

PMID- 1616278
TI  - How to improve communication between the fellowship and the college.

PMID- 1616279
TI  - Surgical training.

PMID- 1616280
TI  - Senior registrars in general surgery.

PMID- 1616281
TI  - A new method for calculation of height centiles for preadolescent children.
AB  - A new method of calculation of cross-sectional attained height centiles is
      proposed. This exploits the variance-stabilizing transformation, which has the
      form log(a+b height) up to age 11 years. Residuals of transformed height about
      the expected value for age are antilogged to give a single Gaussian distribution
      from which centiles can be calculated. In contrast to previous methods the
      standard errors of the centiles can be estimated without imprecise adjustment for
      smoothing. The parameters a and b of the transformation do not need precise
      estimation and the method can be used for population subgroups from which large
      samples cannot be obtained.

PMID- 1616282
TI  - An abnormal concentration of cases of Rendu-Osler disease in the Valserine valley
      of the French Jura: a genealogical and demographic study.
AB  - An important concentration of patients with Rendu-Osler disease occurs in the
      Valserine valley of the French Jura. A study of marriages shows that, in spite of
      its somewhat remote location, the valley cannot be considered an isolate, but
      that, on the contrary, exogamy is widely practised. Only 17.8% of the genes of
      inhabitants during the present century can be traced to the original population,
      but persons affected with the disease belong to a subgroup of the population
      which has lived in the villages for more than 10 generations. All the patients in
      85 sibships are related. The smallest number of originator couples who lived at
      the beginning of the eighteenth century amounts to 16, the unique originator may
      therefore have lived approximately four generations earlier. However, as other
      patients who lived at the periphery of the Valserine valley do not appear to be
      related to any patients living in the valley, and because there has been
      considerable immigration into the valley, a number of hypotheses to explain the
      distribution of the disease in the region remain possible.

PMID- 1616283
TI  - Secular change in the growth and development of Han children in China.
AB  - This paper reports the secular change in physical growth and development of Han
      children in 12 Chinese metropolitan cities including Beijing, Tianjing, Shanghai,
      Jinan, Harbin, Shenyang, Changchun, Nanjing, Hangzhou, Wuhan, Guangzhou, and
      Chengdu. Based on a recent national survey of 14,688 healthy schoolchildren, aged
      7-18 years, and together using the historical records of healthy schoolchildren
      as secondary data source, this study found a secular change in the growth and
      development of Chinese children and youth. In every decade between the 1950s and
      1985 the average height increased by 2.66 cm (range 1.78-3.77) for boys and 2.40
      cm (range 1.72-3.76) for girls, and the average weight increased by 1.64 kg
      (range 1.28-2.63) for boys and 1.14 kg (range 0.63-2.01) for girls in the 12
      cities. In the last decade from the 1970s to 1985, the height and weight
      increments were highest in Beijing, Jinan, Shenyang and Shanghai. In addition,
      the increments were higher during the peak growth years than during other periods
      of growth. In the 30 years studied, the ages of maximum growth velocity were
      advanced, and they were 1 or 2 years earlier in 1985 than in the 1950s in most
      cities. When compared with the data from the 1930s the results indicate that,
      during the last half-century, height increased by 1.12-2.66 cm per decade for
      boys and 1.42-2.67 cm/decade for girls, while weight increased by 0.56-1.27 for
      boys and 0.65-1.18 kg for girls in Beijing, Shanghai, Nanjing, Hanzhou and
      Guangzhou.

PMID- 1616284
TI  - Estimation of stature from second metacarpal length in Japanese children.
AB  - A relationship between stature and second metacarpal length was examined by means
      of a linear regression for sex, skeletal age and locality in 2056 children aged 6
      19 years in five districts of Japan. Significant differences (p less than 0.05)
      were found for the regression of two measurements between immature and mature
      groups according to the TW2 method. Few significant differences were found in the
      regression with sex and locality in both immature and mature groups. Stature
      could be estimated from second metacarpal length with standard errors of 44mm in
      the immature group and 40mm in the mature group. Furthermore, from the bone
      length and TW2 age, stature could be estimated with a standard error of 38mm for
      each sex in combined groups. These figures are similar to the variability in
      stature at a given age and comparable to reliability of estimates from long
      bones. The second metacarpal length may be a reliable and practical marker in
      children for the estimation of stature by means of a general formula regardless
      of sex and locality in a population.

PMID- 1616285
TI  - Population genetics of coagulation factor XIIIB in three ethnic groups of
      Singapore.
AB  - The distribution of plasma coagulation factor XXIIB polymorphism was determined
      by PAG isoelectric focusing and immunoblotting in a group of 670 subjects
      comprising 375 Chinese, 110 Malays and 185 Indians. The frequencies of FXIIIB*1,
      FXIIIB*2, and FXIIIB*3 were found to be 0.27, 0.03 and 0.70 in the Chinese; 0.33,
      0.05 and 0.64 in the Malays and 0.58, 0.08 and 0.33 in the Indians. The
      phenotypic distribution of FXIIIB alleles was at Hardy-Weinberg equilibrium in
      all three populations. A two-dimensional principal-components analysis on the
      basis of three common alleles at the FXIIIB locus among 19 populations, so far
      studied, clearly differentiates the Negroid, Mongoloid and Caucasoid populations
      into three major groups with the exception of Amerindians (Minnesota) and US
      Blacks showing some Caucasoid influence.

PMID- 1616286
TI  - Vertebral body diameters and sex prediction.
AB  - As a direct consequence of the generally larger body size of the male, it is
      reasonable to expect the adult human vertebral column to display sexual
      dimorphism. However, there is a distinct paucity of literature concerning sex
      related variation in vertebral dimensions. This study examines the accuracy with
      which sex may be predicted from vertebral body diameters. In a sample selected
      from a documental skeletal series, sex could be correctly assigned with an
      accuracy approaching 90%. This degree of sexual differentiation is of value for
      both the forensic and archeological identification of human skeletal remains. An
      interesting relationship was noted between the degree of expression of sexual
      dimorphism and the role of each area of the vertebral body in body weight
      transfer. The posterior aspect of the vertebral body is involved in the
      transmission of body weight both vertically and laterally from the transverse
      processes. This area was consistently less dimorphic than the anterior region of
      the vertebral body, which is more concerned with the transfer of body weight from
      the vertebra above.

PMID- 1616287
TI  - Red cell enzyme and serum protein types in the Watut Anga of Papua New Guinea.
AB  - Historically, the Angan populations of Papua New Guinea have maintained a strong
      isolation and absorbed limited genes from their neighbours. This lack of
      intermixing is reflected in their relatively homogeneous cultural, linguistic and
      genetic profiles. We have determined the electrophoretic variation at 26 red cell
      enzyme, serum protein and haemoglobin loci in the Watut Anga, a splinter group
      occupying the Upper Watut Valley of Morobe Province. Their genetic profile
      reveals the lack of a number-of variants, such as PGM2*10 and MDH*3, known to
      exhibit high frequencies in other highland populations. The average
      heterozygosity in the Watut is also much lower when compared with other Papua New
      Guinean populations. Their present numerical strength notwithstanding, it appears
      that the Angan populations have experienced population bottlenecks in their
      evolutionary history which may have accentuated their genetic divergence from
      other Papua New Guinean populations.

PMID- 1616288
TI  - A new method of deriving velocity and acceleration curves for height from the
      kernel estimation of distance.
AB  - Further development of the optimal kernel (OK) method of growth curve analysis of
      Gasser et al. (1984b) is presented with the aim of eliminating the necessity of
      repeated changes in bandwidth to suit different characteristics of the velocity
      and acceleration curves at varying ages. After using the OK method to obtain a
      distance curve for height, we introduce a new method (VADK) to derive velocity
      and acceleration curves from the fitted distance curve. The results from growth
      data on 16 boys and 15 girls from the Edinburgh Longitudinal Study are presented
      in a preliminary test of this method in comparison with the OK estimation.

PMID- 1616289
TI  - A two-level cross-sectional model using grafted polynomials.
AB  - A new statistical model is proposed for the analysis of hierarchically structured
      cross-sectional growth data, especially for where measurements are made over long
      age ranges. The model combines a two-level model with grafted piecewise
      polynomials, to make efficient use of available data.

PMID- 1616291
TI  - Height growth of adolescent German boys and girls.
AB  - Longitudinal annual height measurements of 46 boys and 47 girls from Dortmund,
      Germany, are used to derive 10 parameters concerning the adolescent growth spurt
      of height. Out of three mathematical models applied to our height data, model 1
      of Preece and Baines (1978) proved most suitable. Data of mean heights at age 9
      and 10 of the boys and girls of this study do not differ from those of another
      representative cross-sectional study of our institute. The values of the 10
      parameters agree with the data of studies from other countries. This work
      contributes original German data to the international data on adolescent growth
      spurt of height.

PMID- 1616290
TI  - Gene diversity and estimation of genetic admixture among Mexican-Americans of
      Starr County, Texas.
AB  - The Mexican-Americans of Starr County, Texas, classified by sex and birthplace,
      were studied to determine the extent of genetic variation and contributions from
      ancestral populations such as Spanish, Amerindian and West African. Using 21
      genetic marker systems, genetic distance and diversity analyses indicate that
      subpopulations of Mexican-Americans in Starr County are similar, and that more
      than 99% of the total gene diversity (HT) can be attributed to individual
      variation within the population. Genetic admixture analysis shows the predominant
      influence comes from the Spanish, a lesser contribution from Amerindians and a
      slight one from the West Africans. The contribution of the ancestral population
      to various subpopulations of the Mexican-Americans of Starr County is similar.
      The Mexican-Americans of Starr County are similar to the Mexican population from
      northeastern Mexico. The history of admixture is apparently old enough to have
      brought the entire Mexican-American gene pool to Hardy-Weinberg equilibrium.
      There is no non-random association of alleles among the genetic marker systems
      considered in the present study, in spite of the fact that this population is of
      admixed origin. These results, in aggregate, suggest genetic homogeneity of the
      Mexican-Americans of Starr County, Texas, and point towards the utility of this
      population for genetic and epidemiological studies.

PMID- 1616292
TI  - Microevolution in Ferrara: isonymy 1890-1990.
AB  - The distribution of surnames in the population of the town of Ferrara, as it
      existed in the memory banks of the Municipality Computer in June 1990, was
      studied by sex, age and place of birth of residents. Random isonymy was studied
      separately in persons born before 1901, and in persons born in the nine decades
      thereafter, ending with the period 1981-90. Isonymy was higher in the older age
      groups studied. Also other indicators of the abundance of surnames in the
      distribution, the common ecological indexes derived from entropy, were calculated
      and compared between age groups. It was found that redundancy, as isonymy, is
      larger in older age classes than in younger classes. Surname effective number was
      defined as the inverse of isonymy corrected for sample size, and it was observed
      that it is practically identical with Fisher's alpha. It was then possible to
      separate random isonymy into two components, so that for sample size N its
      formulation becomes Ir = 1/alpha + 1/N It was found that in Ferrara alpha
      increased significantly in time, indicating enrichment of surnames in the
      population in the century 1890-1990.

PMID- 1616293
TI  - Developmental perspective of pulse rate, blood pressures and vital capacity in
      Chinese children.
AB  - Physiological development in Chinese children was analysed based on a national
      survey sample. Close to half a million children and adolescents, aged 7-18 years,
      from Han and 27 minority nationalities were assessed for pulse rate, systolic and
      diastolic blood pressure, and forced vital capacity in these 12 age groups. The
      factors of age, sex, race, and region (urban/rural, north/south) were analysed.
      P95 hypertension screening standard was established for each age group. These
      results were compared with research reports from world literature.

PMID- 1616294
TI  - Biological age in Italian adults: influence of social and behavioural factors.
AB  - This study investigated changes with age in biological characters in a sample of
      571 Italian males aged between 25 and 64 years. The influence of environmental
      factors on inter-individual variation in physical efficiency was examined by
      biological age determination. Data on somatometric, physiometric, haematological
      variables, personal background and lifestyle, were collected. Principal-component
      analysis was used to study the patterns of relationship in these characters. Over
      45% of the total variance is explained by the ageing process, but the secular
      trend also affects the variation of height and of height-related characters.
      Changes with age were investigated clustering the sample in eight 5-year classes:
      results are in agreement with previous findings in Western populations. Ten
      selected variables were transformed into biological age scores reflecting a man's
      status relative to his chronological age peers (Borkan and Norris 1980a).
      Biological age scores of subsamples characterized by different social and
      behavioural situations were compared. Occupation, educational level and physical
      activity seem to have the greatest influence on biological age status. The
      intensity or duration of some habits can induce a clear trend in biological age
      scores. Results suggest that the environmental influence could be related to the
      interindividual differences in physical efficiency and to the increase in
      variability with age observed for some characters.

PMID- 1616295
TI  - Net mechanical efficiency during stepping in chronically energy-deficient human
      subjects.
AB  - Mechanical efficiency during a step test was measured in chronically energy
      deficient (CED) individuals and compared to well-nourished subjects using a whole
      body indirect calorimeter. The CED group had significantly higher net mechanical
      efficiencies than the well nourished subjects. This was also evident in the 15%
      lower energy costs observed in the CED subjects when expressed as a percentage of
      the predicted data. Factors such as a higher proportion of slow muscle fibres as
      well as a greater ergonometric efficiency may contribute to the observed higher
      muscular efficiency aiding conservation of energy expenditure in these
      individuals.

PMID- 1616296
TI  - Skeletal maturity of the hand and wrist in Chinese children in Changsha assessed
      by TW2 method.
AB  - Skeletal maturity of 2122 normal children aged 2-20 years in the southern Chinese
      city of Changsha have been assessed by the TW2 score method. These mean bone ages
      are lower than the British standards up to puberty and thereafter higher than the
      British standards.

PMID- 1616297
TI  - [Prognostic factors of germinal tumors of the testicle].
AB  - Certain risk factors need to be defined in order to evaluate the risk of
      recurrence during the follow-up of patients with stage I non-seminomatous germ
      cell tumours of the testis. Their respective value was studied in order to adopt
      those suggestive of disease progression. In contrast, in the more advanced stages
      of the disease, it is difficult to define a single attitude due to the variable
      prognostic factors taken into account by different authors.

PMID- 1616298
TI  - [Surgical modalities in germinal tumors of the testicle].
AB  - Radical orchidectomy via a kelotomy incision in the first diagnostic and
      therapeutic procedure in germ cell tumours of the testis. The traditional
      extensive bilateral lymph node dissection responsible for ejaculation failure and
      significant complications has now been replaced by limited lymphadenectomies
      using nerve-sparing and nerve-preserving techniques with a simpler post-operative
      course. The resection of residual masses after chemotherapy should be performed
      as a true lymphadenectomy and is associated with certain difficulties,
      particularly in advanced seminomas.

PMID- 1616299
TI  - [Therapeutic modalities for germinal testicular tumors, excluding surgery.
      Radiotherapy--chemotherapy].
AB  - There are two other treatments for germ cell tumours of the testis apart from
      surgery: radiotherapy and chemotherapy. Radiotherapy is ideally administered with
      a linear accelerator delivering photons and electrons. The dose is well
      established and smaller volumes are now irradiated. The precision is increased by
      CT and by the use of personalized shields. Radiotherapy is indicated in pure
      seminomas, with two exceptions: rare seminomas with a large tumour mass (2%),
      rare palliative indications for non-seminomatous germ cell tumours. Chemotherapy,
      following the progress due to the combination of vinblastine and bleomycin, has
      been based, for the last 10 years, on cisplatin, which must be administered at
      the correct dose. VP 16, ifosfamide and other drugs have also been introduced. In
      forms with a poor prognosis and depending on the clinical course, this
      chemotherapy should be administered at high doses with the protection of
      autologous bone marrow transplantation. This requires an appropriate
      infrastructure and a well trained team. The short-term and long-term effects of
      radiotherapy are more clearly defined than effects of chemotherapy.

PMID- 1616300
TI  - [Therapeutic indications for germinal testicular tumors].
AB  - The therapeutic indications for germ cell tumours of the testis depend on the
      histology (pure seminoma: 45%, non-seminomatous germ cell tumour: 55%), the
      extension and the severity of the prognosis. The well standardised approach to
      pure seminomas is less clear for non-seminomatous germ cell tumours. Stage I,
      IIAB pure seminomas (95 to 98% of cases) should be irradiated. The dose and
      target volume are adapted to prophylactic (I) and curative (II) objectives. Rare
      seminomas with a large tumour bulk should be treated with chemotherapy. Survival
      is close to 100%. Stage I non-seminomatous germ cell tumour offers several
      theoretical possibilities. Radiotherapy is not very popular and chemotherapy
      appears to be to aggressive, lumboaortic lymph node dissection is being replaced
      by new imaging modalities and simple follow-up requires a rigorous and
      disciplined approach. At the Val-de-Grace hospital (France) since 1987, we
      perform simple orchidectomy in favourable stage I disease: 80% are cured with no
      other treatment, 20% relapse and are cured by chemotherapy, in the unfavourable
      stage I cancers (histology, markers) or with uncertain follow-up, limited
      chemotherapy is performed (3 cycles of EP). Stage II and more advanced non
      seminomatous germ cell tumours are divided into moderate forms (IIA, B, III,
      IVL1) and major forms (IIC, IVL2, L3, H+, CNS+). In the exclusive
      infradiaphragmatic involvement of moderate forms, some authors propose bilateral
      lumboaortic lymph node dissection which is invasive surgery with an efficacy
      declining from 90% (IIA) to 50% (IIB). The majority of teams, particularly Val-de
      Grace, administer 3 or 4 courses of BEP followed by assessment (CT scan -
      markers) and salvage surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616301
TI  - [The sexual future of patients cured of testicular cancer].
AB  - The sexual future of patients cured of testicular cancer is a legitimate
      preoccupation due to the high rate of successful treatment for this disease. The
      psychological and functional aspects and the fertility before and after treatment
      of operated patients are reviewed and the least harmful solution is proposed for
      each handicap. The question of induction of new cancers by chemotherapy remains
      unanswered; a number of years of follow-up will be required before an answer can
      be proposed.

PMID- 1616302
TI  - [Nephrotoxicity of cisplatin].
AB  - Cis-diamminodichloroplatinum or cisplatin is one of the most widely used
      antineoplastic agents in oncology, particularly in malignant testicular tumours.
      The administration of this potentially nephrotoxic drug requires certain
      precautions in order to avoid renal damage. Nephrotoxicity generally consists of
      an isolated and transient rise in plasma creatinine, occasionally acute renal
      failure and rarely end-stage renal failure. In a series of twelve patients (mean
      age: 26 +/- 8 years) operated for malignant testicular tumour and treated
      secondarily with a cis-diamminodichloroplatinum based chemotherapy protocol
      (cumulative doses ranging from 490 to 2,275 mg) and submitted to nephrological
      follow-up for 56 +/- 20 months after treatment, no cases of immediate or delayed
      acute renal failure or deterioration in renal function were observed.

PMID- 1616303
TI  - [Special issue devoted to testicular neoplasms].

PMID- 1616304
TI  - [Epidemiology of testicular tumors].
AB  - Testicular tumours are rare tumours affecting young adults (75% of tumours are
      diagnosed between the ages of 25 and 40 years). The descriptive epidemiological
      study of the data of the literature reveals a considerable improvement in the
      prognosis of testicular cancers, particularly since the introduction of cisplatin
      in the 1980. An epidemiological study conducted on a series of 200 testicular
      tumours treated at Val-de-Grace military hospital between 1979 and 1989 confirms
      this improvement with a mortality rate of 7.5% for all stages and histological
      types combined, with a follow-up of 2 to 12 years.

PMID- 1616305
TI  - [Cancer of the testicle: diagnosis].
AB  - Although great progress has been made in the treatment of testicular cancer over
      recent years, little progress has been made in the detection of this disease. The
      time between the discovery of a scrotal swelling by the patient and the first
      consultation is still too long. The authors study the presenting symptoms of the
      disease and the clinical examination which have not changed since the description
      by Chevassu. Complementary investigations have become essential: particularly,
      ultrasonography and tumour markers. The place of magnetic resonance imaging has
      yet to be defined. The last step in the diagnostic work-up consists of
      exploratory orchidotomy.

PMID- 1616306
TI  - [Radical orchiectomy].
AB  - The authors recall that exploratory orchidotomy remains an essential operation
      for the diagnosis of testicular cancer and orchidectomy constitutes the primary
      therapeutic procedure. The operative technique is described together with its
      intangible principles, its difficulties and its variants. The tumour markers are
      best assayed on a sample of cord blood. The insertion of a testicular prosthesis,
      which is usually well supported, decreases the psychological effects of
      castration and does not cause any delay in possible adjuvant treatment.

PMID- 1616307
TI  - [Anatomic pathology of testicular tumors].
AB  - Pathological examination of testicular tumours demonstrates the heterogeneity of
      the histological types encountered. Germ cell tumours, with one or several
      components, represent 95% of all testicular tumours. The distinction between
      these various types is always based on morphological criteria, but may also be
      facilitated by the use of immunolabelling techniques on fixed sections. The local
      and regional extension and the distinction between seminomatous and non
      seminomatous germ cell tumours are important criteria in the subsequent
      therapeutic strategy. At the present time, there is no consensus concerning the
      selection of other histoprognostic criteria, which may be observed in the primary
      tumour it its metastases. Residual masses also have a variable histology and
      their pathophysiology is sometimes difficult to interpret.

PMID- 1616308
TI  - Exposure of applicators and residents to chlordane and heptachlor when used for
      subterranean termite control.
AB  - Research was conducted to assess dermal and respiratory exposure to applicators
      from chlordane and heptachlor used for subterranean termite control and exposure
      to residents of treated homes. Dermal exposure of 29 applicators was evaluated by
      using gauze pads attached to outer and inner clothing at selected body regions.
      Respiratory exposure of applicators was monitored with personnel-type air
      samplers worn during application periods. Air samplers were equipped with
      polyurethane foam plugs to trap airborne chlordane and heptachlor. Exposure of
      residents was measured by sampling ambient air of 19 homes treated with the
      termiticides. Electric air samplers equipped with foam plugs were used to monitor
      ambient air from the basement, the kitchen, and one bedroom at: 24 h prior to
      termiticide application, during application, and post-application at 24 h, 1 wk,
      and monthly for 6 mo. Applicator dermal exposure was estimated based on exposure
      rates to each body region. Respiratory exposure was estimated based on
      termiticide concentrations in the air and on the ventilation rate of a person
      doing light work. Residents' exposure was estimated based on the amount of
      termiticide present in ambient air. Results indicated that applicator exposure
      rates to chlordane and heptachlor were 2.54 and 1.88 micrograms/kg/h,
      respectively. Residents were exposed to less than 0.69 and 2.86 micrograms/m3 of
      chlordane and heptachlor, respectively. During this research, the application of
      termiticide containing chlordane and heptachlor posed minimal risk in terms of
      acute exposure to either the applicators or the residents of the treated homes.

PMID- 1616309
TI  - Family pesticide use in the home, garden, orchard, and yard.
AB  - This study examined family use of pesticides in the home, garden, orchard, and
      yard. Data were collected from 238 families in Missouri during telephone
      interviews from June 1989 to March 1990. Nearly all families (97.8%) used
      pesticides at least one time per year and two thirds used pesticides more than
      five times per year. More than 80% used pesticides during pregnancy and 70% used
      pesticides during the first 6 months of a child's life. The most common setting
      for family pesticide use was in the home, where 80% of families used pesticides
      at least once per year. This was followed by herbicide use to control yard weeds
      (57% of families) and insecticide use to control fleas and ticks on pets (50% of
      families). A substantial number of families also used pesticides in the garden or
      orchard (33%). Flea collars were the most popular pest control product (50% of
      families). Carbaryl or Sevin was also popular, with 28.2% of families reporting
      use. No-pest-strips (dichlorvos) and Kwell shampoo (lindane) were used by almost
      10% of participating families. Examination of study data revealed that families
      limited exposure to pesticides for the mother during pregnancy and for children
      during the first 6 months of life. Families failed to recognize and reduce
      pervasive exposures associated with no-pest-strips and flea collars.

PMID- 1616310
TI  - Cytogenetic studies of herbicide interactions in vitro and in vivo using atrazine
      and linuron.
AB  - The herbicides atrazine and linuron, found in Wisconsin's groundwater, were
      tested alone and in combination, both in vivo and in vitro, to determine their
      individual and combined genotoxic effects. Human lymphocytes exposed in vitro to
      either 1 microgram/ml linuron or 0.001 microgram/ml atrazine showed little
      chromosome damage, whereas significant chromosome damage was observed in
      lymphocytes simultaneously exposed to 0.5 microgram/ml linuron and 0.0005
      microgram/ml atrazine, suggesting at least an additive model. In another
      experiment, mice were fed 20 micrograms/ml atrazine, 10 micrograms/ml linuron, or
      a combination of 10 micrograms/ml atrazine and 5 micrograms/ml linuron in their
      drinking water for 90 days, after which bone marrow cells and cultured
      splenocytes were examined for chromosomal damage. None of the treatment groups
      showed chromosome damage in bone marrow, whereas the cultured splenocytes
      demonstrated damage in all treatment groups. These experiments suggest that,
      prior to assessing the risk of a herbicide, it may be necessary to test it in
      combinations which mimic the mixtures which would occur under field conditions,
      such as in contaminated groundwater.

PMID- 1616311
TI  - Sublethal effects of ethylene dibromide on wound healing and morphogenesis in
      Hydra oligactis.
AB  - Morphogenetic activity (budding region regeneration, foot regeneration, tentacle
      regeneration, spikes, separation, and waist) was observed in Hydra oligactis with
      two tandemly arranged gastric regions (2g hydras) following exposure to a
      commercial ethylene dibromide (EDB) mixture. First-stage budding hydras were
      selected for this study. Animals were deprived of food 24 h prior to grafting and
      observed at 24, 48, and 72 h after grafting. The artificial pond water (APW)
      group was not treated with any chemicals prior to grafting. The acetone/APW group
      was pre-exposed to a concentration of 20 mg/L of acetone/APW 24, 48, and 72 h
      prior to grafting and observed at 24 h intervals for a three-day period. The EDB:
      acetone/APW group was exposed to a mixture containing 5 mg/L of EDB and 15 mg/L
      acetone for 24, 48, and 72 h prior to grafting and observed at 24-hr intervals
      for three days. All animals were incubated at 19 +/- 2 degrees C. Ethylene
      dibromide caused a significant decrease in 2 degrees foot regeneration at the 72
      h observation interval for animals pre-exposed to EDB for 48 and 72 h. There was
      also a significant correlation between pre-exposure and a decrease in the number
      of 2 degrees feet regenerated. Tentacle regeneration was significantly suppressed
      following a 24-h pre-exposure to EDB. Waists at the graft border significantly
      increased at the 48 and 72 h observation times and separation of the graft border
      appeared at 72 h after grafting following 72 h pre-exposure of the animals to the
      chemical.

PMID- 1616312
TI  - Impaired cortisol stress response in fish from environments polluted by PAHs,
      PCBs, and mercury.
AB  - The cortisol stress response to capture was investigated in two species of fish
      (Perca flavescens and Esox lucius) from sites polluted by high levels of
      polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and
      mercury, and from reference sites in the St. Lawrence river system. Fish from the
      reference sites exhibited the normal elevation of serum cortisol in response to
      the acute stress of capture and had large pituitary corticotropes. In contrast,
      fish from the most polluted sites were unable to increase their serum cortisol in
      response to the acute stress of capture and their pituitary corticotropes were
      atrophied. These results suggest that a life-long exposure to chemical pollutants
      may lead to an exhaustion of the cortisol-producing endocrine system, possibly as
      a result of prolonged hyperactivity of the system.

PMID- 1616313
TI  - Time to death of mosquitofish (Gambusia holbrooki) during acute inorganic mercury
      exposure: population structure effects.
AB  - Times-to-death (TTD) of mother and offspring mosquitofish (Gambusia holbrooki)
      were examined during acute exposure to mercury concentrations of approximately
      1.0 mg/L. Median TTD were more similar for fish sharing a common mother (defined
      herein as a sibship) and microhabitat during maturation than between sibships.
      Field populations may exhibit structure similar to that of these sibships.
      Correlations between broods (or other population subunits) and allozyme genotype
      could be responsible for transient, genotype effects noted during electrophoretic
      surveys attempting to measure population level response to toxicants.

PMID- 1616314
TI  - Comparative sensitivity of gametes and early developmental stages of a sea urchin
      species (Echinometra mathaei) and a bivalve species (Isognomon californicum)
      during metal exposures.
AB  - Bioassays were developed using sperm of a sea urchin (Echinometra mathaei), and
      sperm, embryos, and larvae of a bivalve species (Isognomon californicum). Sea
      urchin spawning was restricted to only a few months of the year and viability of
      sperm throughout the year varied from 5 to 75%. Sea urchin fertilization assays
      were affected by temporal variation in sperm viability. Spawning in this bivalve
      species occurs year-round and there is little temporal variation in sperm
      viability. Since stringent sperm:egg ratios are not required for the bivalve
      embryo and larval assays, these were less affected by variation in gamete
      quality. The relative sensitivity of the various assays were compared during
      exposure to three different metal pollutants: cadmium, copper, and tributyltin.
      Gametes and embryos were relatively resistant to cadmium toxicity, but larvae
      were very sensitive. With copper and tributyltin, sea urchin and bivalve
      fertilization assays were the least sensitive; and bivalve growth assays were the
      most sensitive, followed closely by the bivalve embryo assays. On the basis of
      sensitivity, ease and time required to conduct the assay, and salinity tolerance,
      the bivalve embryo assay was recommended as the overall single most reliable
      toxicity bioassay. However a multispecies, multidimensional approach using sperm
      fertilization assays as well as embryo assays should be employed, perhaps in a
      hierarchal manner. Larval growth assays were deemed too tedious and time
      consuming to be used routinely, but due to their high sensitivity, should still
      be considered as a valuable comparative tool.

PMID- 1616315
TI  - Failure of gas bladder inflation in striped bass: effect on selenium toxicity.
AB  - Young striped bass (Morone saxatilis) with uninflated gas bladders were less
      sensitive to selenate and more sensitive to selenite exposure than normally
      developing striped bass in 96-hour acute toxicity tests. Gas bladder inflation
      failure is a common problem in the culture of striped bass and some other
      species, and care should be taken to avoid the use of fish with uninflated gas
      bladders in research.

PMID- 1616316
TI  - Patterns of metal accumulation in Laminaria longicruris from Long Island Sound
      (Connecticut).
AB  - Laminaria longicruris de la Pyl. samples were harvested from Long Island Sound
      (Connecticut) from January 1985 to January 1986. Cadmium and copper content was
      determined by atomic absorption spectrophotometry from four tissue types; young
      blade, old blade, young stipe and old stipe. The results were statistically
      analyzed for differences in both type and age of tissue. Concentrations of
      cadmium were consistently lower than copper concentrations for all months and all
      tissue types. Statistically significant differences (p greater than 0.05) were
      found between the four tissue types for copper in the months of March, June,
      July, October and December, and for cadmium in the months of February, March,
      June, July, October and November. Young blade tissue and young stipe tissue were
      the tissues which most frequently found to be statistically different from the
      other tissues. Young stipe tissue had the lowest trace metal concentrations (1.3
      mean ppm, dry wt. Cu, 0.22 mean ppm, dry wt. Cd). Young blade tissue had
      significantly higher metal values in comparison to the other tissues for the
      months of June and October. Old tissue of L. longicruris is the most suitable for
      use in biomonitoring of trace metals due to the relatively little variation in
      metal content that was found throughout the study period.

PMID- 1616317
TI  - Cadmium resistance in Gammarus pulex (L.).
AB  - The ability of Gammarus pulex to develop cadmium resistance through physiological
      acclimation was investigated. Organisms were found to be significantly more
      tolerant to acute cadmium toxicity after pre-exposure to sublethal concentrations
      of cadmium and zinc. The induced elevation in cadmium tolerance was shown to be
      associated with an increase in the body concentration of a metallothionein-like
      protein. Pre-exposure had no apparent effect on cadmium uptake, although it did
      influence the distribution of cadmium within the organisms. Whereas pre-exposure
      to low levels of zinc and cadmium increased cadmium tolerances in acute tests, it
      had no observable effects on sublethal responses measured during chronic
      exposure.

PMID- 1616318
TI  - The 70 kD heat shock protein (hsp 70) in soil invertebrates: a possible tool for
      monitoring environmental toxicants.
AB  - The expression of hsp 70 after heat shock or exposure to heavy
      metals/molluscicides was investigated by fluorography or immunoblot in three
      diplopods (Glomeris marginata, Cylindroiulus punctatus, Tachypodoiulus niger),
      two slugs (Deroceras reticulatum, Arion ater), and one isopod (Oniscus asellus).
      In O. asellus, hsp 70 expression occurred after heat shock and also after lead
      treatment, whereby a solution of 100 mg/kg Pb2+ was sufficient. Animals of the
      same species taken from a heavy metal polluted site in the vicinity of a
      lead/zinc smelter also showed the presence of hsp 70. The comparison of
      laboratory and field experiments demonstrated the suitability of O. asellus for
      monitoring tests. In contrast, the blot pattern after contamination with 1,000
      mg/kg Pb2+ (in the mentioned diplopods) or different concentrations of the
      molluscicide Cloethocarb (BASF, FRG) (slugs) showed no differences compared to
      the respective control group.

PMID- 1616319
TI  - Induction of hepatic CYP1A activity as a biomarker for environmental exposure to
      Aroclor 1254 in feral rodents.
AB  - Specimens of the feral mouse species Reithrodontomys fulvescens trapped from a
      polychlorinated biphenyl (PCB)-contaminated field location had hepatic
      ethoxyresorufin (ETR) O-dealkylase activities and immunoreactive CYP1A protein
      contents which were two- to threefold higher than those measured in animals of
      the same species and sex collected from non PCB-contaminated reference sites.
      Specimens with hepatic ETR O-dealkylase activities differing by as little as 50%
      could readily be assigned as originating from the PCB or reference sites by the
      use of a specific chemical inhibitor of cytochrome P450IA (CYP1A). The relative
      levels of ETR O-dealkylase activity in R. fulvescens significantly correlated
      with hepatic PCB burdens (r = 0.819, P less than 0.01). When the magnitudes of
      the induced ETR O-dealkylase activities corresponding to given hepatic PCB
      burdens were compared between the feral animals, F344/NCr rats (Rattus
      norvegicus) or B6C3F1 mice (Mus musculus) exposed in the laboratory to dietary
      Aroclor 1254, the order of sensitivity to the inducing effects of PCBs were
      F344/NCr rat greater than B6C3F1 mouse greater than R. fulvescens.

PMID- 1616320
TI  - Effect of subacute benzene exposure on the activity of two neuropeptide-degrading
      enzymes in the rat brain.
AB  - Benzene (Bz) is an important industrial chemical, a petroleum by-product, a
      component of unleaded gas, and thus a ubiquitous environmental pollutant. It is
      well established that this organic solvent possesses neurotoxic and behavioral
      effects. However, the neurochemical mechanism of the solvent action remains
      obscure. The aminopeptidases (AP) are proteolytic enzymes that have been proposed
      as a candidate regulator of the degradation of several neuropeptides. In this
      work, changes in Lys- and Leu-aminopeptidase activities in several rat brain
      regions after benzene administration are described. The AP activity was
      determined by measuring the rate of hydrolysis of the artificial substrates Lys-
      and Leu-2-naphthylamides (fluorimetrically detected in triplicate). Both enzyme
      activities decrease in the thalamus, hypothalamus, hippocampus, and amygdala
      after Bz treatment. It is suggested that these aminopeptidase activities play a
      part in the benzene action mechanism, possibly by regulating the activity of
      several neuroactive peptides.

PMID- 1616321
TI  - Rheumatoid arthritis in twins: a study of aetiopathogenesis based on the
      Australian Twin Registry.
AB  - The 1980 cohort of the Australian Twin Registry contains 3808 pairs of twins, 258
      of whom self reported a diagnosis of rheumatoid arthritis (RA) in one or both
      subjects. Seventy two pairs were lost to follow up by 1990. The remaining 186
      pairs received a self administered questionnaire, followed, if necessary, by
      telephone interviews to them, their general practitioners, and their specialists.
      Twenty discordant and three concordant pairs of twins were verified as having RA.
      The prevalence of RA in this sample was 0.40%. There was an 89% false positive
      rate for the self reported diagnosis of RA. Pairwise concordance percentages for
      RA were as follows: monozygotic 21% (95% confidence interval (CI) = 6 to 44),
      dizygotic 0% (95% CI = 0 to 25). It was concluded that: (a) there is a high false
      positive rate in self reporting RA; (b) the prevalence of RA in Australia may be
      less than the 0.8-1.0% often quoted; and (c) genetic factors play some part in
      the aetiopathogenesis of RA but do not account entirely for its determination.

PMID- 1616322
TI  - Controlled trial of methotrexate versus 10-deazaaminopterin in the treatment of
      rheumatoid arthritis.
AB  - A 15 week double blind controlled trial of methotrexate and 10-deazaaminopterin
      for the treatment of rheumatoid arthritis (RA) was performed in 26 patients.
      Significant improvement in all measured clinical parameters was observed in the
      two patient groups. The drugs were well tolerated; only one patient (10
      deazaaminopterin) withdrew from the study because of side effects. It is
      concluded that, in the context of this relatively short clinical trial, 10
      deazaaminopterin is at least as beneficial as methotrexate in the treatment of
      RA.

PMID- 1616323
TI  - Increased incidence of urinary tract infection in patients with rheumatoid
      arthritis and secondary Sjogren's syndrome.
AB  - The incidence of lower urinary tract infection in 120 women with rheumatoid
      arthritis and secondary Sjogren's syndrome was evaluated retrospectively. Thirty
      one patients (26%) had secondary Sjogren's syndrome. Recurrent urinary tract
      infection was significantly more common in these patients (11/31) than in
      patients without Sjogren's syndrome (4/89). Habitual leucocyturia was also more
      common in patients with secondary Sjogren's syndrome (18/31) than in patients
      with rheumatoid arthritis without Sjogren's syndrome (8/89). Of seven patients
      with vaginal sicca symptoms, six had recurrent urinary tract infection. Urinary
      24 hour mucopolysaccharide excretion in 20 patients with Sjogren's syndrome was
      similar to the excretion in 10 patients without Sjogren's syndrome. These results
      show that recurrent urinary tract infection is significantly more common in women
      with rheumatoid arthritis and secondary Sjogren's syndrome. A local deficit in
      protective urinary mucosal secretion or other immune mechanisms may be
      responsible for this susceptibility.

PMID- 1616324
TI  - Sjogren's syndrome: a stepwise approach to the use of diagnostic tests.
AB  - One hundred and forty two patients (62 with definite Sjogren's syndrome, 24 with
      probable Sjogren's syndrome, and 56 in whom Sjogren's syndrome was finally ruled
      out) were studied. Schirmer's test and rose bengal staining for the diagnosis of
      keratoconjunctivitis sicca and salivary scintigraphy and a labial biopsy sample
      for the diagnosis of xerostomaia were studied in all patients. Rose bengal
      staining showed high specificity (98%) but low sensitivity (55%). All patients
      with positive rose bengal staining results had associated xerostomia. In the rose
      bengal staining positive patients, scintigraphy had 100% specificity. A labial
      biopsy sample showed high sensitivity in the rose bengal staining, salivary
      scintigraphy positive group, and high specificity in the rose bengal staining
      positive, salivary scintigraphy negative group. In patients with negative rose
      bengal staining, salivary scintigraphy showed 96% specificity and 36%
      sensitivity. A labial biopsy sample had a sensitivity and specificity greater
      than 90% in rose bengal staining negative patients. Only 29 biopsy samples were
      needed to achieve a diagnosis of Sjogren's syndrome in 142 patients (20%). Hence
      the suggested approach may make it unnecessary to take biopsy samples in
      approximately 80% of patients with suspected Sjogren's syndrome. Using the
      stepwise approach of first rose bengal staining, then salivary scintigraphy, and
      eventually a labial biopsy sample in patients with suspected Sjogren's syndrome,
      the diagnosis is relatively simple.

PMID- 1616325
TI  - Diversity and pattern of inheritance of autoantibodies in families with multiple
      cases of systemic lupus erythematosus.
AB  - The pattern of inheritance of autoantibodies in eight families chosen from a pool
      of 110 families of patients with systemic lupus erythematosus (SLE) is described.
      In all the eight families at least two members were already affected by SLE. In
      total, 19 patients and 43 first degree relatives were examined. The inheritance
      of a large set of antinuclear antibodies (for example, DNA, Sm, RNP, Ro, La,
      histones) and 16/6 idiotype seemed to be related to some unknown genetic factors
      but not related to HLA. The presence of numerous antinuclear autoantibodies in
      the serum of a subject was not necessarily associated with overt disease. The
      incidence of the 16/6 idiotype among patients and their relatives was low. It is
      not yet clear whether the 'autoantibody burden' is greater in families with
      multiple cases of SLE than in families with single cases.

PMID- 1616326
TI  - Risk factors in the pregnancy of patients with systemic lupus erythematosus:
      association of hypocomplementaemia with poor prognosis.
AB  - Fetal wastage is still high in the pregnancies of patients with systemic lupus
      erythematosus (SLE). We examined retrospectively the cases of 38 patients with
      inactive SLE in whom pregnancy was either desired or had already been obtained.
      The prevalence of antiphospholipid antibodies in the group with fetal loss was
      high. The antibodies were, however, also detected in five of 14 patients who had
      had a live birth. It was noted that low levels of serum complement activity (CH50
      less than 25 U/ml) occurred in five of six patients with fetal loss, but in only
      two of 22 with a live birth. Serial studies also confirmed a close association
      between decreased serum complement activity and poor fetal prognosis in lupus
      pregnancy. Treatment with increased doses of prednisolone may help to achieve
      successful live births. Thus hypocomplementaemia may be associated with a worse
      prognosis for the fetus in the pregnancies of some patients with SLE in
      remission.

PMID- 1616327
TI  - Outcome of patients with systemic rheumatic disease admitted to medical intensive
      care units.
AB  - The outcome of patients admitted to intensive care units is known to be
      influenced by such factors as age, previous health status, severity of disease,
      and diagnosis. To estimate the outcome of such patients with systemic rheumatic
      diseases and to determine if the severity of these diseases unfavourably
      influences the prognosis at the time of admission to a medical intensive care
      unit, the clinical courses of all patients with systemic rheumatic disease
      admitted to two medical intensive care units between January 1978 and December
      1988 were studied retrospectively. Sixty nine patients with systemic lupus
      erythematosus (n = 16), necrotising vasculitis (n = 19), rheumatoid arthritis (n
      = 19), and other systemic rheumatic diseases (n = 15) were included. The mean
      (SD) age on admission into the medical intensive care unit was 53 (17) years and
      the mean simplified acute physiological score was 12 (5.5). The principal
      diagnoses on admission were infectious complications (29/69 patients) and acute
      exacerbation of the systemic rheumatic disease (19/69 patients). The death rate
      in the medical intensive care unit was 33% (23/69 patients) and was similar to
      that of a non-selected population with comparable simplified acute physiological
      score. The death rate in hospital was 42% (29/69 patients). Infection was the
      main cause of death in the medical intensive care unit (19/23 patients) and the
      infection was mainly acquired in the unit. Only the simplified acute
      physiological score on admission was a statistically significant prognostic
      factor: the simplified acute physiological score in patients who died was 15
      (5.2) v 9.9 (4.7) for survivors. Long term outcome analysis showed that 83%
      (33/40 patients) of patients were still alive after admission to the medical
      intensive care unit with a follow up time between two months and nine years (mean
      38 months). The death rate was relatively high and was mainly due to nosocomial
      infections. It was not different, however, from that of nonselected patients and
      the long term prognosis was highly favourable. This shows that the complications
      are often reversible, particularly infectious applications, and justifies
      admission to the medical intensive care unit of this group of patients.

PMID- 1616328
TI  - Inhibition by prostaglandin E1 and E2 of 1,25-dihydroxyvitamin D3 synthesis by
      synovial fluid macrophages from arthritic joints.
AB  - Previous work has shown that renal metabolism of 25-dihydroxyvitamin D3
      (25(OH)D3) to the active metabolite, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) is
      stimulated by prostaglandin E2 and inhibited by acetylsalicylate (aspirin). As
      prostaglandins are primary inflammatory mediators and synovial fluid macrophages
      are known to synthesise 1,25(OH)2D3 in vitro, the effects of prostaglandin E1,
      prostaglandin E2, and aspirin on the metabolism of 25(OH)D3 by cells cultured
      from synovial fluid of patients with inflammatory arthritis were investigated.
      Most cultures contained non-proliferating macrophages which formed 1,25(OH)2D3;
      however, two of 13 cultures contained colonies of rapidly proliferating
      fibroblast-like cells which formed 24,25(OH)2D3 (24,25(OH)2D3). Prostaglandin E1
      and prostaglandin E2 (0.01-10 mumol/l) induced marked inhibition of 1,25(OH)2D3
      synthesis (up to 94%) in a dose dependent manner after preincubations of 24 hours
      but not over straightforward six hour incubations. Exposure of macrophages to
      aspirin (1 mumol/l-1 mmol/l) for 24 hours did not affect 1,25(OH)2D3 synthesis
      unless the cells had been pretreated with lipopolysaccharides, in which instance
      1 mM aspirin increased 1,25(OH)2D3 synthesis. Lipopolysaccharide is a macrophage
      activating factor which stimulates macrophages to form 1,25(OH)2D3, and it also
      induces prostaglandin synthesis which would be inhibited by aspirin. Taken
      together these results suggest that prostaglandin E1 and prostaglandin E2
      synthesised by macrophages may act in an autocrine manner to attenuate the
      ability of macrophage activating factors, such as lipopolysaccharide, to
      stimulate 1,25(OH)2D3 synthesis. Prostaglandins synthesised by other inflammatory
      cells may also inhibit 1,25(OH)2D3 synthesis in a paracrine manner. In contrast,
      prostaglandin E2 and aspirin had limited effects on fibroblast 24,25(OH)2D3
      synthesis. This study shows that the effects of prostaglandin E1, prostaglandin
      E2, and aspirin in macrophages contrast with those previously reported for the
      renal 25(OH)D3-1alpha-hydroxylase, where prostaglandin E2 stimulated and aspirin
      inhibited enzyme activity. These results further emphasise that synthesis of
      1,25(OH)2D3 in non-renal sites is independently regulated, which is consistent
      with it having an immunological role at a local level rather than playing a part
      in systemic calcium homeostasis.

PMID- 1616329
TI  - Interleukin 1 alpha and beta production by cells isolated from membranes around
      aseptically loose total joint replacements.
AB  - Aseptic loosening of joint prostheses is accompanied by local osteolysis. To
      determine whether local production of interleukin 1 might contribute to such
      lysis, the number of interleukin 1 secreting cells in the pseudosynovial membrane
      surrounding prostheses was measured. Interleukin 1 alpha and beta secreting cells
      were identified by ELISPOT, a sensitive cytokine secreting assay. The proportion
      of interleukin 1 beta secreting cells in pseudosynovial membrane was comparable
      with the proportion occurring in the synovium of patients with rheumatoid
      arthritis and higher than that in normal subjects and patients with
      osteoarthritis. The proportion of interleukin 1 alpha producing cells was higher
      in pseudosynovial membrane than in diseased synovium. Overall, higher numbers of
      interleukin 1 beta than interleukin 1 alpha secreting cells were detected. A
      correlation was observed between the number of cells in pseudosynovial membrane
      producing interleukin 1 beta and those producing interleukin 1 alpha. When
      divided into area of origin, tissue samples from the femoral area contained a
      higher proportion of interleukin 1 beta producing cells than tissue in the
      acetabular or capsular regions, though due to variance within each group this
      difference did not reach significance.

PMID- 1616330
TI  - Inhibition of proteoglycan synthesis by transforming growth factor beta in
      anatomically intact articular cartilage of murine patellae.
AB  - The effect of transforming growth factor beta (TGF beta) on proteoglycan
      synthesis and degradation in anatomically intact articular cartilage of murine
      patellae was studied. Exogenously added TGF beta up to a concentration of 200
      pmol/l had no effect on proteoglycan synthesis in intact articular cartilage.
      Neutralisation of endogenously produced TGF beta with a specific monoclonal
      antibody to TGF beta, however, led to stimulation of proteoglycan synthesis,
      indicating that TGF beta itself inhibits proteoglycan synthesis in anatomically
      intact cartilage. Transforming growth factor beta decreased the degradation of
      proteoglycans in intact cartilage in the absence of fetal calf serum or insulin
      like growth factor 1. In the presence of fetal calf serum or insulin-like growth
      factor 1, TGF beta had no additional effect on proteoglycan breakdown.

PMID- 1616332
TI  - Echocardiographic abnormalities in ankylosing spondylitis.
AB  - Twenty four patients with ankylosing spondylitis of 10 or more years' duration
      were assessed for evidence of cardiac disease. Seven patients (29%) had evidence
      of cardiac disease, including one patient with a pericardial effusion, three with
      conduction abnormalities, and two with aortic incompetence. Aortic incompetence
      in one patient was clinically silent and was detected only with Doppler
      echocardiography. This patient had, in addition, thickening of the posterior
      aortic wall, an echocardiographic feature not previously described in ankylosing
      spondylitis. There was no evidence of aortic valve disease in a control group
      matched for age and sex. Patients with ankylosing spondylitis and cardiac
      abnormalities were older, had a longer disease duration, and more peripheral
      joint disease than those without cardiac abnormalities. Doppler echocardiography
      is a useful technique in the assessment of cardiac disease in ankylosing
      spondylitis and may detect aortic valve disease at an early preclinical stage.

PMID- 1616331
TI  - Urinary excretion of pyridinium crosslinks of collagen in patients with
      osteoporosis and the effects of bone fracture.
AB  - Values for the urinary excretion of pyridinium crosslinks of collagen,
      pyridinoline and deoxypyridinoline, in a group of 30 elderly women with femoral
      fractures associated with osteoporosis and a group of 20 women without recent
      fracture but with overt or suspected osteoporosis were compared with 27 control
      subjects matched for age. Relative to the control group, the excretion of the
      crosslinks was significantly higher in the group with fractures and the group
      with osteoporosis. Fractures contributed markedly to the excretion of pyridinium
      crosslinks as the patients with fractures showed significantly higher excretion
      of pyridinoline and deoxypyridinoline than the group without recent fractures.
      This was confirmed by the fact that excretion of pyridinium crosslinks in
      patients with accidental bone fractures was significantly higher than for healthy
      control subjects matched for age and sex. The crosslinks appear to provide valid
      indices of bone resorption, but the effects of bone fracture must be considered
      in the clinical application of this technique.

PMID- 1616333
TI  - Chronic otitis media: a new extra-articular manifestation in ankylosing
      spondylitis?
AB  - Following a study reporting a fourfold increase in the occurrence of chronic
      otitis media in patients with ankylosing spondylitis, this prospective study
      examines this association with respect to severity, duration of disease, and
      acute phase in ankylosing spondylitis. Forty two consecutive patients with
      classical ankylosing spondylitis seen at the rheumatology clinic of a teaching
      hospital where the features of ankylosing spondylitis were recorded had an
      otological examination by an otolaryngologist. The occurrence of chronic otitis
      media (all categories) was 12/42 (29%). The acute phase serum markers (C reactive
      protein and IgG) were increased in patients with active or inactive chronic
      otitis media. Extra-articular manifestations were significantly more common in
      the chronic otitis media group than in those with no history of chronic otitis
      media. The results of this study suggest that chronic otitis media may be another
      extra-articular manifestation of ankylosing spondylitis. Alternative
      explanations, however, include similar aetiological factors for the two
      conditions or a previously unrecognised increased occurrence of HLA-B27 in
      patients with chronic otitis media.

PMID- 1616334
TI  - Sternocostoclavicular hyperostosis: its progression and radiological features. A
      study of 12 cases.
AB  - Twelve cases of sternocostoclavicular hyperostosis were followed up over four to
      16 years. The patients underwent repeated radiological examinations of the
      sternocostoclavicular joints and the sternum, and the extrasternal osseous
      manifestations of the disease were studied to show changes in the radiological
      features during long term follow up. Five of 12 (41%) patients had extrasternal
      manifestations. With the exception of one patient extrasternal manifestations
      were first detected by scintigraphs because they were asymptomatic. With respect
      to the sternal manifestations the initial radiological diagnosis was made during
      an acute phase while painful swelling over the sternum and decreased mobility of
      the shoulders occurred. The radiological examinations showed the signs of a
      proliferative destructive arthritis in most patients. In contrast with the
      frequent occurrences of clinical symptoms, the radiological signs of progression
      take several years to become detectable. There are no specific bacteriological,
      serological or histological findings. Usually a permanent increase in the
      erythrocyte sedimentation rates is found. Sternocostoclavicular hyperostosis is a
      slowly progressing disease, characterised by a chronic aseptic destructive
      sternoclavicular arthritis with a reactive low turnover sclerosis that begins in
      a similar way to an enthesopathy and ends after several decades with total
      ankylosis. The radiological identification of retrosternal proliferation of soft
      tissue by computed tomography was found to be a valuable criterion for the
      differential diagnosis from other benign hyperostotic processes of the
      sternoclavicular region.

PMID- 1616335
TI  - Role of technetium-99m diphosphonate and gallium-67 citrate bone scanning in the
      early diagnosis of infectious spondylodiscitis. A comparative study.
AB  - A comparative study of the parts played by technetium-99m diphosphonate and
      gallium-67 citrate bone scanning in the early diagnosis of infectious
      spondylodiscitis is presented. Nineteen patients were included in the study. All
      patients (11 men aged 19-70 years and eight women aged 18-72 years) had a history
      of back pain varying in duration from one to 15 weeks. A 99mTc diphosphonate bone
      scan was positive in 17 patients. The two patients with negative results had less
      than two weeks of back pain. The 67Ga citrate bone scan showed uptake in all
      patients.

PMID- 1616336
TI  - Heredofamilial deficiency of monocyte esterase in patients with rheumatoid
      arthritis.
AB  - Deficiency of the monocyte ectoenzyme non-specific esterase is described in a
      heredofamilial pattern in four patients with rheumatoid arthritis. No association
      with HLA status or rheumatoid factor seropositivity was found.

PMID- 1616337
TI  - Antiphospholipid antibodies in homozygous sickle cell disease.
AB  - Serum samples from 108 unselected Jamaican patients with homozygous sickle cell
      disease and 116 control subjects with normal haemoglobin were screened for the
      presence of antiphospholipid antibodies. Slightly increased levels of IgG
      antiphospholipid antibodies were found in nine patients with sickle cell disease
      and in none of the control subjects. Serial control samples confirmed the
      increased levels of antiphospholipid antibodies. A comparison of the
      haematological and clinical features of patients with positive and negative
      antiphospholipid sickle cell disease did not highlight any differences between
      the groups.

PMID- 1616338
TI  - HTLV-I associated arthritis: characteristics of an HTLV-I virus infected T cell
      line from synovial fluid.
AB  - A T cell line from mononuclear cells in the synovial fluid of a patient with
      polyarthritis was established. The T cell line reacted with serum samples
      positive for antibodies to human T cell lymphotropic virus type I (HTLV-I) and
      with monoclonal antibody to HTLV-I p19. In Southern blotting with an env-pX-LTR
      HTLV-I probe and digestion of T cell line DNA with the restriction enzymes ClaI,
      DraI, and PstI generated fragments that were identical to those found in two HTLV
      I infected T cell lines established from adult T cell leukaemia or HTLV-I
      associated myelopathy. The T cell line expressed CD2, CD3, CD4, CD45RA, CD29, HLA
      DR, CD25, and CD26 antigens, but not CD8 and CD20 antigens. Large amounts of
      interleukin 6, interferon gamma, and tumour necrosis factor alpha were secreted
      in the culture supernatants of this cell line. This line helped immunoglobulin
      production by B cells, but not K562, Raji, and synovial cell lysis.

PMID- 1616339
TI  - Polyarteritis associated with Yersinia enterocolitica infection.
AB  - A patient developed polyarteritis, predominantly affecting the muscles, 10 days
      after a Yersinia enterocolitica O:3 infection. Immunoperoxidase staining showed
      Yersinia enterocolitica O:3 antigen in the subendothelial layer of the blood
      vessels. This suggests that vasculitis should be considered as a rare
      manifestation of Yersinia enterocolitica infection.

PMID- 1616341
TI  - Evaluation of serum ferritin as a marker for adult Still's disease activity.
AB  - Extremely high serum ferritin values (greater than 10,000 micrograms/l) were
      detected in two patients with adult Still's disease. The ferritin concentrations
      decreased to normal after adequate treatment. During a one year follow up
      ferritin concentration was helpful in monitoring disease activity and guiding
      decisions about treatment. Raised concentrations of soluble interleukin 2
      receptors (sCD25) were also found. Detection of ferritin values above 3000
      micrograms/l should lead to the consideration of Still's disease when there is an
      acute febrile illness without evidence for bacterial or viral infections, serum
      ferritin being suitable for monitoring treatment.

PMID- 1616340
TI  - Monarthritis: an unusual presentation of renal cell carcinoma.
AB  - Two cases of acute monarthritis secondary to asymptomatic renal cell carcinoma
      are described. This association has not previously been reported. The patients
      were initially thought to have a septic arthritis, but hot spots were seen on
      isotope bone scans and biopsy samples showed secondary neoplasms, which were
      later confirmed to be a result of renal cell carcinomas. The value of cytological
      examination of synovial fluid when there is clinical doubt as to the cause of a
      joint effusion is shown.

PMID- 1616342
TI  - Acute aortic insufficiency in a patient with presumed Reiter's syndrome.
AB  - Cardiac disease is rare in patients with Reiter's syndrome. There have been 15
      reported cases of aortic insufficiency in patients with Reiter's syndrome, with
      the aortic insufficiency developing over several years. This paper reports the
      case of a black HLA-B27 negative woman who presented with Reiter's syndrome and
      acute aortic insufficiency. An antecedent streptococcal infection is suggested as
      the inciting factor. To our knowledge, this is the first report of Reiter's
      syndrome in a black woman with acute aortic insufficiency.

PMID- 1616343
TI  - An infiltrating rheumatoid nodule?
AB  - The case is presented of a patient with mild rheumatoid arthritis who developed
      an enlarged painful tissue mass in the left lower leg. Although the history,
      clinical, and imaging appearances suggested that it was a soft tissue sarcoma, a
      biopsy specimen showed histological features consistent with either a rheumatoid
      nodule or subcutaneous granuloma annulare.

PMID- 1616344
TI  - Fungal arthritis.

PMID- 1616346
TI  - From Britain, 1991.

PMID- 1616345
TI  - Local immune responses in certain extra-articular manifestations of rheumatoid
      arthritis.

PMID- 1616347
TI  - Septic arthritis complicating hip osteoarthritis.

PMID- 1616348
TI  - Symptomatic salicylate ototoxicity: a useful indicator of serum salicylate
      concentration?

PMID- 1616349
TI  - The heart in ankylosing spondylitis.

PMID- 1616350
TI  - Inhibition of astrocyte proliferation and binding to brain tissue of
      anticardiolipin antibodies purified from lupus serum.
AB  - Polyclonal anticardiolipin antibodies purified from pooled serum samples of
      patients with systemic lupus erythematosus were shown to have inhibitory effects
      on cultured normal rat brain astrocytes (RBA-1 cells). Anticardiolipin antibodies
      at concentrations from 50 to 200 micrograms/ml inhibited the [3H]thymidine
      incorporation of RBA-1 cells in a dose dependent manner after three days of
      culture. A kinetic study showed that anticardiolipin antibodies (100
      micrograms/ml) maximally inhibit the proliferation of RBA-1 cells (20.6 (5.1)% of
      the control value) after incubation for one day. In contrast, human gamma
      globulin (100 micrograms/ml) had no effect on these cells. In the presence of
      anticardiolipin antibodies (100 micrograms/ml), the RBA-1 cells attached to the
      bottom of wells became spherical and the expression of glial fibrillary acidic
      protein in the cytoplasm was slightly reduced. Using 3,3'-dihexyloxacarbocyanine
      iodide as an indicator, anticardiolipin antibodies depolarised the membrane
      potential of RBA-1 cells after one day of culture. In addition, the percentage
      binding of RBA-1 cells with anticardiolipin antibodies was greater than with
      gamma globulin as determined by flow cytometric analysis. Immunofluorescence
      staining of brain tissue from BALB/c mice with anticardiolipin antibodies was
      noted in the corpus callosum, the cellular zone near the corpus callosum, and
      cells scattered in brain tissue. These results suggest that anticardiolipin
      antibodies have an inhibitory effect on brain cells and elicit thrombus formation
      in brain vessels, which plays a part in neuropsychiatric lupus.

PMID- 1616351
TI  - Autoantibodies to T and B cell lines detected in serum samples from patients with
      systemic lupus erythematosus with lymphopenia and hypocomplementaemia.
AB  - Antibodies to lymphocytes in serum samples from 88 patients with systemic lupus
      erythematosus (SLE) and 15 normal control subjects were examined by a cell enzyme
      linked immunosorbent assay (ELISA) with four human T and B cell lines as
      antigens. The antibodies reacted with the Wa B cell line and the T cell lines P12
      (CD4-, CD8+), Jurkat (CD4-, CD8-), and Hut78 (CD4+, CD8-). Antibody titres in
      serum samples from patients with SLE were higher than in those from normal
      control subjects. Titres of antibodies to P12 were correlated with titres of
      antibodies to Wa, Jurkat, and Hut78 in serum samples from patients with SLE. IgG
      antibodies to P12 were associated with lymphopenia and reduced haemolytic
      complement. By thin layer chromatography immunostaining, the antibodies in serum
      samples from two of 10 patients with SLE with high titres of IgG antibodies to
      P12 and lymphopenia were shown to react with three monosialoglycosphingolipids
      and two neutral glycosphingolipids from P12 cells. Antibodies to lymphocytes in
      serum samples from patients with SLE react with T and B cell lines, recognise a
      series of cell membrane glycosphingolipids and are associated with the
      lymphopenia and hypocomplementaemia typical of active disease.

PMID- 1616352
TI  - Rash in systemic lupus erythematosus: prevalence and relation to cutaneous and
      non-cutaneous disease manifestations.
AB  - Rash is a common cutaneous sign in patients with systemic lupus erythematosus
      (SLE) but no data regarding its prevalence or relation to disease manifestations
      are known, possibly due to the fact that it is a common but non-specific sign.
      Rash was present in 48/81 (59%) patients with SLE. Patients with rash had more
      cutaneous symptoms and signs, lymphadenopathy, increased levels of antibodies to
      double stranded DNA and decreased complement levels. They were also receiving a
      higher dose of prednisone. There was no difference between patients with and
      without rash with respect to renal or central nervous system disease. Rash did
      not correlate with the disease activity index and clinical parameters of disease
      exacerbation.

PMID- 1616353
TI  - Immunofluorescence microscopy of healthy skin from patients with systemic lupus
      erythematosus: more than just the lupus band.
AB  - Many papers have been published on the lupus band in systemic lupus erythematosus
      (SLE), but little information exists on the possible diagnostic value of the
      lupus band and other microscopic immunofluorescence phenomena found in clinically
      normal skin of patients with SLE. In a study of 297 subjects (66 patients with
      SLE, 81 patients with other forms of LE, and 150 patients with other systemic
      connective tissue disorders) it was found that: (a) granular deposits of IgA,
      IgG, and IgM in the basal membrane zone and in the deeper blood vessels were more
      common in patients with SLE than in the other two groups; (b) depending on the
      clinical differential diagnosis, IgA and IgG deposits at the epidermal basal
      membrane can be specific for SLE; (c) using logistic regression analysis sets of
      variables can be selected with a high potential to discriminate between SLE and
      the other groups; and (d) immunofluorescence variables do not duplicate the
      information for the diagnosis of SLE given by the American Rheumatism Association
      (ARA) criteria or other laboratory methods. From these results, it is concluded
      that immunofluorescence microscopy of clinically normal skin is a valuable
      diagnostic method which should be reconsidered as a potential criterion for the
      diagnosis of SLE in the next evaluation of the ARA criteria.

PMID- 1616354
TI  - Effects of ultraviolet irradiation on natural killer cell function in systemic
      lupus erythematosus.
AB  - In vitro irradiation with long wavelength ultraviolet light (UV-A), in clinically
      relevant dosages, of a natural killer cell line containing cell preparations from
      17 control subjects reduced natural killer cell cytotoxicity with the cell line
      K562 as target. The spontaneous function of natural killer cells from 12 patients
      with systemic lupus erythematosus (SLE) correlated inversely with the one hour
      erythrocyte sedimentation rate, but not with glucocorticoid doses. After UV-A
      exposure, natural killer cells from patients with SLE exert either increased or
      decreased cytotoxicity, and the direction of change is inversely correlated with
      the spontaneous natural killer cell function.

PMID- 1616355
TI  - Determination of cytokines in synovial fluids: correlation with diagnosis and
      histomorphological characteristics of synovial tissue.
AB  - In a study aimed at correlating cytokine levels in synovial fluid with the
      pathology of rheumatoid arthritis (RA), tumour necrosis factor alpha, interleukin
      1 beta and interferon gamma were immunoassayed in 27 patients with RA, 16
      patients with other arthritides, 23 with osteoarthritis, 13 patients with trauma,
      and 18 patients at necropsy without inflammatory disease and not known to have
      had joint disease (median 27 hours after death). The results for interleukin 1
      beta clearly show higher cytokine levels in patients with RA and other
      arthritides than in patients with osteoarthritis, trauma, or the patients at
      necropsy. Interferon gamma levels in patients with osteoarthritis and the
      patients at necropsy, however, were significantly greater than in patients with
      RA, and tumour necrosis factor alpha levels were also greater in the patients at
      necropsy compared with patients with RA. This study also correlated
      histomorphological patterns of synovitis and indicators of local inflammatory
      activity with synovial fluid cytokine levels, showing, for example, a positive
      association of interleukin 1 beta titre and a negative association of interferon
      gamma titre with ulcerogranulomatous synovitis (itself associated with RA). Taken
      together, these results extend and strengthen data suggesting a possible part
      played by increased synovial fluid levels of interleukin 1 beta in joint
      destruction in RA, but provide no evidence for increases in levels of tumour
      necrosis factor alpha or interferon gamma affecting the disease pathology.

PMID- 1616356
TI  - Localisation of fibronectin mRNA in the rheumatoid synovium by in situ
      hybridisation.
AB  - The distribution of fibronectin, an extracellular matrix glycoprotein which plays
      a part in fibrosis and tissue repair, has previously been described using
      immunohistochemical methods. These do not differentiate between locally
      synthesised and plasma derived fibronectin. In this work the distribution of
      cells actively synthesising fibronectin was assessed by in situ hybridisation
      using a radiolabelled antisense RNA probe in synovial biopsy samples from
      patients with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and
      control subjects without inflammatory disease. Large amounts of fibronectin mRNA
      were found specifically in synovial lining cells, providing evidence for the
      local production of fibronectin in the synovium. Levels of fibronectin mRNA were
      variable between patients. These differences were not related to the diagnosis or
      to the subintimal inflammatory cell infiltrate; where there was synovial lining
      cell hyperplasia there was a concomitant increase in the number of cells
      containing fibronectin mRNA, which was consistent with increased levels of
      immunoreactive fibronectin at this site. Increased levels of fibronectin in
      synovial fluid in patients with rheumatoid arthritis may be due to an increased
      number of lining cells secreting the protein, rather than upregulation of the
      gene by these cells.

PMID- 1616357
TI  - Response of anaemia in rheumatoid arthritis to treatment with subcutaneous
      recombinant human erythropoietin.
AB  - Eleven patients with chronic inflammatory arthritides and haemoglobin
      concentrations less than 105 g/l with symptoms from their anaemia were treated
      with a dose of 250 IU/kg/week of recombinant human erythropoietin for six weeks.
      The treatment was given as subcutaneous injections five days a week. All patients
      had active inflammatory disease. Nine patients responded to treatment with an
      increase in haemoglobin of more than 15 g/l. The mean (SD) haemoglobin
      concentration increased from 93.0 (8.0) g/l before treatment to 115.0 (12.0) g/l
      after six weeks. There was no correlation between the initial serum concentration
      of erythropoietin and the response. It was concluded that anaemia in chronic
      inflammatory arthritides responds to treatment with subcutaneous injections of
      recombinant human erythropoietin.

PMID- 1616358
TI  - Anaemia of chronic disease in rheumatoid arthritis: effect of the blunted
      response to erythropoietin and of interleukin 1 production by marrow macrophages.
AB  - Anaemia in rheumatoid arthritis (RA) is a common and debilitating complication.
      The most common causes of this anaemia are iron deficiency and anaemia of chronic
      disease. Investigations have suggested that interleukin 1 (IL-1) or tumour
      necrosis factor (TNF), or both, from monocytes associated with chronic
      inflammation are responsible for the anaemia of chronic disease. On bone marrow
      examination anaemia of chronic disease is characterised by the diversion of iron
      from the erythropoietic compartment into marrow macrophages. This phenomenon is
      termed failure of iron utilisation. In this study, CFU-E (colony forming unit
      erythroid; late red cell precursors) and BFU-E (burst forming unit erythroid;
      early red cell precursors) stem cells were cultured from 10 normal marrow samples
      and 12 marrow samples from patients with RA with iron deficiency anaemia and 10
      samples from patients with RA with failure of iron utilisation. All patients with
      RA were anaemic (haemoglobin less than 100 g/l), Potential accessory or
      inhibitory cells of erythropoiesis (CD4, CD8, or CD14 positive cells) were
      removed before culture. Control marrow samples were studied in a similar manner.
      Normal marrow samples yielded 377 (17) CFU-E and 133 (6) BFU-E (mean (SD))
      colonies for each 2 x 10(5) light density cells plated. CD4 ablation caused
      reductions of 62 and 100% in CFU-E and BFU-E colonies respectively. CD14 removal
      resulted in considerable but lesser reductions of 46% for CFU-E and 25% for BFU
      E. In both groups of patients with RA, CFU-E colony numbers were significantly
      lower than those seen in normal control subjects, 293 (17) for patients with iron
      deficiency anaemia and 242 (35) for patients with failure of iron utilisation.
      BFU-E colony numbers were 102 (13) and 108 (20) respectively. In patients with
      RA, CD4 removal caused a significantly greater loss of CFU-E colonies compared
      with normal control subjects. Cytolysis of CD14 positive cells caused a reduction
      in CFU-E colonies in the two RA groups which was similar to that seen in normal
      subjects. In conclusion, patients with RA seem to have fewer CFU-E progenitors
      but essentially normal numbers of BFU-E stem cells. Our data suggest a
      stimulatory role for marrow CD4 and CD14 cells in erythropoiesis in patients with
      RA. Monocytes-macrophages (CD14 positive) are known to be producers of IL-1 or
      TNF, or both, however, the predicted increase in the CFU-E colonies on removal of
      CD14 cells is not seen. Therefore, if IL-1 or TNF, or both, are responsible for
      the impairment of erythropoiesis in patients with RA, marrow macrophages are
      unlikely to be the source. Moreover, these results indicate the probability of
      erythropoietin resistance on the basis of diminished CFU-E colony formation in
      patients with RA.

PMID- 1616359
TI  - Double blind, placebo controlled study of metronidazole as a disease modifying
      agent in the treatment of rheumatoid arthritis.
AB  - Anecdotal reports suggest that metronidazole may have disease modifying activity
      in the treatment of rheumatoid arthritis. To assess possible beneficial effects a
      double blind, comparative trial of metronidazole and placebo was performed. Fifty
      patients with active rheumatoid arthritis were randomly allocated to receive
      active drug (n = 24) or placebo (n = 26) and reviewed at weeks 0, 1, 4, 8, 12,
      16, and 24. Detailed assessment of drug safety, biochemical and haematological
      parameters, and efficacy was made at these dates. Dose regimen was 400 mg twice
      daily from weeks 0 to eight, increasing to 400 mg three times a day from weeks
      nine to 24 provided that no adverse effects were recorded. Most patients were
      unable to tolerate metronidazole because of side effects or lack of efficacy,
      with only five (21%) continuing to take the drug at 24 weeks. For those patients
      attaining 12 weeks of treatment an overall improvement in articular index and
      morning stiffness was found. No improvement in laboratory indices of disease
      activity was seen, however. In this study metronidazole did not have disease
      modifying properties and was unacceptably toxic.

PMID- 1616360
TI  - Intranasal calcitonin for the prevention of bone erosion and bone loss in
      rheumatoid arthritis.
AB  - The effect of intranasal salmon calcitonin on pain, erosion progression, and bone
      loss in 40 women with rheumatoid arthritis was investigated. The study design was
      double blind, placebo controlled for the first four months and open for the next
      36 months, allowing for cross over to active drug treatment or to the control
      group. Morning stiffness was reduced in the group treated with salmon calcitonin
      after two and four months. After an average follow up of 28 months no significant
      effect on erosion progression was observed using the Larsen score. The mean (SD)
      monthly progressions in the Larsen score in the calcitonin and control groups
      were 0.21 (0.22) and 0.23 (0.28) respectively. The bone mineral density was
      evaluated in the forearm and spine. During the 12 months of follow up the control
      group lost bone at a rate of 2%/year at the spine and 4.8%/year at the radius
      distal third. In contrast, the group receiving nasal calcitonin gained 1% in bone
      mineral density at the lumbar spine and no loss at the radius distal third. The
      increase in bone density at the spine in the calcitonin group was not sustained
      and a loss of 1.8%/year was observed in the second year. The difference with the
      placebo group remained significant.

PMID- 1616361
TI  - Opinions of patients with rheumatoid arthritis about their own functional
      capacity: how valid is it?
AB  - Self assessment health status questionnaires are increasingly used to measure
      health status or the effect of treatment in patients with rheumatoid arthritis
      (RA). Most of these questionnaires measure functional (physical) disabilities.
      The question arises, however, as to how well self assessment questionnaires
      reflect the true functional status of patients or whether they only reflect their
      imaginary functional capacities. How valid is the opinion of patients with RA
      about their own functional capacity? To answer this question an investigation was
      performed in 80 patients with RA. Forty Dutch and 40 Belgian patients with RA
      completed the functional items of the DUTCH-AIMS, the Dutch version of the
      Arthritis Impact Measurement Scales (AIMS), a self assessment questionnaire
      specific to arthritis. Their scores on the functional scales were compared with
      the scores on the same scales completed by two experienced physiotherapists after
      evaluation of the functional ability of these patients. This was achieved by
      observing the patients perform the tasks given in the questionnaire. Correlation
      coefficients between the scores of the patients and the physiotherapists were
      highly significant for all the scales. No significant differences were found
      between the patients' and physiotherapists' mean scale scores except for the
      mobility scale in the Dutch patients. The strength of agreement (Cohen's kappa)
      of most scale scores of the patients and physiotherapists was substantial. The
      estimates of the overall functional capacity (the mean of the five scale scores)
      of the Belgian and Dutch patients show high correlations between the patients and
      the physiotherapists. It is concluded that patients' opinion about their
      functional ability is valid in that it is in agreement with their real functional
      abilities. This study provides further evidence for the validity of the DUTCH
      AIMS as a measure of functional disability and health status in Dutch and Belgian
      patients with RA.

PMID- 1616362
TI  - Follow up study of labial salivary gland lesions in primary Sjogren's syndrome.
AB  - Labial salivary gland biopsy samples were taken from 27 patients with primary
      Sjogren's syndrome (SS), 10 with rheumatoid arthritis (RA) and secondary SS, and
      four normal control subjects on two occasions at intervals of more than one year.
      In the former group of patients, eight of the nine initially negative analyses
      were positive on the second sample, whereas two of the seven patients with RA and
      secondary SS were negative for the first sample and then positive for the second.
      In primary SS, the mean (SD) variation of the focus score was 1.7 (2.6) and that
      of salivary duct infiltration 0.2 (0.7). The former correlated well with the
      latter.

PMID- 1616363
TI  - Soluble interleukin 2 receptors in patients with polymyositis/dermatomyositis.
AB  - The concentration of soluble interleukin 2 receptor was determined in serum
      samples from 19 patients with polymyositis/dermatomyositis by an enzyme linked
      immunosorbent assay (ELISA). The concentration of soluble interleukin 2 receptor
      in serum samples from patients with polymyositis/dermatomyositis was higher than
      that in samples from normal subjects.

PMID- 1616364
TI  - Absence of autoantibodies to peptides shared by HLA-B27.5 and Klebsiella
      pneumoniae nitrogenase in serum samples from HLA-B27 positive patients with
      ankylosing spondylitis and Reiter's syndrome.
AB  - Some microorganisms which are pathogenic in humans share amino acid sequences
      with human proteins (molecular mimicry). It has been suggested that molecular
      mimicry might be a reason for autoimmunity as a result of immunological cross
      reactivity. A homologous sequence of six amino acids has been found in both
      Klebsiella pneumoniae nitrogenase and the HLA-B27.5 molecule. In addition,
      (auto)antibodies to a synthetic peptide that contained the HLA-B27.5/klebsiella
      mimicking epitope have been detected in serum samples from HLA-B27 positive
      patients with ankylosing spondylitis and Reiter's syndrome. Confirmation of these
      data is important, because ankylosing spondylitis and Reiter's syndrome have so
      far been assumed to be 'seronegative' rheumatic diseases. It was, however, not
      possible to confirm the presence of autoantibodies against the mimicking peptide
      in serum samples from patients with ankylosing spondylitis and Reiter's syndrome.
      Serum samples from 81 patients with ankylosing spondylitis, 38 patients with
      Reiter's syndrome, and 81 healthy blood donors were tested against the 'mimicking
      peptide' in an enzyme linked immunosorbent assay (ELISA). Some of the serum
      samples from patients showed high but non-specific binding to the mimicking
      peptide. A highly significant correlation between binding to plastic coated with
      the mimicking peptide, to plastic coated with an irrelevant peptide, and even to
      non-coated plastic was observed. The nature of the serum component(s) in these
      patient serum samples (and some control serum samples) responsible for the high
      non-specific binding to plastic remains unclear. It was also shown that
      antibodies to the HLA-B27 peptide (containing the mimicking epitope) induced in
      rabbits do not cross react with the klebsiella peptide and vice versa.

PMID- 1616365
TI  - Increased levels of serum IgA as IgA1 monomers in ankylosing spondylitis.
AB  - The various subsets of serum IgA were determined in 43 patients with ankylosing
      spondylitis to investigate the putative mucosal origin of increased IgA
      concentrations in this disease. Total IgA was shown to be increased and weakly
      correlated with the erythrocyte sedimentation rate (ESR). In contrast, although
      the mean concentration (but not the median) of secretory IgA (SIgA) was slightly
      increased, no correlation was found with total IgA nor the ESR. Moreover,
      molecular sieving of nine serum samples selected for their high concentrations of
      total IgA, and absorption with insoluble jacalin showed these immunoglobulins to
      be essentially monomers of the IgA1 subclass. These results are consistent with a
      non-secretory origin of the increase of serum IgA, which must be ascribed to the
      central immune system.

PMID- 1616366
TI  - Joint hypermobility in adults referred to rheumatology clinics.
AB  - Joint hypermobility is a rarely recognised aetiology for focal or diffuse
      musculoskeletal symptoms. To assess the occurrence and importance of joint
      hypermobility in adult patients referred to a rheumatologist, we prospectively
      evaluated 130 consecutive new patients for joint hypermobility. Twenty women
      (15%) had joint hypermobility at three or more locations (greater than or equal
      to 5 points on a 9 point scale). Most patients with joint hypermobility had
      common musculoskeletal problems as the reason for referral. Two patients referred
      with a diagnosis of rheumatoid arthritis were correctly reassigned a diagnosis of
      hypermobility syndrome. Three patients with systemic lupus erythematosus had
      diffuse joint hypermobility. There was a statistically significant association
      between diffuse joint hypermobility and osteoarthritis. Most patients (65%) had
      first degree family members with a history of joint hypermobility. These results
      show that joint hypermobility is common, familial, found in association with
      common rheumatic disorders, and statistically associated with osteoarthritis. The
      findings support the hypothesis that joint hypermobility predisposes to
      musculoskeletal disorders, especially osteoarthritis.

PMID- 1616367
TI  - Aberrant cytokine production from tenosynovium in dialysis associated
      amyloidosis.
AB  - Culture supernatants of tenosynovial tissues from patients with carpal tunnel
      syndrome undergoing chronic haemodialysis contained interleukin (IL) 1-like and
      IL6-like activity. These culture supernatants also induced active proliferation
      of rheumatoid synovial cells. Immunohistochemical analysis of teno-synovial
      tissues showed the accumulation of mononuclear cells bearing CD14 and HLA-DR
      antigens adjacent to the deposition of amyloid protein (beta 2 microglobulin).
      These cells also reacted with antibodies to IL1 and IL6 respectively. These data
      suggest that multiple cytokines, including IL1 and IL6, produced from
      tenosynovial tissues in patients with dialysis associated amyloidosis might
      induce the proliferation of synovial cells that, together with deposition of
      amyloid protein, might cause carpal tunnel syndrome.

PMID- 1616368
TI  - Possible induction of systemic lupus erythematosus by human parvovirus.
AB  - A 59 year old woman presented with an influenza-like illness preceding signs and
      symptoms strongly suggestive of systemic lupus erythematosus (SLE), which
      progressed over several months. Owing to these influenza-like symptoms, a viral
      cause of her illness was sought. Human parvovirus B19 serology was positive and
      antibodies to DNA were detected by two different methods. This patient is
      believed to be the first report of human parvovirus B19 infection coinciding with
      the onset of SLE. The evidence for B19 virus and the part it plays in
      autoimmunity and arthritis is discussed.

PMID- 1616369
TI  - Histiocytic necrotising lymphadenitis in systemic lupus erythematosus.
AB  - Histiocytic necrotising lymphadenitis is the pathognomonic histological
      appearance of lymph nodes in Kikuchi's disease, a condition characterised by a
      brief systemic illness and lymphadenopathy. The case is described of a young man,
      originally diagnosed as having Kikuchi's disease by lymph node histology, who
      subsequently developed systemic lupus erythematosus with symmetrical
      polyarthritis, Coombs' positive haemolytic anaemia and haemorrhagic pneumonitis.
      The case emphasises that a range of diseases is associated with histiocytic
      necrotising lymphadenitis, belying the unitary impression given by the term
      Kikuchi's disease.

PMID- 1616370
TI  - Primary Sjogren's syndrome preceding the presentation of systemic lupus
      erythematosus as a benign intracranial hypertension syndrome.
AB  - The case is reported of a 41 year old white woman who developed systemic lupus
      erythematosus (SLE) seven years after primary Sjogren's syndrome and four years
      after the association of Sjogren's syndrome with Jaccoud's arthritis. The SLE was
      detected by a benign intracranial hypertension, which is a rare neuro-ophthalmic
      presentation of lupus. No associated conditions linked to benign intracranial
      hypertension syndrome were seen in this patient and the hypertension syndrome
      recurred one year later.

PMID- 1616371
TI  - Knee contractures as the presenting manifestation of scleroderma.
AB  - Musculoskeletal disorders may be the primary manifestations of scleroderma. The
      case is reported of a patient admitted for an evaluation of severe knee flexion
      contractures who was diagnosed as having scleroderma but lacked the typical
      presenting features of the disease. Radiographic, serological, and histological
      support for this diagnosis are presented. Scleroderma should be considered in the
      diagnostic evaluation of joint contractures.

PMID- 1616372
TI  - Granulomatous lipophagic panniculitis and temporal arteritis in a patient with
      cryptogenic chronic active hepatitis.
AB  - An elderly woman receiving long term treatment with prednisone and azathioprine
      for cryptogenic chronic active hepatitis developed granulomatous lipophagic
      panniculitis and temporal arteritis. The lymphoplasmahistiocytic inflammatory
      reaction pattern is common to this patient's three diseases. It is suggested that
      an aberration of the defence mechanisms, immunological or otherwise, is
      responsible for this unusual occurrence. The triple association of chronic active
      hepatitis, granulomatous panniculitis and temporal arteritis has not been
      reported previously.

PMID- 1616373
TI  - Multicentric reticulohistiocytosis with arthritis and cardiac infiltration:
      regression following treatment for underlying malignancy.
AB  - The case is reported of a 63 year old man presenting with a rapidly destructive
      symmetrical polyarthritis and widespread papular nodular skin lesions, confirmed
      by a biopsy to be due to multicentric reticulohistiocytosis. Biventricular
      cardiac failure developed secondary to extensive myocardial infiltration with
      multicentric reticulohistiocytosis, a complication of this disease which has not
      previously been reported. The joint, skin, and cardiac manifestations of
      multicentric reticulohistiocytosis substantially regressed following resection of
      an associated squamous cell carcinoma. This report adds to the small amount of
      published work which suggests that multicentric reticulohistiocytosis can be a
      paraneoplastic disease that may respond to treatment directed at the underlying
      tumour.

PMID- 1616374
TI  - Bone mass in osteoarthritis.

PMID- 1616375
TI  - Bone mass in patients with rheumatoid arthritis.

PMID- 1616376
TI  - The genuine Southern surgeon.

PMID- 1616377
TI  - 103rd Annual Scientific Session of the Southern Surgical Association. Hot
      Springs, Virginia, December 1-4, 1991.

PMID- 1616378
TI  - Protecting the ischemic spinal cord during aortic clamping. The influence of
      anesthetics and hypothermia.
AB  - Infrarenal circumaortic occlusion devices were operatively placed in 74 New
      Zealand white rabbits. Two days after operation the animals were randomly
      assigned to one of seven treatment groups: I, control, n = 23; II, halothane, n =
      8; III, thiopental, n = 12; IV, ketamine (30 mg/kg intravenously), n = 6; V,
      halothane+hypothermia, n = 8; VI, thiopental+hypothermia, n = 12; VII,
      ketamine+hypothermia, n = 5. In each group, the infrarenal aorta was occluded for
      21 minutes. Final neurologic recovery after restitution of blood flow was graded
      as acute paraplegia, delayed paraplegia (neurologic deficit developing after
      initial recovery), or normal. Halothane alone was of no benefit. Hypothermia with
      any anesthetic was completely protective and reduced neurologic deficits to 0%
      compared with 91% in controls (p less than 0.05). Thiopental and ketamine
      treatment each reduced acute paraplegia to 17% (as compared with 61% in controls)
      and increased delayed paraplegia from 30% in controls to 75% and 50%,
      respectively (p less than 0.05 for thiopental, p = 0.10 for ketamine). The
      authors interpret the increase in delayed deficits and decrease in acute deficits
      as being the result of partial spinal cord protection. These findings document
      that this model of spinal cord ischemia is sufficiently sensitive to identify
      interventional treatments that protect the ischemic spinal cord.

PMID- 1616379
TI  - Emergency coronary artery bypass surgery for failed percutaneous coronary
      angioplasty. A 10-year experience.
AB  - Six hundred ninety-nine patients have required emergency coronary artery bypass
      after failed elective percutaneous coronary angioplasty during the decade
      September 1980 through December 1990. This represents 4% of 9860 patients having
      12,146 elective percutaneous coronary angioplasty procedures during this
      interval. Emergency coronary artery bypass was required for acute refractory
      myocardial ischemia in 82%. Hospital mortality rate for all patients was 3.1%;
      3.7% in patients with refractory myocardial ischemia but 0.8% in patients without
      refractory myocardial ischemia, p = 0.08. Postprocedural Q-wave myocardial
      infarctions were observed in 21% versus 2.4%, p less than 0.0001, and intra
      aortic balloon pumping was required in 19% with versus 0.8% without refractory
      myocardial ischemia, p less than 0.0001. Multivessel disease, p = 0.004, age
      older than 65 years, p = 0.005, and refractory myocardial ischemia, p = 0.08,
      interacted to produce the highest risk of in-hospital death. Follow-up shows that
      there have been 28 additional late deaths, including 23 of cardiac causes for a
      91% survival at 5 years. Freedom from both late death and Q-wave myocardial
      infarction at 5 years was 61%. In the group going to emergency coronary artery
      bypass with refractory myocardial ischemia, the late cardiac survival was 90%,
      and in those without ischemia, 92% at 5 years, p = not significant. The MI--free
      survival in the group with refractory ischemia, however, was 56% versus 83% in
      the group without ischemia, p less than 0.0001. Multivariate analysis showed the
      highest late event rates for patients with Q-wave myocardial infarction at the
      initial emergency coronary artery bypass, age older than 65 years, angina class
      III or IV, and prior coronary bypass surgery. In spite of a continuing high
      incidence of early acute myocardial infarction and an increasing operative
      mortality rate (7%) in the latest 3 years cohort of patients, excellent late
      survival and low subsequent cardiac event rates demonstrate the lasting
      effectiveness of prompt, successful emergency coronary bypass surgery for failed
      percutaneous coronary angioplasty.

PMID- 1616380
TI  - Infected aortic aneurysms. A changing entity.
AB  - Infected (mycotic) aortic aneurysms are infrequent and, without surgical
      intervention, usually lead to uncontrolled sepsis or catastrophic hemorrhage.
      Symptoms are frequently absent or non-specific during the early stages, and a
      high index of suspicion is essential to make the diagnosis. Surgery performed
      after rupture carries high morbidity and mortality rates. Bacterial endocarditis
      with streptococcus pyogenes was the most common cause of infected aortic aneurysm
      in the pre-antibiotic era. Today, arterial trauma due to iatrogenic manipulation
      and depressed immunocompetence have become more common risk factors.
      Staphylococcus aureus and Salmonella are the most frequent bacteria identified.
      The authors' recent experience in six patients with infected aortic aneurysms who
      underwent arteriography and computed tomography was reviewed and these diagnostic
      methods compared. Computed tomography was found to be more sensitive in the
      diagnosis of the early stages of the disease, allowing for follow-up by serial
      scans in a noninvasive and less costly manner. Successful treatment, in four of
      these patients, was accomplished by aneurysmal resection and extra-anatomic
      bypass or in situ prosthetic reconstruction. A higher clinical awareness of this
      disease, leading to early computed tomography evaluation and prompt surgical
      intervention under appropriate and intensive antibiotic therapy, appears to offer
      the best chance of survival in patients with this difficult condition.

PMID- 1616381
TI  - Juxtarenal aortic occlusion.
AB  - The authors' experience with 113 aortic occlusions in 103 patients during a 26
      year period (1965 to 1991) is reviewed. The authors found three distinct patterns
      of presentation: group I (n = 26) presented with acute aortic occlusion, group II
      (n = 66) presented with chronic aortic occlusion, and group III (n = 21)
      presented with complete occlusion of an aortic graft. Perioperative mortality
      rates were 31%, 9%, and 4.7% for each respective group and achieved statistical
      significance when comparing group I with group II (p = 0.009) and group I with
      group III (p = 0.015). Group I presented with profound metabolic insults due to
      acute ischemia and fared poorly. Group II presented with chronic claudication and
      did well long-term. Group III presented with acute ischemia but did well because
      of established collateral circulation. The treatment and expected outcome of
      aortic occlusion depends on the cause.

PMID- 1616382
TI  - Total IgE in plasma is elevated after traumatic injury and is associated with
      sepsis syndrome.
AB  - Gamma E immunoglobulin (IgE) is associated with allergic reactions, but has not
      been described as being activated after trauma or sepsis. Total plasma IgE
      concentrations were determined in 32 patients with major traumatic injury, 29
      patients undergoing elective abdominal operations, and 30 healthy volunteers.
      Mean total IgE concentrations were 271.7 ng/mL, 52.3 ng/mL, and 41.3 ng/mL,
      respectively (p less than 0.01 for each comparison with the trauma group). Total
      IgE concentrations in trauma patients at the time of admission were not
      significantly different from elective surgical controls, and tended to increase
      during the intensive care unit stay. In the trauma group, total IgE concentration
      was significantly greater in the 18 patients that developed sepsis syndrome
      compared with those that did not (p = 0.034). These data suggest that allergic
      mechanisms may be involved in the physiologic response to major traumatic injury
      and sepsis syndrome, or that other cells known to be involved in the immune
      responses to trauma and sepsis (macrophages, platelets, and B lymphocytes) may
      become activated by IgE-dependent mechanisms.

PMID- 1616383
TI  - Abdominal packing for surgically uncontrollable hemorrhage.
AB  - Planned intra-abdominal packing for surgically uncontrollable hemorrhage from
      liver and retroperitoneal injuries exacerbated by hypothermia, acidosis, and
      coagulopathy regained popularity over the past decade. The authors reviewed 39
      patients injured between August 1985 and September 1990; 31 packed for liver
      injuries, eight for nonliver injuries. The overall mortality rate was 44%
      (17/39); 9 (23%) exsanguinated, 3 (8%) died of head injuries, 3 (8%) of
      multisystem organ failure, 2 (5%) of late complications. The mean age was 33.9 +/
      16.2 (range, 16 to 79); there were 26 men and 13 women. Relaparotomy for pack
      removal was performed 2.0 +/- 1.1 days (range, 1 to 7) after initial operation.
      The authors identified intraoperative risk factors of pH less than or equal to
      7.18, temperature less than or equal to 33 C, prothrombin time greater than or
      equal to 16, partial thromboplastin time greater than or equal to 50, and
      transfusion of 10 units or more of blood as highly predictive of outcome.
      Patients with four to five risk factors (n = 3) had a 100% mortality rate (p less
      than 0.04); two to three risk factors (n = 12), 83% mortality rate (p less than
      0.003), compared with zero to one risk factors (n = 24), 18% mortality rate.
      Complications developed in six of 22 survivors (27%): 5 abdominal abscesses
      (23%), 2 wound dehiscences (9%), and 2 enterocutaneous fistulae (9%). Intra
      abdominal packing will not stop all bleeding; 23% of the patients exsanguinated.
      In 77%, packing helped achieve hemostasis we believed was not otherwise possible.
      Packing may be done to prevent the development of acidosis, hypothermia, and
      coagulopathy or may be done early in the treatment of cold, acidotic patients
      rather than massive transfusion in the face of surgically uncorrectable bleeding.

PMID- 1616384
TI  - Abbreviated laparotomy and planned reoperation for critically injured patients.
AB  - The triad of hypothermia, acidosis, and coagulopathy in critically injured
      patients is a vicious cycle that, if uninterrupted, is rapidly fatal. During the
      past 7.5 years, 200 patients were treated with unorthodox techniques to abruptly
      terminate the laparotomy and break the cycle. One hundred seventy patients (85%)
      suffered penetrating injuries and 30 (15%) were victims of blunt trauma. The mean
      Revised Trauma Score, Injury Severity Score, and Trauma Index Severity Score age
      combination index predicted survival were 5.06%, 33.2%, and 57%, respectively.
      Resuscitative thoracotomies were performed in 60 (30%) patients. After major
      sources of hemorrhage were controlled, the following clinical and laboratory mean
      values were observed: red cell transfusions--22 units, core temperature--32.1 C,
      and pH--7.09. Techniques to abbreviate the operation included the ligation of
      enteric injuries in 34 patients, retained vascular clamps in 13, temporary
      intravascular shunts in four, packing of diffusely bleeding surfaces in 171, and
      the use of multiple towel clips to close only the skin of the abdominal wall in
      178. Patients then were transported to the surgical intensive care unit for
      vigorous correction of metabolic derangements and coagulopathies. Ninety-eight
      patients (49%) survived to undergo planned reoperation (mean delay 48.1 hours),
      and 66 of 98 (67%) survived to leave the hospital. With the exception of
      intravascular shunts, there were survivors who were treated by each of the
      unorthodox techniques. Of 102 patients who died before reoperation 68 (67%) did
      so within 2 hours of the initial procedure. Logistic regression showed that red
      cell transfusion rate and pH may be helpful in determining when to consider
      abbreviated laparotomy. The authors conclude that patients with hypothermia,
      acidosis, and coagulopathy are at high risk for imminent death, and that prompt
      termination of laparotomy with the use of the above techniques is a rational
      approach to an apparently hopeless situation.

PMID- 1616385
TI  - Control of the hypermetabolic response to burn injury using environmental
      factors.
AB  - This study was performed to establish the relative efficiency of occlusive
      dressings and variable ambient temperature (group I) versus no dressings and
      variable ambient temperature (group II) versus no dressings and electromagnetic
      heaters (group III) for controlling the postburn hypermetabolic response. Fifteen
      burn patients and five normal controls (group IV) were studied when subjectively
      comfortable using partitional calorimetry, after which each patient was cold
      stressed by sequentially decreasing external energy support, and repeating
      calorimetry studies and serial plasma catecholamine assays. The percentage
      increase in heat production above predicted normal values was significantly
      increased for all groups when cold (C) versus neutral (N) (group I: [N] 24 +/- 24
      versus [C] 49 +/- 25%; group II: [N] 46 +/- 35 versus [C] 74 +/- 47%; group III:
      [N] 21 +/- 20 versus [C] 78 +/- 25%; group IV: [N] -9 +/- 12 versus [C] 16 +/-
      10%, p less than 0.05 all comparisons). Plasma catecholamine values did not
      increase significantly when patients were subjectively cold. These studies do not
      support the role of catecholamines as the primary mediator in the cause of the
      postburn hypermetabolic response. Using the patients' subjective comfort status
      as a guide for external energy support, it is possible to greatly reduce but not
      to eliminate the hypermetabolic response to burn injury.

PMID- 1616386
TI  - Significant trends in the treatment of hepatic trauma. Experience with 411
      injuries.
AB  - Several significant advances in the treatment of hepatic injuries have evolved
      over the past decade. These trends have been incorporated into the overall
      treatment strategy of hepatic injuries and are reflected in experiences with 411
      consecutive patients. Two hundred fifty-eight patients (63%) with minor injuries
      (grades I to II) were treated by simple suture or hemostatic agents with a
      mortality rate of 6%. One hundred twenty-eight patients (31%) sustained complex
      hepatic injuries (grades III to V). One hundred seven patients (83.5%) with
      grades III or IV injury underwent portal triad occlusion and finger fracture of
      hepatic parenchyma alone. Seventy-three surviving patients (73%) required portal
      triad occlusion, with ischemia times varying from 10 to 75 minutes (mean, 30
      minutes). The mortality rate in this group was 6.5% (seven patients) and was
      accompanied by a morbidity rate of 15%. Fourteen patients (11%) with grade V
      injury (retrohepatic cava or hepatic veins) were managed by prolonged protal
      triad occlusion (mean cross-clamp time, 46 minutes) and extensive finger fracture
      to the site of injury. In four of these patients an atrial caval shunt was
      additionally used. Two of these patients survived, whereas six of the 10 patients
      managed without a shunt survived, for an overall mortality rate of 43%. Over the
      past 4 years, six patients (4.7%) with ongoing coagulopathies were managed by
      packing and planned re-exploration, with four patients (67%) surviving and one
      (25%) developing an intra-abdominal abscess. One additional patient (0.8%) was
      managed by resectional debridement alone and survived. During the past 5 years,
      25 hemodynamically stable and alert adult patients (6%) sustaining blunt trauma
      were evaluated by computed tomography scan and found to have grade I to III
      injuries. All were managed nonoperatively with uniform success. The combination
      of portal triad occlusion (up to 75 minutes), finger fracture technique, and the
      use of a viable omental pack is a safe, reliable, and effective method of
      managing complex hepatic injuries (grade III to IV). Juxtahepatic venous injuries
      continue to carry a prohibitive mortality rate, but nonshunting approaches seem
      to result in the lowest cumulative mortality rate. Packing and planned
      reexploration has a definitive life-saving role when used adjunctively in the
      presence of a coagulopathy. Nonoperative management of select hemodynamically
      stable adult patients, identified by serial computed tomography scans after
      sustaining blunt trauma is highly successful (95-97%).

PMID- 1616387
TI  - Enteral versus parenteral feeding. Effects on septic morbidity after blunt and
      penetrating abdominal trauma.
AB  - To investigate the importance of route of nutrient administration on septic
      complications after blunt and penetrating trauma, 98 patients with an abdominal
      trauma index of at least 15 were randomized to either enteral or parenteral
      feeding within 24 hours of injury. Septic morbidity was defined as pneumonia,
      intra-abdominal abscess, empyema, line sepsis, or fasciitis with wound
      dehiscence. Patients were fed formulas with almost identical amounts of fat,
      carbohydrate, and protein. Two patients died early in the study. The enteral
      group sustained significantly fewer pneumonias (11.8% versus total parenteral
      nutrition 31.%, p less than 0.02), intra-abdominal abscess (1.9% versus total
      parenteral nutrition 13.3%, p less than 0.04), and line sepsis (1.9% versus total
      parenteral nutrition 13.3%, p less than 0.04), and sustained significantly fewer
      infections per patient (p less than 0.03), as well as significantly fewer
      infections per infected patient (p less than 0.05). Although there were no
      differences in infection rates in patients with injury severity score less than
      20 or abdominal trauma index less than or equal to 24, there were significantly
      fewer infections in patients with an injury severity score greater than 20 (p
      less than 0.002) and abdominal trauma index greater than 24 (p less than 0.005).
      Enteral feeding produced significantly fewer infections in the penetrating group
      (p less than 0.05) and barely missed the statistical significance in the blunt
      injured patients (p = 0.08). In the subpopulation of patients requiring more than
      20 units of blood, sustaining an abdominal trauma index greater than 40 or
      requiring reoperation within 72 hours, there were significantly fewer infections
      per patient (p = 0.03) and significantly fewer infections per infected patient (p
      less than 0.01). There is a significantly lower incidence of septic morbidity in
      patients fed enterally after blunt and penetrating trauma, with most of the
      significant changes occurring in the more severely injured patients. The authors
      recommend that the surgeon obtain enteral access at the time of initial celiotomy
      to assure an opportunity for enteral delivery of nutrients, particularly in the
      most severely injured patients.

PMID- 1616388
TI  - Carotid endarterectomy monitored with transcranial Doppler.
AB  - Intraoperative transcranial Doppler monitoring of cerebral ischemia during
      carotid clamping under general anesthesia was done in 238 carotid artery
      operations, mostly endarterectomy. Depending on the severity of reduction of
      middle cerebral artery mean velocity, patients were classified as no, mild, or
      severe ischemia at clamping. With a carotid shunt, velocity was always in the "no
      ischemia" category during shunting. For patients with no ischemia, stroke was
      significantly lower without a shunt (2/175 no shunt versus 2/12 shunt). For mild
      ischemia, shunting did not affect the stroke rate (1/20 no shunt versus 0/9
      shunt). For severe ischemia, strokes were less frequent with a shunt (4/9 no
      shunt versus 0/13 shunt). Intraoperative electroencephalogram predicted most, but
      not all severely ischemic cases. Carotid back pressure correlated with Doppler
      velocity, but transcranial Doppler was more helpful. Transcranial Doppler is a
      new and valuable technique in carotid surgery.

PMID- 1616389
TI  - The effect of gastrin on growth of human stomach cancer cells.
AB  - Gastrin is known as a trophic factor for some stomach and colorectal cancer
      cells; however, the roles of gastrin receptors and the intracellular signal
      transduction pathways by which gastrin regulates cell growth are still unknown.
      The authors examined the effect of synthetic human gastrin-17 on growth of human
      stomach cancer cells (the parent line, AGS-P, and two different clones, AGS-10
      and AGS-12), which were established (and have been maintained) in our laboratory.
      Gastrin stimulated growth of AGS-P and AGS-10 cells, which have gastrin
      receptors, in a dose-dependent fashion. A highly selective gastrin receptor
      antagonist, JMV 320, inhibited the growth-stimulatory effect of gastrin on AGS-P
      cells in a dose-dependent fashion. Concentrations of gastrin (10(-8) to 10(-6)
      M), which stimulated growth of AGS-P cells, did not affect either cyclic
      adenosine monophosphate production or phosphatidylinositol hydrolysis. Gastrin
      (10(-11) to 10(-5) M) mobilized calcium from the intracellular organelles to
      increases intracellular calcium level in AGS-P cells. The AGS-12 clone has no
      gastrin receptors, and gastrin did not affect growth or mobilization of
      intracellular calcium in these cells. Our findings indicate that gastrin
      stimulates growth of AGS cells through a mechanism that involves binding to
      specific gastrin receptors that are linked to the system for mobilization of
      intracellular calcium.

PMID- 1616390
TI  - Cytokine modulation of Na(+)-dependent glutamine transport across the brush
      border membrane of monolayers of human intestinal Caco-2 cells.
AB  - Previous studies have demonstrated that Na(+)-dependent brush border glutamine
      transport is diminished in septic patients. To examine the potential regulation
      of this decreased transport by endotoxin, cytokines, or glucocorticoids, the
      human intestinal Caco-2 cell line was studied in vitro. Na(+)-dependent glutamine
      transport across the apical brush border membrane was assayed in confluent
      monolayers of differentiated cells that were 10 days old. Uptake of 50 microM
      glutamine was determined after a 12-hour incubation with varying doses (10 to
      1000 U/mL) of tumor necrosis factor-alpha, interleukin-1, interleukin-6,
      interferon-gamma, and various combinations of these cytokines. Studies were also
      done in cells incubated with E. coli endotoxin (1 micrograms/mL) or dexamethasone
      (1 and 10 microM). Endotoxin, tumor necrosis factor, interleukin-1, and
      interleukin-6 alone and in combination did not significantly reduce Na(+)
      dependent glutamine transport across the brush border of Caco-2 cells.
      Dexamethasone decreased glutamine transport by 20%, but this decrease was not
      apparent for 48 hours. Interferon consistently decreased glutamine transport by
      30%; this was due to a reduction in carrier maximal transport velocity (3427 +/-
      783 pmol/mg protein/minute in controls versus 2279 +/- 411 in interferon, p less
      than 0.05) rather than a change in Km (276 +/- 29 microM in controls versus 333
      +/- 74 in interferon, p = not interferon + dexamethasone + tumor necrosis factor
      + interleukin-1 resulted in a 38% decrease in transport activity. Cytokines and
      glucocorticoids may work independently and synergistically in regulating Na(+)
      dependent brush border glutamine transport in human intestinal cells. Whether
      these signal molecules play a central role in the cause of the diminished brush
      border glutamine transport that occurs in septic patients requires further study.

PMID- 1616391
TI  - Patterns of ileal recurrence in Crohn's disease. A prospective randomized study.
AB  - To gain information on the pathogenesis of ileal recurrence, 86 patients with
      Crohn's disease undergoing their first ileocolic resection were randomized to
      receive either an end-to-end (n = 47) or side-to-end (n = 39) anastomosis. The
      demographic and clinical characteristics of both groups were similar. There were
      no statistically significant differences between the two groups in postoperative
      complications or in the subsequent development of symptomatic or documented
      recurrences. Among the 43 patients with follow-up in the end-to-end anastomosis
      group, there were 10 documented ileal recurrences (23%), and all involved distal
      ileum in the characteristic preanastomotic location. Among the 35 patients with
      follow-up in the side-to-end anastomosis group, there were 11 documented
      recurrences (31%, not significant). The ileal recurrence pattern could be
      determined accurately in five of these 11 patients and involved the ileum
      adjacent to the colon, but spared the distal ileum in the blind pouch. This study
      suggests that the fecal stream and reflux of colonic contents are important
      factors in determining the pattern of ileal recurrence after ileocolectomy for
      Crohn's disease.

PMID- 1616392
TI  - Evaluation of the relative efficacy of various antimalarial drugs in Nigerian
      children under five years of age suffering from acute uncomplicated falciparum
      malaria.
AB  - A parallel group-randomized comparison of the therapeutic efficacy of chloroquine
      (CQ), amodiaquine (AM), quinine (QN), sulphadoxine-pyrimethamine (S-P),
      mefloquine 15 mg kg-1 (M15) and mefloquine 25 mg kg-1 (M25) in acute symptomatic
      uncomplicated falciparum malaria was carried out in 325 children under the age of
      five years in Ibadan, southwestern Nigeria, using the 28-day in vivo test. The
      parasitological cure rate, assessed only up to day 14, was 85% in the CQ group
      and 100% in the other groups. The mean parasite and fever clearance times were,
      respectively, 2.64 and 1.20 days in the CQ-sensitive subgroup, 2.32 and 1.13 days
      in the AM group, 2.27 and 1.17 days in the QN group, 2.23 and 1.76 days in the S
      P group, 2.13 and 1.10 days in the M15 group, and 2.07 and 1.09 days in the M25
      group. The CQ-treatment failures (seven of 46 patients) were successfully treated
      with 25 mg kg-1 mefloquine, with parasite and fever clearance times of 1.73 and
      1.0 days respectively. The study shows that, in Nigeria, CQ is now less effective
      than AM, S-P, QN and M in acute falciparum malaria in the group most vulnerable
      to the infection (the under-five-year-olds).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616393
TI  - Survival of Trypanosoma brucei brucei in cerebrospinal fluid.
AB  - Different compositions of artificial cerebrospinal fluid (CSF) and the CSF from
      sleeping sickness patients both with and without late-stage [i.e. central nervous
      system (CNS)] involvement were evaluated for their abilities to support survival
      of Trypanosoma brucei brucei. Artificial CSF, containing the major electrolytes,
      amino acids and carbohydrate components of healthy fluid, was equivalent to the
      CSF from patients without CNS involvement (survival time 20 hours). Normal CSF
      does not therefore contain substances which deter the parasite. The CSF from the
      late-stage patients did not support survival for longer than 10 hours, probably
      because it contained increased numbers of lymphocytes and antibodies.

PMID- 1616394
TI  - Drug targeting with polyalkylcyanoacrylate nanoparticles: in vitro activity of
      primaquine-loaded nanoparticles against intracellular Leishmania donovani.
AB  - The efficacy of primaquine-loaded polyisohexylcyanoacrylate (PIHCA) nanoparticles
      was evaluated using J774G8 macrophage-like cells infected with Leishmania
      donovani: as an in vitro model of visceral leishmaniasis. The in vitro
      antileishmanial activity of primaquine-loaded nanoparticles showed a 21-fold
      increase in ED50 compared with free primaquine. Although unloaded PIHCA
      nanoparticles also exhibited a significant anti-leishmanial effect, the loaded
      nanoparticles showed a synergistic effect compared with a mixture of unloaded
      nanoparticles and free primaquine at equivalent concentrations. Primaquine
      release and isohexanol production were evaluated in a lysosomal fraction; the
      correlation of both with protein concentration and the rapid drug release
      indicate the processes are associated with an enzymatic degradation. The results
      indicate that PIHCA and other polyalkylcyanoacrylates may be useful for targeting
      drugs at intracellular Leishmania, and that the unloaded carrier itself could be
      of interest in experimental chemotherapy of leishmaniasis.

PMID- 1616395
TI  - Substituted methyl benzimidazole carbamate: efficacy against experimental
      cysticercosis.
AB  - Methyl [5-([4-(2-pyridinyl)-1-piprazinyl] carbonyl)-1H benzimidazole-2-yl]
      carbamate, a broad spectrum anthelmintic, was tested against Cysticercus
      fasciolaris in rats and the cysticercoids of Hymenolepis nana in beetles. A dose
      of 50 mg kg-1, given intraperitoneally (i.p.) to infected rats on 10 alternate
      days, was found most effective, killing all mature cysticerci. The same dose,
      given on each of five days, either from the fifth day prior to infection or the
      sixth day following infection, fully arrested the establishment of cysticerci. A
      single prophylatic dose of 500 mg kg-1, given intramuscularly (i.m.), protected
      rats against challenge with Taenia taeniaeformis eggs for 10 days. The test
      compound, mebendazole and praziquantel were all totally ineffective against
      mature cysticercoids in grain beetles but, of the beetles fed the drugs in flour,
      66.3%, 50% and 83.8%, respectively, failed to support the development of immature
      cysticercoids. The effective cysticidal action of the compound makes it a
      candidate medical anthelmintic.

PMID- 1616396
TI  - Chemotherapy of human cystic echinococcosis: comparative efficacy of mebendazole
      and albendazole.
AB  - The relative efficacy of mebendazole (MEB) and albendazole (ALB) was tested by
      treating 51 patients with single, multiple and multi-organ hydatid cysts; 28
      patients were treated with MEB, 50-70 mg kg-1 body weight daily for six to 24
      months, and 23 with ALB, 10 mg kg-1 body weight daily in four courses of 30 days
      with 15-day intervals between courses. The therapeutic effect during the follow
      up was assessed by ultrasonography, computerized tomography and chest X-ray. The
      criteria used when assessing the results were: 'success', evidence of effect on
      all cysts; 'partial success', evidence of effect on some of the cysts; and 'no
      success', no changes in cyst morphology. Treatment with MEB was successful in
      eight cases (28.6%), partially successful in eight (28.6%) and unsuccessful in 12
      (42.8%). Treatment with ALB was successful in 10 cases (43.5%), partially
      successful in 10 (43.5%) and unsuccessful in three (13.0%).

PMID- 1616397
TI  - Immune status during albendazole therapy for hydatidosis.
AB  - Immunological monitoring of cystic hydatid patients undergoing medico-surgical
      management has revealed that it is possible to assess individual host responses
      throughout therapy and subsequently be guided by the results obtained. The
      analysis has involved the demonstration of variation in haemagglutination
      antibodies, specific IgG and IgM immunoglobulins and circulating immune complexes
      before, during, and months after albendazole therapy.

PMID- 1616398
TI  - Prevalence of Toxoplasma gondii antibodies in goats in Sri Lanka.

PMID- 1616399
TI  - Immunological localization of blood pl antigen in tissues of Echinococcus
      granulosus.

PMID- 1616400
TI  - Bacteriology of abscesses complicating bites of lance-headed vipers.

PMID- 1616401
TI  - A simplified method for identifying subspecies and strain groups in Trypanozoon
      by isoenzymes.
AB  - To characterize trypanosomes from the subgenus Trypanozoon, 272 stocks in 111
      zymodemes were analysed by the polymorphisms seen in a rationalized range of nine
      enzymes, resolved by electrophoresis, mostly on cellulose acetate. Several highly
      polymorphic or invariant enzymes used previously were omitted, while two new
      enzymes, NHD and SOD were included; the isoenzymes seen for SOD were interpreted
      as two separate enzymes, SODA and SODB. Isoenzyme band patterns were analysed by
      two complementary numerical methods to elucide taxonomic relationships within the
      subgenus; groups of zymodemes corresponding to subspecies and strain groups were
      defined, which agreed closely with previous studies. Except for one zymodeme,
      Trypanosoma evansi could not be clearly distinguished from the bouafle strain
      group. This strain group had enzymic features that overlapped to some extent
      those of the busoga group. Trypanosoma brucei gambiense and the zambezi, kakumbi,
      kiboko and sindo groups were clearly defined. Eight zymodemes could not be
      classified. A rapid identification system using a limited number of enzymes is
      presented.

PMID- 1616402
TI  - [CT vs MRI in the diagnosis of acute stroke].
AB  - 70 patients who had suffered an acute stroke (52 ischaemic and 18 haemorrhagic)
      were studied with CT and MR, performing both techniques during the first week of
      disease and correlating the findings with the clinical data. MR proved superior
      in the detection of ischaemic infarcts, specially those in the posterior
      territory and with a small size; it was also superior to CT in the detection of
      leukoaraiosis and the demonstration of vascular obstructions. CT failed to detect
      a small brain stem haemorrhage secondary to bleeding of a cavernoma, while its
      performance was similar to that of MR in the remaining cases. In all patients
      with intracerebral haemorrhages, including two who were examined on the first
      day, an area of increased density was evidenced in the T1 sequences. It is
      concluded that CT, due to its greater availability and easiness of performance,
      must be maintained as first choice in acute stroke in order to differentiate
      haemorrhage from ischaemia, while MR may provide additional information in
      selected cases.

PMID- 1616403
TI  - [Various capabilities involved in memory and the disturbances caused by amnesia
      syndromes].

PMID- 1616405
TI  - Pathologists in the 1990s and in the 21st century. Physicians providing quality
      diagnoses, laboratory information, and therapies for patient care.

PMID- 1616404
TI  - [Response to the cold test in patients older than 60 years of age with ischemic
      cerebrovascular disease].
AB  - We have realized the test of cold in a group of patients with ischemic
      cerebrovascular attack (AVCi) and in a control group. The comparison of results
      shows a different vascular reactivity into the groups. At present, it is unknown
      if there is a relation of this finding with the AVCi occurrence.

PMID- 1616406
TI  - Professional satisfaction. Can it exist for the pathologist in 2001?

PMID- 1616407
TI  - Another look at manpower studies.

PMID- 1616408
TI  - Pathology trainee manpower. Historical perspectives.
AB  - Discussions of pathology manpower typically involve short-term projections. For
      example, the best current data indicate a significant shortage of community
      hospital/private-laboratory pathologists over the 5-year period from 1988 through
      1993. Even though such short-term predictions are important in the debate over
      strategic planning in pathology, they need to be placed in a broader historical
      context. Therefore, we present the long-term trends in pathology trainee
      manpower. These trends indicate why predictions of a shortage should not come as
      a surprise.

PMID- 1616409
TI  - College of American Pathologists Foundation Conference VI: A Profile of the
      Pathologist in the Year 2001. September 5-8, 1991.

PMID- 1616410
TI  - Probable impact of physician payment reform. A 40-year perspective.

PMID- 1616411
TI  - What will the pathologist be doing in 2001? Speculations of a hospital
      practitioner.
AB  - The 21st century looms ahead, and physicians are increasingly anxious about what
      the practice of medicine will be like in the future. Pathologists, like other
      physicians, are holding conferences and writing papers in an attempt to predict
      what lies ahead. From the perspective of one community pathologist, the future
      looks bright as far as work opportunities. The jobs that will need to be filled
      will include familiar ones and numerous new tasks. There will be plenty of jobs;
      but will there be enough skilled pathologists to fill these positions? The answer
      depends on our ability to attract the needed physicians into pathology and to
      give them the needed variety of skills to survive in a new work environment.

PMID- 1616412
TI  - Next-generation technologies. Impact on the work load of the pathologist.
AB  - Technologies emerging and evolving in the 1990s, particularly in molecular
      biology, therapeutics, computerization, and information management, will alter
      the type of work and work load of the pathologist. In general, new technologies
      will increase the work load of pathologists. However, the extent to which new
      medical technologies affect pathology will be modulated by socioeconomic factors,
      given the relationship between new technology and increased medical costs.
      Pathologists may choose to embrace many new technologies and should play an
      active role in technology assessment to ensure the appropriate use of new
      diagnostic procedures.

PMID- 1616413
TI  - Why manpower surveys in pathology? Use of the National Pathology Manpower
      Database.
AB  - The National Pathology Manpower Database was developed in 1986 as a
      representative subset of pathologists engaged in community hospital and private
      laboratory practice. Manpower surveys in 1987, 1988, and again in 1991 using the
      National Pathology Manpower Database have consistently shown a greater projected
      attrition in the number of pathologists from this practice setting than the
      number of new pathologists entering the specialty. Without periodic surveys of
      pathologists using a valid sample such as the National Pathology Manpower
      Database, it is likely that future decisions regarding the supply and need for
      pathologists would be based on the American Medical Association Master File of
      Physicians that does not specify practice activity or reflect any manpower
      kinetics.

PMID- 1616414
TI  - Problems and opportunities in pathology manpower.
AB  - Speculations regarding the future of pathology manpower most often depend on
      whether the perspective taken is pessimistic or optimistic. In this article, I
      propose that the pessimist-optimist options are inadequate. To speculate
      responsibly about the future, our first task must be to understand clearly the
      present problems and opportunities. Problems facing pathology are numerous: (1)
      practitioners are retiring at an increasing rate, (2) inadequate numbers of newly
      trained pathologists are available to fill vacancies, (3) training program
      numbers continue to decline, (4) attrition of trainees is substantial, and (5)
      recruitment of new trainees encounters significant barriers. Despite these
      problems, significant opportunities to improve training program environments,
      decrease attrition, and increase recruitment are available. The future of
      pathology will depend on how we respond to the problems and opportunities that we
      currently face.

PMID- 1616415
TI  - Are we training the next generation of pathologists correctly?

PMID- 1616416
TI  - The pathologist of 2001 as seen in 1991.

PMID- 1616417
TI  - Can continuing medical education prepare the current practitioner for the 21st
      century?
AB  - The traditional approach to continuing medical education (CME) will be inadequate
      to prepare the practicing pathologist for the 21st century. Seminars at regional
      or national meetings, audiovisual presentations, and similar CME activities are
      useful to provide updates or to fill in more detailed information in the basic
      knowledge that all pathologists must acquire during their training. Different,
      more imaginative approaches will be necessary for the pathologist wishing to
      acquire the necessary knowledge and skills to utilize the newly developing
      techniques in pathology, such as flow cytometry, image analysis, and the myriad
      diagnostic procedures based on molecular biology. Self-directed learning will
      continue to be an essential approach to CME, and the availability of computer
      programs, including videodisks, will be increasingly effective. However, it
      should be acknowledged that self-directed learning has been available since the
      invention of the printing press. The current pressure for public accountability
      of medical practitioners clearly indicates that pathologists must accept the
      reality that CME will not be recognized unless it is provided by an accredited
      organization and attendance is documented. Pathologists should anticipate
      institution of recertification procedures involving peer review, which will
      require documentable CME. This CME will be based on needs assessment, educational
      objectives, more effective formats, and evaluation of whether CME, in fact,
      improved the pathologist's effectiveness in practice. The academicians have their
      sabbaticals to refresh their knowledge and explore new fields; perhaps
      minisabbaticals should be arranged for both the academicians and the practicing
      pathologist who cannot be away from his or her responsibilities for 6 months or 1
      year. The medical specialty societies are the most suitable groups for organizing
      these programs, although the actual programs must be provided in the laboratories
      that actually perform the procedures.

PMID- 1616418
TI  - College of American Pathologists Foundation Conference VI: a profile of the
      pathologist in the year 2001--summary of the conference.

PMID- 1616419
TI  - College of American Pathologists Foundation Conference VI. A profile of the
      pathologist in the year 2001--predictions and recommendations. Board of Directors
      of the College of American Pathologists Foundation.

PMID- 1616420
TI  - Continuous quality improvement. Autologous blood donations.

PMID- 1616421
TI  - Preoperative autologous blood donation in 612 hospitals. A College of American
      Pathologists' Q-Probes study of quality issues in transfusion practice.
AB  - We compared predeposit autologous blood utilization practices in 612 hospitals
      (where 107,559 autologous and 2,504,522 homologous units were transfused in all
      of 1989). Participating blood bankers prospectively followed up donors who
      presented for initial donation during an 11-week period in early 1990. They
      recorded the number of autologous donors whose blood was drawn (n = 22,276);
      units that were donated (n = 40,163), transfused (n = 23,988), crossed over (n =
      937), and discarded (n = 15,443); and donors transfused with autologous blood
      only (n = 11,923) or donors who received homologous blood (n = 2002). Most donors
      (89.7%) avoided homologous blood, including donors (39.5%) who did not require
      transfusion. Units that were donated for low-risk surgery represented 23.1% of
      all units that were collected, and the rate of donation for these procedures was
      directly proportional to the percentage of donors who did not require transfusion
      and to the discard rate. We concluded that a major focus of quality improvement
      in autologous transfusion practice should be the reduction of donations for
      surgical procedures for which blood replacement is rarely needed.

PMID- 1616422
TI  - Toluidine blue in the detection at autopsy of perineal and anal lacerations in
      victims of sexual abuse.
AB  - Toluidine blue dye can be used at autopsy to aid in the detection of genital and
      anal injuries due to child sexual abuse. Four case examples are presented.

PMID- 1616424
TI  - Diagnostic efficiency of carcinoembryonic antigen and CA125 in the cytological
      evaluation of effusions.
AB  - In our previous study, the combination of the concentrations of carcinoembryonic
      antigen (CEA) and CA125 and the findings from cytological examination in 189
      benign and malignant pleural and peritoneal effusions was useful in the
      diagnosis/classification of malignant effusions. Sensitivity of CEA (level,
      greater than 5 ng/mL) was 68%; specificity was 99% for the diagnosis of malignant
      effusions secondary to carcinoma of the lung, breast, gastrointestinal tract, and
      mucinous carcinoma of the ovary. Sensitivity of CA125 (level, greater than 5000
      U/mL) was 85%; specificity was 96% for the diagnosis of malignant effusions in
      carcinoma of the ovary, fallopian tube, and endometrium. We now expanded the
      study to include 840 pleural and peritoneal effusions (benign, n = 520;
      malignant, n = 320) and analyzed the data by the statistical method of Rudolph
      and colleagues. Based on new cutoff values, ie, CEA level at 6.3 ng/mL and CA125
      level at 3652 U/mL, the sensitivities for detection of malignant effusions
      secondary to carcinomas of the lung, breast, and gastrointestinal tract and
      mucinous carcinoma of the ovary varied between 75% and 100%; specificity was 98%.
      Sensitivity of CA125 for detection of malignant effusions from mullerian
      epithelial carcinoma was 71%; specificity was 99%. The elevated CEA fluid level
      alone helped to diagnose malignant effusions of the gastrointestinal tract in
      54%, breast in 19%, and lung in 16%. The high CA125 fluid level was predictive of
      mullerian epithelial carcinoma. Adjunctive use of CEA and CA125 levels in fluid
      enhances the sensitivity of cytological diagnosis and may be predictive of the
      primary site in patients who present with carcinoma of an unknown primary source.

PMID- 1616423
TI  - Evidence of cytotoxic T-cell destruction of epidermal cells in human graft-vs
      host disease. Immunohistology with monoclonal antibody TIA-1.
AB  - A newly described mouse monoclonal IgG1 antibody, TIA-1, binds serine esterase
      positive granule membranes of cytotoxic human T cells and is a candidate for an
      effector molecule involved in T-cell cytolytic mechanisms analogous to those of
      the perforin system. We performed immunohistologic studies on frozen human skin
      (n = 5) and lip (n = 21) sections as well as on control frozen sections of
      tonsils, purified cytolytic T (CD8) cells, and B cells using an indirect
      immunoperoxidase system. We found a strong association of TIA-1+ cells with CD8+
      cells invading the epidermis in lip and skin lesions of graft-vs-host disease in
      human marrow allograft recipients, as well as a sharp geographic association of
      TIA+ lymphocytes with CD8+ regions in human tonsil sections. Double staining of
      CD8 and TIA-1 antigens with fluorescein isothiocyanate and Texas red confirmed
      that 80% to 90% of the CD8 cells were TIA-1+ in the epidermal infiltrates. Leu-7
      activity (natural killer cell) was minimal and found in only three of 17 lip
      biopsy specimens. These data provide new evidence that direct cytolytic attack by
      donor T lymphocytes is the mechanism of epithelial target cell killing in human
      graft-vs-host disease.

PMID- 1616425
TI  - Human pulmonary hypoplasia. Statistical, morphological, morphometric, and
      biochemical study.
AB  - Human pulmonary hypoplasia was studied statistically and pathologically in a
      large series of autopsy cases. Multiple logistic regression analysis indicated
      five independent risk factors from 10 statistically significant factors for
      pulmonary hypoplasia: (1) hydrops fetalis; (2) renal anomalies; (3) hernia,
      including diaphragmatic hernia and omphalocele; (4) skeletal anomalies; and (5)
      abnormalities of amniotic fluid, such as oligohydramnios and polyhydramnios. The
      characteristics of pulmonary hypoplasia for each factor were defined by
      morphological, morphometric, and biochemical methods. All bronchiolar branching,
      acinar complexity, and acinar maturation were retarded in hypoplastic lungs with
      hydrops fetalis, renal anomalies, affected side of diaphragmatic hernia,
      omphalocele, and skeletal anomalies. Only acinar complexity and maturation were
      impaired in the lung with oligohydramnios due to prolonged rupture of membranes.
      The pathogenesis of pulmonary hypoplasias should be considered differently with
      each associated anomaly and time of impairment. While impairment in early
      gestational stage before 16 weeks' gestation results in both reduced bronchiolar
      branching and retarded acinar development, that, at late stage, influences only
      acinar development.

PMID- 1616426
TI  - Sudden death in early infancy due to delayed cardiac tamponade complicating
      central venous line insertion and cardiac catheterization.
AB  - Cardiac tamponade is an unusual cause of sudden death in the first weeks of life.
      We present two cases of cardiac tamponade in the neonatal period that caused
      death 5 to 6 days following the insertion of intracardiac lines, to draw
      attention to the possibility of a "delay phenomenon" between the time of the
      initial procedure and the occurrence of sudden and unexpected death. The presence
      of blood or clear fluid within the pericardial sac should prompt careful
      examination of the myocardium for small foci of traumatic damage, particularly
      when the fluid is under pressure or of large volume. Although the development of
      circulatory impairment or shock in the days following central line insertion or
      catheterization raises the possibility of tamponade, it should be noted that
      sudden death may occur in the absence of any significant antemortem symptoms or
      signs.

PMID- 1616427
TI  - The precision of duplicate prothrombin time and partial thromboplastin time
      assays in neonates.
AB  - An evaluation of duplicate prothrombin time (PT) and activated partial
      thromboplastin time (PTT) assays was performed in 277 neonatal samples.
      Performance criteria were analyzed to determine whether single vs duplicate
      procedures could be utilized reliably without exposing the neonates to the risk
      of erroneous PT and PTT results. In addition, we evaluated whether this approach
      might decrease phlebotomy and hence reduce the number of blood transfusions
      administered. For PT assays, 97.5% (270/277) of the duplicate results were
      different by 1 second or less. Only 2.5% (7/277) differed by 3 seconds. For PTT
      duplicates, 75.0% (207/277) of the values were different by 2 seconds or less and
      13.0% (36/277) by 2 to 4 seconds. An additional 12.3% (34/277) were discrepant by
      as many as 4 seconds. The largest discrepancies occurred in specimens with
      markedly elevated PT and PTT results, indicative of a significant coagulopathy.
      In addition, heparin neutralization was performed successfully in 22 neonatal
      blood specimens showing either partial or full correction of PTT values due to
      heparin specimen contamination. This study indicates that single PT and PTT
      assays as well as heparin neutralization tests can be accurately performed and
      may be able to reduce blood donor exposure by as many as one blood transfusion
      every 2 to 3 days of hospitalization.

PMID- 1616428
TI  - Disseminated microsporidiosis (Encephalitozoon hellem) and acquired
      immunodeficiency syndrome. Autopsy evidence for respiratory acquisition.
AB  - Microsporidia are obligate intracellular protozoal parasites that infect a
      variety of cell types in a broad range of invertebrates and vertebrates. They
      have recently come to medical attention due to the increased frequency with which
      members of two microsporidian genera, Enterocytozoon and Encephalitozoon, are
      being diagnosed in patients with the acquired immunodeficiency syndrome (AIDS).
      The majority of published reports of human microsporidiosis describe
      Enterocytozoon infection of small intestinal enterocytes. In addition, a growing
      number of AIDS patients have been identified with infection due to the two
      species of Encephalitozoon-Encephalitozoon cuniculi and Encephalitozoon hellem,
      observed in conjunctival, corneal, and, recently, sinonasal tissues. However,
      there are scant data regarding the systemic pathology and epidemiology of these
      infections. This article describes a patient with AIDS who died with systemic
      Encephalitozoon infection. The etiologic microsporidian was found to be E hellem
      by using antemortem biochemical and antigenic analyses. A complete autopsy, the
      first to be reported in a patient with this infection, revealed organisms in the
      eyes, urinary tract, and respiratory tract. A surprising observation was the
      occurrence of numerous organisms within the lining epithelium of almost the
      entire length of the tracheobronchial tree, suggestive of respiratory
      acquisition. Detailed light and electron microscopic findings and the biological
      and diagnostic features of microsporidiosis are discussed.

PMID- 1616429
TI  - Yellow lens effects upon visual acquisition performance.
AB  - Twenty subjects made a total of 400 threshold visual acquisitions of T-38
      aircraft approaching from 9 miles out. Half of the acquisitions were made with
      the subjects wearing yellow ophthalmic filters, and the other half without
      filters. No overall statistically significant difference in acquisition
      performance due to the use of yellow filters was found.

PMID- 1616430
TI  - Contact lens wear with the USAF Protective Integrated Hood/Mask chemical defense
      ensemble.
AB  - The Protective Integrated Hood/Mask (PIHM) chemical defense aircrew ensemble
      blows air from the mask's plenum across the visor at a rate of approximately 15
      L/min in order to prevent fogging of the visor and to cool the aircrew member's
      face. This study was designed to determine the effect of the PIHM airflow on soft
      contact lens (SCL) dehydration, contact lens comfort, and corneal integrity.
      There were 26 subjects who participated in this study: 15 SCL wearers, 6 rigid
      gas-permeable (RGP) wearers, and 5 nonspectacle wearing controls. Contrast acuity
      with the 3 Regan charts, subjective comfort, and relative humidity (RH) and
      temperature readings under the PIHM mask were monitored every 0.5 h during 6-h
      laboratory rides. Slit-lamp examinations and SCL water content measurements with
      a hand-held Abbe refractometer were made before and after the rides. High RH
      under the mask may have accounted for the moderate SCL dehydration (8.3%), no
      decrease in contrast acuity for any group, and lack of corneal stress. Although
      all groups experienced some inferior, epithelial, punctate keratopathy, RGP
      wearers had the most significant. SCLs performed relatively well in the PIHM mask
      environment. Testing with other parameter designs is necessary before
      recommending RGPs with the PIHM system.

PMID- 1616431
TI  - Determination of a pressure breathing schedule for improving +Gz tolerance.
AB  - A base of empirical data for developing optimal pressure breathing during +Gz
      (PBG) schedules is lacking. Relaxed +Gz-intensity tolerance with PBG was measured
      during gradual +Gz-onset rate centrifuge profiles using standard lightbar
      criteria. Constant PBG levels ranging from 18-73 mm Hg were randomly assigned. G
      suit pressure followed the standard or an increased inflation schedule. Nine
      subjects wore a jerkin, CSU-15/P G-suit, and TLSS helmet and mask. With mean mask
      cavity pressures of 0, 18, 38, 60, and 73 mm Hg, corresponding +Gz-tolerances
      (mean +/- S.E.M.) were: 5.3 +/- 0.2, 5.8 +/- 0.1, 6.6 +/- 0.2, 7.3 +/- 0.3, and
      7.5 +/- 0.3 Gz (linear correlation, r = 0.994). Increased G-suit pressure did not
      change the +Gz-tolerance improvement with PBG. The inverse of individual subject
      regression slopes ranged from 22.6 to 58.1 mm Hg/+Gz. Considering additional
      factors and adequate +Gz protection for all subjects while relaxed, the proposed
      schedule would apply 42 mm Hg PBG/+Gz beginning at +3.3 Gz with a maximum
      pressure of at least 73 mm Hg.

PMID- 1616432
TI  - Histaminergic response to Coriolis stimulation: implication for transdermal
      scopolamine therapy of motion sickness.
AB  - The blood levels of histamine and 5-hydroxytryptamine (5-HT) in 10 subjects, with
      or without administration of the transdermal therapeutic system of scopolamine
      (TTS-S), were measured following motion sickness (MS) induced by Coriolis
      stimulation. Histamine and 5-HT were assayed using the fluorometric method. The
      results demonstrated that the blood levels of histamine increased significantly
      following MS and were even higher in the subjects using TTS-S, but we found
      neither significant changes in the blood levels of 5-HT following MS nor any
      effect of TTS-S on it. The results suggest that histamine contributes to the
      development of MS, and scopolamine may exert its anti-MS action by affecting the
      histaminergic system as well as the acetylcholinergic system; there may not be a
      definite relation between 5-HT and the development of MS.

PMID- 1616433
TI  - Effect of hypobaric hypoxia on fiber type composition of the soleus muscle in the
      developing rat.
AB  - The fiber type composition of the soleus muscle was investigated in male Sprague
      Dawley rats exposed to hypobaric hypoxia of 460 mm Hg from 5 to 12 weeks of age.
      The muscle fibers were classified as fast-twitch oxidative (FO) and slow-twitch
      (S) on the basis of adenosine triphosphatase (ATPase) and succinate dehydrogenase
      (SDH) reactions. Intermediate fibers (INT) with intermediate ATPase and high SDH
      reaction intensities were also examined. A type shift of muscle fibers from FO to
      INT and S was found in the control group during development. After exposure to
      hypoxia, the hypoxia group had a significantly greater percentage of FO fibers
      than the age-matched control group. There was no significant change in the total
      number of fibers in the muscle during development and after exposure to hypoxia.
      These results indicate that the increased percentage of FO fibers found in the
      developing rat under hypoxic conditions is due to a hypoxia-induced inhibition of
      the type shift of muscle fibers from FO to S during development.

PMID- 1616434
TI  - Use of a motion sickness history questionnaire for prediction of simulator
      sickness.
AB  - This research assessed the usefulness of the Motion History Questionnaire (MHQ)
      for the prediction of simulator sickness, a form of motion sickness experienced
      by pilots training in ground-based flight simulators. Four MHQ scoring keys were
      compared: (1) the original MHQ key which had been validated on a sample of U.S.
      Navy student pilots exposed to Coriolis forces, (2 and 3) two keys which had been
      validated on a sample of civilian college students exposed to simulated ship
      motions, and (4) a simulator sickness key empirically derived in the present
      research and cross-validated. Navy and Marine Corps aviators (N = 456) filled out
      the MHQ prior to their regularly scheduled flight simulator training and were
      divided into validation and cross-validation samples. All scoring keys were
      predictive of reported symptoms of sickness, but highest correlations were
      obtained with the empirically-derived simulator sickness (SS) key. It is
      suggested that the SS key be used for self-testing so that pilots may be made
      aware of their risk for developing simulator sickness.

PMID- 1616435
TI  - Sustained attention and serial responding in heat: mental effort in the control
      of performance.
AB  - The effects of heat (40 degrees C) on sustained attention and serial responding
      were studied in a simple reaction time task and a serial four choice reaction
      time task, respectively. Core temperature (Tc), heart rate variability (HV) and
      subjective reactions were monitored during the 80 min of exposure time. Simple
      reaction time performance and accuracy in the serial choice reaction time task
      deteriorated significantly in heat. In the serial choice reaction time task, the
      effects of heat on response times and on HV were correlated. Performance and
      level of Tc were not correlated, but a relationship was found between performance
      and rate of Tc change. Results are discussed in relation to the
      thermophysiological status of the subjects and the compensatory mechanism of
      effort allocation. It is proposed that task characteristics regulate the degree
      of activity of this compensatory mechanism.

PMID- 1616436
TI  - Cervical injuries during high G maneuvers: a review of Naval Safety Center data,
      1980-1990.
AB  - As aircraft capable of sustaining high "G" maneuvers enter the U.S. Navy Fleet,
      the reported incidence of cervical injury to aircrew seems to have increased. To
      determine the extent of the problem, personal injury reports submitted to the
      Naval Safety Center were reviewed for the 10-year period from 1980 to 1990. In
      addition, confidential questionnaires were sent to flight surgeons supporting
      fighter/or fighter-attack units. The data collected were statistically analyzed.
      The incidence of cervical injuries, defined as at least one day's absence from
      the flight schedule, was computed. Other subjective factors, such as the type
      helmet worn, the cockpit position flown and the type of mission profile
      completed, were examined. As might be expected, the most common offender was air
      combat maneuvering. The most common aircraft was the F/A18, but the radar
      intercept officer position in the F14B was also a significant contributor. The
      most common injury pattern reported was a simple muscle strain. Cervical pain
      after high "G" missions poses a potential threat to combat readiness. However,
      the use of the newer lightweight helmet seems to have reduced the severity.
      Muscle strengthening exercises appear to help in prevention. Treatment is
      successful in most cases with minimal or no residuals noted. As yet, there exist
      little official data to support the notion of a major problem.

PMID- 1616437
TI  - Thyroid hormone changes during military field operations: effects of cold
      exposure in the Arctic.
AB  - This study examined the effect of prolonged physical activity in a cold
      environment upon circulating thyroid hormone levels. A secondary focus of the
      study involved the role of nocturnal habitat upon the thyroidal responses to the
      physical activity and cold exposure. Military personnel exposed to 10 d of field
      based operations in the arctic region of Norway were studied. Blood samples were
      collected before (day 1), and at days 5 and 10 of the operations. Levels of total
      T4, free T4, total T3, free T3, and thyroid binding globulin were assessed in all
      blood samples. The results indicated considerable, significant (p less than 0.05)
      decreases in total thyroid hormone levels, while relative increases of free
      fractions of the hormones occur with the 10-d operations in the Arctic. However,
      no significant influence on thyroidal responses were observed due to the
      nocturnal habitat that the subjects lived in. The hormonal alterations noted are
      possibly brought about by the combined effects of physical activity and cold
      exposure acting synergistically to alter thyroid physiology (e.g., most likely
      the protein carrier binding affinity).

PMID- 1616438
TI  - Inner ear barotrauma: a case for exploratory tympanotomy.
AB  - A case of inner ear barotrauma (IEBT) due to an hypobaric chamber experience is
      presented. IEBT is an exceedingly rare condition in aviation. In the case
      described, the diagnosis was initially unsuspected due to accompanying middle ear
      barotrauma. The underlying etiology, the diagnosis, and management of IEBT are
      discussed.

PMID- 1616439
TI  - Menstrual history in altitude chamber trainees.
AB  - Previous studies have determined a higher rate of altitude-induced decompression
      sickness (DCS) in women than in men. Women are reportedly at higher risk for
      developing DCS during menses. A study of menstrual history in women completing
      altitude chamber training without developing DCS has never been accomplished. The
      purpose of this study was to collect and analyze menstrual history in these
      women. Thirteen U.S. Air Force Aerospace Physiology Units participated in a USAF
      approved survey for 1 year. After completing altitude chamber flights, data on
      age, day of menstrual cycle (DMC), birth control pill use (BCP), and mean
      durations of menstrual cycle and menses were collected. There were 508 responses
      analyzed. There was no differences between mean duration of menstrual cycle and
      menses in the Yes (Y) and No (N) BCP groups. Y and N BCP groups were equally
      distributed across the menstrual cycle. Women completing altitude chamber
      training without developing DCS appear to be evenly distributed across their
      menstrual cycle, with use of BCPs not affecting their susceptibility to DCS.

PMID- 1616440
TI  - Laser surgery procedures in the operational KC-135E aviation environment.
AB  - The operational aviation and space environments present a potential for surgical
      trauma to aircrew and passengers. Current wound care techniques for trauma in the
      aviation and space medicine environment focus on classical surgical management of
      wounds. Medical lasers used in these environments can provide rapid control of
      bleeding wounds, reduce aircraft environmental contamination from body fluids and
      secretions, and foster rapid triage of injured personnel. Self-contained and
      reusable medical lasers have the potential to reduce the material supply of
      medical kits in the aviation and space environment. A miniaturized carbon dioxide
      laser was used to establish protocols and procedures for use on operational
      military KC-135E aircraft. Laser surgery was performed to demonstrate laser
      efficacy and safety in flight.

PMID- 1616441
TI  - Comparison of current Shuttle and pre-Challenger flight suit reach capability
      during launch accelerations.
AB  - The Challenger accident prompted the creation of a crew escape system which
      replaced the former Launch Entry Helmet (LEH) ensemble with the current Launch
      Entry Suit (LES). However, questions were raised regarding the impact of this
      change on crew reach capability. Our study addressed the question of reach
      capability and its effect on realistic ground-based training for Space Shuttle
      missions. Eleven subjects performed reach sweeps in both the LEH and LES suits
      during 1 and 3 Gx acceleration trials in the Brooks AFB, TX, centrifuge. These
      reach sweeps were recorded on videotape and subsequently analyzed using a three
      dimensional motion analysis system. The ANOVA procedure of the Statistical
      Analysis System (SAS) program was used to evaluate differences in forward and
      overhead reach. The results showed that the LES provided less reach capability
      than its predecessor, the LEH. This study also demonstrated that, since there was
      no substantial difference between 1 and 3 Gx reach sweeps in the LES, realistic
      Shuttle launch training may be accomplished in ground-based simulators.

PMID- 1616443
TI  - The future of aerospace medicine: dissolution or growth?

PMID- 1616442
TI  - A new generation of U.S. Army flight helmets.
AB  - Head injuries are the most common cause of fatal injury in helicopter crashes.
      For over 80 years, the U.S. Army has used crash investigation studies to redesign
      flight helmets. This paper describes the evolution of the new fielded U.S. Army
      helmet, the Sound Protection Helmet No. 4B (SPH-4B), and compares its protective
      features to its predecessors, especially the SPH-4. A major contribution to the
      helmet design process was made by the Aviation Life Support Equipment Retrieval
      Program (ALSERP), a functional program at the U.S. Army Aeromedical Research
      Laboratory (USAARL). ALSERP has analyzed more than 500 helmets involved in crash
      events since 1972. Based on these studies of critical safety factors, the Army
      has developed and deployed the SPH-4B, a new helmet with improved energy
      absorption, retention, and stability.

PMID- 1616444
TI  - Functional cytology of the human testis.
AB  - The seminiferous tubular compartment of the human testis occupies about two
      thirds of the volume of the organ and is supported by loose connective tissue
      containing the Leydig cells. Sertoli cells extend from the basal lamina to the
      lumen of the seminiferous tubule and provide structural and functional support to
      the germ cells which proliferate and mature through the complex process of
      spermatogenesis, lasting for approximately 70 days. Histological examination of
      the human seminiferous epithelium gives the impression of a very irregular
      pattern of germ cell development but recent cytological, ultrastructural and
      computer-modelling studies have shown that the arrangement of germ cells within
      the seminiferous tubules is in fact highly organized into a helical pattern based
      upon the geometry of concentric spirals. Thus the human spermatogenic cycle is
      precisely regulated in accordance with the more familiar ordered arrangements of
      germ cells seen in most non-human primates and other mammalian species. The
      population of Leydig cells in the adult human testis represents the third and
      final phase of their developmental history, preceded by distinct neonatal and,
      earlier, fetal Leydig cell generations. Human Leydig cells are irregular in
      outline, deeply staining with basophilic dyes and exhibit a characteristic
      circular or ovoid nucleus. The density of their cytoplasm is attributed to
      extensive domains of smooth endoplasmic reticulum, characteristic of
      steroidogenic tissue. Mitochondria are numerous and lipid droplets and lipfuscin
      inclusions accumulate with advancing age. Crystals of Reinke up to 30 microns in
      length are often noted in the Leydig cell cytoplasm although their function
      remains unknown. The intertubular tissue contains small calibre lymphatic
      vessels, fibroblasts, collagen, blood vessels and occasional macrophages. With
      increasing age, declining sperm production and lowered androgen levels are
      correlated with decreases in the numbers of Sertoli cells and Leydig cells
      although the mechanisms responsible for this attrition have not been defined.
      Continued collaboration between morphologists and physiologists is necessary if
      we are to understand fully the endocrine regulation of spermatogenesis and the
      factors contributing to disturbances of spermatogenic function.

PMID- 1616445
TI  - The prenatal and postnatal development of the testis.

PMID- 1616446
TI  - The Sertoli cell.

PMID- 1616447
TI  - Local control systems within the testis.
AB  - A number of physiological and pathological observations cannot readily be
      explained unless one accepts that there exists within the testis some sort of
      local control system. This local network of regulatory interactions offers not
      only an additional level of fine regulation for individual testicular functions,
      but also creates an opportunity for co-ordination and integration of distinct
      activities such as germ cell development and androgen production. There is an
      overwhelming amount of data indicating that the testis produces a variety of
      regulatory molecules and that many of these agonists have marked effects on the
      function of testicular cells in vitro. Some of these molecules are identical with
      or are at least related to known hormonal and humoral agonists. Others are novel
      and require further characterization. The exact cellular origin of many of these
      regulatory factors remains unknown. This overview has been limited to regulatory
      interactions between somatic testicular cells. Particular attention has been paid
      to communications between the interstitial and the tubular compartment. It should
      be evident that the nature and the significance of these interactions is only
      beginning to emerge. The major difficulty remains to distinguish effects that are
      restricted to the specific and often artificial conditions of in vitro systems
      from phenomena that are relevant to testicular control in vivo. Further progress
      in this field will rely on the development of appropriate systems to study local
      interactions in vivo. Valuable attempts have been made in this direction: vitamin
      A induced synchronization of spermatogenesis may offer a model to study stage
      dependent alterations in the interstitial compartment (Morales and Griswold,
      1987; Bartlett et al, 1989); destruction of Leydig cells followed by substitution
      with androgens might clarify the role of non-steroidal Leydig cell mediators on
      tubular function (Shape et al, 1988). Up to now these approaches have failed to
      demonstrate an important role for local regulatory interactions. It is obvious
      that both models are relatively crude, however, and that subtle changes may have
      been missed under the experimental conditions used. It should be stressed that
      some of the observed complexities may be inherent to local regulatory networks.
      In fact, such networks tend to display a certain level of redundancy. It is
      evident, for example, that a number of locally produced mediators can also reach
      the testis via the circulation. In this setting the relative contribution of
      circulating and locally produced factors may vary depending on developmental
      stages, physiological or pathological conditions. A relative redundancy may exist
      for distinct locally produced mediators.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1616449
TI  - The physiology of testicular inhibin and related proteins.
AB  - The roles of inhibin and related proteins in the male remain unclear, although it
      is becoming increasingly evident that they play a part in FSH regulation and
      testicular function, including spermatogenesis. The difficulties associated with
      these questions have been the limited availability of inhibin and related
      proteins for in vivo studies, the absence of specific assay methods, and the
      unclear relationship of inhibin and testosterone in the regulation of FSH
      secretion. With the availability of human recombinant preparations and the
      current development of new assays, it is anticipated that many of these questions
      will be resolved.

PMID- 1616448
TI  - Control of spermatogenesis by follicle stimulating hormone and testosterone.

PMID- 1616450
TI  - Testicular steroidogenesis and androgen use and abuse.
AB  - The possibility of widespread use of androgens in the normal male population for
      the promotion of growth, sexual dysfunction, contraception, osteoporosis and
      ageing and large scale abuse by athletes have propelled androgen replacement out
      of the narrow confines of male hypogonadism and highlighted the many gaps in our
      knowledge. There is now a new appreciation of the much wider aetiological,
      therapeutic, preventative and public health implications surrounding the clinical
      use of androgens. To realize the many potential health benefits through
      manipulations of the androgen milieu of normal men, basic and clinical
      investigations into a number of key unresolved issues are urgently required.
      There is a need to understand the molecular mechanisms underlying the
      differential roles of testosterone, DHT and oestradiol in various androgen
      responsive target tissues especially with reference to the pathogenesis of
      prostatic hyperplasia or carcinoma. It is also necessary to define the dose
      response relationships of the action of androgens on spermatogenesis (and basis
      for inter-ethnic differences), sexual and aggressive behaviour and bone mineral
      turnover over a wide dose range. Clinically, it is important to systematically
      assess whether there is any increased risk for cardiovascular and prostatic
      diseases in androgen replacement and the risk-benefit issues concerning androgen
      therapy in aged men. Development of androgens with high therapeutic indices, long
      half-lives, zero-order release kinetics and perhaps selective target tissue
      specificity through modification to the steroid structure can further optimize
      future modalities of androgen therapy.

PMID- 1616451
TI  - Evaluation of testicular function.
AB  - The evaluation of testicular function is based primarily on a detailed medical
      history, a careful physical examination, basal measurements of FSH, LH and
      testosterone and a routine semen analysis. In a patient with androgen deficiency,
      the diagnosis can often be made with these basic tests. The clinician will then
      decide on other investigations to localize the organic lesion and to plan further
      treatment for the patient. Sperm function tests are often performed in patients
      presenting with infertility. These newer tests may help to delineate the
      abnormality of the spermatozoa at each stage during the achievement of
      fertilizing capacity such as adequate forward motility, penetration of cervical
      mucus, acrosome reaction, development of hyperactivated motility, binding to the
      zona pellucida, and fusion with the oocyte. Currently, many of these sperm
      function tests depend on cumbersome bioassays with many limiting factors
      contributing to their availability, accuracy and precision. The development of
      biochemical tests as markers of sperm function may allow more precise definition
      of sperm functional abnormalities. With the continued improvement of computer
      aided sperm analysis, objective motion parameter measurements are possible and
      morphological assessment are being developed. These newer objective methods of
      semen analysis have to be shown to be valuable in the clinical assessment of
      patients with testicular dysfunction.

PMID- 1616452
TI  - An approach to the management of male infertility.
AB  - Male factors are present in nearly half the couples consulting for infertility.
      The correct approach to the management of male infertility follows a logical and
      scientifically sound sequence of procedures. These include history taking,
      systematic physical examination for general and local causes of abnormal semen
      quality, complemented by contact-thermoscopy, echography and hormone assays if
      available. Conventional semen analysis can be replaced by more accurate advanced
      methods measuring sperm motility characteristics. Several tests of sperm
      functional capacity are also available. It is mandatory to detect and treat known
      and accepted causes of impaired sperm quality using adequate and reliable
      methods. Complementary methods to stimulate spermatogenesis, or to assist
      reproduction should be offered in well-defined cases. The overall success rate of
      male infertility treatment remains lower than that of female treatment, though
      recent technology has improved results remarkably.

PMID- 1616453
TI  - Effects of transections to the vomeronasal nerves or to the main olfactory bulbs
      on the initiation and long-term retention of maternal behavior in primiparous
      rats.
AB  - While the onset of maternal behavior at parturition is mediated by hormones, the
      maintenance of maternal behavior during the first few postpartum weeks depends on
      experiences acquired while the dam interacts with pups (Rosenblatt, 1990). In
      fact, if female rats are permitted as little as 2 h or maternal experience within
      36 h after Cesarean delivery, they exhibit heightened maternal behavior during
      maternal induction tests 10 days later; in contrast, dams separated from young at
      the time of Cesarean delivery and not permitted a maternal experience fail to
      respond maternally in tests 10 days later (Orpen & Fleming, 1987). In this study
      we investigated the role of chemosensory input through the vomeronasal and main
      olfactory systems in this maternal experience effect. Six groups of primiparous
      females were tested for maternal behavior to foster pups presented 9-10 days
      after Cesarean delivery: three groups were permitted to interact with pups for a
      2-h period 36 h after Cesarean delivery; and three groups were separated from
      pups until testing and were given no maternal experience. Within each experience
      condition, one group sustained bilateral section of the vomeronasal nerves, one
      sustained bilateral coronal cuts through the midsection of the main olfactory
      bulbs, and one group sustained small medial olfactory bulb cuts. The results
      showed that animals sustaining vomeronasal or olfactory transections, regardless
      of experience condition, exhibited significantly reduced latencies to maternal
      behavior in maternal induction tests. However, these chemosensory disruptions did
      not prevent an additional facilitation of maternal behavior produced by a prior
      maternal experience.

PMID- 1616454
TI  - Multitrial inhibitory avoidance learning in the crab Chasmagnathus.
AB  - Chasmagnathus crabs placed in the dark compartment (DC) of a double-chamber
      device and given electrical shocks whenever they entered or remained in the light
      compartment (LC), showed an LC-avoidance behavior when tested 24 h after a
      training session of three 30-min periods with 60-min intervals. The avoidance
      behavior depended neither on the shock number nor on the distribution at training
      but only on exposure to the LC-shock contingency, thus suggesting that crabs
      learn to associate the LC with an aversive situation. The learning outcome
      disclosed a higher degree of refraining from entering the LC rather than a faster
      escaping to the DC. Distributed practice proved more effective on crab avoidance
      learning than massive practice. Retention of the learned behavior occurred after
      a 24-h rest interval in an environment different from that of the training
      apparatus. Experimental devices previously used in avoidance learning studies
      with crabs were improved here by automating both the computation of latency
      values and the event recording.

PMID- 1616455
TI  - Genetic analysis of isolation-induced aggression. I. Comparison between closely
      related inbred mouse strains.
AB  - Young adult males of the inbred mouse strains BALB/c, C57BL/6, CBA, C3H/He, and
      the outbred strain NMRI showed significant interstrain differences for isolation
      induced aggression as measured in a standard-opponent test. Additionally, four
      related inbred strains of common origin (ABG, AB//Halle, ABB, AB//Jena) were
      studied. ABG and AB//Halle showed nearly no overlap for the trait isolation
      induced aggression. Tests of histocompatibility and coat color, as well as
      mandible measurements, confirmed a close genetic relationship between ABG and
      AB//Halle. The large difference for isolation-induced aggression between these
      two closely related strains offers excellent opportunities to search for single
      gene correlates of aggression.

PMID- 1616456
TI  - Age-dependent changes in olfactory-mediated behavioral investigations in the male
      rat.
AB  - In the present experiment male Sprague-Dawley rats at three different ages
      (young, middle-aged, and old) were tested in a series of olfactory-mediated
      behavioral tests. The amount of ano-genital investigation directed to receptive
      females by old rats was significantly reduced compared to that of young and
      middle-aged animals. In contrast, general body investigation of receptive females
      was similar among the three age groups. The amount of anogenital investigation
      directed to nonreceptive females or immature male rats indicated significant
      differences only between young and old rats, with values from middle-aged rats
      being intermediate and not significantly different from either of the two extreme
      groups. General body investigation of nonreceptive females and immature males did
      not differ among the three age groups. Old rats showed the best performance in a
      location of buried food test with latencies to locate food approximately one-half
      that obtained from young and middle-aged rats. Measures of general locomotor
      activity indicated significantly greater values from young compared to middle
      aged and old rats, with the latter two showing very similar levels. These results
      demonstrate clear discriminatory differences in olfactory-mediated behavioral
      performance of the male rat as a function of the specific test and age of the
      animal. Overall, the results suggest that olfactory-mediated behaviors related to
      reproduction appear more sensitive to age-related declines, while behavior
      related to food procurement is more minimally affected.

PMID- 1616457
TI  - Learning of rats under amnesia caused by pentobarbital.
AB  - Dissociated learning of rats in the normal state and the state of amnesia
      produced by pentobarbital (15 mg/kg, ip) was carried out. Rats were trained to
      approach a shelf where they received food reinforcement. In Group 1 the rats were
      trained under the influence of pentobarbital to run to the same shelf as in the
      normal state. In Group 2 the rats were trained to approach different shelves in
      different drug states. It was shown that memory dissociation occurred in both
      groups. Differences in the parameters of training under the influence of
      pentobarbital between Groups 1 and 2 were revealed. These findings show that the
      brain-dissociated state induced by pentobarbital is formed with the participation
      of the mechanisms of information perception.

PMID- 1616458
TI  - A threshold for the protective effect of over-reinforced passive avoidance
      against scopolamine-induced amnesia.
AB  - Acetylcholine-receptor blockers produce amnesia of aversively motivated
      behaviors. However, when animals are submitted to relatively high intensities of
      footshock (over-reinforcement), anticholinergic treatment does not induce memory
      impairments. The aim of this work was to determine whether the antiamnesic effect
      produced by increasing the magnitude of the negative reinforcer is gradually
      established or if a threshold should be reached to obtain such an effect. Wistar
      rats were trained in passive avoidance using 2.5, 2.6, 2.7, 2.8, 2.9 or 3.0 mA; 5
      min after training they were given one systemic injection of scopolamine (8
      mg/kg). An amnesic state was produced in the groups that were trained with the
      lower intensities (2.5-2.7 mA); with the three higher intensities near-perfect
      retention was evident. These results suggest that acetylcholine is critically
      involved in memory consolidation, and that by increasing the magnitude of the
      negative reinforcer, a threshold is reached where cholinergic activity of the
      nervous system is not necessary for the development of the consolidation process.

PMID- 1616459
TI  - Nifedipine blocks retention of a visual discrimination task in chicks.
AB  - Reports that the dihydropyridine Ca2+ channel antagonists may facilitate memory
      led to the present study of the behavioral effects of nifedipine. Ninety-two 4
      day-old male chicks received 0, 100 nM, 100 microM, or 10 mM nifedipine. Drugs
      were administered in volumes of 2 microliters into the fourth cerebral ventricle
      5 min before training on a visual discrimination task. Nifedipine did not produce
      any detectable changes in behavior during acquisition trials. Retention, however,
      was impaired 24 h after training in the 100 nM and 100 microM nifedipine-treated
      chicks, which made significantly more errors than controls. Nifedipine did not
      affect the amount of time required to complete the task. No effects on body
      weight gain were detected, suggesting that the memory impairment was not due to a
      change in feeding behavior. These data are discussed in terms of the role of
      calcium-dependent processes in memory.

PMID- 1616460
TI  - Genetic Tobit factor analysis: quantitative genetic modeling with censored data.
AB  - Parameters of quantitative genetic models have traditionally been estimated by
      either algebraic manipulation of familial correlations (or familial mean
      squares), biometric model fitting, or multiple-group covariance structure
      analysis. With few exceptions, researchers who have used these methods for the
      analysis of twin data have assumed that their data were multinormal and,
      consequently, have used normal-theory estimation methods. It is shown that normal
      theory methods produce biased genetic and environmental parameter estimates when
      data are censored. Specifically, with censored data, (1) normal-theory estimates
      of narrow-sense heritability are either positively or negatively biased, whereas
      (2) estimates of shared-familial environmental variance are always biased
      downward. An alternative method for estimating genetic and environmental
      parameters from censored twin data is proposed. The method is called genetic
      Tobit factor analysis (GTFA) and is an extension of the Tobit factor analysis
      model developed by Muthen (Br. J. Math. Stat. Psychol. 42, 241-250, 1989). Using
      a Monte Carlo design, the performance of GTFA is compared to traditional
      quantitative genetic methods in both large and small data sets. The results of
      this study suggest that GTFA is the preferred method for the genetic modeling of
      censored data obtained from twins.

PMID- 1616461
TI  - The analysis of parental ratings of children's behavior using LISREL.
AB  - A common procedure for assessing children's behavior is to obtain parental
      ratings of the child. Since the ratings obtained are a function of both parent
      and child, disentangling the child's phenotype from that of the rater becomes an
      important methodological problem. For the analysis of genetic and environmental
      contributions to children's behavior, solutions to this are available when
      multiple raters, e.g., two parents, rate multiple children, e.g., twins. This
      paper describes and illustrates simple LISREL models for the analysis of parental
      ratings of children's behavior. We show how the assumption that mothers and
      fathers are rating the same behavior in children can be contrasted with the
      weaker alternative that parents are rating correlated behaviors. Given the
      stronger assumption, which appears adequate for ratings of children's
      internalizing behavior problems, the contribution of rater bias and unreliability
      may be separated from the shared and nonshared environmental components of
      variation in a behavior genetic analysis.

PMID- 1616462
TI  - Decomposition of multivariate phenotypic means in multigroup genetic covariance
      structure analysis.
AB  - Observed differences in phenotypic means between groups such as parents and their
      offspring or male and female twins can be decomposed into genetic and
      environmental components. The decomposition is based on the assumption that the
      difference in phenotypic means is due to a difference in the location of the
      normal genetic and environmental distributions underlying the phenotypic
      individual differences. Differences between the groups in variance can be
      accommodated insofar as they are due to differences in unique variance or can be
      modeled using a scale parameter. The decomposition may be carried out in the
      standard analysis of genetic covariance structure using, for instance, LISREL.
      Illustrations are given using simulated data and twin data relating to blood
      pressure. Other possible applications are mentioned.

PMID- 1616463
TI  - Evidence for a genetic etiology in hyperactivity in children.
AB  - There has been considerable controversy over the nosology of hyperactivity and
      attention deficit hyperactivity disorder (ADHD). There have been suggestions that
      genetic influences may play a role in the origins of individual differences on
      this dimension or dimensions of behavior and that an understanding of the
      significance of genetic factors might help to clarify the classification of these
      disorders. Multiple regression is used to analyze data from a sample of 91 pairs
      of identical twins and 105 pairs of same sex fraternal twins. The heritability of
      extreme group membership (h2g = 0.75) was significant for activity rated by the
      mother. The heritability for one of the measures of attention deficit was also
      significant (h2g = 0.76). The results are consistent with a significant genetic
      contribution to individual differences in activity levels and attention
      abilities.

PMID- 1616464
TI  - Seven generations of genetic selection for ethanol dependence in mice.
AB  - An animal model of alcohol dependence is being produced by selecting mice for
      differences in severity of ethanol withdrawal seizures. Replicate lines of high
      dependence (HA), low-dependence (LA), and control (CA) mice are being developed
      by within-family selection. After seven generations both (replicate) HA and LA
      lines have separated significantly. Some of the difference between the replicate
      pairs of HA and LA in the early generations was due to differences in ethanol
      consumption. This difference in consumption may be attributable to a difference
      in metabolic rate or activity level rather than to a difference in ethanol
      preference. Females are more susceptible to seizures than males; this appears to
      be due partly to their higher consumption of ethanol during treatment.

PMID- 1616465
TI  - Genetics of spike-wave discharges in the electroencephalogram (EEG) of the
      WAG/Rij inbred rat strain: a classical mendelian crossbreeding study.
AB  - The WAG inbred strain might be an animal model for human absence epilepsy. To
      study the inheritance pattern of absence epilepsy, WAG rats were crossbred, in a
      classical Mendelian way, with inbred ACI rats which show no signs of epilepsy. In
      the parental strains, reciprocal F1 hybrids, F2, B1, and B2 generations, the
      number and duration of spike-wave discharges were determined. One hundred percent
      of the F1 animals showed spike-wave discharges, while the percentages for the F2,
      B1, and B2 generations were 79, 95, and 37%, respectively. These results suggest
      that the occurrence of spike-wave discharges is determined by one gene with a
      dominant mode of inheritance. Cavalli's least-squares fitting procedure suggested
      different genetic models for the two parameters (number and duration) during the
      two periods (dark and light). These results confirm our previous findings
      (Peeters et al., Behav. Genet. 20, 453-460, 1990) that a number of genes are
      involved in absence epilepsy. One dominant gene appears to determine the
      occurrence, however, while others manipulate the number and duration of epileptic
      phenomena during the two periods dark and light.

PMID- 1616466
TI  - Behavioral coupling in tettigoniid hybrids (Orthoptera).
AB  - Studies of the mating behavior of male and female F1 hybrids between closely
      related taxa can provide information concerning the genetic control of characters
      that play a major role in speciation. Orthoptera have been used previously for
      such studies. Hybrid crickets show behaviors which are broadly intermediate to
      the parentals but hybrid grasshoppers may retain parental behavior patterns. This
      study examines the behavior of hybrid Ephippiger ephippiger bushcrickets, the
      third major orthopteran group. The differences in male song and female preference
      are probably both mainly additive and male song differences not sex linked. Thus,
      given a choice, hybrid females would prefer to mate with hybrid males, an example
      of "behavioral coupling." The evolutionary inferences which can be drawn from
      studies of F1 hybrids between closely related taxa are discussed.

PMID- 1616467
TI  - Heterosis for concentrations of dopamine, norepinephrine, their metabolites, and
      epinephrine in the chick hyperstriatum ventrale, hypothalamus, and optic tectum.
AB  - A complete diallel cross using both sexes was derived from four parental
      populations of chickens having divergent developmental rates. This paradigm was
      used to investigate the genetic architecture of the neurochemicals,
      norepinephrine (NE), epinephrine (EPI), 3,4-dihydroxyphenylacetic acid (DOPAC),
      dopamine (DA), and 3-methoxy-4-hydroxyphenylglycol (MHPG). No sex differences
      were found for any genetic parameter investigated. Estimates of average line
      effects, maternal effects, and additive sex linkage were not significant. Highly
      significant heterosis, in the form of overdominance, was observed for
      catecholamine and metabolite concentrations. Hybrids exhibited significant line
      heterosis in the positive direction for NE, while heterosis for MHPG was observed
      in the negative direction for all crosses. Heterosis for EPI was both line and
      brain area specific with the hypothalamus showing greatest heterotic effects.
      DOPAC showed significant heterosis for all lines only in the optic tectum, and DA
      showed little heterosis specific to any line, cross, or brain area.

PMID- 1616468
TI  - Parental divorce and adolescent maladjustment: scientific inquiry vs public
      information.

PMID- 1616469
TI  - Cardiophobia: a paradigmatic behavioural model of heart-focused anxiety and non
      anginal chest pain.
AB  - Cardiophobia is defined as an anxiety disorder of persons characterized by
      repeated complaints of chest pain, heart palpitations, and other somatic
      sensations accompanied by fears of having a heart attack and of dying. Persons
      with cardiophobia focus attention on their heart when experiencing stress and
      arousal, perceive its function in a phobic manner, and continue to believe that
      they suffer from an organic heart problem despite repeated negative medical
      tests. In order to reduce anxiety, they seek continuous reassurance, make
      excessive use of medical facilities, and avoid activities believed to elicit
      symptoms. The relationship of cardiophobia to illness phobia, health anxiety, and
      panic disorder is discussed. An integrative psychobiological model of
      cardiophobia is presented which includes previous learning conditions relating to
      experiences of separation and cardiac disease; deficient and inappropriate
      behavioural repertoires which constitute a psychological vulnerability for
      cardiophobic problems; negative life events, stressors, and conflicts in the
      person's present situation that trigger and contribute to the symptoms; current
      affective, cognitive, and behavioural symptoms and their stimulus properties; and
      genetic and acquired biological vulnerability factors. Finally, recommendations
      for the treatment of cardiophobia are derived from the model and areas of future
      research are outlined.

PMID- 1616470
TI  - The many faces of Pan: psychological and physiological differences among three
      types of panic attacks.
AB  - The thesis of this paper is that failure to recognize the psychological and
      physiological differences among panic attacks within DSM-IIIR precludes
      meaningful comparisons and evaluations of research findings, confounds
      theoretical issues, and impairs the development of more specific, and thereby
      more effective, programs of treatment. To remedy this, a recommendation is made
      to define panic attacks on the basis of psychological and physiological
      distinctions that fit three categories of severity: Type I (classic panic
      attack), Type II (anticipatory panic attack), and Type III (cognitive panic
      attack). The logical-empirical rationale for the categories recommended is
      presented in the context of relevant research findings. Implications for theory,
      experimental design, and treatment are discussed.

PMID- 1616471
TI  - Adolescent dental fear and control: prevalence and theoretical implications.
AB  - This study examined the prevalence and etiology of dental fear in a large,
      representative sample of Singapore adolescents. Participants completed a
      questionnaire regarding fear of the dentist, dental beliefs and their most recent
      dental visit. The population prevalence of high dental fear was 115 fearful
      children per 1000 population (SE = 0.02). Children who reported painful treatment
      and perceived lack of control at the dentist were 13.7 times more likely to
      report high fear and 15.9 times less likely to be willing to return to the
      dentist or dental nurse. The etiology of severe clinical fear appears strongly
      related to direct conditioning in the presence of pain and vulnerability.

PMID- 1616472
TI  - Site-specific muscle hyper-reactivity in musicians with occupational upper limb
      pain.
AB  - Fourteen musicians who reported a history of pain in the upper limb associated
      with the playing of their instruments were compared with a sample of pain-free
      musicians, matched for age, sex and musical instrument. Four tasks were presented
      in random order and included neutral, general stressor, personal stressor and
      pain stressor tasks. Ratings of stressfulness and recordings of skin conductance
      level confirmed the effectiveness of the experimental manipulations for both
      subject groups. No differences were found between groups or tasks for frontalis
      surface electromyograph (EMG) activity. Evidence was found, however, of EMG
      elevation in flexor and trapezius muscles on the pain side for the pain subjects,
      in response to the task involving recall of a pain experience. This elevation was
      not found for the pain-free controls or for other stressor tasks, although some
      elevation in response to the pain stressor task was found for pain subjects in
      the trapezius muscles of the non-pain side. The duration of return to baseline of
      EMG following the pain stressor task was found to be extended in pain subjects
      for the trapezius, but not for the flexor muscles of the pain side. The findings
      suggest that site-specific muscle hyper-reactivity may play a role in the
      development and maintenance of occupational upper limb pain in musicians.

PMID- 1616473
TI  - Origins of fear of dogs in adults and children: the role of conditioning
      processes and prior familiarity with dogs.
AB  - One hundred adults and 30 children completed questionnaires to investigate fear
      of dogs. Dog fearful adults asked to recall the origins of their fear reported
      classical conditioning experiences more frequently than vicarious acquisition or
      informational transmission. Overall, however, there was no difference in the
      frequency of attacks reported by the fearful and non-fearful groups.
      Significantly more fearful than non-fearful adults reported little contact with
      dogs prior to the onset of their fear which suggests that early non-eventful
      exposure to dogs may prevent a conditioning event from producing a dog phobia.
      Most adults reported that their fear began in childhood, and dog fear were more
      frequently reported by children than by adults. In the aggregate, however, dog
      fearful adults and children differed in several ways; children were more likely
      than adults to report having received warnings about dogs, but also to recognize
      the potential attractiveness of a friendly dog. Unlike dog-fearful children, dog
      fearful adults reported many other fears in addition to their fear of dogs. A
      better understanding of fear of dogs in adults may depend on discovering why some
      dog-fearful children, but not others, apparently lose their fear of dogs as they
      become older.

PMID- 1616474
TI  - General and specific fears in referred and self-referred adult patients with
      extreme dental anxiety.
AB  - The levels of, and relationships between, dental fear and general fears and
      phobias were studied in 109 adult patients at a specialized dental fear clinic
      using two dental fear scales (the Dental Anxiety Scale and the Dental Fear
      Survey) together with the Fear Survey Schedule II (FSS-II) and some additional
      fear items. Referred and self-referred fearful dental patients answered mailed
      questionnaires in conjunction to being put on a 1 yr waiting list for treatment.
      Among feared objects and situations the separate item 'pain' revealed the highest
      mean scores for both men and women, followed by fear of suffocating, death of a
      loved one and sharp objects among women, and death of a loved one, suffocating
      and hypodermic needles among men. With few exceptions, women scored higher than
      men. The frequencies of extreme fears (6 and 7 on a 7-point scale) were high and
      92.7% of the patients reported at least one extreme fear. Half of the subjects
      (49.5%) reported five fears or more. It was also shown that a number of FSS-II
      items correlated to dental fear indicating a relationship between general and
      dental fear. These results indicated that a large proportion of these dentally
      fearful individuals were prone to fear-associated reactions and behaviors, which
      has previously been shown to negatively influence the prognosis of treatment.

PMID- 1616475
TI  - Panic disorder in the families of patients with normal coronary arteries and non
      fear panic disorder.
AB  - Patients with non-fear panic disorder (NFPD) meet DSM-III-R criteria for panic
      disorder, but do not report subjective fear or anxiety. Although apparently
      common in medical settings, this controversial group is in need of further
      diagnostic validation. This study assessed family history of panic disorder in
      patients with chest pain and normal coronary arteries (CP/NCA) and either NFPD,
      panic disorder with fear, or no panic. It was hypothesized that the two panic
      disorder groups would have similar, elevated rates of panic disorder in their
      first-degree relatives, compared to patients without panic. The results support
      the hypothesis; about 17% of the first-degree relatives of both NFPD and panic
      disorder patients were diagnosable with panic disorder according to proband
      interviews, whereas only 4.6% of the first-degree relatives of patients without
      panic were so diagnosable. These results support the diagnostic validity of NFPD
      in CP/NCA patients, because such patients had a family history of panic disorder
      similar to patients with a more classical panic disorder presentation. The lack
      of fear symptoms and behavior in NFPD may cause panic disorder to be overlooked
      as a potential cause of somatic symptoms in patients with no medical explanation
      for their condition.

PMID- 1616476
TI  - Is pain sensitivity associated with occupational fears in police recruits?
AB  - Gross (Behaviour Research and Therapy, 30, 7-13, 1992a) showed that the fear of
      pain (pain sensitivity) could be distinguished from dental fears and health
      concerns. Furthermore, the Pain Sensitivity Index (PSI) correlated significantly
      with pain expectations, and pain expectations correlated significantly with
      dental avoidance behaviour. However, Gross noted that the psychometric properties
      of the PSI had not been fully determined. The present study examined the factor
      structure of an expanded version of the PSI with a sample of 212 police recruits.
      A single factor accounted for 52.1% of the variance and the reliability
      coefficient (alpha = 0.89) indicates that the PSI possesses a high degree of
      internal reliability. Subsequently, it was hypothesized that pain sensitivity
      correlates positively with fears relating to police tasks which are characterized
      by pain expectancies, such as the fear of being assaulted during operational
      police work. In support of the hypothesis, pain sensitivity correlated highest
      with situations involving pain. The pain sensitivity construct may help to
      explain individual differences in fear reactions to situations where pain could
      be experienced, such as operational police duties or dental attendances.

PMID- 1616477
TI  - Do men lie on fear surveys?
AB  - The likelihood that males equivocate in their ratings of common fears was
      evaluated. A fear survey was given to 30 female and 26 male college students in a
      classroom setting. A second fear survey which contained duplicate items from the
      first was administered to the same students in a laboratory setting prior to
      watching videotaped scenes of fish, rats, mice and a shorter roller coaster ride.
      Before the second survey was given, the students received instructions which
      implied that their truthfulness could be independently evaluated through changes
      in their heart rate while they watched the videotape. Changes in the averaged
      fear ratings for the three high-fear items shown in the videotaped scenes were
      compared between males and females across the two survey conditions. Males'
      ratings of rats, mice, and roller coasters increased markedly from the first
      survey to the second, while fear ratings by females did not change. These results
      are consistent with the idea that the expression of fear by men is affected by
      conformation to the traditional male gender role.

PMID- 1616478
TI  - Biochemical genetics of alcohol dehydrogenase isozymes in the gray short-tailed
      opossum (Monodelphis domestica).
AB  - Polyacrylamide gel-isoelectric focusing (PAGE-IEF) methods were used to examine
      the multiplicity, tissue distribution, and biochemical genetics of alcohol
      dehydrogenase (ADH) isozymes among gray short-tailed opossums (Monodelphis
      domestica). Seven ADH isozymes were resolved and distinguished on the basis of
      their isoelectric points, tissue distributions, and substrate and inhibitor
      specificities. ADH1 and ADH2 exhibited Class I properties and were observed in
      liver (and intestine) extracts. ADH3, ADH4, and ADH5 showed "high-Km" (possibly
      Class IV) properties, with ADH3 and ADH4 exhibiting high activity in cornea, ear,
      stomach, and esophagus extracts. ADH6 and ADH7 exhibited Class III properties,
      including activities as formaldehyde dehydrogenases, with each showing different
      tissue distribution characteristics; ADH6 was widely distributed, and ADH7 was
      restricted to prostate extracts. An additional form of formaldehyde dehydrogenase
      (FDH) was observed, which was inactive with hexenol and ethanol as substrates.
      Isoelectric point variants were observed for ADH3 (three forms) and for ADH4 (two
      forms), and the inheritance of ADH3 was studied in 15 families of M. domestica.
      The data were consistent with codominant inheritance of two alleles (ADH3*A and
      ADH3*B) at a single autosomal locus (designated ADH3) and with a model involving
      a dimeric ADH isozyme: ADH3 (gamma 2 isozyme, forming three dimers designated
      gamma 1(2), gamma 1 gamma 2, and gamma 2(2) in heterozygous individuals).

PMID- 1616479
TI  - Expression and distribution of cytosolic 6-phosphogluconate dehydrogenase
      isozymes in maize.
AB  - Maize (Zea mays L.) cytosolic 6-phosphogluconate dehydrogenase isozymes (EC
      1.1.1.44; 6-PGD) are encoded by unlinked loci Pgd1 and Pgd2. Two families from a
      Robertson's Mutator line were isolated which have no detectable expression of
      Pgd2. These Pgd2-null mutants and a Pgd1-null line were used to generate plants
      homozygous for null alleles at both cytosolic 6-PGD loci. The specific activity
      of 6-PGD in the double-null mutant was between 20 and 30% of wild-type levels in
      root extracts. The double-null mutant was reproductively viable in a moderate
      environment, suggesting that wild-type levels of cytosolic 6-PGD activity are not
      essential for growth. Isozyme dimer ratios in roots, leaves, and scutellum were
      binomial and reflected the wild-type gene copy number. 6-PGD isozymes showed
      tissue- and cell type-specific expression.

PMID- 1616480
TI  - Peptidase B polymorphism in cattle erythrocytes.
AB  - Starch gel electrophoresis and histochemical staining with L-leucylglycyl-glycine
      revealed genetic polymorphism in peptidase B in cattle erythrocytes. Genetic
      analysis of 164 full families indicated that the three phenotypes observed are
      the product of an autosomal locus with two codominant alleles, PepB1 and PepB2. A
      sample consisting of 2630 individuals representing 5 Zebu, 13 European, and 2
      crossbred breeds was studied. This polymorphism was observed in all Zebu and
      crossbred breeds. The frequency of the PepB1 allele was 0.89, 0.83, 0.59, 0.82
      and 0.62 in the Nellore, Gyr, Guzerat, Indubrazil, and Tabapuan breeds,
      respectively. The PepB2 allele appears to be fixed in the European breeds, except
      Marchigiana and Chianina.

PMID- 1616481
TI  - Molecular analysis of cis-regulatory sequences at the alpha-amylase locus in
      Drosophila melanogaster.
AB  - The Amylase locus in Drosophila melanogaster contains duplicate, divergently
      transcribed structural genes for alpha-amylase, AmyA and AmyB. A sensitive and
      reliable transient expression assay was developed for testing amylase activities
      produced by exogenous Amy genes in somatically transformed larvae of an amylase
      null strain of flies. Alleles tested, AmyA and AmyB, came from recombinant clone
      lambda Dm65, which contains genomic DNA from a Canton-S strain. The transient
      assay was used in a deletion analysis aimed at locating cis-regulatory sequences
      within the 5' region of AmyB. Results suggest that upstream regulatory sequences
      for correct spatial expression of AmyA and AmyB in third-instar larvae are
      located within 446 and 430 bp of their respective starts for transcription. A
      sequence required for high levels of AmyB expression was located within its 5'
      upstream region between the base pairs at -332 and -219. AmyA does not appear to
      have a comparable regulatory element in its 5'-flanking sequence. Barely
      detectable expression of AmyB was observed when it was flanked by only 92 bp of
      upstream sequence. A model is proposed for incomplete coordinate control of the
      duplicate Amy genes.

PMID- 1616482
TI  - Variation in coding exons of two electrophoretic alleles at the pigtail macaque
      carbonic anhydrase I locus as determined by direct, double-stranded sequencing of
      polymerase chain reaction (PCR) products.
AB  - Two, electrophoretically distinct, forms of carbonic anhydrase I (CA Ia and CA
      Ib) are found at high polymorphic frequencies in red cells of natural populations
      of pigtail macaques, Macaca nemestrina, from southeast Asia. By use of the
      polymerase chain reaction, exons of the CA I gene were amplified from homozygous
      (a/a, b/b) and heterozygous (a/b) animals. Direct sequencing of the amplified DNA
      from four animals revealed differences between the a and the b electrophoretic
      alleles ranging from three to six nucleotides, and from one to three differences
      within each allele. These results indicate a greater genetic variability at the
      CA I locus in this macaque species than previously realized.

PMID- 1616483
TI  - A biochemical genetic study of alcohol dehydrogenase isozymes of the medfly,
      Ceratitis capitata Wied.
AB  - A concerted effort is under way to analyze, at the genetic, biochemical, and
      molecular level, the Adh gene system in the medfly Ceratitis capitata, an
      important agricultural pest. The isoelectric focusing (IEF) pattern of alcohol
      dehydrogenase (ADH) of the medfly demonstrates the presence of two well
      differentiated, genetically independent dimeric proteins, called ADH-1 and ADH-2.
      These proteins do not exhibit interlocus heterodimeric isozymes, and the genes
      are not controlled coordinately during development, Adh1 and Adh2 being expressed
      mainly in muscle or in fat body and ovary, respectively. From the intensity of
      the IEF isozyme patterns, primary alcohols are judged to be better substrates
      than secondary alcohols, in contrast with Drosophila melanogaster ADH, and
      ethanol is probably the most efficient substrate for both sets of isozymes. The
      isoelectric points of ADH-1 (pI = 5.4) and ADH-2 (pI = 8.6) are different from D.
      melanogaster ADH (pI = 7.6), but the medfly ADH-1 has a native molecular weight
      (approx. 58 kD) close to that of D. melanogaster. A population survey of samples
      both from laboratory strains and from wild geographically different populations
      showed that the Adh1 locus is more polymorphic than Adh2. The most variable
      populations are from Africa, the supposed source area of the species. Further, a
      case of selection at the Adh1 locus under laboratory conditions is reported. The
      hypothesis of Adh gene duplication and the degree of similarity between medfly
      and Drosophila ADH are also discussed.

PMID- 1616484
TI  - Purification and characterization of diaphorases from some Drosophila species.
AB  - Diaphorase-1 and diaphorase-2 were isolated from two Drosophila species, D.
      virilis and D. melanogaster, and purified by gel filtration, affinity
      chromatography, immunoaffinity chromatography, and ion-exchange chromatography.
      The molecular weights of both enzymes were the same in each species. The
      molecular weight of diaphorase-1 was the same under both denaturating and
      nondenaturating conditions, close to 60,000, indicating a monomeric structure.
      Sodium dodecyl sulfate (SDS) electrophoresis of the purified diaphorase-2
      revealed the presence of a single protein band of 55,000 Da, while the molecular
      weight of the native enzyme was found to be 67,000. The two diaphorases were
      further characterized by their pH optima, isoelectric points, and kinetic
      parameters, and antibodies were raised in rabbits against the purified enzymes
      from D. virilis. The antibodies showed no cross-reactions but recognized the
      corresponding diaphorases in D. melanogaster and D. novamexicana as well as D.
      virilis. The data obtained confirmed the hypothesis of an independent genetic
      control of diaphorase-1 and diaphorase-2 in Drosophila.

PMID- 1616485
TI  - Genetic diversity at electrophoretic loci in the house fly, Musca domestica L.
AB  - Vertical polyacrylamide gel electrophoresis was used to separate enzyme proteins
      at 73 putative loci in natural house fly populations sampled in central Iowa.
      Thirty-nine of the loci were polymorphic (53%). The mean effective number of
      alleles per polymorphic locus was 1.93 and 1.47 alleles among 68 scored loci.
      Observed and expected heterozygosities at 34 house fly loci were 0.1628 and
      0.1834, respectively. No statistically significant differentiation was detected
      among nine central Iowa fly populations in 1989 or among nine Iowa and three
      Minnesota populations in 1990.

PMID- 1616486
TI  - A two-base-pair substitution in T7 promoter by SP6 promoter-specific base pairs
      alone abolishes T7 promoter activity but reveals SP6 promoter activity.
AB  - The phage T7 and SP6 RNA polymerase-promoter systems are very similar in many
      characteristics, but maintains stringent specificity for each. In order to
      identify the base pair element that distinguishes between T7 and SP6 promoters,
      the base pairs at -12, -10, -9, and -8 of the T7 promoter consensus sequence were
      changed singly and multiply to the SP6 promoter-specific base pairs, and assayed
      for T7 and SP6 promoter activities. The results indicate that the primary
      discrimination element is the base pairs at -8 and -9. The two-base-pair
      substitution alone in T7 promoter by SP6-specific base pairs is sufficient to
      make the T7 variant be a SP6 promoter, abolishing T7 promoter activity.

PMID- 1616487
TI  - Isolation of a crotalase-like protease with alpha-fibrinogenase activity from the
      western diamondback rattlesnake, Crotalus atrox.
AB  - Venom toxins were isolated from rattlesnake (Crotalus atrox) venom by cation
      exchange chromatography. Seven major fractions could be obtained by single-step
      ion-exchange chromatography with two fractions showing essentially apparent
      homogeneity by SDS-gel electrophoresis. All fractions showed various extents of
      specific proteolytic activity against alpha- or beta-chains of fibrinogen
      molecules. Further characterization of one of the purified fractions with alpha
      fribrinogenase activity indicated that it is a single-chain thrombin-like
      protease with a molecular mass of about 30 kDa. It is relatively heat stable,
      inhibited by phenylmethanesulfonyl fluoride, N alpha-p-tosyl-L-phenylalanine
      chloromethyl ketone and N alpha-p-tosyl-L-lysine chloromethyl ketone but not by
      soybean trypsin inhibitor and beta-mercaptoethanol. Amino acid analysis showed
      that the enzyme possesses an amino acid composition very similar to thrombin and
      crotalase characterized before from the closely related snake venoms. N-Terminal
      sequence analysis of the enzyme corroborated the close similarity between this
      enzyme and those sequences of crotalase and kallikrein-like enzymes characterized
      from the same Crotalidae snake family. This study is in contrast to the previous
      reports which indicated a lack of thrombin- and crotalase-like enzyme in the
      venom of Western diamondback rattlesnake.

PMID- 1616488
TI  - Characterization of superoxide dismutase from south Indian scorpion venom.
AB  - A manganese containing superoxide dismutase was purified to homogeneity from the
      venom of scorpion Heterometrus fulvipes by ammonium sulfate fractionation
      followed by gel filtration on Sephadex G-100 and ion exchange chromatography on
      DEAE-cellulose. The enzyme has a molecular weight of 100,000. Optimum pH for
      enzyme activity was 8.5 and optimum temperature was 45 degrees C. The enzyme was
      not sensitive to either cyanide or hydrogen peroxide but was inhibited by
      chloroform-ethanol mixture and p-hydroxymercuribenzoate. Metal chelators, EDTA, o
      phenanthroline and diethyldithiocarbamate inhibited the enzyme activity in
      decreasing order. The effect of 6 M urea, sodium dodecylsulfate, guanidinium
      chloride and nitroprusside on enzyme activity has been studied. An antiserum
      raised against H. fulvipes venom inhibited the superoxide dismutase activity.

PMID- 1616489
TI  - Glutathione S-transferase isozymes in rat lens.
AB  - Rat lens contains two classes of glutathione S-transferase (GST) isozymes; one is
      class mu, Yb1-Yb1, and the other is class pi, Yp-Yp, judged from their molecular
      weights, immunological properties and N-terminal amino acid sequences. The
      expression pattern of GST isozymes in the rat lens is different from that in pig
      and bovine lenses which have only class pi and class mu isozymes, respectively.

PMID- 1616490
TI  - Studies on oxalate oxidase from beet stems upon immobilization on concanavalin A.
AB  - Oxalate oxidase (EC 1.2.3.4) was purified from beet stems and immobilized on
      concanavalin A. The bound enzyme showed a high resistance of denaturation and
      increased the storage stability at 4 degrees C. The immobilized oxidase showed a
      broad optimum at pH 3.5-5, compared to the free enzyme with a sharp optimum at pH
      4.5. There was a 3-fold increase in the apparent Km value on immobilization. The
      lectin interaction also eliminated the inhibitory effect produced on the enzyme
      by azide, nitrate and glycollate. The stimulatory effect on the enzyme activity
      by the flavins was not seen with the bound enzyme. The interaction of oxidase on
      concanavalin A-Sepharose 4B column and its reversal with methyl alpha-D
      mannoside, indicated the presence of polysaccharides. The glycoprotein nature was
      further confirmed by periodic acid-sciff staining procedure of the enzyme after
      gel electrophoresis.

PMID- 1616491
TI  - Transcript RNA having trans-acting antitermination activity on the T7
      transcription terminator.
AB  - The efficiency of the phage T7 intrinsic terminator was determined in pulse
      labeling in vitro transcription reactions. While the factor-independent
      terminator subcloned in pET3a showed consistently high (approximately 80%)
      efficiency, the efficiency of the same terminator in pGEM3ZT was initially
      approximately 60% but exponentially decreased to approximately 20%, although the
      39-bp terminator, and its 73-bp upstream and 32-bp downstream sequences are
      identical in the two plasmids. When transcription product mixture of pGEM3ZT was
      added to an on-going reaction of pET3a, the terminator efficiency from pET3a was
      immediately reduced to approximately 40%. Furthermore, when the pGEM3ZT product
      mixture was subjected to the promoter-cleaving HinfI digestion and then
      phenol/chloroform extraction, the mixture still maintained the trans-acting
      antitermination activity. The results suggest that the trans-acting component(s)
      are RNA synthesized from pGEM3ZT.

PMID- 1616492
TI  - Impact of chronic phosalone toxicity on Bohr factor and oxygen equilibrium curves
      of rat.
AB  - The multiple sublethal doses of phosalone induced changes in haemodynamics,
      maximum absorption spectra, oxygen equilibrium curves (OEC), half saturation
      tension (P50), degree of interaction (n), pH of blood, Bohr factor and
      circulatory gases of blood in rat, Rattus norvegicus. The results have obviously
      shown that increase the activation of pyridoxal phosphate, shift of OEC to right
      and decrease in the affinity of haemoglobin for oxygen at tissue level.

PMID- 1616493
TI  - Peroxidative crosslinking of myosins.
AB  - The effect of myoglobin, free hemin and H2O2 on myosins from heart and skeletal
      muscle was studied. SDS-gel electrophoresis revealed that each agent caused
      intermolecular thiol crosslinking of both myosins dissociable by excess of beta
      mercaptoethanol. In the simultaneous presence of H2O2 and myoglobin or H2O2 and
      free hemin, myosin formed covalent aggregates undissociable by beta
      mercaptoethanol and therefore assessed to formation of non S-S inter molecular
      covalent bonds. The latter aggregates are suggested to result from pairing of
      myosin radicals formed by the H2O2 induced ferryl iron state in myoglobin, free
      hemin or hemo-myosin.

PMID- 1616494
TI  - Changes in protein and nonprotein thiol contents in bladder, kidney and liver of
      mice by the pesticide sodium-o-phenylphenol and their possible role in cellular
      toxicity.
AB  - Acute treatment of mice with Na-o-phenylphenol or phenylbenzoquinone, an
      electrophilic metabolite of o-phenylphenol, resulted in differential depletion of
      contents of protein and nonprotein thiols in bladder, kidney and liver. Maximum
      decrease in the levels of protein and nonprotein reduced thiols was observed in
      bladder (by both agents) and was followed by kidney (by both agents) and liver
      (phenylbenzoquinone only). The reason for this differential changes in reduced
      thiol contents remains to be understood. The content of protein and nonprotein
      disulfides was higher in bladder of mice treated with Na-o-phenylphenol compared
      to that observed in untreated mice bladder. Phenyl 2,5'-p-benzoquinone mediated
      in vivo depletion of nonprotein and protein thiols suggests that Na-o
      phenylphenol treatment may decrease in vivo thiols via the formation of
      phenylbenzoquinone. Increased disulfide formation is considered to represent an
      index of oxidative stress produced by chemical. Increases in the level of protein
      and nonprotein disulfides in bladder suggest as observed in this study that
      administration of Na-o-phenylphenol to mice produced oxidative stress in bladder.
      Products of redox cycling of xenobiotics are known to cause cellular toxicity via
      altering the homeostasis of thiol status. Therefore, it is concluded that
      decreases in protein thiol contents either via alkylation and/or oxidation of
      sulfhydryl groups of proteins and increases in disulfide contents presumably by
      products of redox cycling of Na-o-phenylphenol may play a role in Na-o
      phenylphenol-induced cellular toxicity.

PMID- 1616495
TI  - Effect of pH and inorganic phosphate on creatine kinase inactivation: an in vitro
      31P NMR saturation-transfer study.
AB  - The pseudo-first-order rate constant of rabbit muscle creatine kinase (CK), in
      the direction of ATP synthesis (kf), was determined by saturation-transfer 31P
      NMR. When pH was varied between 6.0 and 7.4, kf increased linearly at both 20
      degrees C and 37 degrees c. The corresponding flux is very small between pH 6.0
      and 6.5, in contrast to previous studies. Up to 50 h exposure of the CK enzyme to
      high concentrations of inorganic phosphate (Pi), a known inhibitor in certain
      situations, had negligible effect on enzymatic flux in the physiological pH
      range. Thus under in vivo conditions, such as in stroke, where pH falls as low as
      6.2 and Pi rises to high levels, the rate of the CK reaction may be severely
      reduced due to pH but not due to high Pi concentrations.

PMID- 1616496
TI  - Chemiluminescence response of phagocytes in E. coli induced experimental
      ascending pyelonephritis.
AB  - The mechanism of tissue injury at the cellular level by following the
      chemiluminescence response of various phagocytes in E. coli induced experimental
      pyelonephritis in mice was investigated. There was a marked increase in the
      capacity of various phagocytic cells viz; renal neutrophils and macrophages
      peritoneal macrophages, blood monocytes and neutrophils to produce reactive
      oxygens species through the respiratory burst activity as monitored by the
      chemiluminescence response. The chemiluminescence response was observed to be
      increased significantly (p less than 0.001) with increasing days post infection
      in all phagocytic cells. However, the quantity of total reactive oxygen species
      produced per million cells was much more in the renal and peritoneal macrophages
      as compared to blood monocytes and neutrophils. The peak chemiluminescence
      response time was observed to be decreased from 4 to 2 minutes with the
      progression of the diseases. The implications of these findings have been
      discussed.

PMID- 1616497
TI  - Lack of association of Ca(2+)-calmodulin with the beta gamma-subunits of the
      photo-receptor G protein (transducin).
AB  - We previously reported that the beta gamma-subunit of transducin (T beta gamma)
      is composed of two components, T beta gamma-1 and T beta gamma-2 with distinctive
      gamma-subunits, T gamma-1 and T gamma-2, respectively. T beta gamma-2 enhances
      GTP binding to the alpha-subunit of transducin (T alpha) in the presence of a
      photobleaching intermediate of rhodopsin, while T beta gamma-1 is an inactive
      component with little enhancement ability (Fukada, Y., Ohguro, H., Saito, T.,
      Yoshizawa, T., and Akino, T. (1989) J. Biol. Chem. 264: 5937-5943). To further
      elucidate the functional differences between T beta gamma-1 and T beta gamma-2,
      we examined the association of T beta gamma s with Ca(2+)-calmodulin, and the
      effect of Ca2+ on binding of GTP to T alpha in the presence of either T beta
      gamma-1 or T beta gamma-2. Ca2+ had no effect on the GTP binding activity of
      transducin and T beta gamma s could not associate with Ca(2+)-calmodulin,
      indicating that the relationship of T beta gamma with Ca(2+)-calmodulin of is
      different from that of the brain G protein.

PMID- 1616498
TI  - Effect of vanadate administration on polyol pathway in diabetic rat kidney.
AB  - Effect of oral administration of sodium orthovanadate for three weeks on polyol
      pathway in renal cortex and medulla was studied in control and alloxan diabetic
      rats. An enhancement in aldose reductase in cortex and medulla and sorbitol
      dehydrogenase in cortex was observed in alloxan diabetic rats. Despite depressed
      insulin secretion, vanadate treatment to diabetic rats counteracted
      hyperglycemia, normalized elevated enzyme activities and glucose level, prevented
      medullary sorbitol accumulation and markedly checked increase in kidney weight.
      These results show that vanadate causes marked improvement in renal hypertrophy
      and has an antidiabetogenic effect on polyol pathway in diabetic kidney.

PMID- 1616499
TI  - Regulation of poly(ADP-ribose) polymerase gene expression in mitogen-stimulated
      human peripheral blood mononuclear cells.
AB  - The level of mRNA for poly(ADP-ribose) polymerase in human PBMC increased 8 h
      after addition of PHA, reaching its maximum (9-fold over the basal level) 3-4
      days after the stimulation and decreasing thereafter. mRNA maximum slightly
      preceded in time the maximal value of DNA synthesis. The half-life of poly(ADP
      ribose) polymerase mRNA, which is 1.2 h in quiescent PBMC, increased up to 3.4 h
      in stimulated PBMC. This PHA-induced stabilization of the mRNA for poly(ADP
      ribose) polymerase could account for the accumulation of the transcript in
      mitogen-treated PBMC.

PMID- 1616500
TI  - Effect of N-alkyl-N,N,N-trimethylamonium bromides on the auto-peroxidation of egg
      yolk phosphatidylcholine in liposomes.
AB  - N-alkyl-N,N,N-trimethylamonium bromides (cnTMA, n = number of carbons in alkyl)
      stimulate and inhibit the autoperoxidation of egg yolk phosphatidylcholine (EYPC)
      in liposomes at n less than 12 and n greater than 12, respectively, with maximum
      stimulation for n = 8. CnTMA intercalate between EYPC molecules (decreasing the
      yield of ROO. + RH----ROOH+R. reaction, where RH is an unsaturated EYPC acyl
      chain, R. - EYPC acyl radical, and ROO. - peroxy radical of the EYPC acyl chain)
      and disorder the hydrophobic region of the bilayer (increasing the oxygen
      solubility there and thus yield of R. + O2----ROO. reaction). The final level of
      oxidation is affected by a summation of the EYPC lateral separation and
      disordering effects.

PMID- 1616502
TI  - Transactions of the Topeka Psychoanalytic Society.

PMID- 1616501
TI  - Determination of the dissociation constants of pea diamine oxidase.
AB  - The activity of diamine oxidase [EC 1.4.3.6] (DAO) isolated from pea cotyledons
      was measured in Britton-Robinson buffers at pH range 5.0-9.6 by
      spectrophotometric method with E-1,4-diamino-2-butene as substrate. The enzyme
      has the highest activity at pH = 7.7 and in pH greater than 8.0 it is
      irreversible denaturated with time. The dissociation constants of the enzyme and
      enzyme-substrate complex were calculated by Dixon's method from plots of log
      Vmax, log KM and log Vmax/KM against pH. The pKEA = 6.5 suggests that histidine
      is in active site of DAO.

PMID- 1616503
TI  - [Critical comment on Helmut Thoma's essay on "Idea and reality in teaching
      analysis].
AB  - H. Thoma's reformist ideas about training analysis are controversial. Beland
      reproaches Thoma for his insinuation that national as well as international
      training institutions for psychoanalysis supposedly have quantitative rather than
      qualitative motivations for increasing the length of training analyses--after the
      motto "the longer, the better". Against that the author claims that a future
      analyst, in order to qualify, has to become aware of the defenses against his
      fears of annihilation and loss. This goal cannot be reached in 300-400 sessions.
      He argues that the training institutions' artificial restriction on the length of
      analysis would influence the training analyst's analytical attitude negatively
      and would expose the candidate to institutional violence.

PMID- 1616504
TI  - Total quality management/continuous quality improvement in business and health
      care.

PMID- 1616505
TI  - Total quality management in American industry.
AB  - The definition of total quality management is conformance to customer
      requirements and specifications, fitness for use, buyer satisfaction, and value
      at an affordable price. The three individuals who have developed the total
      quality management concepts in the United States are W.E. Deming, J.M. Juran, and
      Philip Crosby. The universal principles of total quality management are (a) a
      customer focus, (b) management commitment, (c) training, (d) process capability
      and control, and (e) measurement through quality improvement tools. Results from
      the National Demonstration Project on Quality Improvement in Health Care showed
      the principles of total quality management could be applied to healthcare.

PMID- 1616506
TI  - TQM/CQI in business and health care. An overview.
AB  - TQM/CQI is increasingly being used by U.S. companies and the health care industry
      to improve their operations and profitability. TQM/CQI can be used by
      occupational health nurses to help focus efforts to improve their health services
      and demonstrate their value. TQM/CQI also is used by businesses to improve the
      quality and cost of external health services. Occupational health nurses who are
      knowledgeable in TQM/CQI can help assure the quality of external health services
      as businesses strive to reduce rising health care costs.

PMID- 1616507
TI  - Quality and quality improvement in occupational health nursing.
AB  - Donabedian first defined quality as the result of assessing the structures,
      processes, and outcomes of health care. The emphasis on quality assurance is
      changing to quality improvement. The definition of quality in health care has
      expanded to include the expectations and opinion of patients, their
      representative, and society. As the cost of health care continues to rise at
      twice the rate of inflation, business wants to know how health care dollars are
      spent. Occupational health nurses, to add value to the businesses in which they
      work, must be a part of the trend in measuring the quality of the products and
      services of their health services.

PMID- 1616508
TI  - Measuring satisfaction with medical case management. A quality improvement tool.
AB  - Medical case management's purpose is to improve the quality of health care and
      decrease medical expenses associated with high cost medical cases. Patient
      satisfaction can be used as a measure of the quality of medical case management.
      This investigation resulted in a reliable and valid questionnaire for assessing
      patient satisfaction and demonstrated mild satisfaction with the medical case
      management services of a vendor for a large manufacturer. Occupational health
      nurses can use this questionnaire to document the quality of medical case
      management that employees or their dependents are receiving and to assess the
      value received in conjunction with the costs incurred.

PMID- 1616509
TI  - Business coalitions on health care. An evolution from cost containment to quality
      improvement.
AB  - Business coalitions on health were unable to achieve community wide savings in
      health care costs in the 1980s. Some coalitions are using TQM/CQI to achieve high
      quality health care at a reduced cost. Although too recent to determine its
      success, the use of TQM/CQI in employer-provider partnerships built on trust and
      good data systems may be the best hope for private sector health care system
      reform. Health professionals knowledgeable about TQM/CQI can play an important
      role in helping their employers make new relationships with health care providers
      work.

PMID- 1616510
TI  - Software documentation: variations and uses.

PMID- 1616511
TI  - Prospective analysis of mental status progression in ethanol-intoxicated
      patients.
AB  - Distinguishing patients with uncomplicated ethanol intoxication from intoxicated
      patients with other causes of mental status depression is a common clinical
      dilemma. The authors serially tested mental status in a group of ethanol
      intoxicated patients to determine the interval over which mental status changes
      could be attributed to uncomplicated intoxication. Study patients were identified
      by (1) admission breath ethanol greater than or equal to 100 mg/dL; (2) ethanol
      related impairment necessitating further observation or treatment; and (3) not
      critically ill or exhibiting focal neurologic signs. Mental status scores (sums
      of specific indices of alertness, orientation, and agitation) were determined
      initially, 1 hour after arrival, then every 2 hours. Causes of mental status
      depression other than acute intoxication were diagnosed in 16 patients, while
      another 18 failed to completely normalize mental status by the time of emergency
      department discharge or hospital admission. The remaining 71 with uncomplicated
      ethanol intoxication required (mean +/- SD) 3.2 +/- 3.6 hours to normalize mental
      status scores. A large proportion, however, took considerably longer to normalize
      mental status: 15 (21%) took 7 or more hours, and three (4%) took as long as 11
      hours. Although patients with ethanol-associated depression of mental status
      lasting 3 hours after emergency department admission should be carefully
      evaluated for other causes of mental status abnormalities, the authors'
      observations indicate considerable individual variation in the duration of mental
      status depression caused by uncomplicated ethanol intoxication.

PMID- 1616512
TI  - Oxygen saturation changes during the pediatric emergency department treatment of
      wheezing.
AB  - This study examined the oxygen saturation (OSAT) changes measured by pulse
      oximetry during emergency department (ED) bronchodilator treatment of wheezing
      patients. Data were collected prospectively on two cohorts (November 1987 to
      November 1988, 2,468 patients; and December 1988 to October 1990, 4,913 patients)
      presenting to a pediatric ED with wheezing-associated respiratory illnesses.
      Initial, posttreatment, and discharge OSAT was recorded in many of these
      patients. Improvement in OSAT following ED bronchodilator administration was
      noted in most patient groups. Initial OSAT was indicative of severity as measured
      by the need for hospitalization and the number of bronchodilator treatments
      administered in the ED. Subcutaneous epinephrine and aerosolized albuterol were
      compared in OSAT improvement and side effects. Aerosolized albuterol was not
      shown to be superior to epinephrine. Improvements in OSAT following
      bronchodilator administration documents the presence of relative preexisting
      hypoxemia which is reversed to some degree with bronchodilators. Pulse oximetry
      is an objective means of assessing asthma severity.

PMID- 1616513
TI  - The effect of ambient temperature extremes on tympanic and oral temperatures.
AB  - Exposure to ambient temperature extremes immediately preceding emergency
      department triage may affect tympanic membrane temperatures taken with infrared
      emission detection thermometers. In a prospective, unblinded study, 20 healthy
      subjects, on 2 separate days, underwent 15-minute exposures to hot (43.5 degrees
      C) and cold (-5 degrees C) temperature extremes in an environmental control room
      (ECR). Tympanic and oral temperatures were taken at baseline and at 2-minute
      intervals for 20 minutes after exiting the ECR. Rectal temperatures remained
      stable during the exposures. Oral temperatures rose significantly after hot
      exposure (P less than .05; max 0.4 degrees C) and briefly decreased after cold
      exposure (max 0.5 degrees C). Tympanic temperatures were elevated for 20 minutes
      after hot exposure (max 0.8 degrees C) and decreased briefly only in male
      subjects after cold exposure (max 0.7 degrees C). Individuals demonstrated wide
      variability in their temperature responses. Tympanic and oral temperatures taken
      within the first 20 minutes after exposure to outdoor temperature extremes may
      fail to accurately reflect the patient's true temperature.

PMID- 1616514
TI  - Cancer presentation in the emergency department: a failure of primary care.
AB  - Emergency departments are intended to be the location of entry into the health
      care system for patients with acute problems, such as injuries and myocardial
      infarctions. In contrast, cancer should optimally be detected during periodic
      health examinations, either through screening procedures or by early detection
      from signs and symptoms which prompt a routine visit to a primary care physician.
      This study was undertaken to describe patients who present to an emergency
      department with urgent symptoms and signs, are hospitalized, and subsequently
      diagnosed with cancer (ED group). One hundred twenty-nine patients were
      retrospectively studied. When compared with patients diagnosed in a primary care
      setting (tumor registry patients), the ED group was significantly older, more
      often male, had a significantly lower survival rate, and more frequent metastatic
      disease at diagnosis (P less than .001). The ED group accounted for 5.3% of the
      new tumor registry patients for the study years. Only 3.1% of the ED group had no
      insurance, and 21% reported no personal physician. Strategies are needed for
      patients and physicians to reduce the number of late-diagnosed cancer cases
      presenting in emergency departments.

PMID- 1616515
TI  - Comparative performance of the Baxt Trauma Triage Rule.
AB  - New methods of deciding which patients require trauma center transport continue
      to be devised. Baxt recently published a Trauma Triage Rule (TTR) using anatomic
      injury, blood pressure, and elements of the Glascow Coma scale which can be used
      to identify adult major trauma patients. The purpose of this study was to compare
      the TTR against three previously published trauma triage instruments; the Triage
      Revised Trauma Score, the Prehospital Index, and the CRAMS scale. We applied
      these rules to a data base of trauma patients transported by the Cleveland, Ohio
      Emergency Medical Services System. All four instruments identified adult trauma
      patients who either died or required emergent operations with sensitivities of at
      least .85. The specificity of the TTR exceeded that of the CRAMS. We conclude
      that the TTR is an effective means of identifying patients who either die or
      require emergent operation.

PMID- 1616516
TI  - The comparative efficacy of various multiple-dose activated charcoal regimens.
AB  - Multiple-dose activated charcoal therapy is used in the management of poisoning
      emergencies to enhance the elimination of enterohepatically and enteroenterically
      secreted toxins. This study was conducted to determine if increasing the
      frequency of activated charcoal administration would enhance the elimination of a
      toxin. In this crossover study, five healthy adult volunteers were randomly
      assigned to either a control phase or one of three study phases. Subjects in the
      control phase and each of the study phases received an intravenous infusion of
      aminophylline (8 mg/kg). During the study phases each subject additionally
      received activated charcoal 50 gm and activated charcoal 12.5 gm every hour, 25
      gm every 2 hours, or 50 gm every 4 hours over a 8-hour period for a cumulative
      activated charcoal dose of 150 gm. Ten blood samples were obtained over 12 hours
      and analyzed for theophylline concentrations. Using area under the curve and half
      life calculations it was determined that each of the dosage regimens
      significantly reduced the reabsorption of theophylline and the plasma half-life
      when compared with control. There were no significant differences between any of
      the treatment groups. Decreasing the dose but increasing the frequency of
      activated charcoal administration is as effective as the traditional every 4 hour
      therapy regimen.

PMID- 1616517
TI  - Bretylium tosylate and electrically induced cardiac arrhythmias during
      hypothermia in dogs.
AB  - The effect of bretylium tosylate on plasma catecholamines and on electrically
      induced arrhythmias was evaluated in anesthetized hypothermic dogs. Bretylium at
      a dose of 7.5 mg/kg was administered prior to cooling from 37 degrees C to 27
      degrees C. During cooling, the ventricular arrhythmia threshold (VAT) in control
      animals decreased from 10.1 +/- 1.9 to 4.4 +/- 1.3 impulses, while the VAT in
      bretylium-treated animals increased from 9.8 +/- 2.9 to 23.2 +/- 2.7 impulses.
      Catecholamine levels increased during cooling in all animals. In control animals,
      the epinephrine/norepinephrine ratio was unchanged, but in animals treated with
      bretylium tosylate, the ratio increased more than 10-fold (from 0.48 +/- 0.1 to
      5.49 +/- 0.32 at 29.9 degrees C). The demonstrated increase in catecholamine
      levels during hypothermia suggests that the protection offered by bretylium
      tosylate against cardiac arrhythmias is not explained by modification of
      catecholamine levels, and is more likely due to an alteration of the
      electrophysiologic properties of cardiac tissues.

PMID- 1616518
TI  - An evaluation of the esophageal detector device using a cadaver model.
AB  - The study was conducted to evaluate the usefulness of an esophageal detector
      device (EDD) to correctly differentiate between esophageal and tracheal
      intubation. The study was conducted in the emergency department using 10 recently
      decreased cadavers (nine males, one female, age range 50-72 years). An 8-mm
      internal diameter endotracheal tube was placed orally into the trachea, and a
      second 8-mm ID tube was placed orally into the esophagus. Both tubes extended the
      same distance from the mouth, and the cuffs were not inflated. After placement of
      the tubes, the EDD was used by advanced life support providers (physicians,
      nurses, paramedics, and respiratory therapists) to determine if each tube was in
      the trachea or the esophagus. The persons who assessed the tube placement were
      not present when the tubes were placed into the cadavers. Multiple evaluators
      were allowed for each cadaver, but each evaluator only participated one time for
      each cadaver. The bulb of the EDD was squeezed by the evaluator, who then
      attached it to the endotracheal tube and rated the bulb inflation as immediate
      inflation, delayed inflation, or no inflation. Prior to participation in the
      study, evaluators were instructed in the use of the EDD. There were a total of 45
      trials performed on the cadavers (median, four evaluations/cadaver, range, one
      eight). For the tracheal tube, the EDD inflated immediately in all cases; it was
      thus 100% correct in identification of tracheal intubation. For the esophageal
      tube, the EDD did not inflate in 44 cases, and in one case it filled with
      vomitus; it thus correctly identified esophageal intubation in all
      cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616519
TI  - Improved compliance with quality assurance markers during trauma room
      resuscitation using trauma nurse specialists.
AB  - Trauma nurse specialists (TNS) have been shown to reduce the burden on house
      staff and to facilitate patient care on trauma wards. In the authors' facility,
      this expertise has been extended to the emergency department where TNS contribute
      to an improved standard of care by (1) nursing assessment and injury recognition
      and (2) continuity of care. As specially trained individuals, TNS expand upon the
      role of the emergency department staff nurse. The TNS could be shown to improve
      compliance with trauma resuscitation room protocol and quality assurance markers
      of direct patient management at a statistically significant level.

PMID- 1616520
TI  - Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular
      tachycardia.
AB  - Two cases of paroxysmal supraventricular tachycardia are reported in which the
      administration of adenosine produced sustained elevation of the rate of
      paroxysmal supraventricular tachycardia. In each case, sinus rhythm was restored
      readily through the use of intravenous verapamil. This adverse reaction to
      adenosine has not been previously described.

PMID- 1616521
TI  - Severe hyperphosphatemia associated with hemorrhagic shock.
AB  - Hyperphosphatemia is an electrolyte abnormality that most frequently results from
      renal insufficiency and the attendant inability to excrete phosphorus (PO4)
      efficiently. A case is presented in which a young man with hemorrhagic shock
      developed severe hyperphosphatemia in the absence of renal failure. This is the
      first such case documented to the authors' knowledge. The prompt correction of
      the primary cause (ie, hypoperfusion and acidosis) resulted in a rapid return of
      PO4 levels to normal. This was probably related to the intracellular shift of
      PO4. Physicians should be aware of this electrolyte disturbance because it is not
      a well-recognized complication and because, in most cases, proper treatment of
      shock will also correct the elevated PO4.

PMID- 1616522
TI  - The incidence of pacemaker dysfunction during helicopter air medical transport.
AB  - A number of recent publications have raised concern regarding in-flight pacemaker
      dysfunction during air medical transport. Unfortunately the clinical importance
      of this problem is unknown. The authors' purpose was to examine the incidence of
      pacemaker use and malfunction during helicopter air medical transport, using an
      incidence (cohort) study of an air medical service of a tertiary-care teaching
      hospital. During the study period, April 1, 1987 through December 31, 1991 2,388
      patients were air-transported. Cardiac patients constituted 72% of the total
      population. Pacemakers were used in 44 patients, temporary transvenous pacemakers
      in 35, permanent transvenous in five, and transcutaneous pacers in four patients.
      No rate-responsive pacemakers were transported. No episodes of pacemaker
      malfunction were observed (95% confidence interval 0 to .002 for the population
      as a whole). The authors conclude that pacemaker dysfunction during air medical
      transport is a very rare occurrence, in part due to the infrequent transport of
      patients requiring these devices.

PMID- 1616523
TI  - Unrecognized incomplete cervical spinal cord injury: review of nine new and 28
      previously reported cases.
AB  - Nine patients with unrecognized incomplete cervical spinal cord injury are
      discussed. Four were sent home as normal, three were called hysterical, and two
      went undiagnosed during stupor or coma. A literature search revealed 28
      additional cases. Eighty percent of these were males, two thirds were over 50
      years old, and most had central or posterior cord syndromes. Falls with
      hyperextension, spondylosis, or disc disease, and motor vehicle accidents were
      the most common causes. Only one of the 37 had a cervical fracture. In some the
      neurologic problem was missed altogether; in others it was attributed to
      hysteria, intoxication, or to other neurologic or systemic diseases. Minor
      injuries without cervical fracture or dislocation, advanced age, unusual or
      changeable neurologic deficits, intoxication, and psychiatric problems all
      contributed to the confusion.

PMID- 1616524
TI  - Occult traumatic avulsion of an ovarian dermoid cyst.
AB  - This case report describes a unique presentation involving avulsion of an ovarian
      dermoid tumor which occurred as the result of blunt trauma secondary to a motor
      vehicle collision. Despite an unimpressive initial presentation and normal
      physical examination, the patient subsequently developed symptoms of severe
      hemorrhage requiring aggressive intravascular volume resuscitation. A ruptured
      ovarian dermoid tumor was eventually diagnosed by computerized axial tomography.
      A review of the literature by the authors did not reveal any similar cases of
      previous reports of this phenomenon.

PMID- 1616525
TI  - Review of all studies of cardiopulmonary resuscitation in animal models reported
      in the emergency medicine literature for the past 10 years.

PMID- 1616526
TI  - The current role of culdocentesis.

PMID- 1616527
TI  - Understanding the incomplete text: interpreting the emergency department patient.

PMID- 1616528
TI  - Activities of the Manpower Task Force of the American College of Emergency
      Physicians.

PMID- 1616529
TI  - Analysis of patient revisits to the emergency department.

PMID- 1616530
TI  - Critical care medicine: an annotated bibliography of the recent literature.

PMID- 1616531
TI  - Pediatric emergency care: an annotated bibliography of the recent literature.

PMID- 1616533
TI  - Untoward reaction to adenosine therapy for supraventricular tachycardia.

PMID- 1616532
TI  - Alternative training in emergency medicine.

PMID- 1616534
TI  - Metamucil bezoar: an unusual cause of small bowel obstruction.

PMID- 1616535
TI  - Glycopyrrolate for asthma.

PMID- 1616536
TI  - Digital endotracheal intubation.

PMID- 1616537
TI  - Traumatic carotideal dissection after blunt cervical injury: an elusive clinical
      entity.

PMID- 1616538
TI  - Ultrasound as a diagnostic tool.

PMID- 1616539
TI  - Twitching as a manifestation of occult uremia.

PMID- 1616540
TI  - Dystrophic calcification of a traumatic neuroma as an incidental finding.

PMID- 1616541
TI  - [Indisposition and acute dysphonia in the professional singer].
AB  - In the event of vocal failure in professional singers, functional causes are at
      least as important as inflammatory mucosal lesions. Treatment should take both
      possibilities into account, together with the personality of the singer.

PMID- 1616542
TI  - [Assessing the quality of the speaking voice after therapy of T1 and T2 vocal
      cord cancers].
AB  - All studies which analysed voice quality after T1 and T2 glottic cancer employed
      sustained vowels for evaluation. Sustained vowels can often be produced more
      clearly than expected in a severe degree of hoarseness in running speech. In this
      investigation voice quality was analysed by measuring the signal-to-noise-ratio
      (SNRc) in running speech. For evaluation these data were correlated to the scores
      from an auditive evaluation and from a clinical examination of the larynx
      considering functional parameters. 39 patients were examined after different
      therapies (primary radiation, chordectomy, frontolateral partial resection). The
      grading of the three different methods for characterisation of the voice quality
      correlated well. Therefore the SNRc is presumed to be a valuable additional
      method to the psychoacoustic voice evaluation. Comparison of voice quality after
      different therapies provided no significant difference between radiotherapy and
      chordectomy. The functional results after frontolateral partial resection were
      significantly less satisfying as expected.

PMID- 1616543
TI  - [Hereditary unilateral deaf-mutism as a variable manifestation of bilateral deaf
      mutism or hearing loss].
AB  - A total of 2,519 patients with bilateral severe congenital deafness (deaf-mutism)
      from Central Switzerland were recorded during the period between 1834 to 1979.
      More recently, 31 persons with unilateral severe deafness were examined. By
      constructing genealogical charts going back to the 17th century, at least ten of
      these unilaterally deaf persons were shown to be related to patients with
      bilateral deafness (pedigrees I-IV). Some of them exhibited a more or less marked
      Klein- Waardenburg syndrome. The unilateral deafness of those patients was
      inherited and not acquired. Congenital unilateral deafness may be understood to
      be the result of the broad variability of the expressivity of acoustic defects.

PMID- 1616544
TI  - [Therapy of functional disorders of the craniovertebral joints in vestibular
      diseases].
AB  - Cervicogenic vertigo is caused by functional disorders of the craniovertebral
      joints. Improvement of vertigonous symptoms by chiropractic treatment was often
      described. The therapeutic effect of chiropractic treatment in 28 patients with
      vertigo and purely functional disorders of the upper cervical spine or with a
      combination of functional disorders of the upper cervical spine and the labyrinth
      was evaluated. Improvement of vertigonous symptoms on patients with purely
      functional disorders of the craniovertebral joints as well as on patients with
      combined functional disorders of the craniovertebral joints and labyrinth could
      be seen. Two of the 28 patients showed persistent relief of symptoms and
      normalisation of cervical motility whereas the vestibular deficit persisted. One
      patient with persistent vestibular dysfunction showed recurrent malfunction of
      the upper cervical spine and vertigo. In our opinion chiropractic treatment is
      mandatory for the therapy of patients with vestibular affections and functional
      disorders of the craniovertebral joints.

PMID- 1616545
TI  - [Time course of nystagmus reactions after rotational stimulation (modified Veits
      long rotation method). I. Comparison of the nystagmus reactions of probands with
      normal equilibrium with those of patients with vestibular disorders].
AB  - In the present study, all the nystagmus reactions following the rotatory test are
      represented graphically after being split up into successive time intervals of 5
      seconds each. The range of reactions is illustrated by comparing healthy subjects
      with patients with acute lesions of the vestibular system. It has been shown that
      during the rotatory test no signs of habituation were to be seen. The use of the
      parameter "fast phase velocity" (FPV) of the nystagmus to analyze the nystagmus
      reactions did not prove meaningful. In particular the findings in patients with
      acute vestibular lesions show that the nystagmus reactions following rotatory
      stimuli of appropriate intensity increase only to a limited extent. When
      interpreting the results, the influence of spontaneous nystagmus which usually
      underlies acute vestibular disease, is discussed in detail.

PMID- 1616546
TI  - [Does the use of free transplanted jejunum segments in advanced laryngeal and
      hypopharyngeal cancer prolong survival? A matched-pair analysis].
AB  - The effect of free transplanted jejunum autografts, inserted after resection of
      extensive squamous cell carcinoma of the larynx and hypopharynx is evaluated in
      terms of survival and the development of local and regional recurrences. In a
      matched-pair analysis, 22 patients with jejunum transplants were compared with 44
      patients with the same performance status, in whom after laryngopharyngectomy,
      the pharynx had been closed with local mucosa. The cumulative survival rate was
      calculated using the Kaplan-Meier method; the statistical comparison of the
      survival curves of the two groups was made with the Mantel-Haezel test. Patients
      of the study group had a statistically significant (p less than = 0.01) better
      survival rate than those of the control group, the 50% survival rate being 36 and
      11 months, respectively. Local recurrences occurred in 9.1% of the patients in
      both the study group and in controls, and regional recurrences in 40.8 and 43.2%,
      respectively. This militates against the possibility that the surgery in patients
      in whom reconstruction with jejunum was possible might have been more radical.
      Further, it may be speculated that the statistically significant better survival
      rate is due to the jejunum itself, presumably to a tumourprotective effect of the
      lymphatic tissue of the transplant.

PMID- 1616547
TI  - [Antineoplastic effectiveness and unwanted side effects of polychemotherapy of
      extensive oro- and hypopharyngeal cancers--results of a prospective therapy study
      with 5-FU/cisplatin versus 5-FU/carboplatin].
AB  - 60 patients with advanced carcinomas of the oropharynx and hypopharynx underwent
      chemotherapy, either with 5-FU/Cisplatin (n = 30) or with 5-FU/Carboplatin (n =
      30). The remission-rates (complete and partial remissions) were comparable in
      both groups. The rate of complete remissions, however, was statistically
      significant higher in the cisplatinum group (6 patients) than in the
      carboplatinum group (1 patient). 2 patients of the 5-FU/Cis-group and 4 patients
      of the 5-FU/Carbo-group developed a progressive disease during chemotherapy.
      Statistically significant differences were found in the nephrotoxic and
      myelotoxic side effects between both therapy groups: nephrotoxic side effects
      were more frequent in the 5-FU/Cis-group, whereas myelotoxic side effects
      occurred mainly in the 5-FU/Carbo-group. The chemotherapy with 5-FU/Carboplatin
      was better tolerated by the patients than in the 5-FU/Cisplatinum-group. In the 5
      FU/Carbo-group especially a lower rate and severity of loss in weight, nausea,
      vomiting, alopecia and mucositis/stomatitis was observed. No statistically
      significant differences were found in ototoxic side effects between both groups.

PMID- 1616548
TI  - [Experimental studies of ischemia of the cochlea. Part 3: Pathophysiology].
AB  - Selective interruption of cochlear blood flow is possible without operative
      manipulations in the middle or inner ear. By fitting a magnet into the external
      auditory canal and injecting iron filings into the cephalic vein is it possible
      to obtain an impaired inner ear in otherwise healthy experimental animals that
      can be kept alive for any length of time. The hearing loss induced by the
      ischemia normally remains unchanged over a period of weeks. The highly
      vascularised areas of the cochlea, namely the spiral ligament, the vascular
      stria, the spiral prominence and the root cells in the external spiral sulcus, as
      well as the spiral limbus were all clearly degenerated, but to different degrees.
      Pronounced vacuolisation of cells, degeneration of tissue, reduction of cellular
      elements, stasis in large and small blood vessels and morphological
      disorganisation were observed. The organ of Corti showed no changes worthy of
      note. On revascularisation of the spiral ligament and the spiral limbus with
      resumption of function, the organ of Corti can return to normal activity again.
      Repeat blood flow disturbances can also lead to recurrent sudden hearing loss and
      intermittent loss of hearing.

PMID- 1616549
TI  - [Interleukin-1-containing cells in cholesteatoma of the middle ear].
AB  - Cholesteatoma of the middle ear and the adjacent temporal bone consists of
      hyperproliferative keratinizing squamous epithelium in the middle ear cavity, and
      is capable of destroying the bone. Interleukin-1 (IL-1), an autocrine growth
      factor for epithelial keratinocytes, is characterized by its capacity to initiate
      bone absorption. Using immunohistochemical methods, the distribution of two
      different species of interleukin, IL-1 alpha and IL-1 beta, in cholesteatoma
      tissue (Fig. 2), the skin of the external ear canal, and the retroauricular
      region was investigated (Fig. 1). Comparable amounts of both IL-1-species were
      found in all squamous epithelia examined, but interleukin in cholesteatoma
      epithelium was increased in comparison with normal epidermis. All cellular layers
      stained uniformly and equally strongly for IL-1 alpha and IL-1 beta, whereas the
      dead cells of the keratin layer were negative for both. Some intensely stained
      cells were found scattered in the connective tissue underlying the basal layer of
      the cholesteatoma (Fig 4). Using double staining techniques these cells were
      shown to be mainly macrophages (Fig 6). Our results suggest that IL-1 could be
      liberated from disintegrating keratinocytes and cells of the monocyte-/macrophage
      lineage, and stimulate the proliferation of the cholesteatoma epithelium in an
      autocrine manner, thus contributing to the increased bone destruction seen in
      cholesteatoma.

PMID- 1616550
TI  - [Synovial chondromatosis of the temporomandibular joint].
AB  - Synovial chondromatosis of the temporomandibular joint is a relatively rare
      disorder. The diagnosis is often difficult because of the untypical clinical
      symptoms and an absence of radiological abnormalities. On the basis of a case
      report, the clinico-pathological, roentgenological and surgical features are
      discussed. After adequate surgical exploration with synovectomy the patient
      became symptom-free.

PMID- 1616551
TI  - [Liability for faulty surgical method in tympanoplasty with retro-auricular
      approach].

PMID- 1616552
TI  - Global considerations affecting the health agenda of the 1990s.
AB  - The author explains why global problems, both known and unknown and
      unpredictable, are going to affect the health sector in the next few decades even
      more than they do today. Five examples are given of global health-related
      dilemmas that must be faced: (1) the worldwide aging of the population and the
      changing morbidity trends and physician supply needs this creates; (2) rising
      worldwide poverty, which has a direct relation to health status and has some new
      causes in this century; (3) ethical dilemmas, such as those resulting from new
      reproductive and life-prolonging technologies; (4) the need for adequate and
      affordable health care systems (the Canadian system is described and several
      misconceptions about it are clarified); and (5) the need to allocate scarce
      resources to meet practically infinite health care demands. The author concludes
      by listing some of the important actions that must be taken if we are to deal
      effectively with the dilemmas fostered by global problems: (1) people must be
      taught that their health status is the result of many factors in addition to
      their health care (e.g., socioeconomic status, lifestyle, the environment); (2)
      medical education must be refocused to prepare physicians to deal with global
      challenges; (3) there must be greater international cooperation (e.g., working
      together to share research and implement strategies to control AIDS); (4)
      countries must invest in worldwide efforts, such as family planning and primary
      education; and (5) international partnerships must be created to develop
      worldwide strategies, such as a global drug strategy.

PMID- 1616553
TI  - Technology assessment in medicine.
AB  - The author defines the concepts medical technology and technology assessment and
      presents a paradigm for the evaluation of medical technologies. He proposes a
      hierarchical assessment scheme in which level I, biologic plausibility, compares
      the technology's proposed mode of action with current biologic information and
      theory. Level II, technical feasibility, determines whether the technology can be
      delivered to the target population. Level III, intermediate outcomes, assesses
      whether the technology has a short-term impact on the biologic or physiologic
      process that is diseased. Level IV, patient outcomes, investigates the overall
      medical, psychologic, and financial impacts of the technology upon the patient,
      including unintended side effects and long-term morbidity and mortality. Level V,
      societal outcomes, measures the cost of the technology to society in terms of
      resource use, ethical issues, and social and political hazards. As an example,
      the author employs this scheme to analyze the use of screening tests for
      hypercholesterolemia.

PMID- 1616555
TI  - A program to foster residents' appreciation of the nurse's role.

PMID- 1616554
TI  - The potential for using non-physicians to compensate for the reduced availability
      of residents.
AB  - Both the number of residents and the amount of time existing residents have in
      which to carry out their activities may soon be decreasing. To consider the
      potential for alternative ways of staffing teaching hospitals, it is necessary to
      know how residents spend their time. The authors sought to learn this by
      conducting a time-motion study of eight internal medicine residents at two urban
      hospitals in New York City in 1988. The residents' activities were observed and
      coded by premedical students, and the authors independently classified the
      possible activities into (1) those that had to be done by a physician, (2) those
      that were educational only, and (3) those that could be done by a non-physician.
      A total of 1,726 activities of 67 kinds were coded, averaging 7.75 minutes each.
      The authors analyze and project their data using two models--the traditional
      model of care in which the physician is the primary medical manager of the
      patient, and an alternative model in which a midlevel practitioner, such as a
      nurse practitioner, would perform the day-to-day monitoring of patients. For
      example, the data indicate that in the traditional model, almost half of a
      resident's time is spent in activities that must be done by a physician, meaning
      that another kind of physician would be needed to do those activities if the
      resident were unavailable; but in the midlevel practitioner model, only around
      20% of the activities would require a physician. The authors give detailed
      breakdowns of their data, estimate the kinds and numbers of non-physician health
      care professionals necessary to substitute for residents in appropriate
      activities, and review possible difficulties in implementing such substitutions.

PMID- 1616556
TI  - The health of the computer-based patient record.

PMID- 1616557
TI  - Strategic thinking about health care reform.

PMID- 1616558
TI  - Should faculty tutors for PBL groups be content experts?

PMID- 1616559
TI  - A program of integrative humanistic study for medical students.

PMID- 1616561
TI  - Sending medical students into the community as health instructors.

PMID- 1616560
TI  - A promising approach to teaching primary care in the ambulatory care setting.

PMID- 1616562
TI  - Recommendations for changing the residency selection process based on a survey of
      program directors.
AB  - The authors conducted a nationwide survey of program directors participating in
      the 1990-91 National Resident Matching Program (NRMP) in order to solicit the
      directors' responses to elements of the current residency selection process and
      to suggested revisions. Of 680 randomly selected directors, 469 (69%) responded
      to the survey questionnaire, using a five-point scale, from 1, indicating strong
      agreement, to 5, indicating strong disagreement. The directors agreed that the
      senior year was distorted by the selection process, that students were pressured
      into making early career decisions, and that there needed to be more structure to
      the senior year. The directors were also in agreement that interviews, the NRMP,
      and the uniform notification date were working well. But deans' letters, other
      letters of recommendation, the Universal Application, and appointment of
      unmatched students were considered to be in need of improvement. The development
      of a centralized residency application service with the electronic transmission
      of data received the directors' support. The authors recommend that a task force
      be convened to consider changes that would improve the selection process and
      would reduce disruption of the students' senior year of medical education.

PMID- 1616563
TI  - Effects of tutors with case expertise on problem-based learning issues.
AB  - At the University of Calgary Faculty of Medicine in 1991, the authors sought to
      determine the effects of tutors' levels of content expertise on learning issues
      generated within problem-based learning (PBL) tutorials. For an integrative
      course taken prior to clinical clerkships, the 70 students in the class of 1992
      divided into ten small groups, which were facilitated alternately by content
      experts and non-experts. The authors found that--across 35 simulated-patient case
      encounters (24 with non-experts and 11 with experts)--when the groups had tutors
      with expertise in the clinical cases studied, the groups generated approximately
      twice as many learning issues per case, and these issues were approximately three
      times more congruent with the case objectives. In addition, when the groups had
      expert tutors they spent approximately twice as much time per case in overcoming
      identified learning deficiencies. The authors conclude that it is important for
      tutors (1) to be well informed about cases and case objectives and (2) to be well
      versed in the PBL tutoring process.

PMID- 1616564
TI  - Effects of expert and non-expert facilitators on the small-group process and on
      student performance.
AB  - At the University of Michigan Medical School in 1990, the authors investigated
      the effects of faculty facilitators' levels of content expertise on the
      educational process and learning outcomes of small-group teaching sessions. The
      study was conducted in a microbiology course for second-year students in which
      four small-group sessions were used to replace 38 hours of lecture and laboratory
      time. The interactions between 11 expert and ten non-expert faculty facilitators
      and 156 students were observed and coded. The students' levels of knowledge and
      satisfaction were measured. The results indicate that, although significant
      differences in faculty-student interactions were not observed, the students in
      the 11 groups led by the content experts had higher levels of satisfaction and
      higher examination scores.

PMID- 1616565
TI  - Association between clinical experiences in family practice or in primary care
      and the percentage of graduates entering family practice residencies.
AB  - In 1990 the authors surveyed all U.S. medical schools in order to solicit
      information about students' clinical experiences in family practice and in
      primary care. Of 126 schools, 104 (82.5%) responded. Survey data were correlated
      with each school's quartile ranking based on the average percentage of graduates
      who entered family practice residencies. A significant association (p = .0013)
      was found between required family practice clerkships or preceptorships and
      institutions ranked in the highest quartile (i.e., having more than 17% of their
      graduates enter family practice). A similarly significant association (p = .0056)
      was found for those 12 institutions that had more than 30% of their students
      select family practice options in required primary care clerkships or
      preceptorships. The authors suggest that active recruiting of students to take
      such options may increase the number of graduates who enter family practice.

PMID- 1616566
TI  - Developing and implementing a "basic science clerkship" for first-year students.
AB  - For over 15 years, human genetics at the University of Illinois College of
      Medicine at Chicago (UICMC) was taught exclusively through lectures. In 1989-90
      the authors revised this course for the graduating class of 1993 in order to
      incorporate many features found in a clerkship experience, such as oral
      presentations and the exploration of differential diagnoses through patient
      cases. In addition to lectures, the revised course consisted of small-group work
      in concentrated blocks of time, involving both a library research project and
      problem-based learning, each of which contributed to (1) significant gains in
      student achievement compared with data from the class of 1992 and (2) extremely
      favorable assessments from the students and faculty. The format of a basic
      science clerkship is being adopted by other departments at UICMC. The authors
      suggest that this format could be used by other medical schools to integrate the
      basic and clinical sciences.

PMID- 1616567
TI  - Evaluations by three graduating classes of a required community health project.
AB  - The authors analyzed seniors' evaluations of the first three years of an
      intensive community health project at the Bowman Gray School of Medicine of Wake
      Forest University in 1988-89, 1989-90, and 1990-91. The project was designed to
      provide a public health perspective by having the students select, study, and
      propose solutions to a community health problem. Of 285 seniors, 240 (84%)
      completed evaluation questionnaires, using a five-point scale. The students'
      perceptions of the value of the project became steadily more favorable with each
      subsequent class; the classes of 1990 and 1991 rated the value of the project as
      being greater than that of most other experiences in their medical education. The
      project was more positively evaluated by the 106 responding students (44%) who
      planned to enter primary care specialties. The students who invested more time in
      the project also perceived its value to be greater.

PMID- 1616568
TI  - An instrument to evaluate alcohol-abuse interviewing and intervention skills.
AB  - At the University of Texas Health Science Center at San Antonio from 1988 through
      1990, the authors developed the Alcoholism Intervention Performance Evaluation
      (AIPE), a rating instrument for the evaluation of alcohol-abuse interviewing and
      intervention skills. Factor analysis of 51 rating items identified seven factors
      that accounted for most of the variability among the items; 35 were retained and
      assigned to the factor with which they correlated most highly, thus resulting in
      a seven-factor instrument with 35 items. The AIPE overall score had an interrater
      reliability of .73 (for four raters each rating approximately 30 videotaped
      simulated-patient interviews) and a test-retest reliability of .89 (for one rater
      rescoring 20 interviews after one month). The authors suggest that the individual
      scores for the seven factors can be used to provide instructional feedback to
      trainees and that the overall score can be used to certify interviewer
      proficiency.

PMID- 1616569
TI  - MEDLINE training for medical students in the clinical curriculum.

PMID- 1616570
TI  - Scripted oral examinations of internal medicine students' clinical skills with
      simulated patients.

PMID- 1616571
TI  - Effect of context on the rating of students by faculty and housestaff in a
      clinical clerkship.

PMID- 1616572
TI  - Synthesis and pharmacological evaluation of some pyrazolo [3,4-e][1,4] diazepin
      4,7-diones.

PMID- 1616573
TI  - Antiinflammatory pyrazolones and pyrazolidones: a study of their inhibition of 5
      beta-dihydrocortisone reduction in rat liver cytosol.
AB  - Seven pyrazolone and pyrazolidone derivates, some of them widely used as
      analgesic and anti-inflammatory drugs, were tested for the inhibitory property of
      the 3 alpha-hydroxysteroid dehydrogenase of rat liver cytosol. The data obtained
      clearly show that, among pyrazolone and pyrazolidone derivates, the correlation
      between IC50 and therapeutic potency is not always verified.

PMID- 1616574
TI  - Synthesis and choleretic activity of 3-[2-(3-R', 4-R'', 5-R'''-benzyl)-5-R
      benzimidazol-1-yl]-butanoic acids.
AB  - On the ground of the evidentiated choleretic activity of 3-[2-benzylbenzimidazol
      1-yl]butanoic acid, 28 new acids were prepared in order to evaluate the influence
      of suitable substitutions in either C5 of heteroring or C3', C4', C5' of benzyl
      group in position 2 on the choleretic activity. Pharmacological results after
      i.v. administration of 0.5 mmol/Kg in rats confirmed a general high choleretic
      activity that in eleven cases showed during the first 4 hours an increase of bile
      volume higher than 80%, that is superior to that produced by dehydrocholic acid.
      Only in a few cases the bile volume increase was less than 37% of basal value.

PMID- 1616575
TI  - A novel class of cholinergic agents structurally related to 2-morpholinol.
AB  - A series of esters and ethers of N-alkylmorpholin-2-ols, and their methiodides,
      which can be considered cyclic analogues of acetylcholine, were synthesized. The
      amines were obtained by acylation or etherification of morpholinols with the
      appropriate acyl chlorides and alcohols. All compounds were tested for their
      ability to interact with the muscarinic receptor M2 (guinea-pig atria) or M3 (rat
      ileum and urinary bladder) subtype. Some compounds, although endowed with
      relatively low potency, proved interesting for their organ selectivity. Some
      considerations on the structure-activity relationship are made and the results
      obtained with reference agonists and antagonists are also shown.

PMID- 1616576
TI  - Synthesis and aldose reductase inhibitory activity of pyridazine derivatives
      possessing acetic acid group.
AB  - N-acetic acid and S-acetic acid derivatives of 5-arylidene pyridazines were
      synthesized for evaluation as new aldose reductase inhibitors. Intrinsic activity
      for each compound was assessed by measuring inhibition of enzymatic activity in
      an isolated pig lens enzyme preparation. All prepared compounds exhibited a
      significant in vitro aldose reductase inhibitory effect (10(-5) M less than or
      equal IC50 less than or equal to 10(-4) M). It was found that lipophilicity was
      important in increasing activity. Furthermore, this activity (log 1/IC50) could
      be correlated directly to a lipophilic parameter (log kw) for the whole data set.

PMID- 1616577
TI  - Comparative sensitivity study of Clostridium perfringens towards 16 antibiotics
      from different classes.
AB  - A series of 16 antibiotics from different classes (5-nitro imidazoles, beta
      lactams, cyclins, macrolids, chloramphenicol) was examined for their
      bacteriostatic and bactericidal activities on 45 strains of Clostridium
      perfringens, with determination of MIC and MBC values. Several techniques of
      multivariate analysis were used in order to visualize differentiations in
      sensitivity profiles: Principal component analysis (PCA) and preferentially
      Correspondence factorial analysis (CFA). This approach revealed the efficacy of
      antibiotics from both general and family classifications.

PMID- 1616578
TI  - Synthesis and anthelmintic activity of carbamates derived from imidazo[2,1
      b][1,3,4]thiadiazole and imidazo[2,1-b]thiazole.
AB  - The anthelmintic activity of 25 compounds, most of them carbamates, was
      determined. The in vitro results are interesting and show that an aromatic
      azapentalene can replace the benzimidazole ring without loss of its biological
      properties. The in vivo results, however, show that the compounds are devoid of
      practical interest.

PMID- 1616579
TI  - 1,5-Benzodiazepines. X. Dialkylamino substituted 1,5-benzodiazepine and
      [1,2,4]triazolo [4,3-a][1,5] benzodiazepine derivatives with inhibitory activity
      on PAF-induced platelet aggregation.
AB  - Novel 4-(dialkylamino) substituted (4, 5 c, 8) and 2,4-bis(dialkylamino)
      substituted (6) 1,5-benzodiazepine derivatives were synthesized. Both these new
      compounds and the substituted 4H-[1,2,4]triazolo[4,3-a][1,5]benzodiazepine-5
      amines 2 a-h, recently described by us, were tested in vitro for their inhibitory
      activity on the PAF-induced aggregation of human platelets. Actually, bicyclic
      compounds 4 d, 5 c and tricyclic compounds 2 g, h showed a significant activity:
      in all them the dialkylamino substituent was the 4-(ethoxycarbonyl)-1-piperazinyl
      group. On the contrary, compounds 4 d, 5 c, 2 g,h showed practically no
      inhibitory activity when platelet aggregation was induced by ADP, A23187, or
      collagen.

PMID- 1616580
TI  - An 1,2,3-triazole derivative bioisoster of a potent in vitro prostaglandin
      synthesis inhibitor: preparation and biological activity.
AB  - This paper reports the preparation of the triazole ester 10, a methylenic
      bioisoster of an oxygenated compound A, effective inhibitor of the prostaglandin
      synthesis in vitro. Biological evaluation of 10 and of the corresponding acid 9
      shows that the compounds maintain a good enzymatic inhibitory activity compared
      with indomethacin and aspirin.

PMID- 1616581
TI  - Macrocyclic polyesters. I. A novel class of 1,3-butandiol derivatives as
      potential antimicrobial agents.
AB  - This paper reports the synthesis of a novel class of macrocyclic tetraesters
      containing 1,3-butandiol sub-units by reacting the stannolan derivative of the
      diol with diacyl chloride. The structure of the possible isomers was assigned by
      spectroscopic data and comparison with samples otherwise prepared. Preliminary
      screening revealed that these compounds have low antimicrobial activity, although
      it is higher than that of the starting diol.

PMID- 1616583
TI  - p24 antibody production in p24 antibody-negative HIV-infected subjects.
AB  - To determine if HIV-infected patients with no detectable serum antibodies to p24
      are producing antibodies to p24 (anti-p24), blood was obtained from 49 HIV
      infected patients at various stages of infection. Serum p24 antigen levels were
      measured and peripheral blood mononuclear cells were cultured for 1 week without
      mitogenic stimulation. The presence of anti-p24 in culture supernatants and sera
      was determined by radioimmunoprecipitation assays. Cells from 89% of the patients
      who had anti-p24 in their sera spontaneously synthesized anti-p24 in vitro.
      Similarly, cells from 83% of the HIV-infected patients who had no detectable anti
      p24 in their sera spontaneously produced anti-p24 in vitro. Thus the absence of
      anti-p24 in serum did not reflect suppression in the ability of patients' cells
      to synthesize and secrete antibodies to p24. However, cells from patients whose
      sera contained anti-p24 spontaneously synthesized more anti-p24 than did cells
      from patients whose sera lacked anti-p24, suggesting that these two groups of
      patients may represent individuals with inherently high or low responses to p24
      epitopes, respectively.

PMID- 1616582
TI  - Human T-cell leukemia virus type-I/II (HTLV-I/II) serologic testing: the
      importance of assaying for the full complement of viral antigens.
AB  - Seventy-one Japanese adult T-cell leukemia (ATL) patients and 411 Japanese
      asymptomatic patients from HTLV-I endemic regions of southern Japan were found to
      be seropositive by radioimmunoprecipitation assay (RIPA). Of these 482 positive
      controls, 62% of ATL patients and 67% of the asymptomatic seropositive patients
      were found to harbor antibodies to p40x. Additionally, 333 preselected Japanese
      blood donors who were identified as seropositive by particle agglutination (PA)
      assay were further tested for antibodies to HTLV-I/II gene encoded envelope (env)
      or group specific antigens (gag) by means of enzyme-linked immunosorbent assay
      (ELISA) and RIPA. Concordance between ELISA and RIPA was noted in 318 samples
      (92.5%). Discordance between ELISA and RIPA was observed in 15 sera (7.5%)--2
      were seropositive by ELISA and seronegative by RIPA and 13 were seronegative by
      ELISA and seropositive by RIPA. Seven of these 13 samples (53.8%) contained
      antibodies to p40x by RIPA and may represent ELISA false negatives on the basis
      of both clinical and laboratory data. Current HTLV-I/II ELISA kits may yield
      false negative results. Additional research into the development of rapid
      detection cost-efficient assays that test for the full compliment of viral
      antigens is needed.

PMID- 1616584
TI  - Regulation of maternal-fetal virus transmission in immunologically reconstituted
      SCID mice infected with lactate dehydrogenase-elevating virus.
AB  - Immunodeficient SCID (C.B-17 scid/scid) mice with persistent lactate
      dehydrogenase-elevating virus (LDV) infection failed to produce IgG anti-LDV
      antibodies, and during chronic infection transmitted virus infection to 95% of
      their offspring. In contrast, normal mice infected 15 or more days prior to
      giving birth produced IgG anti-LDV antibodies and transmitted LDV infection to
      only 0-46% of their fetuses. Transplacental transmission of LDV infection was
      dependent on the timing of maternal infection. Adoptive transfer of immune
      competence to LDV-infected SCID mice resulted in fetal protection from maternally
      transmitted virus infection. Fetal protection correlated with the presence of
      maternal IgG anti-LDV but not with fetal levels of IgG anti-LDV, and the levels
      of viremia in nonimmune SCID mice did not affect transplacental virus
      transmission. These results demonstrate the importance of maternal immunity in
      protecting the fetus from infection, and validate the use of this mouse model for
      investigation of immune mechanisms of transplacental virus transmission.

PMID- 1616586
TI  - Acute effects on health of smog episodes. Report on a WHO meeting.

PMID- 1616585
TI  - Adjuvanticity of stearyl tyrosine on the antibody response to peptide 503-535
      from HIV gp160.
AB  - In this present report we compare the humoral immune response induced by
      immunization with an HIV-1 gp160 peptide corresponding to amino acid sequence 503
      535 complexed with different adjuvants. Specifically, the antipeptide, anti-HIV-1
      gp160 and neutralizing antibody responses were measured in groups of mice and
      baboons that received peptide 503-535 conjugated to a carrier protein in either
      saline, alum, or stearyl tyrosine. The highest antibody responses were induced
      when mice and baboons were immunized with peptide adsorbed on stearyl tyrosine.
      These data indicate that stearyl tyrosine represents a potent candidate as a
      nontoxic adjuvant not only for subunit viral vaccines, but also for HIV peptides.

PMID- 1616587
TI  - Linear quadratic model and biologically equivalent dose for single fraction
      treatments.
AB  - The linear quadratic model has been used to calculate the biologically equivalent
      dose for single fraction treatments. Our calculations suggest that for late
      reacting tissue, such as the brain, a single fraction of 1440 cGy is equivalent
      to a conventional treatment of 5000 cGy in 25 fractions.

PMID- 1616589
TI  - Dosimetry of small field electron beams.
AB  - Measurements of the central axis depth dose curves, isodose profiles and field
      size dependence of the output factors for small field electron beams from a
      Varian Clinac 18 linear accelerator have been performed. Energies of electron
      beams studied were 6, 9, 12, 15, and 18 MeV. Circular fields of 1, 2, 3, 5, and 8
      cm diameter were obtained from cerrobend shields attached to the bottom face of a
      15 x 15 cm2 electron cone applicator. Measurements were carried out in a water
      phantom with an ionization chamber and a silicon diode detector and in a
      polystyrene phantom with Kodak XV-2 film. For all energies studied, as the field
      size of the electron beam becomes smaller: (1) the depth of maximum dose shifts
      toward the surface, (2) the depth of 90% and 80% dose, which are common dose
      prescription depths, becomes smaller, (3) the surface dose increases, and (4) the
      dose fall-off region becomes more gradual. The output of the electron beam
      reduces significantly with reduction in electron beam field size as a consequence
      of lack of lateral equilibrium. Hence, for accurate treatment planning for small
      electron fields, it is essential that the beam characteristics be individually
      measured.

PMID- 1616588
TI  - Estimation of the mean effective organ doses for total body irradiation from
      Rando phantom measurements.
AB  - For the total body irradiation (TBI) procedure, it is necessary to compare the
      mean dose obtained from the tissue or organs and the estimated dose equivalent
      value from the computer program. Due to the easy-access of the Rando phantom and
      repeatability of TLDs and its output, the results from the experiment are quite
      encouraging for the verification of the dose distributions from total body
      irradiation at the given prescribed monitor units. The estimation of effective
      dose equivalent particularly across the lung sections was studied by combinations
      of using arms as the scatter volume to compensate for the inhomogeneity across
      the breast portion, as well as using the spoiler for skin-sparing purposes. The
      results were based upon various beam quality such as 4 MV, 6 MV, and 10 MV X
      rays. One series of experiments performed for this survey to ascertain the dose
      equivalent of the tissues was conducted. This paper describes the method and
      procedure for comparison between the measured data and computed data as a
      reference in the dosimetry of total body irradiation. Comparison of the measured
      and computed data for the largest collimated field shows that the calculated dose
      rates do not differ by more than 2% from the measured data. Because uncertainty
      is inherent in non-patient-like phantoms, the calculated data may be served as a
      reference for the dosimetry. For the total body irradiation setup, considering
      the radiation field size and treatment distances commonly employed, we conclude
      that the best combination of the patient setup will be (1) laying both arms down
      as compensation for lung inhomogeneity, and (2) the spoiler, which is made of
      acrylic about 8 mm thick and functions like a bolus, is needed to reduce the skin
      sparing effects and contribute the uniform dose distribution. The beam spoiler
      with the frame stands near the patient during the treatment.

PMID- 1616590
TI  - Couch rotation technique for treatment of head and neck cancer.
AB  - This paper reviews a technique for patients with head and neck cancer that
      achieves adequate inferior margins on the lateral ports by rotating the treatment
      couch. This technique has the advantage of avoiding multiple ports in an area of
      high risk or over a tumor mass.

PMID- 1616591
TI  - Junctioning adjacent fields using border films and table top measurements.
AB  - We present a technique for matching adjacent treatment fields over the spine. Our
      approach relies on identifying vertebral bodies and correlating their position to
      the table top markings present on the simulator table. The vertebral body levels
      are verified with films taken with the isocenter at the borders (nondivergent
      border films) so the "true" borders are identified. This is in contrast to using
      the usual divergent films, which may misrepresent the field borders with respect
      to the vertebral body level. An additional space between fields may be added as a
      precaution against overlap.

PMID- 1616592
TI  - A technique for postoperative irradiation of carcinomas of the larynx and
      hypopharynx.
AB  - Postoperative radiation is commonly employed for advanced lesions of the larynx
      and hypopharynx which have undergone a laryngectomy. It is technically difficult
      to achieve a homogeneous distribution of irradiation throughout the treatment
      volume because of the marked variation in contour across the treated area. We
      have described a technique which employs a 15 degrees lateral kick-out of the
      treatment table and a 15 degrees gantry angle above the horizontal for each of
      two lateral fields. This technique has certain advantages over other techniques
      previously described in the literature. By adding a gantry angle of 15 degrees
      above the horizontal to the kick-out lateral position of the table, we have found
      that we were able to decrease the amount of irradiation to the shoulder, to
      improve the dose to the posterior superior mediastinum, to lower the applied
      dose, and to avoid a hot spot overlying the spinal cord in the superior posterior
      portion of the field. This technique is particularly useful in patients who lack
      the flexibility to move their shoulders posteriorly and inferiorly.

PMID- 1616593
TI  - The surface doses from orthovoltage x-ray treatments.
AB  - Measurements have been made of the surface dose with treatment cones and lead
      shielding used with orthovoltage x-ray systems. Both devices significantly
      increase the surface dose, probably by the generation of photoelectrons. The
      surface dose depends upon the shape and material of the cone and the x-ray
      energy. The surface dose can be 500% higher than the dose measured with a Baldwin
      Farmer chamber. The significance of these doses is discussed in the light of
      recent information on the thickness of the epithelium. It is suggested that every
      effort be made to reduce the surface dose by using low atomic number material
      between the lead and the patient surface.

PMID- 1616594
TI  - A simple method for use in QC of CT for radiation therapy treatment planning.
AB  - A simple procedure for monitoring constancy of spatial measurement and CT number
      determination from CT images used in radiation therapy treatment planning is
      described. The procedure uses low-Z material rods glued to the underside of the
      CT table insert and does not require a special phantom. Measurements are made on
      the same patient images used for treatment planning. Deviations from
      predetermined baseline values outside quality control limits of +/- 2 mm in
      spatial resolution and +/- 20 CT numbers in density can be detected with a
      confidence level of 97% or better.

PMID- 1616595
TI  - Determination of ion recombination loss by two-voltage method for pulsed
      radiation beams.
AB  - The ion recombination loss is one of the most important correction factors for
      dosimetry using ionization chamber especially for the measurement of high
      intensity pulsed radiation beam. The two-voltage method has been used frequently
      for the correction of ion recombination loss. Several ways to approximate the
      method are presented. Comparisons were carried out to check the validity of the
      approximation. Using four ionization chambers of different types and shapes,
      measurements were made to obtain the optimal value of the ratio for the two
      voltages.

PMID- 1616596
TI  - Radiotherapy treatment planning for prostate cancer in patients with prosthetic
      hips.
AB  - Patients diagnosed with prostate cancer may also have a prosthetic hip. When
      planning radiotherapy for these patients, one must consider the attenuation of
      the dose when the beam passes through the prosthetic hip. It is best to avoid
      administration of radiation to the target through the prosthesis. Example
      treatment plans are evaluated. The potential advantages and disadvantages of each
      plan are reviewed.

PMID- 1616597
TI  - Quantification of doses to mediastinal lymph nodes in Hodgkin's disease.
AB  - Hodgkin's disease is highly curable today. Radiotherapy (RT) is the treatment of
      choice in the early stages. A mantle field is often used in the RT of Hodgkin's
      disease, and the technique and dosimetry are quite complex. We used computerized
      tomography (CT)-based dosimetry to determine doses delivered to different
      mediastinal nodes with the commonly used technique in Hodgkin's disease that was
      originally described by Kaplan. We used dose-volume histograms to determine doses
      to various groups of nodes in nine patients. Significant inhomogeneity (30%, 30%,
      35%, 35%, 30%, 40%, 35%, 35%, and 30% in the nine patients) in dose distribution
      was found within the mediastinum. With the advent of 3-dimensional CT-based
      treatment planning, we are able to quantify such inhomogeneities. The question
      arises whether a homogeneous, lesser dose can achieve equal results. Average
      doses and "effective doses" were also calculated. The "effective doses" in eight
      patients (for a prescribed dose of 44 Gy) with a midline posterior spinal cord
      block added at 20 Gy were 37.3 Gy, 34.3 Gy, 36.0 Gy, 38.4 Gy, 35.8 Gy, 38.1 Gy,
      36.7 Gy, and 36.7 Gy, respectively. A homogeneous dose equivalent to effective
      dose may achieve the same control as an inhomogeneous dose delivery. Prospective
      3-D dosimetric studies are required to confirm this concept.

PMID- 1616598
TI  - Asymmetric field calculations.
AB  - A simple method for performing manual dose calculations in asymmetric fields is
      proposed. The method is based on a generalized central-axis dose calculation
      equation for which open- and wedged-field off-axis provisions have been made. A
      calculation form designed to document the calculation and simplify the
      calculation process is presented. Lastly, the required off-axis dosimetry data
      obtained from a dual-energy accelerator are shown.

PMID- 1616599
TI  - The human hepatic cytochromes P450 involved in drug metabolism.
AB  - The cytochromes P450 are a superfamily of hemoproteins that catalyze the
      metabolism of a large number of xenobiotics and endobiotics. The type and amount
      (i.e., the animal's phenotype) of the P450s expressed by the animal, primarily in
      the liver, thus determine the metabolic response of the animal to a chemical
      challenge. A majority of the characterized P450s involved in hepatic drug
      metabolism have been identified in experimental animals. However, recently at
      least 12 human drug-metabolizing P450s have been characterized at the molecular
      and/or enzyme level. The characterization of these P450s has made it possible to
      "phenotype" microsomal samples with respect to their relative levels of the
      various P450s and their metabolic capabilities. The purpose of this review is to
      compare and contrast the human P450s involved in drug metabolism with their
      related forms in the rat and other experimental species.

PMID- 1616600
TI  - Environmental concentrations and aquatic toxicity data on diflubenzuron
      (dimilin).
AB  - The insecticide diflubenzuron (DFB) is commonly used in various mid-Atlantic
      states for suppression of gypsy moths in hardwood forests. DFB is potentially
      toxic to nontarget biota because it can enter aquatic systems through aerial
      application or runoff after precipitation events. Based on this concern, the
      objectives of this study were to: (1) compile, review, and synthesize literature
      on the fate, persistence, and environmental concentrations of DFB in both
      freshwater and saltwater environments; (2) compile, review, and synthesize acute
      and chronic aquatic toxicity data on DFB effects on freshwater and saltwater
      organisms; (3) assess possible risk to aquatic biota associated with the use of
      this insecticide in one specific area (Maryland); and (4) recommend future
      research based on the data gaps identified from this study. DFB has low
      solubility in water and exists as a technical grade (TG) and wettable powder (WP)
      formulation. The toxicity of both formulations is similar at concentrations less
      than 10 micrograms/l. Organic matter is a major factor influencing the adsorption
      and degradation of DFB in freshwater, saltwater, and sediment. The half-life of
      this insecticide in freshwater is approximately 3 days at a pH of 10 and
      temperature of 36 degrees C. At lower pH conditions of 6 and at the same
      temperature, DFB is more persistent since half-life values of approximately 9
      days have been reported. The half-life of DFB in soil is less than 14 days when
      the particle size was approximately 2 microns. The half-life is generally greater
      in cool, dry soil than in hot, wet soil. Aquatic vegetation acts as a sink for
      DFB by gradually adsorbing the chemical and releasing it over a period of time.
      Freshwater organisms demonstrated a wide range of sensitivity to DFB. Sensitivity
      was dependent on body composition (i.e., exo- vs. endoskeleton), trophic level,
      and life stage. During acute exposures, aquatic invertebrates were more than
      25,000 times as sensitive to DFB than fishes. The most acutely sensitive species
      tested was the Amphipod, Hyallela azteca (96-h LC50 = 1.84 micrograms/l). A
      mature Plecopteran, Skwala sp., was the most resistant invertebrate species
      tested in acute tests (96-h LC50 greater than 100,000 micrograms/l). In chronic
      tests, DFB concentrations of 1 microgram/l or greater were reported to eliminate
      populations of various Plecopteran (stoneflies) and Ephemeropteran (mayflies)
      species after 1 month of exposure. A 30-day LC50 of 0.1 micrograms/l DFB was also
      reported for the Tricopteran, Clistorinia magnifica.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1616601
TI  - Lesions of the fornix but not the amygdala impair the acquisition of concurrent
      discriminations by rats.
AB  - Rats with lesions in either the fornix, the amygdala, or both were compared with
      control animals on the acquisition of three different concurrent object
      discrimination tasks. In the first task the animals received one trial per day on
      each of six pairs of stimulus objects ('spaced' condition). In the second task
      the animals received four trials per day on each of six stimulus pairs
      ('standard' condition), and in the last task the animals received 36 trials on
      each of two stimulus pairs in just a single day ('massed' condition). Animals
      with fornical lesions were impaired on all three conditions. In contrast, the
      amygdala lesions only affected the 'massed' condition and then only when the
      animals had to select the 'non-preferred' stimulus. Although animals with
      combined amygdala and fornical lesions were impaired on all three conditions
      there was no evidence that their deficit was greater than that in the animals
      with lesions restricted to just the fornix. In view of the evidence that
      concurrent discrimination learning offers an appropriate test for anterograde
      amnesia these findings are seen as consistent with the notion that the
      hippocampus, but not the amygdala, is critically involved in the mnemonic
      processes disrupted by amnesia.

PMID- 1616602
TI  - Spontaneous forelimb grasping in free feeding by rats: motor cortex aids limb and
      digit positioning.
AB  - Forelimb use in grasping food during free feeding was studied in control and
      motor cortex damaged rats using videoanalysis and Eshkol-Wachmann Movement
      Notation (EWMN). Rats detected food using olfaction, grasped it by mouth, and
      then sat and reached for it with their paws. Once held in the paws, the food was
      eaten. A reach consists of: (1) lifting the forelimbs from the ground, (2)
      positioning them elbows-in, so that the paws were adjacent to the mouth, and (3)
      clasping the food in the digits. These movements were executed mainly with the
      upper arm. Limb movements were usually bilaterally symmetrical but when
      asymmetrical movements occurred, the forelimb least involved in weight support
      initiated the movement. As the limb was positioned for grasping, the aperture of
      the digits was adjusted to anticipate the size of the food and the food was
      grasped and manipulated with the tips of the digits. Following unilateral motor
      cortex lesions to the forelimb area: (1) the ipsilateral limb (good limb)
      initiated lifting, positioning, and grasping movements, (2) appropriate
      adjustment of the digits of the contralateral limb (bad limb) and grasping were
      impaired, and (3) when contact with food was lost, the bad limb adopted an
      extended, closed-fist spastic posture and could not be repositioned
      independently. The gross impairments cleared within 2 weeks, and after a few
      months impairments were infrequently observed. These findings show that: (1)
      spontaneous food grasping uses both proximal movements of the limb and distal
      movements of the digits, (2) digit aperture anticipates food size in reaching,
      and (3) motor cortex damage impairs both proximal and distal movements more
      profoundly when the limb is used independently than when it is used in
      conjunction with the good limb. The results are discussed in relation to
      kinematic studies on primates and humans.

PMID- 1616603
TI  - The role of histamine in the anterior hypothalamus and its functional interaction
      with the hippocampus on exploratory behavior in adult male rats.
AB  - The possible effects of histamine (HA) locally applied into the preoptic area
      (POA) on hippocampus-mediated behaviors were studied in adult male rats. Animals
      were double-implanted unilaterally with microinjection cannulae into POA and
      hippocampus (HPC). In experiment 1, HA was injected into POA and pyrilamine (H1
      HA antagonist) or ranitidine (H2-HA antagonist) were microinjected into the
      ipsilateral HPC in two different doses. In Experiment 2, HA was injected into POA
      and the histamine antagonists were microinjected into the contralateral HPC. Ten
      min later the animals were tested in an automatic monitor activity. Horizontal,
      ambulatory and vertical movements were measured as general motor exploratory
      behaviors. Contact time (in seconds) to a circular metal rack positioned in the
      center of the animal activity monitor was also recorded as goal-directed
      exploratory activity. Results of Experiment 1 showed that HA in POA exerted an
      inhibitory influence on general motor behaviors and also on goal-directed
      activity. Ipsilateral administration of HA-antagonists into HPC blocked the HA
      effect on behavior. Results of Experiment 2 showed that the administration of the
      HA-antagonists in any of the two doses used were not able to block the depressive
      actions on behavior caused by HA into POA. In conclusion, data suggest that POA
      is linked to the ipsilateral HPC through histaminergic influence to control
      behavioral patterns induced by novelty.

PMID- 1616604
TI  - Vibrissal roughness discrimination is barrelcortex-dependent.
AB  - We have investigated the contribution of the neocortical vibrissal representation
      within the posterior medial barrel subfield (PMBSF) to the high performance
      levels obtained by rats in a complex roughness discrimination task mediated by
      vibrissal inputs. Nine binocularly occluded rats were trained in a two-choice
      roughness discrimination until they obtained the 85% correct response criteria.
      Subsequently, the PMBSF was localized by electrophysiological recordings and
      bilaterally ablated. The locus and extent of the cortical lesions were confirmed
      by histological analysis after additional training and testing. There was no
      evidence of task retention after the cortical lesion and barrelless rats were
      unable to obtain prelesion discriminative performance levels when stimulation was
      restricted solely to vibrissal cues. After extensive postlesion training, four of
      these rats were allowed to palpate the discriminanda with their forepaws. Under
      these conditions rats rapidly reached the 85% correct criterion once again. The
      present results indicate that the PMBSF is essential for complex tactile
      discrimination when sensory information is obtained through the vibrissae by
      active palpation. This deficit is specific for the vibrissal system, the PMBSF is
      not essential to solve the same tactile discrimination task when the source of
      the somatosensory information is provided by other non-vibrissal cutaneous
      sensory receptors.

PMID- 1616605
TI  - Non-cholinergic action of exogenous acetylcholinesterase in the rat substantia
      nigra. I. Differential effects on motor behaviour.
AB  - In the substantia nigra a non-cholinergic action of acetylcholinesterase has been
      demonstrated on motor behaviour. At the cellular level, electrophysiological
      studies have shown not only excitatory actions of AChE, but also inhibitory
      effects in response to larger amounts of the protein. In this study the possible
      dose-dependent effects of AChE were therefore explored in relation to circling
      behaviour. Both 'ipsiversive' turning (towards side of infusion and indicative of
      net decreased activity in the nigrostriatal pathway) and 'contraversive' turning
      (away from side of infusion and indicative of net increased activity) was
      observed for at least 2 weeks following a single unilateral AChE infusion.
      Ipsiversive turning occurred in 15-20% of animals in each group irrespective of
      dose. However, the actual number of animals exhibiting contraversive turning
      increased with increasing dose, whilst those not responding decreased. The most
      critical factor for direction of response appeared to be related not to dose, but
      cannula placement; infusion of AChE into more posterior regions of the substantia
      nigra evoked contraversive circling, whereas there appeared to be a discrete site
      in the anterior nigra in which AChE induced ipsiversive turning. This study thus
      suggests that subpopulations of nigrostriatal neurons show differential
      responsiveness to AChE.

PMID- 1616607
TI  - Analysis of the ongoing behavior of rats in non-matching-to-sample: improved
      acquisition and performance is related to facilitation of investigation.
AB  - In a non-matching-to-sample task, rats were trained according to the conventional
      procedure in which the displacement of the sample object resulted in food
      reinforcement and termination of the sample period. Compared to these animals,
      rats given a longer duration sample period, and rats not reinforced with food for
      displacing the object in the sample period, improved their rate of acquisition
      and their accuracy of performance. Detailed behavioral observations indicated
      that improved discrimination was related to increased investigation of the
      objects in the sample period, reduced side preferences, and an inclination to
      examine both objects in the test period. The results suggest that more accurate
      performance was related to the generalization of sampling habits from the sample
      period to the test period.

PMID- 1616606
TI  - Non-cholinergic action of exogenous acetylcholinesterase in the rat substantia
      nigra. II. Long-term interactions with dopamine metabolism.
AB  - Within the substantia nigra acetylcholinesterase (AChE) has a novel non
      cholinergic action that is functionally manifest as chronic circling behaviour in
      rats. The aim of this study was to explore the possible biochemical mechanisms
      that could underlie the long-term behavioural effects of this protein, infused
      unilaterally into one substantia nigra. A single treatment of
      acetylcholinesterase induced modest but consistent circling behaviour in the
      presence of a systemic amphetamine challenge for the maximum time tested, up to
      50 days: comparable infusions of saline were without effect. When animals
      received a challenge of the direct dopamine agonist apomorphine, no AChE-induced
      circling was observed: this result suggested that the phenomenon did not entail a
      down-regulation of striatal dopamine receptors. On the other hand, a challenge of
      the dopamine uptake inhibitor nomifensine resulted in AChE-induced circling that
      was indistinguishable from that seen in the presence of amphetamine: hence the
      circling behaviour seen could be attributable to an AChE-induced increase in
      availability of extracellular dopamine. In animals where AChE caused
      contraversive rotation, indicative of an enhanced activity in the nigrostriatal
      pathway, there was a significant elevation in the dopamine content of the
      striatum on the treated side. It is concluded that AChE can chronically enhance
      the release of dopamine from the nigrostriatal pathway such that motor behaviour
      is correspondingly modified, but to an extent sufficiently modest to avoid
      compensatory synaptic reversal mechanisms.

PMID- 1616608
TI  - Diencephalic lesions, learning impairments, and intact retrograde memory
      following acute thiamine deficiency in the rat.
AB  - Previous studies have shown that following an acute bout of pyrithiamine-induced
      thiamine deficiency (PTD) rats are impaired in learning appetitively and
      aversively motivated T-maze tasks. The present study examined if PTD-treated rats
      exhibit both anterograde and retrograde memory loss of an aversively motivated
      spatial navigation task. Histological examination revealed two consistent lesions
      in the PTD treated rats: a bilateral, symmetrical destruction of medial thalamus
      centered on the internal medullary lamina (IML), and a lesion of the medial
      nucleus of the mammillary body. In Experiment 1, control and recovered PTD rats
      were trained to find a hidden platform in a Morris water maze. PTD rats with the
      IML lesion were impaired in learning the water maze task but were eventually able
      to perform as well as controls and PTD animals without the IML lesion. In
      Experiment 2, half of the pretrained CT animals underwent thiamine deficiency
      (PTD2), were recovered, and subsequently were tested for retention of the
      platform location. The remaining CT animals and the PTD1 group were also tested
      for retention. No significant group differences were observed on any of the four
      postretention trials. When compared to their performance on the last four
      preretention trials, the performance of PTD1 and PTD2 animals with IML lesions
      were similar to those of the controls. These results demonstrate that acute
      thiamine deficiency in rats produces damage of medial thalamic and mammillary
      body nuclei, a mild anterograde learning deficit, but no loss of retrograde
      memory of the Morris water maze task.

PMID- 1616609
TI  - Scopolamine deficits in negative patterning discrimination: evidence for a role
      of the central cholinergic system in retention but not acquisition of non-spatial
      configural association learning.
AB  - The effects of scopolamine (0.1 mg/kg s.c. and 0.6 mg/kg s.c.) were assessed on
      the acquisition and retention of a negative patterning discrimination task in
      rats. At 0.1 mg/kg scopolamine did not affect either acquisition or retention of
      the task. At 0.6 mg/kg scopolamine did not affect acquisition but did impair
      retention of the task. This impairment is likely to be centrally mediated as N
      methyl scopolamine (0.6 mg/kg s.c.) did not affect retention. Lack of effect of
      scopolamine on acquisition of the task indicates that the central cholinergic
      system is not a necessary substrate of the acquisition of non-spatial configural
      associations. The scopolamine-induced deficit in retention of the task, suggests
      that there may, however, be a central cholinergic involvement in the
      retention/retrieval of this type of learning.

PMID- 1616610
TI  - Double dissociation of fornix and caudate nucleus lesions on acquisition of two
      water maze tasks: further evidence for multiple memory systems.
AB  - The present study examined the effect of lesions of the caudate nucleus or
      fimbria-fornix on the acquisition of two water maze tasks. In both tasks, two
      rubber balls with different visual patterns were used as platforms (i.e., cues).
      The "correct" cue was attached to a submerged rectangular platform and could be
      mounted by an animal to escape the water. The "incorrect" cue was attached to a
      thin round pedestal and could not be mounted. In a spatial version of the task,
      the correct cue was located in the same quadrant of the maze on all trials,
      whereas the visual pattern on the cue was varied from trial to trial. Lesions of
      the fornix, but not the caudate nucleus, impaired acquisition of this spatial
      task in relation to control animals. In a simultaneous visual discrimination
      version of the task, the correct cue on all trials was one with a specific visual
      pattern, and the spatial location of the correct cue was varied from trial to
      trial. Lesions of the caudate nucleus, but not the fornix, impaired acquisition
      of this visual discrimination task in relation to control animals. The double
      dissociation observed supports the hypothesis that the hippocampus and caudate
      nucleus are parts of systems that differ in the type of memory they mediate.

PMID- 1616611
TI  - Object exploration and reactions to spatial and nonspatial changes in hooded rats
      following damage to parietal cortex or hippocampal formation.
AB  - Hooded rats with bilateral lesions of the anterior part of the hippocampal
      formation (HIP), anterior region of the posterior parietal cortex (APC), or
      posterior region of the posterior parietal cortex (PPC) were compared with
      controls for their exploration of 5 objects in an open field, habituation of
      locomotion and object investigation, and response to spatial and nonspatial
      change. First, all groups displayed habituation of both locomotor and exploratory
      activity. Second, controls selectively reexplored displaced objects, and APC
      lesioned rats reexplored all objects, whereas PPC- and HIP-lesioned rats failed
      to react to the spatial change. Third, a novel object induced reexploration in
      all groups. The results are consistent with the roles of the HIP and PPC in
      spatial information processing. Moreover, the APC and PPC are involved in
      attentional effortful processing and visuospatial information processing
      necessary for spatial representation, respectively.

PMID- 1616613
TI  - Memory in the chick: multiple cues, distinct brain locations.
AB  - Training chicks on a one-trial passive avoidance task results in memory-dependent
      synaptic remodeling in the intermediate medial hyperstriatum ventrale (IMHV) and
      lobus parolfactorius (LPO). Because pretraining IMHV lesions are amnestic and
      posttraining IMHV lesions are not, the functional significance of this remodeling
      requires explanation. Chicks use various cues to classify and remember objects.
      If the IMHV were concerned with memory for only one such cue, then posttraining
      IMHV lesions would not lead to "amnesia" because animals would still avoid the
      aversive bead using other contextual cues. This hypothesis was tested using a
      color discrimination task. IMHV lesions, but not LPO lesions, impair color
      discrimination, suggesting that the IMHV may be involved in classifying and
      remembering the bitter bead on the basis of color. Thus, even simple associations
      are stored in the brain in the form of multiple, dispersed representations.

PMID- 1616612
TI  - Loss of hippocampal CA1 pyramidal neurons correlates with memory impairment in
      rats with ischemic or neurotoxin lesions.
AB  - Rats were trained for 20 days in a modified T maze to perform an invariant,
      tactile discrimination and a variable, delayed spatial discrimination, and then
      were exposed either to 30 min of transient forebrain ischemia or to low- or high
      dose ibotenic acid to damage the dorsal hippocampus bilaterally. Only rats
      exposed to ischemia or high-dose ibotenic acid demonstrated impaired performance
      during 30 postoperative test days on both aspects of the task (p less than .05).
      Volume of hippocampal damage did not predict performance. However, the extent of
      CA1 pyramidal neuron loss correlated significantly with performance on the
      delayed spatial discrimination (p less than .01). Damage to the dentate gyrus and
      CA2-3 did not correlate with performance. These results support the view that the
      hippocampus, in particular the CA1 region, is crucial for certain types of memory
      performance.

PMID- 1616614
TI  - Stimulation at a site of auditory-somatosensory convergence in the medial
      geniculate nucleus is an effective unconditioned stimulus for fear conditioning.
AB  - The medial division of the medial geniculate nucleus (MGm) and the posterior
      intralaminar nucleus (PIN) are necessary for fear conditioning to an auditory
      conditioned stimulus (CS), receive both auditory and somatosensory input, and
      project to the amygdala, which is involved in production of fear conditioned
      responses. If CS-unconditioned stimulus (US) convergence in the MGm-PIN is
      critical for fear conditioning, then microstimulation of this area should serve
      as an effective US during classical conditioning, in place of standard footshock.
      Guinea pigs underwent conditioning (40-60 trials) using a tone as the CS and
      medial geniculate complex microstimulation as the US. Conditioned bradycardia
      developed when the US electrodes were in the PIN. However, microstimulation was
      not an effective US for conditioning in other parts of the medial geniculate or
      for sensitization training in the PIN or elsewhere. Learning curves were similar
      to those found previously for footshock US. Thus, the PIN can be a locus of
      functional CS-US convergence for previously for footshock US. Thus, the PIN can
      be a locus of functional CS-US convergence for fear conditioning to acoustic
      stimuli.

PMID- 1616616
TI  - Potentiation or diminution of discrete motor unconditioned responses (rabbit
      eyeblink) to an aversive pavlovian unconditioned stimulus by two associative
      processes: conditioned fear and a conditioned diminution of unconditioned
      stimulus processing.
AB  - In two experiments using the rabbit conditioned eyeblink preparation, the
      conditions under which a Pavlovian conditioned stimulus (CS) potentiates or
      diminishes the unconditioned response (UR) were examined. The results indicated
      that, after discrimination training (CS+ vs. CS-), the CS+ diminished UR
      amplitude at the training interstimulus interval (ISI). When CS+ trials were
      segregated into trials on which a conditioned response (CR) did or did not occur,
      the CS+ diminished the UR when it elicited a CR, but not when a CR failed to
      occur. When the CS-unconditioned stimulus (US) interval was lengthened to 10 s,
      the CS+ reliably potentiated the eyeblink UR on CR trials but did not potentiate
      responding on trials on which a CR was absent. The results are discussed in terms
      of the modulatory effects and temporal properties of conditioned fear and an
      associatively produced decrement in US processing.

PMID- 1616615
TI  - Frequency-specific receptive field plasticity in the medial geniculate body
      induced by pavlovian fear conditioning is expressed in the anesthetized brain.
AB  - Fear conditioning modifies the processing of frequency information; receptive
      fields (RF) in the auditory cortex and the medial geniculate body (MGB) are
      altered to favor processing the frequency of the conditioned stimulus (CS) over
      the pretraining best frequency (BF) and other frequencies. This experiment was
      designed to determine whether brief conditioning in the waking state produces RF
      plasticity that is expressed under general anesthesia. Guinea pigs bearing
      electrodes in the MGB received 20 trials of tone-shock pairing in a single
      training session. RFs were determined with animals under ketamine anesthesia
      before conditioning and 1-3 hr and 24 hr after conditioning. Frequency-specific
      RF plasticity was evident for both postconditioning periods: The BF shifted
      toward or to the CS frequency, responses to the BF decreased, and responses to
      the CS increased. Broadly tuned cells developed greater RF plasticity than
      narrowly tuned neurons. The results demonstrate that the specific neuronal
      results of brief learning experiences can be expressed in the anesthetized brain.

PMID- 1616617
TI  - Conditioning using a cerebral cortical conditioned stimulus is dependent on the
      cerebellum and brain stem circuitry.
AB  - Electrical stimulation of the auditory cortex (AC) was used as a conditioned
      stimulus (CS) in the rabbit conditioned eyeblink preparation to trace the
      functional anatomical connections between the AC and the circuitry underlying
      this conditioned response. Conditioning was shown to be dependent on the
      cerebellar interpositus nucleus and the pontine nuclei (PN), structures that are
      essential for conditioning using a peripheral CS. The results suggest that the
      cerebellum and associated brain stem circuitry are a necessary part of the memory
      trace circuit for the conditioned eyeblink response, even when the cerebral
      cortex is artifically engaged as a CS by electrical stimulation. The results also
      suggest that the PN are a site of convergence between the CS circuit subserving
      classical conditioning for peripheral stimuli and the AC, and may therefore be a
      site where the AC can modulate more elaborate forms of conditioning.

PMID- 1616618
TI  - Visually guided locomotion, distractibility, and the missing-stimulus effect in
      hooded rats with unilateral or bilateral lesions of parietal cortex.
AB  - When hooded rats with bilateral lesions of Krieg's area 7 (parietal cortex) were
      trained to locomote toward visual targets in a runway, they ran less accurately
      than did controls, although unilaterals ran accurately. When flashing lights were
      presented unexpectedly during their run, bilateral parietals were less disrupted
      than were controls, but they failed to show total neglect. Unilateral paritals
      turned toward distracters on either side but turned preferentially toward
      distracters contralateral to the intact hemisphere, particularly when distracters
      occurred bilaterally and simultaneously. Effects due to the omission of expected
      distracters were similar in parietals and controls. Rat parietal cortex is not
      essential for the redirection of attention to stimuli notable for their
      unexpected presence or absence, but parietal cortex may resolve interhemispheric
      competition. The results suggest a homology between parietal cortex in rat and
      primate.

PMID- 1616619
TI  - Ontogeny of feeding motor patterns in infant rats: an electromyographic analysis
      of suckling and chewing.
AB  - During mammalian ontogeny, there is a transition from suckling to the chewing of
      food. The question was asked: Is suckling a neuromuscular precursor to chewing,
      or are suckling and chewing independent systems? Electromyograms (EMGs) were
      recorded in rat pups of ages 6, 9, 12, 15, 18, and 21 days from the superficial
      masseter, anterior digastric, sternohyoideus, and genioglossus muscles during
      suckling and chewing. The EMG patterns of the 3 components of suckling behavior
      (nipple attachment, rhythmic sucking and the stretch response) are distinctive
      from one another and reflect the musculoskeletal biomechanics of suckling.
      Chewing EMGs are present by 12 days of age and attain the adult pattern by 18-21
      days of age. During nipple attachment, pups exhibit a motor pattern that is
      similar to that of adult chewing, but other aspects of suckling differ from
      chewing in some EMG features. Comparison of EMGs between behaviors and between
      ages allowed interpretation of the degree of contunity of muscular activity
      across the suckling-to-chewing transition.

PMID- 1616620
TI  - Odors can induce feeding motor responses in the terrestrial mollusc Limax
      maximus.
AB  - Highly developed odor learning was shown in the terrestrial slug Limax maximus.
      In addition, several key cellular elements of the neural network that controls
      ingestive feeding have been identified. The results of 3 experiments demonstrate
      an interaction between odor input and ingestive feeding in that olfactory
      stimulation with behaviorally attractive odors summed with tactile stimulation
      from plain agar to produce ingestion of plain agar. Agar ingestion did not occur
      in the absence of attractive odor stimulation. The adequacy of odor stimulation
      to trigger agar ingestion was altered by associative learning. Innately
      attractive odors rendered repellent by associative learning no longer triggered
      agar ingestion, whereas innately repellent odors rendered attractive by
      conditioning triggered agar ingestion. The newly discovered feeding command cells
      in the Limax cerebral ganglion are a logical cellular locus for this interaction.

PMID- 1616621
TI  - Hemispheric priming by meaningful and nonmeaningful symbols in language-trained
      chimpanzees (Pan troglodytes): further evidence of a left hemisphere advantage.
AB  - Hemispheric priming was examined in 3 language-trained chimpanzees (Pan
      troglodytes) using a simple reaction time paradigm. Subjects were required to
      hold down a response button until the occurrence of a response cue. A warning
      stimulus was presented to either the left visual field (LVF) or the right visual
      field (RVF) before the response cue occurred. No warning stimulus was presented
      on control trials. The warning stimuli were geometric communicative symbols from
      two semantic categories: foods and tools. A third set of warning stimuli were
      familiar geometric symbols. Dependent measures included reaction time and the
      number of false-positive responses. Reaction-time data indicated an RVF advantage
      in priming when the warning stimuli were food or tool symbols. No significant
      visual half-field differences were found for familiar symbols, but a trend toward
      an RVF advantage was observed. These effects were enhanced when subjects
      responded with their left hand. False-positive data also indicated an RVF
      advantage for the food and tool warning stimuli. The data indicate that
      hemispheric asymmetries for processing communicative symbols are present in
      language-trained chimpanzees.

PMID- 1616622
TI  - Single crystals of long DNA molecules.
AB  - We have grown single crystals of long DNA molecules, 54 and 65 base pairs in
      length which encompass the binding site of the Xenopus protein transcription
      factor IIIA (TFIIIA). These molecules are considerably longer than those
      previously crystallised. X-ray diffraction shows that the crystals are ordered to
      a resolution of 9 A. The DNA molecules are arranged side to side in layers which
      are orientated at 120 degrees with respect to adjacent layers. The phosphate
      backbones of molecules in adjacent layers are interdigitated in both the major
      and minor grooves. The intensity distribution indicates that the average
      structure is B-like, although CD spectra in solution are more consistent with the
      structure, intermediate between A- and B-, found in crystals of a nonamer
      fragment of the binding site. The B-character in our crystals may therefore be
      impressed by the tight packing between layers.

PMID- 1616623
TI  - An eclectic DNA structure adopted by human telomeric sequence under superhelical
      stress and low pH.
AB  - We have found, with the aid of 2-D gel electrophoresis, that double-stranded
      human telomeric repeat, (T2AG3)12.(C3TA2)12, being cloned within a plasmid, forms
      a protonated superhelically-induced structure. Experiments on chemical and
      enzymatic probing also indicate that the human telomeric repeats adopt an unusual
      structure. We have proposed an eclectic model for this structure in which four
      different elements coexist: a non-orthodox intramolecular triplex stabilized by
      the canonical protonated C.G*C+ base-triads and highly enriched by noncanonical
      base-triads; the intramolecular quadruplex formed by a portion of the G-rich
      strand; the single-stranded region encompassing a portion of the G-rich strand
      and, probably, the (C,A)-hairpin formed by a portion of the C-rich strand.

PMID- 1616624
TI  - Electron microscopic observations of the effects of anthraquinone derivatives on
      plasmid DNA.
AB  - Electron microscopy was used to analyse the precipitation of DNA observed when
      mixed with two tripeptide derivatives of mitoxantrone, with or without a 5,8
      dihydroxy group (DHQ-GHK and Q-GHK, respectively) on the anthraquinonic ring.
      This precipitation was compared to that obtained with the basic drugs,
      mitoxantrone (DHAQ) and ametantrone (AQ). The effects of these compounds on the
      supercoiling of form I and the lengthening of form II of pBR322 DNA molecules,
      respectively, were evaluated. A strong lengthening of the DNA molecules was
      observed for ametantrone (max: 57%), but only 32% for Q-GHK, both at r (drug/base
      pari) = 250. With the dihydroxy derivative DHQ-GHK, it was not possible to show
      more than a 10% increase in length because DNA molecules were not measurable at r
      greater than 100. Only Q-GHK relaxed supercoiled molecules at the low r values of
      10. Complex phenomena of condensation-precipitation were observed with these two
      tripeptide derivatives. In addition to a strong lengthening of form II DNA
      molecules, AQ induced specifically the formation of toruses, and DHAQ that of
      large organized DNA condensation. The variety of the aggregations is described
      and discussed with regard to the antitumor properties of these derivatives, and
      the literature concerning the various descriptions of DNA aggregation.

PMID- 1616625
TI  - Ionic strength dependence of the binding of methylene blue to chromatin and calf
      thymus DNA.
AB  - The binding of the intercalating dye methylene blue (MB) to chromatin and to free
      DNA has been studied as a function of ionic strength at very low binding ratios
      (1 MB/400 DNA bases) using absorption spectroscopy. With increasing salt
      concentration MB is displaced from chromatin to a higher extent than from DNA.
      The free energy change for MB binding to chromatin is found to be approximately 5
      kJ/mole lower than for binding to DNA. This difference can be explained by the
      reduced number of high affinity binding sites in chromatin due to the presence of
      histone proteins. The difference in binding energy is virtually independent of
      the degree of chromatin condensation and also of the valence of counter ions,
      suggesting that neither the affinity for, nor the number of intercalation sites
      in the linker DNA is markedly changed upon the salt-induced condensation. The
      unaffected thermodynamics of the linker binding suggests that factors such as DNA
      superhelicity and the electrostatic influence from the chromatosomes remain
      unchanged during chromatin condensation.

PMID- 1616626
TI  - Flexibility of DNA in 2:1 drug-DNA complexes--simultaneous binding of two DAPI
      molecules to DNA.
AB  - Simultaneous binding of two DAPI molecules in the minor groove of (dA)15.(dT)15 B
      DNA helix has been simulated by molecular mechanics calculations. The energy
      minimised structure shows some novel features in relation to binding of DAPI
      molecules as well as the flexibility of the grooves of DNA helices. The minor
      groove of the helix expands locally considerably (to 15 angstroms) to accommodate
      the two DAPI molecules and is achieved by positive propeller twisting of base
      pairs at the binding site concomitant with small variations in the local
      nucleotide stereochemistry. The expansion also brings forth simultaneously a
      contraction in the width of the major groove spread over to a few phosphates.
      These findings demonstrate another facet of the flexible stereochemistry of DNA
      helices in which the local features are significantly altered without being
      propagated beyond a few base pairs, and with the rest of the regions retaining
      the normal structure. Both the DAPI molecules are engaged in specific hydrogen
      bonds with the bases and non specific interactions with phosphates. Stacking
      interactions of DAPI molecules between themselves as well as with sugar-phosphate
      backbone contribute to the stability of the complex. The studies provide a
      stereochemical support to the experimental findings that under high drug-DNA
      ratio DAPI could bind in the 2:1 ratio.

PMID- 1616627
TI  - Conformations of Cyclobut-A and Cyclobut-G: structural resemblance to nucleosides
      and incorporation into double helical DNA.
AB  - Conformational energy calculations have been carried out on two modified
      nucleosides Cyclobut-A and Cyclobut-G using the methods of molecular mechanics
      (MM2) obtainable in the computational software MacroModel. Conformations were
      generated as a function of the torsion angles equivalent to the glycosidic and
      backbone torsions in deoxyribonucleotides. The structural resemblance of the
      energy minimized models of the modified nucleosides to their corresponding
      deoxyribonucleosides has been investigated. It is found that conformations which
      lie within 3 kcal/mole of the global minimum do resemble the overall shape and
      volume of the B-DNA nucleoside. Following this result, two deoxypentanucleotides
      d(GCGCG).d(CGCGC) and d(ATATA).d(TATAT) were model built incorporating cyclobut-G
      and cyclobut-A, respectively. These were then energy refined using the molecular
      mechanics package AMBER. The resultant structures demonstrate that cyclobut-A and
      cyclobut-G can be easily accommodated in double helical polynucleotides with
      minimal overall distortions.

PMID- 1616628
TI  - Monte Carlo simulation of hydration of the guanine-uracil pairs with guanine in
      two tautomeric forms: contribution of water bridging to relative stability of
      mispairs.
AB  - Results are presented from Monte Carlo simulation of hydration of guanine-uracil
      mispairs by 25 and 50 water molecules. The hydration shells of three mispairs
      formed between "normal" dioxo form of uracil (U) and three forms of guanine
      ("normal" amino-oxo tautomer G and two rotamers of the "rare" amino-hydroxy
      tautomer G*) depend on the tautomeric forms of the guanine molecule. The
      simulation shows the important role of hydration effects on the relative
      stability of the mispairs.

PMID- 1616629
TI  - Fuzzy molecular surfaces.
AB  - Surface area of a macromolecule, accessible to a solvent, is defined and
      calculated, taking into account the probabilistic character of atomic positions
      due to the high frequency atomic vibrations. For a given a space point, we
      consider a probability of the event, that this point is covered by a
      macromolecule. A volume is defined as a space integral of this probability field.
      The envelope, accessible to a solvent molecule center, becomes fuzzy, existing
      only in a probabilistic sense. The accessible area is defined as a derivative of
      the envelope volume with respect to the probe size.

PMID- 1616630
TI  - An efficient automated computer vision based technique for detection of three
      dimensional structural motifs in proteins.
AB  - As the number of available three dimensional coordinates of proteins increases,
      it is now recognized that proteins from different families and topologies are
      constructed from independent motifs. Detection of specific structural motifs
      within proteins aids in understanding their role and the mechanism of their
      operation. To aid in identification and use of these motifs it has become
      necessary to develop efficient methods for systematic scanning of structural
      databases. To date, methods of structural protein comparison suffer from at least
      one of the following limitations: (1) are not fully automated (require human
      intervention), (2) are limited to relatively similar structures, (3) are
      constrained to linear alignments of the structures, (4) are sensitive to
      insertions, deletions or gaps in the sequences or (5) are very time consuming. We
      present a method to overcome the above limitations. The method discovers and
      ranks every piece of structural similarity between the structures compared, thus
      allowing the simultaneous detection of real 3-D motifs in different domains,
      between domains, in active sites, surfaces etc. The method uses the Geometric
      Hashing Paradigm which is an efficient technique originally developed for
      Computer Vision. The algorithm exploits the geometrical constraints of rigid
      objects, it is especially geared towards recognition of partial structures in
      rigid objects belonging to large data bases and is straightforwardly
      parallelizable. Computer Vision techniques are for the first time applied to
      molecular structure comparison, resulting in an efficient, fully automated tool.
      The method has been tested in a number of cases, including comparisons of the
      haemoglobins, immunoglobulins, serine proteinases, calcium binding proteins, DNA
      binding proteins and others. In all examples our results were equivalent to the
      published results from previous methods and in some cases additional structural
      information was obtained by our method.

PMID- 1616631
TI  - The affinity of DNA-microtubule protein complexes and their disruption by tubulin
      binding drugs.
AB  - Using the gel shift assay system, we have measured the apparent affinity constant
      for the interaction of two different DNAs with MAP proteins found in both total
      calf brain microtubules and heat stable brain preparations. Both DNAs studied
      contained centromere/kinetochore sequences- one was enriched in the calf
      satellite DNA; the other was a large restriction fragment containing the yeast
      CEN11 DNA sequence. Complexes formed using both DNAs had similar Kapp values in
      the range of 2.1 x 10(7) M-1 to 2.0 x 10(8) M-1. CEN11 DNA-MTP complexes had by
      far the highest Kapp value of 2.0 x 10(8) M-1. The CEN11 DNA sequence is where
      the yeast kinetochore of chromosome 11 is formed and where the single yeast
      microtubule is bound in vivo. The CEN11 conserved region II known binding sites
      (dA/dT)n runs- for mammalian MAP2 protein, are in good agreement with this higher
      Kapp value. The effects of the classical tubulin binding drugs colchicine,
      podophyllotoxin and vinblastine on the DNA-MAP protein complex stability were
      investigated by determining the drug concentrations where the complexes were
      destabilized. Only the complexes formed from total microtubule protein (tubulin
      containing) were destabilized over a wide drug concentration range. Heat stable
      brain protein complexes (no tubulin) were largely unaffected. Furthermore, it
      took 10-100 fold higher drug concentrations to disrupt the CEN11 DNA complexes
      compared to the calf thymus satellite DNA enriched complexes. These data support
      our previous results suggesting that there is a DNA sequence dependent
      interaction with MAP proteins that appears to be conserved in evolution (Marx et.
      al., Biochim. Biophys. Acta. 783, 383-392, 1984; Marx and Denial, Molecular Basis
      of Cancer 172B, 65-75 1985). In addition, these results imply that the classical
      tubulin binding drugs may exert their biological effects in cells at least in
      part by disrupting DNA-Protein complexes of the type we have studied here.

PMID- 1616632
TI  - Dynamic light scattering studies on hydrodynamic properties of fibrinogen
      fibronectin complex.
AB  - A high molecular weight 'cryogel' was obtained as insoluble complexes by cold
      incubation at near-freezing temperatures from heparinized plasma of patients with
      rheumatoid arthritis. After the cryogel was solubilized at 37 degrees C, 1:1
      complex of fibrinogen and fibronectin was purified at room temperature by
      affinity chromatography on a gelatin-Sepharose 4B. Hydrodynamic properties of the
      complex were investigated as a function of temperature and NaCl concentration
      using a dynamic light scattering. The diffusion coefficients of the complex at 20
      degrees C decreased with increasing of NaCl concentration as free fibronectin.
      The complex appears to be a more compact form at low ionic concentration, which
      is associated with conformational changes of fibronectin. The diffusion
      coefficient of the complex at 20 degrees C in 0.05 M TrisHCl(pII7.4) containing
      0.5 M NaCl was estimated as 8.5 x 10(-8) cm2s-1. The complex did not dissociate
      over the temperature range from 20 to 37 degrees C. The diffusion coefficients of
      the complex decreased significantly at 12 degrees C and 40 degrees C. The thermal
      denaturation of fibrinogen molecule in the complex was observed at 40 degrees C.
      The CONTIN analysis of the light scattering data showed that the complex
      associated to form higher aggregates at 15 degrees C, but not at near-freezing
      temperature. The equilibrium between the complex and higher aggregates appeared
      reversible.

PMID- 1616633
TI  - Cellular transcription factors involved in the regulation of HIV-1 gene
      expression.

PMID- 1616634
TI  - Patterns of immunoglobulin G subclass reactivity to HIV-1 envelope peptides in
      children born to HIV-1-infected mothers.
AB  - OBJECTIVE: To analyse the pattern of immunoglobulin (Ig) G subclasses specific
      for HIV-1 envelope peptides in sera from HIV-1-infected mothers and their
      newborns. We sought to determine whether there was a selective transfer of
      antibodies from mother to child, and to establish diagnostic or prognostic
      properties by analysing HIV-1 peptide-specific IgG isotypes. DESIGN AND METHODS:
      Parallel sera from 12 HIV-1-infected mothers and their newborn children were
      analysed for IgG subclass responses to six HIV-1 envelope peptides by enzyme
      linked immunosorbent assay. Levels of IgG were compared with levels of IgG1 and
      IgG3 to an immunodominant gp41 peptide in children's sera obtained during the
      first months of life. In a longitudinal study of 16 children born to HIV-1
      seropositive mothers, of whom 11 were infected, the IgG1 and IgG3 responses to
      peptides representing an immunodominant epitope of gp41 and the principal
      neutralizing determinant of the gp120 V3 region were analysed. RESULTS: IgG1 and
      IgG3 were found to constitute the predominant peptide-specific antibody
      responses. A parallel distribution of IgG subclass reactivity was seen in
      maternal and paediatric sera. There was no evidence of selective antibody
      transfer. Comparable levels of IgG and IgG1 to the immunodominant peptide were
      seen in infected and uninfected children, while the IgG3 had disappeared in the
      majority of uninfected children. A decrease in peptide-specific IgG1 and IgG3
      levels was observed in sequential sera from uninfected children, although the
      kinetic profile varied. Sera from infected children showed de novo synthesis of
      IgG1 and/or IgG3 binding to the selected HIV-1 peptides. Most children with rapid
      disease progression failed to produce IgG1 and/or IgG3 to the V3 peptide.
      CONCLUSION: Analysis of IgG subclass kinetics to selected HIV-1 peptides might be
      a useful additional diagnostic and prognostic tool in evaluating HIV-1 infection
      in children born to seropositive mothers.

PMID- 1616635
TI  - Evaluation of an enzyme immunoassay for the combined detection of antibodies to
      HIV-1, HIV-2, HTLV-I and HTLV-II.
AB  - OBJECTIVE: To assess the sensitivity and specificity of a newly-developed assay
      (Bioelisa HIV-1 + 2, HTLV-1 + 2) for the simultaneous detection of HIV-1, HIV-2,
      HTLV-I and HTLV-II antibodies in human serum or plasma specimens. METHODS: A
      panel of 775 well characterized serum or plasma samples was studied. This
      included samples confirmed to contain antibodies to HIV-1 (n = 46), HIV-2 (n =
      19), HTLV-I (n = 49) and HTLV-II (n = 12), samples containing low titres of anti
      HIV antibody (n = 14) and samples collected during HIV seroconversion (n = 36).
      Eighty-three sera samples which were reactive in one or more HIV or HTLV
      screening assays, but which could not be confirmed to contain anti-HIV-1/2 or
      anti-HTLV-I/II antibodies, were also examined. RESULTS: Excluding the
      seroconversion samples and those selected on the basis of false reactivity in
      other screening assays, the Bioelisa kit had a sensitivity of 100% for antibody
      to all four viruses and a specificity of 98.8%. The ability of the kit to detect
      anti-HIV during seroconversion was similar to that of several other synthetic HIV
      antigen-based screening kits currently in use. CONCLUSIONS: Our findings indicate
      that the Bioelisa kit is sufficiently accurate to screen for both HIV and HTLV
      infections and that it warrants larger scale trials. Its use might allow blood
      donor screening for HTLV infection to be introduced more widely at modest extra
      cost [corrected].

PMID- 1616636
TI  - Clinical correlation of the immunological markers of HIV infection in individuals
      from Thailand.
AB  - OBJECTIVE: To evaluate the usefulness of T-cell subsets, beta-microglobulin
      (B2M), p24 antigen and anti-p24 antibodies as differentiating and prognostic
      markers in HIV-infected Thai patients. DESIGN: Sixty-one HIV-infected patients in
      various stages of disease (six AIDS, three AIDS-related complex, 34 persistent
      generalized lymphadenopathy and 18 HIV-asymptomatic) were followed prospectively
      for 2 years. Patients were examined and immunological markers assessed every 6
      months at least. Any HIV-related complications were treated symptomatically and
      clinical staging was re-evaluated at each visit. Due to financial constraints,
      none of the patients were given antiretroviral drugs. METHODS: T-cell subsets
      were enumerated by indirect immunofluorescence using OKT4 or OKT8 for T-helper
      and T-suppressor cells, respectively. beta 2M and p24 antigen were quantified by
      enzyme-linked immunosorbent assay and anti-p24 antibodies were by immunoblot
      assay. RESULTS: Our preliminary study revealed that the decrease in CD4+ T-cells
      or anti-p24 titre and the increase in p24 antigen or beta 2M correlated well with
      disease staging, as defined by the Centers for Disease Control. Absolute number
      and percentage of CD4+ T-cells, absolute number of CD8+ T-cells, beta 2M level
      and p24 antigen and anti-p24 antibody levels at entry could be used as reliable
      prognostic markers for HIV progression. The combination of p24 antigen with the
      number of CD4+ T-cells substantially increased the prognostic value, compared
      with either used alone. CONCLUSIONS: The annual rate of clinical progression from
      asymptomatic to symptomatic HIV infection in our study was 6.8%. The results we
      obtained in this preliminary study may be used as baseline data for planning
      future therapeutic interventions in Asian patients.

PMID- 1616638
TI  - Mother-to-infant transmission of HIV and hepatitis C infections in children born
      to HIV-seropositive mothers.

PMID- 1616637
TI  - Disease progression and early predictors of AIDS in HIV-seroconverted injecting
      drug users. The Italian Seroconversion Study.
AB  - OBJECTIVE: To evaluate the risk of developing AIDS and to identify early markers
      of disease progression in injecting drug users (IDU). DESIGN: Prospective study.
      SETTING: Sixteen centres throughout Italy. PATIENTS, PARTICIPANTS: Four hundred
      and sixty-eight IDU for whom it was possible to estimate the date of HIV
      seroconversion. MAIN OUTCOME MEASURES: Progression to AIDS. RESULTS: Twenty-six
      subjects developed AIDS during a median follow-up period of 42 months. The risk
      of developing AIDS was 21% within 7 years following seroconversion. Age greater
      than 25 years at seroconversion was associated with more rapid disease
      progression. Progression was similar for men and women. Continued drug injection
      did not accelerate progression to AIDS. Among the laboratory markers studied,
      CD4+ cell count at the first HIV-positive test was the best predictor of disease
      progression. Results were confirmed using multivariate analysis. CONCLUSIONS: Our
      findings indicate the importance of the role played by age in accelerated disease
      progression, which may be determined by a more rapid decline in CD4+ cell number
      in older HIV-infected IDU.

PMID- 1616639
TI  - Lack of correlation between acidified HIV p24 antigen and plasma viraemia.

PMID- 1616640
TI  - Incidence of hepatitis C, hepatitis B and HIV infections among drug users in a
      methadone-maintenance programme.

PMID- 1616641
TI  - Application of blood transfusion guidelines in a major hospital of Kinshasa,
      Zaire.

PMID- 1616642
TI  - Seroprevalence of HIV-1 in patients attending Modena Hospital, northern Italy.

PMID- 1616643
TI  - Monitoring the growing workload for the treatment of people with AIDS (PWA) in a
      university hospital, 1987-1990.

PMID- 1616644
TI  - Neuropsychological assessment of HIV-seropositive hemophiliacs.

PMID- 1616645
TI  - Differences in marital status among men reported with AIDS.

PMID- 1616646
TI  - Simple and efficient production of the core antigens of HIV-1, HIV-2 and simian
      immunodeficiency virus using pGEX expression vectors in Escherichia coli.

PMID- 1616647
TI  - An antitumour necrosis factor therapy.

PMID- 1616648
TI  - Restriction of serum antibody reactivity to the V3 neutralizing domain of HIV
      gp120 with progression to AIDS.
AB  - OBJECTIVE: To identify epitopes on HIV-1 gp120 that correlate with disease
      resistance and/or prognostic indication. DESIGN: The identification of epitopes
      on HIV-1 gp120 was determined by testing the reactivity by immunoblotting of anti
      HIV-positive human sera against partially cleaved Chinese hamster ovary (CHO)
      cell-derived recombinant gp120. Cleavage of recombinant gp120 occurs in the V3
      loop region resulting in 70 and 50K cleavage bands if the protein is subjected to
      sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) under
      reducing conditions. Antibodies reactive with the 120 Mr band alone on
      immunoblotting indicate that binding is restricted to this cleavage site.
      Reactivity to either of the cleavage products is independent of gp120 cleavage
      and indicates that binding occurs in sites other than the V3 cleavage region.
      METHODS: A panel of anti-HIV-positive human sera was tested for virus
      neutralizing activity and reactivity by immunoblotting against CHO cell-derived
      gp120. RESULTS: All sera reacted with the uncleaved from of gp120 but reacted
      either weakly or did not react with its cleavage products. There was a
      statistically significant correlation between serum reactivity to cleavage
      products and clinical stage of disease [Centers for Disease Control (CDC)
      criteria]. Sera of asymptomatic individuals (CDC stage II/III) were more likely
      to recognize either one or both of the cleavage products compared with sera from
      patients presenting with symptoms of disease (CDC stage IV). Furthermore, sera
      reacting with either one or both of the cleavage products were more likely to
      have higher neutralizing antibody titres than those that were unreactive.
      CONCLUSIONS: There is a restriction of serum antibody reactivity (when tested by
      immunoblotting) to the V3 loop with progression to disease. Raised neutralizing
      antibody titres may be dependent on regions outside the V3 cleavage site.

PMID- 1616649
TI  - Isolation and characterization of a new chimpanzee lentivirus (simian
      immunodeficiency virus isolate cpz-ant) from a wild-captured chimpanzee.
AB  - OBJECTIVE: To assess the prevalence of infection with simian immunodeficiency
      virus (SIV) isolate cpz, a lentivirus closely related to HIV-1, in chimpanzees,
      and to obtain new SIVcpz isolates. METHODS: Forty-four wild-captured chimpanzees
      in Belgium and Cote d'Ivoire were tested for HIV and SIV antibodies. Virus was
      isolated from the peripheral blood lymphocytes of positive animals and
      characterized by electron microscopy, Western blot and radioimmunoprecipitation
      assay. RESULTS: One animal had antibodies that cross-reacted with HIV-1. A
      lentivirus was isolated and referred to as SIVcpz-ant. With regard to molecular
      weight patterns, SIVcpz-ant differs from SIVcpz-gab' an HIV-1-related virus
      isolated from a wild-captured chimpanzee in Gabon. The major core protein, the
      transmembrane and outer membrane glycoproteins of the SIVcpz-ant strain
      consistently had higher molecular weights. Significantly more HIV-1-positive sera
      reacted with the envelope proteins of the Gabonese SIVcpz-gab strain than with
      the SIVcpz-ant strain. CONCLUSIONS: This study shows that natural infection of
      wild-captured chimpanzees with an HIV-related virus may not be uncommon. The
      diversity of the two chimpanzee isolates, the different geographical origin and
      the absence of disease suggest that chimpanzees have not recently become SIVcpz
      infected.

PMID- 1616650
TI  - Rapid generation of sequence variation during primary HIV-1 infection.
AB  - OBJECTIVE: HIV-1 undergoes extensive genetic variation in infected individuals.
      The extent of genetic variation has been examined in patients with AIDS, but
      little is known regarding the appearance of HIV-1 genetic variation immediately
      following infection during the primary phase of HIV-1 infection prior to
      seroconversion. DESIGN: We examined HIV-1 genetic variation during this early
      phase of HIV-1 infection by polymerase chain reaction (PCR) and nucleotide
      sequence analysis of the V4 by polymerase chain reaction (PCR) and nucleotide
      sequence analysis of the V4 variable region and the CD4-binding domain. RESULTS:
      Our results demonstrate that extensive sequence variation is seen early after
      infection, although a predominant HIV-1 species is maintained. CONCLUSIONS: The
      type of variants that occur are dynamic, changing over time, and the mutations
      seen are consistent with those expected from random occurrence, unlike the
      pattern of variation previously reported during later stages of disease.

PMID- 1616651
TI  - Cerebrospinal fluid beta 2-microglobulin in patients with AIDS dementia complex:
      an expanded series including response to zidovudine treatment.
AB  - OBJECTIVE: To determine the relationship between cerebrospinal fluid (CSF) beta 2
      microglobulin (beta 2M) and severity of AIDS dementia complex (ADC), and between
      CSF beta 2M and response of ADC to zidovudine. DESIGN: A prospective study.
      SETTING: Tertiary referral hospital. PATIENTS, PARTICIPANTS: Seventy-eight
      patients with varying stages of ADC were selected from a subgroup of a cohort of
      HIV-seropositive patients who are being studied prospectively for the
      neurological complications of HIV-1 infection. To enter our study, patients had
      to have an ADC stage of at least 0.5 (equivocal symptoms or abnormal neurological
      signs in the absence of functional impairment). A control group of 11 HIV-1
      seropositive, neurologically normal patients was chosen randomly from the
      patients followed in the Multicenter AIDS Cohort Study. INTERVENTIONS: Patients
      were assessed neurologically and neuropsychologically and computed tomography of
      the brain and CSF studies were performed. MAIN OUTCOME MEASURES: Patients were
      staged according to severity of ADC on clinical criteria. Neuropsychological test
      scores were converted to an impairment score. CSF beta 2M was quantified in both
      serum and CSF of all patients and in 10 patients with pre- and post-zidovudine
      assessments. RESULTS: There was a high correlation between CSF beta 2M
      concentration and severity of ADC (P less than 0.0001); treatment with zidovudine
      significantly reduced these concentrations (P = 0.013). CSF beta 2M concentration
      was independent of CSF white-cell count and blood-brain barrier impairment. Other
      CSF changes in the same patients (including blood-brain barrier permeability to
      albumin, intrathecal synthesis of immunoglobulin G and HIV-1-p24-antigen levels)
      were less useful as objective correlates of ADC severity and response to
      zidovudine therapy. CONCLUSIONS: CSF beta 2M may be a valuable marker of ADC
      severity and response to antiviral therapy.

PMID- 1616652
TI  - The spectrum of clinical and pathological manifestations of AIDS in a consecutive
      series of autopsied patients in Mexico.
AB  - OBJECTIVE: Little is known about the clinical profile of AIDS in Latin American
      populations. This study characterizes the clinical and pathological
      manifestations of AIDS in a representative series of Mexican AIDS patients at
      autopsy. DESIGN: The clinical and pathological findings were abstracted
      retrospectively for a sequential series of autopsied AIDS patients. SETTING:
      Autopsies were conducted at the four major tertiary level hospitals that serve
      the majority of AIDS patients in Mexico City. PATIENTS: Subjects included 177
      consecutive patients diagnosed with AIDS between March 1984 and January 1989 who
      subsequently died and were autopsied in the same period in the study hospitals.
      MAIN OUTCOME MEASURES: Demographic characteristics, including age, gender,
      residence, socioeconomic status, and risk group; clinical presentation and
      autopsy findings, including opportunistic infections and malignancies. RESULTS:
      Sixty per cent of the AIDS patients presented with wasting syndrome. The most
      common infections were cytomegalovirus (69%), tuberculosis (25%), and
      Pneumocystis carinii pneumonia (24%). Central nervous system infections were also
      common and included toxoplasmosis (19%) and cryptococcoses (10%). Kaposi's
      sarcoma was present in 30% of cases and non-Hodgkin's lymphoma in 9%. CONCLUSION:
      Clinical manifestation, and types and frequency of opportunistic infections in
      our Mexican AIDS patients were more similar to those seen in AIDS patients in
      Africa and Haiti than in the United States and Europe. These findings suggest
      that the AIDS epidemic in Mexico has an 'intermediate' pattern and may be a
      prototype for Latin American countries.

PMID- 1616653
TI  - Patterns and predictors of high-risk sexual behavior in female partners of HIV
      infected men with hemophilia.
AB  - OBJECTIVE: To characterize and quantify high-risk heterosexual activity in HIV
      discordant couples. DESIGN: Analysis of cross-sectional and longitudinal
      questionnaire data from 217 HIV-negative female sexual partners of HIV-infected
      hemophilic men. METHODS: Comparison of prevalence rates of anal sex, oral sex,
      vaginal intercourse with or without condoms, and use of other contraceptives
      between 1985 and 1991. Logistic regression analysis of demographic, sexual and
      clinical variables to predict unprotected vaginal sex. Actuarial estimates of
      semi-annual relapse rates to unsafe sex. RESULTS: The proportion of women at low
      risk increased from 7 to 69% between 1985 and 1991, mainly because more women
      were using condoms during all acts of vaginal intercourse. Other contraceptive
      practices did not change during this time. The proportion engaging in oral or
      anal sex decreased (from 26 to 13% and 13 to 4%, respectively). Unprotected
      vaginal sex was more common among women who enrolled earlier, had less education,
      engaged in oral or anal sex, and among those whose partners had not had AIDS.
      Unprotected vaginal sex before enrollment was the strongest predictor of this
      high-risk activity during follow-up. Two-year rates of relapse to high-risk
      behavior were significantly higher among women who enrolled at high risk compared
      with those who enrolled at low risk (39 versus 8%, P = 0.005). CONCLUSIONS:
      Although high-risk sexual behavior became much less prevalent in this population
      between 1985 and 1991, many continued to have unprotected vaginal sex
      occasionally. Counseling efforts should target couples who have been the most
      sexually active or have less education, and should emphasize not only initial
      risk reduction but also maintenance of low-risk behavior.

PMID- 1616654
TI  - Determinants of survival in adult Brazilian AIDS patients, 1982-1989. The
      Brazilian State AIDS Program Co-Ordinators.
AB  - OBJECTIVE: Little has been published about the length and determinants of
      survival for persons with AIDS in developing countries. This study examined the
      survival experience of Brazilian AIDS patients from 1982 to 1989. DESIGN: A
      retrospective cohort study involving record review of reported AIDS cases.
      METHODS: We obtained information about 2135 adult AIDS patients in Brazil. Local
      health officials supplied data regarding demographic and clinical characteristics
      and length of survival. Statistical techniques of survival analysis were applied.
      RESULTS: Median survival was 5.1 months, much shorter than in developed
      countries, and there was no improvement in survival for cases diagnosed more
      recently. Younger patients and those in the intravenous drug use exposure
      category lived longer than other AIDS patients. Those presenting with Kaposi's
      sarcoma, esophageal candidiasis, and tuberculosis fared relatively well, while
      those presenting with multiple diagnoses or toxoplasmosis did more poorly.
      CONCLUSIONS: These results tend to confirm the predictors of AIDS survival
      previously reported from developed countries and to document the poor survival of
      AIDS patients in the developing world.

PMID- 1616655
TI  - Association between HIV-2 infection and genital ulcer diseases among male
      sexually transmitted disease patients in The Gambia.
AB  - OBJECTIVE: To investigate whether genital ulcer diseases are cofactors which
      enhance the transmission of HIV-2 in West Africa. DESIGN: A cross-sectional study
      of 435 men presenting with a sexually transmitted disease (STD). SETTING: The
      outpatient clinic of the Medical Research Council Laboratories, a primary care
      facility in Fajara, a suburb of Banjul, the capital city of The Gambia (West
      Africa). PATIENTS, PARTICIPANTS: Six hundred and twenty-four men presenting with
      a genital complaint, of whom 443 had an STD. Eight of the men with an STD were
      excluded from further analysis because they were HIV-1-infected (five patients)
      or had indeterminate Western blot patterns (three patients). The remaining 21 HIV
      2-infected and 414 seronegative men constituted our study-group. MAIN OUTCOME
      MEASURES: Participants were questioned about previous STD and behavioural and
      demographic characteristics. A physical examination was performed and serum
      collected for measurement of antibodies against Haemophilus ducreyi and Treponema
      pallidum. RESULTS: HIV-2-infected men were more likely than HIV-seronegative
      participants to have previously had a genital ulcer [odds ratio (OR), 3.00; 95%
      confidence interval (Cl), 1.18-7.60] and to have antibodies against T. pallidum
      (OR, 5.95; 95% Cl, 2.10-16.91), or H. ducreyi (OR, 4.59; 95% Cl, 1.71-12.33).
      Circumcised patients with residual foreskin were more likely to be HIV-2 infected
      than patients with complete circumcision. HIV-2-seropositive patients were six
      times more likely to have generalized lymphadenopathy than their seronegative
      counterparts. CONCLUSIONS: Our data suggest that genital ulcerative diseases,
      such as syphilis and chancroid, are probably cofactors that increase the
      transmission of HIV-2 in West Africa, and that HIV-2 infection frequently results
      in generalized lymphadenopathy.

PMID- 1616656
TI  - A system for surveillance of voluntary HIV testing: results of the first 2 years,
      1989-1990.
AB  - OBJECTIVE: In 1988, in order to improve the already established surveillance of
      AIDS and HIV-infected cases in Scotland, UK, the Communicable Diseases (Scotland)
      Unit [CD(S)U], in collaboration with microbiologists responsible for HIV testing,
      instituted a routine system for the epidemiological surveillance of all voluntary
      HIV tests. METHODS: To facilitate information capture, a standardized HIV request
      form was introduced for use throughout the country by clinicians requesting an
      HIV test. In addition, a network of laboratory computers, operated by clerical
      personnel, was established for the collection and collation of data. RESULTS: In
      1989, of 9483 individuals tested for HIV, 129 (1.4%) were HIV-antibody-positive
      compared with 130 (1.2%) of 11,111 tested in 1990. A comparison of 1989 with 1990
      rates of HIV among specific population groups, including injecting drug users
      (4.1%, 1989; 2.7%, 1990), homosexual men (5.2%, 1989; 4.5%, 1990), heterosexual
      men and women with high-risk partners (1.6%, 1989; 1.8%, 1990) and heterosexual
      men and women with lesser risk (0.3%, 1989; 0.5%, 1990), revealed no
      statistically significance differences at a 95% level of confidence. CONCLUSION:
      We believe that this surveillance system is the first of its kind to be
      implemented on a nationwide basis. The first 2 years' findings suggest a degree
      of stability in new transmissions of HIV occurring in Scotland. However, the
      increasing numbers of those known to be HIV-infected continue to cause
      considerable concern: 1943 individuals were reported to CD(S)U as HIV-antibody
      positive by December 1991.

PMID- 1616657
TI  - The low rate of HIV infection in Japanese homosexual and bisexual men: an
      analysis of HIV seroprevalence and behavioural risk factors.
AB  - OBJECTIVE: To assess the seroprevalence of HIV-1 infection in homosexual and
      bisexual men in Nagoya City, Japan. DESIGN: A prospective study ongoing since
      April 1986. METHODS: Nine hundred and thirty-eight serum samples were collected
      from 531 participants in August 1990 in an anonymous, confidential testing
      programme. A self-administered questionnaire was completed and all participants
      anonymized by a code number. Interviews were conducted and HIV-antibody test
      results given by telephone, except for the positive test results, which were
      given in person and counselling offered. RESULTS: Two out of the 531 participants
      (0.38%) were found to be seropositive for HIV-1, although the seroprevalences of
      sexually transmitted diseases, including hepatitis B, syphilis, chlamydia
      infection and amoebiasis, were remarkably high. A small number of participants
      had had sexual contact with individuals from countries where HIV infection rates
      are high. No patient had had a recent episode of intravenous drug use. Numbers of
      male sexual partners were decreasing and unsafe sexual practices, such as anal
      intercourse without condom use, were also decreasing. CONCLUSIONS: The apparent
      low-risk behaviour of the men studied here (low levels of sexual contact with
      foreigners, absence of intravenous drug use, decreasing numbers of sexual
      partners and unsafe sexual practices) may explain the low prevalence of HIV
      infection.

PMID- 1616658
TI  - Association between HTLV-1 and HIV-2 infections in Bissau, Guinea-Bissau.

PMID- 1616659
TI  - Efficacy of octreotide in the management of chronic diarrhoea in AIDS.

PMID- 1616660
TI  - Clinical implications of recovery of Mycobacterium avium complex from the stool
      or respiratory tract of HIV-infected individuals.

PMID- 1616661
TI  - Refusal of zidovudine by HIV-positive patients.

PMID- 1616662
TI  - The importance of multisite sampling in determining the prevalence of HIV among
      drug injectors in Glasgow and London.

PMID- 1616663
TI  - Update: epidemiology of reported cases of AIDS in women who report sex only with
      other women, United States, 1980-1991.

PMID- 1616664
TI  - High frequency of antibodies against recombinant HIV-2 Nef protein in HIV-2
      positive and HIV-negative sera.

PMID- 1616665
TI  - Decline in immunoglobulins associated with AIDS-related biliary disease.

PMID- 1616666
TI  - Role of major histocompatibility complex recognition in the protection and
      immunopathogenesis of AIDS. Joint Anglo-Italian Workshop on Ponza Island, Italy.

PMID- 1616668
TI  - Community concerns.

PMID- 1616667
TI  - The coming of Euronurse.

PMID- 1616669
TI  - Care in the country.

PMID- 1616670
TI  - Keeping the pressure off.

PMID- 1616671
TI  - Change in practice.

PMID- 1616672
TI  - Communication and care.

PMID- 1616673
TI  - Travesties of care.

PMID- 1616675
TI  - Managing residential care.

PMID- 1616674
TI  - Postural hypotension.

PMID- 1616676
TI  - On the campaign trail.

PMID- 1616678
TI  - Home help in Korea.

PMID- 1616677
TI  - ACE matters.

PMID- 1616679
TI  - Breaking down.

PMID- 1616681
TI  - A credit to the Open University.

PMID- 1616680
TI  - RCN nursing update.

PMID- 1616682
TI  - Fever of unknown origin.
AB  - FUO is an uncommon problem in pediatric patients if one uses a strict definition
      of at least 2 weeks of fever. Perhaps the best definition, as suggested by Lorin
      and Feigin, is more than 1 week of fever and a negative initial evaluation,
      including examination and preliminary laboratory results. Most patients,
      especially younger ones, will spontaneously improve or have common disorders,
      usually respiratory-related infections. Most patients will have uncommon
      manifestations of more commonly recognized disorders. Mortality rates, even in
      those series that include a week in the hospital without a diagnosis, are 15% to
      20% at maximum--half that seen in most series of adult patients. Common mistakes
      are failure to document fever, failure to perform a complete history or physical
      examination, a shotgun approach that uses the laboratory to make diagnoses, and
      overuse or inappropriate use of newer imaging techniques in an undirected
      fashion. Patience, persistence, repeated histories and physical examinations, and
      continued observation offer the best chance of making a diagnosis in difficult
      cases. In the current decade, we continue to learn about new manifestations of
      old disorders--cat-scratch disease, Kawasaki disease, neonatal syphilis, and
      Epstein-Barr virus infection are examples. The use of older and well-established
      methods (history and physical examination) and the addition of newer techniques
      (ultrasound, CT, MRI, etc.) to pursue suggested diagnoses offer the best current
      approaches to the patient with prolonged and unexplained fever.

PMID- 1616683
TI  - Nontuberculous mycobacterial infections in children.

PMID- 1616684
TI  - Congenital syphilis.

PMID- 1616685
TI  - Infectious complications of solid-organ transplantation in children.

PMID- 1616686
TI  - Neonatal sepsis.

PMID- 1616687
TI  - The chronic fatigue syndrome: considerations relevant to children and
      adolescents.

PMID- 1616688
TI  - Uses of intravenous globulin to prevent or treat infections.

PMID- 1616689
TI  - Crystallization and preliminary crystallographic data for the azurin mutant Ala
      114 from Pseudomonas aeruginosa.
AB  - The site-specific mutant alanine 114 of the blue copper protein azurin from
      Pseudomonas aeruginosa in Escherichia coli has been crystallized from PEG 4000 in
      a new crystal form compared to the wild type utilizing the hanging-drop
      procedure. The crystals are blue well-formed prisms. Monoclinic, P2(1), a = 51.03
      (5), b = 83.36 (5), c = 66.30 (6) A and beta = 111.0 (1) degrees. 14,875
      reflections up to 2.7 A have been collected using a modified Syntex P2(1)
      automated four-circle diffractometer.

PMID- 1616690
TI  - Preliminary crystallographic study of peanut peroxidase.
AB  - The cationic isozyme of peroxidase isolated from suspension cultures of peanut
      cells is a heme-containing and calcium-dependent glycoprotein having four
      covalently attached oligosaccharide chains. Attempts were made to crystallize the
      glycoprotein for X-ray diffraction analysis, and these have met with some
      success. Crystals have now been grown that are suitable for a full three
      dimensional structural analysis. The crystals are thin plates and we have shown
      them to be of the orthorhombic space group P2(1)2(1)2(1) with a = 48.1, b = 97.2,
      c = 146.2 A. The crystals diffract to beyond 2.8 A resolution, appear to be
      stable to lengthy X-ray exposure, and contain two molecules of 40,000 daltons
      each in the asymmetric unit.

PMID- 1616691
TI  - Location of the sulfur atoms from the phased anomalous map using native protein
      data can be very helpful in tracing the peptide chain.

PMID- 1616692
TI  - Refinement of rubredoxin from Desulfovibrio vulgaris at 1.0 A with and without
      restraints.
AB  - X-ray data have been recorded from crystals of rubredoxin derived from the
      bacterium Desulfovibrio vulgaris to a resolution of 1.0 A using in part
      synchrotron radiation and in part X-rays from a sealed-tube Mo K alpha source. In
      both cases an imaging-plate scanner was used as detector. The space group of the
      crystals is P2(1) with cell dimensions a = 19.97, b = 41.45, c = 24.41 A and beta
      = 108.3 degrees. The overall merging R(I) factor between symmetry-related
      reflections was 5.8%. The model was refined by least-squares minimization
      initially with stereochemical restraints to an R factor of 16.4%. Only atomic
      positional parameters and isotropic temperature factors for non-H atoms were used
      in the refinement. There were 18,532 independent X-ray observations for a total
      of 1916 atomic parameters. A round of unrestrained refinement gave an R factor of
      16.0%, acceptable geometry for more than 90% of the protein atoms, but emphasized
      the disorder inherent in eight of the residues. A final round of restrained
      refinement gave an R factor of 14.7%. Three of the 389 protein atoms in the
      molecule, in the side chain of Lys2, have been assigned zero occupancy in the
      model. A total of eight atoms in three side chains have been assigned two
      conformations, giving 393 protein atomic sites in the model. In addition there is
      one Fe atom, a sulfate ion and 102 water sites. 339 H atoms were included at
      their calculated positions, which were not refined. There is clear evidence for
      anisotropic thermal motion. This has not been incorporated in the present model.

PMID- 1616693
TI  - The segmented anisotropic refinement of monoclinic papain by the application of
      the rigid-body TLS model and comparison to bovine ribonuclease A.
AB  - The anisotropic displacements of selected rigid groups in monoclinic papain have
      been refined from X-ray diffraction data by application of the rigid-body TLS
      model. The rigid groups chosen were the aromatic side chains of tryptophan,
      tyrosine, histidine and phenylalanine, and the planar carboxylic and guanidinium
      side chains of aspartic acid, glutamic acid, glutamine, asparagine and arginine.
      The derived translation and libration tensors have been compared with those
      previously derived for bovine ribonuclease A and provide evidence for different
      modes and anisotropies of displacement over the two proteins.

PMID- 1616695
TI  - Wisconsin's Disaster Identification team helps set the pace for other states.

PMID- 1616694
TI  - Structure determination of monoclinic canine parvovirus.
AB  - The three-dimensional structure of the single-stranded DNA canine parvovirus has
      been determined to 3.25 A resolution. Monoclinic crystals belonging to space
      group P2(1) (a = 263.1, b = 348.9, c = 267.2 A, beta = 90.82 degrees) were
      selected for data collection using primarily the Cornell High Energy Synchrotron
      Source and oscillation photography. There was one icosahedral particle per
      crystallographic asymmetric unit, giving 60-fold redundancy. The particle
      orientations in the unit cell were determined with a rotation function. The rough
      positions of the particles in the unit cell were estimated by considering the
      packing of spheres into the P2(1) crystal cell. More accurate particle centers
      were determined from Harker peaks in a Patterson function. Hollow-shell models
      were used to compute phases to 20 A resolution. The radii of the models were
      based on packing considerations, the fit of spherical shells to the low
      resolution X-ray data and low-angle solution scattering data. The phases were
      extended to 9 A resolution using molecular replacement real-space averaging.
      These were then used to determine the heavy-atom position of a K2PtBr6
      derivative, for which only 5% of the theoretically observable reflections had
      been recorded. The center of gravity of the 60 independent heavy-atom sites gave
      an improved particle center position. Single isomorphous replacement phases to 8
      A resolution were then calculated with the platinum derivative. These were used
      to initiate phase improvement and extension to 3.25 A resolution using density
      averaging and Fourier back-transformation in steps of one reciprocal lattice
      point at a time. The resulting electron density map was readily interpretable and
      an atomic model was built into the electron density map on a PS390 graphics
      system using the FRODO program. The R factor prior to structure refinement for
      data between 5.0 and 3.25 A was 36%.

PMID- 1616696
TI  - Bite mark evidence contributes to the criminal justice system.

PMID- 1616697
TI  - Yellow Pages advertising.

PMID- 1616698
TI  - Got the UCR blues? What to do when insurance companies tell your patients your
      fees are over the usual and customary.

PMID- 1616699
TI  - The rising cost of healthcare--why?

PMID- 1616700
TI  - Loading and transfer control for Northern hybridization.
AB  - We report a simple and inexpensive method to quantitate loading and transfer of
      RNA and to examine RNA integrity for use with Northern hybridization. This
      technique involves quantitation by computer-assisted video densitometry of a
      negative photograph of 28S and 18S rRNA from ethidium bromide-stained RNA fixed
      to nylon membranes. This method eliminates the issue of variability of expression
      of "housekeeping" genes and the need for a second round of hybridization to
      quantitate control probes.

PMID- 1616701
TI  - A sensitive microplate assay for glycoproteins that utilizes an immunological
      digoxigenin-based detection system.
AB  - A sensitive microplate assay for glycoproteins, based on an immunological
      digoxigenin-based detection system, is described. When log absorbance was plotted
      against log concentration, linear standard curves were obtained over the range 25
      ng/ml to 25 microliters/ml with bovine submaxillary mucin, porcine stomach mucin,
      fetal calf fetuin, asialofetuin and human transferrin. This detection limit and
      range are far superior to other assays that have been described. The use of the
      microtiter plate format means that a large number of samples can be assayed with
      ease. Due to the broad range of the assay, the concentration of the sample is not
      a particular problem, and samples above the upper cutoff value can be serially
      diluted in the microtiter plate to find an appropriate value.

PMID- 1616702
TI  - Efficient production of single-stranded DNA as long as 2 kb for sequencing of PCR
      amplified DNA.
AB  - A modification of the asymmetric PCR method is described, which reliably
      facilitates sequencing of PCR-amplified DNA. This procedure produces single
      stranded DNA fragments as long as two kilobases that are suitable for dideoxy DNA
      sequencing. First, a PCR for double-stranded DNA is preformed under optimal
      conditions (double-stranded PCR). Then, a 5-10-microliters fraction of the double
      stranded PCR and a single primer are used to generate single-stranded DNA in a
      separate PCR (single-stranded PCR). The concentration of the single primer are
      used to generate single-stranded DNA in a separate PCR (single-stranded PCR). The
      concentration of the single primer is approximately 0.4 microM. Usually 15 to 25
      cycles of single-stranded PCR are optimal to produce single-stranded DNA for four
      to eight sequencing reactions. The single-stranded DNA is purified by centrifugal
      ultrafiltration and used directly in dideoxy sequencing. This method was employed
      to produce high-quality single-stranded DNA templates from a variety of organisms
      for efficient DNA sequencing of PCR-amplified DNA.

PMID- 1616703
TI  - A rapid method for cosmid cloning.
AB  - We present a method for genomic library construction using cosmid vectors. With a
      combination of backfilling with Klenow enzyme and a cosmid vector with two cos
      sites, a DNA bank in excess of 500,000 clones can be made from 10 micrograms of
      genomic DNA. The method is more rapid than conventional protocols because size
      fractionation of target DNA is not necessary. A further advantage is that
      libraries can be made from relatively small amounts of genomic DNA.

PMID- 1616704
TI  - Magnesium chelation inactivates beta-galactosidase in -20 degrees C storage.
AB  - Mammalian cell lysate containing beta-galactosidase (beta Gal) derived from the
      transient expression of the bacterial lacZ gene driven by the human beta-actin
      promoter loses activity progressively over time in storage at -20 degrees C in
      the presence of EDTA. The simultaneous presence of NaCl with EDTA exacerbates
      such an inactivation, although NaCl by itself does not. However, EGTA, a
      chelating agent that preferentially binds Ca2+ over Mg2+, does not inactivate
      beta Gal. Addition of equal or higher molar concentration of Mg2+ (as MgCl2) or
      Ca2+ (as CaCl2), both effectively chelated by EDTA, to an EDTA-containing lysate
      prevents this cold-related inactivation, but does not reactivate the enzyme.
      Therefore, the chelation of Mg2+ by EDTA at -20 degrees C inactivates beta Gal.
      Storage of cell lysate at -70 degrees C completely prevents the EDTA-induced
      inactivation of beta Gal. It is recommended that when beta Gal activity is used
      as the reporter for gene expression 1) EDTA should not be used to prepare cell
      lysate and 2) the cell lysate should be stored in a -70 degrees C freezer to
      preserve full activity.

PMID- 1616705
TI  - Application of the chloramphenicol acetyltransferase (CAT) diffusion assay to
      transgenic plant tissues.
AB  - Chloramphenicol acetyltransferase (CAT) activity was quantified in crude extracts
      from tobacco callus tissues using a modification of a previously reported
      diffusion assay. We describe here the alterations necessary in applying this
      rapid and simple assay procedure to plant materials. Due to the high
      concentration of nonspecific oxidases present in most plant tissues, some type of
      protective agent is required to maintain enzyme activity. We have tested beta
      mercaptoethanol, cysteine, dithiothreitol, ascorbic acid and polyvinyl
      pyrrolidone as protective agents within the initial extraction buffer. We also
      investigated the effect of heat (60 degrees C, 10 min) and 5 mM EDTA on CAT
      activity. The highest CAT activity was obtained using 5 mM cysteine plus 5 mM
      EDTA in 40 mM Tris-HCl (pH 7.8) as the initial extraction buffer followed by a
      heat treatment. Using this buffer, CAT activity was stable on ice for more than
      two hours. In our hands, total acetyl-coenzyme A concentration within the assay
      mixture was found to be saturating at 250 microM and the Km determined to be 100
      microM. Assays performed using the same crude plant extract indicate that 1)
      duplicate assays show less than 1.5% variation in activities and 2) CAT activity
      increases linearly with respect to volume of extract used.

PMID- 1616706
TI  - Separation and purification of high molecular weight glycoproteins using agarose
      gel electrophoresis.
AB  - Several components of the extracellular matrix in the molecular weight range of
      220 kDa to 150 kDa were purified by preparative electrophoresis on 2.5% Pro-Sieve
      agarose gels. These high molecular weight glycoproteins, separated under reducing
      conditions, were recovered in solution by extraction of individual agarose gel
      slices and analyzed on sodium dodecyl sulfate polyacrylamide gels and Western
      blots. This simple method permitted the separation and recovery of the laminin B
      chains (220 kDa and 205 kDa) and entactin (150 kDa) and may prove useful for the
      purification of other high molecular weight species.

PMID- 1616707
TI  - Effect of DNA concentration on recombinant plasmid recovery after blunt-end
      ligation.
AB  - We describe conditions for optimal recovery of recombinant plasmids after blunt
      end ligation. It was found that one of the most critical parameters of the blunt
      end ligation reaction is total DNA concentration (vector plus incoming DNA). This
      concentration was optimal in the range of 1-5 micrograms/ml of reaction mixture.
      Concentrations larger than 10 micrograms/ml result in strong inhibition. The
      optimal molar relationship between incoming DNA and vector was found to be 1 or
      less. Under these conditions, using dephosphorylated vector, recombinants are
      generated at a frequency of 10(6) colonies per microgram of insert, provided that
      transforming efficiency is about 5 x 10(7) colonies per microgram of plasmid DNA.

PMID- 1616708
TI  - Direct microtiter plate sequencing of PCR-amplified M13 clones from plaques using
      dried reagents.
AB  - A method is described using dried reagents in microtiter plates for direct PCR
      and sequencing of M13 plaques. The method has advantages of reliability and high
      throughput that make it suitable for medium to large-scale sequencing projects.

PMID- 1616709
TI  - Methods to identify and avoid artifactual formation of interchain disulfide bonds
      when analyzing proteins by SDS-PAGE.
AB  - Amicyanin is a monomeric protein of known structure which possesses a single
      cysteine that serves as a ligand to copper in its native state. Sodium dodecyl
      sulfate polyacrylamide gel electrophoresis (SDS-PAGE) analysis of amicyanin after
      denaturation in the presence and absence of beta-mercaptoethanol, however,
      indicated that this protein was a dimer which was covalently linked by interchain
      disulfide bonds. This artifact was caused by exposure during denaturation of the
      free cysteine that normally binds copper and subsequent formation of a disulfide
      bond between otherwise unliked monomers. This phenomenon is documented, and
      additional control experiments are proposed to identify and avoid this artifact
      when using SDS-PAGE to analyze the subunit structure of proteins.

PMID- 1616710
TI  - A hemagglutinating substance in chitin.
AB  - Chitin from crustacean shells has often been used to isolate and purify plant
      lectins that have an affinity for poly-N-acetylglucosamine (poly-GlcNAc). When we
      used washed chitin from crab shells as an affinity medium to isolate a lectin
      from Pinus strobus L. (eastern white pine) ovules, we found that a substance
      having a strong capacity to agglutinate red blood cells was eluted from the
      chitin during a weak acid desorption step. The chitin agglutinin is a complex
      structure containing protein and poly-GlcNAc. Chitin samples from four
      biochemical suppliers were tested; all contained the elutable agglutinin. Acid
      (0.05 N HCl or 0.1 N acetic acid) appears to hydrolyze the material from the
      solid chitin. NaOH at 0.5 N does not remove the agglutinin. Since agglutination
      is the assay used to monitor lectin purification, care must be taken to avoid the
      native agglutinin if chitin is used as an affinity matrix.

PMID- 1616711
TI  - Combinative oligonucleotide-directed large deletions as a strategy for surveying
      the regulatory region of a gene.

PMID- 1616712
TI  - Increasing DNA synthesizer throughput via off-instrument cleavage and
      deprotection.

PMID- 1616713
TI  - A rapid method for preparation of bacterial chromosomal DNA in agarose plugs
      using Thermus Rt41A proteinase.

PMID- 1616714
TI  - Efficient measurement of radioactivity in oligonucleotides.

PMID- 1616715
TI  - A rapid and efficient protocol for sequencing plasmid DNA.

PMID- 1616716
TI  - An improved enzyme-linked immunoadsorbent assay for the detection of antibodies
      to galactocerebroside.

PMID- 1616717
TI  - One reagent simultaneously identifies the salt and the protein peaks on desalting
      column.

PMID- 1616718
TI  - A modified procedure for replica plating of mammalian cells allowing selection of
      clones based on gene expression.
AB  - The polyester cloth replica-plating technique for selection of mammalian cell
      clones was modified by growing cells in colonies on a flexible
      polytetrafluoroethylene membrane and then transferring them completely to
      polyester cloth (27-microns mesh), from which a replica was made by allowing
      cells to transfer to a cloth of smaller pore size (17-microns mesh). Using this
      technique, two phenotype selection methods are demonstrated here: in situ
      hybridization for detection of a specific mRNA and a photographic film assay for
      detection of luciferase expression. Cells were transfected with pSV2AL-A delta 5'
      in which firefly luciferase cDNA is under the control of the simian virus 40
      promoter. The luciferase assay was adapted for colonies on polyester cloth; cells
      were permeabilized with digitonin to allow access of ATP and luciferin to the
      cell without disruption of colonies. Clones selected for expression or
      nonexpression of luciferase by the photographic film assay were positive or
      negative for expression after isolation from the cloth replica and subsequent
      growth under conventional culture conditions. The replica-plating procedure
      described here should be generally applicable to most mammalian cell types. The
      ability to produce replicas of colonies, combined with in situ hybridization or
      assays that can be adapted to in situ detection, provides phenotype selection for
      clones based on gene expression independent of growth characteristics.

PMID- 1616719
TI  - A new deficiency mapping technique using the SOFI detector.
AB  - We present a new technique for chromosomal deficiency mapping that takes
      advantage of the ability of the SOFI detector to provide fast quantitative data
      of very weak signals. With this new strategy, in contrast to the time-consuming
      traditional method, all the clones corresponding to a given genomic region may be
      mapped for their inclusion inside a deletion with only two hybridizations,
      independent of the size of the genomic region to be analyzed.

PMID- 1616720
TI  - Use of perfluorocarbon emulsions in cell culture.
AB  - Perfluorocarbon emulsions were applied to hybridoma cultures grown in tissue
      culture tubes and column bioreactors. The oxygen transfer enhancement effect of
      perfluorocarbon emulsions was clearly demonstrated by the higher cell densities
      obtained in emulsion-supplemented systems. In addition, perfluorocarbon emulsions
      were shown to provide better cell suspension in a low-shear environment. The
      study in column bioreactors also suggested a cell protective effect of the
      employed perfluorocarbon emulsions in reducing the damage to cells by gas
      bubbles.

PMID- 1616721
TI  - DNA hybridization assay using ATTOPHOS, a fluorescent substrate for alkaline
      phosphatase.
AB  - A fluorometric procedure for the detection of DNA-DNA hybrids is described. The
      procedure involved the detection of probe-bound alkaline phosphatase with the
      fluorescent substrate ATTOPHOS. This substrate is converted to ATTOFLUOR by
      alkaline phosphatase and fluoresces strongly at 550 nm when excited with a
      wavelength of 440 nm. DNA hybridization assays were performed both with dilutions
      of purified target plasmid DNA (pSE9 or PBR322) and whole bacterial cells.
      Streptavidin-alkaline phosphatase conjugates were added to react with bound
      probe. Fluorometric assays, as well as colorimetric assays, using 5-bromo-4
      chloro-3-indolylphosphate + nitroblue tetrazolium for alkaline phosphatase
      activity were performed. The fluorescence of the substrate was measured at time
      intervals, and the slope of the regression line calculated. A slope four times
      greater than that of background was considered positive. One hundred femtograms
      or 2.2 x 10(4) molecules of homologous DNA were detected with the fluorescent
      assay as compared with 10,000 femtograms or 2.2 x 10(6) molecules of homologous
      DNA with the colorimetric assay. Similar results were obtained with whole cells.
      Approximately 1 x 10(3) homologous cells were detected fluorometrically and 1 x
      10(5) cells were detected colorimetrically. Based on these results, we conclude
      that, in our hands, the DNA hybridization assay described here using ATTOPHOS as
      the substrate for alkaline phosphatase is a very sensitive assay for the
      detection of DNA-DNA hybrids.

PMID- 1616722
TI  - HIV-1 infection and cardiothoracic surgery: the difference in attitudes between
      consultants and junior surgeons in the United Kingdom.
AB  - A postal survey was carried out inviting the opinions of consultant and trainee
      cardiothoracic surgeons on the subject of operating upon patients who are either
      HIV-1 antibody positive or suffer from full-blown AIDS. The questionnaire
      contained both cardiac and thoracic clinical situations, all of which under
      normal circumstances would be managed surgically with low operative mortality and
      long median survival. The overall response rate was 72.4%. A significantly
      greater number of consultants replied compared to juniors, 80% and 51.6%,
      respectively (P less than 0.001). In both groups, surgeons were more likely to
      operate upon a patient who was HIV-1 antibody positive than one who had AIDS.
      There were no significant differences in the replies of consultants and juniors
      to the clinical scenarios presented. However, a greater number of juniors
      admitted to modifying their surgical practice in the light of the increasing
      incidence of HIV-1 infection (P less than 0.001). Routine preoperative HIV
      antibody testing was advocated by 77.8% of consultants and 75% of juniors and
      this rose to 95.1% and 97%, respectively, if patients were in the traditionally
      high risk groups. Four consultants admitted that they were already performing
      routine preoperative HIV antibody screening. This survey emphasized the real
      concern amongst cardiothoracic surgeons, irrespective of their grade, about HIV-1
      infection and the need for both education and clear policy guidelines to deal
      with this difficult issue.

PMID- 1616723
TI  - Blunt chest injuries in 1696 patients.
AB  - We review 1696 patients with blunt chest trauma. Road traffic accidents were the
      main cause of injury followed by domestic falls and labour accidents. Outdoor
      falls and sport accidents accounted for a small number of injuries. For clinical
      evaluation, Stoddart's score was used. The injuries were considered as minor in
      710 patients, intermediate in 740 and severe in 246. Global in-hospital mortality
      was low (5%) but increased to 37% when only patients with multiple severe
      injuries were considered. Thoracic wall fractures were present in 1419 patients.
      Flail chest was diagnosed in 140 patients and pulmonary contusion in 275.
      Diaphragmatic rupture was present in 40 patients and tracheobronchial injury in
      6. Cardiovascular injuries occurred in 55 patients. Associated extrathoracic
      injuries were seen in 611 patients: 923 patients were clinically observed and/or
      medically treated. An intercostal tube was inserted in 638 patients. Thoracotomy
      was undertaken in 105 patients. Surgical fixation for flail chest was carried out
      in 29 patients. The results were generally good: 9 patients did not need any
      mechanical ventilation and 11 were ventilated for a short period. No deaths were
      due to the surgical procedure. The authors maintain that a selective attitude
      restricting, but not ignoring, surgical stabilization is the best policy.

PMID- 1616724
TI  - Evaluation and treatment of secondary tricuspid insufficiency.
AB  - To define the role of functional tricuspid insufficiency and right ventricular
      (RV) failure in patients with mitral disease, the data of 121 patients with
      secondary tricuspid insufficiency that underwent mitral valve replacement (MVR)
      from January 1982 to December 1987 were analyzed. The mitral hemodynamic lesion
      was: stenosis in 41 patients (33.9%); insufficiency in 11 (9.1%) and mixed
      stenosis and insufficiency in 69 (57.0%). NYHA functional class was: II in 4
      patients (3.3%), III in 78 (64.5%) and IV in 39 (32.2%). In 100 cases (group 1)
      with tricuspid insufficiency defined as moderate or severe, a De Vega
      annuloplasty was performed while in 21 (group 2) with mild tricuspid
      insufficiency, no tricuspid surgical procedure was performed. Hospital deaths
      occurred in 17 of 121 patients [14% (CL 10.8-17.0)]. There was no significant
      difference in hospital mortality between group 1 and group 2 (15% vs 9.5%; P =
      0.75). Incremental risk factors for hospital mortality as determined by
      multivariate analysis, include: cardiothoracic ratio (P = 0.0016), total aortic
      cross-clamp time (P = 0.006), associated cardiac disease (P = 0.0209) and
      emergency operations (P = 0.0318). Mean follow-up of surviving patients was 50.1
      +/- 28.1 months. Late deaths occurred in 16 patients [15.4% (CL 11.7-18.7)]. The
      actuarial survival rate was 85.6% and 73.8% at 5 and 9 years, respectively. Nine
      patients [8.6% (CL 5.9-11.3)] required reoperation. There was no significant
      difference between group 1 and group 2 in the rate of late cardiac related deaths
      (5.9% vs 5.3%, P = 0.66) and of tricuspid reoperations (4.7% vs 5.3%, P =
      0.62).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616726
TI  - Effect of differing acid-base regulation on cerebral blood flow autoregulation
      during cardiopulmonary bypass.
AB  - Cerebral dysfunction following cardiopulmonary bypass may be aggravated by
      altered autoregulation of cerebral blood flow. We have used trans-cranial Doppler
      to measure middle cerebral artery blood flow velocity during cardiopulmonary
      bypass managed by either pH-stat or alpha-stat acid-base protocols. Fourteen
      patients were studied, 7 in each group. During bypass at 28 degrees C, patients
      underwent incremental alterations in mean arterial pressure from 20-90 mmHg,
      maintaining systemic perfusion flow at 1.75 L/min per m2. The cerebral extraction
      ratio of oxygen was measured to indicate matching of cerebral blood flow to
      demand. The pH-stat group showed a pressure passive cerebral circulation with
      significant (r = 0.999, P less than 0.05) increase in blood flow velocity with
      increasing arterial pressure. This also occurred in alpha-stat group during the
      pressure range of 20-50 mmHg (r = 0.951, P less than 0.05). During the pressure
      range of 50-90 mmHg in alpha-stat group the change in flow velocity (0.16 cm/sec
      per mmHg) was significantly (P less than 0.05) less than that in pH-stat group
      (0.58 cm/second per mmHg). The cerebral extraction ratio of oxygen was less
      depressed in the alpha-stat group than in the pH-stat group, indicating more
      appropriate matching of cerebral blood flow and tissue demand. These results
      suggest that, during alpha-stat managed cardiopulmonary bypass, cerebral blood
      flow velocity is less subject to wide pressure alteration than pH-stat.

PMID- 1616725
TI  - Clinical experience of mitral valve reconstruction with artificial chordae
      implantation.
AB  - To expand the application of mitral valve reconstruction for pure mitral
      regurgitation due to diffuse leaflet prolapse, we have employed artificial
      chordae implantation using GPEP strips in 9 patients and 4-0 PTFE sutures in 20
      patients since November 1986. The total number of GPEP strips implanted was 20
      with a range from 1 to 4 (average 2.2 per patient) and 45 pairs of PTFE sutures
      with a range from 1 to 6 (average 2.3 per patient). There was one hospital death
      (3.4%). All other patients survived operation without valve-related complications
      except 1 patient who required reoperation for failure of mitral valve
      reconstruction. In 27 survivors free from reoperation, the amount of mitral
      regurgitation assessed postoperatively was none or trivial in 19 patients, mild
      in 7 and moderate in 1. All 27 patients improved to NYHA functional class I or
      II. So far, our results were no less acceptable than those with conventional
      procedures for mitral valve prolapse.

PMID- 1616727
TI  - Minimisation of priming volume and blood saving in paediatric cardiac surgery.
AB  - We started a programme of donor blood reduction for open heart surgery in
      children in 1983. At first, only meticulous surgical and perfusion techniques
      were used. Later, increased haemodilution was added. Miniaturisation of the
      perfusion circuit and introduction of blood taken prior from the patient further
      decreased donor blood requirements. In 1989, we used 0.89 l per patient compared
      to 3.2 l per patient in 1983. Miniaturisation of the circuit was tested in a
      pilot study on 30 children undergoing the Senning operation in 1988. Priming
      volume was reduced from 661 +/- 72 ml to 421 +/- 62 ml. In 1989, 167 out of 194
      children (86%) received a clear prime. Ninety-seven of 100 children whose weight
      was over 15 kg received a clear prime: 55 did not require subsequent transfusion.
      Prime miniaturisation and autotransfusion can considerably reduce blood
      requirements for open heart surgery.

PMID- 1616728
TI  - Pectus excavatum. A clinical study with long-term postoperative follow-up.
AB  - Between 1972 and 1987, 192 patients have been operated upon for pectus excavatum
      of which 152 patients were included in the study (79%). Mean age at operation was
      15.3 +/- 5.5 years; 117 were male. Mean follow-up was 8.1 +/- 3.6 years. The
      deformity was noted before the age of 5 in 90%. Type I symmetrical and localized
      deformity was seen in 33.2%, type II symmetrical but diffuse depression in 23.7%
      and type III localized or diffuse asymmetrical deformity in 43.1%. It was
      considered severe in 68.9%, fair in 16.9% and mild in 14.2%. There were
      significantly more asymmetrical defects in the older age groups. The operation
      consisted of subperichondral chondrectomy, transverse sternotomy and division of
      the intercostal bundles at the outer limit of the chondrectomy and suturing the
      edge of this broad sheet of muscle and perichondrium to the anterior surface of
      the chest wall more laterally and under tension, elevating and stabilizing the
      sternum. Results were satisfactory in 83.6% (excellent 44.1%, good 39.5%).
      Results were not significantly influenced by age, sex, severity, type, symmetry,
      the extent of cartilage resection or follow-up. Results were inversely influenced
      by the occurrence of wound problems. The optimal age for operation is considered
      to be between 5 and 10 years. Both physical as well as psychological cosmetic
      factors may serve as an indication for operation.

PMID- 1616729
TI  - Esophageal diverticula. Physiopathological basis for surgical management.
AB  - From 1980 to 1990, 31 patients were treated surgically in our department for
      esophageal diverticula: 12 Zenker's diverticula (ZD); 11 mid-thoracic diverticula
      (MTD); 8 epiphrenic diverticula (ED). Cricopharyngeal dysfunction was detectable
      in 8 of 12 ZD patients (66.6%). Cricopharyngeal myotomy with diverticulectomy was
      performed in all cases. There were no deaths. Relief of dysphagia was obtained in
      all cases. No recurrences of dysphagia or diverticulum were observed at a mean
      follow-up of 3 years. A motility disorder was observed in 10 of 11 MTD (90.9%).
      An extended esophageal myotomy with diverticulectomy was performed in 3 cases, an
      extended myotomy alone in 3 cases, a diverticulectomy alone in 5 cases; an anti
      reflux procedure was added in 6 cases. One patient died on the 7th postoperative
      day. All remaining patients were free of symptoms at a mean follow-up of 3.2
      years. A motor dysfunction was detected in all 8 ED patients (100%). No
      diverticulectomy was performed. Six patients underwent Heller-Dor myotomy and 2
      underwent Nissen fundoplication. There were no deaths. Relief of symptoms was
      obtained in all patients, at a mean follow-up of 3.1 years. Myotomy with
      diverticulectomy represents the treatment of choice in ZD. As regards MTD and ED,
      the treatment of the underlying motor disorder is the main therapeutic goal,
      whereas diverticulectomy is reserved to selected patients.

PMID- 1616730
TI  - Elderly presentation of tetralogy of Fallot precipitated by an occult bronchial
      carcinoid tumour.
AB  - A 68-year-old female with tetralogy of Fallot is presented. She had become
      progressively symptomatic in the 2-3 months prior to referral and at operation
      was found to have a previously unsuspected neuroendocrine secreting bronchial
      carcinoid tumour subsequently removed by lobectomy.

PMID- 1616731
TI  - Intracaval paraganglioma causing superior vena cava syndrome.
AB  - We report a 46-year old female patient with progressive symptoms and signs of
      superior caval syndrome. At surgery, the caval vein with a benign intravascular
      paraganglioma was removed, and a venous interposition using a spiral vein graft
      was performed.

PMID- 1616732
TI  - [The research process in grounded theory: some examples of nursing education and
      nursing practice research].
AB  - The purpose of this paper is to describe the grounded theory method; especially
      of the research process in studies using the method. The article is based on the
      examples of authors' studies of nursing education and nursing practice. The
      grounded theory method is qualitative and inductive, analyzing data from the
      empirical world, from which categories and concepts are emerged. Analysis is made
      by coding and memorizing. The emerging categories will be structured,
      restructured and developed continually during the research process. In the final
      theory the concepts, the relationships between them and their internal and
      external differences are defined in the social process. The meaning of a good
      description of the research process is emphasized, because the evaluation of the
      research studies using grounded theory method are based on well documented
      research process.

PMID- 1616733
TI  - [Current and future work roles of hospital nursing directors].
AB  - This study has three aims: 1) to examine the present role of hospital nurse
      directors; 2) to find out what changes will occur in their role in the near
      future; and 3) to explore what their future role should be. The data were
      collected by a means of a mail questionnaire in winter 1990 from 50 nurse
      directors and 42 chief physicians of departments and 50 head nurses of wards from
      five Finnish university hospitals and from five other large acute hospitals. The
      nurse directors assessed their present role as being the most active and the head
      nurses as the least active in the examined 27 leadership functions. Largest
      differences were found in the evaluation of the hospital nurse directors' present
      role between the nurse directors themselves and the head nurses. However, in
      respect to the future work role the head nurses and nurse directors had rather
      similar expectations. Both emphasized research and development of the nursing
      staff and nursing care. The chief physicians thought that nurse directors should
      concentrate more on the internal leadership functions of the hospitals such as
      personnel management, solving the conflicts between the staff and performing
      routine functions of personnel management. The nurse directors themselves
      emphasized the external functions of hospitals in their present and future work
      role, such as networking and negotiations outside the hospitals and financial
      management. The differences in the evaluations of the present role and in the
      expectations concerning the future role of nurse directors indicate conflicting
      views between the the three groups. All respondents perceived nurse directors as
      being important and needed in hospitals. They also considered that non-nurses
      cannot function as directors of nursing services.

PMID- 1616734
TI  - [Nurses' viewpoint of the effects of breast cancer of hospitalized patients on
      their continued participation in self care].
AB  - This article is focused on the viewpoint of nurses about the effects of breast
      cancer to a patient. What kind of opportunities as well as resources do the nurse
      notice that the patient has and how much does the nursing practice create
      possibilities for a patient to participate. The questionnaire developed was sent
      to special nurses, nurses, radiological nurses and specialized radiological
      nurses in clinics and wards of one university and six local hospitals (N = 125)
      in southwestern Finland. Seventy-one percent of respondents returned the
      questionnaire. The analysis of the data was based on percentual distributions,
      correlations and cross-tabulations. The main statistical analysis was made by
      using log-linear models. The meaning of breast cancer to a patient was seen to
      depend on patient's total life situation. The age, personality and values are
      imagined to effect how the person reacts in an illness situation. According to
      nurses patients have resources to participate in more active way in their care.
      The reasons set limits in patient's participation are seen to be unclear purposes
      in care and different kind of reasons based on health care staff, nursing
      practice, the organization and also patients.

PMID- 1616735
TI  - [Critical thinking during the clinical teaching at the beginning of nursing
      students' clinical education].
AB  - This article examines how critical thinking is seen in learning decision making
      during the clinical lessons in the beginning of nursing students' clinical
      education. The data has been collected by taping all the clinical lessons (11) of
      the students (32). The data was analyzed by using content analysis both
      quantitatively and qualitatively. The phases of the nursing process, in other
      words the phases of decision making appeared clearly in the discussions. A lot of
      assessment of the nursing needs of the patient appeared clearly. Physical needs
      were focused among the nursing problems. The objects of the nursing were defined
      nurse-centrically and generally. The discussion about the implementation and the
      evaluation of the nursing received insufficient attention. There were presented
      neither alternative solutions of the care nor any reasons for proposed solutions.
      Learning of the students represented mainly superficial, mechanical learning,
      lacking critical thinking.

PMID- 1616736
TI  - [The 34th Congress of the Japanese Society of Child Neurology. July 11-13, Omiya,
      Japan. Abstracts].

PMID- 1616737
TI  - [Oropharyngeal functional assessment in patients with Zenker's diverticulum.
      Manometric and isotopic study].
AB  - Twenty patients with the diagnosis of Zenker's diverticulum were studied
      clinically and manometrically. In 8 patients oropharyngeal clearance of liquid
      isotopic markers was done. In three, esophageal emptying of a marked meal was
      also studied. Clinically, sixteen patients had oropharyngeal dysphagia, while for
      remained asymptomatic. Dysphagia was severe in only five patients. In half of the
      patients there were signs of hiatus hernia and/or reflux. Pharyngo-sphincteric
      incoordination was present in 70% of cases with a mean resting pressure of the
      LES significantly lower than in controls. There were no differences among
      patients with or without reflux. Isotopic esophageal clearance was not useful as
      a test, as there were no significant differences with the control group. On the
      other hand, esophageal emptying of solid isotopic meals may show the persistence
      of food in the diverticular sac long time after the meal.

PMID- 1616738
TI  - [Zenker's diverticulum. The clinical manifestations and treatment].
AB  - Clinical manifestations and surgical results are analyzed in a retrospective
      study of 16 patients with a Zenker's diverticulum. Pharyngoesophageal
      diverticulum are an uncommon anomaly, producing cervical dysphagia and recurrent
      airway infections. Treatment should be surgical, as earliest as possible.
      Morbidity is very low and mortality very rare.

PMID- 1616739
TI  - [The effect of resection of the jejunum and ileum on intestinal mucosal trophism.
      An experimental study on the rat].
AB  - Intestinal resection leads to anatomo-physiological adaptive changes in the small
      bowel depending on its localization and extension. Two 50% resection models were
      done, jejunal resection (55 cm.) and ileal resection (55 cm.), in the attempt to
      determine the trophic response of the remnant bowel from jejunal and ileal
      samples. Significant increases were seen in mucosal villous length, jejunal
      values were greater than ileal and the greatest values were when the whole ileum
      was conserved. No significant changes were observed in DNA contents. These data
      suggest the importance of the ileal segment in the intestinal adaptive process,
      especially on the jejunal segment, as well as the apparent end of this response
      two weeks after resection.

PMID- 1616741
TI  - [Biliary calculi resistant to dissolution with bile acids: their heterogeneous
      composition and diversity of treatment response].
AB  - We have studied thirteen biliary stones resistant to biliary acids, using
      technical methods of stereomicroscopy, scanning electronic microscopy and EDX
      analyses. We have investigated changes on surface. Three biliary stones did not
      change and were considered resistant. Seven biliary stones appear partially
      dissolved and we observed many irregularities on surface and/or concentric dips
      in relation with cholesterol dissolution. In six cases, biliary pigment
      alternates with cholesterol. In three cases we observed a calcium carbonate coat
      on surface. One case included organic fibers. One biliary stone showed
      cholesterol with spherical bodies of calcium carbonate and pigment. It was a
      relapsed case of combined treatment. Three stones are composed of small black
      portions of polymerized calcium bilirubinate, rich in copper and iron. Our
      results demonstrate that biliary stones previously selected for treatment are a
      heterogeneous group. Because of this fact we get variable and unpredictable
      results.

PMID- 1616740
TI  - [The duration of the effect of norfloxacin on the fecal flora in cirrhosis
      patients].
AB  - The aim of the study has been to assess if intermittent treatment with
      norfloxacin could be able to maintain selective intestinal decontamination in
      cirrhotic patients in order to prevent bacterial infections. Group I (n = 10,
      subgroup Ia, n = 5, hospitalized cirrhotics, subgroup Ib, n = 5, outpatient
      cirrhotics) received 400 mg/24 h norfloxacin 7 days. Group II (n = 5, outpatient
      cirrhotics) received 400 mg/12 h norfloxacin 7 days. Gram-negative aerobic
      bacilli of the fecal floral were strongly suppressed in all patients at the end
      of the treatment, and they totally (Group I) or partially (Group II) recovered
      the initial concentrations 7 days after the end of the treatment. There were not
      significant differences between subgroups Ia and Ib. These results suggest that
      prophylactic treatment with norfloxacin in cirrhotic patients at high risk of
      infection should be continuous during the period in whom patients must be
      submitted to selective intestinal decontamination.

PMID- 1616743
TI  - [Spontaneous bacterial peritonitis].

PMID- 1616742
TI  - [Biliary surgery on those over 70: an analysis of 109 cases].
AB  - 109 patients older than seventy years of age and operated of gallstone disease in
      our service during a period of 4.5 years are presented. The average age of the
      series was 78.8 years, with a male/female (M/F) ratio of 1/1.6. 77% of the
      patients were admitted on an emergency basis due to a complication derived from
      the gallstone disease they were suffering. Only 39.8% of the patients were
      previously diagnosed of gallstone disease at the time of admission and 10%
      presented an associated surgical condition which was treated simultaneously.
      Overall morbidity of the series was 36%, with a mortality of 2 cases (1.9%).

PMID- 1616744
TI  - [The composition and structure of cholesterol biliary calculi].
AB  - The order and composition of the various elements that are present in the
      cholesterol stones has been analyzed and a useful model that should help in the
      study of already formed stones is proposed and therefore a better understanding
      of the lithogenesis and the physiopathological conditions in which stones
      develop. The existing components are described from the core up to the crust,
      case emphasizing the heterogeneity of the core, the calcium palmitate around it
      and the cholesterol disposition. The various forms of presentation of calcium
      carbonate are defined as well as the different types of ooliths.

PMID- 1616745
TI  - [Severe digestive hemorrhage of an unusual etiology. Visible isolated and
      bleeding esophageal vessels].
AB  - We describe two patients with massive upper gastrointestinal bleeding. The upper
      gastrointestinal endoscopy revealed jet haemorrhage in the distal portion of the
      esophagus, from a visible vessel, without esophageal mucosal damage. In both
      cases arteriography was performed, and did not show vascular malformations or
      fistulous points. The patients were successfully treated, one with endoscopic
      sclerosis and balloon tamponade, and the other with endoscopic sclerosis and
      transcatheter embolization through left gastric artery. For the time being we do
      not know the true importance of these findings, but we hope that other reports
      help us to understand the clinical and pathologic features of this vascular
      lesion, and the best therapeutic approach.

PMID- 1616746
TI  - [Spontaneous rupture of the spleen in chronic pancreatitis].
AB  - The appearing of splenic complications in the evolution of acute or chronic
      pancreatitis is a known fact, even though it is not that frequent. A case of
      splenic rupture happens during an acute bout of chronic pancreatitis. The
      possible pathogenic mechanisms implied are analysed as well as the forms of
      presentation and the approximation to diagnosis. The great difficulty in the
      diagnosis is determined by the scarce specificity of the clinical and biochemical
      manifestations. Therefore, it is called the attention upon the eventuality of
      this complication and the therapeutic attitudes which should be adopted.

PMID- 1616748
TI  - A problem with modern dental materials.
AB  - It may come as a surprise to learn that there is more than one discipline in
      medicine dealing with artificial organs. The obvious one is bio-engineering,
      which is largely concerned with fashioning existing biologically acceptable
      materials into useful spare parts such as hip or knee joints. The materials
      themselves hardly change, and the difference between rival prostheses lies more
      in design than novel chemistry. This is the world of titanium or cobalt-chromium
      joint designs, bone screws and plates, orthotic limbs, supports and wheelchairs,
      and futuristic ideas such as miniature video cameras for artificial eyes.

PMID- 1616747
TI  - [Hepatitis associated with taking diclofenac].

PMID- 1616749
TI  - 'Orthodontic relapse'.

PMID- 1616750
TI  - 'Orthodontic relapse'.

PMID- 1616751
TI  - British orthodontics.

PMID- 1616752
TI  - Glutaraldehyde disinfectants: uses and management.

PMID- 1616753
TI  - 'A practical gloving and handwashing regimen for dental practice'.

PMID- 1616754
TI  - 'A practical gloving and handwashing regimen for dental practice'.

PMID- 1616755
TI  - The aetiology, epidemiology, pathogenesis and changing pattern of infective
      endocarditis, with a note on prophylaxis.
AB  - Infective endocarditis remains a life-threatening condition, although the number
      of deaths due to this disease has fallen by 80% over the past 50 years. Dental
      undergraduate and postgraduate teaching rightly emphasises the use of
      prophylactic antibiotics for those patients most at risk of developing the
      condition. However, the types of patients at risk have also changed with the
      increased use of antibiotics and availability of heart surgery. While oral
      microorganisms may be incriminated in infective endocarditis, causal organisms
      arise from a number of other sites and in many cases the portal of entry is
      unknown. It is now thought that the proportion of cases that are apparently
      dentally related is probably smaller than previously believed. This article
      concentrates on the mechanisms by which this disease occurs, an area which is
      often poorly understood by undergraduates and postgraduates alike. An extract is
      included from the Lancet, which provides the most recent recommendations for
      endocarditis prophylaxis.

PMID- 1616756
TI  - The use of the CPITN to monitor the outcome of periodontal treatment in a dental
      hospital setting.
AB  - The Community Periodontal Index of Treatment Need (CPITN) is recommended for
      monitoring the outcome of periodontal treatment, yet to date there is only one
      published prospective study that has used the index for that purpose. The aim of
      the present study was to monitor the outcome of periodontal treatment of 42
      patients referred to a consultant periodontist in a dental hospital. The CPITN
      was recorded at baseline by a single trained examiner. Subsequently, the patients
      were examined independently by the consultant and a treatment plan formulated.
      The prescribed treatment was carried out, and a record was maintained of the type
      of treatment provided and the number of visits involved. The CPITN was recorded
      again approximately 6 months after baseline by the same trained examiner. Full
      data were obtained for 36 subjects; most (22 patients) had deep pockets (CPITN,
      code 4) at baseline, while nine had shallow pockets (CPITN, code 3). Patients
      with deep pockets at baseline required more complex treatment and more visits
      (mean 6.2 visits) than patients with shallow pockets, calculus or gingival
      bleeding (mean 3.5 visits). Nineteen of the 22 subjects with deep pockets at
      baseline showed a reduction in the number of sextants with deep pockets after 6
      months; however, in only 11 of these subjects were the number of sextants with
      deep pockets reduced to zero. In the light of these findings a modified format
      for summarising such CPITN data is recommended.

PMID- 1616757
TI  - Dental attendance behaviour of children in Scotland between 1983 and 1988.
AB  - Parental permission was sought to monitor longitudinally the dental care of a
      sample of 5, 8, 12 and 15-year-olds in Scotland who took part in the 1983
      national survey of children's dental health. The dental treatment records of
      those who volunteered were released by the Scottish Dental Practice Board and the
      Information and Statistics Division of the Common Services Agency to the Dental
      Health Services Research Unit at Dundee University. The baseline epidemiological
      survey data was passed on by the Office of Population Censuses and Surveys.
      During the period 1983 to 1988, less than half of the children in the sample
      attended for dental care at least once a year on average (ie at least five times
      in five years) and most also let a lapse of more than 2 years occur between
      dental visits at some time within the 5-year study period. Around 20% of the
      three youngest age groups changed dentist three or more times. These results
      indicate that steps need to be taken to improve the dental attendance of children
      in Scotland if the principle of continuing care underlying the new General Dental
      Service contract is to be achieved.

PMID- 1616758
TI  - Wystan Peach Memorial Lecture. The profession and the press--friend or foe?

PMID- 1616759
TI  - Arranging dental care for hostel dwellers: a pilot project.

PMID- 1616760
TI  - 'What other journals say'.

PMID- 1616761
TI  - 'Permanent damage to inferior alveolar and lingual nerves during the removal of
      impacted mandibular third molars'.

PMID- 1616762
TI  - Why has no one ever looked at my gums before?

PMID- 1616764
TI  - 'Do you treat HIV positive patients?'.

PMID- 1616763
TI  - 'A European view of fluoride supplementation'.

PMID- 1616765
TI  - Baseline chartings.

PMID- 1616766
TI  - Carriers of infection within the profession.

PMID- 1616767
TI  - Prosthetic restoration following localised maxillary resection.

PMID- 1616768
TI  - Allergic reactions to rubber gloves in dental patients: report of three cases.
AB  - Three cases of allergy to rubber are described, in which the patients exhibited
      peri-oral rashes following dental treatment by personnel wearing latex rubber
      gloves. Two of the patients were aware of possible allergy to domestic rubber
      products but did not reveal this as part of their medical history. With the
      increase in numbers of dentists wearing rubber gloves it is probable that there
      will be many more such cases reported in the future. Rubber products must then be
      added to the list of potential allergens which may be of some import to the
      practice of dentistry.

PMID- 1616769
TI  - Metastatic breast carcinoma presenting with multiple gingival epulides.
AB  - A case is reported of a young patient with metastases from the breast presenting
      as rapidly growing gingival epulides. The initial gingival lesion appeared
      shortly after a bone scan had given no evidence of dissemination of the diagnosed
      breast cancer. Two further lesions appeared at different sites within 3 weeks.

PMID- 1616771
TI  - The British Dental Journal: a report on its activities 1986-1991.
AB  - The contents of 139 issues of the British Dental Journal, published between
      January 11, 1986 and December 1991, have been analysed. Part I of the Journal
      contains, on average, one Leader, eleven items of news and notes, 12 letters and
      eight abstracts/book reviews. One thousand, three hundred and seventeen
      manuscripts were submitted for publication during the 6-year period. Of these,
      403 original articles, 119 case reports and 203 review articles were accepted and
      published in Part II. Part III of the Journal is devoted to annual and other
      reports and policy documents, worldwide dentistry, practice management and
      vocational training, dental electives, trade news, meeting reports and
      obituaries. Over 40 'strap headings' denoting specialised areas of dentistry were
      used to describe articles published. Almost one-fifth of the papers were
      concerned with restorative dentistry. Case reports comprised 14% of the papers
      published. Oral surgery/oral medicine/oral pathology, and related subjects
      accounted for nearly 15% of papers published. Articles concerned with community
      dental health, orthodontics and paediatric dentistry accounted for a similar
      proportion of the total, as did the section comprising general dental practice,
      vocational training and practice management. Anaesthesia, analgesia, medical
      topics, microbiology and therapeutics took up 12% of articles published. The
      remaining 12% consisted of articles on dental education and research, oral
      biology, dental history, auxiliaries, dental instruments and diagnostic aids.

PMID- 1616770
TI  - Accidental impaction of partial dental prostheses in the upper gastrointestinal
      tract.
AB  - Three accidental cases of accidental ingestion of radiolucent upper partial
      dentures are presented. As impaction in the upper gastrointestinal tract has a
      serious morbidity and even mortality, we recommend that dental surgeons consider
      this possibility when designing a prosthesis to replace anterior teeth.

PMID- 1616772
TI  - Putting the BDJ to bed.
AB  - Twenty-two times a year, usually once every 2 weeks, the British Dental Journal
      drops through letter-boxes around the world. Some recipients read the Journal
      cover to cover, others concentrate on specific sections ('Letters to the Editor'
      are avidly scrutinised), some turn straight to the 'Classified' section and some
      put it away for 'later on'. Considering the amount of effort put into producing
      each issue of the BDJ, it would be deflating to think that some recipients skim
      quickly through it; realistically this must be the case. How many readers,
      however, stop for a moment to consider how the BDJ came into being? While the
      actual production of the BDJ is carried out in exactly the same way as any other
      glossy, colour magazine, whether it be Country Life or Woman's Own, there is a
      great deal of extra work besides, as it is a scientific journal (see p453). This
      article looks at who and what are involved in producing an issue, from the
      perspective of the team in the editorial office.

PMID- 1616773
TI  - TEAMWORK in the South Seas.
AB  - The Pacific island nation of Kiribati has adopted the BDJ TEAMWORK initiative as
      a training programme for government dental assistants. TEAMWORK has proved to be
      adaptable to a hot climate.

PMID- 1616774
TI  - Let there be light--the laser in dentistry.
AB  - A damp and dull London day in March somewhat contradicted the title of the
      meeting of the Odontology Section of the RSM, Let there be light--the laser in
      dentistry, but there was no doubt, once inside, that the organisers had, with
      perfect timing, caught the interest of the profession as a Barnes Room packed to
      capacity was greeted by the president of the section, Margaret Seward. Rather
      apologetically, she confessed that the film Goldfinger was unavailable, but
      promised us equal fascination with a galaxy of international experts to guide us
      through a maze of new developments in laser dentistry.

PMID- 1616775
TI  - [The unemployed work in the health sector].

PMID- 1616776
TI  - [A school with its own "sick ward"].

PMID- 1616777
TI  - [Albanian hospital: shortage of everything].

PMID- 1616778
TI  - [Illness absenteeism. We must take this seriously].

PMID- 1616780
TI  - [Hedmark: time for students].

PMID- 1616779
TI  - [Reform in Health Services for Mentally Retarded: Aksel, address Bjornemyrveien].

PMID- 1616781
TI  - [Quality assurance: avoid all waiting].

PMID- 1616783
TI  - [Exposure of the Norwegian Nurses' Association: nurses in the media].

PMID- 1616782
TI  - [7 out of 10 use NSF's curriculum plan].

PMID- 1616784
TI  - [Use of power against disagreeable servants. Interview by Bjorn Arild Ostby].

PMID- 1616785
TI  - [How long shall we keep quiet?].

PMID- 1616786
TI  - [Motorized ambulance services or private ambulance corporation?].

PMID- 1616787
TI  - [Children--fate or right?].

PMID- 1616788
TI  - [Loyal to our own kind or faithful to outsiders?. Interview by Marit Fonn].

PMID- 1616789
TI  - [Substance abuse].

PMID- 1616790
TI  - [Blankholm attacks right to breastfeed].

PMID- 1616791
TI  - [Fight for life. Interview by Siv Barstad].

PMID- 1616793
TI  - Prospects for reducing virus-associated human cancers by antiviral vaccines.
AB  - The last 25 years have seen a major effort to identify human viruses that either
      cause cancer in humans directly or can be considered significant cofactors or
      promoters of cancer. The prevailing view is that tumor-associated viruses are
      necessary but not sufficient for tumor causation. A long latent period between
      the initial infection and the appearance of the neoplasm is the norm. Generally,
      the virus implicated as causative is integrated into cellular DNA. Various virus
      types have been identified; these include both DNA- and RNA-containing agents
      from the hepadnavirus, herpesvirus, papovavirus, oncornavirus, and lentivirus
      groups. Although these candidate viral agents are less prevalent in the developed
      world, hundreds of millions of people are infected world-wide, and about 1
      million infected people develop virus-associated tumors annually. Furthermore,
      nonviral cofactors are suspect or have been identified in the genesis of many
      virus-associated cancers. A major global approach to prevention of the initial
      infection can be made by developing efficacious and cost-effective vaccines. An
      approved human vaccine is available in one case, whereas in every other situation
      indications exist that a candidate vaccine may soon be available.

PMID- 1616792
TI  - Designer foods: effects on development of cancer.
AB  - There are numerous anticarcinogens in the diet. An important question is how to
      use such substances in an effective, directed way to reduce cancer risk in
      humans. The "designer foods" concept is one approach for accomplishing this goal.
      Foods would be engineered to contain effective levels of anticarcinogens. This
      idea will work only to the extent that there is sufficient scientific knowledge
      on which to base such food design. Obviously, it is not sufficient simply to
      extrapolate from animal data to humans. A hypothetical example of the possible
      "designer fat substitute" is presented and discussed.

PMID- 1616794
TI  - Tumor-susceptibility markers.
AB  - Genetic analyses of unusual hereditary cancers and of common neoplasms suggest
      that tumorigenesis proceeds through a series of genetic alterations involving
      oncogenes and tumor-suppressor genes. Such genes can be viewed as tumor
      susceptibility genes, and DNA tests that examine them might be useful in
      determining an increased risk of cancer development before the onset of a tumor.
      Indeed, DNA tests have already proved useful in the genetic counseling of
      families with an increased risk of rare inherited diseases such as
      retinoblastoma, multiple endocrine neoplasia type 2a, or Li-Fraumeni syndrome.
      The current investigation of these familial disorders is enabling the development
      of expertise, reagents, and methods that will eventually focus on the most common
      cancers. In assessing risk for these common tumors, several genes will probably
      require study to achieve more accurate prediction of cancer risk. For example,
      genetic abnormalities of the ras oncogene and of either the retinoblastoma gene
      (Rb) or the p53 tumor-suppressor gene have been found in many tumors and appear
      to be particularly important in the study of individuals at increased risk of
      lung, breast, or colon cancers. In addition, the study of tumor-associated
      markers that might already be detectable in the preneoplastic state can be
      carried out in parallel with tests that search for evidence of mutations in tumor
      susceptibility genes. Finally, both classes of markers might be complementary in
      genetic counseling or screening of populations at increased risk. However, the
      capacity for detecting tumor-susceptibility markers creates a responsibility for
      the physician in terms of the proper use of this information.

PMID- 1616795
TI  - Identification of cancer-prone individuals: p53 and family cancer syndromes.
AB  - Progress in prevention of any disease is enhanced by the identification of a
      group of individuals who are at increased risk to develop the disease. The
      ability to detect families with evident predisposition to malignancy provides a
      unique opportunity to study high-risk groups. Recent studies of the p53 gene have
      suggested that heritable mutations in this gene may predispose affected
      individuals to the development of a wide variety of tumors. In this article,
      evidence for the involvement of p53 in inheritable cancers is assessed, and the
      implications for future studies are discussed.

PMID- 1616796
TI  - Animal cancer tests and cancer prevention.
AB  - The toxicological significance of exposures to synthetic chemicals is examined in
      the context of exposures to naturally occurring chemicals. We calculate that
      99.99% (by weight) of the pesticides in the US diet are chemicals that plants
      produce to defend themselves (nature's pesticides). Only 52 of these natural
      pesticides have been tested in high-dose animal cancer tests, and 27 are rodent
      carcinogens; these 27 are shown to be present in many common foods. The
      toxicology of synthetic chemicals is compared to that of natural chemicals, which
      represent the vast bulk of the chemicals to which humans are exposed. It is
      argued that animals have a broad array of inducible general defenses to combat
      the changing array of toxic chemicals in plant food and that these defenses are
      effective against both natural and synthetic toxins. Synthetic toxins (eg,
      dioxin) are compared to natural chemicals (eg, indole carbinol [in broccoli] and
      ethanol). The finding that, in high-dose tests, a high proportion of both natural
      and synthetic chemicals are carcinogens, mutagens, teratogens, and clastogens
      (30%-50% for each group) calls into question current efforts to use these tests
      to protect public health by regulating low doses of synthetic chemicals. The
      administration of chemicals at the maximum tolerated dose in standard animal
      cancer tests is postulated to increase cell division (mitogenesis), which in turn
      increases rates of mutagenesis and, thus, carcinogenesis. The animal data are
      consistent with this mechanism, because a high proportion--about 50%--of all
      chemicals tested (whether natural or synthetic) are indeed rodent
      carcinogens.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616797
TI  - Leukemia in children and paternal radiation exposure at the Sellafield nuclear
      site.
AB  - Childhood cancer around nuclear installations has been studied in recent years,
      particularly in the United Kingdom but also in other countries. The early studies
      were prompted by the suggestion of a 10-fold raised level of childhood leukemia
      around the Sellafield nuclear site in England, which was confirmed and followed
      by the identification of generally smaller excesses around some (but not all)
      other nuclear sites in the United Kingdom. Marked excesses have not been reported
      in other countries. The increased leukemia rate around Sellafield has been
      further investigated by examining individual cases in detail in epidemiological
      cohort and case-control studies. The raised incidence seems to have been
      concentrated in children born in the local area but not among children who moved
      in after birth and was particularly associated with fathers who had experienced
      higher levels of occupational external ionizing radiation exposure at Sellafield
      before their children's conception. The underlying cause of this statistical
      association is not yet clear, but the findings have important potential
      implications for radiobiology and for protection of radiation workers and their
      children.

PMID- 1616798
TI  - Relationship of hormone use to cancer risk.
AB  - Exogenous hormones are widely prescribed in the United States, primarily as oral
      contraceptives and hormone-replacement therapy. Each of these frequently used
      categories of drugs has important potential for altering risk of several major
      human cancers. The efficacy of oral contraceptives in preventing ovarian cancer
      and endometrial cancer is well established. There remains controversy about the
      relationship between oral-contraceptive use and breast cancer risk, but most
      studies show that use in the postmenarcheal and perimenopausal periods is
      associated with an increased risk of breast cancer in a duration-dependent
      manner. As with oral contraceptives, the relationship between estrogen
      replacement therapy and breast cancer risk is controversial, but several well
      designed studies showed a moderate increased risk after long-term use. Estrogen
      replacement therapy is a major cause of endometrial cancer. Combination hormone
      replacement therapy will probably reduce some of the excess risk of endometrial
      cancer, but few epidemiological data exist on this relationship. The sparse data
      suggest that combination therapy may enhance breast cancer risk. As with
      endometrial and ovarian cancers, hormonal chemoprevention of breast cancer is
      also feasible. We review two such strategies, ie, gonadotropin-releasing hormone
      agonists and the antiestrogenic drug tamoxifen.

PMID- 1616799
TI  - Health risks associated with excessive warnings about alleged cancer risks.
AB  - As the adage states, "when everything is dangerous, nothing is." If the word
      carcinogen (cancer-causing agent) is used to designate a spectrum of products,
      chemicals, and other environmental exposures, then the classification cancer
      causing when referring to the results of human epidemiological studies becomes
      meaningless. Thus, the emerging "carcinogen-of-the-week" phenomenon is
      counterproductive in preventing the toll of human cancer in that it diverts
      attention from real causes.

PMID- 1616800
TI  - Evidence and overview of global tobacco problem.
AB  - Tobacco use, both smoking and chewing, is a very old habit. Machine-made
      cigarettes appeared early in this century. As a consequence, lung cancer
      increased substantially. The evidence relating cancer to smoking and chewing is
      summarized. Various forms of tobacco use are briefly described. Tobacco exports
      are an important source of hard currency for some developing countries. In the
      Western world, seven major international companies control major market shares.
      In contrast, tobacco monopolies exist in eastern Europe, Japan, and China. The
      public health interests are represented by the relevant national and
      international associations and some governments. Smoking is the largest cause of
      avoidable death in developing countries after infectious disease and
      malnutrition.

PMID- 1616801
TI  - Dietary recommendations for cancer prevention: public policy implementation.
AB  - Dietary recommendations for cancer prevention advise reduced intake of fat;
      increased intake of fruits, vegetables, and grains; and moderate intake of
      alcohol and salt-cured, salt-pickled, and smoked foods. These recommendations are
      virtually identical to those issued by public health agencies for the prevention
      and treatment of coronary heart disease, diabetes, hypertension, and other
      chronic diseases, as well as for the health promotion of the general public. The
      consensus on these recommendations suggests the need for public policies to
      promote their implementation. These policies should be designed not only to
      encourage improvements in the dietary knowledge, attitudes, and behavior of
      individuals but also to address environmental and institutional barriers to
      dietary change.

PMID- 1616802
TI  - Defining and targeting an audience for cancer-prevention messages.
AB  - The target audience for cancer-prevention messages is not the cancer patient.
      Cancer-prevention messages should be designed for and directed toward groups of
      people who have been determined to be at risk for the disease. Potential
      audiences may vary widely in size and nature, depending on the specific cancer,
      its cause, and its etiology. The prevention of specific disease, eg, lung cancer,
      typically demands some behavior on the part of the recipient of a cancer
      prevention message. Thus, members of a target audience may be asked to stop
      smoking or to refrain from starting. Each potential target audience is likely to
      be unique and cannot always be reached with typical mass-media campaigns.
      Messages designed to be effective for such special audiences may be required if a
      significant impact on behavior is to be obtained. This article attempts to
      identify potential audiences for cancer-prevention messages and develops the
      nature of the media to be used, the sources to be employed, and the arguments to
      be developed in such a campaign. Characteristics (eg, sex, race, age, marital
      status, and socioeconomic status) are used as examples of variables that may
      dictate the nature of cancer-prevention campaigns.

PMID- 1616803
TI  - Communicating cancer-prevention information.
AB  - The message to the public regarding cancer prevention should emphasize moderation
      and evolutionary change in living habits rather than revolutions and focus on
      total life-style not just individual factors. It is essential to keep people
      focused on the modifiable factors that can really make a difference. Currently,
      people worry about minutiae, ie, possible substances in the environment that
      might cause some cancers, rather than the main, more clearly defined factors, eg,
      smoking, diet, and sedentary living. The media must play a major role in cancer
      prevention, assisted by rational, clear-speaking professionals.

PMID- 1616804
TI  - Positive evidence on effectiveness of selected smoking prevention programs in the
      United States.
AB  - Various smoking intervention approaches have been demonstrated to successfully
      alter smoking behavior among individual smokers, but it is difficult to
      demonstrate the benefit of these individual cessation approaches across the
      population of smokers. In contrast, efforts that concentrate on altering the
      social and economic environment within which the smoker smokes, most notably the
      media, taxation, and changing the social acceptability of smoking, have been
      linked to substantial shifts in the smoking behavior of the US population.
      Attacking tobacco use as a form of sociological carcinogenesis, rather than
      focusing on the individual smoker, allows alteration at the root of smoking
      behavior, ie, its personal, social, and psychological utility for the smoker.

PMID- 1616805
TI  - Trends in tobacco use in Europe.
AB  - Tobacco consumption in Europe can be estimated from several sources, including
      sales statistics and population surveys. The first source provides a reasonable
      estimate of total tobacco consumption, whereas the second gives estimates of the
      prevalence of smokers by sex and age. In 1950, daily cigarette consumption by
      adults in European countries varied between 1.7 in Portugal and 6.9 in Ireland,
      the corresponding US consumption being 8.9. In 1989, the variation was much
      smaller, ie, between 3.5 in the Netherlands and 10.1 in Greece. In the countries
      where consumption was high in 1950, maximum consumption was achieved around 1975,
      followed by stabilization or reduction. In other countries, where consumption was
      low in 1950, it is still increasing. In a 1987 European survey, the proportion of
      current smokers varied between 33% in Portugal and 46% in Denmark. Much of this
      difference comes from the low prevalence of smoking habits in the adult female
      population of southern Europe.

PMID- 1616806
TI  - US tobacco export to Third World: Third World War.
AB  - Global tobacco-related mortality will rise from the current 2.5 million to over
      10 million annually by 2050. Most of this increase will occur in developing
      countries, where legislative controls and other measures that succeed in limiting
      the use of tobacco in industrialized countries do not exist or are at best
      inadequate. Of particular concern is the penetration of developing countries by
      the transnational tobacco companies, with aggressive promotional campaigns that
      include specific targeting of women, few of whom currently smoke in developing
      countries. The transnational tobacco companies advertise and market in ways long
      banned in the United States, for example, selling cigarettes without health
      warnings, advertising on television, and selling cigarettes with higher tar
      content than the same cigarettes sold in the United States. Also, tobacco
      advertising revenue prevents the media from reporting on the hazards of tobacco,
      a particularly serious problem in developing countries, where awareness of the
      harmfulness of tobacco is low. The transnational tobacco companies interfere with
      the national public health laws of developing countries via political and
      commercial pressures to open markets and to promote foreign cigarettes. This has
      led to an increase in market share by foreign cigarettes, but evidence also
      points to market expansion, especially among young people. The entry of the
      transnationals leads to a collapse of national tobacco monopolies or to their
      changing from unsophisticated government departments that may still cooperate
      with health initiatives on tobacco to copying the aggressive marketing and
      promotional behavior of the transnationals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616807
TI  - Worldwide expansion of transnational tobacco industry.
AB  - As smoking rates fall in North America and western Europe, transnational tobacco
      companies (TTCs) from the United States and Great Britain turn to cigarette
      markets of the developing world to replace those smokers who have quit or died
      from smoking. The majority of these markets are dominated by state tobacco
      monopolies that advertise and promote smoking minimally. Few women or adolescents
      smoke in those nations. The majority of men do, but they smoke far fewer
      cigarettes per year than their counterparts in developed nations. Trade barriers
      in the developing world prevent foreign cigarette companies from entering. TTCs
      employ various techniques to force open those markets, including trade pressure
      from the US government. Once the market is open, Western cigarette advertising
      and promotions target nonsmoking women and children. Retail tobacco outlets
      increase, smoking rates rise, and more death and disease result. Latin America
      was the TTC target in the 1960s, the newly developed nations of Asia during the
      1980s, and, today, the tobacco giants are pushing into eastern Europe, China, and
      Africa. If nothing is done, emerging national smoking-control programs will be
      overwhelmed, and state-owned cigarette monopolies will be taken over by the TTCs.
      Policies and programs to curb smoking exist, but for various reasons many lesser
      developed countries have not adopted them. The threat of TTC entry into a closed
      market offers an opportunity to form national coalitions against smoking, educate
      the public about the dangers of tobacco use, and implement public health policies
      and programs to restrict marketing and use of cigarettes.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1616808
TI  - Role of the health professional in ending the tobacco pandemic: clinic,
      classroom, and community.
AB  - Physicians and other health professionals have become complacent about the
      tobacco pandemic, because there is a mistaken belief that the war on smoking has
      been won. In reality, the survival from lung cancer is little better than it was
      30 years ago, and cigarettes have become the most advertised and promoted product
      in society. The prevalence of overall smoking in the United States has declined
      by only 0.5%/y during the past decade. Among certain US minority populations, the
      decline has been far less or nonexistent. Traditional efforts to control the
      tobacco pandemic have been reactive and static, whereby government agencies,
      schools, and health professionals provide the public with generic information
      about the adverse health effects of smoking. As a result of these efforts, it is
      assumed that individuals will act to change their behavior. In contrast, the
      tobacco industry is proactive and dynamic, changing its brand-name strategies
      through advertising and promotion. To more effectively combat tobacco use, health
      officials need to move beyond patient education and adopt a more active model
      that includes clinic-based, school-based, and community-based tobacco-control
      strategies. Use of humorous, satirical images as part of paid counteradvertising
      campaigns and proactive health education curricula should be part of a concerted
      effort to end the tobacco pandemic and limit the promotional influence of tobacco
      companies.

PMID- 1616809
TI  - Projecting international lung cancer mortality rates: first approximations with
      tobacco-consumption data.
AB  - Cigarette smoking is strongly associated with later lung cancer; British data
      show a 0.83 correlation between tobacco consumption and lung cancer mortality 21
      years later. We apply a simple tobacco-consumption model to data from countries
      in the Organization for Economic Cooperation and Development (OECD) to test the
      model in some nations and to roughly estimate future rates in others. This
      analysis provides some indication of the usefulness of the model, which could be
      applied to predictions for countries in which data are limited. This model
      predicts a US decline in male lung cancer mortality of approximately 25% by 2005
      (a plausible prediction given recent declines in birth-cohort-specific lung
      cancer mortality rates); it also predicts reasonably well the start of documented
      declines in lung cancer mortality. According to this admittedly simple model,
      lung cancer mortality rates will increase in most European countries and Japan
      until 2000, but the twenty-first-century lung cancer epidemic will mostly occur
      in Asia.

PMID- 1616810
TI  - Tobacco litigation--purpose, performance, and prospects.
AB  - Product liability litigation can dramatize the dangers of tobacco use, stymie
      industry propaganda efforts, reveal nefarious industry behavior, and force price
      increases. Recent recognition of nicotine addiction, "discovery" documenting the
      industry's stonewalling campaign of more than 35 years, and favorable legal
      developments make future success likely. Litigation can also be used to pressure
      employers to provide smoke-free working environments, force retailers to obey
      laws prohibiting sales to minors, require tobacco companies to abandon
      "colonialist" Third World marketing practices, publicize the falsity of
      pseudoscientific industry assertions, and prevent television stations from
      broadcasting tobacco advertising masquerading as sports events. Even defending
      against harassing legal actions brought by the industry can embarrass the
      industry and publicly vindicate pro-health groups that oppose it.

PMID- 1616811
TI  - Advocating on behalf of the facts.

PMID- 1616812
TI  - International differences in diet and cancer incidence.
AB  - International variations in the annual incidence rates of reproductive organ and
      gastrointestinal cancers suggest that they have environmental causes and can be
      controlled by public health approaches. Secular trends in the national incidence
      rates of these two groups of tumors and the experiences of migrants moving from
      countries with low rates to countries with higher rates of these cancers increase
      the likelihood that public health dietary interventions will lower cancer
      incidence rates. The results of recent correlation analyses of international
      variations in the consumption of dietary fat and incidence of large-bowel and
      hormone-dependent reproductive organ cancers suggest that both the total amount
      of fat and the specific fatty acids consumed are associated with the incidence of
      these cancers in national populations and that the associations strengthen with
      age and are strengthened rather than weakened by the inclusion of potentially
      confounding and modifying dietary and nondietary factors in the analysis. The
      consistency of estimates developed with coefficients derived from these analyses
      and the degree to which they agree with independent observations suggest that
      they can provide useful parameters for the design of trials to test the
      hypothesis that they measure causal associations.

PMID- 1616813
TI  - Life-style and cancer: from epidemiological evidence to public behavior change to
      mortality reduction of target cancers.
AB  - Cigarette smoking, alcohol consumption, and diet are of essential importance in
      modulating risks of cancer of selected sites, as demonstrated by various
      epidemiological methods. Examples include demographic studies on changing cancer
      risk, correlation studies on dietary fat and cancers of breast and colon, and
      case-control studies on highly salted food and gastric cancer. Evidence was also
      obtained by cohort studies including a census-population-based large-scale
      prospective study in Japan. Results included elevated risk from cigarette smoking
      for cancers of most sites; from alcohol consumption for cancers of the upper and
      lower digestive tract, liver, and prostate; and from daily meat consumption for
      cancers of the pancreas, colon, lung, and breast. Daily consumption of green
      yellow vegetables reduced risk for cancer of the stomach, colon, lung, cervix,
      and prostate. Reports of these results and intensive public education and public
      guidance by governmental and nongovernmental organizations such as cancer
      societies, consumer groups, and mass media resulted in a notable change in public
      behavior in most cases in Japan.

PMID- 1616814
TI  - Diet modification and gastric cancer prevention.
AB  - The relative strengths of the etiologic factors identified for gastric cancer are
      discussed. On the basis of available scientific data, it is recommended that
      dietary prevention of gastric cancer be based on attempts to reduce the ingestion
      of foods with a high content of salt and to increase the intake of fresh fruits
      and vegetables. Other identified etiologic factors offer promise and are being
      investigated but do not yet justify recommendation to the general public.

PMID- 1616815
TI  - Cancers associated with high-fat diets.
AB  - The association between fat intake and several common cancers, eg, those of the
      colorectum, breast, endometrium, ovary, and prostate, received its strongest
      support from correlation studies on populations. On an international scale,
      strong direct correlations were observed between fat intake and incidence or
      mortality from these neoplasms; several correlations were also observed on a
      national level and persisted after allowance for major identified covariates.
      Further support came from the observation of change in rates in migrant groups.
      This association, however, has been described as being weak in individuals as
      opposed to populations. Briefly, diets high in fat (and meat) have been
      associated with high risk of colorectal cancer in several case-control studies,
      with saturated fat being specifically implicated. However, the strength of the
      association is generally moderate, and a few disparities have to be considered.
      In relation to breast cancer, several case-control studies have reported
      associations with total fat, and there was some indication that the associations
      might be stronger for saturated fat. These relationships, however, were weak and
      inconsistent in various studies. Thus, a plausible conclusion from case-control
      studies is that there is indeed some association between fats and breast cancer
      risk, which is, however, limited and, hence, extremely difficult to prove in
      epidemiological terms. To further complicate the issue, the results of cohort
      studies do not support the association. Data from analytical studies are more
      limited for endometrial, ovarian, and prostate cancers, but, again, seem to
      indicate a possible relationship with diets high in fat.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1616816
TI  - Cancer prevention: optimizing life-styles with special reference to nutritional
      carcinogenesis.
AB  - Life-style variables, especially those relating to metabolic overload, are
      significantly linked to risk for human cancer. Although the roles of tobacco use,
      alcohol abuse, sunlight, and select occupations are well established, the impact
      of nutrition on human carcinogenesis, and particularly that of excessive intake
      of fat and low intake of fiber, is less recognized. This article summarizes the
      essential evidence, recommends optimal fat and fiber intake, and suggests ways in
      which comprehensive clinical cancer centers can effectively participate in cancer
      prevention.

PMID- 1616817
TI  - Keynote address: cancer prevention.
AB  - Life-style factors that have a major impact on cancer risk are smoking, alcohol
      consumption, and diet. Current evidence suggests that dietary fat is an etiologic
      factor for colorectal and postmenopausal breast cancer and that foods high in
      dietary fiber may be beneficial against colorectal cancer. Clinical prevention
      trials, augmented by molecular and biological marker studies, will provide new
      knowledge for diet modification and chemoprevention. These studies are likely to
      influence the scope of oncology and public health practices of the future.

PMID- 1616818
TI  - Potential impact of sugar and fat substitutes in American diet.
AB  - Nonnutritive sweeteners and fat substitutes have achieved rapid consumer
      acceptance. This is largely due to the perception held by the public that these
      products are helpful in weight control and diet improvement. The cognitive
      component in human eating behavior makes it difficult to generalize from animal
      research. The effectiveness of these products in weight control has yet to be
      demonstrated conclusively in human research. Currently these products appear to
      add palatibility to reduced-calorie diets and may be helpful to weight-loss
      efforts as part of an overall balanced, nutritious diet and healthy life-style
      that includes exercise.

PMID- 1616819
TI  - Signal transduction system for growth factor receptors associated with tyrosine
      kinase activity: epidermal growth factor receptor signalling and its regulation.

PMID- 1616820
TI  - The role of protein kinase C in insulin action.

PMID- 1616821
TI  - Importance of substrate conformation in the phosphorylation of chromatin
      associated proteins by exogenous protein kinase C.
AB  - Protein kinase C (PKC)-mediated phosphorylation of chromatin-associated proteins
      was studied in vitro. HL-60 and HeLa nuclear proteins were notably unresponsive
      to exogenously added brain PKC. In contrast, 3T3 fibroblasts and lymphocytes from
      primary cultures exhibited PKC-dependent phosphorylation of chromatin-associated
      proteins when chromatin was induced to expand. Unexpanded nuclei in all cell
      lines were unresponsive. Responsiveness was particularly obvious in the
      decondensed chromatin of primary lymphocytes, where a large number of proteins
      were phosphorylated in response to exogenous PKC. DNAase-I and micrococcal
      nuclease strongly modulated these phosphorylation patterns indicating that the
      substrates were DNA-associated. It was concluded that although substrate
      conformation, i.e. condensation state, was the primary determining factor in
      control of PKC-dependent nuclear protein phosphorylation, different cell lines
      greatly differ in their overall responsiveness to exogenous PKC.

PMID- 1616822
TI  - Functional reconstitution of a receptor-activated signal transduction pathway in
      Xenopus laevis oocytes using the cloned human C5a receptor.
AB  - We have used the polymerase chain reaction to isolate and clone the cDNA encoding
      the human C5a receptor, and have injected the cDNA-derived receptor cRNA into
      Xenopus laevis oocytes for functional characterization of the receptor protein.
      Receptor activity was determined either electrophysiologically by measuring the
      agonist-dependent opening of [Ca2+]i-dependent Cl- channels, or by analysing the
      agonist-dependent efflux of 45Ca2+ from the oocytes. Using both methodologies,
      injection of pure C5a receptor cRNA failed to confer C5a sensitivity on the
      oocytes. In contrast, marked responses to C5a were observed when the receptor
      cRNA was supplemented with poly(A)+ RNA isolated from undifferentiated HL-60
      cells, which is devoid of C5a receptor mRNA. Binding studies using radioiodinated
      C5a revealed that the C5a receptor polypeptide was in fact synthesized and
      targeted to the oocyte plasma membrane in oocytes injected with receptor cRNA
      alone, and that the level of receptor expression was not influenced by
      coinjection of poly(A)+ RNA from undifferentiated HL-60 cells. These results
      strongly suggest that the human C5a receptor requires a specific cofactor(s)
      lacking in Xenopus oocytes but present in undifferentiated HL-60 cells, to
      generate intracellular signals in oocytes. Identification and characterization of
      this factor will provide important information about the molecular mechanisms by
      which G-protein-coupled receptors activate phospholipase C.

PMID- 1616823
TI  - Inducible overexpression of human protein kinase C alpha in NIH 3T3 fibroblasts
      results in growth abnormalities.
AB  - We have stably overexpressed the human protein kinase C alpha (hPKC alpha) in NIH
      3T3 fibroblasts under the control of the interferon (IFN) type I inducible murine
      Mx promoter. These cells showed a 10-fold increase in the transcription of hPKC
      alpha mRNA after induction with interferon alpha. The increase in the amount and
      activity of protein kinase C (PKC)-protein in these cells was only about 3-fold
      after induction with interferon alpha. Compared to control cells which were
      transfected with the vector only, the NIH 3T3 fibroblasts transfected with the
      hPKC alpha cDNA showed already a slightly increased PKC-activity and amount of
      PKC-protein in the absence of interferon alpha. The hPKC alpha overexpressing
      cells had an altered, "transformed-like" morphology, which was reversed by
      staurosporine, an increased growth rate and a higher saturation density. The
      growth rate was further increased by treating the cells with interferon alpha.
      The hPKC alpha overexpressing cells were able to grow in soft agarose after
      treatment with phorbol ester such as TPA (12-O-tetradecanoylphorbol 13-acetate).
      After phorbol ester and interferon treatment a stronger expression of the
      protooncogene c-jun was detectable in the hPKC alpha overexpressing cells,
      whereas expression of c-fos and c-myc was not affected. Since these cells show a
      specific response pattern due to induced PKC alpha expression they might be
      useful as an assay system for the development of PKC isozyme-specific inhibitors
      and activators.

PMID- 1616824
TI  - Heterogeneity of protein kinase C in cultured rat mesangial cells.
AB  - Two forms of protein kinase C (PKC) activity in cytosol of cultured rat mesangial
      cells have been characterized in vitro by using histone H1 or endogenous proteins
      as substrates. Histones H1-phosphorylation was significantly increased only when
      calcium, phosphatidylserine (PS) and 1,2-diacylglycerol (DAG) or phorbol
      myristate acetate (PMA) were present together in the incubation medium. EGTA, a
      calcium chelator, completely inhibited this activity. Upon hydroxyapatite
      chromatography (HPLC), the PKC activity was eluted as a main peak at 150 mM
      potassium phosphate with a shoulder at 180 mM. Both peaks corresponded to the
      type III PKC from rat brain and were identified as PKC alpha isoform by
      immunoblot analysis. In contrast with what was observed using histone H1, the
      increased phosphorylation of endogenous proteins in the presence of a mixture of
      Ca2+/PS, plus either DAG or PMA, was only partly reduced by EGTA. Moreover, the
      level of the PKC activity detected in the presence of EGTA was comparable to the
      level of kinase activity, measured in the presence of PS alone or associated with
      DAG or PMA. This suggests that mesangial cells contain PKC activity which does
      not absolutely require calcium. Polyacrylamide gel electrophoresis revealed that
      patterns of phosphorylated mesangial cell proteins are different depending on
      whether calcium was added or not. In the presence of calcium, PKC strongly
      phosphorylated the proteins of 53,000 molecular weight, a doublet of 37,000
      39,000, the 24,000 and the triplet of 17,000-20,000-22,000 molecular weight. The
      addition of EGTA to the assays suppressed completely the labelling of most
      proteins; only the 20,000 molecular weight protein remained strongly labelled,
      while the 39,000 molecular weight band was only faintly visible. The same
      patterns of phosphorylations were obtained after omission of calcium in the
      assays containing only PS and DAG (or PMA). So, the main substrates of calcium
      dependent PKC are proteins of 53,000, 39,000, 37,000, 22,000, 24,000 and 17,000
      molecular weight while the protein of 20,000 molecular weight appears to be the
      main substrate of calcium-independent PKC. The existence in mesangial cells of at
      least two forms of PKC, which phosphorylate specific endogenous proteins,
      emphasizes the complexity of the phospholipid-dependent regulatory cascade and
      raises the possibility that actions of different regulators may be transduced
      through distinct PKC isozymes.

PMID- 1616826
TI  - The influence of aging on the stereoselective pharmacokinetics of propranolol in
      the rat.
AB  - The influence of aging on the pharmacokinetics and the tissue distribution of (R)
      and of (S)-propranolol was studied in 3-, 12-, and 24-month-old rats. After both
      iv and oral administration of rac-propranolol, the plasma concentrations were
      higher for the (R)- than for the (S)-enantiomer. For the tissue concentrations,
      the reverse was true. The free fraction of (S)-propranolol in plasma was about 4
      times larger than that of (R)-propranolol, and this is the main factor
      responsible for the differences in kinetics between the two enantiomers. There
      was a suggestion for a difference in tissue binding between the two enantiomers.
      With aging, the plasma and tissue concentrations of both enantiomers increase,
      probably due to a decrease in blood clearance. Tissue binding did not change much
      with aging. Notwithstanding the marked differences between the kinetics of the
      propranolol enantiomers, the changes which occur with aging affect both
      enantiomers to the same degree.

PMID- 1616825
TI  - Unusual amino acids. I: Asymmetric synthesis of furylalanine derivatives.
AB  - Nonproteinogenic amino acids are valuable active compounds from their
      pharmacological and biochemical effects and also as novel building blocks for
      peptides. The preparation of furylalanine derivatives by asymmetric hydrogenation
      is described. Amino-phosphine-phosphinite-rhodium complexes catalyzed the
      hydrogenation of the prochiral dehydroamino acid precursors in high rate and with
      enantioselectivities of 70-90% ee. Substrate-catalyst ratios up to 2,000 can be
      used depending on the catalyst applied. The procedure turns out to be suitable
      for larger scale preparations.

PMID- 1616827
TI  - Stereoselective biliary elimination of disopyramide and mono-N
      desisopropyldisopyramide in humans.
AB  - The results of a previous pharmacokinetic study of disopyramide (DP) enantiomers
      in humans suggested that DP and/or mono-N-desisopropyldisopyramide (MND) may show
      stereoselective extrarenal elimination. Thus, the present study investigates the
      biliary elimination of DP and MND enantiomers in three patients who had undergone
      cholecystectomy for cholelithiasis. DP and MND enantiomers displayed biliary
      elimination. In both subjects, this elimination pathway showed the same
      characteristics: (1) biliary elimination of DP and MND was stereoselective, (2)
      the stereoselectivity was opposite to that observed for the metabolic and renal
      elimination pathways, i.e., the elimination of the (-)-(R)-enantiomer was higher
      than that of the (+)-(S)-enantiomer, and (3) biliary elimination of MND was
      higher than that of DP, for both enantiomers. Estimates of the relative
      contribution of the biliary clearance in the total clearance of DP and MND
      indicated that this elimination pathway was secondary, especially for DP. The
      biliary clearance (expressed as % of total clearance) was 1.9 to 4.0% for (-)-(R)
      DP, 1.2 to 1.7% for (+)-(S)-DP, 7.8 to 22.9% for (-)-(R)-MND, and 5.2 to 10.5%
      for (+)-(S)-MND.

PMID- 1616828
TI  - The disposition of venlafaxine enantiomers in dogs, rats, and humans receiving
      venlafaxine.
AB  - A stereospecific high-performance liquid chromatographic (HPLC) method was
      developed for the quantitation of the enantiomers of venlafaxine, an
      antidepressant, in dog, rat, and human plasma. The procedure involves
      derivatization of venlafaxine with the chiral reagent, (+)-S-naproxen chloride,
      and a postderivatization procedure. The method was linear in the range of 50 to
      5,000 ng of each enantiomer per ml of plasma. No interference by endogenous
      substances or known metabolites of venlafaxine occurred. Studies to characterize
      the disposition of the enantiomers of venlafaxine were conducted in dog, rat, and
      human, following oral administration of venlafaxine. The Cmax, area under the
      curve (AUC) and (S)/(R) concentration ratios of the (R)- and (S)-enantiomers were
      compared. In rats, the mean plasma ratio of (S)-venlafaxine to that of (R)
      venlafaxine over 0.5 to 6.0 h varied from 2.97 to 8.50 with a mean value of 5.51
      +/- 2.45. The Cmax, AUC0-infinity, and t 1/2 values of the (R)- and (S)
      enantiomers in dogs were not significantly different from one another (P greater
      than 0.1). The mean ratios [(S)/(R)] of enantiomers of venlafaxine in human over
      a 2 to 6 h interval ranged from 1.33 to 1.35 with an overall ratio of 1.34 +/-
      0.26 (n = 12). These ratios of the enantiomers [(S)/(R)] were not statistically
      different from unity (P greater than 0.1) indicating that the disposition of
      venlafaxine enantiomers in humans is not stereoselective and is more similar to
      that in dogs than that in rats.

PMID- 1616829
TI  - Five-year study of medical or surgical treatment in children with severe reflux:
      radiological renal findings. The International Reflux Study in Children.
AB  - The renal findings on intravenous urography (IVU) are reported in 306 children
      (73 boys, 233 girls) from eight European centres entered into an international
      study comparing medical and surgical management of children with urinary tract
      infection and severe vesico-ureteric reflux followed for 5 years. One hundred and
      fifty-five children were randomly allocated to medical and 151 to surgical
      treatment. Protocol and investigative techniques were standardised and
      randomisation, data collection and analysis were performed centrally in Essen,
      Germany. At entry 149 (49%) has established renal scarring (79 medical, 70
      surgical). Children with normal kidneys (105), areas of thinned parenchyma (52)
      and grade of reflux were also evenly distributed. IVU was repeated at 6, 18 and
      54 months and serial urine culture, 99mtechnetium-dimercaptosuccinic acid scans
      and plasma creatinine estimations were performed. Two hundred and seventy-two
      children (89%) completed this follow-up. In 174 children (57%), (90 medical, 84
      surgical) there was renal growth without morphological change. New renal scars
      developed in 19 children treated medically and 20 surgically; 12 (5 medical, 7
      surgical) developed in previously normal kidneys. Six followed post-operative
      obstruction. No significant difference in outcome was found between medical or
      surgical management in terms of the development of new renal lesions or the
      progression of established renal scars.

PMID- 1616830
TI  - Renal function and kidney size in glycogen storage disease type I.
AB  - Renal failure has been reported recently as a late complication of glycogen
      storage disease type I (GSD I). We studied the renal function of 23 patients,
      mean age 10.9 years (range 2.2-21.6 years). The mean glomerular filtration rate
      (GFR) and effective renal plasma flow (ERPF) were 188 +/- 50 and 927 +/- 292
      ml/min per 1.73 m2, respectively (normal values for adult controls 90-145 and 327
      697, respectively). Hyperfiltration (GFR greater than 145 ml/min per 1.73 m2) was
      found in 19 of 23 patients. There was no difference in GFR and ERPF between age
      groups 2-10 and 11-22 years. After a mean follow-up of 2.5 years (range 1-7.5
      years) GFR and ERPF did not significantly change. At follow-up 3 patients (all
      older than 15 years) developed persistent glomerular proteinuria (0.1, 0.5 and
      0.9 g/day). Besides a slight increase in fractional excretion of beta 2
      microglobulin (FE-beta 2m) in 6 patients, proximal tubular function tests (FE
      beta 2m, tubular reabsorption of phosphate and glucosuria) were normal. In
      patients with increased kidney length related to body height, GFR and ERPF were
      significantly higher than in patients with normal kidney length. We conclude that
      GSD I is characterised by hyperfiltration and hyperperfusion. The relative
      increment in kidney length is related to the degree of hyperfiltration.

PMID- 1616831
TI  - Mesangiocapillary glomerulonephritis associated with meningococcal meningitis, C3
      nephritic factor and persistently low complement C3 and C5.
AB  - We report two unusual cases in which mesangiocapillary glomerulonephritis
      occurred in association with meningococcal infection. C3 nephritic factor, an
      autoantibody to alternate pathway C3 convertase, was present. Low serum
      complement C3 and C5 levels were also noted. The depressed complement levels, in
      conjunction with terminal complement complexes at the upper limit of normal,
      suggest activation of the early and late complement cascade. We suggest that
      children presenting with meningococcal infection should have a regular urine
      examination, as well as full complement measurements performed, in view of the
      association with hypocomplementaemic mesangiocapillary glomerulonephritis.
      Similarly, prophylactic penicillin should be prescribed for patients with
      mesangiocapillary glomerulonephritis and persistently low C5 levels to prevent
      meningococcal complications.

PMID- 1616832
TI  - Good outcome in anti-glomerular basement membrane nephritis.
AB  - We report a 6-year-old boy with anti-glomerular basement membrane nephritis
      (Goodpasture's syndrome). Intensive treatment with plasmapheresis and
      immunosuppression resulted in clearance of antibody and good recovery of renal
      function.

PMID- 1616833
TI  - Long-term, low-dose prednisolone therapy in frequently relapsing nephrotic
      syndrome.
AB  - The efficacy of daily administration of a small dose of prednisolone was examined
      in 21 patients with corticosteroid-responsive, frequently relapsing nephrotic
      syndrome (FRNS). After induction of remission of a third or subsequent relapse
      with a 6-week course of prednisolone (standard therapy with prednisolone, STP),
      this drug was continued in a single daily dose of 0.25 mg/kg body weight (low
      dose prednisolone, LDP) for 18 months. Relapses occurring during this period were
      treated with STP, following which LDP therapy was resumed. The historical
      controls comprised 14 patients with FRNS in whom relapses were treated with STP
      and who were observed over a minimum period of 30 months. The two groups were
      comparable for age at the onset of nephrotic syndrome and sex. Twenty patients
      completed LDP therapy, during which 12 had no relapse, 6 had infrequent and 2
      frequent relapses (1 patient became steroid dependent and was taken off LDP).
      Twelve patients were followed for 12-42 months after stoppage of LDP; during this
      period 7 had no relapse, 4 had infrequent relapses and 1 showed steroid
      dependence. The number of relapses during LDP therapy (0.5/patient per year) was
      significantly less (P less than 0.001) than in the preceding 12 months
      (3.62/patient per year), and continued to remain low during the following 12
      months (0.6/patient per year). Whereas the frequency of relapses in the LDP group
      was similar to that in the historical control group in the 1st year of
      comparison, it was significantly less during LDP therapy (0.5/patient per year
      versus 2.25/patient per year). No side effects were observed in patients on the
      LDP regimen, at the end of which the height percentiles improved in 6 patients
      and remained unchanged in 14. Our observations indicate that long-term therapy
      with a small daily dose of prednisolone can significantly reduce the number of
      relapses in patients with FRNS, and that the beneficial effect may continue even
      after its stoppage.

PMID- 1616834
TI  - Reference values for renal concentrating capacity in children by the desmopressin
      test.
AB  - Reference values are reported for maximal renal concentrating capacity in
      children using intranasally administered desmopressin. The report is based on 591
      tests in 473 healthy children aged 0.5-13 years. The concentrating capacity
      increased markedly during the first years of life and reached a plateau at the
      age of 3 years. The mean value minus two standard deviations was 525 mosmol/kg at
      1 year of age and 825 mosmol/kg at 3 years of age.

PMID- 1616835
TI  - Favorable experience with pre-emptive renal transplantation in children.
AB  - We retrospectively examined our experience with live-related donor kidney
      transplants in 66 children during the 7-year period 1984-1990. We compared the
      clinical courses of 26 children who did not receive any dialytic therapy prior to
      transplantation with 40 children who were dialyzed (27 via peritoneal dialysis
      and 13 via hemodialysis). We did not find any statistically significant
      differences in patient or graft survival between these three groups with a follow
      up period of 6-87 months. Based on our results, we conclude that pre-emptive
      transplantation is an acceptable treatment for children who will inevitably
      require renal replacement therapy.

PMID- 1616836
TI  - The effect of growth hormone on the growth failure of chronic renal failure.
AB  - To investigate the effects of growth hormone (GH) on the reversal of growth
      failure in uremia, recombinant human GH (rhGH) was administered to rats with
      chronic renal failure (CRF). The dosage of rhGH was 3 IU/day (i.p.) for 13 days
      after the induction of CRF by 5/6 nephrectomy. Animals were classified into four
      groups: untreated nephrectomized rats (NX, n = 40), GH-treated nephrectomized
      rats (NX+GH, n = 18), sham-operated rats fed ad libitum (SHAMAL, n = 27), and
      sham-operated rats pair-fed with 10 NX rats (SHAMPF, n = 10). NX and NX+GH rats
      developed a similar and moderate degree of CRF, serum urea nitrogen being (mean
      +/- SEM) 49 +/- 3 and 54 +/- 4 mg/dl, respectively, compared with 16 +/- 4 and 19
      +/- 0 mg/dl in SHAMAL and SHAMPF groups. Weight (56.0 +/- 3.3 g) and length (3.5
      +/- 0.1 cm) gains of NX rats were lower than those of SHAMAL rats (94.2 +/- 4.0
      g, P less than or equal to 0.0001 and 4.1 +/- 0.2 cm, P less than or equal to
      0.01). Growth of the SHAMPF group and the matched NX rats was not significantly
      different. Weight (56.2 +/- 5.0 g) and length (3.4 +/- 0.2 cm) gains of NX+GH and
      NX rats were similar, the beneficial effect of GH therapy on growth being
      observed in only those animals with more severe degrees of uremia. This growth
      promoting action resulted from greater food efficiency and not from stimulated
      food intake. The hypercholesterolemia seen in NX rats, 81 +/- 2 mg/dl versus 55
      +/- 3 mg/dl in SHAMAL (P less than or equal to 0.0001), was not increased in the
      NX+GH group, 87 +/- 3 mg/dl. There was a positive and significant correlation
      between serum cholesterol and serum urea nitrogen values in NX and NX+GH animals.
      This study suggests that growth impairment of mild CRF is mainly due to
      malnutrition and is refractory to GH administration. GH therapy improves the
      growth rate of animals with advanced CRF without aggravating their lipid
      abnormalities.

PMID- 1616837
TI  - Transient neonatal distal renal tubular acidosis with secondary
      hyperparathyroidism.
AB  - We describe a neonate with distal renal tubular acidosis with secondary
      hyperparathyroidism manifesting as hyperchloraemia, hypercalcaemia, elevated
      serum parathyroid hormone (PTH) and life-threatening metabolic acidosis. He
      exhibited general weakness, tachypnoea, dry skin and weight loss. Urinary
      excretion of titratable acid and ammonium was decreased. Daily alkali (2.5 mEq/kg
      body weight) was required to maintain a normal plasma bicarbonate (HCO3-). With
      alkali therapy, the fractional excretion of HCO3- was below 5%. Serum calcium and
      PTH were restored to normal promptly on initiation of alkali therapy. After 5
      months of alkali therapy, normal growth and urine acidifying ability were
      restored and alkali therapy was discontinued. The acidification defect in this
      patient was transient. We consider this patient to be consistent with Lightwood's
      syndrome of "transient infantile renal tubular acidosis".

PMID- 1616838
TI  - Hemolytic uremic syndrome due to Escherichia coli O157: H7 in a child with
      multiple infections.
AB  - Hemolytic uremic syndrome (HUS) is characterized by hemolytic anemia,
      thrombocytopenia, and uremia; it is a common cause of acute renal failure in
      children. Although many microbial agents have been associated with HUS, only
      Escherichia coli O157: H7 has been clearly demonstrated to be a major cause of
      this illness. A case is presented of a healthy 4-year-old boy who had a recent
      varicella infection; when evaluated for HUS his blood and stool cultures both
      grew Salmonella montevideo and blood cultures grew group A beta-hemolytic
      streptococci. A stool cultured on MacConkey-sorbitol agar also grew E. coli O157:
      H7. An eightfold rise in serum antibodies to E. coli O157: H7 lipopolysaccharide
      was also demonstrated. The child recovered completely and was healthy 3 years
      later. Although this child had several infectious agents anecdotally associated
      with HUS, appropriate culture of stool showed that he also had E. coli O157: H7
      infection. Previous cases thought to be due to other pathogens may similarly have
      been caused by co-infection with E. coli O157: H7.

PMID- 1616839
TI  - Renal abscess in healthy children: report of three cases.
AB  - We report three cases of renal abscess in otherwise healthy boys. One had a
      history of blunt trauma and two of antecedent skin infection. All presented with
      flank pain and fever. Urine and blood cultures were sterile. The diagnosis was
      made using ultrasound and computerized axial tomography. The first patient had
      recurrent renal abscess, following surgery and a short course of antibiotics.
      Eventually all responded well to long-term antibiotics only.

PMID- 1616840
TI  - The use of a eutectic mixture of local anesthetic in pediatric renal biopsy.
AB  - Eight children undergoing percutaneous renal biopsy had eutectic mixture of local
      anesthetic (EMLA) cream substituted for dermal infiltration of local anesthetic.
      Five children reported no sensation of the initial skin puncture and only one
      child reported feeling a sharp object. EMLA cream may form a useful part of
      pediatric renal biopsy.

PMID- 1616841
TI  - Cyclosporine in the treatment of azathioprine-induced red cell aplasia following
      renal transplantation.
AB  - Azathioprine, a well-known immunosuppressive agent, is used extensively in renal
      transplantation. There have been several case reports of pure red cell aplasia
      induced by this drug following a successful kidney transplant. Previous
      management of azathioprine-induced red cell aplasia included reduction of
      azathioprine dose, or treatment with cyclophosphamide. We propose the
      substitution of cyclosporine for azathioprine, in this clinical setting. Not only
      does cyclosporine allow recovery of bone marrow function, but it maintains a
      level of immunosuppression which stabilizes renal function in the post-transplant
      patient.

PMID- 1616842
TI  - Hyponatremia: pathophysiology and treatment, a pediatric perspective.
AB  - Hyponatremia is the most commonly observed electrolyte abnormality in
      hospitalized children. The most serious consequences of hyponatremia and its
      treatment involve the central nervous system (CNS). Important factors determining
      the development of clinical symptomatology include: the rate of fall in serum
      sodium, and the severity and duration of hyponatremia. Acute hyponatremia is
      associated with increased brain water resulting in varying grades of
      encephalopathy whereas the osmoregulatory mechanism allows normalization of CNS
      water content in chronic hyponatremia. It is recommended that the therapy for
      hyponatremia be initiated on the basis of the presence or absence of symptoms. An
      increase of 4-6 mmol/l in serum sodium over 10-15 min is recommended in
      symptomatic patients. Rapid correction of chronic hyponatremia may result in
      osmotic dehydration syndrome and therefore should be avoided.

PMID- 1616843
TI  - Lead intoxication--new insights into an old problem.
AB  - The epidemiology, clinical symptomatology, diagnosis and management of acute and
      chronic lead intoxication are reviewed. While acute lead intoxication has become
      rare, the elevated environmental lead burden is thought to play a causal role in
      hypertension. Lead may also be linked with neuropsychological disorders of
      children and possibly even chronic renal failure. The epidemiological and
      experimental evidence for this hypothesis is critically discussed.

PMID- 1616845
TI  - Molecular aspects of water transport.
AB  - Due to its fundamental importance, the movement of water across cell membranes
      has been an active area of research for more than 100 years. This subject is
      central to consideration of normal water metabolism by terrestrial animals, as
      well as derangements in overall water balance that are frequently encountered by
      nephrologists in the care of their patients. The objective of this review is to
      discuss the most basic aspects of cell membrane water permeability and provide a
      framework for these data in the context of the care of pediatric patients with
      renal disease. While the water permeability of most cell membranes can be
      accounted for by the diffusion of water across the lipid bilayer, other cells,
      including the red blood cell and certain epithelial cells that line the proximal
      and collecting tubules of the kidney and the urinary bladder of amphibians,
      possess specialized water channels. Water channels are composed of specialized
      proteins that create aqueous pores across cell membrane. Currently, there are
      active research efforts to isolate and characterize water channel proteins from
      these cell types. Data concerning the distribution, permeability and function of
      these various water channels will greatly enhance our knowledge of how water is
      transported across cell membranes.

PMID- 1616844
TI  - Tubular and interstitial factors in the progression of glomerulonephritis.
AB  - All recent studies of the outcome of different forms of progressive
      glomerulonephritis concur that a major factor, apparently determining outcome, is
      the presence and severity of tubulointerstitial changes, and not the degree of
      glomerular alteration. Moreover, at the time of biopsy, tubulointerstitial
      changes correlate much better with the glomerular filtration rate. These at first
      surprising findings are not only useful clinically, but should make us think
      about our models of how progression takes place in so-called glomerular
      nephritides. In fact, a major tubulointerstitial infiltrate of immune-competent
      cells is present in all forms of progressive glomerulonephritis, and again
      correlates with outcome. In addition, it is now clear the tubular epithelium is
      capable of synthesising and secreting a number of factors important in
      fibrogenesis, and of displaying major histocompatibility complex class II
      antigens and leucocyte-adhesion molecules. Tubular cells could thus present
      peptides to T helper cells and amplify, or maybe even initiate, immune reactions.
      Finally, fibrogenesis within the kidney is at last being studied, long after
      studies have been performed on liver and lung. In the past, too much attention
      has been paid to reversible inflammation and not enough to irreversible cirrhosis
      of the kidney.

PMID- 1616846
TI  - Pediatric renal biopsy in the ambulatory care environment.
AB  - The use of pediatric ambulatory care facilities to perform invasive procedures
      that have low morbidity is increasingly popular. Over a 2-year period, 46
      pediatric renal biopsies were performed in an ambulatory care setting at the
      Winnipeg Children's Hospital, with the patient discharged the same day. There was
      no serious complications and adequate tissue was obtained in 45 cases. Renal
      biopsy may be safely performed on an outpatient basis on carefully selected
      patients by experienced operators in properly equipped facilities.

PMID- 1616847
TI  - Normal ranges for urinary excretion of calcium and magnesium in Portuguese
      children.

PMID- 1616848
TI  - Clinical quiz. Nail-patella syndrome (NPS) (hereditary osteo-onychodysplasia).

PMID- 1616849
TI  - Cisplatin and its analogues in the treatment of advanced breast cancer: a review.

PMID- 1616850
TI  - Promotion of hepatic metastases by liver resection in the rat.
AB  - In the early period following radical hepatectomy for hepatoma, recurrences in
      the remaining liver are frequently found. In regenerating liver, implantation and
      growth of tumour cells released into the portal system during surgical treatment
      might be promoted. We examined the relationship between liver regeneration and
      the formation of metastases following hepatic resection. Intraportal injections
      of rat ascites containing hepatoma AH130 cells at a concentration of 1 x 10(5)
      cells 0.2 ml-1 were made at various periods following two thirds liver resection
      in rats. Tumour cell injections immediately at 24 h after surgery resulted in an
      increased number of hepatic metastases compared with control animals. Tumour cell
      injections 2 weeks after hepatectomy, however, had no significant difference in
      effect compared with control rats. In contrast, tumour cells injected immediately
      after removal of half of the caudate lobe resulted in the same number of
      metastases as control animals. These results demonstrate that the number of
      artificially induced hepatic metastases was increased during an initial period of
      active liver regeneration and was proportional to the volume of hepatectomy. The
      effect of 5-fluorouracil (5FU) or mitomycin C (MMC) as inhibitors of hepatic
      regeneration on liver metastasis after hepatectomy was studied. The
      administration of 5FU (20 mg kg-1) or MMC (0.2 mg kg-1) immediately, 24 and 48 h
      after hepatectomy resulted in a marked reduction in metastatic lesions. The
      administration of 5FU caused delays in weight gain and decreases in the wet
      weight of remaining liver, while MMC had no effect on either. Accordingly,
      results of 5FU administration may be due to inhibitory effects on liver
      regeneration whilst that of MMC administration may be due to cytocidal antitumour
      effect. The effect of OK-432 as an immunoactivator on the implantation and growth
      of tumour cells in regenerating liver was also studied. Pretreatment with OK-432,
      0.5 mg intraperitoneally on 7 consecutive days, had no effect on hepatic
      metastases. The pathophysiology of liver regeneration may enhance hematogenous
      hepatic metastasis and release of tumour cells during surgical manipulation may
      represent an important cause of recurrence following hepatic resection.

PMID- 1616851
TI  - A DNA repair defect in a radiation-sensitive clone of a human bladder carcinoma
      cell line.
AB  - DNA repair was measured in an ionising radiation-sensitive mutant of a human
      bladder carcinoma cell line. No difference in the rate or extent of double-strand
      break rejoining was found using the techniques of neutral filter elution and
      pulsed-field gel electrophoresis. In contrast, significant differences in repair
      fidelity, measured by plasmid reconstitution, were found. The parent line had a
      repair fidelity of 84.7% compared with 58.9% for S40b (P = 0.0003). It is
      suggested that repair fidelity can be an important determinant of
      radiosensitivity in human tumour cells.

PMID- 1616852
TI  - Biological activities of phthalocyanines. XIV. Effect of hydrophobic
      phthalimidomethyl groups on the in vivo phototoxicity and mechanism of
      photodynamic action of sulphonated aluminium phthalocyanines.
AB  - Aluminium phthalocyanines substituted to different degrees with hydrophilic
      sulphonic acid and hydrophobic phthalimidomethyl groups were investigated in vivo
      as new agents for the photodynamic therapy of malignant tumours. Parameters
      studied included the photodynamic action on EMT-6 mammary tumours in BALB/c mice,
      the therapeutic window and the potential for direct cell killing, assayed via an
      in vivo/in vitro test. Although the efficiency of photoinactivation of the EMT-6
      tumour increases by a factor of ten with reduction of the number of sulphonic
      acid groups from four to two, no further effect was seen with the addition of the
      hydrophobic phthalimidomethyl groups. Addition of the latter groups however
      increased the potential for direct cell killing by a factor of two and expanded
      the therapeutic window by a factor of four, thus improving the usefulness of the
      dye as a photosensitiser for the photodynamic therapy of cancer.

PMID- 1616853
TI  - Fluorescence distribution and photodynamic effect of ALA-induced PP IX in the DMH
      rat colonic tumour model.
AB  - Aminolaevulinic acid (ALA) is the first committed step in haem synthesis. In the
      presence of excess ALA the natural regulatory feedback system is disrupted
      allowing accumulation of protoporphyrin IX (PP IX) the last intermediate product
      before haem, and an effective sensitiser. This method of endogenous
      photosensitisation of cells has been exploited for photodynamic therapy (PDT). We
      have studied the fluorescence distribution and biological effect of induced PP IX
      in normal and tumour tissue in the rat colon. Fluorescence in normal colonic
      tissue was at a peak of 4 h with a rapid fall off by 6 h. The fluorescence had
      returned to background levels by 24 h. All normal tissue layers followed the same
      fluorescence profile but the mucosa showed fluorescent levels six times higher
      than the submucosa, with muscle barely above background values. At 6 h the ratio
      of fluorescence levels between normal mucosa and viable tumour was approximately
      1:6. At this time laser treatment showed necrosis of normal mucosa and tumour
      with sparing of normal muscle. There was good correlation between the
      fluorescence distribution and the biological effect of ALA-induced
      photosensitisation on exposure to red light. ALA may be superior to conventional
      sensitisers for tumours that produce haem as the PP IX is synthesised in
      malignant cells while the other sensitisers mainly localise to the vascular
      stroma of tumours. There is also a greater concentration difference between the
      PP IX levels in tumours and in normal mucosa and normal muscle than with the
      other photosensitisers raising the possibility of more selective necrosis in
      tumours.

PMID- 1616854
TI  - Factors influencing variability of localisation of antibodies to carcinoembryonic
      antigen (CEA) in patients with colorectal carcinoma--implications for
      radioimmunotherapy.
AB  - Tumour localisation of anti-tumour antibodies varies greatly between patients.
      Factors which may be responsible for this have been investigated in 56 patients
      with colorectal carcinoma with a view to improving radioimmunotherapy. Thirty
      seven to seventy-four MBq of 125-I labelled mouse monoclonal antibody to CEA, was
      given intravenously and tumour resected 70-480 h later. Percentage injected
      activity kg-1 (% inj.act kg-1) in tumour, was inversely correlated with the time
      interval between injection and operation (P = 0.004). To assess the influence of
      other parameters on localisation, patients were divided into two time groups
      according to time interval between injection and operation, 70-120 h (n = 33) and
      144-480 h (n = 23). In neither group was there a significant correlation of %
      inj.act kg-1 with time. The % inj.act kg-1 in tumour showed a significant
      correlation with that in the blood for both groups (P = 0.005 and P = 0.01).
      There was no significant correlation for either time group between % inj.act kg-1
      in tumour and serum CEA values, the per cent of tumour cells positive for CEA and
      vascularity. Tumour to blood ratios varied considerably (range 0.3-28.5:1)
      suggesting that factors other than time and persistence of activity in the blood
      contribute to efficient targeting. Tumour to blood ratios were inversely
      correlated with % inj.act kg-1 in blood for the 70-120 h group (P = 0.007), and
      were positively correlated with % inj.act kg-1 in tumour (P = 0.012).
      Autoradiography showed that antibody localised predominantly on tumour cells but
      was distributed heterogeneously, was not solely related to the expression of
      antigen and in some cases accumulated in necrotic more than viable areas of
      tumour. Penetration of antibody into malignant acinar structures was poor and CEA
      positive cells closer to the blood supply were targeted to a greater extent than
      distant cells. Preoperative administration of radiolabelled antibody to CEA may
      be helpful in selecting patients with favourable localisation for
      radioimmunotherapy.

PMID- 1616855
TI  - Monoclonal antibody targeting of methotrexate (MTX) against MTX-resistant tumour
      cell lines.
AB  - Several Methotrexate (MTX)-resistant sublines of the osteogenic sarcoma cell line
      791T were derived by continuous selection in the presence of MTX and 12-O
      tetradecanoylphorbol-13-acetate (TPA). Studies including assays of the uptake and
      binding of [3H]MTX and fluoresceinated-MTX, determined that these sublines showed
      diminished MTX transport, and that none of them appeared to overproduce the MTX
      target enzyme dihydrofolate reductase. Conjugates of the anti-791T monoclonal
      antibody 791T/36 linked to MTX via human serum albumin (HSA) were prepared by Dr
      M.C. Garnett. These were cytotoxic selectively for cells bearing the 791T/36
      defined antigen (gp72), and were found to be as cytotoxic to most of the MTX
      resistant 791T sublines as they were to parental 791T cells. Furthermore, an anti
      MTX/anti-gp72 bispecific antibody 516 augmented the cytotoxicity of HSA-MTX
      conjugate to the MTX-resistant 791T variant R120 apparently as efficiently as for
      parental 791T cells. It is suggested that acquired drug resistance caused by
      deficient transport mechanisms may be partially or wholly overcome by targeting
      the drug to a readily-internalised cell surface antigen.

PMID- 1616856
TI  - Influence of reducing luxury calories in the treatment of experimental mammary
      carcinoma.
AB  - The aim of this study was to investigate the influence of dietary calorie intake
      at three different fat levels on (a) the growth of established methylnitrosourea
      (MNU)-induced mammary carcinoma, (b) the reappearance of mammary carcinomas after
      surgical removal, and (c) the growth of manifest lesions in animals treated with
      the cytostatic agent hexadecylphosphocholine (HPC). A reduction of calories by
      30% significantly inhibited tumour growth of manifest mammary carcinomas in rats,
      without having a negative influence on body weight gain. After chemotherapeutic
      treatment no significant dietary influence was observed besides the high
      antineoplastic efficacy of HPC, but when feeding calorically restricted diets to
      surgically treated animals the number of reappearing tumours was considerably
      smaller (P = 0.06) than after feeding the diets ad libitum. The fat content of
      the diets did not influence the growth of manifest mammary carcinomas. No
      significant dietary effects were exerted on oestradiol or testosterone levels in
      untreated tumour bearing animals. An elevation of oestradiol levels was observed
      when animals were subjected to HPC and fed a high calorie diet. An elevation of
      testosterone levels was assessed after surgical treatment of the rats,
      irrespective of fat content and calorie level. Our results suggest that a
      reduction of calories can inhibit growth of manifest mammary carcinomas and has
      impeding effects on tumour development after surgical removal. After effective
      chemotherapeutic treatment the additional influence of dietary changes was of
      less relevance. Furthermore, our data do not establish any association between
      growth inhibition of mammary tumours, caused by the mild caloric restriction, and
      altered oestradiol or testosterone production.

PMID- 1616857
TI  - Changes in epidermal growth factor receptor expression and response to ligand
      associated with acquired tamoxifen resistance or oestrogen independence in the ZR
      75-1 human breast cancer cell line.
AB  - We have examined the expression of receptors for epidermal growth factor (EGFR)
      by the ZR-75-1 human breast cancer cell line and tamoxifen resistant (ZR-75-9al 8
      microM) and oestrogen independent/tamoxifen sensitive (ZR-PR-LT) variants. The
      parent line expressed a single class of high affinity binding sites (4,340 +/-
      460 receptors/cell; Kd 0.23 +/- 0.04 nM). ZR-75-9al 8 microM cells, routinely
      maintained in medium containing 8 microM tamoxifen, were negative for oestrogen
      receptor (ER) and progesterone receptor (PGR) and expressed a markedly increased
      number of EGFR (14,723 +/- 2116 receptors/cell). Receptor affinity was unchanged.
      Time dependent reversal of the tamoxifen resistant phenotype was accompanied by a
      return to ER and PGR positivity and a fall in EGFR numbers to parent cell levels.
      In contrast ZR-PR-LT cells had a greatly reduced EGFR content (803 +/- 161
      receptors/cell) accompanying elevated PGR numbers. Pre-treatment of these cells
      with suramin or mild acid stripping failed to expose receptors which may have
      been occupied by endogenously produced ligand. Increased proliferation of ZR-75-1
      cells treated with EGFR (0.01-10 ng ml-1) was only observed in serum-free medium
      lacking insulin and oestradiol. Under these conditions untreated cells failed to
      proliferate. Both variant lines continued to proliferate in serum free medium in
      the absence or presence of insulin and oestradiol but failed to respond to
      exogenous EGF.

PMID- 1616858
TI  - Tumour proliferation assessed by combined histological and flow cytometric
      analysis: implications for therapy in squamous cell carcinoma in the head and
      neck.
AB  - The two techniques of flow cytometry analysis (FCM) and immunohistochemical
      localisation of bromodeoxyuridine (BrdUrd) incorporation after in vivo
      administration, were combined to study proliferation in squamous cell carcinoma
      of the head and neck region. Care was taken in this study to ensure that similar
      material was processed using both techniques such that comparisons could be made.
      FCM underestimated the labelling index (LI) in tumours classified as diploid
      compared to the histological evaluation of the tumour cells within those tumours
      (4.6% vs 17.1%). However, in aneuploid tumours, the FCM LI (10.7%) was similar to
      that obtained from histology (13.5%). Indeed, proliferation assessed by the
      combination of histology LI and FCM duration of S-phase (Ts) indicated that
      diploid tumours had a shorter median potential doubling time (Tpot) of 2.1 days
      compared to aneuploid (2.8 days). Despite the heterogeneity of proliferation
      evident histologically within the specimens, there was not a wide variation in
      the results of FCM analysis when multiple samples from resections were studied.
      Using FCM data alone, 46% of the tumours showed a Tpot of less than 5 days. When
      the Ts from the FCM data was combined with the average histological LI, 84% were
      less than 5 days and with the maximum LI, 99% were within this time interval.
      Compared with previous estimates, the proportion of tumours possessing
      proliferative characteristics which may indicate the need for acceleration of
      treatment seems to be much larger.

PMID- 1616859
TI  - Therapeutic effect of the gastrin receptor antagonist, CR2093 on gastrointestinal
      tumour cell growth.
AB  - The gastrin receptor antagonist, CR2093, competed with 125I-gastrin-17 (5 x 10(
      10) M) for binding to gastrin receptors on the rat pancreatic adenocarcinoma,
      AR42J (CR2093 concentration inducing 50% of 125I-gastrin-17 binding (IC50) was 8
      x 10(-5) M), on the human gastric adenocarcinoma, MKN45 (IC50 5.5 x 10(-5) M) and
      the human colo-rectal adenocarcinoma C523 (IC50 greater than 10(-4) M).
      Intravenous administration of CR2093 (40 mg kg-1 day-1) reduced the gastrin-17
      stimulated growth of AR42J xenografts in nude mice to below that of the original
      basal growth (P = 0.0166 from basal and P = 0.0109 from gastrin stimulated
      growth). CR2093 administration also reduced the gastrin-stimulated growth of
      MKN45 xenografts (P = 0.045) but failed to inhibit the gastrin enhanced
      proliferation of C523 xenografts. This may be related to the affinity (Kd) of the
      gastrin receptors present on the xenograft lines as the Kds of the two xenografts
      inhibited by CR2093 were 4.6 x 10(-10) M (AR42J) and 1.2 x 10(-9) M (MKN45)
      respectively whereas the Kd of C523 was of higher affinity (2.2 x 10(-10) M). GR
      antagonists may be a viable therapeutic option for gastrin receptor positive,
      gastro-intestinal tumours.

PMID- 1616860
TI  - Oestrogen receptor negative-progesterone receptor positive phenotype in 1,211
      breast tumours.
AB  - From 1,211 breast cancers, 15 oestrogen receptor (ER) negative-progesterone
      receptor (PgR) positive breast cancers by conventional dextran coated charcoal
      steroid binding assays in cytosol were reassessed using Elisa techniques with
      monoclonal antireceptors antibodies in the cytosolic and nuclear fractions, and
      immunocytochemistry on cryostat sections. Three categories of results were found
      in this series. Two tumours were false negative ER due to receptor sites
      occupancy by hormonal contraceptive treatment. A second group of ten tumours,
      with high PgR concentrations and immunoreactive ER, corresponds to non ER-binding
      forms of receptors. One PgR positive tumour was found to be devoid of PgR by
      using monoclonal antiPgR antibodies might contain a progesterone binding cyst
      protein. Only two tumours were found to be true ER negative-PgR positive by all
      methods. This rare phenotype deserves further study of the regulation of the PgR
      gene.

PMID- 1616861
TI  - MRI screening of kindred at risk of developing paragangliomas: support for
      genomic imprinting in hereditary glomus tumours.
AB  - Paragangliomas of the head and neck (glomus tumours) can occur in a hereditary
      pattern and may be hormonally active as well as being associated with
      paragangliomas elsewhere. A number of these tumours may be present without
      symptoms. To detect the presence of subclinical paragangliomas we screened 83
      members of a family at risk of developing hereditary paragangliomas using whole
      body MRI and urinary catecholamine testing. In eight previously diagnosed
      members, eight known glomus tumours of which one functioning, and two unknown
      glomus tumours and one unknown pheochromocytoma were present. Six unsuspected
      members showed ten glomus tumours and one pheochromocytoma. It has been suggested
      that the manifestation of hereditary glomus tumours is determined by the sex of
      the transmitting parent. There were no tumours in the descendants of female gene
      carriers. Comparing the likelihood of inheritance with genomic imprinting versus
      inheritance without genomic imprinting we found an odds ratio of 23375 in favour
      of genomic imprinting.

PMID- 1616862
TI  - Late cardiopulmonary toxicity after treatment for Hodgkin's disease.
AB  - Cardiac and pulmonary functions were evaluated in 75 patients aged 50 years or
      under, treated for Hodgkin's disease by mantle radiotherapy at least 3 years
      earlier; all received the same mantle field radiotherapy: radiotherapy alone,
      MOPP chemotherapy plus radiotherapy, MOPP and ABVD chemotherapy plus
      radiotherapy. No patient had any symptom of heart disease. Only borderline
      abnormalities of ECG or echocardiogram were observed in 12 patients. One of them
      showed a moderate aortic stenosis which was known before the treatment; apical or
      septum hypokinesia were present in four patients and one patient had a slightly
      right ventricular dilatation. Twelve (16%) chest radiographs showed moderate or
      severe abnormalities, but there was no significant correlation between the
      results of pulmonary function tests and Xenon ventilation/perfusion scintigraphy,
      the clinical examination and the intensity of the radiological sequelae. Twenty
      nine (64%) Xenon scintigraphies showed a reduction of lung perfusion in the
      irradiated areas without any symptom. The resting mean pulmonary function test
      was significantly lower for the patients than for the control group with regard
      to Total Capacity and Vital Capacity. The exercise tolerance, as indicated by
      analysis of blood gases, was below the one expected for only two patients who
      were dyspneic during the low level of exercise. We did not find any significant
      difference between the three treatment groups. We conclude that the treatment
      with mantle field under good technical conditions (high energy photons, moderate
      doses...) can result in minimal cardiopulmonary dysfunction.

PMID- 1616863
TI  - A phase I study of regional 5-fluorouracil and systemic folinic acid for patients
      with colorectal liver metastases.
AB  - A phase I study was undertaken in order to establish the maximum tolerated dose
      of intra-hepatic arterial 5-fluorouracil (5-FU) when given in combination with
      systemic folinic acid. Patients with colorectal liver metastases (n = 10)
      received escalating doses of 5-FU as a 24 h infusion with a fixed dose (400 mg m
      2) of intravenous folinic acid once per week. Dose limiting toxicity (WHO grade
      greater than 2) was encountered at 2 g m-2 5-FU. Principal adverse effects were
      diarrhoea, vomiting and oral ulceration. The recommended dose for phase II
      studies is 1.5 g m-2 week-1 24 h 5-FU regional infusion with 400 mg m-2 week-1
      intravenous folinic acid.

PMID- 1616864
TI  - The relationship between skin cancers, solar radiation and ozone depletion.
AB  - During the period 1957-1984 the annual age-adjusted incidence rate of cutaneous
      malignant melanoma (CMM) increased by 350% for men and 440% for women in Norway.
      The annual exposure to carcinogenic sunlight in Norway, calculated by use of
      measured ozone levels, showed no increasing trend during the same period. Thus,
      ozone depletion is not a cause of the increasing trend of the incidence rates of
      skin cancers. The incidence rates of basal cell carcinoma (BCC) and squamous cell
      carcinoma (SCC) increase with decreasing latitude in Norway. The same is true for
      CMM in Norway, Sweden, and Finland. Our data were used to estimate the
      implications of a future ozone depletion for the incidence rates of skin cancer:
      a 10% ozone depletion was found to give rise to a 16-18% increase in the
      incidence rate of SCC (men and women), a 19% increase in the incidence rate of
      CMM for men and a 32% increase in the incidence rate of CMM for women. The
      difference between the numbers for men and women is almost significant and may be
      related to a different intermittent exposure pattern to sunlight of the two
      sexes. The increasing trend in the incidence rates of CMM is strongest for the
      trunk and lower extremities of women, followed by that for the trunk of men. The
      increasing incidence rates of skin cancers as well as the changing pattern of
      incidence on different parts of the body is most likely due to changing habits of
      sun exposure. Comparisons of relative densities of CMM, SCC, LMM and SCC falling
      per unit area of skin at different parts of the body indicate that sun exposure
      is the main cause of these cancer forms although other unknown factors may play
      significant roles as well. For the population as a whole sun exposure during
      vacations to sunny countries has so far been of minor importance in skin cancer
      induction.

PMID- 1616866
TI  - Analogues of LHRH versus orchidectomy: comparison of economic costs for
      castration in advanced prostate cancer.
AB  - Analogues of luteinising hormone releasing hormone (LHRH) have recently been
      introduced as an alternative to surgical orchidectomy in prostate cancer, but
      there has been concern about the economic costs of long-term treatment. The paper
      presents a comparison of costs for LHRH analogues versus orchidectomy in patients
      with advanced prostate cancer. The cost for the surgical procedure was estimated
      using data on patients treated with orchidectomy in Stockholm County, Sweden,
      during 1981-86. Estimates of costs for treatment with a depot LHRH analogue was
      based on observed treatment times among patients with symptomatic prostate cancer
      in a British randomised clinical trial of medical castration versus surgical
      orchidectomy. The average cost for orchidectomy was estimated at 2,580 pounds
      i.e. 7-31% less than for treatment with a depot LHRH analogue (2,760 pounds-3,380
      pounds) assuming a mean treatment time in the range 19-23 months. The most cost
      effective policy for castration was found to be initial treatment with an LHRH
      analogue followed by deferred orchidectomy after about 2 years among long-term
      responders. This policy would obviate the need for surgery in about 85% of the
      patients and the average cost (1,900 pounds) would be about 26% lower compared to
      that of a policy of primary orchidectomy in all patients.

PMID- 1616865
TI  - Stage and delay in breast cancer diagnosis by race, socioeconomic status, age and
      year.
AB  - Information on 23,567 Non-Hispanic White, 2,539 Black, and 2,380 Hispanic breast
      cancer cases diagnosed between 1977 and 1985 was used to evaluate the risk of
      late stage diagnosis and long duration of symptoms prior to diagnosis in relation
      to ethnicity, socioeconomic status, age and year of diagnosis. All data were
      collected by the University of Southern California Cancer Surveillance Program,
      the comprehensive population-based incidence registry of Los Angeles County. The
      results indicate that lower socioeconomic status, Black or Hispanic ethnicity,
      younger age, and earlier year of diagnosis are risk factors for late stage
      diagnosis and long duration of symptoms. The effect of ethnicity was not
      explained by lower SES levels among Black or Hispanic women. After controlling
      for duration of symptoms, race and SES remained significantly predictive of more
      advanced stage. More recent diagnosis across the 9 year time frame was not
      associated with improved stage for those of low SES. These results suggest that
      increased efforts are needed to reach low SES and Black and Hispanic women with
      campaigns to improve the stage at which breast cancer is detected.

PMID- 1616867
TI  - Preventive Pap-smears: balancing costs, risks and benefits.
AB  - The pattern of spontaneous screening for cervical cancer by general practitioners
      and gynaecologists in The Netherlands is compared with an efficient screening
      policy resulting from a cost-effective study. Spontaneous screening tends to
      start and stop too early in a woman's life, and leaves too many women
      overscreened or unprotected. The combination in young age of a low incidence of
      invasive cancer and a high incidence of regressive lesions explains relative
      ineffectiveness and harmfulness of present screening practice. When screening
      would take place between ages 30 and at least 60, with intervals of about 5
      years, as many lives could be saved for half the costs and with only 60% of the
      unnecessary referrals and treatments. Much attention should be paid to the
      coverage of the target population. Therapeutic follow-up policies for dysplastic
      lesions should be restrained.

PMID- 1616868
TI  - Guaiac and immunochemical tests for faecal occult blood in colorectal cancer
      screening.
AB  - Seven hundred and eighty-six subjects spontaneously referring to our Center
      performed two guaiac (Rehydrated Hemoccult II (R.HO), and Hemoccult Sensa (HO
      S.)), and two immunochemical (OC Hemodia (Hdia) and Hemeselect (Hsel)) faecal
      occult blood tests on three consecutive faecal determinations. The positivity
      rates of 3 day R.HO, HO S., Hdia, and Hsel were 4.8%, 5.6%, 8.4% and 11.2%
      respectively. One hundred and thirty-five of the 150 subjects with at least one
      positive test completed the diagnostic work-up. Cancer was detected in three
      subjects and adenomas in 15. Three-day specificity estimates of R.HO, HO S., Hdia
      and Hsel in the overall series were 96.1%, 96.0%, 93.8% and 91.2% respectively,
      the differences between guaiac and immunochemical tests being significant.
      Corresponding values of specificity as determined on the first faecal sample only
      in the overall series were 98.1%, 98.3%, 96.1% and 94.9% respectively. No
      significant difference in specificity is evident when 3-day guaiac tests are
      compared to 1-day immunochemical ones. Three-day immunochemical testing is not
      recommended for screening purposes due to its very low specificity. Nevertheless,
      1-day immunochemical testing is almost as specific as 3-day guaiac testing. A
      preliminary estimate of colonic neoplasms detection rates shows no difference as
      well. The benefit of 1-day testing on screening acceptability is evident, but the
      impact on sensitivity should be evaluated in a screening situation with a proper
      study design and a larger sample size.

PMID- 1616869
TI  - Cyclical mastalgia as a marker of breast cancer susceptibility: results of a case
      control study among French women.
AB  - A matched case-control study in a population of urban, non-menopaused women
      living in Paris was performed between 1983 and 1985 to investigate the risk of
      breast cancer (BC) in relation to various factors with a particular interest in
      the effect of the use of oral contraceptive (OC) and the existence of cyclical
      mastalgia (CM). Two hundred and ten non-menopaused women, less than 45 years old,
      with newly diagnosed BC were compared to 210 controls from the same geographic
      area matched on year of birth, age, education level and age at first full term
      pregnancy (FFTP), when justified. The adjusted Relative Risk of BC (RRa) was
      significantly increased for a total duration of OC use longer than 72 months (RRa
      2.80; 95% CI 1.56-5.01), as well as the RRa for OC use above 48 months before
      FFTP (3.26 95% CI 1.37-7.76) and, to a lesser extent, the RRa for OC use above 48
      months after FFTP (2.02 95% CI 1.07-3.84) respectively. Adjustment was performed
      on familial history of BC, personal history of Benign Breast Disease (BBD), age
      at menarche. A previous history of cyclical mastalgia was found to be associated
      with an increased risk of BC. The significant increase remained after adjustment
      on the previously mentioned confounding factors and OC use: RRa 2.12; 95% CI
      (1.31-3.43). Under a precise definition related to the hormonal environment,
      mastalgia appear to be an interesting marker of breast cell susceptibility, the
      importance of which can only be validated by prospective studies.

PMID- 1616870
TI  - High-dose methotrexate in the treatment of malignant mesothelioma of the pleura.
      A phase II study.
AB  - From 1984 to 1989, 63 patients with diffuse, malignant mesothelioma of the pleura
      were treated with 4-8 courses of high-dose methotrexate (HDMTX, 3 g total dose)
      and citrovorum factor rescue. There were 61 male and two female patients of
      median age 60 years. CT scan was performed before and after treatment and used
      for response evaluation. Of 60 patients evaluable for response, 37% showed
      partial or complete remission, 32% showed no change and 32% showed progressive
      disease. Median survival from start of treatment for all patients was 11 months,
      for 42 patients with the epithelial type 12 months, and for 20 patients with
      sarcomatous or mixed types only 5 months. Toxicity was acceptable, with only five
      patients (8%) terminating therapy due to toxicity. One toxic death occurred. We
      conclude that HDMTX is an active regimen in malignant pleural mesothelioma. The
      significantly shorter survival for patients with the sarcomatous or mixed
      subtypes indicates that further investigations on the activity of HDMTX in
      mesothelioma should be limited to patients with the epithelial subtype.

PMID- 1616871
TI  - A method for assessing the quality of life of cancer patients: replication of the
      factor structure.
AB  - The psychometric properties of a method of measuring the quality of life of
      cancer patients based on multiple linear analogue scales have been assessed in a
      group of 294 patients with breast cancer attending one clinical unit. The method
      was found to be readily managed by patients although a small number of scales
      presented difficulties of understanding to patients and difficulties of analysis.
      The scales distinguished readily between patients of different disease and
      treatment status. Factor analysis revealed a 5 factor structure which we
      interpret as relating to physical activities of everyday living, emotional
      disturbance, alimentary disturbances, appearance and cosmetic problems and a
      fifth factor which is more difficult to interpret and includes impairment of
      speech, writing and concentration. We feel the essential factors determining
      quality of life in cancer patients have been demonstrated in this and our earlier
      studies and there is now a substantial level of agreement in the factors that
      have been identified by groups taking quite different approaches. The major
      factors determining quality of life in cancer patients are now known and should
      be assessed in clinical research and clinical trials. The method by which they
      should be assessed is not as yet so clear.

PMID- 1616872
TI  - Surgery in metastatic non-seminomatous germ cell tumours.

PMID- 1616873
TI  - Inverse relationship between ovarian aromatase cytochrome P450 and 5 alpha
      reductase enzyme activities and mRNA levels during the estrous cycle in the rat.
AB  - In the present study, we examined the changes in enzyme activity and mRNA levels
      of aromatase cytochrome P450 (P450AROM) and 5 alpha-reductase in ovarian tissue
      from adult cyclic rats. For each stage of the estrous cycle, the enzymatic
      activities were quantified by means of the 3H2O-release assay in the case of
      P450AROM and thin-layer chromatography in the case of 5 alpha-reductase. Levels
      of mRNA encoding P450AROM and 5 alpha-reductase in the ovary were determined by
      Northern blot analysis utilizing 32P-labeled rat cDNAs as probes. Serum LH levels
      were determined by RIA. Three P450AROM mRNA species were detected (at 1.7, 2.2
      and 2.7 kb) in ovarian tissue from cyclic rats. All three P450AROM transcripts
      were expressed in a co-ordinated fashion throughout the cycle. The P450AROM
      levels were highest during diestrus and proestrus, decreased during estrus while
      at metestrus the levels were nearly nondetectable. Conversely, one 5 alpha
      reductase mRNA species at 2.5 kb was detected in ovarian tissue from cyclic
      animals. Ovarian 5 alpha-reductase mRNA levels were lowest during diestrus and
      proestrus, increased at estrus and were most abundant during metestrus; a pattern
      opposite to that of P450AROM. The pattern of change in P450AROM and 5 alpha
      reductase activities paralleled that of the respective mRNA profiles but lagged
      behind the mRNA profiles by about 24 h, or one stage of the estrous cycle.
      Aromatase activity was 1.5 pmol/h/mg protein during diestrus, increased over 3
      fold at proestrus (approximately 5.5 pmol/h/mg protein), decreased at estrus and
      declined to the lowest values at metestrus (approximately 1.0 pmol/h/mg protein).
      In contrast, the 5 alpha-reductase activity pattern was essentially the mirror
      image of the P450AROM activity pattern during the estrous cycle. 5 alpha
      Reductase levels were lowest during proestrus (approximately 5 pmol/h/mg protein)
      and estrus (approximately 8 pmol/h/mg protein), increased over 3-fold during
      metestrus, while the highest activity levels occurred during diestrus
      (approximately 36 pmol/h/mg protein). The normalization of the P450AROM and 5
      alpha-reductase mRNA levels and their respective enzyme activities revealed a
      correspondence between mRNA abundance and subsequent increases (24 h later) in
      enzyme activity levels during the estrous cycle. These findings suggest that: (a)
      a temporal relationship exists between the profiles of the enzymatic activities
      that follows the changes in the levels of their respective mRNAs and (b) an
      inverse pattern exists between P450AROM and 5 alpha-reductase in terms of both
      enzymatic activity and mRNA expression during the estrous cycle in rat.

PMID- 1616874
TI  - Effects of transforming growth factors and regulation of their mRNA levels in two
      human endometrial adenocarcinoma cell lines.
AB  - The effects of the transforming growth factor-beta 1 (TGF-beta 1) and epidermal
      growth factor (EGF) on the growth of cells from 2 endometrial cancer lines,
      Ishikawa and HEC-50 were evaluated by measuring rates of DNA synthesis and
      changes in cell numbers during culture. EGF at 17 and 1.7 nM concentrations
      consistently enhanced HEC-50 cell proliferation. TGF-beta 1 inhibited Ishikawa
      cell proliferation but, unexpectedly for epithelium-derived cells, stimulated HEC
      50 cell growth. This effect is of interest as it indicates that endometrial cells
      can acquire an altered responsiveness to a growth inhibitor during the process of
      malignant transformation. Northern blot analyses showed expression of TGF-alpha,
      TGF-beta 1 and EGF receptors mRNA in both cell lines. Neither estradiol (E2) nor
      4-hydroxytamoxifen (OHTam) affected mRNA levels for either TGF-alpha or TGF-beta
      in HEC-50 cells, a line unresponsive to E2 for proliferation. In Ishikawa cells,
      previously shown to respond to both E2 and OHTam by increasing proliferation
      rates, E2 increased TGF-alpha mRNA and reduced TGF-beta mRNA levels. OHTam
      lowered the levels of both mRNA species, although the effect was greater on TGF
      beta than TGF-alpha mRNA. These data are consistent with, but do not prove, the
      existence of a possible autocrine regulation by TGF-alpha and TGF-beta of human
      cancer cell proliferation, which might be under E2 influence in Ishikawa cells.

PMID- 1616875
TI  - Effects of progestins on the proliferation of estrogen-dependent human breast
      cancer cells under growth factor-defined conditions.
AB  - The effect was studied of four different synthetic progestins (Org 30659,
      gestodene, 3-ketodesogestrel and levonorgestrel) on the proliferation of the 17
      beta estradiol (E2)-dependent human breast cancer cell line MCF7. All progestins
      were found to stimulate proliferation, but only at high pharmacological dosages.
      Moreover, like estrogens the progestins at high concentrations synergistically
      stimulated MCF7 cell proliferation together with low concentrations of insulin.
      This stimulatory effect could be blocked by antiestrogens, but not by
      antiglucocorticoids and antiprogestins. This suggests that growth stimulation by
      these progestins (or their metabolites) occurs through crossreaction with the E2
      receptor (ER). This is confirmed by the observation that the strong synthetic
      progestin Org 2058 does not stimulate proliferation. The absence of a
      progesterone receptor (PR)-mediated growth response seems not to be due to
      aberrant PR expression in these cells; 27,000 receptors (Kd 1.7 x 10(-10)M) per
      cell were present under growth-assay conditions. Growth stimulation by E2 in the
      absence or presence of insulin, is slightly inhibited or unaffected by the
      progestins, respectively. Our data do not support a role for the recently
      identified gestodene binding sites [Colletta et al., J. Steroid Biochem. 33
      (1989) 1055-1061] in mediating gestodene effects on breast cancer cells:
      gestodene and 3-ketodesogestrel, a compound that does not bind to these gestodene
      binding sites, showed a similar biological activity. The effects of the
      progestins on the MCF7 breast cancer cell line, indicate that the use of these
      compounds at very high concentrations may be unfavourable, but do not support a
      role for them in directly stimulating breast tumor proliferation at the low
      progestin concentration which are reached in the serum in oral contraceptive
      users.

PMID- 1616876
TI  - Comparison of the carbohydrate composition of rat and human corticosteroid
      binding globulin: species specific glycosylation.
AB  - We have examined the carbohydrate composition of corticosteroid-binding globulin
      (CBG) obtained from rat and human serum. Rat CBG contained a carbohydrate
      composition that was strikingly different from that of human CBG. Like other
      glycoproteins that circulate in human plasma, human CBG had a carbohydrate
      composition that was consistent with the presence of biantennary and triantennary
      oligosaccharide structures. In contrast, the carbohydrate composition of rat CBG
      indicated the presence of more than one sialic acid residue per antenna. It is
      not clear whether rat CBG contains a carbohydrate structure with sialic acids
      attached to both galactose and N-acetylglucosamine on the same antenna, or a
      terminal disialylated structure (sialic acid linked alpha 2-8 to sialic acid).
      These structural variations may play a role in the interaction of CBG with its
      receptor.

PMID- 1616878
TI  - Stress-induced changes of glucocorticoid receptor in rat liver.
AB  - The effect of corticosterone injection and of acute and repeated stress on rat
      liver cytosol glucocorticoid receptor was studied to ascertain whether
      corticosterone-induced glucocorticoid receptor (GR) regulation also takes place
      in intact animals as it does in adrenalectomized ones. Adult male rats were
      exposed to six different stressors (swimming, 10 mg/kg histamine i.p., 500 mU/kg
      vasopressin s.c., heat, immobilization and cold) acutely or three times daily for
      18 days (repeated stress). Each of the stressors applied acutely provoked a
      pronounced increase of plasma corticosterone with subsequent induction of hepatic
      tyrosine aminotransferase activity. Depletion of cytosol receptor was however
      only noticed after swimming and histamine injection. On the other hand, sustained
      hypersecretion of corticosterone evoked by repeated stress significantly reduced
      the number of GR in rat liver cytosol without any change in Kd. It is concluded
      that in the presence of intact adrenal glands cytosol receptors are more
      resistant to corticosterone-induced depletion than in their absence. Further,
      repeated stress causes down-regulation of GR in the liver, most probably by
      sustained corticosterone secretion, yet the effect of other stress factors cannot
      be excluded.

PMID- 1616877
TI  - Stimulatory and inhibitory effects of progesterone on FSH secretion by the
      anterior pituitary.
AB  - The purpose of this study was to investigate whether progesterone exerted
      progesterone receptor mediated direct effects on the anterior pituitary in the
      secretion of FSH and whether such effects were mediated through the 5 alpha
      reduction of progesterone. Treatment of anterior pituitary dispersed cells for 48
      h with 0.5 nM estradiol reduced the ED50 for gonadotropin releasing hormone
      (GnRH)-stimulated FSH release from 0.58 to 0.36 ng/ml and the ED50 for GnRH
      induced LH release from 0.54 to 0.19 ng/ml. When dispersed pituitary cells were
      treated with 0.5 nM estradiol and exposed to various doses of progesterone for 1
      to 6 h, the most consistent rise in basal and GnRH-stimulated FSH release was
      observed with the 50 nM dose of progesterone with a 3-h exposure period. All
      three doses of progesterone elevated basal LH and GnRH-stimulated LH was
      increased by the 50 and 100 nM doses of progesterone during the 3-h period of
      treatment. Using the 50 nM dose of progesterone, basal and GnRH-stimulated LH was
      increased after 2, 3 and 6 h of progesterone treatment. When the period of
      exposure of progesterone was extended to 12, 36 or 48 h, there was a significant
      inhibition of GnRH-stimulated FSH release. GnRH-stimulated LH release was
      inhibited at 36 and 48 but not 12 h after progesterone treatment. These studies
      showed that the effect of progesterone administered for periods of 1 to 6 h
      enhanced the secretion of LH and FSH whereas progesterone administered for
      periods beyond 12 h inhibited FSH and LH release by dispersed pituitary cells in
      culture. These results are similar to those observed in vivo after progesterone
      treatment. Furthermore estrogen priming of the dispersed pituitary cells was
      necessary to observe the effects of progesterone. The progesterone antagonist
      RU486 prevented the progesterone-induced rise in GnRH-stimulated FSH release.
      Furthermore the 5 alpha-reductase inhibitor N,N-diethyl-4-methyl-3-oxo-4-aza-5
      alpha-androstane- 17 beta-carboxamide also prevented the progesterone-induced
      rise in GnRH-stimulated FSH release in estrogen-treated dispersed pituitary
      cells. These results indicate that the anterior pituitary is a major site of
      action of progesterone in the release of FSH and that 5 alpha-reduction of
      progesterone plays an important role in FSH release.

PMID- 1616879
TI  - Ontogenic development of liver progesterone metabolism in female sheep.
      Contribution of cytochrome P4502B and P4503A subfamilies.
AB  - Age-related changes in progesterone hepatic metabolism were measured in Lacaune
      ewes in the foetal, neonatal (1 and 4 weeks), growing (7 months), pregnant (11
      months) and adult (6 years) stages. 6 beta-Hydroxylation and 20 alpha-reduction
      were found to be the most efficient metabolic process in ovine microsomes. These
      activities were detected in 3-month-old foetuses and they increased rapidly
      during the first month of life, in a similar manner to the developmental
      expression of the cytochrome P4503A subfamily. 16 alpha- and 21-hydroxylation of
      progesterone were characterized by low, constant turn over in sheep liver
      microsomes during development. The hepatic ovine P4502B isozyme was purified to
      electrophoretic homogeneity by means of successive DEAE cellulose,
      hydroxylapatite and CM cellulose chromatographic separations. This hemoprotein
      had an apparent molecular weight of 51 kDa and was characterized by spectral
      data, NH2-terminal amino-acid sequence, immunological and catalytic properties.
      The relative contribution of this form and of the previously purified ovine
      P4503A subfamily was investigated in liver progesterone metabolism by
      immunoinhibition studies using polyclonal antibodies raised in rabbits and from
      the existence of induction and of significant correlations between microsomal
      activity and specific P450 content. In sheep liver microsomes, it would appear
      that cytochrome P4502B is involved in progesterone 21-hydroxylation whereas
      P4503A participates in the 6 beta- and 16 alpha-hydroxylation and possibly in the
      reductive conversion of progesterone in its 20 alpha-hydroxy derivative.

PMID- 1616880
TI  - Selective inhibition of the 5 alpha-reductase of the rat epididymis.
AB  - The effect of several synthetic steroids belonging either to the 4-aza-3-oxo
      steroid family or to androstene and androstane derivatives was investigated "in
      vitro" on the epididymal as well as prostatic 5 alpha-reductase activity. For
      this purpose rat caput epididymis and prostate were incubated with the different
      steroidal compounds at molar concentrations of 10(-7), 10(-6), and 10(-5) in the
      presence of labelled testosterone as substrate. The steroids 4-MA (17 beta, N,N
      diethyl-carbamoyl-4-aza-5 alpha-androstan-3-one) and 4-OH-A (4-hydroxy
      androstenedione), already known to be effective 5 alpha-reductase inhibitors at
      the level of the prostate, have been used as reference molecules. The 5 alpha
      reductase activity was evaluated by measuring pg of dihydrotestosterone (DHT)
      formed in 2 h of incubation by mg of tissue. The steroids A, B, C, F, G and I
      inhibit the formation of DHT in the rat epididymis although to different extents;
      they are also equally effective on the formation of DHT in the rat prostate. The
      steroids D, E, H and L are devoid of any inhibitory property on the formation of
      DHT in both the rat epididymis and prostate. The most interesting results were
      obtained with compound M which exhibits a dose-dependent and significant
      inhibitory effect on the formation of DHT in the epididymis, but it is inactive
      at the level of the prostate. These findings suggest that it is possible (a) to
      selectively interfere with the 5 alpha-reductase of the epididymis without
      affecting that present in the prostate, and (b) consequently to envisage new ways
      to regulate male fertility.

PMID- 1616881
TI  - Transformation and nuclear translocation of brain type L corticosteroid receptors
      complexed with the mineralocorticoid antagonist ZK 91587, aldosterone or
      dexamethasone.
AB  - Type I corticosteroid receptors were determined in cytosol from hippocampus
      (HIPPO) and amygdala (AMYG), using [3H]aldosterone (ALDO), [3H]dexamethasone
      (DEX) or the mineralocorticoid antagonist [3H]ZK 91587 as ligands. Incubations
      with the first two compounds also contained the pure glucocorticoid RU 28362 to
      block type II receptors. Binding of the three ligands was comparable in cytosol
      from HIPPO and it was slightly higher for [3H]DEX in AMYG. However, after heat
      induced receptor transformation, binding to DNA-cellulose was observed for
      [3H]ALDO-receptor complex obtained from HIPPO or AMYG, whereas it was negligible
      for [3H]ZK 91587. Receptors charged with [3H]DEX or [3H]ALDO showed similar
      retention on DNA-cellulose columns in the case of the AMYG, while binding to the
      polynucleotide was higher for [3H]ALDO in the HIPPO. Finally, only [3H]ALDO was
      taken up to a significant extent in purified cell nuclei prepared from slices of
      HIPPO and AMYG previously incubated with the three ligands. It is concluded that
      binding of a natural agonist steroid may be a prerequisite for type I receptor
      transformation and translocation from the cytoplasm into the nuclear fraction.
      DEX binding to type I receptors resembles a partial agonist with antagonist
      properties, whereas antagonists such as ZK 91587 are bound and retained in
      cytoplasm, without further translocation.

PMID- 1616882
TI  - Substrate specificity of cholesterol oxidase from Streptomyces cinnamomeus--a
      monolayer study.
AB  - The substrate specificity of cholesterol oxidase from Streptomyces cinnamomeus
      was examined in oriented sterol monolayers at the air/water interface. Of the
      cholesterol analogues with structural alterations in the A- or B-ring that were
      examined, it was observed that 5 alpha-cholestan-3 beta-ol was oxidized almost as
      fast as cholesterol itself. When the delta-5 double bond in cholesterol was
      instead at the delta-4 position, the oxidation rate became 3.2-fold slower. A
      similar reduction in the average oxidation rate was observed when the delta-5
      double bond in cholesterol was instead at the delta-7 position (5 alpha-cholest-7
      en-3 beta- ol). 5,7-Cholestadien-3 beta-ol was oxidized 5.1-fold slower compared
      to cholesterol, whereas 3 beta-hydroxy-5-cholesten-7-one and 5 beta-cholestan-3
      beta-ol were not substrates of the enzyme (also verified from the lack of H2O2
      production). With C(17) side chain analogues of cholesterol, it was observed that
      the complete lack of the C(17) side chain (5-androsten-3 beta-ol), or the
      insertion of an unsaturation at delta-24 (desmosterol), or even an ethyl group at
      C(24)(24b-ethyl-5,22- cholestadien-3 beta-ol) had no appreciable effects on
      sterol oxidation rate, implying that the enzyme did not recognize the side chain
      in oriented sterol monolayers. This study has shown that the sterol monolayer
      system is a good technique to examine sterol/cholesterol oxidase interactions,
      since both the orientation of the substrate molecules, and the quality of the
      interface can be mastered.

PMID- 1616883
TI  - Studies on anabolic steroids--12. Epimerization and degradation of anabolic 17
      beta-sulfate-17 alpha-methyl steroids in human: qualitative and quantitative
      GC/MS analysis.
AB  - The epimerization and dehydration reactions of the 17 beta-hydroxy group of
      anabolic 17 beta-hydroxy-17 alpha-methyl steroids have been investigated using
      the pyridinium salts of 17 beta-sulfate derivatives of methandienone 1,
      methyltestosterone 4, oxandrolone 7, mestanolone 10 and stanozolol 11 as model
      compounds. Rearrangement of the sulfate conjugates in buffered urine (pH 5.2)
      afforded the corresponding 17-epimers and 18-nor-17,17-dimethyl-13(14)-enes in a
      ratio of 0.8:1. These data indicated that both epimerization and dehydration of
      the 17 beta-sulfate derivatives were not dependent upon the respective chemical
      features of the steroids studied, but were instead inherent to the chemistry of
      the tertiary 17 beta-hydroxy group of these steroids. Interestingly, in vivo
      studies carried out with human male volunteers showed that only methandienone 1,
      methyltestosterone 4 and oxandrolone 7 yielded the corresponding 17-epimers 2, 5
      and 8 and the 18-nor-17,17-dimethyl-13(14)-enes 3, 6 and 9 in ratios of 0.5:1,
      2:1 and 2.7:1, respectively. No trace of the corresponding 17-epimers and 18-nor
      17,17-dimethyl-13(14)-enes derivatives of mestanolone 10 and stanozolol 11 was
      detected in urine samples collected after administration of these steroids. These
      data suggested that the in vivo formation of the 17-epimers and 18-nor-17,17
      dimethyl-13(14)-enes derivatives of 17 beta-hydroxy-17 alpha-methyl steroids is
      also dependent upon phase I and phase II metabolic reactions other than sulfation
      of the tertiary 17 beta-hydroxyl group, which are probably modulated by the
      respective chemical features of the steroidal substrates. The data reported in
      this study demonstrate that the 17-epimers and 18-nor-17,17-dimethyl-13(14)-enes
      are not artifacts resulting from the acidic or microbial degradation of the
      parent steroids in the gut as previously suggested by other authors, but arise
      from the rearrangement of their 17 beta-sulfate derivatives. Unchanged
      oxandrolone 7 was solely detected in the unconjugated steroid fraction whereas
      unchanged steroids 1, 4 and 11 were recovered from the glucuronide fraction.
      These data are indirect evidences suggesting that the glucuronide conjugates of
      compounds 1 and 4 are probably enol glucuronides and that of compound 11 is
      excreted in urine as a N-glucuronide involving its pyrazole moiety. The urinary
      excretion profiles of the epimeric and 18-nor-17,17-dimethyl-13(14)-ene steroids
      are presented and discussed on the basis of their structural features.

PMID- 1616884
TI  - Effects of dihydrotestosterone and hydroxyflutamide on androgen receptors in
      cultured human breast cancer cells (EVSA-T).
AB  - The purpose of our study was to evaluate the effects of 5 alpha
      dihydrotestosterone (DHT) and hydroxyflutamide (HF), alone or in combination, on
      androgen receptor (AR) dynamics and on cellular growth in cultured breast cancer
      cells (EVSA-T). The incubation of cells with DHT increased the concentration of
      nuclear AR after 24 and 48 h. HF was also able to promote the nuclear
      accumulation of AR after 24 and 48 h of treatment. When HF-treated cells are
      incubated with DHT, the nuclear AR concentration is lower than that found in
      cells treated with DHT alone. We conclude that HF acts by increasing nuclear
      accumulation of receptor-antiandrogen complexes. Moreover, DHT stimulates cell
      growth while HF has an inhibitory effect. Thymidine incorporation in cells also
      increased after DHT treatment and decreased after HF incubation. The HF-induced
      inhibition of cell growth persisted both after renewal of the medium and after
      the addition of DHT to cultures. It may be hypothesized that either DHT is
      converted to inactive metabolites or that HF exerts a persistent inhibitory
      effect. In the latter case, the antiandrogen action of HF could be exerted by
      retention of high levels of antiandrogen in cells or by such a depressed protein
      synthesis that the renewal of growth is slower than the 48 h period studied.

PMID- 1616885
TI  - Cancer research funding: good news from the U.S., bad news from Europe.

PMID- 1616886
TI  - Hormone refractory metastatic prostate cancer.

PMID- 1616887
TI  - The impact of pharmacokinetically guided dose escalation strategies in phase I
      clinical trials: critical evaluation and recommendations for future studies.
AB  - Phase I studies requiring multiple dose escalation steps have led to the
      development of pharmacokinetically guided dose escalation (PGDE) strategies to
      expedite the conduct of early clinical trials. This article critically reviews
      PGDE strategies for a number of new anticancer agents including amphethinile,
      brequinar sodium, iodo-doxorubicin, the anthrapyrazoles (DuP 941, DuP 942 and DuP
      937), rhizoxin, and aphidicolin glycinate. The benefits and problems associated
      with PGDE are examined. Recommendations are made for the optimal deployment of
      pharmacological information in future phase I studies.

PMID- 1616888
TI  - AACR/EACR first joint conference: concepts and molecular mechanisms of multistage
      carcinogenesis.

PMID- 1616889
TI  - Prognostic factors in hormone-resistant progressing cancer of the prostate.
AB  - In 224 consecutive patients with hormone-resistant prostatic cancer referred to 2
      European Cancer Centres for palliation of painful bone metastases the one year
      survival for all patients was 24% (2-year survival: 7%). The median survival was
      8 months. In univariate analyses the following prognostic factors were
      identified: performance status, serum creatinine, alkaline phosphatase, duration
      of response to primary hormone treatment, degree of bone scan involvement and
      hemoglobin. Multivariate analyses confirmed the four first parameters to be
      independent factors. A prognostic model was established (no or one risk factors
      vs 2 risk factors vs 3 or 4 risk factors) based on performance status,
      creatinine, alkaline phosphatase and hormone response duration. The median
      survival of these groups was 10 months, 6 months and 3 months, respectively. This
      model proved to be discriminative in an external data set of 214 patients with
      hormone-resistant prostatic cancer entered in two prospective trials. The above
      differences in outcome between readily and simply defined prognostic groups are
      greater than the differences one can realistically hope to produce using new
      treatment strategies. These prognostic factors should be taken into account both
      in the design and interpretation of clinical studies dealing with the treatment
      of hormone-resistant progressing prostatic cancer and painful bone metastases.

PMID- 1616890
TI  - Fluorouracil-alone versus high-dose folinic acid and fluorouracil in advanced
      colorectal cancer: a randomized trial of the Italian Oncology Group for Clinical
      Research (GOIRC).
AB  - One hundred eighty-one patients with measurable recurrent or metastatic
      colorectal cancer, who had not received prior chemotherapy, were randomized in a
      prospective controlled trial to receive 5-fluorouracil (5FU), 13.5 mg/kg, for
      five days (arm A) or high-dose folinic acid [Cyanamid-Lederle, Italy] (FA), 200
      mg/m2, for five days and 5FU, 400 mg/m2 for five days (arm B). The treatments
      were repeated every four weeks. One hundred fifty-five patients were evaluable
      for response. The two arms were balanced for all potential prognostic factors
      studied. The response rate (CR+PR) was 18% in the 5FU arm and 16% in the 5FU plus
      FA arm. Median duration of response was 56 weeks for 5FU alone and 42 weeks for
      the combination (p = 0.48). Median time to failure (TTF) was 20 weeks for arm A
      and 21 for arm B (p = 0.62). Median survival was 62 weeks on the 5FU arm and 53
      weeks on the FA plus 5FU arm (p = 0.14). Dose intensity (DI) delivered was the
      same in both arms. Diarrhea and mucositis were the most frequent adverse
      reactions in arm B; 20% of the patients in arm A and 38% of those in arm B
      experienced diarrhea (p = 0.008). Mucositis occurred in 34% of patients in arm A
      and 42% in arm B (p = 0.04). In general nausea and vomiting were moderate.
      Hematological toxicity was more severe in patients treated with 5FU alone: 31% in
      arm A and 14% in arm B developed leukopenia (p = 0.015). In the combination arm
      one patient died due to gastrointestinal and hematological toxicity after the
      seventh cycle. This study indicates that, in advanced colorectal cancer, the
      combination of high-dose FA and 5FU is not superior to 5FU alone when utilized at
      standard high-dose intensity.

PMID- 1616892
TI  - Non-Hodgkin's lymphoma in the elderly. A study of 602 patients aged 70 or older
      from a Danish population-based registry. The Danish LYEO-Study Group.
AB  - Within a 7-year period 1,597 newly diagnosed cases of non-Hodgkin's lymphoma
      (NHL) were included in a Danish population-based NHL registry. Of these, 602
      (38%) were aged 70 years or older (age range 70-94, median: 76.8). They represent
      the population defined as 'elderly' patients in the present study. The average
      annual incidence rate for this elderly patient population was 35.7/10(5), as
      compared with 6.6/10(5) for patients aged less than 70 (overall annual incidence:
      9.5/10(5)). Localised cases (stage I and II) and extranodal manifestations were
      found more frequently among elderly patients. The most common sites of extranodal
      involvement were the stomach (21% of all extranodal cases) and the bone marrow
      (16%). Histologically, follicular centroblastic/centrocytic cases were found to
      be less frequent (p less than 0.01) in elderly patients as compared to their
      younger counterparts (less than 70 years), who in contrast had a lower occurrence
      of diffuse centroblastic cases (p less than 0.01). Overall 7-year survival for
      the elderly patient population was 35% (median 1.7 years), and for patients aged
      less than 70 it was 57%. This difference persisted after correction for
      apparently NHL-unrelated deaths (52% vs. 66%, respectively, p less than 0.0001).
      Elderly patients with poor prognosis were characterised by the following features
      identified in a Cox-regression model: hepatic involvement, presence of B
      symptoms, high-grade histology and elevated s-LDH. The corresponding relative
      risk values were in the order 2.4, 2.2, 1.9 and 1.6.

PMID- 1616891
TI  - Teniposide in advanced breast cancer. A phase II trial in patients with no prior
      chemotherapy.
AB  - The objective response rates were determined using teniposide as first-line
      chemotherapy for patients with recurrent breast cancer. Twenty-seven evaluable
      patients with advanced disease received teniposide 70 mg/m2 i.v. days 1-5 every 3
      weeks. A total of 211 courses were given. Responses included one complete (4%)
      and 9 partial responses (33%) with a median duration of response of 9 months
      (range 2-31 months). The main toxicity was myelosuppression. The results show
      that teniposide has at least modest activity in patients with advanced breast
      cancer treated previously with endocrine therapy.

PMID- 1616893
TI  - Steroid receptor status in malignant and non-malignant larynx.
AB  - We investigated for the first time the relationships among all the different
      steroid receptor classes and between steroid receptor status and lymph node
      involvement in laryngeal carcinoma. Androgen (AR), oestrogen (ER), progesterone
      (PR) and glucocorticoid (GR) receptors were assayed in the high-speed soluble
      fraction and in the nuclear extract from 73 carcinomas of the larynx. Forty-one,
      26, 15, and 13 tumours expressed cytosolic GR, ER, AR, and PR, respectively,
      while 33, 26, 13 and 13 biopsies were nuclear-positive for GR, ER, AR, and PR,
      respectively. Data obtained in histologically-proven non-cancerous larynx (N =
      20) compared to those obtained in the malignant specimens showed a significant
      loss of ER and PR in cancerous larynx over that in the non-cancerous tissue.
      Lymph node metastases were evaluated in only 53 of the 73 patients and they were
      noted in 22 cases (41.5%). No significant relationships were found either among
      the different classes of steroid receptors or between steroid receptors and lymph
      node involvement. Despite the apparent absence of any interrelationships among
      the different receptors or tendency towards metastasis, the presence of steroid
      receptors would justify the use of hormonal manipulations which could be
      effective in the management of this disease.

PMID- 1616895
TI  - Phase II trials of fosquidone (GR63178A) in carcinoma of the breast, head and
      neck, ovary and melanoma.
AB  - A total of 91 eligible patients with metastatic cancer have been treated in a
      series of phase II trials of the novel pentacyclic pyrroloquinone, fosquidone.
      Tumour types were breast (24), ovary (25), head and neck (21) and melanoma (21).
      All patients, except those with melanoma had received prior chemotherapy. The
      drug was given intravenously as a 20 min infusion, at the dose of 120 mg/m2 on
      days 1 to 5 of a 3 week cycle. Treatment was well tolerated; the only significant
      side-effects being mild headaches and generalised musculo-skeletal pains.
      Response was assessed after 2 cycles of therapy. Only one patient (with head and
      neck cancer) achieved an objective partial response, lasting 6 weeks. A total of
      12 patients demonstrated stable disease for a median duration of 15 to 20 weeks.
      Using this schedule of administration, fosquidone has no significant antitumour
      activity in this group of tumours.

PMID- 1616894
TI  - Treatment related psychological distress during adjuvant chemotherapy as a
      conditioned response.
AB  - Patients receiving cycles of cytotoxic chemotherapy for cancer often experience
      noxious side effects following treatments and may develop classically conditioned
      side effects, such as anticipatory nausea and vomiting (ANV) during the course of
      repeated infusions. The present study explored the possibility that classical
      conditioning processes may also contribute to treatment related psychological
      distress. Sixty-six patients, scheduled for adjuvant chemotherapy for breast
      cancer (stages I, II, IIIa), agreed to participate. Patients were assessed in the
      clinic on the first day of every chemotherapy cycle and in their homes three to
      five days before their final cycle. Patients experienced considerable
      psychological distress during the course of chemotherapy, and particularly before
      the first infusion. Prior to the last cycle of chemotherapy, psychological
      distress was significantly higher in the clinic environment than in patients'
      homes. Consistent with classical conditioning, psychological distress did not
      escalate over the days before treatment, but rather increased abruptly when
      patients returned to the clinic. The results of the present study indicate that
      several factors are involved in patients' anticipatory psychological distress and
      highlight the potential contribution that conditioning processes may make to
      patients' emotional distress in the clinic environment.

PMID- 1616896
TI  - Intracranial meningioma with metastatic breast carcinoma.

PMID- 1616897
TI  - Crosslinking of the cell surface immunoglobulin (mu-surrogate light chains
      complex) on pre-B cells induces activation of V gene rearrangements at the
      immunoglobulin kappa locus.
AB  - We constructed an expression vector encoding a truncated Ig mu chain that lacks
      both VH and CH1 domains (mu delta m chain) and introduced the mu delta m vector
      into the Ig negative Abelson pre-B cell line P17-27. The transfectants expressed
      a large amount of the mu delta m chain on their surface, which was not complexed
      with the lambda 5 and VpreB surrogate light chain molecules. While P17-27
      transfected with a vector for the intact micron chain (P17-27 micron) shows V
      kappa rearrangements in culture, V kappa rearrangements were not detected in P17
      27 mu delta m cells. When the mu delta m chains on the cell surface were
      crosslinked by anti-mu antibodies, V kappa gene rearrangements were induced in
      P17-27 mu delta m. These results strongly suggest that crosslinking of the micron
      lambda 5-VpreB complex on the pre-B cell surface generates a signal that
      activates V kappa gene rearrangement, and that the lambda 5 and VpreB molecules
      are necessary for the spontaneous crosslinking of surface Ig on pre-B cells.

PMID- 1616898
TI  - Reversal of in vitro T cell clonal anergy by IL-2 stimulation.
AB  - Stimulation of a normal type I mouse T helper cell clone (TH1) with concanavalin
      A in the absence of antigen presenting cells (APC) in vitro results in the
      induction of a hyporesponsive state known as T cell clonal anergy. This state is
      characterized by a decrease in proliferation following stimulation with antigen
      and APC resulting from a decrease in the production of IL-2. Production of the
      lymphokines IL-3/granulocyte macrophage colony stimulating factor and IFN-gamma
      is also reduced, although to a lesser degree. Stimulation of such anergic cells
      with IL-2 results in proliferation and a complete reversal of the state. We
      demonstrate that this reversal is not due to the outgrowth of a subpopulation of
      cells that had escaped anergy induction, but rather occurs in all the cells.
      Anergy also dissipated spontaneously, although much more slowly, in the absence
      of T cell antigen receptor occupancy. Finally, we show that a similar state can
      be produced by normal activation with antigen and APC if IL-2 and other factors
      are removed at 16-20 h. These results indicate that the anergic state is not a
      permanent change in the TH1 cell. Anergy induction appears to be a consequence of
      the inability of the cell to divide extensively following stimulation through the
      antigen-specific receptor. We propose a model to explain these results in terms
      of a relatively stable negative regulatory factor.

PMID- 1616899
TI  - Secretion and function of the third component of complement (C3) by murine
      leukocytes.
AB  - Our new finding of de novo synthesis and secretion of C3 by both murine
      peritoneal macrophages and polymorphonuclear leukocytes (PMN) was confirmed by
      the incorporation of [35S]methionine into C3 molecules and their complete
      inhibition by cycloheximide. The methods of secretion of C3 from these two types
      of cells were compared by examining the C3 contents in their culture
      supernatants. Completely different modes of secretion were observed, i.e.
      although macrophages synthesize and secrete C3 constitutively, PMN has a
      mechanism to store the already synthesized C3 in the cell and secrete it in
      response to stimuli. Protein kinase C (PKC) activators, e.g. 12-O-tetradecanoyl
      phorbol 13-acetate, dioctanoyl glycerol, and mezerein, as well as calcium
      ionophore A23187 stimulate the secretion of C3 from PMN. These results suggest
      the involvement of PKC and the calmodulin pathway. A very sensitive method for
      measuring C3 activity was developed which enabled us to show for the first time
      that C3 secreted by PMN had opsonizing activity and that particles cultured with
      PMN were phagocytosed effectively.

PMID- 1616900
TI  - The lineage relationship between virgin and memory B cells.
AB  - J11d is expressed on a variety of hemopoietic cells, including B cells. In
      previous studies, we have shown that B cells are heterogeneous with respect to
      their levels of J11d expression and that memory B cells are contained within the
      J11dlo B cell population. In this report, we have further examined the
      relationship between memory precursors and memory cells. We have found that the
      ability of J11dlo B cells from unprimed mice to respond to primary antigenic
      stimulation was generally low; the lowest response occurred following
      immunization with soluble antigen in vitro. Following adoptive transfer into
      irradiated mice and repeated stimulation of these mice with antigen, J11dlo cells
      generated memory responses which were similar to those generated by J11dlo memory
      cells obtained from primed mice. In contrast, J11dhi B cells from unprimed mice
      gave rise to both primary and memory responses, but the memory responses were
      lower than those generated by J11dlo cells. Although the expression of J11d on
      both J11dhi and J11dlo cells from unprimed mice decreased after adoptive
      transfer, J11dlo, as compared to J11dhi, virgin cells proliferated more rapidly.
      These results suggest that memory responses are elaborated predominantly from
      J11dlo virgin cells. Taken together with previous results, our studies indicate
      that, J11dlo B cells are different from J11dhi B cells. Hence, they are either
      memory precursors or are memory cells.

PMID- 1616901
TI  - Does body fatness modify the association between dietary cholesterol and risk of
      coronary death? Results from the Chicago Western Electric Study.
AB  - The hypothesis that body fatness modifies the relation between dietary
      cholesterol and 25-year coronary mortality was examined in a cohort of 1,792
      middle-aged men employed by the Western Electric Company in Chicago. Relative
      risks of coronary death (and 95% confidence intervals) associated with a 225
      mg/day greater intake of dietary cholesterol for men with a subscapular skinfold
      thickness less than or equal to 14, 15-20, and greater than or equal to 21 mm
      were 1.44 (1.10-1.90), 1.07 (0.84-1.36), and 0.95 (0.76-1.20), respectively,
      after adjustment for age; serum total cholesterol level; systolic blood pressure;
      cigarette smoking; family history of cardiovascular disease; evidence of major
      organ system disease at baseline; and intake of saturated fatty acids,
      polyunsaturated fatty acids, energy, and ethanol. Adjusted relative risks
      associated with a 15-mm greater subscapular skinfold thickness for men with a
      dietary cholesterol intake less than or equal to 649, 650-799, and greater than
      or equal to 800 mg/day were 1.76 (1.04-2.98), 1.64 (1.04-2.57), and 1.00 (0.69
      1.55), respectively. Fatter men apparently did not benefit from a diet lower in
      cholesterol, while men who ate a diet high in cholesterol apparently did not
      benefit from leanness. These results support the hypothesis that body fatness
      modifies the relation between dietary cholesterol and coronary mortality, perhaps
      because leaner men are more responsive than fatter men to the effects of dietary
      cholesterol on the concentration of low density lipoprotein cholesterol.

PMID- 1616902
TI  - Accelerated cholesterol accumulation in homologous arterial transplants in
      cholesterol-fed rabbits. A surgical model to study transplantation
      atherosclerosis.
AB  - Accelerated coronary artery disease has become a major complication to heart
      transplantation in humans. Therefore, we have developed a surgical model in the
      rabbit, with transplantation of the thoracic aorta as a bypass graft onto the
      abdominal aorta of another rabbit. The model permits the study of cholesterol
      metabolism in transplanted arteries. The graft did not accumulate cholesterol for
      as long as 298 days, provided that the rabbits were normocholesterolemic, i.e.,
      with plasma cholesterol levels of 0.3-0.7 mmol/l. However, after a few weeks of
      cholesterol feeding resulting in plasma cholesterol levels of 2-5 mmol/l, the
      homologous graft accumulated cholesterol compared with intact aortic tissue in
      the rabbits and also compared with autologous aortic grafts. The intimal
      clearance of plasma cholesteryl ester, mainly high density lipoprotein
      cholesteryl ester, in the luminal layer of the aortic graft was 60-150 nl x cm-2
      x hr-1 1-2 hours after transplantation. The intimal clearance in the
      corresponding intact thoracic aorta of the recipient animal was 5-20 nl x cm-2 x
      hr-1. The values were 1,500-3,000 nl x cm-2 x hr-1 51-298 days after
      transplantation, while the intimal clearance of the rabbit's own aorta remained
      unchanged. A pronounced increase in plasma lipoprotein permeability is thus an
      early event in transplanted arteries. It results in a higher cholesteryl ester
      influx that leads to cholesterol accumulation in the artery, but only if the
      rabbits are fed a cholesterol-enriched diet. This rabbit model may be useful in
      the search for interventional measures to prevent or diminish the accelerated
      coronary artery disease in transplanted hearts in humans.

PMID- 1616903
TI  - Determinants of plasma fibrinogen: relation to body weight, waist-to-hip ratio,
      smoking, alcohol, age, and sex. Results from the second MONICA Augsburg survey
      1989-1990.
AB  - In the second World Health Organization MONItoring Trends and Determinants in
      CArdiovascular Disease (MONICA) Augsburg survey in 1989-1990 (n = 4,940), the
      association between nephelometric plasma fibrinogen level and lifestyle-related
      potential determinants was assessed in 4,434 subjects aged 25-74 years (89.8% of
      participants). Irrespective of pregnancy and the use of oral contraceptives,
      crude fibrinogen values were consistently higher in women than in men of all ages
      (age-standardized difference, 12.2 mg/dl; 95% confidence interval, 7.0-17.4
      mg/dl). Fibrinogen concentrations were positively correlated (p less than or
      equal to 0.0001) with age, body mass index, and waist-to-hip ratio in both sexes
      and with cigarette smoking in men and were negatively correlated with alcohol
      consumption in both sexes. In multiple linear regression analyses using
      categorized determinants as independent variables, a strongly J-shaped relation
      for body mass index in women and a linear association for waist-to-hip ratio in
      men were revealed. Smoking had a dose-dependent effect on fibrinogen
      concentration in men but a lesser effect in women. For alcohol consumption a U
      shaped association was found, particularly in men. The curvilinear relations were
      confirmed in multiple polynomial regression models using continuous determinant
      variables. The potential epidemiological impact of a determinant was assessed by
      calculating differences in adjusted fibrinogen concentrations associated with the
      10th and 90th percentile values of the determinant distributions actually
      observed among the study participants. This impact on the population fibrinogen
      level was most pronounced for age in both sexes, followed by body mass index,
      cigarette smoking, and alcohol consumption in women and by smoking, waist-to-hip
      ratio, and alcohol consumption in men.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616904
TI  - Induction of arteriosclerosis in normocholesterolemic rabbits by immunization
      with heat shock protein 65.
AB  - Previous studies have established the presence of high numbers of activated T
      lymphocytes and "aberrant" expression of major histocompatibility complex class
      II antigens by endothelial and smooth muscle cells in human atherosclerotic
      lesions, implicating the involvement of a local cellular immune response. The
      identity of the antigen(s) eliciting this immune response, the extent of their
      effect, and the atherogenic stage at which they occur remain to be determined. In
      the present studies, 120 normocholesterolemic New Zealand White rabbits were
      immunized one or more times with various antigens, with or without adjuvants. The
      antigens and adjuvants included human or rabbit atherosclerotic lesion proteins,
      ovalbumin, Freund's complete and/or incomplete adjuvants, recombinant
      mycobacterial heat shock protein 65 (hsp65), and two hsp-free adjuvants, Ribi
      complete adjuvant and lipopeptide. In addition, some groups received a high
      cholesterol diet. Sixteen weeks after the first immunization the animals were
      killed, and arteriosclerotic lesions in the intima of the aortic arch were found
      to have developed only in those animals immunized with antigenic preparations
      containing hsp, either in the form of whole mycobacteria or as purified
      recombinant hsp65, although their serum cholesterol levels were normal. No
      arteriosclerotic changes exceeding those of controls were found in the other
      groups, irrespective of the antigen used. Immunohistopathologic examination
      revealed that the lesions contained 20% T cells, 10-30% macrophages, and 10-40%
      smooth muscle cells. Analysis of the peripheral blood T-lymphocyte proliferative
      responses revealed that the occurrence of lesions was positively correlated with
      the presence of hsp65-reactive T cells, suggesting that hsp65 is involved in the
      induction of arteriosclerotic lesions. Furthermore, combined immunization with
      hsp-containing material and a cholesterol-rich diet provoked development of
      significantly more severe atherosclerosis and the appearance of characteristic
      foam cells. We conclude that an (auto)immune response to hsp may initiate the
      development of atherosclerosis and that a high blood cholesterol level is only
      one albeit a very important risk factor.

PMID- 1616905
TI  - Mechanisms controlling competence gene expression in murine fibroblasts
      stimulated with minimally modified LDL.
AB  - Mildly oxidized low density lipoprotein (minimally modified low density
      lipoprotein [MM-LDL] is capable of inducing gene expression in cells of the
      artery wall. In this study, we investigated the mechanisms that control the mRNA
      expression of JE, KC, c-myc, and c-fos in quiescent mouse L-cell fibroblasts
      stimulated with MM-LDL. The data demonstrate that MM-LDL induces increases
      greater than or equal to 20-fold in the levels of transcripts of these genes
      within 15-60 minutes. Of the four genes examined, JE and KC mRNA showed the
      greatest response to MM-LDL. The pattern of induction by MM-LDL is distinct from
      that observed in fibroblasts stimulated with serum, a known inducer of these
      genes. Treatment with cycloheximide (10 micrograms/ml) did not block the MM-LDL
      induced increase in the mRNA levels of these genes. The increase of JE and KC
      mRNA levels in response to MM-LDL could be blocked by treatment with actinomycin
      D (5 micrograms/ml). In nuclear runoff studies, MM-LDL increased the
      transcription rate of JE and KC at 4 hours by 13-fold and fivefold, respectively.
      Small but reproducible stimulations of c-fos and c-myc transcription by MM-LDL
      were also observed. In addition, the half-life of JE mRNA was increased after
      addition of MM-LDL to fibroblasts, suggesting that the MM-LDL-induced
      accumulation of these mRNAs might be accomplished by both transcriptional and
      posttranscriptional mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616906
TI  - Reduced HDL2 cholesterol subspecies and elevated postheparin hepatic lipase
      activity in older men with abdominal obesity and asymptomatic myocardial
      ischemia.
AB  - Silent myocardial ischemia (SI), an asymptomatic manifestation of coronary artery
      disease (CAD), was identified in 10% of apparently healthy nonsmoking,
      nondiabetic older (60 +/- 7 years, mean +/- SD) men with normal plasma
      cholesterol levels. We hypothesized that in the absence of other major risk
      factors for CAD, the men with SI would have reduced plasma levels of high density
      lipoprotein (HDL) and HDL2 subspecies due to an upper-body fat distribution
      (waist-to-hip ratio [WHR]), hyperinsulinemia, and abnormal postheparin plasma
      lipoprotein lipase (LPL) and hepatic lipase (HL) activities. Compared with 47
      normal control subjects of similar age, obesity, and maximal aerobic capacity,
      the 18 men with SI had higher plasma triglyceride (TG) (162 +/- 71 versus 102 +/-
      39 mg/dl, p less than 0.001) and lower HDL-C (33 +/- 6 versus 37 +/- 7 mg/dl, p
      less than 0.02) levels with no difference in low density lipoprotein cholesterol
      level. The HDL2b and HDL2a subspecies measured by gradient gel electrophoresis
      were also lower in the men with SI (p less than 0.01). The plasma glucose and
      insulin responses during an oral glucose tolerance test were the same in both
      groups. Postheparin plasma HL activity was significantly higher in 12 men with SI
      than in 41 control subjects (34 +/- 8 versus 27 +/- 10 mumol/ml.hr-1, p less than
      0.03) and was correlated with log insulin area (r = 0.36, p less than 0.05) and
      WHR (r = 0.32, p less than 0.05) in the control subjects but not in the men with
      SI. In the control group, the percent HDL2b subspecies was correlated inversely
      with postheparin plasma HL activity (r = -0.46, p less than 0.01, n = 41) as well
      as WHR (r = -0.49, p less than 0.001, n = 47) and log insulin area (r = -0.37, p
      less than 0.05, n = 47) but not in the men with SI. Postheparin LPL activity was
      the same in both groups of men and did not correlate with HDL, WHR, insulin, or
      plasma TG levels. As the control subjects and men with SI had comparable degrees
      of abdominal obesity and hyperinsulinemia, these results suggest that the reduced
      HDL-C levels in men with SI may be related to elevations in HL activity. Thus,
      abdominal obesity, hyperinsulinemia, elevated TG levels, and low HDL-C and HDL2
      subspecies levels may predispose these older men to atherosclerosis.

PMID- 1616907
TI  - Superoxide-dependent stimulation of leukocyte adhesion by oxidatively modified
      LDL in vivo.
AB  - Low density lipoprotein modified by oxidation (Ox-LDL) causes adhesion of
      leukocytes to the endothelium, a feature common in early atherogenesis. Because
      leukocyte adhesion under various pathophysiological conditions involves
      superoxide generation, we explored the possibility that superoxide is likewise
      involved in leukocyte adhesion in response to Ox-LDL. For our studies, we used
      the dorsal skin fold chamber model for intravital microscopic observation of
      leukocyte-endothelium interactions in hamsters. We show here that injection of
      human LDL (4 mg/kg LDL cholesterol oxidatively modified by incubation in 7.5
      microM Cu2+ for 18 hours at 37 degrees C) elicited in control hamsters (n = 7)
      the rolling and adhesion of circulating leukocytes along the endothelium of
      arterioles and postcapillary venules. This adhesion was significantly attenuated
      when hamsters were pretreated with bovine copper-zinc-superoxide dismutase (CuZn
      SOD, 0.25 mg/kg, n = 7) or heparin (2,000 IU/kg, n = 7). The CuZn-SOD infusion
      and the heparin-induced release of extracellular SOD from endothelial cell
      surfaces to plasma resulted in nearly equal plasma SOD activities. Further
      inhibition of Ox-LDL-induced leukocyte adhesion could not be achieved by
      increasing the dose of CuZn-SOD to 5 mg/kg (n = 6). Pretreatment of the hamsters
      with inactivated CuZn-SOD showed no effect. These results indicate that Ox-LDL
      stimulates leukocyte adhesion through a superoxide-dependent step, and they
      indicate a possible mechanism by which antioxidants might inhibit the onset of
      experimental and clinical atherosclerosis.

PMID- 1616908
TI  - Effect of dietary olive and sunflower oils on the lipid composition of the aorta
      and platelets and on blood eicosanoids in rats.
AB  - The effects on aortic and platelet fatty acid compositions and on blood levels of
      prostacyclin and thromboxane A2 of low- and high-fat diets containing olive oil
      or sunflower oil were studied. For 4 weeks, four groups of weanling rats were fed
      a basal diet containing 5% or 25% olive oil or sunflower oil. Rats fed olive oil
      diets showed higher levels of 18:1(n-9) and polyunsaturated fatty acids of the n
      3 series and lower percentages of 18:0 and 18:2(n-6) in aortic and platelet
      phosphatidylcholine and phosphatidylethanolamine than those fed the sunflower oil
      diets. Arachidonic acid increased in platelet phosphatidylethanolamine and aortic
      phosphatidylcholine of rats fed the diet containing 5% sunflower oil compared
      with those fed 5% olive oil. Plasma 6-ketoprostaglandin F1 alpha increased in
      both groups of animals fed olive oil while these rats also showed the lowest
      levels of serum thromboxane B2 and plasma cholesterol. Olive oil feeding leads to
      changes in lipid metabolism of the vascular compartment that could be favorable
      in the prevention of thrombosis and atherosclerosis.

PMID- 1616909
TI  - Vascular endothelial cell proteoglycans are susceptible to cleavage by
      neutrophils.
AB  - Heparan sulfate proteoglycan associated with vascular endothelial cells in vivo
      plays an important role in a number of endothelial functions, including the
      inhibition of intravascular coagulation and extravasation of plasma proteins and
      blood cells. In this report, we demonstrate that polymorphonuclear neutrophils,
      as well as cell-free neutrophil supernatants, lead to a rapid and dramatic loss
      of proteoglycan from endothelial cells in the absence of evidence of cell lysis.
      This cleavage appears to be relatively (although not absolutely) selective for
      heparan sulfate and is mediated by neutrophil-derived serine proteases.
      Inhibitors of neutrophil elastase appear to be the most effective inhibitors of
      proteoglycan release. Furthermore, purified human neutrophil elastase also leads
      to cleavage of cellular proteoglycans, although not to the same extent as
      neutrophils or neutrophil supernatants. Proteoglycans compared with all other
      protein-containing macromolecules appear to be especially vulnerable to
      neutrophil-mediated cleavage. The results of this study may be germane to the
      interaction of neutrophils with endothelium during the inflammatory process,
      during which the loss of endothelial heparan sulfate proteoglycan may play a
      critical role in the vascular injury that often accompanies inflammation.

PMID- 1616910
TI  - In vivo metabolism of apolipoprotein A-I in a patient with homozygous familial
      hypercholesterolemia.
AB  - Familial hypercholesterolemia (FH), caused by a defect in the low density
      lipoprotein (LDL) receptor, results in high plasma concentrations of LDL
      cholesterol due to both overproduction and delayed catabolism of LDL. FH is also
      associated with significantly lower levels of plasma high density lipoprotein
      cholesterol and apolipoprotein (apo) A-I in both heterozygous and homozygous
      patients. However, the metabolic basis of the hypoalphalipoproteinemia in FH has
      not been elucidated. We investigated the kinetics of apo A-I in a homozygous FH
      patient and two normal control subjects by using endogenous labeling with a
      stable isotopically labeled amino acid. Study subjects were administered a primed
      constant infusion of 13C6-phenylalanine for 12 hours. Apolipoproteins were
      isolated from plasma drawn at selected time points and analyzed for their
      isotopic enrichment by gas chromatography-mass spectrometry. The fractional
      catabolic rate of apo A-I in the FH subject was found to be substantially
      increased (0.38 day-1) compared with that of the normal subjects (mean, 0.26 day
      1). In addition, the apo A-I production rate was decreased in the FH subject (6.5
      mg/kg.day-1) compared with the normal subjects (mean, 11.1 mg/kg.day-1). In
      conclusion, the low levels of high density lipoprotein cholesterol and apo A-I in
      this homozygous FH patient are due to the combined metabolic defects of increased
      apo A-I catabolism and decreased apo A-I production.

PMID- 1616912
TI  - March 1991 meeting of the Israel Physiological and Pharmacological Society.
      Abstracts.

PMID- 1616913
TI  - April 1992 meeting of the Israel Physiological and Pharmacological Society.
      Abstracts.

PMID- 1616911
TI  - Transport of HDL cholesterol esters to the liver is not diminished by probucol
      treatment in rats.
AB  - This study examined the relation of decreased high density lipoprotein (HDL)
      levels in probucol-fed rats and the transport of HDL cholesterol esters (CEs) to
      the liver. HDLs from both control rats and rats fed 1% probucol for 3 weeks were
      doubly labeled in their CE and apolipoprotein A-I moieties with intracellularly
      trapped tracers and then intravenously injected into probucol-fed or control rats
      for determination of plasma decay kinetics and sites of tracer uptake. Results
      for HDL from control and probucol-fed rats were not different. The fractional
      catabolic rate (FCR) of plasma HDL CE was significantly increased by probucol
      feeding (23%) so that mass transport of HDL CE through the plasma compartment was
      not significantly different from that in control rats. The plasma FCR for
      apolipoprotein A-I did not change. Similarly, the FCR for uptake of HDL CE by the
      liver increased on probucol feeding (20%), resulting in a near-normal rate of HDL
      CE mass uptake, whereas the FCR for HDL particle uptake (measured by
      apolipoprotein A-I uptake) did not change. Thus, the maintenance of near-normal
      HDL CE uptake by the liver was exclusively due to increased selective uptake
      (32%). To the extent that hepatic uptake of HDL CE mediates reverse cholesterol
      transport, that process was not significantly compromised in rats fed 1%
      probucol.

PMID- 1616914
TI  - Biomembranes.

PMID- 1616915
TI  - Avidin-induced lysis of biotinylated erythrocytes by homologous complement via
      the alternative pathway depends on avidin's ability of multipoint binding with
      biotinylated membrane.
AB  - It was reported that avidin and streptavidin induce lysis of prebiotinylated red
      blood cells via the alternative pathway of both homologous and heterologous
      complement. Both of these proteins have four biotin-binding sites, providing a
      polyvalent interaction with biotinylated components of the erythrocyte membrane.
      We have compared the effects of mono- and multipoint avidin attachment on the
      sensitivity of biotinylated erythrocytes to lysis by the complement system. In
      the presence of anti-avidin antibody, avidin-bearing biotinylated erythrocytes
      were rapidly lysed by heterologous serum. This lysis was independent from the
      mode of avidin attachment, implying that complement activation by the classical
      pathway triggered by interaction between C1 and avidin-bound antibody on the
      erythrocyte surface is independent from the avidin's ability of polyvalent
      (multipoint) binding with biotinylated membrane components. In the absence of
      anti-avidin antibody, biotinylated erythrocytes bearing polyvalently attached
      avidin were lysed by homologous complement better than cells bearing avidin,
      which possesses reduced ability for multipoint binding with biotinylated
      erythrocyte. Two independent approaches to reduce avidin's ability of multipoint
      binding were used: decrease in surface density of biotin on the erythrocyte
      membrane and blockage of biotin-binding sites of avidin. Both methods result in
      reduced lysis of avidin-bearing erythrocytes as compared with erythrocytes
      bearing an equal amount of polyvalent-bound avidin. Thus the activation of
      homologous complement via the alternative pathway depends on avidin's ability to
      'cross-link' to the biotinylated components of the erythrocyte membrane.

PMID- 1616916
TI  - NADH-activated cell-free transfer between Golgi apparatus and plasma membranes of
      rat liver.
AB  - This report concerns development of a cell-free system from rat liver to study
      transport of membrane constituents from the Golgi apparatus to the plasma
      membrane. Highly purified Golgi apparatus as donor and a mixture of sheets and
      vesicles as plasma membrane acceptor fractions were combined to analyze
      requirements for lipid and protein transport. In the reconstituted system, the
      Golgi apparatus donor was in suspension. To measure transfer, membrane
      constituents of the donor membranes were radiolabeled with [3H]acetate (lipids)
      or [3H]leucine (proteins). The plasma membrane vesicles were used as the acceptor
      and were unlabeled and immobilized on nitrocellulose for ease of recovery and
      analysis. The reconstituted cell-free transfer was dependent on temperature, but
      even at 37 degrees C, the amount of transfer did not increase with added ATP, was
      not specific for any particular membrane fraction or subfraction nor was it
      facilitated by cytosol. ATP was without effect both in the presence or absence of
      a cytosolic fraction capable of the support of cell-free transfer in other
      systems. In contrast to results with ATP, NADH added to the reconstituted system
      resulted in an increased amount of transfer. A further increase in transfer was
      obtained with NADH plus a mixture of ascorbate and dehydroascorbate to generate
      ascorbate free radical. The transfer of labeled membrane constituents from the
      Golgi apparatus to the plasma membrane supported by NADH plus ascorbate radical
      was stimulated by a cytosol fraction enriched in less than 10 kDa components.
      This was without effect in the absence of NADH/ascorbate radical or with ATP as
      the energy source. Specific transfer was inhibited by both N-ethylmaleimide and
      GTP gamma S. The findings point to the possibility of redox activities associated
      with the trans region of the Golgi apparatus as potentially involved in the
      transport of membrane vesicles from the Golgi apparatus to the cytoplasmic
      surface of the plasma membrane.

PMID- 1616917
TI  - Vanadium-induced Cl(-)-secretion in rabbit descending colon is mediated by
      prostaglandins.
AB  - Vanadium in the 4+ (vanadyl-ion) and 5+ (vanadate-ion) oxidation state stimulates
      furosemide-sensitive electrogenic Cl- secretion in isolated epithelia of rabbit
      descending colon. This effect is associated with an increased release of
      prostaglandin E2 from the tissue. Inhibitors of phospholipase A2 or
      cyclooxygenase abolish both vanadium-induced release of prostaglandin E2 and Cl-
      secretion. Neuronal mechanisms are not likely to be involved, as tetrodotoxin
      does not affect the vanadate induced Cl- secretion. Although vanadate is known to
      inhibit Na+,K(+)-ATPase activity, no inhibition of active Na+ transport was
      observed in intact colonic epithelia suggesting a rapid intracellular reduction
      of vanadate ions to vanadyl ions which have no inhibitory effect on the Na+,K(+)
      ATPase. The present findings therefore indicate that vanadate stimulated colonic
      Cl- secretion involves intracellular conversion of vanadate to vanadyl and
      release of prostaglandin E2.

PMID- 1616918
TI  - Lipid-drug interaction: a structural analysis of pindolol effects on model
      membranes.
AB  - The ternary system constituted by distearoylphosphatidylcholine, pindolol (a
      vasodilator drug) and water has been investigated by using X-ray diffraction and
      calorimetric techniques. The structural modifications induced by the drug have
      been determined and a possible interaction model has been derived. In particular,
      the pindolol content-temperature dependent phase diagram shows the occurrence of
      two new phases: the first is an interdigitated gel, and the second is a lamellar
      structure presenting an unusual mixed disordered-ordered conformation of the
      hydrocarbon chains (L alpha beta). The comparative analysis of electron density
      profiles relative to the L alpha beta phase, reveals significant modifications in
      the paraffinic region of the lipid layer. In agreement with thermodynamic
      results, the structural data suggest that the drug induces a stiffening and a
      tightening of the hydrocarbon chains. Moreover, the hydrophilic properties of the
      membrane (particularly in P beta, and L alpha beta phases) present an evident
      dependence with the drug concentration.

PMID- 1616920
TI  - Efflux of potassium (86Rb+) attenuates the volume-restorative effect of sodium
      amino acid cotransport in rat renal inner medullary cells shrunken by exposure to
      hyperosmotic media.
AB  - When the osmolality of the bathing medium was increased from 710 to 2000
      mosmol/kg H2O, cells in incubated slices of rat renal inner medulla lost water
      and K+, and the rate of efflux of preloaded 86Rb+ (a tracer for K+) was
      significantly depressed. Addition of 2-aminoisobutyric acid (AIB, 10 mmol/l)
      partly restored cell water content but without re-accumulation of K+; the rate of
      86Rb+ efflux was greatly increased. The presence of Ba2+ (1 mmol/l) or
      trifluoperazine (50 mumol/l) led to complete recovery of cell volume and K+
      contents, with markedly reduced efflux of 86Rb+. Neither additive had any
      significant effect upon these variables in the absence of AIB or in media of 710
      mosmol/kg. Efflux of 86Rb+ was pH-sensitive within the physiological range, and
      was depressed when external AIB was reduced below approx. 5 mmol/l. When external
      Na+ was increased from 145 to 500 mmol/l (total osmolality 350 to 2500 mosmol/kg)
      efflux was retarded only slightly if AIB was present, but markedly if AIB was
      omitted. Inner medullary cells may contain a class of Ba(2+)-inhibitable,
      calmodulin-dependent K+ conductive pathway which is activated in strongly
      hyperosmotic media by the operation of an inwardly-directed Na(+)-amino acid
      symport (cf. Law, R.O. (1988) Pflugers Arch. 413, 43-50) and which serves to
      moderate the volume-restorative effect of this membrane mechanism.

PMID- 1616919
TI  - The Na(+)-Ca2+ exchanger activity in cerebrocortical nerve endings is reduced in
      old compared to young and mature rats when it operates as a Ca2+ influx or efflux
      pathway.
AB  - The activity of the Na(+)-Ca2+ exchanger, which regulates the entry and the
      extrusion of Ca2+ ions from nerve endings was investigated in Percoll-purified
      cerebrocortical synaptosomes of aged rats. 45Ca2+ uptake in a Na(+)-free medium
      and 45Ca2+ efflux in a 145 mM Na+ medium were significantly reduced in
      cerebrocortical synaptosomes from aged rats (24 months) as compared to those
      occurring in young (4 months) and mature (14 months) rats. 45Ca2+ influx induced
      by 55 mM K+, a concentration of K+ ions which selectively promotes Ca2+ entry
      through voltage-sensitive Ca2+ channels (VSCC), was significantly reduced in
      mature and aged rats as compared to that occurring in young rats. The impairment
      of these mechanisms in aged rats is not accompanied by any variation of fura-2
      monitored Ca2+ levels under resting and depolarizing conditions.

PMID- 1616921
TI  - Exocytosis upon osmotic swelling in human epithelial cells.
AB  - Upon osmotic swelling human epithelial cells exhibited significant increases in
      the membrane capacitance. Evidence for exocytosis includes its dependency on
      temperature, cytosolic Ca2+ and ATP as well as its sensitivity to guanosine 5'-O
      (3-thio)triphosphate (GTP gamma S) and N-ethylmaleimide (NEM). A role of the
      osmotic exocytosis in the subsequent cell volume regulation is suggested.

PMID- 1616922
TI  - Behaviour of a glycosphingolipid with unsaturated fatty acid in
      phosphatidylcholine bilayers.
AB  - N-(Oleoyl)galactosylceramide with perdeuterated acyl chain was prepared by
      partial synthesis, and studied by wide line 2H-NMR in phospholipid liposomes.
      Spectra were obtained for low glycolipid concentrations in bilayers of
      dimyristoyl-, distearoyl-, and 1-palmitoyl-2-oleoylphosphatidylcholines. In an
      attempt to isolate the effects of glycosphingolipid fatty acid cis unsaturation
      on glycolipid behaviour in membranes, spectral findings related to the above
      species were compared to literature NMR data for pure 1-palmitoyl-2
      oleoylphosphatidylcholine bilayers in which the oleoyl chain of the phospholipid
      had been deuterated, and to analogously deuterated glycerol based lipids in
      Acholeplasma laidlawii membranes. The results for N-(oleoyl
      d33)galactosylceramide proved to be qualitatively and quantitatively very similar
      to published data dealing with glycerol based lipids at comparable temperatures.
      In addition, the results were strikingly similar for glycolipids dispersed in
      saturated and unsaturated phospholipid host matrices. It would appear that the
      primary effects of cis 9,10 fatty acid unsaturation in glycosphingolipids (at low
      concentration in fluid phospholipid membranes) are the same as those of fatty
      acid cis unsaturation in glycerolipids. It further appears that the overall
      dynamic behaviour of N-(oleoyl)galactosylceramide in fluid phospholipid membranes
      is very similar to that of glycerolipids with comparable acyl chains.

PMID- 1616923
TI  - Isoprenoid modification of proteins distinct from membrane acyl proteins in the
      prokaryote Acholeplasma laidlawii.
AB  - Isoprenylation is an important posttranslational modification that affects the
      activity, subunit interactions and membrane anchoring of different eukaryotic
      proteins. The small, cell-wall-less prokaryote Acholeplasma laidlawii has more
      than 20 membrane acyl-proteins enriched in myristoyl and palmitoyl chains.
      Radioactive mevalonate, a precursor to isoprenoids, was incorporated into several
      specific membrane proteins of 20 to 45 kDa and two soluble proteins of 23-25 kDa,
      respectively. No acyl proteins and none of the polar acyl lipids became labelled
      but these are all labelled by radioactive fatty acids. Mevalonate was
      incorporated mainly into a minor neutral, non-saponifiable lipid which migrated
      just above a C30-isoprenoid (squalene) on TLC-plates. The isoprenoid chains could
      not be released by mild alkaline hydrolysis from most of the isoprenylated
      proteins, although this procedure releases acyl chains from lipids and all
      acylated proteins. Isoprenylated proteins were enriched in the detergent phase
      upon partition with the non-ionic detergent Triton X-114. This behaviour is
      similar to the acyl proteins of this organism and indicates that the isoprenoid
      chains give the proteins a hydrophobic character.

PMID- 1616924
TI  - Effects of lung surfactant proteolipid SP-C on the organization of model membrane
      lipids: a fluorescence study.
AB  - Lipid-protein interactions of pulmonary surfactant-associated protein SP-C in
      model DPPC/DPPG and DPPC/DPPG/eggPC vesicles were studied using steady-state and
      time-resolved fluorescence measurements of two fluorescent phospholipid probes,
      NBD-PC and NBD-PG. These fluorescent probes were utilized to determine SP-C
      induced lipid perturbations near the bilayer surface, and to investigate possible
      lipid headgroup-specific interactions of SP-C. The presence of SP-C in DPPC/DPPG
      membrane vesicles resulted in (1) a dramatic increase in steady-state anisotropy
      of NBD-PC and NBD-PG at gel phase temperatures, (2) a broadening of the gel-fluid
      phase transition, (3) a decrease in self-quenching of NBD-PC and NBD-PG probes,
      and (4) a slight increase in steady-state anisotropy of NBD-PG at fluid phase
      temperatures. Time-resolved measurements, as well as steady-state intensity
      measurements indicate that incorporation of SP-C into DPPC/DPPG or
      DPPC/DPPG/eggPC vesicles results in a increase in the fraction of the long
      lifetime species of NBD-PC. The results presented here indicate that SP-C orders
      the membrane bilayer surface, disrupts acyl chain packing, and may increase the
      lateral pressure within the bilayer.

PMID- 1616925
TI  - Lateral conductance parallel to membrane surfaces: effects of anesthetics and
      electrolytes at pre-transition.
AB  - The effects of dilute salts and anesthetics were studied on the impedance
      dispersion in the dipalmitoylphosphatidylcholine (DPPC) liposomes. Below the pre
      transition temperature, the apparent activation energy for conductance in DPPC
      H2O without salts was equivalent to pure water, 18.2 kJ mol-1. This suggests that
      the mobile ions (H3O+ and OH-) interact negligibly with the lipid surface below
      the pre-transition temperature. At pre-transition temperature, the apparent
      activation energy of the conductance decreased by the increase in the DPPC
      concentrations. The effects of various salts (LiCl, NaCl, KCl, KBr, and KI) on
      the apparent activation energy of the conductance were studied. Changes in
      anions, but not in cations, affected the activation energy. The order of the
      effect was Cl- less than Br- less than I-. Cations appear to be highly
      immobilized by hydrogen bonding to the phosphate moiety of DPPC. The smaller the
      ionic radius, the more ions are fixed on the surface at the expense of the free
      moving species. The apparent activation energy of the transfer of ions at the
      vesicle surface was estimated from the temperature-dependence of the dielectric
      constant, and was 61.0 kJ mol-1 in the absence of electrolytes. In the presence
      of electrolytes, the order of the activation energy was F- greater than Cl-
      greater than Br- greater than I-. When the ionic radius is smaller, these anions
      interact with the hydration layer at the vesicle surface and the ionic transfer
      may become sluggish. In the absence of electrolytes, the apparent activation
      energy of the dielectric constant decreased by the increase in halothane
      concentrations. In the presence of electrolytes, however, the addition of
      halothane increased the apparent activation energy. We propose that the
      adsorption of halothane on the vesicle surface produces two effects: (1)
      destruction of the hydration shell, and (2) increase in the binding of
      electrolytes to the vesicle surface. In the absence of electrolytes, the first
      effect predominates and the apparent activation energy is decreased. In the
      presence of electrolytes, the latter effect predominates and the apparent
      activation energy is increased.

PMID- 1616926
TI  - Effects of alkyl glycosides incorporated into liposomes prepared from synthetic
      amphiphiles on their tissue distribution in Ehrlich solid tumor-bearing mice.
AB  - A study of the effects of alkyl glycosides incorporated into synthetic liposomes
      with respect to their stability, their in vivo distribution in Ehrlich solid
      tumor-bearing mice and their in vitro interaction with liver cells was
      undertaken. The synthetic liposomes were prepared from N,N-didodecyl-N alpha-[6
      (trimethylammonio)hexanoyl]-L-alaninamide bromide (N+C5Ala2C12) and labeled with
      99mTc. n-Dodecyl glucoside (DG) and n-dodecyl sucrose (DS) were used as alkyl
      glycosides. The stability was hardly changed by incorporation of alkyl glycosides
      into the liposomes in saline and serum. The uptake of DG- and DS-modified
      N+C5Ala2C12 liposomes decreased in liver and spleen compared with that of
      unmodified N+C5Ala2C12 liposomes, resulting in an increase in blood and other
      tissues such as tumor, duodenum and kidney, where the DS-modified N+C5Ala2C12
      liposomes had a marked tendency. It was observed with electron micrographs that
      the size of N+C5Ala2C12 liposomes became small by incorporation of alkyl
      glycoside. The smaller N+C5Ala2C12 liposomes were found to result in the lower
      uptake in liver. The interaction of the liposomes with liver cells in vitro
      indicated that both DG- and DS-modified liposomes had a low affinity for liver
      cells compared with the unmodified liposomes and the extent of interaction of the
      DS-modified liposomes was weaker than that of the DG-modified liposomes.

PMID- 1616927
TI  - Ontogeny of proximal colon basolateral membrane lipid composition and fluidity in
      the rabbit.
AB  - Basolateral membranes from rabbit proximal colon were prepared from isolated
      colonocytes throughout postnatal maturation, using a modification of published
      techniques. In suckling (14-20 day) and post-weaning/mature (35-49 day) animals,
      membranes were purified approx. 10-fold, based upon the enrichment of ouabain
      sensitive, sodium-potassium dependent adenosine triphosphatase activity. Membrane
      lipid analyses demonstrated age-dependent increases in total cholesterol and the
      cholesterol/phospholipid molar ratio, as well as decreases in
      phosphatidylethanolamine content and the fatty acid unsaturation index. Fluidity
      of basolateral membranes and membrane liposomes, determined from fluorescence
      anisotropy measurements using the lipid probes 1,6-diphenyl-1,3,5-hexatriene and
      DL-12-(9-anthroyl)stearic acid, demonstrated significant, ontogenic decreases in
      fluidity; and, additional studies showed that fluidity changes occurred early in
      the weaning period (by day 24 postnatally). Arrhenius plots of liposome
      anisotropies suggested a bilayer lipid thermotropic transition temperature of 22
      degrees C in sucklings 26 degrees C in mature rabbits. These findings demonstrate
      that ontogeny of colonic basolateral membranes is associated with significant
      modulations in lipid composition and fluidity.

PMID- 1616928
TI  - Low-temperature phase behaviour of the major plant leaf lipid
      monogalactosyldiacylglycerol.
AB  - Heating and cooling thermograms of unsaturated MGDG samples isolated from the
      leaves of Vicia faba are surprisingly featureless. This reflects the low
      enthalpies associated with phase transitions in highly unsaturated lipids and the
      fact that these transitions, in the case of MGDG, are to a large extent masked by
      those associated with the freezing and melting of ice. Careful choice of thermal
      heating/cooling regimes, combined with the use of real-time X-ray diffraction and
      freeze-fracture measurements, permits a detailed analysis of the phase behaviour
      of the system. The phase behaviour of unsaturated MGDG samples is shown to be
      basically similar to that seen in saturated MGDG samples. The lipid which exists
      in the inverted hexagonal (HexII) liquid crystal phase at room temperature forms
      a highly disordered lamellar gel (L beta) phase on cooling to temperatures below
      about -15 degrees C. On reheating, this first reorganizes at a temperature of
      about -10 degrees C to form a well-defined Lc1 phase. Above about -2 degrees C,
      this melts to re-form the HexII phase. Samples re-cooled from temperatures
      between -2 degrees C and 14 degrees C revert directly to the Lc1 phase while
      samples cooled from higher temperatures form the L beta phase. This reflects the
      fact that the former samples contain small amounts of unmelted Lc1 phase lipid.
      The implications of these observations are discussed in terms of the general
      problems associated with the measurement of low-temperature phase behaviour of
      membrane lipids.

PMID- 1616929
TI  - Modelling of interaction of basic lipophilic ligands with cytochrome P-450
      reconstituted in liposomes. Determination of membrane partition coefficients of S
      (-)-nicotine and N,N-diethylaniline from spectral binding studies and
      fluorescence quenching.
AB  - The spectral interaction of N,N-diethylaniline and S-(-)-nicotine with cytochrome
      P450IIB4 reconstituted into large unilamellar vesicles could properly be
      described by a model for interaction of basic lipid-soluble ligands with membrane
      bound acceptor sites in which linear partitioning of non-ionized ligand in the
      membrane is postulated. Apparent spectral dissociation constants Ksapp for type I
      binding of N,N-diethylaniline and for type II binding of S-(-)-nicotine increased
      linearly with increasing lipid volume fraction alpha L of the proteoliposomes.
      From plots of Ksapp vs. alpha L, the membrane partition coefficient of each
      ligand was calculated. The apparent affinity of cytochrome P450IIB4 for the
      ligands increased as the pH was raised from 6.0 to 8.5. However, effective
      dissociation constants were virtually independent of the pH, indicating that only
      the uncharged form of the basic ligands interact with cytochrome P450IIB4. For
      each compound, the apparent quenching rate constants kqapp derived from the Stern
      Volmer plots for dynamic quenching of the fluorescence intensity of 8-(2
      anthryl)octanoic acid in liposomes, decreased with increasing liposomal
      concentration. Plots of (kqapp)-1 vs. alpha L of the liposomes yielded the
      overall bimolecular quenching rate constant kq of each quencher. The kq value for
      S-(-)-nicotine was about three orders of magnitude less than that for N,N
      diethylaniline. The values of the partition coefficient of N,N-diethylaniline,
      obtained from the binding studies and the fluorescence quenching measurements,
      were identical (on average, Kp amounted to 383). Analysis of the quenching data
      of N,N-diethylaniline with Scatchard plots likewise revealed that the association
      of the compound with liposomal membranes is a pure partition process.

PMID- 1616930
TI  - Effects of melatonin and light on porphyrin synthesis in the bovine retina,
      pigment epithelium and choroid.
AB  - The quantity of porphyrin synthesized in the presence of 10(-3) M delta
      aminolevulinic acid (ALA) is several times higher in the bovine pigment
      epithelium than in the retina. Synthesis in the retina was found to be increased
      by illumination, whereas synthesis in the pigment epithelium was decreased if the
      whole anatomical unit (retina-pigment epithelium-choroid) was cultivated
      together. The quantity of porphyrin synthesized in the presence of 10(-3) M ALA
      or 10(-6) M melatonin was different when the pigment epithelium and retina were
      separated. The combination 10(-3) M ALA with 10(-6) M melatonin inhibited retinal
      porphyrin synthesis after green light adaptation, while in the pigment epithelium
      green light adaptation induced porphyrin synthesis. It is postulated that the
      light-sensitive porphyrin-haeme synthesis of the retina-pigment epithelium
      choroid functional unit may serve and modulate the synthesis of guanylate cyclase
      for cGMP.

PMID- 1616932
TI  - Uptake of 67Cu by isolated human trophoblast cells.
AB  - The isolated human trophoblast was used as a system to analyze the effects of
      different physiological ligands on cellular uptake of copper. The results show
      that the uptake of copper by these cells follows a similar pattern for the
      ligands tested (histidine, albumin and ceruloplasmin) as that for copper
      chloride. The process follows a typical hyperbolic curve at 37 degrees C. The
      initial phase of uptake follows a linear pattern during 30 min at 37 degrees C
      and at least 60 min at 4 degrees C from which the uptake rate is calculated.
      However, a significant decrease in the uptake rate is observed for albumin. The
      effect of histidine on stimulating copper transport is observed in the presence
      of serum, a phenomenon which is considered to be due to the release of copper
      that is bound to albumin. These results support the role of ceruloplasmin as a
      copper transport protein which releases copper at the cell surface, and a
      subsequent transport of the released copper in a manner similar to that of copper
      chloride or copper-histidine complexes.

PMID- 1616931
TI  - Down-regulation of cellular proto-oncogenes during inhibition of rat parotid
      acinar cell proliferation.
AB  - The role of cell surface galactosyltransferase in mediating isoproterenol-induced
      parotid gland hypertrophy and hyperplasia was examined in rat parotid gland
      acinar cells. Introduction of the transferase modifier, alpha-lactalbumin, or
      galactosyltransferase-associated kinase inhibitor trifluoperazine, into beta
      agonist-treated rats prevented acinar cell proliferation as determined by
      [3H]thymidine incorporation after 96 h of treatment. However, [3H]thymidine
      incorporation into DNA after 24 h of treatment, with injection of a combination
      of isoproterenol/alpha-lactalbumin or isoproterenol/trifluoperazine, was similar
      to injections of isoproterenol alone; suggesting that acinar cells could be
      stimulated to undergo a single round of DNA synthesis. Northern blot analysis of
      myc and fos expression followed a similar pattern of down-regulation to control
      levels after 96 h but not after 24 h. Hybridization with erb B showed little
      change with proliferation, confirming previous observations on protein levels of
      the EGF-receptor in acinar cells. Western blot analysis of nuclear protein
      expression of myc revealed that isoproterenol caused an increase in a 62-kDa
      protein which was again down-regulated with inhibition of cell proliferation.
      Analysis of protein levels of Rb110 protein showed no change in protein level in
      the nucleus with cell proliferation, but did show an associated increase in
      protein phosphorylation in response to growth stimulation.

PMID- 1616934
TI  - Investigation of a role for reduction in ferric iron uptake by mouse duodenum.
AB  - 59Fe uptake rates by mouse duodenal fragments incubated in vitro were markedly
      reduced by non-permeable reagents, ferricyanide (oxidising agent) and ferrozine
      (Fe2+ chelator), in the medium; ferrocyanide had no effect. Reduction of Fe3+, as
      reflected by an increase in ferrozine-(Fe2+)-chelatable iron, was observed in the
      presence of the tissue fragments. The generation of Fe2+ occurred linearly with
      time, was independent of the medium ferrozine concentration, and was not due to
      release of reducing factors from the duodenal fragments. Fe(3+)-reducing activity
      was mainly present on the mucosal surface and was localised primarily to the
      proximal region of the small intestine. Changes in Fe3+ reduction rates closely
      parallelled the changes in duodenal 59Fe uptake, when metabolic inhibitors or
      modulators of membrane potential were included in the medium. The enhancement in
      duodenal mucosal 59Fe uptake in chronic hypoxic and iron-deficient mice
      parallelled the changes in the tissue reduction of medium Fe3+. Moreover, the
      rates of reduction were quantitatively similar to rates of uptake. These
      observations indicate that a sequential reduction and uptake process operates for
      Fe3+ uptake in mouse duodenum.

PMID- 1616933
TI  - Endothelial cell-conditioned medium modulates the synthesis and structure of
      proteoglycans in vascular smooth muscle cells.
AB  - We studied the effect of bovine endothelial cell-conditioned medium on
      proteoglycan synthesis by bovine aorta smooth muscle cells. Confluent cultures
      were incubated with [35S]sulfate, [3H]glucosamine or [3H]serine in medium alone
      (control), or medium that had been conditioned on confluent endothelial cells.
      Metabolically labelled proteoglycans secreted into the culture medium and
      associated with the cell layer were quantified. During a 24 h incubation,
      endothelial cell-conditioned medium increased [35S]sulfate and [3H]glucosamine
      incorporation into medium and cell-layer proteoglycans by 59% and 95%,
      respectively, above controls. [3H]Serine incorporation into proteoglycan core
      protein was increased by 150%. The effect of endothelial cell-conditioned medium
      on [35S]sulfate incorporation was concentration dependent. The stimulatory
      effects of the conditioned medium were abolished by cycloheximide and actinomycin
      D, inhibitors of protein synthesis and transcription, respectively. Endothelial
      cell-conditioned medium caused no significant change in the degradation or
      secretion of proteoglycans, indicating that the increase in proteoglycans was due
      to increased de novo synthesis. TGF-beta neutralizing antibody inhibited 22% of
      the stimulatory effect of the conditioned medium, suggesting that part of the
      stimulation was mediated by TGF-beta. Ion-exchange chromatography of
      [35S]proteoglycans in the culture medium of smooth muscle cells yielded two major
      peaks at 0.52 and 0.57 M NaCl in both control and experimental cultures. In both
      cases the second peak, which represented approx. 80% of the total radioactivity,
      contained isomeric chondroitin sulfate proteoglycan with chondroitin sulfate and
      dermatan sulfate accounting for 90% and 10% of the isomers, respectively. The
      isomeric chondroitin sulfate proteoglycan was fractionated by hydrodynamic size
      on Sepharose CL-4B, resulting in three fractions (A, B and C). Analytical column
      chromatography of fractions A and B on Sepharose CL-2B demonstrated that
      proteoglycans from cultures incubated with endothelial cell-conditioned medium
      were larger in size than those from control cultures (M(r) fraction A, 1700,000,
      compared with 1200,000 M(r); fraction B, 540,000, compared with 390,000). The
      molecular weights of the core proteins were unchanged. The larger size of
      proteoglycan A in cultures exposed to endothelial cell-conditioned medium was due
      to an increase in both the glycosaminoglycan chain number (29 compared to 25) and
      molecular mass (M(r) 52,000, compared to 40,000). The hydrodynamic size of the
      glycosaminoglycans in proteoglycan B of control and experimental cultures was
      identical (M(r) 40,000). Therefore, the increase in the molecular mass of this
      proteoglycan was attributable to an increase in glycosaminoglycan chain number
      (12 compared to 9).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1616935
TI  - The unpolymerized form of tubulin is the target for microtubule inhibition by
      photoactivated tetra(4-sulfonatophenyl)porphine.
AB  - Several porphyrins, including tetra(4-sulfonatophenyl)porphine, sensitize cells
      to photoinactivation. The treatment leads to an accumulation of cells in mitosis,
      directly or indirectly due to a perturbation of the mitotic spindle. The present
      work relates to the target for this mode of action. Cells incubated with tetra(4
      sulfonatophenyl)porphine were exposed to light and the microtubules were
      quantified 30 min after light exposure. The amount of microtubules decreased with
      increasing fluences. The reduction in the amount of microtubules after light
      exposure was enhanced by prior treatment with nocodazole (1 microgram/ml for 20
      min) or low temperature (1 degree C for 60 min). When nocodazole was combined
      with the photochemical treatment the extent of the inhibition of microtubule
      formation was dose-dependent only for the lowest fluences applied. Additional
      light exposure did not further reduce the amount of microtubules 30 min after
      light exposure. The results presented indicate that the unpolymerized fraction of
      tubulin is the target for photochemical inhibition of microtubule formation.

PMID- 1616936
TI  - A low-spin iron complex in human melanoma and rat hepatoma cells and a high-spin
      iron(II) complex in rat hepatoma cells.
AB  - Human melanoma and rat hepatoma cells cultured in the presence of low
      concentrations (2.5 microM) of low-molecular-weight iron (Fe) chelates and Fe
      transferrin complexes have been studied with 57Fe Mossbauer spectroscopy. The
      spectra show that holoferritin is only a minor fraction of the total iron present
      in the cells. The major form of Fe was in a low-spin state unlike the high-spin
      Fe(III) found in ferritin. Only about 10% of the Fe could be attributed to
      ferritin. In addition, the hepatoma cells had a high-spin Fe(II) spectral
      component which made up about 20% of the Fe present.

PMID- 1616937
TI  - Accumulation of S-D-lactoylglutathione and transient decrease of glutathione
      level caused by methylglyoxal load in isolated hepatocytes.
AB  - Methylglyoxal is converted to D-lactic acid through a conjugation with
      glutathione and S-D-lactoylglutathione is an intermediate of this pathway. In
      isolated hepatocytes prepared from fed mice incubated without nutrients (glucose,
      pyruvate and amino acids) the formation and release of S-D-lactoylglutathione and
      also a continuous lowering of cellular glutathione were demonstrated upon
      addition of methylglyoxal (20 mM). Under these incubation conditions, the
      glutathione content of the cells decreased in the controls. On the other hand, in
      hepatocytes incubated in a medium supplemented with the above-mentioned compounds
      an accumulation of S-D-lactoylglutathione and a transient decrease of glutathione
      were shown after addition of methylglyoxal. Under these experimental
      circumstances the glutathione content of the cells was preserved. Buthionine
      sulfoximine--an inhibitor of glutathione synthesis--prevented the restoration of
      glutathione level in hepatocytes observed in the presence of methylglyoxal;
      emetine--an inhibitor of protein synthesis--was ineffective. It is suggested that
      increased methylglyoxal formation may have a role in alterations of glutathione
      metabolism under conditions when serum acetone is increased and methylglyoxal
      production from acetone is elevated.

PMID- 1616938
TI  - Binding of endotoxin to macrophages; interactions of spin-labelled saccharide
      residues.
AB  - The molecular mechanisms of endotoxin action are poorly understood. A
      prerequisite to cellular activation by this agent must be interaction (binding)
      with the plasma membrane. In this study we have investigated the role of the
      polysaccharide region of endotoxin (LPS) in binding to macrophages and macrophage
      like cell lines. The LPS molecules, from Escherichia coli O111.B4, J5 and the
      lipid-A, were spin labelled with 2,2,6,6-tetramethylpiperidine-N-oxyl] (Tempo)
      free radical in their sugar residues, and examined by electron spin resonance
      spectroscopy. This is the first report of the synthesis of spin-labelled
      endotoxins. Measurement of the rotational correlation times (Tc) indicated that
      the saccharide resides do not bind to membrane surface structures and suggests
      that the binding of LPS to macrophages is mediated by the lipid acyl chains. Anti
      sera to LPS from E. coli O111.B4 was effective in binding to the polysaccharide
      of the same LPS bound to the cell surface.

PMID- 1616939
TI  - Changes in catalase activity and concentration during ovarian development and
      differentiation.
AB  - The ovaries of immature rats were used to prepare a peroxisome-enriched fraction
      by differential centrifugation. Following gonadotropin stimulation, which caused
      large numbers of follicles to develop into corpora lutea, the specific activity
      of catalase in the peroxisome-enriched fraction increased 5-fold, while catalase
      recovered in the post-30,000 x g supernatant did not increase in activity. The
      increase in catalase specific activity in the peroxisome enriched fraction was
      shown to be due to an increased concentration of the enzyme as determined by
      Western blotting. Catalase in pig granulosa cells also increased in specific
      activity as the follicles aged and luteinized. This increase appeared to parallel
      increases in the concentration of cytochrome P-450scc. We conclude there is a
      differential regulation of the peroxisomal and cytosolic pools of rat ovarian
      catalase.

PMID- 1616940
TI  - Inhibition of phospholipase A2 and insulin secretion in pancreatic islets.
AB  - Arachidonic acid may be an important mediator of insulin secretion since (1)
      glucose activates phospholipase A2 thus increasing endogenous unesterified levels
      of arachidonic acid, (2) arachidonic acid mobilizes Ca2+ from the islet
      endoplasmic reticulum and (3) arachidonic acid has been proposed to regulate
      voltage-dependent Ca2+ channels in the beta-cell. We have used the phospholipase
      A2 inhibitor, (p-amylcinnamoyl)anthranilic acid (ACA), to determine whether
      phospholipase A2 activation is required for glucose-induced insulin secretion.
      ACA inhibited in a dose-dependent manner glucose-induced insulin secretion, as
      well as glyceraldehyde and alpha-ketoisocaproic acid-induced insulin secretion.
      ACA also totally abolished glucose-induced arachidonate accumulation but did not
      affect phospholipase C suggesting that it was specific for phospholipase A2.
      Furthermore, ACA did not inhibit glucose oxidation. These observations suggest
      that glucose-induced arachidonate increase is essential for insulin secretion.

PMID- 1616941
TI  - Modulation by protein kinase C of the hormonal responsiveness of hepatocytes from
      lean (Fa/fa?) and obese (fa/fa) Zucker rats.
AB  - The effect of phorbol myristate acetate (PMA) on the hormonal responsiveness of
      hepatocytes from lean and obese Zucker rats was studied. Phenylephrine-stimulated
      phosphatydylinositol labeling and phosphorylase activation were antagonized by
      PMA in cells from obese and lean animals; bigger residual effects were observed
      in cells from obese animals even at high PMA concentrations. Cyclic AMP
      accumulation induced by isoproterenol, glucagon, forskolin and cholera toxin was
      higher in cells from lean animals than in those from obese rats. PMA diminished
      glucagon- and cholera toxin-induced cyclic AMP accumulation; cells from lean
      animals were more sensitive to PMA. Two groups of isoforms of protein kinase C
      (PKC) were observed in hepatocytes from Zucker rats using DEAE-cellulose column
      chromatography: PKC 1 and PKC 2. The PKC 1 isozymes were separated into four
      peaks using hydroxylapatite: aa, 1a (PKC-beta), 1b (PKC-alpha) and 1c. Short
      treatment with PMA decreased the activity of PKC 1 (peaks 1b (PKC-alpha) and 1c)
      and to a lesser extent of PKC 2; cells from lean animals were more sensitive to
      PMA than those obtained from obese rats. Our results indicate that cells from
      genetically obese Zucker rats are in general less sensitive to this activator of
      protein kinase C than those from their lean littermates. The possibility that
      alterations in the phosphorylation/dephosphorylation cycles, that control
      metabolism and hormonal responsiveness, may contribute to this obese state is
      suggested.

PMID- 1616942
TI  - Receptor binding on whole cells can oscillate.
AB  - The study of the kinetics of binding of the opiate receptor agonist [3H]DADLE
      with NG108-15 cell suspensions has revealed a new periodic biological phenomenon,
      i.e., oscillations of the cellular receptor activity. The absence of oscillations
      for binding of the receptor antagonist shows that oscillations occur as a result
      of the transformation of the receptor signal only.

PMID- 1616943
TI  - Cytosolic calcium oscillations induced by hepatocyte growth factor (HGF) in
      single fura-2-loaded cultured hepatocytes: effects of extracellular calcium and
      protein kinase C.
AB  - Hepatocyte growth factor (HGF) induced the periodic fluctuations of cytosolic
      calcium concentration ([Ca2+]i) in primary cultured rat hepatocytes, which were
      dependent on extracellular calcium. The HGF-induced [Ca2+]i oscillations were
      suppressed by the pretreatment with phorbol 12-myristate 13-acetate (PMA).
      Administration of PMA during oscillations also caused their blockade, but the
      subsequent addition of protein kinase C (PKC) inhibitor H-7 reversed the
      inhibitory effects of PMA, thereby resulting in the resumption of the oscillatory
      responses. Moreover, the prior exposure to H-7 caused apparent increases in
      [Ca2+]i spike peaks elicited by HGF. These results suggest a negative modulation
      via PKC in HGF-induced repetitive [Ca2+]i transients. The absence of HGF-induced
      oscillations after the thapsigargin treatment indicates that the agonist
      sensitive intracellular Ca2+ pool plays a crucial role in the [Ca2+]
      oscillations.

PMID- 1616944
TI  - New synthesis of immunogenic N6-isopent-2-enyladenosine-protein conjugate.
      Preparation, purification, and specificity of related antibodies.
AB  - An original procedure which preserves the structure of the sugar ring is
      described to link a plant hormone as N6-isopent-2-enyladenosine [( 9R]iP) onto a
      protein carrier to prepare a more specific immunogen. This cytokinin is bound to
      bovine serum albumin (BSA) and ovalbumin by a five-step procedure. These [9R]iP
      protein conjugates have a maximal absorption at 269 nm and show molar ratios of
      hormone bound to proteins in the range of 12:1 and 18:1 for BSA and ovalbumin,
      respectively. Polyclonal antibodies were raised in rabbits against [9R]iP-BSA and
      were purified by affinity chromatography. Titers and specificity of the antisera
      and purified antibodies were determined by ELISA and RIA. These antibodies are
      highly specific for [9R]iP and do not cross-react with zeatin and ribosylzeatin.
      An immunoaffinity matrix was prepared with a capacity of 1 microgram of [9R]iP/mL
      of gel.

PMID- 1616945
TI  - A brief survey of methods for preparing protein conjugates with dyes, haptens,
      and cross-linking reagents.

PMID- 1616947
TI  - Preparation of novel cyclosporin A derivatives.
AB  - The hydroxyl group on the 2-N-methyl-(R)-((E)-2-butenyl)-4-methyl-L-threonine
      residue of cyclosporin A was protected by acetylation, then the double bond on
      the same amino acid residue was oxidatively cleaved using a
      periodate/permanganate reagent. The resultant derivative of cyclosporin A
      contained a carboxylic acid group which was subsequently reacted with the
      nucleophiles 5-(aminoacetamido)fluorescein and poly(L-lysine), in the presence of
      1-ethyl-3-[3-(dimethylamino)propyl] carbodiimide, to furnish novel cyclosporin A
      conjugates.

PMID- 1616946
TI  - Gadolinium complexes of [(myristoyloxy)propyl]diethylenetriaminetetraacetate: new
      lipophilic, fatty acyl conjugated NMR contrast agents.
AB  - New lipophilic contrast agents, 1-[3'-(myristoyloxy)propyl]diethylenetriamine
      1,4,7,7-tetraacetic acid (1MP-DTTA), 4-[3'
      (myristoyloxy)propyl]diethylenetriamine-1,1,7,7-tetraacetic acid (4MP-DTTA), and
      4-[3'-(myristoyloxy)propyl]-2,6-dioxodiethylenetriamine-1,1, 7, 7-tetraacetic
      acid (4MPD-DTTA), were prepared from either diethylenetriamine or 3-amino-1
      propanol (overall yield 16-23%). Liposome-incorporated Gd complexes of ligands
      1MP-DTTA, 4MP-DTTA, and 4MPD-DTTA were prepared by mixing GdCl3 and the prepared
      vesicles consisting of ligand, egg lecithin, and cholesterol (molar ratio
      1.1:5.1) followed by further sonication, and their in vitro relaxivities were
      determined. The relaxivities of these agents were higher than those of the Gd3+
      aquoion, Gd(EDTA), or Gd(DTPA) at both 0.23 and 0.47 T. Gd(4MPD-DTTA) displayed
      the highest relaxivities (24.0 +/- 0.4 and 34.7 +/- 0.4, at 0.23 and 0.47 T,
      respectively) among these new Gd complexes. The relaxivities of these three
      agents increased from the lower to the higher magnetic field, indicating a
      positive field dependence. Stability constants (log K) of Gd(1MP-DTTA), Gd(4MP
      DTTA), and Gd(4MPD-DTTA) were found to be 18.2 +/- 0.2, 18.4 +/- 0.2, and 15.7 +/
      0.8, respectively. A lower limit of 0.3 mmol/kg was found for LD50 for these
      three agents.

PMID- 1616948
TI  - Preparation and characterization of a beta-lactamase-Fab' conjugate for the site
      specific activation of oncolytic agents.
AB  - Antibody-directed catalysis (ADC) is a two-step method for the targeted delivery
      of chemotherapeutic agents in which enzyme-antibody conjugates, prelocalized to
      antigen-bearing cells, activate prodrugs designed to be substrates for the
      enzyme. An enzyme-Fab' conjugate exhibiting both native beta-lactamase activity
      and immunoreactivity toward carcinoembryonic antigen (CEA) was constructed.
      Treatment of CEA-expressing LS174T cells with this conjugate imparted beta
      lactamase activity to the cells; beta-lactamase activity was not imparted by
      treatment with unconjugated beta-lactamase and not to CEA negative cells treated
      with conjugate. Cephalosporin-based prodrugs, and other substrates synthesized as
      model compounds, were found to have wide variations in their kinetic parameters
      toward the conjugate, with kcat values ranging from 16 to 3300 s-1 and KM values
      ranging from 5 to 160 microM. The prodrug derived from desacetylvinblastine-3
      carboxylic acid hydrazide (DAVLBHYD) was studied in vitro and found to be 5-fold
      less cytotoxic to LS174T cells than the parent DAVLBHYD. For antigen-positive
      cells preincubated with conjugate, however, the prodrug showed the same potency
      as the parent drug. Thus, the combination of conjugate and prodrug appears to
      provide antigen-dependent toxicity to tumor cells.

PMID- 1616949
TI  - Synthesis, conformation, biodistribution, and in vitro cytotoxicity of daunomycin
      branched polypeptide conjugates.
AB  - Daunomycin has been attached to various structurally related synthetic branched
      polypeptides with a polylysine backbone, using its acid-labile cis-aconityl
      derivative (cAD). Due to the importance of the side-chain structure in alpha
      helix formation and immunological and pharmacological properties of branched
      polypeptides, we have investigated the conformation, biodistribution, and in
      vitro cytotoxicity of cAD-carrier conjugates with polypeptides containing amino
      acid residues of different identity and/or configuration at the side-chain end
      (XAK type) or at the position next to the polylysine backbone (AXK type), where X
      = Leu, D-Leu, Pro, Glu, or D-Glu. According to CD studies, polycationic
      conjugates with hydrophobic Leu in the side chains could assume a highly ordered
      conformation, while amphoteric conjugates containing Glu proved to be unordered
      in PBS. The reduction of in vitro cytotoxic activity of cAD by conjugation to
      carriers and the biodistribution profile of the conjugates were found to be
      dependent predominantly on the charge properties and on the side-chain sequence
      of the carrier polypeptide. It was demonstrated that by proper combination of
      structural elements of the carrier molecule, it is feasible to construct a cAD
      branched polypeptide conjugate with significantly prolonged blood survival and
      with no reduction in in vitro cytotoxicity of the drug.

PMID- 1616950
TI  - Rational design of a chimeric toxin: an intramolecular location for the insertion
      of transforming growth factor alpha within Pseudomonas exotoxin as a targeting
      ligand.
AB  - To investigate the potential utility of Pseudomonas exotoxin (PE) in forming
      rationally designed chemotherapeutic agents, we inserted a cDNA encoding
      transforming growth factor alpha (TGF alpha) at several locations in a gene
      encoding a mutant full-length PE (PE4E) which does not bind to the PE receptor.
      After expression in Escherichia coli, we purified the chimeric toxins to near
      homogeneity and showed that they were specifically cytotoxic to human epidermoid,
      ovarian, colon, and hepatocellular carcinoma lines. Like the previously reported
      TGF alpha-PE40, one of the new molecules (TGF alpha-PE4E) contains the ligand at
      the amino terminus. Two additional chimeras (PE4E-TGF alpha and PE4E-TGF alpha
      598-613) each contain TGF alpha inserted near the carboxyl terminus of PE. We
      show that preservation of the correct PE carboxyl-terminal amino acid sequence,
      REDLK, allows the toxins containing TGF alpha carboxyl inserts to retain
      significant cytotoxicity against target cells, since another molecule (PE4E-TGF
      alpha-ILK) containing a nonfunctional carboxyl-terminal sequence was over 100
      fold less active. The chimeric toxins with TGF alpha had the same binding
      affinity for the EGF receptor whether the ligand occupied the amino or carboxyl
      position. Molecules with TGF alpha near the carboxyl position were consistently
      less active against target cells but also less toxic to mice than those with TGF
      alpha at the amino terminus, indicating both types of molecules might be
      therapeutically effective. Our results establish that a ligand can be placed near
      the carboxyl terminus of PE, within the portion of the toxin that translocates to
      the cytosol. The amino-terminal position in such molecules is then available for
      the placement of other targeting ligands.

PMID- 1616951
TI  - Properties of chimeric toxins with two recognition domains: interleukin 6 and
      transforming growth factor alpha at different locations in Pseudomonas exotoxin.
AB  - Pseudomonas exotoxin (PE) is a potent cytotoxic agent that is composed of 613
      amino acids arranged into three major domains. We have previously identified two
      positions where ligands can successfully be placed in PE to direct it to cells
      with specific surface receptors. One site is at the amino terminus and the other
      is close to but not at the C-terminus. To examine the possibility of constructing
      oncotoxins with two different recognition elements that will bind to two
      different receptors, we have placed cDNAs encoding either transforming growth
      factor alpha (TGF alpha) or interleukin 6 (IL6) at the 5' end of a PE gene and
      also inserted a cDNA encoding TGF alpha near the 3' end of the PE gene. The
      plasmids encoding these chimeric toxins were expressed in Escherichia coli and
      the chimeric proteins purified to near homogeneity. In all the new toxins, the
      TGF alpha near the C-terminus was inserted after amino acid 607 of PE and
      followed by amino acids 604-613 so that the correct PE C-terminus (REDLK) was
      preserved. For each chimera, the toxin portion was either PE4E, in which the cell
      binding domain (domain Ia) is mutated, PE40, in which domain Ia is deleted, or
      PE38, in which domain Ia and part of domain Ib are deleted. These derivatives of
      PE do not bind to the PE receptor and allow 607, 355, or 339 amino acids,
      respectively, between the two ligands.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616953
TI  - Selective modification of cytosines in oligodeoxyribonucleotides.
AB  - A single deoxycytidine residing in an oligodeoxyribonucleotide which also
      contains 5-methyldeoxycytidines can be selectively derivatized with various
      alkylamines by sodium bisulfite-catalyzed transamination. Selective
      transamination results because 5-methylcytosine, unlike cytosine, does not form a
      bisulfite adduct. When the reaction is carried out at pH 7.1, transamination in
      the oligomer appears to occur to greater than 95% with little or no deamination.
      This procedure has been used to introduce aminoalkyl or carboxyalkyl side chains
      at the N4-position of a deoxycytidine in oligonucleotides. These side chains
      contain potentially reactive amine or carboxy groups which could serve as a sites
      for further conjugation of the oligomer with a variety functional groups.
      Oligonucleotides which carry these side chain form duplexes and triplexes with
      appropriate complementary single-stranded or double-stranded
      oligodeoxyribonucleotide target molecules. The stabilities of the duplexes are
      similar to those formed by unmodified oligomers, whereas the stability of the
      triplexes is approximately 18 degrees C lower than that formed by unmodified
      oligomers.

PMID- 1616952
TI  - Application of an N-(4-azido-2,3,5,6-tetrafluorobenzoyl)tyrosine-substituted
      peptide as a heterobifunctional cross-linking agent in a study of protein O
      glycosylation in yeast.
AB  - In order to investigate the O-mannosyltransferase involved in the initial O
      mannosylation of glycoproteins in Saccharomyces cerevisiae, a photoactive
      hexapeptide, [125I]-N-(4-azido-2,3,5,6-tetrafluorobenzoyl)-3-iodo-Tyr-Asn-Pro-T
      hr-Ser-Val ([125I]azidoTyr-peptide), was synthesized by solid-phase techniques
      using a new photoactive cross-linking reagent, N-(4-azido-2,3,5,6
      tetrafluorobenzoyl)tyrosine, and resin-bound Asn-Pro-Thr(tBu)-Ser(tBu)-Val. When
      this modified hexapeptide substrate was incubated with O-mannosyltransferase
      preparations, the hexapeptide was an acceptor of [14C]-mannose from dolichol
      phosphate-[14C]mannose. After partially purifying the O-mannosyltransferase and
      photolabeling these enzyme preparations with [125I]azidoTyr-peptide, a ca. 82-kDa
      protein was shown to be the only apparent photolabeled protein that was protected
      by unmodified hexapeptide. This ca. 82-kDa protein may be the catalytic subunit
      of the O-mannosyltransferase. The susceptibility of the N-(4-azido-2,3,5,6
      tetrafluorobenzoyl) moiety to reducing agents in aqueous buffers was also
      examined.

PMID- 1616954
TI  - An improved CPG support for the synthesis of 3'-amine-tailed oligonucleotides.
AB  - A new controlled-pore glass (CPG) support is described that allows for the direct
      synthesis of oligonucleotides bearing a 3'-aminohexyl tail. This solid support
      (AH-CPG) exhibits superior performance as compared to a commercially available 3'
      amine CPG. The AH-CPG is prepared from 6-aminohexan-1-ol with a unique protecting
      group for the amine that also functions as the site of attachment to the CPG. A
      3'-amine-tailed oligodeoxynucleotide (ODN) was prepared from this support using
      standard phosphoramidite coupling and deprotection conditions. The 3'-amine
      tailed ODN was subsequently modified with an acridinylpropionic acid
      tetrafluorophenyl ester. Facile synthesis of the AH-CPG and the stability of the
      deprotected product makes this functionalized solid support especially useful for
      preparation of oligonucleotides bearing 3'-amine tails and other modifications.

PMID- 1616955
TI  - Synthesis of N-[6-(ethylenedioxy)hexyl]biotinamide: a biotinyl aldehyde precursor
      for labeling hydrazine-modified biomolecules.
AB  - Synthetic approaches for obtaining biotinyl aldehydes are described. While such
      aldehydes have limited shelflife, the acetal derivative, N-[6
      (ethylenedioxy)hexyl]biotinamide, IX, was found to be indefinitely stable upon
      storage at -20 degrees C. Mild acid hydrolysis conveniently unmasks the aldehyde,
      which can then be used to label hydrazine-tagged biomolecules.

PMID- 1616956
TI  - Biochemical, immunological, and functional aspects of the growth
      suppressor/oncoprotein p53.
AB  - The cellular phosphoprotein p53 was initially discovered in a variety of in vitro
      transformed and tumor-derived cell lines. Later on, p53 was also found in normal,
      nontransformed cells albeit at very low levels. Inhibition of p53 functions by
      microinjection of anti-p53 antibodies prevented quiescent cells from reentering
      the cell cycle after serum stimulation, indicating that p53 might somehow be
      involved in the regulation of cell proliferation. After detection of p53-specific
      mRNAs, the gene was discovered in diverse species ranging from fish and frog to
      man. Knowing the p53 DNA sequence, it became clear that mutant forms of p53 had
      immortalizing and, in cooperation with other oncogenes, transforming activities.
      On the other hand, wild-type p53 could suppress oncogene-mediated transformation.
      It seems clear now that wild-type p53 is a tumor suppressor. Moreover, analysis
      of p53 from many types of human tumors indicates that the p53 gene is a very
      frequent target for mutational alterations. Because the biochemical consequences
      of these alterations are not yet clear, it is not understood yet on the molecular
      level how p53 can act as an oncogenic protein, on one hand, and as a growth
      suppressor protein on the other hand. Therefore, the present review aims to
      summarize the biochemical and immunological properties of p53 and to address some
      biological activities of p53 in order to allow more insight into how p53 might be
      regulated within the cell or how p53 might regulate cell proliferation.

PMID- 1616957
TI  - p53 from basic research to clinical applications.
AB  - Mutations on the TP53 tumor suppressor gene and allele loss on chromosome 17p,
      where this gene has been located, are among the most frequent alterations yet
      identified in human malignancies. The p53 protein is highly conserved through
      evolution and expressed in most normal tissues. Wild-type p53 has been shown to
      control normal cell proliferation possibly through transcriptional regulation.
      The wild-type TP53 gene can suppress cell transformation and neoplastic cell
      growth. In contrast, mutant TP53 has lost the tumor suppressing ability and, in
      most cases, has gained a transformation promoting ability. Many different TP53
      mutations have common conformational and functional consequences on the p53
      protein. However, all the TP53 mutants are not necessarily equivalent in terms of
      biological activity: some mutations confer a strong transforming ability, while
      others lead to truncated products with probably no biological function. Some
      mutants may exhibit a dominant behavior over wild-type TP53, others may be
      recessive. Point mutations of TP53 tend to occur on evolutionary conserved
      positions. However, the TP53 mutational spectrum differs among cancer types, and
      this fact may reflect different exogenous mutagens and endogenous factors
      contributing to human carcinogenesis. In defined types of malignancies, the
      tumors with TP53 alteration or tumors with allele loss on 17p are associated with
      more aggressive phenotypes than those without these alterations. For these
      malignancies, the monitoring of TP53 alteration should now be included in
      therapeutic trials. Germ line mutations on TP53 may also occur. Individuals with
      constitutional TP53 mutation have a predisposition to a wide variety of
      neoplasms. Further characterization of this predisposition will enable the
      definition of the best follow-up for these at-risk patients.

PMID- 1616958
TI  - Regulation of c-myc transcription initiation and elongation.
AB  - The c-myc protooncogene plays an important role in the regulation of cellular
      proliferation and differentiation. Selective downregulation of c-myc expression
      induces differentiation of leukemic cells, whereas constitutive overexpression
      prevents differentiation of the same cell types. The c-myc gene is comprised of
      three exons, the first of which is largely untranslated. Both c-myc mRNA and the
      c-myc gene product have very short half-lives, resulting in a very sensitive
      regulation of this important gene. Both transcriptional and posttranscriptional
      regulation of the c-myc gene expression have been documented. Transcriptional
      regulation can occur at the level of transcriptional initiation or elongation. A
      number of c-myc promoter-binding proteins have been identified and characterized.
      These include positive and negative regulatory factors. It appears that the c-myc
      gene is very tightly regulated in response to positive and negative growth
      stimuli.

PMID- 1616959
TI  - Factors inhibiting differentiation of myeloid leukemia cells.
AB  - Leukemic cells are arrested in less differentiated stages of development.
      However, there are many reports that various leukemic cells can be induced to
      differentiate into mature cells with attenuation of proliferative and
      leukemogenic activity. Mouse myeloid leukemia (Ml) cells both in vitro and in
      vivo can be induced to differentiate into macrophages and granulocytes by various
      compounds. During long-term culture of Ml cells, however, some populations of the
      cells spontaneously become resistant to induces of cell differentiation. The
      isolated resistant variant cell lines have higher leukemogenicity than parent
      cells and produce differentiation inhibitory protein factors (I-factor). The
      variant cell lines are useful to studies on how leukemic cells are arrested in
      less differentiated stages even in the presence of differentiation inducers both
      in vitro and in vivo. We have purified and characterized the I-factor. We review
      herein the properties of the I-factor and other inhibitory factors of
      differentiation of myeloid leukemia cells.

PMID- 1616960
TI  - Candida infections in AIDS patients.

PMID- 1616961
TI  - Congenital syphilis.

PMID- 1616962
TI  - Cryptococcal infection in AIDS.

PMID- 1616963
TI  - AIDS lymphomas.

PMID- 1616964
TI  - Improved outcome of Pneumocystis carinii pneumonia in AIDS patients: a
      multifactorial treatment effect.
AB  - Factors determining the outcome of an episode of Pneumocystis carinii pneumonia
      (PCP) in 149 AIDS patients treated at St Mary's Hospital were identified and
      their importance on improved survival evaluated between 1984 and 1989. The
      proportion of fatal episodes of PCP decreased over time. Fatal compared with
      nonfatal episodes had lower mean alveolar-arterial oxygen gradient (82.5 mmHg vs
      53.8 mmHg, P less than 0.001), mean haemoglobin level (11.2 g/dl vs 12.1 g/dl, P
      = 0.01), mean lymphocyte count (0.68 x 10(9)/l vs 0.92 x 10(9)/l, P = 0.05) and
      more coinfections (31% vs 5%, P less than 0.001). Over time, the most significant
      change which occurred was a reduction in alveolar-arterial oxygen gradient at
      time of first presentation with PCP (r = -0.37, P less than 0.001). Mean alveolar
      arterial oxygen gradient declined from 79.9 mmHg in 1984 to 45.3 mmHg in 1989 (r
      = -0.88, P = 0.02), independently of zidovudine therapy or PCP prophylaxis.
      Patients were being treated at an earlier stage in their disease course as
      indicated by their reduced alveolar arterial oxygen gradient. This is due either
      to earlier patient presentation, earlier medical diagnosis or both. The
      widespread introduction of zidovudine and PCP prophylaxis may further contribute
      to improve morbidity and mortality patterns in the future.

PMID- 1616965
TI  - Prostatitis--clinical and bacterial studies.
AB  - Forty men with clinical prostatitis were studied to determine the value of
      symptomatology and categorization and 30 (75%) were classified as having
      prostatitis on the basis of prostatic localization studies. Of these 3 (10%) had
      chronic bacterial prostatitis, 18 (60%) had chronic abacterial prostatitis, and 9
      (30%) had prostatodynia. No patient had acute bacterial prostatitis. Although
      Enterobacteriaciae were isolated from the 3 men with chronic bacterial
      prostatitis, these bacteria along with Staphlococcus aureus, Streptococcus
      faecalis, and Chlamydia trachomatis were isolated from a further 6 patients. The
      mean pH of the expressed prostatic secretion was measured for each group and was
      found to be 7.6 for those with chronic bacterial prostatitis, 7.1 for chronic
      abacterial prostatitis, 6.5 for prostatodynia, and 6.9 for those with urethritis
      suggesting that this test may be of value in the diagnosis of chronic bacterial
      prostatitis.

PMID- 1616966
TI  - A reappraisal of chlamydial and nonchlamydial acute non-gonococcal urethritis.
AB  - A cohort of 112 men presenting with acute non-gonococcal urethritis (NGU) was
      investigated for the presence of Chlamydia trachomatis. Men with 3 or more
      episodes of NGU in the preceding 12 months, or who had received treatment for NGU
      in the preceding 3 months were excluded. C. trachomatis was sought by examination
      of urethral smears by direct immunofluorescence, and by examination of the
      centrifuged deposit from a first pass urine (FPU) sample by direct
      immunofluorescence, IDEIA, and the polymerase chain reaction. Urethral samples
      from 48 men were positive for CT, and the FPU samples from an additional 7 men
      were positive by at least 2 assays. With such intensive investigation it is
      likely that those men identified as chlamydia-negative were genuinely free from
      the infection. The clinical history and response to treatment of those men who
      were chlamydia-positive were compared with those of the chlamydia-negative men.
      They differed in that a larger proportion of the chlamydia-positive men reported
      having had intercourse with more than one partner in the previous 3 months, and
      having had fewer previous episodes of NGU. Moreover, in contrast to some previous
      studies, after one week of treatment with doxycycline, a larger proportion (65%)
      of the chlamydia-negative men than the chlamydia-positive men (40%) was cured,
      although the difference was not sustained following later treatment.

PMID- 1616968
TI  - Radiological and histological features of intracerebral cryptococcomata.

PMID- 1616967
TI  - Comparison of ofloxacin and metronidazole for the treatment of bacterial
      vaginosis.
AB  - The efficacy and safety of ofloxacin, 200 mg twice daily for 7 days, was compared
      with metronidazole, 400 mg twice daily for 7 days, for the treatment of bacterial
      vaginosis (BV). Diagnosis of BV was confirmed by at least 3 of the following 4
      criteria: the presence of an abnormal vaginal discharge on examination, clue
      cells on microscopy of vaginal specimens, vaginal pH greater than 5.0 and a
      positive amine test. Vaginal specimens were examined for Mobiluncus spp, analysed
      for the succinate/lactate (S/L) ratio and cultured for Trichomonas vaginalis,
      Gardnerella vaginalis, Bacteroides spp. and Mycoplasma hominis. Patients were
      reviewed on completion of treatment (visit 2) and 14 days later (visit 3). The
      diagnosis of BV was accepted in 119 of 149 patients recruited, 60 of whom
      received treatment with ofloxacin and 59 received metronidazole. Sixty-two
      patients, 31 in each treatment group, completed the study. Diagnostic cure at
      visit 2 was significantly better in the metronidazole group with cure rates of
      56% (metronidazole) vs 23% (ofloxacin) (P = 0.001); this was associated with
      higher eradication rates for G. vaginalis (100% vs 56%) and Bacteroides spp. (97%
      vs 49%). There were no significant differences between the two groups in clinical
      cure at either visit 2 or 3 or in diagnostic cure at visit 3. Both treatments
      were well tolerated. We conclude that metronidazole is likely to remain the first
      choice of treatment for BV but ofloxacin offers a safe and effective alternative.

PMID- 1616969
TI  - Intestinal obstruction associated with genital herpes.

PMID- 1616970
TI  - Neisseriaceae and Moraxella sp.: the role of related microorganisms associated
      with conjunctivitis in the newborn.

PMID- 1616971
TI  - Malignant otitis externa in a patient with AIDS.

PMID- 1616972
TI  - Distal urethroscopy: a suggested modification of the meatoscopy technique.

PMID- 1616974
TI  - AIDS literature index.

PMID- 1616973
TI  - STD screening with molluscum contagiosum.

PMID- 1616975
TI  - Isolation of swine infertility and respiratory syndrome virus (isolate ATCC VR
      2332) in North America and experimental reproduction of the disease in
      gnotobiotic pigs.
AB  - A recent epizootic of swine infertility and respiratory syndrome (SIRS) in a
      Minnesota swine herd was investigated. Examination of a sow, neonatal piglets,
      and stillborn fetuses obtained during the epizootic from the affected herd
      revealed interstitial pneumonitis, lymphomononuclear encephalitis, and
      lymphomononuclear myocarditis in the piglets and focal vasculitis in the brain of
      the sow. Fetuses did not have microscopic lesions. No cause for the infertility
      and respiratory syndrome was determined. Therefore, attempts were made to
      experimentally reproduce the disease. Eleven 3-day-old gnotobiotic piglets
      exposed intranasally to tissue homogenates of piglets from the epizootic became
      inappetent and febrile by 2-4 days postexposure and had interstitial pneumonitis
      and encephalitis similar to that seen in the field outbreak. After 2 blind
      passages in gnotobiotic piglets, tissue homogenates were cultured on continuous
      cell line CL2621, and a cytopathic virus (ATCC VR-2332), provisionally named SIRS
      virus, was isolated. Gnotobiotic piglets exposed intranasally to the SIRS virus
      developed clinical signs and microscopic lesions that were the same as those in
      piglets exposed to the tissue homogenates, and the virus was reisolated from
      their lungs. This is the first isolate of SIRS virus in the United States that
      fulfills Koch's postulates in producing the respiratory form of the disease in
      gnotobiotic piglets and the first report of isolation and propagation of the
      virus on a continuous cell line (CL2621). The virus is designated as American
      Type Culture Collection VR-2332.

PMID- 1616976
TI  - Characterization of swine infertility and respiratory syndrome (SIRS) virus
      (isolate ATCC VR-2332).
AB  - The characterization of an isolate of swine infertility and respiratory syndrome
      (SIRS) virus (ATCC VR-2332) is reported. A commercial cell line (CL2621) was used
      for the propagation of the virus for all assays. Laboratory studies indicate that
      this isolate is a fastidious, nonhemagglutinating, enveloped RNA virus. Cesium
      chloride-purified virions visualized by electron microscopy were spherical
      particles with an average diameter of 62 nm (range: 48-83 nm) and a 25-30 nm core
      surrounded by an envelope. Virus replication was restricted to the cytoplasm, as
      demonstrated by immunofluorescence. The virus did not react serologically with
      antisera to several common porcine viruses or with antisera to known viruses in
      the alphavirus, rubivirus, pestivirus, and ungrouped lactic dehydrogenase virus
      genera of the Togaviridae. However, convalescent sow sera and rabbit hyperimmune
      sera neutralized the SIRS virus at titers of 1:256 and 1:512, respectively. The
      virus was stable at 4 and -70 C, but was labile at 37 and 56 C. The properties of
      this isolate of SIRS virus resemble those of the family Togaviridae but do not
      match the described genera.

PMID- 1616977
TI  - Antigenic comparison of Lelystad virus and swine infertility and respiratory
      syndrome (SIRS) virus.
AB  - This study reports the antigenic relatedness of isolates of Lelystad virus
      collected in the Netherlands, Germany, and the United States. The binding of
      antibodies directed against these isolates was tested in a set of field sera
      collected during outbreaks of porcine epidemic abortion and respiratory syndrome
      in Europe and outbreaks of swine infertility and respiratory syndrome (SIRS) in
      North America. Two sets of sera from pigs experimentally infected with Lelystad
      virus or SIRS virus were also tested. Although all 7 isolates reacted with anti
      Lelystad virus sera, antigenic variation was considerable. The 4 European
      isolates resembled each other closely, but differed from the American isolates,
      and the 3 American isolates differed antigenically from each other. To reliably
      diagnose Lelystad virus infection, a common antigen must first be identified.

PMID- 1616978
TI  - Isolation of a cytopathic virus from weak pigs on farms with a history of swine
      infertility and respiratory syndrome.
AB  - Severe clinical signs of swine infertility and respiratory syndrome (SIRS) of
      unknown cause were observed in several Minnesota swine farms between November
      1990 and March 1991. Forty-five lung samples of weak pigs were collected from 13
      swine farms, and virus isolation was attempted using swine alveolar macrophage
      (SAM) cultures. A cytopathic virus was isolated from 19 lung samples collected
      from 6 different farms. Four pregnant sows were infected intranasally with a
      tissue suspension from which virus was isolated, and 4 6-week-old pigs and 2
      contact pigs were infected intranasally with 1 of the isolates. The 4 sows
      farrowed 12 stillborn and 32 normal pigs. Virus was recovered from 10 of 19 pigs
      examined. Infected 6-week-old pigs were clinically normal except for slightly
      elevated rectal temperatures and mild respiratory signs. No or mild interstitial
      pneumonic lesions were observed in inoculated pigs, but the lesion was obvious in
      the 2 contact pigs. Seroconversion was observed in sows and pigs as measured by
      indirect fluorescent antibody (IFA). Serologic identification of the isolates was
      carried out by IFA using reference serum prepared from an experimentally infected
      sow. A cytoplasmic fluorescence was observed on the SAM monolayers infected with
      each of the 19 different isolates. Fluorescence was also observed when the
      monolayers were tested with SIRS virus ATCC VR-2332-infected sow sera.
      Replication of the isolates was not affected in the medium containing 5-iodo-2'
      deoxyuridine but was inhibited by treatment with ether. The isolates were
      relatively stable at 56 C and did not agglutinate with various erythrocytes
      tested.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616979
TI  - An indirect fluorescent antibody test for the detection of antibody to swine
      infertility and respiratory syndrome virus in swine sera.
AB  - An indirect fluorescent antibody (IFA) test was developed and standardized to
      detect and quantitate antibody for swine infertility and respiratory syndrome
      (SIRS) virus in swine sera. Test results were evaluated using sera of pigs
      infected both experimentally and naturally with SIRS virus. The IFA test used
      swine alveolar macrophage (SAM) monolayers prepared in 96-well microplates and
      infected with SIRS virus. The monolayers were incubated with test sera, washed,
      and stained with fluorescein isothiocyanate-labeled rabbit anti-swine IgG. After
      another wash step, the monolayers were examined under a fluorescent microscope. A
      noninfected SAM control well was included for each sample. The antibody titers
      for each serum sample were recorded as the highest serum dilutions with specific
      cytoplasmic fluorescence but no fluorescence in the control wells. To evaluate
      the test, sera of 4 6-week-old pigs that had been infected with SIRS virus, 2
      contact pigs, and 13 experimentally infected sows were used. In the
      experimentally infected pigs, antibody was first detected at 7 days postexposure
      (PE) and peaked (1:256-1,024) between 11 and 21 days PE. All 13 sow sera were
      negative at time of infection but were positive (1:64- greater than or equal to
      1:1,024) at 14-26 days PE. Seven hundred twenty sera collected from 25 different
      swine farms with or without a history of SIRS were also tested. Of 344 sera from
      15 swine farms with a clinical history of SIRS, 257 (74.7%) sera had IFA titers
      greater than or equal to 1:4, whereas 371 (98.7%) of 376 sera from herds with no
      history of SIRS were negative.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1616980
TI  - Retrospective study of testicular degeneration in raccoons with canine distemper
      infection.
AB  - A 6-year (1985-1990) retrospective survey of raccoons with canine distemper
      infection and an outbreak of the disease in 1988 on South Island, South Carolina,
      are described. During this epizootic, 3 male raccoons with the clinical disease
      had gross testicular lesions that, on histopathologic examination, revealed
      severe diffuse degeneration and mineralization of seminiferous tubules. The
      testicular pathology of canine distemper in raccoons has not been previously
      reported.

PMID- 1616981
TI  - Antimicrobial resistance patterns and plasmid profiles of Streptococcus suis
      isolates.
AB  - Streptococcus suis isolates recovered from diseased animals in Quebec and western
      Canada and from human cases in Europe were tested for their susceptibility to
      different antimicrobial agents and screened for their plasmid content. Most
      isolates from Quebec were clindamycin, erythromycin, and tetracycline resistant;
      animal isolates from western Canada were notably less resistant to clindamycin
      and erythromycin, whereas human isolates were considerably more susceptible to
      most antimicrobials tested. More than 60% of isolates had plasmids that ranged
      from 1.5 to 35 kilobases (kb). Of the 7 plasmid profiles found, 2 were
      particularly frequent in isolates from Quebec and western Canada, suggesting the
      presence of epidemic strains in the swine population. A particular plasmid band
      of about 5 kb was present in most Canadian isolates. When this band was used as a
      probe in colony and Southern blot hybridization, most isolates harboring the 5-kb
      plasmid hybridized, even though their plasmid profiles were different. Human
      isolates from Europe differed in their plasmid content from Canadian isolates of
      animal origin. Although a high degree of antimicrobial resistance was associated
      with the presence of plasmids in most isolates, it was not possible to establish
      a causative relationship.

PMID- 1616983
TI  - Fungi associated with bovine abortion in the northern plains states (USA).
AB  - Mycotic infection was diagnosed in 6.8% of 6,858 cases of bovine abortion and
      stillbirth examined during a 9-year period. Aspergilli were associated with
      approximately 5% of all abortion cases and 71% of 446 cases that were cultured
      for fungi and diagnosed as mycotic abortion. Aspergillus fumigatus was the most
      frequent isolate (62%), followed by A. terreus (6.7%), Emericella (Aspergillus)
      nidulans (3.0%), A. flavus (2.9%), and E. rugulosus (less than 1.0%). Zygomycetes
      (Absidia, Mortierella, Rhizomucor, Rhizopus) accounted for 21% of the cases.
      Pseudallescheria boydii and yeasts (Candida, Torulopsis) were each identified in
      2% of the cases. Fungi that uncommonly cause infection accounted for 2% of the
      cases and included Curvularia geniculata, Exophilia jeanselmei, Hendersonula
      toruloidea, Lecythosphora hoffmannii, Talaromyces flavus var. flavus (Penicillium
      vermiculatus), T. (Penicillium) thermophilus, and Wangiella dermatitidis. About
      10% of the mycotic cases were mixed fungal infections involving A. fumigatus
      (87%), A. flavus (12.5%), or E. nidulans (12.5%) coexisting with Absidia
      corymbifera (72%), Rhizomucor pusillus (4.3%), or Rhizopus arrhizus (4.3%). In
      each mixed infection, both septate and nonseptate hyphae were observed in
      placental tissues. Twelve percent of the mycotic abortion cases were diagnosed by
      histologic examination alone because isolation attempts were negative or only
      formalin-preserved tissues were available.

PMID- 1616982
TI  - Etiologic agents detected in a 10-year study of bovine abortions and stillbirths.
AB  - During a 10-year period, specimens from 8,995 bovine abortions were submitted to
      the South Dakota Animal Disease Research and Diagnostic Laboratory; 8,962 of
      these specimens were suitable for examination. A supportable diagnosis was made
      in 2,942 (32.82%) of the abortions examined. An infectious cause was determined
      for 2,723 (30.38%) and a noninfectious cause for 219 (2.44%). Bacteria caused
      1,299 (14.49%), viruses caused 948 (10.57%), and fungi caused 476 (5.31%). The
      infectious bovine rhinotracheitis virus was associated with 485 (5.41%) and the
      bovine viral diarrhea virus with 407 (4.54%). The most common noninfectious
      causes of abortion or stillbirth were anomalous development, 112 (1.25%);
      dystocia, 56 (0.62%); and twinning, 37 (0.41%). The cause of 6,020 (67.17%)
      abortions was not determined. Lesions, many suggesting the presence of infection,
      were present in 1,554 (17.34%) fetuses or placentas in which no infectious agent
      could be demonstrated.

PMID- 1616984
TI  - Serologic evidence incriminating a recently isolated virus (ATCC VR-2332) as the
      cause of swine infertility and respiratory syndrome (SIRS).

PMID- 1616985
TI  - A repository of specimens for comparison of diagnostic testing procedures for
      bovine paratuberculosis.

PMID- 1616987
TI  - Summary of bacterial isolates from farm-reared channel catfish (1979-1988).

PMID- 1616986
TI  - Evaluation of a commercial solid-phase enzyme immunoassay for the detection of
      ovine Chlamydia psittaci.

PMID- 1616988
TI  - Porcine Streptococcus suis in Minnesota.

PMID- 1616989
TI  - Erysipelothrix rhusiopathiae septicemia-polyserositis and streptococcal
      encephalitis in a calf.

PMID- 1616990
TI  - Enteric infection of a goat with enterohemorrhagic Escherichia coli (O103:H2).

PMID- 1616991
TI  - Clostridium chauvoei myositis infection in a neonatal calf.

PMID- 1616992
TI  - Prostatic hemangiosarcoma in a dog: clinical and pathologic findings.

PMID- 1616993
TI  - Hemopericardium in a dog due to hemorrhage originating in a heart base thymic
      remnant.

PMID- 1616994
TI  - The requirement of fibroblasts to confirm the identity of cytogenetic centric
      fusion (CF) carriers in same-sex twin cattle.

PMID- 1616995
TI  - Neuroendocrine tumor (paraganglioma) in an adult bovine.

PMID- 1616996
TI  - Sclerosing peritoneal mesothelioma in a dog evaluated by electron microscopy and
      immunoperoxidase techniques.

PMID- 1616997
TI  - Scoliosis and hydrocephalus in an ovine fetus infected with Toxoplasma gondii.

PMID- 1616998
TI  - Neospora-like protozoan infection as a cause of abortion in dairy cattle.

PMID- 1616999
TI  - Rapid identification of viable bacterial spores using a fluorescence method.
AB  - A method has been devised to differentiate viable and nonviable bacterial spores.
      "Germination-like" changes are initiated in spores with performic acid and
      lysozyme. The germinated spores are stained with aqueous acridine orange, a
      fluorescent dye. Nonviable spores fluoresce lemon-green and viable spores orange
      red. It is proposed that with the use of a membrane filter resistant to performic
      acid and lysozyme, the method may be used for spore enumeration in foods in about
      4 hr compared to conventional plating methods, which usually require up to 72 hr.

PMID- 1617000
TI  - Adaptations of Goldner's Masson trichrome stain for the study of undecalcified
      plastic embedded bone.
AB  - Specialized adaptations for application of Goldner's Masson trichrome stain to
      plastic embedded undecalcified bone specimens are presented. This stain can be
      used successfully on methyl-glycol methacrylate, glycol methacrylate and Spurr
      embedded bones. The stain affords the advantage of good cellular staining due to
      the hematoxylin component with concomitant sharp discrimination of mature bone
      matrix which stains green, immature new bone matrix which stains red, and
      calcified cartilage which stains very pale green. Use of red filters during
      photomicrography aids in bone-osteoid discrimination in black and white
      photographs.

PMID- 1617001
TI  - Serial sectioning of insects with hard exoskeleton by dissolution of the
      exocuticle.
AB  - The method reported here was designed to produce paraffin serial sections as thin
      as 5 microns of insects or other arthropods with a hard cuticle. Heads and
      abdomens of Apis mellifera, Eristalomyia tenax and Tenebrio molitor were fixed
      with Schaffer's liquid, dehydrate with 80% ethanol, 90% ethanol, two changes of
      100% isopropanol (2 hr each) and 12 hr in a 1:1 mixture of paraffin (58 C melting
      point) at 60 C. They were molded in paraffin after 12 hr of infiltration under a
      partial vacuum at 60 C. Large body openings of objects were sealed with paraffin
      to prevent infiltration of solvents. Thereafter, the outer paraffin was removed
      manually and with xylene (15 min); the cuticle was rehydrated with 100%
      isopropanol and 100% ethanol (15 min each). The objects were then treated with
      Sputofluol (Merck; a mixture of NaOH and NaClO) until they became white or their
      colorless endocuticle was stainable with aniline blue WS (C.I. 42755) after
      rinsing in a 50% acetic acid solution (v/v). They were then dehydrated with 100%
      ethanol and 100% isopropanol (15 min each) and subsequently re-embedded in
      paraffin. They were molded, sectioned, stained and mounted as usual.

PMID- 1617002
TI  - Rapid three-dimensional reconstruction at the light microscopic level and a
      technique for re-embedding the same semithin sections for electron microscopic
      examination.
AB  - Rapid three-dimensional reconstruction of serial sections at the light
      microscopic and ultrastructural levels was accomplished using a two-step
      technique. Fixed specimens were embedded in Epon and 1 microns sections were cut
      and placed on glass slides. One of every four sections was drawn onto
      transparency film for rapid three-dimensional reconstruction. The semi-thin
      sections were re-embedded in Epon and sectioned at 90 nm for examination in the
      electron microscopy.

PMID- 1617003
TI  - A pre-embedding reaction method for localizing NADH reductase and succinic
      dehydrogenase in skeletal muscle.
AB  - Paraffin wax embedding methods suitable for demonstrating the distribution of
      enzyme activity in tissues sections are uncommon; most procedures rely on the use
      of frozen section techniques. This paper describes a system for demonstrating
      certain enzymes which involves incubation of the tissue with appropriate
      substrates before a Paramat wax embedding procedure. While it has distinct merits
      of its own, the procedure is eminently suitable for use where a cryostat is not
      available; it can also be readily applied to other enzymes and tissues.

PMID- 1617004
TI  - Identification of the plant nucleolonema using silver staining of serial
      ultrathin sections.
AB  - A simple silver staining technique was applied to serial ultrathin sections of
      Vicia faba root tip meristems to investigate the structural organization of the
      nucleoli. The procedure consists of three steps: hydrophilic Lowicryl resin
      embedding, preparation of ribbons of serial ultrathin sections, and silver
      impregnation. This technique provided good contrast for a filamentous structure,
      previously called the "nucleolonema", in nucleoli at the light microscope level.
      Silver appears to react with some acidic proteins involved with ribosomal RNA
      transcription, since the major constituents of the nucleolonema are believed to
      be active rRNA transcriptional units. Tracing the nucleolonema through serial
      ultrathin sections strongly suggests that the nucleolonema is meandering and
      partly coiling within the nucleolus. The present technique permits identification
      of the nucleolonema in other plant species and investigation of its three
      dimensional structural organization.

PMID- 1617005
TI  - A microcomputer program for evaluating sampling error: an application to
      stereological methods for electron microscopy.
AB  - In situations where there is a need to minimize sampling error or sample size,
      the coefficient of variation (CV) may be used to evaluate sampling error as a
      function of the number of observations or subjects in a sample. For example, CV
      is useful for estimating the minimum number of electron micrographs (Nmin)
      required to obtain a representative field sample for stereological analysis. To
      facilitate the determination of Nmin, we have written a program (COEFficient) for
      DOS microcomputers which calculates CVs. COEF assists the user in reducing error
      to that which solely reflects biological variability, thereby minimizing the time
      and cost of subsequent analyses.

PMID- 1617006
TI  - Staining plant cells with silver. III. The mechanism.
AB  - Silver does not stain all cytological structures with the same intensity. The
      chemical basis for differential silver staining is unclear, but differences in
      protein side groups available to react with silver are likely involved. These
      include amine, carboxyl, phosphate, sulfhydryl and hydroxyl moieties. Here we
      report an investigation of the chemical groups that could be involved in salt
      nylon silver staining of onion root tip squashes. Based on the results, we
      conclude that SN silver staining primarily depends on the presence of tyrosine
      hydroxyl groups, and we propose a mechanism for staining.

PMID- 1617007
TI  - Growth factor requirements for DNA synthesis by Leydig cells from the immature
      rat.
AB  - Puberty in the male is dependent upon the elevated production of testosterone by
      the Leydig cells. LH affects this increase in testosterone output by increasing
      the total number of Leydig cells in the testis and by stimulating the
      steroidogenic pathway in these cells. Since Leydig cell proliferation is a
      prerequisite for the onset of puberty, we have examined the ability of LH and
      growth factors known to be present in the testis to promote DNA synthesis. Leydig
      cells were isolated from 21-day-old rats, cultured in serum-free medium for 48 h
      to become quiescent, and then treated with LH and growth factors for 18 h.
      [3H]Thymidine incorporation into DNA was assessed over the subsequent 4-h
      incubation period. Cells in control cultures incorporated low levels of
      [3H]thymidine into DNA and were stimulated after treatment with LH (100 ng/ml).
      Insulin/insulin-like growth factor-1 (IGF-1) and transforming growth factor-alpha
      (TGF-alpha), previously localized in Leydig cells by immunohistochemistry, also
      stimulated [2H]thymidine incorporation into DNA. The responses of the Leydig
      cells to maximum levels of insulin and TGF-alpha were dependent on the cell
      density. Insulin and TGF-alpha alone and in combination increased the number of
      cells labeled with [3H]thymidine, as assessed by autoradiography. TGF-beta, known
      to be secreted by Sertoli cells, also stimulated DNA synthesis under basal
      conditions, but the maximum response was significantly lower than that achieved
      in the presence of TGF-alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617008
TI  - Androgen maintenance of erectile function in the rat penis.
AB  - Previous research has shown that the frequency and duration of penile erection is
      diminished after castration and that replacement with testosterone will restore
      the process. Using rats, the present study was designed to confirm that erection
      is androgen-dependent and to determine whether castration and androgen
      replacement affect the penile vascular smooth muscle responsiveness to vasoactive
      drugs. Blood pressure in the corpus cavernosum was measured directly during
      erections induced by electrical stimulation of the autonomic innervation of the
      penis. Maximal cavernosal pressure was markedly reduced after castration but was
      returned to normal levels if the castrated animals were treated with
      testosterone. Infusion of nitroglycerin (vasodilator) or phenylephrine
      (vasoconstrictor) resulted in a decline in cavernosal pressure in androgen
      treated animals but not in castrated animals, even though the mean arterial blood
      pressure was strongly affected in all treatment groups by these drugs. When an
      inhibitor of nitric oxide synthesis was infused, cavernosal pressure was
      decreased in all groups, indicating that this substance is involved in penile
      erection. Taken together, these results show that androgens maintain the erectile
      process and may act specifically to support the responsiveness of the vascular
      smooth muscle to vasoactive drugs.

PMID- 1617009
TI  - Comparative studies of the antigens recognized by sperm-immobilizing monoclonal
      antibodies.
AB  - Characteristic properties of the antigens recognized by sperm-immobilizing
      monoclonal antibodies (SI-mAbs) from different sources were compared by ELISA
      competitive inhibition assay, Western blot analysis, chromatographic analysis,
      and enzymatic digestion studies. Among 9 SI-mAbs, human mAb H6-3C4 and three
      mouse mAbs--2C6, 2B6, and 2E5--also possessed strong sperm-agglutinating
      activity. Binding of human mAb H6-3C4 to sperm was strongly inhibited by the
      three mouse mAbs (2C6, 2B6, and 2E5), but not by the rat or the other four mouse
      mAbs. SDS-PAGE revealed that mAb H6-3C4 and three mouse mAbs recognized the same
      antigen molecules of 15-25 kDa present in both sperm extracts and seminal plasma.
      Chemical treatments with trifluoromethanesulfonic acid and sodium metaperiodate
      destroyed the antigen determinants recognized by the above four mAbs, as detected
      by both ELISA and antibody absorption tests. Western blot analysis revealed that
      the antigens were susceptible to treatments with papain, proteinase K, and N
      glycanase, but resistant to trypsin, V8 protease, and thermolysin. These results
      indicate that one of the major antigens recognized by mAbs with sperm
      immobilizing action may be a sperm membrane-associated glycoprotein of 15-25 kDa
      and the epitope may involve N-linked oligosaccharides.

PMID- 1617010
TI  - Effects of antiprogesterones on myometrial cell-to-cell coupling in pregnant
      guinea pigs.
AB  - We used intracellular microelectrodes to investigate the effects of the
      antiprogesterone (AP) compounds RU 486 and ZK 299 on cell-to-cell coupling in the
      guinea pig myometrium during pregnancy. The input resistance (Ro) of myometrial
      cells was high in nonpregnant tissues (44.6 +/- 6.39 M omega), but decreased by
      midgestation (Day 44 or 45 of gestation; 22.9 +/- 3.17 M omega), and was lowest
      at term (between 17.7 +/- 2.90 m omega and 13.1 +/- 4.34 M omega on Days 59-69).
      Treatment with the AP RU 486 or ZK 299 in three groups of midgestational animals
      reduced Ro to a similar level within 24 h. Lucifer Yellow (LY) was injected into
      smooth muscle cells as a direct but qualitative measure of metabolic coupling. In
      term and AP-treated animals, LY spread rapidly to neighboring cells within 60
      sec, but little spread occurred in midgestational control tissues and no spread
      was seen even after 10 min in nonpregnant tissues. This correlation of decreased
      Ro (implying increased electrical coupling) with the development of extensive
      spread of LY indicates increased electrical and metabolical coupling between
      myometrial cells during labor. These data show that myometrial smooth muscle
      cells of guinea pigs are moderately well coupled before the onset of labor, and
      the coupling increases further, just prior to spontaneous delivery or due to
      treatment with APs. These events may be required for synchronizing and
      coordinating the electrical, metabolic, and contractile activity of labor.

PMID- 1617011
TI  - Preovulatory changes in the perifollicular capillary network in the rat: role of
      eicosanoids.
AB  - The aim of this study was to evaluate morphometrically the influence of ovulation
      inhibiting doses of indomethacin, an inhibitor of the cyclooxygenase pathway, and
      esculetin and caffeic acid, inhibitors of the lipoxygenase pathway, on the
      dilatation of the perifollicular capillary network in the theca interna. The
      development of the perifollicular capillary network as a function of follicular
      size and the changes in the vascular lumen were examined by light microscopy on a
      series of semithin cross sections of rat ovaries. The number of capillaries in
      the theca interna increased linearly with increasing follicle diameter. Thus, the
      relative number of capillaries in the theca interna supplying the avascular
      stratum granulosum remained constant. This indicates that follicular function is
      not regulated through changes in the number of capillaries in the theca interna.
      After hCG injection, an increase in the capillary area could be observed in
      follicles having a diameter of more than 600 microns. Indomethacin administration
      increased the capillary area of the ovulatory follicles as compared to the
      untreated side only at 6 h after treatment. By contrast, treatment with
      inhibitors of lipoxygenase resulted in a significant decrease in the capillary
      area of large follicles at all times examined (3, 6, and 9 h after hCG
      injection). Nevertheless, since both types of eicosanoid inhibitors suppressed
      follicle rupture, in spite of their opposing actions on the capillary area, it
      seems unlikely that their action on ovulation is primarily due to their effect on
      this parameter.

PMID- 1617012
TI  - Androgenic activity in 15-day-old male rats: role of the maternal pineal gland.
AB  - Female Sprague-Dawley rats, exposed to a long (18L:6D) or a short (6L:18D)
      photoperiod from 21 days of age, were mated when they reached 55 days of age. On
      Day 2 of gestation, dams were pinealectomized or sham-operated. Pre- and
      postnatal photoperiods were identical, and offspring were killed at 15 days of
      age. Maternal pinealectomy had no effect when rats were kept on 18L:6D. Rats born
      to sham-operated mothers and kept on 6L:18D had higher testicular testosterone
      and androstenedione content than offspring raised on the long photoperiod. This
      stimulatory effect of the short photoperiod was blocked by maternal pinealectomy
      and was not dependent on the offspring's own pineal since it was observed in both
      sham-operated and neonatally (on Day 5 after birth) pinealectomized rats. When
      sham-operated mothers housed on 18L:6D were treated daily during pregnancy and
      lactation by s.c. melatonin injection, there was an increase in the testicular
      testosterone content of offspring. It was concluded that when rats are maintained
      on a 6L:18D cycle the maternal pineal gland enhances the testicular testosterone
      and androstenedione content in 15-day-old offspring. This effect is probably
      mediated by maternally derived melatonin. At 15 days of age, the pineal of the
      offspring had no influence on testicular function.

PMID- 1617013
TI  - Regulation of ovarian antioxidant vitamins, reduced glutathione, and lipid
      peroxidation by luteinizing hormone and prostaglandin F2 alpha.
AB  - Reactive oxygen species are generated by the rat ovary, and they evoke marked
      antigonadotropic responses in ovarian cells. Protection against reactive oxygen
      species is provided by antioxidants such as vitamins C, E, and A, and reduced
      glutathione (GSH). Our objectives were to establish the ovarian levels of these
      antioxidants during development and regression of the corpus luteum of the
      pseudopregnant rat and to determine whether these levels were changed by an acute
      treatment with either a luteotropic (LH) or luteolytic (prostaglandin [PG] F2
      alpha) agent. In addition, we evaluated the extent of oxidative activity in the
      ovary by determining the level of lipid peroxidation. Follicular development was
      associated with a significant increase in ovarian levels of vitamin A and GSH,
      whereas levels of vitamins E and C were unchanged. During the luteal phase,
      vitamin E levels tended to increase, whereas vitamin A and GSH levels decreased.
      Luteal regression was associated with a marked increase in ovarian levels of
      vitamins E and A, whereas GSH levels increased only transiently. Acute treatment
      with LH in the midluteal phase produced a transient decrease in vitamin C levels
      that was maximal at 4 h. Luteal vitamin E levels were markedly increased 24 h
      after LH treatment, whereas vitamin A levels were unchanged, and no evidence of
      lipid peroxidation was seen. Acute treatment with PGF2 alpha produced a transient
      decrease in luteal vitamin C levels coincident with transient lipid peroxidation
      and a sustained fall in serum progesterone levels. Ovarian vitamin A levels were
      elevated 24 h after PGF2 alpha treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617014
TI  - Demonstration of oxytocin release by bovine luteal cells utilizing the reverse
      hemolytic plaque assay.
AB  - Corpora lutea (CL) of a number of species produce oxytocin (OXT). In the present
      experiments we studied basal, prostaglandin (PG) F2 alpha-stimulated and
      ascorbate-stimulated OXT release from individual bovine luteal cells utilizing
      the reverse hemolytic plaque assay (RHPA). Using a mixture of C- and N-terminus
      specific antisera against OXT, we were able to demonstrate OXT plaque formation
      by individual luteal cells. CL consist of two steroidogenic cell types: large
      luteal cells (LLC), believed to derive from granulosa cells and to produce and
      secrete OXT, and small luteal cells (SLC), thought to derive from theca cells. To
      distinguish between these two cell types, we designated cells greater than 20
      microns as LLC and those less than 20 microns as SLC. On the basis of this
      morphological parameter, OXT release from both LLC and SLC was demonstrable.
      After an incubation period of 15 h, 7% of both cell types formed OXT plaques. PGF
      2 alpha and ascorbate increased the size of plaques surrounding both LLC and SLC
      to more than 200% and 240%, respectively (basal plaque size = 100%). The number
      of plaque-forming cells increased only slightly in the presence of either PGF 2
      alpha or ascorbate in comparison to basal conditions. We suggest that the RHPA
      can be used to demonstrate peptide release from luteal cells. It is concluded
      that LLC may be subdivided into functional subclasses because less than 10% of
      bovine luteal cells release OXT. Known OXT secretagogues increased the amount of
      OXT released. It appears that not only LLC but also SLC secrete this
      peptide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617015
TI  - A quantitative comparison of the passage of capacitated and uncapacitated hamster
      spermatozoa through the uterotubal junction.
AB  - Female hamsters were artificially inseminated at the time of ovulation with an
      equal concentration and volume of capacitated sperm suspension in one uterus and
      uncapacitated sperm suspension in the contralateral uterus. When oviducts were
      examined 3.5-4.0 h after insemination, a significantly (paired t-test, p less
      than 0.05) lower number of spermatozoa were found in the oviduct from the side
      inseminated with capacitated sperm suspension compared to the side inseminated
      with uncapacitated sperm suspension. The reduction in the number of spermatozoa
      entering the oviduct on the side inseminated with capacitated sperm suspension
      was particularly evident when nearly all the spermatozoa in the suspension were
      hyperactivated. These results suggest that hamster spermatozoa require a
      progressive linear type of motility pattern to pass efficiently through the
      uterotubal junction and that under normal conditions in vivo, fertilizing
      spermatozoa initiate hyperactivated motility after entering the oviduct.

PMID- 1617016
TI  - Different neuroendocrine systems modulate pulsatile luteinizing hormone secretion
      in photosuppressed and photorefractory ewes.
AB  - The objective of this study was to determine whether two photoperiod regimens
      that induce anestrus in the ewe-short-day photorefractoriness (SDPR) and long-day
      photosuppression (LDPS)--act by different neuronal mechanisms. In separate
      experiments, ovary-intact (INTACT), ovariectomized (OVX), and ovariectomized
      estradiol-treated (OVX + E) ewes were subjected to three different photoperiodic
      regimens that resulted in reproductive quiescence: (1) exposure to long days
      (16L:8D), which caused photosuppression (INTACT, n = 9; OVX, n = 6; OVX + E, n =
      5; (2) prolonged exposure to short days (10L:14D)), which caused
      photorefractoriness (INTACT, n = 10; OVX, n = 6; OVX + E, n = 5); (3) exposure to
      natural photoperiod, which induced seasonal anestrus (INTACT, n = 11; OVX, n = 6;
      OVX + E, n = 5). Effect of photoregimen was monitored by measuring progesterone
      or LH. Drug challenges were made after two sequential estrous cycles were missed
      in INTACT ewes, after mean LH concentrations dropped below 1 ng/ml in OVX + E
      ewes, and after LH interpulse intervals increased in OVX ewes. Effects of drug on
      LH pulse pattern were determined by taking blood samples at 12-min intervals for
      8 h after i.v. diluent injection; then for 8 h after i.v. injection of
      cyproheptadine, a serotonin antagonist (3 mg/kg); and again 7 days later after
      i.v. injection of diluent or pimozide, a dopamine antagonist (0.25 mg/kg).
      Cyproheptadine had little effect except to decrease (p = 0.05) mean LH in INTACT
      anestrous ewes and decrease (p less than 0.01) pulse amplitude in OVX + E SDPR
      ewes. Pimozide did not affect LH pulse frequency in LDPS ewes. However, pimozide
      increased LH pulse frequency (p less than 0.005) and mean concentrations (p less
      than 0.005) in SDPR OVX + E ewes, whereas it suppressed LH pulse frequency (p
      less than 0.05) and amplitude (p less than 0.03) in SDPR INTACT and SDPR OVX
      ewes. The results suggest that (1) the role of the dopaminergic system differs in
      SDPR and LDPS ewes, and that different neuronal systems may effect SDPR and LDPS,
      (2) the effect of pimozide in SDPR ewes is altered by ovarian steroids, and (3)
      the serotonergic system has relatively little role in regulating pulsatile LH
      secretion in any of the three different states of anestrus.

PMID- 1617017
TI  - A similar distribution of gonadotropin isohormones is maintained in the pituitary
      throughout sexual maturation in the heifer.
AB  - Our working hypotheses for this study were that 1) the profile of intrapituitary
      LH and FSH isoforms would be shifted toward acidic forms as sexual maturation
      progresses in the bovine female; and 2) concentration of 17 beta-estradiol (E2)
      in circulation during sexual maturation would be a major factor modulating the
      percentage of the more acidic isoforms. In addition, the biological
      immunoreactive (B:I) ratios of each isoform of LH were evaluated at selected
      stages of sexual maturation. Heifers (7 mo of age) were assigned to one of three
      treatment groups: 1) ovariectomized (OVX; n = 16); 2) OVX and administered E2
      (OVXE; n = 16); or 3) ovary-intact (INTACT; n = 14). Pituitaries were collected
      from heifers in each group at an estimated 120 days (prepubertal) of 25 days
      before puberty (peripubertal). A fourth group of 6 heifers remained intact
      (postpubertal INTACT) to determine time of puberty during the experimental
      period. Pituitaries of heifers assigned to the postpubertal INTACT group were
      collected during the follicular phase of the first or second estrous cycle
      postpuberty. Pituitaries were used for determination of relative amounts of
      gonadotropin isohormones. Tissue extracts of the pituitaries were chromatofocused
      on pH 10.5-4.0 gradients. The LH of all pituitaries resolved into thirteen
      isoforms that were designated isoforms A-L, and S, with isoform A the most basic
      form. Isoforms F and G (basic pH range) were the predominant isoforms of each
      chromatofocusing profile and comprised 50-60% of the immunoreactive LH. Isoforms
      J and K were the major isoforms eluting in the acidic pH range.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1617018
TI  - Sites of estrogen uptake in embryonic Trachemys scripta, a turtle with
      temperature-dependent sex determination.
AB  - Female sex determination can be induced in embryonic red-eared slider turtles
      (Trachemys scripta) by exogenous estrogen, as well as by incubation at warm
      temperature. In the present study, estrogen target areas were identified in
      embryos before (stage 15), during (stage 18), and after (stage 22) the critical
      period for sex determination. Both hyperfilm and emulsion autoradiography were
      used to localize tritium accumulation after the injection of radiolabeled 17 beta
      estradiol. Site-specific tritium-labelling was found at all stages, notably in
      the mesonephros at stage 15, in the mesonephros and oviduct at stage 18, and in
      the mesonephros, oviduct, and the interrenal gland at stage 22. Few if any cells
      in the gonad were tritium-labeled at any stage. The large number of estrogen
      concentrating cells in the mesonephros and interrenal and the lack of binding to
      gonadal tissues indicates that estrogen action on gonadal differentiation during
      the period of sex determination may be indirect.

PMID- 1617019
TI  - Human leukemia inhibitory factor improves the viability of cultured ovine
      embryos.
AB  - Embryos were collected from ewes on Day 6 after estrus (Day 0 = estrus), placed
      in M2 culture medium, and assigned to 1 of 4 treatment groups. Some embryos were
      transferred to recipient ewes on Day 6 of their estrous cycle either in pairs
      (group 1) or singularly (group 2) within 3 h of collection. The remaining embryos
      were individually cultured for 48 h in an atmosphere of 5% CO2 in humidified air
      in either synthetic oviduct fluid (SOF) medium (group 3) or SOF containing 1,000
      U/ml of recombinant human leukemia inhibitory factor (hLIF) (SOF + hLIF: group
      4). These embryos were then transferred to recipient ewes on Day 8 of their
      estrous cycle. The addition of hLIF to culture medium significantly improved the
      development of the embryos compared with control embryos prior to transfer
      (blastocysts hatching from the zona pellucida: group 3 = 16% vs. group 4 = 64%, p
      less than 0.05; those degenerative: group 3 = 27% vs. group 4 = 9%, p less than
      0.05) and the subsequent pregnancy rates of the recipient ewes, receiving a
      single embryo, at Day 70 of pregnancy (group 3 = 16% vs. group 4 = 50%, p less
      than 0.05). The pregnancy rate of ewes given embryos cultured for 48 h in SOF +
      hLIF prior to transfer (50%; group 4) was similar to the group 2 ewes receiving a
      single embryo soon after collection (52%), but the pregnancy rate for both groups
      was significantly lower than that for the group 1 ewes receiving two embryos soon
      after collection (89%: 53% twins, 36% singles; p less than 0.05).

PMID- 1617020
TI  - Proteins secreted from the early ovine conceptus block the action of
      prostaglandin F2 alpha on large luteal cells.
AB  - In this study we evaluated whether the early conceptus secretes a factor that
      blocks the action of prostaglandin (PG) F2 alpha on cultured ovine large luteal
      cells. PGF2 alpha inhibited progesterone production by lipoprotein-stimulated
      large luteal cells and this anti-steroidogenic action was blocked in a dose
      dependent manner by conceptus proteins secreted from Day 15 embryos. Purified
      ovine trophoblast protein-1 (oTP-1) did not exhibit the anti-PGF2 alpha activity,
      but secreted conceptus proteins devoid of oTP-1 did prevent the anti
      steroidogenic effects of PGF2 alpha. This activity does not appear to be a
      nonspecific effect of protein since neither serum albumin nor thyroglobulin,
      gamma globulin, insulin, LH, secreted ovine endometrial proteins, or heat
      inactivated secreted conceptus proteins had this action. After molecular-sizing
      chromatography we found a high- and a low-molecular weight fraction with luteal
      protective activity. Neither of the secreted conceptus protein fractions blocked
      the binding of 3H-PGF2 alpha to large luteal cells. However, conceptus proteins
      did block the anti-steroidogenic action of phorbol ester and calcium ionophore on
      large luteal cells, suggesting that secreted conceptus proteins act after
      activation of the free calcium/protein kinase C intracellular effector pathways.
      Thus, the early ovine conceptus secretes a luteal protective protein(s) that may
      be important for maintaining the corpus luteum during early pregnancy; however,
      the physiologic significance of this luteal protective protein(s) cannot be
      stated without further investigation.

PMID- 1617021
TI  - Influence of cell cycle stage of the donor nucleus on development of nuclear
      transplant rabbit embryos.
AB  - We evaluated the influence of the stage of the cell cycle of the donor nucleus on
      development in vitro of nuclear transplant rabbit embryos. The developmental
      potential of nuclei in early, mid-, and late stages of the cell cycle was
      determined. Duration of the G1 phase in early embryos was determined, and a
      procedure for reversibly synchronizing donor embryos in the G1 phase was
      developed. In addition, the extent of development in vitro of nuclear transplant
      embryos with donor nuclei synchronized in the G1 phase was evaluated. Development
      to blastocysts was greatly affected by the stage of the cycle of the donor
      nucleus. Use of early-stage nuclei led to 59% nuclear transplant blastocysts,
      whereas 32% and 3% were obtained with mid- and late-stage nuclear donors,
      respectively (p less than 0.001). The short duration of the G1 phase in 16- and
      32-cell-stage embryos (approximately 30 min) necessitated a procedure for
      synchronizing blastomeres in the G1 phase. This entailed, first, a 10-h
      incubation in 0.5 micrograms/ml colcemid to arrest embryos in metaphase. After
      release from colcemid, embryos were allowed to cleave in 0.1 microgram/ml of the
      DNA synthesis inhibitor, aphidicolin, and remained blocked at the G1/S
      transition. This treatment was reversible, as assessed by the resumption of DNA
      synthesis, cleavage rate, and development to blastocysts of treated embryos. The
      beneficial effect of using early-stage donor blastomeres was confirmed by the
      enhanced rate of development of manipulated embryos to blastocysts with donor
      nuclei in the G1 phase (71%), as opposed to the late S phase (15%, p less than
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617022
TI  - Effect of donor cell cycle stage on chromatin and spindle morphology in nuclear
      transplant rabbit embryos.
AB  - We investigated the influence of the cell cycle stage of the nuclear donor on
      prematurely condensed chromatin (PCC) and spindle morphology and on chromosome
      constitution in rabbit nuclear transplant embryos. The configuration of PCC
      following nuclear transplantation with G1, early S, and late S phase donor nuclei
      (G1, early S, and late S transplants, respectively) was characterized in whole
      mounts and chromosome spreads. In addition, the influence of the donor cell cycle
      stage on chromosome constitution in cleavage stage-manipulated embryos was
      determined. Within 2 h after fusion of the donor blastomere, the recipient oocyte
      cytoplasm was able to induce formation de novo of a metaphase plate associated
      with a spindle in G1, early S, and late S transplants. Metaphase chromosomes and
      spindle were intact in most cases of PCC in G1 transplants. However, these
      structures displayed minor abnormalities in early S transplants and gross
      abnormalities in late S transplants, such as incomplete or absent spindle
      formation and incomplete chromatin condensation. Normal chromosomes were present
      in G1 and early S transplants, whereas chromosome abnormalities were detected in
      late S transplants. The results indicate that morphology of prematurely condensed
      G1 and early S chromatin has a minor influence on chromosome constitution of
      manipulated embryos. That of late S chromatin, however, affects chromosome
      constitution in embryos and may account for reduced development of nuclear
      transplant embryos when late S phase donor nuclei are used.

PMID- 1617023
TI  - Program for the 25th annual meeting of the Society for the Study of Reproduction.
      Raleigh, North Carolina, July 12-15, 1992. Abstracts.

PMID- 1617024
TI  - [The autologous transfusion concept--a legal necessity or a practical
      development? Are there consequences from the new BGH decision?].

PMID- 1617025
TI  - [Anesthesia and acute hepatic porphyrias].
AB  - Acute hepatic porphyrias are inherited disorders of heme biosynthesis. A
      characteristic feature of acute porphyrias is the occurrence of acute attacks
      which are often precipitated by drugs. Many of the commonly used anaesthetic
      agents may trigger such a potentially lethal attack. Thus, only safe agents
      should be administered to predisposed patients. Recommendations given are based
      on results from animal experiments and on a series of anecdotal reports. Regional
      anaesthesia is presented as anaesthetic technique of choice. General anaesthesia
      should be based on a fentanyl-nitrous oxide regimen, with propofol as induction
      agent. In the case of an acute attack, treatment consists of glucose and haematin
      administration.

PMID- 1617026
TI  - [Systematics and concept of a future integrated anesthesia device].
AB  - On the grounds of the more than one hundred years lasting development of the
      anaesthesia machine the systematics of the components of a future integrated
      anaesthesia machine is described. The new generation of today's anaesthesia
      machine incorporates four main functions: dosing, ventilation, monitoring and
      data management. Given the achievements of the last 15 years in the fields of
      data and signal analysis, of the clinical pharmacology of intravenous
      anaesthetics, of measurement and evaluation of anaesthetic drug action, the four
      main functions are only partially realized in today's anaesthesia machines.
      Especially lacking are the integration of smart dosing devices for intravenous
      anaesthetics, the so-called "therapeutic monitoring" which monitors the efficacy
      of anaesthetic drug action, and a data management system which does not only
      manage data but interprets them in terms of "smart alarms" and maybe in the
      future also by expert systems. The concept of a future integrated anaesthesia
      machine is investigated via a study model and on the basis of a real model
      composed of already existing devices.

PMID- 1617027
TI  - [Are humidity filters necessary in the inspired air in the breathing circuit? A
      new in vivo method of measuring humidity in the air breathed].
AB  - Humidification of inspiratory gases under anaesthetic conditions still is a
      matter of controversial discussion. Physiological humidification and heating of
      breathing air are preconditions for mucociliary clearance, pulmonary cleaning and
      defence mechanisms. These functions of the upper respiratory tract are eliminated
      by application of artificial airways. In general the humidification of
      inspiratory gases should not remain under 70% of relative air humidity at 37
      degrees C. Under clinical conditions it is problematic to ensure sufficiently
      rapid and reproducible measurements of humidity during breathing cycles. We
      developed a measuring method that enables to make these measurements without big
      mechanical device. Aim of this investigation was to measure air humidity in
      typical semiclosed systems during anaesthesia and semiopen CPAP-respiration. The
      necessity and efficiency of a heat and moisture exchanger (HME) was to be
      investigated as well. After approximately 5 minutes there was an inspiratory
      relative air humidity not below 70% at 28 degrees C (19 mg H2O/l humid air)
      within the breathing circuit with CO2 double-absorber. By using an HME it is
      possible to increase relative air humidity within this system to 86% at 29.5
      degrees C (25 mg/l). After one hour's respiration with this system without HME a
      relative humidity of 87% at 30 degrees C (26 mg/l) is reached after replaced HME.
      Initial relative humidity in a semiopen CPAP-system is about 12% at 28 degrees C
      (3 mg/l). This is increased to 85% at 29.5 degrees C (25 mg/l) after 15 minutes
      respiration with HME.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617028
TI  - [Prophylactic administration of glucocorticoids prior to microlaryngoscopies?].
AB  - Intravenous glucocorticoids before direct laryngoscopy? The necessity of a
      preventive injection of corticoids before direct laryngoscopy was determined in a
      prospective, double blind study. 51 patients, who underwent direct laryngoscopy
      under general anaesthesia, received either 250 mg methylprednisolone in 10 ml
      NaCl 0.9% (corticoid group) or 10 ml NaCl (NaCl group) intravenously one hour
      before laryngoscopy. Oedema formation and the degree of inflammation in the
      pharynx and hypopharynx were examined on the day prior to surgery and three to
      four hours postoperatively. Complications of the airways were noted in the
      immediate postoperative phase and at the time of the second examination. Direct
      laryngoscopy did not induce any significant change in oedema formation or degree
      of inflammation in both groups. However, there was a correlation between the
      duration of surgery and the degree of increase in oedema and inflammation in the
      NaCl group but not in the corticoid group. No difference between the groups was
      noted with regard to postoperative complications of the airways. Based on the
      present study, routine application of corticoids to prevent oedema after direct
      laryngoscopy cannot be recommended.

PMID- 1617029
TI  - [The pulmonary first pass effect of noradrenaline following intravenous and
      endobronchial administration for resuscitation].
AB  - In a porcine CPR-model, we investigated the pharmacokinetics and pharmacodynamics
      of norepinephrine (NE) after intravenous (10 g/kg, n = 10, group A) and
      endobronchial (e.b., 100 micrograms/kg, n = 10, group B) administration. After 3
      min of cardiac arrest induced by electroshock, restitution of spontaneous
      circulation (ROSC) was achieved in 8 animals in group A after 3.3 +/- 1.6 min,
      and in group B in 6 animals after 2.5 +/- 0.6 min. Haemodynamics during CPR were
      not significantly different, but during the first hour after ROSC e.b. NE showed
      a depot effect. Maximum venous (642 +/- 182 ng/ml after 3.5 +/- 0.3 min) and
      arterial (147 +/- 21 ng/ml after 4.2 +/- 0.4 min) NE concentrations in group A
      were significantly higher compared with values in group B (77 +/- 18 ng/ml after
      5.5 +/- 0.5 min venous, 46 +/- 11 ng/ml after 6.0 +/- 0.7 min arterial). The area
      under the curve (AUC) in group A was calculated to be 55 +/- 12 ng/ml min
      (venous) and 35 +/- 7 ng/ml min (arterial) representing a pulmonary first-pass
      effect of 40%. In group B, the dose-adjusted AUC (39 +/- 13 ng/ml min venous, 30
      +/- 10 ng/ml min arterial) represented a pulmonary first-pass effect of only 25%.
      Despite this lower pulmonary first pass, however, it is concluded that after e.b.
      administration of NE absorption is too much delayed and peak concentrations are
      too low. Therefore, NE should not be given via this route during CPR.

PMID- 1617030
TI  - [Amrinone for cardiovascular therapy in hypodynamic septic patients?].
AB  - Pulmonary hypertension, systemic vasodilation and the supply dependency of oxygen
      uptake are the major problems associated with sepsis. Thus, the goal of
      haemodynamic therapy in septic patients is an increase in cardiac output large
      enough to permit adequate tissue oxygenation. The purpose of this study was to
      establish whether the additional use of the phosphodiesterase inhibitor amrinone
      is useful in hypodynamic septic patients with inadequate tissue perfusion. Nine
      patients who had developed the clinical signs of sepsis (temperature greater than
      38.5 degrees C, leukocytosis greater than 15,000/mm3, thrombopenia less than
      100,000/mm3 or a drop in platelet count greater than 30%, cardiovascular shock)
      were given amrinone 30 micrograms.kg-1.min-1 for one hour. All patients showed
      mixed venous oxygen saturations below 70% and oxygen extraction rates above 30%,
      despite maximum catecholamine therapy. Haemodynamic parameters were measured with
      the help of a pulmonary artery catheter. Statistical significance was checked
      using the Wilcoxon signed-ranks test. During amrinone application cardiac index
      increased significantly from 4.6.1.81.min-1.m-2 to 5.6 +/- 1.81.min-1.m-2 (p less
      than 0.01), while central venous pressure was kept constant by volume supply.
      Mean pulmonary artery pressure remained nearly unchanged, whereas mean arterial
      pressure dropped significantly from 91 +/- 13 mmHg to 75 +/- 8 mmHg (p less than
      0.01). The oxygen supply rose during administration of amrinone by an average of
      17%, which led to a rise in oxygen uptake. Independence of oxygen uptake from
      oxygen supply, however, could not be attained. In septic patients, amrinone
      increases cardiac output via pulmonary vasodilation. However, pronounced systemic
      vasodilation lowers arterial blood pressure, enhancing the risk of myocardial
      ischaemia.

PMID- 1617031
TI  - [Puncture sets for suprapubic catheter drainage of the bladder].
AB  - Suprapubic fistula catheter drainage (SFC) has numerous important advantages
      compared with transurethral bladder drainage. Commercial SFC-sets should provide
      security and comfort to a high degree for patients and users in general, so that
      they can make profitable use of these advantages. The equipment of SFC-sets
      should be adapted to the site and circumstances of use. Therefore, we recommend
      the introduction of defined standard SFC-sets for application in intensive-care
      units. We describe 16 usual SFC-sets. Every single set possesses certain
      disadvantages. Improvements, especially as far as trocar and catheter are
      concerned, are necessary to lead to a further spread of the SFC-method, so that
      more patients can benefit from the method. Detailed hints for improvements and
      alterations are provided.

PMID- 1617032
TI  - [A case report on a 9-day-long abuse of propofol].
AB  - This case report deals with the case of an alcohol-dependent, but abstinent
      patient, who took 3 x 5 ml/d (= 150 mg) propofol intravenously for nine days.
      Anxiety, inner tension and restlessness routine which had previously occurred
      during his daily vanished. No other psychotropic effects occurred.

PMID- 1617033
TI  - [Historic vignette (3). The narcotizer].

PMID- 1617034
TI  - [How safe is isovolemic hemodilution in elderly patients at risk?].

PMID- 1617035
TI  - Evaluation of new oral antimicrobial agents and the experience with cefprozil--a
      broad-spectrum oral cephalosporin.

PMID- 1617036
TI  - Pharmacology and pharmacokinetics of cefprozil.
AB  - Cefprozil is a new orally administered cephalosporin with a spectrum of in vitro
      activity similar to that of cefuroxime. The pharmacokinetics of cefprozil are
      linear relative to dose size. Gastrointestinal absorption produces maximal plasma
      concentrations of approximately 10 mg/L 1-2 hours after administration of an oral
      dose of 500 mg. Approximately 94% of the dose is absorbed, and 60%-70% is
      excreted in the urine as unchanged drug. The renal clearance exceeds the
      glomerular filtration rate, thus suggesting active tubular secretion.
      Administration with food or antacids produces negligible effects on the rate or
      extent of absorption. Kinetic disposition in the elderly is similar to that in
      young healthy individuals, but elimination is slightly slower in infants and
      children. Because renal impairment, but not hepatic dysfunction, significantly
      reduces the elimination of cefprozil, it is recommended that the dosage be
      reduced by 50% in patients whose creatinine clearance is less than 30 mL/min.
      Penetration of the interstitial fluid by cefprozil is excellent, with
      concentrations approaching those observed in the plasma. The pharmacokinetic
      disposition of cefprozil, coupled with its in vitro activity, supports the use of
      once- or twice-daily dosage regimens.

PMID- 1617037
TI  - Review of the in vitro antibacterial activity of cefprozil, a new oral
      cephalosporin.
AB  - Cefprozil is a newer oral cephalosporin with a spectrum of activity against
      organisms that include gram-positive and gram-negative pathogens. A review of
      published data shows that cefprozil is active (susceptibility, less than or equal
      to 8 micrograms/mL; moderate susceptibility, 16 micrograms/mL; resistance,
      greater than or equal to 32 micrograms/mL) against gram-positive species such as
      streptococci, methicillin-susceptible staphylococci, and Listeria monocytogenes;
      it may have marginal activity against some enterococci. Among the gram-negative
      species, cefprozil has activity against Escherichia coli, Proteus mirabilis,
      Citrobacter diversus, Klebsiella pneumoniae, Klebsiella oxytoca, Haemophilus
      influenzae, and Moraxella catarrhalis. For anaerobic species, cefprozil has
      activity against clostridial species, including Clostridium difficile,
      peptostreptococci, and possibly Bacteroides melaninogenicus and Eubacterium. The
      activity of cefprozil is generally greater than that of cephalexin and generally
      similar to that of cefaclor. In these reports, cefprozil showed more in vitro
      activity than cephalexin and cefaclor against penicillin-resistant pneumococci,
      penicillin-resistant viridans streptococci, beta-lactamase-positive methicillin
      susceptible Staphylococcus aureus, and C. difficile, although the clinical
      significance of some of these differences has yet to be studied.

PMID- 1617038
TI  - Current therapy for otitis media and criteria for evaluation of new antimicrobial
      agents.
AB  - Otitis media is the most commonly diagnosed disease in infants and children in
      the United States. For routine empirical treatment of uncomplicated acute otitis
      media, amoxicillin is the drug of choice. Persistence of signs and symptoms of
      infection during antimicrobial therapy calls for a change to an antibiotic
      effective against beta-lactamase-producing bacteria (e.g., trimethoprim
      sulfamethoxazole, amoxicillin/clavulanate, or one of the newer oral
      cephalosporins) or performance of tympanocentesis/myringotomy or both. The most
      common nonsurgical and surgical methods currently employed for prevention of
      frequent recurrences are antimicrobial prophylaxis, myringotomy with insertion of
      a tympanostomy tube, and adenoidectomy. For patients who have otitis media with
      effusion for which treatment is indicated, antimicrobial agents have been shown
      to be effective; amoxicillin is preferred as initial therapy. Guidelines for
      evaluating new antimicrobial agents in the treatment of otitis media are
      presented in this report.

PMID- 1617039
TI  - Comparison of cefprozil with other antibiotic regimens in the treatment of
      children with acute otitis media.
AB  - In two randomized clinical trials in children with otitis media, the efficacy and
      safety of cefprozil are compared to those of amoxicillin/clavulanate (n = 530)
      and of cefaclor and cefixime (n = 394). The rate of clinical cure or improvement
      was similar among patients receiving each drug regimen, ranging from 78% for
      amoxicillin/clavulanate to 89% for cefaclor; for cefprozil, this rate was 84% and
      85% in the two studies, respectively. In the first study, cefprozil was superior
      to amoxicillin/clavulanate in the satisfactory clinical response rate for
      Streptococcus pneumoniae (P = .049), but response rates were similar for
      Haemophilus influenzae and Moraxella catarrhalis. Significantly more patients
      treated with amoxicillin/clavulanate (P less than .001) in the first study or
      cefixime (P less than .01) in the second study developed diarrhea than did those
      treated with cefprozil. We conclude that cefprozil therapy for otitis media in
      children produces clinical and bacteriologic response rates similar to those seen
      with amoxicillin/clavulanate, cefixime, or cefaclor. Furthermore, diarrhea was
      significantly less common with cefprozil than with cefixime or
      amoxicillin/clavulanate.

PMID- 1617040
TI  - Criteria for evaluation of antimicrobial agents and current therapies for acute
      sinusitis in children.
AB  - Acute sinusitis is a common complication of upper respiratory tract infections in
      children. The primary causative bacteria are Haemophilus influenzae, Moraxella
      catarrhalis, Streptococcus pneumoniae, Streptococcus pyogenes, and alpha
      hemolytic streptococci. Concurrent viral infection may confound interpretation of
      the clinical response to antimicrobial treatment. First-line antimicrobial
      treatment is usually with amoxicillin. The increase in frequency of beta
      lactamase-producing bacteria in some communities, however, may warrant empirical
      treatment with other drugs such as amoxicillin/clavulanate, trimethoprim
      sulfamethoxazole, cefixime, or cefuroxime. With the marketing of newer
      antimicrobial drugs for treating sinusitis, it is important for physicians to
      understand the criteria for evaluating the efficacy of each new drug in relation
      to existing antimicrobial agents. Criteria for clinical and bacteriologic
      evaluation of new antimicrobial drugs in the treatment of sinusitis in children
      are described.

PMID- 1617041
TI  - Streptococcal pharyngitis: current therapy and criteria for evaluation of new
      agents.
AB  - Penicillin has been the recommended drug of choice in most cases of group A
      streptococcus (GAS) pharyngitis for nearly 40 years based on its efficacy in the
      prevention of acute rheumatic fever. Since trials of other drugs for the
      prevention of rheumatic fever are no longer feasible in the United States,
      eradication of GAS pharyngitis has become the surrogate for their evaluation. On
      the basis of this criterion, specific therapeutic regimens have been recommended,
      and numerous other drugs have gained approval as alternatives to penicillin.
      Current therapeutic issues include possible decreased efficacy of penicillin,
      timing of the initiation of therapy, and drugs of choice for patients whose
      treatment fails, who are chronic carriers, or who have frequent infections.
      Criteria for assessment of new drugs include clinical response, likelihood of
      prevention of rheumatic fever, rates of relapse and recurrent infection, and drug
      safety. The establishment of uniform guidelines and definitions of response for
      new drug evaluations by the Infectious Diseases Society of America should aid in
      the further assessment of new antibacterial agents as therapy for GAS
      pharyngitis. However, no data yet suggest that any of these drugs should replace
      penicillin as the drug of choice.

PMID- 1617042
TI  - Treatment of pharyngitis and tonsillitis with cefprozil: review of three
      multicenter trials.
AB  - Cefprozil is a new oral cephalosporin with an in vitro spectrum of activity that
      includes group A beta-hemolytic streptococci (Streptococcus pyogenes). Three
      multicenter, randomized trials were conducted for comparing the clinical efficacy
      and safety of cefprozil administered once or twice daily with that of cefaclor,
      penicillin, or erythromycin ethylsuccinate administered three or four times daily
      in the treatment of mild-to-moderate tonsillopharyngitis. In the cefprozil
      cefaclor trial, the pathogen eradication rate for evaluable patients receiving
      cefprozil was 83%, which was significantly better than that for patients
      receiving cefaclor (76%) (P = .035). The rate of satisfactory clinical response
      was similar with cefprozil (89%) and cefaclor (84%). The overall response rate
      was significantly better with cefprozil (80%) than with cefaclor (72%, P = .018).
      Differences in response rates were not noted when analyzing only patients 2-12
      years of age. In the cefprozil-penicillin trial, the eradication rate of
      bacteriologic pathogens was similar in patients receiving cefprozil (91%) and in
      patients receiving penicillin (87%). A satisfactory clinical response was seen in
      95% of the evaluable cefprozil-treated patients, which was significantly better
      than the rate of satisfactory clinical response seen in the penicillin-treated
      patients (88%; P = .023). In addition, during-therapy cultures for penicillin
      treated patients yielded a significantly higher rate of beta-lactamase-producing
      Staphylococcus aureus than did those for the group of cefprozil-treated patients
      (13% vs. 4.5%, respectively; P = .046). Significantly more clinically symptomatic
      bacteriologic failures occurred in the penicillin group (P = .037).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1617043
TI  - Antibacterial therapy for lower respiratory tract infections in adults: a review.
AB  - Because of difficulties in accurately determining an etiologic diagnosis, the
      ideal treatment for acute community-acquired lower respiratory tract infections
      remains to be established. Suggested regimens, in the absence of persuasive
      findings from gram-stained preparations of sputum, are best guesses made on the
      basis of clinical and epidemiological data. Results from randomized controlled
      trials are only partially helpful since most trials require the isolation of a
      potential pathogen, a condition that excludes as many as half of all potential
      study participants. Nonetheless, initial therapy for patients producing phlegm
      with abundant polymorphonuclear leukocytes should be chosen on the basis of the
      predominant organisms seen on a stained sputum smear. Patients who are admitted
      to the hospital from home, greater than 50 years of age, and not producing phlegm
      can be safely treated with amoxicillin or a second-generation cephalosporin.
      Atypical pneumonia in younger patients is best treated with erythromycin or
      tetracycline. Patients admitted from nursing homes, who frequently fail to
      respond to an initial treatment course in the absence of a diagnostic sputum
      sample, should receive empirical therapy with an agent that is also active
      against aerobic gram-negative rods.

PMID- 1617044
TI  - Review of the experience with cefprozil for the treatment of lower respiratory
      tract infections.
AB  - A regimen of cefprozil (500 mg twice daily), a new oral cephalosporin with a
      broad in vitro spectrum of antimicrobial activity, was compared to standard
      regimens of cefaclor (500 mg three times daily), cefuroxime axetil (500 mg twice
      daily), or amoxicillin/clavulanate (500 mg/125 mg three times daily) for the
      treatment of lower respiratory tract infections (mainly bronchitis and acute
      exacerbations of chronic bronchitis) in adults in three open-label, randomized
      trials. In the first trial, in which bacterial pathogens were isolated in initial
      cultures for only one-third of the patients, 90% of the pathogens were
      susceptible to cefprozil. A satisfactory clinical response was noted for 84% of
      the evaluable patients who received cefprozil versus 79% of those who received
      cefaclor for treatment of lower respiratory tract infections; rates of
      bacteriologic efficacy were 82% and 78%, respectively. In the second study rates
      of satisfactory clinical response were 96% with cefprozil and 83% with cefuroxime
      axetil (P less than .03) for treatment of bronchitis; the respective
      bacteriologic response rates were 100% and 92%. In the third trial, clinical
      efficacy was 91% for cefprozil and 87% for amoxicillin/clavulanate for treatment
      of bronchitis; bacteriologic efficacy was 95% and 96%, respectively. Tolerability
      and safety profiles were comparable, except that there was a higher rate of
      diarrhea among patients who received amoxicillin/clavulanate (P = .03).

PMID- 1617045
TI  - An approach to evaluating antibacterial agents in the treatment of urinary tract
      infection.
AB  - The evaluation of antibacterial therapy for urinary tract infection (UTI) is
      based on the results of randomized, controlled comparative studies (preferably
      double-blinded) in which sufficient numbers of patients are entered into both
      arms to ensure statistical validity. Since the term UTI encompasses a broad array
      of clinical syndromes (acute uncomplicated UTI; acute uncomplicated
      pyelonephritis; complicated UTI; and asymptomatic bacteriuria), the design of
      clinical studies should include a careful definition of the clinical syndromes
      being studied, the course of therapy prescribed, and the microbiological
      characterization necessary for evaluability. End points to be considered in the
      evaluation of new therapies include the effect of therapy on clinical symptoms;
      the ability of the therapy to eradicate the original infecting organism; the
      incidence of reinfection posttherapy; the number of instances of primary drug
      resistance of the infecting inoculum; and the incidence of adverse effects with a
      particular regimen.

PMID- 1617046
TI  - Clinical trials of cefprozil for treatment of skin and skin-structure infections:
      review.
AB  - Limitations of currently used antimicrobial agents for the treatment of skin and
      skin-structure infections (e.g., increased resistance to penicillin and
      erythromycin and inconvenient dosing schedules) have led to an adjustment in the
      kinds of antimicrobial agents prescribed for these diseases. Three recently
      completed clinical studies have demonstrated some therapeutic advantages of
      cefprozil, a new broad-spectrum oral cephalosporin, over cefaclor and
      erythromycin in the treatment of skin and skin-structure infections.
      Specifically, cefprozil offers clinical efficacy equivalent to those of cefaclor
      and erythromycin both at lower total doses and on a less frequent dosing schedule
      (once or twice daily vs. three to four times daily). The advantage of once-daily
      or twice-daily dosing with cefprozil may contribute to patient convenience and
      compliance.

PMID- 1617047
TI  - Safety profile of cefprozil.
AB  - The clinical and laboratory safety of cefprozil was analyzed with data from 4,227
      patients who received the drug in North American and European clinical efficacy
      trials. Of these patients, 3,016 adults and children received capsules or
      tablets, while 1,211 patients (mostly children) were treated with cefprozil
      suspension. Cefprozil was used in single-daily or twice-daily dosing regimens for
      treatment of infections of the upper and lower respiratory tracts, sinuses,
      middle ear, urinary tract, and skin and skin structure. The incidence of adverse
      clinical events and laboratory abnormalities was similar to that associated with
      use of other oral cephalosporins. Gastrointestinal adverse effects were the
      predominant adverse clinical event, although the incidence of diarrhea with
      cefprozil was much lower than that with cephalosporins that are less well
      absorbed. The data confirm the safety of cefprozil in both adult and pediatric
      patients.

PMID- 1617048
TI  - Mycobacterial diseases other than tuberculosis.
AB  - The incidence of tuberculosis in the United States declined steadily until 1985,
      while at the same time, for at least the past 15 years, the frequency of disease
      attributable to other mycobacteria increased both in actual numbers and in the
      proportion of the total burden of mycobacterioses. Chronic pulmonary disease,
      lymphadenitis in children, skin and soft-tissue involvement, and infections of
      the skeletal system were predominant, and the principal etiologic agents were
      Mycobacterium avium/Mycobacterium intracellulare complex. Mycobacterium kansasii,
      Mycobacterium marinum, Mycobacterium fortuitum/Mycobacterium chelonae complex,
      and Mycobacterium scrofulaceum. Since 1986 disseminated disease has become not
      only more common, especially in association with opportunistic infections in
      patients with AIDS, but also attributable in part to the growing population of
      patients who are immunocompromised because of malignancy, receipt of an organ
      transplant, and administration of steroids. Treatment of these patients has been
      difficult because of the frequency of severe underlying conditions and the
      natural resistance of most of the nontuberculous mycobacteria to the presently
      available drugs.

PMID- 1617049
TI  - Pneumococcal antimicrobial resistance: the problem in Hungary.
AB  - An epidemiological survey of penicillin resistance as determined by minimum
      inhibitory concentrations (MICs) in Streptococcus pneumoniae strains collected
      from several Hungarian laboratories in 1988-1989 indicated a prevalence of 58%
      among a total of 135 isolates. A significantly higher resistance rate (69.2%) was
      found for isolates from pediatric patients than from adult patients (44.0%).
      Penicillin-resistant strains were more frequently resistant to non-beta-lactam
      antibiotics (tetracycline, erythromycin, co-trimoxazole, and chloramphenicol)
      than were penicillin-sensitive strains. On the basis of the MIC50 and MIC90
      values of ampicillin and five cephalosporins for penicillin-resistant strains, it
      was established that ampicillin and cephalexin were not superior to penicillin.
      The low MIC90 of ceftriaxone and cefotaxime for these organisms reflects
      promising therapeutic potential, even in septicemia and meningitis caused by
      penicillin-resistant strains. The therapeutic alternative to penicillin in the
      treatment of respiratory tract infection may be second-generation cephalosporins
      such as cefuroxime or cefamandole.

PMID- 1617050
TI  - Geographic distribution of penicillin-resistant clones of Streptococcus
      pneumoniae: characterization by penicillin-binding protein profile, surface
      protein A typing, and multilocus enzyme analysis.
AB  - Examination of several hundred penicillin-resistant clinical isolates of
      Streptococcus pneumoniae has revealed extensive strain-to-strain variation in the
      number and molecular size of penicillin-binding proteins (PBPs). This
      polymorphism has been used to classify resistant isolates into groups (PBP
      families) that share distinct electrophoretic profiles. We describe herein
      properties of four such PBP families: two from Spain (and/or Ohio) and one each
      from Hungary and Alaska. We have discovered that representative isolates assigned
      to each PBP family also share capsular serotype, antibiotic resistance pattern,
      pneumococcal surface protein A type, and multilocus enzyme genotype. The results
      demonstrate independent clonal origin for strains assigned to each PBP family.
      Each resistant clone occurs with uniquely high incidence within specific
      geographic areas.

PMID- 1617051
TI  - Treatment and diagnosis of infections caused by drug-resistant Streptococcus
      pneumoniae.
AB  - Drug-resistant strains of Streptococcus pneumoniae have now been reported from
      all continents and have become the predominant pathogens in some areas; many
      strains are resistant to multiple agents. Because of the importance of
      pneumococci in the etiology of meningitis, the criteria used to assess
      susceptibility are conservative: strains with minimal inhibitory concentrations
      (MICs) of penicillin G of less than or equal to 0.06 microgram/mL are regarded as
      susceptible, those with MICs of 0.1-1 microgram/mL are considered intermediately
      resistant, and those with MICs of greater than 1 microgram/mL are designated
      highly resistant. The diagnosis, treatment, and prevention of infections due to
      resistant pneumococci are the subjects of this review. Methods of susceptibility
      testing have now been well defined for pneumococci. Screening for penicillin
      resistance with 1-microgram oxacillin disks is recommended for all clinically
      significant isolates. The activity of other beta-lactam agents against penicillin
      resistant strains has been documented, and the MICs of a number of non-beta
      lactam agents have been determined as well. Treatment of resistant pneumococcal
      infections depends on the site of infection, the degree of resistance to
      penicillin G, the resistance of the infecting strain to other agents, the
      severity of disease, the presence of underlying conditions, and the dose and
      route of administration of antimicrobial agents. Current recommendations for
      treatment are based on retrospective case studies, and adequate prospective
      studies providing more definitive data are needed. Prevention of pneumococcal
      infections in children less than 2 years of age and in the elderly remains a
      problem. Improved vaccines must be developed for this purpose.

PMID- 1617052
TI  - Yeast perinephric abscess: report of a case and review.
AB  - We report a case of yeast perinephric abscess and review 11 other published
      cases. This rare entity occurs primarily in patients who have diabetes mellitus,
      who have recently undergone surgery, or who have urinary tract obstruction. The
      clinical illness is often subacute or chronic with nonspecific symptoms. Candida
      and Torulopsis species are the reported etiologic agents. Successful therapy
      usually consists of percutaneous or surgical drainage of the abscess. Overall
      mortality is 25%; however, no patient in this series died as a direct result of
      perinephric infection.

PMID- 1617053
TI  - Diagnosis of infection with the human immunodeficiency virus.
AB  - The development and subsequent widespread use of accurate, sensitive, and
      relatively inexpensive diagnostic tests for infection with the human
      immunodeficiency virus (HIV) have been critically important in mapping the spread
      of the virus and managing HIV-infected individuals. Although the ELISA (for
      screening) and western blot (confirmatory test) techniques have, for the most
      part, fulfilled these criteria, interpretation of results of these tests is not
      always as straightforward as would be ideal. For example, what is the
      significance of an indeterminate western blot? How many times should the test be
      repeated? When can the patient be told he/she is truly HIV antibody negative? In
      this AIDS Commentary, Drs. John P. Phair and Steven Wolinsky of the Department of
      Medicine at Northwestern University Medical School address these questions and
      present their thoughts on these timely and extremely important issues.

PMID- 1617054
TI  - Emergence of unusual opportunistic pathogens in AIDS: a review.
AB  - Opportunistic infections are a major cause of morbidity and death among patients
      infected with the human immunodeficiency virus (HIV), particularly late in the
      disease, when immunosuppression is severe. Some pathogens, such as Pneumocystis
      carinii and Toxoplasma gondii, are extremely common in this population and are
      readily recognized by clinicians caring for these patients. However, many other
      organisms occasionally cause conditions that clinically mimic the more commonly
      encountered pathogens. Clinicians must be alert to the threat posed by these less
      frequently occurring organisms and of the broader differential diagnosis that
      must be considered for infections in patients with HIV infection.

PMID- 1617055
TI  - Cutaneous tuberculosis: a rare presentation of malignancy.
AB  - An 88-year-old woman presented with fever, a neck ulcer, and multiple
      subcutaneous nodules on her upper extremities and thorax. Her condition was
      initially diagnosed as malignancy associated with metastatic disease to the skin.
      A subcutaneous nodule was aspirated. A gram stain of the aspirate revealed weakly
      gram-positive bacilli, and a stain for acid-fast bacilli was positive.
      Mycobacterium tuberculosis was isolated from a culture of a specimen of the skin
      lesion.

PMID- 1617056
TI  - Mycobacterium xenopi, Mycobacterium fortuitum, Mycobacterium kansasii, and other
      nontuberculous mycobacteria in an area of endemicity for AIDS.
AB  - Between 1981 and 1990, cultures of specimens from 86 patients at State University
      of New York-Health Sciences Center at Brooklyn were positive for nontuberculous
      mycobacteria other than Mycobacterium avium/Mycobacterium intracellulare complex
      or Mycobacterium gordonae. The most common species isolated were Mycobacterium
      xenopi (33), Mycobacterium fortuitum (28), Mycobacterium kansasii (7), and
      Mycobacterium chelonae (6). Thirty-five patients (41%) had clinical and/or
      serological evidence of human immunodeficiency virus (HIV) infection. Patients
      from whom M. xenopi and M. kansasii were isolated were significantly more likely
      to be infected with HIV than were the remaining patients in this series. Most of
      the mycobacterial isolates were cultured from respiratory secretions. However,
      extrapulmonary infections with M. fortuitum, M. xenopi, M. kansasii,
      Mycobacterium terrae, and Mycobacterium scrofulaceum did occur among the HIV
      infected patients.

PMID- 1617057
TI  - Neurological melioidosis: seven cases from the Northern Territory of Australia.
AB  - Pseudomonas pseudomallei, which causes melioidosis, is most commonly associated
      with pulmonary infection. We describe seven patients who developed a neurological
      syndrome as the predominant manifestation of melioidosis: this syndrome was
      characterized by peripheral motor weakness (mimicking Guillain-Barre syndrome),
      brain-stem encephalitis, aseptic meningitis, and respiratory failure.
      Neurological melioidosis occurred in the absence of demonstrable foci of
      infection in the central nervous system (CNS) in five of six patients whose
      cerebrospinal fluid was available for culture. Computed tomography and magnetic
      resonance imaging of the brain and spinal cord of these patients were not
      suggestive of pyogenic infection, although the latter procedure detected brain
      stem encephalitis. Autopsy findings in one case confirmed brain-stem encephalitis
      without evidence of direct bacterial infection. The clinical presentation of
      neurological melioidosis includes features of an exotoxin-induced neurological
      syndrome, with profound neurological disease occurring in the absence of apparent
      direct infection of the CNS. This syndrome appears to be a newly recognized
      clinical presentation of melioidosis.

PMID- 1617058
TI  - Primary cutaneous fungal infection after solid-organ transplantation: report of
      five cases and review.
AB  - Solid-organ transplant recipients who are receiving immunosuppressive therapy are
      at increased risk of acquiring opportunistic infections, particularly fungal
      infections. We present the cases of five liver transplant recipients who
      developed primary cutaneous opportunistic fungal infections that remained
      localized to the skin. These cases are compared with 27 previously reported cases
      of primary cutaneous fungal infections. In these previously reported cases,
      administration of systemic antifungal medications, including amphotericin B,
      ketoconazole, griseofulvin, and miconazole, resulted in a 71% survival rate.
      Medical and surgical therapy together resulted in an 86% survival rate, and
      surgical excision resulted in a 100% survival rate. Thus, regardless of the age
      of the patient, type of immunosuppressive therapy, clinical presentation, or
      organisms involved, surgical excision yielded the highest cure rate. When
      possible, surgical excision should be performed on solid-organ transplant
      recipients who acquire opportunistic fungal infections.

PMID- 1617059
TI  - Prevention of neonatal infection with herpes simplex virus.

PMID- 1617060
TI  - Infective endocarditis due to Staphylococcus capitis.

PMID- 1617061
TI  - Pyogenic sacroiliitis due to Veillonella parvula.

PMID- 1617062
TI  - Nasal tuberculosis: two cases in elderly patients.

PMID- 1617063
TI  - Listeriosis and cephalosporins.

PMID- 1617065
TI  - Severe cholestatic jaundice caused by mezlocillin.

PMID- 1617064
TI  - Bacteremia due to Campylobacter cinaedi in a patient infected with the human
      immunodeficiency virus.

PMID- 1617066
TI  - Central nervous system tuberculoma presenting as a cavernous sinus tumor.

PMID- 1617067
TI  - Acute toxoplasmic hepatitis in a patient with AIDS.

PMID- 1617068
TI  - Bacteremia and fungemia of unknown origin among patients receiving intensive
      care.

PMID- 1617069
TI  - Prosthetic valve endocarditis and paravalvular abscess caused by
      Peptostreptococcus magnus.

PMID- 1617070
TI  - Medical management of spinal epidural abscesses: case report and review.
AB  - Although the traditional management of spinal epidural abscesses includes
      antibiotic therapy and surgical drainage, numerous reports have appeared in the
      literature that describe a nonsurgical approach. We report the successful
      nonsurgical management of a case of an extensive spinal epidural abscess in which
      the patient was closely monitored by serial studies with magnetic resonance
      imaging. Review of the literature from 1970 to 1990 revealed 37 cases that
      describe conservative management of spinal epidural abscesses. Despite successful
      conservative management reported for some cases, sudden neurological
      deterioration of patients receiving appropriate antibiotic therapy has also
      occurred. A true index of the success of nonsurgical therapy is difficult to
      discern since cases may have been selectively reported and unsuccessful attempts
      at conservative management may have never been reported once a laminectomy was
      performed. A prospective investigation that includes clearly defined indications
      for conservative management vs. surgical intervention and that can be studied
      with an intention-to-treat analysis is needed.

PMID- 1617071
TI  - To decompress or not to decompress--spinal epidural abscess.

PMID- 1617072
TI  - Streptococcal and enterococcal bacteremia in patients with cancer.
AB  - Eighty-two episodes of bacteremia due to streptococci (including the genus
      Enterococcus) in 78 patients hospitalized at Institut Jules Bordet between 1986
      and 1988 were reviewed. The incidence ranged from 5.5 to 7.6 per 1,000 admissions
      (16% of all bacteremias). Enterococcus faecalis, Streptococcus sanguis, and
      Streptococcus mitis were the most prevalent isolates, followed by Streptococcus
      angionosus, Streptococcus salivarius, and large colony-forming beta-hemolytic
      species (A, B, C, and G). Twenty-one episodes were polymicrobial. One-half of the
      patients had solid tumors, and one-half had hematologic malignancies. Forty-two
      patients were neutropenic (less than 1,000 polymorphonuclear neutrophils/microL).
      Only 15 episodes were acquired outside the hospital, and 11 episodes were
      breakthrough bacteremias. Twenty patients died within 1 month of the onset of
      streptococcal bacteremia. Five patients, two of whom were neutropenic, had fatal
      adult respiratory distress syndrome. The source of bacteremia remained
      undetermined in 35.4% of the episodes; the oral mucous membrane and the
      gastrointestinal tract were the most frequently recognized associated sites of
      infection. No unexpected antimicrobial resistance was observed except in two
      penicillin-resistant strains, one S. mitis and one E. faecium. No relation
      between peak or trough serum bactericidal titers and outcome could be
      demonstrated.

PMID- 1617073
TI  - Nosocomial bacteremia due to Enterococcus faecalis without endocarditis.
AB  - During a 2-year observation period at a 2,200-bed university hospital, bacteremia
      due to Enterococcus faecalis was observed in 111 patients. Fifty-five patients
      with nosocomial bacteremia due to E. faecalis could be evaluated. The most common
      entry sites were the urinary tract (25%), the intraabdominal cavity (13%), and
      burn and decubital wounds (11%). Bacteremia was preceded by administration of
      cephalosporins, imipenem, and aztreonam (n = 39); ciprofloxacin (n = 11); and
      other antibiotics (n = 4). Age, sex, underlying disease, portal of entry,
      previous antibiotic therapy, and bacteremia due to other organisms had no
      influence on mortality. Treatment of bacteremia with penicillins (n = 45) and
      glycopeptides (n = 4) resulted in a mortality rate of 37%. The addition of a high
      dose aminoglycoside to a penicillin did not result in a better survival rate.

PMID- 1617074
TI  - Enterococcal endocarditis.
AB  - Enterococci, most often Enterococcus faecalis, cause 5%-20% of cases of infective
      endocarditis (IE). Enterococcal IE is usually a disease of older men, and the
      most frequent source of infection is the genitourinary tract. In cases of
      enterococcal IE, both normal and previously damaged valves can be involved. The
      disease most commonly presents in a subacute fashion; clinical and laboratory
      features are similar to those observed with IE caused by other pathogens.
      Diagnosis is based on the presence of clinical criteria of IE in association with
      positive blood cultures. Optimal therapy entails the parenteral use of a cell
      wall-active agent (penicillin G, ampicillin, or vancomycin) in combination with
      streptomycin or gentamicin in cases caused by enterococcal strains with high
      level resistance to streptomycin. A 4-week treatment course may be adequate in
      many cases. In patients with streptomycin-resistant strains, mitral valve
      disease, illness of greater than 3 months' duration, and/or relapse after
      previous therapy, a 6-week treatment course should probably be administered. With
      standard treatment and the appropriate use of valve replacement, a cure rate of
      approximately 85% can be expected.

PMID- 1617075
TI  - Enterococcal infections in surgical patients: the mystery continues.
AB  - The frequency of isolation of enterococci from surgical patients has increased
      significantly during the past decade, although the role of these organisms as
      pathogens in mixed infections remains a mystery. Bacteremia and other infections
      in which enterococci are the only pathogens frequently result in high morbidity
      and mortality among patients unless specific antimicrobial therapy is initiated
      promptly. Debate continues concerning the necessity for treatment with such
      agents when this organism is isolated as a component of a polymicrobial infecting
      flora. Our recent data indicate that enterococci are rarely isolated in
      postoperative infections after penetrating abdominal trauma if no
      gastrointestinal perforation has occurred. However, they were found in 56% of
      postoperative infections of patients with gastrointestinal perforation. In
      contrast, enterococci were isolated in only 9% of cultures of specimens from
      patients with secondary suppurative peritonitis. The occurrence of superinfection
      after therapy with a cephalosporin appears to be an important factor in this
      finding. Future studies are necessary to evaluate the efficacy of antibiotic
      treatment of enterococcal infections and to assess the need for prophylaxis
      against enterococci.

PMID- 1617076
TI  - Antimicrobial resistance in Streptococcus pneumoniae: an overview.
AB  - Clinical resistance to penicillin in Streptococcus pneumoniae was first reported
      by researchers in Boston in 1965; subsequently, this phenomenon was reported from
      Australia (1967) and South Africa (1977). Since these early reports, penicillin
      resistance has been encountered with increasing frequency in strains of S.
      pneumoniae from around the world. In South Africa strains resistant to penicillin
      and chloramphenicol as well as multiresistant strains have been isolated. Similar
      patterns of resistance have been reported from Spain. Preliminary evidence points
      to a high prevalence of resistant pneumococci in Hungary, other countries of
      Eastern Europe, and some countries in other areas of Europe, notably France. In
      the United States most reports of resistant pneumococci come from Alaska and the
      South, but resistance is increasing in other states and in Canada. Pneumococcal
      resistance has also been described in Zambia, Japan, Malaysia, Pakistan,
      Bangladesh, Chile, and Brazil; information from other African, Asian, and South
      American countries is not available. The rising prevalence of penicillin
      resistant pneumococci worldwide mandates selective susceptibility testing and
      epidemiological investigations during outbreaks.

PMID- 1617077
TI  - Antimicrobial resistance in Streptococcus pneumoniae: a South African
      perspective.
AB  - Resistance to penicillin among South African strains of Streptococcus pneumoniae
      increased from 4.9% in 1979 to 14.4% in 1990. Except for resistance to co
      trimoxazole (44%), resistance to other antimicrobial agents remained relatively
      low. Multiply resistant strains belonged mainly to serovars 6B, 19A, 14, and,
      more recently, 23F. Use of chloramphenicol to treat meningitis caused by strains
      relatively resistant to penicillin proved to be unsatisfactory, probably because
      of the inadequate bactericidal activity of chloramphenicol against these strains.
      Spread of penicillin-resistant nasopharyngeal strains in pediatric wards was most
      common among children who received antimicrobial therapy. Penicillin-binding
      protein (PBP) patterns were shown to vary in resistant clinical strains.
      Interspecies transfer of penicillin resistance between Streptococcus mitis and S.
      pneumoniae was demonstrated and antigenic homology was found in PBPs 1A and 2B of
      strains belonging to these species. Restriction enzyme mapping following DNA
      amplification of the PBP 2B gene revealed six arrangements among South African
      strains within serogroup 19. Despite extensive studies in South Africa and
      several other countries, many questions with regard to the global problem of
      antimicrobial resistance among S. pneumoniae strains remain unanswered,
      especially those that relate to prevalence in developing regions of the world.

PMID- 1617078
TI  - Antimicrobial resistance in Streptococcus pneumoniae: an epidemiological survey
      in France, 1970-1990.
AB  - The antimicrobial resistance of Streptococcus pneumoniae was surveyed in 1970
      1990 at Saint Joseph and Broussais hospitals in Paris (3,279 isolates) and in
      1984-1990 at the National Reference Center for Pneumococci (NRCP) in Creteil
      (8,128 isolates). All isolates were tested for susceptibility and serotyped. At
      St. Joseph and Broussais hospitals, the rate of resistance to tetracycline
      increased from 14% in 1970 to 46.5% in 1978 and then decreased to approximately
      20% in 1988-1990. Resistance to chloramphenicol appeared in 1972; its frequency
      remained at less than 10% until 1990. Resistance to macrolides was first detected
      in 1976, increased to 20% in 1984, and reached 29% in 1990. Among strains
      submitted to the NRCP, resistance to penicillin (MIC, greater than or equal to
      0.1 mg/L) remained infrequent (less than or equal to 1.1%) between 1984 and 1986
      but then increased steadily, reaching 12% in 1990. The frequency of high-level
      resistance to penicillin (MIC, greater than 1 mg/L) among penicillin-resistant
      pneumococci increased from 13% in 1988 to 48% in 1990. Compared with other
      serotypes, the penicillin-resistant serotype isolated most frequently (23F,
      49.3%) was more often highly resistant to penicillin and was more often
      multiresistant.

PMID- 1617079
TI  - Trends in antimicrobial resistance of clinical isolates of Streptococcus
      pneumoniae in Bellvitge Hospital, Barcelona, Spain (1979-1990).
AB  - From January 1979 to December 1990 we studied the susceptibility of 1,492
      pneumococcal strains isolated from adult patients in Bellvitge Hospital,
      Barcelona, Spain, to nine antimicrobial agents. Among clinically significant
      pneumococci, the incidence of penicillin-resistant strains increased from 4.3% in
      1979 to 40% in 1990, and that of erythromycin-resistant strains also rose from 0%
      in 1979 to 9.4% in 1990. On the other hand, the incidence of strains resistant to
      tetracycline decreased from 76.1% to 37.6%, as did that of chloramphenicol
      resistant strains, from 56.5% to 29.4%. The incidence of co-trimoxazole-resistant
      strains was about 40% throughout the study. Even more alarming was the finding
      that about 70% of penicillin-resistant strains showed multiple resistance to non
      beta-lactam antibiotics. All pneumococci were susceptible to vancomycin, and all
      but six were susceptible to rifampin. We observed that isolates from
      cerebrospinal fluid and the respiratory tract were significantly more resistant
      to penicillin than were isolates from blood. The majority of strains (95%)
      belonged to serogroups or serotypes included in the 23-valent pneumococcal
      vaccine and 77.6% of penicillin-resistant strains belonged to groups 23, 6, 9,
      and 19.

PMID- 1617080
TI  - A nonlinear analysis of pulsatile blood flow applied to investigate shear stress
      in arterial prostheses.
AB  - Although the main function of an arterial graft is to restore distal blood flow,
      there is evidence that certain local parameters of blood flow, particularly wall
      shear stresses, are important in determining the graft's long-term patency. Wall
      shear stresses were associated with intimal hyperplasia, intimal proliferation,
      and endothelial cell development, morphology, and attachment. Here we present a
      detailed method which permits the investigation of the wall shear stress acting
      on arteries and prostheses in dogs. The theory takes into account the nonlinear
      terms of the Navier-Stokes equations as well as the nonlinear behaviour and large
      deformation of the arterial wall. It is based on the numerical resolution of the
      nonlinear equations by the Crank-Nicolson method which was selected for its
      unconditional stability. Through the locally measured values of the pressure,
      pressure gradient, radius and flow rate, the velocity distribution and wall shear
      stress at a given location along the artery or the prosthesis, can be determined.
      Complete results on the same dog are presented for the distal aorta and for the
      middle of a chemically processed prosthesis, implanted as substitute in the
      thoracic aorta.

PMID- 1617081
TI  - Syntheses, interfacial active properties and toxicity of new perfluoroalkylated
      surfactants.
AB  - New surfactants have been synthesized with perfluorohexyl-groups as hydrophobic
      tail, a polyethyleneglycol-methylether as hydrophilic head and a prolongator
      between them. The prolongator units are -C4H8-, -C2H4OC5H10-, -C2H4OC3H6C(O)- and
      -CH2CH(OEt)CH2-. The surface tension, CMC and the interfacial tension
      water/perfluorocarbon were measured and the surface excess concentrations of the
      surfactant molecules were calculated. The influence of the surfactants on in
      vitro proliferation of human cell lines Hela and Molt 4 was investigated as a
      parameter for biocompatibility. The influence of the surfactants led to a
      reduction of cell proliferation depending on the concentration and chemical
      nature of the surfactant. Thus the prolongators changed the properties of the
      surfactants. They reduced the interfacial tension water/perfluorocarbon and
      improved the biocompatibility of surfactants.

PMID- 1617082
TI  - Initiation of polymerization with ultrasound in dental composite resin.
AB  - A single paste composite resin comprising methacrylate monomers, inorganic
      fillers, activators and an ultrasonic generator assembled by a piezoceramic
      transducer and a working tip was developed. The resin can polymerize and harden
      under irradiation with ultrasound having frequencies from 20 to 50 KHz and
      intensity from 12 to 40 W/cm2. The new technology is promising as a safe and
      effective method for restoration of tooth defects.

PMID- 1617083
TI  - Short-term effect of guided bone regeneration and electrical stimulation on bone
      growth in a surgically modelled resorbed dog mandibular ridge.
AB  - This study compares the quantitative bone changes that occur in attempting to
      augment a resorbed mandibular ridge by electrical stimulation and by the guided
      bone regeneration technique. At the base line three defects resembling an
      atrophic ridge were created in the mandible of 5 beagle dogs. Concomitantly, a
      constant current generator producing 20 +/- 2 mA was implanted under the floor of
      the mouth. Six weeks later a titanium cathode was inserted in the first bony
      defect and connected to the generator (electrical stimulation = ES); another
      titanium cathode, not connected to the generator, was inserted in the second
      defect (non-electrical stimulation = non-ES); the third defect remained without
      an electrical device (membrane only = MO). All 3 defects were covered with an
      expanded polytetrafluorethylene membrane, so as to prevent soft tissue
      proliferation into the defects. Tetracycline bone labelling compounds were
      administered to mark new bone formation. Four weeks following stimulation, ground
      sections were prepared for fluorescent microscopy. Differences between ES vs MO
      and between non-ES vs MO mean scores were statistically significant, indicating
      that 4 weeks of electrical stimulation resulted in similar bone formation as with
      non- electrical stimulation when both are confined to a membrane isolated
      defects.

PMID- 1617084
TI  - A novel agarose acrobeads protein A column for selective immunoadsorbance of
      whole blood: performance, specificity and safety.
AB  - The present study describes the performance and safety parameters of a novel
      column composed of protein A linked to acrobeads. Hemoperfusion of anticoagulated
      whole human blood was carried out in a closed system. Specific adsorption of IgG
      was documented in whole blood, plasma and IgG diluted in saline. Specific
      activity of the column was 3.52 mg/ml beads. These studies revealed slight
      changes in platelet counts and minor hemolysis. The relatively short period
      needed for maximal hemoperfusion effect and safety may enable the use of this
      novel therapeutic approach in clinical practice.

PMID- 1617085
TI  - Covalent binding of protamine by glutaraldehyde to bioprosthetic tissue:
      characterization and anticalcification effect.
AB  - Calcification is the principal cause of the clinical failure of bioprosthetic
      heart valves (BHV). The hypothesis of this work was that an impaired balance
      between positively and negatively charged amino acids, due to the reaction with
      Lys and Hyl tissue-collagen residues, expose affinity sites to Ca++. We further
      hypothesized that regardless of the cause(s) of BHV calcification, positive
      charge modification of the tissue will prevent their propensity to calcify.
      Modification of BHV tissue was obtained by covalently binding protamine sulfate,
      a polybasic peptide, via glutaraldehyde. The modification procedure resulted in
      stable, covalent links of approximately 5.3% w/w protamine with undiminished
      anticalcification properties, even after long storage. Significant prevention of
      calcification was exhibited by the p-bound tissue in comparison to BHV tissue,
      66.0 and 106.5 micrograms/mg calcium, respectively, after 30 days of subdermal
      implants in rats. The results support our hypotheses, and orthotopical heart
      valve replacements are required in order to completely evaluate the treatment
      efficacy and biocompatibility.

PMID- 1617086
TI  - Purification and characterization of liposomes encapsulating hemoglobin as
      potential blood substitutes.
AB  - In view of the desirability to increase the survival time of the liposome-based
      artificial red blood cells in vivo, the variables influencing optimum hemoglobin
      capture and preservation for the bovine hemoglobin-loaded liposomes (LEHb) are
      investigated. In order to predict the in vivo response, the necessary experiments
      for the in vitro system characterization have been carried out. The liposomes are
      prepared by the Reverse Phase Evaporation technique and then purified using a
      Sepharose 4B column. The purified LEHbs display a unimodal size distribution in
      the submicron range with a volume average diameter of 0.115 microns and a
      particle count of 1.25* 10(15) per ml of suspension. Analysis of the lipi/Hb
      content of the liposomes reveals that the variations in the ratio of Hb
      encapsulated to lipid entrapped (Hb/L)f as a function of the initial Hb
      concentration ([Hb]o) is insignificant compared to the net augmentation of
      (Hb/L)f as a function of the increasing initial lipid to Hb loading ([L]o).
      Meanwhile high [Hb]o s are necessary for the preservation of oxyhemoglobin.

PMID- 1617087
TI  - A potential blood substitute from a tetronic polyol and a modified hemoglobin.
AB  - This investigation reports a new potential blood substitute. An acellular fluid
      is formed between a Tetronic polyol and a modified hemoglobin. It was possible to
      stabilize the hemoglobin with glutaric acid. The subsequent reaction with the
      alcohols of the Tetronic polyol resulted in a useful resuscitative fluid.
      Exchange transfusion experiments in rats was possible at the 75% replacement
      level with an excellent survival rate. This was apparently possible because of
      the effective transport properties of this material. Histological sections of the
      liver, kidney and lungs showed little or no permanent damage to the organs. The
      Tetronic polyol - modified hemoglobin complex was not excreted in the urine in
      contrast to the modified hemoglobin by itself and a solution of unmodified
      hemoglobin. These preliminary studies indicate that this combination of a polymer
      and modified hemoglobin has a potential use as a red cell substitute.

PMID- 1617088
TI  - On the perfluorocarbon emulsions of second generation.
AB  - For formulation of perfluorocarbon-emulsions (PFC-emulsions) of second generation
      new perfluorocarbons (F-dimorpholines, F-dipiperidines and F
      cyclohexylmorpholine) were synthesized, acting both as oxygen carriers and as
      interfacial active compounds (IFACs). The stabilizing effect of these IFACs is
      interpreted and a new theory is introduced. Also new classes of fluorosurfactants
      were synthesized and tested for biocompatibility. In PFC mixtures compounds of
      the type RFRH (RF = CmF2m + 1, RH = CnH2n + 1) are acting as IFACs but also as
      anchor-groups for lipophilic surfactants.

PMID- 1617089
TI  - [Bad times for the coordinators].

PMID- 1617090
TI  - [Introduction of computers in health centers and their efficient application to
      administrative procedures].

PMID- 1617091
TI  - [Study of diffuse chronic hepatopathy in the outpatient context].
AB  - OBJECTIVE: Description of the general characteristics of patients with Diffuse
      Chronic Hepatopathy (DCH) in an ABS. DESIGN: Empirical study of a prospective and
      retrospective type. Site. Primary Care. ABS La Mina. Sant Adria de Besos.
      PATIENTS AND OTHER PARTICIPANTS: All patients diagnosed as suffering DCH since
      1984, in line with histological or clinical--morphological criteria accepted in
      the literature. MAIN MEASUREMENTS AND RESULTS: Using a data base of the centre's
      morbidity and mortality register, 287 reports of patients over 14 years old
      defined as having DCH were examined. 222 cases met the established criteria. Most
      of these were males (68%), and to an even higher proportion in the group with
      alcoholic etiology (84%), which was the most common cause of DCH (64.4%). There
      was a lower number of complications and deaths attributable to DCH than in
      published hospital series. CONCLUSIONS: Among the characteristics of DCH in a
      natural population using the health services, it is important to note the
      predominance of compensated forms having a rate of complications and deaths
      attributable to DCH significantly lower than what was observed in hospital
      series. This information may be of use in planning activities at the ABS level.

PMID- 1617092
TI  - [Morbidity caused by industrial accidents in a health zone].
AB  - OBJECTIVE: The aim of the present study is to discover the morbidity produced by
      workplace accidents among the earning population of Molina de Segura Health Area.
      DESIGN: This was a descriptive crossover study. Site. The study was carried out
      in the Primary Care framework, in the Molina de Segura Health Area and with the
      collaboration of the Labour Health Unit of Insalud-Murcia. PATIENTS AND OTHERS
      PARTICIPANTS: Over a year a total of 774 cases of time off work due to workplace
      accidents, out of a total of 9,302 workers, were examined. 679 cases of workers
      resident in Molina de Segura were included in the study, whose time-off dates
      fell between July 1, 1989 and June 30, 1990 and where the company for which they
      worked was based or had its trading name located in Molina. MAIN MEASUREMENTS AND
      RESULTS: Of the total cases of time off work studied, 539 (79.4%) were men and
      140 (20.6%) were women. The pathologies most often found were "blows, bruisings
      and crushings" (22.8%), "wounds and cuts" (16.8%), "back pain" (10.5%), "strains"
      (9.4%) and "fractures" (4.5%). A statistically significant association was found
      between being "a man" and "back pain"; and "a woman" and "sprains". CONCLUSIONS:
      The predominant pathologies among workplace accidents are of a less serious
      nature. Some pathologies owing to workplace accidents are mistakenly referred to
      the health services as ordinary illness. There is insufficient compliance by
      health professionals with filling in the forms for time off work and return to
      work.

PMID- 1617093
TI  - [The P-10 as a tool in the evaluation of the use of a pediatric hospital
      emergency service by the primary care network].
AB  - With the aim of determining if the Primary Care network adequately uses our
      centre's Emergency service, the 390 P-10s received during May and June 1990 were
      examined. The presence of clinical judgement, the percentage of admissions, the
      place of origin of the P-10, the relationship of the issuing centre to our Health
      Area, the diagnosis made in the Emergency Centre and the patient's destination
      were all analysed. 42.3% came from rural areas. Clinical judgement was exercised
      in 56.13%. The P-10s from urban areas showed that clinical judgement had been
      exercised in 63.6% of cases, as against only 49.7% in the rural areas and 43.2%
      in the special emergency service. 13.2% were admitted. 41.7% of the referral
      forms did not come from our health area. The results led us to conclude that
      there is an insufficient use of the P-10 in our field, as the majority of these
      patients could have been taken on by the Primary Care network.

PMID- 1617094
TI  - [Cognitive deterioration and dementias in an urban geriatric population].
AB  - OBJECTIVE: To find the extent of cognitive deterioration and dementias and their
      approximate etiology, in Pamplona's geriatric population. DESIGN: Crossover
      study. SITE. Pamplona's geriatric population. PATIENTS AND OTHERS PARTICIPANTS:
      Sample of 393 people over 64, drawn in random fashion from among the population
      of this age Pamplona. Ordered according to sex and age group. MAIN MEASUREMENTS
      AND RESULTS: The diagnostic sequence followed for the evaluation of the level of
      cognitive deterioration was that of Folstein's Minimental test; then the DSM-111
      criteria for diagnosing dementia; and the attempt to define dementias by means of
      the Hachinski scale. Scores lower than 24 were observed in 24.9% of old people,
      reaching 82.8% in those over 84. Dementia affected 8.9% of people older than 64,
      and as many as 55.2% of those over 84. The aetiology of these dementias is,
      according to the Hachinski scale, parenchymatous in 42.8% of cases, mixed or
      doubtful in another 42.8% and vascular in 14.4%. Both the low educational level
      of those patients suffering dementia and their serious functional deterioration
      were notable. CONCLUSIONS: A high level of dementias exists in our elderly
      population. A big percentage of these are overlooked as concrete clinical
      phenomena, although their formal diagnosis at the Primary Care stage is
      relatively simple and extremely useful in order to tackle the earliest and most
      treatable cases.

PMID- 1617095
TI  - [Quality assurance of prenatal care in a rural health center].
AB  - OBJECTIVE: This study was carried out with the aim of evaluating the quality of
      Prenatal Care (PNC) and improving attention to the pregnant woman. DESIGN: This
      was a retrospective evaluation, with a later monitoring of two indicators: an
      early start to care and an evaluation of risk. Site. The study was undertaken in
      a rural Primary Care Centre. PATIENTS AND OTHERS PARTICIPANTS: For purposes of
      the evaluation all the pregnant women (222) looked after between 1988 and 1990
      were studied; for the monitoring, all those between July 1990 and June 1991. MAIN
      MEASUREMENTS AND RESULTS: On the first evaluation, both the starting of PNC
      within the first 12 weeks (in 65% of cases) and the evaluation of obstetric risk
      at the first visit (29% compliance) were considered unacceptably low. With the
      help of corrective measures and simple practical monitoring, 100% compliance was
      reached in 12 months. The risk evaluation on subsequent visits (between 73 and
      95% compliance) and the number of checks (90% compliance) were considered
      adequate, and no intervention was made. CONCLUSIONS: We concluded that the PNC
      programmes should include quality assurance activities, as these have a positive
      effect on the improvement of medical care.

PMID- 1617097
TI  - [Acute HIV infection].
AB  - OBJECTIVE: Primary HIV infection presents a non-specific and polymorphous
      clinical profile. We present two cases which show how a high level of clinical
      awareness can lead to an early diagnosis. DESIGN: A retrospective study of all
      the HIV positive patients treated in Zaragoza's Miguel Servet Hospital between
      1985 and 1991 was carried out. Site. The medical records studied concerned the
      hospital as regards admissions and out-patient consultations. PATIENTS: The two
      cases which we contributed fulfilled the serologic criteria of acute HIV
      infection. MAIN MEASUREMENTS AND RESULTS: The man-woman relationship was 1/1. The
      only way of contagion found was heterosexual. Predominant clinical symptoms were
      cutaneous-mucous, with a prominent condition of oesophagitis produced by Candida.
      CONCLUSIONS: A high level of clinical awareness on the part of the Primary Care
      doctor can contribute significantly to the detection of new cases and controlling
      the HIV epidemic.

PMID- 1617096
TI  - [Respiratory manifestations and gastroesophageal reflux].
AB  - OBJECTIVE: Presentation of 7 cases of Gastro-oesophageal Reflux (GOR) detected
      through the respiratory symptomatology which they manifested. DESIGN:
      Retrospective clinical observations. Site. Primary Care. PATIENTS: Six males (41,
      58, 61, 66, 67 and 76 years old) and one woman of 63 were clinically examined on
      presenting a dry after-dinner cough and a night-time cough. RESULTS: 10% of
      people suffering GOR present secondary respiratory manifestations. CONCLUSIONS:
      The importance of its early detection rests on the possibility of avoiding
      chronic respiratory pathologies such as inherent asthma, pulmonary fibrosis,
      laryngitis and recurrent pneumonia, occurring as a consequence of GOR. For this
      reason we consider it vital that this condition in its many forms of
      manifestation should be recognised in the Primary Care sphere, so that correct
      diagnosis and treatments can then be proceeded with.

PMID- 1617098
TI  - [Adolescent medicine (and Part II)].

PMID- 1617100
TI  - [Family physician: much more than an able communicator].

PMID- 1617099
TI  - [Paradoxes and possibilities of community participation in primary health care
      (II). Critical and emancipation alternatives].

PMID- 1617101
TI  - [Prescriptions of parenteral medication].

PMID- 1617102
TI  - [A rare cause of neck tumors. Diagnosis in primary health care].

PMID- 1617103
TI  - Translocation of the nuclear autoantigen La to the cell surface of herpes simplex
      virus type 1 infected cells.
AB  - Recently we developed a procedure to translocalize one of the extractable nuclear
      antigens (ENAs), the La protein, to the cell surface of CV-1 cells. Here we
      report that herpes simplex virus type 1 infection can also induce a translocation
      of the autoantigen to the cell surface. On the cell surface we detected La
      protein assembled with large protrusions. Within these protrusions La protein
      colocalized with virus particles. These protrusions are known to be released from
      the cell after virus infections. Such complexes consisting of self and virus
      could provide helper determinants for an anti-self response, and therefore be
      important in generation of autoimmunity.

PMID- 1617104
TI  - Experimental autoimmune adrenalitis: a murine model for Addison's disease.
AB  - Experimental autoimmune adrenalitis was produced in mice by immunizing 8 times or
      more at intervals of 30 days with syngeneic adrenal extract mixed with Klebsiella
      O3 lipopolysaccharide (KO3 LPS) as a potent adjuvant. The cortex regions of the
      adrenal glands after the 8th injection were definitely infiltrated with
      polymorphonuclear leukocytes (PMN). The main infiltrates in the lesions after the
      9th injection were replaced by mononuclear cells, such as small lymphocytes and
      macrophages, and further by fibrous connective tissues. There were no
      histological changes in the medullary regions. The repeated immunization
      developed the delayed type hypersensitivity to adrenal extract and production of
      anti-adrenocortical autoantibody in those immunized mice. Moreover, the
      adrenalitis could be produced in normal mice by transfer of spleen cells from
      hyperimmunized mice, suggesting the critical role of the cell-mediated immunity.
      This experimental model might be useful to study immunological phenomena in the
      pathogenesis of Addison's disease.

PMID- 1617105
TI  - Search for cross-reactive idiotypes on monoclonal and myasthenia gravis
      acetylcholine receptor antibodies.
AB  - Myasthenia gravis patients have serum anti-acetylcholine receptor antibodies that
      compete with monoclonal antibodies for binding to epitopes on the human
      acetylcholine receptor. To investigate the presence of shared idiotypes we
      immunised syngeneic mice with each of ten well-characterised monoclonal
      antibodies, previously raised against purified human acetylcholine receptor, and
      tested the polyclonal antisera and seven monoclonal anti-idiotype antibodies, for
      binding to the antigen-combining site, to framework idiotopes, and by ELISA. The
      polyclonal sera were mostly directed against antigen-combining site idiotopes and
      cross-reacted only with monoclonal anti-acetylcholine receptor antibodies that
      bound to the same region on the acetylcholine receptor. In contrast, five of the
      seven IgM monoclonal anti-idiotypic antibodies raised, none of which demonstrated
      antigen-combining site specificity in solution, cross-reacted with mAbs binding
      to more than one region. None of the antisera showing reactivity with the antigen
      combining site inhibited the binding of MG anti-acetylcholine receptor antibody.

PMID- 1617106
TI  - Anti-histone reactivity in systemic lupus erythematosus sera: a disease activity
      index linked to the presence of DNA:anti-DNA immune complexes.
AB  - This study shows that purified murine monoclonal anti-DNA antibodies and human
      polyclonal anti-DNA antibodies (from systemic lupus erythematosus--SLE-
      patients), preincubated with DNA, acquire anti-histone reactivity. Conversely,
      DNAse I treatment of SLE patients' antibodies with anti-histone activity
      abolishes such activity. It has previously been demonstrated that anti-DNA
      antibodies bind to the cell membrane and recognize cell-surface polypeptides that
      have been identified with histones by partial sequencing. In a series of 33 sera
      from patients with clinically active disease and 29 sera from patients in
      clinical remission, positivity of an immunoblot analysis detecting antibodies
      against these polypeptides was associated with clinical activity of SLE
      (sensitivity, 0.88; specificity, 0.90). Anti-histone reactivity detected by ELISA
      appeared to be also a good marker of SLE activity (sensitivity, 0.64;
      specificity, 0.54). As expected, anti-native DNA antibody positivity and lowered
      complement dosage were also associated with clinical activity (sensitivity, 0.79
      and 0.63, respectively; specificity, 0.48 and 0.93, respectively). Since anti
      histone reactivity reflects, at least partly, the presence of anti-DNA antibodies
      complexed to DNA, which could bind to cell-membrane determinants, and is
      associated with disease clinical activity, it is suggested that this mechanism
      can contribute to explain the pathogenicity of anti-DNA antibodies.

PMID- 1617107
TI  - Germ-free condition and the susceptibility of BALB/c mice to post-thymectomy
      autoimmune gastritis.

PMID- 1617108
TI  - HLA class II genes in Graves' disease.
AB  - Inheritance of Graves' disease has been linked to the HA-DR3 gene product which
      may function in some specific way in antigen presentation. To determine whether
      the first extracellular domain of this protein, which is specifically involved in
      antigen presentation, has the same sequence in patients with Graves' disease and
      in normal individuals, we have amplified the second exon using the polymerase
      chain reaction, and then cloned and sequenced the DNA segment. In eight subjects
      with Graves' disease, sequences identical to prototypic reported sequence for
      DRB1*0301 were recovered, and in two individuals sequences varied by a few
      nucleotides, leading to 1-3 amino acid substitutions which did not occur in a
      pattern. Sequences identical to the prototypic sequence known as DRB3*0101, also
      previously known as DRw52, were also recovered. Thus the HLA-DRB1 and B3 genes
      present in patients with autoimmune disease appear to be the same as those
      present in the general population. These observations indicate that a unique
      allele is not present in patients with autoimmune disease, but rather that the
      normal DR3 allele itself, in a manner yet to be described, increases the
      probability of developing autoimmune thyroid disease.

PMID- 1617109
TI  - Adoptive transfer of the gld syndrome in double congenic nude lpr mice.
AB  - Homozygosity for either the lymphoproliferation (lpr) or the generalized
      lymphoproliferative disease (gld) mutation of mice causes the development of
      strikingly similar autoimmune and lymphoproliferative syndromes. The relationship
      between the lpr and gld mutations was studied by grafting B6 gld spleen cells
      (SC) to athymic B6 nude lpr mice (B6 nulpr) or to B6 nude (B6 nu) mice as
      controls. The injection of B6 gld SC, but not of B6 wild SC, to B6 nulpr mice
      caused a prolongation of survival of the short living B6 nulpr recipients. This
      was associated with elevated anti-single stranded DNA antibody titers and a serum
      hyperglobulinemia, as well as by a splenomegaly which was nearly as high as in
      genetically B6 gld mice, and by a marked lymphadenopathy (though milder than that
      of B6 gld mice). In contrast the [gld----nu] chimaeras showed a more attenuated
      form of gld-induced syndrome. These results suggest that the lpr environment
      supplied in athymic lpr recipients is compatible with--and may even favour--the
      development of the gld-induced syndrome.

PMID- 1617110
TI  - Cloning of a human autoimmune response: preparation and sequencing of a human
      anti-thyroglobulin autoantibody using a combinatorial approach.
AB  - Thyroid lymphocyte RNA from a Hashimoto patient exhibiting high titre serum IgG
      autoantibodies against thyroglobulin (Tg) has been used to construct a Fab
      library in phage lambda. Screening of this library with radioiodinated Tg has
      permitted the cloning of an anti-Tg antibody (MH52) with an affinity of 4.5 x
      10(9) molar-1 as determined by inhibition ELISA. Sequence analysis showed MH52 to
      be an authentic antibody of the IgG1/K isotype with variable region genes from
      the VHI and VKIII families in combination with the JH3, DK4 and JK2 gene
      segments. The MH52 light chain gene showed high sequence homology (93%) with the
      germline gene used by several rheumatoid factors and some DNA autoantibodies.
      Greater divergence from the germline was observed in the case of the MH52 heavy
      chain gene which showed 86% homology with a germline heavy chain gene isolated
      from human liver. Overall the similarity between the genes coding for MH52 and
      the genes coding for some other autoantibodies of non-related specificity might
      suggest that similar regulatory processes control the formation of these
      different autoantibodies.

PMID- 1617111
TI  - 1,25-Dihydroxyvitamin D3 attenuates the expression of experimental murine lupus
      of MRL/l mice.
AB  - The murine strain MRL/l spontaneously develops a systemic lupus erythematosus
      (SLE)-like syndrome. An increased number of T cells and polyclonal T helper cell
      activity has been described in these mice suggesting a potential role for 1,25
      dihydroxyvitamin-D3 [1,25-D3], an antiproliferative hormone selecting the T
      helper lymphocyte subset. One month old MRL/l mice were submitted or not to 1,25
      D3 0.1 microgram for 4 weeks, then 0.15 microgram given i.p. every other day for
      18 weeks while maintained on a low calcium chow. Dermatologic lesions, i.e.
      alopecia, necrosis of the ear and scab formation, were completely inhibited by
      1,25-D3 therapy. By 20 weeks, all mice had developed proteinuria. However, the
      degree of proteinuria was somewhat reduced in treated mice as assessed by urine
      protein/creatine ratios (less than 4 vs greater than 4 in treated vs untreated
      mice respectively). Moreover, a trend for a reduction in serum titers for anti
      ssDNA antibodies was observed at 18 weeks. The active vitamin D metabolite had no
      effect on the development of the generalized lymphoid hyperplasia. Hypercalcemia
      developed when 1,25-D3 was increased to 0.15 microgram (2.62 +/- 0.12 vs 1.97 +/-
      0.07 mmol/l, treated vs untreated mice respectively). These results suggest a
      beneficial role of 1,25-D3 in the prevention or attenuation of some
      manifestations of murine SLE, a model sharing many immunologic features with
      human SLE.

PMID- 1617112
TI  - Refractory immune hemolytic anemia with a high thermal amplitude, low affinity
      IgG anti-Pra cold autoantibody.
AB  - A 54 y.o. woman presented with acute Coombs-negative hemolytic anemia at an
      outside hospital where she received 25 RBC transfusions and did not respond to
      prednisone or splenectomy. On transfer to our hospital, routine DAT and IAT were
      weakly positive, occasionally negative. When a modified "cold" antiglobulin test
      was employed, the result was strongly positive for IgG, weakly positive for C3d.
      Cold agglutinin titer was 32, and the Donath-Landsteiner test was negative. The
      autoantibody exhibited Pra specificity. The patient failed IV-IgG, high dose IV
      pulse steroids and cyclophosphamide, and continued to require daily transfusions.
      She responded 21 days after receiving daily plasma exchange (x3), with pulse
      cyclophosphamide on the third day, followed by escalating daily oral
      cyclophosphamide.

PMID- 1617113
TI  - Histological characteristics of lupus nephritis in F1 mice with chronic graft
      versus-host reaction across MHC class II difference.
AB  - Renal lesions at the chronic phase of MHC class-II-disparate graft-versus-host
      reaction (GVHR) were examined. To induce GVHR, C57BL/6 (B6) spleen cells were
      injected twice into either (B6 x bm12)F1 (class-II-disparate), (B6 x bm1)F1
      (class-I-disparate) or (bm1 x bm12)F1 mice (class-I + II-disparate). For
      comparison, (C57BL/10 x DBA/2)F1 (BDF1) mice injected with DBA/2 spleen cells
      were also used. (B6 x bm12)F1 and BDF1 recipients showed marked elevation of anti
      DNA antibodies, circulating immune complexes (CIC) and the number of
      immunoglobulin producing cells (IgPC). At 20 weeks after cell injection, severe
      immune complex glomerulonephritis (ICGN) was observed in (B6 x bm12)F1
      recipients, but was far less severe in (bm1 x bm12)F1 recipients and was not
      observed in (B6 x bm1)F1 recipients. ICGN was also observed in BDF1 recipients at
      12 weeks after cell injection. By immunofluorescent microscopy, IC deposition was
      detected along the capillary loops and also in the mesangial area in (B6 x
      bm12)F1 recipients, while BDF1 recipients showed only a capillary pattern. By
      light microscopy, the renal lesion of (B6 x bm12)F1 recipients appeared similar
      to those of BDF1 recipients. Histologically, (B6 x bm12)F1 recipients serve as a
      good model for lupus glomerulonephritis induced by class-II-disparate GVHR.

PMID- 1617114
TI  - Tissue specific binding of lymphocytes to the thyroid gland of BB/W rats may be
      an early event in the development of thyroiditis.
AB  - Thyroiditis occurs in about 50% of diabetic Bio Breeding/Worcester (BB/W) rats.
      In order to investigate the earliest stages of lymphocyte homing to the thyroid
      gland in the development of experimental autoimmune thyroiditis, we measured the
      amount of trapping of peripheral blood lymphocytes (PBL) from BB/W rats to the
      thyroid gland of syngeneic recipient animals. PBL, from donor normal or diabetic
      BB/W rats, labelled with 51Cr, were injected, i.v., into normal, "potentially
      diabetic" or diabetic BB/W recipients. After 24 hr the rats were sacrificed and
      the radioactivity of selected individual organs counted. Results were calculated
      as % binding of 51Cr-labelled PBL/unit weight of tissue and expressed as a
      binding index by comparing to binding to recipient blood lymphocytes. A
      significant binding index was taken as greater than 1.0. PBL from diabetic or
      normal donor BB/W rats were shown to bind significantly to the thyroid gland of 8
      out of 19 "potentially diabetic" or diabetic recipient syngeneic rats, but to
      none of the normal (non diabetic) recipients tested. Sixty percent of
      "potentially diabetic" BB/W rats and 50% of diabetic rats at 3-4 months of age
      showed a significant level of binding of donor lymphocytes from syngeneic
      diabetic or normal animals to their thyroid gland, while, at 5-6 months the
      proportion of recipient rats giving positive tests was much less (17%). The
      source of the donor lymphocytes (diabetic, or normal) did not significantly
      influence the binding. Lymphocyte binding to pancreas was not significantly
      greater than to control tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617115
TI  - Quantitative and functional analyses of spleen and in situ islet immune cells
      before and after diabetes onset in the NOD mouse.
AB  - Cytofluorometric analysis using specific monoclonal antibodies directed against
      the T cell antigens Thy-1.2, CD4, CD8, CD4V beta(8.1 + 8.2 + 8.3), and the
      antigen Mac-1 expressed by mature macrophages and NK cells were used to
      characterize and quantify the phenotypes of (1) unfractionated and Percoll
      gradient fractionated in situ islet immune cells isolated from prediabetic and
      diabetic female NOD mouse spleens. We found in prediabetic female mice that the
      majority (approximately 70%) of the in situ islet immune cells were Thy-1.2
      positive T cells. CD4 positive T cells (approximately 40%) were the most abundant
      phenotype together with double negative T cells (approximately 20%). The
      percentage of CD8 positive T cells were approximately 10%, and only approximately
      4% of the immune cells were Mac-1 positive. The percentages of CD4V beta (8.1 +
      8.2 + 8.3) positive and double negative T cells in diabetic spleens were
      significantly higher in comparison to prediabetic spleens. In C57B1/6J control
      nondiabetic mice the percentage of double negative T cells in the spleens was
      significantly 4-fold lower when compared to diabetic NOD spleens. The specific
      cytolytic activity mediated by in situ islet immune cells against 51Cr-labeled
      dispersed syngeneic single-cell islet cells at an effector to target ratio of 20
      was twenty- to thirty-fold higher than that mediated by prediabetic splenic
      lymphoid cells. It is concluded that prediabetic NOD mouse in situ islet immune
      cells are mostly CD4 positive and double negative T cells, and that CD4 and CD8
      positive T cells in the intra-islet infiltrate warrants further evaluation as
      potential effector T cells in target beta-cell destruction.

PMID- 1617116
TI  - Occupational cancer mortality among urban women in the former USSR.
AB  - Occupational cancer mortality was evaluated among approximately three million
      female pensioners from urban areas of the former USSR. In 1970, these women
      experienced 14,918 cancer deaths. Occupational data were obtained from death
      certificates and the 1970 USSR National Population Census. Thirty-five
      occupational groups, including nine predominantly professional or office-work
      groups and 26 groups involving physical labor, were evaluated. The expected
      mortality rates were based on the urban female population of the USSR in 1970.
      Data for all cancer sites combined, and cancers of the esophagus, stomach, colon,
      rectum, lung, breast, cervix, and hematopoietic system are presented. Among all
      female pensioners, there were significant increases of all cancers combined (rate
      ratio [RR] = 1.05), and cancers of the breast (RR = 1.3), cervix (RR = 1.3), and
      the hematopoietic system (RR = 1.2), and a significant deficit of cancer of the
      esophagus (RR = 0.8). Many well-established associations between cancer and
      occupation among men were observed among the study group of female pensioners,
      such as stomach and lung cancer among miners, and hematopoietic malignancies
      among scientists and physicians. Other associations, to be investigated further,
      also were observed, such as excess lung cancer among waitresses. The peak
      employment period for this cohort of women was during World War II and the
      postwar period, when Soviet women outnumbered men almost two-to-one.
      Consequently, many of the women held jobs that are typically held by men. Thus,
      this study provides valuable information on occupational risks to women that may
      be relevant in other countries where women increasingly are being employed in
      jobs traditionally held by men.

PMID- 1617117
TI  - Diuretics may increase risk of renal cell carcinoma.
AB  - The risk for kidney cancer was examined in a Danish cohort of 192,133 people on a
      hospital discharge register who had been given a diagnosis of hypertension, heart
      failure, or edema, and were presumed to be probable users of diuretics. The
      subjects were identified from 1977 to 1987 and followed-up for cancer through
      1987. A total of 10,630 cancers was observed. While the risk for all cancers was
      increased slightly (standard mortality ratio [SMR] = 122, 95 percent confidence
      interval [CI] = 120-124), the risk for renal cell carcinoma was more than doubled
      (SMR(men) = 221, CI = 192-253; SMR(women) = 246, CI = 213-283). Increased risks
      were found in all age groups, and, although surveillance bias was present
      initially, the risk increased consistently in the years following discharge. Risk
      estimates for individuals discharged with hypertension were similar to those for
      the total cohort. Use of diuretics was validated in a random sample of 100
      individuals. More than 70 percent were taking diuretics at the time of discharge.
      The increased risk for renal cell carcinoma in this cohort may indicate either
      that diuretics are involved in the etiology of renal cell carcinoma or that the
      risk can be attributed to confounders, including smoking, which affect risk for
      both the discharge diagnosis and renal cell carcinoma.

PMID- 1617118
TI  - Risk factors for breast cancer by age and menopausal status: a case-control study
      in Singapore.
AB  - A case-control study was conducted among Singapore Chinese women, comprised of
      200 histologically confirmed cases of breast cancer and 420 hospital controls.
      Subjects were interviewed on family history of breast cancer, social and
      demographic characteristics, reproductive history, and diet one year prior to
      interview. Differences in risk factors were observed according to menopausal
      status. In the premenopausal group, the most consistently significant nondietary
      effect was an increased risk with late age at first birth. In postmenopausal
      women, the most consistent nondietary effects were increased risks with
      nulliparity, tall stature, high educational status, and a family history of
      breast cancer. In premenopausal women, the strongest dietary effects were low
      risks with high intakes of polyunsaturated fatty acids (PUFA), beta-carotene,
      soya protein as a proportion of all protein, and a high risk with high red-meat
      intake. No dietary effects were observed in postmenopausal women. Examination of
      effects by 10-year age groups suggested that the differences in the effects of
      age at first birth, nulliparity, height, education, beta-carotene intake, and
      PUFA intake between premenopausal and postmenopausal women were at least partly
      attributable to age-related differences in the baseline distributions of these
      variables. The variation in the effects of red meat and soya protein appeared to
      be attributable mainly to menopausal status itself, which is consistent with the
      hypothesis that these factors operate on risk by way of hormonal mechanisms.

PMID- 1617119
TI  - Risk factors for kidney cancer in New South Wales, Australia. II. Urologic
      disease, hypertension, obesity, and hormonal factors.
AB  - In a population-based case-control study of kidney cancer in New South Wales,
      Australia, data from structured interviews with 489 cases of renal cell cancer
      (RCC) and 147 cases of renal pelvic cancer (CaRP) diagnosed in 1989 and 1990, and
      523 controls from the electoral rolls, confirmed the link between obesity and
      RCC. In addition, regular consumption of 'diet' pills independently increased the
      risk for this cancer. A diagnosis of hypertension at least two years before
      interview raised the risk for RCC, and regular use of beta-blockers, a class of
      antihypertensive drug, independently increased the risk for RCC and CaRP (risk
      ratio = 1.5-1.8). No independent effect was found for use of diuretics.
      Additional information provided by this study includes increased risks associated
      with kidney injury (RCC, CaRP)--possibly attributed to recall bias--and kidney
      infection (CaRP), as well as a nonsignificantly raised risk linked with kidney
      stones (RCC, CaRP) and a significantly reduced risk for RCC in persons giving a
      history of lower urinary tract infection. No significant association of RCC was
      found with hormonal factors (age at menarche or menopause; child-bearing; regular
      use of oral contraceptives or estrogens; hysterectomy or oophorectomy).

PMID- 1617120
TI  - Herpes simplex virus type 2 infection and cervical cancer: a prospective study of
      12 years of follow-up in Finland.
AB  - This study was initiated to investigate the role of past herpes simplex virus
      type 2 (HSV-2) infection, as determined by serum antibody analysis, in the
      etiology of cervical neoplasia. Two Finnish registers, the registry of the Social
      Insurance Institution's Mobile Clinic Survey and the Finnish Cancer Registry,
      were linked. About 40,000 blood samples were drawn in 1968-72 and stored by the
      Social Insurance Institution. According to the Cancer Registry, 32 cases of
      cervical carcinoma or carcinoma in situ for which serum samples were available
      were diagnosed in this cohort during a follow-up of 12 years (1968-81). The serum
      samples of these individuals and age matched controls (2:1) from the cohort were
      analyzed for HSV-2 antibodies. HSV-2 infection as determined by the best
      available HSV-2 type-specific antibody assay, glycoprotein gG2-ELISA, was not
      related to cervical neoplasia, i.e., the risk of cervical neoplasia among the HSV
      2 positive women was not higher than that among the negative ones (smoking
      adjusted relative risk = 0.5, 95 percent confidence interval = 0.2-1.6). The
      results do not support the hypothesis that HSV-2 is an etiologic agent for
      cervical neoplasia.

PMID- 1617121
TI  - Case-control study of risk factors for cervical neoplasia in Denmark. II. Role of
      sexual activity, reproductive factors, and venereal infections.
AB  - Sexual, reproductive and venereal risk factors for cervical neoplasia were
      investigated in a population-based case-control study of 586 women with
      histologically verified, cervical squamous-cell carcinoma in situ, and 59 women
      with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in
      Copenhagen. Cases were identified from the computerized Danish Cancer Registry.
      An age-stratified control group (n = 614) was drawn at random from the female
      population in the study area by means of the Danish Central Population Register.
      A structured questionnaire was mailed to cases as well as controls. Increasing
      number of sexual partners exerted a significant effect on the risk both for
      carcinoma in situ, and invasive cancer, independently of age at first intercourse
      and other potential confounders. Conversely, the association with early age at
      first intercourse became statistically insignificant after allowance for other
      risk factors, although an increasing risk was still observed with decreasing age
      at sexual debut. Early age at first episode with genital warts was a significant
      risk factor for carcinoma in situ, perhaps indicating a possible increased
      susceptibility of the cervix epithelium during adolescence. A history of genital
      warts was a good predictor of risk for carcinoma in situ, whereas a history of
      previous gonorrhea was associated with an increased risk for invasive carcinoma.
      Women with multiple births had a significantly increased adjusted risk,
      especially for carcinoma in situ, although some association was also observed
      with invasive cervical cancer. The study supports the hypothesis of cervical
      neoplasia being a sexually transmitted disease, and that carcinoma in situ and
      invasive cervical carcinoma, to a high degree, have similar patterns of risk
      factors.

PMID- 1617122
TI  - Obesity in youth and middle age and risk of colorectal cancer in men.
AB  - To investigate an association between colon cancer and obesity during early
      adulthood--a potentially important period in the etiology of this disease--the
      authors assembled, by computer linkage, a population-based historical cohort of
      52,539 men born between 1913 and 1927 residing in Hawaii (USA), for whom weight
      and height had been recorded in 1942-43 and 1972. Linkage of this cohort to the
      Hawaii Tumor Registry resulted in the identification of 737 incident cases of
      colorectal cancer for 1972-86. An average of 3.8 cancer-free controls were
      matched to each case on month and year of birth and ethnicity of the parents. A
      case-control analysis in each anatomic subsite of the large bowel revealed that
      both early and middle-age body mass increased the risk of sigmoid cancer in men
      in a dose-dependent fashion. The odds ratios (OR) for sigmoid cancer for the
      highest compared with the lowest tertiles of Quetelet index were: 2.1 (95 percent
      confidence interval [CI] = 1.4-3.2) and 1.7 (CI = 1.1-2.5), at ages 15-29 and in
      prediagnostic years, respectively. These associations were additive and
      independent of socioeconomic status. Men who were above the median Quetelet index
      in 1942 and 1972 had an OR of 2.7 (CI = 1.8-4.0), compared with those who were
      below the median in both periods. This study provides further evidence for an
      association of obesity with colon cancer in men and suggests that this
      association is limited to the sigmoid colon and may be related to both early and
      late events of colon carcinogenesis.

PMID- 1617123
TI  - Reproductive factors, exogenous female hormones, and colorectal cancer by
      subsite.
AB  - The associations between reproductive factors, exogenous hormones, and colorectal
      cancer were examined among female subjects in a population-based case-control
      study in Sweden. The study was performed in Stockholm in 1986-88, and included
      299 cases and 276 controls. There was little evidence that age at first birth,
      number of months of breast feeding, age at menarche, or age at menopause
      influenced the risk of colon or rectal cancer. However, the results indicate that
      postmenopausal hormone-replacement therapy might reduce the risk of colorectal
      cancer (age-adjusted relative risk [RR] = 0.4, 95 percent confidence interval
      [CI] = 0.2-0.9). Compared with nulliparous women, women with at least four births
      were at reduced risk for colon cancer (RR = 0.5, CI = 0.2-1.2) but not rectal
      cancer (RR = 1.0, CI = 0.4-2.6). However, no trend across increasing parity was
      observed. Adjustments for diet, body mass, and physical activity had little
      influence on the results.

PMID- 1617125
TI  - Soft tissue sarcoma and tobacco use: data from a prospective cohort study of
      United States veterans.
AB  - A report of an increased risk of soft tissue sarcoma (STS) among users of
      smokeless tobacco led us to evaluate this association and the role of other types
      of tobacco in a prospective cohort mortality-study of United States veterans. A
      total of 248,046 veterans provided tobacco-use histories on a mail questionnaire
      in 1954 or 1957. Data on subsequent tobacco use were not collected. By 1980, 119
      deaths from STS had occurred among the cohort members. Veterans who had ever
      chewed tobacco or used snuff had a nonsignificant 40 percent excess of STS (95
      percent confidence interval [CI] = 0.8-2.6; 21 deaths) in comparison with
      veterans who had never used any tobacco products. Risk was limited to former
      users (relative risk [RR] = 1.5) with no excess seen among current users (RR =
      0.9). Frequent former users had higher risk (RR = 1.9) than infrequent users (RR
      = 1.3). Risk was slightly higher in persons who started using smokeless tobacco
      at younger ages, but did not increase with duration of use or with late age at
      cessation of use. Most veterans who used chewing tobacco or snuff also used some
      other form of tobacco. No STS deaths occurred among the 2,308 veterans who used
      smokeless tobacco only. An unexpected finding of the study was the significant
      excess of STS deaths among cigarette smokers (RR = 1.8, CI = 1.1-2.9). Risk was
      higher among ex-smokers (RR = 2.2) than among current smokers (RR = 1.5) and was
      not related to number of cigarettes per day, age started smoking, duration, or
      pack-years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617124
TI  - Alcohol consumption and lung cancer in white males.
AB  - Experimental and epidemiologic investigations in alcoholic and nonalcoholic
      populations have suggested a role of alcohol in lung carcinogenesis. The
      association between alcohol consumption and lung cancer was investigated among
      280 White males with histologically confirmed, primary lung cancer and 564 White
      male controls, participants in the Western New York Diet Study (United States).
      Among heavy smokers (over 40 pack-years), total alcohol consumption was
      associated with an increased risk of lung cancer with adjustment for age, years
      of education, pack-years of cigarette smoking, and intake of carotenoids and fat.
      In this group, the odds ratio for drinkers of more than 24 drinks per month was
      1.6 compared with those who drank less. Drinkers of more than 12 beers per month
      were 1.6 times more likely to develop lung cancer than nondrinkers of beer after
      controlling for age, years of education, and cigarette smoking (95 percent
      confidence interval = 1.0-2.4, P for trend = 0.003). Occupational and dietary
      factors did not seem to explain these findings. Although cigarette smoking is the
      major cause of lung cancer, the role of alcohol, independent or in interaction
      with cigarette smoking, deserves further investigation.

PMID- 1617126
TI  - Low incidence of familial breast cancer among Hispanic women.
AB  - There is a paucity of data on familial patterns of breast cancer among minority
      populations. This study compared the frequency of cancer in 1,095 first-degree
      relatives of 50 White, 46 Black, and 49 Hispanic breast-cancer patients referred
      to The University of Texas M.D. Anderson Cancer Center (United States). Family
      histories of cancer were derived from a self-administered questionnaire on risk
      factors. Expected numbers of cancers were calculated from the Connecticut Tumor
      Registry for White and Black relatives and from the New Mexico Tumor Registry for
      Hispanic relatives. Family history of a first-degree relative with breast cancer
      was the most important risk factor for both Black and White patients.
      Significantly elevated standardized incidence ratios (SIR) for breast cancer were
      noted among White (SIR = 4.5, 95 percent confidence interval [CI] = 1.2-11.4) and
      Black (SIR = 4.1, CI = 1.1-10.4) relatives younger than age 45. Despite the small
      number of Black patients, the combined effect of family history of breast cancer
      and the relative's age at diagnosis (under 45 years) was associated with an SIR
      of 7.1 (CI = 1.9-18.1). A deficit of cancer was noted in Hispanic women; only one
      patient reported having a first-degree relative with breast cancer. These
      findings, although based on small numbers, suggest that Hispanics have a lower
      rate of familial breast cancer than Whites and Blacks, and that they may possess
      protective factors that reduce their risk for breast cancer.

PMID- 1617127
TI  - Neonatal exposure to protoporphyrin-activating lighting as a contributing cause
      of childhood acute lymphocytic leukemia.
AB  - While being a relatively rare disease, acute lymphocytic leukemia (ALL) is the
      leading form of cancer in children in the developed world today. ALL sharply
      peaks in incidence at ages three to four years. In the United States there have
      been persistent, unexplained increases in incidence of ALL in the past two
      decades. We hypothesize that exposure to photosensitizing lighting immediately
      after birth may be a contributing cause of ALL. Fluorescent lamps and other light
      sources with strong illumination, around 400 nanometers, are protoporphyrin
      activating. Activation of protoporphyrin produces superoxides and free radicals
      that can induce breaks in DNA. In newborn nurseries in the US, the intensity of
      lighting has increased five- to 10-fold over the past two decades. Thus,
      protoporphyrin-activating light may be a contributing cause of childhood ALL.
      Additional retrospective and prospective studies should be undertaken of the
      relationship between exposure of newborns to protoporphyrin-activating
      illumination and the development of childhood ALL, along with in vitro studies of
      the hematologic effects of fluorescent lighting. Protoporphyrin-activating
      lighting is clearly not the sole determinant of ALL, but it could be a completely
      preventable cause. Inexpensive plastic filters could reduce these exposures
      substantially.

PMID- 1617128
TI  - Predominance of hospital deliveries among children with acute lymphocytic
      leukemia: speculations about neonatal exposure to fluorescent light.

PMID- 1617129
TI  - Smoking and multiple myeloma.

PMID- 1617130
TI  - Leukemia clusters around nuclear facilities in Britain.

PMID- 1617131
TI  - Leukemia clusters around nuclear facilities in Britain.

PMID- 1617132
TI  - United States--Australia workshop on membrane biophysics.

PMID- 1617133
TI  - Enhancement of carotenoid-to-chlorophyll singlet energy transfer by carotenoid
      carotenoid interaction.
AB  - The apparent quantum yield of singlet-singlet spirilloxanthin-to
      bacteriochlorophyll a energy transfer increases linearly with the residual
      spirilloxanthin content in Rhodospirillum rubrum membrane vesicles from which
      this carotenoid has been partially removed. Since it has been previously shown
      that carotenoid-carotenoid interaction is a linear function of the residual
      spirilloxanthin level in the major pigment-protein complex of those vesicles
      (Zurdo, J., R. M. Lozano, C. Fernandez-Cabrera, and J. M. Ramirez. 1991. Biochem.
      J. 274:881-884), it appears that such degenerate interaction enhances singlet
      energy transfer. Part of the enhancement may be explained if the energy donor is
      the spirilloxanthin 1Bu----1Ag (S2----S0) transition, because exciton coupling
      probably brings its energy closer to that of the Qx (S2----S0) transition of
      bacteriochlorophyll. In contrast, it seems that the possible stabilization of the
      spirilloxanthin 2Ag (S1) state would hardly improve energy transfer, because this
      hidden state probably lies below the S1 bacteriochlorophyll state. In any case,
      the stabilizing effects of carotenoid-carotenoid interactions seem insufficient
      to explain the enhancement of energy transfer. Direct or indirect effects of
      carotenoid dimerization on the three-dimensional structure of the pigment cluster
      appear to be required to account for such enhancement.

PMID- 1617134
TI  - Cytoplasmic hydrogen ion diffusion coefficient.
AB  - The apparent cytoplasmic proton diffusion coefficient was measured using pH
      electrodes and samples of cytoplasm extracted from the giant neuron of a marine
      invertebrate. By suddenly changing the pH at one surface of the sample and
      recording the relaxation of pH within the sample, an apparent diffusion
      coefficient of 1.4 +/- 0.5 x 10(-6) cm2/s (N = 7) was measured in the acidic or
      neutral range of pH (6.0-7.2). This value is approximately 5x lower than the
      diffusion coefficient of the mobile pH buffers (approximately 8 x 10(-6) cm2/s)
      and approximately 68x lower than the diffusion coefficient of the hydronium ion
      (93 x 10(-6) cm2/s). A mobile pH buffer (approximately 15% of the buffering
      power) and an immobile buffer (approximately 85% of the buffering power) could
      quantitatively account for the results at acidic or neutral pH. At alkaline pH
      (8.2-8.6), the apparent proton diffusion coefficient increased to 4.1 +/- 0.8 x
      10(-6) cm2/s (N = 7). This larger diffusion coefficient at alkaline pH could be
      explained quantitatively by the enhanced buffering power of the mobile amino
      acids. Under the conditions of these experiments, it is unlikely that hydroxide
      movement influences the apparent hydrogen ion diffusion coefficient.

PMID- 1617135
TI  - The invertebrate myosin filament: subfilament arrangement of the solid filaments
      of insect flight muscles.
AB  - Transverse sections (approximately 140 nm thick) of solid myosin filaments of the
      flight muscles of the fleshfly, Phormia terrae-novae, the honey bee, Apis
      mellifica, and the waterbug, Lethocerus uhleri, were photographed in a JEM model
      200A electron microscope at 200 kV. The images were digitized and computer
      processed by rotational filtering. In each of these filaments it was found that
      the symmetry of the core and the wall was not the same. The power spectra of the
      images showed sixfold symmetry for the wall and threefold symmetry for the core
      of the filaments. The images of the filaments in each muscle were superimposed
      according to the sixfold center of the wall. These averaged images for all three
      muscles showed six pairs of subunits in the wall similar to those found in the
      wall of tubular filaments. From serial sections of the fleshfly filaments, we
      conclude that the subunits in the wall of the filaments represent subfilaments
      essentially parallel to the long axis of the filament. In each muscle there are
      additional subunits in the core, closely related to the subunits in the wall.
      Evaluation of serial sections through fleshfly filaments suggests that the
      relationship of the three subunits observed in the core to those in the wall
      varies along the length of the filaments. In waterbug filaments there are three
      dense and three less dense subunits for a total of six all closely related to the
      wall. Bee filaments have three subunits related to the wall and three subunits
      located eccentrically in the core of the filaments. The presence of core subunits
      can be related to the paramyosin content of the filaments.

PMID- 1617136
TI  - The myosin filament XIV backbone structure.
AB  - The substructure of the thick filaments of chemically skinned chicken pectoralis
      muscle was investigated by electron microscopy. Images of transverse sections of
      the myosin filaments were determined to have threefold symmetry by cross
      correlation analysis, which gives an unbiased determination of the rotational
      symmetry of the images. Resolution, using the phase residual test (Frank et al.
      1981. Science [Wash. DC]. 214:1353-1355), was found to be between 3.2 and 3.6 nm.
      Three arrangements of nine subfilaments in the backbone were found in all regions
      of the filament at ionic strengths of 20 and 200 mM. In the average images of two
      of these, there were three dense central subfilaments and three pairs of
      subfilaments on the surface of the thick filament. In the average image of the
      third arrangement, all of the protein mass of the nine subfilaments was on the
      surface of the filament with three of them showing less variation in position
      than the others. A fourth arrangement appearing to be transitional between two of
      these was seen often at 200 mM ionic strength and only rarely at 20 mM. On
      average, the myosin subfilaments were parallel to the long axis of the filament.
      The different arrangements of subfilaments appear to be randomly distributed
      among the filaments in a transverse section of the A-band. Relative rotational
      orientations with respect to the hexagonal filament lattice, using the three
      densest subfilaments as reference showed a major clustering (32%) of filaments
      within one 10 degrees spread, a lesser clustering (15%) at 90 degrees to the
      first, and the remainder scattered thinly over the rest of the 120 degrees range.
      There was no obvious pattern of distribution of the two predominant orientations
      that could define a superlattice in the filament lattice.

PMID- 1617137
TI  - Replication of viruses in a growing plaque: a reaction-diffusion model.
AB  - An understanding of the viral replication process commonly referred to as "plaque
      growth" is developed in the context of a reaction-diffusion model. The
      interactions among three components: the virus, the healthy host, and the
      infected host are represented using rates of viral adsorption and desorption to
      the cell surface, replication and release by host lysis, and diffusion. The
      solution to the full model reveals a maximum in the dependence of the velocity of
      viral propagation on its equilibrium adsorption constant, suggesting that
      conditions can be chosen where viruses which adsorb poorly to their hosts will
      replicate faster in plaques than those which adsorb well. Analytic expressions
      for the propagation velocity as a function of the kinetic and diffusion
      parameters are presented for the limiting cases of equilibrated adsorption, slow
      adsorption, fast adsorption, and large virus yields. Hindered diffusion at high
      host concentrations must be included for quantitative agreement with experimental
      data.

PMID- 1617138
TI  - Kinetics and mechanism of cell membrane electrofusion.
AB  - A new quantitative approach to study cell membrane electrofusion has been
      developed. Erythrocyte ghosts were brought into close contact using
      dielectrophoresis and then treated with one square or even exponentially decaying
      fusogenic pulse. Individual fusion events were followed by lateral diffusion of
      the fluorescent lipid analogue 1,1'-dihexadecyl-3,3,3',3'
      tetramethylindocarbocyanine perchlorate (Dil) from originally labeled to
      unlabeled adjacent ghosts. It was found that ghost fusion can be described as a
      first-order rate process with corresponding rate constants; a true fusion rate
      constant, k(f), for the square waveform pulse and an effective fusion rate
      constant, k(ef), for the exponential pulse. Compared with the fusion yield, the
      fusion rate constants are more fundamental characteristics of the fusion process
      and have implications for its mechanisms. Values of k(f) for rabbit and human
      erythrocyte ghosts were obtained at different electric field strength and
      temperatures. Arrhenius k(f) plots revealed that the activation energy of ghost
      electrofusion is in the range of 6-10 kT. Measurements were also made with the
      rabbit erythrocyte ghosts exposed to 42 degrees C for 10 min (to disrupt the
      spectrin network) or 0.1-1.0 mM uranyl acetate (to stabilize the bilayer lipid
      matrix of membranes). A correlation between the dependence of the fusion and
      previously published pore-formation rate constants for all experimental
      conditions suggests that the cell membrane electrofusion process involve pores
      formed during reversible electrical breakdown. A statistical analysis of fusion
      products (a) further supports the idea that electrofusion is a stochastic process
      and (b) shows that the probability of ghost electrofusion is independent of the
      presence of Dil as a label as well as the number of fused ghosts.

PMID- 1617139
TI  - Potentiostatic deposition of DNA for scanning probe microscopy.
AB  - We describe a procedure for reversible adsorption of DNA onto a gold electrode
      maintained under potential control. The adsorbate can be imaged by scanning probe
      microscopy in situ. Quantitative control of a molecular adsorbate for microscopy
      is now possible. We found a potential window (between 0 and 180 mV versus a
      silver wire quasi reference) over which a gold (111) surface under phosphate
      buffer is positively charged, but is not covered with a dense adsorbate. When DNA
      is present in these conditions, molecules adsorb onto the electrode and remain
      stable under repeated scanning with a scanning tunneling microscope (STM). They
      become removed when the surface is brought to a negative charge. When operated at
      tunnel currents below approximately 0.4 nA, the STM yields a resolution of
      approximately 1 nm, which is better than can be obtained with atomic force
      microscopy (AFM) at present. We illustrate this procedure by imaging a series of
      DNA molecules made by ligating a 21 base-pair oligonucleotide. We observed the
      expected series of fragment lengths but small fragments are adsorbed
      preferentially.

PMID- 1617140
TI  - Phospholipid interactions in model membrane systems. I. Experiments on
      monolayers.
AB  - We study the lateral headgroup interactions among phosphatidylcholine (PC)
      molecules and among phosphatidylethanolamine (PE) molecules in monolayers and
      extend our previous models. In this paper, we present an extensive set of
      pressure-area isotherms and surface potential experiments on monolayers of
      phospholipids ranging from 14 to 22 carbons in length at the n-heptane/water
      interface, over a wide range of temperature, salt concentration, and pH on the
      acid side. The pressure data presented here are a considerable extension of
      previous data (1) to higher surface densities, comprehensively checked for
      monolayer loss, and include new data on PE molecules. We explore surface
      densities ranging from extremely low to intermediate, near to the main phase
      transition, in which range the surface pressures and potentials are found to be
      independent of the chain length. Thus, these data bear directly on the headgroup
      interactions. These interactions are observed to be independent of ionic
      strength. PC and PE molecules differ strongly in two respects: (a) the lateral
      repulsion among PC molecules is much stronger than for PE, and (b) the lateral
      repulsion among PC molecules increases strongly with temperature whereas PE
      interactions are almost independent of temperature. Similarly, the surface
      potential for PC is found to increase with temperature whereas for PE it does
      not. In this and the following paper we show that these data from dilute to
      semidilute monolayers are consistent with a theoretical model that predicts that,
      independent of coverage, for PC the P-N+ dipole is oriented slightly into the oil
      phase because of the hydrophobicity of the methyl groups, increasingly so with
      temperature, whereas for PE the P-N+ dipole is directed into the water phase.

PMID- 1617142
TI  - Computer models of a new deoxy-sickle cell hemoglobin fiber based on x-ray
      diffraction data.
AB  - A new x-ray fiber diffraction pattern from deoxygenated sickle cell erythrocytes
      has been observed. It displays 14 layer lines with a 109 A periodicity compared
      with the 64 A periodicity of the "classic" sickle cell hemoglobin (HbS) fiber.
      These data and association energy calculations serve as a basis for computer
      model building. Systematic searches over four-dimensional parameter space yielded
      twelve protofilament models that satisfy the following constraints: (a) two HbS
      molecules be related by twofold screw symmetry with a translational repeat of 109
      A; (b) at least one of the substituted residues in HbS, val beta 6, should
      participate in intermolecular contacts; and (c) the energy of intermolecular
      interaction be less than -24 kcal/mol. Each of the protofilament models is a
      zigzag mono-strand that stands in contrast to the double-stranded protofilament
      of the "classic" fiber. Fiber models were constructed with each of the 12
      protofilament models, pseudo-hexagonally packed. Searches of variable packing
      parameters showed four fiber models with minimal protofilament association
      energies and minimal differences between calculated transforms and observed data.
      The R-factor was less than 0.24 for each of these four models. In three of the
      fiber models the protofilament association energy is between -(93 and 130) kcal,
      and in a fourth, the energy is -64 kcal. One protofilament model constituted
      three distinct fiber models of the lower energy class, and a second protofilament
      model packed with a higher association energy into a fourth fiber model. The
      selection of a unique fiber model from among these four cannot be made because of
      the limited available data. Fibers models constructed with any of the ten other
      protofilament models do not satisfy the conditions of minimal association energy
      and R-factor.

PMID- 1617141
TI  - Phospholipid interactions in model membrane systems. II. Theory.
AB  - We describe statistical thermodynamic theory for the lateral interactions among
      phospholipid head groups in monolayers and bilayers. Extensive monolayer
      experiments show that at low surface densities, PC head groups have strong
      lateral repulsions which increase considerably with temperature, whereas PE
      interactions are much weaker and have no significant temperature dependence (see
      the preceding paper). In previous work, we showed that the second virial
      coefficients for these interactions can be explained by: (a) steric repulsions
      among the head groups, and (b) a tilting of the P-N+ dipole of PC so that the N+
      end enters the oil phase, to an extent that increases with temperature. It was
      also predicted that PE interactions should be weaker and less temperature
      dependent because the N+ terminal of the PE head-group is hydrophilic, hence, it
      is tilted into the water phase, so dipolar contributions among PE's are
      negligible due to the high dielectric constant of water. In the present work, we
      broaden the theory to treat phospholipid interactions up to higher lateral
      surface densities. We generalize the Hill interfacial virial expansion to account
      for dipoles and to include the third virial term. We show that to account for the
      large third virial coefficients for both PC and PE requires that the short range
      lateral attractions among the head groups also be taken into account. In
      addition, the third virial coefficient includes fluctuating head group dipoles,
      computed by Monte Carlo integration assuming pairwise additivity of the
      instantaneous pair potentials. We find that because the dipole fluctuations are
      correlated, the average triplet interactions do not equal the sum of the average
      dipole pair potentials. This is important for predicting, the magnitude and the
      independence of temperature of the third virial coefficients for PC. The
      consistency of the theory with data of both the second and the third virial
      coefficients extends the applicability of the head-group model to
      semiconcentrated monolayers, in agreement with the surface potential data in the
      foregoing paper.

PMID- 1617143
TI  - Consideration of dipole orientation angles yields accurate rate equations for
      energy transfer in the rapid diffusion limit.
AB  - Dipole-dipole energy transfer between suitable donor and acceptor chromophores is
      an important luminescence quenching mechanism and has been shown to be useful for
      distance determination at the molecular level. In the rapid diffusion limit,
      where the excited-state lifetime of the donor is long enough to allow the donor
      and acceptor to diffuse many times their average separation before deexcitation,
      it is usually assumed that the relative dipolar orientation is completely
      averaged due to rotational Brownian motion. Under this simplifying assumption,
      analytical expressions have been derived earlier for the energy transfer rate
      between donor and acceptor characterized by different geometries. Most such
      expressions, however, are only approximate because complete angular averaging is
      permitted only in a geometry that possesses spherical symmetry surrounding each
      chromophore. In this paper analytical expressions that correctly account for
      incomplete angle averaging due to steric hindrance are presented for several
      geometries. Each of the equations reveals a dependence of the energy transfer
      rate on chromophore orientation. It is shown that correctly accounting for this
      effect can lead to improvements in estimates of the distance of closest approach
      from measured quenching rates based on energy transfer experiments.

PMID- 1617144
TI  - Analytical sedimentation studies of turkey gizzard myosin light chain kinase and
      telokin.
AB  - Sedimentation equilibrium and velocity studies were performed with turkey gizzard
      myosin light chain kinase (MLCK) and telokin, a small protein apparently
      corresponding to the sequence of the COOH-terminal end of MLCK. The measurements
      carried out with MLCK give values for the monomer molecular weight (M(r)),
      sedimentation coefficient (S20 degrees,w), and virial coefficient (A2) of
      108,000, 3.74 S, and -1.95 x 10(-4) mol.ml.g-2, respectively. In the case of
      telokin, M(r) = 18,500; S20 degrees, w = 1.63 S; and A2 = 5.81 x 10(-4)mol.ml.g
      2. Combination of the results of the two kinds of experiment shows that MLCK is a
      rod-shaped molecule (a/b = 18.9) with a Stoke's radius of 69 A. Telokin is also
      elongated (a/b = 8.3) with a Stoke's radius of 29 A. MLCK apparently exhibits
      self-association, with 15% of the protein sedimenting as a dimer in the
      experiments.

PMID- 1617145
TI  - A sensitive measure of surface stress in the resting neutrophil.
AB  - The simplest parameterized model of the "passive" or "resting receptive"
      neutrophil views the cell as being composed of an outer cortex surrounding an
      essentially liquid-like highly viscous cytoplasm. This cortex has been measured
      to maintain a small persistent tension of approximately 0.035 dyn/cm (Evans and
      Yeung. 1989. Biophys. J. 56:151-160) and is responsible for recovering the
      spherical shape of the cell after large deformation. The origin of the cortical
      tension is at present unknown, but speculations are that it may be an active
      process related to the sensitivity of a given cell to external stimulation and
      the "passive-active" transition. In order to characterize further this feature of
      the neutrophil we have used a new micropipet manipulation method to give a
      sensitive measure of the surface stress as a function of the surface area
      dilation of the highly ruffled cellular membrane. In the experiment, a single
      cell is driven down a tapered pipet in a series equilibrium deformation
      positions. Each equilibrium position represents a balance between the stress in
      the membrane and the pressure drop across the cell. For most cells that seemed to
      be "passive," as judged by their spherical appearance and lack of pseudopod
      activity, area dilations of approximately 30% were accompanied by only a small
      increase in the membrane tension, indicative of a very small apparent elastic
      area expansion modulus (approximately 0.04 dyn/cm). Extrapolations back to zero
      area dilation gave a value for the tension in the resting membrane of 0.024 +/-
      0.003 dyn/cm, in close agreement with earlier measures. A few cells showed
      virtually no change in cortical tension and fit the persistent cortical tension
      model of Evans and Yeung (1989. Biophys. J. 56:151-160). However, other cells
      that also appeared "passive," as judged by their spherical appearance, had
      membrane tensions that increased as the apparent surface area was increased.
      Thus, the postulated,persistent "cortical tension" does not appear to be a unique
      and constant parameter for all cells as the membrane area is dilated.This
      measurement of membrane tension could represent a sensitive indication of the
      first stages of cell activation and the"passive-active" transition.

PMID- 1617146
TI  - Anti-insulin antibody structure and conformation. II. Molecular dynamics with
      explicit solvent.
AB  - Molecular dynamics at 300 K was used as a conformation searching tool to analyze
      a knowledge-based structure prediction of an anti-insulin antibody. Solvation
      effects were modeled by packing water molecules around the antigen binding loops.
      Some loops underwent backbone and side-chain conformational changes during the 95
      ps equilibration, and most of these new, lower potential energy conformations
      were stable during the subsequent 200-ps simulation. Alterations to the model
      include changes in the intraloop, main-chain hydrogen bonding network of loop H3,
      and adjustments of Tyr and Lys side chains of H3 induced by hydrogen bonding to
      water molecules. The structures observed during molecular dynamics support the
      conclusion of the previous paper that hydrogen bonding will play the dominant
      role in antibody-insulin recognition. Determination of the structure of the
      antibody by x-ray crystallography is currently being pursued to provide an
      experimental test of these results. The simulation appears to improve the model,
      but longer simulations at higher temperatures should be performed.

PMID- 1617147
TI  - Pair distribution functions in small systems: implications for protein structure
      analysis.
AB  - A general formula is derived for the relation between the pair correlation
      function and the histogram of interparticle distances in small nonuniform
      systems. The formula is applied to random packings of spheres in a spherical
      container, which are generated by a Monte Carlo method. When measured properly,
      the resultant correlation functions are very similar to ones in bulk systems with
      the same volume fraction of particles. In contrast, the density is very
      nonuniform as a function of distance from the center of the container. The
      variation is an order of magnitude for the number density of particle centers, or
      severalfold for the occupied volume fraction. It is described how these results
      can be used to analyze the forces that determine protein structure.

PMID- 1617149
TI  - Conformational analysis of a dinucleotide photodimer with the aid of the genetic
      algorithm.
AB  - The solution structure of the photodimer cis,syn-dUp[]dT is derived with the aid
      of the genetic algorithm. The conformational space available for the molecule is
      sampled efficiently using the computer program DENISE and tested against a set of
      constraints available from nmr experiments. The dominant conformation in solution
      found with this approach can be described by the following combinations of sugar
      phosphate backbone torsion angles: epsilon(t), zeta(t), alpha(+), beta(-ac), and
      gamma(t). The conformation of the sugars and glycosidic torsion angles are S type
      and syn, respectively. The cyclobutane ring and pyrimidines are puckered. In
      addition, other conformations that exist in equilibrium with the first are found.
      It is concluded that the cyclobutane-pyrimidine system is rigid, whereas the
      sugar-phosphate backbone is flexible. The solution structures are compared with
      the crystal structure of the strongly related cyano-ethyl ester of cis,syn
      dTp[]dT.

PMID- 1617148
TI  - Development of an extended simulated annealing method: application to the
      modeling of complementary determining regions of immunoglobulins.
AB  - An extended simulated annealing process (ESAP) has been developed in order to
      obtain an ensemble of conformations of a peptide segment from a protein
      fluctuating at a given temperature. The annealing process was performed with a
      fast Monte Carlo method using the scaled collective variables developed by Noguti
      and Go. The system was divided into two parts: one consists of one or more
      peptide segments and is flexible around the main-chain and side-chain torsional
      angles; the other represents the rest of the molecule and was maintained fixed at
      the atomic positions determined by x-ray experiments. The target function
      included the nonbonding atomic interactions and a distance function to anchor the
      N and C terminal ends of each segment to the fixed part. Three systems of
      complementary determining regions (CDR) of antibodies were tested and compared to
      x-ray data: L2 loop (7 residues) of the light chain of lambda-type Bence-Jones
      protein, H1 and the H2 loops (14 residues) of McPC603, and H1 and H2 loops (12
      residues) of HyHEL-5. Each state of CDR conformations was characterized at room
      temperature by the average of their coordinates (average conformation) and the
      internal energy. With a limited number of annealing processes (10), starting from
      the extended conformation, we have obtained states with conformations close to
      the observed x-ray structures, from 1.1 to 1.7 A root mean square deviation
      (rmsd) of main-chain atoms depending on the system. These states were identical
      or within 0.25 A rmsd of those of lowest internal energy. For unknown CDR
      structures the criteria of lowest internal energies from ESAP can be used to
      predict hypervariable loop structures in antibodies with an accuracy comparable
      to other methods.

PMID- 1617150
TI  - Quantum yield for preferential photodimerization in long pyrimidine tracts.
AB  - The quantum yield for cyclobutyl-pyrimidine dimerization in DNA has been observed
      to increase approximately linearly with increasing pyrimidine tract length. A
      model without adjustable parameters for this yield is proposed based on energy
      delocalization, vibronic symmetry switching, and saturation statistics that
      describe the average number of (base pairwise) breathing modes in a given tract
      of pyrimidines. This average number of modes is an approximately linear function
      of the tract length. Monte Carlo techniques are used to simulate base sequences
      and photochemical events, and indicate that this model is consistent with
      experiment for Tetrahymena pyriformis DNA.

PMID- 1617151
TI  - Conformational preferences of oligopeptides rich in alpha-aminoisobutyric acid.
      II. A model for the 3(10)/alpha-helix transition with composition and sequence
      sensitivity.
AB  - The analysis of the factors that control the helical folding of Aib-rich peptides
      is extended to include sensitivity to sequence patterns, and in particular the
      presence of contiguous non-Aib alpha-mono-alkylated residues. The distinct
      hydrogen-bonding network of the 3(10)-helix, as contrasted with that of the
      competing alpha-helical structure, is explicitly incorporated into a theoretical
      model for the 3(10)-helix/alpha-helix equilibrium constant for a given peptide.
      Finite length effects and the "extra" intrahelical hydrogen bond of the 3(10)
      form are expressed naturally as a result of this loop analysis. This
      semiempirical model captures all the established features of existing empirical
      rules for helical conformational transitions in Aib-rich sequences, as well as
      the recently detected helical transition induced solely by sequence permutation.

PMID- 1617152
TI  - The interaction of auramine O with calmodulin: location of the binding site on
      the connecting strand.
AB  - The cationic dye auramine O forms a fluorescent complex with Ca(2+)-liganded
      calmodulin. One moderately strong binding site is present, as well as one or more
      weaker sites. The binding site for auramine O is different from those for
      toluidinyl-naphthalene sulfonate. The dependence of binding upon electrolyte
      concentration suggests a substantial electrostatic component of the free energy
      of binding. The splitting of the bond between residues 77 and 78 by trypsin
      digestion abolishes auramine O binding; the N- and C-terminal half-molecules have
      virtually no binding capacity. This suggests that the primary binding site is
      located near the midpoint of the connecting strand and includes elements of both
      half-molecules. Thrombin digestion, which splits calmodulin between residues 106
      and 107, also substantially reduces auramine O binding; this may be interpreted
      in terms of the stabilization of the structure of the connecting strand by
      interaction with residues within binding domain IV. The binding affinity at pH
      5.0, where the helical organization of the connecting strand may be intact, is
      greater than at neutral pH.

PMID- 1617153
TI  - Conformation and charge distribution of bicyclic beta-lactams: structure-activity
      relationships.
AB  - The structures of 7-oxo-1-azabicyclo[3.2.0]heptane and its 4-oxa, 3-ethylene-4
      oxa, and 3-ethylene-6-methyl-4-oxa derivatives, and of 8-oxo-1
      azabicyclo[4.2.0]octane and its 5-oxa derivative, were studied by ab initio
      methods. Conformations were refined without constraints using the 4-21G and the 4
      21G* basis sets, and energies and charge distributions were improved by single
      point 6-31G*/4-21G* calculations. The results are are interpreted in terms of
      structural trends related to beta-lactamase inhibitor capability.

PMID- 1617154
TI  - The role of cytokines in the pathogenesis of inflammatory eye disease.
AB  - A coherent view of the role of cytokines in inflammatory eye disease is emerging
      as a result of studies both in man and experimental animals. Cytokines have been
      demonstrated in ocular tissue obtained from patients with intraocular
      inflammation (uveitis) (gamma interferon, IL-2) and have been shown to induce
      inflammation in experimental animals after intraocular injection [(IL-1, IL-6, IL
      8, tumour necrosis factor (TNF), granulocyte macrophage-colony stimulating factor
      (GM-CSF)]. Several unique features of the immunology of the eye such as the
      immunosuppression associated with anterior chamber associated immune deviation
      (ACAID) may be due to the effects of cytokines. Similarly, common complications
      of ocular inflammation such as glaucoma, keratic precipitates, retinal (macular)
      oedema and neovascularization may be mediated by cytokines. Understanding of the
      role of cytokines in inflammatory eye disease has the potential to lead to the
      development of therapies to abrogate the effects of these important mediators of
      the inflammatory response.

PMID- 1617155
TI  - Rat gro/melanoma growth-stimulating activity. Assessment of the structure
      responsible for chemotactic activity by use of its fragments prepared by
      proteolysis and chemical synthesis.
AB  - Rat gro/melanoma growth-stimulating activity is a dimer composed of two identical
      subunits. Each subunit consists of 72 amino-acid residues and contains two
      disulfide bridges. In order to obtain information on the structure responsible
      for chemotactic activity, various fragments of gro were prepared and tested for
      their ability to induce chemotaxis. None of the fragments corresponding to
      residues 1-6, 1-21, 12-31, 36-50 or 52-72 was active as a chemoattractant.
      Reduced and carboxymethylated gro as well as the tryptic peptide consisting of
      three peptides, residues 9-21, 28-45 were and 49-61, linked by two disulfide
      bonds Cys-9-Cys-35 and Cys-11-Cys-51, were inactive. Also, these, peptides did
      not inhibit the chemotactic activity of gro. Rat gro lacking the N-terminal 6
      residues had a reduced activity and the one lacking the C-terminal Lys was as
      active as intact gro. Therefore, an almost entire portion of the molecule
      including disulfide cross-links is required for chemotactic activity.

PMID- 1617156
TI  - CD69 is expressed on Daudi cells in response to interferon-alpha.
AB  - An approach to obtain monoclonal antibodies directed against cell surface
      proteins induced by interferon has been developed in order to characterize such
      proteins and determine their role. Hybridomas obtained by fusion of murine
      myeloma cells and spleen cells of mice immunized with interferon-alpha-treated
      Daudi cells were screened for the production of antibodies reacting
      differentially with interferon-alpha-treated and untreated Daudi cells. One such
      hybridoma, 2D5, produced an antibody reacting with a 28/32 kDa homodimeric
      protein (p28/32) expressed at the surface of Daudi cells in response to IFN-alpha
      treatment. IFN-alpha treatment also increased the basal level of p28/32 detected
      on peripheral blood leukocytes (PBL). 2D5 Antibody was used to probe the
      expression of p28/32 on different cells and in response to various inducers. It
      appears that 2D5 reacted in fact with CD69, a marker of leukocyte activation and
      that, following IFN-alpha treatment, CD69 was not induced on all cultured cell
      lines tested. Interestingly, IFN-gamma was also able to induce CD69 expression on
      a restricted number of cell lines but the induction pattern only partially
      overlapped that of IFN-alpha. As expected, activation of cells with phorbol
      myristate acetate (PMA) resulted in a notable increase in the level of CD69 on
      all cell lines considered except for the epithelial and fibroblastic types.

PMID- 1617157
TI  - Enhancement of interleukin 6 cytostatic effect on human breast carcinoma cells by
      soluble IL-6 receptor from urine and reversion by monoclonal antibody.
AB  - Interleukin 6 receptor soluble urinary protein (IL-6-R-SUP), a purified urinary
      protein binding IL-6 and identified as a truncated 50 kDa soluble form of the 80
      kDa IL-6 cellular receptor, was tested for its biological activity. Addition of
      IL-6-R-SUP enhances the growth stimulation of mouse plasmacytoma T1165 by
      subliminal concentrations of human recombinant IL-6. Since this effect could be
      due to a lower affinity of human IL-6 for the mouse cell receptor, we tested the
      effect of IL-6-R-SUP on human cells. We show that the growth-inhibitory effect of
      IL-6 on breast carcinoma cells is enhanced by addition of IL-6-R-SUP to these
      human cells although they possess abundant IL-6 receptors. With IL-6-R-SUP,
      complete growth inhibition by IL-6 could be achieved and the cells became more
      sensitive to low levels of IL-6. These effects were prevented by a monoclonal
      antibody against IL-6-R-SUP which blocks IL-6 binding to cells. The naturally
      occurring IL-6-R-SUP may help to increase the growth-regulatory action of IL-6.

PMID- 1617158
TI  - Effect of major surgery on the release of interferon gamma by peripheral blood
      mononuclear cells: an investigation at the single cell level using the reverse
      haemolytic plaque assay.
AB  - The release of interferon gamma (IFN-gamma) by peripheral blood mononuclear cells
      from patients undergoing abdominal aortic aneurysm repair was measured using the
      reverse haemolytic plaque assay. The plasma of these patients was also assayed
      for interferon gamma using enzyme-linked immunosorbent assay (ELISA). Peripheral
      blood mononuclear cells from the surgical patients released significantly more
      IFN-gamma by 9 hours after incision than that released prior to surgery (P less
      than 0.001). This change persisted up to 9 days after surgery. Plasma IFN-gamma
      was not detectable using either of two different ELISA techniques. The increased
      secretion of IFN-gamma by peripheral blood mononuclear cells following major
      surgery may be a beneficial component of the host's immune response to injury.

PMID- 1617159
TI  - Biological and structural properties of MIP-1 alpha expressed in yeast.
AB  - The murine macrophage inflammatory proteins-1 alpha (MIP-1 alpha) and MIP-1 beta
      are distinct but closely related cytokines. Partially purified mixtures of the
      two proteins affect neutrophil function and cause local inflammation and fever.
      The particular properties of MIP-1 alpha have not been well studied, although it
      has been identified as being identical to an inhibitor of haemopoietic stem cell
      growth. We have expressed MIP-1 alpha in yeast cells and purified it to sequence
      homogeneity. Structural analysis of this biologically active material by circular
      dichroism and fluorescence spectroscopy confirms that MIP-1 alpha has a very
      similar secondary and tertiary structure to platelet factor 4 and interleukin 8
      with which it shares limited sequence homology. The in-vitro stem cell inhibitory
      properties have been confirmed using a range of murine progenitor cells including
      purified bone marrow progenitor cells (FACS-1), the FDCP-mix A4 cell line, and
      spleen colony forming unit (CFU-S) populations. Plateau levels of inhibition of
      stem cell growth were achieved using concentrations of 0.15 micrograms/ml MIP-1
      alpha. We have also demonstrated that MIP-1 alpha is active in vivo: 5 micrograms
      of MIP-1 alpha per mouse given as a bolus injection, protects stem cells from
      subsequent in-vitro killing by tritiated thymidine. MIP-1 alpha was also shown to
      enhance the proliferation of more committed progenitor granulocyte macrophage
      colony forming cells (GM-CFC) in response to granulocyte macrophage-colony
      stimulating factor (GM-CSF).

PMID- 1617160
TI  - Immunocytochemical staining of serous effusions with the monoclonal antibody Ber
      EP4.
AB  - Cytospin preparations were made from 102 serous effusions for immunocytochemical
      staining using a panel of monoclonal antibodies including a new monoclonal
      antibody Ber-EP4. On cytological examination, 32 fluids were reported to contain
      tumour cells consistent with metastatic adenocarcinoma; 66 contained benign cells
      only and three were reported to contain cells suspicious of malignancy. One
      effusion contained tumour cells consistent with malignant mesothelioma. Positive
      staining of the tumour cells with Ber-EP4 was observed in the 32 effusions (100%)
      which contained adenocarcinoma cells. No staining of the mesothelial cells in
      these 32 specimens was observed. Carcinoembryonic antigen, epithelial membrane
      antigen Ca2 and CD15 staining of tumour cells was noted in 53%, 50%, 50% and 9%
      of these cases, respectively. None of the mesothelial cells in the benign
      effusions stained with Ber-EP4. Nor did the malignant mesothelial cells in the
      only case of malignant mesothelioma. These findings suggest that Ber-EP4 is a
      valuable addition to antibodies available for the differential diagnosis of
      mesothelial cells and adenocarcinoma cells in serous effusions.

PMID- 1617161
TI  - Renal transplant aspiration cytology. Role for simple morphological criteria.
AB  - Fine-needle aspiration (FNA) is a well-recognized technique for sampling solid
      organs. It is used in renal transplantation to clarify the cause of a poorly
      functioning graft. Differential scoring techniques with respect to peripheral
      blood cell populations, and immunocytochemistry have been employed in this
      context. We describe the use of simple morphological criteria alone in renal
      transplant FNA. We compare these with needle biopsy and clinical parameters and
      show their value in the detection of active cellular rejection. Their limitations
      are discussed within the framework of other patterns of transplant pathology.

PMID- 1617162
TI  - Fine-needle aspiration cytology in a case of chordoma.
AB  - We report a case of sacrococcygeal chordoma initially diagnosed by fine-needle
      aspiration cytology. The value of awareness by cytopathologists of the histology
      of soft tissue tumours is emphasized.

PMID- 1617163
TI  - An audit of cervical cancer deaths in Nottingham.
AB  - Death certificates were reviewed and 57 women were identified whose primary cause
      of death was cervical cancer. Their cervical smear records were reviewed from
      laboratory files. Only nine had participated in the cervical cancer screening
      programme before the diagnosis of cervical cancer was made. One woman had an
      abnormal smear as a result of cervical screening but failed to attend for follow
      up. The problem of false negative smears is also addressed and the value of
      review of negative smears for the purposes of cytology audit is emphasized.

PMID- 1617164
TI  - Significance of borderline nuclear abnormality in cervical smears.
AB  - Women with cervical smears showing borderline nuclear abnormality (BNA), or
      reactive changes in the form of squamous metaplasia (SM) or endocervical cell
      hyperplasia (ECH), were age-matched with healthy controls to determine the
      outcome of these conditions. No significant difference in the risk of dyskaryosis
      was observed in cases showing reactive changes and the controls. In contrast,
      there was a 23% excess of cases showing dyskaryosis in the repeat smears of cases
      of BNA over the controls. An odds ratio of 8.3 was obtained, showing dyskaryosis
      in subsequent smears after a diagnosis of BNA.

PMID- 1617165
TI  - Silver binding nucleolar organizer regions in adrenocortical neoplasia.
AB  - The possible contribution of the silver colloid technique for staining nucleolar
      organizer regions in the distinction between benign and malignant adrenocortical
      neoplasms was investigated. Nine cases of adenoma, eight cases of carcinoma, nine
      cases of hyperplasia and four normal adrenal cortex specimens were examined. The
      mean silver binding nucleolar organizer region (Ag-NOR) value in adenoma was
      4.29, and in carcinoma 7.16 (P less than 0.001). Adenomas with diameters greater
      than 3 cm had significantly higher Ag-NOR counts than smaller adenomas. For
      normal cortex, the mean Ag-NOR value was 2.05 and in hyperplasia, 3.62. The
      results indicate that the Ag-NOR technique can help in differential diagnosis
      between benign and malignant adrenocortical lesions and thus may have a
      prognostic value.

PMID- 1617166
TI  - Immunity and immunopathology in dengue virus infections.
AB  - Dengue virus infections are a serious public health problem in tropical and
      subtropical areas of the world. Based on epidemiological data, it has been
      postulated that immune responses to dengue virus contribute to the pathogenesis
      of severe dengue illness, dengue hemorrhagic fever (DHF) and dengue shock
      syndrome (DSS). Host immune responses are also important for controlling dengue
      virus infection. Therefore, dengue virus infections are an interesting model to
      explore the interactions between viruses and the immune system which result in
      immunopathology or recovery from infection. In this paper, we review immune
      responses to dengue viruses with an emphasis on the human T cell responses, and
      discuss possible roles of these immune responses in the control of dengue virus
      infection and in the pathogenesis of DHF/DSS.

PMID- 1617167
TI  - Viral antigen presentation and MHC assembly.
AB  - Viruses and other intracellular pathogens represent a unique challenge to the
      vertebrate immune system. To deal with this problem of intracellular invasion the
      immune system has developed an elegant strategy to mark virally infected cells.
      This review discusses current issues relating to the cell biology of MHC molecule
      assembly and antigen presentation events from the standpoint of viruses and anti
      viral immunity.

PMID- 1617168
TI  - [Cortical necrosis of the transplanted kidney. MR tomographic confirmation of the
      diagnosis?].
AB  - Cortical necrosis is a rare complication of renal transplants, which requires
      urgent diagnosis and management to avoid unnecessary immunosuppression. Seven
      renal transplants with suspected cortical necrosis were evaluated by Doppler-US,
      99mTc-DTPA-perfusion study and Gd-DTPA-enhanced dynamic MRI. In four transplants,
      cortical necrosis was confirmed by angiography and histology. In diagnosing
      cortical necrosis with preserved medullary perfusion (n = 2) dynamic MRI was
      superior to the other modalities. Totally necrotic renal transplants (n = 2) were
      reliably diagnosed by all imaging methods.

PMID- 1617169
TI  - [Pseudo-stenosis of the renal artery: a possible defect of color Doppler
      sonography].
AB  - The diagnostic value of pulsed Doppler sonography for the detection of renal
      artery stenosis was questioned by recent studies. Until now, the diagnostic value
      of colour-coded Doppler sonography of the renal arteries is not clearly defined
      in relation to pulsed Doppler. This study deals with specific problems of colour
      coded Doppler sonography in the examination of the renal arteries. Because of
      basic technical principles of colour-coded Doppler sonography a stenosis can be
      imitated especially at the origin of the right renal artery by using a ventral
      approach to the vessel. This pseudo-stenosis is due to a change of colour similar
      to an aliasing-phenomenon in a curved vessel. In order to avoid false positive
      results, a laterodorsal approach to the vessel should be applied additionally. A
      spectral waveform should be also registered routinely.

PMID- 1617170
TI  - [A renal function analysis using computed tomography. CT clearance versus 131I
      hippuran clearance].
AB  - The CT clearance in a number of urological patients (39 patients, 25 with normal
      renal function) was studied by means of an "area under curve" (AUC) method, using
      a region of interest. 31 patients were given meglumine ioxithalamate and 8
      patients Iopamidol as a contrast medium. Both for total and partial function
      there was highly significant correlation with isotope clearance with good
      reproducibility. The difference in the pharmacokinetics of the contrast media
      affected the absolute clearance values.

PMID- 1617171
TI  - [Pharmacokinetics of gadolinium-DTPA in chronic renal insufficiency requiring
      dialysis].
AB  - MRT with gadolinium-DTPA (0.1 mmol/kg body weight) was performed in 10 patients
      with renal insufficiency requiring dialysis and the clearance of gadolinium-DTPA
      was studied. After 3 dialysis on 3 successive days more than 97% of the initial
      concentration of gadolinium-DTPA had been eliminated. Average half-life was 1.87
      hours. There were no side effects in any of the patients. Close laboratory
      observation of liver function showed no significant changes during the period of
      study. No contra-indication for the use of this contrast medium in patients with
      renal insufficiency requiring dialysis was found during this study.

PMID- 1617172
TI  - [MR tomography in testicular processes. The significance of Gd-DTPA enhanced
      sequences in comparison with plain T2-weighted sequences].
AB  - The value of T1-weighted sequences after intravenous administration of Gd-DTPA
      and of T2-weighted sequences was compared in 43 patients suspected of having
      scrotal abnormalities. T2-weighted sequences gave better demonstration of the
      tunica albuginea and better contrast between tumor and parenchyma. The two
      techniques were equally sensitive for demonstrating testicular tumors but
      orchitis was better demonstrated on the contrast enhanced sequences. Motion
      artifacts were less marked in the T1-weighted sequences with contrast
      enhancement. In selected cases, contrast enhancement may be a valuable addition
      to native protocols. Our experience has indicated that MRI provides specific
      findings in cases of orchitis which are clinically atypical; this facilitates the
      decision to conservative treatment and prevents unnecessary exploration of the
      testes.

PMID- 1617173
TI  - [Catheter embolization of the solitary pulmonary arteriovenous aneurysm].
AB  - Catheter embolization with coils was performed as a method of treatment in 3
      patients with solitary pulmonary arteriovenous aneurysms (PAVA). This led to
      permanent occlusion of the PAVA in all cases. There were no complications
      following embolization. Bearing in mind that other workers also achieved good
      results by this method, embolization of a solitary PAVA by coils should be
      preferred to balloon embolization. Surgical treatment should only be carried out
      for a malformation which is not accessible to embolization or as part of a more
      complex procedure.

PMID- 1617174
TI  - [MR venography in deep venous thromboses of the leg and pelvis. A comparison of
      2D single layer images and 3D MIP reconstructions with phlebography].
AB  - A total of 22 MR venograms were performed in 7 volunteers and 15 patients
      suspected of deep vein thrombosis of the lower limb and pelvis. MR findings were
      compared to conventional venography in all patients. MR venography is a reliable
      method for the exclusion of thrombosis proximal to the popliteal vein. In the
      calf veins, diagnosis of thrombosis is not yet reliable. For MR venography 2D
      time-of-flight-inflow-technique and secondary 3D-MIP reconstructions were used
      and compared to each other. With both methods there were no false negative
      results in comparison to conventional venography. 2D single slice MR venography
      showed two false positive results in iliac and one in popliteal vein. MIP 3D
      reconstructions led to seven false positive results (three iliac, two femoral,
      two popliteal). The exclusive interpretation of MIP-3D reconstruction is not
      reliable for decision-making in deep venous thrombosis.

PMID- 1617175
TI  - [MR tomography of injuries of the medial collateral ligaments of the knee joint].
AB  - Frequency and characteristics of lesions of the medial collateral ligaments (MCL)
      were studied by MRI in 155 patients with trauma to the knee. There were
      abnormalities of the MCL in 38% of cases with ligamentous injuries and in 27%
      these were combined with meniscal tears. 11% of these patients showed isolated
      rupture of MCL and as a result of the MRI findings were treated conservatively.
      By means of T2*-weighted images the individual lesions could be accurately
      localised. Characteristic findings have been defined.

PMID- 1617176
TI  - [The femoropatellar gliding motion during active knee stretching. Imaging using
      motion-triggered MR tomography].
AB  - By means of motion-triggered MRT it has been possible for the first time to
      demonstrate movements in the patello-femoral joint by means of MRT. Patello
      femoral movement was studied during active extension of the knee between 30
      degrees flexion and complete extension. The knees of 5 normal females and 7
      normal males were studied together with 2 women with recurrent lateral patellar
      luxation. In normal women there was an average 16 degrees (10 to 18 degrees), in
      men an average of 12 degrees (10 to 14 degrees) of lateralisation of the patella
      during complete extension of the knee. In 1 patient there was 10 degrees medial
      displacement of the patella before extension. In 2 knees with recurrent lateral
      subluxation there was a 20 and 24 degrees displacement of the patella.

PMID- 1617177
TI  - [Optimization of filtration and lighting parameters in pictures of the hand using
      digital luminescence radiography].
AB  - The appearance of digital radiographs were markedly influenced by post
      processing. To optimise images of the hand, radiographs of 7 patients with
      arthritis were modified by various filters. 6 observers evaluated the presence or
      absence of erosive changes during an ROC study and the advantages of low
      filtration were demonstrated. Further images were prepared of anatomical
      preparations in which para-articular defects had been made and of a hand phantom
      covered in perforated plexiglass. Limited filtration and low enhancement factors
      again provided the best results. Dose reduction of 50% resulted in a significant
      deterioration in the ability to recognise erosions and artificial lesions.

PMID- 1617178
TI  - [The diagnosis of bone marrow lesions in the MR tomogram in children with
      diseases of the hematopoietic system with special reference to post-therapy
      changes].
AB  - 119 MR-examinations of both tibiae, knees and the lower part of both femur were
      performed in 41 children suffering from bone marrow disease (27 ALL, 4 AML, 3
      NHL, 1 agranulocytosis, 6 anaemia). T1- and T2-spin-echo sequences and a T2
      gradient-echo sequence were used. Bone marrow changes in leukaemia were diffuse
      before therapy and patchy after therapy. Due to their different signal in T2
      weighted images, differentiation of the post-therapeutic patchy findings into
      infiltrations, fibrosis, necrosis and siderosis seems to be possible. In future,
      MRI will be the method of choice for screening and controlling bone marrow
      disease if the examination time is shortened by using only a T1-spin-echo
      sequence and a T2-gradient-echo sequence.

PMID- 1617179
TI  - [MR mammography in patients at risk].
AB  - Dynamic MR mammography (MRM) has high sensitivity for the demonstration of
      carcinomas. 63 carcinomas were examined by this technique and all showed a signal
      increase of more than 90% 60 seconds after the injection of 0.1 mmol/kg Gd-DTPA
      and an almost constant signal intensity (carcinoma plateau) for a further 7
      minutes. These characteristic changes applied only to active tumour areas and not
      to necrotic or fibrotic tumour regions. A possible explanation is the altered
      vascular architecture due to the growth of malignant tumours. In the presence of
      a suspect mammogram a carcinoma can be excluded with a high degree of certainty
      in the absence of contrast enhancement. Signal enhancement in 54 histologically
      proven cases of non-proliferative mastopathy and in 52 cases of proliferative
      mastopathy could be reliably distinguished from carcinomas (p less than 0.001).
      In rare cases of proliferative mastopathy the signal changes were suspicious of a
      carcinoma. Normal signal increase does not exclude proliferative mastopathy with
      certainty. Patients with increased contrast uptake should be regarded as "high
      risk" and examined at regular intervals.

PMID- 1617180
TI  - [The place of mammography following breast-conserving therapy of breast cancer].
AB  - This study evaluates the radiographical signs of the breast in 168 patients with
      breast carcinoma who were treated with lumpectomy and radiation therapy. Two
      thirds of the postsurgical scars were radiologically seen only up to two years
      after operation. One-third showed only discrete scarred tissue after this period.
      The most characteristic sign was the continuous diminution of the post-surgical
      and post-radiation lesions in the follow-up mammograms (scar densities, fibrosis
      and architectural distortions). Microcalcification highly suspicious of
      malignancy developed in 6%; one-third, however, proved to be benign. Acute and
      chronic edema were the most striking symptoms up to one year after radiotherapy;
      the final stage of the post-radiation alterations was breast fibrosis which
      demonstrated in 60% of the cases rather discretely. The recurrence rate was 7%.

PMID- 1617181
TI  - Statistical analysis of MRI parameters predicting malignancy in 141 soft tissue
      masses.
AB  - Since well-known grading parameters such as cellularity, mitotic rate, matrix and
      presence of necrosis all influence MRI signal intensity, the value of MRI in
      predicting malignancy is potentially high. To assess this value we studied
      retrospectively the findings in 141 soft tissue tumours (84 benign, 57 malignant)
      and evaluated a wide variety of MRI features (size, margins, signal homogeneity,
      shape, signal intensity, neurovascular and bone involvement, degree and pattern
      of enhancement and evidence of necrosis after injection of Gd-DTPA). Statistical
      analysis was carried out to determine accuracy of parameters individually and in
      combination, for predicting malignancy. Highest sensitivity was obtained for
      "absence of low signal intensity on T2" (100%), "mean diameter greater than 33
      mm" (90%), and "inhomogeneous signal on T1" (88%). Highest specificity was
      obtained for "evidence of necrosis" (98%), "bone or neurovascular involvement or
      metastases" (94%), and "mean diameter greater than 66 mm" (87%). Association of
      best sensitivity and specificity was seen for "absence of low signal intensity on
      T2", "signal inhomogeneity on T1", and "mean diameter of the lesion greater than
      33 mm" (81 and 81%).

PMID- 1617182
TI  - [Fibrin glue as intra-arterial embolization material in acute hemorrhage].

PMID- 1617183
TI  - [Intercostal arterial embolization following thoracic trauma].

PMID- 1617184
TI  - [Rhabdomyolysis in computed tomography].

PMID- 1617185
TI  - [Simultaneous percutaneous internal drainage of a pancreatic pseudocyst and
      spontaneous catheter removal].

PMID- 1617186
TI  - Effects of two viral inactivation methods on platelets: laser-UV radiation and
      merocyanine 540-mediated photoinactivation.
AB  - Two viral inactivation methods suggested for use with cellular blood products
      have been evaluated as to their effects on platelets. In the first study, it was
      proposed that pulsed laser-ultraviolet radiation (UVB) at 308 nm could favor
      photodamage to UVB-sensitive viral nucleic acid with minimal effects on blood
      platelets. A "window of efficacy" was observed with UVB doses of 10.5-21.5 J/cm2
      at which 4-6 log10 poliovirus were inactivated while platelets were relatively
      tolerant. However, this "window" occurred only with low-intensity UVB radiation
      (less than or equal to 0.25 MW/cm2). Damage to platelet proteins, evident at high
      laser intensities, was probably due to multiple photon excitation of amino acids.
      In the second study, platelets and viruses were treated with the photosensitizer,
      merocyanine 540 (MC 540) (less than or equal to 24 micrograms/ml), and visible
      light (450-600 nm) (less than or equal to J/cm2). Activation of washed platelets
      by dye/light treatment resulted in a spontaneous release of serotonin,
      spontaneous aggregation, and marked morphological changes. Increasing
      concentrations of albumin in the suspension medium protected against dye-mediated
      photodamage to platelets, but also significantly reduced the antiviral activity
      of MC 540 and light. These results illustrate the relative sensitivities of
      platelets and viruses to two inactivation methods and the difficulty in
      optimizing inactivation of viruses and preservation of platelet function in a
      protein-rich medium.

PMID- 1617187
TI  - Merocyanine-sensitized photoinactivation of enveloped viruses.
AB  - A wide range of enveloped viruses, including human herpes simplex virus type 1,
      human cytomegalovirus, human T cell leukemia/lymphoma virus type I, human
      immunodeficiency virus type 1, Sindbis virus, and Friend erythroleukemia virus,
      are highly susceptible to merocyanine 540 (MC 540)-sensitized photoinactivation.
      By contrast, human pluripotent hematopoietic stem cells, red cells, factor VIII,
      and von Willebrand factor are much less sensitive. This suggests that MC 540 may
      be useful for the inactivation of enveloped viruses in blood and blood products.
      The dye has a low acute systemic toxicity, is rapidly eliminated from the blood
      stream, and has little or no mutagenic potential. The currently available data
      support the view that MC 540-sensitized photo-inactivation interferes with early
      events in the infectious process, notably the ability of the virus to adhere to
      and penetrate its host cell. The viral envelope is a major target of photodynamic
      damages which appear to be mediated at least in part by singlet molecular oxygen.

PMID- 1617188
TI  - Inactivation of viruses in red cell and platelet concentrates with aluminum
      phthalocyanine (AIPc) sulfonates.
AB  - Aluminum phthalocyanine tetrasulfonates (AIPcS) are photoactive compounds with
      absorption maxima at 665-675 nm. The inactivation of viruses (vesicular
      stomatitis virus, VSV; human immunodeficiency virus, HIV) added to either whole
      blood or red blood cell concentrates (RBCC) and platelet concentrates (PC) on
      treatment with tetrasulfonated AIPc (AIPcS4) was evaluated. Treatment of RBCC
      with 10 microM AIPcS4 and 44 J/cm2 visible light resulted in the inactivation of
      greater than or equal to 10(5.5) infectious doses (TCID50) of cell-free VSV,
      greater than or equal to 10(5.6) TCID50 of cell-associated VSV, and greater than
      or equal to 10(4.7) TCID50 of cell-free sindbis virus. Both greater than or equal
      to 10(4.2) TCID50 of cell-free and greater than or equal to 10(3.6) TCID50 of
      cell-associated forms of HIV were also shown to be inactivated.
      Encephalomyocarditis virus, used as a model for nonenveloped viruses, was not
      inactivated. Equivalent virus kill with Photofrin II required a substantially
      higher concentration of dye and longer exposure to visible light. Following
      AIPcS4 treatment, red cell integrity was well maintained as judged by the low
      level (less than 2%) of hemoglobin release immediately following treatment and on
      subsequent storage, by measurements of erythrocyte osmotic fragility, and by the
      normal recovery and circulatory survival on infusion of treated, autologous red
      blood cells in baboons. Treatment of PC with 10 microM AIPcS4 and 44 J/cm2
      visible light also resulted in effective virus kill (greater than or equal to
      10(5.5) TCID50) of VSV; however, both the rate and extent of platelet aggregation
      in response to collagen addition declined by at least 50%. Based on these
      results, further characterization of AIPcS4-treated RBCC is justified.

PMID- 1617189
TI  - Photoinactivation of lymphohemopoietic cells: studies in transfusion medicine and
      bone marrow transplantation.
AB  - Ultraviolet (UV) irradiation affects eukaryotic cells in numerous ways. Exposure
      of blood transfusion products to UVC (200-280 nm) or UVB (280-320 nm) reduces or
      abrogates their immunogenicity and thereby prevents allosensitization and
      transfusion refractoriness in several models. Although the exact mechanism is not
      known, in vitro studies suggest that UV exposure results in a loss of class II
      histocompatibility antigens from the cell surface, alterations of calcium
      homeostasis, and a lack of interaction between antigen presenting and responding
      cells. In the UVB and UVA (320-400 nm) range, lymphocytes appear to be more
      sensitive than hemopoietic cells. In murine transplant models, UVB irradiation of
      spleen and marrow cells can be used to prevent the development of graft-versus
      host disease while allowing for complete hemopoietic reconstitution. Furthermore,
      in clinical marrow transplantation, pilot studies of UVA in conjunction with
      psoralen administration have yielded encouraging results in patients with steroid
      refractory graft-versus-host disease of the skin. Thus, UV irradiation provides
      an interesting tool to study cell/cell and donor/host interactions and may have
      some applications in transfusion medicine and bone marrow transplantation.

PMID- 1617190
TI  - Photochemical inactivation of viruses and bacteriophage in plasma and plasma
      fractions.
AB  - Transfusion-associated transmission of viral diseases remains a problem. A number
      of methods have been developed to inactivate viral pathogens in plasma and plasma
      fractions, including: dry heating, wet heating, solvent-detergent treatment, and
      immunoaffinity purification. While some of these methods successfully inactivate
      pathogenic viruses, inactivation may be incomplete or result in damage to labile
      plasma proteins. We have developed a method of photochemical decontamination
      (PCD) using psoralens and long wavelength ultraviolet light to inactivate
      pathogenic viruses. In the present study, a spectrum of model viruses have been
      added to plasma and plasma fractions to examine the efficiency of photochemical
      decontamination and the effects on labile plasma coagulation factors. Both RNA
      and DNA viruses have been inactivated under conditions which permit preservation
      of coagulation protein function. PCD technology appears to offer a promising
      solution to decontamination of blood products.

PMID- 1617191
TI  - Photoinactivation of viruses and cells for medical applications.

PMID- 1617192
TI  - Factors influencing virus inactivation and retention of platelet properties
      following treatment with aminomethyltrimethylpsoralen and ultraviolet A light.
AB  - A wide variety of viruses are inactivated by psoralen compounds in the presence
      of ultraviolet A light (UVA). Use of aminomethyltrimethylpsoralen (AMT) and UVA
      is being evaluated as a method to inactivate viruses that may be present in
      platelet suspensions prepared for transfusion. Studies have been conducted to
      assess how variation in various environmental parameters influences the extent of
      viral inactivation and the retention of platelet properties. Most notably, it was
      determined that increasing levels of plasma progressively inhibited the
      inactivation of model viruses. As a result, experiments were routinely conducted
      at a plasma level of approximately 14.5%, using 40 micrograms/ml AMT, which was
      determined to be optimal when using this reduced plasma level. The reduced plasma
      level was achieved by dilution with a nonplasma medium that has been shown to be
      satisfactory for storage of platelets. Under these conditions, about 5 logs of
      vesicular stomatitis virus (VSV), pseudorabies, and phi 6 inactivation were
      achieved. Variation of platelet and leukocyte counts, within normal levels, had a
      minimal effect on extent of viral inactivation. Although oxygen level (mean
      levels, 97.9 mm Hg versus 19.2 mm Hg) had only a small influence on viral
      inactivation with 2.4, 4.8, and 7.2 J/cm2 of UVA (equivalent to 1-3 minutes of
      exposure), in vitro platelet properties, such as medium pH, morphology
      characteristics, and aggregation response, were better retained with a longer
      exposure time at the reduced oxygen level. With normal oxygen (97.9 mm Hg),
      platelet properties declined substantially relative to untreated controls (no
      UVA, no AMT) on exposure to 4.8 J/cm2. Our studies have identified two sets of
      conditions that provide about 5 logs of virus inactivation without extensively
      altering platelet in vitro properties.

PMID- 1617193
TI  - Use of 8-methoxypsoralen and long wavelength ultraviolet radiation for
      decontamination of platelet concentrates.
AB  - Transmission of viral diseases through blood products remains a problem in
      transfusion medicine. We have developed a photochemical decontamination system
      (PCD) for platelet concentrates (PC) utilizing treatment with long wavelength
      ultraviolet radiation (UVA, 320-400 nm) and 8-methoxypsorlan (8-MOP). This system
      is capable of inactivating 25-30 logs/hour of bacteria E. coli or S. aureus, 6
      logs/hour of bacteriophage fd, 0.9 log/hour of bacteriophage R17, and 1.1
      logs/hour of feline leukemia virus (FeLV) in PC. Immediately following 6 hours of
      PCD treatment, platelet integrity and function of PCD-treated and control PC were
      equivalent. After overnight storage, PCD-treated and control PC platelet
      properties were equal, but there was a slight reduction in TXB-2 production of
      PCD-treated PC compared to controls. Following PCD treatment, PC were stored for
      48 to 96 hours. Platelet counts, morphology scores, extracellular LDH levels,
      aggregation response, dense body (db) content, and alpha granule (alpha g)
      content of PCD-treated and control PC were comparable. We assessed the ability of
      the PCD technique to inactivate intracellular and extracellular virus, quantified
      the degree of DNA adduct formation in contaminating lymphocytes, and measured the
      inhibition of polymerase chain reaction (PCR) mediated amplification of
      intracellular DNA. High titers of cell-free murine cytomegalovirus added to human
      platelet concentrates (final concentration 10(6)) were inactivated by PCD within
      30 minutes. Cat renal fibroblasts infected at high levels with feline
      rhinotracheitis virus (FeRTV) were seeded into PC followed by PCD treatment with
      inactivation of 4.8 logs of FeRTV within 10 minutes. Purified human lymphocytes
      were seeded into PC and treated with PCD in the presence of 3H 8-MOP. Six hours
      of PCD treatment resulted in the formation of 9.3 to 12.8 8-MOP adducts per 1000
      base pairs (bp) of DNA. PCR amplification of a 242 bp segment at the HLA-DQ alpha
      locus was examined. Inhibition of PCR DNA amplification was dependent on the
      numbers of 8-MOP adducts formed, and no amplification was present when greater
      than 12 adducts per 1000 bp were formed. These studies indicate that PCD can
      effectively inactivate high titers of cell-associated and cell-free virus seeded
      into standard human PC. The efficiency of DNA adduct formation can be
      quantitated, and the level of 8-MOP adduct formation in lymphocytes contaminating
      PC is comparable to the level of adduct formation in cellular DNA reported in the
      absence of platelets.

PMID- 1617194
TI  - Photochemical inactivation of viruses with psoralens: an overview.
AB  - In the presence of longwave ultraviolet light, psoralen derivatives photoreact
      with the nucleic acids within intact viruses and cells. This photoreaction can
      leave protein antigens and other surface components relatively unmodified, while
      eliminating the infectivity of a wide range of infectious agents. The kinetics of
      inactivation differ among RNA and DNA viruses photoreacted with different
      derivatives of psoralen. The inactivation kinetics are nonlinear as a result of
      photodegradation of psoralens and the unexplained biphasic inactivation of some
      viruses. In spite of these complexities, the photoreaction is capable of
      generating broad safety margins in the disinfection of microbial products under
      gentle, physiologic conditions. The psoralen photoreaction provides a potential
      method for inactivating both known and unknown viruses in active blood products.
      Psoralen-inactivated viruses have already proven useful as noninfectious antigens
      for use in immunoassays and as successful experimental vaccines.

PMID- 1617195
TI  - Inactivation of viruses with photoactive compounds.
AB  - The transmission of human immunodeficiency virus (HIV-1) and other enveloped
      virus by blood transfusion is a major concern. Photosensitive dyes such as
      hematoporphyrin derivative (HPD), dihematoporphyrin ether (DHE), benzoporphyrin
      derivatives (BPD), extended ring porphyrins, sapphyrins and texaphyrins, and
      various cyanines were used with viral cultures to test the feasibility of using
      those light-excitable dyes to kill virus. A photodynamic flow cell was used to
      irradiate viral suspensions or viral infected cells in culture media or in whole
      blood. Herpes virus (HSV-1) was used to screen compounds. Effective compounds
      were subsequently tested for their ability to kill HIV-1, CMV, and SIV in culture
      medium and in blood and proved to effectively kill free virus and infected cells
      at significant viremias. Irradiation was achieved with a filtered xenon light
      source and/or tunable dye laser. Concentrations of dyes at 10 times viral kill
      dose were irradiated in blood which was tested for damage to erythrocytes (RBC),
      platelets, and blood proteins. No damage to RBC, complement factors, and
      immunoglobulins was evident immediately after photodynamic treatment. Platelet
      condition is minimally modified with time. Photodynamic treatment of blood
      appears to be a feasible means of eradicating virus and some protozoans from
      blood.

PMID- 1617196
TI  - Risks of cancer associated with long-term exposure to PUVA in humans: current
      status--1991.
AB  - Since 1975 oral 8-methoxypsoralen administered in association with ultraviolet-A
      radiation (UVA), (PUVA) has been widely used to treat psoriasis and other
      cutaneous diseases. PUVA is mutagenic, and in animals carcinogenic. Prospective
      study of a cohort of patients with psoriasis who were first treated with PUVA in
      1975-1976 has provided data on the carcinogenic risk of this treatment. There is
      a dose-dependent increase in the risk of squamous cell cancer of the skin
      associated with exposure to PUVA. A recent large-scale Swedish study confirmed
      this association. The risk of squamous cell cancer of the genitals of males
      exposed to high doses of PUVA is especially high. A consistent, confirmed, and
      significant relationship of exposure to PUVA to other types of malignancies in
      man has not been established. Although highly effective in the treatment of
      psoriasis, the risk of squamous cell cancer associated with long-term therapy
      with PUVA must be considered in determining when this therapy is appropriate for
      an individual patient. Additional study of PUVA-treated patients will better
      define the full spectrum of the carcinogenic risk of PUVA therapy and the
      clinical behavior of tumors that arise in association with this treatment.

PMID- 1617197
TI  - Pathogen-derived resistance to a potyvirus: immune and resistant phenotypes in
      transgenic tobacco expressing altered forms of a potyvirus coat protein
      nucleotide sequence.
AB  - Transgenic Nicotiana tabacum 'Burley 49' plants containing one of six different
      forms of the tobacco etch virus (TEV) coat protein (CP) nucleotide sequence have
      been generated. In whole plant studies, R1 and R2 progeny were inoculated
      mechanically with TEV, and the appearance and severity of symptoms were recorded.
      Symptom phenotype was altered, ranging from near wild type susceptibility to
      apparent immunity. Protoplasts derived from wild type and transgenic Burley 49
      plant lines were transfected with TEV RNA. Protoplasts from transgenic plants
      expressing full-length or truncated forms of TEV CP supported virus replication.
      Protoplasts from certain transgenic plants, producing plus- or minus-sense CP
      transcripts but no CP, did not support virus replication at wild type levels. A
      model is proposed to account for these observations.

PMID- 1617198
TI  - Genetic analysis of the aggA locus involved in agglutination and adherence of
      Pseudomonas putida, a beneficial fluorescent pseudomonad.
AB  - An isolate of Pseudomonas putida, which rapidly adheres to plant roots, is
      agglutinated by a glycoprotein from root surfaces. Agglutination is prevented and
      adherence to the root surface is diminished by Tn5 insertion in mutant 5123. Two
      cosmid clones from wild type P. putida and a 2.7-kbp EcoRI-HindIII subclone
      present in both cosmid clones restored agglutinable to wild type levels in
      transconjugants of the nonagglutinable (Agg-) Tn5 mutant 5123. These three clones
      increased agglutinability in transconjugants of the parental Agg+ isolate. The
      2.7-kbp EcoRI-HindIII subclone restored adherence to bean root surfaces of 5123
      to wild type levels in a short-term binding assay. Deletion analysis of the 2.7
      kbp fragment indicated only 1.45 kbp was necessary for complementation of
      agglutinability in 5123. This sequence, termed the aggA locus, contains an open
      reading frame of 1,356 nucleotides encoding a predicted 50,509-Da protein. The
      distribution of the aggA locus in plant-associated bacteria, as detected through
      Southern hybridization, is limited to bacteria that express the agglutination
      phenotype.

PMID- 1617199
TI  - Two C4-dicarboxylate transport systems in Rhizobium sp. NGR234: rhizobial
      dicarboxylate transport is essential for nitrogen fixation in tropical legume
      symbioses.
AB  - To investigate the role of dicarboxylate transport in nitrogen-fixing symbioses
      between Rhizobium and tropical legumes, we made a molecular genetic analysis of
      the bacterial transport system in Rhizobium sp. NGR234. This braod host range
      strain fixes nitrogen in association with evolutionarily divergent legumes. Two
      dicarboxylate transport systems were cloned from Rhizobium NGR234. One locus was
      chromosomally located, whereas the other was carried on the symbiotic plasmid
      (pSym) and contained a dctA carrier protein gene, which was analyzed in detail.
      Although the DNA and derived amino acid sequences of the structural gene were
      substantially homologous to that of R. meliloti, its promoter sequences was quite
      distinct, and the upstream sequence also exhibited no homology to dctB, which is
      found at this position in R. meliloti. A site-directed internal deletion mutant
      in dctA of NGR234 exhibited a (unique) exclusively symbiotic phenotype that could
      grow on dicarboxylates ex planta, but could not fix nitrogen in planta. This
      phenotype was found for tested host plants of NGR234 with either determinate- or
      indeterminate-type nodules, confirming for the first time that symbiosis-specific
      uptake of dicarboxylates is a prerequisite for nitrogen fixation in tropical
      legume symbioses.

PMID- 1617200
TI  - Transcriptional organization and expression of the large hrp gene cluster of
      Pseudomonas solanacearum.
AB  - Cloning and localized mutagenesis of the larger cluster of hrp genes of
      Pseudomonas solanacearum strain GMI1000 allowed the definition of the borders of
      this cluster, which now extends about 2 kb to the left of the insert of the
      previously described plasmid pVir2 (Boucher et al. 1987, J. Bacteriol. 169:5626
      5632). The size of the cluster has also been expanded 3 kb to the right to
      include a region previously described as dsp; our present data demonstrate that
      insertions occurring in these 3 kb lead to leaky mutations affecting both
      pathogenicity on tomato and ability to induce the hypersensitive response (HR) on
      tobacco. Therefore, the size of the entire hrp gene cluster is estimated to be
      about 22 kb. The use of transposon Tn5-B20, which promotes transcriptional gene
      fusions, allowed us to demonstrate that the hrp gene cluster is organized in a
      minimum of six transcriptional units, which are transcribed when the culture is
      grown in minimal medium but are repressed during growth in rich medium or in the
      presence of peptone or Casamino Acids. The level of expression in minimal medium
      is modulated by the carbon source provided; pyruvate is the best inducer. Under
      these conditions the level of expression observed in vitro appears to be
      representative of the actual expression observed in planta.

PMID- 1617201
TI  - Bovine spongiform encephalopathy.
AB  - A detailed account is given of the occurrence of bovine spongiform encephalopathy
      (BSE), current research into the aetiology of this new disease of cattle, and the
      relationship between BSE, scrapie and other similar diseases. Epidemiology,
      clinical signs, pathology, diagnosis, prevention and control are described.

PMID- 1617202
TI  - Scrapie.
AB  - A detailed review is presented of the history, geographical distribution, cause,
      epidemiology, clinical features, pathogenesis, pathology, diagnosis, prevention,
      control and economic effects of scrapie in sheep. Brief mention is made of the
      disease in goats and moufflon. The nature of the agent causing scrapie, the
      genetic control of the incubation period in sheep and the natural transmission of
      scrapie in sheep and goats are discussed. National efforts to control scrapie in
      various countries are outlined.

PMID- 1617203
TI  - Spongiform encephalopathies in Cervidae.
AB  - The known host range of naturally-occurring transmissible spongiform
      encephalopathies has expanded in recent years to include wild ruminants. Chronic
      wasting disease (CWD) occurs in mule deer (Odocoileus hemionus hemionus) and
      Rocky Mountain elk (Cervus elaphus nelsoni) in Colorado and Wyoming, United
      States of America. These species belong to the family Cervidae. Cases have
      occurred primarily in captive animals but a few affected free-ranging animals
      have been identified. Clinical disease in both species is characterised by
      progressive weight loss, behavioural alterations and excessive salivation. In
      deer polydipsia and polyuria also commonly occur. Significant lesions are
      confined to the central nervous system and consist of spongiform change in grey
      matter, intraneuronal vacuolation, astrocytosis and amyloid plaques. Inflammatory
      reaction is absent. The origin of this disease is not known. In contrast to the
      cases of spongiform encephalopathy recognised in five species of antelope (family
      Bovidae) in British zoological parks, which are an extension of the current
      bovine spongiform encephalopathy epizootic, CWD is not the result of food-borne
      exposure to the infectious agent. CWD appears to be maintained within captive
      populations by lateral and, possibly, maternal transmission. Spongiform
      encephalopathies in wild ruminants are currently geographically isolated and
      involve relatively small numbers of animals. However, these potentially
      transmissible diseases could be of greater importance in the future and should be
      viewed with concern in the light of international movements of wild ruminants and
      the current expansion of the game farming and ranching industry in many parts of
      the world.

PMID- 1617204
TI  - Sub-acute, transmissible spongiform encephalopathies: current concepts and future
      needs.
AB  - The first diagnosis of bovine spongiform encephalopathy (BSE) in the United
      Kingdom in 1986 was to stimulate the most intensive epidemiological study of any
      animal disease of all time in that country. It led also to the initiation of a
      broad-based research programme with an international flavour. This principally
      involved scientists and veterinarians in Europe (especially the United Kingdom)
      and the United States of America, especially those with experience of slow
      infections in general and experimental scrapie in particular. This final chapter
      highlights some of the significant discoveries made in the study of BSE and
      related diseases of this group but also emphasises the deficits in knowledge
      which need to be corrected before such diseases as scrapie in sheep and goats can
      be brought under control. The benefits resultant upon effective disease control
      will be manifest as improvement in animal production, welfare and, importantly,
      the removal of trading barriers currently in place to protect countries in which
      diseases such as BSE and scrapie do not exist. Of key importance is the
      development of a simple, cheap and effective diagnostic test for use in the live
      animal before the onset of clinical signs. This will be difficult since the
      nature of the causal agents is uncertain and none provokes either a detectable
      immune response or inflammatory reaction in the host. The earlier chapters,
      written by acknowledged specialists from around the world, deal with the specific
      diseases in detail and all present some of the most recent knowledge available.
      Here the authors emphasise the important role that major national and
      international agencies have in effecting the highest level of control possible in
      the absence of key information. International collaboration with countries in
      which these diseases exist, and as well as those where they are absent, is of
      paramount importance. It is essential that the BSE epidemic which has severely
      affected the cattle industry of the United Kingdom is not allowed to happen in
      developing countries. Whereas the former has implemented stringent control
      measures based on scientific knowledge and is well on the way to eradicating the
      disease, the latter could have much greater difficulty in establishing control.
      The answer is clear. BSE must be prevented from occurring elsewhere. To do that,
      knowledge of BSE and other members of the group should be widely dispersed and it
      is the purpose of this issue to do just that.

PMID- 1617205
TI  - Role of ultrastructural studies in the analysis of cell lineage in the mammalian
      pre-implantation embryo.
AB  - Ultrastructural studies have contributed significantly to our understanding of
      cell lineage differentiation in the mammalian pre-implantation embryo. Such
      studies have documented, and continue to document, morphological, biochemical,
      and physiological characteristics of the cell lineages established during the pre
      implantation period in eutherian embryos, principally that of the mouse. This
      review evaluates these contributions and identifies areas of study in which
      ultrastructural analysis is most likely to have an important role in the future.

PMID- 1617206
TI  - Preservation and visualization of the sea urchin embryo blastocoelic
      extracellular matrix.
AB  - Several methods were utilized to visualize the structure and orientation of the
      blastocoelic extracellular matrix (ECM) in Strongylocentrotus purpuratus embryos
      at the mesenchyme blastula stage. Rapid freezing in liquid propane cooled to LN2
      temperatures followed by freeze substitution was used to preserve the ECM without
      shrinkage due to dehydration. Scanning, transmission, and light microscopy were
      employed to elucidate the ECMs' structure. The blastocoelic ECM consisted of
      parallel fibrillar sheets that were interconnected by finer filaments and
      oriented along the animal-vegetal axis. The ECM completely filled the
      blastocoelic cavity as viewed by scanning electron microscopy. The basal lamina
      could be distinguished from the blastocoelic ECM as a thin coat on the plasma
      membrane of epithelial cells; the ECM was in contact with this coat. In contrast,
      the blastocoelic ECM attached directly to the plasma membrane of primary
      mesenchyme cells (PMC) which did not possess a basal lamina. The blastocoelic ECM
      was isolated as an intact "bag" and probed in a hydrated state with Con A and
      alcian blue. Confocal microscopy confirmed that the entire blastocoel was filled
      with a fibrillar ECM. These approaches offer advantages for future studies of the
      ECMs of sea urchin embryos and their roles in gastrulation.

PMID- 1617207
TI  - Role of the cytoskeleton during early development.
AB  - Oocytes, eggs, and embryos from a diverse array of species have evolved
      cytoskeletal specializations which allow them to meet the needs of early
      embryogenesis. While each species studied possesses one or more specializations
      which are unique, several cytoskeletal features are widely conserved across
      different animal phyla. These features include highly-developed cortical
      cytoskeletal domains associated with developmental information, microtubule
      mediated pronuclear transport, and rapid intracellular signal-regulated control
      of cytoskeletal organization.

PMID- 1617208
TI  - From egg to pole cells: ultrastructural aspects of early cleavage and germ cell
      determination in insects.
AB  - Insect eggs are giant and very complex cells covered by an extremely resistant
      shell. Both the egg cell and surrounding eggshell express anteroposterior and
      ventrodorsal polarity. The molecular and cytoplasmic organization of both axes
      originates during oogenesis and leads to the production of an ooplasmic system
      which consists of euplasm and deutoplasm (yolk) and contains a nucleus as well as
      extranuclear determinants of maternal origin. Both are part of the store of
      information for early embryogenesis. In addition, the deutoplasm serves as raw
      material and early nutrient supply for building the embryo. The insect egg cell,
      which is arrested in the first maturation division when released from the ovary
      during oviposition, will be activated by different stimuli among different
      species to complete meiosis and start embryogenesis. The zygote nucleus undergoes
      a number of synchronous mitotic divisions leading to cleavage energids which
      initially form a syncytial blastoderm and subsequently the cellular blastoderm.
      In many insects, prior to blastoderm formation, polar granules (or oosome
      material) are incorporated in a single cell or a small number of cells which bud
      off at the posterior pole. These so called pole cells give rise to the primordial
      germ cells. Therefore, polar granules or the oosome material mark the germ line,
      and while structural counterparts of determinants of body pattern formation have
      so far not been found, the polar granules or oosome serve as an autonomous
      ooplasmic determinant for the pole or germ cells. Anteroposterior body polarity
      can arise independent of the germ plasm.

PMID- 1617209
TI  - Cell lineage in molluscan development.
AB  - Cell lineage specification in molluscs is brought about by two mechanism: the
      segregation of morphogenetic plasms and inductive cell interactions. The evidence
      for the existence of morphogenetic plasms is largely circumstantial, but in one
      species, Bithynia, such a plasm has been identified in the polar lobe that forms
      at first cleavage. Inductive cell interactions are thought to be a prerequisite
      for the development of a large number of tissues and organs. The most extensively
      studied example is the specification of the mesodermal stem cell in Lymnaea and
      Patella, which occurs between 5th and 6th cleavage through an interaction between
      one macromere and a large number of micromeres. Both segregation and induction
      are tuned to the animal-vegetal polarity of the egg, at least during early
      development. This polarity probably arises during oogenesis and is manifest in
      regional differentiations of the surface architecture of the egg, in the
      distribution of inner membrane particles in the plasma membrane, in membrane
      fluidity characteristics, in ionic conductance properties of the plasma membrane,
      etc. All these phenomena have in common that they represent properties of the egg
      surface, suggesting that the polarity of the egg is somehow imprinted into the
      plasma membrane and the cortex of the egg during oogenesis.

PMID- 1617210
TI  - Secretion of macrophage cytotoxic factors induced by new desmuramyl
      acylpseudopeptide analogs of muramyl dipeptide.
AB  - Sixteen desmuramyl analogs of muramyl dipeptide (MDP) were tested for their
      abilities to stimulate cytotoxic factor secretion by mouse peritoneal
      macrophages. Among them, the pseudohexapeptide Boc-Gly psi [CH2O]-D-Ala-Ala-D
      Glu[Lys(H-Gly)NHEt]-NH2 appeared to be four times more effective than MDP. From
      this study, the D configuration of the pseudo-alanyl (or lactyl) residue appears
      to be essential for activity.

PMID- 1617211
TI  - Action of hydrazine drugs in tumor-free and 1,2-dimethylhydrazine-treated male
      rats.
AB  - In order to evaluate possible carcinogenesis, young adult male Sprague-Dawley
      rats were fed diets of hydralazine, phenelzine, and isoniazid at levels of 0.020
      0.035% for 87 weeks. Hydralazine and isoniazid were also tested by the
      subcutaneous (sc) route at weekly dosages of 17 and 83 mg/kg, respectively, in
      both intact and partially hepatectomized rats, but many succumbed after 7 to 49
      weeks of treatment. Gastrointestinal lesions were absent and, of the
      miscellaneous changes, sc lesions occurred sporadically among the control and
      drug-treated groups. As a further criterion, male weanlings were placed on the
      diets and, starting on day 15, 1,2-dimethylhydrazine (DMH) was injected sc at 9.0
      mg/kg once weekly for the first 7 weeks and twice per week for a total of 23
      treatments. The rats were killed 22 weeks after the last injection, at which time
      colon adenocarcinomas were observed in over 80% per group, the total number being
      significantly greater for the isoniazid group due to heightened tumor occurrence
      at the distal colon. The tumor number in the descending colon for phenelzine was
      also increased but the overall score, as with the hydralazine group, was in the
      range of the DMH injected controls. Small intestinal adenocarcinomas were lower
      in number and involved fewer rats on the hydralazine and phenelzine diets as
      compared to the isoniazid and control groups. Based on the current data, it is
      concluded that on long term exposure of DMH treated rats to the monoamine oxidase
      inhibitors, hydralazine and phenelzine are not cocarcinogenic, whereas isoniazid
      enhances colon carcinogenicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617212
TI  - Reference listings in cancer research.

PMID- 1617213
TI  - Interstitial deletions in DiGeorge syndrome detected with microclones from 22q11.
AB  - DiGeorge syndrome in humans is characterized by immunodeficiency, heart defects,
      mental retardation and facial dysmorphism; cytogenetic analysis has shown that
      deletions at 22q11 occur in approximately 25% of cases. To generate DNA markers
      from this region, we have microdissected and microcloned band q11 of human
      Chromosome (Chr) 22. Nineteen thousand clones were obtained from material
      dissected from 20 chromosome fragments. Seventeen of 61 clones analyzed (28%)
      were repetitive, 27 (44%) gave no signal, and 17 (28%) detected single copy
      sequences of which ten mapped to Chr 22. Two of these were found to be deleted in
      patients with DiGeorge syndrome and either monosomy for 22q11-pter or visible
      interstitial deletions of 22q11. These two markers are also hemizygous in
      patients with no visible chromosomal abnormality, demonstrating that
      submicroscopic deletions are common in DiGeorge syndrome patients.

PMID- 1617214
TI  - Assignment of eight loci to bovine syntenic groups by use of PCR: extension of a
      comparative gene map.
AB  - The polymerase chain reaction (PCR) has been combined with hybrid somatic cell
      technology to extend the bovine physical map. Eight bovine loci--glycoprotein
      hormone alpha (CGA), coagulation factor X (F10), chromogranin A (CHGA), low
      density lipoprotein receptor (LDLR), human prochymosin pseudogene (CYM), oxytocin
      (OXT), arginine-vasopressin (ARVP), and cytochrome oxidase c subunit IV
      pseudogene (COXP)--were assigned to bovine syntenic groups with this approach.
      CGA was assigned to bovine syntenic group U2, F10 to U27, CHGA to U4 [bovine
      Chromosome (Chr) 21], LDLR to U22, CYM to U6, OXT and ARVP to U11, and COXP to U3
      (bovine Chr 5). Seven of these genes, CGA, F10, CHGA, LDLR, OXT, ARVP, and CYM,
      further delineate regions of chromosomal conservation on human Chrs 6, 13, 14,
      19, 20, 20, and 1, respectively. CHGA, OXT, and ARVP are unmapped in the mouse.
      Comparative mapping predicts the mouse CHGA will map to Chr 12, and mouse OXT and
      ARVP will map to mouse Chr 2. Furthermore, human CYM is predicted to be
      sublocalized to 1p32-q21. The primers developed for these eight loci will be
      useful for the development of hybrid somatic cell panels in the future as well as
      establishing a collection of bovine expressed sequence tags.

PMID- 1617216
TI  - Polymorphisms revealed by PCR with single, short-sized, arbitrary primers are
      reliable markers for mouse and rat gene mapping.
AB  - Ten single, arbitrarily designed oligodeoxynucleotide primers, with 50-70% (G+C)
      content, were used to amplify by polymerase chain reaction (PCR) sequences with
      DNA templates from several mouse species (Mus spretus, Mus musculus musculus, and
      Mus musculus domesticus), as well as DNA from the laboratory rat (Rattus
      norvegicus). Eight of these ten primers, used either individually or associated
      in pairs, generated a total of 13 polymorphic products which were used as genetic
      markers. All of these polymorphic sequences but one were mapped to a particular
      mouse chromosome, by use of DNA panels prepared either from interspecific
      backcross progeny of the type (C57BL/6 x Mus spretus)F1 x C57BL/6 or DNA samples
      prepared from two sets of recombinant inbred (RI) strains (AKXL and BXD). Six rat
      specific DNA segments were also assigned to a particular chromosome with DNA
      panels prepared from 18 rat/mouse somatic cell hybrids segregating rat
      chromosomes. From these experiments we conclude that, under precisely
      standardized PCR conditions, the DNA molecules amplified with these arbitrarily
      designed primers are useful and reliable markers for genetic mapping in both
      mouse and rat.

PMID- 1617215
TI  - Multilocus markers for mouse genome analysis: PCR amplification based on single
      primers of arbitrary nucleotide sequence.
AB  - Polymerase chain reaction (PCR) based on single primers of arbitrary nucleotide
      sequence provides a powerful marker system for genome analysis because each
      primer amplifies multiple products, and cloning, sequencing, and hybridization
      are not required. We have evaluated this typing system for the mouse by
      identifying optimal PCR conditions; characterizing effects of GC content, primer
      length, and multiplexed primers; demonstrating considerable variation among a
      panel of inbred strains; and establishing linkage for several products. Mg2+,
      primer, template, and annealing conditions were identified that optimized the
      number and resolution of amplified products. Primers with 40% GC content failed
      to amplify products readily, primers with 50% GC content resulted in reasonable
      amplification, and primers with 60% GC content gave the largest number of well
      resolved products. Longer primers did not necessarily amplify more products than
      shorter primers of the same proportional GC content. Multiplexed primers yielded
      more products than either primer alone and usually revealed novel variants. A
      strain survey showed that most strains could be readily distinguished with a
      modest number of primers. Finally, linkage for seven products was established on
      five chromosomes. These characteristics establish single primer PCR as a powerful
      method for mouse genome analysis.

PMID- 1617217
TI  - Random sequence oligonucleotide primers detect polymorphic DNA products which
      segregate in inbred strains of mice.
AB  - The random amplification of polymorphic DNA (RAPD) using primers of arbitrary
      nucleotide sequence has been extremely valuable in identifying heritable markers
      in a variety of systems. The present studies examined whether the RAPD technique
      can identify large numbers of polymorphisms that can be used to construct genetic
      maps in inbred strains of mice. By screening the inbred mouse strains C57BL/6J
      and DBA/2J with 481 random 10-mer oligonucleotide primers, we identified 95
      polymorphisms and mapped 76 of these by use of the BXD series of recombinant
      inbred (RI) strains. The results clearly demonstrate that the RAPD technique
      allows for the identification of large numbers of DNA-based polymorphisms that
      distinguish these two inbred strains of mice, and that such markers can readily
      be used to construct molecular genetic linkage maps.

PMID- 1617218
TI  - Genomic mapping within the albino-deletion complex using individual early
      postimplantation mouse embryos.
AB  - Sensitive methods for analysis of DNA from limited amounts of tissue are often
      difficult, error prone, and time consuming. Here, we describe a procedure for
      molecular analysis of individual early postimplantation mouse embryos by Southern
      analysis. The procedure involves embedding single embryos in agarose before
      lysing and deproteinizing in situ. The embedded DNA can be digested with
      restriction enzymes and analyzed by standard Southern-blotting procedures. The
      procedure is sensitive enough to detect single-copy sequences in embryos as early
      as day 6.5 of development. We have used the technique to genotype embryos
      homozygous for an embryonic lethal deletion. Normally, the lethal phenotype
      associated with such mutations is identified by a retrospective statistical
      analysis of abnormal embryos produced from a heterozygous cross as compared to
      those produced from a control cross. Now, if associated with a detectable DNA
      abnormality, the mutant embryo can be genotyped directly. We also report the use
      of this method for mapping cloned markers relative to deletion breakpoints. This
      approach can save considerable time since mapping would conventionally be done
      using restriction fragment length polymorphisms (RFLPs) detected in Mus
      musculus/Mus spretus interspecies hybrids. Using this procedure, we have been
      able to redefine the distal limits of the region of Chromosome (Chr) 7 containing
      a gene (eed) needed for development of the embryonic ectoderm.

PMID- 1617219
TI  - Molecular analysis of human chromosome 16 cosmid clones containing NotI sites.
AB  - To test the feasibility of using cloned NotI sites as markers for physical
      mapping, we have screened for cosmid clones spanning the NotI sites on human
      Chromosome (Chr) 16. Fluorescence in situ hybridization analysis of these clones
      confirms the previously reported cluster of NotI sites on 16p13.3. Methylation
      status of the cloned NotI sites on genomic DNA was established by hybridization
      of the cosmids to Southern blots containing EcoRI and EcoRI/NotI digest of
      genomic DNA. These results indicated that four of six clones included in our
      study can be used as linking clones for physical mapping. Two clones have NotI
      sites which are not cleavable in the cell lines tested. In one clone, the NotI
      site exists as an isolated rare-cutting restriction enzyme site, whereas in the
      other clone the NotI site appears to be island-related.

PMID- 1617220
TI  - Long-range walking techniques in positional cloning strategies.

PMID- 1617221
TI  - Mapping and expression of the ubiquitin-activating enzyme E1 (Ube1) gene in the
      mouse.
AB  - The nucleotide sequence of the human cDNA encoding ubiquitin-activating enzyme E1
      is more than 99% identical with the human A1S9T cDNA, a gene that has been shown
      to complement the temperature-sensitive mutant mouse cell line, tsA1S9. The amino
      acid sequences of the proteins encoded by these two cDNA sequences are identical,
      and both cDNAs were previously shown to be located in the same region of the
      human X chromosome; thus, ubiquitin-activating enzyme E1 and A1S9T appear to be
      the same gene, designated UBE1. By in situ hybridization to metaphase chromosomes
      from male mice and by Southern blot analysis of male and female mouse DNA, we
      show that, in the mouse, a human UBE1 cDNA probe identified both X- and Y-linked
      loci. Ube1 is located at band A2 of the mouse X Chromosome (Chr) and Ube2 on the
      short arm of the Y Chr. This is in contrast to the situation in the human, where
      there is no evidence for Y-linked sequences related to UBE1. Mapping of the Ube1
      gene in interspecific backcrosses between Mus spretus and C57BL/6 shows that the
      Ube1 locus maps close to Timp, in a conserved region of the mouse and human X
      Chrs that include Otc, Cybb, Syn1, Timp, and Araf. Expression of Ube1 on the
      inactive X Chr was examined to determine whether this gene is subject to X-Chr
      inactivation in the mouse, as there is previous evidence that the human UBE1 gene
      escapes, at least partially, X inactivation. Sequencing of reverse transcriptase
      polymerase chain reaction (RT-PCR) products from M. spretus, C57BL/6J, and
      T(X;16)16H x M. spretus F1 female mice indicates that the mouse Ube1 gene is
      subject to X-Chr inactivation in vivo. This represents a new example of
      differences between the sex chromosomes of mouse and human.

PMID- 1617222
TI  - Organization and chromosomal locations of Rap1a/Krev sequences in the mouse.
AB  - The human RAP1A gene encodes a protein that apparently can antagonize the
      function of oncogenic ras genes in gene transfer experiments, but its normal
      function is unknown. To understand the function of this gene, we have undertaken
      a study of the mouse homolog, Rap1a. The complete coding sequence of a mouse
      Rap1a cDNA has been determined, and genomic clones representing three distinct
      Rap1a species were recovered. We find that Rap1a is located on distal mouse
      Chromosome (Chr) 3 near Nras, Ampd-1, Tshb, Ngfb, and Atp1a1. Two related
      sequences (Rap1a-rs1 and Rap1a-rs2) were also characterized. Rap1a-rs1, which was
      not localized, has a sequence very similar to the Rap1a cDNA, suggesting that it
      has been recently acquired by the mouse genome. Rap1a-rs2 is more distantly
      related to the gene sequence and is located on Chr 2 near Actc-1.

PMID- 1617223
TI  - Completion of the physical map of Xq28: the location of the gene for L1CAM on the
      human X chromosome.
AB  - The gene for the neural cell adhesion molecule L1 (L1CAM) has been shown to be
      located close to the color vision pigment genes in mouse and man. This location
      has been confirmed by a number of different mapping strategies in both species.
      With pulsed field gel electrophoresis it has been proposed that L1CAM lies
      between the RCP, GCP, and GDX, G6PD loci. We report here a reinterpretation of
      the location of this gene, based on the physical linkage of L1CAM to the more
      proximal locus DXS15. This places L1CAM between this marker and the color vision
      genes (RCP, GCP), a region very dense in CpG islands, expected to contain a large
      fraction of the disease genes assigned to the Xq28 region. In combination with
      the physical mapping data on Xq28 described previously, this closes the last
      remaining gap in the map of the Xq27-Xq28 region. This removes the last
      contradiction between the maps of this region in the genomes of man and mouse,
      and confirms the close similarity of order and distances of markers between these
      organisms.

PMID- 1617224
TI  - Methylation status of ribosomal RNA gene clusters in the flow-sorted human
      acrocentric chromosomes.
AB  - Southern blot analysis of the human acrocentric chromosomes that were flow-sorted
      from B-lymphoblastoid cell line GM130B revealed that the sensitivity of the
      ribosomal RNA (rDNA) gene clusters to the restriction enzyme NotI differs among
      these rDNA-containing chromosomes: the rDNA clusters of Chromosomes (Chr) 13, 14,
      and 15 are much more sensitive to NotI digestion than those of Chrs 21 and 22 in
      this particular cell line. Detailed analysis by use of methylation-sensitive
      enzymes HpaII and HhaI and methylation-insensitive enzyme MspI confirmed the
      significant variation in the methylation status of rDNA clusters among these
      chromosomes. Quantitative analysis by fluorescent in situ hybridization (FISH)
      indicated that copy number of rDNA varies among individual chromosomes, but the
      average copy number in the acrocentric Chrs 21 and 22 is significantly greater
      than that of the Chrs 13, 14, and 15 in GM130B cells. Similar analysis reveals
      that the methylation status of rDNA clusters in another B-lymphoblastoid cell
      line GM131 was different from that of GM130B. These data together indicate that
      the copy number and methylation patterns of rDNA clusters differ among individual
      acrocentric chromosomes in a given cell line, and they are different among cell
      lines.

PMID- 1617225
TI  - A human chromosome 7-specific genomic DNA library in yeast artificial
      chromosomes.

PMID- 1617226
TI  - Localization of murine HLH gene NSCL to chromosome 1 by use of recombinant inbred
      strains.

PMID- 1617227
TI  - TPA-induced differentiation of rat aortic endothelial cells is substrate-specific
      and receptor mediated.
AB  - Under normal conditions, the morphology of cultured endothelial cells (EC) is
      characterized by a contact-inhibited monolayer with a distinct cobblestone
      appearance. However, when treated with phorbol esters, EC acquire fibroblast-like
      growth characteristics, are no longer contact-inhibited in growth, become
      invasive and form pre-capillary, tubular structures within collagen matrices.
      These events describe the basic processes of angiogenesis. We characterized the
      early effects of phorbol-12-myristate-13-acetate (TPA) on the attachment and
      spreading of rat aortic endothelial cells (RAEC) to purified extracellular matrix
      proteins by analyzing the distribution of fibronectin integrin receptors and the
      organization of cytoskeleton microfilaments during RAEC spreading on four
      different extracellular matrix peptides (i.e., Collagen Types I and IV,
      fibronectin and laminin). Type IV collagen appeared to be the best substrate for
      RAEC adhesion and spreading while laminin proved to be the poorest. TPA (0.1
      micron) decreased the rate of RAEC spreading on Type IV collagen with a
      subsequent delay in cell-cell contact formation. In contrast, TPA increases the
      rate of spreading and cell-cell contact formation of RAEC plated on laminin.

PMID- 1617228
TI  - Aortic endothelial cells in culture: factors which modulate their morphological
      and biosynthetic phenotypes.

PMID- 1617229
TI  - The behaviour of pericytes in vitro: relevance to angiogenesis and
      differentiation.

PMID- 1617230
TI  - Identification of non heparin-binding endothelial cell growth factor from rat
      myofibroblasts.
AB  - Myofibroblasts (Mfs) from rat fat tissues produced a potent endothelial cell
      growth factor (Mf-ECGF). The growth factor activity found in the conditioned
      media from primary cultures of Mfs, was labile to heat (80 degrees C for 10 min)
      and proteinase (trypsin), and did not bind to heparin in the presence of 0.2 M
      NaCl. Mf-ECGF was partially purified 4760-fold with a recovery of 25% from serum
      free conditioned media by sequential carboxymethyl (CM) ion-exchange column
      chromatography and gel filtration. This Mf-ECGF activity was recovered from the
      40 kD region of a non-reducing SDS-PAGE, and from the pH region between 6.5 and 7
      of isoelectric focusing, with recoveries of 20% and 65%, respectively. These
      results indicated that a major portion of ECGF activity in the conditioned media
      was clearly distinct from other well-known endothelial cell growth factors
      including fibroblast growth factors (FGFs).

PMID- 1617231
TI  - Possible mechanisms of type I collagen-induced vascular tube formation.
AB  - We investigated the effect of type I collagen on endothelial behaviour following
      its contact with the apical versus basal surface of cultured human endothelial
      cells. When endothelial cells were plated onto type I collagen they attached via
      their basal surface and formed a confluent monolayer. However, when type I
      collagen (100 micrograms/ml) was added directly to the growth medium, so that it
      made contact with the apical surface of endothelial cells, it induced rapid
      capillary-like tube formation. Possible mechanisms were assessed using a)
      polyclonal (anti-VLA-2) and monoclonal (AK7) antibodies to different epitopes on
      the alpha 2 beta 1 integrin receptor for collagen and b) drugs (chlorpromazine
      and trifluoperazine) that inhibit protein kinase C activity. Both anti-VLA-2 and
      AK7 (1-50 micrograms/ml) showed a dose-dependent inhibition of tube formation and
      cell attachment. At 50 micrograms/ml, anti-VLA-2 completely inhibited tube
      formation whereas AK7 caused only partial inhibition (less than 50%). By
      contrast, AK7 was a more potent inhibitor of cell attachment than anti-VLA-2.
      Both chlorpromazine and trifluoperazine prevented tube formation. CONCLUSIONS: 1)
      The alpha 2 beta 1 integrin receptor plays a role in both endothelial cell
      attachment and the induction of tube formation by type I collagen. 2) Protein
      kinase C may be involved in collagen-induced tube formation.

PMID- 1617232
TI  - Basic fibroblast growth factor bound to cell substrate promotes cell adhesion,
      proliferation, and protease production in cultured endothelial cells.

PMID- 1617233
TI  - Thrombospondin modulates basic fibroblast growth factor activities on endothelial
      cells.
AB  - We previously reported that thrombospondin (TSP) induces endothelial cell (EC)
      adhesion, spreading and motility, suggesting that it can play a role in
      angiogenesis. We then studied whether TSP might modulate EC response to known
      angiogenic stimuli in vitro. Here we describe that TSP inhibits EC chemotactic
      response to basic fibroblast growth factor (bFGF). Furthermore, TSP and its 140
      kD fragment reduce EC proliferative response to serum and bFGF. These data
      support the indicated role of TSP and its 140 kD fragment in angiogenesis and in
      related pathologies including tumor malignancy.

PMID- 1617234
TI  - Liver or lung colonization by F9 teratocarcinoma cells follows specific
      interactions with the target organ.

PMID- 1617235
TI  - Intussusceptive microvascular growth, a new mechanism of capillary network
      formation.
AB  - Growth by intussusception is defined as growth by deposition of new particles or
      pieces of formative material among those already embodied in a tissue or
      structure. In the context of capillary growth the term stands for the extension
      of the capillary system by the insertion of new capillary meshes within the
      existing network. New meshes arise as slender transcapillary tissue pillars.
      These are formed initially by a circumscribed fusion of opposite endothelial
      leaflets. Following reorganization of the junctional complexes, the pillar is
      invaded by interstitial tissue. This means that for the formation of new
      capillaries no sprouting of endothelial cords or tubules is required. The
      mechanism is described in the growing lung, but may occur in other tissues too.
      There may be a chance for in vivo observation of the process in the capillaries
      of the chorio-allantoic membrane of the chicken.

PMID- 1617236
TI  - The effect of angiotensin II on tumor blood flow and the delivery of
      microparticulate cytotoxic drugs.
AB  - Colorectal hepatic metastases have a notoriously poor response to conventional
      systemic chemotherapy. We have synthesised cytotoxic drug (doxorubicin and
      mitomycin C) containing spheres 40 microns in diameter, using human albumin and
      ethyl cellulose as matrices. Introduction of these cytotoxic microspheres into
      the hepatic artery should embolise to the tumor and provide a controlled release
      depot for the anticancer agent. The vasoconstrictor, angiotensin II (AII) has
      been shown to increase tumor blood flow relative to normal tissue when
      administered via the hepatic artery, therefore we have investigated the effect of
      AII on targeting of cytotoxic microspheres to hepatic metastases. Patients with
      hepatic metastatic colorectal carcinoma had hepatic arterial catheters inserted
      at laparotomy and connected to subcutaneous injection ports. Peroperatively,
      99mTc-labelled albumin microspheres were administered via the arterial catheter.
      Fifteen minutes later, AII was infused (10 micrograms per minuter for 4 min) via
      the catheter and 131I-labelled albumin microspheres were administered as a bolus
      at the midpoint of the AII infusion. Multiple biopsies were taken of normal liver
      and tumor metastasis and the tissue radioactivity counted for 99mTc and 131I.
      Further studies were performed postoperatively in which 99mTc-labelled
      microspheres were administered via the hepatic artery catheter and their
      distribution was followed using tomographic SPECT scanning. Combined results of
      this study suggested that AII can increase tumor SPECT scanning. Combined results
      of this study suggested that AII can increase tumor blood flow rates relative to
      normal hepatic tissue by approximately 3-fold.

PMID- 1617237
TI  - Effects of hypercholesterolemia on monokine-induced smooth muscle cell
      proliferation.
AB  - Macrophage/smooth muscle cell interactions play a role in atherogenesis and
      foreign body reactions to biomaterials. This study investigates the effect of a
      hypercholesterolemic diet on the ability of smooth muscle cells (SMCs) to respond
      to monokines which are produced in response to hypercholesterolemia, biomaterials
      or both. Peritoneal macrophages were harvested from rabbits fed either a normal
      (M phi NL) or a 2% cholesterol/6% peanut oil diet (M phi ATH) (plasma cholesterol
      2840 vs 42.3 [p less than 0.005]). The macrophages were then cultured in the
      presence of either 1) polyglactin 910 (PG910), 2) Dacron, or 3) no biomaterial
      (control), and the media collected and pooled by week for the smooth muscle cell
      mitogenesis assays. Rabbit aortic smooth muscle cells were harvested and cultured
      from the same two groups of rabbits (SMCNL or SMCATH), quiesced in serum free
      media (48 h) followed by addition of the test media and 3H-TdR. The addition of
      either biomaterial to M phi NL-conditioned media increased 3H-TdR incorporation
      in both smooth muscle lines as compared to controls. PG910 resulted in
      significantly higher 3H-TdR incorporation than Dacron (weeks 3-5, p less than
      0.005). The addition of either biomaterial to M phi ATH also increased 3H-TdR
      incorporation in both smooth muscle cell lines, however, the magnitude of the
      response was decreased as compared to the M phi NL-conditioned media in both cell
      lines (p less than 0.001 for either SMC line). In contrast to the M phi NL
      conditioned media, the addition of Dacron to M phi ATH resulted in the highest
      level of 3H-TdR incorporation in both cell lines as compared to the media without
      biomaterial. The SMCNL had a higher response to both the monokines in conditioned
      media (2-fold) and to fetal bovine serum (3-fold) than the SMCATH (p less than
      0.001). Although there is a generalized decrease in release of mitogens active on
      SMCs from M phi ATH, the M phi ATH exposed to Dacron release increased amounts of
      mitogenic factors, most active on the SMCATH cell line. A common mode of failure
      of small diameter Dacron grafts in man is pseudointimal hyperplasia, and it is
      inviting to postulate that the Dacron/macrophage/smooth muscle cell interactions
      in this atherosclerotic group of patients plays a role in the pathogenesis of
      this lesion.

PMID- 1617238
TI  - A bone tissue integrated single fibre laser Doppler flowmeter probe.
AB  - Laser Doppler Flowmetry was developed and evaluated mainly for measuring blood
      flow in exposed or superficial tissue layers like skin. Results showed large
      variation coefficients between juxtaposed skin sites with apparently homogeneous
      blood perfusion. Spatial differences in blood flow as well as anatomical
      differences probably explain the obtained results. Vasomotion, hereto only
      discovered with a microscopic technique, was recorded and evaluated for the first
      time. Similar results had been obtained in previous bone perfusion studies. The
      LDF technique has also been used extensively for skin irritancy tests and
      microvascular effects of vasoactive substances and drugs. An in vivo model in
      calibrating LDF quantitatively showed a linear relationship between LDF output
      signal and total blood flow in the range 0-300 ml min-1 100 g-1. This
      quantitative calibration is however tissue specific. Most tissues of interest are
      not superficial. The single fibre LDF provides additional power in studying deep
      tissue physiology and trauma-induced changes in regulation of microvascular
      perfusion. Furthermore long-term studies require implantable and biocompatible
      probes and this could be fulfilled using the SFLDF technique in combination with
      a tissue-integrated titanium probe. Implantation of the titanium probes initially
      creates some trauma to the vascular bed in the bone marrow but almost none in the
      opposite cortical bone layer. The healing process enhances the blood perfusion
      during the first weeks. The increased perfusion can be due to different
      parameters such as angiogenesis. The histological findings support this
      hypothesis. This gives preference to the tissue-integrated probe where
      interference with the tissue should be avoided. The integrated probe technique
      has only been evaluated in bone tissue. Modification of the probe shape and
      dimension, however, would make it suitable for other tissues as well.

PMID- 1617239
TI  - Role of basic fibroblast growth factor in proliferation of endothelium and smooth
      muscle after denuding injury in vivo.

PMID- 1617240
TI  - The direct effect of light therapy on endothelial cell proliferation in vitro.
AB  - During repair, new blood vessels are formed by the process of angiogenesis. The
      prerequisite to blood vessel formation is the proliferation of endothelial cells.
      The purpose of this study was to find out if light therapy is capable of
      affecting endothelial cell proliferation in vitro. The direct effect of light at
      wavelengths of either 660 or 820 nm was studied on primary cultures of bovine
      aortic endothelial cells using varying energy densities, of either 1, 2, 4, or 8
      J/cm2. The proliferation of the endothelial cells was assessed over a period of
      five days after a single irradiation.

PMID- 1617241
TI  - Reactions of microvascular endothelial cells to tumor necrosis factor in vivo.

PMID- 1617242
TI  - FDA regulations for growth factors and related products.
AB  - Biological products, including the majority of growth factors, are regulated by
      the Center for Biologics Evaluation and Research (CBER) in the U.S. Food and Drug
      Administration (U.S.FDA) under two statutes; U.S. Federal Food Drug and Cosmetics
      (FDC) act and the U.S. Public Health Service act. As stipulated in the U.S. Code
      of Federal Regulations (21 CFR) under the FDC act, the testing of new products in
      humans is conducted under an Investigational New Drug (IND) application. The
      primary objective of the FDA in all Phases of an investigation is assure safety
      of human subjects. During phase II and phase III studies, additional assurance
      regarding the scientific quality of the clinical investigation is required. A
      marketing approval is granted by CBER following the review of Product License
      Applications (PLA) and Establishment License Applications (ELA). CBER's review
      process provides guidance to the manufacturers of biological products towards the
      development of safe and effective biological products for human use. Information
      pertinent to preclinical issues and clinical trial design is presented here with
      a special emphasis on the non-hematopoietic growth factors.

PMID- 1617243
TI  - Correlation of cervicovaginal fluid volume with serum estradiol levels and total
      follicular volume during human gonadotropin stimulation.
AB  - During the normal menstrual cycle the volume of cervicovaginal fluid (CVF), as
      determined by the patient at home using a simple volumetric aspirating pipette,
      increases significantly over several days prior to the luteinizing hormone (LH)
      surge and decreases characteristically shortly after ovulation. The present study
      was undertaken to test the hypothesis that self-determined measurements of CVF
      volume would correlate positively with serum estradiol (E2) levels and with total
      follicular volume (TFV) in cycles stimulated with exogenous gonadotropins.
      Consequently, 20 infertility patients, undergoing human menopausal gonadotropin
      (hMG)-stimulated cycles, were asked to measure daily CVF. Routine serum E2
      determinations and vaginal follicular ultrasound studies were performed up to and
      including the day of human chorionic gonadotropin (hCG) administration
      (designated day 0). The mean daily CVF volume (+/- SD) increased from 0.1 +/-
      0.01 ml on day -6 to 0.7 +/- 0.40 ml on day -1 and then decreased to 0.6 +/- 0.40
      ml on day 0. On day 0, 7 of 20 cycles (35%) demonstrated a decrease in CVF, which
      ranged from 0.1 to 1.0 ml (mean, 0.42 ml). The mean daily CVF correlated
      positively (correlation coefficient = r) with the mean daily serum E2 (r = 0.89)
      and with the mean daily TFV (r = 0.88). The mean daily correlation of TFV for E2
      was r = 0.98. The correlation between CVF and E2 of individuals ranged from r =
      0.38 to r = 0.99 and the correlation between CVF and TFV ranged from r = 0.12 to
      r = 1.0, while the individual correlations of E2 to TFV ranged from r = 0.60 to r
      = 0.99.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617244
TI  - In vivo fertilization procedures in infertile women with patent fallopian tubes:
      a comparison of gamete intrafallopian transfer, combined intrauterine and
      intraperitoneal insemination, and controlled ovarian hyperstimulation alone.
AB  - This prospective study was undertaken to evaluate the relative efficacy of three
      in vivo methods of assisted fertilization in 150 infertile women with patent
      fallopian tubes: gamete intrafallopian transfer (GIFT), combined intrauterine and
      direct intraperitoneal insemination (IUI+DIPI), and controlled hyperstimulation
      (COHS) alone. The clinical pregnancy rate was highest in the IUI/DIPI and GIFT
      groups: IUI/DIPI, 29.3%; GIFT, 28.6%; and COHS, 8.9%. We believe that controlled
      ovarian hyperstimulation combined with IUI and DIPI is a good alternative to
      GIFT.

PMID- 1617245
TI  - Motives for parenthood and response to failed in vitro fertilization:
      implications for counseling.
AB  - The purpose of this investigation was to identify in vitro fertilization (IVF)
      candidates' motives for parenthood and hence for seeking treatment. The
      relationship among identified motives, pretreatment emotional adjustment, and
      reaction to treatment failure was then examined. Women as a group placed greatest
      emphasis on fulfilling gender-role requirements, and those strongly endorsing
      such motives showed the poorest adjustment before IVF and the most negative
      reaction to first-cycle failure. In contrast, men in general were more likely to
      stress a desire for marital completion, although this motive was not predictive
      of emotional status before or after IVF. However, men experiencing social
      pressures to have children were at greater risk when treatment failed. The
      results indicate that greater consideration of cognitive factors may enhance
      understanding of emotional reactions to IVF failure and provide important
      insights for therapeutic intervention.

PMID- 1617246
TI  - Religious views regarding treatment of infertility by assisted reproductive
      technologies.

PMID- 1617247
TI  - Fertilizing capacity of various populations of spermatozoa within an ejaculate.
AB  - To determine whether ejaculates consist of various populations of sperm with
      varying degrees of fertilizing capacity, semen was filtered through a glass-wool
      column and the filtrate aliquoted sequentially into three portions. The ejaculate
      and its respective filtrates were evaluated for progressive motility, ability to
      respond to hypoosmotic swelling (HOS) test, acrosin content, ability to
      capacitate and acrosome react (AR), and ability to penetrate into denuded hamster
      oocytes (SPA). Filtrate 1 contained significantly more sperm with progressive
      motility, increased acrosin content, and positive HOS and SPA results than did
      the ejaculate. AR did not differ between the ejaculates and the respective
      filtrates. The data suggest that the ejaculate consists of various populations of
      sperm with different properties and that these populations may be separated by
      glass-wool filtration.

PMID- 1617248
TI  - Microscopic epididymal sperm aspiration (MESA): a new option for treatment of the
      obstructive azoospermia associated with cystic fibrosis.
AB  - Cystic fibrosis is a life-threatening disease. Only recently has the prognosis
      improved. In the male patient there is an almost invariable absence or
      maldevelopment of the vas deferens, creating a situation of obstructive
      azoospermia. Consequently, their fertility potential has been considered
      nonexistent. Having gained experience in microscopic epididymal sperm aspiration
      coupled with the advanced reproductive technologies for the treatment of
      congenital absence of the vasa, we sought to extend this treatment option to the
      male cystic fibrosis population. An Indian male with clinically evident and
      genetically confirmed cystic fibrosis underwent microscopic retrieval of
      epididymal sperm. The anatomy of the epididymis and the quality of sperm obtained
      were similar to those patients with congenital absence of the vas deferens. After
      appropriate spousal genetic testing, superovulation, and transvaginal oocyte
      retrieval, in vitro insemination of sperm was performed. Fifty percent of the
      oocytes were subjected to partial zona dissection and a single embryo resulted.
      Subsequent to transfer, no conception was realized but the effort expanded the
      clinical usefulness of microscopic epididymal sperm aspiration. This should open
      up an avenue of treatment for couples in whom only the most dire predictions for
      fertility have been made to date.

PMID- 1617249
TI  - Culture of human spare preembryos: association between blastocyst formation and
      pregnancy.
AB  - The rate of blastocyst development was studied in cultures of human fertilized
      eggs. A total of 195 spare embryos from 86 cycles in 73 in vitro fertilization
      (IVF) patients resulted in a total of 77 expanded blastocysts, corresponding to
      an overall blastocyst development of 39%. In the group of patients where
      pregnancy occurred, at least one of the spare embryos developed into the
      blastocyst stage in 100% of the patients, while the corresponding figure for
      nonpregnant patients was 53%. Superficially these results seem to indicate that
      blastocyst development could be of decisive importance for the success rate in
      IVF. A detailed analysis revealed, however, that this is not the case as long as
      in vitro culture before replacement is limited to 2-3 days.

PMID- 1617250
TI  - Effects of human sera and human serum albumin on mouse embryo culture.
AB  - Human proteins normally used to supplement human in vitro fertilization-embryo
      transfer (IVF-ET) culture media were tested for their effects on mouse embryo
      development from the zygote stage. These proteins included follicular and luteal
      phase maternal sera, fetal cord sera, and both human and bovine serum albumin.
      Our results revealed that both maternal and fetal cord sera did not permit mouse
      blastocyst formation. Furthermore, predialysis of the human maternal sera and
      removal of IgG by protein A column chromatography did not improve their support
      of mouse embryonic development to the blastocyst stage. Similar detrimental
      effects were observed with maternal sera from term-pregnant IVF-ET patients.
      Interestingly, these serum samples had supported the in vitro growth of the human
      zygotes which resulted in these patients' pregnancies. Only some batches of human
      serum albumin supported mouse blastocyst formation, whereas all sources of bovine
      serum albumin were effective in this regard. These results raise the question of
      the suitability of the mouse embryo culture system as a quality control for the
      testing of protein supplements for human IVF-ET.

PMID- 1617251
TI  - Successful use of the sperm motility enhancer 2-deoxyadenosine in previously
      failed human in vitro fertilization.
AB  - The outcome of in vitro fertilization treatment in male-factor infertility is
      generally poor, due mainly to poor fertilization rate and hence fewer available
      embryos for replacement. This study was carried out to assess the value of
      asthenospermic sperm exposure to a motility enhancing agent, 2-deoxyadenosine (2
      DXA), on our in vitro fertilization program in couples undergoing repeat
      treatment after previous failed fertilization. Following sperm wash and
      incubation in 2-DXA-supplemented medium, marked significant improvements were
      observed in the sperm motility pattern and the number of recoverable sperms as
      compared to control unexposed samples. There was also a significantly better
      fertilization rate and higher number of replaceable embryos available following
      sperm wash in 2-DXA as compared to those washed without it. Following embryo
      transfer, pregnancy rate was comparable to the generally reported pregnancy rates
      for routine in vitro fertilization and embryo transfer treatment. Three normal
      babies were born. Our results indicate that 2-DXA enhances fertilization rate in
      some asthenospermic patients and that it has no adverse effect on embryonic
      development.

PMID- 1617252
TI  - Chromosomal analysis of pregnancy losses in patients undergoing assisted
      reproduction.
AB  - Chromosomal analysis was performed on products of conception from 18 patients
      having early pregnancy loss after assisted reproduction. Sonographic findings
      prior to obtaining tissue varied from gestational sacs consistent with a blighted
      ovum to fetal poles with cardiac activity. The mean age of the patients was 36.3
      years. There were nine (50%) normal karyotypes, five (28%) autosomal trisomies,
      two cases of tetraploidy, one case of monosomy, and a case with two pericentric
      inversions. The results of this study suggest that patients undergoing assisted
      reproduction are not at an increased risk for chromosomal abnormalities.

PMID- 1617253
TI  - Factors associated with premature chromosome condensation (PCC) following in
      vitro fertilization.
AB  - From January 1989 to July 1990 a total of 562 oocytes was fixed in our In Vitro
      Fertilization Program, while cytogenetic data were collected in the case of 433.
      Forty-eight of these (11%) had a set of oocyte chromosomes in metaphase II, and
      at least one other set of sperm chromosomes prematurely condensed in the form of
      single chromatids. In the literature this phenomenon, frequent in our experience,
      has not been separately studied by many authors. Comparative studies with diverse
      parameters have shown a significant correlation between the same phenomenon and
      the use of follicle-stimulating hormone supplementation in ovarian stimulation
      protocols. Also, in some cases we found a high percentage of repetition of the
      phenomenon in one patient.

PMID- 1617254
TI  - Triploidy after in vitro fertilization: cytogenetic analysis of human zygotes and
      embryos.
AB  - Tripronuclear zygotes obtained from a clinical IVF program were studied
      cytogenetically. Successful analysis was possible of 42 specimens at the zygote
      stage and 21 embryos after the first or second cleavage division. In the majority
      of zygotes (88%) the expected triploidy was confirmed, whereas only 14% of
      embryos had solely triploid cells. Therefore it is concluded that after tripolar
      cleavage division, many different types of mosaicism may originate from irregular
      chromosome distributions. Since the findings in individual blastomeres in embryos
      resulting from multipronuclear zygotes do not reflect the genetic content of the
      whole embryo, these embryos are less suitable in a model system for preimplantion
      diagnosis. The distribution of the sex chromosomal types (XXX, XXY, and XYY)
      confirmed theoretical expectations. Since in abortion material or in liveborn
      triploidy cases, the XYY karyotype is hardly ever observed, this indicates that
      most likely the 69,XYY karyotype has a very high embryonic mortality.

PMID- 1617255
TI  - Identifying sources of bacterial endotoxin contamination in an in vitro
      fertilization (IVF) culture environment.

PMID- 1617256
TI  - Early pregnancy in human may not be associated with mild thrombocytopenia.

PMID- 1617257
TI  - Midazolam-fentanyl sedation in conjunction with local anesthesia during oocyte
      retrieval for in vitro fertilization.

PMID- 1617258
TI  - Relation between antisperm antibodies and the rate of fertilization of human
      oocytes in vitro.
AB  - To clarify further the role of antisperm antibodies in in vitro fertilization,
      the occurrence of antisperm antibodies on ejaculated sperm and in sera was
      determined by the immunobead binding assay in 67 couples after an unsuccessful in
      vitro fertilization cycle. Antisperm antibodies in maternal sera were associated
      with a failure of oocyte fertilization (P less than 0.02) or with fertilization
      of only 9-19% of the oocytes (P less than 0.01) in vitro. Antisperm antibodies
      were detected in sera from 13 of 24 women (54.2%) where no fertilization
      occurred, 9 of 14 women (64.3%) where less than 20% of the oocytes fertilized,
      and 3 of 19 women (15.8%) where greater than 40% of the oocytes fertilized.
      Antisperm antibodies in these sera were mostly IgG and directed against the sperm
      tail. Antibodies on the surface of ejaculated motile sperm were also associated
      with a low (9-19%) fertilization rate (P less than 0.01). Sperm-bound antibodies
      were detected in 2 of 24 men (8.3%) where no fertilization occurred, 5 of 14 men
      (35.7%) where less than 20% of the oocytes fertilized, and 0 of 19 men where
      fertilization was greater than 40%. Sperm-bound antibodies were mainly IgA and
      were tail-directed. Antisperm antibodies in sera of males were not related to the
      rate of fertilization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617259
TI  - European developments in complementary medicine.
AB  - Complementary therapies are becoming increasingly integrated into nursing care.
      As more nurses adopt these practices, there is a greater need to standardize
      education in line with European directives to ensure safe, research-based
      practice.

PMID- 1617260
TI  - Nurses fear contact with HIV-infected patients.

PMID- 1617261
TI  - Looking towards the community.

PMID- 1617262
TI  - AIDS: fear of contagion among nurses.
AB  - The current moral panic about HIV/AIDS and the theories of deviance that go with
      it are not a new phenomenon. People expect nurses to know all about HIV/AIDS, but
      many experience the same fears and ignorance as the public. Empathy is crucial in
      the nurse/patient relationship and unfavourable attitudes lead to less than
      optimal care. There is a need to cultivate non-judgmental attitudes towards the
      care of people infected with HIV. This requires systematic and sensitive
      educational programmes. As most patients are nursed at home, it is the
      responsibility of the Government and educational bodies to strengthen the
      knowledge base of community nurses. The WHO's global programme on AIDS emphasizes
      the scope of education and promotes worldwide exchange of information and non
      discriminatory policies.

PMID- 1617263
TI  - Specialist practitioners for people with learning disabilities.
AB  - Recent developments occurring within the nursing profession have signalled the
      need for an introspective review of the role and function of nursing practice in
      each speciality. Learning disabilities is no exception.

PMID- 1617265
TI  - Assessment of head-injured children.
AB  - Adult neurological scales do not always assess conscious levels in head-injured
      children accurately. A new scale, the Pinderfield scale, has been introduced into
      the Major Injuries Unit in Birmingham and has found a favourable reception with
      nurses.

PMID- 1617264
TI  - Therapeutic use of play in hospital.
AB  - Children can suffer much anxiety and stress on entering the hospital environment.
      Play therapy, in all its forms, can help to alleviate such stress, and facilitate
      a smoother adjustment to the new and potentially frightening surroundings.

PMID- 1617266
TI  - A system for delivering care.
AB  - Despite partners and relatives providing care prior to a hospital admission, all
      too often they are not involved or informed about the treatment process during a
      patient's stay in hospital. The primary nurse system is an effective way of
      delivering care within the mental health framework. The primary nurse is
      responsible and accountable for the patient throughout his/her stay in hospital.
      Peplau's model of nursing care concentrates on the development of the nurse
      patient relationship. Care plans should be negotiated with the patient. Care plan
      meetings are useful for discussing problems, receiving feedback and for
      supporting colleagues. Family meetings are essential so that the main carer's
      continuing involvement in care can be acknowledged.

PMID- 1617267
TI  - PREPP: from novice to expert.
AB  - There are similarities between the recommendations of PREPP for a future
      education structure and the Dreyfus skill acquisition model. A model combining
      the stages of PREPP and Benner is suggested here.

PMID- 1617268
TI  - When is a prank not a prank?

PMID- 1617270
TI  - How to apply for a job.
AB  - In the previous article of this series we considered the need for career planning
      when making a job change in order to be successful in the current competitive
      climate. This article aims to assist you with the next stage and will examine job
      selection, the informal visit and the application form.

PMID- 1617269
TI  - Not for resuscitative treatment.
AB  - The nurse is accountable for her actions. A defence of 'obeying orders' will not
      always be acceptable. Decisions made by mentally competent adults prevail. A
      living will is not recognized in the English legal system. Relatives do not have
      the legal power to make treatment decisions on behalf of a mentally incapacitated
      adult but their views should be sought. The practitioner must act in the
      patients' best interests but this does not mean that life should be preserved
      regardless of quality.

PMID- 1617271
TI  - Assessment of staff appraisal systems.
AB  - Staff need regular assessments so that job satisfaction, training and good
      quality services can be ensured. The health service is currently implementing
      various types of staff appraisal systems which must be carefully tailored to
      different settings and needs.

PMID- 1617272
TI  - Audit commission: homeward bound.

PMID- 1617273
TI  - Patient advocacy: what does it really mean?

PMID- 1617274
TI  - Breast reconstruction following mastectomy.
AB  - Plastic surgery techniques remain a mystery to general nurses. The aim of this
      article is to give insight into the varying methods of breast reconstruction
      following mastectomy and the associated nursing management and psychological
      support.

PMID- 1617275
TI  - Understanding shock.
AB  - Shock is a life-threatening condition requiring skillful observation and
      intervention. It is therefore essential for nurses to understand the
      physiological processes associated with different types of shock and the nursing
      management of shocked patients.

PMID- 1617276
TI  - Respite care: challenging tradition.
AB  - Respite care is frequently provided within a hospital setting and such a service
      is likely to increase due to community care policies. Nurses need to challenge
      traditional assumptions on which respite care is based in order to provide a more
      flexible service.

PMID- 1617277
TI  - Tissue expansion.
AB  - Tissue expansion has become a popular method of reconstructive surgery over the
      last few years and is used to reconstruct a wide range of defects. This article
      aims to outline the technique and results of tissue expansion on the plastic
      surgery unit in Bradford.

PMID- 1617278
TI  - Erythema multiforme.
AB  - The control of anxiety and pain by combining patient involvement with effective
      nursing and medical therapy is of paramount importance when caring for the
      conscious critically ill patient. Early intervention with particle flotation
      therapy increased patient comfort, prevented further excessive skin loss and
      promoted healing of new epidermis. Nutritional support using total parenteral
      nutrition can help to reduce the incidence of sequelae such as immuno
      compromization, pulmonary tissue oedema and impaired wound healing. Effective
      infection control measures aimed at preventing excessive colonization of the skin
      helps to promote the development of new healthy epidermis. Multidisciplinary care
      incorporating nursing, medical and physiotherapy disciplines is all important in
      delivering effective critical care.

PMID- 1617279
TI  - Preceptorship and PREPP.
AB  - The transition from student to qualified practitioner is a difficult time for
      nurses. In order to facilitate a less traumatic change in role and status, the
      UKCC has advocated a period of support under the guidance of preceptors.

PMID- 1617280
TI  - Punishing AIDS with specialization.

PMID- 1617281
TI  - Advocacy: what the future holds.
AB  - The author offers a personal view of the importance of the advocacy role for
      nurses and highlights problems that may arise as a result of changes in the
      National Health Service.

PMID- 1617282
TI  - How to compile a curriculum vitae.
AB  - The previous article in this series tackled the best way to apply for a job.
      Increasingly, employers request a curriculum vitae as part of the application
      process. This article aims to assist you in compiling a c.v. by discussing its
      essential components and content.

PMID- 1617283
TI  - Quality assurance: the shape of things to come.
AB  - Quality assurance is a systematic approach to the delivery of consistent, high
      quality services. It requires the implementation of quality systems based on
      international quality standards. Modern quality practice has yet to be addressed
      within healthcare.

PMID- 1617284
TI  - The winds of change: psychiatric nursing in Czechoslovakia.
AB  - This article examines the current state of psychiatry and psychiatric nursing
      within the Czechoslovakian Republic and is the result of the author's invitation
      to teach on the first Postgraduate Diploma in Cognitive Behavioural Psychotherapy
      run in Czechoslovakia.

PMID- 1617285
TI  - A contribution to the model of biliary infection in rats.
AB  - The model of biliary tract infection induced in rats given suspension of E. coli
      into the bile duct is described. To prevent leakage of microorganisms after the
      administration, a temporary ligation of the bile duct followed. Contemporary
      groups of sham-operated and control rats (given saline by intrabiliary injection)
      were compared to assess the significance of the changes. The effect of biliary
      infection was concentration dependent. If 0.1 ml of the concentration containing
      10(2), 10(3) and 10(6) colony-forming units/ml was injected, the mortality of
      rats reached 8%, 57% and 65%, respectively within 24 h. Blood and bile cultures
      from all dead animals grew E. coli. To evaluate the effect of chronic biliary
      infection, the concentration of 10(2) colony-forming units/ml was used. Serum
      concentrations of total and conjugated bilirubin, cholesterol and creatinine,
      activities of S-alanine-aminotransferase, S-aspartate-aminotransferase, alkaline
      phosphatase, the count of leucocytes in blood, total body weight with weight of
      the liver were investigated on days 1, 4 and 12 after the treatment. The results
      showed: an increase in leucocytes (21 +/- 4.2 10(9)/l, p less than 0.02 vs
      control animals) on day 4, an augmentation of serum cholesterol on day 1, (2.1 +/
      0.9 mmol/l, p less than 0.02 vs control animals), the presence of E. coli in
      blood on day 1 and its persistence in the bile on days 1, 4 and 12. Except the
      bile, all of the other symptoms were reversible by day 12.

PMID- 1617286
TI  - Inhibition of ACAT activity after 7-oxo-PGI2 treatment in cholesterol-fed
      rabbits.
AB  - It has been supposed that prostacyclin (PGI2) and its analogues have important
      antiatherogenic effects. The aim of this work was to test the effect of PGI2 and
      7-oxo-PGI2- (a stable analogue of PGI2) (6) treatment on the acyl CoA:
      cholesterol-acyltransferase (ACAT) activity in the aortic wall of rabbits. The
      rabbits had been previously fed with cholesterol and treated with PGI2 and 7-oxo
      PGI2 intravenously. Cholesterol feeding increased ACAT activity compared to the
      control group which was not fed with cholesterol: 16.84 nmol/mg prot./h and 10.03
      nmol/mg prot./h, respectively. PGI2 treatment of the cholesterol fed group did
      not cause a significant decrease, while 7-oxo-PGI2 treatment significantly
      decreased aortic ACAT activity compared to the cholesterol-fed control group;
      14.31 nmol/mg prot./h; 11.53 nmol/mg prot./h and 16.84 nmol/mg prot./h,
      respectively. The decrease found in the ACAT activity after PGI2 and 7-oxo-PGI2
      treatment are new data for the protective effect of these agents against
      atherosclerosis.

PMID- 1617287
TI  - Histomorphometry of focal myocardial lesions by means of the automatic image
      analysis.
AB  - There is an urgent necessity to objectify focal myocardial lesions (fml) before
      structural changes in muscle cells can be seen light microscopically. Therefore
      the succinodehydrogenase (SDH) reaction was chosen because it reliably
      demonstrates the decrease in aerobic capacity already in structurally unchanged
      cells and distinguishes the latter from the SDH-negative structures. A combined
      planimetric and densitometric procedure was developed to measure the area density
      of fml and their 2 constituents mentioned as well as to evaluate the SDH activity
      in fml and its decrease in muscle cells using the automatic image analysing
      system QUANTIMET. The verification tests show that both the area density and
      extinction can be reliably determined with acceptable measuring errors unless the
      area density is too low. The results of interobserver and repeatability tests are
      satisfying.

PMID- 1617288
TI  - Carcinogenicity testing of some constituents of black pepper (Piper nigrum).
AB  - In mice, injection of safrole, tannic acid or methylcholanthrene (MCA) during the
      preweaning period induced tumors in different organs. Safrole and tannic acid
      (constituents of black pepper) were weak carcinogens when compared with MCA which
      was used as a carcinogenic control substance. Force feeding of d-limonene (one of
      the pepper terpenoids) for a long time to the mice which were injected with any
      of the above 3 substances reduced their carcinogenic activity, while force
      feeding of piperine (one of black pepper alkaloids) was ineffective.

PMID- 1617289
TI  - Induction of mitochondrial alterations ex vivo in skeletal muscle.
AB  - The ultrastructural alterations of mitochondria were studied, following a
      fixation delay of 45 min, in the normal type II red muscle fibres of pigeon
      semimetapatagialis muscle. These muscle fibres, were devoid of myofibrillar
      degeneration; however, their mitochondria showed derangement. The latter included
      irregular orientation and loss of cristae, and clearing of the matrix. Some
      mitochondria showed myelin figures of varying complexity in the subsarcolemmal
      areas as well as in the interior of muscle fibres. These alterations bear
      striking resemblance to that seen during some lysosomal formation. The
      significance of these observations is discussed.

PMID- 1617290
TI  - Primary phase of hepatocytic autophagocytosis under ischaemic conditions.
AB  - Increased autophagocytosis in hepatocytes was found in response to conditions of
      ischaemia/hypoxia. Initial stages proved to be recordable. These were found to
      become manifest through the formation of phospholipid membrane structures,
      approximately 5 nm in width, coalescing in circular formations with vesicular
      extensions. They may further develop to form multilayer myelin structures.
      Enveloped cytoplasmic regions and organelles were unchanged, at the beginning,
      and subsequently coalesced typically into autophagolysosomes and autophagic
      vacuoles. Verification will be necessary to find out if these initial stages
      occur only in response to hypoxia or constitute a phenomenon of general validity.

PMID- 1617291
TI  - Comparative studies on the effects of aminoglutethimide on hamster and rat
      adrenal cortex.
AB  - Adult female, intact or steroid suppressed hamsters were treated twice daily with
      7 mg aminoglutethimide phosphate (AG) for 5 days while intact female rats
      received 14 mg AG per injection. AG resulted in an increase in adrenal gland
      weight of both hamster and rat. In the hamster AG had no effect on the amount of
      lipid droplets while in the rat a slightly higher number of fine lipid vacuoles
      was seen. In the hamster, enlargement of the gland was due to hyperplasia of the
      zona reticularis cells while in the rat the number of glomerulosa and fasciculata
      cells increased. AG had no effect on the adrenal cortex of steroid suppressed
      hamsters. The serum cortisol level was markedly higher in AG-treated hamsters
      while the corticosterone level was notably lower in AG-administered rats. In both
      hamsters and rats, AG-treatment did not change the serum ACTH level. Thus the
      study demonstrated different responses of the hamster and rat adrenal cortex to
      AG.

PMID- 1617292
TI  - An ultrastructural study of hydrogen peroxide production by cultured fetal and
      neonatal rat lung cells exposed to hyperoxia.
AB  - Hydrogen peroxide production in organotypic cultures of fetal and newborn rat
      lung cells has been investigated using an ultrastructural histochemical method,
      in which the quantity and location of an electron-dense reaction product derived
      from the interaction of cerium chloride and hydrogen peroxide was detected.
      Hydrogen peroxide was present in fetal cell cultures exposed to hyperoxia (50%
      oxygen) compared to controls maintained in 10% oxygen. This increase could be
      limited by incubation of cultures with ascorbic acid and preincubation with
      dexamethasone. On the other hand, in newborn rat lung cell cultures, less
      hydrogen peroxide was identified in cultures including those exposed to hyperoxia
      (50% oxygen).

PMID- 1617293
TI  - Thickening of the glycocalyx during methotrexate induced small intestinal mucosal
      atrophy in the rat.
AB  - In this study, the morphology of the glycocalyx of small intestinal enterocytes
      in the rat was investigated after the induction of mucosal atrophy by
      methotrexate (MTX) in 18 Wistar rats. On the 2nd, 4th and 6th day after the
      intraperitoneal administration of MTX, a group of 6 rats was sacrificed and
      tissue specimens taken at the level of the Treitz' ligament were post fixed in a
      mixture of 2.0% watery osmiumtetroxide and 1.5% potassium-ferrocyanide to enhance
      visibility of glycoconjugates and processed for electron microscopy. In the
      control rats, the glycocalyx was hardly visible on the villous enterocytes, but
      rather conspicuous on the enterocytes in the crypts. On the second day after
      injection of MTX, the glycocalyx of the villous enterocytes was more pronounced
      but on the crypt enterocytes it resembled that of control animals. On the 4th day
      after MTX administration, a striking reduction and shortening of microvilli of
      villous enterocytes was seen, together with very pronounced glycocalyces, while
      crypt cells possessed well developed cell coats. On the 6th day after the
      injection of MTX, the glycocalyx of both villous and crypt cells appeared almost
      normal again.

PMID- 1617295
TI  - Recession busters!

PMID- 1617294
TI  - Biochemical and morphological changes in rat brain synaptosomes after exposure to
      normobaric hyperoxia in vivo.
AB  - Adult rats were submitted to normobaric hyperoxia for 1 to 24 h, then the brain
      synaptosomes were isolated and their metabolic and morphologic properties were
      studied. Hyperoxia lasting 1-2 h significantly increased the content of
      thiobarbituric acid-reactive material (TBAR) and decreased the level of protein
      thid groups. During the next 5-8 h of hyperoxia SH groups as well as TBAR content
      became almost normal, reflecting adaptation of the animals to an elevated oxygen
      tension. After 24 h of hyperoxia a maximal increase in the TBAR content and
      parallel fall in protein thiol groups were noted. Simultaneously, significant
      morphological differences between control synaptosomes and synaptosomes isolated
      from rats exposed to 24 h oxygenation were observed in electron microscopy. The
      high-affinity dopamine uptake in hyperoxic synaptosomes was significantly
      increased in all experimental groups. A specific high sensitivity of the dopamine
      uptake system in synaptoplasmatic membranes to the free radical modification of
      the membrane structure is suggested.

PMID- 1617296
TI  - More for their money!

PMID- 1617298
TI  - The product payoff.

PMID- 1617297
TI  - Time is money.

PMID- 1617299
TI  - RNA binding proteins, splice site selection, and alternative pre-mRNA splicing.

PMID- 1617300
TI  - RPC10 encodes a new mini subunit shared by yeast nuclear RNA polymerases.
AB  - Yeast RNA polymerases A, B, and C share five small subunits, two of which, ABC10
      alpha and ABC10 beta, comigrate on SDS polyacrylamide gels. The gene encoding
      ABC10 alpha, RPC10, was isolated based on microsequence data. RPC10 is a single
      copy gene localized on chromosome VIII. It codes for a very basic protein of only
      70 amino acids, which contains a zinc binding domain of the form CX2CX13CX2C.
      Deletion of its gene indicated that, despite its very small size, the ABC10 alpha
      subunit is essential for yeast cell viability. ABC10 alpha and ABC10 beta have
      little sequence similarity.

PMID- 1617301
TI  - Identification of novel steroid-response elements.
AB  - A rapid method for defining novel steroid-responsive elements has been developed.
      Large libraries of degenerate oligonucleotides were analyzed using a yeast-based
      screen to identify estrogen-responsive DNA sequences. From a library of 40,000
      recombinants, seven estrogen-responsive clones were identified. When sequenced,
      these elements showed remarkable diversity and were different from the consensus
      vitellogenin A2 ERE. One surprising result was the presence of the two half sites
      as direct repeats in some of the clones. This implies that in vivo estrogen
      receptor can bind and transactivate yeast genes through response elements in
      which the two half sites align as direct repeats. This protocol requires no
      purified protein and specifically selects for functional response elements. It
      has a wide application in the study of any transcription factor/DNA interaction.

PMID- 1617302
TI  - Four sarcomeric myosin heavy chain genes are expressed by human fetal skeletal
      muscle cells differentiating in culture.
AB  - Expression of four sarcomeric myosin heavy chain (MHC) genes was examined in
      continuously passaged human fetal (18-22 week) skeletal myoblasts and in
      myoblasts induced to differentiate by low mitogen medium. Although embryonic MHC
      mRNA predominated at all time points following induction, three additional MHC
      genes were expressed at lower levels. These consisted of perinatal, slow, and
      fast skeletal MHC genes. Temporal regulation of MHC gene expression was observed.
      In myoblasts and early induced cultures, embryonic and fast transcripts were
      detected, accompanied in later induced cultures by the accumulation of perinatal
      and slow MHC transcripts. In situ hybridization analysis of uninduced cells
      revealed that sarcomeric MHC transcripts originated from a small population of
      spontaneously fused multinucleated cells. Taken together, these observations
      demonstrate that human fetal myoblasts induced to differentiate in culture
      execute a developmental program that includes temporally regulated expression of
      four distinct sarcomeric MHC genes.

PMID- 1617303
TI  - Developmental changes in the methylation status of regulatory elements in the
      murine alpha 1(I) collagen gene.
AB  - Regulatory elements contributing to the tissue-specific regulation of the murine
      alpha 1(I) collagen (Colla1) gene have previously been identified in its promoter
      region and first intron. Because several lines of evidence indicate that DNA
      methylation may be involved in the tissue-specific regulation of Colla1 gene
      expression, we have analyzed the methylation status of the 5' region of the gene
      by restriction analysis and a methylation-dependent PCR assay. All sites tested
      were unmethylated in sperm DNA. The region surrounding the start site of
      transcription was partially or completely methylated in undifferentiated
      embryonal cell lines, suggesting that it may be marked by de novo methylation
      during early embryonic development. In differentiated cells and adult tissues,
      the Colla1 promoter was completely demethylated in collagen-producing and some
      nonproducing cells, and partially methylated in other nonproducing cells. The
      first intron was unmethylated in collagen-producing as well as nonproducing
      cells. Only sites in the first exon showed an inverse correlation with
      transcriptional activity, i.e., they were unmethylated in cells that express the
      gene, but predominantly methylated in cells that do not. Our results indicate
      that the methylation status of a small area (less than 1 kb) downstream of the
      Colla1 promoter, but not of the promoter itself or the first intron, may be
      critical for transcriptional activity of the promoter, presumably through an
      indirect mechanism.

PMID- 1617305
TI  - The Women's Health Data Book. A profile of women's health in the United States.

PMID- 1617304
TI  - The start site of the Acanthamoeba castellanii ribosomal RNA transcription unit.
AB  - The 39S ribosomal RNA (rRNA) precursor has been isolated from Acanthamoeba
      castellanii. In vitro capping of the isolated RNA verified that it is the primary
      transcript and identified the 5' nucleotide as pppA. The position of the 5'
      coding nucleotide on the rRNA repeat unit sequence was identified using Northern
      blot, R-loop, and S1 nuclease mapping techniques. Dinucleotide priming of an in
      vitro transcription system stalled because of low initiating nucleotide
      concentration revealed that ApA maximally stimulates initiation of transcription.
      All of these results show that the underlined A in the sequence 5'
      TATATATAAAGGGAC (RNA-like strand) coincides with the 5' nucleotide of the primary
      transcript. This identification is compatible with in vitro transcription
      experiments mapping the promoter for this transcription unit. The initiation
      sequences of rRNA genes from 14 species are compared, and a weak consensus for
      the initiator derived: [Formula; see text].

PMID- 1617306
TI  - Lipids and cardiovascular disease: do the findings and therapy apply equally to
      men and women?
AB  - Dyslipoproteinemia is prevalent in women as well as in men. In both, its
      consequences--premature atherosclerosis and CAD morbidity and mortality--are more
      common. Although clinical evidence of the benefits of cholesterol lowering is
      less abundant in women, it is not entirely absent. As in men, cholesterol
      lowering in women is associated with a decline in CAD risk and with regression of
      coronary atherosclerosis. Lipoprotein risk factors have some special
      characteristics in women. Low-density lipoprotein cholesterol may be a less
      important risk factor in women, perhaps because estrogen protects the arterial
      wall against LDL deposition. High-density lipoprotein cholesterol is a better
      predictor of risk in women than in men. Triglycerides are an independent
      predictor of CAD risk in postmenopausal women. The effects of endogenous gonadal
      hormones in life-cycle changes in women is evident. As girls pass through
      puberty, HDL-C levels do not fall as they do in boys of the same age. In
      pregnancy, LDL-C, HDL-C, and triglyceride levels all rise. However, LDL-C stays
      elevated until well after delivery, whereas triglycerides fall to baseline at
      about the time of delivery, and HDL-C levels begin to fall at about 24 weeks.
      Interestingly, this fall in HDL-C is not accompanied by a fall in apoA-I levels,
      implying a change in HDL composition during the latter portion of pregnancy.
      After menopause, LDL-C levels rise sharply, whereas HDL-C levels decline
      modestly. Again, this decline in HDL-C is accompanied by a rise in apoA-I levels,
      implying a change in HDL composition. Diet, weight loss, and exercise are less
      effective in altering lipoprotein levels in women than in men. The reasons for
      this are not clear, although it is reasonable to speculate that endogenous
      gonadal hormones play a role. Genetic dyslipoproteinemia occurs in women,
      although the effect on CAD rates may be mitigated by the generally higher levels
      of HDL-C enjoyed by women. Exogenous hormones in the form of OCs and
      postmenopausal HRT affect circulating lipoprotein levels according to their
      composition. Generally, estrogens have favorable effects, raising HDL-C and
      lowering LDL-C levels. Progestins are either neutral or oppose estrogen effects,
      depending on their dose and androgenicity. Use of modern OCs probably does not
      adversely affect CAD risk except in combination with cigarette smoking. However,
      HRT has a strong favorable effect on CAD risk when unopposed estrogen is used,
      probably due to increases in HDL-C levels.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1617307
TI  - Obesity and weight gain during adulthood: a health problem for United States
      women.

PMID- 1617308
TI  - A report and recommendations from the Jacobs Institute-Mead Johnson Laboratories
      Symposium on Preventive Health Care for Older Women.

PMID- 1617309
TI  - Compliance with hormone replacement therapy: are women receiving the full impact
      of hormone replacement therapy preventive health benefits?

PMID- 1617310
TI  - Screening for gynecologic and colorectal cancer: is it adequate?

PMID- 1617311
TI  - Why aren't older women getting mammograms and clinical breast exams?

PMID- 1617312
TI  - What is the best strategy for autotransplants in cancer?

PMID- 1617313
TI  - Immune responses to chronic myeloid leukaemia.
AB  - The negative impact of donor marrow T lymphocyte depletion on relapse of chronic
      myeloid leukaemia (CML) following bone marrow transplantation strongly suggests
      that the leukaemia is particularly susceptible to immune regulation. The immune
      response to CML may be mediated by major histocompatibility (MHC) locus
      unrestricted natural killer and lymphokine activated killer cells, or by MHC
      restricted CD4 and CD8 lymphocytes. Interaction with the leukaemia is both by
      direct cell-contact cytotoxicity, and indirectly via cytokines and growth
      factors. T4 and T8 lymphocytes recognize a spectrum of minor histocompatibility
      antigens on the leukaemia cell which may be non-specific, leading to graft-versus
      leukaemia and graft-versus-host reactions, or present only on myeloid cells
      leading to a tissue restricted response. The possibility that the P210 protein
      derived from the BCR/ABL fusion gene on chromosome 22 leads to the presentation
      via MHC molecules of leukaemia-specific peptide antigens is currently under
      investigation. Developments in understanding the immune response to CML open up
      the possibility of developing leukaemia-specific immunotherapy strategies.

PMID- 1617314
TI  - Treatment of infant leukemia with busulfan, cyclophosphamide +/- etoposide and
      bone marrow transplantation.
AB  - Infants with acute leukemia have a poor chance of being cured by conventional
      chemotherapy. We therefore treated cases of infant leukemia with high dose
      chemotherapy followed by bone marrow transplantation (BMT). Six suffered from
      acute leukemia and one from refractory anemia with excess of blasts (RAEB-t). The
      conditioning regimen consisted of busulfan (BU) and cyclophosphamide (CY), and
      was intensified by adding etoposide (VP) in four cases. At the time of BMT the
      children were 4, 5, 12, 13, 13, 14, and 20 months old. Three children were
      autografted, three received HLA-identical marrow from a sibling donor, and one
      child received matched unrelated donor marrow. All five children who were grafted
      in complete (CR) or partial remission (PR) are alive and well in CR 7, 13, 24,
      37, and 46 months after allogeneic (two patients) or autologous (three patients)
      BMT, and 13, 17, 29, 42, and 53 months after initial diagnosis. The child with
      RAEB-t and the one transplanted in second chemotherapy-resistant relapse of acute
      non-lymphoblastic leukemia relapsed at 7 and 17 months respectively. The
      chemotherapy regimen was well tolerated. BU-CY-VP is a promising alternative
      treatment to regimens including total body irradiation for very young children
      suffering from acute leukemia.

PMID- 1617315
TI  - An effective immunomagnetic method for bone marrow purging in T cell
      malignancies.
AB  - An immunomagnetic method was developed to purge human bone marrow of malignant T
      cells, for use in conjunction with autologous bone marrow transplantation in
      patients with acute lymphoblastic leukemia and lymphoma. Three monoclonal
      antibodies anti CD2 (BH1), CD5 (BB8) and CD7 (BF12) were used. In model
      experiments employing MOLT4 cells it was found that with 50-fold excess of
      immunobeads relative to antigen-positive cells, the use of each antibody alone
      resulted in a 3.3-3.6 log tumor cell depletion, as assessed in a sensitive and
      reproducible clonogenic soft agar assay. When all three antibodies were used in a
      mixture, a purging efficacy of 5 logs was achieved. Two treatment cycles improved
      these figures to about 4 logs and more than 5 logs. When MOLT4 cells were mixed
      1:10 with fresh bone marrow cells the antibody mixture yielded 3.1 and more than
      5 log tumor cell depletion with one and two treatment cycles, respectively. This
      procedure resulted in only an insignificant reduction of the number of CFU-GM and
      CFU-GEMM progenitor cells. In two patients autotransplanted with purged marrow,
      the loss of CFU-GM was 37% and 48%, and no tumor cells could be detected by
      immunocytochemistry after purging. Rapid and sustained engraftment was achieved
      and both patients remain in complete remission after more than 20 months.

PMID- 1617316
TI  - Autoantibodies after bone marrow transplantation in children with genetic
      disorders: relation to chronic graft-versus-host disease.
AB  - The occurrence of autoantibodies and their relation to chronic graft-versus-host
      disease (GVHD) have been studied in children, 100 days or more following
      allogenic bone marrow transplantation (BMT), mainly performed for a variety of
      genetic disorder. Seventeen of 40 patients had autoantibodies to thyroid
      microsomes, compared with none of 46 control children of similar age (p less than
      0.001). The presence of these antibodies was strongly associated with chronic
      GVHD (14 of 20 patients), p = 0.001. IgG antibodies to the cytoplasm of squamous
      epithelial cells were demonstrated in 15 of 36 children following transplantation
      (p less than 0.001), none being found in 46 normal children. The incidence and
      titre of these antibodies were significantly higher in patients with chronic GVHD
      (p = 0.041 and p = 0.019 respectively). Despite there being a significant number
      of patients with antibodies to nuclei, smooth muscle and gastric parietal cells,
      these autoantibodies were not related to the presence of chronic GVHD. Although
      the mechanism of production is not known, antibodies to thyroid antigens and the
      cytoplasm of squamous epithelial cells may be useful markers for GVHD.

PMID- 1617317
TI  - Detection of circulating endogenous interleukin-3 in extensive chronic graft
      versus-host disease.
AB  - Recent data suggest that activated immune cells and their products are involved
      in the initiation and progression of graft-versus-host disease (GVHD). To test
      whether the production of endogenous interleukin-3 (IL-3), a product of activated
      immune cells, might be an indicator of disease activity in GVHD, we analysed sera
      of 61 bone marrow transplant (BMT) recipients for IL-3 levels by using an enzyme
      linked immunosorbent assay. Measurable levels (greater than 25 pg/ml) of
      endogenous IL-3 were detected in a significant subgroup (5/16 patients, 31.25%)
      of allograft recipients suffering from extensive chronic GVHD, but not in
      patients with limited chronic GVHD (n = 6) or in those without signs of chronic
      GVHD (n = 17). In IL-3 positive patients, IL-3 levels were not associated with
      pathologic conditions (such as infectious disease) other than GVHD. IL-3 levels
      were undetectable in disease-free phases preceding severe chronic GVHD. Lower
      levels of IL-3 were measured in chronic GVHD patients during extensive disease
      while on high dose steroid medication compared with before and/or after (p less
      than 0.02). IL-3 was also detected in a small group (2/17) of patients suffering
      from acute GVHD. IL-3 could neither be detected in syngeneic (n = 3) nor
      autologous (n = 7) BMT recipients nor in the vast majority (99/100) of healthy
      controls. Together, measurable amounts of IL-3 are produced in a significant
      subgroup of patients suffering from extensive chronic GVHD.

PMID- 1617318
TI  - Total body irradiation with or without lung shielding for allogeneic bone marrow
      transplantation.
AB  - From June 1986 to June 1990, 64 patients with leukaemia (25 acute myelogenous
      leukaemia, 21 acute lymphoblastic leukaemia and 18 chronic myeloid leukaemia)
      undergoing marrow transplantation were randomized to receive cyclophosphamide
      (CY) and fractionated total body irradiation (TBI) without lung shielding (n =
      33) or CY and fractionated TBI with lung shielding (n = 31, control group) as
      conditioning. Patients conditioned with TBI without lung shielding received a
      significantly higher total lung dose compared with the control group (p less than
      0.0001). The 3-year leukaemia-free survival for patients receiving TBI without
      lung shielding is 54 +/- 18% versus 51 +/- 18% for patients receiving TBI with
      lung shielding (p = ns). There was no significant difference in the probability
      of leukaemia relapse (22 +/- 18% for TBI without lung shielding versus 24 +/- 18%
      for control group; p = ns). The probability of interstitial pneumonitis is 15 +/-
      14% for TBI without lung shielding and 5 +/- 5% for TBI with lung shielding (p =
      ns). A higher incidence of lung fungal infection (15 versus 3%) and interstitial
      pneumonitis (12 versus 3%) has been documented in patients receiving TBI without
      lung shielding compared with the control group. The results indicate that higher
      radiation dose to the lung did not increase antileukaemic efficacy of TBI but
      seemed to be associated with the increased pulmonary toxicity.

PMID- 1617320
TI  - Autologous blood transfusion for pediatric bone marrow donors.
AB  - Nine normal bone marrow donors aged 7-166 months (median 69 months) received
      autologous red cells which had been removed from their marrow harvest after
      collection. The median volume of marrow removed from the donors was 18.6 ml/kg
      which was equivalent to a median blood volume loss of 23.3%. Three infant donors
      were transfused with autologous red blood cells intraoperatively. These cells had
      been salvaged from the initial marrow aliquot and were transfused while bone
      marrow harvesting continued. No donors required homologous blood transfusion.
      This technique is useful for marrow donors in the pediatric age group when
      preharvest autologous blood collection is not feasible or available.

PMID- 1617319
TI  - Influence of post-methotrexate folinic acid rescue on regimen-related toxicity
      and graft-versus-host disease after allogeneic bone marrow transplantation.
AB  - Thirty-two patients undergoing related-donor bone marrow transplantation (BMT)
      received cyclosporine (CSP) and methotrexate (MTX) with folinic acid rescue (FAR)
      as graft-versus-host disease (GVHD) prophylaxis. Fifty consecutive related-donor
      BMT patients given the CSP/MTX combination without FAR were utilized as
      historical controls. Patients receiving FAR experienced earlier engraftment, with
      absolute neutrophil count greater than 0.5 x 10(9)/l at a median of 17 days (vs
      21 days in controls, p = 0.002). The day of last platelet transfusion was earlier
      in the FAR group (median of 14 days vs 17 days in controls, p = 0.01). Compared
      with the control group, patients receiving FAR had a lower incidence of grade II
      IV stomatic (53% vs 78%, p = 0.04) and hepatic (25% vs 56%, p = 0.01) regimen
      related toxicity. In the FAR group, 70% required total parenteral nutrition vs
      92% of controls (p = 0.02). Broad-spectrum antibiotics were given to FAR patients
      for a median of 21 days (vs 23 days in controls, p = 0.09). The incidence of
      grade II-IV acute GVHD was similar in the FAR and control populations (45% and
      35%, respectively, p = NS) as was the incidence of chronic GVHD (62% vs 55%,
      respectively, p = NS). Estimated event-free survival is 59% for FAR patients
      (median follow-up 64 weeks) and 58% for controls (median follow-up 109 weeks, p =
      NS). FAR reduces regimen-related toxicity in patients receiving CSP/MTX acute
      GVHD prophylaxis without significantly influencing GVHD incidence or event-free
      survival.

PMID- 1617321
TI  - Regulation of tumor necrosis factor-alpha production and gene expression in
      monocytes.
AB  - Tumor necrosis factor-alpha (TNF-alpha), produced predominantly by activated
      monocytes/macrophages, inhibits leukemic cell growth and may contribute to a
      graft-versus-leukemia effect after marrow transplantation. We examined the
      recombinant cytokines interferon (IFN)-alpha, IFN-gamma, granulocyte- macrophage
      colony-stimulating factor (GM-CSF), and macrophage colony-stimulating factor (M
      CSF), alone or in combination, for their ability to induce monocytes from normal
      donors and patients after marrow grafting to express TNF-alpha mRNA and secrete
      TNF-alpha bioactivity. Monocytes were isolated from peripheral blood by Percoll
      separation of E-rosette-negative cells, and cultured with cytokines under non
      adherent, endotoxin-free conditions. TNF-alpha transcripts were undetectable in
      freshly isolated monocytes from normal donors. Only the combination of IFN
      gamma/GM-CSF was consistently capable of inducing substantial TNF-alpha mRNA
      transcript levels and protein secretion. Levels of TNF-alpha transcripts induced
      by IFN-gamma/GM-CSF were maintained for at least 36 h, in contrast to
      lipopolysaccharide (LPS) stimulation which caused TNF-alpha mRNA levels to peak
      after 2 h and decline rapidly thereafter. IFN-gamma/GM-CSF was also capable of
      inducing a prolonged (at least 48 h) secretion of TNF-alpha bioactivity. In
      contrast, greater than 80% of the total TNF-alpha bioactivity secreted by LPS
      stimulated monocytes was secreted in the first 8 h. When monocytes were incubated
      with IFN-gamma alone ('priming'), washed and then exposed to GM-CSF, both TNF
      alpha mRNA expression and TNF-alpha protein production occurred.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1617322
TI  - Neutropenic enterocolitis associated with autologous bone marrow transplantation.
AB  - Fatal neutropenic enterocolitis was seen in a patient undergoing autologous bone
      marrow transplantation for non-Hodgkin's lymphoma. Excessive drug action due to a
      mildly diminished creatinine clearance could have contributed to the
      pathogenesis. Computed tomographic scanning and ultrasonography demonstrated
      pneumatosis of the gastrointestinal tract, but the disease had become extensive
      by then. Necrotizing enterocolitis should be suspected early in a
      granulocytopenic patient with abdominal pain and diarrhea or vomiting. Aggressive
      surgical or medical management may avoid a fatal outcome.

PMID- 1617323
TI  - An HIV positive haemophiliac with acute lymphoblastic leukaemia successfully
      treated with intensive chemotherapy and syngeneic bone marrow transplantation.
AB  - A 26-year-old HIV positive severe haemophiliac developed Burkitt-type acute
      lymphoblastic leukaemia with intracranial involvement. He underwent standard
      combination therapy, and entered complete remission. Syngeneic bone marrow
      transplantation (BMT) was undertaken; the donor was also HIV positive. The
      patient died 18 months from transplant of isolated intracranial relapse, with no
      evidence of systemic relapse. Unlike other types of non-Hodgkin's lymphoma,
      Burkitt's type occurs in HIV positive patients with relatively normal CD4 cell
      counts. Remission can be achieved using intensive chemotherapy, and since these
      patients may otherwise have a reasonable life expectancy, BMT may be appropriate.

PMID- 1617324
TI  - Interaction between cyclosporin A and anticonvulsants. Bone Marrow
      Transplantation Team.

PMID- 1617325
TI  - Evils in the private practice of psychotherapy.
AB  - The private, and especially solo, practice of psychotherapy often poses conflicts
      of interest between patient and therapist, which, because of the field's
      ambiguities and equivocal guidelines, may tend to be resolved in favor of the
      therapist and to the detriment of the treatment. The author delineates these
      potential conflicts so that awareness and training can minimize their pernicious
      effects.

PMID- 1617326
TI  - Assessing boundary violations in psychotherapy: survey results with the
      Exploitation Index.
AB  - The usefulness of the Exploitation Index (Epstein & Simon, 1990) was evaluated in
      a survey of psychiatrists. Forty-three percent of the respondents indicated that
      at least one item alerted them to behavior they thought could have been
      counterproductive to treatment. Twenty-nine percent found that they were
      stimulated to make specific changes in future treatment practice. On average,
      female respondents endorsed fewer boundary violations than males.

PMID- 1617327
TI  - Eating disorders in the 1990s: clinical challenges and treatment implications.
AB  - Eating disorders are, and most likely will continue to be, a ubiquitous clinical
      and therapeutic challenge. The high morbidity and mortality rate of anorexia
      nervosa and bulimia nervosa presents a major psychiatric problem in contemporary
      mental health treatment. The author briefly reviews the importance of comorbidity
      and sexual abuse in this patient population, the special problems of males with
      eating disorders, salient countertransference paradigms, the role of masochism,
      and the impact of projective identification on the treatment process. She
      describes the major clinical considerations, treatment strategies, and
      psychodynamic issues, giving particular attention to the role of extended
      inpatient treatment for the refractory patient. The author urges treaters to be
      emotionally available to these patients, who struggle with the interpersonal
      dilemma of maintaining separateness while establishing mature connectedness.

PMID- 1617328
TI  - Depression and conduct disorders in children and adolescents: a review of the
      literature.
AB  - The psychological literature presents three explanatory models of the
      relationship between childhood or adolescent depression and conduct disorders:
      (1) a direct causal relationship; (2) an indirect causal relationship, involving
      a third set of variables (i.e., personality disorders and developmental
      deficits); and (3) the "final common pathway" hypothesis, which derives a
      relationship ex post facto. Each of these models has dominated the literature at
      a different period, each was affected by different research purposes, and each in
      turn influenced further research. The author describes and critiques the three
      models and concludes with suggestions for further exploration in the areas of
      theory and etiology, research, diagnosis, and treatment.

PMID- 1617329
TI  - Transitional objects as objectifiers of the self in toddlers and adolescents.
AB  - Particular transitional experiences--such as moving through space or into sleep-
      may evoke the use of transitional objects by children in their second year of
      life. Toddlers still identify objects by their position in space. Thus, at the
      point in development when a child first synthesizes a cohesive ego, literal
      transition of the child from one place to another can disrupt incipient
      confidence in a sense of self. An object representing the self that the child
      transports to the new place can reinforce a sense of personal control and
      personal continuity. Such use, which the author terms self-objectification,
      explains why the presence or absence of the mothering caregiver is not
      necessarily the determining factor in whether a child employs a transitional
      object. Later in life (e.g., adolescence), when identity issues again become
      crucial, concrete transitional mechanisms can again help reduce anxiety. The
      author uses case material from the treatment of three adolescents to illustrate
      this phenomenon.

PMID- 1617330
TI  - Addiction as a form of perversion.
AB  - Psychoanalytic treatment of addiction is often ineffective because therapists
      fail to recognize addiction as a discrete disorder. The author reviews
      psychoanalytic theories of addiction and presents an alternative concept
      comprising biological, behavioral, and psychological characteristics. She
      compares the structural similarities between addiction and perversion and
      describes the use of the addictive substance as a fetish object. Finally, she
      discusses the implications of psychoanalytically oriented treatment and advocates
      a multimodal treatment approach.

PMID- 1617331
TI  - Transference and countertransference implications of psychotherapy conducted in a
      foreign language.
AB  - Psychotherapy possesses distinct characteristics when it is conducted in the
      patient's native language if this language is not also the therapist's mother
      tongue, a fairly common situation with immigrant patients. The choice of a native
      therapist, who speaks the foreign patient's mother tongue but lacks perfect
      command of that language, involves some specific implications, including
      conflicts around issues of control, regression, and separation-individuation. The
      author presents several clinical vignettes to demonstrate these conflicts as they
      are manifested in the therapeutic encounter, especially in various transferential
      and countertransferential phenomena. He suggests that the therapist-patient
      relationship in such cases has significant positive therapeutic implications that
      can facilitate rather than complicate treatment.

PMID- 1617332
TI  - Microbial superantigens and autoimmune disease.

PMID- 1617333
TI  - Heat shock proteins and arthritis.

PMID- 1617334
TI  - Receptor-targeted immunotherapy.
AB  - Modern techniques of genetic engineering have led to the development of novel
      receptor-targeted immunotherapies for human diseases. These new approaches
      include mAbs to the CD4+ subset of T cells, immunotoxins for CD5+ T cells, a
      diphtheria toxin coupled to IL-2, and antibodies to specific TCRs. Additional
      approaches include a specific IL-1 receptor antagonist and soluble receptors for
      IL-1 or TNF. Although initially promising, these new approaches to altering
      immune and inflammatory events need to be thoroughly and carefully evaluated in
      further clinical trials in human diseases. Perhaps these novel forms of receptor
      targeted immunotherapy will eventually prove to be most effective when employed
      in combination with more conventional anti-inflammatory and immunosuppressive
      medications.

PMID- 1617335
TI  - Blood cholesterol: who to test. 2.

PMID- 1617336
TI  - Organization of endoscopy training.

PMID- 1617337
TI  - Neonatal extracorporeal membrane oxygenation.
AB  - Extracorporeal membrane oxygenation is an effective life support technique that
      has had most success in the treatment of neonatal cardiopulmonary failure. We
      review the technique and its potential indications and present the latest UK and
      worldwide survival data.

PMID- 1617338
TI  - Psychiatric disorders in Parkinson's disease.
AB  - Parkinson's disease is associated with a wide variety of psychiatric syndromes.
      Advances in the neuropathology and neuropharmacology have not been applied to the
      associated psychiatric disorders due to complex interactions between social,
      psychological and pathological variables.

PMID- 1617339
TI  - Churg-Strauss syndrome.
AB  - The presentation of Churg-Strauss syndrome is most distinctive, permitting
      diagnosis on clinical grounds. It is a phasic disorder with allergic rhinitis and
      asthma initially, often followed by peripheral blood eosinophilia with
      eosinophilic tissue infiltrates. The vasculitic illness is the life-threatening
      phase, but it can be effectively suppressed by prompt treatment.

PMID- 1617340
TI  - Sexually transmitted diseases in pregnancy.
AB  - Sexually transmitted diseases (STDs), grouped together are one of the most common
      medical complications of pregnancy. They can have serious adverse effects on the
      health of both the pregnant mother and her baby. The increasing prevalence of
      many STDs and the advent of human immunodeficiency virus (HIV)-related problems
      emphasize the need for STD awareness in the care of pregnant women.

PMID- 1617341
TI  - Management of fibrosing alveolitis.
AB  - Fibrosing alveolitis kills half of those who suffer from it within 5 years of
      diagnosis. Its incidence appears to be increasing and the response to treatment
      is disappointing. This article explores the reasons why the response to treatment
      is poor and ways in which new approaches to treatment might be developed.

PMID- 1617342
TI  - Antibiotic resistance in community-acquired pneumonia.
AB  - Antibiotic resistance in bacteria is but one of many factors to consider when
      treating patients with community-acquired pneumonia. Many bacterial resistance
      patterns are stable, but wide geographical variation, increasing penicillin
      resistance in pneumococci and ampicillin resistance in Haemophilus influenzae are
      now being found. The importance of these features and their impact on therapy are
      reviewed.

PMID- 1617343
TI  - Talking with children.
AB  - Talking with children is an enjoyable but often challenging aspect of a doctor's
      work. It is a two-way process, with verbal and non-verbal communication being
      equally important. Patience, humour and imagination are major assets.

PMID- 1617344
TI  - Doctors' working hours and the law.

PMID- 1617345
TI  - Clinical cases in AIDS. 1.
AB  - As the human immunodeficiency virus (HIV) epidemic continues there are increasing
      numbers of patients with HIV-related disease. Doctors studying for the MRCP exam
      will need to be familiar with the common manifestations of HIV infection and
      acquired immunodeficiency syndrome.

PMID- 1617346
TI  - Inhaled anaesthetic agents: from ether to halothane.
AB  - The introduction of general anaesthesia revolutionized surgical practice. In this
      workshop and the one that follows in a future issue the evolution and properties
      of inhalational anaesthetics are reviewed and future developments are considered.
      Here we look at the period between the introduction of ether and of the first
      modern agent, halothane.

PMID- 1617347
TI  - No more dogma to foul the NHS.

PMID- 1617348
TI  - Obesity and Arizona.

PMID- 1617349
TI  - Confusion over definitions of TIA and RIND.

PMID- 1617350
TI  - Three large trials support a role for digoxin in CHF.

PMID- 1617351
TI  - Relief of upper airway obstruction.

PMID- 1617352
TI  - Advantages of locating the subclavian vein by IVDSA.

PMID- 1617353
TI  - Psychosocial influences in schizophrenia.

PMID- 1617354
TI  - The psychological complications of therapeutic abortion.
AB  - Psychological or psychiatric disturbances occur in association with therapeutic
      abortions but they seem to be marked, severe, or persistent in only a minority
      (approximately 10%) of women. These consist mostly of caseness depression and
      anxiety. Psychoses are very uncommon, being reported in only 0.003% of cases -
      most of whom have a history of previous psychiatric illness. Certain groups are
      especially at risk from adverse psychological sequelae; these include those with
      a past psychiatric history, younger women, those with poor social support, the
      multiparous, and those belonging to sociocultural groups antagonistic to
      abortion. This is not to overlook the fact that, adopting a crisis-resolution
      framework, subsequent termination of an unwanted pregnancy is itself
      'therapeutic'. A better understanding of the nature of the risk factors would
      enable clinicians to identify vulnerable women for whom some form of
      psychological intervention might be beneficial.

PMID- 1617355
TI  - Is there a link between suicide in young men and unemployment? A comparison of
      the UK with other European Community Countries.
AB  - Within the context of marked increases in suicide rates in the UK among men
      between 1974 and 1988, the rate among those aged 15-24 years rose more than that
      of any other age band. The UK suicide rate among young men also worsened compared
      with those of most other countries in the EC. Rises in the general male suicide
      rate were statistically associated with rises in unemployment in most of the EC.

PMID- 1617356
TI  - Suicide prevention: spreading the gospel to general practitioners.
AB  - General practitioners were trained in the recognition and treatment of suicide
      risk either by written text alone or combined with a seminar meeting. They filled
      in questionnaires before and after training. In the seminar group, knowledge and
      attitudes changed significantly, while those doctors receiving written material
      only had similar results to those without training.

PMID- 1617357
TI  - Psychiatric morbidity in homeless women.
AB  - The psychiatric status of 70 homeless women from two direct-access hostels in
      inner-London was assessed. Detailed sociodemographic, psychiatric and physical
      illness data were also collected, and where possible, verified from psychiatric
      and general hospital sources. Forty-five women met DSM-III-R criteria for
      schizophrenia, but few were in contact with the psychiatric services or in
      receipt of any treatment.

PMID- 1617358
TI  - A survey of practice at a regional forensic service: what do forensic
      psychiatrists do? Part I: Characteristics of cases and distribution of work.
AB  - During a six-month period, 306 psychiatric assessments were recorded
      prospectively on specifically designed schedules. There was a skewed distribution
      towards younger patients, and 78% were male. Just over half were seen for a court
      report, one-third of cases came from solicitors, and in two-thirds the request
      was merely for advice. Secure care was only sought in 15%. In nearly two-thirds
      an offence had precipitated the referral. Half were seen in prison. The majority
      had a history of dangerous behaviour and one-fifth were regarded as a sexual risk
      to others. Only one-third had not previously seen a psychiatrist. A personality
      disorder was diagnosed in 41%, but only 6% were considered to be psychopaths.
      These and other findings are discussed to help give an insight into the service.

PMID- 1617359
TI  - A survey of practice at a regional forensic service: what do forensic
      psychiatrists do? Part II: Treatment, court reports and outcome.
AB  - Nearly half of those seen in a forensic service were offered some form of help,
      but it did not reliably match that requested. In 63% of court reports there was
      no specific treatment recommendation, but where there was, it was likely to be
      accepted. Only one-third of all out-patients completed the treatment offered -40%
      of the lapses were due to imprisonment. One-third of out-patient treatments were
      conducted under conditions of probation orders, and this form of compulsion was
      associated with a significantly higher number of completed treatment plans.
      Personality disorder was also associated with more treatment completions. These
      and other findings are discussed to assist in an understanding of the service.

PMID- 1617360
TI  - Links between early post-partum mood and post-natal depression.
AB  - The Edinburgh Postnatal Depression Scale (EPDS) was used to rate 217 patients at
      five days and six weeks post-partum. There was a highly significant positive
      correlation between the two scores, together with similar symptom profiles. Of
      the 25 women who suffered post-natal depression (6-week EPDS score greater than
      or equal to 13), 17 had similar symptoms in the first week post-partum (5-day
      EPDS score greater than or equal to 10). Low birth weight of the baby, delivery
      by Caesarean section, a delivery much more difficult than expected, and bottle
      feeding were all significantly associated with a high EPDS score in the first
      week post-partum. Bottle feeding and delivery by Caesarean section were the only
      factors associated with depression at the sixth week. A recollection of low mood
      after a previous birth was also associated with post-natal depression after the
      current birth. This, together with an EPDS score of 13 or more at five days post
      partum, increased the risk of post-natal depression at six weeks 85-fold.

PMID- 1617361
TI  - Feelings of guilt in major depression. Conceptual and psychometric aspects.
AB  - A new scale for the evaluation of feelings of guilt is described. Two types of
      guilt feeling were of potential interest: 'delusional' guilt or shame
      (experienced in relation to one's actions), and 'affective' guilt (a more general
      feeling of unworthiness). Reliability and validity analyses for the first (15
      item) version of the scale were performed in three separate and contrasting
      clinical samples. The second and final (seven-item) version was tested in another
      sample of major depressives and in normal controls. The HRSD was used as a
      measure of severity throughout. The BDI and Widlocher psychomotor retardation
      scale were also used as external criteria for the seven-item scale. Exploratory
      factor analysis of this sample yielded two factors--'cognitive/attitudinal' and
      'mood/feeling'--of which only the first correlated with scores for psychomotor
      retardation. It is suggested that these two factors represent two forms of guilt,
      but that only the former is related to a putative dopaminergic disorder. Guilt
      scores and measures of severity were not correlated. It is suggested that
      feelings of guilt should be considered as a behavioural marker for a subtype of
      depression.

PMID- 1617362
TI  - The relationship of environmental temperature to the incidence and outcome of
      schizophrenia.
AB  - This paper presents new analyses of data from two multicentre studies carried out
      by the WHO. The morbid risk of developing schizophrenia, as broadly defined by
      the Determinants of Outcome Study, was positively related to the mean daily range
      of temperature. The outcome of schizophrenia, as determined by the International
      Pilot Study of Schizophrenia, was found to be positively related to mean
      environmental temperature. Further studies are needed to examine the relationship
      of geographical and climatic variables to schizophrenia in order to complement
      what is already known about the role of sociocultural factors.

PMID- 1617363
TI  - The Nithsdale schizophrenia surveys. X: Obstetric complications, family history
      and abnormal movements.
AB  - Obstetric histories of 54 schizophrenic patients and 114 siblings were obtained
      from their mothers and scored using the Obstetric Complications Scale. There were
      no statistically significant difference in the proportion of schizophrenic
      patients (35%) and siblings (29%) who had at least one definite obstetric
      complication. There was no evidence that schizophrenic patients with a history of
      obstetric complications were less likely to have a first-degree relative with a
      history of psychiatric illness leading to in-patient care. Schizophrenic patients
      with a history of obstetric complications were more likely to have drug-induced
      Parkinsonism. There was a trend for tardive dyskinesia to be more common in those
      schizophrenic patients with no obstetric complications but a family history of
      schizophrenia.

PMID- 1617364
TI  - Specific and non-specific effects of educational intervention for families living
      with schizophrenia. A comparison of three methods.
AB  - Three methods of delivering an educational intervention to families living with a
      schizophrenic relative were compared in terms of their efficacy in improving
      understanding and promoting family and patient well-being. Relatives receiving
      education in a group acquired more information than relatives receiving
      information by post or on video, but these differences were not maintained at six
      month follow-up. The inclusion of homework assignments did not significantly
      affect gains in knowledge or any of the non-specific effects observed. The
      intervention overall led to considerable gains in knowledge, increased optimism
      concerning the family's role in treatment, and reductions in relatives' stress,
      which were maintained at follow-up. Fear was reduced in the short-term.
      Significant improvements in social function were observed at follow-up. The
      results suggest that the delivery of information, rather than the mode of
      delivery, is the crucial element in the intervention; however, the additional
      contextual factors operating in a group may be important if the full potential of
      education is to be realised.

PMID- 1617365
TI  - Clinical observation of assessment using the Composite International Diagnostic
      Interview (CIDI). An analysis of the CIDI Field Trials--Wave II at the St Louis
      site.
AB  - Two clinicians scored the ICD-10 Research Criteria Checklist either while
      observing or after administering CIDI interviews to a sample of 20 subjects.
      Overall diagnostic concordance between clinical and CIDI assessments was found to
      be good (overall kappa = 0.77). Assessment of the specific diagnoses could be
      done only for the three most commonly represented in the studied sample:
      anxiety/phobic disorders (kappa = 0.73), depressive disorders (kappa = 0.78), and
      psychoactive substance use disorders (kappa = 0.83). While the lack of
      independence of the two assessments and the small, non-randomly selected sample
      might have exaggerated the concordance, this study shows that the CIDI provides
      all the data needed to score diagnoses in the ICD-10 nomenclature, as indicated
      by the small number of questions clinicians needed to ask following completion of
      the CIDI.

PMID- 1617366
TI  - The Explanatory Model Interview Catalogue (EMIC). Contribution to cross-cultural
      research methods from a study of leprosy and mental health.
AB  - The Explanatory Model Interview Catalogue (EMIC) has been developed to elicit
      illness-related perceptions, beliefs, and practices in a cultural study of
      leprosy and mental health in Bombay. Leprosy is an especially appropriate
      disorder for studying the inter-relationship of culture, mental health and
      medical illness because of deeply rooted cultural meanings, the emotional burden,
      and underuse of effective therapy. Fifty per cent of 56 recently diagnosed
      leprosy out-patients, 37% of 19 controls with another stigmatised dermatological
      condition (vitiligo), but only 8% of 12 controls with a comparable non
      stigmatised condition (tinea versicolor) met DSM-III-R criteria for an axis I
      depressive, anxiety or somatoform disorder. Belief in a humoral (traditional)
      cause of illness predicted better attendance at clinic.

PMID- 1617367
TI  - Training community psychiatric nurses for psychosocial intervention. Report of a
      pilot study.
AB  - Community psychiatric nurses were trained to deliver psychosocial intervention to
      clients with a diagnosis of schizophrenia living at home with relatives. The
      training package consisted of family assessment, health education, and family
      stress management strategies. In a 'quasi-experimental' design, a sample of
      families (n = 54) were recruited to either a control or experimental condition
      and followed up for 12 months. A number of favourable outcomes were observed in
      the experimental group, including improvements in the client's target symptoms,
      personal functioning, and social adjustment. Relatives' satisfaction with
      services increased and reports of their own minor psychiatric morbidity improved.

PMID- 1617368
TI  - Autosomal dominant gene transmission in a large kindred with Gilles de la
      Tourette syndrome.
AB  - A multiplex kindred ascertained through a single proband with GTS has been
      systematically investigated with standardised diagnostic instruments for other
      cases of GTS and related disorders. Complex segregation analysis supported the
      hypothesis that a single major gene inherited in autosomal dominant fashion but
      with incomplete penetrance contributed most of the variance in the liability to
      develop GTS and related disorders. This result is consistent with previous
      segregation analyses which have employed different methods of ascertainment, and
      tends to confirm that a proportion of GTS is due to a dominant gene and is
      suitable for investigation with genetic markers for linkage analysis.

PMID- 1617369
TI  - The meaning of insight in clinical psychiatry.
AB  - Insight can be defined not only in terms of people's understanding of their
      illness, but also in terms of understanding how the illness affects individuals'
      interactions with the world. The term 'insight' encompasses a complex concept
      which should not be considered as an isolated symptom which is present or absent.
      Instead, it may be more appropriate to think of insight as a continuum of
      thinking and feeling, affected by numerous internal and external variables.
      Different psychiatric disorders involve different mechanisms in the process of
      impairment of insight; this may influence the ways in which insight should be
      assessed in clinical practice.

PMID- 1617370
TI  - Evolutionary genetic theory.

PMID- 1617371
TI  - Western psychotherapy and non-Western populations.

PMID- 1617372
TI  - Western psychotherapy and non-Western populations.

PMID- 1617373
TI  - Suicide prevention.

PMID- 1617374
TI  - Suicide prevention.

PMID- 1617375
TI  - Neuroleptic malignant syndrome.

PMID- 1617376
TI  - The naming of syndromes [corrected].

PMID- 1617377
TI  - The naming of syndromes.

PMID- 1617378
TI  - The naming of syndromes.

PMID- 1617379
TI  - Are non Western beliefs false?

PMID- 1617380
TI  - Idiopathic genital pain and fluvoxamine.

PMID- 1617381
TI  - 'The current literature'--Worcester Development Project.

PMID- 1617382
TI  - British Society for Rheumatology. IXth annual general meeting and VIIth Eulav
      Symposium in conjunction with the British Society for Rheumatology and the
      British League Against Rheumatism. 21-24 July 1992, London. Abstracts.

PMID- 1617383
TI  - Asthma.

PMID- 1617384
TI  - Asthma. Definition and clinical spectrum.
AB  - When variability and periodicity of symptoms and of airway function are
      accompanied by evidence of an allergic pathogenesis (identified inhalant
      precipitants, atopy, raised IgE, eosinophilia) the diagnosis of asthma is obvious
      to patient and physician. But many patients with asthma do not conform to this
      classic stereotype, so that considerable problems of distinction from other types
      of airway obstruction exist. These difficulties have practical significance
      because conferring the label of asthma is associated with physicians prescribing
      more intensive and effective treatment.

PMID- 1617385
TI  - Asthma. Epidemiology.
AB  - Ambiguities over the definition of asthma make both estimates of the prevalence
      of asthma and comparisons between studies difficult to interpret. Comparisons
      made within a study are, for this reason more informative. In children both
      asthma and wheeze appear to be commoner in boys with convergence of the rates
      during adolescence. There is regional variation in rates within countries and
      this is particularly marked in developing countries with low prevalence of
      disease in poor rural communities. Urban areas have a higher prevalence and
      racial differences have been noted in some studies. In the United States blacks
      have higher rates of both wheeze and asthma, but the differences are less clear
      cut in New Zealand and the United Kingdom. A lack of any association with social
      class has been reported from Australia, the United States, New Zealand, England
      and Wales, though some earlier studies have suggested an association with higher
      social class and Dawson et al. suggested that more severe disease was more common
      in poorer children.

PMID- 1617386
TI  - Asthma. Tracheobronchial vasculature.
AB  - The tracheobronchial vasculature consists of a subepithelial capillary network
      and a deeper system of blood sinuses or capacitance vessels. There seem to be no
      arteriovenous anastomoses. Sympathetic nerves constrict the vasculature by the
      transmitters noradrenaline and neuropeptide-Y, parasympathetic nerves dilate it
      by acetylcholine and vasoactive intestinal polypeptide, and sensory nerves
      release neuropeptides including substance P that are dilator. Most inflammatory
      mediators are also vasodilator. In asthma there is mucosal vasodilation due to
      the direct action of mediators on vascular smooth muscle, neuropeptides released
      by axon reflexes in sensory nerve receptors, and possibly reflex vasodilation due
      to stimulation of sensory nerves. The vasodilation increases the thickness of the
      mucosa, both by vascular engorgement and by increased interstitial liquid volume.
      This mucosal thickening will narrow the airways and increase the rigidity of
      their walls. The vascular bed is also dilated by cold and hyperosmolality, and
      this change may be a component of the bronchoconstriction due to
      hyperventilation, inhalation of cold air and exercise. Changes in mucosal blood
      flow influence the uptake of chemical agents from the lumen, and the success of
      aerosol therapy in asthma may to some extent depend upon the influence of mucosal
      blood flow.

PMID- 1617387
TI  - Plasma exudation and oedema in asthma.
AB  - Gross pathology, histological and ultrastructural observations and analysis of
      sputum and lavage fluid indicate that plasma exudation from the bronchial
      microvasculature and the formation of tissue oedema are characteristic features
      of asthma. Appropriate mediators for the induction of plasma exudation are
      generated in the blood and airways of asthmatic patients and when administered
      experimentally will cause plasma leakage and oedema. Plasma exudate may not only
      contribute directly to the thickened bronchial walls and mucus plugs in the
      airways of asthmatics, but may also play a role in epithelial shedding,
      thickening of the basement membrane, hypertrophy of the smooth muscle, inducing
      mucus secretion and in thickening the secreted mucus. The beneficial effect of
      corticosteroids in asthma may be due to an anti-leakage action. Development of
      drugs with a broad spectrum of action against mediator release may have
      therapeutic advantage over specific receptor antagonist drugs.

PMID- 1617388
TI  - Role of inflammatory mediators in asthma.
AB  - Release of inflammatory mediators such as histamine and products of arachidonic
      acid metabolism has been demonstrated in bronchoalveolar lavage fluid of patients
      with asthma. Their precise cellular source is not clear but many cells types such
      as eosinophils, macrophages and mast cells may contribute to the generation of a
      wide variety of chemical mediators. These can mimic many of the features
      associated with asthma including bronchoconstriction, bronchial
      hyperresponsiveness and airway microvascular leakage. Development of specific
      mediator receptor antagonists or inhibitors of mediator synthesis may clarify the
      role of particular inflammatory mediators such as the sulphidopeptide
      leukotrienes or platelet-activating factor in asthma. It seems unlikely that only
      one particular mediator is responsible for all the manifestations of asthma.

PMID- 1617389
TI  - Precipitating factors of asthma.
AB  - Asthma is characterised by bronchial hyperresponsiveness. This feature of the
      asthmatic diathesis predisposes patients to wheezing in response to a number of
      different factors. These precipitating factors include specific allergen acting
      via sensitised mediator cells through an IgE-dependent mechanism. There are
      irritants which may work through a non-specific manner, or stimuli such as
      exercise and hyperventilation, which probably also act through mediator release
      via a non-IgE-dependent manner. The mechanism whereby physical stimuli such as
      exercise induce bronchoconstriction is of interest, because it increases the
      context in which the mast cell may participate in acute asthmatic
      bronchoconstriction. Respiratory infections also commonly provoke asthma,
      especially in infants and may, indeed, precipitate the asthmatic state itself.
      Finally, drugs can often trigger asthma attacks and the mechanisms of asthma
      precipitated by non-steroidal anti-inflammatory drugs such as aspirin have been
      the subject of recent research.

PMID- 1617390
TI  - Asthma as an inflammatory disease: clinical perspectives.
AB  - Asthma is characterised by a persistent, ongoing airway submucosal inflammatory
      process which may underlie bronchial hyperresponsiveness and airways obstruction.
      Indirect assessment of airway inflammation includes examination of sputum or
      serum for eosinophils or eosinophil-derived products, but examination of
      bronchial mucosal biopsies or bronchoalveolar lavage fluid or cells remains the
      gold standard. Lymphocyte and eosinophil activation, with the release of certain
      cytokines such as interleukin-5, lipid mediators such as leukotrienes and
      eosinophil products such as major basic protein, may be important mechanisms of
      inflammation in asthma. Less invasive indirect measures of submucosal
      inflammation are needed to assess the impact of asthma treatment in the clinic.
      Antiinflammatory treatment in asthma should be introduced as early as possible. A
      greater understanding of the inflammatory mechanism or of the actions of
      corticosteroids may lead to the development of more effective and safer drugs for
      asthma.

PMID- 1617391
TI  - New developments in occupational asthma.
AB  - Recent developments in occupational asthma are reviewed. There are now three
      independent estimates of the incidence of occupational asthma in the general
      working population, which all identify the same high risk occupational groups
      (particularly those exposed to isocyanates and flour or wheat). The incidence of
      occupational asthma principally depends on the agent and level of exposure. The
      property of a small molecular weight chemical to bind to and alter the structure
      of body proteins seems important. Smoking both increases the number of workers
      developing specific IgE to occupational agents, and the number developing
      occupational asthma. The relation between increased non-specific bronchial
      responsiveness and occupational asthma is reviewed. Occupational sensitisation
      may be the cause of hyperresponsiveness, or develop in those with pre-existing
      hyperresponsiveness. Around 20% of workers with occupational asthma have
      measurements within the normal range. Once occupational asthma develops, removal
      from exposure, particularly if delayed, often results in continuing asthma.
      Finally the prevention of occupational asthma is discussed.

PMID- 1617392
TI  - Pathology of asthma.
AB  - Asthma is a clinically complex condition but at present the pathologist
      recognises only one disease process. The airways in fatal asthma are occluded by
      tenacious plugs of exudate, mucus and cells. There is fragility of the airway
      surface epithelium and thickening of epithelial reticular basement membrane.
      Bronchial vessel dilation, congestion and oedema, an intense inflammatory cell
      infiltrate and enlargement of the mass of bronchial smooth muscle, and mucus
      secreting gland each contribute to thickening of the airway wall. These changes
      contribute to the cardinal signs of inflammation (i.e. redness, heat, pain,
      swelling and secretion of mucus) and can profoundly modify the effects of airway
      contracture on airflow. The fragility and loss of surface epithelium, thickening
      of its underlying reticular layer and the presence of an inflammatory infiltrate,
      comprising activated T lymphocytes together with 'activated' and secreting
      eosinophils, are early events seen in biopsies of subjects with mild stable
      atopic asthma.

PMID- 1617393
TI  - Asthma. The mast cell.
AB  - The mast cell's association with asthma has a long history dating back to the
      turn of the century, when Dale and Laidlaw described histamine as a spasmogen for
      guinea-pig airways and a proposed mediator of acute anaphylaxis. Almost half a
      century elapsed before histamine was localised to the granules of mast cells,
      although the release of this and other mediators of the acute allergic reaction
      were known to involve reagin subsequently identified as IgE. The biochemical
      mechanisms involved in transduction signalling not only results in the calcium
      and energy-dependent release of preformed mediators by degranulation but also the
      generation and subsequent release of an array of newly formed products, many of
      which are derived from phospholipid precursors.

PMID- 1617394
TI  - Asthma. Eosinophils and neutrophils.
AB  - Eosinophils are strongly implicated as a major proinflammatory cell in the
      pathogenesis of asthma. Basic proteins from the crystalloid granule may be
      responsible for damage to mucosal epithelium whereas membrane-derived lipid
      mediators (particularly platelet activating factor and leukotriene C4) might
      directly influence bronchial smooth muscle contraction, microvascular
      permeability and mucus hypersecretion. The numbers of eosinophils and their
      products correlated with the severity of disease whereas successful treatment is
      usually associated with a resolution of local eosinophilia. Neutrophils may also
      be implicated in the pathogenesis of asthma but the evidence that this cell per
      se plays an important role remains controversial. Neutrophil products have the
      potential for altering airway function. More research is required to define the
      precise role of this cell type in asthma. It needs to be emphasised that the
      inflammation associated with bronchial asthma is complex and involves several
      cell types (i.e. T lymphocytes, mast cells and macrophages) in addition to the
      eosinophil and neutrophil.

PMID- 1617395
TI  - Asthma. Macrophages.
AB  - The airway macrophage has the characteristics required of the conducting cell in
      asthma. First, the airway macrophage is the most numerous cell within the airway
      lumen. Second, it can be activated by antigen and virus infections to release
      both spasmogens and chemotactic cytokines. Thus the common triggers to asthma are
      capable of activating the airway macrophage. Third, the response of the airway
      macrophage to therapeutic agents used in asthma bears a close similarity to the
      profile of disease modification with drugs in asthma, that is, they are inhibited
      by glucocorticosteroids but not beta 2-adrenoceptor agonists.

PMID- 1617396
TI  - Asthma. Epithelial cells.
AB  - The airway epithelium is the first line of defence against air-borne dusts,
      vapour, gases and fumes and plays a vital role in the maintenance of physico
      chemical homoeostasis. Perturbation of the epithelial cells which predominate
      within this barrier, may bring about adverse changes in and around the
      surrounding tissues playing a part in the pathogenesis of asthma. Although the
      specific mechanism(s) which partake in pathogenesis are not clear, several have
      been proposed. These include: (1) increased synthesis and release of inflammatory
      mediators and decreased synthesis of protective mediators; (2) synthesis of
      inflammatory cytokines; (3) modulation of cell adhesion molecules, important in
      determination of epithelial architecture; and (4) immunoregulation of the
      inflammatory cell types. It is likely that these operate together and interact to
      produce, initially functional changes in the epithelium, which lead eventually to
      the structural changes that are characteristic of the airway epithelium of
      asthmatics.

PMID- 1617397
TI  - The myxosporea of fish: a review.

PMID- 1617398
TI  - Serological response of chickens naturally infected with Salmonella typhimurium
      detected by ELISA.
AB  - Four laying flocks of chickens in Britain, each with a history of Salmonella
      typhimurium infection, were investigated serologically and bacteriologically.
      Blood samples were taken from identified birds from a single house on each site
      and sent to the Central Veterinary Laboratory, Weybridge for serological
      examination using enzyme-linked immunosorbent assays (ELISA) and rapid slide
      agglutination test (RST) using stained S. pullorum. The identified birds were
      taken to the local Veterinary Investigation Centre for bacteriological
      examination. On site A no salmonellae were recovered from birds in the house
      chosen for serological examination. Of these birds approximately 20% had
      antibodies to S. typhimurium in ELISA which used either a lipopolysaccharide
      (LPS) or heat-extract (HE) antigen from S. typhimurium. S. typhimurium was
      recovered from birds in one other of the four houses on the same site; these
      birds were not tested serologically. On site B, S. typhimurium was isolated from
      8% of the birds examined. Of the total tested serologically, a third to half were
      seropositive by S. typhimurium ELISA using the LPS and HE antigen respectively. A
      small proportion of birds was seropositive by S. enteritidis ELISA and RST. No
      salmonellae were isolated from the other two sites although about 10% of birds
      tested on site C were seropositive in S. typhimurium ELISA. Cross-reactions were
      seen between S. typhimurium antigens in the ELISA and experimentally prepared
      antiserum to S. enteritidis. The S. enteritidis ELISA was generally more specific
      although cross-reacting antibodies were detected in sera from birds on sites A
      and B.

PMID- 1617399
TI  - The effects of fascioliasis on the activities of some drug-metabolizing enzymes
      in desert sheep liver.
AB  - Desert sheep experimentally or naturally infected with Fasciola gigantica were
      used to study the influence of infection on the activities of some drug
      metabolizing enzymes found in the liver. The enzymes investigated were
      aminopyrine N-demethylase, aniline 4-hydroxylase and UDP-glucuronyltransferase.
      The experimental infection was confirmed histologically by detection of Fasciola
      eggs in faeces and by measuring the activities of sorbitol dehydrogenase (SD),
      glutamate dehydrogenase (GD) and aspartate aminotransferase (AST) in plasma
      during the course of the disease. Liver specimens from naturally infected sheep
      were obtained from the slaughter house. The activities of aminopyrine N
      demethylase and aniline 4-hydroxylase were significantly decreased in sheep
      either naturally infected or during the acute stage of experimental fascioliasis
      (killed 5 weeks post-infection). The activity of UDP-glucuronyltransferase was
      decreased in naturally infected sheep and those killed 9 or 13 weeks post
      experimental infection.

PMID- 1617400
TI  - Serum protein values in canine diabetes mellitus, hypothyroidism and
      hypoadrenocorticism.

PMID- 1617401
TI  - Adaptability of the oxidative capacity of motoneurons.
AB  - Previous studies have demonstrated that a chronic change in neuronal activation
      can produce a change in soma oxidative capacity, suggesting that: (i) these 2
      variables are directly related in neurons and (ii) ion pumping is an important
      energy requiring activity of a neuron. Most of these studies, however, have
      focused on reduced activation levels of sensory systems. In the present study the
      effect of a chronic increase or decrease in motoneuronal activity on motoneuron
      oxidative capacity and soma size was studied. In addition, the effect of chronic
      axotomy was studied as an indicator of whether cytoplasmic volume may also be
      related to the oxidative capacity of motoneurons. A quantitative histochemical
      assay for succinate dehydrogenase activity was used as a measure of motoneuron
      oxidative capacity in experimental models in which chronic electromyography has
      been used to verify neuronal activity levels. Spinal transection reduced, and
      spinal isolation virtually eliminated lumbar motoneuron electrical activity.
      Functional overload of the plantaris by removal of its major synergists was used
      to chronically increase neural activity of the plantaris motor pool. No change in
      oxidative capacity or soma size resulted from either a chronic increase or
      decrease in neuronal activity level. These data indicate that the chronic
      modulation of ionic transport and neurotransmitter turnover associated with
      action potentials do not induce compensatory metabolic responses in the metabolic
      capacity of the soma of lumbar motoneurons. Soma oxidative capacity was reduced
      in the axotomized motoneurons, suggesting that a combination of axoplasmic
      transport, intracellular biosynthesis and perhaps neurotransmitter turnover
      represent the major energy demands on a motoneuron. While soma oxidative capacity
      may be closely related to neural activity in some neural systems, e.g. visual and
      auditory, lumbar motoneurons appear to be much less sensitive to modulations in
      chronic activity levels.

PMID- 1617402
TI  - Factors in amphetamine-induced contralateral rotation in the unilateral 6-OHDA
      lesion rat model during the first-week postoperative: implications for
      neuropathology and neural grafting.
AB  - Amphetamine induced ipsilateral rotation in rats with chronic unilateral 6
      hydroxydopamine (6-OHDA) lesions is a widely accepted line of evidence supportive
      of dopaminergic mediation of amphetamine effects on motoric behavior. However,
      there is literature indicating that amphetamine induces contralateral rotation,
      in the early postoperative phase of a unilateral 6-OHDA lesion. In an attempt to
      reconcile these opposite amphetamine effects on rotation in terms of dopaminergic
      mechanisms, a series of 4 experiments were conducted. These studies showed that
      amphetamine reliably elicits contralateral rotation for up to 7 days
      postoperative but only ipsilateral rotation thereafter. The amphetamine induced
      contralateral rotation differed behaviorally in several respects from subsequent
      ipsilateral rotation induced by amphetamine. It was comparatively more intense;
      and, while onset of peak rotation was dose dependent, rate of rotation was
      independent of dose level (0.5, 1.0 and 2.5 mg/kg). Dopamine and dopamine
      metabolite analyses by HPLC-EC after 3 postoperative intervals (days 3, 6, and 9)
      indicated a progressive and severe depletion of striatal dopamine in conjunction
      with elevated dopamine turnover. Importantly, after 6 days postoperative,
      dopamine was reduced to less than 0.06% after intact hemisphere but yet,
      amphetamine (1.0 mg/kg) elicited contralateral rotation. It was proposed that
      amphetamine could release a small amount of dopamine present in a sparse number
      of residual degenerating terminals and this dopamine, unrestricted by reuptake,
      could widely access supersensitive dopamine receptors to elicit contralateral
      rotation. This possibility calls into question amphetamine tests for neural graft
      efficacy in animal models which use amphetamine induced contralateral rotation as
      the criterion response.

PMID- 1617403
TI  - The role of laminin, a component of Schwann cell basal lamina, in rat sciatic
      nerve regeneration within antiserum-treated nerve grafts.
AB  - Regeneration of the sciatic nerve in transplanted nerve grafts in which laminin
      was inactivated was examined electron microscopically. Nerve grafts for
      transplantation were obtained from close cloned donor Wistar rats; 1-cm nerve
      segments of the sciatic nerve were frozen and thawed to kill the Schwann cells.
      Control recipient rats received grafts treated with normal rabbit serum to repair
      the artificially-made complete defect of the right sciatic nerve, and the
      experimental group of rats received grafts doubly treated with normal serum and
      rabbit anti-laminin antiserum. In the control grafts regenerating axons grew
      almost completely through the inside of the basal lamina scaffolds (92%) and
      adhered to the structure, while in the anti-laminin antiserum treated grafts the
      axons were present outside (52%) and inside (48%) the scaffolds simultaneously.
      In this case, the adhesion of axons to the scaffolds was obscure. Axons were
      associated with and without Schwann cells both inside and outside the basal
      lamina scaffolds. No unassociated Schwann cells were observed. The maximal number
      of axons in a 2 mm portion of the antiserum-treated grafts was approximately 250
      axons per 100 x 100 microns square and 520 in the control at 15 days. At 30 days,
      almost the same number of axons was found at the distal (8 mm) portion of both
      groups. The growth in the former was delayed for 3 days. These results indicate
      that regenerating peripheral nerve axons may enter the basal lamina scaffolds and
      grow well because of the neurotrophic function of laminin present at the inner
      side of Schwann cell basal lamina.

PMID- 1617404
TI  - Time course of nigrostriatal system changes after tract hemisection and effects
      of ganglioside treatment: a multiple retrograde fluorescent tracing study.
AB  - The postlesion phenomena of nigrostriatal neurons following partial tract
      hemisection have been studied with retrograde axonal transport of dyes in rats
      treated with saline or GM1 ganglioside (30 mg/kg, i.p., daily for varying times).
      The time course of the plastic changes in both experimental animal groups was
      determined by a double retrograde fluorescent tracing technique, utilizing Fast
      blue (FB) as prelesion tracer, and Diamidino yellow (DY) as postlesion tracer.
      The data show that the number of nigral cells retrogradely labeled by the
      prelesion intrastriatal injection of FB declined progressively to 50% of their
      initial number over 3 weeks. The ganglioside treatment did not significantly
      influence this temporal pattern of labeled cell loss. By DY-labeling, an almost
      complete block of the retrograde axonal transport was observed up to 1 week
      postlesion and only after 3 weeks a partial recovery was evident, positively
      influenced by the GM1 treatment. Therefore, together with the findings on
      nigrostriatal cell loss, these data indicate that ganglioside treatment favors
      and/or accelerates the recovery of axonal transport of surviving nigral neurons
      but does not significantly affect their degenerative rate in the first 3 weeks
      after the lesion.

PMID- 1617405
TI  - Regional glucose metabolic changes after learning a complex visuospatial/motor
      task: a positron emission tomographic study.
AB  - Regional cerebral glucose metabolic rate (GMR) quantified with positron emission
      tomography (PET) with 18-fluoro-2-deoxyglucose (FDG) was measured twice in 8
      young men performing a complex visuospatial/motor task (the computer game
      Tetris), before and after practice. After 4-8 weeks of daily practice on Tetris,
      GMR in cortical surface regions decreased despite a more than 7-fold increase in
      performance. Subjects who improved their Tetris performance the most after
      practice showed the largest glucose metabolic decreases after practice in several
      areas. These results suggest that learning may result in decreased use of
      extraneous or inefficient brain areas. Changes in regional subcortical glucose
      metabolic rate with practice may reflect changes in cognitive strategy that are a
      part of the learning process.

PMID- 1617406
TI  - The role of GTP binding proteins in ischemic brain damage: autoradiographic and
      histopathological study.
AB  - Cerebral ischemia produces perturbation of signal transduction systems in
      neurons. In order to estimate the contribution of guanine nucleotide-binding
      protein (G-protein) to hippocampal neuronal death, the effect of pertussis toxin
      (PTX) on the CA1 pyramidal cell damage after transient forebrain ischemia in rats
      was examined. PTX was administered 3 days before 20 min of transient forebrain
      ischemia. PTX injection into the CA1 subfield failed to alter the number of
      ischemic-damaged CA1 pyramidal cells. In contrast, ventricular PTX injection
      exacerbated CA1 pyramidal cell damage. We also studied postischemic alteration of
      GTP binding sites in the hippocampal formation using quantitative in vitro
      autoradiography. Autoradiographic imaging demonstrated predominant distribution
      of GTP binding sites in synaptic areas in the hippocampus. No significant change
      of GTP binding activity was observed in the hippocampus until 2 days after
      recirculation. Seven days after ischemia, when the CA1 pyramidal cells were
      depleted, the GTP binding sites of the strata oriens and radiatum in the CA1
      subfield had reduced by 32% and 31%, respectively. In contrast, GTP binding in
      the CA3 subfield and the dentate gyrus remained unaltered throughout the
      reperfusion period. These results suggest that the amount of G-proteins as
      estimated by GTP binding remained unaltered in the hippocampus during the early
      recirculation period, when the CA1 pyramidal cells were morphologically intact,
      and that signal transduction pathways mediated by Gi and Go do not play a major
      role in delayed death of the CA1 pyramidal cells.

PMID- 1617407
TI  - Indole-N-methylated beta-carbolinium ions as potential brain-bioactivated
      neurotoxins.
AB  - N-Methyl-4-phenylpyridinium ion (MPP+), a highly toxic metabolite produced in the
      brain from a street drug contaminant, is selectively taken up by nigrostriatal
      dopaminergic neurons and accumulated intraneuronally in mitochondria. There it
      inhibits respiration, causes neuronal death and, in primates, provokes a
      parkinsonian condition. It has been suggested that endogenously generated or
      activated agents resembling MPP+ may contribute to the development of Parkinson's
      disease. We report here that simple beta-carbolines derived from tryptophan or
      related open chain indoles, when specifically methyl-substituted on both (2[beta]
      and 9[indole]) available nitrogens, display mitochondrial inhibitory potencies
      and neurotoxic effects in vitro (PC12 cultures) and in vivo (striatal
      microdialysis) which approach or even surpass MPP+. These results take on
      physiological significance with our finding that brain enzyme activity catalyzes
      S-adenosylmethionine-dependent methylations of the beta- and indole-nitrogens in
      beta-carbolines that have been detected in vivo. The unusual 9[indole]-N-methyl
      transfer, previously unrecognized in animals, apparently requires prior
      methylation of the 2[beta]-nitrogen. Sequential di-N-methylation of endogenous or
      xenobiotic beta-carbolines to form unique, neurotoxic 2,9-N,N'-dimethyl-beta
      carbolinium ions may serve as a brain bioactivation route in chronic
      neurodegenerative conditions such as Parkinson's disease.

PMID- 1617408
TI  - The occurrence of three isoenzymes of protein kinase C (alpha, beta and gamma) in
      retinas of different species.
AB  - The localisation and immunochemical identification of 3 different forms of
      protein kinase C (PKC-alpha, PKC-beta and PKC-gamma) in retinas of different
      species were analysed by immunohistochemistry and SDS-PAGE-Western blotting,
      respectively. Only in some cases was there a correlation between the findings
      from each procedure. One reason for the lack of correlation could be the small
      amounts of PKC present in some retinas, which made detection possible only by
      first concentrating the antigen by SDS-PAGE and then carrying out Western
      blotting. Another possible reason is that an antibody recognises unknown antigens
      immunohistochemically, but, because of their specific characteristics, they are
      denatured when subjected to SDS-PAGE and Western blotting and therefore remain
      undetected. PKC-beta immunoreactivity is present in rabbit, frog and goldfish
      retinas but absent from the rat retina. However, SDS-PAGE and Western blotting
      experiments showed that the PKC-beta isoenzyme is absent from the fish retina but
      present in the rat retina. PKC-beta immunoreactivity in rabbit retina is present
      in ganglion and/or amacrine cells; in the frog retina the enzyme is associated
      with some bipolar cells. In the goldfish retina, PKC-beta is associated with a
      large population of cells in the ganglion cell layer as well as with some
      amacrine cell bodies. PKC-alpha is present primarily in bipolar cells of rat,
      fish and rabbit retinas and was not detected by immunohistochemistry or blotting
      experiments in the frog retina. SDS-PAGE and Western blotting of retinal extracts
      from different species showed that PKC-gamma occurs in the rabbit where it was
      associated with ganglion and/or amacrine cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617409
TI  - Monoamine-mediated enhancement of acetylcholine release in rat hippocampus by 6R
      L-erythro-5,6,7,8-tetrahydrobiopterin.
AB  - Recently, we reported that intracerebroventricular administration of 6R-L-erythro
      tetrahydrobiopterin (6R-BH4), a common natural cofactor for phenylalanine,
      tyrosine and tryptophan hydroxylases, enhances in vivo exocytotic release of
      acetylcholine (ACh) from the rat hippocampus, as monitored by brain
      microdialysis. In the present study, we developed a method for separation of ACh
      from 6R-BH4 on small columns of Sephadex G-10, which allowed us to determine by
      high pressure liquid chromatography (HPLC) the changes of ACh levels recovered in
      dialysates following addition of 6R-BH4 to the dialyzing fluid. Infusions of 6R
      BH4 (final concentration, 0.25, 0.5 and 1 mM in the perfusing fluid) produced
      concentration-dependent increases in ACh levels in dialysates (1.5-, 3- and 8
      fold of the basal levels, respectively), but was without effect on choline levels
      in dialysates. Infusion of 6S-L-erythro-5,6,7,8-tetrahydrobiopterin (6S-BH4), an
      unnatural diastereoisomer of 6R-BH4, or L-erythro-biopterin (biopterin), an
      oxidized form of 6R-BH4, did not affect the ACh levels in dialysates. The 6R-BH4
      induced increase in ACh levels persisted after pretreatment with atropine, a
      muscarinic antagonist, but did not occur in rats pretreated with reserpine to
      deplete monoamines. These results show that 6R-BH4 stimulates exocytotic ACh
      release in the hippocampus through action on a local monoaminergic system in the
      hippocampus.

PMID- 1617410
TI  - Actions of endothelin at the subfornical organ.
AB  - Endothelin (ET), a potent vasoconstrictor peptide, is believed to have central
      sites of action and potential neurohormonal effects relating to body fluid
      homeostasis and blood-pressure regulation. Systemic endothelin binds to receptors
      at circumventricular organs and has been shown to increase plasma concentrations
      of vasopressin and increase the firing frequency of neurohypophysial vasopressin
      and oxytocin neurons. In the present study we have examined the effects of ET on
      blood-pressure following micro-injection into the subfornical organ (SFO). Micro
      injection of 0.5 and 5.0 pmol of endothelin into SFO caused significant increases
      (10.1 +/- 1.1 and 10.2 +/- 2.1, respectively) in blood pressure, while lower
      doses were without effect. In addition, we have used single unit recording
      techniques to evaluate the effects of systemic ET on the activity of SFO neurons.
      Extracellular recordings from SFO neurons, antidromically identified as
      projecting to PVN, showed predominantly excitatory responses to systemic ET
      (21/35 cells). The data demonstrate that ET has excitatory actions on SFO
      neurons, and further raise the possibility that one of the functional
      consequences of such effects is an increase in arterial blood pressure.

PMID- 1617411
TI  - Medial septal modulation of entorhinal single unit activity in anesthetized and
      freely moving rats.
AB  - Reversible inactivation of the medial septal area results in a spatial memory
      impairment and selective disruption of hilar/CA3, but not CA1, location-specific
      discharge. The present study examined the possibility that such septal
      deafferentation produces effects on hippocampal function by altering
      physiological properties of the primary input and output structures for
      hippocampus, the entorhinal cortex and the subiculum, respectively. Single unit
      activity of hippocampal, entorhinal, and subicular cells was recorded before,
      during, and after septal injection of lidocaine in anesthetized rats. When
      compared to hippocampal cells, relatively few subicular and entorhinal cells
      showed a change in mean firing rate following septal inactivation. Entorhinal
      unit responses to septal inactivation (via tetracaine injection) were also
      examined in freely moving rats performing a spatial maze task. About one-third of
      entorhinal cells showed enhanced or reduced firing rates of 40% or more. Also,
      the spatial distribution of cells found in the superficial, but not deep,
      entorhinal layers became less clear following septal inactivation. Together,
      these data are consistent with the hypothesis that manipulation of the medial
      septum affects hippocampal function via its septosubicular and septo-entorhinal
      projections in addition to the more direct septohippocampal pathway. Since
      entorhinal cortical function was affected by tetracaine injection into the
      septum, it does not appear that direct entorhinal-CA1 afferents were primarily
      responsible for the maintenance of CA1 location-specific neural activity in
      previous septal inactivation experiments. Rather, these data are consistent with
      the hypothesis that the persistence of CA1 place fields was accomplished by
      intrahippocampal neural network operations.

PMID- 1617412
TI  - Pure Schwann cell suspension grafts promote regeneration of the lesioned septo
      hippocampal cholinergic pathway.
AB  - Regeneration of central nervous system (CNS) axons has been studied in the
      cholinergic septo-hippocampal system using various 'bridges' able to support
      fiber growth. In this study, a pure Schwann cell (Sc) suspension labeled with
      bisbenzimide (Hoechst 33342) was grafted in the lesioned septo-hippocampal
      pathway. At 2 weeks post-grafting, acetyl-cholinesterase (AChE)-positive fibers
      invaded the graft and grew in association with the Hoechst-labeled Sc, some of
      which expressed the low-affinity nerve growth factor receptor (NGF-R). At 2
      months and 4 months post-grafting, the dorsal hippocampus was reinnervated with
      an apparently normal innervation pattern. Analysis of fiber growth in the
      hippocampus at four months post-grafting revealed a significant increase of
      reinnervation in the grafted animals (2 mm) compared to the non-grafted ones. No
      difference was observed in the number of cholinergic septal neurons expressing
      the NGF-R. These results demonstrate that a Sc suspension grafted into the
      lesioned septo-hippocampal system, integrates well into the host tissue, and
      supports axonal CNS outgrowth, implying that Sc by themselves provide an adequate
      environment for regeneration to occur.

PMID- 1617413
TI  - GFAP expression of human Schwann cells in tissue culture.
AB  - We have studied the expression of the intermediate filament (IF) proteins,
      vimentin and glial fibrillary acidic protein (GFAP), in cultured human Schwann
      cells (SC) from patients with different neuropathies and normal control cases. SC
      cultures from sural nerve biopsies of 8 subjects with axonal neuropathies, 8 with
      demyelinating neuropathies and 3 normal controls were included in this study and
      processed with double immunofluorescence technique, using anti-vimentin and anti
      GFAP antibodies, during the 2nd, 4th and 6th week of culture. Five cultures
      incubated with anti-GFAP antibodies were also processed for immunoelectron
      microscopy. Specificity tests of the used antibodies were performed. We have
      found that: (1) cultured human SC constantly express vimentin; (2) SC from normal
      controls are GFAP-negative in the first period of culture; (3) SC from pathologic
      nerves can contain GFAP-immunoreactive IF and the percentage of GFAP-positive SC
      is higher in axonal than in demyelinating neuropathies; (4) during the permanence
      in culture human SC from both normal and pathologic cases acquire the ability to
      synthesize GFAP. The obtained data suggest that the removal from axonal contact
      and the resulting loss of myelinating function induce a cytoskeletal cellular
      response in human SC characterized by the cytoplasmic accumulation of GFAP
      immunoreactive IF.

PMID- 1617414
TI  - Mechanism of delayed intracranial hypertension after cerebroventricular infusions
      in conscious rats.
AB  - Prior studies showed that cerebroventricular infusions of artificial
      cerebrospinal fluid, 8 microliter/min for 10 min, followed by a 10 min rest and a
      24 h infusion of 0.5 microliters/min, raised cerebrospinal fluid pressure (CSFp)
      of conscious, unrestrained rats after about 2 h. Here, we report that the 10 min
      infusion alone evoked a delayed, prolonged rise in CSFp. Pressure during the
      infusion itself rose and recovered quickly, as is usually reported.
      Pressure/volume tests, used to calculate resistance to outflow (Ro) and
      compliance (C), revealed that infusions increased Ro and decreased C, after a
      delay (P less than 0.05). The rise in CSFp after infusion was blocked by
      pretreatment with acetazolamide + ouabain (P less than 0.05), but the delayed
      changes in Ro and C were unaffected. We suggest that the 10 min infusion of a
      sterile, balanced salt solution has a primary effect that increases Ro; as CSF
      synthesis continues, C is exhausted and the delayed rise in CSFp ensues. This non
      traumatic method of raising CSFp may be a useful method to study intracranial
      fluid dynamics.

PMID- 1617415
TI  - Characterization of the norepinephrine uptake system and the role of
      norepinephrine in the expression of the adrenergic phenotype by quail neural
      crest cells in clonal culture.
AB  - This study investigates the role norepinephrine (NE) may play in regulating the
      differentiation of quail neural crest cells into sympatho-adrenal cells. Cues
      originating from the embryonic microenvironment are thought to play an important
      role during development. It is conceivable that NE has a positive regulatory
      function because adrenergic expression by quail neural crest cells in clonal
      culture can be inhibited by NE uptake inhibitors such as desipramine (DMI). This
      possibility is further supported by the notion that in the avian embryo
      presumptive adrenergic neural crest cells are likely to encounter catecholamines
      shortly after they have acquired the NE uptake mechanism. Our present data
      indicate that neural crest cells in clonal culture express a high affinity NE
      uptake system that can be inhibited by desipramine. As in the embryo, it appears
      before noticeable levels of catecholamines are accumulated by neural crest cells,
      as judged by formaldehyde-induced catecholamine fluorescence (FIF). A comparison
      of the time course of appearance of different adrenergic markers suggests that
      immunoreactivity against the biosynthetic enzyme tyrosine hydroxylase (TH) may
      appear first, and that it is followed very closely by the appearance of
      detectable levels of dopamine-beta-hydroxylase (DBH) and the NE uptake mechanism.
      Accumulation of catecholamines (FIF) is observed last. Addition of exogenous NE
      leads to an increase in adrenergic expression in vitro as judged by an increase
      in the number of colonies containing FIF-positive cells as well as cells
      expressing the biosynthetic enzymes TH and DBH. This suggests that exogenous NE
      can play a positive regulatory role in the differentiation of quail neural crest
      cells into sympathoadrenal cells.

PMID- 1617416
TI  - Cellular correlates of classical conditioning in identified light responsive
      pedal neurons of Hermissenda crassicornis.
AB  - Cellular correlates of classical conditioning were examined in two recently
      identified light responsive pedal neurons. The correlates of conditioning
      consisted of significant decreases in the pedal cells' responses to light
      (conditioned stimulus) recorded from conditioned animals compared to random
      controls. Pedal cell P7, which exhibits an inhibitory response to light in naive
      animals, showed significantly less inhibition during a 5 min light step in
      conditioned animals as compared to random controls. Pedal neuron P9, which
      exhibits an excitatory response to light in naive animals, showed significantly
      less excitation during a 10 s light step in conditioned animals as compared to
      random controls. The changes in the response to light recorded from pedal neurons
      P7 and P9 in conditioned animals were not accompanied by any significant changes
      in membrane potential, action potential amplitude or dark-adapted spike
      frequency.

PMID- 1617417
TI  - Aberrant regeneration of motor axons into the pia mater after ventral root
      neuroma formation.
AB  - The spinal pia mater receives a rich innervation of small sensory and autonomic
      axons via the ventral roots. In the present study this pathway was interrupted by
      the transection of the L7 ventral root in young kittens. The animals were killed
      12-18 months postoperatively. It was observed that the pia mater adjacent to the
      divided ventral root contained large numbers of myelinated axons. We suggest that
      these axons represent sprouts which had reached the pia mater by retrograde
      growth from the neuroma on the ventral root. Some of these aberrant pial axons
      ended blindly in the pia mater. Abnormal terminal-like swellings were observed
      along pial blood vessels. Fibers with diameters exceeding 11 microns were
      observed. Many fibers had an internodal spacing below 100 microns and the maximum
      value was only about 300 microns. Thus, motor axons which are forced to grow into
      a foreign territory show a maldevelopment which is more obvious with regard to
      nodal spacing than to fiber diameter.

PMID- 1617418
TI  - Electrically evoked turning: asymmetric and symmetric collision between
      anteromedial cortex and striatum.
AB  - Electrical stimulation of the anteromedial cortex (AMC) or striatum of rats
      evoked contraversive eye, head and body movements. In these experiments we test
      which neurons and which pathways are responsible for the turning by delivering
      conditioning (C) pulses to one site and test (T) pulses to the second site, and
      measuring the frequency of pulse pairs required to evoke a full turn in 10 s.
      Decreases in the required frequency were usually found at C-T intervals from 0.6
      to 1.0 ms, whether the C pulses were delivered to the AMC or to the striatum.
      This symmetric effect is attributed to collision in fast-conducting axons
      connecting cortex and striatum. Symmetric collision at C-T intervals of 2-4 ms
      was observed between cortex and 3 dorsal striatal sites, suggesting slower axons
      from cortex to these dorsal striatal sites. In several animals, asymmetric
      changes in required frequency also occurred. When the C pulses were presented via
      the striatal electrode, the recovery in required frequency occurred at C-T
      intervals of 1-4 ms, but when the C pulses were presented via the cortical
      electrode, recovery occurred at C-T intervals of 2-50 ms. This asymmetry is
      attributed to indirect (i.e., transynaptic) activation of corticostriatal or
      striatal output axons. These results suggest that in both cortex and striatum
      there are synapses, transmitting from rostral to caudal, which are important for
      electrically evoked turning. When C and T pulses were delivered to the same site,
      decreases in required frequency occurred at C-T intervals from 0.4 to 4 ms,
      attributable to recovery from refractoriness. In 3 striatal sites, however, large
      changes were also seen at C-T intervals from 6 to 50 ms. In all 3 sites,
      asymmetric collision occurred at these same intervals. The recovery at long C-T
      intervals could be due to transynaptic collision also, resulting from the
      simultaneous activation of presynaptic and postsynaptic axons by a single
      striatal electrode.

PMID- 1617419
TI  - DSP-4, a noradrenergic neurotoxin, produces more severe biochemical and
      functional deficits in aged than young rats.
AB  - The present study examines the effects of noradrenergic lesions (either DSP-4
      i.p. or 6-hydroxydopamine (6-OHDA) into the dorsal noradrenergic bundle on
      biochemical (noradrenaline (NA), dopamine (DA), serotonin (5-HT) and choline
      acetyltransferase (ChAT) activity) and cortical EEG (quantitative EEG (qEEG) and
      high-voltage spindle (HVS)) activity in young and aged rats. Near complete 6-OHDA
      NA lesions, but not partial DSP-4 NA lesions, increased HVS activity in young
      rats. DSP-4 and 6-OHDA lesions produced no significant changes in the 5-HT or DA
      levels or in the ChAT activity in young rats. In some of the aged rats, DSP-4
      produced similar biochemical and HVS effects, as it induced in young rats. In the
      remainder of the aged rats, NA levels were greatly and 5-HT levels slightly
      decreased. DA levels and ChAT activity were unaltered in either set of aged rats.
      HVS activity was increased only in that group of aged rats with the greatly
      lowered NA content. These results suggest that: (1) some of the aged rats are
      more sensitive to DSP-4 treatment than young adult rats; and (2) NA depletions
      have to be complete to produce an increase in HVS activity in young and aged
      rats.

PMID- 1617420
TI  - Passive electrical properties of motoneurons in aged cats following axotomy.
AB  - The objective of this study was to determine whether the aging process influences
      the changes in the electrophysiological properties of motoneurons that occur as a
      consequence of axotomy. Accordingly, using intracellular recording and
      stimulating techniques, the basic electrical properties of control (unaxotomized)
      and axotomized spinal cord motoneurons of aged cats were determined. Compared
      with control motoneurons, axotomized motoneurons exhibited increases in input
      resistance (Rin), membrane time constant (tau b) and the equalizing time constant
      (tau c). While the electrotonic length (L) remained unchanged, axotomy induced a
      decrease in the total cell capacitance (Ccell). The post-axotomy reduction of
      Ccell indicates that the motoneuron surface area was reduced and the increased
      membrane time constant indicates that there was an increase in membrane
      resistivity (Rm). The post-axotomy conservation of L accompanied by an increase
      in Rm suggests that aged axotomized motoneurons undergo geometrical changes.
      Furthermore, calculations based on cable theory suggest that the diameter of the
      equivalent cylinder (d) decreased following axotomy, whereas the equivalent
      cylinder length (l) remained unaffected. It is concluded that axotomy produces
      significant alterations in the soma-dendritic portion of aged spinal motoneurons,
      as indicated by the changes found in their passive electrophysiological
      properties, and that the pattern of the response that occurs in axotomized
      motoneurons of adult cats is also present in axotomized motoneurons of aged
      animals.

PMID- 1617421
TI  - Electrical states in the rabbit brain can be altered by light and electromagnetic
      fields.
AB  - The effect of low-frequency magnetic fields on the rabbit electroencephalograph
      (EEG) was studied using a quantitative procedure that permitted statistical
      evaluation of the response of individual animals. The field conditions used were
      those predicted by various theories to result in field-animal interactions; light
      and sham exposure were employed as positive and negative controls, respectively.
      Sixty-seven percent of the rabbits exhibited changes in the EEG power spectra
      when light was presented in 2-s epochs; none of the animals responded to sham
      exposure. When 1 Gauss, 5 Hz, was presented in 2-s epochs, 100% of the animals
      tested responded to the presence of the field. The rabbits did not respond when
      the magnetic-field frequency was higher than the physiological range (1-20 Hz) or
      when it was tuned for resonance of K+. The results showed that an electrical
      state function may be operationally defined for the rabbit brain, and used to
      assess the occurrence of an interaction between an animal and external magnetic
      fields.

PMID- 1617422
TI  - Activation of nerve growth factor synthesis in primary glial cells by phorbol 12
      myristate 13-acetate: role of protein kinase C.
AB  - Phorbol 12-myristate 13-acetate (PMA) induces a dramatic production of nerve
      growth factor (NGF) in primary cultures of newborn mouse astrocytes maintained in
      a serum-free medium. This stimulation is dose-dependent and a maximal effect on
      the levels of cell-secreted factor was observed at a concentration of 10 nM. At
      this concentration, the promoting effect of PMA appears much more important than
      that elicited by 10% fetal calf serum (FCS) under the same culture conditions.
      PMA acts primarily on the accumulation of NGF mRNA, which was detected by
      northern blot analysis after 6 h of treatment. This accumulation may be totally
      or partially prevented when PMA-treated glial cells are concomitantly exposed to
      the protein kinase inhibitors H-7, H-9, and to a lesser degree, HA-1004. The
      known specificity of these inhibitors agrees with the possibility that protein
      kinase C (PKC), which constitutes so far the sole known target of PMA, represents
      a key element involved in the stimulation of NGF gene. The role of PKC is further
      supported by the observation that alpha phorbol didecanoate, which has no
      activity on PKC, is depleted of effect on the synthesis of NGF. Likewise, 1,2
      dioctanoylglycerol (1,2-DOG) has a weak, but significant promoting action on the
      production of NGF, unlike the 1,3-isomer which is not active on PKC. Finally, a
      treatment of 15 min with 100 nM PMA is sufficient to stimulate the cells,
      suggesting that the activation phase of PKC, rather than its down regulation,
      constitutes an important trigger leading to an increased expression of the NGF
      gene.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617423
TI  - Intracellular HRP study of nociceptive neurons within the ventrobasal complex of
      the cat thalamus.
AB  - Locations and morphological characteristics of nociceptive specific (NS) and wide
      dynamic range (WDR) neurons of the ventrobasal (VB) thalamic complex were studied
      using an intracellular HRP injection technique in cats anesthetized with urethane
      and chloralose. Both NS and WDR neurons were found within the marginal zone of
      the VB complex. Their somata were confined to the VB complex, but dendrites were
      extended into the structures of the thalamus surrounding the VB complex. NS
      neurons were found in the caudal part of the VB complex, whereas WDR neurons were
      found more rostrally. Examinations of their locations within the marginal zone of
      the VB complex confirmed the somatotopic organization, as found previously. We
      also confirmed the previous reports that there are 3 different types of low
      threshold mechanoreceptive (LTM) neurons within the VB complex. They are type I,
      type II and type III neurons. Both NS and WDR neurons were either type I or type
      II neurons. Obvious morphological differences were not found between LTM neurons
      and two classes of nociceptive VB neurons investigated.

PMID- 1617424
TI  - Chronic lithium administration alters a prominent PKC substrate in rat
      hippocampus.
AB  - The therapeutic effect of lithium in the treatment of bipolar disorder exhibits a
      significant delay in the onset of action and a persistence of efficacy beyond
      abrupt discontinuation of treatment. Lithium is known to alter receptor-coupled
      phosphoinositide second messenger pathway in brain, resulting in indirect changes
      in an endogenous activator of protein kinase C (PKC). Such evidence has suggested
      that PKC may be involved in the mechanism of action of lithium in the brain. PKC
      represents a site wherein long-term regulatory changes in cell function occur
      through the phosphorylation of specific phosphoproteins involved in processes
      including neurotransmitter release and receptor activation. In studies of rats
      exposed to lithium, however, we have found no significant effects of chronic
      administration on the relative activity, subcellular distribution, or activation
      of PKC in hippocampus. We did find a major reduction in the in vitro PKC mediated
      phosphorylation of two major substrates, 83 kDa and 45 kDa, in hippocampus of
      rats exposed to chronic lithium and maintaining clinically relevant therapeutic
      levels in brain. Using immunoblot analysis we have identified a known
      myristoylated alanine-rich C kinase substrate (MARCKS) at 83 kDa. In vivo levels
      of MARCKS in hippocampus were found to be significantly reduced after chronic
      lithium exposure. These findings persist in animals withdrawn from lithium, but
      are not apparent following acute treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617425
TI  - Characterization of prolactin receptor in human brain and choroid plexus.
AB  - We have studied the binding of 125I-labeled human prolactin (PRL) to membranes
      from various regions of the human brain (hypothalamus, cerebral cortex,
      cerebellum and choroid plexus) derived from autopsy specimens. Among the various
      regions studied, the choroid plexus of both male and female subjects showed the
      highest specific binding and a clearly detectable specific binding was also
      observed in the hypothalamus of both sexes, whereas it was very low in other
      brain regions. No significant sex differences in PRL binding to various brain
      regions were observed except for the hypothalamus where a higher binding was seen
      in female subjects. The binding did not vary with the age of the subjects.
      Moreover, the cause of death and the time elapsed from death to autopsy in this
      study did not affect the binding significantly. The binding of 125I-labeled human
      PRL to hypothalamus and choroid plexus membranes from female specimens was
      inhibited in a dose-dependent manner by both unlabeled human and ovine PRL and by
      human growth hormone (GH), but not by other polypeptide hormones. Scatchard
      analysis of the binding revealed the presence of saturable binding sites with low
      capacity and high affinity for human PRL ligand. These results provide strong
      preliminary evidence for the presence of PRL binding sites in the human brain.

PMID- 1617426
TI  - Adenosine inhibition of the regeneration in vitro of adult frog sciatic sensory
      axons.
AB  - The sensory axons of the adult frog sciatic nerve have earlier been shown to
      regenerate in vitro. If a local test crush is made at the initiation of
      culturing, regeneration starts after 3.4 days and proceeds at a rate of about 0.8
      0.9 mm/day for several days. In the present experiments regeneration was
      inhibited by adenosine in a reversible and dose-dependent fashion. Similarly,
      both an adenosine analogue, 2-chloroadenosine (2-CA), and a non-hydrolyzable ATP
      analogue, AMP-PNP, reduced the outgrowth of sensory axons. The effect of
      adenosine was partially antagonized by theophylline at a critical concentration.
      Using a compartmental system, it could clearly be shown that adenosine exerted
      its effects at the outgrowth region. Adenosine, 2-CA, and AMP-PNP were also found
      to inhibit the proliferation of Schwann cells in the regenerating nerve. Various
      experiments showed that the latter can not explain the outgrowth inhibitory
      effects, which could be mediated by adenosine receptors associated with the
      elongating axons.

PMID- 1617427
TI  - Decreased [3H]hemicholinium binding to high-affinity choline uptake sites in aged
      rat brain.
AB  - The binding of [3H]hemicholinium ([3H]HCh-3) to sodium-dependent high-affinity
      choline uptake sites provides a useful neuroanatomical and functional marker of
      the cholinergic system. We examined the autoradiographic distribution of [3H]HCh
      3 binding sites in the forebrain of young (4-6 months) and old (32 months) rats.
      There was a widespread reduction of [3H]HCh-3 binding site density in the aged
      rat brain. This loss presented regional differences with maximal reduction in the
      medial and posterior striatum (55%) and in the dentate gyrus (47%), in limbic
      areas such as basolateral amygdala, tubercle olfactorium and piriform cortex the
      autoradiographic signal was about 25-30% lower. In aged hippocampus and cerebral
      cortex the density of [3H]HCh-3 binding sites was about 40% lower, the difference
      between young and senescent animals being less evident in the medial septum and
      basal nucleus. No significant alterations were observed in interpeduncular
      nucleus from old rats. These data are in agreement with the functional results
      obtained by measuring other cholinergic parameters in the aged rat and confirm
      the vulnerability of cholinergic system during aging.

PMID- 1617428
TI  - Norepinephrine activates potassium conductance in neurons of the turtle cerebral
      cortex.
AB  - Whole-cell voltage and current clamp recordings were obtained from cortical
      neurons of the pond turtle, Pseudemys scripta elegans. Norepinephrine (NE)
      induced an outward current in 50% of pyramidal neurons. This current had a
      reversal potential of -88.3 +/- 3.2 mV, consistent with a K+ conductance
      increase, and had a mean amplitude of 18.3 +/- 7.2 pA at -40 mV. The ionic
      dependence and pharmacological analyses are both consistent with alpha 2
      adrenergic receptor stimulation. Inhibition of Na(+)-dependent action potentials
      with TTX did not diminish the NE-induced K+ conductance, indicating that NE acts
      directly on the postsynaptic neuron. In addition to effects on postsynaptic
      conductance, NE dramatically decreased the amplitude of spontaneous inhibitory
      postsynaptic currents (IPSCs) in 55% of pyramidal neurons. The decrease in
      spontaneous IPSCs was observed both in those neurons which exhibited an increase
      in K+ conductance in response to NE administration (81%) and in those which did
      not (33%). Thus, NE modulates neuronal excitability both directly by activating a
      postsynaptic K+ conductance and indirectly by decreasing spontaneous IPSCs.

PMID- 1617429
TI  - Learning impairment following intracerebral administration of the HIV envelope
      protein gp120 or a VIP antagonist.
AB  - The external envelope glycoprotein (gp120) of the human immunodeficiency virus
      (HIV) has been shown to be toxic to neurons in culture. To further investigate
      the neurological effects of gp120, the involvement of this protein with the
      acquisition of spatial discrimination was assessed. Both native and recombinant
      gp120 were administered into the cerebral ventricles of adult rats and
      performance was evaluated in the Morris swim maze. Gp120 treatment retarded
      acquisition after daily administration of 12 ng. The specificity of this
      impairment was demonstrated in that the performance of animals given the same
      amount of gp160 from recombinant baculovirus was not different from animals given
      saline. Vasoactive intestinal peptide (VIP) has been shown to block gp120-induced
      neurotoxicity in culture and a VIP receptor antagonist has displayed toxic
      properties to neurons in culture. We show here that this antagonist, which
      competitively inhibits VIP binding and blocks VIP-mediated functions in cell
      cultures from the CNS, also produced an impairment of performance. This
      retardation was attenuated by cotreatment with VIP, supporting the specificity of
      the observed impairment. Thus, gp120 and the VIP antagonist produced similar
      retardation of spatial discrimination, suggesting that both may impair memory for
      spatially related stimulus control.

PMID- 1617430
TI  - Effects of nerve growth factor on TTX- and capsaicin-sensitivity in adult rat
      sensory neurons.
AB  - We have investigated the effects of nerve growth factor (NGF, 2.5 ng/ml for 1-2
      weeks) on enriched adult rat dorsal root ganglion (DRG) neurons maintained in
      cell culture in defined media. Whole-cell recordings in cells cultured in the
      absence and presence of NGF revealed no significant difference in resting
      membrane potential and input resistance. However, the threshold for spike
      generation was significantly lower in untreated cells than in treated cells; -25
      +/- 1.1 mV vs -19 +/- 2.2 mV, respectively. The sensitivity of the Na+ spike to
      tetrodotoxin (TTX, 1 microM) was different in cells cultured in the absence or
      presence of NGF. For example, spikes were abolished by TTX in 100% of untreated
      cells, while in NGF-treated cells the spike was abolished in only 41% of the
      neurons. Chemosensitivity of DRG neurons was also different in the absence and
      presence of NGF. For example, the percent of neurons in which a current activated
      by 8-methyl-N-vanillyl-6-nonenamide (capsaicin, 500 nM) was detected, increased
      from 18% in untreated cells to 55% in NGF-treated cells. NGF did not influence
      the number of cells surviving. The results indicate that NGF can regulate TTX and
      capsaicin sensitivity in these adult rat sensory neurons. Our experimental
      protocol indicates that this effect is not mediated by a factor in the serum or
      released from non-neuronal cells.

PMID- 1617431
TI  - The interaction of testosterone with the brain of the orchidectomized primate
      fetus.
AB  - At certain times during gestation, the testes of the fetal macaque produce plasma
      levels of testosterone (T) that are similar to those of adults. It is thought
      that testosterone acts on the brain via estrogen and androgen receptors to
      organize the development of sexually dimorphic neural structures that underlie
      sex differences in behavior. To test the proposition that there are male-female
      differences in the occupation of steroid receptor binding sites during fetal
      development in the cynomolgus macaque, we have compared the uptake of [3H]T and
      its metabolites in: (1) 5 intact males (plasma T 571.2 +/- 215.5 ng/100 ml); (2)
      5 intact females (33.8 +/- 25.2 ng/100 ml); (3) in 5 males orchidectomized in
      utero (14.6 +/- 5.7 ng/100 ml). About 1 week after fetal gonadectomy or sham
      operation, all fetuses were given 500 microCi [3H]T s.c. and were then delivered
      60 min later by Cesarean section. Brains were removed and dissected into blocks
      containing the hypothalamus and preoptic area, amygdala, hippocampus, and
      midbrain. Samples of cerebral and cerebellar cortex were also obtained. Purified
      nuclear pellets were prepared by centrifugation through 2 M sucrose and were
      extracted into ether and analyzed by high performance liquid chromatography.
      Hypothalamic nuclear concentrations of [3H]E2 in intact males (847 +/- 195 dpm
      per mg DNA) were significantly lower than those in sham-operated females (2147 +/
      542 dpm per mg DNA) (P less than 0.05), but those in orchidectomized males (2233
      +/- 345 dpm per mg DNA) were similar to concentrations in females.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1617432
TI  - Current source density of sustained potential shifts associated with
      electrographic seizures and with spreading depression in rat hippocampus.
AB  - The membrane currents responsible for the sustained potential shifts associated
      with electrographic seizures and with spreading depression in hippocampus were
      studied in the anesthetized rat. Probes incorporating 16 sensors in a straight
      line, spaced at 150-microns distances, were recording the potential changes with
      DC-coupled amplifiers in CA1 and dentate gyrus (DG) of one hemisphere. Seizures
      and spreading depression were provoked by repetitive stimulation of different
      afferent pathways. Seizures always began in DG before CA1, regardless of the
      pathway stimulated. Tonic seizures were associated with a sustained negative
      potential shift that was largest in the cell body layers. Current source density
      was computed from these recordings and confirmed the presence of a current sink
      limited to the cell body layer throughout the duration of electrographic
      seizures. Spreading depression was associated with a very large sink located in
      the layer of apical dendrites, maximal among the proximal segment of dendrites,
      to which the cell body layer served as a source. We conclude that seizures are
      associated with an inward current in neuron cell bodies, probably flowing through
      membrane channels of as yet no know physiological function.

PMID- 1617433
TI  - Projections from the nucleus accumbens to cholinergic neurons of the ventral
      pallidum: a correlated light and electron microscopic double-immunolabeling study
      in rat.
AB  - A correlated light- and electron microscopic double-immunolabeling study
      combining choline acetyltransferase immunocytochemistry with anterograde tracing
      of Phaseolus vulgaris leucoagglutinin (PHA-L) revealed that axons of the nucleus
      accumbens terminate on cholinergic neurons of the ventral pallidum. These
      findings are discussed with respect to the possibility that these cholinergic
      neurons may be part of parallel circuits, providing feedback to the same cortical
      and amygdaloid areas which innervate the nucleus accumbens.

PMID- 1617434
TI  - Modulation of lateral hypothalamic activity by olfactory bulb and sciatic
      stimulation.
AB  - Lateral hypothalamic area (LHA) single unit activity (extracellular) was studied
      in response to electrical stimulation of the olfactory bulb (OB) or sciatic nerve
      in adult albino rats (n = 39) anesthetized with dialurethane. Olfactory
      stimulation resulted in a greater proportion of LHA units showing inhibitory
      rather than excitatory responses, while sciatic nerve stimulation resulted in
      similar proportions of units showing inhibitory and excitatory responses. Of the
      76 LHA units tested with both OB and sciatic nerve stimulation, 36% responded to
      both stimulation sites, 18% responded only to OB stimulation, 26% responded only
      to sciatic nerve stimulation, and 20% were unresponsive to either stimulation.
      The locations of responsive units were diffuse throughout the LHA sampled. The
      response characteristics of LHA neurons to external sensory stimulation are
      consistent with the anatomy and putative integrative functions of this brain
      region.

PMID- 1617435
TI  - Effect of drinking on angiotensin-II-induced shifts in regional cerebral blood
      flow in the rat.
AB  - A map of brain regions affected by central administration of the octapeptide
      angiotensin II (AII) and that would further reflect the consequences of AII's
      well-known dipsogenic action was developed. Regional cerebral blood flow (rCBF)
      as an indicator of neuronal activity was measured in conscious rats shortly after
      an ICV bolus injection of 100 ng AII or saline vehicle (VEH). AII-treated animals
      were further subdivided into two groups that were either permitted to drink [AII
      (W+)] or whose water was removed when drinking was attempted [AII (W-)]. When
      compared to VEH condition, blood flow increased significantly within 1 min after
      AII treatment in 33 of 53 regions sampled in those rats not given an opportunity
      to drink. In 11 of these 33 regions, ingestion of a small amount of water was
      associated with a reversal of AII-induced elevation in blood flow [i.e., AII (W+)
      less than AII (W-)]; these regions included the organum vasculosum lamina
      terminalis, rostral lateral hypothalamus, supraoptic nuclei, rostral zona
      incerta, and median eminence. A group of similarly treated rats exhibited a
      significant elevation of mean arterial blood pressure following AII treatment
      without significant shifts in arterial blood gases, pH, or bicarbonate. These
      data are consistent with prominent involvement of the anteroventral third
      ventricular region of the rat brain. The results further indicate that rCBF may
      be a sensitive measure for the identification of central sites of action of AII
      as a dipsogenic agent and may reveal distinctions between regions associated
      primarily with initiation of drinking and those reflecting the results of
      subsequent behavioral events.

PMID- 1617436
TI  - Validation of the hypothermic action of preoptic norepinephrine in guinea pigs.
AB  - Conscious guinea pigs were either microinjected intrapreoptically (iPO) with
      various doses of norepinephrine (NE) bilaterally or microdialyzed with pyrogen
      free saline (PFS) or 10 micrograms/microliters NE unilaterally immediately and
      unilaterally or bilaterally 2 days after probe insertion. Core temperature (Tco),
      skin temperature (Tsk), and rate of oxygen consumption (VO2) were monitored
      continuously. The microinjection of low doses of NE induced Tco rises, whereas
      that of the highest dose (10 micrograms/microliters) caused an initial Tco fall
      followed by a rise. The microdialysis of PFS or NE immediately after probe
      insertion caused Tco rises; the former was abolished and the latter was converted
      into a fall by indomethacin (Indo, a prostaglandin synthase inhibitor)
      pretreatment. Two days later, PFS evoked no thermal response whereas NE induced a
      Tco fall; neither response was affected by Indo pretreatment. The falls in Tco
      produced by NE microdialyzed uni- or bilaterally were similar. The microdialysis
      of NE induced a 15% reduction in metabolic rate but no change in Tsk. These
      results indicate that the Tco rise induced by NE microinjected iPO is a
      methodological artifact mediated by PGE2, whereas the Tco fall observed in its
      microdialysis appears to represent the authentic physiological action of this
      transmitter effected by a reduction in metabolic rate.

PMID- 1617437
TI  - Development of gamma-aminobutyric acid-immunoreactive neurons in normal and
      intracranially transplanted retinas in rats.
AB  - Retinas from embryonic day 14 Sprague-Dawley rats were transplanted
      intracranially to the midbrain or cortex of newborn (P0) rats with right eyes
      enucleated at the time of transplantation and the gamma-aminobutyric acid (GABA)
      immunoreactivity in developing retinal transplants, host as well as normal
      retinas, was studied. The results showed that GABA-immunoreactive neurons were
      identified in retinas of normal and host rats from the day of birth (P0) onward
      and that their somata were distributed primarily in the inner half of the
      internal nuclear layer and in the ganglion cell layer. The adult pattern of GABA
      immunoreactivity was first observed at P16 when several immunoreactive sublaminae
      were clearly identifiable in the inner plexiform layer. In contrast, gamma
      aminobutyric acid-immunoreactive somata could not be identified in retinal
      transplants until P4, with a significant reduction in the density and number of
      GABAergic neurons detected by P12. Moreover, only two immunoreactive sublaminae
      were observed in the inner plexiform layer in all transplants at P12, as well as
      in more mature stages. These results suggest that significant changes occurred in
      the GABA system of the transplanted retina, despite the fact that the overall
      pattern of organization of the GABAergic neurons and their processes in the
      retinal transplants was comparable to that of the normal retina.

PMID- 1617438
TI  - Release of angiotensin in response to ionic stimulation: a possible role for
      calmodulin in the secretory event.
AB  - Although the synthesis and distribution of the putative neurotransmitter
      angiotensin (ANG) has been well established, little is known about the mechanism
      for its release. In this study, we utilized dissociated cell cultures of fetal
      rat brain to examine the cellular and ionic properties of angiotensin release.
      Graded concentrations of 0-60 mM KCl in the presence of 5 mM CaCl2 were added to
      the cultured cells and the resulting angiotensin release was measured by
      radioimmunoassay and high-performance liquid chromatography. Levels of
      angiotensin release increased from 13.85 +/- 1.53 pg/mg protein to 172.64 +/-
      17.49 pg/mg protein with increasing concentrations of K+. Cultures incubated with
      60 mM KCl buffer that did not contain CaCl2 released 39.87 +/- 15.74 pg ANG/mg
      protein. To further show the link between ionic stimulation and angiotensin
      release and determine the potential role of extracellular sodium ions on
      angiotensin release, cultures were incubated with the Na(+)-channel blocker
      tetrodotoxin (300 nM TTX) prior to maximal stimulation with 60 mM KCl/5 mM CaCl2
      in the presence of the channel antagonist. Release was attenuated following
      incubation with stimulating buffer containing TTX (300 nM) to 5.49 +/- 4.37 pg/mg
      protein. Finally, to determine the role of the calcium binding protein calmodulin
      in the release event, the cells were incubated with graded concentrations of W-7
      (2.5-250 microM) and subsequently stimulated with 60 mM KCl/5 mM CaCl2 in the
      presence of the calmodulin antagonist. W-7, which displays specificity for
      inhibition of the Ca2+/calmodulin complex below 0.2 mM, decreased angiotensin
      release in a dose-dependent manner.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617439
TI  - Influence of nucleus tractus solitarius stimulation and baroreceptor activation
      on rat parabrachial neurons.
AB  - The parabrachial nucleus (PBN) within the dorsolateral pons is a major recipient
      of autonomic-related inputs from more caudal levels of the brainstem and, in
      particular, the nucleus of the solitary tract (NTS). Although the anatomical
      projections from the NTS to the PBN are well characterized, less is known
      concerning the influence of activating NTS efferents on PBN neurons and the
      response of the latter to cardiovascular-related inputs. The present study
      examined the response of PBN neurons to electrical stimulation of the depressor
      area within the NTS in urethane anesthetized rats, and subsequently, the
      influence of arterial baroreceptor activation and systemic angiotensin II (ANG
      II) on these cells. Extracellular single-unit PBN recordings indicated that 92 of
      227 (40.5%) cells were orthodromically excited and 35 of 227 (15.4%) inhibited
      consequent to NTS stimulation. Ten (4.5%) PBN cells displayed antidromic
      activation from the NTS. Of 41 of 119 neurons responding to both NTS stimulation
      and baroreceptor activation, 29.3% revealed a excitatory and 31.7% an inhibitory
      response to the two stimuli. Fifteen PBN cells responded to NTS stimulation,
      baroreceptor activation, and the administration of systemic ANG II, with six
      cells displaying either an excitatory or inhibitory response to all three
      stimuli. These observations provide electrophysiological support for reciprocal
      connections between the NTS and PBN and indicate the presence of both excitatory
      and inhibitory projections to the pontine nucleus. A population of neurons
      influenced by activation of NTS efferents also reveal a similarity of responses
      to inputs originating from peripheral arterial baroreceptors and systemic ANG II.

PMID- 1617440
TI  - Excitation of hypothalamic paraventricular neurons by stimulation of the raphe
      nuclei.
AB  - Extracellular recordings were made from 467 anti-dromically identified
      neurosecretory neurons and 148 non-neurosecretory neurons in the paraventricular
      nucleus of the hypothalamus of hemispherectomized cats under pentobarbital
      anesthesia. Stimulation of the dorsal, median, and pontine raphe nuclei excited
      31%, 26%, and 12% of neurosecretory neurons tested, respectively, and inhibited
      9%, 7%, and 8%. The excitatory responses in 13 of 14 neurons tested were blocked
      by either of two intravenously administered 5-HT2 antagonists, cyproheptadine or
      methysergide. The 5-HT1A antagonist, (-)pindolol, partially blocked the
      excitatory responses elicited by raphe stimulation in three of five neurons
      tested. The inhibitory responses to raphe stimulation were not affected by
      application of these antagonists. More non-neurosecretory neurons than
      neurosecretory neurons were excited in response to raphe stimulation and these
      excitatory responses were also blocked by these antagonists. We conclude that
      most electrically stimulated synaptic inputs from the midbrain raphe nuclei to
      the hypothalamic paraventricular nucleus are excitatory and are mainly mediated
      by 5-HT2 receptors.

PMID- 1617441
TI  - Chronic ethanol treatment reduces inhibition in CA1 of the rat hippocampus.
AB  - The effect of chronic ethanol exposure on inhibition in the rat hippocampal slice
      was investigated using paired-pulse stimulation techniques with stimulation in
      stratum radiatum or stratum oriens of CA1. Experimental animals were fed ethanol
      in a liquid diet for 20 weeks and were withdrawn for at least 8 weeks prior to
      electrophysiological recording. Prior ethanol treatment had no effect on basic
      input-output relationships for the extracellular population spike. Ethanol
      treatment significantly reduced the recurrent inhibition produced by antidromic
      stimulation in a manner dependent upon stimulus intensity. In addition, with
      orthodromic paired-pulse stimulation of either stratum radiatum or oriens, a
      trend toward an augmentation of the facilitation of population spike amplitude
      was observed, suggesting that feedforward inhibition may also be reduced. These
      results are similar to those found with treatments that reduce inhibition.
      Therefore, we conclude that chronic ethanol exposure produces an enduring
      disruption of inhibitory neuronal function in the rat hippocampus.

PMID- 1617442
TI  - NADPH-diaphorase activity in the hypothalamic magnocellular neurosecretory nuclei
      of the rat.
AB  - A histochemical study of the distribution of NADPH diaphorase activity in the
      hypothalamus of normal rats was carried out. Our study demonstrates the presence
      of NADPH-diaphorase activity in the circularis and anterior and posterior
      fornicals nuclei for the first time. Additionally, we confirm the presence of
      NADPH-diaphorase-stained neurons in the paraventricular (both magno- and
      parvicellular neurons) and supraoptic nuclei, as well as a population of isolated
      positive neurons (not included in any hypothalamic nuclei) located among the
      different nuclei. Because NADPH diaphorase has recently been shown to be a nitric
      oxide synthase, our study reveals a wide presence of this enzymatic activity in
      the hypothalamus of the rat.

PMID- 1617443
TI  - Rapid morphological changes in supraoptic nucleus and posterior pituitary induced
      by a single hypertonic saline injection.
AB  - Neurosecretory neurons of the supraoptic nucleus (SON) which manufacture,
      transport, and secrete neuropeptide hormones are activated by administration of
      hypertonic NaCl. Male rats were given single intraperitoneal injections of
      isotonic (0.15 M) or hypertonic (1.5 M) NaCl solution and sacrificed 5 h after
      injection. Electron micrographs were compared to determine morphological
      differences in the SON and in the neural lobe in the two conditions. In the SON,
      significant decreases were found in the extent of glial contact with the
      magnocellular neuroendocrine cell (MNC) membrane; the amount of nerve terminal
      contact and amount of apposition of MNC membrane with other MNC cell bodies or
      dendrites increased. The number of multiple synapses (one terminal contacting two
      or more cells) per 100 microns of somatic membrane in the 1.5 M NaCl condition
      was double that found in the 0.15 M NaCl condition. Size of nucleoli, overall
      cell body size, and amount of Golgi apparatus were significantly larger in the
      animals injected with 1.5 M NaCl. The neural lobes of animals receiving 1.5 M
      NaCl injections showed increased neural contact with the basal lamina and
      decreased cytoplasmic enclosure of axon terminals. The large and rapid changes
      induced by this stimulus suggest that it is an extremely effective activator of
      morphological plasticity in the hypothalamo-neurohypophysial system.

PMID- 1617444
TI  - Visualization of efferent retinal projections by immunohistochemical
      identification of cholera toxin subunit B.
AB  - The present study describes the use of cholera toxin subunit B as an anterograde
      and retrograde neuronal tracer for studying retinal projections of the rat,
      mouse, gerbil, and hamster. The tracer was pressure injected in the posterior
      chamber of the eye and the labeled neurons were identified using an avidin-biotin
      immunoperoxidase technique using diaminobenzidine as chromagen. Doses of 3-8
      microliters (30-80 micrograms) cholera toxin subunit B and a survival for 24 h
      resulted in an optimal transport of the tracer in all rodent species
      investigated. The cholera toxin subunit B-containing retinal efferents were
      effectively stained and yielded the presence of axons with delicate boutons on
      passage and nerve endings. Smooth and thick fibers were also observed, indicating
      a distinction between passing and terminating axons, respectively. Immunoreactive
      axons were observed in the hypothalamus, thalamus, ad mesencephalon, and the
      precise distribution of positive nerves could be identified in counterstained
      sections, some of them as delicate endings in apposition to neuronal surfaces.
      Labeled cell bodies were observed in the oculomotor nucleus and the pretectum,
      indicating that the tracer is transported retrogradely as well. Because the
      tracer is identified immunohistochemically, the retinofugal and retinopetal
      pathways can be mapped more precisely, perhaps in combination with
      immunohistochemical detection of other antigens.

PMID- 1617445
TI  - Estrogen-like effects of the mammary carcinogen 7,12
      dimethylbenz(alpha)anthracene on hypothalamic neuronal membranes.
AB  - Previous studies have shown that in Sprague-Dawley female rats, but not in Wistar
      females, the mammary carcinogen dimethylbenz(alpha)anthracene (DMBA) results in
      extended preovulatory prolactin and estradiol surges, associated with inhibition
      of preovulatory gonadotropin surges, and in the induction of mammary tumors.
      Because earlier studies of similar endocrine states have shown this to be linked
      to hypothalamic arcuate nucleus neuronal membrane organization, in this study
      freeze-fracture methodology was used to determine whether DMBA may affect the
      ultrastructure of the neuronal membrane in the arcuate nucleus. The effects of
      estradiol valerate and DMBA were studied on 55- to 60-day-old cycling females, in
      Sprague-Dawley and Wistar rats, 8 weeks after the treatment. DMBA alone (15
      mg/rat by gastric intubation) resulted in a significant decrease in the numerical
      density of intramembrane protein particles (IMP) in Sprague-Dawley rats but not
      in Wistar rats. The SC injection of estradiol valerate (1 mg/rat) resulted in a
      significant decrease of IMP numbers in both strains of rats. Although the
      subcutaneous injection of DMBA alone (1 mg/rat) did not affect IMP numerical
      density in either strain, the same potentiated the effect of estradiol valerate
      (1 mg/rat) on IMP's in Sprague-Dawley but not in Wistar females. These results
      indicate that DMBA affects the organization of neuronal plasma membrane in the
      hypothalamus of Sprague-Dawley rats. Wistar females are insensitive to both the
      endocrine and neuronal membrane effects of DMBA. Estradiol affected neuronal
      membranes in both strains and potentiated DMBA's effect. It appears that the
      estrogen-sensitive mechanism of DMBA activation may be lacking in Wistar rats.

PMID- 1617446
TI  - Fluoxetine shortens circadian period for wheel running activity in mice.
AB  - Fluoxetine is a potent and specific serotonin re-uptake inhibitor and an
      effective antidepressant drug. Male mice were treated with either fluoxetine (8
      mg/kg body weight per day) or saline. Wheel running activity was monitored for 2
      weeks in a 12:12 LD cycle followed by 2 weeks in constant darkness (DD).
      Fluoxetine significantly shortened free-running circadian period for wheel
      running activity (23.93 +/- 0.08 h for fluoxetine treated mice versus 24.17 +/-
      0.07 h for saline treated mice; p less than 0.03). These results are consistent
      with a role for serotonin in the regulation of circadian period in mice.

PMID- 1617447
TI  - Microinjection of the alpha 1-agonist methoxamine into the paraventricular
      hypothalamus induces anorexia in rats.
AB  - Adrenergic receptors within the paraventricular hypothalamus (PVN) play a
      prominent role in the control of food intake: stimulation of alpha 2
      adrenoceptors induces food intake whereas stimulation of alpha 1-adrenoceptors
      suppresses food intake. This study further examines the role of PVN alpha 1
      adrenoceptors by examining the effects on food and water intake of the alpha 1
      adrenergic agonist methoxamine (100, 200, 400 nMol) microinjected into the rat
      paraventricular hypothalamus. Methoxamine suppressed food intake but not water
      intake. Doses of 100, 200, and 400 nMol methoxamine suppressed food intake by
      47%, 64%, and 96%, respectively. These results further confirm the hypothesis
      that administration of alpha 1-agonists into the PVN acts to significantly
      suppress food intake; an action that is in opposition to the facilitory effects
      of alpha 2-adrenergic agonists on food intake.

PMID- 1617448
TI  - Administration of satiety factors and gustatory responsiveness in the nucleus
      tractus solitarius of the rat.
AB  - The administration of certain factors associated with postprandial satiety
      decreases gustatory responsiveness. We compared the effects of intravenous
      injections of glucose, insulin, pancreatic glucagon (PG), and cholecystokinin
      (CCK) on multiunit activity evoked from taste responsive neurons in the nucleus
      tractus solitarius of rats. Glucose, insulin, and PG reliably suppressed evoked
      responses to lingual application of 1.0M glucose, whereas responses that followed
      CCK remained unchanged. A common physiological consequence of glucose, insulin,
      and glucagon is increased glucose availability which may impact directly on
      gustatory neurons or indirectly through modifications in ventral forebrain or
      vagal afferent activity.

PMID- 1617449
TI  - Auditory magnetic source localization in twins.
AB  - We recorded magnetoencephalographic (MEG) auditory evoked fields (EF) from the L
      and R hemispheres of 12 paris of twins, 6 monozygotic (MZ), and 6 dizygotic (DZ)
      and localized the source of the 100 msec latency EF component termed the M100.
      M100 sources exhibited greater similarity in location in MZ twin pairs,
      especially in the L hemisphere. These findings support the hypothesis that the
      functional location of processing of nonmeaningful unattended auditory stimuli
      may depend more heavily on left hemisphere structures. Furthermore, genetic
      effects are evident in these left hemisphere structures and their activity, as is
      a substantial amount of environmental variance.

PMID- 1617450
TI  - Iron induces degeneration of nigrostriatal neurons.
AB  - Parkinson's-diseased (PD) brains have been reported to contain increased
      quantities of iron within the zona compacta of the substantia nigra (SN). To test
      whether excess iron in the SN could cause a PD-like loss of dopaminergic neurons,
      various concentrations of iron were infused unilaterally within the SN of adult
      male rats. At 1-2 months post-infusion, examination of thionine and iron stained
      brain sections from animals infused with low concentration iron revealed: (1)
      iron diffusion limited to and concentrated within the infused SN and (2) a
      selective degeneration of neurons within zona compacta of SN. Infusion of higher
      iron concentrations induced near complete neuronal losses in zona compacta, as
      well as neuronal degeneration within zona reticularis and areas immediately
      adjacent to the SN. Striatal dopamine and its catabolites dihydroxyphenylacetic
      acid (DOPAC) and homovanillic acid (HVA) were reduced in a dose-dependent
      fashion, with over 80% depletions observed at the highest iron concentration
      infused. These data indicated that neurons within zona compacta of SN are
      sensitive to infusions of low iron concentrations. The data support the notion
      that iron in zona compacta of the SN could act as an endotoxin in the
      pathogenesis of PD.

PMID- 1617451
TI  - Degenerative changes in traumatic brain injury: post-injury magnetic resonance
      identified ventricular expansion compared to pre-injury levels.
AB  - Magnetic resonance (MR) scans obtained 42 days and 10 months post-injury were
      compared to scans obtained in similar planes three months prior to injury. In
      comparison to pre-injury scans, post-injury MR scan analysis demonstrated
      significant ventricular volume increase which is considered a measure of the
      degree of diffuse axonal injury. Most important, the trauma induced degenerative
      effects appeared to be quite complete by 42 days post-injury as there was little
      further degeneration that occurred between the 6 week and 10 month post-injury
      scans. This study demonstrates that in humans the majority of gross trauma
      induced degenerative changes are complete by 6 weeks post-trauma.

PMID- 1617452
TI  - Effect of paradoxical sleep deprivation on vasoactive intestinal peptide-like
      immunoreactivity in discrete brain areas and anterior pituitary of the rat.
AB  - To determine whether vasoactive intestinal peptide (VIP) is involved in
      paradoxical sleep (PS) homeostasis, VIP-like immunoreactivity (VIP-LI) of
      discrete brain areas was determined by radioimmunoassay after 24 and 48 h of PS
      deprivation by the watertank technique followed or not by 5 h of sleep rebound.
      This study was carried out with an environmental control (placed in dry
      watertank: DWC) and a nonstressed control. Such PS deprivation induced a decrease
      of VIP content in PS-deprived rats restricted to cortex and anterior pituitary.
      In the cortex, the decrease in VIP-LI was of the same magnitude after 24 and 48 h
      of PS deprivation and VIP-LI was normal by 5 h of sleep rebound; as such a
      decrease was also observed after 48 h in DWC, it could be due to the stress
      related to the experiment rather than lack of sleep. In the anterior pituitary,
      the decrease was related to the duration of deprivation with a greater decrease
      in VIP-LI after 48 than after 24 h of PS deprivation and specifically related to
      PS deprivation since it was not observed in DWC rats. After 5 h of sleep rebound,
      recovery of VIP-LI was total in the 24-h experiment and partial in the 48-h one.
      In all eight other structures studied, VIP was unchanged after experimentation.
      These results strongly suggest that VIP is not involved in PS homeostasis but as
      indicated by other experiments more probably in circadian organization of sleep.

PMID- 1617453
TI  - The locus coeruleus and dopaminergic function in rat brain: implications to
      parkinsonism.
AB  - Clinical and experimental evidence suggests that degeneration of the locus
      coeruleus (LC) may be responsible for certain symptoms of Parkinson's disease
      (PD). We have, therefore, studied the effects of LC lesion on dopamine (DA)
      metabolism in the rat striatum. Unilateral depletion of norepinephrine (NE) was
      obtained by stereotaxic injection of 6-hydroxydopamine (6-OHDA) into the dorsal
      NE bundle (DNEB). Rats were sacrificed 1 or 3 weeks after lesioning. 6-OHDA
      induced approximately 50% depletion of NE in the ipsilateral hippocampus at 1
      week postinjection, and over 75% depletion after 3 weeks. DNEB lesions had no
      effect on DA or DOPAC levels in the ipsi- or contralateral striatum at either
      time point. Lesions also failed to affect DA synthesis or utilization in either
      striatum. The metabolism of exogenous levodopa in the striatum was also
      unaffected. It is suggested that any possible effect of the LC on DA transmission
      in the striatum is not mediated by the DNEB.

PMID- 1617454
TI  - Postnatal development of gustatory recipient zones within the nucleus of the
      solitary tract.
AB  - Previous studies have examined pre- and postsynaptic development of the first
      order central gustatory relay, located in the rostral nucleus of the solitary
      tract (NST). This region of the NST is innervated by primary gustatory axons
      arising from the facial-intermediate nerve. However, a large portion of the
      gustatory NST is innervated by axons arising from the glossopharyngeal nerve, and
      although the time course for development of N.VII recipient zones has been
      defined development of glossopharyngeal afferent terminal fields has not been
      examined. Moreover, the time course for development of projection neurons located
      postsynaptic to gustatory afferent axons has not been examined in any portion of
      the NST. The objectives of the present study were to 1) define the time course
      for development of N.VII and N.IX terminal fields and 2) examine temporal
      relationships between development of afferent terminal fields and development of
      projection neurons located postsynaptic to gustatory afferent axons. To this end,
      triple fluorescent labeling procedures were used to simultaneously visualize
      developing axons and projection neurons. Results show that afferent terminal
      fields develop along the rostrocaudal axis of the NST. Axons of the N.VII
      terminal field are present in the rostral NST at P1 and develop to approximately
      P25. Axons and terminal endings of N.IX do not enter the NST until approximately
      P9-P10, and these terminal fields develop within the intermediate NST until
      approximately P45. Many NST neurons destined to project axons to the second-order
      central gustatory relay, located in the caudal parabrachial nucleus (PBN), do not
      possess axonal connections with the PBN during the first 2-3 weeks of postnatal
      life. As afferent terminal fields develop, these neurons establish connections
      with the PBN between the ages of approximately P7 and P45-P60. The delay between
      afferent terminal field development and development of PBN projection neurons in
      the N.VII terminal field is approximately 3 weeks. The delay between pre- and
      postsynaptic development in the N.IX terminal field is approximately 1 week.
      Potential relationships between pre- and postsynaptic development are discussed,
      in addition to relationships between anatomical development in the NST and the
      emergence of taste-guided behaviors.

PMID- 1617455
TI  - Immunocytochemical survey of haloperidol-induced immunoreactive changes of
      [Met]enkephalin-Arg6-Gly7-Leu8 in the rat forebrain.
AB  - It has already been demonstrated that chronic treatment with the dopamine
      receptor blocker, haloperidol, results in an increase of proenkephalin-A-derived
      peptides in the caudate-putamen (CP). To examine this phenomenon at the cellular
      level, we used immunocytochemistry to investigate the effects of haloperidol on
      [Met]enkephalin-Arg6-Gly7-Leu8 (MEAGL) immunoreactivity in the rat forebrain.
      After daily haloperidol (5 mg/kg, IP, for 6 days) or haloperidol decanoate (70
      mg/kg, IM, given once or twice) treatment, immunoreactive neurons appeared
      diffusely in the whole CP and in the core part of the nucleus accumbens (Acb) and
      less frequently in the outer shell part of the Acb and the cell-dense layer of
      the tuberculum olfactorium (TuO). Increase of MEAGL-immunoreactive fibers in the
      CP, Acb, and TuO was also detected after these treatments, a particularly
      prominent increase being found in the striopallidal terminals in the globus
      pallidus and ventral pallidum. Haloperidol or haloperidol decanoate had no effect
      on MEAGL immunoreactivity in the cerebral cortex, amygdala, or hypothalamus.
      Reserpine treatment (5 mg/kg, IP, for 6 days) caused similar effects on the
      dorsal and ventral striopallidal system, and the direct injection of 6
      hydroxydopamine (10 micrograms/5 microliters) into the CP led to the appearance
      of MEAGL-immunoreactive neurons in accordance with the depleted dopaminergic
      terminal area. These findings suggest that haloperidol influences enkephalinergic
      neurons region specifically and that in the dorsal and ventral striopallidal
      enkephalinergic system haloperidol increases MEAGL immunoreactivity in cell
      bodies, fibers, and terminals by blocking intrastriatal dopaminergic
      neurotransmission.

PMID- 1617456
TI  - Electrophysiological properties of in vitro intrinsic cardiac neurons in the pig
      (Sus scrofa).
AB  - Physiological properties and synaptically mediated responses of 34 ganglionated
      plexus neurons from the right atrium of the pig heart were studied with in vitro
      intracellular recording techniques. Whole-cell input resistance of these neurons
      was lower, time constant was shorter, and threshold for directly evoked action
      potentials was higher than the same properties in extracardiac autonomic neurons.
      Long intracellular depolarizing current pulses (400-500 ms) failed to generate
      more than one or two action potentials. Nicotinic and non-nicotinic synapses were
      present on neurons in cardiac ganglia and neuronal properties could be modified
      by norepinephrine. Based on their physiological properties, cardiac ganglionated
      plexus neurons in the pig appear to represent a distinct population of autonomic
      neurons that may be capable of intracardiac integration of efferent information
      to the heart.

PMID- 1617457
TI  - Cerebral blood flow and metabolism in soman-induced convulsions.
AB  - Regional cerebral blood flow (CBF) and regional cerebral glucose utilization
      (CGU) were studied by quantitative autoradiographic techniques in rats. Animals
      were treated either with a toxic dose of soman, an irreversible organophosphorus
      cholinesterase inhibitor, that produced convulsions or with saline as controls.
      An increased arterial blood pressure (mean increase = 41% of control) always
      preceded onset of convulsions. Convulsive activity was associated with an
      increase of plasma glucose concentration and marked increases over controls of
      CGU [average of all regions: control = 75 +/- 5 mumol.100 g-1.min-1, n =
      regions/animals (304/8); seizures = 451 +/- 20 mumol.100 g-1.min-1, n = 190/5]
      and CBF [average of all regions: control = 135 +/- 6 ml.100 g-1.min-1, n = 190/5;
      seizures = 619 +/- 29 ml.100 g-1.min-1, n = 190/5). Regional distribution of
      these effects revealed a greater proportional increase of CBF over CGU in
      cingulate, motor, and occipital cortex and caudate-putamen. In contrast, a lower
      proportional increase of CBF over CGU in CA3 region of hippocampus, dentate
      gyrus, medial thalamus, and substantia nigra was observed, implying the existence
      of a relative ischemia in these brain areas. These findings may be relevant to
      the pathogenesis of brain lesions associated with soman-induced convulsions.

PMID- 1617458
TI  - Action of habenular efferents on ventral tegmental area neurons studied in vitro.
AB  - Action of habenular efferents on neurons of the ventral tegmental area (VTA) was
      studied with a slice preparation that preserved the habenula (Hb) and the VTA
      together with the interconnecting fiber bundle, the fasciculus retroflexus (FR).
      In the VTA, two types of neurons, presumably corresponding to the dopaminergic
      and nondopaminergic neurons, were discerned on the basis of the
      electrophysiological properties. Of 52 VTA neurons sampled, 42 [with the mean
      resting membrane potential of 56 +/- 7 mV (mean +/- SD)] responded with
      excitatory postsynaptic potentials (EPSPs) to FR stimulation. The EPSPs were
      monosynaptic in nature and rather weak in effect in the sense that they rarely
      triggered spikes. No significant differences in latency, duration, and time to
      peak were noted between the EPSPs generated in different types of neurons. FR
      stimulation evoked inhibitory postsynaptic potentials (IPSPs) in only six
      neurons, their resting membrane potential being 51 +/- 4 mV. The IPSPs frequently
      showed a fluctuation in latency. FR stimulation also produced antidromic
      responses in a few VTA neurons, but their long latencies precluded the
      possibility that the VTA-Hb projections contributed to the FR-evoked orthodromic
      responses in the VTA. EPSPs evoked by FR stimulation could be suppressed by
      kynurenic acid (1 mM). The findings indicate that the efferents of the Hb
      primarily have an excitatory effect on VTA neurons of any type and that the
      excitation may be mediated by amino acid receptors.

PMID- 1617460
TI  - Reevaluation of the plasticity in the rat supraoptic nucleus after chronic
      dehydration using immunogold for oxytocin and vasopressin at the ultrastructural
      level.
AB  - It has been shown that during physiological stimuli, such as dehydration,
      supraoptic nucleus (SON) neurons undergo profound morphological changes. However,
      little is known about how much each type of cell, oxytocin (OT) or vasopressin
      (VP), contributes to this plasticity during dehydration. Using postembedding
      immunogold cytochemistry for both OT and VP hormones at the electron microscopic
      level, we address this question. Rats were chronically dehydrated (given 2%
      saline to drink for 10 days) and their SON neurons were studied morphologically.
      The results were compared to control animals with free access to water. Both VP
      and OT somata showed an enlargement in size in dehydrated animals. Percentage of
      somasomatic/dendritic membrane contact increased significantly in both VP and OT
      neurons, with no significant changes in percentage of coverage of the cells by
      astrocytic membrane. Only the VP cells had a lesser amount of axosomatic membrane
      contact after dehydration, possibly due to an increase in cell size rather than a
      decrease in synaptic contact. Multiple synapses (MSs) (i.e., terminals that form
      more than one synapse with adjacent somata and or dendrites) occurred only
      between positively labeled cells and between negatively labeled cells, but not
      between positively and negatively labeled cells. The number of MSs per 100
      microns OT somatic membrane or per 100 OT cells was significantly higher in
      dehydrated rats but was unchanged with regard to VP neurons. These findings
      indicate that both VP and OT neurons undergo morphological changes during chronic
      dehydration and, thus, that plasticity is not limited to OT cells as some earlier
      reports have suggested.

PMID- 1617459
TI  - Microelectrophoretic application of kainic acid into the globus pallidus:
      disturbances in feeding behavior.
AB  - Body weight changes, food and water intake, and sensorimotor disturbances of male
      rats were studied after bilateral kainic acid-(KA) induced lesions of the globus
      pallidus (GP). To minimize the extent of damages, KA was applied
      electrophoretically by means of glass micropipettes (tip diameter of the pipettes
      was 10-15 microns). The neuron-specific damages of the GP resulted in aphagia and
      adipsia and rapid body weight decrease. Lesioned animals showed permanent motor
      disturbances but only temporary difficulties in the orientation toward sensory
      stimuli. Our data show that the selective destruction of the GP neurons results
      in a complex disorder that has motivational, (sensori)motor, and metabolic
      components.

PMID- 1617461
TI  - Effects of thyrotropin-releasing hormone, oxytocin, and prolactin on thiopenthal
      induced narcosis in rats.
AB  - Neuropeptides that may induce behavioral activation--thyrotropin-releasing
      hormone (TRH), oxytocin (OXY), and prolactin (PRL)--were tested on thiopenthal
      induced narcosis after IV administration in male rats. TRH caused a significant
      shortening of sleeping time at the doses of 3 and 5 mg/kg, but did not change
      this parameter at lower doses. Oxytocin was effective at all doses tested (200,
      300, and 400 micrograms/kg). Prolactin also shortened sleeping time at the doses
      of 0.2 and 1 mg/kg administered IV, slightly increasing it at the dose of 5
      mg/kg. These results indicate that various neuropeptides are capable of reducing
      the duration of thiopenthal-induced sleep in rats.

PMID- 1617463
TI  - Spike-train analysis reveals "overshoot" in developing rat prefrontal cortex
      function.
AB  - A multivariate analysis of spontaneous single neuron firing in the developing
      prefrontal cortex (PFC) of urethane anesthetized rats has been made using
      selected spike-train parameters. In particular, the development of modal
      interspike intervals closely paralleled the volumetric 'overshoot' reported
      earlier by us for rat PFC. Thus, the growth phase is characterized by
      progressively higher firing rates associated with longer modal intervals (i.e., a
      change from phasic to tonic firing, suggestive of increasingly effective
      inhibition). In contrast, the subsequent abrupt reduction in PFC volume is
      accompanied by the appearance of extremely short interspike intervals with no
      concomitant change in overall mean discharge rates ('burst' firing). This last
      development could be largely due to the 'pruning' of excessive excitatory
      synaptic contacts.

PMID- 1617462
TI  - Species differences in amphibian olfactory neuron reactivity to a monoclonal
      antibody.
AB  - A monoclonal antibody immunostained a subpopulation of olfactory sensory neurons
      in cryostat sections of the olfactory mucosa of the grass frog, Rana pipiens, and
      the bullfrog, Rana catesbeiana. However, in the olfactory tissues of the African
      clawed frog, Xenopus laevis, only mucus and mucus-secreting components were
      stained, and no cell-specific immunoreactivity was seen in the tiger salamander,
      Ambystoma tigrinum. This antibody is a useful marker of olfactory neuronal
      subpopulations in some amphibians and illustrates the difficulties in cross
      species immunocytochemistry.

PMID- 1617464
TI  - The effects of low pass filtering on central somatosensory conduction time.
AB  - Central Somatosensory conduction time (CSCT) in the rat was measured by
      simultaneously recording the cortical somatosensory evoked potential (SEP) and
      cervical SEP and then subtracting the peak latency of the cervical response from
      that of the primary cortical response. The low frequency (high pass) filter of
      the recording system was kept fixed at 3.2 Hz but the high frequency cut-off was
      progressively raised from 32 to 16 kHz to examine the effects of low pass
      filtering on the two waveforms from which CSCT is derived. With a bandpass of 3.2
      32 Hz, no activity could be reliably identified in either the cortical or
      cervical traces. With subsequent rises in the high frequency filter, the
      amplitude of both potentials increased with a concomitant decrease in their
      latencies. Stable values were obtained with a bandpass of 3.2-3.2 kHz and there
      was little additional change in waveform configuration. In contrast to the
      waveforms, low pass filtering had only minimal effects on CSCT and near constant
      values (in the range 3.6-4.1 ms) were obtained regardless of the setting of the
      low pass filter. I concluded that low pass filtering has a largely uniform effect
      on somatosensory activity generated in both primary cortical and cervico
      medullary locations.

PMID- 1617465
TI  - Immobility-reducing effects of antidepressants in a genetic animal model of
      depression.
AB  - Chronic treatment with the tricyclic antidepressants imipramine (15 mg/kg) and
      desmethylimipramine (5 mg/kg) significantly reduced the exaggerated immobility
      normally exhibited by the Flinders Sensitive Line (FSL) rats in the Forced Swim
      Test. The control group, Flinders Resistant Line (FRL) rats were only slightly
      affected. In contrast, chronic treatment with the anticholinesterase diisopropyl
      fluorophosphate at doses known to down regulate muscarinic receptors did not
      alter swim test immobility in either FSL or FRL rats. Our findings support the
      validity of the FSL rats as an animal model of depression and suggest that
      serotonergic and/or noradrenergic, but not cholinergic mechanisms, may underlie
      the exaggerated immobility of the FSL rats.

PMID- 1617466
TI  - Cocaine-induced suppression of renin secretion is mediated in the brain:
      investigation of cardiovascular and local anesthetic mechanisms.
AB  - Acute cocaine reduces renin secretion. To determine a peripheral versus central
      site of action, intracerebroventricular (ICV) versus intraperitoneal (IP)
      injections of cocaine were compared. Cocaine was more potent reducing plasma
      renin activity (PRA) and concentration (PRC) when injected ICV (0.050 mg/kg) than
      IP (5 mg/kg), suggesting a central site of action. Furthermore, addition of
      cocaine (10(-4) M) to kidney slices in vitro did not influence renin release,
      indicating that cocaine does not suppress renin secretion by acting directly in
      the kidney. We also investigated whether the hypertensive or local anesthetic
      properties of cocaine mediate its inhibition of renin secretion. Therefore, we
      compared the cardiovascular and endocrine effects of cocaine with those of the
      local anesthetic drug procaine. Both cocaine and procaine (500 micrograms/kg,
      ICV) produced rapid and short-term increases in blood pressure, but cocaine
      decreased PRC whereas procaine increased PRC. Intra-arterial (IA) and IP
      injections of cocaine also reduced PRC whereas procaine had no effect (IA) or
      elevated PRC (IP). Together, the data suggest that cocaine decreases renin
      secretion by acting in the brain. It is not likely that the cardiovascular or
      local anesthetic actions of cocaine are the main cause of its suppressive effect
      on renin secretion.

PMID- 1617467
TI  - Parenting stress and child maltreatment in drug-exposed children.
AB  - This study was conducted to examine the relationship between prenatal exposure to
      drugs and parenting stress and child maltreatment. The sample was comprised of 48
      subjects including 24 drug-exposed children and a comparison group of 24 non-drug
      exposed children matched on age, race, gender and socioeconomic status. The
      subjects' age ranged from 1 to 33 months with a mean of 13 months. As predicted,
      mothers who used drugs during pregnancy reported higher levels of stress than
      foster mothers and comparison mothers on total parenting stress, child related
      stress, and parent related stress as measured by the Parenting Stress Index
      (Abidin, 1990). Biological mothers and foster mothers of drug-exposed infants
      scored higher than comparisons on child-related stress, most notably in the areas
      of hyperactivity, distractability and adaptability. A strong association was
      found between maternal use of drugs and child maltreatment serious enough to
      necessitate removal of the children by CPS. Over 40% of the drug-exposed children
      were in foster care, most often with maternal grandmothers. Most mothers who used
      drugs during pregnancy were polysubstance abusers and 21% were intravenous drug
      users increasing the risk of HIV infection for mothers and children. Implications
      for intervention are discussed.

PMID- 1617468
TI  - Children's strategies for coping with adverse home environments: an
      interpretation using attachment theory.
AB  - The coping strategies of four groups of maltreated children were compared with
      those of adequately reared children. The children were videotaped in a brief play
      session with their mothers, then in the Strange Situation, and finally during
      free play while the parent(s) were being interviewed. The coded videotapes of
      mother-child interaction yielded four scores for the children: cooperation,
      compulsive compliance, difficultness, and passivity. The coded videotapes of the
      Strange Situation yielded ten patterns of child attachment to the mother. The
      coded observations of play during the interview were analyzed in terms of seven
      child behaviors. The results indicated that abused, and abused-and-neglected
      children were difficult or compliant in interaction with their mothers, avoidant
      under stress, and aggressive with siblings; neglected children were cooperative
      in play with the mother, anxious under stress, and aggressive with siblings;
      adequately reared children were cooperative with both their mothers and siblings
      and secure under stress. Older children who had experienced abuse were less
      difficult and more compulsively compliant. Both marginally maltreated and
      adequately reared 1-year-olds were more difficult than either older or younger
      children from those groups but at all ages cooperation was the dominant pattern.
      The coherencies in the children's coping strategies were interpreted in terms of
      underlying internal representational models of relationships.

PMID- 1617469
TI  - Early identification of maternal depression as a strategy in the prevention of
      child abuse.
AB  - Maternal suicide and infanticide are merely the extreme tip of the iceberg of
      psychological and social morbidity associated with post-partum depression.
      Despite research indicating an association between maternal depression and
      disturbed parent-child interaction, maternal depression has been largely ignored
      in the literature on child maltreatment and in child protection practice.
      Practitioners should be alert to the potential risks to the child associated with
      maternal depression. In cases where child abuse has occurred, they should
      consider the possibility that the mother is depressed and that this needs to be
      treated as a problem in its own right. In terms of prevention of child
      maltreatment, early identification of maternal depression is an important
      strategy in which primary health workers have an important role. This study
      investigates the feasibility of broadening the traditional infant health focus of
      the role of the Australian Maternal and Child Health Nurse or Public Health Nurse
      to encompass maternal emotional and social well-being. Using quantitative and
      qualitative methods, the conditions under which mothers would find this
      acceptable, and the factors that facilitate or constrain such role redefinition
      are analyzed.

PMID- 1617470
TI  - Professional attitudes regarding the sexual abuse of children: comparing police,
      child welfare and community mental health.
AB  - A survey was completed involving three of the key professional groups engaged in
      the investigation and treatment of child sexual abuse. Police, child welfare and
      community mental health in a large, rural geographic area in Canada completed
      attitudinal items relating to professional response to child sexual abuse. An
      empirical scale was created which was comprised of three orthogonal factors, each
      with acceptable levels of internal consistency: 1) Beliefs in regard to the
      extensiveness and seriousness of the issue; 2) treatment versus punishment
      priority; and 3) view regarding identity of those who perpetrate child sexual
      abuse. Important gender differences were found across professional groupings in
      attitude toward sexual abuse. Greatest difference in attitude between service
      sectors was tied to emphasis placed on treatment versus punishment as a primary
      aspect of professional intervention. Significant differences were found between
      child welfare and police, the two service sectors most needing a coordinated
      approach during the "investigative phase" of professional intervention.

PMID- 1617471
TI  - The ability of elementary school children to learn child sexual abuse prevention
      concepts.
AB  - This research was designed to address several of the methodological problems in
      the current body of knowledge on the efficacy of child abuse prevention programs
      for elementary school-aged children. A new measure, the Children's Knowledge of
      Abuse Questionnaire (C.K.A.Q.) was developed, and its psychometric properties
      assessed. In total, 400 children were tested in four groups. Half of the sample
      participated in a child abuse prevention program Touching, and the other half
      were in a waiting list control group. Half of each group were pretested, and the
      other half were not, in order to determine whether the pretesting sensitized the
      students. All children were tested again 5 months afterward to investigate the
      long-term retention of prevention concepts. Results showed that children who
      participated in the prevention program scored significantly higher on the
      C.K.A.Q. than children in the control condition. Age was a critical factor, with
      significant improvements as age increased between the kindergarten, Grade 1,
      Grade 3 and Grade 6 students. All participants maintained their level of
      knowledge after 5 months had passed. The relevance and practical implications
      which stem from this research are discussed.

PMID- 1617472
TI  - Child care workers' knowledge about reporting suspected child sexual abuse.
AB  - As reports of the sexual abuse of preschool-aged children increase and the number
      of children in day care expands, it is important to recognize child care workers
      as potentially important resource persons for sexually abused preschoolers.
      Although they are potential resources for abused children, they may fail to
      report suspected abuse if they do not know their legal responsibilities and their
      rights and protections under the law. The purpose of this study was to determine
      child care workers' knowledge about their reporting rights and responsibilities.
      Relative to child sexual abuse experts, day care personnel knew significantly
      less about the procedures for reporting suspected abuse and their protection
      under the law. Suggestions for improving child care workers' knowledge about
      reporting suspected sexual abuse cases are provided.

PMID- 1617473
TI  - Sexual abuse trauma among professional women: validating the Trauma Symptom
      Checklist-40 (TSC-40).
AB  - This study examines the usefulness of the Trauma Symptom Checklist (TSC-40) in
      measuring the long-term sequelae of sexual abuse. In a national survey of 2,963
      professional women, the TSC-40 was found to be reliable and to display predictive
      validity with regard to childhood sexual victimization. Women who reported a
      sexual abuse history scored significantly higher than did women with no history
      of abuse on each of the six subscales and on the overall TSC-40 score. Various
      aspects of childhood victimization were associated with the subscale scores, with
      the Sexual Abuse Trauma Index and Dissociation subscales being more sensitive to
      the specific components of the abuse.

PMID- 1617474
TI  - A retrospective study of long-term methods of coping with having been sexually
      abused during childhood.
AB  - Methods of coping with childhood sexual abuse were retrospectively studied in a
      community sample of 54 adult women who had been sexually abused in childhood.
      From the time the abuse ended until the present, "denial" and "emotional
      suppression" were the coping methods most commonly employed of the nine methods
      measured. One purpose of this study was to determine if the methods used to cope
      with the aftermath of being sexually abused during childhood were associated with
      current psychological adjustment beyond what could be predicted by the
      characteristics of the abusive experience per se. A partial correlation analysis
      and a multiple regression analysis suggested that avoidant/emotion suppressing
      coping strategies although frequently used and rated by subjects as helpful, were
      in fact associated with poorer adult psychological adjustment.

PMID- 1617475
TI  - Effects of older brother-younger sister incest: a study of the dynamics of 17
      cases.
AB  - The purpose of this study was to explore the effects of older brother-younger
      sister incest from the perspective of the women who experienced it in childhood
      or adolescent years. Dynamics in the families-of-origin were also explored, as
      these related or contributed to the effects from the incest. Seventeen women were
      interviewed, using an in-depth, semi-structured interview. Four self-report
      objective instruments were also administered that measure dynamics in the family
      of-origin and symptomatology that is often associated with the effects of trauma.
      Interview and objective data were analyzed by systematically organizing the
      women's perceptions and conceptualizations into common themes. All of the women's
      families of origin were described as dysfunctional. Common effects reported
      included mistrust of men and women, chronic low or negative self-esteem, sexual
      response difficulties, and intrusive thoughts of the incest. Women regarded
      individual therapy, talking with supportive family and friends, and validating
      themselves as victims at the time of the incest as ways in which they have helped
      themselves to deal with the effects of the incest. These results have important
      implications for therapy, including serious consideration of the impact and
      contribution of this kind of incest on reported symptomatology, and on emerging
      issues and conflicts in the therapeutic process.

PMID- 1617476
TI  - Use of anatomical dolls by Boston-area professionals.
AB  - Anatomical dolls are a widely used but controversial tool for interviewing child
      victims of sexual abuse. The present research examines how a representative
      sample of professionals who evaluate children actually use the dolls. Contrary to
      past reports, the results revealed that 96.6% of professionals who use the dolls
      had received training in anatomical doll use, 77.8% followed some standard
      protocol for interviewing, and 97.3% had at least 1 year of experience with
      anatomical dolls. The results also revealed that the majority of professionals
      did not engage in the "leading" behaviors of presenting unclothed dolls to
      children or undressing the dolls for the child, again contrary to past reports.
      The present research indicates that the professionals in this sample are more
      experienced and better trained than is typically thought.

PMID- 1617477
TI  - Relationships between perceived parental acceptance-rejection, psychological
      adjustment, and substance abuse among young adults.
AB  - This study examined the relationship between perceived parental acceptance
      rejection, psychological adjustment, and substance abuse. A volunteer sample of
      40 young adult substance abusers was compared to a comparable volunteer sample of
      40 nonabusers with respect to individuals' perceptions of paternal and maternal
      acceptance-rejection and psychological adjustment. Discriminant function analysis
      using the jackknife procedure was utilized to examine the predictive power and
      the classification accuracy of perceived parental acceptance-rejection and
      psychological adjustment. Results of the research show that: (a) Both perceived
      paternal and maternal rejection in childhood tend to be significantly higher
      among substance abusers than among nonabusers, and; (b) substance abusers are
      more impaired in their current psychological adjustment than are nonabusers.
      These two classes of predictor variables yield a correlation of .77 with group
      membership (i.e., abusers vs. nonabusers), and the three predictor variables
      successfully discriminate substance abusers from nonabusers with jackknifed
      classification accuracy of 87.5%. Adding the demographic variable "education
      level" to the model raises the jackknifed classification accuracy to 91.2%,
      yielding only seven misclassifications in the total sample of 80 volunteers.

PMID- 1617478
TI  - The youth protection program of the Boy Scouts of America.

PMID- 1617479
TI  - Anatomical doll play of preschooler referred for sexual abuse and those not
      referred.

PMID- 1617480
TI  - [Purification of lipase from latex of Euphorbia characias by an extraction method
      with apolar solvent].
AB  - A lipase from the latex of Euphorbia characias was purified using a new method
      involving extraction by apolar solvent and adsorption chromatography on silica.
      The lipase (specific activity 1,500 IU/mg of protein) was eluted from silica
      complexed with a lipid. The main proteic fraction, showing a molecular weight of
      38,000, was inactive when dissociated from the lipid fraction. It was necessary
      to reassociate the lipid and proteic fractions for 72% of the lipolytic activity
      to be recovered.

PMID- 1617482
TI  - Purchasers, providers and contracts--here to stay?

PMID- 1617481
TI  - [New data on a second endogenous molecular form of mammalian hypothalamic LHRH,
      (hydroxyproline 9) LHRH].
AB  - An endogenous hydroxylated form of LHRH, (Hyp) LHRH, is able to displace LHRH
      bound to pituitary membrane preparations. In parallel, it stimulates release of
      both LH and FSH from pituitary cells in primary culture. The potency ratio of
      (Hyp)LHRH is approximately 1:20 and 1:5 with respect to the native decapeptide
      when peptidasic degradation is or is not inhibited. This correlates with a
      greater resistance of (Hyp) LHRH towards enzymatic degradation; in contrast to
      LHRH, the C-terminal (residues 6 to 10) end of (Hyp) LHRH is not degraded and
      generates C-terminal fragments which account for 64% of the LHRH immunoreactivity
      in extrahypothalamic areas as the hippocampus. Besides its weak gonadotropin
      releasing activity and its action or its localization in peripheral organs
      (placenta, gonads), a major role of the hydroxylated decapeptide may thus be to
      serve as a precursor of smaller active fragments on targets other than pituitary
      receptors.

PMID- 1617483
TI  - Some social correlates with the dental health of young children.
AB  - A socio-dental investigation was carried out among 405 five-year-old school
      children living in a predominantly rural area of West Wales. Information was
      gathered from a clinical examination of the children and a questionnaire to their
      parents. The replies to the questionnaires were then cross-tabulated with the
      clinical findings. The results indicated that lower dmft values were positively
      associated with household ownership of a telephone and a car and a higher
      educational attainment by mothers. Mothers with a high level of anxiety about a
      dental visit and an expectation of eventual edentulousness tended to be the
      parents of the children with the highest level of untreated carious teeth. The
      importance of a family pattern of service use is also demonstrated.

PMID- 1617484
TI  - Preventive oral health related behaviour of dentally anxious schoolchildren aged
      13-14 years in Lothian, Scotland.
AB  - The aim of this study was to determine the self-reported preventive oral health
      related behaviours of dentally anxious schoolchildren. 1103 children participated
      in the study, mean age 14 years (SD 0.35 years), and the prevalence of high
      dental anxiety was 7.1 per cent (95 per cent confidence interval = 5.6 per cent,
      8.6 per cent). Children with high self reported dental anxiety were more likely
      to defer, cancel and or not attend dental appointments. In addition, for this
      group the last dental visit was more likely to be as a result of pain and less
      likely to have been for a dental examination only. Overall dentally anxious
      children did not help themselves by keeping their teeth clean. Fluorides were
      infrequently used by all the children, and only 12 per cent of all who
      participated in the study used fluoride supplements regularly. In this context it
      is not surprising that no differences in present or past use of fluoride
      supplements could be determined between high and low/moderate dental anxiety
      groups. The high dental anxiety group spend significantly more (median = 50p) on
      sweets per day and drank more cans of fizzy drinks (median = 2) compared with the
      low/moderate anxiety groups. These effects were significant after taking into
      account social class and gender differences. It was clear from the study that
      even when social class and gender are taken into account the children with high
      dental anxiety were not helped by their relatively poor attitudes towards
      preventing disease in their own mouths.

PMID- 1617485
TI  - Caries-risk-reducing effects of xylitol-containing chewing gum and tablets in
      confectionery workers in Finland.
AB  - Two-hundred and thirty-two workers who had taken part in a comprehensive study on
      occupational risks in the Finnish confectionery industry and who were still in
      the same employment, were tested for their willingness to use xylitol-containing
      products for caries prevention and for the effects of voluntary use of these
      products on their caries-promoting salivary characteristics. Xylitol-sorbitol
      chewing-gum and xylitol tablets were provided at the places of work for free use
      over a three-month period. The consumption was measured, the workers were asked
      for their opinions of the xylitol, and the effects of the products used on
      salivary characteristics were studied by means of a caries-risk index. Eighty-six
      per cent of the workers on the production lines reported having used xylitol
      containing products during the study period. About 70 per cent consumed on
      average either 6.9 pieces of chewing-gum (range 0-20) or 1.2 tablets (range 0-15)
      per day. Eighty-one per cent thought that use of xylitol was good for their
      dental health. Five per cent thought the opposite. Use of xylitol-containing
      products was found to increase salivary flow and salivary buffer capacity of the
      subjects. A decrease in the number of workers with high salivary S. mutans count
      was observed. On examining shifts from risk groups to non-risk groups, a
      statistically significant positive change was noted. The results indicate that an
      ordinary commercial xylitol-containing chewing-gum can be used to decrease caries
      risk factors in confectionery workers.

PMID- 1617486
TI  - Prediction of costs in a selective caries prevention programme.
AB  - A method is proposed for the prediction of the costs of a selective caries
      prevention programme; that is one where preventive treatment is given only to
      individuals who have been classified as at high risk of caries. A person so
      identified may be correctly classified as "high risk" or misclassified as "low
      risk". Similarly, a person at low risk may be correctly classified or
      misclassified as high risk. Therefore costs have to be calculated for each of the
      four situations, and expected frequencies of all four possible classifications
      have to be taken into account. After the identification of a logistic regression
      model which permits the prediction of whether a child will experience a high
      caries increment, sensitivity (SN) and specificity (SP) can be calculated for a
      set of different decision rules (critical scores, cutpoints or cut-off points
      Pcp). An example is presented in detail to demonstrate how the expected costs
      etc. for a specified prevention programme can be calculated without additional
      effort. The plotting of SN, SP and measures of costs as functions of Pcp permits
      the anticipation of expected effects of a caries prevention programme and helps
      to choose the appropriate cutpoint. Such plots may be helpful when comparing
      different caries prevention programmes and when deciding whether such a programme
      should be started.

PMID- 1617487
TI  - Assessment of orthodontic treatment needs by teenagers in an Asian community in
      Singapore.
AB  - The purpose of this study was to determine (1) the preference of dental occlusion
      types among teenagers, and (2) their assessment of the necessity for orthodontic
      treatment. A total of 1189 teenagers (mean age 15.3 +/- 3.2 years) were asked to
      rank a series of colour photographs of seven occlusion types. Their ranking, in
      descending order of attractiveness, were as follows: Class I occlusion, anterior
      open bite, Class III occlusion, Class II occlusion, anterior spacing, anterior
      crowding and deep bite occlusion. The perceived need for treatment was found to
      be inversely correlated with the rank order of attractiveness. There appeared to
      be no statistical difference (P less than 0.05) in the perception for treatment
      among different racial and income groups. However, with the exception of anterior
      open bite and deep overbite occlusions, a statistically significant (P less than
      0.05) greater number of females than males perceived a need for treatment.
      Assessment of occlusal disharmonies among teenagers could provide clinicians and
      health care personnel with an indication of the relative attractiveness among
      occlusion types and hence the establishment of treatment priorities.

PMID- 1617490
TI  - Heritage and dentistry: a comparative analysis of the cultural determinants of
      professional status.

PMID- 1617489
TI  - Dentistry in Japan.

PMID- 1617491
TI  - Information needs for monitoring dental health and for planning local dental
      services.
AB  - The working party was established by the Council of The British Association for
      the Study of Community Dentistry in response to health circular HC(89)2 and its
      equivalents in areas other than England, to consider the information necessary to
      monitor the dental health of adult populations and for planning local dental
      services. Recommendations are made as to the type of information required and its
      availability. A key issue is the definition of local geographical units suitable
      for planning purpose. Effective collaboration between District Health Authorities
      and Family Health Services Authorities is essential in achieving in agreed
      approach which is the foundation of a comprehensive information system.
      Information for monitoring the dental health of the population and for planning
      dental services should include data on local demography, the needs, demands and
      expectations of the population, the local availability of dental services and the
      distribution of facilities, and the activity of dentists and the uptake of dental
      care. It is the view of the working party that much useful information about
      adult dental health can be obtained from the use of self-reporting questionnaires
      and that clinical examinations are not generally required. However there are
      circumstances which may justify the collection of clinical data and it is
      desirable that such studies are conducted in a manner which permits comparisons.
      Criteria for the standardised clinical assessment of adult dental health have
      been prepared and it is recommended that these are adopted for general use.
      Further research is required to test and validate appropriate questions for
      inclusion in self reporting studies. This should lead to the selection of a set
      of core questions which can be widely used to allow local and regional
      comparisons of adult dental health.

PMID- 1617488
TI  - Knowledge of AIDS and HIV infection displayed by Tanzanian operating dental staff
      in 1988 and 1989: a follow-up study.
AB  - In many urban areas of Central and Eastern Africa 20-30 per cent of the sexually
      active population has been infected with HIV. It can be assumed that every member
      of the operating dental staff in Tanzania frequently treats HIV-positive
      patients. The knowledge of AIDS and HIV infection was investigated by Tanzanian
      dental teams in 1988 and 1989. In both years almost one quarter of the dental
      officers and half the other operating team members chose incorrect information
      about the methods of transmission of HIV. Several respondents named health care
      workers as belonging to a high risk group. Fever and loss of weight were known to
      be early symptoms of AIDS. In 1989, when asked to identify oral manifestations of
      HIV, one quarter of all the dental staff could not mention any of them. The
      findings of the study emphasise the need for urgent further education of dental
      teams in Tanzania.

PMID- 1617493
TI  - A comparison of two dual-energy X-ray absorptiometry systems for spinal bone
      mineral measurement.
AB  - Two dual-energy X-ray absorptiometry (DEXA) systems--the Hologic QDR-1000 and the
      Norland XR-26 bone densitometers--were evaluated in terms of precision, accuracy,
      linearity of response, X-ray exposure, and correlation of in vivo spinal
      measurements. In vitro precision and accuracy studies were performed using the
      Hologic anthropomorphic spine phantom; linearity of response was determined with
      increasing thicknesses of aluminum slabs and concentrations of Tums E-X in a
      constant-level water bath. Both systems were comparable in precision, achieving
      coefficients of variation (CVs) of less than 1% in bone mineral content (BMC, g),
      bone area (cm2), and bone mineral density (BMD, g/cm2). Both were accurate in
      their determination of BMC, bone area, and BMD with reference to the Hologic
      spine phantom. Both systems also showed good BMC and BMD linearity of response.
      Measured X-ray skin surface exposures for the Hologic and the Norland systems
      were 3.11 and 3.02 mR, respectively. In vivo spinal measurements (n = 65) on the
      systems were highly correlated (BMC: r = 0.993, SEE = 1.770 g; area: r = 0.984,
      SEE = 1.713 cm2; BMD: r = 0.990, SEE = 0.028 g/cm2). In conclusion, both systems
      are comparable in terms of precision, accuracy, linearity of response, and
      exposure efficiency.

PMID- 1617492
TI  - Cytokines, hematopoiesis, osteoclastogenesis, and estrogens.

PMID- 1617494
TI  - Bioavailability of fluoride in postmenopausal women: comparative study between
      sodium fluoride and disodium monofluorophosphate-calcium carbonate.
AB  - Fluoride (F) increases trabecular bone mass and can be used in the treatment of
      osteoporosis with crush fractures. As the bioavailability of sodium fluoride
      (NaF) can be impaired by concomitant absorption of calcium, both drugs have to be
      ingested separately. However, disodium monofluorophosphate-calcium carbonate (MFP
      Ca), another F compound, allows a single administration. In a cross-over
      randomized study, we compared the bioavailability of both drugs under regular
      conditions of prescription. Ten postmenopausal women (aged 48-77 years) with
      glomerular filtration rate (GFR) greater than 70 ml/minute and without bone
      disease entered the study. Each received 25 mg of NaF [i.e., 11.3 mg F ion (F-)]
      fasting and 100 mg of Na2FPO3-1250 mg CaCO3 (i.e., 13.2 mg F-) with breakfast in
      a single dose separated by an 8-day washout. After dosing, plasma F levels and
      fractionated and total urinary F collection were determined during a 24-hour
      period using a specific electrode. Results show a significant shorter lag time
      absorption (Tmax = 1.4 +/- 0.2 hour) and a higher maximal concentration (Cmax =
      260 +/- 60 ng/ml) for MFP-Ca than for NaF (Tmax = 2.5 +/- 0.4 hour; Cmax = 200 +/
      85 ng/ml). However, areas under curve (AUC) for MFP-Ca (1711 +/- 195
      micrograms/liter/hour) and for NaF (1202 +/- 147 micrograms/liter/hour) were not
      significantly different. The relative bioavailability of both F compounds related
      to their fluoride content (i.e., 1.22 for AUC ratio) was equivalent, according to
      the Westlake method. These data provide the first evidence of comparable
      bioavailability of two F compounds in a population of postmenopausal
      women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617495
TI  - Effects of combined and separate intermittent administration of low-dose human
      parathyroid hormone fragment (1-34) and 17 beta-estradiol on bone
      histomorphometry in ovariectomized rats with established osteopenia.
AB  - To evaluate the potential use of a combination of parathyroid hormone (PTH) and
      estrogen as therapy for osteoporosis, we examined the effects of combined and
      separate administration of low-dose PTH and estradiol in ovariectomized rats with
      established osteopenia. Ovariectomized rats were untreated for 5 weeks after
      surgery and then injected s.c. with vehicle (Ovx + V), 1-34 hPTH (2.5
      micrograms/kg/day) (Ovx + P), 17 beta-estradiol (50 micrograms/kg/day) (Ovx + E),
      or a combination of these (Ovx + P + E), for a further 4 weeks. We found no
      differences in serum calcium, tubular reabsorption of phosphate, or 25OHD.
      1,25(OH)2D levels were significantly higher in Ovx + P and lower in Ovx + E, when
      compared with Ovx + V. Though there was no change in bone mineral density (BMD)
      in the diaphysis region of femurs, reduction of BMD in the distal region of the
      femurs in Ovx + V was reversed in Ovx + E and Ovx + P + E. Compared with Ovx + V,
      Ovx + P and Ovx + P + E had significantly higher cancellous bone volume (Cn
      BV/TV) whereas Ovx + E showed a nonsignificant increase. When indices of bone
      turnover were examined, PTH alone showed a small but not significant improvement
      in bone formation rate (BFR). Increased osteoclast surface (OCS), as the result
      of ovariectomy, was inhibited in Ovx + E and Ovx + P + E. Estrogen alone (Ovx +
      E) severely inhibited BFR, but co-administration of PTH and estrogen (Ovx + P +
      E) showed an impressive reversal of such inhibition.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1617496
TI  - Regulation of bone turnover and prevention of bone atrophy in ovariectomized
      beagle dogs by the administration of 24R,25(OH)2D3.
AB  - In order to determine whether the administration of 24R,25(OH)2D3 had any
      beneficial effect on the regulation of bone turnover and the prevention of bone
      atrophy, we examined beagles for 31 months after ovariectomy (OVX). Fourteen
      beagle dogs (8.54 +/- 1.22 kg body wt-b.w.) were divided into four groups. Group
      1 (n = 3) was the sham, and Group 2 (n = 3) served as the OVX control. In Group 3
      (n = 4) and Group 4 (n = 4), 24,25-dihydroxyvitamin D3(24R,25(OH)2D3) was given
      daily at dose levels of 2 and 10 mcg/kg B.W., respectively. In Group 4, the dose
      level was increased to 100 mcg/kg by 17 months. During the experiments, urinary
      hydroxyproline (U-HPr), serum chemistry, serum bone gla-protein (BGP), and
      vitamin D metabolite levels were monitored. At the end of the experiment, bone
      mineral content (BMC) in the 6th and 7th lumbar vertebrae and right femur was
      determined by single photon absorptiometry. The left iliac bone sample was
      obtained after tetracycline labeling, and undecalcified sections were observed.
      In Group 2, excretion of U-HPr increased after OVX and had reached a level of
      approximately twice the baseline values by 10 months; then it gradually came down
      to the original level. In Group 3, however, U-HPr excretion remained at the same
      level as the baseline value, as it did in Group 1. In Group 4, it was remarkably
      reduced down to 50-60% of the baseline values. Serum BGP level was markedly
      reduced in Group 4. Serum 24,25(OH)2D levels were markedly increased in Groups 3
      and 4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617497
TI  - Vitamin D metabolites prevent vertebral osteopenia in ovariectomized rats.
AB  - The present study investigated the prophylactic effects of vitamin D metabolites
      and vitamin D metabolite combinations on static and dynamic, tetracycline-based,
      histomorphometric parameters in the axial skeleton of ovariectomized rats. Forty
      three Fischer-344 rats (10 weeks old, 130 g each body weight, BW) were either
      bilaterally ovariectomized (OVX) or sham-operated (SHAM). The rats were allocated
      into the following groups: SHAM; OVX; OVX + 7.5 ng 1 alpha,25-dihydroxyvitamin D3
      [1,25(OH)2D3]/rat/day; OVX + 15 ng 1 alpha,24R,25-trihydroxyvitamin D3 [1,24,25
      (OH)3D3]/rat/day; OVX + 75 ng 24R,25-dihydroxyvitamin D3 [24,25(OH)2D3]/rat/day;
      OVX + 7.5 ng 1,25(OH)2D3/rat/day + 15 ng 1,24,25(OH)3D3/rat/day; OVX + 7.5 ng
      1,25(OH)2D3/rat/day + 75 ng 24,25(OH)2D3/rat/day. The vitamin D metabolites were
      fed orally starting 4 weeks after surgery. Urine and blood samples were collected
      12 and 16 weeks postovariectomy, respectively. Sixteen weeks after surgery, all
      rats were sacrificed, and the first lumbar vertebrae were processed undecalcified
      for histomorphometric analysis. Ovariectomy induced a highly significant
      reduction (P less than 0.001) of cancellous bone mass in the secondary spongiosa
      of the lumbar vertebral body. The bone loss in OVX rats was accompanied by a
      distinct elevation of all histomorphometric parameters of bone formation and
      resorption. 1,25(OH)2D3 and both vitamin D metabolite combinations significantly
      raised serum calcium levels and prevented the bone loss by inhibiting the
      increased bone resorption in OVX rats. In the applied dosage, 1,24,25(OH)3D3 and
      24,25(OH)2D3 alone were ineffective in preserving the cancellous bone of the
      lumbar vertebra in OVX rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617498
TI  - Development of monoclonal antibodies to parathyroid hormone-induced resorptive
      factors from osteoblast-like cells.
AB  - Parathyroid hormone (PTH) induces osteoblast-like cells to secrete factors
      capable of increasing cellular bone resorption; these factors are extremely
      labile. We have partially isolated them from supernatants of PTH-stimulated ROS
      17.2 cells using affinity chromatography. Products eluted from the matrix,
      carboxymethyl cellulose covalently linked to Cibacron Blue F3GA, (CM-AB) were
      used as immunogens in mice. Serum from these mice blocked the effect of PTH
      stimulated supernatants in a bioassay for bone resorption (the bone rudiment
      system). Then, hybridomas were produced from spleen cells of these mice.
      Screening of these hybridoma cultures revealed a consistent blocking effect of
      supernatants at a dilution of 1:100 in the bioassay. At higher dilution (1:1000),
      however, fewer culture supernatants blocked this effect in the bioassay. Mixed
      hybridoma cultures have been cloned and subcloned. Evaluation of the resulting
      hybridoma supernatants revealed that supernatants from at least three clones were
      necessary to neutralize the effect of the PTH-induced, osteoblast-produced
      resorption factors in organ culture. Similarly, using sucrose density gradient
      analysis, it is necessary to use three antibodies to bind all the 35S-labeled
      protein from supernatants of PTH-stimulated ROS cultures (equivalent to the
      fraction used as immunogen in the mice). The effect of PTH in organ culture is
      blocked by this same group of hybridoma supernatants. The antibodies appear
      specific for osteoblast-like cell resorption factors, as they do not block the
      effect of PTH on cAMP accumulation in ROS cell cultures. On the other hand, they
      do block the effects of dibutyryl cAMP on resorption in organ culture.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1617499
TI  - Effects of long-term daily administration of prostaglandin-E2 on maintaining
      elevated proximal tibial metaphyseal cancellous bone mass in male rats.
AB  - The effects of long-term prostaglandin E2 (PGE2) on cancellous bone in proximal
      tibial metaphysis were studied in 7-month-old male Sprague-Dawley rats given
      daily subcutaneous injections of 0, 1, 3, and 6 mg PGE2/kg/day and sacrificed
      after 60, 120, and 180 days. Histomorphometric analyses were performed on double
      fluorescent-labeled undecalcified bone specimens. After 60 days of treatment,
      PGE2 produced diffusely labeled trabecular bone area, increased trabecular bone
      area, eroded and labeled trabecular perimeter, mineral apposition rate, and bone
      formation rate at all dose levels when compared with age-matched controls. In
      rats given PGE2 for longer time periods (120 and 180 days), trabecular bone area,
      diffusely labeled trabecular bone area, labeled perimeter, mineral apposition,
      and bone formation rates were sustained at the elevated levels achieved earlier
      at 60-day treatment. The eroded perimeter continued to increase until 120 days,
      then plateau. The observation that continuous systemic PGE2 administration to
      adult male rats elevated metaphyseal cancellous bone mass to 3.5-fold of the
      control level within 60 days and maintained it for another 120 days indicates
      that the powerful skeletal anabolic effects of PGE2 can be sustained with
      continuous administration.

PMID- 1617500
TI  - Effect of different phospholipid-cholesterol membrane compositions on liposome
      mediated formation of calcium phosphates.
AB  - The present report compares the effects of different membrane phospholipid (PL)
      cholesterol compositions on the kinetics of liposome-mediated formation of
      calcium phosphates from metastable solutions (2.25 mM CaCl2; 1.5 mM KH2PO4) at 22
      degrees C, pH 7.4 and 240 mOsm. In most experiments, the liposomes were composed
      of 7:2:X mixtures of phosphatidylcholine (PC), neutral or acidic phospholipids,
      and cholesterol (Chol, X = 0, 10, 35, or 50 mol%). The neutral phospholipids
      (NPL) examined, in addition to PC, were phosphatidylethanolamine (PE) and
      sphingomyelin (Sph), and the acidic phospholipids (APL) examined were
      dicetylphosphate (DCP), dioleolylphosphatidylglycerol (DOPG),
      dioleolylphosphatidic acid (DOPA), phosphatidylserine (PS) and
      phosphatidylinositol (PI). The 7:2:X liposomes did not initiate mineralization in
      metasable external solutions per se or, with the exception of DOPA, show
      extensive Ca-PL binding. However, solution Ca2+ losses due to precipitation
      occurred when the liposomes were encapsulated with 50 mM KH2PO4 and made
      permeable to external Ca2+ with X-537A. The extent of these Ca2+ losses was
      sensitive to both the phospholipid and Chol makeup of the membrane. Moderate-to
      extensive intraliposomal precipitation occurred in all 7PC:2APL and 7PC:2NPL
      liposomes containing 0 or 10 mol% Chol. In contrast, at 50 mol% Chol,
      mineralization inside all liposomes was negligible. The only significant
      discriminating effect on internal mineralization among the different
      phospholipids was observed at 35 mol% Chol, where mineral accumulations ranged
      from negligible to moderate. At 0 or 10 mol% Chol, extraliposomal precipitation
      was extensive in all but DOPA- and PS-containing liposomes.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1617501
TI  - Liposome interactions with hydroxyapatite crystals: a possible mechanism in the
      calcification of atherosclerotic plaques.
AB  - Some stages in the calcification of atherosclerotic plaques may involve
      associations between lipids and hydroxyapatite (HA) by surface interactions.
      Liposomes, artificial membranous lipid vesicles, have been used in this study as
      model structures for biological calcification processes. Liposome (containing
      cholesterol and phosphatidylcholine in most cases) suspensions were prepared by
      sonication, after which HA seed crystals were added to the suspensions and
      stirred at 37 degrees C. Aliquots of the liposome suspensions were analyzed for
      particle size distribution and by transmission electron microscopy and electron
      diffraction. The results showed that HA induced aggregation of liposomes and
      modifications of the microscopic shapes of the liposomes in the aggregates. These
      data can be explained by the electron diffraction pattern where superimposition
      of liposome reflection and crystal reflection exists and may suggest organic
      inorganic interaction. The potential of HA crystals to induce formation of
      liposome aggregates may be seen as a step in atherosclerotic plaques
      calcification.

PMID- 1617502
TI  - Changes in the solubility of enamel mineral at various stages of porcine
      amelogenesis.
AB  - The solubility of enamel mineral (a carbonated apatite) formed at various stages
      of porcine amelogenesis was investigated at controlled partial pressures of CO2.
      Enamel samples were obtained from the outer (young) secretory, inner (old)
      secretory, early (soft) and late (hard) mature enamel of the permanent dentition
      of slaughtered piglets. The dissected enamel was pulverized and subjected to a
      plasma ashing at low temperature to remove organic matter. The composition (Ca,
      total P, HPO4, and CO3) of the enamel mineral was determined chemically. The
      enamel mineral contained significant amounts of carbonate and acid phosphate; the
      model adopted for its stoichiometry was [Ca]5-x [HPO4]v[CO3]w[PO4]3-x[OH]1-x.
      Each enamel sample was equilibrated in dilute phosphoric acid solutions (0.01-1.2
      mM) under Pco2 = 1.86 and 1.75%. Equilibration of the enamel samples usually took
      20-25 days; the solution composition (pH, concentrations of Ca, P, Mg, Na, and K,
      and activity of Ca2+) was determined periodically. The composition of the
      solution at equilibrium showed that (1) the outer (younger) secretory mineral was
      the most soluble and the solubility of enamel mineral decreased with advancing
      developmental stages; (2) the mean activity product in the saturated solutions
      for the outer secretory enamel was the same as that calculated on the basis of
      the reported composition of the enamel fluid; and (3) the solubility data
      obtained with most of the enamel samples were consistent with a model in which
      the equilibration includes two processes: dissolution of the original enamel
      mineral and precipitation of a new carbonatoapatite. Analyses of the equilibrated
      samples, particularly the mature enamel, by electron microscopy, supported the
      precipitation of carbonatoapatite.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617503
TI  - Localization of malachite green positive lipids in the matrix of bone nodule
      formed in vitro.
AB  - An electron histochemical study was carried out on bone nodules formed in vitro
      in collagenase-released calvarial cells in order to visualize the lipid
      components of the extracellular matrix (EM). The malachite green aldehyde
      fixative technique, which allows both preservation and staining of some
      phospholipids of the extracellular matrix, was used. Controls were performed on
      sections demineralized, and then submitted to lipid extraction with a
      chloroformmethanol mixture (2/1 v/v) and to glycosaminoglycans digestion with
      0.5% bovine testicular hyaluronidase to verify specificity for lipid staining.
      This allowed us to visualize the lipids (1) in the osteoid as granules associated
      to ribbon-like structures connected to the collagen fibers, (2) as electrondense
      deposits seen as dots on the outer surface membrane of the matrix vesicles, and
      (3) in the mineralized matrix as roundish patches formed of needle-shaped
      materials and at the mineralization front as individual ones. This study
      demonstrated that at the EM level, the lipids are present in the osteoid at
      locations very similar to what have been observed for the glycosaminoglycans, and
      in the mineralized matrix as components of the crystal ghosts.

PMID- 1617504
TI  - The role of morphogens in endochondral ossification.
AB  - The formation of bone occurs normally by one of two developmental processes:
      intramembranous or endochondral ossification. Endochondral ossification occurs in
      the morphogenesis of the limb buds and growth plates, and in the regeneration of
      bone following injury (fracture callus). Two classes of diffusible morphogen-like
      molecules (MLMs) involved in limb development are the bone morphogenetic proteins
      (BMPs) and retinoic acid (RA). These MLMs are associated, respectively, with the
      apical ectodermal ridge (AER) and the zone of polarizing activity (ZPA) of the
      primitive limb bud. They function as potent regulators of pattern formation and
      are involved in tissue proliferation and differentiation. The presence of
      endochondral ossification in fracture callus suggests a role for MLMs in that
      process as well. To date, virtually nothing is known about the role of morphogens
      in the regeneration of bone (fracture healing). In this article, we review the
      current knowledge of MLMs in bone formation and propose a theory on their role in
      fracture healing. We hypothesize that MLMs involved in fracture healing may also
      express spatial and temporal information. A more complete understanding of the
      role of morphogens in both limb development and fracture healing is of major
      importance to practicing orthopedists and their patients.

PMID- 1617505
TI  - Measurement of bone cell metabolism in vitro using mass spectrometry.
AB  - The metabolism of bone cells can be monitored directly and continuously 'in
      vitro' by a new technique, based on mass spectrometry. The consumption of oxygen
      and production of carbon dioxide were measured in 6 different cultures of human
      bone cells. The method was feasible for measurement of bone cell metabolism and
      was also tested in suspensions of hepatocytes. The data obtained with these cells
      were comparable to results obtained with traditional techniques, and a relation
      to cellular concentration was demonstrated.

PMID- 1617506
TI  - Etiology of Paget's disease of bone: a new perspective.

PMID- 1617507
TI  - Exercise and cardiovascular health.

PMID- 1617508
TI  - Coronary thrombolysis--persisting uncertainties about optimal regimens and
      patient selection.
AB  - A tremendous body of excellent clinical trial data has provided clinicians with a
      clear rationale for the use of several thrombolytic agents for patients with
      acute myocardial infarction. Efficacy over a considerable range of circumstances
      and patient characteristics has been demonstrated. Nevertheless, many
      uncertainties remain and are being addressed in further clinical trials. Economic
      analyses of interventions shown to have clinical efficacy should assist health
      care planners in decisions as to which of these interventions may be justified
      expenses as the demands upon the health care dollar increase.

PMID- 1617509
TI  - Potential cost effectiveness of intravenous tissue plasminogen activator versus
      streptokinase for acute myocardial infarction.
AB  - OBJECTIVE: An economic evaluation of the potential incremental benefits of
      intravenous tissue plasminogen activator (tPA) versus streptokinase (SK) for
      treatment of acute myocardial infarction. DESIGN: Cost effectiveness analysis
      from a third-party payer perspective (Ontario Ministry of Health). ECONOMIC
      INPUTS: Fully allocated costs for cardiovascular procedures and hospitalization
      for myocardial infarction were obtained anonymously for four Ontario teaching
      hospitals and converted to 1988 Canadian dollars. Professional charges were taken
      from the provincial health insurance fee schedule and drug costs obtained from
      the manufacturers. CLINICAL INPUTS: The baseline analysis was for nonelderly
      patients with uncomplicated myocardial infarctions; sensitivity analyses allowed
      extrapolation to higher risk subgroups. Short and longer term mortality and short
      term invasive procedure rates were estimated using data from clinical trials.
      MAIN RESULTS: If tPA achieves a 1% short term mortality advantage over SK with no
      advantages for other survivors, cost per life-year gained can be comparable to
      other cardiovascular interventions at $58,600. In the absence of immediate
      survival advantages, but assuming greater left ventricular preservation, the
      constant annual hazard rate advantage must be about 0.5% per year for competitive
      cost effectiveness ratios. CONCLUSIONS: A full range of projections is presented
      to help guide the policy decisions that will arise in the wake of the Global
      Utilization of SK and tPA for Occluded Coronary Arteries (GUSTO) trial. The
      analysis also illustrates the general importance of considering longer term
      effects of in-hospital therapies for acute myocardial infarction.

PMID- 1617510
TI  - Effects of a fish oil supplement on blood pressure and serum lipids in patients
      treated for coronary artery disease.
AB  - OBJECTIVE: The purpose of this study was to evaluate the effects of a concentrate
      of fish oil on blood pressure and serum lipids in patients treated for coronary
      artery disease. DESIGN: One hundred and twenty-five patients were randomly
      assigned to receive 15 g/day MaxEPA (4.5 g eicosapentaenoic and docosahexaenoic
      acids) or olive oil. Blood pressure and serum lipids were measured at enrollment
      and six months thereafter. MAIN RESULTS: As an important proportion of
      antihypertensive or antianginal drug users stopped their usual medication during
      the trial, blood pressure increased in both groups. The increase in systolic
      blood pressure was less in the fish oil group than in the control group (P =
      0.002). Serum triglyceride levels decreased markedly in the fish oil group while
      they remained constant in the control group (P = 0.0001). Fish oil
      supplementation had no effect on total cholesterol and only marginal independent
      influence on high density lipoprotein and low density lipoprotein cholesterol
      levels. CONCLUSIONS: In conclusion, fish oil supplementation has a beneficial
      effect on blood pressure and serum triglycerides in patients treated for coronary
      artery disease.

PMID- 1617511
TI  - Pheochromocytoma: an unusual presentation and sequela.
AB  - A 40-year-old male presenting with exercise-induced headaches was found to have a
      pheochromocytoma which was subsequently removed. His blood pressure was never
      recorded as elevated. He went on to develop recurrence of asthma, which had been
      absent for at least 20 years, 48 h postoperatively. This is the first case of
      pheochromocytoma manifesting as exercise-induced headache in the absence of
      detectable hypertension.

PMID- 1617512
TI  - [Sudden death in leukemic patients treated with doxorubicin].
AB  - Cardiotoxicity of the anthracycline antineoplastic drugs is well known,
      especially the chronic effects, manifested mainly as congestive heart failure.
      Fewer reports have been published about the acute cardiotoxicity of these
      medications, and risk factors associated with their use. Two cases of malignant
      arrhythmias leading to sudden death associated with severe hypokalemia are
      reported. These cases suggest a synergistic effect between anthracyclines and
      electrolyte disorders resulting in the acute cardiotoxicity of these drugs. The
      administration of these antineoplastic drugs should include regular and
      systematic control of serum electrolytes and correction of hypokalemia during
      treatment.

PMID- 1617513
TI  - Left ventricular mural bacterial endocarditis: diagnosis by transesophageal
      echocardiography.
AB  - An unusual case of staphylococcal endocarditis with a vegetation attached to the
      left ventricular myocardium is described. No valvular vegetations are present.
      The diagnosis was made by transesophageal echocardiography. The patient had no
      chronic debilitating disease, nor was she immunosuppressed.

PMID- 1617514
TI  - The cellular electropharmacology of mexiletine in papillary muscles of guinea
      pigs chronically treated with amiodarone.
AB  - OBJECTIVE: The combination of mexiletine and amiodarone has proved useful in the
      control of serious ventricular arrhythmias, but the electrophysiological basis
      for their effectiveness in combination is unknown. The objective of this study
      was to compare the effects of mexiletine on action potential parameters of
      papillary muscles taken from guinea pigs chronically treated with amiodarone,
      with tissue taken from a control group. DESIGN: The effects of 12.5 to 200 microM
      mexiletine on action potential parameters of papillary muscles taken from guinea
      pigs chronically treated with amiodarone were compared with tissue taken from a
      control group, at frequencies of 1.0, 1.5 and 3.0 Hz, using standard
      microelectrode techniques. Onset of use-dependent block was assessed by 30 beat
      trains, and recovery from block by extrastimuli at diastolic intervals ranging
      from 200 to 5000 ms at both 1.5 and 3.0 Hz. ANIMALS: Eighteen four-week-old
      guinea pigs were randomly divided into two groups. One group received amiodarone
      in a loading dose of 20 mg/kg/day by intraperitoneal injection for one week,
      followed by 10 mg/kg/day for 15 weeks. The control animals were given equivalent
      volumes of dextrose intraperitoneally for 16 weeks. MAIN RESULTS: Mexiletine
      depressed the maximum rate of depolarization of phase 0 of the action potential
      (Vmax) in a concentration- and use-dependent fashion. Whereas chronic amiodarone
      treatment did not alter steady-state Vmax values, the extent of tonic Vmax
      depression induced by mexiletine was decreased, while use-dependent depression
      was increased. Mexiletine combined with amiodarone increased effective refractory
      period prolongation from 306.7 +/- 27.2 to 348.8 +/- 37.2 ms, while action
      potential duration shortening of mexiletine was moderated from 134.0 +/- 19.8 to
      151.0 +/- 8.3 ms (to 90% repolarization at 3 Hz in the presence of 200 microM
      mexiletine).

PMID- 1617515
TI  - "Not on the outward appearance .... but on the heart." Matthew Baillie and
      cardiology.
AB  - The work of Matthew Baillie (1761-1823), pathologist and physician, is presented
      with particular relation to the cardiovascular system. Baillie wrote the first
      systematic textbook of morbid anatomy in the English (or any other) language, and
      commissioned a book of elegant and accurate illustrations by William Clift (1775
      1849). Baillie laid down the anatomical groundwork on which the subsequent
      generation of physicians built an accurate knowledge of cardiovascular disease.
      His textbook was widely translated, and influenced medical students and
      physicians over the first half of the 19th century. His influence on morbid
      anatomy was similar to that of Vesalius on the science of normal anatomy.

PMID- 1617516
TI  - Heartbeat--the rhythm of health. World Health Day 1992 focuses on cardiovascular
      disease.

PMID- 1617517
TI  - The safety of pediatric cardiac catheterization in an adult hospital setting.
AB  - OBJECTIVE: To assess the safety of performing diagnostic and interventional
      cardiac catheterization of neonates, infants and children in a laboratory located
      in an adult hospital. DESIGN: Retrospective medical record review. SETTING:
      Children's Hospital of Western Ontario. PATIENTS: All patients 18 years or
      younger undergoing cardiac catheterization procedures performed by pediatric
      cardiologists between January 1986 and December 1989. MAIN RESULTS: The total
      number of procedures performed was 289. Three major (1%), nine moderate (3%) and
      20 minor (7%) complications were documented with none fatal. These rates are
      comparable with complications documented for larger centres with dedicated
      pediatric catheterization facilities. CONCLUSION: Although less than ideal, the
      use of an adult facility for pediatric cardiac catheterization appears to be a
      safe and reasonable alternative.

PMID- 1617518
TI  - John Keith lecture 1991. Pediatric cardiology: the practice of paradox?

PMID- 1617519
TI  - Rescue angioplasty during myocardial infarction has a beneficial effect on
      mortality: a tenable hypothesis.
AB  - HYPOTHESIS: Rescue percutaneous transluminal coronary angioplasty (PTCA) reduces
      mortality during myocardial infarction. OBJECTIVE: To determine if PTCA after
      failed thrombolytic therapy results in reduced mortality. DESIGN: Twenty-eight
      patients with a persistently occluded infarct artery following thrombolytic
      therapy more than 3 h after symptom onset were randomized to rescue PTCA (n = 16)
      or conservative treatment (n = 12) as part of a prospective randomized trial of
      reperfusion therapy during myocardial infarction in 184 patients. Hospital
      mortality was assessed in these groups as well as in the 177 patients with known
      infarct artery status after initial attempts at reperfusion. MAIN RESULTS: There
      was one death among the 16 patients in the rescue PTCA group versus four deaths
      in the 12 patients treated conservatively (P = 0.13). Moreover, the death in the
      rescue PTCA group occurred in one of three patients in whom the procedure failed.
      Mortality in the entire study group was 10.3% (19 of 184); 4.2% (six of 142) in
      patients in whom patency was achieved after thrombolysis and/or PTCA and 34.3%
      (12 of 35) in those in whom reperfusion was not achieved (P less than 0.001). In
      patients with anterior myocardial infarction, mortality was 6.7% (four of 60) in
      those with reperfusion and 47.1% (eight of 17) in those with a persistently
      occluded artery (P less than 0.001). In patients with inferior myocardial
      infarction, 2.4% (two of 82) with reperfusion and 22.2% (four of 18) with a
      persistently occluded artery died (P less than 0.01). CONCLUSIONS: Although the
      number of patients in the randomized groups was small, the trend toward a lower
      mortality after rescue PTCA supports the hypothesis that rescue PTCA may be
      beneficial. The mortality results in relation to presence or absence of
      reperfusion from the entire study population underscores the importance of
      achieving patency during myocardial infarction.

PMID- 1617520
TI  - Lambl's excrescences and papillary fibroelastomas: are they different?
AB  - OBJECTIVE: To determine if Lambl's excrescences (LEs) and papillary
      fibroelastomas (PFEs) differ histologically. SETTING: Materials were obtained
      from post mortem examinations performed at the Ottawa Civic Hospital, a tertiary
      care teaching hospital in Ottawa, Ontario. DESIGN AND PATIENTS: Hearts with
      grossly 'classic' PFEs (n = 10) or 'typical' LEs (n = 20) were examined. The
      patients with PFEs had a mean age of 63.5 years (range 24 to 79), similar to that
      of 68.1 years (range 47 to 83) for those with LEs. The LEs and PFEs were compared
      regarding their gross characteristics, sizes, locations and microscopic
      appearances. MAIN RESULTS: Lesions which were termed LEs had a similar
      microscopic appearance to grossly categorized PFEs; however, the LEs were smaller
      and broader-based. Some LEs and PFEs were microscopically indistinguishable.
      CONCLUSIONS: As LEs and PFEs may be virtually identical microscopically in some
      instances, separation of these two lesions may be artificial; however, this
      separation remains useful because it highlights the gross appearances, unusual
      locations and potential clinical sequelae of papillary fibroelastomas.

PMID- 1617521
TI  - Interaction between an angiotensin converting enzyme inhibitor, perindopril, and
      a thiazide diuretic in the spontaneously hypertensive rat.
AB  - Fifty adult male spontaneously hypertensive rats were randomly allocated to
      receive daily oral treatment with placebo, hydrochlorothiazide (HCTZ 10 mg/kg)
      and three different dosages of perindopril (S9490-30.1, 0.3 and 1 mg/kg)
      administered alone or in combination with HCTZ for two eight-day treatment
      periods separated by a therapeutic washout period of 13 days. Effect of order of
      treatment was evaluated in rats receiving perindopril plus HCTZ. Time course of
      changes in systolic blood pressure, heart rate, 24 h urine volume and urinary
      excretion of sodium, potassium and chloride were studied and compared for all
      groups. HCTZ alone and lower dosages of perindopril (0.1 mg/kg, 0.3 mg/kg) were
      ineffective in lowering elevated systolic blood pressure of the spontaneously
      hypertensive rat, and there were no significant intergroup differences in urine
      volume and electrolytes. However, antihypertensive efficacy of lower dosages of
      perindopril was significantly (P less than 0.01) enhanced when administered in
      combination with HCTZ. The combined treatment also induced significant (P less
      than 0.01) diuresis and urinary chloride excretion. No significant effect was
      seen in heart rate. The dose-effect relationship of the combination confirmed the
      existence of synergistic antihypertensive action between HCTZ and perindopril in
      the spontaneously hypertensive rat.

PMID- 1617522
TI  - Early neonatal death due to an unusual pattern of total anomalous pulmonary
      venous drainage.
AB  - Total anomalous pulmonary venous drainage (TAPVD) is an uncommon congenital
      cardiovascular anomaly caused by failure of the common pulmonary vein to develop
      a connection with the common atrium in early ontogeny, resulting in persisting
      connections between pulmonary and systemic venous systems and a left-to-right
      shunt. This usually occurs via a single, enlarged, well-defined venous channel.
      The authors present an unusual case of TAPVD with venous obstruction with a
      profusely arborizing plexus of veins arising from the common pulmonary vein and
      forming multiple tiny anastomoses with the systemic venous system. This plexus
      may represent the persistence of an earlier, less involuted embryological form of
      the primitive pulmonary splanchnic plexus than those found in previously
      described patterns of TAPVD.

PMID- 1617523
TI  - Vasodepressor syncope in a cardiac transplant recipient: a case of vagal re
      innervation?
AB  - At the time of hemodynamic assessment three years after cardiac transplantation,
      a patient developed symptoms and signs of a vasodepressor reaction. In addition
      to sudden deceleration of heart rate, a 26% fall in mean blood pressure and a 36%
      fall in cardiac output was observed. Subsequent investigations revealed the
      presence of respiratory sinus arrhythmia, profound heart rate acceleration on
      standing and an approximately normal heart rate response during the following
      exercise. Contrary to current thinking, these observations suggest that certain
      individuals may develop autonomic re-innervation following orthotopic cardiac
      transplantation.

PMID- 1617525
TI  - Yet more on the Barer-Stoddart report.

PMID- 1617524
TI  - Assessment of the cardiac patient for fitness to drive.

PMID- 1617526
TI  - Relativity and cardiology.

PMID- 1617527
TI  - Holter monitor recording for the detection of myocardial ischemia: validation of
      a new recorder and chest lead positions.
AB  - OBJECTIVE: To validate the Reynolds Tracker II Holter system using newly
      described lead positions during both upright treadmill exercise and in the
      recumbent position following exercise. The specific lead positions HL1 and HL2
      were chosen to detect anterior and postero-inferior myocardial ischemia,
      respectively, without interfering with the surgical field in the hypothetical
      situation of open-heart surgery. Similar lead positions have previously been used
      to monitor myocardial ischemia during induction of anesthesia, but have never
      been validated by comparison with 12-lead modified electrocardiogram (ECG)
      recording. METHODS: To validate the authors' 'chosen' Holter lead positions (HL1
      and HL2), both at the fifth intercostal space just lateral to the midclavicular
      line and on the back, 1.5 cm to the left of the vertebral column, respectively)
      49 candidates for routine treadmill exercise testing underwent a simultaneous
      Holter monitor recording using the described lead positions. DATA ANALYSIS: The
      Holter ECG recordings were separately analyzed by two physicians unaware of
      patients' identity. RESULTS: Using the modified 12-lead ECG as the 'gold
      standard', the sensitivity of Holter for detecting ischemia (defined as 0.1 mV or
      ST depression lasting at least 60 s) was 77 and 83%, and its specificity was 100
      and 92%, respectively, for observers 1 and 2. Most episodes of myocardial
      ischemia were detected by the modified lead V5 for the 12-lead ECG and by HL1 for
      the Holter recording. Using the Holter Tracker II system and the chosen lead
      positions, it was possible to detect successfully most episodes of exercise
      induced myocardial ischemia. CONCLUSION: Holter monitoring might be useful in
      detecting perioperative myocardial ischemia.

PMID- 1617528
TI  - Drug therapy of ventricular tachycardia: a cost comparison of randomized
      noninvasive and invasive approaches.
AB  - OBJECTIVE: Economic evaluation of noninvasive (suppression of ventricular
      arrhythmias detected by ambulatory monitoring) and invasive (suppression of
      arrhythmias induced by programmed stimulation) approaches to antiarrhythmic drug
      selection for ventricular tachyarrhythmias. DESIGN/SETTING: Randomized clinical
      trial/tertiary-care hospital. PATIENTS: Of 124 consecutive patients referred for
      treatment of symptomatic ventricular tachyarrhythmias, 57 consenting patients
      were eligible to have drug therapy selected by either noninvasive or invasive
      approaches. MEASUREMENTS: Costs of initial and follow-up (26 +/- 15 months)
      admissions for the two groups were compared. This economic evaluation also
      considered relative efficacies of the approaches using the primary outcome
      variable of symptomatic, sustained ventricular tachyarrhythmia recurrence
      (including sudden death). RESULTS: Initial hospitalization for therapy selection
      was less costly by the noninvasive approach ($6,869 +/- 4,019) than by the
      invasive approach ($13,164 +/- 6,740) (P less than 0.001). However, the
      noninvasive approach generated higher follow-up hospital costs ($9,204 +/- 9,217)
      than the invasive approach ($3,784 +/- 4,944) (P = 0.01). Thus, total hospital
      costs of the noninvasive ($16,073 +/- 9,423) and invasive approaches ($16,949 +/-
      7,174) were equivalent. The two-year actuarial probability of a recurrent,
      sustained, symptomatic ventricular tachyarrhythmia was greater in noninvasive
      (0.50 +/- 0.10) than in invasive (0.20 +/- 0.08) approach patients (P = 0.02).
      CONCLUSIONS: The lower initial hospital costs of the noninvasive approach are
      offset by greater follow-up costs. Within two years the costs of the two
      approaches are equivalent. Thus, greater antiarrhythmic efficacy can be achieved
      by the invasive approach to drug selection without increasing total hospital
      costs.

PMID- 1617529
TI  - Epidemiology of congestive heart failure: Canadian data from 1970 to 1989.
AB  - OBJECTIVE: To assess mortality rates from congestive heart failure in Canada from
      1970 to 1989. DESIGN: Observational, retrospective design using national
      population and mortality data. MAIN RESULTS: There is a definite age gradient for
      deaths from congestive heart failure which, combined with a general ageing of the
      Canadian population, has lead to an increase in the absolute number of deaths.
      However, Standardized Mortality Ratios, which account for shifting population
      distributions, have shown steadily decreasing values for both men and women since
      1980. CONCLUSIONS: Recent improvements in cardiology care demonstrated in
      controlled clinical trials appear also to be present in epidemiological studies.

PMID- 1617530
TI  - Resuscitating the cardiology journal club.

PMID- 1617531
TI  - Microdialysis of noradrenaline in rostral ventrolateral medulla after intravenous
      methionine enkephalin administration in anesthetized rats.
AB  - The objective of this research was to define the role of central and peripheral
      opioid receptors for the regulation of cardiovascular action. Cardiovascular
      effects of methionine-enkephalin (met-enkephalin) after intracisternal,
      intravenous or direct administration into the rostral ventrolateral medulla (C1
      area) were compared in inactin-anesthetized Sprague-Dawley rats. A microdialysis
      probe was stereotaxically implanted in the C1 area to dialyze monoamines during
      intravenous administration of met-enkephalin. An intravenous injection of met
      enkephalin decreased both arterial pressure and heart rate in a dose-dependent
      manner. There were no cardiovascular responses to intracisternal dosages of up to
      10 micrograms/kg, but as little as 0.1 micrograms/kg met-enkephalin decreased
      arterial pressure and heart rate after a direct injection into the C1 area. Onset
      of the met-enkephalin effect was similar regardless of drug doses after
      intravenous administration; however, duration and magnitude of the peptide's
      action and time to peak effect were directly related to the dose. Intravenous
      infusion of 100 micrograms/kg/min met-enkephalin increased the extracellular
      concentration of noradrenaline in the C1 area. There was a differential blockade
      by naloxone of the hypotensive action of met-enkephalin after intravenous or C1
      administration. This study suggests the importance of both central and peripheral
      sites(s) of met-enkephalin for its cardiovascular action. Additionally, the data
      suggest that the C1 area is a communication site between catecholamines and
      opioid peptides for cardiovascular regulation.

PMID- 1617533
TI  - Ultrasonography--whose turf?

PMID- 1617532
TI  - Preventing vascular injuries in revision total hip replacement.

PMID- 1617534
TI  - Aortobifemoral bypass--an enduring operation.
AB  - Aortobifemoral bypass (ABF) has been available as a method for treating patients
      with aortoiliac occlusive or aneurysmal disease for 40 years. ABF has been
      successful in alleviating the symptoms of claudication and critical ischemia. The
      long-term patency rates have been excellent with low operative morbidity and
      mortality. Major improvements have been made in indications, preoperative
      assessment and operative and postoperative care. With careful follow-up the
      natural history of a patient who undergoes ABF is known. Predicting outcome is
      now possible and a cost:benefit analysis can be made. ABF has proved to be a
      successful and enduring procedure.

PMID- 1617535
TI  - Arteritis due to Salmonella with aneurysm formation: two cases.
AB  - Although arterial infection due to Salmonella is rare, it remains one of the most
      common causes of primary mycotic aneurysms. The presentation is one of sepsis,
      cultures positive for Salmonella and rapid expansion or rupture of the aneurysm.
      The authors' experience at Victoria Hospital, London, Ont., includes two cases of
      aneurysms infected with Salmonella--one aneurysm of the aorta and the other of
      the common femoral artery. Both patients were treated by excision of the
      aneurysm, extra-anatomic reconstruction in an area remote from the infected field
      and long-term administration of appropriate antibiotics. One patient was alive
      and well 36 months after resection. The other died of multiple organ failure 10
      days after resection. From a review of the English and French literature since
      1948, 64 cases of abdominal aortic aneurysms infected with Salmonella were found;
      half of the patients survived the perioperative period. The diagnosis of mycotic
      aneurysm must be considered in any patient with an aneurysm and culture specimens
      positive for Salmonella. The authors favour wide debridement of the infected
      aneurysm with extra-anatomic reconstruction. This view is supported by a review
      of the literature. The appropriate antibiotic therapy is bactericidal rather than
      bacteriostatic.

PMID- 1617536
TI  - Vascular injury and repair associated with retroperitoneal lymphadenectomy for
      nonseminomatous germinal cell tumours of the testis.
AB  - Metastatic disease adjacent to major vascular structures in the retroperitoneum
      sometimes necessitates planned removal of portions of these vessels, or the
      vessels may inadvertently be injured when retroperitoneal lymphadenectomy is
      performed. In 78 patients who underwent retroperitoneal lymphadenectomy, 17 (22%)
      required vascular repair intraoperatively. The vena cava was most frequently
      involved (eight cases) followed by inadvertent injury to the renal arteries (five
      cases) or the infrarenal aorta (three cases). Resection of the infrarenal aorta
      was planned in two cases without postoperative complication. In six cases a
      resection of either the whole inferior vena cava or a portion of it was needed to
      remove all of the tumour. There were nine cases of inadvertent injury to the
      aorta, vena cava or a renal artery. The outcome after arterial repair was
      satisfactory with the exception of the inadvertent renal artery injuries, which
      required nephrectomy in three cases. Leg swelling was not a long-term sequela of
      either caval repair or resection.

PMID- 1617537
TI  - The role of descending venography in the management of patients with chronic
      venous disease of the lower extremity.
AB  - The purpose of this paper is to evaluate the efficacy and clinical information
      obtained from the authors' first 17 consecutive descending venograms. All 17
      patients had chronic venous disease refractory to standard conservative and
      surgical measures. The standard classification of valvular insufficiency was used
      in evaluating these venograms. There were no deaths, slight morbidity and minimal
      patient discomfort. In 16 patients meaningful clinical information was derived
      from the venograms, with 7 patients having deep venous valvular surgery.
      Descending venography will demonstrate the site of incompetent valves and
      estimate the degree of reflux. This test is necessary before anticipated
      reconstruction of deep vein valves.

PMID- 1617538
TI  - Prevention of vascular injuries in revision total hip replacement.
AB  - Iliac-vessel injury from total hip arthroplasty is associated with hemorrhagic
      complications and an increased death rate. The authors identified seven patients
      who had severe medial displacement of the acetabular prosthesis and associated
      vascular injury to the iliac vessels after total hip replacement. One patient had
      two hip replacements. Preoperative findings included a pelvic mass (three hips),
      pelvic pain (eight), radiologic evidence of cement in the pelvis (three) and the
      acetabular prosthesis in the pelvis (eight), computed tomographic evidence of
      cement in the pelvis and proximity of the prosthesis to the iliac vessels (four),
      and arteriography showing displacement or compression of the iliac vessels
      (seven). Operative management in all cases involved medial exposure, mobilization
      and repair of the iliac vessels before revision of the hip prosthesis.
      Postoperative complications were deep vein thrombosis (three), in spite of
      prophylaxis, and occlusion of a vein interposition graft (one) requiring
      placement of a femoral crossover graft. There were no deaths, amputations or
      hemorrhagic complications. The authors advocate preoperative identification of
      patients who have iliac-vessel involvement by their total hip prosthesis and
      initial medial extraperitoneal exposure and repair of these vessels before
      removal of the displaced acetabular prosthesis.

PMID- 1617540
TI  - Scalp as a donor site for grafts to facial and neck burns in children.
AB  - In facial and neck burns, attention to cosmetic details, in addition to
      preservation of function, is crucial. The authors describe use of the scalp as a
      graft donor site for such burns. The advantages include excellent colour match of
      the graft and minimal morbidity at the donor site. The technique for graft
      harvest is outlined, and the potential pitfalls are described. Based on their
      experience with this technique, the authors believe the scalp should be
      considered as a donor graft site during the acute phase of facial and neck burns.

PMID- 1617539
TI  - Prosthetic replacement of the superior vena cava with a custom-made pericardial
      graft: an experimental study.
AB  - Prosthetic replacement of the vena cava has been disappointing, mainly because of
      the hemodynamic characteristics of the venous system and the physical properties
      of the prostheses used. Spiral grafts constructed with autogenous saphenous vein
      have been the most successful prostheses to date, but their use is limited to
      replacement of short segments, and intraoperative construction is time consuming.
      The authors report their experience with a graft constructed of extra-thick
      bovine pericardium (PX) and surgical staples. Externally stented
      polytetrafluoroethylene (PTFE) was used as a control. The superior vena cava was
      replaced in 13 ewes; PTFE was used in 6 (group 1) and PX in 7 (group 2). Mean
      follow-up was 15 +/- 8 months for group 1 and 13 +/- 8 for group 2. Cumulative
      graft follow-up totalled 4612 graft-days. There was one graft occlusion in each
      group. Patency rates (80%) were similar for the two groups. Histologic changes in
      pericardial grafts were more marked but did not influence patency. This study
      reports the longest experimental follow-up (maximum 23 months) and graft patency
      to date for replacement of the superior vena cava. Both types of graft performed
      excellently.

PMID- 1617541
TI  - Cemented ceramic acetabular component: a 7-year review.
AB  - A 7-year review of 30 cases of cemented ceramic acetabular components has shown
      that all components rapidly become surrounded by a lucent zone between the cement
      and bone that appears to be nonprogressive. Although these prostheses have
      functioned well, some separation inferiorly between the ceramic cup and the
      cement suggests that "creep" of the cup within the cement occurs and that the cup
      should be modified to provide greater "pull out" resistance from the cement. This
      study has failed to substantiate some of the theoretical advantages of ceramic
      cups.

PMID- 1617542
TI  - Priapism in the newborn.
AB  - The authors describe a rare case of priapism in a newborn infant. Treatment with
      intravenous ketamine hydrochloride produced rapid detumescence. The literature is
      reviewed with respect to priapism in the newborn and its management, and the
      authors propose injection of ketamine hydrochloride as an alternative method of
      management for this condition in newborn infants.

PMID- 1617543
TI  - An epidemic of hepatitis B among injection drug users in a rural area.
AB  - An epidemic of hepatitis B occurring in a rural area of Nova Scotia in 1988 and
      1989 was investigated. This epidemic identified injection drug use (IDU) as the
      major determinant of transmission and was the first highly visible indication of
      IDU in rural Nova Scotia. Contact-tracing was used to identify 186 injection drug
      users (IDUs), of whom 153 (82%) were interviewed. Of 133 (72%) IDUs who underwent
      serological testing, 78 had serological evidence of hepatitis B infection. Using
      epidemiological criteria, 57 IDUs formed a cluster of hepatitis B infections.
      Using logistic regression techniques, age (O.R. = 1.1), the total number of IDU
      contacts named (O.R. = 1.1), and the number of hepatitis B seropositive IDU
      contacts named (O.R. = 1.3), were identified as risk factors predictive of an IDU
      being a cluster case. The characterization of this epidemic may be useful as a
      model for the spread of hepatitis B and other viral infections among IDUs in
      rural areas.

PMID- 1617544
TI  - Contact-tracing among injection drug users in a rural area.
AB  - An epidemic of hepatitis B occurring in 1988 and 1989 in Cape Breton brought to
      light the existence of a group of "buddies" who engaged in injection drug use.
      Interviewing was conducted by Public Health in 82% of the 186 IDU contacts named.
      In comparison with published reports of contact-tracing efforts for viral
      hepatitis among IDUs, the Cape Breton experience seems successful. This article
      describes the approach used by Public Health. Aspects of the management of the
      epidemic and the interview technique which may have contributed to the
      comparative success of contact-tracing include collaboration with family
      physicians and laboratories; collaboration among public health investigators; and
      a nonjudgemental interview technique with 6 "golden rules".

PMID- 1617545
TI  - Assessment of occupational health risk during unusual workshifts: review of the
      needs and solutions for modifying environmental and biological limit values for
      volatile organic solvents.
AB  - Aspects of occupational health risk assessment for unusual workshifts are
      discussed in relation to the question of: 1) using a suitable model for adjusting
      occupational exposure limits, and 2) assessing the influence of altered work
      schedules on biological exposure limits. The relative importance of two separate
      approaches, i.e., mathematical and pharmacokinetic, for the adjustment of
      exposure limits is discussed. Emphasis is placed on the usefulness of a
      physiologically based pharmacokinetic model for the exposure limits adjustments
      during prolonged work hours. The influence of prolonged work schedules on
      biological exposure limits is discussed and it is concluded that the latter do
      not have to be adjusted for unusual workshifts. Research needs arising as a
      result of unusual workshifts and pertaining to the practice of industrial hygiene
      and biological monitoring are suggested.

PMID- 1617546
TI  - [Strategies to increase and maintain high immunization levels in children].
AB  - Various strategies for achieving high immunization rates and better knowledge of
      immunization status are evaluated. Sixty-nine studies were assessed. Laws
      requiring documented proof of immunity for all children at the beginning of the
      school year are associated with a substantial increase in immunization rates,
      while computerized registries contribute to improved knowledge of immunization
      status. Research on recall systems, whether parent or provider oriented, produces
      contradictory evidence. The question of provider motivation as a determinant for
      achieving high immunization rates remains to be adequately assessed. Laws
      requiring documented proof of immunity and access to a centralized and efficient
      immunization registry are key measures for maintaining high immunization levels.

PMID- 1617547
TI  - An investigation of two apparent cancer clusters in one community.
AB  - Two apparent cancer clusters in a single municipality were brought to public
      attention within a few years of each other. The clusters occurred first in a high
      school and later in a general hospital across the street. Analysis of the
      clusters was based on the comparison of the observed with the expected cancers,
      where the expectation of cancer occurrence was derived from data in the Ontario
      Cancer Registry. While the observed/expected ratios were statistically
      significant for the high school staff and students, these ratios were based on a
      very small number of cases (n = 6), and represented 4 different cancer types. The
      data for the hospital did not appear as excess cancer, either across age groups
      or in different working locations within the hospital. In addition, cancer rates
      were examined for the town in which the high school and hospital were located. A
      number of alternative explanations are discussed, as are the issues surrounding
      the analysis of cancer clusters in the community. We concluded that the two
      apparent clusters did not require further study.

PMID- 1617548
TI  - A study to validate the Canadian Aerobic Fitness Test.
AB  - Our purpose was to assess the validity of VO2 max values predicted from The
      Canadian Aerobic Fitness Test (CAFT) by comparing them with peak VO2 values
      measured during a maximal treadmill protocol. Male and female subjects, 15-69 yr
      (n = 129), performed two submaximal exercise tests (CAFT protocol), and one
      maximal treadmill test. There was no significant heart rate habituation between
      the first two CAFT protocols. Peak VO2 values measured during the treadmill test
      (TM) were significantly higher than those predicted from the CAFT whether the
      sample was analyzed overall or categorized by sex. When the sample was
      categorized by age group, all but groups 1 (15-19) and 6 (60-69) had treadmill
      peak VO2 values significantly higher than those predicted using Jette's equation.
      Using treadmill measured peak VO2 scores as the gold standard, VO2 max
      predictions using the CAFT protocol and Jette equation placed individuals of
      lower fitness levels more accurately than highly fit individuals, into one of
      five fitness categories.

PMID- 1617549
TI  - Meningococcal disease and public health: welcome to the '90s.

PMID- 1617550
TI  - The Prince Edward Island meningococcal immunization program. January-February
      1992.

PMID- 1617551
TI  - [Mass vaccination against meningococcal disease in three regions of the province
      of Quebec, January 1992].

PMID- 1617552
TI  - An outbreak of meningococcal disease in Ottawa-Carleton. December 1991-February
      1992.

PMID- 1617553
TI  - Meningococcus meningitis in Ottawa, 1940-41.

PMID- 1617555
TI  - Meningococcal disease and death in rural Alberta. December 1991.

PMID- 1617554
TI  - Invasive meningococcal disease, British Columbia. December 1991-March 1992.

PMID- 1617556
TI  - Incidence and prevalence of end-stage renal disease among Ontario's James Bay
      Cree.
AB  - End-stage renal disease (ESRD) and chronic renal failure (CRF) among Canadian
      natives is more common than among the general Canadian population. The results of
      this study show the James Bay Cree in Northern Ontario in 1989 experienced ESRD
      prevalence rates 3.2 times greater than the national rate. The average annual
      incidence rates for 1981-1989 were 1.6 times the national rate. Methodological
      difficulties inherent in incidence and prevalence studies of native Canadians are
      examined. With tertiary treatment care facilities available only in southern
      urban centres, native Canadians in remote northern communities face considerable
      psychosocial disruption when seeking out medical assistance for ESRD such as
      renal dialysis services.

PMID- 1617557
TI  - Needs of the family caregivers of frail elderly.
AB  - The purpose of the study was to determine the needs of family caregivers of frail
      elderly. Forty-one caregivers were interviewed. More than two-thirds of the
      caregivers were spouses and about 85% of them had health problems which affected
      their caregiving. Ninety-eight percent of the caregivers were living with the
      care recipients and the cumulative stress from their continual involvement had
      affected their lifestyle. Also more than 58% felt that the care recipients needed
      more care than they could provide. More than 68% of the caregivers were seniors.
      Differential planning based on each of the caregivers' needs can maximize the
      care they provide.

PMID- 1617558
TI  - Income inequalities in oral health among older adults in four Ontario
      communities.
AB  - We used data from telephone interviews, personal interviews and clinical
      examinations to assess income inequalities in oral health among older adults
      living in four Ontario communities. Lower income groups had significantly higher
      rates of edentulism than upper income groups. In dentate subjects aged 50 to 64
      years, significant associations were observed between income and 9 of 10
      clinical, functional and subjective oral health indicators. Among those aged 65
      years and over, associations were found for only 5 of these indicators. The data
      suggested that the association between income and clinical and functional
      measures of oral health was stronger among those aged 50 to 64 years, while the
      association between income and subjective indicators was stronger among those
      aged 65 years and over. No association was noted between income and oral health
      status among edentulous subjects. These observations are difficult to explain
      because of the cross-sectional nature of the study and the complexity of the
      processes which may lead to social inequalities in health. Nevertheless, the data
      do suggest the need for the targeting of oral health promotion programs and
      appropriate dental services at disadvantaged groups.

PMID- 1617559
TI  - Factors associated with acquiring giardiasis in British Columbia residents.
AB  - Giardia is the most frequently reported intestinal parasite in Canada. More than
      2,000 cases are reported annually in British Columbia which exceeds the number of
      cases of either campylobacteriosis or salmonellosis. Since the different ways
      this parasite is spread in British Columbia have not been determined, our purpose
      was to investigate certain factors that might be associated with acquiring
      giardiasis in this province. Telephone interviews provided information from a
      group of infected persons and from a group of non-infected control subjects.
      Information obtained from these interviews was used to identify associated risk
      factors in this group of cases. If results of the study are generalized to the
      population-at-risk, they indicate that water (drinking and recreational) is an
      important vector for transmission of Giardia in British Columbia.

PMID- 1617560
TI  - Health promotion and health advocacy for and by immigrants enrolled in English as
      a second language classes.
AB  - An intersectoral immigrant health promotion project in Hamilton, Ontario is
      described. The project goal was to facilitate the entry of new immigrants to the
      Ontario health care system and equip them with knowledge and skills to strengthen
      their preventive and promotive health practices. A needs assessment preceded
      project development. The three phases of the project are described. The first
      phase commenced with the development of culturally sensitive health promotion
      resource materials to be used with immigrants enrolled in English as a Second
      Language Classes. In phase two, activities focussed on strengthening the ability
      of ESL teachers to incorporate a preventive and promotive health focus in their
      classes. The final phase shifted to a community-based project. During this phase,
      a core immigrant group developed their skills as health advocates for their
      immigrant community.

PMID- 1617561
TI  - Health of Canada's aboriginal people.

PMID- 1617562
TI  - Chaos and public health: implications for an epidemic.

PMID- 1617563
TI  - Perceived health status and desired health information needs of university
      students.

PMID- 1617564
TI  - Changing profiles of a typology of youth suicide in Canada.

PMID- 1617565
TI  - The effectiveness of commercially available disinfectants upon Giardia lamblia
      cysts.

PMID- 1617566
TI  - Fluoridation: a prophylaxis program for dental caries and dementia?

PMID- 1617568
TI  - Baby Susan.

PMID- 1617567
TI  - Aluminum, fluoride and the prevention of Alzheimer's disease.
AB  - The evidence regarding the link between aluminum and Alzheimer's disease is
      summarized. This evidence suggests strongly that aluminum is one of the etiologic
      or contributing factors in the occurrence of Alzheimer's disease. One reported
      study suggests that relatively high fluoride in drinking water plays a preventive
      role in Alzheimer's disease. The rationale for this is the evidence that aluminum
      and fluoride compete for absorption in the gut. However, this study had
      methodologic limitations, and no firm conclusion can be drawn. Further
      investigation of relatively high fluoride in drinking water as a preventive
      measure for Alzheimer's disease should receive high priority.

PMID- 1617569
TI  - Resolving the health care crisis: where is the CNS?

PMID- 1617570
TI  - The clinical nurse specialist as case manager in a collaborative practice model:
      bridging the gap between quality and cost of care.
AB  - The status of the current health care environment demands that health care
      providers deliver quality health care while reducing health care costs. While the
      nursing profession is faced with the critical issue of providing quality cost
      effective care, the clinical nurse specialist (CNS) is caught in a controversy
      created by cost containment efforts and the nursing shortage. To provide
      effective yet efficient care mandates that patient care be comprehensive and
      integrated. This article presents a model of delivery of care that proposes the
      utilization of the CNS in a collaborative model of practice based upon case
      management. The operationalization of the model is based upon the interweaving of
      the role dimensions of the CNS, the goals of case management, and the components
      of collaborative practice into patient care.

PMID- 1617571
TI  - The CNS as a cost manager.
AB  - The role of the clinical nurse specialist (CNS) in a cost-conscious environment
      includes the need to be alert to opportunities for cost-containment. Efforts to
      improve the quality of nursing care need to be balanced with the ability to
      manage costs. The CNS is in a key position to guide and influence decision-making
      about cost savings. This article reviews costs in health care and the elements of
      total nursing costs. CNSs can affect costs in three areas: direct costs, indirect
      costs, and supplies/equipment. Practical examples in each of the three areas are
      given for actions that are potentially useful to the CNS who desires to reduce
      the costs to patients and document the cost savings generated by nursing.

PMID- 1617573
TI  - Family and group psychoeducational approaches in the management of schizophrenia.
AB  - The family movement is one of the most important movements in the mental health
      field in recent decades. In light of this trend, a psychoeducational focused
      group for schizophrenics and their families to learn management of schizophrenic
      illness is described. Antipsychotic medication for patients is assured by depot
      administration by the facilitator in a clinic immediately after the group
      sessions. This psychoeducational approach can serve as a prototype for others.

PMID- 1617572
TI  - Let's talk about clinical consultation.

PMID- 1617574
TI  - The clinical nurse specialist as expert witness.
AB  - A clinical nurse specialist is an ideal expert witness in cases alleging nursing
      negligence. Nurses choose to serve in this capacity for a variety of reasons. As
      an expert witness, a clinical nurse specialist may act as a consultant, review
      medical records, give depositions, translate medical jargon, testify in court,
      educate attorneys, suggest questions for attorneys to ask of witnesses, and
      provide opinions about the standard of care a client received. Guidelines for
      qualifications of an expert, reviewing medical records, preparing opinions, and
      testifying are given. Reactions to serving as an expert are discussed.

PMID- 1617575
TI  - Pessimism or optimism for role recognition?

PMID- 1617576
TI  - Music therapy: an intervention to reduce anxiety in the myocardial infarction
      patient.
AB  - The purpose of this study was to examine the effects of relaxing music on
      elevated state anxiety in patients with a confirmed medical diagnosis of acute
      myocardial infarction. In addition, the relationship between trait anxiety and
      state anxiety was analyzed. A purposive sample of 40 myocardial infarction
      patients was randomly assigned to an experimental or control group. Statistically
      significant reduction in heart rate, respiratory rate, and state anxiety scores
      were found in the group that listened to relaxing music. A statistically
      significant positive correlation was found between trait anxiety scores and
      baseline state anxiety scores. Statistically significant negative correlations
      were found between trait anxiety scores and the degree of change in posttreatment
      state anxiety scores when examined as a net change, as well as a percent change.
      Results suggested that music therapy may be an effective intervention to reduce
      state anxiety levels in the acute myocardial infarction patient.

PMID- 1617577
TI  - Case management and the CNS.

PMID- 1617578
TI  - Case management of homeless families.
AB  - Homeless families are the fastest growing subgroup of the homeless population.
      They have multiple health care needs that can be best met by the community
      clinical nurse specialist. Nursing actions must be planned based on an assessment
      of this group's unique service needs. Interventions require the use of
      individualized delivery strategies such as case management, which necessitates
      that the clinical nurse specialist develop specialized skills in both service
      stimulation and system advocacy.

PMID- 1617579
TI  - The clinical nurse specialist in the school setting: case management of migrant
      children with dental disease.
AB  - Dental disease is a major health problem for all school-age children in the
      nation; for migrant children the problem is most severe. This paper presents
      strategies for the clinical nurse specialist (CNS) in the school setting in case
      management of migrant children with dental disease. The barriers migrant families
      face in obtaining health care are addressed. Leininger's transcultural care
      theory serves as a conceptual framework. Examples of how the CNS functions in the
      roles of clinician, educator, consultant, and researcher are given. The federally
      funded Migrant Education Program is described, along with a model dental program
      developed by a CNS. Suggestions for documenting the effectiveness of the CNS's
      role in cost containment and in influencing positive outcome measures of school
      age children are presented.

PMID- 1617580
TI  - Regression analysis.

PMID- 1617581
TI  - "The role of pediatric clinical nurse specialist in a general emergency
      department".

PMID- 1617582
TI  - Application of the case study design: nursing interventions for discharge
      readiness.
AB  - A single case study design was used to explore the nursing process and
      intervention related to discharge preparation of one family with a child
      requiring complex care at home. Helping methods described by Orem were used to
      categorize identified nursing interventions. Discharge readiness was assessed to
      verify consideration of conditions for discharge. The major study question was
      "How is discharge preparation conducted?" Collected data provided evidence to
      support each of three case study propositions: (1) patients and their home
      caregivers are involved in discharge preparation as planners and as learners, (2)
      nursing interventions occur in five major helping areas as outlined by Orem, (3)
      discharge preparation addresses each component of discharge readiness. The case
      study design was effective as an approach to explore nursing interventions,
      verify considerations of discharge conditions, and refine the concept of
      discharge readiness. A decision trail is presented for nurses to replicate the
      process with questions related to their practice.

PMID- 1617583
TI  - A content methodology for advancing gerontological nursing practice.
AB  - The content methodology process is a method of observation, research, and
      application that refines the caregiving practice. An application of the content
      methodology process with cognitively-impaired individuals with dementia is
      explored, and correlations drawn to language abilities of older patients.

PMID- 1617584
TI  - Determining CNS cost effectiveness.

PMID- 1617585
TI  - Live in the past ... or face the future???

PMID- 1617586
TI  - Definition of an advanced nursing practice role in the NICU: the clinical nurse
      specialist/neonatal practitioner.
AB  - We surveyed 655 health professionals affiliated with tertiary level neonatal
      intensive care units in Canada and the United States to define an expanded role
      for nurses in neonatology and to determine the educational requirements for the
      role. The role, comprising advanced clinical practice, educational, research, and
      administrative responsibilities, is a blend of nurse practitioner and clinical
      nurse specialist activities. Based on survey findings, a neonatal stream within
      the existing Master of Health Sciences program at McMaster University was
      developed. To date, 15 clinical nurse specialists/neonatal practitioners
      (CNS/NPs) are employed in five neonatal intensive care units in Ontario and other
      related institutions. A randomized trial to evaluate these individuals is in
      progress.

PMID- 1617587
TI  - A nursing bioethics program.
AB  - In 1985 the Seattle Veterans' Administration Medical Center nursing service
      implemented a nursing program for bioethics with three goals: (1) to expand the
      nurse's knowledge of bioethical principles, (2) to develop the nurse's ability
      and confidence in analyzing bioethical dilemmas, and (3) to increase bioethical
      application at the bedside. Two psychosocial clinical nurse specialists (CNSs)
      led this highly successful nursing program that prepared nurses to more actively
      and responsibly participate in bioethical decision making within the medical
      center. The program offers an annual workshop for new members, holds a monthly
      discussion group, conducts a yearly enrichment program, and completes an annual
      evaluation report. This article describes nursing service bioethics program from
      planning through evaluation and the role of the CNS as program coordinator,
      facilitator, and educator in the expanding field of bioethics.

PMID- 1617588
TI  - The World Health Organization's Histological Classification of Salivary Gland
      Tumors. A commentary on the second edition.
AB  - The second edition of the World Health Organization's Histological Classification
      of Salivary Gland Tumors is more extensive and detailed than the previous edition
      published 20 years ago. The new edition is based on data regarding newly
      described tumor entities and the behavior and prognosis of the previously
      classified tumors. The distinct morphologic features of monomorphic adenomas
      justify their separation for purposes of identification. Among the carcinomas,
      various types were distinguished for purposes of recognition, prognosis, and
      treatment. The term tumor was replaced by carcinoma in the following two
      entities: acinic cell carcinoma and mucoepidermoid carcinoma. The tumor-like
      lesions were described in more detail.

PMID- 1617589
TI  - Prophylactic lymph node dissection in patients with advanced gastric cancer
      promotes increased survival time.
AB  - BACKGROUND: There is no consensus of opinion regarding the efficacy of lymph node
      dissection. METHODS: Data were analyzed from 452 patients with advanced gastric
      cancer who underwent curative resection in the Department of Surgery II, Kyushu
      University Hospital, between 1970 and 1985, with special reference to the lymph
      node metastasis. RESULTS: Metastatic lesions were evident in the dissected lymph
      nodes of 300 of 452 (66.4%) patients. Survival time for patients without lymph
      node metastasis was longer than for those with it (P less than 0.01). In patients
      without lymph node metastasis, the tumor was smaller, serosal invasion was less
      prominent, tumor growth was less infiltrating, and the tumor stage was,
      therefore, less advanced. Lymphatic involvement was found in 38.9% of the
      patients with no evidence of lymph node metastasis. CONCLUSIONS: Because the
      postoperative mortality rate is low in patients with lymph node dissection, the
      authors advocate prophylactic lymph node dissection to prevent a recurrence.

PMID- 1617590
TI  - Social class and colon cancer survival in Finland.
AB  - METHODS. Social class differences in colon cancer survival were studied in 3147
      patients with colon cancer diagnosed in Finland from 1979-1982. Of these
      patients, 2969 were eligible for survival analysis. RESULTS. A clear social class
      gradient in colon cancer survival was detected. The difference in the age
      adjusted relative risk of death due to colon cancer between the highest (I) and
      lowest (IV) social class was 19%. Stage of disease at diagnosis accounted for a
      substantial proportion of differences in survival, and treatment accounted for
      the rest of them. Differences in treatment by social class were most apparent
      among patients with advanced or unknown stage of disease at diagnosis.
      Controlling for the place of residence had little effect on the survival
      differences. Delay in diagnosis did not account for the observed differences in
      survival by social class.

PMID- 1617591
TI  - The WHO Histological Classification of Tumors of the Gallbladder and Extrahepatic
      Bile Ducts. A commentary on the second edition.
AB  - The second edition of the WHO Histological Classification of Tumors of the
      Gallbladder and Extrahepatic Bile Ducts is more comprehensive and detailed than
      the previous one. Advances in our understanding of dysplasia, carcinoma in situ,
      various lines of differentiation among the carcinomas, and the recognition of a
      variety of tumor-like lesions have resulted in more than three times as many
      entities in the current classification as in the previous one. The new edition
      should facilitate pathologic, epidemiologic, and therapeutic comparisons.

PMID- 1617592
TI  - Lung cancer in association with human immunodeficiency virus infection.
AB  - The association of lung cancer and infection by the human immunodeficiency virus
      (HIV) is uncommon. This report and critical review of the medical literature
      defines a clinical profile of 22 patients affected with this uncommon
      association. This clinical profile includes young age (median, 38 years),
      intravenous drug abuse (14 of 22 patients), preponderance of adenocarcinoma over
      other cell subtypes (11 of 22 patients), and advanced clinical stage at
      presentation (10 of 15 patients with staging data had Stage III or IV disease).
      This study also examines a possible increased risk for lung cancer in patients
      infected by HIV. Continued surveillance and reporting of lung tumors (other than
      lymphomas and Kaposi sarcomas) in patients infected by HIV should help to define
      the frequency of the association and the validity of the clinical profile.

PMID- 1617593
TI  - Cardiac metastasis of lung cancer. A study of metastatic pathways and clinical
      manifestations.
AB  - BACKGROUND: Although lung cancer frequently spreads to the heart, details of
      cardiac metastases of lung cancer have not been fully discussed. The authors
      attempted to elucidate the relationship between the mechanisms of cardiac
      metastasis and a variety of clinical manifestations caused by cardiac metastasis.
      METHODS: Clinical and autopsy records were reviewed in 74 autopsied cases of lung
      cancer. In cases with cardiac metastasis, the metastatic pathways to the heart
      were determined by the macroscopic examinations, and the relationship between the
      metastatic pathways and the clinical manifestations were studied. RESULTS:
      Metastases to the pericardium or heart were seen in 23 cases (31%). A lymphatic
      metastatic pathway was detected in 18 cases (hilar lymphatic routing in 12 cases,
      and mediastinal lymphatic routing in 6 cases), and a hematogenous metastatic
      pathway was detected in 5 cases. Malignant pericardial effusion was documented in
      15 of 23 cases. The metastatic pathway in 14 of 15 cases was lymphatic (hilar
      lymphatic routing in 10 cases, and mediastinal lymphatic routing in 4 cases).
      Patients showing lymphatic metastasis had higher incidence of malignant
      pericardial effusion than those with hematogenous metastasis (P less than 0.05).
      Of 23 cases of cardiac metastasis, myocardial infarction was found in 1 case,
      resulting from the compression of the coronary arteries by the tumor. Concurrent
      supraventricular arrhythmias were recorded in eight cases with cardiac
      metastasis. Patients with cardiac metastasis had higher incidence of arrhythmia
      than those without cardiac metastasis (P less than 0.05). In cases of cardiac
      metastasis, patients with arrhythmia were older (P less than 0.01) than those
      without arrhythmia. CONCLUSIONS: The authors concluded that the hilar lymphatic
      pathway is essential for early development of malignant pericardial effusion in
      lung cancer and that aging and cardiac metastasis may be responsible for
      arrhythmia in patients with lung cancer.

PMID- 1617594
TI  - Malignant thymoma.
AB  - Sixty-one patients underwent operations for malignant thymomas between 1961 and
      1989. Twenty-three patients had associated myasthenia gravis (MG), an incidence
      of 37.7%. Upon being admitted to the hospital, the patients' most common symptoms
      included chest pain, MG, cough, and dyspnea. Only 7 of 61 (11.5%) patients had no
      symptom. Tumor staging of 58 patients with invasive thymomas was performed
      according to Masaoka classification. The patients were classified as follows:
      Stage II disease, 5; Stage III, 41; Stage IVa, 8; and Stage IVb, 4. In addition,
      thymic carcinoma was present in three patients. The series had a resection rate
      of 55.7%. The incidence of operative complications was 16.3%. Only one patient
      died of myocardial infarction; the incidence of operative mortality was 1.6%. The
      patients with MG had a higher rate of resection (69.6%) and a higher incidence of
      complete thymectomy (14 of 23 patients; 60.9%). Mixed lymphoepithelial tumors and
      epithelial cell predominant tumors were the most frequent histologic patterns
      (45.9% and 34.4%, respectively). Fifty-two patients had postoperative radiation
      therapy, and 10 patients had chemotherapy. The overall cumulative survival rates
      in the series were 59% and 34% at 5 and 10 years, respectively. The results
      demonstrated that the factors affecting the prognosis may include resectability,
      postoperative irradiation or chemotherapy, MG, and tumor staging. The influence
      of histologic variation on survival rates could not be clearly defined in the
      series. Surgical resection, particularly complete thymectomy, followed by
      irradiation is the primary option of therapeutic management for malignant
      thymoma.

PMID- 1617595
TI  - Spleen findings in generalized mastocytosis. A clinicopathologic study.
AB  - BACKGROUND: Little information regarding the morphologic findings of the spleen
      in generalized mastocytosis (GM) is available and no comprehensive review of the
      literature on this subject has been published. METHODS: The authors reviewed
      their records to study the macroscopic and microscopic features of the spleen in
      53 patients; the authors also studied these features in 135 patients reported in
      the literature. Thus, a total of 188 patients with GM were studied. RESULTS:
      Splenomegaly was noted in 72% of the patients, including 71% of the patients from
      the authors' files and 73% of the patients reported in the literature. The spleen
      weight, recorded in 39 of the patients, ranged from 160 g to 2300 g; in 29 (80%)
      patients the spleen weighed more than 500 g and in 4 (10%) patients, more than
      2000 g. However, mast cell (MC) infiltration of the spleen was recorded in only
      65 (34%) patients (patients from authors' records, 39%; patients reported in
      literature, 32%). The following combinations were extremely rare: splenomegaly
      without evidence of MC infiltration (n = 1); and histologic evidence of MC
      infiltration in the absence of splenomegaly (n = 2). The histologic findings of
      the spleen could be assessed in nine of the patients from the authors' files,
      eight of whom had MC infiltration. In four patients, infiltration was diffuse and
      confined mainly to the red pulp; in the other four patients, it was more focal
      and involved mainly the white pulp. Spleen plasmacytosis was found in eight
      patients, eosinophilia in five, hemosiderosis in seven, and fibrosis in six.
      Concurrent acute nonlymphoblastic leukemia was diagnosed in four patients, none
      of whom had the skin lesions of urticaria pigmentosa. CONCLUSIONS: The authors'
      findings show that (1) splenomegaly is a common finding in GM and often is
      pronounced; (2) MC infiltration probably is the most important factor in the
      pathogenesis of splenomegaly in this disease; and (3) two different patterns of
      MC infiltration (diffuse and focal) can be identified in GM.

PMID- 1617596
TI  - Bone resorption by macrophage polykaryons of a pilar tumor of scalp.
AB  - The nature of keratin-associated giant cells of a pilar tumor of scalp (PTS) was
      assessed for several osteoclast-like characteristics, including antigenic
      phenotype, ultrastructure, calcitonin response, and bone resorbing ability. The
      giant cells, unlike osteoclasts, did not respond morphologically to calcitonin,
      had the antigenic phenotype of cells of the monocyte/macrophage lineage, and
      showed ultrastructural features of macrophage polykaryons. However, like
      osteoclasts, the giant cells were capable of bone resorption, including
      resorption pit formation. This indicates that the giant cells in PTS are of
      histiocytic and not osteoclastic differentiation. Bone resorption by tumor
      associated macrophage polykaryons shows that this is not a unique defining
      characteristic of osteoclasts. It also suggests that such histiocytic cells may
      contribute to the osteolysis associated with skeletal metastases of squamous and
      other carcinomas.

PMID- 1617597
TI  - Recurrent cutaneous leiomyosarcoma.
AB  - BACKGROUND: Soft tissue sarcomas comprise approximately 0.7% of all malignant
      neoplasms. Superficial leiomyosarcoma, a rare malignant lesion, constitutes 4.0
      6.5% of all soft tissue sarcomas, an overall incidence of approximately 0.04%
      among all cancers. Currently, less than 125 cumulative cases of cutaneous and
      subcutaneous leiomyosarcoma have been reported in the English literature.
      METHODS: The authors report the case of a 70-year-old Japanese man with recurrent
      cutaneous leiomyosarcoma who was treated by wide local excision. A comprehensive
      literature survey is also presented. RESULTS: The patient is free from recurrence
      1 year after wide local excision of a second recurrence of cutaneous
      leiomyosarcoma. Moreover, superficial leiomyosarcoma can be subdivided into
      cutaneous leiomyosarcoma and subcutaneous leiomyosarcoma, based on
      histopathologic and prognostic differences. CONCLUSIONS: The treatment of choice
      of superficial leiomyosarcoma is wide local excision. Cutaneous leiomyosarcoma is
      associated with local recurrence only, although subcutaneous leiomyosarcoma
      undergoes metastatic spread in 30-60% of cases, with a 30-40% mortality rate.

PMID- 1617598
TI  - Detection of local recurrence after conservative therapy for breast carcinoma.
AB  - BACKGROUND: Early detection of local recurrence after conservative therapy for
      breast cancer is associated with improved survival. This review was undertaken to
      determine the ability to detect recurrence and identify patterns of recurrence.
      METHODS: Records of women with local tumor recurrence were retrospectively
      reviewed. RESULTS: In 42 women with 43 local recurrences, tumors were detected by
      mammography alone in 18 instances (42%), physical examination alone in 14 (33%),
      and by both in 11 (25%). Of 29 recurrences mammographically detected, 19 were
      diagnosed by microcalcifications, 9 by a mass, and 1 by a mass with
      microcalcifications. Twenty of 25 tumors detected by physical examination were
      felt as a mass. Recurrences detected by mammography were more often in situ (72%
      or 13 of 18) than those detected by physical examination alone (7% or 1 of 14).
      Treatment failure at the site of the original tumor seemed to occur earlier than
      failures elsewhere in the breast and was more common in women younger than 43
      years of age or with disease that was originally axillary node-positive.
      CONCLUSIONS: Mammography often detects more in situ recurrences than physical
      examination, but both are complimentary. Recurrence at the site of the original
      tumor is usually earlier and in younger women and may be associated with tumors
      that were originally node-positive.

PMID- 1617599
TI  - Independent validation of APACHE II severity of illness score for predicting
      mortality in patients with breast cancer admitted to the intensive care unit.
AB  - BACKGROUND: To determine the validity and predictive accuracy of the Acute
      Physiology and Chronic Health Evaluation (APACHE II) scoring system for severity
      of illness by comparing the actual hospital mortality with the predicted
      mortality for patients with breast cancer admitted to the intensive care unit
      (ICU). METHODS: APACHE II scores were calculated based on retrospective
      evaluation of the medical records of 52 patients with breast cancer who received
      ICU care. The relationships between hospital mortality and APACHE II scores,
      number of sites of metastatic disease, duration of metastatic disease, number of
      chemotherapeutic regimens given for metastatic disease, presence of neutropenia
      or thrombocytopenia, age, reason for ICU admission, and length of ICU stay were
      assessed. RESULTS: Twenty-two patients (42%) died during the hospital stay during
      in which they were admitted to the ICU. Predicted mortality based on a logistic
      regression model using APACHE II scores was 21 patients (40%). APACHE II
      specificity was 87%; sensitivity was 54%. There were significant relationships
      between presence of metastatic disease, number of metastatic sites, reason for
      ICU admission, and length of ICU stay. Patients with more than two sites of
      metastatic disease and those with respiratory failure had particularly poor
      chances of survival. Regression analysis incorporating the number of sites of
      metastatic disease, reason for ICU admission (whether for a pulmonary or a
      cardiovascular problem), and APACHE II score suggested that APACHE II could
      predict hospital survival. CONCLUSIONS: This retrospective study showed that
      APACHE II scores were associated with hospital mortality in patients with breast
      cancer who were admitted to ICU. The number of metastatic sites and the type of
      major organ system failure were also associated with outcome. Regression analysis
      suggested that APACHE II scores were independently associated with survival
      outcome.

PMID- 1617600
TI  - Breast carcinoma presenting as axillary metastases without evidence of a primary
      tumor.
AB  - BACKGROUND: Sixty cases of axillary metastases from clinically occult breast
      cancer were analyzed. All cases had histologic evidence of metastatic nodes
      compatible with breast carcinoma. METHODS: Thirty-three patients underwent breast
      surgery at the time of histologic diagnosis of the axillary metastases, 6
      patients were treated with radiation therapy to the breast, and 17 patients did
      not receive any immediate treatment of the breast carcinoma (9 of these
      subsequently had a primary breast carcinoma) during the follow-up. Thirty-seven
      of 60 patients underwent adjuvant therapy (29 underwent chemotherapy and 8
      underwent tamoxifen therapy). From the histologic point of view, the number of
      metastatic nodes was 1 in 13 patients, 2 to 3 in 10 patients, and 4 or more in 23
      patients; the number of metastatic nodes was not evaluable in 14 cases. Invasion
      was extranodal in 92% of cases. Eighty-six percent of cases were histologically
      classified as Grade 3 according to Bloom and Richardson. RESULTS: The 5-year and
      10-year survival rates were 77% and 58%, respectively. The comparison between the
      survival curves of the patients treated with immediate surgery/radiation therapy
      and of the patients whose cases were followed-up without treatment to the breast
      showed no difference. Adjuvant treatments did not improve prognoses. CONCLUSIONS:
      The coexistence of a minimal (or unidentifiable) primary carcinoma with an
      extensive involvement of axillary nodes and a predominance of the
      undifferentiated histologic type, together with an unexpectedly good prognosis,
      makes this type of presentation an interesting example of a dissociated host
      resistance.

PMID- 1617601
TI  - Mammography screening credit card and compliance.
AB  - BACKGROUND: Screening for breast cancer using mammography has been shown to be
      effective in reducing mortality from breast cancer. The authors attempted to
      determine if use of a wallet-size plastic screening "credit" card would increase
      participants' compliance for subsequent mammograms when compared with traditional
      methods of increasing compliance. METHODS: Two hundred and twenty consecutive
      women, ages 40-70 years, undergoing their first screening mammography were
      recruited and assigned randomly to four groups receiving (1) a reminder plastic
      credit card (2) reminder credit card with written reminder; (3) appointment card;
      and (4) verbal recommendation. Return rates of the four groups were determined
      after 15 months. RESULTS: The return rate for subsequent mammograms was
      significantly higher for participants (72.4%) using the credit card than for
      participants (39.8%) exposed to traditional encouragement/reminders (P less than
      0.0001). CONCLUSIONS: The credit card was designed to show the participant's
      screening anniversary, and the durability of the card may have been a factor in
      increasing the return rate. The use of reminder credit cards may increase
      compliance for periodic screening examinations for other cancers and other
      chronic diseases.

PMID- 1617602
TI  - Functioning ovarian carcinoids induce severe constipation.
AB  - Five patients with ovarian carcinoid who had severe constipation for a long
      period preoperatively showed marked reduction of this symptom postoperatively.
      Because this phenomenon was believed to be caused by some biologically active
      substance rather than a mechanical effect of the tumor, reactivity to 17 amine
      and peptide hormones was studied immunohistochemically in these patients.
      Numerous peptide YY (PYY)-positive cells were detected, with PYY-positive cells
      representing more than 50% of all carcinoid tumor cells in each patient. PYY,
      which has a pharmacologic inhibitory action on intestinal motility, was
      presumably the cause of the constipation in these patients.

PMID- 1617603
TI  - Cerebral neurocytoma. A new subset of benign neuronal tumors of the cerebrum.
AB  - Three cases of patients with unusual neuronal tumors in the cerebral hemisphere
      are reported. All were associated with long-standing epileptic seizures. Computed
      tomography disclosed low-density lesions without contrast enhancement, which were
      interpreted as either arachnoid cysts or a cerebral infarction at initial
      diagnosis. Magnetic resonance imaging scans, however, revealed the lesions to be
      solid tumors. At surgery, the tumors were found to be relatively well demarcated,
      soft, and gelatinous. Histologically, all tumors were composed of small uniform
      stellate cells, which proliferated in a loose myxoid fibrillary matrix and
      resembled either oligodendroglial or astrocytic tumors. Ultrastructurally,
      however, all tumors showed neuronal differentiation, including numerous clear and
      occasional dense-core vesicles, microtubules, and a number of synapses. A review
      of the literature uncovered no other such cases, and therefore it was decided to
      classify these tumors as a distinct group of benign neuronal tumors, designated
      as "cerebral" neurocytoma compared with "intraventricular" neurocytoma. Related
      nosologic problems of neuronal tumors of the central nervous system and their
      possible histogenesis are also discussed.

PMID- 1617604
TI  - Precursor Langerhans cell histiocytosis. An unusual histiocytic proliferation in
      a patient with persistent non-Hodgkin lymphoma and terminal acute monocytic
      leukemia.
AB  - BACKGROUND: Langerhans cell precursors are considered to be identical to their
      mature counterparts except for the lack of Birbeck granules. Proliferations
      composed of such histiocytes appear to be uncommon. METHODS: Standard
      immunophenotypic, molecular genetic, and DNA content studies were used to
      characterize various hematopoietic disorders, including a proliferation of
      precursor Langerhans cells, which arose sequentially in a patient. RESULTS: The
      patient studied initially had a low-grade, B-cell, non-Hodgkin lymphoma and
      subsequently had an unusual histiocytic proliferation (precursor Langerhans cell
      histiocytosis) in cutaneous and lymph node sites. The patient eventually died of
      acute myelogenous leukemia (FAB, M5). CONCLUSIONS: A larger series is required to
      determine the significance of the precursor Langerhans cell phenotype,
      particularly with respect to the development of acute myelogenous leukemia.

PMID- 1617605
TI  - Necrotizing pneumonitis caused by 5-fluorouracil infusion. A complication of a
      Hickman catheter.
AB  - The authors report the case of a patient with a Hickman catheter that migrated
      into the lung parenchyma. The resultant inadvertent infusion of 5-fluorouracil
      caused necrotizing chemical pneumonitis. Possible mechanisms of catheter
      migration include the lateral orientation of the catheter tip and the partial
      thrombosis of the innominate vein and superior vena cava. The patient recovered
      but had residual contraction fibrosis of the right upper lobe of the lung.

PMID- 1617606
TI  - Diagnostic value of microvillus-matrix associations in tumors.
AB  - Until now microvillus-matrix associations have been reported to occur only in
      mesotheliomas and hence this phenomenon is thought to be of value in
      distinguishing mesothelioma from pulmonary adenocarcinoma. We report here the
      occurrence of microvillus-matrix associations in two pulmonary adenocarcinomas
      which reduces the value of this phenomenon in the differential diagnosis of these
      tumors.

PMID- 1617607
TI  - New interpretations in rhinosporidiosis, enigmatic disease of the last nine
      decades.
AB  - Fungal etiology is widely quoted for the disease rhinosporidiosis. Identity of
      the fungal sporangium and its relationship with the disease have baffled medical
      scientists and mycologists for several decades. This study provides unequivocal
      evidence against involvement of fungus in rhinosporidiosis. The so-called
      sporangium is found to be a unique body containing residue-loaded lysosomal
      bodies ('spores') for elimination from the system. 'Sporangia' have been
      redesignated nodular bodies (NB) and 'spores' as spheres of cellular waste (scw).
      Two carbohydrates, namely defective proteoglycans synthesized intracellularly and
      an exogenous polysaccharide ingested through diet of tapioca constitute
      indigestible material in NB and scw. Polysaccharide in NB which has beta, 1-4
      glycosidic bonds between mannose residues is not degraded by gastrointestinal
      enzymes nor in intracellular lysosomes which break only alpha-glycosidic bonds. A
      link between NB and dry tapioca has been deduced. Rhinosporidiosis is a complex
      phenotype with perhaps no parallel in medical science. This report erases 99
      years (1892-1991) of controversies regarding 'causal organism' of
      rhinosporidiosis.

PMID- 1617608
TI  - Morphometric analysis of Mauthner axon cytoskeletal components in adult and
      subadult fish.
AB  - A previous cytoskeletal analysis on trout MA during developmental stages
      demonstrated, during the subadult stages, neurofilaments (NF) as main components
      as expressed by the high values of neurofilament to microtubules (MT) ratio which
      was found to be of the order of 300:1. Since the MA cytoskeletal composition is
      not known in the adult fish, the MA cytoskeletal composition has been compared to
      other axons of much smaller diameter of the fasciculus longitudinalis medialis
      (flm) among which the MA run in the ventral spinal cord. The following parameters
      were measured on conventional electron microscopy in MA and flm axons cross
      sections micrographs by means of a computer linked graphic tablet (Apple II):
      axonal caliber, number of microtubules (MT), microtubular (MT/microns2) and
      neurofilament (NF/microns2) densities. The analysis of these parameters
      demonstrated that neurofilaments are the main architectural components in the
      adult and subadult fish MA and flm axons. However, MA cytoskeletal composition
      differs from the other flm axons because of its particular very high ratio of
      neurofilaments to microtubules. The inverse relationship of axonal caliber to
      microtubular density, previously found in the trout during developmental stages
      and suggested also for many other vertebrate species, was further confirmed for
      flm axons which, with calibers 10 times smaller than MA, exhibit a microtubular
      density 10 times larger.

PMID- 1617609
TI  - The axonal microtubular density is higher than normal in fibres innervating
      spastic muscles.
AB  - In infants with spastic disorders and with congenital dysplasia of the hip (CDH),
      the microtubular content of nonmedullated and myelinated fibres of the anterior
      obturator nerves was studied with the electron microscope. In CDH infants, the
      microtubular content of nonmedullated and myelinated fibres was similar to values
      reported for experimental animals. In spastic patients, the microtubular content
      of nonmedullated fibres was similar to that found in CDH patients while the
      microtubular densities of 3- and 10-microns myelinated fibres were 37.5 and 16.7
      microtubules/micron2, respectively, or 100% and 43% greater than corresponding
      values of CDH patients. We propose that the high firing rate determines the
      abnormally high microtubular content of myelinated axons supplying spastic
      muscles.

PMID- 1617610
TI  - Unusual assembly juxtaposed to Golgi elements in a mitotic B16F10 mouse melanoma
      cell.

PMID- 1617611
TI  - Preferential localization of hafnium in nodular lymphatic cells. Study by
      electron microprobe.
AB  - In a previous work we used the electron microprobe to study the intracellular
      localization of zirconium after administration of soluble salt at low doses. That
      element was concentrated in nodular lymphatic cells. In the present work using
      the same methods we studied hafnium, another element in group IVb of the periodic
      table, which has chemical properties similar to zirconium. After administration
      at low doses of soluble salt of hafnium, this element was similarly concentrated
      in nodular lymphatic cells and was as zirconium uniquely localized in the
      lysosomes of macrophages where it is associated with phosphorus.

PMID- 1617612
TI  - Met-enkephalin induces fast synaptic plasticity of magnocellular neurons in the
      rat supraoptic nucleus.
AB  - A morphometric-ultrastructural study was made of the supraoptic nucleus of rats
      of both sexes following central administration of met-enkephalin. Ten minutes
      after met-enkephalin treatment the number of axo-somatic synapses was
      significantly increased. This effect was more pronounced in female rats than in
      males and could be prevented by preceding administration of naloxone. Animals
      that received naloxone followed by met-enkephalin showed a dilation of the rough
      endoplasmic reticulum into a vesicular shape. Our results provide preliminary
      evidence for a fast remodeling of synaptic input to magnocellular hypothalamic
      neurons. It is likely that the known inhibitory action of opioids on the
      hypothalamo-neurohypophysial system is partly mediated by this plasticity.

PMID- 1617613
TI  - Influence of a short oxidative stress on the LDL endocytosis by human endothelial
      cells: an ultrastructural study.
AB  - Following injury induced by oxidant stress (exposure to xanthine-xanthine oxidase
      during 120 min), cultured human umbilical vein endothelial cells were severely
      modified. These lesions were evaluated by electron microscopy and the types of
      injury were shown to be progressive cell blebbing as well as altered
      mitochondrial features. Enlargement of the endoplasmic reticulum and swelling of
      the Golgi apparatus were also observed. With the intention of learning more about
      the role of oxygen-derivative-induced alterations of the endocytotic apparatus
      (plasma membrane, endosomes, lysosomes), the receptor-mediated endocytosis of
      colloidal gold-conjugated LDL was evaluated. It was demonstrated that this
      endocytosis is drastically decreased following this type of injury, corroborating
      our previous report of important reduction in 125I-LDL endocytosis under the same
      conditions. Tubular electron-lucent structures, often observed in the vicinity of
      blebs, could possibly be involved in the impairment of LDL receptor
      accessibility.

PMID- 1617614
TI  - Tight endothelial junctions in the developing microvasculature: a thin section
      and freeze-fracture study in the chick embryo optic tectum.
AB  - The development of the interendothelial tight junctions was studied in the
      microvessels of the otpic tectum of chick embryos, at the 14th-16th and 18th-20th
      incubation day (i.d.), and in post-hatching chickens, using thin sections and
      freeze-fracture techniques. At the 14th-16th i.d., the junctional plasmamembranes
      of the endothelial cells are simply apposed or fused for brief tracts showing a
      pentalaminar or trilaminar configuration. In the replicas the P-faces of the
      fractured junctional membranes are either lacking in intramembrane particles
      (IMPs) and characterized by finger-like depressions, or provided with discrete
      IMPs aligned in rows. At the 18th-20th i.d., the thin peripheral expansions of
      the endothelial cells are superimposed and welded by continuous pentalaminar
      junctions. Their fracture P-faces display junctional strands formed by parallel
      fibrils of fused IMPs, with or without interconnections. In the 10-day-old
      chickens the junctions consist of highly complex networks of fibrils. The results
      have made it possible to recognize precise relationships between the features of
      the developing endothelial junctions in the ultrathin sections and, respectively,
      in the replicas. Moreover, the observations suggest that tight junction formation
      occurs progressively in the cerebral microvessels by processes of alignment and
      fusion of the IMPs, which conclude with the arrangement of fibrils in networks.

PMID- 1617616
TI  - Instruments that measure beliefs about cancer from a cultural perspective.
AB  - Understanding beliefs about cancer from a cultural perspective is of great
      importance as the population mix of this country continues to shift and change.
      In order to assess the cancer beliefs held by diverse populations, culturally
      specific tools are needed. The purpose of this article is to identify and
      describe instruments that have been used to assess beliefs about cancer. Eight
      published and unpublished instruments were identified from a review of the
      literature. These tools address attitudes and beliefs toward cancer, cancer
      prevention, and cancer treatment within a variety of age groups and ethnic
      populations. One tool was related to adolescents, whereas the remainder focused
      on adults; three were translated into other languages; four tools involved
      questionnaire format and four interview format. Although it is encouraging to
      report that culturally specific tools are being developed, there is a
      demonstrated need to increase the expertise in developing such instruments.

PMID- 1617615
TI  - Blood vessel architecture in lymph nodes of the dog viewed by scanning electron
      microscopy.
AB  - Scanning electron microscopy was used to investigate the submicroscopic
      organization of the blood vessels of dog lymph nodes (LN). The LN vessels were
      casted by systemic perfusion of the animals vasculature with two resins of
      distinct viscosity. This resulted in the retrieval of two types of LN vascular
      replicas that depicted either the arterial blood system alone (methacrylate
      casting) or both the arterial and venous blood systems (Mercox casting). We found
      that the dog LN showed a significantly higher density of arterial vessels in the
      cortex than in the medulla. In the cortical domain, a subcapsular layer stood out
      because of its rich content in arterial capillaries. The use of the high
      resolution resin (mercox) resulted in excellent structural detail of the luminal
      surface of the LN vessels that allowed a clear distinction between arterioles and
      venules based on the geometrical pattern of the imprints left in the replicas by
      the nuclei of endothelial cells. At the cortex-medulla frontier, most arterioles
      showed narrowings of their lumen that suggested the existence of sphincters at
      this level. Our findings document that the microanatomical arrangement of blood
      vessels in the LN of the dog is different from that of LN from other mammals
      studied so far, in particular from rodents where vascular-poor microdomains have
      been reported in the LN cortex. The arteriolar sphincters that we detected at the
      innermost zone of the cortex may represent the structural counterpart of the
      physiological modulation of the blood supply of the cortex exerted by arterial
      branches coming from the hilus.

PMID- 1617617
TI  - Potential predictors of information-seeking behavior by homosexual/bisexual (gay)
      men with a human immunodeficiency virus seropositive health status.
AB  - Seeking ways to improve their health, gay men with human immunodeficiency virus
      (HIV) infections living in San Francisco are developing information networks and
      patterns of self-care behavior. Drawing from a set of explanatory theories, this
      cross-sectional survey with retrospective elements examined patterns and
      potential predictors of information-seeking activity in a cohort or 162 HIV
      seropositive (HIV+) men, 60 of whom provided complete data sets. The study
      suggests that 1 year after becoming aware of an HIV+ health status, most patients
      have developed multifaceted information networks. The amount of tangible aid
      acquired from these networks and frequency of consultation is positively related
      to patterns of HIV self-care behaviors and "feeling calm" (p less than 0.01),
      suggesting that these variables may be important markers for the need of
      supportive-educative nursing care. Suggestions for nursing practice and research
      are also described.

PMID- 1617618
TI  - Bereavement care. A role for nurses.
AB  - Bereavement care is an important, yet often forgotten, area of care. Evidence
      suggests that early and prompt interventions for high-risk individuals can
      facilitate grief and can minimize the adverse consequences of grief. Nurses can
      play a pivotal role in providing care to bereaved individuals. However, it is
      essential to have a thorough knowledge of the normal grief response, and a
      framework for assessment and management. This article provides fundamental
      information about the manifestations of grief, and offers information about
      appropriate nursing assessment and management for bereaved individuals.

PMID- 1617619
TI  - Use of ethyl chloride topical anesthetic to reduce procedural pain in pediatric
      oncology patients.
AB  - Pediatric cancer patients often become anxious, agitated, combative, and
      uncooperative due to the pain or fear of pain during invasive procedures.
      Generally, it is not the actual administration of medicines that produces this
      reaction, but the fear of the needle stick itself. Increased education and
      implementation of coping mechanisms is often not enough to allay this fear. The
      tangible solution of using ethyl chloride, an anesthetic spray, before port
      sticks, lumbar punctures, and bone marrow aspirations, was instituted by the
      hematology-oncology clinic to determine if the pain, emotional trauma, and fear
      of cancer treatments could be reduced in oncology patients. Survey results on 60
      patients and 60 parents/caretakers showed that when given the choice to use the
      spray or to refuse its use, 68% of the parents thought that the patient had more
      of a sense of control and, thus, involvement in their treatment. Seventy-eight
      percent of the patients reported experiencing less pain associated with
      procedures. Staff noted an increase in cooperation, less combativeness, and more
      compliance with treatment. Perceiving the child's discomfort diminished, 87% of
      the parents/caretakers report feeling less anxious and, therefore, more capable
      of being supportive to each other and their child. These results verified the
      staff's perceptions of the advantages of using this noninvasive anesthetic. Ethyl
      chloride is an easy, effective, concrete approach to reducing procedural pain in
      pediatric oncology patients.

PMID- 1617620
TI  - Fundamentals for a new concept of oncology nursing in the professional nursing
      education program.
AB  - Cancer is a life-threatening illness affecting approximately one-third of the
      population in America and western Europe. All nurses and student nurses will in
      all probability be confronted at some time in their careers with the specific
      problems of cancer patients and their families. Are all nurses, however, being
      prepared in their basic nursing education programs to deal with these problems?
      It is the purpose of this paper, first of all, to examine this question through a
      review of appropriate literature and through review of a questionnaire, sent to
      nursing students in their final semester, relating to perceived needs in this
      area. Secondly, our purpose is to suggest actions that may need to be taken in
      order to assure quality care of cancer patients and adequate preparation and
      support of professional nurses involved in this care.

PMID- 1617621
TI  - Nursing's involvement in the primary and secondary prevention of cancer.
      Nationally and internationally.

PMID- 1617622
TI  - Inhibition of dihydroorotate dehydrogenase activity by brequinar sodium.
AB  - The novel anticancer drug candidate brequinar sodium (DuP 785, NSC 368390, 6
      fluoro-2-(2'-fluoro-1,1'-biphenyl-4-yl)-3-methyl-4-quinoline- carboxylic acid
      sodium salt) was shown previously to be an inhibitor of dihydroorotate
      dehydrogenase, the fourth enzyme of the de novo pyrimidine biosynthetic pathway.
      Brequinar sodium inhibits the activity of this enzyme isolated from mammalian
      sources only but not those forms isolated from yeast or bacteria, which also use
      ubiquinone as the cofactor. Brequinar sodium also does not inhibit the activity
      of a soluble Zymobacterium oroticum dihydroorotate dehydrogenase which uses NAD+
      as a cofactor. Brequinar sodium inhibits L1210 dihydroorotate dehydrogenase with
      mixed inhibition kinetics with respect to either the substrate (dihydroorotate)
      or the cofactor (ubiquinone Q6) with Ki' values in the 5-8 nM range. Our results
      suggest that brequinar sodium inhibits dihydroorotate dehydrogenase by binding to
      the enzyme at a unique site that is distinct from the dihydroorotate or the
      ubiquinone-binding site. This binding site appears to be unique to the mammalian
      enzyme, because brequinar sodium does not inhibit the yeast, Escherichia coli, or
      Z. oroticum forms of the enzyme.

PMID- 1617623
TI  - Uptake of the noncytotoxic transport probe procainamide in the Chinese hamster
      ovary model of multidrug resistance.
AB  - Many of the cytotoxic substrates of the multidrug transporter are organic
      cations. Cimetidine, procainamide, and tetraethylammonium bromide were used in a
      Chinese hamster ovary model of multidrug resistance, to study handling of
      noncytotoxic cationic transport probes. Cimetidine and procainamide, but not
      tetraethylammonium, accumulated to a greater extent (5-fold) in the sensitive
      CHOAUXB1 (AB) cell line than in the resistant CHRC5 (C5) cell line. Accumulation
      of both cimetidine and procainamide was significantly increased by verapamil in
      C5 but not AB. Procainamide accumulation in both AB and C5 was temperature
      dependent and occurred by passive diffusion. Diltiazem, nifedipine, rifampin,
      tamoxifen, rhodamine, and ethidium also increased procainamide accumulation in C5
      but not AB. Azide in glucose-free medium increased procainamide accumulation in
      C5, and this was reversed when glucose, but not 3-O-methylglucose, was added.
      Procainamide efflux rates were similar in AB and C5 and not affected by verapamil
      or azide. The initial rate of procainamide uptake was higher in AB than in C5,
      and both verapamil and azide increased the initial rate of procainamide uptake in
      C5. Thus, differences in accumulation of the noncytotoxic transport probe
      procainamide in the colchicine-sensitive and colchicine-resistant components of
      the Chinese hamster ovary cell line mimic the accumulation of known cytotoxic
      substrates for the multidrug transporter, such as colchicine, vinblastine, and
      doxorubicin. The differential accumulation of procainamide is due to differences
      in rates of drug influx, rather than efflux. Since procainamide influx is passive
      and decreased accumulation in the resistant line appears to parallel M(r) 170,000
      glycoprotein presence and activity, we would speculate that decreased
      procainamide accumulation may be due to an indirect effect of the M(r) 170,000
      glycoprotein, such as its effect on intracellular pH.

PMID- 1617624
TI  - Metabolism of N-nitrosomethyl-n-amylamine by microsomes from human and rat
      esophagus.
AB  - Asymmetric dialkylnitrosamines induce esophageal cancer in rats and hence might
      be involved in the etiology of this cancer in humans. As a test of this
      hypothesis, we examined whether nitrosamines can be activated by segments of
      human esophagus and by microsomes of human and rat esophagus and liver. Specimens
      of 8 human esophagi were removed less than 6 h after death, and segments were
      incubated for 6 h with 23 and 300 microM N-nitrosomethyl-n-amylamine (NMAA).
      Hydroxy-NMAA yields were determined by gas chromatography-thermal energy analysis
      and were insignificant except for those of 5-hydroxy-NMAA, which were low.
      Microsomes were prepared from 4 batches of human esophagi and samples with 0.6 mg
      protein were incubated for 20 min with NMAA and cytochrome P-450 cofactors. We
      determined hydroxy-NMAAs as before and aldehydes by high-performance liquid
      chromatography of their 2,4-dinitrophenylhydrazones. Incubation of these
      microsomes with 12 mM NMAA yielded mean values of 0.64 nmol formaldehyde
      ("demethylation"), 0.21 nmol pentaldehyde ("depentylation"), and 0.56 nmol total
      hydroxy-NMAAs/min/mg protein. Metabolite yields under various conditions were
      determined, including a demonstration that carbon monoxide inhibited 81% of NMAA
      demethylation, indicating that cytochrome P-450 enzymes were involved. We also
      examined N-nitrosodimethylamine (NDMA) demethylation by the same microsomes. Rat
      esophageal microsomes dealkylated NMAA and NDMA similarly to human esophageal
      microsomes, but with 2-6 times and twice the activity, respectively. Human and
      rat esophageal microsomes demethylated 6 mM NMAA 18-20 times as rapidly as they
      demethylated 5 mM NDMA, in contrast to liver microsomes of these species, which
      demethylated 6 mM NMAA only 0.9-1.4 times as rapidly as they demethylated 5 mM
      NDMA. However, liver microsomes of both species were more active than esophageal
      microsomes for NMAA depentylation. The occurrence of NMAA demethylation and (to a
      lesser extent) depentylation with both human and rat esophageal microsomes is
      important because these are the activating reactions, and suggests that both
      human and rat esophagus contain P-450 isozymes that specifically dealkylate
      asymmetric dialkylnitrosamines.

PMID- 1617625
TI  - Synergism between dipyridamole and cisplatin in human ovarian carcinoma cells in
      vitro.
AB  - Dipyridamole (DPM), a nucleoside membrane transport inhibitor, enhanced the
      cytotoxicity of cisplatin (DDP) for human ovarian carcinoma 2008 cells by a
      factor of 4.7 +/- 0.4-fold (mean +/- SD) and for the 10-fold DDP-resistant
      2008/C13*5.25 subline by a factor of 5.8 +/- 2.7-fold. This interaction was shown
      to be truly synergistic by isobologram and median effect analysis. DPM
      enhancement of DDP cytotoxicity was schedule dependent; it was greatest when
      cells were exposed to DPM continuously during and following a 1-h exposure to DDP
      and less pronounced when DPM exposure was limited to pretreatment or concurrent
      treatment only. DPM increased DDP uptake in a concentration-dependent manner as
      measured with both [195mPt]-DDP and the DDP analogue [3H]-cis
      dichloro(ethylenediamine) platinum. Nitrobenzylthioinosine, another nucleoside
      membrane transport inhibitor, did not enhance DDP cytotoxicity or uptake at
      concentrations that produced equivalent degrees of inhibition of [3H]uridine
      uptake. DPM did not interact synergistically through an increase in cellular
      cyclic AMP levels. DPM did not increase trypan blue or propidium iodide uptake,
      or change cell size, indicating that it did not nonspecifically increase membrane
      permeability. We conclude that DPM interacts synergistically with DDP and that,
      while an increase in DDP uptake is one component of the mechanism of this
      interaction, there are additional components since maximal effect was observed
      only with prolonged DDP exposure.

PMID- 1617627
TI  - Acrolein initiates rat urinary bladder carcinogenesis.
AB  - Acrolein, a reactive, alpha,beta-unsaturated aldehyde which is ubiquitous in the
      environment, forms DNA adducts, is mutagenic, and is teratogenic. However,
      studies have not indicated a carcinogenic effect in rodent bioassays. Since it is
      present in cigarette smoke and is the toxic metabolite of cyclophosphamide with
      respect to the urinary tract, we investigated the possibility that acrolein might
      have carcinogenic activity toward the rat urinary bladder. We also evaluated
      whether it possessed initiating and/or promoting activity. To evaluate initiating
      activity, acrolein was administered at a dose of 2 mg/kg i.p. twice a week for 6
      weeks followed by uracil as 3% of the diet for 20 weeks and then control diet for
      6 weeks. N-[4-(5-Nitro-2-furyl)-2-thiazolyl]formamide (FANFT) as 0.2% of the diet
      followed by uracil was used as a positive control, and a negative control group
      was administered solvent control (water) i.p. during the 6-week initiation period
      followed by uracil. Acrolein followed by uracil produced an incidence of 18 of 30
      rats (60%) with papilloma compared to 8 of 30 rats (27%) treated with solvent
      control followed by uracil. FANFT followed by uracil produced an incidence of 70%
      carcinomas and 30% papillomas, clearly indicating that it is a much more potent
      initiating agent than acrolein. Acrolein for 6 weeks followed by control diet
      produced no tumors. To evaluate promoting activity, groups of rats were fed FANFT
      for 6 weeks followed by acrolein. Acrolein administered during the initial 6
      weeks and continued for the second phase of the experiment (to evaluate complete
      carcinogenic activity) resulted in severe toxicity. Administration of acrolein
      had to be terminated after 21 weeks of the experiment. The animals were
      maintained for 53 weeks of the experiment without further chemical treatment, and
      there was no evidence of papilloma or carcinoma development. This study clearly
      indicates that acrolein has initiating activity for the urinary bladder when
      administered by i.p. injection to the male F344 rat, but toxicity precluded
      evaluation of its promoting or complete carcinogenic activity.

PMID- 1617626
TI  - Adriamycin-induced modulation of host defenses in tumor-bearing mice.
AB  - Using the C57BL/6/EL4 tumor model, studies were carried out to demonstrate the
      feasibility of administering Adriamycin (ADM) in therapeutic doses and schedules
      such that the host antitumor defenses would not be suppressed and in some cases
      might be stimulated by treatment. ADM treatment caused prolongation of survival
      and, in general, either stimulated host cytolytic activities above untreated
      control levels or had no effect. These effects by ADM were observed with the ADM
      sensitive parent EL4 line as well as with an ADM-resistant subline, indicating
      that the effects did not result entirely from direct antitumor activity. The
      cytolytic activities examined were those of cytolytic T-lymphocytes, lymphokine
      activated killer cells, and splenic and peritoneal macrophages. All activities
      were assessed against the syngeneic EL4 target line. The information obtained in
      this investigation provides a rational basis for the future development of
      curative protocols with ADM plus biological response modifiers, which would
      depend on a functional immune system for optimum efficacy and would also exploit
      synergistic immunomodulating effects of the agents used in combination.

PMID- 1617628
TI  - Inhibition of skin tumor promoter-caused induction of epidermal ornithine
      decarboxylase in SENCAR mice by polyphenolic fraction isolated from green tea and
      its individual epicatechin derivatives.
AB  - Green tea, next to water, is the most popular and commonly consumed beverage in
      the world, especially in eastern countries. In prior studies we have shown that
      the polyphenolic fraction isolated from green tea (GTP) exerts antigenotoxic
      effects in various mutagenicity test systems (Mutat. Res., 223: 273-285, 1989)
      and that its topical application or oral feeding in drinking water protects
      against polycyclic aromatic hydrocarbon-induced skin tumor initiation and
      complete carcinogenesis in SENCAR and BALB/c mice [Cancer Lett., 42: 7-12, 1988;
      Carcinogenesis (Lond.), 10: 411-415, 1989] and UV B radiation-induced
      photocarcinogenesis in SKH-1 hairless mice [Carcinogenesis (Lond.), 12: 1527
      1530, 1991]. In the present study we assessed the effect of skin application of
      GTP to SENCAR mice on 12-O-tetradecanoylphorbol-13-acetate (TPA) and other skin
      tumor promoter-caused induction of epidermal ornithine decarboxylase (ODC)
      activity. Topical application of GTP to mouse skin inhibited TPA-induced
      epidermal ODC activity in a dose-dependent manner. The inhibitory effect of GTP
      was also dependent on the time of its application relative to TPA treatment.
      Maximum inhibitory effect was observed when GTP was applied 30 min prior to
      topical application of TPA. GTP application to animals also inhibited the
      induction of epidermal ODC activity caused by several structurally different
      mouse skin tumor promoters. In order to identify which of the specific
      epicatechin derivatives present in GTP is responsible for these inhibitory
      effects, they were isolated from GTP and evaluated for their inhibitory effects
      against TPA-caused induction of epidermal ODC activity. Among these, (
      )epigallocatechin-3-gallate (EGCG), which was the major constituent present in
      GTP by weight, exerted the maximum inhibition. EGCG also showed greater
      inhibitory effects against TPA-caused induction of epidermal ODC activity when
      compared with several other naturally occurring polyphenols. The results of this
      study suggest that GTP, specifically its epicatechin derivative EGCG, could
      provide anti-tumor-promoting effects against a wide spectrum of skin tumor
      promoters.

PMID- 1617629
TI  - Meal frequency and risk of colorectal cancer.
AB  - The relation between meal frequency and the risk of colorectal cancer was
      investigated in a case-control study conducted in North Italy on 889 cases of
      colon cancer, 581 cases of rectal cancer, and 2475 controls admitted to hospital
      for acute, nonneoplastic, or digestive disorders. As compared to individuals who
      reported 2 or fewer meals per day, the multivariate colon cancer odds ratios were
      1.7 [95% confidence interval (95% CI), 1.5-2.1] for 3, and 1.9 (95% CI, 1.1-3.3)
      for 4 meals or more. Corresponding rectal cancer odds ratios were 1.4 (95% CI,
      1.1-1.7) for 3, and 1.9 (95% CI, 1.1-3.5) for 4 meals or more. The direct trends
      in risk of colorectal cancer with frequency of eating were not substantially
      modified by allowance for various dietary and nondietary potential confounding
      factors, including an approximate measure of total energy intake, and did not
      show significant effect modification across strata of age, sex, education, and
      other major risk covariates. A role of meal frequency in the etiology of
      colorectal cancer is biologically plausible, since when a meal is eaten, the
      gallbladder contracts and releases bile acids. Thus, eating patterns can
      influence the enterohepatic circulation and, consequently, the exposure time of
      intestinal mucosa to bile acids.

PMID- 1617630
TI  - Interaction of antileukemia agents adriamycin and daunomycin with sphinganine on
      the differentiation of human leukemia cell line HL-60.
AB  - A slight induction of granulocytic differentiation of HL-60 cells occurred after
      treatment with antileukemia chemotherapeutic agents Adriamycin (ADM) and
      daunomycin (DM). Addition of an inhibitor (sphinganine, SP) of protein kinase C
      (PKC) enhanced 2-4-fold the ADM or DM-induced differentiation. This phenomenon
      was accompanied by a slightly augmented antiproliferative effect. The enhancement
      of differentiation induction in these treatments seemed to be absolute, since the
      combination treatment (ADM-SP or DM-SP) showed about 2.5-3.6 times as many
      differentiated cells as the treatment with the anticancer drugs ADM or DM alone.
      Further characterization of the interaction of ADM and DM with SP on
      differentiation of HL-60 cells was carried out. Whereas the addition of SP in the
      fresh medium after the removal of ADM or DM (0.5 h treatment) enhanced the
      induction of differentiation, a pretreatment (24 h) of the cells with SP followed
      by continuous exposure to ADM or DM did not show such enhancement effect. The
      addition of SP at as late as 48 h after the administration of ADM or DM
      potentiated the induction of differentiation to the same extent as in the
      simultaneous combination of ADM-SP or DM-SP. Similar results were obtained in the
      experiments with another PKC inhibitor, staurosporine. These results indicated
      that inhibition of PKC activities may play an important role in the later events
      during the induction of differentiation elicited by ADM or DM. The use of the
      antileukemia drugs ADM and DM in combination with an inhibition of PKC activity
      results in enhancement of induction of differentiation and suggests a new
      strategy and a promising approach to the treatment of leukemia.

PMID- 1617631
TI  - L-histidinol: preclinical therapeutic studies in combination with antitumor
      agents and pharmacokinetic studies in mice.
AB  - Therapeutic studies were conducted with L-histidinol, in combination with
      cyclophosphamide, bischloroethylnitrosourea, 5-fluorouracil, phenylalanine
      mustard, or cis-platinum(II)diammine dichloride, in several transplantable tumors
      in mice. These tumor types included murine L1210 P388 leukemias, M5076 sarcoma,
      mammary 16/C adenocarcinoma, human LOX melanoma, and colon HT-29 adenocarcinoma.
      Therapeutic benefits of adding L-histidinol to a regimen, compared to the regimen
      alone, were marginal. Pharmacokinetic studies indicated a rapid clearance of L
      histidinol following a bolus dose (250 mg/kg i.p.), peak plasma concentration of
      200 micrograms/ml (1.4 mM), and beta phase t1/2 of 12.6 min. Maximum tolerable
      plasma steady state concentrations with a 24-h infusion (2000 mg/kg/24 h) were no
      greater than 25 micrograms/ml (0.18 mM).

PMID- 1617632
TI  - Inhibition of in vitro ovarian cancer cell invasion by modulation of urokinase
      type plasminogen activator and cathepsin B.
AB  - HOC-I ovarian cancer cells express the single-chain form of the urokinase-type
      plasminogen activator (uPA) and cathepsin B (cath B) on their cell surface. The
      significance of the expression of cell surface uPA/cath B activity to the
      invasive potential was examined by preincubating with uPA/cath B-modulating
      agents in in vitro invasion assay. The anti-uPA monoclonal antibody 394
      effectively inhibited invasion in a dose-dependent manner. On the contrary, anti
      cath B antibody did not affect the invasive potential of the cells. E-64, a
      specific inhibitor for cysteine proteases, blocked invasion as effectively as
      monoclonal antibody 394. The data reveal that the uPA and cysteine proteases
      contribute significantly to the invasive capacity of the cells. We suggest that
      the cysteine proteases facilitate the action of uPA, possibly by activating
      proenzyme uPA produced by cancer cells. Evidence for the role of a cathepsin-uPA
      activation cascade in HOC-I cell invasion is provided.

PMID- 1617633
TI  - 2-Amino-3,4-dimethylimidazo[4,5-f]quinoline induces and inhibits cytochrome P450
      from the IA subfamily in chick and rat hepatocytes.
AB  - Several heterocyclic amines, found in cooked food, are powerful mutagens in the
      Ames Salmonella mutagenicity test system. One of these, 2-amino-3,4
      dimethylimidazo[4,5-f]quinoline (MeIQ) is one of the most mutagenic chemicals
      tested in this assay. In primary cultures of chick and rat hepatocytes, MeIQ, by
      itself, induced cytochrome P450 from the IA subfamily but was a weak inducer
      compared to 3-methylcholanthrene. However, in both chick and rat hepatocytes in
      culture, MeIQ decreased the amount of 3-methylcholanthrene-induced
      ethoxyresorufin deethylase activity, which is catalyzed by cytochrome P450 IA.
      The protein moiety of cytochrome P450 IA was decreased at MeIQ concentrations of
      2.5 micrograms/ml or greater in chick hepatocytes and 25 micrograms/ml in rat
      hepatocytes. In hepatic microsomes from methylcholanthrene-treated chicks and
      rats, MeIQ was a competitive inhibitor of both ethoxyresorufin deethylase
      activity, a reaction catalyzed mainly by rodent cytochrome P450 IA1, and
      uroporphyrinogen oxidation, a reaction catalyzed by rodent P450 IA2. In cultured
      chick hepatocytes, MeIQ also decreased cytochrome P450-mediated oxidation of
      uroporphyrinogen by intact cells. The ability of MeIQ to inhibit as well as to
      induce cytochrome P450s of the IA subfamily may be important in assessing the
      mutagenic and carcinogenic effects of MeIQ in mammals.

PMID- 1617634
TI  - Characterization and purification of a guanidinobenzoatase: a possible marker of
      human renal carcinoma.
AB  - Guanidinobenzoatases are cell surface-associated proteinases supposed to be
      involved in cancer metastasis, cell migration, and tissue remodeling. The main
      features of the guanidinobenzoatase associated with human renal carcinoma plasma
      membrane are weak membrane association, continuous cleavage of p-nitrophenyl-p'
      guanidinobenzoate conversely to the site titration effect of this compound when
      used with trypsin, and a peculiar sensitivity to serine protease inhibitors,
      compatible with a poorly active form. Plasma membrane preparation followed by
      agmatine-trisacryl affinity chromatography allows the purification of
      guanidinobenzoatase to homogeneity with an apparent enrichment factor of 450.
      Purified guanidinobenzoatase appears as a single polypeptide chain of M(r)
      80,000, likely stabilized by intrachain disulfides bonds. The properties of
      purified guanidinobenzoatase indicate that it is an original enzyme in spite of
      some similarities with plasminogen activators. Indeed, in addition to differences
      in substrate and inhibitor specificity, guanidinobenzoatase is not recognized by
      specific monoclonal antibodies directed against plasminogen activators or their
      single-chain precursors. Thus, human renal carcinoma guanidinobenzoatase appears
      to be an original enzyme whose activity is undetectable in the nontumoral tissue
      of origin. In this respect, use of purified guanidinobenzoatase would allow us to
      obtain specific tools to give new insights in cancer cell metastasis.

PMID- 1617635
TI  - Low-density lipoprotein for delivery of an acrylophenone antineoplastic molecule
      into malignant cells.
AB  - In vitro and in vivo data have indicated that tumor cells actively internalize
      the low-density lipoprotein (LDL) from the circulation. A family of 2
      (aminomethyl) acrylophenones (AMA) possesses an in vitro antileukemic activity
      but is devoid of any in vivo antineoplastic activity, because the compounds are
      actively captured by proteins in solution in the blood. In order to achieve a
      selective delivery of these drugs via the LDL pathway, we have incorporated an
      AMA drug, 2-morpholinomethyl-2',3',4'- trimethoxy acrylophenone hydrochloride
      (ILE) into LDL particles. ILE spontaneously associated with LDL to produce an LDL
      ILE complex containing 200 +/- 100 molecules of drug per LDL particle. The LDL
      ILE complex was highly electronegative as detected by electrophoresis. Further,
      this complex presented an immunologically detected over expression of the ligand
      binding domain to the LDL receptor. In spite of these modifications, the LDL
      receptor processing bound, internalized, and degraded the LDL-ILE complex.
      Nevertheless, these biological properties were reduced by 32, 20, and 40%,
      respectively, in comparison to native LDL. Despite its high electronegativity,
      the LDL-ILE complex was not recognized by the macrophagic scavenger receptor. The
      LDL-ILE complex showed specific LDL receptor mediated in vitro cytotoxicity as
      judged from the growth inhibition of neoplastic A549 cells and of normal
      fibroblasts, but no activity on defective LDL receptor cells. Further, the
      pharmacological activity of the complex against A549 cells has been demonstrated
      to be equally potent as that of the free drug (median inhibitory dose, 5 microM).
      It is suggested that LDL drug targeting of AMA molecules could specifically
      deliver active molecules to cancer cells, avoiding their entrapment by other
      blood proteins and their rapid clearance by the reticuloendothelial system.

PMID- 1617636
TI  - Inhibition of breast cancer cell growth in vitro by a tyrosine kinase inhibitor.
AB  - Human breast cancer cell proliferation is regulated by growth factors that bind
      to receptors with intrinsic tyrosine kinase (TK) activity, including the
      epidermal growth factor (EGF) receptor. To determine whether inhibition of
      receptor TK activity inhibits tumor growth, we studied the effects of a tyrosine
      kinase inhibitor, RG-13022, on cultured human breast cancer cells. RG-13022
      represents a class of compounds which have been shown to inhibit preferentially
      the TK activity of the EGF receptor in a cell-free system and also to inhibit EGF
      stimulated growth of cultured cells. RG-13022 significantly inhibited EGF
      stimulated autophosphorylation of its receptor in two breast cancer cell lines
      that have abundant, although not amplified, EGF receptor content (MDA-231 and
      T47D). RG-13022 also inhibited EGF-stimulated DNA synthesis and proliferation of
      T47D and MCF-7 breast cancer cells in a reversible and dose-dependent manner.
      Inhibition was observed at 0.1 microM, and it was maximal at 10 microM. The
      effect was rapid (within 3 h), persisted for 18 h, and was partially reversed by
      24 h at 1 microM. At 5 microM, inhibition persisted for more than 50 h.
      Inhibitory effects were also observed in a panel of estrogen receptor-positive
      and estrogen receptor-negative breast cancer cell lines. RG-13022 inhibited not
      only EGF-induced growth but also growth stimulated by insulin, insulin-like
      growth factor I, insulin-like growth factor II, or transforming growth factor
      alpha. RG-13022 also totally blocked estrogen-stimulated phosphorylation of the
      EGF receptor, as well as estrogen-induced cell proliferation, suggesting that
      functioning TK pathways are required for estrogen action. The TK inhibitor RG
      13022 is a potent inhibitor of hormonally regulated growth of human breast
      cancer. Tyrosine kinase inhibitors have the potential of providing a new strategy
      for the "endocrine therapy" of breast cancer.

PMID- 1617637
TI  - New approach for detection of amplification in cancer DNA using restriction
      landmark genomic scanning.
AB  - We developed a new approach for detecting the gene amplification of cancer DNAs
      with restriction landmark genomic scanning (RLGS). In cancer research, much
      effort has been made to find the amplified loci of cancer DNAs, because many
      lines of evidence indicate association between oncogene amplification and
      carcinogenesis. Conventionally, such gene amplification has been detected by
      using Southern hybridization with DNA probes. However, only the information of
      one locus can be obtained by one hybridization procedure, and analysis of many
      loci throughout the genome is too laborious and time consuming, even if only
      several candidate genes are investigated. On the other hand, the "in-gel
      renaturation method" was reported as another alternative for detection of
      amplified regions. However, even though this method is much improved, it is
      difficult to detect less than 7-fold amplification, which is often higher than
      the amplification of many cancer cases. To overcome these limitations and, in
      addition, to locate the amplified DNA two dimensionally, we applied RLGS for
      analysis of DNA amplification in cancer tissues, such as breast cancer
      (infiltrative tubuloadenocarcinoma), neuroblastoma, meningioma (endotheliomatous
      meningioma), and thyroid cancer (papillary adenocarcinoma). In some cases of
      breast cancer, several amplified spots located on the same amplicon were
      detected. In thyroid cancer, in which no amplification has yet been reported, low
      grade amplification was also detected. In this report, we demonstrated that RLGS
      allows us to screen 2000-3000 restriction landmarks distributed on the genome
      simultaneously, and even low-grade amplification could be detected effectively.
      Thus, RLGS has proven to be a very useful method in detecting DNA amplification.

PMID- 1617638
TI  - Response of human breast cancer cells to heat shock and chemotherapeutic drugs.
AB  - Previous studies have shown that certain chemotherapeutic drugs are less
      effective on tumor cells when cells have been previously exposed to hyperthermia.
      In the present study, we have evaluated whether specific modifications in heat
      shock protein (hsp) expression are associated with resistance to anticancer
      drugs. RNA levels for hsp90, hsp70, and hsp27 were studied by Northern and slot
      blots, while proteins were studied by two-dimensional gel electrophoresis, in MCF
      7/BK and MDA-MB-231 breast cancer cells. The sensitivities of these cells to
      doxorubicin, colchicine, 5-fluorouracil, cisplatin, actinomycin D, and
      methotrexate were tested by clonogenic assays. These techniques were applied to
      both cell lines before (control) and after heat shock. The study revealed that
      elevated hsp70 and hsp27 levels were associated with doxorubicin resistance. In
      addition, the presence of phosphorylated hsp27 isoforms was also associated with
      doxorubicin resistance. The study showed that elevated hsps were not associated
      with multidrug resistance. Heat shock did not induce P170 glycoprotein mRNA
      overexpression or resistance to the other drugs tested. We also found that the
      level of doxorubicin protection conferred by the overexpression of hsp was lower
      than that obtained in cells expressing a multidrug resistance phenotype (MDA-A1R
      cells). In these cells, heat shock did not confer additional doxorubicin
      resistance and hsp27 phosphorylation was deficient. Our studies suggest that
      specific hsps are associated with doxorubicin resistance in certain human breast
      cancer cells and that this mechanism seems to be independent of the multidrug
      resistance system.

PMID- 1617639
TI  - Effect of a dihydropyridine analogue, 2-[benzyl(phenyl)amino]ethyl 1,4-dihydro
      2,6-dimethyl-5-(5,5-dimethyl-2-oxo- 1,3,2-dioxaphosphorinan-2-yl)-1-(2
      morpholinoethyl)-4-(3-nitrophenyl)-3 -pyridinecarboxylate on reversing in vivo
      resistance of tumor cells to adriamycin.
AB  - A newly synthesized dihydropyridine analogue, 2-[benzyl(phenyl)-amino]ethyl 1,4
      dihydro-2,6-dimethyl-5-(5,5-dimethyl-2-oxo-1,3,2-dioxaphosphorina n-2-yl)-1- (2
      morpholinoethyl)-4-(3-nitrophenyl)-3-pyridinecarboxylate (PAK-200), at 5 microM
      inhibited the efflux of [3H]vincristine from KB-C2 cells and increased the
      accumulation of [3H]vincristine in KB-C2 cells to a level similar to that in KB-3
      1 cells. PAK-200 inhibited the photoaffinity labeling of P-glycoprotein in KB-C2
      membranes by [3H]azidopine. At 5 microM, PAK-200 enhanced the cytotoxic effect of
      Adriamycin on drug-sensitive KB-3-1 cells, multidrug-resistant KB-8-5 cells, and
      two human colorectal carcinoma tumor lines, COK-28LN and COK-36LN, by factors of
      2, 5, 2, and 3 times, respectively. The calcium antagonistic activity of PAK-200
      was about 1000 and 5 times lower than that of another dihydropyridine analogue,
      nicardipine, and of verapamil, respectively. PAK-200 in combination with
      Adriamycin completely suppressed the growth of KB-3-1 and COK-36LN and partially
      suppressed the growth of KB-8-5 but had no significant effect on COK-28LN cells
      xenografted in nude mice. The level of MDR1 expression of COK-36LN was about 3
      times higher than that of COK-28LN, but lower than that of KB-8-5 cells. These
      results suggest that the interaction of PAK-200 with P-glycoprotein may be partly
      correlated with the enhancement of the antitumor effect of Adriamycin on
      xenografted KB-8-5 and COK-36LN cells in nude mice.

PMID- 1617640
TI  - Interleukin 6 gene transfection into Lewis lung carcinoma tumor cells suppresses
      the malignant phenotype and confers immunotherapeutic competence against parental
      metastatic cells.
AB  - To investigate the influence of interleukin 6 (IL-6) production on malignancy of
      tumor cells we transfected cells of the high-metastatic, low-immunogenic D122
      clone of the Lewis lung carcinoma with a mammalian expression vector containing
      the human IL-6 complementary DNA. In vitro, IL-6 positive transfectants showed
      growth inhibition that was directly correlated with the levels of IL-6
      production. The in vitro growth arrest did not seem to be a function of an
      autocrine system mediated via the secreted human IL-6 acting on the tumor cell
      surface receptors since neutralizing antibodies to human IL-6 did not prevent the
      growth inhibition. Neither did exogenous human recombinant IL-6 affect the growth
      of D122 cells. In vivo, IL-6 positive transfectants showed reduction of
      tumorigenicity and significant suppression of metastatic competence in syngeneic,
      immunocompetent mice. In mature T-cell deficient nude mice, the IL-6
      transfectants showed some arrest of local growth but no suppression of lung
      metastasis. It seems therefore that the reduction of metastatic competence of IL
      6 transfectants is primarily a function of stimulation by the transfectants of
      host T-cell immune responses. Immunization with inactivated high-positive IL-6
      transfectants induced high levels of anti-tumor cytotoxic T-lymphocytes and
      protected mice against metastatic growth of a subsequent graft of parental tumor
      cells. Moreover, reduction of metastatic growth of parental highly metastatic
      D122 cells was also achieved when immunization of mice was begun after
      establishment of the primary parental tumors. Thus, inactivated IL-6
      transfectants were effective when used as a cellular vaccine for experimental
      immunotherapy of metastasis.

PMID- 1617641
TI  - Oxidation of methylhydrazines to mutagenic methylating derivatives and inducers
      of the adaptive response of Escherichia coli to alkylation damage.
AB  - The methylhydrazines, monomethylhydrazine, 1,1-dimethylhydrazine, and 1,2
      dimethylhydrazine, are known carcinogens but only weak mutagens in the Ames test.
      Chemical oxidation of these compounds by potassium ferricyanide greatly enhanced
      their mutagenicity to an Escherichia coli ada mutant and converted them into
      inducers of the adaptive response of E. coli to alkylation damage. Enzymatic
      oxidation of monomethylhydrazine by horseradish peroxidase-H2O2 also yielded
      products which induced the adaptive response. Thus, methylhydrazines can be
      oxidized to active DNA-methylating derivatives which generate
      methylphosphotriesters (the inducing signal of the adaptive response), O6
      methylguanine and/or O4-methylthymine (the miscoding bases repaired by the Ada
      protein) in DNA. These observations support the suggestion that metabolic
      oxidation of methylhydrazines in mammalian systems may be required to generate
      the mutagenic/carcinogenic derivatives.

PMID- 1617642
TI  - The potential superiority of bromodeoxyuridine to iododeoxyuridine as a radiation
      sensitizer in the treatment of colorectal cancer.
AB  - Although the thymidine analogues 5-bromo-2'-deoxyuridine (BrdUrd) and 5-iodo-2'
      deoxyuridine (IdUrd) have been used successfully as radiation sensitizers in
      clinical trials, it is not clear which of these agents is the more promising to
      pursue. To begin to assess this question with regard to colorectal cancer
      metastatic to the liver, a study was carried out using HT29 human colon cancer
      cells in culture and implanted in nude mice as xenografts. Cells and animals were
      treated with BrdUrd +/- the thymidylate synthase inhibitor 5-fluoro-2'
      deoxyuridine (FdUrd), and the results compared to our previous studies with IdUrd
      +/- FdUrd (T. S. Lawrence, M. A. Davis, P. E. McKeever, J. Maybaum, P. L.
      Stetson, D. P. Normolle, and W. D. Ensminger. Cancer Res., 51: 3900-3905, 1991).
      Using cultured cells, it was found that FdUrd (at concentrations of greater than
      10 nM) increased: (a) the incorporation of BrdUrd into the DNA of cultured tumor
      cells; (b) BrdUrd-mediated radiosensitization; (c) BrdUrd-mediated increase in
      radiation-induced DNA damage; and (d) BrdUrd-mediated decrease in the repair of
      radiation-induced damage. The incorporation of BrdUrd was greater than or equal
      to the incorporation of IdUrd previously determined under the same exposure
      conditions. Studies using nude mice bearing HT29 xenografts showed that FdUrd
      increased BrdUrd incorporation more into tumors than into the normal liver. Most
      tumor cells incorporated BrdUrd (labeling index after a 4-day infusion = 87 +/-
      2%; SE); in the liver, labeling was confined chiefly to nonparenchymal cells. In
      both the presence and absence of FdUrd, the incorporation of BrdUrd into tumors
      was significantly and consistently greater than the incorporation of IdUrd
      measured under the same conditions of drug administration (by a factor of 1.2
      3.6). Furthermore, the administration of BrdUrd +/- FdUrd tended to produce less
      weight loss and hematological toxicity than IdUrd +/- FdUrd. These findings
      suggest that BrdUrd may be superior to IdUrd as a radiation sensitizer in the
      treatment of colorectal cancer metastatic to the liver.

PMID- 1617643
TI  - Responsiveness of three newly established human colorectal cancer cell lines to
      transforming growth factors beta 1 and beta 2.
AB  - We have established 3 new human colorectal cancer cell lines (LS411N, LS513, and
      LS1034) from clinical biopsy samples. These lines are tumorigenic and grow s.c.
      as adenocarcinomas in nude mouse xenografts. Specific marker chromosomes are
      observed in each line. Carcinoembryonic antigen is expressed at the surface of
      all 3 lines, but with marked quantitative differences. Indeed, less than 10% of
      the cells from the HT-29 line used as a reference express carcinoembryonic
      antigen while more than 90% of the LS1034 cells do so. LS513 and LS1034
      consistently express HLA class I antigens and intercellular adhesion molecule 1
      which are not detected at the surface of the LS411N cells. No expression of HLA
      class II antigens DR, DQ, and DP has been measured on any of the lines. All three
      lines grow well in 5% fetal calf serum medium without addition of exogenous
      growth factors. The LS1034 line has been adapted to growth in serum-free
      conditions and exhibits increased clonogenicity when cells are seeded in serum
      free methylcellulose medium, as compared with medium containing 5% fetal calf
      serum. The LS513 and LS1034 lines have proved to be of particular interest since
      they respond to the growth-inhibitory action of TGF-beta 1 and TGF-beta 2 in both
      liquid and semisolid medium. Both factors were, at pM concentrations, equipotent
      inhibitors of LS1034 cell proliferation. In contrast, higher concentrations of
      TGF-beta 1 are inhibitory for proliferation of LS513 cells, whereas TGF-beta 2
      has no effect on the growth of these cells in liquid assay. On this basis, using
      appropriate anti-TGF-beta 1 and anti-TGF-beta 1 IgY, we developed a bioassay for
      TGF-beta 1 and TGF-beta 2. Two of the three lines have indeed been shown to
      produce latent-TGF-beta 1 activity.

PMID- 1617644
TI  - Differentiation of choriocarcinoma cell line (JAr).
AB  - Choriocarcinoma, a highly malignant tumor arising from the trophoblast, comprises
      a heterogenous population of cells including cytotrophoblasts, intermediate
      trophoblasts, and syncytiotrophoblasts. In order to investigate trophoblast
      differentiation, we used centrifugal elutriation to separate cells from the JAr
      choriocarcinoma cell line according to their size and to further show that the
      resultant cell populations differ in their stage of differentiation. Two % of the
      cell population consists of large, multinuclear cells, which display the highest
      level of chorionic gonadotropin (CG) mRNAs. The increase in the CG beta mRNA with
      cell size is a consequence of the transcriptional mechanism, since agents which
      induce differentiation in JAr cells, i.e., methotrexate, increase the level of CG
      alpha and CG beta transcripts, cause a shift in cell size, and result in the
      formation of multinuclear cells. The multinuclear cells in the JAr population
      arise, at least partly, from kariokinesis without cytokinesis.

PMID- 1617645
TI  - Evaluation of the wap-ras transgenic mouse as a model system for testing
      anticancer drugs.
AB  - Transgenic mouse models have provided many valuable insights into the molecular
      mechanisms of tumorigenesis; unfortunately, there is a paucity of published
      information on the utility of these models for evaluating potential anticancer
      therapeutics. Line 69 wap-ras transgenic mice have an activated, human c-Ha-ras
      gene on their Y chromosome. Adult males develop salivary and/or mammary
      adenocarcinomas. Both tumor types express high levels of human ras oncoprotein.
      Two new sublines, designated wap-ras/F, were created by selective breeding.
      Subline 69-2 wap-ras/F males developed multiple mammary tumors at puberty. Tumor
      onset was delayed by cyclophosphamide treatment prior to puberty. Mammary tumors
      from cyclophosphamide-treated mice weighed 0.57 +/- 0.09 g/mouse (SD +/- SEM; n =
      8), while tumors from control mice weighed significantly more at 2.36 +/- 0.25
      g/mouse (n = 8; P less than or equal to 0.001; SD +/- SEM). These results suggest
      that subline 69-2F mice will be valuable for testing therapeutic regimes designed
      to interfere with processes occurring early in tumorigenesis, before palpable
      tumor presentation. Tumor sensitivity to several clinically relevant cytotoxins
      was also tested in adult wap-ras males with palpable tumors. Both salivary and
      mammary tumors were sensitive to cyclophosphamide and 5-fluorouracil, but not
      methotrexate. This suggests that wap-ras transgenic mice will indeed be useful in
      the discovery of novel therapeutics against neoplasia.

PMID- 1617646
TI  - Elevated level of nuclear protein kinase C in multidrug-resistant MCF-7 human
      breast carcinoma cells.
AB  - Previous studies have demonstrated elevated levels of protein kinase C (PKC)
      activity in multidrug-resistant human breast carcinoma MCF-7/ADR cells compared
      to control drug-sensitive MCF-7/WT cells (R.L. Fine, J. Patel, and B.A. Chabner,
      Proc. Natl. Acad. Sci. USA, 85:582-586, 1988). In our present studies,
      immunohistochemical localization analysis using a polyclonal PKC antibody
      recognizing the alpha, beta, and gamma subtypes of PKC demonstrates that
      immunoreactivity is enhanced in MCF-7/ADR cells, with pronounced staining noted
      in the nuclear region. Other studies with purified nuclei isolated from MCF-7/ADR
      cells also show a marked increase in the intensity of immunostaining for PKC when
      compared to nuclei prepared from control MCF-7/WT cells. Western blot analysis of
      proteins extracted from purified nuclear preparations further establishes an
      increase in PKC enzyme protein associated with the nuclear fraction of MCF-7/ADR
      cells. Subcellular fractionation studies also indicate that MCF-7/ADR cells have
      4-8 times higher nuclear PKC activity compared to that of control MCF-7/WT cells.
      MCF-7/ADR cells also possess 3-5-fold elevated cytosolic PKC activity, while a
      less than 2-fold increase is found in PKC activity associated with the plasma
      membrane fraction of MCF-7/ADR cells. Examination of these extracts with PKC
      isotype-specific antisera, as well as by DEAE-cellulose chromatography, reveals
      that nuclei prepared from MCF-7/ADR cells contain markedly elevated amounts of a
      slightly altered form of PKC alpha. These results suggest that elevated levels of
      a modified form of PKC alpha at the nucleus may play a role in modulating nuclear
      events to promote the development of multidrug resistance in MCF-7 cells.

PMID- 1617647
TI  - Human immunodeficiency virus type 1 tat gene up-regulates interleukin 4 receptors
      on a human B-lymphoblastoid cell line.
AB  - The human immunodeficiency virus type I (HIV-1) regulatory gene, tat III, is a
      powerful trans-activator of gene expression from the viral long terminal repeat
      and is essential for HIV replication. In addition, tat III protein has been shown
      to be immunosuppressive as indicated by the inhibition of antigen mediated T-cell
      proliferation. To further test whether tat III might play a direct role in the
      immunosuppressive effects of HIV-1 in addition to its role in virus replication,
      we examined the regulation of interleukin 4 (IL-4) receptors on a human B
      lymphoblastoid cell line (Raji) transfected with HIV-1 tat gene (Raji-tat III).
      We used radioligand receptor binding analysis for cell surface expression and
      Northern blot analysis for the expression of human IL-4 receptor gene in Raji-tat
      III cells. Control Raji cells expressed 1383 +/- 361 (SE; n = 3) IL-4 binding
      sites/cell with a dissociation constant (Kd) of 144 +/- 27 pM (n = 3). However,
      Raji-tat III cells expressed about three times higher IL-4 receptors (4000 +/-
      633 IL-4 binding sites/cell; P less than 0.03 compared to Raji cells) with a
      similar Kd of 273 +/- 90 pM (n = 3; P greater than 0.05 compared to Raji cells).
      Whereas both Raji and Raji-tat III cells exhibited a single mRNA species
      (approximately 4 kilobases) of IL-4 receptors by Northern blot analysis, the mRNA
      level was about 3-fold higher in Raji-tat III cells compared to Raji cells.
      Cycloheximide inhibited the expression of IL-4 receptors by 50% in about 2 h in
      both cell types indicating both the half-life of IL-4 receptors and the
      requirement for protein synthesis for the tat III up-regulation of IL-4
      receptors. Since IL-4 under certain circumstances has been shown to be
      immunosuppressant, our observation that the HIV-1 tat gene up-regulates IL-4
      receptors suggests the possibility that the immunosuppressive effects of HIV-1
      are mediated at least in part through IL-4 receptors.

PMID- 1617648
TI  - p53 mutations in C57BL/6J murine thymic lymphomas induced by gamma-irradiation
      and N-methylnitrosourea.
AB  - Genomic DNA from thymus tissue obtained from 47 C57BL/6J animals treated with the
      DNA alkylating agent N-methylnitrosourea or gamma-irradiation were screened for
      the presence of p53 mutations by using the single strand conformation
      polymorphism assay. Mutations were detected in 13% (4 of 30) of primary thymic
      lymphomas but none of 17 early stage lymphomas. The frequency of p53 mutations
      was the same in tumors induced by N-methylnitrosourea (2 of 15) or by gamma
      irradiation (2 of 15). Mutations occurred in the highly conserved regions of the
      p53 gene in exons 5, 7, and 8. G:C to A:T transitions were commonly observed. One
      of 4 of the tumors analyzed contained two p53 mutations in exons 7 and 8. A
      previous study of the same tumors showed that ras mutations occurred with high
      frequency (greater than 50%) (E. W. Newcomb et al., Cancer Res., 48:5514-5521,
      1988). Our data suggest that p53 mutations do not play a major role in carcinogen
      induced thymic lymphomas studied here.

PMID- 1617649
TI  - Stimulation of malignant growth in rodents by antidepressant drugs at clinically
      relevant doses.
AB  - Tricyclic antidepressants, such as amitriptyline (Elavil), and the nontricyclic
      agent, fluoxetine (Prozac), bind to growth-regulatory intracellular histamine
      receptors, associated with anti-estrogen binding sites in microsomes and nuclei.
      The prototype anti-estrogen binding site/intracellular histamine receptor ligand,
      N,N-diethyl-2-[4-(phenylmethyl)phenoxy]ethanamine HCl, inhibits normal cell
      proliferation in vitro but stimulates tumor growth in vivo. Because of their
      structural similarity to N,N-diethyl-2-[4-(phenylmethyl)phenoxy]ethanamine HCl,
      we carried out studies to determine whether amitriptyline and fluoxetine
      stimulate tumor growth and/or development in rodents at concentrations relevant
      to the treatment of human depression (equivalent human dose range, approximately
      100-150 mg/day for amitriptyline and approximately 20-80 mg/day for fluoxetine).
      All experiments were performed blinded. In studies of growth stimulation of
      transplantable syngeneic tumors, groups of mice were inoculated s.c. with C-3
      fibrosarcoma cells or given i.v. or s.c. injections of B16f10 melanoma cells,
      followed 24 h later by daily i.p. injections of saline, amitriptyline, or
      fluoxetine. Tumor latency (fibrosarcoma), aggregate tumor weight (s.c. injected
      melanoma), or time to death from pulmonary metastasis (i.v. injected melanoma)
      was determined; drug-induced stimulation of DNA synthesis in C-3 fibrosarcoma
      cells in vitro was correlated with tumor growth acceleration in vivo. In a
      mammary carcinogenesis model, the effects of chronic saline, amitriptyline, or
      fluoxetine administration on the rate and frequency of development of mammary
      tumors in rats fed dimethylbenzanthracene (DMBA) were compared. Eight of 20
      amitriptyline- or fluoxetine-treated mice developed fibrosarcoma tumors by day 5,
      as compared to none of 20 saline controls (P less than 0.002). Similarly, 20 of
      21 DMBA-treated rats receiving the antidepressant drugs developed 33 mammary
      tumors by week 15 as compared to 5 tumors in 4 of 7 DMBA-treated rats receiving
      saline (P less than 0.001). For both models, tumor latency decreased 30-40% and,
      in the DMBA model, tumor frequency increased greater than 2-fold in the
      antidepressant-treated rats as compared to controls. Stimulation of fibrosarcoma
      growth in vivo correlated with a corresponding bell-shaped drug-induced increase
      in DNA synthesis in vitro. While the median time to death from pulmonary
      metastases did not differ among groups given i.v. injections of melanoma cells, a
      significant (P less than 0.01) stimulation of growth of s.c. injected melanoma
      was observed in mice receiving the antidepressants.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1617650
TI  - p53 mutations in basal cell carcinomas.
AB  - Genomic DNA from 14 basal cell carcinoma biopsies was screened for the presence
      of mutations in the p53 gene, using the polymerase chain reaction followed by
      direct DNA sequencing. Heterozygous mutations were detected in 7 of 14 (50%)
      samples investigated. All mutations were G:C-A:T transitions, and five (71%) of
      these mutations were transitions at hot spots with CpG sites, three at codon 248
      and two at codon 273. The striking similarity of the type of mutations detected
      in this study and with the UV mutagenesis studies reported in literature suggest
      the hypothesis that UV may act on the p53 gene in a carcinogenic-specific
      fashion.

PMID- 1617651
TI  - Partial characterization of nuclear matrix attachment regions from human
      fibroblast DNA using Alu-polymerase chain reaction.
AB  - The proteinaceous nuclear matrix of mammalian cell nuclei has been suggested to
      be involved in the regulation of chromatin structure, DNA replication, and gene
      expression. Interaction between cellular DNA and the nuclear matrix is mediated
      by putative DNA binding sequences, matrix attachment regions (MARs), which may
      become altered during early events in cellular transformation. Among the cellular
      changes occurring during the development of neoplasia, all of which may
      potentially involve the nuclear matrix, are alterations in nuclear structure,
      loss of control of DNA replication, and significant modifications of cellular
      gene expression. Therefore, a better understanding of the interaction between DNA
      and the nuclear matrix is needed. Isolated matrix associated DNA from pulse
      labeled SV40 transformed human fibroblasts was shown to be enriched in newly
      replicated DNA, confirming the association of DNA replication with the nuclear
      matrix as observed by others. Subgenomic fractions of matrix associated DNA
      enriched in putative MARs sites were prepared from quiescent and logarithmically
      growing normal human fibroblasts and SV40 transformed human fibroblasts. These
      fractions of DNA were analyzed by Alu-polymerase chain reaction and agarose gel
      electrophoresis, revealing complex and unique patterns of DNA products for each
      cell type investigated. A number of prominent DNA fragments with similar
      molecular size were found to be present in the amplified DNA products of each DNA
      source, suggesting that these DNA fragments may represent common DNA sequences
      which contain MARs sites or which are associated with MARs sites. The application
      of Alu-polymerase chain reaction to the molecular analysis of nuclear matrix
      associated DNA may facilitate the isolation and characterization of potentially
      new human MARs sequences.

PMID- 1617652
TI  - An altered 11-kilobase transcript in leukemic cell lines with the
      t(4;11)(q21;q23) chromosome translocation.
AB  - The 11q23 chromosome band is frequently associated with chromosomal aberrations
      in human leukemias. We have previously cloned a DNA fragment derived from
      chromosome 11 which could be used as a probe to detect rearrangements in DNAs
      from the leukemic cells of patients with the t(4;11), t(9;11), and t(11;19)
      translocations. In this study we now show that the same probe detects DNA
      rearrangements in malignant cells from patients with the t(1;11), t(6;11),
      t(10;11), and del (11q23) chromosomal abnormalities. A second probe obtained from
      a region located centrometric to the breakpoint cluster detects major and minor
      transcripts of 12.5 and 11.5 kilobases, respectively, in all cell lines examined.
      The same probe identifies an altered 11-kilobase RNA in all three independent
      cell lines with the t(4;11)(q21;q23) chromosome translocation.

PMID- 1617653
TI  - Gadd45 and Gadd153 messenger RNA levels are increased during hypoxia and after
      exposure of cells to agents which elevate the levels of the glucose-regulated
      proteins.
AB  - We have investigated overlapping activation pathways for two families of stress
      genes that are expressed in cells exposed to hypoxia. The growth arrest and DNA
      damage (gadd) genes are induced by DNA damage and irradiation, and their
      expression is associated with growth arrest. The glucose-regulated proteins
      (GRPs) are induced by chemical agents that disrupt protein trafficking in the
      endoplasmic reticulum such as tunicamycin and A23187 and by hypoxia. Here, we
      demonstrate that the treatment of NIH-3T3 cells with chemical inducers of GRPs
      results in increased levels of gadd45 and gadd153 mRNA as well as GRP78 mRNA. In
      addition, hypoxia was also able to increase gadd45, gadd153, and GRP78 mRNA.
      Therefore the GRP and gadd genes can be activated by similar stimuli (e.g.,
      hypoxia and chemical inducers). However, the mechanisms leading to increased
      levels of GRP78 and gadd gene mRNA are different and may involve distinct protein
      kinases. Increased expression of GRPs after treatment with chemical inducers is
      sensitive to cycloheximide and the protein kinase inhibitors genistein, 2
      aminopurine, and H7, whereas the increase in gadd gene mRNA could be blocked by
      the protein kinase inhibitors H7 and 2-aminopurine but not by genistein or
      cycloheximide. GRP78 induction occurs by a pathway that requires protein
      synthesis and is sensitive to genistein, H7, and 2-aminopurine, whereas gadd gene
      induction is independent of protein synthesis and is inhibited by H7 and 2
      aminopurine only.

PMID- 1617655
TI  - Retraction. T-cell receptor V beta gene expression differs in tumor-infiltrating
      lymphocytes within primary and metastatic melanoma.

PMID- 1617654
TI  - Correspondence Re: L.E. Damon et al., Plasma and cerebrospinal fluid
      pharmacokinetics of 1-beta-D-arabinofuranosylcytosine and 1-beta-D
      arabinofuranosyluracil following the repeated intravenous administration of high-
      and intermediate-dose 1-beta-D-arabinofuranosylcytosine. Cancer Res., 51: 4141
      4145, 1991.

PMID- 1617656
TI  - Distribution of misonidazole adducts in 9L gliosarcoma tumors and spheroids:
      implications for oxygen distribution.
AB  - The 9L rat gliosarcoma is a widely used experimental brain tumor which has an
      unusual radiation response. The radiation sensitivity of cells in subcutaneous
      tumors has been shown to be intermediate between those of aerobic and hypoxic 9L
      cells in vitro, and cells in spheroids and intracranial tumors appear to be as
      sensitive as fully aerobic cells. The hypoxic marker misonidazole was used to
      investigate the distribution of oxygen in these 9L systems. In vitro calibration
      of binding of [3H]-misonidazole as a function of oxygen concentration
      demonstrated an inverse relationship similar to those of several other
      experimental tumors. In autoradiograms of sections from tumors labeled in vivo
      the grain density rose gradually from the periphery of the tumor to the center.
      Over millimeter distances the distribution of grains was remarkably uniform, in
      contrast to the substantial variation reported for several other tumors. The
      grain density as a function of distance from capillaries was essentially
      constant. Several interpretations of this result are possible, including the
      postulate that intermittent blood flow occurs in all 9L tumor capillaries, which
      results in the majority of the binding of misonidazole occurring during the
      periods of transient hypoxia. Cells adjacent to the necrotic center in 9L
      spheroids and the rare necrotic regions in tumors appeared to be severely
      hypoxic, based on the quantity of misonidazole they bound. Spheroid "cure"
      experiments demonstrated that these cells were not clonogenic.

PMID- 1617657
TI  - Long-term growth suppression of human glioma xenografts by chemoimmunoconjugates
      of 4-desacetylvinblastine-3-carboxyhydrazide and monoclonal antibody 9.2.27.
AB  - A conjugate of 4-desacetylvinblastine-3-carboxyhydrazide (DAVLBHY) and the glioma
      reactive monoclonal antibody (mAb) 9.2.27 induced long-term suppression of tumor
      growth in athymic nude mice engrafted with U87MG human glioma cells. In vitro,
      DAVLBHY had the strongest antiproliferative activity (inhibitory concentration at
      which incorporation of [3H]thymidine is at 50% of untreated control is 2.0 x 10(
      9) M) of seven cytotoxic drugs tested and so was chosen for conjugation to mAb
      9.2.27, which reacts specifically with the core protein of chondroitin sulfate
      proteoglycans found in human glioblastomas. After conjugation of DAVLBHY to the
      carbohydrate residues of mAb 9.2.27 it retained its full binding capacity. For in
      vivo studies, DAVLBHY and several conjugate derivatives were evaluated by using
      two dosages of i.v. injections, each starting 2 days after s.c. tumor
      inoculation. The control tumors reached a volume of nearly 3000 mm3 within 30
      days. Tumor growth was delayed by about 20 days with four i.v. injections of 0.5
      mg/kg 9.2.27-DAVLBHY, which was slightly superior to the unconjugated drug.
      Moreover, 9.2.27-DAVLBHY produced a highly significant suppression of growth so
      that the average tumor volume was only 3% of that observed in untreated controls
      after 28 days. Four injections of this conjugate at a larger dose, 2.0 mg/kg,
      prevented recurrence of the tumors for 130 days in all animals tested, thus
      demonstrating a significant increase in the therapeutic index, since the
      unconjugated drug provided limited inhibition of tumor growth for only 40 days.
      The specificity of the antitumor effect was demonstrated in a comparison with the
      control conjugate, KS1/4-DAVLBHY, which despite partial tumor suppression had
      only a transient effect. The specific antitumor effect of 9.2.27-DAVLBHY was
      unexpected, since the target antigen is expressed at a relatively low density
      (40,000 sites/cell) on U87MG glioma cells.

PMID- 1617658
TI  - Effect of systemic hyperinsulinemia in cancer patients.
AB  - Data defining the isolated effect of insulin on whole body protein and glucose
      metabolism in cancer patients are limited. Ten normal volunteers (controls), age
      55 +/- 3 years (mean +/- SEM); 8 cancer patients, age 61 +/- 3 years, weight loss
      2 +/- 1% (CANWL); and 8 cancer patients, age 55 +/- 2 years, weight loss 18 +/-
      2% (CAWL), were studied in the post-absorptive state. Whole body leucine kinetics
      were determined during a baseline and then a study period during which insulin
      was infused at 1.0 milliunits/kg/min to achieve a high physiological level of 71
      +/- 6, 83 +/- 5, and 64 +/- 5 microunits/ml in controls, CANWL, and CAWL,
      respectively. Whole body net balance equals protein synthesis minus protein
      breakdown. Glucose disposal (mg/kg/min) is the rate of D30 infusion at steady
      state. Glucose disposal of CANWL and CAWL during the study period was
      significantly (P less than 0.05, analysis of variance) less than controls (3.91
      +/- 0.6 in CANWL, 3.66 +/- 1.0 in CAWL, and 5.87 +/- 0.6 mg/kg/min in controls),
      suggesting resistance to insulin with respect to carbohydrate metabolism.
      Hyperinsulinemia, under euglycemic and near basal amino acid conditions,
      significantly reversed the negative postabsorptive leucine net balance (P less
      than 0.05, analysis of variance) by decreasing protein breakdown in controls as
      well as weight-stable and weight-losing cancer patients, suggesting that cancer
      patients are not resistant to the anti-catabolic effect of insulin with respect
      to whole body protein metabolism.

PMID- 1617659
TI  - Modulation of ethylnitrosourea-induced toxicity and mutagenicity in human cells
      by O6-benzylguanine.
AB  - We have examined the contributions of O6-alkylguanine-DNA alkyl-transferase (AGT)
      and nucleotide excision repair to the protection of human cells from the toxic
      and mutagenic effects of ethylnitrosourea. Three human lymphoblastoid cell lines
      were used: one which possesses both of these DNA repair pathways; one derived
      from a xeroderma pigmentosum complementation group A patient, which expresses AGT
      but is deficient in nucleotide excision repair; and a third which does not
      express AGT but is capable of excision repair. The level of active AGT in the
      cells was further modulated with the use of the AGT inhibitor, O6-benzylguanine.
      These cells were exposed to ethylnitrosourea in both the presence and absence of
      O6-benzylguanine, and population survival, growth, and mutagenesis at the
      hypoxanthine-guanine phosphoribosyl-transferase locus were measured. The results
      for all three measurements indicated that the lack of either AGT or nucleotide
      excision repair significantly impairs the ability of human cells to withstand DNA
      ethylation damage. Furthermore, the inhibition of AGT in xeroderma pigmentosum
      group A cells did not increase toxicity or mutagenicity, suggesting that AGT and
      nucleotide excision repair cooperate in the removal of DNA ethyl adducts. Related
      studies in our laboratory have shown that AGT and nucleotide excision repair are
      both necessary for the efficient removal of O6-ethyldeoxyguanosine.

PMID- 1617660
TI  - Mechanism-related circumvention of acquired cis-diamminedichloroplatinum(II)
      resistance using two pairs of human ovarian carcinoma cell lines by ammine/amine
      platinum(IV) dicarboxylates.
AB  - Acquired resistance to cisplatin has been generated in vitro in two human ovarian
      carcinoma cell lines: 41M, established from a previously untreated patient; and
      CH1, from a patient previously treated with cisplatin and cis-diammine-1,1
      cyclobutane dicarboxylatoplatinum(II) (carboplatin). In neither cell line with
      acquired resistance did intracellular detoxification (via increased glutathione
      or metallothioneins) appear to be a major determinant of resistance. Resistance
      in 41McisR (resistance factor of 4.7) appeared to be due predominantly to a
      reduced platinum accumulation (levels were only 23.8% in 41McisR versus 41M).
      This was also reflected at the DNA level by a similar level of reduced DNA
      interstrand cross-links and total platinum-DNA adducts measured immediately after
      a 2-h exposure to cisplatin in 41McisR versus 41M. Conversely, for CH1cisR
      (resistance factor of 6.5), platinum accumulation, and initial numbers of DNA
      interstrand cross-links and total DNA-platinum adducts were not significantly
      different from the parent CH1 line. This is suggestive of a resistance mechanism
      involving increased DNA repair or tolerance to platinum-DNA adducts operating in
      the CH1cisR/CH1 pair of lines. Cross-resistance to carboplatin and partial cross
      resistance to the 1,2-diaminocyclohexane-containing agent, (trans-d,l)-1,2
      diaminocyclohexane tetrachloroplatinum(IV) (tetraplatin), was observed in both
      pairs. However, two novel platinum(IV) ammine/amine dicarboxylates, ammine
      dibutyratodichloro(cyclohexylamine)platinum(IV) (JM221) and ammine
      dibenzoatodichloro(propylamine)platinum(IV) (JM244), completely circumvented
      resistance in 41McisR to produce some collateral sensitivity (resistance factors
      of 0.67 and 0.54, respectively) but showed cross-resistance in CH1cisR
      (resistance factors of 3.7 and 4.6). In contrast to the data for cisplatin,
      intracellular platinum levels were not significantly different between the 41M
      and 41McisR pair of cell lines after exposure to JM244. These results suggest
      that the ammine/amine platinum(IV) dicarboxylates, which show considerably
      greater in vitro cytotoxicity than cisplatin, are capable of circumventing
      acquired cisplatin resistance which is due to decreased intracellular
      accumulation but are not able to overcome resistance at the level of DNA
      platination and removal.

PMID- 1617661
TI  - Relation of obesity and body fat distribution to endometrial cancer in Shanghai,
      China.
AB  - In a case-control study involving 268 cases of endometrial cancer and an equal
      number of population controls, we assessed the relationship of risk to body
      weight and fat distribution, examining weight at various ages and current
      anthropometric measurements. Weight gain during later adulthood and resultant
      high body masses were important risk predictors, indicating that obesity is an
      important risk factor, even in an area where the prevalence of obesity and
      incidence of endometrial cancer are low. Certain fat distribution patterns were
      related to risk of endometrial cancer independent of general obesity. In
      particular, fat deposits on the trunk were associated with elevated risks, with
      the odds ratio for the highest versus lowest quartile of subscapular skinfolds
      remaining significant even after adjustment for body mass index (odds ratio =
      2.9; 95% confidence interval, 1.1-7.3). Central versus peripheral obesity, as
      measured by the subscapular:triceps ratio, also was related to increased risk,
      although the association failed to remain significant after adjustment for body
      mass (highest to lowest quartile, odds ratio = 1.7). In contrast, upper body
      obesity, as assessed by the waist:thigh ratio, was unrelated to risk. These
      results support the need for future studies assessing the relationship of
      hormonal and other biological parameters of fat distribution to assist in
      identifying causal mechanisms for this tumor.

PMID- 1617662
TI  - Phase II study of intravenous idarubicin in unfavorable non-Hodgkin's lymphoma.
AB  - Idarubicin, a new analogue of daunorubicin, was administered i.v. at a dose of 15
      mg/m2 to 31 previously treated patients with unfavorable non-Hodgkin's lymphoma.
      Clinical characteristics included median age, 69 years; performance status, 1;
      and prior chemotherapeutic regimens, 1. Twenty of the patients were relapsing
      after prior therapy and 11 were refractory; 29 had received prior anthracycline
      or anthracenedione. Responses were observed in 43% of patient (3 complete
      remission and 10 partial remission) with a median duration of 10+ months (2-29+
      months). Idarubicin was well tolerated with nonhematological toxicities
      (nausea/vomiting, mucositis, and anorexia) seen in less than 50% of patients.
      Median hematological values during the first cycle for this dosage included WBC,
      1,300/mm3; platelets, 129,000/mm3; and hemoglobin, 10.9 mg/dl. With dose
      escalation, hematological toxicity was dose limiting. Symptomatic cardiac
      toxicity was observed in one patient who had received maximum dose doxorubicin
      and radiotherapy. Median values for the cardiac ejection fraction during the full
      course of therapy for the entire group of patients were 0.62 (initial) and 0.60
      (final). Idarubicin in i.v. form is an active drug in previously treated patients
      with unfavorable non-Hodgkin's lymphoma.

PMID- 1617663
TI  - Inhibition of tobacco-specific nitrosamine-induced lung tumorigenesis in A/J mice
      by green tea and its major polyphenol as antioxidants.
AB  - In this study we examined the effects of green tea and its major components, (-)
      epigallocatechin gallate (EGCG) and caffeine, on the tobacco-specific nitrosamine
      4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-induced lung tumorigenesis
      in A/J mice. We also studied the effects of green tea and EGCG on O6
      methylguanine and 8-hydroxydeoxyguanosine (8-OH-dGuo) formation in lung tissues
      caused by NNK treatment. Mice were given 2% tea, 560 ppm EGCG, or 1120 ppm
      caffeine in drinking water for 13 weeks. During this time, NNK (11.65 mg/kg body
      weight) was administered by gavage three times weekly for 10 weeks from weeks 3
      to 12. The bioassay was terminated 6 weeks after the last NNK treatment. Mice
      treated with NNK developed 22.5 lung adenomas per mouse, whereas NNK-treated mice
      that drank green tea or EGCG as drinking water developed only 12.2 (P less than
      0.01) and 16.1 (P less than 0.05) tumors per mouse, respectively. Mice that drank
      green tea or caffeine solution showed lower body weight gains, although little
      difference in water and diet consumption was noted in these groups. While green
      tea and EGCG exerted little effect on the formation of O6-methylguanine, a
      critical DNA lesion in NNK lung tumorigenesis, both treatments suppressed the
      increase of 8-OH-dGuo levels in mouse lung DNA. The inhibition of 8-OH-dGuo
      formation in lung DNA by green tea and EGCG is consistent with their ability to
      inhibit lung tumorigenesis by NNK. Because 8-OH-dGuo is a DNA lesion caused by
      oxidative damage, these results suggest that the mechanism of inhibition by green
      tea and EGCG in NNK-induced lung tumorigenesis is due at least partly to their
      antioxidant properties.

PMID- 1617664
TI  - Tumoricidal activation of murine resident peritoneal macrophages by interleukin 2
      and tumor necrosis factor alpha.
AB  - The capacity of recombinant human interleukin 2 (rH-IL2), alone or in combination
      with recombinant tumor necrosis factor (r-TNF alpha), to activate murine resident
      peritoneal macrophages to a tumoricidal state was examined. Resident peritoneal
      exudate cells from C57BL/6 mice were cultured for 18 h with activating agents and
      washed and the adherent cells (macrophages) were assessed for cytolytic activity
      against radiolabeled target tumor cells (EL4, P815). Under these conditions, rH
      IL2 alone activated macrophages to a tumoricidal state in a concentration
      dependent fashion. Neither murine nor human r-TNF alpha alone had any activating
      effect but, when combined with rH-IL2, further stimulated rH-IL2-inducible
      responses. Using polymyxin B, it was shown that macrophage activation was not due
      to an inadvertent lipopolysaccharide contamination of the r-TNF alpha or rH-IL2
      preparations. It was also unlikely that target cell lysis was a direct result of
      increased TNF alpha production by rH-IL2 stimulated macrophages since P815 is
      totally resistant to lysis by r-TNF alpha. Although the lytic effector function
      was mediated by adherent cells, nonadherent peritoneal exudate cells were
      required for activation to occur. Furthermore, antisera against murine gamma
      interferon, when added to activation cultures, reduced the level of cytolytic
      activity which developed. These data suggest that rH-IL2-induced peritoneal
      macrophage activation requires stimulation of nonadherent cells and is dependent
      upon gamma-interferon mediated mechanisms.

PMID- 1617665
TI  - Identification of novel antimitotic agents acting at the tubulin level by
      computer-assisted evaluation of differential cytotoxicity data.
AB  - Data generated in the new National Cancer Institute drug evaluation program,
      which are based on inhibition of cell growth in 60 human tumor cell lines, were
      probed with nine known antimitotic agents using the COMPARE algorithm.
      Cytotoxicity data were available on approximately 7000 compounds at the time of
      the analysis, and, based on the criteria used, 82 compounds were selected as
      positive by the computer search. Nine were the probe compounds themselves, and 41
      were analogues of known antimitotic agents. Among the remaining 32 compounds
      there were 19 distinct chemical species. Agents in ten of these groups
      (containing 20 compounds) were effective inhibitors of in vitro tubulin
      polymerization and caused the mitotic arrest of cells grown in culture. Two
      compounds were related natural products binding in the Vinca domain of tubulin,
      and the others were synthetic agents which interfered with colchicine binding.
      The remaining 12 agents (one natural product, the remainder synthetic) fell into
      several groups: two compounds were weak inhibitors of tubulin polymerization,
      inhibited colchicine binding, and caused mitotic arrest; one compound weakly
      inhibited tubulin polymerization but did not cause an increase in the number of
      cells arrested in mitosis; two compounds caused mitotic arrest at micromolar
      concentrations, but thus far no in vitro interaction with tubulin has been
      observed; the remainder neither inhibited tubulin polymerization nor caused a
      rise in the number of cultured cells arrested in mitosis. Tubulin-dependent GTP
      hydrolysis was stimulated or inhibited by all agents which inhibited tubulin
      polymerization with the exception of one compound. The analysis of differential
      cytotoxicity data thus appears to have great promise for the identification of
      new antimitotic agents with antineoplastic potential.

PMID- 1617666
TI  - Correlation of loss of alleles on the short arms of chromosomes 11 and 17 with
      metastasis of primary breast cancer to lymph nodes.
AB  - To examine the role of loss of heterozygosity (LOH) during tumor development
      and/or progression, we looked for correlations between metastasis of breast
      cancer to a regional lymph node(s) and LOH of chromosomal arms 11p, 13q, 16q,
      17p, and 17q, where frequent losses in primary tumors have been detected. No
      correlation between lymph node metastasis and LOH of chromosomes 13q, 16q, or 17q
      was observed. However, tumors showing LOH of chromosomes 11p (chi 2 = 10.82, P
      less than 0.01) and 17p (chi 2 = 6.78, P less than 0.01) revealed a significantly
      higher incidence of metastasis to a regional lymph node(s) than tumors without
      LOH on these chromosomal arms. Furthermore, only four of 30 (13%) patients with
      tumors that retained both 11p and 17p had metastasis to a regional lymph node(s),
      compared with 24 of 32 (75%) patients with tumors that had lost both 11p and 17p.
      Analysis of LOH with markers on chromosomes 11p and 17p in a large number of
      tumors indicated that the peritelomeric region of each of these chromosomal arms
      contains a tumor suppressor gene that may be associated with tumor progression,
      particularly metastasis to a regional lymph node(s).

PMID- 1617667
TI  - p53 mutations occur in aggressive breast cancer.
AB  - Using a polymerase chain reaction-single strand conformation polymorphism
      approach we analyzed 96 human primary breast tumors for the presence of mutations
      in exons 2, 5, 6, 7, 8, and 9 of the p53 gene. These exons have been shown to
      comprise highly conserved sequences and the portion including exons 5 through 9
      is believed to be the target for over 90% of the acquired mutations in human
      cancer. Eighteen tumors of the 96 (18.7%) tested showed reproducibly a variant
      band indicative of a mutation. Most (15 tumors) of the mutations were single
      nucleotide substitutions and G:C to A:T transitions were prevalent (6 tumors),
      G:C to T:A transversions came next (4 tumors), and guanines were always on the
      nontranscribed strand. Concomitant loss of the wild type allele and mutation of
      the other copy was observed in only 3 of 18 mutated cases; this is consistent
      with the heterogeneous cellular composition of breast tumors. Furthermore p53
      mutations were correlated to estrogen and/or progesterone receptor negative
      tumors, thus indicating their relationships to aggressive breast cancer. No
      association could be observed with DNA amplification events in these tumors.

PMID- 1617668
TI  - Insulin receptor expression and function in human breast cancer cell lines.
AB  - We have previously reported that insulin receptor expression is increased in
      human breast cancer specimens (V. Papa et al., J. Clin. Invest., 85:1503-1510,
      1990). In the present study, in order to further understand the role of the
      insulin receptor in breast cancer, insulin receptor expression and function were
      characterized in three human breast cancer cell lines, MCF-7, ZR-75-1, and T-47D,
      and compared to a nonmalignant human breast epithelial cell line, 184B5. Insulin
      receptor content, measured by radioimmunoassay, was elevated 5- and 3-fold in MCF
      7 and ZR-75-1 breast cancer cell lines, respectively, when compared to the
      nonmalignant cell line 184B5. In contrast, the insulin receptor content of T-47D
      cells was not increased. The increase in insulin receptor content in MCF-7 and ZR
      75-1 cells was not due to amplification of the insulin receptor gene. Also, total
      insulin receptor mRNA content was not increased in breast cancer cells in respect
      to nonmalignantly transformed 184B5 breast epithelial cells. However, significant
      differences in the content of receptor mRNA species were observed. The insulin
      receptors in the breast cancer cell lines were functional: (a) In all 4 cell
      lines, high-affinity insulin-binding sites were detected, and, in concert with
      the insulin receptor radioimmunoassay data, binding capacity was highest in MCF-7
      and then in ZR-75-1 cells. (b) In all cell lines, insulin stimulated insulin
      receptor tyrosine kinase activity. However, the effect of insulin was greater in
      breast cancer cell lines than in nonmalignant breast cells. (c) In all cell
      lines, insulin at concentrations of 1 nM or less stimulated [3H]thymidine
      incorporation. This effect of insulin was inhibited by 50% in MCF-7 cells and by
      60% in 184B5 cells when alpha-IR3, a monoclonal antibody to the insulin-like
      growth factor I receptor, was present. In these cells, therefore, insulin was
      active via both its own receptor and the IGF-I receptor. In contrast, alpha-IR3
      antibody was without effect in T-47D and ZR-75-1 cells, suggesting that in these
      cell lines insulin acted only via its receptor. In the breast cancer cells, MA-5,
      an agonist monoclonal antibody to the insulin receptor, stimulated [3H]thymidine
      incorporation. This present study indicates therefore that in breast cancer cell
      lines there are functional insulin receptors that regulate breast cancer cell
      growth.

PMID- 1617669
TI  - Genetic modification of a murine fibrosarcoma to produce interleukin 7 stimulates
      host cell infiltration and tumor immunity.
AB  - Retroviral-mediated gene transfer was used to introduce and express the gene for
      murine interleukin 7 (IL-7) in a fibrosarcoma tumor (FSA). The tumorigenicity of
      these genetically modified FSA cells was greatly decreased in immunologically
      intact syngeneic mice but was unaltered in T-cell-deprived mice. IL-7-infected
      tumors that did grow in intact animals from large size inocula did so slowly and
      had a high incidence of spontaneous regression. Furthermore, mice that had
      rejected tumors became specifically immune to challenge with uninfected parental
      tumor cells. IL-7-infected FSA growing in intact mice were heavily infiltrated
      with host T-cells that were presumably responsible for slow growth and tumor
      regression, and tumor cells were in the minority. Fluorescence-activated cell
      sorter analysis showed that there was a 530% increase in T-cells in IL-7-infected
      FSA compared with control tumors. CD8+ T-cells were particularly elevated, but
      CD4+ lymphocytes were also increased in number, as were eosinophils and
      basophils. The CD4+:CD8+ ratio in IL-7-infected FSA was 1:1.7 in comparison to
      1:0.6 in control tumors. Lymphocytes isolated from IL-7-producing tumors had
      greatly enhanced cytotoxicity towards uninfected, parental FSA cells. Killing of
      non-cross-reacting fibrosarcoma line was also increased but to a much lesser
      extent. Injection of recombinant human IL-7 directly into established FSA tumors
      slowed their growth and, in a significant number of instances, caused complete
      regression. Mice that had rejected tumor became specifically immune. The dose
      that was needed for this effect was, however, somewhat large: 20 micrograms twice
      daily for 10 days. This result contrasts with the efficacy of IL-7 gene infection
      in stimulating responses to the same tumor. These considerations make IL-7 a good
      candidate for tumor-directed cytokine gene therapy.

PMID- 1617670
TI  - N-ras mutation in ultraviolet radiation-induced murine skin cancers.
AB  - UV radiation is a potent DNA-damaging agent and a known inducer of skin cancer in
      experimental animals. To elucidate the role of oncogenes in UV carcinogenesis, we
      analyzed UV-induced murine skin tumors for mutations in codon 12, 13, or 61 of Ha
      ras, Ki-ras, and N-ras oncogenes by amplification of genomic tumor DNAs by the
      polymerase chain reaction followed by dot-blot hybridization to synthetic
      oligonucleotide probes designed to detect single base-pair mutations. In addition
      to UV-induced C3H mouse skin tumors, we also analyzed skin tumors induced in the
      same strain of mice by other carcinogenic agents such as 8-methoxypsoralen + UVA,
      angelicin + UVA, dimethylbenz-[a]anthracene + UV + croton oil, and 4
      nitroquinoline-1-oxide. We found that 4 of 20 UV-induced skin tumors contained
      either C----A or A----G base substitutions at N-ras codon 61. In addition, 2 of 5
      melanomas possessed a G----A transition in N-ras codon 13 and an A----T
      transversion in N-ras codon 61, respectively. Interestingly, none of the 8
      methoxypsoralen + UVA- or angelicin + UVA-induced tumors we analyzed contained
      mutations in any of the ras genes. However, 1 of 4 4-nitroquinoline-1-oxide
      induced tumors exhibited a G----T transversion at Ki-ras codon 12, a potential
      site for formation of a 4-nitroquinoline-1-oxide adduct with a guanine residue.
      We also found that 2 nonmelanoma tumors induced by dimethylbenz[a]anthracene + UV
      + croton oil contained an A----T transversion at Ha-ras codon 61 position 2,
      which is characteristic of most dimethylbenz[a]anthracene-induced tumors. These
      results suggest that UV-induced C3H mouse tumors display mutations preferentially
      in the N-ras oncogene. Since most N-ras mutations in UV-induced tumors occurred
      opposite dipyrimidine sequences (T-T or C-C), one can infer that these sites are
      the targets for UV-induced mutation and transformation.

PMID- 1617671
TI  - Mechanism of c-fos induction by active oxygen.
AB  - We have compared the mechanisms of the transcriptional induction of c-fos in
      mouse epidermal cells JB6 (clone 30) by an extracellular burst of active oxygen
      of the type produced by inflammatory phagocytes to induction by serum and phorbol
      ester. All three inducers elicit a characteristic immediate early response of c
      fos which is inhibited by the protein kinase inhibitor H7 but enhanced by the
      protein synthesis inhibitor cycloheximide. Experiments with stable transfectants
      containing fos 5' upstream regulatory sequences linked to an HSV-tk-chloram
      phenicol-acetyl-transferase reporter construct indicate that the joint dyad
      symmetry element-AP-1 motifs exert the most potent enhancer effect in response to
      active oxygen as well as serum. It is concluded that the different signal
      transduction pathways used by these inducers converge to the same 5' regulatory
      sequences of c-fos. In contrast to these common features only active oxygen
      induction of c-fos required the poly-ADP-ribosylation of chromosomal proteins.
      The inhibitors of ADP-ribose transferase benzamide and 3-amino-benzamide
      suppressed the elongation of the c-fos message and the de novo synthesis of
      nuclear factors, among them c-Fos and c-Jun, which bind to the fos-AP-1 motif in
      vitro only following stimulation with active oxygen. No active oxygen-induced
      change was observed in the protein complex which binds to an oligonucleotide
      containing the SIF and dyad symmetry element motifs in vitro. The presence of Fos
      and Jun proteins was detected in this complex. Only active oxygen, but not serum
      or phorbol ester, induces DNA breakage. We propose that poly-ADP-ribosylation is
      required because it participates in the repair of DNA breaks which interfere with
      transcription. We observed that Fos protein is weakly poly-ADP-ribosylated in
      response to active oxygen, but the functional role of this modification remains
      unclear.

PMID- 1617672
TI  - Salmonella typhimurium strains expressing human arylamine N-acetyltransferases:
      metabolism and mutagenic activation of aromatic amines.
AB  - Epidemiological studies have established the carcinogenic risk of occupational
      exposure to aromatic amines such as benzidine, beta-naphthylamine, and 4
      aminobiphenyl. Metabolic activation of these chemicals to reactive, genotoxic
      electrophiles, via enzymatic N-oxidation and subsequent conjugation reactions, is
      necessary for their carcinogenic potential to be realized. Many aromatic amines
      are mutagenic in prokaryotic test systems, in the presence of exogenous mammalian
      activating enzymes such as those contained in hepatic 9000 x g supernatant.
      However, in the Ames (Salmonella typhimurium) assay, induction of mutations by
      aromatic amines and nitroarenes is also almost completely dependent upon the
      activity of the endogenous bacterial enzyme, N-acetyltransferase/O
      acetyltransferase. The relevance of this assay to the prediction of the
      carcinogenic potential of aromatic amines in humans is thus restricted by the
      likelihood that the bacterial and human enzymes possess different substrate
      specificities. In this paper we report the construction and use of new tester
      strains of S. typhimurium that express high levels of functional human arylamine
      N-acetyltransferases, NAT1 and NAT2, retaining characteristic arylamine substrate
      specificities that are distinct from those of the bacterial enzyme. These new
      strains support the mutagenic activation of benzidine, 2-aminofluorene and 2
      amino-3,4-dimethylimidazo[4,5-f]quinoline in the Ames test and may provide a new
      tool for evaluating the carcinogenic potential of aromatic amines.

PMID- 1617673
TI  - Distribution of the glucose transporters in human brain tumors.
AB  - In the present study, we have investigated the expression of both the erythrocyte
      type (GLUT1) and the brain-type (GLUT3) glucose transporter isoforms in primary
      human brain tumors. In situ hybridization made it possible to localize and
      semiquantify both GLUT1 and GLUT3 mRNAs of individual cells in all 18 samples
      examined. More signals for GLUT3 mRNA than for GLUT1 mRNA were found over
      astrocytoma cells, while the reverse was the case in all 6 meningiomas. In
      astrocytomas, for both mRNAs, the density of silver grains over tumor cells was
      well correlated with the malignancy of the cells. This correlation was, as was
      also confirmed by Northern blot analysis, more marked with GLUT3 mRNA than with
      GLUT1 mRNA. In 2 of 5 anaplastic astrocytomas and in all 3 glioblastomas,
      numerous tumor cells with large amounts of both mRNAs tended to surround the
      perivascular regions. "Tumor vessels" with endothelial proliferation, an almost
      pathognomonic feature of glioblastomas, expressed much GLUT3 mRNA but no
      significant GLUT1 mRNA, while a single- or a few-layered capillary endothelium
      expressed much GLUT1 mRNA. The distribution of both mRNAs was in good accordance
      with that of both proteins. Our results suggest that the expression of both
      glucose transporter isoforms may contribute to the maintenance of human brain
      tumors and that the expression of the GLUT3 isoform may be closely related to the
      malignant change of astrocytomas and particularly related to the aberrant
      neovascularization which accompanies glioblastomas.

PMID- 1617674
TI  - Complete inhibition of growth followed by death of human malignant melanoma cells
      in vitro and regression of human melanoma xenografts in immunodeficient mice
      induced by camptothecins.
AB  - The plant alkaloid camptothecin and three camptothecin derivatives were used to
      study responses of human malignant melanoma (BRO) cells xenografted in
      immunodeficient (nude) mice. Camptothecin and its derivatives 9-nitro-20(S)
      camptothecin and 9-amino-20(S)-camptothecin inhibited growth of tumors and caused
      regression in all tumor-bearing mice. Tumor regression was accompanied by
      degenerative changes in the tumor cells, as assessed by microscopic observations
      of histological sections prepared from the tumors. No toxic effects were observed
      in the drug-treated mice, with or without xenografts. In parallel experiments,
      camptothecin, 9-nitro-20(S)-camptothecin, and 9-amino-20(S)-camptothecin
      inhibited proliferation of BRO cells in vitro and resulted in dramatic
      morphological cellular changes comparable to those observed in the sections of
      solid tumors. The derivative 12-nitro-20(S)-camptothecin had no effect on BRO
      tumors or cell cultures. The difference between 9-nitro-20(S)-camptothecin and 12
      nitro-20(S)-camptothecin is the position at which the NO2 group is attached to
      the camptothecin molecule. In contrast to BRO melanoma cells, none of the
      camptothecin derivatives had any effect on cultured human melanocytes, the normal
      counterparts of melanoma cells. Taken together, the findings indicate that
      camptothecin and derivatives exert different effects on the growth and morphology
      of normal and malignant (BRO) melanocytes.

PMID- 1617675
TI  - Localization of tumors and evaluation of their state of oxygenation by
      phosphorescence imaging.
AB  - Oxygen-dependent quenching of phosphorescence has been used to image the
      distribution of oxygen pressure in small tumors and surrounding tissue.
      Suspensions of cultured 9L cells or small pieces of solid tumors from 9L cells
      were injected into the surface of the muscle of the hindquarter of rats, and the
      tumors were grown until they were 0.2-1.0 cm in diameter. The phosphorescent
      probe for oxygen was injected into the systemic blood, and phosphorescence was
      imaged with a video camera. Images of the phosphorescence were collected using a
      series of different delay times after illumination with a light flash (less than
      5-microseconds width at half-height), and the phosphorescence decay constants
      (lifetimes) and oxygen pressure were calculated for each pixel of the image
      arrays. The areas of tissue within the tumors were observed to have increased
      phosphorescence lifetimes and lower oxygen pressures than the surrounding tissue.
      Phosphorescence imaging is, therefore, a noninvasive optical method which permits
      quantitation of the distribution of oxygen in small tumors and also, at least in
      the 9L tumors, differentiation of tumor from normal tissue.

PMID- 1617676
TI  - Growth inhibition of human glioma cells induced by 8-chloroadenosine, an active
      metabolite of 8-chloro cyclic adenosine 3':5'-monophosphate.
AB  - 8-Chloroadenosine 3':5'-monophosphate (8ClcAMP) inhibits the growth of human
      glioma cell lines at much lower concentrations than more commonly used cyclic AMP
      analogues, without inducing morphological differentiation. The mechanism by which
      8ClcAMP exerts this effect is not fully understood. We examined whether the
      growth-inhibitory effect of this compound is due to an active metabolite, using a
      sulforhodamine protein stain assay to determine the proliferation rate of the WF
      human glioma cell line. 8-Chloroadenosine, one of the metabolites, inhibited the
      proliferation of WF human glioma cells more potently than 8ClcAMP. In the
      presence of adenosine deaminase, which converts 8-chloroadenosine into 8
      chloroinosine, 8-chloroadenosine no longer inhibited human glioma cell growth.
      Addition of adenosine deaminase also largely reduced the growth-inhibitory effect
      of 8ClcAMP, but not of 8-(4-chlorophenylthio)cAMP. High performance liquid
      chromatography analysis revealed that at least part of the 8ClcAMP in the culture
      medium is converted into 8-chloroadenosine. We concluded that 8ClcAMP exerts its
      growth-inhibitory effect through its active metabolite 8-chloroadenosine.
      Adenylate cyclase assays showed that 8-chloroadenosine does not affect the
      intracellular cAMP production through adenosine A1 or A2 receptor activation,
      which makes it unlikely that 8-chloroadenosine inhibits glioma cell growth by
      increasing the intracellular cyclic AMP concentration.

PMID- 1617677
TI  - Subcellular distribution of the anticancer drug mitoxantrone in human and drug
      resistant murine cells analyzed by flow cytometry and confocal microscopy and its
      relationship to the induction of DNA damage.
AB  - Flow cytometry and laser scanning confocal imaging have been used to analyze the
      uptake of the anticancer topoisomerase II poison mitoxantrone by intact mammalian
      cells and the results correlated with the induction of DNA damage. Unlike
      Adriamycin, mitoxantrone displays only minimal levels of red fluorescence when
      excited at 514 wavelength. However, using these excitation and emission
      conditions, flow cytometry could detect low levels of fluorescence in human
      transformed fibroblasts exposed to high concentrations (5-20 microM) of
      mitoxantrone for 1 h. Over this dose range whole cell fluorescence was a function
      of cell size and increased with drug concentration while drug-induced DNA-protein
      cross-linking showed saturation. Confocal microscopy revealed the time- and dose
      dependent appearance of fluorescence, interpreted here as reflecting the
      disposition of drug molecules, preferentially within the cytoplasm, nuclear
      membrane, and nucleoli. This pattern contrasted with the intense intranuclear
      fluorescence observed in Adriamycin-treated human cells. Loss of the nuclear
      membrane during mitosis resulted in an apparent increase in chromatin-associated
      fluorescence. Photon counting procedures revealed a predominantly cytoplasmic,
      possibly lysosomal, location for fluorescence from human cells exposed for 1 h to
      a low but cytotoxic concentration (0.1 microM, yielding approximately 90% cell
      kill) of mitoxantrone. At this low concentration, human cells displayed minimal
      levels of DNA strand cleavage or DNA-protein cross-linking. Murine cells,
      displaying mitoxantrone resistance as part of the P-glycoprotein-mediated
      multidrug resistance phenotype, showed specific extinction of mitoxantrone
      associated fluorescence from inside nuclei but not from within extranuclear
      compartments. The study demonstrates the feasibility of high resolution studies
      on the intracellular distribution of mitoxantrone in intact living cells. We
      suggest a mechanism by which cytoplasmic sequestration of mitoxantrone may be
      important in determining the response of normal and multidrug-resistant cells as
      they attempt to progress through mitosis.

PMID- 1617678
TI  - Herbimycin A, an inhibitor of tyrosine kinase, prolongs survival of mice
      inoculated with myeloid leukemia C1 cells with high expression of v-abl tyrosine
      kinase.
AB  - Herbimycin A, a benzoquinonoid ansamycin antibiotic, reduces intracellular
      phosphorylation by some tyrosine kinases, including v-abl. The mouse
      megakaryoblastic cell line C1 expresses v-abl protein at high levels. Herbimycin
      A at about 20 ng/ml caused 50% inhibition of growth of C1 cells but at 100 ng/ml
      scarcely affected the growth of another mouse leukemia cell line, M1 cells, or of
      normal bone marrow cells. Injection of 10(6) C1 cells into nude mice resulted in
      death of all the mice within 30 days. Administration of herbimycin A
      significantly enhanced the survival of mice inoculated with C1 cells but scarcely
      affected the survival of mice inoculated with M1 cells. These results suggest
      that herbimycin A and/or related compounds may be useful for treatment of some
      types of leukemia in which tyrosine kinase activity is implicated as a
      determinant of the oncogenic state.

PMID- 1617679
TI  - Limonene-induced regression of mammary carcinomas.
AB  - Dietary administration of the monocyclic monoterpenoid d-limonene causes complete
      regression of both dimethylbenz[alpha]anthracene- and N-nitroso-N-methylurea
      induced rat mammary carcinomas. Carcinomas regress when limonene is added to the
      diet either when the tumor is small and still capable of spontaneously regressing
      or when it is large and progressed beyond the stage when it is susceptible to
      spontaneous regression. The limonene dose-tumor regression response relationship
      is steep. Significant regressions are not observed at 5% dietary levels, while a
      majority of tumors completely regress above a 7.5% dietary level. Limonene
      appears to act in a cytostatic fashion. Its removal from the diet results in a
      significant number of tumor recurrences. Regressing tumors have a unique
      histopathological appearance that is not associated with gross cytotoxicity,
      immune cell involvement, or apoptosis. Preliminary analysis suggests a
      remodeling/redifferentiation event underlying regression. The underlying
      mechanism of action of limonene in causing tumor regression is unknown. However,
      it should be noted that limonene can selectively inhibit the isoprenylation of
      small G proteins. Monoterpenoids such as limonene represent a novel class of
      anticancer drugs with the potential to cause tumor regressions with limited
      toxicity.

PMID- 1617680
TI  - Expression of a transfected H-2Kb gene in B16 cells correlates with suppression
      of liver metastases in triple immunodeficient mice.
AB  - In vivo experiments performed with NIH (nu/nu, bg/bg, xid/xid) triple
      immunodeficient (TD) mice revealed the striking ability of i.v. injected B16-F1
      and B16-F10 murine melanoma cells to colonize not only the lungs but also the
      liver of TD mice. Subsequently, B16 melanoma cell cultures, which express very
      low levels of H-2Kb antigen, were cotransfected with plasmids pRSVneo, containing
      the neomycin resistance gene, and 6-2B1pMT, expressing the H-2Kb complentary DNA
      under the control of the metallothionein enhancer-promoter. Several neomycin
      resistant clones were analyzed for H-2Kb and H-2Db expression by RNase protection
      and flow cytometry assays. All parental lines and transfected clones expressed
      normal levels of H-2Db mRNA, while only some of the transfected clones expressed
      easily detectable levels of H-2Kb mRNA. Moreover, in these clones H-2Kb
      expression could be enhanced in the presence of Zn2+, indicating that the
      metallothionein enhancer was functioning properly. Parental cells and transfected
      clones were injected i.v. in TD mice to assess the possible involvement of H-2Kb
      antigen in regulating the metastatic potential of B16 melanoma cells. We observed
      a remarkable correlation between expression of H-2Kb antigen and suppression of
      liver-specific metastases in TD mice. Identical results were obtained when we
      gave TD mice injections of mixed populations of transfectants expressing H-2Kb
      antigen, obtained by fluorescence-activated cell sorting. These experiments
      allowed us to rule out the possibility that the observed changes in metastatic
      potential were due to clonal variability among individual transfected clones.
      Taken together, the results of our in vivo studies with immunodeficient mice
      support the notion that specific major histocompatibility complex Class I
      molecules modulate the metastatic potential of malignant cells also by mechanisms
      which are independent of their well-established role in antigen presentation.

PMID- 1617681
TI  - Enhancement of antioxidant and phase II enzymes by oral feeding of green tea
      polyphenols in drinking water to SKH-1 hairless mice: possible role in cancer
      chemoprevention.
AB  - Following the oral feeding of a polyphenolic fraction isolated from green tea
      (GTP) in drinking water, an increase in the activities of antioxidant and phase
      II enzymes in skin, small bowel, liver, and lung of female SKH-1 hairless mice
      was observed. GTP feeding (0.2%, w/v) to mice for 30 days significantly increased
      the activities of glutathione peroxidase, catalase, and quinone reductase in
      small bowel, liver, and lungs, and glutathione S-transferase in small bowel and
      liver. GTP feeding to mice also resulted in considerable enhancement of
      glutathione reductase activity in liver. In general, the increase in antioxidant
      and phase II enzyme activities was more pronounced in lung and small bowel as
      compared to liver and skin. The significance of these results can be implicated
      in relation to the cancer chemopreventive effects of GTP against the induction of
      tumors in various target organs.

PMID- 1617682
TI  - 3-Aminobenzamide can act as a cocarcinogen for ultraviolet light-induced
      carcinogenesis in mouse skin.
AB  - Chronic irradiation (three times a week) with ultraviolet B light of the skin of
      hairless mouse Uscd (Hr) strains resulted in the induction of skin tumors after
      25 to 41 weeks. Topical applications of 3-aminobenzamide (3AB; 0.1 or 1 M) after
      each irradiation significantly shortened the earliest time of onset of tumors to
      13 to 25 weeks and increased the number of animals that developed tumors over 41
      weeks from 67% without 3AB to 73% and 81% with 0.1 and 1 M 3AB, respectively. 3
      Aminobenzamide has previously been shown to inhibit radiation-induced
      transformation in vitro. In vivo, 3AB has the opposite effect, indicating the
      need for caution in extrapolating from in vitro systems to carcinogenesis in
      vivo.

PMID- 1617683
TI  - Workshop report from the Division of Research Grants, National Institutes of
      Health. Metal carcinogenesis--a Chemical Pathology Study Section Workshop.

PMID- 1617684
TI  - Positional identification of fluorine in methyl per-O-acetyl-x-deoxy-x-fluoro
      alpha-D-hexopyranosides by electron impact and chemical ionisation mass
      spectrometry.
AB  - Fully acetylated methyl x-deoxy-x-fluoro-alpha-D-glucopyranosides have been
      studied using electron impact and ammonia chemical ionisation mass spectrometry.
      Mass analysed metastable ion kinetic energy spectroscopy (MIKE), collisional
      activation (CID), and accelerated voltage scanning have been used to evaluate
      complete fragmentation schemes. Characteristic differences in the fragmentation
      of positional isomers were noted on analysis of the spectra, and these make it
      possible to determine the location of fluorine in the molecules studied.
      Collisionally activated fragmentation of [M-OCH3]+ ions, produced by electron
      impact, provides an alternative method for localisation of the fluorine atoms. To
      the contrary, MIKE and CID spectra of [M + NH4]+ cluster ions produced by
      chemical ionisation did not afford such structural information.

PMID- 1617685
TI  - Isotope-edited 1D and 2D n.m.r. spectroscopy of 13C-substituted carbohydrates.
AB  - Three isotope-edited n.m.r. methods have been applied to selectively 13C
      substituted monosaccharides and nucleosides to simplify their spectra and/or
      measure 1H-1H, 13C-1H, or 13H-13C spin-couplings detected via the labeled site.
      1D INADEQUATE spectra allowed the selective detection of the natural-abundance
      carbons that are spin-coupled to the labeled carbon, and adjustment of the mixing
      time permitted further discrimination between one-bond and longer-range 13C-13C
      coupling pathways. Geminal and vicinal 13C-1H coupling constants were determined
      from the analysis of 1H-1H COSY cross-peaks for those protons coupled to the
      labeled carbon. Long-range 13C-(HETCOR) and 1H-detected (HMBC) 13C-1H chemical
      shift correlation spectra permitted the selective observation of those protons
      coupled to the labeled site, and JH,H values were measured from data projections.
      The implications of these methods for structural studies of more complex systems
      is briefly discussed.

PMID- 1617687
TI  - Synthesis and antitumour activity of derivatives of curdlan and lichenan branched
      at C-6.
AB  - Derivatives of curdlan and lichenan, linear (1----3)-beta-D- and (1----3/1----4)
      beta-D-glucans, respectively, have been synthesised having alpha-L
      arabinofuranosyl, alpha-L-rhamnosyl, beta-D-glucosyl, and beta-gentiobiosyl side
      chains attached at positions 6. These water-soluble derivatives, obtained by
      condensation of the 2,4- and 2,4-/2,3-di-O-phenylcarbamoyl derivatives of curdlan
      and lichenan, respectively, with appropriate ortho esters followed by
      saponification, were characterised by methylation analysis, g.p.c., and
      interaction with Congo Red. The curdlan derivatives and the lichenan derivative
      with few glucosyl branches were active against the Sarcoma 180.

PMID- 1617686
TI  - Synthesis of methyl 2,4-di-O-methyl-3-O-(2-O-methyl-alpha-L-rhamnopyranosyl)
      alpha-L- rhamnopyranoside and methyl 2,4-di-O-methyl-3-O-[2-O-methyl-3-O-(2-O
      methyl-alpha-L-fucopyranosyl)- alpha-L-rhamnopyranosyl]-alpha-L-rhamnopyranoside:
      di- and tri-saccharide segments of a phenolic glycolipid of Mycobacterium
      kansasii.
AB  - Syntheses of the title glycosides are described. The critical O-glycosylations
      were carried out in the presence of boron trifluoride etherate with a high degree
      of alpha-selectivity.

PMID- 1617688
TI  - Synthesis and antitumour activity of sulfoalkyl derivatives of curdlan and
      lichenan.
AB  - 2-Sulfoethyl, 3-sulfopropyl, and 4-sulfobutyl derivatives of the (1----3)-beta-D
      glucan curdlan and the (1----3/1----4)-beta-D-glucan lichenan have been
      synthesised. The substituents are located mainly at positions 6. The curdlan
      derivatives strongly inhibited the growth of the Sarcoma 180 tumour, whereas the
      lichenan derivatives were inactive, indicating that a (1----3)-linked beta-D
      glucan backbone is essential for activity.

PMID- 1617689
TI  - Multiply 13C-substituted monosaccharides: synthesis of D-(1,5,6-13C3)glucose and
      D-(2,5,6-13C3)glucose.
AB  - D-(1,5,6-13C3)Glucose (7) has been synthesized by a six-step chemical method. D
      (1,2-13C2)Mannose (1) was converted to methyl D-(1,2-13C2)mannopyranosides (2),
      and 2 was oxidized with Pt-C and O2 to give methyl D-(1,2-13C2)mannopyranuronides
      (3). After purification by anion-exchange chromatography, 3 was hydrolyzed to
      give D-(1,2-13C2)mannuronic acid (4), and 4 was converted to D-(5,6-13C2)mannonic
      acid (5) with NaBH4. Ruff degradation of 5 gave D-(4,5-13C2)arabinose (6), and 6
      was converted to D-(1,5,6-13C3)glucose (7) and D-(1,5,6-13C3)mannose (8) by
      cyanohydrin reduction. D-(2,5,6-13C3)Glucose (9) was prepared from 8 by molybdate
      catalyzed epimerization.

PMID- 1617690
TI  - Structural features of a water-soluble arabinoxylan from the endosperm of wheat.
AB  - A cold-water-soluble wheat-endosperm arabinoxylan consisting of a backbone of (1-
      --4)-linked beta-D-xylopyranosyl residues that are variously unsubstituted, and 3
      or 2,3-substituted with single alpha-L-arabinofuranosyl groups, was subjected to
      1H-n.m.r. spectroscopy. The results of 2D homonuclear Hartmann-Hahn and 1D 1H
      n.m.r. spectroscopy allowed the identification of 3- and 2,3-substituted xylose
      residues, each with adjacent unsubstituted xylose residues, and also substituted
      xylose residues with a substituted xylose residue as a neighbour. The 1H-n.m.r.
      data were correlated with 13C-n.m.r. data by means of a 13C-1H 2D proton-detected
      heteronuclear multiple-quantum correlation experiment, which showed that only
      different types of branching (i.e., 3- and 2,3-) can be identified by the 13C
      n.m.r. data.

PMID- 1617692
TI  - Mass spectra of some di-D-fructose dianhydride derivatives.

PMID- 1617691
TI  - Analysis of Macrocystis pyrifera and Pseudomonas aeruginosa alginic acids by the
      reductive-cleavage method.
AB  - Permethylated alginic acids comprised of 4-linked D-mannopyranosyluronic acid and
      4-linked L-gulopyranosyluronic acid residues undergo reductive cleavage to yield,
      after acetylation, methyl 3-O-acetyl-2,6-anhydro-4,5-di-O-methyl-D-mannonate (2b)
      and methyl 3-O-acetyl-2,6-anhydro-4,5-di-O-methyl-D-gluconate (3b) as major
      products. Small amounts (ca. 13%) of ring-contracted products, namely methyl 2-O
      acetyl-3,6-anhydro-4,5-di-O-methyl-D-mannonate (9) and methyl 2-O-acetyl-3,6
      anhydro-4,5-di-O-methyl-D-gluconate (10), were also observed in these
      experiments. These results are in marked contrast to previous results on the
      reductive cleavage of 4-linked D-glucopyranosyluronic acid residues, wherein the
      ring-contracted product was formed exclusively. Formation of the ring-contracted
      products could be completely eliminated by reduction (LiAlH4) of ester groups in
      the permethylated alginic acid prior to reductive cleavage. In the latter
      experiments, 4,6-di-O-acetyl-1,5-anhydro-2,3-di-O-methyl-D-mannitol (5b) and 4,6
      di-O-acetyl-1,5-anhydro-2,3-di-O-methyl-L-gulitol (6b) were the sole products of
      reductive cleavage of the 4-linked ManA and 4-linked GulA residues, respectively.
      However, in the previous experiments it was noted that low yields of
      permethylated alginic acids were obtained and that extensive depolymerization
      occurred under methylation conditions. Depolymerization could be avoided and
      higher yields of permethylated polysaccharides could be obtained, by reduction of
      the carboxyl groups of the alginic acids prior to methylation. Reductive cleavage
      of the latter polysaccharides yielded the products expected from 4-linked D
      mannopyranosyl and 4-linked L-gulopyranosyl residues, namely 4-O-acetyl-1,5
      anhydro-2,3,6-tri-O-methyl-D-mannitol (13b) and 4-O-acetyl-1,5-anhydro-2,3,6-tri
      O-methyl-L-gulitol (14b), respectively. Using the latter analytical strategy, it
      was established that the Macrocystis pyrifera alginate was comprised of 60% 4
      linked ManA and 40% 4-linked GulA residues, whereas the Pseudomonas aeruginosa
      alginate was comprised of 80% 4-linked ManA and 20% 4-linked GulA residues.

PMID- 1617693
TI  - Synthesis of methyl O-alpha-L-fucopyranosyl-(1----2)-O-beta-D- galactopyranosyl
      (1----3)-2-acetamido-2-deoxy-beta-D-glucopyranoside, using 2,3,4-tri-O-benzoyl
      alpha-L-fucopyranosyl bromide as the alpha-L-fucosylating agent.

PMID- 1617694
TI  - Interstitial cells associated with the deep muscular plexus of the guinea-pig
      small intestine, with special reference to the interstitial cells of Cajal.
AB  - Interstitial cells associated with the deep muscular plexus of the guinea-pig
      small intestine were studied by electron microscopy, and three-dimensional cell
      models were reconstructed from serial ultrathin sections with a computer graphic
      system. Three types of cells were recognized. The first type was similar in shape
      to smooth muscle cells, but did not contain an organized contractile apparatus.
      Many large gap junctions comprising about 4% of the cell surface were present;
      they connected cells of the first type to each other, to the second type of cell
      and to smooth muscle cells of the outer circular layer. The second type of cell
      had a well-demarcated cell body with long slender processes and was characterized
      by a large amount of glycogen comprising about 9% of the cell volume. The third
      type of cell was similar to fibroblasts, and contained well-developed Golgi
      apparatus and rough endoplasmic reticulum. Some of these fibroblast-like cells (a
      possible subtype) formed small gap junctions. All three types of cells showed
      close relationships with nerve varicosities. This cellular network consisting of
      gap-junction-rich cells, glycogen-rich cells and smooth muscle cells may be
      involved in the pacemaking activity of intestinal movement.

PMID- 1617695
TI  - Progressive redistribution of alcohol dehydrogenase during vitellogenesis in
      Drosophila melanogaster: characterization of ADH-positive bodies in mature
      oocytes.
AB  - The use of monoclonal antibodies against Drosophila alcohol dehydrogenase (ADH)
      provides a powerful tool in the analysis of the tissue and temporal patterns of
      Adh gene expression. Immunocytochemical techniques at the light- and electron
      microscopic levels have been used to determine the distribution of ADH in the
      ovarian follicles of D. melanogaster during oogenesis. In the early stages of
      oogenesis, small amounts of ADH are detectable in the cystocytes. At the
      beginning of vitellogenesis (S7), ADH appears to be located mainly in the nurse
      cells. From stage S9 onwards, the ADH protein is evenly distributed in the
      ooplasm until the later stages of oogenesis (S13-14), when multiple ADH-positive
      bodies of varying size appear in the ooplasm. This change in distribution is a
      result of the compartmentalization of the ADH protein within the glycogen yolk or
      beta-spheres. Yolk becomes enclosed within the lumen of the primitive gut during
      embryonic development, and thus our results suggest a mechanism for the transfer
      of maternally-inherited enzymes to the gut lumen via yolk spheres.

PMID- 1617696
TI  - Morphological differentiation of endothelial cells co-cultured with astrocytes on
      type-I or type-IV collagen.
AB  - In this study bovine aortic endothelial cells were co-cultured with astrocytes
      from fetal Wistar Kyoto rats. Endothelial cells growing on type-I collagen, co
      cultured with astrocytes, showed various stages of development. Although some
      cells appeared to be mature, horseradish peroxidase penetrated within 1 min of
      incubation through the intercellular junctions of these endothelial elements
      maintained on type-I collagen. In contrast, endothelial cells on type-IV
      collagen, co-cultured with astrocytes, were well developed; their intercellular
      junctions were well established, and plasmalemmal vesicles reduced in number. As
      a result, horseradish peroxidase was unable to penetrate through the endothelial
      cells grown on type-IV collagen and co-cultured with astrocytes because of the
      reduced extent of the junctional and vesicular transport. These findings reveal
      that (1) type-IV collagen is essential for the differentiation of endothelial
      cells, (2) endothelial cell-astrocyte interactions occur during co-culture, and
      (3) endothelial permeability depends on astrocyte-produced factors, in addition
      to type-IV collagen.

PMID- 1617697
TI  - Ultrastructure of the basement membrane and its precursor in developing rat
      submandibular gland as shown by alcian blue staining.
AB  - The ultrastructure of the epithelial basement membrane and membrane precursor was
      studied in rat submandibular rudiment and a model system of the reconstructed
      basement membrane, by transmission electron microscopy following alcian blue
      staining. Directly beneath the epithelial plasma membrane, a meshwork layer was
      found to consist of anastomosing thin fibers arranged as a three-dimensional
      meshwork (100-400 nm in thickness). Straight strands (5-10 nm in diameter) could
      sometimes be seen to pass through the meshwork. Adjacent to this layer, a coarse
      network composed of threads (20-40 nm in diameter) connected the meshwork layer
      with collagen fibers of the underlying connective tissue. The earliest precursors
      recognized in the reconstruction-model system were part of the fine-meshwork
      structure, and showed this structure to be a fundamental component of the
      basement membrane.

PMID- 1617698
TI  - 12-O-tetradecanoylphorbol-13-acetate induces selective desquamation of
      superficial cells in rat urinary bladder epithelium.
AB  - 12-O-tetradecanoylphorbol-13-acetate (TPA) is known to affect the proliferation
      and/or differentiation of several types of cells. We injected TPA directly into
      the lumen of rat bladder to determine, using scanning and transmission electron
      microscopy, its effects on the bladder epithelium in vivo. At 1 h after TPA
      injection (1 microgram/ml), the superficial cells of the epithelium had changed
      their morphology, and large spherical vacuoles occupied their cytoplasm. In some
      areas, the underlying intermediate cells were exposed by the desquamation of the
      superficial cells. During the next few hours, TPA was excreted from the bladder
      lumen by voluntary micturition, but the desquamation of the superficial cells
      proceeded further. All the superficial cells were lost from the luminal surface
      by 24 h after TPA injection. The changes noted were specific for the superficial
      cells and were not observed in the intermediate or basal cells. After 24 h, part
      of the epithelium had a three-layer structure, indicating that regeneration was
      taking place. These results demonstrate that TPA selectively affects and
      desquamates superficial cells in a short period of time. This experimental system
      may be useful for studying in vivo cell proliferation and/or differentiation.

PMID- 1617699
TI  - Structural changes in condylar cartilage following prolonged exposure to the
      human parathyroid hormone fragment (hPTH) 1-34 in vitro.
AB  - This investigation presents the structural changes in condylar cartilage
      incubated in the presence of human parathyroid hormone (1-34) in an organ culture
      system for 6 to 12 days. Control cultures maintained their cartilaginous
      characteristics whereas human parathyroid hormone (1-34)-treated cultures
      revealed the following modifications: (1) The chondroprogenitor cell zone at the
      apical region of the explant underwent a substantial enlargement. The cells
      changed from a mesenchyme-like morphology into polygonal, glycogen-rich cells
      that were tightly attached to each other by a fibrillar intercellular matrix, but
      even by 12 days the apical region was comprised of healthy cells. (2) The
      mineralizing zone in the hypertrophic cartilage revealed a change in its cellular
      population. Hypertrophic chondrocytes were replaced by cells with amoeboid
      extensions and large numbers of secretory granules or vesicles. Based upon the
      above findings it appears that the chondroprogenitor cells that are initially
      stimulated to proliferate, are being suppressed from subsequent differentiation
      into chondroblasts; and that hypertrophic chondrocytes apparently undergo a
      dedifferentiation process followed by development into an as yet unknown cell
      population.

PMID- 1617700
TI  - Cellular changes in rat parathyroids provoked by progesterone and testosterone.
AB  - Male rats kept on a standard diet were treated either with progesterone or
      testosterone by a single intramuscular injection of preparations which are slowly
      absorbed and metabolized. The rats were anaesthetized 24 h after application of
      the hormones, perfused with glutaraldehyde, and the parathyroid glands prepared
      for electron microscopy. Morphometric analysis revealed that both progesterone
      and testosterone provoked (1) an increment in nuclear and cell volume and a
      concomitant increment in cell surface area, and (2) an increment in surface area
      of rough endoplasmic reticulum by 42% and 49%, and of the Golgi complex by 85%
      and 63%, respectively. Previously, we had found that oestradiol treatment led to
      a similar response in parathyroid cells. The conclusion is thus drawn that male
      and female sex hormones induce membrane synthesis resulting in an enhanced
      capacity for parathyroid hormone secretion since RER and Golgi complex are
      concerned with this secretion. It is considered probable that sex hormones have
      the ability fundamentally to modulate secretory activity in parathyroid cells.

PMID- 1617701
TI  - Octopamine-immunoreactive neurons in the central nervous system of the cricket,
      Gryllus bimaculatus.
AB  - The distribution of octopamine-immunoreactive neurons is described using whole
      mount preparations of all central ganglia of the cricket, Gryllus bimaculatus. Up
      to 160 octopamine-immunoreactive somata were mapped per animal. Medial unpaired
      octopamine-immunoreactive neurons occur in all but the cerebral ganglia and show
      segment-specific differences in number. The position and form of these cells are
      in accordance with well-known, segmentally-organized clusters of large dorsal and
      ventral unpaired medial neurons demonstrated by other techniques. In addition,
      bilaterally arranged groups of immunoreactive somata have been labelled in the
      cerebral, suboesophageal and terminal ganglia. A detailed histological
      description of octopamine-immunoreactive elements in the prothoracic ganglion is
      given. Octopamine-immunoreactive somata and axons correspond to the different
      dorsal unpaired medial cell types identified by intracellular single-cell
      staining. In the prothoracic ganglion, all efferent neurons whose primary
      neurites are found in the fibre bundle of dorsal unpaired cells are
      immunoreactive. Intersegmental octopamine-immunoreactive neurons are also
      present. Collaterals originating from dorsal intersegmental fibres terminate in
      different neuropils and fibre tracts. Fine varicose fibres have been located in
      several fibre tracts, motor and sensory neuropils. Peripheral varicose octopamine
      immunoreactive fibres found on several nerves are discussed in terms of possible
      neurohemal releasing sites for octopamine.

PMID- 1617702
TI  - Uptake and intracellular transport of cationic ferritin in the bronchiolar and
      alveolar epithelia of the rat.
AB  - Cationic ferritin was used as a marker to reveal the processes of endocytosis and
      intracellular transport in bronchiolar and alveolar epithelia. The marker was
      injected into the lung via the trachea, and ultrastructural observation of the
      distribution of ferritin particles in bronchiolar and alveolar epithelial cells
      was carried out at intervals of 5, 15, 30 and 60 min after the injection. The
      luminal surface of the airway and the alveolar epithelium showed diffuse labeling
      with cationic ferritin. In general, ferritin particles were observed in vesicles
      and vacuoles of the bronchiolar and alveolar epithelial cells within 5 min of
      injection; they appeared in multivesicular bodies within 15 min. Multivesicular
      bodies and secondary lysosomes containing ferritin particles, some of which
      showed a positive reaction for acid phosphatase, were seen in the basal cytoplasm
      within 30 min; ferritin particles appeared in the basal lamina below the Clara
      cells, ciliated cells and type 2 alveolar cells within 30 min. Ferritin particles
      were seen in ovoid granules of some Clara cells and in lamellar inclusion bodies
      of many type 2 alveolar cells. Brush cells and type 1 alveolar cells took up only
      a small quantity of ferritin particles.

PMID- 1617703
TI  - Intercellular communication between cultured granulosa cells of the marmoset
      (Callithrix jacchus).
AB  - The influence of follicle-stimulating hormone, forskolin, insulin-like growth
      factor type I, epidermal growth factor, and 12-tetradecanoyl-phorbol-13-acetate
      on marmoset granulosa cell communication via gap junctions was investigated by
      morphological means and microinjection of carboxyfluorescein. Gap junctions
      between neighbouring granulosa cells were present in all groups. The number, but
      not length, of gap junctions between marmoset granulosa cells increased when the
      cells had been treated with follicle-stimulating hormone, insulin-like growth
      factor type I, and follicle-stimulating hormone plus insulin-like growth factor
      type I. No effect on gap junctions was seen, after exposure of the cells to the
      other three substances. Carboxyfluorescein and counting of the surrounding
      labelled cells showed that supplementation with follicle-stimulating hormone,
      forskolin, insulin-like growth factor type I and epidermal growth factor from the
      beginning of cultivation led to an increase in stained cells after 48 h. When
      treatment was started in 48 h cultures the substances reached their maximal
      activity within 30 min (forskolin and epidermal growth factor) or 3 h (follicle
      stimulating hormone and insulin-like growth factor type I). Spreading of the
      fluorescent dye was inhibited when the medium was supplemented with 12
      tetradecanoyl-phorbol-13-acetate. This effect was maximal after 30 min. Additive
      effects regarding the coupling of the cells were seen by combining of epidermal
      growth factor with follicle-stimulating hormone, but not with insulin-like growth
      factor type I or forskolin plus follicle-stimulating hormone.

PMID- 1617704
TI  - Transient serotonin-immunoreactive neurons coincide with a critical period of
      neural development in coho salmon (Oncorhynchus kisutch).
AB  - In coho salmon (Oncorhynchus kisutch), smolt transformation has been shown to be
      associated with sequential surges of neurotransmitters in the brain. In order to
      determine if the surge of serotonin (5-HT) is correlated with structural changes,
      we have used immunocytochemistry to observe changes in the serotonin
      immunoreactivity before, during and after the 5-HT surge. The following stages
      were studied: 12-month-old freshwater presmolts, 17-month-old freshwater
      presmolts, 18-month-old saltwater smolts, 19-month-old saltwater postsmolt, 24
      month-old postsmolt, and adult spawners. In the 17-month-old samples, but not at
      any other stage, we found a set of transient (serotonin-immunoreactive) 5-HT
      immunoreactive neurons in the lateral preoptic area, as well as a discrete
      population of 5-HT-immunoreactive neurons in the lateral part of the dorsal right
      habenular nucleus. In addition, a higher density of serotonergic fibers was found
      in the telencephalon at this stage compared to the following two stages. Since
      the transient 5-HT-immunoreactive structures presented here do not appear
      simultaneously with the 5-HT total brain concentration surge, we conclude that
      they are unlikely to be the source of the 5-HT surge, but are probably related to
      other developmental changes in the brain associated with smolt transformation.

PMID- 1617706
TI  - Initial and long-term results of percutaneous transluminal coronary angioplasty
      in patients 75 years of age and older.
AB  - In 212 patients aged 75 years and older the immediate and long-term results of
      percutaneous transluminal coronary angioplasty (PTCA) were assessed. For 293
      stenoses the primary angiographic success rate was 96% and the overall clinical
      success rate was 90.6%. Angioplasty caused a myocardial infraction in 7 patients
      (3.3%), 2 patients (0.9%) needed emergency aorto coronary bypass surgery, and 4
      patients (1.9%) died following the procedure. Actuarial 7 year survival was
      calculated at 69.3% with a standard deviation (SD) of 8%. Actuarial cardiac
      survival at 7 years was 92.1% (SD 3%), whereas non-cardiac survival at 7 years
      was 75.3% (SD 9%). Actuarially, at 7 years 98.5% (SD 1%) were estimated to remain
      free from myocardial infarction in the angioplasty-related area, 95.7% (SD 2%) to
      remain free from any myocardial infarction, 93.9% (SD 2%) to remain free from re
      PTCA because of a recurrence, 84.7% (SD 5%) to remain free from any re-PTCA, and
      97.1% (SD 2%) to remain free from (re)-operation. Fifty-two point three percent
      (SD 8%) were estimated to remain free from any cardiac event. If recurrence of
      angina is taken into account, only 25.8% (SD 13%) remain asymptomatic during 7
      years follow-up. After successful angioplasty in patients aged 75 and older the
      chance of remaining free from any event or angina at 7 years actuarial follow-up
      gets as low as 15.7% (SD 9%). We conclude that in selected elderly patients
      angioplasty can be performed with a high success rate, although the
      periprocedural mortality and morbidity appear to be higher than in the younger
      age group. During long-term follow-up, most of the patients remain free of
      cardiac events and survival appears to be largely dependent on noncardiac
      factors. However, long-term relief from angina is probably less than in younger
      patients.

PMID- 1617705
TI  - Granulated metrial gland cells in the pregnant uterus of mice expressing the
      collagen mutation tight-skin (Tsk/+).
AB  - Influences of the extracellular matrix (ECM) on the differentiation and
      distribution of granulated metrial gland (GMG) cells, a uterine natural killer
      (NK)-like cell subset, were studied by histological examination of implantation
      sites in the mouse mutant Tsk/+. Tsk/+ mice overproduce collagens I and III. GMG
      cell differentiation appeared to progress normally in Tsk/+ mice between days 6.5
      and 12.5 of gestation. The distribution of GMG cells, however, was abnormal.
      Significant numbers of GMG cells were found in the antimesometrial and lateral
      decidual regions at day 8.5 of gestation and in the regions between implantation
      sites until day 10.5 of gestation. Loss of GMG cells from these regions normally
      occurs by day 6.5 of gestation. These data suggest that alterations to the ECM
      change the migration properties or life span of GMG cells.

PMID- 1617707
TI  - Coronary stenting: single institution experience with the initial 100 cases using
      the Palmaz-Schatz stent.
AB  - We studied 100 patients who had coronary implantation of Palmaz-Schatz stents in
      our institution from November 1989 until March 1991. A total of 126 standard and
      6 short stents were implanted. The patients' mean age was 58 +/- 5 years, and 97
      were males. The indications were lesions with high risk of restenosis (29
      patients), restenosis (27 patients), suboptimal result of angioplasty (24
      patients), dissection (16 patients), and recanalized chronic total occlusion (6
      patients). In 17 patients a brachial cut-down approach was used. Stents were
      correctly placed in 98 patients. Stent related complications occurred in 9
      patients: major ischemic complications in 7 patients (acute myocardial infarction
      in 2 patients, emergency bypass surgery in 3 patients and emergency angioplasty
      in 2 patients); in 3 of these patients there was a subacute closure of the stent
      and in 2 patients there were delivery problems. Vascular complications at the
      site of arterial puncture occurred in 3 patients (some patients had more than one
      complication). A learning curve was observed. There was a decrease in the
      complication rate with the higher number of patients treated: 28% for the first
      50 patients and 6% for the last 50 patients. Clinical follow-up was available in
      all patients. Of the 92 patients eligible for follow-up (7 +/- 2 months), 69
      patients were asymptomatic and 23 had recurrence of angina: 19 patients for stent
      restenosis and 4 patients for coronary artery disease progression. Follow-up
      angiogram was done in 79/92 (86%) patients: 21 had restenosis (27%).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1617708
TI  - Multicenter dose-finding trial for thrombolysis with urokinase preactivated pro
      urokinase (TCL 598) in acute myocardial infarction. German Preactivated Pro
      Urokinase Study Group.
AB  - In a multicenter dose-finding study, the thrombolytic potency of urokinase
      preactivated pro-urokinase was evaluated. Sixty-two patients were randomly
      assigned to receive 250,000 U of urokinase plus either 4.5 mega U (group I: n =
      33) or 6.5 mega U (group II: n = 29) of pro-urokinase. Patency rates were 36.4%
      (20.4-54.9%) vs. 54.5% (36.3-71.9%) (n = 27) at 60 minutes and 55.6% (32.5-70.6%)
      vs. 62.1% (42.3-79.3%) at 90 min into thrombolysis (n.s.). In a third group of 12
      patients treated with 500,000 U of urokinase plus 6.5 mega U of pro-urokinase
      patency was achieved in 33.3% (9.9-65.1%) and 41.7% (15.2-72.3%) at 60 and 90
      min, respectively. Patency rates at 24 hr follow-up angiography (n = 35) were
      78.6% (49.2-95.3%), 85.7% (57.2-98.2%), and 85.7% (42.1-99.6%). Coagulation
      analysis in 37 patients revealed similar alterations in the three treatment
      groups with minor decreases in fibrinogen levels, moderate drops in plasminogen
      and alpha-2-antiplasmin levels, and moderate increases in the concentrations of
      the total fibrinogen/fibrin degradation products, the differences between the
      groups not being significant. Bleeding complications were observed in 12.9%,
      13.8%, and 25% of patients in groups I, II, and III, respectively, mainly related
      to catheter sites. Hence, the safety profile of urokinase preactivated pro
      urokinase seems comparable to other thrombolytic regimens. Reopening of occluded
      coronary arteries, however, is achieved relatively slowly. Thus, in its use for
      thrombolysis in myocardial infarction, urokinase preactivated pro-urokinase does
      not seem to offer superior advantages.

PMID- 1617709
TI  - Maximum stress-volume index ratio of the left ventricle in hypertrophic
      cardiomyopathy.
AB  - To evaluate the left ventricular contractile state in patients with
      nonobstructive hypertrophic cardiomyopathy (HCM), we analyzed the maximum stress
      volume index ratio (MSVR) using catheter-tip cineangiography in 11 patients with
      HCM and 16 normal subjects. The value of the MSVR in normal subjects was 6.48 +/-
      1.25 kdyn/cm5/m2 (mean +/- SD) and we defined the range of the mean +/- 2 SD as
      the normal MSVR range. Six patients with HCM placed inside the normal MSVR range
      (IN), but the other 5 patients placed outside and to the right of the normal
      range (RIGHT). This suggests that the contractile states of the patients of the
      RIGHT group were depressed. Compared with IN, the end-diastolic and end-systolic
      volume indices of RIGHT were larger (EDVI; 69.3 +/- 6.9 vs. 96.1 +/- 11.1 ml/m2,
      p less than 0.01, ESVI; 18.2 +/- 3.2 vs. 29.1 +/- 8.3 ml/m2, p less than 0.05),
      but the ejection fraction did not differ (IN 73.5 +/- 5.7 vs. RIGHT 69.6 +/-
      8.3%, NS). End-diastolic pressure of IN and RIGHT was higher than that of normal
      subjects (IN 16.5 +/- 4.5, RIGHT 16.7 +/- 4.6 vs. 8.3 +/- 2.5 mm Hg, both p less
      than 0.05), but there was no difference between the two groups in HCM. End
      systolic pressure did not differ among the three groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1617710
TI  - Enough with the fantastic voyage: will IVUS pay in Peoria?

PMID- 1617711
TI  - Ambiguous coronary angiography: clinical utility of intravascular ultrasound.
AB  - We report the use of intravascular ultrasound (IVUS) in situations where
      angiography was ambiguous or uncertain in assessing the significance of coronary
      stenoses. The indications for performing intravascular ultrasound were 1)
      angiographic findings did not correlate with the clinical presentation (n = 5)
      and 2) the lesion was not seen well by angiography because of overlapping vessels
      at the site of suspected stenosis (n = 3). We studied eight lesions in seven
      patients. Six nonobstructive stenoses on angiography were shown by IVUS to be
      significant. In two patients, stenoses were thought to be significant on
      angiography, but, due to overlapping of the vessels, there was doubt regarding
      the severity of the narrowing. In these two patients, IVUS clearly showed that
      the lesions were nonobstructive. As seen from the above results, angiography
      underestimated 6/8 stenoses and overestimated in 2/8 stenoses when compared to
      IVUS. We conclude that IVUS can be used to clarify ambiguous angiographic
      findings which can have a major impact on the clinical decision making.

PMID- 1617712
TI  - Interpretation of cardiac pathophysiology from pressure waveform analysis:
      coronary hemodynamics, Part III: Coronary hyperemia.
AB  - Basal patterns (systolic/diastolic components) of coronary flow velocity as
      previously described are generally maintained during hyperemia and can be easily
      recorded in the catheterization laboratory during pharmacologic stimulation. The
      interpretation of the clinical significance of coronary vasodilatory reserve may
      be complicated by both coronary and myocardial diseases. Distal coronary artery
      hyperemic responses measured with ultrasound Doppler-tipped guidewires will
      provide new information on traditional observations of coronary physiology in
      humans.

PMID- 1617713
TI  - Intracoronary thrombus: chronic urokinase infusion and evaluation with
      intravascular ultrasound.
AB  - Percutaneous revascularization of coronary arteries with intraluminal thrombi is
      a clinical problem. We report a patient in whom we administered prolonged
      infusion of intracoronary urokinase and then assessed the stenosis with
      intravascular ultrasound before and after atherectomy. We found both angiography
      and intravascular ultrasound to be misleading in determining the presence of
      residual thrombus after thrombolysis.

PMID- 1617714
TI  - Ultrasound guided ablation of pseudoaneurysm following coronary artery stent
      placement: a preliminary report.
AB  - A femoral artery pseudoaneurysm in a 47 year old woman following coronary artery
      stent placement was treated with color-flow duplex ultrasound guided compression.
      This technique may be useful following stent placement because of the requirement
      for continued anticoagulation post-procedure.

PMID- 1617715
TI  - Complete heart block complicating retrograde left-heart catheterization of
      patients with cardiac allografts.
AB  - The development of complete heart block during left-sided cardiac catheterization
      is an uncommon event. We describe three cases of complete heart block
      complicating left-sided cardiac catheterization of patients with cardiac
      allografts. Review of the cases performed at our institution suggests that
      complete heart block during left-sided catheterization may be more common in
      patients with cardiac allografts.

PMID- 1617716
TI  - Sequential proximal and distal infusion of urokinase resulting in recanalization
      of acutely occluded aortocoronary bypass graft after coronary angioplasty.

PMID- 1617717
TI  - Percutaneous transfemoral spring coil embolization of a pseudoaneurysm of the
      femoral artery.
AB  - Pseudoaneurysm of the femoral artery is a possible complication of percutaneous
      transfemoral catheterization. Its typical treatment has been open surgical
      repair. This article describes a new technique for the treatment of femoral
      artery pseudoaneurysm by spring coil embolization.

PMID- 1617718
TI  - Interpretation of cardiac pathophysiology from pressure waveform analysis: aortic
      regurgitation.

PMID- 1617719
TI  - Initial experience with a new compression device for hemostasis after femoral
      arterial puncture.
AB  - We evaluated a new hemostasis device to maintain focused pressure over the
      femoral artery puncture site for 2-6 hours in 330 cases after diagnostic
      catheterization or coronary angioplasty. No patient developed later hematoma or
      vascular complications. The initial favorable experience suggests that this
      hemostasis device has advantageous features of stability and site visualization
      and is a suitable adjunct to current methods of maintaining puncture site
      pressure after brief manual compression following arterial catheterization.

PMID- 1617720
TI  - Congenital atresia of left main coronary artery.

PMID- 1617721
TI  - Diagnostic coronary arteriography.

PMID- 1617722
TI  - Movement and resolution of Holliday junctions by enzymes from E. coli.
AB  - RuvA and RuvB act together to move Holliday junctions. RuvC cleaves Holliday
      junctions and apparently acts in concert with RuvA and RuvB. RecG can substitute
      for RuvABC in the RecBCD pathway of recombination but not in the RecF pathway.

PMID- 1617723
TI  - Wnt genes.

PMID- 1617724
TI  - The level of CD8 expression can determine the outcome of thymic selection.
AB  - During thymic development, thymocytes that can recognize major histocompatability
      complex (MHC) molecules on thymic epithelial cells are selected to survive and
      mature (positive selection), whereas thymocytes that recognize MHC on
      hematopoietic cells are destroyed (negative selection). It is not known how MHC
      recognition can mediate both death and survival. One model to explain this
      paradox proposes that thymocytes whose T cell antigen receptors (TCRs) recognize
      MHC with high affinity are eliminated by negative selection, whereas low affinity
      TCR-MHC interactions are sufficient to mediate positive selection. Here we report
      that, while the expression of a 2C TCR transgene leads to positive selection of
      thymocytes in H-2b mice, expression of both a CD8 transgene and a 2C TCR
      transgene causes negative selection. This observation indicates that quantitative
      differences in TCR-MHC recognition are a critical determinant of T cell fate, a
      finding predicted by the affinity model for thymic selection.

PMID- 1617726
TI  - Architecture and design of the nuclear pore complex.
AB  - A three-dimensional analysis of the nuclear pore complex reveals the underlying,
      highly symmetric framework of this supramolecular assembly, how it is anchored in
      the nuclear membrane, and how it is built from many distinct, interconnected
      subunits. The arrangement of the subunits within the membrane pore creates a
      large central channel, through which active nucleocytoplasmic transport is known
      to occur, and eight smaller peripheral channels that are probable routes for
      passive diffusion of ions and small molecules.

PMID- 1617725
TI  - CNTF and LIF act on neuronal cells via shared signaling pathways that involve the
      IL-6 signal transducing receptor component gp130.
AB  - Ciliary neurotrophic factor (CNTF) has a variety of actions within the nervous
      system. While some of the actions of leukemia inhibitory factor (LIF) on neurons
      resemble those of CNTF, LIF also has broad actions outside of the nervous system
      that in many cases mimic those of interleukin-6 (IL-6). Comparison of the
      tyrosine phosphorylations and gene activations induced by CNTF and LIF in neuron
      cell lines reveals that they are indistinguishable and also very similar to
      signaling events that characterize LIF and IL-6 responses in hematopoietic cells.
      We provide a basis for the overlapping actions of these three factors by
      demonstrating that the shared CNTF and LIF signaling pathways involve the IL-6
      signal transducing receptor component gp130. Thus, the receptor system for CNTF
      is surprisingly unlike those used by the nerve growth factor family of
      neurotrophic factors, but is instead related to those used by a subclass of
      hematopoietic cytokines.

PMID- 1617727
TI  - Mutations at the 3' splice site can be suppressed by compensatory base changes in
      U1 snRNA in fission yeast.
AB  - U1 snRNA is an essential splicing factor known to base pair with 5' splice sites
      of premessenger RNAs. We demonstrate that pairing between the universally
      conserved CU just downstream from the 5' junction interaction region and the 3'
      splice site AG contributes to efficient splicing of Schizosaccharomyces pombe
      introns that typify the AG-dependent class described in mammals. Strains carrying
      mutations in the 3' AG of an artificial intron accumulate linear precursor,
      indicative of a first step block. Lariat formation is partially restored in these
      mutants by compensatory changes in nucleotides C7 and U8 of U1 snRNA. Consistent
      with a general role in fission yeast splicing, mutations at C7 are lethal, while
      U8 mutants are growth impaired and accumulate linear, unspliced precursor to U6
      snRNA. U1 RNA-mediated recognition of the 3' splice site may have origins in
      analogous intramolecular interactions in an ancestral self-splicing RNA.

PMID- 1617728
TI  - ATP-dependent branch migration of Holliday junctions promoted by the RuvA and
      RuvB proteins of E. coli.
AB  - The RuvA and RuvB proteins of E. coli, which are induced as part of the cellular
      response to DNA damage, act together to promote the branch migration of Holliday
      junctions. Addition of purified RuvA and RuvB to a RecA-mediated recombination
      reaction stimulates the rate of strand exchange and the formation of hetero
      duplex DNA. Stimulation does not occur via interaction with RecA; instead, RuvA
      and RuvB act directly upon recombination intermediates (Holliday junctions) made
      by RecA. We show that RuvAB-mediated branch migration requires ATP and can bypass
      UV-induced DNA lesions. At high RuvB concentrations, the requirement for RuvA is
      overcome, indicating that the RuvB ATPase provides the motor force for branch
      migration. RuvA protein provides specificity by binding to the Holliday junction,
      thereby reducing the requirement for RuvB by 50-fold. The newly discovered
      biochemical properties of RuvA, RuvB, and RuvC are incorporated into a model for
      the postreplicational repair of DNA following UV irradiation.

PMID- 1617729
TI  - The Drosophila homolog of the immunoglobulin recombination signal-binding protein
      regulates peripheral nervous system development.
AB  - The J kappa RBP binds to the immunoglobulin recombination signal sequence
      flanking the kappa-type J segment. We previously isolated the highly conserved
      homolog of the J kappa RBP gene from D. melanogaster, which is not thought to
      have immunoglobulin molecules. Using many deficiency mutants and in situ
      hybridization, we mapped the Drosophila J kappa RBP gene in a region containing
      two recessive lethal mutations, i.e., br26 and br7, which shows the dominant
      Suppressor of Hairless (Su(H)) phenotype in heterozygotes. All six Su(H) alleles
      analyzed at the DNA level contained mutations in the Drosophila J kappa RBP gene.
      Since the Su(H) mutation affects peripheral nervous system development, the
      Drosophila J kappa RBP gene product is involved in gene regulation of peripheral
      nervous system development. The results also imply that the immunoglobulin
      recombination signal sequence and the target sequence of the Drosophila J kappa
      RBP protein might have a common evolutionary origin.

PMID- 1617730
TI  - Suppressor of Hairless, the Drosophila homolog of the mouse recombination signal
      binding protein gene, controls sensory organ cell fates.
AB  - Suppressor of Hairless (Su(H)) is required at two stages of adult sensory organ
      development in Drosophila. Complete loss of Su(H) function results in a
      "neurogenic" phenotype in imaginal discs, in which too many cells adopt the
      sensory organ precursor cell fate. Su(H) is also involved in controlling the
      fates of sensillum accessory cells and is specifically expressed in two of these
      cells. Su(H) is the Drosophila homolog of the mouse J kappa RBP gene, whose
      product binds specifically to the recombination signal sequence of immunoglobulin
      J kappa segments. The Su(H) and J kappa RBP proteins are 82% identical over most
      of their length, and share with bacteriophage integrates and yeast recombinases a
      motif that includes residues directly involved in catalyzing recombination.

PMID- 1617731
TI  - A reticulocyte-binding protein complex of Plasmodium vivax merozoites.
AB  - Plasmodium vivax merozoites primarily invade reticulocytes. The basis of this
      restricted host cell preference has been debated. Here we introduce two novel P.
      vivax proteins that comigrate on reducing SDS-polyacrylamide gels, colocalize at
      the apical pole of merozoites, and adhere specifically to reticulocytes. The
      genes encoding these proteins, P. vivax reticulocyte-binding proteins 1 and 2
      (PvRBP-1 and PvRBP-2), have been cloned and analyzed. Homologous genes are
      evident in the closely related simian malaria parasite, P. cynomolgi, which also
      prefers to invade reticulocytes, but are not evident in the genome of another
      related simian malaria parasite, P. knowlesi, which invades all red blood cell
      subpopulations. Native PvRBP-1 is likely a transmembrane-anchored disulfide
      linked protein, and along with PvRBP-2 may function as an adhesive protein
      complex. We propose that the RBPs of P. vivax, and homologous proteins of P.
      cynomolgi, function to target the reticulocyte subpopulation of red blood cells
      for invasion.

PMID- 1617733
TI  - Transformation of Aspergillus flavus: construction of urate oxidase-deficient
      mutants by gene disruption.
AB  - A transformation procedure based on the complementation of a genetic defect was
      developed using a nitrate reductase-deficient mutant of Aspergillus flavus. The
      initial transformation efficiency was improved 40-fold by combining factors in a
      planned experimental program. Although low, this transformation rate was
      sufficient to obtain transformants in which the urate oxidase-encoding gene (uaZ)
      was disrupted in a gene replacement experiment. These new uaZ- strains were
      unable to utilize uric acid as the unique nitrogen source and could be reversed
      directly to the wild-type phenotype in second order transformation experiments
      using a urate oxidase-expressing vector.

PMID- 1617732
TI  - Multiple copies of SUC4 regulatory regions may cause partial de-repression of
      invertase synthesis in Saccharomyces cerevisiae.
AB  - Transformation to generate multiple copies of regulatory DNA sequences has been
      used to study the interactions between regulatory proteins and their target
      sequences, since a high copy number of these sequences may titrate trans-acting
      regulatory proteins. We have analyzed the synthesis of invertase in yeast strains
      carrying different SUC genes transformed with the multiple-copy plasmid pSH143, a
      derivative of pJDB207 containing the promoter and upstream regulatory sequences
      of SUC4. The results obtained seem to be strain dependent. Under repressing
      conditions a high copy number of SUC4 promoter regions may cause increased
      expression of the invertase genes resulting in the synthesis of external
      glycosylated protein. A similar result was obtained under de-repressing
      conditions since transformants from some strains showed higher levels of
      activity. These results suggest that transcriptional regulatory (negative)
      factors may become limiting when the copy number of their target DNA sequences is
      increased. This effect may depend on the amount of active repressor molecules as
      well as on their affinity for SUC4 upstream sequences. This is discussed on the
      basis of the nucleotide sequences of SUC promoters.

PMID- 1617735
TI  - High efficiency transformation of Fusarium solani f. sp. cucurbitae race 2
      (mating population V).
AB  - A cosmid vector, suitable for library construction and DNA transformation in
      filamentous fungi, has been constructed and a reliable and highly efficient PEG
      mediated DNA transformation system for F. solani f. sp. cucurbitae, based on
      resistance to hygromycin B, has been developed for use with this vector. This
      transformation system yielded 10(4) transformants per micrograms of DNA when
      using 10(7) protoplasts. Factors important in achieving high efficiency included:
      the maintenance of an osmoticum in all transformation steps, PEG 4000
      concentration, and the ratio of transforming vector DNA to protoplasts.
      Approximately 60% of transformants stably integrated vector DNA. Molecular
      analysis revealed multiple copies of the plasmid integrated into the genome at
      one or more sites. The frequency of transformation achieved will facilitate the
      isolation of genes from this fungus by complementation.

PMID- 1617734
TI  - Cloning and mutation of the gene encoding endothiapepsin from Cryphonectria
      parasitica.
AB  - Endothiapepsin is an aspartic protease secreted by Cryphonectria parasitica. It
      has a milk-clotting activity and is used in the cheese industry. The eapA gene
      encoding endothiapepsin has been cloned and sequenced. An open reading frame of
      419 codons, which encodes a precursor differing from mature endothiapepsin by the
      presence of an 89 aa residue prepro-sequence, was found. The eapA gene is
      interrupted by three introns. C. parasitica mutant strains deficient in the
      production of endothiapepsin (eapA-) were constructed using a gene-replacement
      strategy. Two nonsense mutations were introduced at the beginning of the coding
      sequence by PCR-induced mutagenesis. The mutated DNA fragment was introduced in
      C. parasitica by co-transformation with a benomyl-resistant (benR) selection
      plasmid. Transformants which have the eapA- phenotype were obtained. Protein
      analysis confirmed that they secreted no detectable amount of endothiapepsin. No
      ectopic integration of the mutated eapA gene occurred in the eapA- transformants.
      Moreover, after one conidiation step, eapA- transformants yielded benomyl
      sensitive (benS) segregants which were analyzed by Southern blotting experiments.
      The results revealed no difference with the wild-type strain, suggesting that the
      eapA-, benS segregants differed from the non-transformed strain only by the
      presence of the two nonsense mutations in the eapA locus.

PMID- 1617736
TI  - Electrophoretic karyotyping of wild-type and mutant Trichoderma longibrachiatum
      (reesei) strains.
AB  - An electrophoretic karyotype of Trichoderma longibrachiatum (reesei) was obtained
      using contour-clamped homogeneous electric field (CHEF) gel electrophoresis.
      Seven chromosomal DNA bands were separated in the wild-type T. longibrachiatum
      strain QM6a. The sizes of the chromosomal DNA bands ranged from 2.8 to 6.9 Mb,
      giving an estimated total genome size of about 33 Mb. The electrophoretic
      karyotype of the strain QM6a was compared to three hyper-celluloytic mutant
      strains, QM9414, RutC30 and VTT-D-79125. The chromosome pattern of the mutant
      QM9414 was quite similar to that of the wild-type QM6a except that the smallest
      chromosome differed somewhat in size. The VTT-D-79125 and RutC30 strains, which
      have undergone several mutagenesis steps, showed striking differences in their
      karyotype compared to the initial parent. The chromosomal DNA bands were
      identified using the previously characterized T. longibrachiatum genes (egl1,
      egl2, cbh1, cbh2, pgk1, rDNA) and random clones isolated from a genomic library.
      In all strains the cellulase genes cbh1, cbh2 and egl2 were located in the same
      linkage group (chromosome II in the wild-type), while the main endoglucanase,
      egl1, hybridized to another chromosomal DNA band (chromosome VI in the wild
      type).

PMID- 1617737
TI  - Suppression of cytoplasmic senescence in Neurospora.
AB  - We have shown that senescence in Kalilo strains of Neurospora, caused by a linear
      mitochondrial plasmid called kalDNA, is suppressible by existing variants of the
      nuclear genome. The suppressors are manifested by 4:4 segregation of senescence
      and immortality in asci from crosses between senescent female strains and males
      chosen from non-senescent candidate stocks. In one case of suppression, the asci
      also show segregation at the plasmid level. There is a reduction of kalDNA to
      barely detectable levels in the four ascospores showing immortality, so this
      suppressor evidently influences the maintenance of the plasmid itself. In the
      other case of suppression, the phenotypic segregation is not correlated with
      segregation at the plasmid level, and all eight ascospores in the asci show both
      free and inserted forms of kalDNA. This suggests that the suppression genotype
      provides a way of tolerating the presence of the plasmid rather than diminishing
      it. However, the allele f, which provides an analogous kind of suppression for
      the cytoplasmic mutation poky, does not suppress Kalilo or Maranhar senescence.
      Suppression is hence shown to be a possible option for host strains to combat the
      plasmid in nature, but no examples of suppressors were found in a limited survey
      of natural isolates. In addition, we have shown that long-lived, presumably non
      senescent, strains do not arise by suppressor mutation, but lose senescence
      plasmid DNA by another mechanism.

PMID- 1617738
TI  - Chloroplast RNA polymerase genes of Chlamydomonas reinhardtii exhibit an unusual
      structure and arrangement.
AB  - Nucleotide sequence analysis of a 17043 base-pair (bp) region of the
      Chlamydomonas reinhardtii plastome indicates the presence of three open reading
      frames (ORFs) similar to RNA polymerase subunit genes. Two, termed rpoB1 and
      rpoB2, are homologous to the 5'- and 3'-halves of the Escherichia coli beta
      subunit gene, respectively. A third, termed rpoC2, is similar to the 3'-half of
      the bacterial beta' subunit gene. These genes exhibit several unusual features:
      (1) all three represent chimeric structures in which RNA polymerase gene
      sequences are juxtaposed in-frame with long sequences of unknown identity; (2)
      unlike their counterparts in plants and eubacteria, rpoB1 and rpoB2 are separated
      from rpoC2 by a long (7 kilobase-pair, kbp) region containing genes unrelated to
      RNA polymerase; (3) DNA homologous to the 5' half of rpoC (termed rpoC1 in other
      species) is not present at the 5' end of rpoC2 and could not be detected in C.
      reinhardtii chloroplast DNA. RNA expression could not be detected for any of the
      RNA polymerase genes, suggesting that they are pseudogenes or genes expressed at
      stages of the C. reinhardtii life-cycle not investigated. The three genes are
      flanked by GC-rich repeat elements. We suggest that repeat DNA-mediated
      chloroplast recombination events may have contributed to their unusual
      arrangement.

PMID- 1617739
TI  - Co-transcription of orf25 and coxIII in rice mitochondria.
AB  - Southern hybridization analysis using homologous maize probes indicated that
      orf25 and coxIII are closely linked in the mitochondrial genome of rice (Oryza
      sativa) cultivar IR36. The two coding regions were found on the same 5.1 kb BamHI
      fragment, and this fragment was cloned, mapped and partially sequenced. Using
      probes for each gene derived from the rice clone, a 2.4 kb dicistronic mRNA
      transcript was found containing both orf25 and coxIII coding regions. Multiple 5'
      ends were identified by primer extension analysis and a double stem/loop
      structure was mapped to the 3' end. The orf25 coding region shares greater than
      85% identity with orf25 sequences from maize, tobacco and wheat, suggesting that
      orf25 may code for a conserved protein product.

PMID- 1617740
TI  - Nuclear genes control changes in the organization of the mitochondrial genome in
      tissue cultures derived from immature embryos of wheat.
AB  - Although the mitochondrial genomes of the Chinese Spring and Aquila varieties of
      wheat are normally similar in organization, this is not so in tissue cultures
      initiated from their immature embryos where the mitochondrial genomes of both are
      rearranged and in different, characteristic, ways. However, the mitochondrial
      genomes of tissue cultures of reciprocal F1 crosses between these varieties were
      almost identical to one another, showing that nuclear genes control the
      rearrangement processes. These rearrangements are either due to the appearance of
      new structures or else result from changes in the relative amounts of subgenomic
      components. The severe reduction in the amount of certain molecular
      configurations in tissue cultures from reciprocal crosses is probably due to the
      presence of dominant information in the Aquila nuclear genome. Data obtained from
      tissue cultures initiated from F2 embryos of the cross Aquila x Chinese Spring
      suggest that at least two complementary genes are involved in this control. In
      contrast, the presence of new molecular arrangements appears to be under the
      control of a dominant allelic form of a Chinese Spring gene or genes. Thus, this
      study demonstrates that at least two sets of nuclear genes control the
      reorganization of the mitochondrial genome which occurs when tissue cultures are
      initiated from the immature embryos of wheat.

PMID- 1617742
TI  - [Pathological analysis of sudden coronary death in 31 autoptic cases].
AB  - 31 cases of sudden coronary death (within 1 hour, unexpected death) in 160
      autoptic cases of coronary heart disease were studied (19.4%), including 24 male
      and 7 female; age 16-79, average 59.5. Most cases of sudden death had no obvious
      inductive causes. 18 patients died without cardiac symptoms, including those died
      before admission or during deep sleep. There was atherosclerotic stenosis (grade
      4), of the coronary artery in 25 cases, of which 18 cases were with multiple
      branches involvement (grade 4) and 7 cases were with simple branch damage.
      Myocardial infarction was found in 24 cases, and myocardial ischemia in 7 cases.
      Old myocardial infarction was seen in 14 cases, and it was combined with acute
      myocardial infarction in 8 cases. Simple acute myocardial infarction was only
      seen in 2 cases. 8 cases showed ventricular aneurysm and 1 patient died of
      cardiac rupture. Conclusively, severe coronary stenosis and myocardial infarction
      are considered as one of the important bases of sudden coronary death.

PMID- 1617741
TI  - Organization and structure of plastome psbF, psbL, petG and ORF712 genes in
      Chlamydomonas reinhardtii.
AB  - We have determined the nucleotide sequence of a 5159 base-pair (bp) region of the
      Chlamydomonas reinhardtii plastome containing three photoelectron transport
      genes, psbF, psbL and petG, and an unusual open reading frame, ORF712. The
      photosynthetic genes have an unprecedented arrangement, psbF and psbL are located
      in close proximity to petG, and are not grouped with two other genes of the
      cytochrome b559 locus, psbE and ORF42. ORF712, located adjacent to psbL, has
      homology at its 5'- and 3'-ends to the ribosomal protein rps3 gene, but contains
      a central 437 residue domain that lacks similarity to any other known sequence.
      These sequences add to the growing body of evidence that the chloroplast genome
      of C. reinhardtii has a significantly different gene arrangement to its
      counterpart in plants. The structure of ORF712 also provides another example of a
      phenomenon we have discovered with C. reinhardtii RNA polymerase genes (Fong and
      Surzycki 1992); namely, that the algal plastome contains chimeric genes in which
      reading frames with homology to known genes are juxtaposed in-frame with long
      coding regions of unknown identity.

PMID- 1617743
TI  - [The phenotype of mast cells in primary adenoid liver tumours of rats and its
      relation to tumor cells].
AB  - Mast cells in adenoid liver tumours of 32 rats induced with nitrosomorpholine
      were observed ultrastructurally, and among them, some were studied
      immunocytochemically via immunogold techniques. Data indicated that mast cells
      which located in tumour tissues presented positive expression of rat mast cell
      protein (RMCP) II, indicating origination from the mucosal mast cells, while
      those in the connective tissues around tumours were largely stained negatively
      with either RMCP II or RMCP I antisera, with the exception of only a few cells
      showing positive RMCP II staining. Ultrastructural observation showed that mast
      cells in tumors contacted closely with the tumor cells. Membranes of the
      intracellular granules in these mast cells were fusing together. The content
      inside the granules were discharged and spread along the intercellular space
      between the tumor cells. There was not any lesion obtained ultrastructurally at
      the contacting point between the tumor cells and the mast cells. The significance
      of mucosal mast cells in adenoid liver tumors is briefly discussed.

PMID- 1617744
TI  - [Autopsy study of 100 elderly patients].
AB  - Clinical and autopsy records of 100 elderly patients were analyzed. The most
      common cause of death in this series was malignant tumors (39%). The second
      leading cause of death was diseases of the circulatory system (37%), in which
      cerebrovascular accident alone accounted for 21%. Cor pulmonale and myocardial
      infarction were also common causes of death. In addition, infective diseases,
      especially pneumonia and septicemia were often fatal to elderly patients. The
      discrepancy between clinical and post-mortem diagnoses in this series was 24.7%.
      The causes of incorrect and missed diagnoses are discussed. The results suggest
      that extensive autoptic study still has vital practical significance.

PMID- 1617745
TI  - [Clinicopathological study on 3441 cases of benign and malignant ulcers. The
      National Cooperative Group for Pathological Study on the Canceration of Gastric
      Ulcer].
AB  - Resected specimens of benign and malignant gastric ulcers from 3441 cases were
      studied and compared clinically and pathologically. Among them, 421 cases of
      malignant ulcer were found. The malignant ulcers differed notably from the
      ulcerating gastric carcinoma and showed many similarities to the benign chronic
      gastric ulcer (CGU). The most distinct feature of malignant ulcer was the lack of
      cancerous infiltration and muscular residue in the scar tissue of ulcer base. The
      existence of this type of ulcer clinically and pathomorphologically supports the
      viewpoint that CGU can undergo malignant change. The rate of malignant change of
      CGU in this study was 3.48%.

PMID- 1617747
TI  - [Three-dimensional microstructure and its significance of pseudotubular formation
      in the crescents of rapidly progressive glomerulonephritis].
AB  - Tubuloid structure of the crescents in rapidly progressive glomerulonephritis
      (RPGN) was studied in order to detect its morphological features and functional
      significance by using three-dimensional microstructure method. The results showed
      that the tubuloid structure was actually pseudotubular formation in the
      crescents. Their inner lumens were communicating between the Bowman's capsular
      space and lumens of the renal tubules. It indicated that pseudotubular formation
      in the crescents may play an important role in repairing the damaged structure of
      those injured glomeruli.

PMID- 1617746
TI  - [Pathological study of malignant peripheral nerve sheath tumor in rat].
AB  - Sequential morphological studies of rat malignant peripheral nerve sheath tumors
      induced with ethylnitrosourea were performed by light microscopy, transmission
      electron microscopy, scanning electron microscopy, immunohistochemistry and nude
      mice transplantation. The result indicated that rat malignant peripheral nerve
      sheath tumor was actually a sarcoma arising from Schwann cell within the
      peripheral nerve, which possesses some basic morphological characteristics as
      those of human malignant peripheral nerve sheath tumor, and is considered worthy
      to be used as a model for further studies.

PMID- 1617748
TI  - [Interaction of foamy cells from experimental hyperlipemia rabbits with smooth
      muscle cells and the endothelial surface of intima preparation].
AB  - In the development of atherosclerosis (AS), circulating monocytes emigrate into
      and accumulate in the intima as foamy cells. Interaction of the lipid laden
      macrophage (M phi) with cells of the arterial wall may contribute to the
      formation of atheromatous plaque. Using subcutaneous and peritoneal foamy cells
      (FC) collected from diet-induced hyperlipemia rabbits, the authors observed the
      influence of lipid laden on macrophage's functions relevant to AS lesion
      formation. In comparison with normal M phi, peritoneal FC were 4.8 and 5.4 fold
      more adhesive to the endothelial surface of intima preparation and the smooth
      muscle cells (SMC), while the adhesion rate produced by subcutaneous FC were
      increased 0.79 and 0.16 fold. SMC migration stimulated by both FC-conditioned
      medium slowed 5.78 and 5.90 fold increased respectively as in comparing with the
      control's, whereas normal M phi-conditioned medium only gave a 2.3 fold increase
      of SMC migration stimulation. In addition, both FC-conditioned medium stimulated
      SMC growth making 1.96 and 2.59 fold increase, and normal M phi-conditioned
      medium produced a 1.3 fold increase as compared with the control's. The results
      suggest that lipid-laden macrophages, may accelerate AS development due to
      changes of their biological properties. Since more than 95% of peritoneal
      macrophages as well as macrophages in the pleura, pericardial and synovial
      cavities from experimental hyperlipidemia rabbits are fully filled with lipid
      assuming the morphologic characteristics of atheromatous intimal foamy cells, it
      is considered that these cells will be valuable as the model.

PMID- 1617749
TI  - [Value of monoclonal antibodies in the diagnosis of Hodgkin's disease in paraffin
      sections].
AB  - A comprehensive panel of monoclonal antibodies that mark R-S/H cell, T- and B
      cell, monocyte/histocyte was tested in paraffin sections of 107 cases of
      Hodgkin's disease (HD) including 21 cases of lymphocyte predominance (LP) and 86
      cases of Non-LP HD. Thirty cases each of peripheral T-cell lymphoma and B-cell
      lymphoma were also tested for comparison. R-S/H cells were not stained with T
      cell marker (UCHL-1) or monocyte/histocyte marker (Mac387) in all of these cases
      of HD. The results showed presence of certain difference in the phenotype of LP
      from non-LP. The H+L type of R-S/H cells of LP often reacted with B-cell markers
      including L26, LN2, LN1 and MB2 (93.3%-100%), LCA (83.3%) and EMA (92.3%), but
      rarely with LeuM1,T mu 9, or BerH2. On the contrary, most of the R-S/H cells of
      non-LP reacted with LeuM1 (80%), T mu 9(84%), BerH2(65%) but not with B-cell
      markers, LCA or EMA. Our study suggests a B-cell (probably the follicular center
      cell) derivation for L+H type of R-S/H cells in LP. The fact that 1 case of LP in
      this group transformed to a large cell B-cell lymphoma also supports this
      consideration. PNA is a sensitive marker of R-S/H cells but is not a specific
      one, since PNA stains 43.3% of the peripheral T-cell lymphoma and 20% of the B
      cell lymphomas. Our findings indicate that using a panel of antibodies which mark
      R-S/H cells, T- and B-cells in paraffin sections will be helpful in the diagnosis
      and subtyping of Hodgkin's disease.

PMID- 1617750
TI  - [The protective effect of apolipoprotein C1 on endothelial cells injured by low
      density lipoprotein in vitro].
AB  - High serum low density lipoprotein (LDL) level is known injurious to endothelial
      cell (EC) and that high density lipoprotein (HDL) protects EC from such injury.
      The protective effect of HDL and apolipoprotein C1 (apo C1) on the endothelial
      cells (EC) isolated originally from human umbilical vein and injured by LDL was
      studied morphologically with phase-contrast and transmission electron microscope.
      Additionally, their functional changes were detected by measuring the amount of
      lactate dehydrogenase (LDH) and 6-keto-prostaglandin F1 alpha (PGF1 alpha)
      released. The EC were divided into four groups: control, HDL+LDL, apo C1 + IDL
      and LDL group. EC after being injured by LDL showed cell contraction, increased
      release of LDH and decreased secretion of PGF1. Anyhow, they would be left normal
      on morphology, LDH release and PGF1 alpha synthesis if HDL or apo C1 had been
      added to the culture media before LDL injury. The results indicated that both HDL
      and apo C1 can resist the injurious effect of LDL on the cultured EC.

PMID- 1617751
TI  - [Application of the centripetal nature rescue in the emergency department].

PMID- 1617753
TI  - [Psycho-soma holistic care model for abdominal surgery].

PMID- 1617752
TI  - [Survey of psychotic inpatients who refuse treatment].

PMID- 1617754
TI  - [Using the hospital stress scale in nursing practice].

PMID- 1617756
TI  - [Nursing care of children with head and neck cancer treated by radiotherapy].

PMID- 1617755
TI  - [Changes in endocrine rhythm of nurses on night duty].

PMID- 1617757
TI  - [Speech rehabilitation after cleft palate surgery].

PMID- 1617758
TI  - The perception and use of child health clinics in a sample of working class
      families.
AB  - The frequency and pattern of clinic use by a sample of 60 working class families
      is described. An attempt is made to explain attendance and non-attendance in
      terms of the mothers' perceptions of the clinic's functions and relevance and in
      terms of certain social and organizational barriers. The implications of the
      findings for clinic use and for the organization and delivery of the service to
      working class families are discussed.

PMID- 1617759
TI  - The role of social support and stressors for mothers and infants.
AB  - This correlational study of mothers and their 6-month-old infants examined the
      importance of social support and stressors for parenting and infant development.
      Mothers (n = 79) were primarily White, married, and ranged in socio-economic
      status from low to high. All data were collected in mothers' homes when infants
      were 6 months old. Diversity of sources of social support and diversity of father
      support were positively related to parenting (quality of stimulation in the
      home). Diversity of sources of social support buffered the negative relationship
      of maternal fatigue (stressor) to parenting. Parenting was related to social,
      hearing-speech, locomotor, and general development. Additionally, social support
      and aggravation (people in the mother's said network who make life difficult)
      were related to infant development, independent of parenting.

PMID- 1617760
TI  - The school entry medical examination. What do teachers think of it?
AB  - Questionnaires were sent to 76 schools in the Macclesfield district. Seventy-four
      of these were returned by head teachers and/or reception teachers. Replies
      concerned the school entry medical examination, information on individual
      children, general health information and access to professionals. Additional
      comments on any aspects of the service were also solicited. The results have been
      analysed. The majority of teachers considered that the school entry medical
      examination is of value, but the quality of information reaching teachers is
      viewed more critically. Meetings were the most favoured means of communication,
      but there are obvious defects in the system. Some teachers did not even know of
      access channels. If improvements do not occur some of the value of the
      examination will be lost. Suggestions for better communications are made. With
      local management of schools, teacher opinion must be considered if a better
      school health service is to be provided for the children of the district.

PMID- 1617761
TI  - For discussion: a rethink on exploitation of young persons.

PMID- 1617762
TI  - Regular physical exercise and low-fat diet. Effects on progression of coronary
      artery disease.
AB  - BACKGROUND: Significant regression of coronary and femoral atherosclerotic
      lesions has been documented by angiographic studies using aggressive lipid
      lowering treatment. This study tested the applicability and effects of intensive
      physical exercise and low-fat diet on coronary morphology and myocardial
      perfusion in nonselected patients with stable angina pectoris. METHODS AND
      RESULTS: Patients were recruited after routine coronary angiography for stable
      angina pectoris; they were randomized to an intervention group (n = 56) and a
      control group on "usual care" (n = 57). Treatment comprised intensive physical
      exercise in group training sessions (minimum, 2 hr/wk), daily home exercise
      periods (20 min/d), and low-fat, low-cholesterol diet (American Heart Association
      recommendation, phase 3). No lipid-lowering agents were prescribed. After 12
      months of participation, repeat coronary angiography was performed; relative and
      minimal diameter reductions of coronary lesions were measured by digital image
      processing. Change in myocardial perfusion was assessed by 201Tl scintigraphy. In
      patients participating in the intervention group, body weight decreased by 5% (p
      less than 0.001), total cholesterol by 10% (p less than 0.001), and triglycerides
      by 24% (p less than 0.001); high density lipoproteins increased by 3% (p = NS).
      Physical work capacity improved by 23% (p less than 0.0001), and myocardial
      oxygen consumption, as estimated from maximal rate-pressure product, by 10% (p
      less than 0.05). Stress-induced myocardial ischemia decreased concurrently,
      indicating improvement of myocardial perfusion. Based on minimal lesion diameter,
      progression of coronary lesions was noted in nine patients (23%), no change in 18
      patients (45%), and regression in 13 patients (32%). In the control group,
      metabolic and hemodynamic variables remained essentially unchanged, whereas
      progression of coronary lesions was noted in 25 patients (48%), no change in 18
      patients (35%), and regression in nine patients (17%). These changes were
      significantly different from the intervention group (p less than 0.05).
      CONCLUSIONS: In patients participating in regular physical exercise and low-fat
      diet, coronary artery disease progresses at a slower pace compared with a control
      group on usual care.

PMID- 1617763
TI  - Recombinant tissue-type plasminogen activator and immediate angioplasty in acute
      myocardial infarction. One-year follow-up. The European Cooperative Study Group.
AB  - BACKGROUND: The European Cooperative Study Group conducted two randomized trials
      in patients with suspected myocardial infarction to assess the effect of 100 mg
      single-chain recombinant tissue-type plasminogen activator (rt-PA, alteplase) on
      enzymatic infarct size, left ventricular function, morbidity and mortality
      relative to placebo (alteplase/placebo trial) and to assess the effect of
      immediate percutaneous transluminal coronary angioplasty (PTCA) in addition to
      alteplase (alteplase/PTCA trial). One-year follow-up results are reported.
      METHODS AND RESULTS: In the alteplase/placebo trial, 721 patients with chest pain
      of less than 5 hours and extensive ST-segment elevation were allocated at random
      to 100 mg alteplase or placebo (double-blind) over 3 hours. In the alteplase/PTCA
      trial, 367 similar patients received alteplase and subsequently were allocated at
      random to immediate coronary angiography and angioplasty of the infarct-related
      vessel or control. All patients received aspirin and intravenous heparin. In the
      alteplase/placebo trial, mortality during the first year was reduced by 36% with
      alteplase (from 9.3% to 5.6%; difference, -3.7%; 95% confidence interval, -7.5%
      to 0.2%). Revascularization was performed more frequently after alteplase, and
      more patients in the alteplase group were in New York Heart Association
      functional class I or II. Reinfarction tended to occur more frequently after
      alteplase than after placebo. In the alteplase/PTCA trial, reinfarction was less
      common after immediate PTCA, and revascularization procedures were less frequent.
      However, this benefit was offset by a high rate of immediate reocclusion and
      early recurrent ischemia and by higher mortality at 1 year (9.3% versus 5.4%;
      difference, 3.9%; 95% confidence interval, -1.5% to 9.2%) in the invasive group.
      In a multivariate analysis of 1,043 hospital survivors, mortality after discharge
      was related to coronary anatomy, left ventricular function, age, and previous
      infarction but not to initial treatment allocation. Reinfarction after hospital
      discharge tended to be more common after alteplase and related to coronary
      anatomy. CONCLUSIONS: Benefit from treatment with alteplase, heparin, and aspirin
      is not diminished at 1 year. Routine immediate PTCA does not confer additional
      benefit. Prognosis after hospital discharge mainly is determined by coronary
      anatomy and residual left ventricular function and is unrelated to initial
      treatment assignment.

PMID- 1617764
TI  - Pathogenesis of congestive state in chronic obstructive pulmonary disease.
      Studies of body water and sodium, renal function, hemodynamics, and plasma
      hormones during edema and after recovery.
AB  - BACKGROUND: The pathogenesis of salt and water accumulation in patients with
      chronic obstructive pulmonary disease is unclear and may differ from that in
      patients with congestive heart failure due to myocardial disease. This study was
      undertaken to investigate some of the mechanisms involved. METHODS AND RESULTS:
      Hemodynamics, water and electrolyte spaces, renal function, and plasma hormone
      concentrations were measured in nine patients with edema due to chronic
      obstructive pulmonary disease and in six patients after recovery. Mean cardiac
      output (3.8 +/- 0.26 l/min.m2) was normal, but right atrial (11 +/- 1 mm Hg) and
      mean pulmonary arterial (41 +/- 3 mm Hg) pressures were increased. Mean pulmonary
      arterial wedge pressure (11 +/- 1 mm Hg) was normal. Pulmonary vascular
      resistance (8.6 +/- 1.3 mm Hg.min.m2/l) was increased, but systemic vascular
      resistance (19.3 +/- 1.3 mm Hg.min.m2/l) and mean arterial pressure (83 +/- 4 mm
      Hg) were low. All patients were hypoxemic (PaO2, 40 +/- 2 mm Hg) and hypercapnic
      (PaCO2, 60 +/- 2 mm Hg). There was a significant increase in total body water
      (+21%), extracellular volume (+45%), plasma volume (+45%), blood volume (+88%),
      and exchangeable sodium (+38.2%). Renal plasma flow was severely reduced (
      63.2%), but glomerular filtration rate was only mildly decreased (-32%).
      Significant increases were seen in plasma norepinephrine (3.5-fold normal), renin
      activity (7.6-fold normal), vasopressin (twice normal), atrial natriuretic
      peptide (9.4-fold normal), growth hormone (10.7-fold normal), and cortisol (1.9
      fold normal). After recovery, the PaO2 increased (50 +/- 3 mm Hg) and PaCO2 fell
      (45 +/- 4 mm Hg), and the patients became free from edema. All the body
      compartments returned toward normal, although they did not entirely reach normal
      values. Renal plasma flow increased significantly, and glomerular filtration
      became normal. Right atrial and pulmonary arterial pressures and pulmonary
      vascular resistance decreased (p less than 0.01). Cardiac output decreased but
      not significantly. Blood pressure increased but not significantly. However,
      systemic vascular resistance increased significantly to a normal value.
      CONCLUSIONS: We conclude that patients with edema due to chronic obstructive
      pulmonary disease have severe retention of salt and water, reduction in renal
      blood flow and glomerular filtration, and neurohormonal activation similar to
      that seen in patients with edema due to myocardial disease. However, unlike the
      latter, in chronic obstructive pulmonary disease cardiac output is normal, and
      systemic vascular resistance and arterial blood pressure are low. This probably
      is due to the vasodilator properties of hypercapnia. The consequent low arterial
      blood pressure may be the stimulus for the neurohormonal activation and retention
      of salt and water.

PMID- 1617765
TI  - Eighteen-year follow-up in the Veterans Affairs Cooperative Study of Coronary
      Artery Bypass Surgery for stable angina.
AB  - BACKGROUND: The 18-year effect of bypass surgery compared with medical therapy on
      survival, incidence of myocardial infarction, and relief of angina was evaluated
      in 686 randomized patients with stable angina in the Veterans Affairs Cooperative
      Study of Coronary Artery Bypass Surgery. METHODS AND RESULTS: The primary
      treatment comparisons were made according to intent to treat; 44% of the entire
      medical cohort had bypass surgery during a median follow-up of 16.8 years.
      Overall 18-year survival rates were 33% for medicine compared with 30% for
      surgery (p = 0.60). Survival rates for high-risk patients without left main
      disease, which had shown a significant advantage for surgical therapy up to 11
      years, were 23% medicine versus 24% surgery for patients with three-vessel
      disease and impaired left ventricular function (p = 0.49) and 22% versus 25% for
      those with multiple clinical risk factors (p = 0.12). For patients with two
      vessel disease, who had significantly better survival with medical therapy at 11
      years, rates were similar at 18 years in the two treatment groups (34% medicine
      versus 30% surgery, p = 0.09). Cumulative 18-year myocardial infarction rates
      (fatal plus nonfatal) were 41% in medical and 49% in surgical patients (13%
      perioperative infarction rate), p = 0.15. Nonfatal infarction rates were lower
      with medical than with surgical therapy (32% versus 44%, p = 0.015), but fatal
      infarction rates were similar (14% medicine versus 13% surgery, p = 0.62). The
      combined rate of myocardial infarction or death was also lower with medical
      therapy (75% versus 82%, p = 0.016). In contrast, surgery reduced mortality after
      myocardial infarction by 35% at 10 years (p less than 0.001) but only by 13% at
      18 years (p = 0.09). The percent of medical and surgical patients who were angina
      free was 3% versus 22% (p less than 0.001) at 1 year and 4% versus 12% (p less
      than 0.001) at 5 years compared with rates of 6% versus 5% (p greater than 0.50)
      at 10 years and 3% versus 4% (p greater than 0.50) at 15 years. CONCLUSIONS: The
      benefits of coronary artery bypass surgery on survival, symptoms, and
      postinfarction mortality were transient and lasted fewer than 11 years. The
      benefits began to diminish after 5 years, when graft closure accelerated. Surgery
      was effective in reducing mortality only for patients with a poor natural
      history. Low-risk patients, who had a good prognosis with medical therapy,
      derived no survival benefit with surgical therapy at any time during the follow
      up period. Regardless of risk, surgery also did not reduce the incidence of
      myocardial infarction or the combined incidence of infarction or death.

PMID- 1617766
TI  - Thrombolysis in patients with unstable angina improves the angiographic but not
      the clinical outcome. Results of UNASEM, a multicenter, randomized, placebo
      controlled, clinical trial with anistreplase.
AB  - BACKGROUND: The value of thrombolytic therapy in unstable angina is unclear.
      METHODS AND RESULTS: To study this problem, 159 patients were studied in a double
      blind, placebo-controlled multicenter trial. Patients without a previous
      myocardial infarction, with a typical history of unstable angina, and ECG
      abnormalities indicative of ischemia were included. After baseline angiography,
      study medication (anistreplase or placebo) was given. Angiography was repeated
      after 12-28 hours. A significant decrease occurred in diameter stenosis between
      the first and second angiogram in the anistreplase group compared with the
      placebo group (11% versus 3%, p = 0.008). This difference was caused by reopening
      of occluded vessels in the thrombolytic group. However, no beneficial clinical
      effects of thrombolytic treatment were found. Bleeding complications were
      significantly higher in patients who received thrombolytic therapy (21 versus
      seven patients, p = 0.001). CONCLUSIONS: Thus, angiographic but no clinical
      improvement after thrombolytic treatment with anistreplase was found in patients
      with unstable angina with an excess of bleeding complications. Therefore,
      thrombolytic treatment cannot be recommended in patients diagnosed as having
      unstable angina until proven otherwise.

PMID- 1617767
TI  - Expression and localization of dystrophin in human cardiac Purkinje fibers.
AB  - BACKGROUND: Mutations in the dystrophin gene produce clinical manifestations of
      disease in heart, brain, and skeletal muscle in patients with Duchenne and
      Beckers muscular dystrophy (DMD/BMD). Conduction disturbances and heart block
      contribute to cardiac decompensation in these patients, which suggests an
      important role for dystrophia in the cardiac conduction system. We therefore
      examined the messenger RNA (mRNA) expression and protein localization of
      dystrophin in normal human cardiac Purkinje fibers. METHODS AND RESULTS:
      Polymerase chain reaction amplification of isolated Purkinje fiber complementary
      DNA identified several alternatively spliced mRNA transcripts encoding for
      carboxy-terminal isoforms of the dystrophin protein. The predominant mRNA
      transcript detected was a splice form previously detected in the brain.
      Antipeptide antibodies specific for a carboxy-terminal dystrophin sequence were
      used for Western blot analysis and immunocytochemical localization. These
      antisera detect approximately 400,000-d immunoreactive band or bands on Western
      blot in normal heart and Purkinje fibers but not in DMD heart. Immunocytochemical
      staining showed that dystrophin was localized to the membrane surface of the
      Purkinje fiber. CONCLUSIONS: These results suggest that dystrophin may be an
      important molecule for membrane function in the Purkinje conduction system of the
      heart and support the hypothesis that defective dystrophin expression contributes
      to the cardiac conduction disturbances seen in DMD/BMD:

PMID- 1617768
TI  - Intravascular ultrasound imaging of coronary arteries. Is three layers the norm?
AB  - BACKGROUND: The purpose of this study was to evaluate the significance of the
      three-layered appearance of coronary arteries in adolescence and adults from
      intravascular ultrasound scans and to correlate these observations with
      histopathology. METHODS AND RESULTS: Sixteen intact hearts were excised at
      autopsy from patients with no clinical history of coronary artery disease. The
      patients' ages ranged from 13 to 55 years. A 30-MHz ultrasound imaging catheter
      was used to obtain images throughout the epicardial coronary vasculature. A total
      of 72 image cross sections was marked by epivascular sutures, and the
      corresponding histological sections were examined. Ultrasound images were
      classified into two groups: images exhibiting three-layered appearance and images
      without distinct layering. Histological analysis revealed a significantly greater
      degree of intimal thickening in segments with three layers (243 +/- 105 microns)
      than in nonlayered segments (112 +/- 55 microns). Discriminant analysis of these
      data predicted the threshold between the two groups to be 178 microns.
      Measurements of medial thickness were not different between these two groups (235
      +/- 61 versus 210 +/- 76 microns). In the nonlayered group, the average patient
      age was 27.1 +/- 8.5 years, whereas in the three-layered groups, the average age
      was 42.8 +/- 9.8 years. CONCLUSIONS: The intracoronary ultrasound image
      appearance of young, morphologically normal coronary artery walls is homogeneous
      without layering. A three-layered appearance suggests the presence of at least
      178 microns of intimal thickening and is seen more frequently with advancing age.

PMID- 1617769
TI  - Estimation of left ventricular cavity area with an on-line, semiautomated
      echocardiographic edge detection system.
AB  - BACKGROUND: Automated edge detection of endocardial borders in echocardiograms
      provides objective, reproducible estimation of cavity area; however, most methods
      have required off-line analysis. A recently developed prototype echocardiographic
      imaging system permits real-time automated edge detection during imaging and
      thus, the potential for measurement of cyclic changes in cavity area and the
      assessment of left ventricular function on-line. Our purpose was to compare
      measurements of endocardial area manually traced from conventional
      echocardiograms with those obtained with the real-time automated edge detection
      system in normal subjects. METHODS AND RESULTS: Two training sets of images were
      used to establish optimal methods of gain setting; the settings were then
      evaluated in a test set of images. In the high-gain training group (n = 8
      subjects, 119 images), gain settings were adjusted sufficiently high to display
      at least 90% of the endocardial border. Manually drawn and real-time area
      measurements correlated at r = 0.92, but manually drawn areas were underestimated
      by computer. In the low-gain training group (n = 7 subjects, 104 images), gain
      settings were adjusted sufficiently low to avoid cavity clutter despite the
      presence of dropout of endocardial edges. Manually drawn and real-time areas
      again correlated (r = 0.79), but manually drawn areas were overestimated by
      computer. In the intermediate-gain test group (n = 7 subjects, 105 images), gain
      settings were balanced between maximal endocardial definition (greater than or
      equal to 90%) and minimal cavity clutter (less than or equal to 1 cm2). Manually
      drawn and real-time areas correlated at r = 0.91 for the group, and r ranged from
      0.94 to 0.99 in individual subjects. Interobserver variability was 9.5% for
      manually traced areas and 10.6% for real-time area measurements. CONCLUSIONS:
      Real-time on-line automated edge detection provides accurate estimation of
      manually drawn cavity areas. Although the method is gain dependent, measurements
      are reproducible. The system should have clinical application in settings in
      which measurements of left ventricular function are important.

PMID- 1617770
TI  - A new strategy for the assessment of viable myocardium and regional myocardial
      blood flow using 15O-water and dynamic positron emission tomography.
AB  - BACKGROUND: We have developed a new measure of myocardial viability, the water
      perfusable tissue index (PTI), which is calculated from transmission, C15O, and
      H2(15)O positron emission tomography (PET) data sets. It is defined as the
      proportion of the total anatomical tissue within a given region of interest (ROI)
      that is capable of rapidly exchanging water and has units g (perfusable tissue)/g
      (total anatomical tissue). The aim of this study was to assess the prognostic
      value of PTI in predicting improvement in regional wall motion after successful
      thrombolysis for acute myocardial infarction (AMI) and to measure the myocardial
      blood flow to the perfusable tissue (MBFp, ml/min/g [perfusable tissue]).
      Furthermore, PTI was compared with 18FDG metabolic imaging in patients with old
      myocardial infarction (OMI). METHODS AND RESULTS: PET scans were performed in
      healthy volunteers (group 1, n = 8), patients with OMI (group 2, n = 15), and in
      patients who were successfully thrombolysed after an AMI (group 3, n = 11).
      Systolic wall thickening was measured by two-dimensional echocardiography within
      2-4 days of AMI and after 4 months to assess contractile recovery. In the healthy
      volunteers, MBFp was 0.95 +/- 0.13 ml/min/g (perfusable tissue). PTI in these
      regions was 1.08 +/- 0.07 g (perfusable tissue)/g (total anatomical tissue),
      which was consistent with all normal myocardium being perfusable by water. In the
      OMI group, the ratio of the relative 18FDG activity to the relative MBFp defect
      (metabolism-flow ratio) was calculated for each asynergic segment. Regions in
      which the metabolism-flow ratio was greater than or equal to 1.20 were considered
      reversibly injured, whereas those in which the ratio was less than 1.20 were
      deemed irreversibly injured. PTI in the former group of regions (n = 9) was 0.75
      +/- 0.14 g (perfusable tissue)/g (total anatomical tissue) and was significantly
      higher than in irreversibly injured regions (n = 6) (0.53 +/- 0.12 g [perfusable
      tissue]/g [total anatomical tissue], p less than 0.01). Values of MBFp were
      similar in these segments. Seven of 12 segments in the AMI patients showed
      improved systolic wall thickening on follow-up. PTI in these recovery segments
      was 0.88 +/- 0.10 g (perfusable tissue)/g (total anatomical tissue) (p = NS
      versus control). PTI in the nonrecovery regions was 0.53 +/- 0.11 g (perfusable
      tissue)/g (total anatomical tissue), which was similar to the segments in group 2
      in which 18FDG uptake was absent. MBFp was similar in both the recovery and
      nonrecovery segments in the subacute phase. CONCLUSIONS: These data indicate that
      PTI may be a good prognostic indicator for the recovery of contractile function
      after successful thrombolysis and show that myocardial viability may be assessed
      by PET without metabolic imaging.

PMID- 1617771
TI  - Coronary reserve and exercise ECG in patients with chest pain and normal coronary
      angiograms.
AB  - BACKGROUND: Coronary vasodilator reserve is reduced in some patients with a
      history of chest pain and angiographically normal coronary arteries. ECG changes
      suggestive of myocardial ischemia during exercise also can be demonstrated in a
      subset of these patients. METHODS AND RESULTS: We have investigated the
      correlation between coronary vasodilator reserve, assessed with 13N-labeled
      ammonia and positron emission tomography, and the ECG during exercise stress in
      45 patients with a history of chest pain, angiographically normal coronary
      arteries, and a negative ergonovine test. ST segment depression on the ECG during
      exercise was present in 29 of 45 patients. Mean resting left ventricular blood
      flow was 1.04 +/- 0.22 ml.min-1.g-1; it increased to 1.32 +/- 0.47 ml.min-1.g-1
      (p less than 0.01 versus baseline value) during atrial pacing and to 2.52 +/-
      0.96 ml.min-1.g-1 (p less than 0.01 versus baseline value) after dipyridamole
      (0.56 mg/kg i.v.). No regional flow defects could be demonstrated in any patient
      during pacing or after dipyridamole. Myocardial flows after dipyridamole,
      however, did not show a normal frequency distribution (Kolmogorov-Smirnov test),
      and two patient populations could be identified. Twenty-nine (67%) patients had a
      mean left ventricular flow of 3.02 +/- 0.33 ml.min-1.g-1 after dipyridamole
      (range, 2.13-5.46 ml.min-1.g-1), and 14 (33%) patients had a mean flow of 1.48 +/
      0.29 ml.min-1.g-1 (range, 1.06-2.04 ml.min-1.g-1, p less than 0.01 versus the
      "high-flow group"). CONCLUSIONS: Approximately one third of patients in our
      series showed a reduced coronary vasodilator reserve. Although 12 of 14 patients
      in the "low-flow group" had ST segment depression during exercise stress, 16 of
      29 patients in the high-flow group also had ST segment depression during exercise
      stress. Therefore, despite a good sensitivity (86%) in identifying patients with
      a blunted increment of coronary flow, the ECG response during exercise stress
      appears to have a rather low specificity (45%). This suggests that factors other
      than reduced coronary reserve and myocardial ischemia may play a role in the
      genesis of the ST segment depression in these patients.

PMID- 1617772
TI  - Effect of ketanserin on proximal and distal coronary constrictor responses to
      intracoronary infusion of serotonin in patients with stable angina, patients with
      variant angina, and control patients.
AB  - BACKGROUND: Serotonin, released by aggregating platelets, may contribute to or
      cause myocardial ischemia by constricting epicardial vessels. Experimental
      studies suggest that this constriction is mediated by two distinct serotonin
      receptor subtypes: 5-hydroxytryptamine1-like (S1-like) and 5-hydroxytryptamine2
      (S2). METHODS AND RESULTS: To determine the relative contribution of S1-like and
      S2 receptors to the vasoconstrictor effects of serotonin, we studied the effect
      of ketanserin (0.75 mg, intracoronary), a selective S2 receptor antagonist, on
      the constrictor response of human coronary vessels to intracoronary infusions of
      serotonin. In control patients (n = 7), serotonin (10(-4) mol/l) caused
      significant (p less than 0.05) constriction only in distal segments, which was
      significantly (p less than 0.05) inhibited by ketanserin. In stable angina
      patients (n = 8), serotonin (10(-4) mol/l) caused significant constriction in
      proximal (p less than 0.01) and distal (p less than 0.01) segments, which was
      significantly inhibited by ketanserin in proximal (p less than 0.05) but not
      distal (p = 0.30) segments. In patients with variant angina (n = 3), epicardial
      occlusion at the site of preexisting stenoses in proximal locations occurred at
      infused concentrations of 10(-6) (one patient) or 10(-5) (two patients) mol/l.
      The infusion of the same concentration of serotonin after ketanserin again caused
      epicardial occlusion. CONCLUSIONS: Our results suggest that functionally
      important S1-like receptors that mediate vasoconstriction exist in the epicardial
      vessels of patients with stable or variant angina. Their activation, either at
      hyperreactive sites in patients with variant angina or in the distal epicardial
      vessels of patients with chronic stable angina, may contribute to or cause
      myocardial ischemia when serotonin is released after the intracoronary activation
      of platelets.

PMID- 1617773
TI  - Hemodynamic evaluation before and after closure of fenestrated Fontan. An acute
      study of changes in oxygen delivery.
AB  - BACKGROUND: Acute changes in hemodynamics and oxygen delivery accompanying
      temporary occlusion of atrial defects in 14 patients after a fenestrated Fontan
      procedure were evaluated at a median interval of 32 days after surgery to
      identify candidates for permanent transcatheter closure of their defects. METHODS
      AND RESULTS: Patients ranged in age from 9 months to 33 years and in weight from
      7.9 to 69 kg. Right atrial (RA), left atrial (LA), and aortic pressures, mixed
      venous (SmvO2) and aortic (SaO2) oxygen saturation, and whole-body oxygen
      consumption (VO2) were measured, and systemic blood flow (Qs), systemic oxygen
      transport (SOT), and oxygen extraction were calculated before and after
      occlusion. SmvO2, VO2, and RA pressures did not change, but SaO2 increased from
      84 +/- 6% to 95 +/- 3% (p less than 0.05), and LA pressures fell from 5.1 +/- 3.6
      to 3.7 +/- 2.2 mm Hg (p less than 0.05). Qs fell from 2.4 +/- 0.7 to 1.8 +/-
      0.41.min-1.m-2 (p less than 0.05), SOT fell from 425 +/- 154 to 366 +/- 112
      ml.O2.min-1.m-2 (p less than 0.05), and oxygen extraction increased from 0.40 +/-
      0.12 to 0.46 +/- 0.13 (p less than 0.05). Only one patient did not undergo
      definitive closure of his defect because of a marked decrease in Qs and SOT with
      a significant rise in RA pressure. CONCLUSIONS: Although delayed closure of an
      atrial defect in these patients improved morbidity and mortality, the complete
      separation of the venous and systemic circulations was accomplished at the
      expense of decreased Qs and oxygen delivery despite the improved level of
      arterial oxygenation. The resting levels of oxygen extraction are elevated and
      will be associated with decreased exercise capability. The long-term benefits of
      closure of these fenestrations are yet to be shown.

PMID- 1617775
TI  - Circadian variation in ischemic threshold. A mechanism underlying the circadian
      variation in ischemic events.
AB  - BACKGROUND: There is a circadian pattern in the occurrence of cardiac events in
      patients with coronary artery disease. Whether changes in coronary vascular tone
      contribute to these phenomena is unknown. We measured the ischemic threshold,
      defined as either the heart rate or rate-pressure product at 1-mm ST segment
      depression during treadmill exercise and used it as an index of the lowest
      coronary vascular resistance; the premise was that when ischemic threshold became
      lower, coronary vascular resistance was higher, and vice versa. METHODS AND
      RESULTS: Fifteen patients (group A) with stable coronary artery disease underwent
      four identical treadmill exercise tests in 24 hours, and ischemic threshold was
      measured as the heart rate at the onset of 1-mm ST depression. Before each
      treadmill test, postischemic forearm vascular resistance was measured after 5
      minutes of forearm occlusion, using strain-gauge plethysmography. Sixteen
      additional patients (group B) underwent two treadmill tests at 8 AM and 1 PM, and
      ischemic threshold was measured as the heart rate-blood pressure product at 1-mm
      ST depression. A circadian variation was noted: In group A, the heart rate
      derived ischemic threshold was lower at 8 AM and 9 PM compared with noon and 5 PM
      (p less than 0.03). Also, in group B, the rate-pressure product-derived ischemic
      threshold was 8 +/- 2% lower at 8 AM compared with 1 PM (p = 0.008). A circadian
      variation parallel to the observed variation in ischemic threshold was also noted
      in the postischemic forearm blood flow, which was lower in the morning and at
      night (p less than 0.004). There was a strong correlation between postischemic
      forearm blood flow and ischemic threshold (p less than 0.0001), such that
      ischemic threshold was lower at the time of day when postischemic forearm blood
      flow was lower, and vice versa. CONCLUSIONS: A lower ischemic threshold in the
      morning suggests that the ischemia-induced coronary vascular resistance is
      increased at this time, a finding supported by a similar variation in
      postischemic forearm vascular resistance. Parallel changes in forearm and
      coronary resistance suggest that generalized (neural or humoral factors) rather
      than local factors are responsible for the observed circadian changes. Increased
      coronary tone in the mornings may not only contribute to the higher incidence of
      transient ischemia but may help trigger acute cardiac events at this time.

PMID- 1617774
TI  - Obstruction of inferior vena caval orifice by giant left atrium in patients with
      mitral stenosis. A Doppler echocardiographic study from the right parasternal
      approach.
AB  - BACKGROUND: To examine whether an extremely enlarged left atrium (giant left
      atrium) obstructs the venous return from the inferior vena cava (IVC), the
      velocity of IVC flow was measured at its junction with the right atrium (IVC
      orifice) in patients with mitral stenosis by use of color and pulsed-wave Doppler
      echocardiography from a right parasternal longitudinal plane. METHODS AND
      RESULTS: The maximum dimension of the IVC orifice by two-dimensional
      echocardiography and the maximum IVC orifice flow velocity by pulsed-wave Doppler
      echocardiography were measured in 74 patients with mitral stenosis and atrial
      fibrillation (mean age, 59 years). The control population consisted of 16
      subjects with atrial fibrillation alone (mean age, 61 years). Flow velocities in
      the superior vena cava and hepatic vein were also obtained by pulsed-wave Doppler
      echocardiography from the supraclavicular and subcostal views, respectively.
      Fifty-one mitral stenosis patients without severe tricuspid regurgitation were
      divided into two groups according to the left atrial dimension (LAD), which was
      measured by the standard left parasternal long-axis view (group A: n = 33, LAD
      less than 65 mm; group B: n = 18, LAD greater than or equal to 65 mm). Peak
      inspiratory and expiratory velocities of IVC orifice flow in diastole averaged
      over three consecutive inspirations in group B (mean +/- SD, 93.4 +/- 32.0 and
      47.6 +/- 19.8 cm/sec) were significantly greater (p less than 0.01) than in the
      control subjects (67.9 +/- 12.8 and 34.5 +/- 7.0 cm/sec) and in group A (70.2 +/-
      18.4 and 38.1 +/- 11.5 cm/sec, respectively). However, there were no significant
      differences in superior vena caval and hepatic vein flow velocities among the
      three groups. The maximum IVC orifice dimension in group B (11.4 +/- 4.4 mm) was
      significantly smaller than in the control subjects (20.1 +/- 2.1 mm) and in group
      A (18.6 +/- 5.4 mm) because of displacement of the atrial septum into the right
      atrium. There were significant negative correlations between the IVC orifice
      dimension and the peak IVC orifice flow velocity (r = -0.62, SEE = 0.33 cm/sec, n
      = 67, y = e(-0.01x + 3.6), p less than 0.01) as well as the left atrial dimension
      (r = -0.71, SEE = 0.32 mm, n = 67, y = e(-0.02x + 3.8), p less than 0.01) in
      these 51 patients and control subjects. In the remaining 23 patients with severe
      tricuspid regurgitation, the peak inspiratory IVC orifice velocity (n = 9, 88.6
      +/- 30.0 cm/sec) was significantly greater (p less than 0.05) and the IVC orifice
      dimension (23.8 +/- 9.7 mm) significantly smaller (p less than 0.05) in patients
      with a giant left atrium than in those without (n = 14, 69.9 +/- 15.3 cm/sec and
      30.5 +/- 9.6 mm, respectively); in the latter, the IVC orifice dimension was
      significantly (p less than 0.05) greater than in the controls. CONCLUSIONS: A
      giant left atrium in patients with mitral stenosis obstructs venous return at the
      IVC orifice by marked displacement of the atrial septum toward the right atrium.

PMID- 1617776
TI  - Adrenergic effects on reentrant ventricular rhythms in subacute myocardial
      infarction.
AB  - BACKGROUND: Reentry has been shown to be a mechanism of ventricular arrhythmias
      elicited by programmed premature stimulation in the subacute ischemic period of
      dogs subjected to myocardial infarction. The spatial distribution of
      refractoriness in these hearts has been shown to play an important part in the
      formation of functional arcs of conduction block during programmed ventricular
      stimulation. Because the adrenergic nervous system influences cardiac arrhythmias
      and myocardial infarction can directly affect sympathetic innervation in the
      heart, we investigated the role of the sympathetic nervous system on reentry in
      the canine heart 4 days after infarction. METHODS AND RESULTS: The influences of
      adrenergic stimuli on the initiation of reentrant ventricular excitation were
      studied using a 128-channel computerized recording system in the canine heart 4
      days after ligation of the left anterior descending coronary artery. Bilateral
      stimulation of the ansae subclavia preferentially improved conduction of
      premature beats in the normal zones. This corresponded to an improvement in
      excitability, as measured by a decrease in stimulus strength at the same
      premature coupling interval as control. Consequently, the effective refractory
      period was preferentially shortened at normal sites but not at ischemic sites.
      Both of these changes contributed to a shift of the arc of functional conduction
      block toward more normal tissue. As a result, sites proximal to the arc of
      functional conduction block had more time to recover excitability and thereby
      were available to be reexcited by the distal activation wave front. Conversely,
      intravenous infusion of norepinephrine preferentially shortened the effective
      refractory period of sites in the ischemic zone, thereby indicating that
      denervation hypersensitivity had occurred at these sites. The spatial dispersion
      of refractoriness and the arc of functional conduction block were significantly
      reduced in size. As a consequence, previously inducible reentrant rhythms were no
      longer inducible. CONCLUSIONS: Sympathetic stimulation can be considered an
      arrhythmogenic intervention, whereas norepinephrine infusion may be considered
      antiarrhythmic in this experimental model.

PMID- 1617777
TI  - Effects of inhibition of nitric oxide formation on regional blood flow in
      experimental myocardial infarction.
AB  - BACKGROUND: Large myocardial infarction is associated with reactive hypertrophy
      and dilation of the left ventricle, depressed coronary flow reserve, and the
      development of heart failure including systemic vasoconstriction. We hypothetized
      that changes in endothelial function, e.g., in the synthesis or action of nitric
      oxide in the coronary and peripheral vasculatures, might be involved in the
      depressed coronary flow reserve and increased systemic vascular resistance
      observed in postinfarction myocardial hypertrophy and failure. METHODS AND
      RESULTS: The regional blood flow changes that occur as a result of inhibiting the
      basal release of nitric oxide with NG-monomethyl-L-arginine (L-NMMA) and how this
      regional pattern may be altered in large MI (infarct size, 30-51% of left
      ventricle) were examined. Measurements were made 24 hours and 8 weeks after
      myocardial infarction or sham operation in conscious rats. The left ventricular
      end-diastolic pressure and effects of L-NMMA on left ventricular end-diastolic
      pressure was similar 24 hours and 8 weeks after myocardial infarction. The
      effects of L-NMMA (30 mg/kg i.v.) on heart rate and blood pressure were similar
      in infarcted and sham animals. L-NMMA exerted a marked vasoconstriction in the
      renal, splanchnic, cutaneous, and cerebral circulations of similar magnitude in
      sham-operated rats and animals with myocardial infarction. The coronary
      vasoconstrictor effect of L-NMMA was attenuated significantly in the
      hypertrophied right and noninfarcted left ventricle of 8-week-old infarcted rats
      (p less than 0.01 versus sham-operated animals) but not 24 hours after induction
      of myocardial infarction when cardiac hypertrophy has not yet developed. The
      increase in left ventricular coronary resistance in 8-week-old infarcted animals
      was inversely related to infarct size (r = -0.787, p = 0.012, n = 9).
      Nitroglycerin exerted similar increases in coronary blood flow in rats with
      chronic myocardial infarction and sham-operated animals, arguing against a
      reduced vascular responsiveness to nitric oxide. Transmission electron microscopy
      of coronary resistance vessels in 8-week-old infarcted animals did not reveal
      endothelial abnormalities. CONCLUSIONS: These data suggest that the basal release
      of nitric oxide in the renal, intestinal, and cutaneous circulations is not
      affected adversely in this model of myocardial infarction and failure. However,
      the blunted coronary vasoconstrictor effect of L-NMMA late after large myocardial
      infarction supports the view that the basal release of nitric oxide is impaired
      in postinfarction reactive cardiac hypertrophy.

PMID- 1617778
TI  - Noninvasive measurement of the time constant of left ventricular relaxation using
      the continuous-wave Doppler velocity profile of mitral regurgitation.
AB  - BACKGROUND: The time constant of isovolumic relaxation (tau) is an important
      parameter of ventricular diastolic function, but the need for invasive
      measurement with high-fidelity catheters has limited its use in general clinical
      cardiology. The Doppler mitral regurgitant velocity spectrum can be used to
      estimate left ventricular (LV) pressure throughout systole and may provide a new
      noninvasive method for estimating tau. METHODS AND RESULTS: Mitral regurgitation
      was produced in nine dogs, and ventricular relaxation was adjusted
      pharmacologically and with hypothermia. High-fidelity ventricular pressures were
      recorded, and tau was calculated from these hemodynamic data (tau H) assuming a
      zero-pressure asymptote. Continuous-wave mitral regurgitant velocity profiles
      were obtained, and the ventriculo-atrial (VA) pressure gradient was calculated by
      the simplified Bernoulli equation; tau was calculated from the Doppler data from
      the time of maximal negative dP/dt until LV-LA pressure crossover. Three methods
      were used to correct the Doppler VA gradient to better approximate the LV
      pressure before calculating tau: 1) adding actual LA V wave pressure (to yield
      tau LA); 2) adding 10 mm Hg (tau 10); and 3) no adjustment at all (actual VA
      gradient used to calculate tau 0). The agreement between tau H and the three
      Doppler estimates of tau was assessed by linear regression and by the mean and
      standard deviation of the error between the measurements (delta tau). the
      measurements (delta tau). tau H ranged from 29 to 135 msec. Without correction
      for LA pressure, the Doppler estimate of tau seriously underestimated tau H: tau
      0 = 0.30 tau H + 9.4, r = 0.79, delta tau = -35 +/- 18 msec. This error was
      almost completely eliminated by adding actual LA pressure to the VA pressure
      gradient: tau LA = 0.92 tau H + 7.6, r = 0.95, delta tau = 2 +/- 7 msec. Addition
      of a fixed LA pressure estimate of 10 mm Hg to the VA gradient yielded an
      estimate that was almost as good: tau 10 = 0.89 tau H + 4.9, r = 0.88, delta tau
      = -2 +/- 12 msec. In general, tau was overestimated when actual LA pressure was
      below this assumed value, and vice versa. Numerical analysis demonstrated that
      assuming LA pressure to be 10 mm Hg should yield estimates of tau accurate to +/-
      15% between true LA pressures of 5 and 20 mm Hg. CONCLUSIONS: This study
      demonstrates that the Doppler mitral regurgitant velocity profile can be used to
      provide a direct and noninvasive measurement of tau. Because mitral regurgitation
      is very common in cardiac patients, this method may allow more routine assessment
      of tau in clinical and research settings, leading to a better understanding of
      the role of impaired ventricular relaxation in diastolic dysfunction and the
      effect of therapeutic interventions.

PMID- 1617779
TI  - Protamine releases endothelium-derived relaxing factor from systemic arteries. A
      possible mechanism of hypotension during heparin neutralization.
AB  - BACKGROUND: When used to reverse the anticoagulant effect of heparin, protamine
      sulfate often causes vasodilation that can lead to systemic hypotension.
      Protamine is rich in the basic amino acid arginine, which is the precursor of
      endothelial cell synthesis of nitric oxide, and nitric oxide is the active
      component of endothelium-derived relaxing factor (EDRF). METHODS AND RESULTS: To
      determine whether the hypotensive effect of protamine could be due to stimulated
      release of EDRF, we studied rings (4-5 mm) of canine coronary, femoral, and renal
      artery suspended in organ chambers containing physiological salt solution (37
      degrees C and 95% O2-5% CO2). Arterial rings with and without endothelium were
      contracted with prostaglandin F2 alpha (2 x 10(-6) M) and exposed to increasing
      concentrations of protamine (final organ bath concentration, 40-400
      micrograms/ml). In arterial segments without endothelium, protamine caused only a
      modest decrease in tension. However, protamine induced concentration-dependent
      relaxation in all arterial segments with endothelium, which was significantly
      greater than in segments without endothelium (p less than 0.05). The endothelium
      dependent relaxation induced by protamine was inhibited by NG-monomethyl-L
      arginine (L-NMMA) (10(-5) M), but L-NMMA had no effect on rings without
      endothelium. The action of L-NMMA could be reversed by L-arginine (10(-4) M) but
      not D-arginine (10(-4) M). CONCLUSIONS: This study demonstrates that protamine
      stimulates the release of EDRF from arterial endothelium, and that endothelium
      dependent vasodilation may be an important cause of systemic hypotension during
      protamine infusion.

PMID- 1617780
TI  - Efficacy of antiarrhythmic drugs in patients with arrhythmogenic right
      ventricular disease. Results in patients with inducible and noninducible
      ventricular tachycardia.
AB  - BACKGROUND: Ventricular tachyarrhythmias are the major clinical manifestation of
      arrhythmogenic right ventricular disease. Although antiarrhythmic therapy has
      been widely advocated, there is only limited information available on the
      efficacy of antiarrhythmic drugs in these patients. METHODS AND RESULTS: The
      short- and long-term efficacies of various antiarrhythmic agents were
      retrospectively and prospectively analyzed in 81 patients (mean age, 39 +/- 14
      years; range, 16-68 years; 61.7% males) with arrhythmogenic right ventricular
      disease. In 42 patients with inducible ventricular tachycardia during programmed
      ventricular stimulation, the following efficacy rates were obtained: class Ia and
      Ib drugs (n = 18), 5.6%; class Ic drugs (n = 25), 12%; beta-blockers (n = 8), 0%;
      sotalol (n = 38), 68.4%; amiodarone (n = 13), 15.4%; verapamil (n = 5), 0%; and
      drug combinations (n = 26), 15.4%. Only one of the 10 patients not responding to
      sotalol was treated effectively by amiodarone, whereas the remaining nine
      patients proved to be drug refractory toward all other drugs tested (3.8 +/- 2.3
      drugs, including amiodarone in five cases) and underwent nonpharmacological
      therapy. During a follow-up of 34 +/- 25 months, three of the 31 patients (9.7%)
      discharged on pharmacological therapy had nonfatal recurrences of ventricular
      tachycardia after 0.5, 51, and 63 months, respectively. In 39 patients with
      noninducible ventricular tachycardia during programmed ventricular stimulation,
      the following efficacy rates were observed: class Ia and Ib drugs (n = 16), 0%;
      class Ic agents (n = 23), 17.4%; beta-blockers (n = 7), 28.6%; sotalol (n = 35),
      82.8%; amiodarone (n = 4), 25%; verapamil (n = 24), 50%; and drug combinations (n
      = 11), 9.1%. During a follow-up of 14 +/- 13 months, four of 33 patients (12.1%)
      discharged on antiarrhythmic drugs had nonfatal relapses of their clinical
      ventricular arrhythmia. CONCLUSIONS: Thus, in arrhythmogenic right ventricular
      disease, sotalol proved to be highly effective in patients with inducible as well
      as noninducible ventricular tachycardia. Patients with inducible ventricular
      tachycardia not responding to sotalol are likely to not respond to other
      antiarrhythmic drugs and should be considered for nonpharmacological therapy
      without further drug testing. Amiodarone did not prove to be more effective than
      sotalol and may not be an alternative because of frequent side effects during
      long-term therapy, especially in young patients. Verapamil and beta-blockers were
      effective in a considerable number of patients with noninducible ventricular
      tachycardia and may be a therapeutic alternative in this subgroup. Class I agents
      appear to be rarely effective in the treatment of both inducible and noninducible
      ventricular tachycardia in arrhythmogenic right ventricular disease.

PMID- 1617781
TI  - Metabolic consequences and predictability of ventricular fibrillation in hypoxia.
      A 31P- and 23Na-nuclear magnetic resonance study of the isolated rat heart.
AB  - BACKGROUND: Ventricular fibrillation has deleterious metabolic and functional
      consequences for the heart. This study had two purposes: first, to define the
      effects of ventricular fibrillation during hypoxia on energy metabolism and
      accumulation of intracellular Na+ and, second, to test whether the occurrence of
      ventricular fibrillation can be predicted from functional or metabolic
      parameters. METHODS AND RESULTS: Isolated isovolumic rat hearts were perfused
      with oxygenated Krebs-Henseleit buffer at 37 degrees C. After a prehypoxic
      period, hearts were subjected to hypoxic perfusion (95% N2-5% CO2) for 30
      minutes. High-energy phosphates and intracellular pH were determined by 31P
      nuclear magnetic resonance (NMR) spectroscopy, and intracellular Na+ accumulation
      was followed by 23Na-NMR spectroscopy in combination with the shift reagent
      dysprosium triethylenetetraminehexa-acetate. Five of 10 (31P-NMR) and four of 10
      (23Na-NMR) hearts developed spontaneous ventricular fibrillation at 19 +/- 2
      minutes (31P-NMR) and 18 +/- 3 minutes (23Na-NMR) of hypoxia (ventricular
      fibrillation group), whereas other hearts (non-ventricular fibrillation group)
      remained beating throughout hypoxia. Cardiac function and high-energy phosphate
      content declined during hypoxia, and ventricular fibrillation exacerbated this
      decline significantly. Similarly, ventricular fibrillation exacerbated the
      accumulation of intracellular Na+ occurring during hypoxia. Statistical analysis
      showed that the event of ventricular fibrillation could be predicted from changes
      of end-diastolic pressure, rate-pressure product, and creatine phosphate content
      before ventricular fibrillation. However, the strongest predictor of ventricular
      fibrillation was intracellular Na+ accumulation, which occurred in ventricular
      fibrillation hearts throughout the hypoxic period long before ventricular
      fibrillation was initiated. CONCLUSIONS: Loss of systolic and diastolic
      functions, creatine phosphate depletion, and, in particular, intracellular Na+
      accumulation may be causally related to induction of ventricular fibrillation
      during hypoxia, all of which are most likely linked to concomitant intracellular
      Ca2+ accumulation.

PMID- 1617782
TI  - Age as a modulator of coronary capillary angiogenesis.

PMID- 1617783
TI  - Intravascular ultrasound. Research technique or clinical tool?

PMID- 1617784
TI  - A normal coronary artery: what size is it?

PMID- 1617785
TI  - Sinus node during atrial fibrillation. To beat or not to beat?

PMID- 1617787
TI  - Standardization of cardiac tomographic imaging. From the Committee on Advanced
      Cardiac Imaging and Technology, Council on Clinical Cardiology, American Heart
      Association; Cardiovascular Imaging Committee, American College of Cardiology;
      and Board of Directors, Cardiovascular Council, Society of Nuclear Medicine.

PMID- 1617786
TI  - Are restenosis cells containing nonmuscle myosin really vascular smooth muscle
      cells?

PMID- 1617788
TI  - Statement on exercise. Benefits and recommendations for physical activity
      programs for all Americans. A statement for health professionals by the Committee
      on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology,
      American Heart association.

PMID- 1617789
TI  - Myocardial viability in patients with Q wave myocardial infarction and no
      residual ischemia.
AB  - BACKGROUND: Coronary revascularization in patients with persistent angina after
      myocardial infarction reduces the incidence of recurrent angina pectoris and
      myocardial infarction and improves left ventricular function. The results of
      revascularization after a Q wave myocardial infarction when there is no residual
      ischemia may depend on myocardial viability. METHODS AND RESULTS: To determine
      whether there was viable myocardium in the infarct area in the absence of
      clinical and scintigraphic evidence of myocardial ischemia, 15 asymptomatic
      patients with a Q wave myocardial infarction, no redistribution on stress 201Tl
      test, and single-vessel disease (greater than 70% stenosis) with persistent
      anterograde blood flow were randomized to percutaneous transluminal coronary
      artery angioplasty (PTCA) or conservative medical treatment. After 2 months of
      follow-up, mean coronary blood flow measured by Doppler catheter in the infarct
      related artery was higher in the PTCA treatment group (33 +/- 6 ml/min, n = 8)
      than in the conservative treatment group (16 +/- 4 ml/min, n = 7; p less than
      0.05 between groups). The 201Tl pathological-to-normal ratios measured on
      postexercise images did not change in patients treated conservatively during the
      follow-up period (delta = +1.1 +/- 2.2%; NS from baseline) but increased
      significantly in patients treated by PTCA (delta = +8.5 +/- 2.3%; p less than
      0.01 from baseline; p less than 0.05 between groups). Segmental wall motion
      improved on left ventricular angiography 2 months after PTCA (delta = +11.5 +/-
      2.2%; p less than 0.001 from baseline) significantly more than in the
      conservative treatment group (delta = +4.1 +/- 1.4%; p less than 0.05 between
      both groups). Improvements of 201Tl ratios and segmental wall motion indexes
      correlated significantly (r = 0.73, p = 0.002). The mild improvement of global
      left ventricular ejection fraction measured in the PTCA treatment group did not
      differ significantly from changes in the conservative treatment group.
      CONCLUSIONS: Successful angioplasty of the stenotic infarct artery in patients
      with a Q wave myocardial infarction and no residual ischemia improved coronary
      flow, 201Tl uptake in the infarct area, and regional wall motion. Therefore,
      myocardial viability may last several weeks, as long as residual blood flow
      persists in the infarct-related artery. Optimal assessment of viability by
      imaging techniques should identify patients who are most likely to benefit from
      revascularization.

PMID- 1617791
TI  - Contribution of localized calcium deposits to dissection after angioplasty. An
      observational study using intravascular ultrasound.
AB  - BACKGROUND: Atherosclerotic plaque fracture and dissection of the arterial wall
      are frequent concomitants of the balloon angioplasty process. The composition and
      morphology of plaque within the vessel may be critical in determining the extent
      of plaque fracture and dissection during balloon angioplasty. To examine this
      potential association in the clinical setting, we studied patients with
      intravascular ultrasound imaging after balloon angioplasty. METHODS AND RESULTS:
      Forty-one patients were studied with intravascular ultrasound after angioplasty
      in both peripheral and coronary arteries. Ultrasound images representing the
      target lesion cross section were digitized, stored on computer, and analyzed off
      line. The presence of intralesional calcium and the relative size of dissection
      for each lesion was computed. Thirty-one patients (76%) had ultrasound evidence
      of significant dissection or plaque fracture immediately after balloon dilation.
      In 23 of 31 (74%) of the lesions, the ultrasound scans showed significant
      localized calcium deposits within the plaque substance. In 87% of these cases,
      the dissections were adjacent to the calcific portion of the vessel wall. In
      addition, the relative size of dissections referenced to the neolumen area were
      significantly larger (p less than or equal to 0.002) in the calcified vessels
      (27.5 +/- 12.3%) compared with the size of the dissections in lesions without
      calcium (11.2 +/- 5.8%). CONCLUSIONS: The presence of calcium within the vessel
      wall appeared to be significantly associated with both the location and size of
      the dissected tissue arm from the vessel wall. These data suggest that localized
      calcium deposits have a direct role in promoting dissection, presumably by
      increasing shear stresses within the plaque.

PMID- 1617792
TI  - Excimer laser-facilitated coronary angioplasty. Relative risk analysis of acute
      and follow-up results in 200 patients.
AB  - BACKGROUND: Excimer laser coronary angioplasty has been reported to be a
      promising treatment for complex coronary artery disease. The purpose of this
      study was to define the predictors of acute success and restenosis after this
      experimental intervention. METHODS AND RESULTS: A cohort of 200 consecutive
      patients had a minimum of 6 months of follow-up evaluation after treatment of 215
      coronary stenoses that were carefully selected for excimer laser coronary
      angioplasty. At the time of the initial procedure, the laser catheter alone
      produced a residual stenosis of less than or equal to 50% at 119 of 215 lesions
      (55.4%). For complete dilatation, 87.9% of the lesions required adjunctive
      balloon angioplasty. Clinical success was achieved in 183 of the 200 patients
      (91.5%), as indicated by a reduction by at least 20% of the narrowing of the
      vessel diameter, less than or equal to 50% residual stenosis, and no in-hospital
      complication. Complications included abrupt closure (5.0%), myocardial infarction
      (3.5%), bypass surgery (3.0%), perforation (2.0%), and death (0.0%). Logistic
      regression analysis showed that lesions at vessel bifurcations (success rate,
      66%; adjusted odds ratio [OR] = 0.16; p = 0.002) or in tortuous vessels (success
      rate, 82%; OR = 0.48; p = 0.004) were associated with decreased clinical success.
      However, acceptable success rates were achieved in patients with lesions in
      saphenous vein grafts more than 3 years old (success rate, 94%; OR = 1.40; p =
      0.75), in ostial lesions (success rate, 100%; OR = 3.36; p = 0.43), and in
      lesions longer than 10 mm (success rate, 93.5%; OR = 1.50; p = 0.39). Clinical
      follow-up was available in 197 of the 200 patients (98.5%) a mean of 5.9 +/- 1.9
      months after angioplasty, at which time 31.0% of patients had developed symptoms
      or evidence of ischemia. No patient died during the study. Follow-up angiography
      was obtained in 83.1% of eligible patients after a mean [+/- SD] of 5.2 +/- 2.0
      months. Angiographic restenosis, defined by greater than 50% stenosis, appeared
      at 78 of 164 lesions (47.6%). By logistic regression analysis, only lesions in
      saphenous vein grafts were associated with a decreased rate of restenosis
      (restenosis rate, 20%; OR = 0.18; p = 0.01). CONCLUSIONS: This analysis, which
      defines the profile of risk for excimer laser angioplasty, provides a sound basis
      for rigorous comparison of adjunctive excimer laser with balloon angioplasty for
      ostial narrowings, long lesions, and saphenous vein graft stenoses.

PMID- 1617793
TI  - Determinants of infarct size in reperfusion therapy for acute myocardial
      infarction.
AB  - BACKGROUND: Experimental animal studies have demonstrated that myocardium at
      risk, residual collateral flow, and duration of coronary artery occlusion are
      important determinants of final infarct size. The present study examined these
      variables in patients with acute myocardial infarction in relation to final
      infarct size. METHODS AND RESULTS: Myocardium at risk was assessed with hexakis(2
      methoxyisobutyl isonitrile) technetium (I) (99mTc sestamibi) in 89 patients with
      first-time myocardial infarction (anterior, 48 patients; inferior, 41 patients).
      All patients had successful reperfusion therapy with either intravenous
      thrombolysis (32 patients) or primary coronary angioplasty (57 patients) within
      24 hours of the onset of chest pain (4.7 +/- 3.9 hours; range, 0.5-21.5 hours)
      documented by coronary angiography. 99mTc sestamibi was injected intravenously
      before reperfusion therapy, and tomographic imaging was performed 1-6 hours
      later. Myocardium at risk was quantitated for each patient and expressed as a
      percentage of the left ventricle: 35 +/- 19%; range, 2-73%. Collateral flow was
      estimated by both invasive and noninvasive methods. Fifty-three patients with
      TIMI grade 0 or I flow who underwent primary coronary angioplasty had collateral
      flow graded angiographically (0-3) before the first balloon inflation. All
      patients had collateral flow estimated noninvasively from the acute sestamibi
      short-axis profile curve by three methods that assess the severity of the
      perfusion defect. Each of these three methods was significantly associated with
      angiographic collateral grade. Final infarct size was determined at hospital
      discharge by a second sestamibi study (17 +/- 17%; range, 0-59%). Myocardium at
      risk (r = 0.61, p less than 0.0001), angiographic collateral grade (p = 0.0003),
      and radionuclide estimates of collateral flow (r = 0.69-0.70, all p less than
      0.0001) were all significantly associated with final infarct size. The time to
      reperfusion therapy was not significantly associated with final infarct size by
      univariate analysis (r = 0.18, p = 0.10). Two multivariate models were
      constructed to determine which variables were independently associated with final
      infarct size. In the invasive model, myocardium at risk, angiographic collateral
      grade with an interaction term for infarct location, and time to reperfusion were
      all independently significant and accounted for 70% of the variability in final
      infarct size. The noninvasive model, which substituted a radionuclide estimate of
      collateral flow for angiographic collateral grade, showed nearly identical
      results, accounting for 68% of the variability in infarct size in patients where
      the infarct artery was known to be occluded. When all patients were included
      (patients with and without acute angiography), the noninvasive model accounted
      for 59% of the variability in infarct size. CONCLUSIONS: Myocardium at risk,
      collateral flow, and duration of coronary occlusion are each independently
      associated with final infarct size and account for most of its variability.
      Ideally, all three parameters should be examined in evaluation of the efficacy of
      new treatment strategies for acute myocardial infarction.

PMID- 1617790
TI  - Angioplasty triggers intracoronary leukotrienes and lipoxin A4. Impact of aspirin
      therapy.
AB  - BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) is a widely
      used and important method of reperfusing coronary arteries. However, it is also
      associated with serious complications such as acute reocclusion and accelerated
      restenosis. The factors as well as the mechanisms involved in PTCA-associated
      complications remain to be fully elucidated. Because peptidoleukotrienes and
      lipoxins are potent vasoactive compounds, the formation of which is not inhibited
      by aspirin (ASA) treatment in vitro, it is possible that these eicosanoids are
      involved in PTCA-associated untoward events. To test this, we determined the
      intracoronary levels of peptidoleukotrienes and lipoxin A4 (LXA4) as well as
      thromboxane (TX) and 5S,12S-dihydroxyeicosatetraenoic acid (5S,12S-DiHETE; a
      product of double dioxygenation) after plaque rupture and evaluated the impact of
      ASA therapy. METHODS AND RESULTS: PTCA was performed on 12 patients with coronary
      artery disease, six undergoing ASA therapy and six without ASA therapy, for at
      least 2 weeks before PTCA. By means of a technique that permitted sampling of
      intracoronary blood at the plaque site in situ, samples were taken immediately
      before and 10 seconds after initiation of plaque rupture. Lipoxygenase (LO)
      derived products, including LXA4 and 5S,12S-DiHETE, and a marker of
      cyclooxygenase activity, i.e., TXB2, were quantitated after extraction and
      chromatography using deuterium-labeled internal standards and electron capture
      negative ion chemical ionization mass spectrometry. Peptidoleukotrienes (LTC4 and
      LTD4) were quantitated after reverse-phase high-performance liquid chromatography
      coupled with radioimmunoassay. Intracoronary blood taken before PTCA showed no
      detectable levels of these eicosanoids (the minimum limits of detection were
      within the picomole range). In contrast, each of these LO products was detected
      after PTCA. Patients undergoing ASA treatment showed elevated levels of each LO
      product examined compared with those not receiving ASA. Eicosanoid levels were
      (mean +/- SEM): LTC4, 7.10 +/- 1.22 ng/ml (ASA) versus 0.48 +/- 0.10 ng/ml; LTD4,
      4.92 +/- 0.56 ng/ml (ASA) versus 1.17 +/- 0.48 ng/ml; LXA4, 24.98 +/- 4.11 ng/ml
      (ASA) versus 15.83 +/- 2.43 ng/ml; 5S,12S-DiHETE, 19.47 +/- 3.98 ng/ml (ASA)
      versus 11.98 +/- 1.83 ng/ml; TXB2, complete blockage (ASA) versus 31.04 +/- 7.38
      ng/ml (p less than 0.05 for LTC4 and LTD4). To distinguish between dilatation of
      whole blood versus dilatation of whole blood and atheroma for contribution of
      eicosanoids, we also monitored their formation in Gore-tex grafts. Upon balloon
      inflation, TXB2 was generated, but LO products were not detected. In contrast,
      injection of platelet- and leukocyte-directed agonists within the graft led to
      both peptidoleukotriene and lipoxin formation. CONCLUSIONS: The results indicate
      that PTCA triggers the intraluminal release of peptidoleukotrienes and LXA4 and
      that ASA therapy enhances their appearance in intracoronary blood. In addition,
      they provide direct evidence for LO products (LTC4, LTD4, and LXA4) in a local
      milieu in vivo. Moreover, the presence of the double dioxygenation product 5S,12S
      DiHETE (a potential marker of 5- and 12-LO interactions) suggests that
      transcellular metabolic events can contribute to eicosanoid formation in vivo.

PMID- 1617794
TI  - Balloon mitral commissurotomy after previous surgical commissurotomy. The
      National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry
      participants.
AB  - BACKGROUND: Mitral restenosis after surgical mitral commissurotomy often occurs
      within 5-15 years, necessitating a repeat procedure. Balloon mitral
      commissurotomy (BMC) has been advocated as an alternative to repeat surgery for
      mitral restenosis. METHODS AND RESULTS: The purposes of this study are to
      determine the short- and intermediate-term outcomes of patients undergoing BMC
      after previous surgical commissurotomy, to compare these patients with those
      undergoing balloon mitral commissurotomy as an initial procedure, and to
      elucidate the multivariate determinants of acute procedural and clinical outcome.
      Of 738 patients undergoing BMC as part of the National Heart, Lung, and Blood
      Institute Balloon Valvuloplasty Registry, 133 underwent BMC after previous
      surgical mitral commissurotomy. Prospective data obtained included demographic,
      hemodynamic, echocardiographic, and clinical follow-up. BMC after previous
      surgical commissurotomy produced a significant reduction in transvalvular
      gradient from 13 +/- 5 to 6 +/- 3 mm Hg (p less than 0.0001) and an increase in
      mitral valve area from 1.0 +/- 0.3 to 1.8 +/- 0.8 cm2 (p less than 0.0001). BMC
      as an initial procedure increased valve area from 1.0 +/- 0.4 to 2.0 +/- 0.8 cm2
      (p less than 0.0001) (p = 0.03 versus prior surgery). Baseline characteristics
      including mitral valve echo score were similar for both groups. Comparing 6-month
      status in patients with prior surgery to those without, 80% versus 90% were New
      York Heart Association (NYHA) functional class I or II (p = 0.004). Mortality was
      similar. In patients with previous mitral valve surgery, multivariate predictors
      of improvement in 6-month clinical status included the experience of the center
      (p = 0.006), lower echocardiographic score (p = 0.001), and lower left
      ventricular end-diastolic pressure (p = 0.008). Multivariate determinants of a
      final mitral valve area greater than or equal to 1.5 cm2 were a lower baseline
      NYHA functional class (p = 0.003) and lower mitral valve echocardiographic score
      (p = 0.008). CONCLUSIONS: BMC after previous surgical mitral commissurotomy
      results in similar hemodynamic changes as in patients undergoing BMC as an
      initial procedure. Symptomatic improvement at 6 months is slightly less frequent
      in prior commissurotomy patients. Patients with favorable valvular morphology and
      preserved left ventricular function who undergo BMC in experienced centers are
      most likely to achieve symptomatic improvement after previous surgical
      commissurotomy. In general, BMC is an effective treatment for mitral restenosis
      after previous surgical commissurotomy.

PMID- 1617795
TI  - Signal transduction in endocrine tissues.

PMID- 1617796
TI  - Computerized tomography versus magnetic resonance imaging: a comparative study in
      hypothalamic-pituitary and parasellar pathology.
AB  - OBJECTIVE: We wished to analyse the relative value of computerized tomography and
      magnetic resonance in patients referred for evaluation of pituitary and
      parasellar lesions. DESIGN: We performed a separate evaluation by two independent
      neuroradiologists of computerized tomography and magnetic resonance images
      ordered numerically and anonymously, with no clinical data available. PATIENTS:
      We studied 40 patients submitted for hypothalamic-pituitary study; 31 were
      carried out preoperatively, of which histological confirmation later became
      available in 14. The remaining nine patients were evaluated postoperatively.
      MEASUREMENTS: Over 40 parameters relating to the bony margins, cavernous sinuses,
      carotid arteries, optic chiasm, suprasellar cisterns, pituitary, pituitary stalk
      and extension of the lesion were evaluated. These reports were compared with the
      initial ones offered when the scans were ordered, and with the final diagnosis.
      RESULTS: Concordance between initial computerized tomography and magnetic
      resonance was observed in 27 cases (67.5%); among the discordant cases
      computerized tomography showed the lesion in two, magnetic resonance in 10, while
      in the remaining case reported to harbour a microadenoma on computerized
      tomography the differential diagnosis between a true TSH-secreting microadenoma
      and pituitary resistance to thyroid hormones is still unclear. Both
      neuroradiologists coincided in their reports in 32 patients (80%); when the
      initial report was compared with those of the neuroradiologists, concordance was
      observed with at least one of them in 34 instances (85%). Discordant results were
      observed principally in microadenomas secreting ACTH or PRL and in delayed
      puberty. In the eight patients with Cushing's disease (histologically confirmed
      in six) magnetic resonance was positive in five and computerized tomography in
      two; the abnormal image correctly identified the side of the lesion at surgery.
      CONCLUSIONS: In patients referred for evaluation of Cushing's syndrome or
      hyperprolactinaemia (due to microadenomas) or after surgery, magnetic resonance
      is clearly preferable to computerized tomography. In macroadenomas both scans are
      equally diagnostic but magnetic resonance offers more information on pituitary
      morphology and neighbouring structures. Nevertheless, there are cases in which
      the results of computerized tomography and magnetic resonance will complement
      each other, since different parameters are analysed with each examination and
      discordant results are encountered.

PMID- 1617797
TI  - Reactivity to stress and psychological adjustment in adults with pituitary
      insufficiency.
AB  - OBJECTIVE: Hypopituitary adults who were affected during childhood have a below
      average rate of marriage, a rate of unemployment that exceeds national norms, and
      often indicate dissatisfaction with their life circumstances. We undertook the
      present study to determine the effects of short stature versus those of pituitary
      hormone deficiency. DESIGN AND PATIENTS: We compared hypopituitary adults (n =
      25) with normal short adults (n = 25) who were matched for height, sex, age and
      socioeconomic status. MEASUREMENTS: In these two groups of subjects, we compared
      the physiological responses to a simulated social stressor, a public speaking
      task, and we measured the psychometric attributes that are indicators of social
      assertiveness and extraversion. RESULTS: Before, during and after the stress of
      public speaking, patients with multiple pituitary hormone deficiencies (n = 20)
      had lower mean systolic and diastolic blood pressures than controls, while
      patients with isolated growth hormone deficiency (n = 5) were equivalent to
      controls. The reactivity to stress, assessed using delta scores based on changes
      in blood pressure and heart rate, was also decreased in multiple hormone
      deficient patients. Psychometric test results indicated that patients with
      multiple hormone deficiencies showed lower openness, lower assertiveness, greater
      neuroticism and a tendency towards less extraversion than did controls. The
      responses of patients with isolated GH deficiency on the psychometric tests were
      not statistically different from controls, but the number of subjects in this
      group (n = 5) was too small to draw conclusions. CONCLUSIONS: The impaired
      cardiovascular responses to stress in patients with multiple hormone
      deficiencies, compared to short control subjects and to patients with GH
      deficiency leads us to conclude that factors other than stature and GH are
      responsible for these observations. The differences might be related to
      insufficiency of catecholamines or cortisol in the patients with multiple hormone
      deficiencies. These hormonal deficiencies might also account for the socially
      inhibited behaviour of these patients. Our results suggest that more attention
      needs to be directed at preparing hypopituitary patients for the challenges of
      adulthood. Also, these patients may be helped by more intensive efforts at
      hormonal replacement in adulthood.

PMID- 1617798
TI  - Abnormalities of the hypothalamo-pituitary-gonadal axis after head injury.
AB  - OBJECTIVE: We aimed to investigate the mechanisms of hypogonadism which develops
      after head injury. DESIGN: Pulsatile secretion of LH was studied in subjects 6-10
      days after major head injury. PATIENTS: We studied five male subjects admitted
      with major head injuries and six healthy age-matched control subjects.
      MEASUREMENTS: During the pulsatility study, LH was measured at 5-minute intervals
      for 4 hours and 15-minute intervals for a further 2 hours. In addition,
      testosterone and LH were measured on Days 1-5, 14 and after 3-6 months. RESULTS:
      The analysis of pulsatile secretion of LH demonstrated an LH pulse frequency
      similar to control subjects, but a significantly reduced LH pulse amplitude (P
      less than 0.001, fixed threshold method; P less than 0.02, Detect method). Both
      testosterone and LH levels were reduced after injury with the nadir occurring on
      Day 4. CONCLUSIONS: Hypogonadism after head injury is due to defective LH
      secretion, with normal pulse frequency but a reduced pulse amplitude.

PMID- 1617799
TI  - Differential effects of arginine on growth hormone releasing hormone and insulin
      induced growth hormone secretion.
AB  - OBJECTIVE: We wished to investigate the interaction of arginine, GHRH and insulin
      stress on GH secretion. DESIGN: Six healthy, non-obese volunteers underwent seven
      separate studes in random order. They received (1) insulin alone at 0 minutes;
      (2) GHRH alone at 15 minutes; (3) arginine alone at 0-30 minutes; (4) arginine at
      0-30 minutes and GHRH at 15 minutes; (5) insulin at 0 minutes and arginine at 0
      30 minutes; (6) insulin at 0 minutes, GHRH at 15 minutes and arginine at 0-30
      minutes; (7) insulin at 0 minutes and GHRH at 15 minutes. MEASUREMENTS: GH and
      PRL were measured from -30 to 150 minutes at intervals of 15 minutes. RESULTS:
      Arginine increased GH responses to GHRH and decreased GH responses to
      hypoglycaemia, but this inhibitory effect of arginine was reversed by GHRH.
      CONCLUSIONS: The findings suggest that arginine-induced GH release is mainly
      mediated by a decrease in somatostatinergic tone, while GH responses to insulin
      stress are probably mediated by both an increase in hypothalamic GHRH release and
      inhibition of somatostatin.

PMID- 1617800
TI  - Percutaneous ethanol injection treatment of autonomous thyroid adenoma: hormonal
      and clinical evaluation.
AB  - OBJECTIVE: We have evaluated the efficacy of percutaneous ethanol injection as an
      alternative to surgery and iodine-131 treatment in solitary autonomous thyroid
      adenoma. DESIGN: Percutaneous ethanol injection (0.5-2.8 ml ethanol/ml nodular
      tissue) was performed under sonographic guidance in 3-5 (1-2 weekly) sessions; a
      7.5 MHz linear real-time scanner (Toshiba, mod. 32B) was used for sonographic
      studies. The thyroid hormone profile was assessed during treatment and for the
      next 6 months. PATIENTS: Fifty-six patients (40 females, 16 males, mean age 46 +/
      SD 9 years; 30 pretoxic, 26 toxic) were included in the study: their
      pretreatment technetium-99 m thyroid scan showed a single hot nodule with total
      suppression of extranodular tissue in 45 and near-total suppression in 11.
      MEASUREMENTS: Thyroid hormones, antithyroglobulin and antiperoxidase antibodies
      were measured by specific radioimmunoassay, while thyrotrophin was evaluated by
      ultrasensitive immunoradiometric assay. RESULTS: Apart from a case of transient
      pyrexia, no relevant adverse effects were observed. A slight thyroid hormone
      increase was seen in both groups immediately following a treatment. Six months
      after therapy a biochemical and clinical remission of hyperthyroidism was
      observed in 18 out of 22 toxic patients (81.8%); a significant increase of TSH
      levels was seen in both groups (P less than 0.01). With follow-up, significant
      volume shrinkage (P less than 0.001) as well as structural alterations of the
      nodule were consistently recorded at sonography; a linear relationship (r = 0.98;
      P less than 0.0001) between pretreatment volume and volume reduction was found.
      At scintiscan, functional activity of extranodular parenchyma was found in 40 out
      of 56 patients (71.4%), 16/26 (61.5%) in the hyperthyroid group, 24/30 (80.0%) in
      the pretoxic group. CONCLUSIONS: These data confirm that percutaneous ethanol
      injection is effective in obtaining functional ablation and in inducing remission
      of hyperthyroidism, when present; adverse effects seem infrequent.

PMID- 1617801
TI  - Re-evaluation of the captopril test for the diagnosis of primary
      hyperaldosteronism.
AB  - OBJECTIVE: We aimed to re-evaluate the captopril test in the diagnosis of primary
      hyperaldosteronism. DESIGN: Serum aldosterone and plasma renin activity were
      measured supine prior to and 60, 90, 120 minutes after oral captopril, 25 mg.
      PATIENTS: We have performed this test in ten patients with primary
      hyperaldosteronism, two with hypertension and secondary hyperaldosteronism and in
      ten normokalaemic patients with essential hypertension. MEASUREMENTS: Validity
      was assessed by mathematical prediction methods. RESULTS: Using a ratio of
      aldosterone to plasma renin activity greater than or equal to 1400 pmol/l per
      microgram/ml/h as a predictor of primary hyperaldosteronism, the captopril test
      had a sensitivity of 100%, a specificity of 83% and a predictive value of 82%
      with a 60-minute post captopril evaluation being sufficient. Nevertheless, this
      test was only marginally superior to a careful analysis of the supine values
      where a similar ratio in the presence of a normal or suppressed plasma renin
      activity predicted primary hyperaldosteronism with a sensitivity also of 100% but
      a slightly lower specificity of 75% and predictive value of 77%. CONCLUSION:
      Application of the captopril test to patients identified as abnormal by screening
      confirms all cases of primary hyperaldosteronism but false positive or equivocal
      results, necessitating further investigation, may occur in some patients with
      essential hypertension.

PMID- 1617802
TI  - Follow-up of ovarian endocrine function in premenopausal women after hysterectomy
      by daily measurements of salivary progesterone.
AB  - OBJECTIVE: The effect of hysterectomy on ovarian endocrine function of
      premenopausal women was studied. DESIGN: The patients collected daily salivary
      samples during one preoperative cycle (1), the cycle of operation (2), the
      subsequent period of 30 days (3) and the cycle 6 months after operation (4).
      PATIENTS: Forty-one premenopausal women (aged 33-48 years) undergoing
      hysterectomy were studied; their preoperative cycles served as controls. The
      patients were also compared with a reference group of 17 younger fertile women.
      MEASUREMENTS: Salivary progesterone levels were measured by radioimmunoassay.
      RESULTS: Cycle 1 was more frequently short (P less than 0.01), with short luteal
      phase (P less than 0.01) and low progesterone secretion (P less than 0.05), than
      the cycles of younger women. Cycle 2 was longer than the other cycles (P less
      than 0.01), due to prolonged follicular phase (P less than 0.01). Cycle 3
      differed from cycle 1 by the lesser frequency of short cycles (P less than 0.01).
      Cycle 4 and its follicular phase were longer than those measured in cycle 1 (P
      less than 0.05). Of the women with normal cycle 1, 39% (P less than 0.01)
      presented with luteal insufficiency (LPD, low luteal progesterone secretion) or
      anovulation (8%) in at least one of cycles 2 to 4. The frequency of LPD or
      anovulation was significantly higher in cycle 3 (P less than 0.05) but not in
      cycle 4, compared to 1. CONCLUSIONS: Acute luteal progesterone deficiency after
      hysterectomy in premenopausal women is common but in most cases reversible.

PMID- 1617803
TI  - Determination of bone mineral density by quantitative computed tomography and
      single photon absorptiometry in subclinical hyperthyroidism: a risk of early
      osteopaenia in post-menopausal women.
AB  - OBJECTIVE: There is evidence that treatment with L-thyroxine increases the risk
      of early osteopaenia. The aim of our study was to investigate the effect of
      subclinical hyperthyroidism in patients on TSH-suppressive L-thyroxine in view of
      the increased risk of decalcification. DESIGN: Measurements of bone mineral
      density were performed in patients with subclinical hyperthyroidism at different
      scanning sites of varying trabecular portion. Bone mineral values as well as
      biochemical data were compared to those of normal controls. PATIENTS: Fifty
      patients (nine men, 25 premenopausal and 16 post-menopausal women) on TSH
      suppressive doses of L-thyroxine were investigated after removal of thyroid
      cancer. MEASUREMENTS: Dual energy quantitative computed tomography was used for
      osteodensitometry in the lumbar spine. Single photon absorptiometry from a 125I
      source was applied to the calcaneus, midshaft radius and distal as well as
      proximal scanning sites of the distal radius. Normal bone mineral values for each
      measurement site were taken from healthy reference populations. RESULTS: A
      significant decrease of bone mineral density in the calcaneus was found in 26 of
      50 patients. Bone mass assessment yielded a 9.1% decrease of mean bone mineral
      content in all patients compared to controls (P less than 0.01). The decrease in
      post-menopausal women was 22% (P less than 0.001). In premenopausal women bone
      mineral density changes in the calcaneus were not statistically significant.
      Cortical measurement sites like the midshaft radius and the proximal scanning
      site of the distal forearm showed a 14.8% (P less than 0.05) and 10.8% (P = NS)
      decalcification in post-menopausal women but normal values at the distal scanning
      site. The lumbar spine was not affected by subclinical hyperthyroidism in either
      pre or post-menopausal women. In hypoparathyroid patients, bone density did not
      essentially differ from normals. There was no significant correlation between
      bone mineral values and duration of treatment or osteocalcin values. CONCLUSIONS:
      Our data suggest that TSH suppressive L-thyroxine treatment has a detrimental
      effect on the appendicular skeleton in post-menopausal women. Additional effects
      of oestrogen deficiency and subclinical hyperthyroidism might lead to accelerated
      bone loss requiring close supervision to determine the smallest dose needed for
      suppression of the pituitary-thyroid axis.

PMID- 1617805
TI  - Leydig cell hypoplasia leading to two different phenotypes: male
      pseudohermaphroditism and primary hypogonadism not associated with this.

PMID- 1617804
TI  - Primary adrenocortical failure masked by exogenous steroid administration.

PMID- 1617806
TI  - Oculocutaneous diseases I.

PMID- 1617807
TI  - Human ocular anatomy.
AB  - An understanding of the anatomy of the eye is the sine qua non for an
      appreciation of the pathophysiology of ocular disease. This introductory article
      is a brief review and elucidation of the pertinent aspects of ocular anatomy.
      Also included is a glossary of opthalmologic terms that may help clarify some of
      the more esoteric terminology as the reader peruses the various articles in this
      issue.

PMID- 1617808
TI  - Cutaneous and ocular ramifications of ultraviolet radiation.
AB  - In this article,the uses of photobiologic techniques such as ultraviolet B
      radiation and PUVA are discussed, as is a general review of their potential acute
      and chronic side effects. The authors then focus, in more extensive detail, on
      the potential acute and chronic ocular toxicity associated with these modalities.

PMID- 1617809
TI  - Ocular effects of topical and systemic steroids.
AB  - Topical and systemic steroids have proven to be invaluable agents in the
      treatment of a wide range of disorders, but their use is not without potential
      complications. Before initiation of therapy with systemic steroids, a personal or
      family history of cataracts, glaucoma, hypertension, diabetes, hyperlipidemia,
      renal stones, peptic ulceration, and current infection or pregnancy should be
      ascertained, because these patients have an increased risk of complications.
      Prior to long-term therapy with systemic steroids, blood pressure measurement,
      tuberculin skin test, and anergy panel are recommended. Monthly follow-up may
      include measurements of weight, blood pressure, electrolytes, and blood sugar and
      guaiac testing of the stool. To prevent the ocular complications of steroid
      therapy, routine screening is indicated (Table 1). Screening for cataracts, which
      occur most commonly as a sequela of continuous systemic steroid use, may be
      performed by slit-lamp examinations conducted three or four times a year for
      patients on long-term therapy and twice a year for patients taking intermittent
      topical ocular or systemic steroids. Glaucoma is more often associated with
      topical ocular or periocular steroids than with systemic steroids; recommended
      screening includes a baseline intraocular pressure measurement, then routine
      pressure measurements taken every few weeks initially, then every few months.
      Ocular rebound inflammation may develop secondary to rapid tapering or abrupt
      discontinuation of topical ocular steroid use and is best prevented with gradual
      tapering. Opportunistic infections of the eye include bacterial, viral, and
      fungal infections and are most often associated with the use of topical ocular
      steroids. Ophthalmologic evaluation is indicated promptly if patients treated
      with ocular steroids develop ocular discharge, pain, photophobia, or redness.

PMID- 1617810
TI  - Antimalarial agents and the eye.
AB  - Antimalarial compounds have been demonstrated to be both safe and efficacious in
      the treatment of lupus erythematosus as well as several other dermatologic
      conditions. It is imperative, however, that physicians familiarize themselves
      with the potential complications associated with the use of these agents.
      Furthermore, it is essential that a successful collaborative relationship be
      developed between the dermatologist and the ophthalmologist who are to treat and
      monitor the patient to avoid any untoward complications that might afflict the
      patient. It is important to stress that patients on antimalarial drug therapy be
      evaluated by an ophthalmologist prior to starting treatment and every 4 to 6
      months thereafter. The use of Amsler's grids in compliant patients is
      recommended. If the patient develops retinal changes consistent with the
      diagnosis of premaculopathy, then careful consideration should be given to the
      availability and use of alternative agents.

PMID- 1617811
TI  - Retinoids and the eye.
AB  - Systemic retinoids are being used more frequently to treat various disorders of
      the skin, particularly disorders of keratinization. They are promising agents for
      chemoprevention of cancer and as such may be widely used in the future. Both
      natural and synthetic retinoids may affect the eye, both on the surface
      epithelium and the visual metabolism. Three basic effects of pharmacologic doses
      of synthetic retinoids have been seen. Blepharoconjunctivitis has been
      particularly prominent with isotretinoin use. Pseudotumor cerebri has been
      reported sporadically. Recently, night blindness has been reported with both
      isotretinoin and fenretinide. The greater use of isotretinoin may be more
      important in explaining the increased incidence of these side effects than is the
      individual metabolism of the different available synthetic retinoids. These three
      major side effects of the eye will be carefully evaluated as newer synthetic
      retinoids are proposed for further trials. Fortunately, it seems that all of
      these ocular manifestations are dose dependent and reversible, giving the
      clinician several alternatives to adjust the treatment regimen.

PMID- 1617812
TI  - Upper eyelid dermatosis syndrome.
AB  - UEDS is a complex, fascinating syndrome that, when approached in its totality,
      can often produce a satisfactory resolution for the patient. Clearly, we have
      much to learn.

PMID- 1617813
TI  - Immunobullous diseases with ocular involvement.
AB  - Collaborative efforts of the dermatologist and ophthalmologist and other
      physicians with interest and experience in the management of the autoimmune
      bullous diseases optimize patient care by avoiding potentially harmful delay in
      diagnosis or implementation of therapy. At our institution, ophthalmologic and
      dermatologic follow-up visits for patients with bullous disorders involving the
      eyes are arranged for the same day so that ophthalmic examination and monitoring
      and adjustment of medication by the dermatologist can be effected. During
      initiation of treatment, visits are monthly. Later, when patients are stabilized,
      intervals may be extended to 3 to 6 months. More frequent visits are arranged as
      needed with the ophthalmologist to manage infectious complications or problems
      requiring surgical management and with the dermatologist to manage extraocular
      disease and adverse reactions to medication and to triage concurrent illnesses.

PMID- 1617814
TI  - Oculocutaneous manifestations of the erythema multiforme/Stevens-Johnson
      syndrome/toxic epidermal necrolysis spectrum.
AB  - Although they were once believed to be distinct diseases, many observers
      currently consider erythema multiforme, Stevens-Johnson syndrome, and toxic
      epidermal necrolysis to represent a mild-to-severe continuum of the same process.
      Each shares certain clinical, histologic, and etiologic characteristics; among
      the latter two are frequent ocular involvement. Because long-term ophthalmic
      sequelae may be catastrophic, early recognition and therapy of this acute
      oculocutaneous disease spectrum are critically important.

PMID- 1617815
TI  - Genetic disorders of the skin and eye.
AB  - This article discusses some of the most uncommon diseases ever seen by the
      ophthalmologist or dermatologist. Some of these conditions can cause irreparable
      eye damage if not recognized and treated early after their inception.

PMID- 1617816
TI  - Ocular and cutaneous manifestations of heritable disorders of collagen and
      elastic tissue.
AB  - Ocular and cutaneous stigmata are hallmarks of the heritable disorders of
      collagen and elastic tissue. Awareness of the oculocutaneous features is
      essential both to aid diagnosis and to direct management of affected patients.
      Although the angioid streaks of PXE, blue sclerae of OI, ocular fragility of EDS
      and ectopia lentis of Marfan syndrome are the best-known ocular signs of these
      disorders, other relevant ophthalmologic symptoms often accompany such classic
      findings.

PMID- 1617817
TI  - Ichthyoses and hyperkeratotic disorders.
AB  - Many of the ichthyotic disorders have characteristic ocular findings. These
      disorders include X-linked ichthyosis, lamellar ichthyosis, Sjogren-Larsson
      syndrome, KID syndrome, Refsum's disease, neutral lipid storage disease,
      chondrodysplasia punctata, and Richner-Hanhart syndrome. A knowledge of the
      ocular manifestations may provide a valuable aid to diagnosis in difficult cases.
      In some cases, knowledge of the ocular complications results in early referral
      for optimal ophthalmologic care.

PMID- 1617818
TI  - Ocular manifestations of pigmentary disorders.
AB  - Disorders of pigmentation can result from either an abnormal number of
      melanocytes, as in nevus of Ota and vitiligo, or an abnormal amount of melanin
      production, as in albinism. Melanin-producing cells are found in the skin, mucous
      membranes, uveal tract, and retinal pigment epithelium of the eye and the stria
      vascularis of the inner ear. Thus, many of the hereditary or congenital
      pigmentary disorders of the skin are associated with similar pigmentary
      abnormalities in the eye, such as iris heterochromia or changes in pigmentation
      of the fundus; however, more commonly, the associated eye finding is a defect in
      ocular motility, i.e., strabismus and nystagmus, suggesting a concomitant defect
      in neurologic development. In albinos, the observed neurologic abnormality in the
      visual pathway and foveal hypoplasia are hypothesized to be related directly to
      the lack of melanin in the pigment epithelium during development. In acquired
      disorders of pigmentation, in particular, vitiligo, Vogt-Koyanagi-Harada
      syndrome, and onchocerciasis, there is a frequent association with uveitis,
      suggesting an inflammatory cause for the cutaneous pigmentary changes.

PMID- 1617819
TI  - Ocular and dermatologic manifestation of neurocutaneous syndromes.
AB  - The dermatologic and ophthalmologic manifestations of neurocutaneous syndromes
      are numerous and varied, but familiarity with them is essential to the clinician
      from any specialty who may have to deal with these disorders. Although many of
      their complications are unfortunately still difficult or impossible to treat
      effectively, there may be significant benefit to the patient from prompt
      detection of optic glioma in NF, retinal angiomas in VHL disease, and glaucoma in
      SWS. Recognition of characteristic lesions of skin and eye in individuals with
      mild expressions of NF and TS is essential for genetic counseling. For affected
      children and their parents, early diagnosis (based on sometimes subtle findings)
      and formulation of a complete and accurate prognosis can considerably ease the
      burden imposed by any of these conditions.

PMID- 1617820
TI  - The value and promise of echocardiography in acute myocardial infarction and
      coronary artery disease.
AB  - Two-dimensional and Doppler echocardiography have become extremely useful in the
      management of patients with acute myocardial infarction (AMI). Echocardiography
      is noninvasive, relatively inexpensive, and has no known biohazards. It offers
      unequaled information about cardiac anatomy and function. In the acute setting it
      is useful in the diagnosis of AMI and its complications. It is an excellent tool
      for monitoring therapy. Echocardiography has been shown to be useful in risk
      stratification upon presentation to the emergency ward and prior to hospital
      discharge. Stress echocardiography has broadened and sharpened the diagnostic and
      prognostic information. Contrast echocardiography has promise for demonstrating
      coronary artery flow. Research in ultrasonic myocardial tissue characterization
      shows potential for differentiating ischemic myocardium from infarcted
      myocardium. Thus, echocardiography is likely to become increasingly important in
      the future management of patients with AMI.

PMID- 1617821
TI  - Effects of captopril on regional segment motion during acute coronary occlusion.
AB  - The effects of captopril on myocardial segment function in different degrees of
      transient coronary occlusion were studied using ultrasonic dimension gauges in 15
      open-chest dogs. The occlusion procedures (OP) were performed on the left
      anterior descending coronary artery (LAD) in eight dogs and on the left
      circumflex coronary artery (Cx) in seven dogs. To measure the changes in segment
      shortening in the subendocardium we used eight dogs (ischemic and control zones:
      four dogs LAD and four dogs Cx). To measure the changes in wall thickening we
      used seven dogs (ischemic and control zones: three dogs LAD and four dogs Cx).
      Total coronary OP lasting 1 min and partial OP (70-80%) lasting 1 min and 2 min
      30 s, before and after captopril (0.25 mg/kg i.v.) were performed. Left
      ventricular pressure, dP/dt, coronary flow, and ECG were monitored. Total
      coronary OP (1 min) changed segment shortening (18% LAD; 14% Cx) and wall
      thickening (19% LAD; 18% Cx) to values of dyskinesis (-3% and -4% for shortening;
      -6% and -5% for thickening). Captopril improved regional function maintaining
      positive values for shortening (4% LAD; 3% Cx) and thickening (0.3% LAD; 4% Cx).
      Similar responses were obtained during partial OP and captopril. Results suggest
      that captopril produced a significant improvement in the regional function
      parameters affected by ischemia both in total and partial obstructions.

PMID- 1617822
TI  - Comparative effects of pravastatin and lovastatin on nighttime sleep and daytime
      performance.
AB  - Pravastatin and lovastatin, two HMG-CoA reductase inhibitors with similar
      cholesterol-lowering effects, differ in their lipid solubility. The hydrophilic
      characteristics of pravastatin may explain why the drug has not been detected in
      cerebrospinal fluid. On the other hand, lovastatin, a lipophilic compound, has
      been detected in the cerebrospinal fluid. Previous reports have suggested that
      lovastatin administration may be associated with insomnia, which reflects an
      action in the central nervous system. The effects of the two drugs on nocturnal
      sleep and day-time performance in young, healthy men have been assessed in
      randomized, double-blind, placebo-controlled studies. Computer-based performance
      tests were administered on two consecutive days before drug administration and at
      the end of a 3-week active drug or placebo treatment period. Results from both
      sites were combined for analysis. Neither pravastatin nor lovastatin
      significantly affected nocturnal sleep or daytime sleepiness in this study
      population, but lovastatin significantly affected daytime performance. In
      subjects treated with lovastatin, the results showed that two measures of
      performance, divided attention (p less than 0.05) and vigilance (p less than
      0.01), worsened significantly from baseline as did global performance (p less
      than 0.01). Performance was not affected in the pravastatin and placebo groups.
      These results provide preliminary evidence of an adverse effect of lovastatin on
      daytime performance.

PMID- 1617823
TI  - Myocardial systolic function in systemic lupus erythematosus: a study based on
      radionuclide ventriculography.
AB  - We assessed left ventricular systolic function by means of radionuclide
      ventriculography in 20 consecutive unselected patients with systemic lupus
      erythematosus. All patients had normal left ventricular systolic function
      (defined as ejection fraction greater than 45%) in a resting state. Regional wall
      motion abnormalities were, however, seen in 4 patients (20%). Of these 20
      patients, 8 were able to exercise on a bicycle ergometer. These patients were
      subjected to exercise radionuclide ventriculography. Of these 8 patients, 3
      (37.5%) had an abnormal ventriculographic response to exercise (as evidenced by a
      subnormal rise in ejection fraction or a fall, appearance of a new regional wall
      motion abnormality or worsening of a pre-existing one). This probably reflects
      subclinical left ventricular dysfunction unmasked by the stress of exercise. The
      clinical significance of these abnormalities on long-term myocardial function and
      their possible reversibility with remission of the disease needs to be assessed
      in future studies.

PMID- 1617824
TI  - Coronary heart disease risk factors in Hansen's disease sufferers.
AB  - In the frame of an epidemiologic study of Hansen's disease (HD) sufferers,
      several risk factors have been investigated which might explain the high
      prevalence of coronary heart disease (CHD) among HD patients. The data analyzed
      in the present study are derived from 293 HD patients (157 men and 136 women).
      The patients, after having completed a WHO adopted questionnaire, were given a
      complete physical examination, a resting and an exercise electrocardiogram, and
      biochemical as well as hematological examinations. Coronary HD patients, when
      compared to noncoronary HD patients, showed statistically significant differences
      in the following parameters: (1) mean age, (2) mean concentration of the
      electrophoretic fraction of alpha-lipoproteins, (3) deviation from mean weight,
      (4) prevalence of hypertension, and (5) prevalence of the borderline lepromatous
      form of HD. However, the differences found when comparing other parameters, such
      as blood pressure, smoking, diabetes mellitus, total cholesterol, triglycerides,
      pre-beta and beta-lipoproteins, uric acid, erythrocyte sedimentation rate, ABO
      blood groups, etc., did not reach the level of significance. These findings
      suggest that HD sufferers are a special population subgroup with reference to CHD
      risk factors, differing in many ways from the general population.

PMID- 1617825
TI  - Direct current cardioversion of established atrial fibrillation.
AB  - Restoration and maintenance of sinus rhythm is a desirable end point in patients
      with chronic atrial fibrillation. If clinically indicated, external cardioversion
      using direct current is the method of choice in most centers. The results range
      from 20 to 90% and are highly influenced by the underlying etiology. A number of
      determinants including age, duration of atrial fibrillation, and size of left
      atrium are usually taken into account in the indications but have been recently
      questioned. The use of prophylactic antiarrhythmic therapy has been shown to
      reduce the recurrence of atrial fibrillation significantly, but concerns remain
      regarding the safety of this treatment. In patients who failed external
      cardioversion, shocks delivered within the right atrium according to a recently
      described technique may be attempted. The initial results are promising, as 83%
      of patients are successfully cardioverted and 46% of patients are in sinus rhythm
      at 12 months. This new technique offers an additional alternative in patients
      with chronic atrial fibrillation and may therefore reduce the incidence of
      frightening embolic complications.

PMID- 1617826
TI  - Anatomy, histology, and pathology of coronary arteries: a review relevant to new
      interventional and imaging techniques--Part I.
AB  - In the last 15 years, intense interest has focused on various interventional
      pharmacologic and mechanical forms of therapy for the treatment of
      atherosclerosis coronary artery disease. Many techniques and devices (dilating
      balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy
      devices, stents, intravascular ultrasound) have been used or are under study for
      future use. Many of these techniques and devices require an understanding of
      histologic and pathologic features of the coronary arteries and diseases which
      affect them. This article reviews selective areas of anatomy, histology, and
      pathology relevant to the use of various new interventional techniques. Part I of
      this review will focus on anatomic aspects of the epicardial coronary artery
      system, coronary arterial distribution, myocardial supply, and histologic
      features of the normal coronary artery.

PMID- 1617827
TI  - Isolated left main coronary stenosis and mediastinal irradiation.
AB  - This report draws an association between mediastinal irradiation and isolated
      left main coronary artery stenosis. The report highlights two patients who
      developed selective left main coronary artery stenosis post mediastinal
      treatment. In the animal model, it has been shown that high serum cholesterol
      levels at the time of, or soon after, irradiation are necessary to initiate
      arteriosclerotic plaque formation.

PMID- 1617828
TI  - Use of transesophageal echocardiography to visualize an anomalous right coronary
      artery arising from the left main coronary artery (single coronary artery).
AB  - This case report demonstrates a role for transesophageal echocardiography in
      defining the course of anomalous coronary arteries. Origin of the right coronary
      artery (RCA) from the left main (LM) (single coronary artery) is an exceedingly
      rare congenital anomaly. It is not always benign and may result in myocardial
      infarction. This may be due to compression between the aorta and the pulmonary
      artery. Transesophageal echocardiography offers a low-risk, noninvasive means of
      imaging the proximal coronary arteries. In the majority of patients, the proximal
      segments of the three major coronaries can be clearly visualized. With the
      addition of color flow, it is possible to visualize flow in most patients.
      Proximal obstructive lesions can be seen in some patients although sensitivity
      thus far seems low.

PMID- 1617829
TI  - Anomalous origin of left coronary artery from the pulmonary artery: evolution of
      left ventricular function and perfusion after surgery in a 44-year-old man.
AB  - Anomalous origin of left coronary vessel from the pulmonary artery is an almost
      universally fatal form of congenital heart disease unless appropriate corrective
      surgery is performed at an early age. A case was diagnosed in a symptomatic 44
      year-old man who presented an impairment of systolic left ventricular function.
      The abnormality was successfully treated with ligation of the left coronary
      artery combined with left internal mammary artery anastomosis. Left ventricular
      function improved dramatically six months after surgery, both at rest and during
      exercise. Such an evolution suggests that surgery may be indicated not only in
      infants but also in adults with this congenital heart abnormality.

PMID- 1617830
TI  - Ventricular tachycardia of right bundle-branch block--left axis deviation
      morphology and organic heart disease.
AB  - Most series of patients with ventricular tachycardia (VT) of right bundle-branch
      block (RBBB)-left axis deviation (LAD) morphology include young individuals with
      no overt evidence of structural heart disease. In the present report, the
      clinical and electrophysiologic findings in two patients with verapamil
      responsive VT and organic heart disease are described.

PMID- 1617831
TI  - Samuel A. Levine (1891-1966).

PMID- 1617832
TI  - Immunotherapy of mammary adenocarcinoma metastases in C3H/HeN mice with chronic
      administration of cyclo-oxygenase inhibitors alone or in combination with IL-2.
AB  - In this study the efficacy of treatment of two cyclo-oxygenase inhibitors,
      ibuprofen (Ibu) and indomethacin (Indo), are compared in the immunotherapy of
      metastasis designed to reverse prostaglandin E2 (PGE2)-mediated inactivation of
      interleukin-2 (IL-2)-dependent host killer cell lineages. These agents were
      tested either alone for the prevention of metastasis or in combination with IL-2
      for the eradication of established metastasis. C3H/HeN mice were placed on
      chronic oral Ibu (CIbT; 200 and 600 micrograms/ml of water) or Indo (CIT; 10
      micrograms/ml) 5 days after s.c. transplantation of 5 x 10(5) metastatic C3L5
      mammary carcinoma for the prevention of spontaneous lung metastases. They showed
      intolerance to Indo at a dosage of 14 micrograms/ml, which was well tolerated by
      other mouse strains in previous studies, but tolerated the Ibu dosages used.
      Control and treated mice were killed on day 30 to score metastatic lung colonies,
      to evaluate killer activity in splenocytes against natural killer (NK)-sensitive
      YAC-1 lymphoma or NK-resistant C3L5 adenocarcinoma and 8911 lymphoma targets, and
      to phenotype the surface markers of killer cells. CIbT and CIT alone at the above
      dosage significantly reduced the number of lung colonies, retarded local tumor
      growth and restored NK activity of splenic killer cells expressing AGM-1+, Thy-1
      , Lyt-2- phenotype. To treat established lung metastasis, mice bearing 15-day
      C3L5 transplants were given CIbT or CIT alone or in combination with two 4-day
      rounds (days 20-23, 31-34) of IL-2 (15,000 Cetus units, i.p. every 8 h) and were
      killed on day 35 to score lung colonies and characterize splenic killer cells.
      CIbT or CIT alone reduced the number of spontaneous lung metastases and restored
      anti-YAC-1 killer function of splenocytes with NK-like phenotype (AGM-1+, Thy-1-,
      Lyt-2-); some anti-C3L5 killer function was also generated in the high dose Ibu
      group and the killer cell showed AGM-1+, Thy-1+ and Lyt-2+ phenotype. Combined
      therapies with CIbT or CIT plus IL-2 were more effective in reducing metastases
      and promoting killer cell function, the best results being achieved with high
      dose Ibu+IL-2. All killer cells expressed AGM-1 and Thy-1. In addition, C3L5
      killer cells also expressed Lyt-2, suggesting T-cell stimulation. PGE2 synthesis
      in the host was inhibited by at least 50% in mice subjected to CIbT or
      CIT.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1617833
TI  - Metastasizing lung carcinomas in Hann: Wistar rats.
AB  - In Hann:Wistar rats, 25 weekly subcutaneous injections of dipentylnitrosamine
      (DPNA) at doses of 0, 62.5, 125 and 250 mg/kg body weight induced lung carcinomas
      which metastasized partly. The incidence of the primaries was 2.5, 20.0, 77.5 and
      100% in the males and 0, 0, 12.5 and 57.5% in the females, respectively. The
      frequency of metastases was 0, 12.5, 38.7 and 72.5% in the males and 0, 0, 40.0
      and 52.2% in the females, respectively. The most common metastatic sites in males
      and females together were: lung-associated lymph nodes (82.1%), adrenal gland
      (53.6%), kidney (39.3%), pancreas (32.1%), bones (16.1%), heart (12.5%),
      mesentery (12.5%) and CNS (8.9%). In the females, metastases were also detected
      in the uterus (21.4%) and ovary (42.9%). The results indicate that: (1) through
      subcutaneous injections of DPNA metastasizing lung carcinomas can be induced with
      high incidence, and (2) the metastatic pattern is very similar to human cases.
      Thus, this model could be useful for the study of metastasizing lung carcinomas
      in experimental animals.

PMID- 1617834
TI  - A YIGSR-containing novel mutein without the detrimental effect of human TNF-alpha
      of enhancing experimental pulmonary metastasis.
AB  - The injection of B16F10 melanoma cells with recombinant human tumor necrosis
      factor alpha (TNF-alpha) into the tail vein of C57BL/6 mice resulted in 2- to 25
      fold more metastatic foci in the lungs than the injection of tumor cells alone.
      Clearly, TNF-alpha significantly enhanced experimental tumor metastasis.
      Furthermore, it enhanced the metastasis of Lewis lung carcinoma cells. In
      contrast, a mutein of TNF-alpha, designated as F4236, having the cell-adhesive
      sequence (Tyr-Ile-Gly-Ser-Arg) at the N-terminus of the TNF molecule did not
      enhance metastasis, but rather exhibited similar antitumor activity to wild-type
      TNF-alpha in fibrosarcoma-bearing mice.

PMID- 1617835
TI  - Na[trans-RuCl4(DMSO)Im], a metal complex of ruthenium with antimetastatic
      properties.
AB  - The antitumor and antimetastatic effects of a ruthenium(III) complex, Na[trans
      RuCl4(DMSO)Im], have been examined in mice bearing MCa mammary carcinoma.
      Na[trans-RuCl4(DMSO)Im] is capable of reducing primary tumor growth and of
      prolonging the survival time with different schedules of administration. However,
      better effects were obtained (a) with treatments started soon after tumor
      implantation, (b) with daily administration rather than with treatments at 4-day
      intervals and (c) using relatively low daily doses. The prolongation of survival
      time in tumor-bearing hosts, greater than that obtained with cisplatin, cannot be
      simply related to the effect on primary tumor growth, always less than that of
      cisplatin. Rather, emphasis is placed on the reduction of lung metastasis
      formation, obtained either by i.v. injection of tumor cells (lung colonization or
      spontaneously from i.m. tumor implants, which is significantly greater than the
      reduction of primary tumor growth. The antimetastatic effect depends on the
      treatment schedule and is greater with low doses given daily than with high doses
      administrated with drug-free intervals. Metastasis reduction involved mainly
      large metastatic nodules, reducing the average weight of each metastasis by 8
      fold for spontaneous metastases and by 5-fold for lung colonies. The
      antimetastatic action of Na[trans-RuCl4(DMSO)Im] thus indicates the possibility
      that related analogs can represent a new generation of antitumor compounds
      capable of selectively interacting with metastasis formation of solid tumors.

PMID- 1617836
TI  - Esophageal dysmotility as a serendipitous observation on ventilation-perfusion
      imaging of the lungs.
AB  - Tc-99m DTPA aerosol is often swallowed during inhalation for lung ventilation
      scans. The authors evaluated a 16-year-old girl with a known history of mixed
      collagen disorder (positive lupus anticoagulants) for symptoms of cough and acute
      shortness of breath. Tc-99m DTPA accumulated in the distal esophagus during
      aerosol inhalation and remained there at the end of the perfusion study, a period
      of approximately 1 hour. This serendipitous observation antedates clinical signs
      and symptoms of dysphagia.

PMID- 1617837
TI  - High-resolution bone scintigraphy of the adult wrist.
AB  - Bony anatomic landmarks of the wrist (e.g., pisiform, hook of hamate, radioulnar
      joint, and styloid processes of the radius and ulna) were routinely identified in
      28 adult patients examined for wrist pain. With the wrists prone and immobilized,
      bone scintigrams were obtained for 500,000 counts with an asymmetric (133 to 161
      keV) Tc-99m energy window and either a converging (best choice) or straight-bore,
      high-resolution collimator. High-resolution scintigraphy precisely localized
      degenerative joint disease (nine patients), scaphoid fractures (five), pisiform
      fracture (one), lunate avascular necrosis (one), radioulnar arthritis (one),
      septic or inflammatory arthritis (six), ulnocarpal impingement (two), and reflex
      sympathetic dystrophy syndrome (two). Images obtained palm down with the wrist in
      ulnar deviation helped identify increased uptake within the scaphoid. Fracture
      and significant bone or joint disease were excluded in one patient.

PMID- 1617838
TI  - Evaluation of sensitivity and specificity of upper extremity radionuclide
      venography in cancer patients with indwelling central venous catheters.
AB  - Two hundred twenty upper extremity radionuclide venograms were performed using
      upper extremity injection of 5 mCi of Tc-99m DTPA in each arm of patients with
      indwelling central lines. Evidence of obstruction was found in 123 patients,
      collateral flow without anatomic obstruction in six patients, and a slow-flow
      pattern in 12 patients. Twenty-six of these also underwent upper extremity
      contrast venography within 48 hours of the scan. Contrast venograms and
      radionuclide venograms agreed in 19 patients (16 correctly identified as
      obstructed, three correctly identified as unobstructed). Six patients showed the
      slow-flow pattern without collaterals or obstruction. Subsequently, six follow-up
      contrast studies showed no evidence of obstruction or collaterals. The authors
      conclude that obstruction with collateral flow on radionuclide venograms
      correctly predicts obstruction. However, the slow-flow pattern does not and
      should not be used as the sole criterion to diagnose partial obstruction.

PMID- 1617839
TI  - Comparison of Tl-201 renal uptake with Tc-99m DTPA angiorenography in patients
      with hypertension. Measures of renal asymmetry.
AB  - Renal uptake of Tl-201 reflects renal perfusion and may have a role in defining
      renal asymmetry in patients with hypertension who are referred for myocardial
      scintigraphy. The authors compared two methods of quantitating differential renal
      uptake of Tl-201, with similar data obtained from the angiographic and renal
      uptake (RU) phases of Tc-99m DTPA scintigraphy in 35 patients with hypertension.
      For Tl-201, asymmetry in renal counts was quantitated based on a simple outline
      technique or on interpolative background subtraction of 5-minute posterior
      images. Inter-observer and intra-observer variability among duplicate
      measurements were lower for Tl-201, particularly with interpolative background
      subtraction, than for Tc-99m DTPA. Renal/background ratios were similar for Tl
      201 and RU-phase Tc-99m DTPA images when considering liver, spleen, or inter
      renal regions as background; however, paraspinal uptake was relatively higher
      with Tl-201 (P less than 0.01). Qualitatively, renal asymmetry scores with the
      two radiotracers agreed (r = 0.89, blinded readings by four observers), although
      asymmetry was more marked with Tl-201 (P = 0.06). Measurements with Tl-201 agreed
      with both phases of Tc-99m DTPA (r = 0.96 to 0.98), but interpolative background
      subtraction systematically yielded greater inter-renal asymmetry than RU (P less
      than 0.01), reflecting the qualitative impression. Thus, ancillary Tl-201 imaging
      reflects differences between the kidneys in a fashion similar but not identical
      to Tc-99m DTPA scintigraphy.

PMID- 1617840
TI  - Tc-99m DTPA and I-131 hippurate renography. Findings in hepatorenal syndrome.
AB  - Tc-99m DTPA and I-131 OIH renography were performed simultaneously in a patient
      with hepatorenal syndrome. Blood flow was delayed and diminished bilaterally;
      there was Tc-99m DTPA and I-131 OIH retention in the parenchyma with no evidence
      of tracer retention in the collecting systems. The I-131 OIH renogram curve
      demonstrated a steadily rising pattern, whereas the Tc-99m DTPA curve
      demonstrated an initial vascular peak and was subsequently flat. There was no
      appreciable response to furosemide. These findings are not specific for
      hepatorenal syndrome, and the diagnosis is based on the characteristic clinical
      setting and the exclusion of other causes of renal failure. A brief literature
      review and a discussion of differential diagnosis are included.

PMID- 1617841
TI  - 'Reverse crescent pattern' on SPECT brain perfusion scan in chronic subdural
      hematoma.
AB  - A SPECT brain perfusion scan was performed on a patient who had symptoms of
      dementia. The SPECT scan showed marked crescentic medial displacement of the left
      cerebral hemisphere ("reverse crescent pattern"), and mildly decreased cortical
      perfusion in the affected hemisphere. Crossed cerebellar diaschisis was not
      present. On x-ray CT, the underlying abnormality was found to be a unilateral
      chronic subdural hematoma causing a significant mass effect. A reverse crescent
      pattern without crossed cerebellar diaschisis on SPECT brain perfusion scan in
      patients with dementia may suggest the diagnosis of chronic subdural hematoma.

PMID- 1617842
TI  - Identification of hypometabolic areas in the brain using brain imaging and
      hyperbaric oxygen.
AB  - Current neurologic assessments consider idling neurons and ischemic penumbras to
      be metabolically lethargic and electrically nonfunctional or nonviable.
      Diagnosis, prognosis, and therapeutics of central nervous system dysfunctions
      require differentiation between viable and nonviable neurons. It is necessary to
      develop and document efficacious and safe techniques for reactivating idling
      neurons. The authors present a case study of a near drowning 12 years earlier.
      Areas of cortical hypometabolism were identified by using SPECT imaging in
      conjunction with hyperbaric oxygen therapy (HBOT). Delayed imaging after HBOT (1
      hour, 1.5 atm abs) suggested viable but metabolically lethargic neurons. After
      HBOT (80 1-hour treatments, monoplace chamber, 1.5 atm abs), marked improvements
      in cognitive and motor functioning were demonstrated. The data support the
      hypothesis that idling neurons and ischemic penumbras, when given sufficient
      oxygen, are capable of reactivation. Thus, changes in tracer distribution after a
      single exposure to HBOT may be a good prognostic indicator of viable neurons.
      HBOT may be valuable not only in recovery from anoxic encephalopathy but also
      from other traumatic and nontraumatic dysfunctions of the central nervous system,
      including stroke. HBOT in conjunction with physical and rehabilitative therapy
      may help reactivated idling neurons to remain permanently active.

PMID- 1617843
TI  - Imaging of regional spread of breast cancer by internal mammary
      lymphoscintigraphy, CT, and MRI.
AB  - Forty women with breast cancer underwent imaging by internal mammary
      lymphoscintigraphy (IMLS), which was correlated with the results of CT and MRI of
      the chest. IMLS was performed and interpreted using the previously described
      methods of Ege. It identified 22 instances of ipsilateral internal mammary nodal
      involvement, none of which corresponded to cases of abnormally enlarged (diameter
      greater than 1.0 cm) internal mammary nodes on CT and/or MRI. Positive IMLS was
      associated with axillary nodal metastases in 15 out of 22 instances. The authors
      conclude that IMLS provides information on regional nodal spread of breast cancer
      that is not available with either CT/MRI imaging or axillary biopsy.

PMID- 1617844
TI  - Serendipitous scintigraphic detection of asymptomatic anastomotic pseudoaneurysms
      in human pancreatic allografts.
AB  - Two cases of scintigraphically detected asymptomatic graft anastomotic
      pseudoaneurysms are reported. Both patients previously underwent simultaneous
      renal and pancreatic transplantation. The role of imaging in the diagnosis of
      this relatively rare, but potentially lethal, vascular complication of pancreatic
      transplantation is discussed. This is the first report of anastomotic
      pseudoaneurysms in pancreatic transplants being diagnosed by scintigraphy.

PMID- 1617845
TI  - Significance of increased Tl-201 uptake by the lungs in patients undergoing oral
      dipyridamole-thallium myocardial imaging.
AB  - The purpose of this study was to evaluate the significance of increased Tl-201
      uptake by the lungs after oral dipyridamole testing. In conjunction with
      myocardial perfusion scintigraphy, intravenous dipyridamole has been recently
      approved as an alternative to exercise for the evaluation of coronary artery
      disease in patients who cannot adequately exercise, and it will largely replace
      oral dipyridamole testing. This study contributes to the understanding of the
      significance of increased lung thallium uptake during pharmacologic stress
      testing. Oral dipyridamole, 400 mg, was administered to 192 patients undergoing
      Tl-201 imaging for clinical indications. Mild adverse effects occurred in 31% of
      patients (chest pain, nausea, headache, or flushing). Dipyridamole had minimal
      hemodynamic effects. The lung/heart thallium activity ratio was determined in 152
      patients. These were subdivided into four groups according to the presence or
      absence of ischemia, transient myocardial perfusion defect, or scar as indicated
      by a fixed myocardial perfusion defect. In 61 patients without transient
      myocardial perfusion defect or fixed myocardial perfusion defect (group 1), the
      lung/heart thallium activity ratio was 0.39 +/- 0.01 (mean +/- SEM). In 31
      patients without transient myocardial perfusion defect but with fixed myocardial
      perfusion defect (group 2), the lung/heart thallium activity ratio was higher,
      0.44 +/- 0.02 (P less than 0.05). In 27 patients with transient myocardial
      perfusion defect but no fixed myocardial perfusion defect (group 3) and in 33
      patients with both transient myocardial perfusion defect and fixed myocardial
      perfusion defect (group 4), the lung/heart thallium activity ratio was 0.51 +/-
      0.03 and 0.52 +/- 0.03, respectively, both significantly higher than either group
      1 or group 2 (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617846
TI  - An unusual presentation of carcinoid tumor metastatic to bone.

PMID- 1617847
TI  - A novel cause of Ga-67 localization. Subclinical myopathy after conventional
      exercise.

PMID- 1617848
TI  - Stunned thyroid after high-dose I-131 imaging.

PMID- 1617849
TI  - Pseudotumor of the liver caused by pectus excavatum as seen on sulfur colloid
      scintigraphy.

PMID- 1617850
TI  - Three-phase bone scintigraphy in Maffucci's syndrome.

PMID- 1617851
TI  - Ga-67 imaging of amiodarone pulmonary toxicity with pseudocavitary lung lesion.

PMID- 1617852
TI  - Pulmonary gallium photopenia from oligemia.

PMID- 1617853
TI  - Skeletal scintigraphy. Radiographic artifacts.

PMID- 1617854
TI  - False-positive Tl-201 SPECT studies in patients with left bundle branch block:
      frequency and clinical significance.

PMID- 1617855
TI  - Pharmacokinetic and pharmacodynamic data collection in children and neonates. A
      quiet frontier.

PMID- 1617856
TI  - Pharmacokinetic studies in paediatric patients. Clinical and ethical
      considerations.
AB  - Important advances in paediatric clinical pharmacology have been made over the
      past 2 decades. However, there remains a reluctance to pursue pharmacodynamic and
      pharmacokinetic studies in children and, consequently, many important therapeutic
      agents have not been adequately studied in this population. Age-related
      pharmacokinetic/pharmacodynamic studies are not only essential to provide optimal
      drug therapy for children, but are quite feasible. Usually, paediatric
      pharmacokinetic studies are conducted in children receiving treatment for a
      specific medical condition. The approach to soliciting participation of
      paediatric subjects requires special sensitivity to the fears and anxieties of
      the child and the parents. Factors influencing subject enrollment and suggestions
      to enhance enrollment into study protocols are discussed.
      Pharmacokinetic/pharmacodynamic studies require repeated measurements over time
      and often entail obtaining multiple blood and urine samples. Techniques for
      reducing sample volume and number of necessary samples while minimising the
      discomfort and fear associated with obtaining multiple samples include the
      development of highly sensitive analytical methods to measure drug concentrations
      in small volume samples. The number of samples obtained from individual subjects
      can be minimised by using pharmacokinetic analytical approaches such as the
      nonlinear mixed effect model (NONMEM) which allows estimation of pharmacokinetic
      characteristics of a population using limited data from each subject. In
      addition, less invasive methods to measure drug metabolism/elimination such as
      salivary sampling, transcutaneous collection and breath analysis have been
      applied to the study of certain drugs. Children are a particularly vulnerable
      population because of their limited cognitive abilities and dependence on adults.
      Thus, they must be afforded greater protection from exploitation as research
      subjects than that provided to adults.

PMID- 1617857
TI  - Intranasal insulin. Clinical pharmacokinetics.
AB  - Insulin administered nasally has considerable potential for the treatment of both
      insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetes. For patients
      with NIDDM it is possible to prevent preprandial hyperglycaemia and postprandial
      hypoglycaemia by employing a suitable and properly timed intranasal insulin dose.
      The low bioavailability of simple formulations of insulin can be greatly improved
      by using absorption enhancers or novel delivery systems such as bioadhesive
      microspheres. The need for nontoxic and nonirritant systems is stressed.

PMID- 1617859
TI  - Population pharmacokinetics of gentamicin. Use of the nonparametric expectation
      maximisation (NPEM) algorithm.
AB  - A new nonparametric expectation maximisation (NPEM) algorithm for the estimation
      of population pharmacokinetic parameter values was evaluated. The algorithm, in
      the form of a personal computer program, was used to compute population
      pharmacokinetic parameter densities of gentamicin in a group of 9 patients with
      indicators of malnutrition. The 1-compartment parameter values for clearance
      (CL), volume of distribution (Vd) and elimination rate constant (k) were compared
      with values generated using a standard 2-stage (STS) approach. NPEM was used with
      a full data set (72 gentamicin concentrations) and a sparse data set (only peak
      and trough concentrations for each patient; 18 in total). There were no
      differences in parameter value estimations between the STS and NPEM with all the
      data (p greater than 0.05) or with the sparse data (p greater than 0.05). Mean
      parameter value estimates from the STS and NPEM (with sparse data) were used as a
      priori data sets in the USC*PACK gentamicin Bayesian program to predict
      concentrations in 8 subsequent patients with similar indicators of malnutrition.
      There were no differences in predicted gentamicin concentrations between STS
      (3.75 +/- 2.06 mg/L) and NPEM (3.75 +/- 2.17 mg/L). NPEM was able to generate
      population pharmacokinetic parameter values for gentamicin in a defined
      population of patients using sparse routine clinical data. It was also shown to
      function with only a single data point per patient.

PMID- 1617858
TI  - Pharmacokinetics and therapeutic efficacy of retinoids in skin diseases.
AB  - The retinoids are a class of compounds that includes the natural forms and
      synthetic analogues of vitamin A. Isotretinoin, often referred to as a first
      generation retinoid, may be of considerable benefit to patients with severe,
      recalcitrant acne. Etretinate and acitretin, 2 aromatic compounds representing
      the second generation, have found their major success in the treatment of
      psoriasis, particularly in combination with more traditional therapies. Retinoid
      therapy is associated with a distinctive adverse effect profile typical of
      hypervitaminosis A; thus, it is especially important that fertile women
      undergoing retinoid therapy adhere to a contraceptive regimen. These drugs are
      extensively metabolised and only traces of unchanged drugs are eliminated in
      urine. The terminal elimination half-lives of isotretinoin, etretinate and
      acitretin after long term treatment are up to 20h, 120 days and 48h,
      respectively. Because of lack of definite correlation between plasma
      concentration and desired pharmacological effects, in conjunction with the very
      pronounced inter- and intraindividual variation in systemic availability (15 to
      90%) after oral administration of these drugs, initial dosages in individual
      patients can only be roughly judged on the basis of the general pharmacokinetics
      of the agents. Later dosage adjustments should be made on the basis of monitoring
      of both plasma drug (and possible metabolite) concentrations, and the efficacy
      and tolerability of the drugs.

PMID- 1617860
TI  - Evaluation of hepatic function using the pharmacokinetics of a therapeutically
      administered drug. Application to the immunosuppressant cyclosporin.
AB  - A method is presented for the simultaneous estimation of functional hepatic blood
      flow and intrinsic clearance. The method uses pharmacokinetic data of a
      therapeutically employed drug and one of its primary metabolites following
      intravenous and oral administration of the parent compound. When the disposition
      of the drug is linear, this method can cope with complicated dosage regimens
      commonly confronted in clinical data. The feasibility of the method was
      demonstrated in 10 patients who had undergone liver transplantation and were
      receiving cyclosporin in the immediate postoperative period. Mean hepatic blood
      flow was estimated to be 0.89 (95% CI: 0.62 to 1.23) L/h/kg and intrinsic
      cyclosporin clearance as 0.60 (95% CI: 0.49 to 0.72) L/h/kg. Apart from the
      hepatic parameters, bioavailability and the fraction of the dose absorbed, a
      detailed pharmacokinetic description of the parent drug and the elimination
      pharmacokinetics of a primary metabolite are provided. This information not only
      allows optimisation of individual therapy, but also may be used to compare
      absorption properties of different pharmaceutical formulations.

PMID- 1617861
TI  - CaEDTA vs CaEDTA plus BAL to treat children with elevated blood lead levels.
AB  - The effectiveness of CaEDTA alone vs CaEDTA plus BAL was compared retrospectively
      in a group of 72 children with lead levels between 2.41 mumol/L (50
      micrograms/dL) and 2.90 mumol/L (60 micrograms/dL). The children who received
      both drugs had higher median zinc protoporphyrin (ZnP) concentrations at the
      initiation of therapy than children who received CaEDTA alone (160 micrograms/dL
      vs 96 micrograms/dL, p less than .01). There was a significantly increased
      incidence of vomiting and abnormal liver-function test results in the children
      who received both drugs. The children who received CaEDTA alone had a greater
      percent mean fall in lead level at one to three weeks postchelation (30.5% vs
      18.1%, p less than .05). Children who received both CaEDTA and BAL had a greater
      percent decrease in ZnP at four to eight months postchelation, but there was no
      difference in percent decrease in lead levels. Children who received both drugs
      also had a greater number of repeat courses of chelation by six months. The
      addition of BAL to CaEDTA for treatment of children with lead levels of 2.41
      mumol/L (50 micrograms/dL) to 2.90 mumol/L (60 micrograms/dL) produced greater
      toxicity and does not seem to prevent repeat chelations within six months.

PMID- 1617862
TI  - Predicting length of hospitalization of sick neonates from their initial status.
AB  - It has been suggested that the estimated date of confinement (EDC) may be used to
      predict the length of hospital stay for sick newborns. We have found this method
      unreliable and designed the following study to develop a mathematical model to
      predict length of stay (LOS). We reviewed the records of 393 neonates.
      Statistical analysis was performed using multiple linear regression. The factors
      that reached statistical significance were birth weight (BW), gestational age
      (GA), and a combined respiratory score (RES). The RES was developed to quantify
      the degree of initial respiratory illness. Through this model we developed the
      following formula: log(e) (LOS) = 4.395-0.023 (GA) -0.00054(BW) + 0.0274 (RES).
      The R value is 0.78. The model predicts an LOS +/- 10 days in 73% of cases.
      Overall, this model yields a 29% improvement in predictability of LOS compared
      with a model which used EDC only. This formula may provide useful information for
      parents and caregivers of hospitalized neonates.

PMID- 1617863
TI  - Effect of dietary aspartame on plasma concentrations of phenylalanine and
      tyrosine in normal and homozygous phenylketonuric patients.
AB  - Six normal subjects each ingested a single 12-oz can of a diet cola (Diet Coke)
      providing 184 mg aspartame (APM), of which 104 mg is phenylalanine (Phe), and, on
      another occasion, a single 12-oz can of regular cola (Coke Classic). Neither cola
      significantly affected plasma concentrations of Phe or tyrosine over the three
      hour postingestion study period. Each of five homozygous phenylketonuric (PKU)
      subjects (ages 11, 16, 17, 21, and 23 years) ingested a single 12-oz can of the
      same diet cola. In these five subjects (three with classic PKU and two with
      hyperphenylalinemia), the increase in plasma Phe concentrations varied from 0.26
      mg/dL to 1.77 mg/dL two or three hours after ingestion (baseline levels, 5.04 to
      17.2 mg/dL). Tyrosine concentrations did not differ significantly from baseline
      levels. The data indicate that ingestion of dietary Phe, as supplied in a single
      can of diet cola, is readily handled in both normal and PKU subjects. The small
      increases in plasma Phe concentrations in the homozygous PKU patients are not
      considered clinically significant.

PMID- 1617864
TI  - Improving resources for foster care.
AB  - The number of foster children and their psychological and medical morbidity are
      growing. To gain insight into how to recruit and retain foster homes,
      characteristics of 64 foster families were determined by interview. Foster
      parents had low-to-moderate incomes, were approaching middle age, had
      underutilized home space, and wanted more children. Most enjoyed foster care and
      planned to continue. Twenty-three percent of the 64 had half of all foster
      children in the study in their homes at interview and had cared for seven times
      as many children in the past, including 66% of all the teens and 83% of all the
      handicapped children who had been in the 64 homes. These "high providers"
      functioned like group homes for mentally handicapped individuals. Adapting the
      group-home concept to foster homes could improve care, especially for children
      with special needs.

PMID- 1617865
TI  - Interobserver variability in assessing pediatric postextubation stridor.
AB  - The reliability of parameters used to assess pediatric postextubation upper
      respiratory distress is unknown. We prospectively studied the interobserver
      reliability of six parameters commonly used to assess respiratory distress in
      children. Eligible patients were less than 15 years old and hospitalized for
      traumatic injuries at Harborview Medical Center between March and September 1989.
      At extubation, patients were examined independently by a physician, a nurse, and
      a respiratory therapist, each of whom evaluated respiratory rate (RR), stridor,
      air movement, flaring/retractions (F/R), level of consciousness (LOC), and oxygen
      saturation (O2 sat). Reliability was measured by percentage agreement and
      weighted kappa (Kw). The 25 children (27 extubations) had a median age of 7
      years, and eight of the 27 required treatment for upper airway obstruction.
      Percentage agreement ranged from 82% (for air movement) to 96% (for O2 sat).
      Weighted kappas were excellent for RR and F/R (Kw greater than .6); moderate for
      LOC, stridor, and O2 sat (0.4 less than Kw less than .06); and poor for air
      movement (Kw less than .4). Further improvements in interobserver agreement are
      required to provide more consistent upper airway management in critically ill
      children.

PMID- 1617866
TI  - Chronic nonspecific diarrhea of childhood.

PMID- 1617867
TI  - The role of bicycle helmets in bicycle-related injury prevention.

PMID- 1617868
TI  - Hypocalcemia as the initial manifestation of occult cholestatic liver disease.

PMID- 1617869
TI  - Cerebral cavernous angiomas in the newborn.

PMID- 1617870
TI  - Localized meningoencephalitis and group A streptococcal bacteremia.

PMID- 1617871
TI  - Intervertebral disc calcification.

PMID- 1617872
TI  - Antibiotic dosages in the treatment of group A streptococcal infections.

PMID- 1617873
TI  - Anisometropic amblyopia: an easily overlooked cause of visual loss in children.

PMID- 1617874
TI  - Prevention of prematurity.

PMID- 1617875
TI  - Prematurity prevention: who is at risk?
AB  - Previous preterm birth, previous preterm labor, regular uterine activity, uterine
      distention, and preterm cervical change are factors that are most often present
      in patients treated for preterm labor or in patients delivered prematurely. In
      addition to their frequency, their severity is also the highest in terms of
      patient risk. These factors usually are easily identified, and an appropriate
      management plan can be implemented to decrease the incidence of preterm births or
      to at least increase the fetal time in utero. Antenatal bleeding, chronic urinary
      tract infections, smoking, and maternal age are also associated with preterm
      labor. Although these factors are not present as often, they have the potential
      to precipitate preterm labor and preterm delivery. When they are identified, it
      is necessary to utilize the appropriate therapeutic measures commensurate to the
      number and/or the degree of the risk factors. Vaginal microbiology, maternal
      hematocrit, substance abuse, and coitus are factors that are undergoing active
      investigation in regards to precipitating preterm birth. They are frequently seen
      in normal pregnancies, but recently have been associated with a greater
      likelihood for preterm labor and preterm birth. Unequivocal evidence of this
      association is currently unavailable; however, more and more investigations are
      reporting a significant association of these factors with preterm births. The
      relative degree of risk and the optimal management plans for dealing with these
      factors also await further definition and refinement. We know that there is no
      surveillance technique, or combination of techniques, that will identify all
      patients who will eventually deliver preterm. In many reports, despite the
      diligent attention to many of the earlier-mentioned risk factors, almost two of
      three patients who have delivered preterm had no easily identified risk factor.
      In addition, many patients delivered preterm report no perception of uterine
      activity (Garbaciak JA, Desch C, unpublished data). Other investigators have
      concluded that because most of the potentially preventable births occur in groups
      that present with marked cervical dilatation, it may be difficult to lower
      significantly the preterm birth rate below the current levels. Despite the
      sometimes dismal outlook regarding the prevention of preterm labor and delivery,
      the multiple investigators that have reported certain successes in their study
      populations should give us hope and encourage us to apply those techniques that
      appear appropriate and effective in our individual populations and patients. We
      can see and measure successful outcomes only if we are willing to look and
      aggressively to attempt to decrease untoward perinatal events.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1617876
TI  - Predicting prematurity: the mammary stimulation test.
AB  - The MST appears to have theoretical rationale, predictive utility, simplicity,
      safety, and low cost that suggests that its routine use in prematurity prevention
      may ultimately save significant health care dollars. Presently, the MST should be
      used as an adjunct to prenatal care until further and more definitive
      investigation has been conducted; however, it seems promising that the MST will
      provide some reassurance in patients with negative tests and signify patients
      that are at significant risk for premature delivery (positive MST). It is hoped
      that further investigation will validate the MST's use in prematurity prevention
      in order to help decrease the incidence of preterm delivery.

PMID- 1617877
TI  - An aspirin a day to prevent prematurity.
AB  - Intrauterine fetal growth retardation and preeclampsia remain a substantial cause
      of preterm birth world wide. There is evidence to suggest that a functional
      imbalance between vascular prostacyclin and platelet-derived thromboxane A2
      production plays a central role in the pathogenesis of these disorders. Low-dose
      aspirin appears to reverse the above functional balance resulting in increased
      prostacyclin to thromboxane ratio. The efficacy and safety of low-dose aspirin in
      preventing preeclampsia and fetal growth retardation were tested in several
      randomized and uncontrolled trials. The data in the literature suggest that low
      dose aspirin is effective in reducing preterm birth due to the above
      complications in selected high-risk pregnant women.

PMID- 1617878
TI  - Uterine surgical approaches to reduce prematurity.
AB  - Success rates of up to 80% can be expected after surgical treatment of abnormal
      uteri. A careful investigation should be conducted to verify that other causes of
      prematurity are not present prior to surgical intervention.

PMID- 1617879
TI  - Home uterine activity monitoring.
AB  - Despite tremendous improvements in maternal and neonatal care, preterm delivery
      remains the leading cause of infant mortality. Widespread use of tocolytics and
      aggressive preterm labor management have had little effect on reducing the
      overall neonatal mortality. To improve the success of tocolysis and preterm labor
      management, it is critical that preterm labor be diagnosed prior to significant
      cervical change. At present, a combination of several components is indicated for
      successful preterm birth prevention programs. These should include periodic risk
      assessment, patient education, cervical assessment, daily contact by highly
      skilled perinatal nurses, daily home uterine activity monitoring, and aggressive
      patient management. Studies support that this approach results in early detection
      of preterm labor, subsequently more effective tocolytic therapy and prevention of
      preterm birth.

PMID- 1617880
TI  - Multiple gestation: the role of multifetal pregnancy reduction and selective
      termination.
AB  - With the increased use of fertility agents and the transfer of multiple embryos,
      multifetal gestations have increased in number. As the number of fetuses
      increases, the probability of premature birth and delivery does. The role of
      multifetal pregnancy reduction and selective termination is reviewed.

PMID- 1617881
TI  - Polyhydramnios: does reducing the amniotic fluid volume decrease the incidence of
      prematurity?
AB  - Polyhydramnios is an uncommon cause of premature labor and delivery. After
      sonographic evaluation has confirmed the polyhydramnios and a determination is
      made of the potential etiologies, indomethacin appears to be an effective agent
      in reducing the amniotic fluid volume and in preventing prematurity.

PMID- 1617882
TI  - Premature rupture of the membranes: management controversies.
AB  - Preterm premature rupture of the membranes continues to be a leading cause of
      perinatal morbidity and mortality in the United States. In the absence of
      amnionitis or fetal compromise, expectant management is a reasonable alternative
      to permit fetal weight gain and to allow for fetal lung maturation. When
      embarking on an expectant management course, a variety of clinical approaches are
      available to the practicing clinician.

PMID- 1617883
TI  - Amnioinfusion with preterm, premature rupture of membranes.
AB  - Excluding labor, the greatest risks to the fetus from preterm PROM are umbilical
      cord accidents and infection. Heretofore, the clinical options for the PROM
      patient have been limited. With the advent and refinement of amnioinfusion, the
      utility of expectant management may be greatly increased. Through the use of
      amnioinfusion or its permutations, a number of diagnostic and therapeutic
      procedures previously unavailable to the PROM patient may become routine,
      including amniotic fluid volume expansion and direct in utero
      prophylaxis/treatment of amnionitis.

PMID- 1617884
TI  - The low birth weight infant: is there a preferred route of delivery?
AB  - In the management of the preterm pregnancy, cesarean delivery cannot be supported
      in the delivery of the preterm (less than 1500 g) cephalic-presenting fetus.
      Although cesarean may be of benefit in the management of the preterm breech fetus
      (less than 1500 g), there is yet no perspective randomized clinical trial to
      support its use.

PMID- 1617885
TI  - Placenta previa.
AB  - Placenta previa occurs in approximately one in 200 pregnancies. The cause is
      unknown, but endometrial damage due to prior pregnancy, cesarean section, and
      other factors predispose to it. Diagnosis is usually made by transabdominal
      ultrasonography. False-positive diagnoses are common in the second trimester and
      the term "potential placenta previa" has been proposed to describe this
      situation. Bleeding with placenta previa is usually associated with uterine
      contractions, thus the introduction of tocolysis. Placenta accreta is common in
      the patient with one or more previous cesarean sections and placenta previa in
      the current pregnancy. Management of placenta previa is expectant and involves
      avoidance of digital vaginal examination, delay of delivery until 36 weeks'
      gestation and/or documented fetal lung maturity, transfusion support to maintain
      maternal hematocrit greater than or equal to 30%, serial ultrasonography,
      antepartum fetal heart rate monitoring, glucocorticoids, tocolytic therapy, and
      elective delivery by cesarean section. Maternal mortality is rare with placenta
      previa. Perinatal mortality is currently 4% to 8% primarily related to
      complications of prematurity.

PMID- 1617886
TI  - Antepartum fetal surveillance in the preterm fetus.
AB  - Over the past two decades, obstetric and neonatal health care has shifted its
      attention to the preterm pregnancy. Due to the immaturity of the fetal autonomic
      nervous system, the usual diagnostic criteria for intervention in the preterm
      fetus are not available. Alternative methods such as the biophysical profile and
      Doppler offer the clinician a reasonable alternative in identifying potential
      fetal compromise.

PMID- 1617887
TI  - Obstetric critical care issues in prematurity.
AB  - Typically, obstetric critical care issues focus on the management of the patients
      whose pregnancies are complicated by severe preeclampsia and oliguria. Here, the
      focus is on the expectant management of the preterm pregnancy complicated by
      severe preeclampsia, HELLP syndrome, or eclampsia. Then, the emphasis shifts to
      tocolytic and severe preeclampsia-related pulmonary edema and its clinical
      management.

PMID- 1617888
TI  - Neonatal management of the very low birth weight infant: the use of surfactant.
AB  - The use of surfactant in the low birth weight infant with respiratory distress
      syndrome has undergone multicenter randomized clinical trials. This article
      addresses the properties of surfactant, the clinical aspects of surfactant
      replacement therapy and the implications for future research.

PMID- 1617889
TI  - Ethical issues in obstetric cases involving prematurity.
AB  - This article explores the ethical issues confronted when the process of
      childbirth is threatened by premature labor and delivery. In this article,
      obstetric ethics are distinguished within the larger study of "ethics,"
      frameworks for decision making are critiqued, and factors that frequently
      influence the formation of ethical judgments are commented on.

PMID- 1617890
TI  - Effect of rheumatoid arthritis upon other members of the family.

PMID- 1617891
TI  - The role of pregnancy in the course and aetiology of rheumatoid arthritis.
AB  - The aetiology of rheumatoid arthritis (RA) is unknown, although being female is
      generally recognized as the most important independent risk factor, the disease
      being 2 to 3 times more frequent in females than in males. The dramatic effect of
      pregnancy in rheumatoid arthritis has been documented for over 50 years. This
      review examines the evidence and possible mechanisms by which pregnancy modifies
      the disease process and may alter predisposition to the development of RA in
      later life.

PMID- 1617892
TI  - Pulmonary hypertension in MCTD: report of two cases with anticardiolipin
      antibody.
AB  - We report on 2 patients with well-documented mixed connective tissue disease
      (MCTD) accompanied by severe pulmonary hypertension (PH) due to thrombosis or
      thromboembolism. In a previous report we indicated (1) that patients with MCTD
      complicated by PH have a significantly worse prognosis than patients with other
      connective tissue disease (CTD) complicated by PH. Both our patients had
      anticardiolipin antibody (a-CL) in the initial stages of the disease. We also
      studied the relationship of a-CL to PH in patients with other CTD. Patients of
      either MCTD or SLE with high levels of a-CL had significantly higher values of
      mean pulmonary arterial pressure than patients without a-CL. Several factors were
      suggested for the pathogenesis of PH such as vasospasm, arteritis, platelet
      dysfunction, and thrombosis or thromboembolism. The presence of a-CL may be one
      of important factors in development of PH among patients with MCTD with recurrent
      pulmonary thrombosis or thromboembolism.

PMID- 1617893
TI  - Serum levels of interleukin-1b, tumour necrosis factor-a and interleukin-2 in
      rheumatoid arthritis. Correlation with disease activity.
AB  - Cytokines are potent immunoregulatory factors and may be directly involved in the
      disordered immunoregulation found in chronic rheumatic diseases. Interleukin-1b
      (IL-1b), Interleukin-2 (IL-2) and Tumour Necrosis Factor-a (TNF-a) have been
      implicated in the pathogenesis of rheumatoid arthritis (RA) as mediators of
      chronic inflammation. Serum levels of IL-1b and TNF-a measured by
      radioimmunoassay were significantly higher in patients with RA than in healthy
      controls of similar sex and age while serum levels of IL-2 were significantly
      lower in the same patients. Further IL-1b and TNF-a were significantly elevated
      in RA patients with active disease and IL-2 was significantly reduced when
      compared with patients with low active disease. Serum IL-1b and TNF-a appear to
      correlate with systemic inflammation, and systemic features of RA may result from
      dissemination of cytokines produced in the synovium. The role of IL-2 in RA
      remains controversial. Reduced levels of IL-2 may be an expression of a
      deficiency of T-cells to produce IL-2 in the active phases of RA or may be due to
      a possible absorption of IL-2 by lymphocyte receptors.

PMID- 1617894
TI  - Serum anti-tropo:anti-alpha-elastin antibody ratio assessing elastin turnover in
      scleroderma.
AB  - Serum antibodies to native (tropo) and denatured (alpha) elastins appear to
      correlate with the production and breakdown respectively of elastic tissue.
      Elastin may be degraded as a part of autoimmune diseases. This possibility was
      tested by measuring IgG antibodies to tropo- and alpha-elastins by ELISA in the
      sera of 111 patients with a variety of connective tissue diseases compared with
      18 healthy individuals. Anti-alpha-elastin antibodies were significantly higher
      in sera from 18 scleroderma patients than from healthy controls (p less than
      0.008). Conversely, anti-tropoelastin antibody levels for scleroderma patients (p
      less than 0.03) and for patients with a variety of other connective tissue
      diseases (p less than 0.02) were lower than in healthy controls. Low antibody
      levels to native elastin and high levels of antibodies to denatured elastin
      suggest a low synthesis: degradation ratio for elastin in scleroderma.
      Scleroderma may be a unique model for elastin turnover because of its heretofore
      unrecognized accelerated elastolysis.

PMID- 1617895
TI  - Plasminogen activator inhibitor and von Willebrand factor in polymyalgia
      rheumatica.
AB  - Endothelial cell products, plasminogen activator inhibitor (PAI) and von
      Willebrand factor (vWF), were assayed in 25 patients with newly-diagnosed and
      untreated polymyalgia rheumatica (PMR), before and after three and 12 months of
      corticosteroid treatment. The mean values of PAI and vWF, and also the levels of
      acute phase reactants (erythrocyte sedimentation rate, fibrinogen, haptoglobin,
      orosomucoid, C-reactive protein) and platelet counts, were elevated in the active
      untreated disease. In contrast to the acute phase proteins, both PAI and vWF
      remained increased after three and 12 months of glucocorticoid treatment. This
      suggested an active vasculitis, despite a clinically-inactive disease.
      Particularly high levels of vWF both before and after glucocorticoid therapy were
      found in two patients who subsequently developed vascular complications during
      the follow-up period.

PMID- 1617896
TI  - Management of proteinuria secondary to penicillamine therapy in rheumatoid
      arthritis.
AB  - To determine if a policy of continuing penicillamine therapy in successfully
      treated patients with rheumatoid arthritis in the presence of persistent
      proteinuria, was associated or not with resolution of this adverse effect, a
      computer record of patients receiving penicillamine for rheumatoid arthritis was
      searched for patients with persistent proteinuria and the case notes of these
      patients reviewed. Eleven patients with persistent proteinuria were identified,
      eight of whom did not have nephrotic syndrome and were continued on penicillamine
      with close monitoring. In 5 patients proteinuria resolved after 16-21 months; 3
      developed peripheral oedema (2) or worsening of pre-existing hypertension and
      proteinuria (1). In one of these the proteinuria subsequently resolved and one
      died of unknown cause. Of the 3 initially nephrotic patients, two had resolved at
      the time of the study. Persistent proteinuria in penicillamine-treated patients
      with rheumatoid arthritis resolves with continued therapy in the absence of
      nephrotic syndrome but vigilance is required for the development of any
      complications.

PMID- 1617897
TI  - Psychosocial factors and self-help in ankylosing spondylitis patients.
AB  - The purpose of this research was to investigate psychological factors associated
      with ankylosing spondylitis (AS), focusing on possible differences between
      members and nonmembers of self-help groups for people with this form of chronic
      disease. Analysis of health locus of control beliefs along 3 dimensions:
      internality, powerful others and chance, showed that members of National
      Ankylosing Spondylitis Society (NASS) self-help groups placed significantly less
      reliance on "powerful others" for control of health than did nonmembers. This
      pattern of beliefs may be related to the nature of AS, which is incurable,
      progressive, unpredictable and difficult to diagnose. It may therefore appear to
      the patient that health care professionals have little to offer them. People who
      join a self-help group may also feel less reliant on medical personnel to control
      their health. Group members also differed from nonmembers in terms of belief in
      the value of exercise for AS, frequency of exercise, tendency to seek information
      about the disorder and perceived social support. A combination of psychosocial
      and medical variables discriminated between members and nonmembers at a rate of
      71.9% accuracy. Results indicate that NASS self-help group members appear to
      comply more with exercise treatment and also receive a valuable source of social
      support from fellow members. This investigation demonstrates the utility of
      including psychosocial variables in the study of chronic disease.

PMID- 1617898
TI  - Renal tubular acidosis in primary Sjogren's syndrome.
AB  - Renal tubular acidosis (RTA) is a frequent extraglandular manifestation of
      Sjogren's syndrome; however, no distinction on the incidence of this renal
      tubular defect between primary and secondary Sjogren's syndrome has been
      reported. This study was undertaken in order to define the frequency of RTA and
      the possible pathogenetic mechanisms in a group of 21 randomly selected primary
      Sjogren's syndrome patients. RTA was found in 7 (33%) patients. The incomplete
      type of the disorder was the most frequent. It seems that the etiology of RTA is
      multifactorial. Renal excretion of monoclonal proteins and the immunologically
      induced interstitial inflammation are the main possible factors of this renal
      tubular defect.

PMID- 1617899
TI  - Osteophytosis of the knee: association with changes in weight-bearing exercise.
AB  - Osteoarthritis has been held to result from wear and tear. We addressed this
      hypothesis by analysis of anteroposterior radiographs of the knees of 51 subjects
      with mean age of 60 years who regularly practiced weight-bearing exercise.
      Radiographs were assessed for longitudinal changes in spur formation over a two
      year period. The results showed a negative association between changes in weight
      bearing exercise and changes in the rate of spur development in both males and
      females. The findings suggest that increasing repetitive impulse loading in the
      form of regular painless weight-bearing activity does not promote osteophytosis
      (or perhaps degenerative disease) in knee joints.

PMID- 1617900
TI  - HLA B27 and clinical features in Reiter's syndrome.
AB  - HLA B27 and other clinical findings were investigated in 18 Turkish patients with
      Reiter's syndrome (mean age 35.8 +/- 8.09). Male/female ratio was 2/1. All 18
      patients were seronegative, 12 (66.6%) presenting with an asymmetrical
      oligoarticular arthritis. Radiological sacroiliitis and enthesopathy was found in
      9 (50%) and 7 (45.6%) patients respectively. HLA B27 was present in 11 (61.1%)
      patients.

PMID- 1617901
TI  - Mud pack therapy in rheumatoid arthritis.
AB  - Twenty-eight patients with classical or definite rheumatoid arthritis were
      randomly divided into two groups of fourteen patients each. All patients were
      treated once a day with mud packs derived from the Dead Sea heated to 40 degrees
      C and applied over the four extremities, neck and back for 20 minutes. Group 1
      was treated with the true mud packs and Group 2 with washed out and less
      concentrated mud packs. The study was double blind and of two weeks duration. All
      patients were evaluated by one rheumatologist both before treatment and two weeks
      later at the end of the treatment period. Follow-up evaluations were made one and
      three months after conclusion of the treatment. The clinical indices evaluated
      included duration of morning stiffness, hand-grip strength, activities of daily
      living, patient's own assessment of disease activity, number of active joints and
      the Ritchie index. A statistically significant improvement (p less than 0.01 or p
      less than 0.05) was observed in Group 1 only in most of the clinical indices,
      lasting between 1 to 3 months.

PMID- 1617902
TI  - Prevalence of anti-endothelial cell antibodies in patients with autoimmune
      diseases.
AB  - The prevalence of anti-endothelial cell antibodies (AECA) of IgA, IgG and IgM
      classes was studied by means of enzyme-linked immunosorbent assays (ELISA) in 466
      patients with autoimmune/inflammatory disorders. The reference limits in the
      ELISAs for the AECA were determined from a random population sample of 249
      subjects. The frequency of AECA was highest in patients with SLE (n = 42), 14.6%
      mainly of IgG class, and the presence of AECA correlated with disease activity in
      these patients. In the RA patient group (n = 200), 9.5% had AECA, mostly of IgA
      type. We found no association between the presence of AECA and extra-articular
      manifestations of RA or survival rate. In patients with undefined connective
      tissue disease (n = 57), ankylosing spondylitis (n = 109), and psoriatic
      arthritis (n = 58), the frequency of AECA corresponded to that of the random
      population sample. In a cohort of samples sent to the laboratory for
      determination of anti-nuclear antibodies (ANA) there was a correlation between
      the presence of ANA and AECA. Our findings indicate that RA patients are
      characterized by IgA class AECA, whereas SLE patients have IgG class AECA also
      correlating to disease activity.

PMID- 1617903
TI  - HLA and Behcet's disease in northern Spain: their lack of correlation with
      arthritis pattern.
AB  - We have studied the characteristics of arthritis present in 32 patients with
      Behcet's disease (BD), and how this arthritis is related to the HLA markers class
      I. 84% of the patients presented arthritis, the most common being mono-arthritis
      as the initial presentation, and oligoarthritis in subsequent episodes. In 63% of
      the cases, the development was in episodes of acute/subacute arthritis. We found
      statistically significant association between antigens B-5 and B-51, and the
      group with BD, with a relative risk of 3.89 and 4.71 respectively. The attempt to
      relate markers B-5, B-51 and B-27 to the presence of arthritis as well as to its
      manifestation and further development was not conclusive.

PMID- 1617904
TI  - HLA typing and seropositivity in Finnish and in Polish patients with rheumatoid
      arthritis and amyloidosis.
AB  - We determined HLA-A, -B, -C and -DR antigens in 83 patients with rheumatoid
      arthritis (RA) and reactive secondary amyloidosis (RSA), 60 in Finland and 23 in
      Poland, and compared the results with control RA patients and blood donors. There
      were no significant differences in the frequencies of HLA between the RA patients
      with and those without RSA in either Finland or Poland, and no significant
      differences between the Finnish and Polish patients with RSA. All the RSA
      patients from Finland and 70% of the RSA patients from Poland were seropositive.
      In the development of RSA, the prolonged period of inflammatory stimuli may play
      a more important role than genetic factors.

PMID- 1617905
TI  - Cerebral involvement in adult onset Still's disease.
AB  - Still's disease was diagnosed in a 40-year-old patient as a cause of psycho
      organic syndrome with complete disorientation and stupor, sensory and motor
      aphasia. There were no signs of a tumour, cerebrovascular accident, bacterial or
      viral infection. The patient recovered quickly from the cerebral disturbances
      under treatment with corticosteroids. Similar symptoms in adult patients with
      Still's disease are seldom found in the literature.

PMID- 1617906
TI  - Polyarthritis associated with hydatid disease (echinococcosis) of the liver.
AB  - A 36-year-old male developed asymmetric polyarthritis during the course of
      hydatid disease of the liver. Excision of the hydatid cyst was accompanied by
      full remission of the arthritis without recurrence during the 7-year follow-up
      period. This sequence of clinical events suggests an eventual cause and effect
      relationship. A "reactive" immune mechanism, triggered by a parasite located at a
      distant site, appears to be responsible for this type of arthritis.

PMID- 1617907
TI  - Nonsteroidal anti-inflammatory drugs and gallstone formation.

PMID- 1617908
TI  - FDA announces four initiatives for drug approval system.

PMID- 1617909
TI  - Value of transdermal fentanyl.

PMID- 1617910
TI  - Oxaprozin: a once-daily nonsteroidal anti-inflammatory drug.
AB  - The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and
      dosage of oxaprozin are reviewed. Oxaprozin, a nonsteroidal anti-inflammatory
      drug (NSAID) under consideration for approval by the Food and Drug
      Administration, is characterized as a propionic acid. By inhibiting cyclo
      oxygenase, oxaprozin decreases the formation of prostaglandin (PG) precursors
      from arachidonic acid, resulting in decreased PG biosynthesis and reduced pain
      and inflammatory responses. Oxaprozin is well absorbed after oral administration,
      and peak plasma concentration is reached in three to six hours. Oxaprozin is
      primarily eliminated by urinary excretion of the unchanged drug. It has a long
      elimination half-life and persists in synovial fluid. In clinical studies,
      oxaprozin was equally or more effective than aspirin and as effective as naproxen
      in the treatment of rheumatoid arthritis. For treatment of osteoarthritis,
      oxaprozin was as effective as naproxen and more effective than aspirin or
      piroxicam. Studies have also shown oxaprozin to be effective therapy for juvenile
      rheumatoid arthritis and ankylosing spondylitis. Oxaprozin, like other NSAIDs,
      can cause gastrointestinal adverse effects. Other possible adverse effects
      include allergic reactions, analgesic nephropathy, hepatotoxicity, and increased
      bleeding times. For adults, the anticipated daily dosage is 600-1200 mg given as
      a single dose for rheumatoid arthritis, osteoarthritis, and analgesia. In
      children, oxaprozin 10-20 mg/kg/day has been used to treat juvenile rheumatoid
      arthritis. Oxaprozin is as effective as other NSAIDs and offers once-daily
      dosing; however, it does not offer any therapeutic advantage over other currently
      available NSAIDs.

PMID- 1617911
TI  - Ticlopidine: a new platelet aggregation inhibitor.
AB  - The chemistry, pharmacology, pharmacokinetics, clinical efficacy, adverse
      effects, and dosage of ticlopidine are reviewed. Ticlopidine appears to inhibit
      platelet aggregation induced by adenosine diphosphate. Ticlopidine hydrochloride
      is rapidly absorbed after oral administration, and maximum antiplatelet effects
      occur one to three hours after the dose. In multicenter, randomized, double-blind
      trials, ticlopidine was more effective than aspirin or placebo in preventing
      stroke, myocardial infarction, or death caused by vascular events. Ticlopidine
      was more effective than aspirin in preventing recurrent transient ischemic
      attacks after six months of therapy. Ticlopidine has also been used to prevent
      occlusion and improve patency of aortocoronary bypass grafts, to prevent ischemic
      ulcers in patients with chronic arterial occlusive disease, and to slow the
      progression of diabetic microangiopathy. The most serious adverse effect,
      neutropenia, occurred in about 1% of patients. The most frequently reported
      adverse effects are diarrhea, nausea, vomiting, and abdominal cramps. Ticlopidine
      is indicated for reducing the risk of thrombotic stroke in patients who have
      experienced a minor stroke, transient ischemic attack, or completed thrombotic
      stroke. The recommended dosage is 500 mg/day in two divided doses taken with
      food. Ticlopidine is an alternative agent for the primary and secondary
      prevention of stroke. Because of the risk of neutropenia and agranulocytosis and
      the high cost of therapy, ticlopidine should be reserved for patients who are
      intolerant of or lack benefit from aspirin.

PMID- 1617912
TI  - Long-term dobutamine therapy for refractory congestive heart failure.
AB  - The proposed benefit of long-term dobutamine therapy is explained, relevant
      clinical trials are described, and recommendations for this treatment are
      discussed. Dobutamine increases cardiac contractility and causes vasodilation
      with little change in heart rate. It is routinely administered for short periods
      to relieve exacerbations of congestive heart failure (CHF) in hospitalized
      patients. Sustained effects have been seen with dobutamine infusions, although
      the known properties of the drug do not explain these effects. Long-term
      dobutamine therapy can lessen the symptoms of CHF and improve exercise tolerance
      and cardiac function. Nine published reports showed consistent improvement in 77
      patients treated with multiple infusions of dobutamine. At Ohio State University,
      long-term dobutamine therapy (typically 5.0-7.5 micrograms/kg/min infused
      continuously) is used in patients with refractory CHF and those awaiting heart
      transplantation. Because the therapy does not prolong survival in most patients,
      specific endpoints of therapy should be determined for each patient. Because it
      may cause sudden death, patients receiving this therapy must be carefully
      monitored. Long-term use of dobutamine infusion lessens the symptoms of CHF but
      does not prolong survival.

PMID- 1617913
TI  - Influence of sucralfate on the detection of occult blood in simulated gastric
      fluid by two screening tests.
AB  - The influence of sucralfate on the detection of occult blood in simulated gastric
      fluid by two screening tests was investigated. Two simulated gastric solutions
      (pH 1.2 and 4.1) containing sucralfate 2.5 or 10 mg/mL were spiked with fresh
      whole blood (hemoglobin concentration, 15.7 g/dL) to achieve a blood
      concentration of 1 or 5 microL/mL. Fifty-microliter samples were applied to
      separate Hemoccult and Gastroccult test slides, which were read by a blinded
      evaluator at 60, 120, and 180 seconds after the addition of developer. Any trace
      of blue in the test area was considered a positive result. Sucralfate-free
      simulated gastric fluid spiked with blood served as a positive control, and fluid
      with or without sucralfate and containing no blood served as a negative control.
      No false-positive or false-negative results were obtained with Gastroccult.
      Hemoccult yielded false-positive results in 3 of 20 determinations at 60 seconds
      for solution containing sucralfate 10 mg/mL (pH 1.2) and 13 of 20 determinations
      at 60 seconds for solution containing sucralfate 2.5 mg/mL (pH 1.2). All the
      results with Hemoccult were positive when the slides were read at 120 and 180
      seconds. Also, all the results for the negative controls were positive at 120
      seconds. Hemoccult did not produce any false-negative results. False-positive
      results occurred when Hemoccult was used to test simulated gastric fluid that had
      a low pH (1.2) and contained sucralfate. Gastroccult did not yield false-positive
      results.

PMID- 1617914
TI  - Safety and tolerability of an intravenous immune globulin at various
      concentrations in 5% dextrose injection or sterile water for injection.

PMID- 1617915
TI  - Warfarin-induced intramural hematoma of the small intestine.
AB  - A case of warfarin-induced intramural hematoma and hemorrhagic infarction of the
      small intestine is described, and the literature on this adverse effect is
      reviewed. A 32-year-old white woman who had been receiving warfarin and
      carbamazepine came to a clinic complaining of lower back and stomach pain. She
      had a history of iliofemoral deep venous thromboses and seizures. A pelvic
      sonogram showed a large quantity of fluid present. Her prothrombin time (PT) was
      29.2 sec. Her hemoglobin concentration and hematocrit were within the normal
      ranges. The patient was admitted to the hospital when her back pain increased and
      she vomited. The warfarin was discontinued. On day 5 the patient was still having
      abdominal pain and nausea. Her hemoglobin concentration and hematocrit had fallen
      to 6.6 g/dL and 20%, although her PT had decreased to 12.5 sec. On the same day,
      the patient underwent an exploratory laparotomy, and an indurated and ischemic
      area of jejunum was found and resected. The pathology report indicated the
      presence of hemorrhage and infarction consistent with an anticoagulant-related
      disorder. About 100 cases of intramural hematoma of the small intestine induced
      by anticoagulant therapy have been reported. Most patients are white males about
      60 years of age. The sites most frequently involved are the duodenum and proximal
      jejunum. Symptoms include constipation, nausea, vomiting, and abdominal pain.
      Laboratory test and radiological findings are fairly nonspecific, but when found
      together in a patient receiving an anticoagulant, the diagnosis can be made with
      some confidence. Management may be complicated by the bleeding disorder, the
      intestinal obstruction if present, and the original indication for warfarin
      therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617916
TI  - Sucralfate-associated aluminum toxicity in a patient with renal failure:
      treatment with deferoxamine.

PMID- 1617917
TI  - Domain-specific reasoning: social contracts, cheating, and perspective change.
AB  - What counts as human rationality: reasoning processes that embody content
      independent formal theories, such as propositional logic, or reasoning processes
      that are well designed for solving important adaptive problems? Most theories of
      human reasoning have been based on content-independent formal rationality,
      whereas adaptive reasoning, ecological or evolutionary, has been little explored.
      We elaborate and test an evolutionary approach. Cosmides' (1989) social contract
      theory, using the Wason selection task. In the first part, we disentangle the
      theoretical concept of a "social contract" from that of a "cheater-detection
      algorithm". We demonstrate that the fact that a rule is perceived as a social
      contract--or a conditional permission or obligation, as Cheng and Holyoak (1985)
      proposed--is not sufficient to elicit Cosmides' striking results, which we
      replicated. The crucial issue is not semantic (the meaning of the rule), but
      pragmatic: whether a person is cued into the perspective of a party who can be
      cheated. In the second part, we distinguish between social contracts with
      bilateral and unilateral cheating options. Perspective change in contracts with
      bilateral cheating options turns P & not-Q responses into not-P & Q responses.
      The results strongly support social contract theory, contradict availability
      theory, and cannot be accounted for by pragmatic reasoning schema theory, which
      lacks the pragmatic concepts of perspectives and cheating detection.

PMID- 1617918
TI  - Modal reasoning, models, and Manktelow and Over.
AB  - Manktelow and Over (1991) argue that their studies of Wason's selection task
      favor explanations of deontic reasoning based on mental models, but that such
      theories need to incorporate utilities. This theoretical note proposes a simpler
      explanation of the phenomena: subjects in the selection task consider only those
      cards that are explicitly represented in their models of the conditional, and so
      insight into the task depends on constructing fully explicit models. Such models
      for modal conditionals of the form, If p occurs then q may occur are: [formula:
      see text] Each line denotes a separate model, and the models represent either
      what is possible, or, in the deontic interpretation, what is permissible. A
      deontic rule is accordingly violated by the contingency: [symbol: see text] p and
      q, for example the rule, "If you spend more than 100 pounds, then you may take a
      free gift" is violated by taking the free gift (q) but not spending more than 100
      pounds ([symbol: see text] p). If the rule is interpreted as a bi-conditional,
      then the second of the models, p and [symbol: see text] q, is also now a
      violation, for example spending more than 100 pounds (p) but not getting the free
      gift ([symbol: see text] q). Manktelow and Over's instructions lead subjects to
      focus on one or other of the two sorts of violations of the rule. There is
      accordingly no need to introduce utilities into models in order to explain the
      phenomena.

PMID- 1617919
TI  - Utility and deontic reasoning: some comments on Johnson-Laird and Byrne.

PMID- 1617920
TI  - The early development of numerical reasoning.
AB  - Children of age 1-4 years were found capable of engaging in numerical reasoning.
      Children were presented with a task in which they placed a set of objects one by
      one into an opaque container. An experimenter then visibly performed either an
      addition, a subtraction, or no transformation on the screened set. Children were
      then instructed to remove all objects from the container. Across two experiments,
      children searched for and removed the correct number of objects when set
      numerosity was small. Knowledge of numerical identity and knowledge of the
      effects of addition and subtraction transformations on numerosity were present
      even in children who had not yet begun to count verbally. These findings provide
      evidence that the emergence of numerical reasoning does not depend upon the prior
      development of a verbal counting ability or upon cultural experience with
      numbers.

PMID- 1617921
TI  - Factors affecting nonadherence with antibiotics.
AB  - Nonadherence with antibiotic therapy has profound implications both for patient
      health and the health care system that bears the financial costs incurred.
      Significant levels of nonadherence with antibiotic prescriptions have been
      demonstrated. Of the many proposed variables involved, those that are potentially
      modifiable relate to aspects of the doctor-patient interaction and drug regimen.
      Despite the potential for intervention with these variables, there have been very
      few methodologically sound studies examining their effect on adherence with
      either medications generally or antibiotics specifically. Only two studies were
      located that had tested the effectiveness of reduced complexity of antibiotic
      dosage schedules. The results suggest that the less complex the schedule, the
      greater is the adherence. Both practitioners and patients must be encouraged to
      use and accept simpler dosage schedules, preferably once-daily schedules wherever
      possible. The paucity of well-controlled studies to date highlights the need for
      further research evaluating intervention strategies that utilize variations in
      dosage schedule and elements of the doctor-patient interaction to improve
      adherence with antibiotic medications.

PMID- 1617922
TI  - Clinical evaluation of roxithromycin 300 mg once daily as an alternative to 150
      mg twice daily.
AB  - A multicenter, double-blind, randomized, two-arm study was conducted to compare
      two dosage regimens of roxithromycin--150 mg b.i.d. and 300 mg once daily--in
      1588 patients with infectious disease, 1573 of whom were evaluable for safety and
      1391 for efficacy. There were no significant differences in demographic or
      disease characteristics at presentation. Treatment duration averaged 10 days in
      both groups. Clinical response rates (% satisfactory response) were similar in
      both arms (b.i.d. versus once daily, respectively): upper respiratory tract, 95.3
      and 95.0; lower respiratory tract, 93.1 and 93.6; and skin and soft tissue, 93.1
      and 93.0. Bacteriologic response was also similar. The overall incidences of
      adverse events were 8.5% for daily dosing and 7.2% for b.i.d. dosing, but there
      was a slightly greater frequency of gastrointestinal events (p less than 0.03)
      was observed with the once-daily regimen. Thus roxithromycin 300 mg once daily
      can be recommended as an effective and well-tolerated alternative to the
      conventional b.i.d. regimen.

PMID- 1617923
TI  - Roxithromycin versus doxycycline in the treatment of acute exacerbations of
      chronic bronchitis.
AB  - The efficacy and safety of roxithromycin (300 mg once daily) and doxycycline (200
      mg once daily) in the treatment of acute exacerbations of chronic bronchitis in
      general practice were compared in a multicenter, double-blind, double-dummy
      trial. The data presented here are the results of an interim analysis of 76
      patients. A satisfactory clinical response was obtained in 81% of patients
      treated with roxithromycin and 80% of those treated with doxycycline. Among
      patients receiving roxithromycin, 12.2% volunteered adverse events, compared with
      33% of those receiving doxycycline; the test treatments were considered possibly
      or probably responsible for the adverse events in 9.8% and 21.2% of cases,
      respectively. Though patient numbers are too small for statistically significant
      differences to be detected, we conclude that the results to date suggest that
      roxithromycin and doxycycline are equivalent in terms of efficacy, but that
      roxithromycin is better tolerated.

PMID- 1617924
TI  - A randomized, comparative study of the efficacy and tolerance of roxithromycin
      and doxycycline in the treatment of women with positive endocervical cultures for
      Chlamydia trachomatis and Mycoplasma spp. in an in vitro fertilization program.
AB  - A total of 45 patients wishing to enter an in vitro fertilization program had
      positive endocervical cultures for Chlamydia trachomatis, 86 had positive
      cultures for Ureaplasma urealyticum, and 11 had positive cultures for Mycoplasma
      hominis. These patients and their consorts were randomly allocated to treatment
      with either roxithromycin or doxycycline. Both antibiotics were completely
      effective against C. trachomatis. In patients with U. urealyticum infection,
      roxithromycin was successful in 73% and doxycycline in 87% of cases. Mycoplasma
      hominis was eradicated in 100% of cases by doxycycline and in 85% of cases by
      roxithromycin. Doxycycline caused significantly more side effects than did
      roxithromycin.

PMID- 1617925
TI  - Multicenter double-blind study of the efficacy and tolerance of roxithromycin
      versus erythromycin ethylsuccinate in acute orodental infection in adults.
      Odontogenic Infections Study Group.
AB  - A total of 194 patients with orodental infection were randomized either to
      roxithromycin 150 mg twice daily plus placebo or to erythromycin 1 g twice daily
      plus placebo for a mean duration of 8 days. The infections consisted of
      cellulitis, pericoronitis, and adenopathy, or any two in combination. In the 176
      cases in which efficacy was evaluable, outcome was satisfactory in 94% and 91% of
      cases treated with roxithromycin and erythromycin, respectively (p = 0.45).
      Patients were evenly distributed with respect to demographic characteristics,
      diagnosis, and concomitant treatment. Surgery was performed in 63%, primarily for
      abscess formation in cellulitis (p less than 0.001); 18% of patients with an
      abscess did not undergo surgery. The success rate was identical irrespective of
      whether surgery was performed, including in those with an abscess. Tolerance was
      evaluated in 1986 patients. Unwanted effects, elicited by direct questioning,
      were reported in approximately 20% of cases per group (19% for roxithromycin and
      21% for erythromycin). They consisted of mild gastrointestinal upsets which
      caused treatment to be withdrawn in eight cases (four per group). Thus,
      roxithromycin and erythromycin twice daily for orodental infection are similar in
      both efficacy and tolerance.

PMID- 1617926
TI  - In vitro activity of roxithromycin against Moraxella catarrhalis.
AB  - The in vitro activity of roxithromycin was compared with that of the other
      antimicrobial agents (erythromycin, tetracycline, ampicillin, and cotrimoxazole)
      against 188 distinct clinical isolates of Moraxella catarrhalis. Of these, 106
      strains (66%) produced beta-lactamase. The MIC90 of roxithromycin was 0.25
      micrograms/ml compared with values of 0.5, 1, greater than 8, greater than 8:0.4
      micrograms/ml for erythromycin, tetracycline, ampicillin, and sulfamethoxazole
      trimethoprim, respectively. These results, allied with its improved
      pharmacokinetic properties, suggest that roxithromycin should be an effective
      treatment in children and adults for upper and lower respiratory tract infections
      caused by M. catarrhalis.

PMID- 1617927
TI  - The effect of roxithromycin on the virulence of gram-positive cocci.
AB  - Antibiotics whose recognized mode of action comprises inhibition of bacterial
      protein biosynthesis are also recognized to modulate the expression of bacterial
      virulence factors when incorporated into culture media at sub-MIC levels. In this
      respect, one of the new macrolides, roxithromycin, has been examined for its
      effect on toxin/enzyme production by strains of Staphylococcus aureus,
      Streptococcus pyogenes, and Streptococcus pneumoniae. Biosynthesis of
      staphylococcal coagulase and DNase could be potentiated, whereas that of
      staphylococcal alpha-hemolysin, streptolysins O and S, and pneumolysin were
      unaltered. Expression of one structural virulence factor, pneumococcal
      polysaccharide, was repressed in the drug's presence, resulting in potentiation
      of phagocytic ingestion of the drug-exposed bacteria. The drug failed to have any
      effect on ingestion of Staph. aureus or Strep. pyogenes. These studies provide
      evidence that roxithromycin may exhibit "added value" as an antibiotic in its
      ability to potentiate the susceptibility of Strep. pneumoniae to host defenses
      such as phagocytosis.

PMID- 1617928
TI  - Penetration of roxithromycin into gingival tissue.
AB  - Roxithromycin is a new macrolide with an antibacterial spectrum similar to that
      of erythromycin. Absorption is rapid and complete, resulting in high serum levels
      and a long half-life. Tissue distribution is extensive and sustained, as shown by
      the high concentrations measured in the lung, prostate, ovaries, liver, kidney,
      and skin. In this study, we measured the penetration of roxithromycin into
      gingival tissue at steady state in 30 patients treated orally with 150 mg every
      12 hr for 5 days. Tissue specimens were sampled at 2, 4, 6, 8, or 12 hr (n = 6
      each time) after dose 10, and blood samples were taken simultaneously. Serum and
      tissue concentrations of roxithromycin were measured by high-performance liquid
      chromatography. The peak serum level, reached 4 hr after dosing, was 6.60 +/-
      1.15 micrograms/ml. The peak tissue level was 4.63 +/- 1.84 micrograms/g and was
      reached after 8 hr. From 4 to 10 hr after dosing, tissue concentrations were
      greater than 2 micrograms/g, that is, higher than the MIC90 of roxithromycin
      against most oral pathogens. These data support the use of roxithromycin in the
      treatment of oral infections.

PMID- 1617929
TI  - An international clinical trial on the efficacy and safety of roxithromycin in
      40,000 patients with acute community-acquired respiratory tract infections.
AB  - An ongoing eight-country study is being conducted in an unprecedented number of
      general practice patients with acute upper and lower respiratory tract infections
      to compare the efficacy and tolerance of roxithromycin 150 mg b.i.d. for 7-14
      days with the data acquired in the prelaunch studies of these same parameters.
      The target population is 40,000 (to be achieved by the end of 1991) and we report
      the interim results from 32,405 patients, 18,020 with upper and 14,385 with lower
      respiratory tract infections. In acute pharyngitis/tonsillitis sinusitis, and
      otitis, clinical resolution or improvement has been achieved in 97%, 96%, and 96%
      of cases, respectively. The figures for bronchitis, exacerbation of chronic
      bronchitis, and pneumonia are 97%, 94%, and 95%. Side effects have been reported
      in only 4% of patients to date, 75% consisting of moderate gastrointestinal
      upsets. Of the patients, 1% withdrew from treatment because of side effects.
      These interim figures confirm the data from the prelaunch, controlled comparative
      trials and show roxithromycin to be an appropriate choice of first-line
      antibiotic therapy in the management of respiratory tract infections in general
      practice.

PMID- 1617930
TI  - Comparison of two oral antibiotics, roxithromycin and amoxicillin plus clavulanic
      acid, in lower respiratory tract infections.
AB  - In a randomized, multicenter, open-label study, 490 ambulatory adult patients
      with lower respiratory tract infection (LRTI) were randomized to roxithromycin
      (ROX) 150 mg b.i.d. orally (n = 244) or amoxicillin plus clavulanic acid (AMX +
      CA) as 500 mg AMX + 125 mg CA t.i.d orally (n = 24). Clinical results were
      analyzed in 477 patients with acute bronchitis (79%), chronic bronchitis (CB)
      (14%), and pneumonia (7%). There were significantly more patients with underlying
      disease (cardiovascular diseases, p = 0.045; and alcoholism, (p less than 0.001),
      and more patients over the age of 65 years (p = 0.045) in the ROX group. Overall
      clinical efficacy was similar in both groups: 88% (206:235) in the ROX group and
      85% (205:242) in the AMX + CA group. Side effects were reported in 67 cases (28%)
      in the AMX + CA group and in 21 cases (9%) in the ROX group (p less than 0.0001),
      causing withdrawal in 21 and three cases, respectively (p less than 0.001). Thus,
      despite being administered to a significantly older and more ill group of
      patients with LRTI, roxithromycin was as effective as amoxicillin plus clavulanic
      acid and better tolerated.

PMID- 1617931
TI  - Roxithromycin versus amoxicillin-clavulanic acid in the treatment of respiratory
      tract infections.
AB  - A multicenter, double-blind, double-dummy trial was conducted in 96 general
      practice patients with upper and lower respiratory tract infection to compare the
      efficacy and tolerance of roxithromycin (150 mg b.i.d.) and amoxicillin
      clavulanic acid (500 mg/125 mg t.i.d.). Good clinical response was obtained in
      96% and 95% of cases, respectively, but only 4% of patients receiving
      roxithromycin volunteered adverse events possibly or probably related to their
      test treatment, as opposed to 17% of those receiving amoxicillin-clavulanic acid.
      The results indicate that both drugs are equally effective in the treatment of
      respiratory tract infection, but that roxithromycin is better tolerated.

PMID- 1617933
TI  - Elevated urinary excretion of orotic acid in sheep caused by intraruminal
      infusion of sodium propionate.
AB  - 1. The effect of sodium propionate on urinary excretion of orotic acid was
      investigated. 2. Solutions containing sodium propionate or NaCl, 750 mM/day each,
      were continuously infused into the rumen for 10 days. 3. During NaCl infusion, an
      urinary orotic acid excretion of 290 +/- 80 micrograms/day was noted. The
      intraruminal infusion of sodium propionate raised the concentration of propionic
      acid in the rumen fluid from 14.0 +/- 0.9 to 26.9 +/- 1.9 mM. 4. During this
      experimental period the excretion of orotic acid via urine significantly
      increased to 492 +/- 30 micrograms/day. Parameters of nitrogen balance were not
      altered by propionate. 5. It is suggested that the site of propionate action in
      intact sheep is in the pyrimidine synthesis pathway.

PMID- 1617932
TI  - A randomized double-blind controlled trial of roxithromycin and cefaclor in the
      treatment of acute lower respiratory tract infections in general practice.
AB  - A multicenter, randomized, double-blind, single-dummy placebo-controlled study is
      being undertaken by the Research Unit of the Royal New Zealand College of General
      Practitioners to compare the efficacy and tolerance of 150 mg twice daily
      roxithromycin with 250 mg three times daily cefaclor in the treatment of 250
      general practice patients with acute lower respiratory tract infections (LRTIs).
      Interim analysis of 200 patients reveals no statistically significant differences
      in the study parameters. Of the patients on roxithromycin and cefaclor, 83% and
      67%, respectively, had a moderate or severe illness. Based on efficacy criteria,
      96% of roxithromycin recipients and 99% of cefaclor recipients had a satisfactory
      or improved response. On an intention-to-treat basis, this was reduced to 95% for
      both treatment groups. Sputum grading and semiquantitative culturing was
      performed according to NCCLS standards. The most common isolates in order were
      Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae.
      Efficacy for bacteriologically evaluable cases was 87.5% for roxithromycin and
      57% for cefaclor. Four patients on roxithromycin (3.9%) and 11 patients on
      cefaclor (11.3%) withdrew because of side effects probably or possibly related to
      the study treatment. The study is ongoing.

PMID- 1617934
TI  - The uptake and conversion of L-[U14C-] aspartate and L-[U14C-] alanine to 14CO2
      by intact trophozoites of Giardia duodenalis.
AB  - 1. Intact trophozoites of Giardia duodenalis (clone P1C10) took up and
      metabolised L-[U14C-] aspartate to 14CO2 at rates of 10.27 +/- 0.76 and 27.6 +/-
      2.07 ng hr-1 10(-6) cells in a simple maintenance medium (MM) and in a complex
      bile supplemented (BIS-33) medium respectively. 2. Intact trophozoite of G.
      duodenalis (clone P1C10) also took up and metabolised L-[U14C-] alanine to 14CO2
      at rates of 20.6 +/- 1.1 and 91.4 +/- 17.5 ng hr-1 10(-6) cells in the simple
      (MM) and complex (BIS-33) medium respectively. 3. trophozoite sonicates contained
      significant levels of aspartate-2-oxoglutarate transaminase (AST; EC 2.6.1.1) and
      alanine-2-oxoglutarate transaminase (ALT; EC 2.6.2.2.). Specific activities (at
      23 degrees C) were 95.1 +/- 11.3 and 87.3 +/- 9.8 nmol (min)-1 (mg protein)-1
      respectively. 4. These observations suggest that Giardia has the capacity to
      utilise aspartate and alanine and possibly other amino acids as alternative
      sources of energy. 5. The extrusion or uptake of alanine by Giardia trophozoites
      may be dictated by the intracellular redox-status of the protozoan parasite or
      components in the external mileu.

PMID- 1617935
TI  - Distribution of 5'-nucleotidase in muscle of some marine fishes.
AB  - A preliminary examination for the purification and characterization of 5'
      nucleotidase of fish muscle was carried out and the following results were
      obtained. 1. The activities of 5'-nucleotidase in the muscles of marine
      vertebrates and invertebrates (total 11 species) were determined. The highest
      activity of 5'-nucleotidase was found in Blackrock fish Sebastes inermis, which
      was then used as a material for estimation of subcellular distribution and
      solubilization of the enzyme. 2. The 5'-nucleotidase of ordinary muscle of the
      fish Sebastes inermis was found in nuclear, microsomal and cytosolic fractions.
      About half of the total activity was found in the nuclear fraction, whereas the
      highest specific activity was observed in the microsomal fraction. 3. Complete
      solubilization of the enzyme was attained by using a high concentration of
      detergent such as Triton X-100, CHAPS, octylglucoside, octylthioglucoside and
      sodium deoxycholate, suggesting that the enzyme was tightly bound to the
      membrane. 4. Based on the results of solubility and stability tests, Triton X-100
      seemed suitable for solubilizing 5'-nucleotidase from the membrane. 5. Microsomal
      5'-nucleotidase was an Mg(2+)-activated enzyme, and no inactivation was observed
      up to 50 mM of Mg2+.

PMID- 1617936
TI  - Wide distribution of the skin type I collagen alpha 3 chain in bony fish.
AB  - 1. Skin Type I collagens were isolated from the five species of non-teleostean
      fish and examined with respect to their subunit chains. 2. In addition to alpha
      1(I) and alpha 2(I) chains, a fish-specific chain, alpha 3(I), was previously
      found only in teleostean fish. The present study, however, has revealed the
      occurrence of alpha 3(I) in a chondrostean fish, white sturgeon. 3. The alpha
      3(I) gene appears to have arisen from a duplication of the alpha 1(I) gene near
      the time of the adaptive radiation of bony fish.

PMID- 1617937
TI  - Study on fatty acid binding by proteins in yeast. Dissimilar results in
      Saccharomyces cerevisiae and Yarrowia lipolytica.
AB  - 1. The presence of soluble proteins with fatty acid binding activity was
      investigated in cell-free extracts from Saccharomyces cerevisiae and Yarrowia
      lipolytica cultures. 2. No significant fatty acid binding by proteins was
      detected in S. cerevisiae, even when grown on a fatty acid-rich medium, thus
      indicating that such proteins are not essential to fatty acid metabolism. 3. An
      inducible fatty acid binding protein (K0.5 = 3-4 microM) was found in Y.
      lipolytica which had grown on a minimal medium with palmitate as the sole source
      of carbon and energy. 4. The relative molecular mass of this protein was 100,000
      as inferred from Sephacryl S-200 gel filtration.

PMID- 1617938
TI  - Purification and characterization of a latent form of multicatalytic proteinase
      from fish muscle.
AB  - 1. A latent form of multicatalytic proteinase (MCP) was purified to apparent
      homogeneity from white croaker muscle by DEAE-Sephacel, Mono-Q, Sephacryl S-300
      and second Mono-Q chromatographies. 2. The enzyme preparation was
      electrophoretically and immunologically similar to MCP purified from the same
      source by a different method (Folco et al., 1988b, Archs Biochem. Biophys. 267,
      599-605) but showed much lower chymotrypsin- and trypsin-like activities. 3.
      These activities responded to sodium dodecyl sulphate (SDS), urea and heat
      treatments in different ways: SDS stimulated both activities, urea stimulated the
      former and inhibited the latter and heating stimulated the former and did not
      affect the latter. 4. The stimulation of chymotrypsin-like activity by the three
      treatments was irreversible. 5. Exposure of MCP to SDS or urea in the absence of
      substrate rapidly inactivated it, whereas heat activation took place irrespective
      of the presence of substrate. 6. The stimulating effect of SDS on chymotrypsin
      like activity was lost in the presence of urea. 7. These results suggest that the
      enzyme may be activated by different mechanisms.

PMID- 1617939
TI  - Identification, comparison and partial characterization of glycoproteins in the
      hemolymph of Schistosoma mansoni (Trematoda)-susceptible and resistant
      Biomphalaria glabrata (Gastropoda).
AB  - 1. Glycoproteins in the plasma (cell-free hemolymph) of Schistosoma mansoni
      resistant and susceptible strains of Biomphalaria glabrata were identified,
      characterized and compared using sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, electroblotting and a series of peroxidase-labeled lectins with
      different sugar specificities. 2. Schistosome-resistant snails possessed at least
      three glycoproteins (70, 116, 205 kDa) that were not present in plasma from
      susceptible snails. 3. Sporocysts (larval S. mansoni) preincubated in plasma from
      schistosome-resistant or susceptible B. glabrata adsorbed certain glycoproteins
      to their surface and some altered the binding of lectin probes to the parasite.
      4. This study indicates that glycoproteins in the plasma of B. glabrata are
      associated with S. mansoni-susceptibility and resistance.

PMID- 1617941
TI  - A comparison of hepatic glucokinase gene expression in high- and low-activity
      strains of mice.
AB  - 1. Compared with the rat, mouse liver glucokinase activities show a different
      sensitivity to changes in insulin concentrations. When animals from a high
      glucokinase-high insulin level strain C3H/He are crossed with those from a low
      glucokinase-low insulin strain C58, individuals from recombinant inbred lines
      show non-parental phenotypes with high glucokinase activity but low insulin and
      vice versa. 2. Messenger RNA levels are greater in high-enzyme-activity mice
      strains than in low-activity animals, suggesting that differences in either
      transcription of the glucokinase gene or in mRNA stability occur between the two
      strains. 3. There is no evidence of a different number of glucokinase genes in
      the high- and low-activity strains. Differences in activity therefore suggest
      that dissimilarities in the regulation of the expression of these genes may well
      occur.

PMID- 1617940
TI  - Individual expression patterns of myotoxin isoforms in the venom of the snake
      Bothrops asper.
AB  - 1. In order to investigate the distribution of myotoxin isoforms in the snake
      Bothrops asper, venoms from individual specimens were analyzed by a cathodic
      electrophoretic system for basic proteins under native conditions. 2. The
      electrophoretic system resolved at least five bands with slight differences in
      mobility, corresponding to the fastest migrating proteins in the venom. The
      identity of the bands was confirmed by immunoblotting, using a rabbit anti
      myotoxin serum. 3. There were clear differences in the individual patterns of
      myotoxin isoform expression, both in specimens from the Atlantic and Pacific
      regions of Costa Rica. Some individuals possessed all five variants. 4. In
      agreement with previous reports, the venoms of ten newborn (less than 10 days of
      age) specimens completely lacked myotoxin bands, indicating an ontogenetic
      regulation in the expression of these toxins in B. asper. 5. One of the bands,
      corresponding to the lysine-49 phospholipase myotoxin II, was the only isoform
      present in all individuals studied, suggesting a possible selective pressure for
      the conservation of this type of protein in the venom of B. asper.

PMID- 1617942
TI  - Age-related changes of the branched-chain fatty acid concentration in rat skin
      surface lipid.
AB  - 1. Age-related change of the branched-chain fatty acid distribution in rat skin
      surface lipid was studied for 24 months. 2. The proportion of even carbon number
      iso-acid increased from infancy to month 5 and thereafter decreased with
      advancing age toward senescence. 3. Concentration of odd carbon number iso-acid
      depicted a similar shape of time course, but with a lesser magnitude and a peak
      value at month 1. 4. Anteiso- fatty acid reached the plateau level at month 5 and
      remained roughly constant through maturity to senescence.

PMID- 1617944
TI  - Effect of training on fibre composition and phosphate metabolites in rest
      measured in vitro in muscles of young pigs.
AB  - 1. Fibre type composition and phosphate metabolites were studied in m.
      longissimus thoracis (MLT), m. rectus femoris (MRF) and m. triceps brachii (MTB)
      in trained (N = 6) and sedentary (N = 6) pigs. 2. Samples were analyzed
      histochemically and by means of in vitro 31P NMR spectroscopy. 3. Training
      (duration 11 weeks) consisted of treadmill running at a speed of 1.1 m/sec. The
      daily exercise time of trained animals gradually increased from 10 min during the
      very first days to 60 min at the end of the 4th week. 4. During the final 7 weeks
      exercise time remained unchanged. Sedentary animals were not subjected to
      training. 5. A higher proportion of type beta R fibres in MRF, MTB and MLT and a
      lower proportion of type alpha W fibres were found in the trained group of
      animals compared to the control group. 6. In MLT no significant differences in
      the proportion of type alpha W were observed between both groups. 7. No
      significant differences in average fibre diameter of muscle fibres were found
      between groups. 8. No differences in concentration of phosphate compounds were
      observed between trained and sedentary groups. 9. Muscles with a higher
      proportion of type IIb fibres in both groups of pigs contained higher amounts of
      phosphocreatine (PCr) and were also characterized by a higher ratio of PCr to
      inorganic phosphate (Pi).

PMID- 1617943
TI  - Thiol groups and other chemical characteristics of rat monoclonal immunoglobulin
      A.
AB  - 1. Three aspects of the monoclonal rat IgA IR22 were investigated: its free thiol
      groups, its hinge structure and its glycopeptides. 2. Exposed thiol groups, 1.5
      per IgA dimer, were located in the Fc region, and buried thiol groups, 3.2 per
      IgA dimer, were located in the Fd region. 3. Rat IgA was cleaved to Fab fragments
      by pepsin, but, unlike mouse IgA, it was not cleaved at the hinge region by
      papain. 4. The contents of GlcNAc indicated that there were two N-linked
      glycopeptides in the Fab region, and one in the Fc or tail regions.

PMID- 1617945
TI  - Fractionation of DNA from marine invertebrate (Maja crispata, Mytilus
      galloprovincialis) haemolymph by alkaline elution.
AB  - 1. An alkaline elution procedure for the detection of DNA damage in marine
      invertebrate haemolymph has been developed. 2. Provided that three criteria are
      optimized, such as buffer composition, small filter pores (0.22 microns GVWP 025
      00, Millipore), and optimal amounts of haemolymph applied, flow rates may be
      changed within the range of 0.2 ml/min to 0.05 ml/min without adverse back
      pressure on the filter and without blocking filter pores. 3. Under optimal
      conditions, 70% of mussel haemolymph DNA, and 80% of crab haemolymph DNA will be
      retained on the filter after 6 hr of elution, indicating shorter DNA in mussel
      haemolymph. 4. The technique is applicable for testing the in vivo effects of
      different compounds on DNA in marine invertebrates, and to measurements of DNA
      damage in naturally exposed mussels. 5. This argues an important case for the use
      of alkaline elution technique for assessment of environmental genotoxicity, and
      especially for investigation of DNA damage in different marine organisms which
      cover a broad range in their DNA molecular weights.

PMID- 1617946
TI  - Functional and immunochemical comparison of hepatic UDP-glucuronosyltransferases
      in a piscine and a mammalian species.
AB  - 1. The aglycone specificity of hepatic microsomal glucuronidation was compared
      under uniform conditions in a fish, Pleuronectes platessa and a mammal, Rattus
      norvegicus, representative of the most primitive and advanced vertebrate classes.
      2. Both species exhibited comparable UDP-glucuronosyltransferase (UDPGT) activity
      towards planar phenolic substrates (1-naphthol, 4-nitrophenol); however, plaice
      activity towards bulky non-planar substrates such as (-)-morphine was either 200
      fold lower, or for an arylacetic acid (RS-2-phenylpropionic acid) and an
      aryloxyacetic acid (clofibric acid) non-detectable. 3. Conjugation of the
      endogenous substrates, bilirubin and steroids were 4- to 40-fold lower in the
      plaice than in the rat. Whilst both species formed diglucuronides of the
      asymmetrical bilirubin IX alpha, they displayed a reciprocal preference for the
      initial esterification, conjugation of the C-8 side chain predominating in the
      rat and of C-12 in the fish. 4. Immunoblot analysis using two polyclonal antisera
      preparations raised against rat UDPGTs demonstrated the presence of multiple
      weakly cross-reacting polypeptides in fish microsomes indicative of multiple
      isoforms and conservation of common structural motifs over more than 350 million
      years since evolutionary divergence of the mammals.

PMID- 1617947
TI  - Tumour-localizing properties of porphyrins. In vivo studies using free and
      liposome encapsulated aminolevulinic acid.
AB  - 1. Using different doses of free and liposome encapsulated aminolevulinic acid
      (ALA) (between 2 and 8 mg/animal), given i.p., s.c. and intra-tumoural (i.t.), in
      vivo porphyrin synthesis by tumour, red blood cells (RBC) and different organs
      from tumour-bearing mice (TBM) and normal mice (NM) at different times, up to 24
      hr after ALA administration, was examined. 2. It was found that by giving
      entrapped ALA, at a dose of 6 mg/animal (or 200 mg/kg wt), after 10 hr, a high
      level of porphyrin accumulation in the tumour was produced (7 micrograms/g
      tissue). Low synthesis occurred in muscle, lung, brain, RBC and skin; in spleen,
      kidney and liver synthesis is significant after 10 hr, but after 24 hr returned
      to normal values in the spleen and to about 2-3 micrograms/g tissue in the kidney
      and liver. 3. The tumour/skin porphyrin concentration ratio after 10 hr was
      nearly 30, the highest so far reported. 4. These results support our previous in
      vitro findings, indicating that free or encapsulated ALA might be used for early
      diagnosis of cancer and in photodynamic therapy.

PMID- 1617948
TI  - A program to facilitate cytotoxicity assay data reduction.
AB  - A report of a program which performs the initial computational reduction of the
      raw data from a cytotoxicity assay and outputs the reduced data as an image of
      the arrangement of the assay(s) upon the microwell plate. The program accepts the
      raw data either as manual or diskette file input.

PMID- 1617949
TI  - MW/Pharm, an integrated software package for drug dosage regimen calculation and
      therapeutic drug monitoring.
AB  - The pharmacokinetic software package MW/Pharm offers an interactive, user
      friendly program which gives rapid answers in clinical practice. It comprises a
      database with pharmacokinetic parameters of 180 drugs, a medication history
      database, and procedures for an individual drug dosage regimen calculation. The
      included curve-fitting facilities allow estimation of pharmacokinetic parameters
      on the basis of medication history, taking into account a varying status of the
      patient with respect to body weight and kidney function, optionally using a
      Bayesian procedure. The module KinBes performs the evaluation of bioavailability
      studies, including various methods, and an extensive statistical evaluation of
      bioequivalence.

PMID- 1617950
TI  - Classification of chromatic visual evoked potentials with the aid of a neural
      net.
AB  - Twelve normal subjects, and six color blind (three protanopes and three
      deuteranopes) individuals were used in this study. Visual evoked potentials (50
      150 msec post-stimulus) were recorded in response to three stimuli: (a) three
      horizontal, achromatic bars alternating in luminosity between bright and dim, (b)
      bars alternating between blue and red, and (c) bars alternating between green and
      red. The resulting waveforms were normalized in amplitude and submitted to a
      commercial neural net program for classification. The network correctly
      identified 24 of the 36 normal responses. (2) The network was also asked to
      distinguish between the responses of normal and color blind individuals. Based
      upon the blue/red response, the network correctly classed 12 of 18 responses, and
      based upon the green/red response correctly classified 14 of 18 (including all 6
      color blinds). (3) These results are statistically highly significant and suggest
      that the VEP elicited by chromatic stimulation is substantially different from
      that elicited by achromatic stimuli.

PMID- 1617951
TI  - Automated recognition of corrupted arterial waveforms using neural network
      techniques.
AB  - A data acquisition system that automatically discards corrupted or undesirable
      signals would save untold hours of drudgery for researchers. Continuous recording
      of variables to provide detailed behavior patterns generates huge amounts of raw
      data. Unfortunately waveforms usually require visual inspection for isolating
      desired behavior or validating signal integrity. This tedious and time-consuming
      step can potentially be eliminated using a novel computer science technique. We
      have trained a simulated neural network to recognize corrupted arterial pressure
      waveforms. Our system can now evaluate the validity of the arterial waveform
      without human intervention with an average false positive error rate of 2.2% and
      an average false negative error rate of 12.6%.

PMID- 1617952
TI  - A PC program for growth prediction in the context of Rao's polynomial growth
      curve model.
AB  - We consider the problem of growth prediction in the context of Rao's [1] one
      sample polynomial growth curve model and provide a PC program, written in GAUSS,
      to perform the associated computations. Specifically, the problem considered is
      that of estimating the value of the measurement under consideration for a "new"
      individual at the Tth time point given measurements on that individual at T-1
      previous points in time and the values of the measurement on N "similar"
      individuals at all T time points. The times of measurement t1, t2, . . ., tT need
      not be equally spaced, but we assume that each of the N individuals comprising
      the normative sample were measured at these times. The method and the program are
      illustrated using the leave-one-out method on a sample of N = 12 male rhesus
      monkeys whose mandibular ramus height was measured five times at yearly
      intervals.

PMID- 1617953
TI  - The French communicable diseases computer network: a technical view.
AB  - This paper describes an information system (IS) established in France in 1984 for
      the national surveillance of communicable diseases. This IS is based on a
      videotex server and a relational database management system. The videotex server
      is the IS front-end. It performs the following functions: interpersonal
      communications, synthetic information retrieval into an epidemiologic info-base
      and data entry owing to its specialized applications. The relational database
      management system allows the user to manage and consult an epidemiologic database
      updated in quasi-real time. Several specific tools have also been developed in
      order to enhance data representation and analysis and the decision support
      capabilities of the IS.

PMID- 1617954
TI  - A computerized documentation system for cancer pain management units.
AB  - A cancer pain management unit can benefit markedly from a well-planned
      documentation system for administrative and scientific purposes. This article
      presents the principles of such a computerized system based on relational data
      base programs. The described system has been used by the authors for the last
      seven years. The successful documentation of more than 1400 patients over
      treatment periods of up to 2 years has provided detailed administrative and
      scientific information.

PMID- 1617955
TI  - A computer program for planimetric analysis of digitized images.
AB  - Planimetrical measurements are made to calculate the area of an entity. By
      digitizing the entity the planimetrical measurements may be done by computer.
      This computer program was developed in conjunction with a research project
      involving measurement of the pneumatized cell system of the temporal bones as
      seen on X-rays. By placing the X-rays on a digitizer tablet and tracing the
      outline of the cell system, the area was calculated by the program. The
      calculated data and traced images could be stored and printed. The program is
      written in BASIC; necessary hardware is an IBM-compatible personal computer, a
      digitizer tablet and a printer.

PMID- 1617956
TI  - Elicitation of release of luteinizing hormone by N-methyl-d,l-aspartic acid
      during three paradigms of suppressed secretion of luteinizing hormone in the
      female pig.
AB  - Two experiments were conducted to determine the minimal effective dose during
      lactation and site of action of N-methyl-d,l-aspartic acid (NMA) for elicitation
      of release of luteinizing hormone (LH) in female pigs. In the first experiment,
      three doses of NMA were given to lactating primiparous sows in which endogenous
      LH was suppressed by suckling of litters. In the second experiment,
      ovariectomized gilts were pretreated with estradiol benzoate or porcine antisera
      against GnRH to suppress LH and then given NMA to determine if it elicited
      secretion of LH directly at the anterior pituitary or through release of GnRH. In
      experiment 1, 3 lactating sows (17 +/- 1.5 d postpartum) were each given three
      doses of NMA (1.5, 3.0 and 5.0 mg/kg body weight [BW]; IV) on 3 consecutive days
      in a Latin Square design. Blood samples were collected every 10 min from -1 to 1
      hr from injection of NMA. NMA at 1.5 and 3.0 mg/kg did not affect (p greater than
      .5) secretion of LH; however, 5 mg NMA/kg elicited a 114% increase (p less than
      .001) in circulating levels of LH during 1 hr after treatment. In experiment 2, 8
      ovariectomized gilts were given either estradiol benzoate (EB; 10 micrograms/kg
      BW; IM n = 4) to suppress release of GnRH or porcine antiserum against GnRH (GnRH
      Ab; titer 1:8,000; 1 ml/kg BW; IV; n = 4) to neutralize endogenous GnRH. Gilts
      infused with GnRH-Ab were given a second dose of antiserum 24 hr after the first.
      Gilts were then given NMA (10 mg/kg BW; IV) 33 hr after EB or initial GnRH-Ab.
      Blood samples were drawn every 6 hr from -12 to 24 hr from EB or GnRH-Ab
      treatments, and every 10 min from -2 to 2 hr from NMA. Serum LH declined (p less
      than .001) after EB (from 1.87 +/- .2 ng/ml at 12 hr before EB to 0.46 +/- .02
      ng/ml during 24 hr after EB) and GnRH-Ab (from 1.97 +/- .1 to 0.59 +/- .02
      ng/ml). In gilts treated with EB, the area under the curve (AUC) for the LH
      response (ng.ml-1.min) 1 hr after NMA (38.7 +/- 3) was significantly greater (p
      less than .01) than the 1 hr prior to NMA (21.3 +/- 1.5). Treatment with NMA had
      no effect (p greater than .5) on secretion of LH in gilts infused with GnRH
      Ab.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1617957
TI  - Neuroendocrine regulation of growth hormone secretion in sheep. V. Growth hormone
      releasing factor and thyrotrophin releasing hormone.
AB  - The effects of intravenous (IV) and intracerebroventricular (ICV) administration
      of either bovine growth hormone releasing hormone (GRF) or thyrotrophin releasing
      hormone (TRH) on plasma growth hormone (GH) and glucose levels have been examined
      in sheep. Intravenous GRF 1-29NH2 at 3 and 30 micrograms stimulated an increase
      in GH levels in a dose-dependent fashion; administration of GRF into a lateral
      cerebral ventricle, however, produced a smaller GH response which was similar at
      these two doses. Evaluation of somatostatin levels in petrosal sinus blood (which
      collects pituitary effluent blood) showed that ICV administration of GRF
      stimulated a release of somatostatin into the blood. Furthermore, concurrent
      administration of GRF and a potent anti-somatostatin serum ICV resulted in a much
      enhanced release of GH which was similar to that obtained with a comparable dose
      of GRF given IV. TRH (as another putative GH-secretagogue) was also administered
      both IV and ICV. When given IV, 200 micrograms (but not 100 micrograms) TRH
      produced an elevation in GH levels. By contrast, when 5 micrograms TRH was given
      ICV there was a decrease in circulating GH levels, but no change in plasma
      somatostatin concentrations. These results indicate that the smaller GH response
      to ICV- compared with IV-administered GRF is due to the release of somatostatin
      within the brain. In addition, it would seem that TRH is not a physiological GH
      secretagogue in sheep.

PMID- 1617958
TI  - Effect of active immunization against growth hormone releasing factor on
      concentrations of somatotropin and insulin-like growth factor I in lactating beef
      cows.
AB  - Two experiments were conducted to determine the effects of immunoneutralization
      of growth hormone-releasing factor [GRF(1-29)-NH2] on concentrations of
      somatotropin (ST) and insulin-like growth factor I (IGF-I) in lactating beef
      cows. In Experiment 1, multiparous Hereford cows were immunized against 2 mg
      GRF(1-29)-(Gly)4-Cys-NH2 conjugated to human serum albumin (GRFi, n = 3) or 2 mg
      human serum albumin (HSAi, n = 3) at 52 +/- 1 d prior to parturition. Boosters (1
      mg) were administered on days 12, 40 and 114 postpartum (pp). Serum samples were
      collected at 15-min intervals for 5 hr on days 18, 46 and 120 pp, followed by
      administration (IV) of an opioid agonist (FK33-824; 10 micrograms/kg) and an
      antagonist (naloxone; .5 mg/kg) at hours 5 and 7, respectively. A GRF-analog
      ([desamino-Tyr1, D-Ala2, Ala15] GRF (1-29)-NH2; 3.5 micrograms/kg) and arginine
      (.5 g/kg) were administered at hour 10 on days 47 and 121, respectively.
      Percentage binding of [125I]GRF (1:100 dilution of serum) 28 d after primary
      immunization was greater in GRFi (14.3 +/- 4.9) than in HSAi (.7 +/- .3) cows.
      Binding increased to 29.3 +/- 6.5% after first booster in GRFi cows. Episodic
      release of ST was abolished by immunization against GRF; concentration and
      frequency of release of ST were lower (P less than .05) in GRFi than in HSAi cows
      on all days pp. Concentrations of IGF-I were lower in GRFi than in HSAi cows
      throughout lactation. Serum ST failed to increase following FK33-824 or arginine
      in GRFi; however, ST increased after both compounds in HSAi cows. Concentrations
      of ST following GRF-analog were greater (P less than .05) in HSAi than in GRFi
      cows. Experiment 2 was conducted to determine if a lower dose of antigen and a
      single booster would be sufficient to lower ST and IGF-I in lactating cows.
      Multiparous Hereford and Angus cows were assigned to GRFi (n = 6) or HSAi (n =
      6). Primary (1.2 mg) and booster (.5 mg) immunizations were administered -14 and
      8 d from calving, respectively. Cows were restricted to 60% of recommended intake
      of energy during lactation in order to elevate concentrations of ST. Serum
      samples were collected at 15-min intervals for 6 hr on days 26, 50, 73, 90 and
      109 pp. Two of six GRFi cows had binding less than 10% (1:1,000 dilution of
      serum) and were omitted from further analyses.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1617959
TI  - Effects of intracerebroventricular corticotropin-releasing hormone and
      intravenous morphine on cortisol, prolactin and growth hormone secretion in
      sheep.
AB  - It has previously been demonstrated that naloxone and morphine modify the
      adrenocortical and pituitary responses of sheep to stress. Since CRH acts within
      the brain to co-ordinate the stress response, the present experiment was
      conducted to determine whether morphine has similar effects in sheep given oCRH
      centrally. Plasma concentrations of cortisol, prolactin and growth hormone were
      measured in blood samples collected at 10 min intervals from sheep (N = 5) over a
      3-hr period. Intravenous injections of saline vehicle or morphine sulphate (0.4
      mg/kg) were given after 40 min and intracerebroventricular injections of oCRH (0,
      5 or 20 micrograms) were administered after 60 min. Sustained, dose-related,
      increases in cortisol were induced by oCRH and, in agreement with findings in
      stressed sheep, these responses were reduced by pretreatment with morphine.
      Prolactin levels appeared to increase after morphine but oCRH, on its own, did
      not increase prolactin secretion in this study. There was no change in growth
      hormone concentrations after oCRH whereas morphine transiently stimulated
      release.

PMID- 1617960
TI  - Lack of a nocturnal rise of serum melatonin in prepubertal gilts.
AB  - Experiments were conducted to determine if a nocturnal rise in serum melatonin
      occurs in prepubertal gilts and whether acute exposure of gilts to light during
      the dark period abruptly reduces serum concentrations of melatonin. In experiment
      1, 12 prepubertal crossbred gilts (Duroc x Hampshire x Chester White x Yorkshire)
      weighing 96.4 + 1.3 kg at 5.1 + .1 mo of age were housed in an LD cycle of 10:14.
      Following a 3-wk acclimation period, blood samples were drawn at 1-hr intervals
      from indwelling jugular catheters. Serum concentrations of melatonin were similar
      (P greater than .05) among blood samples collected during light and dark periods.
      In experiment 2, serum concentrations of melatonin did not change (P greater than
      .05) when gilts were abruptly exposed to light during the normal dark period. In
      experiment 3, serum concentrations of melatonin were similar (P greater than .05)
      in blood samples collected at 2-hr intervals under 700 lux of light or in total
      darkness from gilts maintained in either LD 9:15 or LD 24:0. Data from experiment
      4 demonstrated that serum melatonin could be detected in nighttime samples if
      exogenous melatonin was ingested by gilts at night. Together, these experiments
      clearly indicate that prepubertal gilts do not exhibit a nocturnal rise in serum
      melatonin when maintained under short daylengths (10L:14D or 9L:15D), and serum
      melatonin concentrations are unaffected by abrupt changes in light/dark
      conditions.

PMID- 1617961
TI  - Serum hormone and metabolite concentrations in fasted young bulls and steers.
AB  - The effect of dietary energy restriction on serum insulin, insulin-like growth
      factor I (IGF-I), growth hormone, (GH), cortisol, plasma urea nitrogen (PUN) and
      nonesterified fatty acid (NEFA) concentrations was examined. Angus bulls and
      steers (10 mo) were allotted to two groups of 12 animals and assigned a treatment
      order. In a switchback design, animals in order 1 were fed a high grain diet,
      then fasted, while order 2 animals were fasted, and then fed. Animals were
      allowed 60 hr to acclimate between treatments. Serum and plasma were obtained at
      20 min intervals and 60 min, respectively, for 6 hr after feeding and for the
      last 6 hr of a 30 hr fast. Serum was assayed for insulin, IGF-I, GH, and cortisol
      (total and free). Plasma was assayed for PUN and NEFA. Mean insulin (ng/ml)
      differed between fed (.95 +/- .08) and fasted (.26 +/- .08) animals (P less than
      01). Both mean total and free cortisol (ng/ml) were lower in fed (11.48 +/- .99)
      (1.06 +/- .12) than in fasted (17.10 +/- .93) (1.62 +/- .12) animals,
      respectively (P less than .01). Animals in order 1 differed in mean IGF-I (ng/ml)
      between fed (199.0 +/- 8.0) and fasted (116.5 +/- 7.2) treatments (P less than
      .01). Mean IGF-I for animals in order 2 was 146.7 +/- 7.2 in fed and 213.9 +/-
      7.2 in fasted animals (P less than .01). Mean GH did not differ between
      treatments. Mean PUN and NEFA were higher in fasted than in fed animals (P less
      than .01). Except for % free cortisol (P less than .05), the hormones did not
      differ between bulls and steers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1617962
TI  - Six-month carbohydrate metabolism studies in women using oral contraceptives
      containing gestodene and ethinyl estradiol.
AB  - Twenty-five women had their carbohydrate metabolism prospectively evaluated
      during the six months that they used a gestodene and ethinyl estradiol monophasic
      oral contraceptive. Serum glucose and insulin levels were measured during a 75
      gram three-hour oral glucose tolerance test. At the six-month test, the three
      hour glucose and the fasting and three-hour insulin values were significantly
      elevated. The literature on carbohydrate metabolism during gestodene oral
      contraceptive use is also reviewed.

PMID- 1617963
TI  - Removal of intrauterine devices with missing tails during early pregnancy.
AB  - During a 70-month period, CO2 hysteroscopy was carried out on 52 pregnant women
      wearing IUDs with retracted tails. Ultrasonography was done prior to hysteroscopy
      to determine the size of the gestational sac and the site of the device.
      Successful removal of the device occurred in 46 cases. The technique, the
      findings of the study, and the limitations of the procedure are described.

PMID- 1617964
TI  - Conditions for choosing between drug-induced and surgical abortions.
AB  - In France, pregnant women with amenorrhoea of no more than 49 days intending to
      terminate pregnancy can choose between a surgical abortion via vacuum aspiration
      under local or general anesthesia and a drug method combining Mifepristone orally
      administered (RU 486 degrees), with a prostaglandin analogue. This prospective
      survey was conducted to study the conditions under which women choose their
      abortion method, and to evaluate the acceptability of each method after the
      abortion. The data gathered from 488 women were analyzed according to their
      initial decision, and then according to the method actually used. The majority
      (62%) chose RU 486. The women's choice was found to be linked to sociodemographic
      characteristics such as age, education, occupation, geographic origin, and
      certain attitudes towards pregnancy, as well as to the individual criteria of
      each method. The women who chose the drug protocol had most often already made
      their decision before going to the family planning center (68%), having been
      advised by their doctor (20%). They were slightly less satisfied with the
      abortion experience than they had expected: 12.4% were unsatisfied in the RU
      group and 3.6% in the aspiration group. They needed more rest and quiet
      afterwards (50%) than the other women. They were distinguished by their desire to
      verify the expulsion (63%). The length of pregnancy is therefore not the only
      criterion to be considered when recommending one or other of these methods: the
      women concerned have different requirements and should have several possibilities
      to choose from.

PMID- 1617965
TI  - Serum nickel, copper and zinc in Norplant users.
AB  - Changes in serum nickel, copper and zinc were evaluated in 45 Norplant users. Two
      groups were selected for this study. Group I included 15 regularly menstruating
      females as controls and as short-term users (90 days after Norplant insertion).
      Group II included 30 Norplant users for one year or more as long-term users.
      These elements were determined by atomic absorption spectrophotometry. Serum
      nickel showed no significant change in short-term nor in long-term users when
      compared to the control group or to each other. Serum copper and zinc revealed a
      significant increase in short-term users for a short period of time, which
      returned to normal levels in long-term users. There was disappearance of the
      cyclic changes in serum copper and zinc concentrations on comparing their levels
      in ovulatory to non-ovulatory Norplant users. The use of Norplant has no
      deleterious effects on serum levels of nickel, copper and zinc.

PMID- 1617966
TI  - Serum and endometrial sodium and potassium levels with inert and copper
      containing IUCDs and relation to serum steroid levels.
AB  - Serum and endometrial sodium (Na) and potassium (K) levels and serum estradiol,
      progesterone, testosterone and cortisol were measured in the mid-follicular and
      mid-luteal phases of the menstrual cycle in 20 Lippes loop and 20 CuT-200 IUCD
      users and 20 matched controls. Na and K were measured by atomic absorption
      spectrophotometry, while serum steroids were measured by RIA. Regarding steroids,
      the only significant difference between the three groups was a significantly
      lower mean mid-luteal serum estradiol in CuT-200 IUCD users compared to Lippes
      loop users (p less than 0.05). Regarding sodium in the control group, there was
      significantly lower mean mid-luteal serum and endometrial Na (p less than 0.01)
      that was not found in both groups of IUCD users. In the mid-follicular phase,
      there was significantly higher mean serum Na in both Lippes loop and CuT-200
      groups compared to controls (p less than 0.05). Mean endometrial Na showed no
      significant difference between the three groups in both phases of the menstrual
      cycle. Regarding potassium in the control group, there was significantly lower
      mean levels in the mid-luteal-phase of the cycle (p less than 0.01) that was not
      seen with both groups of IUCD users. Serum K showed no significant difference in
      the three groups in both phases of the menstrual cycle. Endometrial K showed a
      significantly higher mean level in both Lippes loop and CuT-200 IUCD users
      compared to controls in the mid-luteal (p less than 0.01), but not in the mid
      follicular phases of the cycle.

PMID- 1617967
TI  - Hormonal profile of the menstrual cycle in Chinese women after tubal
      sterilization.
AB  - Ten women after tubal sterilization were studied for the hormonal profile of the
      menstrual cycle. They had undergone sterilization procedures, on the average 5.3
      years (range 1.5-10 years) earlier. The serum concentrations of LH, FSH,
      prolactin, estradiol and progesterone were measured by RIA in daily blood samples
      of a complete menstrual cycle. Another ten normal women were studied at the same
      time and were used as the control group. There were no significant differences in
      the hormonal patterns of the menstrual cycle between the two groups. There was a
      significantly lower LH level in the early luteal phase of the tubal ligation
      group compared to the control group. Also, a significantly lower E2 luteal peak
      compared to the preovulatory peak was observed in the tubal ligation group. The
      physiological significance of these minor changes is not clear. Only one out of
      ten women in the tubal ligation group, who had undergone sterilization 1.5 years
      prior, showed a deficiency in luteal function, but her ovulatory function and
      menstrual cycle appeared normal. This study indicates that normal hormonal
      profiles are retained after tubal sterilization.

PMID- 1617968
TI  - Conducting a hospital-based case-control study of the relationship between
      vasectomy and cardiovascular disease in Korea--an experience in an Asian setting.
AB  - An increasing number of case-control studies are being performed in the
      developing world. This paper describes the difficulties and advantages the author
      has experienced in conducting a hospital-based case-control study in the Republic
      of Korea testing the hypothesis of whether vasectomy is associated with
      subsequent cardiovascular disease. This experience should provide a useful
      reference for researchers planning studies using a similar approach in an Asian
      setting.

PMID- 1617969
TI  - Pregnane derivatives as pregnancy interceptive agents: efficacy determination on
      growing trophoblasts (in vitro) and in pregnant hamsters (in vivo).
AB  - An in vitro test system was standardized to study potentiality of five hormonally
      inert pregnane derivatives on growing trophoblasts isolated from ectoplacental
      cone (EPC) of day 8 hamster embryo. Cells were incubated with different
      concentrations of respective compounds in surface droplets. The response was
      determined by analyzing the sequence of changes in cell morphology like
      attachment, growth, proliferation, differentiation and/or degeneration within 24
      or 48 h following seeding. The in vivo efficacy of these compounds was determined
      in hamster during peri- and immediate post-implantation periods (days 3-8 post
      coitum). Two compounds 88/583 and 88/585 were found to inhibit not only growth
      and proliferation of the cells but caused total degeneration within 24 h. The
      same compounds induced partial to complete resorption of the foetuses in treated
      animals. Whereas, the other three compounds 88/506, 88/594 and 89/43 that showed
      lack of comparable potentiality in vitro were found to be equally ineffective in
      vivo. The results indicate a positive correlationship between in vitro and in
      vivo activity.

PMID- 1617970
TI  - Pressure-flow relationships of the pulmonary circulation during endotoxin
      infusion in intact dogs.
AB  - BACKGROUND AND METHODS: We aimed to characterize the effects of an endotoxin
      insult (Escherichia coli 0127:B8) on the relationships between pulmonary vascular
      pressure and flow in intact dogs. To achieve this goal, multipoint plots of total
      pressure gradient, arterial pressure gradient, and venous pressure gradient vs.
      flow were generated by graded inflation of a right atrial balloon, which was used
      to vary flow. The partitioning of the total pressure decrease across the
      pulmonary vasculature (total pressure gradient = pulmonary arterial pressure
      pulmonary artery occlusion pressure [PAOP]) into gradients across pulmonary
      arterial (arterial pressure gradient = pulmonary arterial pressure--effective
      capillary pressure) and pulmonary venous (venous pressure gradient = effective
      capillary pressure--PAOP) regions was assessed by a waveform mathematical
      analysis of the pulmonary arterial pressure profile during arterial occlusion,
      with computation of both PAOP and effective pulmonary capillary pressures. Slopes
      and extrapolated pressure intercepts from linear regression fits to the pulmonary
      vascular pressure/flow plots were determined in seven dogs after a 2-hr endotoxic
      infusion interval and were compared with the corresponding values that
      characterized a similar group of sham-operated dogs. RESULTS: Under normal
      conditions, the extrapolated pressure intercept for pulmonary arterial pressure
      gradient was virtually 0 mm Hg; for total pulmonary arterial pressure gradient
      and pulmonary venous pressure gradient, the mean extrapolated pressure intercepts
      were substantially positive: 2.4 +/- 0.2 and 2.1 +/- 0.3 mm Hg, respectively.
      Endotoxin infusion at 0.25 micrograms/kg/min significantly increased the pressure
      intercepts from 2.4 to 8.7 and from 2.1 to 8.3 mm Hg of total pressure gradient
      and venous pressure gradient vs. flow, respectively. This infusion produced a
      minor, nonsignificant change in the intercept of arterial pressure gradient vs.
      flow, whereas it increased its slope significantly (p less than .05) from 0.036
      to 0.081 mm Hg/mL/min/kg. CONCLUSIONS: These data suggest that endotoxin's
      effects on vascular resistance are exerted at two different loci such that these
      effects are additive. These endotoxin-induced effects consisted of increased
      vascular resistance of the arterial segment and appearance of a Starling resistor
      at the venous side of the pulmonary circulation, which acted as the relevant back
      pressure to flow.

PMID- 1617971
TI  - Hemodynamic and metabolic effects of epinephrine during cardiopulmonary
      resuscitation in a pig model.
AB  - BACKGROUND AND METHODS: This study was designed to assess the effect of
      epinephrine during cardiopulmonary resuscitation (CPR) on left ventricular
      myocardial blood flow, systemic oxygen delivery and consumption, and on plasma
      glucose and lactate concentrations. Fourteen pigs were allocated to receive
      either 0.9% saline (n = 7), or 45 micrograms/kg epinephrine (n = 7) after 5 mins
      of ventricular fibrillation, and 3 mins of open-chest CPR. Left ventricular
      myocardial blood flow was measured with radiolabeled microspheres. Plasma
      catecholamine concentrations were measured by high-pressure liquid
      chromatography. RESULTS: During open-chest CPR, mean (+/- SD) values of left
      ventricular myocardial blood flow before, 90 secs, and 5 mins following drug
      administration were 49 +/- 10, 46 +/- 12, 43 +/- 15 mL/min/100 g, respectively,
      in the control group, and 52 +/- 12, 118 +/- 21, 84 +/- 28 mL/min/100 g,
      respectively, in the epinephrine group (p less than .05 at 90 secs and 5 mins).
      At the same time points, mean (+/- SD) oxygen delivery indices were 7.7 +/- 3.0,
      6.0 +/- 2.1, 6.5 +/- 2.7 mL/min/kg in the control group and 7.6 +/- 2.5, 5.3 +/-
      2.1, 5.5 +/- 1.9 mL/min/kg in the epinephrine group (nonsignificant). Mean oxygen
      consumption indices were 5.8 +/- 2.4, 4.6 +/- 1.6, 5.2 +/- 2.6 mL/min/kg in the
      control group and 5.4 +/- 1.6, 4.2 +/- 1.6, 4.4 +/- 1.4 mL/min/kg in the
      epinephrine group (nonsignificant). During CPR and before epinephrine
      administration, arterial plasma epinephrine concentrations increased from
      prearrest values of 0.77 +/- 0.70 to 62.1 +/- 48.7 micrograms/L, and plasma
      norepinephrine concentrations increased from 0.28 +/- 0.32 to 104.3 +/- 57.1
      micrograms/L. After administered epinephrine, there was an additional increase to
      271 +/- 83 micrograms/L at 90 secs in arterial plasma epinephrine, but no
      important alteration in the plasma norepinephrine concentration. At no time point
      could we find a clinically important difference in plasma glucose or lactate
      concentrations between the two groups. CONCLUSIONS: At a dose of 45
      micrograms/kg, epinephrine caused an increase in left ventricular myocardial
      blood flow after a total of 8 mins of cardiac arrest, including 3 mins of CPR,
      while not altering systemic oxygen delivery and consumption, plasma glucose, or
      lactate concentrations.

PMID- 1617972
TI  - Advance directives: implications for critical care.
AB  - OBJECTIVE: To discuss the relative merits and limitations of living wills and the
      durable power of attorney for health care. DATA SOURCES: Computerized search of
      MEDLINE. STUDY SELECTION: Studies involving treatment decisions at the end of
      life and descriptive articles on advance directives. RESULTS: The recent Cruzan
      case and passage of the Patient Self-Determination Act have led to an ethical and
      legal recognition of advance directives, and therefore, critical care
      practitioners must be familiar with these documents. A living will is a mechanism
      by which patients can communicate their desires for medical treatment at the end
      of life. However, the condition that patients be in a "terminal condition," the
      inability to predict every possible clinical circumstance, and linguistic
      vagueness have limited the usefulness of living wills. The durable power of
      attorney for health care overcomes the inherent restrictive weaknesses of living
      wills, because informed decisions are made by people based on their knowledge of
      the patient's beliefs and the nuance of the clinical scenario. A concern with
      this advance directive is that some patients may not know a suitable person to
      appoint or that the chosen agent may not be available. CONCLUSIONS: We recommend
      the execution of both a living will and a durable power of attorney for health
      care to provide the best assurance that patients' desires concerning medical
      treatments will be respected.

PMID- 1617973
TI  - Acute care research: is it ethical?
AB  - BACKGROUND: Research in acute care is a troubling area for Institutional Review
      Board (IRB) approval and informed consent. Confusion about ethical and legal
      requirements has hampered research efforts and subsequent patient benefits.
      ANALYSIS: Acute care patients are the relatively few critical care patients who
      have suffered unexpected events that carry a high probability of mortality or
      severe morbidity unless immediate medical intervention is provided. We argue that
      acute care research is justified if the usual ethical requirements for research
      are modified to reflect the uniqueness of the situation. CONCLUSIONS: Our
      recommendations are to: a) use an explicit definition of acute care as distinct
      from other modes of critical care; b) eliminate the requirement for informed
      consent (as it is usually understood); and c) require stringent IRB oversight,
      regarding the unique ethical problems raised by this area of research. We further
      suggest that IRB oversight includes review of the protocol by a panel of
      individuals who represent possible enrollees in the proposed study.

PMID- 1617974
TI  - A clinical librarian program in the intensive care unit.
AB  - OBJECTIVES: Clinical decision-making in the intensive care setting frequently
      requires the physician to obtain additional resource information. Physicians
      typically consult with colleagues, use personal medical books or files, or use
      library materials. Clinical librarians may also be used. This study evaluates the
      effectiveness of an ongoing clinical librarian program in the intensive care
      setting. DESIGN/SETTING: During a 3-month period, house officers in the medical
      and coronary ICUs in a major teaching hospital asked the clinical librarian 66
      patient-care questions. Attached to the information selected by the clinical
      librarian was a questionnaire asking how the information was applied. MAIN
      RESULTS: There was an overall response rate of 65.1%. House officers indicated
      that the information: a) aided in diagnosis (37.2%), b) contributed to a better
      understanding of the therapy (51.2%), and c) resulted in improved patient
      management (30.2%). In some instances, the information was multibeneficial. The
      clinical librarian spent an average of 47 mins/question, and accumulated an
      average computer charge of $3.59. Personnel and on-line charges over the 3-month
      study period averaged $45/question. CONCLUSIONS: Clinical librarian programs may
      deliver patient-specific information in a timely, cost-effective manner. This
      information has an impact in the intensive care setting.

PMID- 1617975
TI  - Pulmonary capillary pressure: a review.
AB  - OBJECTIVES: To demonstrate the importance of a) measuring effective pulmonary
      capillary pressure and b) evaluating the longitudinal distribution of pulmonary
      vascular resistance relative to pre- and postcapillary resistances. To review the
      development of methods used to determine pulmonary capillary pressure in
      experimental animal and clinical studies. DATA SOURCES: Human, animal, and
      modeling studies published since 1966 identified through MEDLINE and a review of
      bibliographies of relevant articles. STUDY SELECTION AND DATA EXTRACTION: All
      studies identified were reviewed with an emphasis on recent studies and those
      studies identifying various methodologies used to determine capillary pressure.
      Experimental studies were selected for their historical value and applicability
      to the clinical setting. DATA SYNTHESIS: Different models of the pulmonary
      circulation have been proposed. The electrical circuit model, which incorporated
      capacitance elements and two or four resistive elements, has been the basis for
      the determination of pulmonary capillary pressure in isolated lungs and in situ
      lungs in animals and patients. Methods used to determine pulmonary capillary
      pressure from a pulmonary arterial pressure tracing after balloon occlusion are:
      a) division of waveform into two components and logarithmic extrapolation of the
      slow component to occlusion time; b) visual determination of the pressure
      inflection point of the pulmonary arterial pressure tracing; and c) computer
      processing of the total arterial pressure transient. Both ease of calculations
      and difficulties can arise when each method is used. CONCLUSIONS: Pulmonary
      capillary hydrostatic pressure is an important determinant of pulmonary edema
      especially in the setting of pulmonary hypertension and adult respiratory
      distress syndrome. Hypoxia, sepsis, cardiac valvular disease, and inflammatory
      mediators produce variable changes in the longitudinal distribution of pulmonary
      vascular resistance so that an increased capillary pressure cannot be predicted
      by the pulmonary arterial or occlusion pressure. For proper therapy aimed at
      decreasing pulmonary vascular resistance, it is important to determine whether or
      not the particular therapy increases capillary pressure. Pulmonary capillary
      pressure is the most important determinant of lung fluid balance and is the major
      physiologic parameter that should be measured when various forms of plasma volume
      expansion and pulmonary vasodilators are used in the critically ill patient.

PMID- 1617976
TI  - Guidelines for the care of patients with hemodynamic instability associated with
      sepsis. Guidelines Committee; Society of Critical Care Medicine.

PMID- 1617977
TI  - Use of isoflurane for sedation in intensive care.

PMID- 1617978
TI  - Traumatic mitral insufficiency complicating blunt chest trauma treated medically:
      a case report and review.

PMID- 1617979
TI  - Periportal tracking on computed tomography scan diagnostic of extensive liver
      injury in a neonate.

PMID- 1617980
TI  - Gastric mucosal pH as a prognostic index of mortality in critically ill patients.

PMID- 1617981
TI  - Demystification of the septic response.

PMID- 1617982
TI  - Giants of critical care: a tribute to Max Harry Weil, MD, PhD.

PMID- 1617983
TI  - Antioxidant treatment with N-acetylcysteine during adult respiratory distress
      syndrome: a prospective, randomized, placebo-controlled study.
AB  - OBJECTIVE: To examine whether the antioxidant N-acetylcysteine could ameliorate
      the course of the adult respiratory distress syndrome (ARDS) in man. DESIGN:
      Randomized, double-blind, placebo-controlled study. SETTING: Medical and surgical
      ICU in a regional hospital. PATIENTS: Sixty-six ICU patients with ARDS.
      INTERVENTIONS: Patients with ARDS (PaO2/FiO2 ratio less than 250 torr) were
      treated with either the antioxidant N-acetylcysteine 150 mg/kg as a loading dose
      and then 20 mg/kg/hr, or with placebo for 6 days. MEASUREMENTS AND MAIN RESULTS:
      No improvement could be demonstrated in the PaO2/FiO2 ratio in the study group as
      compared with the control group on any day. Pulmonary compliance was higher in
      the N-acetylcysteine group than in the placebo group on all days, but this
      difference did not reach the chosen 5% level of significance. No difference
      between the two groups could be demonstrated on chest radiograph or on survival
      rate. We documented that N-acetylcysteine acts as an anticoagulant and perhaps
      decreases pulmonary fibrin uptake during ARDS. CONCLUSIONS: N-acetylcysteine
      might be of benefit in ARDS. Before further clinical studies are started,
      problems with N-acetylcysteine and coagulation have to be elucidated in order to
      find out whether N-acetylcysteine could have a beneficial effect in the treatment
      of ARDS.

PMID- 1617984
TI  - Measurement of alveolar gas mixing in mechanically ventilated patients.
AB  - OBJECTIVE: To evaluate a computer-based, real-time, multibreath nitrogen washout
      technique in mechanically ventilated patients, incorporating an in-line flow
      measurement device to measure functional residual capacity and two indices of gas
      mixing, ventilatory efficiency, and alveolar mixing efficiency. SETTING: ICU,
      Charing Cross Hospital, London. DESIGN: Within-patient reproducibility of a
      multibreath nitrogen washout technique. PATIENTS: Seven intubated patients
      requiring mechanical ventilation. One patient completed two sets of readings.
      INTERVENTIONS: Patients were connected to a pneumatically driven ventilator
      fitted with a switching device to be operated either by an appropriate oxygen
      nitrogen mixture or equivalently blended oxygen-argon mixture. An inspiratory
      expiratory, two-way valve was attached to the delivery port of the ventilator,
      with a pneumotachograph for flow measurement and a gas sampling probe for gas
      concentration measurement in line with the patient's endotracheal tube. The
      analog signals were digitized and handled by a microcomputer. MEASUREMENTS AND
      MAIN RESULTS: No significant differences were found for any index, with
      coefficients of variation of 1.5%, 2.9%, and 2.1% for functional residual
      capacity, ventilatory efficiency, and alveolar mixing efficiency, respectively.
      CONCLUSIONS: This method gives excellent reproducibility for biological
      measurements in a clinical setting and shows that these measurements can readily
      be made on mechanically ventilated patients.

PMID- 1617985
TI  - Evaluation of right heart catheterization in critically ill patients. Ontario
      Intensive Care Study Group.
AB  - OBJECTIVE: To determine physicians' assessment of the therapeutic effect and
      patient benefit of data obtained from right heart catheterization. DESIGN:
      Before/after study. SETTING: One medical and one surgical academic ICU in two
      medical centers. PATIENTS: A total of 107 critically ill patients with uncertain
      hemodynamic status. DATA COLLECTION: Physicians looking after the patients were
      asked to evaluate the extent to which results of right heart catheterization
      resulted in changes in therapy and outcome. The same questions were asked of
      academic intensivists, two of whom reviewed each chart. RESULTS: Agreement
      regarding whether right heart catheterization had changed therapy was poor
      (chance corrected agreement [kappas] of -0.02 to 0.33). Treating physicians were
      more inclined than chart reviewers to conclude that management changes based on
      right heart catheterization improved outcome. Agreement on which patients
      benefited was poor (kappas of 0.03 to 0.32). CONCLUSIONS: Physicians' assessment
      of the effect of right heart catheterization on treatment decisions and patient
      outcomes is not reliable. Credible information regarding the benefits of right
      heart catheterization will require randomized trials.

PMID- 1617986
TI  - Blood vitamin concentrations during the acute-phase response.
AB  - OBJECTIVES: To investigate the effect, if any, of the acute-phase response on
      blood vitamin concentrations and to test the hypothesis that these concentrations
      may change during stress. DESIGN: Open study, utilizing a volunteer sample of
      patients. SETTING: Tertiary care center. PATIENTS: Twenty-six healthy adult
      volunteers (14 female and 12 male); 25 volunteers underwent uncomplicated
      orthopedic surgery and one suffered traumatic limb fractures. INTERVENTIONS:
      None. MAIN OUTCOME MEASUREMENTS: The presence of a systemic acute-phase response
      was documented by the determination of serum C-reactive protein concentrations.
      Blood vitamin concentrations were determined from sequentially collected blood
      samples over a 7-day period, and compared with entry values. RESULTS: The
      presence of the acute-phase response was documented by significant and transient
      increases in C-reactive protein values. This response was accompanied by
      significant and transient decreases in the concentrations of leukocyte vitamin C,
      and in plasma concentrations of vitamin A, retinol-binding protein, vitamin E,
      total lipids, pyridoxal-5'-phosphate, and albumin. Blood concentrations of
      pyridoxal-5'-phosphate, retinol-binding protein, and leukocyte vitamin C
      decreased to values below the respective normal ranges. These concentrations
      normalized without any therapeutic interventions. CONCLUSIONS: We demonstrated
      transient, but significant, decreases in blood vitamin concentrations during the
      acute-phase response. Recommendations regarding daily supplementation with these
      vitamins in clinical practice cannot be made on the basis of these results, as
      the functional importance of these observations is not, at present, clear.
      However, what is clear is that biochemical vitamin concentrations, determined
      during the acute-phase response, should be interpreted with care.

PMID- 1617988
TI  - Metabolic requirements in tetanus.
AB  - OBJECTIVE: To measure the metabolic requirements of patients with severe tetanus
      who require mechanical ventilation. DESIGN: Prospective, consecutive, open study
      using routine monitoring. SETTING: A multidisciplinary ICU in a large teaching
      hospital. PATIENTS: Five consecutive patients (age range 30 to 54 yrs) with
      severe tetanus. Four patients had clinical evidence of sympathetic nervous system
      overactivity. INTERVENTIONS: All patients were mechanically ventilated and
      appropriately treated for severe tetanus. Sympathetic nervous system overactivity
      was reduced by the administration of sedatives. MEASUREMENTS AND MAIN RESULTS:
      Measurements of metabolic rates were made using an indirect calorimetry device.
      Each of the five patients had three 8-hr periods of continuous metabolic
      monitoring for each of three levels of daily enteral nutritional support. The
      measured metabolic rates varied from 1310 to 2050 kcal/24 hrs (predicted 1280 to
      1770 kcal/24 hrs). The variations from predicted basal metabolic rates varied
      from -6.3% to +10.5%. CONCLUSIONS: The measured metabolic rates of patients with
      severe tetanus who are appropriately sedated are relatively constant and are
      within 10.5% of the predicted basal metabolic rates.

PMID- 1617987
TI  - Cardiac vagal tone predicts outcome in neurosurgical patients.
AB  - OBJECTIVE: To evaluate the relationship between presurgical levels of cardiac
      vagal tone and outcome in neurosurgical patients. DESIGN: Prospective series.
      SETTING: Respiratory ICU in a university hospital. PATIENTS: Fifty-one adults
      admitted to the respiratory ICU between 1982 and 1985. Forty-two patients were
      scheduled for elective neurosurgery, and nine patients suffered from head trauma.
      INTERVENTIONS: Ten minutes of electrocardiographic (EKG) data were recorded
      before medical intervention. Neurosurgical patients scheduled for surgery had EKG
      data recorded 24 hrs before their operation. Trauma patients had EKG data
      recorded immediately after arrival in the respiratory ICU. MEASUREMENTS AND MAIN
      RESULTS: Cardiac vagal tone was evaluated using a vagal tone index, quantified
      from the EKG. Cardiac vagal tone monitored before surgical intervention
      significantly distinguished between the outcome groups only for the elective
      neurosurgical patients. Age, gender, heart rate, Glasgow Coma Scale scores, and
      tumor location, size, and malignancy were not related to outcome in the elective
      neurosurgery group. However, within the trauma group, low Glasgow Coma Scale
      scores were significantly related to poor outcome. CONCLUSIONS: Cardiac vagal
      tone may offer important predictive value by alerting the physician to the
      functional consequence of head injury. Information relating to autonomic nervous
      system functioning, such as the vagal tone index used in this study, may provide
      additional information that will complement the computed tomography scan results.
      This study demonstrates that the vagal tone index is a predictive factor that may
      be efficiently extracted from the heart rate pattern routinely monitored in ICUs.

PMID- 1617989
TI  - A novel score for predicting the mortality of septic shock patients.
AB  - OBJECTIVE: To establish a prognostic scoring system for septic shock patients.
      DESIGN: The clinical, biological, and hemodynamic data of these patients were
      retrospectively explored to select variables independently associated with
      outcome. According to the risk of death, ratings from 0 to 2 points were
      attributed to each value. SETTING: Medical intensive care service of a 1,000-bed
      tertiary care university medical center. PATIENTS: Eighty-eight patients in
      septic shock in whom hemodynamic measurements were performed using pulmonary
      artery flotation catheters. RESULTS: Fourteen clinical, biological, and
      hemodynamic variables were selected and rated for each patient. A Simplified
      Septic Shock Score, available immediately after admission and catheterization,
      was established by adding the rates of these variables. The mean Simplified
      Septic Shock Score was 2.5 +/- 1.7 (SD) in 43 survivors and 6.5 +/- 2.3 in 45
      nonsurvivors (p less than .0001). Some underlying diseases and characteristics of
      infections also correlated with the outcome. Further ratings from 0 to 2 points
      were attributed to these conditions. A Complete Septic Shock Score was calculated
      by adding these rates to the Simplified Septic Shock Score. The Complete Septic
      Shock Score had a slightly better prognostic value than the Simplified Septic
      Shock Score, but it could be determined only after the availability of the
      microbiological data. The mean Complete Septic Shock Score was 3.1 +/- 1.9 in
      survivors and 8.4 +/- 2.6 in nonsurvivors (p less than .0001). Both Simplified
      and Complete Septic Shock Scores showed better association with patient outcome
      than the Simplified Acute Physiology Score or the Acute Physiology and Chronic
      Health Evaluation (APACHE II) score. CONCLUSIONS: The Simplified and the Complete
      Septic Shock Scores are simple scoring systems that appear to predict the outcome
      of septic shock patients more accurately than general scoring systems, such as
      the Simplified Acute Physiology Score and APACHE II score. These septic shock
      scores might be useful in assessing the severity of septic shock patients.

PMID- 1617990
TI  - Nonphysician transport of intubated pediatric patients: a system evaluation.
AB  - OBJECTIVE: To evaluate the occurrence of complications and patient deteriorations
      during the air and ground transportation of intubated pediatric patients,
      performed by a nonphysician-based team under the direction of an intensive care
      attending physician or fellow. DESIGN: Retrospective chart review. SETTING: A 600
      bed university hospital with a 16-bed neonatal ICU and a 12-bed pediatric ICU.
      PATIENTS: All intubated pediatric patients (422 of 614 patients transported
      during the study period) transported by the dedicated neonatal/pediatric
      transport team from April 1988 to April 1990. MEASUREMENTS AND MAIN RESULTS: The
      transport records of intubated pediatric patients were abstracted. Recorded data
      included age, weight, gestational age, vital signs, diagnosis, interventions
      received, and use of paralytic agents and sedatives/analgesics. Patients were
      analyzed in three groups: group 1 (n = 295) included neonates; group 2 (n = 66)
      included patients greater than 1 month and less than 1 yr of age; and group 3
      patients (n = 61) were ages greater than 1 yr. Group 1 had nine (3.1%)
      complications or patient deteriorations; four (1.4%) were related to the
      endotracheal tube. Group 2 had one (1.5%) airway complication and one
      deterioration. Group 3 had no complications or deteriorations. All but one of the
      airway complications were effectively handled by the transport team. At the
      referring hospital, the transport nurse or respiratory therapist intubated 62
      (19.8%) patients in group 1, five (7.5%) in group 2, and three (4.9%) patients in
      group 3. Sixty-seven (23%), 21 (32%), and 30 (49%) patients of groups 1, 2, and
      3, respectively, were paralyzed for transport. No complications were secondary to
      the use of paralytic agents or sedatives. CONCLUSIONS: Under proper medical
      guidance, well-trained nonphysician personnel can provide low-risk transport of
      intubated pediatric patients. Use of sedatives and paralytic drugs did not
      increase the risk of complications or patient deterioration.

PMID- 1617991
TI  - Outcome in critical care patients: a multivariate study.
AB  - OBJECTIVE: To identify patient variables that were significantly associated with
      outcome in the ICU. DESIGN: Retrospective chart study of ICU patients. SETTING:
      Letterman Army Medical Center, Presidio of San Francisco. PATIENTS: A total of
      110 consecutive patients who remained in the ICU for greater than 72 hrs.
      METHODS: Univariate analysis of 26 input variables, representing physiologic
      status and chronic health assessment at the time of ICU admission of the
      patients, and adverse events that occurred during their ICU stay. The dependent
      variable assessed was the outcome of patients after ICU intervention. A bad
      outcome included patient mortality or discharge from the ICU in worse condition
      or in a chronic vegetative condition. Five selected input variables were used in
      a multivariate logistic regression analysis to identify independent predictors of
      a successful outcome. RESULTS: Univariate statistical techniques comparing the
      values of 26 input variables of patients who improved during their ICU stay (46
      patients) with those values of patients who did not improve (52 deaths and 12
      unimproved patients) indicated that the following nine variables were
      significantly different in these two groups: a) age (p = .04), b) acute
      physiologic score (p = .047), c) Acute Physiology and Chronic Health Evaluation
      (APACHE II) score (p = .040), d) the number of repeat ICU admissions during a
      given hospitalization (p = .019), e) development of respiratory complications
      while in the ICU (p = .033), f) sepsis developing while in the ICU (p = .0001),
      g) renal failure developing while in the ICU (p less than .0001), h) disseminated
      intravascular coagulation while in the ICU (p = .0028), and i) the occurrence of
      any iatrogenic complication while in the ICU (p less than .0001). Five of these
      nine variables were used in a stepwise logistic regression analysis to develop a
      model to predict ICU outcome. This model showed the following three variables to
      be significantly associated with unfavorable ICU outcome: a) occurrence of any
      iatrogenic event while in the ICU (p less than .001), b) development of renal
      failure in the ICU (p = .001), and c) occurrence of sepsis while in the ICU (p =
      .042). A common iatrogenic complication associated with unfavorable ICU outcome
      was related to drug therapy (frequently aminoglycoside toxicity). Twenty-one
      iatrogenic drug complications occurred in 64 patients who did not improve in the
      ICU, whereas only three iatrogenic drug complications occurred in 46 patients who
      improved (p less than .001). CONCLUSIONS: For patients who remain in the ICU for
      greater than 72 hrs, events occurring after ICU admission are negatively
      associated with ICU outcome, more so than ICU admission status as reflected by
      such indices as APACHE II scores. Iatrogenic complications, often due to
      inappropriate drug therapy, have a significant association with adverse outcome
      by multivariate analysis. We suggest that iatrogenic complications influence ICU
      outcome, and that they are potentially preventable. By lessening their frequency,
      ICU outcome may be improved.

PMID- 1617992
TI  - Tissue oxygenation during liver transplantation.
AB  - OBJECTIVES: a) To assess perioperative changes in tissue oxygenation parameters
      during liver transplantation; b) to evaluate the need for venovenous bypass as
      hemodynamic support; and c) to assess the efficacy of mixed venous oxygen
      saturation monitoring and the importance of lactate determinations in the
      management of patients following liver transplantation. DESIGN: Prospective case
      series. SETTING: Liver transplant unit in a university hospital. PATIENTS: A
      total of 68 consecutive patients undergoing liver transplantation. The entire
      population was analyzed before and after transplantation, dividing the patients
      into two groups, based on whether their initial cardiac index was higher (n = 37)
      or lower (n = 31) than 4.5 L/min/m2. MEASUREMENTS: Hemodynamic measurements and
      blood gas analyses were made before incision, before vascular clamping (including
      hepatic artery, portal vein and inferior vena cava), during the anhepatic phase,
      and at 5, 30, 60, and 120 mins following unclamping. Oxygen transport and oxygen
      consumption values were calculated. Serum lactate concentrations were measured by
      enzymatic technique. MAIN RESULTS: Mixed venous oxygen saturation was correlated
      with oxygen transport (Do2) in the whole population in which an abnormal oxygen
      consumption (Vo2)-Do2-dependent relationship occurred from the beginning of
      operation until 30 mins following unclamping. The comparison between hyperdynamic
      patients (initial cardiac index greater than 4.5 L/min/m2) with impaired tissue
      oxygenation and normodynamic patients showed that mixed venous oxygen saturation
      failed to correlate with Do2 when the cardiac index was greater than 4.5 L/min/m2
      and that the Vo2-Do2 dependency was only noted in these patients. The serum
      lactate concentrations were similar in both groups. CONCLUSIONS: The Vo2-Do2
      dependent relationship and mixed venous oxygen saturation-Do2 correlation noted
      in the 68 studied patients suggest the need for venovenous bypass and the
      reliability of mixed venous oxygen saturation monitoring in all patients
      scheduled for liver transplantation. However, a sharper comparison between
      hyperdynamic and normodynamic patients demonstrated the lack of efficacy of mixed
      venous oxygen saturation monitoring in predicting adequate tissue oxygenation in
      the first group and the mandatory need for venous shunting to limit tissue
      hypoxia which occurred despite its use only in these patients. Lactic acidosis
      appeared similarly in both groups and could not be linked to tissue hypoxia.

PMID- 1617993
TI  - Prolonged ventilatory support after open-heart surgery.
AB  - OBJECTIVES: To characterize the course of open-heart surgery patients who require
      prolonged (greater than 72 hrs) mechanical ventilation and to define the role and
      timing of tracheostomy. DESIGN: Retrospective review. SETTING: Cardiac surgery
      ICU and surgery wards at a university hospital. PATIENTS: All open-heart surgery
      patients during an 18-month period from January 1988 to July 1989 (n = 581). From
      this group, 58 patients (9.9%) required prolonged mechanical ventilation.
      INTERVENTIONS: Study patients (n = 58) were followed through the course of
      intubation and/or tracheostomy until they were extubated, left the hospital on
      ventilation, or died. MEASUREMENTS AND MAIN RESULTS: End-points for mortality and
      complications were determined. Overall mortality rate was 43% in the patients who
      required prolonged mechanical ventilation. Twenty-eight percent of the 58
      patients died within the first 14 days. Of those patients who survived, 55%
      required an endotracheal tube only and were extubated in less than 14 days; 45%
      of the patients required tracheostomy. Of those patients who required
      tracheostomy, five (26%) were eventually extubated, seven (37%) remained
      mechanically ventilated, and seven (37%) died. The complication rate for
      endotracheal tubes was 65%; the complication rate for tracheostomy was 37%.
      CONCLUSIONS: Open-heart surgery patients requiring prolonged mechanical
      ventilation are a desperately ill subset of cardiac surgery patients. Those
      patients who survive are either extubated in less than 14 days or require
      prolonged mechanical ventilation beyond that point. In our opinion, patients
      should be given 1 wk to recover and one trial of weaning from the ventilator. If
      this approach fails, then they should undergo elective tracheostomy.

PMID- 1617994
TI  - Effect of septic serum on vascular smooth muscle: in vitro studies using rat
      aortic rings.
AB  - BACKGROUND AND METHODS: Septic shock in humans is characterized by hypotension,
      low systemic vascular resistance, and high cardiac output. We hypothesized that
      circulating vasodilatory substances are, in part, responsible for this low
      systemic vascular resistance. To investigate this possibility, we exposed
      isolated rat aortic rings to sera from patients with septic shock and to sera
      from dogs made septic by intraperitoneal implantation of infected clots. Isolated
      rings from rat thoracic aortas were mounted on hooks in chambers filled with
      modified Krebs' buffer and bubbled with 95% oxygen/5% CO2. After documentation of
      functional endothelium, the rings were precontracted with norepinephrine. Serum
      was then added and ring tension measured continuously over the next 20 mins.
      RESULTS: Sera from normal humans increased ring tension by 6% (60 +/- 39 [SEM] mg
      tension/mg ring). Sera from nine patients with septic shock decreased tension by
      30% (350 +/- 42 mg tension/mg ring; p less than .001). In response to sera from
      control dogs, tension increased by 16% (122 +/- 37 mg tension/mg ring). In
      contrast, septic dog sera caused tension to decrease by 36% (278 +/- 38 mg
      tension/mg ring;p less than .001). Vasodilation was unaffected when the septic
      patient and dog sera were dialyzed to remove molecules less than 10,000 molecular
      weight. Chemical deendothelialization with sodium deoxycholate also did not
      affect the vasodilatory response to septic patient or dog sera. CONCLUSIONS:
      Septic sera can relax rat aortic smooth muscle. Dialyzing to exclude the effects
      of small molecules and removing the endothelium did not eliminate this
      vasodilatory response. These data suggest the presence in septic serum of
      circulating substances capable of relaxing vascular smooth muscle that may play
      an important role in the pathogenesis of the cardiovascular abnormalities in
      septic shock.

PMID- 1617995
TI  - Reliability of in vivo mixed venous oximetry during experimental
      hypertriglyceridemia.
AB  - BACKGROUND AND METHODS: The spectral absorbance of iv lipid emulsion produces
      interference in the in vitro spectrophotometric measurement of hemoglobin
      saturation. Therefore, we investigated in vivo mixed venous oximetry during lipid
      emulsion infusions. Boluses of lipid emulsion, increasing by 0.1-g/kg increments,
      were infused every 30 mins into nine anesthetized dogs. After each lipid bolus,
      laboratory and hemodynamic data measurements were repeated, and arterial and
      mixed venous blood gases were analyzed on a laboratory cooximeter that was
      equipped for canine blood. The in vivo mixed venous oxygen saturation was
      continuously monitored via an indwelling, optically equipped pulmonary artery
      catheter. RESULTS: As expected, increasing concentrations of lipid emulsion
      increased (r2 = .92) serum triglyceride concentration. As a result, the in vitro
      measurements of percentage methemoglobin increased artifactually, reducing in
      vitro measurements of arterial (r2 = .74) and mixed venous (r2 = .44) oxygen
      saturations. The in vivo mixed venous oxygen saturation, however, remained
      constant during hypertriglyceridemia (r2 less than .01). CONCLUSIONS: In vivo
      mixed venous oximetry remained constant during hypertriglyceridemia, while in
      vitro measurements of arterial and mixed venous saturations were artifactually
      reduced.

PMID- 1617996
TI  - Ovarian cancer, Part II: Treatment.
AB  - The death rate from epithelial ovarian cancer has only slightly decreased in the
      past decade. In contrast, there have been dramatic improvements in the treatment
      of germ cell tumors of the ovary and the majority of patients even with advanced
      disease is now cured because of the development of effective platinum-based
      combination chemotherapy. Unfortunately, most patients with ovarian cancer have
      the epithelial histologic type, and only one third of these patients can be cured
      with standard approaches. It has recently been shown that a subset of patients
      with early stage ovarian cancer has a greater than 90% cure rate without
      chemotherapy. Consequently, a major focus of current research is to develop
      effective screening modalities in order to diagnose epithelial tumors when they
      are still confined to the ovaries and pelvis. Currently, three fourths of
      patients are diagnosed at the time the disease has spread throughout the
      peritoneal cavity, and the standard approach has been cytoreductive surgery
      followed by combination chemotherapy. The two-drug combination of carboplatin
      plus cyclophosphamide has now become the treatment of choice, although it is
      equally effective as and less toxic than a regimen of cisplatin plus
      cyclophosphamide. In addition, Taxol has been identified as an extremely active
      agent against this disease, and new Taxol-containing combinations are under
      clinical investigation. Clinical trials are also in progress with
      hexamethylmelamine and ifosfamide combinations as well as with more dose-intense
      regimens based on considerable retrospective evidence that survival is correlated
      with the dose intensity of platinum compounds. New agents such as WR2721, IL-3,
      and IL-1 alpha are undergoing clinical evaluation to determine whether the
      toxicities of platinum compounds can be decreased and lead to further
      exploitation of the dose response relationship. After induction chemotherapy,
      approximately 50% of patients will be in a clinical complete remission.
      Unfortunately, 30% to 50% of these patients will have recurrent disease; clinical
      trials are currently in progress to determine whether any form of therapy
      following the initial induction regimen can prevent or delay recurrences. Based
      on laboratory investigations in relevant models of human ovarian cancer, clinical
      trials are also in progress with novel new agents that may be capable of
      reversing drug resistance to platinum compounds and alkylating agents. For
      patients with germ cell tumors of the ovary, platinum-based combination
      chemotherapy has produced the same dramatic effects as in testicular cancer.
      Clinical trials are now focused on retaining therapeutic efficacy but decreasing
      the toxicity of treatment in these tumors that frequently affect women in their
      reproductive ages.

PMID- 1617997
TI  - Oral disposition kinetics of ofloxacin in patients with compensated liver
      cirrhosis.
AB  - The disposition kinetics of ofloxacin, a quinolone antibacterial agent excreted
      essentially unmodified by the kidney, was studied after single oral
      administration in 8 patients with compensated liver cirrhosis and in 8 control
      subjects. Mean elimination half-life and apparent volume of distribution were
      significantly increased in the cirrhotic group (7.6 vs. 4.9 h and 1.6 vs. 1.2
      liters kg-1, respectively). A reduction in the renal clearance of ofloxacin was
      also observed in the cirrhotic patients, in spite of an apparently normal renal
      function. These observations indicate that also the pharmacokinetics of
      unmetabolized drugs may be altered in compensated liver cirrhosis. The serum
      concentration-time profiles of nearly all subjects exhibited a secondary peak 4-6
      h after dosing. This double-peak behavior was interpreted as either enterohepatic
      circulation or biphasic gastric emptying of ofloxacin.

PMID- 1617998
TI  - Cefonicid versus cefuroxime: an in vitro study of 1,000 Enterobacteriaceae.
AB  - Cefuroxime and cefonicid, two common representatives of the second-generation
      cephalosporins, were compared for their spectrum of activity against 1,000
      isolates of gram-negative Enterobacteriaceae. Cefuroxime had an overall advantage
      of 6.3% over cefonicid. Upon investigation, we found that this was mainly due to
      Escherichia coli: 11.2% of the E. coli strains proved resistant to cefonicid
      whilst only 0.4% were cefuroxime resistant.

PMID- 1617999
TI  - Effects of cefuzonam on peptidoglycan cross-linking reactions in gram-negative
      bacilli.
AB  - Cefuzonam [CZON, sodium (-)-(6R,7R)-7-[(Z)-2-(2-amino-4-thiazolyl)-2-
      methoxyiminoacetamido]-3-[(1,2,3-thiadiazol-5-yl)thiomethyl]-8-oxo -5-thia-1
      azabicyclo(4.2.0)oct-2-ene-2-carboxylate] is a newly developed semisynthetic
      cephem with a broad antibacterial spectrum. The effects of CZON on peptidoglycan
      cross-linking reactions were examined in Escherichia coli, Serratia marcescens
      and Pseudomonas aeruginosa. The cross-linking enzyme(s) from P. aeruginosa was
      the most susceptible to CZON, although the bacterium was resistant to CZON. CZON
      was active against S. marcescens in spite of its weak inhibitory activity against
      the enzyme(s) from the bacterium.

PMID- 1618000
TI  - Bactericidal activities of ofloxacin and its optically active isomer (DR-3355) on
      non-growing cells of Escherichia coli and Pseudomonas aeruginosa.
AB  - In this paper the bactericidal activities of ofloxacin and its optically active
      derivative, DR-3355, against non-growing cells of Escherichia coli and
      Pseudomonas aeruginosa are described. E. coli and P. aeruginosa were killed
      rapidly by ofloxacin and DR-3355. After treatment with these quinolones, the
      resting cells of E. coli and P. aeruginosa became plasmolyzed, with apparent
      cytoplasmic shrinkage without filamentation. Membrane-bound intracellular
      vacuoles and disruption of the cell envelope were also observed, resulting in
      extrusion of the cytoplasmic contents. These results indicate that non-growing
      cells of E. coli and P. aeruginosa were susceptible to ofloxacin and DR-3355, as
      were logarithmically growing cells.

PMID- 1618001
TI  - Antibacterial activity of cefixime against Streptococcus pneumoniae,
      Streptococcus pyogenes, and Haemophilus influenzae in the presence of Moraxella
      (Branhamella) catarrhalis.
AB  - We measured the sizes of the inhibition zones of oral beta-lactam antibiotics for
      Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae in
      the presence of beta-lactamase-producing-Moraxella (Branhamella) catarrhalis by
      the agar double-layer method. The sizes of the zones of amoxicillin for S.
      pneumoniae alone were the largest, followed in a descending order by those of
      cefixime and cefaclor. In the presence of 10(7) CFU/ml of M.(B.) catarrhalis,
      however, significant reduction of the sizes of the zones was seen with
      amoxicillin and cefaclor; inhibition with cefixime was nearly unchanged. Similar
      results were observed in those for S. pyogenes. These variable findings were
      attributed to the difference in stability of these drugs to the beta-lactamase
      produced by M.(B.) catarrhalis. When the susceptibility of H. influenzae in the
      presence of 10(8) CFU/ml of M.(B.) catarrhalis to cefixime, cefoteram,
      cefpodoxime, cefotiam and cefuroxime was examined, the sizes of the inhibition
      zones of all the drugs were reduced by the presence of 10(8) CFU/ml of M.(B.)
      catarrhalis, but those of cefixime were the largest of all the drugs tested. Our
      agar double-layer method is simple and useful for evaluating the influence of
      beta-lactamase-producing organism, as M.(B.) catarrhalis, on the disk
      susceptibility of other pathogens to antibiotics.

PMID- 1618002
TI  - In vitro activity of a new broad-spectrum, beta-lactamase-stable oral
      cephalosporin, cefixime, in comparison with other drugs, against Haemophilus
      influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis and Streptococcus
      pneumoniae.
AB  - Cefixime, a new orally absorbed iminomethoxyaminothiazolyl cephalosporin, was
      tested against some microorganisms involved in upper and lower respiratory tract
      infections such as Haemophilus (influenzae and parainfluenzae), Moraxella
      catarrhalis and Streptococcus pneumoniae, isolated in the period from November
      1990 to April 1991. Its activity was compared to nine other antimicrobial agents:
      erythromycin, trimethoprim-sulfamethoxazole, ampicillin, amoxicillin-clavulanate,
      cefaclor, ceftazidime, ceftriaxone, cefotaxime and ofloxacin. Cefixime inhibits
      90% of S. pneumoniae, H. influenzae and H. parainfluenzae, both beta-lactamase
      producers (BLP) or not (NBLP) at concentrations of less than 0.25 mg/l. It
      inhibits 90% of M. catarrhalis (BLP and NBLP) at concentrations of less than 1
      mg/l. In general, cefixime has a superior in vitro activity with respect to
      cefaclor and the other cephalosporins as well as erythromycin and amoxicillin
      (the last one in BLP strains). In the evaluation of the antibacterial activity of
      beta-lactam against Haemophilus and M. catarrhalis, the authors observed
      different indications in the guidelines for ampicillin. Cefixime is not destroyed
      by the plasmid-mediated beta-lactamase produced by Haemophilus sp. and M.
      catarrhalis (TEM and ROB in Haemophilus strains and BRO in M. catarrhalis). In
      view of its excellent in vitro activity against the commonly encountered
      respiratory tract pathogens, cefixime is indicated in the therapy of these
      infections.

PMID- 1618003
TI  - Subinhibitory concentration of octenidine and pirtenidine: influence on the lipid
      and sterol contents of Candida albicans.
AB  - The effect of subinhibitory concentrations of octenidine and pirtenidine on the
      lipid and sterol composition of Candida albicans was investigated. The total
      lipid and sterol contents of C. albicans grown in the presence of either
      octenidine or pirtenidine were reduced compared with control-grown cells. The
      major differences in the lipid composition of drug-grown and control cells were
      phosphatidylglycerol, phosphatidylcholine and monogalactosyldiacylglycerol, which
      increased in the presence of octenidine and pirtenidine. Lower proportions of
      phosphatidic acid were found in yeasts grown in the presence of the drugs when
      compared with control C. albicans. Fatty acid analysis of control-grown cells
      showed that the major fatty acids were C16 and C18. Drug-grown cells had higher
      proportions of palmitic and linolenic acids but lower proportion of oleic acid.
      The C16/C18 ratios were higher for octenidine- and pirtenidine-grown cells than
      control cells. Differences in the fatty acid composition of major phospholipids
      and neutral lipids between drug-grown and control yeasts were also observed.
      Sterol analysis of control-grown cells showed that the major sterol present was
      ergosterol (65.9%). A significant increase in squalene and 4,14
      dimethylzymosterol was observed in pirtenidine-treated cells, while octenidine
      treated cells showed an increase in zymosterol and obtusifoliol contents. Our
      results suggest that octenidine and pirtenidine affect the lipids and sterol of
      C. albicans in different ways. The implications of these findings on the mode of
      action of these two drugs is discussed.

PMID- 1618004
TI  - Effects of 1-(halogenalkoxy)alkyl-5-fluorouracil derivatives on cell growth, cell
      volume and nucleus size of mouse lymphoma cells.
AB  - The effects of three 1-(halogenalkoxy)alkyl-5-fluorouracil derivatives on
      cultured mouse lymphoma cells were studied and compared with those of N-methyl
      bis-(2-chloroethyl)amine hydrochloride (Lost). The derivatives exert only little
      influence on cell proliferation and cell volume. However, all derivatives cause a
      concentration-dependent nucleus contraction, probably due to DNA cross-linkings.
      Bromodesoxyuridine modulates the effects of the derivatives on the DNA, leading
      to swelling of the nucleus, which may be caused by DNA strandbreaks. It is
      suggested that the derivatives exert synergistic effects with other factors. It
      is concluded that these studies are suitable for the prescreening of agents to be
      investigated in mutagenicity tests.

PMID- 1618005
TI  - Effect of a membrane-active agent on uptake of adriamycin in Lewis lung carcinoma
      cells derived from 'primary' and 'metastatic' growths.
AB  - The treatment of metastatic growth still constitutes a challenge for cancer
      research. Tumor progression is often accompanied by a loss in sensitivity to
      previously efficient drugs. Decreased intracellular accumulation of cytotoxic
      agents is probably the major reason for drug resistance, although other
      mechanisms have also been described. Properties of the cell membrane have been
      shown to determine the metastatic phenotype. This cellular organelle is also
      responsible for the multiple drug resistance phenomenon. Membrane-active agents
      may increase cell permeability to drugs, counteracting thereby drug resistance.
      In the present study the effect of the nonionic detergent Tween 80 on sensitivity
      to adriamycin (ADR) of cells derived from Lewis lung carcinoma 'primary tumors'
      (PT)-the local growth following subcutaneous inoculation - and 'metastatic
      tumors' (MT) - lung tumors which develop following intravenous injection - was
      compared. Flow cytometry analysis demonstrated several differences between cells
      derived from the PT and the MT: (1) single ADR treatment showed that MT cells
      possessed a lower percentage of a high ADR permeability subpopulation than PT
      cells; (2) a dose-dependent shift to a higher ADR accumulating population was
      seen in the presence of Tween 80 for both cell types. However, the increase in
      percentage of high ADR permeability cells was more pronounced in MT (up to x4.7)
      than in PT (up to x1.3) cells. This differential effect of the membrane-acting
      agent was evident at various ADR (10-50 micrograms) and Tween 80 (0.1-0.4%)
      concentrations. The present results corroborate previous data obtained in our
      group in another tumor progression model, AKR lymphoma.

PMID- 1618006
TI  - Killing rate and growth rate comparison for newer beta-lactamase-stable oral beta
      lactams against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella
      catarrhalis.
AB  - A new method of data presentation that takes into account the relationship
      between growth and killing rate was used to evaluate the comparative in vitro
      bactericidal activity of cefpodoxime, cefuroxime, cefixime and an
      amoxicillin/clavulanic acid combination against Streptococcus pneumoniae and beta
      lactamase-producing strains of Haemophilus influenzae and Moraxella catarrhalis.
      For each strain, the viable count decrease (log CFU/ml) after 6 h of exposure to
      different antibiotic concentrations was plotted against the viable count increase
      in the control culture, over the same time. Higher killing rates than those
      predicted by growth rates were defined as a positive balance; lower rates than
      those predicted by growth rates were defined as a negative balance. The activity
      of the 4 drugs against S. pneumoniae and M. catarrhalis was characterized by a
      positive balance. Conversely, the 3 cephalosporins showed a negative balance for
      H. influenzae.

PMID- 1618007
TI  - Netilmicin plus ceftriaxone versus amikacin plus ceftriaxone in the treatment of
      infections in granulocytopenic patients.
AB  - For the treatment of febrile episodes in granulocytopenic cancer patients, a
      combination of bactericidal and intravenously administered broad spectrum agents
      is recommended. An aminoglycoside plus a beta-lactame (piperacillin, azlocillin
      or IIIrd generation cephalosporins) are the drugs of first choice in an empiric
      approach. Because of frequent parenteral interventions (e.g. catheters,
      cannulations) in thrombopenic patients with multifactorial immunosuppression, we
      consider the application of once daily drugs, such as ceftriaxone, netilmicin or
      amikacin. For single dose treatment (1st day two applications), we used
      ceftriaxone in combination with netilmicin or amikacin as the first approach and
      retrospectively evaluated 47 patients for efficacy and safety.

PMID- 1618008
TI  - Study on the mechanism of cytogenetic adaptive response induced by low dose
      radiation.
AB  - Pre-exposure of human lymphocytes to low dose radiation (D1) could induce a
      cytogenetic adaptive response expressed as a decrease of chromatid aberrations
      caused by subsequent large dose radiation (D2). There are two possible
      explanations for its mechanism, i.e., activation of enzymatic processes by D1
      facilitating repair of chromosomal damage and induction of protective proteins by
      D1 reducing the number of chromosomal aberrations. The results here showed: (1)
      the cytogenetic adaptive response could be enhanced by hyperthermia (41 degrees C
      and 43 degrees C) and suppressed by hypothermia (4 degrees C); (2) hyperthermia
      (41 degrees C) alone could also induce the cytogenetic adaptive response; (3) the
      cytogenetic adaptive response could be inhibited by cycloheximide--an inhibitor
      of protein synthesis; (4) supernatant from cultured lymphocytes treated with D1
      failed to show the protective effect. The results imply that the cytogenetic
      adaptive response is not only related to the activation of repair enzymes, but
      also to the induction of protective proteins.

PMID- 1618009
TI  - Clinical manifestations and prevalence of different types of supraventricular
      tachycardia among Chinese.
AB  - Sixty-nine cases of paroxysmal supraventricular tachycardia (PSVT) were submitted
      to electrophysiological studies. The prevalence of different types of PSVT is as
      follows: 49% of the cases had atrioventricular reentry tachycardia (AV-RT), 14.5%
      atrioventricular nodal reentry tachycardia (AVN-RT), 28% AV + AVN - RT, and 8.5%
      other types. Altogether 77% in this group had atrioventricular accessory pathway,
      of which half are concealed pathway. Electrocardiographic characteristics during
      tachycardia give hints to diagnosis: (1) AV - RT has the fastest heart rate, with
      62% 200 BPM or more, and 82% more than 188 BPM; (2) retrograde P waves can be
      detected in 64% of cases with AV bypass; (3) 50% of AV - RT shows QRS of bundle
      branch block pattern. Since accessory pathways are present in the majority of
      PSVT patients in China, the importance of treatment is stressed.

PMID- 1618010
TI  - Extended parietal cell vagotomy in the treatment of perforation, hemorrhage and
      stenosis due to duodenal ulcer.
AB  - Ninety-five patients with perforation, hemorrhage or stenosis due to duodenal
      ulcer were treated by extended parietal cell vagotomy. Postoperative follow-up
      ranged from 3.5 to 10 years (mean 6 years) in 88 patients (92%) with acute
      perforation (60), hemorrhage (8) and stenosis (20). There was no operative
      mortality. Ulcer recurrence was 2.3%. Only one patient (5%) had restenosis and
      required reoperation. There was no recurrent hemorrhage and there were few long
      term complications. According to the Visick classification, 67 patients (76%)
      belonged to grade I, 13 (14.7%) grade II, 4 (4.5%) grade III, and 4 (4.5%) grade
      IV. Extended parietal cell vagotomy proved to be safe with excellent results, low
      ulcer recurrence and few complications. Moreover, recurrent ulcers healed rapidly
      following medical therapy. The authors believe that extended parietal cell
      vagotomy should be the treatment of choice for acute perforation, hemorrhage or
      stenosis due to duodenal ulcer.

PMID- 1618011
TI  - Automatic perimetry in detecting early glaucomatous visual field defects. A
      follow-up study.
AB  - A prospective study was conducted to identify the value of the differential light
      threshold changes in glaucoma patients. Using Humphrey Field Analyzer, we
      determined the differential light threshold on 42 preselected points in the
      Bjerrum area in the age-matched early glaucoma and normal group, each in 50 eyes,
      whose initial Goldmann perimetries were normal. It was found that both
      generalized and localized sensitivity of the retina declined obviously in the
      glaucomatous group. After Goldmann perimetry follow-up for 2.5 years, 24 eyes
      showed reproducible typical visual field defects (VFD) in the glaucoma group,
      which appeared in the same location where light threshold had reduced previously.
      Therefore, a typical glaucoma VFD was preceded by the slight localized depression
      of light sensitivity in the Bjerrum area.

PMID- 1618012
TI  - Tube-perilymph fistula. An experimental study.
AB  - Before exploratory tympanotomy, it is difficult to diagnose an idiopathic
      perilymph fistula (PLF) because of its variable presentations. An animal model
      tube-PLF on guinea pigs was established to evaluate the change of the sensitivity
      of the cochlea function and the value of the postural audiometry in PLF. A fine
      polyethylene tube (O.D. 0.6mm) was inserted into the scala tympani of the basal
      turn through the incised round window membrane in 10 experimental guinea pigs,
      and another 5 as controls. The hearing threshold (HT), action potential (AP)
      latency for stimulus of 105 dB SPL, difference of HT and AP latency from the test
      ear down to up were measured by electrocochleography (ECoG) immediately after
      operation and one week later. The HT, AP latency and postural audiometry showed
      no significant changes immediately but a significant difference one week later in
      HT (P less than 0.01) and postural audiometry, the AP latency also presented a
      significant delay (P less than 0.01). The results showed that the tube-PLF model
      may be a valuable method for studying chronic PLF.

PMID- 1618013
TI  - Mirror writing of Chinese characters in children and neurologic patients.
AB  - Mirror writing was done in 72 preschool children, 40 school children, 60 mentally
      retarded school children, 40 normal adults, 37 patients suffering from
      cerebrovascular diseases with or without aphasia and 13 patients with Parkinson's
      disease. The results showed that total mirror writing was demonstrated in only 2
      cases and partial mirror writing with the left hand in 72 cases and with the
      right hand in 16 cases. The incidence of mirror writing in writing with left hand
      was higher (45.8%) in preschool children. It gradually decreased to 43.3% in
      mentally retarded school children, 24.3% in cerebrovascular disease (CVD)
      patients, 10.0% in school children, 7.7% in Parkinson's disease (PD) patients and
      2.5% in normal adults. The relationships between mirror writing and left/right
      disorientation, between mirror writing and development of Chinese writing
      language and between mirror writing and higher cerebral function were observed.

PMID- 1618014
TI  - Ni-Ti memory alloy clamp plate for fracture of short tubular bone.
AB  - The clamp shape implant has a special memorial function. It consists of one main
      rod and 3 or 4 pairs of curved short arms located at both sides of the rod. Each
      pair of arms rolls into a circle, which can embrace 2/3 of the circumference of
      the fractured bone shaft, thus fixing fragmental bones at multiple points more
      securely without any limitation to the motion of adjacent joints. Therefore,
      clamp implant is especially useful for comminuted fracture of the short tubular
      bone, which is difficult to fix by other methods.

PMID- 1618015
TI  - Investigation of allotypes of HLA class III (C2, BF and C4) in patients with
      schizophrenia.
AB  - The allotypes of HLA Class III (C2, BF and C4) in 60 patients with schizophrenia
      were investigated. Significantly higher frequencies of BF*F, BF*SO7 and C4A*4 in
      patients were found as compared with those of the normal controls. The relative
      risks (RR) of the three allotypes to schizophrenia were 1.81, 7.79 and 4.18 and
      the etiologic fraction (EF) were 0.086, 0.060 and 0.042, respectively. There were
      no significant changes of C2 allotypes.

PMID- 1618016
TI  - Research on rapid identification of auto-microbiology system for pathogenic
      yeast.
AB  - The auto-microbiology system yeast biochemical card (AMS-YBC; Vitek System, Inc.)
      was studied in 77 clinical isolates and 50 laboratory kept isolates on the basis
      of routine identification. Results of 123 isolates were obtained in 24 hours,
      while that of the other 4 in 48 hours. 122 (96.1%) were coincidently identified
      with AMS and routine method. The results suggest that AMS is a rapid, accurate
      and simple identification method for common pathogenic yeast.

PMID- 1618017
TI  - Experimental research on antimotion sickness effects of Chinese medicine
      "pingandan" pills in cats.
AB  - Pingandan was a secret prescription for treatment of stomach upset, nausea and
      vomiting for emperors in the Qing Dynasty of China. This study was to compare the
      effects of Pingandan with those of scopolamine and dramamine on motion sickness
      (MS) and nystagmus. Fourteen cats were tested in a parallel swing (0.22 Hz, 3.9
      m/S2) for 20 min, and then in a rotating chair (10 degrees/S2, 20 rpm) for 1-2
      min. The effects of scopolamine 1 mg, dramamine 25 mg and three doses of
      Pingandan 50x, 30x, 10x of 0.45 g/kg were observed and compared to placebos.
      These drugs or placebos were administered to each cat 30-60 min prior to the
      tests. The post-rotary nystagmus and MS symptoms were recorded. The Suri's scale
      for MS severity, Latin square and double blind techniques were used. The interval
      between any two tests was 2-5 days. It was found that Pingandan 50x and
      scopolamine 1 mg were more effective than placebos in reducing MS symptoms (P
      less than 0.01) and suppressing slow phase velocity of nystagmus (P less than
      0.05), while Pingandan 30x significantly reduced MS symptoms only (P less than
      0.01). Pingandan 10x and dramamine 25 mg had no anti-MS effect. Chinese medicine
      Pingandan is an effective anti-MS drug.

PMID- 1618018
TI  - Treatment of hallux valgus in China.
AB  - This is a review of the treatment of hallux valgus based on the paper material
      submitted to the First and Second Sino-American Conferences on Foot Disorders
      held in Beijing in 1987 and 1990. The data consisted of 676 cases (979 feet) from
      10 major hospitals in China. There were 122 men and 554 women, giving a male to
      female ratio of 1:45. Sixty-nine (10%) cases had a family history of hallux
      valgus and 120 cases (18%) were associated with hammer toe deformity. The age
      ranged from 16-85 years with an average of 42. Among the 412 female cases (78.5%)
      at the age of 20-35, 339 (82.3%) had the history of wearing high heeled and
      narrow tipped shoes. Osteoarthritis changes of the first M-P joint were seen in
      31 cases, all above the age of 60. 615 cases (90.9%) were treated surgically for
      pain relief and only 25 cases (3.7%) at the age of 20-30 had the deformity
      corrected for cosmetic purpose. The surgical procedures employed were
      bunionectomy (Silver's operation, 39 feet), Keller's operation (344 feet),
      McBride's operation (239 feet) and a variety of osteotomies of the first
      metatarsal (295 feet). Joplin and Lapidus operations were used by one author in 5
      and 2 cases respectively. Overall excellent and good results were obtained in 609
      cases (90%) during the follow-up of 1-14 years.

PMID- 1618019
TI  - Endobronchial leiomyoma.

PMID- 1618020
TI  - Adenoacanthoma developing in adenomyosis uteri.

PMID- 1618021
TI  - The fragile X syndrome: isolation of the FMR-1 gene and characterization of the
      fragile X mutation.
AB  - Fragile X syndrome, associated with the fragile X chromosome, is the most common
      cause of familial mental retardation. A breakthrough has been made in molecular
      biological research into the fragile X site. In this review we describe the
      molecular investigations that have led to the isolation of the FMR-1 gene. The
      nature of the fragile X mutation as well as the implications of the DNA test for
      the mutation are discussed.

PMID- 1618022
TI  - Molecular analysis of the aberrant replication banding pattern on chromosome 15
      in murine T-cell lymphomas.
AB  - Cytogenetic techniques revealed an altered early replication banding pattern on
      the distal part of chromosome 15 in some murine T-cell lymphomas. This pattern
      reverted back to normal replication in somatic cell hybrids that had become non
      tumorigenic after fusion of leukemic cells with normal fibroblasts. The altered
      banding pattern was correlated with malignancy. To investigate the molecular
      basis of the aberrant pattern in more detail, centrifugal elutriation of cells
      containing bromodeoxyuridine labeled DNA was used to prepare newly replicated DNA
      from selected intervals of the S-phase from tumor cells, as well as from hybrid
      cells with the revertant phenotype. These different DNA fractions were probed for
      DNA sequences distributed over the distal half of chromosome 15. Only two out of
      ten chromosome 15 specific genes tested showed a clear change in replication
      timing between the two different cell lines tested. These two genes were the
      lymphocyte antigen-6, Ly-6, and the neighboring thyroglobulin gene, Tgn, which
      replicated at the beginning of S in the tumor cells and later in S in the non
      tumorigenic hybrid cells.

PMID- 1618023
TI  - Orientation and segregation of a micromanipulated multivalent: familiar
      principles, divergent outcomes.
AB  - We studied the orientation and segregation of a particular quadrivalent in living
      grasshopper spermatocytes. Quadrivalents were detached from the spindle by
      micromanipulation, then placed and bent as desired. The detached quadrivalents
      reattach and orient on the spindle. Their orientation is determined by the same
      principles that apply to ordinary chromosomes in mitosis and meiosis, but the
      outcome is different. Certain characteristics of the quadrivalent lead to a
      variety of orientations rather than the single one typical of ordinary
      chromosomes. Two kinetochores in the quadrivalent are linked to the others by
      unusually long, flexible chromosome arms. These kinetochores may face either the
      same pole or opposite poles and tend to orient initially to the pole toward which
      they face. Consequently, the initial orientation of the flexibly linked
      kinetochores is variable, and, moreover, they frequently reorient. In contrast,
      the other two kinetochores are as rigidly connected as those in a small bivalent
      and so display the typical back-to-back arrangement. Usually, this arrangement
      leads quickly to a stable orientation of the two kinetochores to opposite poles.
      Sometimes, however, the back-to-back arrangement changes to a side-by-side
      arrangement so that the orientation of both kinetochores to the same pole is
      favored. The combined effect of this diverse behavior is that the quadrivalent
      has four stable orientations, each leading to a different distribution of
      chromosomes in anaphase. The result is genetic chaos. Ironically, this chaos is
      produced by the same mechanisms that, in ordinary bivalents and mitotic
      chromosomes, produce a single stable orientation and genetically appropriate
      chromosome distribution.

PMID- 1618024
TI  - Properties of isolated extrachromosomal nucleoli from Tetrahymena pyriformis.
AB  - Extrachromosomal nucleoli were isolated from log phase cells of Tetrahymena
      pyriformis (amicronucleate strain) in a highly purified state. Nucleoli located
      at the periphery of the macronucleus were detached from the nucleoplasmic mass of
      isolated macronuclei with agitation and separated from macronuclei by filtration
      through a Nuclepore membrane filter (pore size 5 microm). The filtrate
      constitutes the crude nucleolar preparation, as judged by electron microscopy and
      DNA analysis. Further purification of the nucleoli was performed by isopycnic
      centrifugation of the filtrate in a Metrizamide density gradient. After this
      step, the purity of the nucleoli, as defined by rDNA content and measured by
      analytical CsCl centrifugation, was almost 100%. Electron microscopy of the
      purified nucleoli revealed structures that resemble those of an in situ nucleoli.
      Undegraded 35S pre-rRNA, together with 26S and 17S rRNA, could be isolated from
      purified nucleoli. In vitro RNA synthetic activity was associated with isolated
      nucleoli. This activity is insensitive to low and high concentrations of alpha
      amanitin, indicating that the form I RNA polymerase is functioning.

PMID- 1618025
TI  - Isolation and characterization of a mouse subtelomeric sequence.
AB  - A mouse subtelomeric sequence, ST1, was generated from genomic DNA of the mouse
      HR9 (129/Sv origin) cell line by the polymerase chain reaction (PCR) using a
      single telomeric primer. ST1 was cloned and characterized: it is composed of 670
      bp of novel DNA sequence flanked on each end by inverted telomeric hexanucleotide
      repeats (TTAGGG)n. PCR amplification from BALB/c mouse DNA using this single
      primer gave the same major product. Southern analysis and PCR using internal ST1
      primers confirmed that the ST1 sequence is present in mouse genomic DNA. In situ
      hybridization to metaphase chromosomes of SJL origin mapped ST1 to many, if not
      every, mouse telomere. PCR experiments using different combinations of the
      telomeric, minor satellite, and ST1 primers indicated that some ST1 copies are
      adjacent to minor satellite sequences, that telomeric and ST1 sequences are not
      generally interspersed with minor satellite sequences, and that ST1 and the minor
      satellite have a consistent and specific orientation relative to each other and
      to the telomere.

PMID- 1618026
TI  - The genome of the Mediterranean fruitfly Ceratitis capitata: localization of
      molecular markers by in situ hybridization to salivary gland polytene
      chromosomes.
AB  - We hybridized cloned DNA segments to salivary gland polytene chromosomes of the
      medfly, Ceratitis capitata, and thus established molecular markers for 24 sites
      on 6 out of 10 autosomal arms. An additional marker identified a medfly
      repetitive element that hybridizes to approximately 100 autosomal sites as well
      as a granular network that is thought to represent the X chromosome. Some of the
      markers correspond to 9 characterized transcription units, while 17 remain
      anonymous; at least 3 of the latter are restriction fragment length polymorphism
      (RFLP) markers. The characterized transcription units document that chromosomal
      arm 5L of C. capitata is homologous to the Drosophila melanogaster X chromosome,
      in agreement with previous inferences based on the extensive conservation of
      linkage groups in Diptera.

PMID- 1618028
TI  - [Relationship between developmental stenosis of cervical spinal canal and spinal
      cord injury].
AB  - A retrospective study of 55 patients with acute cervical spinal cord injury
      caused by trauma was performed. On radiographic examination of the cervical spine
      in each of 55 cases showed no fracture or dislocation but developmental stenosis
      determined on lateral view radiograms. Ninety five point nine percent of this
      cases had block of the dyeing columns myelographically both in prone and supine
      positions. Eighty point nine percent of 47 cases demonstrated segmental
      instability of the cervical spine on full extension and flexion radiograms.
      Thirty eight cases suffered a minor trauma but resulted in incomplete spinal cord
      injury with moderate neurologic deficits. Most patients who had been treated
      conservatively for about 3 years demonstrated the neurologic deficits worsened
      gradually. In the later 50 cases underwent surgical treatment. A follow-up study
      showed that Robinson's procedure and laminectomy resulted in unsatisfactory
      outcome, in contrast to those of open-door technic. It is suggested that
      developmental stenosis may be a potential factor in the spinal cord injury.

PMID- 1618027
TI  - Molecular analysis of the lethal(1)B214 region at the base of the X chromosome of
      Drosophila melanogaster.
AB  - Approximately 50 kb of genomic DNA was isolated from polytene chromosome bands
      19F1 and 2 of Drosophila melanogaster. Bands 19F1 and 2 are in the immediate
      vicinity of the beta-heterochromatin at the base of the X chromosome and
      encompass the little fly-like and lethal(1)B214 complementation groups. The
      cloned DNA consists of an approximately 21 kb stretch of unique or low copy
      number sequence that is bounded by repetitive elements interspersed with further
      unique sequences. The presence of repeated sequences is characteristic of regions
      within and adjacent to beta-heterochromatin. At least part of a tRNA gene cluster
      is present within the 50 kb of cloned DNA. The cloned region also produces at
      least 18 discrete size classes of developmentally regulated poly(A)+ RNA species.
      A 2 kb EcoRI fragment (E10), which lies in the 21 kb stretch of unique sequence,
      generates seven of these transcripts (of sizes 3.5, 3.35, 2.1, 2.0, 1.5, 1.2 and
      1.0 kb) in wild-type flies. However, a small deletion of approximately 75 bp in
      E10 in a lethal(1)B214 mutant allele is associated with alterations in the
      production or processing of all seven of these transcripts. These data identify
      E10 sequences as belonging to the lethal(1)B214 gene and suggest that the wild
      type lethal(1)B214 gene encodes multiple transcripts. Furthermore, no transcripts
      of the same size and having the same developmental profile as those generated by
      the wild-type E10 fragment were identified by probes covering the remainder of
      the cloned region. This suggests that at least the larger transcripts hybridizing
      to E10 are partly transcribed from sequences located outside the cloned region,
      which indicates that the lethal(1)B214 gene extends for more than 20 kb and
      contains other transcriptionally active sequences within it.

PMID- 1618029
TI  - [Developmental stenosis of the cervical spinal canal hyperextension injury].
AB  - Sixteen cases of cervical spinal cord injury with developmental stenosis of
      cervical spinal canal were treated. The numbness and quadriplegia of the patients
      were caused by hyperextension X-ray of the cervical spine showed no fracture or
      dislocation but the sagittal diameter of the canal and that of the corresponding
      cervical vertebral body was less than 0.75. All of the patients were treated by
      operation including laminoplasty on 12 cases. The numbness and quadriplegia in
      most of the patients were improved obviously after operation. The mechanism of
      hyperextension injury on the cervical spinal cord was discussed. When spinal
      column was extended, annulus fibrosus of disk and ligamentum flavum would enfold
      into the spinal canal and only a slight force would do severe on the cord.
      Laminoplasty is the recommended treatment for this kind of lesions.

PMID- 1618030
TI  - [Complications of scoliosis following surgery].
AB  - The complications of scoliosis in 100 cases were treated surgically in the past 8
      years. The early complications were pulmonary complications (3 cases), syndrome
      of supra-mesenteric artery (2), and wound infection (3). Late complications were
      unhooked Harrington instrumentality (10) cases), fracture of Harrington rods (9),
      protrusion of upper end of Luque rods (7), breakage of tethering wire (4) and
      pseudarthrosis (3). there was no operative mortality or paraplegia after
      operation.

PMID- 1618031
TI  - [Diagnosis and treatment of congenital atlantoaxial dislocation].
AB  - 23 patients, aged from 10 to 52 years (24 years on the average), with congenital
      dislocation of atlanto-axial joint were treated. Symptoms were chiefly functional
      disturbance of motion; diagnosis was based on malformation of cranio-vertebral
      junction shown on radiograms; and operation of transoral decompression or/and
      posterior decompression and fusion was performed on each patient. Such operation
      did benefited 19 patients, a rate of 82.6%, evaluated in 0.2 to 8.7 years (1.9
      years on the average) after operation. Skull traction tried on several patients
      failed to reduce the dislocation because of dense fibrous tissues in the joint
      space, hindering reduction. Posterior decompression alone was seldom effective
      and even dangerous. For this condition, transoral decompression and anterior or
      posterior fusion is a good choice of treatment. Mechanism of developing symptoms,
      key points of making diagnosis and surgical procedures were described in detail.

PMID- 1618032
TI  - [Mechanical efficacy of different internal fixation devices in the treatment of
      thoracolumbar fractures].
AB  - To know the efficacy of different internal fixation devices used in the treatment
      of thoracolumbar fractures, specimens of 15 adult cadaveric (T-8 to L-4) were
      prepared and were divided into 5 groups for comparative study. Except the control
      group, the vertebra of T-12 of every specimen in other 4 groups was artificially
      fractured, imitating flexion fracture dislocation, with standard technic. Then,
      they were fixed in each group, with Luque's rod, Dick's screw, pedicle screw
      plate or Dunn's device respectively. The stress distribution and yielding stress
      under load and dimensional motions in each group were recorded and compared among
      the groups and with the control. In the experimental groups, Dunn's device gave
      the strongest support, against load on the anterior and middle columns. Dick's
      screw and pedicle screw plate could theoretically fix the anterior, middle and
      posterior columns rigidly; however, because of the weakness persisted in the
      connection of their components, their fixation effectiveness was reduced. Luque's
      rod acted though effectively against bending on every direction, it could not
      stand much axial load. It is obvious that each of these 4 devices has its own
      advantages and could be used to prevent horizontal displacement of the fixed
      fracture, but fail to control torsional stress.

PMID- 1618033
TI  - [Immunohistocytochemistry in evaluation of spinal cord injury].
AB  - The results of spinal cord injury were evaluated immunohistocytochemically with
      monoclonal antibody to neurofilament (NF) or glial fibrillary acidic protein
      (GFAP) for labelling the nerve cells, nerve fibres and astrocytes in 13 dogs.
      Their cords were taken out in 6, 12, 24, 48 hours or 10-12 weeks after trauma by
      standard injury. Morphometric analysis was also used. We found that the injured
      nerve fibres expanded gradually and then disappeared, the astrocytes became GFAP
      positive and the GFAP framework structures disrupted 24 hours after injury. Later
      in 10-12 weeks after injury, the nerve cells changed in 3 different functional
      patterns: active phase, stable phase and week phase. There was a significant
      correlation between axon counting and GFAP area ratio, also the active phase
      counting to the muscle function. Its biological significance was also discussed.

PMID- 1618034
TI  - [Surgical treatment of spondylolisthesis].

PMID- 1618035
TI  - [Intracerebral cograft of Schwann's cells and fetal adrenal medulla in the
      treatment of Parkinson's disease].
AB  - 10 cases Parkinson's disease received intracerebral cograft of Schwann's cells
      and fetal adrenal medulla. Good result was achieved. In some cases, symptoms
      continued to improve after one-year follow-up. There was no "rebounce" phenomenon
      which was often seen in the autologous adrenal medulla transplantation. We
      conclude that selection of patients, medication of amamtadion after surgery and
      cografting of Schwann's cells are essential to the satisfactory results.

PMID- 1618036
TI  - [Surgical treatment of primary tumor in the right heart].
AB  - From April 1986 to March 1990, 5 patients with primary tumor of the right heart
      were treated surgically at our hospital. Two of them had right atrial myxomas,
      and one had malignant lymphoma of the right atrium. The remaining 2 patients had
      tumors of the right ventricle (fibromyxoma 1 patient and leiomyosarcoma 1). The
      diagnosis was confirmed by 2-D echocardiography in all patients. Three patients
      with cardiogenic shock were operated on at emergency clinic. There were no
      operative deaths. Two patients with primary malignant tumors underwent incomplete
      resection with poor results. Three patients with benign tumors who had the tumors
      totally removed showed good results after operation.

PMID- 1618037
TI  - [Long-term results of bioprosthetic valves mounted on flexible stent].
AB  - From April, 1984 to April, 1989, 104 heart valve replacements were performed in
      103 patients. The atrio-ventricular valves (97 mitral and 7 tricuspid valves)
      were replace by bioprosthetic valves mounted on the flexible stent made of
      Elgiloy. They included 91 porcine aortic valves and 13 bovine pericardial valves.
      Only 74 patients recovered and discharged from the hospital because of high
      operative mortality of re-replacement and double valve replacement (19 and 30
      patients, respectively). These patients were followed-up for 8 to 68 months with
      a total follow-up period of 297 patient-years. Two patients developed cerebral
      embolism and two developed bacterial endocarditis. The incidence of the two
      complications was 0.67%/patient-year. No valve failure occurred. Long-term
      results of bioprosthetic heart valves mounted on flexible stent were better than
      those mounted on rigid stent.

PMID- 1618038
TI  - [Diagnosis and treatment of early rupture of traumatic peripheral false
      aneurysms].
AB  - The causes, symptoms and treatment of ruptured false aneurysms in 14 cases were
      reviewed with special attention to early diagnosis. Once aneurysmal wall
      ruptured, emergency surgery was necessary to stop bleeding. The repairment of the
      artery depended on the position, size of the rupture, and the patient's
      condition. Small arteries were safely embolized using spring-coil on
      arteriography. In dealing with ruptured large aneurysm, we suggest resection of
      the aneurysm and repair of the artery after occlusion of blood circulation by
      balloon catheter.

PMID- 1618039
TI  - [Cranioplasty using preserved subaponeurotic bone plate].
AB  - Cranial bone defect in 6 patients (5 males and 1 female) was repaired with
      preserved subaponeurotic bone plate. The defect was caused by evacuation of
      hematoma (5 patients) and resection of pituitary tumor (1 patient). Bone plates
      used measured 5-8 x 6-10 cm, and preserved for 57-92 days. Microscopic
      examination showed that the bone plates was alive, and small blood vessels were
      connected with two aponeuroses. X-ray examination showed normal density of the
      bone plates. No complication was noted. The bone plate can be used in
      postoperative cranioplasty.

PMID- 1618040
TI  - [Anesthetic management of patients with pre-excitation syndrome].
AB  - The authors reviewed the experience of anesthesia in 30 patients under
      extracorporeal circulation for surgical interruption of Kent's bundle. The key
      points of anesthetic management are to prevent and control supraventricular
      tachycardia, which had 35 episodes in 20 of the 30 patients, and disappeared
      after appropriate treatment. In this group, 18 patients had mild pre-excitation
      syndrome. After discontinuation of cardiopulmonary bypass, fifteen of the 18
      patients were free from pharmacologic support, while 8 of the remaining 12
      associated with other cardiac anomalies often necessitated positive inotropic
      agents.

PMID- 1618041
TI  - [Reoperation for recurrent gliomas].
AB  - Twenty-three cases of recurrent gliomas were reoperated upon. The indications and
      some factors influencing the length of survival time after reoperation were
      studied. It was found that reoperation is important in the management of
      recurrent gliomas, but strict indications must be followed with special attention
      to prevent CSF leakage, breaking and infection of the incision. Reoperation is
      not only to prolong life time but also to improve living quality. After
      reoperation, a comprehensive treatment is needed.

PMID- 1618042
TI  - [Autohemotransfusion in patients with intraperitoneal hemorrhage. Report of 221
      cases].
AB  - Autohemotransfusion was performed in 221 patients with intraperitoneal
      hemorrhage. The total amount of blood autotransfused was 198,760 ml, accounting
      for 90% of whole the blood transfused during the operations. The average amount
      of blood transfused was 899 ml per case, the largest amount being 3600 ml. There
      was no any adverse reaction observed. We consider that autohemotransfusion may
      avoid some shortcomings of donor's blood, and is of great importance in the
      treatment of patients with hemorrhagic shock when bank blood is not immediately
      available. The indications and contraindications of autohemotransfusion are
      discussed.

PMID- 1618043
TI  - [Ultrasonic diagnosis of liver hydatid disease].
AB  - The experience of the ultrasonic diagnosis of intrahepatic secondary changes in
      36 cases with liver hydatidosis was reported. The ultrasonograms were classified
      into five types: I. separated internal capsule, II. disruptive internal capsule;
      III. mixed echo; IV. thick-wall calcification; and V. consolidation. We studied
      the ultrasonogram character of the five types, and considered that the occurrence
      of type I, type II, and type IV resulted from single cyst pattern, while type III
      and type V resulted from multiple cyst pattern. Analysing the pathological
      foundation of the ultrasonogram changes can offer clinicians a reliable basis for
      choosing a treatment method.

PMID- 1618044
TI  - [Effect of superoxide dismutase on mitochondrial function in rats with
      hemorrhagic shock].
AB  - We observed the alterations in mitochondrial function and activity of endogenous
      SOD, and studied the protective effects of SOD on rats with hemorrhagic shock. It
      was found that after two hours' shock, RCR in hepatic and kidney mitochondria
      decreased significantly (liver P less than 0.01, kidney P less than 0.05), the
      activity of endogenous SOD depressed more or less in samples of blood and
      mitochondrial fraction (blood P less than 0.01. liver P less than 0.01. kidney P
      greater than 0.05). Further descent was found in these parameters in the
      deteriorating process of shock. After the rats were treated with SOD, RCR and
      activity of endogenous SOD increased considerably. Mere reflow did not affect
      them remarkably. This results suggest that oxygen-derived free radicals be the
      important factor impairing mitochondrial function in hemorrhagic shock, and that
      SOD can effectively ameliorate mitochondrial function.

PMID- 1618045
TI  - [Production and characterization of a group of monoclonal antibodies to human
      transitional cell carcinoma].
AB  - A panel of specific mouse monoclonal antibodies, BIU-H4, BIU-H6, BIU-H9, was
      obtained by immunization with BIU-87 cells (a transitional cell carcinoma cell
      line of the bladder), which was blocked by the serum of mouse anti-human
      lymphocyte. Detailed descriptions were given concerning their reactivity patterns
      by ABC-ELISA and IIF assays against various cells. They showed positive reactions
      with transitional cell carcinoma of the bladder and negative with normal bladder.
      BIU-H6 did not react with any of the other normal or malignant tissues. The
      subclass of immunoglobulin for BIU-H4,6 was IgG1, for BIU-H9 is IgG2 alpha. The
      molecular weight of the antigen recognized by BIU-H6,9 is 102 KD.

PMID- 1618046
TI  - [DNA content examination for atypical hyperplasia of adenosis and carcinoma of
      the breast].
AB  - Nuclear DNA content of breast specimens in 80 cases was measured with
      microspectrophotometer. The results showed that there was no difference in the
      nuclear DNA content between normal breast and breast adenosis with epithelial
      hyperplasia grade I. The DNA content increased gradually with the development of
      atypical hyperplasia, while there was no difference in DNA content between breast
      adenosis with atypical hyperplasia grade III, malignant transformation of breast
      adenosis and breast cancer grade I. There was a statistically significant
      difference among the other groups. It was extremely important to measure nuclear
      DNA content in patients with atypical hyperplasia of the breast in order to study
      the precancerous lesion and to supervise clinically the tendency of cancerous.

PMID- 1618047
TI  - [Measurement of portosystemic shunting rates during the operation].
AB  - Portosystemic shunting rates were measured with Archie's formula in 10 normal
      dogs and 26 patients with portal hypertension. The average values of the
      portosystemic shunting rates were 10.1 +/- 4.5(SD) per cent in the 10 dogs and
      53.9 +/- 14.2 percent in the 26 patients. There was significantly negative
      relativity between the difference of the SOPP and FPP and the portosystemic
      shunting rates (r = -0.885, P less than 0.001). After splenectomy and
      portoazygous disconnection, the shunting rates were significantly reduced (P less
      than 0.002 and P less than 0.005, respectively). There was significantly positive
      relativity between the degrees of patient's esophageal varices and the
      postoperatively reduced portosystemic shunting rates (r = 0.661, P less than
      0.001). It shows that the more the portal blood reverts through the varices, the
      better the result of portoazygous disconnection.

PMID- 1618048
TI  - Suppression of myoelectrical activity of gastric smooth muscle by endogenous
      gastric prostaglandin E2.
AB  - The myoelectrical activity of the gastric smooth muscle, recorded by a bipolar
      electrode placed at the gastric antrum in rats, could be recorded when the
      stomach was distended with 5 ml of physiological saline. This activity may be
      induced by a mucosal reflex and was inhibited both by atropine and by
      pirenzepine. Replacement of physiological saline with solutions of NaCl
      suppressed this myoelectrical activity. This suppression was dependent on the
      concentrations of NaCl in the solutions, from 0.3 to 1.0 M. Pretreatment with
      indomethacin (10 mg/kg, intravenous) completely prevented this suppression
      induced by different concentrations of NaCl solutions. Intragastric
      administration of 1.0 M NaCl in solution caused an increase in the levels of PGE2
      in the gastric lumen. Intragastric administration of OU-1308, a synthetic
      derivative of PGE1, also suppressed the myoelectrical activity in a dose
      dependent manner. It is concluded that the suppression of gastric myoelectrical
      activity by hyperosmolar NaCl may be attributable to the generation of endogenous
      PGE2 in the stomach.

PMID- 1618049
TI  - Effect of meal composition and sham feeding on duodenojejunal motility in humans.
AB  - The disruptive effect of meals of different fat content and caloric value and of
      sham feeding on the interdigestive migrating motor complex (IDMMC) was studied in
      eight healthy subjects using an ambulatory recording system that allowed
      continuous monitoring of small bowel motility for three consecutive days. The
      durations of fed pattern were not significantly different between meals of 800
      kcal/50% fat, 400 kcal/50% fat, and 800 kcal/25% fat, but were significantly
      longer compared to IDMMC cycle length and sham feeding. The latter two were not
      significantly different. On a separate day, five subjects consumed a meal of 400
      kcal/9% fat and a second one of 800 kcal/50% fat. The duration of the fed pattern
      following the high fat meal was significantly longer than the low fat one. Sham
      feeding significantly increased plasma concentrations of gastrin and neurotensin
      (NT), but did not affect those of cholecystokinin (CCK), insulin, and peptide YY
      (PYY). The various variables of the IDMMC were not different during the two
      nights of the study, and velocity of migration of phase III during the first day
      and both nights was similar. We conclude that the duration of the fed pattern
      depends, in part, on the composition of the meal. Sham feeding, resulting in an
      increase in both plasma gastrin and NT concentrations, does not disrupt the
      IDMMC. When using thin probes, IDMMC is stable during prolonged recording.

PMID- 1618050
TI  - Ornithine decarboxylase activity during gastric ulcer healing in dogs.
AB  - Ornithine decarboxylase (ODC) activity has been associated with mucosal growth
      and injury, yet, little information is available on ODC activity during gastric
      ulcer healing. We measured ODC activity in the ulcer base submucosa and the
      surrounding mucosa at 1 cm and 2 cm and assessed ulcer surface healing and a
      histologic score in experimentally induced ulcers (Quinton ulcer-maker) at 0 and
      5 hr and at one, two, three, four, and seven days. A total of 26 dogs were
      studied, eight of which received 2% difluoromethylornithine (DFMO, a specific
      inhibitor of ODC) in drinking water. Ulcer healing was assessed by digitizing
      initial (plug size), and final ulcer surface area and was expressed as percent
      ulcer surface reduction. A histologic score was assessed by two independent
      pathologists unaware of the treatment. ODC induction was observed in the
      submucosa of the ulcer base but not in the surrounding mucosa. The baseline
      submucosal ODC activity was measured at 0.2 +/- 0.1 pmol (14CO2)/mg protein/hr,
      and at one day the ODC activity increased to 4.0 +/- 0.7, at three days to 15.2
      +/- 5.5, and at seven days to 2.6 +/- 1.0 (P less than 0.001). DFMO treatment
      delayed GU healing significantly up to three days, but no difference was noted at
      seven days. The assessed histologic parameters did not correlate with ODC
      activity, and DFMO treatment did not alter the histologic score. These data
      suggest that polyamine biosynthesis occurs in the ulcer base submucosa during the
      first seven days of experimentally placed gastric ulcers.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1618051
TI  - Evidence that gastric antisecretory action of lipopolysaccharide is not due to a
      toxic effect on gastric parietal cells.
AB  - We have recently found that bacterial lipopolysaccharide (LPS) or endotoxin at
      minute doses inhibits the secretion of gastric acid and pepsin in rats. The
      present study was performed to determine whether this antisecretory action of LPS
      was a reversible biological response or a result of the destruction of gastric
      parietal cells by endotoxin. The intraperitoneal injection of LPS into pylorus
      ligated rats resulted in a dose-related (40-4000 ng/kg) decrease in gastric acid
      secretion, with maximal inhibition being observed at a dose of 4000 ng/kg. The
      stomach then was examined both macroscopically and microscopically for the
      presence or absence of mucosal lesions or damaged gastric parietal cells. No
      morphological changes in the gastric mucosal structure including parietal cells
      were observed even in the rats injected with 4000 ng/kg of LPS. Next, basal
      gastric acid output was compared in the rats that had received LPS (4000 ng/kg,
      intraperitoneal) or saline alone 24 hr before. There was no significant
      difference in gastric acid secretion between the saline- and LPS-pretreated
      groups, indicating that the secretory capacity of gastric parietal cells returned
      to the control level at 24 hr after the injection of a maximal antisecretory dose
      of LPS. These results clearly suggest that the LPS-induced inhibition of gastric
      secretion results not from its toxic or destructive effect on the gastric
      secretory mechanism but from its reversible biological effect on gastric
      physiology.

PMID- 1618052
TI  - Role of prostaglandin E2 in cholinergic-mediated glycoprotein synthesis in canine
      antrum.
AB  - We studied the mechanism of cholinergic stimulation of mucin synthesis in canine
      antral explants, including the role of PGE2 as an intermediate messenger.
      Isolated antral mucosa was incubated with 10(-5) M carbachol (Cb), 10(-5) M
      indomethacin (IND), 10(-5) M pirenzepine (PZ), 10(-5) M Cb + 10(-5) M PZ, 10(-5)
      M Cb + 10(-5) M IND, and 10(-5) M IND + PGE2 (10(-8), 10(-7) and 10(-6) M) in the
      presence or absence of [3H]glucosamine. After 24 hr, total glycoprotein synthesis
      was quantitated by Sepharose-4B chromatography and by 10% TCA/1% PTA
      precipitation with lipid extraction. PGE2 released into the media was measured by
      radioimmunoassay (RIA). Cb significantly increased total glycoprotein synthesis
      and produced a significant increase in PGE2 release. The increase in glycoprotein
      synthesis and the release of PGE2 was blocked by the addition of muscarinic
      antagonist PZ. The addition of IND significantly inhibited glycoprotein synthesis
      and almost entirely suppressed PGE2 secretion. IND also inhibited the effect of
      Cb on glycoprotein synthesis and PGE2 release. Moreover, PGE2 (10(-6) and 10(-7)
      M) significantly increased the glycoprotein synthesis in the canine stomach. This
      suggests the coordinate participation of PGE2-releasing cell population in
      modulation of glycoprotein synthesis in gastric mucosa.

PMID- 1618053
TI  - Effects of acarbose on starch hydrolysis. Study in healthy subjects, ileostomy
      patients, and in vitro.
AB  - The effect of acarbose on hydrolysis of a pure starch meal was investigated in
      normal subjects and ileostomy patients by means of 13CO2 breath tests and blood
      glucose levels as parameters of absorption, and of H2 breath tests, serum acetate
      levels, and ileal loss of carbohydrate as parameters of malabsorption. Additional
      information on the effect of acarbose on alpha-amylase activity was obtained by
      in vitro experiments. Acarbose (200 and 400 mg) significantly delayed starch
      absorption. Serum acetate was found to be a less sensitive marker of
      malabsorption than breath H2 excretion. After intake of 50 g starch plus 400 mg
      acarbose, 23-71% of the starch load was lost in the ileostomy effluent, for a
      large part as starch. This suggests that acarbose considerably inhibits alpha
      amylase, and not only brush-border enzymes. In vitro experiments confirm that an
      inhibition of two thirds of alpha-amylase activity can be expected from
      pharmacologically used doses of acarbose.

PMID- 1618054
TI  - Long-term outcome of severe radiation enteritis treated by total parenteral
      nutrition.
AB  - The outcome of 31 patients with severe radiation enteritis treated by total
      parenteral nutrition (TPN) was analyzed. Before initiation of parenteral
      nutrition, 18 of the patients had not had abdominal surgery, while 13 had either
      a resection or an intestinal bypass for radiation enteritis. Median follow-up was
      2 1/2 years (range: 1 month to 12 years) from the time of initiation of
      parenteral nutrition. Surgery was required in 15 cases because parenteral
      alimentation could not be continued. Only eight of these 15 were able to resume a
      normal oral intake. Total parenteral nutrition allowed oral feeding to be resumed
      in 11 (36%) after a median follow-up of 40 months (range: 6-142 months). In
      general, total parenteral nutrition was well tolerated and was associated with
      low morbidity. Eighteen patients died, 13 of complications due to radiation
      therapy, four of cancer recurrence, and one of an unrelated cause. Survival
      probability was 58% at one year and 36% at five years. When possible, prognostic
      factors present either before or at initiation of total parenteral nutrition were
      analyzed. Age, predisposing vascular factors (hypertension, diabetes mellitus, or
      vascular disease), and enteric fistula and/or perforation were found to have
      prognostic value. The probability of clinical radiation enteritis recurrence was
      34% at one year and 47% at two years. A clinical recurrence of symptoms was more
      frequent but not significantly so after parenteral nutrition as compared to
      surgical therapy of radiation enteritis. Although TPN corrected denutrition and
      allowed deferred surgery in some patients, severe radiation enteritis remains a
      poorly predictable progressive disease with numerous relapses.

PMID- 1618055
TI  - Spatial clustering of simultaneous nonhereditary gastrointestinal angiodysplasia.
      Small but significant correlation between nonhereditary colonic and upper
      gastrointestinal angiodysplasia.
AB  - Simultaneous nonhereditary colonic and upper gastrointestinal angiodysplasia were
      spatially clustered in an endoscopic study of 46 consecutive patients. For
      example, clustering of colonic angiodysplasia was demonstrated using a
      nonparametric test of clustering (Kruskal-Wallis statistic with 29 degrees of
      freedom = 76.2, P less than 0.0005), and a parametric test of clustering (F test
      statistic with 29 and 101 degrees of freedom = 6.91, P less than 0.0005). In
      accord with spatial clustering, only two of 13 patients (15%) with colonic
      angiodysplasia who underwent panendoscopy had upper gastrointestinal
      angiodysplasia. Two of nine patients (22%) with upper gastrointestinal
      angiodysplasia who underwent colonoscopy had colonic angiodysplasia. These
      findings suggest that local factors may be important in the pathogenesis of
      simultaneous nonhereditary angiodysplasia. Possible local factors include
      intermittent venous obstruction, increased intraluminal pressure, intermittent
      abnormal arterial flow, and local vascular degeneration. Due to the approximately
      20% correlation between upper and lower nonhereditary gastrointestinal
      angiodysplasia, the upper and lower tract should be examined by endoscopy prior
      to elective local resection for bleeding from gastrointestinal angiodysplasia.

PMID- 1618056
TI  - Regional alterations in intestinal sucrase expression in streptozocin-treated
      chronically diabetic rats.
AB  - In ad libitum-fed diabetic rats, sucrase specific activities in jejunum and ileum
      were significantly increased two- to threefold compared to controls, a response
      unaltered by pair-feeding. Gradients of sucrase activities along the ileal villus
      to-crypt axis were readily measured in crypt regions in diabetic, but not in
      nondiabetic, rats. Changes in sucrase activities were commensurate with increases
      in sucrase immunoreactivity and not a result of altered functional activity.
      Insulin treatment reversed these effects, although insulin-deficiency, studied in
      food-deprived, nondiabetic rats, did not affect sucrase expression. We conclude
      that chronic diabetes significantly stimulates sucrase expression along the
      proximal-to-distal and villus-to-crypt axes of rat small intestine. In ileum,
      these changes suggest marked alterations in phenotypic development of enterocytes
      along the villus-to-crypt axis. Alterations in sucrase expression do not appear
      to correlate with insulin states and are not a consequence of altered functional
      activity.

PMID- 1618057
TI  - Effects of prolonged exposure to histamine on guinea pig intestinal neurons.
AB  - Intracellular microelectrodes were used to study the effects of prolonged
      exposure to histamine on the electrophysiological behavior of AH/type-2 neurons
      in the myenteric plexus of the guinea pig small intestine. Application of
      histamine activated H2 receptors to convert the neurons to a heightened state of
      excitability. Heightened excitability was evident as repetitive spike discharge
      made possible, in part, by suppression of postspike after-hyperpolarization. The
      hyperexcitable state persisted unchanged for prolonged periods of 4.5 hr in the
      continued presence of histamine, suggesting that desensitization may never occur
      in vivo. The results are interpreted as a neural correlate for the
      pathophysiology associated with microscopic colitis and other inflammatory
      conditions involving mast cell hyperplasia.

PMID- 1618058
TI  - Ultrastructural study of M cells from colonic lymphoid nodules obtained by
      colonoscopic biopsy.
AB  - The present study was undertaken to investigate ultrastructurally the epithelium
      covering lymphoid nodules obtained from colonoscopic biopsies of the human colon
      and rectum. Colonoscopy using the dye spraying contrast method was performed in
      nine patients who showed x-ray evidence of lymphonodular hyperplasia. Fifty-two
      colonoscopical biopsy specimens of lymphoid nodules were obtained from the
      ascending, transverse, and descending colon and rectosigmoid region. All
      specimens were observed by light and electron microscopy. Light microscopy
      disclosed large lymphoid follicles protruding into the lumen with a "dome-type"
      configuration. These extended to the lamina propria of the mucosa and were
      associated with a massive lymphoid aggregation extending as far as the muscularis
      mucosa from the submucosa. The epithelium covering these nodules contained a few
      goblet cells and many lymphocytes. Observation of the elevated surface at the
      apex by scanning electron microscopy revealed M cells with sparse microvilli in
      the dome epithelium surrounded by crypts. Transmission electron microscopy
      disclosed M cells enfolding many immature or mature lymphocytes and plasmocytes.
      The M cells had cytoplasmic microvilli (so-called "microfolds") on their
      surfaces, well-developed tubulovesicular systems, and vacuoles in the cytoplasm.
      The basic structure of the M cells as observed by scanning and transmission
      electron microscopy was the same as that of M cells in the Peyer's patches of
      humans and mice. The apical surface of the colonic lymphoid follicles in Crohn's
      disease patients was associated with erosions observed by scanning electron
      microscopy. The erosions proved to be the naked surface of the dome after removal
      of the epithelium, and many holes from 2.0 to 6.0 microns in diameter were
      observed on the naked surface. At high magnification, lymphocytes were seen
      projecting from holes (18%) on the naked surface of the dome. These
      ultrastructural findings indicate that human colonic lymphoid follicles are very
      similar to those seen in other species.

PMID- 1618059
TI  - Effect of gut-associated lymphoid tissue on cellular proliferation in proximal
      and distal colon of the rat.
AB  - In previous studies, chemically induced colonic carcinomas were found to
      originate preferentially from crypts adjacent to lymphoid tissue. Proliferative
      parameters and mucosecretion were analyzed in proximal and distal rat colon in
      relation to the proximity of lymphoid patches. Animals received an
      intraperitoneal pulse of bromodeoxyuridine 1-hr before death. In both proximal
      and distal colon, crypts located at the immediate proximity of the lymphoid
      formations contained fewer mucous cells (P less than 0.001), but a higher
      percentage of proliferative epithelial cells (P less than 0.001) than the crypts
      far from lymphoid formations. The labeling index was higher in crypts adjacent to
      lymphoid patches compared to crypts distant from lymphoid patches only in the
      lower third of the crypts. The association of an increased proliferative activity
      and a decrease in differentiated mucosecreting cells in colonic crypts adjacent
      to lymphoid patches could be related to the particular sensitivity of these
      crypts cells to the effects of mutagens and carcinogens.

PMID- 1618060
TI  - Malignant lymphoma of the liver. Report of five cases and review of the
      literature.
AB  - Primary hepatic lymphoma is a rare disease. We report five cases here and
      summarize clinical and pathologic features of our own and reported cases from
      Western countries and Japan. The total number of cases was 68. The age of
      patients ranged from 7 to 87 years (median 55) with a male-to-female ratio of
      3.1:1. Chronic hepatitis or cirrhosis before onset of hepatic lymphoma was noted
      in 44% of Japanese cases and 9.6% of Western cases. Macroscopically, the liver
      was occupied by solitary mass (60%), multiple masses (35%), or a diffuse lesion
      without nodule formation (5%). Histologically all cases were non-Hodgkin's
      lymphoma with the diffuse large cell type being most common. Three cases (4.4%)
      were follicular lymphoma. Immunohistochemically about 80% of the cases were B
      cell type. Follow-up study showed that hepatic lymphoma had a relatively
      favorable prognosis when early detection of the disease was possible.

PMID- 1618061
TI  - Serum markers of immune activation and liver allograft rejection.
AB  - We monitored the immune response after liver transplantation in 20 patients by
      measuring the serum levels of soluble interleukin-2 receptor (sIL-2R), soluble
      CD8 (sCD8), serum amyloid-A protein (SAA), and tumor necrosis factor-alpha (TNF
      alpha). In six patients data were available to extend the follow-up period to one
      year. In all patients mean sIL-2R levels increased in the first month after liver
      transplantation, and subsequently decreased to values similar to pre-OLT ones,
      while SAA mean levels rose in the first week after OLT only in patients with
      rejection. sCD8 levels did not significantly rise after OLT, and TNF-alpha was
      undetectable in most cases. During episodes of rejection, rejector patients had
      significantly higher levels of sIL-2R, sCD8, and SAA than stable (without
      complications) patients. Conversely, no significant difference between rejectors
      and patients with other complications existed for any of the markers studied.
      These results diminish the importance of these serum markers of immune activation
      as laboratory tools in the differential diagnosis of acute rejection from other
      complications. However, sIL-2R, SAA, and sCD8 levels correlated with the
      histological grade of rejection and therefore can be utilized to monitor patients
      with an established diagnosis of acute rejection.

PMID- 1618062
TI  - Granulomatous tonsillitis. A rare extraintestinal manifestation of Crohn's
      disease.
AB  - Oral lesions, varying in nature and location, appear to be one of the common
      extraintestinal manifestation of Crohn's disease. In particular, oral involvement
      preceding intestinal disease may lead to the diagnosis of Crohn's disease. The
      present case report of a 17-year-old male patient describes a very rare
      nonintestinal manifestation of Crohn's disease with severe granulomatous
      involvement of the tonsils. A sore throat caused by hyperplastic tonsils with
      granulomatous inflammation as an oral manifestation of Crohn's disease was the
      leading symptom in this case.

PMID- 1618063
TI  - Reversal of gastric electrical dysrhythmias by cisapride in children with
      functional dyspepsia. Report of three cases.
AB  - Three children (ages 5, 7.6, and 8 years), with recurrent unexplained upper
      abdominal symptoms such as vomiting, epigastric pain, anorexia, early satiety and
      without structural or mucosal abnormalities of gastrointestinal tract, underwent
      electrogastrography (EGG)--recording of gastric electrical activity using
      cutaneous electrodes positioned on the epigastric region and connected to a
      recording polygraph. Frequency of EGG signals was analyzed by fast Fourier
      transform. Significant changes of fasting and fed gastric myoelectrical activity
      (tachygastria, bradygastria, flatline pattern) were recorded in the three
      patients; furthermore, gastric emptying (GE) of a solid-liquid mixed meal,
      measured by ultrasonography, was significantly prolonged in them. A follow-up
      study was carried out after an eight-week course with oral cisapride: in all
      patients symptoms improved, GE time normalized, and EGG analysis showed normal
      electrical rhythm. It is suggested that gastric dysrhythmias can play a
      pathogenetic role in patients with functional gastrointestinal symptoms and that
      symptomatic improvement is accompanied by normalization of gastric electrical
      rhythm.

PMID- 1618064
TI  - Tuberculous abscess of the pancreas. Case report and review of the literature.

PMID- 1618065
TI  - Muscle cramps in chronic liver diseases and treatment with antispastic agent
      (eperisone hydrochloride)

PMID- 1618066
TI  - Creatine kinase isoenzymes in diagnosis of intestinal infarction.

PMID- 1618067
TI  - Diffuse esophageal spasm.

PMID- 1618068
TI  - Ischemic colitis associated with psychotropic drugs.

PMID- 1618069
TI  - Computer assessment of life-style in a gastroenterology clinic.
AB  - To examine the potential benefit of a computer-assisted interview about life
      style in gastroenterology practice, 34 consecutive patients attending a
      gastroenterology clinic were questioned by a computer using software designed to
      obtain a comprehensive history of alcohol, caffeine, cigarette, and illicit drug
      use, together with an assessment of exercise, sexual activity, and nutrition.
      Comparisons of the information obtained by the computer with clinical records
      revealed that physicians documented only 3% of the patients as problem drinkers,
      3% as caffeine abusers, and 17% as smokers, whereas the computer identified 10%
      of the patients as problem drinkers, 27% as caffeine abusers, and 43% as smokers.
      These findings imply that patients may be more apt to tell more about adverse
      life-style to the computer than to a physician during clinical interview. In a
      sample patient population from a gastroenterology clinic, a microcomputer
      provides an acceptable, efficient, and potentially cost-effective way to assess
      life-style.

PMID- 1618071
TI  - Chylothorax: a complication of thoracic trauma or surgery.
AB  - Chylothorax is a troublesome complication of thoracic trauma and surgery. The
      critical care nurse's assessment of respiratory changes is frequently the first
      sign that this serious complication is occurring. Chylothorax may cause a
      previously stable thoracic patient to develop sudden, potentially serious
      respiratory problems.

PMID- 1618070
TI  - Cisapride vs metoclopramide. An acute study in diabetic gastroparesis.
AB  - Radionuclide gastric solid-phase emptying was studied in 10 subjects with
      diabetic gastroparesis comparing the acute intravenous administration of
      cisapride (2.5, 5, 10 mg), placebo, and metoclopramide (10 mg). No hemodynamic or
      electrocardiographic changes were noted. While both cisapride and metoclopramide
      normalized impaired solid emptying, cisapride at its highest dosage (10 mg)
      resulted in significantly faster gastric emptying (P = 0.003) than
      metoclopramide. The effects of cisapride were dose related and correlated well (r
      = 0.48, P less than 0.01) with the plasma drug levels. Clinical studies of
      chronic oral usage must take into account the dose-related response and factors
      affecting blood levels.

PMID- 1618072
TI  - Temporary DDD pacing: evaluating hemodynamic performance.
AB  - Temporary DDD pacing is new technology which requires careful nursing assessment
      and monitoring of the patient. Although nursing care for temporary DDD pacing
      patients is similar to permanent DDD pacing, there are some unique aspects
      related to the temporary nature of this treatment.

PMID- 1618073
TI  - The clinical nurse specialist role in product research and development.
AB  - Think about the variety of products used each day in the critical care
      environment. They include everything from the most sophisticated monitors to the
      many disposable products. Most products function very well, but when they do not,
      do you wish you could talk to the person who designed that product? How can your
      input make medical products work better? The authors describe a career
      opportunity open to critical care nurses, that of a clinical nurse specialist for
      a medical products corporation, whose job it is to influence the design and
      quality of medical products.

PMID- 1618074
TI  - Physician collaboration dilemma.
AB  - This dilemma which was submitted to DCCN for review involves a collaboration
      problem between two physicians, the family, and a nurse with both legal and
      ethical implications. Following the case is a legal and an ethical analysis by
      DCCN consultants in these fields. This case is from a Neonatal Intensive Care
      Unit (NICU) setting, but these conflicts between medical departments occur in all
      critical care settings, so the key legal and ethical issues are applicable in all
      ICU settings.

PMID- 1618075
TI  - Copel and Stolarik's research analysis on SvO2 monitoring.

PMID- 1618076
TI  - [In vitro quantitative study on invasive process of two human nasopharyngeal
      carcinoma cell lines, CNE-1 and CNE-2Z].
AB  - Computer-image processing system was used in the quantitative study on invasion
      in organ culture of two human nasopharyngeal carcinoma cell lines of different
      degree of differentiation, CNE-1 and CNE-2Z. For invasion of tumor cells into
      precultured heart fragments (PHF), observations were done on days 1,3,5 and 7
      after organ culture. The results showed that the invasion of both CNE-1 and CNE
      2Z cells was progressive. The invasion of CNE-1 tumor cells covered 82.22% of PHF
      on day 7, but on days 1 to 3 the invasion of CNE-2Z tumor cells covered 80-92% of
      PHF. This indicates that CNE-2Z cells are more invasive then CNE-1 cells.

PMID- 1618077
TI  - [Preparation of an anti-human immunotoxin against bladder carcinoma and its in
      vitro targeting cytotoxicity].
AB  - The intact ricin was linked to a monoclonal antibody BD I-1, which recognizes a
      determinant expressed on two human bladder carcinoma cell lines, BIU-87 and E-J,
      to form an immunotoxin BD I-1 Ricin. The results of indirect immunofluorescence
      test, FACS analysis and competition binding assay showed that the binding
      activity of antibody in this immunotoxin was retained by 80% of the original
      activity. The in vitro cytotoxicity assay indicated that the immunotoxin in the
      presence of 0.1 mol/L galactose is potent cytotoxic agent for BIU-87 and E-J cell
      lines. The immunotoxin BD 1-1-Ricin could kill the target cells BIU-87 and E-J
      cell lines by 50% at a concentration of 0.00008 mumoI/L and 0.00025 mumol/L
      respectively. At a concentration of 0.001 mumol/L no apparent cytotoxic activity
      to human colon carcinoma Lovo cell line was observed.

PMID- 1618078
TI  - [Comparative study of single-point method and multipoint method in the
      measurement of estrogen receptor and progesterone receptor in breast cancer].
AB  - A comparative study of estrogen receptor (ER) and progesterone receptor (PgR) by
      single-point method and multi-point method in dextran coated charcoal assay (DCC)
      was carried out in 50 and 47 cases of breast cancer, respectively. Taking 10
      fmol/mg protein as the positive value, the conformation rate of both methods in
      ER measurement was 96.0% (48/50) with r = 0.978 by linear regression analysis (P
      less than 0.001). In PgR measurement, the conformation rate of both methods was
      95.7% with r = 0.988 (P less than 0.001). Statistically, the difference between
      single-point method and multi-point method in the ER and PgR measurements was not
      significant (P greater than 0.5) both in rank-sum test and in paired t-test. The
      authors suggest that ER and PgR of breast cancer samples be measured with single
      point method for its simplicity and less tumor tissue required.

PMID- 1618079
TI  - [Estimation of cancer latency using data from a case-control study with time
      related factors--estimated latency for consumption of alcohol and tobacco in
      relation to gastric cancer].
AB  - As a practical application of theory, the susceptible exposure age and latency
      distribution of consumption of alcohol and tobacco in relation to stomach cancer
      is discussed. It was revealed that, in univariate, estimation of the susceptible
      exposure age of alcohol and tobacco were 15-50 years and 35-50 years. The
      estimated latency were 35 years and 15 years. Those of accumulative period and
      preneoplastic period were 30 and 10 years. In a multivariate analysis, the
      latency for alcohol consumption was changed to 20 years as the incubation time in
      preneoplastic period was prolonged by 5 years due to consumption of vegetables.
      This could give a theoretical interpretation of second line cancer prevention.

PMID- 1618080
TI  - [Surgical treatment for carcinoma of gastric stump--a report on 13 patients].
AB  - Thirteen patients with carcinoma of gastric cardia after gastrectomy were treated
      in our hospital from 1981 to 1990. They comprised 1.3% of 932 cancers of the
      gastric cardia treated during the same interval. Partial esophagogastrectomy and
      esophagogastrectomy were performed under the aortic arch in 2 patients. Total
      gastrectomy was carried out in 8 patients with 7 Roux-Y and 1 end-to-side
      esophagojejunostomy. In the remaining 3 patients, only exploration was done. In
      the resected patients, two (20%) were complicated by anastomotic leak which was
      obviously higher than that by the conventional partial esophagogastrectomy for
      gastric cardia carcinoma. Due to reflux of bile and pancreatic juice, the
      incidence of gastric cardiac cancer in gastric stump after Billroth II operation
      was much higher than that following Billroth I type. Hence, Billroth I type
      should be the method of choice for patients to be operated by the distal partial
      gastrectomy. If Billroth I type was not feasible, Roux-Y anastomosis should be
      the alternative for Billroth II type in order to reduce the possibility of
      developing cancer in the proximal pouch. The route of entry, either left
      posterolateral thoracotomy or left thoracoabdominal incision should be resorted
      to in conformity with the size of the tumor.

PMID- 1618081
TI  - [Association of esophageal carcinoma with achalasia--report on 7 cases].
AB  - Among 11,821 cases of esophageal carcinoma treated in a 32 year period, 7 were
      found to be associated with achalasia (0.059%). Five cases were proved by biopsy
      or cytology and 2 were diagnosed by esophagograms. There were 4 men and 3 women.
      The age ranged from 30-54 years with a median of 38. The age was younger than
      that of esophageal carcinoma unassociated with achalasia. Duration of achalasia
      was from 7 to 20 years. Three patients died within 1 year and 1 died 17 months
      after diagnosis. Three were lost to follow-up. The presenting symptoms were
      aggravating dysphagia in 4; and hoarseness, dyspnea and bloody regurgitation in
      the other two. Patients with achalasia should be treated energetically in the
      early stage. Double contrast esophagography and esophagoscopy should be done
      carefully during the followup. Preparation of the esophagus is most important
      when performing the X-ray examination of the esophagus.

PMID- 1618082
TI  - [Pathologic and immunohistochemical study of 11 patients with malignant lymphoma
      of the gonad].
AB  - We report 11 cases of malignant lymphoma of the gonad collected during the past
      31 years in our hospital. 8/11 cases conformed well to Fox's criteria for primary
      gonadal malignant lymphoma. Clinically, they often manifest as a mass in the
      gonad without any symptoms. Histologically, diffuse NHL of intermediate or high
      malignancy was observed. According to morphologic criteria of the working
      formulation in combination with the immunohistochemical study, five cases were
      designated as T-cell lymphoma. This frequency in Chinese is different from that
      reported in the western countries.

PMID- 1618083
TI  - [Long-term results of radiotherapy for malignant tumors of the nasal cavity-
      report on 317 patients].
AB  - From 1964 to 1982, 317 patients with malignant tumors of the nasal cavity were
      treated by radiotherapy. All had been proved pathologically prior to treatment.
      The over-all 5- and 10-year survival rates were 42.6% and 32.7%. Those of T1N0
      lesions were 64.3% and 54.3%. Patients with submaxillary metastasis gave 5- and
      10-year survivals of 35.3% and 26.9% while those with regional lymph node
      metastasis in the neck gave 26.9% and 15.8%, respectively. The results of
      orthovoltage X-rays treatment were not inferior to those of telecobalt.
      Pathologic classification and the radiation dose given bore no weight on
      survival. The major sequelae were nose bleeding (due to mucosal atrophy),
      deformity, atrophy or perforation of septum. 57.1% of death was attributed to
      local progression or recurrence while 32.5% due to distant metastasis. 72% of
      death occurred within 2 years of treatment.

PMID- 1618084
TI  - [Color Doppler flow imaging and duplex Doppler in the examination of primary
      liver cancer].
AB  - We examined 40 cases of primary liver cancer with color doppler flow imaging and
      duplex doppler. In 20 cases, there was arterial flow in the tumor. In 17 cases,
      there was arterial and portal venous flow in the tumor. In 22 cases, there was
      arterial flow entering the tumor from its surroundings. In 28 cases, the right or
      left hepatic artery was dilated. We compared the results of digital subtraction
      angiography with the doppler ultrasound in 28 cases and found the difference was
      not significant (chi 2 = 1.05, P greater than 0.05). Therefore, we believe that
      the doppler ultrasonography is the method of choice in the diagnosis of primary
      liver cancer.

PMID- 1618085
TI  - [Experimental and clinical studies on pancreatic duct obstruction in preventing
      pancreatic fistula formation].
AB  - Even after prolonged use in clinical practice, obstruction of the pancreatic duct
      in preventing fistula formation still lacks solid proof. Sixteen dogs were
      randomized into an pancreatic duct obstruction group and a control group. Four to
      8 ml of silicon gel was injected into the pancreatic duct in the former group
      while the latter group received exploratory laparotomy only. The pancreas was
      examined histopathologically 1, 3, 5, 7 and 9 months after operation. It was
      shown that the exocrine glands underwent marked atrophy but the endocrine glands
      showed only mild damage. Clinical studies on 27 patients who were operated for
      pancreatic cancers and diseases showed that pancreatic fistula developed in 7.7%
      of patients (1/13) in the obstruction group and 21% (3/14) in the control group.

PMID- 1618086
TI  - [Relationship between plasma and urinary platinum pharmacokinetics with cisplatin
      nephrotoxicity in breast cancer patients].
AB  - In 25 cycles of 20 breast cancer patients who received 26 cycles of high-dose
      cisplatin (100 mg/m2, iv drip), the urinary Alb, IgG and NAG values were elevated
      above normal. These patients were divided into low-nephrotoxicity and high
      nephrotoxicity groups by the degree of renal dysfunction. Of these patients 35%
      showed high-nephrotoxicity. They had significantly higher plasma and/or urinary
      Pt peak levels during cisplatin infusion than did those with low-nephrotoxicity.
      And 70-80% of the patients developed significant nephrotoxicity when the urinary
      Pt level rose up to greater than 40 micrograms/ml or plasma Pt level greater than
      4 micrograms/ml. It is very important to keep the urinary and plasma Pt level
      below 40 micrograms/ml and 4 micrograms/ml respectively in order to reduce the
      nephrotoxicity. It is suggested that the urine output be maintained over 300
      ml/hr for 2 hours before and after the completion of infusion and greater than
      100 ml/hr in the following 3 days. This helps keep the cisplatin-induced
      nephrotoxicity in less severe and the function of kidney easy to recover.

PMID- 1618087
TI  - [Relationship between gastric carcinoma and enzyme spectrum activity in gastric
      mucosal intestinal metaplasia].
AB  - Biochemical method was adopted to examine 10 kinds of histologic enzyme spectrum
      activities in gastric intestinal metaplasia, carcinoma and normal or superficial
      gastritis mucosa taken from different sites from 17 fresh surgical specimens of
      stomach. The enzymes are aldolase (ALD), pyruvate kinase (PYK), phospho hexo
      isomerase (PHI), lactic dehydrogenase (LDH), creatine phosphokinase (CPK),
      hydroxybutyrate dehydrogenase (HBD), glutamic-pyruvic transaminase (GPT),
      alkaline phosphatase (AKP), acid phosphatase (ACP), r-glutamyl-transpeptidase
      (gamma-GT). Among glycolytic enzymes the content of ALD, PYK in intestinal
      metaplasia were 24.5 u and 24.6 u respectively, which were higher than those in
      the normal mucosa (15.7, 18.0) and lower than carcinoma (28.4, 29.6) (P less than
      0.01-0.05). The content of CPK in intestinal metaplasia was lower (218.5 u) than
      that in the normal (463.9 u) and higher than that in carcinoma (110.3 u) (P less
      than 0.01). Among protease and amino acid enzymes the content of HBD in
      intestinal metaplasia was lower (108.2 u) than those in the normal (221.3 u) and
      carcinoma (113.9 u) (P less than 0.05). The content of GPT in intestinal
      metaplasia was (6.7 u) which was lower than that in the normal (9.4 u) and higher
      than that in carcinoma (3.7 u) (P less than 0.01). The above results could
      provide reference indices for judging the potential malignancy of gastric
      intestinal metaplasia.

PMID- 1618088
TI  - [Characteristics and reactivities of a panel of monoclonal antibodies (McAbs)
      recognizing human colon cancer associated antigens].
AB  - Characteristics and reactivities of 16 monoclonal antibodies (McAbs) were
      identified. They were prepared from mice immunized with freshly isolated colon
      carcinoma cells. Of these 16 McAbs, 13 belonged to IgG1, and 3 to IgM. The
      reactivities by immunohistochemical staining revealed 2 varieties: tumor
      associated antigens and common normal tissue antigens as defined by McAbs with
      737 kinds of tissues and cells from more than 12,000 samples. The antigens
      defined by McAbs were assayed by western immunoblotting to have a about molecular
      weights of 200 KD as glycoproteins unrelated to CEA. These results suggest that
      these McAbs may be used for further research on cancers.

PMID- 1618089
TI  - [Preliminary study on nutrition and precancerous lesions of the esophagus in the
      adolescents].
AB  - This paper reports the prevalence of chronic esophagitis and nutritional status
      among 538 persons 15-26 years old in the high-risk area of esophageal cancer. 166
      subjects were from households with history of esophageal cancer while 372 from
      households without. The frequency of chronic esophagitis among male and female
      adolescents in the high risk areas (37.6% and 36%) was significantly, higher than
      that in the low risk areas. Furthermore, the frequency of chronic esophagitis in
      the adolescents in households with history of esophageal cancer was also higher
      than that without history of this cancer. There was a positive correlation
      between avitaminosis C and chronic esophagitis. Suffering from avitaminosis C and
      B2, these people are prone to develop chronic esophagitis which, in turn, may
      serve as an early phase in the carcinogenesis of esophageal epithelium.

PMID- 1618090
TI  - [Cytomorphometric analysis of normal, premalignant and malignant nasopharyngeal
      epithelium].
AB  - Cellular morphology of nasopharyngeal epithelium in 76 specimens was
      quantitatively analyzed by stereological technique using point-counting method.
      There were 18 normal epithelium, 16 simple hyperplasia and metaplasia, 18
      dysplasia and 24 untreated nasopharyngeal carcinoma (NPC). Altogether 19
      parameters were morphometrically measured and calculated. The results showed that
      with the process of malignant transformation the great majority of cellular
      parameters gradually changed. There was no marked difference between the normal
      and simple hyperplastic and metaplastic epithelium. The majority of parameters of
      dysplastic cells were significantly different as compared with the other three
      groups. It is highly suggestive that the transitional nature of dysplasia from
      the normal to the malignant cells shows no significant difference concerning
      these three parameters in terms of mean cellular area (MCA), the standard
      deviation of nuclear area (SDNA) and surface area per unit volume of nucleus
      (SsV). However, it is valuable to analyze these three parameters in
      discriminating the precancerous lesions. Six of the 19 parameters processed by
      multivariate stepwise analysis were useful in discriminary functions. The 76
      specimens as re-estimated by these 6 functions gave a conformation rate of 91% to
      the clinicopathologic diagnosis. Cytomorphometric analysis might be of predictive
      value in the diagnosis of early malignant change in the nasopharyngeal
      epithelium.

PMID- 1618091
TI  - [Structure of qualifications for the nursing professions. Place of the nursing
      professions in the educational system of the Federal Republic of Germany].

PMID- 1618092
TI  - [Structure and organization of the educational system in nursing].

PMID- 1618093
TI  - [Continuing education--a necessity].

PMID- 1618094
TI  - [Taking stock of nursing personnel in Germany].

PMID- 1618095
TI  - [From head nurse to nursing administrator].

PMID- 1618096
TI  - [Public health and nursing].

PMID- 1618097
TI  - [The academization of nursing].

PMID- 1618098
TI  - [The importance of nursing research for nursing].

PMID- 1618099
TI  - [Boards for the nursing professions].

PMID- 1618100
TI  - [Alternatives to Nursing Boards].

PMID- 1618101
TI  - [Possibilities and limitations of a nursing department. Nursing and politics].

PMID- 1618102
TI  - [Nursing unions--the perspective of the future].

PMID- 1618103
TI  - [Quality circles in geriatric and general nursing. A participative effort for the
      organizational and personal development in health facilities].

PMID- 1618104
TI  - [Geriatric nursing. Concepts, limits and perspectives of geriatric nursing as a
      profession].

PMID- 1618105
TI  - [Pediatric nursing between professionalization and women's socialization].

PMID- 1618106
TI  - [Requirements for instruments for cleaning and disinfection of flexible
      endoscopes].

PMID- 1618107
TI  - [Nursing problems in the prevention of thrombosis].

PMID- 1618108
TI  - [Compression stockings: caring for a nursing model in need of care].

PMID- 1618109
TI  - [Fluorouracil as monotherapy or combined with folinic acid in the treatment of
      metastasizing colorectal carcinoma].
AB  - In a prospective randomized multicentre trial 139 patients with metastatic
      colorectal carcinoma (70 men, 69 women; age 35-81 years) were given palliative
      treatment with fluorouracil (400 mg/m2 daily for 5 days) alone or combined with
      folic acid (100 mg/m2 before each dose of fluorouracil). Both groups were
      comparable in respect of age, sex, Karnofsky index and number of localisations of
      metastases. The criterion for starting the treatment was progression of the
      malignancy or clinical symptoms caused by the tumour. Resulting remission rates
      (fluorouracil monotherapy vs combination with folic acid) were: complete or
      partial remission, 9 vs 16%; arrest of tumour growth, 20 vs 60%; progression 71
      vs 24%. Peripheral side effects, such as stomatitis and diarrhoea, were similarly
      frequent with the two treatment regimens and reasonably tolerable. Median
      survival time for the fluorouracil monotherapy was 7.24 months from onset of
      treatment, and 9.1 months from the time that any metastases were diagnosed. The
      combination treatment with folic acid achieved a significantly longer median
      survival time (P less than 0.0001), 14.98 months from treatment onset and 16.3
      months from metastasis diagnosis. The higher rate of response and the
      significantly prolonged survival time signify an improvement of the therapeutic
      profile of fluorouracil by addition of folic acid in the palliative therapy of
      colorectal carcinomas.

PMID- 1618110
TI  - [Primary amyloidosis of the liver].
AB  - For 2 years a 72-year-old man had suffered from nonspecific upper abdominal
      discomfort and hepatomegaly. The gamma-glutamate transaminase concentration was
      increased to 121 U/l, the erythrocyte sedimentation rate was 80 mm in the first
      hour. Histological examination of tissue from the enlarged liver (22 cm in the
      midclavicular line) revealed the diagnosis of amyloidosis. The gastric mucosa,
      duodenum and rectum were not involved. Two years later ascites developed; six
      months after this he was again hospitalized in hepatic coma. Now, for the first
      time, a type IgA-lambda paraprotein was demonstrated by serum
      immunoelectrophoresis. The patient died of slowly progressing anicteric liver
      failure after having been ill for a total of 4 1/2 years. At autopsy there were
      extensive amyloid deposits throughout the liver and spleen so that the structure
      of these organs was hardly recognizable. The amyloid deposits in the liver were
      restricted to the glomerular region, while there was no amyloid in the heart.
      Histochemical tests showed that the deposits were strongly positive to the anti
      lambda antibody. This was thus a case of primary (AL-lambda) amyloidosis of the
      liver and spleen which had taken an unusually prolonged course, because the heart
      was not involved at all and the kidneys only slightly.

PMID- 1618111
TI  - [Plasminogen activator inhibitor 1--a new thrombosis risk marker].
AB  - The plasma activity of plasminogen activator inhibitor 1 (PAI-1) was measured in
      278 clinically healthy subjects (98 men, 180 women; mean age 26 [18-50] years).
      In 198 of them there were factors increasing the risk of thrombosis, such as
      smoking, over-weight and/or oral contraceptives. PAI-1 activity was within normal
      range (less than 4 U/ml) in male nonsmokers of normal weight and in female
      nonsmokers not taking oral contraceptives. In male smokers (5.76 +/- 1.93 U/ml)
      and in overweight subjects of both sexes (7.49 +/- 1.87 U/ml) PAI-1 was increased
      up to 10.6 U/ml as an indication of decreased fibrinolysis capacity. Nonsmoking
      females on oral contraceptives had lower PAI-1 levels (2.72 +/- 0.86 U/ml) than
      nonsmokers without hormonal intake (3.21 +/- 1.03 U/ml; P less than 0.001).
      Apparently the increased risk of thrombosis that occurs on oral contraceptives is
      not due to increased PAI-1 activity.

PMID- 1618113
TI  - [Surgery in the Ancient Egypt].

PMID- 1618112
TI  - [Causes of functional dyspepsia].

PMID- 1618114
TI  - [Diagnosis of hereditary hemochromatosis].

PMID- 1618115
TI  - [Blood sedimentation reaction and C-reactive protein].

PMID- 1618116
TI  - [Dexamethasone in bacterial meningitis].

PMID- 1618117
TI  - [Thyroid gland volume and urinary iodine excretion in children 2-16 years of
      age].
AB  - Thyroid volume on ultrasound and urinary iodine excretion in relation to
      creatinine excretion were determined in 252 children (130 boys, 122 girls; mean
      age 8.7 [2-16] years) from the central Ruhr area of Germany. The data were
      compared with those published for children of other regions of Germany and
      Sweden. Mean thyroid volume in the 2-year olds was 2.0 +/- 0.5 ml, in 4-year olds
      2.9 +/- 1.1 ml, in 6-year olds 4.2 +/- 1.9 ml, in 9-year olds 5.2 +/- 1.3 ml and
      in 13-year olds 8.7 +/- 2.4 ml. Mean iodine excretion for the whole group was
      101.0 +/- 41.5 micrograms iodine/g creatinine, in the 13-year olds it was 69 +/-
      27 micrograms/g. These values are clearly below those of Swedish children on an
      adequate iodine intake. The thyroid volume measurements agree reasonably well
      with those published for children in the region of Germany and are clearly above
      those of the Swedish children. In 69% of cases the thyroid volume was more than 3
      S.D. above the mean for Swedish children. The reported data support the demand
      for a higher iodine intake of the German population.

PMID- 1618119
TI  - [Morgagni's hernia: diagnosis and therapy].
AB  - A 35-year-old man reported persistent exertional dyspnoea and pressure sensation
      over the left chest for the last six weeks. On auscultation there were diminished
      breath sounds over the right base. Chest X-ray demonstrated a 10 cm large ventral
      paracardiac shadow on the right. Computed tomography suggested a hernia of the
      foramen of Morgagni; persisting symptoms indicated a laparotomy. This revealed an
      opening of about 1.5 cm in the right substernocostal triangle through which the
      entire greater omentum had herniated into the thorax. The omentum was
      repositioned and the hernial defect closed by direct suture. The postoperative
      course was without complication and the patient was discharged after seven days.

PMID- 1618118
TI  - [Diagnosis and course of patients with HIV infections and exclusion of
      Pneumocystis carinii pneumonia].
AB  - 30 patients infected with HIV (20 men, 10 women; mean age 34 [26-54] years),
      suspected of having Pneumocystis carinii (Pc) pneumonia, had undergone
      bronchoalveolar lavage which proved negative for Pc. They were then kept under
      observation for 5 months. No transbronchial biopsy was performed. 27 patients
      were in stage IV of the HIV infection, and 14 had been on pentamidine
      prophylaxis. The most frequent diagnosis with the bronchial lavage was bacterial
      infection (19 patients), next most frequent was mycobacterial infection (6,
      atypical in 5). A neoplasia (Kaposi sarcoma; non-Hodgkin lymphoma) was found in
      two, with pulmonary involvement. The diagnosis remained unclear in only three
      patients who were treated as for Pc pneumonia. The remaining 27 patients did not
      receive any treatment against Pc. Nonetheless, there were no cases of Pc
      pneumonia in the 5 months of observation so that bronchoalveolar lavage has a
      negative predictive value of 90% (27 of 30), high enough to make additional
      bronchial biopsy unnecessary.

PMID- 1618120
TI  - [Chronic bromide intoxication caused by bromide-containing combination drugs].
AB  - A 49-year-old woman who had noted increasing fatigue and found it difficult to
      concentrate became confused and uncoordinated with rapid speech. Anxious and
      suffering from insomnia she had for 6 weeks taken a prescription-free bromide
      containing drug mixture (daily 0.09 g potassium bromide and 1.8 g sodium
      bromide), to a total bromide intake of 60 g. The admission diagnosis of chronic
      bromism was confirmed by a markedly increased serum bromide concentration (325
      mg/l). Once she had stopped taking the drug and had increased her salt intake she
      became symptom-free within 8 days. The case demonstrates that, while chronic
      bromism has become rare, it should still be included in the differential
      diagnosis, even after intake of supposedly harmless medication.

PMID- 1618122
TI  - [Consultation hour for musicians. An interdisciplinary concept].

PMID- 1618121
TI  - [Radiological aspects of the craniocervical junction].

PMID- 1618123
TI  - [Gestational diabetes].

PMID- 1618124
TI  - [Refractory fulminating meningococcal infection].

PMID- 1618125
TI  - [Percutaneous biliary drainage and endoscopic jejunostomy for intestinal bile
      recycling].

PMID- 1618126
TI  - [Human insulin and symptoms of hypoglycemia].

PMID- 1618128
TI  - Metanephric mesenchyme contains multipotent stem cells whose fate is restricted
      after induction.
AB  - At least fourteen epithelial cell types of the mammalian nephron develop from the
      metanephric mesenchyme. To distinguish whether this single embryological
      primordium contains a heterogenous population of committed renal cell lines or a
      multipotent stem cell, the lac-Z gene was introduced into individual renal
      progenitors by retroviral mediated gene transfer. The differentiated fate of lac
      Z-tagged daughters derived from single metanephric mesenchymal cells was
      characterized after cytodifferentiation. We found that the metanephric mesenchyme
      contains multipotent stem cells that can generate at least three distinct cell
      types; glomerular, proximal and distal epithelia. After induction the fate of
      this multipotent cell becomes restricted to populate a single nephron segment.

PMID- 1618127
TI  - Spatial restriction of AChR gene expression to subsynaptic nuclei.
AB  - Acetylcholine receptors (AChRs) and the mRNAs encoding the four AChR subunits are
      highly concentrated in the synaptic region of skeletal myofibers. The initial
      localization of AChRs to synaptic sites is triggered by the nerve and is caused,
      in part, by post-translational mechanisms that involve a redistribution of AChR
      protein in the myotube membrane. We have used transgenic mice that harbor a gene
      fusion between the murine AChR delta subunit gene and the human growth hormone
      gene to show that innervation also activates two independent transcriptional
      pathways that are important for establishing and maintaining this non-uniform
      distribution of AChR mRNA and protein. One pathway is triggered by signal(s) that
      are associated with myofiber depolarization, and these signals act to repress
      delta subunit gene expression in nuclei throughout the myofiber. Denervation of
      muscle removes this repression and causes activation of delta subunit gene
      expression in nuclei in non-synaptic regions of the myofiber. A second pathway is
      triggered by an unknown signal that is associated with the synaptic site, and
      this signal acts locally to activate delta subunit gene expression only in nuclei
      within the synaptic region. Synapse-specific expression, however, does not depend
      upon the continuous presence of the nerve, since transcriptional activation of
      the delta subunit gene in subsynaptic nuclei persists after denervation. Thus,
      the nuclei in the synaptic region of multinucleated skeletal myofibers are
      transcriptionally distinct from nuclei elsewhere in the myofiber, and this
      spatially restricted transcription pattern is presumably imposed initially by the
      nerve.

PMID- 1618129
TI  - Wound closure in foetal rat skin.
AB  - Foetal rat skin rapidly closes an open wound in organ culture and in vivo, this
      possibly being unique to organs still in the morphogenetic stage. In the present
      study, examination was made of morphological changes in foetal rat skin during
      closure of open wounds inflicted at day 16 of gestation. Phase-contrast
      microscopy of open-wounded skin cultured in vitro indicated inward spreading of
      the peripheral skin to be responsible for wound closure. Wound closure in vitro
      was inhibited by cytochalasin B (10 micrograms/ml), not by hydroxyurea (2 mM),
      indicating prenatal wound closure to be mediated by regulation of the
      microfilament system rather than cell proliferation. During wound closure in
      vitro and in vivo, light and scanning electron microscopy of the peripheral skin
      showed cells in the periderm, the outermost layer of the foetal epidermis, to
      elongate centripetally and en masse, whereas the shape of underlying epidermal
      cells not to change. Numerous spindle-shaped cells and fibrous matrices in the
      mesenchyme were redistributed, becoming oriented along the wound edge. Following
      isolation of the mesenchyme and epidermis by treatment with Dispase and separate
      culturing, the capacity for wound closure in vitro was found to be retained only
      by the mesenchyme. Cellular activity within the mesenchyme, rather than in the
      epidermis, would thus appear essential to wound closure in foetal rat.

PMID- 1618130
TI  - Localized enhancement and repression of the activity of the TGF-beta family
      member, decapentaplegic, is necessary for dorsal-ventral pattern formation in the
      Drosophila embryo.
AB  - Seven zygotically active genes are required for normal patterning of the dorsal
      40% of the Drosophila embryo. Among these genes, decapentaplegic (dpp) has the
      strongest mutant phenotype: in the absence of dpp, all cells in the dorsal and
      dorsolateral regions of the embryo adopt fates characteristic of more ventrally
      derived cells (Irish and Gelbart (1987) Genes Dev. 1, 868-879). Here we describe
      the phenotypes caused by alleles of another of this set of genes, tolloid, and
      show that tolloid is required for dorsal, but not dorsolateral, pattern.
      Extragenic suppressors of tolloid mutations were isolated that proved to be
      mutations that elevate dpp activity. We studied the relationship between tolloid
      and dpp by analyzing the phenotypes of tolloid embryos with elevated numbers of
      the dpp gene and found that doubling the dpp+ gene dosage completely suppressed
      weak tolloid mutants and partially suppressed the phenotypes of tolloid null
      mutants. We conclude that the function of tolloid is to increase dpp activity. We
      also examined the effect of doubling dpp+ gene dosage on the phenotypes caused by
      other mutations affecting dorsal development. Like tolloid, the phenotypes of
      mutant embryos lacking shrew gene function were suppressed by elevated dpp,
      indicating that shrew also acts upstream of dpp to increase dpp activity. In
      contrast, increasing the number of copies of the dpp gene enhanced the short
      gastrulation (sog) mutant phenotype, causing ventrolateral cells to adopt dorsal
      fates. This indicates that sog gene product normally blocks dpp activity
      ventrally. We propose that the tolloid, shrew and sog genes are required to
      generate a gradient of dpp activity, which directly specifies the pattern of the
      dorsal 40% of the embryo.

PMID- 1618131
TI  - Intracellular free Ca2+ changes during physiological polyspermy in amphibian
      eggs.
AB  - We have made the first measurements of intracellular free calcium activity
      ([Ca2+]i) in urodele eggs during physiological polyspermic fertilization. Jellied
      eggs of the urodele amphibian Pleurodeles waltlii were impaled with intracellular
      Ca(2+)-selective microelectrodes and inseminated under various conditions of
      sperm:egg ratio to obtain various degrees of polyspermy. In 17 out of 45 cases
      the egg [Ca2+]i level (0.41 microM) showed no variation following fertilization.
      In 28 other cases, however, the egg displayed a slow increase in [Ca2+]i of 0.15
      microM, starting around 15 minutes after fertilization and reaching a plateau
      level around 10 minutes later. The amplitude of the fertilization-associated
      increase in [Ca2+]i was found to be independent of the number of sperm
      interacting with the egg surface. Measurements with two Ca(2+)-microelectrodes
      impaled in single eggs showed that the increase in [Ca2+]i did not simultaneously
      occur at distinct places within the egg cortex and, in some cases, could be
      detected by only one of the two microelectrodes. This latter observation, as well
      as the absence of [Ca2+]i change at fertilization in some experiments, strongly
      suggested that each sperm interacting with the egg might, at various places,
      trigger a localized, non-propagating change in [Ca2+]i. Experiments in which eggs
      were locally inseminated, using a micropipette directed towards the site of
      impalement of one of the two Ca(2+)-microelectrodes, clearly established that
      [Ca2+]i changes, although incapable of propagating over the entire egg cortex,
      might nevertheless travel very slowly over short distances, their amplitude
      vanishing rapidly as they propagate from around the sites of sperm
      entry.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618132
TI  - Commitment of abdominal neuroblasts in Drosophila to a male or female fate is
      dependent on genes of the sex-determining hierarchy.
AB  - Adult specific neurons in the central nervous system of holometabolous insects
      are generated by the postembryonic divisions of neuronal stem cells
      (neuroblasts). In the ventral nervous system of Drosophila melanogaster, sex
      specific divisions by a set of abdominal neuroblasts occur during larval and
      early pupal stages. Animals mutant for several sex-determining genes were
      analyzed to determine the genetic regulation of neuroblast commitment to the male
      or female pattern of division and the time during development when these
      decisions are made. We have found that the choice of the sexual pathway taken by
      sex-specific neuroblasts depends on the expression of one of these genes,
      doublesex (dsx). In the absence of any functional dxs+ products, the sex-specific
      neuroblasts fail to undergo any postembryonic divisions in male or female larval
      nervous systems. From the analysis of intersexes generated by dominant alleles of
      dsx, it has been concluded that the same neuroblasts provide the sex-specific
      neuroblasts in both male and female central nervous systems. The time when
      neuroblasts become committed to generate their sex-specific divisions were
      identified by shifting tra-2ts flies between the male- and female-specifying
      temperatures at various times during larval development. Neuroblasts become
      determined to adopt a male or female state at the end of the first larval instar,
      a time when abdominal neuroblasts enter their first postembryonic S-phase.

PMID- 1618133
TI  - Motor neuron pathfinding following rhombomere reversals in the chick embryo
      hindbrain.
AB  - Motor neurons are segmentally organised in the developing chick hindbrain, with
      groups of neurons occupying pairs of hindbrain segments or rhombomeres. The
      branchiomotor nucleus of the trigeminal nerve occupies rhombomeres 2 and 3 (r2
      and r3), that of the facial nerve r4 and r5, and that of the glossopharyngeal
      nerve r6 and r7. Branchiomotor neuron cell bodies lie within the basal plate,
      forming columns on either side of the ventral midline floor plate. Axons
      originating in rhombomeres 2, 4 and 6 grow laterally (dorsally) towards the exit
      points located in the alar plates of these rhombomeres, while axons originating
      in odd-numbered rhombomeres 3 and 5 grow laterally and then rostrally, crossing a
      rhombomere boundary to reach their exit point. Examination of the trajectories of
      motor axons in odd-numbered segments at late stages of development (19-25) showed
      stereotyped pathways, in which axons grew laterally before making a sharp turn
      rostrally. During the initial phase of outgrowth (stage 14-15), however, axons
      had meandering courses and did not grow in a directed fashion towards their exit
      point. When r3 or r5 was transplanted with reversed rostrocaudal polarity prior
      to motor axon outgrowth, the majority of axons grew to their appropriate, rostral
      exit point, despite the inverted neuroepithelial polarity. In r3 reversals,
      however, there was a considerable increase in the normally small number of axons
      that grew out via the caudal, r4 exit point. These findings are discussed with
      relevance to the factors involved in motor neuron specification and axon
      outgrowth in the developing hindbrain.

PMID- 1618134
TI  - Effects of the developmental colour mutations silver and recessive spotting on
      proliferation of diploid and immortal mouse melanocytes in culture.
AB  - The developmental mouse coat-colour mutations silver (si, chromosome 10) and
      recessive spotting (rs, chromosome 5, mapping very close to the dominant white
      spotting or W/c-kit locus), appear to reduce the numbers of functional
      melanocytes in the skin. They were studied at the cellular level by melanocyte
      culture. Cellular morphology, differentiation and survival appeared normal.
      However, both mutations were found to reduce the melanocyte proliferation rate in
      primary cultures, as measured by [3H]thymidine labelling indices. Two immortal
      si/si melanocyte lines (designated melan-si1 and melan-si2) and one rs/rs line
      (melan-rs) were established. Melan-si1 and melan-rs were cloned. All three
      immortal lines at low passage levels had doubling times significantly greater
      than those of our other melanocyte lines melan-a, melan-b and melan-c. Thus they
      retained the phenotype of slow proliferation.

PMID- 1618135
TI  - Inducible cell ablation in Drosophila by cold-sensitive ricin A chain.
AB  - We have developed a system for temperature-inducible killing of specific cells in
      the fruitfly Drosophila melanogaster. The system overcomes many of the
      limitations of existing cell ablation methods and is in principle applicable to
      any non-homeothermic eukaryote. Temperature-sensitive and cold-sensitive
      mutations in the ricin toxin A chain (RTA) of castor bean were generated in
      yeast. One cold-sensitive mutation, RAcs2, produced temperature-dependent
      ablation of eye cells in Drosophila when expressed under control of the eye
      specific sev enhancer. At 29 degrees C, cell death was observed within 7 hours in
      the developing eye and no obvious toxic effects were observed elsewhere; at 18
      degrees C, extremely low toxicity was observed. DNA sequencing of RAcs2 revealed
      a single amino acid substitution in the RTA active site cleft.

PMID- 1618136
TI  - Cholinergic neuronal differentiation factors: evidence for the presence of both
      CNTF-like and non-CNTF-like factors in developing rat footpad.
AB  - Catecholaminergic sympathetic neurons are able to change their transmitter
      phenotype during development and to acquire cholinergic properties. Cholinergic
      sympathetic differentiation is only observed in fibers innervating specific
      targets like the sweat glands in the rat footpad. A function for ciliary
      neurotrophic factor (CNTF) in this process has been implied as it is able to
      induce cholinergic properties (ChAT, VIP) in cultured chick and rat neurons. We
      show here that a CNTF-like, VIP-inducing activity is present in rat footpads and
      that its increases 6-fold during the period of cholinergic sympathetic
      differentiation. Immunohistochemical analysis of P21 rat footpads demonstrated
      CNTF-like immunoreactivity in Schwann cells but not in sweat glands, the target
      tissue of cholinergic sympathetic neurons. The expression of this factor in
      footpads seems to be dependent on the presence of intact nerve axons, as nerve
      transection results in a loss of CNTF-like cholinergic activity and
      immunoreactivity. Immunoprecipitation experiments with rat footpad extracts
      provided evidence for the presence of ChAT-inducing factors other than CNTF,
      which may independently or together with CNTF be involved in the determination of
      sympathetic neuron phenotype.

PMID- 1618137
TI  - Organization and regulation of cortical microtubules during the first cell cycle
      of Xenopus eggs.
AB  - Anti-tubulin antibodies and confocal immunofluorescence microscopy were used to
      examine the organization and regulation of cytoplasmic and cortical microtubules
      during the first cell cycle of fertilized Xenopus eggs. Appearance of
      microtubules in the egg cortex temporally coincided with the outgrowth of the
      sperm aster. Microtubules of the sperm aster first reached the animal cortex at
      0.25, (times normalized to first cleavage), forming a radially organized array of
      cortical microtubules. A disordered network of microtubules was apparent in the
      vegetal cortex as early as 0.35. Cortical microtubule networks of both animal and
      vegetal hemispheres were reorganized at times corresponding to the cortical
      rotation responsible for specification of the dorsal-ventral (D-V) axis. Optical
      sections suggest that the cortical microtubules are continuous with the
      microtubules of the sperm aster in fertilized eggs, or an extensive activation
      aster in activated eggs. Neither assembly and organization, nor disassembly of
      the cortical microtubules coincided with MPF activation during mitosis. However,
      cycloheximide or 6-dimethylaminopurine, which arrest fertilized eggs at
      interphase, blocked cortical microtubule disassembly. Injection of p13, a protein
      that specifically inhibits MPF activation, delayed or inhibited cortical
      microtubule breakdown. In contrast, eggs injected with cyc delta 90, a truncated
      cyclin that arrest eggs in M-phase, showed normal microtubule disassembly.
      Finally, injection of partially purified MPF into cycloheximide-arrested eggs
      induced cortical microtubule breakdown. These results suggest that, despite a
      lack of temporal coincidence, breakdown of the cortical microtubules is dependent
      on the activation of MPF.

PMID- 1618138
TI  - Expression of a novel FGF in the Xenopus embryo. A new candidate inducing factor
      for mesoderm formation and anteroposterior specification.
AB  - We have cloned and sequenced a new member of the fibroblast growth factor family
      from Xenopus laevis embryo cDNA. It is most closely related to both mammalian
      kFGF (FGF-4) and FGF-6 but as it is not clear whether it is a true homologue of
      either of these genes we provisionally refer to it as XeFGF (Xenopus embryonic
      FGF). Two sequences were obtained, differing by 11% in derived amino acid
      sequence, which probably represent pseudotetraploid variants. Both the sequence
      and the behaviour of in vitro translated protein indicates that, unlike bFGF (FGF
      2), XeFGF is a secreted molecule. Recombinant XeFGF protein has mesoderm-inducing
      activity with a specific activity similar to bFGF. XeFGF mRNA is expressed
      maternally and zygotically with a peak during the gastrula stage. Both probe
      protection and in situ hybridization showed that the zygotic expression is
      concentrated in the posterior of the body axis and later in the tailbud. Later
      domains of expression were found near the midbrain/hindbrain boundary and at low
      levels in the myotomes. Because of its biological properties and expression
      pattern, XeFGF is a good candidate for an inducing factor with possible roles
      both in mesoderm induction at the blastula stage and in the formation of the
      anteroposterior axis at the gastrula stage.

PMID- 1618139
TI  - Neural induction and regionalisation in the chick embryo.
AB  - Induction and regionalisation of the chick nervous system were investigated by
      transplanting Hensen's node into the extra-embryonic region (area opaca margin)
      of a host embryo. Chick/quail chimaeras were used to determine the contributions
      of host and donor tissue to the supernumerary axis, and three molecular markers,
      Engrailed, neurofilaments (antibody 3A10) and XlHbox1/Hox3.3 were used to aid the
      identification of particular regions of the ectopic axis. We find that the age of
      the node determines the regions of the nervous system that form: young nodes
      (stages 2-4) induced both anterior and posterior nervous system, while older
      nodes (stages 5-6) have reduced inducing ability and generate only posterior
      nervous system. By varying the age of the host embryo, we show that the
      competence of the epiblast to respond to neural induction declines after stage 4.
      We conclude that during normal development, the initial steps of neural induction
      take place before stage 4 and that anteroposterior regionalisation of the nervous
      system may be a later process, perhaps associated with the differentiating
      notochord. We also speculate that the mechanisms responsible for induction of
      head CNS differ from those that generate the spinal cord: the trunk CNS could
      arise by homeogenetic induction by anterior CNS or by elongation of neural
      primordia that are induced very early.

PMID- 1618140
TI  - Fgf-4 expression during gastrulation, myogenesis, limb and tooth development in
      the mouse.
AB  - Fgf-4, initially isolated as a transforming gene from human tumors, is a member
      of the Fibroblast Growth Factor (FGF) family. It has previously been shown by
      northern blot hybridization analysis to be expressed in teratocarcinoma and
      embryonic stem cells, suggesting that it plays a role in embryonic development.
      We have carried out an RNA in situ hybridization analysis of Fgf-4 expression in
      the developing mouse embryo, from fertilization through the 14th day of gestation
      (E14.5). Our results show that Fgf-4 RNA is first detected at the late blastocyst
      stage in cells that give rise to all of the embryonic lineages (inner cell mass
      cells). During the early stages of gastrulation, expression becomes restricted to
      the primitive streak where mesoderm and definitive endoderm are formed.
      Expression continues in the distal (rostral) two-thirds of the streak through
      approx. E10, and then is detected in the tail bud, which replaces the streak as
      the primary source of mesoderm. Additional sites of expression are found after
      the three primary germ layers are established and organogenesis begins. Fgf-4 RNA
      is detected transiently in the branchial arch units, the somitic myotome, the
      apical ectodermal ridge of the developing limb bud and the tooth bud, suggesting
      that the gene has multiple roles during embryogenesis. These results are compared
      with the expression patterns of other FGF genes. Taken together, the data suggest
      that individual members of the gene family are expressed sequentially in
      developmental pathways such as mesoderm formation and myogenesis, and play a role
      in specific epithelial-mesenchymal interactions.

PMID- 1618141
TI  - Early mRNAs, spatially restricted along the animal-vegetal axis of sea urchin
      embryos, include one encoding a protein related to tolloid and BMP-1.
AB  - The cloning and characterization of cDNAs representing four genes or small gene
      families that are coordinately expressed in a spatially restricted pattern during
      the very early blastula (VEB) stage of sea urchin development are presented. The
      VEB genes encode multiple transcripts that are expressed transiently in embryos
      of Strongylocentrotus purpuratus between 16-cell stage and hatching, with peak
      abundance 12 to 15 hours post-fertilization (approximately 150-250 cells). The
      VEB transcripts share the same spatial pattern in the early blastula embryo: they
      are asymmetrically distributed along the animal-vegetal axis but their
      distribution around this axis is uniform. Thus, the VEB transcripts are the
      earliest messages to reveal asymmetry along the primary axis in the sea urchin
      embryo. The temporal and spatial patterns of VEB transcript accumulation are not
      consistent with involvement of these gene products in cell division or in tissue
      specific functions. Furthermore, VEB messages cannot be detected in either ovary
      or adult tissues, suggesting that these genes function exclusively during
      embryogenesis. We suggest that the VEB genes function in constructing the early
      blastula. Two VEB genes encode metalloendoproteases: one (SpHE) is hatching
      enzyme and the other (SpAN) is similar to bone morphogenetic protein-1 (BMP-1;
      Wozney et al., Science 242: 1528-1534, 1988) and the Tolloid gene product (tld)
      (Shimell et al., Cell 67: 459-482, 1991). Several lines of evidence suggest that
      the VEB genes are regulated directly by factors or regulatory activities
      localized along the maternally specificed animal-vegetal axis.

PMID- 1618142
TI  - Isolation of temperature-sensitive diphtheria toxins in yeast and their effects
      on Drosophila cells.
AB  - We have isolated temperature-sensitive diphtheria toxins (DT-A(ts)) to develop a
      method that allows temporal impedement of cellular functions. Four DT-A(ts) genes
      were isolated in a mutagenesis screen using the yeast, Saccharomyces cerevisiae.
      When expressed in yeast, these DT-A(ts) arrest growth at 18 degrees C but not at
      30 degrees C. Three DT-A(ts) were subsequently tested in the R1-R6 photoreceptor
      cells of transgenic fruit flies, Drosophila melanogaster. The toxins show similar
      temperature dependence in both organisms, suggesting that they may be useful in a
      wide range of non-homeothermic species. DNA sequence analysis revealed that three
      of the four DT-A(ts) mutations are novel. Interestingly, the fourth DT-A(ts)
      carries the same point mutation as the extensively characterized CRM197, an ADP
      ribosyltransferase-defective form of diphtheria toxin.

PMID- 1618143
TI  - Compensatory synaptic growth in the rod terminals as a sequel to partial
      photoreceptor cell loss in the retina of chimaeric mice.
AB  - In the retina of chimaeric mice of rd and wild-type genotypic combination,
      selective loss of rd/rd photoreceptor cells, after initial development, leads to
      a mosaic retina with variable amounts of normal photoreceptor cells present over
      the retinal surface. In some of the rod terminals of these retinas the synaptic
      complexes with the second order retinal neurons are seen to contain multiple
      synaptic ribbons and an increased number of profiles of the postsynaptic
      elements. These changes are observed only in the rod terminals and not in the
      cone pedicles. Computer aided three-dimensional reconstruction of the altered
      synapses shows that these changes result from an increase in the number of
      synaptic sites, characterized by multiplication of the synaptic ribbons and
      enlargement of the second order neuronal processes. A quantitative analysis of
      such synapses, based on serial electron micrographs, shows that these are most
      frequently located in the retinal regions of the chimaeric individuals that have
      suffered maximum photoreceptor cell loss. Thus synaptic growth appears to take
      place as a reaction to the reduction of afferent input to the postsynaptic
      components. These findings demonstrate persistent synaptic plasticity in the rod
      terminals of mammalian retina during the maturational phase of late postnatal
      development. Compensatory synaptic growth in the rod terminals, as recorded here,
      can have important implications for the maintenance of visual sensitivity in the
      diseased or ageing retina.

PMID- 1618144
TI  - Pathfinding by cranial nerve VII (facial) motorneurons in the chick hindbrain.
AB  - Cranial nerve VII (facial) motorneurons begin extending axons through rhombomeres
      4 and 5 (R4 and R5) in the chick hindbrain on the second day of incubation.
      Without crossing the midline, facial motorneuron axons extend laterally from a
      ventromedial cell body location. All facial motorneuron axons leave the hindbrain
      through a discrete exit site in R4. To examine the importance of the exit site in
      R4 on motorneuron pathfinding, we ablated R4 before motorneuron axonogenesis. We
      find that mechanisms intrinsic to R5 direct the initial lateral orientation of R5
      motorneuron axons. Upon reaching a particular lateral position, all R5
      motorneuron axons must turn. In normal embryos the axons all turn rostrally to
      reach the nerve exit in R4. In embryos with R4 ablated, sometimes the axons turn
      rostrally and sometimes they turn caudally. A model combining permissive fields
      and chemotropic cues is presented to account for our observations.

PMID- 1618145
TI  - Altered mitotic domains reveal fate map changes in Drosophila embryos mutant for
      zygotic dorsoventral patterning genes.
AB  - The spatial and temporal pattern of mitoses during the fourteenth nuclear cycle
      in a Drosophila embryo reflects differences in cell identities. We have analysed
      the domains of mitotic division in zygotic mutants that exhibit defects in larval
      cuticular pattern along the dorsoventral axis. This is a powerful means of fate
      mapping mutant embryos, as the altered position of mitotic domains in the
      dorsoventral pattern mutants correlate with their late cuticular phenotypes. In
      the mutants twist and snail, which fail to differentiate the ventrally derived
      mesoderm, mitoses specific to the mesoderm are absent. The lateral mesectodermal
      domain shows a partial ventral shift in twist mutants but a proportion of ventral
      cells do not behave characteristically, suggesting that twist has a positive role
      in the establishment of the mesoderm. In contrast, snail is required to repress
      mesectodermal fates in cells of the presumptive mesoderm. In the absence of both
      genes, the mesodermal and the mesectodermal anlage are deleted. Mutations at five
      loci delete specific pattern elements in the dorsal half of the embryo and cause
      partial ventralization. Mutations in the genes zerknullt and shrew affect cell
      division only in the dorsalmost cells corresponding to the amnioserosa, while the
      genes tolloid, screw and decapentaplegic (dpp) affect divisions in both the
      prospective amnioserosa and the dorsal epidermis. We demonstrate that in each of
      these mutants dorsally placed mitotic domains are absent and this effect is
      correlated with an expansion and dorsal shift in the position of more ventral
      domains. The loss of activity in each of the five genes results in qualitatively
      similar alterations in the mitotic pattern; mutations with stronger ventralizing
      phenotypes affect increasingly greater subsets of the dorsal cells. Double mutant
      analysis indicates that these genes act in a concerted manner to specify dorsal
      fates. The correlation between phenotypic strength and the progressive loss of
      dorsal pattern elements in the ventralized mutants, suggests that one of these
      gene products, perhaps dpp, may provide positional information in a graded
      manner.

PMID- 1618146
TI  - Pathfinding by zebrafish motoneurons in the absence of normal pioneer axons.
AB  - Individually identified primary motoneurons of the zebrafish embryo pioneer cell
      specific peripheral motor nerves. Later, the growth cones of secondary
      motoneurons extend along pathways pioneered by primary motor axons. To learn
      whether primary motor axons are required for pathway navigation by secondary
      motoneurons, we ablated primary motoneurons and examined subsequent pathfinding
      by the growth cones of secondary motoneurons. We found that ablation of the
      primary motoneuron that pioneers the ventral nerve delayed ventral nerve
      formation, but a normal-appearing nerve eventually formed. Therefore, the
      secondary motoneurons that extend axons in the ventral nerve were able to pioneer
      that pathway in the absence of the pathway-specific primary motoneuron. In
      contrast, in the absence of the primary motoneuron that normally pioneers the
      dorsal nerve, secondary motoneurons did not pioneer a nerve in the normal
      location, instead they formed dorsal nerves in an atypical position. This
      difference in the ability of these two groups of motoneurons to pioneer their
      normal pathways suggests that the guidance rules followed by their growth cones
      may be very different. Furthermore, the observation that the atypical dorsal
      nerves formed in a consistent incorrect location suggests that the growth cones
      of the secondary motoneurons that extend dorsally make hierarchical pathway
      choices.

PMID- 1618147
TI  - Transforming growth factor-alpha (TGF-alpha) and insulin gene expression in human
      fetal pancreas.
AB  - Transforming growth factor-alpha (TGF-alpha) mRNA is expressed in several
      pancreatic cancer cell lines, but its expression during normal fetal pancreas
      development has not been studied. We investigated the expression of TGF-alpha,
      its receptor (EGF-R) and insulin mRNA and their corresponding peptides in human
      fetal pancreata (15-20 gestation weeks). Polymerase chain reaction (PCR) and
      RNAase protection analysis revealed that TGF-alpha and insulin mRNAs were
      detectable in pancreas during the developmental span studied. In northern blot
      analysis a single band of 4.8 kilobases (kb) corresponding to the TGF-alpha
      transcript and a 0.6 kb for the insulin mRNA were detected in the pancreas. Using
      in situ hybridization, TGF-alpha mRNA expression was seen in a low copy number in
      both the exo- and endocrine pancreas. By immunohistochemistry TGF-alpha
      immunoreactive cells were detected in the ducts, acini and islets showing that
      the mRNA was translated into protein. By contrast, insulin transcripts were
      detected in a high copy number, restricted to the islets of Langerhans. However,
      monoclonal insulin antibody detected less insulin containing cells than could be
      expected from the mRNA pattern suggesting that fetal beta-cells rapidly secrete
      insulin instead of storing it in the secretory granules. Alternatively, the
      translation of insulin mRNA could be inefficient. By double labeling the pancreas
      sections with polyclonal TGF-alpha antiserum and monoclonal insulin antibody the
      TGF-alpha- and insulin-like immunoreactivity was localized to beta-cells.
      Furthermore, mRNA for the TGF-alpha receptor, EGF-R, together with EGF-R
      immunoreactive cells were also present in pancreas.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1618148
TI  - Skeletal muscle phenotypes initiated by ectopic MyoD in transgenic mouse heart.
AB  - Forced expression of the myogenic regulatory gene MyoD in many types of cultured
      cells initiates their conversion into skeletal muscle. It is not known, however,
      if MyoD expression serves to activate all or part of the skeletal muscle program
      in vivo during animal development, nor is it known how limiting the influences of
      cellular environment may be on the regulatory effects of MyoD. To begin to
      address these issues, we have produced transgenic mice which express MyoD in
      developing heart, where neither MyoD nor its three close relatives--myogenin, Myf
      5, and MRF4/herculin/Myf-6--are normally expressed. The resulting gross phenotype
      in offspring from multiple, independent transgenic founders includes abnormal
      heart morphology and ultimately leads to death. At the molecular level, affected
      hearts exhibit activation of skeletal muscle-specific regulatory as well as
      structural genes. We conclude that MyoD is able to initiate the program that
      leads to skeletal muscle differentiation during mouse development, even in the
      presence of the ongoing cardiac differentiation program. Thus, targeted
      misexpression of this tissue-specific regulator during mammalian embryogenesis
      can activate, either directly or indirectly, a diverse set of genes normally
      restricted to a different cell lineage and a different cellular environment.

PMID- 1618149
TI  - Prenatal expression of the growth hormone (GH) receptor/binding protein in the
      rat: a role for GH in embryonic and fetal development?
AB  - Although fetal growth is generally considered to be independent of pituitary
      growth hormone (GH), it is possible that pituitary GH plays a modulatory role in
      organ development or that a GH-like substance of non pituitary origin may
      influence fetal growth through the GH receptor. Accordingly, we have used
      immunohistochemistry, northern blot analysis, the reverse transcriptase
      polymerase chain reaction and solution hybridization to study the ontogeny of the
      GH receptor/binding protein (BP) from the 12-day-old embryo (E12) to the E18 rat
      fetus. GH receptor/BP immunoreactivity was observed in all major organ systems of
      the E18 rat fetus and was not preferentially associated with any germ layer
      derivative. A general increase in GH receptor/BP immunoreactivity was evident
      from E12 to E18, with a marked increase occurring between E16 and E18.
      Hemangioblastic tissue was, however, strongly or intensely immunoreactive at all
      stages of development, as was the placenta. Most noteworthy of the other tissues
      expressing GH receptor/BP immunoreactivity by day 18 were skeletal and smooth
      muscle, chondroprogenitor cells, epithelial lining cells, neuronal ganglia,
      ependymal cells and the adrenal cortex. In the placenta, the most prominent
      immunoreactivity was associated with decidual cells. Total RNA was isolated from
      E12 to E18 rat fetuses and adult rat liver. Northern hybridization with a 35S
      labelled rat GH receptor cRNA probe revealed that 3.9 kb and 1.2 kb transcripts
      complementary to the rat GH receptor riboprobe are present from at least E16. The
      existence of GH receptor mRNA at E12 and E14 was demonstrated by the polymerase
      chain reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618150
TI  - Cellular and extracellular involvement in the regeneration of the rat lower
      vibrissa follicle.
AB  - The sequence of events leading to the reconstruction of a fibre-producing hair
      follicle, after microsurgical amputation of the lower follicle bulb, has been
      detailed by immunohistology and electron microscopy. The initial response was
      essentially found to be a wound reaction, in that hyperproliferative follicle
      epidermis quickly spread to below the level of amputation--associated with
      downward movement of mesenchymal (or dermal) sheath cells. Fibronectin was
      prominent in both dermis and epidermis at this stage and, as in wound repair,
      preceded laminin and type IV collagen in covering the lower dermal-epidermal
      junction. Once a new basal line of epidermis and a complete basement membrane
      were established, laminin and type IV collagen were detected below this junction
      and within the prospective papilla-forming mesenchyme. This coincided with
      ultrastructural observations of profuse sub-basement membrane extracellular
      material in the region of new papilla formation. The glassy membrane displayed
      extensive ultrastructural modifications at its lower level, and these
      corresponded with localized variations in staining intensities for all three
      antibodies over time. The membrane hung below the level of the epidermis, and was
      crossed by migrating cells from the mesenchymal dermal sheath of the follicle -
      it acted to segregate the inner group of follicular dermal cells from wound
      fibroblasts. Extracellular matrix may be a mediator of the dermal-epidermal
      interactions associated with this hair follicle regeneration phenomenon.

PMID- 1618151
TI  - Diffusible rod-promoting signals in the developing rat retina.
AB  - We previously developed a reaggregate cell culture system in which embryonic rat
      retinal neuroepithelial cells proliferate and give rise to opsin-expressing rod
      photoreceptor cells (rods) on the same schedule in vitro as they do in vivo. We
      showed that the proportion of neuroepithelial cells in the embryonic day 15 (E15)
      retina that differentiated into opsin+ rods after 5-6 days in such cultures
      increased by approximately 40-fold when the E15 cells were cultured in the
      presence of an excess of postnatal day 1 (P1) neural retinal cells. In the
      present study, we have further analyzed this rod-promoting activity of neonatal
      neural retinal cells. We show that the activity is mediated by a diffusible
      signal(s) that seems to act over a relatively short distance. Whereas neonatal
      (P1-P3) neural retina has rod-promoting activity, E15 and adult neural retina,
      neonatal thymus, cerebrum and cerebellum do not. Finally, we show that neonatal
      neural retina promotes rod but not amacrine cell development.

PMID- 1618152
TI  - Transforming growth factor-beta 1, -beta 2 and -beta 3 in cartilage and bone
      cells during endochondral ossification in the chick.
AB  - The localization of TGF-beta 1, -beta 2 and -beta 3 was studied in the growth
      plate, epiphysis and metaphysis of the tibiotarsus of three-week-old chicks. The
      different TGF-beta isoforms were localized to hypertrophic chondrocytes,
      chondroclasts, osteoblasts and osteoclasts using immunohistochemical staining
      analysis with specific TGF-beta antibodies. TGF-betas in osteoclasts and
      chondroclasts were restricted to those cells located on the respective matrices.
      TGF-beta 3 localization was mainly cytoplasmic in the transitional (early
      hypertrophic) chondrocytes, but nuclear staining was also detected in some
      proliferating chondrocytes. The cell-specific localization of these TGF-beta
      isoforms supports the hypothesis that TGF-beta has a role in the coupling of new
      bone formation to bone and cartilage matrix resorption during osteochondral
      development and suggests that TGF-beta may be a marker of chondrocyte
      differentiation. TGF-beta localization preceded a marked increase in type II
      collagen mRNA expression in transitional chondrocytes, suggesting a role for TGF
      beta in the induction of synthesis of extracellular matrix.

PMID- 1618153
TI  - Regeneration of dopaminergic neurons in goldfish retina.
AB  - The conditions necessary to trigger regeneration of dopaminergic neurons were
      investigated in the goldfish retina. Intraocular injection of 6-hydroxydopamine
      (6-OHDA) was used to destroy dopaminergic neurons, and neuronal regeneration was
      monitored by injections of the thymidine analog bromodeoxyuridine (BUdR).
      Regenerated dopaminergic neurons, (identified by double-labeling with anti
      tyrosine hydroxylase and anti-BUdR antibodies) were found within 3 weeks after 2
      injections of 0.6 mg/ml 6-OHDA (estimated intraocular concentration), but not
      after injection of lower doses. All retinas with regenerated dopaminergic neurons
      also contained other types of regenerated neurons, including cones and ganglion
      cells, consistent with nuclear counts which revealed non-selective cell loss (34
      36%) in both the outer and inner nuclear layers after exposure to the high dose,
      but not lower doses of 6-OHDA. Regenerated neurons were produced by clusters of
      dividing neuroepithelial cells probably derived from rod precursors in the outer
      nuclear layer. These results demonstrate that dopaminergic neurons will not
      regenerate after they are selectively ablated but only as part of a developmental
      process that involves generation of multiple cell types.

PMID- 1618154
TI  - Evolutionary dissociation between cleavage, cell lineage and embryonic axes in
      sea urchin embryos.
AB  - Using vital dye staining and the microinjection of fluorescent cell lineage
      autonomous tracers, the relationship between the first cleavage plane and the
      prospective larval dorsoventral axis was examined in several sea urchin species,
      including: Strongylocentrotus purpuratus, S. droebachiensis, Lytechinus pictus,
      Clypeaster rosaceus, Heliocidaris tuberculata and H. erythrogramma. The results
      indicate that there is no single relationship between the early cleavage pattern
      and the dorsoventral axis for all sea urchins; however, specific relationships
      exist for individual species. In S. purpuratus the first cleavage plane occurs at
      an angle 45 degrees clockwise with respect to the prospective dorsoventral axis
      in most cases, as viewed from the animal pole. On the other hand, in S.
      droebachiensis, L. pictus and H. tuberculata, the first cleavage plane generally
      corresponds with the plane of bilateral symmetry. There does not appear to be a
      predominant relationship between the first cleavage plane and the dorsoventral
      axis in C. rosaceus. In the direct-developing sea urchin H. erythrogramma the
      first cleavage plane bisects the dorsoventral axis through the frontal plane.
      Clearly, evolutionary differences have arisen in the relationship between
      cleavage pattern and developmental axes. Therefore, the mechanism of cell
      determination is not necessarily tied to any particular pattern of cell cleavage,
      but to an underlying framework of axial systems resident within sea urchin eggs
      and embryos.

PMID- 1618155
TI  - Regulation of proneural gene expression and cell fate during neuroblast
      segregation in the Drosophila embryo.
AB  - The Drosophila embryonic central nervous system develops from sets of progenitor
      neuroblasts which segregate from the neuroectoderm during early embryogenesis.
      Cells within this region can follow either the neural or epidermal developmental
      pathway, a decision guided by two opposing classes of genes. The proneural genes,
      including the members of the achaete-scute complex (AS-C), promote neurogenesis,
      while the neurogenic genes prevent neurogenesis and facilitate epidermal
      development. To understand the role that proneural gene expression and regulation
      play in the choice between neurogenesis and epidermogenesis, we examined the
      temporal and spatial expression pattern of the achaete (ac) regulatory protein in
      normal and neurogenic mutant embryos. The ac protein is first expressed in a
      repeating pattern of four ectodermal cell clusters per hemisegment. Even though 5
      7 cells initially express ac in each cluster, only one, the neuroblast, continues
      to express ac. The repression of ac in the remaining cells of the cluster
      requires zygotic neurogenic gene function. In embryos lacking any one of five
      genes, the restriction of ac expression to single cells does not occur; instead,
      all cells of each cluster continue to express ac, enlarge, delaminate and become
      neuroblasts. It appears that one key function of the neurogenic genes is to
      silence proneural gene expression within the nonsegregating cells of the initial
      ectodermal clusters, thereby permitting epidermal development.

PMID- 1618156
TI  - A temporally regulated, diffusible activity is required for rod photoreceptor
      development in vitro.
AB  - The retina is a relatively simple and well-characterized CNS structure in which
      cell-cell interactions have been hypothesized to influence cell type
      determination. By manipulating cell density in serum-free cultures we show that
      rat rod photoreceptor development requires a diffusible activity produced by
      neonatal retinal cells. This effect is not mediated by changes in cell survival
      or mitosis. Production of the rod promoting activity varies with developmental
      stage and is temporally correlated with the timing of rod generation in vivo. In
      low density cultures, which do not support rod development, an increased fraction
      of cells stain with an antibody specific for another retinal neuron, the bipolar
      cell. Thus, the diffusible rod promoting activity may influence cell fate
      determination, and not only terminal differentiation. These results provide an
      approach for the molecular characterization of developmentally important signals
      in the vertebrate retina.

PMID- 1618157
TI  - Evidence for endogenous proteases, mRNA level and insulin as multiple mechanisms
      of N-cadherin down-regulation during retinal development.
AB  - Our previous studies of the role of cell adhesion in retinal development have
      focused on the expression and function of N-cadherin, the predominant calcium
      dependent intercellular adhesion protein of neural tissues. During the course of
      retinal development, N-cadherin expression undergoes significant qualitative and
      quantitative changes in its pattern of expression, most prominently a sharp down
      regulation of expression throughout most of the retina. The present studies were
      directed at investigating the epigenetic mechanisms that could mediate this loss
      of N-cadherin from the retina. Using an in vitro intact retinal organ culture
      system, results were obtained which suggest that insulin enhances the down
      regulation of N-cadherin expression in a protein-synthesis-dependent fashion.
      Furthermore, the metalloprotease inhibitor 1,10-phenanthroline inhibits the loss
      of N-cadherin from the retina. While N-cadherin is down-regulated in organ
      culture, other cell adhesion molecules, which are not down-regulated in vivo, are
      also not down-regulated in organ culture. The defined organ culture medium
      conditioned by the retina accumulates both a soluble 90 x 10(3) M(r) N-terminal
      fragment of N-cadherin as well as a number of secreted proteases. Both of these
      components are also shown to be present in vivo in the vitreous humor. Northern
      blot analysis indicates a single mRNA encoding N-cadherin in the retina and no
      evidence for a second message that could encode the 90 x 10(3) M(r) fragment.
      However, the amount of N-cadherin mRNA detectable on northern blots decreases
      during development. The results reported here suggest that the down-regulation of
      N-cadherin that occurs during retinal development is possibly mediated by
      multiple mechanisms, which include turnover at the cell surface mediated by
      endogenous proteolysis, reduced levels of N-cadherin mRNA and modulation by
      growth factors.

PMID- 1618158
TI  - Evidence of a role for endogenous electrical fields in chick embryo development.
AB  - We have tested directly the hypothesis that the endogenous electrical field in
      the chick embryo plays a causal role in development. Conductive implants, which
      shunt currents out of the embryo and thus alter the internal field, were placed
      under the dorsal skin at the mid-trunk level of stage 11-15 embryos. Currents
      leaving the posterior intestinal portal (p.i.p.) of these embryos were reduced by
      an average of 30%. Control embryos receiving non-conductive implants showed no
      change in p.i.p. currents. In the group receiving current shunts, 92% of the
      embryos exhibited some developmental abnormality. Only 11% of the control group
      displayed defects. The most common defect in the experimental group (81%) was in
      tail development. Tail defects ranged from complete absence to the formation of a
      normal length, but morphologically abnormal tail. Internally, tail structures
      (neural tube, notochord and somites) were frequently absent or aberrantly formed.
      In 33% of the experimental embryos, the notochord continued lengthening in the
      absence of any other tail development. This led to the formation of ourenteric
      outgrowths from the hindgut. Defects in limb bud and head development were also
      found in experimentally treated embryos, but at a much lower frequency than tail
      defects. The abnormalities observed in experimental embryos were very similar to
      those produced naturally in rumpless mutant chicks. A vibrating probe analysis of
      these mutants (from both dominant and recessive strains) showed that currents
      leaving the p.i.p. were significantly lower in phenotypically abnormal mutants
      than in wild-type and phenotypically normal mutant embryos from both strains.
      There was no apparent correlation between the average transepithelial potential
      (TEP) of these mutants and the development of tail abnormalities. The possible
      role of endogenous electrical fields in chick tail development is discussed.

PMID- 1618159
TI  - Embryonic cytoplasmic extracts rescue murine androgenones to the blastocyst
      stage.
AB  - Androgenones (paternally derived genome) show a significant inability to form a
      blastocoele cavity. Eighty percent of these embryos die or arrest at earlier
      stages. Factor(s) from both normal and parthenogenetic late preimplantation
      embryos injected into each blastomere of androgenetic 4-cell stage can rescue
      more than twice as many to the blastocyst stage (47.2% versus 19.2% for non
      injected androgenones). This factor(s) becomes available beginning at the 4-cell
      stage and is titratable. Injected total cytoplasmic mRNA will also cause a rescue
      response. Isolating this specific factor message(s) will permit the eventual
      cloning of possibly the earliest parentally imprinted gene(s) expressed during
      development.

PMID- 1618160
TI  - Anatomy of the steroid receptor zinc finger region.

PMID- 1618161
TI  - The molecular biology of RU486. Is there a role for antiprogestins in the
      treatment of breast cancer?

PMID- 1618162
TI  - The molecular biology of thyroid peroxidase: cloning, expression and role as
      autoantigen in autoimmune thyroid disease.

PMID- 1618163
TI  - Dissociation of dopamine from its receptor as a signal in the pleiotropic
      hypothalamic regulation of prolactin secretion.
AB  - We have reviewed the literature, which supports an important role for dopamine
      withdrawal in the regulation of PRL secretion. Concentrations of dopamine in the
      hypophyseal portal circulation are sufficient to occupy the majority of dopamine
      receptors (1) and tonically suppress PRL secretion (20-26). Brief escapes from
      dopaminergic regulation associated with the secretion of PRL have been observed
      (37-41). Therefore, dopamine regulates secretion of PRL both by occupancy of, as
      well as dissociation from, specific D2 dopamine receptors. The rapid off rate
      from its receptor (2) is consistent with signals transmitted through brief
      decreases in dopamine concentration. The removal of dopamine for 10 min results
      in increases in intracellular cAMP and presumably activation of protein kinase A
      (39, 138) as well as activation of phospholipase C (137, 138) and protein kinase
      C (136). The removal of dopamine results directly in the release of PRL (37-41).
      Furthermore, the brief removal of dopamine results in the long-term potentiation
      of the PRL-releasing action of TRH (38-40). The potentiating action of dopamine
      withdrawal appears to be mediated by the activation of protein kinase A since
      pretreatment with VIP, a hormone that signals via protein kinase A, also
      potentiates the action of TRH (39). TRH stimulates PRL release via Ca2+/protein
      kinase C (177-184). The potentiating action of dopamine removal is selective for
      the Ca2+/protein kinase C pathway since dopamine removal does not potentiate the
      PRL-secreting action of VIP (38, 87, 92). The action of TRH is potentiated up to
      30 min after the return of dopamine and the suppression of PRL to basal levels
      (38). In Fig. 10, dopamine dissociation from its receptor or VIP association to
      its receptor are shown separated by a broken line to indicate that by the time
      the potentiation of the action of TRH is tested, either dopamine is again
      occupying its receptor or VIP is no longer present. Therefore, the effect of
      protein kinase A activation is remembered by the lactotroph. We hypothesize that
      the responsiveness of the cell to TRH is potentiated by the phosphorylation of
      proteins by protein kinase A. Two potential substrates for protein kinase A are
      voltage-dependent Ca2+ channels and protein phosphatase inhibitors that would
      prolong the action of protein kinase C. When TRH occupies its receptor,
      intracellular Ca2+ levels are increased first from intracellular stores and
      subsequently by extracellular Ca2+ influx (187-189). Intracellular Ca2+ is
      mobilized by increased levels of IP3(128). Extracellular Ca2+ enters the
      lactotroph via voltage-dependent Ca2+ channels (189, 190).(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1618164
TI  - The impact of gonadal steroid hormone action on growth hormone secretion during
      childhood and adolescence.

PMID- 1618166
TI  - Brain and pituitary angiotensin.

PMID- 1618165
TI  - Physiology and molecular genetics of mutations that increase ovulation rate in
      sheep.

PMID- 1618167
TI  - Counterpoint: molecular analysis of the angiotensin II receptor.

PMID- 1618169
TI  - Adaptation in patients with chronic rheumatoid arthritis: application of a
      general model.
AB  - We derived a model of appraisal, coping, and adaptation in patients with
      rheumatoid arthritis (RA) from the more general theory of Lazarus and Folkman
      (1984) and examined this model using a longitudinal data set spanning 4 years and
      involving 239 RA patients (of whom 157 contributed to the primary analyses, with
      the remainder contributing to various follow-up analyses). This model attempted
      to identify the short- and long-term adaptational consequences of coping as well
      as the antecedents (appraisals, beliefs, social support, disease activity, etc.)
      that promote particular coping styles. Interrelations among the variables were
      examined using path-analytic techniques. Many observed relations were consistent
      with the model. Significant relations were subjected to more stringent analyses
      examining the ability of hypothesized causal variables to predict changes in
      outcome variables 1 year later. These analyses provided additional support for
      many observed relations and suggested the existence of a vicious cycle involving
      helplessness appraisals, passive coping with pain, and psychosocial impairment
      that promotes maladaptation in the face of RA. Theoretical implications,
      strengths, and limitations of the study are discussed.

PMID- 1618168
TI  - Hostility and health: current status of a psychosomatic hypothesis.
AB  - Recent research has renewed interest in the potential influence of hostility on
      physical health. This review indicates that the evidence available from
      prospective studies, although not entirely consistent, suggests that hostile
      persons may be at increased risk for subsequent coronary heart disease and other
      life-threatening illnesses. Further, several plausible mechanisms possibly
      linking hostility and health have been articulated and subjected to initial
      evaluation. Hostile individuals display heightened physiological reactivity in
      some situations, report greater degrees of interpersonal conflict and less social
      support, and may have more unhealthy daily habits. Additional research is needed,
      and it must address a variety of past conceptual and methodological limitations.
      Perhaps the most central of these concerns are the assessment of individual
      differences in hostility and the role of social contexts in the psychosomatic
      process.

PMID- 1618171
TI  - A model of the precaution adoption process: evidence from home radon testing.
AB  - We present the precaution adoption process model--a stage theory consisting of
      seven distinct states between ignorance and completed preventive action. The
      stages are "unaware of the issue," "aware of the issue but not personally
      engaged," "engaged and deciding what to do," "planning to act but not yet having
      acted," "having decided not to act," "acting," and "maintenance." The theory
      asserts that these stages represent qualitatively different patterns of behavior,
      beliefs, and experience and that the factors that produce transitions between
      stages vary depending on the specific transition being considered. Data from
      seven studies of home radon testing are examined to test some of the claims made
      by this model. Stage theories of protective behavior are contrasted with theories
      that see precaution adoption in terms of movement along a single continuum of
      action likelihood.

PMID- 1618170
TI  - Emotional inhibition in essential hypertension: obstacle to communication during
      medical visits?
AB  - A substantial literature on the "hypertensive personality" links essential
      hypertension (EH) with the suppression of negative emotions, implying that
      suppression may elevate blood pressure. Yet affective inhibition might also
      impair communication with health care providers and exacerbate EH by limiting
      therapeutic collaboration. We studied 542 patient-physician interviews from a
      national sample to see if patients with EH (n = 203) were less likely to exhibit
      negative emotions than normotensive patients (n = 339) as rated by their
      physicians and independent observers. EH patients did not differ from others on
      self-rated emotional or physical health. However, physicians were less accurate
      in characterizing the emotional states of EH patients than those of normotensive
      patients, and they rated EH patients as exhibiting fewer signs of distress during
      the visit. Independent observers also judged the EH patients as less distressed
      than normotensives, thereby validating the physicians' appraisals. Content
      analysis disclosed that physicians paid less attention to psychosocial concerns
      and concentrated on biomedical matters to a greater degree with hypertensive
      patients than with their normotensive patients. EH patients, particularly those
      experiencing emotional distress, appear to have patterns of self-presentation
      that could present an obstacle to effective communication with their physicians,
      and this difficulty may be amplified by physicians' disinclination to probe for
      emotional difficulty.

PMID- 1618172
TI  - A longitudinal study of the development of anticipatory nausea and vomiting in
      cancer chemotherapy patients: the role of absorption and autonomic perception.
AB  - We interviewed 70 cancer patients receiving chemotherapy at home before their
      second treatment session to obtain baseline measures of absorption, autonomic
      perception, depression, state-trait anxiety, and basic demographic information.
      Patients were then interviewed before each of their next six treatment sessions,
      at which time measures of depression, state anxiety, severity and duration of
      postchemotherapy nausea and/or vomiting (PCNV), and experience of anticipatory
      nausea and/or vomiting (ANV) were obtained. Previous findings suggesting that
      motion sickness, trait anxiety, depression, sex of subject, and age are
      predictors of the development of ANV were not replicated. Patients with ANV did
      score significantly higher on measures of absorption and autonomic perception
      than patients who did not develop ANV. Those variables hypothesized to mediate
      conditioning (i.e., toxicity of treatment drugs, severity of PCNV, levels of
      state anxiety) accurately predicted which patients developed ANV. Absorption and
      autonomic perception added significantly to the prediction.

PMID- 1618173
TI  - The health belief model and adolescents with insulin-dependent diabetes mellitus.
AB  - We tested the predictive utility of the health belief model (HBM) for adherence
      with a complex, ongoing medical regimen in the context of a chronically ill
      youthful population (56 adolescent outpatients with insulin-dependent diabetes
      mellitus; mean age = 14 years). A three-construct model of health beliefs was
      tested: Threat (perceived susceptibility combined with severity), Benefits-Costs,
      and Cues to seek treatment. Multiple indicators of compliance were used, and
      metabolic control was measured by glycosylated hemoglobin. The Benefits-Costs and
      Cues constructs were related to compliance in the theoretically expected positive
      direction. Threat interacted with Benefits-Costs in the prediction of compliance
      and with Cues in the prediction of metabolic control. The greatest compliance was
      achieved with low perceived Threat and high perceived Benefits-Costs. Poor
      metabolic control was associated with high Threat and Cues. As age increased,
      adherence to the exercise, injection, and frequency components of the regimen
      decreased.

PMID- 1618174
TI  - Correlates of hypoglycemic fear in type I and type II diabetes mellitus.
AB  - We examined whether fear of hypoglycemia in insulin-dependent diabetes mellitus
      was associated with (a) higher levels of trait anxiety and general fearfulness,
      (b) difficulty in differentiating symptoms of anxiety and hypoglycemia, and (c)
      past experience with hypoglycemia. Joslin Diabetes Center outpatients with Type I
      and Type II diabetes (N = 232), all requiring insulin, were surveyed. Type I
      patients experienced significantly more fear of hypoglycemia than Type II
      patients. For the Type I and Type II groups, higher scores on the Worry subscale
      of the Hypoglycemia Fear Survey (HFS-W) were associated with higher levels of
      trait anxiety and fear. Higher scores on the Behavior subscale (HFS-B) were
      associated with higher levels of fear. Among Type I subjects only, HFS-W scores
      were also positively associated with past hypoglycemic experience and with
      difficulty in differentiating anxiety and hypoglycemic symptoms. These latter
      relations remained significant even after the variance resulting from trait
      anxiety and fear was removed. Other significant associations with HFS-B scores
      were not observed.

PMID- 1618175
TI  - Family/media approach to HIV prevention: results with a home-based, parent-teen
      video program.
AB  - We describe the first study with a home-based HIV prevention video program for
      parents and young teenagers. The objectives of the program are to inform parents
      and teenagers about the causes and prevention of HIV infection and other sexually
      transmitted diseases, to increase family problem-solving skills, and to increase
      teen problem-solving and assertiveness skills. The objectives pertain to the
      goals of increasing skills needed to help teenagers avoid or manage high-risk
      behaviors and situations. Forty-five families with at least one 12- to 14-year
      old were randomly assigned to either experimental (receive video program) or
      control (no video) conditions in a pretest-posttest design. After 6 months
      (Follow-Up 1), the experimental and control families were reassessed. The control
      families next received the video program, and the control families were assessed
      again (Follow-Up 2). The results indicate increases in parent and teen knowledge
      and skills only with video viewing. Approaches to improving the video program,
      particularly with teenagers, are discussed.

PMID- 1618176
TI  - 3-alkyl GABA and 3-alkylglutamic acid analogues: two new classes of
      anticonvulsant agents.
AB  - Recently we showed that 3-alkyl-4-aminobutanoic acids are in vitro activators of
      brain L-glutamic acid decarboxylase (GAD) that show anticonvulsant activity.
      Since activation of GAD leads to increased concentrations of the inhibitory
      neurotransmitter gamma-aminobutyric acid (GABA) in vitro, these compounds could
      represent a new class of anticonvulsant agents. Here it is shown that 3
      alkylglutamic acid analogues also activate GAD and that all of the compounds in
      both series are active anticonvulsant agents against low intensity electroshock
      in mice. The most active compound, 3-isobutyl GABA, was tested further against
      maximal electroshock in mice and was shown to be very potent after both
      intravenous and oral administration without causing ataxia. It is not known if
      brain GABA levels are elevated in vivo by administration of these compounds or if
      the mechanism of anticonvulsant activity is related to their ability to activate
      GAD.

PMID- 1618178
TI  - Characteristics of dorsal and ventral striatal kindling in rats.
AB  - We examined the characteristics of kindling of seizures with stimulation of the
      dorsal or ventral striatum in rats. Different groups of rats carried electrodes
      directed towards the nucleus accumbens or the head, middle, or tail of the
      caudate. Thresholds for afterdischarge (AD) were high at all sites, and
      stimulation often produced forced motor responses (motor responses that occurred
      during the stimulation and were not a consequence of kindling). Kindling at sites
      in the accumbens proceeded more slowly than at the sites in the caudate, which
      did not differ among themselves. The duration of accumbens seizures increased
      dramatically over the course of kindling, whereas the duration of caudate
      seizures remained relatively short and invariant. Although the kindled seizures
      resembled seizures kindled from limbic sites, they also contained aspects of
      seizures triggered from stimulation of the anterior neocortex. We conclude that
      striatal kindling comprises elements of both limbic and neocortical kindling.

PMID- 1618177
TI  - Sustained and selective block of IPSPs in brain slices from rats made epileptic
      by intrahippocampal tetanus toxin.
AB  - A small dose of tetanus toxin (2-5 ng; 10 mouse LD50) injected into the rat
      hippocampus produces a chronic epileptic syndrome in which epileptic discharges
      recur intermittently for 6-8 weeks. Hippocampal slices prepared during this
      period and maintained in vitro generate both evoked and spontaneous epileptic
      discharges. The present study used slices prepared 8-18 days after injection of
      tetanus toxin or vehicle solution into both hippocampi to test whether or not
      synaptic inhibition was selectively impaired in this experimental epilepsy.
      Intracellular recordings were made from CA3 pyramidal layer neurones within the
      tetanus toxin focus, which was identified by field potential recordings of
      synchronous bursts evoked by afferent stimulation. The intrinsic properties of
      these neurones did not differ from comparable cells in control-injected rats. All
      cells generated excitatory postsynaptic potentials (EPSPs) following stimulation
      of stratum radiatum in CA3. In control slices EPSPs were followed by a 'fast'
      inhibitory postsynaptic potential (IPSP), peaking at 25-30 ms, with a mean
      amplitude (+/- SEM) of -6.7 mV (+/- 0.66). In the epileptic slices these were
      absent, and the EPSP prolonged so that the potential at 30 ms was a
      depolarisation of +6.6 mV (+/- 2.75). The slow IPSP at 120 ms dropped to -0.27 mV
      (+/- 0.18) from -3.97 mV (+/- 1.43) (11 cells in each group). The loss of IPSPs
      cannot be attributed to a shift in reversal potentials in the toxin-injected
      group because no IPSPs were unmasked by current injection (n = 11). IPSPs also
      occurred spontaneously in the neurones in control slices, with a mean amplitude
      of -1.30 mV. Their frequency decreased by a factor of 13 in cells from the
      chronic focus induced by tetanus toxin (P less than 0.0001, analysis of
      variance), but their amplitude did not change significantly (mean of -1.22 mV).
      Spontaneous EPSPs were significantly more frequent and slightly smaller in the
      toxin-injected group (mean amplitudes 1.35 and 1.13 mV respectively). Together
      these studies support the hypothesis that the chronically recurring seizures
      induced by low doses of tetanus toxin can be attributed to a substantial,
      persistent and selective reduction of inhibitory neurotransmission in the
      hippocampus.

PMID- 1618179
TI  - Loreclezole monotherapy in patients with partial seizures.
AB  - Monotherapy is preferable in the treatment of epilepsy; a new antiepileptic drug
      has to be checked on its efficacy in monotherapy. In this study patients who had
      successfully been treated with loreclezole in previous studies were gradually
      withdrawn from their antiepileptic comedication. Nine patients participated in
      the study. Reduction of comedication was well tolerated in all, no serious side
      effects occurred. In 6 patients seizure frequency remained unchanged, i.e.,
      within 50% limits. Two patients experienced a clear increase in seizure
      frequency. In 2 patients reintroduction of a second antiepileptic drug was
      mandatory. One patient experienced a further reduction in seizure frequency when
      monotherapy was reached. This observation indicates efficacy of loreclezole, also
      in monotherapy.

PMID- 1618180
TI  - Lamotrigine-induced carbamazepine toxicity: an interaction with carbamazepine
      10,11-epoxide.
AB  - We report an interaction between lamotrigine (LTG), a new antiepileptic drug
      (AED), and carbamazepine (CBZ) and its primary metabolite CBZ-10,11-epoxide (CBZ
      E) in 9 consecutive patients (5 male, 4 female, aged 19-31 years). After
      introduction of LTG (median daily dose 200 mg, range 100-300 mg) the mean serum
      CBZ-E concentration increased by 45% (P less than 0.01) and the CBZ-E/CBZ ratio
      increased by 19% (P less than 0.02). In 4 patients these changes were associated
      with clinical toxicity (dizziness, nausea, diplopia). The possibility of an
      increase in serum CBZ-E concentrations needs to be considered if toxicity
      symptoms develop when LTG is added to CBZ therapy.

PMID- 1618181
TI  - In vitro studies on the broad spectrum anticonvulsant loreclezole in the
      hippocampus.
AB  - In hippocampal slices from guinea-pig a paired-pulse stimulation protocol was
      used to examine the effects of loreclezole, R-(+)-etomidate, phenobarbital and
      pentobarbital on orthodromic and antidromic GABAergic neuronal inhibition in the
      CA1 region. All four compounds increased orthodromic GABAergic inhibition, with R
      (+)-etomidate and pentobarbital inducing a quantitatively larger effect than
      loreclezole and phenobarbital. Only R-(+)-etomidate and pentobarbital increased
      antidromic GABAergic inhibition. We propose that all four compounds are
      anticonvulsant by increasing feed-forward dendritic GABAergic inhibition, whilst
      only the sedative/hypnotic compounds (R-(+)-etomidate, pentobarbital) increase
      feedback recurrent GABAergic inhibition. Loreclezole was also shown to inhibit
      'low Ca2+' and 'low Mg2+' epileptogenesis at similar concentrations to those
      active on inhibition. Thus loreclezole may possess other pharmacodynamic
      properties, beyond its ability to increase feed-forward GABAergic neuronal
      inhibition, which contribute to its antiepileptic action.

PMID- 1618182
TI  - Repeated anticonvulsant testing: contingent tolerance to diazepam and clobazam in
      kindled rats.
AB  - The acute anticonvulsant efficacy of diazepam (1.5 mg/kg, i.p.) was evaluated by
      repeated test injection in kindled rats subcutaneously implanted with diazepam
      filled or empty silastic tubes for 3 weeks. Tolerance developed to acute test
      injections in both diazepam- and sham-implanted rats. Tolerance developed to a
      lesser extent in another group of diazepam-implanted rats which did not receive
      acute intermittent anticonvulsant tests. The hypothesis that contingent tolerance
      had developed to the anticonvulsant actions of benzodiazepines (diazepam, 1.5
      mg/kg, i.p. and clobazam, 10 mg/kg, i.p.) in kindled rats given acute
      intermittent injections was investigated using a 'before-after' design.
      Significant contingent tolerance developed in rats which received intermittent
      benzodiazepine treatment before, but not after, amygdala stimulation. Tolerance
      developed to different extents depending on the seizure measure evaluated
      (forelimb clonus duration, amygdala afterdischarge duration, motor seizure
      latency and duration, and seizure stage). Contingent tolerance to both
      benzodiazepines developed at a similar rate. The findings suggest that contingent
      tolerance may contribute a sizeable component to the overall functional
      benzodiazepine tolerance measured in long-term anticonvulsant drug studies in
      kindled rats. Several questions regarding contingent tolerance phenomena are
      posed and the implications of these findings for studies using repeated
      anticonvulsant testing are discussed.

PMID- 1618183
TI  - The effect of training on endurance and the cardiovascular responses of
      individuals with paraplegia during dynamic exercise induced by functional
      electrical stimulation.
AB  - Endurance for dynamic exercise, cardiac output, blood pressure, heart rate,
      ventilation, and oxygen consumption was measured in eight individuals with
      paraplegia at the end of 4-min bouts of exercise on a friction braked cycle
      ergometer. Movement of the subjects' legs was induced by electrically stimulating
      the quadriceps, gluteus maximus and hamstring muscles with a computer-controlled
      biphasic square--wave current at a frequency of 30 Hz. The friction braked cycle
      ergometer was pedalled at work rates which varied between 0 and 40 W.
      Measurements were repeated after 3 and 6 months to assess the affect of training.
      After 3 months of training it was found that endurance increased from 8 min at a
      work rate of 0 W to 30 min at a work rate of 40 W. Compared to the cardiovascular
      responses in non-paralyzed subjects, computerized cycle ergometry was found to be
      associated with higher relative stresses for a given level of absolute work. Mean
      blood pressure, for example, increased by over 30% during maximal work in
      individuals with paralysis compared to the typical response obtained for able
      bodied subjects. Analysis of the data showed that instead of the 20-30% metabolic
      efficiency commonly reported for cycle ergometry, the calculated metabolic
      efficiency during computer-controlled cycle ergometry was only 3.6%.

PMID- 1618184
TI  - Oxygen delivery does not limit peak running speed during incremental downhill
      running to exhaustion.
AB  - Oxygen consumption (VO2), ventilation (VI), respiratory exchange ratio (R),
      stride frequency and blood lactate concentrations were measured continuously in
      nine trained athletes during two continuous incremental treadmill runs to
      exhaustion on gradients of either 0 degree or -3 degrees. Compared to the run at
      0 degree gradient, the athletes reached significantly higher maximal treadmill
      velocities but significantly lower VO2, VI, R and peak blood lactate
      concentrations (P less than 0.001) during downhill running. These lower VO2 and
      blood lactate concentrations at exhaustion indicated that factors other than
      oxygen delivery limited maximal performance during the downhill run. In contrast,
      stride frequencies were similar at each treadmill velocity; the higher maximal
      speed during the downhill run was achieved with a significantly longer stride
      length (P less than 0.001); maximal stride frequency was the same between tests.
      Equivalent maximal stride frequencies suggested that factors determining the rate
      of lower limb stride recovery may have limited maximal running speed during
      downhill running and, possibly, also during horizontal running.

PMID- 1618185
TI  - Effects of training on iron status in cross-country skiers.
AB  - Haematological changes were studied in cross-country skiers during a 33-week
      training season (7 h a week). The daily amounts of training were calculated from
      the duration and the intensity of the exercise and then used to estimate training
      responses associated with a first order transfer function. The profile of system
      training responses (STR) was determined by convolution between the amounts of
      training and a first-order transfer function. Linear regressions were used to
      determine correlation coefficients between STR and iron status indices. Among the
      values for the time constants of decay, the one giving the best fit between STR
      and iron status indices was chosen. A relationship was noted between on the one
      hand STR and changes in serum ferritin concentration ([FERR]) and on the other
      hand STR and change in mean cell volume (MCV). The [FERR] was decreased and MCV
      was increased by training. It is suggested that a decrease in [FERR] could have
      been related to a decrease in total body iron stores. However, large and rapid
      changes in [FERR] could not have been a reflection of changes in total body iron
      stores. Equilibrium between [FERR] and total body iron stores could have been
      temporarily altered by the effects of training. Moreover, iron stores did not
      seem to have been sufficiently depleted to restrict erythropoiesis. The MCV
      increased slightly in response to intense training suggesting that training
      enhances the proportion of young erythrocytes.

PMID- 1618186
TI  - Thermoregulatory stress during rest and exercise in heat in patients with a
      spinal cord injury.
AB  - Twelve subjects with spinal cord injuries and four controls (all male) were
      exposed to heat while sitting at rest or working at each of three environmental
      temperatures, 30, 35 and 40 degrees C, with a relative humidity of 50%. Exercise
      was accomplished at a load of 50 W on a friction-braked cycle ergometer which was
      armcranked or pedalled. Functional electrical stimulation of the legs was
      provided to the subjects with quadriplegia and paraplegia to allow them to pedal
      a cycle ergometer. The data showed that individuals with quadriplegia had the
      poorest tolerance for heat. As an example, in this group, accomplishing armcrank
      ergometry while working at an environmental temperature of 40 degrees C resulted
      in an increase in aural temperature of 2 degrees C in 30 min. The aural
      temperature of individuals with paraplegia working for the same length of time
      under the same conditions rose approximately 1 degree C. There was virtually no
      change in the aural temperature in the control subjects.

PMID- 1618187
TI  - Aerobic endurance, anatomical factors and time properties of laser Doppler
      recorded skin postocclusive hyperaemia.
AB  - Aerobic endurance capacity is partly dependent on blood supply to and metabolic
      capacity of the active muscles. Recordings of lower limb skin postocclusive
      hyperaemia with laser Doppler flowmetry can differentiate between patients with
      lower limb atherosclerosis and healthy controls. In this study, we investigated
      the relationship between aerobic endurance, calf volume, common femoral artery
      diameter and time properties of the postocclusive laser Doppler curve. A group of
      16 healthy male subjects with values for aerobic endurance which varied from
      those of untrained men to elite endurance trained athletes were examined.
      Duration of laser Doppler recorded skin postocclusive hyperaemia was
      significantly correlated to both aerobic power and anaerobic threshold (P less
      than 0.01). Hyperaemia in subjects with large common femoral artery diameter was
      of shorter duration (P less than 0.05). The peak and mean body mass related blood
      flow during hyperaemia was correlated to anaerobic threshold (P less than 0.05).
      These results were in agreement with previous studies indicating an effect of
      endurance training on the blood supply to the muscles concerned.

PMID- 1618188
TI  - Studies on the immediate and delayed leucocytosis elicited by brief (30-min)
      strenuous exercise.
AB  - Eight healthy male volunteers exercised for two 30-min sessions starting 3 h
      apart on an electronically braked cycle ergometer at a work load (mean 155.9 W,
      SD 33.4 W) which required an oxygen consumption that was 70% of their maximal
      rate of oxygen uptake. Venous blood samples were taken through an indwelling
      cannula over a period of 6 h beginning shortly before the first bout of exercise
      and were analysed for routine haematological parameters and for lactate,
      noradrenaline, adrenaline and cortisol. Both bouts of exercise induced an
      immediate leucocytosis due to rises in lymphocytes and neutrophils but only the
      first exercise bout induced a substantial delayed neutrophilia. In at least five
      subjects, changes in lymphocyte and platelet numbers were correlated (Spearman's
      rank procedure, P less than 0.05) with simultaneous changes in the plasma
      concentrations of lactate, noradrenaline and adrenaline over the 6-h period
      studied. Increases in the plasma concentration of cortisol due to exercise
      correlated positively with the percentage changes in neutrophil numbers at 3 h
      and 6 h. These results are consistent with the suggestion that the immediate and
      delayed leucocytosis induced by exercise are mediated respectively by
      catecholamine and by cortisol.

PMID- 1618189
TI  - Changes in the leucocyte count during and after brief intense exercise.
AB  - Twelve healthy male volunteers exercised at 200 W on a cycle ergometer for 8 min
      or until exhausted, if sooner. Retrospectively, subjects fell into two groups.
      During the last minute of exercise at 200 W, those in group 1 (n = 5) had a mean
      respiratory exchange ratio (R) of 1.06 (SD 0.01) and were working at a mean of
      79% (SD 4%) of their maximum oxygen consumption (VO2max) as measured in a
      separate incremental load test. For subjects in group 2 (n = 7), R was 1.31 (SD
      0.08) and their VO2 was maximal (mean 101%. SD 3%). Plasma lactate, and
      adrenaline concentrations rose to higher levels during exercise in subjects in
      group 2 than in those in group 1. At the finish of exercise, the leucocyte count
      and the plasma lactate concentration immediately began to fall in subjects in
      group 1 whereas in group 2 subjects both rose for several minutes before falling.
      Plasma catecholamine concentrations fell rapidly in both groups during recovery.

PMID- 1618191
TI  - Phosphorus-31 magnetic resonance spectroscopy of forearm flexor muscles in
      student rowers using an exercise protocol adjusted for differences in cross
      sectional muscle area.
AB  - To assess exercise energy metabolism of forearm flexor muscles in rowers, six
      male student rowers and six control subjects matched for age and sex were studied
      using phosphorus-31 magnetic resonance spectroscopy (31P-MRS). Firstly, to adjust
      for the effect of differences in cross-sectional muscle area, the maximal cross
      sectional area (CSAmax) of the forearm flexor muscles was estimated in each
      individual using magnetic resonance imaging. Multistage exercise was then carried
      out with an initial energy production of 1 J.cm-2 CSAmax for 1 min and an
      increment of 1 J.cm-2 CSAmax every minute to the point of muscle exhaustion. A
      series of measurements of 31P-MRS were performed every minute. The CSAmax was
      significantly greater in the student rowers than in the control subjects [19.8
      (SD 2.2) vs 17.1 (SD 1.2) cm2, P less than 0.05]. The absolute maximal exercise
      intensity (J.min-1) was greater in the rowers than in the control subjects.
      However, the maximal exercise intensity per unit of muscle cross sectional area
      (J.min-1.cm-2) was not significantly different between the two groups. During
      mild to moderate exercise intensities, a decrease in phosphocreatine and an
      increase in inorganic phosphate before the onset of acidosis were significantly
      less in the rowers, indicating a requirement of less adenosine 5'-diphosphate to
      drive adenosine 5'-triphosphate production. The onset of acidosis was also
      significantly delayed in the rowers. No difference was observed in forearm blood
      flow between the two groups at the same exercise intensity (J.min-1.cm
      2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618190
TI  - Exogenous carbohydrate oxidation from maltose and glucose ingested during
      prolonged exercise.
AB  - Intestinal perfusion studies have shown that glucose absorption from maltose
      occurs faster than from isocaloric glucose. To determine whether ingested maltose
      might be a superior source of carbohydrate (CHO) for endurance athletes, we
      compared the rates of gastric emptying, absorption and oxidation of 15 g.100 ml-1
      solutions of maltose and glucose. Six endurance-trained cyclists drank 1200 ml of
      either U-14C maltose or U-14C glucose as a 400-ml loading bolus immediately
      before exercise, and as 8 x 100-ml drinks at 10-min intervals during a 90-min
      ride at 70% of maximal oxygen consumption. The rates of gastric emptying [maltose
      690 (SD 119) ml.90 min-1; glucose 655 (SD 93) ml.90 min-1], the appearance of U
      14C label in the plasma, and the peak rates of exogenous CHO oxidation [maltose
      1.0 (SD 0.09) g.min-1; glucose 0.9 (SD 0.09) g.min-1] were not significantly
      different. Further, the 51 (SD 8) g of maltose and the 49 (SD 9) g of glucose
      oxidised during exercise were similar. Each accounted for approximately 20% of
      the total CHO oxidised during the 90 min of exercise. Since only half of the CHO
      delivered to the intestine was oxidised in the 90-min ride (maltose 49%; glucose
      50%), we conclude that neither the rate of gastric emptying, nor digestion
      limited the rate of ingested CHO utilisation during the early stages of
      exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618192
TI  - Relationship between record time and maximal oxygen consumption in middle
      distance running.
AB  - The relationship between record time (tr) and maximal oxygen uptake (VO2max) has
      been examined in 69 male physical education students who had taken part in 800-m
      and 1500-m footraces. It was found that tr and VO2max were inversely related. The
      relationships tr = f(VO2max) have been fitted by two exponential equations: tr
      (1500 m) = 698e-0.0145VO2max; tr (800 m) = 272e-0.011VO2max; P less than 0.001. A
      mathematical formulation of the energy conservation principle in supramaximal
      running, based on the exponential increase of the oxygen uptake as a function of
      time with a rate constant of 0.025 s-1 has been applied to the tr calculation
      from VO2max. As calculated tr were highly correlated to measured tr (P less than
      0.001), it was concluded that the relationships tr = f(VO2max) can be interpreted
      on the basis of the model described in this study.

PMID- 1618193
TI  - Age-specific correlation analysis of longitudinal physical fitness levels in men.
AB  - This study investigated the age-specific tracking of adult health- and
      performance-related fitness scores. In addition, the independent contribution of
      adolescent physical characteristics to the explanation of adult fitness scores
      was also studied. The sample consisted of 173 adults observed at age 30 years.
      These subjects had been followed at annual intervals from age 13 to age 18 years
      and were remeasured at age 30 years. At each age nine fitness tests were
      administered together with the recording of anthropometric dimensions, biological
      maturation, sports participation and family characteristics. Tracking was
      measured by the inter-age correlations at each age between 13 and 18 years and
      the performance scores at 30 years. The independent contribution of
      characteristics observed during adolescence to the explanation of adult fitness
      was investigated through stepwise multiple regression analysis and discriminant
      analysis with the adult fitness scores as the dependent variables and the
      fitness, maturation, anthropometric characteristics, sports participation and
      family background as the independent variables. Tracking between age 13 and age
      30 years was moderately high (46% of variance explained) for flexibility, low to
      moderate (between 19% and 27% of variance explained) for the other fitness
      parameters and low for pulse recovery and static strength (7% to 11% of variance
      explained). Between age 18 and age 30 years the tracking was high for
      flexibility, moderately high for explosive and static strength, and moderate for
      the other fitness parameters except for pulse recovery. The amount of variance of
      adult fitness levels explained increased significantly when other characteristics
      observed during adolescence entered the regressions or discriminant
      functions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618194
TI  - Aerobic capacity of forestry workers and physical demands of forestry operations.
AB  - The present study aimed at evaluating the aerobic capacities of forestry workers
      and the physical demands of their occupation. A submaximal cycle ergometer test
      was conducted on 22 male forestry workers and 15 male sedentary office workers
      aged 40-59 years. The slope of the regression line of heart rates on given
      exercise intensities was significantly smaller in the forestry workers than in
      the office workers. The mean heart rate of the forestry workers was 9 beats.min-1
      less than that of the office workers at the initial exercise intensity of 50 W.
      This difference increased to 25 beats.min-1 at 175 W. For 6 of the 22 forestry
      workers, heart rates were recorded continuously during a usual workday. The
      metabolic rates, as multiples of basal metabolic rate (in met) of various
      forestry activities were estimated from the average heart rate during the
      activity of interest and a predicted maximal oxygen consumption of the subject
      obtained from a submaximal cycle ergometer test. The mean energy expenditure was
      4.5 met with a range of 3.3-6.3 met for an average of 509 min at a worksite.
      These results indicated that the forestry workers had high aerobic capacities and
      this was ascribed to the high physical demands of their occupation.

PMID- 1618195
TI  - Oxygen availability and motor unit activity in humans.
AB  - Six men were studied to determine the interrelationships among blood supply,
      motor unit (MU) activity and lactate concentrations during intermittent isometric
      contractions of the hand grip muscles. The subjects performed repeated
      contractions at 20% of maximal voluntary contraction (MVC) for 2 s followed by 2
      s rest for 4 min with either unhindered blood circulation or arterial occlusion
      given between the 1st and 2nd min. The simultaneously recorded intramuscular MU
      spikes and surface electromyogram (EMG) data indicated that mean MU spike
      amplitude, firing frequency and the parameters of surface EMG power spectra (mean
      power frequency and root mean square amplitude) remained constant during the
      experiment with unhindered circulation, providing no electrophysiological signs
      of muscle fatigue. Significant increases in mean MU spike amplitude and frequency
      were, however, evident during the contractions with arterial occlusion. Similar
      patterns of significant changes in the surface EMG spectra parameters and venous
      lactate concentration were also observed, while the integrated force-time curves
      remained constant. These data would suggest that the metabolic state of the
      active muscles may have played an important role in the regulation of MU
      recruitment and rate coding patterns during exercise.

PMID- 1618196
TI  - Changes in the concentrations of Na+, K+ and Cl- in secretion from the skin
      during progressive increase in exercise intensity.
AB  - A simple method for sampling skin secretion in 1-min periods was developed for
      investigating the effects of progressive increases in exercise intensity on Na+,
      K+ and Cl- secretions from the skin of the forearm. Ten healthy male subjects
      performed exercise consisting of eight stepwise increases in intensity from 50 to
      225 W, with a 25-W increase at each step. Exercise at each step was for 3 min
      followed by a 1-min recovery period. Samples of blood and skin secretion were
      taken during the recovery period. Significant positive correlations were found
      between the mean concentrations of Na+ and Cl- and between those of K+ and Cl- in
      the skin secretion. The concentrations of electrolytes in the skin secretion also
      showed significant correlations with the blood lactate concentrations. The
      inflection points for secretions of Na+, K+ and Cl- were 4.04, 3.61 and 3.83
      mmol.l-1 of blood lactate; 64.42, 61.96 and 62.14% of maximal oxygen consumption
      (VO2max); and exercise intensities of 123.01, 117.65 and 125.07 W, respectively.
      No significant differences were observed between the value of 67.27% of VO2max or
      134.00W at the onset of blood lactate accumulation (OBLA) and the inflection
      points. From these results we concluded that changes in electrolyte
      concentrations in skin secretion during incremental exercise according to this
      protocol were closely related with the change in the blood lactate concentration,
      and that the inflection points for electrolytes may have been near the exercise
      intensity at OBLA.

PMID- 1618197
TI  - Acute myocardial infarction (AMI) in Finland--baseline data from the FINMONICA
      AMI register in 1983-1985.
AB  - The acute myocardial infarction (AMI) register of the FINMONICA study, the
      Finnish part of the WHO-coordinated multinational MONICA project, operates in the
      provinces of North Karelia and Kuopio in eastern Finland and in Turku, Loimaa and
      in communities around Loimaa in southwestern Finland. The AMI register serves as
      an instrument for the assessment of trends in mortality from coronary heart
      disease (CHD) and of the incidence and attack rates of AMI among 25-64-year-old
      residents of the study areas. This report describes the methods used in the
      FINMONICA AMI register and the findings during the first 3 years of the study, in
      1983-1985. The criteria of the multinational WHO MONICA project were used in the
      classification of fatal events and in the diagnosis of non-fatal definite AMI,
      but based on the experience within the FINMONICA study, stricter diagnostic
      criteria than those originally described in the WHO MONICA protocol were used for
      non-fatal possible AMI. This led to a marked improvement in the comparability of
      the data from the three study areas with regard to the incidence and attack rates
      of non-fatal AMI. During the 3-year period the total number of registered events
      was 6266 among men and 2092 among women. Among men the incidence and attack rates
      of AMI and mortality from CHD were higher in eastern than in southwestern
      Finland. Also among women the incidence and attack rates of AMI were higher in
      eastern than in southwestern Finland, whereas there was no regional difference in
      mortality from CHD among women. The mortality findings of the FINMONICA AMI
      Register were in good agreement with the official CHD mortality statistics of
      Finland.

PMID- 1618198
TI  - Incidence of heart failure in eastern Finland: a population-based surveillance
      study.
AB  - Heart failure is a frequent disorder, but there is little population-based data
      available on its incidence. We have studied the incidence of heart failure in 45
      74-year-old inhabitants in four rural communities in eastern Finland (total
      population 37,600; 11,000 45-74 years of age). The aim was to identify all
      patients in whom symptoms had started and in whom a diagnosis of heart failure
      had been established during a 2-year study period. General physicians, working in
      community health centres in the study area, referred all their patients with
      suspected heart failure to the study. A register of drug reimbursement, hospital
      discharge and other health care registers were used to identify patients who had
      not been referred. The Boston criteria were used to verify the diagnosis. One
      hundred and thirteen subjects (51 men and 62 women) were enrolled, of whom 51 (38
      men and 13 women) had definite heart failure. Age-adjusted incidence rate of
      heart failure (per 1000 . year-1) was 4.0 in men and 1.0 in women, and the
      incidence rates increased with age in both sexes. Coronary heart disease or
      hypertension was evident in 41 (80%) cases. The striking difference in the
      incidence rates between men and women is probably explained by the excessive
      occurrence of coronary heart disease among men in eastern Finland.

PMID- 1618199
TI  - Morning peak in the incidence of myocardial infarction: experience in the ISIS-2
      trial. ISIS-2 (Second International Study of Infarct Survival) Collaborative
      Group.
AB  - To investigate the circadian pattern of acute myocardial infarction (MI) in a
      large international patient population, the time of day of the onset of symptoms
      was prospectively determined in 12,163 consecutive patients randomized in the
      ISIS-2 Trial (Second International Study of Infarct Survival). Overall, there was
      a marked circadian variation (P less than 0.001) in the incidence of MI
      characterized by a sharp increase from 0600 h to 0800 h, with a peak period from
      0800 h to 1100 h followed by a gradual decline from 1100 h to 1800 h. During the
      evening and night there was a steady trough, with no evidence of a second peak.
      Although there was some scatter, this circadian pattern was similar among
      patients of five different geographic regions on three continents and in various
      subcategories of patients defined with respect to age, gender, previous MI, and
      aspirin intake prior to MI. The circadian pattern of diabetics, however, was
      different compared with non-diabetics (P less than 0.005, adjusted less than
      0.01), and it demonstrated no significant variation. This increased morning
      incidence of MI indicates specific triggering mechanisms that are particularly
      likely to occur during, or just before, that time of day. Further investigation
      of physiological changes during the day is needed to identify any such triggers
      of MI and so perhaps to aid in improving preventive strategies of the disease.

PMID- 1618201
TI  - The accuracy of decision-making of a semi-automatic defibrillator during cardiac
      arrest.
AB  - The accuracy of decision-making of a semi-automatic defibrillator was assessed at
      57 cardiac arrests in 55 patients. The initial rhythm was ventricular
      fibrillation at 40 arrests and was correctly identified in 37 (sensitivity
      92.5%). In the other 17 arrests initial rhythms were not ventricular fibrillation
      and 16 were correctly identified (specificity 94%). Continuous
      electrocardiographic recordings of the arrests were analysed in 8-12 s segments:
      of 432 segments showing ventricular fibrillation, 352 were correctly identified
      (sensitivity 81%); 3895 of 4139 segments showing rhythms other than ventricular
      fibrillation were correctly identified (specificity 94%). The percentage accuracy
      of detection of ventricular fibrillation varied from 0-100% (mean 91%) and for
      non-ventricular fibrillation from 51-100% (mean 92%). When 104 segments of
      ventricular fibrillation and 470 segments of non-ventricular fibrillation with
      cardiopulmonary resuscitation artefact were excluded from the analysis, a
      sensitivity of 91% and specificity of 96% were obtained. Thus the detection of
      cardiac arrest rhythms using a microprocessor based detection system for patients
      with cardiac arrest has a high sensitivity for ventricular fibrillation and
      specificity for non-ventricular fibrillation.

PMID- 1618200
TI  - Late potentials after acute myocardial infarction. Performance of different
      criteria for the prediction of arrhythmic complications.
AB  - In order to compare different criteria for the definition of late potentials in
      patients after myocardial infarction, three signal averaged ECG variables,
      duration of the signal-averaged QRS complex (QRS), root-mean-square voltage of
      the terminal 40 ms (RMS-40), and the duration of low amplitude signals less than
      40 microV (LASD-40), were assessed in 332 survivors of acute myocardial
      infarction who were followed-up for at least 6 months, during which 12 patients
      died suddenly and 14 suffered symptomatic sustained ventricular tachycardia. The
      associations of the three variables with arrhythmic events were analysed in the
      total population, in infarct site and age-specific subgroups. The sensitivity and
      specificity for the prediction of arrhythmic events was computed (for all
      dichotomy points) and compared with nine published criteria for late potentials
      based on the same three variables. Analysis showed that (a) the total signal
      averaged QRS duration was a better predictor of arrhythmic events than the other
      two variables, (b) for arrhythmic events in cases of anterior infarctions, higher
      RMS-40 dichotomy limits and lower QRS and LASD-40 dichotomy limits were needed
      for cases of inferior infarction, (c) a multivariate stratification of arrhythmic
      events based on all three variables performed better in the anterior infarction
      population than in the inferior infarction population, (d) the strategy defining
      late potentials, which requires that two variables reach critical values, is
      better than the strategies that require that any one or all three variables reach
      critical values, (e) all the definitions of late potentials performed differently
      in the populations with anterior as compared to inferior infarctions; to identify
      groups at similar risk of arrhythmic events, different criteria defining late
      potentials should be used in these subpopulations.

PMID- 1618202
TI  - Magnetocardiographic non-invasive localization of accessory pathways in the Wolff
      Parkinson-White syndrome by a multichannel system.
AB  - Electrical activity can be localized by magnetocardiography (MCG) non-invasively.
      In this study a 37-SQUID (Super Conducting Quantum Interference Device) sensor
      multi-channel system (KRENIKON) was used to assess the potential of
      magnetocardiography to localize accessory pathways with a multichannel system.
      Seven WPW patients were studied by means of magnetocardiography. Prior to the MCG
      recordings, the site of the accessory pathway had been determined in all patients
      by invasive catheter mapping. MR images of the heart were used for anatomical
      correlation. The magnetocardiographic localization of the accessory pathway
      corresponded with catheter mapping within 2.1 cm on average (total range: 0-5
      cm). This is thus, a promising new method for non-invasive localization of
      accessory pathways in WPW patients.

PMID- 1618203
TI  - Amyloid cardiomyopathy in systemic non-hereditary amyloidosis. Clinical,
      echocardiographic and electrocardiographic findings in 30 patients with AA and 24
      patients with AL amyloidosis.
AB  - To underline the role of echocardiography in the detection of cardiac involvement
      in patients with amyloidosis, physical examination, echocardiography and
      electrocardiography were performed in 30 patients with AA amyloidosis (amyloid
      protein A, associated with chronic inflammatory disease, usually without
      cardiomyopathy) and 24 patients with AL amyloidosis (the immunoglobulin light
      chain derived type, often associated with cardiomyopathy). All patients had
      histological confirmation of amyloidosis by rectal or subcutaneous abdominal fat
      biopsy. The combination of increased thickness of the left ventricular posterior
      wall and interventricular septum with a low voltage electrocardiographic pattern
      is highly specific for cardiac amyloidosis and was found in 3/30 (10%) of the AA
      patients and in 13/24 (54%) of the AL patients. The echocardiographic
      abnormalities were strongly related to the degree of clinical heart disease,
      showing mildly or moderately increased wall thickness in the early asymptomatic
      phase or severe thickening and hypokinesia of the left ventricular posterior wall
      and interventricular septum in clinically apparent cardiac dysfunction.
      Echocardiography appears to be a sensitive test for the detection of cardiac
      involvement in amyloidosis, in symptomatic as well as asymptomatic patients.

PMID- 1618204
TI  - Epidural spinal electrical stimulation for severe angina: a study of its effects
      on symptoms, exercise tolerance and degree of ischaemia.
AB  - The effectiveness of epidural spinal electrical stimulation has been studied in
      14 patients with severe intractable angina unresponsive to standard therapies
      including bypass grafting. After implantation of the neurostimulator units the
      patients were assessed by a symptom questionnaire, treadmill exercise testing and
      right atrial pacing. There was a significant improvement of symptoms and GTN
      consumption fell markedly. With the neurostimulator on, exercise duration
      increased from a mean (CI) of 414 (153) to 478 (149) s, and total ST segment
      depression was less both at maximum exercise (7.1 (4.5) vs 5.6 (4.2) mm) and at
      90% of the maximum control heart rate (3.5 (3.7) vs 2.6 (4.3) mm), with similar
      rate-pressure product at maximum exercise. With right atrial pacing the maximum
      heart rate reached before onset of angina was increased (143 (14) to 150 (7)
      b.min-1) and total ST segment depression was less at all heart rates. Benefit has
      persisted in some patients for over 2 years without any apparent adverse
      sequelae. Epidural spinal electrical stimulation is, therefore, an alternative
      therapy for some patients with intractable angina which has not responded to
      standard therapies.

PMID- 1618205
TI  - Electrocardiographic changes associated with haematocrit variations.
AB  - The electrical resistivity of intracardiac blood is less than the resistivity of
      the surrounding tissues. This affects the transmission of cardiac forces to the
      body surface: the radial forces are enhanced, whereas the transmission of
      tangential forces is diminished (the Brody effect). Blood resistivity is directly
      related to haematocrit, hence, haematocrit changes are expected to affect the
      transmission of cardiac forces, resulting in changes in QRS complex voltage. To
      assess this hypothesis, a 12-lead electrocardiogram was recorded in 40 patients
      affected by thalassaemia before and after a transfusion of concentrated red
      cells. The voltage of each QRS component was carefully measured in every lead,
      and the sum of all R wave amplitudes (sigma R) was calculated. The post
      transfusional electrocardiogram reflected a significant decrease in the R wave
      amplitude in every lead. sigma R also decreased, whereas S wave amplitude in lead
      V6 increased. A negative correlation between the ratio of haematocrit pre/post
      transfusion and that of the corresponding sigma R values was also observed (r = 
      0.434; P less than 0.01). An increase in haematocrit is therefore associated with
      a decrease in R wave amplitude. These findings explain why several patients with
      high haematocrit manifest relatively low voltage QRS complexes.

PMID- 1618206
TI  - M-mode, 2-D and Doppler echocardiographic study in 65 patients with Behcet's
      syndrome.
AB  - The cardiac involvement in Behcet's syndrome in sixty-five patients (mean disease
      duration 5.7 +/- 4.1 SD years) was studied, in comparison with 70 healthy, age-
      and sex-matched controls. The electrocardiograms, chest radiographs and M-mode, 2
      D and Doppler echocardiography were evaluated in a blind protocol. There were no
      significant differences in the prevalence of cardiac findings between the
      probands and the controls. It is concluded that cardiac involvement in Behcet's
      syndrome occurs only sporadically.

PMID- 1618207
TI  - Doppler echocardiographic observations of diastolic trans-septal flow through
      small ventricular septal defects.
AB  - Turbulent left-to-right trans-septal diastolic blood flow with a peak velocity
      greater than 0.5 m.s-1 was detected by pulsed Doppler echocardiography in 10 out
      of 204 (4.9%) children with isolated small ventricular septal defects. For
      children older than 10 years, it was observed in over a quarter of cases (27%).
      Peak diastolic velocities ranged from 0.6-1.9 m.s-1 (mean 1.2 m.s-1) and in all
      patients the duration of diastolic flow exceeded that of the systolic trans
      septal jet. Three different patterns of diastolic flow were observed and in eight
      cases pre-systolic acceleration was present. Turbulent diastolic flow across
      small ventricular septal defects is a common finding in older children and should
      not be confused with other causes of disturbed diastolic flow within the right
      ventricle.

PMID- 1618208
TI  - Evaluation of changes in myocardial function on exercise in patients with
      coronary artery disease using gated MIBI scintigraphy.
AB  - Technetium-99m-methoxy-isobutyl-isonitrile (MIBI) is a myocardial perfusion agent
      which allows simultaneous assessment of left ventricular function. We evaluated
      left ventricular (LV) function with exercise using a new method of myocardial
      profiling in 43 patients with chest pain. Twenty-eight had significant coronary
      artery disease and 15 were normal on coronary angiography. Results were compared
      to equilibrium radionuclide ventriculography. MIBI fractional shortening (FS)
      correlated well with ejection fraction (EF) on exercise (r = 0.79, P = less than
      0.001). There was also a good correlation between changes in global function from
      rest to exercise (r = 0.82, P = less than 0.001) with a sensitivity of diagnosing
      CAD of 71% and specificity of 80%. New regional wall abnormalities were detected
      in 25/28 with CAD with a sensitivity of 89% and specificity of 60%. There was
      also a close correlation between mean diameters measured with gated MIBI scans
      and volumes measured with RNV, end-diastolic diameter (EDD) versus end-diastolic
      volume (EDV) r = 0.78 (P = less than 0.001) at rest and r = 0.74 (P = less than
      0.001) on exercise and end-systolic diameter (ESD) versus end-systolic volume
      (ESV) r = 0.72 (P = less than 0.001) at rest and r = 0.72 (P = less than 0.001)
      on exercise. This produced a sensitivity for detecting CAD of 79% and a
      specificity of 73%. These results show that gated MIBI scanning on exercise
      provides information comparable to RNV so enhancing the diagnostic usefulness of
      MIBI.

PMID- 1618209
TI  - A prospective study on percutaneous coronary angioscopy with different guiding
      techniques in patients with coronary heart disease.
AB  - The technical success of percutaneous coronary angioscopy using different guiding
      techniques was evaluated in 17 patients before (n = 17) and after (n = 8)
      coronary angioplasty. Steering the angioscope along or over a guidewire was
      successful in both groups; failures were predominantly due to insufficient
      alignment of the angioscope using along-the-wire guiding. Although over-the-wire
      angioscopy promises superior guiding and alignment capabilities, several
      technical problems remain unsolved.

PMID- 1618210
TI  - Sudden death from pulmonary thromboembolism: chronobiological aspects.
AB  - The aim of this study was to determine whether sudden cardiac death from
      pulmonary embolism exhibits any chronobiological rhythm. Five hundred and seven
      consecutive subjects dying suddenly outside of hospital and brought into our
      Emergency Department from January 1983 to December 1989 were studied. The time
      and date of event were accurately recorded. All subjects underwent autopsy and 48
      of them were found to have died of pulmonary embolism (23 males, mean age 73.9 +/
      8 years and 25 females, mean age 76 +/- 12 years). All data were analysed by
      means of single cosinor[19,20]. In the subjects with pulmonary emboli both a
      circadian and a circannual rhythmicity were found, with a significant acrophase
      respectively in the morning (h.min. 11.46, P = 0.003) and in winter (-19.3, P =
      0.009).

PMID- 1618211
TI  - Prevalence of transient myocardial ischaemia during the first year after a
      myocardial infarction. Effect of treatment with verapamil. The Danish Study Group
      on Verapamil in Myocardial Infarction.
AB  - DAVIT-II is a double-blind, randomized, multicentre, placebo-controlled study of
      long-term treatment with verapamil 360 mg per day administered to patients who
      have suffered an acute myocardial infarction (AMI). In the present study,
      comprising a subset of DAVIT-II, 48 h continuous ECG recordings demonstrated
      transient ST segment deviation indicative of myocardial ischaemia after one week,
      prior to randomization, in 18% (10 of 57) of the patients. After one month, 24%
      (11 of 46) of the placebo and 8% (3 of 39) of the verapamil-treated patients (P =
      0.04) had myocardial ischaemia; after one year the figures were 26% (9 of 35) and
      4% (1 of 27) (P = 0.02), respectively. At 18 months the 'major' event rate in
      patients who had had ischaemia before randomization was 40% and 23.8% in patients
      without ischaemia (P = 0.057). In the placebo group, 63% of 91 episodes of ST
      depression were recorded between 0600 h and 1800 h, and 62% of 26 episodes of ST
      elevation between 1800 h and 0600 h (P less than 0.001). Nine episodes of ST
      depression and no episode of ST elevation were recorded in the verapamil-treated
      patients. In conclusion, 20-25% of post-AMI patients have transient ischaemia;
      verapamil prevents ischaemia, and a pronounced circadian variation of ST segment
      deviations can be demonstrated.

PMID- 1618212
TI  - Efficacy, safety and duration of nitrate-free interval to prevent tolerance to
      transdermal nitroglycerin in effort angina.
AB  - The magnitude of tolerance to the anti-anginal efficacy of transdermal
      nitroglycerin and the efficacy and safety of short (4 h) and long (10 h) nitrate
      free intervals for its prevention, were investigated in a randomized, double
      blind, placebo-controlled crossover trial of 4 week-long treatment regimens:
      placebo, continuous therapy with a 50 mg patch (10 mg.24 h-1), and 4 h and 10 h
      nitrate-free periods. Only patients showing greater than 1 min increase in time
      to 1 mm ST depression after acute patch administration were eligible. Twelve men
      completed the study. One other anti-anginal medication (a beta-blocker in nine
      and calcium antagonist in two) was permitted in a constant dose throughout the
      study. Patients underwent exercise testing on days 1 and 7 of each treatment
      period, and 24 h ambulatory ECG monitoring on day 6. Compared to placebo,
      transdermal nitroglycerin on day 1 significantly improved time to 1 mm ST
      depression by 35%, and time to angina, exercise duration and maximal workload by
      21%, 13% and 9% respectively. These improvements were totally lost after 7 days'
      continuous therapy, but completely maintained by a 10 h nitrate-free period
      (improvements of 35%, 25%, 16% and 11% respectively) but not by a 4 h nitrate
      free period (non-significant improvements of 15%, 2%, 4% and 1% respectively).
      The differences between 10 and 4 h nitrate-free were significant for each end
      point. Neither duration of ambulatory ischaemia, nor the proportion of patients
      experiencing greater than or equal to 5 min ischaemia during the scheduled
      nitrate-free interval differed between treatments.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1618213
TI  - Transluminal implantation of artificial heart valves. Description of a new
      expandable aortic valve and initial results with implantation by catheter
      technique in closed chest pigs.
AB  - A new artificial aortic valve prosthesis was developed for implantation by the
      transluminal catheter technique without thoracotomy or extracorporal circulation.
      The new heart valve was prepared by mounting a porcine aortic valve into an
      expandable stent. Before implantation, the stent-valve was mounted on a balloon
      catheter and compressed around the deflated balloon. The stent-valve mounted
      balloon catheter was then advanced retrogradely to the ascending aorta or the
      aortic root in anaesthetized pigs. Implantation was performed by balloon
      inflation which expanded the stent-valve to a diameter exceeding the internal
      diameter of the vessel--thus ensuring a stable fixation against the vessel wall.
      A total of nine implantations were performed in seven 70 kg closed chest pigs.
      Sub- and supracoronary implantation was performed in two and three pigs,
      respectively, while implantation in both positions was done in two. Angiographic
      and haemodynamic evaluation after implantation revealed no significant stenosis
      (less than or equal to 16 mmHg) in any of the nine valves and trivial
      regurgitation in only two. Complications were associated with restriction of the
      coronary blood flow in three animals. This preliminary study indicates that
      artificial aortic valves can be implanted in closed chest animals by transluminal
      catheter technique.

PMID- 1618214
TI  - Histopathological findings in three children with His bundle tachycardia
      occurring subsequent to cardiac surgery.
AB  - This report concerns three children with His bundle tachycardia who died
      following cardiac surgery. At autopsy the conduction system was examined in
      detail. In all three, the sinus node was intact and supplied by a well-formed
      artery. Haemorrhagic tracks were identified invading the penetrating
      atrioventricular bundle. The tracks originated from stitches placed close to the
      conduction tissue. The hypothesis that disruption of the conduction tissue
      results in an arrhythmogenic focus is discussed.

PMID- 1618215
TI  - Acquired aorto-pulmonary fistula in acute dissection.
AB  - We describe a 41-year-old man with an acute dissection of the ascending aorta
      with fistulation into the pulmonary artery. The diagnosis was made pre
      operatively by 2-D and Doppler echocardiography. Surgery was successfully
      performed.

PMID- 1618216
TI  - Pleural effusion following coronary perforation during balloon angioplasty: an
      unusual presentation of the postpericardiotomy syndrome.
AB  - We report on the development of features of the postpericardiotomy syndrome
      following coronary perforation during balloon angioplasty, in a patient that was
      managed conservatively. The case illustrates that while cardiac tamponade does
      not invariably follow coronary perforation, late consequences derived from this
      complication may occur. It also widens the spectrum of conditions where the
      postpericardiotomy syndrome has been observed.

PMID- 1618217
TI  - Mesothelioma of the atrioventricular node: first successful follow-up after
      excision.
AB  - Mesothelioma of atrioventricular nodes may cause congenital heart block and
      diagnosis is usually confirmed at post-mortem. Awareness of the possibility of
      the development of this tumour and selective coronary arteriography may help to
      diagnose this in life.

PMID- 1618218
TI  - Differences in the antiischaemic effects of molsidomine and isosorbide dinitrate.

PMID- 1618219
TI  - The future of gynaecological oncology in Spain.

PMID- 1618220
TI  - The influence of initial residual disease on the outcome of second-look
      laparotomy in patients with carcinoma of the ovary.
AB  - Sixty four patients with epithelial ovarian cancer underwent second-look
      laparotomy. Influencing factors on the outcome of the second-look laparotomy were
      analysed. Both grade and stage appeared to have an effect on the outcome of the
      procedure. However, this effect appeared to be dependent on the amount of
      residual disease after primary surgery. The amount of residual disease appeared
      to be independently associated with the outcome of second-look laparotomy.

PMID- 1618221
TI  - Endometrioid carcinoma arising in endometriosis. Case report.
AB  - Malignant transformation arising in endometriosis has been reported in some
      cases. Following Sampson's criteria, about 0.7%-1% of all cases of endometriosis
      undergo malignant transformation and the ovary is the most frequent site. A case
      is reported of a patient with endometriosis which, after 10 years, grew into
      ovarian endometrioid carcinoma. The relationship between endometriosis and cancer
      suggests a radical treatment of endometriosis and a careful assessment of
      postmenopausal woman presenting reactivation signs.

PMID- 1618222
TI  - Uterine cervix carcinoma. Histological radiation response (H.R.R.).
AB  - As most Carcinoma of the Uterine Cervix (CUC) has been found at advanced stages,
      Radiotherapy (RT) is still the most important treatment. Unfortunately not all
      CUC are responsive to RT Histological Radiation Response of the CUC according to
      Saryadi and Osborne (1975) determines 3 grades: good--moderate--poor HRR
      respectively, which conforms with the Cancer cells response grading according to
      National Cancer Center Hospital in Japan. In 1982, B. Hadiyanto and Sutoto
      reported a highly significant difference in the 5 y.s.r. of CUC patients who had
      better RHH (N = 52). In 1989, Sutoto, Suprijono and W. Adijono also reported
      highly significant differences among such groups of patients, of whom part
      received High-dosage of Mitomycin C (N = 46). Lately, Ristiyati and Sutoto have
      also found that the 5 y.s.r. among 187 patients treated with Radiotherapy alone
      and R.R. + Mitomycin showed significantly better survival in patients with better
      HRR. These studies showed that HRR is one of the most important points in CUC
      Radiotherapy. It has potential use in improving the result of RT, such as:
      Switching further treatment to surgery; Administering more aggressive adjuvant
      chemotherapy, among the worst responders.

PMID- 1618223
TI  - Expression and localization of epidermal growth factor receptors and ras oncogene
      products in gynecologic tumors.
AB  - We have investigated the expression of the products of two well-characterized
      oncogenes, erbB and Ha-ras, in the primary cultures of human gynecologic tumor
      cells by indirect immunofluorescent analysis. Epidermal growth factor receptor (c
      erbB gene product) and p21 (ras gene product) were highly expressed in 21 out of
      26 cases (81%) and 14 out of 18 cases (78%), respectively. Furthermore, they were
      frequently co-localized in the same region of the cells. These results suggest
      that these two oncogene products may play a part in gynecologic tumorigenesis and
      that they can interact with each other.

PMID- 1618224
TI  - Cytoreductive surgery in the treatment of advanced ovarian carcinoma. Some
      controversial aspects.
AB  - Primary cytoreductive surgery in the treatment of advanced ovarian carcinoma is
      widely accepted and practiced. Its value has however never been established by
      controlled trials and the concept is therefore not unchallenged. Data with regard
      to the benefit of interval and secondary debulking are limited and often
      conflicting. Prospective randomized studies specifically designed to elucidate
      the controversies relevant to cytoreductive surgery are warranted.

PMID- 1618225
TI  - Combined radio-surgical treatment in early invasive cervix carcinoma according to
      prognostic factors. Experience of the Gustave-Roussy Institute.
AB  - In the Gustave-Roussy Institute the standard protocol of limited stages (IB,
      proximal II) of cervix carcinoma, combines endocavitary brachytherapy (low dose
      rate) and surgery (BSOH + lymphadenectomy) are eventually followed by external
      beam irradiation. According to age of patients and to prognostic factors
      adaptations of this combined treatment are discussed: young patient (40 years)
      with small tumor, large volume of primary tumor (4 cm), lymphatic node
      involvement. Analysis of the results in 2 series of patients entirely treated at
      the Gustave-Roussy Institute: survival, local control, metastases, complications.

PMID- 1618226
TI  - Serous tumors of the ovary: ultrastructural observations.
AB  - One borderline primary serous ovarian tumor and six carcinomas were studied by
      means of electron microscopy. Borderline malignant tumor evidenced concomitant
      presence of both benign and malign serous epithelium. Ultrastructural
      observations revealed differentiation characteristics which involved complex
      architecture of cell arrangement and polarity in the distribution of the
      organelle and intercellular junctions. The cilia believed to be more frequent in
      benign tumors were also reported in poorly differentiated carcinomas and so may
      not be considered as reliable prognostic markers.

PMID- 1618227
TI  - Improvement of combined method of cervix cancer therapy and evaluation of the
      results of its clinical use.
AB  - The results of combined therapy in 544 cervix cancer patients involving in the
      first step surgery (213 patients) or radiation combinations (331 patients) have
      been analysed. A method involving in the first step preoperative radiation
      ensuring a decrease in frequency of local-regional tumor recurrences was found to
      be more effective. The use of preoperative radiation by large-dose fractionation
      regimen proved to be reasonable, allowing us to avoid regrowth of tumor in the
      area of surgical and radiation attack without an increase in the number and
      severity of postoperative sequalae.

PMID- 1618228
TI  - Of mice and men...

PMID- 1618229
TI  - Alterations in an indium-111 Fab' under conditions of utilization.
AB  - This study was conducted to investigate alterations that occur in an indium/111
      Fab' of a monoclonal antibody following its in vivo administration. Patients were
      infused with 111In-Fab' of the monoclonal antibody ZCE-025. Serum and urine
      specimens were collected from these patients. Starting materials, serum, urine
      and controls samples were studied by electrophoresis. Animal distribution studies
      were performed in normal Balb/c mice and, in some cases, nude mice bearing a
      carcinoembryonic antigen (CEA)/producing human colon tumour since the antibody
      targets CEA. The studies indicated that the molecule circulated almost totally
      intact for at least 4 h and to a considerable extent for 24 h, with some evidence
      for in vivo fragmentation by 24 h. Evidence was also obtained suggesting the
      formation of a high molecular weight species in some patients. Shortly after
      infusion, some of the 111In in the urine appeared as the intact Fab', but within
      hours the majority migrated electro-phoretically as low molecular weight species.
      We conclude that while the majority of the 111In-Fab' of this particular antibody
      remains intact and immunoreactive following its administration, the molecule is
      structurally changed to some degree shortly after its infusion into humans. Since
      each monoclonal antibody is unique, the degree and rapidity of degradation of its
      Fab' in vivo could vary markedly from the above and possibly adversely effect its
      utility as a radiopharmaceutical.

PMID- 1618230
TI  - Lymphoma imaging with a new technetium-99m labelled antibody, LL2.
AB  - The lesion detection capability of a new technetium-99m labelled B-cell lymphoma
      monoclonal antibody (MoAb) imaging agent, LL2, was evaluated in 8 patients with
      non-Hodgkin's lymphoma and 1 patient with chronic lymphocytic leukaemia. The MoAb
      kit consists of a 1-vial, 1-mg Fab' form of LL2 ready for instant labelling with
      technetium. The patients were injected with approximately 925 MBq (25 mCi) of
      99mTc-LL2 Fab' (1 mg), and planar and single photon emission tomography (SPET)
      studies were performed at 3-4 h post injection and at 24 h. There was no evidence
      of thyroid or stomach activity up to 24 h. Uniform splenic uptake was seen in all
      patients. Two non-lymphoma patients were also administered with the same agent
      and demonstrated a similar splenic distribution; therefore, splenic targeting was
      not scored as tumour-specific. A total of 29 from 48 tumour sites were detected
      by scintigraphy, including tumours of various grades and histological types.
      Excluding 1 patient who had a large tumour burden of over 500 g, 29 of 33 lesions
      were detected. One patient was free of disease at the time of the study and had a
      negative scan. Another patient showed excellent targeting of gallium-negative
      sites in the liver and bone. The bone involvement was not known prior to the
      antibody study and was subsequently confirmed by a bone scan. Additional sites of
      MoAb localization could not be followed in this group, since most patients went
      on to radioimmunotherapy immediately following the 99mTc-LL2 study.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1618231
TI  - The binding parameters of radiolabelled monoclonal F (ab')2 and Fab' fragments
      relative to immunoglobulin G in reactions with surface-bound antigens.
AB  - The binding parameters of iodine-125-labelled intact monoclonal immunoglobulin G
      (IgG), F(ab')2 and Fab' fragments were compared. The study was carried out with
      the two monoclonal antibodies (MoAbs) K13 and K16 specific for human Ig light
      chains kappa and lambda, respectively. When testing the 125I-MoAbs against
      monodisperse polymer particles coated with the specific antigens, the Ka for the
      F(ab')2 fragments were similar to that for IgG, while the Ka for the Fab'
      fragments were reduced to 10%-20% of that for IgG. The number N of effective
      target sites revealed with Fab' was higher than with F(ab')2 and IgG, presumably
      because less surface area is occupied by the small Fab' molecules. The
      immunoreactive fraction F ranged according to IgG greater than F(ab')2 greater
      than Fab'. The explanation of the moderate difference between the Ka of the
      monoclonal Fab' and the divalent IgG and F(ab')2 was that the divalent molecules
      were not divalently attached to the particles. When testing the same antibody
      preparations against human lymphoma cells producing Ig with light chains kappa or
      lambda, the binding results were less reliable than when particles were utilised,
      presumably due to antigen shedding. Different MoAbs vary in their loss of
      immunoreactivity due to enzymatic degradation and the radiolabelling procedure.
      The preparation of the radiolabelled fragments should therefore be optimized for
      each MoAb, and evaluation is necessary before injection. Artificial targets with
      a low leakage of antigen, like the monodisperse polymer particles here applied,
      are recommended for the in vitro evaluation of the immunoreactivity of labelled
      MoAb preparations.

PMID- 1618232
TI  - Tumour localization and pharmacokinetics of iodine-125 human monoclonal IgM
      antibody (COU-1) and its monomeric and half-monomeric fragments analysed in nude
      mice grafted with human tumour.
AB  - Human monoclonal IgM antibodies reactive with cancer-associated antigens may not
      have the optimal imaging capability due to their large size. Fragmentation of
      human IgM is less than straight-forward due to the loss of immunoreactivity. From
      the human monoclonal IgM antibody COU-1 we have prepared monomeric and half
      monomeric fragments, which retain the ability to bind to colon cancer cells in
      vitro. The pharmacokinetics and tumour localization were evaluated in nude mice
      bearing human colon adenocarcinoma and human melanoma grafts. Faster clearance
      from the circulation was seen for the smaller half-monomeric fragment with a half
      life (rapid phase/slow phase) of 2 h/16 h compared with the intact antibody, 4
      h/25 h, and the monomeric fragment, 3 h/27 h. Intact COU-1 as well as the
      fragments accumulated in the colon tumour graft. Higher amounts of radioactivity
      were found in the colon tumour as compared to normal organs for intact COU-1 at
      days 4 and 6, for the monomeric fragment at day 4, and for the half-monomeric
      fragment at day 2 after injection. This investigation demonstrates the favourable
      biodistribution of the half monomeric COU-1 fragment. The fast clearance of this
      fragment resulted in a tumour-to-muscle ratio as high as 22 on day 2 after
      injection. Also, only this fragment gave a positive tumour-to-blood ratio. Normal
      IgM and its fragments were used as controls. Radioimmunoscintigraphy demonstrated
      the colon tumour discriminatory properties of each of the three iodine-labelled
      antibody preparations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618233
TI  - Development of a high performance zinc-62/copper-62 radionuclide generator for
      positron emission tomography.
AB  - Clinical utilisation of positron emission tomography could be enhanced by the
      availability of short-lived radionuclides derived from generator systems. The
      zinc-62/copper-62 combination is one such system which could be used as a source
      for a number of copper-62 radiopharmaceuticals. We have developed and optimised a
      high activity (5.6 GBq, 150 mCi) zinc-62/copper-62 generator to provide 62Cu in a
      form that is suitable for direct labelling of pyruvaldehyde-bis-(N4
      methylthiosemicarbazone)-copper(II), Cu(PTSM). The distribution coefficients of
      Zn(II) and Cu(II) between anion-exchange resin and various hydrochloric
      acid/organic solvent mixtures were measured. Based on these measurements a
      generator eluent of 0.3 M HCl/40% ethanol provided 62Cu in greater than 90% yield
      in a 3-ml volume. A very low 62Zn breakthrough of less than 3 x 10(-7)% was
      achieved. Copper-PTSM was successfully labelled with the no-carrier-added 62Cu
      eluent directly from the generator with 94% radiochemical yield.

PMID- 1618234
TI  - A method of computerised isotope dynamic proctography.
AB  - Patients with long-standing constipation were examined by radioisotope
      proctography. A radiolabelled synthetic potato mash was inserted intrarectally
      and the dynamic changes during simulated defaecation recorded using a gamma
      camera. Computer images from the stored data illustrate changes in the anorectal
      angle and pelvic floor. The median (and 95% confidence intervals) of the
      anorectal angles were: at rest 105 degrees (101 degrees, 116 degrees), on
      voluntary contraction of the pelvic floor by 'squeezing' 91 degrees (81 degrees,
      98 degrees), on straining 120 degrees (107 degrees, 137 degrees) and during
      evacuation 126 degrees (116 degrees, 153 degrees). The pelvic floor movements
      were: pelvic floor ascent on voluntary contraction 28 mm (9, 34 mm), pelvic floor
      descent on straining -8 mm (-14, -4 mm) and descent during evacuation -27 mm (
      34, -11 mm). Useful additions to previous methods are measurement of the
      completeness of rectal evacuation 58% (42, 77%), the defaecation time 64 s (50,
      138 s) and the defaecation rate 0.9%/s (0.4, 1.4%/s).

PMID- 1618235
TI  - Evaluation of monoclonal idiotypic-specific antibodies as clearing antibodies for
      enhancement of target localisation by tumour-specific monoclonal antibodies:
      diversity of effects in nude mice with human tumour xenografts.
AB  - Three tumour-specific monoclonal antibodies (MoAbs) showed localisation in human
      tumour xenografts in nude mice, although the tumour discrimination was limited by
      the survival of a greater proportion of the MoAb in the blood and body as a
      whole. An attempt was made to increase tumour discrimination by the subsequent
      administration of syngeneic idiotypic-specific MoAbs (anti-id) directed against
      the first antibodies, in the expectation of clearing excess of the first MoAb
      from the circulation. With one MoAb (NCRC-2), its anti-id (NCRC-60) did
      effectively clear it from the blood, and, at least within a few hours, the tumour
      to-blood ratios were increased. After longer periods, however, the tumour levels
      of NCRC-2 were also reduced, and the tumour discrimination was no longer
      increased. With another MoAb (NCRC-23) the tumour levels were reduced to a
      greater extent than were the blood levels in mice treated with its anti-id (NCRC
      59), so that rather than being increased the tumour discrimination was actually
      reduced to about a third of that in control mice. With a third MoAb (NCRC-48),
      there was no effect on the tumour or blood levels within a few hours of injection
      of its anti-id (NCRC-62), and so there was no short-term effect on tumour
      discrimination. Subsequently, however, the tumour levels were slightly reduced,
      while the blood levels increased in mice treated with anti-id compared with
      control mice, so that the tumour-to-blood ratios decreased.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1618236
TI  - Comparison of stress-only vs. stress/rest with technetium-99m
      methoxyisobutylisonitrile myocardial perfusion imaging.
AB  - Unlike conventional thallium-201 myocardial imaging, technetium-99m
      methoxyisobutylisonitrile (MIBI) requires separate stress and rest injections. We
      prospectively studied 148 consecutive patients referred for myocardial perfusion
      studies to determine the diagnostic value of rest images once normal exercise or
      dipyridamole tomographic images had been obtained. In patients referred with no
      history of previous myocardial infarction in whom the diagnosis of coronary
      artery disease was suspected, 45 of 109 (41%) patients had normal stress
      tomographic images. Obtaining rest images did not alter the final interpretation
      in any of these cases. From this we infer that in patients with normal images
      after exercise or dipyridamole administration and no past history of myocardial
      infarction, 99mTc-MIBI rest images are not required. This provides several
      advantages including increased speed of diagnosis, decreased patient radiation
      exposure, improved cost efficiency and decreased demand on tomographic camera
      time.

PMID- 1618237
TI  - Combined nuclear and digital subtraction contrast arthrography in painful knee
      prosthesis.
AB  - The evaluation of a painful knee prosthesis remains a difficult problem for both
      orthopaedic surgeons and radiologists. We have compared digital subtraction
      arthrography with nuclear arthrography in 7 patients with a painful knee
      prosthesis. Three patients showed a loose tibial component, demonstrated by both
      digital subtraction and nuclear arthrography. All 3 underwent revision of their
      prosthesis. One patient had an equivocal digital subtraction arthrogram and
      negative nuclear arthrogram, while both studies were negative in the 3 remaining
      patients. Nuclear arthrography is a simple procedure and can provide useful
      additional information when combined with digital subtraction arthrography.

PMID- 1618238
TI  - Scintigraphic evaluation of the pharmacokinetics of a soluble polymeric drug
      carrier.
AB  - There is a growing interest in the use of macro-molecular carriers for
      therapeutic agents. If these carriers can be labelled with an appropriate gamma
      emitter, their biodistribution could be followed by scintigraphy. We have imaged
      the biodistribution of a synthetic branched polypeptide, based on a poly-L-lysine
      backbone (average molecular mass 45 kDa). The polymer was conjugated to
      diethylene triamine penta-acetic acid and labelled by chelation with indium-111.
      Mice were injected i.v. with labelled material and imaged with a gamma-camera
      with a pin-hole collimator. Images showed the majority of tracer remaining in the
      blood pool, but about 35% appeared in the urinary bladder within 1.5 h. When the
      111In-polymer was fractionated by gel filtration chromatography on S-300, the
      imaging showed that the early eluting material was retained, the intermediate
      showed some renal clearance, and the late was rapidly excreted. These findings
      show the value of gamma-scintigraphy for biodistribution studies with such
      polymeric drug carriers and its potential for clinical pharmacokinetic studies.

PMID- 1618239
TI  - Imaging of metabolism and autonomic innervation of the heart by positron emission
      tomography.
AB  - Positron emission tomography (PET) allows, in combination with multiple
      radiopharmaceuticals, unique physiological and biochemical tissue
      characterization. Tracers of blood flow, metabolism and neuronal function have
      been employed with this technique for research application. More recently, PET
      has emerged in cardiology as a useful tool for the detection of coronary artery
      disease and the evaluation of tissue viability. Metabolic tracers such as
      fluorine-18 deoxyglucose (FDG) permit the specific delineation of ischaemically
      compromised myocardium. Clinical studies have indicated that the metabolic
      imaging is helpful in selecting patients for coronary artery bypass surgery or
      coronary angioplasty. More recent research work has concentrated on the use of
      carbon-11 acetate as a marker of myocardial oxygen consumption. Together with
      measurements of left ventricular performance, estimates of cardiac efficiency can
      be derived from dynamic 11C-acetate studies. The non-invasive evaluation of the
      autonomic nervous system of the heart was limited in the past. With the
      introduction of radiopharmaceuticals which specifically bind to neuronal
      structures, the regional integrity of the autonomic nervous system of the heart
      can be evaluated with PET. Numerous tracers for pre- and postsynaptic binding
      sites have been synthesized. 11C-hydroxyephedrine represents a new catecholamine
      analogue which is stored in cardiac presynaptic sympathetic nerve terminals.
      Initial clinical studies with it suggest a promising role for PET in the study of
      the sympathetic nervous system in various cardiac diseases such as
      cardiomyopathy, ischaemic heart disease and diabetes mellitus. The specificity of
      the radio-pharmaceuticals and the quantitative measurements of tissue tracer
      distribution provided by PET make this technology a very attractive research tool
      in the cardiovascular sciences with great promise in the area of cardiac
      metabolism and neurocardiology.

PMID- 1618240
TI  - The effects of a salicylate, ibuprofen, and naproxen on the disposition of
      methotrexate in patients with rheumatoid arthritis.
AB  - We have studied the pharmacokinetics of methotrexate in patients with rheumatoid
      arthritis concurrently treated with choline magnesium trisalicylate, ibuprofen,
      naproxen, or a non-NSAID analgesic (control treatment). The apparent systemic
      clearance of methotrexate was significantly reduced by all three treatments.
      Trisalicylate and ibuprofen both significantly reduced methotrexate renal
      clearance, but only the trisalicylate significantly displaced methotrexate from
      protein, increasing the fraction unbound by 28%. These data show that NSAIDs can
      affect the disposition of methotrexate, possibly increasing the potential for
      toxicity and necessitating dosage adjustments. However, large inter-subject
      variability precludes specific dosage recommendations.

PMID- 1618241
TI  - Pravastatin and lovastatin similarly reduce serum cholesterol and its precursor
      levels in familial hypercholesterolaemia.
AB  - The hypocholesterolaemic effect of pravastatin 40 mg and lovastatin 40 mg daily
      has been compared in patients with familial hypercholesterolaemia (FH).
      Administration of the two drugs was separated by a three-month washout period.
      The reduction in total serum cholesterol after 1,2 and 4 weeks of treatment was
      similar after pravastatin (-23%, -32% and -32%) and lovastatin (-23%, -30% and 
      31%). The serum concentrations of LDL cholesterol were similarly reduced, whilst
      triglycerides, other lipoproteins, cholestanol and squalene were not altered. The
      reductions in the serum levels of the cholesterol precursor sterols, delta 8
      cholesterol, desmosterol and lathosterol were not significantly different after
      either drug. The lack of difference suggests that cholesterol synthesis was
      equally inhibited by the two agents. In addition, the serum content of the plant
      sterols campesterol and sitosterol tended to be equally increased. The
      comparability of the increases suggests that the absorption and biliary
      elimination of the two sterols were equally affected by the two statins. Thus, no
      difference was found between the effects of pravastatin and lovastatin on the
      serum levels and metabolic precursors of cholesterol in FH during four weeks of
      treatment.

PMID- 1618242
TI  - Ambulatory blood pressure monitoring for the assessment of nicardipine as a third
      drug in severe essential hypertension.
AB  - The antihypertensive efficacy of sustained-release nicardipine compared to
      placebo as third-line therapy has been assessed by ambulatory blood pressure
      monitoring in severely hypertensive patients with clinically unsatisfactory blood
      pressure control on 50 mg hydrochlorothiazide o.d. and 75 mg captopril b.d. Forty
      two patients, 31 m and 11 f, with supine diastolic blood pressure 95-115 mm Hg
      after a 4 week run-in period on open hydrochlorothiazide and captopril, were
      randomly allocated to sustained-release nicardipine 45-60 mg/d or placebo. At a
      visit to the clinic blood pressure and heart rate were measured 12 h after the
      evening dose by a trained observer unaware of the treatment. Twenty-four hour
      ambulatory monitoring was performed at the end of baseline and after 8 weeks of
      blinded medication. There was no significant change in BD at the visit or on
      ambulatory monitoring in the placebo treated patients. In contrast, nicardipine
      produced a significant reduction in both blood pressures without affecting heart
      rate. Nicardipine also decreased the mean 24-h blood pressure by 14/10 mm Hg in
      patients whose clinical hypertension had been confirmed by ambulatory blood
      pressure monitoring but by only 3/2 mm Hg in ambulant patients who were
      normotensive on two-drug therapy. One patient experienced an episode of severe
      symptomatic hypotension while on nicardipine. Otherwise, the numbers and
      percentages of patients from each group reporting adverse experiences were
      similar. It is concluded that nicardipine appears to be an effective
      antihypertensive agent when used as third line therapy with diuretics and
      angiotensin converting enzyme inhibitors in patients with severe
      hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618243
TI  - Intravenous amine pressor tests in healthy volunteers. Within- and between
      subject variances and sex differences.
AB  - The pressor effect of intravenous tyramine (TYR) and noradrenaline (NA) has been
      evaluated, respectively, in 157 tests in 19 healthy unmedicated subjects, and in
      202 tests in 24 similar subjects, all of whom took part in greater than or equal
      to 3 test sessions. The pressor dose (PD) that raised systolic blood pressure by
      30 mm Hg (PD30) ranged from 2 to 8 mg for TYR, and from 3.5 to 17 micrograms.min
      1 for NA. Coefficients of variation ranged from 3 to 47% and from 6 to 38% for
      TYR and NA, respectively, in the intra-subject comparison. The average inter
      subject variation in the TYR PD30 was 22% for 8 females and 30% for 11 males; the
      corresponding variation in the NA PD30 was 27% (8 females) and 26% (16 males).
      While the average PD30 for NA was similar for males (10.8 micrograms/min) and
      females (10.9 micrograms/min), a sex-related difference was found for the PD30 of
      i.v. TYR: 4.4 mg for 11 males and 3.8 mg for 8 females. Additional results from
      volunteers who took part in fewer than 3 pressor test sessions supported this
      observation; PD30 of TYR 4.6 mg in 34 males vs 3.5 mg in 21 females. The large
      intra- and inter-subject variations in the i.v. TYR and NA pressor test results,
      and the sex difference in the systolic blood pressure response to i.v. TYR,
      should be considered in assessing the number and gender of subjects required in
      studies intended to show "significant" differences in the blood pressure response
      in amine pressor tests.

PMID- 1618244
TI  - Acute changes in forearm haemodynamics produced by cigarette smoking in healthy
      normotensive non-smokers are not influenced by propranolol or pindolol.
AB  - The aim of the present study was to examine the effect of cigarette smoking in
      healthy non-smokers on blood pressure and forearm haemodynamics after acute oral
      administration of non-selective beta-adrenoceptor blockers with and without
      intrinsic sympathomimetic activity, viz. pindolol 15 mg and propranolol 80 mg. A
      preliminary study was done to compare cigarette smoking and sham smoking to
      evaluate the time-course of the haemodynamic effects of cigarette smoking. The
      second experiment was then carried out in the same six volunteers, according to a
      double-blind randomized placebo-controlled crossover design, to evaluate the
      possible effect of pre-treatment with beta-adrenoceptor blockers on blood
      pressure, heart rate and forearm haemodynamics (forearm blood flow, brachial
      artery diameter and brachio-radial pulse-wave velocity) measured at baseline,
      during smoking and every five minutes up to 1 h afterwards. No major difference
      from placebo in blood pressure or forearm haemodynamics was found and pre
      treatment with beta-blockers did not prevent the acute vascular effects of
      cigarette smoking.

PMID- 1618245
TI  - Differences in antidiabetic drug utilisation between three different health
      systems in the same national region.
AB  - The consumption of antidiabetic drugs in a Spanish region (Extremadura) in the
      period 1986-1987 has been investigated by the "defined daily dose" (DDD) method.
      The study was done in three health care systems in the region: civil servants
      ("Mutualidad de Funcionarios Civiles del Estado: MUFACE") armed forces group
      ("Instituto Social de las Fuerzas Armadas: ISFAS") and the national system
      ("Instituto Nacional de la Salud: INSALUD"). The total consumption of
      antidiabetic drugs varied three-fold, ranging from 5,73 DDD per 1000 inhabitants
      per day (3,71 DDD per 1000 inhabitants per day for oral antidiabetic drugs and
      2,02 DDD per 1000 inhabitants per day for insulin) in the civil servant group to
      15,82 DDD per 1000 inhabitants per day (12 DDD per 1000 inhabitants per day for
      oral antidiabetic drugs and 3,82 DDD per 1000 inhabitants per day for insulins)
      in the armed forces. The differences were more pronounced for oral antidiabetics
      than for insulins. The utilization of insulin among the civil servants was about
      half of that by the two other groups. Of oral antidiabetics, sulphonylureas were
      the most frequently used by the three groups, and within them glibenclamide
      accounted for more than half of the DDDs, while biguanides were scarcely used in
      any group. The differences are difficult to assess, since they could be due to
      several factors, such as age-differences in the population studied, different
      prescribing habits, and differences in sociocultural level. The results justify
      further comparative studies of drug utilization in different health systems
      within the same region.

PMID- 1618246
TI  - The effects of two different local anaesthetic solutions administered for oral
      surgery on plasma potassium levels in patients taking kaliuretic diuretics.
AB  - The effects of two different dental local anaesthetic solutions, administered for
      oral surgery, on the plasma potassium levels of patients taking non-potassium
      sparing diuretics has been investigated. There was a significant reduction in
      plasma potassium concentration in eight subjects who received 4.4 ml of 2%
      lignocaine with 1:80,000 adrenaline; the mean reduction from baseline being 0.30
      mmol.l-1 10 min following intraoral extravascular injection of the local
      anaesthetic. There was no significant difference from the pre-treatment plasma
      potassium concentration 10 min following similar injections of 3% prilocaine with
      0.03 IU.ml-1 felypressin in 8 patients; the mean change in these subjects being 
      0.05 mmol.l-1. It is suggested that the use of adrenaline-free local anaesthetics
      would seem to be appropriate in patients receiving kaliuretic diuretics.

PMID- 1618247
TI  - 0.25% prednicarbate cream and the corresponding vehicle induce less skin atrophy
      than 0.1% betamethasone-17-valerate cream and 0.05% clobetasol-17-propionate
      cream.
AB  - The atrophogenic potential of medium-potent topical glucocorticoids is still
      controversial. In a double-blind controlled trial 24 healthy volunteers either
      applied 0.25% prednicarbate cream or the corresponding vehicle to one and 0.1%
      betamethasone-17-valerate cream or 0.05% clobetasol-17-propionate cream to the
      other forearm twice daily. Skin thickness was regularly assessed during the six
      week period of application and for further three weeks thereafter, using both the
      B- and A-mode of a 20 MHz ultrasound scanner. Both betamethasone-17-valerate and
      clobetasol-17-propionate cream significantly reduced skin thickness as compared
      to cream base while prednicarbate cream did not. Given that 0.1% betamethasone-17
      valerate- and 0.25% prednicarbate cream are reported to be about equipotent in
      the treatment of atopic eczema the latter preparation shows an increased ratio
      between its desired anti-inflammatory and its unwanted atrophogenic effect.

PMID- 1618248
TI  - Disposition of quinine in plasma, red blood cells and saliva after oral and
      intravenous administration to healthy adult Africans.
AB  - The pharmacokinetics of quinine has been studied in ten healthy adult Africans
      after intravenous infusion and oral ingestion of a 500 mg dose. Blood and saliva
      samples were collected over 48 h and quinine in plasma, red cells and saliva was
      determined by HPLC. Quinine was rapidly and almost completely absorbed after an
      oral dose, with absorption half-life of 0.53 h, a tmax of 1-3 h and a
      bioavailability of 88%. Analysis of the i.v. data gave an apparent volume of
      distribution of 3.6 l.kg-1 and a plasma clearance of 0.19 l.kg-1.h-1. The
      concentration-time curves for plasma, red cells and saliva had declining phases
      were approximately parallel, giving a similar half-life that in all three media.
      The half-lives after the i.v. infusion also did not different from those after
      oral administration. The dose was well tolerated by both methods of
      administration.

PMID- 1618249
TI  - Binding of a metabolite of triflusal (2-hydroxy-4-trifluoromethylbenzoic acid) to
      serum proteins in rat and man.
AB  - 2-hydroxy-4-trifluoromethylbenzoic acid (HTB) is the main active metabolite of
      the platelet antiaggregant drug triflusal. Its binding to plasma proteins of rats
      and healthy volunteers in vitro and in vivo has been studied. Rats were given a
      single oral dose of 50 mg.kg-1 triflusal and the healthy volunteers received 300
      mg as a single oral dose or a multiple dose regimen of 600 mg every 24 h and 300
      mg every 8 h, both for 13 days. Protein-free HTB was obtained by ultrafiltration.
      Unbound and total HTB concentrations were determined by HPLC. HTB was primarily
      bound to albumin in plasma. The Scatchard plots suggested two types of binding
      sites for HTB on the albumin molecule. In rats, the binding constants (K =
      intrinsic affinity constant, n = number of binding sites) were K1 = 1.4 x 10(5)
      l.mol-1, n1 = 1.23, and K2 = 4.1 x 10(3) l.mol-1 and n2 = 3.77. The mean plasma
      concentration in rats after oral administration was 185 (37) micrograms.ml-1
      (protein-free HTB:2.44 (0.77)%). The binding constants in human plasma were K1 =
      4.7 x 10(5) l.mol-1, n1 = 1.93, K2 = 4.3 l.mol-1 and n2 = 4.28. The plasma HTB
      concentration in man (n = 8) was 35 micrograms.ml-1 (Cmax) after a single oral
      dose of triflusal 300 mg, 172.96 micrograms.ml-1 (Cmax.ss) during the multiple
      dosage regimen of 300 mg every 8 h, and 131 micrograms.ml-1 (Cmax.ss) during the
      multiple oral dose regimen of 600 mg every 24 h. Unbound HTB ranged from 0.27 to
      0.43%, depending on dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618250
TI  - Temporary reversal of serum to cerebrospinal fluid glycerol concentration
      gradient after intravenous infusion of glycerol.
AB  - Glycerol 50 g infused i.v. over 2 to 6 h is widely used to treat cerebral oedema
      in patients with acute stroke. Its transit through the blood-cerebrospinal fluid
      barrier in subjects with uninflamed meninges has now been examined. In 7 patients
      with an external ventriculostomy for occlusive hydrocephalus, each of whom was
      given 500 ml of a 10% solution IV over 4 h, serum and CSF were repeatedly sampled
      during and after the infusion and glycerol was measured enzymatically. The
      highest serum glycerol level of 191-923 mg/l was observed at the end of the
      infusion. The maximum CSF glycerol of 18.7-110.8 mg/l was attained 0-1 h after
      the end of the infusion. Elimination both from serum and CSF approximated a
      single-exponential decay; the elimination half-life from serum was 0.29-0.56 h
      compared to 1.03-3.68 h from CSF. In six of the seven cases there was a temporary
      reversal of the serum/CSF concentration gradient during glycerol elimination. The
      ratios of the AUCs of CSF and serum, which describe the overall penetration of
      glycerol into CSF, ranged from 0.09-0.31. In conclusion, the serum level of
      glycerol produced by giving 50 g IV glycerol over 4 h may not be sufficiently
      high reliably dehydrate to brain tissue in many patients, and the slow
      elimination of glycerol from the CSF may be related to the so-called rebound
      phenomenon.

PMID- 1618251
TI  - Formation and excretion of dipyrone metabolites in man.
AB  - The formation and urinary excretion of the dipyrone metabolites,
      methylaminoantipyrine (MAA), aminoantipyrine (AA), formylaminoantipyrine (FAA)
      and acetylaminoantipyrine (AAA) were determined following administration of a
      single oral 1.0 g dose of dipyrone to 12 healthy volunteers. The AAA/AA plasma
      ratio showed that 3 subjects were slow and 9 were rapid acetylators.
      Pharmacokinetic parameters were determined separately for each group. A good
      correlation was found between the plasma and urine AAA/AA ratios. The renal
      clearance of the four metabolites was similar for both phenotypes. A significant
      difference in the rate of formation of dipyrone metabolites was found for AA,
      0.25 (slow) vs 0.1 ml.min-1.kg-1 (rapid), and for AAA 0.75 (slow) vs 7.53 ml.min
      1.kg-1 (rapid). There were comparable differences between slow and rapid
      acetylators in the AUC and the urinary excretion extrapolated to infinity for AA
      and AAA. The present results show that the kinetics of dipyrone metabolites in
      plasma and urine can provide a useful measure of the activity of the enzymes
      involved in their production.

PMID- 1618252
TI  - Prediction of creatinine clearance by several methods in patients with severe
      infections.
AB  - Since almost all urinary creatinine is derived from the muscle mass, the amount
      of creatinine in the urine will be proportional to muscle mass, and it will show
      an almost constant decrease with age. A simple equation for estimating creatinine
      clearance has been derived. For women the creatinine clearance (ml.min-1) was
      [150-(years)].body weight (kg)/serum creatinine (mumol.l-1). For men less than 70
      years it was [170-age (years)].body weight (kg)/serum creatinine (mumol/l) and
      for men greater than or equal to 70 years it was [160-age (years)].body weight
      (kg)/serum creatinine (mumol/l). The prediction was quite simple when laboratory
      results were given in SI units. A simple nomogram was devised for easy estimation
      of the creatinine clearance in individual patients according to the age, sex and
      weight. Predicted values according to our equations were compared with those
      derived from other formulae in 54 patients with severe infections treated with
      aminoglycosides. No major differences were found, but the new method seemed more
      convenient.

PMID- 1618253
TI  - Effect of salbutamol on digoxin pharmacokinetics.
AB  - A single dose of the beta 2-adrenoceptor agonist salbutamol has previously been
      shown to decrease serum digoxin concentration in healthy volunteers. A possible
      explanation of the phenomenon is a beta 2-adrenoceptor-mediated increase in the
      specific binding of digoxin to skeletal muscle. The present study was undertaken
      to further elucidate the effect of salbutamol on the pharmacokinetics of digoxin
      in man. Nine volunteers were studied on two occasions during salbutamol or
      placebo treatment. On test days salbutamol, 4 micrograms.kg-1.h-1 or saline was
      infused for 10 h, preceded and followed by four and three days, respectively, of
      oral administration. A single i.v. injection of digoxin 15 micrograms.kg-1, was
      given 20 min after starting the infusion. At the end of the infusion a muscle
      biopsy was taken from the vastus lateralis. Blood samples for the analysis of
      serum digoxin and potassium were repeatedly taken over 72 h. Urine was collected
      over a period of 24 h for determination of the renal excretion of digoxin and
      potassium. The serum digoxin concentration, expressed as the AUC 0-6 h was 15%
      lower during salbutamol infusion than during saline infusion. Salbutamol caused
      significantly faster elimination of digoxin from the central volume of
      distribution to deeper compartments. Salbutamol had no effect on the renal
      clearance of digoxin. The skeletal muscle digoxin concentration tended to be
      higher (48%) during salbutamol compared to placebo treatment. The serum potassium
      concentration was significantly lower after salbutamol compared to placebo, as
      was the rate of renal excretion of potassium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618254
TI  - Lack of effect of omeprazole, cimetidine, and ranitidine on the pharmacokinetics
      of ethanol in fasting male volunteers.
AB  - The effects of three gastric antisecretory drugs on the pharmacokinetics of
      ethanol have been studied in a randomized crossover experiment. Male medical
      students (n = 12) took ethanol 0.8 g/kg body weight at 08.00 h after an overnight
      fast. On seven successive days before drinking ethanol they were given omeprazole
      20 mg, cimetidine 800 mg, ranitidine 300 mg, or no drug, with a period of at
      least 7 days between treatments. The peak blood ethanol concentration of 21.9 to
      22.8 mmol.l-1 occurred at 64 to 70 min after the end of drinking. The rate of
      disappearance of ethanol from the blood ranged from 3.0 to 3.3 mmol.l-1.h-1 and
      the rate of removal from the whole body ranged from 8.0 to 8.5 g.h-1. The
      apparent volume of distribution of ethanol was almost the same for all four
      treatments: mean 0.68 l.kg-1, corresponding to a mean total body water of 44 l
      (59% body weight). Mean areas under the concentration-time profiles of ethanol
      ranged from 83 to 87 mmol.l-1.h for the four treatments. It is concluded that
      omeprazole, cimetidine and ranitidine do not alter the kinetics of a moderate
      dose of ethanol.

PMID- 1618255
TI  - Influence of verapamil on the coronary arteriovenous difference in long chain
      free fatty acids in hypertrophic cardiomyopathy.
AB  - The percentage composition of free fatty acids in the coronary circulation has
      been studied during the passage of blood through the heart in patients with
      hypertrophic cardiomyopathy. Under basal conditions the percentages of palmitic
      and stearic acid decreased significantly. Verapamil i.v. produced a tendency
      towards a preferential myocardial uptake of oleic acid.

PMID- 1618256
TI  - Plasma thiamine concentrations after intramuscular and oral multiple dosage
      regimens in healthy men.
AB  - A novel liquid chromatographic method for the determination of thiamine in plasma
      has been developed and has been used to study plasma thiamine concentrations
      after multiple dosage regimens for 11 days. The method involves purification,
      concentration and analytical separation of thiochrome on-line, using a switching
      column system. Ten healthy men were given 500 mg thiamine i.m. once a day (Group
      1) and ten were given 250 mg p.o. every 12 h (Group 2). The times to reach steady
      state (7 and 5.6 days for Groups 1 and 2, respectively) were not different (P
      greater than 0.05). The mean elimination half-life was 1.8 days. The mean minimum
      steady-state concentration after the oral regimen (23 micrograms.l-1) was 78% of
      that after the intramuscular regime (29 micrograms.l-1).

PMID- 1618257
TI  - Absence of interaction between tenoxicam and warfarin.
AB  - The influence of tenoxicam on plasma warfarin concentrations and on its
      anticoagulant effect has been studied in healthy volunteers. Tenoxicam did not
      alter the plasma warfarin concentration versus time profile. Treatment with it
      for 14 days had no effect on the average dose of warfarin required to maintain
      the prothrombin time within a specified range. The coumarin dose index, an
      indicator of warfarin sensitivity, remained unchanged during tenoxicam
      administration. The results demonstrate the lack of a clinically relevant effect
      of tenoxicam on warfarin-induced anticoagulation.

PMID- 1618258
TI  - No effect of cisapride on paracetamol absorption after oral simultaneous
      administration.
AB  - We have measured the effect of oral cisapride on paracetamol absorption in 12
      healthy volunteers in a double-blind placebo-controlled study. Volunteers
      received paracetamol plus placebo, paracetamol plus cisapride 10 mg and
      paracetamol plus cisapride 20 mg. Mean plasma paracetamol AUC at 60 min were
      1070, 1051 and 1031 micrograms.min.ml-1 and maximum paracetamol concentrations
      were 31.5, 29.3 and 27.4 micrograms.ml-1 respectively (no significant
      differences). There was no difference also in time to maximum paracetamol
      concentration [median (range) 30 (15-120), 30 (15-90) and 30 (15-60) min,
      respectively]. .

PMID- 1618259
TI  - Drinking induced by subcutaneous injection of angiotensin II in the rat is
      blocked by the selective AT1 receptor antagonist DuP 753 but not by the selective
      AT2 receptor antagonist WL 19.
AB  - The role of AT1 and AT2 receptors in mediating the drinking response induced by
      angiotensin II in the rat was examined. Angiotensin II (0.1-1.0 mg/kg s.c.)
      caused a dose-dependent increase in drinking in water-replete rats. The
      angiotensin Il-induced drinking response was dose dependently blocked by the
      selective AT1 receptor antagonist DuP 753 (1-30 mg/kg s.c.). In contrast, the
      selective AT2 receptor antagonist WL 19 failed to block angiotensin II-induced
      drinking up to doses of 100 mg/kg s.c. and significantly enhanced the response at
      3 and 100 mg/kg. These data suggest that drinking induced by angiotensin II is
      mediated by AT1 receptors and that AT2 receptor activation may inhibit the
      drinking response.

PMID- 1618260
TI  - Anti-IL-5 monoclonal antibody inhibits allergic late phase bronchial eosinophilia
      in guinea pigs: a therapeutic approach.
AB  - In this study the effect of purified rat anti-mouse IL-5 monoclonal antibody on
      aeroallergen-induced infiltration of eosinophils in the bronchoalveolar lavage
      fluid of guinea pigs was studied. The i.p. injection of anti-IL-5 antibody 4 h
      after aeroallergen challenge inhibited eosinophil infiltration in a dose
      dependent fashion. The resulting ED50 was 10 (3.4-32.8) micrograms/kg. The
      clinical therapeutic usefulness of anti-IL-5 or anti-IL-5-producing cells in
      asthma/allergy treatment remains to be an intriguing possibility.

PMID- 1618261
TI  - Carbon monoxide does not inhibit glyceryl trinitrate biotransformation by or
      relaxation of aorta.
AB  - Carbon monoxide (CO) was employed to assess the role of ferrous hemoproteins in
      the vasodilation and biotransformation of glyceryl trinitrate (GTN) in rabbit
      aortic strips. These tissues were contracted submaximally with phenylephrine,
      exposed to CO for 5 min, and then incubated with 0.5 microM [1,3(14) C]GTN in the
      presence of CO for 2 min or 30 s. The [14C]GTN-induced relaxation of the strips
      was recorded, and [14C]GTN biotransformation to [14C]glyceryl dinitrate
      metabolites by the tissues was determined by thin-layer chromatographic-liquid
      scintillation spectrometric analysis. CO treatment inhibited neither GTN-induced
      relaxation nor GTN biotransformation to glycerol dinitrate metabolites. These
      results indicate that ferrous hemoproteins are probably not involved in the
      biotransformation of GTN that is associated with relaxation of the rabbit aortic
      strips.

PMID- 1618262
TI  - The potent 5-HT3 receptor antagonist (R)-zacopride labels an additional high
      affinity site in the central nervous system.
AB  - The binding characteristics of [3H](R)- and [3H](S)-zacopride were investigated
      in membranes from the rat entorhinal cortex and NG 108-15 clonal cells. In
      contrast to [3H](S)-zacopride which bound solely to 5-HT3 receptors, [3H](R)
      zacopride recognized another class of binding sites, called the (R)-sites, in
      both membrane preparations. In addition to (R)-zacopride (Ki = 3-11 nM), only (R)
      iodo-zacopride, (R)-dechloro-zacopride, prazosin and mianserin exhibited high to
      moderate affinity for the (R)-sites, whose possible functions remain to be
      established.

PMID- 1618263
TI  - Differential effects of picrotoxin and RO 15-1788 on high and low ethanol
      concentrations on rat locus coeruleus in vitro.
AB  - In an in vitro electrophysiological single-cell recording model, ethanol had an
      inhibitory effect on locus coeruleus (LC) neurons at both low (0.1 mmol/l) and
      high (500 mmol/l) concentrations. In order to test if the benzodiazepine-GABA
      (gamma-aminobutyric acid) receptor complex could be implicated in this effect, we
      tested the interaction of these ethanol concentrations with picrotoxin (100
      mmol/l) and RO 15-1788 (10 nmol/l). RO 15-1788 reversed the inhibitory effect
      induced by ethanol 500 mmol/l, but not by ethanol 0.1 mmol/l; picrotoxin reversed
      the effects of both concentrations. This indicates that the mechanisms of action
      of ethanol on LC neurons are not the same for high and low concentrations.
      Furthermore, the effect of concentrations related to a behavioral effect (greater
      than 10 mmol/l) was reversed by a low-calcium medium that abolishes transmitter
      release. Therefore, the inhibition induced by ethanol 500 mmol/l seems to be due
      to the release of an endogenous benzodiazepine-like compound.

PMID- 1618264
TI  - Corticotropin-releasing hormone excites myenteric neurons in the guinea-pig small
      intestine.
AB  - The electrophysiological actions of corticotropin-releasing hormone (CRH) on
      myenteric neurons from the guinea-pig ileum were studied by intracellular
      microelectrode recording. CRH, when applied by micropressure ejection or in the
      medium (0.2-20 nM) evoked prolonged depolarization in 21 of 42 S/type 1 neurons
      and in 28 of 40 AH/type 2 neurons. These responses were associated with increased
      input resistance and augmented excitability. The post-spike hyperpolarization in
      AH/type 2 cells was suppressed during the CRH-evoked responses. The reversal
      potential of the response to CRH was about -90 mV, consistent with the closure of
      potassium channels by the peptide. The CRH-induced depolarization was prevented
      by incubation in 10 microM 5'-N-ethylcarboxamidoadenosine (NECA, an adenosine
      analog) suggesting that the response was mediated by stimulation of adenylate
      cyclase and elevation of cAMP. CRH reduced the amplitude of fast nicotinic
      excitatory postsynaptic potentials. This appeared to be a postsynaptic action
      because the peptide also reduced the responses to exogenously applied
      acetylcholine. These results suggest that CRH can directly influence intestinal
      function by acting on myenteric neurons.

PMID- 1618265
TI  - Differential inhibition by the PAF receptor antagonist, WEB 2170, of allergic
      inflammation in single sensitized and boosted mice.
AB  - Interference of the PAF antagonist, WEB 2170, with the paw edema induced by
      antigen in boosted or unboosted sensitized mice was investigated. Edema was
      triggered by the intraplantar injection of ovalbumin to animals actively
      sensitized 21 days before and that received (boosted), or did not receive
      (unboosted), a second immunization after 14 days. There was no difference in the
      intensity of the response to antigen or to PAF (platelet-activating factor) in
      boosted or in unboosted animals. Intraperitoneal treatment with WEB 2170 1 h
      before challenge reduced dose dependently the edema in boosted mice but did not
      modify the reaction in unboosted mice. It is noteworthy that WEB 2170 was more
      effective against PAF-induced paw edema in unboosted than in boosted mice, the
      maximum inhibition of 84% being reached at 16 mg/kg. In addition, topical and
      selective desensitization to PAF inhibited the edema caused by antigen only in
      boosted animals. Our findings indicate that the booster injection during the
      immunization process shifts the anaphylactic mouse paw edema from a PAF
      independent to a PAF-dependent reaction.

PMID- 1618266
TI  - Effects of yohimbine on morphine analgesia and physical dependence in the rat.
AB  - The effects of yohimbine on morphine analgesia and on the development of opiate
      physical dependence were studied to find out more about the involvement of alpha
      2-adrenergic mechanisms in opioid actions. Male Sprague-Dawley rats (250-300 g)
      were used. The acute effect of morphine (5 mg/kg i.p.) in the tail-flick test was
      reduced significantly by pretreatment with a single dose of yohimbine (2 mg/kg
      i.p.). Alone yohimbine, produced a slight hyperalgesia. Animals treated with a
      sustained-release preparation of morphine (300 mg/kg s.c.) showed the same
      sensitivity to opiate analgesia 72 h later whether they were treated
      concomitantly with yohimbine or not, but they exhibited fewer withdrawal symptoms
      upon naloxone injection after yohimbine (2 or 4 mg/kg i.p. 24, 28, 48 and 52 h
      after the start of systemic morphine treatment). The results obtained confirm
      previous data on the effects of yohimbine on morphine analgesia and reveal the
      importance of alpha 2-adrenergic activation in the development of opioid physical
      dependence.

PMID- 1618267
TI  - Effect of the beta-adrenoceptor antagonist, propranolol, on feeding induced by
      noradrenaline and muscimol in rats kept at high and temperate-ambient
      temperatures.
AB  - Both the gamma-aminobutyric acid (GABA) receptor agonist, muscimol, and
      noradrenaline stimulated the feeding behavior of rats in the two environments.
      When noradrenaline or muscimol was administered, however, the food intake at 26
      degrees C was greater than that at 33 degrees C. In addition, the stimulatory
      effect of noradrenaline on food intake was significantly depressed by propranolol
      pretreatment at both temperatures. The stimulatory effect of muscimol on food
      intake was significantly depressed by the propranolol pretreatment at 33 degrees
      C but not at 26 degrees C. Some eating-stimulatory subsystems associated with
      feeding behavior induced by noradrenaline or muscimol might have been depressed
      in the hot environment, thus the food intake increased by these drugs in rats
      acclimated to the hot environment was less than that in rats acclimated to the
      temperate environment.

PMID- 1618268
TI  - Elevated basal firing rates and enhanced responses to 8-Br-cAMP in locus
      coeruleus neurons in brain slices from opiate-dependent rats.
AB  - Extracellular, single unit activity was recorded in noradrenergic neurons of the
      nucleus locus coeruleus (LC) in brain slices prepared from rats treated
      chronically with morphine. In contrast to previous reports, basal firing rates of
      LC neurons were 2-fold higher in slices from opiate-dependent animals compared to
      controls and they remained elevated for at least 7 h. In neurons from dependent
      animals the maximal excitation in response to 8-bromoadenosine 3':5'-cyclic
      monophosphate (8-Br-cAMP), but not the EC50, was found to be substantially
      greater than in controls. This result parallels biochemical evidence of an up
      regulation of the cAMP pathway in the LC of opiate-dependent animals. There was
      no difference in the response to glutamate between cells from dependent and
      control animals. We conclude that an increase in basal firing rate, possibly
      mediated by an up-regulation of the intrinsic cAMP pathway, contributes to the
      hyperactivity of the LC during opiate withdrawal in vivo.

PMID- 1618269
TI  - Comparison of peripheral and central nervous system sympatholytic actions of
      prazosin using the cat nictitating membrane.
AB  - Prazosin is a highly selective alpha 1-adrenoceptor antagonist that decreases
      blood pressure by actions on both the peripheral and central (CNS) divisions of
      the nervous system. The present investigation was undertaken in an attempt to
      characterize the relative contribution of these two sympatholytic sites of
      action. Submaximal contractions of the nictitating membranes were evoked by
      electrical stimulation of the preganglionic cervical sympathetic nerve trunk and
      by stimulation of the posterior hypothalamus in anesthetized cats. In initial
      control experiments, phenoxybenzamine (0.1-3.0 mg/kg i.v.) produced an equivalent
      depression of evoked nictitating membrane responses from both peripheral and CNS
      sites of activation which suggests only a peripheral blocking action as well as
      functional equivalence of the intensity of CNS and peripheral nerve stimulation.
      In contrast, prazosin (3-300 micrograms/kg i.v.) caused a differential dose
      related depression of the evoked responses with ED50s of 81.5 micrograms/kg
      (peripheral stimulation) and 12.5 micrograms/kg (CNS stimulation) respectively; P
      less than 0.05. Pretreatment with rauwolscine (500 micrograms/kg i.v.) totally
      prevented the differential CNS sympatho-inhibition produced by prazosin. These
      results indicate that, although both CNS and peripheral sites of drug action are
      manifest, the ED50 for prazosin-induced CNS sympatho-inhibition is approximately
      6-fold less than that required for direct alpha 1-adrenoceptor blockade at the
      end organ. In addition, prazosin produces CNS sympatho-inhibition indirectly by
      means of an alpha 2-adrenoceptor mechanism.

PMID- 1618270
TI  - Inhibitory and stimulatory actions of danazol in rat ovarian and uterine tissues.
AB  - We examined whether danazol has a direct action on ovarian steroid secretion
      and/or uterine prostaglandin (PG) F2 alpha catabolic activity in immature rats in
      which the first ovulation was induced and in adult ovariectomized rats. The
      preovulatory surge of estradiol and progesterone was markedly suppressed together
      with that of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by
      danazol administration under conditions that blocked the first ovulation. Uterine
      weight and PGF2 alpha catabolic activity enhanced by endogenous estrogen were
      greatly decreased by danazol treatment at a dose that did not block the first
      ovulation in immature rats. When danazol (30 mg) was given s.c. once daily for 2
      days to ovariectomized rats, the uterine weight and PGF2 alpha catabolic activity
      per uterus were clearly increased, and the compensatory increase in FSH levels as
      a result of castration was not influenced, although the compensatory increase in
      LH levels was inhibited. These results demonstrate that danazol has a direct
      action on the ovary and uterus, and give further support to the view put forward
      in our previous paper that these actions of danazol may contribute to its
      therapeutic effects.

PMID- 1618271
TI  - Influence of a long-acting bradykinin antagonist, Hoe 140, on some acute
      inflammatory reactions in the rat.
AB  - We studied the influence of Hoe 140, a bradykinin antagonist, on inflammatory
      reactions induced in rats. Hoe 140 reduced paw oedema induced by bradykinin
      alone, bradykinin plus prostaglandin (PG) E1, carrageenan, urate crystals or
      urate crystals plus captopril. The inhibitory effect of Hoe 140 lasted for at
      least 4 h. Hoe 140 also reduced plasma exudation in sponges implanted in the back
      of the rat. However it did not modify paw oedema induced by zymosan or by heating
      the paw at 55 degrees C for 30 s. Carrageenan oedema developed to a small extent
      in kininogen-deficient rats while the swelling induced by heating the paw of
      kininogen-deficient rats was the same as that measured in normal animals. Hoe 140
      had no effect on the slight swelling induced by carrageenan in kininogen
      deficient rats. We conclude that the kinin system is involved in inflammatory
      reactions induced by carrageenan, urate crystals, sponge implantation but not by
      zymosan and scalding.

PMID- 1618272
TI  - Stereoselective antimuscarinic effects of 3-quinuclidinyl atrolactate and 3
      quinuclidinyl xanthene-9-carboxylate.
AB  - The relative affinity and selectivity of the stereoisomers of 3-quinuclidinyl
      atrolactate (QNA) and the enantiomers of 3-quinuclidinyl xanthene-9-carboxylate
      (QNX) for the pharmacologically defined muscarinic receptor subtypes was
      determined using functional responses of rabbit vas deferens (M1), guinea pig
      atria (M2) and bladder detrusor muscle (M3). All the stereoisomers behaved as
      competitive antagonists yielding the same rank order of potency at each receptor
      subtype: (RR)-QNA greater than (RS)-QNA greater than (SR)-QNA greater than (SS)
      QNA and (R)-QNX greater than (S)-QNX. Moreover, the eudismic ratios relative to
      (RR)-QNA for (RS)-, (SR)- and (SS)-QNA, respectively, ranged from 4 to 308 at all
      three subtypes. Stereoselective effects were also observed for QNX; (S)-QNX/(R)
      QNX ratios ranged from 76 to 248. In contrast, there was a distinct lack of
      receptor selectivity among the isomers of QNA and QNX for either the M1, M2 or M3
      muscarinic receptor subtypes. Stereoselective effects were also evident in vivo
      in the guinea pig cystometrogram, where the rank order of potency of the isomers
      of QNA and QNX was similar to that observed in vitro. (RR)-QNA and (R)-QNX
      equipotently depressed intravesical bladder pressure (PvesP) (ID50 = 0.06 mg/kg
      i.v.). Other parameters (bladder capacity, threshold pressure) were unaltered by
      the stereoisomers. The data demonstrate that despite the high affinity of the
      eutomers of QNA and QNX for muscarinic receptors, they discriminate poorly among
      muscarinic subpopulations, thus limiting their utility to subclassify muscarinic
      receptors.

PMID- 1618273
TI  - Similarity between the vasorelaxing activity of dinitrosyl iron cysteine
      complexes and endothelium-derived relaxing factor.
AB  - Dinitrosyl iron complexes with cysteine (DNIC) induced a concentration-dependent
      relaxation of pre-contracted (norepinephrine, 10(-7) M) de-endothelialized ring
      segments of rat aorta. The vasodilator response was more similar to acetylcholine
      (ACh)-induced relaxation in intact aortic rings than to nitric oxide (NO)-induced
      relaxation. The time course of tone recovery after maximal concentrations (10(-5)
      M) of DNIC was similar to the time course of tone recovery after endothelium
      dependent relaxation induced by ACh, whereas the restoration of tone after NO was
      much faster. Vessel tone was restored by oxyhemoglobin (10(-5) M) in all cases.
      The results suggest that DNIC with cysteine may function as endothelium-derived
      relaxing factor in the vessels.

PMID- 1618274
TI  - Release of endothelin in the oleic acid-induced respiratory distress syndrome in
      rats.
AB  - Rats injected intravenously with oleic acid developed pulmonary edema leading to
      hypoxia and hypercarbia. These changes were accompanied by an increase in
      immunoreactive endothelin (ir-ET) in plasma as early as 15 min after injection.
      At 45 min after injection plasma levels peaked at 114 +/- 19 pg/ml plasma (n = 8)
      and reached basal levels again after 240 min. In contrast, much larger amounts of
      ir-ET were found in the bronchoalveolar lavage fluid, with a peak at 120 min
      (2878 +/- 258 pg/lung, n = 7) preceding the maximum hypoxia observed at 180 min.
      In both plasma and bronchoalveolar lavage fluid samples ir-ET was characterized
      by reverse-phase HPLC as a mixture consisting mainly of ET-1 and smaller amounts
      of big ET-1, ET-2 and ET-3. In light of the biological effects of ET, the data
      suggest that these peptides might be of pathophysiological significance in this
      model of adult respiratory distress syndrome.

PMID- 1618275
TI  - Analysis of the antagonistic actions of HOE 140 and other novel bradykinin
      analogues on the guinea-pig ileum.
AB  - The type of antagonism exhibited by three novel bradykinin (BK) antagonists, D
      Arg-[Hyp3,Thi5,D-Tic7,Oic8]BK (HOE 140, compound I), D-Arg-[Hyp3,D-Tic7,Oic8]BK
      (compound II) and [Arg(Tos)1,Hyp3,Thi5,D-Tic7,Oic8]BK (compound III), was
      compared with that of a conventional antagonist, D-Arg-[Hyp2,Thi5,8,D-Phe7]BK
      (compound IV), on the guinea-pig ileum. The novel compounds induced rightward
      displacements of cumulative concentration-response curves to BK, accompanied by a
      progressive reduction of the maximum effect (Emax) without a significant decrease
      in the slope, whereas no reduction of Emax was observed with compound IV. Actions
      of substance P on the guinea-pig ileum and of vasopressin on the rat uterus
      remained completely unaffected. It is concluded that as the novel BK analogues
      show competitive as well as non-competitive inhibition in the guinea-pig ileum,
      but the inhibition is reversible and specific, they are dual antagonists.

PMID- 1618276
TI  - Role of intracellular Na+ activity in the negative inotropy of strophanthidin in
      cardiac Purkinje fibers.
AB  - The relation between intracellular sodium activity (aNai) and different phases of
      strophanthidin inotropy was studied in sheep cardiac Purkinje fibers superfused
      in vitro. Strophanthidin (1 microM) progressively increases aNai whereas
      increases and then decreases contractile force, induces contracture ('mechanical
      toxicity') and arrhythmias ('electrical toxicity'). Contractile force begins to
      decrease at approximately 11 mM aNai. Force and aNai show a positive correlation
      during the increasing and a negative correlation during the decreasing phase of
      strophanthidin inotropy. In high [K]o (8, 12 and 16 mM), strophanthidin increases
      aNai and force to a smaller peak and fails to induce toxicity. In high [Na]o
      (+18.5%), strophanthidin increases aNai and force to a larger peak and induces
      electrical toxicity below and mechanical toxicity above a higher aNai value
      (approximately 15 mM). In higher [K]o, high [Na]o restores the ability of
      strophanthidin to induce mechanical toxicity. Thus, mechanical toxicity begins
      when aNai increases past a critical value and the continuing aNai increase
      correlates with decrease in contractile force and contracture. The critical value
      of aNai is modified by Ca load related to changes in membrane potential or to Na
      electrochemical gradient.

PMID- 1618277
TI  - Different radiant heat intensities differentiate intracerebroventricular morphine
      from beta-endorphin-induced inhibition of the tail-flick response in the mouse.
AB  - The antinociceptive effects of morphine and beta-endorphin given
      intracerebroventricularly (i.c.v.) or intrathecally (i.t.) were evaluated by
      inhibition of the tail-flick and hot-plate paw-licking responses evoked by three
      different intensities of heat stimulation (low, intermediate and high) in male
      ICR mice. Morphine given i.c.v. was more potent in inhibiting the tail-flick
      response evoked by low than high intensity of heat stimulus. beta-Endorphin given
      i.c.v., on the other hand, was equally potent in inhibiting the tail-flick
      response evoked by different intensities of heat. This differential effect of
      morphine and beta-endorphin was not shown when morphine and beta-endorphin were
      given i.t. Morphine and beta-endorphin given i.c.v. or i.t. were equally potent
      in inhibiting the paw-licking response at different intensities of hot-plate
      temperature. Our results suggest that morphine given i.c.v. may inhibit high
      intensity heat-evoked tail-flick response spinally and inhibits low intensity
      heat-evoked tail-flick response supraspinally. Our results also provide
      additional evidence for different neural mechanisms of antinociceptive action of
      morphine and beta-endorphin.

PMID- 1618278
TI  - Development of tolerance to the anticonvulsant effect of vigabatrin in amygdala
      kindled rats.
AB  - The anticonvulsant, adverse and biochemical effects of the novel antiepileptic
      drug vigabatrin (gamma-vinyl GABA), which increases GABA (gamma-aminobutyric
      acid) levels by inhibition of the GABA degrading enzyme GABA aminotransferase,
      were examined in amygdala-kindled rats after acute and chronic administration.
      Vigabatrin proved to be a potent anticonvulsant drug at acute doses (100-200
      mg/kg), but during chronic administration, the anticonvulsant activity of the
      treatment was lost already in the second week of treatment. Tolerance also
      developed to the adverse effects, i.e. hypothermia, sedation and motor
      impairment. Determination of vigabatrin in plasma indicated that tolerance was
      not due to declining drug levels. Furthermore, determination of endogenous amino
      acids in plasma showed that GABA levels were highly elevated throughout the
      period of treatment, although the extent of GABA accumulation decreased in the
      second week. After cessation of chronic treatment with vigabatrin, there was no
      clear indication of withdrawal symptoms, except a prolonged seizure or
      afterdischarge duration in experiments with 100 mg/kg per day. The data suggest
      that chronic treatment with vigabatrin may be associated with a loss of
      anticonvulsant efficacy, at least when the drug is given as monotherapy.

PMID- 1618279
TI  - Evidence for a saturable, energy-dependent and carrier-mediated uptake of oral
      antidiabetics into rat hepatocytes.
AB  - The hepatic uptake of two sulfonylureas, glisoxepide and glibenclamide, was
      investigated in isolated rat hepatocytes. Two transport processes were defined:
      passive physical diffusion and saturable carrier transport. For diffusion at pH
      7.4 the permeability coefficients were 3.3 x 10(-6) cm/s for glisoxepide and 10.6
      x 10(-6) cm/s for glibenclamide. Saturable uptake differed among the
      sulfonylureas. Glibenclamide uptake was neither energy- nor sodium-dependent and
      temperature dependence was linear. The apparent activation energy for saturable
      glibenclamide uptake was 15.2 kJ/mol and Q10 values for uptake between 7 and 37
      degrees C were 1.17 +/- 0.12. Saturable glibenclamide uptake exhibited a Km = 3.1
      microM and a Vmax = 416 pmol/mg cell protein per min. Thus glibenclamide uptake
      was defined kinetically as a facilitated diffusion process. Glisoxepide uptake
      revealed two Km values: Km1 = 2-3 microM and Vmax1 = 200 pmol/mg protein per min,
      and Km2 = 110 microM and Vmax2 = 1600 pmol/mg protein per min. Uptake at low and
      high substrate concentration was energy-dependent, sodium-dependent and was
      inhibited by ouabain. Temperature dependence increased markedly beyond 22 degrees
      C and the apparent activation energy was 59.7 kJ/mol at low Km1 glisoxepide
      concentrations and 60.3 kJ/mol at high Km2 concentrations. Whereas glisoxepide
      was slowly taken up into AS-30D hepatoma cells, glibenclamide was not. The
      hepatic uptake of glibenclamide was not inhibited by glisoxepide but
      glibenclamide inhibited glisoxepide uptake. The inhibition by glibenclamide was
      noncompetitive. Isolated hepatocytes accumulated the sulfonylureas markedly and
      metabolized both. The metabolized radioligands were slowly released into the
      incubation buffer. The results indicate that the hepatic uptake of the two
      sulfonylureas is by carrier-mediated transport. The uptake processes are,
      however, strikingly different, indicating heterogeneity of sulfonylurea
      transporters.

PMID- 1618280
TI  - Interaction of sulfonylureas with the transport of bile acids into hepatocytes.
AB  - The sulfonylurea compounds glisoxepide and glibenclamide inhibit the uptake of
      bile acids into isolated rat hepatocytes. The Ki values for the inhibition of
      cholate uptake was 9 microM with glibenclamide and 200 microM with glisoxepide.
      The inhibition of cholate uptake by both sulfonylureas was noncompetitive. Uptake
      of the conjugated bile acid taurocholate was inhibited by glibenclamide, Ki = 75
      microM. Again the inhibition was noncompetitive. Glisoxepide inhibited
      taurocholate uptake only in the absence of sodium ions. Under sodium-free
      conditions glisoxepide also strongly inhibited cholate uptake. The inhibition was
      competitive, Ki = 42 microM. Both bile acids interfered with the hepatocellular
      uptake of [3H]glisoxepide, with IC50 values of 375 and 467 microM for cholate and
      taurocholate, respectively. The uptake of [3H]glibenclamide was inhibited by
      cholate, IC50 = 328 microM, but not by taurocholate. Glisoxepide uptake was
      further inhibited by blockers of the hepatocellular monocarboxylate transporter,
      by the loop diuretic bumetanide, by 4,4'-diisothiocyano-2,2'-stilbenedisulfonate
      (DIDS) and by sulfate. Glibenclamide uptake was weakly inhibited by DIDS and by
      anthracene-9-carboxylic acid (A-9-C) but not by bumetanide and sulfate. Neither
      bromosulfophthalein nor the fatty acid oleate inhibited glisoxepide or
      glibenclamide uptake. These results are consistent with the transport of
      glisoxepide via the transport system for the unconjugated bile acid cholate.
      Glibenclamide uptake is mediated by a still unknown hepatocellular transport
      system.

PMID- 1618281
TI  - Inhibitory effect of inaperisone hydrochloride (inaperisone), a new centrally
      acting muscle relaxant, on the micturition reflex.
AB  - We examined the effects of inaperisone hydrochloride (inaperisone), a new
      centrally acting muscle relaxant, on bladder function in anesthetized rats and
      isolated rat tissues. We also investigated its mechanism of action. When a
      balloon inserted into the bladder was expanded, rhythmic bladder contractions
      were observed; inaperisone (4 mg/kg i.v.) abolished these contractions, in both
      normal and decerebrated rats. The bladder tonus or bladder contraction induced by
      peripheral stimulation of the pelvic nerve was barely inhibited by inaperisone (4
      mg/kg i.v.), but this dose of inaperisone abolished the efferent discharge from
      the pelvic nerve that accompanied the rhythmic bladder contractions. The doses of
      intracerebroventricularly (i.c.v.) and intrathecally injected inaperisone which
      abolished the rhythmic bladder contractions were 10 and 100 micrograms,
      respectively. The inhibitory effects of inaperisone (4 mg/kg i.v.) were not
      diminished by naloxone (1 mg/kg i.v.) or by bicuculline (0.5 mg/kg i.v.), but
      were diminished by phaclofen (30 mg/kg i.v. or 300 micrograms i.c.v.). The
      specific binding of [3H]baclofen to rat brain synaptosomal membranes was barely
      inhibited by inaperisone (up to 1 mM). From these results, it is speculated that,
      among other possible mechanisms, inaperisone inhibits the micturition reflex by
      acting indirectly on GABAB receptors in the brainstem.

PMID- 1618282
TI  - The anti-parkinsonian drug amantadine inhibits the N-methyl-D-aspartic acid
      evoked release of acetylcholine from rat neostriatum in a non-competitive way.
AB  - The anti-viral drug amantadine is used in the treatment of Parkinson's disease
      without the drug having a well established mechanism of action. Amantadine is
      reported to displace the non-competitive NMDA receptor antagonist MK-801 from its
      binding site in the central nervous system. We show that amantadine inhibits, in
      a non-competitive way, the NMDA receptor-mediated stimulation of acetylcholine
      release from rat neostriatum in vitro in 'therapeutic' (i.e. low micromolar
      range) concentrations. Moreover, contrary to previous reports, amantadine, in
      this concentration range, did not affect the in vitro release of dopamine from
      neostriatal tissue.

PMID- 1618283
TI  - Endothelin-1 release from the mesenteric arteries of cyclosporine-treated rats.
AB  - The release of endothelin-1 from mesenteric arteries from cyclosporine-treated
      rats was measured by a specific enzyme immunoassay after purification of the
      perfusate on an immunoaffinity column. Mesenteric arteries from cyclosporine
      treated rats (25 mg/kg per day for 6 weeks) released a significantly larger
      amount of endothelin-1 than arteries from vehicle-treated control rats (P less
      than 0.05). Serum creatinine levels were not significantly different in the two
      groups. These findings indicate that cyclosporine is a potential inducer of
      endothelin release from the mesenteric artery.

PMID- 1618284
TI  - Quantitative light microscopic demonstration of increased pallidal and striatal
      met5-enkephalin-like immunoreactivity in rats following chronic treatment with
      haloperidol but not with clozapine: implications for the pathogenesis of
      neuroleptic-induced movement disorders.
AB  - Acute and late onset movement disorders frequently complicate the treatment of
      psychosis with typical neuroleptic drugs like haloperidol, but not with atypical
      neuroleptic drugs like clozapine. Although the neural mechanisms underlying
      neuroleptic-induced movement disorders remain unknown, alterations in basal
      ganglia function are likely involved. A potential role for the endogenous opiate
      peptides in neuroleptic-induced movement disorders is suggested by the
      immunocytochemical localization of met5-enkephalin (ME) in the striatopallidal
      projection pathway, and by the increased levels of ME measured by
      radioimmunoassay in the rat caudate-putamen nuclei (CPN) following haloperidol
      treatment. We sought to determine whether met5-enkephalin-like immunoreactivity
      (MELI) in terminal fields within globus pallidus and in perikarya in CPN was
      differentially altered in rats chronically treated with haloperidol or clozapine.
      Acrolein-fixed forebrain sections were collected from cohorts of adult rats
      receiving 21-day oral administration of haloperidol, clozapine, or water.
      Sections from the three treatment groups were collectively processed for
      immunocytochemical labeling using varying dilutions of ME antiserum and the
      avidin-biotin peroxidase method. In globus pallidus, densitometry measures
      revealed significantly increased levels of immunoperoxidase labeling for ME in
      haloperidol-treated, but not in clozapine-treated animals. In CPN, optical
      densitometry as well as cell counting measurements also showed a significant
      increase in MELI only in the haloperidol-treated group. These results support the
      concept that alterations in endogenous opiate peptides in basal ganglia may
      contribute to movement disorders seen in patients receiving typical neuroleptic
      drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618285
TI  - Responses in the CA1 region of the rat hippocampus to a noxious stimulus.
AB  - We report here some physiological and pharmacological characteristics of noxious
      stimuli-induced changes in the hippocampal CA1 pyramidal cell synaptic
      excitability to field CA3 stimulation. A noxious heat stimulus applied to the
      left hind paw (LHP) produced a persistent depression of the CA1 population spike
      (PS) which habituated to a repetition of the stimulus. Interestingly, exposure of
      the tail to a noxious stimulus following habituation of the LHP produced a
      depression of the CA1 PS. This finding suggested that persistent depression and
      habituation are topographically represented. In separate experiments we
      determined that while the persistent depression of the CA1 population spike was
      accompanied by, in most cases, a prolonged increase in the amplitude of the CA1
      antidromic field potential, there was a concurrent persistent depression and
      habituation of the CA1 PS and the corresponding apical dendritic field excitatory
      postsynaptic potential (dfEPSP). This suggested that noxious stimulus-induced CA1
      synaptic depression is mediated at the apical dendritic region, perhaps
      postsynaptically at the dendrites and/or presynaptically on CA3 afferent
      terminals. Furthermore, atropine sulfate (40 mg/kg ip), which prevented the
      depression of the CA1 PS, also blocked the depression of dfEPSP when
      iontophoresed at the apical dendritic recording site. In addition atropine
      antagonized the depression of the dfEPSP produced by iontophoretic acetylcholine
      (Ach) but not gamma-aminobutyric acid. However, iontophoretic atropine at the
      cell body recording site did not prevent the depression of the CA1 PS. These
      results are consistent with the notion that Ach release in the apical dendrites
      of CA1 pyramidal cells following a noxious stimulus depresses CA1 synaptic
      excitability.

PMID- 1618286
TI  - Immune system of the spontaneously hypertensive rat. I. Sympathetic innervation.
AB  - Extensive bidirectional interactions are believed to exist between the
      sympathetic nervous system and the immune system. The spontaneously hypertensive
      rat (SHR) is known to possess both increased sympathetic nervous system activity
      with increased tissue catecholamine levels in several peripheral organs and a
      moderate T lymphocyte immune deficiency. We examined the development of
      innervation in both primary (thymus) and secondary (spleen) organs of the immune
      system of the SHR compared to immunocompetent Wistar-Kyoto (WKY), Fisher 344 (F
      344), and Long Evan (LE) rats from birth through 24 weeks. Using glyoxylic acid
      induced histofluorescence to visualize monoaminergic nerve fibers, coded
      specimens were examined and morphologically evaluated for the extent and
      distribution of innervation. The innervation of the SHR thymus was significantly
      increased at 2 and 12 weeks of age over the other strains. Unlike the control
      strains, splenic innervation in SHR was delayed until 2 weeks of age when it
      suddenly became exuberant. At 12 weeks, the innervation of the SHR spleen was
      increased over all control strains. By 24 weeks the innervation had regressed to
      a level comparable to the levels of the other rat strains in these tissues.
      During the suckling period, the size (weight) of the WKY spleen was larger and
      the level of innervation was decreased compared to the other strains. These
      strain-related differences in the development of sympathetic innervation of
      thymus and spleen likely reflect the complex, bidirectional interplay between the
      nervous and the immune systems.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618287
TI  - A morphological and morphometric analysis of the optic nerve in the hypothyroid
      rat.
AB  - This investigation was designed to morphologically evaluate the effects of
      hypothyroidism on the development of myelin and axons in the rat optic nerve.
      Four pups from each group of normal and propylthiouracil-induced hypothyroid rats
      were sacrificed at 14, 21, 28, and 35 postnatal days. Optic nerves were studied
      by both light and electron microscopes. The hypothyroid animals had significantly
      reduced body and brain weights compared to those of their age-matched controls.
      In the hypothyroid animals, the cross-sectional area of the optic nerve, the
      fiber density, and fiber occupancy were significantly diminished compared to
      those of the controls. The mean individual fiber size was unaffected. However,
      the relationship between the total axonal area to myelin thickness was similar in
      the control and experimental groups, implying that the feedback mechanism between
      myelinating cells and axons was not affected by hypothyroidism. Thus, this study
      indicates that the principal insult of neonatal hypothyroidism results in a delay
      in myelin acquisition of myelinated fibers, resulting in diminished cross
      sectional area of the optic nerve, fiber density, and fiber occupancy.

PMID- 1618288
TI  - Fate of B1-B2 and B3 rhombencephalic cells transplanted into the transected
      spinal cord of adult rats: light and electron microscopic studies.
AB  - Embryonic cell suspensions (14-day embryos) containing either B3 or B1-B2
      serotonergic cell groups were obtained by microdissection of specific
      rhombencephalic regions and transplanted into the transected spinal cord of adult
      male Sprague-Dawley rats. After 3 months of survival, the animals were sacrificed
      and the spinal cords processed for the immunocytochemical detection of serotonin
      (5-HT). 5-HT-immunoreactive fibers from B1-B2-grafted cells were selectively
      distributed in the ventral horn and the intermediolateral cell column (IML) where
      they established conventional synaptic contacts. However, B3 5-HT cells grew and
      extended their processes into the dorsal horn where in addition we observed
      scarce synaptic contacts as in the normal spinal cord. These results suggest that
      the specificity of the 5-HT innervation of the spinal cord by grafted neurons is
      due, at least partly, to the presence of local mechanisms mediating guidance and
      cell recognition, possibly operating in conjunction with preexisting substrate
      pathways.

PMID- 1618289
TI  - The stimulatory effect of magnetic fields on regeneration of the rat sciatic
      nerve is frequency dependent.
AB  - The effects of exposure to sinusoidal magnetic fields on regeneration of the rat
      sciatic nerve were studied. Regeneration distances were measured after a crush
      lesion. The rats were exposed to a 0.1-mT magnetic field of various frequencies
      (50-2000 Hz) inside a pair of Helmholtz coils for various periods of time.
      Regeneration was measured by the pinch test or by immunocytochemical staining for
      neurofilaments 3, 4, or 6 days after the lesioning. Frequencies of 250, 500, and
      1000 Hz significantly increased the regeneration distance. Higher (2000 Hz) and
      lower (50 Hz) frequencies had no effect. Maximal stimulation was obtained at 1000
      Hz. At this frequency the rate of regeneration was increased by 24%. The results
      suggest that a broad frequency window exists within which the regeneration
      processes are sensitive to perturbation by magnetic fields and/or currents
      induced in the animal.

PMID- 1618290
TI  - Induction of dendritic spine proliferation by an astrocyte secreted factor.
AB  - A number of neuron-supporting functions have been ascribed to astrocytes. In this
      study we found that a proliferation of Purkinje cell dendritic spines, a target
      site for presynaptic axon terminals, was induced in cytosine arabinoside-treated
      cerebellar cultures by exposure to astrocyte-conditioned medium. This result
      suggests that astrocytes may instigate the elaboration of postsynaptic neuronal
      elements prior to the appearance of axons. This may be an important mechanism in
      neural development, postdevelopmental neuroplastic change, or regeneration.

PMID- 1618291
TI  - Amitriptyline produces analgesia in the formalin pain test.
AB  - A dose of 20 mg/kg of amitriptyline reduced pain in the second phase of the
      formalin test, which is an animal model of long-lasting pain in humans. Since the
      analgesic effect was produced by a single dose, which is insufficient to produce
      an antidepressant effect, these results indicate that amitriptyline has analgesic
      properties that are independent of its antidepressant properties.

PMID- 1618292
TI  - New mRNA probes for hippocampal responses to entorhinal cortex lesions in the
      adult male rat: a preliminary report.
AB  - Three new mRNA responses were found in the hippocampus of the adult male rat
      after entorhinal cortex lesions (ECL) that induce synaptic reorganization.
      Hippocampus cDNA libraries were screened by a subtractive hybridization strategy
      designed to detect ECL-induced mRNAs. Partial sequencing showed clones with
      similarities to mouse vimentin, ferritin, and polypeptide 7B-2. A sequence
      similar to mouse SNAP-25 sequence was also detected. Using a mouse SNAP-25 probe,
      rat SNAP-25 mRNA increased in the hippocampus after ECL.

PMID- 1618293
TI  - alpha-Amylases and approaches leading to their enhanced stability.
AB  - The recent state of the knowledge of properties and structure of alpha-amylases
      is reviewed with the aim of elucidation the basis for their stabilization. Three
      principal ways for obtaining stable alpha-amylases (isolation of enzymes from
      extremophiles, production of extremophilic enzymes in mesophiles, and
      modification of mesophilic enzymes) are discussed separately. Detailed
      experimental examples are given for modification approaches.

PMID- 1618294
TI  - HSP70-related 65 kDa protein of beet yellows closterovirus is a microtubule
      binding protein.
AB  - Beet yellows virus (BYV) genome encodes a 65 kDa protein homologous to the HSP70
      family of cellular heat-shock proteins (Agranovsky, A.A., Boyko, V.P., Karasev,
      A.V., Koonin, E.V. and Dolja, V.V. (1991) J. Mol. Biol. 217, 603-610). The
      respective gene was cloned and expressed in vitro yielding a product of the
      expected size (p65). This product was found to bind to the purified microtubules
      with a binding constant of 4 x 10(-7) M. The binding of p65 was stimulated if ATP
      presented in the translation mixture was hydrolyzed by apyrase. Removal of the
      short C-terminal domains of alpha- and beta-tubulin by subtilisin digestion
      abolished the binding, demonstrating its specificity. The possible role of p65
      association with microtubules in the movement of virus within and/or between
      plant cells is proposed.

PMID- 1618295
TI  - Correlation between local cell membrane displacements and filterability of human
      red blood cells.
AB  - Local mechanical fluctuations of the cell membrane of human erythrocytes were
      shown to involve MgATP- and Mg(2+)-driven fast membrane displacements. We propose
      that these local bending deformations of the cell membrane are important for cell
      passage through capillaries. In order to verify this hypothesis, we examined cell
      membrane fluctuations and filterability of erythrocytes over a wide range of
      medium osmolalities (180-675 mosmol/kg H2O). The results indicate the existence
      of a positive correlation between the amplitude of local cell membrane
      displacements and cell filterability. We suggest that the occurrence of
      metabolically driven membrane displacements on the side surface of the red blood
      cell diminishes its bending stiffness and enables it to fold more efficiently
      upon entrance into blood capillaries. Thus, local cell membrane displacements
      seem to play an important role in microcirculation.

PMID- 1618296
TI  - On the catalytic mechanism of EcoRI and EcoRV. A detailed proposal based on
      biochemical results, structural data and molecular modelling.
AB  - EcoRI and EcoRV have a very similar active site, as is apparent from a comparison
      of the structures of their respective protein-DNA complexes. Based on structural
      and mechanistic data, as well as detailed molecular modelling presented here, a
      mechanism for the DNA cleavage by these enzymes is suggested in which the
      attacking water molecule is activated by the phosphate group 3' to the scissile
      phosphodiester bond, and in which the leaving group is protonated by a water
      molecule associated with the essential cofactor, Mg2+. The mechanism proposed may
      also apply to other nucleases.

PMID- 1618297
TI  - A modified Kex2 enzyme retained in the endoplasmic reticulum prevents disulfide
      linked dimerisation of recombinant human insulin-like growth factor-1 secreted
      from yeast.
AB  - The majority of the recombinant human insulin-like growth factor-1 (IGF1)
      molecules, secreted from yeast using the prepro sequence of the prepro-alpha
      factor, are not active monomers but inactive, disulfide-linked dimers. The prepro
      sequence of the prepro-alpha-factor, usually referred to as the alpha-factor
      leader (alpha FL), consists of a pre or signal sequence and a proregion. After
      signal sequence removal during translocation into the endoplasmic reticulum (ER)
      the proregion is still attached to IGF1 when it folds to acquire a tertiary
      structure. Mature IGF1 is released only in a late Golgi compartment by the
      membrane-bound endoprotease Kex2p. We find that co-expression of a novel ER
      retained Kex2p variant, soluble Kex2pHDEL, can prevent intermolecular disulfide
      bond formation between two IGF1 molecules, implying that the presence of the
      proregion during the folding of IGF1 in the ER could be a reason for disulfide
      linked dimerisation. This result indicates that the proregion of the alpha FL may
      have a role in the folding of some heterologous proteins in yeast, and that the
      ER-retained Kex2p mutant could be used as a convenient tool to study the cellular
      function of the proregions present naturally in various eucaryotic precursor
      proteins.

PMID- 1618298
TI  - Identification of reactive tyrosine residues in cysteine-reactive dehydrogenases.
      Differences between liver sorbitol, liver alcohol and Drosophila alcohol
      dehydrogenases.
AB  - Modification of tyrosine residues with tetranitromethane and reversible sulphite
      protection of cysteine residues were tested on three dehydrogenases of two
      families. In liver alcohol dehydrogenase no Tyr residue is appreciably labelled,
      while in the homologous sorbitol dehydrogenase Tyr-109 is specifically labelled;
      the difference corresponds to a segment correlating with subunit interactions and
      the different quaternary structures of the proteins. In Drosophila alcohol
      dehydrogenase, Tyr modification is multiple, and the results show the presence of
      two different states of Cys residues, reactive in the presence and absence of
      cupric ions, respectively. Super-activation with cyanide was also noticed after S
      sulphocysteine protection. The results demonstrate the possibility of
      identification of specific Tyr residues in proteins with reversibly protected Cys
      residues.

PMID- 1618299
TI  - Two-way cleavage of beta-amyloid protein precursor by multicatalytic proteinase.
AB  - The beta-amyloid protein (beta-AP) derived from a beta-amyloid protein precursor
      (APP) is a hallmark of Alzheimer's disease. The abundant generation of beta-AP
      suggests the abnormal processing of APP, but the molecular mechanism remains
      unclear. The main APP-processing enzyme was purified from the rat brain and
      identified to be a macropain-like multicatalytic proteinase. The purified enzyme
      cleaved the Gln15-Lys16 bond of beta-AP, but altered to cleave at the N-terminus
      of beta-AP to release the extracellular domain of beta-AP in the presence of
      Ca2+. These findings suggest that the functional change in this multicatalytic
      proteinase may result in abnormal processing of APP.

PMID- 1618300
TI  - Detection of a new mutant alpha-1-antichymotrypsin in patients with occlusive
      cerebrovascular disease.
AB  - A new mutant alpha-1-antichymotrypsin (variant ACT) was found by direct
      sequencing and PCR-single strand conformation polymorphism (PCR-SSCP). This
      variant ACT was a point mutation of exon V of ACT, with the substitution of Met
      by Val. Four out of six individuals with this variant ACT had occlusive
      cerebrovascular disease, leading to one hypothesis that there might be an
      association between this mutation and occlusive-cerebrovascular disease.

PMID- 1618302
TI  - Exon-intron organization of the Arabidopsis thaliana protein kinase genes CDC2a
      and CDC2b.
AB  - We have previously shown by cDNA cloning that a higher plant, Arabidopsis
      thaliana, possesses at least two CDC2 genes (CDC2a and CDC2b) similar to the cell
      cycle-controlling cdc2 gene of Schizosaccharomyces pombe. To understand the exon
      intron organization of these genes, genomic clones were isolated and their
      nucleotide sequences determined. The coding and 5'-untranslated regions of CDC2a
      were interrupted by seven and one introns, respectively, whilst CDC2b contained
      three introns within the coding portion. These intron positions partly overlapped
      with each other and with those of the yeast cdc2 gene, nevertheless the lengths
      and sequences of the corresponding introns were diverse.

PMID- 1618301
TI  - Group II phospholipase A2 induced by interleukin-1 beta in cultured rat gingival
      fibroblasts.
AB  - Previously, we reported the presence of group II-like phospholipase A2 activity
      in the soluble fraction of rat gingiva. In the present study, we found that
      treatment of rat gingival cells with human recombinant interleukin-1 beta
      resulted in dose-dependent stimulation of intracellular and extracellular
      phospholipase A2 activity. Antisera against group II phospholipase A2 totally
      blocked the interleukin-1 beta-induced phospholipase A2 activity, but antisera
      against group I phospholipase A2 did not. Moreover, immunoblot analysis showed
      that the induced phospholipase A2 was group II phospholipase A2. These findings
      suggest that the induced enzyme belongs to the group II phospholipase A2 family
      of proinflammatory enzymes.

PMID- 1618303
TI  - Conversion of 5,6-dihydroxyeicosatetraenoic acids. A novel pathway for lipoxin
      formation by human platelets.
AB  - Leukotriene A4 may be metabolized to 5(S),6(R)- and 5(S),6(S)-dihydroxy-7,9-trans
      11,14-cis-eicosatetraenoic acids by enzymatic or non-enzymatic hydrolysis.
      Incubation of human platelet suspensions with these dihydroxy acids led to the
      formation of lipoxin A4 and 6(S)-lipoxin A4 via lipoxygenation at C-15.
      Furthermore, human platelets converted the two 5(R),6(S)- and 5(R),6(R)-dihydroxy
      7,9-trans-11,14-cis-eicosatetraenoic acids to tetraene-containing
      trihydroxyeicosatetraenoic acids. In contrast, leukotrienes C4, D4 and E4 were
      not transformed to cysteinyl-lipoxins. Time-course studies of leukotriene A4
      metabolism in human platelet suspensions indicated lipoxin formation via two
      pathways: (i) direct conversion of leukotriene A4, leading to formation of the
      lipoxin intermediate 15-hydroxy-leukotriene A4; and (ii) 15-lipoxygenation of the
      5(S),6(R)- and 5(S),6(S)-dihydroxyeicosatetraenoic acids. The results demonstrate
      that lipoxygenation at C-15 of 5,6-dihydroxy-7,9,11,14-eicosatetraenoic acids may
      be an alternative novel pathway for platelet-dependent lipoxin formation.

PMID- 1618304
TI  - Involvement of separate domains of the cellulosomal protein S1 of Clostridium
      thermocellum in binding to cellulose and in anchoring of catalytic subunits to
      the cellulosome.
AB  - Fragments of the 250 kDa S1 subunit of the Clostridium thermocellum cellulosome
      were obtained by protease-induced or spontaneous degradation. All detectable
      fragments, down to a mass of about 30 kDa, retained the ability to bind to 125I
      labelled endoglucanase CelD, one of the catalytic subunits of the cellulosome.
      Several fragments were able to bind both to cellulose and to CelD. However, some
      fragments that could still bind to CelD did not have the ability to bind to
      cellulose. Therefore, S1, a putative scaffolding protein of the cellulosome, is
      likely to carry two separate types of domains, one of which binds to cellulose,
      while the other type binds to the various catalytic subunits of the complex.

PMID- 1618305
TI  - Relationship of neural cell adhesion molecules (N-CAMs) with adenylate cyclase.
AB  - Bovine brain cDNA cloned earlier and attributed to calmodulin-independent
      adenylate cyclase encodes the neural cell adhesion molecule (N-CAM). The
      expression of N-CAM mRNA in Xenopus laevis oocytes increases their basal
      adenylate cyclase activity. Polyclonal antibodies against synthetic peptide A,
      VAENQQGKSKAAHFV (664-678 amino acid residues of bovine N-CAM), containing
      sequence AXXXXGKS which is homologous to the nucleotide-binding consensus
      sequence GXXXXGKS, inhibit the adenylate cyclase activity. A close relationship
      appears to exist between adenylate cyclase and N-CAM.

PMID- 1618306
TI  - Autophagic degradation of peroxisomes in isolated rat hepatocytes.
AB  - Degradation of the peroxisomal enzymes fatty acyl-CoA oxidase and catalase was
      studied in hepatocytes isolated from rats treated with clofibrate and from
      control rats. Hepatocytes were incubated in the absence of amino acids in order
      to ensure maximal flux through the autophagic pathway and in the presence of
      cycloheximide to inhibit protein synthesis. (1) Degradation of the two
      peroxisomal enzymes in hepatocytes from clofibrate-fed rats, but not in
      hepatocytes from control rats, was much faster than that of other intracellular
      enzymes. This increased degradation of the peroxisomal enzymes was almost
      completely prevented by 3-methyladenine, an inhibitor of macroautophagic
      sequestration. (2) The increased degradation of the peroxisomal enzymes was also
      inhibited by a long-chain (C16:0) and a very-long-chain (C26:0) fatty acid, but
      not by C12:0, a medium-chain fatty acid, or by C8:0, a short-chain fatty acid.
      These results provide direct evidence for the proposal that autophagic
      sequestration can be highly selective [(1987) Exp. Mol. Pathol. 46, 114-122]. It
      is concluded that preferential autophagy of peroxisomes is prevented when these
      organelles are supplied with their fatty acid substrates.

PMID- 1618307
TI  - Transcription efficiency of human apolipoprotein A-I promoter varies with
      naturally occurring A to G transition.
AB  - In human, the gene coding for apolipoprotein A-I (apo A-I), a protein of the
      plasma lipid transport system, is expressed only in the liver and the intestine.
      A naturally occurring A to G substitution in the promoter at position -78 was
      shown to be associated with high density lipoproteins (HDL) in females. We have
      studied the effect of this mutation on promoter activity using various lengths of
      promoter sequences and the CAT reporter gene system. Transient expression studies
      after introduction of these constructs into Hep 3B cells revealed that in the
      region spanning -330 to +1 of the promoter an A to G substitution increases the
      activity approximately twofold. On the other hand, when further upstream region (
      1469 to +397) is also included, the promoter activity seems comparable in both
      alleles. Our results show how minimal sequence variations can affect the in vitro
      analysis of promoter activity.

PMID- 1618308
TI  - Coordinate regulation of murein peptidase activity and AmpC beta-lactamase
      synthesis in Escherichia coli.
AB  - In the periplasmic space of Escherichia coli, the (L)-m-A2pm-(D)-m-A2pm peptide,
      the lipoprotein, and the AmpC beta-lactamase are controlled by growth rate. To
      explain this coordinate regulation, it is proposed that the AmpC protein
      functions as an LD-endopeptidase in addition to its known function as a beta
      lactamase. As LD-peptides, DD-peptides and beta-lactams are structurally similar,
      LD-peptidases may belong to the larger family of DD-peptidases and serine beta
      lactamases. In contrast to E. coli, many related bacteria possess an inducible
      AmpC protein. Several gene systems necessary for AmpC induction are known to
      affect various aspects of peptidoglycan metabolism. It is proposed that AmpC
      induction occurs indirectly via a recyclable cell wall peptide.

PMID- 1618309
TI  - Characterisation of a chloroplast-encoded secY homologue and atpH from a
      chromophytic alga. Evidence for a novel chloroplast genome organisation.
AB  - secY is a prokaryotic gene that encodes the SecY protein, an integral membrane
      component of the prokaryotic protein translocation apparatus. A chloroplast
      encoded secY homologue has been identified in the unicellular, chromophytic alga,
      Pavlova lutherii. The gene predicts a protein composed of ten membrane-spanning
      regions, that is approximately 25% homologous and 50% similar to bacterial and
      plastid SecY proteins. The secY gene from P. lutherii is independent of the
      ribosomal protein (rp) gene cluster to which it is closely linked in other
      organisms. In P. lutherii secY is located 5' to atpI and atpH. Since, in higher
      plants the atpIHFA gene cluster and the rp gene cluster are separated by
      approximately 50 kb, we conclude, this indicates a novel chloroplast gene
      arrangement in P. lutherii.

PMID- 1618310
TI  - Inositol trisphosphate-induced hyperpolarization in rat dorsal root ganglion
      neurons.
AB  - Inositol 1,4,5-trisphosphate (1,4,5-InsP3) was perfused into rat dorsal root
      ganglion (DRG) neurons by whole-cell patch-clamp electrodes, while measuring the
      membrane potential. This operation evoked a transient (2-3 min) membrane
      hyperpolarization of about -15 mV (from -42 mV) followed by a depolarization. The
      membrane hyperpolarization was abolished when 30 mM EGTA was perfused together
      with 1,4,5-InsP3 or when 0.2 mM quinine was added to the bath solution. The
      hyperpolarizing response was enhanced when a low-Ca2+ EGTA-free intracellular
      solution was used. Two InsP2 isomers induced a different response. Our results
      suggest that the hyperpolarization is due to 1,4,5-InsP3-induced Ca2+ release
      which may trigger Ca-sensitive K+ channels to open. Present results show that
      cultured DRG neurons are able to respond to 1,4,5-InsP3 perfusion in the whole
      cell configuration.

PMID- 1618311
TI  - Correlation between carbohydrate-binding specificity and amino acid sequence of
      carbohydrate-binding regions of Cytisus-type anti-H(O) lectins.
AB  - A carbohydrate-binding peptide of the di-N-acetylchitobiose-binding Cytisus
      sessilifolius anti-H(O) lectin I (CSA-I) was isolated from the endoproteinase Asp
      N digest of CSA-I by affinity chromatography on a column of N-acetyl-D
      glucosamine oligomer-Sepharose (GlcNAc oligomer-Sepharose). The amino acid
      sequence of the carbohydrate-binding peptide of CSA-I was determined to be
      DTYFGKTYNPW using a gas-phase protein sequencer. This sequence corresponds to the
      sequence from Asp-129 to Trp-139 based on the primary structure of CSA-I, and
      shows a high degree of homology to those of the putative carbohydrate-binding
      peptide of the Laburnum alpinum lectin I (LAA-I) (DTYFGKAYNPW) and of the Ulex
      europaeus lectin II (UEA-II) (DSYFGKTYNPW). The binding of these three anti-H(O)
      lectins is known to be inhibited by di-N-acetylchitobiose but not by L-fucose.
      These results strongly suggest that there is a good correlation between the
      carbohydrate-binding specificity and the amino acid sequence of the carbohydrate
      binding regions of di-N-acetylchitobiose-binding lectins.

PMID- 1618312
TI  - Photoinduced degradation of the D1 protein in isolated thylakoids and various
      photosystem II particles after donor-side inactivations. Detection of a C
      terminal 16 kDa fragment.
AB  - Photoinduced degradation of the photosystem II (PSII) reaction center D1 protein
      was studied in isolated thylakoids and different PSII subparticles. A 16 kDa
      fragment corresponding to the C-terminus of the protein is detected in thylakoids
      when they are inactivated at the donor side before illumination. The same D1
      fragment is found in different types of PSII preparations at different
      integration levels characterized by different polypeptide compositions so long as
      they have an inactivated donor side and an active electron acceptor for the
      reduced pheophytin. However, when the PSII particle is equal to or smaller than
      the 43-less PSII core complex, other fragments are observed which are not found
      in more integrated systems.

PMID- 1618313
TI  - IL-2-dependent in vivo and in vitro tyrosine phosphorylation of IL-2 receptor
      gamma chain.
AB  - We previously reported a molecule, p64, which was tentatively named the gamma
      chain, coprecipitable with the beta chain of human interleukin-2 receptor (IL
      2R). The present study demonstrated that the gamma chain, as well as the beta
      chain expressed on IL-2-responsive cells, is phosphorylated on tyrosine residues
      in an IL-2-dependent manner in vivo and in vitro. The in vivo tyrosine
      phosphorylation of both chains was similarly induced within 1 min after IL-2
      stimulation, and their in vitro tyrosine phosphorylation with the anti-IL-2R beta
      antibody-directed immunocomplex was also increased by treatment of cells with IL
      2. These results suggest that a tyrosine kinase is associated with the beta gamma
      subunit complex, of which activation by IL-2 may result in transduction of
      intracellular signals.

PMID- 1618314
TI  - Purification and primary structure of murine cryptdin-1, a Paneth cell defensin.
AB  - We have purified and determined the amino acid sequence of cryptdin-1, a murine
      Paneth cell defensin. The peptide corresponds to a previously characterized mRNA
      that accumulates to high abundance during postnatal ontogeny of the small bowel.
      Acid-extracted intestinal protein was fractionated by cation-exchange
      chromatography and fractions were assayed for antimicrobial activity. One peak of
      anti-Salmonella activity contained a putative defensin, based on its predicted
      electrophoretic migration in acid-urea PAGE. The peptide was purified to
      homogeneity by RP-HPLC and sequenced. These studies demonstrate defensin
      expression in non-myeloid tissue. The N-terminal extension of cryptdin-1 is a
      unique structural feature of this novel epithelial defensin.

PMID- 1618315
TI  - Natural abundance 15N NMR assignments delineate structural differences between
      intact and reactive-site hydrolyzed Cucurbita maxima trypsin inhibitor III.
AB  - 15N NMR assignments were made to the backbone amide nitrogen atoms at natural
      isotopic abundance of intact and reactive-site (Arg5-Ile6) hydrolyzed Cucurbita
      maxima trypsin inhibitor III (CMTI-III and CMTI-III*, respectively) by means of
      2D proton-detected heteronuclear single bond chemical shift correlation (HSBC)
      spectroscopy, utilizing the previously made sequence-specific 1H NMR assignments
      (Krishnamoorthi et al. (1992) Biochemistry 31, 898-904). Comparison of the 15N
      chemical shifts of the two forms of the inhibitor molecule revealed significant
      changes not only for residues located near the reactive-site region, but also for
      those distantly located. Residues Cys3, Arg5, Leu7, Met8, Cys10, Cys16, Glu19,
      His25, Tyr27, Cys28 and Gly29 showed significant chemical shift changes ranging
      from 0.3 to 6.1 ppm, thus indicating structural perturbations that were
      transmitted throughout the molecule. These findings confirm the earlier
      conclusions based on 1H NMR investigations.

PMID- 1618316
TI  - Increase in protein kinase C activity is associated with human fibroblast growth
      inhibition.
AB  - Protein kinase C (PKC) activity and DNA synthesis were measured in human fetal
      bone marrow fibroblasts following treatment with tumor necrosis factor alpha (TNF
      alpha) (500 U/ml) or conditioned media containing natural cell proliferation
      inhibitor (CM-NCPI). Treatment with TNF alpha led to growth stimulation (120 +/-
      7% of control in 24 h, 141 +/- 6% in 72 h). At the same time particulate PKC
      activity diminished, reaching 55 +/- 8% of control in 24 h and remaining at this
      level at 72 h. CM-NCPI treatment of the cells resulted in a decrease in DNA
      synthesis (by 39 +/- 6% in 2 h, by 58 +/- 5% in 24 h, and by 78 +/- 8% in 72 h).
      This was accompanied by a significant rise in particulate PKC activity which
      increased over 3-fold in 2 h, over 5-fold in 24 h, and up to 11-fold in 72 h.
      This 11-fold elevation was maintained after 2 week exposure of the fibroblasts to
      CM-NCPI. The PKC inhibitor neomycin abolished CM-NCPI induced growth inhibition,
      whereas PKC activator 12-O-tetradecanoylphorbol 13-acetate intensified it. These
      results suggest that CM-NCPI acts as PKC activator and that negative growth
      regulation by extracellular agents may involve stimulation of PKC activity.

PMID- 1618317
TI  - Baculovirus expression of mammalian G protein alpha subunits.
AB  - Complementary DNAs encoding three subtypes of the alpha subunit (alpha i-1, alpha
      o and alpha s) of rat guanyl nucleotide regulatory proteins were used to
      construct recombinant baculoviruses which direct high-level expression of the
      corresponding proteins in cultured Sf9 insect cells. The expressed proteins were
      recognized by polyclonal antisera specific for the different alpha chains, and co
      migrated with the native proteins from rat brain membranes in immunoblotting
      analyses. Soluble and particulate forms of all three immunoreactive alpha chains
      were observed following ultracentrifugation of cell lysates. Biosynthetic
      radiolabelling of infected cells with [35S]methionine or [3H]myristate showed
      that both soluble and particulate forms of alpha i-1 and alpha o were
      myristoylated; in contrast, alpha s did not incorporate myristate. The soluble
      fractions from cells expressing alpha chains showed high levels of GTP-binding
      activity over that observed in uninfected cells, or in cells infected with wild
      type virus. The peak expression levels observed at 72 h post-infection were
      highest for alpha o at ca. 400 pmol of GTP-gamma-35S/mg protein, or roughly 2% of
      the total soluble protein. The results of this work show that the baculovirus
      system can be employed for high-level production of mammalian G protein alpha
      chains which retain GTP-binding activity and are appropriately modified by
      myristoylation.

PMID- 1618318
TI  - Purification of the MglC/E membrane proteins of the binding protein-dependent
      galactose transport system of Salmonella typhimurium.
AB  - The high affinity galactose transport system of Salmonella typhimurium consists
      of four proteins, a periplasmic galactose binding protein (the MglB protein), and
      three inner membrane-associated proteins, the MglA, MglC and MglE proteins. We
      purified the MglC/E proteins from an MglC/E hyperproducing strain after
      solubilisation of inclusion bodies in guanidine hydrochloride followed by
      renaturation in a detergent-containing buffer and affinity chromatography on a
      MglB-Sepharose column. The MglC/E proteins are devoid of ATPase activity and they
      complement an extract from a strain carrying a plasmid with the mglA gene for
      reconstitution of the MglB-dependent galactose transport in proteoliposomes.

PMID- 1618319
TI  - GTP-binding proteins in luminal and basolateral membranes from pars convoluta and
      pars recta of rabbit kidney proximal tubule.
AB  - The GTP-binding proteins on luminal and basolateral membrane vesicles from outer
      cortex (pars convoluta) and outer medulla (pars recta) of rabbit proximal tubule
      have been examined. The membrane vesicles were highly purified, as ascertained by
      electron microscopy, by measurements of marker enzymes, and by investigating
      segmental-specific transport systems. The [35S]GTP gamma S binding to vesicles,
      and to sodium cholate-extracted proteins from vesicles, indicated that the total
      content of GTP-binding proteins were equally distributed on pars convoluta, pars
      recta luminal and basolateral membranes. The membranes were ADP-ribosylated with
      [32P]NAD+ in the presence of pertussis toxin and cholera toxin. Gel
      electrophoresis revealed, for all preparations, the presence of cholera toxin
      [32P]ADP-ribosylated 42 and 45 kDa G alpha s proteins, and pertussis toxin
      [32P]ADP-ribosylated 41 kDa G alpha i1, 40 kDa G alpha i2 and 41 kDa G alpha i3
      proteins. The 2D electrophoresis indicated that Go's were not present in luminal
      nor in basolateral membranes of pars convoluta or pars recta of rabbit proximal
      tubule.

PMID- 1618320
TI  - The kinetics of a two-state transition of myosin subfragment 1. A temperature
      jump relaxation study.
AB  - Temperature-jump measurements were carried out on myosin subfragment 1 (S1)
      labeled at Cys-707 with 5-(iodoacetamido)fluorescein (S1-AF). The relaxation was
      monitored by following the increase in the fluorescence intensity of the attached
      probe after a jump of 5.8 degrees C. A single relaxation process was observed
      over a range of final temperatures, and the relaxation time decreased from 16.69
      ms at 15 degrees C to 3.91 ms at 27 degrees C. The relaxation results are
      interpreted in terms of a two-state transition: (S1-AF)L K+ in equilibrium with K
      (S1-AF)H, and the observed single relaxation time (tau) equals l/(k(+) + k-).
      The individual first-order rate constants, k+ and k-, were calculated from tau
      and the equilibrium constant previously determined. The activation energy was
      21.9 kcal/mol for the forward reaction and 9.3 kcal/mol for the reverse reaction,
      corresponding to an enthalpy value of 12.6 kcal/mol for the two-state transition.
      The results provide, for the first time, direct kinetic evidence of a two-state
      transition of S1 in the absence of bound nucleotide, and support a two-state
      model of unliganded myosin subfragment 1.

PMID- 1618321
TI  - Quantitative analysis of dystrophin in fast- and slow-twitch mammalian skeletal
      muscle.
AB  - The relative tissue content of dystrophin has been evaluated in the slow-twitch
      soleus (primarily type I fibers) and fast-twitch vastus lateralis (primarily type
      IIb fibers) muscles of the rat and mouse, as well as in human biopsy samples from
      the vastus lateralis and gluteus maximus muscles, using a sensitive
      immunochemical assay. The dystrophin content of the soleus muscle was
      approximately twofold higher than in the vastus lateralis muscle. This difference
      is not entirely explained by the higher total sarcolemmal surface of the smaller
      soleus muscle type I fibers, and is therefore attributed to a higher content of
      dystrophin in the type I fibers compared to type IIb fibers. PCR analysis of the
      dystrophin transcript levels in the two muscle types indicated no significant
      differences. Analysis of human muscle biopsies revealed a twofold higher
      dystrophin content in the vastus lateralis muscle compared to the gluteus maximum
      muscle. It is concluded that the tissue content of dystrophin may vary
      significantly among physiologically different skeletal muscle types.

PMID- 1618322
TI  - Cyclosporin A protects hepatocytes subjected to high Ca2+ and oxidative stress.
AB  - Hepatocytes incubated with 0.8 mM t-butylhydroperoxide are protected by
      cyclosporin A when the medium Ca2+ concentration is 10 mM, but not when it is 2.5
      mM. The highest Ca2+ level is associated with an inhibition of t
      butylhydroperoxide-dependent malondialdehyde accumulation and with mitochondrial
      Ca2+ loading within the cells. These findings are new evidence that t
      butylhydroperoxide can kill cells by peroxidation-dependent and -independent
      mechanisms, and suggest that the mitochondrial permeability transition and the
      resultant de-energization are components of the peroxidation-independent
      mechanism. Cyclosporin A may have considerable utility for the protection of
      cells subjected to oxidative stress.

PMID- 1618323
TI  - Inhibitors of polyamine biosynthesis affect the expression of genes encoding
      cytoskeletal proteins.
AB  - The polyamines are ubiquitous components of mammalian cells. Those compounds have
      been postulated to play an important role in different cellular functions
      including the reorganization of cytoskeleton associated with the cell cycle. In
      the studies reported here, it was found that inhibitors of polyamine
      biosynthesis, methylglyoxal-bis[quanylhydrazone] (MGBG) and
      difluoromethylornithine (DFMO), prevent mitogen-induced accumulation of mRNAs
      encoding major cytoskeletal components, beta-actin and alpha-tubulin, in mouse
      splenocytes. These findings suggest mechanisms through which polyamines may exert
      their effects on the cytoskeleton integrity.

PMID- 1618324
TI  - The identification and characterisation of an actin-binding site in alpha-actinin
      by mutagenesis.
AB  - We have shown previously that the N-terminal actin-binding domain of alpha
      actinin retains activity when expressed in E. coli as a fusion protein with
      glutathione-S-transferase. In the present study we have made a series of N- and C
      terminal deletions within this domain and show that an actin-binding site is
      contained within residues 120-134. Amino acid substitutions within this region
      indicate that several highly conserved hydrophobic residues are involved in
      binding to F-actin. The hypothesis that the interaction between alpha-actinin and
      F-actin is predominantly hydrophobic in nature is supported by the observation
      that binding is relatively independent of salt concentration.

PMID- 1618325
TI  - A protein factor extracted from murine brains confers physiological Ca2+
      sensitivity to exocytosis in sea urchin eggs.
AB  - Exocytosis in sea urchin eggs can be reconstituted in vitro using the cell ghosts
      (the isolated cortices). When the isolated cortices were handled in the medium
      primarily composed of non-chaotropic ions, exocytosis can be induced by a
      micromolar level of Ca2+. However, when the cortices are exposed to chaotropic
      anions such as Cl-, it is induced only at higher Ca2+ concentrations of 10(-5) to
      10(-4) M, due to the chaotropic anionic effect, by which a specific protein(s) is
      dissociated from the cortex. The dissociated protein can be added back to the
      cortex to restore the original Ca2+ sensitivity [(1984) Dev. Biol. 101, 125-135].
      A protein which has the similar effect on the isolated cortex was also found in
      the extract of murine brain. This protein was neither calmodulin, a G-protein or
      a kinase. The data suggest the general regulatory mechanism of the Ca2+
      sensitivity of exocytosis by a protein factor widely distributed among cells.

PMID- 1618326
TI  - Acidic pH induces fusion of cells infected with baculovirus to form syncytia.
AB  - The enveloped baculovirus insect cell system has been used extensively for
      expression of recombinant proteins, including viral fusion proteins. We tested
      wild-type baculovirus for endogenous fusion protein activity. Syncytia formation,
      dye transfer, and capacitance changes were observed after incubating infected
      Spodoptera frugiperda cells in acidic media, consistent with fusion protein
      activity. Only a short acidic pulse of 10 s is needed to trigger syncytia
      formation. Identical results were obtained with recombinant baculovirus. This new
      system is convenient for studying pH activated cell-cell fusion. However, using
      this enveloped virus to study the mechanism of recombinant fusion proteins
      requires caution.

PMID- 1618327
TI  - Identification of DEBS 1, DEBS 2 and DEBS 3, the multienzyme polypeptides of the
      erythromycin-producing polyketide synthase from Saccharopolyspora erythraea.
AB  - The ery A region of the erythromycin biosynthetic gene cluster of
      Saccharopolyspora erythraea has previously been shown to contain three large open
      reading frames (ORFs) that encode the components of 6-deoxyerythronolide B
      synthase (DEBS). Polyclonal antibodies were raised against recombinant proteins
      obtained by overexpression of 3' regions of the ORF2 and ORF3 genes. In Western
      blotting experiments, each antiserum reacted strongly with a different high
      molecular weight protein in extracts of erythromycin-producing S. erythraea
      cells. These putative DEBS 2 and DEBS 3 proteins were purified and subjected to N
      terminal sequence analysis. The protein sequences were entirely consistent with
      the and DEBS 3 proteins were purified and subjected to N-terminal sequence
      analysis. The protein sequences were entirely consistent with the translation
      start sites predicted from the DNA sequences of ORFs 2 and 3. A third high
      molecular weight protein co-purified with DEBS 2 and DEBS 3 and had an N-terminal
      sequence that matched a protein sequence translated from the DNA sequence some
      155 base pairs upstream from the previously proposed start codon of ORF1.

PMID- 1618328
TI  - Cloning of a human choline kinase cDNA by complementation of the yeast cki
      mutation.
AB  - A human choline kinase cDNA was cloned by complementation of the yeast choline
      kinase mutation, cki, from a human glioblastoma cDNA expression library. The
      deduced sequence of the human enzyme comprised 456 amino acids with a calculated
      relative molecular mass of 52,065. The human enzyme resembled the rat liver
      enzyme over the entire sequence. It also resembled the yeast enzyme in the
      carboxy-terminal region, but not much in the amino-terminal region.

PMID- 1618329
TI  - Transcriptional activation of the gene for the large subunit of human m-calpain
      by 12-o-tetradecanoyl-phorbol-13-acetate.
AB  - The effect of the treatment of HeLa cells with a tumor-promoting phorbol ester,
      12-o-tetradecanoyl-phorbol-13-acetate (TPA) on the expression of the genes for
      the calpain family has been examined. Among the mRNAs for the calpain family,
      only the mRNA for the large subunit of human m-calpain (calpain mL) was
      specifically induced by treatment of cells with TPA, suggesting its specific
      function in response to cellular stimuli. The effect of TPA on the expression of
      the calpain mL gene was further examined using fusion genes containing the
      promoter/enhancer region of the calpain mL gene fused upstream of the bacterial
      chloramphenicol acetyltransferase (CAT) gene, showing that the promoter/enhancer
      sequence of the calpain mL gene contains a cis-acting element which responds to
      TPA and activates transcription of the downstream sequence.

PMID- 1618330
TI  - Zwitterionic amphiphiles that raise the bilayer to hexagonal phase transition
      temperature inhibit protein kinase C. The exception that proves the rule.
AB  - We synthesized the zwitterionic amphiphile cholesterylphosphorylethylpyridinium.
      This substance activated protein kinase C (PKC) in a micelle-based assay, but in
      a vesicle assay it was inhibitory. An analog of this compound, in which the
      pyridine ring is saturated and the nitrogen methylated, showed similar behaviour
      with PKC. Replacing cholesterol by an aliphatic alcohol lowered the extent of
      activation in the micelle assay. These results demonstrate that, with some
      membrane additives, the vesicle and micelle assays give opposite results. Results
      from the membrane-based vesicle assay for PKC are in accord with the
      generalization that zwitterionic amphiphiles that raise the bilayer to hexagonal
      phase transition temperature in model membranes are inhibitors of PKC.

PMID- 1618331
TI  - Fluorescence studies on the interaction of adenine with ricin A-chain.
AB  - Ricin A-chain, an N-glycosidase that attacks 28S rRNA at a highly conserved
      adenine residue, has a unique tryptophan (Trp-211) in the putative active site
      cleft. Fluorescence spectroscopy revealed that specific binding of adenine to the
      A-chain caused a large enhancement of Trp-211 fluorescence (70%) and a
      concomitant red shift of the emission spectrum (8 nm). A Scatchard plot of the
      fluorescence enhancement data was not linear, indicating that the environment of
      Trp-211 was altered by heterogeneous binding of adenines. These results, taken
      together with the protective effect of adenine on the ribosome-inactivation by
      ricin A-chain, suggest that at least two adenines bind to the active site cleft.

PMID- 1618332
TI  - The Euglena gracilis rbcS gene contains introns with unusual borders.
AB  - We have recently shown that, in Euglena gracilis, leader sequences are
      transferred by trans-splicing to the vast majority of cytoplasmic mRNAs. Trans
      splicing is involved in the maturation of the rbcS transcript, which encodes
      eight small subunits of the ribulose 1,5 bisphosphate carboxylase/oxygenase. In
      this report, we show that the Euglena rbcS gene introns are different from
      introns found in plant rbcS genes. In addition these introns do not have the
      conserved 5' and 3' border sequences found in introns of eucaryotic nuclear
      encoded pre-mRNAs, and they do not present any homology with self-splicing
      introns of groups I and II. Secondary structure analyses show that the 5' and 3'
      ends of Euglena introns can base-pair, suggesting that an unusual splicing
      mechanism exists in Euglena.

PMID- 1618333
TI  - Identification of cholesterol-bound aldehydes in copper-oxidized low density
      lipoprotein.
AB  - Lipid-soluble cholesteryl ester core aldehydes (aldehydes still bound to the
      cholesterol ring) were identified among the products of copper-catalyzed
      peroxidation of human low density lipoprotein (LDL). The LDL was exposed to
      oxygenated buffer and 5 microM CuSO4 for 24 h. The core aldehydes were isolated
      as the dinitrophenylhydrazones, and were identified by reverse-phase HPLC with
      mass spectrometry. The major components were the C4-C10 oxoalkanoyl esters of
      cholesterol and 7-ketocholesterol, and accounted for 1-2% of the cholesteryl
      linoleate and arachidonate consumed.

PMID- 1618334
TI  - Is bupivacaine a decoupler, a protonophore or a proton-leak-inducer?
AB  - This paper deals with the mechanism of bupivacaine uncoupling of oxidative
      phosphorylation in rat heart mitochondria. By comparison with the effects of QX
      572, a permanently charged quaternary amine-type local anesthetic, it is
      concluded that the effects of bupivacaine and QX 572 may be explained by
      classical uncoupling behaviour. In the case of bupivacaine this uncoupling effect
      is mediated through a protonophore-like mechanism, whereas that of QX 572 is
      simply explained by an electrophoretic uptake.

PMID- 1618335
TI  - Yeast ADP/ATP carrier (AAC) proteins exhibit similar enzymatic properties but
      their deletion produces different phenotypes.
AB  - Saccharomyces cerevisiae strains expressing a single type of ADP/ATP carrier
      (AAC) protein were prepared from a mutant in which all AAC genes were disrupted,
      by transformation with plasmids containing a chosen AAC gene. As demonstrated by
      measurements of [14C]ADP specific binding and transport, all three translocator
      proteins, AAC1, AAC2 and AAC3 when present in the mitochondrial membrane,
      exhibited similar translocation properties. The disruption of some AAC genes,
      however, resulted in phenotypes indicating that the function of these proteins in
      whole cells can be quite different. Specifically, we found that the disruption of
      AAC1 gene, but not AAC2 and AAC3, resulted in a change in colony phenotype.

PMID- 1618336
TI  - Biological activity of bovine placental lactogen in 3T3-F442A preadipocytes is
      mediated through a somatogenic receptor.
AB  - Bovine placental lactogen (bPL) exhibited antimitogenic differentiation-promoting
      biological activity in 3T3-F442A preadipocytes. Competitive binding studies and
      affinity labelling revealed bPL activity to be mediated through a somatogenic
      type of receptor that recognizes human growth hormone (hGH) and bovine GH, but
      not ovine prolactin or human PL. The bioactivity of bPL was sixfold lower than
      that of hGH despite that bPL is binding to the somatogenic receptors with
      fivefold higher affinity. This discrepancy may result from the relatively low
      ability of bPL to induce post-receptoral effects such as receptor dimerization.

PMID- 1618337
TI  - 1H NMR study on the conformation of bacitracin A in aqueous solution.
AB  - The conformation of bacitracin A, a widely used cyclic dodecapeptide antibiotic
      in aqueous solution, has been investigated using 500 MHz 1H NMR and molecular
      modeling. Findings revealed that a region (residues 1-6) is folded over the
      cyclic ring, resulting in metal coordination sites, a thiazoline ring, and Glu4
      and His10 being proximate to each other.

PMID- 1618338
TI  - Cloning and expression of a glycine transporter from mouse brain.
AB  - We have isolated a cDNA clone from a mouse brain library encoding the glycine
      transporter (GLYT). Xenopus oocytes injected with a synthetic mRNA accumulated
      [3h]glycine to levels of up to 80-fold above control values. The uptake was
      specific for glycine and dependent on the presence of Na+ and Cl- in the medium.
      The cDNA sequence predicts a highly hydrophobic protein of 633 amino acids with
      12 potential transmembrane helices. The predicted amino acid sequence has 40-45%
      identity to the GABA, noradrenaline, serotonin and dopamine transporters. This
      implies that all of these neurotransmitter transporters may have evolved from a
      common ancestral gene that diverged into the GABA, glycine and catecholamine
      subfamilies at nearly the same time.

PMID- 1618339
TI  - Synthesis and characterization of a 29-amino acid residue DNA-binding peptide
      derived from alpha/beta-type small, acid-soluble spore proteins (SASP) of
      bacteria.
AB  - A 29-amino acid residue peptide (SASP-peptide) derived from the sequence of the
      putative DNA-contacting portion at the carboxyl terminus of an alpha/beta-type
      small, acid-soluble spore protein (SASP) of Bacillus subtilis has been
      synthesized by automated solid-phase methods and tested for its ability to
      interact with DNA. Circular dichroism (CD) spectroscopy reveals an interaction
      between this SASP-peptide and DNA, both by an increase in alpha-helix content of
      the peptide (which alone has a mostly random conformation) and by enhancement of
      the 275-nm CD band of the DNA. In contrast to results with intact alpha/beta-type
      SASP, however, the peptide does not induce a B----A conformational transition in
      the DNA. The SASP-peptide also binds to poly(dG).poly(dC) and protects this
      polynucleotide against DNase I digestion and UV light-induced cytosine dimer
      formation, parallel to findings made previously with native alpha/beta-type SASP.
      The results confirm the hypothesis that the carboxyl-terminal region of the
      alpha/beta-type SASP directly contacts DNA and possesses some, but not all, of
      the functional characteristics of the intact molecule.

PMID- 1618340
TI  - Measurement of GTP gamma S binding to specific G proteins in membranes using G
      protein antibodies.
AB  - We developed a novel method to quantitatively measure GTP gamma S binding to
      specific G proteins in crude membranes using G-protein antibodies. The basic
      strategy was that the materials were initially incubated with [35S]GTP gamma S at
      37 degrees C. After 4 degrees C incubation in the wells of an ELISA plate
      precoated with G-protein antibodies, the radioactivity of each well was counted.
      This method, using an anti-Gi antiserum and an anti-Gs antiserum, quantitatively
      and specifically detected the binding of GTP gamma S to purified Gi2 and Gs. In
      S49 cell membranes, GTP gamma S binding to immunoreactive Gs was observed in a
      time-dependent manner that obeyed first-order kinetics, and the rate constant was
      stimulated approximately twofold in response to isoproterenol. The effect of
      isoproterenol was not observed in unc mutant membranes. The present method thus
      makes it possible to quantitatively measure GTP gamma S binding to specific G
      proteins in cell membranes.

PMID- 1618341
TI  - Targeting efficiencies of various permutations of the consensus C-terminal
      tripeptide peroxisomal targeting signal.
AB  - Two types of peptide signals are known to independently target proteins into the
      peroxisomal matrix. One of these is a consensus C-terminal tripeptide which is
      conserved in many microbody proteins derived from diverse species. The second
      signal is an N-terminal sequence found in a small subset of peroxisomal proteins.
      We have tested 18 possible variants of the consensus tripeptide targeting signal
      for their ability to facilitate the transport of a cytosolic passenger protein,
      chloramphenicol acetyltransferase, into peroxisomes of monkey kidney cells. Our
      results reveal the presence of a hierarchy of preferred amino acid substitutions
      at each position of the tripeptide.

PMID- 1618342
TI  - Calcium administration stimulates the expression of calcium-binding protein
      regucalcin mRNA in rat liver.
AB  - The distribution and expression of mRNA encoding the Ca(2+)-binding protein
      regucalcin in rats were investigated by Northern blot analyses. Liver regucalcin
      cDNA (0.6 kb) was used as a probe. The analyses of total RNAs extracted from
      various tissues of rat indicated that regucalcin mRNA was mainly present in liver
      but only slightly in kidney with a size of 1.8 kb. The expression level decreased
      with increasing age (3, 10 and 25 weeks). A single intraperitoneal administration
      of calcium chloride (15 mg Ca/100 g body weight) induced a remarkable increase in
      regucalcin mRNA in liver; the level was about 200% of control at 30 min after the
      administration. Subsequently, the expression level began to decrease with time
      and was about 40% of control level at 120 min after the administration. The
      increase in regucalcin mRNA levels at 30 min after calcium administration was
      dose-dependent. These observations show that the expression of regucalcin mRNA is
      specific in liver of various tissues, and that it is regulated by Ca2+
      administration. Regucalcin may have a role as regulatory protein for calcium
      homeostasis in liver cells.

PMID- 1618343
TI  - Oxidized low density lipoproteins elicit DNA fragmentation of cultured
      lymphoblastoid cells.
AB  - Lymphoblastoid cell lines continuously pulsed with mildly oxidized low density
      lipoproteins, exhibited a significant increase of DNA fragmentation induced by
      oxidized LDL internalized by cells. DNA fragmentation was associated with an
      increasing number of morphologically characteristic apoptotic cells
      simultaneously with the increase of cytotoxicity indexes, and the activation of
      the poly(ADP-ribose) polymerase, a nuclear enzyme stimulated by DNA strand
      breaks. The potential involvement of these biochemical and morphological changes
      in atherogenesis is discussed.

PMID- 1618344
TI  - Nucleotide composition of genes and hydrophobicity of the encoded proteins.
AB  - We find that true proteins are generally more hydrophobic than the corresponding
      hypothetical proteins encoded by the randomized gene nucleotide sequences.
      Furthermore, the protein hydrophobicity but not its gene nucleotide composition
      is conserved within evolutionary families of functionally related proteins. These
      two findings indicate that there is a general drift to modify gene nucleotide
      composition in the course of evolution. An inspection of codon usage in genes
      shows that the drift mainly increases the content of adenine at the expense of
      thymine.

PMID- 1618345
TI  - Heat-labile enterotoxin crystal forms with variable A/B5 orientation. Analysis of
      conformational flexibility.
AB  - A new native crystal form of heat-labile enterotoxin (LT) has two AB5 complexes
      in the asymmetric unit with different orientations of the A subunit with respect
      to the B pentamer. Comparison with other crystal forms of LT shows that there is
      considerable conformational freedom for orientating the A subunit with respect to
      the B pentamer. The rotations of A in different crystal forms do not follow one
      specific axis, but most of them share a hinge point, close to the main
      interaction area between A and B5. Analysis of the two high-resolution structures
      available shows that these rotations cause very little change in the actual
      interactions between A and B5.

PMID- 1618346
TI  - Phosphoramidon-sensitive endothelin-converting enzyme in vascular endothelial
      cells converts big endothelin-1 and big endothelin-3 to their mature form.
AB  - Incubation of big endothelin-3 (big ET-3(1-41)) with the membrane fraction
      obtained from cultured endothelial cells (ECs) resulted in an increase in
      immunoreactive-ET (IR-ET). This increasing activity was markedly suppressed by
      phosphoramidon, which is known to inhibit the conversion of big ET-1(1-39) to ET
      1(1-21). Reverse-phase HPLC of the incubation mixture of the membrane fraction
      with big ET-3 revealed one major IR-ET component corresponding to the elution
      position of synthetic ET-3(1-21). When the cultured ECs were incubated with big
      ET-3, a conversion to the mature ET-3, as well as an endogenous ET-1 generation,
      was observed. Both responses were markedly suppressed by phosphoramidon. By the
      gel filtration of 0.5% CHAPS-solubilized fraction of membrane pellets of ECs, the
      molecular mass of the proteinase which converts big ET-1 and big ET-3 to their
      mature form was estimated to be 300-350 kDa. Phosphoramidon almost completely
      abolished both converting activities of the proteinase. We conclude that the
      above type of phosphoramidon-sensitive metalloproteinase functions as an ET
      converting enzyme to generate the mature form from big ET-1 and big ET-3 in ECs.

PMID- 1618347
TI  - Fibronectin type III-like sequences and a new domain type in prokaryotic
      depolymerases with insoluble substrates.
AB  - Fibronectin type III-like sequences are present in many proteins from higher
      eukaryotes and are involved in protein-protein interactions, heparin binding and
      cell adhesion. A nine-member family of bacterial sequences is shown to be
      significantly homologous to the type III-like sequences. All the sequences are
      contained in secreted depolymerases acting on complex, energy-rich insoluble
      substrates, in which they apparently do not participate in catalysis or substrate
      binding, their exact function remaining unclear. Furthermore, a new family of
      sequences, present in some cellulases, is presented.

PMID- 1618348
TI  - More on pay and play physician contribution to health care reform.

PMID- 1618349
TI  - Video-assisted thoracic surgery: our first 20 cases.
AB  - Video-assisted thoracic surgery has been performed in 20 patients at the Medical
      Center of Delaware. Operations included seven pulmonary wedge resections, one
      mediastinal procedure, and 12 pleural procedures. In all cases, a definitive
      diagnosis was made or the lesion was removed. One postoperative atypical
      pneumonia occurred. One patient whose wedge resection proved to be squamous cell
      carcinoma on frozen section underwent a formal thoracotomy and lobectomy.
      Estimated savings in the eight patients who formerly would have undergone a
      thoracotomy incision is estimated at $30,000 for room cost alone. We foresee a
      markedly expanded role for this technique in major pulmonary resections,
      esophageal procedures, and cardiac surgery in the near future.

PMID- 1618350
TI  - When a doctor plays judge.

PMID- 1618351
TI  - And so much for arbitration.

PMID- 1618352
TI  - Wake up call--get involved.

PMID- 1618353
TI  - Photoaffinity labeling of an acorn barnacle lectin with a photoactivatable
      fluorescent reagent derivative of D-galactosamine.
AB  - A photoactivatable D-galactosamine derivative was prepared by reaction of the
      amino group of D-galactosamine with 1-azide-5-naphthalene sulfonyl chloride (ANS
      Cl). The derivative (GalN-ANS) inhibited the agglutination activity of an acorn
      barnacle lectin against rabbit erythrocytes to the same extent as D
      galactosamine. We used GalN-ANS for photoaffinity labeling of the lectin. The
      photolabeled lectin was digested with pronase and the digest was separated by
      reversed-phase high-performance liquid chromatography by monitoring fluorescence
      and uv absorption to isolate the peptide labeled with GalN-ANS. Amino acid
      analyses of the labeled peptides revealed that GalN-ANS preferentially covalently
      labeled two regions in the carbohydrate recognition domain of the lectin. One of
      them was the highly conserved amino-acid sequence region throughout all calcium
      dependent animal lectins.

PMID- 1618354
TI  - Phenol oxidase activity in hemolymph compartments of Aedes aegypti during
      melanotic encapsulation reactions against microfilariae.
AB  - Monophenol oxidase (MPO) and diphenol oxidase (DPO) activity was assessed in
      hemocytes, cell-free plasma and complete hemolymph collected from Aedes aegypti
      Liverpool strain, intrathoracically inoculated with saline alone, immune
      activated by the inoculation of Dirofilaria immitis microfilariae (mff), and
      uninoculated. Enzyme activities between groups were compared using a radiometric
      hydroxylation assay (MPO) and a high pressure liquid chromatography with
      electrochemical detection assay (DPO). There were no significant differences in
      enzyme activity in hemocytes, cell-free plasma, and complete hemolymph between
      uninoculated and saline-inoculated controls. Both MPO and DPO activity of
      mosquito hemocytes and complete hemolymph from immune-activated mosquitoes were
      significantly increased at 12 and 24 h postinoculation as compared with the
      enzyme activity from saline-inoculated mosquitoes, but no significant increase in
      enzyme activity was detected in cell-free plasma from immune-activated
      mosquitoes. Increases of MPO and DPO activity in hemocytes and hemolymph
      following immune activation were proportional, thereby suggesting that a single
      enzyme might react with both monophenols and o-diphenols within the hemolymph of
      A. aegypti. Results also suggest that augmented phenol oxidase activity
      associated with melanotic encapsulation reactions is associated primarily with
      hemocytes.

PMID- 1618355
TI  - Toxicity of Aeromonas salmonicida cells to Atlantic salmon Salmo salar peritoneal
      macrophages.
AB  - Several strains of Aeromonas salmonicida were toxic to cultured peritoneal
      macrophages of Atlantic salmon, Salmo salar, in minimum doses of 5 x 10(6) CFU,
      whereas other strains were not. There was no correlation between cytotoxicity and
      in vivo virulence of the bacteria, the presence or absence of the two major
      surface components of A. salmonicida (namely, the A-layer and the O
      polysaccharide chain of the LPS) nor, finally, with the ability of the strains to
      produce the following enzymes in vitro: protease, hemolysin, elastase and
      lecithinase. Toxicity was only observed with metabolically active bacteria and
      not with formalin- or heat-killed bacteria. The exact nature of the toxic factor
      remains unknown but is most likely associated with the surface of the bacteria.
      It is not extracellular since 24 and 48 h culture supernatants of the cytotoxic
      strains had no apparent effect on macrophages. The cytotoxic effect was found to
      be severe and rapid, it is likely a major virulence factor of A. salmonicida, but
      the exact role of such a potent toxin in the pathology of furunculosis has yet to
      be clarified.

PMID- 1618356
TI  - Stress and human reproduction.
AB  - The interaction between emotional stress and infertility has been investigated
      for many years. Many infertile couples show marked stress during infertility
      evaluation and treatment. Most of the investigations that were performed during
      the last two decades show that in the majority of cases stress is the result and
      not the cause of infertility. The biological interaction between stress and
      infertility is the result of the action of stress hormones at the brain level,
      especially on the hypothalamus-pituitary and on the female reproductive organs.
      Stress hormones such as catecholamines (adrenalin, nonadrenaline and dopamine)
      and the hypothalamic-pituitary-adrenal axis interact with hormones which are
      responsible for normal ovulatory cycles: i.e., gonadotropin releasing hormone
      (GnRH), prolactin, LH and FSH. Endogenous opiates and melatonin secretion are
      altered by stress and interfere with ovulation. Sympathetic innervation of the
      female reproductive system provides routes by which stress can influence
      fertility at the of the sex organs level. Infertility causes stress which is
      aggravated as time passes and the couple remains infertile. Among the causes of
      stress are the couple's isolation, life with unrealized potential and unborn
      child, disruption of day-to-day life during infertility evaluation and treatment,
      and the couple's feeling that they do not have control of their own lives. The
      IVF program is considered by many as the final step for the evaluation of the
      couples fertility potential, hence, couples participating in an IVF program are
      highly stressed, especially after a failed IVF cycle.

PMID- 1618357
TI  - Pregnancy-specific beta 1-glycoprotein (SP1) and its relation to fetal birth
      weight at term pregnancy.
AB  - The relation between serum levels of pregnancy-specific beta 1-glycoprotein (SP1)
      and actual fetal and placental weights was studied in 100 full-term pregnant
      women. This was compared with fetal weight determination by ultrasound. SP1
      levels significantly correlated with fetal and placental weights. Its
      determination was found to be comparable to ultrasonography in placental fetal
      weight assessment, especially at the extremes of fetal weight (macrosomia and
      small for gestational age) where special obstetric management is warranted.

PMID- 1618358
TI  - Pregnancy in idiopathic aplastic anemia (report of 10 patients).
AB  - This paper reports on 6 patients with severe, 2 with moderate and 2 with mild
      aplastic anemia who had a total of 18 pregnancies after the diagnosis. All four
      pregnancies that occurred during the active state of severe and moderate aplastic
      anemias were electively terminated. Two out of 14 pregnancies that occurred
      during the long-term remission were electively terminated for non-medical reason,
      two spontaneous abortions occurred and 10 live births were seen. All offspring
      were healthy at follow-up. During pregnancy the circulating blood cell levels
      decreased in 1 out of 6 pregnancies in patients who were in remission from mild
      and moderate aplastic anemias, and in 4 out of 8 pregnancies in patients who were
      in remission from severe aplastic anemia. In all 5 cases that showed a relapse
      during pregnancy the remission recurred following the termination of pregnancy.
      The data presented suggest that aplastic anemia in long-term remission can
      unpredictably relapse during pregnancy, but its final outcome appears not to be
      affected by pregnancy. Furthermore, there is no correlation between the pre
      pregnancy clinical course and the events during pregnancy. The outcome of
      pregnancy during the remission of aplastic anemia seems beneficial, and
      spontaneous delivery should be preferred.

PMID- 1618359
TI  - Reference ranges of lipids and apolipoproteins in pregnancy.
AB  - In order to establish the reference ranges of lipids and apolipoproteins apoA-I
      and apoB in serum for different periods of pregnancy we examined 719 healthy
      pregnant women. 172 of them were in the first trimester, 227 in the second and
      320 in the third trimester. The control group, consisting of 65 healthy
      nonpregnant women, was used to determine the magnitude and statistical
      significance of the lipid changes. All lipids and apolipoproteins apoA-I and apoB
      were significantly elevated during the second and the third trimesters. The most
      prominent change was a 2.7-fold triglyceride increase in the third trimester; in
      the same trimester the mean level apoB increased by 56%, total cholesterol by
      43%, low-density lipoprotein (LDL) cholesterol by 36% and apolipoprotein A-I by
      32%. High-density lipoprotein (HDL) cholesterol rose maximally (25%) in the
      second trimester. The 95th percentiles of the distributions in the second and the
      third trimesters are: total triglyceride: 2.87 and 4.68 mmol/l; total
      cholesterol: 8.24 and 9.83 mmol/l; LDL-cholesterol: 5.61 and 6.48 mmol/l; apoA-I:
      2.48 and 2.61 g/l; apoB: 1.47 and 1.92 g/l. The fifth percentiles of HDL
      cholesterol distributions are: 1.09 in the second trimester and 1.04 in the third
      one. The ratios of total cholesterol to HDL-cholesterol, of LDL-cholesterol to
      HDL-cholesterol and apoB to apoA-I were decreased in the first trimester, without
      change in the second, and increased in the third trimester. These data may
      indicate that hyperlipidaemia of pregnancy is not atherogenic.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1618360
TI  - Fetal motility and chronic exposure to antiepileptic drugs.
AB  - The potential influence of antiepileptic drugs (AEDs) on fetal CNS function was
      studied with respect to motility patterns. Quantitative and qualitative aspects
      of spontaneous fetal activity were investigated for chronic AED-exposed fetuses
      and controls at three intervals during pregnancy: i.e. 20, 32 and 38 weeks.
      Movements were observed applying real-time ultrasound. Third trimester rest
      activity cycles were determined according to the fetal behavioural state concept.
      Quantitative analysis revealed no marked differences in gross fetal motility
      between AED-exposed fetuses and controls. Both groups demonstrated the same
      developmental trend from midterm towards the third trimester. The number of trunk
      movements decreased, while their median duration increased. The incidence of
      fetal eye movements during C2F was lower for AED-exposed fetuses than for
      controls (significant for 38 weeks). In qualitative analysis, general movements
      of AED-exposed fetuses were more often labeled as suspect or abnormal than those
      of control fetuses (respectively, 8 out of 31 and 1 out of 20; P = 0.06). Future
      studies concerning chronic fetal AED-exposure and fetal CNS function should focus
      on qualitative rather than quantitative aspects of motility.

PMID- 1618361
TI  - Does labetalol influence the development of proteinuria in pregnancy
      hypertension? A randomised controlled study.
AB  - It is the development of proteinuria in pregnancy-induced hypertension which is
      associated with an increased perinatal mortality. There is some evidence to
      suggest that labetalol may diminish the amount of proteinuria in patients who
      have already developed proteinuric pre-eclampsia. A randomised controlled study
      design was used to investigate whether labetalol treatment, started when a
      persistent diastolic blood pressure greater than 90 mmHg was observed, influenced
      the subsequent development of proteinuria. One hundred and fourteen women with
      singleton pregnancies and hypertension in the absence of proteinuria were
      randomised to receive either labetalol or no antihypertensive therapy. At
      recruitment maternal age, blood pressure and gestation were similar in both the
      labetalol and control groups. There was no difference in the frequency, quantity
      or timing of subsequent proteinuria between treatment and control groups. Overall
      34% of primigravidae and 10% of parous women developed proteinuria. Labetalol
      did, however, control the blood pressure in 45 of the 51 treated women (88%)
      within 24 h. This effect was often shortlived requiring dose escalation after 3
      to 5 days in the majority of cases. Labetalol was well tolerated and no
      significant maternal toxicity was noted.

PMID- 1618362
TI  - Evidence of growth retardation in neonates of apparently normal weight.
AB  - The aim of this study was to examine the relationship of ponderal index (PI) and
      the ratio of mid-arm circumference to occipito-frontal circumference (MAC/OFC) to
      the delivered weight of the child. Measurements were made on 160 singleton
      neonates with birthweight greater than 2500 g and delivery at 37 weeks or more.
      Surprisingly, there was a highly significant correlation between PI and
      birthweight and MAC/OFC and birthweight. We conclude that: (1) values of PI must
      be evaluated in relation to birthweight, and not against a single absolute
      standard for the whole normal population; (2) measurement of PI and MAC/OFC may
      reveal a group of growth-retarded infants amongst infants of apparently 'normal'
      birthweight; and (3) this group of infants might be a target for the extra care
      normally accorded to the low birthweight infant.

PMID- 1618363
TI  - Synchronous primary malignancies of the female genital tract.
AB  - This study includes 29 patients with synchronous primary malignancies of the
      female genital tract. These patients constituted 1.7% of all genital
      malignancies. The most frequently observed synchronous neoplasms were those of
      the ovary together with the endometrium (51.7%). Most patients had early-stage
      and low-grade disease. Stage I disease was observed in 68.1% of patients with
      ovarian cancer. Patients with synchronous ovarian and endometrial cancer had a
      73.3% 5-year survival rate, suggesting a favorable prognosis.

PMID- 1618364
TI  - A rare case of chorioamnionitis by Morganella morganii complicated by septicemia
      and adult respiratory distress syndrome.
AB  - Morganella morganii, a gram-negative bacterium, usually infects older patients
      with urinary catheters, but does not commonly affect pregnant women. In this
      report we present a case of chorioamnionitis caused by Morganella morganii. The
      case was complicated by a life-threatening Adult Respiratory Distress Syndrome.

PMID- 1618365
TI  - Have 'real' NSTs been used for fetal surveillance?

PMID- 1618367
TI  - Doppler velocimetry in twin pregnancy.
AB  - The flow velocity waveform profile in the umbilical artery was measured in 50
      pairs of twins during the last week before birth. A significant association was
      found between high resistance indicies and occurrence of late fetal heart rate
      decelerations; the higher the resistance, the more frequent the decelerations.
      Further, the connection between high resistance in the circulation of the
      umbilical artery and low birth weight was confirmed. Flow velocity measurements
      in the umbilical artery seem to be a valuable tool in identifying twin fetuses
      suffering from placental insufficiency.

PMID- 1618366
TI  - Pelvic pain and pelvic joint instability, association with oral contraceptives.

PMID- 1618368
TI  - Contextual control of conflicting associations in the developing rat.
AB  - Two experiments examined the effects of manipulations of contextual cues on the
      expression of conflicting associations in 18-, 26-, and 35-day-old rats. Subjects
      learned to GO RIGHT in a water-filled T-maze, then were trained to reverse this
      position habit (GO LEFT). When the competing responses were learned in the same
      visual context, all age groups displayed a recency effect on a subsequent test in
      extinction; they behaved in accordance with the last-learned GO LEFT habit. If
      the competing responses were learned in different visual contexts, and testing
      took place in the context of the first problem, 35-day-old subjects behaved in a
      manner consistent with the GO RIGHT context (reduced recency). However, similarly
      trained 18-day-old subjects showed no evidence of a reduced recency effect. Given
      that 18-day-old rats are sensitive to other context manipulations, the present
      results suggest that the ability to "disambiguate" conflicting associations by
      context may depend upon the maturation of a relatively late-developing configural
      learning system.

PMID- 1618369
TI  - Variation in maternal care and individual differences in play, exploration, and
      grooming of juvenile Norway rat offspring.
AB  - Individual differences in two different forms of maternal licking, time in nest
      and nursing, were measured during the first 2 weeks after birth. Two treatments
      were imposed to reduce maternal anogenital licking (AGL): peripheral zinc sulfate
      to interfere with reception of pup chemosignals, and dietary saline to reduce
      appetite for pup urine. Both treatments reduced AGL but did not affect other
      maternal licking. Zinc sulfate was more effective than saline during the first
      week, but was somewhat less selective as it also increased time in nest. Selected
      behavioral patterns were measured in male and female juveniles and related by
      multiple regression to the behavior of their mothers. Independent of the method
      of manipulation, maternal AGL was a significant predictor of play and open-field
      defecation males and of some forms of activity in the open field in both sexes.
      The relationships between other maternal variables and juvenile behavior were
      more modest. These data demonstrate that intervening in the sensory regulation of
      maternal behavior can produce predictable changes in stimulation provided by the
      dam, thereby providing a useful means for investigating the effects of protracted
      differences in early stimulation in otherwise normal developmental contexts.

PMID- 1618371
TI  - Development of antipredator responses in snakes: V. Species differences in
      ontogenetic trajectories.
AB  - The ontogeny of antipredator responses in five species of Natricine snakes was
      examined. In a split-litter experiment, neonates were given a standardized
      defensive behavior test at 1 and/or 20 days of age. Thamnophis sirtalis and
      Thamnophis melanogaster showed a significant increase in both striking and
      fleeing from a threatening stimulus. Thamnophis butleri was not reactive in terms
      of striking at either age but did flee frequently at both ages. Thamnophis radix
      showed low rates of striking and high rates of fleeing; only fleeing increased
      significantly between the two tests. Nerodia rhombifer exhibited moderate rates
      of both striking and fleeing at both ages with no developmental effects. Subsets
      of most of these species tested at 40 or 60 days of age found no further
      developmental changes.

PMID- 1618372
TI  - Temperature-dependent effects of maternal separation on growth, activity, and
      amphetamine sensitivity in the rat.
AB  - This study was conducted to examine the effects of an early stressor, maternal
      separation, on development, arousal, and sensitivity to amphetamine in the rat.
      Rat pups were maternally separated at nest temperature (WARM), room temperature
      (COLD), or nest temperature with agitation (AGIT) for 6 hr each day from 2 to 15
      days of age. A control group (CONT) remained with the mother in the nest during
      this time. COLD subjects were developmentally delayed and had lower body and
      brain weights than the other three groups into adulthood. WARM and AGIT subjects
      (both maternally separated at nest temperature) had significant growth delays
      compared to CONT, but grew more quickly than COLD subjects. COLD subjects were
      less active than the other maternally separated groups, and WARM and AGIT groups
      were more active. Activity did not differ at 28 or 75 days of age. However, adult
      WARM subjects were less sensitive and COLD subjects were more sensitive to
      amphetamine as measured by locomotor activity than CONT and AGIT subjects, who
      did not differ from each other. The relationship between early stress, changes in
      dopaminergic systems, and altered drug responsiveness are discussed in terms of
      the implications for the etiology of drug abuse.

PMID- 1618370
TI  - Neonatal 6-OHDA lesions and rearing in complex environments: regional effects on
      adult brain 14C-2-deoxyglucose uptake revealed by exposure to novel stimulation.
AB  - Behavioral and neuromorphological data have suggested at least a partial
      interaction between the effects of norepinephrine-depleting neonatal 6-OHDA
      lesions and the effects of rearing in enriched environments. The present study
      examined the impact of both of these early manipulations upon regional brain
      uptake of 14C-2-deoxyglucose (14C-2DG) in adulthood. Newborn rats received 6-OHDA
      (50 mg/kg s.c.) or vehicle and, after weaning at 25 days, were reared in isolated
      versus enriched conditions. Regional brain 14C-2DG uptake was then examined at 70
      80 days of age--either in the home cage or while animals were being exposed to
      novel, presumably arousing, stimulation. Ninety-seven brain regions were examined
      in eight separate groups. Results indicated that (1) Under baseline conditions,
      neither neonatal 6-OHDA nor differential rearing conditions produced widespread
      alterations in regional brain 14C-2DG uptake profiles. An overall enrichment
      effect was seen on only five brain areas, with rats reared in enriched
      environments showing lower levels of 14C-2DG uptake (-20% to -30%) than isolated
      rats. Neonatal 6-OHDA produced no main effect on 14C-2DG uptake in any brain
      region. (2) In contrast, when 14C-2DG uptake was assessed during exposure to a
      novel environment, five brain areas showed differential 14C-2DG uptake in 6-OHDA
      treated rats, and 20 brain areas showed differential uptake in rats reared in
      enriched conditions. (3) No significant interaction effect on brain regional 14C
      2DG uptake was observed between neonatal 6-OHDA and environmental complexity
      factors. These results are consistent with the notion that enduring effects of
      rearing and early 6-OHDA treatment may, independently, relate to a general
      reactivity factor. They also indicate that some effects of early neurochemical
      injury and subsequent experiential factors may not be apparent under normal
      resting conditions, but only become evident in the presence of appropriate
      "activating" stimulation.

PMID- 1618373
TI  - Regulation of murine embryonic epithelial cell differentiation by transforming
      growth factors beta.
AB  - The expression of some members of the transforming growth factor beta (TGF beta)
      family of genes in embryonic craniofacial tissue suggests a functional role for
      these molecules in orofacial development. In an attempt to ascertain a role for
      the TGF beta s during palatal ontogeny, murine palatal shelves were excised on
      gestation day (GD) 12, prior to overt epithelial differentiation, grown in organ
      culture under serum-free conditions and exposed to TGF beta 1 and TGF beta 2 for
      18 or 42 h. Shelves were labeled with [3H]-thymidine (20 microCi/ml) during the
      last 4 h in culture, fixed, dehydrated, embedded in paraffin and sections stained
      and examined by autoradiography. Treatment of GD12 palates with TGF beta 1 and
      TGF beta 2 resulted in precocious cessation of medial edge epithelium (MEE) DNA
      synthesis followed by elimination of the MEE. In addition, this response appeared
      to be dose-related with higher concentrations of growth factor eliciting a more
      marked biological response. TGF beta treatment of homologous shelves grown in
      apposition also resulted in precocious fusion of apposing MEE. Thus, members of
      the TGF beta family, known to be synthesized by palatal MEE, appear to act in an
      autocrine/paracrine fashion in this tissue and are capable of regulating
      differentiation of embryonic palatal medial edge epithelium.

PMID- 1618374
TI  - [Plasmapheresis in the comprehensive treatment of autoimmune hemolytic anemia].
AB  - It is shown that low volumes of plasmapheresis can be used in combined treatment
      of patients with autoimmune hemolytic anemia who did not respond well to the
      routine therapy. It is a safe detoxication method with immunocorrective,
      hyposensitizing action that promotes more effective transfusion of red blood cell
      pack and washed red blood cells, and permits a significant decrease in
      glucocorticosteroid doses. It has been suggested that plasmapheresis could be
      used at early stages of the disease treatment.

PMID- 1618375
TI  - [Effect of antilymphocytic globulin on immunologic parameters in children with
      acquired aplastic anemia].
AB  - Subpopulations of rosette-forming cells were studied in lymphoid pools of
      peripheral blood and bone marrow of 24 children with acquired aplastic anemia,
      after a course of treatment with antilymphocytic globulin (ALG). After
      termination of the preparation transfusion a decrease in the levels of "active" T
      lymphocytes and cells with C3-receptors was recorded. The levels of immature T
      lymphocytes were found to be lowered four weeks after ALG-therapy, while other
      subpopulations remained within the normal. The lowering activity of immunogenesis
      in the bone marrow combined with hemopoietic recovery after the immunosuppressive
      therapy have evidenced a possible participation of immunologic mechanisms in the
      pathogenesis of acquired aplastic anemia in children.

PMID- 1618376
TI  - [Factors influencing the serum ferritin level in acute leukemia patients before
      chemotherapy].
AB  - Serum ferritin level was studied in 158 adult patients with different forms and
      variants of leukemia, and it was found to be elevated in 85.4% of cases. A number
      of factors influencing ferritin concentration in the blood serum have been
      established: a high degree of serum iron deficiency, leukemic intoxication,
      infectious complications (pneumonia, sepsis, necrosis, etc.), hemolytic syndrome.
      All these factors should be taken into consideration in evaluating serum ferritin
      levels in acute leukemia patients.

PMID- 1618377
TI  - [Myocardial function and rheologic properties of blood in multiple myeloma].
AB  - Echocardiographic and rheologic parameters were studied in 25 patients with
      multiple myeloma (MM). The lowering of the contractile function of the left
      ventricle myocardium was attended by disorders in blood rheologic properties
      characterized by increasing concentration of total protein and colloid-osmotic
      pressure, by a decrease in the hematocrit, red blood cell deformability, volume,
      and mean cell hemoglobin. It has been shown that rheologic and echocardiographic
      shifts play an important role in the pathogenesis of hyperviscous syndrome and in
      the development of circulation insufficiency in MM patients. Current corrective
      measures are necessary for abolishing this state.

PMID- 1618378
TI  - [Expression of glucocorticoid receptors and blast cell clearance in children with
      different variants of acute lymphoblastic leukemia].
AB  - Glucocorticoid receptor (GR) levels were estimated in blast cells of 24 children
      with acute lymphoblastic leukemia, in different immunocytologic subvariants of
      the disease. No relationship was revealed between immunophenotype and GR number
      in blasts. It was found that the response to prednisolone therapy did not depend
      on the number of sites specifically bound to glucocorticoids. The response
      character is determined not by immunophenotype but by the initial number of blast
      cells in the peripheral blood (the higher blastosis, the worse response). High
      blastosis is probably dependent on the tumor growth rate.

PMID- 1618379
TI  - [Splenectomy in the treatment of chronic forms of lympholeukemia].

PMID- 1618380
TI  - [Compensation-adaptation reactions of hemopoiesis-inducing microenvironment of
      bone marrow in stress].
AB  - The time course of compensation-adaptation reactions of bone marrow hemopoiesis
      inducing microenvironment (HIM) was studied in F1 (CBA x C57BL/6) mice subjected
      to 10-hour immobilization. The number of macrophage and fibroblastoid colony
      forming units, committed and stem precursor stroma cells responsible for HIM
      transport was shown to increase in the hemopoietic tissue during adaptation
      syndrome. HIM activation in stress was found to be macrophage- and lymphocyte
      dependent process.

PMID- 1618381
TI  - [Natural and antibody-dependent cytotoxicity of peripheral blood lymphocytes in
      health and in various blood system diseases].

PMID- 1618382
TI  - [Hemostatic drugs of resorptive action].

PMID- 1618383
TI  - [Transfusion policy in massive obstetric blood loss].

PMID- 1618384
TI  - [Transfusion therapy in beta-thalassemia and sickle-cell anemia].

PMID- 1618385
TI  - Handedness and spatial ability in children: further support for Geschwind's
      hypothesis of "pathology of superiority" and for Annett's theory of intelligence.
AB  - Spatial ability of 60 left-handed and 60 right-handed school children was
      investigated using a battery of nine tasks. The results do not agree with Levy's
      (1969, 1976) theory predicting spatial inferiority of left-handed individuals.
      Instead, higher performance by left-handed children provided further support for
      Annett's (Annett & Manning, 1989) theory on intelligence and for Geschwind's
      (Geschwind & Galaburda, 1985) hypothesis of "pathology of superiority." The
      distinction of left-handed and right-handed individuals into familial and
      nonfamilial groups appeared to be psychologically equivocal according to our
      results.

PMID- 1618386
TI  - Hordein variation in the genus Hordeum as recognized by monoclonal antibodies.
AB  - The composition of the major storage protein, hordein, in wild barley species has
      been studied by using gel electrophoresis, Coomassie staining, and immunoblot
      assays. We have shown earlier that it is possible to obtain cross-reaction
      outside the cultivated barley, with monoclonal antibodies raised against hordeins
      from the barley cultivar Bomi. These antibodies have now been used to investigate
      the hordein composition in all species of the Hordeum genus. The results showed
      that polypeptides similar to the two major hordein groups of cultivated barley,
      the B- and C-hordeins, are produced in all wild Hordeum species, and that there
      are both similarities and differences between the two hordein groups. The
      similarities indicate a common evolutionary origin, while the distinction between
      B- and C-hordeins in the entire genus clearly shows that the divergence of their
      coding genes preceded the divergence of the Hordeum species. The presence of the
      same antigenic site in two different species indicates that they are
      evolutionarily related. Among the wild species, two rarely occurring sites were
      exclusively found in H. vulgare ssp. spontaneum and H. bulbosum, which confirms
      that they are the cultivated barley's closest relatives. Some of the antibodies
      also gave an extensive reaction pattern with H. murinum, which suggests a fairly
      close relationship to H. vulgare, though not as close as between H. vulgare and
      H. bulbosum.

PMID- 1618387
TI  - Gamma irradiation induced deletions in an alien chromosome segment of the wheat
      'Indis' and their use in gene mapping.
AB  - Deletion mutants were produced in a translocated chromosome segment derived from
      Thinopyrum distichum (Thunb.) Love. Spikes of the translocation line 'Indis' were
      irradiated with gamma rays at dosages of 15, 20, and 25 Gy. The irradiated spikes
      were pollinated with 'Inia 66' pollen and the F2 and F3 generations screened for
      translocation mutants, using the genes for leaf rust resistance and yellow
      endosperm pigmentation as markers. Finally, endopeptidase polymorphisms were
      utilized to select mutant translocation homozygotes within each of 29 families.
      An investigation of polymorphisms at the alpha-Amy-D2 and Wsp-D1 loci of
      chromosome arm 7DL revealed that 'Indis' did not produce an alpha-AMY-D2 product,
      but it did produce a novel WSP-D1 protein. The mutants were characterized for
      their leaf and stem rust resistances and the presence of WSP-D1 and yellow flour
      pigments. The stem rust resistance gene could not be accurately mapped. The
      linear order of the remaining loci on 7DL was centromere - leaf rust resistance -
      Wsp-D1 and yellow pigment. The data obtained suggested that the 'Indis'
      translocation has homo(eo)logy to the Lr19 translocation and homoeology to 7DL of
      common wheat.

PMID- 1618388
TI  - Nucleolar fragmentation in polytene trichogen cells of Lucilla cuprina and
      Chrysomya bezziana (Diptera: Calliphoridae).
AB  - The location of genes coding for 18S and 28S ribosomal RNA in mitotic and
      polytene cells of Lucilia cuprina and Chrysomya bezziana was investigated using
      in situ hybridization of an 18 + 28S ribosomal gene probe and silver staining. In
      both species ribosomal genes were localized to secondary constriction regions in
      sex chromosome heterochromatin. In L. cuprina mitotic cells the probe hybridizes
      to a distal secondary constriction region in the short arms of the X and Y
      chromosomes. In C. bezziana mitotic chromosomes ribosomal genes were located in
      distal secondary constriction regions in the long arms of the X and Y
      chromosomes. In polytene trichogen cells of both species, hybridization results
      varied with the level of polyteny. Cells of low polyteny have a single
      hybridization site, but with greater polytenization, increasing numbers of
      extrachromosomal fragments strongly hybridize to the ribosomal gene probe. No
      hybridization occurs in structures representing the sex chromosomes or in the
      autosomes. These results indicate that fragmentation and dispersal of the
      nucleolus occurs during polytenization. Silver staining of both unsquashed and
      squashed polytene nuclei show identical behaviour of multiple, varied-sized
      nucleolar bodies, thus confirming the in situ hybridization results. Uridine
      incorporation studies in L. cuprina indicated that transcription occurs in
      extrachromosomal bodies similar to nucleolar fragments. Nucleolar fragmentation
      is more pronounced in L. cuprina males, particularly in those with the
      translocation T(Y;2)540. Chromosomally normal C. bezziana show nucleolar
      fragmentation levels similar to that in L. cuprina males. Ribosomal genes are
      disproportionately replicated in trichogen cells to a much greater extent than
      surrounding heterochromatin. Nucleolar fragmentation may be a gene amplification
      system, but it is not known to what degree, relative to diploid amounts,
      ribosomal genes replicate in trichogen cells.

PMID- 1618389
TI  - Polytene chromosomes of the Old World screwworm fly (Chrysomya bezziana) and its
      evolutionary relationships with Lucilia cuprina and Cochliomyia hominivorax
      (Diptera: Calliphoridae).
AB  - Standard polytene chromosome maps for the Old World screwsworm fly, Chrysomya
      bezziana, are presented. Good quality polytene chromosomes obtainable from pupal
      trichogen cells allow detailed analysis of autosomal euchromatin. The sex
      chromosomes are represented by irregular heterochromatic structures resembling
      those described previously in trichogen polytene chromosomes of the Australian
      sheep blowfly, Lucilia cuprina. A high degree of homology with the banding
      pattern of L. cuprina polytene chromosomes allowed direct recognition of
      approximately 60% of the L. cuprina complement in the C. bezziana maps. A further
      13% may be homologous. The extensive homology observed is discussed in relation
      to the rate of chromosome rearrangement and conservation of karyotype elements in
      the evolution of Calliphorid flies. The observed conservation in polytene banding
      patterns should facilitate construction of phylogenies over a number of generic
      groups.

PMID- 1618390
TI  - Development of a selection index to improve market value of cultured Atlantic
      salmon (Salmo salar).
AB  - Genetic parameters were estimated on growth and development traits using analyses
      of variance and covariance of 42 full-sib families from a select line, 39 full
      sib families from a control line of the same strain, and 37 full-sib families
      from another unselected strain. The traits included percent 1+ smolts, percent
      sexually immature fish after 1 year in seawater (nongrilse), and fork length
      measured at intervals throughout the production cycle. The number of fish sampled
      per family was 30 of 300-1500 for all freshwater traits and 15-60, i.e., all
      individuals present, for all seawater traits. Heritability estimates of
      freshwater traits had a broad range (0.15-0.61), but estimates were lower for
      seawater traits (0.06-0.29). There was a general reduction in heritability
      estimates for traits measured at increasing ages both in freshwater and seawater.
      These reductions may in part represent declines of maternal and common
      environmental effects that inflate heritability estimated from full-sib families.
      The genetic correlations indicated positive associations between freshwater and
      seawater growth parameters. However, the correlations decreased with increasing
      intervals between measurements. A selection index was developed using the
      estimates of the genetic and phenotypic parameters for three economically
      important traits: percent 1 + smolts, percent nongrilse, and harvest length. The
      seawater traits, percent nongrilse, and fork length at 17 months (harvest length)
      were the most important in the index.

PMID- 1618391
TI  - The polytene chromosomes of Drosophila triauraria and D. quadraria, sibling
      species of D. auraria.
AB  - The polytene chromosomes of Drosophila triauraria and D. quadraria, two of the
      sibling species of D. auraria, were examined. The polytene chromosomes of all
      three species exhibit very clear homology. Unlike the stock of D. auraria that we
      studied, D. triauraria and D. quadraria carry heterozygous paracentric
      inversions. In both species, 2R and 3R are the arms where these inversions are
      concentrated. In addition, in D. quadraria, the 3L chromosome arm is very
      complicated because of heterozygous inversions. The mode of inheritance of these
      rearrangements was studied. A homozygous strain for all chromosome arms of D.
      triauraria was isolated, while a homozygous strain was obtained only for the arms
      X, 2L, 3L, and 4 of D. quadraria. Like D. auraria, both species show a large
      number of inverted tandem duplications in the paired condition, even in the
      chromosomes of their hybrids. Small deletions were also detected, one of which,
      in D. triauraria, is homozygous terminal. Hypotheses are discussed concerning the
      relationships of the species and the existence of inverted tandem duplications.

PMID- 1618392
TI  - A polytene chromosome study of four populations of Anopheles aquasalis from
      Venezuela.
AB  - Polytene chromosome studies were undertaken to elucidate taxonomic relationships
      among populations of Anopheles aquasalis and A. emilianus in Venezuela. Four
      collection sites were chosen: two in Sucre state (Santa Fe and Guayana) where A.
      aquasalis (considered to be A. emilianus by Gabaldon and Escalante) is presumed
      to be the major regional vector of Plasmodium vivax; and two in areas where no
      malaria transmission occurs (Cano Rico, Aragua state, and Puerto Cabello,
      Carabobo state). The chromosome banding pattern of the four populations was
      identical and conformed to the standard chromosome map of A. aquasalis from
      Brazil. These results suggest that the population from Santa Fe and Guayana,
      considered to be A. emilianus, is conspecific with A. aquasalis. However, its
      status as a distinct species with a homosequential polytene chromosome banding
      pattern cannot be ruled out.

PMID- 1618393
TI  - Structure of the 5S rRNA genes in birch (Betula papyrifera) and alder (Alnus
      incana).
AB  - Hybridization of a 5S rDNA probe to Southern transfers of birch (Betula
      papyrifera) or alder (Alnus incana) DNA digested with BamH1 reveals similar
      triple-band "ladder-like" patterns. The sizes of sequenced 5S repeat units from
      both plants ranges only from 471 to 490 base pairs, suggesting that the
      complexity detected by Southern analysis is not due to different size classes of
      5S repeats as found in other species. Within the intercistronic spacer region,
      conservation of large blocks of sequence between birch and alder 5S is observed
      implying a close evolutionary relationship between these two species. In both
      species, a duplication of part of the coding sequence including a restriction
      site for BamH1 introduces a second BamH1 site into the repeat unit. Differential
      methylation of the two BamHI restriction sites can account for the observed
      triple-band pattern.

PMID- 1618394
TI  - Studies of a spontaneous lethal mutation at the albino locus in SELH/Bc mice.
AB  - We report a new mutation at the albino locus in SELH/Bc mice. The mutation arose
      spontaneously in a male mouse that appeared to be a somatic and germ line mosaic
      for a new albino (c) allele, provisionally named cBc. The mutation is a recessive
      lethal, causing embryonic death soon after implantation. We have shown that there
      is no detectable activity of the Mod-2 allele in cis with the mutation and
      conclude that the mutation is probably a deletion that includes the c locus, the
      Mod-2 locus, the intervening 2 cM, and at least one locus essential for
      postimplantation embryonic survival, either proximal to the c locus or distal to
      the Mod-2 locus. This new mutation is similar to most previously reported
      spontaneous mutations at the albino locus in that it arose in a somatic and germ
      line mosaic mutant animal but differs from them in that it is an embryonic lethal
      when homozygous and is apparently a deletion. SELH/Bc mice appear to have a high
      mutation rate. This lethal albino mutation that appears to be a postmeiotic
      deletion should be useful in the search for the mechanism of mutagenesis in
      SELH/Bc mice. It may also be useful in mapping essential genes in the c-locus
      region.

PMID- 1618396
TI  - Nurses' aides: low pay, high turnover.

PMID- 1618395
TI  - Relationships between amino acid sequences determined through optimum alignments,
      clustering, and specific distance patterns: application to a group of scorpion
      toxins.
AB  - Optimum alignment in all pairwise combinations among a group of amino acid
      sequences generated a distance matrix. These distances were clustered to evaluate
      relationships among the sequences. The degree of relationship among sequences was
      also evaluated by calculating specific distances from the distance matrix and
      examining correlations between patterns of specific distances for pairs of
      sequences. The sequences examined were a group of 20 amino acid sequences of
      scorpion toxins originally published and analyzed by M.J. Dufton and H. Rochat in
      1984. Alignment gap penalties were constant for all 190 pairwise sequence
      alignments and were chosen after assessing the impact of changing penalties on
      resultant distances. The total distances generated by the 190 pairwise sequence
      alignments were clustered using complete (farthest neighbour) linkage. The
      square, symmetrical input distance matrix is analogous to diallel cross data
      where reciprocal and parental values are absent. Diallel analysis methods
      provided analogues for the distance matrix to genetical specific combining
      abilities, namely specific distances between all sequence pairs that are
      independent of the average distances shown by individual sequences. Correlation
      of specific distance patterns, with transformation to modified z values and a
      stringent probability level, were used to delineate subgroups of related
      sequences. These were compared with complete linkage clustering results.
      Excellent agreement between the two approaches was found. Three originally
      outlying sequences were placed within the four new subgroups.

PMID- 1618398
TI  - Aging and mental health: prevention of caregiver overload, abuse, and neglect.
      Part 3.
AB  - This final installment of a three-part panel discussion on aging and mental
      health reviews the role of the primary care physician in issues of caregiver
      burden, elder abuse, and nursing home placement. Federal regulations and
      reimbursement policies have some effect on how the physician manages these
      concerns. A teamwork approach to geriatric case management that includes other
      health professionals is also discussed.

PMID- 1618397
TI  - Preventive geriatrics: basic principles for primary care physicians.
AB  - The goal of preventive geriatrics is to nurture a state of health that allows
      maximal active life expectancy while maintaining high levels of function. The
      physician's role in promoting such a state of health is disease prevention and
      the control of chronic diseases of aging. Barriers such as insufficient time
      and/or staff resources and insufficient third-party reimbursement restrict the
      delivery of multiple risk factor intervention and healthy aging counseling in the
      office setting. A systematic approach to preventive geriatrics proposed by the
      U.S. Prevention Services Task Force is discussed.

PMID- 1618399
TI  - Oral antibiotics: practical prescribing rules for practitioners.
AB  - Oral antibiotics are frequently prescribed for older patients for the treatment
      of such common bacterial infections as upper respiratory and urinary tract
      infections. Six practical prescribing rules can help control the cost of therapy.
      1) Oral antimicrobials used to prevent hospitalization are always cost-effective.
      2) Oral antimicrobials are always less expensive than parenteral antimicrobials.
      3) Generic antimicrobials are not always less expensive than proprietary
      antimicrobials. 4) The best drug for the infection is usually the most cost
      effective in the long run, regardless of cost. 5) The use of antimicrobials for
      marginal indications is almost always cost-ineffective. 6) The simplest regimens
      are often the most cost-effective.

PMID- 1618400
TI  - Fetal tissue implants: therapy for Parkinson's disease?. Interview by Kevin
      Tanzillo.

PMID- 1618401
TI  - [Ludwik Fleck (1896-1961), bacteriologist and scientific theorist: science grows
      with collective thinking].
AB  - This is a short biography of the Polish-Ukrainian-Israelian bacteriologist and
      science theoretician Ludwik Fleck, whose life was marked by wars, years of
      captivity in concentration camps and changes of nationality. His most important
      insight into the way in which scientific knowledge is gained was that knowledge
      is not the result of an individual process of a theoretical consciousness by
      itself, but the result of collective social activity.

PMID- 1618403
TI  - [S. A. Tissot and his effect on the "Dessau-Worlitzer Cultural Circle"].
AB  - In the 2nd half of the 18th century, the small Duchy of Anhalt-Dessau was the
      model of an enlightened State, also in matters of health policy. The author
      stresses the influence of the Swiss Samuel-Andre Tissot on both Prince Leopold
      Friedrich Franz (1740-1817) and his foremost physician, Samuel Friedrich
      Kretzschmar (1730-1793). Tissot's influence manifested itself also in the early
      introduction of variolation.

PMID- 1618402
TI  - [The bacteriological revolution and theories of the etiology of goiter and
      cretinism].
AB  - During the 19th century, a large number of researchers produced many different
      and even contradictory theories about the aetiology of endemic goiter and
      cretinism. The bacteriological revolution, i.e. the acceptance of the germ theory
      of infectious diseases, pushed scientists to try to isolate a germ for every
      disease. In the case of goiter and cretinism, this was fruitless endeavour.
      Nevertheless, the impact of the bacteriological revolution was largely positive
      because it provided a new scientific model of the genesis of disease and
      strengthened confidence in the possibility of fighting endemic as well as
      epidemic disease by simple but generally applied preventive measures such as, in
      the present case, iodine prophylaxis.

PMID- 1618404
TI  - [Aortic stenosis and pregnancy: presentation and physiopathology of a case].
AB  - This is the case of a female patient, 31 years of age with the diagnosis of
      aortic stenosis, prolapse of mitral valve, aortic insufficiency, with pregnancy.
      The literature is reviewed and the management of this type of condition is
      analyzed.

PMID- 1618405
TI  - [Corpus luteum defect. Analysis of 30 cases in clinical pregnancy].
AB  - Deficient corpus luteum (DCL) is an ovulatory dysfunction little defined but
      real. It is said that is frequency is 3 and 10% of sterile couples and 30 to 40%
      of habitual abortion. Is part of the group of ovulatory aberrations together with
      in situ luteinization and syndrome of not broken luteinized folicle. The
      diagnosis is based in endometrial morphology and progesterone determination. The
      objective of this work is to analyze 30 cases of DCL that achieved pregnancy. The
      diagnosis was done based on low determination of progesterone in serum, biopsy of
      irregular or indysphase endometrium and all the factors, remaining normal of
      esterility. Average age of patients was 36 years and for sterility 3.1. Treatment
      consisted in clomiphen cytrate (CC) administration 100 mg daily of hCG in 21
      cases, CC only in eight cases and associated to bromocriptine in one case
      (concomitant hyper-prolactinemia); 26 pregnancies went to term, seven of them
      with support of exogenous progesterone the first weeks. There were three
      abortions and an ectopic one. It is concluded that with a complete study of
      sterility that only shows low seric progesterone and/or endometrium in dysphase
      or irregular, the diagnosis of DCL is probable and should be treated first with
      CC plus hCG. The evolution of pregnancies is normal and according to these
      results is little acceptable the use of progesterone as a support in pregnancy.

PMID- 1618406
TI  - [Rubella and pregnancy. Perinatal results].
AB  - Twenty six patients at different stages of pregnancy and diagnosis of rubella
      were studied prospectively in order to evaluate the perinatal outcome. Diagnosis
      was based in the detection of specific IgM or on a four-fold rise in antibody
      titre (IHA) with an interval of three weeks between one and other specimen blood.
      The stage of pregnancy was defined as the interval between the last menstrual
      period and onset of the rash. The pregnancies surveillance was performed with
      biophysics test periodically. The pregnancies were terminated in base of the
      obstetrical conditions. The analyzed variables were: Maternal age, stage of
      pregnancy at the attack, duration of the rash, parity, clinical diagnosis of the
      newborn. Pregnancy continued in 16 patients and were followed up to the birth of
      the infants. The frequency of congenital infection after maternal rubella was
      more than 80% during the 4-8 weeks. Congenital rubella syndrome occurred in 2
      newborn infected at the organogenesis period (4-8 weeks). Nevertheless there are
      12 children identified serologically which do it interesting the following of
      these infants for to identify in an opportune form possible structural
      alterations as late manifestations of rubella.

PMID- 1618407
TI  - [GnRH-agonists in gynecology I].
AB  - The present review has the objective to describe the chemical and pharmacological
      characteristics of GnRH analogs and the present time indications of it's use in
      gynecology. It is a critical review about use of GnRH analogs in: Anticonception,
      Assisted Reproduction, Uterine leiomyomas, Endometriosis, Polycystic Ovarian
      Syndrome, Precosious Puberty, Premenstrual Tension Syndrome and Breast Cancer.

PMID- 1618408
TI  - [Ovarian pregnancy. Presentation of a case and review of the literature].
AB  - Ovarian pregnancy is a rare phenomenon with an incidence of 1 case in 7000
      deliveries. We present a case implanted in the corpus luteum and discuss the
      possible etiology and the classification. We also review the diagnostic problems
      that it presents, and the advances made with transvaginal ultrasonography and hCG
      determinations in urine. The surgical management is presented, with special
      interest in conservative procedures.

PMID- 1618409
TI  - [Reliability of the pre-labor weight as a reference mark].
AB  - Total weight gain during pregnancy has been an anthropometric mean associated
      with the birth condition. Based on the fact that it is impossible to evaluate
      every woman in the pregestational period, the referred pregestational weight at
      week 30 has been evaluated. Such validation was done, comparing the weight gain
      of a group of women that referred their pregestational weight, with another group
      who had both weights evaluated. The results suggest, that the women studied, knew
      and referred correctly the data.

PMID- 1618411
TI  - [Menopause, a critical stage in life].
AB  - Menopause is the physiologic state that is consequence of ovarian function
      cessation and everyday more women reach it. In this article is reviewed the
      pathophysiology of menopause and treatment of osteoporosis.

PMID- 1618410
TI  - [Gynecologic and obstetric infections caused by aerobic bacteria].
AB  - The anaerobic bacteria (AB) are between the most numerous microorganisms (mo)
      that constitute the flora of the female genital tract, so they can participate in
      the etiology of obstetric and gynecologic infections (OGI). The objective of this
      study was to investigate the frequency of AB isolations and the clinical
      characteristics of the anaerobic infections (AI) in patients of the National
      Institute of Perinatology, from January 1st, 1988 to May 31, 1991. AB were
      isolated from 117 patients who developed 163 infections; 167 anaerobic and 83
      aerobic bacteria were recovered from these infections. The 99.2% were obstetric
      patients. The 85.5% of the isolations of AB were done from patients with
      endometritis, and 8.5% from postsurgical wound abscesses. Most of the AI were
      polymicrobial with a mean of 2.1 mo by infection. Peptostreptococcus, Clostridium
      and Bacteroids were the AB most frequent recovered. The majority of the patients
      had resolution of the infection within the first 5 days of antimicrobial
      treatment. There was no mortality in this group. We concluded that the AB have an
      important role in the etiology of OGI, then it is necessary that the treatment of
      these infections include antibiotics that cover AB.

PMID- 1618412
TI  - [GnRH-agonists in gynecology II].
AB  - The present review has the objective to describe the chemical and pharmacological
      characteristics of GnRH analogs and the present time indications of it's use in
      gynecology. It is a critical review about use of GnRH analogs in: Anticonception,
      Assisted reproduction, Uterine leiomyomas, Endometriosis, Polycystic ovarian
      syndrome, Precocious puberty, Premenstrual tension syndrome and breast cancer.

PMID- 1618413
TI  - [Ovulation induction with gonadotropins aided by cervix mucus analysis and
      echography].
AB  - Induction of ovulation was performed in 148 cycles using human menopausal
      gonadotropins (HMG) in 52 patients, seven with hypothalamic-pituitary failure and
      45 suffering dysfunction at this level. Several induction schemes were used
      beginning on the second day of the cycle, until one or more follicles larger than
      14 mm were found, to administrate 10,000 UI of human chorionic gonadotropin
      (HCG). Clinical valuation of cervical mucus and ultrasound of the ovaries to
      assess follicular development were done, from day eight of the cycle. Twenty five
      pregnancies resulted in 23 patients (44%), three in patients with failure and 22
      in the dysfunction group. A total of 19 healthy babies were taken home, however
      three neonatal deaths, four miscarriages and one ectopic pregnancy occurred.
      Multiple gestation was present in three patients (12%), one was quadruplet, one
      triplet and one twin. The ovarian hyperstimulation syndrome (OHS) was detected in
      seven patients (13.4%), three were mild, two moderate and two severe; two cases
      of OHS had multiple pregnancies. Although induction of ovulation with HMG in
      patients with anovulation is a complex procedure requiring strict clinical
      vigilance and advanced technological resources, in this clinical study it was
      possible to obtain similar results to other series, using high resolution
      ultrasound only, without daily measurements of hormones.

PMID- 1618414
TI  - [2nd International Symposium of Gynecologic Surgery and Prevention of Adhesions.
      Palm Beach, Florida, January 31-February 2, 1992].

PMID- 1618415
TI  - [Contralateral finger transplantation for reconstruction of thumb function].
AB  - Finger transplantation from the contralateral hand for the purpose of thumb
      reconstruction is rarely performed, more widespread use of this procedure being
      prevented by the psychological problems for the patients. Two cases are
      described, in which a previously damaged index finger of the contralateral hand
      was transplanted. The metacarpophalangeal joint of the index finger replaced that
      of the thumb in both cases. A strong pinch grip with sensibility was achieved.
      The aesthetic result was substantially improved, both on the donor and the
      recipient hand.

PMID- 1618416
TI  - [Thumb reconstruction with cryopreserved autogenous thumb skeleton and
      microneurovascular flap].
AB  - This paper describes a procedure for thumb reconstruction using autogenous cryo
      conserved bone from the thumb itself. In a case of severe explosion injury, the
      thumb and index finger were amputated at the carpometacarpal joint level and the
      remaining fingers at the distal interphalangeal joint level. Severe soft tissue
      damage and lesion of both the superficial and deep palmar arterial arches
      rendered customary surgical procedures for thumb reconstruction impossible. The
      cryo-conserved bone was replanted following soft tissue healing and then covered
      with a free radial forearm flap. This procedure resulted in a stable and painfree
      thumb and provided satisfactory grip.

PMID- 1618417
TI  - [Replacement of the long extensor tendon of the thumb by transposition of the
      index finger extensor tendon].
AB  - Transposition of the extensor indicis seems to be the most common procedure for
      reconstruction of the ruptured or severed extensor pollicis longus (EPL) tendon.
      From 1959 to 1988, we performed 115 extensor indicis transpositions in 34 open
      EPL injuries and 81 subcutaneous EPL ruptures. The open injuries involved failed
      primary repair (n = 6) or untreated tendon injuries (n = 19). The subcutaneous
      ruptures occurred after distal radius fractures or other closed injuries of the
      wrist (n = 62), arthrosis or rheumatoid synovialitis (n = 8). Forty-seven
      patients returned for follow-up examination six months to 18 years after
      operation. The evaluation included twelve parameters involving thumb, index
      finger and overall hand function as well as subjective patient assessment. We
      found significant loss of motion and strength only in two cases, where the
      tension of the transposed tendon was obviously inadequate. A certain loss of
      independent index extension was without functional impairment. Although several
      authors prefer EPL reconstruction with an intercalated tendon graft, we recommend
      the extensor indicis transposition as a simple procedure with predictable
      satisfactory results.

PMID- 1618418
TI  - [Complications after surgical management of scaphoid pseudarthroses].
AB  - The Matti-Russe technique yields a 95% success rate in treating scaphoid non
      unions diagnosed in the first years after trauma and without osteoarthrosis of
      the radiocarpal joint. Between October 1981 and December 1989, 215 patients were
      treated by Matti-Russe procedure at the University Hospital of "Bergmannsheil"
      Bochum. In ten cases, this operation did not lead to osseous consolidation. The
      results are presented and discussed.

PMID- 1618419
TI  - [Computerized tomography of the hand with high resolution technique].
AB  - The results of 175 high-resolution computed tomography (CT) scans of the hand and
      wrist are analysed and compared to the results of conventional radiographs.
      Advantages of the procedure can be demonstrated when assessing pathological
      changes within the complex three-dimensional structure of the hand and wrist, and
      in the analysis of articular surfaces. In some cases, fractures and dislocations
      of the distal radioulnar joint and the carpal bones were missed in conventional
      radiographs. In cases of scaphoid fracture and nonunion, CT scans give valuable
      additional information surpassing the possibilities of conventional radiographs.
      For instance, bone healing after bone grafting can be better evaluated with a CT
      scan. Furthermore, preoperative planning is simplified, when tumors and cysts of
      the carpal bones can be located precisely using computed tomography.

PMID- 1618420
TI  - [Malposition of healed distal radius fracture. Indications, technique and timing
      of correction].
AB  - Typical complications of distal radius fractures include post-traumatic
      malalignment in about 20%. This is associated with ulno-carpal pain and impaired
      wrist function. Various corrective procedures have been recommended. Between 1972
      and 1986, 96 patients with posttraumatic disorders after distal radius fractures
      underwent surgical treatment. Three different procedures were carried out: simple
      corrective osteotomy of the distal radius, combined correction of the radius and
      ulna, as well as isolated correction of the ulna (distal resection, step-cut
      osteotomy, hemiresection arthroplasty). 83 (86.5%) of the patients were followed
      up for an average of 7 years postoperatively. The functional results were
      evaluated according to Lidstrom. Excellent and good results were found in 58
      (69.9%), fair in 20 (24.1%) and bad results in 5 (6.0%). The best results were
      mostly seen in cases with a short interval between trauma and corrective
      procedure. Distal ulna resection has not been performed in our department since
      1986 because of poor results and concommitant wrist-instability. We recommend
      combined correction procedures in those patients with painful deformities within
      a period of no more than six to nine months after trauma. The indication should
      also take individual aspects such as profession, age, activities, complaints, and
      radiological findings into account. Signs of osteoarthrosis and wrist disorders
      due to severe soft tissue problems are contra-indications to any of the
      aforementioned correction procedures.

PMID- 1618421
TI  - [Differential, oncologically adequate therapy of basalioma].
AB  - Surgical treatment of basal cell carcinoma demands straightforward tumor
      management. This study investigated the radicality of surgical excision,
      procedures performed for defect coverage, the recurrency rate depending on the
      histological tumor type, among other parameters. Despite a low general incidence
      of 14%, sclerodermiformal BCC (morphea-like lesions) is found in 88% of all
      recurrencies. Based upon the results of this study, the following therapeutic
      guidelines are recommended: Resection with tumor-free margins must be insisted
      on, particularly in any exposed surfaces of the body. Histological subtyping by
      the pathologist is required. After initially incomplete resection in certain
      histological subtypes, subsequent radical resection is not mandatory. Complete
      resection of sclerodermiformal BCC is mandatory, and continuous follow-up of
      these cases is recommended.

PMID- 1618422
TI  - [Ultrastructure of the long flexor and extensor tendons of the hand in rheumatic
      tenosynovitis].
AB  - Tendon ruptures are a frequent problem in patients affected by rheumatoid
      arthritis. The aim of the present study was to further characterize the known
      macroscopic changes of tendon tissue by micromorphological methods. Flexor and
      extensor tendon samples (n = 28) in rheumatoid arthritis were investigated by
      light- and transmission electron microscopy. In all cases, marked alterations in
      fibril architecture and structure were found. The fibril diameter showed a higher
      variability (range = 20-490 nm, x = 98.9 nm, s = 49.1 nm) in comparison with the
      control group of normal tendons (range = 20-290 nm, x = 119.0 nm, s = 34.9 nm).
      The average distance between the major bands in rheumatoid arthritis was reduced
      (from 57.3 nm down to 54.8 nm). Rare minor bands were detected. Oxytalan and
      mature elastic fibres were destroyed. These findings suggest that a causal
      correlation exists between altered matrix substructure and insufficient function
      of the tendon tissue in rheumatoid arthritis.

PMID- 1618423
TI  - [Posterior interosseous nerve paralysis after overexertion. A case report].
AB  - Entrapment neuropathies in the upper extremity are common. Spontaneous paralysis
      of the posterior intersosseous nerve may occur by compression at the arcade of
      Frohse, where the nerve enters the plane between the superficial and deep muscle
      bellies of the supinator. Benign soft tissue tumors, minor trauma, and local
      inflammation have led to paralysis of the posterior interosseous nerve in several
      cases. An additional report on paralysis of this nerve a few days after
      overexertion with later spontaneous recovery is presented.

PMID- 1618424
TI  - Medical social work long-term care referrals for people with HIV infection.
AB  - Hospital social workers were surveyed to identify referral efforts and outcomes
      for clients with human immunodeficiency virus (HIV) infection who required long
      term placement. Over a three-month period, none of the 42 identified clients was
      admitted to a nursing home. In two-thirds of the cases, social workers contacted
      only one facility, and in about one-sixth of the cases, workers reported no
      placement attempts. Clients remained in the hospital a median overstay of eight
      days beyond acute care needs, representing 205 aggregate days that could have
      been spent in less intensive settings. Workers made few placement attempts
      because of beliefs that they would be unsuccessful or that nursing homes would
      not accept admissions. Increased communication and education both for referring
      workers and for long-term care facilities may improve the referral process,
      reduce costs, and decrease emotional distress for people infected with HIV.

PMID- 1618425
TI  - Social workers' knowledge about AIDS: working with vulnerable and oppressed
      people.
AB  - This study assessed social workers' differential knowledge about human
      immunodeficiency virus (HIV) infection. A questionnaire was mailed to a random
      sample of 500 members of the National Association of Social Workers in July 1988.
      Results show that social workers have the most information regarding transmission
      of HIV infection and the least information about the effects of HIV on specific
      subpopulations. Of particular concern was that respondents who stated they had
      either a personal or professional reason for being knowledgeable about acquired
      immune deficiency syndrome were no more informed about minority issues than those
      who did not think they had a personal or professional reason for being
      knowledgeable.

PMID- 1618426
TI  - Brown versus New York: the Rashomon of delivering mental health services in the
      1990s.
AB  - This article examines a case study of one homeless mentally ill woman in New York
      City to show the differing perspectives on mental illness among mental health
      consumers, family members, mental health professionals, and advocates. Different
      issues emerge, and different priorities for care become clear. The social worker
      as case manager must design intervention strategies based on these differing
      perspectives, a crucial challenge for the profession. This article reviews the
      current literature on case management and suggests a holistic approach that
      better meets the needs of mentally ill people, their family members, and the
      community.

PMID- 1618427
TI  - Is case management effective for people with serious mental illness? A research
      review.
AB  - Recent literature on caring for people with serious mental illnesses reflects a
      growing belief in the effectiveness of case management services for this
      population. This article reviews recent outcome studies on case management to
      assess the extent to which prevailing claims that it is effective are supported
      empirically. Based on this review, the author concludes that the hypothesis that
      case management is effective remains plausible, but conclusive claims that its
      efficacy has been empirically demonstrated are premature. The outcome studies
      reflect diversity and ambiguity in the ways case management is conceptualized and
      implemented, problems in the research methodologies employed, and inconsistencies
      in outcomes. Consequently, implications for further research are drawn.

PMID- 1618428
TI  - I am John.
AB  - "John's" story details the history of services provided to people with mental
      retardation in the United States from the 1720s to the present. Although "John"
      is fictitious, the facts relating to mental retardation, service, and treatment
      through the years are accurate. There are no social workers in John's life story
      mainly because mental retardation has not been a part of schools of social work
      curriculum. John's life might have been different if there had been social
      workers advocating for him.

PMID- 1618429
TI  - Social work in health care regulation and legislation.

PMID- 1618430
TI  - Family as a resource: maintaining chronically mentally ill members in the
      community.

PMID- 1618431
TI  - Disability policy and social work practice.

PMID- 1618432
TI  - 'Concealed ovulation' and sexual signals in primates.
AB  - The absence of conspicuous sexual signals in some primates, particularly humans
      and vervets, has been interpreted as evidence that females of these species are
      'concealing' ovulation from males. This conclusion is unjustified: the null
      hypothesis of no adaptation, that the absence of conspicuous sexual signals has
      resulted from the absence of selective pressures maintaining such adaptations, is
      both more parsimonious and better fits the facts. The related suggestion that
      there has been adaptation among females to conceal ovulation from their own
      consciousness is also unjustified. What, then, maintains sexual signals in those
      species that do have them? Many proposed hypotheses for the function of sexual
      signals do not account for their most puzzling feature: their conspicuousness.
      According to current theory on the evolution of communication, two explanations
      seem most plausible: conspicuous sexual signals function to communicate to
      distant receivers and/or to convince reluctant receivers. There is some empirical
      support for both hypotheses, but not overwhelming support for either.

PMID- 1618433
TI  - Oldest known Nannopithex (Primates, Omomyiformes) from the early Eocene of
      France.
AB  - Numerous dental remains of Nannopithex zuccolae, n. sp., from the terminal early
      Eocene locality of Premontre (Aisne), France, show the lower anterior dentition
      to be similar to that of other Nannopithex. Similarities include enlarged I1,
      reduced I2, reduced lower canine, loss of P2, small P3 and large P4. Upper
      molars, P3 and P4 all present primitive characters, making this species the most
      primitive as well as the oldest known microchoerid.

PMID- 1618434
TI  - Responses to a live snake by Lemur macaco macaco and Lemur fulvus mayottensis in
      captivity.

PMID- 1618435
TI  - Is there sex-biased mortality in primates?

PMID- 1618436
TI  - Sex-biased juvenile mortality in primates: a reply to Hauser and Harcourt.

PMID- 1618437
TI  - Allometry of food intake in free-ranging anthropoid primates.

PMID- 1618438
TI  - Basal metabolic rate, body weight and diet in primates: an evaluation of the
      evidence.
AB  - The relationship between basal metabolic rate (BMR), body weight and diet is
      examined for primates. Contrary to the results reported in several recent works,
      there is no strong evidence that diet is directly linked to BMR, although a low
      BMR, relative to body weight, may be found in species with folivorous diets.
      There is some evidence that nocturnal haplorhine species have a relatively low
      BMR, but strepsirhines appear to have a uniformly low relative BMR regardless of
      their primary activity period. The evolution of BMR in primates is discussed in
      the light of these findings. Some predictions are made about the relative BMRs
      that should be found for other species whose BMR is, as yet, unknown.

PMID- 1618439
TI  - Some features of Balkan endemic nephropathy.
AB  - This paper presents a brief review of the initial investigative efforts in three
      countries--"Yugoslavia", Bulgaria and Romania--on Balkan endemic nephropathy.
      There is now expert agreement that the disease represents an unusual type of
      chronic interstitial nephropathy of unknown aetiology. The epidemiological and
      histopathological data are summarized very briefly. The clinical symptoms and
      signs and the diagnostic approach to the disease are presented in greater detail.
      The possibilities of an early diagnosis in the latent, subclinical and early
      phases of the disease are discussed, together with the importance of the
      detection of a tubular type of proteinuria and enzymuria as a diagnostic aid.

PMID- 1618440
TI  - Epidemiology of Balkan endemic nephropathy.
AB  - The first outbreak of Balkan endemic nephropathy (BEN) was reported between 1955
      and 1957, initially in Serbia and soon afterwards in Croatia and in Bosnia and
      Herzegovina. The disease appears to be of a focal nature. In Yugoslavia at least
      six foci are known, generally along major rivers of the Danubian river basin, in
      areas that have often been flooded in the past and even today suffer from high
      ground waters. The prevalence rate of the disease is reported to be between 2 and
      10%. In the endemic area of Croatia, a systematic survey of 'in-the-field' cases
      of the disease since 1975 has shown a prevalence between 0.5 and 4.4%. When
      suspected cases are also included the prevalence rises to 20% or more. Specific
      mortality (based on official statistics) during the period 1957-1984 averaged
      1.54/1000 per annum, but some studies have shown that mortality is actually more
      than twice as high as this figure. More women are affected than men; women also
      more frequently die of BEN than men. Lethality is extremely high. A striking
      feature of BEN is the familial occurrence of the disease. Incidence does not seem
      to be connected with ethnic group differences. Immigrants into the endemic area
      may also contract the disease. An increased incidence of malignant tumours of the
      urinary tract has been recorded in populations living in endemic areas.
      Epidemiological characteristics suggest that the disease is contracted in the
      domestic situation, or possibly from other family members. Factors to be
      considered are food, water or long close contact. It is also possible that the
      disease is contracted outside the house, in connection with farming activities,
      since the affected persons are almost exclusively farmers.

PMID- 1618441
TI  - Clinical features of Balkan endemic nephropathy.
AB  - This paper describes the clinical symptoms and signs of Balkan endemic
      nephropathy (BEN). The initial asymptomatic period followed by weakness and
      lassitude during renal insufficiency is emphasized. Non-characteristic lumbar
      pain may be present and episodes of macrohaematuria may occur. There is no fever,
      no severe dysuria, and no general disease preceding the symptoms. No oedema of
      the nephrotic type is recognized. Working capacity is unaffected until the late
      stage of the disease. In the advanced stages pallor of the skin and xantochromia
      of palms and soles are noticeable. Blood pressure is normal, but in the advanced
      phase may be elevated. In the uraemic phase a full uraemic syndrome is found.
      Urothelial tumours are frequent, occurring in 2-47% of cases; tumour cells may be
      found in the urine. Proteinuria of tubular type may be found early; in the
      uraemic phase it is constant. In the urinary sediment there are scarce white and
      red blood cells (the latter episodically abundant). Bacteriuria is present in
      about 20% of women patients. Glucosuria (less than 10%) and aminoaciduria (less
      than 10%) have been reported. In the early stages of BEN the urine concentration
      capacity is impaired earlier than renal blood flow and glomerular filtration
      rate. Enzymuria is present in the early phases. Tamm-Horsfall protein may be
      increased in the urine. Normo- or hypochromic normocytic hyporegenerative anaemia
      is a frequent finding. Bone marrow and leucocytes are normal. Serum proteins and
      immunoglobulins are not altered. Complement is normal; anti-glomerular basal
      membrane and anti-tubular basal membrane are negative. On radiography, kidney
      size varies from normal to the size of a small contracted kidney. The clinical
      picture of the disease is that of a slowly progressing tubulo-interstitial
      chronic nephritis.

PMID- 1618442
TI  - Pathomorphology of Balkan endemic nephropathy.
AB  - Within the county of Slavonski Brod, Yugoslavia hyperendemic areas of Balkan
      endemic nephropathy (BEN) have been recognized for a long time. As the Department
      of Pathology and Forensic Medicine of the Medical Centre in Slavonski Brod is
      responsible for all diagnostic post-mortem examinations in the county, and at the
      same time is engaged in surgical pathological diagnosis, a considerable amount of
      material relating to BEN and concomitant urinary-tract tumours has been collected
      during a 16-year period. This material has been classified and used for
      pathological, anatomical and histological investigations. In this paper the most
      relevant findings are described and briefly discussed, without the intention to
      speculate on possible aetiology of BEN. As the origin of BEN and of the high
      frequency of urinary tumours among the people from the endemic areas are still
      unexplained, and uniform criteria for the pathomorphological diagnosis of BEN are
      badly needed, the proposal to set up an archive encompassing cases from all the
      centres investigating BEN is supported.

PMID- 1618443
TI  - Ochratoxin A in blood and its pharmacokinetic properties.
AB  - Since there are pathomorphological similarities between porcine mycotoxic
      nephropathy caused by ochratoxin A and Balkan endemic nephropathy (BEN), it has
      been suggested that the same aetiological agent has a role in BEN. Based on the
      results from several field and experimental studies carried out on pigs, an
      appropriate analytical method of monitoring possible human exposure to ochratoxin
      A was developed. The toxicokinetic properties of the toxin were species specific,
      although in all the animal species studied (with the exception of fish), as well
      as in humans, two binding proteins were found in the plasma. The monkey had the
      longest elimination half-life of the toxin, 510 hr, in contrast to the fish whose
      elimination half-life was only 0.68 hr. The fish kidney displayed a specific
      pattern of distribution. In the laying quail the most prominent observation was
      the accumulation of labelled ochratoxin A in egg yolk. Generally, [14C]ochratoxin
      A was eliminated rapidly from the quail body, but had a long retention time in
      the circulating blood in the mouse. Although the elimination of ochratoxin A from
      the body depending on its binding to plasma constituents, the existence of
      enterohepatic circulation might have been partially responsible for its prolonged
      retention and elimination from the body of mammals. The toxicokinetic profile of
      ochratoxin A did not contradict the mycotoxic hypothesis in the aetiology of BEN.

PMID- 1618444
TI  - Relevance of a rat model of papillary necrosis and upper urothelial carcinoma in
      understanding the role of ochratoxin A in Balkan endemic nephropathy and its
      associated carcinoma.
AB  - Ochratoxin A is nephrotoxic and has been implicated in the genesis of Balkan
      endemic nephropathy (BEN), a condition that leads to end-stage renal disease and
      upper urothelial tumours. This compound induces renal parenchymal carcinoma in
      male mice only, and is not considered to be a potent carcinogen nor is there
      experimental evidence of its propensity to cause upper urothelial carcinoma.
      There is, however, evidence that exposure to more than one mycotoxin may be an
      important factor in the clinical spectrum of BEN. Analgesic nephropathy is
      clinically different, but is also associated with an upper urothelial carcinoma.
      The combination of urothelial initiation and an acute papillary necrosis in rats
      produces upper urothelial carcinoma. This two-stage experimental model offers the
      potential to assess the role of ochratoxin A in BEN-associated upper urothelial
      carcinoma under experimental conditions.

PMID- 1618445
TI  - Role of ochratoxin in disease causation.
AB  - Under experimental conditions renal damage has been induced by alimentary
      exposure to ochratoxin A in all single-stomach animals tested so far, including
      rodents, dogs, pigs and birds, and even in young ruminants still functioning as
      single-stomach animals. Most information on ochratoxin-induced nephropathy has
      been obtained in pigs during experimental studies comprising structural as well
      as functional changes. The renal damage is characterized morphologically by
      atrophy of the proximal tubules, interstitial cortical fibrosis and sclerotized
      glomeruli, and functionally by impairment of tubular function indicated by a
      decrease in TmPAH/Cin and reduced ability to produce concentrated urine. The
      renal effect has been observed using exposure levels of ochratoxin A in the range
      200 to 4000 micrograms/kg feed. Field cases of ochratoxin-induced nephropathy in
      pigs have been encountered in many countries, and the disease mycotoxic porcine
      nephropathy (MPN) is recognized as an endemic disease entity in several northern
      and central European countries. Epidemics of MPN have been reported, closely
      related to excessive climatic conditions in periods preceding harvest. Ochratoxin
      A is a recognized renal carcinogen in the mouse. In female pigs exposed to
      alimentary ochratoxin A for 2 years, no renal cancer was observed. Ochratoxin A
      is metabolized and excreted relatively fast in animals, with an RL50 (residue
      elimination) in the pig of a few days for various tissues. Past exposure data is
      a requirement in retrospective epidemiological studies, but because of the short
      RL50 values tissue analysis for ochratoxin A is unlikely to provide that kind of
      data, in animals or in humans. In order to meet this demand a procedure has been
      developed, using renal biopsy material for activity analysis of two renal tubular
      enzymes, phosphoenolpyruvate carboxykinase and gamma-glutamyl transpeptidase. In
      pigs exposed to ochratoxin A for 1 week a 40% reduction of the enzyme activity
      was observed. The dose-related activity decrease of the two enzymes was
      accompanied by a dose-related aggravation of renal impairment, as measured by a
      reduction of TmPAH/Cin, suggesting that these enzymes are sensitive indicators of
      ochratoxin A-induced nephropathy.

PMID- 1618446
TI  - Styrene migration from general-purpose and high-impact polystyrene into food
      simulating solvents.
AB  - General-purpose and high-impact polystyrenes (GPPS and HIPS, respectively) are
      used in many food-contact applications for the packaging of aqueous-based, fatty
      and dry foods. The correlation of residual styrene concentrations in polystyrene
      with styrene migration into food-stimulating solvents is of interest in order to
      predict the potential exposure of consumers to styrene from food-packaging
      applications. Studies of the migration of styrene into 8% ethanol and cooking oil
      from a GPPS and a HIPS polymer, each containing three different residual styrene
      levels, have been completed at temperatures ranging from 70 to 180 degrees F (21
      to 82 degrees C). The results showed that the amount of styrene migrating from
      both polymers into cooking oil was proportional to the square root of the time of
      exposure, and the total amount of styrene migrating was proportional to the
      residual levels of styrene in the polymers. The calculated diffusion coefficients
      were found to be independent of the residual levels of styrene in a given polymer
      at a given temperature. While the partition equilibrium was not approached when
      the polymers were exposed to cooking oil, it was observed in the 8%-ethanol
      exposure studies. The calculated partition coefficients between the polymers and
      8% ethanol appeared to be independent of the residual levels of styrene in the
      polymers at a given temperature. Linear relationships were observed between the
      logs of the diffusion and partition coefficients and the inverse of the absolute
      temperature of exposure.

PMID- 1618448
TI  - Sex difference in the nephrotoxicity of thiabendazole in mice depleted of
      glutathione by treatment with DL-buthionine sulphoximine.
AB  - In ICR mice depleted of glutathione (GSH) by treatment with DL-buthionine
      sulphoximine (BSO), males were much more susceptible to thiabendazole (TBZ)
      nephrotoxicity than females. The nephrotoxicity was indicated by increases in
      relative kidney weight and serum urea nitrogen (SUN) concentration and by a
      decrease in renal GSH concentration at 24 hr after TBZ administration. The
      susceptibility of males to TBZ-induced nephrotoxicity was completely eliminated
      by pretreatment with oestradiol (OD). Castration of male mice also reduced,
      though not completely, their susceptibility to TBZ nephrotoxicity. In females
      pretreated with testosterone (TS), the nephrotoxic effect of TBZ was increased to
      an extent comparable with that in males.

PMID- 1618447
TI  - Effects of selected secondary metabolites of Fusarium moniliforme on unscheduled
      synthesis of DNA by rat primary hepatocytes.
AB  - The Fusarium moniliforme mycotoxins--fusarin C, fumonisin B1, moniliformin and
      bikaverin--were evaluated for genotoxicity by their ability to induce unscheduled
      DNA synthesis (UDS) in primary rat hepatocytes. Isolated hepatocytes were exposed
      to several concentrations of moniliformin (5.0-500 microM), bikaverin (1.0-500
      microM), fumonisin B1 (0.5-250 microM), or fusarin C (1.0-100 microM). Aflatoxin
      B1, a known inducer of UDS, was included as a positive control. UDS was
      determined by autoradiography of cells after their exposure to [3H]thymidine. The
      highest doses of fusarin C and bikaverin caused cell death, but no cytotoxicity
      was observed in cells exposed to moniliformin or fumonisin B1. Fumonisin B1,
      moniliformin and bikaverin were not genotoxic in the UDS assay. The results of
      the UDS assay with fusarin C were inconclusive since a marginal effect on UDS was
      obtained.

PMID- 1618449
TI  - Lack of renal tumour-initiating activity of a single dose of potassium bromate, a
      genotoxic renal carcinogen in male F344/NCr rats.
AB  - The renal tumour-initiating activity of potassium bromate (KBrO3), a known
      genotoxic rat renal carcinogen, was investigated in male F344/NCr rats. 6-wk-old
      rats were given KBrO3 intragastrically as a single dose of 300 mg/kg body weight,
      which was confirmed by our preliminary toxicity study as a maximum tolerated
      single dose for this strain of rat. Starting 2 wk after KBrO3 treatment, groups
      of 39 rats received either a basal diet or a diet containing 4000 ppm barbital
      sodium (BBNa) as a promoting regimen and were killed at 30, 52, or 104 wk.
      Control rats received either dietary BBNa (4000 ppm) or the basal diet alone from
      wk 2 to 52 or 104 wk. Nephropathy was observed in all rats treated with KBrO3
      followed by BBNa at 30 wk and in rats receiving BBNa alone, but not in rats
      exposed to KBrO3 alone. Dysplastic renal tubular cell foci (DTF), putative
      preneoplastic renal tubular cell lesions were found associated with nephropathy
      in rats exposed to KBrO3 followed by BBNa from 47 wk. The incidences and
      multiplicities of DTF and renal tubular cell tumours observed from 31 to 104 wk
      revealed no initiating effect of KBrO3 treatment. These results indicate that the
      KBrO3 dose of 300 mg/kg did not initiate renal carcinogenesis.

PMID- 1618450
TI  - Sodium monochloroacetate poisoning of greenfinches.
AB  - A large number of passerine birds, mainly greenfinches, were found dead or dying
      in a hedgerow close to a field of onions recently sprayed with sodium
      monochloroacetate (SMCA). An analytical method is described for isolating
      monochloroacetic acid from bird tissues, as its potassium salt, by ion exchange
      chromatography. The ion exchange eluate is evaporated to dryness, acidified,
      extracted with ether and the ethereal extract methylated with diazomethane. The
      concentration of the methyl ester of monochloroacetic acid is determined using
      the Mass Selective Detector in the selected ion mode. Chemical analysis confirmed
      the exposure of the birds to SMCA. It is calculated that 50 microliter of spray
      contained the lethal dose of SMCA for a greenfinch.

PMID- 1618451
TI  - Semen fingerprint.

PMID- 1618452
TI  - Age estimation from the structure of adult human teeth: review of the literature.
AB  - The literature on age estimation from the structure of adult human teeth is
      reviewed. Several anatomic changes of teeth have been shown to be valuable in age
      determination, but there is still controversy concerning the accuracy of cemental
      annulation. It is believed that improvements in age estimation can be made using
      direct measurement rather than scoring systems.

PMID- 1618453
TI  - An express immunological method for detection of human seminal plasma.
AB  - Monoclonal antibodies (Mabs) against human seminal plasma (HSP) were produced and
      during screening procedures dissociation constants of the antigen/antibody
      complexes were determined. Mab 1E5 was selected for further studies because of
      its high reactivity in an enzyme-linked immunoassay (ELISA) and high affinity for
      its corresponding antigen. The specificity of Mab 1E5 was checked in absorption
      ELISA with human organ extracts and some biological secretions. It was
      established that the 1E5-corresponding epitope was a thermostable peptide moiety
      which could be detected in HSP, only. This monoclonal antibody was used for the
      development of an express method for detection of human semen. The assay was
      applied for screening of 57 cases of suspected rape. A complete correlation was
      found between the results obtained by the proposed test and by routine
      microscopic methods. The newly designed immunoassay is reliable, it is easily
      performed and it is less time-consuming.

PMID- 1618454
TI  - Rectal temperature time of death nomogram: dependence of corrective factors on
      the body weight under stronger thermic insulation conditions.
AB  - Ninety-eight test coolings were made under various cooling conditions (moving
      air, two types of both clothing and covering) on dummies of real masses of 1,
      3.3, 9.9, 24.5 and 33.4 kg, respectively, which cool under standard conditions
      (unclothed, uncovered, still air) like human bodies of 14, 33, 41, 83 and 104 kg,
      respectively. The results provide evidence of a non-linear dependence of
      corrective factors of body weight upon the body weight. The dynamics of the
      dependence increases with the thickness of thermic insulation. Transferred to the
      use of the nomogram method on bodies, cooling conditions requiring corrective
      factors between 0.75 (moving air) and 1.3 (rather thin clothing/covering), known
      from experience on bodies of an average weight, can be used as in the past,
      independent of the body weight. According to experience the dependence of
      corrective factors on the body weight must be taken into account in bodies of a
      very high or low body weight. For that purpose both a simplified table and a
      formula for computing is given.

PMID- 1618455
TI  - Quantitative liquid chromatography, thermospray/tandem mass spectrometry
      (LC/TSP/MS/MS) analysis of some thermolabile benzodiazepines in whole-blood.
AB  - An LC/TSP/MS/MS selected reaction monitoring (SRM) method in the daughter ion
      scan mode can be applied successfully for the quantitative determination of
      thermolabile benzodiazepines in whole-blood following an Extrelut extraction
      method. Detection limits as low as 100 pg per injection can be reached for all
      benzodiazepines. The benzodiazepines under investigation proved to be stable,
      with the exception of ketazolam for which complete degradation to diazepam was
      observed.

PMID- 1618457
TI  - The occurrence of cervical fractures in victims of judicial hanging.
AB  - Cervical vertebrae from 34 victims of judicial hanging were examined. In only six
      cases was there a fracture of the axis and only one other fracture was seen in
      the series. The fractures were of two types. Three were the traditional
      'Hangman's fracture' whilst three were of a type previously unreported. The
      incidence of fracture was unassociated with drop, date age or hangman. The
      results of the post mortems on these subjects were reviewed and found to be
      grossly inaccurate with regard to fractures. The results indicate that the
      traditional hangman's fracture occurred in only a small proportion of cases of
      judicial hanging. The cause of fractures and cause of death in judicial hanging
      are discussed with a brief history of judicial hanging in this country.

PMID- 1618456
TI  - Rapid death from thrombotic thrombocytopaenic purpura following caesarean
      section.
AB  - We report a case of rapid death from thrombotic thrombocytopaenic purpura (TTP)
      in a young pregnant lady who developed full blown symptoms soon after caesarean
      section. Extensive intramyocardial confluent haemorrhages and widespread
      microthrombi in heart, brain, adrenals and kidney were found at autopsy.
      Thrombotic thrombocytopaenic purpura is an uncommon condition, which carries a
      high fatality rate if untreated. Awareness of this syndrome together with its
      high risk of sudden death underlines the importance of rapid diagnosis and
      treatment.

PMID- 1618459
TI  - Patient transport--"hitching a ride".

PMID- 1618458
TI  - Screening and confirmation of drugs in urine: interference of hordenine with the
      immunoassays and thin layer chromatography methods.
AB  - Hordenine cross-reacted with various enzyme linked immunosorbent assay (ELISA) or
      radioimmunoassay (RIA) kits used for the screening of urine samples. Morphine
      ELISA kit was most sensitive, whereas etorphine- and buprenorphine-ELISA kits
      were least sensitive to hordenine cross-reactivity. Hordenine also interfered
      with the thin layer chromatography of oxymorphone, hydromorphone and apomorphine.
      The major source of hordenine in humans is beer brewed from barley, whereas the
      major source of hordenine in horses is canary grass or barley. Therefore, the
      presence of hordenine in the urine of humans consuming beer or in the urine of
      horses consuming canary grass may give false positive values when the immunoassay
      and TLC methods are used for the screening of the urine sample. In order to
      distinguish hordenine from the opiate drugs, simple and sensitive gas
      chromatographic/mass spectrometric (GC/MS) and high performance liquid
      chromatographic (HPLC) methods have been developed in this study.

PMID- 1618460
TI  - My experience as a courier.

PMID- 1618461
TI  - My experience as a courier.

PMID- 1618462
TI  - Patient transport--yesterday and today.

PMID- 1618463
TI  - Intracranial pressure monitoring and liver transplantation for fulminant hepatic
      failure.
AB  - Cerebral edema and intracranial hypertension, commonly present in fulminant
      hepatic failure, may lead to brainstem herniation and limit the survival of
      comatose patients awaiting liver transplantation before a donor organ becomes
      available. Also, they are likely responsible for postoperative neurological
      morbidity and mortality. Although intracranial pressure monitoring has been
      proposed to aid clinical decision making in this setting, its use in the
      prevention of brainstem herniation preoperatively, in the selection of patients
      for liver transplantation who have the potential for neurological recovery and in
      the maintenance of cerebral perfusion during liver transplantation has not been
      examined in detail. To address these issues, we established a protocol for
      intracranial pressure monitoring in comatose patients with fulminant hepatic
      failure as part of their preoperative and intraoperative management. Twenty
      adults and three children underwent intracranial pressure monitoring. Ten
      patients required preoperative medical therapy with mannitol, barbiturates or
      both for a rise in intracranial pressure above 25 mm Hg. Four patients had a
      sustained lowering of intracranial pressure, three of whom survived
      hospitalization. Six patients had intracranial hypertension refractory to medical
      management, were removed from a waiting list for a donor organ and died with
      brainstem herniation. Of the remaining 17 patients, 3 died of other causes while
      awaiting a donor organ, 2 recovered spontaneously without neurological sequelae
      and 12 underwent liver transplantation. All but one patient undergoing liver
      transplantation had transient intraoperative intracranial hypertension develop,
      requiring medical treatment. The 12 patients who had transplants recovered
      neurologically and were discharged from the hospital.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1618464
TI  - Direct measurement of hepatic blood flow in native and transplanted organs, with
      accompanying systemic hemodynamics.
AB  - The purpose of this study was to investigate intraoperatively a population of
      patients with end-stage liver disease before and after liver transplantation with
      respect to (a) the range of hepatic and systemic hemodynamics and their changes
      associated with transplantation and (b) the ability to identify native
      hemodynamic correlates with specific diagnostic groups. Hepatic artery and portal
      vein blood flows were determined with square-wave electromagnetic flowmetry.
      Significant differences related to the type of preservation solution used--Euro
      Collins or University of Wisconsin--were identified in some hepatic and systemic
      hemodynamic measurements from the graft livers. Specifically, cardiac output,
      total liver blood flow and liver weight were significantly increased in the Euro
      Collins group compared with the native and University of Wisconsin groups.
      Hepatic artery flow was significantly greater and portal vein pressure was
      significantly lower in the University of Wisconsin group than in the native or
      Euro-Collins group. In general, comparing the graft and native livers, hepatic
      artery and portal vein blood flow increased significantly after transplantation,
      as did hepatic oxygen consumption. Portal vein pressures were dramatically
      reduced, but systemic arterial pressure remained remarkably constant. The
      percentage of cardiac output going to the liver increased, as did the portal vein
      percentage of the total liver blood flow. Diagnostic groups could not clearly be
      associated with characteristic native liver or systemic hemodynamics.
      Hemodynamics may be associated more with the stage of the disease process than
      the disease itself.

PMID- 1618465
TI  - Sodium benzoate in the treatment of acute hepatic encephalopathy: a double-blind
      randomized trial.
AB  - A prospective randomized double-blind study was conducted to evaluate the
      efficacy of sodium benzoate in the treatment of acute portal-systemic
      encephalopathy. Seventy-four consecutive patients with cirrhosis or surgical
      portasystemic anastomosis and hepatic encephalopathy of less than 7 days duration
      were randomized to receive lactulose (dose adjusted for 2 or 3 semiformed
      stools/day) or sodium benzoate (5 gm twice daily). Assessment of response
      included mental status, asterixis, arterial ammonia level, electroencephalogram
      and number-connection test. Each was given a score between 0 and 4+. A portal
      systemic encephalopathy index was calculated with these scores. Visual, auditory
      and somatosensory evoked potentials and a battery of psychometric tests for
      intelligence and memory were also performed to assess improvement. Thirty-eight
      patients received sodium benzoate; 36 took lactulose. Thirty patients (80%)
      receiving sodium benzoate and 29 (81%) receiving lactulose recovered; the
      remaining patients died. Improvement in portal-systemic encephalopathy parameters
      occurred in both treatment groups and was similar (p greater than 0.1).
      Electroencephalogram and evoked potentials were not as helpful as mental status
      in assessing of recovery. Psychometric test scores remained abnormal after
      recovery of mental status (21 to 42 days) and were probably too sensitive for
      monitoring of these patients. The incidence of side effects was similar in the
      two treatment groups. The cost of lactulose for one course of therapy was 30
      times that of sodium benzoate. We conclude that sodium benzoate is a safe and
      effective alternative to lactulose in the treatment of acute portasystemic
      encephalopathy.

PMID- 1618466
TI  - Association between heterozygous alpha 1-antitrypsin deficiency and genetic
      hemochromatosis.
AB  - Primary hemochromatosis is a genetically determined autosomal recessive disorder
      characterized by the excessive accumulation of body iron, most of which is
      deposited in the parenchymal cells of various organs. alpha 1-Antitrypsin
      deficiency is characterized among others by defective secretion of alpha 1
      antitrypsin from liver cells. Whereas the risk of cirrhosis is increased in
      homozygous patients (PI ZZ) and possible in heterozygous patients (non-PI MM) as
      well, a greater risk for hepatocellular carcinoma has been suggested only in
      homozygous patients. Because these two metabolic disorders are relatively common,
      it has been difficult to determine whether they are associated with each other.
      In this study, we tried to determine the relationship between these two disorders
      using the case material seen at the University of Pittsburgh during a 7-yr
      period. We studied 15 patients with genetic hemochromatosis. alpha 1-Antitrypsin
      quantitation and phenotyping were performed in each case using standard methods.
      The distribution of the various Pi phenotypes was compared with that found in a
      normal population and reported elsewhere. Odds ratio and chi 2 tests were used to
      measure the relative risk and significance of association, respectively. Eleven
      patients (73%) were found to be PI M and four (27%) were identified as being
      heterozygotes: three (20%) were PI MZ, and one (7%) was PI MS. The prevalence of
      the PI MS phenotype was similar to that in the general population (7% vs. 6.4%;
      NS). The PI MZ phenotype, however, was statistically more common in patients with
      hemochromatosis than in the general population (20% vs. 2.2%; p less than
      0.004).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618468
TI  - Neurological complications after liver retransplantation.
AB  - Postoperative neurological complications in 185 patients who underwent two or
      more orthotopic liver transplantations were reviewed. The most common
      neurological complications were alteration of mental status (84%), seizures (33%)
      and focal motor deficits (15%). The frequency of neurological complications after
      a second orthotopic liver transplantation was significantly greater than that
      after a single orthotopic liver transplantation. However, neurological
      complications were more frequent after a second orthotopic liver transplantation
      than after a third transplant. Significantly more neurological complications
      occurred in patients who did not survive a year than in those who did, regardless
      of the number of transplants they underwent. These findings indicate that the
      risk of neurological complications among patients with multiple orthotopic liver
      transplantations is greater in those who require a second transplant; this risk
      appears to diminish after a third transplant. Importantly, the presence of
      neurological complications is associated with increased post-orthotopic liver
      transplantation mortality rate.

PMID- 1618467
TI  - Plasma levels of brain natriuretic peptide in patients with cirrhosis.
AB  - Plasma levels of brain natriuretic peptide, a recently identified cardiac hormone
      with natriuretic activity, were measured in 11 healthy subjects, 13 cirrhotic
      patients without ascites, 18 nonazotemic cirrhotic patients with ascites and 6
      patients with cirrhosis, ascites and functional kidney failure. Plasma levels of
      brain natriuretic peptide were similar in healthy subjects and cirrhotic patients
      without ascites (5.56 +/- 0.65 and 7.66 +/- 0.68 fmol/ml, respectively). In
      contrast, cirrhotic patients with ascites, with and without functional kidney
      failure, had significantly higher plasma concentrations of brain natriuretic
      peptide (19.56 +/- 1.37 and 16.00 +/- 1.91 fmol/ml, respectively) than did
      healthy subjects and patients without ascites (p less than 0.01); no significant
      difference was found between the two groups of cirrhotic patients with ascites
      with respect to this parameter. In the whole group of cirrhotic patients included
      in the study, brain natriuretic peptide level was directly correlated with the
      degree of impairment of liver and kidney function, plasma renin activity and
      plasma levels of aldosterone and atrial natriuretic peptide. The results of this
      study indicate that brain natriuretic peptide is increased in cirrhotic patients
      with ascites and suggest that sodium retention in cirrhosis is not due to
      deficiency of this novel cardiac hormone.

PMID- 1618469
TI  - Hepatic fibrosis in rats produced by carbon tetrachloride and
      dimethylnitrosamine: observations suggesting immunoassays of serum for the 7S
      fragment of type IV collagen are a more sensitive index of liver damage than
      immunoassays for the NH2-terminal propeptide of type III procollagen.
AB  - Liver fibrosis was induced in rats both with carbon tetrachloride and
      dimethylnitrosamine. Assays were performed on steady-state levels of messenger
      RNAs in the liver for several collagens and basement membrane components. The
      results indicated marked increases in the steady-state levels of messenger RNA
      for type I collagen, type III collagen, type IV collagen and the B2 component of
      laminin. In the same animals, immunoassays were performed for serum levels of the
      N-terminal propeptide of type III procollagen and the 7S fragment of type IV
      collagen. The results demonstrated an increase in the serum levels of 7S fragment
      that occurred early and closely paralleled the increase in the steady-state
      levels of messenger RNA for the alpha 1(IV) chain of type IV collagen. In
      contrast, no significant increase was seen in the serum levels of the N
      propeptide of type III procollagen. The results suggest that immunoassays for 7S
      fragment of type IV collagen in serum are a more sensitive index for liver cell
      damage and fibrosis than assays for the N-propeptide of type III procollagen. The
      results suggest that greater attention should be paid to assays of 7S fragments
      in assessing hepatic fibrosis in man.

PMID- 1618470
TI  - Uptake of a protein-bound polar compound, acetaminophen sulfate, by perfused rat
      liver.
AB  - The hepatocytic entry of acetaminophen sulfate conjugate was examined in the rat
      liver, perfused with red cells with and without albumin, by use of the multiple
      indicator dilution technique. [3H]acetaminophen sulfate was injected into the
      portal vein in a bolus of blood containing 51Cr-labeled red blood cells (a
      vascular reference), sucrose (a low-molecular-weight interstitial reference) or
      125I-labeled albumin (a high-molecular-weight interstitial reference, included
      when albumin was present), and the time courses of their outflow into the hepatic
      venous blood were observed. The [3H]acetaminophen sulfate, which binds partially
      to albumin, emerged between albumin and sucrose in the presence of albumin,
      processed the upslope of the sucrose curve and showed a late low-in-magnitude
      tailing; the precession disappeared in the absence of albumin. Biliary excretion
      of [3H]acetaminophen sulfate was less than 1% of the dose. Quantitative
      evaluation with a barrier-limited, space-distributed variable transit time model
      (including rapidly equilibrating albumin binding) accounted for the albumin
      effect on [3H]acetaminophen sulfate behavior and demonstrated a low liver cell
      permeability for the acetaminophen sulfate and a small interstitial binding space
      for its nonalbumin-bound fraction in excess of that for sucrose, which in the
      absence of albumin was of similar dimensions.

PMID- 1618471
TI  - Changes of IgG-bearing cell populations in the portal tracts of patients with
      chronic liver disease of viral etiology: an evaluation by immunoperoxidase method
      and computerized image analysis.
AB  - Little is known about the distribution of IgG-bearing cell subpopulations in
      normal liver and their possible changes in disease conditions. We developed an
      immunohistochemical method that proved suitable and accurate for the
      identification and characterization of IgG-bearing cells and their subpopulations
      in liver specimens. The method uses specific monoclonal antibodies on serial
      mirror liver sections. We applied this method to four normal liver tissue
      specimens and 25 liver biopsy samples of chronic hepatitis of viral etiology.
      Only rare IgG-bearing cells could be observed in the portal tracts of normal
      liver specimens. In contrast, a dense infiltrate of such cells was seen in liver
      specimens from patients with chronic viral hepatitis. The density of IgG-bearing
      cells in such patients ranged from 6 to 20 cells x 10(-4) micron2 in the
      different specimens (mean = 11 x 10(-4) micron2). The increase in IgG-bearing
      cells did not appear to be related to the histological diagnosis, to the degree
      of histological inflammatory activity or to the type of viral infection. The
      major population of IgG-bearing cells consisted of IgG1-positive cells (68%);
      IgG2- (17%), IgG3- (8%) and IgG4 (7%)-bearing cells represented only minor
      fractions. The increased prevalence of IgG1-bearing cells observed in chronic
      hepatitis but not in normal liver specimens suggests that these findings may
      reflect an activation of antibody production directed toward viral antigens or
      antigenic structures of self. The identification of the antigenic specificities
      of the antibodies produced by IgG-bearing cells might provide important clues in
      understanding the pathogenesis of chronic viral hepatitis.

PMID- 1618473
TI  - Ethinylestradiol increases volume and decreases sinusoidal membrane surface in
      the rat liver: a stereological analysis.
AB  - Structural alterations of liver parenchyma caused by ethinylestradiol, a
      synthetic estrogen known to induce cholestasis and to act as a tumor promoter
      factor, were investigated. Male rats treated with 17 alpha-ethinylestradiol (5
      mg/kg body weight for 5 days) were compared with controls (n = 5 each). After
      perfusion fixation and systematic random sampling, paraffin sections, semithin
      sections and thin sections were examined observing standard stereological
      techniques. Ethinylestradiol treatment induced an increase in liver volume by 65%
      (p less than 0.001), which was caused more by hypertrophy (volume of singular
      hepatocyte +35%, p less than 0.001) than by hyperplasia (number of hepatocytes
      +23%, p less than 0.001). A decrease in sinusoidal membrane surface density (
      43%, p less than 0.005) associated with a decrease in sinusoidal microvillar
      volume density (-50%, p less than 0.005) were both compensated for by the
      increase in liver volume. No canalicular alterations were observed. Thus changes
      in hepatocytes detectable with stereological techniques affect the sinusoidal
      pole where decreased sinusoidal membrane surface is associated with or reflects a
      substantial loss of membrane phospholipids. The increased liver volume may
      constitute an adaptive response compensating for the relative decrease in
      sinusoidal membrane surface and displays characteristics comparable to those of
      preneoplastic hepatocytes.

PMID- 1618472
TI  - Biglycan and decorin gene expression in normal and fibrotic rat liver: cellular
      localization and regulatory factors.
AB  - The expression of genes encoding the core proteins of the novel small
      chondroitin/dermatan sulfate proteoglycans decorin and biglycan was studied in
      the livers of normal rats and in liver tissue during fibrogenesis induced by
      prolonged bile-duct ligation and thioacetamide poisoning. The cell types
      responsible for the expression of these transcripts and some key regulatory
      factors were identified. Both biglycan and decorin messenger RNAs were detected
      in normal liver tissue. Their relative abundance increased strongly during liver
      fibrogenesis, reaching highest levels in cirrhotic tissue 8 wk after common bile
      duct ligation and after 12 wk of peroral thioacetamide administration,
      respectively. Specific proteoglycan transcripts were almost absent in hepatocytes
      from normal and regenerating liver, and only trace amounts were observed in
      freshly isolated and cultured Kupffer cells. Fat-storing cells clearly expressed
      both biglycan and decorin transcripts. The steady-state levels of their messenger
      RNAs increased threefold (biglycan) and fourfold (decorin) during primary
      culture. Myofibroblastlike cells (transformed fat-storing cells after the second
      passage) contained dramatically reduced levels of decorin messenger RNA and also
      lower levels of biglycan messenger RNA compared with primary cultures. These
      changes of core protein messenger RNA expression were not reflected by the
      synthesis rates of medium proteoglycans labeled with 35S as Na2SO4, in particular
      that of medium chondroitin sulfate. Transiently acidified (but not native)
      conditioned media from Kupffer cells and myofibroblastlike cells and transforming
      growth factor-beta 1 enhanced the relative abundances of biglycan and decorin
      messenger RNAs up to five times in primary-cultured fat-storing cells. Biglycan
      and decorin in myofibroblastlike cells did not respond to these stimuli.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1618474
TI  - Urea and protein synthesis in cold-preserved isolated rat hepatocytes.
AB  - We used an isolated-hepatocyte model to study how hypothermic storage (simulating
      liver preservation) affects metabolism after prolonged preservation. Rat
      hepatocytes were stored in the University of Wisconsin solution for up to 72 hr.
      After each day of storage, protein synthesis, urea synthesis, ATP content and
      lactate dehydrogenase release were determined in rewarmed (37 degrees C) and
      oxygenated hepatocytes. Protein synthesis ([3H]-leucine incorporation into
      protein) was depressed by 16% +/- 4%, 54% +/- 6% and 69% +/- 4% after 24 hr, 48
      hr and 72 hr, respectively. Urea synthesis, ATP synthesis and lactate
      dehydrogenase release were similar to those in control hepatocytes (no
      preservation). Fasting of the rats before isolation of hepatocytes caused more
      rapid loss of protein-synthesis capabilities (59% in 24 hr) with no significant
      loss of lactate dehydrogenase, urea synthesis or ATP synthesis. Hepatocyte
      viability (lactate dehydrogenase release) as judged by membrane permeability, ATP
      synthesis and potassium content can be maintained after up to 6 days of cold
      storage. However, protein synthesis is depressed after only 48 hr of cold
      storage. Thus hypothermic storage of the liver causes a change in the metabolic
      capabilities of the hepatocytes, and the timing of the loss of protein synthesis
      is similar to the limits of successful cold storage of the whole liver (48 hr).
      Thus a limit to long-term storage of the liver may be related to loss of protein
      synthesis. In liver transplantation, one indication of poor preservation is a
      decrease in serum albumin and clotting factors with increased tissue edema and
      bleeding diathesis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618475
TI  - Brain water and acute liver failure: the emerging role of intracranial pressure
      monitoring.

PMID- 1618476
TI  - Transforming growth factor-beta: the elusive hepatic chalone?

PMID- 1618477
TI  - Pumping ions: regulation of intracellular pH in hepatocytes.

PMID- 1618478
TI  - Quantitating hepatic encephalopathy in rats after portacaval anastomosis.

PMID- 1618479
TI  - Recurrence of alveolar echinococcosis in the liver graft after liver
      transplantation.

PMID- 1618480
TI  - Fulminant hepatitis related to transmission of hepatitis B variants with precore
      mutations between spouses.
AB  - A precore defective variant of hepatitis B virus has been indicated to cause
      fulminant hepatitis in various instances such as intrahospital outbreaks or
      mother-to-child transmission of hepatitis B virus. To learn whether similar
      variants are involved in interspouse transmission, we analyzed three cases of
      fulminant hepatitis B that developed in formerly healthy subjects whose only
      exposure to hepatitis B virus was contact with their longtime spouses, who were
      carriers of HBV and positive for antibody to HBe. The DNA clones for precore and
      S genes were propagated from patients and spouses and sequenced. Because of the
      conservation of S-gene sequences and the identity of subtypes between patient and
      spouse, it was suggested that patients were infected with hepatitis B virus from
      their spouses, not from other sources. A TGG-to-TAG mutation at the 28th codon of
      the precore gene of hepatitis B virus was commonly observed in all DNA clones
      from patients with fulminant hepatitis and from their spouses. A 29th-codon GGC
      to-GAC mutation was additionally evident in DNAs from one patient-and-spouse
      couple. A significant rise in the circulating hepatitis B virus concentration was
      transiently observed in the index spouse of this case just before development of
      fulminant hepatitis in her husband. The increase in circulating HBV DNA was
      associated with a rise in abundancy of variants with mutations at both the 28th
      and 29th codons, compared with variants with only a 28th-codon mutation. The
      double mutation in hepatitis B virus DNA may either help the virus escape immune
      surveillance or replicate at a higher rate than before.

PMID- 1618481
TI  - Hepatitis B virus DNA in peripheral-blood mononuclear cells in chronic hepatitis
      B after HBsAg clearance.
AB  - In this study, peripheral-blood mononuclear cells from patients with chronic
      hepatitis B and spontaneous or therapy-induced disappearance of HBsAg were
      examined for HBV DNA. Samples were evaluated by in situ hybridization and
      polymerase chain reaction both before and after clearance of HBsAg. By in situ
      hybridization, positive signals were observed in 2 of 13 samples collected after
      HBsAg loss, in 8 of 15 samples before HBsAg loss and in 0 of 4 control patients
      without serological markers of active or prior HBV infection. When polymerase
      chain reaction analyses were performed, HBV DNA was detected in 5 of 12 HBsAg
      negative samples and 10 of 15 HBsAg-positive samples from the study group.
      Testing of mononuclear cells after disappearance of HBsAg revealed that two of
      eight patients were HBV DNA positive by in situ hybridization and by polymerase
      chain reaction, whereas two additional patients were positive by polymerase chain
      reaction alone. Mononuclear cell-associated HBV DNA was detected between 2 and 9
      mo after the disappearance of circulating HBsAg by in situ hybridization and as
      long as 4 yr later by polymerase chain reaction. These data indicate that
      patients who have undergone HBsAg seroconversion may nonetheless harbor HBV DNA
      in their peripheral-blood mononuclear cells for prolonged periods.

PMID- 1618482
TI  - Ischemic-type biliary complications after orthotopic liver transplantation.
AB  - Nonanastomotic biliary strictures that involve only the biliary tree of the graft
      occur after orthotopic liver transplantation in patients with hepatic artery
      thrombosis, chronic ductopenic rejection and ABO blood group incompatibility.
      This complication may also occur in the absence of these known risk factors. The
      major focus of our study was to evaluate the risk factors for nonanastomotic
      biliary stricturing of unknown cause after orthotopic liver transplantation.
      Results demonstrate that the development of biliary strictures is strongly
      associated with the duration of cold ischemic storage of allografts in both Euro
      Collins solution and University of Wisconsin solution. Results also demonstrate
      that strictures are not associated with the type of biliary reconstruction, the
      primary liver disease, cytomegalovirus infection, allograft rejection or the
      presence of a positive lymphocytotoxic crossmatch. More recently, we have
      markedly reduced the occurrence of nonanastomotic biliary stricturing by
      decreasing the ischemia time of our allografts. Thus nonanastomotic biliary
      strictures appear to be the result of the ischemia/reperfusion-induced tissue
      injury associated with the harvest and implantation of allografts.

PMID- 1618483
TI  - Isolation and characterization of the mannose receptor from human liver
      potentially involved in the plasma clearance of tissue-type plasminogen
      activator.
AB  - Various studies have shown that mannose receptors rapidly eliminate glycoproteins
      and microorganisms bearing high mannose-type carbohydrate chains from the blood
      circulation. The purpose of this study was to characterize the mannose receptor
      in the liver, which in vivo is involved in the rapid clearance of tissue-type
      plasminogen activator from the circulation. Human liver membranes were
      solubilized in Triton X-100, and the solution was applied to a tissue-type
      plasminogen activator Sepharose column. Bound proteins were eluted with
      ethylenediaminetetraacetate (10 mmol/L). A second, similar purification step
      rendered a single liver protein of 175,000 daltons. A combination of ligand
      blotting and a chromogenic assay for tissue-type plasminogen activator
      demonstrated that the identified liver protein is a mannose receptor because it
      bound tissue-type plasminogen activator, this tissue-type plasminogen activator
      binding being fully inhibited by 0.2 mol/L D-mannose. Western-blot analysis
      revealed that the isolated liver protein is immunologically identical to the
      human mannose receptor from placenta. Treatment of the liver protein and the
      placenta mannose receptor with trypsin yielded the same pattern of proteolytic
      degradation products as identified on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. We conclude that the physiologically relevant mannose receptor
      for tissue-type plasminogen activator clearance isolated from human liver is
      immunologically and structurally similar to or identical with the human mannose
      receptor isolated from placenta.

PMID- 1618484
TI  - Reversal of fulminant hepatic failure using an extracorporeal liver assist
      device.
AB  - Liver transplantation is currently the only effective therapy for patients with
      fulminant hepatic failure. The availability of an artificial liver could bridge
      these patients through the relatively brief crisis period and allow their own
      livers to regenerate, providing a more favorable outcome and sparing the trauma
      and expense of transplant. We have developed a device consisting of a highly
      differentiated human liver cell line cultured in a hollow fiber cartridge. This
      device is capable of supporting dogs with acetaminophen-induced fulminant hepatic
      failure for a period long enough for their own livers to resume function. Even
      though liver function tests such as albumin and prothrombin time became extremely
      abnormal during the course of the experiment, the dogs did not become
      encephalopathic. Two of the three treated animals recovered sufficient liver
      function after 42 to 48 hr of treatment that they could be disconnected from the
      device, and they survived the experiment. Histological results and serum ALT
      levels suggest that the device affected the course of the disease in two animals,
      allowing recovery of hepatocytes that would otherwise have lysed. In the third
      animal, regenerative nodules demonstrated that, even in the presence of severe
      liver injury, the device was capable of supporting total liver function.

PMID- 1618485
TI  - Interrelationships of bile acid and phospholipid fatty acid species with
      cholesterol saturation of duodenal bile in health and gallstone disease.
AB  - The relative amount of cholesterol and the fatty acid composition of
      phosphatidylcholines in bile can be influenced by the bile acid species secreted.
      To search for a contribution of secondary bile acids and of phosphatidylcholines
      to supersaturation of bile in gallstone disease, we compared the relative amount
      of cholesterol and the biliary composition of bile acids and of phospholipid
      fatty acids in cholecystokinin-stimulated duodenal bile of 22 female gallstone
      patients and 16 healthy controls and analyzed the interrelationships of these
      bile constituents. Gallstone patients had higher molar percentages of cholesterol
      than did controls (10.2 +/- 3.2 vs. 6 +/- 1.5 mol%; p less than 0.001) and
      demonstrated a trend toward larger fractions of deoxycholic and lithocholic
      acids. By linear models, variation of cholesterol saturation could be predicted
      (p less than 0.001) up to 53% by the bile acid pattern and up to 81% by the fatty
      acid pattern of phospholipids. Linear path analysis (goodness-of-fit index =
      0.973) confirmed the tight relationship between phospholipid fatty acids
      (positive: oleic, arachidonic; negative: linoleic, palmitoleic) and the relative
      amount of cholesterol; more than half the influence of cholic, deoxycholic and
      lithocholic acids on the relative amount of cholesterol could be explained
      indirectly by their influence on the phospholipid fatty acid pattern. We conclude
      that the relationships examined by path analysis support the working hypothesis
      that secondary bile acids contribute to supersaturation of bile mainly by
      changing the fatty acid pattern of the secreted phospholipids (presumably the
      pattern of phosphatidylcholines), which increases the molar ratio of
      cholesterol/phospholipids in bile.

PMID- 1618486
TI  - A prospective randomized trial comparing repeated endoscopic sclerotherapy and
      propranolol in decompensated (Child class B and C) cirrhotic patients.
AB  - A prospective randomized study was conducted to compare the efficacy of long-term
      endoscopic sclerotherapy vs. propranolol in Child class B and C patients with
      variceal bleeds within the 30 days before the study. Forty-five and 46 patients
      were randomized to receive sclerotherapy and propranolol, respectively, after
      preentry stratification for Child scores. Sclerotherapy was administered with 1%
      polidocanol at 10-day intervals until obliteration of varices was achieved.
      Propranolol was administered to achieve a reduction in resting pulse rate of 25%.
      Rebleeding occurred in 19 patients undergoing sclerotherapy and in 31 receiving
      propranolol (p less than 0.05). The number of episodes of rebleeding was higher
      (p less than 0.05) in the propranolol group (n = 64) than in the sclerotherapy
      group (n = 35). The mean bleeding risk factor, number of hospitalizations for
      rebleeding and blood transfusion requirement were also significantly higher in
      the propranolol-treated patients. The median bleed-free period was more than 36
      mo in the sclerotherapy group and 2.5 mo in the propranolol group (p less than
      0.01). The median survival time was significantly longer in the sclerotherapy
      group (greater than 36 mo) than in the propranolol group (greater than 24 mo). We
      conclude that in decompensated cirrhotic patients, long-term endoscopic
      sclerotherapy is superior to propranolol in preventing rebleeding and improving
      survival.

PMID- 1618487
TI  - Differences in apolipoprotein (a) polymorphism in west Greenland Eskimos and
      Caucasian Danes.
AB  - Previous studies in Greenland suggest that death rates from ischemic heart
      disease [IHD] are lower in Eskimos than in Danes and other Caucasian populations.
      This has been explained by a high intake of n-3 polyunsaturated fatty acids with
      beneficial effects on blood lipids and hemostasis. In other populations,
      lipoprotein(a) [Lp(a)] is associated with IHD, plasma concentrations of Lp(a)
      being genetically determined to a major extent. We have compared Lp(a)
      concentrations and apo(a) phenotypes in 120 Greenlandic Eskimos with those in 466
      Danish men. The median Lp(a) concentration in Eskimos (8.7 mg/dl;[95% CI 6.5
      10.7]) was not significantly different from that in Danes (6.3 mg/dl; [95% CI 5.2
      7.0]), whereas the 90th percentile was significantly higher among Danes: 46.36
      mg/dl; [95% CI 43.0-54.3] vs. 27.6 mg/dl [95% CI 20.7-36.9]. In 20% of the Danes,
      but in only 8% of the Eskimos (P = 0.009), the concentration of Lp(a) exceeded 30
      mg/dl. The difference is probably explained by a low frequency of the low
      molecular weight apo(a) phenotypes among Eskimos, since the apo(a) isoforms F and
      B were absent, and the S1 and S2 types were present in only 3.3% of Eskimos. In
      contrast, these apo(a) isoforms were present in 26.6% of the Danes in either
      single-band or double-band phenotypes. The pattern of apo(a) polymorphism found
      in this study could provide part of a genetic explanation for the putative low
      rates of IHD in Eskimo populations.

PMID- 1618488
TI  - Simple repeat sequences on the human Y chromosome are equally polymorphic as
      their autosomal counterparts.
AB  - The human genome contains a large number of interspersed simple repeat sequences
      that are variable in length and can therefore serve as highly informative,
      polymorphic markers. Typing procedures include conventional multilocus and single
      locus probing, and polymerase chain reaction aided analysis. We have identified
      simple sequences in a cosmid clone stemming from the human Y chromosome and
      consisting of (gata)n repeats. We have compared these with two equivalent simple
      repeat loci from chromosome 12. After amplifying the tandemly repeated motifs, we
      detected between four and eight different alleles at each of the three loci.
      Codominant inheritance of the alleles was established in family studies and the
      informativity of the simple repeat loci was determined by typing unrelated
      individuals. The polymorphisms are suitable for application in linkage studies,
      practical forensic case work, deficiency cases in paternity determination, and
      for studying ethnological questions. The mutational mechanisms that bring about
      changes in simple repeats located both on the autosomes and on the sex
      chromosomes, are discussed.

PMID- 1618489
TI  - Mutation analysis and prenatal diagnosis in a Lesch-Nyhan family showing non
      random X-inactivation interfering with carrier detection tests.
AB  - A nonsense mutation at the CpG-site in the codon for Arg(169) in the gene for
      hypoxanthine phosphoribosyltransferase (hprt) was identified by genomic
      polymerase chain reaction (PCR) and DNA sequencing in cultured fibroblasts from
      two brothers with Lesch Nyhan's syndrome. The recurrence of mutation at this CpG
      site in several unrelated Lesch-Nyhan families suggests that deamination of 5
      methylcytosine is a possible mechanism for mutagenesis. The level of hprt-mRNA in
      the fibroblasts of the patients was similar to that in healthy controls, whereas
      hprt-enzyme activity was not detectable. The mutation in this family was also
      identified in five female relatives and prenatally in a male fetus. Unexpectedly,
      results from hair follicle analyses and fibroblast selection studies in 8
      azaguanine and 6-thioguanine medium showed a non-carrier phenotype in three of
      the female heterozygotes, whereas X-inactivation mosaicism was demonstrated in
      one heterozygote. A possible explanation for the apparent non-random X
      inactivation in this family is the co-existence of the hprt mutation with an
      undefined X-linked lethal mutation. This observation is of practical relevance
      for carrier detection in other Lesch-Nyhan families.

PMID- 1618491
TI  - The segregation of a translocation t(1;4) in two male carriers heterozygous for
      the translocation.
AB  - We examined the meiotic segregation pattern of a t(1;4)(p36.2;q31.3) reciprocal
      translocation in two male cousins heterozygous for the translocation. The wife of
      subject 1 had four recognized spontaneous abortions and two carrier daughters,
      and the wife of subject 2 had three recognized spontaneous abortions and no live
      born children. The results showed that subject 1 had an imbalance rate of 54% and
      subject 2 had an imbalance rate of 61% with respect to the translocation. This
      was not statistically different (P = 0.3174) and the 95% confidence intervals
      overlapped for each segregation type. The sex ratio of X- and Y-bearing sperm was
      not statistically different than the expected 50%. The rate of structural
      abnormalities was 11.3% in subject 1 and 17.8% in subject 2. Both of these values
      were above the range of control subjects in our lab, but only subject 2's value
      fell outside the 95% confidence interval for the control population.

PMID- 1618490
TI  - Deletions in the dystrophin gene: analysis of Duchenne and Becker muscular
      dystrophy patients in Quebec.
AB  - We have analyzed patient DNA samples in 77 unrelated Duchenne (DMD) and Becker
      (BMD) muscular dystrophy families, 73 of which were of French Canadian origin. We
      show that the frequency (68%) and distribution of deletions within the dystrophin
      gene was neither random nor unique in this population. We localized 33% of the
      deletions to the proximal portion of the dystrophin gene while 63% involved the
      exons spanning introns 43 through 55 with breakpoint clusters occurring within
      introns 44 and 50. Whether the dystrophin open reading frame (ORF) is maintained
      constrains the distribution of DMD/BMD deletions such that BMD deletions tend to
      be strikingly homogeneous. Finally, the conservation of the dystrophin ORF and
      the severity of the clinical phenotype were concordant in 95% of the DMD/BMD
      deletions documented by this work.

PMID- 1618492
TI  - Familial pericentric inversion (3)(p12q24).
AB  - A large kindred with a familial pericentric inversion of chromosome 3, (p12q24),
      was found after an investigation initiated by a young female with three
      spontaneous first-trimester abortions. Altogether 22 (33%) inversion carriers
      were discovered, 9 females and 13 males. 6 women and 9 men were included in the
      fertility and segregation analyses because they were all either sexually mature
      or past maturity. The abortion frequency was below the average European rate in
      both the inversion carrier group and the cytogenetically normal relative group;
      6%:3%, respectively. The mean numbers of pregnancies and live births (1.8-3.1)
      did not vary significantly in the two comparison groups. The segregation analysis
      among the inversion carriers showed a good correspondence to the theoretical 1:1
      ratio (16:13). Males and females contributed equally. No duplication/deletion
      syndromes have been found in the kindred; all family members are phenotypically
      normal. We report a balanced familial pericentric inversion with no adverse
      effects. This chromosome aberration could be an example of a harmless chromosome
      polymorphism.

PMID- 1618493
TI  - Genetic and biochemical heterogeneity in patients with the rhizomelic form of
      chondrodysplasia punctata--a complementation study.
AB  - The genetic relationship between 10 patients with clinical manifestations of
      rhizomelic chondrodysplasia punctata (RCDP) was studied by complementation
      analysis after somatic cell fusion. Biochemically, 9 out of the 10 patients were
      characterized by a partial deficiency of acyl-CoA: dihydroxyacetone phosphate
      acyltransferase (DHAP-AT) and an impairment of plasmalogen biosynthesis,
      phytanate catabolism and the maturation of peroxisomal 3-oxoacyl-CoA thiolase; 3
      oxoacyl-CoA thiolase was strongly reduced in the peroxisomes of these patients.
      Fusion of fibroblasts from these 9 patients with Zellweger fibroblasts resulted
      in complementation as indicated by the restoration of DHAP-AT activity,
      plasmalogen biosynthesis, and punctate fluorescence after staining with a
      monoclonal antibody to peroxisomal thiolase. No complementation was observed
      after fusion of different combinations of the 9 RCDP cell lines, suggesting that
      they belong to a single complementation group. The tenth patient was
      characterized biochemically by a deficiency of DHAP-AT and an impairment of
      plasmalogen biosynthesis. However, maturation and localization of peroxisomal
      thiolase were normal. Fusion of fibroblasts from this patient with fibroblasts
      from the other 9 patients resulted in complementation as indicated by the
      restoration of plasmalogen biosynthesis. We conclude that mutations in at least
      two different genes can lead to the clinical phenotype of RCDP.

PMID- 1618494
TI  - Paracentric inversion 11q in Canadian Hutterites.
AB  - Four Canadian Hutterite families were found to carry the paracentric inversion
      inv(11)(q21q23). We did not document any adverse effects that could be directly
      attributable to this inversion. It is possible that the mutation that caused this
      inversion is the same mutation hypothesized as the cause of the inversion in
      families from the Netherlands.

PMID- 1618495
TI  - Single-strand conformational polymorphisms (SSCP): detection of useful
      polymorphisms at the dystrophin locus.
AB  - We searched for DNA polymorphisms in seven amplified fragments of the dystrophin
      gene. Three fragments exhibited variable mobilities during nondenaturing strand
      separating gel electrophoresis (SSGE). These variants were due to single base
      changes (three transversions and one transition). Three were intronic (upstream
      from exons 17, 15, and 48) and one was in exon 48. The frequencies of these
      sequence variants were determined in a sample of 54 normal X chromosomes of
      Caucasian origin. One of these DNA polymorphisms was observed in every 650 bp
      tested and the average heterozygosity was 0.05% per base pair (0.08% if exons
      were excluded). Such a detection density and the fact that single-strand
      conformational polymorphisms do not depend on the presence of any specific
      sequence makes them especially valuable as genetic markers. In the dystrophin
      locus this approach could allow simultaneous detection of frequent deletions.

PMID- 1618496
TI  - The Kell blood group locus is close to the cystic fibrosis locus on chromosome 7.

PMID- 1618497
TI  - Molecular diagnosis of the transthyretin (TTR) Met111 mutation in familial
      amyloid cardiomyopathy of Danish origin.
AB  - Familial amyloid cardiomyopathy in a Danish kindred is associated with a specific
      mutation (Met for Leu111) in the transthyretin (TTR) gene, causing the loss of a
      recognition site for the restriction enzyme DdeI in the gene. We describe a
      diagnostic test for the molecular detection of this mutation. A sequence of the
      TTR gene containing the mutation was amplified by the polymerase chain reaction
      from isolated genomic DNA of two affected patients and several controls. DdeI
      digestion of the amplified DNA from the patients revealed 3 bands by gel
      electrophoresis, whereas amplified DNA of the controls showed only 2 bands,
      consistent with complete digestion. Thus, the assumed heterozygous TTR Met111
      mutation was confirmed in the affected patients.

PMID- 1618498
TI  - Data on the interaction of ABO blood groups and the haptoglobin system.

PMID- 1618499
TI  - [K.7 K.pote: an original experience in the promotion of condoms among youths].
AB  - The CRIPS is a specialised AIDS prevention center in the Paris metropolitan
      region. The Paris metropolitan region regroups 10 million inhabitants in its
      urban zone. This region is one of the most affected areas in Europe by AIDS and
      HIV infection, and contains more than 50 percent of the AIDS cases in France. As
      of June 30, 1991, the rate of declared AIDS cases in Paris was 8 for every one
      thousand inhabitants. At the beginning of the epidemic, AIDS basically concerned
      homosexuals in the center of Paris. Today, more and more young heterosexual drug
      users are affected. Adolescents from a low socio-economic background are often at
      risk of marginalization from the mainstream of society and thus at risk to become
      part of this new HIV affected population. They are often not reached by mass
      media, general public campaigns. In France, very little information materials are
      directly targetted to this young, socio-economically disadvantaged population.
      The CRIPS set out to devise a new prevention tool which would target young males
      from this population, particularly those in the 15-20 year age group. In
      preparation for the project, six months were spent on field research in the
      neighborhoods where the young people lived, worked and socialized. Interviews
      were held with young people themselves and adults in the area, particularly bar
      men and others working where the youth socialized.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1618500
TI  - A dutch smoking prevention project: an overview.

PMID- 1618502
TI  - The Barcelona Smoke-free Olympics project.

PMID- 1618501
TI  - The Athoor experience. Field perspectives for implementing child survival
      programmes in the 90s.

PMID- 1618504
TI  - Transfer of the Regional Office for Europe to The Netherlands.

PMID- 1618503
TI  - Health education in Kupat Holim.

PMID- 1618505
TI  - Advocacy for health. The policy of health promotion and the role of health
      education in Europe in the 1990s.

PMID- 1618506
TI  - A world united against AIDS.

PMID- 1618508
TI  - World breastfeeding week. August 1-7 1992. World Alliance for Breastfeeding
      Action.

PMID- 1618507
TI  - Update: the baby-friendly hospital initiative.

PMID- 1618509
TI  - Dangerous myths.

PMID- 1618510
TI  - Leading the way to a baby-friendly world.

PMID- 1618511
TI  - Education for a better quality of life.

PMID- 1618512
TI  - Health challenges of the developed world.

PMID- 1618513
TI  - World health in perspective. The developing countries' point of view.

PMID- 1618514
TI  - Communication campaigns to change health-related lifestyles.

PMID- 1618515
TI  - Health and life style transition.

PMID- 1618516
TI  - Health and local development education.

PMID- 1618517
TI  - Health--united efforts.

PMID- 1618518
TI  - Social action for health: emerging perspectives for health education.
AB  - Most of the world's major health problems and premature deaths are preventable.
      Health technology and scientific knowledge exists to combat health problems at an
      affordable cost. And, health education is recognized as a viable public health
      intervention and a vitally important means of addressing health challenges.

PMID- 1618519
TI  - A tale of two programmes--a health education success story from the International
      Federation of Red Cross and Red Crescent Societies.

PMID- 1618520
TI  - Health promotion and public policy.

PMID- 1618521
TI  - A new configuration for the health care system of the USSR.

PMID- 1618522
TI  - Namibia's health policies and strategies.

PMID- 1618523
TI  - School health education: challenge for national and international agencies.
AB  - There are, in today's world, more than a billion young people of school age.
      Hundreds of millions of them are enrolled in the schools. They constitute the
      greatest single readily-reachable population group and present one of our
      greatest opportunities toward achieving a brighter health future. Are we availing
      ourselves of this opportunity? It is sad but true that too often school health
      education is considered as "something extra", a matter of peripheral interest,
      and is given low priority in school curriculum. Yet these young people--in the
      schools and outside them--are the parents, the citizens, the leaders of tomorrow.
      Theirs is the health of the future. We cannot afford to leave the health
      citizenship of the future to a generation only causally educated about life.

PMID- 1618525
TI  - Training of health educators.

PMID- 1618524
TI  - Health education: historic windows of opportunity.

PMID- 1618526
TI  - Breakthrough to nursing's early years.

PMID- 1618527
TI  - Imprint through the years.

PMID- 1618528
TI  - Diary from the eighties.

PMID- 1618529
TI  - Issues in the eighties.

PMID- 1618530
TI  - NSNA and the ANA: cooperation for the future.

PMID- 1618531
TI  - NSNA in the decade of the 90's.

PMID- 1618532
TI  - Tragedy in Mexico.

PMID- 1618533
TI  - A student-designed activity program for the chronically mentally ill.

PMID- 1618534
TI  - Phillip Shipley.

PMID- 1618535
TI  - Men in OB/GYN nursing: a student's enlightenment or nightmare?

PMID- 1618536
TI  - Surveillance of news media: a nursing responsibility.

PMID- 1618537
TI  - Environmental assessment of the workplace.

PMID- 1618538
TI  - NSNA: how it grew. 1952-1977. The first 25 years. 1977.

PMID- 1618539
TI  - Interview with Frances Tompkins, first NSNA Executive Director. Interview by
      Diane Mancino.

PMID- 1618540
TI  - NSNA in the 1960's.

PMID- 1618541
TI  - Challenges of the seventies and early eighties.

PMID- 1618542
TI  - Power by association: NSNA in its teens.

PMID- 1618543
TI  - Issues in the 70's.

PMID- 1618544
TI  - Conduit artery compliance and distensibility are not necessarily reduced in
      hypertension.
AB  - The goal of this study was to investigate whether the elastic behavior of conduit
      arteries of humans or rats is altered as a result of concomitant hypertension.
      Forearm arterial cross-sectional compliance-pressure curves were determined
      noninvasively by means of a high precision ultrasonic echo-tracking device
      coupled to a photoplethysmograph (Finapres system) allowing simultaneous arterial
      diameter and finger blood pressure monitoring. Seventeen newly diagnosed
      hypertensive patients with a humeral blood pressure of 163/103 +/- 4.4/2.2 mm Hg
      (mean +/- SEM) and 17 age- and sex-matched normotensive controls with a humeral
      blood pressure of 121/77 +/- 3.2/1.9 mm Hg were included in the study. Compliance
      pressure curves were also established at the carotid artery of 16-week-old
      anesthetized spontaneously hypertensive rats (n = 14) as well as Wistar-Kyoto
      normotensive animals (n = 15) using the same echo-tracking device. In these
      animals, intra-arterial pressure was monitored in the contralateral carotid
      artery. Mean blood pressures averaged 197 +/- 4 and 140 +/- 3 mm Hg in the
      hypertensive and normotensive rats, respectively. Despite the considerable
      differences in blood pressure, the diameter-pressure and cross-sectional
      compliance-pressure and distensibility-pressure curves were not different when
      hypertensive patients or animals were compared with their respective controls.
      These results suggest that the elastic behavior of a medium size muscular artery
      (radial) in humans and of an elastic artery (carotid) in rats is not necessarily
      altered by an increase in blood pressure.

PMID- 1618545
TI  - Increased systolic pressure in chronic uremia. Role of arterial wave reflections.
AB  - To assess the role of arterial wave reflections in the mechanism of systolic
      hypertension and altered pulsatile arterial dynamics in patients with end-stage
      renal disease (ESRD), 79 ESRD patients were compared with 73 age-matched control
      subjects with normal renal function and similar mean blood pressure. Wave
      reflections were investigated from the carotid pulse contour recorded by
      applanation tonometry using a Millar micromanometer-tipped probe. Wave
      reflections were quantified as the ratio (augmentation index, %) of the height of
      the late systolic peak to the total height of carotid pulse wave. Travel time of
      the reflected wave was timed from the foot of the pressure wave to the foot of
      the late systolic peak. Systolic and pulse pressure were increased in ESRD
      patients (p less than 0.001) and was not attributable to differences in left
      ventricular ejection pattern. The augmentation index was increased in ESRD
      patients (23.2 +/- 15.0 versus 9.8 +/- 15.6%; p less than 0.001) in association
      with a shorter travel time of reflected wave (109 +/- 24 versus 131 +/- 30 msec;
      p less than 0.001). Multiple regression analysis showed two principal factors
      associated (p less than 0.001) with the increase in augmentation index and
      shortened travel time of reflected wave: increased aortic pulse wave velocity and
      smaller stature with shorter body height in ESRD patients. The study points to
      the role of arterial wave reflections in the mechanisms producing alterations in
      pulsatile arterial dynamics in ESRD and is the first, through the mechanisms of
      early wave reflections, to show in humans that the increase in systolic and pulse
      pressures is associated with lesser body size.

PMID- 1618546
TI  - Renal effects of prolonged synthesis inhibition of endothelium-derived nitric
      oxide.
AB  - The aim of the present study was to investigate in conscious dogs the long-term
      effects of nitric oxide synthesis inhibition on glomerular filtration rate,
      sodium and water excretion, and plasma levels of renin and aldosterone. After a
      control period of 3 days, an inhibitor of endothelium-derived nitric oxide
      synthesis, NG-nitro-L-arginine-methyl ester, was infused for 3 consecutive days
      at a dose (50 ng/kg/min) that did not induce significant changes in arterial
      pressure (n = 6). The inhibition of nitric oxide synthesis led to a large and
      sustained decrease (p less than 0.05) in glomerular filtration rate of
      approximately 35%. This change was accompanied by a decrease (p less than 0.05)
      in urinary sodium excretion from 78.9 +/- 4.6 meq/day to 49.8 +/- 6.8, 60.1 +/-
      4.2, and 53.5 +/- 9.0 meq/day by days 1, 2, and 3 of nitric oxide synthesis
      inhibition, respectively. Changes in fractional sodium excretion failed to
      achieve statistical significance. Nitric oxide synthesis inhibition also induced
      a significant and sustained decrease in urine flow rate. The decrease in
      glomerular filtration rate, natriuresis, and diuresis was accompanied by a 45%
      increase in plasma renin activity (p less than 0.05) and no change in plasma
      aldosterone concentration. By day 3 of the recovery period, glomerular filtration
      rate, natriuresis, diuresis, and plasma renin activity returned to values similar
      to those found during the control period. The administration of L-arginine during
      3 consecutive days (5 micrograms/kg.min i.v.) did not modify any of the
      parameters measured but effectively prevented all the renal changes induced by
      the 3 days of nitric oxide synthesis inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618547
TI  - Oxygen free radicals and cardiac reperfusion abnormalities.
AB  - Oxygen free radicals are highly reactive compounds causing peroxidation of lipids
      and proteins and are thought to play an important role in the pathogenesis of
      reperfusion abnormalities including myocardial stunning, irreversible injury, and
      reperfusion arrhythmias. Free radical accumulation has been measured in ischemic
      and reperfused myocardium directly using techniques such as electron paramagnetic
      resonance spectroscopy and tissue chemiluminescence and indirectly using
      biochemical assays of lipid peroxidation products. Potential sources of free
      radicals during ischemia and reperfusion have been identified in myocytes,
      vascular endothelium, and leukocytes. In several different experimental models
      exogenous free radical-generating systems have been shown to produce alterations
      in cardiac function that resemble the various reperfusion abnormalities described
      above. Injury to processes involved in regulation of the intracellular Ca2+
      concentration may be a common mechanism underlying both free radical-induced and
      reperfusion abnormalities. Direct effects of free radicals on each of the known
      Ca(2+)-regulating mechanisms of the cell as well as the contractile proteins and
      various ionic membrane currents have been described. Free radicals also inhibit
      critical enzymes in anaerobic and aerobic metabolic pathways, which may limit the
      metabolic reserve of reperfused myocardium and contribute to intracellular Ca2+
      overload. Inhibiting free radical accumulation during myocardial
      ischemia/reperfusion with free radical scavengers and inhibitors has been
      demonstrated to reduce the severity of myocardial stunning, irreversible injury,
      and reperfusion arrhythmias in many, but not all, studies. This evidence strongly
      implicates free radical accumulation during myocardial ischemia/reperfusion as an
      important pathophysiological mechanism of reperfusion abnormalities, although
      many issues remain unresolved.

PMID- 1618549
TI  - Pseudohypertension and the measurement of blood pressure.
AB  - Riva-Rocci Korotkoff (RRK) blood pressure measurements may overestimate the intra
      arterial pressure (IAP) in individual patients. To study pseudohypertension,
      defined as an overestimation larger than 10 mm Hg, we compared RRK and IAP
      measurements in 76 patients. These patients were considered to be at risk for
      pseudohypertension because of high age, hypertension, or vascular disease. RRK
      measurements underestimated simultaneously measured systolic IAP values by 6.0 +/
      6.5 (mean +/- SD) mm Hg, whereas simultaneous diastolic RRK readings
      overestimated the IAP by 1.9 +/- 5.6 mm Hg. Diastolic overestimation increased
      slightly with age. Vascular rigidity, as measured by counterpressure
      plethysmography, did not correlate with these errors. Systolic and diastolic
      pseudohypertension was observed in two and five patients, respectively.
      Pseudohypertension was only present in the group in which IAP was measured in the
      aorta. However, the number of patients with systolic and diastolic
      pseudohypertension could be increased to three and seven by using the average
      intra-arterial systolic and diastolic pressure during an RRK measurement or to
      six and 11 by using the IAP during a control period just before an RRK
      measurement rather than the IAP at the moment of appearance or disappearance of
      the Korotkoff sounds. The widely diverging prevalence of pseudohypertension
      described in the literature might be explained because of such different
      comparison techniques.

PMID- 1618548
TI  - Hypertension induces alternatively spliced forms of fibronectin in rat aorta.
AB  - Fibronectin expression was shown recently to increase in the rat aorta in
      response to experimental hypertension. Fibronectin is known to alter the
      phenotype of vascular smooth muscle and endothelial cells, and relative changes
      in the expression of different isoforms of fibronectin, generated by alternative
      splicing and distinguished by the absence or presence of inserts designated as
      EIIIA, EIIIB, and V, may reflect a change in cell phenotype. In the present study
      we examined the expression of alternatively spliced forms of aortic fibronectin
      during deoxycorticosterone-salt hypertension. Aortic RNA was analyzed
      quantitatively using Northern blot analysis and ribonuclease protection assays.
      Using Northern blot analysis, deoxycorticosterone-salt treatment for 21 days led
      to a 4.9-fold increase in EIIIA fibronectin messenger RNA, while EIIIB and V
      forms increased by 2.6- and 2.5-fold, respectively. As determined by ribonuclease
      protection assays, the percentage of fibronectin transcripts containing either
      EIIIA, EIIIB, or V in control aorta was 7.3%, 19%, and 40%, respectively. The
      percentage of EIIIA transcripts increased 42% over control levels after 21 days
      of deoxycorticosterone-salt treatment, whereas no proportionate change in the
      other alternatively spliced forms was found. Thus, all forms increased, but a
      selective increase in the EIIIA form was induced. Analogous increases in each of
      the fibronectin isoforms were found in the spontaneously hypertensive rats when
      compared with age-matched Wistar-Kyoto or Wistar rats, and 40-week-old animals
      showed increases over 10-week-old animals in all strains, consistent with an age
      dependent increase in aortic fibronectin expression.

PMID- 1618550
TI  - Hypertension and ST segment depression during ambulatory electrocardiographic
      recording. Results from the prospective population study 'men born in 1914' from
      Malmo, Sweden.
AB  - The aim of this study in 341 men (aged 68 years) without history of ischemic
      heart disease was to study the relation between hypertension and silent ischemic
      type ST segment depression during ambulatory long-term electrocardiographic
      recording and to assess the influence between these two variables on
      cardiovascular morbidity and mortality rates. Seventy-nine men (23%) demonstrated
      one or more episodes of silent ischemic ST segment depression. One hundred and
      sixty-seven men (49%) were considered to have hypertension (i.e., they had a
      diastolic blood pressure of 95 mm Hg or greater or were treated with
      antihypertensive therapy). Forty-nine (72%) of the 68 treated hypertensive
      subjects were classified as uncontrolled (i.e., their diastolic blood pressure
      was 95 mm Hg or greater). The occurrence of ischemic ST depression was higher in
      hypertensive men (28%) than in normotensive men (19%). The highest incidence of
      ischemic ST depression (41%) was observed in treated hypertensive men with
      inadequate blood pressure control. Cardiac event rate during a 53-month follow-up
      was 6.6% in hypertensive men and 4.6% in normotensive men. Uncontrolled treated
      hypertensive men had a higher event rate (14%) than hypertensive men overall.
      Hypertensive men with inadequate blood pressure control and who demonstrated ST
      segment depression had the highest event rate (25%).

PMID- 1618551
TI  - Clustering of cardiovascular risk factors in confirmed prehypertensive
      individuals.
AB  - Numerous studies have indicated that hypertensive subjects have an atherogenic
      lipoprotein pattern, hyperinsulinemia, and impaired glucose tolerance relative to
      normotensive individuals. These abnormalities could be due to adverse effects of
      certain antihypertensive agents, to pathophysiological concomitants of the
      hypertensive state itself, or to both. In this report, we describe the
      cardiovascular risk factor profile of 1,440 subjects who were normotensive and
      were not taking any antihypertensive medications when first examined and who
      subsequently participated in the 8-year follow-up of the San Antonio Heart Study.
      Hypertension developed in 130 subjects during the follow-up period. At baseline
      these prehypertensive individuals had significantly higher levels of blood
      pressure, fasting total and low density lipoprotein cholesterol, triglyceride,
      glucose, and insulin, and 2-hour glucose than those who remained free of
      hypertension. In addition, they had higher body mass indexes, a less favorable
      body fat distribution, and lower levels of high density lipoprotein cholesterol.
      In multiple linear regression analyses, baseline levels of triglyceride and blood
      pressure remained significantly higher and high density lipoprotein cholesterol
      remained significantly lower in the subjects who later converted to hypertension
      than in those who remained normotensive. Although baseline insulin levels were
      also higher in the prehypertensive subjects, this difference was not
      statistically significant. In nonobese subjects, however, those with high
      baseline insulin concentrations had an increased incidence of hypertension
      compared with those with low insulin concentrations. The present results suggest
      that the cluster of atherogenic changes associated with hypertension actually
      precede the development of the hypertensive state.

PMID- 1618552
TI  - Skin arteriolar responses to local temperature changes in hypertensive rats.
AB  - A rat skin preparation was developed to determine if the responses of the
      resistance vessels to local skin warming and cooling were abnormal in
      spontaneously hypertensive rats (SHR). A major advantage of this preparation is
      that all the skin resistance vessels from small arteries preceding the
      microcirculation to small arterioles can be studied by intravital microscopy
      techniques. An abdominal skin flap was reflected with intact vasculature and
      positioned on a temperature-controlled manifold. Diameters of small arteries and
      large through small arterioles were measured at normal skin temperature (35
      degrees C) and after cooling to 25 degrees C and warming to 38 degrees C, there
      were no differences in control diameters for comparable branching orders between
      normotensive (Wistar-Kyoto) and hypertensive rats; however, the maximum diameter
      of small arteries was 13% smaller in hypertensive rats. All arteriolar branching
      orders possessed vascular tone that was not altered by neural blockade with
      tetrodotoxin. With cooling to 25 degrees C, all branching orders constricted
      (range, 12-37%). The largest and smallest vessels of hypertensive rats
      constricted almost twice as much as their normotensive counterparts. With warming
      to 38 degrees C, only the smallest arterioles dilated (19% in normotensive versus
      43% in hypertensive rats). This study demonstrates major differences in the
      arteriolar branching orders that respond to local warming and cooling of
      nonapical skin regions in both normotensive and hypertensive rats and also shows
      that skin arterioles in SHR are more responsive to local temperature changes.

PMID- 1618553
TI  - Vascular responsiveness in rats resistant to aldosterone-salt hypertension.
AB  - Wistar-Furth rats have been shown to be resistant to mineralocorticoid-salt
      hypertension, but the mechanism for this resistance is unknown. In the current
      experiments, adult male Wistar and Wistar-Furth rats were given a subcutaneous
      aldosterone infusion (0.15 microgram/hr) for 4 weeks, and changes in blood
      pressure and vascular reactivity were studied. Rats received a 1% NaCl, 0.2% KCl
      solution to drink. After 4 weeks of aldosterone infusion, systolic blood pressure
      measured using a tail-cuff technique had increased by 60 mm Hg in Wistar rats but
      was unchanged in Wistar-Furth rats. Hypokalemia occurred in both strains in
      response to the aldosterone infusion. Isolated, helically cut strips of common
      carotid artery and aorta were prepared for isometric force recording. Cumulative
      concentration-response curves to norepinephrine, serotonin, KCl, calcium,
      nitroprusside, and acetylcholine were performed in carotid artery strips, and
      concentration-response curves to ouabain were performed in aortic strips.
      Increased vascular contractile sensitivity to KCl, ouabain, norepinephrine, and
      serotonin was observed in vessels from Wistar rats treated with aldosterone and
      salt. The same treatment in Wistar-Furth rats produced only increased vascular
      sensitivity to ouabain and serotonin, and these changes were of smaller magnitude
      than those seen in Wistar rats. Aldosterone-salt treatment produced decreased
      vascular sensitivity to acetylcholine and nitroprusside in both Wistar and Wistar
      Furth rats. These results support the hypothesis that resistance of Wistar-Furth
      rats to aldosterone-salt hypertension is due to resistance to the effects of
      aldosterone-salt treatment that normally result in increased vasoconstrictor
      sensitivity.

PMID- 1618555
TI  - A reduced elastic modulus of vascular wall components in hypertension?

PMID- 1618554
TI  - Aldosterone enhances angiotensin II receptor binding and inositol phosphate
      responses.
AB  - Clinical states in which angiotensin II is increased are often associated with
      increases in mineralocorticoids. To determine the effects of mineralocorticoids
      on angiotensin II action, we examined the effects of aldosterone on angiotensin
      II receptor expression and function in cultured rat vascular smooth muscle cells.
      Incubation with aldosterone resulted in concentration- and time-dependent
      increases in angiotensin II receptor number, without changes in binding affinity.
      For example, incubation with 1 microM aldosterone for 40 hours resulted in 59%
      increases in angiotensin II receptor number. Increases in angiotensin II
      receptors were dependent on protein synthesis as evidenced by the time dependency
      of upregulation and inhibition by cycloheximide. Incubation with aldosterone
      resulted in enhanced angiotensin II-stimulated phospholipase C activation, as
      demonstrated by increases in angiotensin II-induced inositol phosphate responses
      in proportion to the increases in receptor number. In addition, aldosterone
      prevented angiotensin II-induced downregulation of angiotensin II surface
      receptors and angiotensin II desensitization of inositol phosphate formation. In
      summary, aldosterone 1) directly increased angiotensin II receptor number, 2)
      increased angiotensin II-stimulated inositol phosphate responses, and 3)
      prevented angiotensin II-induced downregulation and desensitization. In
      conclusion, aldosterone may potentiate the pressor responses of angiotensin II
      via effects on angiotensin II receptors.

PMID- 1618556
TI  - Role of neutral endopeptidase in the metabolism of endothelin.
AB  - Endothelin is a potent vasoconstrictor produced by endothelial cells. Although
      endothelin has been studied extensively, little is known about its metabolism in
      vivo. Neutral endopeptidase EC.3.4.24.11 is reported to degrade endothelin in
      vitro. Therefore, we studied the effect of neutral endopeptidase inhibition by
      SQ29,072 on plasma levels and urinary excretion of endogenous and exogenous
      endothelin. Injection of 30 or 60 mg/kg SQ29,072 into anesthetized rats increased
      the urinary excretion of endothelin nearly 14-fold. The response was maximal
      during the first 30 minutes of collection and lasted for 90 minutes. The larger
      dose of inhibitor caused a 37-43% increase (p less than or equal to 0.05) in the
      plasma concentration of endothelin. Only 0.20 +/- 0.04% of the total
      radioactivity injected as 125I-endothelin (1 microCi; 1,308 pg) into normal rats
      was recovered in the urine within 30 minutes. Urinary radioactivity increased to
      0.54-0.63% (p less than or equal to 0.05) of the total infused in rats pretreated
      with SQ29,072. Chromatographic analysis of radioactivity in the urine revealed
      that intact endothelin accounted for only 6-9% of the total counts in control
      rats but 50-56% in rats pretreated with the inhibitor. We also studied the
      effects of another inhibitor of neutral endopeptidase, SQ28,063, on the
      distribution of radioactivity in the urine, kidney, and lung of rats injected
      with 125I-endothelin. SQ28,063 increased urinary excretion of labeled endothelin
      and increased total radioactivity accumulated in the lung and kidney from 157 and
      105 pg to 234 and 157 pg, respectively. Intact endothelin accounted for 90% or
      more of the accumulated counts in both tissues. These results indicate that 1)
      little circulating endothelin is cleared into the urine, 2) endothelin in the
      urine is likely of renal origin, and 3) neutral endopeptidase EC.3.4.24.11 plays
      a major role in the inactivation of endothelin.

PMID- 1618557
TI  - Sympathetic nervous system in high sodium one-kidney, figure-8 renal
      hypertension.
AB  - The contribution of the sympathetic nervous system and vasopressin to the
      maintenance of arterial pressure was investigated in high sodium-fed rats 4 weeks
      after the induction of one-kidney, figure-8 renal wrap hypertension. Arterial
      pressure was significantly greater in renal-wrapped rats than in sham-operated
      animals. The contribution of the sympathetic nervous system was assessed
      functionally by measuring the arterial pressure response to ganglionic blockade
      and estimating the apparent rate of release of norepinephrine. The contribution
      of vasopressin was assessed by administration of the vascular antagonist
      d(CH2)5Tyr(Me)-AVP. Whole-animal vascular responsiveness and cardiac baroreceptor
      reflex sensitivity were determined by graded intravenous bolus injections of
      angiotensin II, vasopressin, and phenylephrine. Hypertensive rats demonstrated an
      exaggerated reduction in arterial pressure to autonomic blockade before and after
      blockade of vascular vasopressin receptors. There was a significant 27% increase
      in the apparent rate of release of norepinephrine into the plasma. Administration
      of d(CH2)5Tyr(Me)-AVP did not affect arterial pressure when given alone. However,
      after ganglionic blockade, inhibition of the vasopressin system elicited similar
      falls in blood pressure in both normotensive and hypertensive rats. Arterial
      pressure dose-response effects of phenylephrine, angiotensin II, and vasopressin
      were similar between renal-wrapped and sham-operated animals; however, cardiac
      baroreceptor reflex sensitivity was suppressed in the hypertensive rats. These
      studies indicate that the maintenance of arterial pressure in chronic, high
      sodium renal-wrap hypertension is associated with an augmented sympathetic
      nervous system function.

PMID- 1618558
TI  - Femoral shaft fractures treated with plate fixation and interlocked nailing: a
      comparative retrospective study.
AB  - In a retrospective study, the results of 39 patients with fresh unilateral
      femoral shaft fractures were studied: 19 had been treated with an AO interlocking
      nail and 20 with an AO plate. The preoperative characteristics of both groups
      were similar. The interlocking nail procedure took significantly longer (P =
      0.002, Wilcoxon's test) and was associated with technical faults in seven
      patients. Full weight-bearing was allowed significantly earlier (P = 0.001,
      Wilcoxon's) in the interlocking nail group. Delayed union was observed in three
      patients in the plate osteosynthesis group but was not encountered in the
      interlocking nail group. Cancellous autogenous bone grafting was performed seven
      times during or after plating, but was not necessary in the interlocking nail
      group. Two cases of osteitis arose after plating and none after interlocked
      nailing. At follow-up, one patient in each group was suffering from serious
      complaints. CONCLUSION: The interlocking nail procedure took longer than plating,
      but allowed earlier full weight-bearing. The final results were similar in both
      groups of patients.

PMID- 1618559
TI  - Treatment of fracture of the shaft of the femur in total hip arthroplasty by a
      combination of a Kuntscher nail and a modified cemented Charnley stem.
AB  - Eight cases of fracture of the femoral shaft in total hip arthroplasty were
      treated by a combination of a Kuntscher nail and a modified Charnley stem with
      cement. Radiological union was achieved in all patients at an average of 8
      months.

PMID- 1618560
TI  - Herbert screw: results of a single-centre trial.
AB  - We report the results of a single-centre trial of the Herbert screw in the
      treatment of acute fractures, fracture-dislocations and non-unions of the carpal
      scaphoid. In the trial, 22 patients were studied with a maximum follow-up of 2.5
      years. Of the patients, 84 per cent had minimal or no pain, and 94 per cent were
      happy with their result or significantly improved. There was an average loss of
      34 per cent of radial deviation of the wrist and of 10 per cent in cylinder grip
      strength. On radiographic examination, 86 per cent achieved satisfactory union.
      However, only 73 per cent of type D2 fractures united. Overall, the subjective
      and objective clinical results achieved were more satisfactory than the
      radiographic results would suggest.

PMID- 1618561
TI  - Subtrochanteric fracture: fixation using the AO tibial nail.
AB  - We describe an alternative fixation for the pure uncomminuted subtrochanteric
      fracture by using the AO tibial nail. There were no intraoperative complications
      in 24 fractures with this method. The fractures healed within 4 months
      postoperatively in 18 non-pathological fractures that could be followed up. There
      were minor complications, including 10 degrees external malrotation in one case
      and varus angulation after nail breakage in another. The nails were removed in
      seven healed fractures without problems. Two pathological fractures which were
      stabilized by the AO tibial nail, combined with the use of bone cement to fill
      the bone defect, were able to have early postoperative ambulation without any
      problems with the fixing device.

PMID- 1618562
TI  - Humeral shaft fractures treated by interlocking nailing: a preliminary report on
      16 patients.
AB  - A series of 16 selected patients with humeral shaft fractures were operated on
      using the Seidel interlocking nail. At the follow-up 5.5 months later, solid
      union was obtained in 13 of the 14 survivors. In these 13 patients the result was
      classified as excellent or good, even though impingement was seen in four
      patients; no other complications were encountered.

PMID- 1618563
TI  - Plating of fresh clavicular fractures: results of 122 operations.
AB  - A total of 131 fractures of the clavicle were operated on in 129 patients. There
      was no bony infection or infected pseudarthrosis. Four clavicles refractured
      after removal of the plate and five operations led to pseudarthroses which were
      successfully treated by reoperation. Radiological and clinical results in the
      majority of the re-examined patients were excellent. Indications, operative
      technique and causes of poor results are described.

PMID- 1618564
TI  - Preoperative traction in patients with hip fractures.
AB  - A series of 80 patients with cervical, trochanteric or subtrochanteric hip
      fractures were randomized to either treatment without traction, skin traction, or
      skeletal traction during the 1883 h between admission and operation. The
      institution of skin or skeletal traction was not particularly painful for the
      patient, but we found no indication that either was of discernible benefit. The
      number of analgesic medications needed was no higher in patients without
      traction. We conclude that traction should not be administered routinely to
      patients awaiting operation for hip fracture.

PMID- 1618565
TI  - Fracture bracing the humerus.
AB  - The use of humeral fracture braces has become our preferred method of treatment
      for fractures of the shaft of the humerus. These braces are easy to apply and
      adjust; the patient's acceptance of this method of treatment is high. We compared
      this method of treatment with the traditional method of plaster U-slab
      immobilization. A group of patients treated with a plaster U-slab were matched
      for type and level of fracture with a group treated with a humeral fracture brace
      and compared with regard to fracture healing and functional outcome. There was no
      difference between groups for healing time and final alignment of the fracture.
      However, there was a greater range of elbow motion at the time of union in the
      fracture brace group (11 degrees-126 degrees) compared with the U-slab group (50
      degrees-119 degrees P less than 0.05). These results confirmed that humeral
      fracture bracing permits greater functional use of the limb without affecting
      fracture healing and alignment.

PMID- 1618566
TI  - Helicopter doctors?
AB  - All roadside procedures carried out by doctors of the Royal London Hospital
      Helicopter Emergency Medical Service were recorded. Of 100 injured patients
      treated consecutively, 68 patients required 73 treatments or procedures that were
      beyond the current training of the ambulance paramedic in the United Kingdom.
      Doctors are therefore an essential part of HEMS operations and allow earlier live
      saving medical intervention in the prehospital phase of care.

PMID- 1618567
TI  - The Johannesburg Hospital mobile anaesthesia service.
AB  - At a teaching hospital such as the Johannesburg Hospital with an air ambulance
      service, the need may arise for the administration of an anaesthetic outside the
      hospital. The occurrence of just such an event prompted the authors to review the
      literature regarding anaesthesia in adverse circumstances and to assemble, in a
      portable container, the equipment and drugs considered necessary to cope with the
      situation. In addition, the responsible anaesthetic personnel are receiving
      training in the use of the equipment and techniques required.

PMID- 1618568
TI  - Return to work of road accident victims claiming compensation for personal
      injury.
AB  - Road accidents resulting in personal injury are an increasing cost to society.
      This study is based on 609 accident victims (of whom 521 survived injury) who
      were in employment when injured and whose claims for personal injury were settled
      for 5000 pounds or more by one insurance company over 2 years. It examines
      survivors' residual disablement, return to work and involvement with
      rehabilitation services. Data on a representative sample of 101 cases are
      analysed in more detail to identify possible 'predictors' of return to work. Both
      univariate and stepwise logistic regression analysis suggest that return to work
      is less associated with clinical variables, on which much medical advice on
      return to work is based, than with such other variables as time off work, absence
      of psychological problems and younger age. Very low rates of referral to
      rehabilitation may indicate that a rehabilitative approach to cost containment is
      underutilized in comparison with the traditional emphasis on preventive measures
      and enhanced medical treatment. More effective rehabilitation, however, may
      require new approaches to clinical case management, especially in orthopaedic
      departments where most personal injury claimants are treated.

PMID- 1618569
TI  - Arthroscopic management of tibial plateau fractures.
AB  - Ten tibial plateau fractures treated arthroscopically are reported. In eight
      cases, closed internal fixation was performed under arthroscopic control while in
      another two patients, arthroscopic washout alone was undertaken. Only one case
      required external splintage (a cast brace), the remainder being mobilized non
      weight-bearing without plaster immediately after the operation. The results were
      good. We suggest that the arthroscope is a useful tool in the treatment of these
      fractures and provides information not otherwise available. There is a low
      morbidity, inpatient stay is short and early joint movement can be encouraged.

PMID- 1618570
TI  - Plastic bullets: significant risk of serious injury above the diaphragm.
AB  - A series of 123 patients who attended a district general hospital in Belfast over
      a 14-year period from 1975, sustained 126 plastic bullet injuries, resulting in
      one death and several serious injuries. This report shows the significant
      association of serious injury and/or death from plastic bullets in which the
      impact is above diaphragmatic level.

PMID- 1618571
TI  - Diagnostic peritoneal lavage: it's red but is it positive?
AB  - The aim of this study was to ascertain whether qualitative assessment could
      accurately determine a concentration of 100,000 RBC/mm3 in simulated peritoneal
      lavage fluid. The results show that the qualitative methods used are inaccurate
      and do not reliably predict a red cell concentration of 100,000 per mm3. We
      therefore recommend that the red cell concentration of peritoneal lavage fluid is
      always measured before the result is considered 'positive'.

PMID- 1618572
TI  - Effect of an algorithm on the treatment of knee injuries.
AB  - An audit was performed of the treatment of patients presenting with acute knee
      injuries to the accident and emergency department of a district general hospital.
      This showed that for patients requiring follow-up the majority were reviewed by
      the casualty officers themselves in the accident department, with the result that
      definitive diagnosis and treatment for patients with continuing symptoms was
      often delayed. Once the current treatment had been discussed at an audit meeting,
      a protocol (in the form of an algorithm) of the treatment of knee injuries was
      produced. A further audit was performed after the protocol had been in use. This
      demonstrated that the protocol was effective in encouraging the casualty officers
      to seek the help of more senior members of staff and also reduced the time taken
      to definitive diagnosis and treatment.

PMID- 1618573
TI  - Stage diving injuries.

PMID- 1618574
TI  - Gluteal compartment syndrome following drug overdose.

PMID- 1618575
TI  - Shoulder stabilization following traumatic scapulectomy.

PMID- 1618576
TI  - Traumatic dislocation of the lumbar spine at two levels.

PMID- 1618577
TI  - Post-traumatic unilateral lumbosacral ligamentous instability.

PMID- 1618578
TI  - Rammed by a ramp causing low-velocity sternal fractures.

PMID- 1618579
TI  - Bird strike at 140 mph!

PMID- 1618580
TI  - Scaphoid fractures and wrist pain.

PMID- 1618581
TI  - Prognostic factors in soft tissue injuries of the cervical spine.

PMID- 1618583
TI  - Social status of DUI offenders in jail.
AB  - It has been argued that DUI (driving under the influence) is an offense of the
      economically privileged, which suggests that DUI offenders may be different from
      other offenders. Studies of DUI arrestees and jail inmates, however, suggest they
      have more extensive criminal histories than other licensed drivers and similar
      criminal histories to other jail inmates. This study utilizes data from a
      representative national survey of over 5,000 jail inmates to compare jailed DUI
      offenders with other offenders on social characteristics, prior criminality, drug
      use, and alcohol use. The purpose of these comparisons is to determine whether
      DUI inmates represent a distinct "class" of offender for whom jail is a new
      experience. The implications of this distinction for policies which mandate jail
      time for DUI offenders are discussed.

PMID- 1618582
TI  - The drinking-smoking syndrome and social context.
AB  - Drinking and smoking concurrence is examined in a national sample of 6,072
      respondents. Results indicate that the two addictive behaviors are
      synergistically associated in the general population: persons who both drink and
      smoke tend to drink to a greater extent than nonsmokers; drinkers smoke more than
      nondrinkers and smokers drink more than nonsmokers. As predicted, a multivariate
      analysis of drinking and smoking covariance was significantly correlated with
      social group affiliation, both across the life span and proportionately among men
      and women. The social context of interpersonal relationships may therefore be a
      critical factor in the process of pharmacological conditioning and environmental
      reinforcement of the drinking and smoking habits. This report confirms the strong
      drinking and smoking covariation found among social drinkers and heavy alcohol
      consumers in clinical and experimental studies, suggesting that drinking and
      smoking may also be interrelated in the rehabilitative process. Finally, it is
      suggested that the present investigation extends the research literature on the
      drinking and smoking syndrome in several important respects. Various implications
      of the study are discussed.

PMID- 1618584
TI  - Trends in illicit drug use in the United States: conflicting results from
      national surveys.
AB  - Data from several national studies lead to divergent conclusions regarding trends
      in illicit drug use in the United States. Two major population studies point to a
      downturn in drug use dating to the late 1970s. However, a study of drug-related
      deaths and hospital emergency room visits shows increases in these events in
      recent years. Studies also show drug use, especially cocaine, continuing to
      increase among criminals. Additionally, drugs were identified as the most
      important problem facing the nation in a Gallup poll conducted during the summer
      of 1989. This paper offers some possible explanations for the divergent trends.
      Most notably, we suggest that methodological differences in the studies being
      compared, and lags between trends in the general population and certain
      subgroups, account for most of the variation in the trend estimates. The paper
      concludes that illicit drug use is decreasing in the United States.

PMID- 1618585
TI  - Elderly alcohol misuse.
AB  - Over 800 patient records were analyzed to identify factors related to problem
      drinking for older adults. Most importantly, the study found that some symptoms,
      such as those related to emotional distress, and employment status did have an
      association with problem drinking for older adults. However, these findings
      suggest that alcohol use throughout life may simply be carried into old age.
      Finally, the research noted a distinct pattern of drinking for older females in
      contrast to that of older males. The reasons for these gender differences, as
      well as a closer examination on the role of retirement and later onset of
      drinking for older adults, are identified as topics for future research.

PMID- 1618586
TI  - Self-efficacy-based smoking situation factors: the effects of contemplating
      quitting versus relapsing in a Turkish sample.
AB  - The patterning of smoking situations on the basis of self-efficacy expectations
      among 174 Turkish smokers was examined by factor analysis which yielded five
      smoking situations. The examination of the effects of relapse versus
      contemplation to quit showed that contemplators had higher efficacy expectations
      as compared to noncontemplators, whereas relapse had no significant effect on
      efficacy beliefs. Least self-efficacy was observed for situations involving
      affective elements and highest efficacy for habitual situations. Results were
      discussed in terms of the heterogeneity of smokers and treatment implications.

PMID- 1618587
TI  - Conditioned immunopharmacologic effects on cell-mediated immunity.
AB  - One of the several lines of evidence documenting a relationship between the brain
      and the immune system is the research on behaviorally induced alterations in
      immune reactivity. The present review concentrates on the use of
      immunopharmacologic agents, stress, and antigenic stimuli as unconditioned
      stimuli (UCSs) in the classically conditioned suppression and enhancement of cell
      mediated immune reactions including host-vs-graft and graft-vs-host reactions and
      delayed type hypersensitivity.

PMID- 1618588
TI  - Thymic endocrinology.
AB  - Thymus endocrinology is characterized by the action of various hormones on the
      thymus endocrine milieu consisting of thymocytes, thymic epithelial cells and
      thymic stromal cells. Extrathymic hormonal influences include pituitary-derived
      hormones, such as prolactin and indirectly by ACTH via hydrocortisone from the
      adrenal, by thyroid-stimulating hormone (TSH) via thyroid hormones from the
      thyroid, and by LH and RH via sex steroids from gonads and adrenal. In addition,
      the thymus produces several putative thymic hormones: thymosin alpha 1, thymulin
      and thymopoietin, which have been reported to circulate and to act on both
      prothymocytes and mature T-cells in the periphery thus maintaining their
      commitment to the T-cell system and its functions. These endocrine influences
      decline with age and are associated with "thymic menopause" and cellular immune
      senescence contributing to the development of diseases in the aged. The
      intrathymic environment is characterized by a complex network of paracrine and
      autocrine endocrine signals involving both interleukins and thymic peptides.
      Thymic epithelial cells respond to IL-1 with proliferation and secretion of IL6
      and GM-CSF. They similarly respond to cellular interactions with the production
      of IL1. Thymic epithelial cells also secrete thymic hormones, as exemplified by
      the zinc-thymulin complex, under stimulation with IL1 and other hormonal
      influences. Thymic stromal cells contribute, at minimum, IL1. These various
      interleukin and thymic hormone influences can be envisioned to operate in a
      synergistic interactive network to carry the evolving T-cell through its stepwise
      development to a mature T-cell.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618589
TI  - Thymic regulation of the hypothalamic-pituitary-gonadal axis.
AB  - The thymus gland and the cells that it regulates produce a number of soluble
      factors that are capable of indirectly modulating the immune system via
      reproductive neuroendocrine circuits. Studies dating to the turn of the century
      were designed to evaluate the effects of partially purified thymic extracts in
      treating various reproductive disorders as well as changes in gonadal tissue
      weights. More recent studies have focused on the chemical nature of the factors
      responsible for regulating reproductive function. A number of factors have been
      described. These include thymosin beta 4 which has been found to stimulate the
      release of luteinizing hormone releasing hormone and luteinizing hormone (LH).
      Other factors such as interleukin-1 (IL-1) have been found to inhibit the release
      of these two peptides. IL-1 has also been found to alter the expression of LH
      receptors in rat granulosa cells. Certain interferons have been found capable of
      suppressing estrogen and progesterone release. While many of the studies have
      been carried out using adult animal models, there is increasing evidence that
      exposure to cytokines during early development can have long lasting if not
      permanent effects upon the reproductive axis. These and related topics are the
      subject of this review.

PMID- 1618590
TI  - Nutrition and cellular immunity.
AB  - We have investigated the influence of nutrition on immune function in animals and
      man over the past two decades. The profound impairment of immune function that
      had not been observed in children in developing countries could not consistently
      be reproduced in the laboratory setting; paradoxically, moderate nutritional
      restriction could even enhance T-cell-based cell-mediated immune responses in
      experimental animals. Studies of the crucial role of the element zinc in
      maintenance of vigorous cellular immunity provided at least a partial explanation
      of this paradox. Zinc, shown to be absolutely crucial for development and
      expression of both T- and B-cell functions, was commonly deficient as were other
      micronutrients under many conditions of protein-calorie malnutrition. Indeed,
      administration of adequate zinc alone could correct some of the T-cell-mediated
      immune functions in children with protein-calorie malnutrition. In later
      investigations we found that as long as all essential nutrients were supplied in
      adequate amounts, 40% chronic energy (calorie) restriction will regularly extend
      lifespan and maintain vigorous immunologic function while preventing numerous
      cancers and immunologically based diseases of aging, such as profound and
      destructive autoimmune diseases in genetically short-lived mice strains, as it
      was known to do for moderately long-lived rats and long-lived strains of mice.
      Such undernutrition without malnutrition appears to influence a wide range of
      critical metabolic and physiologic processes in both short-lived and long-lived
      animals. One of the most challenging of these influences was a down-regulation of
      cellular proliferation and cell turnover in each of the rapidly replicating
      tissues studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618591
TI  - Chemicals trophic for the thymus: risk for immunodeficiency and autoimmunity.
AB  - The thymus is considered as the privileged site of T-lymphocyte generation. The
      organ is extremely vulnerable to the toxic action of chemicals. The classical
      example is the "acute stress-induced involution" mediated by glucocorticoid
      steroid hormones from the adrenal cortex. Nowadays a number of substances have
      been identified that act in a differential way on the thymus. Examples presented
      are some organotin compounds acting on immature lymphoblasts in the outer cortex,
      glucocorticosteroids acting on small thymocytes in the cortex, 2,3,7,8
      tetrachlorodibenzo-p-dioxin acting on epithelial cells in the cortex, and
      cyclosporin acting on dendritic cells and epithelium in the medulla. The
      mechanisms of toxicity include receptor binding (Ah, aryl hydrocarbon receptor;
      dioxin); the Ca(2+)-dependent activation of an endogenous endonuclease resulting
      in DNA fragmentation ("programmed cell death" or apoptosis; dioxin and
      glucocorticosteroids); and interference with cell proliferation (some organotin
      compounds). The consequences of toxicity can be a decrease in thymic output of
      newly-generated T-lymphocytes (i.e. generation of a new T-cell repertoire), or
      induction of autoimmune symptoms by the creation of unwanted repertoire. This
      latter phenomenon may be applicable to cyclosporin that under specified
      conditions can induce so-called syngeneic graft-vs-host disease. This survey
      presents a brief description of the function of the thymus and the various thymic
      cell populations involved. Thereafter the susceptibility to toxic insults and the
      mechanisms of toxicity are reviewed. Finally, the consequences of toxic action
      for the host defence system, and hence the health status, are considered.

PMID- 1618592
TI  - Synergy in the toxicity of cytokines: preclinical studies.
AB  - Synergistic therapeutic activity has been observed both preclinically and
      clinically with combinations of chemotherapeutic and immunotherapeutic agents as
      well as with several combinations of immunotherapeutic agents. Frequently the
      synergistic therapeutic activity has been accompanied by unexpected toxicities
      demonstrating the need for the development of systematic studies to determine the
      nature and origin of the toxicity observed when these potent immunoregulatory
      agents are combined. Several examples have been demonstrated including IFN-gamma
      and TNF and AZT and IFN-alpha. In this paper approaches to study the pathobiology
      of combination cytokine therapy and strategies to limit the toxicity, to
      understand its mechanism, and to retain the synergistic therapeutic activity are
      discussed.

PMID- 1618593
TI  - Pre-clinical toxicity of IL-4: a model for studying protein therapeutics.
AB  - The purpose of this presentation was to review issues and findings in the pre
      clinical development and evaluation of recombinant human protein therapeutics.
      Since human cytokines and lymphokines are endogenous proteins, their pre-clinical
      development and evaluation would seem straightforward and their toxicities
      minimal. Unfortunately, the pre-clinical development of this class of agents has
      been problematic and confounding. Some of the clinical toxicities and
      pharmacodynamics have been predicted by the pre-clinical evaluation and others
      have not. Some molecules are species specific which limits species selection for
      pre-clinical evaluation. Other confounding issues include: route of exposure,
      synergy of toxicity with other lymphokines, length of study design,
      immunogenicity, predictiveness of pre-clinical evaluation and iatrogenic
      toxicities. An approach used by SWPRD in the evaluation of this class of
      molecules was discussed. Insight gained during the pre-clinical and clinical
      development of these molecules should simplify the further development of protein
      therapeutics that follow. Specific studies with recombinant human interleukin-4
      (rhuIL-4) were reviewed in detail as part of a pre-clinical safety evaluation.
      Native IL-4 has properties that exemplify many of the immune recognition-induced
      lymphokines and is produced principally by activated T-lymphocytes CD4+. It is a
      co-factor in B-cell proliferation and enhances ex vivo B-cell expansion and is
      believed to be a candidate for the treatment of refractory cancer based on this
      immune enhancement ability. rhuIL-4 is a 15,400 molecular weight cytokine
      produced in a yeast expression system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618594
TI  - Review: transcriptional and post-transcriptional regulation of interleukin 1 gene
      expression.
AB  - Interleukin 1 alpha (IL-1 alpha) and beta (IL-1 beta) are proinflammatory
      cytokines that are encoded by distinct genes, but share most biological
      activities. During the past several years, intense investigation has focused on
      elucidating the molecular basis for the regulation of IL-1 alpha and beta gene
      expression. While the overall organization of both genes is conserved in mammals,
      the DNA sequence homology is surprisingly limited. This supports the growing body
      of evidence suggesting that each gene is regulated by distinct cis- and
      transacting elements. Most recently, novel regulatory DNA sequence elements and
      several nuclear regulatory proteins have been identified, which ultimately
      participate in the control of IL-1 beta gene transcription. In addition to
      transcriptional controls, the stability of IL-1 mRNA can be selectively regulated
      by various inducing stimuli and other cytokines. Taken together, these
      transcriptional and post-transcriptional regulatory mechanisms provide stringent,
      yet flexible, control over expression of the IL-1 alpha and beta genes.

PMID- 1618595
TI  - Interleukin 3: from colony-stimulating factor to pluripotent immunoregulatory
      cytokine.
AB  - IL-3 is best known as a multicolony-stimulating factor, produced by T-cells, mast
      cells and eosinophils. Based on its broad spectrum of hemopoietic growth factor
      activity, the role of IL-3 in the homeostasis of leukocytes is apparent, although
      the precise mechanisms of this process are yet to be determined. The fact that
      activated T-helper cells are one of the most potent sources of IL-3 suggests an
      additional role for IL-3 in the regulation of the immune response. Although the
      presence of IL-3 receptors on monocytes has been demonstrated, the role of IL-3
      in regulating macrophage functions was not clear until recently. We have
      demonstrated a unique spectrum of macrophage activating properties of IL-3,
      distinct from that of IFN gamma, IL-4 and other CSFs. These novel macrophage
      activating properties of IL-3 include its capacity to directly induce the
      expression of Ia antigens and members of the beta 2 integrin family (e.g.
      CD11a/CD18[LFA-1]), as well as to contribute to the regulation of cytokine
      production (IL-1, IL-6 and TNF alpha). Moreover, we observed a significant
      synergy between IL-3 and IFN gamma in the induction of Ia and LFA-1, as well as
      between IL-3 and LPS in the induction of Ia and macrophage cytokines. Our data
      suggest that IL-3 may help control the antigen presentation (AP) capacity of
      macrophage via the regulation of Ia, beta 2 integrins and macrophage cytokines.
      It is also possible that the differential state of activation of macrophages that
      we demonstrated following their induction with IL-3, IFN gamma or IL-3+IFN gamma
      results in the development of functionally distinct AP cells. Further
      immunoregulatory properties of IL-3 were observed in vivo by Kimoto and
      colleagues when IL-3 administration led to profound enhancement of the T-cell
      dependent immune response, with no changes in the antibody response to T-cell
      independent antigens. Thus, in vitro and in vivo data both confer an
      immunoregulatory role for IL-3 in the development of the immune response, most
      likely via its effects on the antigen presenting cells (macrophages). This review
      will summarize evidence documenting a range of immunoregulatory properties of IL
      3 and discuss the mechanisms of action of IL-3.

PMID- 1618597
TI  - Transgenic mouse as a tool for the study of autoimmune disease: insulin-dependent
      diabetes mellitus.
AB  - Transgenic mice have been used for analyses of cis-acting elements which are
      involved in the tissue-specific and developmental-specific expression, for
      analyses of physiological function of genes, or for the production of a human
      disease model. This approach is especially successful in the fields of immunology
      and oncology. Several years ago it was shown that the major histocompatibility
      complex (MHC) class II gene is identical to the immune response gene by
      demonstrating that the immune response can be restored by the new expression of
      class II molecules on immunocompetent cells. Recent evidence suggests that the
      class II molecule is involved in the generation of autoimmune disease, such as
      insulin-dependent diabetes mellitus (IDDM). The NOD (non-obese diabetic) mouse is
      shown to be a mouse model for human IDDM. Concerning the class II genes, the NOD
      mouse has two characteristic features, the lack of I-E and the presence of unique
      I-A. It is discussed how the role of class II molecules in the development of
      IDDM in the NOD mouse can be analyzed. In addition, the transgenic technique can
      be applied to the study of differentiation and oncogenesis of lymphoid cells.
      Factors or molecules that affect these processes will also be discussed.

PMID- 1618596
TI  - IL-6 receptor and mechanism of signal transduction.
AB  - Interleukin-6 (IL-6) is a multifunctional cytokine which acts on a wide variety
      of cells, exerting growth promotion, growth inhibition, or specific gene
      expression including cellular differentiation. The IL-6 receptor system consists
      of two membrane proteins, a ligand-binding chain (IL-6R) and a non-ligand-binding
      signal transducer, gp130, both of which belong to the cytokine receptor family.
      Binding of IL-6 to IL-6R triggers the association of IL-6R and gp130, and gp130
      in turn transduces the signal. Despite its lack of IL-6 binding property, gp130
      is involved in the formation of high-affinity IL-6 binding sites. This two-chain
      IL-6 receptor system can be applied to some other cytokine receptors, such as IL
      3R, IL-5R and GM-CSFR which share a second signal-transducing component. A
      nuclear factor for controlling IL-6 gene expression (NF-IL6) is a leucine zipper
      containing transcription factor and is homologous to C/EBP, a liver nuclear
      factor. NF-IL6 is also involved in the transcriptional regulation of various
      acute phase protein genes IL-6-triggered association of IL-6R and gp130 on
      hepatocytes, through intermediate steps including serine-phosphorylation of pre
      existing NF-IL6 protein, leads to binding of NF-IL6 to IL-6-responsive elements
      and activation of acute-phase protein genes.

PMID- 1618598
TI  - The macroscopic and microscopic pharmacology of monoclonal antibodies.
AB  - When monoclonal antibodies directed against tumor-associated antigens are
      injected intravenously, they sometimes fail to distribute uniformly in the
      substance of a tumor. To understand the possible reasons, it is necessary to
      consider both macroscopic and microscopic features of the pharmacology. We have
      analyzed antibody penetration into microscopic primary tumors and metastases by
      melding together information on the global pharmacokinetics, convective and
      diffusive transport across the blood capillary wall, diffusion through the tumor
      interstitial space, antigen - antibody interaction, metabolism, and lymphatic
      outflow. This analysis predicts that the very fact of successful binding will
      decrease the homogeneity of distribution. We believe that this "binding site
      barrier" constitutes major challenges to the molecular design of next-generation
      antibodies and also to the design of many other types of ligands for use in
      treatment of solid tumors.

PMID- 1618599
TI  - Levamisole, the story and the lessons.
AB  - The history of the use of levamisole in man is summarized, from its start as an
      anthelmintic in the early sixties, through its world-wide recognition as an
      immunotropic agent especially in the seventies and early eighties, and its return
      to clinical prominence in 1989-90 as an effective adjuvant treatment for operable
      colon cancer. The knowledge accumulated from experimental tumour models and from
      clinical use in various types of cancer, supplemented with the recent evidence
      obtained from large-scale controlled trials in resectable colon cancer is
      reviewed. It is speculated that we may not have seen the end of levamisole story
      yet; also, the role of serendipidity in drug research is emphasized.

PMID- 1618600
TI  - Review: inducer of cytokines in vivo: overview of field and romurtide experience.
AB  - We have reported that the bacterial cell-wall skeletons, such as mycobacteria,
      nocardia, corynebacteria, propionibacteria and listeria, had potent adjuvant
      activity on immune responses. It was reported that N-acetylmuramyl-L-alanyl-D
      isoglutamine (MDP) was the minimum structural requirement of adjuvant activity of
      the bacterial cell-wall skeleton and a variety of MDP derivatives and related
      compounds were synthesized. Among the synthetic MDP derivatives, we have selected
      MDP-Lys(L18)(romurtide) as the immunostimulant, by using experimental models for
      non-specific host resistance against Escherichia coli in mice. Romurtide was
      shown to have host-stimulating activity against bacterial, fungal and viral
      infections, cytokine producing activity and the capacity to increase the number
      of leukocytes and platelets in experimental models. It was also shown that the
      clinical effectiveness of romurtide on the restoration of the number of
      leukocytes and platelets of cancer patients treated with chemotherapy or
      radiation therapy. The mechanism of action of romurtide is discussed.

PMID- 1618601
TI  - Strategies for the development of new antiarthritic agents.
AB  - Therapeutic advances in rheumatoid arthritis (RA) have largely focused on the
      development of non-steroidal antiinflammatory drugs (NSAIDs) with improved
      characteristics compared with aspirin [Brooks & Day, New Engl. J. Med., 324, 1716
      1725 (1991)]. For example, greater potency, safety, improved tolerance in the
      elderly and reduced frequency of dosing have been achieved. However, these agents
      are generally considered to be palliative treating of the symptoms of the
      disease. The development of disease modifying drugs (DMD), also known as second
      line drugs, for RA has not been very successful. Most of the agents that are
      currently used in this category were originally used to treat other diseases such
      as malignancy (cyclophosphamide, methotrexate), Wilson's disease (d
      penicillamine) and tuberculosis (gold salts) [Pullar, Br. J. clin. Pharmac., 30,
      501-510 (1990)]. Unfortunately, none of the agents is ideal and each has
      potentially serious side-effects. There have been several attempts to develop
      agents with new mechanisms of action that hopefully will greatly improve these
      current therapies.

PMID- 1618602
TI  - The discovery and development of zileuton: an orally active 5-lipoxygenase
      inhibitor.
AB  - The enzyme 5-lipoxygenase is a key target in the effort to discover drugs which
      inhibit the pathophysiology associated with the formation of leukotrienes. The
      research efforts of these laboratories have focused on the discovery of direct
      enzyme inhibitors of 5-lipoxygenase. In particular, compounds with hydroxamate or
      N-hydroxyurea functionalities have proven to be potent inhibitors of leukotriene
      biosynthesis in vitro and more importantly in vivo. One of these compounds,
      zileuton (N-(1-benzo-[b]-thien-2-ylethyl)-N-hydroxyurea) has been shown recently
      to be an effective leukotriene inhibitor in man. The critical approaches and
      breakthroughs in the discovery and development of zileuton are described. In
      addition, some recent results with zileuton in animals and man are detailed.

PMID- 1618603
TI  - Vaccines for control of fertility and hormone dependent cancers.
AB  - Two vaccines, namely one inducing antibodies against hCG and the other against
      GnRH, are now in clinical trials. The hCG vaccine has entered Phase II clinical
      trials in three centres in India after successfully completing Phase I clinical
      studies in several centres in India and in four countries abroad. The vaccine was
      found to be devoid of side-effects; its effect was reversible. The available data
      on 179 cycles indicate that the vaccine prevents pregnancy at antibody titres
      above 50 ng/ml. A genetically engineered version of the vaccine has also been
      approved for trials in human lung cancer patients of the type which make hCG. hCG
      is observed to be a growth factor for such tumours. The GnRH vaccine is usable in
      both males and females as the deca-peptide is common to both sexes. Following
      suitable experimental and toxicology studies, the vaccine is currently in Phase
      I/Phase II clinical trials in patients of prostate carcinoma. Where antibody GnRH
      antibodies were induced, the LH, FSH and testosterone levels declined. This was
      accompanied by a reduction in prostate specific antigen. Clinical improvement was
      observed in many cases. The vaccine has also entered Phase I clinical studies in
      postpartum women, with the objective to extend the lactational amenorrhoea and
      extend inter-child interval.

PMID- 1618604
TI  - European Society for Microcirculation, 17th European Conference. July 5-10, 1992,
      London, UK. Abstracts.

PMID- 1618605
TI  - Intracellular actions of vitamin A.
AB  - Because the effects of vitamin A vary with tissue type and often with the form of
      vitamin A itself, a complete understanding of the mechanism(s) of action still
      has not been attained. The action of vitamin A may be at the level of genomic
      expression, at the membrane level, or both. Intercellular and intracellular
      transport of vitamin A are facilitated by specific binding proteins but probably
      not in the cellular uptake of vitamin A. Subcellularly, vitamin A may exert a
      direct effect on transit through the Golgi apparatus, as observed from both
      biochemical and morphological studies. In my laboratory, recent work using cell
      free systems has shown that retinol stimulates transition vesicle formation from
      endoplasmic reticulum in a GTP-requiring step.

PMID- 1618606
TI  - Cerebellar lectins.

PMID- 1618607
TI  - The role of jasmonic acid and related compounds in the regulation of plant
      development.

PMID- 1618608
TI  - Subcellular and molecular mechanisms of bile secretion.
AB  - One of the liver's principal functions is the formation of bile, which is
      requisite for digestion of fat and elimination of detoxified drugs and
      metabolites. Bile is a complex fluid made up of water, electrolytes, bile acids,
      pigments, proteins, lipids, and a multitude of chemical breakdown products. In
      this review, we have summarized the source of various biliary components, the
      route by which they end up in bile, including the underlying subcellular and
      molecular mechanisms, and their contribution to bile formation. One of the
      reasons why bile formation is so complex is that there are many mechanisms with
      overlapping substrate specificities, i.e., many biochemically unrelated biliary
      constituents share common transport mechanisms. Additionally, biliary
      constituents may reach bile by more than one pathway. Some biliary components are
      critical for bile formation; others are of minor significance for bile formation
      but play a major physiological role. The major driving force for bile formation
      is the uptake and transcellular transport of bile salts by hepatocytes. The
      energy for bile formation comes from the sodium gradient created by the
      basolateral Na+/K(+)-ATPase, to which bile salt transport is coupled. The
      secretory pathway for bile salts involves uptake at the basolateral surface of
      the hepatocyte, vectorial transcellular movement, and transport across the
      canalicular membrane into the canalicular lumen. Hydrophilic bile salts are taken
      up via a sodium-dependent, saturable, carrier-mediated process coupled to the
      Na+/K(+)-ATPase. This uptake mechanism is also shared by other substrates, such
      as electroneutral lipids, cyclic oligopeptides, and a wide variety of drugs.
      Hydrophobic bile acids are taken up by a sodium-independent facilitated carrier
      mediated mechanism in common with other organic ions, including sulfated bile
      acids, sulfobromophthalein, bilirubin, glutathione, and glucuronides, or by
      nonsaturable passive diffusion. Two major carrier proteins have been identified
      on the hepatocyte basolateral membrane: a 48-kDa protein that appears to be
      involved with Na(+)-dependent bile salt uptake, and a 54-kDa protein, thought to
      be associated with Na(+)-independent bile salt uptake. The intracellular
      transport of bile salts may involve cytosolic carrier proteins, of which several
      have been identified. Some evidence suggests a vesicular transport mechanism for
      bile salts. Since bile acids clearly do not enter the cell by endocytosis,
      formation of transport vesicles must be a more distal event in the transcellular
      translocation process. Some bile salts appear to be transported within the same
      unilamellar vesicles that are involved in the secretion of cholesterol and
      phospholipid.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1618609
TI  - Cell biology of the subcommissural organ.

PMID- 1618610
TI  - [Hemodilution therapy in peripheral arterial occlusive disease].

PMID- 1618611
TI  - A different perspective on changing times.

PMID- 1618612
TI  - PET scanning has promising future at UI Hospitals and Clinics.

PMID- 1618613
TI  - National health care planning: the shape of things to come.

PMID- 1618614
TI  - Voiding dysfunction and incontinence.

PMID- 1618615
TI  - Sexually active teens.

PMID- 1618616
TI  - Research increasingly aimed at prevention.

PMID- 1618617
TI  - Medical ethics and health care reform.

PMID- 1618618
TI  - Internal medicine manpower in Iowa.

PMID- 1618619
TI  - Internal medicine: concern over supply continues.

PMID- 1618620
TI  - Peripheral vascular disease.

PMID- 1618621
TI  - Bacterial meningitis: an 11-year review.

PMID- 1618622
TI  - More ethical CME.

PMID- 1618623
TI  - Respiratory distress.

PMID- 1618624
TI  - Speaks out for BME.

PMID- 1618625
TI  - A systems model of clinical preventive care: an analysis of factors influencing
      patient and physician.
AB  - An ideal model for clinical preventive care must consider the physician, the
      patient and the many factors which influence each of them. In this paper, we
      review existing models, examining their strengths and weaknesses. We then propose
      a new model, the Systems Model of Clinical Preventive Care. This model is unique
      in its focus on the patient-physician interaction and details the factors
      impinging on each that promote or inhibit the completion of preventive care
      activities. These factors include patient and physician predisposing factors,
      such as health beliefs and attitudes; enabling factors, such as skills and
      resources; and reinforcing factors, such as social support. Additional factors
      include health care system organizational factors, such as access or
      availability; characteristics of the preventive activity, such as cost; and cues
      to action, such as symptoms or reminders. The proposed model contains components
      of behavioral, communication, health education and psychosocial theories. We then
      apply our model to mammography as an example of a screening activity. Finally, we
      describe the strengths and weaknesses of the proposed model, and identify areas
      for future research.

PMID- 1618626
TI  - Evaluation of the Health Belief Model and decision making regarding amniocentesis
      in women of advanced maternal age.
AB  - The Health Belief Model (HBM) was developed as an attempt to explain an
      individual's decision regarding obtaining preventive health care. This model was
      applied to predict the decisions of women of advanced maternal age regarding
      their obtaining amniocentesis in a one-year study conducted in Toledo, Ohio. A
      questionnaire based on the HBM was administered to a sample of 98 pregnant women
      of advanced maternal age. A total of 96 questionnaires were eligible for
      inclusion in the study. Sixty-one women reported that they would have
      amniocentesis, 22 would not, and 13 were unsure. A multivariate analysis of
      variance among amniocentesis decision groups was performed using the health
      belief components (perceived susceptibility, perceived seriousness, perceived
      benefit, perceived barrier) and knowledge as variables. There was a significant
      difference (Wilks' criterion, p less than .0001) among the three decision groups,
      but the differences were in the health belief components and not in knowledge. A
      stepwise discriminant function analysis was used to classify subjects on the
      amniocentesis decision. Of the variables examined, only the HBM component
      perceived benefit factor was a significant discriminant (p = .0001). It is not
      necessarily the lack of knowledge that prevents women who are at risk because of
      advanced maternal age from having amniocentesis but their perceptions regarding
      amniocentesis. Genetic counselors need to focus more on exploring the perceptions
      of amniocentesis benefits in this population to facilitate the decision making
      process.

PMID- 1618627
TI  - Self-efficacy for AIDS preventive behaviors among tenth grade students.
AB  - To guide acquired immunodeficiency syndrome (AIDS) prevention program planning,
      181 tenth grade students residing in or near an AIDS epicenter completed a survey
      measuring past year involvement in sexual intercourse and condom use, beliefs
      about self-efficacy for AIDS preventive behaviors, and beliefs about
      susceptibility to and severity of AIDS, and outcome efficacy of AIDS preventive
      actions. A degree of uncertainty existed for all areas of self-efficacy surveyed:
      refusing sexual intercourse under a variety of circumstances, questioning sex
      partners about past risky behaviors, and correct and consistent condom use.
      Students were most uncertain of their ability to refuse sex with a desirable
      partner, under pressure, or after drinking alcohol or using marijuana; to
      purchase condoms, or use them consistently after drinking alcohol or using
      marijuana; and to question partners about past homosexual history. Those students
      with lower self-efficacy for refusing sex were twice as likely to have had sexual
      intercourse. Similarly, those students with lower self-efficacy for correct,
      consistent condom use were five times less likely to have used condoms
      consistently. These associations remained even after adjusting for the influence
      of other AIDS-related beliefs. Implications of these findings focus on exploiting
      the link between self-efficacy and behavior by building a prevention program that
      emphasizes skills-building rather than the traditional knowledge-only approach.

PMID- 1618628
TI  - Health education and injury control: integrating approaches.
AB  - The prevention of injuries, a major public health problem, is of interest to a
      growing number of public health professionals from a variety of disciplines.
      Historically, there has been tension between those who propose injury prevention
      strategies that focus on the adoption of protective behaviors by individuals and
      those who propose strategies that circumvent the role of individual behavior by
      providing automatic or passive protection. This tension may be counterproductive
      to finding comprehensive solutions to injury problems, and a better understanding
      of the inherent strengths and limitations of each of these approaches is needed.
      The purposes of this paper are to: (1) describe the arguments over individual
      liberties and individual behavior that can occur in the design of injury
      prevention programs; (2) review the principles that typically guide the
      development of injury control programs and health education programs; and (3)
      integrate the two most widely used approaches in injury control and health
      education programs--Haddon's injury countermeasures and Green's PRECEDE framework
      -into one program planning framework that addresses both behavioral and
      nonbehavioral components of an injury problem. This unified framework is offered
      in the hope that its use will facilitate multidisciplinary, comprehensive
      approaches to developing injury prevention programs that are efficient and
      effective.

PMID- 1618629
TI  - The role of community organizations in AIDS prevention in two Latino communities
      in New York City.
AB  - Black and Latino community organizations can play a major role in acquired
      immunodeficiency syndrome (AIDS) prevention. Their ongoing relationships with
      their constituents, knowledge of relevant cultural values and channels of
      communication, and commitment to safeguard the well-being of their neighborhoods
      are an important resource for AIDS prevention campaigns. In order to better
      understand the process by which community groups have taken on the issue of AIDS,
      investigators conducted in-depth interviews with a convenience sample of 47
      neighborhood organizations in two primarily Latino communities in New York City.
      Researchers also attended community meetings, interviewed AIDS educators, and
      conducted focus groups with respondents. More than half the groups had already
      sponsored some AIDS prevention activities prior to the first interview. More
      active groups were more likely to have multiple missions, previous experience
      with the target population, and prior experience working with people with AIDS.
      Respondents reported a variety of obstacles to more active involvement in AIDS
      prevention at the community, organizational, and individual levels. To strengthen
      the role of community organizations in AIDS prevention, more resources should be
      provided to grass roots groups, AIDS should be linked to other urgent social
      problems facing black and Latino communities, and funders and AIDS organizations
      should respond more flexibly to the needs of neighborhood organizations.

PMID- 1618630
TI  - Process evaluation of a home-based program to reduce diet-related cancer risk:
      the "WIN at Home Series".
AB  - A random mailed survey (response N = 226; 75.3%) of participants in diet-related
      home-based learning evaluated exposure to recruitment channels and impact on
      salience, utility, level of participation, sharing the course with others,
      knowledge, and performing recommended behaviors. A post-only design, the study
      was conducted in a small Minnesota city (population = 20,000), part of the Cancer
      and Diet Intervention (CANDI) project. About 18.5% of residents (3,711) enrolled
      during an 8-week media campaign; women, college graduates, and those over 44
      years old were overrepresented. Participants learned about the program through
      mass media (97%); small media (41.9%); and interpersonal sources (50%). Women
      were more likely to learn about the course through interpersonal sources. In
      analysis of variance (ANOVA) modeling, salience and utility predicted level of
      participation in course activities. Level of participation in turn predicted
      nutrition knowledge and with salience predicted performance of recommended
      behaviors. Although the course appealed to individuals who needed it less, there
      was evidence of diffusion to the unenrolled. About 57% of responding participants
      reported sharing it with spouses; about 67% reported sharing it with someone
      outside their households.

PMID- 1618631
TI  - A Health Belief Model-Social Learning Theory approach to adolescents' fertility
      control: findings from a controlled field trial.
AB  - We evaluated an 8- to 12-hour Health Belief Model-Social Learning Theory (HBM
      SLT)-based sex education program against several community- and school-based
      interventions in a controlled field experiment. Data on sexual and contraceptive
      behavior were collected from 1,444 adolescents unselected for gender,
      race/ethnicity, or virginity status in a pretest-posttest design. Over 60%
      completed the one-year follow-up. Multivariate analyses were conducted separately
      for each preintervention virginity status by gender grouping. The results
      revealed differential program impacts. First, for preintervention virgins, there
      were no gender or intervention differences in abstinence maintenance over the
      follow-up year. Second, female preintervention Comparison program virgins used
      effective contraceptive methods more consistently than those who attended the HBM
      SLT program (p less than 0.01); among males, the intervention programs were
      equally effective. Third, both interventions significantly increased
      contraceptive efficiency for teenagers who were sexually active before attending
      the programs. For males, the HBM-SLT program led to significantly greater follow
      up contraceptive efficiency than the Comparison program with preintervention
      contraceptive efficiency controlled (p less than 0.05); for females, the programs
      produced equivalent improvement. Implications for program planning and evaluation
      are discussed.

PMID- 1618632
TI  - Attitudes, norms, and self-efficacy: a model of adolescents' HIV-related sexual
      risk behavior.
AB  - Using data from a cross-sectional, statewide survey of 1,720 Texas ninth graders
      in 13 school districts, a model of psychosocial predictors of human
      immunodeficiency virus (HIV)-related sexual risk behavior was tested. Predictor
      variables in the model, based on variables from the Theory of Reasoned Action and
      Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral
      intentions. Attitudes, norms, and self-efficacy predicted 36.4% of the variance
      in the intention to limit the number of sexual partners and the same variables
      plus intention predicted 24.6% of the variance in number of sexual partners in
      the past year. Attitudes, norms, and self-efficacy regarding condom use predicted
      17.0% of the variance in condom use intentions; these variables plus intentions
      predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and
      intentions were directly related to the number of sexual partners, while self
      efficacy ad condom use intentions were directly related to frequency of condom
      use.

PMID- 1618633
TI  - Histochemical demonstration of glutamate dehydrogenase and phosphate-activated
      glutaminase activities in semithin sections of the rat retina.
AB  - The activities of the glutamate metabolizing enzymes phosphate-activated
      glutaminase (PAG) and glutamate dehydrogenase (Gldh) are demonstrated in semithin
      sections of the rat retina. Highest activities of both enzymes are found in the
      photoreceptor inner segments, PAG additionally in the outer plexiform layer and
      Gldh in the inner plexiform layer and in mueller glial cells. Although their non
      randomly distribution makes a role in neurotransmitter metabolism possible, their
      high activities in inner segments point towards the general problem of the
      functional interpretation of both molecules.

PMID- 1618634
TI  - Immunocytochemical localization of cathepsin D in the rat osteoclast.
AB  - We performed immunocytochemical localization of cathepsin D in osteoclasts of the
      proximal growth plate of the rat femurs using both the avidin-biotin-peroxidase
      complex method for cryo-semi-thin (1 micron) sections and the colloidal gold
      labeled IgG method for K4M ultra-thin sections. At the light microscopic level,
      cathepsin D immunoreactivity in the osteoclasts appeared at the vesicles,
      granules, and/or small vacuoles. They were distributed throughout the cytoplasm
      of each cell and were relatively numerous close to the bone surface. This antigen
      could not be detected at the eroded bone surface. As for other cells,
      immunoreactivity was seen only in the lysosomes of osteoblast-like cells.
      Immunoreactivity in the osteoclasts was stronger and greater in the density and
      number than in osteoblast-like cells. At the electron microscopic level,
      osteoclasts with well-developed ruffled border possessed numerous cathepsin D
      containing lysosomes, vacuoles, and coated vesicle-like structures. Cathepsin D
      containing lysosomes fused with cathepsin-negative vacuoles and formed large
      secondary lysosomes. Osteoclasts with poorly developed ruffled border possessed
      fewer cathepsin D-containing lysosomes than those with well-developed ruffled
      border. No immunogold particles were seen in vacuole-like channel expansions of
      the ruffled borders, between the channels of the ruffled borders, or on the
      eroded bone surface. These findings demonstrate that osteoclasts contain a large
      amount of cathepsin D. They suggest that cathepsin D is necessary for
      osteoclastic bone resorption, that it plays an indirect rather than direct role.

PMID- 1618635
TI  - Colocalization of protein kinase C beta-subtype and calcitonin gene-related
      peptide in rat spinal cord.
AB  - Colocalization of calcitonin gene-related peptide (CGRP) and protein kinase C
      beta-subtype (PKC-beta) like immunoreactivities (LI) and the subcellular
      localization of CGRP-LI were studied in the ventral horn of rat spinal cord.
      Ultrastructurally CGRP-LI was localized on the membranes of the Golgi-complexes,
      in multivesicular bodies and in vesicles adjacent to the Golgi-complex in
      motoneuron perikarya. The colocalization of PKC-beta and CGRP-LI was detected in
      most of the ventral horn motoneurons. However, few motoneurons were only PKC-beta
      immunoreactive. These results suggest that PKC-beta may be involved in the
      regulation of CGRP release from motoric axon terminals.

PMID- 1618636
TI  - Immunocytochemical localization of phospholipase A2 in hamster spermatozoa.
AB  - Antibodies raised against porcine pancreatic phospholipase A2 (PLA2) react in
      immunoblottings with both the antigen as well as with one protein band of about
      14 kDa from hamster spermatozoa extracts. Immunoblottings of proteins extracted
      from spermatozoon head and tail fractions also show similar results. Anti-PLA2
      purified IgGs were employed for light and electron microscopic
      immunocytochemistry in order to detect PLA2 in hamster cauda epididymal
      spermatozoa. When whole mount spread spermatozoa were used under light (employing
      the PAP complex) or electron microscopy (using anti-rabbit gold conjugated), the
      acrosomal area of the gametes shows a noticeable labelling; a characteristic
      which is not observed in samples treated with the pre-immune serum.
      Immunocytochemistry undertaken in ultrathin sections from spermatozoon samples
      embedded in Lowicryl, demonstrates that the antigen appears preferentially
      distributed in the acrosome. Besides, sperm tails showed a scattered distribution
      of gold granules in the mitochondria of the midpiece. Results suggest that the
      antibody used recognizes a PLA2 which is preferentially located in the acrosome
      and mitochondria. On the other hand, the presence of a surface PLA2 in the plasma
      membrane covering the acrosome is suggested. This surface PLA2 would be probably
      related to the acrosome reaction phenomenon that occurs in the spermatozoon
      before penetrating the oocyte.

PMID- 1618637
TI  - Islet amyloid polypeptide (IAPP) is synthesized in the islets of Langerhans.
      Detection of IAPP polypeptide and IAPP mRNA by combined in situ hybridization and
      immunohistochemistry in rat pancreas.
AB  - We investigated the localization of IAPP mRNA by means of in situ hybridization
      in tissue sections of rat pancreas. A 35S-labeled, IAPP-specific DNA probe-
      hybridized specifically in the islets of Langerhans. This localization was
      confirmed by immunohistochemical localization of insulin and IAPP polypeptides on
      adjacent tissue sections. Moreover, combined in situ hybridization of IAPP mRNA
      and immunohistochemistry of insulin and IAPP polypeptide on the same section,
      using insulin as specific marker shows the presence of IAPP mRNA in the islets of
      Langerhans.

PMID- 1618638
TI  - Distribution of estrogen and progesteron receptors in the uterus: an
      immunohistochemical study in the immature and adult pseudopregnant rabbit.
AB  - In order to clarify the distribution and content of estrogen (ER) and progesteron
      receptors (PR) under changing hormonal influences within the various cell
      populations of the uterus (glandular and luminal endometrial epithelium, stroma,
      myometrium), immunohistochemical determinations using specific monoclonal
      antibodies were made. To correlate the immunohistochemical findings with
      peripheral hormone levels and specific tasks of the endometrium, 17 beta
      estradiol and progesterone serum levels were measured and cell proliferation
      determined by use of BrdU-labelling-immunohistochemistry. At the subcellular
      level ER and PR were located exclusively in the cell nuclei of female rabbits,
      which were either immature and lacking any peripheral hormone levels or were
      pseudopregnant (d0-d8 p.hCG). In the immature rabbits a general faint ER and PR
      immunostaining was found. In addition to a general increase in ER and PR in all
      cell populations estrous rabbits (d0 p.hCG) showed a significant rise of ER in
      the epithelial cells and of PR in the myometrium. Within the epithelial cells and
      the myometrium the ER dropped heavily within a few days of pseudopregnancy. The
      PR, however, increased sharply during the first two days of pseudopregnancy and
      decreased gradually following d4 p.hCG. A close relationship was observed between
      the high PR content and the proliferation rate of the epithelial cells on d2
      p.hCG. In spite of the more rapid decrease of ER compared with PR, the glandular
      epithelium retained positive immunostaining. In the stroma the ER and especially
      PR content did not change significantly during the course of pseudopregnancy
      suggesting that some of the well-known differentiation events in the luminal
      epithelium may be mediated by the stroma.

PMID- 1618639
TI  - The influence of buffers during fixation on the appearance of smooth endoplasmic
      reticulum and glycogen in hepatocytes of normal and glycogen-depleted rats.
AB  - Liver tissue of normal and glycogen depleted rats was prepared for transmission
      electron microscopy by perfusion fixation and subsequent osmication in the
      presence of various buffers, dehydration in aethanol and embedding in epon. The
      use of Na/K-phosphate or Na-cacodylate to buffer glutaraldehyde led to similar
      appearance and distribution of SER. When Na-cacodylate was used during
      osmication, more SER membranes were retained but less accumulations of glycogen
      were found than after osmication in the presence of Na/K-phosphate. Fixation with
      s-collidine buffered osmium led to an easily recognisable network of SER
      comprising wide tubules whereas glycogen was hindered to be stained. Veronal
      acetate or Na-cacodylate supplemented with sucrose resulted in marked dilation
      and disintegration of SER. A similar effect was obtained when Na/K-phosphate or
      Na-cacodylate was used in hyposmolar concentration as buffer for glutaraldehyde.
      Liver of fasted rats or glucagon-treated rats after perfusion with Na/K-phosphate
      buffered glutaraldehyde and osmication in the presence of Na/K-phosphate or Na
      cacodylate comprised glycogen-depleted hepatocytes which contained abundant SER
      membranes occupying the entire space between other organelles even in samples
      harvested 3 h after glucagon administration. The diversity in appearance and
      distribution of SER and glycogen granules, which depends to a large extend on the
      buffer used, suggests that SER membranes may not be sufficiently stabilized
      during aldehyde fixation and osmication. We thus consider it likely that large
      accumulations of glycogen granules are the consequence of disintegration of SER
      membranes during processing rather than they represent the morphologic substrate
      of physiological degradation of SER membranes in the course of glycogen synthesis
      and deposition.

PMID- 1618640
TI  - Postnatal development and distribution of peptide-containing nerves in the
      genital system of the male rat. An immunohistochemical study.
AB  - The distribution and relative density of peptide-containing nerves was studied in
      the rat in order to assess the progression of neuronal changes during the
      postnatal development of the male genital system from the prepubertal age to
      adulthood. Testis, caput and cauda epididymis, ductus deferens, seminal vesicles,
      prostate and penis from 8-, 20-, 38-, and 70-day-old rats were sectioned and were
      immunostained with antisera to the neuropeptides calcitonin gene-related peptide
      (CGRP), vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY), and to a
      general neuronal marker, protein gene product 9.5 (PGP 9.5). The testicular
      parenchyma and caput epididymis did not show any immunoreactivity. Very scattered
      CGRP-containing nerves were present in 8-day-old rats; numerous VIP-, CGRP-, and
      NPY-peptide-containing nerves were observed in the cauda epididymis, ductus
      deferens, accessory glands and penis of 20-day-old rats. The number of nerves
      increased in 35-day-old rats while no changes were observed in more adult rats. A
      parallel increase was seen for the immunostain for PGP 9.5. These data suggest
      that peptide-containing nerves appear in the genital system after birth and reach
      a full development before the completion of puberty. Peptide-containing nerves
      were visible first in the interstitial area and then spread in the muscular coat
      of the ducts, glands and of the blood vessels. While CGRP- and NPY-containing
      nerves were distributed in the vicinity of the muscle cells, VIP-containing
      nerves were also observed in the subepithelial regions, suggesting a possible
      role of this neuropeptide in the control of epithelial functions.

PMID- 1618641
TI  - Fluorescent staining of the actin cytoskeleton in human lymphocytes, monocytes
      and polymorphonuclear cells using a DNAse 1/anti-DNAse 1 immunoglobulin
      fluorescein conjugated system.
AB  - The actin associated with membrane-enriched extracts of leukocytes can be
      quantitated by DNAse 1 inhibition. Using this assay, we previously demonstrated
      that the actin level in monocytes was significantly higher than that in
      polymorphonuclear, T and B cells respectively. However, the extracellular
      location of the actin fraction detected by DNAse 1 inhibition (monomeric "G")
      remained unclear. This study using the DNAse 1/anti DNAse 1 immunoglobulin
      fluorescein conjugated system demonstrated that G-actin is present primarily in
      the cortical cell cytoplasm of leukocytes, in confirmation of our previous
      biochemical findings. Since the solubilized G-actin activities of membrane-rich
      lymphoid cell fractions, measured by DNAse 1 inhibition, are a reflection of the
      migratory potential, this immunofluorescent system may permit identification of
      the leukocytic cell subpopulations that have a potential for active circulation.

PMID- 1618642
TI  - A critical evaluation of neoglycoprotein binding sites in vivo and in sections of
      mouse tissues.
AB  - Endogenous lectins are reported to play a vital role in cell to cell
      communication. Their distribution in tissues has been widely studied by the use
      of labelled neoglycoproteins. In the present study, labelled neoglycoproteins
      were used on fixed and unfixed tissue sections and the results were compared with
      those observed after i.v. application of neoglycoproteins in mice. The study
      indicates that neoglycoprotein binding to tissue sections is not inhibited by
      application of the simple monosaccharides that were used to synthesize them.
      Furthermore the binding of neoglycoproteins following i.v. application into mice
      is rather limited. It is concluded that neoglycoproteins, which are synthesized
      using simple monosaccharides, do not provide a sensible tool to detect endogenous
      lectins in animal tissue sections. This is in sharp contrast to the results of
      most other studies reported in the literature.

PMID- 1618643
TI  - Immunohistochemical demonstration of glycoconjugates bearing the type 2 chain
      backbone structure in human fetal, normal and neoplastic gastrointestinal tract.
AB  - Immunohistochemical distributions of carbohydrate antigens based on the type 2
      chain in normal as well as fetal and neoplastic tissues of human gastrointestinal
      tract were investigated with a monoclonal antibody (MAb) H11 (specific for type 2
      chain) alone and in combination with the two MAbs MSG15 (for alpha 2----6
      sialylated type 2 chain) and IB9 (for the alpha 2----6 sialylated type 2 chain
      and glycoproteins having NeuAc alpha 2----6Gal-NAc), and 188C1 (for short- and
      long-chain Lex antigens) and FH2 (for the long-chain Lex antigen). In the pyloric
      mucosa of secretors, the type 2 chain is oncodevelopmentally expressed, but in
      non-secretors it is detected in surface mucous cells of normal gastric mucosa.
      The alpha 2----6 sialylation, which is confined to endocrine cells of normal
      pyloric mucosa, occurs in fetal and carcinoma tissues. Irrespective of the
      secretor status, the short- and the long-chain Lex antigens can be detected in
      mature and immature glandular mucous cells of normal gastric mucosa,
      respectively; both antigens are also expressed in fetal and carcinoma tissues. In
      the colon, the type 2 chain and its alpha 2----6 sialylated counterpart are
      expressed in an oncodevelopmental manner. The short- and the long-chain Lex
      antigens are significantly enhanced in colonic carcinoma. The glycoproteins with
      NeuAc alpha 2----6GalNAc residues appear in gastric and colonic carcinoma as well
      as intestinalized gastric mucosa and transitional mucosa. Thus, some of these
      antigens were distinctively expressed in certain epithelial cells lining the
      normal gastrointestinal tract depending on maturation and patients' secretor
      status, and some were oncodevelopmental or carcinoma-associated antigens of the
      human gastrointestinal tract.

PMID- 1618644
TI  - Altered expression of sialyl-Tn, Lewis antigens and carcinoembryonic antigen
      between primary and metastatic lesions of uterine cervical cancers.
AB  - Immunohistochemical examination was performed of serial sections of 24 normal
      human adult cervical tissues and 53 human cervical carcinomas including 36 cases
      with lymph node metastasis. For this investigation, monoclonal antibodies
      directed to Lewis-X, Lewis-Y, sialyl-dimeric Lewis-X (SDLX), sialyl-Tn (STn) and
      carcinoembryonic antigen (CEA) were used. STn and CEA antigens were expressed
      very weakly in the normal cervical epithelium but strongly in the cancer cells,
      indicating the antigens to be oncogenic antigens of cervical squamous cell
      carcinoma. No significant difference in immunoreactivity was observed between
      primary and metastatic lesions of carcinoma or between primary lesions with and
      without metastasis. However, the expression patterns of STn and Lewis-Y antigens
      were quite different between primary lesions and metastatic lesions. In primary
      lesions the cancer cell nests tended to be stained centrally, but in metastatic
      lesions the cancer cell nests tended to be stained peripherally. This finding may
      reflect an important role of these carbohydrate chains in the process of
      metastasis of cervical squamous cell carcinoma to regional lymph nodes.

PMID- 1618645
TI  - Analysis of the transcripts of cytochrome P-450IID gene subfamily in bovine
      adrenal gland.
AB  - An in situ hybridization experiment showed that the gene transcripts of P-450IID
      subfamily were uniformly distributed in bovine liver cells and at low levels in
      bovine adrenal cortex and medulla. There was no clear localization of transcripts
      of P-450IID genes in three adrenocortical zones, zona glomerulosa, zona
      fasciculata and zona reticularis. The intensity of signal obtained in the adrenal
      cortex and medulla showed approximately 2.5:1 ratio. The presence of gene
      transcripts of P-450IID subfamily in adrenocortex was confirmed by amplifying
      cDNA using PCR and hybridizing the PCR products with P-450IID cDNA.

PMID- 1618646
TI  - Extracellular alkaline phosphatase activity in mineralizing matrices of cartilage
      and bone: ultrastructural localization using a cerium-based method.
AB  - The ultrastructural localization of alkaline phosphatase (A1P) activity has been
      demonstrated in epiphyseal growth cartilage and metaphyseal bone of rats.
      Epiphyso-metaphyseal specimens were decalcified with EDTA and treated with MgCl2
      to regenerate the enzymatic activity before incubation in a medium containing
      beta-glycerophosphate, MgCl2 and CeCl3. A1P activity was present on the outer
      surface of the plasmamembrane of maturing and hypertrophic chondrocytes and of
      osteoblasts. Moreover, the reaction product was present in chondrocyte lacunae,
      in matrix vesicles, and in cartilage matrix, as well as among uncalcified
      collagen fibrils of osteoid tissue in bone. The intensity of reaction was the
      lowest, or completely lacking, where the degree of matrix calcification was the
      highest. These results suggest that alkaline phosphatase is transported from the
      cells into the cartilage and bone matrix by its association with matrix vesicles
      and plasmamembrane components, and that its activity in cartilage and bone matrix
      is inhibited as it is incorporated in the mineral substance.

PMID- 1618647
TI  - Labeling with fluorescent carbocyanine dyes of cultured endothelial and smooth
      muscle cells by growth in dye-containing medium.
AB  - We describe a method for labeling cultured endothelial cells (ECs) and smooth
      muscle cells (SMCs) by letting the cells grow for three days in culture medium
      containing a low concentration of the fluorescent carbocyanine dyes DiI and DiO.
      We show that good labeling can be obtained with considerably lower concentrations
      (2.5 micrograms/ml) than has previously been described. With optimal
      concentration the labeling is very strong and seems to label all membranous
      structures in the cells. It was possible to clearly distinguish differentially
      pre-labeled cells both in coculture and seeded on denaturated vascular grafts.
      The cells remain fluorescent for more than seven days and may be passaged with
      retained proliferative capability. We suggest that DiI/DiO-labeling using dye
      containing medium may be used for several cell types and is applicable in tissue
      culture and in the detection of implanted cells in vivo.

PMID- 1618649
TI  - Microwave-stimulated glutaraldehyde and osmium tetroxide fixation of plant
      tissue: ultrastructural preservation in seconds.
AB  - Microwave-enhanced fixation of animal tissues for electron microscopy has gained
      in interest in recent years. Attempts to use microwave irradiation for the
      preparation of plant tissues are rare. In this study; I report on microwave
      conditions which allow a high quality preservation of plant cell structure.
      Tissues used were: internodes of Chara vulgaris, leaves of Hordeum vulgare, root
      tips of Lepidium sativum. Microwave irradiation was done with a commercial
      microwave oven (Sharp R-5975). Fixatives used were: 2.5% glutaraldehyde in 0.1 M
      sodium cacodylate buffer, pH 7.2 and 1% osmium tetroxide in veronal/acetate
      buffer, pH 7.2. Conventional fixations with glutaraldehyde/osmium were compared
      with microwave fixations. Examinations of thin sections showed that microwave
      fixation (glutaraldehyde or sequential aldehyde/osmium) is an attractive and
      rapid alternative method for processing plant tissues for electron microscopy.
      The optimal conditions found were: microwave oven at power level 50 W, 6.5 ml of
      fixative solution, irradiation times between 32-34 s, final temperature between
      40 degrees C and 47 degrees C.

PMID- 1618648
TI  - Expression of calbindin-D28k in developing and growing chick testes.
AB  - Calbindin, a 28-kDa vitamin D-dependent calcium-binding protein was localized
      immunohistochemically in developing and growing chick testes. The protein first
      appeared in the germinal epithelium of developing testes of the eight-day-old
      embryo and remained therein throughout development. Calbindin was not present in
      the germinal epithelium after hatching. Calbindin was next detected in the
      spermatogonia and spermatocytes of one-week-old and growing chick testes.
      Calbindin-positive spermatogonia and spermatocytes gradually increased in number
      and staining intensity as the seminiferous tubules further developed. A few
      interstitial Leydig cells were positive for calbindin from five-week-old and
      older chicks. Comparison of the time-course of appearance and increase in
      calbindin content in spermatogonia and spermatocytes with spermatogenesis in
      chickens suggests that calbindin may be involved in the mitotic process in
      spermatogonia and spermatocytes.

PMID- 1618650
TI  - Immunocytochemical localization of platelets in baboon hepatic sinusoids using
      monoclonal mouse anti-human platelet glycoprotein IIIa following induction of
      thrombocytopenia.
AB  - A commercially available mouse monoclonal antibody to human platelet glycoprotein
      IIIa was used to demonstrate sequestration of platelets in hepatic biopsies
      obtained from baboons following intravenous infusion of echistatin, a novel
      fibrinogen receptor antagonist derived from the venom of the snake Echis
      carinatus. Biopsies of liver and spleen were taken prior to administration of
      echistatin. The hepatic biopsies were either snap-frozen in Freon-22/liquid
      nitrogen or fixed in 10% neutral buffered formalin. Biopsies of spleen were snap
      frozen. During infusion of echistatin (2.3 micrograms/kg/min), circulating
      platelet counts decreased from 331,000/mm3 to 167,000/mm3. Selective
      sequestration within the liver was confirmed using whole body gamma camera
      imaging to demonstrate 111Indium-oxine labeled platelet accumulation within the
      liver during the thrombocytopenic episode. Hepatic biopsies were again taken and
      either snap-frozen in Freon-22/liquid nitrogen or fixed in 10% neutral buffered
      formalin. Biopsies of spleen and inguinal lymph node were also snap-frozen.
      Platelet rich plasma smears, included as positive controls, dewaxed paraffin
      sections, and cryosections of liver, spleen, and lymph node were stained with
      monoclonal mouse anti-human platelet glycoprotein IIIa using an avidin
      biotinylated peroxidase complex (ABC) technique. Prior to infusion of echistatin,
      platelet staining within the liver was minimal. After echistatin infusion,
      hepatic cryosections showed prominent platelet staining within hepatic sinusoids.
      No localization was shown in lymph node, however, the spleen showed prominent
      platelet staining both before and after echistatin infusion. Platelet rich plasma
      smears were intensely positive. No prominent platelet staining was observed in
      formalin-fixed, paraffin-embedded material. Thus, this immunocytochemical
      technique may help localize platelets in cryosections of tissues from baboons and
      other primate species.

PMID- 1618651
TI  - Heterogeneity and distribution of fast myosin heavy chains in some adult
      vertebrate skeletal muscles.
AB  - Three monoclonal antibodies, LM5, F2 and F39 raised to chicken fast skeletal
      muscle myosin, specific for myosin heavy chain (MHC) subunit, were used to study
      the composition and distribution of this protein in some vertebrate skeletal
      muscles. These antibodies in immunohistochemical investigations did not react
      with the majority of the type I fibres in most muscles. Antibodies LM5 and F39
      stained all the type II fibres in all the adult chicken skeletal muscles studied.
      Antibody F2 also stained all the type II fibres in most chicken skeletal muscles
      tested except in gastrocnemius in which a proportion of both the type IIA and IIB
      fibres either did not stain or stained only weakly. Antibody F2 unlike LM5 and
      F39 stained most of the type IIIB fibres in anterior latissimus dorsi (ALD) and
      IB fibres in red strip of chicken Pectoralis muscle. Antibodies LM5 and F2 in the
      rat diaphragm reacted with all the type IIA and IIB fibres, while antibody F39
      stained only the type IIB fibres darkly with most IIA fibres being either not
      stained or only weakly stained. In the rat extensor digitorum longus (EDL) and
      tibialis anterior (TA) muscles, antibody LM5 stained all the IIA and IIB fibres.
      Antibody F2 in these muscles stained all the type IIA fibres but only a
      proportion of the IIB fibres. The remaining IIB fibres were either unstained or
      only weakly positive. Antibody F39 in rat EDL and TA muscles did not only
      distinguish subgroups of IIB fibres (dark, intermediate and negative or very
      weak) but also of the IIA fibres. These three antibodies used together therefore
      detected a great deal of heterogeneity in the myosin heavy chain composition and
      muscle fibre types of several skeletal muscles.

PMID- 1618652
TI  - A study on the vibration-dose limit for Japanese workers exposed to hand-arm
      vibration.
AB  - To obtain a vibration-dose limit for Japanese workers exposed to hand-arm
      vibration, the prevalences of vibration-induced white finger (VWF) and numbness
      of the hand were studied in 5 different groups of workers exposed to segmental
      vibration. In addition, the prevalence of primary Raynaud's phenomenon (PRP) in
      the general population without occupational vibration exposure was computed. The
      vibration levels in the exposed groups (except chain saw operators) ranged from
      124.1-129.2 dB (reference value, 10(-6) m/s2). The prevalence of VWF in these
      groups was 2.2-4.8%. This value was not statistically significant (p greater than
      0.05) when compared to the prevalence of PRP in the general Japanese population
      (2.7-2.9% in our study and 0.5-4.6% in other surveys in Japan). Although the
      prevalence of numbness of the hands fluctuated among the groups, no significant
      differences could be demonstrated. Our results were then compared to those of
      previous reports by literature study [319 papers on hand-arm vibration syndrome
      (HAVS) and 25 reports on PRP]. At a glance the Japanese population showed a lower
      prevalence for PRP compared to other countries, which suggested that exposure to
      cold and biological abilities should also be considered to assess vibration
      syndrome. A comparison of the vibration characteristics of different tools and
      the occurrence of VWF in the hands of workers in the literature with those of our
      data suggested that a daily hand-arm vibration exposure at a level lower than 2.5
      m/s2 (128 dB, reference value 10(-6) m/s2) could possibly decrease the risk of
      VWF among workers exposed to segmental vibration.

PMID- 1618653
TI  - Acute effects of ozone on EEG activity, sleep-wakefulness and heart rate in rats.
AB  - Effects of exposure to O3 on EEG activity, sleep-wakefulness and heart rate were
      examined using conscious rats which had been chronically implanted with
      electrodes for EEG, EMG and ECG recordings. Exposure to 0.5 ppm O3 for 6 hrs and
      1.0 ppm O3 for 3 hrs suppressed amounts of wakefulness (W) and paradoxical sleep
      (PS) at the expense of an increase in slow-wave sleep (SWS), and lowered the
      amplitude of fast EEG waves and heart rate (HR). The lowered EEG amplitude and
      the suppressed PS recovered more rapidly during the post-exposure period than did
      the lowered HR. The ip administration of atropine sulfate blocked the suppressed
      W, the increased SWS and the lowered HR, while the lowered EEG amplitude and the
      suppressed PS were not blocked. These observations suggest that the O3-induced
      bradycardia results from enhanced activity of cardiac parasympathetic nerves and
      that the O3-induced changes in W and SWS result secondarily from some circulatory
      factor including the bradycardia.

PMID- 1618654
TI  - Health risk appraisal (HRA) and its educational effect on bank employees.

PMID- 1618655
TI  - Organization of C4 and CYP21 loci in gorilla and orangutan.
AB  - The standard human haplotype contains two C4 and two CYP21 loci arranged in the
      order C4A ... CYP21P ... C4B ... CYP21 and intercalated between the class I and
      class II loci of the HLA complex. The C4A gene is 22 kilobases (kb) long; the C4B
      gene is either 22 kb or 16 kb long. The CYP21P is a pseudogene characterized by
      an eight base pair (bp) deletion in exon 3 and other defects; the CYP21 is a
      functional gene. The standard chimpanzee haplotype is arranged in the same way as
      the standard human haplotype, except that both C4 genes are of the short variety;
      like the human gene, the chimpanzee CYP21P gene contains the 8 bp deletion. In
      the present study we demonstrate that a representative gorilla haplotype also
      consists of two short C4 genes and two CYP21 genes, neither of which, however,
      has the characteristic 8 bp deletion. On the other hand, the single characterized
      orangutan haplotype is organized in the following way: C4A ... CYP21 ... C4A ...
      CYP21 ... C4B ... CYP21. The first two C4 genes are of the long variety, the
      third gene is short. None of the defects characterizing the human CYP21P gene is
      present in any of the three orangutan genes. These conclusions are based on the
      analysis of overlapping clones isolated from cosmid libraries of the indicated
      species. The observed haplotype organization of the four primate species can be
      explained by expansion and contraction of the C4-CYP21 region through unequal
      homologous crossing-over, which preserves the differentiation of the C4 genes
      into the A and B categories but otherwise homogenizes these genes, as well as the
      CYP21 genes, within a given species. The 8 bp deletion in the CYP21P gene is
      postulated to have occurred before the separation of the lineages that led to
      modern humans and chimpanzees, but after the separation of these two lineages
      from the lineage that led to modern gorillas. The 6 kb insertion generating the
      long C4 gene is postulated to have occurred before the separation of the
      orangutan, gorilla, chimpanzee, and human lineages.

PMID- 1618656
TI  - DNA typing for HLA class I alleles: I. Subsets of HLA-A2 and of -A28.
AB  - A group of HLA-A locus alleles known to be comprised of approximately 14 closely
      related variants are collectively called HLA-A2 and -A28. Variations among these
      alleles are given by differences in only a few codons, and in the case of A*6901,
      elements of A*6801 (exons 1 and 2) and of A*0201 are combined. The purpose of
      these experiments was to determine the possibility of designing oligonucleotide
      probes to identify and develop a typing method for all or most of the A2 and A28
      variants. Because the regions of interest are also shared by alleles of other
      groups, allele-specific or group-specific primers were needed to amplify only the
      alleles under study. HLA-A2-specific amplification of exon 2 and selective
      amplification of portions of exon 3 of the A2-A28 group were accomplished with
      sequence-specific primers and after appropriate adjustments of the PCR
      conditions. Hybridization patterns using products of four PCR reactions with our
      set of probes distinguished 11 alleles. Two other alleles might be recognized
      with the reagents used, but were not found in the panels in this study. A*0201
      and A*0209, which are different in exon 4, were not resolved because exon 4 was
      not tested. A new variant of Aw68, defined by a hybridization pattern obtained
      with our probes, was different from A*6801 only in that it was negative with
      probe A6. It was called A*68.3. Population studies were performed in North
      American whites, blacks, and Indians and in a sample of subjects from North
      China. HLA-A*0201 was the most frequent allele. A*0202 was found only in blacks,
      and A*0203 and A*0207 were found only in Chinese. Among the A28-positive
      subjects, Caucasoids were predominantly A*6801 or A*68.3; A*6802 was the most
      frequent subtype in American blacks; among American Indians the predominant type
      was A*68.3. The two A28-positive Chinese subjects studied had A*6901. The results
      obtained demonstrate that DNA typing is an efficient method for determining these
      alleles. The methodology should be applicable to other class I groups and should
      be useful for more extensive population studies, for matching for bone marrow
      transplantation, and for investigation of certain diseases associated with HLA
      class I alleles.

PMID- 1618657
TI  - Polymorphism at the HLA-E locus predates most HLA-A and -B polymorphism.
AB  - The extensive polymorphism of the classic class I antigens has been well
      described. In contrast, the nonclassic HLA antigens are distinguished by their
      low polymorphism. We examine here the HLA polymorphism of the HLA-E locus by
      examining the DNA sequence of cDNA from nine ethnically diverse individuals. From
      this analysis, we show that there is no polymorphism in the regions including
      exon 1 and from exon 4 to exon 8, the 3' untranslated exon. In exons 2 and 3,
      there are two base substitutions, one of which is at a replacement site and the
      other silent. The replacement substitution changes an arginine to a glycine at
      position 107, defining two alleles at the HLA-E locus. Using the PCR on exon 3
      from genomic DNA and hybridization with oligonucleotide probes, we have examined
      90 HLA-typed individuals to determine the relative frequency of the two alleles
      in the population and their association with the classical antigens. This
      analysis showed that these two alleles were present at nearly equal frequencies
      in the population. Surprisingly, both alleles were found in an essentially random
      association with all but one HLA-A and -B haplotype. The single exception was to
      the A1-B8 haplotype, which appeared to be linked to only one of the two alleles.
      One implication of this random association is that these HLA-E alleles may have
      existed before most of the HLA-A and B polymorphism. Thus, selection has
      maintained the HLA-E locus essentially unaltered during a time when considerable
      polymorphism was being selected for at the HLA-A and -B loci. This finding may
      also have important consequences in an unrelated bone marrow transplant, where it
      is predicted that 37% of HLA-A and -B matched donors are mismatched at the HLA-E
      locus.

PMID- 1618658
TI  - Typing of HLA-DQA1 and DQB1 using DNA single-strand conformation polymorphism.
AB  - The technique of single-strand conformation polymorphism (SSCP), which is capable
      of distinguishing DNA sequence variability, was adapted to the identification of
      the HLA-DQA1 and DQB1 alleles. Eight DQA1 alleles and 12 DQB1 alleles were
      distinguished by amplifying the second exon of the genes in the presence of
      radioactive deoxynucleotide, denaturing the products with heat, and separating
      the single strands by electrophoresis in nondenaturing gels. For DQA1, it was
      possible to distinguish the eight alleles with standard bis-acrylamide or with a
      Hydrolink gel matrix. Twelve DQB1 alleles were identified by a protocol employing
      a combination of oligohybridization and SSCP using products amplified by specific
      DQB1 primers.

PMID- 1618659
TI  - Effects of localized HLA class II beta chain polymorphism on binding of antigenic
      peptide and stimulation of T cells.
AB  - The relationship between HLA-DR1 polymorphism and recognition of antigen by T
      cells was investigated. Two allelic variants of HLA-DR1, which differ by amino
      acid substitution at positions 85 and 86 of the beta chain, were characterized
      for the effect of substitution on recognition of foreign antigen by DR1
      restricted T cells. Substitution of alanine and valine for valine and glycine
      residues at positions 85 and 86 of the DR1 beta chain resulted in deficient T
      cell stimulation as demonstrated by the requirement for higher concentrations of
      antigen to induce maximal levels of T-cell proliferation, induction of lower
      levels of proliferation at optimal antigen concentrations, and slower kinetics of
      formation of stimulatory peptide-DR1 complexes. Direct binding studies employing
      both biotinylated and radioiodinated forms of antigenic peptide demonstrated
      quantitatively lower levels of peptide bound to substituted DR1 molecules and low
      levels of site-specific binding as assessed by competitive inhibition analyses.
      The effect of MHC class II polymorphism on peptide-binding affinity as opposed to
      induction of appropriate peptide conformation and the impact of polymorphism at
      DR1 beta chain positions 85 and 86 on allorecognition of HLA-DR1 are discussed.

PMID- 1618660
TI  - Characterization of a novel DQB1 allele associated with HLA-DQw3: implications
      for oligotyping.
AB  - During HLA-DQ oligotyping, the presence of a novel HLA-DQB1 allele was suggested
      by a pattern of probe hybridization that was inconsistent with the presence of
      any possible combination of two known alleles. The nucleotide sequence of the
      second exon of the HLA-DQB1 gene was determined, revealing a novel HLA-DQB1
      sequence differing from the DQB1*0301 allele by a single nucleotide substitution
      at codon 57. All published HLA-DQ oligotyping systems could assign inaccurate
      oligotypes when this allele is present. An additional amplification primer was
      utilized to achieve discrimination of all possible combinations of known HLA-DQB1
      alleles.

PMID- 1618661
TI  - The larynx ... so to speak: everything I wanted to know about laryngeal cancer I
      learned in the last 32 years.

PMID- 1618662
TI  - Adjuvant chemotherapy for resectable squamous cell carcinomas of the head and
      neck: report on Intergroup Study 0034.
AB  - To test the efficacy of sequential chemotherapy as an adjuvant to surgery and
      postoperative radiotherapy for patients with locally-advanced but operable
      squamous cell cancers of the head and neck region, a randomized clinical trial
      was conducted under the auspices of the Head and Neck Intergroup (Radiation
      Therapy Oncology Group, Southwest Oncology Group, Eastern Oncology Group, Cancer
      and Leukemia Group B, Northern California Oncology Group, and Southeast Group).
      Eligible patients had completely resected tumors of the oral cavity, oropharynx,
      hypopharynx, or larynx. They were then randomized to receive either three cycles
      of cis-platinum and 5-FU chemotherapy followed by postoperative radiotherapy
      (CT/RT) or postoperative radiotherapy alone (RT). Patients were categorized as
      having either "low-risk" or "high-risk" treatment volumes depending on whether
      the surgical margin was greater than or equal to 5 mm, there was extracapsular
      nodal extension, and/or there was carcinoma-in-situ at the surgical margins.
      Radiation doses of 50-54 Gy were given to "low-risk" volumes and 60 Gy were given
      to "high-risk" volumes. A total of 442 analyzable patients were entered into this
      study with the mean-time-at-risk being 45.7 months at the time of the present
      analysis. The 4-year actuarial survival rate was 44% on the RT arm and 48% on the
      CT/RT arm (p = n.s.). Disease-free survival at 4 years was 38% on the RT arm
      compared to 46% on the CT/RT arm (p = n.s.). At 4 years the local/regional
      failure rate was 29% vs. 26% for the RT and CT/RT arms, respectively (p = n.s.).
      The incidence of first failure in the neck nodes was 10% on the RT arm compared
      to 5% on the CT/RT arm (p = 0.03 without adjusting for multiple testing) and the
      overall incidence of distant metastases was 23% on the RT arm compared to 15% on
      the CT/RT arm (p = 0.03). Treatment related toxicity is discussed in detail, but,
      in general, the chemotherapy was satisfactorily tolerated and did not affect the
      ability to deliver the subsequent radiotherapy. Implications for future clinical
      trials are discussed.

PMID- 1618663
TI  - Velotonsillar squamous cell carcinoma: 277 cases treated by combined external
      irradiation and brachytherapy--results according to extension, localization, and
      dose rate.
AB  - From 1977 to 1987, 277 patients with velotonsillar cancer (oropharyngeal cancer
      excluding base of tongue and valleculae) were treated by brachytherapy either
      alone (14 patients) or combined with external beam irradiation (263 patients)
      using a new afterloading Iridium-192 technique. The distribution of patients
      according to the localisation was as follows: 106 tonsillar region, 98 soft
      palate, 45 anterior pillar, 8 posterior pillar and 20 pharyngoglossal sulcus.
      According to the UICC TNM classification of 1979, the patients were staged as
      follows: 65 T1, 103 T2, 101 T3, 8 TX. 172 patients were NO, 74 N1, 3 N2, 20 N3 et
      8 NX. According to the tumor extension, the 5 year actuarial local control,
      locoregional control, specific survival and overall survival by T stage (T1 [65
      pts], T2 [103 pts.], T3 [101 pts]) were respectively: local control: 89%, 86%,
      69%; locoregional control: 84%, 80%, 67%; specific survival (excluding patients
      dead with intercurrent disease or second cancer): 78%, 62%, 46%; overall
      survival: 62%, 53%, 43%. No local recurrence was detected after 3 years.
      According to the localization, the tumors arising from the tonsillar region, the
      soft palate and the posterior pillars (A Group) had a better prognosis than the
      tumors arising from the anterior pillars and glossotonsillar sulcus (B Group).
      The complications were classified into four grades according to their extension
      and duration: Grade 1 (minor) with very small tissue ulcer which healed within 2
      months with medical treatment (20%). Grade 2 (moderate) (5%), grade 3 (severe)
      (1.4%), grade 4 (fatal) (0.4%). The dose rate seemed to be relatively higher in
      patients with grade 2 and 3 complications (70 cGy per hour on average) versus the
      dose rate of patients without complications (50 cGy per hour) but the difference
      was not significant. In conclusion, the brachytherapy boost after external
      irradiation can be performed under favourable conditions with an acceptable rate
      of complications. It was set out in order to attempt to improve the local control
      of the tumor while preserving the salivary function and lessening the muscular
      fibrosis. It shows how experienced the team is, however only a randomized study
      would allow to state whether this technique brings about a real improvement
      especially as for tumors T2 or T3.

PMID- 1618664
TI  - Stage T3 squamous cell carcinoma of the glottic larynx: a comparison of
      laryngectomy and irradiation.
AB  - One-hundred eighteen patients with previously untreated T3 squamous cell
      carcinoma of the glottic larynx were treated with curative intent between March
      1965 and November 1988 at the University of Florida. All patients were observed
      for at least 2 years and 83% were observed for 5 or more years. Fifty-three
      patients were treated with irradiation alone and 65 patients were treated with
      surgery alone (32) or combined with irradiation (33). Thirty-two patients treated
      with irradiation alone had twice-daily fractionation and the remainder had once
      daily fractionation. The local-regional control rates, including patients
      successfully salvaged after a local-regional recurrence, were 81% after
      irradiation alone and 81% after surgery alone or combined with adjuvant
      irradiation. The local control rates for patients treated with irradiation alone
      were 53% after once-daily fractionation and 71% after twice-daily fractionation.
      There was no relationship between vocal cord mobility at 5000 cGy, at the end of
      radiotherapy, or at 1 month after treatment and subsequent local control. The 5
      year cause-specific survival rates were 74% for patients treated with irradiation
      alone and 63% for patients treated surgically. The incidence of severe
      complications, including those associated with salvage procedures, was 15% for
      both treatment groups. The rates of laryngeal voice preservation were 66% after
      irradiation alone and 2% after surgery. Irradiation alone for selected patients
      with T3 glottic cancer resulted in similar rates of local-regional control,
      survival, and severe complications, with a significantly higher likelihood of
      voice preservation, compared with surgery.

PMID- 1618665
TI  - Does neck stage influence local control in squamous cell carcinomas of the head
      and neck?
AB  - Recently, reports have suggested that the probability of local control of head
      and neck cancers treated with radiotherapy alone is inversely related to the
      extent of neck node disease at presentation. This has led some to conclude that
      primary lesions in patients with neck node metastases should be treated more
      aggressively than lesions of the same T stage in patients presenting with a
      clinically negative neck. We reviewed the records of 607 patients with squamous
      cell carcinoma of the head and neck to determine the relationship between the
      extent of neck node disease at diagnosis and the probability of tumor control at
      the primary site. All patients were treated with continuous-course irradiation
      alone to the primary site and have a minimum follow-up of 2 years. Mucosal sites
      analyzed included the oropharynx (soft palate, tonsillar region, base of tongue),
      hypopharynx (pharyngeal wall, pyriform sinus), and supraglottic larynx. Patients
      with simultaneous primary lesions were excluded from the analysis. Parameters
      tested included T stage, N stage, and fractionation (once daily or twice daily).
      For statistical analyses, N stage was grouped as N0, N1, N2A-N3A, and N2B-N3B.
      Local control was analyzed using a multivariate analysis, the forward stepwise
      long-rank test of association of covariates. Multivariate analyses revealed that
      the following parameters significantly influenced local control: oropharynx, T
      stage only (p = .0010); hypopharynx, T stage (p = .001) and twice-daily
      fractionation (p = .0031); and supraglottic larynx, T stage only (p = .0002). No
      significant correlation was found between neck stage and primary tumor control on
      univariate or multivariate analyses. Our data do not support the conclusion that
      primary lesions are controlled less often in patients with clinically positive
      neck nodes.

PMID- 1618666
TI  - Postoperative radiotherapy in head and neck carcinoma with extracapsular lymph
      node extension and/or positive resection margins: a comparative study.
AB  - In head and neck carcinoma, the finding of extracapsular lymph node extension
      and/or positive resection margins portends poor locoregional control and
      survival. The effectiveness of postoperative radiotherapy in these patients has
      been controversial due to insufficient studies comparing resected patients with
      those also receiving radiation. Between 1982 and 1988, 441 radical head and neck
      resections were performed at the Medical College of Virginia. Pathologic review
      of these cases identified 125 with extracapsular lymph node extension and/or
      positive resection margins. Of these, 43 had extracapsular lymph node extension
      only, 24 had both positive resection margins and extracapsular lymph node
      extension, and 58 demonstrated positive resection margins only. Surgery alone was
      performed in 71 of these patients while 54 cases received surgery and
      postoperative radiotherapy, (combined modality treatment) CMT. Radiotherapy doses
      ranged from 50 to 70 Gy. The surgery alone and combined modality treatment groups
      were comparable with respect to the distribution of positive resection margins
      and extracapsular lymph node extension. Slightly more CMT patients had clinical
      T4 disease compared with the surgery alone group (22% vs 14%). Slightly fewer
      combined modality treatment patients had clinical N0 necks than the surgery alone
      group (20% vs 29%). Multivariate analysis was performed with the variables T, N
      stages, radiotherapy, margin status, primary tumor sites, microscopic and
      macroscopic extracapsular lymph node extension, number of positive lymph nodes,
      number of nodes with extracapsular lymph node extension. Locoregional control was
      maintained at 5 years in 59% of the combined modality treatment group and 31% of
      the surgery alone group (p.0001). Subgroup analysis likewise reveals significant
      differences favoring the combined modality treatment group for positive resection
      margins only (49% vs 41%; p = .04), extracapsular lymph node extension only (66%
      vs 31%; p = .03) and extracapsular lymph node extension+positive resection
      margins (68% vs 0%; p = .001). Adjusted survival also shows a significant benefit
      of combined modality treatment vs surgery alone for the entire group (72% vs 41%;
      p = .001). Multivariate analysis revealed that the use of radiotherapy is a
      strongly favorable variable for local control and adjusted survival. Macroscopic
      extracapsular lymph node penetration and positive resection margins are
      unfavorable independent variables for local control. T-stage is the only variable
      predicting local control in the combined modality group. Extracapsular extension
      remains an important negative prognostic variable for survival in both treatment
      groups. In conclusion, this study demonstrates a locoregional control and
      survival benefit for postoperative radiotherapy in patients with the high risk
      pathologic findings of extracapsular lymph node extension and positive resection
      margins.

PMID- 1618667
TI  - Cervical nodal metastasis of squamous cell carcinoma of unknown origin:
      indications for withholding radiation therapy.
AB  - The records of patients with pathologically confirmed metastatic squamous cell
      carcinoma involving cervical lymph nodes who were treated at the Mayo Clinic
      between January 1965 and December 1987 were reviewed. In 117 patients a primary
      tumor could not be discovered. Of these, 24 patients underwent curative resection
      of all gross disease by neck dissection or excisional biopsy. All 24 patients
      presented with unilateral adenopathy. Their median age was 63 years. Eighteen
      patients were men. Fourteen patients were in clinical stage N1; six, N2a; three,
      N2b; and one, N3. Six patients had grade 1 or 2 nodal metastases; 14, grade 3;
      and 4, grade 4. Gross or microscopic evidence of extracapsular tumor extension
      was noted in eight patients. All patients were followed until death or for a
      median of 8.5 years (range, 3.3-20.4 years). A squamous cell carcinoma of the
      upper aerodigestive tract subsequently developed in only one patient (4%) within
      5 years of operation. In six patients (25%), a recurrence developed in the
      dissected neck a median of 3 months (2.4 months-6.6 years) after operation. Five
      of these patients had extracapsular extension, and four had pathologic Stage N2a
      or higher neck disease. Both patients with pathologic Stage N1 disease who had
      recurrences in the dissected neck had extracapsular extension. Delayed,
      contralateral neck metastases in an undissected neck developed in two patients.
      The 5-year overall and cause-specific survivals for all 24 patients were 66% and
      74%, respectively. Extracapsular extension was a predictor of neck recurrence,
      control of disease above the clavicles, cause-specific survival, and overall
      survival. Patients with pathologic Stage N1 neck disease with no extracapsular
      extension can be managed by surgery alone. Patients with pathologic Stage N2 or
      higher neck disease or extracapsular extension should be considered for
      postoperative, adjuvant radiation therapy.

PMID- 1618668
TI  - Electron beam intraoperative radiation therapy (EBIORT) for localized pancreatic
      carcinoma.
AB  - Treatment results for 37 patients with localized pancreatic carcinoma treated
      using electron beam intraoperative radiation therapy (EBIORT) with curative
      intent from 1978 to 1990 in National Shikoku Cancer Center Hospital and the
      related hospitals were presented in comparison with those of a control group
      comprising 40 patients treated with no use of EBIORT. With additional treatment
      of EBIORT, 37 patients survived longer than the control 40 patients (p less than
      0.05 during the 19th and 31st month). In the macroscopically total or partial
      resection, patients treated with EBIORT survived slightly longer than the
      controls. In the unresectable lesions, patients treated with EBIORT survived
      longer than the control patients (p less than 0.05 during the 7th month). In this
      group, there was one 5-year survivor who received EBIORT plus postoperative
      external radiation therapy (ERT) to the unresectable pancreatic head lesion but
      died 5 years later of massive bleeding from the duodenal ulcerations. Patients
      with unresectable carcinoma treated by EBIORT plus ERT survived longer than
      patients treated with EBIORT alone (p = 0.065). Pain relief was obtained in 95.0%
      of the unresectable patients with pain. Major adverse effects caused by
      irradiation were gastrointestinal troubles in five patients (leakage of
      choledochojejunostomy, gastric ulcerations, duodenal stenosis, gastric
      ulcerations and duodenal stenosis, duodenal perforation and ulcerations). EBIORT
      proved to be effective in the relief of serious pain and in the improvement of
      the survival of patients with localized pancreatic carcinoma.

PMID- 1618669
TI  - Hyperthermia combined with radiation therapy for primarily unresectable and
      recurrent colorectal cancer.
AB  - The value of adjuvant hyperthermia to radiotherapy in the treatment of locally
      advanced colorectal cancers was investigated. Between 1981 and 1989, 71 primarily
      unresectable or recurrent colorectal tumors were treated with radiotherapy at the
      Department of Radiology, Kyoto University Hospital. Of the 71 tumors, 35 were
      treated with radiotherapy plus hyperthermia (group I), while 36 tumors (group II)
      were unsuitable for hyperthermia mainly because of difficulties with the
      insertion of temperature probes or the thickness of the patient's subcutaneous
      fat (greater than 2 cm). The mean total radiation dose was 58 Gy and 57 Gy for
      groups I and II, respectively. Thirty deep-seated pelvic tumors were treated with
      an 8 MHz radiofrequency capacitive heating device, and five subsurface tumors
      were treated with a 430 MHz microwave hyperthermia system. Hyperthermia was given
      following radiotherapy for 30-60 min for a total of 2-14 sessions (mean 5.7). In
      32 of the 35 tumors heated, direct measurement of tumor temperature was
      performed. For the five tumors treated with the microwave heating device, the
      means of the mean maximum, average, and minimum measured intratumoral
      temperatures were 45.4 degrees C, 43.3 degrees C, and 40.6 degrees C,
      respectively. The corresponding values were 42.2 degrees C, 41.3 degrees C, and
      40.3 degrees C for the 27 tumors treated with the capacitive heating device.
      Effective heating of deep-seated pelvic tumors was more difficult than heating of
      abdominal wall or perineal tumors. The local control rate at 6 months after the
      treatment, which was defined as absence of local progression of the tumors, was
      59% (17/29) and 37% (11/30) for groups I and II, respectively. The objective
      tumor response rate (complete regression plus partial response) evaluated by
      computed tomography was 54% (19/35) in group I, whereas it was 36% (10/28) in
      group II. A better response rate of 67% was obtained in the 15 tumors with a mean
      average tumor temperature of greater than 42 degrees C. Although limitation of
      our current heating devices exist, the combination of hyperthermia with
      radiotherapy is a promising treatment modality in the treatment of locally
      advanced colorectal cancer.

PMID- 1618670
TI  - Radiation therapy for skin cancer near the eye: kilovoltage x-rays versus
      electrons.
AB  - When skin cancer near the eye is irradiated, a corneal shield is placed between
      the lids and globe to protect ocular structures. The effectiveness of the shield
      was evaluated with 250 kVp x-ray and 6-20 MeV electron beams. To simulate the
      clinical situation, a face phantom was constructed out of solid pieces of water
      equivalent epoxy. In the region of the eye the phantom was milled to the exact
      contour of a human face. The phantom was used to reconstruct the setup that had
      been used to treat a patient with a 1-cm basal cell carcinoma of the mid portion
      of the lower lid. A medium-sized corneal shield (2-mm-thick lead plated with 0.1
      mm gold) was placed on the eye portion of the phantom. A contoured lead (6 mm
      thick) face mask was placed on the surface of the phantom to define a 3-cm
      diameter radiation field that included only the inferior hemisphere of the
      shield. The doses that the cornea, lens, and retina would receive beneath the
      midpoint of the inferior hemisphere of the shield were measured using
      thermoluminescent and film dosimetry. With 6 to 8 MeV electrons, the corneal dose
      was 2 to 4 times higher than with 250 kVp x-rays. Corneal and lens doses rose
      rapidly with increasing electron beam energy such that with greater than 8 MeV
      the shield would provide relatively poor ocular protection. A scanning ion
      chamber and film dosimetry were used to determine the isodose profiles of 250 kVp
      x-ray and 6 MeV electron beams for a 3-cm diameter field collimated on the
      surface. With 250 kVp x-rays the 95% isodose area was 32% wider than with 6 MeV
      electrons. The ease of shielding and the ability to minimize field size argue in
      favor of kilovoltage x-rays for early-stage skin cancer near the eye.

PMID- 1618671
TI  - The use of 3-D dose volume analysis to predict radiation hepatitis.
AB  - Although it is well known that the tolerance of the liver to external beam
      irradiation depends on the volume of liver irradiated, few data exist which
      quantify this dependence. Therefore, a review was carried out of our clinical
      trial for the treatment of intrahepatic malignancies in which the dose of
      radiation delivered depended on the volume of normal liver treated. Three
      dimensional treatment planning using dose-volume histogram analysis of the normal
      liver was used for all patients. Nine of the 79 patients treated developed
      clinical radiation hepatitis. None of the patient related variables assessed were
      associated with radiation hepatitis. All patients who developed radiation
      hepatitis received whole liver irradiation, as all or part of their treatment,
      which produced a mean dose greater than or equal to 37 Gy. Dose volume histograms
      were used to calculate normal tissue complication probabilities based on
      parameters derived from the literature. The risk of complication was greatly
      overestimated among patients receiving a high dose of radiation to part of the
      liver without whole liver treatment. An estimation of model parameters based on
      the clinical results indicated a larger magnitude for the "volume effect
      parameter" than the literature estimate (n = 0.69 +/- 0.05 vs 0.32; p less than
      0.001). Computation of the normal tissue complication probabilities using the
      larger value of n produced a good description of the observed risk of radiation
      hepatitis. These findings suggest that dose volume histogram analysis can be used
      to quantify the tolerance of the liver to radiation. The predictive value of this
      parameterization of the normal tissue complication probability model will need to
      be tested with liver tolerance and dose volume histogram data from an independent
      clinical trial.

PMID- 1618672
TI  - Evaluation of multileaf collimator design for a photon beam.
AB  - Various aspects of multileaf collimator (MLC) design are examined relative to
      clinical requirements. The characteristics studied included: (a) irregular field
      edge definition or "effective" penumbra, (b) optimum field coverage for the
      multileaf portion of the field, and (c) leaf velocity. A film dosimetry technique
      was developed to measure the rapid 2-dimensional change in dose at an edge
      defined by a multileaf collimator with the segments staggered. The method applies
      a correction factor which allows for the changing ratio of scattered to primary
      photons at the field edge so that the energy dependence of the film is corrected.
      Stepped lead alloy blocks were irradiated with 6 MV photons to obtain films
      simulating a double-focused multileaf collimator, and the results were compared
      to films of fields shaped with standard divergent blocks. The effect of the shape
      of the leaf face (the end of the leaf) on penumbra was also studied. Proper
      shaping of the leaf ends may eliminate the need to exactly match beam divergence
      so that the mechanical of the collimator system is simplified. Leaves having
      several different end shapes and moving horizontally to intercept a vertical beam
      were compared to the divergent design where a straight face moves along an arc.
      The measurements showed that the "effective" penumbra (measured as the distance
      from the 80 to 20% isodose lines) for the multileaf collimator is a function of
      the angle between the direction of leaf motion and the edge defined by the
      leaves. In addition, all leaf end shapes showed some increase in penumbra
      compared to standard divergent blocking and also had increasing penumbra width as
      they moved over or back from the field center line. A total of 459 treatment
      fields and six disease sites were examined to determine the percentage of fields
      potentially shaped by multileaf segments of specified length. This study showed
      93% of the fields had lengths of 30 cm or less and 99% had widths of 25 cm or
      less. A study conducted to determine the required leaf velocity to shape various
      target volume configurations during complete rotation (at 1 RPM) showed that a
      leaf speed of at least 1.5 cm/sec at isocenter is needed for dynamic conformal
      treatment.

PMID- 1618673
TI  - Single biopsy, tumor kinetic analyses: a comparison of methods and an extension
      to shorter sampling intervals.
AB  - There is emerging and established clinical and laboratory evidence that
      proliferation of tumor clonogens during radiation therapy can impair local tumor
      control. The pre-treatment, tumor potential doubling time, T(pot), estimated with
      in situ bromodeoxyuridine (BrdUrd) labeling, followed by a single biopsy and flow
      cytometry, may be a predictor of a given tumor's ability to undergo such intra
      treatment proliferation. Recent studies have found a strong similarity between
      T(pot)'s determined in this fashion and the effective doubling times of surviving
      tumor cells during radiotherapy, as estimated from tumor control versus treatment
      duration data. Furthermore, several preliminary clinical studies have indicated
      that T(pot) may be a predictor of outcome, with faster tumors doing worse.
      Accelerated fractionation might overcome such proliferation, but is more acutely
      toxic and is unlikely to benefit patients with slowly proliferating tumors. Thus,
      the BrdUrd/single biopsy method may offer the possibility of selecting between
      accelerated and conventional or hyperfractionated treatment. Several approaches
      to the analysis of data generated by this method have been described, but there
      has been little documentation of the validity of methods in experimental systems,
      particularly in human experimental tumors. This study explores various analytic
      methods employed with the BrdUrd, delayed, single-biopsy technique used in
      determining the potential doubling time, T(pot), of tumors. It compares methods
      of analysis in three experimental systems and in 40 in situ-labeled human tumors,
      and proposes a method for shortening the required labeling-biopsy interval to a
      clinically more convenient range of 3 to 4 hours.

PMID- 1618674
TI  - Morphologic effects of fast neutrons or photons on the canine kidney.
AB  - Thirty-nine adult male Beagles received either fast neutron or photon irradiation
      to the right thorax to determine the relative biological effectiveness of fast
      neutrons on normal pulmonary tissue. The right anterior abdomen, including the
      cranial half of the right kidney, was included in the field of irradiation.
      Twenty-four dogs (six/group) received fast neutrons with an average energy of 15
      MeV to total doses of 1000, 1500, 2250, or 3375 cGy in four fractions per week
      for 6 weeks. Fifteen dogs received 3000, 4500, or 6750 cGy of photons
      (five/group) in an identical fractionation pattern. All 12 neutron irradiated
      dogs receiving 3375 and 2250 cGy and 1 of 6 receiving 1500 cGy, developed
      clinical and clinical pathologic signs of hepatic, pancreatic, and
      gastrointestinal disturbances, but no signs of renal injury were seen. These 13
      dogs died or were euthanatized 47-367 days after irradiation. Only 1 of 5 dogs
      receiving 6750 cGy of photons developed similar signs and died 708 days post
      irradiation. The remaining 11 neutron irradiated dogs and 14 photon irradiated
      dogs eventually died of other causes. All 39 dogs were necropsied and their
      kidneys were compared to each other and to control dogs. Radiation induced
      lesions included hemorrhages, necrosis and disappearance of tubular epithelia,
      glomerulosclerosis, atrophy and fibrosis. These lesions were associated with
      degenerative and occlusive vascular changes and were much more severe in the
      neutron irradiated dogs. The relative biologic effectiveness of fast neutrons for
      canine kidney assessed by gross and microscopic pathology is approximately 4.5
      (6750/1500).

PMID- 1618675
TI  - Effect of administration schedules on the potentiation of 1,3-bis(2-chloroethyl)
      1-nitrosourea (BCNU) by misonidazole in subcutaneous 9L tumors.
AB  - Our previous studies demonstrated that metabolism of misonidazole (MISO) by
      hypoxic cells is required to potentiate the cytotoxicity of 1,3-bis(2
      chloroethyl)-1-nitrosourea (BCNU) in sc 9L tumors. To determine the influence of
      administration schedules on this chemosensitization, tumors were either clamped
      to produce a reversible hypoxia or left unclamped. MISO (2.5 mmoles kg-1) was
      administered to rats with unclamped tumors simultaneously with BCNU (9 or 12 mg
      kg-1), 20 min before BCNU, or 2.5 hr before BCNU, and the drug pharmacokinetics
      and BCNU cytotoxicity were measured. MISO administered 20 min or 2.5 hr before
      BCNU increased the plasma elimination half-time (t1/2) of BCNU, but MISO
      administered simultaneously with BCNU did not change the plasma elimination t1/2
      of BCNU. In unclamped sc 9L tumors, all administration schedules decreased the
      peak BCNU concentration and increased the initial BCNU elimination t1/2; however,
      the BCNU exposure dose (AUC0-infinity) calculated from these data did not change
      significantly. In agreement with the AUC calculations, none of the administration
      schedules altered the BCNU cytotoxicity in unclamped tumors. If the tumors were
      clamped for 5-120 min after the peak MISO concentration was reached, BCNU-induced
      cell kill was increased by a constant factor of 3 over the first hour of the
      clamping period and by an additional factor of 7 over the second hour of the
      clamping period. If the tumors were clamped for 2 hr after the peak MISO
      concentration was reached and then BCNU administered 0-60 min after the clamp was
      released, this chemosensitization remained at a constant factor of approximately
      20 for the first 10 min, and then decreased rapidly to a factor of approximately
      3 by 20 min after the clamp was released. These data indicate that in sc 9L
      tumors, (1) at least two biochemical mechanisms are involved in this MISO-BCNU
      interaction, one of which depends on the duration and extent of the metabolism of
      MISO by hypoxic cells, and (2) reoxygenation does not immediately eliminate the
      potentiation of BCNU by MISO. These data also suggest that MISO should be given 2
      4 hr before BCNU to achieve the maximum chemosensitization in clinical trials.

PMID- 1618676
TI  - Late reaction following twice-a-day irradiations in the murine foot: possible
      repopulation or consequential late effect.
AB  - The effect of twice-a-day irradiation on the foot reaction was studied in
      C3Hf/Sed mice. A numerical scoring system was used to evaluate the foot reaction
      that became visible shortly after irradiation. Peak reaction occurred on the 21st
      to 23rd day and reappeared after approximately the 200th postirradiation day.
      These reactions are called early- and late-appearing reactions, respectively.
      Animals studied for early-appearing reactions were continuously scored for more
      than 600 days after irradiation. The late-appearing reaction increased
      continuously or remained constant, but never decreased during the course of the
      experiments. Animal feet were irradiated with a fraction size from 1.0 to 5.0 Gy
      twice-a-day daily with a treatment interval of 6 and 18 hours, and varying
      numbers of fractions were given. A top-up dose of 20 Gy was given as the last
      dose. The late-appearing foot reaction following a fraction size of 1.5 Gy or
      greater increased with increasing total dose. However, the increase in the late
      reaction score with increasing total dose was trivial following multiple doses
      with a fraction size of 1.0 Gy, suggesting a possible repopulation during
      prolonged irradiation or that the observed reaction was a consequential late
      effect. The Fe-plot based on doses which induced fibrosis in one-half of the
      irradiated animals, showed an alpha/beta ratio of 6.57 +/- 0.62 Gy, and the
      presence of a breaking point at approximately 1.5 Gy. The alpha/beta ratios
      calculated by Joiner's method and Thames direct analysis were identical. The
      slope of the Fe-plot below 1.5 Gy was significantly steeper than that above 1.5
      Gy.

PMID- 1618677
TI  - Design and implementation of a microcomputer-based tutorial in radiation
      oncology.
AB  - The design and implementation of a computer-based training system for radiation
      oncology was undertaken. A frame-based system was chosen, with factual
      information from Principles and Practices of Radiation Oncology, by Perez and
      Brady, as the body of knowledge. Each unit of the system was based on a site
      (chapter) and consists of three sections: text, review questions, and patient
      management problems. The text section contains text, tables, and references and
      defines the information upon which the review questions and clinical cases are
      based. The review questions are multiple choice and true-false, and immediate
      feedback is given for both correct and incorrect responses. The patient
      management problems are interactive and provide alternative methods of presenting
      information and stimulating problem-oriented thought. The emphasis in all
      sections is on learning rather than testing. Advantages of a computer-based
      tutorial include the ability to present large volumes of information easily, the
      capacity for immediate feedback, and the flexibility of format in presentation of
      material. Potential applications are discussed.

PMID- 1618678
TI  - Recurrent locally advanced nasopharyngeal carcinoma treated with heavy charged
      particle irradiation.
AB  - Between June 1981 and May 1990, 11 patients with recurrent locally advanced
      nasopharyngeal carcinoma were treated with heavy charged particle radiation at
      Lawrence Berkeley Laboratory. All patients had previously undergone full course
      radiotherapy to a median dose of 70.2 Gy [range 61-81 Gy]. Median time to
      recurrence was 18.2 months. At the time of heavy charged particle radiotherapy
      treatment, all had evidence of invasion of the base of skull and 7 of 11 had
      cranial nerve deficits. None of the patients were candidates for brachytherapy
      because of tumor extent or poor geometry. The tumor histology was squamous cell
      carcinoma in 10 patients and lymphoepithelioma in one patient. Ten of the 11
      patients had received chemotherapy prior to re-irradiation. The heavy charged
      particle tumor dose delivered ranged from 31.80 GyE to 62.30 GyE (average 50.25
      GyE, median 50 GyE). Local control was achieved in 45%. Median survival was 42
      months. Actuarial survival was 59% at 3 years and 31% at 5 years (Kaplan-Meier).
      There were no fatal complications. The results in treating locally advanced
      recurrent nasopharyngeal carcinoma with heavy charged particles appear superior
      to those reported by others using photon therapy.

PMID- 1618679
TI  - Adjuvant chemotherapy for resectable squamous cell carcinoma of the head and
      neck. Report on Intergroup Study 0034.

PMID- 1618680
TI  - The uncertainty principle in clinical data.

PMID- 1618681
TI  - Unknown primary squamous cell carcinoma of the head and neck: is mucosal
      irradiation necessary?

PMID- 1618683
TI  - [Answers to various questions on endometriosis].

PMID- 1618685
TI  - [Transcervical GIFT--successful treatment of unexplained infertility in Huddinge
      hospital].

PMID- 1618682
TI  - Activation of the heat shock transcription factor by hypoxia in normal and tumor
      cell lines in vivo and in vitro.
AB  - Cells exposed to hypoxia increase their synthesis of a specific set of proteins
      called oxygen regulated proteins. Recently, three of these proteins have been
      identified as hemoxygenase, Glucose Regulated Protein 78 kilodaltons and Glucose
      Regulated Protein 94 kilodaltons. In contrast, reoxygenation from hypoxic
      conditions increases the synthesis of the heat shock proteins. Although the
      molecular signals required for regulation of both sets of proteins by hypoxia and
      reoxygenation are still under investigation, it is known that their expression is
      regulated at the transcriptional level. This finding suggests that these stresses
      work either singularly or together to control the activation of nuclear
      transcription factors which bind distinct regulatory sequences in the promoter
      region of these genes. One possible nuclear transcription factor which could act
      as a transcriptional regulator for both hypoxia and reoxygenation gene
      transcription is the heat shock transcription factor. In this report, we focused
      on the kinetics of HSF activation by hypoxia in normal and tumor cell lines of
      murine and human origins. In cell culture, both the normal diploid cell line
      AG1522 and the tumor cell line JSQ-3 possess the same kinetics of HSF activation
      (binding to the heat shock element) by hypoxia, with maximal induction at or
      after 3 hr. We have also shown that the activation of HSF occurs in the SCCVII
      tumor in vivo without clamping, but not in SCCVII cells grown in monolayers. When
      SCCVII tumors are dissociated and allowed to reoxygenate in cell culture, HSF
      binding decreased in 5 hr, and was undetectable after 18 hr. Furthermore, one
      human tumor biopsy tested for the presence of hypoxia by both the pO2 histograph
      (Eppendorf, Germany) and HSF binding showed good agreement for both techniques.
      These results suggest that HSF binding may be a useful marker for monitoring the
      tumor hypoxia.

PMID- 1618684
TI  - [Glimpses from the history of abortion].

PMID- 1618686
TI  - [Baby-friendly hospital in Sweden].

PMID- 1618687
TI  - ["Nursing activities"--innovations in a maternal-infant department].

PMID- 1618689
TI  - [Report of a study trip to north Germany].

PMID- 1618688
TI  - [Ethiopian midwives during the last year].

PMID- 1618690
TI  - [Natural family planning].

PMID- 1618691
TI  - Cytokines; from phenomenology to molecular biology.

PMID- 1618692
TI  - Absence of HTLV-II co-infection in HTLV-I-associated myelopathy patients.
AB  - Syncytium inhibition assay to distinguish between HTLV-I and HTLV-II infection
      was performed with sera and cerebrospinal fluid of 15 HTLV-I-associated
      myelopathy (HAM) patients. Also, genome analysis of HTLV-II proviral DNA was
      performed in some HAM patients by use of the polymerase chain reaction method.
      All of the HAM patients were negative for co-infection with HTLV-II.

PMID- 1618693
TI  - Ecologic study of lung cancer risk factors in the U.S. and Japan, with special
      reference to smoking and diet.
AB  - Lung cancer mortality rates among United States and Japanese males were compared
      and related to smoking and dietary data. Mortality rates increased from 1950 to
      1985 in both countries, but the absolute values are consistently lower in Japan
      (38.2 deaths/100,000 in 1985) than in the U.S. (72.2/100,000). The proportion of
      smokers is higher in Japan than in the U.S. since 1955. Japanese males start
      smoking considerably later than U.S. males, but smoke a higher quantity of
      cigarettes per day. Available information on inhalation practices and yield and
      type of cigarettes smoked showed no differences among the two countries large
      enough to account for the differences in mortality rates. Further data in this
      regard should be obtained. Dietary data show that fat consumption (as percentage
      of calories) is consistently higher in the U.S. than in Japan from 1950 (40% vs.
      7.9%) through 1985 (43.5% vs. 24.5%). A linear relationship is observed between
      lung cancer mortality and fat intake. Our data support the hypothesis that
      dietary habits may modulate the carcinogenic effects of tobacco smoking.

PMID- 1618694
TI  - Efficacy of lung cancer screening; comparison of results from a case-control
      study and a survival analysis. The Japanese Lung Cancer Screening Research Group.
AB  - A case-control study to evaluate the efficacy of lung cancer screening conducted
      by us showed that lung cancer screening may reduce the mortality of the disease
      up to 28%. Assuming this efficacy is unbiased, and that the screening rate is
      51.6%, which was observed in the control group in the above study, the number of
      lung cancer deaths prevented by screening in the study period was calculated to
      be 47 for males and females combined. In the same study population, screen
      detected lung cancer patients (N = 207) in the same study period were followed
      and the 7-year survival rate (46.9%) was compared to the 5-year survival rate
      (11.3%) obtained by the Osaka Cancer Registry, in which screen-detected lung
      cancer patients were only 1.8%. The number of lung cancer deaths prevented by
      screening, estimated by the difference in the above two survival rates, was 74
      (95% confidence interval; 55-93). The number of lung cancer deaths prevented by
      screening estimated from the case-control study was significantly lower than that
      estimated from the survival analysis. This indicates that the efficacy of lung
      cancer screening estimated by the case-control study was within the range that
      could be explained by the actual long-term survivors among the screen-detected
      patients in the study population.

PMID- 1618695
TI  - Suppression of diethylnitrosamine-initiated preneoplastic foci development in the
      rat liver by combined administration of four antioxidants at low doses.
AB  - Potential synergism between 4 antioxidants acting at low doses on development of
      glutathione S-transferase placental form (GST-P)-positive liver cell foci was
      examined in male rats initially given diethylnitrosamine (200 mg/kg, i.p.).
      Beginning 2 weeks after the initiation, rats received the antioxidants,
      individually or in combination, in the diet for 6 weeks. All rats were subjected
      to two-thirds partial hepatectomy at week 3 and killed at week 8. The numbers and
      areas of GST-P-positive foci were significantly decreased by single treatment
      with butylated hydroxyanisole (BHA, 1%), tert-butylhydroquinone (TBHQ, 1%) and
      catechol (0.8%), but not with sesamol (0.5%). Combined treatments (BHA + TBHQ,
      catechol + sesamol, or all 4 chemicals) at a quarter of the above dose levels
      resulted in decrease in numbers and areas of foci to levels less than the sums of
      individual inhibition data obtained with the one-quarter levels. Although these
      combined effects were not statistically significant in the additive model, the
      results indicate possible synergistic suppression of carcinogenesis by low-dose
      combined treatment with anti-cancer agents and the usefulness of the present
      protocol for this type of analysis.

PMID- 1618696
TI  - Inhibition of human immunodeficiency virus-1 infection by human conglutinin-like
      protein: in vitro studies.
AB  - The lectin-like protein analogous to bovine conglutinin was purified from human
      serum. The carbohydrate-binding ability of conglutinin-like protein was inhibited
      by D-mannose, N-acetylglucosamine and L-fucose as well as by mannan-containing
      oligosaccharides. By applying a lectin-based ELISA system it was demonstrated
      that conglutinin-like protein binds to human immunodeficiency virus-1 (HIV-1)
      glycoprotein 120 (gp120) via its carbohydrate binding site. In vitro experiments
      with T-lymphoblastoid CEM cells revealed that conglutinin-like protein abolishes
      infection by HIV-1; a 50% cytoprotective concentration of 23.9 micrograms/ml was
      measured. These findings demonstrate that human conglutinin-like protein binds to
      HIV-gp120 and inhibits, under the described in vitro conditions, CEM cell
      infection.

PMID- 1618697
TI  - Flow cytometric bromodeoxyuridine/DNA analysis of hyperthermia and/or adriamycin
      for human pancreatic adenocarcinoma cell line Capan-2.
AB  - The effects of hyperthermia, adriamycin (ADM), and hyperthermia combined with ADM
      on pancreatic cancer cells were investigated from the viewpoint of cytokinetics
      using flow cytometric bromodeoxyuridine (BrdUrd)/DNA analysis. Human pancreatic
      adenocarcinoma cell line Capan-2 was used. The untreated cells could be clearly
      divided into G1, S, G2M phases on contour plots of BrdUrd/DNA distribution. After
      heat treatment at 41-43 degrees C, there was an accumulation of cells in the G2M
      phase which was correlated with the increase in temperature. After heat treatment
      at 44 or 45 degrees C, there was marked increase in non BrdUrd-labeled cells in
      the S phase. ADM caused no change in the percent of non BrdUrd-labeled cells in
      the S phase, even after treatment with a concentration of 1.0 micrograms/ml,
      though that concentration of ADM caused a marked increase in the percent of cells
      in the G2M phase. After hyperthermia combined with ADM, the accumulation of the
      G2M phase increased remarkably, and was significantly higher than that after each
      treatment alone (P less than 0.005); however, non BrdUrd-labeled cells in the S
      phase did not increase. In this study the synergistic effect of hyperthermia
      combined with ADM in increasing the percent of cells in the G2M phase could be
      observed by flow cytometry. The study illustrates the importance of performing in
      vitro flow cytometric BrdUrd/DNA analysis of combined therapy prior to the use of
      the combined therapy in patients.

PMID- 1618698
TI  - Progression of weakly malignant clone cells derived from rat mammary carcinoma by
      host cells reactive to plastic plates.
AB  - Tumor progression is the process by which tumor cells acquire more malignant
      properties, such as invasiveness and metastasis, during tumor development. To
      elucidate mechanisms of tumor progression, we examined the role of interactions
      between the tumor and its host by using a cloned cell line, ER-1, which was
      derived from a rat mammary carcinoma. ER-1 is weakly tumorigenic and non
      metastatic when s.c. injected into syngeneic hosts in single cell suspension.
      However, ER-1 cells show a high incidence of lethal growth when s.c. implanted (5
      x 10(2) cells), being attached to a 10 x 5 x 1 mm polystyrene plate. Tumor cell
      lines (PLT) obtained from tumors which had arisen from the plate-attached ER-1
      cells no longer required plates for their growth in normal hosts, and had
      acquired metastatic ability to the lungs. The malignant phenotypes of PLT were
      stable under a usual culture condition for at least 6 months. Furthermore, the
      incidence of tumor development increased when small numbers of ER-1 cells were
      injected onto plates (or at their periphery) which had previously been implanted
      s.c. without tumor cells. The tumorigenicity of ER-1 cells increased after they
      were cocultivated for more than 30 days with host reactive cells obtained from
      the tissues surrounding the plates. These results suggest that host cells
      reactive to the foreign body (plastic plate) may not only promote the local
      growth of ER-1 cells but also convert them into much more malignant tumors.

PMID- 1618699
TI  - Low frequency of intestinal metaplasia in gastric biopsies from Mexican patients:
      a comparison with Japanese and Swedish patients.
AB  - A systematic analysis of the cellular and structural components of intestinal
      metaplasia (IM) was carried out in 691 consecutive endoscopic gastric biopsies
      from Mexicans patients. Two-thirds of the patients (461 or 66.7%) had chronic
      gastritis, 27.6% (or 191 patients) had gastric ulcers and 5.6% (39 patients)
      gastric carcinomas. IM was found in 17.4% of the gastric biopsies. While IM was
      present in 27.7% of patients with gastric peptic ulcer, patients with gastric
      malignancy had only 18.7%, and the lowest rate (13.4%) was found in 461 biopsies
      from patients with chronic gastritis. IM was influenced by the age but not by the
      sex of the patients. Only one of 120 biopsies with IM (0.8%) had incomplete IM (a
      lesion claimed to be a precursor of gastric carcinoma). In a previous study it
      was found that 32.3% of 359 Swedish patients and 59.2% of 625 Japanese patients
      with chronic gastritis had IM, the proportion of incomplete IM being 23.3% and
      25.1%, respectively. The low frequency of IM among Mexicans (a population with a
      low incidence of gastric carcinoma), contrasts with the moderate frequency of IM
      among Swedes (who have a moderate gastric cancer incidence) and with the high
      frequency of IM among Japanese (with a high incidence of gastric carcinoma).
      These findings recorded in disparate geographical regions strongly support the
      view that IM is a lesion evoked by environmental factors and associated with
      gastric carcinogenesis.

PMID- 1618700
TI  - Quantitation of gastric intestinal metaplasia by morphometry in Japanese
      patients.
AB  - With the aid of an image processor, the length of the intestinal metaplasia (IM)
      was recorded in 33 gastrectomy specimens (23 with early gastric cancer and 10
      with gastric peptic ulcer). A total of 1917 sections were analyzed. The length of
      the areas with IM and the total length of the muscularis mucosa were measured in
      individual sections. The resulting ratio (length of IM/length of muscularis
      mucosa) was noted as the intestinal metaplasia index (IMI), as an expression of
      the extension of IM in the specimens. The IMI was influenced by the age of the
      patient and by the histologic type of the tumor: a higher IMI was found among
      older patients and among patients with adenocarcinoma of intestinal type. A
      comparison with a similar study done in gastrectomy specimens from Swedish
      patients indicates that despite the latter group being older, and the tumors
      being more advanced, the IM was much more extended in the gastric mucosa of the
      Japanese patients with gastric adenocarcinomas of intestinal type. From the
      results it is suggested that extended IM in the gastric mucosa may have some
      bearing on the histogenesis of gastric carcinomas, particularly adenocarcinomas
      of intestinal type.

PMID- 1618701
TI  - Suppressive effect of LD78 on the proliferation of human hemopoietic progenitors.
AB  - LD78 is a cDNA newly isolated from human stimulated tonsillar lymphocytes. The
      expression of LD78 is related to inflammatory responses and its structure has a
      homology with macrophage inflammatory protein 1-alpha, which is known to have an
      inhibitory effect on murine CFU-S. Using a colony assay technique, we examined
      the effects of LD78 on human hemopoietic progenitors. The addition of doses of
      100 ng/ml or more of LD78 suppressed the colony formation of KMT-2, a factor
      dependent myelomonocytic cell line established from cord blood cells; this
      suppressive activity was neutralized by the addition of antibody against LD78.
      The same doses of LD78 suppressed the formation of neutrophil, macrophage, and
      megakaryocytic colonies which were supported by human interleukin-3 and
      erythropoietin; however, LD78 did not affect colony formation by either non
      phagocytic mononuclear cells or sorted CD34+ cells. The conditioned medium of KMT
      2 cells or peripheral blood mononuclear cells cultured with LD78 suppressed
      colony formation by CD34+ cells. From these findings, it is suggested that LD78
      affects phagocytic cells and induces factors that are inhibitory for hemopoiesis.
      We consider LD78 to be a new cytokine that plays an inhibitory role in
      hemopoiesis.

PMID- 1618702
TI  - The number of platinum atoms binding to DNA, RNA and protein molecules of HeLa
      cells treated with cisplatin at its mean lethal concentration.
AB  - HeLa S-3 cells were treated with 195mPt-radiolabeled cis
      diamminedichloroplatinum(II) (CDDP) under various conditions, and the
      relationship between lethal effect and the number of Pt atoms binding to DNA, RNA
      and proteins was examined. The mean lethal concentrations for the cells treated
      with CDDP at 37 degrees C for 1, 2 and 3 h were 2.8, 2.0 and 1.1 microgram/ml,
      respectively. By using identically treated cells, the number of Pt atoms combined
      with DNA, RNA and protein molecules were determined after fractionation of the
      cells using the method of Schneider. In this way, the D0 values given as the drug
      concentration were substituted for the number of Pt atoms combined with each
      fraction, then the target volumes expressed as the reciprocals of D0 values were
      calculated for each fraction. The results provide strong support for the idea
      that DNA is the primary target for cell killing by CDDP, and the target volumes
      were 5.17 x 10(4), 5.71 x 10(4) and 1.03 x 10(5) nucleotides for 1, 2 and 3 h
      treated cells, respectively.

PMID- 1618703
TI  - Kinetic analysis of combination effect of navelbine (KW-2307) with cisplatin
      against human lung adenocarcinoma PC-12 cells in culture.
AB  - The combination effect of navelbine (NVB, KW-2307), a newly synthesized vinca
      alkaloid, and cisplatin (CDDP) was compared with that of vindesine (VDS) and CDDP
      using human lung adenocarcinoma PC-12 cells. The growth-inhibitory activity of
      NVB or VDS was time-dependent, whereas that of CDDP was AUC (area under the
      curve)-dependent. When NVB or VDS was used in combination with CDDP
      simultaneously for 24 h, antagonism was observed in terms of growth-inhibitory
      activity. However, additive combination effect was observed when NVB or VDS
      treatment was followed by CDDP treatment. On this treatment schedule, a
      synergistic combination effect was observed in terms of the cell-killing activity
      assessed by colony formation assay. The growth-inhibitory activity of NVB or VDS
      was detected 24 h after the treatment, whereas that of CDDP became significant 72
      h after the treatment. NVB and VDS caused cell accumulation in G2M phase at 10
      times their IC80 values, and cells with less than diploid DNA content were
      detected after 24 h at IC80. CDDP caused accumulation of cells in S phase, and
      the effect became detectable 16 h after the treatment. The DNA histogram of cells
      treated with NVB or VDS in combination with CDDP was a superposition of those of
      cells treated with each drug alone. Significant differences in the
      characteristics of anticellular activity were not detected between NVB and VDS,
      although NVB inhibited cell growth at a slightly lower concentration than VDS at
      the short exposure time of 1-8 h.

PMID- 1618704
TI  - Metallic elements in the perilymph measured with an inductively-coupled plasma
      atomic emission spectrometer.
AB  - Metallic elements in the perilymph of the scala tympani in normal and
      acoustically overstimulated guinea pigs were measured using a new method, an
      inductively-coupled plasma atomic emission spectrometry. The concentrations of
      phosphorus and eight metallic elements, i.e. calcium, copper, iron, potassium,
      magnesium, sodium, lead and zinc were measured simultaneously in a 2 microliters
      sample of perilymph. The mean concentration values of calcium, copper, iron,
      magnesium, phosphorus, lead and zinc were 2.03 mM, 38.5 microM, 69.3 microM,
      0.822 mM, 0.851 mM, 43.5 microM and 25.0 microM, respectively. There was no
      significant effect of acoustic overstimulation on the concentrations of these
      elements except for magnesium, which decreased significantly after the exposure
      to a intense sound (2 kHz, 115 dB SPL) for 15 min. This is the first report
      describing the synchronous determination of metallic poly-elements, including
      copper, iron, lead and zinc, in the perilymph.

PMID- 1618705
TI  - Effects of tone burst frequency and intensity on the auditory brainstem response
      (ABR) from albino and pigmented rats.
AB  - Young adult male Sprague-Dawley (SD) and Long-Evans (LE) rats were evaluated
      using the auditory brainstem response (ABR). ABRs were evoked by stimuli with
      intensities ranging from 15 to 100 dB peSPL. Stimuli were tone bursts of 2000,
      4000 and 8000 Hz. As stimulus intensity decreased from 100 to 15 dB, the ABR peak
      latencies prolonged, interpeak latencies (IPLs) shortened and amplitudes
      decreased. As stimulus frequency decreased from 8000 to 2000 Hz, ABR latencies
      prolonged, amplitudes decreased and ABR thresholds increased. The longest IPLs
      were in response to the 4000 Hz tone bursts. SD rats had ABRs with shorter peak
      latencies, larger amplitudes and lower thresholds than LE rats. The IPLs usually
      did not show significant strain-dependent differences. Our observations on
      stimulus intensity and frequency are consistent with previous reports. Our
      observations also suggest that the SD (albino) rat has better auditory acuity
      than the LE (pigmented) rat over the frequency range of 2000 to 8000 Hz. This
      implies that previous concerns about the use of albino animals in audiological
      research are somewhat overstated.

PMID- 1618706
TI  - Single-fibre and whole-nerve responses to clicks as a function of sound intensity
      in the guinea pig.
AB  - This paper describes a study of the intensity dependence of click-evoked
      responses of auditory-nerve fibres in relation to the simultaneously recorded
      compound action potential (CAP). Condensation and rarefaction clicks were
      presented to normal hearing guinea pigs over an intensity range of 60 dB. The
      recorded poststimulus time histograms (PSTHs) were characterized by the latency
      (tp), amplitude (Ap) and synchronization (Sp) of their dominant peak, parameters
      that are particularly important for the understanding of the CAP. For all fibres
      tp decreased monotonically with increasing intensity, in a continuous way for
      fibres with high characteristic frequency (CF greater than 3 kHz), and in
      discrete steps of one CF-cycle for low-CF (CF less than or equal to 3 kHz)
      fibres. An additional analysis of PSTH envelopes revealed that average latency
      shifts with intensity are similar for all CFs above 2 kHz. For all fibres Ap
      increased monotonically with intensity; the increase was stronger and maximum
      values were larger for low-CF than for high-CF fibres. A schematic model PSTH was
      then formulated on the basis of the experimental data. A sum of these model PSTHs
      from a hypothesized fibre population was convolved with an elemental unit
      response (Versnel et al., 1992) in order to simulate the compound action
      potential. Synthesized CAPs agreed with experimental CAPs in their main aspects.

PMID- 1618707
TI  - Round-window recorded potential of single-fibre discharge (unit response) in
      normal and noise-damaged cochleas.
AB  - Unit responses (URs) of eighth-nerve fibres have been determined at the round
      window by spike-triggered averaging in both normal and pathological guinea pig
      cochleas. The pathology was mainly noise-induced damage. The URs have been
      analysed with respect to their dependence on the fibre's threshold,
      characteristic frequency (CF) and spontaneous rate (SR). The results from normal
      cochleas confirmed earlier data (Prijs, 1986): the UR has a diphasic waveform and
      the amplitude of its negative first peak is about 0.1 microV. From the six
      parameters (amplitude, latency, and width of the two peaks) by which the UR was
      described only the amplitude of the positive peak showed a significant variation
      with CF: a small decrease with increasing CF (CF-range 0.1 to 20 kHz). This
      finding may possibly be caused by oscillations in the spike-triggered average for
      low CFs. URs for most low- and medium-SR fibres were found to be large (greater
      than 0.3 microV). However, this result is interpreted as an artefact caused by
      synchrony of fibre spontaneous activity. In damaged cochleas only slight changes
      of the UR were found: the waveform duration became significantly shorter and on
      some occasions the positive peak increased in amplitude, but latency and
      amplitude of the negative component of the UR remained unchanged.

PMID- 1618708
TI  - Cochlear degeneration in aged rats of four strains.
AB  - Animals with various degrees of inbreeding, some of which are albino, are
      frequently used in biological research. Albinos do not produce melanin and it is
      therefore absent from the cochlea. While the function of melanin is unknown, it
      has been hypothesized that it is involved in cochlear homeostasis. It is possible
      then, that age-related degeneration may be affected by the presence or absence of
      melanin. We therefore evaluated young (2-6 months old) and aged (24-36 months
      old) cochleas in 4 different rat strains: albino Fischer 344 and Lewis rats and
      pigmented Lewis-Brown Norway F1 rats and Brown Norway rats. Cochlear morphology
      was the same across all strains of young adult animals with the exception that
      the pigmented animals had small, darkly stained granules in the stria vascularis.
      The aged pigmented animals all had large granules as well as small ones.
      Degeneration of spiral ganglion cells in the apical region of the ganglion had
      occurred in the old animals of all strains. Strial degeneration at the apex was
      also present in aged animals. There was no correlation between the presence or
      absence of melanin and the magnitude of cochlear degenerative changes in the aged
      animals. The presence or absence of melanin therefore, appears to have no effect
      on cochlear degeneration in the aged rat cochlea.

PMID- 1618709
TI  - The human frequency-following response (FFR): normal variability and relation to
      the click-evoked brainstem response.
AB  - The frequency-following response (FFR) was recorded from twenty human subjects
      (11 female and 9 male) over a frequency range of 128-832 Hz in order to study the
      normal variability of this evoked potential and its dependence on age and sex.
      Moreover the relation of the FFR to the click-evoked brain stem response (BER)
      was analyzed in order to contribute to the FFR source discussion. The FFR had a
      maximum amplitude of about 400 nV and a latency of about 6.4 ms for stimulus
      frequencies around 350 Hz; the inter-individual variance of the best frequency
      and of the shape of the frequency function was considerable. Large second
      harmonics were seen in the FFR to stimuli below about 200 Hz. The FFR amplitude
      tended to be larger in younger subjects, whereas no such effect was found for the
      BER. No significant sex effect was found for the FFR amplitude, whereas the BER
      waves IV and VI were larger for females than for males. There were no
      correlations between FFR and BER latencies. Significant correlations were found
      between the amplitudes of the FFR and BER components II, III and IV, but not of
      waves V and VI. The results support the notion that the FFR and the BER reflect
      different mechanisms. Moreover the results do not favor the common hypothesis
      that the inferior colliculus is the major source of the scalp-recorded human FFR,
      but rather point to lower brainstem levels.

PMID- 1618710
TI  - Expression of heat shock protein, HSP72, in the guinea pig and rat cochlea after
      hyperthermia: immunochemical and in situ hybridization analysis.
AB  - The induction of the heat shock protein, HSP72, was studied in the cochlea of
      guinea pigs and rats subjected to a hyperthermic stress. Analyses were done by
      immunoblotting and immunocytochemistry at 6 and 12 h after heat shock, using a
      commercially available monoclonal antibody (Amersham), and by in situ
      hybridization 1 h after heat shock using an oligonucleotide probe. In guinea pig
      immunoblots of the cochlea, HSP72 was present in both unstressed and heat
      stressed animals and immunocytochemistry did not reveal any difference of
      staining between them. As opposed to guinea pig, HSP72 was not found in
      unstressed rat cochlea. Heat shock induced HSP72 expression in most inner ear
      tissues of the rat examined by immunoblotting. Immunocytochemistry and in situ
      hybridization localized HSP72 synthesis in ganglion neurons, Schwann cells,
      spiral limbus, spiral ligament and stria vascularis. The strongest
      immunoreactivity and highest density of silver grains were seen in the stria
      vascularis. All blood vessels were strongly immunoreactive and were outlined with
      silver grains. These results show that HSP72 synthesis can be induced by
      hyperthermia in rat cochlea and suggest that this protein could be a useful
      marker for assessment of the effects of specific stresses in this organ.

PMID- 1618711
TI  - Frequency and intensity discrimination in Mongolian gerbils, African monkeys and
      humans.
AB  - Frequency (delta F) and intensity (delta I) difference limens were directly
      compared in Mongolian gerbils (Meriones unguiculatus), Old World African Monkeys
      (Cercopithecus mitis, Cercocebus albigena), and humans. Methods employed a
      repeating background AX discrimination procedure, and positive (food)
      reinforcement for animals. For delta I, there were small quantitative differences
      between the species. At 1 kHz, 70 dB SPL, DLs averaged 2.82 dB for gerbils, 2.29
      dB for monkeys, and 0.75 dB for humans. For delta F, there were larger
      differences between the species. At 1 kHz, 60 dB SPL, frequency DLs were highest
      for gerbils, averaging 108 Hz. DLs were lower for monkeys, averaging 32.6 Hz,
      similar to recently reported DLs for other Old World monkeys (Prosen et al.,
      1990). Human DLs, averaging 2.27 Hz, were markedly lower than those of either
      monkeys or gerbils. These results suggest that animals provide better models of
      human delta I than delta F.

PMID- 1618712
TI  - Changes in the tonotopic map of the dorsal cochlear nucleus following induction
      of cochlear lesions by exposure to intense sound.
AB  - Hamsters were exposed to intense tones (10 kHz) at levels and durations
      sufficient to cause stereocilia lesions. The purpose was to determine how the
      tonotopic map of the dorsal cochlear nucleus (DCN) readjusts to loss of receptor
      sensitivity. Neural population thresholds and tonotopic organization was mapped
      over the surface of the DCN in normal unexposed animals and those showing tone
      induced lesions. The results indicate that cochlear lesions characterized mainly
      by loss of stereocilia in a restricted portion of the organ of Corti cause
      changes in a corresponding region of the tonotopic map which reflect primarily
      changes in the shape and thresholds of neural tuning curves. In many cases the
      center of the lesion was represented in the DCN as a distinct characteristic
      frequency (CF) gap in the tonotopic map in which responses were either extremely
      weak or absent. In almost all cases the map area representing the center of the
      lesion was bordered by an expanded region of near-constant CF, a feature
      superficially suggestive of map reorganization. These expanded map areas had
      abnormal tip thresholds and showed other features suggesting that their CFs had
      been shifted downward by distortion and deterioration of their original tips.
      Such changes in neural tuning are similar to those observed by others in the
      auditory nerve following acoustic trauma, and thus would seem to have a
      peripheral origin. Thus, it is not necessary to invoke plastic changes in the
      cochlear nucleus to explain the changes observed in the tonotopic map.

PMID- 1618713
TI  - Cochleotopic selectivity of a multichannel scala tympani electrode array using
      the 2-deoxyglucose technique.
AB  - The 2-deoxyglucose (2-DG) technique was used to study the cochleotopic
      selectivity of a multichannel scala tympani electrode array in four cats with
      another acting as an unstimulated control. Each animal was unilaterally deafened
      and a multichannel electrode array inserted 6 mm into the scala tympani.
      Thresholds to electrical stimulation were determined by recording electrically
      evoked auditory brainstem responses (EABRs). Each animal was injected with 2-DG,
      and electrically stimulated using bipolar electrodes located either distal or
      proximal to the round window. The contralateral ear was stimulated with acoustic
      tone pips at frequencies that matched the electrode place. Stimulation of both
      distal and proximal bipolar electrodes at 3 x EABR threshold, evoked localized 2
      DG labelling in both ipsilateral cochlear nucleus (CN) and the contralateral
      inferior colliculus (IC), which was very similar in orientation and breadth to
      labelling evoked by the contralateral tone pips. The cochleotopic position of
      labelling to proximal stimulation was located in the 24-26 kHz region of each
      structure, whereas the distal labelling was located around 12 kHz. Distal
      stimulation at 10 x EABR threshold produced very broad 2-DG labelling in IC
      centered around the 12 kHz place. The present 2-DG results clearly illustrate
      cochleotopic selectivity using multichannel bipolar scala tympani electrodes. The
      extent of this selectivity is dependent on electrical stimulus levels. The 2-DG
      technique has great potential in evaluating the efficacy of new electrode array
      designs.

PMID- 1618714
TI  - Stiffness of hair bundles in the chick cochlea.
AB  - The stiffness of hair bundles from isolated chick cochlear hair cells was
      measured in tissue culture medium. A water jet was used to deflect fiberglass
      fibers, quartz fibers, and hair bundles of isolated hair cells. A voltage
      displacement curve was generated for a water jet ramp stimulus applied to
      miniature fiberglass and quartz fibers. Fiber displacements were measured using
      video image subtraction techniques. A force-voltage calibration curve was then
      derived for the fibers by modelling them as cantilever beams subjected to point
      forces at the tips. A voltage-displacement curve was then generated for isolated
      hair cell stereociliary bundles using the same procedure as for the fibers. A
      corresponding force-displacement curve was derived for isolated hair cells under
      water jet stimulation by correlating maximum ramp voltage from the hair cell's
      voltage-displacement curve to a corresponding force applied to a fiber from the
      fiberglass fiber calibration curve. The stiffness of the hair bundle, which is
      the slope of the hair cell's force-displacement curve, was then calculated using
      Hooke's law, assuming the force was distributed along the entire length of the
      hair bundle. The mean stiffness value was 5.04 +/- 2.68 x 10(-4) N/m for 14 hair
      cells, and was in close agreement with previously reported stiffness values of
      several investigators utilizing different animal models and procedures.

PMID- 1618715
TI  - Conjugal transfer of R plasmids to and from Enterobacteriaceae isolated from
      sewage.
AB  - The potential of the transfer of natural plasmids between sewage strains has been
      studied. In vitro transfer was conducted at 37 degrees C in tryptone soya broth
      and sterile raw sewage as mating media. In situ transfer was carried out in
      sterile raw sewage within membrane diffusion chambers at 10.6 degrees C. When the
      recipient was a laboratory strain of Escherichia coli K-12, the in situ frequency
      values were significantly lower (P less than 0.001) than those obtained in vitro
      for the same mating pair. When the laboratory recipient was replaced with
      recipients from the same sewage source, frequency values decreased progressively
      from the optimum conditions to the most adverse. However, in situ frequency
      values were higher than those for the same donors mated with a laboratory
      recipient.

PMID- 1618716
TI  - Synthetic DNA probes for detection of genes for enterotoxins A, B, C, D, E and
      for TSST-1 in staphylococcal strains.
AB  - A dot blot hybridization technique with oligonucleotide probes was developed for
      the specific detection of the TSST-1 gene and the staphylococcal enterotoxin (SE)
      genes A, B, C, D and E. For each toxin gene a probe sequence was chosen from the
      previously determined sequence. A total of 145 staphylococcal strains (133
      Staphylococcus aureus and 12 coagulase-negative staphylococci (CNS) were studied
      by this genotypic method and by two phenotypic assays (gel immunodiffusion and
      ELISA). An excellent correlation (96%) was observed between the genotypic and
      phenotypic assays. DNA from two CNS strains hybridized with a probe without
      detection of the corresponding toxin (SEB for one strain and SEC for the other
      strain). One Staph. aureus strain was shown to be an SEC producer, but was not
      detected by the corresponding probe. Gene probe and immunological assays seem to
      be complementary methods for studies of staphylococcal strains producing (or
      potentially producing) TSST-1 or enterotoxins.

PMID- 1618717
TI  - Detection of salmonellas by DNA hybridization with a fluorescent alkaline
      phosphatase substrate.
AB  - This study evaluates a DNA hybridization assay for salmonella with AttoPhos (JBL
      Scientific, San Luis Obispo, CA), a fluorescent substrate for alkaline
      phosphatase. The probe used (50 ng/ml) was a biotinylated 600 bp fragment
      consisting of a tandem repeat of an insertion sequence (IS200) found in most
      Salmonella spp. evaluated. The hybridization was carried out at 65 degrees C for
      2 h without prior prehybridization and hybrids were detected by the addition of a
      streptavidin-alkaline phosphatase conjugate. Circles (5 mm) were cut from the
      membrane and placed in a cuvette containing 1 ml of 1 mmol/l AttoPhos. The
      reaction was evaluated after 30 min at 37 degrees C with a fluorometer with an
      excitation wavelength of 440 nm and an emission wavelength of 550 nm. The
      sensitivity of the probe was estimated to be 10,000 copies of target DNA or 5 x
      10(-20) mol of DNA. All 74 salmonella strains tested reacted with the probe but
      none of the 98 heterologous species tested gave positive results. The results of
      this study indicate that our assay method, which employs a biotinylated tandem
      repeat of IS200 and AttoPhos, is a specific and highly sensitive quantitative
      method for the detection of salmonellas.

PMID- 1618718
TI  - Fungal and actinomycete spore aerosols measured at different humidities with an
      aerodynamic particle sizer.
AB  - An aerodynamic particle sizer (APS) that uses laser Doppler velocimetry was used
      to determine aerodynamic diameters of spores of fungal and thermophilic
      actinomycete species common in mouldy hay, aerosolized at different humidities
      and temperatures. Results were compared with those obtained from inertial
      impaction in a cascade impactor. The APS gave slightly smaller measurements than
      the cascade impactor. Both methods gave aerodynamic diameters generally slightly
      smaller than the average spore dimensions observed on cascade impactor slides
      with a microscope. The latter measurements were less than axial dimensions given
      in the literature. Brief passage of spores through air at 95% relative humidity
      (RH) and 38 degrees C, compared with 40% RH and 20 degrees C, caused an immediate
      increase in their aerodynamic diameter and the breaking of chains of spores.
      Cultures maintained at 75% RH and aerosolized at 98% RH similarly produced larger
      spore particles than those passed through dry air. These findings have
      implications for mould-induced asthma and allergic alveolitis since they relate
      to physical behaviour of airborne spores and particle deposition sites in the
      lung.

PMID- 1618719
TI  - The effect of dilution rate and pH on biomass and proteinase production by
      Micrococcus sedentarius grown in continuous culture.
AB  - Micrococcus sedentarius, an organism associated with pitted keratolysis, produced
      two proteinases in culture supernatant fluids, as shown by non-denaturing PAGE
      with overlaying with a casein substrate. A mixture had optimal activity at pH 10
      with azocasein substrate. At pH 7.1 and 8.1 in continuous culture with varying
      dilution rates high proteinase production occurred at relative specific growth
      rates (mu rels) 0.39 and 0.77 and biomass concentrations decreased with
      increasing dilution rate. One proteinase was constitutive and varied little in
      production with different growth rates. The other proteinase was under control
      with high production at low growth rates and no production at high growth rates.
      With varying pH at mu rels 0.39 and 0.77 maximum biomass concentration and
      proteinase production occurred between pH 8.0 and 9.0 as did the highest specific
      growth rate. These results support the hypothesis that Mic. sedentarius produces
      pitting in the stratum corneum when the skin is hydrated and the pH rises above
      neutrality.

PMID- 1618720
TI  - Typing of Aeromonas strains from patients with diarrhoea and from drinking water.
AB  - Aeromonas strains (187) from human diarrhoeal stools and from drinking water
      (263) in The Netherlands were typed by three different methods. Biotyping alone
      was found to be of little value for epidemiological studies because 84% of all
      strains belonged to only 10 biotypes. Common biotypes could be further
      differentiated by serotyping. Gas-liquid chromatography of cell wall fatty acid
      methyl esters (FAME) was useful for species identification as well as for typing:
      86% of all strains could be identified to the species level, and within this
      group 92% of all identifications corresponded with the biotype. Cluster analysis
      and principal component analysis of FAME profiles could be used for comparison of
      strains from different sources and gave the same general conclusions as bio- and
      serotyping. There was little overall similarity between Aeromonas strains from
      human (diarrhoeal) faeces and from drinking water, differences being most
      pronounced for Aeromonas caviae and least for A. sobria.

PMID- 1618721
TI  - An unusual low-abdominal tumor: cystadenoma of the seminal vesicle.
AB  - Cystadenoma of the seminal vesicle is an extremely rare benign tumor, which to
      our findings has only been mentioned earlier in seven previous reports. It is a
      benign and mostly multilocular tumor, thought to originate from embryologic
      remnants. Preoperative diagnosis is rarely made. Complete extirpation is the
      correct treatment. We present this first Belgian case with a discussion of
      imaging techniques, symptomatology, pathology, diagnosis, and treatment.

PMID- 1618722
TI  - Acutely symptomatic benign mediastinal cysts.
AB  - Usually, cystic mediastinal masses are considered as benign. However, the size of
      the cyst is of importance, chiefly in a closed space such as the superior
      mediastinum. Rarely a dramatic symptomatology may develop though this was the
      case in the two patients we describe, who were admitted in the department. In the
      first case (a parathyroid cyst), the symptoms were due to a thrombosis of the
      left innominate vein, and in the second case (a thyroid cyst), the severity was
      dominated by a dramatic compression of the trachea and the vessels. The
      contribution of computed tomography is nowadays undisputed. It enables the
      diagnosis of the cystic nature before surgery. The diagnosis can easily be
      confirmed by percutaneous drainage.

PMID- 1618723
TI  - [Lumbar arachnoid cysts: 2 unusual cases].
AB  - Two cases of arachnoid cyst in the lumbar region are described. One is
      intradural, acquired, and associated to severe arachnoiditis while the other is
      extradural in location and probably congenital. The interest of myelography, CT
      myelography, and MRI for the diagnosis is discussed.

PMID- 1618724
TI  - [Encysted gossypiboma of the lesser omentum: complementary aspects of echography
      and computerized tomography].
AB  - The authors report the fortuitous demonstration of an asymptomatic gossypiboma
      during the preoperative staging of a rectal carcinoma 13 years after abdominal
      surgery for perforated gastric ulcer. Ultrasonography disclosed a well-defined
      hypoechoic mass containing highly echogenic foci with a strong posterior shadow.
      The CT findings are reported, as well as the complementary aspects of sonography.
      Differential diagnosis from tumors of the lesser omentum is also presented.

PMID- 1618725
TI  - Osteoarthritis of the facet joints and its role in low-back pain: evaluation with
      conventional tomography.
AB  - Thirty-seven patients with chronic low-back pain and an atypical irradiation to
      one or both legs were examined by conventional tomography of the facet joints. A
      disc herniation was excluded by computed tomography (CT) in 31 patients. The
      facet joints were considered normal in 4 patients. Four grades of facet joint
      disease were used to classify the pathological changes. Correlation of the
      radiological findings with the facet joint block by injection of a local
      anesthetic was obtained in 12 patients. It appears that conventional tomography
      is a very sensitive technique as it is possible to detect even discrete
      abnormalities of the facet joints. However, as it is time consuming and high in
      radiation dose, the examinations should be reserved for patients with a normal CT
      examination of the lumbar spine in whom there still remains a high suspicion of
      facet joint disease.

PMID- 1618726
TI  - [Vertebral osteoporosis manifesting systemic mastocytosis].
AB  - A case of systemic mastocytosis in a 33-year-old man, with multiple spine
      fractures caused by severe osteoporosis, is presented. The diagnosis could only
      be established three years after the initial symptoms, when the patient developed
      skin eruption. Skin and bone biopsy, as well as histamine dosage, confirmed the
      diagnosis.

PMID- 1618727
TI  - Magnetic resonance imaging of extraabdominal desmoid tumors.
AB  - The authors describe the MR appearance of extra-abdominal desmoid in three
      patients, with longitudinal follow-up during a period of up to 29 months in two
      of them. For the MR examinations various pulse sequences, including spin-echo and
      gradient-echo sequences, were used. Both non-enhanced and Gd-DTPA contrast
      enhanced studies were made. We found gradient-echo T2*-weighted sequences best
      suited for the detection of extra-abdominal desmoids. Best correlation between MR
      features and histologic findings was obtained on spin-echo T2- and contrast
      enhanced T1-weighted studies. Although preliminary, our results suggest that MRI
      might predict evolution of extra-abdominal desmoids by providing data about
      cellularity and relative amount of mucoid matrix of the lesions.

PMID- 1618728
TI  - [Anorectal anaplastic cancer (neuroendocrine)].
AB  - An extensive case of undifferentiated neuroendocrine carcinoma with small cells
      of the anorectal region is reported. The carcinoma is related to pulmonary
      anaplasia and quite rare in the colonic and rectal region. Its aggressivity is
      considerable with a strong propensity for hematogenous and lymphatic metastases
      and with a disastrous prognosis: 0% survival over 1 year. The incidence, the
      characteristic features, the histogenesis, and the anatomical pathology of this
      rare neoplasm are mentioned. Furthermore, the case illustrates a radiological
      pattern typical for major lymphatic dissemination with an intra- and
      extraparietal component. The mechanism of dissemination is explained by the
      "lymphatic block" theory. The absolute necessity of obtaining an histology in
      radiologically unusual and/or extensive cases is mentioned.

PMID- 1618729
TI  - Signal transduction and osmoregulation in Escherichia coli: a novel mutant of the
      positive regulator, OmpR, that functions in a phosphorylation-independent manner.
AB  - In Escherichia coli, expression of the outer membrane proteins, OmpF and OmpC, is
      regulated by the regulatory factors, EnvZ and OmpR, at the transcriptional level
      in response to the medium osmolarity. In this particular osmotic regulation,
      phosphorylation of OmpR at an aspartate residue (Asp-55) by EnvZ plays an
      important role. The previously isolated mutant, ompR55Q, with the amino acid
      replacement of Asp-55 to Gln, exhibits an OmpF- and OmpC- phenotype. In this
      study, we isolated a novel type of ompR mutant, in which the defect caused by the
      ompR55Q mutation is suppressed. The intragenic suppressor mutation we isolated
      results in the amino acid replacement of Tyr-102 to Cys in the N-terminal domain
      of OmpR, and exhibits an OmpF+ and OmpC+ phenotype in response to the medium
      osmolarity in an EnvZ-independent manner. It was revealed that this amino acid
      replacement in OmpR enhances the in vitro DNA-binding ability to the cognate
      DNAs. These results suggested that OmpR is capable of functioning in a
      phosphorylation-independent manner under certain in vivo conditions, and further
      suggested that an EnvZ-independent mechanism may also be involved in the
      osmotically regulated expression of ompF and ompC.

PMID- 1618730
TI  - Mutualism based on stress: selective synthesis and phosphorylation of a stress
      protein by an intracellular symbiont.
AB  - The effects of a temperature shift-up and various metabolic inhibitors on the
      protein synthesis of an endosymbiont isolated from the pea aphid were studied.
      The syntheses of at least three major polypeptides were stimulated transiently
      immediately after a temperature shift-up, and treatment with ethanol and heavy
      metals (Cd2+ and As2+). One of these proteins, the 63 kDa heat-shock protein (63
      kDa HSP), was immunoprecipitated with antiserum raised against symbionin, which
      is selectively synthesized by the endosymbiont harbored by the aphid
      bacteriocytes. The 63 kDa heat-shock protein has a molecular mass of 800 kDa and
      is more acidic than symbionin. It was also shown that symbionin is subject to
      phosphorylation in vivo and in vitro after a temperature shift-up. It was thought
      likely that forms of environmental stress such as heat shock and metabolic
      inhibitors stimulate the synthesis of a phosphorylated form of symbionin. It was
      also suggested that the in vitro phosphorylation of symbionin is due to its own
      catalytic activity. Since symbionin is a homolog of the Escherichia coli groEL
      protein, a stress protein, it is likely that the endosymbiont suffers stress when
      harbored by the bacteriocytes and responds in a similar manner to environmental
      stress when outside these cells.

PMID- 1618731
TI  - Carbohydrate-binding peptides from several anti-H(O) lectins.
AB  - Peptide fragments have been obtained from L-fucose-binding anti-H(O) lectins
      [Lotus tetragonolobus lectin (LTA) and Ulex europeus lectin I (UEA-I)] and di-N
      acetylchitobiose-binding anti-H(O) lectins [Ulex europeus lectin II (UEA-II) and
      Laburnum alpinum lectin I (LAA-I)] by treatment with endoproteinase Asp-N or Lys
      C. The peptide fragments were fractionated by affinity chromatography on a column
      of Fuc-Gel for LTA and UEA-I, and on a column of N-acetyl-D-glucosamine oligomer
      Sepharose for UEA-II and LAA-I. The peptides with affinity for these columns were
      identified by peptide sequencing. All of these retarded peptides were found to be
      parts of the metal-binding regions of these lectins. It is strongly suggested
      that these peptides represent the carbohydrate-binding and metal ion-binding
      sites of legume lectins, respectively.

PMID- 1618732
TI  - Effect of dietary sodium restriction on mRNA for aldosterone synthase cytochrome
      P-450 in rat adrenals.
AB  - Changes in the level of mRNA for aldosterone synthase cytochrome P-450
      (cytochrome P-450aldo) in rats on dietary sodium restriction were studied by
      means of Northern and slot blot hybridization using an oligonucleotide probe that
      allowed differentiation of the message for this enzyme from that for cytochrome P
      450(11)beta. These two enzymes have been shown to be highly homologous with each
      other, exhibiting 88% homology in their nucleotide sequences in the coding
      region. Upon sodium restriction for 2 weeks, cytochrome P-450aldo mRNA in rat
      adrenals increased 7-fold, whereas the cytochrome P-450(11) beta mRNA level in
      the same adrenals did not change significantly. The increase in cytochrome P
      450aldo mRNA paralleled that in cytochrome P-450aldo protein, as analyzed by
      immunoblot technique. These results, together with our previous finding that
      angiotensin II induced cytochrome P-450aldo in rat adrenocortex [Shibata, H.,
      Ogishima, T., Mitani, F., Suzuki, H., Murakami, M., Saruta, T., & Ishimura, Y.
      (1991) Endocrinology 128, 2534-2539], suggest that the production of cytochrome P
      450aldo is regulated by angiotensin II at the pretranslational level, most likely
      at the transcriptional level.

PMID- 1618733
TI  - Membrane assembly of lactose permease of Escherichia coli.
AB  - Lactose permease, the lacY gene product in Escherichia coli, is an integral
      membrane protein. Its induction was examined in secAts and secYts mutants by
      measuring o-nitrophenyl-beta-galactoside uptake activity. In contrast to the
      synthesis of the maltose binding protein, the malE gene product, which is
      dependent on the secA and secY gene products, lactose permease seemed to be
      produced and integrated functionally into membrane independently of SecA or SecY.
      Gene fusion of the lamB signal sequence to the N-terminal part of the lactose
      permease gene resulted in production of active fused permease in the E. coli
      membrane. The signal sequence did not seem to be processed, judging from its
      mobility on SDS polyacrylamide gel electrophoresis. E. coli cell growth was super
      sensitive to induction of production of the fused permease with the signal
      sequence in contrast to induction of the normal lactose permease. These results
      are consistent with the above observation that production and integration of LacY
      protein into membrane is relatively independent of the SecY protein that may have
      a certain specificity for the signal sequence or, more generally, membrane
      translocation intermediates.

PMID- 1618734
TI  - Characterization of adrenodoxin precursor expressed in Escherichia coli.
AB  - The precursor of bovine adrenodoxin (pAd), a mitochondrial protein, was expressed
      in Escherichia coli. The cloned cDNA of pAd was ligated to an expression vector
      pET-3d, and silent mutations were introduced into the N-terminal portion of the
      cDNA in order to increase the expression. The precursor was highly expressed
      (approximately 20% of the total cell protein) as the inclusion body, and
      contained an iron-sulfur center as judged from its optical absorption spectra.
      The inclusion body was solubilized with 7 M urea and pAd was purified in the
      presence of urea. The purified pAd was efficiently imported into isolated bovine
      adrenal cortex mitochondria and processed to the mature form. The import reaction
      required ATP inside the mitochondria in addition to the inner membrane potential,
      and was strongly inhibited by trypsin treatment of the mitochondria, as in the
      case of the in vitro translated precursor. It was, however, not dependent on the
      unfolding activity of the cytosolic factor with extramitochondrial ATP.

PMID- 1618735
TI  - Reconstitution of the active form from the amino- and carboxyl-terminal fragments
      of a reactive site-modified subtilisin inhibitor of adzuki beans (Vigna
      angularis).
AB  - The complex of an adzuki bean subtilisin inhibitor (ASI-II) with its target
      enzyme, prepared at pH 7.6, was subjected to reversed-phase HPLC in a
      trifluoroacetic acid-acetonitrile system. Two peptide fragments derived from the
      reactive site-modified ASI-II were obtained. The analyses of the amino acid
      composition and sequence of these two fragments revealed that one corresponded to
      the region from the amino-terminal Lys to the reactive site P1 Ala and the other,
      to the region from the reactive site P1' Asp to the carboxyl-terminal Gly of the
      inhibitor. Although neither fragment alone showed inhibitory activity against
      subtilisin, an equimolar mixture of both fragments was found to inhibit strongly
      the target enzyme, as did the intact inhibitor. Thus, it was suggested that the
      two fragments have strong specific affinity with each other, regenerating the
      reactive site-modified ASI-II, to inhibit the target enzyme.

PMID- 1618736
TI  - Evidence for the existence of O-linked sugar chains consisting of glucose and
      xylose in bovine thrombospondin.
AB  - We have recently discovered unusual sugar chains [xylose-glucose and (xylose)2
      glucose] linked to a serine residue in the first epidermal growth factor (EGF)
      like domains of human and bovine coagulation factors VII, IX, and protein Z. The
      sequence surrounding this serine residue has a common -Cys-X-Ser-X-Pro-Cys-
      structure. Since one (residues 533-538) of the three EGF-like domains found in
      human thrombospondin contains the conserved sequence, we examined the presence of
      such O-linked sugar chains in bovine thrombospondin (bTSP) and its 210-kDa
      fragment. Component sugar analysis after pyridylamination (PA) of the acid
      hydrolysates of the S-aminoethylated proteins revealed that the proteins contain
      glucose (Glc) and xylose (Xyl). The oligosaccharide moieties released from intact
      bTSP by hydrazinolysis followed by pyridylamination were separated into two PA
      oligosaccharides by high performance liquid chromatography (HPLC). Component
      sugar analysis of these PA-oligosaccharides indicated that they consist of Glc
      and Xyl in molar ratios of 1:1 and 1:2 (or 1:3). The reducing ends of both PA
      sugar chains were found to be PA-Glc, as judged from the retention time of the
      HPLC peak of their hydrolysates. The presence of these PA-sugar chains in bTSP
      was confirmed by HPLC mapping with two different columns, using standard PA-di-
      or PA-trisaccharide derived from coagulation factors. From these results, we
      concluded that bTSP contains O-linked sugar chains consisting of Glc and Xyl in
      one of its three EGF-like domains.

PMID- 1618737
TI  - Purification and characterization of formaldehyde dehydrogenase from rat liver
      cytosol.
AB  - Formaldehyde dehydrogenase was purified to electrophoretic and column
      chromatographic homogeneity from rat liver cytosolic fraction by a procedure
      which includes ammonium sulfate precipitation, DEAE-cellulose-, hydroxyapatite-,
      Mono Q-chromatography, and gel filtration. Its molecular mass was estimated to be
      41 kDa by gel filtration and SDS-PAGE, suggesting that it is a monomer. It
      utilized neither methylglyoxal nor aldehydes except formaldehyde as a substrate.
      It has been reported that liver class III alcohol dehydrogenase and formaldehyde
      dehydrogenase are the same enzyme and oxidize formaldehyde and long chain primary
      alcohols. However, the enzyme examined here did not use n-octanoi as a substrate.
      The Km values for formaldehyde and NAD+ were 5.09 and 2.34 microM at 25 degrees
      C, respectively. The amino acid sequences of 10 peptides obtained from the
      purified enzyme after digestion with either V8 protease or lysyl endopeptidase
      were determined. From these results, the enzyme was proved to be different from
      the previously described mammalian formaldehyde dehydrogenase and is the first
      true formaldehyde dehydrogenase to be isolated from a mammalian source.

PMID- 1618738
TI  - Effects of low culture temperature on the induction of hsp70 mRNA and the
      accumulation of hsp70 and hsp105 in mouse FM3A cells.
AB  - We have shown that heat shock does not induce the synthesis of hsp70 in FM3A
      cells maintained at a low culture temperature of 33 degrees C although it does so
      in cells maintained at 37 degrees C [T. Hatayama et al. (1991) Biochem. Int. 24,
      467-474]. In this paper, we show that FM3A cells maintained at 37 degrees C
      produced hsp70 mRNA during continuous heating at 42 degrees C or during
      postincubation at either 37 or 33 degrees C after being heated at 45 degrees C
      for 15 min, whereas cells maintained at 33 degrees C did not produce hsp70 mRNA
      during continuous heating at 37, 39, 42, or 45 degrees C, or during
      postincubation after being heated at any temperature. Thus the lack of hsp70
      synthesis in cells maintained at 33 degrees C seemed to be due to the absence of
      hsp70 mRNA induction. Also, hsp70 was accumulated in cells maintained at 37
      degrees C during continuous heating at 42 degrees C and during postincubation at
      37 degrees C after heat shock at 45 degrees C, but not during postincubation at
      33 degrees C. The cellular level of the constitutive hsp73 as well as the mRNA
      level were both similar in cells maintained at 33 and 37 degrees C. On the other
      hand, the cellular level of the constitutive hsp105 in cells maintained at 33
      degrees C was only half of that in cells maintained at 37 degrees C. These hsp105
      levels increased significantly in both types of cells after continuous heating at
      39 degrees C. These findings indicate that the culture temperature affects not
      only the induction of hsp70 mRNA but also the accumulation of hsp70 and hsp105 in
      the cells.

PMID- 1618739
TI  - Isolation and characterization of a mouse protein C cDNA.
AB  - Protein C (PC) is a vitamin K-dependent serine protease, a deficiency of which
      results in thrombus. There is no spontaneously occurring mouse model of the
      disease. Attempts to create such a model in mice by using anti-sense gene
      technology requires isolation of a normal mouse PC cDNA. When a mouse liver
      (BALB/c) cDNA library was screened using a human PC cDNA as a probe, nine
      overlapping cDNA clones were isolated and sequenced. The cloned mouse PC cDNA
      comprised 1,512 nucleotides and the open reading frame of the cDNA encoded a
      polypeptide of 461 amino acids residues including a leader peptide composed of 41
      amino acids. Mouse PC exhibited high homology to both human and bovine PCs. Mouse
      PC also had several structural features common in other PCs; locations of 23 Cys
      residues, location of putative beta-hydroxy Asp71, possible carbohydrate
      attachment sites involving Asp residues at amino acid positions 249, 314, and
      330, and location of active sites such as His212, Asp258, and Ser361. Northern
      blot hybridization analysis identified a single species of mouse PC mRNA (2.0 kb
      in length) in mouse liver.

PMID- 1618740
TI  - Comparison of two reconstituted systems for in vitro transcription and
      replication of influenza virus.
AB  - The transcription and replication of influenza RNA can be studied in vitro by the
      reconstitution of functional ribonucleoprotein (RNP) complex from viral core
      proteins including the RNA polymerase (complex of three P protein subunits) and
      nucleoprotein (NP), and model templates. Here, two different core protein
      preparations, one based on CsCl centrifugation (CS enzyme) and the other on
      micrococcal nuclease treatment of viral cores (MN enzyme), were compared side-by
      side. Short model RNA templates and their 3'-half molecules of both viral RNA
      (vRNA) and complementary RNA (cRNA) senses were reconstituted with the core
      protein preparations in parallel, and RNA polymerase activity was tested either
      in the presence or absence of ApG or globin mRNA as primers. Both enzyme
      preparations were active in the syntheses of short vRNA and cRNA transcripts
      using ApG as a primer, although the synthesis of cRNA was 2-10-fold higher
      (depending on the template used) than the synthesis of vRNA. The MN enzyme,
      however, was more active per weight of total protein than the CS enzyme, probably
      because of its higher content of RNA polymerase. Both enzymes failed to show
      primer-independent synthesis of vRNA. The differences observed in the synthesis
      of short transcripts using globin mRNA as a primer are discussed.

PMID- 1618741
TI  - Nonspecific lipid transfer protein in castor bean cotyledon cells: subcellular
      localization and a possible role in lipid metabolism.
AB  - The subcellular localization and several biochemical activities of nonspecific
      lipid transfer protein (nsLTP) were investigated. A section of a castor bean
      cotyledon cell was labeled with anti-nsLTP serum followed by protein A-gold. Gold
      particles were more abundant in the glyoxysome matrix and the vessel cell wall
      than in other areas. Cell fractionation analysis of 6-day-old castor bean
      cotyledons by sucrose density gradient centrifugation demonstrated that 13% of
      nsLTP was distributed in the glyoxysomal fraction, identified on the basis of
      catalase as a marker, and 87% in the soluble fraction near the top of the
      gradient. The location of castor bean nsLTP in glyoxysomes was further confirmed
      by in vitro import experiments. The synthesized precursor of nsLTP (pro-nsLTP-C)
      was incorporated into intact castor bean glyoxysomes and processed to the mature
      form after import into the glyoxysomes, but it was not imported into canine
      pancreatic microsomes. Castor bean nsLTP-A was found to possess the ability to
      bind oleic acid and oleoyl-CoA by means of a method involving Lipidex 1000. The
      dissociation constants (Kd) for oleic acid and oleoyl-CoA binding to nsLTP-A were
      4.8 and 5.0 microM, respectively. The saturated binding capacities (Bmax) for
      oleic acid and oleoyl-CoA per mol of nsLTP-A were 1.1 and 1.2 mol, respectively.
      When acyl-CoA oxidase activity was assayed in the glyoxysomal fraction, marked
      enhancement of the activity was observed in the presence of nsLTP. These results
      suggest the possibility that nsLTP regulates fatty acid beta-oxidation through
      the enhancement of acyl-CoA oxidase activity in glyoxysomes. The occurrence of
      castor bean nsLTP in the vessel wall was discussed.

PMID- 1618742
TI  - Trypsin treatment may impair the interfacial activation action of lipoprotein
      lipase.
AB  - Lipoprotein lipase was expressed in Chinese hamster ovary (CHO) cells transfected
      with human lipoprotein lipase cDNA. The lipoprotein lipase retained tributyrin,
      water-soluble substrate, hydrolyzing activity (esterase activity). The catalytic
      action of this enzyme was studied by monitoring the esterase activity. The
      esterase activity was enhanced 4.5-fold by the addition of triolein emulsified
      with Triton X-100. This process was named interfacial activation. Treatment of
      LPL with trypsin (100 micrograms/ml, 37 degrees C for 10 min) caused the loss of
      the triolein hydrolyzing activity without that of the esterase activity. The
      esterase activity of trypsin-treated LPL was not enhanced by the addition of the
      triolein emulsion. The trypsin-treated LPL retained the ability to bind to very
      low density lipoproteins (VLDL). These results are consistent with the idea that
      LPL has a catalytic site and a lipid interface recognition site, and that the
      enzyme undergoes interfacial activation, in which the concealed catalytic site is
      revealed after the enzyme binds to the surface. Based on this hypothesis, the
      results obtained suggest that trypsin nicking may impair the interfacial
      activation process and cause the loss of the lipase activity.

PMID- 1618743
TI  - Primary structure and disulfide bridge location of arrowhead double-headed
      proteinase inhibitors.
AB  - Two arrowhead proteinase inhibitors (inhibitors A and B) were characterized and
      their primary structures were determined. Both inhibitors A and B are double
      headed and multifunctional protease inhibitors. Inhibitor A inhibits an equimolar
      amount of trypsin and chymotrypsin simultaneously and weakly inhibits kallikrein.
      Inhibitor B inhibits two molecules of trypsin simultaneously and inhibits
      kallikrein more strongly than does inhibitor A. The amino acid sequences of
      inhibitors A and B were determined by sequencing the reduced and S
      carboxamidomethylated proteins and their peptides produced by cyanogen bromide or
      proteolytic lysylendopeptidase or Staphylococcus aureus V8 protease cleavage.
      Inhibitors A and B consist of 150 amino acid residues with three disulfide bonds
      (Cys 43-Cys 89, Cys 110-Cys 119, and Cys 112-Cys 115) and share 90% sequence
      identity, with 13 different residues. Since the primary structures are totally
      different from those of all other serine protease inhibitors so far known, these
      inhibitors might be classified into a new protease inhibitor family.

PMID- 1618744
TI  - Ligation activity of FLP recombinase. The strand ligation activity of a site
      specific recombinase using an activated DNA substrate.
AB  - The FLP protein of the 2-microns plasmid of yeast belongs to the integrase family
      of site-specific recombinases whose members form a covalent bond between a
      conserved tyrosine of the recombinase and the 3'-phosphoryl group at the site of
      cleavage. We have made an activated DNA substrate and have shown that FLP can
      promote efficient strand ligation without forming a covalent intermediate with
      the DNA substrate. The strand ligation activity of FLP is independent of its
      ability to cleave DNA. Since site-specific recombinases are members of the larger
      class of topoisomerases, these findings may be generally applicable to other
      members of this class of enzymes.

PMID- 1618745
TI  - Altered cellular interactions between endothelial cells and nonenzymatically
      glucosylated laminin/type IV collagen.
AB  - Laminin and type IV collagen are two major basement membrane glycoproteins. In
      previous studies it has been shown that nonenzymatic glucosylation induces
      structural alterations of these macromolecules and also reduces their ability to
      self-associate. In the present study, endothelial cells were tested for their
      ability to adhere and spread on nonenzymatically glucosylated laminin and type IV
      collagen. Adhesion and spreading were reduced when glucosylated macromolecules
      were used as substrates. Glucosylation-induced changes in adhesion and spreading
      may be an important initial event signaling other phenotypic modifications of
      cells in the microvasculature and may be a crucial factor in order to understand
      the pathogenesis of diabetic microangiopathy at the molecular level.

PMID- 1618746
TI  - Post-transcriptional regulation of expression of plasminogen activator inhibitor
      type 1 mRNA by insulin and insulin-like growth factor 1.
AB  - In humans and non-human primates, alternative cleavage and polyadenylation of
      plasminogen activator inhibitor type-1 (PAI-1) pre-mRNA transcripts results in
      two forms of mature mRNA, an unstable 3.2-kilobase (kb) form, and a relatively
      more stable 2.2-kb form. Insulin and insulin-like growth factor I (IGF-1)
      increase steady state levels of PAI-1 mRNA in Hep G2 cells independently and
      synergistically. In the present study we found that the rate of transcription of
      the PAI-1 gene is not affected by insulin, IGF-1, or both but that insulin
      prolongs the half-life of the 3.2-kb PAI-1 mRNA species 2.7-fold without
      affecting the half-life of the 2.2-kb species. In contrast IGF-1, alone or with
      insulin, markedly prolongs the half-lives of both species. Our results
      demonstrate a novel mechanism of regulation of expression of the PAI-1 gene by
      insulin and IGF-1 operating at the post-transcriptional level.

PMID- 1618747
TI  - Activation of insulin receptor signaling by a single amino acid substitution in
      the transmembrane domain.
AB  - The insulin receptor is a ligand-activated tyrosine kinase composed of two alpha
      and two beta subunits. A single transmembrane domain composed of 23 hydrophobic
      residues is contained in each beta subunit. We examined the role of the
      transmembrane domain in regulating insulin receptor signaling by inserting a
      negatively charged amino acid (Asp) for Val938 (V938D). Chinese hamster ovary
      (CHO) cells were stably transfected with a plasmid containing both the neomycin
      resistance gene and either the wild-type or the mutant (V938D) insulin receptor
      cDNA. Insulin binding increased similarly in CHO cells stably transfected with
      the wild-type and the V938D-mutant insulin receptor cDNA. Insulin stimulated
      glucose transport and cell growth in cells expressing the normal insulin
      receptor. By contrast, in the absence of insulin, glucose transport and cell
      growth in CHO-V938D cells were as high as in insulin-stimulated control cells and
      no longer responsive to insulin stimulation. Phosphorylation of the beta subunit
      of the insulin receptor was also increased in CHO-V938D cells not exposed to
      insulin. These results support an essential role of the transmembrane domain of
      the insulin receptor in the transduction of insulin signaling.

PMID- 1618748
TI  - The alpha 2-macroglobulin receptor/low density lipoprotein receptor-related
      protein binds and internalizes Pseudomonas exotoxin A.
AB  - The alpha 2-macroglobulin receptor/low density lipoprotein receptor-related
      protein (alpha 2 MR/LRP) is a large cell-surface glycoprotein consisting of a 515
      kDa and an 85-kDa polypeptide; this receptor is thought to be responsible for the
      binding and endocytosis of activated alpha 2-macroglobulin and apoE-enriched beta
      very low density lipoprotein. A similar high molecular weight glycoprotein has
      been identified as a potential receptor for Pseudomonas exotoxin A (PE). We
      demonstrate that the alpha 2 MR/LRP and the PE-binding glycoprotein have a
      similar mobility upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      and are immunologically indistinguishable. Furthermore, affinity-purified alpha 2
      MR/LRP binds specifically to PE but not to a mutant toxin defective in its
      ability to bind cells. The 39-kDa receptor-associated protein, which blocks
      binding of ligands to alpha 2 MR/LRP, also prevents binding and subsequent
      toxicity of PE for mouse fibroblasts. The concentration of receptor-associated
      protein that was required to reduce binding and toxicity to 50% was approximately
      14 nM, a value virtually identical to the KD measured for the interaction of
      receptor-associated protein with the purified receptor. Overall, the studies
      strongly suggest that the alpha 2 MR/LRP is responsible for internalizing PE.

PMID- 1618749
TI  - The A20 zinc finger protein protects cells from tumor necrosis factor
      cytotoxicity.
AB  - Resistance against the cytotoxic actions of tumor necrosis factor alpha (TNF) is
      an active process requiring the synthesis of TNF-inducible proteins. The specific
      TNF-induced proteins so far identified (manganese superoxide dismutase and
      plasminogen activator inhibitor type 2) as having a role in resistance against
      TNF cytotoxicity are able to confer only partial protection to cells, suggesting
      that other genes are involved. A20 is a TNF-induced primary response gene which
      encodes a novel zinc finger protein. In this report we demonstrate that A20
      protein is induced by TNF in a variety of cells. A survey of A20 expression in
      human breast carcinoma cell lines that are either sensitive or resistant to TNF
      cytotoxicity revealed increased expression of A20 message and protein in TNF
      resistant cells. Constitutive expression of A20 after stable transfection of NIH
      3T3 and WEHI 164 cells results in significant, but partial, resistance to TNF
      cytotoxicity. This work gives additional support to a role for TNF-induced
      immediate early response genes in protecting cells from TNF-induced death.

PMID- 1618750
TI  - Overexpression of c-myc by amplification of negative promoter domain.
AB  - Amplification of myc proto-oncogenes has been reported in many human
      malignancies, but whether the amplified genes are properly regulated has not been
      well studied. Transcription factors that control gene expression are of limited
      abundance, and we have previously shown (Johnston, R.N., and Kucey, B.L. (1988)
      Science 242, 1551-1554) that amplified heat shock promoter sequences can compete
      with natural heat shock genes for these factors, resulting in heat shock gene
      disregulation. To establish whether protooncogenes may also be disregulated in
      this manner, a previously identified negative regulatory domain from the human c
      myc promoter was amplified by up to 800-fold in Chinese hamster ovary cells. The
      amplified cells showed up to a 14-fold increase in hamster c-myc transcript
      abundance when compared with controls and also displayed reduced doubling times,
      enhanced incorporation of tritiated thymidine, elevated growth in soft agar, and
      a fusiform morphology, consistent with an elevation in the degree of cellular
      transformation. We infer that overexpression of endogenous hamster c-myc genes in
      the experimental cells was elicited in trans by sequestration of an inhibitory
      factor or complex that bound to excess nonfunctional human c-myc promoter
      domains. The transcriptional inhibitory activity we detect is consistent with
      anti-oncogene function.

PMID- 1618751
TI  - Specific inhibition of hepatitis B viral gene expression in vitro by targeted
      antisense oligonucleotides.
AB  - A 21-mer oligodeoxynucleotide complementary to the polyadenylation signal for
      human hepatitis B virus (HBV) was complexed to a soluble DNA-carrier system that
      is targetable to hepatocytes via asialoglycoprotein receptors present on those
      cells. A cell line, HepG2 (2.2.15) that possesses asialoglycoprotein receptors
      and is permanently transfected with hepatitis B virus (ayw subtype) was exposed
      to complexed antisense DNA or controls. In the presence of complexed antisense
      DNA, the concentration of hepatitis B surface antigen in medium was 80% lower
      than controls after 24 h. Furthermore, during the next 6 days, there was no
      significant increase in surface antigen concentration in the presence of
      complexed antisense DNA. The inhibition could be effectively blocked by
      competition with an excess of free asialoglycoprotein. Total protein synthesis
      remained unchanged by exposure to complexed antisense sequences under identical
      conditions. In addition, HBV DNA in the medium and cell layers after 24-h
      exposure to complexed antisense sequences was 80% lower than in controls. The
      data indicate that antisense oligonucleotides complexed by a soluble DNA-carrier
      system can be targeted to cells via asialoglycoprotein receptors resulting in
      specific inhibition of hepatitis B viral gene expression and replication.

PMID- 1618752
TI  - Stimulation of sphingomyelin biosynthesis by brefeldin A and sphingomyelin
      breakdown by okadaic acid treatment of rat hepatocytes.
AB  - Studies on sphingomyelin metabolism in rat hepatocytes were facilitated by the
      use of choline-deficient cells which allowed for the rapid labeling of
      phosphatidylcholine and as a result sphingomyelin. Pulse and pulse-chase studies
      with [methyl-3H]choline and [methyl-3H]methionine demonstrated that both
      compounds were effectively used for sphingomyelin biosynthesis and that newly
      made and pre-existing phosphatidylcholine could be used for sphingomyelin
      biosynthesis. When hepatocytes were incubated with brefeldin A, there was a 2.4
      fold stimulation of the conversion of phosphatidylcholine into sphingomyelin.
      Since brefeldin A causes collapse of the cis/medial Golgi into the endoplasmic
      reticulum the stimulation of sphingomyelin biosynthesis could be due to more
      rapid access of the labeled phosphatidylcholine in the endoplasmic reticulum to
      sphingomyelin synthase in the collapsed Golgi. Forskolin inhibited the brefeldin
      A-induced stimulation of sphingomyelin biosynthesis. To investigate whether or
      not phosphorylation reactions regulate sphingomyelin metabolism, hepatocytes were
      incubated with okadaic acid, a potent inhibitor of protein phosphatases 1 and 2A.
      Rather than stimulating sphingomyelin biosynthesis, okadaic acid enhanced the
      catabolism of sphingomyelin. In contrast, a cyclic AMP analogue and forskolin had
      no effect on sphingomyelin biosynthesis or catabolism. Surprisingly, other pulse
      chase studies demonstrated that okadaic acid stimulated the catabolism of only
      newly made sphingomyelin. The brefeldin A and okadaic acid effects were
      independent of lysosomal involvement. Subcellular fractionation studies revealed
      that brefeldin A and okadaic acid effects were generalized in all sphingomyelin
      containing membranes. The brefeldin A studies suggest that the rate of transfer
      of phosphatidylcholine from the endoplasmic reticulum to the Golgi might be
      limiting for sphingomyelin biosynthesis. The okadaic acid studies indicate that
      the catabolism of sphingomyelin by a sphingomyelinase is regulated by an
      unidentified protein kinase and by either protein phosphatase 1 and/or 2A
      activity in hepatocytes.

PMID- 1618753
TI  - On the mechanism of oxidation of cholesterol at C-7 in a lipoxygenase system.
AB  - Incubation of [7-2H2]cholesterol with soybean lipoxygenase and linoleic acid in
      the presence of oxygen gave a mixture of 5-cholestene-3 beta,7 alpha-diol, 5
      cholestene-3 beta,7 beta-diol, 3 beta-hydroxy-5-cholesten-7-one,5 alpha,6 alpha
      epoxycholestan-3 beta-ol, and 5 beta,6 beta-epoxycholestan-3 beta-ol. The
      conversion into the 7-oxygenated products was associated with a very high
      intermolecular isotope effect (KH/KD = 15-17), suggesting that the rate-limiting
      step in the overall conversion is likely to be the abstraction of hydrogen at C-7
      in a radical reaction. Evidence that linoleic acid is to some extent directly
      involved was obtained with the use of [7-3H]cholesterol. Incubation of [7
      3H]cholesterol resulted in a significant incorporation of 3H in the reisolated
      linoleic acid fraction. The isotope effect associated with conversion of [7 alpha
      2H]cholesterol into 7-oxygenated products in the lipoxygenase system was 2-3,
      indicating that the extraction of hydrogen is nonstereospecific. Incubation of [7
      2H2]cholesterol with 13-hydroperoxy-9,11-octadecadienoic acid gave the above 7
      oxygenated products with relatively small isotope effects (KH/KD = 3-4). It is
      concluded that the most important mechanism for oxidation of cholesterol at C-7
      in the lipoxygenase system involves participation of radicals and that a carbon
      centered linoleic acid radical can extract hydrogen directly from cholesterol.
      Fatty acid hydroperoxides and their secondary products seem to be less important
      as initiators in connection with oxidation of cholesterol.

PMID- 1618754
TI  - Identification of 5-oxo-15-hydroxy-6,8,11,13-eicosatetraenoic acid as a novel and
      potent human eosinophil chemotactic eicosanoid.
AB  - Incubation of human eosinophils with arachidonic acid led to the formation of a
      novel and potent eosinophil chemotactic lipid (ECL) (Morita, E., Schroder, J.-M.,
      and Christophers, E. (1990) J. Immunol. 144, 1893-1900). To test the working
      hypothesis of whether ECL could have been formed via eosinophil-arachidonic acid
      15-lipoxygenase we investigated whether other arachidonic acid 15-lipoxygenases
      such as soybean lipoxygenase I catalyze formation of a similar ECL. In the
      presence of hemoproteins and soybean lipoxygenase I arachidonic acid is converted
      to an ECL, which has physicochemical properties similar to those found for the
      eosinophil-derived ECL. Purification of this ECL by high performance liquid
      chromatography revealed that ECL is structurally different from well known
      eosinophil chemotactic eicosanoids such as leukotriene B4, 5,15-(6E,8Z,11Z,13E)
      dihydroxyeicosatetraenoic acid (5,15-diHETE), and (8S,15S)-(5Z,9E,11Z,13E)
      dihydroxyeicosatetra eno ic acid ((8S,15S)-diHETE). UV spectra of this ECL with
      absorbance maxima at 230 and 278 nm revealed the presence of two independent
      chromophores such as a conjugated oxodiene and a conjugated diene. Catalytic
      hydrogenation of ECL methyl ester led to the formation of 5,15-dihydroxyarachidic
      acid methyl ester. Reduction of ECL with sodium borohydride produced a product
      which is identical with authentic (5S,15S)-(6E,8Z,11Z,13E)-diHETE. Formation of
      an ECL monomethoxime derivative supports the conclusion that this highly potent
      eosinophil chemotactic eicosanoid is structurally identical with 5-oxo-15-hydroxy
      6,8,11,13-eicosatetraenoic acid.

PMID- 1618755
TI  - Purification and characterization of the photosystem I complex from the
      filamentous cyanobacterium Anabaena variabilis ATCC 29413.
AB  - A photoactive photosystem I complex has been purified from the filamentous,
      nitrogen-fixing cyanobacterium Anabaena variabilis ATCC 29413. Cells were broken
      using glass beads, and the membrane fraction was solubilized with beta-dodecyl
      maltoside followed by two rounds of fast protein liquid chromatography on anion
      exchange columns. The polypeptide composition of the isolated complex was
      determined by sodium dodecyl sulfate-urea-polyacrylamide gel electrophoresis and
      N-terminal amino acid sequencing of the fractionated proteins. The purified
      complex consists of at least 11 proteins, identified as the PsaA, PsaB, PsaC,
      PsaD, PsaE, PsaF, PsaI, PsaJ, PsaK, PsaL, and PsaN proteins. The spectrum of the
      flash-induced absorbance change measured between 670 and 830 nm shows that the
      purified complex contains 99 +/- 11 chlorophyll a molecules per P700, the primary
      donor in photosystem I. The kinetics of the rereduction of oxidized P700
      following an actinic flash indicate that forward electron transfer from P700 to
      the FA/FB iron-sulfur center acceptors is functional in the isolated complex.

PMID- 1618756
TI  - A synthetic sialic acid analogue is recognized by influenza C virus as a receptor
      determinant but is resistant to the receptor-destroying enzyme.
AB  - Synthetic sialic acid analogues varying in the substitutents at position C-9 were
      analyzed for their ability to replace the natural receptor determinant for
      influenza C virus, N-acetyl-9-O-acetylneuraminic acid (Neu5,9Ac2). By incubation
      of erythrocytes with sialyltransferase and the CMP-activated analogues, the cell
      surface was modified to contain sialic acid with one of the following C-9
      substituents: an azido, an amino, an acetamido, or a hexanoylamido group. Among
      these, only 9-acetamido-N-acetylneuraminic acid (9-acetamido-Neu5Ac) was able to
      function as a receptor determinant for influenza C virus as indicated by the
      ability of the virus to agglutinate the modified red blood cells. In contrast to
      the natural receptors, 9-acetamido-Neu5Ac-containing receptors were found to be
      resistant against the action of sialate 9-O-acetylesterase, the viral receptor
      destroying enzyme. No difference in the hemolytic activity of influenza C virus
      was detected when analyzed with erythrocytes containing either Neu5,9Ac2 or 9
      acetamido-Neu5Ac on their surface. This finding indicates that cleavage of the
      receptor is not required for the viral fusion activity. The sialic acid analogues
      should be useful for analyzing not only the importance of the receptor-destroying
      enzyme of influenza C virus, but also other biological processes involving sialic
      acid.

PMID- 1618757
TI  - The primary structure of omega-amino acid:pyruvate aminotransferase.
AB  - The complete amino acid sequence of bacterial omega-amino acid:pyruvate
      aminotransferase (omega-APT) was determined from its primary structure. The
      enzyme protein was fragmented by CNBr cleavage, trypsin, and Staphylococcus
      aureus V8 digestions. The peptides were purified and sequenced by Edman
      degradation. omega-ATP is composed of four identical subunits of 449 amino acids
      each. The calculated molecular weight of the enzyme subunit is 48,738 and that of
      the enzyme tetramer is 194,952. No disulfide bonds or bound sugar molecules were
      found in the enzyme structure, although 6 cysteine residues were determined per
      enzyme subunit. Sequence homologies were found between an omega-aminotransferase,
      i.e. mammalian and yeast ornithine delta-aminotransferases, fungal gamma
      aminobutyrate aminotransferase and 7,8-diaminoperalgonate aminotransferase, and
      2,2-dialkylglycine decarboxylase. The enzyme structure is not homologous to those
      of aspartate aminotransferases (AspATs) including the enzymes of Escherichia coli
      and Sufolobus salfactaricus, though significant homology in the three-dimensional
      structures around the cofactor binding site has been found between omega-APT and
      AspATs (Watanabe, N., Sakabe, K., Sakabe, N., Higashi, T., Sasaki, K., Aibara,
      S., Morita, Y., Yonaha, K., Toyama, S., and Fukutani, H. (1989) J. Biochem. 105,
      1-3).

PMID- 1618758
TI  - Role of the antithrombin-binding pentasaccharide in heparin acceleration of
      antithrombin-proteinase reactions. Resolution of the antithrombin conformational
      change contribution to heparin rate enhancement.
AB  - The synthetic antithrombin-binding heparin pentasaccharide and a full-length
      heparin of approximately 26 saccharides containing this specific sequence have
      been compared with respect to their interactions with antithrombin and their
      ability to promote inhibition and substrate reactions of antithrombin with
      thrombin and factor Xa. The aim of these studies was to elucidate the
      pentasaccharide contribution to heparin's accelerating effect on antithrombin
      proteinase reactions. Pentasaccharide and full-length heparins bound antithrombin
      with comparable high affinities (KD values of 36 +/- 11 and 10 +/- 3 nM,
      respectively, at I 0.15) and induced highly similar protein fluorescence,
      ultraviolet and circular dichroism changes in the inhibitor. Stopped-flow
      fluorescence kinetic studies of the heparin binding interactions at I 0.15 were
      consistent with a two-step binding process for both heparins, involving an
      initial weak encounter complex interaction formed with similar affinities (KD 20
      30 microM), followed by an inhibitor conformational change with indistinguishable
      forward rate constants of 520-700 s-1 but dissimilar reverse rate constants of
      approximately 1 s-1 for the pentasaccharide and approximately 0.2 s-1 for the
      full-length heparin. Second order rate constants for antithrombin reactions with
      thrombin and factor Xa were maximally enhanced by the pentasaccharide only 1.7
      fold for thrombin, but a substantial 270-fold for factor Xa, in an ionic strength
      independent manner at saturating oligosaccharide. In contrast, the full-length
      heparin produced large ionic strength-dependent enhancements in second order rate
      constants for both antithrombin reactions of 4,300-fold for thrombin and 580-fold
      for factor Xa at I 0.15. These enhancements were resolvable into a nonionic
      component ascribable to the pentasaccharide and an ionic component responsible
      for the additional rate increase of the larger heparin. Stoichiometric titrations
      of thrombin and factor Xa inactivation by antithrombin, as well as sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis of the products of these reactions,
      indicated that pentasaccharide and full-length heparins similarly promoted the
      formation of proteolytically modified inhibitor during the inactivation of factor
      Xa by antithrombin, whereas only the full-length heparin was effective in
      promoting this substrate reaction of antithrombin during the reaction with
      thrombin.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1618759
TI  - The cDNA for the type I iodothyronine 5'-deiodinase encodes an enzyme manifesting
      both high Km and low Km activity. Evidence that rat liver and kidney contain a
      single enzyme which converts thyroxine to 3,5,3'-triiodothyronine.
AB  - The enzymatic conversion of thyroxine (T4) to 3,5,3-triiodothyronine (T3) by
      iodothyronine 5'-deiodinase(s) is an obligate step in the physiologic action of
      thyroid hormones in most extrathyroidal tissues. In the rat liver and kidney, 5'
      deiodinase processes having either high Km (micromolar range) or low Km
      (nanomolar range) values for thyroid hormone substrates have been described. The
      number of enzymes mediating these reactions, however, remains uncertain and
      controversial. To examine this question we have compared the 5'-deiodinase
      activity expressed in membrane preparations of Xenopus laevis oocytes after the
      injection of either rat liver poly(A)+ RNA or in vitro prepared RNA transcribed
      using the G21 full-length type I 5'-deiodinase cDNA. In oocytes injected with rat
      liver poly(A)+ RNA, high Km (i.e. type I) activity was observed when 20 mM
      dithiothreitol was used as the thiol cofactor, whereas Km values in the nanomolar
      range were noted with 0.5 mM dithiothreitol, glutathione, or a reconstituted
      thioredoxin cofactor system. This complex pattern of 5'-deiodinase activity,
      which mimics that found in homogenates and subcellular fractions of rat liver and
      kidney, was reproduced exactly in oocytes by the microinjection of G21-derived
      RNA transcripts. Furthermore, hybrid arrest of translation in oocytes using a
      partial type I 5'-deiodinase cDNA completely inhibited the expression of both
      high and low Km activity after the injection of rat liver poly(A)+ RNA. These
      findings demonstrate that rat liver and kidney contain only a single 5'
      deiodinase which manifests either high or low Km activity depending on the
      reduced thiol cofactor utilized in the reaction.

PMID- 1618761
TI  - Stereoselective hydrolysis catalyzed by related beta-1,4-glucanases and beta-1,4
      xylanases.
AB  - Over 80 beta-1,4-glucanases and beta-1,4-xylanases can be classified into one of
      eight families on the basis of amino acid sequence similarities in their
      catalytic domains (Gilkes, N. R., Henrissat, B., Kilburn, D. G., Miller, R. C.,
      Jr., and Warren, R. A. J. (1991) Microbiol. Rev. 55, 303-315). As a test of this
      classification, the stereochemical course of hydrolysis of 10 enzymes
      representative of five families has been determined using proton NMR. These data,
      together with published data for six additional enzymes, show that
      representatives of a given enzyme family have the same stereoselectivity: four
      families catalyze hydrolysis with retention of anomeric configuration, two with
      inversion. The results support the hypothesis that family members share a common
      general fold, active site topology, and catalytic mechanism.

PMID- 1618760
TI  - Identification and expression of five mutations in the human acid
      sphingomyelinase gene causing types A and B Niemann-Pick disease. Molecular
      evidence for genetic heterogeneity in the neuronopathic and non-neuronopathic
      forms.
AB  - The deficient activity of the human lysosomal hydrolase, acid sphingomyelinase
      (ASM, EC 3.1.4.12), results in the neuronopathic (Type A) and non-neuronopathic
      (Type B) forms of Niemann-Pick disease (NPD). To investigate the genetic basis of
      the phenotypic heterogeneity in NPD, the molecular lesions in the ASM gene were
      determined from three unrelated NPD patients and evaluated by transient
      expression in COS-1 cells. A Type A NPD patient of Asian Indian ancestry (proband
      1) was homoallelic for a T to A transversion in exon 2 of the ASM gene which
      predicted a premature stop at codon 261 of the ASM polypeptide (designated
      L261X). In contrast, an unrelated Type A patient of European ancestry (proband 2)
      was heteroallelic for a two-base (TT) deletion in exon 2 which caused a frame
      shift mutation at ASM codon 178 (designated fsL178), leading to a premature stop
      at codon 190, and a G to A transition in exon 3 which caused a methionine to
      isoleucine substitution at codon 382 (designated M382I). Transient expression of
      the fsL178, L261X, and M382I mutations in COS-1 cells demonstrated that these
      lesions did not produce catalytically active ASM, consistent with the severe
      neuronopathic Type A NPD phenotype. In contrast, an unrelated Type B patient of
      European descent (proband 3) was heteroallelic for two missense mutations, a G to
      A transition in exon 2 which predicted a glycine to arginine substitution at ASM
      codon 242 (designated G242R), and an A to G transition in exon 3 which resulted
      in an asparagine to serine substitution at codon 383 (designated N383S).
      Interestingly, the G242R allele produced ASM activity in COS-1 cells at levels
      about 40% of that expressed by the normal allele, thereby explaining the mild
      Type B phenotype of proband 3 and the high residual activity (i.e. approximately
      15% of normal) in cultured lymphoblasts. In contrast, the N383S allele did not
      produce catalytically active enzyme. None of these five ASM mutations was
      detected in over 60 other unrelated NPD patients analyzed, nor were these
      mutations found in over 100 normal ASM alleles. Thus, small deletions or nonsense
      mutations which trunctated the ASM polypeptide, or missense mutations that
      rendered the enzyme noncatalytic, resulted in Type A NPD disease, whereas a
      missense mutation that produced a defective enzyme with residual catalytic
      activity caused the milder nonneuronopathic Type B phenotype. These findings have
      facilitated genotype/phenotype correlations for this lysosomal storage disease
      and provided insights into the functional organization of the ASM polypeptide.

PMID- 1618762
TI  - Golgi vacuolization and immunotoxin enhancement by monensin and perhexiline
      depend on a serum protein. Implications for intracellular trafficking.
AB  - Vacuole formation around the Golgi and immunotoxin enhancement induced by low
      doses of the ionophore monensin were inhibited by 50% human plasma (final
      concentration), whereas the lysosomal pH increase remained unaffected.
      Immunotoxin enhancement by the Ca2+ antagonist perhexiline was also inhibited by
      plasma. The inhibiting factor was present in different species and highly
      concentration-dependent. After purification on DEAE- and CM-Sepharose it showed a
      heterogeneous distribution between 45 and 50 kDa, in sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, an extreme isoelectric point near 3.5, and
      binding to wheat germ agglutinin-Sepharose. Maximum inhibition was found in the
      lower molecular mass fraction of 45 kDa. The 50-kDa fraction, although showing
      immunological identity reactions, remained almost inactive. The simultaneous
      inhibition of morphological alterations and the enhancement of immunotoxin
      activity by the highly enriched protein provides a first direct link between both
      events. Apart from a role of this serum glycoprotein on in vivo inhibition of
      immunotoxin enhancement, its ability to maintain normal intracellular trafficking
      in the presence of blocking agents, such as monensin and perhexiline, suggests a
      more fundamental role in the regulation of these mechanisms.

PMID- 1618763
TI  - Expression of cytochrome b5 in yeast and characterization of mutants of the
      membrane-anchoring domain.
AB  - The soluble and membrane-bound forms of the synthetic rat cytochrome b5 gene have
      been expressed in Saccharomyces cerevisiae. In order to examine the topology and
      function of the COOH-terminal membrane binding domain of cytochrome b5, mutants
      have been constructed, expressed, purified, and partially characterized. Pro-115
      is located in the middle of the putative alpha-helical membrane-anchoring domain
      of cytochrome b5 and has been hypothesized to give rise to either a hairpin-like
      loop or approximately equal to 26 degrees kink in the helix, depending on whether
      it exists, respectively, in the cis or trans configuration. The Pro-115----Ala
      mutant, which is expected to have a straight transmembrane helix, inserted
      normally into the endoplasmic reticulum and exhibited wild type levels of
      activity in yeast microsomes and in vitro in the cytochrome P-450 mixed function
      oxidation system. Since a hairpin structure does not appear to be essential, it
      is likely that the membrane binding domain of cytochrome b5 spans the membrane.
      Characterization of the truncated cytochrome b5 molecule, Pro-115----Stop,
      lacking 19 amino acids at the COOH terminus indicates that the distal part of the
      membrane binding domain of cytochrome b5 is necessary for in vivo binding to the
      endoplasmic reticulum and for functioning with its membrane-associated electron
      transfer partners. Replacement of Ser-104 to Met-125, the putative membrane
      anchoring domain of cytochrome b5, with 22 leucine residues results in a protein
      which targets to the endoplasmic reticulum but the extent of its reduction is
      only 50% of that of the wild type in yeast microsomes. In vitro, the polyleucine
      mutant is unable to support substrate oxidation by cytochrome P-450. The mutation
      of Ala-131 and Glu-132, amino acids flanking the transmembrane domain, to lysines
      resulted in a protein with normal membrane topology and function.

PMID- 1618764
TI  - Alpha-isoenzyme of alcohol dehydrogenase from monkey liver. Cloning, expression,
      mechanism, coenzyme, and substrate specificity.
AB  - The cDNA for the alpha-isoenzyme from rhesus monkey (Macaca mulatta) liver was
      cloned and expressed in yeast. The alpha-isoenzymes of human and monkey liver
      alcohol dehydrogenase differ from the other human and horse liver enzymes in
      having Met57, Ala93, and Val116 instead of Leu57, Phe93, and Leu116 in the
      substrate binding pocket and Gly47 instead of Arg47 near the pyrophosphate moiety
      of the coenzyme. The effects of these differences on the kinetic mechanism,
      substrate specificity, and coenzyme binding were studied with the purified,
      recombinant monkey alpha-isoenzyme (MmADH alpha) and mutated enzymes with Gly47
      substituted with His or Arg. The mechanism appears to be random for the binding
      of NAD+ and ethanol and ordered for NADH and acetaldehyde, with formation of a
      dead-end enzyme-NADH-ethanol complex. MmADH alpha reacts 130-fold slower (V/K)
      with ethanol and 3-25-fold slower with 2-methyl alcohols but 20-fold faster with
      cyclohexanol, as compared with horse (Equus caballus) liver EE isoenzyme (EqADH).
      MmADH alpha is stereoselective for the R isomer of 2-butanol, whereas EqADH
      favors the S isomer. Both enzymes have comparable reactivity with larger primary
      alcohols. MmADH alpha is more reactive with secondary alcohols and has highest
      activity with cyclohexanol. However, it does not react with steroids such as 5
      beta-androstane-17 beta-ol-3-one. Molecular modeling suggests that the
      differences between MmADH alpha and EqADH are a result of the substitution of Ala
      for Phe93 and Thr for Ser48. MmADH alpha binds NAD+ most rapidly when a group
      with a pK of 7.4 is unprotonated, implicating His51 in this reaction. The G47R
      substitution decreased the dissociation constants for NAD+ and NADH and turnover
      numbers only about 2-fold, whereas the G47H substitution increased dissociation
      constants 7-14-fold and turnover numbers 4-fold. A basic residue at position 47
      is not crucial for activity, as multiple interactions determine coenzyme
      affinity.

PMID- 1618765
TI  - Reversible stepwise mechanism involving a carbanion intermediate in the
      elimination of ammonia from L-histidine catalyzed by histidine ammonia-lyase.
AB  - L-Histidine labeled with deuterium at the C-5' position of the imidazole ring, L
      [5'-2H]histidine (His-5'-D), was used as a probe for investigating a stepwise
      reversible mechanism via a carbanion intermediate in the elimination of ammonia
      catalyzed by histidine ammonia-lyase (EC 4.3.1.3). The labeled L-histidine (His
      5'-D) (2.45 mM) was incubated with histidine ammonia-lyase (200 units) from
      Pseudomonas fluorescens at pH 7.0 or 9.0 at 25.0 degrees C for 24 h. The time
      course of the reaction was examined to determine the rates of enzyme-catalyzed
      hydrogen exchange at C-5' of L-histidine and urocanic acid. The finding of the
      enzyme-catalyzed hydrogen exchange at C-5' of both L-histidine and urocanic acid
      in the presence of L-histidine provided a rational explanation for a stepwise
      reversible mechanism via a carbanion intermediate in the elimination reaction.
      The rate of increase in the concentration of urocanic acid exchanged with
      hydrogen (UA-5'-H) did not depend on the formation rate of urocanic acid and UA
      5'-H was continuously formed at a constant rate (25.6 microM/h) even after the
      completion of urocanic acid formation. These observations suggested the presence
      of the reversible reaction of urocanic acid and a carbanion intermediate. Since
      there was only a minor contribution for the formation of UA-5'-H from L-histidine
      exchanged with solvent hydrogen (His-5'-H), the main pathway in the enzymatic
      reaction of His-5'-D must be the formation of UA-5'-D via a carbanion
      intermediate (carbanion-D). Regeneration of the carbanion-D from UA-5'-D by its
      reverse reaction and subsequent hydrogen incorporation at C-5' would contribute
      to a large extent for the formation of UA-5'-H. The stability of carbanion was
      also demonstrated to be approximately three times higher at pH 7.0 than at pH
      9.0.

PMID- 1618767
TI  - Escherichia coli ribonucleotide reductase. Radical susceptibility to hydroxyurea
      is dependent on the regulatory state of the enzyme.
AB  - Ribonucleotide reductase catalyzes the reduction of ribonucleotides to their
      corresponding deoxyribonucleotides via a radical-mediated mechanism. The enzyme
      from Escherichia coli consists of the two non-identical proteins, R1 and R2, the
      latter of which contains the necessary free radical located to a tyrosine
      residue. The radical scavenger hydroxyurea was found to reduce the tyrosyl
      radical of R2 in a second-order reaction. The rate constant (0.50 M-1 s-1 at 25
      degrees C) for this process was several orders of magnitude lower than the
      hydroxyurea-dependent reduction of free tyrosyl radicals in solution. This
      difference probably reflects the fact that the R2 tyrosyl radical is buried in
      the interior of the protein. Formation of the R1R2 complex changed the
      susceptibility of the radical to hydroxyurea in a manner that reflects the
      regulatory state of the holoenzyme. Furthermore, binding of substrate or product
      to the holoenzyme complex made the R2 radical at least 10 times more susceptible
      to inactivation by hydroxyurea than it was in the isolated R2 protein. One active
      site mutation in the R1 protein was shown to affect the sensitivity of the
      tyrosyl radical of R2 differently than wild type protein R1 does. Our results
      clearly show that the susceptibility of the tyrosyl radical in R2 to inactivation
      by hydroxyurea can be used as an efficient probe for the regulatory state of the
      holoenzyme complex.

PMID- 1618766
TI  - Structure and ligand binding properties of leucine 29(B10) mutants of human
      myoglobin.
AB  - Site-specific mutants of human myoglobin (Mb) have been prepared, in which Leu29
      (B10) is replaced by Ala(L29A) or Ile(L29I), in order to examine the influence of
      this highly conserved residue in the hydrophobic clusters of the heme distal site
      on the heme environmental structure and ligand binding properties of Mb.
      Structural characterizations of these recombinant Mbs are studied by electronic
      absorption, infrared (IR), one- and two-dimensional proton nuclear magnetic
      resonance spectroscopies, and ligand-binding kinetics by laser photolysis
      measurements under ambient and high pressures (up to 2000 bar). Multiple split
      carbon monoxide (CO) stretch bands in the IR spectra of mutant Mbs exhibit a
      relative decrease of the 1945 cm-1 band (approximately 50%) which is associated
      with an upright binding geometry of CO, accompanied by an increase of the tilted
      CO conformer at 1932 cm-1. On the basis of these results, replacement of
      Leu29(B10) by Ala or Ile appears to allow bound CO to rotate from a conformation
      pointing toward the beta meso carbon of the heme group to the one pointing toward
      the alpha meso carbon atom, presumably filling the space left by removal of the
      delta 2 carbon atom of Leu29(B10). These substitutions cause the rate constants
      for CO and O2 association to decrease almost 3-5-fold. Present results show that
      CO and O2 bindings to the heme iron of Mb are controlled by Leu29(B10) by
      influencing the structure of close vicinity of the heme and the geometry of iron
      bound ligand. Further, mutant Mbs (Leu72(E15)----Ala and Leu104 (G5)----Ala)
      which have altered residues in another hydrophobic clusters around proximal and
      distal site are also examined.

PMID- 1618768
TI  - Caracemide, a site-specific irreversible inhibitor of protein R1 of Escherichia
      coli ribonucleotide reductase.
AB  - The anticancer drug caracemide, N-acetyl-N,O- di(methylcarbamoyl)hydroxylamine,
      and one of its degradation products, N-acetyl-O-methylcarbamoyl-hydroxylamine,
      were found to inhibit the enzyme ribonucleotide reductase of Escherichia coli by
      specific interaction with its larger component protein R1. No effect on the
      smaller protein R2 was observed. The effect of the degradation product was about
      30 times lower than that of caracemide itself. The caracemide inactivation of R1
      is irreversible, with an apparent second-order rate constant of 150 M-1 s-1. The
      R1R2 holoenzyme was approximately 30 times more sensitive to caracemide
      inactivation than the isolated R1 protein. The ribonucleotide reductase
      substrates were potent competitors of the caracemide inhibition, with a Kdiss for
      GDP binding to R1 of 80 microM. The reducing agent dithiothreitol was also found
      to be a potent competitor of caracemide inactivation. These results indicate that
      caracemide inactivates R1 by covalent modification at the substrate-binding site.
      By analogy with the known interaction between caracemide and acetylcholinesterase
      or choline acetyltransferase, we propose that the modification of R1 occurs at an
      activated cysteine or serine residue in the active site of the enzyme.

PMID- 1618769
TI  - O-acetylated gangliosides in bovine buttermilk. Characterization of 7-O-acetyl, 9
      O-acetyl, and 7,9-di-O-acetyl GD3.
AB  - Three O-acetylated gangliosides, G1, G2, and G3, were purified from bovine
      buttermilk by using chloroform/methanol extraction, Folch partitioning,
      chromatography on DEAE-Sephadex A-25, and Iatrobeads columns. The final yields of
      gangliosides G1, G2, and G3 were 2 mg, 37 mg, and 40 mg per 1.7 kg of the
      buttermilk powder, respectively. On the basis of immunostaining on high
      performance thin layer chromatography with specific monoclonal antibodies, mild
      alkaline treatment, gas-liquid chromatographic analysis, fast atom bombardment
      mass spectrometry, and proton nuclear magnetic resonance studies, G1 and G2 are
      characterized as O-acetylated GD3 and G3 as O-acetylated GT3, and the structures
      of these gangliosides are as follows: [formula: see text] The major fatty acids
      of these gangliosides were C18:0, C22:0, C23:0, and C24:0, and the long chain
      base was C18-sphingosine.

PMID- 1618770
TI  - Post-transcriptional regulation of 3-hydroxy-3-methylglutaryl coenzyme A
      reductase by 24(S),25-oxidolanosterol.
AB  - We have examined the mechanism of regulation of 3-hydroxy-3-methylglutaryl
      coenzyme A reductase by 24(S),25-oxidolanosterol, a C30-sterol naturally
      occurring in mammalian tissues. In the absence of enzymatic demethylation to the
      C27-sterol, 24(S),25-epoxycholesterol, oxidolanosterol is shown to be a post
      transcriptional regulator of reductase synthesis in both primary rat hepatocytes
      and Chinese hamster ovary cells. Under these conditions, oxidolanosterol also
      increases the rate of degradation of reductase protein in these cells. When
      demethylation is not inhibited, oxidolanosterol treatment produces
      transcriptional regulation of sterol-sensitive genes in Chinese hamster ovary
      cells. In contrast to previous findings with the oxygenated C27-sterol, 25
      hydroxycholesterol, oxidolanosterol can act as a post-transcriptional regulator
      in cells starved for mevalonate. These findings are consistent with the
      hypothesis that oxidolanosterol down-regulates sterol synthesis in a fashion
      mechanistically distinct from that of C27-sterols.

PMID- 1618771
TI  - Preparation, purification, and determination of the biological activities of 12 N
      terminus-truncated recombinant analogues of bovine placental lactogen.
AB  - Removal of 13 to 15 amino acids from the N terminus of bovine placental lactogen
      (bPL), which according to the three-dimensional structure of pGH corresponds to a
      nonhelical part of bPL, did not effect its secondary structure or change the
      monomer content of the protein preparation. However, it remarkably decreased the
      binding of the prolactin (PRL) type of receptors on Nb2 cells with subsequent
      reduction in bioactivity. The binding to the growth hormone (somatogen) receptors
      either did not change or was increased, resulting in an increase of somatogen
      receptor-mediated bioactivity. Further truncation (17-18 amino acids) resulted in
      a decrease of alpha-helical content and loss of binding properties and biological
      activity mediated through interaction of the analogues with both somatogen (3T3
      F442A cells) and lactogen (PRL) receptors (NB2-11C cells). Truncation of 19-27
      amino acids caused additional loss in activity, without further change in the
      secondary structure. Replacement of Leu28 by a more hydrophobic Phe has only
      minor, if any, effect on the bioactivity of bPL. Occasional point mutations due
      to polymerase chain reaction errors in several analogues did not seem to have any
      major effect on the hormone properties. It can thus be suggested that the N
      terminal part of the nonhelical portion of bPL, which corresponds to the portion
      of the molecule that does not exist in growth hormones, is required for efficient
      binding to the lactogen (PRL) but not to the somatogen or unique bPL receptors.
      Removal of the N-terminal part of pBL changed the specificity of bPL by
      decreasing its PRL receptor-mediated activities and increasing its somatogen
      receptor-mediated activities.

PMID- 1618772
TI  - Small-angle x-ray scattering study of metal ion-induced conformational changes in
      Serratia protease.
AB  - Metal ion-induced conformational changes in Serratia protease which contains one
      zinc ion per molecule were investigated by the small-angle x-ray scattering
      method. The molecule is an elongated ellipsoid of approximately 110 x 40 x 40 A
      with a large cleft in its central region. Comparisons of the native (zinc-enzyme)
      with the zinc-free (apoenzyme) enzyme and with the zinc-replated metalloenzyme
      show small but significant differences in their radii of gyration, maximum
      particle dimensions, and intraparticle pair-distance distributions. The radius of
      gyration and maximum particle dimension of the native enzyme are almost the same
      as those of the cobalt-enzyme but are shorter and longer, respectively, than
      those of the apo- and cadmium-enzymes. Simulation analysis based on the
      intraparticle pair-distribution function showed that these modified enzymes are
      comparable with the native enzyme in overall structure, and, except for the
      cobalt-enzyme, differ in cleft size. The residual enzymatic activity of the
      cobalt-enzyme is the same as that of the native enzyme, but the apo- and cadmium
      enzymes have considerably less activity. The size of the cleft therefore is
      strictly controlled to ensure optimal enzyme activity, and the position and
      coordination behavior of the zinc ion in the cleft appears to be essential both
      for biological functioning and for the maintenance of the gross tertiary
      structure.

PMID- 1618773
TI  - Role of carnitine and carnitine palmitoyltransferase as integral components of
      the pathway for membrane phospholipid fatty acid turnover in intact human
      erythrocytes.
AB  - The deacylation and reacylation process of phospholipids is the major pathway of
      turnover and repair in erythrocyte membranes. In this paper, we have investigated
      the role of carnitine palmitoyltransferase in erythrocyte membrane phospholipid
      fatty acid turnover. The role of acyl-L-carnitine as a reservoir of activated
      acyl groups, the buffer function of carnitine, and the importance of the acyl
      CoA/free CoA ratio in the reacylation process of erythrocyte membrane
      phospholipids have also been addressed. In intact erythrocytes, the incorporation
      of [1-14C]palmitic acid into acyl-L-carnitine, phosphatidylcholine, and
      phosphatidylethanolamine was linear with time for at least 3 h. The greatest
      proportion of the radioactivity was found in acyl-L-carnitine. Competition
      experiments using [1-14C]palmitic and [9,10-3H]oleic acid demonstrated that [9,10
      3H]oleic acid was incorporated preferentially into the phospholipids and less
      into acyl-L-carnitine. When an erythrocyte suspension was incubated with [1
      14C]palmitoyl-L-carnitine, radiolabeled palmitate was recovered in the
      phospholipid fraction, and the carnitine palmitoyltransferase inhibitor, 2
      tetradecylglycidic acid, completely abolished the incorporation. ATP depletion
      decreased incorporation of [1-14C]palmitic and/or [9,10-3H]oleic acid into acyl-L
      carnitine, but the incorporation into phosphatidylcholine and
      phosphatidylethanolamine was unaffected. In contrast, ATP depletion enhanced the
      incorporation into phosphatidylcholine and phosphatidylethanolamine of the
      radiolabeled fatty acid from [1-14C]palmitoyl-L-carnitine. These data are
      suggestive of the existence of an acyl-L-carnitine pool, in equilibrium with the
      acyl-CoA pool, which serves as a reservoir of activated acyl groups. The
      carnitine palmitoyltransferase inhibition by 2-tetradecylglycidic acid or
      palmitoyl-D-carnitine caused a significant reduction of radiolabeled fatty acid
      incorporation into membrane phospholipids, only when intact erythrocytes were
      incubated with [9,10-3H]oleic acid. These latter data may be explained by the
      differences in rates and substrates specificities between acyl-CoA synthetase and
      the reacylating enzymes for palmitate and oleate, which support the importance of
      carnitine palmitoyltransferase in modulating the optimal acyl-CoA/free CoA ratio
      for the physiological expression of the membrane phospholipids fatty acid
      turnover.

PMID- 1618774
TI  - Hemoglobin Thionville. An alpha-chain variant with a substitution of a glutamate
      for valine at NA-1 and having an acetylated methionine NH2 terminus.
AB  - In hemoglobin (Hb) Thionville, the substitution of a glutamic acid for the alpha
      chain NH2-terminal valine inhibits the cleavage of the initiator methionine which
      is then acetylated. The elongation of the alpha-chain NH2 terminus modifies the
      three-dimensional structure of hemoglobin at a region that is known to have an
      important role in the allosteric regulation of oxygen binding. Relative to Hb A,
      Hb Thionville has a lower affinity for oxygen, and the heterotropic allosteric
      effects of protons, chloride, and bezafibrate are reduced. In contrast, the
      response to 2,3-diphosphoglycerate is normal. Analysis of oxygen equilibrium data
      within the framework of the two-state allosteric model indicates that the
      structure of deoxy Hb Thionville is stabilized relative to that of deoxy Hb A.
      The x-ray crystal structure of deoxy Hb Thionville shows that the glutamate side
      chain extends away from the alpha 1-alpha 2 interface, whereas the methionine
      side chain (which has two conformations) extends into the alpha 1-alpha 2
      interface, physically displacing chloride and bezafibrate. The increased
      stability of deoxy Hb Thionville is due to new intrasubunit and intersubunit
      contacts made by the methionine. These interactions replace the indirect
      contacts, made through bound chloride ions, that Val-1 alpha normally contributes
      to the alpha 1-alpha 2 interface.

PMID- 1618775
TI  - Purification and characterization of a UDP-GalNAc:polypeptide N
      acetylgalactosaminyltransferase specific for glycosylation of threonine residues.
AB  - A UDP-GalNAc:polypeptide N-acetylgalactosaminyltransferase from porcine
      submaxillary glands was purified to electrophoretic homogeneity. IgG prepared
      from antisera against the pure enzyme immunoprecipitated the transferase in
      Triton X-100 extracts of submaxillary glands. The submaxillary transferase is a
      membrane-bound enzyme in contrast to the pure bovine colostrum enzyme, which is
      soluble in the absence of detergents. Both transferases have similar properties
      but also differ significantly. Examination of the acceptor substrate specificity
      of the submaxillary gland transferase showed that it specifically transferred N
      acetylgalactosamine from UDP-GalNAc to the hydroxyl group of threonine and was
      devoid of transferase activity toward serine-containing peptides. These results
      imply that more than one transferase is involved in forming the GalNAc-threonine
      and the GalNAc-serine linkages found in O-linked oligosaccharides in
      glycoproteins. The amino acid sequence adjacent to glycosylated threonine
      residues may influence the rate of glycosylation by the pure transferase. For
      example, the second threonine residue in the sequence, Thr-Thr, appears to be
      glycosylated about twice as fast as the first and more rapidly than single,
      isolated threonine residues. However, no unique consensus sequence for
      glycosylation of threonine residues is evident, and any accessible threonine
      residue appears to be a potential acceptor substrate.

PMID- 1618776
TI  - Diversity of immunodominant 56-kDa type-specific antigen (TSA) of Rickettsia
      tsutsugamushi. Sequence and comparative analyses of the genes encoding TSA
      homologues from four antigenic variants.
AB  - There are several antigenic variants in Rickettsia tsutsugamushi, and a type
      specific antigen (TSA) of 56-kilodaltons located on the rickettsial surface is
      responsible for the variation. The primary structures of the protein in two
      variants, Gilliam and Karp, have been reported independently by us and Stover et
      al. by cloning and sequencing the corresponding genes (Ohashi, N., Nashimoto, H.,
      Ikeda, H., and Tamura, A. (1990) Gene (Amst.) 91, 119-122; Stover, C. K., Marana,
      D. P., Carter, J. M., Roe, B. A., Mardis, E., and Oaks, E. V. (1990) Infect.
      Immun. 58, 2076-2084). In the present study, genes encoding the TSA homologues of
      the other four variants, Kato, Kawasaki, Kuroki, and Shimokoshi, which are all
      distinguishable serologically, were cloned and sequenced, and consequently, it
      became possible to compare the primary structures of the six antigenic variants.
      The sequence analyses revealed a complete open reading frame encoding 55,308
      56,745-dalton proteins with 521-532 amino acids, in which a putative signal
      peptide consisting of 22 amino acids was recognized at the NH2-terminal end.
      Transcription of the gene is regulated by several tandem promoters. All TSA
      molecules have the characteristics of transmembrane proteins with alternating
      hydrophobic and hydrophilic regions, and contain four variable domains with spans
      of 16-40 amino acids which are located in the hydrophilic regions in the molecule
      and show different amino acid sequences among the strains. Phylogenetic
      classification among the R. tsutsugamushi strains based on TSA homologues
      supports the antigenic relationships known in the closely and distantly related
      strains.

PMID- 1618777
TI  - Adipsin and an endogenous pathway of complement from adipose cells.
AB  - The alternative complement pathway is best known for its role in humoral
      suppression of infectious agents. We have previously shown that adipose cells
      synthesize adipsin, the mouse homolog of human complement factor D, and that the
      synthesis of this protein is reduced in several rodent models of obesity. We show
      here that adipose cells and adipose tissue also synthesize two other essential
      components of the alternative pathway of complement, factors C3 and B, and
      activate the proximal portion of this pathway. This activation occurs in the
      absence of infectious agents and without triggering the terminal, lytic part of
      this pathway. We demonstrate the production in vitro of several polypeptides
      characteristic of complement activation that are known to have potent biological
      activities, including the anaphylatoxin C3a. Cultured adipocytes require
      stimulation with cytokines to activate complement, while explanted adipose tissue
      has no such requirement. The adipose tissue from obese mice is deficient in this
      localized activation of the alternative pathway. These results indicate that
      complement activation occurs in a localized site, adipose tissue, in normal mice
      and is impaired in a state of metabolic dysfunction. This suggests a novel
      function for the proximal portion of this complement pathway related to adipose
      cell biology or energy balance.

PMID- 1618778
TI  - Calcium is required for folding of newly made subunits of the asialoglycoprotein
      receptor within the endoplasmic reticulum.
AB  - By resolving immunoprecipitates on nonreducing sodium dodecyl sulfate gels, we
      have detected several disulfide-bonded intermediates in folding within the
      endoplasmic reticulum of newly made H1 subunits of the asialoglycoprotein
      receptor. H1 in the endoplasmic reticulum (ER) can be partially unfolded by
      treatment of cells with dithiothreitol, but H1 in Golgi or post-Golgi organelles
      is resistant to such unfolding. This defines a late step in H1 folding that
      occurs just prior to exit from the ER. Depletion of calcium from the endoplasmic
      reticulum, either by treatment with A23187 or thapsigargin, has no effect on
      folding or secretion of newly made albumin, but totally blocks H1 maturation from
      the ER. No ER intermediates in H1 folding are formed in cells treated with A23187
      or thapsigargin, indicating that at least an early step in H1 folding requires a
      high Ca2+ concentration in the ER lumen. As judged by cross-linking experiments,
      formation of H1 dimers and trimers occurs immediately after biosynthesis of the
      peptide chain, before monomer folding, and occurs normally in cells in which ER
      Ca2+ is reduced and where the monomer never folds properly. Calcium is essential
      for the asialoglycoprotein receptor to bind galactose, and our results suggest
      that Ca2+ is also essential for the receptor polypeptides to fold in the ER.

PMID- 1618779
TI  - Purification and properties of the F sex factor TraD protein, an inner membrane
      conjugal transfer protein.
AB  - Using a traD overexpression plasmid, we purified the F sex factor TraD protein in
      milligram quantities. The purified protein has an apparent molecular weight of
      82,000 and an amino acid composition rich in acidic residues. Using specific
      antibodies, TraD was localized to the inner membrane of F+ cells under conditions
      where it is produced in physiologically normal amounts. Furthermore, the protein
      was soluble only in the presence of detergents, but there is evidence that the
      carboxyl terminus is water-soluble. The purified protein shows pH-sensitive
      binding to DNA cellulose columns.

PMID- 1618780
TI  - Enhanced insulin-induced mitogenesis and mitogen-activated protein kinase
      activities in mutant insulin receptors with substitution of two COOH-terminal
      tyrosine autophosphorylation sites by phenylalanine.
AB  - We have studied the function of a mutant human insulin receptor in which two COOH
      terminal autophosphorylation sites (Tyr-1316 and -1322) were replaced by
      phenylalanine (F/Y COOH-terminal 2 tyrosines (CT2)). In addition, we have also
      constructed a mutant receptor in which Lys-1018 in the ATP-binding site was
      changed to arginine (R/K 1018). Both the wild type insulin receptor (HIR) and the
      mutant receptors were expressed in Chinese hamster ovary (CHO) cells by stable
      transfection. Autophosphorylation of solubilized and partially purified F/Y CT2
      was decreased by approximately 30% compared with the HIR. Tyrosine kinase
      activities of F/Y CT2 and HIR toward exogenous substrates were almost equal. When
      CHO cells transfected with F/Y CT2 (CHO-F/Y CT2) were stimulated with insulin,
      autophosphorylation of the beta-subunit of the insulin receptor and the
      phosphorylation of an endogenous substrate (pp185) in the intact cell were normal
      compared with cells expressing HIR (CHO-HIR). CHO-F/Y CT2 exhibited the same
      insulin sensitivity as CHO-HIR with respect to 2-deoxyglucose uptake. However,
      the dose-response curve of insulin-stimulated thymidine incorporation in CHO-F/Y
      CT2 was shifted to the left (approximately 5-7-fold) compared with that in CHO
      HIR. There was no significant difference in insulin-like growth factor 1
      stimulated thymidine incorporation between CHO-F/Y CT2 and CHO-HIR. Furthermore,
      the dose-response curve of insulin-stimulated kinase activity toward myelin basic
      protein in CHO-F/Y CT2 was also shifted to the left (approximately 5-fold)
      compared with that in CHO-HIR. Kinase assays in myelin basic protein-containing
      gels revealed that both species of MAP kinases (M(r) 44,000, 42,000) were more
      sensitive to activation by insulin in CHO-F/Y CT2 than in CHO-HIR. This
      observation was confirmed in immune complex kinase assays toward microtubule
      associated protein 2 (MAP2) using specific antibodies against mitogen-activated
      protein (MAP) kinase. R/K 1018 mutant insulin receptors showed an absence of
      insulin-stimulated kinase activity and CHO cells transfected with R/K 1018 (CHO
      R/K 1018) failed to enhance 2-deoxyglucose uptake or thymidine incorporation in
      response to insulin. In addition, R/K 1018 kinase-defective insulin receptors
      were unable to mediate insulin-stimulated MAP kinase activation. These data
      suggest that: 1) tyrosine kinase activity of the insulin receptor is required for
      activation of insulin-stimulated MAP kinases and 2) phosphorylation of COOH
      terminal tyrosine residues may play an inhibitory role in mitogenic signaling
      through regulation of MAP kinases.

PMID- 1618781
TI  - Depletion of poly(ADP-ribose) polymerase by antisense RNA expression results in a
      delay in DNA strand break rejoining.
AB  - The effects of inducible expression of poly(ADP-ribose) polymerase (PADPRP)
      antisense RNA in HeLa cells were determined in order to gain further insight into
      the biological roles of the poly(ADP-ribosyl)ation modification of nuclear
      proteins. A recombinant expression plasmid was prepared with the mouse mammary
      tumor virus (MMTV) promoter upstream of the antisense-oriented PADPRP cDNA.
      Expression of the antisense RNA was under strict control, with negligible effects
      on cell growth being apparent in the absence of inducer. Consistent with the
      previously described stability of PADPRP (half-life of at least 2 days, in vivo),
      48-72 h were required after induction of antisense RNA expression by
      dexamethasone for the abundant concentration of PADPRP, normally present in HeLa
      cells, to be reduced by greater than 80%. The depletion of endogenous PADPRP as
      mediated by induced antisense RNA expression was established by: (i) a
      progressive synthesis of antisense transcripts in cells as assessed by Northern
      analysis; (ii) an 80% decrease in activity of the enzyme; and (iii) a greater
      than 90% reduction in the cellular content of PADPRP protein, as demonstrated by
      both immunoblotting and immunohistochemical analysis in intact cells. Several
      biological parameters were monitored in cells depleted of PADPRP. The chromatin
      of PADPRP-depleted cells was shown to have an altered structure as assessed by
      deoxyribonuclease I susceptibility. Cell morphology was also altered, with
      multinucleated aggregates being evident 72 h after induction of antisense RNA
      expression. Cells depleted of PADPRP were not able to commence DNA strand break
      joining of damaged DNA. However, DNA repair capacity was re-established at later
      time periods, indicating that PADPRP may contribute to alterations in chromatin
      structure that occur initially in DNA strand break rejoining and that the
      concentration of the enzyme in nuclei exceeds the requirement for DNA
      repair/replication.

PMID- 1618782
TI  - Structure of peptostreptococcal protein L and identification of a repeated
      immunoglobulin light chain-binding domain.
AB  - The gene for protein L, an immunoglobulin (Ig) light chain-binding protein
      expressed by some strains of the anaerobic bacterial species Peptostreptococcus
      magnus, was cloned and sequenced. The gene translates into a protein of 719 amino
      acid residues. Following a signal sequence of 18 amino acids and a NH2-terminal
      region ("A") of 79 residues, the molecule contains five homologous "B" repeats of
      72-76 amino acids each. Further, toward the COOH terminus, two additional repeats
      ("C") were found. These are not related to the "B" repeats, but are highly
      homologous to each other. After the C repeats (52 amino acids each), a
      hydrophilic, proline-rich putative cell wall-spanning region ("W") was found,
      followed at the COOH-terminal end by a hydrophobic membrane anchor ("M").
      Fragments of the gene were expressed, and the corresponding peptides were
      analyzed for Ig-binding activity. The B repeats were found to be responsible for
      the interaction with Ig light chains. An Escherichia coli high level expression
      system was adapted for the production of large amounts of two Ig-binding protein
      L fragments comprising one and four B repeats, respectively.

PMID- 1618783
TI  - Induction of myogenic differentiation by an expression vector encoding the DNA
      methyltransferase cDNA sequence in the antisense orientation.
AB  - To test the hypothesis that DNA methylation controls the state of differentiation
      of a mammalian cell, we transfected the stable mesenchymal line 10T1/2 with an
      expression vector encoding sequences from the DNA methyltransferase (DNA MeTase)
      cDNA in the antisense orientation. 10T1/2 cells transfected with the antisense
      construct (pZ alpha M), but not with the vector alone, exhibit morphological
      changes, convert into multinucleated tubular cells, and express the skeletal
      myosin heavy chain protein. The conversion to myogenic phenotype is a late event
      and is dependent on the number of replication events that the cell has undergone,
      suggesting that induction of myogenesis is a multistep process. Demethylation of
      sequences that are not involved in the myogenic process is detected at early
      passages, while demethylation and expression of the MyoD gene is a late event.
      This report establishes for the first time that demethylation is a very early
      event in commitment to myogenic differentiation, while demethylation and
      expression of MyoD is a late event. We suggest that other genes serve as the
      initial targets for demethylation and commitment of mesenchymal cells to
      myogenesis. The cell lines described in this report can serve as an important
      system for identifying these genes.

PMID- 1618784
TI  - Chicken vinculin and meta-vinculin are derived from a single gene by alternative
      splicing of a 207-base pair exon unique to meta-vinculin.
AB  - meta-Vinculin and vinculin are closely related proteins that are cytoplasmic
      components of microfilament-associated cell junctions. This report describes the
      structural relationship between these two proteins and the genetic basis for
      tissue-specific expression of meta-vinculin. Analysis of genomic DNA coding for
      amino acids 676-1066 of vinculin revealed 9 exons spanning an 11.7-kilobase pair
      region of the genome. In the 4 kilobase pairs of intervening sequence that
      separates vinculin exons E896-E915 and E916-E984, there is an open reading frame
      that predicts a sequence homologous to the 68-amino acid peptide specific to
      porcine meta-vinculin (Gimona, M., Small, J. V., Moeremans, M., Van Damme, J.,
      Puype, M., and Van-dekerckhove, J. (1988) EMBO J. 7, 2329-2334). Analysis of the
      corresponding cDNA established that chicken meta-vinculin contains a 69-amino
      acid insertion between residues 915 and 916 of vinculin and that there are no
      other amino acid sequence differences between chicken vinculin and meta-vinculin.
      Muscle-specific expression of meta-vinculin occurs by alternative splicing of a
      transcript produced from a single gene because: all 20 genomic isolates that
      contain the 3' vinculin exons, also contain the meta-vinculin-specific exon;
      Southern blots performed at high stringency with exon-specific probes indicate
      the presence of a single gene; and the 3'-untranslated sequences of vinculin and
      meta-vinculin cDNAs are identical.

PMID- 1618785
TI  - Efficient plasma membrane expression of a functional platelet glycoprotein Ib-IX
      complex requires the presence of its three subunits.
AB  - The glycoprotein (GP) Ib-IX complex of the platelet plasma membrane mediates the
      adhesion of platelets to damaged blood vessel wall. The complex is composed of
      three membrane-spanning polypeptides, GP Ib alpha, GP Ib beta, and GP IX, all of
      which are absent from the platelets of patients with the hereditary bleeding
      disorder Bernard-Soulier syndrome. In this study we report stable expression of
      the recombinant receptor in three cell lines and demonstrate that the three
      subunits of the complex are necessary for its efficient expression on the plasma
      membrane. The expressed complex associates with the cytoskeleton of the
      transfected cells through an interaction with actin-binding protein and binds its
      ligand, von Willebrand factor. These data suggest that the lack of plasma
      membrane GP Ib-IX complex in the Bernard-Soulier syndrome could potentially arise
      from mutations affecting any one of its three subunits.

PMID- 1618786
TI  - Protein targeting across the three membranes of the Euglena chloroplast envelope.
AB  - A system has been developed for the import in vitro of precursor proteins into
      Euglena chloroplasts, which have three envelope membranes. Preparation of
      functional chloroplasts with intact envelope membranes has been optimized. Import
      of the precursor (50 kDa) for the tetrapyrrole biosynthesis enzyme
      porphobilinogen deaminase (PBGD), and processing to the mature size (40 kDa),
      occurred at 25 degrees C in the light and the presence of ATP, with an estimated
      efficiency of 62%. Pretreatment of the chloroplasts with proteases abolished this
      import, suggesting the involvement of specific protein receptors. The presequence
      of PBGD was found to be cleaved by Escherichia coli leader peptidase to an
      intermediate form (46 kDa). A construct in which the first 30 residues of the
      presequence (presumed to be the region removed by leader peptidase) had been
      deleted was no longer imported. Neither prePBGD nor the truncated precursor were
      imported into pea chloroplasts, although both bound to the pea chloroplast
      envelope. Conversely, a chimeric construct, in which the mature PBGD protein was
      fused downstream of the transit peptide for pea ferredoxin-NADP reductase, was
      efficiently imported into pea chloroplasts and processed to the mature size.
      However, this was not imported into Euglena chloroplasts, although again it bound
      to them. These results provide preliminary evidence for the possibility of two
      functional domains within the Euglena PBGD presequence. The implications of these
      findings with respect to the evolution of Euglena chloroplasts are discussed.

PMID- 1618787
TI  - Expression of four protein kinase C isoforms in rat fibroblasts. Distinct
      subcellular distribution and regulation by calcium and phorbol esters.
AB  - Protein kinase C (PKC), the major receptor for tumor-promoting phorbol esters,
      consists of a family of at least eight distinct lipid-regulated enzymes. How the
      various PKC isozymes are regulated in vivo and how they couple to particular
      cellular responses is largely unknown. We have examined the expression and
      regulation of PKC isoforms in R6 rat embryo fibroblasts. Northern and Western
      blot analyses indicate that these cells express four PKC isoforms, cPKC alpha,
      nPKC epsilon, nPKC delta, and nPKC zeta; of which nPKC epsilon and nPKC delta are
      the most abundant. In agreement with the simultaneous presence of cPKC and nPKC
      isozymes, both Ca(2+)-dependent and -independent PKC activities were detected in
      extracts of these cells. cPKC alpha and nPKC zeta were predominantly localized in
      the cytosol when subcellular fractionation was carried out in the presence of
      [ethylenebis(oxyethylenenitrilo)]tetraacetic acid. When cell lysis was carried
      out in the presence of Ca2+, greater than 50% of cPKC alpha redistributed to the
      particulate fraction, whereas nPKC zeta remained in the cytosol. In contrast to
      cPKC alpha and nPKC zeta, 60-80% of nPKC epsilon and nPKC delta were located in a
      Ca(2+)-insensitive, membrane-bound form. Treatment of R6 cells with 12-O
      tetradecanoyl phorbol 13-acetate (TPA), resulted in the translocation of all four
      PKC isozymes to the membrane fraction, and the subsequent down-regulation of cPKC
      alpha, nPKC zeta, and nPKC delta, nPKC epsilon, however, was only partially down
      regulated in response to long-term TPA exposure. Overproduction of exogenous cPKC
      beta I in R6 cells conferred partial resistance of nPKC delta to TPA-induced down
      regulation and potentiated the resistance of nPKC epsilon to down-regulation.
      These results demonstrate that the multiple isoforms of PKC which coexist within
      a single cell type are differentially regulated by extra- and intracellular
      stimuli and may thereby influence growth control and transformation via distinct
      mechanisms.

PMID- 1618788
TI  - Expression of four protein kinase C isoforms in rat fibroblasts. Differential
      alterations in ras-, src-, and fos-transformed cells.
AB  - In the accompanying study (Borner, C.B., Guadagno, S. N., and Weinstein, I. B.
      (1992) J. Biol. Chem. 267, 12892-12899) we found that R6 embryo fibroblasts
      express four isoforms of PKC, cPKC alpha, nPKC epsilon, nPKC delta, and nPKC zeta
      whose subcellular distribution, activation, and down-regulation are
      differentially regulated. Furthermore, we demonstrated that overproduction of an
      exogenous cPKC beta I isoform in these cells (R6-PKC3) altered the TPA-induced
      down-regulation of nPKC delta and nPKC epsilon. In this paper we show that
      transformation of R6 or R6-PKC3 cells with a variety of different oncogenes
      results in differential alterations in expression of individual PKC isoforms. R6
      or R6-PKC3 cells transformed by an activated c-H-ras oncogene displayed a marked
      increase in the expression of both cPKC alpha and nPKC delta, decreased
      expression of nPKC epsilon, and no change in the expression of nPKC zeta. These
      alterations occurred at both the mRNA and protein levels but did not
      significantly affect the subcellular distribution of any of the four isoforms.
      Studies using actinomycin D and nuclear run-off assays indicated that the
      increased expression of cPKC alpha in ras-transformed cells was due to increased
      de novo transcription rather than increased mRNA stability. Qualitatively
      similar, but less extensive changes in the expression of the four PKC isoforms
      were seen in v-fos-transformed R6-PKC3 cells. Decreased expression of nPKC
      epsilon was also seen in the v-src-transformed R6- and R6-PKC3 lines; however,
      the cellular level of cPKC beta I appeared to be a limiting factor in mediating
      the effects of v-src on the increased expression of cPKC alpha and nPKC delta.
      Interestingly, no major changes in the levels of expression of any of the four
      PKC isoforms were found when R6 cells were transformed by myc, neu/erb-B2, or mos
      oncogenes. These results demonstrate that transformation of R6 cells by the
      oncogenes ras, src, and fos differentially alter the expression of three isoforms
      of PKC in the same host cell, and they suggest that individual isoforms may play
      distinct roles in mediating cellular transformation by specific oncogenes.

PMID- 1618789
TI  - Molecular cloning and analysis of an eIF-4A-related rat liver nuclear protein.
AB  - In this paper, we report the cloning and analysis of a cDNA encoding a protein of
      M(r) congruent to 47,000 (p47), which is localized to the nucleus of rat
      hepatocytes. The cDNA showed 37% overall sequence identity with a mouse
      translation initiation factor, eIF-4A, which belongs to a family of putative ATP
      dependent RNA helicases. We raised polyclonal antibodies against the fusion
      protein and by indirect immunofluorescence on primary cultures of hepatocytes
      have demonstrated that p47 is located in the nucleus. Although only approximately
      27% of hepatocytes showed this nuclear staining, most of the nuclei in
      proliferating transformed cell lines such as 3T3, PtK-1, and Hela were
      fluorescently labeled. Studies on serum-starved cells in culture indicated that
      p47 was expressed in a cell cycle-dependent manner. Northern analyses
      demonstrated that the levels of p47 mRNA were high in fetal liver and dropped
      significantly after birth to low levels in adult liver. Our data suggest that p47
      is developmentally regulated in rat liver at the mRNA level.

PMID- 1618790
TI  - Heat shock protein 27 and alpha B-crystallin can form a complex, which
      dissociates by heat shock.
AB  - We have previously demonstrated that in non-oncogenic adenovirus-transformed baby
      rat kidney cells a complex of hsp27 and a 22-kDa protein is present, which is
      lacking in oncogenic cells (Zantema, A., de Jong, E., Lardenoije, R., and van der
      Eb, A. J. (1989) J. Virol. 63, 3368-3375). Here we show that the 22-kDa protein
      is identical to alpha B-crystallin. The complex of hsp27 and alpha B-crystallin
      is also found in some other (non-transformed) cells. However, in most cells
      tested only hsp27 and no alpha B-crystallin is synthesized. Gel filtration
      studies show that both proteins are present almost exclusively in a 700-kDa
      complex. Heat treatment makes the complex fall apart, which is accompanied by a
      change in the conformation of alpha B-crystallin. Upon recovery, complexes are
      formed again from both pre-existing and newly synthesized proteins.

PMID- 1618791
TI  - Sequence and specificity of a soluble lactose-binding lectin from Xenopus laevis
      skin.
AB  - A 16-kDa lactose-binding lectin comprises 5% or more of the soluble protein in
      Xenopus laevis skin. This lectin is mainly localized in the cytoplasm of granular
      gland cells. In response to stress, the lectin along with a variety of toxic and
      antibiotic peptides are released onto the skin surface by holocrine secretion. We
      have purified the lectin, sequenced tryptic peptides using tandem mass
      spectrometry and Edman degradation, and isolated full-length cDNA using a deduced
      oligonucleotide. Comparison of the cDNA and peptide sequences revealed expression
      of at least two isolectins, which differ in sequence at only two or three amino
      acids. Comparison of cDNA with complementary message by ribonuclease protection
      confirmed expression in approximately equal abundance of two nearly identical
      messages. The major soluble lactose-binding lectin expressed in Xenopus muscle is
      composed of these same isolectins, but at 100-fold lower levels. Similarities and
      distinctions in sequence and carbohydrate-binding specificity indicate that this
      lectin is a novel member of a family of soluble lactose-binding lectins expressed
      in a wide range of vertebrate tissues.

PMID- 1618792
TI  - A deletion in the ornithine aminotransferase gene in gyrate atrophy.
AB  - Gyrate atrophy (GA) is an autosomal recessive chorioretinal degenerative disease
      of the eye caused by an inborn defect of the nuclear encoded mitochondrial enzyme
      ornithine aminotransferase (OAT). We have described previously a GA patient with
      a 5.0-kilobase pair truncated EcoRI OAT gene fragment and the absence of OAT mRNA
      on Northern blot analysis. Cloning and sequencing analysis of the truncated gene
      fragment revealed a 1,072-base pair (bp) deletion including the entire exon 6,
      starting in intron 5, 172 bp upstream of exon 6 and ending in intron 6, 772 bp
      downstream of exon 6. A short direct repeat sequence (AGGAGC), resembling the
      sequence shown to cause DNA polymerase alpha to pause, and sequences capable of
      forming hairpin loops were both present at the 5' and 3' break-points of the
      deletion. Reverse transcription-polymerase chain reaction amplification of the
      patient's RNA with OAT primers yielded DNA fragments of two different sizes,
      consistent with a low level expression of OAT mRNA. Direct sequencing of the
      smaller fragment demonstrated the complete absence of exon 6 sequence in the mRNA
      predicted from the deletion, causing a reading frame shift which results in a
      premature termination codon at position 192. The mutation in the other allele has
      been demonstrated by polymerase chain reaction, denaturing gradient gel
      electrophoresis, and direct sequencing also to be a premature termination codon
      in exon 6. The absence of detectable OAT mRNA in this patient is consistent with
      these premature termination mutations because they have been shown to decrease
      the level of mRNA, especially if present early in the coding sequence.

PMID- 1618793
TI  - Release and recycling of eukaryotic initiation factor 2 in the formation of an 80
      S ribosomal polypeptide chain initiation complex.
AB  - The eukaryotic initiation factor (eIF)-5 mediates hydrolysis of GTP bound to the
      40 S initiation complex in the absence of 60 S ribosomal subunits. The eIF-2.GDP
      formed under these conditions is released from the 40 S ribosomal subunit while
      initiator Met-tRNA(f) remains bound. The released eIF-2.GDP can participate in an
      eIF-2B-catalyzed GDP/GTP exchange reaction to reform the Met-tRNA(f).eIF-2.GTP
      ternary complex. In contrast, when 60 S ribosomal subunits were also present in
      an eIF-5-catalyzed reaction, the eIF-2.GDP produced remained bound to the 60 S
      ribosomal subunit of the 80 S initiation complex. When such an 80 S initiation
      complex, containing bound eIF-2.GDP, was incubated with GTP and eIF-2B, GDP was
      released. However, eIF-2 still remained bound to the ribosomes and was unable to
      form a Met-tRNA(f)l.eIF-2.GTP ternary complex. In contrast, when 60 S ribosomal
      subunits were preincubated with either free eIF-2 or with eIF-2.eIF-2B complex
      and then added to a reaction containing both the 40 S initiation complex and eIF
      5, the eIF-2.GDP produced did not bind to the 60 S ribosomal subunits but was
      released from the ribosomes. Thus, the 80 S initiation complex formed under these
      conditions did not contain bound eIF-2.GDP. Under similar experimental
      conditions, preincubation of 60 S ribosomal subunits with purified eIF-2B (free
      of eIF-2) failed to cause release of eIF-2.GDP from the ribosomal initiation
      complex. These results suggest that 60 S ribosome-bound eIF-2.GDP does not act as
      a direct substrate for eIF-2B-mediated release of eIF-2 from ribosomes. Rather,
      the affinity of 60 S ribosomal subunits for either eIF-2, or the eIF-2 moiety of
      the eIF-2.eIF-2B complex, prevents association of 60 S ribosomal subunits with
      eIF-2.GDP formed in the initiation reaction. This ensures release of eIF-2 from
      ribosomes following hydrolysis of GTP bound to the 40 S initiation complex.

PMID- 1618794
TI  - Structural characterization of a novel cholinergic neuron-specific ganglioside in
      bovine brain.
AB  - A new ganglioside antigen, termed Chol-1 alpha-b, recognized by cholinergic
      neuron-specific antibody, Chol-1 alpha, was isolated from bovine brain
      ganglioside mixture using Q-Sepharose. The yield was approximately 1.3 mg from 5
      g of the total ganglioside. The chemical structure was characterized as a novel
      ganglioside by means of gas-liquid chromatography, a permethylation study, mild
      acid hydrolysis, thin layer chromatography-enzyme immunostaining, fast atom
      bombardment mass spectrometry, and proton nuclear magnetic resonance
      spectroscopy. The ganglioside has the following unique structure. [formula: see
      text] When examined by thin layer chromatography immunostaining and enzyme-linked
      immunosorbant assays, this ganglioside has the most intense immunoreactivity with
      Chol-1 alpha antibody among bovine brain gangliosides. As combined with our
      previous results (Hirabayashi, Y., Hyogo, A., Nakao, T., Tsuchiya, K., Suzuki,
      Y., Matsumoto, M., Kon, K., and Ando, S. (1990) J. Biol. Chem. 265, 8144-8151;
      Ando, S., Hirabayashi, Y., Kon, K., Inagaki, F., Tate, S., and Whittaker, X.
      (1992) J. Biochem. (Tokyo), 111, 287-290), the present study indicates the
      occurrence of a new series of gangliosides containing N-acetylneuraminic acid
      residue attaching to N-acetylgalactosamine as cholinergic specific antigens.

PMID- 1618795
TI  - Cardiac expressions of alpha- and beta-myosin heavy chains and sarcomeric alpha
      actins are regulated through transcriptional mechanisms. Results from nuclear run
      on assays in isolated rat cardiac nuclei.
AB  - In the heart, mRNA accumulations for sarcomeric actins and myosin heavy chains
      (MHC) are subject to diverse regulatorial processes. To study cardiac contractile
      protein transcriptional regulations, an in vitro transcription system using
      nonenzymatically isolated rat cardiac nuclei was characterized. Transcription was
      shown to be rapid and continuous during the first 20 min of incubation and 5.4
      fold less than that seen from comparably isolated hepatocyte nuclei. Neither
      RNase nor DNase activities were detectable. Direct transcriptional analyses of
      the alpha- and beta-MHC and cardiac and skeletal alpha-actin genes from cardiac
      nuclei were performed. In 23-24-day-old rats, significant levels of transcription
      were seen for alpha-MHC and for the sarcomeric alpha-actins. beta-MHC was just
      detectable, and no positive signals were ever seen for fibronectin. We then
      compared the perecentages of MHC and sarcomeric alpha-actin expressions
      determined from 1) the transcriptional assays and 2) total isolated RNA (alpha
      MHC: 90.1 +/- 4.8% (transcription), 93.0 +/- 4.7% (accumulation); beta-MHC: 9.9
      +/- 4.8%, 7.0 +/- 4.7%; cardiac alpha-actin: 84.0 +/- 2.5%, 84.9 +/- 2.5%;
      skeletal alpha-actin: 16.1 +/- 2.5%, 15.0 +/- 2.5%). The results support the
      conclusion that the primary mechanisms controlling the accumulations of these
      gene products are transcriptional. Additionally, we show that an anti-sense mRNA
      showing strong homology or identity with the 5' end of the beta-MHC gene is
      transcribed in cardiac nuclei but not in hepatocyte nuclei.

PMID- 1618796
TI  - Four conserved cysteine residues are required for the DNA binding activity of
      nuclear factor I.
AB  - The role of Cys residues in the site-specific DNA binding activity of the nuclear
      factor I (NFI) family of proteins was assessed by chemical modification and site
      specific mutagenesis. Treatment with the thio-specific reagent N-ethylmaleimide
      abolished site-specific DNA binding of all forms of NFI present in HeLa nuclear
      extracts. Preincubation of cell extracts with an oligonucleotide containing an
      NFI-binding site provided partial protection of NFI from N-ethylmaleimide
      inactivation. Mutations were made in the cDNA encoding a truncated form of the
      NFI-C/CAAT box transcription factor-1 protein, converting each of the five Cys
      residues in the DNA-binding domain of the protein into Ser residues. NFI-C
      proteins containing mutations in any of four conserved Cys residues, expressed in
      Escherichia coli or in vitro, did not bind to DNA. NFI-C with a mutation in a
      nonconserved Cys residue had normal DNA binding activity. Both this active mutant
      and wild-type NFI-C protein were inactivated by modification of their sulfhydryl
      residues with 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB), and preincubation with
      an oligonucleotide containing an NFI-binding site gave partial protection against
      inactivation. After modification with DTNB, DNA binding activity was partially
      restored by subsequent incubation with dithiothreitol, indicating that
      inactivation of NFI by DTNB was reversible. These studies indicate an essential
      role for free sulfhydryl residues in NFI-DNA binding.

PMID- 1618797
TI  - Pro-opiomelanocortin synthesized by corticotrophs bears asparagine-linked
      oligosaccharides terminating with SO4-4GalNAc beta 1,4GlcNAc beta 1,2Man alpha.
AB  - We have determined that greater than or equal to 80% of the Asn-linked
      oligosaccharides on the glycosylated form of mouse adrenocorticotropin (15-kDa
      adrenocorticotropin (ACTH)) bear one or more branches terminating with the
      sequence SO4-4GalNAc beta 1,4GlcNAc beta 1,2Man alpha (S4GGnM).
      Proopiomelanocortin (POMC), the precursor of ACTH, is the first example of a
      glycoprotein that is not a member of the glycoprotein hormone family to bear such
      sulfated structures. Like lutropin and thyrotropin, 15-kDa ACTH bears dibranched
      oligosaccharides terminating with SO4-4-GalNAc; however, at least half of the
      oligosaccharides on 15-kDa ACTH terminating with SO4-4-GalNAc consist of more
      highly branched structures that have not previously been described. Both the
      GalNAc beta 1,4GlcNAc beta 1,2Man-4-sulfotransferase and the glycoprotein hormone
      specific GalNAc-transferase are expressed in the corticotroph-derived AtT-20 cell
      line. A tripeptide recognition sequence, Pro-Val-Lys, similar to the Pro-Leu-Arg
      sequence required for recognition of glycoprotein hormone alpha- and beta
      subunits by the glycoprotein hormone-specific GalNAc-transferase, is present 8
      residues amino-terminal to the glycosylated Asn of 15-kDa ACTH. Thus, POMC has
      the features expected for specific addition of the S4GGnM sequence to its
      oligosaccharides. The recent discovery of a receptor in hepatic endothelial cells
      that recognizes oligosaccharides terminating with S4GGnM suggests these sulfated
      oligosaccharides will regulate the circulatory half-life of glycosylated POMC
      cleavage products.

PMID- 1618798
TI  - The human gene for renin-binding protein.
AB  - The human renin-binding protein (RnBP) gene was isolated from a human placental
      genomic library and characterized. The gene spans about 10 kilobases and consists
      of 11 exons separated by 10 introns. The 5'-flanking region and the exon-intron
      boundaries were sequenced. Residue G* in 5'-CGAG*TGG-3' was identified as the
      major transcription initiation site, and "GC" boxes were found in the vicinity of
      the cap site. No typical "TATA" or "CCAAT" box exists in the 5'-flanking region.
      The hydrophobic domain followed by a leucine-zipper motif in RnBP is encoded by
      the sixth exon. A fragment of the human RnBP gene (nucleotides -739 to +244)
      linked to the chloramphenicol acetyltransferase gene was transfected into human
      Wilms' tumor G401 and mouse L929 cells. The expression of this chimeric gene in
      G401 cells was 4-fold higher than that in L929 cells, the tissue-specific
      regulation of RnBP gene expression thus being suggested. The promoter for the
      RnBP gene was shown to be localized in nucleotides -35 to +244 on assaying of the
      promoter activity using deletion mutants of the chimeric constructs. The RnBP
      gene was found to be located in human chromosome X by means of polymerase chain
      reaction of hybrid DNAs from human and hamster somatic cells.

PMID- 1618799
TI  - Thyroid hormone receptor mutants that cause resistance to thyroid hormone.
      Evidence for receptor competition for DNA sequences in target genes.
AB  - Several distinct mutations in the ligand-binding domain of the beta form of the
      thyroid hormone receptor have been reported in kindreds with the autosomal
      dominant syndrome of generalized resistance to thyroid hormone (GRTH). GRTH
      receptor mutants are functionally inactive but capable of inhibiting normal
      receptor function in transient expression studies. We examined the possibility
      that this dominant negative activity of the GRTH mutants involves competition for
      receptor binding to DNA. Mutations introduced into either the T3 ligand-binding
      domain (LBD) or into the DNA-binding domain (DBD) of the receptor eliminated the
      transcriptional activity of the receptor. In cotransfection experiments, the LBD
      mutants, but not the DBD mutants, inhibited the transcriptional activity of the
      normal receptor. The inhibitory activity of the LBD mutants was abolished by the
      introduction of an additional mutation into the DBD, suggesting that the DBD is
      required for dominant negative activity. A chimeric receptor, in which the DNA
      binding domain of the thyroid hormone receptor was exchanged with the homologous
      region in the glucocorticoid receptor (GTG), was used to study thyroid hormone
      receptor competition for GTG interactions with thyroid receptor target sequences.
      In the absence of thyroid hormone, the normal thyroid hormone receptor inhibited
      dexamethasone stimulated transcription by GTG. The transcriptional activity of
      GTG was also inhibited by the LBD mutants but not by a DBD mutant of the thyroid
      hormone receptor. These results indicate that the thyroid hormone receptor
      mutations that occur in GRTH compete with normal receptors at DNA-binding sites
      in target genes to block normal receptor function.

PMID- 1618800
TI  - Evidence that mutations in a loop region of the alpha-subunit inhibit the
      transition from an open to a closed conformation in the tryptophan synthase
      bienzyme complex.
AB  - Rapid-scanning stopped-flow (RSSF) UV-visible spectroscopy has been used to
      investigate the effects of single amino acid mutations in the alpha-subunit of
      the Salmonella typhimurium tryptophan synthase bienzyme complex on the reactivity
      at the beta-subunit active site located 25 to 30 A distant. The pyridoxal 5'
      phosphate (PLP) cofactor provides a convenient spectroscopic probe to directly
      monitor catalytic events at the beta-active site. Single substitutions of Phe for
      Glu at position 49, Leu for Gly at position 51, or Tyr for Asp at position 60 in
      the alpha-subunit strongly alter the observed steady state and pre-steady state
      inhibitory effects of the alpha-subunit-specific ligand alpha-glycerophosphate
      (GP) on the PLP-dependent beta-reaction. However, similar GP-induced allosteric
      effects on the distribution of covalent intermediates bound at the beta-site that
      are observed with the wild-type enzyme (Houben, K.F., and Dunn, M.F. (1990)
      Biochemistry 29, 2421-2429) also are observed for each of the mutant bienzyme
      complexes. These results support the hypothesis that the preferred pathway of
      indole from solution into the beta-site is via the alpha-site and the
      interconnecting tunnel (Dunn, M.F., Aguilar, V., Brzovic, P., Drewe, W.F.,
      Houben, K.F., Leja, C.A., and Roy, M. (1990) Biochemistry 29, 8598-8607).
      Residues alpha E49, alpha G51, and alpha D60 are part of a highly conserved
      inserted sequence in the alpha/beta-barrel topology of the alpha-subunit. We
      propose that the GP-induced inhibition of the beta-reaction results, in part,
      from a ligand-dependent conformational change from an "open" to a "closed"
      structure of the alpha-subunit which involves this region of the alpha-subunit
      and serves to obstruct the direct access of indole into the tunnel. Our findings
      suggest that the altered kinetic behavior observed for the alpha-mutants in the
      presence of GP reflects an impaired ability of the modified bienzyme complex to
      undergo the conformational transition from the open to the closed form.

PMID- 1618801
TI  - The amino terminus of ADP-ribosylation factor (ARF) is a critical determinant of
      ARF activities and is a potent and specific inhibitor of protein transport.
AB  - Deletion of the amino-terminal 17 residues from human ADP-ribosylation factor
      (ARF) resulted in a protein ([delta 1-17]mARF1p) devoid of ARF activity but which
      retained the ability to bind guanine nucleotides with high affinity. Unlike the
      wild type, the binding of guanine nucleotides to this deletion mutant was found
      to be independent of added phospholipids. A chimeric protein was produced,
      consisting of 10% (the amino-terminal 17 amino acids) human ARF1p and 90% ARL1p,
      an ARF-like protein (55% identical protein sequence) from Drosophila. This
      chimera was found to have ARF activity, lacking in the parental ARL1 protein.
      Thus, the amino terminus of ARF1p was shown to be a critical component of ARF
      activity. A synthetic peptide, derived from the amino terminus of ARF1p, has no
      ARF activity. Rather, the peptide was found to be a specific inhibitor of ARF
      activities. This peptide was also found to be a potent and specific inhibitor of
      both an in vitro intra-Golgi transport assay and the guanosine 5'-3-O
      (thio)triphosphate-stimulated accumulation of coated vesicles and buds from Golgi
      preparations. We conclude that ARF is required for the budding of coated vesicles
      from the Golgi stacks and serves a regulatory role in protein secretion through
      the Golgi in eukaryotic cells.

PMID- 1618802
TI  - Evidence for ADP-ribosylation factor (ARF) as a regulator of in vitro endosome
      endosome fusion.
AB  - We have used an in vitro endosome fusion assay, recombinant ARF, synthetic
      peptides, and guanosine 5'-3-O-(thio)triphosphate (GTP gamma S) to study the role
      of ARF during endocytosis. Previous work has shown that GTP gamma S stimulates in
      vitro endosome fusion in dilute cytosol (less than 0.5 mg/ml) but inhibits fusion
      in concentrated cytosol (greater than 1.0 mg/ml). Two peptides corresponding to
      the NH2-terminal 16 amino acids of human ARF1 and ARF4 blocked GTP gamma S
      stimulation of fusion in dilute cytosol and reversed GTP gamma S inhibition of
      fusion in concentrated cytosol. The addition of recombinant human ARF1 to
      endosomes in dilute or concentrated cytosol resulted in GTP gamma S-dependent
      inhibition of fusion. Only the myristoylated form of ARF inhibited fusion. The
      NH2-terminal ARF1 peptide reversed inhibition by recombinant ARF1. Preincubation
      experiments showed that endosomes could form an ARF-resistant intermediate during
      the fusion process. Western blot analysis revealed clathrin-coated vesicles
      extracted with detergent retained ARF. The results suggest that ARF is involved
      in both the stimulatory and inhibitory effects of GTP gamma S in dilute and
      concentrated cytosol, respectively. Furthermore, myristoylation, the NH2-terminal
      domain, and binding to GTP appear to be critical for ARF activity during an early
      prefusion step required for endocytosis.

PMID- 1618803
TI  - ADP-ribosylation factor is required for vesicular trafficking between the
      endoplasmic reticulum and the cis-Golgi compartment.
AB  - We describe the potential role of ADP-ribosylation factor (ARF) in vesicular
      trafficking using an in vitro assay that efficiently reconstitutes transport
      between the endoplasmic reticulum (ER) and the cis-Golgi compartment in mammalian
      semi-intact cells, a population of cells in which the plasma membrane is
      physically perforated to reveal intact ER and Golgi compartments. We demonstrate
      that peptides identical to the amino-terminal domain of ARF, which inhibit ARF
      cofactor activity in cholera toxin-catalyzed ADP-ribosylation of G alpha S (Kahn,
      R. A., Randazzo, P., Serafini, T., Weiss, O., Rulka, C., Clark, J., Amherdt, M.,
      Roller, P., Orci, L., and Rothman, J. E. (1992) J. Biol. Chem. 267, 13039-13046),
      inhibit transport of the vesicular stomatitis virus G protein between the ER and
      cis-Golgi compartment. Inhibition of transport was rapid (t1/2 = 30-60 s) and
      irreversible. Half-maximal inhibition was observed at concentrations of 15 and 22
      microM with peptides identical to the amino-terminal domain of the human ARF4
      (hARF4) protein and the human ARF1 protein, respectively. Kinetic analysis of
      vesicular stomatitis virus G protein transport suggested that the hARF4 peptide
      inhibits a late vesicle fusion step. In addition, incubation of semi-intact cells
      in the presence of the myristoylated form human ARF1 (hARF1myr) protein, but not
      the nonmyristoylated form of ARF1, inhibited transport. In contrast to peptide,
      the hARF1myr blocked an early transport step, similar to that observed with
      guanosine 5'-3-O-(thio)triphosphate. These results suggest that ARF and
      components facilitating ARF function play an important role in the cyclical
      fission and fusion of transport vesicles mediating ER to Golgi trafficking.

PMID- 1618804
TI  - A common sequence motif, -E-G-Y-A-T-A-, identified within the primase domains of
      plasmid-encoded I- and P-type DNA primases and the alpha protein of the
      Escherichia coli satellite phage P4.
AB  - DNA primases encoded by the conjugative plasmids ColIb-P9 (IncI1), RP4, and R751
      (IncP), and the protein of the Escherichia coli satellite phage P4 alpha were
      shown to contain a common amino acid sequence motif -E-G-Y-A-T-A-. The P4 alpha
      gene product, required for initiation of phage DNA replication, exhibits primase
      activity on single-stranded circular DNA templates. This priming activity
      resembles the enzymatic activity of DNA primases encoded by conjugative plasmids
      in terms of template utilization and the ability to synthesize primers that can
      be elongated by DNA polymerase III holoenzyme. The -E-G-Y-A-T-A- motif is part of
      an extended sequence region most conserved within the primase domains of the four
      enzymes. Single amino acid substitutions generated in the -E-G-Y-A-T-A- motif of
      the RP4 TraC2 and the P4 alpha protein affect priming activity, supporting the
      hypothesis that the conserved sequence motif is part of the active center for
      primase function. A mutation that eliminates priming activity causes P4 phage to
      grow poorly and to depend upon the host dnaG primase. Computer analysis
      identified two additional sequence motifs within the amino acid sequence of the
      P4 alpha protein: a potential zinc-finger motif and a "type A" nucleotide binding
      site, both strikingly similar to sequence motifs described in various DNA
      primases and helicases.

PMID- 1618805
TI  - The epithelin precursor encodes two proteins with opposing activities on
      epithelial cell growth.
AB  - Epithelin 1 and 2 were originally purified from rat kidneys based on their
      ability to inhibit the growth of A-431 human epidermoid carcinoma cells (Shoyab,
      M., McDonald, V.L., Byles, C., Todaro, G.J., and Plowman, G.D. (1990) Proc. Natl.
      Acad. Sci. U.S.A. 87, 7912-7916). This study presents the complete amino acid
      sequence of these two growth factors and the cloning of their cDNA from rat,
      mouse, and human sources. Epithelins 1 and 2 are 56- and 57-amino acid
      polypeptides, respectively, and share 47% amino acid sequence identity with the
      conserved spacing of 12 cysteine residues. Molecular cloning revealed that both
      proteins are encoded by a single precursor that contains 7 1/2 copies of this
      novel 12-cysteine motif, 2 of which represent the known active molecules.
      Recombinant expression in COS cells demonstrated that the epithelin 1 protein was
      mitogenic on rodent keratinocytes and fibroblasts. In contrast, epithelin 2 had
      no activity on these cells, but at high concentrations was capable of
      antagonizing the growth proliferative activities of epithelin 1. Northern
      analysis shows the epithelin mRNA to be expressed in many types of epithelial
      cells. The broad expression profile of epithelin transcripts, along with the
      opposing activities of the two mature protein products, implicates these factors
      as natural mediators of epithelial homeostasis.

PMID- 1618806
TI  - An actin footprint on villin. Single site substitutions in a cluster of basic
      residues inhibit the actin severing but not capping activity of villin.
AB  - Villin is a multidomain protein that severs, caps, and bundles actin filaments.
      We employed a chemical modification/cleavage strategy to identify residues whose
      chemical reactivities are reduced when villin is complexed with actin. We found
      that actin protects 3 methionine residues, Met125, Met379, and Met711 from
      oxidation by N-chlorosuccinimide. Because Met125 lies within the actin-severing
      domain of villin (44T), we probed this region for actin binding sites using a
      series of overlapping peptides each with an additional cysteine residue at their
      C terminus. Each peptide, as a disulfide-bonded dimer, was examined for actin
      cross-linking activity by electron microscopy and light scattering. Our results
      with M3R suggest this region contains an F-actin binding site and are consistent
      with proteolysis and deletion mutagenesis studies of gelsolin. Single
      substitution of the basic residues modulated actin severing but not capping
      activity of 44T. Circular dichroism and protease digestions did not detect
      alterations in secondary structure or conformational changes in the mutants,
      although some are cleaved more rapidly, thereby suggesting a change in the
      packing of the domains. Our results highlight that basic residues comprise part
      of the F-actin binding site that is involved in the actin severing activity of
      villin.

PMID- 1618807
TI  - Redesigned purification yields a fully functional PutA protein dimer from
      Escherichia coli.
AB  - Proline utilization by Escherichia coli and Salmonella typhimurium requires
      expression of genes putP (encoding a proline transporter) and putA. Genetic data
      indicate that the PutA protein is both put repressor and a respiratory chain
      linked dehydrogenase. We report a redesigned purification procedure as well as
      the physical characteristics and biological activities of the PutA protein
      purified from E. coli. The purified protein was homogeneous as determined by
      electrophoresis performed under denaturing and nondenaturing conditions. Its N
      terminal sequence corresponded to that predicted by the DNA sequence. We showed
      copurification of proline and delta 1-pyrroline-5-carboxylate dehydrogenase
      activities. Purified PutA protein bound put DNA in vitro in an electrophoretic
      band-shift assay and it could be reconstituted to inverted membrane vesicles,
      yielding proline dehydrogenase activity. The Stokes radius and Svedberg
      coefficient of the protein were determined to be 7.1 nm and 9.9 S, respectively.
      These hydrodynamic data revealed that the protein in our preparation was dimeric
      with a molecular mass of 293 kDa and that it had an irregular shape indicated by
      the friction factor (f/f0) of 1.6.

PMID- 1618808
TI  - A 13-amino acid n-terminal domain of a basic proline-rich protein is necessary
      for storage in secretory granules and facilitates exit from the endoplasmic
      reticulum.
AB  - We have investigated the role of different domains of a salivary basic proline
      rich protein in intracellular transport and sorting of proline-rich proteins to
      the secretory granules. We have cloned a full-length cDNA of a basic proline-rich
      protein from the rat parotid and expressed it in AtT-20 cells. It was correctly
      sorted into secretory granules as shown by EM immunolocalization and by its
      presence in 8-bromocyclic AMP-stimulated secretion. Deletion of the N-terminal
      thirteen amino acid domain upstream from the proline-rich domain eliminated
      storage whereas deletion of the C-terminal 20-amino acid domain downstream from
      the proline-rich domain had no effect. Intracellular transport of full-length and
      mutant proline-rich proteins was unusually slow due to slow exit from the
      endoplasmic reticulum. However, the rate of transport increased with increasing
      level of expression for the full-length protein and the C-terminal deletion
      mutant. In contrast, the rate of transport of the N-terminal deletion mutant was
      independent of the level of expression. These results imply that the N-terminal
      domain is necessary for both storage and efficient intracellular transport.
      Moreover, interactions (self-aggregation?) that mediate sorting may begin as
      early as the endoplasmic reticulum.

PMID- 1618809
TI  - Internalization of the human insulin receptor. The insulin-independent pathway.
AB  - Internalization of the human insulin receptor requires the activation by insulin
      of the intrinsic kinase of the receptor. However, even in the absence of kinase
      activation, insulin receptors slowly enter the cells. In the present study, we
      addressed the question of this insulin-independent pathway of internalization. To
      that end, we traced insulin receptor internalization with a monoclonal antibody
      (mAb 83-14) directed against the alpha-subunit of the human insulin receptor.
      Internalization of this antibody was followed in Chinese hamster ovary (CHO)
      cells transfected with either normal (CHO.HIRC2) or kinase-deficient (CHO.A1018)
      human insulin receptors. The internalization rate of 125I-mAb 83-14 was
      comparable in CHO cells expressing kinase-active or kinase-inactive receptors and
      was similar to that observed for 125I-insulin in CHO.A1018 cells. Moreover, in
      CHO.HIRC2 cells, the internalization of 125I-mAb 83-14 was identical with that of
      its 125I-Fab fragments. Thus, mAb 83-14 represents an appropriate tool to study
      the constitutive internalization of the insulin receptor. Internalization of
      insulin receptors tagged with 125I-mAb 83-14 was unaffected by cytochalasin B,
      which excluded a macropinocytotic process. By contrast, internalization was
      sensitive to hypertonia, which abrogates clathrin-coated pits-mediated
      endocytosis. The implication of clathrin-coated pits in this internalization
      process was directly demonstrated by quantitative electron microscopic
      autoradiography, which showed that 125I-mAb 83-14 present on the nonvillous
      domain of the cell surface preferentially associate with clathrin-coated pits at
      all time points.

PMID- 1618810
TI  - The signal for Golgi retention of bovine beta 1,4-galactosyltransferase is in the
      transmembrane domain.

PMID- 1618811
TI  - Cyclosporin A, the cyclophilin class of peptidylprolyl isomerases, and blockade
      of T cell signal transduction.
AB  - Cyclosporin A, the major immunosuppressive drug in transplantation, and the more
      potent therapeutic drug candidate, FK506, have led to the discovery of two
      superfamilies of immunosuppressant binding proteins, the cyclophilins and the FK
      binding proteins. These proteins, enzymes with high kcat values for isomerization
      of X-Pro bonds in peptides and protein substrates, are distributed in all cell
      compartments where protein folding normally occurs. It is likely that they play
      major roles in the protein folding and protein trafficking in the cell. It is
      also likely that they have been suborned in T cells by the immunosuppressant
      drugs that are potent pseudosubstrate ligands that selectively block the signal
      transduction cascade. The discovery of the inhibition of protein phosphatase 2B
      (calcineurin) by the drug-immunophilin complex (CsA-CyP or FK506-FKBP) provides
      evidence for a specific downstream target of the drug-immunophilin complexes and
      may prompt a search for endogenous ligands of cyclophilin and FKBP that may
      effect signal transduction regulation. The molecular insights gained over a short
      time in this area have been remarkable; they promise to elucidate the steps in T
      cell activation and delineate new targets for immunosuppressive therapy.

PMID- 1618812
TI  - Presequence binding factor-dependent and -independent import of proteins into
      mitochondria.
AB  - A cytosolic protein factor(s) is involved in the import of precursor proteins
      into mitochondria. PBF (presequence binding factor) is a protein factor which
      binds to the precursor form (pOTC) of rat ornithine carbamoyltransferase (OTC)
      but not to the mature OTC, and is required for the mitochondrial import of pOTC.
      The precursors for aspartate aminotransferase and malate dehydrogenase as well as
      pOTC synthesized in a reticulocyte lysate were efficiently imported into the
      mitochondria. However, the precursors synthesized in the lysate depleted for PBF
      by treatment with pOTC-Sepharose were not imported. Readdition of the purified
      PBF to the depleted lysate fully restored the import. pOTC synthesized in the
      untreated lysate sedimented as a complex with a broad peak of around 9 S, whereas
      pOTC synthesized in the PBF-depleted lysate sedimented at an expected position of
      monomer (2.5 S). When the purified PBF was readded to the depleted lysate, pOTC
      sedimented as a complex of about 7 S. In contrast to most mitochondrial proteins,
      rat 3-oxoacyl-CoA thiolase is synthesized with no cleavable presequence and an
      NH2-terminal portion of the mature protein functions as a mitochondrial import
      signal. The thiolase synthesized in the PBF-depleted lysate could be efficiently
      imported into the mitochondria, and readdition of PBF had little effect on the
      import. The thiolase synthesized in the untreated, the PBF-depleted, or the PBF
      readded lysate sedimented at an expected position of monomer (2.5 S). These
      observations provide support for the existence of PBF-dependent and -independent
      pathways of mitochondrial protein import.

PMID- 1618813
TI  - Expression of functional G protein beta gamma dimers of defined subunit
      composition using a baculovirus expression system.
AB  - The 36-kDa beta 1, 35-kDa beta 2, and 6.5-kDa gamma 2 subunits of the
      heterotrimeric guanine nucleotide-binding proteins have been overexpressed in Sf9
      cells using a baculovirus expression system. The gamma 2 subunit expressed in Sf9
      cells incorporated label derived from [3H]mevalonate and is therefore likely to
      be isoprenylated, as is its mammalian counterpart. Extracts of Sf9 cells doubly
      infected with viruses encoding a beta subunit and viruses encoding a gamma
      subunit are active in promoting the pertussis toxin-catalyzed ADP-ribosylation of
      a G protein alpha subunit. However, extracts from Sf9 cells singly infected with
      viruses encoding either a beta or gamma subunit are not active in this assay.
      Results demonstrate utility of the insect/baculovirus system for expressing G
      protein beta gamma subunits of defined composition.

PMID- 1618814
TI  - Insulin receptors are bivalent as demonstrated by photoaffinity labeling.
AB  - Insulin receptors in human placental membranes were photoaffinity-labeled with a
      radioactive human insulin-like growth factor I (hIGF-I) photoprobe N epsilon B28
      monoazidobenzoyl 125I-hIGF-I either alone or together with a non-radioactive
      insulin photoprobe N epsilon B29-monoazidobenzoyl insulin. Precipitation of the
      solubilized receptors with anti-insulin antibody showed that receptors labeled
      with the radioactive hIGF-I photoprobe were detected in the immunoprecipitate
      only when photolabeling was carried out in the presence of the non-radioactive
      insulin photoprobe. Comparable results were obtained in converse experiments
      using a radioactive insulin photoprobe N epsilon B29-monoazidobenzoyl 125I
      insulin, a non-radioactive hIGF-I photoprobe N epsilon B28-monoazidobenzoyl hIGF
      I, and an antibody to hIGF-I. The amount of radioactive receptors precipitated by
      either the anti-insulin antibody or the anti-hIGHF-I antibody was close to the
      expected amount. These observations demonstrate that the insulin receptor is
      bivalent being capable of binding two molecules of ligand.

PMID- 1618815
TI  - Destabilization of ornithine decarboxylase by transfected antizyme gene
      expression in hepatoma tissue culture cells.
AB  - The degradation of ornithine decarboxylase (ODC) is stimulated by polyamines in a
      protein synthesis-dependent manner. It has been suggested that antizyme, an ODC
      inhibiting protein induced by polyamines, is involved in the process of polyamine
      stimulated ODC decay. In this study, we investigated the direct effect of
      antizyme on ODC decay in hepatoma tissue culture (HTC) cells. A truncated rat
      antizyme cDNA, Z1, was inserted into an expression vector at a site under the
      control of a glucocorticoid-inducible promoter and transfected into HTC cells. In
      the transfected cells dexamethasone increased the amount of Z1 mRNA and induced
      active antizyme in the absence of exogenous polyamines. When dexamethasone was
      added to cells with a high level of ODC, rapid decays of ODC activity and protein
      were elicited after a lag time. Cycloheximide abolished the effect of
      dexamethasone. These effects of dexamethasone were not observed in control HTC
      cells transfected with the chloramphenicol acetyltransferase gene. This study
      indicated that, once induced, antizyme stimulated ODC degradation independently
      of polyamines and strongly supported our previous hypothesis that the ODC decay
      accelerating action of polyamines is mediated by antizyme.

PMID- 1618816
TI  - Identification of potential active-site residues in the Escherichia coli leader
      peptidase.
AB  - Leader peptidase of Escherichia coli cleaves the leader sequence from the amino
      terminus of membrane and secreted proteins after these proteins insert across the
      membrane. Despite considerable research, the mechanism of catalysis of leader
      peptidase remains unknown. This peptidase cannot be classified using protease
      inhibitors to the serine, cysteine, aspartic acid, or metallo- classes of
      proteases (Zwizinski, C., Date, T., and Wickner, W. (1981) J. Biol. Chem. 256,
      3593-3597). Using site-directed mutagenesis, we have attempted to place leader
      peptidase in one of these groups. We found that leader peptidase, lacking all of
      the cysteine residues, can cleave the leader peptide from procoat, the precursor
      to bacteriophage M13 coat protein. Replacement of each histidine residue with an
      alanyl residue was without effect on catalysis. Among all the serine and aspartic
      acid residues, serine 90 and serine 185 as well as aspartic acid 99, 153, 273,
      and 276 are necessary to cleave procoat in a detergent extract. However, only
      serine 90 and aspartic acid 153 were required for processing using a highly
      sensitive in vivo assay. In addition to the residues directly affecting
      catalysis, aspartic acid 99 plays a role in maintaining the structure of leader
      peptidase. Replacement of this residue with alanine results in a very unstable
      leader peptidase protein. This study thus defines two critical residues, serine
      90 and aspartic acid 153, that may be directly involved in catalysis and provides
      evidence that leader peptidase belongs to a novel class of serine proteases.

PMID- 1618817
TI  - Induction of low density lipoprotein receptor and a transcription factor SP-1 by
      tumor necrosis factor in human microvascular endothelial cells.
AB  - We have previously reported that tumor necrosis factor-alpha (TNF-alpha) enhances
      expression of interleukin-6, collagenase, plasminogen activator inhibitor-1, and
      basic fibroblast growth factor genes in human omental microvascular endothelial
      (HOME) cells in culture. In this study, we found that treatment of HOME cells
      with TNF-alpha or interleukin-1 (IL-1) caused enhanced expression of low density
      lipoprotein (LDL) receptor. A few-fold increase in both LDL binding activity and
      the receptor mRNA levels was observed when HOME cells were treated with either
      TNF-alpha or IL-1. Northern blot analysis showed that cellular expression of LDL
      receptor gene was significantly increased 12-24 h after exposure to TNF-alpha. No
      significant changes in the life-span of LDL receptor mRNA were observed in
      untreated and TNF-alpha-treated cells. Scatchard analysis showed an increased
      receptor number for LDL in TNF-alpha-treated cells. Parallel to increased LDL
      binding activity, internalization and degradation of LDL were also increased in
      HOME cells treated with TNF-alpha or IL-1. TNF-alpha-induced enhancement of LDL
      receptor gene expression was not observed when cycloheximide was present.
      Cellular mRNA level of SP-1 gene was increased about 3-4-fold at 12 h after
      treatment with TNF-alpha. Nuclear run-on assays showed increased transcription of
      LDL receptor gene as well as SP-1 gene by TNF-alpha. Gel retardation assay with
      the SP-1 consensus fragment showed that SP-1 binding activity was increased about
      4-5-fold 12-24 h after treatment with TNF-alpha. NF-kB binding activity was also
      dramatically increased, but there is no NF-kB motif on the promoter for LDL
      receptor gene. The induction of LDL receptor by TNF might be mediated through a
      transcription factor, SP-1.

PMID- 1618818
TI  - The influence of charge and the distribution of charge in the polar region of
      phospholipids on the activity of UDP-glucuronosyltransferase.
AB  - Studies of the mechanism of lipid-induced regulation of the microsomal enzyme UDP
      glucuronosyltransferase have been extended by examining the influence of charge
      within the polar region on the ability of lipids to activate delipidated pure
      enzyme. The effects of net negative charge, of charge separation in
      phosphocholine, and of the distribution of charge in the polar region of lipids
      were studied using the GT2p isoform isolated from pig liver. Prior experiments
      have shown that lipids with net negative charge inhibit the enzyme (Zakim, D.,
      Cantor, M., and Eibl, H. (1988) J. Biol. Chem. 263, 5164-5169). The current
      experiments show that the extent of inhibition on a molar basis increases as the
      net negative charge increases from -1 to -2. The inhibitory effect of negatively
      charged lipids is on the functional state of the enzyme and is not due to
      electrostatic repulsion of negatively charged substrates of the enzyme. Although
      the inhibitory effect of net negative charge is removed when negative charge is
      balanced by a positive charge due to a quaternary nitrogen, neutrality of the
      polar region is not a sufficient condition for activation of the enzyme. In
      addition to a balance of charge between Pi and the quaternary nitrogen, the
      distance between the negative and positive charges and the orientation of the
      dipole created by them are critical for activation of GT2p. The negative and
      positive charges must be separated by the equivalent of three -CH2- groups for
      optimal activation by a lipid. Shortening this distance by one -CH2- unit leads
      to a lipid that is ineffective in activating the enzyme. Reversal of the
      orientation of the dipole in which the negative charge is on the polymethylene
      side of the lipid-water interface and the positive charge extends into water also
      produces a lipid that is not effective for activating GT2p. On the other hand,
      lipids with phosphoserine as the polar region, which has the "normal" P-N
      distance but carries a net negative charge, do not inhibit GT2p. This result
      again illustrates the importance of the dipole of phosphocholine for modulating
      the functional state of GT2p.

PMID- 1618819
TI  - Enantiomeric activation of glucuronidation in dog hepatic microsomes.
AB  - Isomer-specific mechanisms of conjugation were investigated by evaluating the
      hepatic glucuronidation of the enantiomers of the 5-lipoxygenase inhibitor
      zileuton. The glucuronidation of the individual isomers was stereoselective, as
      dog hepatic microsomes glucuronidated the S-isomer but failed to generate a
      glucuronide conjugate of the R-isomer. In combination, the nonglucuronidated R
      isomer caused a concentration-dependent increase in the rate of glucuronidation
      of its enantiomorph. Kinetic analysis of this interaction indicated that the R
      isomer affected rates of glucuronidation by decreasing the Km of the S-isomer for
      this process. This effect appeared enantioselective as the achiral analogue A
      65838 had no effect on the Vmax and Km of S-isomer glucuronidation. The data were
      modeled using Michaelis-Menten kinetics in which the Km of S-isomer
      glucuronidation was reduced in a saturable manner by the concentration of the R
      isomer. These data indicate that the nonconjugated R-isomer competitively
      activates the glucuronidation of its enantiomorph. To our knowledge, these data
      represent the first demonstration of enantiomeric activation of an enzyme
      involved in hepatic drug metabolism.

PMID- 1618820
TI  - Active site topology of Saccharomyces cerevisiae lanosterol 14 alpha-demethylase
      (CYP51) and its G310D mutant (cytochrome P-450SG1).
AB  - Incubation of phenyldiazene (PhN = NH) with lanosterol 14 alpha-demethylase, a
      cytochrome P-450 enzyme (CYP51) that oxidatively removes the 14 alpha-methyl
      group of lanosterol, results in the appearance of a 478-nm band indicative of
      phenyl-iron complex formation. In situ oxidation of the phenyl-iron complex by
      ferricyanide yields exclusively the N-phenylprotoporphyrin IX regioisomer with
      the phenyl group on the nitrogen of pyrrole ring C (NC). The biphenyl-iron
      complex formed in the analogous reaction of the enzyme with biphenyldiazene
      similarly rearranges on treatment with ferricyanide to the NC regioisomer of N
      biphenylprotoporphyrin IX. The active site cavity must therefore be at least 10 A
      high directly above the iron atom and pyrrole ring C of the heme group, and
      lanosterol binds to the enzyme in the region above pyrrole ring C. Phenyl-iron
      complex formation is not detected spectroscopically with cytochrome P-450SG1, a
      catalytically inactive G310D mutant of lanosterol 14 alpha-demethylase in which
      the sixth iron coordination site is thought to be occupied by an imidazole
      ligand. Nevertheless, oxidation of the phenyldiazene-treated enzyme with
      ferricyanide provides the NA and NC regioisomers of N-phenylprotoporphyrin IX in
      a 40:60 ratio. The single amino acid substitution in cytochrome P-450SG1 thus
      causes a conformational change that retracts the amino acid residues that cover
      pyrrole ring A and moves an imidazole ligand into the active site.

PMID- 1618821
TI  - Escherichia coli dnaJ deletion mutation results in loss of stability of a
      positive regulator, CRP.
AB  - The dnaJ deletion mutant K7052(lambda dnaK) has a temperature-sensitive defect in
      the synthesis of beta-galactosidase. We confirmed this operon-specific and
      temperature-sensitive defect in cell-free extracts prepared from the mutant cells
      and found that the missing factor was CRP. In the mutant, the cellular
      concentration of CRP was too low to allow the expression of the lac operon at a
      nonpermissive temperature. Introduction of a CRP over-producing plasmid into the
      dnaJ deletion mutant suppressed the defect of beta-galactosidase synthesis. The
      lower content of CRP in the mutant was found to result from extreme instability
      of the protein. These results strongly suggested that the heat shock protein dnaJ
      is involved in the stabilization (or degradation) of CRP.

PMID- 1618822
TI  - Receptor binding and internalization of mouse interleukin-2 derivatives that are
      partial agonists.
AB  - Mouse interleukin-2 (mIL-2) mutant proteins with subunit-specific receptor
      binding defects have been previously described. Some of these mutant proteins are
      unable to trigger a maximum proliferative response of T cells. In this study, mIL
      2 and mIL-2 mutant proteins were labeled with 32P, and their association and
      dissociation kinetics with the high affinity IL-2 receptor (IL-2R) were
      investigated. A mIL-2 mutant protein with a partial defect in binding to the low
      affinity component of IL-2R had a slower on-rate than mIL-2. On the other hand, a
      mIL-2 antagonist with a binding defect to the intermediate affinity component of
      IL-2R had a normal on-rate, whereas its off-rate at 37 degrees C was faster than
      mIL-2. This fast off-rate at physiological temperature interfered with mIL-2
      internalization. When three mIL-2 partial agonists, each inducing a different
      maximal response, were examined, no difference was found between their
      dissociation rates or their internalization properties. The significance of these
      findings for the function of each receptor subunit in the IL-2R complex, as well
      as for the mechanism of activation of the receptor, is discussed.

PMID- 1618823
TI  - Partial phenotypic suppression of a peroxisome-deficient animal cell mutant
      treated with aminoglycoside G418.
AB  - Certain enzymes normally associated with peroxisomes, such as the
      dihydroxyacetone phosphate (DHAP) acyltransferase involved in plasmalogen
      biosynthesis, are present at low levels in peroxisome-deficient mutants of
      Chinese hamster ovary (CHO) cells. We now show that the aminoglycoside G418
      increases the residual DHAP acyltransferase in mutant ZR-82 by 60-fold. This is
      accompanied by a dose- and time-dependent restoration of the plasmalogen content.
      G418 treatment of ZR-82 also increases residual peroxisomal beta-oxidation
      activity by 3.8-fold. G418 does not affect wild-type CHO cells (CHO-K1) or a
      different peroxisome-deficient mutant, ZR-78.1. The effects of G418 on ZR-82 are
      transient, since plasmalogens and DHAP-acyltransferase decline to basal levels 5
      days after G418 withdrawal. Other aminoglycosides and lysosomotropic agents do
      not alter plasmalogen levels in ZR-82. The subcellular distribution of catalase
      (an enzyme of the peroxisomal matrix which is present in normal amounts in
      peroxisome-deficient mutants but is mislocalized in the cytosol) is unaffected by
      G418 treatment of ZR-82, demonstrating that G418 does not restore peroxisomes.
      Localization of catalase by immunofluorescence microscopy confirms a total
      absence of intact peroxisomes in ZR-82, either before or after exposure to G418.
      This study is the first to demonstrate that some peroxisome-deficient mutants can
      be induced to accumulate functional DHAP acyltransferase and other peroxisomal
      enzymes, usually missing in the absence of peroxisomes. G418 may have some
      therapeutic value in selected patients with inborn errors of peroxisome assembly,
      such as Zellweger syndrome.

PMID- 1618825
TI  - Evidence for two sites on rat liver plasma membranes which interact with high
      density lipoprotein.
AB  - There is little dispute that high density lipoprotein (HDL) binds to cells,
      however, the nature of the interaction is not fully understood. We now present
      evidence for a new binding site of higher affinity but lower capacity than the
      sites previously described in the literature. This new site is characterized by
      high affinity/low capacity for HDL binding (Kd = 0.94 microgram/ml, Bmax = 36
      ng/mg), while the low affinity site (Kd = 36 micrograms/ml, Bmax approximately
      700 ng/mg) appears to be consistent with the literature values for the
      interaction of HDL with cells and isolated membranes. Proteolysis of HDL with
      trypsin abolished its interaction with the high affinity site, suggesting an
      apolipoprotein requirement, while having no effect on binding to the lower
      affinity site. Kinetic rates of association/dissociation were determined in order
      to further characterize the high affinity site. At a concentration which favored
      the binding of HDL with the high affinity site (1 microgram/ml, 37 degrees C),
      the time course of association of HDL with rat liver plasma membranes, displayed
      a biphasic pattern, requiring 6-8 h to reach the level of binding predicted from
      the saturation studies. The second phase was highly sensitive to temperature,
      being considerably slower at 24 degrees C and totally abolished at 0 degrees C. A
      kinetic Kd, derived from the measured association and dissociation rate constants
      (Kd = 0.31 microgram/ml), was found to be of a similar magnitude to the Kd
      calculated for the high affinity site by Scatchard analysis (Kd = 0.94
      microgram/ml). In summary, the high affinity site on rat liver plasma membranes
      displays an apoprotein requirement and kinetic parameters, consistent with a
      ligand-receptor interaction.

PMID- 1618824
TI  - Purification, gene cloning, and gene disruption of the transcription elongation
      factor S-II in Saccharomyces cerevisiae.
AB  - Saccharomyces cerevisiae S-II was purified to near homogeneity as a protein
      stimulating RNA polymerase II. Four of seven lysyl endopeptidase-digested
      fragments of S-II were located in the PPR2 sequence reported previously. Analysis
      of a genomic clone of S-II revealed that S-II and PPR2 are the same protein
      consisting of 309 amino acid residues, and frame shifts were found in the
      sequence of PPR2 gene reported previously. Yeast S-II and mouse S-II showed high
      similarity in their amino acid sequences, especially in their amino-terminal and
      carboxyl-terminal regions. A gene disruption experiment showed that an S-II null
      mutant was not lethal under usual growth conditions, indicating that S-II is not
      essential for the growth of yeast.

PMID- 1618827
TI  - Definition of the carbohydrate response element of the rat S14 gene. Evidence for
      a common factor required for carbohydrate regulation of hepatic genes.
AB  - The 5'-flanking region of the S14 gene from -4316 to +18 contains regulatory
      sequences responsible for activation of promoter activity in response to elevated
      carbohydrate metabolism in primary hepatocytes. To map these sequences, a series
      of constructs containing various internal deletions of the S14 5'-flanking
      sequence were assayed in primary hepatocytes. The region from -1601 to -1395 was
      found to be essential for this response. Comparison of the sequence of this S14
      region to a region of the L-type pyruvate kinase gene that has been shown to
      mediate carbohydrate regulation (Thompson, K. S., and Towle, H. C. (1991) J.
      Biol. Chem. 266, 8679-8682) revealed a segment with 9 out of 10 identity. In both
      cases, this conserved sequence aligned with a DNase I footprint formed with
      hepatic nuclear extract. Oligonucleotides (approximately 30 base pairs) from
      either S14 or pyruvate kinase genes containing the conserved element bound to a
      hepatic nuclear factor(s) that gave identical complexes by mobility shift assay.
      Furthermore, these two oligonucleotides cross-competed for binding to the nuclear
      factor(s), suggesting that a common factor(s) binds to this conserved element.
      Reinsertion of the S14 oligonucleotide into an unresponsive S14 promoter
      construct restored the carbohydrate control. Moreover, this oligonucleotide could
      confer a glucose response when fused to a heterologous promoter. Thus, the S14
      segment from -1457 to -1428 is a carbohydrate response element essential for the
      binding of nuclear factor(s) regulated by increased carbohydrate metabolism. This
      factor(s) may be common to the carbohydrate regulation of the S14 and pyruvate
      kinase genes.

PMID- 1618826
TI  - Purification and characterization of fatty acid ethyl ester synthase-II from
      human myocardium.
AB  - Fatty acid ethyl ester synthases metabolize ethanol nonoxidatively in those
      extrahepatic organs most commonly damaged by alcohol abuse. This study was
      designed to isolate and purify human myocardial synthase-II, one of the enzymes
      responsible for catalyzing the formation of fatty acid ethyl esters. DEAE
      cellulose chromatography of human myocardial cytosol at pH 8.0 separated synthase
      I, synthase-II, and synthase-III activities, eluting at conductivities of 5, 7,
      and 11 mS, respectively. From this elution profile, fatty acid ethyl ester
      synthase-II accounts for up to 50% of total synthesis in the human heart. This
      enzyme species was purified over 2200-fold to homogeneity after chromatography
      over hydroxylapatite, CM-cellulose, and hydroxylapatite. Sodium dodecyl sulfate
      polyacrylamide gel electrophoresis of this homogeneous species showed a single
      band at 65 kDa which corresponded to its molecular weight determined by gel
      filtration. This molecular weight and its lack of glutathione transferase
      activity indicate that this species is not related to synthase-I and -III.
      Homogeneous synthase-II has a Vmax for palmitate, stearate, oleate, and linoleate
      of 70, 80, 140, and 120 nmol/mg/h, respectively. The Km for palmitate, stearate,
      oleate, and linoleate is 0.19, 0.12, 0.10, and 0.18 mM, respectively. The
      substrate specificity with respect to alcohol chain length was also investigated
      in the presence of 0.65 mM [14C]oleic acid. The Vmax for methanol, ethanol,
      propanol, and butanol was 180, 100, 280, and 410 nmol/mg/h, respectively. The Km
      for methanol, ethanol, propanol, and butanol was 1.16, 1.04, 0.58, and 0.33 M,
      respectively. The N-terminal 17-amino acid sequence of human synthase-II does not
      correspond to any known N-terminal amino acid sequence, indicating that this may
      be a novel protein. However, it has over 70% homology to a sequence close to the
      C terminus of rabbit cytochrome P-450IIC1 and over 50% homology to a sequence of
      human hemopexin starting at residue 16. Synthase-II does not cross-react with
      human hemopexin antibody and rat cytochrome P-450C antibody. Thus, this study
      provides evidence that synthase-II is a novel protein, distinct from synthase-I
      and -III, and it also provides a foundation for subsequent cloning and genetic
      studies of fatty acid ethyl ester synthase-II in man.

PMID- 1618828
TI  - Characterization of the interaction between the A2 subunit and A1/A3-C1-C2 dimer
      in human factor VIIIa.
AB  - Factor VIIIa is a heterotrimer of the factor VIII heavy chain-derived A1 and A2
      subunits plus the factor VIII light chain-derived A3-C1-C2 subunit. While the A1
      and A3-C1-C2 subunits can be isolated as a stable dimer, the A2 subunit is weakly
      associated with the dimer. In the human protein, the association of A2 with dimer
      is reversible and governed by a pH-dependent dissociation constant. Using the
      specific activity of factor VIIIa as an indicator of trimer concentration, the Kd
      (pH 6.0) was determined to be 28 nM whereas at the more physiologic pH (pH 7.4)
      this value was approximately 260 nM. Results from pH shift experiments confirmed
      the reversible binding of A2 to dimer as did the capacity for high levels of
      exogenous A2 subunit to inhibit the spontaneous decay of factor VIIIa activity.
      A2 subunit associated with the A1 subunit in the A1/A3-C1-C2 dimer based upon the
      capacity for free A1 subunit to inhibit the reconstitution of factor VIIIa from
      A2 subunit and dimer. These results indicate that the primary mechanism for the
      spontaneous decay of human factor VIIIa is the reversible dissociation of A2
      subunit from the A1 subunit of the A1/A3-C1-C2 dimer.

PMID- 1618829
TI  - Hexose metabolism in pancreatic islets. Ca(2+)-dependent activation of the
      glycerol phosphate shuttle by nutrient secretagogues.
AB  - A method is proposed for the measurement of the flux through the glycerol
      phosphate shuttle in pancreatic islets. Such a flux is taken as the ratio between
      the production of 3HOH and the specific radioactivity of L-[2-3H]glycerophosphate
      in islets exposed to [2-3H]glycerol. D-Glucose and non-glucidic nutrient
      secretagogues, such as 2-ketoisocaproate and 2-aminobicyclo[2,2,1]heptane-2
      carboxylate, stimulate, in a Ca(2+)-dependent manner, circulation in the glycerol
      phosphate shuttle. The shuttle flux is commensurate with the fraction of pyruvate
      generation which is not coupled with L-lactate production. These findings support
      the view that a rise in D-glucose concentration leads to activation of the FAD
      linked mitochondrial glycerophosphate dehydrogenase through an increase in
      cytosolic Ca2+ concentration.

PMID- 1618830
TI  - Resonance Raman spectra of horseradish peroxidase and bovine liver catalase
      compound I species. Evidence for predominant 2A2u pi-cation radical ground state
      configurations.
AB  - The nature of the porphyrin pi-cation radicals in the horseradish peroxidase and
      bovine liver catalase (BLC) compound I species have been investigated by studying
      their resonance Raman spectra. A variety of laser excitation and sample
      interrogation procedures have been employed in order to minimize previously
      documented problems arising from photoinduced conversions. With Soret band
      excitation, the spectra obtained for both species resemble that of a compound II
      like photoproduct unless the samples are excited with residence times in the
      microsecond regime with very low (approximately 1 milliwatt) powers. When these
      precautions are taken, spectra attributable to the compound I species themselves
      are obtained. The spectrum for horseradish peroxidase compound I is similar to
      that reported by Paeng and Kincaid (Paeng, K.-J., and Kincaid, J. R. (1988) Am.
      Chem. Soc. 110, 7913-7915) using a similar approach. Both horseradish peroxidase
      and BLC compound I exhibit frequency shifts relative to their compound II species
      that are in the direction observed for model pi-cation radicals with predominant
      2A2u character. The magnitudes of these shifts are smaller than those observed
      for heme models that lack aromatic axial ligands, but agree well with those
      observed on formation of the compound I analog of N alpha-acetyl microperoxidase
      8 that has His as a proximal ligand. This observation is consistent with partial
      delocalization of the radical density onto the proximal His-170 and Tyr-357
      ligands in horseradish peroxidase and BLC, respectively. The strong ligand field
      provided by these ligands on the proximal side and oxo ligand on the distal side
      of the heme group is apparently sufficient to reverse the 2A1u radical ground
      state preference observed for heme-like porphyrin species (e.g.
      octaethylporphyrins) with weak axial fields. Enhancement of several bands
      assigned to the Tyr-357 ligand has also been observed for BLC compound I with
      406.7-nm excitation. This is attributed either to resonance with a tyrosinate---
      Fe(IV) charge transfer band or to the coupling provided by radical spin
      delocalization onto the tyrosinate ligand.

PMID- 1618831
TI  - Identification of 5,6-dimethylbenzimidazole as the Co alpha ligand of the
      cobamide synthesized by Salmonella typhimurium. Nutritional characterization of
      mutants defective in biosynthesis of the imidazole ring.
AB  - The Co beta-cyano derivative of the cobamide isolated from Salmonella typhimurium
      was identified as Co alpha-(alpha-5,6-dimethylbenzimidazolyl)-Co beta
      cyanocobamide, indicating that this bacterium synthesizes 5,6
      dimethylbenzimidazole (DMB) de novo. We found that mutants deficient in the
      synthesis of DMB can incorporate benzimidazole without modification to form Co
      alpha-(alpha-benzimidazolyl)cobamide, a cobamide that is physiologically active.
      The analysis of the nutritional requirements of mutants deficient in DMB
      synthesis identified 4,5-dimethylphenylenediamine as a putative intermediate in
      the synthesis of the imidazole ring of DMB. Our results suggest that the CobII
      region of the cob operon of S. typhimurium only encodes functions involved in the
      synthesis of the imidazole ring of DMB.

PMID- 1618832
TI  - Transport of fatty acids into human and rat peroxisomes. Differential transport
      of palmitic and lignoceric acids and its implication to X-adrenoleukodystrophy.
AB  - The different topology of palmitoyl-CoA ligase (on the cytoplasmic surface) and
      of lignoceroyl-CoA ligase (on the luminal surface) in peroxisomal membranes
      suggests that these fatty acids may be transported in different form through the
      peroxisomal membrane (Lazo, O., Contreras, M., and Singh, I. (1990) Biochemistry
      29, 3981-3986), and this differential transport may account for deficient
      oxidation of lignoceric acid in X-adrenoleukodystrophy (X-ALD) (Singh, I., Moser,
      A. B., Goldfisher, S., and Moser, H. W. (1984) Proc. Natl. Acad. Sci. U.S.A. 81,
      4203-4207). To define the transport mechanism for these fatty acids through the
      peroxisomal membrane and its possible implication to lignoceric acid metabolism
      in X-ALD, we examined cofactors and energy requirements for the transport of
      palmitic and lignoceric acids in isolated peroxisomes from rat liver and
      peroxisomes isolated from X-ALD and control fibroblasts. The similar rates of
      transport of palmitoyl-CoA (87.6 +/- 6.3 nmol/h/mg protein) and palmitic acid in
      the fatty acid activating conditions (83.4 +/- 5.1 nmol/h/mg protein) and lack of
      transport of palmitic acid (4% of palmitoyl-CoA transport) when ATP and/or CoASH
      were removed or substituted by alpha,beta-methyleneadenosine-5'-triphosphate
      (AMPCPOP) and/or desulfoCoA-agarose from assay medium clearly demonstrate that
      transport of palmitic acid requires prior synthesis of palmitoyl-CoA by palmitoyl
      CoA ligase on the cytoplasmic surface of peroxisomes. The 10-fold higher rate of
      transport of lignoceric acid (5.3 +/- 0.6 nmol/h/mg protein) as compared with
      lignoceroyl-CoA (0.41 +/- 0.11 nmol/h/mg protein) and lack of inhibition of
      transport of lignoceric acid when ATP and/or CoASH were removed or substituted
      with AMPCPOP or desulfoCoA-agarose suggest that lignoceric acid is transported
      through the peroxisomal membrane as such. Moreover, the lack of effect of removal
      of ATP or substitution with AMPOPCP (a nonhydrolyzable substrate) demonstrates
      that the translocation of palmitoyl-CoA and lignoceric acid across peroxisomal
      membrane does not require energy. The transport, activation, and oxidation of
      palmitic acid are normal in peroxisomes from X-ALD. The deficient lignoceroyl-CoA
      ligase (13% of control) and oxidation of lignoceric acid (10% of control) as
      compared with normal transport of lignoceric acid into peroxisomes from X-ALD
      clearly demonstrates that pathogenomonic accumulation of very long chain fatty
      acids (greater than C22) in X-ALD is due to the deficiency of peroxisomal
      lignoceroyl-CoA ligase activity.

PMID- 1618833
TI  - Redox ribonucleosides. Isolation and characterization of 5-hydroxyuridine, 8
      hydroxyguanosine, and 8-hydroxyadenosine from Torula yeast RNA.
AB  - Three hydroxyribonucleosides catalyzing the oxido-reduction of NADH and K3F3(CN)6
      were purified from Torula yeast RNA by a series of steps including sodium dodecyl
      sulfate/phenol extraction, nuclease P1 digestion, alkaline phosphatase digestion,
      anion-exchange chromatography, and high performance liquid chromatography on an
      ODS column. Analysis by fast atom bombardment-mass spectrometry and 1H and 13C
      NMR spectroscopy led to identification of the redox ribonucleosides as 5
      hydroxyuridine, 8-hydroxyguanosine, and 8-hydroxyadenosine. Their mass spectra,
      chromatographic behavior, UV spectra, NMR spectra, and IR spectra were identical
      to those from natural and synthetic sources. Oxidoreduction activities were
      specific for K3Fe(CN)6 as the oxidant and NADH as the reductant; and their
      magnitudes decreased in the order 5-hydroxycytidine, 5-hydroxyuridine, 8
      hydroxyguanosine, and 8-hydroxyadenosine. The fact that these nucleosides have
      redox activities suggests new functional roles for RNAs as catalysts.

PMID- 1618834
TI  - Polyethylene glycol enhanced refolding of bovine carbonic anhydrase B. Reaction
      stoichiometry and refolding model.
AB  - Polyethylene glycol (PEG) inhibited aggregation during refolding of bovine
      carbonic anhydrase B (CAB) through the formation of a nonassociating PEG
      intermediate complex. Stoichiometric concentrations of PEG were required for
      complete recovery of active protein during refolding at aggregating conditions.
      For example, a PEG (Mr = 3350) to CAB molar ratio ([PEG]/[CAB]) of 2 was
      sufficient to inhibit aggregation during refolding at 1.0 mg/ml (33.3 microM)
      protein and 0.5 M guanidine hydrochloride. In addition, the PEG concentration
      required for enhancement was dependent upon the molecular weight and only
      molecular weights between 1000 and 8000 were effective in inhibiting aggregation.
      In the presence of PEG, the rate of refolding was the same as that observed for
      refolding without the formation of associated species. Refolding in the presence
      of PEG resulted in the rapid formation of a PEG complex with the molten globule
      first intermediate, and this PEG-intermediate complex did not aggregate. The CAB
      refolding kinetics in the presence of PEG were determined and used to develop a
      model of the PEG enhanced refolding pathway. The mathematical model was validated
      by independent activity measurements of CAB refolding. This model predicted that
      PEG enhanced refolding of CAB occurred by a specific interaction of PEG with the
      molten globule first intermediate to form a nonassociating complex which
      continued to fold at the same rate as the first intermediate. The predicted
      pathway and binding properties of PEG indicate that PEG enhanced refolding may be
      analogous to chaperonin mediated protein folding.

PMID- 1618835
TI  - Kinetics of colchicine binding to purified beta-tubulin isotypes from bovine
      brain.
AB  - Tubulin, the constituent protein of microtubules, is an alpha beta heterodimer;
      both alpha and beta exist in several isotypic forms whose functional significance
      is not precisely known. The antimitotic alkaloid colchicine binds to mammalian
      brain tubulin in a biphasic manner under pseudo-first-order conditions in the
      presence of a large excess of colchicine (Garland, D. L. (1978) Biochemistry 17,
      4266-4272). We have studied the kinetics of colchicine binding to purified beta
      tubulin isotypes and find that each of the purified beta-tubulin isotypes binds
      colchicine in a monophasic manner. The apparent on-rate constants for the binding
      of colchicine to alpha beta II-, alpha beta III-, and alpha beta IV-tubulin
      dimers are respectively 132 +/- 5, 30 +/- 2, and 236 +/- 7 M-1 s-1. When the
      isotypes are mixed, the kinetics become biphasic. Scatchard analysis revealed
      that the isotypes differ significantly in their affinity constants (Ka) for
      binding colchicine. The affinity constants are 0.24 x 10(6), 0.12 x 10(6), and
      3.31 x 10(6) M-1, respectively, for alpha beta II-, alpha beta III-, and alpha
      beta IV-tubulin dimers. Our results are in agreement with the hypothesis that the
      beta-subunit of tubulin plays a major role in the interaction of colchicine with
      tubulin. Our binding data raise the possibility that the tubulin isotypes might
      play important regulatory roles by interacting differently with other non-tubulin
      proteins in vivo, which in turn, may regulate microtubule-based functions in
      living cells.

PMID- 1618836
TI  - Comparison of terbium (III) luminescence enhancement in mutants of EF hand
      calcium binding proteins.
AB  - The luminescent isomorphous Ca2+ analogue, Tb3+, can be bound in the 12-amino
      acid metal binding sites of proteins of the EF hand family, and its luminescence
      can be enhanced by energy transfer from a nearby aromatic amino acid. Tb3+ can be
      used as a sensitive luminescent probe of the structure and function of these
      proteins. The effect of changing the molecular environment around Tb3+ on its
      luminescence was studied using native Cod III parvalbumin and site-directed
      mutants of both oncomodulin and calmodulin. Titrations of these proteins showed
      stoichiometries of fill corresponding to the number of Ca2+ binding loops
      present. Tryptophan in binding loop position 7 best enhanced Tb3+ luminescence in
      the oncomodulin mutant Y57W, as well as VU-9 (F99W) and VU-32 (T26W) calmodulin.
      Excitation spectra of Y57F, F102W, Y65W oncomodulin, and Cod III parvalbumin
      revealed that the principal Tb3+ luminescence donor residues were phenylalanine
      or tyrosine located in position 7 of a loop, despite the presence of other nearby
      donors, including tryptophan. Spectra also revealed conformational differences
      between the Ca2+- and Tb(3+)-bound forms. An alternate binding loop, based on
      Tb3+ binding to model peptides, was inserted into the CD loop of oncomodulin by
      cassette mutagenesis. The order of fill of Tb3+ in this protein reversed, with
      the mutated loop binding Tb3+ first. This indicates a much higher affinity for
      the consensus-based mutant loop. The mutant loop inserted into oncomodulin had 32
      times more Tb3+ luminescence than the identical synthetic peptide, despite having
      the same donor tryptophan and metal binding ligands. In this paper, a ranking of
      sensitivity of luminescence of bound Tb3+ is made among this subset of calcium
      binding proteins. This ranking is interpreted in light of the structural
      differences affecting Tb3+ luminescence enhancement intensity. The mechanism of
      energy transfer from an aromatic amino acid to Tb3+ is consistent with a short
      range process involving the donor triplet state as described by Dexter (Dexter,
      D. L. (1953) J. Chem. Phys. 21, 836). This cautions against the use of the
      Forster equation in approximating distances in these systems.

PMID- 1618837
TI  - Follicle-stimulating hormone inhibits granulosa cell 5 alpha-reductase activity.
      Possible role of 5 alpha-reductase as a steroidogenic pubertal switch.
AB  - In order to elucidate the role of 5 alpha-reductase in the ovarian pubertal
      transition from 5 alpha-reduced to non-5 alpha-reduced steroids, we examined the
      characteristics and regulation of granulosa cell (GC) 5 alpha-reductase activity.
      Maximum activity was observed at 37 degrees C and at a pH of 6.5-8.0. Synthetic 4
      aza-3-oxosteroids proved to be potent inhibitors (76% inhibition at 0.1 microM)
      of ovarian 5 alpha-reductase activity, and 20 alpha-DHP was a better substrate
      than either progesterone or testosterone (4- or 7-fold higher affinity constants,
      respectively). The Km (20 alpha-DHP) of the enzyme was 0.50 +/- 0.03 microM and
      0.75 +/- 0.20 microM in homogenates of whole ovaries and GC, respectively. 17
      beta-Estradiol was a non-competitive inhibitor (KI = 6.97 microM). 5 alpha
      Reductase activity was 22-fold (immature) to 68-fold (mature) higher in liver
      than ovary and 4-fold higher in theca-interstitial shells than in isolated GC.
      Ovarian 5 alpha-reductase activity decreased markedly with age (greater than 60%
      inhibition in mature, randomly cycling rats as compared to immature rats). In
      vivo administration of follicle-stimulating hormone (FSH) to immature rats
      produced a dose-dependent decrease in GC 5 alpha-reductase activity (36 +/- 1.1%
      and 46 +/- 5.9% inhibition following 12 micrograms and 24 micrograms FSH,
      respectively). Similarly, the in vitro provision of FSH (100 ng/ml) to cultured
      GC from immature rats resulted in (36-59%) inhibition in 5 alpha-reduced
      steroids. Inasmuch as FSH promotes GC development and the advancement of puberty,
      its ability to "switch-off" ovarian 5 alpha-reductase activity may enhance the
      formation of biologically potent (i.e. non-5 alpha-reduced) progestins as well as
      the availability of aromatizable androgens, in the best interests of pubertal
      steroidogenesis.

PMID- 1618838
TI  - Increased expression of protein kinase C alpha plays a key role in retinoic acid
      induced melanoma differentiation.
AB  - Differentiation of B16 mouse melanoma cells induced by retinoic acid (RA) is
      preceded by a large increase in protein kinase C alpha (PKC alpha) mRNA and
      protein. To determine the role of PKC alpha in the differentiation program, we
      stably transfected B16-F1 cells with a plasmid containing the full length PKC
      alpha cDNA driven by an SV40 promoter. Two out of thirty-two colonies screened
      were determined to overexpress PKC by 2-4-fold according to Western blot analysis
      and PKC enzyme activity. When compared to control cells (wild-type cells and
      cells transfected only with the neomycin resistance gene), PKC alpha
      overexpressing clones displayed longer doubling times, diminished anchorage
      independent growth, and increased melanin production. RA treatment of control
      cells mimicked these phenotypic characteristics. When injected subcutaneously
      into syngeneic mice, PKC alpha overexpressing clones produced smaller tumors and
      had longer latencies than control cells. These findings, combined with the fact
      that phorbol esters down-regulate PKC and antagonize RA action suggest that PKC
      alpha plays a key role in the RA-induced melanoma differentiation.

PMID- 1618839
TI  - Association of the type II cAMP-dependent protein kinase with a human thyroid RII
      anchoring protein. Cloning and characterization of the RII-binding domain.
AB  - The type II cAMP-dependent protein kinase (PKA) is localized to specific
      subcellular environments through binding of the dimeric regulatory subunit (RII)
      to anchoring proteins. Subcellular localization is likely to influence which
      substrates are most accessible to the catalytic subunit upon activation. We have
      previously shown that the RII-binding domains of four anchoring proteins contain
      sequences which exhibit a high probability of amphipathic helix formation (Carr,
      D. W., Stofko-Hahn, R. E., Fraser, I. D. C., Bishop, S. M., Acott, T. E.,
      Brennan, R. G., and Scott J. D. (1991) J. Biol. Chem. 266, 14188-14192). In the
      present study we describe the cloning of a cDNA which encodes a 1015-amino acid
      segment of Ht 31. A synthetic peptide (Asp-Leu-Ile-Glu-Glu-Ala-Ala-Ser-Arg-Ile
      Val-Asp-Ala-Val-Ile-Glu-Gln-Val -Lys-Ala-Ala-Tyr) representing residues 493-515
      encompasses the minimum region of Ht 31 required for RII binding and blocks
      anchoring protein interaction with RII as detected by band-shift analysis.
      Structural analysis by circular dichroism suggests that this peptide can adopt an
      alpha-helical conformation. Both Ht 31 (493-515) peptide and its parent protein
      bind RII alpha or the type II PKA holoenzyme with high affinity. Equilibrium
      dialysis was used to calculate dissociation constants of 4.0 and 3.8 nM for Ht 31
      peptide interaction with RII alpha and the type II PKA, respectively. A survey of
      nine different bovine tissues was conducted to identify RII binding proteins.
      Several bands were detected in each tissues using a 32P-RII overlay method.
      Addition of 0.4 microM Ht 31 (493-515) peptide to the reaction mixture blocked
      all RII binding. These data suggest that all anchoring proteins bind RII alpha at
      the same site as the Ht 31 peptide. The nanomolar affinity constant and the
      different patterns of RII-anchoring proteins in each tissue suggest that the type
      II alpha PKA holoenzyme may be specifically targeted to different locations in
      each type of cell.

PMID- 1618840
TI  - Purification and characterization of a novel proline-directed protein kinase from
      bovine brain.
AB  - A novel protein kinase which phosphorylates a synthetic peptide substrate
      (RRPDAHRTPNRAF) has been purified approximately 200,000-fold from bovine brain.
      This peptide contains the consensus sequence for phosphorylation by the p34cdc2
      kinase. The purification procedure took advantage of the phenomenon that this
      novel brain kinase, in partially purified extracts, chromatographed on a gel
      filtration column as a high molecular weight complex which dissociated in buffer
      containing 1 M NaCl. The purified native enzyme was estimated to be approximately
      63,000, and displayed two bands of M(r) = 33,000 and 25,000 on sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis. On Western immunoblot, the M(r) =
      33,000 peptide reacted strongly with antibodies specific for a conserved amino
      terminal sequence, weakly with antibodies to the conserved PSTAIRE sequence, and
      not at all with antibodies to the carboxyl terminus, of HeLa cell p34cdc2. The
      brain kinase and p34cdc2 were similar in displaying good activity toward the
      parent peptide substrate, but no activity toward peptide analogues in which the 
      T-P- motif was substituted with either -T-G- or -T-A-. Both kinases showed marked
      preference in phosphorylating a peptide derived from H1 histone
      (KTPKKAKKPKTPKKAKKL), and both kinases could be phosphorylated by the src-family
      tyrosine kinase, p56lyn, purified from bovine spleen. However, the brain kinase
      did not co-purify with a subunit having a molecular weight corresponding to known
      cyclins, nor did it undergo specific interaction with p13suc1 beads, suggesting
      that this enzyme is distinct from p34cdc2.

PMID- 1618841
TI  - Influence of membrane fluidity on the assembly of Staphylococcus aureus alpha
      toxin, a channel-forming protein, in liposome membrane.
AB  - By use of multilamellar phosphatidylcholine (PC) liposomes of different acyl
      composition and cholesterol content as model membranes, we studied whether or not
      membrane fluidity affects the assembly process of Staphylococcus aureus alpha
      toxin. Under conditions using fluid and solid membranes, we assayed accessibility
      (or hemolytic activity) of liposome-bound alpha-toxin to rabbit erythrocytes
      added, hexamerization of membrane-bound toxin using sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE) under nondenaturating conditions,
      and susceptibility of liposome-bound toxin to trypsin digestion. Our data
      indicated 1) that alpha-toxin bound to PC membrane as a hemolytically active
      monomer (or reversibly bound state); 2) that when the membrane was fluidized
      either by phase transition of PC or by inclusion of cholesterol over 20 mol %,
      the hemolytically active monomer of the toxin was irreversibly converted to
      nonhemolytic monomer (and/or unstable oligomer) in a first-order kinetics with a
      t1/2 of about 1 min, and thereafter hexamerization of the toxin gradually
      proceeded in the following 60-90 min; 3) that alpha-toxin might have different
      topology and/or conformation in PC membrane, depending on the presence or absence
      of cholesterol in the PC membrane; and 4) that coexistence of unsaturated acyl
      chain-carrying PC and cholesterol was a prerequisite for efficient hexamerization
      of alpha-toxin in membrane. Thus, increase in membrane fluidity promoted the
      assembly process of S. aureus alpha-toxin.

PMID- 1618842
TI  - Hm1 muscarinic cholinergic receptor internalization requires a domain in the
      third cytoplasmic loop.
AB  - Selected regions of the Hm1 muscarinic cholinergic receptor were mutated to
      analyze the molecular mechanisms of agonist-induced receptor internalization (or
      sequestration). The wild-type and mutant Hm1 genes were expressed, using pSG5, in
      U293 human kidney cells. Whereas surface receptor density measured with the polar
      tracer N-[3H]methylscopolamine was rapidly reduced by carbachol exposure, total
      receptor content measured with [3H]quinuclidinyl benzilate did not decline for at
      least 24 h, indicating the absence of extensive receptor down-regulation in U293
      cells. Carbachol stimulation of phosphatidylinositol turnover paralleled receptor
      internalization, both with EC50 values of 10-20 microM. Furthermore, a D71N point
      mutation that prevented receptor activation also abolished carbachol-induced
      receptor internalization, indicating that receptor activation (but not
      necessarily second messenger stimulation) was required for internalization.
      Truncation of the COOH-terminal tail (K447 trunc) and point mutations of several
      potential Ser and Thr phosphorylation sites to Ala failed to affect receptor
      activation and internalization. In contrast, partial deletions of the third
      intracellular loop (i3) (Tyr208-Thr366) resulted in receptor mutants deficient in
      agonist-induced receptor internalization/sequestration. Various deletions caused
      either complete loss of internalization (d 232-358) or impaired internalization,
      ranging from 10 to 30% over 2 h, whereas wild-type Hm1 internalized to
      approximately 50%. Whereas the reason for the observed differences among the
      deficient deletion mutants remains unclear, the initial rate of N
      [3H]methylscopolamine binding loss from the cell surface was much slower than
      that of wild-type Hm1 in each case. The deletion of only one single domain, 284
      292 (SMESLTSSE), in the middle of i3 was consistently associated with impaired
      internalization. Domain 284-292 is partially conserved among closely related
      muscarinic receptors, whereas most of the remainder of i3 is not (except for the
      i3 membrane junctions), and similar Ser- and Thr-rich regions are present in many
      other G protein-coupled receptors. We propose that a small receptor domain in the
      middle of the i3 loop of Hm1 is involved in agonist-induced receptor
      internalization.

PMID- 1618843
TI  - Hemoglobin-binding site on human haptoglobin. Identification of lysyl residues
      participating in the binding.
AB  - The locus of human haptoglobin (Hp) molecules that interacts with human
      hemoglobin (Hb) was examined by the differential labeling technique. First, amino
      groups of Hp were extensively labeled with ethyl acetimidate (EAI) either in the
      free state (experiment A) or in the equimolar complex with Hb (experiment B).
      Each of the labeled Hp samples was reduced and S-carboxymethylated, and the
      remaining amino groups were then allowed to react with trinitrobenzenesulfonic
      acid (TNBS) under denatured conditions. Only 0.6 mol/mol of the trinitrophenyl
      (TNP) group was introduced into the heavy chain of Hp in experiment A, whereas
      2.5 mol/mol of TNP groups were into the same chain in experiment B. The extent of
      TNP modification for the light chain was very low in either of the experiments.
      The amino acid residues carrying TNP groups in the heavy chain were identified by
      the peptide mapping procedure. They were Ile1, Lys136, and Lys218 in experiment
      B, and only Ile1 in experiment A. These findings suggest that epsilon-amino
      groups of Lys136 and Lys218 in the heavy chain are both situated within the Hb
      binding locus of Hp, and that the alpha-amino group of Ile1 is buried inside the
      molecule either in the presence or absence of Hb.

PMID- 1618844
TI  - Substrate specificity of phospholipase B from guinea pig intestine. A glycerol
      ester lipase with broad specificity.
AB  - The substrate specificity of a calcium-independent, 97-kDa phospholipase B
      purified from guinea pig intestine was further investigated using various natural
      and synthetic lipids. The enzyme was equally active toward enantiomeric
      phosphatidylcholines under conditions allowing a strict phospholipase A activity.
      The lysophospholipase activity declined with the following substrates: 1-acyl-sn
      glycero-3-phosphocholine greater than 1-palmitoyl-propanediol-3-phosphocholine
      greater than 1-palmitoyl-glycol-2-phosphocholine, suggesting some influence of
      the polar residue vicinal to the cleavage site. The enzyme also acted on various
      neutral lipids including triacylglycerol, diacylglycerol, and monoacylglycerol,
      whereas cholesteryl oleate remained refractory to enzymatic hydrolysis. The
      lipase hydrolyzed sequentially the sn-2 and sn-1 acyl ester bonds of
      diacylglycerol, although some direct cleavage of the external acyl ester bond
      could also occur, as shown with diacylglycerol analogues bearing a
      nonhydrolyzable alkyl ether or amide bond in the sn-1 or sn-2 position. The three
      main activities of the enzyme (phospholipase A2, lysophospholipase, and
      diacylglycerol lipase) were resistant to 4-bromophenacyl bromide, but they were
      inhibited by N-ethylmaleimide, 5,5'-dithiobis-(2-nitrobenzoic acid), and
      diisopropyl fluorophosphate, suggesting the possible involvement of both cysteine
      and serine residues in a single active site. It is concluded that guinea pig
      intestinal phospholipase B, which was also detected in rat and rabbit, is
      actually a glycerol ester lipase with broad substrate specificity and some unique
      enzymatic properties.

PMID- 1618845
TI  - Partial characterization of the major lipooligosaccharide from a strain of
      Haemophilus ducreyi, the causative agent of chancroid, a genital ulcer disease.
AB  - The first preliminary structure of a surface lipooligosaccharide from Haemophilus
      ducreyi has been determined. The major oligosaccharide was released by mild acid
      hydrolysis and analyzed by liquid secondary ion and tandem mass spectrometry. The
      mass spectral data combined with composition and methylation analysis yielded the
      most probable structure; Gal1----4GlcNAc1----3Gal1----4Hep1----6Glc1----( Hep1---
      2Hep1----)3,4Hep1---- KDO, where the reducing terminal 3-deoxy-D-manno
      octulosonic acid (or KDO) exists in an anhydro form. This anhydro species results
      from the elimination of a phosphate from C-4 of KDO during mild acid hydrolysis.
      The core heptose trisaccharide consists of L-glycero-D-manno-heptose, but
      analysis of the peracetylated sugars indicated that the 1,4-linked heptose is
      likely D-glycero-D-manno-heptose. The monoclonal antibody 3F11 generated against
      Neisseria gonorrhoeae also binds to this lipooligosaccharide and suggests that
      the terminal trisaccharide is Gal beta 1----4GlcNAc beta 1----3Gal beta 1----, an
      epitope found in the glycose moiety of the human erythrocyte glycosphingolipid
      lactoneotetraglycosylceramide. Mass spectrometric and composition analysis of the
      lipid A moiety shows that it is similar to the lipid A of Haemophilus influenzae
      strain I-69 Rd-/b+ proposed by Helander et al. (Helander, I. M., Lindner, B.,
      Brade, H., Altmann, K., Lindberg, A. A., Rietschel, E. T., and Zahringer, U.
      (1988) Eur. J. Biochem. 177, 483-492). Electrospray mass spectrometric analysis
      of the intact O-deacylated lipooligosaccharides gave an average Mr of 2710, and
      supported an overall structure consisting of the above nonasaccharide linked
      directly to a diphosphorylated lipid A moiety through the single KDO which is
      phosphorylated. This structure should provide a framework to investigate the
      roles of lipooligosaccharides in the host immunochemical response and pathology
      of H. ducreyi infection, a leading cause of genital ulcer disease.

PMID- 1618846
TI  - Structural requirements for tRNA methylation. Action of Escherichia coli
      tRNA(guanosine-1)methyltransferase on tRNA(1Leu) structural variants.
AB  - The Escherichia coli enzyme tRNA(m1G)methyltransferase, one of a group of post
      transcription tRNA-modifying enzymes, shows remarkable specificity in selecting
      the tRNA species and the specific guanosine base to be methylated. To examine the
      structural basis of this specificity, we synthesized a total of 15 modifications
      of tRNA(1Leu) and measured their methylation reaction kinetics in vitro.
      Elimination of any one of the three tRNA side loops, the V loop, the T loop, or
      the D loop, reduced the Vmax for methylation by about 1 order of magnitude.
      Elimination of all three side loops reduced Vmax by about 2 orders of magnitude.
      Clearly, gross tRNA structure is important for full enzyme activity. At the
      bottom of the stem proximal to the anticodon loop, in the pair at positions 31
      39, substitution of a G-C for a C-G, a change that should not weaken the helical
      structure, had little effect on Vmax or Km. However, substitution of a G for a C
      increased Vmax and Km, whereas substitution of a C for G sharply reduced Vmax
      and, to a lesser extent, Km. These results appear to be a consequence of the
      principle that purines are better than pyrimidines in the stacking of adjacent
      bases for stability. Stacking in the stem structure appears to be important for
      methylation enzyme activity. In the anticodon loop itself, changing a U to a C
      had little effect, but changing the G of the anticodon to a C reduced Vmax over
      20-fold, demonstrating the importance of the presence of the anticodon G adjacent
      to the G being methylated for enzyme recognition.

PMID- 1618848
TI  - Hysteretic behavior of nitrate reductase. Evidence of an allosteric binding site
      for reduced pyridine nucleotides.
AB  - In the absence of NADH, at 25 degrees C, partially purified NADH:nitrate
      reductase undergoes an approximately 50% reduction of its initial activity during
      2 h. With the increase of inactivation, the NADH and nitrite concentration time
      curves become typical "sigmoidal," i.e. the reaction velocity of the nitrate
      reductase catalyzed reaction goes through a maximum before equilibrium is
      reached. About 80% of the original activity of nitrate reductase is restored when
      the enzyme is incubated for 2 min with 200 microM NADH or NADPH. Also other NADH
      substrate analogues have similar effects in restoring the lost activity. After
      incubation with the reduced pyridine nucleotides, the sigmoidal appearance of the
      NADH concentration time curve disappears almost completely. Despite the fact that
      NADPH increases the activity of the enzyme, NADPH does not show any competition
      with the NADH-binding site of nitrate reductase and does not produce nitrite in
      the absence of NADH. It is therefore concluded that there must be an additional
      allosteric site which binds either NADH or NADPH, or other pyridine nucleotides
      with the effect of increasing the activity of the enzyme. A kinetic model is
      presented which simulates the observed experimental findings.

PMID- 1618847
TI  - Brefeldin A enhances receptor-mediated transcytosis of transferrin in filter
      grown Madin-Darby canine kidney cells.
AB  - The effects of brefeldin A (BFA) on transferrin (Tf) transcellular transport, Tf
      receptor (TfR) distribution, and TfR-mediated endocytosis in filter-grown Madin
      Darby canine kidney (MDCK) cells were studied. BFA (1.6 micrograms/ml) markedly
      enhanced the transcytosis of 125I-labeled Tf (125I-Tf) in both apical-to-basal
      and basal-to-apical directions; yet, BFA did not enhance the transcytosis of
      either native horseradish peroxidase (HRP) or membrane-bound HRP-poly(L-lysine)
      conjugates. Furthermore, this enhanced transcytosis of 125I-Tf was abolished
      either by competition with excess unlabeled Tf or by incubation at temperatures
      less than or equal to 25 degrees C. In addition, BFA treatment to MDCK cells: (a)
      increased 125I-Tf specific binding to the apical membrane and decreased 125I-Tf
      specific binding to the basal membrane; (b) decreased TfR recycling at the
      basolateral membrane; (c) altered the apical/basolateral distribution of TfRs in
      favor of the apical side; and (d) markedly increased 59Fe extraction, but not
      transcytosis, from apically endocytosed 59Fe-loaded Tf. These effects are
      consistent with a model in which BFA alters the traffic pattern of internalized
      Tf by decreasing basolateral TfR recycling, while diverting the nonrecycled
      fraction to the apical side of the cell. Our results indicate that, unlike the
      reported inhibition of polymeric IgA transcytosis (Hunziker, W., Whitney, J. A.,
      and Mellman, I. (1991) Cell 67, 617-627), BFA can enhance the transcytosis of Tf
      in MDCK cells. Thus, by altering the intracellular traffic of ligand-receptor
      complexes, BFA can elicit either a decrease or an increase in transcytosis
      depending on the nature of the intracellular receptor processing.

PMID- 1618849
TI  - 5' flanking sequences of the murine adenosine deaminase gene direct expression of
      a reporter gene to specific prenatal and postnatal tissues in transgenic mice.
AB  - Adenosine deaminase (ADA), an enzyme of purine metabolism, is highly expressed in
      four tissues of the mouse: the maternal decidua, the fetal placenta, the
      keratinizing epithelium of the upper alimentary tract (tongue, esophagus, and
      forestomach), and the absorptive epithelium of the proximal small intestine. ADA
      is produced at relatively low levels in all other tissues. To identify genetic
      elements that direct appropriate prenatal and postnatal expression of the ADA
      gene, a segment of DNA including the ADA promoter and 6.4 kilobases of the
      adjacent 5' flanking region was tested for the ability to direct the expression
      of a reporter gene in transgenic mice. In seven lines of transgenic mice studied,
      this construct directed high levels of reporter gene expression in the placenta
      and forestomach and exhibited correct developmental regulation in these tissues.
      This construct failed to direct significant reporter gene expression to either
      the maternal decidua or the proximal small intestine. Thus, different gene
      regulatory elements are required to target high expression to the four tissues
      characterized by high levels of ADA.

PMID- 1618850
TI  - Differential role of insulin receptor autophosphorylation sites 1162 and 1163 in
      the long-term insulin stimulation of glucose transport, glycogenesis, and protein
      synthesis.
AB  - The long-term regulatory effect of insulin on glucose transport activity and
      glucose transporter expression was examined in Chinese hamster ovary (CHO)
      transfectants that overexpress either human insulin receptors of the wild type
      (CHO-R cells) or human insulin receptors mutated at two major autophosphorylation
      sites, Tyr1162 and Tyr1163 (CHO-Y2 cells). Previous studies showed that, when
      acutely stimulated by insulin, CHO-Y2 cells exhibit decreased receptor kinase
      activity along with decreased signaling of several pathways, including that for
      glucose transport, as compared with CHO-R cells. We now report the following. (i)
      When treated for 24 h with insulin (10(-10) to 10(-6) M), CHO-R and CHO-Y2 cells
      displayed closely similar concentration-dependent increases in 2-deoxyglucose
      uptake. In both transfectants, the maximal insulin-induced increase
      (approximately 3.5-fold) in uptake was cycloheximide-sensitive and was paralleled
      by equivalent increases in the levels of GLUT-1 immunoreactive protein and mRNA.
      (ii) By contrast, under similar conditions, CHO-Y2 cells exhibited a marked
      decrease in their response to insulin for [U-14C]glucose incorporation into
      glycogen (decreased sensitivity and maximal responsiveness) and for [U
      14C]leucine incorporation into protein (decreased sensitivity) as compared with
      CHO-R cells. (iii) After a 24-h treatment with 10(-7) M insulin, CHO-R (but not
      CHO-Y2) cells showed a decreased ability to respond to a subsequent acute insulin
      stimulation of either receptor exogenous kinase activity or 2-deoxyglucose uptake
      as compared with respective untreated controls. These results indicate that (i)
      insulin receptors mutated at Tyr1162 and Tyr1163 retain normal signaling of the
      long-term stimulatory effect of insulin on glucose transport activity and GLUT-1
      expression, but not on glycogenesis and overall protein synthesis; (ii) these
      three insulin signaling pathways may be triggered by distinct domains of the
      insulin receptor beta-subunit; and (iii) wild-type (but not twin-tyrosine mutant)
      receptors undergo negative regulation by chronic insulin treatment for subsequent
      signaling of acute biological actions of insulin.

PMID- 1618852
TI  - Purification of nuclear proteins that bind to cisplatin-damaged DNA. Identity
      with high mobility group proteins 1 and 2.
AB  - The biochemical processes responsible for the recognition and repair of cisplatin
      damaged DNA in human cells are not well understood. We have developed a damaged
      DNA affinity precipitation technique that allows the direct visualization and
      characterization of cellular proteins that bind to cisplatin-damaged DNA. The
      method separates damaged DNA-binding proteins from complex radiolabeled cell
      mixtures and further resolves them into individual polypeptides by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis. This technique is complementary to
      gel retardation and Southwestern blotting analyses that have been previously used
      to identify cellular components that specifically bind to cisplatin-damaged DNA.
      Using this technique, we have characterized a set of HeLaS3 nuclear proteins of
      26.5, 28, 90, and 97 kDa that specifically bind to cisplatin-DNA adducts.
      Competition studies with soluble cisplatin-damaged DNA confirmed these findings.
      The major cisplatin-damaged DNA-binding proteins of 26.5 and 28 kDa recognized
      adducts of DNA modified with cisplatin but not with its trans-isomer or with UV
      radiation. These proteins were purified 450-fold to near homogeneity by ion
      exchange and cisplatin-damaged DNA affinity chromatography. Amino-terminal
      sequence analysis showed that the 26.5- and 28-kDa proteins were identical to
      high mobility group (HMG) proteins HMG-2 and HMG-1, respectively.

PMID- 1618851
TI  - CAP-50, a newly identified annexin, localizes in nuclei of cultured fibroblast
      3Y1 cells.
AB  - A 50-kDa protein, which binds to the growth-regulated gene (2A9) product,
      calcyclin in a calcium-dependent manner, was purified from bovine lung. Partial
      amino acid sequencing of the protein revealed it to be the bovine equivalent of
      rabbit lung CAP-50 (calcyclin-associated protein, 50 kDa), which is a member of
      the annexin family and binds to calcyclin in a calcium-dependent manner. Specific
      polyclonal antibodies to bovine lung CAP-50 were prepared. Comparative studies
      between CAP-50 and synexin (annexin VII) on the immunoreactivity against anti-CAP
      50 antibodies and the ability of binding to calcyclin revealed that CAP-50 was a
      distinct molecule from synexin. Using specific polyclonal antibodies to bovine
      lung CAP-50, tissue distribution and subcellular distribution of CAP-50 were
      investigated. In most rat tissues, except those in the central nervous systems
      and kidney, CAP-50 is expressed at a high or moderate level. Both studies by
      subcellular fractionation and by indirect immunofluorescence staining of the rat
      embryonic fibroblast cell line, 3Y1, revealed that CAP-50 mainly localized in
      nuclei. Moreover, between the cells at interphase and at mitotic phase, different
      distributions of CAP-50 were observed. That is, in the cells at interphase, CAP
      50 seemed to localize throughout the nucleoplasm. On the other hand, in the cells
      during mitosis, CAP-50 was concentrated at the loop-like structure around the
      mitotic apparatus. CAP-50 was found in isolated 3Y1 nuclei lacking outer nuclear
      membranes, and approximately 50% of CAP-50 was extracted from the nuclei by
      chelating calcium. Thus, CAP-50, a unique annexin, localizes in nuclei.

PMID- 1618853
TI  - Identification and localization of multiple forms of serine
      hydroxymethyltransferase in pea (Pisum sativum) and characterization of a cDNA
      encoding a mitochondrial isoform.
AB  - Serine hydroxymethyltransferase (SHMT) has been purified from the mitochondria of
      green pea leaves. Activity can be fractionated into two distinct peaks by ion
      exchange chromatography. While these two forms of the enzyme are immunologically
      indistinguishable, immunoinhibition experiments show the presence of a distinct
      non-mitochondrial third form of the enzyme to also be present in green pea
      leaves. While this mitochondrial form of SHMT is abundant in leaves it is absent
      from roots, although the two tissues have comparable SHMT activity. An antibody
      raised to purified mitochondrial SHMT was used to screen a cDNA expression
      library. The sequence of one of the isolated positive clones contained an open
      reading frame, which encoded a sequence that matched the amino acid sequence
      determined from the N terminus of the mature protein. The open reading frame
      encodes a mature protein of 487 amino acids with a M(r) of 54,000, together with
      a 27-31 amino acid serine-rich leader sequence, presumably required for
      mitochondrial targeting. The cDNA hybridizes to a small multigene family of 2-3
      genes, which appear to be expressed predominantly in leaves. Comparison of the
      deduced amino acid sequence with the amino acid sequences of the rabbit
      mitochondrial and cytoplasmic SHMT, show that pea mitochondrial SHMT is equally
      similar to both of these enzymes. In addition, the rabbit sequences are more like
      one another than they are to the pea sequence, suggesting an interesting
      evolutionary relationship for these proteins.

PMID- 1618854
TI  - Regulation of rat glutathione S-transferase Ya subunit gene expression. DNA
      protein interaction at the antioxidant responsive element.
AB  - We have characterized the interaction of the antioxidant responsive element (ARE)
      in the 5'-flanking region of the rat glutathione S-transferase Ya subunit gene
      with its trans-acting factor. The ARE core sequence, 5'-ggTGACaaaGC-3',
      previously identified as the cis-acting element required for activation of the Ya
      subunit gene by planar aromatic compounds and phenolic antioxidants, is shown to
      be the high affinity recognition motif for a trans-acting factor(s) as determined
      by gel mobility shift assays as well as methylation interference and protection
      studies. The DNA-protein interaction appears to occur in the major groove and
      involves the GpG dinucleotide preceding and the G residue within the TGAC
      tetramer on the coding strand of the core sequence. In addition, DNase I
      protection analysis maps an extended region 5' from the core recognition motif,
      which was shown previously to be essential for basal activity of the ARE. The
      trans-acting factor is present in nuclear extracts from untreated and tert
      butylhydroquinone-treated cells as determined by photochemical cross-linking
      experiments. The cross-linked protein appears to be a heterodimer with subunit
      molecular weights of approximately 28,000 and approximately 45,000.

PMID- 1618855
TI  - Characteristics of the F52 protein, a MARCKS homologue.
AB  - A recently cloned mouse cDNA designated F52 encodes a putative protein with
      striking sequence similarity to the MARCKS protein, a major cellular substrate
      for protein kinase C (PKC). Major regions of sequence similarity include the
      amino-terminal myristoylation consensus sequence and the central calmodulin
      binding/PKC phosphorylation site domain. The F52 protein was expressed in
      Escherichia coli with apparent M(r) 50,000; it was a substrate for PKC and
      comigrated on two-dimensional electrophoresis with a myristoylated protein whose
      phosphorylation was stimulated by phorbol 12-myristate 13-acetate in mouse
      neuroblastoma cells. The F52 protein also was myristoylated in E. coli by co
      expression with N-myristoyltransferase. A 24-amino acid peptide derived from the
      protein's phosphorylation site domain was a good substrate for PKC; like the
      cognate MARCKS peptide, it was phosphorylated with high affinity (S0.5 = 173 nM)
      and positive cooperativity (KH = 5.4). The F52 peptide also bound calmodulin with
      high affinity (Kd = less than 3 nM); this binding could be disrupted by
      phosphorylation of the peptide with PKC, with a half-time of 8 min. The F52
      protein is clearly a member of the MARCKS family as defined by primary sequence;
      in addition, the two proteins share several key attributes that may be
      functionally important.

PMID- 1618856
TI  - Regulated degradation of 3-hydroxy-3-methylglutaryl-coenzyme A reductase in
      permeabilized cells.
AB  - We have studied the regulated degradation of the enzyme 3-hydroxy-3
      methylglutaryl-coenzyme A (HMG-CoA) reductase within the endoplasmic reticulum in
      cells permeabilized with digitonin. Using Chinese hamster ovary cells transfected
      with a plasmid encoding HMGal, a chimeric protein containing the membrane domain
      of HMG-CoA reductase coupled to beta-galactosidase, we have demonstrated
      mevalonate and sterol-stimulated loss of beta-galactosidase activity. In pulse
      chase experiments we have demonstrated mevalonate-stimulated degradation of both
      HMGal and HMG-CoA reductase. The rate of mevalonate-stimulated degradation
      observed in permeabilized cells tends to be slightly slower than that observed in
      intact cells treated with mevalonate and is dependent upon incubation of cells
      with mevalonate prior to permeabilization. The degradation process measured in
      this report extends a previous report of HMG-CoA reductase degradation in
      digitonin-permeabilized cells (Leonard, D. A., and Chen, H. W. (1987) J. Biol.
      Chem. 262, 7914-7919) by mimicking key physiological features of the in vivo
      process, including: stimulation by regulatory molecules, specifically mevalonate
      and sterols; inhibition by cycloheximide; and inhibition by an inhibitor of
      neutral cysteine proteases.

PMID- 1618858
TI  - Reconstitution of the activities of the RecBCD holoenzyme of Escherichia coli
      from the purified subunits.
AB  - The Escherichia coli RecBCD holoenzyme and the individual constituent subunits
      have been purified from overproducing strains. The purified RecBCD holoenzyme has
      a native molecular mass of approximately 330 kDa, indicative of a heterotrimer
      subunit assembly. The RecB, RecC, and RecD subunits can associate in vitro to
      give nuclease, helicase, ATPase, and Chi-specific endonuclease activities which
      are indistinguishable from those of the RecBCD holoenzyme. At concentrations at
      which the reconstituted RecB + C + D enzyme is very active, none of the
      individual RecB, RecC, or RecD subunits have readily detectable activities of the
      holoenzyme, except RecB protein which had previously been shown to exhibit DNA
      dependent ATPase activity (Hickson, I. D., Robson, C. N., Atkinson, K. E.,
      Hutton, L., and Emmerson, P. T. (1985) J. Biol. Chem. 260, 1224-1229). At higher
      concentrations and with shorter DNA substrates reconstituted RecBC protein
      exhibits low levels of helicase and exonuclease activity.

PMID- 1618857
TI  - Isolation and characterization of a novel cardiac adenylylcyclase cDNA.
AB  - A novel adenylylcyclase cDNA (type V) was isolated from a canine heart cDNA
      library. Northern blotting indicates that the expression of this message is most
      abundant in heart with a lesser amount in brain but is absent in a variety of
      other tissues including lung, kidney, skeletal muscle, lymphocyte, and testis.
      The putative protein product predicted from the cDNA sequence has the motif of
      tandem six-transmembrane spans separated by a large hydrophilic cytoplasmic loop
      as seen in other members of the adenylylcyclase family. When this protein is
      expressed using a CMT cell transient expression system, the adenylylcyclase
      activity was stimulated by NaF, GTP gamma S, and forskolin, but not by
      calmodulin. The activity was inhibited in a concentration-dependent manner with
      either P-site active agents such as adenosine or in the presence of calcium.
      These data indicate that the protein encoded by this cDNA is adenylylcyclase with
      the biochemical features characteristic of the cardiac isoform.

PMID- 1618859
TI  - Isolation and characterization of a novel trypsin-like protease found in rat
      bronchiolar epithelial Clara cells. A possible activator of the viral fusion
      glycoprotein.
AB  - A novel trypsin-like protease associated with rat bronchiolar epithelial Clara
      cells, named Tryptase Clara, was purified to homogeneity from rat lung by a
      series of standard chromatographic procedures. The enzyme has apparent molecular
      masses of 180 +/- 16 kDa on gel filtration and 30 +/- 1.5 kDa on sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis under reducing conditions. Its
      isoelectric point is pH 4.75. Studies with model peptide substrates showed that
      the enzyme preferentially recognizes a single arginine cleavage site, cleaving
      Boc-Gln-Ala-Arg-4-methylcoumaryl-7-amide most efficiently and having a pH optimum
      of 7.5 with this substrate. The enzyme is strongly inhibited by aprotinin,
      diisopropylfluorophosphate, antipain, leupeptin, and Kunitz-type soybean trypsin
      inhibitor, but inhibited only slightly by Bowman-Birk soybean trypsin inhibitor,
      benzamidine, and alpha 1-antitrypsin. Immunohistochemical studies indicated that
      the enzyme is located exclusively in the bronchiolar epithelial Clara cells and
      colocalized with surfactant. An immunoreactive protein with a molecular mass of
      28.5 kDa was also detected in airway secretions by Western blotting analyses,
      suggesting that the 30-kDa protease in Clara cells is processed before or after
      its secretion. Proteolytic cleavage of the hemagglutinin of influenza virus is a
      prerequisite for the virus to become infectious. Tryptase Clara was shown to
      cleave the hemagglutinin and activate infectivity of influenza A virus in a dose
      dependent way. These results suggest that the enzyme is a possible activator of
      inactive viral fusion glycoprotein in the respiratory tract and thus responsible
      for pneumopathogenicity of the virus.

PMID- 1618860
TI  - Transcriptional repression of the C/EBP-alpha and GLUT4 genes in 3T3-L1
      adipocytes by tumor necrosis factor-alpha. Regulations is coordinate and
      independent of protein synthesis.
AB  - We have previously demonstrated the ability of tumor necrosis factor-alpha (TNF)
      to down-regulate the expression of GLUT4 (insulin-responsive glucose transporter)
      and C/EBP-alpha (CCAAT/enhancer-binding protein) (Stephens J. M., and Pekala, P.
      H. (1991) J. Biol. Chem. 266, 21839-21845). As C/EBP-alpha has been suggested to
      control GLUT4 expression, we have examined the time course for attenuation of
      transcription of these genes. Run-on transcription assays indicate a coordinate
      transcriptional repression of both GLUT4 and C/EBP-alpha genes (as well as the
      422/aP2 gene, the adipocyte lipid-binding protein, whose expression has also been
      proposed to be controlled by C/EBP-alpha). Inhibition of transcription was
      observed within 1 h of TNF addition, with maximal suppression observed after 4 h.
      The inhibition was not blocked by cycloheximide. Okadaic acid treatment (1 h, 0.5
      microM) also resulted in the coordinate transcriptional repression of the C/EBP
      alpha, GLUT4, and 422/aP2 genes, consistent with involvement of a kinase
      phosphatase system in the regulation of these genes. The decrease in C/EBP-alpha
      protein content was detectable 4 h after TNF addition and declined to 25% of
      controls within 24 h. A minor decrease in the protein content of GLUT4 was
      observed during the first 24 h of exposure to TNF; however, after 72 h of
      exposure GLUT4 protein was not detectable. The rapid coordinate transcriptional
      regulation of C/EBP-alpha, GLUT4, and 422/aP2 by TNF in the presence of
      cycloheximide suggests that the TNF-induced loss of GLUT4 protein may be mediated
      by a post-translational modification of an existing transcription factor.
      However, the rapid loss of C/EBP-alpha protein may be a contributing factor to
      further transcriptional suppression of the GLUT4 gene at the later time points.
      In addition to the transcriptional effect, we report that TNF-induced
      destabilization of these mRNAs contributes to decreased expression of all three
      genes.

PMID- 1618861
TI  - Identification of palmitoylation sites on CD4, the human immunodeficiency virus
      receptor.
AB  - We report that the cell surface glycoprotein CD4 expressed in HeLa cells can be
      metabolically labeled with [3H]palmitic acid. Analysis of the 3H-label after
      hydrolysis of the protein indicated that it was incorporated predominantly as
      palmitic acid. Comparison of the amount of [3H]palmitate incorporated into CD4
      with that incorporated into a protein known to contain one molecule of esterified
      palmitate suggested that one to two molecules of palmitate were added to CD4. The
      fatty acid was readily cleaved from CD4 by treatment with weak base suggesting a
      thioester linkage. Mutations of each of 2 cysteine residues, Cys394 and Cys397,
      in CD4 at the junction of the transmembrane and cytoplasmic domains reduced
      labeling with [3H]palmitic acid, and mutation of both cysteines eliminated
      labeling. These results indicate that both cysteines are esterified to palmitate.
      Modification with palmitate was not required for expression of CD4 on the cell
      surface or for binding of p56lck to its cytoplasmic domain.

PMID- 1618862
TI  - Bordetella pertussis adenylate cyclase toxin. Structural and functional
      independence of the catalytic and hemolytic activities.
AB  - The Bordetella pertussis calmodulin-dependent adenylate cyclase (CyaA) is a 1706
      residue-long toxin, endowed with hemolytic activity. We have constructed B.
      pertussis mutant strains producing modified CyaAs devoid of adenylate cyclase
      activity. Our results show that such modified CyaAs display hemolytic activity
      identical to the wild-type toxin, thus demonstrating that the hemolytic activity
      is independent of the adenylate cyclase activity. Furthermore, B. pertussis and
      Escherichia coli strains producing CyaA lacking the catalytic domain (residues 1
      373) were constructed. The truncated protein exhibits hemolytic activity
      comparable to the wild-type toxin, thus establishing that the carboxyl-terminal
      1332 residues alone are endowed with hemolytic activity. Together, these findings
      show that adenylate cyclase and hemolytic activities are located in two distinct
      regions of the molecule (respectively, approximately amino acids 1-400 and 401
      1706) and that the two regions of CyaA are functionally independent.

PMID- 1618863
TI  - Antibodies selected from whole antiserum by fusion proteins as tools for the
      study of the topology of mitochondrial membrane proteins. Evidence that the N
      terminal extremity of the sixth alpha-helix of the uncoupling protein is facing
      the matrix.
AB  - The reactivity to freeze-thawed mitochondria or submitochondrial particles of a
      whole antiserum raised against the uncoupling protein has been investigated.
      Incubation with freeze-thawed brown adipose tissue mitochondria trapped
      antibodies reactive toward accessible parts of the uncoupling protein. One-third
      to one-half of antibodies against uncoupling protein which were present in the
      serum remained free. These antibodies were highly reactive with the vesicles
      obtained by sonication of mitochondria, in which the matricial side of the inner
      membrane was made accessible. To define epitopes recognized by the antiserum,
      different fusion proteins made up of MalE protein and uncoupling protein
      fragments were used. Immunoaffinity chromatography, using an immobilized purified
      fusion protein containing amino acids 253 to 290 of uncoupling protein, selected
      antibodies specifically directed against this part of the protein. A more precise
      localization of the main epitope recognized by these antibodies is proposed.
      These purified antibodies reacted with the protein only in submitochondrial
      particles, indicating a matricial orientation of this epitope. This result,
      associated with other data concerning uncoupling protein or related mitochondrial
      carriers such as the ADP/ATP translocator and the phosphate carrier, allowed us
      to determine the orientation of the sixth alpha-helix of the uncoupling protein.

PMID- 1618864
TI  - Enhanced growth of a human keratinocyte cell line induced by antisense RNA for
      parathyroid hormone-related peptide.
AB  - We have used antisense RNA technology to inhibit endogenous parathyroid hormone
      related peptide (PTHRP) production in the established human keratinocyte cell
      line, HPK1A, in order to assess the role of PTHRP as a potential modulator of
      cell growth. Rat PTHRP cDNA was cloned into the replication defective retroviral
      vector pYN in an antisense orientation and a stable cell line (HPK1A-AS) was
      generated after infection by amphotropic virus and selection by the neomycin
      derivative, G418. Expression of the transfected antisense sequence was confirmed
      with an RNA sense probe for PTHRP. The effect of the retrovirally mediated gene
      transfer on the endogenous PTHRP transcript was examined with an RNA antisense
      probe which demonstrated an absence of the endogenous transcript in HPK1A-AS
      cells. A 1.6-kilobase transcript was, however, present in equivalent quantities
      in both uninfected HPK1A and pYN-infected (HPK1A-pYN) cells. Immunocytochemistry
      and assessment of PTHRP secretion into the medium using an NH2-terminal
      radioimmunoassay and a UMR 106 adenylate cyclase bioassay confirmed the absence
      of PTHRP in HPK1A-AS cells. Examination of the inhibition of PTHRP production on
      cell growth demonstrated a reduction in doubling time and an increase in
      [3H]thymidine incorporation. Cell cycle analysis showed an increase in the
      proportion of the cell population in the S phase (relative to G0/G1) in HPK1A-AS
      cells compared to HPK1A or HPK1A-pYN cells. These data, therefore, indicate that
      endogenous PTHRP acts as an effective inhibitor of cell growth in this
      keratinocyte model and that this action occurs, at least in part, by diminishing
      entry into the S phase of the cell cycle. Furthermore, the antisense RNA method
      is a potent one to evaluate the cellular actions of PTHRP.

PMID- 1618865
TI  - Factor-stimulated RNA polymerase II transcribes at physiological elongation rates
      on naked DNA but very poorly on chromatin templates.
AB  - We used an in vitro assay system based on HeLa cell core transcription components
      to examine transcript elongation by RNA polymerase II on either naked DNA or
      chromatin templates as a function of the three known elongation factors, IIS,
      TFIIF, and TFIIX. We demonstrate for the first time that mammalian RNA polymerase
      II can achieve physiological elongation rates on naked DNA templates in vitro.
      The addition of TFIIF alone gave this rate, although IIS was required to minimize
      the block to elongation at intrinsic termination sites. However, IIS and TFIIF
      provided only a slight increase in the very poor elongation efficiency of RNA
      polymerase II on chromatin templates. The addition of TFIIX to reactions
      containing IIS and TFIIF reduced the elongation rate on naked DNA templates but
      slightly increased the elongation efficiency on chromatin. The ability of
      elongation factors either separately or in combination to stimulate transcription
      on naked DNA and chromatin templates was also examined.

PMID- 1618866
TI  - Binding of single-stranded oligonucleotides to a non-B-form DNA structure results
      in loss of promoter activity of the platelet-derived growth factor A-chain gene.
AB  - Levels of expression of the platelet-derived growth factor (PDGF) A-chain gene
      differ significantly in normal and transformed cells. We have identified an S1
      nuclease-sensitive site in a GC box located at -55 to -72 in the PDGF A-chain
      promoter region. We now demonstrate that a 24-base, G-rich complementary
      oligonucleotide anneals specifically to the C-rich strand of the GC box and
      protects the GC box from nicking by S1 nuclease whereas the C-rich complementary
      oligonucleotide and its double-stranded counterpart do not. In transient
      transfection assays, expression of the PDGF A-chain gene is sharply reduced by
      deletions within the GC box or if the 24-base G-rich complementary
      oligonucleotide is preincubated with the promoter construct prior to
      transfection. The data suggest that the GC box of the PDGF A-chain gene may
      promote a non-B-form DNA structure, which is recognized by S1 nuclease and which
      anneals to a short complementary G-rich oligonucleotide. The data also suggest
      that this non-B-form DNA is important for efficient transcription of PDGF A-chain
      gene.

PMID- 1618867
TI  - Interaction between complementary polymerization sites in the structural D and E
      domains of human fibrin.
AB  - Plasmic degradation products of human fibrin, fragments DD, D, and E, bind to
      fibrin. It has been inferred from this observation that the binding occurs by
      attraction of complementary sites located in the NH2- and COOH-terminal domains
      of the fibrin molecule. The interaction between fragments D1 and E1 has been
      investigated in this work since it represents the first step in the process of
      fibrin clot formation. Fragment D1, that was initially as active as fragment DD,
      lost most of its anticoagulant activity after purification by cation-exchange
      chromatography. The lability of fragment D1 function explained the previous
      unsuccessful attempts to form a complex between fragments D1 and E1. The loss of
      fragment D1 anticoagulant activity was not associated with the cleavage of the
      gamma 63-85 chain segment, since fragments D1A and D1 identically inhibited the
      fibrin monomer polymerization rate. In order to demonstrate the formation of a
      complex between fragments D1 and E1, three lines of experiments were advanced.
      First, the anticoagulant activity of fragment D1 was neutralized by fragment E1
      in a dose-dependent manner, demonstrating that the association between these
      fragments involved polymerization sites. Second, two products, D1.E1 and
      D1.E1.D1, were stabilized in a reaction with bifunctional cross-linking reagents,
      proving the formation of D.E complexes in aqueous solution. Third, immobilized
      fragment D1 bound fragments E1 and E2, but not fragment E3, showing that
      fragments E1 and E2 attached via a polymerization site to the complementary one
      in fragment D1, since this association was disrupted by fibrin polymerization
      inhibitory peptide GPRP. These results provided direct evidence for specific
      binding between the structural D and E domains of fibrin mediated through
      complementary polymerization sites. Thus, the initial formation of fibrin clot
      fibers appears to be driven by specific association of these sites.

PMID- 1618868
TI  - Post-transcriptional regulation of the human transforming growth factor-beta 1
      gene.
AB  - Since many lines of evidence suggest that expression of the transforming growth
      factor-beta 1 (TGF-beta 1) gene may be regulated post-transcriptionally, we
      examined the effect of the 5'-untranslated region (UTR) of this gene on TGF-beta
      1 expression. For this purpose, fragments of the 840-nucleotide highly GC-rich
      TGF-beta 1 5'-UTR were inserted into the 5'-UTR of the structural gene for human
      growth hormone driven by the simian virus 40 early promoter. A portion of the 5'
      UTR of TGF-beta 1 mRNA spanning the sequences from +11 to +147 was shown to
      inhibit growth hormone expression by as much as 22-fold. This effect was cell
      specific; growth hormone production was inhibited in PC-3 human prostate
      adenocarcinoma and A-549 human lung adenocarcinoma cells, while no effect was
      seen in rat pheochromocytoma PC12 cells, which show efficient translation of
      endogenous TGF-beta 1 mRNA. Computer analysis showed that this region of the 5'
      UTR contained a stable secondary stem-loop structure spanning sequences +49 to
      +76. This stem-loop region alone is sufficient to inhibit expression of the
      growth hormone gene, suggesting that it plays an important role in post
      transcriptional regulation of TGF-beta 1 gene expression.

PMID- 1618869
TI  - Interaction of pertussis toxin with cells and model membranes.
AB  - The interaction of pertussis toxin (PT) with cells and model membranes was
      investigated by examining PT-induced intoxication of Chinese hamster ovary cells
      and by studying the binding of PT and its subunits to phospholipid vesicles.
      Since certain bacterial toxins require an acidic environment for efficient
      interaction with membranes and subsequent entry into the cell, the requirement
      for an acidic environment for PT action was examined. PT, unlike bacterial toxins
      such as diphtheria toxin, did not require an acidic environment for efficient
      intoxication of Chinese hamster ovary cells. Potential modes by which PT might
      interact with biological membranes were studied by examining the binding of PT to
      a model membrane system. PT was found to be capable of interacting with
      phospholipid vesicles, however, efficient binding of the toxin to the vesicles
      occurred only in the presence of both ATP and reducing agent. The A subunit
      portion of the toxin bound preferentially to the vesicles while little binding of
      the B oligomer portion of PT to the model membranes was observed. Isolated A
      subunit, in the absence of the B oligomer, also bound to the vesicles with
      optimal binding occurring in the presence of reducing agent. After cleavage of
      the A subunit by trypsin, probably at Arg-181, Arg-182, and/or Arg-193, large
      fragments which lacked the C-terminal portion of the A subunit of PT no longer
      associated with the lipid vesicles. These results suggest that the A subunit of
      PT can interact directly with a lipid matrix and, if freed from the constraints
      imposed by the B oligomer, may be capable of interacting with cellular membranes.

PMID- 1618870
TI  - Parathyroid hormone inhibits 25-hydroxyvitamin D3-24-hydroxylase mRNA expression
      stimulated by 1 alpha,25-dihydroxyvitamin D3 in rat kidney but not in intestine.
AB  - Using a cDNA probe for rat renal 24-hydroxylase, expression of its mRNA was
      compared in the rat kidney and intestine. Vitamin D-deficient rats received a
      single injection of 1 alpha,25-dihydroxyvitamin D3. Expression of 24-hydroxylase
      mRNA was first detected in the kidney at 3-h post-injection and increased
      thereafter. Similarly, 24-hydroxylase mRNA was expressed in the intestine after 1
      alpha,25-dihydroxyvitamin D3 injection. However, the dose level of 1 alpha,25
      dihydroxyvitamin D3 required to induce the intestinal 24-hydroxylase mRNA
      expression was only 1/100 the amount required to induce renal 24-hydroxylase
      mRNA. Induction of intestinal 24-hydroxylase mRNA expression by 1 alpha,25
      dihydroxyvitamin D3 was far more rapid than that of renal 24-hydroxylase mRNA.
      Thyroparathyroidectomy shortened the time required to induce expression of renal,
      but not intestinal, 24-hydroxylase mRNA. Administration of either parathyroid
      hormone or cAMP to vitamin D-deficient rats greatly reduced the expression of 24
      hydroxylase mRNA in the kidney but not in the intestine. When rats were fed a
      vitamin D-repleted diet containing 0.7% (adequate) or 0.03% (low) calcium for 2
      weeks, intestinal expression of 24-hydroxylase mRNA could be induced only in the
      low calcium group. In contrast, renal mRNA expression was preferentially
      stimulated in the adequate calcium group. These results clearly demonstrate that
      the expression of 24-hydroxylase mRNA is down-regulated by parathyroid hormone in
      the kidney but not in the intestine.

PMID- 1618871
TI  - Specific disruption of renal function and gene transcription by cyclosporin A.
AB  - The effects of cyclosporin A (CsA) are cell-specific, ranging from its
      immunosuppressive action on cells of the immune system to a variety of
      nonimmunologic toxic side effects. The predominant undesirable side effects of
      CsA occur in the kidney. Although many toxic renal effects of CsA have been
      described, the molecular basis of the nephrotoxicity is unknown. Elucidation of
      the molecular basis for the renal action of CsA may shed light on the function of
      cyclophilin in nonimmune cell types. The present study demonstrates that CsA
      selectively reduces the gluconeogenic capacity of rat proximal tubules via a
      decrease in activity of phosphoenolpyruvate carboxykinase (GTP:oxaloacetate
      carboxy-lyase (transphosphorylating), E.C. 4.1.1.32; PEPCK). The decrease in
      renal PEPCK activity occurs within 3 days and reflects a corresponding reduction
      in renal PEPCK mRNA abundance. This, in turn, is due to a selective inhibition of
      renal PEPCK gene transcription. Expression of several other renal genes is
      unaffected by CsA, as is expression of the PEPCK gene in liver. Thus, the effects
      of CsA are organ-specific and do not represent a general cytotoxic effect on
      proximal tubule cells. These results suggest that selective inhibition of the
      activity of a transcription factor(s) required for expression of specific genes
      in renal tubules may play a role in CsA-induced nephrotoxicity.

PMID- 1618872
TI  - Cap structure of U3 small nucleolar RNA in animal and plant cells is different.
      gamma-Monomethyl phosphate cap structure in plant RNA.
AB  - U3 small nucleolar RNA (snoRNA) is an abundant small RNA involved in the
      processing of pre-ribosomal RNA of eukaryotic cells. U3 snoRNA has been
      previously characterized from several sources, including human, rat, mouse, frog,
      fruit fly, dinoflagellates, slime mold, and yeast; in all these organisms, U3
      snoRNA contains trimethylguanosine cap structure. In all instances where
      investigated, the trimethylguanosine-capped snRNAs including U3 snoRNA, are
      synthesized by RNA polymerase II. However, in higher plants, the U3 snoRNA is
      synthesized by RNA polymerase III and contains a cap structure different from
      trimethylguanosine (Kiss, T., and Solymosy, F. (1990) Nucleic Acids Res. 18, 1941
      1949; Marshallsay, C., Kiss, T., and Filipowicz, W. (1990) Nucleic Acids Res. 18,
      3451-3458; Kiss, T., Marshallsay, C., and Filipowicz, W. (1991) Cell 65, 517
      526). In this study, we present evidence that cowpea and, most likely, tomato
      plant U3 snoRNA contains a methyl-pppA cap structure. These data show that the
      same U3 snoRNA contains different cap structures in different species and suggest
      that the kind of cap structure that an uridylic acid-rich small nuclear RNA
      contains is dependent on the RNA polymerase responsible for its synthesis. In
      vitro synthesized plant U3 snoRNA, with pppA or pppG as its 5' end, was converted
      to methyl-pppA/G cap structure in vitro when incubated with extracts prepared
      from wheat germ or HeLa cells. These data show that the capping machinery is
      conserved in organisms as evolutionarily distant as plants and mammals.
      Nucleotides 1-45 of tomato U3 snoRNA, which are capable of forming a stem-loop
      structure, are sufficient to direct the methyl cap formation in vitro.

PMID- 1618874
TI  - British Orthopaedic Association. Cambridge, UK, September 25-27, 1991. Abstracts.

PMID- 1618873
TI  - Mutation spectrum of copper-induced DNA damage.

PMID- 1618875
TI  - South African Orthopaedic Association. Johannesburg, South Africa, September 2-6,
      1991. Abstracts.

PMID- 1618876
TI  - Improvements in rheologic properties of blood by fluid resuscitation after burn
      injury in rats.
AB  - Severe burn injury impairs tissue perfusion both by adversely altering the
      rheologic properties of blood and by decreasing circulating blood volume.
      Although resuscitation is known to improve perfusion by increasing whole blood
      volume, it is possible that it may also improve blood flow. To assess these
      latter effects of resuscitation after burn injury, we studied several
      determinants of blood flow. Burned animals were resuscitated with 20 ml of
      lactated Ringer's solution given intraperitoneally. This fluid resuscitation
      significantly improved the hemoconcentration that was produced by burn injury (p
      less than 0.05). Burn injury caused an increase in free plasma hemoglobin (p less
      than 0.05). Fluid resuscitation after injury reduced free plasma hemoglobin
      compared with that of the burned animals (p less than 0.05), although it still
      remained higher than free plasma hemoglobin in unburned controls (p less than
      0.05). Increased whole blood viscosity and increased osmotic fragility, which
      were caused by burn injury, were also corrected by fluid resuscitation. Finally,
      the decrease in red blood cell membrane deformability that is associated with
      burn injury was improved by resuscitation, although it never completely returned
      to normal. These results demonstrate beneficial effects of fluid resuscitation on
      rheologic properties of blood after burn injury. Restoration of blood flow to
      tissue by resuscitation after burn injury may be due to improved blood rheology
      as well as to intravascular volume loading.

PMID- 1618877
TI  - Equations for the estimation of energy expenditures in patients with burns with
      special reference to ventilatory status.
AB  - There are advantages to the use of easily assessed variables for the prediction
      of energy expenditures of patients with burns. The purpose of this study was to
      determine whether height, age, sex, weight, ventilatory status, and diagnosis
      could be correlated with measured energy expenditures of hospitalized patients.
      With the use of data from 200 patients, stepwise, multivariate regression
      analysis derived the following equations: EEE(v) = 1925 - 10(A) + 5(W) + 281(S) +
      292(T) + 851(B) (R2 = 0.43); EEE(s) = 629 - 11(A) + 25(W) - 609(O) (R2 = 0.50);
      where EEE = estimated energy expenditure (kcal/day), v = ventilatory dependency,
      s = spontaneously breathing, A = age (yr), W = body weight (kg), S = sex (male =
      1, female = 0), diagnosis of T = trauma, B = burn, O = obesity present = 1,
      absent = 0). The equations were tested on 100 patients. Measured energy
      expenditures were not significantly different from calculated EEE(s) or EEE(v)
      (paired t test, p greater than 0.25). Energy expenditures can be accurately
      estimated in a variety of patients, including those with major burns with the use
      of easily attained information.

PMID- 1618878
TI  - Transcutaneous oxygen and carbon dioxide measurements for determination of skin
      graft "take".
AB  - The feasibility of using transcutaneous partial pressure of oxygen (TCPO2) and
      transcutaneous partial pressure of carbon dioxide (TCPCO2) measurements as a way
      of determining skin graft "take" was investigated in 13 patients who received
      partial-thickness sheet grafts. Transcutaneous measurements were obtained from
      the graft and an area of normal skin starting on the day of surgery and then
      daily for 2 weeks. No complications or discomfort resulted from the
      determinations. Initially, graft TCPO2 was extremely low (less than 8 mm Hg) and
      never rose above a value of 30 to 40 mm Hg, whereas skin levels ranged between 60
      and 80 mm Hg. Graft TCPO2 levels never approached skin levels until graft
      maturity was achieved. Graft TCPCO2 levels were 80 to 100 mm Hg on the first few
      days after grafting but decreased to levels just above those of the skin (40 to
      50 mm Hg) by 5 to 6 days after grafting. Graft TCPCO2 normalized at the time of
      clinical graft vascularization and remained levels just above those of the skin
      throughout the remainder of the study. Graft TCPCO2 determinations provide a
      noninvasive and objective measure of skin graft vascularization, and graft TCPO2
      values reflect graft maturity.

PMID- 1618879
TI  - Depression in children after recovery from severe burns.
AB  - This outcome study of children and adolescents with severe burns (ages 7 to 19
      years) reports that unrecognized depression is common during their lifetimes.
      Thirty children who had severe burns (range, 5% to 95% body surface area) were
      assessed for depression at a mean of 9 years after burn injury. This article
      presents an analysis of depression items from the Diagnostic Interview for
      Children and Adolescents, which was used in face-to-face interviews to assess
      child psychiatric disorders with diagnostic criteria from the American
      Psychiatric Association's Diagnostic and Statistical Manual--Third Edition. At
      the time that the interviews took place, only one child had symptoms of major
      depression and only three children had symptoms of dysthymic disorder. However,
      eight children had a lifetime history of major depression; two of them had been
      abused by burning and two had been physically or sexually abused. Four had made
      suicide attempts: one suicide attempt was the cause of the burn injury and three
      attempts were made after burn injury. Thirteen children had had suicidal
      thoughts, and their parents were often unaware of this. Other types of affective
      disorders were prevalent. There was no statistically significant association
      between depression and burn size or disfigurement. Although burn-related factors
      were associated with some depressive episodes, other biologic and social risk
      factors were also very important. The authors conclude that referral for
      diagnostic services and psychotherapy, and for some, treatment with
      antidepressant medication, is often a necessary part of medical services for
      children with burns.

PMID- 1618881
TI  - Aquatic access for the disabled.
AB  - Innovations in rehabilitation engineering can now provide aquatic access for the
      disabled. In the regional burn center, the Bodi-Gard cart shower system (Hospital
      Therapy Products, Inc., Wood Dale, Ill.) uses three flexible hoses to provide
      precise hydrotherapy and debridement. Its main mixing valve controls temperature
      and pressure and is easily disinfected by an in-line chamber. This shower system
      is complemented by the foldable Bodi-Gard mobile seat shower system (Hospital
      Therapy Products, Inc.). This system, which is covered by a disposable liner,
      surrounds the patient with eight water jets that empty into any floor drain. The
      Bather 2001 (Silcraft Corp., Traverse City, Mich.) is a fiberglass hydrotherapy
      bathtub with a unique Aqua-Seal door (Silcraft Corp.) that can be raised to
      provide patient access. Its unique closed-loop disinfection system prevents
      contamination of its internal components. The Nolan Tublift (Aquatic Access,
      Louisville, Ky.) is a lightweight, removable lift that uses water power to gently
      raise and lower its seat. It can be manually swiveled to allow access from a
      wheelchair. Transfer benches span the tub wall to provide access to the shower
      and bathtub. Although they are a less expensive alternative to the Tublift, they
      allow water to spill outside the tub, which may create a slippery bathroom floor.
      The Nolan Poolift (Guardian Products, Arleta, Calif.) is a water-powered pool
      lift, which automatically rotates as it descends. It is capable of lifting up to
      135 kg with a home water pressure of 55 psi. In contrast, the water-powered
      Aquatic Access Poolift is a less expensive pool lift, which rotates manually with
      assistance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1618880
TI  - Reorganization of a burn unit in response to underutilization: a critical
      assessment.
AB  - The incidence of burn injury in the United States has declined over the past few
      years, resulting in a dramatic decrease in the number of admissions to burn
      centers. This decrease has generated considerable concern, leading to a variety
      of proposals to modify burn units to control the cost of inpatient care. In 1986
      Albany Medical Center Hospital, a 654-bed regional academic health sciences
      center, closed its burn unit and implemented a program to manage thermally
      injured patients in the intensive and progressive care areas of the medical
      center. A retrospective study was performed to compare patient outcomes and
      length of stay for the dedicated burn unit and the integrated burn program.
      Between the year before and the year after this change there was no significant
      difference in mortality rate, length of stay, or number of positive blood
      cultures. The relationship between burn severity and length of stay was unaltered
      by the burn program change. A comparison of data collected just after the change
      to those collected 2 years later again showed no difference, except that the
      annual census had dropped more than 50%. The results suggest that burn units can
      be converted to integrated burn programs without compromising patient care
      outcomes, although the lack of a cohesive burn team and the unavailability of
      beds designated for patients with burns ultimately resulted in a deemphasis of
      the burn program and consequent marked reduction in the number of patients with
      burns seen in the institution.

PMID- 1618882
TI  - A survey of postoperative elbow immobilization approaches.
AB  - A survey of 200 North American burn units was designed to gather data about elbow
      immobilization positions and methods. Respondents were asked to identify the
      position of elbow and forearm immobilization after grafting to the upper
      extremity, the rationale for this, the location of the burn for the
      immobilization position chosen, who was responsible for immobilizing the
      patient's elbow after surgery, what type of material was used, and on what day
      range of motion to the elbow was resumed. Results indicated that elbow
      immobilization positions varied from full extension to more than 20 degrees of
      flexion, although full extension and slight flexion were used most, as was the
      forearm midposition. The rationale for immobilization that was most frequently
      given was prevention of contractures. Occupational therapists were most likely to
      be involved in or responsible for elbow immobilization, and thermoplastic
      materials were used most often. The day that range of motion was resumed also
      varied but was most frequently postoperative day 5.

PMID- 1618883
TI  - Research priorities for burn nursing: report on physiologic issues.
AB  - This Delphi study was designed and conducted to identify the issues of greatest
      concern to care of patients with burns and to the profession of burn nursing, so
      that nursing research could be directed toward these ends. One hundred and one
      questions were prioritized by the 94 participants who completed the four
      sequential rounds of questionnaires. A total of 11 questions (10.9%), which
      addressed physiologic-based issues, were identified.

PMID- 1618884
TI  - Vitamin C supplementation in the patient with burns and renal failure.
AB  - Vitamin C supplementation is an important component of nutritional management in
      patients with burns. To supply appropriate vitamin C therapy, complications such
      as renal failure must be considered. An understanding of current vitamin regimens
      and potential metabolic sequelae can assist the practitioner in providing safe
      and therapeutic vitamin C doses.

PMID- 1618885
TI  - "Burn repeaters" and injury control.
AB  - The purposes of this study were (1) to identify the percentage of patients with
      burns or intergenerational family members who have had previous burn injuries
      that required hospitalization and (2) to assess the need for an inpatient burn
      prevention program for patients and families. This study revealed an increase
      from 8% to 19% "burn repeaters," with a yearly average of 13% in a 5-year census
      and a 20.1% etiologic fraction related to the marker of increased risk (previous
      burn injury). These results strongly substantiate the necessity for an inpatient
      prevention program for patients and families to promote injury control by
      reduction of subsequent burn injury and thus break the burn injury cycle.

PMID- 1618886
TI  - Reconstructive goals for children with burns: are our goals the same?
AB  - It is often difficult if not impossible to include a pediatric patient in the
      planning of burn reconstruction. To give the patient greater input into his or
      her reconstructive plan, we developed a survey tool to evaluate the different
      reconstructive goals of the patient, the parent, and the physician. Each patient,
      parent, and physician were requested to complete a separate goal form. Each form
      consisted of a simple line drawing of a child that shows both anterior and
      posterior views. The patient, the parent, and the physician were each asked to
      circle the desired reconstruction site or sites. The responses were collated and
      compared by sex, age, size of burn, and evaluator (patient, parent, or
      physician). Patients indicated fewer and different desired reconstruction sites
      than the physicians or the parents. Before reconstruction is planned, the patient
      should be consulted. The desires of the parents and the physician may differ
      significantly from those of the patient.

PMID- 1618887
TI  - Interferon and interleukin-2 induced spontaneous cell-mediated cytotoxicity: a
      preliminary evaluation.
AB  - The contribution of natural cell-mediated cytotoxicity and its modulation with
      biological response modifiers in antitumour immunity was evaluated in patients
      with precancers and cancers of the oral cavity. The results were compared to
      those in normal controls. Both groups of patients showed highly significant
      depression of the natural killer cell activity. This depression was stage
      related, suggesting an influence of tumour or tumour products on this activity.
      Depression in augmentation of this cytotoxicity was evident in both patient
      groups with cancers and precancers, suggesting a defect in the response of killer
      cells to biological response modifiers for reasons other than the tumour per se.

PMID- 1618888
TI  - Chemical carcinogenesis of the urinary bladder--a status report.
AB  - Cigarette smoking and certain types of occupational exposure to arylamines appear
      to be the main cause of human urinary bladder cancer. Little is known of the
      promotion of bladder cancer in humans, although this stage has been demonstrated
      in rodents. Perhaps as a consequence of initiation, multifactorial alterations of
      cellular genes occur. These genes include the epidermal growth factor receptor
      gene, erbB-2, int-2, hst, and H-ras, which exert positive control over cell
      growth, as well as the suppressor genes Rb-1, and the gene coding for p53.
      Chromosomal changes such as deletions, translocations and/or amplifications
      related to these genes may be of significance for prognosis of this disease.

PMID- 1618889
TI  - Liver tumor promotion by the cyanobacterial cyclic peptide toxin microcystin-LR.
AB  - Certain waterblooms of toxic cyanobacteria (blue-green algae) are a health threat
      because of their production of toxic peptides, termed microcystins, which cause
      liver damage in wild and domesticated animals. The most widely studied
      microcystin is microcystin-LR, a heptapeptide containing the two L-amino acids,
      leucine and arginine. The inhibition of protein phosphatase type 1 and type 2A
      activities by microcystin-LR is similar to that of the known protein phosphatase
      inhibitor and tumor promoter okadaic acid. We show in this report that
      microcystin-LR, applied below the acute toxicity level, dose-dependently
      increases the number and percentage area of positive foci for the placental form
      of glutathione S-transferase in rat liver, which was initiated with
      diethylnitrosamine. The result was obtained independently through two animal
      experiments. This observation indicates that microcystin-LR is a new liver tumor
      promoter mediated through inhibition of protein phosphatase type 1 and type 2A
      activities. This provides further evidence that the okadaic acid pathway is a
      general mechanism of tumor promotion in various organs, such as mouse skin, rat
      glandular stomach and rat liver.

PMID- 1618890
TI  - Effects of barbiturates with or without liver-tumor-promoting activity on
      survival and DNA synthesis of suckling and adult rat hepatocytes in serum-free
      primary culture.
AB  - The effects of four barbiturates with or without liver-tumor-promoting activity
      were examined on survival and deoxyribonucleic acid (DNA) synthesis of suckling
      and adult rat hepatocytes in serum-free primary culture: Of the four
      barbiturates, two promoters, phenobarbital and barbital, enhanced DNA synthesis
      of suckling rat hepatocytes at low concentrations of 0.5-2 mM or 0.5 mM, but
      suppressed it at high concentrations of 3 mM or 1.5-4 mM. DNA synthesis of adult
      rat hepatocytes was, however, only suppressed by phenobarbital within the dose
      range tested of 1-3 mM. On the other hand, two remaining non-promoters,
      barbituric acid and amobarbital, did not increase but only suppressed DNA
      synthesis of suckling rat hepatocytes within the dose ranges of 0.5-4 mM and 0.05
      0.5 mM respectively. Phenobarbital and amobarbital were effective for supporting
      survival and maintaining morphological features of suckling and adult rat
      hepatocytes at the relatively high concentrations of 3-4 mM and 0.5-0.75 mM
      respectively. However, barbital and barbituric acid were ineffective for
      maintenance of hepatocytes. The results show that the ability to support survival
      of primary cultured hepatocytes is not a common property of liver-tumor-promoter
      barbiturates but is a common property of some barbiturates with high
      lipophilicity, and that the maintenance of hepatocytes by phenobarbital or
      amobarbital is not due to a counterbalance of stimulated proliferation and death
      of the cells.

PMID- 1618891
TI  - Time-related interference of misoprostol with experimental gastric cancer
      formation induced by N-methyl-N'-nitro-N-nitrosoguanidine in the rat.
AB  - The purpose of this study was to investigate the effect of long-term misoprostol
      administration, at non-antisecretory doses, on N-methyl-N'-nitro-N
      nitrosoguanidine(MNNG)-induced gastric carcinogenesis. The incidence of gastric
      carcinomas and precancerous lesions was evaluated in 50 male 250-g Sprague-Dawley
      rats after 52 weeks of continuous oral administration of MNNG (120 mg/l; n = 20),
      MNNG plus misoprostol (2 mg kg-1 day-1; n = 20) or tap water (n = 10) (experiment
      1), and in 30 rats treated with MNNG for 30 weeks followed by tap water (n = 15)
      or by misoprostol (n = 15) for 22 weeks; a third group (n = 10) received tap
      water only for 52 weeks (experiment 2). After sacrifice, gastric mucosal lesions
      were macroscopically evaluated and their histology obtained. MNNG consumption was
      comparable in all groups (6.5 +/- 1.1 mg rat-1 day-1). Misoprostol consumption
      was 180 +/- 0.25 mg kg-1 day-1 rat-1. In experiment 1 the incidence of gastric
      carcinomas was 60% in the MNNG group and 25% in the group treated with MNNG plus
      misoprostol (P less than 0.05). Cytotoxic and hyperplastic gastric mucosal
      lesions were also significantly reduced by misoprostol. In experiment 2 the
      incidence of carcinomas was 31% and 38.6% respectively. Misoprostol significantly
      decreased the incidence of gastric cancer formation when given from the beginning
      of the experiment. By contrast, when administered after 30 weeks of MNNG
      treatment it did not interfere with experimental gastric cancer formation.
      Exogenous prostaglandins are able to prevent the early MNNG-induced gastric
      mucosal lesions, thus interfering with gastric carcinogenesis.

PMID- 1618892
TI  - Protective role of aqueous turmeric extract against mutagenicity of direct-acting
      carcinogens as well as benzo [alpha] pyrene-induced genotoxicity and
      carcinogenicity.
AB  - Turmeric (Curcuma longa Linn.) has been shown to inhibit chemical carcinogenesis.
      In this study, we compared the chemopreventive efficacy of an aqueous turmeric
      extract (AqTE) and its constituents, curcumin-free aqueous turmeric extract
      (CFAqTE) and curcumin, using the Salmonella typhimurium mutagenicity assay and
      the bone marrow micronucleus test in female Swiss mice. AqTE exhibited
      antimutagenic activity against direct-acting mutagens, 4-nitro-O-phenylenediamine
      and 1-methyl-3-nitro-1-nitrosoguanidine, in strains TA 98 and TA 100
      respectively. Both AqTE and CFAqTE inhibited the mutagenicity of benzo
      [alpha]pyrene in the two strains in the presence of Aroclor-1254-induced rat
      liver homogenate. The inhibition in both studies was dose-dependent.
      Administration of AqTE, CFAqTE and curcumin at a dose of 3 mg/animal 18 h prior
      to i.p. benzo [alpha]pyrene injection (250 mg/kg) significantly inhibited bone
      marrow micronuclei formation in female Swiss mice by 43%, 76%, and 65%
      respectively. Furthermore, the incidence and multiplicity of forestomach tumours
      induced by benzo [alpha]pyrene (1 mg/animal, twice weekly, p.o. for 4 weeks) in
      female Swiss mice were significantly inhibited by AqTE, CFAqTE and curcumin given
      2 weeks before, during and after the carcinogen treatment. These data indicate
      that the protection against genomic damage by turmeric extract and its components
      tested could be necessary for some aspects of its cancer chemoprevention.

PMID- 1618893
TI  - Adjuvant effects of antineoplastic prostaglandins to cisplatin in nude mice
      bearing human ovarian cancer cells.
AB  - Effects of antineoplastic prostaglandins (PG) on human ovarian cancer cell growth
      were examined by using HR cells derived from ascites of a patient with serous
      cystadenocarcinoma of the ovary. With regard to inhibition of cancer cell
      proliferation in vitro, the effects of delta 7-PGA1 was most marked, followed by
      that of delta 12-PGJ2, PGJ2 and PGD2. When antineoplastic prostaglandins were
      administered to nude mice bearing HR cells, tumor growth in groups treated with
      PGJ2 and delta 12-PGJ2 alone was significantly inhibited 63 days after tumor
      inoculation, compared to that in an untreated group. Consequently, a significant
      prolongation of median survival was obtained with delta 12-PGJ2, compared to that
      in untreated groups and in groups with cisplatin alone. In addition, when
      prostaglandins were administered together with cisplatin, adjuvant inhibitory
      effects on the tumor growth were obtained 35, 56 and 63 days after tumor
      inoculation. Subsequently a significant prolongation of median survival was
      observed when cisplatin was combined with PGD2 or delta 7-PGA1, compared to the
      results in groups treated with PGD2 alone, delta 7-PGA1 alone or cisplatin alone.
      Combination of PGJ2 or delta 12-PGJ2 and cisplatin resulted in a significant
      decrease of hematocrit and body weight 63 days after tumor inoculation,
      suggesting a deterioration of the median survival. These results suggest that
      combination of PGD2 or delta 7-PGA1 with cisplatin may be of clinical use for
      ovarian cancer resistant to cisplatin.

PMID- 1618894
TI  - High-dose folinic acid and 5-fluorouracil plus cisplatin on a weekly schedule in
      the treatment of advanced cancer of the head and neck.
AB  - A group of 60 patients with advanced head/neck cancer were treated with high-dose
      folinic acid (500 mg/m-2/week-1) plus 5-fluorouracil (400 mg/m-2/week-1 on day 1,
      and cisplatin (20 mg/m-2/week-1) 24 h after folinic acid infusion was completed.
      Out of 55 evaluable patients, 10 patients (18%) experienced a complete response
      with a mean duration of 11.4+ months, 25 patients had a partial response (45%) of
      6.7+ months, 6 patients (11%) showed a stabilization of 4.8+ months, and 14 (25%)
      progressed. The overall response rate was 63.6% (95% confidence limits 56.5%
      69.5%). Patients pretreated with radiotherapy had a 67% overall response rate,
      while those pretreated with chemotherapy showed a 54% overall response rate. All
      patients with cancer of the oropharynx had a major response, while patients with
      cancer of the oral cavity had the lowest response rate. The mean survival of
      patients who attained a complete response was 14.5+ months. Partial responders
      had a mean survival of 10.6+ months, while patients who progresses survived a
      mean of 3.6+ months. The treatment has been very well tolerated with few cases of
      grade 3 gastrointestinal toxicity. Grade 1-2 leukopenia was recorded in 64% of
      cases, grade 1-2 nausea/vomiting in 85%. In one case therapy was stopped because
      of persistent diarrhoea.

PMID- 1618895
TI  - Tumor-associated eosinophilia in interleukin-2-treated patients: evidence of
      toxic eosinophil degranulation on bladder cancer cells.
AB  - Blood eosinophilia in tumor patients treated with interleukin-2 (IL-2) is well
      known and is regarded as evidence of toxicity or as a side-effect [Lotze et al.
      (1986) Arch Surg 121:1373-1379; West et al. (1987) N Engl J Med 316:898-905]. We
      recently described a new local IL-2 approach to therapy for advanced bladder
      carcinoma that allows, for the first time, high-dose continuous administration of
      natural interleukin-2 (nIL-2) at the tumor site without side-effects [Huland and
      Huland (1989) Cancer Res 49:5469-5474]. Tumor-associated eosinophilia of up to
      65% (i.e. eosinophils constituting 65% of leukocytes) was seen in four of five
      patients after treatment, but never before treatment or in untreated controls.
      Activated eosinophils were attached to bladder tumor cells. Local activation was
      seen only after natural IL-2 treatment and was determined by cytological criteria
      and by staining with monoclonal antibody (mAb) EG1 directed against all
      eosinophil granule proteins and mAb EG2 directed against the active secretory
      granule proteins of the eosinophils. Bladder cancer cells in urinary sediment
      also stained with these two mAbs, revealing active degranulation of eosinophils
      on bladder tumor cells. The number of eosinophils in blood increased, however,
      without signs of activation. These data constitute strong evidence that activated
      eosinophils in vivo are involved in the IL-2-induced antitumor response.

PMID- 1618896
TI  - Export of mRNA from microinjected nuclei of Xenopus laevis oocytes.
AB  - Export of mRNA from the nucleus to the cytoplasm was studied in mature Xenopus
      laevis oocytes. In vitro transcribed, capped 32P-labeled mRNA was microinjected
      into nuclei, and its appearance in the cytoplasm measured by counting
      radioactivity or by RNA extraction and gel electrophoresis. Both for a 5.0-kb
      transferrin receptor mRNA and a 2.0-kb 4F2 antigen heavy chain mRNA we found
      saturable transport with an apparent Km of 3.6 x 10(8) molecules per oocyte
      nucleus. Under non-saturating conditions the half-time for mRNA export from the
      nucleus was approximately 2 min at 20 degrees C. At higher concentrations of
      injected mRNA this half-time was prolonged, and the maximal transport rate was
      reached at approximately 1.6 x 10(8) molecules/min. mRNA transport showed
      properties of an energy-dependent mechanism, since it was inhibited at 4 degrees
      C or by ATP depletion. Co-injection of the cap dinucleotide m7GpppG blocked the
      export effectively, suggesting a role for the cap in this process. The export was
      also inhibited by the pre-injection of wheat germ agglutinin. The effect of the
      lectin was specific and abolished by co-injection of N-acetylglucosamine.
      Finally, we found significant competitive inhibition in mRNA export by the
      presence of tRNA. Our results suggest that mRNA transport is a facilitated
      process which may share common steps with tRNA transport. Preliminary gel
      retardation experiments show that injected mRNA associates with endogenous
      nuclear proteins and suggest an exchange of some of the bound components during
      the transport to the cytoplasm.

PMID- 1618897
TI  - Two Saccharomyces cerevisiae kinesin-related gene products required for mitotic
      spindle assembly.
AB  - Two Saccharomyces cerevisiae genes, CIN8 and KIP1 (a.k.a. CIN9), were identified
      by their requirement for normal chromosome segregation. Both genes encode
      polypeptides related to the heavy chain of the microtubule-based force-generating
      enzyme kinesin. Cin8p was found to be required for pole separation during mitotic
      spindle assembly at 37 degrees C, although overproduced Kip1p could substitute.
      At lower temperatures, the activity of at least one of these proteins was
      required for cell viability, indicating that they perform an essential but
      redundant function. Cin8p was observed to be a component of the mitotic spindle,
      colocalizing with the microtubules that lie between the poles. Taken together,
      these findings suggest that these proteins interact with spindle microtubules to
      produce an outwardly directed force acting upon the poles.

PMID- 1618898
TI  - Intracellular distribution of the U1A protein depends on active transport and
      nuclear binding to U1 snRNA.
AB  - Nuclear transport of the U1 snRNP-specific protein U1A has been examined. U1A
      moves to the nucleus by an active process which is independent of interaction
      with U1 snRNA. Nuclear localization requires an unusually large sequence element
      situated between amino acids 94 and 204 of the protein. U1A transport is not
      unidirectional. The protein shuttles between nucleus and cytoplasm. At
      equilibrium, the concentration of the protein in the nucleus and cytoplasm is
      not, however, determined solely by transport rates, but can be perturbed by
      introducing RNA sequences that can specifically bind U1A in either the nuclear or
      cytoplasmic compartment. Thus, U1A represents a novel class of protein which
      shuttles between cytoplasm and nucleus and whose intracellular distribution can
      be altered by the number of free binding sites for the protein present in the
      cytoplasm or the nucleus.

PMID- 1618899
TI  - Steady state dynamics of intermediate filament networks.
AB  - We have conducted experiments to examine the dynamic exchange between subunit and
      polymer of vimentin intermediate filaments (IF) at steady state through the use
      of xrhodamine-labeled vimentin in fluorescence recovery after photobleaching
      (FRAP) analysis. The xrhodamine-vimentin incorporated into the endogenous
      vimentin IF network after microinjection into fibroblasts and could be visualized
      with a cooled charge-coupled device (CCD) camera and digital imaging fluorescence
      microscopy. Bar shaped regions were bleached in the fluorescent IF network using
      a beam from an argon ion laser and the cells were monitored at various times
      after bleaching to assess recovery of fluorescence in the bleached zones. We
      determined that bleached vimentin fibers can recover their fluorescence over
      relatively short time periods. Vimentin fibers in living cells also can exhibit
      significant movements, but the recovery of fluorescence was not dependent upon
      movement of fibers. Fluorescence recovery within individual fibers did not
      exhibit any marked polarity and was most consistent with a steady state exchange
      of vimentin subunits along the lengths of IF.

PMID- 1618900
TI  - Nerve growth factor transcriptional control of c-fos promoter transfected in
      cultured spinal sensory neurons.
AB  - High efficiency gene transfer (greater than 90%) in chicken dorsal root ganglion
      neurons has been obtained by DNA calcium phosphate co-precipitation, hence
      providing an important tool to study control of gene expression in primary
      neurons. Transfection with c-fos promoter sequences linked to the chloramphenicol
      acetyltransferase reporter gene showed that the serum responsive element
      functions as a strong transcriptional enhancer. Transcription from this element
      is developmentally regulated, and mediates the genetic response to nerve growth
      factor (NGF) in developing avian sensory neurons. Furthermore, NGF exerts a
      negative effect on transcription from the cyclic AMP responsive element, thereby
      supporting the involvement of tyrosine kinase activation by NGF in primary
      sensory neurons.

PMID- 1618901
TI  - Synthesis and localization of ciliary neurotrophic factor in the sciatic nerve of
      the adult rat after lesion and during regeneration.
AB  - Ciliary neurotrophic factor (CNTF) is expressed in high quantities in Schwann
      cells of peripheral nerves during postnatal development of the rat. The absence
      of a hydrophobic leader sequence and the immunohistochemical localization of CNTF
      within the cytoplasm of these cells indicate that the factor might not be
      available to responsive neurons under physiological conditions. However, CNTF
      supports the survival of a variety of embryonic neurons, including spinal
      motoneurons in culture. Moreover we have recently demonstrated that the exogenous
      application of CNTF protein to the lesioned facial nerve of the newborn rat
      rescued these motoneurons from cell death. These results indicate that CNTF might
      indeed play a major role in assisting the survival of lesioned neurons in the
      adult peripheral nervous system. Here we demonstrate that the CNTF mRNA and
      protein levels and the manner in which they are regulated are compatible with
      such a function in lesioned peripheral neurons. In particular,
      immunohistochemical analysis showed significant quantities of CNTF at
      extracellular sites after sciatic nerve lesion. Western blots and determination
      of CNTF biological activity of the same nerve segments indicate that
      extracellular CNTF seems to be biologically active. After nerve lesion CNTF mRNA
      levels were reduced to less than 5% in distal regions of the sciatic nerve
      whereas CNTF bioactivity decreased to only one third of the original before
      lesion levels. A gradual reincrease in Schwann cells occurred concomitant with
      regeneration.

PMID- 1618902
TI  - A multifunctional cell surface developmental stage-specific antigen in the
      cockroach embryo: involvement in pathfinding by CNS pioneer axons.
AB  - mAb DSS-8 binds to a 164-kD developmental stage-specific cell surface antigen in
      the nervous system of the cockroach, Periplaneta americana. The antigen is
      localized to different subsets of cells at various stages of development. The
      spatial and temporal distributions of DSS-8 binding were determined and are
      consistent with this antigen playing multiple roles in the development of the
      nervous system. Direct identification of some of these functions was made by
      perturbation experiments in which pioneer axon growth occurs in embryos that are
      cultured in vitro in the presence of mAb DSS-8 or its Fab fragment. Under these
      conditions the pioneer axons of the median fiber tract grow but follow altered
      pathways. In a smaller percentage of the ganglia, the immunoreagents additionally
      produce defasciculation of a subset of DSS-8 labeled axons. Therefore, direct
      roles for the DSS-8 antigen in both the guidance of pioneer axons and selective
      fasciculation have been demonstrated.

PMID- 1618904
TI  - Chondrodysplasia in transgenic mice harboring a 15-amino acid deletion in the
      triple helical domain of pro alpha 1(II) collagen chain.
AB  - We have generated transgenic mice by microinjection of a 39-kb mouse pro alpha
      1(II) collagen gene construct containing a deletion of exon 7 and intron 7. This
      mutation was expected to disturb the assembly and processing of the homotrimeric
      type II collagen molecule in cartilage. Expression of transgene mRNA at levels
      equivalent or higher than the endogenous mRNA in the offspring of two founder
      animals resulted in a severe chondrodysplastic phenotype with short limbs,
      hypoplastic thorax, abnormal craniofacial development, and other skeletal
      deformities. The affected pups died at birth due to respiratory distress. Light
      microscopy of epiphyseal growth plates of transgenic pups demonstrated a marked
      reduction in cartilaginous extracellular matrix and disruption of the normal
      organization of the growth plate. The zone of proliferating chondrocytes was
      greatly reduced whereas the zone of hypertrophic chondrocytes was markedly
      increased extending deep into the diaphysis suggestive of a defect in
      endochondral ossification. Electron microscopic examination revealed chondrocytes
      with extended RER, a very severe reduction in the amount of cartilage collagen
      fibrils, and abnormalities in their structure. We postulate that the deletion in
      the alpha 1(II) collagen acts as a dominant negative mutation disrupting the
      assembly and secretion of type II collagen molecules. The consequences of the
      mutation include interference with normal endochondral ossification. These mice
      constitute a valuable model to study the mechanisms underlying human
      chondrodysplasias and normal bone formation.

PMID- 1618905
TI  - Kinetochores and chromatin diminution in early embryos of Parascaris univalens.
AB  - In Parascaris the mitotic chromosomes of gonial germline cells are holocentric
      and possess a continuous kinetochore along their entire length. By contrast, in
      meiotic cells, the centromeric activity is restricted to the heterochromatic tips
      where direct insertion of spindle microtubules into chromatin without any
      kinetochore plate is seen. In the presomatic cells of early embryos, which
      undergo heterochromatin elimination, only euchromatin shows kinetic activity.
      After developing a technique to separate the very resistant egg shell from the
      embryos, we studied the cell divisions during early embryogenesis by
      immunochemical and EM approaches. The results reported here show that in
      presomatic cells microtubules bind only the euchromatin where a continuous
      kinetochore plate is present. We also report observations suggesting that the
      binding of the long kinetochores to the mitotic spindle initiates to a limited
      number of sites and extends along the entire length, during chromosome
      condensation. The existence of different centromere stages in different cell
      types, rends Parascaris chromosomes a very good model to study centromere
      organization.

PMID- 1618903
TI  - Different extracellular domains of the neural cell adhesion molecule (N-CAM) are
      involved in different functions.
AB  - The neural cell adhesion molecule (N-CAM) engages in diverse functional roles in
      neural cell interactions. Its extracellular part consists of five Ig-like domains
      and two fibronectin type III homologous (type III) repeats. To investigate the
      functional properties of the different structural domains of the molecule in cell
      interactions and signal transduction to the cell interior, we have synthesized,
      in a bacterial expression system, the individual domains and tandem sets of
      individual domains as protein fragments. These protein fragments were tested for
      their capacity to influence adhesion and spreading of neuronal cell bodies,
      promote neurite outgrowth, and influence cellular migration patterns from
      cerebellar microexplants in vitro. Ig-like domains I and II and the combined type
      III repeats I-II were most efficient for adhesion of neuronal cell bodies, when
      coated as substrates. Neurite outgrowth was best on the substrate-coated combined
      type III repeats I-II, followed by the combined Ig-like domains I-V and Ig-like
      domain I. Spreading of neuronal cell bodies was best on substrate-coated combined
      type III repeats I-II, followed by Ig-like domain I and the combined Ig-like
      domains I-V. The cellular migration pattern from cerebellar microexplant cultures
      plated on a mixture of laminin and poly-L-lysine was modified by Ig-like domains
      I, III, and IV, while Ig-like domains II and V and the combined type III repeats
      I-II did not show significant modifications, when added as soluble fragments.
      Outgrowth of astrocytic processes from the explant core was influenced only by Ig
      like domain I. Metabolism of inositol phosphates was strongly increased by Ig
      like domain I and less by the Ig-like domains II, III, IV, and V, and not
      influenced by the combined type III repeats I-II. Intracellular concentrations of
      Ca2+ and pH values were increased only by the Ig-like domains I and II.
      Intracellular levels of cAMP and GMP were not influenced by any protein fragment.
      These experiments indicate that different domains of N-CAM subserve different
      functional roles in cell recognition and signal transduction, and are
      functionally competent without nervous system-derived carbohydrate structures.

PMID- 1618906
TI  - Correct folding of alpha-lytic protease is required for its extracellular
      secretion from Escherichia coli.
AB  - alpha-Lytic protease is a bacterial serine protease of the trypsin family that is
      synthesized as a 39-kD preproenzyme (Silen, J. L., C. N. McGrath, K. R. Smith,
      and D. A. Agard. 1988. Gene (Amst.). 69: 237-244). The 198-amino acid mature
      protease is secreted into the culture medium by the native host, Lysobacter
      enzymogenes (Whitaker, D. R. 1970. Methods Enzymol. 19:599-613). Expression
      experiments in Escherichia coli revealed that the 166-amino acid pro region is
      transiently required either in cis (Silen, J. L., D. Frank, A. Fujishige, R.
      Bone, and D. A. Agard. 1989. J. Bacteriol. 171:1320-1325) or in trans (Silen, J.
      L., and D. A. Agard. 1989. Nature (Lond.). 341:462-464) for the proper folding
      and extracellular accumulation of the enzyme. The maturation process is
      temperature sensitive in E. coli; unprocessed precursor accumulates in the cells
      at temperatures above 30 degrees C (Silen, J. L., D. Frank, A. Fujishige, R.
      Bone, and D. A. Agard. 1989. J. Bacteriol. 171:1320-1325). Here we show that full
      length precursor produced at nonpermissive temperatures is tightly associated
      with the E. coli outer membrane. The active site mutant Ser 195----Ala (SA195),
      which is incapable of self-processing, also accumulates as a precursor in the
      outer membrane, even when expressed at permissive temperatures. When the protease
      domain is expressed in the absence of the pro region, the misfolded, inactive
      protease also cofractionates with the outer membrane. However, when the folding
      requirement for either wild-type or mutant protease domains is provided by
      expressing the pro region in trans, both are efficiently secreted into the
      extracellular medium. Attempts to separate folding and secretion functions by
      extensive deletion mutagenesis within the pro region were unsuccessful. Taken
      together, these results suggest that only properly folded and processed forms of
      alpha-lytic protease are efficiently transported to the medium.

PMID- 1618907
TI  - Lowering the cholesterol content of MA104 cells inhibits receptor-mediated
      transport of folate.
AB  - The folate receptor is clustered on the surface of MA104 cells in association
      with caveolae. This relationship is thought to be essential for the proper
      internalization and recycling of the receptor during the delivery of 5
      methyltetrahydrofolate to the cytoplasm of folate-depleted cells. Both the
      clustered organization of the receptor and the integrity of caveolae are
      disrupted when cells are deprived of cholesterol. We now show that cholesterol
      depletion of MA104 cells markedly reduces the rate of 5-methyltetrahydrofolate
      internalization and causes a 70% decline in the number of receptors present in
      the internal, recycling compartment. This effect is consistent with morphologic
      data showing that cholesterol-depleted MA104 cells have a reduced number of
      caveolae as well as fewer receptors per caveolae.

PMID- 1618908
TI  - How Listeria exploits host cell actin to form its own cytoskeleton. I. Formation
      of a tail and how that tail might be involved in movement.
AB  - After Listeria is phagocytosed by a macrophage, it dissolves the phagosomal
      membrane and enters the cytoplasm. The Listeria then nucleates actin filaments
      from its surface. These actin filaments rearrange to form a tail with which the
      Listeria moves to the macrophage surface as a prelude to spreading. Since
      individual actin filaments appear to remain in their same positions in the tail
      in vitro after extraction with detergent, the component filaments must be cross
      bridged together. From careful examination of the distribution of actin filaments
      attached to the surface of Listeria and in the tail, and the fact that during and
      immediately after division filaments are not nucleated from the new wall formed
      during septation, we show how a cloud of actin filaments becomes rearranged into
      a tail simply by the mechanics of growth. From lineage studies we can relate the
      length of the tail to the age of the surface of Listeria and make predictions as
      to the ratio of Listeria with varying tail lengths at a particular time after the
      initial infection. Since we know that division occurs about every 50 min, after 4
      h we would predict that if we started with one Listeria in a macrophage, 16
      bacteria would be found, two with long tails, two with medium tails, four with
      tiny tails, and eight with no tails or a ratio of 1:1:2:4. We measured the
      lengths of the tails on Listeria 4 h after infection in serial sections and
      confirmed this prediction. By decorating the actin filaments that make up the
      tail of Listeria with subfragment 1 of myosin we find (a) that the filaments are
      indeed short (maximally 0.3 microns in length); (b) that the filament length is
      approximately the same at the tip and the base of the tail; and (c) that the
      polarity of these filaments is inappropriate for myosin to be responsible or to
      facilitate movement through the cytoplasm, but the polarity insures that the
      bacterium will be located at the tip of a pseudopod, a location that is essential
      for spreading to an adjacent cell. Putting all this information together we can
      begin to unravel the problem of how the Listeria forms the cytoskeleton and what
      is the biological purpose of this tail. Two functions are apparent: movement and
      pseudopod formation.

PMID- 1618909
TI  - How Listeria exploits host cell actin to form its own cytoskeleton. II.
      Nucleation, actin filament polarity, filament assembly, and evidence for a
      pointed end capper.
AB  - After Listeria, a bacterium, is phagocytosed by a macrophage, it dissolves the
      phagosomal membrane and enters the cytoplasm. The Listeria than nucleates actin
      filaments from its surface. These newly assembled actin filaments show
      unidirectional polarity with their barbed ends associated with the surface of the
      Listeria. Using actin concentrations below the pointed end critical concentration
      we find that filament elongation must be occurring by monomers adding to the
      barbed ends, the ends associated with the Listerial surface. If Listeria with
      tails are incubated in G actin under polymerizing conditions, the Listeria is
      translocated away from its preformed tail by the elongation of filaments attached
      to the Listeria. This experiment and others tell us that in vivo filament
      assembly must be tightly coupled to filament capping and cross-bridging so that
      if one process outstrips another, chaos ensues. We also show that the actin
      filaments in the tail are capped on their pointed ends which inhibits further
      elongation and/or disassembly in vitro. From these results we suggest a simple
      picture of how Listeria competes effectively for host cell actin. When Listeria
      secretes a nucleator, the host's actin subunits polymerize into a filament. Host
      cell machinery terminate the assembly leaving a short filament. Listeria
      overcomes the host control by nucleating new filaments and thus many short
      filaments assemble. The newest filaments push existing ones into a growing tail.
      Thus the competition is between nucleation of filaments caused by Listeria and
      the filament terminators produced by the host.

PMID- 1618911
TI  - Heterodimerization and transcriptional activation in vitro by NF-kappa B
      proteins.
AB  - The NF-kappa B family of transcription proteins represents multiple DNA binding,
      rel related polypeptides that contribute to regulation of genes involved in
      immune responsiveness and inflammation, as well as activation of the HIV long
      terminal repeat. In this study multiple NF-kappa B related polypeptides ranging
      from 85 to 45 kDa were examined for their capacity to interact with the PRDII
      regulatory element of interferon beta and were shown to possess distinct
      intrinsic DNA binding affinities for this NF-kappa B site and form multiple DNA
      binding homo- and heterodimer complexes in co-renaturation experiments.
      Furthermore, using DNA templates containing two copies of the PRDII domain linked
      to the rabbit beta globin gene, the purified polypeptides specifically stimulated
      NF-kappa B dependent transcription in an in vitro reconstitution assay as
      heterodimers but not as p50 homodimers. These experiments emphasize the role of
      NF-kappa B dimerization as a distinct level of transcriptional control that may
      permit functional diversification of a limited number of regulatory proteins.

PMID- 1618910
TI  - Kinesin-related proteins required for assembly of the mitotic spindle.
AB  - We identified two new Saccharomyces cerevisiae kinesin-related genes, KIP1 and
      KIP2, using polymerase chain reaction primers corresponding to highly conserved
      regions of the kinesin motor domain. Both KIP proteins are expressed in vivo, but
      deletion mutations conferred no phenotype. Moreover, kip1 kip2 double mutants and
      a triple mutant with kinesin-related kar3 had no synthetic phenotype. Using a
      genetic screen for mutations that make KIP1 essential, we identified another
      gene, KSL2, which proved to be another kinesin-related gene, CIN8. KIP1 and CIN8
      are functionally redundant: double mutants arrested in mitosis whereas the single
      mutants did not. The microtubule organizing centers of arrested cells were
      duplicated but unseparated, indicating that KIP1 or CIN8 is required for mitotic
      spindle assembly. Consistent with this role, KIP1 protein was found to colocalize
      with the mitotic spindle.

PMID- 1618912
TI  - Release of iron by human retinal pigment epithelial cells.
AB  - Retinal pigment epithelial cells, which form one aspect of the blood-retinal
      barrier, take up iron in association with transferrin by a typical receptor
      mediated mechanism (Hunt et al., 1989. J. Cell Sci. 92:655-666). This iron is
      dissociated from transferrin in a low pH environment and uptake is sensitive to
      agents that inhibit endosomal acidification. The dissociated iron enters the
      cytoplasm as a low molecular weight (less than 10 kD) component and subsequently
      binds to ferritin. No evidence for recycling of iron in association with
      transferrin was found. Nevertheless, much of the iron that is taken up is
      recycled to the extracellular medium, primarily from the low molecular weight
      pool. This release of iron is not sensitive to inhibitors of energy production or
      of vesicular acidification but is increased up to a maximum of about 40% of the
      total 55Fe incorporated when cells are incubated with serum or the medium is
      changed. When a short loading time for 55Fe from 55Fe-transferrin is used (i.e.,
      when the low molecular weight pool is proportionately larger), a much larger
      fraction of the cell-associated radiolabel is released than when longer loading
      times are used. The data suggest that a releasable intracellular iron pool is in
      equilibrium with the externalized material. The released iron may be separated
      into a high and a low molecular weight component. The former is similar on
      polyacrylamide gel electrophoresis to ferritin although it cannot be immune
      precipitated by anti-ferritin antibodies. The low molecular weight 55Fe which is
      heterogeneous in nature can be bound by external apo-transferrin and may
      represent a form that can be taken up by cells beyond the blood-retinal barrier.

PMID- 1618913
TI  - Effect of osmolality on 86Rb+ uptake and release by Leishmania donovani.
AB  - Promastigotes from late-log phase cultures of Leishmania donovani were washed and
      resuspended in Hanks' Balanced Salt Solution without glucose or phenyl red but
      with 20 mM (N-[2-hydroxyethyl] piperazine-N'-[2-ethanesulfonic acid]) (HEPES)
      (HBSS-, 305 mOsm/kg). They were then added to a solution containing 86Rb such
      that the final osmolality and ionic composition was as desired. Samples were
      taken at known times and the amount of intracellular 86Rb was measured.
      Similarly, experiments were performed in which 86Rb was added to the cultures
      about 18 hr before collection, and the amount of 86Rb released from the washed
      cells was measured. Under iso-osmotic conditions only about 1.3% of the
      intracellular 86Rb was released in 900 sec. This increased about 4-fold if the
      osmolality was reduced from 305-153 mOsm/kg. This is much slower than the very
      rapid release of alanine in response to hypo-osmotic stress, indicating that
      alanine release is not via a non-specific pore. Reducing the temperature from 26
      degrees C to 3-4 degrees C completely inhibits 86Rb release under iso-osmotic
      conditions and largely inhibits it under hypo-osmotic conditions. The rate of
      86Rb release was not sensitive to K+ concentration and was not altered if
      chloride was replaced by sulfamate. Ouabain had no effect on either 86Rb uptake
      or release, but carbonylcyanide P-trifluoromethoxyphenylhydrazone (FCCP) reduced
      the rate of 86Rb release and, after about a 300 sec exposure, completely
      inhibited 86Rb uptake. Amiloride partially inhibited 86Rb release, but had no
      effect on uptake. A decrease in pH from 7.1-5.9 had little effect on 86Rb release
      under iso-osmotic conditions and slightly increased the rate of release under
      hypo-osmotic conditions, but it decreased the rate of uptake under both iso
      osmotic and hypo-osmotic conditions. Cells taken from 3-day stationary phase
      cultures released 86Rb more slowly under iso-osmotic conditions than cells from
      late log phase cultures, but were more responsive to hypo-osmotic stress than
      were log phase cells. These data appear to rule out an [Na-K-Cl] transporter or a
      [K-Cl] cotransporter as the means of K+ release, but are consistent with the
      possibility that a K+/H+ exchanger is present. The possibility that other carrier
      systems may be present is also discussed.

PMID- 1618914
TI  - Development of acute thermotolerance in L929 cells: lack of HSP28 synthesis and
      phosphorylation.
AB  - We investigated the correlation between the development of acute thermotolerance
      and the phosphorylation, synthesis, and expression of the HSP28 family in murine
      L929 cells. Following heating at 43 degrees C for 30 min, thermotolerance
      developed rapidly in exponential-phase cells and reached its maximum 4-9 h after
      heat shock. Maximal thermal resistance was maintained for 24 h and then gradually
      decayed. However, heat-induced phosphorylation of HSP28 was not detected.
      Furthermore, HSP28 synthesis during incubation at 37 degrees C for 12 h following
      heat shock was not detected by [3H]-leucine labeling followed by two-dimensional
      polyacrylamide gel electrophoresis. In addition, Northern blots failed to
      demonstrate expression of the HSP28 gene. Unlike HSP28, the expression of
      constitutive and inducible HSP70 genes, along with the synthesis of their
      proteins, was observed during incubation at 37 degrees C after heat shock. These
      results demonstrate that HSP28 synthesis and its phosphorylation are not required
      to develop acute thermotolerance in L929 cells.

PMID- 1618915
TI  - The proto-oncogene c-myc is involved in cell differentiation as well as cell
      proliferation: studies on growth plate chondrocytes in situ.
AB  - A combination of immunocytochemistry and microdensitometry has been used to
      localize and quantify the expression of the proto-oncogene c-myc within
      chondrocytes of the proximal growth plates of rat and chick long bones. Although
      the c-myc protein was localized in all chondrocytes of the growth plate of both
      species the most intense staining was restricted to the proliferating and
      differentiating chondrocytes. These were identified by their ability to
      synthesize DNA (bromodeoxyuridine positive) and the presence of alkaline
      phosphatase activity, respectively. Species differences did exist with the c-myc
      concentration of the chick proliferating and differentiating chondrocytes being
      higher (128% and 240%, respectively) than the respective chondrocytes of the rat.
      The higher c-myc concentration in the chick proliferating chondrocytes paralleled
      the differences in the bromodeoxyuridine labelling index between the two species.
      In the rat, the concentration of c-myc protein present in the differentiating
      chondrocytes was 74% higher than in the respective proliferating chondrocytes,
      while in the chick it was 146% higher. The data not only provides further
      evidence for a role of the c-myc protein in cell proliferation but also suggests
      involvement of this protein in chondrocyte differentiation and/or hypertrophy.

PMID- 1618916
TI  - Imaging neutrophil activation: analysis of the translocation and utilization of
      NAD(P)H-associated autofluorescence during antibody-dependent target oxidation.
AB  - Fluorescence intensified/enhanced microscopy has been used to study the metabolic
      activation of living human neutrophils in time-lapse sequences. The
      autofluorescence associated with NAD(P)H's emission band was studied within
      individual quiescent and stimulated cells. Excitation of NAD(P)H-associated
      autofluorescence was provided by a high-intensity Hg-vapor lamp. The background
      subtracted autofluorescence signals were computer enhanced. In some cases the
      ratio image of NAD(P)H-associated autofluorescence to tetramethyl-rhodamine
      methyl ester (TRME) fluorescence, which was found to be uniformly distributed
      within neutrophils, was calculated to normalize autofluorescence intensities for
      cell thickness. Activation of the NADPH oxidase by phorbol myristate acetate, F-,
      N-formyl-methionyl-leucyl-phenylalanine (FMLP), or tumor necrosis factor (TNF)
      dramatically reduced autofluorescence levels. Membrane solubilization with sodium
      dodecyl sulfate eliminated autofluorescence. Thus, control experiments indicated
      that most or all of the detectable NAD(P)H-associated autofluorescence was due to
      NAD(P)H, consistent with previous non-microscopic studies. To understand the
      metabolic events surrounding the internalization and oxidative destruction of
      targets, we have imaged the NAD(P)H-associated autofluorescence of neutrophils
      and the Soret band of antibody coated target erythrocytes during cell-mediated
      cytotoxicity. Absorption contrast microscopy of the erythrocyte's Soret band is
      an especially sensitive indicator of the entry of reactive oxygen metabolites
      into this target's cytosol. Thus, it is possible to spectroscopically dissect and
      image the substrate (NADPH) and product (O2-) reactions of the NADPH oxidase in
      living unlabeled neutrophils. During real-time experiments at 37 degrees C, the
      level of NAD(P)H-associated autofluorescence surrounding phagosomes greatly
      increases before the disappearance of the target's Soret band. NAD(P)H-associated
      autofluorescence in the vicinity of phagocytosed erythrocytes is greatly
      diminished after target oxidation. This suggests that NAD(P)H is translocated to
      the vicinity of phagosomes prior to the oxidation of targets. The apparent
      cytosolic redistribution of NAD(P)H was confirmed by ratio imaging microscopy to
      control for cell thickness. We suggest that NADPH including its sources and/or
      carriers accumulate near phagosomes prior to target oxidation and that local
      NADPH molecules are consumed during target oxidation.

PMID- 1618917
TI  - Inhibition of cell-cell adhesion and morphogenesis of Dictyostelium by carnitine.
AB  - Carnitine (gamma-trimethylammonium beta-hydroxy-butyric acid) possesses the novel
      property of preventing cell aggregation elicited by clusterin or by fibrinogen
      (I.B. Fritz and K. Burdzy, J. Cell. Physiol., 140:18-28 [1989]). In
      investigations reported here, we show that carnitine also affects cell-cell
      adhesion in Dictyostelium discoideum, a cellular slime mold whose cells interact
      in specific and complex manners during discrete stages of development. Two types
      of cell adhesion systems sequentially appear on the surface of developing
      Dictyostelium cells, involving the surface glycoprotein gp24 which mediates EDTA
      sensitive binding sites, and the surface glycoprotein gp80 which mediates the
      EDTA-resistant binding sites. Addition of increasing concentrations of D(+)
      carnitine and L(-)-carnitine resulted in a progressive inhibition of both the
      EDTA-sensitive binding sites and the EDTA-resistant binding sites of
      Dictyostelium cells at different stages of development. In contrast, comparable
      or higher concentrations of choline, acetyl-beta-methylcholine, or deoxycarnitine
      had no detectable effects on cell aggregation. Concentrations of carnitine
      required for 50% inhibition of EDTA-resistant adhesion sites were found to be
      dependent upon levels of gp80 expressed by Dictyostelium, with greatest
      inhibition by carnitine of reassociation of cells containing the lowest levels of
      gp80. Removal of carnitine from cells by washing resulted in the rapid
      restoration of the ability of Dictyostelium to form aggregates and to resume
      normal development. We discuss possible mechanisms by which carnitine inhibits
      the aggregation of cells.

PMID- 1618918
TI  - K-current mediation of prolactin-induced proliferation of malignant (Nb2)
      lymphocytes.
AB  - The effects of different concentrations of various K-current blockers on
      prolactin-induced proliferation and membrane K-currents in malignant lymphocytes
      (Nb2 cells) were investigated. Membrane currents were measured with the whole
      cell patch-clamp technique, and lymphocyte density was quantified by both
      spectrophotometric and conventional methods. K-current blockers tested
      (quinidine, 4-aminopyridine, barium, and tetraethylammonium) exhibited similar
      rank order potency for K-current block and inhibition of prolactin-induced
      proliferation of malignant lymphocytes. Because Nb2 cells proliferate
      independently of a transmembrane Ca-influx, these results suggest that K-currents
      per se rather than K-current modulation of Ca-influx is an essential event for
      lymphocyte proliferation.

PMID- 1618919
TI  - Platelet-activating factor stimulates phospholipase C activity in human
      endometrium.
AB  - Human preimplantation embryos secrete platelet-activating factor (PAF), which
      stimulates prostaglandin E2 synthesis from secretory endometrium. This study
      investigated the action of PAF on phosphatidylinositol 4,5-bisphosphate
      (PtdIns(4,5)P2)-specific phospholipase C activity in human endometrium. Slices of
      normal endometrium were incubated with 5 microCi/ml myo-[2-3H] inositol for 3 h
      at 37 degrees C in 95% O2 and 5% CO2 to label tissue phosphoinositides. Inositol
      phosphates were extracted using trichloroacetic acid precipitation and
      diethylether neutralization and production was measured using Dowex 1-X8 anion
      exchange column chromatography. PAF induced rapid and concentration-dependent
      accumulation of inositol phosphates (IP) from secretory endometrium, but had no
      effect on endometrium removed in the proliferative phase of the menstrual cycle.
      The IP3 fraction was significantly elevated from a median value of 14.0 c.p.m. mg
      1 dry wt [range: 8-41 c.p.m. mg-1 dry wt] to 28.0 c.p.m. mg-1 dry wt [range: 11
      87 c.p.m. mg-1 dry wt, P less than 0.002] following 1 min exposure of secretory
      endometrium to PAF-acether, in the presence of 10 mM LiCl. PAF-induced hydrolysis
      of PtdIns(4,5)P2 was inhibited by the specific PAF receptor antagonist WEB 2086,
      in a dose-dependent manner (P less than 0.02), indicating that in human
      endometrium PtdIns(4,5)P2 hydrolysis is mediated via a PAF receptor. These
      results indicate that PAF receptor coupling activates endometrial PtdIns(4,5)P2
      specific phospholipase C only in the secretory phase of the menstrual cycle,
      suggesting that the PAF response may be under ovarian steroid regulation. It is
      proposed that the ability of the endometrium to respond to PAF appears to be a
      feature of the preparation of this tissue for implantation and that the second
      messengers generated may play a role in cellular processes involved in the
      maternal recognition of very early human pregnancy.

PMID- 1618920
TI  - Effect of hypoxia upon intracellular calcium concentration of human endothelial
      cells.
AB  - Ischemia is a situation occurring in several diseases including myocardial
      infarction and organ transplantation in which oxygenated blood supply is
      impaired. Ischemia leads to many cellular and tissue modifications, the most
      important one being cell death. Several explanations have been proposed to
      account for these modifications and cell death; among them is calcium overload.
      However, the influence of calcium concentration on the alteration of endothelial
      cell functions or viability during ischemia are still unknown. We developed here
      an in vitro model where human endothelial cell monolayers were submitted to
      hypoxia with or without reoxygenation and variation in calcium concentration was
      followed using a specific intracellular probe Fura 2. We observed a significant
      increase of [Ca2+]i during 2 h hypoxia reaching values similar to those observed
      during agonist stimulation of endothelial cells but far lower than values toxic
      for the cells. This increase was constant during the hypoxic incubation and was
      due mainly to an influx of extracellular calcium. Viability was also followed
      during hypoxia and using calcium channel blockers, we could show that there was
      no correlation between viability and the rise in calcium concentration. During
      the reoxygenation period, [Ca2+]i decreased to reach the normal value of resting
      cells after 45 min, suggesting that cells were still able to recover their
      calcium homeostasis. The use of a ketone body (beta-hydroxybutyrate) indicated
      that an energy deficiency was responsible for the hypoxia-induced increase in
      [Ca2+]i. We actually observed a 43% decrease in ATP concentration after 2 h
      hypoxia. This decrease was already significant after 30 min which thus precedes
      the changes in [Ca2+]i. These results show that during hypoxia, energy deficiency
      led to an increase in [Ca2+]i which is, however, too low to account for the loss
      of viability but which is within the range of concentrations observed during
      stimulation of endothelial cells. We propose that such increased intracellular
      calcium concentrations could play a role in the synthesis of mediators leading to
      the development of local inflammation.

PMID- 1618921
TI  - Effects of acute vs. chronic phorbol ester exposure on transepithelial
      permeability and epithelial morphology.
AB  - In previous experiments we have shown that acute (30 minutes) exposure to phorbol
      esters or other protein kinase C activators causes increased transepithelial
      permeability, specifically by the increased paracellular permeability through
      tight junctions. However, the role of protein kinase C activators in
      carcinogenesis is predicted upon a chronic exposure of an effective dose at
      frequent intervals for a prolonged period of time. We therefore sought to
      determine the effect of chronic phorbol ester exposure on transepithelial
      permeability by exposing cells of the polar renal epithelial cell line, LLC-PK1,
      to phorbol esters for time periods as long as 16 weeks. The following changes
      ensued: (1) after the initial drop in transepithelial resistance due to phorbol
      ester exposure, i.e., an increase in transepithelial permeability (in the acute
      phase of exposure), an adaptive response occurs as transepithelial resistances in
      chronically exposed cultures recover to approximately 50% of control values, (2)
      the cell sheets in chronically exposed cultures lose their acute responsiveness
      of transepithelial permeability to phorbol ester exposure, (3) cell sheet
      architecture changes as cells occasionally multilayer and actual polyp-like cell
      masses appear at high frequency, and (4) cytosolic protein kinase C activity
      decreases to 50% of control level with acute exposure and then is further
      decreased to less than 1% of control level in chronically treated cells; membrane
      associated PKC activity is not as sharply decreased. The possible role of
      transepithelial permeability in carcinogenesis and the value of chronically
      treated epithelial cell cultures as a model for two-stage carcinogenesis are
      discussed.

PMID- 1618922
TI  - Cell density dependent effects of TGF-beta demonstrated by a plasminogen
      activator-based assay for TGF-beta.
AB  - Transforming growth factor-beta 1 (TGF-beta 1) induces a decrease in plasminogen
      activator (PA) expression in confluent cultures of bovine aortic endothelial
      (BAE) cells. We describe an assay using the suppression of PA expression in
      confluent BAE cells by TGF-beta 1 which detects concentrations of the growth
      factor ranging from 5 to 200 pg/ml and has an ED50 of 15-20 pg/ml. The assay can
      be performed in 96-well plates and requires a minimum of 35 ul of solution per
      sample, thereby limiting the amount of reagents required and allowing many
      samples to be tested in a single assay. Here we demonstrate that the effect of
      TGF-beta 1 on PA expression in BAE cells depends on the length of time the cells
      are exposed to the growth factor and the density at which the cells are plated.
      In cells plated at a high density (3.5 x 10(5) cells/cm2), both 4 h and 24 h
      exposures to TGF-beta 1 suppress PA expression. However, with cells plated
      sparsely (3.5 x 10(4) cells/cm2), a 4 h exposure to TGF-beta 1 increases PA
      expression 2-fold, whereas a 24 h exposure results in an 85% inhibition of basal
      PA expression. The paradoxical stimulation of PA expression in cells at a sparse
      density upon 4 h exposure to TGF-beta 1 occurs in a dose-dependent manner with an
      ED50 of 15-20 pg/ml. This bifunctional response of PA production in cells exposed
      to TGF-beta 1 may have implications with regard to the role of TGF-beta 1 in
      angiogenesis.

PMID- 1618923
TI  - Demonstration of an insulin-insensitive storage pool of glucose transporters in
      rat hepatocytes and HepG2 cells.
AB  - The subcellular distribution of glucose transporters in rat hepatocytes and HepG2
      cells was studied in the absence and in the presence of insulin. Glucose
      transporters were quantitated by measuring glucose-sensitive cytochalasin B
      binding and by protein immunoblotting using isoform-specific antibodies. Plasma
      membrane contamination into subcellular fractions was assessed by measuring
      distribution of 5'-nucleotidase and cell surface carbohydrate label. In
      hepatocytes, GLUT-2 occurred in a low-density microsomal (LDM) fraction at a
      significant concentration, and as much as 15% of cellular GLUT-2 was found
      intracellularly that cannot be accounted for by plasma membrane contamination. In
      HepG2 cells which express GLUT-1 and GLUT-2, the two isoforms showed distinct
      subcellular distribution patterns: GLUT-2 was highly concentrated in LDM while
      very little GLUT-1 was found in this fraction, indicating that a large portion of
      GLUT-2 occurs in intracellular organelles. Insulin treatment did not change the
      subcellular distribution patterns of glucose transporters in both cell types. Our
      results suggest that rat hepatocytes and HepG2 cells possess an intracellular
      storage pool for GLUT-2, but lack the insulin-responsive glucose transporter
      translocation mechanism.

PMID- 1618924
TI  - Leukemia inhibitory factor/differentiation-stimulating factor (LIF/D-factor):
      regulation of its production and possible roles in bone metabolism.
AB  - Leukemia inhibitory factor/differentiation-stimulating factor (LIF/D-factor),
      expression of its mRNA, and possible roles in bone metabolism were studied in
      murine primary and clonal osteoblast-like cells. Local bone-resorbing factors
      such as IL-1, TNF alpha, and LPS strongly induced expression of LIF/D-factor mRNA
      in both clonal MC3T3-E1 cells and primary osteoblast-like cells. Neither
      parathyroid hormone nor 1 alpha,25-dihydroxyvitamin D3 stimulated expression of
      LIF/D-factor mRNA. LIF/D-factor per se did not stimulate expression of its own
      mRNA. Appreciable amounts of LIF/D-factor were detected in synovial fluids from
      rheumatoid arthritis (RA) patients but not in those with osteoarthritis (OA).
      Simultaneous treatment with LIF/D-factor, IL-1, and IL-6 at the concentrations
      found in synovial fluids from RA patients greatly enhanced bone resorption,
      though these cytokines did not stimulate bone resorption when separately applied.
      This suggests that LIF/D-factor produced by osteoblasts is in concert with other
      bone-resorbing cytokines such as IL-1 and IL-6 involved in the bone resorption
      seen in the joints of RA patients. LIF/D-factor specifically bound to MC3T3-E1
      cells with an apparent dissociation constant of 161 pM and 1,100 binding
      sites/cell. LIF/D-factor dose-dependently suppressed incorporation of
      [3H]thymidine into MC3T3-E1 cells. In addition, it potentiated the alkaline
      phosphatase activity induced by retinoic acid, though LIF/D-factor alone had no
      effect on enzyme activity. These results suggest that LIF/D-factor is involved in
      not only osteoclastic bone resorption but also osteoblast differentiation in
      conjugation with other osteotropic factors.

PMID- 1618925
TI  - Tissue-specific regulation of glucokinase gene expression.
AB  - Glucokinase contributes to the maintenance of blood glucose homeostasis by
      catalyzing the high Km phosphorylation of glucose in the liver and the pancreatic
      beta cell, the only two tissues known to express this enzyme. Molecular
      biological studies of the glucokinase gene and its products have advanced our
      understanding of how this gene is differentially regulated in the liver and beta
      cell. The production of an active glucokinase isoform is determined by both
      transcriptional and post-transcriptional events. Two different promoter regions
      that are widely separated in a single glucokinase gene are used to produce
      glucokinase mRNAs in the liver, pancreatic beta cell, and pituitary. The
      different transcription control regions are tissue-specific in their expression
      and are differentially regulated. In liver, glucokinase gene expression is
      regulated by insulin and cAMP, whereas in the beta cell it is regulated by
      glucose. The upstream glucokinase promoter region, which gives rise to the
      glucokinase mRNA in pituitary and pancreas, is structurally and functionally
      different from the downstream promoter region, which gives rise to the
      glucokinase mRNA in liver. The use of distinct promoter regions in a single
      glucokinase gene enables a different set of transcription factors to be utilized
      in the liver and islet, thus allowing a functionally similar gene product to be
      regulated in a manner consistent with the different functions of these two
      tissues. In addition, the splicing of the glucokinase pre-mRNA is regulated in a
      tissue-specific manner and can affect the activity of the gene product.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1618926
TI  - Alterations in glucose transporter expression and function in diabetes:
      mechanisms for insulin resistance.
AB  - Insulin resistance is a major pathologic feature of human obesity and diabetes.
      Understanding the fundamental mechanisms underlying this insulin resistance has
      been advanced by the recent cloning of the genes encoding a family of facilitated
      diffusion glucose transporters which are expressed in characteristic patterns in
      mammalian tissues. Two of these transporters, GLUT1 and GLUT4, are present in
      muscle and adipose cells, tissues in which glucose transport is markedly
      stimulated by insulin. To understand the mechanisms underlying in vivo insulin
      resistance, regulation of these transporters is being investigated. Studies
      reveal divergent changes in the expression of GLUT1 and GLUT4 in a single cell
      type as well as tissue specific regulation. Importantly, alterations in glucose
      transport in rodent models of diabetes and in human obesity and diabetes cannot
      be entirely explained by changes in glucose transporter expression. This suggests
      that defects in glucose transporter function such as impaired translocation,
      fusion with the plasma membrane, or activation probably contribute importantly to
      in vivo insulin resistance.

PMID- 1618927
TI  - Identification of a core motif that is recognized by three members of the HMG
      class of transcriptional regulators: IRE-ABP, SRY, and TCF-1 alpha.
AB  - Insulin induces glyceraldehyde-3-phosphate dehydrogenase (GADPH) gene
      transcription in part by regulating one or more proteins that bind a cis-acting
      element, IRE-A. We have recently cloned a protein, IRE-ABP, that binds the IRE-A
      element. IRE-ABP is a member of the HMG class of transcriptional regulators and
      is 67% identical within its HMG box domain to the candidate gene for the testis
      determining factor, SRY. IRE-ABP and SRY share binding specificity for the IRE-A
      motif. This sequence is also highly conserved with a core motif, 5'-Py-ctttg(a/t)
      3', contained in T-cell specific genes that have high affinity for TCF-1 alpha,
      another member of the HMG class of transcriptional regulators. Thus, diverse
      members of the HMG family interact with similar nucleotide sequences to regulate
      expression of genes that initiate and maintain the differentiated phenotype. We
      have found this core motif in the upstream region of many genes that are
      positively and negatively regulated by insulin. These observations suggest that
      IRE-ABP or a related family member may coordinate the expression of these genes.
      The HMG family of proteins has diverse functions ranging from the regulation of
      differentiation and mating type in yeast to the regulation of tissue- and species
      specific gene expression in mammals. Insulin regulates GAPDH gene transcription
      in a tissue-specific manner. We propose that members of the IRE-ABP family play
      an important role in controlling tissue specificity of the insulin response.

PMID- 1618928
TI  - Heterotrimeric configuration is essential to the adhesive function of laminin.
AB  - Mouse PFHR9 laminin, B1B2-heterodimers, and free B1-chains were separated from
      one another by gel filtration on Superose 6. The cell attachment promoting
      activity of these species was measured after immunoprecipitation with monoclonal
      anti-laminin antibodies coupled to Sepharose 6MB beads. These antibodies, which
      did not react with the laminin E8 fragment, were directed against epitopes in the
      NH2-terminus of the laminin B1-chain and in the central region of laminin. After
      incubation with purified EHS laminin, the immunosorbents revealed efficient
      adhesion substrates for a rat rhabdomyosarcoma cell line which attached
      preferentially to the laminin E8 fragment. Although both were immunoprecipitated
      efficiently, B1B2-heterodimers and B1-chains, unlike PFHR9 laminin, did not
      support the attachment of RMS cells. On a molar basis B1B2-heterodimers were 24
      times less efficient than PFHR9 laminin or EHS laminin in supporting cell
      attachment. These data suggest that heterotrimeric configuration is essential to
      the adhesive function of the laminin E8 fragment.

PMID- 1618929
TI  - Modulation of collagen and fibronectin synthesis in fibroblasts by normal and
      malignant cells.
AB  - The influence of various normal and malignant human cells on the level of
      collagen synthesis by human fibroblasts was tested in coculture. As revealed by
      immunoperoxidase staining, in cocultures with breast adenocarcinoma cells (MCF7,
      SA52, T47D) fibroblasts synthesized collagen while tumor cells did not.
      Fibroblasts displayed increased collagen production without change in the overall
      protein synthesis. Several other types of cells derived from normal human tissues
      (keratinocytes, normal mammary cells) or from fibrosarcoma, melanoma, cervical
      carcinoma, choriocarcinoma, or other breast adenocarcinoma (SW613, MDA, BT20) did
      not affect collagen synthesis of fibroblasts. Although to a lesser extent, this
      stimulating effect was reproduced by using the conditioned medium (CM) of the
      active cells but not with CM of the other cell types. A slight stimulation was
      also obtained when tumoral MCF7 cells and fibroblasts shared the same medium but
      were physically separated, suggesting that close contact was required for optimal
      stimulation of collagen synthesis. The collagen synthesis stimulating activity
      was not related to a modification of fibroblast proliferation rate. The
      production of collagen types I, III, and VI and fibronectin were increased in
      cocultures of fibroblasts with MCF7 cells. The increased synthesis of collagen
      types I and III and fibronectin was paralleled by similar changes in the steady
      state level of their mRNAs. On the contrary, the increased production of collagen
      type VI appeared regulated at a post-transcriptional level.

PMID- 1618930
TI  - Butanol-extractable and detergent-solubilized cell surface components from murine
      large cell lymphoma cells associated with adhesion to organ microvessel
      endothelial cells.
AB  - Metastatic variant cell lines of the murine RAW117 large cell lymphoma were used
      to study the cell surface components involved in syngeneic tumor cell/microvessel
      endothelial cell interactions. Poorly liver-metastatic parental RAW117-P cell
      line adhered to murine hepatic sinusoidal endothelial cell monolayers at
      significantly lower rates than the liver-selected, highly liver-metastatic RAW117
      H10 line and both cell lines were poorly adherent to lung microvessel and bovine
      aorta endothelial cells. Viable, 2% 1-butanol-treated RAW117-H10 tumor cells
      formed fewer liver tumor nodules in experimental metastasis assays than untreated
      H10 cells and were significantly less adherent to murine hepatic sinusoidal
      endothelial cell monolayers. When 2% 1-butanol extracts of metabolically labeled
      or CHAPS detergent lysates of cell surface-labeled tumor cells were analyzed for
      their ability to bind to fixed microvessel endothelial cell monolayers,
      quantitative differences were found in the extractable tumor cell surface
      components that bound to the different organ-derived microvessel endothelial
      cells. Cell surface components (1-butanol extractable), of Mr approximately
      85,000-90,000 and approximately 37,000-40,000 bound to hepatic sinusoidal
      endothelial cell monolayers to a greater extent than to murine lung microvessel
      endothelial or bovine aortic endothelial cell monolayers, whereas tumor cell
      surface components of Mr approximately 45,000, approximately 33,000, and
      approximately 25,000 bound similarly to endothelial cells regardless of origin.
      The results suggest but do not prove that tumor cell/endothelial cell adhesion
      involves multiple tumor cell surface components, some of which commonly bind to
      various endothelial cells and others for which binding may be dictated by the
      tissue origin and type of endothelial cell. Particular RAW117 butanol-extractable
      cell membrane components were associated with tumor cell-endothelial cell
      adhesion, and these components could be responsible, in part, for the
      preferential adhesion of RAW117 cells to liver sinusoidal endothelial cells and
      metastasis to liver.

PMID- 1618931
TI  - Rate transition and regulatory coupling in endocytosis of interferon-alpha and
      tumor necrosis factor-alpha in human epithelial tumor cells.
AB  - The time-dependent concentrations of interferon-alpha and tumor necrosis factor
      alpha associated with the membrane and internalized by cells contain information
      on the kinetics of endocytosis and their cellular processing. This information
      can be reduced quantitatively by application of the respective compartmental
      models. In our studies of human epithelial tumor cells interacting with human
      interferon-alpha and human tumor necrosis factor-alpha, we accounted only for
      actual endocytosis and elimination of the tracer from cells by a novel method
      sensitive to changes in the rate of endocytosis, to the delay in tracer
      elimination, and to the nonlinear regulatory coupling between endocytosis and the
      internalized ligand. Data reduced by this method resulted in best-fit parameter
      values statistically superior to values obtained by previous methods (Bajzer et
      al., 1989). The results indicate a change with time in the rate of endocytosis of
      tumor necrosis factor-alpha and the inhibition of endocytosis by the endocytosed
      ligand-receptor complex. We conclude that sorting and processing of interferon
      alpha and tumor necrosis factor-alpha are restricted by the type of both the
      receptor and the cell.

PMID- 1618932
TI  - Potential language and attentional networks revealed through factor analysis of
      rCBF data measured with SPECT.
AB  - We used changes in regional cerebral blood flow (rCBF) to disclose regions
      involved in central auditory and language processing in the normal brain. rCBF
      was quantified with a fast-rotating, single-photon emission computerized
      tomograph (SPECT) and inhalation of 133Xe. rCBF data were obtained simultaneously
      from parallel, transverse slices of the brain. The lower slice was positioned to
      include both Broca's and Wernicke's areas. The upper slice included regions
      generally regarded by neurobehaviorists as less related to primary auditory or
      linguistic functions. We presented three types of auditory stimuli to ten
      healthy, young volunteers: (a) diotically presented Danish speech, (b) dichotic
      word stimulation, and (c) white noise. Wilcoxon's signed ranks sum test revealed
      increased rCBF in language-related areas of cortex, viz., Wernicke's area and its
      right-sided homologous area as well as in Broca's area (left hemisphere), when
      subjects listened to narrative speech, compared to white noise (baseline). No
      significant rCBF differences were detected with this test during dichotic
      stimulation vs. white noise. A more sophisticated statistical method (factor
      analysis) disclosed patterns of functionally intercorrelated regions. The factor
      analysis reduced the highly intercorrelated rCBF measures from 28 regions of
      interest to a set of three independent factors. These factors accounted for 77%
      of the total variation in rCBF values. These three factors appeared to represent
      statistical analogues of independent brain networks involved in (I)
      auditory/linguistic, (II) attentional, and (III) visual imaging activity.

PMID- 1618933
TI  - Decreases in frontal and parietal lobe regional cerebral blood flow related to
      habituation.
AB  - We previously reported decreased mean CBF between consecutive resting conditions,
      ascribed to habituation. Here we address the regional specificity of habituation
      over three consecutive flow studies. Regional CBF (rCBF) was measured in 55
      adults (12 right-handed men, 12 right-handed women, 14 left-handed men, 17 left
      handed women), with the 133Xe inhalation technique, during three conditions:
      resting, verbal tasks (analogies), and spatial tasks (line orientation). Changes
      in rCBF attributable to the cognitive tasks were eliminated by correcting these
      values to a resting equivalent. There was a progressive decrease in mean rCBF
      over time, reflecting habituation. This effect differed by region, with
      specificity at frontal (prefrontal, inferior frontal, midfrontal, superior
      frontal) and inferior parietal regions. In the inferior parietal region,
      habituation was more marked in the left than the right hemisphere. Right-handers
      showed greater habituation than did left-handers. There was no sex difference in
      global habituation, but males showed greater left whereas females showed greater
      right hemispheric habituation. The results suggest that habituation to the
      experimental setting has measurable effects on rCBF, which are differently
      lateralized for men and women. These effects are superimposed on task activation
      and are most pronounced in regions that have been implicated in attentional
      processes. Thus, regional decrement in brain activity related to habituation
      seems to complement attentional effects, suggesting a neural network for
      habituation reciprocating that for attention.

PMID- 1618934
TI  - Vibration-induced regional cerebral blood flow responses in normal aging.
AB  - Task-induced changes in regional CBF (rCBF) can be measured with positron
      emission tomography (PET) and provide a powerful tool to map brain function. Many
      studies using these techniques have investigated responses in healthy young
      subjects. Since many pathological conditions occur more commonly in older
      subjects, it is necessary to compare blood flow responses in these patients with
      appropriately age-matched controls. Furthermore, the effects of normal aging on
      such blood flow responses remain unknown. For both reasons, we designed this
      study to determine whether vibration-induced CBF responses change with advancing
      age in normals. CBF was measured with PET and bolus-administered H2(15)O in 26
      subjects from 20 to 72 years old (mean = 39; SD = 19). Regional responses were
      identified by subtraction-image analysis. Left and right hand vibration produced
      consistent responses in contralateral primary sensorimotor area (PSA) and
      supplementary motor area (SMA). Response magnitudes were compared to age by
      linear regression. There were no substantial relationships between age and
      responses to vibration for PSA or SMA (PSA r = -0.28, p = 0.054; SMA r = -0.33, p
      = 0.13). Power analysis demonstrates a high degree of confidence (99.7% for PSA
      and 87% for SMA) for detecting at least a moderate correlation (r = 0.6) between
      response magnitude and age. We conclude that the rCBF responses to vibrotactile
      hand stimulation do not change with normal aging.

PMID- 1618935
TI  - Imaging muscarinic cholinergic receptors in human brain in vivo with Spect,
      [123I]4-iododexetimide, and [123I]4-iodolevetimide.
AB  - A method to image muscarinic acetylcholine receptors (muscarinic receptors)
      noninvasively in human brain in vivo was developed using [123I]4-iododexetimide
      ([123I]IDex), [123I]4-iodolevetimide ([123I]ILev), and single photon emission
      computed tomography (SPECT). [123I]IDex is a high-affinity muscarinic receptor
      antagonist. [123I]ILev is its pharmacologically inactive enantiomer and measures
      nonspecific binding of [123I]IDex in vitro. Regional brain activity after tracer
      injection was measured in four young normal volunteers for 24 h. Regional
      [123I]IDex and [123I]ILev activities were correlated early after injection, but
      not after 1.5 h. [123I]IDex activity increased over 7-12 h in neocortex,
      neostriatum, and thalamus, but decreased immediately after the injection peak in
      cerebellum. [123I]IDex activity was highest in neostriatum, followed in rank
      order by neocortex, thalamus, and cerebellum. [123I]IDex activity correlated with
      muscarinic receptor concentrations in matching brain regions. In contrast,
      [123I]ILev activity decreased immediately after the injection peak in all brain
      regions and did not correspond to muscarinic receptor concentrations. [123I]IDex
      activity in neocortex and neostriatum during equilibrium was six to seven times
      higher than [123I]ILev activity. The data demonstrate that [123I]IDex binds
      specifically to muscarinic receptors in vivo, whereas [123I]ILev represents the
      nonspecific part of [123I]IDex binding. Subtraction of [123I]ILev from [123I]IDex
      images on a pixel-by-pixel basis therefore reflects specific [123I]IDex binding
      to muscarinic receptors. Owing to its high specific binding, [123I]IDex has the
      potential to measure small changes in muscarinic receptor characteristics in vivo
      with SPECT. The use of stereoisomerism directly to measure nonspecific binding of
      [123I]IDex in vivo may reduce complexity in modeling approaches to muscarinic
      acetylcholine receptors in human brain.

PMID- 1618936
TI  - Measurement of radiotracer concentration in brain gray matter using positron
      emission tomography: MRI-based correction for partial volume effects.
AB  - Accuracy in in vivo quantitation of brain function with positron emission
      tomography (PET) has often been limited by partial volume effects. This
      limitation becomes prominent in studies of aging and degenerative brain diseases
      where partial volume effects vary with different degrees of atrophy. The present
      study describes how the actual gray matter (GM) tracer concentration can be
      estimated using an algorithm that relates the regional fraction of GM to partial
      volume effects. The regional fraction of GM was determined by magnetic resonance
      imaging (MRI). The procedure is designated as GM PET. In computer simulations and
      phantom studies, the GM PET algorithm permitted a 100% recovery of the actual
      tracer concentration in neocortical GM and hippocampus, irrespective of the GM
      volume. GM PET was applied in a test case of temporal lobe epilepsy revealing an
      increase in radiotracer activity in GM that was undetected in the PET image
      before correction for partial volume effects. In computer simulations, errors in
      the segmentation of GM and errors in registration of PET and MRI images resulted
      in less than 15% inaccuracy in the GM PET image. In conclusion, GM PET permits
      accurate determination of the actual radiotracer concentration in human brain GM
      in vivo. The method differentiates whether a change in the apparent radiotracer
      concentration reflects solely an alteration in GM volume or rather a change in
      radiotracer concentration per unit volume of GM.

PMID- 1618937
TI  - Effect of photic stimulation on human visual cortex lactate and phosphates using
      1H and 31P magnetic resonance spectroscopy.
AB  - Previous animal and human studies showed that photic stimulation (PS) increased
      cerebral blood flow and glucose uptake much more than oxygen consumption,
      suggesting selective activation of anaerobic glycolysis. In the present studies,
      image-guided 1H and 31P magnetic resonance spectroscopy (MRS) was used to monitor
      the changes in lactate and high-energy phosphate concentrations produced by PS of
      visual cortex in six normal volunteers. PS initially produced a significant rise
      (to 250% of control, p less than 0.01) in visual cortex lactate during the first
      6.4 min of PS, followed by a significant decline (p = 0.01) as PS continued. The
      PCr/Pi ratios decreased significantly from control values during the first 12.8
      min of PS (p less than 0.05), and the pH was slightly increased. The positive
      P100 deflection of the visual evoked potential recorded between 100 and 172 ms
      after the strobe was significantly decreased from control at 12.8 min of PS (p
      less than 0.05). The finding that PS caused decreased PCr/Pi is consistent with
      the view that increased brain activity stimulated ATPase, causing a rise in ADP
      that shifted the creatine kinase reaction in the direction of ATP synthesis. The
      rise in lactate together with an increase in pH suggest that intracellular
      alkalosis, caused by the shift of creatine kinase, selectively stimulated
      glycolysis.

PMID- 1618938
TI  - Anoxia-induced changes in extracellular K+ and pH in mammalian central white
      matter.
AB  - In gray matter (GM), anoxia induces prominent extracellular ionic changes that
      are important in understanding the pathophysiology of this insult. White matter
      (WM) is also injured by anoxia but the accompanying changes in extracellular ions
      have not been studied. To provide such information, the time course and magnitude
      of anoxia-induced changes in extracellular K+ concentration ([K+]o) and
      extracellular pH (pHo) were measured in the isolated rat optic nerve, a
      representative central WM tract, using ion-selective microelectrodes. Anoxia
      produced less extreme changes in [K+]o and pHo in WM than are known to occur in
      GM; in WM during anoxia, the average maximum [K+]o was 14 +/- 2.9 mM (bath [K+]o
      = 3 mM) and the average maximum acid shift was 0.31 +/- 0.07 pH unit. The
      extracellular space volume rapidly decreased by approximately 20% during anoxia.
      Excitability of the rat optic nerve, monitored as the amplitude of the
      supramaximal compound action potential, was lost in close temporal association
      with the increase in [K+]o. Increasing the bath glucose concentration from 10 to
      20 mM resulted in a much larger acid shift during anoxia (0.58 +/- 0.08 pH unit)
      and a smaller average increase in [K]o (9.2 +/- 2.6 mM). The increased
      extracellular glucose concentration presumably provided more substrate for
      anaerobic metabolism, resulting in more extracellular lactate accumulation
      (although not directly measured) and a greater acid shift. Enhanced anaerobic
      metabolism during anoxia would provide energy for operation of ion pumps,
      including the sodium pump, that would result in smaller changes in [K+]o. These
      effects were probably responsible for the observation that the optic nerve showed
      significantly less damage after 60 min of anoxia in the presence of 20 mM glucose
      compared to 10 mM glucose. Under normoxic conditions, increasing bath K+
      concentration to 30 mM (i.e., well beyond the level shown to occur with anoxia)
      for 60 min caused abrupt loss of excitability during the period of application
      but minimal change in the amplitude of the compound action potential following
      the period of exposure. The anoxia-induced increase in [K+]o, therefore, was not
      itself directly responsible for irreversible loss of optic nerve function. These
      observations indicate that major qualitative differences exist between mammalian
      GM and WM with regard to anoxia-induced extracellular ionic changes.

PMID- 1618939
TI  - Regional cerebral L-[14C-methyl]methionine incorporation into proteins: evidence
      for methionine recycling in the rat brain.
AB  - The specific activity (SA) of free methionine was measured in plasma and in
      different regions of the rat brain at 15, 30, or 60 min after intravenous
      infusion of L-[14C-methyl]methionine. Within these time periods, an apparent
      steady state of labeled free methionine in plasma and in brain was reached.
      However, the brain-to-plasma free methionine SA ratio was found to be
      approximately 0.5, showing that an isotopic equilibrium between brain and plasma
      was not attained. This suggests the presence of an endogenous source of brain
      free methionine (likely originating from protein breakdown), in addition to the
      plasma source. The contribution of this endogenous source to the content of free
      methionine varies significantly among the different brain regions. Our results
      indicate that the regional rates of protein synthesis measured with L-[11C
      methyl]methionine using positron emission tomography would be underestimated,
      since the local fraction of brain methionine derived from protein degradation
      would not be considered.

PMID- 1618940
TI  - Chronic parasympathetic sectioning decreases regional cerebral blood flow during
      hemorrhagic hypotension and increases infarct size after middle cerebral artery
      occlusion in spontaneously hypertensive rats.
AB  - Regional cerebral blood flow (rCBF) during controlled hemorrhagic hypotension
      (140-20 mm Hg) was assessed 10-14 days after chronic unilateral sectioning of
      parasympathetic and/or sensory fibers innervating pial vessels in spontaneously
      hypertensive rats (SHR). rCBF was measured in the cortical barrel fields
      bilaterally by laser Doppler blood flowmetry. Immunohistochemistry of middle
      cerebral artery (MCA) whole mount preparations was used to verify the surgical
      lesion. During hemorrhagic hypotension, rCBF was equivalent on the two sides in
      shams, after selective sensory denervation, or in parasympathetically sectioned
      animals exhibiting small decreases (less than or equal to 30%) in immunoreactive
      vasoactive intestinal peptide (VIP)-containing fibers. After chronic
      parasympathetic denervation, decreases in perfusion pressure were accompanied by
      greater reductions in rCBF on the lesioned side; changes in vascular resistance
      were also attenuated on that side. The rCBF response to hypercapnia (PaCO2 50 mm
      Hg), however, was symmetrical and robust. To examine the effects of impaired
      neurogenic vasodilation on the pathophysiology of cerebral ischemia, infarct size
      was measured 24 h following tandem MCA occlusion in denervated animals.
      Infarction volume was larger after selective parasympathetic sectioning (sham,
      156 +/- 27 vs. 196 +/- 32 mm3, respectively) but only in those denervated animals
      demonstrating greater than or equal to 40% decrease in immunoreactive VIP
      containing fibers within the ipsilateral MCA. Lower than expected blood
      flow/perfusion pressure in the cortex distal to an occluded blood vessel may
      relate the observed blood flow responses to the occurrence of larger cortical
      infarcts in parasympathetically denervated animals. If true, the findings suggest
      a novel role for neurogenic vasodilation in the pathophysiology of cerebral
      ischemia and in rCBF regulation within the periinfarction zone.

PMID- 1618941
TI  - The effect of hypothermia on transient middle cerebral artery occlusion in the
      rat.
AB  - We investigated the effect of moderate whole body hypothermia (30 degrees C) on
      transient middle cerebral artery occlusion (MCAO) in the rat. Male Wistar rats
      were subjected to 2 h of ischemia by inserting a suture into the lumen of the
      internal carotid artery and occluding the origin of the MCA. Experimental groups
      were (a) MCAO induced at 37 degrees C body temperature (n = 15); (b) 30 degrees C
      body temperature induced prior to ischemia and maintained for 2 h of MCAO and 1 h
      of reperfusion (n = 12); and (c) MCAO with regional brain and body temperatures
      measured in normothermic (n = 3) and hypothermic MCAO rats (n = 2).
      Histopathological evaluation was performed 96 h after reperfusion. All
      normothermic MCAO animals exhibited ischemic infarct involving the ipsilateral
      cortex and basal ganglia with infiltration of neutrophils, macrophages, and
      microvascular proliferation. Hypothermic MCAO animals exhibited minor ischemic
      damage ranging from selective neuronal injury to small focal areas of infarct
      with minimal inflammatory response. Our data demonstrate that transient ischemia
      induced by using the intra-arterial suture method to occlude the MCA results in a
      reproducible brain lesion and that moderate hypothermia has a profound protective
      effect on the brain injury after transient MCAO.

PMID- 1618942
TI  - Evoked neuronal activity accompanied by transmitter release increases oxygen
      concentration in rat striatum in vivo but not in vitro.
AB  - Dopamine and oxygen (O2) were measured in the caudate nucleus of anesthetized
      rats and in striatal slices during electrical stimulation. Simultaneous
      electrochemical detection of dopamine and O2 was accomplished with fast-scan
      cyclic voltammetry at a Nafion-coated carbon-fiber microelectrode. Stimulation of
      the medial forebrain bundle resulted in synaptic overflow of dopamine in the
      caudate nucleus. At the same time, O2 concentration increased in the
      extracellular fluid with two separate phases. The amplitude of the initial
      increase directly correlated with the frequency of the stimulus, with the time of
      maximum concentration reproducible across a range of frequencies. The second
      increase occurred at later times with a more random amplitude and with a broad,
      variable shape. Agents which blocked vasodilation affected both phases: atropine
      attenuated the initial increase, while the second feature was nearly absent after
      theophylline. Yohimbine and alpha-methyl-p-tyrosine did not affect the O2
      responses. Local electrical stimulation of the slice preparation also resulted in
      dopamine overflow, but a prolonged decrease in O2 concentration accompanied this
      event. Striatal field stimulation in vivo produced changes in O2 concentration
      dependent on the relative position of the stimulating and working electrodes, but
      none of the responses resembled that seen in the caudate slice. Thus, while
      measurements in brain slices show O2 consumption as a result of stimulated
      neuronal activity, an apparent elevation of local cerebral blood flow during and
      after stimulation dominate the in vivo response.

PMID- 1618944
TI  - Regulation of cortical blood flow by the dorsal raphe nucleus: topographic
      organization of cerebrovascular regulatory regions.
AB  - We examined in rat: (1) the time-course and magnitude of change in cortical blood
      flow (CoBF) following electrical stimulation of the dorsal raphe nucleus (DRN)
      and (2) whether DRN lesions affect resting CoBF or the cerebrovascular response
      to CO2. Animals were anesthetized (chloralose), paralyzed, and artificially
      ventilated. The effect of stimulus frequency (1-200 Hz) and intensity (10-100
      microA) on arterial pressure, heart rate, and CoBF was examined; lesions were
      made electrolytically. CoBF was measured using a laser-Doppler flowmeter with the
      probe placed extradurally over the parietal sensorimotor cortex. The DRN was
      computer reconstructed in three dimensions from Nissl stained coronal sections
      for localization of electrode placements. Brief stimuli (8 s; n = 6) elicited
      frequency and intensity-dependent increases in arterial pressure, heart rate, and
      CoBF. Sustained intermittent trains of stimuli of rostral DRN (200 Hz; 1 s on/1 s
      off; 70 microA) elicited a decrease (85 +/- 12% of baseline; n = 9) in CoBF (p
      less than 0.05) while stimulation in caudal DRN resulted in increased CBF (126 +/
      13% of baseline; n = 9). Phenylephrine infusion (0.1-1 microgram; i.v.; n = 8)
      increased arterial pressure and CoBF less than that elicited by brief DRN
      stimulation (p less than 0.05). DRN lesions did not affect resting CoBF (140 +/-
      25 perfusion units (PU) before; 127 +/- 16 PU after DRN lesion; p greater than
      0.05, n = 5) or mean arterial pressure (127 +/- 13 before; 120 +/- 11 after); nor
      did it affect the cerebrovascular response to change in arterial PCO2. Sustained
      intermittent stimulation of the DRN can evoke either increases or decreases in
      CoBF depending on the anatomical sublocalization. The DRN does not tonically
      maintain resting CoBF, nor participate in the cerebrovascular response to change
      in PCO2.

PMID- 1618943
TI  - Effect of 2-chloroadenosine on cerebrovascular reactivity to hypercapnia in
      newborn pig.
AB  - The effect of local administration of vasodilative concentrations of the
      adenosine receptor agonist 2-chloroadenosine (2-CADO) on the hyperemic responses
      of the pial and parenchymal microcirculations to graded hypercapnia was
      determined. The cranial window and brain microdialysis-hydrogen clearance
      techniques were utilized in two groups of isoflurane-anesthetized newborn pigs to
      measure changes in pial diameters and local CBF, respectively, in response to
      graded hypercapnia in the absence and presence of 2-CADO. Progressive size
      dependent dilations of pial arterioles [small = 41 +/- 7 microns (mean +/- SD),
      intermediate = 78 +/- 13 microns, and large = 176 +/- 57 microns in diameter]
      occurred in response to graded hypercapnia alone (PaCO2 = 58 and 98 mm Hg) and to
      superfusions of 2-CADO (10(-5) M) during normocapnia; the magnitude of the
      dilative response to each of these stimuli was inversely proportional to vessel
      size. When hypercapnia was induced concomitantly with 2-CADO superfusion, the
      dilative effects of each stimulus were directly additive. Similarly, local
      microdialysis infusion of 10(-5) M 2-CADO, which doubled CBF during normocapnia,
      did not affect the hyperemic response of the parenchymal circulation to graded
      hypercapnia (PaCO2 = 69 and 101 mm Hg). Our findings are consistent with the
      participation of adenosine in the mediation of cerebral hypercapnic hyperemia.
      If, however, adenosine is not involved in this dilative response, our results
      indicate that concomitant vascular and neuromodulatory actions induced by
      adenosine receptor stimulation do not affect the mechanism responsible for the
      hypercapnic hyperemic response.

PMID- 1618945
TI  - Rapid autoregulation of cerebral blood flow: a laser-Doppler flowmetry study.
AB  - The mechanisms underlying autoregulation of CBF were studied in 19 rabbits using
      laser-Doppler flowmetry. A cranial plexiglas window was chronically inserted in
      the skull with dental cement under general anesthesia. The animals then were
      reanesthetized 5-7 days later and subjected to aortic bleeding while CBF was
      measured with the probe placed on the window. In the first set of experiments,
      MABP was decreased (from 90 to 30 mm Hg) and was maintained constant for 1 min.
      During the first seconds, CBF followed the steep decrease of MABP. Then, CBF
      increased and reached a plateau within 3-13 s, depending on the severity of
      hypotension. Hyperemia occurred when blood was restored, and the CBF recovered
      from this posthypotensive hyperemia with a rapid phase (within 2 s) and a slow
      phase (total recovery within 1 min). The lower limit of autoregulation was found
      to be 40 mm Hg. An increase in CBF due to papaverine showed that vasodilation was
      not maximal below this limit. In the second set of experiments, the rabbits were
      subjected to four episodes of hypotension at 40 mm Hg each but of different
      durations (from 2-3 to 60 s). The posthypotensive hyperemia was not influenced by
      the duration of hypotension, but the time of the total recovery phase increased
      with the duration of hypotension. We conclude that there exist rapid adaptive
      mechanisms leading to autoregulation and that the vasodilation is not dependent
      upon the duration of hypotension.

PMID- 1618947
TI  - Changes in neuropeptide Y after experimental traumatic brain injury in the rat.
AB  - We utilized a model of fluid percussion (FP) brain injury in the rat to examine
      the hypothesis that alterations in brain neuropeptide Y (NPY) concentrations
      occur following brain injury. Male rats (n = 44) were subjected to FP traumatic
      brain injury. One group of animals (n = 38) was killed at 1 min, 15 min, 1 h, or
      24 h after brain injury, and regional brain homogenates were analyzed for NPY
      concentrations using radioimmunoassay. A second group of animals (n = 6) was
      killed for NPY immunocytochemistry. Concentrations of NPY in the injured left
      parietal cortex were significantly elevated at 15 min post injury (p less than
      0.05). No changes were observed in other brain regions. NPY-immunoreactive fibers
      were seen at 15 min post injury predominantly in the injured cortex and adjacent
      hippocampus. These temporal changes in NPY immunoreactivity, together with
      previous observations concerning posttraumatic changes in regional CBF in these
      same areas, suggest that an increase in region NPY concentrations after brain
      injury may be involved in part in the pathogenesis of posttraumatic
      hypoperfusion.

PMID- 1618946
TI  - Attenuated development of ischemic brain edema in vasopressin-deficient rats.
AB  - Brain edema formation was investigated in the vasopressin-deficient Brattleboro
      rat using a middle cerebral artery occlusion model of early ischemic injury.
      Water and sodium accumulation after 4 h of ischemia were attenuated 36 and 20%,
      respectively, in the Brattleboro strain as compared to the control Long-Evans
      strain. This effect was independent of differences in animal size and state of
      hydration. In addition, measurements of cerebral blood flow indicated that
      Brattleboro and Long-Evans rats had equal levels of ischemia following middle
      cerebral artery occlusion. Systemic treatment of Brattleboro rats with
      vasopressin normalized their serum electrolyte concentrations and osmolarity but
      did not alter sodium or water accumulation in the ischemic brain. In contrast,
      intraventricular administration of vasopressin in Brattleboro rats increased
      edema formation to that seen in control rats. The reduced water and sodium
      accumulation in Brattleboro rats subjected to middle cerebral artery occlusion
      may be related to alterations in blood-brain barrier permeability since the blood
      to-brain sodium flux was 36% less in the ischemic tissue of the Brattleboro as
      compared to the Long-Evans strain. These results support the hypothesis that
      central vasopressin is a regulator of brain volume and electrolyte homeostasis.
      Furthermore, our findings suggest a role for central vasopressin in the
      development of ischemic brain edema.

PMID- 1618948
TI  - The endothelium-dependent effects of thimerosal on mouse pial arterioles in vivo:
      evidence for control of microvascular events by EDRF as well as prostaglandins.
AB  - Thimerosal causes synthesis and/or release of both endothelium-derived relaxing
      factor (EDRF) and prostaglandins from conductance vessels in vitro. We tested its
      effects and mechanism of action on mouse pial arterioles in vivo using intravital
      microscopic techniques. Topical thimerosal dilated pial arterioles. This effect
      was eliminated by endothelial injury produced by a laser/Evans blue technique.
      Dilation was also eliminated by topical L-NMMA, a reported inhibitor of EDRF
      synthesis. Topical thimerosal also reduced the incidence of platelet
      adhesion/aggregation ("capture") at a site of minimal endothelial damage. This
      effect was eliminated by L-NMMA pretreatment. The ability of thimerosal to dilate
      arterioles was eliminated not only by treatments thought to eliminate
      synthesis/release of EDRF, but also by cyclooxygenase inhibitors. However,
      inhibition of platelet adhesion/aggregation was not affected by cyclooxygenase
      inhibition. Thimerosal significantly increased production of prostaglandin E2
      recovered from a closed cranial window. We conclude that the dilating effects of
      thimerosal on diameter require two endothelium-derived agents: EDRF and one or
      more prostaglandins acting in concert. However, the inhibiting effect of
      thimerosal on local platelet adhesion/aggregation appears to be caused only by an
      increase in EDRF at the injured site.

PMID- 1618949
TI  - Characterization of an aminopeptidase in cerebrospinal fluid. Structure
      elucidation of enzyme hydrolysis products of synthetic methionine-enkephalin by
      reversed-phase high-performance liquid chromatography and mass spectrometry.
AB  - An aminopeptidase was found in canine cerebrospinal fluid via the presence of two
      products: Y, which has an [M + H]+ ion at m/z 182; and GGFM, which has an [M +
      H]+ ion at m/z 411. The linked scan at a constant ratio of the magnetic field to
      the electric field of the GGFM [M + H]+ ion at m/z 411 generates product ions at
      m/z 120, 150, 266, 297, 354, 357, and 411. That aminopeptidase was bestatin
      sensitive (BSAP = bestatin-sensitive aminopeptidase), and had a half-time for
      disappearance of 60 min, maximum velocity of 1.08 nmol ml-1 min-1, and Michaelis
      constant of 0.26 nM.

PMID- 1618950
TI  - Analysis of conjugated bile acids by packed-column supercritical fluid
      chromatography.
AB  - A rapid method has been developed for the simultaneous separation of the polar
      glycine- and taurine-conjugated bile acids by packed-column supercritical fluid
      chromatography. Samples were analysed on a cyanopropyl-bonded silica column with
      ultraviolet detection at 210 nm and carbon dioxide modified with methanol as the
      mobile phase. The influence of the stationary phase, modifier concentration,
      temperature, column pressure and modifier identity on retention was also studied.
      This new chromatographic method is applicable to the assay of conjugated bile
      acids in duodenal bile samples from patients with hepatobiliary diseases.

PMID- 1618951
TI  - High-performance liquid chromatographic method to resolve and determine
      lipopolysaccharide sub-groups of Escherichia coli endotoxin in isolated perfused
      rat liver perfusate.
AB  - A high-performance liquid chromatographic method was developed for resolving
      heterogeneous preparations of fluorescently labelled endotoxin derived from
      Escherichia coli (Serotype 0111:B4) into separate lipopolysaccharide sub-groups.
      The endotoxin was chromatographed on an analytical gel permeation column using a
      mobile phase of acetonitrile (20%, v/v) and 100 mM phosphate buffer (pH 7.75).
      Four fluorescent peaks were resolved, representing sub-groups of markedly
      different molecular sizes. Three of the four sub-groups contained the core
      polysaccharide 2-keto-3-deoxyoctonate, confirming that they contained
      lipopolysaccharide. Fluorescein isothiocyanate (FITC)-labelled endotoxins derived
      from Vibrio cholerae and Salmonella minnesota chromatographed using the same
      system eluted with distinctly different patterns of peaks from each other and
      from E. coli. Extraction of E. coli FITC-endotoxin from a buffer solution using a
      phenol-diethyl ether method and subsequent chromatography allowed the
      determination of three of the four fluorescent sub-groups over the concentration
      range 1-15 micrograms/ml.

PMID- 1618952
TI  - Optimization of high-performance liquid chromatographic assay for catecholamines.
      Determination of optimal mobile phase composition and elimination of species
      dependent differences in extraction recovery of 3,4-dihydroxybenzylamine.
AB  - This paper describes the application of a window diagram technique to optimize
      the four components of eluent (sodium acetate, sodium heptanesulfonate,
      acetonitrile and pH adjusted by monochloroacetic acid), for complete separation
      of five catecholamine compounds and the internal standard (3,4
      dihydroxybenzylamine, DHBA). In addition, studies were performed to address the
      problem of the variable recovery of DHBA from dog plasma due to a time-dependent
      loss of DHBA. We found that this phenomenon can be prevented by pH adjustment
      prior to addition of DHBA, allowing development of an accurate high-performance
      liquid chromatographic assay for plasma catecholamines in dogs.

PMID- 1618953
TI  - Reversed-phase high-performance liquid chromatographic tryptic digest peptide map
      comparisons of monoclonal antibodies to human tumor necrosis factor.
AB  - An automatic computer technique was used to compare the retention times and
      ultraviolet spectra of sixty-two peaks in peptide maps of three monoclonal
      antibodies against human tumor necrosis factor (TNF) and one monoclonal antibody
      against recombinant factor VIII. The anti-TNF monoclonal, B6, which has an
      overlapping epitope with the anti-TNF monoclonal, A10G10, had a 90% peak match
      with A10G10. The anti-TNF monoclonal, A6, with a different epitope to TNF than
      A10G10, had only a 60% peak match. The A6 match to A10G10 was similar to the 50%
      peak match of the anti-factor VIII monoclonal with A10G10. The results of this
      study suggest that peptide mapping can be used as a quantitative characterization
      technique for comparing monoclonal antibodies.

PMID- 1618954
TI  - Large-scale purification and characterization of recombinant tick anticoagulant
      peptide.
AB  - Recombinant tick anticoagulant peptide (r-TAP), a potent and specific inhibitor
      of blood coagulation factor Xa, was purified to greater than 99% homogeneity at
      the multi-gram scale. Genetically engineered yeast secreted 200-250 mg/l of the
      heterologous protein into the medium. Cells were separated from broth by
      diafiltration and purification was done by two chromatographic steps, both
      conducive to operation on a large scale. Analysis of the purified protein by
      several methods indicated that it was greater than 99% homogeneous and no
      incompletely processed or truncated proteins were detected. Physico-chemical
      characterization data of r-TAP show that it exists as a monomer in solution and
      no evidence of post-translational modification was observed. The purified protein
      was fully active in inhibiting human coagulation factor Xa.

PMID- 1618955
TI  - Interactions of human alkaline phosphatase isoenzymes with triazine dyes using
      affinity partitioning, affinity chromatography and difference spectroscopy.
AB  - Aqueous two-phase systems consisting of dextran, polyethylene glycol and dye
      liganded polyethylene glycol were employed to investigate the affinity
      partitioning behaviour of isoenzymes of human alkaline phosphatase. Whereas in
      the system without a dye ligand the partition coefficients of the isoenzymes from
      human intestine and placenta were identical, the isoenzyme from human liver
      showed a significantly lower partition coefficient under the same conditions.
      After addition of dye-liganded polyethylene glycol two groups of dyes possessing
      substantial affinities to the isoenzymes were found. One, represented by Procion
      Yellow HE-3G, interacts specifically with the active centre of the isoenzymes.
      Differences in the affinity of the isoenzymes towards the individual dye ligands
      are caused only by the carbohydrate content, especially by the terminal sialic
      acid residues. The other group of dye ligands, represented by Procion Navy MX-RB,
      binds obviously in a more complex fashion involving other binding sites, which
      are only present in alkaline phosphatase of human liver. Procion Navy MX-RB was
      found to function as a suitable affinity ligand for the separation of human liver
      alkaline phosphatase from the other isoenzymes. Differences in the primary
      structure of two allelic forms of human placental alkaline phosphatase [(SS) and
      (F)] are not recognized in aqueous two-phase systems with or without dye-liganded
      polyethylene glycol.

PMID- 1618956
TI  - Subtraction method for the high-performance liquid chromatographic measurement of
      plasma adenosine.
AB  - The measurement of plasma adenosine with traditional high-performance liquid
      chromatographic techniques is difficult because of its nanomolar concentration,
      its short half-life in blood, and because of the difficulty in isolating
      adenosine from interfering peaks in the chromatogram. To prevent loss of
      adenosine in the blood sample, a "stop solution" is used to prevent enzymatic
      degradation and cellular uptake. Peak-shifting techniques on fractionated samples
      to measure adenosine derivatives have been used in the past to avoid interfering
      peaks in the chromatogram. A new method has been developed by which nanomolar
      levels of plasma adenosine can be accurately measured despite co-eluting peaks in
      the chromatogram. In this method, plasma samples are collected with a stop
      solution, processed, and divided. Adenosine deaminase is added to part of the
      sample to form a blank. A computer program subtracts the blank chromatogram from
      the paired unknown, and the result is compared to adenosine standards prepared
      from the blank and subtracted in a similar fashion. With this subtraction method,
      the overall recovery of physiological concentrations of adenosine was 89% from
      dog blood, and the average coefficient of variation was 12%. In summary, the
      subtraction method of plasma adenosine measurement offers good recovery,
      reproducibility, and the ability to quantify low levels of adenosine despite
      interfering peaks in the chromatogram.

PMID- 1618957
TI  - High-performance liquid chromatographic determination of 3-hydroxypyridinium
      derivatives as new markers of bone resorption.
AB  - Hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) are intermolecular cross
      linking amino acids of collagen and their urinary excretion reflects bone
      resorption. An isocratic high-performance liquid chromatographic assay using a
      reversed-phase column with a prefractionation step and fluorescence detection was
      developed. The accuracy and reproducibility were assessed by loading experiments
      and by double analysis of urinary samples. The recoveries after various loads
      were above 90% for HP and between 87 and 94% for LP, with an intra-assay relative
      standard deviation (R.S.D.) of 5% for HP and 8% for LP. The inter-assay R.S.D.s
      were 8% for HP and 12.4% for LP. The fasting and 24-h urinary excretions of HP
      and LP were measured in 40 healthy subjects (mean age 35 years) of both sexes.
      There was no difference between males and females. Mean adult normal values were
      33.6 +/- 8.1 pmol/mumol creatinine for HP and 7.0 +/- 2.5 pmol/mumol creatinine
      for LP in morning fasting urine and 2-.9 +/- 7.0 pmol/mumol creatinine for HP and
      5.8 +/- 1.9 pmol/mumol creatinine for LP after 24-h urinary collection. HP and LP
      excretions were significantly higher in morning fasting urine than in 24-h
      collections, in agreement with the physiological circadian rythm of bone
      resorption. This simplified and optimized procedure is a good method for the
      determination of pyridinolines and should be useful for the evaluation of bone
      resorption.

PMID- 1618958
TI  - Separation and sensitive determination of i-urobilin and 1-stercobilin by high
      performance liquid chromatography with fluorimetric detection.
AB  - i-Urobilin and 1-stercobilin were separated by high-performance liquid
      chromatography on a reversed-phase octadecylsilane-bonded column and detected
      fluorimetrically through formation of phosphor with zinc ions in the eluent. The
      separation and the intensity of the fluorescence response were affected by
      concentrations of zinc acetate and sodium borate buffer, pH and methanol content
      in the eluent. The optimal eluent used consisted of 0.1% zinc acetate in 75 mM
      boric acid buffer (pH 6.0)-methanol (25:75). The detection limit was 0.2
      microgram/l for both i-urobilin and 1-stercobilin (signal-to-noise ratio 2),
      which makes the method 250-2500 times more sensitive than conventional methods.

PMID- 1618959
TI  - Novel solid-state fluorodensitometric method for the determination of haptens in
      protein-hapten conjugates. Demonstration with a toxic glycoside of Cleistanthus
      collinus.
AB  - A method is reported for the solid-state fluorodensitometric determination of
      haptens in hapten-protein conjugates. The applicability of the method is shown
      using the bovine serum albumin conjugate of cleistanthin B, a toxic glycoside of
      the plant Cleistanthus collinus. This non-destructive technique, which is
      relatively simple, sensitive, rapid and versatile, can be used for the
      determination of protein conjugates of fluorogenic haptens.

PMID- 1618960
TI  - Fully automated determination of a new anthracycline N-l-leucyldoxorubicin and
      six metabolites in plasma by high-performance liquid chromatography with on-line
      sample handling.
AB  - N-l-Leucyldoxorubicin (Leu-Dox) was developed as a prodrug of doxorubicin (Dox)
      in order to diminish the cardiotoxic side-effect associated with repeated
      anthracycline treatment. To study the pharmacokinetics of Leu-Dox, Dox and other
      metabolites a sensitive and selective assay was needed. Leu-Dox and six of its
      known metabolites were extracted from plasma using an in-line reversed-phase
      precolumn (40-50 microns C8 particles). The trapped analytes were subsequently
      flushed to the analytical column (3 microns C18) using 0.5 ml of phosphate buffer
      (pH 3.5)-acetonitrile (2:1, v/v), which also served as the isocratic mobile
      phase. Within 12 min, a clean baseline-resolved chromatogram is obtained by
      fluorescence detection. Recoveries were almost quantitative and highly
      reproducible, with standard deviations less than or equal to 5.4% and less than
      or equal to 2.7% at spiked concentrations of 10 and 100 nM. Using 300 microliters
      of plasma, detection limits ranged from 0.3 to 0.8 nM at a signal-to-noise ratio
      of 3. The calibration curves were linear from 1 to 300 nM (r2 greater than or
      equal to 0.999) for each of the seven compounds. The between-day accuracy was in
      the range 91-99% and 99-105% at 10 and 100 nM, respectively, with standard
      deviations of 1-4%. Application of the assay to the analysis of plasma from
      patients after administration of Leu-Dox proved successful.

PMID- 1618961
TI  - Determination of yohimbine and its two hydroxylated metabolites in humans by high
      performance liquid chromatography and mass spectral analysis.
AB  - The existence of at least two metabolites of yohimbine (YO) in humans is
      demonstrated. Combined high-performance liquid chromatographic (HPLC), NMR and
      mass spectral analyses permitted them to be identified as hydroxylated
      metabolites at the C-10 and C-11 positions. A normal-phase HPLC method allowing
      the simultaneous determination of YO and its main metabolite, 11-hydroxyyohimbine
      (11-OHYO), in biological samples is described. This assay was performed using a
      LiChrosorb Si 60 column and a mobile phase consisting of 0.02 M sodium acetate
      (pH 5)-methanol (5:95, v/v) at a flow-rate of 1 ml/min. Detection was achieved by
      a fluorimetric method (excitation at 280 nm and emission at 320 nm). The
      extraction yields of YO, 10-OHYO and 11-OHYO from plasma were 91.8, 45.3 and
      17.8%, respectively, and their respective within-day reproducibilities were 3.8,
      1.4 and 5.9%. The between-day reproducibility for YO at the concentrations of 1
      and 10 ng/ml were 8.9 and 6.4%, respectively. The accuracy of the method for YO
      at concentrations of 1 and 10 ng/ml were 5.1 and 2.3%, respectively. The limits
      of determination of YO, 10-OHYO and 11-OHYO were 0.1, 0.5 and 1 ng/ml,
      respectively. The method was used in bioavailability study of YO following oral
      and intravenous administration in humans.

PMID- 1618962
TI  - Biodetermination of N-(deacetyl-O-4-vinblastoyl-23)-L-tryptophan, a metabolite of
      vintriptol, by high-performance liquid chromatography with fluorescence
      detection.
AB  - The determination of N-(deacetyl-O-4-vinblastoyl-23)-L-tryptophan (vintriptol
      acid, VtrpA), a metabolite of the investigational semi-synthetic vinca alkaloid
      vintriptol [N-(deacetyl-O-4-vinblastoyl-23)-L-ethyltryptophan, VtrpE], in plasma
      and urine samples is described. Sample pretreatment included liquid-liquid
      extraction of the buffered (pH 5.0) biological samples with chloroform-2-propanol
      (95:5, v/v). The analyses were performed by ion-exchange high-performance liquid
      chromatography on normal-phase silica with fluorescence detection. The assay was
      applied to the analysis of samples from cancer patients who had been treated with
      VtrpE in a phase I clinical study. VtrpA was found to be a principal metabolite
      of VtrpE with up to 1.2% of the administered dose excreted in the urine.

PMID- 1618963
TI  - Determination of fumonisin B1 in plasma and urine by high-performance liquid
      chromatography.
AB  - Fumonisin B1 (FB1), the major compound of the newly described fumonisin
      mycotoxins, has been shown to be the causative agent of the animal diseases
      leukoencephalomalacia in horses and pulmonary oedema in pigs. Whereas previous
      analytical methods have dealt with the determination of FB1 in feed and
      foodstuffs, this report for the first time details methods for FB1 determination
      in the physiological fluids, plasma and urine. The methods involve solid-phase
      anion-exchange clean-up, precolumn derivatisation with o-phthaldialdehyde and
      reversed-phase high-performance liquid chromatography with fluorescence
      detection. These methods were shown to be sensitive (detection limit around 50 ng
      ml-1), reproducible (relative standard deviation on six replicates less than 5%)
      and accurate (recoveries on spiked blank samples above 85%).

PMID- 1618964
TI  - Simultaneous determination of chloroquine and its three metabolites in human
      plasma, whole blood and urine by ion-pair high-performance liquid chromatography.
AB  - A method was developed for the separation and measurement of chloroquine and
      three metabolites (desethylchloroquine, bisdesethylchloroquine and 4-amino-7
      chloroquinoline) in biological samples by ion-pair high-performance liquid
      chromatography with UV detection. The method uses 2,3-diaminoaphthalene as an
      internal standard and provides a limit of detection between 1 and 2 ng/ml for
      chloroquine and its metabolites. The assay was linear in the range 12.5-250 ng/ml
      and the analytical recovery and reproducibility were sufficient. The assay was
      applied to the analysis of biological samples from a patient undergoing
      chloroquine chemoprophylaxis and a patient who had ingested chloroquine in a
      suicide attempt.

PMID- 1618965
TI  - High-performance liquid chromatographic procedure for the determination of
      tiagabine concentrations in human plasma using electrochemical detection.
AB  - A sensitive and precise high-performance liquid chromatographic procedure has
      been developed for the measurement of tiagabine concentrations in human plasma.
      Isolation of tiagabine and the internal standard was achieved using solid-phase
      extraction on disposable C8 columns. Separation was performed on a C18 analytical
      column using a mobile phase containing sodium octanesulfonate. The effluent was
      monitored with coulometric electrochemical detection at ca. + 0.76 V. The workup
      procedure recovered more than 95% of tiagabine from plasma. Standard curves were
      linear over the concentration range 0-500 ng/ml. The precision of the method was
      good: coefficients of variation were typically less than 5% for concentrations as
      low as 8 ng/ml and although they were higher at concentrations less than 8 ng/ml,
      they remained within acceptable limits (less than 17%) for concentrations as low
      as the limit of quantitation (2 ng/ml using a l-ml plasma sample). The stability
      of tiagabine in plasma was excellent, with no evidence of degradation after 23 h
      at room temperature or 2 months at -20 degrees C.

PMID- 1618966
TI  - Determination of the tricyclic compound adosupine and its three metabolites in
      plasma and brain of rat using high-performance liquid chromatography.
AB  - An analytical method for the detection in biological samples of the novel
      tricyclic compound adosupine (10-acetoamido-5-methyl-5,6-dihydro-11H
      dibenzo[b,e]azepin-6 ,11-dione), which is capable of influencing various forms of
      urinary bladder hyperreflexia has been developed using high-performance liquid
      chromatography with UV detection. Liquid-liquid extraction was used to isolate
      the parent compound, three metabolites and an analogue (added as internal
      standard) from plasma and brain of rat. Adosupine was well separated from its
      three metabolites with 0.01 M disodium hydrogenphosphate-acetonitrile-methanol
      nonylamine (59.986:38:2:0.014) at pH 4.5 as mobile phase using a C18 reversed
      phase column. The standard curves were linear in the range 50-5000 ng/ml (or
      ng/g) for adosupine and metabolites in both plasma and brain. The between- and
      within-assay variations for high and low concentrations of the parent compound
      and the three metabolites were 8.2-14%. In the range 50-5000 ng/ml (or ng/g) the
      accuracy of the method was satisfactory, with the relative error always lower
      than 10%. Analytical recoveries of added adosupine and the three metabolites were
      higher than 82%. The method has been applied successfully, to investigate the
      pharmacokinetics of the drug and its distribution in the central nervous system
      of rats.

PMID- 1618967
TI  - Bioanalysis of some anthracyclines in human plasma by capillary electrophoresis
      with laser-induced fluorescence detection.
AB  - A rapid method for the determination of daunorubicin, doxorubicin and epirubicin
      in human plasma is described. Samples are pretreated and concentrated by liquid
      liquid extraction with chloroform and back-extraction into phosphoric acid,
      respectively. This pretreatment results in a sample matrix of low ionic strength
      in comparison with the electrophoresis buffer, permitting a 20-30-fold increase
      in the injected amount by zone sharpening when electrokinetic injection is
      applied. Analyte interaction with the capillary wall is prevented by using high
      acetonitrile contents in the electrophoresis buffer, which results in
      reproducible migration times and highly efficient separations. Laser-induced
      fluorescence detection provides an extremely sensitive and selective method
      without detectable biological interferences. The limit of determination of
      daunorubicin, epirubicin and doxorubicin in plasma ranges from 125 to 250 pg/ml.

PMID- 1618968
TI  - Analysis of pipecolic acid in biological fluids using capillary gas
      chromatography with electron-capture detection and [2H11]pipecolic acid as
      internal standard.
AB  - A sensitive and accurate stable isotope dilution assay was developed for the
      measurement of pipecolic acid in body fluids using capillary gas chromatography
      with electron-capture detection. The method utilizes [2H11]pipecolic acid as the
      internal standard. Sample preparation consisted of derivatization in aqueous
      solution (pH 11.5) of the amine moiety with methyl chloroformate to the N
      methylcarbamate, followed by acidic ethyl acetate extraction at pH less than or
      equal to 2 and further derivatization of the carboxyl moiety with
      pentafluorobenzyl bromide, the excess of which was removed by solid-phase
      extraction. Control values have been determined in the plasma of at-term infants,
      age greater than 1 week (n = 21, mean = 1.36 microM, range = 0.47-3.27 microM).
      The utility of the method was demonstrated by quantitating pipecolic acid in
      biological fluids derived from patients with peroxisomal disorders. The method
      was validated against an established electron-capture negative ion mass
      fragmentographic technique.

PMID- 1618969
TI  - Measurement of histamine in rat bronchoalveolar lavage fluid by high-performance
      cation-exchange chromatography coupled with post-column derivatization to o
      phthaldialdehyde.
AB  - To better define involvement of mast cell derived mediators in the pulmonary
      response to fibrogenic dusts, a rapid and accurate method was required to analyze
      samples of bronchoalveolar lavage fluid for histamine. Samples of rat lung lavage
      were analyzed for histamine via high-performance cation-exchange chromatography
      coupled with post-column derivatization with o-phthaldialdehyde. The fluorescent
      derivative could be detected to ca. 1 ng/ml of lavage. Recoveries averaged 94.2%
      with an average relative standard deviation of +/- 5.3%. There were no
      correlations between amount or fibrogenicity of inhaled dust and subsequent
      release of histamine into lavage fluid.

PMID- 1618970
TI  - Determination of endothelin-converting enzyme activity by high-performance liquid
      chromatography-on-line radioactive flow monitoring.
AB  - A rapid method to investigate the metabolism of 125I-labelled or non-labelled
      human big endothelin to endothelin-1 by reversed-phase high-performance liquid
      chromatography (HPLC) and on-line radioactive flow monitoring and/or ultraviolet
      detection was developed. Samples were processed by solid-phase extraction
      (average recovery 70-80% for non-labelled and 20-25% for 125I-labelled big
      endothelin and endothelin-1) followed by HPLC analysis (total analysis time 20
      min). The method was successfully employed to monitor the conversion of big
      endothelin to endothelin-1 by various blood-borne cells, such as human
      polymorphonuclear leukocytes or monocytes/macrophages.

PMID- 1618971
TI  - Gas chromatographic determination of urinary phenol conjugates after acid
      hydrolysis/extractive acetylation.
AB  - Phenolic metabolites of inhaled aromatic solvent vapours were liberated by acid
      hydrolysis of their urinary conjugates. Steam distillation enhanced by salting
      out with MgSO4 gave good recoveries. After extractive acetylation, the
      derivatives of all cresols and xylenols were completely separated on a Se-54
      capillary column. The overall recoveries of urinary phenols relative to the
      internal standard, 3-chlorophenol, were in the range 92-99%.

PMID- 1618972
TI  - Microanalytical high-performance liquid chromatographic assay for cefpirome in
      human milk and urine.
AB  - To permit the characterization of cefpirome disposition in lactating females, a
      previously published high-performance liquid chromatographic (HPLC) method for
      determining the drug in serum was adapted for use with milk and urine. This
      automated, microanalytical technique requires 50 microliters of biological
      matrix, which is subjected to an isopropanol extraction. Chromatography was
      accomplished using a microbore HPLC system, a reversed-phase C18 column and a
      mobile phase of 0.3% triethylamine in water (pH 5.1). Cefpirome and the internal
      standard (beta-hydroxypropyltheophylline) were monitored using UV detection at
      240 nm and had retention times of 2.84 and 5.05 min, respectively. The method was
      linear up to 500 mg/l for both matrices and had a limit of detection of 0.6 mg/l.
      The interday variation (relative standard deviation) at concentrations of 5.0,
      50.0 and 500.0 mg/l was consistently less than 5% in both urine and breast milk.
      The method was found to be free from interference by other commonly administered
      medications and readily adaptable for use in clinical investigations. The ease of
      sample preparation, small sample volume requirement, short chromatographic time,
      apparent lack of interferences, analytical sensitivity and high precision and
      accuracy make this method ideal for use in pharmacokinetic investigations
      involving the determination of cefpirome in human milk and urine.

PMID- 1618973
TI  - High-performance liquid chromatographic method for the simultaneous determination
      of monoethylglycinexylidide and lignocaine.
AB  - An accurate and sensitive high-performance liquid chromatographic method with UV
      detection was developed for the simultaneous measurement of
      monoethylglycinexylidide (MEGX) and lignocaine in human plasma and serum, using
      organic solvent extraction and trimethoprim (TMP) as an internal standard. The
      mean recoveries for MEGX, TMP and lignocaine were 86.1 +/- 3.7, 98.3 +/- 1.8 and
      77.0 +/- 4.7%, respectively (n = 6). The relative standard deviations for MEGX
      concentrations of 10 and 200 ng/ml were less than 4% and for lignocaine
      concentrations of 200 and 1200 ng/ml they were less than 8%.

PMID- 1618974
TI  - Automated determination of disopyramide and N-monodealkyldisopyramide in plasma
      by reversed-phase liquid chromatography with a column switching system.
AB  - A rapid and simple column liquid chromatographic method involving a column
      switching system for the determination of disopyramide and its N-monodealkyl
      metabolite (NMD) in plasma is described. The deproteinized plasma is applied to
      an automated system. Purification and concentration were performed using a
      precolumn connected to a six-position valve; analytical separation was done on
      line using a cyano reversed-phase column with a mobile phase consisting of 10
      mmol/l trimethylamine (pH 2.5, adjusted with phosphoric acid)-acetonitrile
      tetrahydrofuran (78:20:2, v/v/v). Absorbance was measured at 265 nm, with a
      minimum detectable amount of disopyramide and NMD of 0.1 micrograms/ml. The
      method can be applied to drug monitoring and pharmacokinetic studies.

PMID- 1618975
TI  - Assay of protein drug substances present in solution mixtures by fluorescamine
      derivatization and capillary electrophoresis.
AB  - A method is described to enhance the resolution and detection sensitivity of
      proteins, peptides, and amino acids in capillary electrophoretic analysis of
      solution mixtures. The method consists of derivatizing the analytes with
      fluorescamine, which is normally used as a fluorogenic reagent for compounds
      containing a reactive primary amine functional group, and then using the
      derivative as an ultraviolet chromophore to enhance detection sensitivity
      (measured at 280 nm) in capillary electrophoresis. The results demonstrated a
      significant improvement in the separation and detection sensitivity of the
      derivatized analytes as compared to their underivatized counterparts. The use of
      chromophores, such as fluorescamine, in capillary electrophoresis facilitates the
      analysis of components of solution mixtures, such as pharmaceutical formulations,
      that could not be resolved and/or detected by conventional capillary
      electrophoresis procedures.

PMID- 1618976
TI  - Evaluation of restricted access media for high-performance liquid chromatographic
      analysis of sulfonamide antibiotic residues in bovine serum.
AB  - Three commercially-available high-performance liquid chromatographic columns
      packed with restricted access media were evaluated for suitability in multi
      residue direct injection analysis at the ng/ml level. The internal surface
      reversed-phase and shielded hydrophobic phase columns were not sufficiently
      retentive to separate all analytes from the tail of the matrix peak. Coelution of
      some of the analytes was also observed with these columns. The semi-permeable
      surface column was significantly more retentive and selective, providing good
      separation of analyte and matrix peaks. With this column, an analytical protocol
      requiring no organic solvents was developed for the assay of six sulfonamides at
      a detection limit of 25 ng/ml.

PMID- 1618977
TI  - Simultaneous determination of amounts of major phospholipid classes and their
      fatty acid composition in erythrocyte membranes using high-performance liquid
      chromatography and gas chromatography.
AB  - A method for the simultaneous determination of amounts of major phospholipid
      classes and their fatty acid composition in erythrocyte membranes is described.
      The method consists in extraction of phospholipids from erythrocyte membranes,
      separation of phospholipid classes by high-performance liquid chromatography,
      methylation of phospholipids and determination of phospholipid-bound fatty acids
      by capillary gas chromatography. The amounts of phospholipid classes are
      calculated from the total weight of phospholipid-bound fatty acids and their
      average molecular weights. The method was applied to erythrocytes from rats. The
      results show that the method is reproducible and is useful for the determination
      of amounts of phospholipid classes and their fatty acid composition in small
      blood samples.

PMID- 1618978
TI  - High-performance hydrophobic interaction chromatography of proteins on reversed
      phase supports coated with non-ionic surfactants of polyoxyethylene type.
      Purification of a fungal aspartic proteinase.
AB  - On coating reversed-phase supports with polyoxyethylene-type non-ionic
      surfactants, proteins are no longer retained on such supports at moderate or low
      ionic strength, but they are retained at high ionic strength and can be desorbed
      by a decreasing ionic strength gradient. These reversibly modified supports were
      used for hydrophobic interaction chromatography (HIC). The proteins probably
      interact with the polyoxyethylene tail of the non-ionic surfactant while the
      hydrophobic part of the surfactant anchors the surfactant to the reversed-phase
      support by interactions with its alkane coverage. Although the interactions
      between non-ionic surfactant and reversed-phase support are non-covalent and the
      HIC mobile phases contained no surfactant, the modified columns were stable and
      could be used repeatedly. A surfactant-modified reversed-phase column provided a
      rapid, efficient, one-step purification of a fungal aspartic proteinase from a
      commercial crude preparation.

PMID- 1618979
TI  - On-line continuous-flow dialysis thermospray tandem mass spectrometry for
      quantitative screening of drugs in plasma: rogletimide.
AB  - The application of a continuous-flow dialysis system, consisting of a membrane
      dialyser and a trace enrichment column, in on-line combination with tandem mass
      spectrometry via a thermospray interface is described. The method is applied to
      the quantitation of drugs in complex biological matrices containing
      macromolecular interferences. The potential of the method is demonstrated by the
      quantitative analysis of the anti-cancer drug rogletimide in the plasma of
      patients after treatment.

PMID- 1618980
TI  - High-performance liquid chromatographic separation of molecular species of
      neutral phospholipids.
AB  - Molecular species of neutral phospholipids, phosphatidylcholine (PC) and
      phosphatidylethanolamine (PE), were resolved by reversed-phase high-performance
      liquid chromatography (HPLC) using mobile phases of acetonitrile-methanol-water
      containing tetraalkylammonium phosphates (TAAPs). Competitive interactions of
      TAAPs and analyte solutes with a reversed-phase HPLC column resulted in reduced
      retention of PC or PE with concomitant increase in detection sensitivity. The
      chromatographic data for PC and PE were distinctly different from those for
      negatively charged phospholipids where ion-pair retention mechanisms prevailed.
      While PC (or PE) components eluted at longer retention times with a larger size
      of TAAP, an increase in the TAAP concentration invariably caused a decrease in
      phospholipid retention times. Optimization of HPLC conditions by using high
      concentrations (25-100 mM) of tetramethylammonium phosphate in acetonitrile
      methanol-water (70:22:8) facilitated elution of components with improved peak
      symmetry. HPLC separations of neutral phospholipids derived from animal sources
      were more complex than those from soybeans.

PMID- 1618981
TI  - Analysis of sterol esters from alga and yeast by high-performance liquid
      chromatography and capillary gas chromatography-mass spectrometry with chemical
      ionization.
AB  - Sterol esters from the green alga Chlorella kessleri and the yeast Saccharomyces
      cerevisiae were analysed by tandem high-performance liquid chromatography (HPLC
      HPLC). Non-polar lipids were separated by normal-phase HPLC into individual
      classes and the fraction of sterol esters was subsequently separated by reversed
      phase HPLC into intact molecular species. Further separation and identification
      of the fractions after HPLC were effected by capillary gas chromatography-mass
      spectrometry (cGC-MS) with positive and/or negative chemical ionization. A
      technique consisting of direct injection of the sample after its passage through
      the detector into the on-column injector of the gas chromatograph was used to
      transfer the sample from HPLC-HPLC to cGC-MS. By means of this method it was
      possible to demonstrate more than 30 sterols in both the alga and the yeast, and
      more than 20 new sterol esters were detected.

PMID- 1618982
TI  - Simultaneous assay for amatoxins and phallotoxins in Amanita phalloides Fr. by
      high-performance liquid chromatography.
AB  - A reversed-phase high-performance liquid chromatographic method is described that
      allows the simultaneous determination of up to eight amatoxins and phallotoxins.
      The method identifies both neutral toxins (alpha- and gamma-amanitin, phalloidin,
      phallisin and phalloin) and acidic toxins (beta-amanitin, phallacidin and
      phallisacin). Toxins were separated, identified and determined by gradient
      elution with 0.02 M aqueous ammonium acetate-acetonitrile and simultaneous
      monitoring of the absorbances at 214 and 295 nm. The assay was successfully
      applied to the analysis of the toxins in a crude extract of Amanita phalloides.
      The limit of detection for each toxin was 10 ng/ml of extraction medium. The
      assay was further validated by analysing the toxin content in Galerina marginata,
      a species containing only amatoxins. This relatively simple method should be
      suitable for the detection of amatoxins and phallotoxins in almost any species of
      mushrooms.

PMID- 1618983
TI  - Isolation of Der pI, the Dermatophagoides pteronyssinus major mite allergen, from
      a crude mite culture extract, purification by ion-chromatography, and comparison
      between the material obtained and a cDNA-coded Der pI.
AB  - A high degree of purity is a prerequisite for an allergen preparation to be
      suitable for clinical diagnosis and therapy. A pure allergen can easily be
      obtained from a crude mite culture extract by using an immunosorbent prepared
      with highly specific monoclonal antibodies or from a cDNA-coded material.
      However, up to now none of these methods has been performed on a process scale.
      Here large-scale purification is defined as a process in which a crude
      Dermatophagoides pteronyssinus mite culture extract is essentially fractionated
      by acetone and ammonium sulphate precipitations followed by anion-exchange high
      performance liquid chromatography. A high yield of a very pure Der pI allergen is
      obtained during the first isocratic run, as shown by sodium dodecylsulphate
      polyacrylamide gel electrophoresis, capillary electrophoresis, chromatofocusing
      and a two site monoclonal antibody enzyme-linked immunosorbent assay.
      Microsequencing revealed that the 25-residue sequence obtained is entirely in
      agreement with the sequence derived from the cDNA of Der pI.

PMID- 1618984
TI  - High-performance liquid chromatographic separation of detritylated
      oligonucleotides on highly cross-linked poly-(styrene-divinylbenzene) particles.
AB  - Detritylated oligonucleotides were separated by reversed-phase high-performance
      liquid chromatography on highly cross-linked polystyrene-based particles having a
      mean particle diameter of 2.3 microns. The addition of poly(vinyl alcohol) during
      polymerization, which resulted in the presence of hydroxyl groups on the surface
      of the poly(styrene-divinylbenzene) beads, was necessary to obtain baseline
      resolution of phosphorylated oligodeoxyadenylic acids with a chain length of up
      to 30 bases. The impact of temperature was investigated and optimum resolution
      was achieved at 40 degrees C. At pH 7.0, the retention times of oligonucleotides
      were found to depend on the ratio of bases and to increase in the order of C less
      than G less than A less than T. Under the same conditions, it was possible to
      separate phosphorylated from dephosphorylated oligonucleotides, the former being
      eluted earlier. Recoveries ranged from 92 to 100%.

PMID- 1618985
TI  - Application of capillary reversed-phase high-performance liquid chromatography to
      high-sensitivity protein sequence analysis.
AB  - A continuous gradient elution method for capillary column (less than 0.32 mm
      I.D.) liquid chromatography was developed. Gradient eluent from a microbore
      liquid chromatograph was split ahead of the injector so that an accurate
      percentage (2-3%) of the mobile phase delivered by the pump flowed through the
      capillary column. The outlet of the column was connected to a length of 0.075 mm
      I.D. fused-silica capillary tubing which, in turn, was connected to a 6-mm
      optical path length longitudinal capillary flow cell. Fused-silica capillary
      columns of 0.32 mm I.D. were slurry-packed efficiently with 7-microns spherical,
      300 A pore size, C8 bonded-phase particles, and evaluated in terms of their
      ability to resolve mixtures of proteins, peptides or phenylthiohydantoin (PTH)
      amino acid derivatives. The gradient elution profiles agreed with those obtained
      using microbore (less than 2.1 mm I.D.) and larger bore columns. The minimum
      detectable amounts for proteins and PTH-amino acids on 0.32 mm I.D. capillary
      columns were 50 pg and 25 fmol, respectively. At a flow-rate of 3.6
      microliters/min, proteins and peptides were recovered from the capillary columns
      in volumes of about 2-8 microliters. The use of a multiple-wavelength, forward
      optics detector for identifying tryptophan- and tyrosine-containing peptides is
      discussed.

PMID- 1618986
TI  - Selective high-performance liquid chromatographic purification of bispecific
      monoclonal antibodies.
AB  - The recent development of improved production techniques for bispecific
      monoclonal antibodies (biMAbs) has significantly increased interest in specific
      purification procedures. In this investigation, a general high-performance liquid
      chromatographic (HPLC) purification method is proposed that allows highly
      purified biMAbs to be obtained from mouse ascites fluid containing a mixture of
      different antibodies, i.e., parental MAbs, active biMAb and a mixture of randomly
      assembled heavy and light chains. Proteins from ascites fluid were precipitated
      with ammonium sulphate and applied to a high-performance protein A column to
      separate the total immunoglobulin fraction. BiMAbs were isolated from other
      immunoglobulins by two subsequent passages through a high-performance
      hydroxyapatite (HPHT) column. This purification protocol combines specificity of
      protein A for immunoglobulin G (IgG) and high selectivity of hydroxyapatite for
      different IgG idiotypes. All purification steps were performed rapidly and
      reliably by HPLC. This method was applied to the purification of six different
      biMAbs with consistently high yields, purity and homogeneity. This general
      purification method may prove extremely valuable when highly pure preparation of
      biMAbs is required, as for in vivo use.

PMID- 1618987
TI  - Characterization of the heterogeneity of polyethylene glycol-modified superoxide
      dismutase by chromatographic and electrophoretic techniques.
AB  - Covalent attachment of polyethylene glycol (PEG) chains to the enzyme Cu,Zn
      superoxide dismutase (SOD) produces a heterogeneous mixture of modified protein
      species. The heterogeneity of the product (PEG-SOD) derives from a variable
      stoichiometric combination of PEG with individual SOD molecules in addition to
      the polydispersity of the PEG reagent. Characterization of PEG-SOD presents
      significant challenges due in part to this heterogeneity in addition to the
      hybrid nature of the modified enzyme. The application of classical methods of
      protein characterization is not always successful for these PEG-proteins
      requiring the development of alternative or modified procedures. A series of
      chromatographic techniques including reversed-phase, ion-exchange, size
      exclusion, and hydrophobic interaction high-performance liquid chromatography
      along with electrophoretic techniques including isoelectric focusing, sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis, and capillary zone
      electrophoresis have been developed for assessing the degree of heterogeneity of
      PEG-SOD samples which encompass a range of different stoichiometries. Examples
      will be given demonstrating the application of these techniques to characterize
      PEG-SOD samples of different composition produced during the course of the
      reaction between SOD and an activated PEG reagent.

PMID- 1618988
TI  - Peptide maps of five human pepsin isoenzymes and other aspartic proteinases.
AB  - Peptide maps of five individual human pepsins were developed using reversed-phase
      high-performance liquid chromatography after protein digestion with either
      Staphylococcus aureus proteinase (V8) or alpha-chymotrypsin. Human pepsins 3a, 3b
      and 3c produced almost identical peptide maps suggestive of proteins with very
      similar amino acid sequences. The map for human pepsin 1 was similar to pepsin 3b
      (the most predominant human pepsin) but less than half the expected amount of
      each equivalent peptide fragment was generated, indicating that the actual mass
      of digested protein used was less than the dry weight measurement would suggest,
      probably as a result of carbohydrate attached to pepsin 1. Comparison of human
      pepsin 3b maps with other aspartic proteinases confirmed a significant homology
      with swine pepsin A but not with endothiapepsin. The alpha-chymotrypsin digests
      compared with V8 gave more complex peptide maps as a result of its broader bond
      cleavage specificities.

PMID- 1618989
TI  - Influence of operating parameters on the preparative gradient elution
      chromatography of insulins.
AB  - The mass-overloaded separation of bovine and porcine insulins has been studied in
      the reversed-phase gradient elution mode. Strong solute-solute displacement
      effects have been found, which are related to the efficiency of the column used.
      Low flow-rates and small particle diameters maximise the displacements, as well
      as improve the resolution between the parent insulin and its desamido
      contaminant. The gradient slope did not substantially affect the separation
      between the parent insulins, but, due to the relative "S" values of the solutes,
      an increase in gradient slope improved the separation of the parent insulin from
      its desamido compound. An optimum pore size of 150 A was found for the insulins.
      Experiments to optimise the loadability were not carried out, but a recovery of
      90% at a purity of 99.5% was obtained with a loading of 12 mg/g of porcine
      insulin.

PMID- 1618990
TI  - Chromatographic analysis of low-molecular-mass copper-binding ligands from the
      crab species Scylla serrata and Portunus pelagicus.
AB  - Two copper-binding proteins and a zinc-binding ligand were isolated from the
      hepatopancreas of the crab Portunus pelagicus. The copper-binding proteins behave
      similarly to those from the crabs Carcinus maenas and Scylla serrata, and were
      shown to be metallothioneins. Reversed-phase high-performance liquid
      chromatographic (HPLC) analysis confirmed the relative purity of both proteins
      with only cross-contamination between the two different forms of
      metallothioneins, and offers a good method to separate the two forms of
      metallothioneins. The vast difference in the retention times (and hence the
      hydrophobicity) in reversed-phase HPLC indicates that the two proteins could be
      conformationally very different.

PMID- 1618991
TI  - Prediction of peptide retention time in reversed-phase high-performance liquid
      chromatography.
AB  - Peptide retention in reversed-phase chromatography depends mainly on the amino
      acid composition of peptides and can therefore be predicted by summing the
      relative hydrophobic contributions of each constitutive amino acid residue. The
      prediction is correct for small peptides but overestimates the retention times of
      peptides larger than 10-15 residues. A new prediction model is proposed in which
      the contribution to peptide retention of each amino acid residue is not a
      constant but a decreasing function of peptide length. From the retention times of
      104 peptides, the parameters of decreasing functions were estimated by a non
      linear multiple regression analysis. The contribution to peptide retention of
      charged, polar and non-polar residues appears to be differently affected by
      peptide length. The secondary structure of most peptides during reversed-phase
      high-performance liquid chromatography could be responsible for this. The high
      correlation between the predicted and observed retention times of peptides which
      were not used to establish the model indicates a good predictive accuracy of the
      new model.

PMID- 1618992
TI  - Influence of different N- and O-linked carbohydrates on the retention times of
      synthetic peptides in reversed-phase high-performance liquid chromatography.
AB  - Glycopeptides consisting of 6-19 amino acid residues and different mono- and
      disaccharides attached to single asparagine and serine residues were synthesized
      on solid-phase and were characterized by reversed-phase high-performance liquid
      chromatography and circular dichroism. It was shown that the decreased retention
      times due to glycosylation could be correlated with the increasing length of the
      sugar moiety. Phosphorylation of the same sequences reduced the retention times
      1.6 times more than glycosylation with monosaccharides did. The binding to the
      column was dependent on the structure of the disaccharide when derivatized and
      glycosylated asparagine, the building block of N-glycopeptide syntheses was
      studied. However, this structural dependence of the elution times disappeared in
      the final glycopeptides. Although both glycosylation and phosphorylation resulted
      in altered secondary structure of the peptide backbone, it appears that the
      retention times reflect the increased hydrophilicity more strongly than induced
      conformational orientation on the surface of the bonded phase.

PMID- 1618993
TI  - Chromatographic analysis of tropomyosins from rabbit skeletal, chicken gizzard
      and earthworm muscle.
AB  - Tropomyosins from rabbit skeletal, chicken gizzard and earthworm muscle all exist
      as dimeric, ca. 100% alpha-helical coiled-coil species in benign media. Two major
      tropomyosin isoforms from each muscle source have been identified and can be
      conveniently designated alpha (fast) and beta (slow) based on electrophoretic
      mobility under denaturing conditions. The ratio of alpha to beta chains is ca. 3
      4:1 for rabbit skeletal and ca. 1:1 for chicken gizzard and earthworm
      tropomyosins. Each chain from the former two muscle sources has been sequenced,
      thus providing a molecular basis for interpreting the in vivo population of homo-
      and hetero-dimers. The characteristics of each purified tropomyosin in weak-anion
      exchange, strong-cation exchange and reversed-phase high-performance liquid
      chromatography are described. Binding to and/or elution from the reversed-phase
      matrix results in dissociation into highly helical monomeric chains. This mode of
      chromatography separates the alpha and beta chains of earthworm and chicken
      gizzard tropomyosins, but not those of the rabbit protein. Both anion- and cation
      exchange chromatography use mild (benign) elution conditions under which the
      native, in vivo dimer population should be preserved. Only the rabbit protein
      exhibited peak separation on the anion-exchange resin, with peak assignment
      corresponding to the known molecular organization of homo- and hetero-dimers. In
      strong cation-exchange analysis, all three tropomyosins exhibit a chromatographic
      transition near pH 6.5, possibly the result of histidine(s) titration.
      Collectively, the chromatographic data confirm the present understanding of the
      in vivo mixture of dimers for tropomyosin from rabbit skeletal and chicken
      gizzard. It is concluded that native earthworm tropomyosin exists predominantly
      as an alpha beta hetero-dimer.

PMID- 1618994
TI  - Clinical review 35: Growth factors and their potential clinical value.

PMID- 1618995
TI  - Androstenedione metabolism in cultured human osteoblast-like cells.
AB  - Bone is a target organ of androgens. The mechanism by which these steroids exert
      their action within bone cells is still poorly understood. The metabolism of
      androstenedione, the major circulating androgen in women, was, therefore,
      assessed in osteoblast-like bone cells cultured from bone of 16 postmenopausal
      women (mean age, 69 yr; range, 56-80) and 3 elderly men (mean age, 71 yr; range,
      69-73) undergoing total hip replacement. Each cell strain was incubated under
      standardized conditions with varying concentrations of [1,2,6,7
      3H]androstenedione (0.05-5 microM). In every instance 5 alpha-reduced metabolites
      and 17 beta-hydroxysteroids were formed. There was no correlation between the
      volumetric density of the resected bone and androstenedione metabolism of the
      corresponding cultured bone cell strains. The apparent Km for the 5 alpha
      reductase activity (sum of androstanedione and dihydrotestosterone) of all 19
      cell strains was 0.7 +/- 0.1 microM (mean +/- SEM), and the apparent Km for 17
      beta-hydroxysteroid dehydrogenase (sum of testosterone and dihydrotestosterone)
      was 2.3 +/- 0.8 microM (mean +/- SEM), values similar to those reported for other
      androgen target organs. Our results demonstrate that human osteoblast-like cells
      have the capacity to transform androstenedione into the more potent biological
      androgens testosterone and dihydrotestosterone. Since the Km values of both 5
      alpha-reductase and 17 beta-hydroxysteroid dehydrogenase exceed the serum
      androstenedione concentration, the formation of testosterone and
      dihydrotestosterone appears to be mainly a function of substrate availability.

PMID- 1618997
TI  - Sex steroid priming effects on growth hormone response to pyridostigmine
      throughout the menstrual cycle.
AB  - To explore the effect of estradiol and progesterone on the GH response to the
      indirect cholinergic agonist pyridostigmine nine healthy women were challenged
      with both active drug and placebo at three time points in two consecutive
      menstrual cycles: a total of six neuroendocrine tests. A randomized, double
      blind, counterbalanced design was used. Subjects were tested in the early
      follicular, mid-cycle, and luteal phases of the cycle. A cannula was inserted in
      a forearm vein after an overnight fast and baseline GH, estradiol, and
      progesterone samples were drawn. After 120 mg oral pyridostigmine or placebo
      tablets further blood samples for GH analysis were drawn at intervals over 3 h.
      When expressed as maximum change from baseline (delta GH) mean GH responses to
      pyridostigmine increased incrementally from early (8.4 +/- 2.7 micrograms/L)
      through mid (18 +/- 1.3 micrograms/L) to late (22.2 +/- 1.9 micrograms/L) cycle.
      This represents a significant effect of cycle phase on the GH response to
      pyridostigmine (P less than 0.001, as assessed by analysis of variance).
      Responses to placebo did not vary. Plasma estradiol values were significantly
      correlated with GH responsivity to active drug throughout the cycle (P less than
      0.02). Multiple regression analysis also revealed a significant positive
      correlation between progesterone levels and GH response to pyridostigmine (P less
      than 0.02). Estrogens augment GH responses to other challenges but a priming
      effect of progesterone on GH responsivity has not previously been demonstrated.
      Various mechanisms are discussed including a possible sex steroid priming effect
      on acetylcholine neurotransmission.

PMID- 1618996
TI  - Decreased hypoglycemic effect of insulin at night in insulin-dependent diabetes
      mellitus and healthy subjects.
AB  - Diurnal variations in insulin-induced hypoglycemia and in plasma
      counterregulatory hormone concentrations were explored in eight insulin-dependent
      diabetic and six healthy subjects during a 100-min iv insulin infusion performed
      at 0300 h and 1500 h. In healthy subjects, plasma glucose concentrations (mean +/
      SD) fell by 35 +/- 2% during the daytime test and by 26.5 +/- 2% during the
      nocturnal test (P less than 0.01). Plasma cortisol, GH, and epinephrine
      concentrations increased more during the daytime than during the nocturnal test.
      In contrast, plasma glucagon concentrations rose more during the nocturnal tests.
      In insulin-dependent diabetes mellitus patients, insulin infusion had to be
      interrupted in three subjects because plasma glucose fell below 1.9 mmol/L 80 min
      after the beginning of the test. In the other five patients plasma glucose fell
      by 34 +/- 5% during the daytime test while no significant decrease in plasma
      glucose was observed in any of the eight patients during the nighttime test.
      Counterregulatory hormone concentrations were consistent with the results of
      plasma glucose, with no change during the nocturnal test and significant
      increases in cortisol, GH, and epinephrine during the daytime test. These results
      show that insulin sensitivity is decreased at night in comparison to midafternoon
      in healthy subjects and that in insulin-dependent diabetes mellitus patients this
      phenomenon is exaggerated, even in patients with defective counterregulation to
      hypoglycemia.

PMID- 1618998
TI  - Measurement of derivatives of proinsulin-like growth factor-II in serum by a
      radioimmunoassay directed against the E-domain in normal subjects and patients
      with nonislet cell tumor hypoglycemia.
AB  - We describe a modified RIA using a rabbit polyclonal antiserum directed against
      the first 21 amino acids of the E-domain (E-21) of proinsulin-like growth factor
      II (pro-IGF-II). For standardization, we purified big IGF-II from patients with
      nonislet cell tumor hypoglycemia (NICTH). Under the conditions of our assay there
      was no significant interference from IGF-binding proteins. The big IGF-II present
      in the serum of a patient with NICTH displaced [125I]E-(1-21) from antibody
      parallel to our big IGF-II standard. We found a progressive rise in E-21
      immunoactivity (IA) during childhood, with somewhat higher values in girls than
      in boys. In normal adults the mean E-21 IA level was 138 +/- 49 (+/- SD)
      micrograms/L. Women with twin pregnancies had higher E-21 IA than women with
      single pregnancies (302 +/- 66 compared with 120 +/- 18 micrograms/L). We found a
      marked elevation of E-21 IA in patients with NICTH due to sarcomas (n = 3),
      hepatoma (n = 2), adrenal carcinoma (n = 1), and carcinoma of the lung (n = 1).
      No elevation of E-21 IA was present in the serum of a hypoglycemic patient with a
      hypernephroma or another patient with carcinoma of the lung. Marked elevation of
      E-21 IA was observed in the serum of patients with renal failure receiving
      chronic hemodialysis. We conclude that this assay will prove useful in the
      diagnosis of NICTH in patients who are not azotemic and the investigation of the
      role of the kidney in clearing products of pro-IGF-II processing.

PMID- 1618999
TI  - Effects of thyroid hormone on sex hormone-binding globulin gene expression in
      human cells.
AB  - We have used a human hepatoblastoma cell line to establish a model system for
      thyroid hormone (T3) action in human cells. HepG2 cells were grown for 3 days in
      Dulbecco's Modified Eagle's Medium containing fetal calf serum and were
      maintained in serum-free medium for experimental manipulations. [125I]T3
      incubated with cells was bound by newly secreted protein and degraded. After 24-h
      exposure to HepG2 cells in Dulbecco's Modified Eagle's Medium, only 35-40% of the
      radioactivity was recovered as authentic T3. Degradation of hormone was neither
      time nor concentration dependent, and occurred to a greater degree in the absence
      of cells, suggesting an interaction between the hormone and the plastic culture
      dish. After 4 days, in the absence of fetal calf serum and considering hormone
      binding and degradation, the concentration of free T3 available to cells was
      approximately 15% of that added initially. Sex hormone-binding globulin (SHBG)
      was secreted by HepG2 cells in the absence of T3 and was specifically stimulated
      by the addition of T3. After 4 days, maximum stimulation occurred with added T3
      concentrations of 10(-8) M or greater, and half-maximal stimulation of SHBG
      secretion was observed at about 3 x 10(-11) M free T3. No significant changes in
      total secreted protein or cellular DNA content were observed under similar
      conditions. Northern analysis of RNA extracted from HepG2 cells revealed a SHBG
      mRNA of 2 kilobases, which was stimulated in a dose-responsive manner by T3. No
      stimulation of corticosteroid-binding globulin mRNA was seen. Stimulation of the
      SHBG gene in HepG2 cells may be a useful model for investigation of T3 action in
      human cells.

PMID- 1619000
TI  - Circadian rhythm abnormalities in totally blind people: incidence and clinical
      significance.
AB  - When people are completely isolated from environmental time cues, their circadian
      rhythms free run with a nearly 24-h cycle, generated by an internal body clock.
      Free-running temperature, cortisol, and melatonin rhythms have also been
      described in totally blind people, even though they were living in normal society
      and had access to abundant time cues; thus an intact visual system may be
      essential for synchronization of the circadian system. However, because of the
      small numbers of subjects studied, the incidence and clinical significance of
      circadian rhythm abnormalities among the blind has remained uncertain. In this
      study, plasma melatonin (n = 20), cortisol (n = 4), and sleep propensity (n = 1)
      were measured in serial samples taken from totally blind subjects for 24 h. Most
      totally blind subjects had circadian rhythm abnormalities. In about half of the
      subjects, the rhythms were free-running. Some blind subjects suffered recurrent
      insomnia and daytime sleepiness that were maximal when the internal rhythms were
      out of phase with the preferred sleep times. The high incidence of abnormal
      circadian rhythms in blind people underscores the importance of the light-dark
      cycle as an important environmental synchronizer for the human circadian system.

PMID- 1619001
TI  - Genetic variation of human sex hormone-binding globulin: evidence for a worldwide
      bi-allelic gene.
AB  - Genetic variation of human sex hormone-binding globulin (SHBG) has been
      investigated on 1690 unrelated neuraminidase-treated serum samples using
      isoelectric focusing followed by transfer to nitrocellulose membranes and
      immunostaining. Three clearly distinct isoelectric focusing patterns, consistent
      with the expression of an autosomal genetic system, were identified. Using allele
      frequencies, calculated on the basis of a bi-allelic gene, an excellent agreement
      between observed and expected phenotype numbers was obtained in every examined
      population sample. Family data along with the observed distribution of the three
      SHBG phenotypes among racially different groups and sexes indicate that SHBG is
      worldwide encoded by two autosomal codominant alleles. Compared with healthy
      Belgian blood donors no statistically significant differences were noted for the
      allele frequencies among 399 patients and 70 hirsute women of Belgian origin.
      Evidence is also presented that the subunit produced by the variant allele
      (SHBG2) has a higher molecular mass than the one produced by the regular allele
      (SHBG1) and that the three SHBG genotypes have identical binding characteristics
      for 5 alpha-dihydrotestosterone.

PMID- 1619002
TI  - Effects of triiodothyronine (T3) and identification of specific nuclear T3
      binding sites in cultured human fetal epiphyseal chondrocytes.
AB  - The effects of T3 on cultured human fetal epiphyseal chondrocytes were assessed
      by studying its effects on DNA synthesis and alkaline phosphatase activity. DNA
      synthesis was evaluated as follows: after 48-h incubation in Ham's F-12 serum
      free medium, cultured chondrocytes were incubated with or without T3 (0.1-100 nM)
      in MCDB-104 serum-free medium for different periods of time (2-10 days), with the
      addition of [3H]thymidine (5 microCi/mL) for the last 24 h. Confluent cultured
      chondrocytes in 25-cm2 tissue culture flasks were incubated in Ham's F-12 serum
      free medium for up to 9 days with or without T3 (0.1-100 nM); the cellular
      cytoplasmic fraction was obtained, and alkaline phosphatase activity was
      evaluated using paranitrophenylphosphate as a substrate. No significant effects
      of T3 (0.1-100 nM) on DNA-[3H]thymidine incorporation were observed in any
      experiment (n = 17) for any gestational age (12-39 weeks) or for any incubation
      period studied (2-10 days). However, a significant (P less than 0.025 or more)
      stimulatory effect of T3 (0.1-100 nM) on alkaline phosphatase activity was
      observed after 9 days of incubation. This effect was highest for 5 nM T3 and was
      present in cultured chondrocytes from human fetuses of all ages studied (13-40
      weeks). Cultured human fetal epiphyseal chondrocytes from human fetuses 12-40
      weeks old (n = 8) showed specific nuclear binding sites for T3. The binding
      capacity was 27.14 +/- 2.84 fmol/100 micrograms DNA, and the Kd was 0.66 +/- 0.14
      x 0.1 nM (mean +/- SEM), with no significant differences among fetal ages. In
      conclusion, our results show that T3 elicits a biological response in cultured
      human fetal epiphyseal chondrocytes and has specific nuclear binding sites. Since
      alkaline phosphatase is closely related to the mineralization of epiphyseal
      cartilage, these results suggest that thyroid hormones could regulate this
      process.

PMID- 1619003
TI  - Intact parathyroid hormone overestimates the presence and severity of parathyroid
      mediated osseous abnormalities in uremia.
AB  - To examine the possibility that uremia alters the relationship between bioactive
      PTH serum concentrations and its osseous end-organ response, we evaluated the
      relationship between circulating intact PTH and bone turnover in 39 end-stage
      renal disease patients with hyperparathyroid-mediated bone disease of varying
      severity. We excluded from analysis patients with coexistent defects in
      mineralization to insure that bone remodeling indices primarily reflected the
      effects of PTH. The distribution of serum PTH levels ranged from normal to
      markedly elevated. Regression analysis between circulating intact PTH
      concentrations, measured by a two-site immunoradiometric assay, and osseous
      indices of hyperparathyroidism, determined by quantitative bone histological
      analysis of iliac crest bone biopsies, showed that bioactive serum PTH levels
      correlated linearly with bone formation (r = 0.836), woven osteoid volume (r =
      0.718), and marrow fibrosis (r = 0.856), and nonlinearly with parameters of bone
      resorption (r = 0.760). From these functional relationships, we found that the
      average serum intact PTH level of approximately 165 pg/mL, a value that exceeds
      the upper limit of intact PTH in nonuremic subjects (65 pg/mL) by 2.5-fold,
      defines the upper normal limit of bone turnover in uremic subjects. Indeed, the
      average serum PTH concentrations reached 500 pg/mL before histological evidence
      of severe hyperparathyroidism developed in uremic subjects. These findings
      demonstrate that elevated PTH concentrations are necessary to maintain normal
      bone remodeling in the uremic setting. Consequently, it may not be necessary to
      attain normal serum intact PTH levels to control the osseous manifestations of
      PTH excess in uremic subjects.

PMID- 1619004
TI  - Effects of systemic growth hormone (GH) administration on regional adipose tissue
      in children with non-GH-deficient short stature.
AB  - Chronic administration of exogenous GH to GH-deficient children is associated
      with a selective depletion of the abdominal sc fat depot and a resultant relative
      increase in gluteal, relative to abdominal, adipocyte lipid content. In GH
      deficient children, the degree of this change in relative lipid content per
      adipocyte appears to be correlated with decreases in sensitivity of abdominal
      subcutaneous fat to the antilipolytic action of insulin. We studied abdominal and
      gluteal sc adipose tissue from 10 children with short stature (height less than
      5% ile, growth velocity less than 5 cm/yr, bone age delayed at least 2 yr), who
      were not GH deficient based upon provocative testing (non-GH-deficient short
      stature) 1) before beginning and 2) after 3 months of therapy with exogenous GH
      (Humatrope, 0.1 mg/kg sc 3 times/week). In abdominal and gluteal adipocytes, we
      measured lipid content, rates of reesterification of fatty acids released by
      ongoing lipolysis and rates of in vitro lipolysis and lipogenesis in response to
      insulin, adenosine, and various adrenoreceptor agonists. These biochemical
      measures were correlated with measures of statural growth and adipose tissue
      distribution in each subject. We found that GH therapy was associated with a
      significant reduction in abdominal adipocyte size (0.48 microgram +/- 0.08 lipid
      per cell prior to therapy vs. 0.43 microgram +/- 0.08 lipid per cell after
      therapy, P less than 0.05) and a significant increase in responsiveness of
      gluteal sc adipose tissue to the lipogenic actions of insulin. The significant
      correlations of changes in abdominal adipocyte volume with changes in regional
      adipose tissue insulin sensitivity that were noted in GH-deficient children were
      not noted in this subject population, perhaps due to effects of endogenous GH on
      pretreatment insulin responsiveness of adipose tissue. These data reaffirm that
      GH has site-specific effects on regional adipose tissue depots.

PMID- 1619005
TI  - Effect of low and high intensity exercise on circulating growth hormone in men.
AB  - We hypothesized that circulating GH would increase only if a threshold of work
      intensity [corresponding to the anaerobic or lactate threshold (LT)] was
      exceeded. Ten healthy male volunteers (18-35 yr) first performed ramp-type
      progressive cycle-ergometer exercise to determine the LT and the maximal oxygen
      uptake. On subsequent mornings after an overnight fast, each subject performed
      bouts of 1, 5, and 10 min constant work rate exercise of either high intensity
      (above LT) or low intensity (below LT). A 1-h interval separated exercise bouts.
      Gas exchange (breath-by-breath), GH, immunoreactive insulin, glucose, lactate,
      pyruvate, and epinephrine and norepinephrine were measured at regular intervals.
      After the 10-min bouts of high compared with low intensity exercise, lactate was
      7.2 +/- 3.7 mmol/L vs. 1.4 +/- 1.3, P less than 0.05; epinephrine was 1,113 +/-
      519 pmol/L vs. 496 +/- 273, P less than 0.05; and norepinephrine was 7.89 +/-
      3.45 nmole/L vs. 2.83 +/- 1.34, P less than 0.05. GH did not increase
      significantly from preexercise baseline during low intensity exercise (e.g., GH
      after 10-min low intensity exercise changed from baseline values by 1.5 +/- 2.0
      micrograms/L, NS). Although lactate was elevated after 5-min of high intensity
      exercise, peak GH was significantly elevated (mean increase above baseline of 7.7
      +/- 2.4 micrograms/L, P less than 0.05) only after 10 min of high intensity
      exercise (increases in 9 of 10 subjects). The GH increase occurred despite
      simultaneous increases in both IRI and glucose. A minimum duration of 10 min,
      high intensity exercise consistently increased circulating GH in adult males.

PMID- 1619006
TI  - A randomized comparison of intranasal and injectable octreotide administration in
      patients with acromegaly.
AB  - Fifteen acromegalic patients received four single doses of octreotide in random
      order (500 micrograms, 1000 micrograms, and 2000 micrograms applied intranasally
      and 100 micrograms given sc). Serum octreotide and GH data were subjected to
      pharmacokinetic analyses, and local nasal effects were evaluated by acoustic
      rhinometry. Average areas (+/- SEM) under the serum octreotide curves were: 2000
      micrograms: 4597 +/- 536; 1000 micrograms: 1923 +/- 439; 500 micrograms: 957 +/-
      168; and 100 micrograms sc: 896 +/- 81 micrograms.L-1.min (n = 13). The
      calculated relative availability was 27% +/- 0.03; 22% +/- 0.05; 22% +/- 0.03,
      respectively, for the three nasal doses. The rate of absorption after
      intranasally administered octreotide was greater than after sc application: t1/2
      ka: 7.1 +/- 1.6; 7.9 +/- 1.6; 11.3 +/- 1.9, respectively, vs. 24.1 +/- 2.5 min,
      whereas the rates of disappearance were similar. GH suppression started
      immediately after application and reached minimum levels 1-2 h later. The average
      intervals during which serum GH was below 50% of preadministration values were:
      2000 micrograms: 544 +/- 47; 1000 micrograms: 423 +/- 56; 500 micrograms: 289 +/-
      52 vs. 351 +/- 34 min after sc injection of 100 micrograms. With 2000 micrograms
      intranasally all but one of the 15 patients attained constant suppression of
      serum GH below 5 micrograms/L for 273 to 680 min. Pharmacokinetic analysis
      demonstrated that 100 micrograms sc and 1000 micrograms intranasally induced the
      same GH suppressive effect and that 2000 micrograms intranasally approximately
      doubled the duration of action. Acoustic rhinometry was performed after nasal
      application of the largest dose of 2000 micrograms and after carrier (n = 9). A
      highly significant tumescence of the nasal mucosa was maximal after 10 min and
      gradually receded over the next 2 h. However, this was felt by the patients to be
      acceptable. The effect was caused by octreotide per se and was probably due to
      vasodilation.

PMID- 1619007
TI  - Effect of body mass index and fat distribution on insulin sensitivity, secretion,
      and clearance in nonobese healthy men.
AB  - The effects of variation in body mass index (BMI; kg/m2) and body fat topography
      on insulin sensitivity, secretion, and clearance were determined in a group of
      146 nonobese nondiabetic males. Volunteers underwent an i.v. glucose tolerance
      test, with determination of plasma glucose, insulin, and C-peptide levels. BMI
      was taken as a measure of overall adiposity, while skinfold thickness ratios were
      used to assess the centrality of fat distribution and the localization of central
      fat within the trunk. Measurements of insulin sensitivity, secretion, and
      clearance were obtained by mathematical modelling of the i.v. glucose tolerance
      test concentration profiles. Increasing BMI and centrality of fat distribution
      had no significant effect on glucose tolerance, but were independently associated
      with diminished insulin sensitivity and increased insulin secretion. The
      elevation in secretion occurred almost entirely during the second phase of
      pancreatic insulin release. These results show that the variations in insulin
      sensitivity and secretion that have often been reported in obesity are also
      present in a group within the normal range of BMI. However, the absence of any
      decrease in hepatic uptake, also reported in the obese, indicates that this might
      be an additional mechanism recruited to maintain glycemic control at higher
      levels of adiposity. Localization of central fat in the lower trunk was
      correlated with elevated first phase insulin secretion, but no concomitant change
      in insulin sensitivity. There may, therefore, be a direct effect of the
      distribution of central fat on insulin secretion.

PMID- 1619008
TI  - Growth hormone and insulin-like growth factor-I stimulate hormonal function and
      proliferation of thymic epithelial cells.
AB  - We have investigated the role of GH and insulin-like growth factor-I (IGF-I) in
      controlling the secretion of thymulin, a hormone produced by thymic epithelial
      cells (TEC). Thymulin plasma concentrations (mean +/- SD) were increased in 21
      patients with acromegaly compared to those in 30 controls, as assessed by
      bioassay (4.24 +/- 0.97 vs. 2.67 +/- 0.87; P less than 0.001) and RIA (561 +/-
      241 vs. 315 +/- 113 pg/L; P less than 0.01). Good correlations were observed
      between plasma levels of thymulin and IGF-I (P less than 0.001). In vitro
      experiments demonstrated that both recombinant human GH and IGF-I significantly
      increased thymulin production in culture supernatants of normal human TEC and a
      rat TEC line. In parallel, IGF-I also significantly stimulated the proliferation
      of human TEC, as measured by bromodeoxyuridine incorporation. Additionally, the
      stimulatory effect of GH on thymulin production was abrogated by both an anti-IGF
      I antibody and an anti-IGF-I receptor antibody. These results support a role for
      GH and IGF-I in the control of thymic hormonal function in man and suggest that
      the effect of GH may be mediated by local secretion of IGF-I within the thymus.

PMID- 1619009
TI  - A radioimmunoassay for measurement of 3,5,3'-triiodothyronine sulfate: studies in
      thyroidal and nonthyroidal diseases, pregnancy, and neonatal life.
AB  - A highly sensitive, specific, and reproducible RIA has been developed to measure
      T3 sulfate (T3S). Only T4 sulfate cross-reacted significantly (approximately 3%)
      in the RIA; rT3 sulfate, T4, T3, rT3, and diiodothyronine cross-reacted less than
      0.01%. T3S was bound by thyronine-binding globulin and albumin in serum. The free
      fraction of T3S in four normal sera averaged 0.25% compared to a value of 0.35%
      for T3. Therefore, T3S was measured in ethanol extracts of serum. Recovery of the
      nonradioactive T3S added to serum averaged 92%. The dose-response curves of
      inhibition of binding of [125I]T3S to anti-T3S antibody by serial dilutions of
      serum extracts were essentially parallel to the standard curve. The detection
      threshold of the RIA was 20 pmol/L (1.5 ng/dL). The coefficient of variation
      averaged 7.8% within an assay and 11% between assays. The serum concentration of
      T3S was (mean +/- SE) 76 +/- 7.2 pmol/L in normal subjects, 268 +/- 29 in
      hyperthyroid patients with Graves' disease, 92 +/- 28 in hypothyroid patients,
      201 +/- 32 in patients with systemic nonthyroidal illnesses, 40 +/- 6.2 in
      pregnant women (15-31 weeks gestation), and 429 +/- 39 in cord sera of newborns;
      the values in hyperthyroidism, nonthyroidal illnesses, and newborns were
      significantly different from normal (P less than 0.01). The mean concentration of
      T3S in amniotic fluid samples at 15-31 weeks gestation (90 +/- 1.3 pmol/L) was
      significantly higher than the corresponding value in maternal serum (P less than
      0.05) and significantly lower than the corresponding value in newborn cord blood
      serum (P less than 0.001). Oral administration of sodium ipodate (Oragrafin; 3 g)
      to two hyperthyroid patients was associated with a 76-190% increase in serum T3S
      at 8 h, followed by a gradual decrease to a nadir that was 25-60% of the baseline
      value 2-3 days after ipodate ingestion. We conclude that 1) T3S is a normal
      component of human serum, and its levels change substantially in several
      physiological and pathological conditions; 2) sulfation pathway plays an
      important role in the metabolism of iodothyronines in man; and 3) high serum T3S
      levels in newborns and low normal levels in pregnancy despite elevated thyronine
      binding globulin levels may signify markedly different metabolism of T3S in the
      mother and fetus.

PMID- 1619010
TI  - Measurement of estradiol-17-fatty acid esters in human tissues.
AB  - We have developed a gas chromatographic/mass spectral method for the sensitive
      and reproducible measurement of estradiol-17-fatty acid esters in human tissues
      and blood. To provide an internal standard for quantification, a trideuterated
      analog of a representative estradiol ester is added to the tissues. Estradiol
      (E2) released from the nonpolar ester fraction by alkaline hydrolysis is
      derivatized to form the ditrimethylsilyl ether and then analyzed by gas
      chromatographic/mass spectral, monitoring the molecular ions mass per U charge of
      the ditrimethylsilyl derivative of E2 and [2H3]E2. There are low but detectable
      levels of E2 ester in the blood of cycling females; there are none in urine.
      While the E2 ester is present in breast cyst fluid, its concentration, 77-140
      pmol/L, is considerably less than E2, 110-2,863 pmol/L. But there is a large
      amount of E2 ester in fat. In premenopausal women the average E2 ester in fat (sc
      and omental) is 957 +/- 283 38 fmol/g (SEM); in women who are menopausal less
      than 12 yr, the E2 ester in fat is 669 +/- 158 fmol/g; in women who are
      menopausal at least 15 yr, the fat level is 399 +/- 146 fmol/g. Muscle from the
      same women have lower concentrations of the ester; in 8 out of 12 muscle
      specimens it was not detectable. The E2 esters are extremely potent estrogens.
      Although they are hormonally active they require enzymatic hydrolysis to exert
      their hormonal action. These studies show that these long chain esters of E2 are
      sequestered in fatty tissues, wherein they represent a protected store of
      preformed hormone. Under the proper stimulation, adipose tissue can activate the
      estrogenic signal through the action of hormonally sensitive esterases. Thus,
      through signaling between estrogen sensitive tissues and neighboring fat cells, a
      local paracrine loop may exist.

PMID- 1619012
TI  - A point mutation in the 3,5,3'-triiodothyronine-binding domain of thyroid hormone
      receptor-beta associated with a family with generalized resistance to thyroid
      hormone.
AB  - A tight linkage between generalized resistance to thyroid hormone (GRTH) and the
      thyroid hormone receptor-beta (TR beta) gene is indicated. We evaluated a family
      with GRTH for the TR beta gene. We found that a new point mutation, consisting of
      a cytosine to adenine replacement at nucleotide position 1642, resulted in
      substitution in codon 448 in the T3-binding domain of TR beta. This base
      substitution was found in only one allele of affected members, but not in
      unaffected members of the family. The in vitro translation products of this
      mutant TR beta gene demonstrated significantly reduced T3-binding affinity.
      Previously, others have reported a kindred with GRTH, in that the same codon was
      subjected to proline to histidine replacement due to a mutation consisting of a
      cytosine to adenine replacement at nucleotide position 1643. There appeared to be
      a significant phenotypic difference between our kindred and that described by
      others.

PMID- 1619011
TI  - Thyrotoxicosis after needle aspiration of thyroid cyst.
AB  - We report a new type of thyrotoxicosis (postaspiration thyrotoxicosis) that
      occurred after needle aspiration of thyroid cysts. In a retrospective study five
      patients with thyroid cysts developed transient thyrotoxicosis without
      significant symptoms of hyperthyroidism after needle aspiration. These patients
      had elevated serum thyroid hormone levels with suppressed serum TSH and thyroid
      radioiodine uptake. The thyroid hormone content in the cystic fluid was greater
      in patients who developed thyrotoxicosis than in patients who did not. In a
      prospective study we examined thyroid function tests after needle aspiration in
      52 consecutive patients with thyroid cysts and 63 patients with solid thyroid
      nodules and confirmed an occurrence of postaspiration thyrotoxicosis in a patient
      with thyroid cyst. Our observation indicates that postaspiration thyrotoxicosis
      occurs only in patients with thyroid cyst and that the incidence of this disorder
      is probably less than 1% of patients who undergo thyroid needle aspiration.
      Although the exact mechanism of elevated serum hormone levels is unknown, an
      inflammatory process after needle aspiration might have triggered the release of
      thyroid hormone.

PMID- 1619013
TI  - Tyrosine kinase activity of skeletal muscle during insulin infusion in humans.
AB  - Insulin receptor tyrosine kinase is stimulated by insulin in vivo, and this
      provides a mechanism by which the signal from insulin is transmitted into target
      cells. This study examined the time course of the in vivo activation of the
      kinase. Five nondiabetic Pima Indians had a euglycemic clamp at an insulin dose
      of 600 mU/min.m2, resulting in plasma insulin concentrations of about 15 nM by 30
      min. Percutaneous muscle biopsies were taken from the vastus lateralis before and
      at regular intervals during insulin infusion, and the in vivo and in vitro
      tyrosine kinase activities were measured. There was a rapid in vivo activation of
      the kinase, detectable at less than 10 min and reaching a maximum within 30 min
      of insulin infusion. The time course of in vivo kinase activity, plasma insulin
      concentrations, and insulin-mediated glucose disposal rates displayed parallel
      patterns, indicating close interrelationships among these variables. The insulin
      concentration at which the kinase activity was maximal was about 10 nM both in
      vivo and in vitro. In vitro, however, this maximum increased with the degree of
      the kinase activation in vivo, indicating that the kinase potential in vitro is
      dependent on previous insulin exposure in vivo. We conclude that in vivo
      activation of the insulin receptor tyrosine kinase in human skeletal muscle is a
      rapid process, related to insulin action on glucose disposal, and that
      circulating insulin primes inactive insulin receptor molecules for subsequent
      tyrosine kinase activation by a mechanism that remains to be elucidated.

PMID- 1619014
TI  - Postparathyroidectomy transient thyrotoxicosis.
AB  - Three patients are described who had spontaneously resolving transient
      thyrotoxicosis after resection of a parathyroid adenoma without thyroidectomy or
      an apparent thyroid abnormality before or during surgery. All had documented
      thyrotoxicosis that developed within 2 weeks after surgery, which was clinically
      symptomatic in two of three patients. The thyrotoxicosis was associated with
      subnormal radioactive iodine thyroid uptake when performed in the two symptomatic
      patients and was consistent with a postsurgical inflammatory etiology secondary
      to thyroid gland trauma during parathyroidectomy. In all patients, the clinical
      and biochemical evidence of thyrotoxicosis resolved within 2 months.
      Antithyroglobulin and antimicrosomal antibodies were not detected in the two
      patients who had a complete recovery 3 months after surgery. However, in the
      patient who had autoimmune thyroiditis, hyperthyroidism due to Graves' disease
      subsequently developed 19 months after parathyroidectomy and was associated with
      increasing titers of antithyroglobulin and antimicrosomal thyroidal
      autoantibodies. From these observations, we conclude that 1) spontaneously
      resolving transient thyrotoxicosis of varying severity may occur in some patients
      after parathyroidectomy, which could be secondary to intraoperative thyroid gland
      manipulation, and 2) while the occurrence of subsequent Graves' hyperthyroidism
      in a patient with underlying autoimmune thyroiditis may have been a coincidence,
      this observation also raises the possibility that thyroidal autoantigen released
      during parathyroidectomy may trigger the reactivation of autoimmune thyroid
      disease in a predisposed subject.

PMID- 1619015
TI  - Reversal of diet-induced catabolism by infusion of recombinant insulin-like
      growth factor-I in humans.
AB  - Treatment of catabolic conditions with insulin-like growth factor I (IGF-I), the
      peptide that mediates some of the anabolic growth-promoting effects of GH, offers
      potential advantages of avoiding the hyperglycemia caused by treatment with GH. A
      state of moderate catabolism was produced in six normal, young adult volunteers
      by restricting their daily dietary intake to 20 kilocalories/kg/day. During the
      last 6 days of two 2-week diet-study periods, they received either IGF-I (12
      micrograms/kg/h by i.v. infusion over 16 h) or GH (0.05 mg/kg/day by sc
      injection). IGF-I improved nitrogen balance from -236 +/- 45 mmol/day (+/- SE)
      during diet alone, to -65 +/- 40 mmol/day (P less than 0.001) during the last 4
      days of IGF-I infusion. A similar effect was produced by GH. IGF-I infusion
      decreased fasting blood glucose from 4.94 +/- 0.91 mmol/L to 3.13 +/- 0.44 mmol/L
      (P less than 0.001), while GH raised blood glucose values (4.75 +/- 1.01 mmol/L
      on diet alone, to 5.48 +/- 1.00 during the period of GH treatment; P less than
      0.05). Despite these differences in blood glucose, IGF-I infusions decreased
      serum insulin (74.9 +/- 26.8 pmol/L on diet alone, to 16.7 +/- 1.5 pmol/L during
      IGF-I) and serum connecting-peptide concentrations (2.14 +/- 0.89 mmol/L on diet
      alone, to 0.97 +/- 0.14 during IGF-I), while GH raised insulin (109.4 +/- 31.3
      pmol/L, P less than 0.05 during GH) and connecting-peptide (3.12 +/- 0.59 mmol/L,
      P less than 0.02). At the dose of each hormone used, the attenuation of nitrogen
      wasting produced by infusions of IGF-I was similar in magnitude and timing to
      that produced by injections of GH. The reduction in serum glucose concentrations
      produced by IGF-I compared with the increase in glucose noted during GH
      treatment, could benefit hyperglycemic catabolic patients.

PMID- 1619016
TI  - Sinus node function in hyperthyroid patients.
AB  - We have studied the electrophysiology of the sinus node and the role of the
      autonomic nervous system on sinus node function in 8 thyrotoxic patients of both
      sexes, 37.5 +/- 4.3 (mean +/- SE) yr old. The resting heart rate (RHR), the sino
      atrial conduction time (SACT), and the sinus node recovery time (SNRT) were
      measured in the untreated condition (basal), after sympathetic blockade with
      propranolol 0.2 mg/kg body weight (BW) i.v. infusion, and after complete
      autonomic blockade with the additional administration of atropine 0.04 mg/kg BW
      i.v. bolus. 1) In the thyrotoxic patients the RHR was higher [117 +/- 6 beats per
      min (bpm)] than in 20 normal subjects (73 +/- 1 bpm, P less than 0.001), whereas
      the SACT and SNRT values were not different. 2) After sympathetic blockade with
      propranolol, the RHR decrement and SACT increase were greater in the hyperthyroid
      patients than in normal subjects, whereas there was no difference in SNRT values
      between the two groups. 3) In the thyrotoxic patients the complete autonomic
      blockade reestablished the electrophysiological parameters to values similar to
      those observed in basal condition. In conclusion, in thyrotoxic patients the
      intrinsic activity of the sinus node is increased. It appears that this is a
      direct consequence of thyroid hormone excess, rather than an effect of extrinsic
      influences exerted by the autonomic nervous system on sinus node activity.

PMID- 1619017
TI  - Maternal side effects of prenatal dexamethasone therapy for fetal congenital
      adrenal hyperplasia.
AB  - Prenatal treatment of virilizing congenital adrenal hyperplasia in female fetuses
      via maternal dexamethasone (Dex) therapy (1-1.5 mg/day) from first trimester to
      birth was associated with excessive weight gain (47-56 pounds at 35-37 weeks
      gestation), Cushingoid facial features, severe striae resulting in permanent
      scarring, and hyperglycemic response (8-11.7 nmol/L) to oral glucose
      administration in all our experience (three cases). Other symptoms included
      hypertension, gastrointestinal intolerance, or extreme irritability. Previous
      pregnancies were uncomplicated by these problems. In each case, first or second
      trimester amniotic fluid 17-hydroxyprogesterone (17OHP, 17-41 nmol/L; normal less
      than 0.4 nmol/L), androstenedione (22-31 nmol/L, normal less than 5 nmol/L), and
      testosterone levels (0.54-0.7 nmol/L, normal less than 0.4 nmol/L) during Dex
      treatment were elevated regardless of the newborn genital outcome. Maternal serum
      estriol (E3) levels in one mother (normal newborn genitalia) were consistently
      low (less than 0.2 nmol/L) during the second and third trimester. In two mothers
      (partially virilized newborn genitalia) initial second trimester E3 levels were
      unsuppressed (11, 17.4 nmol/L) and suppressed (less than 1.4 nmol/L) following
      short-term increased dose. CONCLUSION: prenatal Dex treatment of virilizing
      congenital adrenal hyperplasia at a dose of 1-1.5 mg daily throughout gestation
      is associated with significant maternal side effects. Parents should be informed
      of these side effects before initiation of treatment. Careful monitoring for
      signs of side effects, medical intervention when necessary, and lowering of Dex
      dose during the second half of gestation would minimize the side effects.
      Maternal serum E3 levels appear useful for prediction of fetal outcome while
      amniotic fluid steroid levels may not.

PMID- 1619018
TI  - Persistence of impaired insulin secretion in infant rhesus monkeys that had been
      hyperinsulinemic in utero.
AB  - Chronic in utero hyperinsulinemia in the fetal rhesus monkey produces a number of
      changes in the fetus that are similar to those found in the human infant of the
      diabetic mother, including macrosomia, selective organomegaly, and altered
      insulin secretion during the neonatal period. The chronically hyperinsulinemic
      fetal rhesus model has been used to test the hypothesis that the effects of
      chronic hyperinsulinemia persist beyond the neonatal period into later life and
      may, in part, be responsible for the increased prevalence of impaired glucose
      tolerance or diabetes found in the human infant of the diabetic mother. We report
      that infant rhesus monkeys that had plasma insulin concentrations of
      approximately 10 times basal levels (2176 +/- 808 pmol compared to 172 +/- 101
      pmol) exhibited reduced insulin secretion during the first 5 months of life. The
      integrated incremental change in plasma insulin and immunoreactive C-peptide
      (IRCP) concentration was significantly reduced by approximately 50% in response
      to i.v. glucose, arginine, and tolbutamide when given at 3, 4, and 5 months of
      age. The response to glucagon at 2 months of age was equivocal with a
      significantly reduced insulin response but without the corresponding IRCP
      reduction. There was no difference between groups in insulin sensitivity as
      measured at 6 months of age by an i.v. insulin tolerance test. The glucagon and
      glucose tolerance tests were repeated annually in both groups until the animals
      were 3 yr of age with no differences in insulin or IRCP secretion being observed.
      We conclude that chronic in utero euglycemic hyperinsulinemia results in impaired
      insulin secretion that persists beyond the neonatal period.

PMID- 1619019
TI  - Treatment of macroprolactinomas with the long-acting and repeatable form of
      bromocriptine: a report on 29 cases.
AB  - Twenty-nine patients with macroprolactinomas were treated by monthly
      intramuscular injections of the long-acting and repeatable form of bromocriptine
      (Parlodel-LAR) in doses ranging from 50-150 mg. They were divided into two
      groups: group I consisted of 22 patients who received Parlodel LAR before
      transsphenoidal adenomectomy; group II was composed of 7 patients with earlier
      neurosurgery and of 2 patients from group I not cured by transsphenoidal
      adenomectomy. Duration of therapy varied from 1-12 months, and a total of 104
      injections was given. At nadir day, serum PRL levels were situated between less
      than 1% and 43% of pretreatment values. At day 28 after the first injection,
      serum PRL levels varied between less than 1% to 139% of initial values. No
      difference could be detected between the two groups regarding the percent of PRL
      inhibition. Long-term treatment with Parlodel-LAR resulted in a sustained
      inhibition of PRL secretion, except for 1 case. Resumption of menstrual cycles
      occurred in 4 out of 15 women and correction of hypogonadism in 4 out of 14 men.
      Amelioration of disturbed visual fields was recorded in 3 out of 8 patients.
      Diminution of the adenoma volume was radiologically documented in 14 out of 22
      cases. Only few and mild side effects were recorded. One patient with partial
      adrenal deficiency suffered from a syncope, but this was prevented by
      hydrocortisone supplementation during the subsequent Parlodel-LAR administration.
      In conclusion, Parlodel-LAR proved effective in the treatment of
      macroprolactinomas, achieving rapid inhibition of PRL secretion, and in some
      patients amelioration of hypopituitarism, reduction in tumor size, and
      improvement in visual fields, and caused no serious side effects. It is a
      valuable preparation to surgery and can also be used in long-term medical
      therapy.

PMID- 1619020
TI  - Growth hormone-releasing hormone-like messenger ribonucleic acid and
      immunoreactive peptide are present in human testis and placenta.
AB  - Although the sequence of human GH-releasing hormone (GHRH) has been determined,
      all of the information concerning gene expression has been based on pathological
      sources of ectopic GHRH, since the only established physiological source of GHRH
      in humans is the hypothalamus. We recently reported the presence of
      extrahypothalamic GHRH-like mRNA and immunoreactive material in rat testis and
      placenta. To determine if human testis and placenta also contain immunoreactive
      GHRH-like peptides, tissue extracts were analyzed using enzyme-linked
      immunosorbent assay methodology. Both tissues had detectable quantities of
      immunoreactive peptide recognized by a monoclonal antibody to synthetic human
      GHRH-(1-44) (testis, 2.4 ng/g tissue, 0.68 ng/mg protein; placenta, 2.6 ng/g
      tissue, 0.36 ng/mg protein). The origin of these peptides was confirmed by
      extracting total RNA from human testis and placenta, with analysis on Northern
      blots probed with riboprobes for rat hypothalamic GHRH cDNA and human pancreatic
      tumor GHRH cDNA. Human testis and placenta total RNA both contain an
      approximately 790-nucleotide RNA species similar in size to that reported in
      ectopic GHRH-producing human tumors. In addition, two larger hybridization
      signals were seen at 3000 and 4900 nucleotides. These data suggest that testis
      and placenta are extrahypothalamic sites of expression of the human GHRH gene.
      Normal expression of the GHRH gene in extrahypothalamic sites may include
      transcription of larger mRNA species than those observed in ectopic pathological
      sources of GHRH expression.

PMID- 1619021
TI  - Body fat distribution and peripheral insulin sensitivity in healthy men: role of
      insulin pulsatility.
AB  - Abdominal fat distribution is associated with insulin resistance in healthy young
      men. Factors modulating this phenomenon remain unclear. Pulsatile insulin release
      has been implicated as a potential regulator of insulin action. The relationship
      of pulsatility of peripheral insulin levels to fat distribution and peripheral
      insulin sensitivity was examined in 10 healthy men. Fat distribution was
      determined by the waist to hip ratio. Peripheral insulin sensitivity was assessed
      by the euglycemic clamp at an insulin infusion rate of 287 pmol/min.m2.
      Pulsatility of insulin was assessed by sampling every 2 min for 90 min in the
      basal state. The characteristics of insulin pulses were assessed by the computer
      program Pulsar. The waist to hip ratio was negatively associated with insulin
      sensitivity (r = -0.70, P less than 0.05) and insulin pulse interval (r = -0.66,
      P less than 0.05). The insulin pulse interval was positively correlated with
      peripheral insulin sensitivity (r = 0.73, P less than 0.05). The insulin
      interpulse interval was the primary determinant of insulin sensitivity. The
      increased frequency of insulin pulses may play a role in inducing insulin
      resistance in individuals with abdominal fat distribution.

PMID- 1619022
TI  - Immunoreactivity to Yersinia enterocolitica antigens in patients with autoimmune
      thyroid disease.
AB  - Recent reports have suggested that Yersinia enterocolitica proteins encoded by a
      72-kilobase virulence plasmid (known as release proteins and now identified as
      YOP2-5) are antigens recognized specifically by patients with Graves' disease and
      of potential etiological importance in this disorder. To examine this hypothesis,
      we evaluated immune responses to YOP in patients with autoimmune thyroid disease
      and in normal controls. Humoral responses to Yersinia were assessed using Western
      blots of crude Y. enterocolitica membrane proteins, Yersinia release proteins
      (YOP2-5), and human thyrocyte membranes. Twenty-four of 25 Graves' and 10 of 18
      Hashimoto's patients showed reactivity with the release proteins, primarily the
      67-, 46-, 36-, and 25-kilodalton bands. However, 17 of 24 normal subjects also
      demonstrated serological reactivity to the release proteins, and the pattern of
      reactivity of these sera was similar to that in the thyroid patients. No
      correlation was noted between serological reactivity to the release proteins and
      thyroid hormone levels. Patients and controls with serological reactivity to YOP
      also showed reactivity with Yersinia membranes. In addition to the serological
      studies, cellular immune responses were determined by peripheral blood
      mononuclear cell proliferation assays. Cellular reactivity to the release
      proteins was present in four of five Graves' and both Hashimoto's patients
      tested, but also in two of six nonthyroid illness patients with serological
      immunity to the release proteins. Intrathyroidal lymphocytes obtained from two
      Graves' patients demonstrated marked proliferation in response to the release
      proteins. These results indicate that there is no unique pattern of serological
      reactivity against Yersinia membranes or the release proteins in patients with
      autoimmune thyroid diseases and suggest that any causal relationship between
      Yersinia infection and Graves' disease may be related to T-cell immunity.

PMID- 1619023
TI  - Steroid hormone receptors in the adrenal glands of fetal and adult rhesus
      monkeys.
AB  - Sex steroid hormone receptors have been identified in the adrenal glands of
      rodents and may have a role in adrenal function. The highly estrogenic
      environment during pregnancy has been proposed to influence steroidogenesis by
      the fetal zone of the primate fetal adrenal gland. In order to determine whether
      these effects involve receptor-mediated mechanisms, we have examined the
      concentration and distribution of estrogen receptor (ER), androgen receptor, and
      progesterone receptor (PR) in the adrenal glands of fetal, immature, and adult
      rhesus monkeys. Monoclonal antibodies were used for immunocytochemistry (ICC),
      and in a gradient shift assay, for determination of receptor distribution and
      concentrations, respectively. There was no difference between the concentrations
      of ER in the adrenal glands from male and female adult animals (12.4 +/- 2.2, n =
      3 and 13.2 +/- 2.0 fmol/mg DNA, n = 7; respectively); however, the concentration
      of ER in the fetal adrenal glands was markedly lower than in the adults (combined
      adult 12.7 +/- 1.6, n = 10, and fetal 0.9 +/- 0.4 fmol/mg DNA, n = 7; P less than
      0.01). The concentration of ER in the adrenal glands of immature animals was also
      lower compared to adult animals (6.1 +/- 1.6, n = 6, P less than 0.05). In the
      adult, ICC revealed that staining for ER was restricted to the cell nucleus and
      was most dense in the zone fasciculata, with lesser staining in the zona
      glomerulosa and zona reticularis, and with no detectable staining in the medulla.
      ER staining was virtually absent in the fetal zone which comprises the major
      portion of the fetal gland; however, some staining was observed in the narrow
      definitive zone. The distribution of androgen receptor was similar to that of ER,
      whereas there was no detectable staining for PR in the adrenals of either adult
      or fetal animals. We conclude: 1) that the lower concentration of ER in fetal
      adrenal glands is due to the absence of ER in the fetal zone; 2) the lack of ER
      and PR in the fetal zone suggests that estrogens and progestins do not influence
      the growth or function of the fetal zone by receptor-mediated mechanisms; 3)
      estrogens and androgens may influence the function of the adult adrenal cortex.

PMID- 1619024
TI  - Abnormal overnight dexamethasone suppression test in subjects receiving
      rifampicin therapy.
AB  - We have studied the effects of rifampicin on the overnight 1-mg dexamethasone
      suppression test usually employed to exclude suspected Cushing's syndrome.
      Previous observations indicate that in humans, rifampicin profoundly attenuates
      the biological effects of hydrocortisol and prednisolone, probably by increasing
      the metabolism of these drugs in the liver. The study was carried out in 16
      normal volunteers. All subjects had a normal overnight 1-mg dexamethasone
      suppression test (468 +/- 86 vs. 32 +/- 21 nmol/L; mean +/- SD). In 8 subjects
      treated with rifampicin (600 mg) for 10 days, the inhibitory effect of
      dexamethasone on serum cortisol was completely prevented (575 +/- 114 vs. 434 +/-
      82). In the remaining 8 rifampicin-treated subjects, the inhibitory effect of 1,
      2, or 3 mg dexamethasone on serum cortisol was not observed. When 4 mg
      dexamethasone were administered, the serum cortisol level was 193 nmol/L, above
      the expected normal suppression value. The plasma dexamethasone concentration was
      very low after rifampicin treatment (range, 1.2-4.8 nmol/L). We conclude that
      when patients are treated with rifampicin, the standard overnight dexamethasone
      suppression test not only has no diagnostic value, but can be very misleading.

PMID- 1619025
TI  - Luteinizing hormone synthesis in cultured fetal human pituitary cells exposed to
      gonadotropin-releasing hormone.
AB  - To investigate whether GnRH regulates LH synthesis during human development,
      pituitary cells from second trimester fetuses were incubated with [35S]methionine
      ([35S]met) and [3H]glucosamine ([3H]gln) for 48 h with 0, 10(-9), and 10(-7)
      mol/L GnRH. Immunoassayable (i) LH was measured in media and cellular lysates,
      and dual label scintillation analysis was used to quantitate incorporation of
      radiolabeled precursors into cells, trichloroacetic acid-precipitable proteins,
      and immunoprecipitated LH subjected to electrophoresis. Exposure of cells to GnRH
      did not affect cellular uptake or incorporation of precursors into proteins, but
      specifically increased total (secreted plus cellular) LH synthesis. Both GnRH
      concentrations significantly increased iLH release and enhanced secreted and
      cellular [3H]gln-LH. The secretion of [35S] met-LH was stimulated only by 10(-7)
      mol/L GnRH. The proportion of newly synthesized LH that was secreted and the
      3H/35S ratio of secreted and cellular LH were uninfluenced by GnRH. Although
      basal LH synthesis was not sex dependent, total iLH content and GnRH-stimulated
      LH translation were greater in cells from females than in those from males.
      Therefore, GnRH regulates LH synthesis by second trimester fetal human
      gonadotrophs without influencing the proportion of total radiolabeled LH that is
      secreted. The existence of a sex difference in total iLH content and GnRH
      stimulated LH translation is consistent with the sexual dimorphism in pituitary
      LH content occurring during human development.

PMID- 1619026
TI  - Plasma aldosterone response to upright posture and angiotensin II infusion in
      aldosterone-producing adenoma.
AB  - Nineteen patients with primary aldosteronism due to surgically confirmed
      aldosterone-producing adenoma (APA) were examined to evaluate the response of
      aldosterone to upright posture and angiotensin II infusion. Upright posture
      reportedly decreases the plasma aldosterone concentration (PAC) in APA but raises
      it in idiopathic hyperaldosteronism. However, our findings showed the opposite
      result, in that the upright posture did not change or raised PAC in 15 of 19
      cases (79%). Angiotensin II was infused i.v. at doses from 0.5-2 ng/min.kg body
      weight in six patients in whom the upright posture raised PAC, but did not raise
      PAC in all cases. This result supports the assumption that APA is functionally
      insensitive to angiotensin II. A concomitant rise of ACTH, pretreatment with
      calcium channel blockade, and other modulating factors may be involved in this
      PAC rise. Whatever the reason, such a high frequency of patients with increased
      PAC in APA raises some question about the clinical value of the upright posture
      test. We believe, then, there is reason to check any interpretation concerning
      increased PAC in the case of the upright posture test in distinguishing between
      APA and idiopathic hyperaldosteronism.

PMID- 1619027
TI  - Thyroid follicular cells produce interleukin-8.
AB  - Interleukin-8 (IL-8) is a potent proinflammatory cytokine known to be produced by
      several cell types. To elucidate whether endocrine cells can also make IL-8, we
      have tested supernatants from eleven thyroid follicular cell primary cultures. IL
      8 was readily detected under basal conditions (range 3.4-32.1 ng/ml from 1 x
      10(5) cells in 3 days) and was increased 4-20 fold by stimulation with IL-1. TSH
      and tumor necrosis factor had an inconsistent effect, while gamma-interferon
      reduced basal and IL-1-stimulated IL-8 production. Since IL-8 can act as a
      chemoattractant for lymphocytes, these observations may explain in part the
      accumulation of lymphocytes within the gland in autoimmune thyroiditis.

PMID- 1619028
TI  - Analysis of the sex-determining region of the Y chromosome (SRY) in sex reversed
      patients: point-mutation in SRY causing sex-reversion in a 46,XY female.
AB  - The first and essential step in normal sexual differentiation takes place during
      the 5th-6th week of gestation. The testis determining factor (TDF) directs the
      undifferentiated gonad into a testis, which secretes hormones responsible for
      normal male development. A new candidate for TDF has recently been reported, and
      it has been called the sex determining region of the Y (SRY). The hypothesis has
      been supported by the finding of XX individuals with SRY, and two females with
      46,XY karyotype and a mutation in SRY. However, XX males without SRY has been
      reported, and the role of SRY still has to be determined. We have tested three
      human females with 46,XY karyotype and gonadal dysgenesis and two 46,XX males for
      the presence of SRY using the polymerase chain reaction and subsequent DNA
      sequencing. Both 46,XX males contained SRY, whereas one of the 46,XY females had
      suffered a point mutation in SRY changing a codon for lysine to a stop codon.
      This information supports the hypothesis that SRY is significant in normal male
      sex differentiation. The two remaining 46,XY individuals had an intact HMG box,
      but it is possible that a mutation may be found in a regulatory gene or further
      downstream in the gene regulatory cascade. Two patients including the one with a
      mutation in SRY had gonadoblastomas supporting the hypothesis that another gene
      on the Y-chromosome is involved in the pathogenesis of this neoplasia.

PMID- 1619030
TI  - Determinants of total body and regional bone mineral density in normal
      postmenopausal women--a key role for fat mass.
AB  - In order to determine which clinical, anthropometric, dietary, and biochemical
      variables are independent predictors of total and regional bone mineral density
      (BMD) in normal postmenopausal women, a cross-sectional study of 140 normal
      postmenopausal women has been carried out. Subjects were white, aged 45-71 yr
      (mean 58 yr), and had no history of disorders or medication use likely to
      influence bone or calcium metabolism. Multiple regression analysis was used to
      derive models for total and regional BMD in terms of the other variables
      measured. The analysis indicated that total body BMD was positively related to
      fat mass (P less than 0.0001), serum estrone (P = 0.0095) and age at menopause (P
      = 0.0165), and negatively related to age (P less than 0.0001), 24-h urine calcium
      (P = 0.0002), sex hormone-binding globulin (P = 0.0003), and serum alkaline
      phosphatase activity (P = 0.0029) (R2 = 0.61). Similar relationships were found
      in the subregions of the total body scans and in the lumbar spine and proximal
      femur, with insulin-like growth factor-1, parity, and age at menarche also being
      related to BMD at at least two of these sites. Lean body mass was not an
      independent correlate of BMD at any site once fat mass was taken into account.
      Muscle strength, physical activity, alcohol intake, and dietary intakes of
      calcium, sodium and protein did not emerge as significant predictors of BMD in
      this homogeneous group of postmenopausal women. We conclude that total body fat
      is the most significant predictor of BMD throughout the skeleton and this
      relationship is not explicable in terms of either estrone production in fat
      tissue or the dependence of skeletal load-bearing on fat mass. The mechanism
      underlying this relationship is an important question to be addressed in bone
      biology.

PMID- 1619029
TI  - Oral testosterone undecanoate in the management of delayed puberty in boys:
      pharmacokinetics and effects on sexual maturation and growth.
AB  - Therapeutic induction of puberty using oral testosterone (T) undecanoate (TU) 40
      mg daily was performed in 4 pubertal boys aged 12.7-17.1 yr with constitutional
      delayed puberty and/or short stature. Single-dose pharmacokinetics study was
      performed on matched plasma and saliva samples obtained half-hourly for 10 h
      after the first dose and then repeated 3 and 6 months later. Treatment was
      continued for 15-21 months. Peak plasma total T concentration was achieved at 255
      +/- 51 (SEM) min after the first 40 mg dose of TU, 300 +/- 76 min at 3 months,
      and 293 +/- 103 min at 6 months, the levels remaining elevated above baseline for
      at least 8 h after a single oral dose. Total T levels were initially high (mean
      13.0 +/- 2.5; peak 38.7 +/- 4.2 nmol/L) but dropped significantly at 3 months
      (mean 8.3 +/- 1.8; peak 23.6 +/- 5.6 nmol/L) and at 6 months (mean 9.2 +/- 1.6;
      peak 24.8 +/- 3.5 nmol/L) paralleled by a dramatic fall in sex hormone binding
      globulin (73.9 +/- 18.0 to 35.1 +/- 9.7 at 3 month and 29.2 +/- 6.0 nmol/L at 6
      month). Mean concentrations of unbound and free T (non-sex hormone binding
      globulin-bound T, free T, and salivary T) were below the normal adult range and
      remained unchanged over the same period. Plasma dihydrotestosterone
      concentrations were elevated after the first dose (mean 5.4 +/- 1.3; peak 11.0 +/
      2.5 nmol/L), the extent of this rise being less after 6 months (mean 4.1 +/-
      0.8; peak 7.1 +/- 1.1 nmol/L) as was the case with mean estradiol (51.5 +/- 8.9
      to 38.1 +/- 3.7 pmol/L). Signs of virilization progressed to Tanner stage G3 PH2
      3 with testicular volumes increasing to 3-4 mL at 12 months, and G4 PH4-5 with
      further testicular growth to 6-10 mL at 24 months. Height velocity rose from 3.2
      +/- 0.3 cm/yr (pretreatment) to 7.2 +/- 1.0 cm/yr in the first year and was
      maintained at 7.3 +/- 0.4 cm/yr despite cessation of therapy during the second
      year. Bone age advanced by 1.1 +/- 0.1 yr at 12 months and a further 0.8 +/- 0.3
      yr at 24 months. Predicted adult height remained unchanged. No side effects were
      observed. Our preliminary data suggest that oral TU is a well accepted,
      effective, and safe treatment for the initiation of male puberty without
      disproportionate skeletal maturation. Continued pubertal advance was evident
      after cessation of treatment in all patients.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1619031
TI  - Will postpartum recurrence of Graves' hyperthyroidism become a thing of the past?

PMID- 1619032
TI  - Postpartum lactational anovulation in a nonhuman primate (Macaca fascicularis):
      endogenous opiate mediation of suckling-induced hyperprolactinemia.
AB  - The physiological amenorrhea occurring in suckled females has been associated
      with both hypopulsatile gonadotropin secretion and hyperprolactinemia. To test
      whether these phenomena are opiate mediated and whether these effects are
      dependent on the presence of ovaries, we studied six suckled, lactating
      cynomolgus monkeys, three with intact ovaries and three that were ovariectomized
      14 days postpartum. Frequent blood sampling (every 15 min) was performed at
      approximately monthly intervals using chronic venous catheters accessed remotely
      via a jacket and tether system. Each monkey was administered saline or naloxone
      (2 mg bolus then 2 mg/h) by constant infusion, in alternating 6-h blocks. During
      saline infusions, PRL concentrations varied markedly in a diurnal pattern with
      concentrations varying from 30-70 micrograms/L during the day and from 100-200
      micrograms/L during the night. In both gonadal intact and ovariectomized groups
      of monkeys naloxone dramatically suppressed and maintained PRL concentrations at
      less than 20 micrograms/L irrespective of the time of day or the order of
      administration. The effects of naloxone on gonadotropin concentrations were much
      less dramatic. In gonadal-intact monkeys, no effect of naloxone was seen on pulse
      frequency of either FSH or LH, or on mean LH concentration, and only a slight
      increase was noted in mean FSH concentrations. In ovariectomized monkeys,
      naloxone was also without effect on pulsatile LH secretion, although mean LH
      concentrations were slightly higher during naloxone infusions than during saline
      infusions (P less than 0.05). From these results, we conclude that opiate
      peptides are released in response to the suckling stimulus in the cynomolgus
      monkey and that they mediate the effects of suckling on PRL secretion in both
      gonadal-intact and agonadal cynomolgus monkeys. The lack of effect of opiate
      blockade on gonadotropin concentrations suggests that multiple pathways may be
      involved with the inhibition of the GnRH pulse generator during lactational
      anovulation.

PMID- 1619033
TI  - Differences in basal and poststimulation glucose homeostasis in nondiabetic first
      degree relatives of black and white patients with type 2 diabetes mellitus.
AB  - Black Americans (blacks) have a higher prevalence and earlier onset of type 2
      diabetes than white Americans (whites). To examine metabolic differences in both
      races, we measured the basal glucose turnover rates (D-]3-3H]glucose technique)
      and plasma glucose, insulin, and C-peptide levels before and after an oral
      glucose load in 24 glucose-tolerant black and 14 white female relatives of
      patients with type 2 diabetes. Eight black and 8 white female subjects with no
      family history of diabetes served as controls. Mean fasting and postglucose
      plasma glucose levels were not significantly different between the black and
      white relatives and the control subgroups. Mean fasting plasma insulin and C
      peptide levels were slightly greater but not significantly different between the
      relatives. After oral glucose ingestion, mean incremental integrated plasma
      insulin areas were significantly (P less than 0.02) greater in the black than the
      white relatives (70 +/- 14 vs. 29 +/- 6 nM.min). In addition, incremental
      integrated C-peptide areas were greater in the black than the white relatives
      (303 +/- 55 vs. 115 +/- 33; P less than 0.005). Similarly, we found significantly
      greater integrated incremental insulin (61 +/- 11 vs. 22 +/- 3 nM.min; P less
      than 0.02) and C-peptide (248 +/- 58 vs. 47 +/- 16; P less than 0.005) areas in
      the black than the white controls, respectively. The estimated basal and
      postglucose hepatic insulin extraction values, expressed as molar ratios of C
      peptide and insulin, were not significantly different between the relatives.
      While basal hepatic insulin extraction was significantly (P less than 0.05) lower
      in the black controls, the postprandial insulin clearance was not different
      between the black and white controls. Mean basal hepatic glucose production was
      greater (P less than 0.02) in the black than the white relatives (2.49 +/- 0.13
      vs. 2.02 +/- 0.12 mg/kg.min). Similarly, the black controls had greater hepatic
      glucose production than the white controls (2.36 +/- 0.15 vs. 1.81 +/- 0.08
      mg/kg.min; P less than 0.001). We conclude that basal and poststimulation glucose
      homeostatic regulation appear to be different in black and white females,
      regardless of family history of type 2 diabetes.

PMID- 1619034
TI  - Combined bromocriptine and growth hormone (GH) treatment in GH-deficient children
      with macroprolactinoma in situ.
AB  - Experience with PRL-secreting macroadenomas in the pediatric and adolescent
      population is limited. Although use of synthetic GH after treatment of central
      nervous system tumors in children without active disease is accepted practice,
      reports of GH use in patients with central nervous system tumors in situ are
      rare. Furthermore, the effect of GH on tumor growth is not known. We report GH
      treatment (10 and 11.5 months), concomitant with bromocriptine (BC; dopamine
      agonist) therapy in two children, a 15.5-yr-old male and a 15.5-yr-old female,
      with PRL-secreting macroadenomas in situ. Surgical resection was deemed
      undesirable because of the risk of major morbidity due to the large size of the
      tumors and the close proximity to major vessels. Both patients were GH deficient
      and had heights below the fifth percentile coupled with arrested pubertal
      progress. During BC therapy, a decrease in tumor size and a reduction in serum
      PRL levels occurred in both patients, which continued after the addition of GH
      treatment. Neither patient experienced changes in visual acuity during combined
      treatment, and both experienced marked improvement in growth velocity. We
      conclude that in children with PRL-secreting tumors and GH deficiency in whom
      surgery is not advised, combined treatment with BC and GH appears to be safe and
      efficacious. To our knowledge, these patients represent the first report of the
      combined therapeutic use of BC and GH as the primary mode of treatment in
      children with prolactinoma in situ with documented GH deficiency.

PMID- 1619035
TI  - Role of the ovary in the synthesis of placental protein-14.
AB  - Women with absent ovarian function provide an opportunity to investigate the
      ovarian contribution to secretion of placental proteins (PP), such as PP14, in
      early pregnancy. We present data on serum PP14 levels in 12 women (median age,
      30.5 yr; range, 26-37 yr) with premature ovarian failure (POF) who conceived
      after ovum donation and embryo transfer with exogenous sex steroid support using
      transdermal (n = 5) or oral (n = 7) estradiol and vaginal (n = 8) or im (n = 4)
      progesterone. The women were closely monitored throughout early pregnancy, with
      measurement of serum levels of estradiol (E2), progesterone (P4), and PP14.
      Levels of E2 and P4 were entirely normal. Levels of PP14 were significantly
      subnormal (P = 0.008) in all 12 agonadal women compared with levels of PP14 in a
      control group of women with normal ovarian function between 6-12 weeks gestation.
      Basal and peak levels for subjects with absent ovarian function were 40 and 124
      micrograms/L, respectively. For each week between 6-12 weeks of pregnancy, the
      mean serum levels of PP14 for women with normal ovarian function were between 706
      940 micrograms/L. These observations support the concept that PP14 arises from
      the ovary in early pregnancy or that factors under the control of the maternal
      ovary are involved in its production by the endometrium.

PMID- 1619036
TI  - A combination of adoptive transfer and antigenic challenge induces consistent
      murine experimental autoimmune encephalomyelitis in C57BL/6 mice and other
      reputed resistant strains.
AB  - Adoptive EAE was induced in SJL mice by the transfer of MBP-primed and in vitro
      stimulated donor lymph node cells into naive syngeneic recipients. Priming donor
      mice with OVA instead of restimulating MBP-primed donor cell with OVA resulted in
      no transfer of EAE. This apparent lack of disease, however, could be overcome if
      the recipients were subsequently challenged with MBP. When this transfer
      challenge technique was applied to BALB/c and C57BL/6 mice, these reputed
      (MBP)EAE-resistant strains developed consistent and severe disease similar to
      that seen in susceptible strains. In fact, a survey of eleven (MBP)EAE-resistant
      strains, defined on the basis of their inability to mount an encephalitogenic
      response in recipient mice following the transfer of MBP-primed and in vitro
      activated lymph node cells, revealed that EAE could be induced in all these
      strains. Since the surveyed strains represented a wide spectrum of genetic
      backgrounds as well as the common MHC congenic haplotypes (H-2b,d,k,m,r,s,v), it
      is concluded that the machinery for recognition of MBP, i.e. MHC genes and the
      appropriate T cell receptors, is functionally intact in these resistant mice.
      While MHC and T cell receptor genes are required for T cell responses, they are
      not the limiting factors that confer resistance in murine EAE.

PMID- 1619037
TI  - The pineal hormone melatonin exaggerates development of collagen-induced
      arthritis in mice.
AB  - We have previously shown that constant darkness enhances autoimmunity to type II
      collagen (CII) and exaggerates development of collagen-induced arthritis (CIA) in
      DBA/1 mice. This effect was suggested to be mediated via the major hormone of the
      pineal gland, melatonin, since this hormone (1) is known to be strongly dependent
      on environmental lighting and (2) has been reported to affect the immune
      function. The present study was performed in order to clarify if melatonin could
      account for the previous observation that mice kept in darkness had a more
      pronounced development of CIA. First, DBA/1 mice kept in constant darkness were
      analysed for serum melatonin levels. An increase in background levels in
      comparison to mice kept in a normal dark/light cycle or in constant light was
      recorded. Then, different groups of mice (kept in constant light in order to
      minimize endogenous melatonin levels) were immunised with rat CII to induce
      arthritis and injected with melatonin. Melatonin injections were performed daily
      (1 mg/kg b.w.) in the afternoons (at 4 p.m.) for 10 days at two different
      periods: day 1-10 after collagen injection, or at the onset of the disease (day
      30-39). Mice injected with melatonin at day 1-10 developed a more severe
      arthritis while those injected at onset did not differ significantly from the
      corresponding controls. Our results support the hypothesis that the pineal gland
      can exaggerate the development of CIA via a high release of melatonin, probably
      via enhancement of T-cell priming.

PMID- 1619038
TI  - An immunohistochemical study of phospholipase A2 in peripheral nerve during
      Wallerian degeneration.
AB  - Antiserum raised against purified Crotalus adamanteus venom phospholipase A2
      (PLA2) was used to localise the enzyme in normal and crushed sciatic nerve to
      determine the effect of nerve trauma on PLA2 distribution in the PNS. The tissue
      was Bouin's fixed, and stained immunohistochemically using the Vectastain ABC
      technique. Anti-PLA2 antiserum showed weak reactivity with normal rat myelin,
      while only 'resident' macrophages stained in normal mouse sciatic nerve. Post
      crush, in the mouse, myelin staining was localised close to the crush site, with
      strong lysosomal staining within both 'resident' and invading haematogenously
      derived macrophages. In the rat, myelin sheaths stained strongly throughout the
      nerve very soon after crush, but no macrophages were detected using these
      antisera. Paranodal myelin and some Schmidt-Lanterman incisures were the first
      regions of the sheath to show an increase in PLA2 staining post-crush, areas
      where the first ultrastructural changes occur in myelin after trauma, with
      staining of compact myelin closely following. Our findings support the idea that
      PLA2 may be involved in the early process of myelin breakdown seen in Wallerian
      degeneration.

PMID- 1619039
TI  - Role of arachidonic acid metabolism on corticotropin-releasing factor (CRF)
      release induced by interleukin-1 from superfused rat hypothalami.
AB  - The present work shows that the corticotropin-releasing factor (CRF)-releasing
      activity of interleukin-1 (IL-1) is partially inhibited by a phospholipase A2
      (mepacrine) or a cyclooxygenase (indomethacin) inhibitor, but is not affected by
      inhibition of the lypoxygenase pathway with norhydroguaiaretic acid. These
      results indicate that the metabolism of arachidonic acid plays an important role
      as mediator of the effects of IL-1 on CRF release. It is also shown that products
      of the cyclooxygenase activity such as prostaglandins can stimulate CRF secretion
      by a direct action on the hypothalamus. Whereas PGE2 failed to induce increases
      on CRF release, PGF2 alpha stimulated in a dose-dependent manner (21-340 nM), the
      CRF release from continuous perifused hypothalami. It is suggested that PGF2
      alpha could be involved as a messenger in the hypothalamic CRF secretion induced
      by IL-1.

PMID- 1619040
TI  - Interleukin-1 activity in lesioned peripheral nerve.
AB  - The cytokine interleukin-1 (IL-1) is involved in a wide range of inflammatory and
      immune responses. As such, IL-1 could play a role in peripheral nerve repair
      mechanisms. Specifically, by its already established properties as a regulator of
      nerve growth factor (NGF) synthesis, and as a chemotactant to macrophages. We
      examined, therefore, IL-1 production in injured mouse peripheral nerve. Injured
      nerve segments were incubated in serum free medium to produce conditioned medium
      (CM) that was then tested for IL-1 activity in a thymocyte proliferation assay.
      CM induced thymocyte proliferation in a dose-dependent manner. Proliferation was
      inhibited by the M20 IL-1 inhibitor, the IL-1 receptor antagonist, and antisera
      raised against recombinant mouse IL-1 alpha. Inhibitions produced by these three
      specific inhibitors of IL-1-induced thymocyte proliferation strongly suggest that
      proliferation induced by CM was mediated largely by IL-1 secreted by non-neuronal
      cells residing in the damaged nerve. IL-1 activity was detected within hours
      after lesion, and 1 week thereafter. The rapid and prolonged production of IL-1
      indicates that IL-1-dependent mechanisms can play roles in the response of the
      peripheral nerve to injury: degeneration and regeneration. The regulation of NGF
      synthesis, and the recruitment of white blood cells, macrophages in particular,
      from blood into the damaged nerve tissue, are two such mechanisms.

PMID- 1619041
TI  - Functional organization of vagal reflex systems in the brain stem of the
      goldfish, Carassius auratus.
AB  - The coordination of secretory and motor responses to food within the alimentary
      canal requires well organized brain stem reflex systems. In the goldfish,
      Carassius auratus, three vagal reflex systems control three phases of ingestion
      and digestion. The orobranchial system sorts food from substrate, the pharyngeal
      chewing organ prepares items deemed to be food for digestion and absorption, and
      the abdominal system regulates the digestion of food. Each system is represented
      in the central nervous system by separate sensory and motor nuclei. The aim of
      the present study was to determine whether the interrelationships among the vagal
      sensory and motor nuclei reflect the peripheral organization. The sensory nucleus
      of each vagal system was injected with the neuronal tracer horseradish peroxidase
      (HRP), in separate cases. HRP injections into the vagal lobe sensory layers
      (orobranchial system) labeled fibers projecting topographically to the vagal lobe
      motor layer, but not at all to the pharyngeal or abdominal motor nuclei.
      Similarly, injections of HRP into the pharyngeal and abdominal sensory nuclei
      selectively labeled nerve fibers projecting to the pharyngeal and abdominal motor
      nuclei, respectively. All injections resulted in labeled fibers and/or cells in
      the lateral reticular formation, and in fibers ascending in the secondary
      gustatory-visceral tract. Gustatory information from the pharynx is apparently
      processed in the same brain stem system as pharyngeal general visceral
      information, suggesting that functional or regional characteristics of visceral
      sensory information may be more important for brain stem processing than the
      traditional "special" (gustatory) versus "general" visceral dichotomy. These
      results indicate that anatomically and functionally separate reflex systems exist
      within the goldfish vagal visceral nuclei.

PMID- 1619042
TI  - Anatomical organization of the brainstem octavolateralis area of the oyster
      toadfish, Opsanus tau.
AB  - Anatomical studies were undertaken to analyze the brainstem organization of the
      auditory, vestibular, and lateral line nuclei in a teleost, the oyster toadfish,
      Opsanus tau. Neuronal cytoarchitectonics and horseradish peroxidase label of
      cranial nerves were utilized to delineate the borders of the five octavus and two
      lateralis brainstem nuclei. Each of the eight octavolateralis nerves were labeled
      individually to compare and contrast their central projections. Projections of
      the three semicircular canals were found to be largely overlapping. Terminal
      fields were observed within the eminentia granularis and in each of the octavus
      nuclei. The nucleus anterior octavus was reciprocally innervated by the
      semicircular canals and the saccule. The canals terminated heavily in the ventral
      portions of the anterior octavus, whereas the saccule terminated extensively in
      the dorsal nuclear portions. The saccule also distributed terminals throughout
      the octavus cell column, including a light terminal field within the dorsal,
      medial, and anterior portions of the descending octavus nucleus, a region densely
      innervated by this end-organ in other species. These results suggest that the
      anterior octavus nucleus may have a dual function. The dorsal portions may be an
      auditory relay nucleus, whereas the ventral portions may subserve vestibular
      function. Utriclar and lagenar afferents also terminated throughout the octavus
      cell column. Afferents of the anterior and posterior lateral lines ended within
      the eminentia granularis and the lateral line nuclei. Semicircular canal
      afferents and lateral line afferents appeared completely segregated within the
      eminentia. The above results are useful as an aid in the understanding of an
      ongoing, comprehensive functional analysis of auditory and vestibular mechanisms
      in toadfish and complement previous work on the efferent vestibular and sound
      producing motor systems. Examination of toadfish contributes to a more general
      and complete overview of the octavolateralis area of teleosts and the eventual
      identification of primitive and derived patterns of octaval organization.
      Additionally, this work may permit the further demonstration of species-typical
      characters that may indicate adaptations to particular behavioral repertoires.

PMID- 1619043
TI  - Ultrastructure of the periaqueductal grey matter of the rat: an electron
      microscopical and horseradish peroxidase study.
AB  - The neurons of the mesencephalic periaqueductal grey substance (PAG) in the rat
      are small and medium sized. The cells are frequently located in small clusters,
      without interdigitating glial elements and may be connected by direct membrane
      appositions or by gap junctions. The inner zone of the PAG is cell poor. In many
      cases, the cytoplasm of the cells is filled with extensive rough endoplasmic
      reticulum, free ribosomes, Golgi apparatus, and large lysosome-like granules. The
      nuclei show large indentations. The cells have a high nucleus-cytoplasm ratio.
      The neuropil is very extensive and particularly rich in large numbers of small
      unmyelinated axons, dendrites, axonal varicosities, and synaptic connections.
      Myelinated fibres are relatively scarce. The orientation of the fibres was
      studied in transverse and horizontal sections, in combination with HRP track
      tracing experiments. It appeared that throughout the PAG most of the fibres were
      orientated longitudinally. Quantitation showed that most fibres were present in
      the inner zones of the PAG. Moreover, the diameter of the fibres adjacent to the
      aqueduct was smaller than that of the fibres in the peripheral parts of the PAG.
      The thin unmyelinated fibres made extensive synaptic connections within the PAG.
      Many synaptic varicosities were found in the neuropil of the PAG. There were four
      types of synaptic varicosities, characterized by different populations of clear
      and dense-core secretory granules and by the different morphology of the synaptic
      specializations. In general, the different types of varicosity were homogeneously
      distributed in the different parts of the PAG. Electron dense secretory granules,
      when present, were located at some distance from the synaptic junction. Serial
      sections revealed varicosities which contained only dense-core secretory
      granules, without synaptic specializations. The dendrites of PAG neurons
      generally lacked synaptic spines. Many dendrites, particularly those of neurons
      located in the peripheral parts of the PAG, were directed toward the aqueduct.
      The present study shows that the PAG is a very complex brain area. The
      crisscrossing of axons and dendrites with synaptic connections at considerable
      distances from the cell bodies render it very difficult to unravel the
      relationships between the possible sources and destinations of ongoing
      information. This structure complicates the search for relationships between the
      functional organization and the cytoarchitectural borders in the PAG area.

PMID- 1619044
TI  - Dorsal mesencephalic projections to pons, medulla, and spinal cord in the cat:
      limbic and non-limbic components.
AB  - The vertebrate dorsal mesencephalon consists of the superior colliculus, the
      dorsal portion of the periaqueductal gray, and the mesencephalic trigeminal
      neurons in between. These structures, via their descending pathways, take part in
      various behavioral responses to environmental stimuli. This study was undertaken
      to compare the origins and trajectories of these pathways in the cat. Injections
      of horseradish peroxidase into the cervical spinal cord and upper medullary
      medial tegmentum retrogradely labeled cells mainly in the contralateral
      intermediate and deep superior colliculus, and in the ipsilateral dorsal and
      lateral periaqueductal gray and adjacent tegmentum. Only injections in the
      medullary lateral tegmental field labeled mesencephalic trigeminal neurons
      ipsilaterally. Autoradiographic tracing results, based on injections across the
      dorsal mesencephalon, revealed three efferent fiberstreams. A massive first
      fiberstream (limbic pathway), consisting of thin fibers, descended ipsilaterally
      from the dorsal and lateral periaqueductal gray and adjacent superior colliculus
      through the mesencephalic and pontine lateral tegmentum, terminating in these
      areas as well as in the ventral third of the caudal pontine and medullary medial
      tegmentum. A few fibers from the dorsal periaqueductal gray matter (PAG) were
      distributed bilaterally to the dorsal vagal, solitary, and retroambiguus nuclei.
      The second fiberstream (the predorsal bundle) descended contralaterally from the
      superior colliculus (SC) and consisted of both thick and thin labeled fibers. The
      thin fibers terminated bilaterally in the dorsomedial nucleus reticularis
      tegmenti pontis and the medial half of the caudal medial accessory inferior
      olive. The thick fibers targeted the contralateral dorsal two thirds of the
      caudal pontine and medullary medial tegmental fields, and the facial, abducens,
      lateral reticular, subtrigeminal, and prepositus hypoglossi nuclei. A few fibers
      recrossed the midline to terminate in the ipsilateral medial tegmentum. Caudal to
      the obex, fibers terminated laterally in the tegmentum and upper cervical
      intermediate zone. From the lateral SC, fibers terminated bilaterally in the
      lateral tegmental fields of the pons and medulla and lateral facial subnuclei.
      The third fiberstream (mesencephalic trigeminal or Probst tract) terminated in
      the supratrigeminal and motor trigeminal nuclei, and laterally in the tegmentum
      and upper cervical intermediate zone. In summary, neurons in the PAG and in the
      deep layers of the SC give rise to a massive ipsilateral descending pathway, in
      which a medial-to-lateral organization exists. A similar topographical pattern
      occurs in the crossed SC projections. The possibility that these completely
      different descending systems cooperate in producing specific defensive behaviors
      is discussed.

PMID- 1619045
TI  - Development of catecholaminergic, indoleamine-accumulating and NADPH-diaphorase
      amacrine cells in rabbit retinae.
AB  - We have investigated the ontogeny of four classes of amacrine cells in the rabbit
      retina. In particular, the distribution, number, soma diameter, dendritic field
      diameter, and pattern of dendritic stratification were studied in
      catecholaminergic (CA) and indoleamine-accumulating (IA) amacrines and in two
      classes of nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase
      amacrine cells. The first CA and IA cells are observed on the 27th
      postconceptional day (27PCD) and the first NADPH-diaphorase cells on 28PCD. These
      first cells are concentrated in the central part of the visual streak, and at
      subsequent ages, cells in this part of the streak have larger somata and more
      mature dendritic fields than those elsewhere, supporting the notion that the peak
      density region is a developmentally advanced part of the retina. Throughout
      development, amacrine cells of all classes are concentrated in the visual streak,
      with their density reaching minima at the superior and inferior retinal margins.
      As their total number increases, the difference in cell density between the
      streak and the periphery decreases, presumably because proportionately more cells
      are added at the periphery. Their total number peaks around 42PCD, followed by a
      decline of 12-31% to adult values. Once the peak number of cells has been
      reached, the difference in cell density between the streak and periphery begins
      to increase. The rate of this increase is closely correlated with the increase in
      retinal area. This redistribution of amacrine cells, as well as a greater
      expansion of their dendritic fields in peripheral retina, is almost certainly the
      product of nonuniform retinal expansion.

PMID- 1619046
TI  - Distribution of immunoreactivity for gamma-aminobutyric acid in the salamander
      olfactory bulb.
AB  - Intrinsic neurons provide inhibitory synaptic input to mitral (and tufted) output
      cells within several laminae of the olfactory bulb. In rodents, the two main
      types of intrinsic neurons are granule and periglomerular cells, both of which
      contain gamma-aminobutyric acid (GABA). In the present study, immunocytochemical
      techniques were used to determine whether intrinsic neurons in the salamander
      olfactory bulb might also contain GABA. With the aid of two antisera to different
      GABA-conjugates, immunoreactivity for GABA was localized within the olfactory
      bulb laminae. In the glomerular layer, periglomerular cells, which were strongly
      immunoreactive, were concentrated in clusters along the border with the olfactory
      nerve layer. Dendrites of the cells encircled nearby glomeruli and were
      presumably a primary source of intraglomerular processes that were also stained.
      In the subglomerular region and external plexiform layer, relatively few
      immunoreactive cells were observed, most of which appeared to be periglomerular
      and tufted cell types with glomerular dendrites. Throughout the external
      plexiform and mitral cell layers, however, a dense matrix of spiny processes and
      puncta was stained, outlining large, unstained dendrites derived from the large,
      unstained cell bodies of mitral cells. The spiny processes and puncta appeared to
      be derived from granule cells, which were the most abundant immunoreactive cells
      in the bulb. Granule cell bodies filled the granule cell layer. In tissue fixed
      with 0.1-0.2% glutaraldehyde, staining in the olfactory bulb laminae was blocked
      by preadsorption of the two antisera with glutaraldehyde-conjugated GABA-bovine
      serum albumin. The staining therefore appeared to be specific for fixed
      GABA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619047
TI  - Segmental distribution and peptide content of primary afferent neurons
      innervating the urogenital organs and colon of male rats.
AB  - Many visceral afferent neurons contain peptides, which have been proposed as
      histochemical markers for nerve pathways of particular targets or as transmitter
      candidates. The former possibility was investigated in the present study. Primary
      afferent neurons which project to the urinary bladder, distal colon or penis of
      rats, and the colon of cats were labelled with retrogradely transported
      fluorescent dyes (Fast Blue, True Blue, or Fluoro Gold). One to six weeks after
      dye injection into the organs, lumbosacral dorsal root ganglia were removed,
      treated with colchicine, and processed for immunohistochemical identification of
      five peptides. Dye-labelled neurons were distributed in an organ-specific manner
      in the lower lumbosacral ganglia, where colon afferent neurons were almost
      exclusively found in S1 ganglia, penis neurons primarily in L6, and bladder
      neurons at both levels. Substance P- (SP), calcitonin gene-related peptide
      (CGRP), vasoactive intestinal peptide- (VIP), enkephalin- (ENK), and somatostatin
      (SOM) immunoreactivity (IR) were detected in neurons in all lumbosacral ganglia
      but only some of these peptides were present in a large percentage of labelled
      neurons. The numbers of peptide-containing neurons innervating each organ were
      CGRP greater than SP greater than VIP greater than ENK greater than SOM; however
      some differences were observed in the relative proportions of these neuronal
      populations between upper lumbar and lower lumbosacral ganglia and between
      different organs. The major difference seen at the upper lumbar level was amongst
      the SP-IR neurons, which were common (25-30%) amongst bladder and colon afferent
      neurons but absent in penis neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619048
TI  - Distribution of buccalin-like immunoreactivity in the central nervous system and
      peripheral tissues of Aplysia californica.
AB  - The neuropeptide buccalin A was originally purified and sequenced from a nerve
      muscle system used in feeding-related behaviors of Aplysia californica in which
      it has been proposed that it acts as a modulatory cotransmitter. The distribution
      of buccalin-like immunoreactivity in the central ganglia and in peripheral
      tissues of Aplysia californica was examined by whole mount immunohistochemical
      techniques. Immunoreactive material was located in specific cell bodies and
      clusters of neurons in each of the ganglia. Immunoreactive fibers were present in
      each of the connectives between ganglia, in tracts coursing through the ganglia,
      and in the majority of the peripheral nerves. Most fibers were smooth in contour,
      but some had regularly spaced swellings. Varicosities containing immunoreactive
      material were located on specific neuronal somata and on certain tissues
      associated with the feeding, circulatory, digestive, and reproductive systems.
      The specific and widespread distribution of buccalin-like immunoreactivity
      supports the hypothesis that members of the buccalin peptide family act as
      neuromodulators or neurotransmitters in a variety of central and peripheral
      circuits in Aplysia.

PMID- 1619049
TI  - Differential calbindin-like immunoreactivity in the brain stem auditory system of
      the chinchilla.
AB  - Calbindin is a 28 kD calcium-binding protein found in neural tissue. Although its
      functional role in neurons is unknown, it has been proposed that calbindin is
      involved in intracellular buffering and could therefore influence temporal
      precision of neuronal firing. In the barn owl, calbindin-like immunoreactivity
      was found to be selectively present in brain stem auditory pathways used to
      process interaural time differences, but was absent from the interaural intensity
      pathway. The present study demonstrates calbindin immunoreactivity in the
      auditory brain stem of the chinchilla, a rodent with exceptionally good low
      frequency hearing. In the superior olivary complex and periolivary areas,
      immunoreactivity was divided between neuropil labeling in the lateral and medial
      superior olives and dorsomedial periolivary nucleus, and labeling of the somata
      of the medial and ventral nuclei of the trapezoid body and anterolateral
      periolivary nucleus. Strong immunoreactivity was observed in the ventral and
      dorsal divisions of the ventral nucleus of lateral lemniscus somata and the
      ventral division's columnarly organized fiber plexus. The dorsal nucleus of the
      lateral lemniscus was void of immunoreactivity. Virtually all principal neurons
      of the sagulum showed darkly labeled somata surrounded by a densely labeled fiber
      plexus. Immunoreactivity in the inferior colliculus was primarily limited to the
      paracentral nuclei, with only an occasional labeled cell in the central nucleus.
      In conclusion, although selective labeling of calbindin in the mammalian auditory
      brain stem is impressive, no distinctive labeling of a functionally defined
      timing pathway was apparent as reported previously in the barn owl or electric
      fish.

PMID- 1619050
TI  - Correlation of filiform hair position with sensory afferent morphology and
      synaptic connections in the second instar cockroach.
AB  - An attempt is made to relate the distribution of filiform hairs on the cercus of
      the second instar cockroach, Periplaneta americana, to the morphology and
      patterns of synaptic connectivity of their afferents. We studied the most distal
      25 of the 39 filiform hairs which are commonly present. Filiform afferent
      arborizations were stained by cobalt filling from the cell body in the cercus.
      Three fundamental arbor types were found, two similar to those of the first
      instar medial (M) and lateral (L) afferents, and a third, novel type. L-type
      arbors could be divided into four subtypes. The most obvious correlate of arbor
      type is the circumferential position of the hair on the cercus. The proximodistal
      position of the sensillum within each cercal segment is also a determinant of its
      arbor. By comparison of hair positions and afferent morphologies, we were able to
      ascribe homologies between the second instar hairs and members of adult
      longitudinal hair columns. The patterns of monosynaptic connections between
      afferents and giant interneurons (GIs) 1, 2, 3, 5, and 6 were determined by
      recording synaptic potentials in GIs evoked by direct mechanical displacement of
      individual filiform hairs. Latency from stimulus onset to the rise phase of the
      first excitatory postsynaptic potential (EPSP) was used as the criterion of
      monosynapticity. The EPSP amplitudes of the two original L and M afferents are
      halved in the second instar, in the absence of a significant decrease in GI input
      resistance. The other afferents can be divided into two basic classes: those
      which input to GI5 (M-type), and those which input to GI3 and GI6 (L-type). The
      former is correlated with a central or medial position, while the latter is
      associated with a group of afferents situated laterally on the cercus. In
      segments 3 and 4, input to GIs 1 and 2 also correlates with a medial cercal
      position, however, in the more proximal segments 5 and 6, afferents at all
      positions input to these interneurons. The occurrence of afferents of identical
      morphology and similar connectivity in equivalent positions in different segments
      suggests that each sensory neuron is determined by its two-dimensional position
      within a segment. The presence of afferents with the same morphology which
      display proximodistal differences in synaptic connectivity, and of other
      afferents which have M-type connectivity despite L-type morphology, means that
      anatomy is generally a poor predictor of synaptic connectivity.

PMID- 1619051
TI  - Efferent connections of the centromedian and parafascicular thalamic nuclei in
      the squirrel monkey: a light and electron microscopic study of the
      thalamostriatal projection in relation to striatal heterogeneity.
AB  - The organization of the thalamostriatal projections arising from the centromedian
      (CM) and parafascicular (Pf) thalamic nuclei in the squirrel monkey (Saimiri
      sciureus) was studied at both light and electron microscopic levels. Following
      selective injections of the anterograde axonal tracer Phaseolus vulgaris
      leucoagglutinin (PHA-L) into the CM or Pf, patterns of terminal arborization
      within the striatum were compared to the biochemical heterogeneity of the
      striatum as revealed by immunohistochemical staining for the calcium-binding
      protein calbindin D-28k (CaBP), and histochemical staining for the enzymes
      acetylcholinesterase (AChE) and nicotinamide adenine dinucleotide phosphate
      diaphorase (NADPH-diaphorase). The PHA-L-labeled axon terminals within the
      striatum were further analyzed at the ultrastructural level to characterize their
      pattern of synaptic organization. Dense and heterogeneous terminal fields occur
      in the "sensorimotor" territory of the striatum after CM injections, or in the
      "associative" striatal territory following Pf injections. In the associative
      territory labeled axons arborize in a diffuse manner predominantly within areas
      enriched with CaBP, AChE, or NADPH-diaphorase, representing the matrix
      compartment, and tend to avoid areas poor in these substances, corresponding to
      the patch/striosome compartment. In the sensorimotor territory labeled axons form
      bands that occupy a subregion of the NADPH-diaphorase-rich zone in the putamen.
      The terminal pattern of the CM-striatal projection suggests the existence of a
      more complex mosaic organization within the sensorimotor territory.
      Ultrastructural analysis of PHA-L-labeled elements within the striatum reveals
      that both CM and Pf projections form asymmetric synapses upon dendrites and
      spines of striatal cells. A total of 339 PHA-L-labeled boutons were examined
      after CM injections and compared to 293 boutons following Pf injections. After CM
      injections, 29% of PHA-L-labeled terminals form synapses on dendritic spines and
      66% on dendritic shafts, whereas after Pf injections only 12% of synapses occur
      on dendritic spines compared to 81% on dendritic shafts. Labeled terminals
      forming axosomatic or axoaxonic synapses were not seen within the striatum
      following either CM or Pf injections. It is concluded that in the squirrel
      monkey: 1) Pf-striatal fibers profusely arborize within the matrix compartment of
      the associative territory, 2) CM-striatal fibers form bands that occupy a
      subregion of the NADPH-diaphorase-rich zone within the sensorimotor territory,
      and 3) that both Pf- and CM-striatal projections establish asymmetric synapses
      with dendrites and spines of medium-sized spiny cells.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1619052
TI  - The calcium binding proteins parvalbumin and calbindin-D 28K form complementary
      patterns in the cat superior colliculus.
AB  - Parvalbumin (PV) and calbindin-D 28K (CaBP) are calcium binding proteins involved
      in calcium regulation in the brain. In some regions they coexist in the same
      neuron, while in other regions they are found in different cell types. We have
      studied the distribution and morphology of PV labeled neurons in the cat superior
      colliculus (SC) with antibody immunocytochemistry and compared this labeling to
      that of CaBP. PV neurons were concentrated in a dense tier within the deep
      superficial gray and upper optic layers. Scattered PV neurons also were found
      within the deep layers of SC. By contrast, CaBP neurons were concentrated in
      three tiers: one within the zonal and upper superficial gray layers, a second
      within the deep optic and upper intermediate gray layers (IGL), and a third
      within the deep gray layer. The distribution of PV neurons is thus complementary
      to that of CaBP neurons, with the CaBP cell tiers bordering the dense tier of PV
      neurons. PV neurons varied in size and morphology. The average diameter of
      labeled cells was 20 microns, almost twice the size of CaBP neurons. The cells
      were predominantly round, vertical fusiform, or stellate, and included the very
      large neurons found scattered in the IGL. Horseradish peroxidase injections into
      the lateral geniculate nucleus, the lateral posterior nucleus, the opposite
      superior colliculus, the dorsal lateral pontine gray nucleus, and two descending
      pathways--the crossed predorsal bundle and the tecto-ponto-bulbar tracts--each
      labeled SC neurons that were also labeled by PV. A large percentage (84%) of
      projection neurons contained PV. This result also differs from CaBP neurons in
      SC, most of which are interneurons. Two antigen double-label experiments did not
      produce any cells that contained both PV and CaBP. The two calcium binding
      proteins thus reveal a unique sublaminar organization in SC that consists of
      alternating small cell interneuron groups and large cell projection neuron
      groups.

PMID- 1619053
TI  - Serotoninergic projections from the raphe nuclei to the preoptic area in sheep as
      revealed by immunohistochemistry and retrograde labeling.
AB  - A retrograde tracer, fluorogold, was injected into the sheep preoptic area in
      order to demonstrate the origin of the serotoninergic fibers observed in this
      area. Within the raphe nuclei, retrogradely fluorogold-labeled neurons were
      observed mainly in the median raphe nucleus (B8), groups B6/B5, and in the area
      lateral to the nucleus interpeduncularis (group S4), but not in the dorsal raphe
      nucleus. About 50% of these fluorogold-containing neurons were immunostained with
      a specific antiserum raised against serotonin. Double-labeled neurons (serotonin
      immunoreactive and fluorogold containing neurons) represented less than 20% of
      the whole number of serotoninergic neurons. We concluded that a few
      serotoninergic neurons in the median raphe nucleus and in groups B5/B6 and S4
      project to the preoptic area. Moreover, these nuclei contained non-serotoninergic
      neurons which project to the same area. These results give new information on the
      serotoninergic innervation of the preoptic area in the sheep.

PMID- 1619054
TI  - Mechanisms of metastasis.
AB  - The role of dermatologists in the diagnosis and treatment of skin cancer
      continues to increase. Consequently, they will more frequently be involved in the
      diagnosis, treatment, and management of patients with metastatic or potentially
      metastatic tumors. Squamous cell carcinomas and malignant melanomas are
      frequently seen in dermatologic practices and have the capability to metastasize.
      Metastases are the result of a complex process that is characterized by a
      sequence of steps, each of which requires acquisition by the malignant cell of
      key biologic properties. The metastatic sequence can be conceptualized as
      detachment from the primary tumor followed by invasion, intravasation into a
      vessel, circulation, stasis within a vessel, extravasation, invasion of the
      recipient tissue bed, and ultimately proliferation. The basic steps of the
      metastatic sequence are described as well as how these steps and other tumor cell
      adaptations can affect the clinical patterns of metastasis. Finally, practical
      applications of the understanding of these principles of metastasis are
      discussed.

PMID- 1619055
TI  - Diffuse neonatal hemangiomatosis treated successfully with interferon alfa-2a.

PMID- 1619056
TI  - Zosteriform speckled lentiginous nevus.

PMID- 1619057
TI  - Erythema ab igne: treatment with 5-fluorouracil cream.

PMID- 1619058
TI  - Clinical evaluation of etretinate for the treatment of canine solar-induced
      squamous cell carcinoma and preneoplastic lesions.
AB  - BACKGROUND: Tumors of the skin and subcutaneous tissue account for 30% of all
      canine neoplasms. Canine solar-induced squamous cell carcinoma (SCC) is the most
      frequently reported canine cutaneous neoplasm. OBJECTIVE: The purpose of this
      study was to provide preliminary observations on the safety and efficacy of
      etretinate for the treatment of solar-induced SCC and associated preneoplastic
      lesions in dogs. METHODS: Etretinate was administered to 10 dogs at 1 mg/kg twice
      daily for a minimum of 90 days. RESULTS: Clinically, two dogs showed complete
      resolution of their preneoplastic lesions, three dogs had partial responses, two
      dogs maintained stable disease, and three dogs showed progression of lesions
      after 90 days of etretinate administration. Three dogs showed histologic
      improvement, four dogs showed no changes, and three dogs showed evidence of
      progressing SCC. Treatment-related biochemical abnormalities included reversible
      hypertriglyceridemia and transient serum liver enzyme elevations in three dogs.
      CONCLUSION: These preliminary findings suggest that etretinate, at the dosage
      administered, may provide therapeutic efficacy for solar-induced preneoplastic
      lesions in the dog, particularly for those multifocal lesions not easily managed
      by local methods of therapy.

PMID- 1619059
TI  - Pool palms.

PMID- 1619060
TI  - Evaluation of anthralin for mycosis fungoides.

PMID- 1619061
TI  - Localized unilateral hyperhidrosis: eccrine nevus.

PMID- 1619062
TI  - Starvation-associated pruritus: a clinical feature of eating disorders.

PMID- 1619063
TI  - Acetaminophen-induced progressive pigmentary purpura (Schamberg's disease).

PMID- 1619064
TI  - Metastasis.

PMID- 1619065
TI  - Approved drugs for unapproved indications: some clouds on the horizon.

PMID- 1619066
TI  - Dermabrasion of Hailey-Hailey disease and Darier's disease.

PMID- 1619067
TI  - Screening photoprotective agents against UVA radiation.

PMID- 1619068
TI  - Serum aminoterminal propeptide of type III procollagen in the management of
      methotrexate-induced fibrogenesis.

PMID- 1619069
TI  - Grafting of leg ulcers with undifferentiated keratinocytes.

PMID- 1619070
TI  - Malignant melanoma of the eyelid. A report of eight cases and a review of the
      literature.
AB  - BACKGROUND: Because of the relatively rare occurrence of malignant melanoma (MM)
      of the eyelid, prognostic factors in relation to survival in these patients have
      not been established. OBJECTIVE: Our purpose was to examine prognostic indicators
      in relation to survival in patients with MM of the eyelid. METHODS: All patients
      seen at UCLA Medical Center with MM of the eyelid as well as all cases reported
      in the literature were reviewed retrospectively. RESULTS: The data obtained from
      47 total cases seen at UCLA Medical Center revealed a significant disadvantage in
      5-year survival for those patients with MM involving the lid margins in
      comparison to those without lid margin involvement. CONCLUSION: Our review
      suggests that melanoma involving the eyelid margin and conjunctiva has a worse
      prognosis than melanomas of the eyelid that do not involve the conjunctiva. We
      can make no predictions in regard to the benefits of narrow versus wide surgical
      margins in the treatment of these patients.

PMID- 1619071
TI  - Influence of cumulative sun exposure on the prevalence of common acquired nevi.
AB  - BACKGROUND: Conflicting evidence exists on the relation between sun exposure and
      the number of common acquired nevi. The increase in the number of common acquired
      nevi until early adulthood and their greater concentration on sun-exposed areas
      suggested that the growth of common acquired nevi is promoted by UV radiation.
      Nevertheless, it was noticed that although solar exposure accumulates with age,
      the number of common acquired nevi decreases after the third decade. OBJECTIVE:
      Our purpose was to examine the relation between the prevalence of common acquired
      nevi and accumulative sun exposure. METHODS: The number of common acquired nevi
      on 128 patients with multiple solar keratoses (SK) was compared with their number
      on 82 control subjects. The existence of SK served as a biologic marker for long
      term solar effects. RESULTS: On patients with SK we counted 1285 nevi (mean 10.0
      nevi per person) and on control subjects, 1521 nevi (mean 18.5 nevi) (p = 0.0046;
      Kruskal-Wallis test). The finding that persons exhibiting signs of accumulating
      sun effects have fewer nevi was maintained irrespective to differences of gender,
      occupation, and complexion. CONCLUSION: Our data suggest that accumulating solar
      effects may contribute to the natural maturation and elimination of common
      acquired nevi in late adulthood.

PMID- 1619072
TI  - Sun exposure in Australian adolescents.
AB  - BACKGROUND: Little information is available on the sun-related behavior of
      teenagers despite the considerable resources spent to decrease sun exposure in
      this age group. OBJECTIVE: Our purpose was to describe the sun exposure behavior
      of Australian adolescents and define characteristics that predict use of sun
      protection. METHODS: Cross-sectional study of a random sample of 972 school
      students 13 to 15 years of age from three different locations in Australia (two
      urban and one rural) using a diary to document sun exposure and sun protection on
      two consecutive weekends. RESULTS: More than 80% of adolescent boys in each place
      and more than 60% of adolescent girls in both of the large cities spent more than
      2 hours outdoors during the peak ultraviolet (UV) periods on each weekend.
      Neither sunscreen nor hats were used for more than half the time spent in the
      sun; however, shirts were worn most of the time. Students who wore hats were more
      likely to be boys (odds ratios [OR] = 2.2, 95% confidence intervals [CI] 1.40 to
      3.44) and live in the rural region (OR = 4.6, 95% CI 2.36 to 9.04). Students who
      used sunscreen tended to have skin that sunburned easily (OR = 3.2, 95% CI 1.27
      to 7.88) and score highly on the knowledge questions (OR = 2.9, 95% CI 1.46
      5.69). This model was not a good predictor of behavior on a subsequent weekend,
      possibly because behavior was highly variable, with 35% to 50% of students
      changing their pattern of protection use from one weekend to the next.
      CONCLUSION: Adolescents spend long periods on summer weekends in the sun and do
      not follow recommended sun protection guidelines. The high variability of sun
      related behavior makes modeling and consequent development of education programs
      a difficult task.

PMID- 1619073
TI  - Topical corticosteroids and Staphylococcus aureus in atopic dermatitis.
AB  - BACKGROUND: Atopic dermatitis is commonly colonized with Staphylococcus aureus in
      high densities. OBJECTIVE: Our purpose was to study the effect of topical
      corticosteroids on the colonization of S. aureus in atopic dermatitis. METHODS:
      Sixty-six patients were treated with moderately potent, or very potent
      corticosteroids. Quantification of S. aureus and evaluation of the severity of
      the eczema was performed before, after 1 week, and after 2 weeks of treatment.
      RESULTS: Fifty-three patients carried S. aureus in the most pronounced lesion
      before treatment. The colonization was significantly correlated with the severity
      of the eczema. The density of S. aureus was reduced by topical corticosteroids.
      The reduction increased with the potency of the corticosteroid and was most
      pronounced during the first week. S. aureus was eliminated after a successful 2
      week treatment with a very potent corticosteroid. Propylene glycol 25% added to a
      moderately potent corticosteroid did not significantly increase the reduction of
      S. aureus. CONCLUSION: Topical corticosteroids of sufficient potency reduce the
      density of S. aureus in atopic dermatitis.

PMID- 1619074
TI  - Failure of Borrelia burgdorferi to survive in the skin of patients with
      antibiotic-treated Lyme disease.
AB  - BACKGROUND: Borrelia burgdorferi has been cultivated from clinically normal skin
      (previous erythema migrans sites) after antibiotic therapy for Lyme disease.
      OBJECTIVE: We investigated the possibility of similar findings in 13 of our
      patients with antibiotic-treated Lyme disease from whom B. burgdorferi was
      cultivated from their erythema migrans lesions before antibiotic therapy.
      METHODS: After treatment with doxycycline or a combination of amoxicillin and
      probenecid, skin biopsy specimens were obtained from clinically normal skin
      adjacent to the previous biopsy sites and cultured. RESULTS: B. burgdorferi was
      not cultivated from these posttreatment biopsy sites. CONCLUSION: The failure of
      B. burgdorferi to survive in the former erythema migrans sites of our antibiotic
      treated patients, as well as their favorable clinical response, supports the use
      of doxycycline or combined amoxicillin and probenecid in the treatment of early
      Lyme disease but does not preclude the survival of the organism in other tissues.

PMID- 1619076
TI  - Diagnostic utility of magnetic resonance imaging in malignant melanoma.
AB  - BACKGROUND: Dermatologists sometimes have difficulty in making the diagnosis of a
      melanocytic tumor. OBJECTIVE: Our purpose was to establish a noninvasive method
      for the diagnosis of malignant melanoma. We investigated the diagnostic
      usefulness of magnetic resonance imaging (MRI) in 23 lesions of primary malignant
      melanoma, metastatic malignant melanoma, and benign pigmented skin tumors.
      METHODS: The morphologic characteristics and the signal intensity of the tumors
      were analyzed to differentiate malignant and benign pigmented skin tumors by
      means of the tumor-to-fat contrast ratio of the signal intensity. RESULTS: The
      morphologic characteristics of the tumors obtained by MRI were not an absolute
      criterion for diagnosis of malignant melanoma, but the signal intensity of the
      tumor assessed by the tumor-to-fat contrast ratio on T2-weighted images clearly
      differentiated between primary malignant melanoma and benign pigmented skin
      tumors. CONCLUSION: These findings indicated that MRI is useful for noninvasive
      diagnosis of malignant melanoma.

PMID- 1619075
TI  - Darier-White disease: a review of the clinical features in 163 patients.
AB  - BACKGROUND: Darier's disease is a rare, dominantly inherited genodermatosis;
      there have not been any large clinical studies of patients with this disease.
      OBJECTIVE: Our purpose was to document the clinical features in a large group of
      patients with Darier's disease. METHODS: Data were collected from 163 affected
      persons. RESULTS: The onset usually occurred between the ages of 6 and 20 years.
      The disease has a predilection for the skin in seborrheic areas; 96% had acral
      signs; 6% had hypertrophic flexural involvement; and 13% had oral mucosal
      lesions. There was no remission. Topical therapy sometimes provided relief of
      symptoms but had no effect on the progress of the disease. Oral retinoids were
      effective, but long-term therapy was tolerated poorly. Most patients did not have
      other medical problems. CONCLUSION: Although Darier's disease is a chronic and
      unremitting burden, most patients manage to lead a relatively normal life.

PMID- 1619077
TI  - Eosinophilic pustulosis of the scalp in childhood.
AB  - BACKGROUND: Among sterile pustulosis in childhood, a pruritic relapsing
      eosinophilic variant beginning in infancy and located mostly in the scalp was
      first described as eosinophilic pustular folliculitis in infancy by Lucky and
      colleagues in 1984. OBJECTIVE: Our purpose is to describe such a condition in
      five boys and one girl and comment on differential diagnosis and relation with
      Ofuji's disease. METHOD: This is a clinicopathologic study. RESULTS: All patients
      had scalp pustules beginning in infancy or early childhood that were unresponsive
      to antibiotic therapy. Lesions also occurred on other areas but the scalp was the
      major site of involvement. Although secondary infection was demonstrated in one
      case, the lesions were primarily sterile. Smears of pustules showed a variable
      proportion of eosinophils. Histopathologic findings suggested a major role for
      eosinophils in this disorder because dermal eosinophilia was noted in all
      patients. The inflammatory pattern was not similar to Ofuji's disease. Transient
      blood eosinophilia was recorded in five patients. Topical steroids relieved
      inflammatory episodes. Dapsone was tried in one case with apparent benefit.
      CONCLUSION: Eosinophilic pustulosis of the scalp in childhood is a self-limited
      disease that can be relieved by topical steroids.

PMID- 1619078
TI  - Treatment of adult Langerhans cell histiocytosis with etoposide.
AB  - BACKGROUND: Langerhans cell histiocytosis (LCH) is a reactive disease in which
      abnormal Langerhans cells accumulate in various body sites and cause damage to
      affected organs. Adults often do not respond to conventional therapy with local
      or systemic steroids. OBJECTIVE: Our purpose was to investigate intravenous
      etoposide as monotherapy in the treatment of adult patients with severe or
      resistant LCH. METHODS: In an open study, three adult patients with LCH (one with
      single-system skin disease and two with multisystem disease) were treated with
      etoposide, 100 mg/m2/day, for 3 days. This was repeated every 3 or 4 weeks for
      three or four cycles. RESULTS: All patients achieved clinical remission that
      persisted during a 12- to 14-month follow-up. No serious side effects were noted.
      CONCLUSION: We recommend the use of etoposide monotherapy in severe or restricted
      LCH in adults.

PMID- 1619079
TI  - Treatment of aggressive basal cell carcinoma with intralesional interferon:
      evaluation of efficacy by Mohs surgery.
AB  - BACKGROUND: Intralesional interferon has shown activity in the treatment of
      noduloulcerative and superficial basal cell carcinomas (BCC). OBJECTIVE: Our
      purpose was to study the efficacy of intralesional interferon in the treatment of
      aggressive BCCs. METHODS: Fifteen patients with histologically proven primary
      morpheaform or recurrent BCCs were referred for Mohs surgery. They received nine
      intralesional injections of 1.5 million IU of interferon alfa-2b three times a
      week for 3 weeks (total dose 13.5 million IU). All tumors were located on the
      face and measured 7 to 25 mm in diameter. RESULTS: In four patients (27%) no
      residual tumor was found at surgery. In five (33%) tumor size was reduced by 75%.
      The remaining six patients (40%) showed no response to intralesional interferon.
      CONCLUSION: At the dosage used, interferon was able to cure only a minority of
      aggressive BCCs.

PMID- 1619080
TI  - The reliability of a second biopsy for determining residual tumor.
AB  - BACKGROUND: Often after biopsy a skin cancer appears to resolve clinically and a
      repeat biopsy may be done on the area in question before proceeding with further
      treatment. OBJECTIVE: Our purpose was to assess the value of a subsequent biopsy
      in the treatment of skin cancers previously diagnosed by biopsy results. METHODS:
      The results of a subsequent biopsy were compared with the results of Mohs
      micrographic surgery in 291 patients with biopsy-established basal cell carcinoma
      and squamous cell carcinoma. Pre-Mohs surgery curettings were examined in 60 of
      these patients to evaluate whether these could have caused false-negative Mohs
      results. RESULTS: One hundred nineteen patients had a negative second biopsy, of
      which 75 (63%) had residual tumor at surgery. Eight of 60 patients in whom the
      curettings were examined had negative results from both biopsy and Mohs surgery;
      tumor in the curettings was shown in six of these eight patients (75%).
      CONCLUSION: This study suggests that 63% or more of subsequent biopsy specimens
      for skin cancer may yield false-negative results and casts doubt on the
      usefulness of a subsequent biopsy before surgery.

PMID- 1619081
TI  - Immunofluorescence on split skin for the detection and differentiation of
      basement membrane zone autoantibodies.
AB  - The autoimmune subepidermal bullous diseases are characterized by autoantibodies
      to the basement membrane zone of stratified squamous epithelium. Recent studies
      have shown that the antibodies have characteristic ultrastructural and antigenic
      binding properties and that differentiating between those properties can be
      useful in distinguishing one disease from another. Immunofluorescence microscopy
      is widely used to detect basement membrane zone autoantibodies. The test has
      traditionally used tissue substrates with an intact basement membrane zone. Those
      substrates are limited because autoantibody binding cannot always be detected and
      because autoantibodies with different ultrastructural and antigenic binding
      properties cannot be distinguished from each other. Normal human skin that has
      been separated through the basement membrane zone (i.e., split skin) has recently
      been used as a substrate for detecting and characterizing basement membrane zone
      autoantibodies by immunofluorescence. Studies indicate that split skin is a more
      sensitive substrate than intact skin for detecting the antibodies and that
      antibodies with different ultrastructural binding sites can often be
      differentiated from one another on split skin. Those studies suggest split skin
      is the substrate of choice for the routine immunofluorescence evaluation of
      autoimmune subepidermal bullous diseases.

PMID- 1619082
TI  - Topical glucocorticoids with improved benefit/risk ratio: do they exist?
AB  - Topical glucocorticoids are still among the dermatologicals most frequently used.
      This is due to their undebatable potency in inflammatory skin disease. Their use
      is limited by the fear of side effects both systemic and topical, especially skin
      atrophy. Hence, congeners with an increased benefit-risk ratio are urgently
      needed and research on new drugs no longer focuses on more active drugs but safer
      ones. Only recently, evidence has been forwarded that the goal is realistic. Some
      new glucocorticoids, especially the nonfluorinated double-ester type such as
      prednicarbate, appear promising. In fact, they seem to affect fibroblast growth
      in vitro as well as skin thickness in vivo less than equipotent conventional
      glucocorticoids. Pertinent findings in humans have been obtained with the use of
      ultrasound equipment. The relevant aspects of chemistry, pharmacology, clinical
      benefits, and toxicology of the various glucocorticoids old and new are reviewed,
      as are potential future alternatives.

PMID- 1619083
TI  - The spectrum of nail disease in patients with human immunodeficiency virus
      infection.
AB  - There are no known pathognomonic nail signs of human immunodeficiency virus (HIV)
      infection. However, several presentations should increase the index of suspicion.
      (1) Proximal white subungual onychomycosis or superficial white onychomycosis,
      especially of the fingernails, is present. Trichophyton rubrum appears to cause
      both most commonly in HIV-infected patients. Periungual dermatophyte involvement
      and involvement of all 10 fingernails is unusual in non-HIV-infected persons. (2)
      Candida is a primary pathogen of the nail bed and nail plate especially if many
      nails are involved. (3) A destructive, almost granulomatous-like psoriatic
      involvement of the nails is present. (4) Squamous cell carcinoma of the nail bed
      in a young adult. There are no clinical trails to confirm the efficacy of therapy
      mentioned in this article. The treatment suggestions are empirical and are the
      personal views of the authors.

PMID- 1619084
TI  - Psoriasis. I. Pathogenesis.

PMID- 1619085
TI  - A comparison of the diagnoses of a graphologist with results of psychological
      tests. 1941.
AB  - A class of twenty-four students who had previously been given intelligence,
      interest, and personality tests wrote to a newspaper graphologist for vocational
      guidance, their university connection being disguised and the requests being
      staggered over a period of more than one week. The vocational recommendations and
      the diagnoses of personality traits were then compared with the test scores. It
      was found that: 1. Assuming that a certain minimum intelligence is necessary for
      a given occupation, the occupations recommended by the graphologist showed no
      more than a change relationship with the recommendations which a psychologist
      would have made on the basis of intelligence tests. 2. Assuming that a certain
      pattern of interests is desirable for adjustment in an occupation, the occupation
      recommended by the graphologist were quite different from those which a
      psychologist would have recommended on the basis of an interest inventory,
      certain unsuitable occupations being recommended with more than chance frequency
      by the graphologist. 3. The graphologist's estimates of the students' personality
      traits showed no more than a chance agreement with those made by a psychologist
      on the basis of personality inventories in the case of four traits, and in the
      case of the two others were worse than change, again revealing a constant error.
      4. There was reason for ascribing these constant errors to a belief in the
      existence of opportunities in certain areas rather than to poor diagnosis alone,
      and to the use of clues to personality traits not intrinsic in handwriting. 5. It
      was pointed out that, with certain graphological principles gaining acceptance in
      scientific circles, it is still important to check the activities of persons who
      claim to use these newer principles.

PMID- 1619086
TI  - Introduction to the special section on the emotional concomitants of brain
      damage.
AB  - The purpose of this introduction is to emphasize the theoretical and clinical
      implications of studying emotion after brain damage. Theoretically, it is one way
      of elucidating critical neural substrates of emotion and the interaction of
      cognitive and noncognitive determinants. Clinically, the cognitive and other
      behavioral changes associated with certain types of brain damage may make
      traditional methods of assessing emotion inaccurate. This special section is
      designed to review current knowledge regarding these issues and to emphasize
      their theoretical and clinical importance.

PMID- 1619087
TI  - Neural mechanisms of emotion.
AB  - When viewed from an evolutionary perspective, the neural mechanisms of emotion
      can be seen to be distributed across the brainstem, limbic, paralimbic, and
      neocortical regions. Descending and ascending connections among these levels are
      discussed in relation to three types of emotional processes: peripheral effects
      on patterned bodily responses, central effects on cognitive processing, and
      subjective emotional experience. Descending influences from the higher to the
      lower levels allow for an increasing coordination and flexibility of emotional
      responses, culminating in patterned activity across the peripheral endocrine,
      autonomic, and motor systems. Ascending influences from lower to higher levels
      provide preparatory modulation of cortical pathways, thus enabling perceptual and
      cognitive processing that is adaptive given the current emotional state. The
      bodily feelings of emotion are a function of cortical interoceptive sensory
      fields, activated by centrally generated signals or peripheral inputs from the
      body.

PMID- 1619088
TI  - Interhemispheric and intrahemispheric control of emotion: a focus on unilateral
      brain damage.
AB  - Neocortical contributions to emotional processing are discussed. First,
      parameters critical to the neuropsychological study of emotion are examined:
      interhemispheric (right, left) and intrahemispheric (anterior, posterior)
      factors, processing mode (expression, perception), and communication channel
      (facial, prosodic, lexical). Second, neuropsychological theories of emotion are
      described: right-hemisphere and valence hypotheses. Third, experimental studies
      of right-brain-damaged, left-brain-damaged, and normal adults are reviewed, on
      the basis of mode and channel, with a focus on stroke. Findings support right
      cerebral hemispheric dominance for emotion, regardless of valence and channel,
      and are more consistent for perception than expression. When lesion site is a
      factor, posterior sites are important for perception and anterior ones for
      expression. Finally, clinical implications are suggested for aphasia
      rehabilitation and for assessment of affect in neurological disorders.

PMID- 1619089
TI  - "No longer Gage": frontal lobe dysfunction and emotional changes.
AB  - This review presents the multiple changes in emotional response and personality
      that occur after damage to the frontal systems, proposes operational definitions,
      and analyzes the published reports according to these definitions. Neurological
      causes of frontal lobe damage and associations of frontal dysfunction with
      psychiatric disturbances are summarized. It is concluded that symptoms of frontal
      lobe damage that have been labeled as emotional disturbances may be classified as
      disorders of drive or motivation, mood (subjective emotional experience), and
      affect (emotional expression). It is proposed that the primary change after
      frontal lobe pathology is a disorder of personality, a change in the stable
      response patterns that define an individual as a unique self. Dysfunction of
      personality includes cognitive abilities, with a disorder of self-reflective
      awareness as a key deficit.

PMID- 1619090
TI  - Personality disturbances associated with traumatic brain injury.
AB  - Personality disturbances associated with traumatic brain injury are reviewed. The
      varied structural pathology of the brain in this patient group makes it difficult
      to specify how different brain lesions may result in specific emotional and
      motivational disturbances. However, an attempt to clarify terms and review
      empirical findings is made. Longitudinal prospective studies that utilize
      appropriate control groups are needed. Future research may especially benefit by
      considering the long-term effects of early agitation following traumatic brain
      injury as well as the problem of aspontaneity and impairment of self-awareness.

PMID- 1619091
TI  - Emotional changes with multiple sclerosis and Parkinson's disease.
AB  - Multiple sclerosis (MS) and Parkinson's disease (PD) are relatively common
      neurological disorders. Both disorders are chronic and progressive, produce
      varying degrees of physical disability, and result in characteristic
      neuropathological changes to a variety of subcortical brain structures. Patients
      with MS or PD also exhibit a higher prevalence of emotional disorders relative to
      other patient groups with comparable degrees of physical disability. The present
      review (a) examines specific methodological issues associated with research in
      this area, (b) describes the range and severity of emotional disorders in MS and
      PD, and (c) examines both endogenous and reactive explanations to account for the
      increased prevalence of emotional dysfunction in these two disorders. Suggestions
      for future research are offered, as well as implications for treatment.

PMID- 1619092
TI  - Alzheimer's disease and depression.
AB  - This article reviews the empirical literature available on the phenomenon of
      depression in Alzheimer's disease (AD). Although not extensively studied, there
      is accumulating evidence to suggest that depression affects a large number of
      patients with AD and can have profound effects on both the long-term functioning
      of these patients and the well-being of their caregivers. Thus far, the field is
      dominated by studies of prevalence. Considerably rarer are studies investigating
      etiology, association with other aspects of disease, impact on patients and
      caregivers, assessment, and treatment. The conceptual issues, methodological
      differences, and implications of the studies that exist thus far are discussed.

PMID- 1619093
TI  - Biological markers, treatment outcome, and 1-year follow-up in endogenous
      depression: electroencephalographic sleep studies and response to cognitive
      therapy.
AB  - Although there are now considerable data attesting to the efficacy of several
      forms of treatment for depression, there is surprisingly little information to
      guide the selection of the treatment most likely to benefit a given patient.
      Biologic markers of depression have received much attention for their potential
      to provide theoretically and clinically meaningful subgroups for specific
      treatments. The relationship between electroencephalographic (EEG) sleep
      disturbances, treatment outcome, and 1-year follow-up was examined for a sample
      of 53 patients with endogenous major depression receiving cognitive-behavioral
      therapy. Overall, there was little support for the prediction of a difference in
      short- or long-term outcome between patients with and without EEG sleep
      disturbances.

PMID- 1619094
TI  - Clinically significant change: Jacobson and Truax (1991) revisited.
AB  - The relationship between statistically and clinically significant change has been
      enigmatic. Jacobson and Truax (1991) have proposed an important step toward
      rapprochement. However, their suggested index of clinically significant change
      neglects possible confounding of improvement rate estimates by regression to the
      mean. An alternative method is described that incorporates an adjustment that
      minimizes this confounding when statistical regression has been shown to be
      present. If regression is not present, the Jacobson and Truax method is more
      appropriate; if regression is present, the Edwards-Nunnally method (Edwards,
      Yarvis, Mueller, Zingale, & Wagman, 1978) is more appropriate. The two methods
      are compared, and the effects of instrument reliability and sample deviance on
      estimated improvement rates are demonstrated using general well-being test-retest
      data from a sample of older adult mental health outpatients.

PMID- 1619095
TI  - Epidemiology of trauma: frequency and impact of different potentially traumatic
      events on different demographic groups.
AB  - The frequency and impact of 10 potentially traumatic events were examined in a
      sample of 1,000 adults. Drawn from four southeastern cities, the sample was half
      Black, half White, half male, half female, and evenly divided among younger,
      middle-aged, and older adults. Over their lifetimes, 69% of the sample
      experienced at least one of the events, as did 21% in the past year alone. The 10
      events varied in importance, with tragic death occurring most often, sexual
      assault yielding the highest rate of posttraumatic stress disorder (PTSD), and
      motor vehicle crash presenting the most adverse combination of frequency and
      impact. Numerous differences were observed in the epidemiology of these events
      across demographic groups. Lifetime exposure was higher among Whites and men than
      among Blacks and women; past-year exposure was highest among younger adults. When
      impact was analyzed as a continuous variable (perceived stress), Black men
      appeared to be most vulnerable to the effects of events, but young people showed
      the highest rates of PTSD.

PMID- 1619096
TI  - Cognitive-behavioral intervention with aggressive boys: three-year follow-up and
      preventive effects.
AB  - This study examined the longer term preventive effects of a school-based
      intervention with boys referred by classroom teachers as highly aggressive and
      disruptive. Three years after intervention, boys who had received an anger coping
      (AC) program were compared with a group of untreated boys. The AC boys had lower
      rates of drug and alcohol involvement and had higher levels of self-esteem and
      social problem-solving skills. The AC boys were not significantly different from
      previously nonaggressive boys on these variables at follow-up. Although the
      overall intervention did not have longer term effects on delinquency rates or
      classroom behavior, a subset of boys who also received booster sessions did
      display maintenance of certain classroom behavior improvement. Implications for
      intensification of cognitive-behavioral interventions are discussed.

PMID- 1619097
TI  - Stress, coping, and psychological adjustment of adults with sickle cell disease.
AB  - A transactional model of psychological adjustment to chronic illness was examined
      with 109 African-American adults with sickle cell disease (SCD). Good
      psychological adjustment was associated with lower levels of perceived daily
      stress and stress regarding SCD illness tasks, higher efficacy expectations, less
      use of palliative coping methods, less use of negative thinking/passive adherence
      pain-coping strategies, and family functioning characterized by high levels of
      support and low levels of conflict and control. Overall the underlying stress and
      coping conceptual model accounted for 44-50% of the variance in psychological
      adjustment.

PMID- 1619098
TI  - Therapeutic empathy and recovery from depression in cognitive-behavioral therapy:
      a structural equation model.
AB  - This study demonstrated that therapeutic empathy has a moderate-to-large causal
      effect on recovery from depression in a group of 185 patients treated with
      cognitive-behavioral therapy (CBT). The authors simultaneously estimated the
      reciprocal effect of depression severity on therapeutic empathy and found that
      this effect was quite small. In addition, homework compliance had a separate
      effect on clinical recovery, over and above the effect of therapeutic empathy.
      The patients of novice therapists improved significantly less than did the
      patients of more experienced therapists, when controlling for therapeutic empathy
      and homework compliance. Ss who terminated therapy prematurely were less likely
      to complete the self-help assignments between sessions, rated their therapists as
      significantly less empathic, and improved significantly less. Ss with borderline
      personality disorder improved significantly less, but they rated their therapists
      as just as empathic and caring as other patients. The significance of these
      findings for psychotherapy research, treatment, and clinical training is
      discussed.

PMID- 1619099
TI  - A comparison of three family therapy programs for treating family conflicts in
      adolescents with attention-deficit hyperactivity disorder.
AB  - Sixty-one 12- to 18-year-olds were randomized to 8-10 sessions of behavior
      management training (n = 20), problem-solving and communication training (n =
      21), or structural family therapy (n = 20). Families were assessed at pre- and
      posttreatment and 3-month follow-up. All treatments resulted in significant
      reductions in negative communication, conflicts, and anger during conflicts and
      improved ratings of school adjustment, reduced internalizing and externalizing
      symptoms, and decreased maternal depressive symptoms. Most outcomes remained
      stable between posttreatment and follow-up, and some continued to improve over
      this time. Despite group improvements, analyses of clinically significant change
      and clinical recovery within Ss showed that only 5-30% reliably improved from
      treatment and only 5-20% recovered following treatment. The three treatments did
      not differ in these rates.

PMID- 1619100
TI  - Social support, AIDS-related symptoms, and depression among gay men.
AB  - This study examined the impact of social support and HIV-related conditions on
      depression among 508 gay men participating in the San Francisco Men's Health
      Study, a population-based prospective study of single men aged 25-54 years. The
      number of HIV-related symptoms experienced significantly predicted depression
      cross-sectionally and 1 year later. Satisfaction with each of three types of
      social support (emotional, practical, informational) was inversely correlated
      with depression. Men who were more satisfied with the social support they
      received were less likely to show increased depression 1 year later. Degree of
      satisfaction with informational support appeared especially critical in buffering
      the stress associated with experiencing HIV symptoms. These findings offer
      valuable insight in understanding the psychological needs of gay men confronting
      the AIDS crisis and have important practical implications for designing mental
      health services to meet those needs.

PMID- 1619101
TI  - Attributions and relapse in opiate addicts.
AB  - This study investigated whether attributions of opiate addicts would predict both
      their ability to abstain from future use and their reactions to abstinence
      violations. Measures of generalized beliefs about responsibility for positive and
      negative outcomes and specific attributions about relapse episodes were elicited
      from 80 addicts at the time of admission for inpatient detoxification and
      treatment. Addicts who at admission attributed to themselves greater
      responsibility for negative outcomes and who attributed relapse episodes to more
      personally controllable factors were subsequently (at 6-month follow-up) more
      likely either to be completely abstinent or to contain the effects of temporary
      lapses into opiate use.

PMID- 1619102
TI  - Psychological and social indicators of suicide ideation and suicide attempts in
      Zuni adolescents.
AB  - Suicide behavior is a significant problem for many American Indian populations,
      often more so than in the general population, but little tribal-specific data
      available. In this study, baseline data on the correlates of suicide ideation and
      the social and psychological differences between suicide attempters and
      nonattempters were collected on a sample of 84 Zuni adolescents. Results show
      significant correlations between a measure of suicide ideation and past suicide
      attempt behavior, drug use, depression, hopelessness, stress, psychological
      symptomatology, social support, liking for school, and interpersonal
      communication. Significant differences between the 30% of the students who
      reported having previously attempted suicide and the nonattempters were also
      found on these measures. Areas for education and prevention efforts are
      suggested.

PMID- 1619103
TI  - Deterioration of intellect among children surviving leukemia: IQ test changes
      modify estimates of treatment toxicity.
AB  - This study assessed the association of young age at treatment, cranial
      irradiation, and time since treatment with intellectual deterioration among 49
      long-term survivors of childhood leukemia. Ss had been randomized to receive low
      dose cranial radiation therapy or high-dose chemotherapy. Longitudinal
      assessments of intellect were conducted. No significant effects of treatment
      group or age at treatment were detected. A small but statistically significant
      decline in mean full-scale IQ was noted over time (M = -3.6). Reanalysis with IQ
      test version included as a covariate eliminated IQ declines found initially.
      Results suggest (a) that there has been reduced toxicity of these methods of
      treatment and (b) that the magnitude and direction of error introduced by
      changing tests may approximate the magnitude of adverse effects on IQ from
      treatment.

PMID- 1619104
TI  - Control of the straw itch mite (Acari: Pyemotidae) with sulfur in an insect
      rearing facility.
AB  - The ectoparasitic mite Pyemotes tritici (Lagreze-Fossat & Montane) (Acari:
      Pyemotidae) caused paralysis and reduced longevity in eucalyptus longhorned
      borer, Phoracantha semipunctata F., under laboratory rearing conditions.
      Application of dusting sulfur to logs that contained pupating borers greatly
      reduced densities of mites on emerging adult beetles and increased beetle
      survivorship. Uniform application to all logs in a glasshouse effectively
      eradicated the mite infestation. A bioassay showed that sulfur may physically
      impede the dispersal of immature mites by adhering to the cuticle, but sulfur
      vapor did not act as a toxin.

PMID- 1619105
TI  - Differential development and reproduction of the German cockroach (Dictyoptera:
      Blattellidae) on three laboratory diets.
AB  - Development of nymphs and oocyte maturation in adults were examined in Blattella
      germanica (L.) reared on three commercial diets. Nymphs fed rat food developed
      significantly faster than nymphs fed two commercial dog foods. Similarly, oocytes
      matured more quickly in adult females that were raised on rat food than in
      females raised on dog food. Nymphal development and oocyte maturation were slower
      in insects that were fed whole dog food pellets than in insects fed ground dog
      food, suggesting that grinding the diet diminishes a mechanical barrier in whole
      dog food pellets. Comparisons of processed canine food and unprocessed canine
      food indicated that diets were significantly inferior after the steam extrusion
      process. Rat food is normally not subjected to such conditions and both processed
      and unprocessed rat food are equally suitable for B. germanica. The significance
      and implications for comparative studies with cockroaches are discussed.

PMID- 1619106
TI  - Simple in-vitro feeding system for northern fowl mites (Acari: Macronyssidae).
AB  - The use of Parafilm membranes for in-vitro feeding of northern fowl mites,
      Ornithonyssus sylviarum (Canestrini & Fanzago), is described. A membrane
      stretched in two perpendicular directions, folded, heat-sealed, inflated, and
      twisted at the ends to form a sphere allowed a high percentage (greater than 80%)
      of surviving adult female mites to feed on whole chicken blood. A high percentage
      (7 of 10) of protonymphs also fed through the membrane. Mites were able to feed
      from the same sac for 3 d and oviposited on the sac. This technology has
      potential applications for use in rearing O. sylviarum and other hematophagous
      arthropods, and for physiological experimentation.

PMID- 1619107
TI  - Effects of permethrin on aquatic organisms in a freshwater stream in south
      central Alaska.
AB  - Permethrin (0.5%) was applied to individual Lutz spruce, Picea x lutzii Little,
      to protect them from attack by spruce beetles, Dendroctonus rufipennis (Kirby).
      Residue levels were monitored in a freshwater stream above, adjacent to, and
      below the treatment site at intervals before, during, and after treatment.
      Maximum residue levels in the stream within the treatment site ranged from 0.05
      +/- 0.01 ppb 5 h after treatment to 0.14 +/- 0.03 ppb 8-11 h after treatment,
      with a decrease to 0.02 +/- 0.01 ppb 14 h after treatment. Levels of permethrin
      in standing pools near the stream within the treatment site were 0.01 +/- 0.01
      ppb. Numbers of drifting aquatic invertebrates increased 2-fold during treatment
      and 4-fold 3 h after treatment and declined to before spray numbers within 9 h.
      Terrestrial insects did not appear to respond to treatments because none was
      found in stream drift samples. Trout fry (Dolly Varden), aquatic insect larvae,
      and periphyton (attached algae) within and below the treatment site during and
      after treatment did not show signs of mortality compared with an upstream
      untreated control site.

PMID- 1619108
TI  - Field worker exposure to selected insecticides applied to corn via center-pivot
      irrigation.
AB  - Field workers were monitored for dermal and respiratory exposure to chlorpyrifos
      (with and without crop oil), carbaryl, and permethrin at reentry intervals of 2,
      4, 8, 24, and 48 h after application. Insecticides were applied to R3 stage corn
      through an overhead center-pivot irrigation system. Dermal exposure was measured
      by analyzing 18 gauze pads attached to the clothing of workers to represent human
      body regions. Hand exposure was determined using cotton gloves. Respiratory
      exposure was determined using portable air samplers equipped with polyurethane
      foam plugs to trap ambient insecticide residues. Gas liquid chromatography was
      used to quantify residues of chlorpyrifos and permethrin in gauze pads, gloves,
      and foam plugs. Carbaryl residues in pads, gloves, and foam plugs were analyzed
      using high-performance liquid chromatography. Highest dermal and respiratory
      exposures were found at the 2-h reentry interval. Exposures decreased as reentry
      interval increased. Dermal exposure was primarily confined to the hands. Residues
      detected by air samplers ranged from 0 to 0.03 micrograms/liter. Based on the
      estimated percentages of acute toxic dose (all less than 0.00038%), the risk of
      acute toxicity to workers at the intervals studied was low.

PMID- 1619109
TI  - Basal cell carcinoma arising on the ear of a young adult.

PMID- 1619110
TI  - Detection of selenium in generalized and localized argyria: report of four cases
      with X-ray microanalysis.
AB  - Electron microscopic and X-ray microanalytic studies were performed on four cases
      of argyria; one generalized and three localized. Deposition of electron dense
      granules was predominantly found on elastic fibers and around basal laminas of
      secretory portions of eccrine glands, although the amount of deposition was much
      less in the case of generalized argyria. In all four cases, X-ray microanalysis
      revealed that the depositions consisted mainly of silver, selenium, and sulfur.
      The importance of selenium in the detoxification of heavy metals was discussed.

PMID- 1619111
TI  - Significance of monocytosis in varicella and herpes zoster.
AB  - Percent ratios and absolute numbers of peripheral blood monocytes in patients
      with varicella and herpes zoster were determined and compared with those in
      patients with herpes simplex virus infection, measles and rubella. Monocytosis
      during the acute stage (p less than 0.01) was statistically significant in
      varicella and generalized and localized herpes zoster, compared with the levels
      in herpes simplex virus infection, measles and rubella. Absolute monocyte counts
      in varicella and HZ were significantly increased (p less than 0.02) beyond those
      of measles and rubella. The high % ratios of monocytes in varicella and herpes
      zoster during the acute stage decreased to normal ranges with cure.

PMID- 1619112
TI  - On multidimensional ultrasonic scattering in an inhomogeneous elastic background.
AB  - This work is concerned with the modeling of elastic wave scattering by solid or
      fluid-filled objects embedded in an inhomogeneous elastic background. The medium
      is probed by a monochromatic force and the scattered field is computed (forward
      problem) or observed (inverse problem) at some known receiver locations. Based on
      vector integral equations for elastic scattering, a general framework is
      developed, independent of both the problem geometry and the transmitter-receiver
      characteristics. This framework encompasses both forward and inverse modeling. In
      the forward model, a Born approximation for an inhomogeneous background is
      applied to obtain a closed form expression for the scattered field. In the
      inverse model, this approximation is also invoked to linearize for the
      multiparameter characteristic of the object. Finally, an iterative inversion
      scheme alternating forward and inverse modeling is proposed to improve the
      resolution and accuracy of the reconstruction algorithm.

PMID- 1619113
TI  - Annoyance caused by simultaneous impulse, road-traffic, and aircraft sounds: a
      quantitative model.
AB  - In this study, total annoyance caused by different simultaneous environmental
      sounds is investigated. In spite of a number of puzzling data in the literature,
      it is fairly well established that in combinations in which the annoyance of one
      source is considerably higher than that of another source, total annoyance is
      equal to the maximum annoyance of the separate sources. For combinations in which
      both sounds are about equally annoying, total annoyance seems to be higher than
      the maximum source-specific annoyance. The available data, however, are too rough
      to model total annoyance in these conditions. The present laboratory studies were
      therefore designed to explore further possible procedures to quantify total
      annoyance. Subjects rated the (total) annoyance caused by various combinations of
      impulse, road-traffic, and aircraft sounds. The results support a simple model
      which predicts the overall or total rating sound level L(t) for combinations of
      several types of sounds. Here, L(t) is numerically equal to the A-weighted
      equivalent sound level L(eq) of road-traffic sound with the same annoyance as
      caused by the combination of sounds. In the model, the sound exposure caused by
      the impulse and/or aircraft sounds is first expressed in the L(eq) of equally
      annoying road-traffic sound. With the help of source-specific dose-effect
      relationships, this is achieved by adding level-dependent penalties to the L(eq)
      of the respective sources. Weighted summation of the corrected L(eq)'s of the
      various sources then results in L(t). An optimal overall fit of the data from two
      separate experiments was obtained when the weighted summation of the corrected
      L(eq)'s was performed with the parameter k in k log(sigma 10(corrected L(eq) of
      source j)/k) set to 15. The standard deviation of the differences between the
      experimental results and the model predictions with k = 15 was equivalent to the
      small change in annoyance produced by a 1.5-dB shift in the L(eq) of road-traffic
      sound. Adoption of k = 15 implies that after correction, two equal L(eq)'s yield
      a total rating sound level which is 4.5 dB higher than each single-source
      corrected L(eq).

PMID- 1619114
TI  - A new portable sound processor for the University of Melbourne/Nucleus Limited
      multielectrode cochlear implant.
AB  - A new processor, called the spectral maxima sound processor (SMSP), has been
      developed for the University of Melbourne/Nucleus Limited multielectrode cochlear
      implant. The SMSP analyses sound signals by means of a bandpass filterbank having
      16 channels which are allocated tonotopically to the implanted electrodes. Every
      4 ms, typically, the six channels with the largest amplitudes are selected, and
      six corresponding electrodes are activated. In an ongoing study the performance
      of the SMSP is being compared with that of the Mini Speech Processor (MSP). Some
      results of speech perception tests from the first two SMSP users are presented,
      in which scores for the recognition of vowels, consonants, and words all showed
      significant increases over the corresponding MSP scores.

PMID- 1619115
TI  - Grouping in pitch perception: effects of onset asynchrony and ear of presentation
      of a mistuned component.
AB  - Three experiments investigated how the onset asynchrony and ear of presentation
      of a single mistuned frequency component influence its contribution to the pitch
      of an otherwise harmonic complex tone. Subjects matched the pitch of the target
      complex by adjusting the pitch of a second similar but strictly periodic complex
      tone. When the mistuned component (the 4th harmonic of a 155 Hz fundamental)
      started 160 ms or more before the remaining harmonics but stopped simultaneously
      with them, it made a reduced contribution to the pitch of the complex. It made no
      contribution if it started more than 300 ms before. Pitch shifts and their
      reduction with onset time were larger for short (90 ms) sounds than for long (410
      ms). Pitch shifts were slightly larger when the mistuned component was presented
      to the same ear as the remaining 11 in-tune harmonics than to the opposite ear.
      Adding a "captor" complex tone with a fundamental of 200 Hz and a missing 3rd
      harmonic to the contralateral ear did not augment the effect of onset time, even
      though the captor was synchronous with the mistuned harmonic, the mistuned
      component was equal in frequency to the missing 3rd harmonic of the captor
      complex tone and it was played to the same ear as the captor. The results show
      that a difference in onset time can prevent a resolved frequency component from
      contributing to the pitch of a complex tone even though it is present throughout
      that complex tone.

PMID- 1619116
TI  - Informational processing of complex sound. III: interference.
AB  - In this study, theoretical results from information theory and detection theory
      are applied to provide a formal analysis of the interaction of target and context
      uncertainty on the discrimination of brief multitone sequences. The experiments
      employ a sample-discrimination task in which the performance of an ideal observer
      is held constant while the relative variability of the target sigmaT and context
      sigmaC is varied. Listener performance in these experiments was less than ideal
      but increased monotonically with sigmaT/sigmaC whether the task was to
      discriminate the frequency or the intensity of the target. Performance was also
      constant for a constant sigmaT/sigmaC regardless of the target's position in the
      sequence. The results are consistent with a class of models in which the decision
      variable is a weighted sum of the tone values comprising the sequence. Weighting
      functions computed from the trial-by-trial date suggest that limits in
      performance result from trial-by-trial variability in the weights. The decision
      variable also serves as the basis for an analysis in which performance is
      linearly related to the information rate of the context independent of target
      position or task. In this analysis, target and context uncertainty contribute
      additively to the overall uncertainty associated with the decision variable.

PMID- 1619117
TI  - Evaluation of a method of simulating reduced frequency selectivity.
AB  - The accuracy of a method of simulating reduced frequency selectivity by the
      spectral smearing of complex stimuli has been evaluated. First an excitation
      pattern that would be evoked by a given nonsmeared stimulus in an impaired ear
      with broad auditory filters was estimated. Then the spectral smearing of the
      stimulus that would be necessary to create the same excitation pattern in a
      normal ear was calculated. The smearing was based on the shapes of simulated
      broad auditory filters; both symmetric and asymmetric broad filters were
      simulated. The method was used to process notched noise, and tones in notched
      noise, and the processed stimuli were used in a series of experiments with
      normally hearing subjects measuring the threshold for the tone in notched noise.
      The resulting data were used to derive auditory filter shapes. The derived filter
      shapes were generally similar to the expected shapes (based on the type of
      spectral smearing used), but there were some systematic discrepancies and some
      individual differences. The discrepancies do not seem to be due to the use of
      information derived from phase locking, since they were observed both at 1 kHz
      (where phase locking occurs) and at 6 kHz (where phase locking probably does not
      occurs). The discrepancies also do not seem to be due to the transmission
      characteristics of the outer/middle ear, since they occurred both when these
      characteristics were taken into account in the fitting procedure, and when the
      stimuli were preshaped to compensate for these characteristics. The influence of
      the subjects' own auditory filters probably can explain some of the
      discrepancies; the excitation pattern evoked by the spectrally smeared stimuli
      can be significantly influenced by the subjects' own filters when those filters
      are not much sharper than the simulated filters used to produce the smeared
      stimuli. Finally, some of the discrepancies can probably be explained by subjects
      combining information across auditory filters, rather than just using the single
      'best' filter in each condition; this represents a limitation of the fitting
      procedure rather than of the simulation itself. Overall, the simulation worked
      reasonably well, especially when the smearing was based on symmetric filters.

PMID- 1619118
TI  - The detectability of a tone added to narrow bands of equal-energy noise.
AB  - The ability to detect a 2000-Hz tone added to bands of noise centered at 2000 Hz
      was measured using a two-interval, forced-choice, pulsed-masker paradigm. The
      stimuli ranged in duration from 50-200 ms, and the maskers ranged in bandwidth
      from 5-320 Hz. In one condition, the bands of noise had equal energy across the
      two intervals of each trial and in a second condition the levels of the stimuli
      were independently and randomly chosen from a 30-dB range on a presentation-by
      presentation basis. The energy model failed to predict the data obtained either
      in the presence or in the absence of level variation. Control experiments showed
      that exposure to level variation yielded an overall reduction in sensitivity,
      suggesting that the presence of level variation leads to changes in the
      listeners' detection strategies. Computer simulations indicated that changes in
      either the fine structure or envelopes of the waveforms were sufficient to
      account for detection when changes in stimulus energy were not reliable.

PMID- 1619120
TI  - Accuracy of pitch matching for pure tones and for complex tones with overlapping
      or nonoverlapping harmonics.
AB  - The discrimination of the fundamental frequency (fo) of pairs of complex tones
      with no common harmonics is worse than the discrimination of fo for tones with
      all harmonics in common. These experiments were conducted to assess whether this
      effect is a result of pitch shifts between pairs of tones without common
      harmonics or whether it reflects influences of spectral differences (timbre) on
      the accuracy of pitch perception. In experiment 1, pitch matches were obtained
      between sounds drawn from the following types: (1) pure tones (P) with
      frequencies 100, 200, or 400 Hz; (2) a multiple-component complex tone,
      designated A, with harmonics 3, 4, 8, 9, 10, 14, 15, and fo = 100, 200, or 400
      Hz; (3) A multiple-component complex tone, designated B, with harmonics 5, 6, 7,
      11, 12, 13, 16, and with fo = 100, 200 or 400 Hz. The following matches were
      made; A vs A, B vs B, A vs P, B vs P and P vs P. Pitch shifts were found between
      the pure tones and the complex tones (A vs P and B vs P), but not between the A
      and B tones (A vs B). However, the variability of the A vs B matches was
      significantly greater than that of the A vs A or B vs B matches. Also, the
      variability of the A vs P and B vs P matches was greater than that for the A vs B
      matches. In a second experiment, frequency difference limens (DLCs) were measured
      for the A vs A, B vs B, and A vs B pairs of sounds. The DLCs were larger for the
      A vs B pair than for A vs A or B vs B. The results suggest that the poor
      frequency discrimination of tones with no common harmonics does not result from
      pitch shifts between the tones. Rather, it seems that spectral differences
      between tones interfere with judgements of their relative pitch.

PMID- 1619119
TI  - The role of envelope fluctuations in an apparent demonstration of suppression in
      simultaneous masking.
AB  - Fastl and Bechly [J. Acoust. Soc. Am. 74, 754-757 (1983)] reported that the
      threshold of a brief 900-Hz signal simultaneously masked by a band of noise. 100
      Hz wide, centered at 1000 Hz, was reduced by approximately 8 dB by the addition
      of an 1150-Hz tone having a level of 20 dB above that of the narrow-band masker.
      They concluded that this decrease in threshold was a demonstration of suppression
      in simultaneous masking. Here it is argued that Fastl and Bechly's results simply
      reflect the poorer detectability of signals masked by higher-frequency
      fluctuating maskers (their narrow-band masker) than by relatively flat-envelope
      maskers (their composite narrow-band plus tonal masker). The results of three
      experiments support the masker-envelope explanation. In the first experiment, as
      in the report of Fastl and Bechly, the masker centered at 1000 Hz (M1) was a
      narrow-band noise and the masker centered at 1150 Hz (M2) was a tone. Fastl and
      Bechly's result was replicated. However, thresholds obtained when M1 was
      presented alone (the M1-only condition) were more affected by the starting level
      of the signal within each adaptive track than were thresholds obtained when M1
      and M2 were presented together (the M1+M2 condition). This result paralleled a
      previous report that starting level influenced performance more with fluctuating
      than with flat-envelope maskers. For the four of seven subjects wh showed
      learning, there was also more improvement in the M1-only than in the M1 + M2
      condition. In the second experiment, M1 was a tone and M2 was a narrow-band
      noise.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619121
TI  - Fringe effects in modulation masking.
AB  - Modulation detection thresholds (20 log ms) for a sinusoidally amplitude
      modulated (SAM) noise were measured in the presence of a SAM noise masker with a
      modulation depth (mm) of 1.0 and a modulation frequency of 16 or 64 Hz. The
      signal and masker carriers were presented continuously, and the signal was
      modulated during one of the two 500-ms observation intervals. The masker was
      modulated during both observation intervals and, in some conditions, for a
      certain amount of time before and after signal modulation. The duration of this
      "fringe" ranged from 62.5 ms to continuous (masker modulated throughout the
      thresholds estimate). The first experiment showed that a 500-ms fringe could
      reduce masked thresholds by 4-6 dB, but only at low signal modulation frequencies
      (2-8 Hz). In the second and third experiments, it was found that the fringe had
      to have a duration of 500 ms and a depth of about 0.75 to be maximally effective.
      A final, supplementary experiment indicated that the fringe effect is not due
      solely to the fringe that occurs prior to the observation intervals. The results
      are discussed in terms of both peripheral and central auditory processing.

PMID- 1619122
TI  - Differences in auditory performance between monaural and dichotic conditions. I:
      masking thresholds in frozen noise.
AB  - Thresholds of a 5-ms, 1-kHz signal were determined in the presence of a frozen
      noise masker. The noise had a flat power spectrum between 20 Hz and 5 kHz and was
      presented with a duration of 300 ms. The following interaural conditions were
      tested with four listeners: Noise and signal monaural at the same ear (monaural
      condition, NmSm), noise and signal identical at both ears (diotic condition,
      NoSo), noise identical at both ears and signal monaural (dichotic condition,
      NoSm) and uncorrelated noise at the two ears and signal monaural (NuSm). The
      signal was presented at a fixed temporal position with respect to the frozen
      noise in all measurements and thresholds were determined for different starting
      phases of the carrier frequency of the signal. Variation of the carrier phase
      strongly influenced the detection in the diotic condition and the masked
      thresholds varied by more than 10 dB. The pattern of thresholds for the monaural
      condition was less variable and the thresholds were generally higher than for the
      diotic condition. The monaural-diotic difference for specific starting phases
      amounted to as much as 8 dB. Comparison measurements using running noise maskers
      revealed no such difference. This relation between monaural and diotic thresholds
      was further investigated with eight additional subjects. Again, monaural and
      diotic thresholds in running noise were identical, while in frozen noise, diotic
      thresholds were consistently lower than monaural thresholds, even when the ear
      with the lower NmSm threshold was compared. For the starting phase showing the
      largest monaural-diotic difference, the thresholds for NoSm lay between the
      monaural and the diotic values. At other starting phases, the NoSm threshold was
      clearly lower than both the NmSm and the NoSo threshold. One possible explanation
      of the observed monaural-diotic differences relates to contralateral efferent
      interaction between the right and the left hearing pathway. A prediction based on
      this explanation was verified in a final experiment, where frozen-noise
      performance for NmSm was improved by simultaneously presenting an uncorrelated
      running noise to the opposite ear.

PMID- 1619123
TI  - Formant frequency estimates for abruptly changing area functions: a comparison
      between calculations and measurements.
AB  - Vocal tract area functions may contain quite abrupt changes in cross-sectional
      area. In formant frequency calculations for such area functions, an inner length
      correction (ILC) should be applied. The relevance of this correction was
      investigated by comparing acoustic measurements obtained from a physical model of
      the vocal tract with data gathered by means of computer simulations. Calculating
      formant frequencies without applying internal length corrections caused
      substantial errors, particularly for area functions representing apical stops
      just anterior to occlusion. Decentering and axial symmetry in the arrangement of
      the area elements of the physical model were briefly studied and found to have
      effects on the formant frequency values.

PMID- 1619124
TI  - Young cochlear implant users' response to delayed auditory feedback.
AB  - This investigation determined whether the signal provided by the Cochlear
      Corporation Nucleus cochlear implant can convey enough speech information to
      induce a response to delayed auditory feedback (DAF), and whether prelingually
      deafened children who received a cochlear implant relatively late in their speech
      development are susceptible. Ten children with the Nucleus cochlear implant spoke
      simple phrases, first without and then with DAF. Three prelingually deafened
      subjects and the only two postlingually deafened subjects demonstrated longer
      phrase durations when speaking with DAF than without it. Two of the prelingually
      deafened subjects who demonstrated a response received their cochlear implants at
      the age of 5 years.

PMID- 1619125
TI  - The use of static and dynamic vowel cues by multichannel cochlear implant users.
AB  - Multichannel cochlear implant users vary greatly in their word-recognition
      abilities. This study examined whether their word recognition was related to the
      use of either highly dynamic or relatively steady-state vowel cues contained in
      /bVb/ and /wVb/ syllables. Nine conditions were created containing different
      combinations of formant transition, steady-state, and duration cues. Because
      processor strategies differ, the ability to perceive static and dynamic
      information may depend on the type of cochlear implant used. Ten Nucleus and ten
      Ineraid subjects participated, along with 12 normal-hearing control subjects.
      Vowel identification did not differ between implanted groups, but both were
      significantly poorer at identifying vowels than the normal-hearing group. Vowel
      identification was best when at least two kinds of cues were available. Using
      only one type of cue, performance was better with excised vowels containing
      steady-state formants than in "vowelless" syllables, where the center vocalic
      portion was deleted and transitions were joined. In the latter syllable type,
      Nucleus subjects identified vowels significantly better when /b/ was the initial
      consonant; the other two groups were not affected by specific consonantal
      context. Cochlear implant subjects' word-recognition was positively correlated
      with the use of dynamic vowel cues, but not with steady-state cues.

PMID- 1619126
TI  - Formant frequency discrimination by Japanese macaques (Macaca fuscata).
AB  - These studies investigated formant frequency discrimination by Japanese macaques
      (Macaca fuscata) using an AX discrimination procedure and techniques of operant
      conditioning. Nonhuman subjects were significantly more sensitive to increments
      in the center frequency of either the first (F1) or second (F2) formant of single
      formant complexes than to corresponding pure-tone frequency shifts. Furthermore,
      difference limens (DLs) for multiformant signals were not significantly different
      than those for single-formant stimuli. These results suggest that Japanese
      monkeys process formant and pure-tone frequency increments differentially and
      that the same mechanisms mediate formant frequency discrimination in single
      formant and vowel-like complexes. The importance of two of the cues available to
      mediate formant frequency discrimination, changes in the phase and the amplitude
      spectra of the signals, was investigated by independently manipulating these two
      parameters. Results of the studies indicated that phase cues were not a
      significant feature of formant frequency discrimination by Japanese macaques.
      Rather, subjects attended to relative level changes in harmonics within a narrow
      frequency range near F1 and F2 to detect formant frequency increments. These
      findings are compared to human formant discrimination data and suggest that both
      species rely on detecting alterations in spectral shape to discriminate formant
      frequency shifts. Implications of the results for animal models of speech
      perception are discussed.

PMID- 1619127
TI  - Pitch and voiced/unvoiced determination with an auditory model.
AB  - In this paper, an accurate pitch and voiced/unvoiced determination algorithm for
      speech analysis is described. The algorithm is called AMPEX (auditory model-based
      pitch extractor) and it performs a temporal analysis of the outputs emerging from
      a new auditory model. However, in spite of its use of an auditory model, AMPEX
      should not be regarded as a substitute for any psychophysical theory of human
      auditory pitch perception. What is mainly described is the design of a
      computationally efficient auditory model, the perceptually motivated
      determination of the model parameters, the conception of a reliable pitch
      extractor for speech analysis, and the elaboration of an experimental procedure
      for evaluating the performance of such a pitch extractor. In the course of the
      evaluation experiment several kinds of speech stimuli including clean speech,
      bandpass-filtered speech, and noisy speech were presented to three different
      pitch extractors. The experimental results clearly indicate that AMPEX
      outperforms the best algorithms available.

PMID- 1619128
TI  - Effects of musical training and absolute pitch ability on event-related activity
      in response to sine tones.
AB  - The neural correlates of music perception have received relatively little
      scientific attention. The neural activity of listeners without musical training
      (N = 11), highly trained musicians (N = 14), and musicians possessing "absolute
      pitch" (AP) ability (N = 10) have been measured. Major differences were observed
      in the P3, an endogenous event-related potential (ERP), which is thought to be a
      neurophysiological manifestation of working memory processing. The P3 was
      elicited using the classical "oddball" paradigm with a sine-tone series.
      Subjects' musical backgrounds were evaluated with a survey questionnaire. AP
      ability was verified with an objective pitch identification test. The P3
      amplitude, latency and wave shape were evaluated along with each subjects'
      performance score and musical background. The AP subjects showed a significantly
      smaller P3 amplitude than either the musicians or nonmusicians, which were nearly
      identical. The P3 latency was shortest for the AP subjects, and was longer for
      the nonmusicians. Performance scores were uniformly high in all three groups. It
      is concluded that AP subjects do indeed exhibit P3 ERPs, albeit with smaller
      amplitudes and shorter latencies. The differences in neural activity between the
      musicians and AP subjects were not due to musical training, as the AP subjects
      had similar musical backgrounds to the musician group. It is also concluded that
      persons with the AP ability may have superior auditory sensitivity at cortical
      levels and/or use unique neuropsychological strategies when processing tones.

PMID- 1619129
TI  - Formant frequencies in Estonian folk singing.
AB  - Formant frequencies in an old Estonian folk song performed by two female voices
      were estimated for two back vowels /a/ and /u/, and for two front vowels /e/ and
      /i/. Comparison of these estimates with formant frequencies in spoken Estonian
      vowels indicates a trend of the vowels to be clustered into two sets of front and
      back ones in the F1/F2 plane. Similar clustering has previously been shown to
      occur in opera and choir singing, especially with increasing fundamental
      frequency. The clustering in the present song, however, may also be due to a
      tendency for a mid vowel to be realized as a higher-beginning diphthong, which is
      characteristic of the North-Estonian coastal dialect area where the singers come
      from. No evidence of a "singer's formant" was found.

PMID- 1619130
TI  - Reduction of tympanic membrane displacement during vocalization of the arboreal
      frog, Eleutherodactylus coqui.
AB  - Tympanic membrane (TM) velocities of vocalizing male frogs, Eleutherodactylus
      coqui, were measured in the field using laser vibrometry. The animal's call
      produced levels of 114-120 dB SPL measured at distances of 12-20 mm from the
      eardrum and mean TM displacements in response to the two notes of the male's own
      advertisement call were 1.84 and 2.08 nm, respectively. These values are close to
      the TM displacements obtained in response to playback of the two-note call at
      much lower sound levels. Thus TM vibrations are attenuated during phonation in
      the frog, and several candidate mechanisms for auditory sensitivity reduction are
      discussed.

PMID- 1619131
TI  - The role of interaural time difference and fundamental frequency difference in
      the identification of concurrent vowel pairs.

PMID- 1619132
TI  - Premorbid behavioral and psychosocial adjustment of children with traumatic brain
      injury.
AB  - The premorbid adjustment of 85 six- to sixteen-year-old children with traumatic
      brain injury was assessed by means of standardized rating forms that were
      completed by the children's parents and teachers. Parents and teachers were in
      moderate agreement when rating children's premorbid functioning. Less than 11% of
      the children appeared to have premorbid disturbances. Premorbid adjustment did
      not appear to be clearly related to injury severity or to type of injury. It is
      concluded that premorbid behavioral and psychosocial factors are not strongly
      related to the incidence of traumatic brain injury in a sample of children with
      predominantly relatively severe injuries.

PMID- 1619133
TI  - Prevention and treatment of juvenile problem behavior: a proposal for a socio
      ecological approach.
AB  - This study proposes a socio-ecological model representing the relation between
      emotional and behavioral problems of children and risk factors in the family, at
      school and in the peer group. An empirical examination of a sample of 150
      children at risk for delinquency shows that the model explains 30-40% of the
      variance in problem behavior. The model is used to provide possibilities for
      prevention and intervention.

PMID- 1619134
TI  - Adolescents with attention deficit hyperactivity disorder: mother-adolescent
      interactions, family beliefs and conflicts, and maternal psychopathology.
AB  - A group of 83 adolescents with attention deficit hyperactivity disorder (ADHD)
      were subdivided into those with ADHD alone (n = 27) and those with ADHD and
      oppositional defiant disorder (ADHD/ODD, n = 56). They were compared to each
      other and a community control group (n = 77) on measures of family conflicts,
      family beliefs, maternal adjustment, and observations of mother-adolescent
      interactions during both a neutral and conflict discussion. Both ADHD groups had
      more topics on which there was conflict and more angry conflicts at home than
      control adolescents on parent reports. Only the ADHD/ODD adolescents reported
      more such conflicts, endorsed more extreme and unreasonable beliefs about their
      parent-teen relations, and demonstrated greater negative interactions during a
      neutral discussion than the control teenagers. Similarly, only mothers of the
      ADHD/ODD teens displayed greater negative interactions during a neutral
      discussion, more extreme and unreasonable beliefs about their parent-teen
      relations, greater personal distress, and less satisfaction in their marriages
      than the mothers in the control group. Most findings for the ADHD only group were
      between the control group and the group with mixed ADHD/ODD but did not differ
      from either group. Results imply that it is the combination of ODD symptoms with
      those of ADHD that is associated with the greater-than-normal conflicts, anger,
      poor communications, unreasonable beliefs, and negative interactive styles seen
      in ADHD adolescents. These same characteristics typify their mothers'
      interactions as well such that both the adolescents' ODD symptoms and maternal
      psychological distress (hostility) make unique contributions to the degree of
      conflict and anger in the parent-teen relations of ADHD adolescents.

PMID- 1619136
TI  - Correlates of sociometric status in school children in Buenos Aires.
AB  - Teacher ratings on Spanish translations of the Comprehensive Behavior Rating
      Scale for Children and peer nominations were obtained for 110 school children (42
      boys and 68 girls) in grades 2-5 at a public elementary school in Buenos Aires.
      Nominations of "likes best" were negatively correlated with language processing
      deficits, attention problems, and sluggish tempo as rated by both teachers and
      peers, and positively correlated with teacher ratings of social competence, for
      both boys and girls. The reverse pattern was found for nominations of "likes
      least." Children were assigned to sociometric status groups of popular (n = 27),
      rejected (n = 28), neglected (n = 7) controversial (n = 11), and average (n = 37)
      based on number of LL and LB nominations. Rejected and popular children could be
      differentiated by teacher and peer ratings of linguistic information processing
      deficits, inattention, and sluggish tempo. Behavioral characteristics of motor
      hyperactivity, impulsivity, and aggression were significantly associated with
      being male but did not differ by sociometric status group.

PMID- 1619135
TI  - Attention, play, and social behavior in ADHD preschoolers.
AB  - We investigated attention, play and nonplay behavior in preschool children with
      attention deficit hyperactivity disorder (ADHD) and a matched control group of
      non-ADHD children. Forty 4- to 5-year-old children (20 ADHD and 20 matched
      control) participated. Across a 6-week-period, children's social and play
      interactions as well as nonplay behaviors were videotaped in the classroom.
      Videotape recordings were analyzed for the level of attention, cognitive play,
      and social participation. In addition, children's level of attention and
      cooperative behavior were observed during two group activities. Findings
      indicated that ADHD, relative to non-ADHD, children engaged in less overall play
      and greater functional or sensorimotor play. ADHD children also engaged in more
      transitional behavior, were less competent with peers, and were less attentive
      and cooperative during group activities.

PMID- 1619137
TI  - Development of conduct problems and peer rejection in preschool children: a
      social systems analysis.
AB  - The development of impulsive-aggressive problem behavior and peer rejection was
      examined in sixty 4- to 5-year-old boys from low-income family backgrounds.
      Children's sociometric status and behavioral adjustment were assessed
      longitudinally at the beginning and end of the preschool year, and related to
      measures of peer interaction at three different points in time. Boys identified
      as socially rejected and aggressive in the beginning of the year were highly
      likely to be identified as such at the end of the year. Early in the preschool
      year, these children contributed to their own rejection by initiating socially
      aversive exchanges with peers. Although peers clearly perceived these problems,
      they did not reciprocate with counteraggression at first. However, as time
      passed, peers began to actively victimize these children, and most of the
      aggression on the part of victims became reactive in nature. Thus, the current
      findings strongly support a transactional model of the development of early peer
      rejection and conduct problems.

PMID- 1619138
TI  - Dental CAD/CAM.

PMID- 1619139
TI  - More on molars.

PMID- 1619140
TI  - Importance of critical reading.

PMID- 1619141
TI  - NIDR funds AIDS study.

PMID- 1619142
TI  - New approaches to preventing and treating postoperative pain.
AB  - Dental pain is estimated to account for 15 million lost U.S. work days each year.
      A flexible analgesic scheme, described in this report, can effectively manage
      acute pain so patients won't avoid dental treatment they perceive as painful.

PMID- 1619143
TI  - Managing anxiety and pain during dental treatment.
AB  - Behavioral techniques can teach patients how to cope with anxiety and tension
      while undergoing dental procedures. Practitioners need to know which technique
      best fits each patient. This report reviews the repertoire of procedures.

PMID- 1619144
TI  - Managing TMD patients: initial therapy is the key.
AB  - It has been the intention of this brief paper to help dentists respond quickly
      and effectively to patients with TMD. (In lieu of a detailed bibliography, a
      brief list of articles and books that deal with diagnosis and therapy for TMD
      follows.) Several present actual guidelines for practice, while others discuss
      concepts in greater detail. Knowing how to help these troubled patients by using
      contemporary basic principles of pain management should make every practicing
      dentist feel a well-deserved sense of fulfillment.

PMID- 1619145
TI  - Controlling dental pain.
AB  - The obligation to manage pain and relieve a patient's suffering is an important
      part of dentistry. The practitioner must balance pain control, concern for
      patient safety and side effects of pain treatment. There are no rigid
      prescriptions to manage postoperative pain.

PMID- 1619146
TI  - Preventing dental caries: breaking the chain of transmission.
AB  - Besides using all possible techniques to increase host resistance (fluoride,
      sealants) and decrease exposure to fermentable carbohydrates (for example, use of
      sugar substitutes), dentists must treat caries as infectious and transmissible.
      Antimicrobial agents are recommended.

PMID- 1619147
TI  - Phenytoin-induced hyperplasia found in edentulous patients.

PMID- 1619148
TI  - Tooth restorations for mature people: some new hope with new materials.

PMID- 1619149
TI  - Clinical board examinations: variation found in pass rates.
AB  - This study found significant variation in pass rates within and among state and
      regional dental board clinical examinations during 1979-1988. This suggests that
      factors other than the abilities of the candidates influence exam outcomes. As
      long as individual states can argue that there is currently no definitive system
      to assure the quality of dental care, states may remain reluctant to relax their
      restrictions on dentists' freedom of movement.

PMID- 1619150
TI  - Non-maleficence: do no harm!

PMID- 1619151
TI  - Creating your practice philosophy: it's your chance to set goals.

PMID- 1619152
TI  - Microbiology of the mouth.

PMID- 1619153
TI  - Sterilization and disinfection.

PMID- 1619154
TI  - Infection control.

PMID- 1619155
TI  - Blood analysis.

PMID- 1619156
TI  - OSHA guidelines.

PMID- 1619157
TI  - Antisealants.

PMID- 1619158
TI  - Licensure.

PMID- 1619159
TI  - Patient medication costs as a therapeutic consideration.
AB  - Don't neglect therapeutic considerations in selecting drugs, but take their cost
      into account. Sometimes, selecting an older, established drug or generic
      equivalent can represent a significant savings for the patient.

PMID- 1619160
TI  - Rationale for removing impacted teeth: when to extract or not to extract.
AB  - Age, crowding, disease and root resorption all influence the decision to remove
      impacted teeth. While not every impacted tooth causes a significant problem, each
      has that potential.

PMID- 1619161
TI  - Cranial bone grafting in oral and maxillofacial surgery.

PMID- 1619163
TI  - Patient fights for right to records.

PMID- 1619162
TI  - FDA explains status of N2 material.

PMID- 1619164
TI  - Ceramic orthodontic brackets: how and when to use them. Council on Dental
      Materials, Instruments and Equipment.

PMID- 1619165
TI  - States take the lead on health care reform.

PMID- 1619166
TI  - Risk management: then and now.

PMID- 1619167
TI  - Using posterior composites appropriately.
AB  - The success rates of posterior composite restorations vary depending on whether
      they are used in clinical studies or by practitioners. This article offers a
      guide to determining when to use these materials.

PMID- 1619168
TI  - Alternative therapies for major aphthous ulcers in AIDS patients.

PMID- 1619169
TI  - Report of case: reviewing cephalic tetanus.
AB  - In this case, either caries or a root canal procedure provided the point of entry
      for cephalic tetanus. Facial/head pain may signal the first symptom.

PMID- 1619170
TI  - Ingesting an onlay. A case report.
AB  - When a patient attempted to speak during a dental procedure, she swallowed an
      onlay. After four weeks, it was mechanically removed from her colon.

PMID- 1619171
TI  - The key to an active practice? It's continuing patient education.

PMID- 1619172
TI  - A matter of trust.

PMID- 1619173
TI  - Point of view defining a nutritious diet: need for new dietary standards.

PMID- 1619174
TI  - Nutritional management of the obese gestational diabetic pregnant woman.

PMID- 1619175
TI  - Caloric restriction in pregnant diabetic women: a review of maternal obesity,
      glucose and insulin relationships as investigated at the University of
      California, San Diego.
AB  - Caloric restriction during pregnancy is contraindicated for women with a normal
      body mass index (BMI) of 19.8-26 kg/m2. Reduction of caloric intake in obese
      pregnant normal and diabetic women has been a controversial topic for many years.
      This paper reviews several clinical studies initiated in 1978 at the University
      of California, San Diego. One focus of this review concerns modest caloric
      reduction in obese women with gestational diabetes mellitus (GDM). Metabolic
      observations of diabetes during pregnancy in the past decade include extensive
      use of a 400 kcal isocaloric breakfast meal tolerance test to assess maternal
      glucose:insulin relationships and the degree of insulin resistance in obese
      pregnant subjects. We have previously reported that maternal hyperinsulinemia
      with or without maternal hyperglycemia is an important factor in fetal
      macrosomia. We suggest for obese pregnant diabetic women implementation of
      nutritional recommendations of the 1990 Committee on Nutritional Status During
      Pregnancy and Lactation, Food and Nutrition Board, Institute of Medicine,
      National Academy of Sciences that advise a lower caloric intake for obese normal
      pregnant women with BMIs greater than 26. In obese noninsulin-dependent diabetic
      women and those with GDM, we urge that a large prospective epidemiologic study be
      undertaken to assess the respective roles of modest maternal caloric restriction
      and maternal glucose:insulin relationships on neonatal and long-term longitudinal
      measurements of growth and development of children of diabetic mothers.

PMID- 1619176
TI  - Caloric restriction in gestational diabetes mellitus: when and how much?
AB  - Variations in nutritional intake during pregnancy have measurable effects on the
      circulating levels of maternal nutrients, maternal weight gain, and birth weight
      of the offspring. A growing body of evidence indicates that alterations in
      maternal metabolism can also have long-term consequences in the offspring in
      relation to adult adiposity, glucose tolerance, and perhaps intellectual
      development. Therefore, recommendations for diet during pregnancy must be made
      with great care, and with as much scientific understanding as possible.
      Nutritional advice traditionally given to all pregnant women, including those
      with gestational diabetes mellitus (GDM) or noninsulin-dependent diabetes, does
      not allow for individual differences in caloric needs as a function of the degree
      of maternal obesity and thus, may encourage excessive weight gain. Evidence
      reviewed below suggests that adjusting caloric intake to meet new guidelines for
      weight gain during pregnancy may be advantageous in reducing maternal blood sugar
      and insulin levels, without producing abnormalities in other metabolic variables.
      Modest caloric reduction which limits excessive weight gain in the mother may
      also be associated with a small reduction of fetal weight. However, more
      stringent dietary manipulations in obese gravida should be discouraged as a
      routine measure until more knowledge is available from large-scale clinical
      trials about their effects on the entire panoply of maternal nutrients and their
      impact on the offspring.

PMID- 1619178
TI  - Effect of daytime on resting energy expenditure and thermic effect of food in
      obese adolescents.
AB  - The aim of this study was to investigate the effect of daytime on resting energy
      expenditure (REE) and thermic effect of food (TEF), REE and TEF were measured in
      11 obese boys (mean age +/- SD 11.9 +/- 1.6 years; body mass index 30.1 +/- 4.0
      kg/m2) by indirect calorimetry (SensorMedics 2900) on two consecutive days: early
      in the morning (7:30 a.m.) on one day and at 12 noon on the other day or vice
      versa. REE was measured for 30 minutes and TEF for 180 minutes after a 600 kcal
      liquid meal containing 13% protein, 39% fat and 48% carbohydrates. REE measured
      in the morning was not statistically different from that measured at noon (2191
      +/- 358 vs 2223 +/- 319 kcal/24 hours) and morning values were highly correlated
      with afternoon values (r2 = 0.805). Therefore we conclude that the effect of
      daytime is negligible for measurements of REE if the patients are in a
      postabsorptive state and avoid physical activity and stress 10-12 hours prior to
      measurements. The thermic effect of food calculated in the morning also was not
      statistically significantly from values found in the afternoon (8.2 +/- 8.8% in
      the morning and 6.6 +/- 7.5% in the afternoon). However, because of very high
      within-patient variability the correlation between morning and afternoon values
      was weaker than for REE (r2 = 0.289).

PMID- 1619177
TI  - Brief communication: changes in thermogenesis and caloric efficiency with high
      and normal protein-reducing diets in women.
AB  - A pilot study with four women (40-60% above ideal weight, 32-42 years old) was
      conducted for 6 weeks of weight maintenance, 12 weeks at 50% calories (1000 and
      1200 kcal/day) and 6 weeks of weight maintenance after weight loss. Two women
      consumed 17% and two 32% of their calories from protein during restriction; their
      energy metabolism and body composition changes were examined. The use of doubly
      labeled water for measuring energy expenditure during weight loss was evaluated.
      Although the 32% protein diet did not reduce lean body tissue loss, the apparent
      increased efficiency of calorie utilization compared to the 17% protein diet is
      worthy of further investigation. Thermic effect of a meal was greatly reduced in
      these women compared to previously reported responses. Further refinements of the
      doubly labeled water method are needed prior to application in weight loss
      studies.

PMID- 1619179
TI  - Thiamin and vitamin B6 intakes and erythrocyte transketolase and aminotransferase
      activities in morbidly obese females before and after gastroplasty.
AB  - To assess the need for postoperative vitamin supplements, intakes and nutritional
      status of thiamin (B1) and vitamin B6 were studied in 18 female gastroplasty
      patients who received a placebo or different levels of supplemental vitamins.
      Postoperative erythrocyte transketolase basal (BA) and thiamin pyrophosphate
      stimulated (SA) activities and activity coefficients (AC) correlated
      significantly with B1 intake. Despite a decrease in apotransketolase, low thiamin
      intakes were associated with increased AC values during the first 3 months. With
      return to low B1 intakes following repletion during month 4, the AC values
      remained normal with low total activities. Both alanine (EALT) and aspartate
      (EAST) aminotransferase apoenzyme levels declined and AC values increased
      significantly during the first 3 months. Although the EALT-indices were more
      sensitive to changes in B6 intake than the EAST-indices, the EASTBA and SA
      correlated most consistently with the intake. Postoperative dietary intakes of
      both vitamins were inadequate for maintenance of normal activities of these
      erythrocyte enzymes. Although B1 intake of greater than or equal to 1.0 mg/day
      was adequate for maintenance of normal thiamin status in most subjects of this
      study, supplementation with greater than or equal to 1.5 mg/day is prudent even
      though it may not prevent the early postoperative loss of apotransketolase.
      Vitamin B6 intake at the current recommended dietary allowance (1.6 mg) was not
      adequate to maintain coenzyme saturation of the erythrocyte aminotransferases.
      Marginal intake of other nutrients may have affected the utilization of both
      thiamin and vitamin B6.

PMID- 1619180
TI  - Dietary intake, exercise, obesity and noncommunicable disease in rural and urban
      populations of three Pacific Island countries.
AB  - Dietary intake surveys of rural and urban communities in three Pacific Island
      countries were conducted using an adjusted 24-hour dietary recall method. Dietary
      survey samples were drawn from noncommunicable disease surveys of Melanesians and
      Indians in Fiji, Micronesians in Kiribati and Melanesians in Vanuatu. Comparisons
      of total energy and macronutrient intakes and of obesity, hypertension, diabetes
      mellitus, serum cholesterol and physical activity levels revealed similar
      rural/urban trends. Urban subjects were more obese than rural ones, had higher
      prevalence rates of diabetes and hypertension, and generally had higher
      cholesterol levels. Rural subjects were leaner, suffered less from diabetes and
      hypertension, and had greater total energy intakes than urban dwellers. Rural
      people ate a greater proportion of carbohydrates, while urban subjects ate
      proportionally more protein and fat, apart from the outer Kiribati atolls with
      high coconut intakes. Rural subjects in all three studies had higher levels of
      physical activity. These studies provide persuasive evidence that exercise as
      well as diet has a significant effect on rural/urban differentials in obesity and
      noncommunicable disease, and that energy intake reflects energy expenditure.

PMID- 1619181
TI  - Plasma lipoproteins in hyperlipidemic subjects eating iodine-enriched eggs.
AB  - Iodine-enriched (IE) eggs are produced by chickens fed a diet containing kelp.
      These eggs have been reported to reduce plasma cholesterol in humans and
      experimental animals. The purpose of this study was to determine the effect of
      the ingestion of one IE egg/day on the plasma lipoprotein cholesterol in
      borderline and hyperlipidemic individuals ingesting a low-fat diet. One hundred
      three subjects with entry cholesterol levels greater than 5.17 mmol/L were placed
      on a low-fat, low-cholesterol diet for 12 weeks. Between weeks 4 and 12,
      approximately half of the subjects were randomly assigned to either a diet
      control group (n = 53), or a group who ingested one IE egg/day in addition to
      this diet (n = 50). Subjects in both the egg group and the diet control group had
      a significant reduction in total plasma cholesterol (TC) at the end of the study
      compared with study entry; addition of the egg in the diet did not abolish the TC
      reduction in the egg group. However, paired comparisons of total and lipoprotein
      cholesterol levels at the end of the egg intervention period with the end of the
      initial dietary period demonstrated that the egg group had a significantly
      greater increase than the diet control group in TC (egg group: 7.2 +/- 1.5%
      increase; diet controls: 1.5 +/- 0.9% increase; p less than 0.01) and low-density
      lipoprotein cholesterol (egg group: 9.2 +/- 1.7% increase; diet controls: 3.9 +/-
      1.5% increase; p less than 0.01). This effect was most pronounced in subjects
      with higher initial cholesterol levels and subjects with mixed hyperlipidemia
      (elevated cholesterol and triglyceride). Results suggest that these particular
      groups of subjects are most susceptible to cholesterol changes associated with
      ingestion of IE eggs.

PMID- 1619182
TI  - Omega-3 fatty acid content of the US food supply.
AB  - In this study, levels and sources of omega-3 fatty acids (FA) available for
      consumption in the US food supply, dating from 1935, are estimated. omega-3 FA
      assessed are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and
      linolenic acid (LNA). Estimates are based on annual per capita food use data and
      data on the omega-3 FA content of foods. Although fish use increased, the EPA
      level was slightly lower in 1985 than in 1935-1939, reflecting a marked decline
      in use of certain fatty fish. The level of DHA increased, due to greater use of
      poultry. The level of LNA increased because of greater use of soybean oil. These
      estimates are currently the only source of data on omega-3 FA in the American
      diet.

PMID- 1619183
TI  - Prolonged tube feeding in long-term care: nutritional status and clinical
      outcomes.
AB  - This study examines nutritional status and clinical outcomes, including pressure
      ulcers and death in 40 chronically tube-fed long-term care patients.
      Anthropometric, biochemical, clinical and dietary data were collected over a 3
      month period, with follow-up of mortality at 1 year. Subjects' functional and
      cognitive status was generally poor. Adequate calories and protein were provided,
      with sample means exceeding standard means for energy, protein and
      micronutrients. Still, subjects showed weight loss and severe depletion of lean
      and fat body mass. Mean serum protein and micronutrient status measures were in
      the low normal range. Hemoglobin, hematocrit, and serum zinc and carotenoid
      levels were below normal in a sizable proportion of patients. Pressure ulcers
      were present in 65% of patients. Weight loss was associated with longer time on
      tube feeding and more pressure ulcers. Negative correlations with ulcer number
      were observed for cholesterol, albumin, zinc, retinol, alpha-tocopherol and iron.
      This study shows that despite administration of apparently adequate formula,
      micronutrient deficiencies and marasmic malnutrition exist in chronically ill
      patients. Causes may include the combined effects of chronic disease, sepsis,
      immobility, and severe neurologic deficits. Clinical outcomes may be expressions
      of an organism-wide diminution of protein synthesis, the cause of which is
      unknown. For clinical management, serial measures of weight, albumin,
      cholesterol, hemoglobin and hematocrit are recommended. Future research must
      address the many subsets of the population of chronically tube-fed patients.

PMID- 1619184
TI  - Effect of magnesium supplementation on strength training in humans.
AB  - This study investigated the effects of dietary magnesium (Mg) on strength
      development during a double-blind, 7-week strength training program in 26
      untrained subjects (14 = control, C and 12 = Mg supplemented, M), 18-30 years
      old. Subjects' 3-day diet records were analyzed and Mg content was calculated. C
      received a placebo and M received a supplement (Mg oxide) to bring Mg intake,
      including diet, to 8 mg/kg body weight/day. Body composition was assessed with
      bioelectrical impedance. Pre and post quadriceps torque (T) measurements were
      made with an Orthotron at 120 deg/sec. Each subject performed three sets of 10
      reps, leg press and leg extension, three times/week. Both groups gained strength,
      however, results indicated a significant (p less than 0.05) increase for the M
      group compared to the C group in absolute T, relative T adjusted for body weight
      (T/BWT), and relative T adjusted for lean body mass (T/LBM) when pre values were
      used as the covariate. M was consistently greater than C (T: 211 vs 174 Nm;
      T/BWT: 3.07 vs 2.58 Nm/kg; T/LBM: 3.84 vs 3.36 Nm/kg). CONCLUSION: Significant
      differences in T gains after strength training were demonstrated in M vs C. Mg's
      role may be at the ribosomal level in protein synthesis.

PMID- 1619185
TI  - Cardiomyopathy of copper deficiency: effect of vitamin E supplementation.
AB  - The present study was undertaken to determine whether the intraperitoneal
      injection of vitamin E to copper-(Cu) deficient rats fed fructose will protect
      the animals against the severity of Cu deficiency. Cu-deficient and adequate rats
      were fed a diet containing 62% carbohydrate as fructose. Half the Cu-deficient
      rats fed fructose were injected daily with vitamin E. Vitamin E treated rats were
      not protected against the lethal consequences of the interaction between Cu and
      fructose. These data provide evidence that the cardiomyopathy of Cu deficiency in
      rats consuming a fructose-based diet cannot be ameliorated by vitamin E
      supplementation.

PMID- 1619186
TI  - Garlic oil extract ameliorates the severity of copper deficiency.
AB  - This study was undertaken to determine whether a reduction in hepatic lipogenesis
      would be beneficial in the amelioration of copper (Cu) deficiency when fructose
      is fed. Garlic was chosen as the agent for reducing hepatic lipogenesis. Forty
      eight weanling rats were fed Cu-deficient or adequate diets containing fructose
      or starch with or without garlic for 5 weeks. Garlic ameliorated the signs
      associated with Cu deficiency, although hepatic lipogenesis was not affected.
      Administration of garlic reduced the activity of the lipogenic enzyme glucose-6
      phosphate dehydrogenase only in Cu-adequate rats. Consumption of garlic resulted
      in increased epididymal fat pad and pancrease sizes, and higher hematocrits,
      insulin and thyroxine concentrations. Mechanisms other than lipogenesis that
      could be responsible for this phenomenon are discussed.

PMID- 1619187
TI  - Why aluminum phosphate is less toxic than aluminum hydroxide.
AB  - Initially characterized in uremic patients undergoing hemodialysis, toxic effects
      due to high aluminum (Al) body loads were subsequently observed in a number of
      conditions, in particular following ingestion of Al-containing antacids. Among
      compounds of this class, aluminum phosphate (AlPO4) was recognized as safer than
      aluminum hydroxide (Al(OH)3), which was thought to result from its lower
      solubility and thus absorption in the gastrointestinal (gi) tract. However, while
      virtually insoluble at acid pH, AlPO4 is more soluble than Al(OH)3 under alkaline
      conditions, leading to the hypothesis that Al is predominantly absorbed in the
      acidic region of the gi tract. Our present results suggest otherwise. Al
      bioavailability depends on the solubility of the salt ingested as well as on the
      physicochemical properties of the Al soluble complexes formed in the gi fluid.
      Anions of dietary acids may indeed dissolve significant fractions of Al salts and
      form absorbable Al complexes. It is in these terms that the well documented
      increase of Al gi absorption by citrate has been interpreted from computer-based
      speciation studies. Using similar calculations, we now demonstrate that a series
      of dietary acids (namely malic, oxalic, tartaric, succinic, aspartic and glutamic
      acids) can also dissolve significant amounts of Al(OH)3 and form Al neutral
      complexes available to the gi membrane. In contrast, both effects are far less
      apparent when Al is administered as AlPO4. We conclude from this observation that
      the lower toxicity of AlPO4 vs Al(OH)3 stems from its better capacity to resist
      dissolution and neutral complex formation in the presence of acids commonly
      present in food.

PMID- 1619188
TI  - Oral diet does not alter pulmonary pentane or ethane excretion in healthy
      subjects.
AB  - Ethane and pentane are alkanes that are excreted through the lungs to a small
      degree in healthy subjects. These gasses are produced from the peroxidation of
      unsaturated fats which are found both in body tissues and in foods. These gasses
      are excreted in larger amounts by patients with increased production of reactive
      oxygen metabolites, including those with inflammation or ischemia. Thus,
      detection of these gasses in excessive quantities is considered evidence for
      lipid peroxidation. However, the effects of dietary factors on these measurements
      have not been defined. To define the effects of eating on the pulmonary excretion
      of these alkanes, 29 healthy subjects were fed a standardized liquid diet (1060
      kcal, 12.9 g linoleic acid and 385 mg linolenic acid) after an overnight fast.
      Breath alkanes were measured at 0, 1, 3, and 6 hours. All subjects had normal
      vitamin E (1.11 + 0.26 mg/dl), retinol (64 +/- 14 micrograms/dl), beta carotene
      (27 +/- 21 micrograms/dl), lycopene (23 +/- 12 micrograms/dl) and zinc (81.9 +/-
      13.5 micrograms/dl) levels. No statistically significant changes in either alkane
      were noted relative to the fasting level. We conclude that oral diet does not
      alter pulmonary ethane or pentane excretion in healthy subjects.

PMID- 1619189
TI  - Changes in serum and urinary uric acid levels in normal human subjects fed purine
      rich foods containing different amounts of adenine and hypoxanthine.
AB  - The effect of ingesting some purine-rich foods (beef liver, haddock fillets and
      soybeans) on uric acid metabolism was investigated in 18 male subjects with no
      history of gout or kidney disorder. In a crossover design, three isoenergetic and
      isonitrogenous meals were fed to volunteers during a 3-week period. Only the
      content of uricogenic bases (adenine and hypoxanthine) varied among the test
      meals. Ingestion of all experimental meals caused an increase in serum uric acid
      levels at 120 minutes and this increase was more marked (about twofold) with
      haddock and soybean ingestion. In all groups, the postprandial serum uric acid
      levels at 240 minutes were lower than those obtained at 120 minutes, but still
      remained elevated in comparison to the fasting level. The test foods had little
      or no effect on serum and urinary creatinine values. As expected, 24-hour urinary
      uric acid excretion was similar for the three test meals due to the
      isonitrogenous load of proteins and purines. Assessment of each purine base
      content rather than the total purine content of foods should be considered in
      future recommendations for hyperuricemic individuals.

PMID- 1619190
TI  - Conclusions, guidelines and recommendations from the IUNS/WHO Workshop: nutrition
      in the pediatric age group and later cardiovascular disease.

PMID- 1619191
TI  - Position statement: the 'pros' of cholesterol screening of children.

PMID- 1619192
TI  - Position statement: the 'cons' of cholesterol screening of children.

PMID- 1619193
TI  - Position statement: cholesterol screening in children is not indicated, even with
      positive family history.
AB  - The same reasons for the policy of rejecting universal blood cholesterol
      screening in all children also lead us to reject selective screening in those
      with a family history of premature CHD or high blood cholesterol. It is probably
      true that this large group--roughly 25% of all children, 12 million in the United
      States and many tens of millions worldwide--is at somewhat higher risk than the
      other 75% of children of eventually dying of CHD many decades later. But the
      small size and remoteness of any benefit achieved by cholesterol intervention is
      illustrated by the projection that we would need to treat 300 girls in the top
      cholesterol quintile, and treat them effectively for 50-60 years, in order to
      defer just one premature CHD death before age 65. The benefits of cholesterol
      screening and treatment in children are not only very small and remote, they are
      also uncertain; we have no firm evidence that they exist. The benefits are not
      needed, given the clinical trial evidence that most of the risk associated with
      high blood cholesterol among adults is reversible, even when intervention is not
      begun until middle age. The harmful effects of cholesterol screening and
      treatment are more firmly established than the benefits, and some are very
      serious. Such a program would be expensive orders of magnitude from conventional
      criteria for cost effectiveness. It would cause malnutrition in some children,
      and have the adverse consequences of labelling.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619194
TI  - Cholesterol blood levels in children: comparison of a Munich screening to
      worldwide studies from 1980 to 1990.
AB  - Total cholesterol results of a screening of 134 Munich school children aged 6-11
      years are described. In reviewing worldwide studies on blood lipids in children,
      in the last 10 years, I note a large variance in the so-called "normal" values,
      with mean levels of total cholesterol ranging from 148 to 214 mg%. Age-, sex-,
      and race-specific reference data for a population are needed. Only with these
      special data can one determine the point for intervention. With school health
      education programs, including medical screening examinations, the aim of primary
      prevention of coronary heart disease can be reached.

PMID- 1619196
TI  - Primary prevention of cardiovascular disease in childhood: recent knowledge and
      unanswered questions.
AB  - Efforts at prevention of chronic disease in adult life must include investigation
      of causal pathogenetic clues in early life. There is adequate rationale for
      identification of children who are at risk of developing cardiovascular disease
      (CVD) in later years. At the present time, practical considerations would favor a
      selective rather than universal screening of children. If the latter is
      instituted, then it is ideal to test children 4-7 years of age. In either case,
      total cholesterol greater than 200 mg/dl warrants a complete lipid-lipoprotein
      profile. Those with confirmed abnormal values of total cholesterol, low-density
      lipoprotein cholesterol, and apolipoproteins A1 and B should be offered dietary
      advice and encouraged to participate in regular exercise. In a few cases, drug
      therapy would be required. Limited data suggest that an integrated approach will
      result in a reduction of cardiovascular risk factors. Perinatal nutrition also
      may influence the risk of CVD among adults; a reduction in the prevalence of low
      birth weight and prevention of failure to thrive in early infancy may be
      additional useful strategies for prevention of CVD.

PMID- 1619195
TI  - Cholesterol and lipoprotein levels in Milanese children: relation to nutritional
      and familial factors.
AB  - Dyslipidemia is a major risk factor for atherosclerosis in adults and children.
      This study investigated the levels of lipoproteins in a northern Italian
      pediatric population, in relation to nutritional and familial factors. We studied
      650 children on the basis of a 3-day dietary record; 361 of these children had
      their lipid levels [total cholesterol (TC), high-density lipoprotein cholesterol
      (HDL-C), and triglycerides] measured by a dry, multilayer method and apoprotein A
      I and B by an immunonephelometric method. Familial history of cardiovascular
      disease and dyslipidemia was recorded. Anthropometric variables were taken for
      each child. Mean TC and low-density lipoprotein cholesterol (LDL-C) were high
      compared with southern Italian data, but similar to those of other Western
      countries. Family history of cardiovascular disease could not identify children
      with higher levels of atherogenic lipoprotein. Nutritional factors affected
      lipoprotein levels. The most important finding was a higher TC/HDL-C ratio in the
      lower quartile of polyunsaturated fatty acid intake. Obese children had higher
      levels of ApoB, triglycerides, TC and LDL-C, and lower levels of HDL-C; figures
      were higher for obese boys than for obese girls. Our study confirms a high
      prevalence of elevated levels of atherogenic lipoproteins among the northern
      Italian pediatric population and an association with nutritional factors and
      weight.

PMID- 1619197
TI  - Serum lipids, lipoproteins and apolipoproteins in children with and without
      familial history of premature coronary heart disease.
AB  - A positive family history of premature cardiovascular disease is recognized as an
      independent predictor of risk for cardiovascular death in first degree relatives.
      It is of great interest whether the progeny of families with manifest coronary
      heart disease can be discriminated from children with a negative family history.
      Therefore, we examined serum lipids, lipo- and apolipoproteins in 338 offspring
      whose fathers and/or mothers had been affected with a myocardial infarction
      before the age of 55, in comparison with 448 age- and sex-matched, healthy
      controls. Statistical analyses revealed marked differences between the two
      groups: In both age groups only high-density lipoprotein cholesterol (HDL-C), as
      a single parameter, and the ratios of total cholesterol (TC)/HDL-C, as well as
      low-density lipoprotein cholesterol (LDL-C)/HDL-C, showed a significant
      difference between the risk and nonrisk groups. Whereas the ratio of
      apolipoprotein A1 (ApoAI) to apolipoprotein B is the strongest discrimination in
      children less than or equal to 20 years, the ratio of HDL-C/ApoAI takes this
      position in the older ones. Apolipoproteins seem to be of considerable importance
      as risk indicators between offspring who might be at higher risk for later
      cardiovascular diseases, even in childhood and younger adolescence.

PMID- 1619198
TI  - Cardiovascular risk factors in schoolchildren.
AB  - A total of 1470 students in Berlin, Germany, aged 7-22 years, were screened for
      cardiovascular risk factors such as hypercholesterolemia, hypertension, obesity,
      smoking habits, and a positive family history. Only 56% had no modifiable risk
      factor, but 16% showed total cholesterol (TC) levels greater than 200 mg/dl. One
      percent had severe and 11% had borderline hypertension. Also, 21% were
      overweight, and 27% of the adolescents greater than or equal to 15 years admitted
      to smoking regularly. In this paper we concentrate on cholesterol findings of
      this study, i.e., the dependence of TC on sex, age, weight, and the use of oral
      contraceptives. There was an age dependency in both sexes. In boys the lowest TC
      levels were found in the 12-17-year-olds, whereas the group under 10 had the
      highest ones. In the age group over 17, TC was higher than in the younger groups.
      The age dependency of the TC levels in girls was similar, but less pronounced.
      The minimum level was reached earlier, namely in the group 14-15 years old,
      rather than in the group 16-17. TC levels of girls compared to boys were
      significantly higher in the 12-13 and 16-17 age groups. Girls who use oral
      contraceptives had significantly higher TC levels. Obesity had no influence on
      TC. Our results support the demand for screening for cardiovascular risk factors
      in children.

PMID- 1619199
TI  - Cardiovascular risk factors in obese children in relation to weight and body fat
      distribution.
AB  - To assess the relationship between obesity and body fat distribution with
      cardiovascular risk factors in children, various measures of obesity and waist-to
      hip circumference ratio (WHR) were related to serum lipids, lipoproteins,
      apolipoproteins, glucose, insulin, uric acid, systolic (SBP) and diastolic blood
      pressure (DBP). In boys univariate analysis revealed an association of
      triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density
      lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), the ratio ApoAI/ApoB,
      cholesterol/HDL-C, glucose and insulin to WHR. SBP and DBP and serum uric acid
      correlated with all measures of obesity [body mass index (BMI), percent
      overweight, percent body fat, skinfolds], but not with WHR. In girls lipid
      parameters (triglycerides, LDL-C, HDL-C, HDL2, ApoAI, ApoB) and atherogenic
      ratios correlated with measures of obesity and WHR. Glucose, insulin, SBP and DBP
      showed the highest correlation with WHR (r = 0.598, p less than 0.001 and r =
      0.713, p less than 0.001). Multivariate analysis in girls revealed a first step
      dependency of ApoAI, the ratio cholesterol/ApoAI, insulin, SBP and DBP on WHR,
      triglycerides, HDL-C, LDL-C and the ratio ApoAI/ApoB, a first step dependency on
      percent body fat mass. In boys triglycerides, ApoB and the ratio ApoAI/ApoB were
      related to WHR for insulin, SBP and DBP, but a positive association with the WHR
      was found, explaining 33, 21.8, and 22.6% of the variance. This study
      demonstrates that cardiovascular risk factors in obese children are related to
      obesity and body fat distribution. Obese children with predominantly abdominal
      fat mass show a risk profile that is less favorable than gluteal-femoral fat
      distribution. Evaluation of body fat distribution in obese children, therefore,
      may help to identify persons most susceptible to cardiovascular risk in
      adulthood.

PMID- 1619200
TI  - Early lesions of atherosclerosis in childhood and youth: natural history and risk
      factors.
AB  - This paper traces the development of knowledge concerning early lesions of
      atherosclerosis and the relationship to risk factors in children, youth, and
      young adults. Autopsy studies have shown that atherosclerosis begins in childhood
      with the appearance of aortic fatty streaks. Aortic fatty streaks of some degree
      are present in practically all individuals from every human population. Coronary
      fatty streaks begin to form in adolescence. Most persons 20-29 years of age have
      coronary fatty streaks of some degree, regardless of sex, race, or national
      origin. While fatty streaking is clinically harmless and potentially reversible,
      progression to fibrous plaques and more advanced lesions often leads to a
      critical stage of atherosclerosis in which clinical disease develops. Development
      of fibrous plaques begins in the 20s. The most recent studies of atherosclerosis
      in youth and young adults provide additional details to establish the
      relationship of these lesions to serum lipids and lipoproteins and other
      identified risk factors for atherosclerosis and coronary heart disease in adults.
      One report shows that microscopic counterparts of fatty streaks occur in the left
      anterior descending coronary artery in the majority of children 10-14 years of
      age. Over 5% have more advanced microscopic lesions at this age. Autopsy studies
      of youth have shown that serum total cholesterol and low-density lipoprotein
      cholesterol levels are strongly related to aortic fatty streaks and the very-low
      density lipoprotein cholesterol levels are positively correlated to coronary
      artery fatty streaks. Finally, a definitive report indicates that serum
      lipoprotein cholesterol concentrations and smoking are important determinants of
      the early stages of atherosclerosis in adolescents and young adults.

PMID- 1619201
TI  - Predicting hypertension in childhood: value of blood pressure measurement and
      family history.
AB  - An elevated casual blood pressure (BP) in children and a positive family history
      for hypertension are risk indicators for adult hypertension. The risk of future
      hypertension is higher when BP levels in children or their parents are higher.
      Using multiple BP readings in children and their parents, groups of children can
      be discriminated with contrasting risks as a basis for studying the early phase
      of primary hypertension. Yet, as a means of detecting groups of children eligible
      for intervention, family history and BP level lack sensitivity for adequate
      selection. Before screening for future hypertension may be initiated successfully
      in prepubertal children, more should be known about the determinants and etiology
      of future BP rise.

PMID- 1619202
TI  - Diet and body lipid composition: lessons from animal and human experiments.
AB  - It is accepted that atherosclerosis begins early in life and will develop over
      several years. The type of diet fed to young rats and other mammals plays a role
      in the regulation of adult lipid homeostasis. Foods vary in fatty acid content.
      The importance of diet on lipid profile has been demonstrated in several animal
      studies and in different human population groups. Bridging the effect of early
      diet and later adult cardiovascular disease deserves decisive collaboration among
      different specialists, as well as preventive dietary intervention based on recent
      advances from food composition and dietotherapy.

PMID- 1619203
TI  - Effects of developmental changes and early nutrition on cholesterol metabolism in
      infancy: a review.
AB  - Plasma cholesterol levels usually range between 50 and 100 mg/dl at birth, with
      the cholesterol approximately equally distributed between low-density lipoprotein
      (LDL) and high-density lipoprotein (HDL). Plasma cholesterol increases rapidly
      over the first days after birth, predominantly due to an increase in cholesterol
      with LDL, irrespective of whether the infant is breast fed or fed with infant
      formulas. With continued feeding, plasma cholesterol becomes progressively, and
      significantly, higher in infants who are breast fed compared to those fed low
      cholesterol, polyunsaturated fatty acid-rich infant formula. Studies in the
      developing young of other species have suggested that up-regulation of
      cholesterol synthesis, or turnover and excretion, at stages when these pathways
      are acquiring functional maturity may have lasting effects on cholesterol
      metabolism. The information available, however, indicates the diet-related
      differences in plasma cholesterol of the more mature human newborn are temporal
      in nature and probably not of significance to adult cardiovascular disease.
      Infants born early in the third trimester of gestation, however, are at risk for
      marked elevations in plasma cholesterol, with stimulation of endogenous
      cholesterol biosynthesis, as a result of the intravenous nutrition required to
      sustain life. Whether this has long-term consequences for this group of infants
      is unknown. There is presently no reason to advocate diet modification to alter
      the plasma cholesterol of normal infants under the age of 2 years.

PMID- 1619204
TI  - Influence of diets containing cow's milk or soy protein beverage on plasma lipids
      in children with familial hypercholesterolemia.
AB  - The present article summarizes the effects of diets containing either cow's milk
      or soy protein beverage on plasma lipids and lipoproteins in children with
      familial hypercholesterolemia. After a stabilization period of 6 weeks without
      any hypolipemic medication, 10 subjects aged 6-12 years were randomly assigned to
      either cow's milk or soy protein beverage with subsequent crossover after a
      washout period, each of 4 weeks duration. During the experimental periods,
      subjects were fed diets containing 20% of energy as protein, of which 35% was
      from cow's milk protein or soy protein isolate, 28% of energy as fat with a
      polyunsaturated:monounsaturated:saturated fat ratio of 1:3:3, and less than 200
      mg/day of cholesterol. The soy protein beverage, compared to cow's milk, induced
      significant reductions in plasma triglycerides and very-low-density lipoprotein
      cholesterol, as well as a significant increase in high-density lipoprotein
      cholesterol, indicating that consumption of soy protein beverage may be
      beneficial for the prevention of coronary heart disease in children with familial
      hypercholesterolemia.

PMID- 1619206
TI  - Position statement: monounsaturated fatty acids in human nutrition.

PMID- 1619205
TI  - Achievable guidelines for food consumption to reach a balanced fat and nutrient
      intake in childhood and adolescence.
AB  - In many highly industrialized countries a reduction in the high average intake of
      fat, especially saturated fatty acids and cholesterol, has been recommended for
      the prevention of cardiovascular diseases for the general population, including
      children. However, it has not yet been shown that such a diet is generally
      achievable in childhood and that it meets the Recommended Dietary Allowances
      (RDA) for essential nutrients. Based on results of a nutrition survey using a 3
      day weighing method for 350 German children and adolescents (1-14 years of age),
      achievable dietary modifications have been proposed to improve the observed
      nutrient intake (percentages of energy intake from protein:fat/saturated fatty
      acids:carbohydrates 13:39/18:48%). Age-related average daily quantities are given
      for 11 main food groups (e.g., milk, lean meat, visible fats, grain products,
      vegetables). The main proposals for food consuption are: avoidance of fatty meat
      and fatty meat products, reduction of fatty foodstuffs commonly consumed with
      bread and of foodstuffs with a high sucrose content and an increase in whole
      grain cereal products, potatoes and vegetables. The food consumption proposals
      are compatible with the typical meal patterns of German children and adolescents.
      Nutrient content of the proposed diet is presented. The proportions of
      protein:fat/saturated fatty acids:carbohydrates are 13:35/12:52% of total energy
      intake. It is shown that the US RDA for most of the calculated minerals, trace
      elements and vitamins can be met by the proposed balanced mixed diet without
      using special dietary products or products with added nutrients.

PMID- 1619207
TI  - Accurate measurement of serum total cholesterol: the need for standardization.
AB  - Heightened awareness of the importance of cholesterol and heart disease has
      increased cholesterol testing in the United States. The demand for reliable
      cholesterol measurements has become a focal concern of the patient as well as the
      clinician. This paper covers the major analytical and preanalytical issues and
      factors that can affect the reliability of cholesterol results. We discuss
      factors that lead to impression and inaccuracy; solutions for some of the major
      problems; resources and techniques to help standardize cholesterol measurement;
      and preanalytical issues that can affect cholesterol results--i.e., patient
      preparation; collection, processing, storage and proper analysis of the specimen;
      biological and seasonal variations; age and gender; diet; alcohol consumption;
      weight changes; exercise; primary diseases; and infections and trauma. Many of
      these can be controlled by the physician, resulting in more reliable cholesterol
      readings under stable metabolic conditions. Accurate values will help to classify
      the patient's coronary heart disease risk, define appropriate treatment
      strategies, and simplify monitoring of dietary and/or drug intervention.

PMID- 1619208
TI  - Position statement: nutrition options when reducing saturated fat intake.

PMID- 1619209
TI  - Children on adult diets: is it harmful? Is it healthful?
AB  - Physicians and parents are very concerned about providing children with the best
      nutrition and optimal diets. The pursuit of better health is one of the prime
      reasons for individual food choices. Often the main determinant in selecting food
      is a desire for a healthful diet that will foster longevity and prevent the
      devastating consequences of chronic degenerative disease. However, unlike
      nutritional deficiencies, which undoubtedly afflict those who consume an
      inadequate diet, the underlying causes of these chronic disorders are complex and
      poorly understood. Thus, no one can predict at present what the effects of the
      current recommendations will be, particularly when implemented in childhood. By
      implying that such nutritional strategies against chronic diseases of middle
      adulthood are necessary and should be applicable to the population at large,
      including growing children, health officials have shaken confidence in our
      Western diets and may have created a widespread fear of food. Strict adherence to
      low-fat, low-cholesterol diets in childhood may result in nutritional growth
      failure, while long-term benefits in reducing coronary heart disease may not be
      accomplished for the majority of the population who may not need marked dietary
      changes. Moderation is the theme for adequate nutrition in childhood.

PMID- 1619210
TI  - Adrenal medullary secretion with splanchnic stimulation in spinal cats.
AB  - This project was undertaken to determine whether previously observed adrenal
      medullary hyperactivity that developed following high spinal cord transection in
      the cat could be explained by increased sensitivity of the synapse between the
      splanchnic nerve and chromaffin cell. The splanchnic nerve was stimulated in
      acute (2-3 h; n = 7) or chronic (61-64 days; n = 7), spinally transected (T3)
      cats that were decerebrate and unanesthetized. Mean arterial blood pressure and
      adrenolumbar venous blood flow were significantly greater in the chronic animals.
      Stimulation (30 V; 1 ms pulses) was applied at 3 Hz and 30 Hz to deliver the same
      number of pulses within 3 min. Adrenal medullary secretion (ng/min) of
      epinephrine (EPI), norepinephrine (NE), dopamine, neuropeptide Y (NPY),
      [Met]enkephalin (ENK), and encrypted [Met]enkephalin was determined at baseline
      and in relation to both patterns of stimulation. With near threshold (3 Hz)
      stimulation, the following differences were observed between groups: (1)
      secretion of EPI, NPY, and ENK was significantly greater in the chronic than in
      the acute animals; and (2) preferential secretion of NE was elicited in the acute
      animals. These observations suggest that there may be some facilitation of the
      splanchnic nerve--chromaffin cell synapse that occurs over time following high
      thoracic spinal cord transection. However, it is likely that central, spinal
      mechanisms also contribute to adrenal medullary hyperactivity.

PMID- 1619211
TI  - Sites at which neuropeptide Y modulates parasympathetic control of heart rate in
      guinea pigs and rats.
AB  - Immunohistological evidence indicates that neuropeptide Y (NPY) is present in the
      cardiac innervation of numerous species. The present experiments determined if
      NPY influences in vivo parasympathetic control of heart rate in guinea pigs and
      rats by either pre- or postganglionic mechanisms or by an interaction at
      muscarinic receptors at the sino-atrial node. Urethane-anesthetized animals were
      prepared with arterial and venous catheters, and ECG leads. The cervical vagi
      were sectioned and propranolol was administered to minimize reflex changes in
      heart rate. Methacholine injection, carbachol injection, or electrical
      stimulation of the peripheral end of the vagus nerve was performed to activate
      the neuroeffector site, intracardiac ganglion cells, or preganglionic neurons,
      respectively. All three trials were performed before, during, and after NPY
      infusion. No differences in methacholine- or carbachol-induced bradycardia were
      observed between control and NPY groups in either species. NPY infusion inhibited
      vagal-mediated bradycardia in guinea pigs and in rats. However, NPY inhibited
      vagal-mediated bradycardia at a lower dose in guinea pigs (1 microgram/kg/min)
      than in rats (4 micrograms/kg/min). These data indicate that NPY modulates
      cardiac vagal preganglionic, but not postganglionic nerve function or
      neuroeffector sites at the sino-atrial node, in guinea pigs and rats.
      Furthermore, due to the different effective dosages, NPY may play a greater
      modulatory role in guinea pigs than in rats.

PMID- 1619213
TI  - Visualization of enteric and gallbladder ganglia with a vital fluorescent dye.
AB  - A method is described here for the vital staining of the nerve plexuses of the
      gastrointestinal tract with the fluorescent dye 4-(4-diethylaminostyryl)
      methylpyridinium iodide (4-Di-2-ASP). This dye stained nerve fibers in the
      myenteric and submucosal plexuses and in the intramural ganglia of the
      gallbladder. In addition to staining the ganglia, the dye clearly revealed the
      secondary and the fine tertiary fibers of the myenteric plexus. In the submucosal
      plexus thin fibers innervating the blood vessels were also stained. This method
      proved to be effective in tissues that are relatively thick and in which the
      visualization of the nerves is quite difficult without staining--the myenteric
      plexus of rat small intestine, guinea-pig gallbladder and human large intestine.
      The staining did not fade within at least 6-8 h, or after long exposure to bright
      light. Intracellular recordings from myenteric neurons in the guinea pig ileum
      showed that cellular properties were not significantly altered after incubation
      in the dye solution. 4-Di-2-ASP thus appears to be suitable for rapid vital
      staining of nerves in whole mount from many parts of the gastrointestinal tract.

PMID- 1619212
TI  - Viscero-sympathetic reflex responses to mechanical stimulation of pelvic viscera
      in the cat.
AB  - Viscero-sympathetic reflex responses to mechanical stimulation of urinary bladder
      and colon were studied in cutaneous vasoconstrictor (CVC) neurones supplying
      hairy skin, in muscle vasoconstrictor (MVC) neurones supplying skeletal muscle
      and in sudomotor (SM) neurones supplying the sweat glands of the central paw pad
      of the cat hindlimb. The cats were anaesthetized, paralysed and artificially
      ventilated. The vasoconstrictor activity was recorded from the axons of the
      postganglionic fibres that were isolated in filaments from the respective
      peripheral hindlimb nerves. The activity in the sudomotor neurones was monitored
      by recording the fast skin potential changes occurring on the surface of the
      central paw pad. Afferents from the urinary bladder and from the colon were
      stimulated by isotonic distension and isovolumetric contraction of the organs.
      Most CVC neurones with ongoing activity were inhibited by these stimuli; only a
      few CVC neurones were excited. The MVC and SM neurones were generally excited by
      the visceral stimuli, yet the size of the evoked skin potential changes was
      variable. The reflex responses elicited in the sympathetic outflow to the cat
      hindlimb by stimulation of visceral afferents from the pelvic organs are uniform
      with respect to the different types of afferent input system but differentiated
      with respect to the efferent output systems. Graded stimulation of the visceral
      afferents from the urinary bladder by isotonic pressure steps elicited graded
      reflex responses in CVC (threshold less than 30 mmHg) and MVC neurones (threshold
      less than 20 mmHg) and a graded increase of the arterial blood pressure
      (threshold less than 20 mmHg). These graded reflex responses are closely related
      to the quantitative activation of sacral afferent neurones with thin myelinated
      axons innervating the urinary bladder that are also responsible for eliciting the
      micturition reflex, but not to the quantitative activation of sacral afferent
      neurones with unmyelinated axons. The latter have thresholds of 40-50 mmHg
      intravesical pressure at which the size of the vesico-sympathetic reflexes in the
      vasoconstrictor neurones was about 50% of maximal size. This does not exclude the
      fact that activation of unmyelinated vesical afferents contributes to the vesico
      sympathetic reflexes.

PMID- 1619214
TI  - A study of catecholamine concentrations in selected renal segments of cats of
      different ages.
AB  - Renal concentrations of the catecholamine neurotransmitters norepinephrine (NE)
      and dopamine (DA) in 19 cats were measured by reverse-phase high pressure liquid
      chromatography (HPLC) with electrochemical detection. Animals of five different
      age groups (2-4, 6-8, 10-12 and 16-20 weeks and adult animals one year and older)
      were anesthetized and the kidneys were excised, sectioned into cortical, outer
      medullary and inner medullary segments, and processed for HPLC. There were no
      statistical differences in cortical NE concentrations between the 2-4 week and
      adult age groups, suggesting that peak noradrenergic nerve terminal density in
      the cortex is achieved at or before 2-4 weeks of age. NE concentration in the
      outer medulla and DA concentration in the cortex and outer medulla increased from
      the 2-4 to the 10-12 week age group but did not change significantly in the older
      animals. There were significant decreases in inner medullary NE and DA
      concentrations from the 10-12-week to the 16-20 week age group. The decrease in
      concentration of inner medullary catecholamines in the early postnatal period is
      consistent with the reported total loss of tyrosine hydroxylase- and dopamine
      beta hydroxylase-immunoreactive inner medullary nerve terminals at approximately
      12 weeks of age.

PMID- 1619217
TI  - Foreign bodies.

PMID- 1619215
TI  - Deltamethrin residues in milk and tissues of lactating dairy cows.
AB  - Lactating dairy cows were fed deltamethrin (2 or 10 mg kg-1 feed) for 28
      consecutive days and deltamethrin residues measured in milk and tissues.
      Deltamethrin residues were higher relative to dose administered. The order of
      relative concentrations of deltamethrin in tissues, measured 1, 4, and 9 days
      after the last dose was: renal fat greater than subcutaneous fat greater than
      forequarter muscle greater than hindquarter muscle greater than liver greater
      than kidney. Depletion of deltamethrin residues in milk was very rapid indicating
      the half-life of the insectide of about 1 day. Trace amounts of deltamethrin
      metabolites 3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane carboxylic acid (less
      than 0.0235 ppm) and 3-phenoxybenzoic acid (less than 0.034 ppm) were also
      detected in milk and tissues of treated cows.

PMID- 1619216
TI  - Pharmacokinetic profile and anticholinesterase properties of phenamiphos in male
      rats.
AB  - The pharmacokinetics and anticholinesterase properties of a single oral dose 6
      mg/Kg of technical phenamiphos [ethyl 4-(methylthio)-m-tolyl
      isopropylphosphoramidate] were investigated in male rats. Animals were killed at
      each time intervals of 0.5, 1.0, 1.5, 3, 6, 12, 24, 48, and 72 hrs after dosing.
      The total recovered amount of phenamiphos from brain and plasma tissues reached
      high level at the first time interval and disappeared biexponentially from both
      tissues to low level at the end of the experiment. Brain tissue has a greater
      affinity to phenamiphos than plasma tissue. The half-life of the elimination of
      phenamiphos from brain and plasma were 100 and 212 hr corresponding to the rate
      constant values of 0.01 and 0.003 hr-1, respectively. Plasma AUC (area under the
      curve) value was 1239.81 micrograms hr/L, explaining there was no tendency for
      the compound to accumulate in the brain tissue (AUC = 774.38 micrograms hr/Kg)
      compared to the plasma. On the other hand, determination of cholinesterase
      activity showed that, phenamiphos inhibited the enzymes in both brain and plasma,
      where the depression of ChE activity was usually more marked in plasma than in
      brain.

PMID- 1619218
TI  - An assessment of oblique base wedge osteotomy stability in the first metatarsal
      using different modes of internal fixation.
AB  - The modified Juvara osteotomy is a classic oblique base wedge osteotomy of the
      first metatarsal and is often used to reduce hallux valgus deformity. However,
      complications attributed to osteotomy instability and currently available modes
      of osteosynthesis are common. The authors have developed a technique that enables
      them to quantitatively and objectively evaluate the stability of this osteotomy
      when various modes of internal fixation are used. Stability testing was performed
      on fresh, previously frozen human cadaveric specimens using engineering
      principles. Results indicate that there is no statistically significant
      difference in stability between crossed 0.062-inch Kirschner wire fixation and
      internal fixation using a single 3.5-mm. cancellous screw. The tests also
      indicate that both of these techniques are superior to two 2.7-mm. cortical
      screws for stability.

PMID- 1619219
TI  - Neurilemmoma of the posterior tibial nerve with an uncommon case presentation.
AB  - A neurilemoma presenting in the foot is uncommon. The tumor is a solitary benign
      type that does not require transection of the involved nerve. A clinical review
      with an uncommon presentation and brief history of a benign neurilemoma is
      presented, followed by a discussion using magnetic resonance imaging,
      ultrasonification, double contrast doppler, arteriograms and venograms to aid in
      a differential diagnosis.

PMID- 1619220
TI  - Peroneal tubercle osteochondroma.
AB  - Osteochondromas are common bone lesions; however, their occurrence in the
      calcaneus is rare. A discussion of this lesion along with an unusual case and
      related findings are presented.

PMID- 1619221
TI  - Ankle dislocation without fracture: an unusual case report.
AB  - Complete dislocation of the ankle joint without associated fracture is considered
      a rare injury. Few cases are reported in the literature. A case report is
      presented, and a review of the etiological factors and treatment principles are
      discussed.

PMID- 1619222
TI  - McBride's operation for hallux valgus can be used in patients older than 30
      years.
AB  - Over a 10-year period, 46 feet with hallux valgus in 36 patients were treated
      with the McBride procedure. The median age was 35 years. At follow-up of 2 to 11
      years after operation, a reduction in the hallux valgus angles, the
      intermetatarsal angles and the width of the forefeet was found. In patients older
      than 30 years there were significant reductions. In patients younger than 30
      years, the reduction was not significant. The rate of problems with daily
      footwear was reduced from 36 of 46 feet to 13 of 38 feet. The authors noted few
      problems and a high rate of satisfied patients, despite the age. In 37 of 46 feet
      the overall result was found satisfactory by the patients. The authors find that
      McBride's operation can be used for hallux valgus, also in patients above 30
      years, in spite of the generally accepted restriction to younger individuals.

PMID- 1619223
TI  - Gadopentetate-enhanced magnetic resonance imaging with fat saturation in the
      evaluation of Morton's neuroma.
AB  - Morton's neuromas, though usually diagnosed clinically, can occasionally be
      problematic. When required, imaging may be performed via ultrasound or computed
      tomography, though the former can be quite operator-dependent, and the latter
      exposes the patient to ionizing radiation. Magnetic resonance imaging can be very
      helpful in certain clinical situations. This case report demonstrates the
      usefulness of gadopentetate-enhanced magnetic resonance imaging with fat
      saturation in the evaluation of interdigital neuromas.

PMID- 1619224
TI  - Thorn-induced granuloma of the medial cuneiform.
AB  - A lytic lesion of the medial cuneiform of a 10-year-old boy was explored
      surgically, and a date palm thorn was identified. Histology revealed an aseptic
      granuloma. Even in the absence of a definite history of trauma, an organic
      foreign body lesion should be considered in the differential diagnosis of a lytic
      lesion of bone.

PMID- 1619225
TI  - Internal neurolysis.
AB  - One hundred seventy-eight patients diagnosed with a lower extremity nerve
      compression syndrome were treated conservatively using orthopedic, medical, and
      physical therapy modalities. Eighty-two per cent of these patients improved and
      recovered, and required no further care. Eighteen per cent of these patients did
      not recover or experience significant improvement in their sensory or motor loss.
      This chronic group was treated by internal neurolysis. Ninety-five per cent of
      this chronic group treated by internal neurolysis improved. Only 5% did not have
      significant prolonged relief or improvement and eventually required excision of a
      sensory peripheral nerve. Internal neurolysis may not be indicated in those
      patients who suffer from transient sensory paresthesias; conservative care and/or
      an external peripheral nerve decompression may suffice. Internal neurolysis is
      indicated in those patients who have constant sensory aberations or motor loss
      from a chronic peripheral nerve compression syndrome or any other nerve lesion
      that has not responded well to conservative care or to an external nerve
      decompression procedure. Internal neurolysis, in addition to conservative care
      regimes presented here, has been found to be effective in reversing heretofore
      thought to be irreversible pain syndromes in the lower extremity even when
      significant atrophy has already occurred.

PMID- 1619226
TI  - Fractures of the proximal phalanx of the hallux: the use of plates with displaced
      multifragment fractures.
AB  - Fractures of the proximal phalanx of the hallux are a common injury. Due to the
      important biomechanical function of the first ray, these injuries must be treated
      properly. Incorrectly treated, a fracture of the hallux can be debilitating.
      These injuries will be discussed, and several illustrative cases will be
      presented with the use of plate fixation.

PMID- 1619227
TI  - A unique osteochondral fracture of the first metatarsophalangeal joint.
AB  - Presented is a case report of an osteochondral fracture occurring at the base of
      the proximal phalanx of the hallux secondary to trauma. Initial radiographic and
      clinical examination did not reveal the diagnosis. However, prolonged symptoms of
      pain, swelling, and limitation of first metatarsophalangeal joint range of motion
      led to further radiographic evaluation, which confirmed a suspected diagnosis of
      an osteochondral fracture. This is regarded as a most interesting case by the
      authors, in light of the fact that review of the literature revealed a paucity of
      descriptions of osteochondral fracture of the first metatarsophalangeal joint. In
      addition, all of the previously described lesions have been localized to the
      first metatarsal head. A review of the literature failed to reveal any fractures
      occurring at the base of the proximal phalanx of the hallux.

PMID- 1619228
TI  - Asymptomatic naviculocuneiform synostosis with a ganglion cyst.
AB  - This is the report of a naviculocueniform synostosis in a patient whose primary
      symptoms were due to a ganglion cyst over the involved area. Only eight patients
      have been reported in any past literature with this particular condition. This is
      the first case to present with an overlying ganglion cyst.

PMID- 1619229
TI  - Smooth Kirschner (K) wire fixation of distal metaphyseal osteotomy
      bunionectomies: a 10-year retrospective survey.
AB  - The authors reviewed 500 distal metaphyseal osteotomy bunionectomies with smooth
      Kirschner (K)-wire fixation performed over a 10-year period. Postoperatively, the
      patients were allowed to ambulate with a forefoot compression bandage and a
      semirigid surgical shoe. The cases were evaluated radiographically for malunion,
      delayed union, nonunion, aseptic necrosis, bone callus formation, and final
      alignment. Soft tissue and bone infection, as well as pin irritation, were also
      evaluated. Computation of results demonstrated eight malunions, one delayed
      union, no nonunions, and two cases of aseptic necrosis. There were 52 cases
      (10.4%) that led to bone callus formation; 54 patients (10.8%) experienced pin
      irritation. A total of seven infections occurred (1.4%) that could possibly be
      attributed to the pin, of which four (0.8%) required incision and drainage. It
      was observed that certain procedures, such as the Laird osteotomy, decreased the
      effectiveness of the K-wire, while others, such as the Chevron osteotomy,
      resulted in the fewest complications. Bunionectomies performed bilaterally or
      with adjunct procedures, in contrast to isolated bunionectomies, were also found
      to decrease the effectiveness of the K-wire. Due to the minimal number of
      complications that were encountered and the high success rate that was attained,
      the authors conclude that utilization of smooth K-wire fixation for distal
      metaphyseal osteotomy bunionectomies remains a viable and effective treatment
      alternative.

PMID- 1619230
TI  - Intra-operative contamination of bone and cartilage during an Austin
      bunionectomy.
AB  - During an Austin bunionectomy the potential exists for the head of the metatarsal
      to leave the sterile field and become contaminated. The authors present a case in
      which this occurred, with a 20-month follow-up. Possible options for
      decontamination are reviewed.

PMID- 1619231
TI  - Wu's bunionectomy: a clinical analysis of 150 personal cases.
AB  - The author discusses his modification of the Mitchell distal metatarsal
      osteotomy/bunionectomy, in a study of 150 cases. He advocates a distal transverse
      first metatarsal osteotomy, with fixation using Herbert bone screws. Stepwise
      description of the surgical technique with evaluation of cases including
      complications is provided.

PMID- 1619233
TI  - Coralline hydroxyapatite bone graft substitutes: radiographic evaluation.
AB  - The authors discuss a recently described bone graft material substitute derived
      from sea corals. They briefly review its background leading to the potential for
      clinical use. Radiologic evaluation is provided, with attention directed to its
      characteristics, compared with other bone grafts.

PMID- 1619232
TI  - Osteochondroma: review of the literature and case report.
AB  - Osteochondroma is the most common bone tumor of the foot. The podiatric surgeon
      should have an organized protocol to diagnose and treat suspicious osseous
      lesions in order to prevent undertreatment of malignant lesions, or overtreatment
      of benign lesions. The presence of a solitary osteochondroma is not sufficient
      indication for surgical removal. Surgical removal is indicated if the tumor
      produces pain, has radiographic features of malignancy, or shows abnormal
      increase in size. This case involves an osteochondroma of the fifth digit that
      was treated by digital amputation.

PMID- 1619234
TI  - A comparison of Biofix rods to rigid internal fixation in the treatment of
      elective osteotomies in foot surgery.

PMID- 1619235
TI  - Prospects for control of cholera with oral vaccines.

PMID- 1619236
TI  - Village health care providers in Matlab, Bangladesh: a study of their knowledge
      in the management of childhood diarrhoea.
AB  - This study was conducted among village health care providers in Matlab,
      Bangladesh in 1987. The objectives were to assess their knowledge of childhood
      diarrhoea and methods of management. All types of health care providers
      considered diarrhoea as a major childhood disease and opined that treatment
      should be initiated in case of four or more loose motions a day. Slightly more
      than half of the allopaths were aware of the scientific causes of diarrhoea;
      homeopaths and traditional healers in large proportions related diarrhoeal
      diseases with certain types of food, and 'evil eyes'. Eighty per cent of the
      allopaths reported use of oral rehydration solution in treating watery diarrhoea
      against 20% of the others. Prescription of antibiotics in treating dysentery was
      higher among allopaths than others. Allopaths were also less restrictive
      regarding continuation of breastfeeding and intake of food during diarrhoea among
      children.

PMID- 1619237
TI  - Haemolysin and enterotoxin production by Aeromonas caviae isolated from
      diarrhoeal patients, fish and environment.
AB  - Beta-haemolytic activity was shown by 46 (63%) of the 73 Aeromonas caviae strains
      isolated from diverse sources, such as diarrhoeal stools, fish ulcers and water
      in titres of 16-64 HU/ml. Only 2 strains showed alpha-haemolytic activity and the
      remaining 27% of them were nonhaemolytic. Live cells and culture filtrates of
      60.3% of the A. caviae isolates caused accumulation of fluid in rabbit gut loops
      in the initial set of experiments. Of the 46 strains showing beta-haemolytic
      activity only 34 gave positive ileal loop reactions in the initial experiments.
      One of the 2 strains showed alpha-haemolytic activity and 9 of the 20
      nonhaemolytic strains also caused fluid accumulation in the same set of
      experiments. Those strains that showed beta-haemolytic activity caused
      significantly more (p less than 0.01) fluid outpouring than the alpha- or
      nonhaemolytic isolates regardless of their sources of origin. Twenty-nine (39.7%)
      strains that showed alpha-, beta-, and nonhaemolytic activity and caused little
      or no fluid accumulation in initial experiments did so after 1-3 consecutive
      passages through rabbit gut. The nontoxic strain showing alpha- and non
      haemolytic activity switched over to production of beta-haemolytic activity once
      their live cells gave positive loop reactions. However, on repeated subcultures
      or on preservation in the laboratory for 2-3 weeks, all of them reverted back to
      their original nontoxic haemolytic types, i.e. alpha- or nonhaemolytic activity.

PMID- 1619238
TI  - Knowledge, attitudes, and practices and their policy implications in childhood
      diarrhoea in Uganda.
AB  - A nationwide study of the knowledge, attitudes, and practices about childhood
      diarrhoea among health workers and mothers of children less than 5-years old was
      conducted in Uganda during 1987. We found that each child, on the average, has 6
      episodes of diarrhoea in a year. While most parents (65%) continue with almost
      normal feeding practices during their children's diarrhoea, as is officially
      recommended, there are some foods that are traditionally withheld. The use of
      oral rehydration therapy in the form of a salt and sugar solution is very limited
      and needs to be promoted. Herbal treatment for diarrhoea is a widespread practice
      and needs to be studied further to ascertain its usefulness. Over 55% of mothers
      recognise poor hygiene as the most important cause of childhood diarrhoea. The
      general level of sanitation is not satisfactory and needs to be improved to
      achieve the widespread availability of safe water and adequate means of human
      waste disposal for all homes. The radio was found to be a potentially effective
      tool for health education, and the need to provide all health workers with
      continuing education about diarrhoea management was identified.

PMID- 1619240
TI  - A community-based intervention for childhood diarrhoea control.

PMID- 1619239
TI  - Evaluation of a DNA probe to identify enteroaggregative Escherichia coli from
      children with diarrhoea in Bangladesh.
AB  - Six hundred and seventy-five Escherichia coli isolates obtained from 225
      diarrhoeal children less than five years of age were tested for adherence to HeLa
      cells and for hybridisation with DNA probes for genes conferring aggregative
      adherence (AggA), localised adherence (LA) and diffuse adherence (DA) to assess
      the usefulness of a recently developed DNA probe for AggA of enteroaggregative E.
      coli (EAggEC). The strains were further analysed with the DNA probes for heat-
      labile enterotoxin (LT), heat--stable enterotoxin (ST), Shiga--like toxins (SLT I
      and SLT II) and for enteroinvasiveness and adherent strains were all negative for
      these properties. The HeLa cell assay and DNA probe assays showed excellent
      agreement in identifying LA and DA positive isolates. However, significant
      disparities occurred in the case of AggA positive isolates, and the DNA probe
      failed to identify 31.9% (15 of 47) of the EAggEC identified by the HeLa cell
      adherence assay. The failure of the DNA probe to identify all the EAggEC
      indicated that there may be a high degree of genetic heterogeneity for the
      expression of AggA, and development of more DNA probes is necessary to detect all
      the possible genetic variants of EAggEC.

PMID- 1619241
TI  - STb producing Escherichia coli are rarely associated with infantile diarrhoea.

PMID- 1619242
TI  - Vibrio mimicus bacteraemia in a child.

PMID- 1619243
TI  - Enterotoxigenic Bacteroides fragilis: epidemiologic studies of its role as a
      human diarrhoeal pathogen.
AB  - Strains of Bacteroides fragilis which produce enterotoxin(s) (ETBF) have been
      associated with diarrhoeal diseases in young domestic animals and have also been
      isolated from humans with diarrhoea. We have determined epidemiologically that
      ETBF are significantly associated with diarrhoea in humans. We studied Apaches,
      primarily children, with diarrhoea attending an outpatient facility in
      Whiteriver, Arizona, from July 1986 through July, 1988. Stool cultures for
      isolation of ETBF and other diarrhoeal pathogens were taken from these persons as
      well as from age and time-matched control persons who did not have diarrhoea.
      ETBF were isolated significantly more often from persons with diarrhoea (12%)
      than from controls (6%), p = 0.03. Isolation was highest (20-24% of stool
      cultures positive) during the second and third years of life. The diarrhoeal
      syndrome associated with ETBF was non-specific, and most characteristic of a
      secretory, rather than inflammatory, type of diarrhoea. ETBF are significantly
      associated with acute diarrhoea in Apache children, and may be an important newly
      described cause of diarrhoea in humans.

PMID- 1619244
TI  - A nine-month old malnourished baby girl presenting with shigellosis, pneumonia
      and shock.

PMID- 1619245
TI  - Bibliography on diarrhoeal diseases.

PMID- 1619246
TI  - When siting works, Canada-style.
AB  - Hazardous waste management poses increasing problems for Canadian provinces and
      American states, given the vast quantities and types of wastes generated and the
      virtual inability to open new storage, treatment, or disposal facilities. The
      Canadian experience is very similar to the American one in many respects, except
      for the fact that three provinces (Alberta, Manitoba, and Quebec) have devised
      alternative approaches to siting that appear successful in moving beyond the
      political gridlock so common on this issue. In each of these cases, traditional,
      top-down approaches to siting have been eschewed in favor of a more comprehensive
      approach that includes extensive public participation, economic and social
      compensation packages, formal partnerships between public and private
      organizations, and direct links between siting proposals and other aspects of
      waste management, including waste reduction, recycling, and export/import
      control.

PMID- 1619247
TI  - The effects of tort reform on medical malpractice insurance markets: an empirical
      analysis.
AB  - I use statewide loss ratio data to assess empirically the manner in which tort
      reforms have affected relative prices and profitability, and underwriting risk in
      the medical malpractice insurance industry. The empirical evidence suggests that
      the imposition of statutory ceilings on recoveries both decreased risk and
      improved relative profitability. Reforms that codified the required standard of
      care appeared to have a beneficial effect on relative profitability in certain
      cases.

PMID- 1619248
TI  - Speech, privacy, and the power of the purse: lessons from the abortion "gag rule"
      case.

PMID- 1619249
TI  - Can consumer choice reward quality and economy? Towards a test of economic
      competition.

PMID- 1619250
TI  - Will Medicare beneficiaries switch physicians? A test of economic competition.
AB  - We assess the potential of increased economic competition by examining whether
      Medicare beneficiaries are willing to switch to physicians who agree to accept
      all services on assignment. Data come from a survey of Medicare beneficiaries
      conducted in November 1988. Our principal finding is that beneficiaries are not
      sensitive to price when making decisions about whether or not to switch
      physicians. Less than one-half of 1 percent of the sample had switched physicians
      for economic reasons in the year prior to the survey. Furthermore, willingness to
      switch was not correlated with ability to pay. We conclude that policies aimed at
      altering consumer demand may not be the most effective way to control Medicare
      costs.

PMID- 1619251
TI  - The media and the fate of the Medicare Catastrophic Extension Act.
AB  - We examine the Medicare Catastrophic Extension Act of 1988, which was repealed in
      1989, finding a broad range of messages on this controversial legislation in the
      press. The time needed to craft compromise legislation in response to objections
      to the original bill was cut short by the impending deadline for payments by the
      elderly, January 1990. Outright repeal rather than modification was the result.
      Our study confirms earlier studies, which show that trends of opinion--in this
      case that of senior citizens over 65 years of age--could be forecast from mass
      media stories, and is consistent with the notion that legislation occurs in a
      climate shaped by the media. In addition to being a key conduit for passing
      information and pressures to the public and lawmakers, the media could also serve
      to indicate the impact of messages passed through other channels, such as direct
      mailings.

PMID- 1619252
TI  - HMOs for Medicaid: the road to financial independence is often poorly paved.
AB  - During the 1980s both the federal government and the private sector articulated
      policies to encourage the development and participation of health maintenance
      organizations (HMOs) in the Medicaid program. However, the policies, intended to
      save costs, limited the ability of new HMOs to achieve financial independence.
      New plans that emphasize Medicaid participation have few, if any, options on
      benefit design or in setting capitation rates. Relative to fee-for-service
      Medicaid programs, their costs to provide services may be quite high, as they
      have neither the buying power not the ability to impose discounts. As a
      consequence, plans must focus their financial planning efforts on targeting and
      attaining a stable enrollment base and on controlling the amount of services
      provided, tasks that are difficult for all HMOs. Achieving a stable enrollment
      base is particularly hard because Medicaid eligibles have few incentives to
      enroll and once enrolled often lose their Medicaid eligibility. Traditional HMOs
      control the amount of services provided through physician selection, financial
      incentives on physicians, and monitoring and utilization review. Lack of
      information and the difficulty inherent in attracting sufficient provider
      participation limit the first two strategies, so new plans often adopt
      organization structures that rely heavily on monitoring activities.
      Unfortunately, management information systems for HMOs are often the weakest
      link. We discuss the tasks and present data on financial planning, on putting
      financial plans into operation, and on monitoring progress toward financial
      independence for a set of ten demonstration projects sponsored by the Robert Wood
      Johnson Foundation.

PMID- 1619253
TI  - Decisions without consequences: cost control and access in state Medicaid
      programs.
AB  - States have implemented a number of strategies to provide services, pay
      providers, and control Medicaid spending. We test the effects of some differences
      in state Medicaid policies on program enrollees' access to and use of health care
      services. Logistic and OLS regression analyses of cross-sectional data indicate
      that these policies exert significant influences on enrollees' access to health
      services but have a weaker direct effect on their use of them. However, we find
      evidence that utilization is affected indirectly (through increased access) by
      state policy decisions. Somewhat surprisingly, Medicaid policies designed to
      contain costs by limiting utilization appear to affect neither access nor
      utilization. Medicaid enrollees have greater access to a private physician in
      states with higher physician reimbursement and additional Medicare insurance for
      their enrollees. Other nonpolicy variables with pronounced impacts on access to
      private office physicians include race and the availability of private insurance.

PMID- 1619254
TI  - Structure and meaning in medical sociology.
AB  - The point of all this, one made by others as well (e.g., Cook and Reichhardt
      1979), is to emphasize the potential for a synergistic exchange between
      structuralists who do surveys and meaning-oriented workers who do qualitative
      work. The ways in which survey researchers come to understand the social worlds
      of people can and should be influenced by the ways in which people understand and
      interpret their own worlds. Correspondingly, our efforts to capture the social
      life of people through their eyes can be advanced by an understanding of the
      structures in which their lives are embedded and the effects of these structures.
      Each orientation benefits from drawing on the other. In this way, sociology is
      the ultimate beneficiary. I see nothing to be gained from intellectual antagonism
      and the distancing of one side from the other. I do not claim that there is more
      similarity and less difference between the two than meets the eye. The substance
      of interests and the styles of inquiry are really quite different. That's as it
      should be. Indeed, their differences permit each to give something to the other.
      Both should be nurtured and developed. However, in the training of new medical
      sociologists and in the research of old ones, we should have enough appreciation
      and knowledge of both orientations so that even if we are planted firmly in one,
      we are at least prepared to dip into the other. Those searching for structural
      effects and those searching for meaning are potentially natural partners, a
      relationship much superior to being unnatural antagonists.

PMID- 1619255
TI  - Widowhood and depression: explaining long-term gender differences in
      vulnerability.
AB  - Results from a 1986 national survey (N = 3,614) show that having ever been
      widowed is associated with current levels of depression and that this association
      is greater for men than women. Some of this apparent gender difference occurs
      because men have been widowed for a shorter average period of time than women and
      the effects of widowhood appear to lessen over time. Widowhood also is associated
      with different types and amounts of life strain for men and women. The results
      suggest that the primary mechanism linking widowhood to depression among women is
      financial strain. Among men, the more critical mechanisms seem to be strains
      associated with household management. When specific strains occur, they appear to
      have different effects on respondents who have ever been widowed and those who
      have not. Taken together, these results suggest that what appears on the surface
      to be a gender difference in vulnerability to the same life event turns out upon
      closer examination to occur because widowhood does not affect men and women in
      the same way.

PMID- 1619256
TI  - Parental role strains, salience of parental identity and gender differences in
      psychological distress.
AB  - Although past research indicates that women's higher levels of psychological
      distress can be accounted for by their greater exposure and vulnerability to role
      related stress, the social psychological factors contributing to female
      vulnerability have not been fully identified. This paper applies identity theory
      to the phenomenon of gender differences in distress among parents. From an
      identity perspective, I propose that salience of the parental identity in women's
      self-conceptions contributes to their vulnerability to parental role strains.
      Using 1988 survey data from a stratified random sample of married and divorced
      Indianapolis residents (N = 448), I find that gender differences in distress are
      explained by differences in exposure to parental role strains. Further analyses
      reveal, however, that salience of the parental identity contributes to both men's
      and women's vulnerability to parental role strains. These findings underscore the
      utility of identity theory for explaining psychological distress among women and
      men.

PMID- 1619257
TI  - Innovations in the measurement of life stress: crisis theory and the significance
      of event resolution.
AB  - Further progress in understanding the significance of stress for psychological
      well-being requires improved strategies for controlling both inter- and intra
      event variability across subjects studied. This paper reports on an innovation in
      stress measurement suggested by a proposition drawn from crisis theory that
      recognizes life events as representing opportunities as well as hazards. The
      crucial contingency is hypothesized to be the outcome of the event with respect
      to the extent of its resolution in emotional and practical terms. This paper
      examines the possibility that life events that have been resolved successfully
      may not contribute to individual stress. Data was gathered from community samples
      of physically limited individuals and of non-limited comparison subjects. Results
      from separate analyses of these data generally support this hypothesis.

PMID- 1619258
TI  - Predicting continued use of marijuana among adolescents: the relative influence
      of drug-specific and social context factors.
AB  - Most research on the determinants of adolescent drug use has focused on
      predictors of either initiation or current use. Little attention has been given
      to the determinants of continued use of drugs after initiation, even though some
      researchers have found that the consequences of continued use are more serious
      than those associated with experimental or occasional use. In this study, a
      longitudinal sample of 456 secondary and high school students who had already
      tried marijuana was used to examine the determinants of continued use of
      marijuana. Nearly 38 percent of those who had tried marijuana continued using,
      according to the definition operationalized in this study. Potential predictor
      measures were grouped in a drug-specific domain and a social context domain, and
      their effects on continued use, controlling for background characteristics, were
      examined in logistic regression models. Results showed that only the drug
      specific domain had a statistically significant effect on the likelihood of
      continued use. Students who felt that the adverse physical and psychological
      effects of marijuana were not very important reasons for discontinuing use and
      those who had gotten stoned during their experimental stage of use were the most
      likely to continue use after initiation. The results suggest that the perceived
      physical and psychological effects of the drug are more important determinants of
      continued use than are social factors or benefits related to use. Any
      relationships between social factors and continued use are mediated by the
      perceived effects and risks of the drug.

PMID- 1619259
TI  - Parental and peer characteristics as modifiers of the bond-behavior relationship:
      an elaboration of control theory.
AB  - Three bonds are at the core of Hirschi's control theory: attachment to parents,
      commitment to conventional activities, and belief in the conventional rules of
      society. Control theory does not include parental and peer attitudes and
      behaviors, variables that frequently are implicated in adolescent behavior. This
      study examines whether parental and peer behaviors and attitudes modify
      bond/behavior relationships. Adolescent cigarette smoking is the behavior of
      interest. Panel data from a probability sample of 685 adolescents shows that the
      relationship between attachment and adolescent smoking is modified by parental
      smoking; the relationship between commitment to conventional activities and
      adolescent smoking is modified by father's smoking; but the relationship between
      belief in conventional rules and adolescent smoking is not modified by parental
      or peer variables. We conclude that control theory needs to encompass parental
      behavior when considering adolescent smoking behavior.

PMID- 1619260
TI  - Trajectories of functional impairment in later life.
AB  - Functional impairment trajectories in late adulthood over a decade are
      characterized using the Longitudinal Retirement History Study (LRHS) data set.
      Non-linear patterns of age-related increase in impairment are documented with
      longitudinal data. Subsets of panelists from the initial large, nationally
      representative probability sample of employed males and unmarried employed
      females (N = 11,000) also exhibit differential non-linear trajectories of
      impairment by sex, income, and educational attainment. Concurrent analysis of the
      relationship over a decade among sex, SES, and functional impairment suggests
      that in health research, both sex and SES are broad proxy variables whose
      usefulness for understanding health outcomes and for policy analysis would be
      enhanced by the specification of components.

PMID- 1619261
TI  - Race differences in the effects of multiple roles on health: longitudinal
      evidence from a national sample of older men.
AB  - This paper examines race differences in the effects of social roles on physical
      health. Using data from the older men cohort of the National Longitudinal Surveys
      of Labor Market Experience, we examine the impact of employment, marriage, and
      being a supporter on health limitations and mortality. Employment has the most
      consistent health-protective effect, and the benefits of employment are more
      pronounced for Blacks than for Whites. Marriage affects health in conjunction
      with employment. These findings lend further support to the growing literature on
      the effects of roles on health. The results further illustrate the importance of
      ascribed statuses as structural determinants of the relationship between roles
      and health, highlighting the very real differences in the meanings and
      expectations of social roles for Blacks and Whites.

PMID- 1619262
TI  - Marital status and psychiatric disorders among blacks and whites.
AB  - This paper examines the association between marital status and psychiatric
      disorder for Blacks and explores the extent to which these patterns differ from
      those for Whites. Widowed and separated/divorced Black males and females have
      higher rates of disorder than the married; never-married Blacks do not have an
      elevated risk of psychiatric illness. The association between marital status and
      disorder for White males is similar and stronger than that observed for Blacks.
      For White women, the separated/divorced have a higher risk of disorder than the
      married, and unmarried White females have higher rates of the substance abuse
      disorders, but lower rates of the anxiety disorder than the married. Across all
      marital status groups, Black males and White males have higher rates of disorder
      (except for depression), than females. A complex pattern emerges when gender
      differences in the relative rates of disorder for unmarried Blacks compared to
      married Blacks are considered. Separated/divorced Black men, widowed Black women,
      and never-married Black men are worse off than their respective peers. Except for
      the separated/divorced, opposite patterns are evident for Whites. Directions for
      further research are outlined.

PMID- 1619263
TI  - Impact of a preventive job search intervention on the likelihood of depression
      among the unemployed.
AB  - Drawing on coping resources theory, we evaluate the impact of a job search
      intervention on depressive symptoms in a randomized field experiment at three
      follow-up periods covering two and one-half years. Baseline depressive symptoms,
      low social assertiveness, and financial hardship were identified as significant
      risk variables predicting depressive symptoms at follow-up. These variables then
      were used to identify high- and low-risk individuals in both experimental and
      control groups. Results indicated that the job search intervention had its
      primary impact on persons identified as being at higher risk for depression.
      Furthermore, the intervention had an impact on both the incidence and prevalence
      of more severe depressive symptoms among high-risk individuals.

PMID- 1619264
TI  - Bringing social worlds together: computers as catalysts for new interactions in
      health care organizations.
AB  - In this case study, computer systems are explored as catalysts for new
      interactions between departments in health care organizations. Hypotheses
      investigated changes in the extent to which members of different departments (1)
      exchange information and (2) understand each other's work following
      implementation of an integrated medical information system. Analyses showed that
      communication-based forms of involvement in implementation (communicating with
      systems personnel and trainers, communicating about new ways to use the system,
      and receiving support from supervisors for doing so) were overwhelmingly more
      important than either general participation or computer use in predicting
      increases in interdepartmental interaction. Changes in tasks and roles also led
      to new, informal, face-to-face contacts to support computer system use, as well
      as greater administrative control over the organization as a whole. In addition,
      results of interviews and observations over the two-year study period illustrate
      the importance of work group identification in predicting changes accompanying
      computerization.

PMID- 1619265
TI  - Gender differences in symptoms of depression among adolescents.
AB  - In this paper, we examine sources of gender differences in depressive symptoms
      among adolescents. Using data collected from a self-administered survey of 306
      high school students, we examine differences in the impact of life events,
      psychosocial resources, and parent-child relationships on levels of psychological
      distress. Our results confirm a substantial gender difference in level of
      psychological distress. Moreover, analyses indicate that this gender difference
      may be due largely to higher levels of self-esteem among males and a tendency for
      adolescents to perceive their fathers to be overprotective. There is, however,
      also evidence that other psychosocial resources and parent-child relationships
      are implicated in this gender difference. We also present analyses to support our
      contention that parent-child relationships have important effects on the
      development of psychosocial resources of adolescents that, in turn, influence
      levels of depressive symptoms.

PMID- 1619266
TI  - Social structure, life stress and depressive symptoms in a high school-aged
      population.
AB  - Data from a randomly selected sample of 1,208 high school-aged adolescents were
      used to examine the means through which life stress is associated with depressive
      symptoms. Analyses focus on family structure, socioeconomic status, and gender as
      background risks which directly and indirectly influence symptoms, as well as
      vulnerability contexts that shape differential responsiveness to stressful
      experiences. Findings indicate (1) significant gender differences in aspects of
      stress exposure and in additive models of stress effects, but stresses and
      supports do not explain the significant gender difference in depressive symptoms;
      (2) girls in low education backgrounds have the highest levels of depressive
      symptoms; (3) there are no gender differences in vulnerability to stress; (4)
      children in single-parent families have higher symptom levels, effects explained
      by economic conditions and stress exposure--they are no more vulnerable than
      others to the depressing effects of these stresses; and (5) both boys and girls
      in low SES backgrounds are more vulnerable to a wide range of stresses and
      support deficits.

PMID- 1619267
TI  - Pseudo-outbreak of blastomycosis associated with contaminated bronchoscopes.

PMID- 1619268
TI  - Heliport-associated nosocomial mucormycoses.

PMID- 1619269
TI  - Of guides and guidelines.

PMID- 1619270
TI  - The agenda for change: development of the Joint Commission infection control
      indicators.

PMID- 1619271
TI  - Nosocomial human parvovirus B19 infection: lack of transmission from a
      chronically infected patient to hospital staff.
AB  - OBJECTIVE: To assess the potential for nosocomial spread of parvovirus B19 from a
      chronically infected patient. DESIGN: Employees exposed to the index case and
      control (unexposed) employees were evaluated by baseline and follow up parvovirus
      B19 serologies and hematologic assessments, and completed baseline and follow up
      epidemiologic questionnaires. SETTING: A chronically infected patient was
      hospitalized on a hematology ward in a research referral hospital for 3.5 weeks
      prior to a diagnosis of parvovirus B19 infection and the institution of isolation
      precautions. METHODS: Sera were screened for parvovirus B19 DNA (dot blot
      analysis), and IgG and IgM anti-B19 antibodies (capture immunoassay). Hematologic
      assessment included CBC, differential, and reticulocyte count. RESULTS: The index
      case had parvovirus B19 DNA at approximately 10(6) genome copies per ml of serum,
      elevated IgM and low levels of IgG B19 antibodies. Of the 21 exposed staff, 11
      (52%) had IgG B19 antibodies and were immune; of the 8 unexposed staff, 6 (75%)
      had IgG B19 antibodies. No employees developed IgM B19 antibodies, B19 DNA,
      hematologic abnormalities, or clinical symptoms. CONCLUSIONS: In contrast to
      reports of documented nosocomial transmission of B19 parvovirus from patients in
      transient aplastic crisis, nosocomial transmission did not occur--even in the
      absence of isolation precautions--presumably from the lower level of B19 viremia
      in our chronically infected (rather than acutely infected) patient.

PMID- 1619272
TI  - Impact of a shielded safety syringe on needlestick injuries among healthcare
      workers.
AB  - OBJECTIVES: Evaluate the impact of a shielded 3 cc safety syringe on needlestick
      injuries among healthcare workers. DESIGN: Surveillance study. SETTING: Three
      medical centers. RESULTS: The total number of needlesticks from all sources rose
      from 134 during the baseline period to 140 during the study phase. However, the
      overall rate of needlesticks involving 3 cc syringes decreased from 14/100,000
      inventory units to 2/100,000, and the frequency declined substantially at each of
      the participating medical centers. CONCLUSIONS: These results suggest that
      shielded syringes and related technology may offer potential for reducing the
      risk of needlestick injuries among hospital and other healthcare employees. This
      study should be viewed as a preliminary effort to assess the potential of
      shielded-syringe technology for reducing the risk of needlestick injuries among
      healthcare workers. The results are encouraging, but more clinical experience
      with this new device and longer follow up are essential to provide the data
      necessary for a definitive assessment of efficacy.

PMID- 1619273
TI  - FDA issues safety alert for hypodermic needles on secondary i.v. administration
      sets.

PMID- 1619274
TI  - In situ hybridization of bone matrix proteins in undecalcified adult rat bone
      sections.
AB  - We have developed a method for in situ hybridization of adult bone tissue
      utilizing undecalcified sections and have used it to histologically examine the
      mRNA expression of non-collagenous bone matrix proteins such as osteocalcin (bone
      Gla protein, BGP), matrix Gla protein (MGP), and osteopontin in adult rats.
      Expression was compared with that in bone tissues of newborn rats. In the adult
      bone tissue, osteocalcin mRNA was strongly expressed in periosteal and endosteal
      cuboidal osteoblasts but not in primary spongiosa near the growth plate.
      Osteopontin mRNA was strongly expressed in cells present on the bone resorption
      surface, osteocytes, and hypertrophic chondrocytes, but not in cuboidal
      osteoblasts on the formation surface. Osteopontin and osteocalcin mRNAs were
      expressed independently and the distribution of cells expressing osteopontin mRNA
      corresponded with acid phosphatase-positive mononuclear cells and osteoclasts.
      Expression of MGP mRNA was noted only in hypertrophic chondrocytes. In newborn
      rat bone tissues, expression of osteocalcin mRNA was much weaker than in adult
      rat bone tissues. These results clearly indicate the differential expression of
      mRNAs of non-collagenous bone matrix proteins in adult rat bone tissues.

PMID- 1619275
TI  - Procedures for specific detection of silver-stained nucleolar proteins on western
      blots.
AB  - Nucleolar organizer region (NOR)-silver staining of the chromosomes and nucleoli
      is a method that enables the detection of proteins associated with the ribosomal
      genes. We adapted the most commonly used cytochemical NOR-silver staining
      techniques to Western-blotted proteins of HeLa cells, mimicking the silver
      staining of cells in situ, and testing several parameters that may influence the
      in situ reaction. Two of these techniques, both one-step methods with colloidal
      developers, were standardized to obtain reproducible results. The specificity of
      NOR staining is documented by: (a) only a few bands are revealed among the many
      proteins detected by total proteins staining on gels or blots; two major groups
      of bands are found around 100 KD and 40 KD that could correspond at least in part
      to nucleolin and B23 nucleolar proteins; (b) the silver staining of bands was not
      the result of the high relative protein concentrations; and (c) the same number
      of NOR-silver-stained bands was observed across a large range of protein
      concentrations. The reaction appeared to be specific for a subset of nucleolar
      proteins, because the same bands were observed with the use of nucleolar,
      nuclear, or total cell protein extracts, and the silver grains observed in
      electron microscopy were clearly confined to the nucleolar fibrillar centers and
      dense fibrillar component. The efficiency of the reaction was not modified by any
      of the tested fixative pre-treatments except that involving methanol. The
      presented standardization of NOR-silver staining on Western blots allows the
      characterization of the Ag-NOR proteins and their specific regions responsible
      for silver staining of the nucleolus.

PMID- 1619276
TI  - Subcellular localization of xanthine oxidase in rat hepatocytes: high-resolution
      immunoelectron microscopic study combined with biochemical analysis.
AB  - Xanthine oxidase (XO), a molybdo-flavoprotein enzyme involved in purine
      degradation, was localized immunocytochemically in rat hepatocytes by high
      resolution immunoelectron microscopy. XO was isolated from rat liver and a 150 KD
      polypeptide was purified. Antibodies were raised in rabbits. Small pieces of
      fresh liver were quickly frozen by contact with a copper block pre-cooled with
      liquid helium and were freeze-substituted with either 2.5% OsO4 or 0.2%
      glutaraldehyde in acetone. They were then warmed and embedded in Epon-Araldite or
      Araldite 6005. Resin sections were treated by indirect immunostaining using anti
      rat liver XO antibody and protein A-gold. The labeling pattern was clearly over
      the cytosol and not on cell organelles. A few gold particles were found over the
      mitochondrial matrix, but not over the endoplasmic reticulum, Golgi apparatus,
      lysosomes, or peroxisomes, including their crystalloid core. These results are
      consistent with those of the biochemical assay of XO in this study. The
      significance of the occasional immunolabeling of the mitochondrial matrix remains
      obscure, since biochemical determinations in this study indicate no XO activity
      in the mitochondrial fraction.

PMID- 1619277
TI  - Distribution of type II collagen mRNA in Xenopus embryos visualized by whole
      mount in situ hybridization.
AB  - We have developed a whole-mount histochemical method to monitor the distribution
      of expressed genes within the intact, developing vertebrate embryo. Background
      problems that result from alkaline phosphatase- or horseradish peroxidase-based
      stains have been minimized, enabling both early and late stages of Xenopus
      embryogenesis to be monitored. The feasibility and utility of this non-isotopic
      method has been demonstrated by using a specific DNA probe to localize Xenopus
      laevis Type II collagen mRNA expression to areas surrounding the vacuoles of the
      notochord in Stage 30 embryos. Expression expands by Stage 41/42 to form a
      visually striking distribution pattern that includes a variety of chondrogenic
      tissues such as the vertebrae, otocysts, mandible, and periocular region.
      Although these experiments focused on expression of a structural gene, the high
      resolution and sensitivity of the method should allow it also to monitor
      expression of less abundant mRNA products of non-structural genes such as
      transcription factors, cytoplasmic regulators, and growth factors. In addition,
      this approach should be a successful tool to probe expression in normal and
      perturbed embryos not only of amphibians but also of other vertebrates, including
      avians and mammals.

PMID- 1619278
TI  - Identification of type I collagen-producing cells in human gastrointestinal
      carcinomas by non-radioactive in situ hybridization and immunoelectron
      microscopy.
AB  - Invasive growth of cancer cells induces desmoplastic reaction as one of the host
      reactions. It has been a matter of controversy whether stromal collagen is
      produced by cancer cells or stromal fibroblasts. In the present study, we
      investigated the cellular origin of Type I collagen in human gastrointestinal
      carcinomas by in situ hybridization and immunoelectron microscopy. In situ
      hybridization technique with digoxigenin-labeled RNA probes revealed that spindle
      shaped fibroblasts in the stromal area were abundantly positive for transcripts
      of pro alpha 1(I) collagen in intestinal-type adenocarcinoma. Gland-forming
      carcinoma cells were negative. In diffuse-type carcinoma of the stomach, spindle
      shaped or stellate fibroblasts were positive, whereas dissociated, oval carcinoma
      cells were negative. A precise determination of cell type was done by
      immunoelectron microscopy. Intracellular immunoreactivity for Type I collagen was
      observed in rough endoplasmic reticulum of fibroblasts (including myofibroblasts)
      in the stromal area. No definite reactivity was obtained in cancer cells by
      either in situ hybridization or immunoelectron microscopy. Our results indicated
      that stromal Type I collagen is produced by stromal fibroblasts, which are
      activated by cancer invasion.

PMID- 1619279
TI  - Distribution of manganese superoxide dismutase in rat stomach: application of
      Triton X-100 and suppression of endogenous streptavidin binding activity.
AB  - The distribution of rat manganese superoxide dismutase (Mn-SOD) was
      immunohistochemically investigated in the rat stomach with a specific polyclonal
      antibody and a labeled streptavidin-biotin immunoglobulin detection system in
      cryosections. Parietal cells in the stomach were intensely stained, whereas the
      other epithelial cells in the gastric gland and pit exhibited only slight
      staining. Rapid-freezing and freeze-substitution immunoelectron microscopy
      revealed that Mn-SOD in parietal cells was mainly localized in mitochondria.
      Therefore, the large amount of Mn-SOD in parietal cells is due to the abundant
      mitochondria, in which Mn-SOD is considered to play important roles in protecting
      the ion pump and the cell itself from superoxide insult. Application of Triton X
      100, cryosectioning, and the streptavidin-biotin system are needed to distinctly
      visualize Mn-SOD with our antibody. Treatment of the cryosections with Triton X
      100 enhanced not only the immunoreactivity but also the false-positive staining,
      which showed a similar distribution pattern to that of Mn-SOD and thus made it
      difficult to determine the localization. The most plausible cause of the false
      positive staining is thought to be endogenous biotin in the stomach, which
      survives paraformaldehyde fixation and is revealed by Triton X-100 treatment.
      Suppression of the endogenous streptavidin binding activity is important when
      cryosections, the streptavidin-biotin system, and Triton X-100 are employed.

PMID- 1619281
TI  - Differing cell surface distribution of human leukocyte antigen-DR molecules on
      epidermal Langerhans cells and eccrine duct cells.
AB  - Scanning electron microscopy (SEM) with immunogold labeling was employed to
      observe the undersurface of the human epidermis after it was split from dermal
      connective tissue, in an attempt to localize the molecules actually expressed on
      cell/tissue surfaces. We found that human leukocyte antigen-DR (HLA-DR) molecules
      were expressed on the surfaces of eccrine duct cells as well as those of
      epidermal Langerhans cells (LC) in normal skin. HLA-DR molecules, visualized by
      the deposition of gold particles, were distributed evenly on the LC surface but
      were present only along the interdigitating borders of the individual duct cells,
      thus producing a meshwork pattern on the duct surface. Transmission electron
      microscopy confirmed that the gold particles labeling cell surface HLA-DR
      molecules were seen only on the portions of duct cell membranes the
      interdigitated with neighboring duct cells. These findings suggest that the
      function of HLA-DR molecules may vary with their location and distribution. On
      the LC surface, the evenly distributed molecules seem to be well suited for
      promoting "accessory cell" functions. On duct cell surfaces, the HLA-DR molecules
      present along the intercellular spaces may be involved in trapping various
      peptide antigens that pass into the sweat gland filtrate and then are reabsorbed
      by the excretory duct, since these molecules have a highly permissive capacity
      for binding various peptides.

PMID- 1619280
TI  - Electron microscopic localization of the multicatalytic proteinase complex in rat
      liver and in cultured cells.
AB  - The multicatalytic proteinase (MCP) prosome or proteasome is a large
      multifunctional complex which is believed to play a major role in non-lysosomal
      pathways of intracellular protein degradation and has recently been implicated in
      antigen processing. In this study, affinity-purified antibodies against rat liver
      MCP were used to investigate the localization of the proteinase both in rat liver
      and in growing human L-132 cells in culture, using electron microscopic
      immunogold techniques. Quantitation of the MCP in different subcellular
      localizations by morphometric analysis of electron micrographs showed the
      proportion in the nucleus to be 17% for hepatocytes and 51% for L-132 cells,
      demonstrating differences in the distribution of MCP in different cell types. In
      hepatocytes, 14% of the total MCP was found associated with the endoplasmic
      reticulum. The remainder was localized in the cytoplasmic matrix.
      Immunofluorescence studies with L-132 cells also showed a reaction in nuclei and
      cytoplasm. The localization of MCP is consistent with its proposed multiple
      functions in protein turnover, in the production of peptides for antigen
      presentation, and in RNA processing.

PMID- 1619282
TI  - Demonstration of dopamine-immunoreactive cells in the gastrointestinal tract of
      gerbils (Meriones unguiculatus).
AB  - We investigated dopamine immunoreactivity in the small intestine of gerbils
      (Meriones unguiculatus), using a sensitive and selective antibody against
      glutaraldehyde-conjugated dopamine. Dopamine-immunoreactive cells were found
      within the mucosal epithelium along the entire extent of the small intestine.
      Labeled cells were regularly distributed in the upper half of the intestinal
      villi, basally attached to the basement membrane and always reaching as far as
      the epithelial surface. Dopamine-containing cells revealed a spindle-like shape,
      and both light and electron microscopic characteristics relate them to typical
      open-type gut endocrine cells. Thus, this current study directly identified
      dopamine as a probable secretory product in basal granulated cells of the small
      intestine. The functional significance of these cells is discussed in relation to
      the current view of dopaminergic actions in peripheral tissues.

PMID- 1619283
TI  - Histochemical studies of acid and alkaline phosphatases in rat tooth germs with
      undecalcified resin-embedded specimens.
AB  - A novel technique for the histochemical demonstration of acid phosphatase
      (AcPase) and alkaline phosphatase (AkPase) in hard tissues has been proposed.
      Fresh, unfixed, undecalcified samples of rat tooth germs and surrounding
      structures were embedded in LR Gold resin at -20 degrees C. Sections of 2 microns
      were taken and subsequently processed for enzyme histochemistry. AkPase reaction
      product appeared as strong linear staining outlining cell boundaries and was
      present in the enamel organ, dental pulp, and osteoblast cells. Tartrate
      resistant AcPase staining was seen exclusively in the osteoclasts of developing
      alveolar bone. Our results demonstrated that the use of unfixed, undecalcified LR
      Gold resin-embedded specimens for histochemistry is a novel technique which may
      be of value for certain studies when decalcification of specimens is undesirable.
      The technique appears to give good preservation of enzyme activity combined with
      the ability to prepare sections with excellent morphological detail.

PMID- 1619284
TI  - On intranucleolar chromatin and fibrillar centers in higher plants.

PMID- 1619285
TI  - Health and environment in Czechoslovakia.
AB  - The study summarizes basic information on environmental conditions and health
      status of the Czechoslovak population. It analyzes the relationships between
      health and environmental conditions, and Appendix brings the comprehensive
      results of relevant studies performed in Czechoslovakia. The analytic results
      suggest the quality of Czechoslovak ecology as unsatisfactory, which in some
      localities, e.g. North Bohemia coal fields, Prague, Ostrava, is next to critical,
      with heavy impact on the population's health. The Czechoslovak citizens are more
      prone to falling ill, die sooner than their peers in the majority of European and
      non-European countries. In addition to the specific effects of individual factors
      and life style also immunity, reproduction cycle, metabolic processes etc. become
      involved in the health-living conditions relationships. All these influences are
      responsible for high rates of morbidity due to the so-called civilization
      diseases. Inevitably, the only possible solution is to protect effectively human
      healthy by protecting his living conditions, i.e. environment and life style.

PMID- 1619286
TI  - Biological carrier improves passive protection of mice against Pseudomonas
      aeruginosa infection.
AB  - In a model experiment, the use of specific hyperimmune globulins (SHG) alone
      failed to protect mice against infection with homologous and heterologous P.
      aeruginosa serotypes. However, the therapeutic potential of SHG dramatically
      improved after its conjugation with A1(OH)3, used as a biological carrier. The
      binding of SHG to this carrier proved to be the most effective and stable
      combination in the treatment of acute pseudomonad infections in mice.

PMID- 1619287
TI  - Microbial causative agents of male urethritis.
AB  - The incidence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma
      hominis, Neisseria gonorrhoeae and Trichomonas vaginalis was studied in men with
      urethritis. Out of 150 examined men 48.7% had the positive isolation of U.
      urealyticum, 26.0% C. trachomatis, 22.7% N. gonorrhoeae, 18.7% M. hominis and in
      one (0.7%) patient T. vaginalis was found. None of the above mentioned
      microorganisms was detected in 24.7% of examined men. In 43.3% cases only one
      agent was isolated. In 23.3% of the men the combination of two agents, in 8.0%
      the combination of three and in 0.7% even the combination of four studied
      microorganisms was observed. C. trachomatis was most frequently observed in
      combination with N. gonorrhoeae (15 cases) and U. urealyticum (14 cases). M.
      hominis and U. urealyticum occurred simultaneously in 22 examined
      men.N.gonorrhoeae was most frequently found together with U. urealyticum (16
      cases). Concerning the occurrence of other bacteria and yeasts, no significant
      difference was found between the groups positive and negative for the above
      mentioned microorganisms.

PMID- 1619288
TI  - Studies on immunomodulatory properties of isoniazid: V. Influence of isoniazid on
      secretion of interleukin-1.
AB  - Isoniazid in vitro decreased interleukin-1 production by glass-adherent cells
      from the blood of healthy donors. The previously described modulation of T cell
      activation by isoniazid seems to be independent of decreased interleukin-1
      secretion.

PMID- 1619289
TI  - Reaction of macrophage disappearance as a method for the evaluation of cellular
      immunity in experimental plague.
AB  - The reaction of macrophage disappearance (RMD) was found to develop one day after
      the immunization of experimental animals with the antigen FIA of Y. pestis and to
      persist for 21 days, correlating with a pronounced protective effect of the above
      antigen over this period. There were differences between white mice and guinea
      pigs in the intensity of the RMD, particularly when immunization was carried out
      using an FIA preparation without prolonged action. These differences are thought
      to reflect varying degrees of immunity elicited by FIA immunization. It is
      recommended that the RMD be used to quantify cellular immunity to Y. pestis.

PMID- 1619290
TI  - A toxicological and epidemiological study on reproductive functions of male
      workers exposed to lead.
AB  - The reproductive ability of 24 men exposed to lead was observed and the same
      number of no-exposed men were taken as controls. The influential factors, such as
      age, smoking and drinking were controlled. The finding shows higher prevalence of
      congenital epilepsy and heart disease in the filial generation of workers exposed
      to lead and high rate of teratospermia in the exposed workers. Meanwhile
      hypospermia, as well as decreased lactate dehydrogenase-x(LDH-x) and
      succinodehydrogenase (SDH) in sperm were found in exposed group.

PMID- 1619291
TI  - Biological monitoring of deltamethrin in sprayers by HPLC method.
AB  - Using HPLC, the authors had investigated the three metabolites of deltamethrin
      (DM) in the urine of spraymen and one suicide, namely: dibromovinyl
      dimethylcyclopropane carboxylic acid (Br2A), 3-phenoxybenzyl-hydroxy-ethyl
      acetate (PHE) and 3-phenoxyl-benzoic acid (BA). Br2A was chosen as the biological
      monitoring parameter for DM exposed people, and the urine samples of one suicide
      and 11 farmers sprayed DM or DM plus methamidophos were examined for Br2A
      quantitatively which was detected in 8 of 11 sprayers and in the suicide case.

PMID- 1619293
TI  - Serosurveillance of susceptibility to rubella in a Mexican female group.
AB  - The susceptibility to rubella of a group of Mexican females of childbearing age
      was determined. Members of the group were selected based on the highest
      probability of having been exposed to the virus they were older than 15, and from
      a low socio-economic urban stratum. Anti-viral antibodies were determined by
      hemagglutination inhibition. Concentration was expressed as International Units
      of IgG anti-rubella hemagglutinin (IU). Antibody concentrations lower than 15.6
      IU/ml were regarded as non-protective. A 16% susceptibility was found.

PMID- 1619292
TI  - Epidemiologic studies on human and feline toxoplasmosis.
AB  - Human serological profiles, and feline serological and fecal profiles were used
      to study the epidemiology of toxoplasmosis in Santa Clara County, California. The
      prevalence of human toxoplasmosis was determined to be 42.9% in a test population
      of 147 women. The prevalence of feline toxoplasmosis was indicated to be 34.8%
      based on serological analysis of 158 felines. Of 107 cats tested, 6.5% were
      shedding Toxoplasma gondii - like oocysts in their feces. Statistical analyses of
      questionnaire data indicated that the major infection sources for seropositive
      humans in this study were: (1) eating rare-medium cooked beef; (2) exposure to
      cats; and (3) working in an outside garden. Of these three sources, gardening
      represented the least risk. The data from questionnaires with reference to age,
      residence, and eating and toilet habits of owned felines were evaluated and found
      to show no significant statistical correlation with seropositivity. The infection
      sources for seropositive felines could not be determined. The plausible
      significance of feline-human interaction, human consumption of infected meat, and
      gardening habits is stressed.

PMID- 1619294
TI  - Empiric therapy of common bacterial infections in Saudi Arabia; a review.
AB  - The common infective conditions encountered at King Khalid Teaching Hospital,
      Riyadh, Saudi Arabia were described. These data were collected mostly during a
      period of 8 years between 1981 to 1988. These infections included brucellosis,
      cholecystitis, conjunctivitis, enteric fever, gastroenteritis, infective
      endocarditis, meningitis, otitis media, pneumonia, septicaemia, sorethroat,
      treponemal infections, urethritis, urinary tract infections, and vaginitis. A
      scheme for empiric chemotherapy has been suggested for these infections based on
      the sensitivity results obtained mostly from the microbiology laboratory at
      Teaching Hospital, Riyadh. This scheme of empiric therapy is offered as a guide
      only. It does not cover all possibilities and is not intended as a rigid dogma.
      Empiric therapy has also been suggested for some other infective conditions where
      sufficient data were not available from the Teaching Hospital. Empiric therapy
      should be started after relevant specimens are collected. Culture and sensitivity
      tests are invaluable in the management of patients with infectious diseases. As
      soon as sensitivities of the infecting organisms' are known, treatment should be
      adjusted accordingly. In some cases, Gram-staining is valuable to guide the
      initial therapy (eg. meningitis, pneumonia, and urethritis). Finally, close
      liaison between physicians and clinical microbiologists is mandatory for
      successful therapy.

PMID- 1619295
TI  - Semiautomatic photometric screening of urine samples for significant bacteriuria
      with high predictive values.
AB  - A simple method for screening urine specimens for significant gramnegative
      bacteriuria is presented, in which microtitration plates, a vertical-beam
      photometer used for reading ELISA and an inexpensive microcomputer are employed.
      The wells of the plate containing brain-heart infusion broth are inoculated with
      urine. Every hour turbidity is measured and the values are compared with the
      original ones. The whole examination is terminated in five hours. At the actual
      prevalence of 0.27, specificity is 0.97, the predictive value of a negative
      result is 0.97 and false positives 0.03. The method is used for rapid reporting
      to the ward, and for subsequent differentiated standard cultivation.

PMID- 1619296
TI  - Determination of Haemophilus influenzae and Haemophilus parainfluenzae
      susceptibility to ampicillin and other antibiotics.
AB  - A sample comprising 40 H. influenzae and 74 H. parainfluenzae strains was used to
      verify methods for determining susceptibility to antibiotics. Modified Levinthal
      agar proved to be suitable for the agar dilution and agar diffusion method, while
      brain heart infusion with the thermally released components of sheep blood (X and
      V factor) and lysed horse blood performed well in the dilution micromethod. The
      iodometric method served well for beta-lactamase production. A substantial
      proportion of strains was resistant to penicillin, erythromycin, roxitromycin and
      sulfamethoxazole. Ampicillin susceptibility was of crucial importance. Resistance
      was largely due to beta-lactamase production. Since there are ampicillin
      resistant strains which fail to produce beta-lactamase, it is necessary either to
      determine the MIC value or use a disk with 2 micrograms ampicillin. A disk
      containing 10 micrograms ampicillin may yield a false positive result.

PMID- 1619297
TI  - Toxicity of Bacillus thuringiensis against Damalinia ovis
      (Phthiraptera:Mallophaga).

PMID- 1619298
TI  - Isolation and characterization of four new strains of Bacillus sphaericus from
      central Nigeria highly toxic to mosquito larvae.

PMID- 1619299
TI  - The capacities of earthworms to heal wounds and to destroy allografts are
      modified by polychlorinated biphenyls (PCB).
AB  - Earthworms (Lumbricus terrestris) were maintained at 15 degrees C and exposed on
      filter paper to 10 micrograms/cm2 of the polychlorinated biphenyl (PCB) Aroclor
      1254 for 5 days prior to surgical treatments which consisted of wounds,
      autografts, and allografts. At 1 day after surgery, we observed a higher
      percentage of healing defects and a significantly greater number of early signs
      of allograft rejection in exposed worms. Observations for 25 days post
      transplantation revealed no response to autografts, but an acceleration of the
      allograft rejection process in exposed earthworms. We postulate that Aroclor
      modified host coelomocytes and/or their interactions associated with antigen
      recognition and inflammation.

PMID- 1619300
TI  - A framework for automatic analysis of the dynamic behaviour of coronary
      angiograms.
AB  - A framework for coronary vessels analysis in digital subtracted angiograms is
      described. This method combines the motion estimation with the frame-to-frame
      structure detection in a natural way such that they act interactively. The first
      step consists of the extraction of the vessel centrelines in one image and their
      organization into meaningful constituents or branches of the coronary arterial
      tree. The motion is then estimated along the centrelines through a gradient based
      method. These motion estimates supply an initial positioning of an active contour
      model (or 'snake') in the next image. This model adapts itself by changing its
      shape to accurately fit onto the new centrelines. This process is then reiterated
      on the subsequent images to depict the dynamic behaviour of all the relevant
      branches. The main interests of this scheme are: (1) the active models operate
      locally so a fast detection of the vessels can be performed; (2) the centrelines
      extraction is fully guided by the confluence of the motion estimation and the
      contour model; (3) both morphological and kinetic features are provided on a
      quantitative basis.

PMID- 1619301
TI  - Computer methods in quantitation of cardiac wall parameters from two dimensional
      echocardiograms: a survey.
AB  - With increasing use of two-dimensional echocardiograms (2DE) for diagnosis [1,
      2], efforts to computerize the process of quantification of cardiac parameters
      have increased. Visual processing of echocardiograms is time and labor intensive,
      and usually provides qualitative results with subjective variations [3]. In
      contrast, computer assisted methods are efficient and provide quantitative
      reproducible results. On the basis of the extent of computer usage, the 2DE
      processing methods are classified into three categories, namely, manual [9-30],
      interactive [32-49], and automatic methods [51-82]. This work is a structured
      survey of the published research on these three categories.

PMID- 1619302
TI  - Exercise echocardiography and single photon emission computed tomography in
      patients with left anterior descending coronary artery stenosis.
AB  - To compare the diagnostic value of exercise echocardiography and perfusion single
      photon emission computed tomography (SPECT) in the detection of the presence and
      the severity of coronary artery disease, we studied 21 patients with isolated
      stenosis of different degree of the left anterior descending artery. Both
      echocardiography and SPECT were performed in conjunction with the same symptom
      limited bicycle exercise test. Positivity of the test was based on the presence
      of exercise-induced wall motion abnormalities and transient perfusion defects,
      respectively. For both tests, an 'ischemic' score was derived, as index of extent
      and severity of myocardial ischemia. Coronary arteriography was evaluated by
      caliper. The agreement between exercise echocardiography and SPECT for the
      presence of coronary artery disease was 90%; the discordance was due to two
      patients with positive echocardiography and negative SPECT. A good correlation
      between ischemic wall motion and perfusion score indices was found (r = 0.78, p
      less than 0.0001. Moreover, the percent diameter stenosis was well correlated
      with both ischemic indices (r = 0.75, p less than 0.0001; r = 0.67, p less than
      0.001, respectively). In patients with a positive test, the mean value of
      ischemic wall motion score index was higher in patients with a diameter stenosis
      greater than or equal to 70% than in patients with a diameter stenosis less than
      70% (0.59 +/- 0.19 vs 0.29 +/- 0.12, p less than 0.01); a similar trend was found
      for ischemic perfusion score index (0.51 +/- 0.35 vs 0.27 +/- 0.12, ns).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1619303
TI  - Iopamidol in cardioangiography: a retrospective, multicenter study. Part I. Adult
      patients.
AB  - To evaluate the occurrence of complications during diagnostic or interventional
      catheterization a retrospective analysis of catheterization procedures in 12
      Italian laboratories using the nonionic contrast medium (CM) iopamidol (370
      mgI/ml) was performed. Data obtained on 26,219 patients greater than or equal to
      14 years are presented. The overall complication rate was 1.89% (485/26,219). The
      overall mortality rate was 0.1% (27/26,219). Procedure related complications were
      389 (1.48%) and CM related complications were 106 (0.4%). No death was attributed
      to CM. Ventricular fibrillation (VF) rate was 0.11% comparable to the low rate
      observed with nonionic CM in other studies and less than the rate observed in
      surveys concerning the use of ionic CM. Fifty-seven thrombotic events were
      recorded (0.22%), a rate comparable with other surveys with ionic and nonionic
      CM. The total complication rate (6.1%), the rates of coronary occlusion (1.34%),
      myocardial infarction (0.37%) and urgent coronary artery by-pass grafting (0.5%)
      in 1,348 coronary angioplasties were lower than those recorded in previous
      surveys. These data confirm a good tolerability and no increased risk of VF and
      thrombotic events with iopamidol in cardiac catheterization.

PMID- 1619305
TI  - Left ventricular opacification after peripheral venous injection of a modified
      albumin solution.
AB  - The usefulness of a modified albumin solution was assessed in 8 dogs after
      peripheral venous and inferior vena cava injections. The contrast agent is a
      mixed solution made of glucose, albumin and glycerin, with sonicated microbubble
      diameter of 5.0 +/- 2.3 microns. Multiple injections (8 ml each) of this contrast
      agent (total 80 injections) into peripheral vein and inferior cava were
      performed. The blood pressure from femoral artery was measured before, during and
      after injections. Two-dimensional echocardiograms were recorded in a modified
      long axis view on videotapes for play back analysis. The pulmonary transit time
      and left ventricular contrast persistent time was determined for each injection.
      The videodensity of the region of interest (ROI) at the center of right ventricle
      and left ventricle was measured. The background videodensity of both ventricles
      was evaluated. The videodensity over the ROI of both ventricles with peak
      contrast enhancement was measured in all frames for 3 consecutive cardiac cycles.
      The peak videodensity of right and left ventricle subtracting the background
      videodensity of each ventricles was further calculated respectively. The
      injections caused no change in blood pressure or heart rate. All injections
      produced right ventricular contrast echo. As much as 85% of peripheral venous and
      82.5% of inferior vena cava injections resulted in left ventricular contrast
      which was 0.68 and 0.65 as bright as that produced in the right ventricle.
      Pulmonary transit time and left ventricle contrast persistent time of peripheral
      venous injection was 4.05 +/- 0.53 and 13.67 +/- 4.28 seconds respectively. No
      difference of these data (3.93 +/- 0.47 and 11.65 +/- 4.66 seconds) from those
      produced by inferior vena cava injections were noted.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1619304
TI  - Iopamidol in cardioangiography: a retrospective, multicentre study. Part II.
      Paediatric patients.
AB  - To evaluate the complication rate in paediatric cardioangiography with the
      nonionic contrast medium iopamidol data on 8,166 procedures were retrospectively
      collected in 12 centres. The overall complication rate was 3.78% (309/8,166).
      3.44% were related to the procedure, and 0.34% to the contrast medium. The
      mortality rate varied with age. It was higher in patients less than 2 months
      (0.38%) than in patients greater than 2 months-2 years (0.06%) and in patients
      older than 2 years (0.03%). The total complication rate was higher than the one
      observed in a similar retrospective analysis performed in adult patients (1.89%).
      This difference is probably due to higher risk conditions of the younger
      patients. However the contrast medium related complication rate (0.34% vs 0.4%)
      and the mortality rate (0.11% vs 0.1%) were comparable, confirming the good
      tolerability of iopamidol in cardiac catheterisation also in paediatric patients.

PMID- 1619307
TI  - [Two metalloproteinases produced from Pseudomonas aeruginosa, especially on the
      structure of active site and substrate specificity].

PMID- 1619306
TI  - Coronary artery-cardiac chamber shunt: cineangiographic analysis.
AB  - Coronary artery-cardiac chamber shunts (CA-CC shunts) were observed in 101 out of
      2267 consecutive patients (4.5%) receiving selective coronary angiography. In
      these patients, contrast medium injected into the coronary artery escaped
      directly into the cardiac chamber. CA-CC shunts were angiographically classified
      into the following two types. Type I: The endocardial layer was diffusely
      opacified, and contrast medium escaped into the cardiac chamber on systole (n =
      83). Type II: Contrast medium escaped directly into the cardiac chamber via an
      undilated branch (n = 11). Type I and type II shunts were observed simultaneously
      in 7 patients. It is speculated that type I is a shunt via a persistent arterio
      sinusoidal vessel, while type II is a shunt via a persistent arterio-luminal
      vessel. Both types were observed frequently (24.9%) in hypertrophic
      cardiomyopathy. The degree of CA-CC shunts in hypertrophic cardiomyopathy was not
      influenced by the presence or absence of myocardial squeezing. CA-CC shunts are
      considered to be due to an abnormality in the coronary microcirculation of the
      myocardium. We describe the angiographic features of the two types of CA-CC shunt
      and discuss their pathophysiological significance.

PMID- 1619308
TI  - [Structural and functional aspects for the active site of glutathione
      synthetase].

PMID- 1619309
TI  - [Topogenic sequences of integral membrane proteins for endoplasmic reticulum
      membranes].

PMID- 1619310
TI  - [Immunohistochemical study on the expression of E-cadherin in normal tissues and
      squamous cell carcinomas of the uterine cervix].
AB  - The expression of epithelial cadherin (E-cadherin) was immunohistochemically
      analyzed in normal tissues and squamous cell carcinomas of the uterine cervix and
      investigated clinicopathologically in relation to factors including the
      histological type, clinical stage (FIGO), tumor invasion and lymph node
      metastasis. The following results were obtained. (1) In normal cervix, E-cadherin
      was found at the cell to cell borders in both squamous and columnar epithelia,
      but not in stromal tissues. (2) In 38 patients with cervical cancer, 6 patients
      exhibited homogeneous staining of E-cadherin, while 32 showed heterogeneous
      expression, suggesting that cell to cell adhesion is not uniform in most cases.
      (3) In cases with large cell non-keratinizing squamous cell carcinoma invading to
      a depth exceeding 2/3 of the cervix, a significantly higher frequency of
      heterogeneous expression of E-cadherin was seen (p less than 0.05). (4) Patients
      who had cancer invasion exceeding 2/3 of the cervix with heterogeneous expression
      tended to have a high incidence of nodal metastasis. These results indicate that
      the expression of E-cadherin in cancer may be one of the factors most responsible
      for the process of invasion and metastasis in cervical cancer.

PMID- 1619311
TI  - [Significance of CA19-9 in mature cystic teratoma].
AB  - We comparatively studied preoperative and postoperative serum CA19-9 levels in
      170 mature cystic teratoma (MCT) cases. In MCT cases with positive serum CA19-9
      levels, immunohistochemistry by means of an enzyme immunoassay was performed to
      determine in which tissues the high levels of serum CA19-9 had originated. 1. The
      preoperative serum CA19-9 level was high, 83.8 U/ml, against the low
      postoperative level of 32.9 U/ml. This suggested the possibility of CA19-9 being
      produced in the tumor of MCT. 2. There were 31 CA19-9 positive cases and CA19-9
      was found in the bronchial gland tissue and surface epithelium in 9 and 4 cases,
      respectively, out of 23 cases with serum levels of more than 101U/ml. Out of 45
      cases with normal CA19-9 levels, 4 had bronchial gland tissue and 3 had surface
      epithelium, both without CA19-9. Lewis system examination of those cases
      indicated Lewisa(-) and Lewisb(-) in all of them. 3. CA19-9 levels were higher in
      cystic fluid than in serum from MCT patients. This suggested two routes for the
      transfer into blood of tumor-tissue-produced CA19-9: 1) directly excreted in
      serum via surface epithelium; 2) retained in the ovarian cyst, then leaking into
      surrounding capillary vessels via the interstitium. 4. Clinically, CA19-9 is a
      marker necessary for examining MCT recurrence.

PMID- 1619312
TI  - [Relationship between sonographic endometrial images and endometrial histology
      during the secretory phase].
AB  - Transvaginal sonographic endometrial images and endometrial biopsies were
      obtained during the luteal phase (L5-L10) from 31 patients with normal menstrual
      cycles. The Hyperechoic Endometrial Area (HEA) ratio was used as the index of
      sonographic endometrial dating, and 12 glandular and/or stromal parameters were
      used as the index of histological endometrial dating. The day of ovulation was
      determined with sequential transvaginal sonography. In 20 patients with a typical
      sonographic image, 80% of the HEA ratio was equal to L6 based on the histological
      endometrial dating, and 90% was equal to L9. These results suggested the efficacy
      of the sonographic endometrial dating. The remaining 11 patients with an atypical
      sonographic endometrial image were classified into 3 groups (hyperechoic, spotted
      and hypoechoic type). Two characteristic features, delayed glandular element and
      increased stromal cell density, were observed in the hyperechoic group. On the
      other hand, dissociation between glandular and stromal dating was observed in the
      spotted group. Hypoplastic glands and insufficient secretion were characteristic
      of the hypoechoic group. These results show that sonographic endometrial dating
      has clinical efficacy. This dating has enough coincidence with endometrial
      histology. Moreover, two advantages were recognized in the sonographic dating
      over the histological dating. One is the non-invasive examination, and the other
      is the real-time evaluation of the endometrium.

PMID- 1619313
TI  - [Recovery of ovarian function during postpartum period].
AB  - To determine the effect of serum prolactin (PRL) on the recovery of ovarian
      function in the postpartum period, FSH, PRL, estradiol (E2), and 17 alpha-OH
      progesterone (17-P) levels were measured in postpartum women and the levels were
      compared with those in patients treated with bromocriptine. In addition, hMG was
      given for two days on the 10th and 30th postpartum days to the mothers treated
      with/without bromocriptine. On the 10th day, FSH levels tended to increase and
      the E2 and 17-P levels were significantly increased by bromocriptine treatment
      and these levels are compatible to those on the 30th day in the control group.
      Although no apparent change in E2 and 17-P levels was observed before and after
      hMG administration in the control, a significant increase in E2 on the 30th day
      and in 17-P on the 10th and 30th day was observed when the patients were treated
      with bromocriptine. These results suggest that high concentrations of PRL in the
      postpartum period suppressed the ovarian function not only due to the low
      gonadotropin secretion but also to the poor ovarian response to gonadotropin. 17
      P seems to be preceded by estradiol secretion in the recovery of ovarian function
      during the postpartum period.

PMID- 1619314
TI  - [Assessment of diagnostic criterion of coldness in women with thermography].
AB  - In this study 99 women were examined by thermography to diagnose coldness. We
      investigated the correlation between the surface temperature of various parts of
      the body and the atmospheric temperature during a day in 66 women with coldness
      and 33 without coldness by means of thermography. RESULTS: 1) Peripheral portions
      of the lower limbs giving readings lower than 26 degrees C in thermography were
      found in 67% of women with coldness and in 6% of those without coldness. 2) In
      the group of women with coldness, the mean surface temperatures in the peripheral
      portions of limbs were closely correlated with the mean atmospheric temperatures
      (r = 0.63, p less than 0.001), and the gradient of temperatures from the abdomen
      to the peripheral portions of limbs was greater at lower mean atmospheric
      temperatures. 3) A significantly large number (p less than 0.001) of women with
      coldness had a gradient of more than 6 degrees C observed compared with the other
      group. 4) The gradient was significantly larger (p less than 0.001) in women with
      coldness when the mean atmospheric temperature was under 15 degrees C than in
      women without coldness. CONCLUSION: When the gradient of the surface temperature
      from the abdomen to the peripheral portions of the limbs in thermography was more
      than 6 degrees C, we might be able to conclude that the subjects have coldness.

PMID- 1619315
TI  - [Molecular biological study on the overexpression of c-myc gene in uterine
      cervical carcinomas].
AB  - The expression of mRNA for c-myc gene was investigated in 30 cases of human
      uterine cervical carcinoma by Northern blot hybridization, and c-myc gene
      amplification was also examined by Slot blot hybridization. Overexpression of c
      myc gene was detected in one (7.7%) of 13 cases of carcinoma in situ (stage 0),
      one (10.0%) of 10 stage I and 4 (57.1%) of 7 stage II uterine carcinoma, and c
      myc gene amplification was detected in 2 cases (6.7%) in which c-myc gene
      overexpression was also found. The patient whose c-myc mRNA level was more than
      10 times as high as in normal uterine cervical tissue relapsed and died within 2
      years after the first treatment. Our results suggest that the overexpression of c
      myc gene occurred more frequently in advanced than in early uterine cervical
      carcinoma and that it might be useful in prognosing cervical cancer.

PMID- 1619316
TI  - [Heterogeneity of CA 125 antigens released from human endometrial heterotopic
      epithelium and ovarian cancer].
AB  - We purified CA125 antigen from the conditioned media (CM) of eutopic and
      heterotopic endometrial epithelial cells (EC) as well as ovarian cancer cell
      lines, SHIN-3 and HOC-I, to determine what molecular weight forms of CA125
      antigen were identifiable. Treatment of the high-molecular-weight CA125 antigen
      with 6M urea yielded a much lower molecular mass peak. After purification by
      OC125 affinity column chromatography, samples were applied to 3 to 7%
      polyacrylamide gradient gel and analyzed by Western blot. A single band with a
      molecular weight (MW) of 200KDa was identified in eutopic EC materials. The CA125
      polypeptide of the 110KDa molecule could be detected in all of the CM obtained
      from heterotopic EC, irrespective of the length of time in the cell culture. A MW
      of approximately 200 KDa was also observed in some heterotopic EC samples. On the
      other hand, although the multiple bands with a MW equal to orless than 200KDa
      were observed in the CM of two ovarian cancer cells, the CA125 polypeptide of
      110KDa molecules could not be detected. This preliminary finding offers promise
      that the 110KDa molecule detection method may be a useful adjunct in the
      differential diagnosis of heterotopic EC and ovarian cancer.

PMID- 1619317
TI  - [Bone mineral content in premenopausal women treated with gonadotropin-releasing
      hormone analogue].
AB  - To assess bone metabolism during treatment with gonadotropin-releasing hormone
      analogue (GnRHa), serum osteocalcin (BGP), alkaline phosphatase (ALP),
      parathyroid hormone (PTH), calcitonin (CT), calcium (Ca) and phosphorus (P) were
      determined before and after 6 months of GnRHa treatment in 15 premenopausal women
      with clinically diagnosed endometriosis. The bone mineral content (BMC) of the
      lumbar spine (L3) was measured by single energy quantitative computed tomography
      in 9 women, and in 6 of these 9 women microdensitometry was performed
      simultaneously during the treatment. BMC decreased significantly to 92.5 +/- 6.8%
      (mean +/- SD) of the pretreatment value after 6 months of treatment. On the other
      hand, microdensitometry revealed no significant change during treatment. Serum
      BGP and ALP were significantly higher after 6 months of treatment than before
      treatment, indicating an increase in bone formation. These data indicate that the
      GnRHa treatment induces an increase in bone turnover and a significant bone loss.

PMID- 1619318
TI  - [Quantitative evaluation of human placental aromatase during pregnancy by ELISA].
AB  - To examine the relationship between the modulation of estrogen synthesis and
      placental maturation during pregnancy, we measured enzyme quantities and
      catalytic activities of aromatase in 78 normal human placentas (7-41 weeks
      gestation). The quantity was determined by ELISA with monoclonal antibodies
      specific to aromatase cytochrome P-450 (P-450arom). The activity was assessed by
      radioassay with [1 beta-3H] androstenedione. Intracellularly, the P-450arom
      concentration was twice as great in the microsomal fraction of term placentas
      (0.18 +/- 0.07%) as in the homogenate and mitochondrial fractions. Aromatase
      activity was also twice as great in the microsomal fraction as in the other
      fractions. The P-450arom concentration in microsomes increased linearly as
      pregnancy progressed (r = 0.759, p less than 0.001). The total P-450arom quantity
      in the placenta increased quadratically as pregnancy progressed (r = 0.891).
      Similar results were observed for aromatase activity. These results indicated
      that the increase in P-450arom was responsible for the increase in aromatase
      activity in normal human placenta. Therefore, in addition to the increase in
      placental weight and substrate derived from fetal adrenal during pregnancy, a
      further increase in P-450arom contributes to the marked increase in maternal
      estrogen production.

PMID- 1619319
TI  - [In vitro and in vivo effects of ginsenoside Rh2 on the proliferation of serous
      cystadenocarcinoma of the human ovary].
AB  - Inhibition of human ovarian cancer cell proliferation in vitro and in vivo by
      Ginsenoside Rh2(Rh2) isolated from Red Ginseng was examined by using a cell line
      (HRA) derived from ascites of a patient with serous cystadenocarcinoma of the
      ovary. The HRA cell proliferation in vitro was inhibited in a dose-dependent
      manner with between 10 and 100 microM of Rh2. The uptake of radiolabeled
      precursors (3H-thymidine, 3H-uridine, and 3H-varine) by HRA cells was also
      inhibited in a dose-dependent manner with between 30 and 100 microM of Rh2. The
      growth of HRA cells transplanted into nude mice was not significantly inhibited
      by Rh2 alone. On the other hand, when cisplatin was administered together with 10
      microM, 30 microM, or 50 microM Rh2, the growth of HRA cells was inhibited 31 and
      35 days after tumor inoculation. Survival was also prolonged when cisplatin was
      administered with 10 microM and 30 microM Rh2. These results suggest that there
      is a synergistic effect between cisplatin and Rh2.

PMID- 1619320
TI  - [The clinical and pharmacokinetic evaluation of two-route chemotherapy with
      cisplatin and sodium thiosulfate in combination with angiotensin II].
AB  - Thirty-six courses of chemotherapy with cisplatin (CDDP) and sodium thiosulfate
      (STS) were performed in 31 patients with gynecologic cancer 2 weeks after
      operation under the hypertensive condition induced by angiotensin II (AT-II). One
      hundred-fifty mg of CDDP/body was intraperitoneally administered while the usual
      systolic blood pressure was increased to 130-140% by AT-II. The hypertension was
      maintained for 15 minutes after finishing CDDP infusion, then 8g of STS was
      intravenously infused immediately after the cessation of AT-II. The urinary Pt
      level measured 15 minutes after finishing CDDP infusion was extremely low at 1.37
      +/- 0.47 micrograms/ml, in spite of the significantly high levels of plasma total
      Pt (7.83 +/- 0.85 micrograms/ml) and filtrable Pt (4.02 +/- 0.55 micrograms/ml).
      This suggests that, during renal vasoconstriction induced by AT-II, the renal
      blood flow as well as renal uptake of CDDP was decreased. Plasma filtrable Pt
      levels were measured at 15, 30, 60 and 120 minutes after intraperitoneal
      administration of CDDP. At 15 and 30 minutes a significantly higher blood
      concentration was found than in the control group (p less than 0.05). However,
      CDDP-induced toxicities of the bone marrow, liver, kidney and alimentary tract
      were not increased. The extreme vasoconstriction in the kidneys and other organs
      induced by AT-II might have protected these organs from the toxicities of CDDP
      despite the fact that STS infusion was delayed by 15 minutes after CDDP infusion.
      STS infused immediately after the cessation of AT-II could neutralize the CDDP
      preventing the occurrence of toxicities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619321
TI  - [Clinical significance of amniotic fluid interleukin-6--newly developed method,
      luminescence enzyme immunoassay].

PMID- 1619322
TI  - [The effects of dipyridamole on proteinuria in preeclampsia].

PMID- 1619323
TI  - [Psychosomatic approach for generalized anxiety disorders in climacterium].

PMID- 1619324
TI  - [The 25th annual meeting of the Japanese Orthopaedic Association Musculoskeletal
      Tumor Society. July 17-18, 1992, Matsuyama, Japan. Abstracts].

PMID- 1619325
TI  - [Diagnosis of adrenal gland diseases].

PMID- 1619326
TI  - [Test procedures for the diagnosis of adrenal gland diseases].

PMID- 1619327
TI  - [Imaging diagnosis of adrenal gland diseases].

PMID- 1619329
TI  - [Drug enhancement of cortisol and glucocorticoid metabolism].

PMID- 1619328
TI  - [Primary pigmented nodular adrenocortical diseases and hyporeninemic
      hypoaldosteronism].

PMID- 1619330
TI  - [Diagnosis and therapy of adrenergic hypertension].

PMID- 1619331
TI  - [Diagnosis and therapy of aldosterone-producing adrenal gland adenoma].

PMID- 1619332
TI  - [Diagnosis and therapy of pheochromocytoma].

PMID- 1619333
TI  - [Key points in diagnosis and therapy of adrenal gland diseases: discussion].

PMID- 1619334
TI  - [Case of pulmonary valve stenosis due to tuberculous pericardio-pleural
      calcification].

PMID- 1619335
TI  - [Case of pure progressive autonomic failure with sleep apnea syndrome].

PMID- 1619336
TI  - [Case of arachnoid cyst complicated by multiple cystic disease].

PMID- 1619337
TI  - [Autopsy case of palatal granulocytic sarcoma preceding the development of a
      tumor].

PMID- 1619338
TI  - [Recent progress in the study of positron CT].

PMID- 1619339
TI  - [Chronic fatigue syndrome].

PMID- 1619340
TI  - [Case of glycogenosis III with marked fibrosis of the myocardium and cardiac
      failure].

PMID- 1619341
TI  - Cysts of the mandible and maxilla.
AB  - Mandibular and maxillary cysts originate from elements of the teeth
      (odontogenic), or from epithelial remnants trapped in fusion lines during
      development (nonodontogenic). Both types can be clinically asymptomatic and must
      be treated surgically. The specific diagnosis of a jaw cyst and its recurrence
      depends upon the anatomical location, the radiographic appearance, and the
      pathological diagnosis.

PMID- 1619342
TI  - Dr Marion Souchon. Physician and artist.

PMID- 1619343
TI  - Chronic fatigue syndrome.
AB  - The chronic fatigue syndrome (CFS) is a poorly understood condition with
      nonspecific signs and symptoms, especially debilitating fatigue. Most patients
      can pinpoint the onset of their illness and usually describe a flu-like state.
      The search for an etiologic agent has focused on a number of viruses such as
      Epstein-Barr, enteroviruses, retroviruses, and human herpesvirus-6. Evidence
      supports persistent viral infection in a small percentage of CFS patients.
      Immunologic abnormalities do exist in CFS, which indicate the presence of immune
      activation in CFS patients. Although abnormal muscle biopsies have been found in
      some patients with CFS, strength and endurance appear normal, but perception of
      exertion may be abnormal. Patients with chronic fatigue have a high incidence of
      premorbid and concurrent psychiatric disorders, and on physical examination many
      often have reproducible tender points similar to fibromyalgic patients. Clinical
      evaluation should rule out other potential causes of fatigue, but elaborate
      diagnostic tests are seldom required. Presently, no specific treatment exists for
      CFS. A cognitive behavioral approach with or without the use of tricyclics has
      been advocated. Patients should be encouraged to maintain functional status and
      should not be discouraged from exercise. Several medications have been tried but
      with no definite clinical benefit.

PMID- 1619345
TI  - OSHA and the private practitioner.
AB  - The Occupational Safety and Health Act (OSHA) was passed by Congress over 20
      years ago. Although the Act excludes workplaces with 10 employees or fewer, those
      employers affected are rarely knowledgeable about the Act provisions as they
      pertain to the specific workplace. Physicians' offices may have enough employees
      that compliance with OSHA is necessary. This brief article describes some
      highlights of regulations affecting health care workplaces.

PMID- 1619344
TI  - Lung cancer rates and risk factors in St Bernard Parish, Louisiana: an ecologic
      study.
AB  - The white population of St Bernard Parish, Louisiana displays excessive incidence
      and mortality rates for lung cancer. Examination of 14 years of case reports from
      the Louisiana Tumor Registry reveals an apparent cluster of high incidence in the
      rural portion of the parish. Based on a telephone survey, lifestyle risk factors
      for lung cancer (such as diet and tobacco consumption) appear to vary from one
      part of the parish to another. Specifically, cigarette smoking is more prevalent
      in the rural zones, particularly among males over the age of 45. In addition, the
      index of total vitamin A intake appears to be lowest in the rural zones where
      lung cancer incidence is highest. Occupational and environmental factors are also
      considered, but do not seem to vary geographically with lung cancer incidence.

PMID- 1619346
TI  - Physician practices and attitudes on HIV-related issues: a survey of LSMS primary
      care physicians.
AB  - In recent years there has been a dramatic increase in the number of HIV/AIDS
      patients in Louisiana. Despite this increase, there has been little investigation
      of physician perceptions of (1) the adequacy of treatment or (2) attitudes toward
      general HIV related issues. A study of LSMS primary care members (n = 470)
      indicated that most had not treated a HIV-infected or AIDS patient although the
      vast majority would readily do so. Reluctance was related to concern over
      scientific knowledge rather than any bias against such patients. Among physicians
      treating such patients, there was strong concern over availability of adequate
      hospitalization and home health care.

PMID- 1619347
TI  - 'Now, altogether'.

PMID- 1619348
TI  - Kentucky's bicentennial and a brief overview of 200 years of medical practice and
      the physician. 1.

PMID- 1619349
TI  - Sketch of the Kentucky State Medical Society. 1951.

PMID- 1619350
TI  - The truth about mammography.

PMID- 1619351
TI  - Nursing home restraints and legal liability. Merging the standard of care and
      industry practice.

PMID- 1619352
TI  - The impact of large medical malpractice awards on malpractice awardees.

PMID- 1619353
TI  - Therapeutic deception. A comparison of Halacha and American law.

PMID- 1619355
TI  - The diagnosis and treatment of TMD: Part 2.

PMID- 1619354
TI  - Wrongful death and the lost society of the unborn.

PMID- 1619356
TI  - Impacted teeth--an overview of treatment rationales.

PMID- 1619357
TI  - Bile acid solubility and precipitation in vitro and in vivo: the role of
      conjugation, pH, and Ca2+ ions.
AB  - The principles governing the in vitro solubility of the common natural conjugated
      and unconjugated bile acids and salts in relation to pH, micelle formation, and
      Ca2+ concentration are considered from a theoretical standpoint and then
      correlated first with experimental observations on model systems and second with
      the formation of precipitates containing bile acids in health and disease. In
      vitro, taurine-conjugated bile acids are soluble at strongly acidic pH; glycine
      conjugated bile acids are poorly soluble at moderately acidic pH; and many of the
      common, natural unconjugated bile acids are insoluble at neutral pH. For both
      glycine-conjugated and unconjugated bile acids, solubility rises exponentially,
      with increasing pH, until the concentration of the anion reaches the critical
      micellization concentration (CMC) when micelle formation occurs and solubility
      becomes practically unlimited. In vivo, in health, conjugated bile acids are
      present in micellar form in the biliary and intestinal tract. Unconjugated bile
      acids formed in the large intestine remain at low monomeric concentrations
      because of the acidic pH of the proximal colon, binding to bacteria, and
      absorption across the intestinal mucosa. In diseases in which proximal small
      intestinal content is abnormally acidic, precipitation of glycine-conjugated bile
      acids (in protonated form) occurs. Increased bacterial formation of unconjugated
      bile acids occurs with stasis in the biliary tract and small intestine; in the
      intestine, unconjugated bile acids precipitate in the protonated form. If the
      precipitates aggregate, an enterolith may be formed. In vitro, the calcium salts
      of taurine conjugates are highly water soluble, whereas the calcium salts of
      glycine conjugates and unconjugated bile acids possess limited aqueous solubility
      that is strongly influenced by bile acid structure. Precipitation occurs
      extremely slowly from supersaturated solutions of glycine-conjugated bile acids
      because of metastability, whereas super-saturated solutions of unconjugated bile
      acids rapidly form precipitates of the calcium salt. In systems containing Ca2+
      ions and unconjugated bile acids, pH is important, since it is the key
      determinant of the anion concentration. For bile acids with relatively soluble
      calcium salts (or with a low CMC), the concentration of the anion will reach the
      CMC and micelles will form, thus precluding formation of the insoluble calcium
      salt. For bile acids, with relatively insoluble calcium salts (or with a high
      CMC), the effect of increasing pH is to cause the anion to reach the solubility
      product of the calcium salt before reaching the CMC so that precipitation of the
      calcium salt occurs instead of micelle formation.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1619358
TI  - Effect of dietary oils on lipid peroxidation and on antioxidant parameters of rat
      plasma and lipoprotein fractions.
AB  - In order to investigate the influence of fatty acid pattern and antioxidants
      other than vitamin E on lipid peroxidation and antioxidant levels of plasma very
      low density and low density lipoproteins (VLDL + LDL), the effects of three diets
      (equalized for vitamin E) containing soybean oil, olive oil, or an oleate-rich
      mixture of triglycerides (triolein) were studied in rats. A significantly lower
      concentration of thiobarbituric acid-reactive substances (TBA-RS) in plasma and
      lipoproteins was found after the olive oil diet (soybean oil, 3.7 +/- 0.4
      nmol/ml; triolein, 2.1 +/- 0.5 nmol/ml; olive oil, 1.5 +/- 0.3 nmol/ml, in
      plasma) (soybean oil, 0.99 +/- 0.16 nmol/ml; triolein, 0.96 +/- 0.13 nmol/ml;
      olive oil, 0.38 +/- 0.12 nmol/ml, in the VLDL + LDL fraction). Furthermore, the
      results from in vitro copper-induced lipid peroxidation, expressed in terms of
      conjugated dienes, lipid hydroperoxides, and TBA-RS content, showed that VLDL +
      LDL particles from olive olive oil-fed rats were remarkably resistant to
      oxidative modification. The results suggest that the fatty acid unsaturation of
      dietary oils is not the only determining factor of the antioxidant capacity of
      lipoproteins in this animal model. The maximal protection observed after the
      olive oil diet may be explained by the presence of other unidentified
      antioxidants in addition to vitamin E, derived from oil intake. Therefore, the
      optimal balance between the content of unsaturated fatty acids and natural
      antioxidants in dietary oils appears to be of major importance.

PMID- 1619359
TI  - Solubility of calcium salts of unconjugated and conjugated natural bile acids.
AB  - The approximate solubility products of the calcium salts of ten unconjugated bile
      acids and several taurine conjugated bile acids were determined. The formation of
      micelles, gels, and/or precipitates in relation to Ca2+,Na+, and bile salt
      concentration was summarized by "phase maps." Because the ratio of Ca2+ to bile
      salt in the precipitates was ca. 1:2, and the activity of Ca2+ but not that of
      bile salt (BA-) could be measured, the ion product of aCa2+ [BA-]2 was
      calculated. The ion product (= Ksp) ranged over nine orders of magnitude and the
      solubility thus ranged over three orders of magnitude; its value depended on the
      number and orientation of the hydroxyl groups in the bile acid. Ion products (in
      units of 10(-9) mol/l)3 were as follows: cholic (3 alpha OH,7 alpha OH,12 alpha
      OH) 640; ursocholic (3 alpha OH,7 beta OH,12 alpha OH) 2300; hyocholic (3 alpha
      OH,6 alpha OH,7 alpha OH) 11; ursodeoxycholic (3 alpha OH,7 beta OH) 91;
      chenodeoxycholic (3 alpha OH,7 alpha OH) 10; deoxycholic (3 alpha OH,12 alpha OH)
      1.5; 12-epideoxycholic (lagodeoxycholic, 3 alpha OH,12 beta OH) 2.2;
      hyodeoxycholic (3 alpha OH,6 alpha OH) 0.7; and lithocholic (3 alpha OH) 0.00005.
      The critical micellization temperature of the sodium salt of murideoxycholic acid
      (3 alpha OH,6 beta OH) was greater than 100 degrees C, and its Ca2+ salt was
      likely to be very insoluble. Taurine conjugates were much more soluble than their
      corresponding unconjugated derivatives: chenodeoxycholyltaurine, 384;
      deoxycholyltaurine, 117; and cholyltaurine, greater than 10,000. Calcium salts of
      unconjugated bile acids precipitated rapidly in contrast to those of glycine
      conjugates which were metastable for months. Thus, hepatic conjugation of bile
      acids with taurine or glycine not only enhances solubility at acidic pH, but also
      at Ca2+ ion concentrations present in bile and intestinal content.

PMID- 1619360
TI  - Bile acid synthesis. VI. Regulation of cholesterol 7 alpha-hydroxylase by
      taurocholate and mevalonate.
AB  - Taurocholate, a relatively hydrophobic bile salt, is a potent down-regulator of
      HMG-CoA reductase and cholesterol 7 alpha-hydroxylase (C7 alpha H), the rate
      determining enzymes of the cholesterol and bile acid biosynthetic pathways,
      respectively. Inhibition of cholesterol synthesis with a bolus dose of mevinolin
      (lovastatin) a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A
      (HMG-CoA) reductase, profoundly decreases the specific activity of cholesterol 7
      alpha-hydroxylase and rate of bile acid synthesis in rats with complete biliary
      diversion. It is therefore conceivable that taurocholate may suppress cholesterol
      7 alpha-hydroxylase primarily by down-regulating the activity of HMG-CoA
      reductase. To test this hypothesis, taurocholate was coinfused simultaneously to
      rats with chronic bile fistula with mevalonate (administered as mevalonolactone),
      an intermediate in the cholesterol biosynthetic pathway. Mevalonolactone was
      administered to provide a constant supply of newly synthesized cholesterol to
      cholesterol 7 alpha-hydroxylase, in order to overcome any inhibitory effect of
      taurocholate on HMG-Coa reductase. Infusions were started 72 h after biliary
      diversion, and carried out for an additional 48 h. Complete biliary diversion
      resulted in an increase in C7 alpha H specific activity (510%), protein mass
      (550%), steady-state mRNA levels (1430%), and transcriptional activities (330%)
      as compared to control rats with intact enterohepatic circulations. When rats
      with biliary diversion were infused intraduodenally with taurocholate, the
      specific activities of HMG-CoA reductase and cholesterol 7 alpha-hydroxylase
      activities decreased by 75% (P less than 0.001) and 73% (P less than 0.001),
      respectively. Cholesterol 7 alpha-hydroxylase mass, mRNA, and transcriptional
      activity decreased after intraduodenal infusion of taurocholate to levels similar
      to those of rats with an intact enterohepatic circulation. The combination of
      constant infusion of mevalonate and taurocholate failed to reverse the inhibitory
      effects of taurocholate on cholesterol 7 alpha-hydroxylase activity, mRNA levels,
      and in vitro transcriptional rates. These data provide evidence that taurocholate
      represses cholesterol 7 alpha-hydroxylase at the level of gene transcription, and
      not via down-regulation of HMG-CoA reductase. Infusion of mevalonate alone to
      biliary diverted rats did not alter cholesterol 7 alpha-hydroxylase activity or
      mRNA levels, while leading to a 57% decrease in C7 alpha H gene transcription.
      This latter finding suggests that mevalonate or its metabolites may be capable of
      stabilizing C7 alpha H mRNA levels while down-regulating transcriptional
      activity.

PMID- 1619361
TI  - Glycerolipid synthesis in isolated adipocytes: substrate dependence and influence
      of norepinephrine.
AB  - Studies of fatty acid (FA) esterification by adipocytes have led to conflicting
      views with respect to how the process is regulated by norepinephrine (NE). It
      remains unclear whether NE directly modulates the pathway or whether its effects
      are indirect and reflect its well-known action to activate lipolysis. Changes in
      lipolysis can complicate estimation of esterification rates by altering both
      medium FA and the hydrolysis of newly formed FA esters. In this report, we
      describe an experimental approach that determined the effect of NE on FA
      esterification, amidst the complications introduced by activation of lipolysis.
      Esterification rates were estimated from the simultaneous incorporations (0.1-60
      min) of [14C]glucose and [3H]oleate into diglyceride (DG), phospholipid (PL), and
      triglyceride (TG). Saturation kinetics of incorporation rates, with respect to
      FA, and more specifically to unbound or albumin-free FA (ubFA), were determined
      in both basal and NE-treated cells. To obtain true estimates of ester synthesis,
      incorporation rates were adjusted for label loss from breakdown of labeled
      esters. Our findings were: 1) In basal versus NE-treated cells, [3H]oleate, on
      its pathway to esterification, was diluted, respectively, by 2 and 50% of
      measured cell FA, and the diluting FA appeared derived from lipolysis. 2)
      Syntheses of PL, DG, and TG, estimated from incorporation of [14C]glucose,
      saturated at low ubFA. The Km for TG synthesis (0.06 microM) was within the
      physiological range of ubFA which meant that changes in plasma FA will modulate
      TG synthesis. PL synthesis, on the other hand (Km less than 0.01 microM), would
      be largely saturated under physiological conditions. 3) NE treatment increased
      the molar ratio of FA to albumin in the medium an average 8-fold and ubFA about
      87-fold. In addition, NE accelerated hydrolysis of labeled PL and DG. Adjusting
      incorporation rates for these changes indicated that NE does not directly
      regulate glyceride synthesis. The assays described should allow estimation of
      glycerolipid synthesis under various metabolic or disease states and will
      distinguish direct effects from those reflecting changes in FA concentration or
      in hydrolysis of labeled FA esters.

PMID- 1619362
TI  - Genetic regulation of fatty acid synthetase expression in adipose tissue:
      overtranscription of the gene in genetically obese rats.
AB  - We have investigated the molecular mechanism of the overactivity of fatty acid
      synthetase (FAS) in adipose tissue from the genetically obese Zucker rat.
      Purified FAS from lean and obese rat adipose tissues displayed kinetics
      constants, molecular weight, and immunological properties that were identical.
      Western blot analysis revealed that FAS overactivity in obese versus lean rat
      adipose tissue was paralleled by a proportionate increase in FAS mass, i.e., 4
      fold increase in suckling normoinsulinemic 16-day-old pups and 25-fold in weaned
      hyperinsulinemic 30-day-old rats. The determination of absolute FAS mass
      disclosed that FAS was quantitatively a major protein in obese rat adipose tissue
      accounting for 13% of cytosolic proteins versus 2% in lean rat at 30 days of age.
      FAS hyperabundance could be ascribed to an increased relative rate of FAS
      synthesis that was 6-fold higher in obese than in lean rat adipose tissue.
      Northern blot analysis demonstrated that FAS mRNA levels in obese rats were
      increased 4- and 14-fold over those of lean rats at 16 and 30 days of age,
      respectively, in very close proportion to the 3- and 15-fold increases in FAS
      gene transcription rates revealed by nuclear run-on assays. Southern analysis of
      genomic DNA did not allow for detecting amplification or any major structural
      changes in the FAS gene. It is concluded that FAS overactivity, shown here to be
      a life-long and general feature of all adipose tissue sites in the obese rat,
      arises primarily from FAS gene overtranscription.

PMID- 1619363
TI  - Two apolipoprotein B gene defects in a kindred with hypobetalipoproteinemia, one
      of which results in a truncated variant, apoB-61, in VLDL and LDL.
AB  - We report the presence of two distinct defects of the gene for apolipoprotein B,
      one resulting in a new truncated variant, apoB-61, in a kindred with familial
      hypobetalipoproteinemia (FHB). The proband (age 33) and a sister (age 36) are
      both compound heterozygotes with total cholesterol levels of 39 mg/dl and 50
      mg/dl, and apoB levels of 1 mg/dl and 2 mg/dl in plasma, respectively. Both
      appear to be asymptomatic. The apoB-61 mutation, present in a total of five
      individuals and inherited from the proband's father, is a 37 bp deletion in exon
      26 starting with nucleotide 8525. This results in an apoB of 2784 amino acids
      with 12 novel carboxy-terminal residues. The apoB-61 is present to a considerable
      degree, relative to apoB-100, in the proband's very low (VLDL) and low density
      (LDL) lipoprotein fractions. Both lipoprotein fractions have abnormal particle
      size distribution by electron microscopy. The LDL contain cuboidal particles.
      Total cholesterol, LDL cholesterol, and apoB levels in the family display three
      phenotypic patterns: normal, low, and extremely low. ApoB haplotyping indicates
      the presence of another defective apoB allele in a total of seven individuals.
      This allele leads to low levels of apoB-100. The second apoB gene-linked defect
      occurring together with the apoB-61 mutation explains the 3-phenotype pattern.
      The severe hypocholesterolemia seen in the proband and a sister result from the
      genetic compound state involving both alleles. This study shows that severe
      hypolipidemia in an individual heterozygous for a truncation in apoB is likely to
      involve a second genomic defect.

PMID- 1619364
TI  - Lecithin:cholesterol acyltransferase gene expression is regulated in a tissue
      selective manner by fibrates.
AB  - Plasma lipoprotein metabolism is influenced by several factors that may act by
      regulating the expression of proteins involved in lipoprotein metabolism, such as
      lecithin:cholesterol acyltransferase (LCAT). We determined the influence of
      several hormones and hypolipidemic drugs on hepatic LCAT gene expression and
      plasma LCAT activity. Liver LCAT mRNA levels were resistant to regulation by the
      hormones ethinylestradiol, L-thyroxine, hydrocortisone, or by the hypolipidemic
      drugs probucol, simvastatin, and nicotinic acid. In contrast, hepatic LCAT mRNA
      levels decreased to 67%, 64%, and 46% of the control levels after treatment with
      the fibric acid derivatives clofibrate, gemfibrozil, and fenofibrate,
      respectively. Fenofibrate lowered liver LCAT mRNA levels in a dose-dependent
      manner, which was paralleled by a decrease in plasma LCAT activity to 54% of the
      controls at a dose of 0.5% (w/w) in rat chow. The decrease in liver LCAT mRNA
      levels was maximal after 1 day, whereas the fall in plasma LCAT activity trailed
      by 2 days. Cessation of treatment with fenofibrate restored liver LCAT mRNA
      levels to control levels within 1 week. The transcription rate of the LCAT gene
      decreased by 25% in nuclei isolated from fenofibrate-treated rat liver, thereby
      indicating that hepatic LCAT gene expression is, at least partly, regulated at a
      transcriptional level. In contrast to the liver, brain and testis LCAT mRNA
      levels remained constant after treatment with fenofibrate, indicating that
      fibrates regulate LCAT gene expression in a tissue-selective manner.

PMID- 1619365
TI  - Reduction in the concentration and activity of plasma cholesteryl ester transfer
      protein by alcohol.
AB  - Plasma cholesteryl esters, synthesized within high density lipoproteins (HDL),
      may be transferred from HDL particles to other lipoproteins by plasma cholesteryl
      ester transfer protein (CETP). Alcohol consumption is associated with increased
      HDL cholesterol concentration and reduced plasma CETP activity. The alcohol
      induced decrease in CETP activity may be due to a low concentration of CETP in
      plasma or the inhibition of CETP by specific inhibitor proteins or alterations in
      the composition of plasma lipoproteins. The first two possibilities are studied
      further in this paper using data on 47 alcohol abusers and 31 control subjects.
      The activity of CETP was measured as the rate of cholesteryl ester transfer
      between radio-labeled low density lipoproteins and unlabeled HDL using an in
      vitro method independent of endogenous plasma lipoproteins. Plasma CETP
      concentration was determined by a Triton-based radioimmunoassay. The alcohol
      abusers consuming alcohol (on average 154 g/day) had 28% higher HDL cholesterol
      (P less than 0.01), 27% lower plasma CETP concentration (P less than 0.001), and
      22% lower plasma CETP activity (P less than 0.001) than the controls. Plasma CETP
      concentration showed a negative correlation with HDL cholesterol among all the
      subjects (r = -0.317, P less than 0.01) but not among the alcohol abusers alone
      (r = -0.102, N. S.). During 2 weeks of alcohol withdrawal, plasma CETP
      concentration and activity of 8 subjects increased, whereas HDL cholesterol
      decreased by 42% (P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619367
TI  - In vivo metabolism of a mutant apolipoprotein, apoA-IIowa, associated with
      hypoalphalipoproteinemia and hereditary systemic amyloidosis.
AB  - Apolipoprotein (apo) A-I is the major protein constituent of plasma high density
      lipoproteins (HDL). A kindred has been identified in which a glycine to arginine
      mutation at residue 26 in apoA-I is associated with hypoalphalipoproteinemia and
      hereditary systemic amyloidosis. We isolated the mutant protein, termed apoA
      IIowa, from the plasma of an affected subject and studied its in vivo metabolism
      compared to that of normal apoA-I in two heterozygous apoA-IIowa subjects and two
      normal controls. Normal and mutant apoA-I were radioiodinated with 131I and 125I,
      respectively, reassociated with autologous plasma lipoproteins, and
      simultaneously injected into all subjects. Kinetic analysis of the plasma
      radioactivity curves demonstrated that the mutant apoA-IIowa was rapidly cleared
      from plasma (mean fractional catabolic rate [FCR] 0.559 day-1) compared with
      normal apoA-I (mean FCR 0.244 day-1) in all four subjects. The FCR of normal apoA
      I was also substantially faster in the heterozygous apoA-IIowa subjects (mean FCR
      0.281 days-1) than in the normal controls (mean FCR 0.203 days-1). Despite the
      rapid removal from plasma of apoA-IIowa, the cumulative urinary excretion of its
      associated radioactivity after 2 weeks (44%) of the injected dose) was
      substantially less than that associated with normal apoA-I (78% of injected
      dose), indicating extravascular sequestration of radiolabeled apoA
      IIowa.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619366
TI  - A missense (Asp250----Asn) mutation in the lipoprotein lipase gene in two
      unrelated families with familial lipoprotein lipase deficiency.
AB  - We have identified the molecular basis for familial lipoprotein lipase (LPL)
      deficiency in two unrelated families with the syndrome of familial
      hyperchylomicronemia. All 10 exons of the LPL gene were amplified from the two
      probands' genomic DNA by polymerase chain reaction. In family 1 of French
      descent, direct sequencing of the amplification products revealed that the
      patient was heterozygous for two missense mutations, Gly188----Glu (in exon 5)
      and Asp250----Asn (in exon 6). In family 2 of Italian descent, sequencing of
      multiple amplification products cloned in plasmids indicated that the patient was
      a compound heterozygote harboring two mutations, Arg243----His and Asp250----Asn,
      both in exon 6. Studies using polymerase chain reaction, restriction enzyme
      digestion (the Gly188----Glu mutation disrupts an Ava II site, the Arg243----His
      mutation, a Hha I site, and the Asp250----Asn mutation, a Taq I site), and allele
      specific oligonucleotide hybridization confirmed that the patients were indeed
      compound heterozygous for the respective mutations. LPL constructs carrying the
      three mutations were expressed individually in Cos cells. All three mutant LPLs
      were synthesized and secreted efficiently; one (Asp250----Asn) had minimal
      (approximately 5%) catalytic activity and the other two were totally inactive.
      The three mutations occurred in highly conserved regions of the LPL gene. The
      fact that the newly identified Asp250----Asn mutation produced an almost totally
      inactive LPL and the location of this residue with respect to the three
      dimensional structure of the highly homologous human pancreatic lipase suggest
      that Asp250 may be involved in a charge interaction with an alpha-helix in the
      amino terminal region of LPL. The occurrence of this mutation in two unrelated
      families of different ancestries (French and Italian) indicates either two
      independent mutational events affecting unrelated individuals or a common shared
      ancestral allele. Screening for the Asp250----Asn mutation should be included in
      future genetic epidemiology studies on LPL deficiency and familial combined
      hyperlipidemia.

PMID- 1619369
TI  - Really bad reimbursements at various stages (RBRVS).

PMID- 1619368
TI  - Correlations of plasma lipoproteins with LDL subfractions by particle size in men
      and women.
AB  - Nondenaturing gradient gel electrophoresis of plasma low density lipoprotein
      (LDL) has been used to identify major LDL subclasses that are influenced by
      genetic and other factors. In the present paper, this technique has been extended
      by measuring absorbance of lipid- or protein-stained gels as an index of
      concentration at intervals of 0.05 nm across the entire LDL particle size range
      (21.8-30 nm) in moderately overweight men (n = 115) and women (n = 78). When LDL
      absorbance levels were correlated with other lipoprotein variables, we found that
      the strengths of the correlations with each of triglycerides, apolipoprotein
      (apo) B, high density lipoprotein (HDL)2, and apoA-I achieve relative maximum
      values for two regions within the small LDL range (21-26 nm), one within LDL-IVB
      (22-23.2 nm) and a second within LDL-III (24.2-25.5 nm). We also found that the
      increase in LDL accompanying higher triglyceride levels occurs below 25.5 nm in
      men and between 24.5 and 26.5 nm in women, suggesting either that triglycerides
      are related to different LDL subclasses in men and women, or that particle sizes
      of metabolically homologous LDL subclasses may differ in men and women. As
      compared to analytic ultracentrifuge measurements, gradient gel measurements of
      LDL absorbance by the procedure described here provide greater resolution of LDL
      subclasses but less precision in estimating LDL levels.

PMID- 1619370
TI  - The forging of the Renaissance physician. Part III: The physicians and the period
      of rebirth.

PMID- 1619371
TI  - The forging of the Renaissance physician. Part IV: Physicians for all seasons.

PMID- 1619372
TI  - A national resource--a state treasure.

PMID- 1619373
TI  - Experience with cultured skin in a Georgia regional burn unit.

PMID- 1619374
TI  - "And there's more..."--Federal Trade Commission announces "new concern" with
      physician joint ventures.

PMID- 1619375
TI  - Ultrastructure of Staphylococcus aureus as revealed by microwave fixation.
AB  - The ultrastructure of the cell wall of Staphylococcus aureus was examined at
      electron microscopic level using new chemical fixation techniques during
      microwave irradiation and the results obtained were compared with those obtained
      by other conventional techniques. By using microwave fixation the concentric
      circular or zipper-like structure was observed in the cell wall. This structure
      was observed also with the spray-freeze-etch technique but not in thin section of
      the cells chemically fixed by conventional technique. For chemical fixative,
      glutaraldehyde is more advantageous than OsO4 as a concomitant fixative during
      microwave irradiation and postfixation by OsO4 is unnecessary and rather harmful
      for the preservation of the ultrastructure. The function of the observed
      structure is briefly discussed.

PMID- 1619376
TI  - "Pored-domes" of the fenestrated endotheliocyte of the glomerular and peritubular
      capillaries in the rodent kidney.
AB  - The fenestrated endotheliocyte of peritubular and glomerular capillaries in rat
      and mouse kidneys were observed with SEM and TEM. In the glomerular capillary, so
      called "pored-domes" were found not only at the fenestrated areolae but also at
      the nuclear region of the endotheliocyte. At the region between filtration
      surface and nuclear region, they accumulated to construct a sponge-like
      structure. The endotheliocyte of peritubular capillary also showed small "pored
      domes". The size and morphology of the pores in the "pored-domes" of glomerular
      and peritubular capillaries were similar to those of areolae fenestratae of the
      respective capillary. Based on the findings, we assumed that pored-domes and the
      sponge-like structure are the reservoir for the fenestrated area of the
      endotheliocyte to accommodate the rapid expansion of capillary lumen.

PMID- 1619377
TI  - Location of peptidoglycan and teichoic acid on the cell wall surface of
      Staphylococcus aureus as determined by immunoelectron microscopy.
AB  - Anti-peptidoglycan (PG) and anti-teichoic acid (TA) antibodies were prepared from
      sera of rabbits immunized with the cell wall fraction of Staphylococcus aureus
      Cowan I by the specific adsorption technique with purified teichoic acid or
      peptidoglycan. The anti-PG antibody recognized the trichloroacetic acid-treated
      walls (TCA wall) prepared from S. aureus, Bacillus subtilis, and Micrococcus
      luteus but did not react with teichoic acid or proteins extracted from the cell
      wall of Staphylococcus. The anti-TA antibody specifically reacted with cell wall
      teichoic acid of beta-type sugar configuration. The reaction sites of these
      antibodies on the cell wall of S. aureus Wood 46 were determined by
      immunoelectron microscopy using colloidal gold as a probe. The anti-TA antibody
      reacted mostly with the fibrous electron-dense mass on the cell surface. The
      reaction was also seen on the inner surface of the cell wall. The anti-PG
      antibody reacted with the fibrous structures and also directly on the cell wall
      surface. The distribution of the probes on the cell wall surface examined with
      the scanning electron microscope showed that there was no localized distribution
      in respect to the cell division. We knew from these observations that the
      external surface of the cell wall of Staphylococcus is covered with the fibrous
      mass which consists mostly of teichoic acid but partially of peptidoglycan.

PMID- 1619378
TI  - Preserving the original architecture of elastin components in the formic acid
      digested aorta by an alternative procedure for scanning electron microscopy.
AB  - The present study examined procedures of specimen preparation for observing
      elastin components in the formic acid-digested tissue by scanning electron
      microscopy (SEM). The rat thoracic aorta fixed in 4% paraformaldehyde was treated
      with 90% formic acid for 85-96 hr at 45 degrees C and processed in two different
      ways: 1) the tissues were freeze-dried directly from water and 2) they were
      treated with tannic acid and osmium followed by critical point drying. The former
      procedure caused marked deformation of elastin components, while the latter
      preserved them well in shape and arrangement. Thus, the three-dimensional
      organization and ultrastructure of the elastin components were precisely
      demonstrated in this study.

PMID- 1619380
TI  - Genetic polymorphisms in drug metabolism.

PMID- 1619379
TI  - A support film of plasma-polymerized naphthalene for electron microscopy: method
      of preparation and application.
AB  - Methods of preparing of a new support film by plasma polymerization in a glow
      discharge, and its application were described. The recently developed plasma
      polymerization replica technique was used to prepare ultrathin films from
      naphthalene monomer gas on the surface of a newly cleaved sodium chloride crystal
      or on cover glass. The film was floated off on water or hydrofluoric acid
      solution to free it from the base. The plasma-polymerized naphthalene support
      film (PNS) prepared in this way was shown to have excellent properties by its
      application to negative staining of virus antigen particles and by the
      observation of whole ultrathin sections of animal tissue mounted on a 2 x 1 mm
      single slot grid. Features of the new support film are (1) its ease of
      preparation as a clean, very thin film of less than 10 nm, (2) its amorphous
      texture and high transparency to electrons, (3) its mechanical strength,
      resistance to heat and chemicals, and electron bombardment, and (4) its smooth
      and slightly hydrophilic surface. The PNS would be useful for both routine and
      high-resolution electron microscopy.

PMID- 1619381
TI  - Aplastic anaemia: pathogenetic mechanisms and treatment with special reference to
      immunomodulation.
AB  - Aplastic anaemia (AA) has been defined as a syndrome in which the presence of
      pancytopenia is accompanied by marrow hypocellularity. Ample laboratory data and
      clinical observations continue to make immune mediation of bone-marrow failure an
      attractive hypothesis. Recent progress in the practice of bone-marrow
      transplantation has led to a survival rate of approximately 80% in the best
      cases, but such a treatment is only amenable in young patients (less than 45-50
      years) with HLA-identical bone-marrow donors. Anti-lymphocyte and thymocyte
      globulin treatment has been surprisingly effective for AA, resulting in
      transfusion independence in 40-80% of patients. The mechanism of action is
      unknown, although effects on immunosuppression appear to be the most likely
      candidates. Long-term results for patients receiving cyclosporin A treatment will
      soon be available, and preliminary data show an effect similar to that of
      antithymocyte globulin. In contrast to successful bone-marrow transplantation,
      improvement following immunomodulation leaves quantitative abnormalities in all
      haematopoietic cell lines, and patients are prone to develop clonal (malignant)
      disease.

PMID- 1619382
TI  - A 3-month double-blind cross-over study of the effect of benazepril and
      hydrochlorothiazide on functional class in symptomatic mild heart failure.
AB  - The non-sulfhydryl selective angiotensin-converting enzyme inhibitor benazepril
      (20 mg daily) was compared with hydrochlorothiazide (50 mg daily) in post
      infarction (6-24 months) patients with symptomatic (NYHA functional class 2) mild
      heart failure. No concomitant drug therapy was given. The study had a double
      blind cross-over design with 3-month treatment periods. Both drugs were well
      tolerated, and both caused a similar reduction in systolic blood pressure. Heart
      rate was higher with the diuretic. Benazepril improved the NYHA functional class
      in 17 out of 29 (59%) patients, whereas one patient improved with
      hydrochlorothiazide (P = 0.0004). With regard to global efficacy score,
      benazepril was also superior. Thus, angiotensin-converting enzyme inhibitors may
      be superior to diuretics as first-choice therapy in symptomatic mild heart
      failure.

PMID- 1619383
TI  - Impaired erythrocyte fluidity during treatment of renal anaemia with
      erythropoietin.
AB  - Seventeen haemodialysis patients with renal anaemia were treated with recombinant
      human erythropoietin (rhEPO) and observed for 30 weeks. The viscosity of whole
      blood and plasma, the erythrocyte aggregation tendency, and the erythrocyte
      deformability, measured as fluidity, were analysed every second week. All
      patients responded with increasing haematocrit and whole-blood viscosity. The
      plasma viscosity and the erythrocyte aggregation tendency were already increased
      before the start of treatment, and remained unchanged during treatment. The basal
      erythrocyte fluidity tended to be impaired, although not significantly so. During
      treatment, significant impairment of fluidity was observed at the beginning of
      the treatment period. After 24 weeks the fluidity started to increase, and it
      later reached values observed before the start of treatment. Hence, the quality
      of the erythrocytes formed during the corrective phase of rhEPO treatment differs
      in some respects from that of cells formed at a normal production rate. The
      impaired fluidity might have important implications for the flow resistance in
      small vessels, and contribute to the development or aggravation of hypertension
      that is often seen during rhEPO treatment.

PMID- 1619384
TI  - Suppression of autoantibodies to factor VIII and correction of factor VIII
      deficiency with a combined steroid-cyclophosphamide-porcine factor VIII treatment
      in a patient with rheumatoid arthritis.
AB  - The presence of autoantibodies against factor VIII is an unusual but serious
      complication in rheumatoid arthritis. We describe the case of a patient who
      developed this kind of complication, with spontaneous bleeding and marked changes
      in the haematological parameters, that was unsuccessfully treated with a high
      dose of intravenous gammaglobulin. Subsequently, combined therapy with porcine
      factor VIII concentrate, cyclophosphamide and steroids led to the disappearance
      of the anti-factor VIII autoantibodies.

PMID- 1619385
TI  - Simultaneous occurrence of polymyalgia rheumatica in a married couple.
AB  - The case of a married couple who simultaneously developed polymyalgia rheumatica
      is presented. Both patients responded to steroid treatment, and when the steroid
      dose was gradually reduced both patients relapsed. The aetiology and pathogenesis
      of polymyalgia rheumatica remain unclear; familial aggregation indicates the
      involvement of genetic factors, whereas conjugal aggregation indicates
      infectious/environmental agents. In previous reports of polymyalgia rheumatica in
      married couples, the onset of symptoms in the two patients has usually been
      separated by a long chronological interval. It is concluded that the present
      report of simultaneous development of polymyalgia rheumatica in a married couple
      lends further support to an environmental or contagious aetiology.

PMID- 1619386
TI  - Familial hypercholesterolaemia and LDL receptor mutations.
AB  - Inherited defects in the gene for the low density lipoprotein (LDL)-receptor give
      rise to familial hypercholesterolaemia (FH), a disorder in which defective
      catabolism of LDL causes a marked increase in its concentration in plasma. As a
      result, there is excessive deposition of cholesterol in the arterial wall leading
      to accelerated atherosclerosis and premature coronary heart disease in most
      patients, although there are differences in its severity. Many different
      mutations have been found in the LDL receptor genes of FH patients, and although
      this heterogeneity has provided information about the relationship between
      structure and function in different domains of the protein, it makes simple DNA
      based diagnosis of the disease impossible. When sufficient groups of patients
      with defined mutations are available it will be possible to determine the
      relative importance of any particular mutation compared with other genetic or
      environmental factors in relation to the severity of their symptoms or their
      response to treatment.

PMID- 1619387
TI  - Apolipoprotein B gene mutations affecting cholesterol levels.
AB  - In the past 5 years, many different mutations in the apolipoprotein (apo) B gene
      have been described that affect plasma cholesterol levels. More than 20 different
      mutations in the apoB gene have been shown to cause familial
      hypobetalipoproteinaemia, a condition characterized by abnormally low plasma
      concentrations of apoB and LDL cholesterol. Almost all of the mutations are
      nonsense or frameshift mutations that interfere with the translation of a full
      length apoB100 molecule. Many, but not all, of these apoB gene mutations result
      in the synthesis of a truncated species of apoB that can be detected within the
      plasma lipoproteins. Familial hypobetalipoproteinaemia heterozygotes are almost
      always asymptomatic and have LDL cholesterol levels about one-quarter to one
      third of those of unaffected family members. Several homozygotes and compound
      heterozygotes for familial hypobetalipoproteinaemia have been described. In these
      individuals, the LDL cholesterol levels are extremely low, usually less than 5 or
      10 mg dl-1, and the clinical phenotype is variable, ranging from completely
      asymptomatic to severe problems related to intestinal fat malabsorption. One
      missense mutation in the apoB gene (an Arg----Gln substitution at apoB amino acid
      3500) is associated with very poor binding of apoB100 to the cellular LDL
      receptor. This syndrome has been designated familial defective apolipoprotein B
      (FDB). The amino-acid substitution at residue 3500 delays the clearance of LDL
      from the plasma and results in hypercholesterolaemia. In some Western
      populations, the frequency of FDB heterozygotes appears to be as high as 1 in 500
      individuals.

PMID- 1619388
TI  - The role of apolipoprotein E genetic variants in lipoprotein disorders.
AB  - Apolipoprotein E plays a central role in lipoprotein metabolism by serving as a
      ligand for the binding of lipoproteins to lipoprotein receptors. Both common and
      rare variants of apoE have been described. The common variants apoE2 and apoE4
      have a significant impact on interindividual variation of lipid and lipoprotein
      levels in normal subjects. The common variant apoE2 and more than half a dozen
      rare variants are defective in binding to the low-density lipoprotein (LDL)
      receptor, and all are causally associated with the lipid disorder type III
      hyperlipoproteinaemia (HLP). The mode of inheritance of the disorder can be
      either dominant or recessive, depending on the particular mutation(s) in apoE,
      although the mechanisms involved are not fully understood. The common variant
      apoE4 and other rare variants have been reported to be associated with a variety
      of other lipoprotein disorders, but a causal link has not been established.

PMID- 1619390
TI  - Hypertriglyceridaemia due to genetic defects in lipoprotein lipase and
      apolipoprotein C-II.
AB  - Hypertriglyceridaemia, as defined by fasting triglyceride levels of greater than
      2.8 mmol l-1, is a prevalent dyslipoproteinaemia in our population. The
      underlying pathophysiological mechanisms that result in elevations of plasma
      triglycerides are heterogeneous and, in most cases, incompletely understood.
      However, in a subset of patients presenting with this lipid disorder, the
      biochemical and genetic defects that lead to hypertriglyceridaemia have been well
      characterized. These individuals present with the familial chylomicronaemia
      syndrome, a rare genetic disorder that is inherited as an autosomal recessive
      trait, and is characterized by severe fasting hypertriglyceridaemia, massive
      accumulations of chylomicrons in plasma, and recurrent bouts of pancreatitis. The
      two major causes of the familial chylomicronaemia syndrome are a deficiency of
      the enzyme, lipoprotein lipase (LPL), or its cofactor, apolipoprotein (apo) C-II.
      Together, these two proteins initiate the hydrolysis of triglycerides present in
      chylomicrons and very low density lipoproteins. In the past decade our
      understanding of the underlying molecular defects that lead to familial
      chylomicronaemia has been greatly enhanced by the identification of mutations in
      the genes for LPL and apoC-II. Characterization of these defects has provided new
      insights into the structure and function of apoC-II and LPL and established the
      important role that these two proteins play in normal triglyceride metabolism.

PMID- 1619389
TI  - Metabolic and genetic control of HDL cholesterol levels.
AB  - Variation of HDL cholesterol levels in man shows a strong inverse relationship to
      the incidence of atherosclerotic vascular disease. Thus the regulation of HDL
      cholesterol levels has been the subject of intense investigation. Human genetic
      differences in cholesteryl ester transfer protein and hepatic lipase illustrate
      the importance of these factors in the normal catabolism of HDL, while metabolic
      and population studies show that lipoprotein lipase activity plays a central role
      in the transfer of lipids and apoproteins into HDL. Metabolic turnover studies in
      humans suggest that variations in the fractional catabolism of the HDL structural
      proteins, apoA-I and apoA-II, account for much of the variation of HDL levels in
      human populations. Although the catabolism of these apolipoproteins is poorly
      understood, changes in the core lipid composition of HDL may lead to changes in
      catabolism of the HDL proteins. The core lipid composition of HDL appears to be
      determined by lipid transfer processes, and the activities of lipoprotein and
      hepatic lipase. Thus many genetic and environmental factors that influence HDL
      levels appear to operate by changing the activities of the lipases or the lipid
      transfer process.

PMID- 1619391
TI  - How pigeons estimate rates of prey encounter.
AB  - Pigeons were trained on operant schedules simulating successive encounters with
      prey items. When items were encountered on variable-interval schedules, birds
      were more likely to accept a poor item (long delay to food) the longer they had
      just searched, as if they were averaging prey density over a short memory window
      (Experiment 1). Responding as if the immediate future would be like the immediate
      past was reversed when a short search predicted a long search next time
      (Experiment 2). Experience with different degrees of environmental predictability
      appeared to change the length of the memory window (Experiment 3). The results
      may reflect linear waiting (Higa, Wynne, & Staddon, 1991), but they differ in
      some respects. The findings have implications for possible mechanisms of
      adjusting behavior to current reinforcement conditions.

PMID- 1619392
TI  - Instrumental performance following a shift in primary motivation depends on
      incentive learning.
AB  - In 5 experiments the role of incentive learning in instrumental performance
      following a shift in primary motivation was examined. In Experiments 1 and 2 rats
      trained to perform an instrumental action reinforced by either pellets or
      maltodextrin when in a low-deprivation state were shifted to a high-deprivation
      state and tested in extinction. This shift in deprivation increased performance
      only if the animals had been exposed to the reinforcer in the high-deprivation
      state prior to instrumental training. Experiments 3, 4, and 5 examined the
      reverse shift training in a high-deprivation state and testing in a low
      deprivation state, and found, similarly, that performance was only sensitive to
      this shift if animals were previously exposed to the reinforcer while in the low
      deprivation state. These experiments support the conclusion that instrumental
      performance following revaluation of the reinforcer depends on a process of
      incentive learning.

PMID- 1619393
TI  - Responding to a conditioned stimulus depends on the current associative status of
      other cues present during training of that specific stimulus.
AB  - The comparator hypothesis is a response rule stating that responding to a
      Pavlovian conditioned stimulus (CS) reflects the associative strength of the CS
      relative to that of other cues (comparator stimuli) that were present during CS
      training. Thus, modulation of the associative strength of a CS's comparator
      stimulus should alter responding to that CS. These studies examined the stimulus
      specificity of this effect using within-subjects designs. Rats were trained on 2
      CSs, each with a unique comparator stimulus, to determine the degree to which
      posttraining extinction of the comparator stimulus for one CS influences
      responding to the other CS. Using negative contingency (Experiments 1 and 2),
      overshadowing (Experiment 3), and local context (Experiment 4) preparations,
      stimulus specificity was observed. In each case, posttraining extinction of the
      comparator stimulus for one CS had greater impact on responding to that CS than
      on responding to the alternate CS.

PMID- 1619394
TI  - A configural analysis for feature-negative discrimination learning.
AB  - In 4 experiments, rats were initially trained with an A+ AXo discrimination in
      which Stimulus A by itself signaled the delivery of food, A+, whereas the
      simultaneous presentation of A and X was followed by nothing, AXo. In each
      experiment X was then paired with food prior to a test phase in which A and X
      were again presented for a discrimination. The discrimination was of the form A+
      AXo in Experiments 1 and 2, whereas it was of the form X+ AXo for Experiments 3
      and 4. In all 4 experiments the test discrimination was acquired more rapidly
      than a control discrimination. The results are interpreted in terms of the
      original A+ AXo discrimination resulting in the growth of an association between
      a representation of the entire AX compound and the effects of nonreinforcement.

PMID- 1619395
TI  - Detection of cryptic prey: search image or search rate?
AB  - Animals' improvement in capturing cryptic prey with experience has long been
      attributed to a perceptual mechanism, the specific search image. Detection could
      also be improved by adjusting rate of search. In a series of studies using both
      naturalistic and operant search tasks, pigeons searched for wheat, dyed to
      produce 1 conspicuous and 2 equally cryptic prey types. Contrary to the
      predictions of the search-rate hypothesis, pigeons given a choice between the 2
      cryptic types took the type experienced most recently. However, experience with 1
      cryptic type improved accuracy on the other cryptic type, a result inconsistent
      with a search image specific to 1 prey type. Search image may better be thought
      of as priming of attention to those features of the prey type that best
      distinguish the prey from the background.

PMID- 1619396
TI  - Dissociation of theories of choice by temporal spacing of choice opportunities.
AB  - Rats were trained on a discrete-trial version of a concurrent variable-interval
      (VI) variable-ratio (VR) schedule in which the relative reinforcement rates were
      varied across conditions. Subjects with the shorter intertrial interval (ITI) had
      a significant bias toward the VR alternative, as predicted by optimality theory,
      and were also more likely to choose the VI alternative with longer times since
      responses to the VI alternative, as predicted by momentary-maximizing theory.
      Subjects with the longer ITI failed to show either of these effects.
      Approximation to the matching law was greater with the longer ITI. Thus, matching
      is not derivative of the processes postulated by optimality or momentary
      maximizing theory but instead is in competition with those processes.

PMID- 1619397
TI  - Inactivated Lassa virus elicits a non protective immune response in rhesus
      monkeys.
AB  - We attempted to protect three rhesus monkeys from Lassa fever by vaccination with
      a preparation of purified whole Lassa virus which had been inactivated by gamma
      irradiation. The vaccinated monkeys developed antibodies against the three major
      viral proteins of Lassa virus demonstrated by radioimmunoprecipitation. When the
      three vaccinated monkeys and two unvaccinated control monkeys were challenged all
      five became severely ill and died. Prior to death a secondary, high-titer
      antibody response to Lassa virus was observed in the three vaccinated monkeys,
      whereas the two unvaccinated monkeys developed a primary, low-titer antibody
      response. Though titers of Lassa virus in serum reached peak levels earlier
      following challenge in the non vaccinated, at the time of death serum and organ
      virus titers did not differ significantly. Changes in platelet aggregation,
      leukocyte counts, and liver enzymes, abnormalities of which have been associated
      with severity of Lassa fever, were found to be comparable in the two groups. The
      humoral antibody response measured in these animals following vaccination,
      although of the same magnitude as found in humans recovered from Lassa fever, was
      insufficient to protect the animals from this fatal disease. Evidence is now
      accumulating that the cell-mediated immune response must be activated in order to
      protect against challenge with arenaviruses.

PMID- 1619398
TI  - Hepatitis E virus: the cause of a waterbourne hepatitis outbreak.
AB  - Newly developed assays for antibody to hepatitis E virus (HEV) were used to study
      114 serum samples collected during an outbreak of enterically transmitted
      hepatitis that occurred in Kashmir in 1978/9. The sera included samples from
      patients with viral hepatitis, anicteric hepatitis, contacts of cases, and
      unaffected persons. A total of 71% of patients with viral hepatitis were found
      positive for anti-HEV specific IgG, and 75% of these were also positive for IgM.
      These data confirm the hepatitis E virus as the causative agent in this outbreak.

PMID- 1619399
TI  - Fine specificity of the humoral immune response to HIV-1 GP160 in HIV-1 infected
      individuals from Tanzania.
AB  - A total of 160 sera from HIV-1 infected individuals from Tanzania were examined
      for their fine specificity characteristics relative to 9 synthetic peptides that
      define HIV-1 gp160 epitopes. Immunorecessive and immunodominant epitopes were
      identified in both gp120 and gp41 based on serologic reactivity of these HIV-1
      infected sera. A significant difference in fine specificity among HIV-1 infected
      individuals from Tanzania and the United States was observed for an
      immunodominant gp41 epitope. No significant differences in reactivity among
      asymptomatic vs. symptomatic HIV-1 infected individuals were detected for the
      selected HIV-1 gp160 epitopes defined by these peptides. The majority of sera
      from HIV-1 infected Tanzanians contained antibodies that recognized a peptide
      corresponding to the V3 region of gp120 from the HIV-1 MN isolate. These data
      suggest that regional isolates of HIV-1 may exist in Tanzania that differ from
      HIV-1 isolated in the United States. However, based on serology, HIV-1 isolates
      exhibiting sequences with HIV-1 MN V3 similarity may also be prevalent in
      Tanzania. The results of this study may be useful for the design of more
      effective AIDS diagnostic and therapeutic products for use worldwide.

PMID- 1619400
TI  - 1H NMR and UV-Vis spectroscopic characterization of sulfonamide complexes of
      nickel(II)-carbonic anhydrase. Resonance assignments based on NOE effects.
AB  - The binding of acetazolamide, p-fluorobenzensulfonamide, p-toluenesulfonamide,
      and sulfanilamide to nickel(II)-substituted carbonic anhydrase II has been
      studied by 1H NMR and electronic absorption spectroscopies. These inhibitors bind
      to the metal ion forming 1:1 complexes and their affinity constants were
      determined. The 1H NMR spectra of the formed complexes show a number of
      isotropically shifted signals corresponding to the histidine ligands. The
      complexes with benzene-sulfonamides gave rise to very similar 1H NMR spectra. The
      NMR data suggest that these aromatic sulfonamides bind to the metal ion altering
      its coordination sphere. In addition, from the temperature dependence of 1H NMR
      spectra of the p-fluorobenzenesulfonamide adduct, a conformational change is
      suggested. The T1 values of the meta-like protons of the coordinated histidines
      have been measured and resonance assignments based on NOE experiments were
      performed.

PMID- 1619402
TI  - The 13C NMR study of the binding of gold(I) thiomalate with ergothionine in
      aqueous solution.
AB  - The interaction of gold(I) thiomalate (Autm) (Myocrysine) with ergothionine
      (ErSH) has been studied in aqueous solution at pH 7.4. It was found that ErSH
      forms a ternary complex of the type ErS-Au-tm at a 1:1 mole ratio; unlike other
      thiols (e.g., cysteine and glutathione) it does not eject thiomalate (Htm) as a
      free ligand. However, in the presence of glutathione (GtSH), both ligands, ErSH
      as well as Htm, from the ErS-Au-tm complex were freed. The 13C NMR chemical
      shifts of C-2 resonance of ergothionine in the presence of Autm shifts greater
      than imidazolidine-2-thione (Imt) and 1,3-Diazinane-2-thione (Diaz), indicating
      the stronger complexation of ErS-Au-tm compared to Imt-Au-tm and Diaz-Au-tm.

PMID- 1619401
TI  - Cytoprotective effect of copper(II) complexes against ethanol-induced damage to
      rat gastric mucosa.
AB  - The cytoprotective effect of various copper(II) complexes on the gastric mucosa
      damage induced by acute intragastric administration of ethanol was investigated.
      For in vitro experiments, the following copper(II) complexes were tested:
      Cu(II)(L-Trp)(L-Phe), Cu(II)(L-Leu)Cu(II)(L-Leu-Leu)(L-Leu), Cu(II)(L-Phe-L-Leu),
      Cu(II)(Gly-His-Lys), and Cu(II)(cyHis)2(ClO4)2. Inorganic copper such as CuSO4
      was also tested. The free radical generating system, acting for 2 hr on cardial
      and fundic mucosa scrapings or mucosal microsomes, was Fe++ (20 microM)/ascorbate
      (0.25 mM). We found a marked inhibition to 75% of lipid peroxidation in the range
      10-100 mM, regardless of whether copper was given in complexed or inorganic form.
      The results suggest that nontoxic copper(II)-amino acid complexes are able to
      neutralize oxygen-derived free radicals. In addition, copper(II) complexes
      suppressed membrane lipid peroxidation when mucosa homogenates were exposed to t
      butyl hydroperoxide (1-20 microM) plus Fe++ (50 microM). In vivo experiments on
      rat stomachs, pretreated p.o. by gavage either with Cu(II)(L-Trp)(L-Phe) as
      paradigmatic agent or with copper sulphate at equivalent doses in the range 3-30
      mg/kg body weight showed a significant decrease (30 min after 95% ethanol
      administration) in the number and severity of mucosal hemorrhagic lesions. In the
      gastric mucosa scrapings of copper-treated rats after ethanol exposure, we found
      that malondialdehyde and conjugated diene levels were unchanged compared to those
      of untreated controls; five enzyme activities released from lysosomes were near
      control values. In isolated mucosal cells, whether or not pretreated with 200
      microM solution of either Cu(II)(L-Trp)(L-Phe) or CuSO4, the release of cathepsin
      D activity was also unmodified. The results suggest that the cytoprotective
      effect of Cu(II) complexes against ethanol-induced mucosal lesions was not
      associated in vivo to lipid peroxidation.

PMID- 1619403
TI  - Synthesis, characterization, and microbiocidal activity of alpha-methyl-(2
      thiophenomethylene) aryloxyacetic acid hydrazides and their metal complexes.
AB  - Complexes of alpha-methyl-(2-thiophenomethylene) aryloxyacetic acid hydrazides
      with Cu(II) and Zn(II) metal salts were synthesized and characterized by
      elemental analysis, molecular weight determination, molar conductance, and
      magnetic moment and spectroscopic techniques. In these complexes, the ligands
      form a conjugate O-N-S tridenate system, thus coordinating with metal through
      oxygen of the carbonyl group, nitrogen of azomethine, and sulphur of
      thiophenemoiety. Octahedral geometry is proposed for all the complexes.
      Antifungal activity of the ligands and their Cu(II) and Zn(II) complexes was
      determined against plant pathogenic fungi viz. Alternaria alternata, Rhizoctonia
      solani, Colletotrichum capsicum, and Glomeralla cingulata at 28 degrees C.
      Antibacterial activity of ligands and their metal complexes was determined on
      gram positive Bacillus subtilis and gram negative Escherichia coli bacteria at 37
      degrees C by the serial dilution method. In some cases an increase in biocidal
      activity of the ligands on coordination with metal ions was observed in terms of
      minimum inhibitory concentration (MIC) values.

PMID- 1619404
TI  - The relevance to psychiatry of recent advances in functional imaging.

PMID- 1619405
TI  - Jean Nicot 1530-1600.

PMID- 1619406
TI  - Measuring visual neglect in acute stroke and predicting its recovery: the visual
      neglect recovery index.
AB  - An overall measure of the recovery of visual neglect in patients with an acute
      stroke is described: The "Visual Neglect Recovery Inde" (VNRI) expresses the
      amount of visual neglect on a battery of visual neglect tests as a percentage of
      complete recovery from the maximal visual neglect measurable. The principles
      underlying the development of the index are similar to those involved in the
      development of the Motricity Index for hemiplegia. A population of 68 survivors
      of stroke who presented with visual neglect at two to three days were followed
      for up to six months. The VNRI showed that neglect was greater in those with
      right hemisphere stroke than in those with left hemisphere stroke and that
      recovery was most rapid over the first 10 days and reached a plateau at three
      months. Most patients, including many with severe initial visual neglect, showed
      little visual neglect at three months. Stepwise regression analysis showed that
      the severity of visual neglect at three months and at six months post-stroke
      could be predicted by the severity of visual neglect and the presence of
      anosognosia at two to three days. A regression equation was produced which may
      enable clinicians to select patients for intensive treatment of visual neglect.

PMID- 1619407
TI  - Migraine aura without headache: transient ischaemic attack or not?
AB  - Patients with "migraine aura without headache" can be separated from those with
      transient ischaemic attacks (TIA) on the basis of the onset of symptoms, which is
      generally gradual and which spread or intensify over minutes or hours, and from
      the typical migrainous nature of their visual symptoms. Fifty cases were
      prospectively identified and these were compared with 50 age matched patients
      with a TIA. Surprisingly, there were no significant differences in the prevalence
      of vascular risk factors and diseases in the two groups although those with TIAs
      tended to have more. Only one patient with "migraine aura without headache"
      suffered a subsequent vascular event (a myocardial infarction). Three patients
      with TIAs had strokes and two others died from vascular disease. Although the
      results are not conclusive, they do suggest that patients with the clinical
      characteristics of "migraine aura without headache" have a low risk of subsequent
      vascular events, lower than those with TIAs, despite perhaps having similar
      prevalence of vascular risk factors. Although their risk factors should be
      treated, patients with "migraine aura without headache" should be reassured and
      not subjected to inappropriate and potentially hazardous investigations and
      treatment.

PMID- 1619409
TI  - The site of brainstem lesions causing semicircular canal paresis: an MRI study.
AB  - Ten patients with canal paresis of central origin and ten patients with
      peripheral canal paresis were studied using MRI of the brainstem to identify
      lesions within the central vestibular pathways. In the central group, the
      magnitude of the canal paresis was generally lower than in the peripheral group
      and removal of fixation had little effect on the nystagmic response. In the
      peripheral group, removal of fixation enhanced the nystagmus and lessened the
      discrepancy between the two ears. Statistical processing of the MRI showed that
      in the central group significant spatially coincident lesions occurred within the
      medial vestibular nucleus, lateral vestibular nucleus and proximal portion of the
      vestibular fascicle.

PMID- 1619408
TI  - Lacunar versus non-lacunar infarcts: pathogenetic and prognostic differences.
AB  - To characterise the pathogenetic and prognostic features of lacunar infarcts, 88
      patients with these infarcts were compared with 103 patients with non-lacunar
      infarcts. Potential cardioembolic sources were significantly more frequent among
      patients with non-lacunar infarcts (p = 0.0025). Although the prevalence of
      hypertension was higher among lacunar infarcts, this difference was not
      statistically significant. However, the distribution of hypertensive patients in
      the two groups of lacunar and non-lacunar infarcts was influenced by the presence
      or absence of cardioembolic sources: hypertension was significantly associated
      with the presence of cardioembolic sources among non-lacunar infarcts, whereas
      among lacunar infarcts it was significantly more frequent in patients without a
      cardioembolic source. This indicates that cardioembolism may exert a confounding
      effect by suppressing the relation between hypertension and lacunar infarcts. In
      a mean follow up period of 28.1 months, lacunar infarcts had a significantly
      lower incidence of stroke recurrence and of myocardial infarction (age-adjusted
      survival analysis: p = 0.0008); mortality from all causes was also lower in
      patients with lacunar infarct (age-adjusted survival analysis: 0.04 less than p
      less than 0.05). In a multivariate regression analysis, stroke subtype was an
      independent predictor of new major vascular events. These findings support the
      lacunar hypothesis and should be considered in the planning of epidemiological
      and therapeutic studies in patients with cerebral infarction.

PMID- 1619410
TI  - High dose steroids in acute relapses of multiple sclerosis: MRI evidence for a
      possible mechanism of therapeutic effect.
AB  - The integrity of the blood-brain barrier (BBB) in multiple sclerosis (MS) was
      monitored by serial gadolinium-(Gd)-DTPA enhanced MRI during and after the
      treatment of acute relapses with a three day course of high dose intravenous
      methylprednisolone (IVMP). During treatment there was a rapid reduction of BBB
      abnormalities in 96% of enhancing lesions. In spite of sustained clinical
      improvement, many lesions re-enhanced within a few days of stopping IVMP, and new
      lesions frequently appeared within one month. It is possible that the rapid,
      albeit transient, reversal of BBB abnormalities contributes to the accelerated
      recovery from relapses associated with IVMP treatment.

PMID- 1619411
TI  - Effect of practice on performance of a skilled motor task in patients with
      Parkinson's disease.
AB  - Parkinson's disease leads to a breakdown in the execution of highly practised,
      skilled movements such as walking and handwriting. The improved execution of
      skilled movements with practice can be understood as a process of schema
      learning, the determining of the relevant parameters of the specific movement.
      The ability of patients with Parkinson's disease and age matched normal control
      subjects to improve their performance, with practice, on a skilled motor task,
      doing up buttons, was assessed. The task was assessed on its own and with
      simultaneous foot tapping. Both groups showed an initial improvement in the task
      on its own and deterioration in performance when buttoning with foot tapping. The
      amount of interference, however, decreased with practice, particularly in the
      patients with a 2 Hz tapping rate. The results suggest that patients with
      Parkinson's disease are capable of schema learning but require more practice than
      control subjects to achieve comparable levels of performance. This may be a
      reflection of the fundamental motor dysfunction of the disease rather than a
      specific learning deficit.

PMID- 1619412
TI  - Value of somatosensory evoked potentials in saphenous entrapment neuropathy.
AB  - Neuralgia of the saphenous nerve (SN) is a rare clinical syndrome simulating a
      vascular disorder of the lower extremities. In four cases, the presenting
      complaint was persistent pain on the medial aspect of the knee. Examination
      revealed tenderness over the site of exit of the SN form the femoral canal.
      Femoral nerve motor conduction, quadriceps H-reflex and EMG of the leg muscles
      were normal. The sensory nerve action potential of the SN in the leg was not
      obtained in some patients, even in the unaffected leg. SEP were therefore
      preferred for diagnosis and performed at the infrapatellar and descending
      branches of the right and left SN and recordings from the Cz'-Fz electrode.
      Latency and amplitude differences were evaluated and compared with a control
      group of healthy subjects. An alteration in the SEP from one branch was observed
      on the painful side. Posterior tibial responses were normal. In one case, pain
      resolved immediately after neurolysis, confirming SN entrapment above the femoral
      canal, before its division. Pain resolved in two other cases and persisted in the
      last after medical treatment. SEP studies are valuable in the diagnosis of an
      isolated lesion of the SN.

PMID- 1619414
TI  - Motor and somatosensory evoked potentials in coma: analysis and relation to
      clinical status and outcome.
AB  - Central sensory and motor conduction were studied in 23 comatose and three brain
      dead patients. Motor evoked potentials (MEPs) to transcranial magnetic (magMEP)
      and electrical (elMEP) stimulation were recorded from the hypothenar muscle, and
      somatosensory evoked potentials (SEPs) were recorded after median nerve
      stimulation. Comparison of clinical with evoked potential (EP) findings revealed:
      1) a painful stimulus applied to the skin of the arm lowered excitation threshold
      to cortical stimulation and was a prerequisite to obtain MEPs in 14 instances; 2)
      only in braindead patients were all EPs abolished simultaneously and bilaterally;
      3) MEPs (p less than or equal to 0.05, chi 2-Test), but not necessarily SEPs (p
      greater than 0.1) were preserved in the arms that showed normal motor reaction
      during clinical examination; 4) no correlation was found between EP findings and
      the Glasgow Coma Scale (GCS). The results of clinical and EP testing were
      examined in the light of the patient's outcome 10 months later: 1) fatal outcome
      was predicted by a GCS of three (38% of cases, p less than or equal to 0.05,
      Fisher's exact test), abolished brainstem- or papillary reflexes (38%, p less
      than or equal to 0.05), the combination of these clinical signs (54%, p less than
      or equal to 0.01), bilateral abolition of elMEPs (38%, p less than or equal to
      0.05), magMEPs (38%, p less than or equal to 0.05), or SEPs (23%, p greater than
      0.1), or a combination of clinical and EP data (85%, p less than or equal to
      0.0005); 2) good outcome was predicted by a GCS of greater than or equal to 8
      only in post-traumatic coma, and EPs did not help to predict fatal outcome of
      coma; 1) if this appears impossible on the basis of clinical data alone; 2) if a
      second indicator is needed to confirm a clinical impression; 3) SEPs may be first
      evaluated during the acute stage of coma treatment, because they can be recorded
      in the presence of anaesthetic or relaxant agents; 4) MEP may be studied if
      outcome prediction remains ambiguous, and if the clinical situation allows for
      discontinuation of these agents.

PMID- 1619413
TI  - Unilateral brain damage after prolonged hemiconvulsions in the elderly associated
      with theophylline administration.
AB  - The brains of 14 elderly patients who died after status epilepticus were examined
      pathologically. Three of the 14 patients showed unilateral brain damage which
      corresponded to the side of the seizures, and the lesions were thought to be
      caused by seizures. In these three and two other patients, no causative lesion
      related to the seizures was found. In these five patients, status epilepticus
      occurred during theophylline therapy and thus the seizures in these five patients
      were assumed to be induced by theophylline. In the three patients with unilateral
      brain damage, the damage was seen in the hippocampus, amygdala and thalamus in
      two patients, while in the third, the whole hemisphere was damaged, including the
      hippocampus, amygdala, thalamus, basal ganglia and cerebral cortex. The
      distribution of pathological changes within the thalamus was described. It is
      suggested that the thalamus was primarily affected by seizures, rather than by
      secondary degeneration from the cortex.

PMID- 1619415
TI  - Behavioural and psychosocial sequelae of severe closed head injury and regional
      cerebral blood flow: a SPECT study.
AB  - Thirty six patients (31 male, 5 female) who had suffered severe closed head
      injury were re-examined at an average of 39.3 (SD 12.8, range 7-66) months after
      the injury. Behavioural symptoms were measured using the Giessen test. The
      relatives' reports were used for data analysis to ensure that results were valid.
      The neurophysical impairment subscale of the Glasgow assessment schedule was
      completed by two neurologists, and the number connection test was completed by
      each patient. The adjective mood scale was completed by each relative. All
      patients were investigated by single photon emission computerised tomography
      (SPECT). Exploratory factor analysis using the principal components method was
      carried out separately for SPECT results and psychological measures and
      correlations were sought between the resulting factors. Factor analysis of the
      data from the Giessen test identified social isolation, disinhibition, and
      aggressive behaviour as major components of post-traumatic personality changes;
      it indicates that these behavioural features are independent of the level of
      neurological and neuropsychological impairment, which loaded on a single
      independent factor. Relatives' psychic health seemed to be relatively resistant
      to physical and cognitive disability and was mainly affected by disinhibitive
      behaviour. The highest correlation was between frontal flow indices and
      disinhibitive behaviour (p less than 0.01): the severity of disinhibition
      increased with lower frontal flow rates. There was a significant but somewhat
      weaker correlation (p less than 0.05) between flow indices of the left cerebral
      hemisphere and social isolation. Low flow values of the right brain regions were
      related to aggressive behaviour (p less than 0.05). Neurological and cognitive
      impairment correlated negatively with the thalamus; worse neurological and
      cognitive performance indicate by raised scores on the neurophysical scale and on
      the number connection test was associated with low thalamic flow values. The
      results support the importance of lesion location in the production of post
      traumatic behavioural disorders.

PMID- 1619416
TI  - Surgical outcome in an elderly population with intracranial meningioma.
AB  - Thirty seven patients aged 70 and over (mean = 74 years) with an intracranial
      meningioma who had craniotomy between the years 1978-88 were reviewed. There were
      20 women and 17 men. Resection was total in 28 (76%) and subtotal in 9 (24%)
      cases and each tumour was histologically verified. The location of the tumours
      were: base of skull 11, convexity 10, parasagittal 9, falx 6, and tentorial 1.
      The most frequent associated diseases were: hypertension (35%), chronic ischaemic
      heart disease (22%) chronic obstructive pulmonary disease (19%), and diabetes
      (14%). The Karnofsky Scale (KS) score before surgery ranged from 30 to 90 (mean =
      59). It was less than 40 in ten patients. The length of anaesthesia during the
      surgical procedure varied from 4 to 12 hours and was not related to the outcome.
      There were two perioperative deaths (mortality = 5.4%). There were major
      complications in 8 patients and minor complications in 7 patients. In a mean
      follow up period of 29 months (shortest 6 and longest 96 months) the results
      were: excellent (KS 90-100) 39%, good (KS 70-80) 49%, fair (KS 60) 6%, and poor
      (KS 40-50) 6%. The difference between the mean preoperative KS value (KS = 59)
      and the mean postoperative KS value (KS = 80) was statistically significant (P
      less than 0.001). The results support a more aggressive therapeutic approach to
      the elderly patient with an intracranial meningioma.

PMID- 1619417
TI  - Mifepristone (RU 486) treatment of meningiomas.
AB  - Meningiomas are common brain tumours which are generally benign, well
      circumscribed and slow growing. In a minority of patients complete surgical
      removal is not possible and re-growth of tumour tissue is a major clinical
      problem. Most meningiomas contain progesterone receptors. The anti-progestational
      drug mifepristone (RU 486) binds to these receptors. Ten patients were treated
      with 12 recurrent or primary "inoperable" meningiomas, all of whom had shown
      recent neuroradiological and/or ophthalmological evidence of tumour growth. They
      received 200 mg mifepristone daily for 12 months. Most patients initially had
      complaints of nausea, vomiting and/or tiredness. In four patients prednisone (7.5
      mg/day) was given after which these side-effects subsided. CT scan analysis of
      tumour size, showed progression of growth of five meningiomas in four patients,
      stable disease in three patients with three tumours and regression of four
      tumours in three patients. A decrease in the complaints of headache and an
      improved general well being was observed in five patients. Two patients died
      during the treatment period from unrelated causes. Mifepristone treatment
      resulted in control of tumour growth (= stable disease) in six of 10 patients who
      had shown recent evidence of tumour growth. In three of these six patients
      consistent tumour shrinkage was observed.

PMID- 1619419
TI  - Delayed diagnosis of juvenile myoclonic epilepsy.
AB  - Fifteen cases of juvenile myoclonic epilepsy (JME) were identified from one
      hundred and eighty consecutive patients referred to a new epilepsy clinic at St
      Thomas' Hospital between April 1989 and December 1990, a prevalence of 8.3%. Of
      these, only one was referred with a putative diagnosis of JME. Diagnosis of the
      other patients on referral included "epilepsy", "grand mal", "temporal lobe
      epilepsy", "photoconvulsive epilepsy" and "alcohol-induced epilepsy". At least 11
      of the 15 patients had been seen by a neurologist in the United Kingdom before
      referral. Definitive diagnosis was delayed by a mean of 14.5 years. In seven
      patients inappropriate anticonvulsants had been prescribed. Control of seizures
      was improved in most patients after diagnosis. Factors responsible for the delay
      in diagnosis include lack of familiarity with the syndrome, failure to elicit a
      history of myoclonic jerking and high prevalence of focal abnormalities on the
      EEG. Precipitation of fits by alcohol and sleep deprivation may not be recognised
      by the physician as part of the syndrome of JME. Diagnosis may also be delayed in
      patients whose absence and generalised tonic-clonic seizures pre-date myoclonic
      jerks.

PMID- 1619418
TI  - Preoperative psychological adjustment and surgical outcome are determinants of
      psychosocial status after anterior temporal lobectomy.
AB  - This investigation evaluated the role of preoperative psychological adjustment,
      degree of postoperative seizure reduction, and other relevant variables (age,
      education, IQ, age at onset of epilepsy, laterality of resection) in determining
      emotional/psychosocial outcome following anterior temporal lobectomy. Ninety
      seven patients with complex partial seizures of temporal lobe origin were
      administered the Minnesota Multiphasic Personality Inventory (MMPI), Washington
      Psychosocial Seizure Inventory (WPSI), and the General Health Questionnaire (GHQ)
      both before and six to eight months after anterior temporal lobectomy. The data
      were subjected to a nonparametric rank sum technique (O'Brien's procedure) which
      combined the test scores to form a single outcome index (TOTAL PSYCHOSOCIAL
      OUTCOME) that was analysed by multiple regression procedures. Results indicated
      that the most powerful predictors of patients' overall postoperative psychosocial
      outcome were: 1) The adequacy of their preoperative psychosocial adjustment, and
      2) A totally seizure-free outcome. Additional analyses were carried out
      separately on the MMPI, WPSI, and GHQ to determine whether findings varied as a
      function of the specific outcome measure. These results were related to the
      larger literature concerned with the psychological outcome of anterior temporal
      lobectomy.

PMID- 1619420
TI  - Pure alexia and right hemiachromatopsia in posterior dementia.
AB  - A 66 year old, right handed woman presented with pure alexia and right
      hemiachromatopsia (PARH) in the context of a posterior dementia. PARH was
      accompanied by prosopagnosia, 2-D object agnosia, and environmental agnosia.
      Visual fields were normal to confrontation testing. The pathological anatomy of
      PARH involves circumscribed damage to the lingual and fusiform gyri and
      paraventricular white matter of the left occipital cortex, two contiguous
      cortical regions functionally specialised for processing colour and word form
      information, respectively.

PMID- 1619421
TI  - Impairment in bilateral alternating movements in Parkinson's disease?
AB  - Although problems in bilateral simultaneous movements in Parkinson's disease (PD)
      are well known, such deficits have not been reported to be any more impaired than
      simultaneous movements within the same limb. This is surprising, since (a) the
      parallels between supplementary motor area (SMA) damage and PD are well
      documented and (b) the SMA seems to play a special role in bilateral motor
      control. Bilateral versus unilateral movements in PD were examined by using a
      task that compared alternating movements of fingers of the same hand with
      alternating movements of fingers of the opposite hands. PD patients showed
      particular problems in programming and transferring motor activity to fingers on
      the opposite side of the body, as opposed to switching motor activity between
      fingers on the same side of the body. These findings outline the relevance of SMA
      dysfunction to PD.

PMID- 1619422
TI  - The neuropsychology of hanging: an historical perspective.

PMID- 1619423
TI  - A neurological audit in Vitoria, Spain.

PMID- 1619424
TI  - HLA antigens in familial Guillain-Barre syndrome.

PMID- 1619425
TI  - Adult onset acid maltase deficiency associated with epilepsy and dementia: a case
      report.

PMID- 1619426
TI  - A reappraisal of "direction of scratch" test: using somatosensory evoked
      potentials and vibration perception.

PMID- 1619427
TI  - Seventh nerve palsy as a false localising sign.

PMID- 1619428
TI  - Lumbosacral meningoradiculitis associated with Chlamydia pneumoniae infection.

PMID- 1619429
TI  - Postoperative fourth ventricle tension pneumocephalus.

PMID- 1619430
TI  - Hospital outpatient clinics, a neurology audit in south Catalonia.

PMID- 1619431
TI  - The brain in schizophrenia.

PMID- 1619432
TI  - The neuropsychological sequelae of attempted hanging.

PMID- 1619433
TI  - A predominantly cervical form of spinal muscular atrophy.

PMID- 1619434
TI  - Defining prognosis in medical coma.

PMID- 1619435
TI  - A prospective study of physical trauma and multiple sclerosis.

PMID- 1619436
TI  - Multiple sclerosis, tropical spastic paraparesis and HTLV-I infection.

PMID- 1619437
TI  - Neuropathological features of Alzheimer's disease in non-demented parkinsonian
      patients.

PMID- 1619438
TI  - The evolution of brain infarcts. A review.

PMID- 1619439
TI  - Arcuate nucleus hypoplasia in the sudden infant death syndrome.
AB  - Abnormalities in central respiratory control during sleep, arousal and/or cardiac
      activity have been reported in some infants who subsequently die of the sudden
      infant death syndrome (SIDS). We postulate that these abnormalities may result
      from dysfunction of the ventral and ventrolateral medulla, which, based on animal
      data, is an integrative site for chemosensitivity, ventilation, autonomic
      function, and arousal. The arcuate nucleus along the ventral surface of the human
      medulla has been proposed to facilitate chemosensitivity to carbon dioxide and/or
      hydrogen ion. In this study, we surveyed serially or extensively sectioned
      medullae of 41 SIDS and 27 controls, and identified two SIDS victims with
      isolated hypoplasia of the arcuate nucleus. Three-dimensional reconstructions and
      volume measurements of each hemimedulla of one of these SIDS victims and three
      controls were performed from serial sections. The volume of the right arcuate
      nucleus of the SIDS case was 0.7 mm3, compared to a range of 3.4-26.3 mm3 (median
      5 mm3) in three infant controls. On the basis of the anatomic connections of the
      human arcuate nucleus and of neurons in homologous positions in animals, we
      postulate that arcuate hypoplasia may lead to death by dyssynergy between
      cerebellar coordination of ventilation and autonomic/chemosensory/arousal
      integration, especially during sleep, hypercarbia, and in a critical
      developmental period.

PMID- 1619440
TI  - Three-dimensional analysis of the relationship between synaptic pathology and
      neuropil threads in Alzheimer disease.
AB  - Recent studies have shown that the Alzheimer disease (AD) neocortex is
      characterized by a loss of large neurons, the presence of dilated terminal axons,
      widespread loss of synapses, and a disruption of the dendritic cytoskeleton which
      is manifested as Tau immunoreactive threads. In the present study we have
      investigated the relationship between synaptic and dendritic abnormalities in the
      neocortex of Alzheimer patients and examined the extent to which these structural
      alterations correlate with the severity of cognitive impairment in AD.
      Quantitative neuroanatomical data were obtained from immunofluorescence-labeled
      specimens using a laser-scanning confocal microscope, computer-assisted image
      processing and serial section reconstruction techniques. We found that the AD
      cases showed a 34% loss in the number of presynaptic terminals per 100 square
      (sq) microns, many of which showed structural abnormalities. The AD neuropil had
      an average of 10 +/- 7 dendritic threads per 1,000 sq microns, with the average
      thread measuring 2 sq microns. Severe AD cases had thicker threads compared with
      mild to moderate AD cases. Three-dimensional analysis showed clustering of
      synapses around threads, as well as presynaptic boutons apposed to dendritic
      neuropil threads. Statistical analysis showed that the strongest correlation was
      between synapse density and Blessed score of cognitive impairment. Thread counts
      did not correlate with either but were correlated with tangle counts. Stepwise
      multiple regression analysis showed that tangle counts, but not threads,
      strengthened the correlation between Blessed score and synapses. We conclude that
      synaptic damage may precede dendritic thread and tangle formation, and that
      threads do not necessarily induce synaptic pathology. Instead, dendrite sprouting
      in the denervated regions could be associated with increased accumulation of
      cytoskeletal proteins observed in the dendritic threads.

PMID- 1619441
TI  - Effects of spaceflight in the adductor longus muscle of rats flown in the Soviet
      Biosatellite COSMOS 2044. A study employing neural cell adhesion molecule (N-CAM)
      immunocytochemistry and conventional morphological techniques (light and electron
      microscopy).
AB  - The effects of spaceflight upon the "slow" muscle adductor longus were examined
      in rats flown in the Soviet Biosatellite COSMOS 2044. The techniques employed
      included standard methods for light microscopy, neural cell adhesion molecule (N
      CAM) immunocytochemistry and electron microscopy. Light microscopic observations
      revealed myofiber atrophy and segmental necrosis accompanied by cellular
      infiltrates composed of macrophages, leukocytes and mononuclear cells. Neural
      cell adhesion molecule immunoreactivity (N-CAM-IR) was seen on the myofiber
      surface and in regenerating myofibers. Ultrastructural alterations included Z
      band streaming, disorganization of myofibrillar architecture, sarcoplasmic
      degradation, extensive segmental necrosis with apparent preservation of the
      basement membrane, degenerative phenomena of the capillary endothelium and
      cellular invasion of necrotic areas. Regenerating myofibers were identified by
      the presence of increased amounts of ribosomal aggregates and chains of
      polyribosomes associated with myofilaments. The principal electron microscopic
      changes of the neuromuscular junctions showed axon terminals with a decrease or
      absence of synaptic vesicles replaced by microtubules and neurofilaments,
      degeneration of axon terminals, vacant axonal spaces and changes suggestive of
      axonal sprouting. The present observations suggest that alterations such as
      myofibrillar disruption and necrosis, muscle regeneration and denervation and
      synaptic remodeling at the level of the neuromuscular junction may take place
      during spaceflight.

PMID- 1619443
TI  - Inbred SAM-P/10 as a mouse model of spontaneous, inherited brain atrophy.
AB  - We developed a novel inbred strain of mouse with age-related brain atrophy and it
      was named "Senescence Accelerated Mouse (SAM)-P/10." Macroscopic morphometry
      indicated that the brains of SAM-P/10 showed age-dependent involutional changes
      mainly in the frontal portion of the cerebrum. The brain weight decreased by 8.6%
      throughout the life-span. There were no obvious defects in postnatal development.
      Semi-macroscopic morphometry revealed a prominent atrophy in the neocortex,
      olfactory cortex and amygdala. Microscopic morphometry showed that the
      neocortical neurons were lost with aging, with mostly the large neurons being
      affected which were lost by 35.6% throughout the life-span. Somata of the
      neocortical neurons shrank with advancing age. In a control SAM-R/1 strain with
      only a slight macroscopic involutional change in the brain without weight loss,
      neither loss of the neocortical large neurons nor shrinkage of the neocortical
      neurons was evident with aging. Learning and memory skills were evaluated using
      the one-trial passive avoidance task and conditional avoidance task. Young SAM
      P/10 mice performed well in both tasks but older SAM-P/10 showed a poorer
      performance in both tasks, and this was even poorer than the performance of very
      old SAM-R/1 mice. Thus, SAM-P/10 can serve as a spontaneous animal model of brain
      atrophy for a variety of studies of aging of the brain. A better understanding of
      neurodegenerative diseases with dementia should be forthcoming.

PMID- 1619442
TI  - Herpes simplex virus type I (HSV I)-induced multifocal central nervous system
      (CNS) demyelination in mice.
AB  - Multifocal central nervous system (CNS) demyelination develops in the brains of
      SJL/J, PL/J, and A/J mice following lip inoculation with a specific strain of
      herpes simplex virus I (HSV I). The lesions in all three inbred strains of mice
      share similar characteristics including demyelination, relative preservation of
      axons, and a mononuclear cell (MNC) infiltrate. The lesions, developing during
      the early phase of demyelination, also appear sequentially in the CNS (trigeminal
      root entry zone of the brainstem greater than cerebellum greater than cerebral
      hemispheres) of all three strains of mice but differ in the time of their initial
      appearance following infection as well as their morphology. In SJL/J mice, new
      areas of demyelination are observed for only 24 days following lip inoculation
      with virus. Late stage multifocal CNS demyelination persists throughout 28 weeks
      postinoculation (pi) in PL/J mice while in A/J mice the development of new areas
      of demyelination are restricted to 8 weeks pi. Although mononuclear inflammatory
      cells are present in the new areas of demyelination in either PL/J or A/J mice,
      viral antigens are not detected in the CNS beyond 12 days pi. In contrast, in
      situ hybridization studies using 35S-cDNA HSV probes and performed beyond day 12
      pi identify probe-positive cells central to a number of the multifocal CNS
      demyelinating lesions in A/J mice. Results from studies with inbred and congenic
      strains of mice indicate that the major histocompatibility complex (H-2) does not
      determine the development of multifocal CNS demyelination following lip
      inoculation with HSV I but does influence the morphological appearance of the
      lesions that do develop.

PMID- 1619444
TI  - The role of pyrrole formation in the alteration of neurofilament transport
      induced during exposure to 2,5-hexanedione.
AB  - Exposure to the gamma-diketone, 2,5-hexanedione (HD), results in the accumulation
      of neurofilaments within the distal axon and is associated with acceleration of
      neurofilament transport within the proximal axon. The epsilon-amino groups of
      lysyl residues react with HD forming pyrrole adducts, followed by pyrrole
      mediated protein crosslinking. Both reaction steps have been proposed as
      mechanisms causing neurofilament accumulation and acceleration of transport. In
      order to assess the importance of these steps on neurofilament transport, we
      compared transport in the optic system of rats exposed to HD and 3-acetyl-2,5
      hexanedione (AcHD), a non-toxic analog of HD which forms pyrroles but does not
      crosslink proteins. Control, HD-treated, and AcHD-treated rats received
      intraoptic injections of [35S]-methionine and were exposed to saline, HD, or AcHD
      by intraperitoneal injections before and during the period of neurofilament
      transport. Neurofilament triplet proteins in the optic nerve and tract were
      identified by polyacrylamide gel electrophoresis followed by fluorography. The
      rate of neurofilament transport was accelerated in HD-treated animals over that
      of controls. However, despite higher levels of protein-bound pyrroles in AcHD
      treated animals, the rate of transport was indistinguishable from that of
      controls. These findings indicate that pyrrole formation alone is not sufficient
      to cause acceleration of neurofilament transport.

PMID- 1619446
TI  - Insulin-like growth factor II expression in the developing human brain.
AB  - Insulin-like growth factor II (IGF-II) is a polypeptide hormone with insulin-like
      metabolic activity and neurotrophic activity in vitro that has been implicated in
      human brain development. In this study, we used northern blot analysis to examine
      the patterns of IGF-II mRNA expression in selected regions of 18 human brains
      from cases ranging in age from 20 gestational weeks to 2.5 years (median age 31
      gestational weeks). The expression of IGF-II mRNA was widespread throughout the
      brain from midgestation through the perinatal period. Each region showed a
      distinct developmental pattern of expression and IGF-II mRNA levels varied
      considerably between regions. The highest levels of expression at all ages were
      in leptomeninges and choroid plexus. After two postnatal months, IGF-II mRNA
      virtually disappeared from parenchymal regions. Beyond the perinatal period, IGF
      II expression persisted primarily in choroid plexus. Transcripts of both 6.0 and
      4.8 kb were detected in most brain regions. A developmental change in the
      relative amounts of the two transcripts occurred in choroid plexus, leptomeninges
      and medulla. The expression of IGF-II mRNA in the brain parenchyma during the
      last half of gestation correlates with a period of major brain growth and
      supports the hypothesis that high levels of IGF-II stimulate the proliferation
      and differentiation of neural cells early in development.

PMID- 1619445
TI  - Clinically-silent mutation in the putative iron-responsive element in exon 17 of
      the beta-amyloid precursor protein gene.
AB  - Three missense mutations in exon 17 of the beta-amyloid precursor protein (APP)
      gene have been reported to cosegregate in families with early onset Alzheimer's
      disease (AD). All three mutations result in amino acid substitutions at codon 717
      and may produce AD by altering the structure of the transmembrane domain of APP.
      Alternatively, the mutations may destabilize the stem of a putative iron
      responsive element (IRE) in which they lie and confer pathogenicity by
      inactivating this negative regulatory element. We have detected a clinically
      silent mutation in codon 716 that would also be expected to disrupt the putative
      IRE but results in no amino acid substitution. This result strongly suggests that
      the missense mutations at codon 717 produce AD by altering the amino acid
      sequence of APP rather than the IRE. Furthermore, the identification of a
      clinically-silent mutation among four point mutations that span only three
      nucleotides of exon 17 suggests that this region may be a mutational "hot" spot.

PMID- 1619447
TI  - Third meeting of the European Neurological Society. 27 June-1 July 1992,
      Lausanne, Switzerland. Abstracts.

PMID- 1619448
TI  - The effects of gender and age on associations between blood lipid levels and
      obesity in Danish men and women aged 35-65 years.
AB  - The purpose of the study was to assess the influence of gender and age on the
      associations between different measures of obesity, and blood lipid levels.
      Overall obesity (body fat, body fat percentage and body mass index) or abdominal
      obesity (waist/hip-ratio, waist/thigh-ratio and waist-circumference) and lipid
      levels [high density lipoprotein (HDL), low density lipoprotein (LDL), very low
      density lipoprotein (VLDL), total cholesterol and triglyceride level] were
      measured in 1987/88 in a random Danish population sample of men and women (N =
      2987), aged 35, 45, 55 and 65 yr. All lipid levels were dependent on gender and
      age. The associations between most measures of obesity and HDL or LDL were
      independent of gender and age, whereas, with a few exceptions, associations
      between measures of obesity and total cholesterol, VLDL or triglycerides were
      dependent on gender and/or age. Compared to levels of HDL, LDL and total
      cholesterol, abdominal obesity specifically affected levels of VLDL or
      triglycerides, whereas overall obesity affected HDL, LDL, VLDL, total cholesterol
      and triglyceride levels more evenly. When men and women were compared,
      associations between the measures of obesity and blood lipids were stronger in
      men than in women of the same age, except for the associations between measures
      of abdominal obesity and VLDL or triglycerides in 45-year-old women. No age trend
      was found for associations between the measures of obesity and VLDL or
      triglycerides, whereas young age-groups showed stronger associations between
      obesity and total cholesterol than older age-groups. Failure to consider
      age/gender effects induces bias and may lead to misleading conclusions regarding
      the bivariate association between obesity and lipids, and further may make
      results from population studies incomparable.

PMID- 1619450
TI  - Comparison of "Rose Questionnaire Angina" to exercise thallium scintigraphy:
      different findings in males and females.
AB  - Validation of the London School of Hygiene (Rose) Questionnaire with objective
      measures of myocardial ischemia is incomplete. Therefore, we compared the Rose
      Questionnaire with exercise thallium-201 myocardial scintigraphy in 147 male and
      97 female patients with chest pain referred for clinical exercise testing. Of
      those with "Rose Questionnaire angina", 26% of the females and 73% of the males
      had positive thallium-201 scans. Negative results on both the Rose Questionnaire
      and thallium-201 scintigraphy were observed in 71% of the females and 47% of the
      males. The sensitivity of the Rose Questionnaire was similar in females (41%) and
      males (44%). The specificity was 77% in males, while in females it was
      significantly lower at 56%. The specificity values reflect the higher (p less
      than 0.05) prevalence of "false positive" Rose Questionnaire results in females
      (75%) compared with males (27%). In addition, males had a greater (p less than
      0.05) number of "false negative" results (53%) than females (29%). The accuracy
      of the Rose Questionnaire for myocardial ischemia was 0.19 in females, 0.48 in
      males, and 0.29 overall when including both males and females. Our results
      indicate a generally poor relationship between Rose Questionnaire angina and
      thallium-201 scintigraphy, an objective measure of myocardial ischemia in
      patients with chest pain referred to clinical exercise testing. Further, there
      are gender-specific differences in this relationship between the questionnaire
      and exercise thallium-201 imaging.

PMID- 1619449
TI  - Identification of fractures from computerized Medicare files.
AB  - Study of non-hip fractures, which are a serious public health problem for persons
      greater than or equal to 65 years of age, has been hindered by the absence of an
      economical method for case identification. We assessed the utility of
      computerized Medicare inpatient, emergency room, hospital outpatient department
      and physician claims for identifying fractures in an elderly Tennessee Medicaid
      population. We used these files for 1987 to identify 3086 possible fractures and
      reviewed medical records for a sample of 1440. Using this sample, we developed a
      definition of probable fractures that excluded claims unlikely to represent newly
      diagnosed fractures. For all fractures, this definition had a positive predictive
      value of 94%, which for individual fracture sites, ranged from 79% (tibia/fibula)
      to 98% (hip). Of fractures in the reviewed sample, 91% were identified as
      probable fractures; this upper bound for sensitivity varied between 75% (femoral
      shaft) and 100% (patella). These data suggest that computerized Medicare files
      can be used for rapid and economical fracture ascertainment among persons greater
      than or equal to 65 years of age. However, further work is needed to obtain
      better estimates of sensitivity.

PMID- 1619451
TI  - Data collection strategies in genetic epidemiology: The Epilepsy Family Study of
      Columbia University.
AB  - A large-scale study of genetic influences on seizure disorders is described here
      as a primer of tested methods for collection of family history data. 1957 adult
      probands with epilepsy were ascertained from voluntary organizations. Personal
      and family history data were obtained from probands in semistructured telephone
      interviews. To increase sensitivity, an independent family history was obtained
      from a second family informant in a similar interview. To increase specificity
      and diagnostic detail, family members reported to be affected were interviewed,
      and medical records of probands and affected relatives were collected.
      Participation rates for probands were 84-90%. Interviews were completed with
      second informants in 67% of families, and with 51% of eligible affected
      relatives. The main reasons for non-interview were lack of permission from
      probands and difficulties in locating relatives. Although 90% of probands gave
      verbal permission for medical record review, only 75% of these signed and
      returned consent forms for this purpose. Physicians returned 87% of the records
      requested. The resulting proportion of probands with medical records was 59%.
      These findings illustrate the complexity involved in assembling useful databases
      in genetic epidemiology.

PMID- 1619452
TI  - Further thoughts on the importance of models in the assessment of clinical
      evidence.

PMID- 1619453
TI  - Coffee consumption and cause-specific mortality. Association with age at death
      and compression of mortality.
AB  - The relationship between reported coffee consumption and specific causes of death
      was examined in 9484 males enrolled in the Adventist Mortality Study in 1960 and
      followed through 1985. Coffee consumption was divided into three levels: less
      than 1 cup per day, 1-2 cups per day, and greater than or equal to 3 cups per
      day. Approximately one third of the subjects did not drink coffee. Cause-specific
      mortality rates were compared using survival analysis including Cox's
      proportional hazard model, and controlling for potential confounders such as body
      mass index, heart disease and hypertension at baseline, race, physical activity,
      marital status, educational level, smoking history, and dietary pattern.
      Inclusion of interaction terms between coffee consumption and attained age as
      time-dependent covariates allowed the hazard ratio to vary with age. Univariate
      analyses showed a statistically significant association (p less than 0.05) for
      coffee consumption and mortality for most endpoints. Multivariate analyses showed
      a small but statistically significant association between coffee consumption and
      mortality from ischemic heart disease, other cardiovascular diseases, all
      cardiovascular diseases, and all causes of death. For the major causes of death,
      the hazard ratios decreased from about 2.5 at 30 years of age to 1.0 around 95
      years of age. These results indicate that abstinence from coffee leads to
      compression of mortality rather than an increase in lifespan.

PMID- 1619454
TI  - The role of health care providers and significant others in evaluating the
      quality of life of patients with chronic disease: a review.
AB  - The use of proxy raters of patients' quality of life has been suggested as a
      means of facilitating the factoring of quality-of-life considerations explicitly
      into the medical decision-making process and of resolving the problem of missing
      data in longitudinal quality-of-life investigations. This review addresses two
      questions related to the potential role of such proxy raters in clinical research
      and practice: (1) to what extent are health care providers and lay individuals
      involved in the care of patients ("significant others") able to assess accurately
      the quality of life of patients with chronic disease? and (2) under what
      conditions, if any, is inclusion of such proxy ratings in quality-of-life
      investigations warranted? Although the extant literature yields few unequivocal
      findings, a number of clear trends can be identified: (i) health care providers
      and significant others tend, in general, to underestimate patients' quality of
      life; (ii) health care providers and significant others appear to evaluate
      patients' quality of life with a comparable degree of (in)accuracy; (iii) health
      care providers tend to underrate the pain intensity of their patients; (iv) proxy
      ratings appear to be more accurate when the information sought is concrete and
      observable; and (v) while significant others' ratings tend to be more accurate
      when they live in close proximity to the patient, they can also be biased by the
      caregiving function of the rater. There is need for more methodologically sound
      studies that: (a) incorporate head-to-head comparisons of health care providers
      and significant others as proxy raters; (b) employ well-validated quality-of-life
      measures; and (3) employ a longitudinal design in order to examine the effect of
      changes in patients' health status over time on the ability of proxies to provide
      valid quality-of-life assessments.

PMID- 1619455
TI  - The relationship between multiparity and lipoprotein levels in older women.
AB  - The relation between multiparity and lipid and lipoprotein levels was examined in
      a sample of 1275 Rancho Bernardo women aged 50-89. Number of pregnancies ranged
      from 0 to 13 with a mean of 2.1. Pregnancy was unrelated to high density
      lipoprotein cholesterol level in women with 4 or fewer pregnancies, but women
      with 5 or more pregnancies had significantly lower levels both before and after
      adjustment for age, obesity, diabetes, alcohol and cigarette consumption,
      exercise and estrogen use. After multiple regression analysis, women with 5 or
      more pregnancies had high density lipoprotein levels that were 4.9 mg/dl lower
      than women with 4 or fewer pregnancies. No differences in total cholesterol, low
      density lipoprotein cholesterol or triglyceride levels were observed by number of
      pregnancies. If confirmed by others, these results suggest that one factor
      mediating the previously reported relationship between multiparity and
      cardiovascular disease may be a decreased level of high density lipoprotein
      cholesterol.

PMID- 1619456
TI  - Variance imputation for overviews of clinical trials with continuous response.
AB  - Overviews of clinical trials are an efficient and important means of summarizing
      information about a particular scientific area. When the outcome is a continuous
      variable, both treatment effect and variance estimates are required to construct
      a confidence interval for the overall treatment effect. Often, only partial
      information about the variance is provided in the publication of the clinical
      trial. This paper provides heuristic suggestions for variance imputation based on
      partial variance information. Both pretest-posttest (parallel groups) and
      crossover designs are considered. A key idea is to use separate sources of
      incomplete information to help choose a better variance estimate. The imputation
      suggestions are illustrated with a data set.

PMID- 1619457
TI  - Social and environmental factors and dysthymic disorder in old age.
AB  - This community-based epidemiological survey is concerned with relationships
      between social and environmental factors and dysthymic disorder (long-lasting
      depression according to the DSM-III classification) in a Finnish population aged
      60 years or over. A greater proportion of dysthymic than non-depressed men had
      retired and did not work at all. The occurrence of dysthymic disorders in both
      men and women was related to retirement because of sickness rather than age, a
      small number of rooms in their homes, lack of intimate friendships and the
      occurrence of many long-standing and current social stress factors. The dysthymic
      women had lived at their present place of residence for a shorter period than had
      the non-depressed women. A positive association of dysthymic disorders with
      moving house due to poor health and living in institutions was also found in the
      men, and with a low number of hobbies and poor social participation in the women.
      In addition, the dysthymic women felt their relationships with their spouse,
      children, daughters-in-law and friends to be more distant than did their non
      depressed counterparts. The dysthymic women also felt that elderly people were
      not appreciated. The log-linear models showed three interactions for the
      dysthymic men and six for the dysthymic women. The dysthymic persons reported a
      significantly larger number of detrimental events of an interpersonal nature than
      did the non-depressed persons.

PMID- 1619458
TI  - Sources of interobserver variation in histopathological grading of cervical
      dysplasia.
AB  - The present study aimed to assess where the interobserver variation in grading
      cervical dysplasia stems from. Four experienced pathologists examined 93
      histological slides, after they agreed on which morphological characteristics
      should be considered relevant for grading. They scored 6 morphological
      characteristics for each slide and assigned it to a degree of dysplasia. Compared
      to a previous study, the interobserver variation showed a statistically
      significant improvement: the weighted group kappa value increased from 0.55 to
      0.69. For the scores of the individual characteristics considerable interobserver
      variation was observed: weighted group kappa values ranged from 0.28 to 0.49. The
      pathologists slightly differed in which characteristics they considered most
      important for their grading. The agreement on the degree of dysplasia turned out
      to be better than the agreement on the morphological characteristics on which
      this diagnosis is based. In the discussion, a few explanations for this
      paradoxical finding are put forward.

PMID- 1619459
TI  - The accuracy of self and informant ratings of physical functional capacity in the
      elderly.
AB  - To compare the accuracy of self-ratings with informant-ratings of physical
      functional capacity in the elderly, 150 elderly patients attending a geriatric
      day hospital (GDH) and their formal and informal community carers were
      administered a questionnaire about their ability to perform activities of daily
      living (ADL). Direct observation of the patients' performance by therapists at
      the GDH was used as a standard, after the reliability and validity of this
      approach had been evaluated. Self-ratings were shown to be more accurate and less
      biased than informant-ratings, both for individual ADL and overall functional
      capacity. The accuracy of all ratings tended to be greater for less complex or
      physically demanding ADL, and informants tended to consistently underestimate
      functional capacity. The concurrent validity of the adapted Barthel Index in a
      self-report format was also demonstrated. Wherever possible, information
      concerning the physical functional capacity of an elderly subject should in the
      first instance be sought from the subject himself, as the quality of such
      information may be superior to that of his carers.

PMID- 1619460
TI  - When philosophers shoot from the hip.

PMID- 1619461
TI  - Abstract expression.

PMID- 1619462
TI  - Body mass and breast cancer.

PMID- 1619464
TI  - Age, dietary selenium and quantity of 7,12-dimethylbenz(a)anthracene influence
      the in vivo occurrence of rat mammary DNA adducts.
AB  - The present studies determined the impact of age, dietary selenium and 7,12
      dimethylbenz(a)anthracene (DMBA) dosage on the occurrence of DMBA-DNA adducts in
      rat mammary tissue. Diets formulated to contain selenium, as sodium selenite, at
      0.1 (control) or 2.0 mg/kg were fed for 2 wk before DMBA treatment. Food intake
      and weight gain were not influenced by selenium intake. Anti- and syn-dihydrodiol
      epoxide adducts reached maximum binding by 24 and 36 h, respectively, after
      treatment with DMBA. Consumption of the diet containing 2.0 mg Se/kg inhibited
      the appearance of both anti- and syn-adducts by approximately 50% compared with
      controls. The occurrence of DMBA-DNA adducts correlated with a dosage of DMBA
      from 5 to 50 mg/kg body wt (r greater than or equal to 0.95). The ability of
      supplemental selenite to lower DMBA binding to mammary cell DNA increased as the
      quantity of the carcinogen administered increased. DMBA-DNA binding was found to
      increase with the increasing age of the rat. Nevertheless, dietary selenium
      supplementation was effective in reducing DMBA binding to DNA in all ages
      examined. These data confirmed the ability of dietary selenium to inhibit the in
      vivo metabolism of DMBA under a variety of conditions.

PMID- 1619463
TI  - Dietary calcium modifies concentrations of lead and other metals and renal
      calbindin in rats.
AB  - We studied the effects of dietary calcium on kidney, femur, testis, liver, heart
      and brain concentrations of lead, magnesium, iron, copper, calcium and zinc in
      rats exposed to lead for 1 y. Renal levels of the 28,000 Da, vitamin D-dependent,
      calcium-binding protein calbindin-D28K were also measured. Seventy-two weanling
      male Sprague-Dawley rats were randomly assigned to one of nine treatment groups.
      Rats were fed diets containing 0.1, 0.5 or 2.5% Ca for 52 wk and were
      simultaneously given either 0, 50 or 100 mg lead/L in their drinking water. Rats
      fed the 0.1% Ca diet had organ lead concentrations that were two- to 20-fold
      greater than the corresponding animals fed 0.5% Ca. Rats fed diets containing
      2.5% Ca had the lowest organ lead concentrations. Despite substantial effects of
      diet Ca on organ lead concentrations, Ca did not significantly influence
      concentrations of most other divalent metals studied with the exception of kidney
      calcium and magnesium, testis iron, plasma ionic calcium and magnesium, and
      several femur metals. Kidney calcium concentrations were lower in rats fed 2.5%
      Ca diets than in those fed 0.1 or 0.5% Ca diets. For rats not given lead, renal
      calbindin concentrations were highest in rats fed 0.1% Ca, and lowest in rats fed
      2.5% Ca. Lead inhibited an increase in renal calbindin in the rats fed 0.1% Ca,
      but paradoxically increased renal calbindin levels in animals fed 2.5% Ca.

PMID- 1619465
TI  - Protein deficiency impairs erythropoiesis in rats by reducing serum
      erythropoietin concentration and the population size of erythroid precursor
      cells.
AB  - Erythropoietin (EPO), a glycoprotein produced mainly by the kidney, is the major
      physiological regulator of erythropoiesis. We developed a sensitive and rapid
      ELISA for measurement of rat serum EPO with two monoclonal antibodies that
      recognize different epitopes. To understand the mechanism by which erythropoiesis
      is impaired in rats deficient in dietary protein, we investigated the levels of
      the immunoreactive EPO (iEPO) in serums and erythroid precursor cells in
      hemopoietic tissues during protein deprivation. The iEPO level of 32-d-old rats
      fed a protein-free diet was lowered to one-third that of rats fed 20% casein at 6
      h after protein deprivation began. Protein deprivation decreased the number of
      EPO-responsive cells in spleen. These results indicate that the impairment of
      erythropoiesis during protein deficiency is caused by the decrease in serum EPO
      and the subsequent reduction of the population size of erythroid precursor cells
      in spleen.

PMID- 1619466
TI  - Cobalt-vitamin B-12 deficiency decreases methionine synthase activity and
      phospholipid methylation in sheep.
AB  - Two groups of lambs were fed either a Co-deficient or a Co-sufficient whole
      barley-based diet for 28 wk to induce a severe Co-vitamin B-12 deficiency. Holo
      and apo methionine synthase activities were significantly lower in the liver,
      kidney and spinal cord of Co-deficient animals compared with controls. Neither
      form of this enzyme in the brain was affected by Co deficiency. The ratio of the
      tissue concentrations of S-adenosyl methionine to S-adenosyl homocysteine was
      significantly lower only in the liver of Co-deficient animals, suggesting that
      the activity of hepatic SAM-dependent methyltransferase enzymes would be
      impaired. Measurements of tissue concentrations of phosphatidyl choline and
      phosphatidyl ethanolamine revealed lower concentrations of phosphatidyl choline
      and a lower phosphatidyl choline:phosphatidyl ethanolamine ratio in both liver
      and brain of the Co-deficient animals. The latter finding occurred in the absence
      of changes in either methionine synthase activity or the methylation ratio and
      may result from impaired availability of hepatic phosphatidyl choline for
      transport into the brain.

PMID- 1619467
TI  - Methyl group metabolism in the pancreas of folate-deficient rats.
AB  - Several studies have suggested that the metabolism of one-carbon compounds may
      have a special role in the function of the exocrine pancreas. An amino acid
      defined diet was used to produce folate deficiency in a group of male rats. These
      rats were compared with a group of rats pair-fed the same diet supplemented with
      adequate folate and with a third group fed the folate-supplemented diet with ad
      libitum access. Pancreatic folate concentrations were already severely depleted
      after 4 wk of feeding the deficient diet (0.95 +/- 0.10, 5.81 +/- 0.29 and 4.58
      +/- 0.30 nmol/g for the deficient, pair-fed control and ad libitum-fed control
      groups, respectively). The level of folate present in the pancreas of
      nondeficient animals was second only to that reported for liver. Urinary amylase
      excretion by animals in the deficient group was higher than that by the other
      groups (245.5 +/- 21.9, compared with 181.9 +/- 14.5 and 195.3 +/- 10.9 units/mg
      creatinine for the deficient, pair-fed control and ad libitum-fed control groups,
      respectively) after 4 wk. The ratio of S-adenosylmethionine to S
      adenosylhomocysteine was 18.6 +/- 1.6 and 14.5 +/- 1.0 after 4 wk for the ad
      libitum-fed control and pair-fed control groups, respectively, but was
      significantly lower at 6.3 +/- 1.1 for the deficient group. These results
      indicate a profound effect of folate deficiency upon methyl group metabolism of
      the pancreas and suggest that this may result in decreased pancreatic function.

PMID- 1619468
TI  - Dietary cholesterol and type of fat differentially affect cholesterol metabolism
      and atherosclerosis in baboons.
AB  - This study was designed to determine the differences in cholesterol metabolism
      due to dietary cholesterol and type of fat in adult baboons. From weaning at 16
      wk to 7-8 y of age, 80 baboons were fed one of four diets: high cholesterol (0.24
      mg/kJ) or low cholesterol (0.0024 mg/kJ) with 40% of energy from saturated fat
      [polyunsaturated/saturated fatty acid ratio (P/S) = 0.37] or unsaturated fat (P/S
      = 2.1). High cholesterol and saturated fat independently raised serum lipoprotein
      and apolipoprotein concentrations to about the same extent. The liver cholesterol
      concentration of baboons fed high cholesterol diets was 23% higher than that of
      baboons fed low cholesterol. High dietary cholesterol also increased bile
      cholesterol concentration by 25%, the neutral steroid excretion rate by 66% and
      the bile acid excretion rate by 30%. With feeding of saturated fat, compared with
      unsaturated fat, liver cholesterol was 24% lower, bile cholesterol 26% lower and
      the neutral steroid excretion rate 12% lower. Dietary cholesterol greatly
      suppressed whole-body cholesterol synthesis, but type of fat did not affect
      cholesterol synthesis rate. These results suggest that dietary cholesterol and
      saturated fat increase plasma lipoprotein concentrations through different
      physiological mechanisms.

PMID- 1619469
TI  - Iron nutrition does not account for the hemoglobin differences between blacks and
      whites.
AB  - Many researchers have reported lower hemoglobin concentrations in blacks than in
      whites, but the reason for this difference is unknown. Data for 2515 persons (in
      3-12 y and 18-45 y age groups) from the Second National Health and Nutrition
      Examination Survey (NHANES II) were evaluated to investigate the roles of iron
      intake and biochemical iron status indicators in explaining black and white
      differences in hemoglobin concentration. Dietary iron intake was estimated from
      one 24-h food recall, and hemoglobin, serum ferritin, transferrin saturation and
      erythrocyte protoporphyrin were measured by standard laboratory methods.
      Hemoglobin levels were substantially lower in black children (120.3 g/L) than in
      white children (126.8 g/L). Hemoglobin concentrations were also lower in black
      women (128.4 g/L) than in white women (133.9 g/L), and in black men (144.8 g/L)
      than in white men (153.2 g/L). Blacks had lower hemoglobin concentration than
      whites at most levels of dietary iron intake, serum ferritin, transferrin
      saturation and erythrocyte protoporphyrin. Despite their lower hemoglobin levels,
      blacks had higher serum ferritin levels than whites. These results suggest that
      the difference in hemoglobin concentrations between blacks and whites in the
      United States is the result of factors other than iron intake and iron status.
      More specific investigations of both the genetic and environmental determinants
      of iron utilization in blacks are needed.

PMID- 1619470
TI  - A method for estimating the available energy of incompletely digested
      carbohydrates in rats.
AB  - We developed a method to estimate the available energy from carbohydrates that
      are unavailable or partially unavailable through direct digestion and absorption.
      Radiolabeled bacterial and plant cellulose and polydextrose were administered
      orally to germfree and conventional rats. Label in breath, feces, intestinal
      contents and carcass were determined with excellent total recovery of the
      administered label. Comparison of these measurements in germfree and conventional
      rats was used to calculate the energy directly available by digestion and that
      available only after fermentation. Although the method overestimates available
      energy because of the more efficient digestive metabolism of the germfree rat, it
      provides a reliable, maximum energy value based upon fewer assumptions than
      previous methods. In conventional rats, 65% of the administered cellulose and 54%
      of the administered polydextrose were recovered in feces. In conventional rats,
      appreciable amounts of cellulose were fermented and an available energy value of
      3.5 kJ/g was calculated. Calculation of the total availability of polydextrose,
      taking into account the direct absorption of small amounts of monomers present
      and the efficiency of fermentation, indicates an available energy value of 4.7
      kJ/g.

PMID- 1619471
TI  - Mitotic activity in mice is suppressed by energy restriction-induced torpor.
AB  - We monitored core body temperature by telemetry in energy-restricted (201 kJ/wk)
      and control (397 kJ/wk) C57BL/6 and SHN/C3H F1 mice to determine whether torpor
      may be involved in the suppression of mitotic activities resulting from energy
      restriction. The energy restriction regimen employed inhibited the development of
      cancer and greatly extended longevity in both these mouse strains. Male and
      female C57BL/6 mice subjected to energy restriction from 4 wk of age and tested
      at 3 mo of age became torporific (body temperature less than 31 degrees C) at
      ambient air temperatures of 20-22 degrees C, whereas control animals stayed
      euthermic (greater than 35 degrees C). Energy restriction also induced torpor in
      3- and 13-mo-old SHN/C3H F1 female mice, whereas 3-, 13- and 24-mo-old control
      mice were euthermic. Energy restriction decreased mitotic activities to
      approximately 30% of control values in both jejunum and epidermis in 3-mo-old
      female C57BL/6 mice maintained at 20-22 degrees C. However, this suppression of
      mitotic activities was antagonized by housing the energy-restricted mice at 30
      degrees C for 2 wk, indicating that torpor plays a substantial role in
      suppressing mitotic activities in energy-restricted mice.

PMID- 1619473
TI  - Retention of 14C label is lower in old than in young Wistar rats after oral
      dosing with [14C]pyridoxine.
AB  - Ten young (6-mo-old) and ten old (31-mo-old) male Wistar rats fed a purified diet
      (250 g casein and 6 mg pyridoxine.HCl per kg) from weaning were given either a
      single oral dose or five repeated oral doses of 14C-labeled pyridoxine. At
      various times after dosing animals of each age group were killed. Absorption of
      orally dosed [14C]pyridoxine.HCl was not found to be different between young and
      old rats. Total body retention of 14C label administered was modestly but
      significantly lower in old than in young rats. However, distribution of 14C label
      over various tissues and among the various B-6 vitamers was similar. No
      significant age-related differences were observed in the biokinetic parameters
      derived from urinary excretion data. Contrary to the findings for 14C label
      distribution, age-related differences were observed for absolute level of tissue
      14C-labeled vitamers. The lower [14C]pyridoxal-5'-phosphate content in liver and
      muscle, and [14C]pyridoxamine-5'-phosphate content in liver, of old animals
      indicated an age-related difference in liver and muscle vitamin B-6 disposition.
      In both young and old rats, and in both liver and muscle tissue, pyridoxamine-5'
      phosphate was observed to be a faster-exchanging tissue vitamin B-6 pool than
      pyridoxal-5'-phosphate.

PMID- 1619474
TI  - Dietary arginine deficiency alters flux of glutamine and urea cycle intermediates
      across the portal-drained viscera and liver of rats.
AB  - The effect of an arginine-deficient diet on net flux of amino acids across the
      portal-drained viscera and across the liver was studied in rats. Blood was
      obtained after food deprivation and 1 and 2 h after a meal of a 1.0% arginine
      control diet or an arginine-deficient diet containing 3.4% glutamate. The
      arginine-deficient diet decreased net portal-drained viscera flux of arginine and
      increased net portal-drained viscera flux of ornithine and proline. However, net
      portal-drained viscera flux of citrulline (0.35 +/- 0.05 mumol/min) was not
      influenced by diet; of this rate, 46% (0.16 mumol/min) bypassed the liver and was
      available for extrahepatic arginine synthesis. However, rats continued to exhibit
      signs of arginine deficiency such as decreased blood arginine concentrations (by
      28%) and increased orotic acid excretion (90-fold). Arterial blood glutamine
      concentration was 25% higher in rats fed the arginine-deficient diet. In the fed
      state, net hepatic flux of glutamine was elevated from 0.15 (control) to 1.39
      mumol/min, indicating that the liver was a major source of the increased blood
      glutamine concentrations. Increased production of hepatic glutamine and orotic
      acid may help rats compensate for dietary arginine deficiency, whereas splanchnic
      output of citrulline was not increased with dietary arginine deficiency even with
      a substantial dietary supply of glutamate.

PMID- 1619472
TI  - Sodium-dependent transport of riboflavin in brush border membrane vesicles of rat
      small intestine is an electrogenic process.
AB  - Transport of riboflavin across the intestinal brush border membrane in rats was
      studied using the brush border membrane vesicle technique. Uptake of riboflavin
      into the membrane vesicles was predominantly the result of transport into an
      osmotically reactive space. Binding of the substrate to the membrane surface
      increased as a function of time and with lowering of the incubation buffer pH.
      The transport of riboflavin at low substrate concentrations was carrier mediated
      and Na+, but not K+, dependent with a distinct overshoot phenomenon. Uptake as a
      function of substrate concentration revealed dual transport characteristics in
      the presence of a Na+ gradient but linearity in the presence of a K+ gradient.
      The apparent Km value of the saturable, carrier-mediated and Na(+)-dependent
      component was calculated by two independent methods to be 0.25 or 0.38 mumol/L.
      Because uptake of riboflavin into brush border membrane vesicles in the presence
      of a Na+ gradient was increased by a valinomycin-induced K(+)-diffusion potential
      and by sodium thiocyanate vs. NaCl (intravesicular negative membrane potential),
      riboflavin transport is most likely an electrogenic process. The Na(+)-dependent
      riboflavin uptake into the vesicles was inhibited by structural analogues at low
      substrate concentrations only and increased by a low buffer pH.

PMID- 1619475
TI  - Energy expenditure in rats maintained with intravenous or intragastric infusion
      of total parenteral nutrition solutions containing medium- or long-chain
      triglyceride emulsions.
AB  - Energy expenditure was determined in male Fischer 344 rats (235-246 g) fed by
      intravenous (IV) or intragastric (IG) infusion with total parenteral nutrition
      solutions providing 65% of nonprotein energy as fat from long-chain triglyceride
      (LCT) or a 3:1 admixture of medium-chain triglyceride (MCT) and LCT emulsions.
      Respiratory gas exchange and somatomotor activity were assessed continuously for
      24 h during d 5 and 11 of infusion feeding. The MCT infusion resulted in one
      third the weight gain noted with LCT infusion (MCT, 10 +/- 2 g/14 d; LCT, 32 +/-
      4 g/14 d; P less than 0.0001). Insulin concentration was 60% higher with IV than
      with IG infusion and approximately 100% higher with IV-MCT than with IG-MCT or
      LCT infusion (P less than 0.05). Rats receiving IV infusion of MCT displayed
      similar levels of motor activity but 8-13% greater daily energy expenditure
      (kJ.kg-0.75.kJ intake-1) than rats receiving IG-MCT or LCT infusion (P less than
      0.05). The MCT infusion also resulted in an elevation in respiratory quotient
      after cessation of nutrient infusion (MCT, 0.87-0.92; LCT, 0.83-0.85; P less than
      0.05). Total and resting energy expenditure decreased approximately 13% from 5 to
      11 d of infusion feeding. The lower weight gain and greater energy expenditure
      seen with MCT- compared with LCT-supplemented total parenteral nutrition may be
      mediated by higher insulin concentrations.

PMID- 1619476
TI  - Biotin deficiency in rats: disturbances of leucine metabolism are detectable
      early.
AB  - 3-Methylcrotonyl-CoA originates from catabolism of leucine and is normally
      metabolized to acetyl-CoA. However, in biotin deficiency, reduced hepatic
      activity of the biotin-dependent enzyme methylcrotonyl-CoA carboxylase causes the
      enzyme's substrate 3-methylcrotonyl-CoA to be shunted via an alternate pathway to
      3-hydroxyisovaleric acid (3-HIA), which is excreted at increased rates in the
      urine. In a previous study, unequivocal separation in 3-HIA excretion rates
      between biotin-deficient and control animals was not apparent until d 35 of
      feeding a diet that induced biotin deficiency. The present study tested the
      hypothesis that abnormal 3-HIA excretion could be detected earlier in the course
      of biotin deficiency if 3-HIA were more accurately measured using a method that
      incorporated an improved extraction regimen, deuterated 3-HIA as internal
      standard, and unlabeled 3-HIA as external standard. Biotin deficiency was induced
      in rats by feeding a diet containing avidin; control rats received the same diet
      and biotin injections. With the more accurate method, unequivocal detection of
      deficiency was possible in all deficient rats by d 16. This study provides
      evidence that, in rats, reduction of analytical error allows earlier detection of
      biotin deficiency and that disturbances of leucine metabolism occur earlier than
      previously appreciated.

PMID- 1619477
TI  - Oleic acid (18:1) in plasma, liver and brain myelin lipid of piglets fed from
      birth with formulas differing in 18:1 content.
AB  - Recent studies have shown reduced 18:1 fatty acids in brain total lipid of
      piglets fed formula with 17% 18:1 fatty acids rather than sow milk providing 37%
      18:1. Because 18:1 is a major fatty acid in brain myelin lipid and is rapidly
      deposited during myelination, it is important to know if this reflects deposition
      of myelin lipid containing reduced 18:1 and/or delayed myelination, or is related
      to changes in other brain membranes. Therefore, these studies determined the
      myelin total lipid, phosphatidylethanolamine and plasma and liver phospholipid
      fatty acids in piglets fed from birth to 15 d with formula containing (g/100 g
      fatty acids): 18:1, 17 and 18:3(n-3), 0.8; 18:1, 38 and 18:3(n-3), 0.6 fatty
      acids; or 18:1, 40 and 18:3(n-3), 4; or sow milk. Different levels of formula
      18:3(n-3) fatty acids were studied because of the known effect of essential fatty
      acid deficiency on myelination. The brain 2',3'-cyclic nucleotide 3'
      phosphohydrolase (CNPase) activity and cerebroside concentration were also
      determined and used as indicators of myelination. Piglets fed the low 18:1
      formula had lower 18:1 fatty acids in their plasma and liver phospholipid than
      sow milk-fed piglets. Formula providing a similar level of 18:1 to sow milk
      resulted in higher 18:1 fatty acids in the piglet plasma and liver phospholipid
      than in the sow milk-fed piglets. The brain myelin monoenoic fatty acids, CNPase
      activity and cerebroside concentration were similar in sow milk- and formula-fed
      piglets, irrespective of the formula 18:1 or 18:3(n-3) content.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1619478
TI  - Type I iodothyronine deiodinase activity after high selenium intake, and
      relations between selenium and iodine metabolism in rats.
AB  - Type I iodothyronine deiodinase (I-D), which catalyzes the production of the
      thyroid hormone 3,3',5-triiodothyronine from thyroxine, has recently been
      identified as a selenoenzyme. It is therefore of interest to investigate the
      relationships between selenium and iodine metabolism. In the livers of Se
      deficient rats I-D activity was inhibited; the production of 3,3',5
      triiodothyronine and 3,3'-diiodothyronine from added thyroxine was decreased by
      greater than 95% relative to Se-adequate controls. The hepatic I-D activity was
      also reduced in rats fed a diet with a low iodine concentration. Unaltered
      glutathione peroxidase activities in liver and plasma of these rats suggest,
      however, that with normal Se intake this metabolic pathway of Se is not affected
      by iodine depletion. When rats were administered 75Se-labeled selenium at levels
      equal to the amounts ingested from diets with Se concentrations of 0.3 or 2 mg
      Se/kg, greater Se concentrations were found in the thyroid and liver of the
      animals receiving the higher dosage. The thyroidal 3,3',5-triiodothyronine and
      thyroxine concentrations, however, were comparable in rats fed diets with 0.3 mg
      Se/kg diet as selenite and 2 mg Se/kg as selenite or L-selenomethionine. The
      measurement of the hepatic I-D and glutathione peroxidase activities in these
      animals showed that excessive Se supply does not elevate the activities of the
      two enzymes but might even have the opposite effect. At high Se intake tissue Se
      concentration cannot therefore be used as indicator of the selenoenzyme
      activities.

PMID- 1619479
TI  - Copper deficiency alters vasodilation in the rat cremaster muscle
      microcirculation.
AB  - The effects of copper deficiency on smooth muscle relaxation were studied in the
      cremaster muscle microcirculation. Male Sprague-Dawley rats were fed either a
      copper-adequate diet (CuA, 5 micrograms copper/g diet) or copper-deficient diet
      (CuD, no added copper) for 17-27 d before experimentation. In vivo television
      microscopy was used to quantify agonist-induced diameter changes in third-order
      arterioles. Endothelium-dependent relaxation, which is hypothesized to be
      mediated by nitric oxide, was attenuated by copper deficiency. Both receptor
      (acetylcholine, 10(-7) to 10(-4) mol/L) and nonreceptor (calcium ionophore
      A23187, 10(-8) to 10(-7) mol/L) relaxation was decreased. Nitric oxide-mediated
      dilation, which was endothelium-independent (10(-7) to 10(-5) mol/L sodium
      nitroprusside), was also attenuated by copper deficiency. Maximal responses were
      as follows: for acetylcholine, 136 +/- 16% CuA vs. 45 +/- 15% CuD; for A23187,
      104 +/- 16% CuA vs. 21 +/- 11% CuD; and for nitroprusside, 125 +/- 12% CuA vs. 46
      +/- 13% CuD. There was no difference in microvascular dilation between groups
      treated with 10(-6) to 10(-4) mol/L of the phosphodiesterase inhibitor papaverine
      (e.g., CuA 109 +/- 11% vs. CuD 133 +/- 21% with 10(-4) mol/L). These results
      suggest that copper deficiency inhibits the nitric oxide-mediated mechanism of
      vascular smooth muscle relaxation without altering the capacity of the smooth
      muscle to relax. We suggest that copper deficiency either decreases nitric oxide
      radical availability or disrupts the nitric oxide-guanylate cyclase interaction.

PMID- 1619480
TI  - Modification of the clastogenic activity of X-ray and 6-mercaptopurine in mice by
      prefeeding with vitamins C and E.
AB  - The effect of a 30-d pretreatment with vitamin C (L-ascorbic acid) in the
      drinking water and vitamin E (all-rac-alpha-tocopherol) in the diet on the
      clastogenic activity induced by X-rays and 6-mercaptopurine was investigated in
      female ICR/Jcl mice by the bone-marrow micronucleus test. Prefeeding with vitamin
      E-deficient diets led to a significant decrease in serum vitamin E concentration
      and to an enhancement of micronucleus formation by X-rays in bone marrow cells.
      Although dietary supplementation with vitamin E significantly increased the
      vitamin E concentration in serum, it did not affect the frequency of X-ray
      induced micronuclei. Treatment with a high level of vitamin C in drinking water
      was effective in protecting against micronucleus formation by X-rays. The
      increase in micronucleus frequency in the vitamin E-deficient mice compared with
      the mice fed vitamin E-normal diets was no longer observed when a high level of
      vitamin C in drinking water was given simultaneously. The most efficient
      protective action against X-rays was observed when vitamin E-supplemented diets
      and a high level of vitamin C in drinking water were used together as a
      pretreatment. Any combination of the vitamins did not affect the micronucleus
      induction by 6-mercaptopurine.

PMID- 1619481
TI  - Cardiac ultrastructural and electrophysiological abnormalities in postweanling
      copper-restricted and copper-repleted rats in the absence of hypertrophy.
AB  - Cardiac ultrastructural and functional characteristics were determined in copper
      depleted and copper-repleted rats. Male weanling rats were randomized into five
      groups that were fed either copper-adequate or copper-deficient diets. After 5
      wk, one group fed each diet was studied to obtain baseline values. At this time,
      one copper-adequate postweanling group continued to receive the adequate diet as
      control, one deficient postweanling group was fed the adequate diet to evaluate
      the effect of copper repletion and one postweanling adequate group was fed the
      deficient diet to evaluate copper depletion in relatively older rats. These
      dietary treatments were continued for six additional weeks. Copper-depleted rats
      of both ages exhibited significant cardiac ultrastructural pathology and
      electrocardiogram abnormalities and the postweanling copper-depleted rats
      exhibited these abnormalities in the absence of hypertrophy and anemia. Increased
      mitochondrial volume density, disarranged cristae, and nonaligned myofibrils with
      disturbances at Z-bands were displayed. Additionally, all copper-depleted rats
      demonstrated fragmented basal laminae at capillary-myocyte interface. Increased
      QRS amplitude and notching and greater QT intervals were displayed. Copper
      repleted rats exhibited some, but not total, reversal of these abnormalities.
      These results suggest that capillary-myocyte interface changes may play an
      important role in the developing pathology of copper depletion.

PMID- 1619482
TI  - Zinc nutritional status modulates the response of 1,25-dihydroxycholecalciferol
      to calcium depletion in rats.
AB  - Male Lewis rats (n = 27) were fed a nonpurified diet containing 0.9% calcium,
      0.7% phosphorus, and 0.005% zinc until 8 wk of age. At this time rats were
      assigned randomly to one of two groups. Both groups were fed a low calcium, low
      zinc, purified diet (0.2% calcium, 0.4% phosphorus, less than 0.00007% zinc), but
      one group was fed 1.78 mg Zn/(animal.d). The zinc-replete animals were
      individually matched by weight to the zinc-depleted animals and pari-fed.
      Balances and plasma concentrations of zinc, calcium, and phosphorus and
      parathyroid hormone, 25 hydroxycholecalciferol [25(OH)D] and 1,25
      dihydroxycholecalciferol [1,25(OH)2D] were determined at the start of calcium
      depletion and 2 wk later. Calcium and 25(OH)D levels were lower in both groups
      after calcium depletion. Dietary zinc had no significant effect on calcium or
      25(OH)D levels. Phosphorus concentrations were lower after calcium depletion, but
      phosphorus concentration was higher in the zinc-depleted compared with the zinc
      replete group at the end of the experiment. 1,25(OH)2D increased in both groups,
      but was higher in the zinc-replete than the zinc-depleted group at the end of the
      experiment. Calcium and phosphorus balances were greater in the zinc-depleted
      group at the end of the experiment. We conclude zinc depletion diminishes the
      response of 1,25(OH)2D to calcium depletion in rats. The mechanism is unknown,
      but may involve nonhormonally mediated changes in gastrointestinal absorption of
      calcium and phosphorus or an affect of zinc on extraintestinal processes.

PMID- 1619483
TI  - Dietary sucrose but not starch promotes protein-induced differences in rates of
      VLDL secretion and plasma lipid concentrations in rats.
AB  - Casein instead of soybean protein in a low fat, cholesterol-free diet containing
      sucrose increases both lipid secretion by rat liver and plasma cholesterol
      concentration. Male rats were studied to determine whether dietary sucrose is a
      prerequisite for these protein-induced differences of lipid metabolism in vivo.
      After 6 wk of consuming either casein plus sucrose, soybean protein isolate plus
      sucrose, casein plus starch or soybean protein isolate plus starch (carbohydrate,
      69 g/100 g diet; protein, 20 g/100 g diet) plasma lipids were measured. VLDL
      degradation was blocked by Triton WR-1339 and rates of lipid secretion were
      calculated from the observed linear increase in plasma levels with time. Plasma
      cholesterol concentrations and rates of secretion of VLDL cholesterol and
      triglycerides were 27, 47 and 34% higher, respectively, in animals fed casein
      plus sucrose compared with soybean protein plus sucrose. These differences were
      clearly diminished or absent when starch was the dietary carbohydrate. The data
      substantiate the finding that dietary sucrose but not dietary starch promotes a
      casein-induced increase in hepatic cholesterol secretion and thus contributes to
      casein-induced hypercholesterolemia in rats. On the contrary, differences of
      triglyceride secretion were not reflected in different plasma lipid
      concentrations.

PMID- 1619484
TI  - Low protein diets potentiate lithocholic acid-induced cholestasis in rats.
AB  - Earlier studies showed that low protein diets (LPD) reduce bile flow and bile
      acid secretion. We therefore examined the effect of LPD on lithocholic acid (LCA)
      induced intrahepatic cholestasis. Female Sprague-Dawley rats were fed LPD (8%
      casein) soon after weaning for 4 or 12 wk, and then were injected intravenously
      with a single dose of LCA (4 mumol/100 g body wt). Bile was collected for 30-min
      periods, and bile flow as well as biliary lipid secretory rates were measured.
      Bile acid metabolism was also studied and the results were compared with those
      obtained in rats fed an adequate protein diet (26% casein). The LPD produced
      significantly lower bile flow and bile acid secretion, which were attributed to a
      reduced bile acid pool and a reduction in synthesis. They also enhanced the LCA
      induced decline in bile flow, and rate of biliary output of total bile acids,
      phospholipids and cholesterol. The LPD were also associated with impaired LCA
      secretion in bile and increased retention in plasma and liver. Studies of LCA
      metabolism in rats fed a LPD indicated lower hepatic LCA hydroxylation, a greater
      percent contribution of glyco conjugates and lower levels of tauro conjugates.
      The present findings suggest that the reduced bile acid pool size, diminished LCA
      excretion and biotransformation to less toxic bile acids may explain the greater
      cholestasis in LPD-fed rats.

PMID- 1619485
TI  - Company-sponsored health exams.

PMID- 1619486
TI  - Working conditions.

PMID- 1619487
TI  - Excess cancer among white-collar workers in studies based on death certificates.

PMID- 1619488
TI  - Factors in job decisions.

PMID- 1619489
TI  - Preemployment drug screening. The epidemiologic issues.
AB  - Deciding to test applicants for employment for drugs raises complex, legal,
      moral, economic, and technical issues. However, we focus here on three
      epidemiologic issues germane to this decision. In one industry, the United States
      Postal Service, two recent studies suggest associations between positive
      preemployment drug screens and turnover, absenteeism, accidents, injuries, and
      discipline, but these associations are weaker than had been assumed. Cost-benefit
      analyses show that whether drug screening saves money depends both on the costs
      associated with adverse outcomes such as accidents and on the prevalence of drug
      use in the population screened. Finally, the predictive value of a positive drug
      screen also depends crucially on the prevalence of drug use. In populations with
      low prevalence of drug use, a large proportion of the positives may be false
      positives.

PMID- 1619491
TI  - Personal and job characteristics of musculoskeletal injuries in an industrial
      population.
AB  - A cross-sectional study was conducted of 10,350 full-time regular employees who
      worked at Shell Oil Company's manufacturing facilities between 1987 and 1989. Two
      hundred seventy-five employees with low-back and 456 with nonlow-back
      musculoskeletal injuries were compared with 8295 employees who did not have
      musculoskeletal injuries during this period. Based on morbidity data collected
      from a prospective health surveillance system, this study shows that estimated
      relative risks (RRs) for low-back injuries are significantly higher among smokers
      (RR = 1.54, P less than .01) and overweight persons (RR = 1.42, P less than .01).
      This observation is also true for nonlow-back musculoskeletal injury (RR = 1.23,
      P = .05 for smokers and RR = 1.53, P less than .01 for overweight persons). In
      addition, persons in potentially more physically demanding jobs (primarily
      maintenance job titles) had an increased RR for both low-back and nonlow-back
      musculoskeletal injuries (RR = 1.57, P less than .01 and RR = 1.35, P = .02,
      respectively). The findings of this study suggest that it may be possible to
      reduce the impact of musculoskeletal injury through implementation of an
      integrated injury prevention program. Such programs would include not only the
      traditional elements of job factors evaluation and modifications, employee
      education and training, and an overall increased attention to ergonomics but also
      medical counseling and support for personal fitness programs, workplace smoking
      cessation programs, and weight-reduction programs.

PMID- 1619490
TI  - Olfactory impairment after chronic occupational cadmium exposure.
AB  - Disorders of olfaction affect millions of Americans, but the extent to which
      occupational and environmental exposures contribute to these disorders is
      unknown. We examined 55 workers with chronic occupational exposure to cadmium
      fumes in a brazing operation. We estimated cadmium body burden using urinary
      cadmium levels and assessed cadmium-induced renal damage by urinary beta 2
      microglobulin levels. We quantified olfactory function using a standardized test
      that measured two components of olfaction, butanol detection threshold and odor
      identification, and compared workers with a reference group. Forty-four percent
      of the cadmium-exposed workers were mildly hyposmic, and 13% were either
      moderately or severely hyposmic. In the reference group, 31% were mildly
      hyposmic, and the rest were normosmic. The workers with both high urinary cadmium
      levels and tubular proteinuria had the most significant olfactory dysfunction,
      with a selective defect in odor detection threshold. Our findings suggest that
      chronic occupational cadmium exposure sufficient to cause renal damage also is
      associated with impairment in olfactory function.

PMID- 1619492
TI  - Effects of aircraft noise on hearing and auditory pathway function of airport
      employees.
AB  - The effects of aircraft noise on hearing and auditory pathway function were
      studied in 112 airport employees, both by audiometry and brainstem auditory
      evoked potentials (BAEPs) to evaluate cochlear function and to verify the
      possibility of retrocochlear involvement. Employees were divided into five groups
      according to their daily jobs. Group A was made up of 23 maintenance workers,
      Group B of 20 firemen, Group C of 24 policemen, Group D of 34 airline ground
      staff, and Group E of 14 civil servants. The typical audiogram pattern of noise
      induced hearing loss (NIHL) was a dip at 3 or 4 kHz and moderate hearing loss in
      the frequency range of 6 to 8 kHz. The results of audiograms in this study
      revealed the prevalence rate of high-frequency loss in all employees was 41.9%.
      The incidences of NIHL were highest in the groups of maintenance workers (65.2%)
      and firemen (55.0%), who are almost continuously exposed to aircraft noise. As
      for the BAEPs, both click threshold and latencies showed that the impairment was
      most severe in the groups of maintenance workers and firemen. There was
      prolongation in central conduction time, shown mainly in intervals of I-V and III
      V. This suggests that involvement of the central auditory pathway, especially
      between the pons and midbrain, is present. In summary, the degree of auditory
      damage coincided with job patterns. Furthermore, damage of both peripheral
      cochlear organs and the central auditory pathway by high-frequency aircraft noise
      exposure was confirmed.

PMID- 1619493
TI  - Cobalt cardiomyopathy. A report of two cases from mineral assay laboratories and
      a review of the literature.
AB  - Two young men employed in the mineral assay industry developed non-inflammatory
      cardiomyopathy. By review of clinical findings, elicitation of occupational and
      environmental histories, work-site evaluations, and ascertainment of tissue
      cobalt levels, Nevada Public Health authorities confirmed these cases to be due
      to occupational cobalt exposure. Hair and heart cobalt levels were elevated for
      the cases, but control samples had no detectable cobalt. Excess ischemic heart
      disease mortality among cobalt-exposed workers may reflect misdiagnosis of
      cardiomyopathy.

PMID- 1619494
TI  - The core technology of work-site wellness.
AB  - Work-site wellness programming his evolved through four stages of development.
      This article proposes a core technology of work-site wellness programs comprised
      of 10 dimensions that organize and systematize the range of activities undertaken
      by such programs. These 10 dimensions address the following tasks: (1)
      establishing program policy, (2) assessing the health status of the work force,
      (3) linking the work site with service providers, (4) linking individual
      employees with services appropriate to their needs, (5) providing options for
      behavior change strategies and interventions, (6) engaging employees in these
      various interventions, (7) organizing work-sitewide activities to support health
      improvement, (8) reviewing and altering organizational policies to make the work
      environment more supportive of health, (9) routinely evaluating program process
      and changes in health risks, and (10) periodically assessing longer-term program
      results. Two future dimensions are described that require further evidence of
      impact. Arguments and evidence in support of each dimension are provided,
      including discussion on how activities within each dimension work together to
      produce maximum effectiveness, and how various dimensions relate to each other to
      make an effective overall program.

PMID- 1619495
TI  - Neuropsychologic and postural sway improvement after Ca(++)-EDTA chelation for
      mild lead intoxication.
AB  - Neuropsychologic and postural sway test performance improved following Ca(++)
      EDTA chelation in a bridge worker with persistent central nervous system (CNS)
      symptoms 2 years after an episode of subacute lead intoxication. This case
      highlights the value of these tests in verifying symptoms and documenting
      response to therapy. Persistent disabling CNS symptoms with objective
      neuropsychologic deficits was unexpected, given the borderline total body lead
      burden.

PMID- 1619496
TI  - Cost effectiveness of work-site cholesterol screening and intervention programs.
AB  - A study was conducted to evaluate the costs and cost effectiveness of behavioral
      interventions designed to reduce high serum cholesterol levels in a manufacturing
      population. A sample of 3202 employees participating in a screening was separated
      into four intervention groups and a control group. All four intervention groups
      received an educational program of varying length (1 or 3 months). Two of these
      groups also received incentives. A second screening was conducted after the
      interventions to determine effectiveness. The 1-month educational intervention
      with incentive and the 3-month educational intervention had the lowest costs per
      participant ($46.28 and $53.09, respectively) and costs per borderline high or
      high risk participant reducing cholesterol greater than 10% ($285.89 and $351.56)
      and the greatest effectiveness per dollar spent (0.60 and 0.62). The cost
      effectiveness analyses were affected by the impact of the intervention and
      participation rate. Sensitivity analyses showed that increasing participation had
      a greater impact on the less cost-effective interventions.

PMID- 1619497
TI  - Introduction to a structural basis for renal and vascular complications in
      diabetes and hypertension.
AB  - BACKGROUND: An understanding of the structural basis for cardiovascular and renal
      complications in diabetes and hypertension is critical to design-focused
      intervention strategies. HYPOTHESIS: The processes leading to vascular damage in
      the kidney and in the arteries in diabetes and hypertension appear to be
      characterized by hypertrophic/hyperplastic changes in a number of cell types
      (such as smooth muscle cells, fibroblasts, mesangial cells) and by excessive
      deposition of extracellular matrix material. Markers of cell
      growth/proliferation, such as Na(+)-H+ exchange, show increased activity in
      diabetic patients with renal disease and in patients with essential hypertension.
      Insulin resistance is a feature of arterial hypertension and diabetes and may
      contribute to renal and cardiovascular damage in these patients. A number of risk
      factors for cardiovascular disease cluster in the subset of diabetic patients
      prone to renal disease. These include dyslipidaemia, left ventricular hypertrophy
      and hypertension. It is postulated that a familial predisposition to renal and
      cardiovascular disease is the underlying reason for the susceptibility to the
      diabetic cardiorenal syndrome. CONCLUSION: In the management of diabetes and
      hypertension, it may prove possible to instigate preventive strategies by using
      therapeutic agents such as angiotensin converting enzyme inhibitors, which have
      the potential to interfere with the haemodynamic, growth and insulin sensitivity
      processes that contribute to vascular damage.

PMID- 1619498
TI  - What to treat? The structural basis for renal and vascular complications and
      hypertension, and the role of angiotensin converting enzyme inhibition.
      Symposium, 26th meeting of the European Association for the Study of Diabetes.
      Dublin, Ireland, 10 September 1991.

PMID- 1619499
TI  - Renal structure and function in insulin-dependent diabetes mellitus in man.
AB  - PURPOSE: To review renal pathological changes in diabetes, which include
      thickening of all renal extracellular basement membranes and the mesangial matrix
      and, to a lesser extent, mesangial cell expansion. CRITICAL RENAL LESIONS IN
      DIABETIC NEPHROPATHY: Two renal lesions appear critical in diabetic nephropathy.
      Mesangial expansion out of proportion to the size of the glomerulus is inversely
      related to proteinuria, hypertension and a declining glomerular filtration rate.
      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.
      FUTURE RESEARCH: Longitudinal studies of renal structure and function and a
      simultaneous study of potential risk factors and pathways of injury are necessary
      to develop more refined predictors and clearer pathogenic concepts of this
      important diabetic complication.

PMID- 1619500
TI  - Micro-albuminuria and large vessel disease in diabetes.
AB  - BACKGROUND: Atherosclerosis is a major cause of morbidity and mortality in
      insulin-dependent diabetes mellitus. Recent studies have shown that albuminuria
      is a predictor of cardiovascular disease in these patients and there is a
      particularly high incidence of coronary heart disease in the early stages of
      albuminuria. AVAILABLE EVIDENCE: A number of established cardiovascular risk
      factors, such as elevated blood pressure, atherogenic changes in the plasma
      concentrations of lipids and lipoproteins, elevated plasma levels of fibrinogen
      and, probably, hyper-reactivity of platelets are present in patients with
      diabetic nephropathy. Further, albuminuria may be a marker of generalized disease
      in the vascular wall of small and large blood vessels. Findings of an elevated
      rate of transcapillary albumin escape, an elevated plasma concentration of von
      Willebrand's factor and impaired fibrinolytic capacity in early diabetic
      nephropathy support this hypothesis. CONCLUSION: The initial pathophysiological
      mechanisms involved in diabetic nephropathy are still hypothetical and largely
      unknown.

PMID- 1619501
TI  - The vascular endothelium in diabetes and hypertension.
AB  - PURPOSE: To review recent research into the function of endothelial cells in
      relation to diabetes and hypertension, and the implications for cardiovascular
      control. ENDOTHELIAL FUNCTIONS: Endothelial cells extract and inactive
      circulating hormones, convert inactive precursors into vasoactive products, and
      synthesize and secrete vasodilator and vasoconstrictor mediators, which also
      modify platelet function and cell growth. DIABETES: Abnormalities in endothelial
      cell morphology and function are recognized features of diabetes. Diminished
      endothelium-dependent relaxation and enhanced endothelium-dependent contraction
      have been described. HYPERTENSION: Similar defects in endothelial cell function
      have been demonstrated in animal and human hypertension. These might lead to
      increased vascular tone, vasospasm, platelet activation and atheroma. THERAPY:
      Certain drugs modify or mimic endothelium-derived mediators. Endothelial
      dysfunction may contribute to cardiovascular pathology, but the precise clinical
      and therapeutic significance of modifying endothelial function remains to be
      determined.

PMID- 1619502
TI  - Micro-albuminuria and the organ-damage concept in antihypertensive therapy for
      patients with insulin-dependent diabetes mellitus.
AB  - OBJECT OF TREATMENT: Antihypertensive treatment in hypertensive patients with
      insulin-dependent diabetes mellitus is intended to prevent long-term
      complications, particularly diabetic nephropathy. DIABETIC HYPERTENSIVES WITH
      ABNORMAL ALBUMINURIA: Antihypertensive therapy, particularly with angiotensin
      converting enzyme (ACE) inhibitors, typically produces a permanent reduction in
      the decline of the glomerular filtration rate (GFR) in diabetic patients with
      abnormal albuminuria. The rate of decline in the GFR during antihypertensive
      treatment is a well accepted end-point in diabetic renal disease. DIABETIC
      HYPERTENSIVES WITHOUT ABNORMAL ALBUMINURIA: In insulin-dependent diabetic
      patients with essential hypertension but with normal urinary albumin excretion
      there is no reduction in the GFR. Longitudinal studies have shown a fall in the
      GFR only in the presence of significantly increased urinary albumin excretion.
      ABNORMAL ALBUMINURIA AS A MARKER OF INCIPIENT NEPHROPATHY: Micro-albuminuria and
      proteinuria may be pathogenetic factors in the development of nephropathy,
      leading eventually to end-stage renal failure in diabetic patients. Measurements
      of micro-albuminuria and proteinuria, in addition to blood pressure recordings,
      might therefore be used as indications for initiating antihypertensive treatment.
      NEED TO MONITOR PATIENTS FOR ABNORMAL ALBUMINURIA: Transglomerular macromolecular
      traffic may produce mesangial damage, with subsequent glomerulopathy and diabetic
      nephropathy. Thus, close monitoring for micro-albuminuria and proteinuria is
      desirable in the management of diabetic hypertensive patients.

PMID- 1619504
TI  - Abstracts presented at the 14th Scientific Meeting of the International Society
      of Hypertension. 14-19 June 1992, Madrid, Spain.

PMID- 1619503
TI  - Potassium as a link between insulin and the renin-angiotensin-aldosterone system.
AB  - PURPOSE: To focus on the interactions between insulin secretion, glucose
      tolerance and insulin sensitivity on the one hand and the renin-angiotensin
      aldosterone system on the other. EFFECTS ON INSULIN: Insulin is a potent stimulus
      for hypokalaemia, sparing body potassium from urinary excretion by transporting
      it into cells. Potassium also appears to play a key role in the antinatriuretic
      effect of insulin. Insulin-induced hypokalaemia increases plasma renin and
      angiotensin II levels while decreasing the serum aldosterone concentration. In
      turn, the renin-angiotensin-aldosterone system affects glucose tolerance by
      modulating plasma potassium levels, which act as a stimulus for glucose-induced
      insulin release. EFFECTS OF ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITION:
      Interference with the renin-angiotensin-aldosterone system by ACE inhibition
      blunts the hypokalaemic response to insulin, thereby improving glucose-induced
      insulin release and oral glucose tolerance. ACE inhibition, however, does not
      cause major changes in insulin sensitivity. POTASSIUM AND BLOOD PRESSURE: Plasma
      potassium levels are inversely related to blood pressure, both in population
      surveys and in intervention studies. In addition, in patients with essential
      hypertension, the level of plasma potassium appears to predict the blood pressure
      response to ACE inhibition. SUMMARY: Potassium metabolism is an important link
      between carbohydrate metabolism and the renin-angiotensin-aldosterone system by
      way of a double-feedback mechanism. Through the potential effects on blood
      pressure control, plasma levels of potassium represent a link between insulin and
      blood pressure in humans.

PMID- 1619505
TI  - [Comparison of CT and MRI in diagnosis of parapharyngeal tumors].
AB  - Recently, the usefulness of CT and MRI in diagnosing parapharyngeal tumors has
      been established. At the same time, several modalities for these imagings, i.e.
      plane and enhanced CT, T1, 2 weighted MRI and Gadolinium enhanced MRI, have been
      developed. We compared the image findings of 12 tumors involving the
      parapharyngeal space with their operative records. T1 was most suited to
      diagnosing the sites of origins of tumors because of its superior depiction of
      the internal carotid artery and parapharyngeal fat. Enhanced CT was also superior
      in depicting these structures, but in cases where the parapharyngeal fat was
      diminished, or the parapharyngeal fat had been invaded by malignant tumor,
      enhanced CT was inferior to T1. The spatial resolution of T2 was poor, T2 was
      thus not useful in diagnosing the sites of origins of tumors. Because tumor
      intensity tended to be similar to that of fat in Gadolinium enhanced MRI imaging,
      Gadolinium was not as useful as T1. In diagnosing the extents of tumors, we
      examined the depiction of both tumor-fat and tumor-muscle interfaces. With regard
      to the depiction of the tumor-fat interface, enhanced CT and T1 were most useful.
      In diagnosing the tumor-muscle interface, Gadolinium enhanced MRI was most
      suitable. The net result is that MRI is superior to CT.

PMID- 1619506
TI  - [On the postoperative mucocele of the maxillary sinus and its simulating cases. A
      clinical treatise].
AB  - The postoperative mucocele of the maxillary sinus typically occurs after 11-15
      years after the initial Caldwell-Luc operation with the complaints of swollen and
      painful cheek. Typical signs and symptoms will be divided into two groups, the
      one which is associated with expansive lesions and the other with pains along the
      various branches of the maxillary nerve. In the clinical set-ups, cases with the
      similar signs and symptoms, and yet lacking definite mucoceles, are often
      encountered. The present treatise will compare 86 definite cases and 27
      simulating cases as to the history, signs and symptoms, various modalities of
      imaging (CT & MRI), and the possible causes leading to simulating cases. The age
      at onset, gender, affected side, and period after the initial sinus surgery all
      showed no differences between the two, i.e., definite and simulating cases. Among
      signs and symptoms, the definite case showed more of swelling-related matters
      whereas the simulating case more of pain-related except toothache. The past
      history of surgeries for the mucoceles on the similar sides to the present lesion
      is more often seen in the simulating case (64.3%) than in the definite case
      (18.3%). The findings by imagings in the simulating cases are as follows;
      obliterated sinus (25.0%), healthy, aerated postop. cavity (35.7%), postop.
      cavity with mucosal thickening (32.1%), and cyst-like aerated cavity (7.1%). The
      possible causes leading to the simulating cases are as follows; causes unknown
      (39.3%), recurrent infection in the postop. cavity (28.6%), dental origin
      (10.7%), atypical neuralgia (10.7%) and the case shortly after the proceeding
      sinus surgery (within 12 months, 10.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619508
TI  - [Carbohydrate structure of glycoconjugate in the murine eustachian tube
      pharyngeal orifice].
AB  - In this study, neuraminidase (sialidase) and 6 different lectins, wheat germ
      agglutinin (WGA), Limax flavus agglutinin (LFA), Sambucus nigra agglutinin (SNA),
      Maackia amurensis agglutinin (MAA), peanut agglutinin (PNA), and Amaranthin, were
      used to histochemically characterize the carbohydrate structure of glycoconjugate
      in the murine eustachian tube pharyngeal orifice. A microwave irradiation
      technique was used to reduce the incubation time and background staining. After
      neuraminidase treatment, WGA, LFA, MAA, Amaranthin, and PNA stained epithelial
      goblet cells, glandular mucous cells, cell surfaces, and the mucous blanket.
      Without neuraminidase treatment, SNA and PNA did not stain any secretory cells.
      These results revealed that sialoglycoconjugates in the murine eustachian tube
      pharyngeal orifice are produced from epithelial goblet cells and glandular mucous
      cells, are present on cell surfaces and within the mucous blanket, and that their
      terminal trisaccharide linkage appears to be the sequence Neu5Ac (alpha 2-3) Gal
      (beta 1-3) GalNAc.

PMID- 1619507
TI  - [Flow cytometric analysis of DNA ploidy in nasosinal papilloma].
AB  - Using paraffin embedded specimens taken from 32 patients with histologically
      benign nasosinal papillomas, we conducted nuclear DNA analysis by flow cytometry
      and studied the biological degree of malignancy in this disease. Aneuploidy,
      which is frequently observed in malignant tumors was not seen in any of these
      nasosinal papilloma cases. Age did not affect either S+G2M % or polyploid %, two
      parameters that reflect cell proliferation capacity. Both parameters, S+G2M % and
      polyploid %, were higher in inverted papillomas which are more likely to become
      malignant than epithelial papillomas. In recurrent cases of nasosinal papilloma
      both S+G2M % and polyploid % were higher than in nonrecurrent cases. Moreover,
      the polyploid % was significantly different, supporting speculation that this can
      be used as a parameter for predicting recurrence of nasosinal papilloma.

PMID- 1619509
TI  - [Statistical survey of multiple primary cancers of the head and neck].
AB  - The incidence and factors associated with multiple primary cancer were surveyed
      and analyzed from April 1978 through December 1990 in our clinic. Fifty-nine
      cases with multiple primary cancers were selected for study from among 579 cases
      with malignant head and neck region tumors. The cancers involved the larynx in 17
      cases (8.4%), oral cavity in 14 (19.4%), oropharynx in 13 (41.9%), hypopharynx in
      7 (8.0%) and nasal cavity or paranasal sinus in 7 (8.0%). Twenty-one cases
      (35.6%) arose synchronously within one year. From our observations, heavy
      drinking and smoking were most strongly suspected to be risk factors for
      induction of malignancy. Most multiple primary cancers in the head and neck
      region were observed to coexistent in a "so called multicentric zone" consisting
      of the oral area, pharyngeal area, larynx, esophagus, stomach, and
      tracheobronchial tree. To avoid overlooking concealed cancer in the multicentric
      zone, upper gastro-intestinal endoscopy, bronchial endoscopy, chest X-ray and
      sputum examination should be performed for screening of patients with head and
      neck malignancies.

PMID- 1619510
TI  - [Quantitative analysis of cholesteatoma using high resolution computed
      tomography].
AB  - Seventy-three cases of adult cholesteatoma, including 52 cases with pars flaccida
      type cholesteatoma and 21 with pars tensa type cholesteatoma, were examined using
      high resolution computed tomography, in both axial (lateral semicircular canal
      plane) and coronal sections (cochlear, vestibular and antral plane). These cases
      were classified into two subtypes according with the presence of extension of
      cholesteatoma into the antrum. Sixty cases with chronic otitis media with central
      perforation (COM) were also examined as controls. The various locations of the
      middle ear cavity were measured in term of size with comparisons among pars
      flaccida type cholesteatoma, pars tensa type cholesteatoma and COM. The results
      were as follows: 1) The width of the attic was significantly larger in both pars
      flaccida type and pars tensa type cholesteatoma than in COM. 2) With pars
      flaccida type cholesteatoma there was a significantly larger distance between the
      malleus and lateral wall of the attic than with COM. In contrast, the distance
      between the malleus and medial wall of the attic was significantly larger with
      pars tensa type cholesteatoma than with COM. 3) With cholesteatoma extending into
      the antrum, regardless of the type of cholesteatoma, there were significantly
      larger distances than with COM at the following sites; the width and height of
      the aditus ad antrum, and the width, height and anterior-posterior diameter of
      the antrum. However, these distances were not significantly different between
      cholesteatoma without extension into the antrum and COM. The hitherto
      demonstrated qualitative impressions of bone destruction in cholesteatoma were
      quantitatively verified in detail using high resolution computed tomography.

PMID- 1619511
TI  - [Surgical treatments of adult chronic sinusitis--a study by questionnaire from
      434 hospitals in Japan].
AB  - Information concerning surgical treatment of adult patients with chronic
      sinusitis was obtained through questionnaires from 434 hospitals in Japan. The
      hospitals were authorized for an in-service otorhinolaryngological training
      institute by the Oto-Rhino-Laryngological Society of Japan. The questionnaires
      were sent to the hospitals in December, 1989, and answers were obtained from 370
      hospitals within 2 months, an 85.3% response rate. The following results were
      obtained. In 96.2% of the hospitals, permaxillary sinus surgery was performed on
      patients whose maxillary and ethmoid lesions were severe. With moderate lesions
      of both the maxillary and ethmoid sinuses, permaxillary sinus surgery and
      endonasal sinus surgery were performed in 76.0% and 24.9%, respectively.
      Application of an endoscope for sinus surgery was reported by 89 hospitals. In
      January, 1990, a further survey was sent to the 89 hospitals where endoscopic
      sinus surgery was performed. Questionnaire responses were obtained from 75
      hospitals. Rigid endoscope was used most frequently and operative microscope was
      also used. Endoscopy was applied to all of the sinus surgery procedures in 21.6%,
      and to a portion of the procedures in 74.3% of the hospitals. About 50% of the
      hospitals performed endoscopic surgery in fewer than 30% of sinus surgery cases.
      When questioned as whether endoscopic surgery had been successful, 42.6% said
      yes, 10.7% said no, and 42.6% were unsure.

PMID- 1619512
TI  - [Quantitative assessment of facial palsy by Moire topography].
AB  - It is essential to establish an objective and quantitative method for evaluating
      facial palsy and to measure the extent of paralysis in order to evaluate
      therapeutic efficacy, determine prognosis, select appropriate treatment and
      observe the process of recovery. This study utilized Moire topography, which
      displays three-dimensional facial symmetry with high precision and is based on
      light interference theory, to determine the extent of facial palsy in 38 patients
      (20 men and 18 women) 5 months to 73 years of age. A stereoscopic lattice type
      Moire camera (FM3013) was connected to a CCD camera and to the monitoring device
      for confirming Moire stripes. Moire photographs were taken with a thermal imager
      (FTI-200). The photos were visually and objectively evaluated on the basis of the
      Moire pattern and were then input into a personal computer with a digitizer for
      data processing and analysis. To view the functions of facial nerve branches,
      five Moire photographs were taken: at rest, wrinkling the forehead, closing the
      eyes lightly, blowing out the cheeks and grinning. Results indicated that the
      number of stripes and their polarization adequately reflected the function of
      individual facial nerve branches. Thus, a well-defined Moire pattern could
      clarify the characteristics of the site and the degree of facial palsy and of
      recovery from paralysis. It is an analytical method that can be quickly applied
      and seems especially useful in infants and young children, in whom point-based
      assessment is difficult. It is possible to quantitatively evaluate facial palsy
      in terms of the Asymmetry Index (AI), which is 20-25% for severe paralysis, 12
      19% for partial paralysis, and 5-10% for an essentially normal condition.
      However, the numerical value of the AI overlap in all three paralysis categories,
      indicating that quantitative assessment of paralysis would be difficult. Moire
      topography is an excellent method of determining the extent of facial palsy,
      compensating for the short falls of examination-based assessment and permitting
      reproducible visual, objective, and quantitative evaluation.

PMID- 1619513
TI  - [The quantitation of Pseudomonas aeruginosa elastase in suppurative chronic
      otitis media using a sensitive ELISA method].
AB  - A sensitive sandwich ELISA method has been developed in order to quantitate the
      Pseudomonas aeruginosa elastase (PE) of ear discharge from chronic suppurative
      otitis media (CSOM) patients. Samples were incubated with EDTA-2Na before ELISA
      in order to inhibit the PE activity which hydrolyzes anti-PE IgG antibody into
      smaller molecular fragments. Quantitation of PE in middle ear effusions (MEE)
      from 10 patients with chronic otitis media with effusion (OME) were also
      performed. In CSOM, 12 of 14 samples revealed a significant amount of PE from 0.6
      microliter/ml to 62.1 microliters/ml, which was significantly higher than those
      in MEE (p less than 0.05). In MEE, 8 of 10 samples were under the detection
      limit. Two samples in CSOM with Pseudomonas aeruginosa infection had high levels
      of PE. The quantitation was linear, with a concentration from 5 ng PE/sample to
      500 ng PE/sample. This ELISA system is a sensitive method for quantitation of PE
      requiring only very small samples.

PMID- 1619515
TI  - [Induction of cytotoxic activity from regional lymph node lymphocytes in head and
      neck malignant tumor].
AB  - Cytotoxic activities of rIL-2-stimulated effector cells from peripheral blood
      mononuclear cells (PBMC-LAK), and those from the regional lymph node cells (LN
      LAK) from patients with head and neck malignant tumor were examined by 4-hour
      51Cr release assay. Cytotoxicity of LAK cells from involved lymph node (LN (+)
      LAK) were significantly lower than those of PBMC-LAK. LAK cells from non-involved
      lymph node (LN (-)-LAK) had a significantly higher cytotoxicity against Daudi
      cell than PBMC-LAK. Cytotoxic activities against K562 cell and autologous tumor
      cells mediated by LN (-)-LAK were not significantly different from those by PBMC
      LAK. However, autologous tumor cell lysis by LN (-)-LAK from lymph nodes showing
      follicular lymphoid hyperplasia (FLH) pattern was higher than that by PBMC-LAK.
      The effector cells against autologous tumor cells were characterized CD56+ cells
      and CD8+ cells (CD8+CD11b- cells) by phenotypic analysis and negative selection
      assay using immunomagnetic isolation technique.

PMID- 1619514
TI  - [Study of tinnitus masking by self-recording audiometer].
AB  - The tinnitus masking test, in which the minimum masking levels of tinnitus by
      various pure tones and band noises are measured and used to produce tinnitus
      masking curves, is one of the methods for evaluating the character of tinnitus.
      At present, the tinnitus masking test is usually performed using a pure tone
      audiometer. In this study, tinnitus masking curves were produced using a self
      recording audiometer (Bekesy audiometer) in 22 cases of tinnitus, and the basic
      nature of the tinnitus masking curves from the self-recording audiometer was
      investigated and compared with those from a pure tone audiometer. The results
      showed no changes in the masking level, and the amplitudes of the tinnitus
      masking curves from the self-recording audiometer were observed to be at the
      tinnitus pitches. The amplitude of the tinnitus masking curve showed a negative
      correlation with tinnitus loudness as measured by the loudness balance test for
      tinnitus, that is, the amplitude tended to decrease as the tinnitus became
      louder. This suggests that the loudness of the masking tone influences the
      tinnitus masking phenomenon.

PMID- 1619516
TI  - Pyrimidine dimer splitting in covalently linked dimer-arylamine systems.
AB  - Cyclobutadipyrimidines (pyrimidine dimers) undergo photosplitting which is
      sensitized by electron donors. We prepared a series of compounds in which a dimer
      is directly linked to an arylamine, which acts as sensitizer for dimer splitting.
      Two diastereomers of the dimer-arylamine exhibited very different splitting
      efficiencies. Also studied were N-methyl, ring methoxy, as well as deuterated
      derivatives of the sensitizer. These dimer-arylamines had an absorption band with
      lambda max approximately 300 nm. In each case intramolecular photosensitization
      of dimer splitting was highly dependent on the solvent, ranging in one instance
      from phi spl = 0.02 in water to a high value of 0.31 in the least polar solvent
      mixture examined (1,4-dioxane: isopentane, 1:99). A mechanism is proposed which
      involves photoinduced electron transfer from arylamine to dimer and splitting of
      the dimer radical anion. The dependence of splitting on the solvent was
      rationalized on the basis of retardation of back electron transfer due to Marcus
      inverted behavior of the charge-separated species. Photolyases might achieve
      their high efficiency of dimer splitting in part by employing a hydrophobic
      active site to slow back electron transfer in a similar manner.

PMID- 1619517
TI  - Preparation of a chemiluminescent imidoester for the non-radioactive labelling of
      proteins.
AB  - A chemiluminescent aryl acridinium ester was synthesized which possesses an
      imidate ester group capable of reacting with proteins under mild conditions. The
      compound can be detected at levels as low as 5.2 x 10(-19) mol using commercially
      available luminometers and can therefore be used to produce high specific
      activity labelled antibodies for use in immunochemiluminometric assays. The
      imidate ester compares favourably with a previously reported N-succinimidyl ester
      in terms of its labelling properties but is easier to synthesize, requiring one
      less step. The compound was used to label affinity purified to synthesize,
      requiring one less step. The compound was used to label affinity purified sheep
      antibodies to human parathyroid hormone to demonstrate its utility in a two-site
      immunochemiluminometric assay for the measurement of intact parathyroid hormone.

PMID- 1619518
TI  - Combination therapy involving photosensitizing agents.

PMID- 1619519
TI  - The chick chorioallantoic membrane (CAM) as an in vivo model for photodynamic
      therapy.

PMID- 1619520
TI  - Psychoactive drugs and human sexual behavior: the role of serotonergic activity.
AB  - A wide range of both prescription and nonprescription drugs has been reported to
      affect human sexual functioning. While the sexual side effects resulting from
      drug use have often been attributed to adrenergic, anticholinergic or
      dopaminergic activity, the present review considers the potential role of
      serotonin. Based on animal studies, serotonin has been shown to either facilitate
      or inhibit sexual activity depending on which serotonin receptor subtype is
      activated. However, few studies have been done in the human that assess the
      effects of drugs that bind selectively to serotonin receptors. Consequently,
      little is known about the role of serotonin in human sexual functioning. In this
      review, a wide range of drugs that affect both brain serotonergic systems and
      human sexual behavior is examined in an effort to determine the possible role of
      serotonin in human sexual behavior. A review of the literature is consistent with
      the hypothesis that the 5-HT1A and the 5-HT2 receptor subtypes play a
      facilitatory role in human sexual behavior. The evidence suggests that drugs that
      act as agonists on these receptor sites enhance sexual functioning in the human,
      while those that act as antagonists inhibit sexual functioning.

PMID- 1619521
TI  - Reaching the unreached: targeting hidden IDU populations with clean needles via
      known user groups.
AB  - Needle exchange is a practical and important part of the Dutch prevention
      strategy to check the spread of HIV among injecting drug users (IDUs). However,
      needle-exchange programs are often tied to drug treatment programs that only
      reach a limited number of IDUs. To overcome this limitation, alternative designs
      are considered and initiated. This article describes a community-based approach
      to needle exchange that is built on empowerment of, and intense participation by,
      known IDUs to target unknown IDUs for delivery of clean needles. The needle
      exchange patterns of the IDUs participating in this collective scheme are
      compared to those of other users who exchanged needles on an individual basis. It
      was found that this approach extended the reach of the program to a great degree
      and that it was well received in the IDU community. However, the results were
      negatively influenced by police activities aimed at closing down places where
      drugs were used and sold. It is concluded that engaging IDUs in peer-group
      directed prevention efforts is both feasible and promising.

PMID- 1619522
TI  - Marathon therapy: treating rape survivors in a therapeutic community.
AB  - Odyssey House is a therapeutic community (TC) in New York City that treats a wide
      range of drug abusers. For over 20 years. Odyssey House has conducted an annual
      marathon therapy group for women who are rape survivors. This article summarizes
      the program's experience with the marathon and reports on its therapeutic
      accomplishments.

PMID- 1619523
TI  - A heroin revival in Miami: notes from a street survey.

PMID- 1619524
TI  - Retrospective reports of psychiatric symptoms before, during, and after drug use
      in a recovering population.

PMID- 1619525
TI  - Staying off methadone maintenance.

PMID- 1619526
TI  - Twenty-four-hour esophageal pH monitoring: what's the score?

PMID- 1619528
TI  - Evaluation of reflux episodes during simultaneous esophageal pH monitoring and
      gastroesophageal reflux scintigraphy in children.
AB  - Gastroesophageal pH monitoring and reflux scintigraphy were simultaneously
      performed in 65 children, who were being investigated for suspected
      gastroesophageal reflux disease. The aim of the study was to compare, peak per
      peak, the information provided by the two techniques during a 1-h simultaneous
      recording period. During this period, 123 reflux episodes were recorded with both
      techniques, but only six occurred simultaneously. Significantly more reflux
      episodes were recorded on scintigraphy (n = 88; p less than 0.05), particularly
      during the first half-hour period (n = 62), if compared with the number of pH
      drops greater than 1 unit, even at pH levels higher than 4 (n = 41; p less than
      0.05). It is concluded that the two techniques explore differently the reflux
      phenomenon.

PMID- 1619527
TI  - Comparison of methods of assessing 24-hour intraesophageal pH recordings in
      children.
AB  - Prolonged intraesophageal pH recording, an important test in the evaluation of
      children with suspected gastroesophageal reflux (GER) disease, may be performed
      and evaluated by markedly different methodologies. Twenty-four-hour
      intraesophageal pH recordings from 67 consecutive infants were evaluated by three
      scoring methods: early postprandial, late postprandial, and total recording. In
      addition, the scoring methods were evaluated for their ability to identify 20
      infants with clinically defined GER-induced acute life-threatening events
      (ALTEs). There were significant positive correlations between each pair of
      scoring systems (early postprandial with late postprandial, early postprandial
      with total recording, and late postprandial with total recording). However, our
      data indicate that the three methods identify different groups of patients. The
      early and late postprandial methods disagreed in designating "normal" versus
      "abnormal" in approximately 20% of patients. The total recording method was more
      likely to label patients as normal than either of the other methods; it yielded
      normal results in approximately one half of patients abnormal by either the early
      or the late postprandial methods. Patients with GER-induced ALTEs were identified
      by the early postprandial method in 90% of cases, the late postprandial method in
      95% of cases, and the total recording method in only 45% of cases. By applying
      three different scoring methods to the same 24-h intraesophageal pH recording, we
      demonstrated less-than-perfect correlation among the methods. Long-term follow-up
      is needed to determine if these differences are of clinical significance. We feel
      that effort should be directed toward standardizing the approach to
      intraesophageal pH monitoring in infants.

PMID- 1619529
TI  - Bacterial ileocecitis caused by Escherichia coli O157:H7.
AB  - Escherichia coli O157:H7 is most commonly linked to hemorrhagic colitis and the
      hemolytic uremic syndrome. Diagnostic ultrasound was used to demonstrate terminal
      ileum abnormalities suggestive of bacterial ileocecitis, a recently described
      entity that resembles acute appendicitis, in a patient whose stool culture
      yielded E. coli O157:H7. This case extends the spectrum of disease caused by E.
      coli O157:H7 and expands the number of organisms that can cause bacterial
      ileocecitis.

PMID- 1619530
TI  - In vivo effect of yogurt on excretion of enteropathogen Escherichia coli RDEC-1
      during acute diarrhea in the just-weaned rabbit.
AB  - Yogurt has been shown to inhibit, by various mechanisms, pathogenic bacterial
      growth in vitro, including that of the rabbit Escherichia coli strain RDEC-1. To
      determine whether this in vitro inhibition by yogurt has an in vivo counterpart,
      60 newly weaned New Zealand rabbits were randomly assigned to receive a diet
      supplemented with either milk or yogurt. Four days later, rabbits were infected
      intragastrically with 10(8) E. coli strain RDEC-1. During the 30 days
      postinfection, animals were checked regularly for weight, stool characteristics,
      and fecal excretion of bacteria. Results show that the duration of diarrhea as
      well as bacterial excretion were the same in the milk and yogurt groups,
      indicating that in vivo, yogurt did not interfere with the growth of the
      pathogenic E. coli strain RDEC-1. The pattern of the survival curves was
      significantly different in the two groups (p less than 0.03), but the difference
      between their mortality at 30 days postinfection was not significant (80% in the
      milk group versus 67% in the yogurt group). These results indicate that the
      bactericidal activity of yogurt observed in vitro against the E. coli strain RDEC
      1 does not have an in vivo counterpart in the model of the just-weaned rabbit
      infected by RDEC-1.

PMID- 1619532
TI  - Breath methane excretion in Hong Kong Chinese children.
AB  - The factors which determine whether an individual is a methane excretor or a
      nonexcretor are not clearly understood. Genetic makeup, ethnic origin, diet,
      environment, or an interaction of all these factors have been implicated. In
      order to delineate the incidence, the age of onset, and environmental factors
      that may influence the excretion of methane in our community, we investigated a
      total of 425 Chinese children in Hong Kong (204 females, 221 males). End
      expiratory breath samples were collected after an overnight fast and measured by
      gas-chromatography using a flame ionization detector. Thirty one children (7.3%)
      excreted at least 1 ppm methane above the ambient level (median = 6.4, range =
      1.8-26.0 ppm). There was no difference in methane excretion status and pattern
      between the sexes or between children who lived at home and those who lived at an
      institution. There was a general increase in the number of methane excretors with
      age, but a statistically significant increase was reached only after 14 years of
      age. The amount of methane excreted was unrelated to age and there were no
      excretors detected under the age of 5 years. It is concluded that the methane
      excretion pattern of these children was generally similar to those previously
      reported from other regions, but the incidence is much lower and the age of onset
      appears to be more gradual.

PMID- 1619531
TI  - Reference values of the steatocrit and its modifications in diarrheal diseases.
AB  - Conflicting results have been reported on the use of the steatocrit to measure
      fecal fat excretion. Aiming to assess the reliability of this method and its
      usefulness in the diagnosis of intestinal enteropathies, we measured the
      steatocrit in 747 healthy children and 442 children with diarrhea grouped
      according to diagnosis. The steatocrit was found to correlate strictly (r = 0.93)
      with the chemical measurement of fecal fat. Reference values and ranges were
      established. The maximal steatocrit was observed in neonates; afterwards, it
      progressively decreased to an undetectable level in children older than 2 years
      of age. A steatocrit abnormally high for age was found in 20% of patients with
      acute diarrhea and in 53% of those with chronic diarrhea. All celiac patients
      with a gluten-containing diet showed a marked increase of steatocrit. We conclude
      that the steatocrit is a reliable and easy-to-perform test, which quickly
      provides valuable information in the diagnostic workup of the child with
      diarrhea.

PMID- 1619533
TI  - Plasma and gastric juice levels of prostaglandins in critically ill children.
AB  - The levels of prostaglandin (PG) E2 and 6-keto-PGF1 alpha (stable metabolite of
      prostacyclin) in plasma and gastric juice were determined in 113 critically ill
      children and adolescent, and compared to those registered in a plasma control
      group of 24 children and a gastric juice control group of 15. The gastric juice
      concentration of PGE2 is our patients [9.2 +/- 3.1 (SEM) pg/ml] was significantly
      lower (p = 0.001) than in the control group [81.1 +/- 18.1 (SEM) pg/ml]. There
      were no differences in plasma levels of PGE2 and plasma gastric juice levels of 6
      keto-PGF1 alpha between the patients and the control groups. Children who died
      had lower plasma levels of PGE2 [6.2 +/- 2.2 (SEM) pg/ml] and gastric juice
      levels of PGE2 [2.3 +/- 0.8 (SEM) pg/ml] than the survivors (p less than 0.05).
      The gastric juice concentration of PGE2 was also lower in children who suffered
      important upper gastrointestinal bleeding, although the difference did not reach
      statistical significance.

PMID- 1619534
TI  - Determination of body composition in growing rats by total body electrical
      conductivity.
AB  - Total body electrical conductivity (TOBEC), measured with an Em-Scan SA-1
      analyzer, was evaluated as a means of estimating fat-free mass and total body
      water content noninvasively in small laboratory animals. Ninety-four rats whose
      weight ranged from 5.53 to 170.84 g at 0-50 days of age were studied. The animals
      were killed by intraperitoneal injection of a pentobarbital overdose. After
      weight, crown-rump length (CRL) and TOBEC were measured, and the animals were
      minced with scissors and desiccated to constant weight in a convection oven. Fat
      was extracted by multiple bathings in petroleum ether followed by Soxhlet
      extraction. Fifty-four rats were used to determine the relation between fat-free
      mass (FFM), total body water (TBW), and TOBEC# (E) by regression analysis. The
      best correlations were observed between FFM and (E x CRL)1/2 (r = 0.995, p less
      than 0.0001). Forty rats were used to determine the predictive value of TOBEC
      estimates. With this instrument, TOBEC tended to underestimate FFM by an average
      of 3.9% and TBW by 5.3%. Accuracy was questionable for animals smaller than 13 g
      and TOBEC did not provide useful estimates of total body fat. Subject to these
      limitations, TOBEC instruments should prove to be useful for sequential in vivo
      estimations of body composition during growth and development of small animals.

PMID- 1619535
TI  - Changes in fatty acid profiles of red blood cell membranes mediated by dietary
      nucleotides in weanling rats.
AB  - Dietary nucleotides have been described to play multiple physiological roles. We
      examined the effect of feeding, for 4 weeks, nucleotide-supplemented diets (N-50
      and N-250) on red blood cell (RBC) membrane fatty acid composition in weanling
      rats. Long-chain polyunsaturated fatty acids (LC-PUFA) of the n-6 series,
      especially arachidonic acid, increased in total RBC phospholipids in N-50 and N
      250 groups. Concentrations of LC-PUFA of the n-3 series were preserved or
      slightly decreased. Saturates and monoenates also decreased.
      Phosphatidylethanolamine and sphingomyelin followed the variations observed for
      total phospholipids. Phosphatidylcholine showed a different response; saturated
      fatty acids increased while n-6 LC-PUFA decreased. Dietary nucleotides seem to
      affect the conversion of essential fatty acids to their long-chain derivatives in
      weanling rats in a similar way to that occurring in newborn infants during early
      life. These results show that the rat may be a valid model with which to study
      the biochemical mechanisms by which dietary nucleotides affect fatty acid
      desaturation.

PMID- 1619536
TI  - Multiple biliary papillomatosis in a child.

PMID- 1619537
TI  - Veno-occlusive disease of the liver after combined adjuvant chemotherapy for a 1
      year-old boy with rhabdomyosarcoma: potential usefulness of the gabexate mesylate
      (FOY).
AB  - A tumor in the left thigh of a 1-year-old boy was diagnosed as rhabdomyosarcoma
      (stage 1). The tumor was excised and vincristine (1.5 mg/m2 given twice),
      actinomycin D (15 micrograms/kg given five times), and cyclophosphamide (600
      mg/m2 given once) were prescribed. On the 12th day after initiating this
      chemotherapy, his liver rapidly enlarged and ascites, pleural effusion, and
      disturbance of consciousness due to hepatic failure successively appeared. Before
      these clinical signs appeared, laboratory data demonstrated enhanced coagulation
      and fibrinolysis such as thrombocytopenia refractory to platelet transfusion and
      a marked increase in fibrinogen and fibrin degradation product (FDP). Hepatic
      veno-occlusive disease (VOD) was suspected, and based on the laboratory data
      indicating enhanced coagulation, anticoagulant (gabexate mesylate; FOY),
      diuretic, and supportive therapy for hepatic failure was begun. The clinical
      course was favorable and recovery was complete in 2 months, with no sequelae. We
      propose that platelet count, coagulation factor levels, and FDP may be useful for
      the early detection of VOD, and an anticoagulant drug such as FOY is worthy of
      consideration for the prevention and treatment of VOD.

PMID- 1619538
TI  - Effects of indomethacin in congenital chloride diarrhea.
AB  - Clinical and biochemical effects of indomethacin were monitored in a patient with
      congenital chloride diarrhea (CCD) before and after 10 days of therapy. During
      indomethacin treatment, no clinical improvement could be achieved whereas
      hyperreninemia and hyperaldosteronism improved. Excretion rates of prostaglandin
      (PG) E2, PGF2 alpha, as well as PGE-M were found to be slightly raised and
      decreased during therapy with indomethacin. However, loss of electrolytes
      remained substantially unchanged. Prostaglandins, therefore, seem to play no
      important role in intestinal loss of electrolytes in CCD, and it is suggested
      that indomethacin is of no importance in the treatment of patients with CCD.

PMID- 1619540
TI  - Somatic gene therapy in gastroenterology: approaches and applications.
AB  - Somatic gene therapy represents a new approach for treating a variety of genetic
      and acquired diseases and has many potential applications in gastroenterology.
      Somatic gene therapy is based on the ability to transfer recombinant genes
      efficiently into somatic tissues, such as the liver or intestine, and achieve
      expression of the recombinant gene product. Gene transfer could be used to
      replace genetically defective gene functions or prevent the progression of
      acquired or multifactorial diseases. The therapeutic application of gene transfer
      technologies requires development of methods for achieving efficient transfer and
      expression of recombinant gene products, research directed at developing
      strategies for altering the course of disease, and clinical research aimed at
      assessing both the technical feasibility and therapeutic efficacy of this
      approach.

PMID- 1619539
TI  - Hypertrophic gastropathy with transient sessile polyps.
AB  - We report an 8-year-old boy with hypertrophic gastropathy (HG) associated with
      duodenal Giardia lamblia infestation. The follow-up was complicated by the
      development of gastric polyps at the site of previous biopsies that spontaneously
      disappeared within 15 months. Despite the histological similarity, the different
      course between Menetrier's disease (MD) in adults (chronic, with frequent
      development of sessile or pedunculate polyps) and HG (uncomplicated and usually
      spontaneously resolving) suggests a different pathogenesis. Viral
      (cytomegalovirus) and bacterial (Helicobacter pylori) infections have been
      described in association with HG and they could play an important pathogenetic
      role. The term HG better defines the childhood disease in which a conservative
      management is recommended.

PMID- 1619541
TI  - Helicobacter, Helicobacter everywhere, and not a drop to drink!

PMID- 1619542
TI  - Erythromycin--additional perspective on its prokinetic effects.

PMID- 1619543
TI  - Penicillamine hepatotoxicity in the treatment of Wilson's disease.

PMID- 1619544
TI  - Protein-losing enteropathy and Helicobacter pylori.

PMID- 1619545
TI  - Necrotizing enteritis involving the second part of the duodenum.

PMID- 1619547
TI  - Sensation seeking, stress, and adolescent injuries: a test of stress-buffering,
      risk-taking, and coping skills hypotheses.
AB  - The potential stress-buffering effects of sensation seeking were assessed in a
      prospective study involving high school athletes. A significant positive relation
      between major negative sport-specific life events and subsequent injury time-loss
      occurred only for athletes low in sensation seeking. No evidence was obtained for
      a competing hypothesis that high sensation seeking would constitute an injury
      vulnerability factor by increasing risk-taking behaviors. Although low sensation
      seekers reported poorer stress management coping skills, there was no evidence
      that differences in coping efficacy mediated the injury vulnerability difference.
      Results indicate that sensation seeking is a stress-resiliency factor and suggest
      the utility of assessing relations between life stressors and outcomes that occur
      within the same environmental context.

PMID- 1619546
TI  - Intestinal disaccharidase activity in giardiasis.

PMID- 1619548
TI  - Compartmentalization of positive and negative self-knowledge: keeping bad apples
      out of the bunch.
AB  - Three studies examined whether categorical organization of knowledge about the
      self explains variance in self-esteem and depression beyond that which is
      accounted for by sheer amount of positive or negative content.
      Compartmentalization is the tendency to organize positive and negative knowledge
      about the self into separate, uniformly valenced categories (self-aspects). As
      long as positive self-aspects are activated, access to negative information
      should be minimized. Compartmentalization was associated with high self-esteem
      and low depression scores for individuals whose positive self-aspects were
      important; when negative self-aspects were important, compartmentalization was
      correlated with low self-esteem and high depression scores. An analysis of self
      aspect labels showed that individuals with compartmentalized organization define
      negative self-aspects in especially narrow terms. A possible relationship between
      compartmentalized organization and cognitive complexity is discussed.

PMID- 1619549
TI  - The generality of the automatic attitude activation effect.
AB  - Fazio, Sanbonmatsu, Powell, and Kardes (1986) demonstrated that Ss were able to
      evaluate adjectives more quickly when these adjectives were immediately preceded
      (primed) by attitude objects of similar valence, compared with when these
      adjectives were primed by attitude objects of opposite valence. Moreover, this
      effect obtained primarily for attitude objects toward which Ss were presumed to
      hold highly accessible attitudes, as indexed by evaluation latency. The present
      research explored the generality of these findings across attitude objects and
      across procedural variations. The results of 3 experiments indicated that the
      automatic activation effect is a pervasive and relatively unconditional
      phenomenon. It appears that most evaluations stored in memory, for social and
      nonsocial objects alike, become active automatically on the mere presence or
      mention of the object in the environment.

PMID- 1619550
TI  - Changes in the marital relationship after the first baby is born: predicting the
      impact of expectancy disconfirmation.
AB  - A longitudinal study of 50 couples during the transition to first parenthood
      examined how failure to confirm expectations regarding the sharing of child-care
      and housekeeping responsibilities influenced postpartum reports of marital
      satisfaction. On the basis of recent theories of expectancy confirmation
      processes, 5 variables representing strength and importance were identified as
      possible moderators. As predicted, disconfirmation of stronger and more important
      expectations generally led to more negative reports about the marriage.
      Surprisingly, some subsets of wives showed opposite reactions; less negative
      feelings when they were doing more than they expected. These findings were
      interpreted in terms of personal and role traditionality influencing the valence
      of the reactions to expectancy disconfirmation.

PMID- 1619551
TI  - Emotion and autonomic nervous system activity in the Minangkabau of west Sumatra.
AB  - Physiology and emotional experience were studied in the Minangkabau of West
      Sumatra, a matrilineal, Moslem, agrarian culture with strong proscriptions
      against public displays of negative emotion. Forty-six Minangkabau men were
      instructed to contract facial muscles into prototypical configurations of 5
      emotions. In comparison with a group of 62 Ss from the United States, cross
      cultural consistencies were found in (a) autonomic nervous system (ANS)
      differences between emotions and (b) high configuration quality being associated
      with increased ANS differentiation and increased report of emotional experience.
      These findings provide the first evidence that these patterns of emotion-specific
      ANS activity and the capacity of voluntary facial action to generate this
      activity are not unique to American culture.

PMID- 1619552
TI  - Trust, distrust, and interpersonal problems: a circumplex analysis.

PMID- 1619553
TI  - The revealing of Mr. Stubbs: stories from the heart.

PMID- 1619554
TI  - Grow days: nurturing spiritually healthy teens.

PMID- 1619555
TI  - Toning the temple: a church-based health fair.

PMID- 1619556
TI  - Realities: a summer in Zambia.

PMID- 1619557
TI  - To smile again.

PMID- 1619558
TI  - Reminiscence: a Biblical basis for telling our stories.

PMID- 1619559
TI  - Lamentations.

PMID- 1619560
TI  - Drug delivery via the mucous membranes of the oral cavity.
AB  - The delivery of drugs via the mucous membranes lining the oral cavity (i.e.,
      sublingual and buccal), with consideration of both systemic delivery and local
      therapy, is reviewed in this paper. The structure and composition of the mucosae
      at different sites in the oral cavity, factors affecting mucosal permeability,
      penetration enhancement, selection of appropriate experimental systems for
      studying mucosal permeability, and formulation factors relevant to the design of
      systems for oral mucosal delivery are discussed. Sublingual delivery gives rapid
      absorption and good bioavailability for some small permeants, although this site
      is not well suited to sustained-delivery systems. The buccal mucosa, by
      comparison, is considerably less permeable, but is probably better suited to the
      development of sustained-delivery systems. For these reasons, the buccal mucosa
      may have potential for delivering some of the growing number of peptide drugs,
      particularly those of low molecular weight, high potency, and/or long biological
      half-life. Development of safe and effective penetration enhancers will further
      expand the utility of this route. Local delivery is a relatively poorly studied
      area; in general, it is governed by many of the same considerations that apply to
      systemic delivery.

PMID- 1619561
TI  - Relationship between in vivo skin blanching and in vitro release rate for
      betamethasone valerate creams.
AB  - Betamethasone valerate creams from two firms were evaluated using the skin
      blanching procedure. In both studies, the same cream formulation exhibited
      significantly higher blanching compared to the other product. An in vitro release
      rate was determined for these betamethasone valerate cream products using a
      diffusion cell system, with a cellulose acetate membrane and a 60% ethanol:water
      receptor medium. The release rate (flux) of betamethasone valerate was higher for
      the higher blanching formulation and was statistically different from the other
      product. The integrity of the cellulose acetate membrane in 60% ethanol:water
      mixture was ascertained using hydrocortisone cream product. The in vitro drug
      release method, using a diffusion cell system and a synthetic membrane, can serve
      as a good quality control test method for topical creams.

PMID- 1619562
TI  - Two steady-state pharmacokinetic parameters: peak-to-trough drug concentration
      ratio and time of occurrence of time-averaged concentration.

PMID- 1619563
TI  - Zidovudine serum, cerebrospinal fluid, and brain concentrations following chronic
      administration of a new zidovudine formulation via an implantable pump in dogs
      [corrected].
AB  - Zidovudine (AZT), prepared as an alkaline solution, was administered iv and
      intraarterially (ia) by continuous infusion via an implantable pump in dogs. The
      AZT serum and cerebrospinal fluid (CSF) concentrations were measured over a 28
      day treatment period by HPLC. Terminal brain AZT concentrations were also
      measured. Control (vehicle only) animals were also studied. All animals were
      evaluated for pathological changes associated with the AZT and vehicle infusions
      in catheterized vessels and other organs. In the iv AZT treatment group, serum
      AZT concentrations were relatively constant, with individual coefficients of
      variations (%CV) of 20% or less. Mean CSF:serum and brain:serum AZT concentration
      ratios were 0.149 and 0.212, respectively. In the ia AZT treatment group, serum
      AZT concentrations were more variable than in the iv group, with %CV ranging from
      22 to 79%. The fluctuations in serum concentrations were attributed to temporary
      blockages of the outflow catheter. Mean CSF:serum and brain:serum AZT
      concentration ratios were 0.126 and 0.249, respectively. Pathological changes,
      similar in both control and treatment groups, included endothelial denudation and
      myointimal proliferation at the infusion sites. The conclusions of the study are
      (1) steady-state greater than 1 microM AZT serum concentrations can be maintained
      chronically by use of an implantable pump containing a basic pH AZT solution; (2)
      ia delivery of AZT did not increase central nervous system uptake compared with
      iv administration; and (3) morbidity associated with the infused solutions does
      not seem to be a limitation for this mode of therapy.

PMID- 1619564
TI  - Fraction of the bioavailable dose remaining in the body at the time of peak
      plasma concentration in a linear, open, one-compartment model.

PMID- 1619565
TI  - Influence of D-glucose-induced water absorption on rat jejunal uptake of two
      passively absorbed drugs.
AB  - The intestinal absorption of D-glucose is coupled to transepithelial sodium
      transport and this process generates intestinal water absorption. In situ jejunal
      perfusions were performed in rats to determine the extent of water transport as a
      function of perfusion flow rate, perfusate osmolality, and D-glucose
      concentration. Jejunal perfusions of iso-osmolar D-glucose, at flow rates and
      concentrations representative of the fed state, increased the dimensionless
      membrane permeabilities of the analgesic acetaminophen from 0.6 to 1.4, and that
      of the corticosteroid prednisolone from 1.6 to 2.2. This increase is less
      important for the more hydrophobic prednisolone since its baseline permeability
      (1.6) is indicative of complete uptake from solution, while the lower baseline
      permeability (0.6) of the more hydrophilic acetaminophen represents incomplete
      membrane uptake. The results suggest that nutrient-induced water transport can
      enhance jejunal uptake of small hydrophilic solutes. This phenomenon may
      contribute to variability in the absorption of drugs in this physicochemical
      class during the fed state.

PMID- 1619566
TI  - Absolute bioavailability, rate of absorption, and dose proportionality of
      sulpiride in humans.
AB  - The pharmacokinetics of orally administered sulpiride was determined in a series
      of three studies. In the first study, 12 subjects received an oral solution (200
      mg) and an iv dose (100 mg). The second study also included an iv dose, and
      examined the absorption of 200-, 300-, and 400-mg doses given as 50-mg capsules
      to six subjects. The third study compared the bioavailability of a 200-mg capsule
      dose with a 200-mg im dose in eight subjects. The concentration of sulpiride in
      plasma, red blood cells, and urine was measured by HPLC. The disposition of the
      drug was generally best described by a two-compartment pharmacokinetic model,
      with absorption appearing to occur by two sequential zero-order processes. The
      fraction of dose absorbed after oral administration was approximately 30% based
      on plasma and urine data. After the 200-mg dose, the mean elimination half-life
      was 7.0 h, and the mean residence time was 8.4 h. For each subject, total
      clearance, corrected for the fraction absorbed, and renal clearance were similar.
      The dose proportionality study demonstrated linear disposition kinetics.

PMID- 1619567
TI  - Modulation of the effector functions of cytolytic T-lymphocytes with synthetic
      peptide inhibitors of protein kinases.
AB  - The hypothesis was tested that it is possible to influence cellular responses of
      intact cells using synthetic peptide substrates, pseudosubstrates, and inhibitors
      of protein kinases. Using cytotoxic T-cells (CTL), we demonstrate here that some
      basic amino acid-containing synthetic peptide substrates of protein kinases
      [e.g., of cGMP-dependent protein kinase (peptide PKG-S), synthetic peptide
      inhibitor of cGMP-dependent protein kinase (peptide PKG-I), and peptide
      corresponding to the tyrosine phosphorylation site in pp60src (peptide RR-src)]
      were strongly inhibitory in T-cell receptor (TCR) and T-cell growth factor,
      interleukin 2 (IL-2)-triggered proliferation of CTL. These peptides also
      inhibited other cellular responses of CTL. Peptides which contain basic amino
      acids, but do not have substrate specificity determinants for protein kinase,
      were not inhibitory. The inhibition with peptides is not due to their toxicity,
      since no cell death was observed by the trypan blue exclusion test and by lactate
      dehydrogenase release. Use of the granule exocytosis assay provided opportunities
      to clarify the mechanism of the peptide action. Tested peptides inhibited not
      only cell-surface ligand-induced CTL activation, but also affected cell-surface
      receptor-independent CTL activation (granule exocytosis and gamma-interferon
      secretion) induced by the synergistic action of the protein kinase C activator
      (PMA) and ionophore A23187. It was found that minor changes in amino acid
      composition or amino acid position in the synthetic peptides dramatically change
      their ability to affect lymphocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619568
TI  - Possible effect of pigment on the pharmacokinetics of ofloxacin and its excretion
      in hair.
AB  - The mechanism of excretion of the antimicrobial ofloxacin in human scalp hair was
      investigated. When black and white hairs were taken from a patient with grizzled
      hair, who had been treated with ofloxacin, a much larger quantity of the drug was
      detected in the black hair. To study this difference and to elucidate the cause,
      ofloxacin (6, 20, and 60 mg/kg/day, b.i.d.) was administered ip for 5 weeks to
      albino and pigmented rats, whose backs had been depilated beforehand. In the last
      week of administration, the time-plasma concentration profile of ofloxacin was
      determined. One week after the last dosing, the newly grown hair on the depilated
      area was collected, and the drug concentration in hair was measured. The
      concentration in hair of the pigmented rats correlated significantly with the
      daily dose, area under the plasma concentration curve (AUC), and maximum plasma
      concentration (Cmax) at steady state, whereas that in the albino rats correlated
      with the dose and Cmax only, because AUC did not increase linearly with the dose
      in the albino rats. Moreover, the drug concentration in the hair of the pigmented
      rats was always much larger than that in the hair of the albino ones, although
      AUC and Cmax did not differ greatly between both rat groups. The findings suggest
      that ofloxacin is excreted in the hair in relation to the dose administered, and
      that the mechanism of the excretion is closely linked with the presence of
      melanin.

PMID- 1619569
TI  - Discontinuous alterations of platelet structure and function by bound, ionizable
      verapamil.
AB  - We have investigated several effects of verapamil (5-[(3,4
      dimethoxyphenethyl)methylamino]-2-(3,4-dimethoxyphenyl)-2-
      isopropylvaleronitrile) on platelet structure and function. At concentrations
      below a threshold of approximately 4.2 x 10(7) molecules.cell-1, verapamil binds
      to platelets according to a typical Langmuir adsorption isotherm (i.e., binding
      is saturable and noncooperative). By extrapolation, we calculate that saturation
      would occur at 6.8 x 10(7) +/- 1.9 x 10(7) molecules.platelet-1, with one bound
      verapamil molecule per two membrane phospholipids. Saturation is never achieved,
      however, because past the threshold surface concentration, the adsorption
      isotherm becomes discontinuous and further adsorption becomes a linear function
      of the concentration of drug in solution. We attribute this discontinuity to
      disorganization of the membrane bilayer which is stretched beyond cohesion by
      insertion of too many amphiphilic molecules of a length shorter than that of the
      phospholipid. The partitioning of verapamil between the bulk aqueous phase and
      the newly created lipid phase would then account for the linear portion of the
      adsorption isotherm. The discontinuity of binding is accompanied by
      discontinuities in the verapamil-dependent swelling of platelets and the
      verapamil-dependent inhibition of both ADP-inducible binding of fibrinogen to,
      and aggregation of, platelets. In contrast, N-methylverapamil (5-[(3,4
      dimethoxyphenyl)- methylamino]-2-(3,4-dimethoxyphenyl)-2-isopropylvaleronitrile),
      a hydrophilic quaternary amine derivative of verapamil, neither swells platelets
      nor inhibits the ADP-dependent processes that we investigated. From this we
      conclude that deprotonated verapamil is the operative species of the drug.
      Collectively, these data suggest that verapamil alters platelet structure and
      function by mechanisms involving disorganization of the platelet plasma membrane.

PMID- 1619570
TI  - Use of fractal geometry to determine effects of surface morphology on drug
      dissolution.
AB  - We extend and modify the Noyes-Whitney equation and the Hixon-Crowell cube root
      law to include surface roughness effects on the dissolution rate of drugs. The
      problem is treated theoretically in terms of the fractal reaction dimension, DR,
      of the effective surface which undergoes dissolution. Effects of changes in DR on
      the dissolution rate are identified and explained.

PMID- 1619572
TI  - Polymeric sorbents for bile acids. I: Comparison between cholestyramine and
      colestipol.
AB  - Isotherms for the sorption of bile acids at 20 degrees C, in
      tris(hydroxymethyl)aminomethane.HCl(tris) and KH2PO4-NaOH (phosphate) buffers (pH
      7.4), indicate that the binding by cholestyramine and colestipol is mainly
      through ionic linkages, although hydrophobic interactions are also of importance.
      Cholestyramine has a higher sorption capacity for bile acids, in both buffers,
      than colestipol. The chloride form of cholestyramine has a higher capacity for
      cholate in tris buffer than the iodide form. Increased ionic strength of the
      medium leads to decreased amounts of sorption.

PMID- 1619571
TI  - Mechanism of skin penetration-enhancing effect by laurocapram.
AB  - In order to clarify the mechanism of action of laurocapram (Azone) on the skin
      permeation of drugs, the following experiments were done. First, the effect of
      Azone on the skin components was compared with that of other penetration
      enhancers. Azone markedly fluidized liposomal lipids (as a model lipid system)
      compared with other enhancers. Ethanol extracted large amounts of the stratum
      corneum lipids, whereas Azone did not. These results suggest that the effect of
      Azone on the lipids in the stratum corneum is not the same as that of ethanol. In
      addition, ethanol increased the amount of free sulfhydryl (SH) group of keratin
      in the stratum corneum, whereas Azone did not directly affect the stratum corneum
      protein. Azone increased water content in the stratum corneum, as measured by
      skin conductance. This effect might be a reason for the action of Azone. For
      further understanding, the enhancing effects of Azone on the skin permeation of
      several model compounds (alcohols, sugars, and inorganic ions) were compared with
      the effects of pretreatment with distilled water, which was thought to increase
      water-holding capacity, and pretreatment with ethanol, which was thought to
      affect the lipids and protein in the skin barrier (i.e., stratum corneum).
      Pretreatment with water or ethanol enhanced skin permeation of hydrophilic
      compounds, whereas they decreased that of octanol, a hydrophobic compound. The
      tendency of Azone to increase or decrease the skin permeation rate of most
      compounds was similar to that of pretreatment with water or ethanol. However, the
      effect of Azone on the skin permeation of inorganic ions was relatively low,
      whereas that of pretreatment with water or ethanol was high.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1619573
TI  - Role of sulfhydryl-containing agents in the healing of erosive gastritis and
      chronic gastric ulceration in the rat.
AB  - One milliliter of 1, 2, or 5% DL-cysteine (cysteine) or DL-methionine
      methylsulfonium chloride (MMSC) was instilled into the rat stomach 1, 24, and 48
      h after giving ethanol (1 mL of 40% solution) by gavage. One hour following the
      administration of ethanol, gastric mucosal injury was seen in all the animals
      (22.6 +/- 1.1 mm2, mean +/- SEM; n = 10). Twenty-four hours after giving the
      ethanol, all the rats treated with cysteine or MMSC still had the mucosal injury.
      Treatment with 2% cysteine or MMSC significantly (p less than 0.01) reduced the
      extent of this injury (10.2 +/- 0.6 and 10.1 +/- 0.5 mm2, respectively, versus
      20.7 +/- 1.2 mm2, mean +/- SEM; n = 10), an action that was similarly achieved by
      the 5% solutions (10.1 +/- 0.5 and 9.9 +/- 0.3 mm2, respectively, versus 20.7 +/-
      1.2 mm2, mean +/- SEM; n = 10). Forty-eight hours following the administration of
      ethanol, 30% of the animals given 1% cysteine or MMSC still had gastric mucosal
      injury, which was significantly (p less than 0.001) less extensive than that seen
      with ethanol alone (3.8 +/- 0.3 and 4.1 +/- 0.3 mm2, respectively, versus 13.1 +/
      0.8 mm2, mean +/- SEM; n = 10). At this time period, however, none of the
      animals treated with 2 or 5% solutions of cysteine or MMSC still had any injury.
      Healing of the ethanol-induced injury was confirmed microscopically and was
      achieved by regeneration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619574
TI  - Phenylbutazone action on dimiristoyl phosphatidylcholine liposome phase
      transition and 8-anilino-1-naphthalene sulfonate binding.
AB  - Phenylbutazone (PhB), a powerful anti-inflammatory drug, is able to modify the
      phase transition of phospholipid bilayers without changing its calorimetric
      enthalpy (delta Hcal), as can be shown by differential scanning calorimetry (DSC)
      experiments. Under PhB interaction, dimiristoyl phosphatidylcholine (DMPC)
      multilamellar liposomes (MLV) undergo lateral phase separation as a result of
      immiscibility in the bilayer plane. On the other hand, the binding of the anionic
      fluorescent probe 8-anilino-1-naphthalene sulfonate (ANS) to the surface of DMPC
      liposomes is altered by PhB. Even though the quantum efficacy of the probe
      fluorescence emission remains unaffected, the negative cooperativity of the
      binding process disappears, with the intrinsic dissociation constant showing only
      a minor variation. From these results it is concluded that PhB would be most
      likely located close to the lipid:water interface.

PMID- 1619575
TI  - Mechanism of diffusion of monosubstituted benzoic acids through ethylene-vinyl
      acetate copolymers.
AB  - Ethylene-vinyl acetate (EVAc), a biocompatible copolymer, has been employed as
      the rate-controlling membrane in several drug delivery systems. To study the
      mechanism(s) of diffusion of drugs through EVAc membranes, the diffusion,
      permeability, and partition coefficients of monosubstituted benzoic acids were
      studied as a function of vinyl acetate content. The diffusion coefficients were
      found to occupy a narrow range, but the permeability and partition coefficients
      were found to increase in a nonlinear fashion as a function of vinyl acetate
      content, indicating that the diffusion process was partition governed. The
      partitioning data were analyzed on the basis of the partitioning between the
      vinyl acetate moiety and the aqueous phase, assuming the formation of 1:1 benzoic
      acid:vinyl acetate complexes. The effects of ionization and the addition of 2
      propanol to the diffusion medium were studied. The results suggest that the un
      ionized neutral forms of the benzoic acids are responsible for transport across
      the copolymer. Altering the composition of the medium by addition of 2-propanol
      increased the donor phase solubility of the acid, the steady-state rate, and the
      permeability, suggesting that cosolvent modification provides an excellent
      chemical means to increase release rates.

PMID- 1619576
TI  - Examination of self-crosslinked gelatin as a hydrogel for controlled release.
AB  - A gelatin matrix crosslinked by extensive dehydration was examined for use in
      controlled drug delivery in this preliminary investigation. Crosslinking is
      necessary to prevent gelatin dissolution and immediate drug release at body
      temperature. Treatment at 105 degrees C and reduced pressure induced crosslinking
      in discs prepared from Type B gelatin. Crosslinking was evaluated by determining
      changes in gelatin solubility at 37 degrees C in a USP paddle dissolution
      apparatus. The crosslinking treatment was reproducible and resulted in 90% of the
      original gelatin mass remaining after 12 h in water and in phosphate buffer
      solutions of pH 3 and 6.4. The treated gelatin discs remained intact for greater
      than 24 h at pH 6.4. Chlorpromazine.HCl (CPZ) was incorporated as a model drug by
      soaking the treated gelatin discs in an aqueous solution of the drug. Release of
      CPZ at 37 degrees C in the dissolution apparatus was fitted to an empirical
      equation. A coefficient of this equation was used as the initial release rate for
      comparison between different release profiles. The roles of drug solubility,
      matrix swelling and erosion, and potential drug-matrix interactions were examined
      by conducting release studies at pH values of 3, 4, 6.4, and 7.4. The insoluble,
      un-ionized form of the drug had the slowest release rate. The soluble, ionized
      form under conditions of maximum swelling and a possible drug-matrix repulsive
      interaction had the fastest release rate. General electrostatic drug-matrix
      interactions were noted which could influence the drug release rate depending on
      conditions of the study. The times for 50% release of CPZ ranged from 1.8 to 11.3
      h.

PMID- 1619577
TI  - Determination of fenoverine, a modulator of smooth muscle motility, in capsules
      and in human plasma: application to dosage form stability and a pilot study in
      humans.
AB  - Fenoverine is a novel, potent, musculotropic, spasmolytic agent that affects
      primarily the gastrointestinal tract, bile duct, and female genital organs. A
      simple, specific, and accurate HPLC method was developed for the determination of
      fenoverine in capsules and plasma. This method has been successfully applied to
      stability studies of fenoverine capsules and to a pilot study in a normal,
      healthy volunteer following oral administration of fenoverine. For the
      determination of fenoverine in capsules, a Nucleosil 5-micron CN column, with
      acetonitrile:0.1 M ammonium acetate (60:40) as mobile phase and detection at 254
      nm, was employed. The mean correlation coefficient of the calibration curve (n =
      6) for the assay was 0.9999 over a concentration range of 24.6 to 147.6
      micrograms/mL of fenoverine standard solutions. Fenoverine did not decompose
      significantly at 4, 45, 55, and 65 degrees C for 3 months. The mean correlation
      coefficients of within-day and between-day calibration curves were 0.9995 and
      0.9999, respectively, over a range of 10 to 1000 ng/mL of fenoverine in plasma.
      The limit of detection was 10 ng in plasma.

PMID- 1619578
TI  - Structural study of benzidamine salicylate in the solid state and in solution.
AB  - The vibrational (IR and Raman) and 1H and 13C NMR spectra of the analgesic and
      anti-inflammatory benzidamine salicylate (Benzasal) have been examined, and the
      results are described. The crystal structure of this compound has been determined
      by X-ray diffraction. To assist in interpretation of the spectroscopic data, some
      measurements of benzidamine, benzidamine hydrochloride, and salicylic acid have
      also been made. The most important intermolecular interactions of benzidamine
      salicylate in the solid state are N(+)H...O(-)...-C hydrogen bonds involving both
      salicylate oxygen atoms (d = 2.658 A and 3.228 A). At least the stronger hydrogen
      bond remains in CDCl3 solution. Moreover, the strong intramolecular hydrogen bond
      O-H...O(-)...-C within the salicylate anion has also been observed in the solid
      state and in solution.

PMID- 1619579
TI  - Independent contractors or employees.

PMID- 1619580
TI  - Revolutions in the evolution of American Dentistry.

PMID- 1619582
TI  - Alexithymia and somatic complaints in psychiatric out-patients.
AB  - This study investigated the prevalence of alexithymia and its relationship with
      somatic complaints in a sample of 118 general psychiatric out-patients. Of the
      sample 39.8% scored in the alexithymic range of the Toronto Alexithymia Scale.
      Compared with the non-alexithymic patients, the alexithymic patients scored
      significantly higher on several Minnesota Multiphasic Personality Inventory
      (MMPI) scales that collectively measure a diverse and extensive range of somatic
      symptoms and bodily concerns. In addition, the alexithymic patients had
      significantly higher levels of anxiety, depression, and general psychological
      turmoil. Although the alexithymic and non-alexithymic patients did not differ on
      the MMPI Repression and overall Hysteria Scales, which reflect the defenses of
      denial and repression, the alexithymic patients had significantly less ego
      strength and were significantly more dependent and more likely to engage in
      impulsive and acting out behaviours. The overall pattern of results is consistent
      with the view that alexithymic individuals are prone to both 'functional' somatic
      symptoms and symptoms of emotional turmoil because they are not well equipped
      psychologically.

PMID- 1619581
TI  - The psychosocial impact of HIV infection in men with haemophilia: controlled
      investigation and factors associated with psychiatric morbidity.
AB  - The aim of the investigation was to establish the prevalence of psychosocial
      problems in men with haemophilia and HIV infection, and to identify factors
      associated with psychological morbidity. A cross-sectional controlled study
      including 37 HIV seropositive and 36 HIV seronegative men with haemophilia under
      the care of the Oxford Haemophilia Centre were included in the investigation. The
      outcome measures included current psychological status (PSE, POMS, Beck
      Hopelessness Scale and Self-Esteem) and psychiatric history; coping and health
      beliefs (Self-Control Schedule, Hardiness Scale, Health Locus of Control Scale);
      social functioning (Modified Social Adjustment Scale); and sexual functioning.
      The results showed that seropositive individuals, whether symptomatic or not, had
      significantly worse total PSE scores and had higher levels of hopelessness. In
      addition, symptomatics had worse depression scores (POMS) than seronegatives.
      However, levels of psychiatric morbidity were generally low, even in the
      seropositive group. High levels of psychological morbidity were associated with
      high levels of hopelessness, unfavourable social adjustment, past psychiatric
      history and symptomatic HIV disease. Seropositives reported greater negative
      impact on their sex lives, and sexually active seropositives reported a
      significantly greater prevalence of sexual dysfunction than seronegatives. The
      majority of seropositives reported regular condom use during intercourse, and
      also continuing concerns about infecting their sexual partners in spite of it. In
      summary, it was found that men with haemophilia an HIV infection have higher
      levels of psychological distress and sexual problems than seronegatives. The
      skilled staff involved in their treatment are in a good position to identify
      their difficulties and ensure that good care is provided.

PMID- 1619583
TI  - The acute appendicitis syndrome: psychological aspects of the inflamed and non
      inflamed appendix.
AB  - The aetiological importance of stressful life events and psychological
      characteristics was assessed amongst 280 appendicectomy patients of whom 80% were
      classified with 'acutely inflamed' (organic) appendicitis and 20% with 'non
      inflamed' (non-organic) appendicitis. Patients were compared with a community
      comparison group. Specific characteristics of life stressors, namely severe goal
      frustration for organic patients and severe threat for non-organic patients, were
      the best predictors of patient outcome. Whilst psychological characteristics were
      not useful in discriminating between patients, depression in particular, was
      clearly associated with both conditions, with 38% of non-organic and 28% of
      organic patients with depression scores in the clinical range. As the patient's
      clinical depression status failed to modify the effect of the life stress
      predictors, it was concluded that life stress played an important role in the
      development of the patients GI symptoms, irrespective of their clinical
      depression status.

PMID- 1619584
TI  - Vital exhaustion and perception of sleep.
AB  - Sleep complaints and unusual sleep durations have been found to increase the risk
      for coronary heart disease. One explanation states that insomnia and excess
      fatigue on final waking are predictive for myocardial infarction because they are
      part of a state of 'vital exhaustion'. Sleep complaints and sleep durations,
      however, are usually assessed with retrospective self-report procedures. Such
      procedures must be interpreted with reserve because in insomniacs, a consistent
      disparity in the perception of habitual and current sleep has been observed. This
      caused us to question whether this phenomenon is present in exhausted males also.
      Two approaches were used. The first one consisted of a retrospective assessment
      of subjective sleep characteristics, the second one of self-monitoring these
      sleep characteristics during 21 days. In the second week, subjects slept in a
      laboratory. No disparity was found in how exhausted males perceive their habitual
      and current sleep. It appeared that sleep quality is worse and sleep duration is
      shorter in exhausted males. They also feel more sleepy and take longer naps
      during the day, indicating that their daytime functioning is impaired. Sleeping
      in a laboratory reduced time asleep and midsleep wake. Sleep quality, however,
      was essentially the same as at home. These findings made us conclude that it is
      not the intrusion of nocturnal wake times per se but more likely the impaired
      daytime functioning which is the reason for exhausted males to complain about
      their sleep.

PMID- 1619585
TI  - The impact of infertility on psychological functioning.
AB  - To explore the impact of infertility on psychological functioning 130 couples
      presenting with primary infertility were assessed at their initial visit to an
      infertility clinic. Of these, 116 couples were assessed on a second occasion some
      7-9 months later when in most cases the medical tests were complete. Measures of
      personality, psychopathology, perceived social support, sex role identity and
      marital state were obtained from both partners. The set was subsequently divided
      into five subgroups on the basis of the diagnosis made or the outcome (female
      cause, male cause, female and male cause, unexplained and pregnant). The results
      show little evidence of psychopathology in the sample, depression scores remained
      low throughout the period of investigation. The results also indicated stable
      marital relationships. Scores on tests of anxiety and psychiatric morbidity
      declined between the first and second assessment except in the case of men who
      were diagnosed with a fertility problem. The implications of these findings are
      discussed in the increased use of donor insemination which circumvents rather
      than treats the problem of male infertility.

PMID- 1619586
TI  - The cardiac denial of impact scale: a brief, self-report research measure.
AB  - Denial is an important aspect of recovery from cardiac trauma. It has been
      associated with reduced anxiety, better initial physical and psychological
      outcomes, decreased retention of information about the illness, and decreased
      treatment compliance. Although interview methods for assessing denial have been
      available for some time, they present both psychometric and methodological
      difficulties that a self-report measure could alleviate. This study provides the
      initial psychometric evaluation of the self-report Cardiac Denial of Impact
      Scale. It demonstrated adequate internal consistency as well as good criterion
      and discriminant validity. The availability of a self-report measure of denial
      can simplify its assessment in both research and treatment applications.

PMID- 1619587
TI  - Contingent and non-contingent biofeedback training for Type A and B healthy
      adults: can Type As relax by competing?
AB  - This paper investigates an alternative approach to the modification of
      cardiovascular reactivity in healthy Type A adults using contingent (true) and
      non-contingent (false) heart rate biofeedback. Sixteen Type A and sixteen Type B
      subjects were either given instructions to compete for heart rate reduction or
      were given no competitive instructions. There were four relaxation sessions. In
      one, subjects were given contingent heart rate biofeedback and in another they
      were given no feedback. In two sessions 'feedback' was non-contingent: in one
      condition feedback suggested that heart rate decreased across the session; in the
      other the suggestion was of increase. Results showed that overall, biofeedback
      was an effective method for heart rate reduction but non-contingent feedback
      (decreased heart rate) was found to be as effective as contingent feedback.
      Overall, Type A subjects reduced heart rate significantly more than Type Bs. More
      importantly, Type As reduced heart rate significantly more when competing than
      when competition was not mentioned. These results suggest that core elements of
      Type A behaviour, in particular competition, could be exploited in the
      modification of physiological hyperactivity in healthy Type A individuals.

PMID- 1619588
TI  - Psychiatric morbidity in a gynaecology clinic in Nigeria.
AB  - Psychological disorders among 233 women attending a gynaecology out-patient
      clinic was assessed by a two-stage screening procedure, using the GHQ-30 and the
      PSE. The prevalence of psychiatric disorders was found to be 35.2%. Psychiatric
      morbidity was significantly associated with a history of induced abortion,
      previous marriages, having no children, complaints of menstrual abnormalities,
      chronic pelvic pain and having unsupportive husbands. It is suggested that more
      attention needs to be paid to the psychological health of patients with
      gynaecological disorders (in line with the biopsychosocial model of health care).
      This will ensure an overall improvement in the quality of care.

PMID- 1619589
TI  - Denial mechanisms in myocardial infarction: their relations with psychological
      variables and short-term outcome.
AB  - From a selected sample of 97 males suffering from a first myocardial infarction,
      67 patients were studied to ascertain the influence of denial mechanisms (DM) on
      their cardiological and psychological outcome. There were no differences among
      high deniers and low deniers with respect to the cardiological outcome, but high
      deniers showed less anxiety and depressive reactions both in the coronary unit
      and 1 month later, and also presented less psychopathology in general. In the
      last evaluation, one year after leaving the hospital (N = 52), there was no
      difference among deniers and non deniers in demand for psychiatric attention.

PMID- 1619590
TI  - Stress-induced changes in the rate of sodium excretion in healthy black and white
      men.
AB  - The effects of exposure to competitive mental stressors on rates of excretion of
      sodium (Na), potassium (K) and fluid, together with cardiovascular responses,
      were evaluated in 14 black and 14 white normotensive men after 3 days of
      controlled diet (200 mEq Na, 100 mEq K daily). In the first hour of a 5-hr
      protocol, subjects ingested a standard dinner and drank 1 liter of water. In
      hours 2-5, they voided to provide urine collections every 30 min, and drank 200
      ml additional water after each collection. Hours 1-2 were for stabilization of
      excretion, hour 3 was baseline, hour 4 was stress and hour 5 was post-stress
      rest. During stress, 20 men showed faster natriuresis and 8 showed slower
      natriuresis than at baseline. These subgroups did not differ in any excretion
      measure at baseline. During stress, the slow stress natriuresis group showed
      slower excretion of potassium and fluid as well as sodium; slow natriuresis and
      kaliuresis persisted 30 min after stress. Creatinine clearance rate was also
      decreased, but only during the first 30 min of stress. Slow stress natriuresis
      subjects were found to have higher blood pressures during baseline and stress,
      greater heart rate and cardiac output increases during stress, and a larger
      percentage had hypertensive parents (63 vs 37%) compared to fast stress
      natriuresis subjects. Slow stress natriuresis was observed in 50 vs 17% of men
      with resting diastolic levels above vs below 80 mmHg, and in 43% of blacks vs 18%
      of whites tested. Overall, black subjects tended to excrete sodium more slowly
      than whites at baseline, and showed significantly lesser increases in sodium
      excretion rate when pressures rose during stress.

PMID- 1619592
TI  - Respiratory distress resulting from acute lung injury in the veterinary patient.
AB  - Because of improved management of animals in intensive care facilities,
      veterinarians are often confronted with patients at risk of developing adult
      respiratory distress syndrome (ARDS). The four objectives of this review are: 1)
      to describe the clinical conditions which place animals at risk for development
      of ARDS, 2) to give the reader a comprehensive understanding of the
      pathophysiology of endotoxin-induced lung injury, 3) to address the interspecies
      variability in susceptibility to endotoxin-induced lung injury, and 4) to outline
      areas where veterinarians should be concentrating their diagnostic and
      therapeutic efforts with regards to this syndrome. Because there is little
      written in the veterinary literature on ARDS, this review will rely heavily on
      the human ARDS literature as well as on research in animal models of acute lung
      injury.

PMID- 1619591
TI  - Canine bladder and urethral tumors: a retrospective study of 115 cases (1980
      1985).
AB  - One hundred and fifteen dogs with neoplasms of the lower urinary tract (bladder
      and/or urethra) were retrospectively evaluated at five referral institutions
      participating in ongoing studies by the Veterinary Cooperative Oncology Group.
      Most tumors were malignant (97%) and of epithelial origin (97%). Lower urinary
      tract tumors were more common in older dogs weighing greater than 10 kg. The
      following significant (P less than 0.05) statistical associations were found
      using the University of Guelph hospital population as control; there was no sex
      predisposition although the female:male ratio was 1.95:1. Neutered dogs were
      predisposed as were Airedale Terriers, Beagles, and Scottish Terriers, whereas
      German Shepherds were significantly under-represented among dogs with lower
      urinary tract tumors. These statistical associations should be interpreted
      cautiously because of possible demographic differences in hospital populations
      among the University of Guelph and other cooperating institutions. There were no
      significant correlations between age, gender, weight, breed, response to therapy,
      and survival time. Clinical signs were indicative of lower urinary tract disease
      and included hematuria, stranguria, and pollakiuria. The laboratory data were
      nonspecific except for urinalysis test results. Hematuria and inflammatory
      urinary sediments were most commonly reported; neoplastic cells were identified
      in the urine sediment of 30% of dogs with lower urinary tract tumors. Contrast
      cystography was a useful noninvasive diagnostic method since 96% of the dogs had
      a mass or filling defect in the lower urinary tract demonstrated by this
      technique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619593
TI  - Unilateral and bilateral brainstem auditory-evoked response abnormalities in 900
      Dalmatian dogs.
AB  - In a survey of 900 Dalmatian dogs, brainstem auditory-evoked responses (BAER) and
      clinical observations were used to determine the incidence and sex distribution
      of bilateral and unilateral BAER abnormalities and their association with
      heterochromia iridis (HI). To assess the efficacy of BAER testing in guiding
      breeding programs, data from 749 dogs (subgroup A), considered to be a sample of
      the population at large, were compared with data from a subgroup (subgroup B; n =
      151) in which selection of breeding stock had been based on BAER testing from the
      beginning of the 4-year survey. Brainstem auditory-evoked responses were elicited
      by applying click stimuli unilaterally, while applying a white noise masking
      sound to the contralateral ear. Under these conditions, BAER were either normal,
      unilaterally absent, or bilaterally absent. Dogs with bilaterally absent BAER
      were clinically deaf; dogs with unilaterally absent BAER were not clinically deaf
      but appeared dependent on their BAER-normal ears for their auditory-cued
      behavior. Dogs with unilaterally absent BAER often were misidentified as normal
      by uninformed observers. Among the 900 dogs, 648 (72.0%) were normal, 189 (21.0%)
      had unilateral absence of BAER, and 63 (7.0%) had bilateral absence of BAER or
      were clinically deaf and assumed to have bilaterally absent BAER (n = 4). Total
      incidence in the population sampled was assumed to be higher, because some
      bilaterally affected dogs that would have been members of subgroup A undoubtedly
      did not come to our attention. Among females, 24.0% were unilaterally abnormal
      and 8.2% were bilaterally abnormal whereas, among males, 17.8% were unilaterally
      abnormal and 5.7% were bilaterally abnormal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619594
TI  - Brainstem auditory-evoked potential assessment of congenital deafness in
      Dalmatians: associations with phenotypic markers.
AB  - To screen for congenital deafness, brainstem auditory-evoked potential (BAEP)
      testing was performed on 1031 Dalmatians from three geographically separated
      areas. Phenotypic marker assessment was done to determine markers possibly
      associated with deafness. Markers included sex, hair coat color, pigmentation of
      different areas of skin (eye rims, nose, and ears), presence of a patch, spot
      size and marking (density of spotting), sire and dam BAEP status, and presence of
      iris and retinal tapetal pigmentation. Combined data from all test sites showed
      8.1% bilateral deafness (N = 83 dogs) and 21.6% unilateral deafness (N = 223), or
      an overall 29.7% incidence of hearing disorders. Significant (P less than 0.05)
      associations with deafness for the data from all test sites combined were seen
      for patch, sire and dam BAEP, iris pigment, and retinal pigment. However, results
      differed for several of the significant phenotypic markers when analyses were
      done on the data from the individual test sites; changes from significant to not
      significant were found. This suggested the existence of multiple populations of
      deafness patterns, and reinforced the precautionary conclusion that associations
      of phenotypic markers with deafness are not necessarily functionally significant.

PMID- 1619595
TI  - Post-transfusion survival of 50Cr-labeled erythrocytes in neonatal foals.
AB  - Erythrocytes transfused allogeneically into mature horses have a short survival
      (less than 4 days) compared with an expected erythrocyte life span of 140-150
      days. Yet, foals undergo transfusions for neonatal isoerythrolysis successfully.
      The authors have determined the survival of transfused erythrocytes in neonatal
      foals, using the stable isotope, 50Cr, to label the erythrocytes. Normal foals
      underwent transfusions with labeled erythrocytes from three sources: their own
      erythrocytes (autologous), the erythrocytes of their dam, and the erythrocytes of
      an unrelated castrated male. After transfusion, samples were taken at 15 minutes
      and then daily for a week and every 2 or 3 days for 20 days. A stable isotope of
      iron (57Fe) and 50Cr were determined on diluted-packed erythrocytes by
      inductively coupled argon-coupled mass spectrometry techniques. 57Fe was used as
      measure of the sample hemoglobin concentration. The ratio of 50Cr to 57Fe
      decreased exponentially in all foals. Half-time (T1/2) was 11.7 days (standard
      error = 2.2) for four foals that underwent autologous transfusions, 5.5 +/- 1.0
      days for five foals that underwent transfusions with the erythrocytes of their
      dams, and 5.2 +/- 1.1 days for five foals that had transfusions with erythrocytes
      from an unrelated gelding. The authors conclude that erythrocytes that are
      transfused allogenically into neonatal foals will survive longer than those
      transfused into mature horses and that 50Cr labeling can be used to measure
      survival of transfused erythrocytes.

PMID- 1619596
TI  - A review of disorders of the gallbladder and extrahepatic biliary tract in the
      dog and cat.
AB  - Disorders of the gallbladder and extrahepatic biliary tract in the dog and cat
      can easily be confused with other intra-abdominal disorders. This confusion
      results because many times the clinical course and signs of biliary tract disease
      are similar to these other intra-abdominal disorders. This review discusses the
      normal anatomy and physiology of the gallbladder, bile duct, and bile in the dog
      and cat and then summarizes the historic, physical examination,
      clinicopathologic, diagnostic, histologic and therapeutic aspects of all the
      cases of extrahepatic biliary tract disease reported in the veterinary
      literature.

PMID- 1619597
TI  - Failure of passive transfer in foals.

PMID- 1619598
TI  - Hepatic organelle pathology in dogs with CPSS.

PMID- 1619600
TI  - Cervex-Brush and Cytobrush: comparison of their ability to sample abnormal cells
      for cervical smears.

PMID- 1619599
TI  - Intrapleural administration of cisplatin (DDP) for treatment of pleural
      neoplasia.

PMID- 1619601
TI  - Traditional and molecular cytogenetics.
AB  - Traditional cytogenetic methods have relied on tissue culture techniques to
      generate adequate mitotic cells for the analysis of chromosome disorders for
      prenatal diagnosis. Chromosome banding techniques allow the evaluation of mitotic
      cells for structural and numerical aberrations and define the nature of any
      rearrangement. With the advent of fluorescent in situ hybridization methodology,
      which combines the molecular technologies of chromosome-specific probes and in
      situ molecular hybridization, it has become possible to analyze chromosomal
      numerical and structural aberrations from interphase cells. The use of molecular
      cytogenetic techniques should greatly increase the speed and diagnostic
      resolution of clinical specimens.

PMID- 1619602
TI  - TORCH infections. Diagnosis in the molecular age.
AB  - TORCH agents cause a varied spectrum of disease. Advances in ultrasound, invasive
      perinatal procedures and molecular diagnostics have allowed in utero evaluation.
      Infected fetuses, especially those which are sonographically abnormal, may be
      treated in utero depending upon the pathogen and attendant pathophysiology.
      Subclinical perinatal infections may lead to later childhood deficits. Such
      infected fetuses may benefit from early diagnosis and prompt initiation of
      rehabilitative measures.

PMID- 1619603
TI  - Prospects for human gene therapy.
AB  - Retroviral vectors containing marker genes and the sequence for human proteins
      have been used to transduce cultured lymphocytes, which have then been reinfused
      into patients. Circulating hematopoietic progenitor cells from human fetal cord
      blood obtained at the time of term and premature deliveries as early as 19 weeks
      of gestation have been shown to express such transduced genes in vitro. Cord
      blood cells from fetal sheep sampled and transduced ex vivo and transfused back
      in utero expressed marker genes up to two years after birth. Although the
      efficiency of gene transfer into cells and their long-term expression need to be
      improved, the potential exists for treating some genetic diseases after prenatal
      diagnosis either in utero or shortly after birth.

PMID- 1619604
TI  - In utero stem cell therapy.
AB  - In utero stem cell transplantation offers the potential for treating a number of
      genetic disorders. The combination of fetal immunotolerance and fetal marrow
      space makes the fetus an excellent transplant recipient. Experiments on the
      mouse, sheep and rhesus monkey have indicated that in utero transplantation is
      feasible. Human trials are currently beginning.

PMID- 1619605
TI  - Legal and ethical issues arising from the new genetics.
AB  - Legal and ethical issues involving genetics arise at the level of carrier
      screening, preimplantation diagnosis in embryos and prenatal diagnosis in
      fetuses. A strong commitment to procreative liberty and autonomy should permit
      patients and physicians to gain access to genetic information at every stage of
      decision making. Even if Roe v Wade is reversed, considerable room for the use of
      genetic information in procreative decision making will remain.

PMID- 1619606
TI  - Endothelium-derived relaxation of the pregnant and nonpregnant canine uterine
      artery.
AB  - Vascular responses to acetylcholine (ACh) and the calcium ionophore A23187 were
      studied in rings of pregnant and nonpregnant canine uterine arteries. Segments
      were fixed vertically in Krebs-Henseleit solution, and isometric tension was
      measured with force-displacement transducers. In nonpregnant canine artery
      preparations precontracted to a stable plateau tension with norepinephrine, ACh
      and A23187, dose-dependent relaxation was elicited in intact rings but not in
      endothelium-denuded rings. This endothelium-dependent relaxation was not affected
      by pretreatment with indomethacin but was inhibited by pretreatment with
      lipoxygenase inhibitors, nordihydroguaiaretic acid and the selective 5
      lipoxygenase inhibitor AA861. Therefore, relaxation appeared to be mediated by a
      noncycloxygenase metabolite or metabolites. Similar endothelium-dependent
      relaxation was also observed in pregnant canine artery preparations. The results
      indicate that an endothelium-derived relaxing factor might play a physiologic
      role in maintaining the blood flow of the uterine circulation.

PMID- 1619607
TI  - Laser vaporization conization.
AB  - Laser vaporization conization is a modified technique for the diagnosis and
      treatment of cervical intraepithelial neoplasia. Two circles are marked on the
      cervix with the laser; the inner circle outlines the circumference of the
      conization specimen, while the outer one outlines an area 3 mm peripheral to all
      colposcopically abnormal tissue. The area between the circles is vaporized to 7
      mm. This initial vaporization allows easier manipulation of the conization
      specimen. Laser conization is then performed. This technique is significantly
      easier to perform than laser excisional conization or combination excisional
      vaporization conization and thus is ideal for teaching residents laser
      conization. Besides ease of performance, laser vaporization conization retains
      the advantages of laser vaporization and provides a specimen for pathologic
      review. In this study the median laser time was 14 minutes. There was minimal
      operative hemorrhaging, and only one patient (2%) developed a secondary cervical
      hemorrhage. A significant laser artifact was present in one case (2%). One case
      of invasive squamous cell cancer was diagnosed.

PMID- 1619608
TI  - Confusion of trimester and viability. Consequences for abortion laws in the
      United States and abroad.
AB  - The present U.S. abortion law, Roe v Wade, is based on the trimester/viability
      concept. However, both concepts seem to be biologically ill founded and are
      likely to contribute to confusion regarding abortion laws. A survey of the
      abortion laws in individual states revealed a lack of uniformity. The time limit
      for abortion upon request varies from 13 to 28 weeks; nine states have no
      specific abortion law. This confusion also exists in other countries. Standards
      are lacking regarding requests for the dates of the last menstrual period,
      fertilization and implantation. Some states do not allow termination of pregnancy
      for maternal indications after 24 weeks, and the definition of maternal
      endangerment has rarely been addressed and remains vague. Only a few states have
      provisions for fetal malformation. Such terms as trimester and viability are not
      biologically founded and are likely to contribute to the confusion. The
      terminology should be clarified so abortion, contraception, birth control and
      other such terms are uniform.

PMID- 1619609
TI  - Characteristics of second labor occurring 10 or more years after the first.
AB  - Labor characteristics in 89 women undergoing a second vaginal delivery 10-18
      years after the first were compared retrospectively with those of 136 women with
      an interval of 1-4 years between their first and second vaginal deliveries and
      with those of 128 nulliparous women. The pelvic findings on admission, average
      length of stages 1 and 2 of labor, average cervical dilation per hour and rates
      of surgical intervention in relation to arrest disorders were similar in the two
      multiparous groups and significantly different from these parameters in the
      nulliparous group. Women with long intervals between their first and second
      vaginal deliveries should be managed in the same way as are other multiparas and
      not like nulliparas with respect to such issues as indications for oxytocin
      treatment, surgical intervention and use of conduction anesthesia.

PMID- 1619610
TI  - Value of subcutaneous and intravenous pulsatile gonadotropin releasing hormone in
      polycystic ovary disease.
AB  - Nine patients with clomiphene-resistant polycystic ovary disease (PCOD) were
      treated with pulsatile gonadotropin releasing hormone (GnRH). The patients were
      started on subcutaneous (SC) GnRH. If they failed to ovulate on SC therapy,
      intravenous (IV) therapy was administered. Nine patients were treated for a total
      of 22 cycles; 13 were SC and 9, IV. There were nine ovulatory cycles (41%); four
      were SC (31%) and five, IV (56%). Two conceptions occurred, both among the IV
      cycles. One conception was a singleton; the infant was delivered uneventfully at
      term. The second conception was quadruplets, with the delivery of four healthy
      infants at 36 weeks. These data suggest that ovulation and conception in
      clomiphene-resistant PCOD patients using pulsatile GnRH are more likely to occur
      after IV than SC administration. However, the overall pregnancy rate was not
      greater than with gonadotropin treatment, and the risk of multiple births after
      IV administration is potentially high.

PMID- 1619611
TI  - Conservative management of splenic subcapsular hematoma in the third trimester of
      pregnancy. A case report.
AB  - A delayed splenic hemorrhage from a subcapsular hematoma occurred in association
      with pregnancy. That rare complication carries a high mortality rate, is rarely
      diagnosed preoperatively and is correctly diagnosed only 20% of the time. The
      clinical setting and a high index of suspicion led us to investigate for the
      presence of a splenic hematoma. A computed tomographic scan was invaluable in
      establishing the diagnosis. We adopted a conservative approach and followed the
      patient's clinical course from 28 to 40 weeks' gestation, until she delivered
      vaginally. In general, patient management (conservative vs. splenectomy) and mode
      of delivery will depend on how close one is to the initial event, on the
      patient's and fetus's clinical condition and on the gestational age.

PMID- 1619612
TI  - Vulvar cicatricial pemphigoid as a lichen sclerosus imitator. A case report.
AB  - Because vulvar lichen sclerosus is very common, a clinician confronted with
      hypopigmentation and agglutination of the labia minora is tempted to make a
      diagnosis of the disease without the benefit of a skin biopsy or a careful
      examination of other epithelial surfaces. Unfortunately, that clinical picture is
      also consistent with the end stage of several other diseases, including
      cicatricial pemphigoid (benign mucous membrane pemphigoid), as demonstrated by a
      case of cicatricial pemphigoid affecting the vulva.

PMID- 1619613
TI  - Antepartum fetomaternal hemorrhage. Report of a case with the use of
      cordocentesis in diagnosis and management.
AB  - Clinical recognition of antepartum fetomaternal hemorrhage (FMH) is most often
      achieved by the observation of characteristic fetal heart rate (FHR) patterns and
      positive Kleihauer-Betke acid elution staining. Both methods are noted to lack
      sensitivity and specificity. A case of suspected antepartum FMH occurred with
      intermittent sinusoidal FHR tracings. Fetal blood sampling by cordocentesis in
      situations with equivocal antenatal testing, such as in this case, allows not
      only confirmation of fetal anemia but assessment of fetal acid-base status. In
      pregnancies of less than 32 weeks' gestation complicated by severe antepartum
      FMH, intravascular transfusion may be offered via this technique. Cordocentesis
      is beneficial in the management of pregnancies with uncertain FHR patterns when
      antepartum FMH is suspected.

PMID- 1619614
TI  - Synthesis and anti-HIV activity of isonucleosides.
AB  - A series of isomeric 2',3'-dideoxynucleosides which contains a modified
      carbohydrate moiety has been prepared. This class of compounds was designed to
      mimic the activity of known anti-HIV dideoxynucleosides, while imparting enhanced
      chemical and enzymatic stability. Isonucleosides containing the standard
      heterocyclic bases (A, C, G, T) were synthesized via nucleophilic addition of the
      base to an isomeric sugar unit. Modified derivatives were generated by
      manipulation of the intact isonucleoside. Two of the compound prepared, iso-ddA
      (1) and iso-ddG (6), exhibit significant and selective anti-HIV activity, as well
      as beneficial hydrolytic stability.

PMID- 1619615
TI  - 2-Alkynyl derivatives of adenosine and adenosine-5'-N-ethyluronamide as selective
      agonists at A2 adenosine receptors.
AB  - In the search for more selective A2-receptor agonists and on the basis that
      appropriate substitution at C2 is known to impart selectivity for A2 receptors, 2
      alkynyladenosines 2a-d were resynthesized and evaluated in radioligand binding,
      adenylate cyclase, and platelet aggregation studies. Binding of [3H]NECA to A2
      receptors of rat striatal membranes was inhibited by compounds 2a-d with Ki
      values ranging from 2.8 to 16.4 nM. 2-Alkynyladenosines also exhibited high
      affinity binding at solubilized A2 receptors from human platelet membranes.
      Competition of 2-alkynyladenosines 2a-d for the antagonist radioligand [3H]DPCPX
      and for the agonist [3H]CCPA gave Ki values in the nanomolar range, and the
      compounds showed moderate A2 selectivity. In order to improve this selectivity,
      the corresponding 2-alkynyl derivatives of adenosine-5'-N-ethyluronamide 8a-d
      were synthesized and tested. As expected, the 5'-N-ethyluronamide derivatives
      retained the A2 affinity whereas the A1 affinity was attenuated, resulting in an
      up to 10-fold increase in A2 selectivity. A similar pattern was observed in
      adenylate cyclase assays and in platelet aggregation studies. A 30- to 45-fold
      selectivity for platelet A2 receptors compared to A1 receptors was found for
      compounds 8a-c in adenylate cyclase studies.

PMID- 1619616
TI  - Substituent variation in azabicyclic triazole- and tetrazole-based muscarinic
      receptor ligands.
AB  - The effect of variation of the 1-azabicyclic substituent on the novel 1,2,3
      triazol-4-yl-, 1,2,4-triazol-1-yl, tetrazol-5-yl-, and tetrazol-2-yl-based
      muscarinic receptor ligands has been studied, and the exo-azabicyclic[2.2.1]hept
      3-yl substituent was found to give the most potent and efficacious compounds. In
      addition, variation of the second substituent on 1,2,4-triazol-1-yl- and tetrazol
      2-yl-based muscarinic receptor ligands has yielded a series of novel compounds
      with high potencies and efficacies, ranging from full agonists to antagonists.
      Small lipophilic electron withdrawing substituents give potent but low efficacy
      compounds, while small polar electron donating substituents give potent and
      efficacious compounds. The activity of these compounds is described in terms of a
      model of the receptor involving lipophilic and hydrogen bonding interactions.
      These compounds provide muscarinic ligands with high potency and a range of
      efficacies suitable for testing as candidate drugs in the treatment of
      Alzheimer's disease.

PMID- 1619617
TI  - Inhibition of N8-acetylspermidine deacetylase by active-site-directed metal
      coordinating inhibitors.
AB  - A number of substrate analogues of N8-acetylspermidine (N8-AcSpd) (16) and
      chemical modifying agents containing metal coordinating ligands were assayed as
      inhibitors of the cytoplasmic enzyme N8-AcSpd deacetylase from rat liver. The
      enzyme is inhibited by metal chelators, several omega-amino-substituted
      carboxylic acids, and some thiol reagents. Inhibition by diisopropyl
      fluorophosphate was observed only at high concentrations. These results suggest
      that the catalytic mechanism of the enzyme requires a transition state metal and
      free sulfhydryl groups for activity. The most potent inhibitor synthesized 6-[(3
      aminopropyl)amino]-N-hydroxyhexanamide (15), has an apparent Ki of 0.001 microM.
      It binds to the target enzyme 11,000 times tighter than the substrate (apparent
      Km = 11 microM). These compounds and a previously reported series of compounds
      (Dredar, S. A.; Blankenship, J. W.; Marchant, P. E.; Manneh, V. A.; Fries, D. S.
      J. Med. Chem. 1989, 32, 984-989) are useful in mapping the active site and
      determining the physiological function of N8-AcSpd deacetylase.

PMID- 1619618
TI  - Quantitative structure-activity relationships of benzamide derivatives for anti
      leukotriene activities.
AB  - To determine the structural requirements of the benzamide derivatives reported by
      Nakai et al. (J. Med. Chem. 1988, 31, 84-91) for antileukotriene activity, we
      studied their conformational characteristics in comparison with those of
      leukotriene. By superimpositions of the conformations of antagonists on that of
      leukotriene, we found that the conformations of the conjugated benzamide moiety,
      tetrazole ring, and benzopyran or benzodioxan ring of the antagonists correspond
      to the triene moiety, peptide carboxylic acid residue, and cysteine residue of
      leukotriene, respectively, but that no moiety of the antagonists corresponds to
      the terminal aliphatic carboxylic acid moiety of leukotriene. Furthermore, the
      stable conformations of alkyl and alkoxy groups of the antagonists were quite
      different from that of the omega-chain of leukotriene. However, conformational
      analyses taking all the possible rotations of these flexible chains into
      consideration showed that antagonists in which these flexible chains can most
      feasibly adopt the same lengths as those of the omega-chain exhibit potent
      antagonist activity. From these results, we deduced the structural features of
      benzamide derivatives necessary for potent antileukotriene activity.

PMID- 1619619
TI  - Structure-activity relationship in the gastric cytoprotective effect of several
      sesquiterpene lactones.
AB  - The structural requirements for the gastric cytoprotective activity of several
      sesquiterpene lactones are reported. A theoretical-experimental study on the
      potentially active centers is carried out. The biological evaluation of reduced
      analogues and the simulation of the molecular interactions between these
      compounds and an endogenous cysteine residue suggest that the presence of a non
      sterically hindered Michael acceptor seems to be an essential structural
      requirement for the cytoprotective activity in this family of compounds. This
      observation suggests that cytoprotection is mediated through a Michael reaction
      between the sulfhydryl-containing peptides of the mucosa and Michael acceptors
      present in the molecules under study. This mechanism of action is in addition to
      and distinct from the one proposed in our previous paper, namely, that these
      sesquiterpenes stimulate endogenous synthesis of prostaglandins.

PMID- 1619620
TI  - Extraordinarily potent antimalarial compounds: new, structurally simple, easily
      synthesized, tricyclic 1,2,4-trioxanes.
AB  - New, racemic, tricyclic trioxane alcohol 3 was designed and synthesized as a
      structurally simple analog of clinically useful, tetracyclic, antimalarial
      artemisinin. A series of 20 ester and ether derivatives of alcohol 3 were
      prepared easily, without destruction of the essential trioxane system. Chemical
      structure-antimalarial activity for each derivative was evaluated in vitro
      against chloroquine-resistant and chloroquine-sensitive Plasmodium falciparum
      parasites. Many of these derivatives were highly efficacious; carboxylate ester
      9f, carbamate ester 10a, and sulfonate ester 12a had antimalarial potency similar
      to that of artemisinin, and carboxylate esters 9b and 9d, carbamate esters 10b
      and 10c, and phosphate esters 11a-c had antimalarial potency up to 7 times higher
      than that of artemisinin. Several of these most active analogs (e.g., carboxylate
      9b and carbamates 10a and 10c) are stable crystalline solids, a feature of
      considerable practical value for any new drug candidate.

PMID- 1619621
TI  - Novel sulfonamides as potential, systemically active antitumor agents.

PMID- 1619622
TI  - Isopropyl and phenyl esters of 3 beta-(4-substituted phenyl)tropan-2 beta
      carboxylic acids. Potent and selective compounds for the dopamine transporter.

PMID- 1619623
TI  - Unprincipled QALYs: a response to Harris.

PMID- 1619624
TI  - No-fault compensation for victims of non-therapeutic research--should government
      continue to be exempt?

PMID- 1619625
TI  - Health care ethics and casuistry.

PMID- 1619626
TI  - On lying and deceiving.
AB  - This article challenges Jennifer Jackson's recent defence of doctors' rights to
      deceive patients. Jackson maintains there is a general moral difference between
      lying and intentional deception: while doctors have a prima facie duty not to
      lie, there is no such obligation to avoid deception. This paper argues 1) that an
      examination of cases shows that lying and deception are often morally equivalent,
      and 2) that Jackson's position is premised on a species of moral functionalism
      that misconstrues the nature of moral obligation. Against Jackson, it is argued
      that both lying and intentional deception are wrong where they infringe a
      patient's right to autonomy or his/her right to be treated with dignity. These
      rights represent 'deontological constraints' on action, defining what we must not
      do whatever the functional value of the consequences. Medical ethics must
      recognise such constraints if it is to contribute to the moral integrity of
      medical practice.

PMID- 1619627
TI  - Attitudes of a Mediterranean population to the truth-telling issue.
AB  - The attitudes of the Greeks, a Mediterranean population, to the issue of telling
      the truth to the patient have been studied. There is no clear answer to the
      question: 'Do the Greeks wish to be informed of the nature of their illness?'.
      The answer is: 'It depends'. It depends on age, education, family status,
      occupation, place of birth and residence and on whether or not they are religious
      people. However, it does not depend on their sex--men and women have similar
      reactions to the issue of truth-telling. Although the present study shows lower
      percentages of those who wish to know the truth than studies on other
      populations, the conclusion is that, emphasising the need for good communication
      between doctors and patients, doctors should not lie, but should disclose to
      their patients the part of the truth they are ready to accept.

PMID- 1619629
TI  - A proposal to classify happiness as a psychiatric disorder.
AB  - It is proposed that happiness be classified as a psychiatric disorder and be
      included in future editions of the major diagnostic manuals under the new name:
      major affective disorder, pleasant type. In a review of the relevant literature
      it is shown that happiness is statistically abnormal, consists of a discrete
      cluster of symptoms, is associated with a range of cognitive abnormalities, and
      probably reflects the abnormal functioning of the central nervous system. One
      possible objection to this proposal remains--that happiness is not negatively
      valued. However, this objection is dismissed as scientifically irrelevant.

PMID- 1619628
TI  - The psychological profile of parents who volunteer their children for clinical
      research: a controlled study.
AB  - Three standard psychometric tests were administered to parents who volunteered
      their children for a randomised, double-blind placebo-controlled trial of a new
      asthma drug and to a control group of parents whose children were eligible for
      the trial but had declined the invitation. The trial took place at a children's
      hospital in Australia. The subjects comprised 68 parents who had volunteered
      their children and 42 who had not, a participation rate of 94 per cent and 70 per
      cent, respectively. The responses of these parents to the Gordon Survey of
      Interpersonal Values Questionnaire, the Coopersmith Self-Esteem Inventory and the
      Cattell Sixteen Personality Factor Questionnaire were analysed by computer. There
      was a marked difference between the psychological profiles of the two groups of
      parents. Volunteering parents put more value on benevolence while non
      volunteering parents were more concerned with power and prestige. The self-esteem
      of volunteering parents was much lower than that of non-volunteering parents.
      Finally, volunteering parents were more introverted, exhibited greater anxiety
      and low supergo, while non-volunteering parents appeared to have greater social
      confidence and emotional stability. Since an individual's values, self-esteem and
      personality may be important antecedents of behaviour, these findings suggest
      that parents who volunteer their children for clinical research are not only
      socially disadvantaged and emotionally vulnerable, but may also be
      psychologically predisposed to volunteering. Furthermore, these findings provide
      evidence for the existence of a psychosocial 'filter' effect of the informed
      consent procedure, which may be discouraging the better educated, more privileged
      and psychologically resilient members of society from participation as research
      subjects.

PMID- 1619630
TI  - Resource allocation--what is the first priority?

PMID- 1619631
TI  - Experience with direct molecular diagnosis of fragile X.
AB  - The utility of the pfxa3 probe for direct molecular diagnosis of the fragile X
      (FRAXA) has been established. This probe detects amplification of an unstable DNA
      element consisting of variable length CCG repeats. The size of the amplified
      fragment is correlated with phenotype and was determined using PstI digested DNA
      in family members. In 35 families with the fragile X, there was correspondence in
      183 cases between the presence of an amplified unstable element and the presence
      of the fragile X chromosome independently determined by cytogenetics, position in
      the pedigree, or linked DNA markers flanking the fragile X. There was also
      correspondence in 124 cases between the presence of the normal 1.0 kb PstI
      fragment and absence of the fragile X chromosome independently determined by
      linked flanking markers. Six additional families considered to be isolated cases
      of 'fragile X' had been diagnosed before recognition of FRAXD. The pfxa3 probe
      confirmed the cytogenetic diagnosis in three families, the other three being
      rediagnosed as non-fragile X. A further two families had consistent expression of
      a different folate sensitive fragile site, FRAXE, close to FRAXA but not
      associated with fragile X syndrome and not detectable with the pfxa3 probe.
      Subsequent referrals were received from additional family members or from members
      of new families for whom carrier status had not been predetermined by linked
      markers. Direct pfxa3 diagnosis for the 135 females within these 222 additional
      cases was confirmed by dosage analysis with the control probe pS8.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1619632
TI  - Detection and characterisation of an overmodified type III collagen by analysis
      of non-cutaneous connective tissues in a patient with Ehlers-Danlos syndrome IV.
AB  - The clinical and biochemical observations in a patient with a mild form of Ehlers
      Danlos syndrome (EDS) type IV are described. The patient's skin fibroblasts
      produced markedly diminished amounts of type III collagen. SDS-polyacrylamide gel
      electrophoresis of collagens produced by cells obtained from other, non-cutaneous
      tissues showed two forms of collagen alpha 1(III) chains, a normal and a slow
      migrating, mutant form. Further analysis confirmed that the type III collagen
      molecules containing mutant alpha chains which were overmodified had a lower
      thermal stability and were poorly secreted into the extracellular medium. The
      protein defect was mapped by in situ cyanogen bromide digestion and was located
      in alpha 1(III) CB9, the C-terminal peptide of the collagen triple helix. This
      study shows that non-cutaneous connective tissues can be a useful source for the
      study of type III collagen defects in patients with EDS type IV.

PMID- 1619633
TI  - Limb-girdle type muscular dystrophy in a large family with distal myopathy:
      homozygous manifestation of a dominant gene?
AB  - A family study was carried out to clarify the problem of two separate muscle
      disease phenotypes in a large consanguineous pedigree. These were a severe limb
      girdle type muscular dystrophy and a mild late onset distal myopathy. Thirty-two
      first degree and 14 other relatives of 18 previously examined index patients were
      available for clinical examination. Twenty-three subjects underwent computed
      tomography of the lower leg muscles. No new cases of limb-girdle type muscular
      dystrophy were found. Distal myopathy was diagnosed in 14 subjects, 10 first
      degree relatives and four other relatives. Segregation analysis showed that the
      corrected proportion of affected with the severe proximal type was 0.246 and the
      proportion of affected with the distal myopathy was 0.58. Pedigree analysis is
      compatible with the possibility that the mild, late onset distal myopathy is
      caused by a dominant gene and that the limb-girdle type may be expressed in
      homozygotes.

PMID- 1619634
TI  - Use of oocytes from anonymous, matched, fertile donors for prevention of
      heritable genetic diseases.
AB  - Heritable genetic diseases can be prevented with the use of donor oocytes. We
      report our experience in using donor oocytes from anonymous, matched, fertile
      donors in four women with heritable genetic disorders. Our results show that use
      of donor oocytes is a practical, successful, and currently available technique
      for the prevention of genetic disorders.

PMID- 1619635
TI  - A complex rearrangement associated with sex reversal and the Wolf-Hirschhorn
      syndrome: a cytogenetic and molecular study.
AB  - We report a male infant referred with multiple congenital abnormalities
      consistent with the Wolf-Hirschhorn syndrome. Cytogenetic analysis showed a
      chromosome complement of 46,XX with a deletion of 4p15.2----4pter and its
      replacement by material of unknown origin. The patient was positive for a number
      of Yp probes including SRY, the testis determining factor, and in situ
      hybridisation localised the Yp material to the tip of the short arm of one X
      chromosome. Using pDP230, a probe for the pseudoautosomal region, and M27 beta,
      which recognises a locus in proximal Xp, the material translocated on to 4p was
      identified as originating from the short arm of the paternal X chromosome. The
      most reasonable explanation for this complex rearrangement is two separate
      exchange events involving both chromatids of Xp during paternal meiosis. An
      aberrant X-Y interchange gave rise to the sex reversal and an X;4 translocation
      resulted in additional, apparently active Xp material and a deletion of 4p which
      produced the Wolf-Hirschhorn phenotype.

PMID- 1619636
TI  - Distal 8p deletion (8p23.1----8pter): a common deletion?
AB  - The clinical manifestations and cytogenetic details of five patients with a de
      novo deletion of the short arm of chromosome 8, del(8)(p23), are described. Of
      the four surviving children all had mild mental retardation and subtle facial
      anomalies; three of the five had cardiac abnormalities. The clinical features
      seen in these patients are compared with those of three previous single case
      reports with del(8)(p23), and with patients described as having the '8p-'
      syndrome associated with del(8)(p21). The findings in these patients suggest that
      major congenital anomalies, especially congenital heart defects, are frequent
      even in small distal 8p deletions, but facial dysmorphism may be subtle and
      mental retardation less severe than in those with deletions associated with more
      proximal breakpoints. The five patients were detected within a four year period,
      suggesting that this deletion syndrome is relatively frequent. The possible
      mechanisms for the formation of terminal deletions are discussed.

PMID- 1619637
TI  - Angelman syndrome.

PMID- 1619638
TI  - Acromegaloid facial appearance (AFA) syndrome: report of a second family.
AB  - A family is reported in which the 'acromegaloid facial appearance' (AFA)
      phenotype was segregating through two generations. The five affected persons
      showed a striking resemblance to the patients previously reported, including
      progressively coarse acromegaloid-like facial appearance, narrow palpebral
      fissures, bulbous nose, and thickening of the lips and intraoral mucosa,
      resulting in exaggerated rugae and frenula. These patients also had increased
      birth weight and dull mentality. It is unclear if the differences between the two
      families mark distinct syndromes or simply extend the AFA phenotype.

PMID- 1619639
TI  - An infant with multiple congenital abnormalities and biochemical findings
      suggesting a variant of galactosialidosis.
AB  - A female newborn probably with a variant form of galactosialidosis is described.
      The patient, in addition to the common findings seen in early infantile forms of
      classical galactosialidosis, displayed an unusual combination of congenital
      malformations including complex cyanotic congenital heart disease with
      dextrocardia and situs inversus.

PMID- 1619640
TI  - The 3-M syndrome: risk of intracerebral aneurysm?
AB  - We describe a child with typical features of the 3-M syndrome who presented with
      acute hydrocephalus owing to haemorrhage from one of two intracranial cerebral
      vascular aneurysms. We suggest that other children with this disorder should be
      screened for similar complications.

PMID- 1619641
TI  - Cardiofaciocutaneous syndrome with new ectodermal manifestations.
AB  - We describe a 7 year old girl whose features satisfy the diagnosis of
      cardiofaciocutaneous syndrome. Her ectodermal features consist of fine, sparse
      hair, thin, opalescent nails, finger tip pads, generalised pigmentation of the
      skin, but no hyperkeratosis. Skin pigmentation and finger tip pads have not been
      previously reported in this syndrome. Twenty-two cases of CFC have been described
      but there is debate as to whether it is distinct from Noonan syndrome.

PMID- 1619642
TI  - Recurrence of orbital cysts in the branchio-oculo-facial syndrome.
AB  - Two sibs with the branchio-oculo-facial syndrome are reported. They both have
      orbital haemangiomatous cysts, which is a previously unreported feature. Both
      parents are clinically normal and unrelated. This disorder has been reported
      showing autosomal dominant transmission so this family could represent either an
      autosomal recessive form or germline mosaicism for the dominant gene.

PMID- 1619643
TI  - Two sibs with Wiedemann-Rautenstrauch syndrome: possibilities of prenatal
      diagnosis by ultrasound.
AB  - A girl with Wiedemann-Rautenstrauch syndrome was born to a non-consanguineous
      couple. During the pregnancy, growth retardation particularly in the biparietal
      and abdominal diameters but not the femoral length was detected through serial
      ultrasound scans. When the woman became pregnant again, in spite of having been
      assessed as having a 25% risk of recurrence, the prenatal findings seen in her
      previous pregnancy led us to suggest sequential echography and a similar pattern
      of growth retardation was shown. After termination, the male fetus was found to
      be affected by Wiedemann-Rautenstrauch syndrome. This case shows that ultrasound
      examination can be a useful tool in the prenatal diagnosis of this rare,
      autosomal recessive syndrome.

PMID- 1619644
TI  - The demonstration of monozygosity in twins discordant for sacral agenesis.

PMID- 1619645
TI  - Proceedings of the Pathological Society of Great Britain and Ireland, 165th
      meeting. Manchester, July 9-10, 1992. Abstracts.

PMID- 1619646
TI  - Unwinding of heterologous DNA by RecA protein during the search for homologous
      sequences.
AB  - The search for homologous sequences promoted by RecA protein in vitro involves a
      presynaptic filament and naked duplex DNA, the multiple contacts of which produce
      nucleoprotein networks or coaggregates. The single-stranded DNA within the
      presynaptic filaments, however, is extended to an axial spacing 1.5 times that of
      B-form DNA. To investigate this paradoxical difference between the spacing of
      bases in the RecA presynaptic filament versus the target duplex DNA, we explored
      the effect of heterologous contacts on the conformation of DNA, and vice versa.
      In the presence of wheat germ topoisomerase I, RecA presynaptic filaments induced
      a rapid, limited reduction in the linking number of heterologous circular duplex
      DNA. This limited unwinding of heterologous duplex DNA, termed heterologous
      unwinding, was detected within 30 seconds and reached a steady state within a few
      minutes. Presynaptic filaments that were formed in the presence of ATP gamma S
      and separated from free RecA protein by gel filtration also generated a ladder of
      topoisomers upon incubation with relaxed duplex DNA and topoisomerase. The
      inhibition of heterologous contacts by 60 mM-NaCl or 5 mM-ADP resulted in a
      corresponding decrease in heterologous unwinding. In reciprocal fashion, the
      stability or number of heterologous contacts with presynaptic filaments was
      inversely related to the linking number of circular duplex DNA. These
      observations show that heterologous contacts with the presynaptic filament cause
      a limited unwinding of the duplex DNA, and conversely that the ability of the DNA
      to unwind stabilizes transient heterologous contacts.

PMID- 1619648
TI  - Atomic interactions in protein-carbohydrate complexes. Tryptophan residues in the
      periplasmic maltodextrin receptor for active transport and chemotaxis.
AB  - We have refined the 1.9 A resolution crystal structures of two maltodextrin
      receptor mutants in which tryptophan residues 230 and 232 have been changed to
      alanine and compared these structures with the refined 1.7 A structure of the
      wild-type protein. In the wild-type structure, Trp230, which is located in the
      maltodextrin-binding groove, stacks against the B-face of the reducing sugar of
      the bound maltose. Trp232, which is located near the protein surface, does not
      participate directly in sugar binding. Relative to the wild-type structure,
      neither mutation caused a significant rearrangement in the overall protein
      structure or in the mode of binding maltose. Although the position once occupied
      by Trp230 remains empty, a new water molecule has moved near the void. In
      contrast, a new water molecule has entered into the space once occupied by
      Trp232. Whereas one hydrogen bond is formed with the water molecule near the
      Trp230 void, no hydrogen bond is associated with the water molecule occupying the
      space vacated by Trp232. The three van der Waals' contacts between Trp230 and
      maltose in the wild-type structure that are lost in the W230A mutation could
      contribute to the 12-fold decrease in ligand-binding activity of the mutant
      protein. The W232A mutation causes little change in binding activity. The
      structures of these mutant proteins also provide some insight into the
      complicated tryptophan fluorescence spectra of the maltodextrin binding-protein.
      The change in fluorescence due to the deletion of Trp230 can readily be explained
      as resulting directly from loss of Trp230 in the sugar-binding site. The change
      in fluorescence due to deletion of Trp232, however, is ascribed to the
      modification of local interactions mediated by the binding of maltodextrin since
      the tryptophan is not directly involved in any sugar-binding interaction.

PMID- 1619647
TI  - Prediction of gene structure.
AB  - We have developed a hierarchical rule base system for identifying genes in DNA
      sequences. Atomic sites (such as initiation codons, stop codons, acceptor sites
      and donor sites) are identified by a number of different methods and evaluated by
      a set of filters and rules chosen to maximize sensitivity; these are combined
      into higher-order gene elements (such as exons), evaluated, filtered and combined
      as equivalence classes into probable genes, which are evaluated and ranked. The
      system has been tested on an extensive collection of vertebrate genes smaller
      than 15,000 bases. Results obtained show that, on average, 88% of the predicted
      coding region for a transcription unit is actually coding, and 80% of the actual
      coding is correctly predicted. This will, in most applications, be sufficient for
      a search against protein sequence databases for the identification of probable
      gene function. In addition, the system provides a general test platform for both
      gene atomic site identification and the rules for their evaluation and assembly.

PMID- 1619649
TI  - Molecular and genomic organization of clusters of repetitive DNA sequences in
      Caenorhabditis elegans.
AB  - Repetitive sequences in Caenorhabditis elegans are interspersed along the
      holocentric chromosomes. We have physically mapped some of these repetitive
      families and found that, although the distribution of members of each family is
      relatively even along the chromosomes, members of more than one family tend to
      cluster in some locations. We compared the sequence organization of 11 clusters
      located at known positions on different chromosomes in the N2 strain. These
      studies allow a comparison between repetitive elements belonging to the same
      family that are located on the same or on different chromosomes, providing an
      important tool in the study of genome turnover and evolution.

PMID- 1619650
TI  - Crystal structure of the factor for inversion stimulation FIS at 2.0 A
      resolution.
AB  - The factor for inversion stimulation (FIS) binds as a homodimeric molecule to a
      loose 15 nucleotide consensus sequence in DNA. It stimulates DNA-related
      processes, such as DNA inversion and excision, it activates transcription of tRNA
      and rRNA genes and it regulates its own synthesis. FIS crystallizes as a
      homodimer, with 2 x 98 amino acid residues in the asymmetric unit. The crystal
      structure was determined with multiple isomorphous replacement and refined to an
      R-factor of 19.2% against all the 12,719 X-ray data (no sigma-cutoff) extending
      to 2.0 A resolution. The two monomers are related by a non-crystallographic dyad
      axis. The structure of the dimer is modular, with the first 23 amino acid
      residues in molecule M1 and the first 24 in molecule M2 disordered and not "seen"
      in the electron density. The polypeptide folds into four alpha-helices, with
      alpha A, alpha A' (amino acid residues 26 to 40) and alpha B, alpha B' (49 to 69)
      forming the core of the FIS dimer, which is stabilized by hydrophobic forces. To
      the core are attached "classical" helix-turn-helix motifs, alpha C, alpha D (73
      to 81 and 84 to 94) and alpha C', alpha D'. The connections linking the helices
      are structured by two beta-turns for alpha A/alpha B, and alpha C1 type
      extensions are observed at the C termini of helices alpha B, alpha C and alpha D.
      Helices alpha D and alpha D' contain 2 x 6 positive charges; they are separated
      by 24 A and can bind adjacent major grooves in B-type DNA if it is bent 90
      degrees. The modular structure of FIS is also reflected by mutation experiments;
      mutations in the N-terminal part and alpha A interfere with FIS binding to
      invertases, and mutations in the helix-turn-helix motif interfere with DNA
      binding.

PMID- 1619651
TI  - Crystal structure solution and refinement of the semisynthetic cobalt-substituted
      bovine erythrocyte superoxide dismutase at 2.0 A resolution.
AB  - The semisynthetic Co-substituted bovine erythrocyte superoxide dismutase (SOD)
      has been crystallized in a new crystalline form and the structure determined at
      2.0 A (1 A = 0.1 nm) resolution. The crystals belong to space group P2(1)2(1)2(1)
      with cell constants: a = 51.0, b = 147.6, c = 47.5 A, and contain one dimeric
      molecule of 32,000 M(r) per asymmetric unit. The structure has been solved by
      molecular replacement techniques using the Cu,Zn bovine enzyme as a search model,
      and refined by molecular dynamics with the crystallographic pseudo-energy term,
      followed by conventional crystallographic refinement. The R-factor for the 18,964
      unique reflections in the resolution range from 10.0 to 2.0 A is 0.176 for a
      model comprising 2188 protein atoms and 200 solvent molecules; the root-mean
      square deviation from the ideal bond lengths is 0.010 A, and the average atomic
      temperature factor is 26.5 A2. The dimeric molecule of the enzyme is composed of
      two identical subunits related by a non-crystallographic 2-fold axis. The subunit
      has as its structural scaffolding the conventional SOD-flattened antiparallel
      eight-stranded beta-barrel, with three external loops. The co-ordination geometry
      of the metal center in the active site is fairly well preserved when compared
      with the native Cu,Zn bovine enzyme. Co2+ is in tetrahedral co-ordination, while
      the Cu2+ ligands show an uneven distortion from the square planar geometry. The
      least-squares superposition of the metals ligands and the catalytically important
      Arg141 of the native and Co-substituted enzyme yields a root-mean-square value of
      0.401 A, the largest deviation occurring at the Co2+ ligand Asp81. An additional
      copper ligand, compatible with a water molecule, is observed at 2.38 A from Cu2+
      in the active-site channel, at the supposed binding site of the O2- anion
      substrate. Several ordered water molecules have been observed on the protein
      surface and in the active-site channel; their structural locations coincide
      remarkably with those of related water molecules found in the crystal structure
      of the phylogenetically distant superoxide dismutase from yeast.

PMID- 1619652
TI  - A 9 A two-dimensional projected structure of cholera toxin B-subunit-GM1
      complexes determined by electron crystallography.
AB  - Highly ordered two-dimensional crystals of cholera toxin B-subunit pentamers have
      been grown by specific interaction with planar lipid films containing
      monosialoganglioside GM1. Electron diffractograms of frozen-hydrated crystals
      show diffraction peaks extending to beyond 4 A, while electron images diffract to
      8 A. A two-dimensional projected structure of cholera toxin B-subunit-GM1 complex
      has been calculated at 9 A resolution by combining electron diffraction and image
      data. Crystals present an approximate pgg projection symmetry, with unit cell
      dimensions a = 119(+/- 1) A, b = 123(+/- 1) A, gamma = 90 degrees. Each
      pentameric assembly presents two concentric rings of electron scattering density,
      separated by an area of lower density. The outer and inner rings are centered at
      25 A and and 11 A from the pentamer centre, respectively. The apparent projected
      density of the outer ring is larger than that of the inner ring. We propose that
      the outer and inner density rings correspond respectively to the peripheral beta
      sheet arrangement and the central alpha-helix barrel, recently identified in the
      crystal structure of the heat-labile enterotoxin from Escherichia coli.

PMID- 1619653
TI  - A 500 ps molecular dynamics simulation study of interleukin-1 beta in water.
      Correlation with nuclear magnetic resonance spectroscopy and crystallography.
AB  - We report the results of a 500 ps molecular dynamics simulation of the cytokine
      interleukin-1 beta, a protein of 153 amino acids, immersed in a sphere of 3783
      bulk water molecules with a radius of 33 A. The simulation reproduces the
      amplitudes of the fast librational motions of the backbone N-H bonds determined
      from 15N nuclear magnetic relaxation data, as well as the crystallographic B
      factors. Moreover, this study suggests a molecular picture of the nature of the
      slow internal motions that have been inferred from nuclear magnetic resonance
      relaxation experiments. These experiments indicated that, in addition to fast
      motions common to all residues, 32 surface residues exhibit slow motions on the
      400 ps to 5 ns time-scale. While the present simulation is not sufficiently long
      to provide a quantitative description of events on this time-scale, it is long
      enough to observe several large amplitude transitions that are likely candidates
      for these slow motions. Specifically, in many of these 32 residues, the N-H
      groups are hydrogen bonded and infrequent dihedral transitions cause the N-H
      vectors to jump between states with well-defined orientations. It is shown that
      the time course of the angular reorientational correlation functions of these
      residues calculated from the trajectory is a reflection of the random times at
      which these infrequent jumps happen to have occurred. Thus, while the rate of
      these transitions cannot be quantified, the simulated decay of these correlation
      functions is completely consistent with the physical picture in which the N-H
      vectors, in addition to fast librational motion, undergo large amplitude jumps
      between conformations stabilized by hydrogen bonds.

PMID- 1619654
TI  - Towards an understanding of the arginine-aspartate interaction.
AB  - We have made a comparison of the geometries of intra- and intermolecular arginine
      aspartate interactions by extracting orientation information from protein co
      ordinate data. The results show a pronounced difference, with both types of
      interaction preferring to form twin N-H . . . O = C hydrogen bonds, but involving
      different nitrogen atoms. In intramolecular interactions, the aspartate favours a
      "side on" geometry, forming hydrogen bonds with N epsilon and N eta 2; in the
      intermolecular case, however, "end on" contacts involving N eta 1 and N eta 2 of
      the arginine are preferred. We have used Distributed Multipole Analysis of the
      methylguanidinium-acetate system to model the electrostatic component of the
      arginine-aspartate ion pair interaction in vacuo. We find, in agreement with the
      experimental arginine-aspartate distribution, that side on and end on doubly N-H
      . . . O = C hydrogen-bonded configurations are clearly the most favourable, with
      the side on being marginally lower in energy. Thus, despite the many competing
      side-chain interactions in proteins, many arginine-aspartate pairs adopt one of
      the minimum electrostatic energy conformations, or one close to a minimum. Within
      each of the two regions (side on and end on) we find only a small energy gap
      between the "symmetric" doubly hydrogen-bonded and slightly displaced "staggered"
      structures, again in agreement with the crystal structure data. Further
      calculations of the total ab initio interaction energy show that this follows the
      electrostatic term in its orientational variation, this phenomenon of
      "electrostatic domination" being well known in hydrogen-bonded systems. The end
      on arginine nitrogen atoms are observed to be more surface-exposed than N
      epsilon, as demonstrated by their greater accessibilities over a large sample of
      proteins. This helps explain the side on and end on preferences of intra- and
      intermolecular interactions, respectively. We also note the effect of short
      sequence intervals, particularly i in equilibrium with i + 2 relationships, in
      forcing many intramolecular contacts to be side on.

PMID- 1619655
TI  - Modulation of thrombin-hirudin interaction by specific ion effects.
AB  - Kinetic studies of the inhibition of thrombin amidase activity by recombinant
      hirudin have been conducted as a function of salt concentration in the range 0.05
      to 1 M, using NaCl, KCl, NaBr and KBr. At the same ionic strength, the value of
      KI for thrombin-hirudin interaction is found to be different with different
      salts. The slope d ln KI/d ln a+/-, where a+/- is the mean ion activity, is
      constant in the range 0.05 to 0.5 M, is sensitive to the particular salt present
      in solution and is equal to 1.07 +/- 0.09 (NaCl), 0.92 +/- 0.10 (KCl), 1.37 +/-
      0.10 (NaBr) and 0.56 +/- 0.10 (KBr). These results indicate that specific ion
      effects are involved in the modulation of thrombin-hirudin interaction in the
      form of ion release, as recently found in the case of thrombin interaction with
      its natural substrate fibrinogen. The linkage hierarchy for ion release found in
      the case of thrombin-fibrinogen interaction also applies in the case of thrombin
      hirudin interaction, with the number of released ions decreasing in the order
      NaBr greater than NaCl greater than KCl greater than KBr. It is proposed that the
      process of bridge-binding to the fibrinogen recognition site and the catalytic
      pocket of the enzyme, as seen in the case of fibrinogen and hirudin, is linked to
      ion release and controlled by modulation of the association rate constant.

PMID- 1619656
TI  - Crystallization and preliminary X-ray study of minor glucoamylase from
      Aspergillus awamori variant X-100/D27.
AB  - Crystals of the reduced form of glucoamylase were obtained from polyethylene
      glycol 6000 solution by the hanging-drop method. The protein was treated with
      alpha-mannosidase to partly remove the sugar component. The crystals belong to
      the space group P2(1)2(1)2(1) with cell dimensions a = 116.7 A, b = 104.3 A, c =
      48.5 A and diffract beyond 2.5 A resolution.

PMID- 1619657
TI  - Crystallization, activity assay and preliminary X-ray diffraction analysis of the
      uncleaved form of the serpin antichymotrypsin.
AB  - Crystals of recombinant wild-type antichymotrypsin have been prepared by the
      method of vapor diffusion with polyethylene glycol 4000 as a precipitant at pH
      5.7. Two crystal forms are observed. One form belongs to tetragonal space group
      P4(3)2(1)2 (or P4(1)2(1)2) and has unit cell dimensions a = b = 126 A, c = 243 A,
      with two molecules in the asymmetric unit. The other crystal form belongs to
      orthorhombic space group P2(1)2(1)2(1) and has unit cell parameters of a = 73 A,
      b = 78 A and c = 80 A, with one molecular in the asymmetric unit. Diffraction
      intensity measurements have been made on the tetragonal crystal form to a
      limiting resolution of 4.1 A, and reflections have been observed on X-ray still
      photographs to a limiting resolution of 2.5 A for the orthorhombic form. An
      activity assay of redissolved tetragonal form crystals indicates that the
      uncleaved, functional serpin has been crystallized.

PMID- 1619658
TI  - Crystallization of Sindbis virus and its nucleocapsid.
AB  - Crystals of Sindbis virus, which contains a lipid-bilayer membrane, have been
      grown using polyethylene glycol. The space group is R32, a = b = 640 A, c = 1520
      A. The crystals are highly mosaic, and recorded diffraction is therefore
      restricted to spacings of about 30 A. The crystals show that the packing of
      glycoproteins E1 and E2 in the icosahedral outer shell is sufficiently precise
      that it permits regular and repeated interactions between virus particles in the
      lattice. Crystals of Sindbis nucleocapsids have also been grown. The limited
      diffraction data are consistent with close packing of nucleocapsids 404 A in
      diameter.

PMID- 1619659
TI  - Crystallization and preliminary X-ray crystallographic analysis of Mirabilis
      antiviral protein.
AB  - Mirabilis antiviral protein is a single-chain ribosome-inactivating protein
      purified from the tuberous root of Mirabilis jalapa L. We obtained several forms
      of crystals of the protein by the hanging drop vapor diffusion method, but most
      of these crystals were not suitable for X-ray crystallography. After refining the
      growth conditions, crystals of crystallographic quality were grown in 20
      microliters droplets of an equi-volume mixture of 1.5% (w/v) protein solution and
      a reservoir solution containing 49 to 50% (w/v) ammonium sulfate and 50 mM
      ammonium citrate (pH 5.4) at room temperature. Addition of 2 mM-adenine sulfate
      reduced twinning and "crystal shower". The resulting trigonal crystals diffract
      beyond 2.5 A resolution using a rotating anode X-ray generator. The space group
      was determined to be P3(1)21 or P3(2)21 (a = b = 103.9.A, c = 134.6 A, alpha =
      beta = 90 degrees, gamma = 120 degrees) based on their precession photography of
      h0l and hk0 zones. There seems to be three monomers in an asymmetric unit for VM
      = 2.51 A3/Da.

PMID- 1619660
TI  - Contribution of the hydrophobic effect to globular protein stability.
AB  - The decrease in conformational stability, delta(delta G), has been measured for
      72 aliphatic side-chain mutants from four proteins in which a larger side-chain
      is replaced by a smaller side-chain so that steric effects are minimal. When
      these delta(delta G) values are corrected to the same accessibility, namely 100%
      buried, then the following -delta(delta G) values per -CH2- group (in kcal/mol)
      are obtained: Ile----Val (1.26), Ala (1.26), Gly (1.26); Leu----Ala (1.16), Gly
      (1.21); Val----Ala (1.23), Gly (1.53). The average of these values is 1.27(+/-
      0.07) kcal/mol. The 72 individual values range from 0 to 2.4 kcal/mol with an
      average value of 1.27(+/- 0.51) (standard deviation) kcal/mol. When the delta Gtr
      values from n-octanol to water are corrected for the difference in volume between
      the solutes and the solvents, the average value for the same substitutions is
      1.25(+/- 0.05) kcal/mol. This suggests that proteins gain 1.3(+/- 0.5) kcal/mol
      in stability for each -CH2- group buried in folding, and, furthermore, that the
      volume corrected delta Gtr values for n-octanol for the amino acid side-chains
      provide good estimates of the contribution of the hydrophobic effect to globular
      protein stability.

PMID- 1619661
TI  - Asp537, Asp812 are essential and Lys631, His811 are catalytically significant in
      bacteriophage T7 RNA polymerase activity.
AB  - To define catalytically essential residues of bacteriophage T7 RNA polymerase, we
      have generated five mutants of the polymerase, D537N, K631M, Y639F, H811Q and
      D812N, by site-directed mutagenesis and purified them to homogeneity. The choice
      of specific amino acids for mutagenesis was based upon photoaffinity-labeling
      studies with 8-azido-ATP and homology comparisons with the Klenow fragment and
      other DNA/RNA polymerases. Secondary structural analysis by circular dichroism
      indicates that the protein folding is intact in these mutants. The mutants D537N
      and D812N are totally inactive. The mutant K631M has 1% activity, confined to
      short oligonucleotide synthesis. The mutant H811Q has 25% activity for synthesis
      of both short and long oligonucleotides. The mutant Y639F retains full enzymatic
      activity although individual kinetic parameters are somewhat different. Kinetic
      parameters, (kcat)app and (Km)app for the nucleotides, reveal that the mutation
      of Lys to Met has a much more drastic effect on (kcat)app than on (Km)app,
      indicating the involvement of K631 primarily in phosphodiester bond formation.
      The mutation of His to Gln has effects on both (kcat)app and (Km)app; namely,
      three- to fivefold reduction in (kcat)app and two- to threefold increase in
      (Km)app, implying that His811 may be involved in both nucleotide binding and
      phosphodiester bond formation. The ability of the mutant T7 RNA polymerases to
      bind template has not been greatly impaired. We have shown that amino acids D537
      and D812 are essential, that amino acids K631 and H811 play significant roles in
      catalysis, and that the active site of T7 RNA polymerase is composed of different
      regions of the polypeptide chain. Possible roles for these catalytically
      significant residues in the polymerase mechanism are discussed.

PMID- 1619662
TI  - Formation of open and elongating transcription complexes by RNA polymerase III.
AB  - The Saccharomyces cerevisiae transcription factors (TF) IIIB and IIIC assemble
      onto their respective DNA-binding sites on the SUP4 tRNA(Tyr) gene at 0 degrees
      C. RNA polymerase III specifically associates at 0 degrees C with this TFIIIC
      TFIIIB-DNA complex to form a stable "closed" promoter complex in which the DNA
      surrounding the transcriptional start retains its duplex form. Promoter "opening"
      is a temperature-dependent and readily reversible process that involves up to 22
      unwound base-pairs of DNA, and can be followed by analyzing the hyperreactivity
      of thymine to KMnO4 oxidation. This promoter opening increases progressively from
      10 degrees C to 40 degrees C, with at least two regions within the transcription
      bubble appearing to melt independently. In contrast, the temperature dependence
      of forming an initiated transcription complex containing a 17 nucleotide nascent
      RNA chain displays a sharp transition between 10 degrees C and 15 degrees C. When
      RNA polymerase initiates transcription under conditions that limit the nascent
      RNA chain to less than six nucleotides, there is no displacement of the
      transcription bubble. These transcription complexes are distinguishable from
      "open" promoter complexes in their maintenance of the transcription bubble at 0
      degrees C, and from transcription complexes with more extended (17 nucleotide)
      RNA chains in their sensitivity to disruption by heparin. In light of recent
      results by others that demonstrate a requirement for an RNA transcription factor
      in a Bombyx mori-based in vitro RNA polymerase III transcription system, we have
      searched for a comparable component in the S. cerevisiae-derived system. We show
      that if an RNA component is required in the yeast-derived system, it is not
      susceptible to inactivation by massive amounts of micrococcal nuclease, RNase A,
      or RNase T1.

PMID- 1619663
TI  - Isorepressor of the gal regulon in Escherichia coli.
AB  - Inducible overexpression of the Escherichia coli gal operon in the absence of the
      Gal repressor is known as ultrainduction. The requirement of induction can be
      eliminated by mutation of a new locus, galS, resulting in constitutive and
      ultrainduced levels of gal expression. Characterization of the galS gene and its
      product has revealed an isorepressor of the gal regulon. The Gal isorepressor is
      a protein of 346 amino acid residues whose amino acid sequence and cellular
      function, as described here, are very similar to that of Gal repressor, encoded
      by the galR gene. Transcription from different promoters of the gal regulon,
      galP1, galP2 and mglP, was examined by primer extension and reverse transcription
      of mRNA isolated from strains containing mutations in galR and/or galS. In
      strains containing a galS mutation, overexpression of gal message occurred only
      in the presence of inducer, while mgl message was constitutively derepressed. The
      galS mutation also constitutively derepressed an mglA::lacZ fusion, demonstrating
      that GalS is the mgl repressor. A potential operator site in the mgl promoter was
      identified at a position analogous to OE in gal. Thus, the gal and mgl operons
      constitute a regulon. Crosstalk, temporal action, induction spectrum or heteromer
      formation between repressor and isorepressor may help co-ordinate high affinity
      galactose transport and galactose utilization.

PMID- 1619664
TI  - Molecular interactions in myosin assembly. Role of the 28-residue charge repeat
      in the rod.
AB  - We have used internal deletions of multiples of seven residues to change the
      phase of the 28-residue charge repeat in a light meromyosin cDNA construct
      expressed in Escherichia coli. The solubility behaviour of these mutants was
      similar to that of the wild-type material, but the molecular packing in the
      aggregates formed at low ionic strength was different. Whereas wild-type material
      formed paracrystals in which molecules were in close contact over most of their
      length, molecules in the paracrystals formed by the mutants were in close contact
      for only a short distance, which was just short enough to exclude the deletion
      from the overlap. These data indicate that, although the 28-residue charge
      periodicity is important in myosin molecular interactions, it is probably not the
      major driving force for myosin assembly and instead influences the detailed axial
      stagger of the interacting molecules.

PMID- 1619665
TI  - Mutagenesis of the Bacillus subtilis "-12, -24" promoter of the levanase operon
      and evidence for the existence of an upstream activating sequence.
AB  - The levanase operon of Bacillus subtilis is controlled by RNA polymerase
      associated with sigma 54 factor and by the LevR activator that is homologous to
      the NifA/NtrC family of regulators. A "-12, -24" promoter is present at the
      appropriate distance from the transcription start site. The drastic down effect
      of base substitutions in the TGGCAC, TTGCA consensus sequence on the expression
      of the levanase operon confirmed the involvement of the "-12, -24" region in
      promoter function. Deletion derivatives of the upstream sequence of the operon
      promoter were constructed using translational levD'-'lacZ fusions and were
      integrated as single copies at the amyE locus of the B. subtilis chromosome. A
      cis-acting DNA sequence that is required for activation of the operon promoter by
      LevR was identified. This regulatory sequence is about 50 base-pairs long and is
      centered 125 base-pairs upstream from the transcription start site in a region
      containing a 16 base-pair palindromic structure. This region of dyad symmetry
      functions as a regulatory element when placed up to at least 600 base-pairs
      upstream from the "-12, -24" promoter, although the efficacy of activation is
      lowered. Thus, in common with most sigma 54-dependent promoters, an upstream
      activating sequence (UAS) is involved in the control of expression of the
      levanase operon. The isolation and characterization of eight mutations in the UAS
      region confirmed the importance of the palindromic structure in promoter
      activation. Moreover, the expression of the levanase operon was inhibited by
      placing the UAS in trans on a multicopy plasmid, probably through titration of
      the LevR polypeptide. In conclusion, the levanase promoter region can be divided
      into two regulatory sequences: the "-12, -24" promoter recognized by the sigma 54
      RNA polymerase holoenzyme and the UAS, an inverted repeat sequence that is
      probably the LevR binding site.

PMID- 1619666
TI  - Interstitial adenosine: the measurement, the interpretation.

PMID- 1619667
TI  - Heterogeneity and sampling volume dependence of epicardial adenosine
      concentrations.
AB  - Rapid steady-state estimates of interstitial fluid (ISF) adenosine concentrations
      (ADOi) in the left ventricular epicardium of anesthetized dogs were obtained by
      the epicardial porous disc (EPD) method described herein. Because of the high
      temporal and spatial resolution of this method, it was ideally suited to test the
      hypothesis that ADOi may vary in these domains. Variance in steady-state EPD
      solute concentrations was quantified statistically by the coefficient of
      variation (CV = standard deviation/mean), which we used as an index of
      heterogeneity. A significant temporal variation in steady-state EPD adenosine
      concentrations was observed when samples were sequentially collected from one
      epicardial location (CV = 42.9 +/- 3.5%). When steady-state sample pairs (n = 45)
      were collected simultaneously from two distinct epicardial locations, a 2.6 +/-
      0.3-fold mean difference in their respective adenosine concentrations was
      measured. About 25% of this variation was inherent in procedural methodology,
      based on the variability of steady-state EPD concentrations of extracellularly
      equilibrated 14C sucrose (CV = 12.7 +/- 1.2%) and the variability of steady-state
      concentrations of both solutes measured using in vitro preparations (mean CV =
      9.7 +/- 1.2%). Thus, we contend that endogenous myocardial ISF adenosine is
      temporally and perhaps spatially heterogeneous. Our estimates of steady-state
      ADOi obtained with the EPD method ranged from 0.47 to 0.99 microM. Using
      modifications of the EPD technique and the epicardial chamber, we also
      demonstrated that the adenosine concentration in 'steady-state' epicardial
      samples is reduced when the volume/surface area ratio of the sample buffer is
      increased. We hypothesize that sampling-induced decreases in steady-state ADOi
      underlie these observations, because losses of ISF adenosine to high volumes of
      sample buffer can be greater than the myocardial cells are capable of replacing.
      However, with the very low volume/surface area ratio of a single EPD (7.5
      microliters/cm2), steady-state ADOi may remain constant during sampling, allowing
      for accurate determinations of ADOi with this method.

PMID- 1619668
TI  - Protective activity of the spin trap tert-butyl-alpha-phenyl nitrone (PBN) in
      reperfused rat heart.
AB  - The aim of this work was to ascertain whether free radicals play a causal role in
      the injury occurring in myocardial ischemia and reperfusion. To this purpose we
      observed whether spin-trapping compounds protect the heart when used at a
      concentration capable of reacting with free radicals. The lipophilic spin trap
      alpha-phenyl-t-butyl nitrone (PBN) was used because it is taken up by the
      myocites. Isolated Langendorff rat hearts were subjected to ischemia according to
      two schemes: "Model A" = 30 min zero-flow ischemia followed by 30 min
      reperfusion; "Model B" = 60 min of low-flow ischemia (10% of the individual
      value; N2 saturated) followed by 30 min reperfusion. Treated groups received in
      addition 5.0 mM PBN which was supplied continuously. The following parameters
      were measured throughout the experiment: contractile performance (RPP); coronary
      flow (CF); CPK; phosphocreatine (PCr), ATP, inorganic phosphate (Pi),
      intracellular pH (pHi). The pathology obtained by "Model A" is more severe than
      that of Model B, and partly irreversible. During the ischemic phase in "Model A",
      contractility, PCr and ATP dropped to near zero; during initial reflow CPK rose
      about 13-fold and Pi rose 2.5-fold, while pHi decreased to 6.1. During
      reperfusion, a partial recovery of PCr, Pi and pHi was observed, while RPP and
      ATP did not increase; PBN treatment improved significantly PCr and CPK, while the
      other parameters were unaffected. During ischemia, "Model B" hearts showed a drop
      of contractility to near zero, of PCr to 35%, of ATP to 50%; CPK rose 7-fold and
      Pi 1.5-fold; pHi was not modified. During reperfusion, all parameters recovered
      in part, with exception of Pi. PBN developed a marked protective activity on all
      tested parameters, which gained a nearly normal value. The results of the present
      investigations show that the lipophilic spin trap PBN partly protects the heart
      from the ischemia/reperfusion injury, thus confirming that free radicals play a
      causal role in this pathology; the continuous loading of the tissue with the drug
      can be an important factor for obtaining the protective effect.

PMID- 1619669
TI  - Myocardial glycoproteins in diabetes: type VI collagen is a major PAS-reactive
      extracellular matrix protein.
AB  - An investigation of myocardial glycoproteins was undertaken to elucidate the
      molecules responsible for the periodic acid-Schiff (PAS) reactivity of the
      increased extracellular matrix of diabetic cardiomyopathy. Perfusion with
      radiolabeled mannose indicated an enhanced formation of matrix components in the
      diabetic compared to the normal rat heart. Electrophoretic separation of
      radiolabeled extracts demonstrated the presence of glycoproteins with Mr values
      of 205, 142 and 90 kDa which could be separated by Bio-Gel A-5 m filtration.
      Fractionation of non-perfused hearts resulted in the isolation of only the 205
      and 142 kDa components, which were shown by amino acid analyses and collagenase
      digestion to belong to the collagen family of proteins and by immunoblotting to
      represent type VI collagen. The carbohydrate content of these rat myocardial type
      VI collagen subunits, determined from monosaccharide analyses, was 11 and 12%,
      respectively, and N-glycanase digestion of the 142 kDa chain resulted in a
      decrease in size of approximately 14 kDa, indicating the presence of asparagine
      linked units. Examination of normal and diabetic rat heart sections indicated
      that the latter contained abundant PAS-positive strands and nodules which
      corresponded to the distribution of anti type VI collagen reactivity. Moreover,
      immunoblots showed higher levels of Type VI collagen in diabetic than in normal
      heart extracts. Type VI collagen therefore appears to represent a major
      glycoprotein of myocardial extracellular matrix and to be implicated in diabetic
      cardiomyopathy.

PMID- 1619670
TI  - Diabetes and susceptibility to reperfusion-induced ventricular arrhythmias.
AB  - Studies using chemically-induced models of diabetes have shown the diabetic
      myocardium to exhibit abnormalities in cellular ion transport, which may affect
      susceptibility to reperfusion-induced arrhythmias. We studied the incidence of
      reperfusion-induced ventricular tachycardia (VT) and fibrillation (VF) in
      isolated hearts from rats with streptozotocin-induced diabetes and from age
      matched and weight-matched control rats (n = 12 per group). Following 5 min of
      regional ischaemia, reperfusion resulted in a similarly low incidence of
      arrhythmias in all three groups. Following 10 min of regional ischaemia, the
      incidence of VT was 92, 100 and 92%, and the incidence of VF was 75, 92 and 92%
      in diabetic, age-matched control and weight-matched control groups, respectively
      (NS). However, among those hearts which exhibited VF, the incidence of sustained
      (greater than or equal to 120 s) VF was 73 and 55% in age-matched and weight
      matched control groups, respectively, and 0% in the diabetic group (P less than
      0.05 vs both controls). The mean duration of VF in the diabetic group was reduced
      from 201 +/- 33 and 171 +/- 36 s in age-matched and weight-matched control
      groups, respectively, to 9 +/- 3 s (P less than 0.05). Thus, streptozotocin
      induced diabetes in the rat does not result in an increased susceptibility to
      reperfusion-induced arrhythmias. To the contrary, hearts from diabetic rats are
      less susceptible to potentially lethal arrhythmias during reperfusion. Likely
      contributory factors to this phenomenon include (i) increased myocardial content
      of free radical scavenging enzymes, (ii) prolonged action potential duration, and
      (iii) reduced activity of sarcolemmal Na+/H+ and Na+/Ca2+ exchange processes, all
      of which have previously been reported in similar models of diabetes.

PMID- 1619671
TI  - Cytosolic Ca2+ concentration and pH of diabetic rat myocytes during metabolic
      inhibition.
AB  - To investigate the role of Ca2+ metabolism and pH in diabetic cardiomyopathy,
      intracellular Ca2+ concentration ([Ca2+]i) and intracellular pH (pHi) of isolated
      myocytes were measured simultaneously using fura-2 and BCECF. We used diabetic
      (D.M.) rats at 8 weeks after the injection of streptozotocin (45 mg/kg, i.v.).
      (1) [Ca2+]i of D.M. myocytes was lower than that of controls (53 +/- 3 and 75 +/-
      5 nM, mean +/- S.E., P less than 0.01). There was no difference in pHi (7.06 +/-
      0.02 in D. M., 7.07 +/- 0.02 in control). There was no difference in the
      percentage of non-rounded cells at 30 min after the perfusion of glucose-free
      solution which contained 2 mM sodium cyanide (NaCN) between D.M. and controls
      (53% and 52%). When cells were rounded, the value of [Ca2+]i was significantly
      lower in D.M. myocytes than that in controls (172 +/- 21 and 421 +/- 106 nM, P
      less than 0.05). (2) When the cells were shortened or rounded in the high [Ca2+]o
      solution (24.5 mM), [Ca2+]i of D.M. rats was significantly lower than that of
      control rats. (3) The percentage of non-rounded cells at 30 min after the
      perfusion of NaCN increased in controls by 50 mM glucose (95%, P less than 0.01),
      but not in D.M. (47%). Insulin (25 mU/ml) and glucose (15 mM) increased the
      percentage of non-rounded cells in D.M. after 30 min perfusion with NaCN (88%, P
      less than 0.01 v.s. 53% without glucose nor insulin). It is suggested that there
      are disturbances of Ca2+ metabolism in D.M. myocytes, and that there is a close
      relation between cell injury and glucose utilization during metabolic inhibition.

PMID- 1619673
TI  - Breakdown of the blood-brain barrier after fluid percussive brain injury in the
      rat. Part 1: Distribution and time course of protein extravasation.
AB  - Experimental brain injury is associated with marked vasogenic edema, as evidenced
      by an increase in brain water content. This prominent and widespread response
      raises questions about the vulnerability of microvasculature in the brain to
      injury. In the present report we further characterize the vascular response by
      evaluating the integrity of the blood-brain barrier to circulating proteins.
      Vascular permeability to endogenous immunoglobulins (IgG) and to the protein
      horseradish peroxidase (HRP) was examined after a lateral, fluid percussive brain
      injury in the rat. In study 1 IgG was immunolocalized in brain sections 1-24 hr
      after injury. In studies 2 and 3 HRP was given intravenously either before impact
      (study 2) or 10 min before sacrifice (study 3). Permeability to this protein was
      assessed at 1-6 hr (study 2) or at 1-72 hr (study 3) after injury. In studies 1
      and 2 the extravascular accumulation of proteins was evaluated. Pronounced
      abnormal permeability to IgG and HRP occurred within the first hour after injury
      and was widespread throughout both hemispheres. The intensity of immunostaining
      for IgG increased with time up to 24 hr after injury. In contrast, maximal
      extravascular accumulation of HRP occurred within the first hour after injury. In
      study 3 the time course for re-establishment of the blood-brain barrier to HRP
      was determined. Maximal permeability occurred at 1 hr after injury. At 24 hr
      abnormal permeability was restricted to the impact site and this area remained
      permeable up to 72 hr after injury. In summary this study demonstrates that
      breakdown of the blood-brain barrier to plasma proteins is a prominent feature of
      experimental brain injury. This abnormal permeability is characterized by its
      transient expression and widespread distribution. The time course for re
      establishment of the blood-brain barrier to circulating proteins is most delayed
      at the impact site.

PMID- 1619672
TI  - Cognitive deficits following traumatic brain injury produced by controlled
      cortical impact.
AB  - Traumatic brain injury produces significant cognitive deficits in humans. This
      experiment used a controlled cortical impact model of experimental brain injury
      to examine the effects of brain injury on spatial learning and memory using the
      Morris water maze task. Rats (n = 8) were injured at a moderate level of cortical
      impact injury (6 m/sec, 1.5-2.0 mm deformation). Eight additional rats served as
      a sham-injured control group. Morris water maze performance was assessed on days
      11-15 and 30-34 following injury. Results revealed that brain-injured rats
      exhibited significant deficits (p less than 0.05) in maze performance at both
      testing intervals. Since the Morris water maze task is particularly sensitive to
      hippocampal dysfunction, the results of the present experiment support the
      hypothesis that the hippocampus is preferentially vulnerable to damage following
      traumatic brain injury. These results demonstrate that controlled cortical impact
      brain injury produces enduring cognitive deficits analogous to those observed
      after human brain injury.

PMID- 1619674
TI  - The novel 21-aminosteroid U74006F attenuates cerebral edema and improves survival
      after brain injury in the rat.
AB  - The present study evaluated the effect of the nonglucocorticoid 21-aminosteroid
      U74006F, an inhibitor of iron-dependent lipid peroxidation, on the development of
      regional cerebral edema after lateral fluid-percussion (FP) brain injury. Male
      Sprague-Dawley rats (n = 40) were anesthetized and subjected to FP brain injury
      of moderate severity centered over the left parietal cortex (2.5-2.6 atms).
      Fifteen minutes after brain injury, animals randomly received an i.v. bolus of
      either U74006F (3 mg/kg, n = 21) followed by a second bolus (3 mg/kg) at 3 hr or
      buffered sodium citrate vehicle (equal volume, n = 15). An additional group of 12
      surgically prepared but uninjured animals served as preinjury controls. At 48 hr
      after injury, animals were sacrificed and brain tissue assayed for water content
      and regional cation concentrations. With the use of specific gravimetric
      techniques, no significant differences were observed in posttraumatic cerebral
      edema between drug- and control-treated animals. However, using wet weight/dry
      weight methodology, we found that administration of U74006F significantly reduced
      water content in the right hippocampus (contralateral to the site of injury)
      compared to saline-treated animals (p less than 0.05). U74006F also significantly
      prevented the postinjury increase in sodium concentrations in the ipsilateral
      hippocampus (p less than 0.05) and thalamus (p less than 0.03). Regional
      concentrations of potassium were unaltered after drug treatment. Administration
      of U74006F significantly reduced postinjury mortality, from 28% in control
      animals to zero in treated animals (p = 0.01). These results suggest that lipid
      peroxidation may be involved in the pathophysiological sequelae of brain injury
      and that 21-aminosteroids may be beneficial in the treatment of brain injury.

PMID- 1619675
TI  - Tumor-specific T-cell immunity: ready for prime time?

PMID- 1619676
TI  - Oregon health system overhaul may become national model.

PMID- 1619677
TI  - Unconventional methods under review by NIH.

PMID- 1619678
TI  - Researchers link low literacy to high health care costs.

PMID- 1619679
TI  - Far East's cancer mortality patterns shift, reflecting cultural changes.

PMID- 1619680
TI  - ACS mobilizes forces to keep record straight.

PMID- 1619681
TI  - NCI appropriations law not expected until fall.

PMID- 1619682
TI  - Antitumor activity and immune responses induced by a recombinant carcinoembryonic
      antigen-vaccinia virus vaccine.
AB  - BACKGROUND: Human carcinoembryonic antigen (CEA) is a 180-kd glycoprotein
      expressed in human colorectal, gastric, pancreatic, breast, and non-small-cell
      lung carcinomas. Previous studies have demonstrated enhanced immune responses to
      other antigens presented with vaccinia virus proteins via a recombinant vaccinia
      virus construct. In addition, we have developed a recombinant CEA-vaccinia virus
      construct, designated rV(WR)-CEA, and have demonstrated humoral anti-CEA
      responses in mice after immunization with that virus. PURPOSE: The goals of this
      study were (a) to construct a recombinant CEA-vaccinia vaccine in a less virulent
      vaccinia strain that is potentially safe and effective for treatment of patients
      whose tumors express CEA and (b) to evaluate the ability of the recombinant CEA
      vaccinia vaccine to prevent and reverse tumor growth in mice and to elicit cell
      mediated and humoral anti-CEA immune responses. METHODS: Using the New York City
      strain of vaccinia virus, which is used in smallpox vaccination and is more
      attenuated for humans than rV(WR), we derived a recombinant CEA-vaccinia
      construct, designated rV(NYC)-CEA. The ability of this construct to induce
      antitumor immunity was evaluated in mice receiving subcutaneous injections of
      murine colon adenocarcinoma cells expressing the human CEA gene. RESULTS:
      Administration of rV(NYC)-CEA in mice induced strong anti-CEA antibody responses,
      as well as CEA-specific cell-mediated responses, including delayed-type
      hypersensitivity, lymphoproliferative, and cytotoxic responses. Vaccination of
      mice with the rV(NYC)-CEA rendered them resistant to the growth of subsequently
      transplanted CEA-expressing tumors. Moreover, when mice were vaccinated 7 days
      after tumor cell injection, tumor growth was either greatly reduced or
      eliminated. No toxic effects were observed in any of the mice. CONCLUSION: These
      studies demonstrate that antitumor activity can be induced with the use of a
      recombinant CEA-vaccinia virus construct derived from an attenuated vaccinia
      strain, and they reveal the range of cell-mediated and humoral responses induced
      by this recombinant vaccine.

PMID- 1619683
TI  - Dietary fat and postmenopausal breast cancer.
AB  - BACKGROUND: Although the results of animal studies and cross-cultural comparisons
      generally support a role for dietary fat in the etiology of breast cancer,
      results of analytic epidemiology studies are equivocal. PURPOSE: The association
      between dietary fat and subsequent breast cancer was examined in a cohort of
      34,388 postmenopausal women from Iowa. METHODS: Dietary habits were assessed by a
      food-frequency questionnaire mailed in January 1986. Through December 31, 1989,
      459 incident cases of breast cancer occurred in this cohort. Proportional hazards
      regression was used to examine the dietary fat-breast cancer association while
      adjusting for potential confounders. The effects on this association of four
      analytic approaches to adjustment for energy intake were also considered.
      RESULTS: After adjustment for known determinants of breast cancer, a modest
      positive association of total fat intake with risk of breast cancer was seen.
      Polyunsaturated fat intake was also positively associated with breast cancer
      (relative risk from lowest to highest intake, 1.0, 1.25, 1.31, and 1.49; P for
      trend = .052). Different approaches to adjustment for energy intake, however,
      provided different impressions of the dietary fat-breast cancer association. One
      method, involving categorization of crude fat intake and inclusion of total
      energy intake in regression analysis, gave relative risk estimates from low to
      high fat intake of 1.0, 1.17, 1.25, and 1.38 (P for trend = .18). Another method,
      based on categorization of fat intake residuals in which the variation in fat due
      to total energy intake was removed, gave corresponding estimates of 1.0, 1.24,
      1.30, and 1.16 (P for trend = .29). The former suggests increasing breast cancer
      risk with increasing fat intake; the latter suggests no association. CONCLUSIONS:
      These results are consistent with other cohort studies that have shown a weak
      association or no association between dietary fat and breast cancer. They are
      also consistent with studies suggesting that fat intake is a determinant of
      breast cancer, particularly after accounting for inaccuracies in dietary
      assessment. The effects of different energy-adjustment methods may account in
      part for the varying interpretations of four previous cohort studies of dietary
      fat and breast cancer. IMPLICATIONS: Further work is needed to clarify not only
      the nature of the dietary fat-breast cancer association, but also the impact of
      different analytic methods used in the investigation of diet-disease
      associations.

PMID- 1619684
TI  - Molecular genetic studies of tumor suppressor gene regions on chromosomes 13 and
      17 in colorectal tumors.
AB  - BACKGROUND: In the majority of colorectal carcinomas, both copies of the tumor
      suppressor gene TP53 (tumor protein 53) are known to be inactivated. In contrast
      to a loss of tumor suppressor function, it has been suggested that an increased
      copy number of the RB1 gene is involved in the progression of these tumors.
      PURPOSE: To determine genetic alterations at chromosomes 13 and 17 in colorectal
      tumors, we have studied several loci on these chromosomes, with special focus on
      the RB1 and TP53 genes at both the level of DNA sequence and the level of gene
      expression. METHODS: Restriction fragment length polymorphism analysis was
      performed after alkaline Southern blotting of the DNA fragments and hybridization
      (in 7% sodium dodecyl sulfate and 0.5 M NaPO4) of the nylon membranes with
      multiprimed, radioactively labeled probes. Total RNA was extracted from tissue
      biopsy specimens by homogenization of the samples in guanidinium thiocyanate
      followed by separation in a CsCl gradient. By use of an image-processing system,
      x-ray film signals were measured densitometrically. Point mutations within the
      TP53 gene were detected by use of polymerase chain reaction (PCR) in combination
      with constant denaturant gel electrophoresis. Direct sequencing of PCR products
      revealed the exact nature of the mutations. Protein expression of TP53 was seen
      by immunostaining of sections from paraffin-embedded material using a mouse
      monoclonal antibody. The two-sided Fisher's Exact Test was used for statistical
      analysis. RESULTS: An increase in allelic copy number at 13q loci was seen in 10
      (32%) of 31 tumors. In the majority of the cases, this increase probably
      reflected a change in the diploid status of chromosome 13; in some cases,
      however, only part of the 13q seemed to be involved. The RB1 gene showed an
      elevated level of RNA compared with the beta-actin signal. Fourteen (48%) of 29
      tumors showed loss of heterozygosity at loci on 17p, and base mutations within
      the TP53 gene were seen in 14 (42%) of 33 tumors. RNA and protein analyses of
      TP53 revealed an increased level of expression in the tumors compared with normal
      mucosa. Allelic variations seen at 13q and 17p were not associated (P = .7).
      CONCLUSIONS: Our results suggest that, in addition to aneuploidy, gain of
      specific chromosome 13 sequences is involved in the tumorigenesis of the colon
      and rectum. In addition, they confirm the importance of TP53 mutations for the
      progression of such tumors and support the view that accumulation of events is
      more important than the order of events. The genetic changes observed at
      chromosome arms 13q and 17p seem to be independent of each other.

PMID- 1619685
TI  - Breast cancer risks in relatives of male breast cancer patients.
AB  - BACKGROUND: Previous studies have provided conflicting results concerning the
      familial effect of male breast cancer on breast cancer risks in female relatives.
      PURPOSE: We studied breast cancer risks in first-degree relatives of male
      patients and compared them with relatives of female patients. METHODS: Our study
      included 88 consecutively ascertained male patients and 320 of their first-degree
      relatives as well as 186 consecutively ascertained female patients and 633 of
      their first-degree relatives. Observed numbers of breast cancers in relatives
      were compared with the expected number derived from the Connecticut Tumor
      Registry. Multiple logistic regression analysis was also performed. RESULTS:
      Relatives of male patients exhibited a significant twofold increased risk when
      compared with expected rates and no difference in risk when compared with that of
      relatives of female patients. Prostate cancer in the family of a male patient
      resulted in a significant fourfold increased breast cancer risk compared with a
      risk of 1.4 in families with no history of prostate cancer. A family history of
      lung cancer, colon cancer, or melanoma had no effect on increasing risks of
      breast cancer. CONCLUSION: The familial effect of male breast cancer is the same
      as that of female breast cancer. IMPLICATIONS: Any estimates of breast cancer
      risk provided to individuals should also consider the occurrence of prostate
      cancer in the family, since prostate cancer appears capable of at least doubling
      the underlying twofold risk.

PMID- 1619687
TI  - Frequency of thyroid cancer in Pacific populations.

PMID- 1619686
TI  - Parity and primary liver cancer among young women.

PMID- 1619688
TI  - Asbestos-related cancer.

PMID- 1619689
TI  - [Basic educational materials for the members of the Japanese Society of
      Toxicological Sciences].

PMID- 1619690
TI  - Role of sympathetic nerve and adrenal gland in the potentiation of hypoxic
      pulmonary vasoconstriction during cigarette smoking.
AB  - The aim of this study was to investigate the role of sympathetic nerve and
      adrenal gland in the changes in hemodynamics and hypoxic pulmonary
      vasoconstriction (HPV) induced by cigarette smoking in Wistar rats. Data showed
      that an increment of pulmonary vascular resistance (PVR) induced by alveolar
      hypoxia was partially prevented by prazosin (alpha 1-receptor blocker) and
      prazosin combined with propranolol (beta-receptor blocker), but not significantly
      affected by propranolol or adrenalectomy. Cigarette smoking could increase PVR
      and potentiate HPV, whereas the potentiation of HPV was partially inhibited by
      prazosin and strengthened by propranolol, but not affected by adrenalectomy. It
      is suggested that the sympathetic nerve excitation caused by cigarette smoking
      may play a role in the strengthening of HPV.

PMID- 1619691
TI  - Effect of endotoxin on hypoxic pulmonary vasoconstriction--the role of
      prostaglandins and leukotrienes.
AB  - In this study, we observed the effect of endotoxemia on hypoxic pulmonary
      vasoconstriction (HPV) in dogs and explored roles played by prostaglandins and
      leukotrienes in this process. 5 micrograms/kg BW of E. coli endotoxin induced
      transient rise in pulmonary arterial pressure and pulmonary vascular resistance
      (PVR). 30 min after injection of endotoxin when PVR tended to decline, pulmonary
      vasoconstriction response to alveolar hypoxia was lost, and the ratio of TXB2 to
      6-keto-PGF1 alpha decreased significantly. HPV was enhanced at 60-100 min and
      then returned to the control level at 2 h after injection of endotoxin. At these
      periods the ratio of TXB2 to 6-keto-PGF1 alpha was the same as before use of
      endotoxin, whereas plasma concentration of leukotrienes was markedly increased.
      Indomethacin could prevent the early loss of HPV, but no effect on the late
      increment of HPV was found. Diethylcarbamazine, which blocked the production of
      leukotrienes after use of endotoxin, could inhibit late increment of HPV. We
      concluded that the early loss of HPV was related to the vasodilator prostacyclin,
      and the late increment of HPV was mainly brought about by leukotrienes.

PMID- 1619692
TI  - An image analysis on pathological changes in pulmonary arteries in chronic
      obstructive pulmonary disease.
AB  - The changes in small pulmonary arteries of 15 patients with chronic obstructive
      pulmonary disease (COPD) were investigated by light and electron microscopy,
      image analysis etc. It was found that the structural changes in the pulmonary
      arteries of the patients with COPD were characterized by muscularization of non
      muscular arterioles, media hypertrophy, longitudinal smooth muscle bundles in the
      intima and fibrosis in both the media and intima. In the course of time, these
      lesions resulted in thickening of the arterial wall and narrowing of the lumen.
      Clinically, the patients developed pulmonary hypertension causing cor pulmonale.
      Initial data on the structure of arterial wall at different segments were
      compared statistically. There was very significant difference between the COPD
      and control groups (P less than 0.001). By Fisher's auto-classification
      (automatic pattern recognition), the rate recognized was correct in more than 90%
      in the small arteries of less than 200 microns in diameter. It is suggested that
      these arteriolar changes are closely related to pulmonary hypertension. The image
      analysis showed that the ratios of MWA/MVA and MWT/MD were of great value in
      evaluating the degree of the changes in the arteries of the patients with COPD.

PMID- 1619693
TI  - Investigation on the effect of selenium on T lymphocyte proliferation and its
      mechanisms.
AB  - The effects of selenium on T lymphocyte proliferation and its mechanisms have
      been investigated. The results showed that selenium is able to enhance lectin
      stimulated T lymphocyte proliferation, to increase the production of interleukin
      2 (IL-2) by lymphocytes and interleukin 1 (IL-1) by macrophages in the presence
      of lectin and to augment the response of T lymphoblasts to IL-2 and that of
      thymocytes to IL-1. The data presented suggest that selenium may be an important
      modulator for immune response. Selenium might enhance IL-2 production and
      response through the augmentation of IL-1 production and response, thereby
      promoting the enhancement of the proliferation and action of T lymphocytes and
      other immunocompetent cells. Based on these results, we may consider using
      selenium as an immunological enhancement agent to enhance or recover immune
      functions of the organism.

PMID- 1619694
TI  - Inhibitory effect of cyclosporin A on T lymphocyte DNA synthesis.
AB  - The interference of Cyclosporin A (CyA) with peripheral lymphocytes DNA synthesis
      was investigated. The results showed that the drug could strongly inhibit T cell
      proliferation in response to PHA stimulation if added at the start or at the
      early phase of the process, and it failed to do so if added 48 h later when most
      cells had already started to proliferate. Without PHA, no obvious differences
      were detected between normal control and CyA-treated cells. A comparison was made
      between T cell DNA synthesis of peripheral blood lymphocytes of healthy
      volunteers and renal transplant patients. It was found that T-cell DNA synthesis
      of patients was significantly lower than that of the healthy controls. From the
      above it may be suggested that CyA activity on T cell proliferation is similar in
      vivo and in vitro.

PMID- 1619696
TI  - [1585 cases of retinal detachment surgery with homologous skin as buckling
      material].
AB  - From January 1963 to December 1989, 1585 consecutive cases of retinal detachment
      were operated with homologous skin as buckling material, the rate of operative
      success being 91.6%. Human skin is easy to obtain, sterilize and preserve;
      because of its appropriate thickness and firm but elastic consistency it
      satisfactorily meets the need to produce sufficient height and to maintain
      necessary duration of the scleral buckling; in addition to a high rate of
      reattachment, homologous skin implantation was well tolerated, very rarely
      rejected (0.06%) and infected (0.25%), and no late complications occurred.
      Therefore, the authors prefer using human skin as buckling agent rather than
      conventional synthetic material, e.g., silicon sponge etc.

PMID- 1619695
TI  - Analysis of intrahepatic HBVDNA in serologic HBV markers-negative or HBsAg
      negative patients with chronic hepatitis.
AB  - To explore HBV infection status in a group of serologic HBV markers-negative or
      HBsAg-negative patients with chronic hepatitis, in situ hybridization to
      hepatocellular HBVDNA was carried out in combination with detection of HBsAg and
      HBcAg in the liver tissues. It was found that prevalence of intrahepatic HBVDNA,
      HBsAg and HBcAg was 43%, 39% and 17% respectively, and 15 out of 23 cases studied
      were sure to bear one or more positive marker(s) of intrahepatic HBVDNA, HBsAg
      and HBcAg. These findings suggest that more than half of the patients with
      chronic hepatitis were still undergoing HBV infection, despite serologic HBV
      markers or HBsAg negative. Furthermore, we found that hepatocytes containing
      HBVDNA or surface or core antigen were often close to hepatic necrosis foci,
      indicating that HBV replication and its antigen(s) expression in hepatocytes
      could account for chronic, active and necrotic inflammation occurring in the
      liver of the patients mentioned above.

PMID- 1619697
TI  - [Influence of cigarette smoking on the hypoxic pulmonary vasoconstriction in
      isolated rat lungs--the role of prostaglandins and leukotrienes].
AB  - Isolated rat lungs perfused with blood were used to determine the effects of
      cigarette smoke, delivered into the lung by a ventilator, on the pulmonary
      vascular resistance (PVR), and on the hypoxic pulmonary vasoconstriction (HPV),
      and to explore the role the prostaglandins (PG) and leukotrienes (LT) play in
      that effect. The results showed that PVR did not change, while HPV was
      significantly enhanced by smoking. Indomethacin, an inhibitor of PG biosynthesis,
      administered in the perfusing blood (20 micrograms/ml) increased HPV in non
      smoking lungs, but not in lungs after smoking. Diethylcarbamazine citrate (DEC; 1
      mg/ml), an inhibitor of LT biosynthesis, decreased HPV before and after smoking.
      After perfusion with both indomethacin and DEC, HPV also decreased. It is
      suggested that LT act as mediators whereas PG as modulators in HPV, and PG and LT
      might play an important role in the increase of HPV by cigarette smoking.

PMID- 1619699
TI  - Effect of periodontal disease on the pulp.

PMID- 1619698
TI  - [Histochemical study of estrogen and progesterone receptors in cervical
      carcinoma].
AB  - Estrogen and progesterone receptors were determined in 56 cases of primary
      cervical carcinoma tissue by histochemical methods. 42.86% of the 56 cases were
      ER positive and 46.43% PR positive. No correlation was found between ER and PR
      status and age, menopausal status of the patient and clinical stage.
      Adenocarcinoma had significantly higher ER and PR positive rate than squamous
      carcinoma. Highly differentiated carcinoma had higher ER and PR positive rate
      than middle- and dedifferentiated carcinoma. A positive correlation between ER
      and PR and cellular infiltration of stroma and peritumoral reaction of fibrin was
      found. The patients with ER and PR positive had a significantly higher 5-year
      survival. ER and PR may be used as prognostic factors in cervical carcinoma.

PMID- 1619700
TI  - Women's perceptions of caesarian delivery.
AB  - A Perception of Caesarian Delivery Scale that measured the incidence and severity
      of perceptions and feelings in response to recent Caesarian delivery was
      administered to 60 mothers who had had Caesarian sections. The scores obtained
      from this scale were analyzed by factor analysis to determine the relationships
      within categories of responses, and were analyzed by one-way ANOVA to measure any
      variation among different demographic groups. A reliability coefficient of 0.93
      was obtained for this scale. Factor analysis of the quantitative data defined
      four categories of women's perceptions associated with Caesarian delivery. Each
      of the four categories were labeled and discussed. However, there were no
      significant differences in factor scores between groups with different parities,
      types of anesthesia, and types of Caesarian section.

PMID- 1619701
TI  - Incidence and antimicrobial resistance of Salmonella serotypes in southern Taiwan
      from 1978 through 1987.
AB  - A total of 3,269 Salmonella strains, isolated from patients suffering from
      salmonellosis, was divided into 43 different serotypes during the period between
      1978 and 1987. The commonest ten serotypes in the order of prevalence were S.
      typhimurium (43.7%), S. muenchen (13.7%), S. panama (9.0%), S. krefeld (8.1%), S.
      bovis-morbificans (6.3%), S. derby (4.0%), S. anatum (2.7%), S. braenderup
      (1.6%), S. typhi (1.2%), and S. dumfries (0.7%). Norfloxacin was found highly
      effective against Salmonella isolates in vitro. Moxalactam and cefotaxime were
      more effective than cephalothin against strains tested. Nalidixic acid and
      trimethoprim-sulfamethoxazole inhibited 81-100% strains of Salmonella isolates,
      except S. bovis-morbificans and S. typhimurium. In general, S. typhimurium showed
      high incidence of multiple drug resistance. Among 1,430 strains of S.
      typhimurium, 158 isolates showed a uniquely high level resistance to a number of
      antimicrobial agents, including ampicillin, amikacin, carbenicillin, cephalothin,
      chloramphenicol, gentamicin, kanamycin, tetracycline and trimethoprim
      sulfamethoxazole. It was noted that all S. typhi isolates in this study were
      sensitive to all drugs tested.

PMID- 1619702
TI  - Studies of taeniasis in Taiwan. XIV. Current status of taeniasis among Yami
      aborigines on Lanyu Island, Taitung County, southeast Taiwan.
AB  - In December 1989, 1,457 Yami aborigines in six villages on Lanyu District (Lanyu
      Island), Taitung County, Southeast Taiwan, were examined by questionnaire and
      demonstration of the proglottides or by scotch tape perianal swab technique for
      taeniasis. The overall infection rate was 5%. The highest rate was found at
      Yehyin (8%) and the lowest at Yujen (2%). However, the rate did not significantly
      differ among the villages. The infection rate peaked in the 51-60 yr age group
      (15%) and the lowest rate was observed in the 11-20 yr age group (less than 1%).
      No infection was found in the 21-30 yr age group. The infection rates of men and
      women were similar (5%). Twenty-one per cent of 304 families was found to include
      one or more infected members and a family with five infected person was observed
      at Yehyin. The infection rate of taeniasis on Lanyu Island decreased from 16% in
      1984 to 5% in 1989. However, 51 persons who were negative in 1984 were positive
      at present, 26 were found to be positive in both studies, and 216 (12 died) who
      were positive in 1984 were now negative. These results indicate that the Yami
      people still eat raw meat and viscera of animals.

PMID- 1619703
TI  - Comparison between thallium-technetium subtraction scan and other imaging
      modalities in the preoperative localization of abnormal parathyroid glands.
AB  - A total of 15 patients who underwent total neck exploration for
      hyperparathyroidism were studied with four different imaging modalities: (a) Tl
      201/Tc-99m subtraction scan (SS), (b) ultrasonography (US), (c) computed
      tomography (CT) and (d) magnetic resonance imaging (MRI). Accuracy for locating
      enlarged parathyroid(s) was 60.0% by SS, 60.0% by US, 33.3% by CT and 71.4% by
      MRI. Our results suggested that at present none of the imaging modalities was
      adequate on its own to locate all enlarged parathyroid gland(s) in patients with
      hyperparathyroidism.

PMID- 1619704
TI  - The contralateral variation of peak systolic velocity in common carotid arteries.
AB  - In order to evaluate the contralateral variation of the peak systolic velocity
      (Vmax) in common carotid arteries (CCAs), 9 clinically healthy persons (Group A),
      11 patients with simple goiter (Group B) and 16 patients with diffuse toxic
      goiter (Graves' disease, Group C) were referred for radionuclide scanning, duplex
      Doppler ultrasonography (duplex US) and determination of serum level of the
      thyroid hormones (T3, T4, T3U) by radioimmunoassay. In Group A, Vmax of right CCA
      was 98.8 +/- 34.5 cm/sec and that of left CCA was 113.4 +/- 28.9 cm/sec; the left
      CCA had a higher blood flow velocity than the right one in normal subjects (p
      less than 0.01). However, the left and right CCA Vmaxes did not significantly
      differ to each other in Group B (93.5 +/- 21.4 cm/sec vs 98.6 +/- 21.4 cm/sec, p
      greater than 0.05) and Group C (146.9 +/- 29.3 cm/sec vs 149.9 +/- 28.9 cm/sec, p
      greater than 0.05). We conclude that there is a contralateral difference of blood
      flow velocity of common carotid arteries with the left value higher than the
      right one in healthy persons and this should be kept in mind in evaluation of
      thyroid functional and carotid arterial diseases.

PMID- 1619705
TI  - Neonatal lupus erythematosus: a case report.
AB  - Neonatal lupus erythematosus is a syndrome characterized by congenital heart
      block and/or cutaneous lupus erythematosus in the presence of maternal
      autoantibodies. We report a female newborn with cutaneous lesions of the neonatal
      lupus erythematosus born to a clinically asymptomatic mother. She presented with
      erythematous maculopapules on the face, neck and upper trunk at birth. Complete
      blood cell count showed leukopenia and thrombocytopenia. Antinuclear antibodies,
      anti-Ro/SSA and anti-La/SSB antibodies were positive in the mother and infant.
      The skin lesions became annular, erythematous and slightly scaling three weeks
      later. A skin biopsy performed at seven weeks of age showed edema of the dermis
      and perivascular mononuclear cell infiltration. Immunofluorescent studies showed
      immune complex deposition of IgG an IgM in the basal zone of epidermis. She
      received supportive treatment and sun avoidance. Hematologic abnormalities
      recovered by nine weeks of age. Skin lesions faded gradually during the following
      four months, leaving residual hypopigmentation and telangiectasia.

PMID- 1619706
TI  - Microsurgical replantation of avulsed scalp--two cases report.
AB  - Two female patients with scalp avulsion were treated successfully by
      microsurgical replantation. The first patient suffered an avulsion of the right
      half of scalp and which survived fully after replantation. The second patient
      suffered avulsion of the entire scalp as well as the forehead skin and nape of
      the neck. Almost all of the avulsed part survived except partial skin loss in the
      posterior neck and left occipital area. Only one temporal artery and one vein was
      anastomosed in each case. Near normal hair growth recurred in both cases.

PMID- 1619707
TI  - Jugular venous vasopressin increases during carotid endarterectomy after cerebral
      reperfusion.
AB  - Several recent reports have suggested that pressor hormones may be released
      during and after carotid endarterectomy and that release of these factors may be
      associated with postoperative hypertension and other postoperative morbidity. We
      measured vasopressin, adrenocorticotropic hormone, and cortisol in jugular venous
      blood during carotid endarterectomy under general anesthesia in 43 patients with
      routine carotid shunting. Jugular venous vasopressin increased significantly
      after the second period of carotid occlusion for shunt removal and remained
      increased at closure. Vasopressin did not change during the initial carotid
      occlusion for shunt placement or during the endarterectomy itself, and neither
      ACTH nor cortisol changed at any sample time. Greater resting vasopressin and
      cortisol and larger responses of vasopressin were observed in patients receiving
      phenylephrine to correct intraoperative hypotension. There were no correlations
      between postoperative hypertension or postoperative complications and
      intraoperative hormone values. These results suggest (1) basal intraoperative
      vasopressin values reflect the blood volume of the patient, (2) increased
      vasopressin was not related to postoperative morbidity, and (3) intraoperative
      increases in pressor hormones are most likely physiologic responses to specific
      stimuli such as hypovolemia or hypotension rather than pathologic phenomena. We
      speculate that the increase of vasopressin after the second carotid occlusion and
      reperfusion of the brain may be due to the action of humoral factors released
      into the carotid circulation from the endarterectomy site.

PMID- 1619708
TI  - Validation of Doppler measurement of pressure gradients across peripheral model
      arterial stenosis.
AB  - Hemodynamic assessment of aortoiliac occlusive disease is necessary for
      successful arterial reconstruction of the legs. Various methods have been
      proposed, and the "pull through" intraarterial pressure measurement method is
      accepted as the best standard. The pressure readings, however, seemed to depend
      on the intraluminal position of the catheter. To explain these observations and
      make a comparison between the Doppler method and the pull through method, we have
      studied centerline velocity changes at the stenosis throat by Doppler
      ultrasonography, and axial and lateral pressure gradients by use of pressure
      transducers mounted 10 mm and 40 mm downstream of short (4 mm) axisymmetric sharp
      edged model stenoses having cross-sectional reduced areas of 64%, 84%, 91%, and
      96%. Axial manometric pressures measured 10 mm beyond the throat of 84% stenosis
      were more than twice as high as the lateral pressures. No significant difference
      was observed between axial and lateral pressures measured 40 mm downstream from
      the throat. This pressure distribution has important clinical relevance. Mean and
      peak pressure gradients for both the Doppler method and manometric measurements
      were compared. Measurements with Doppler method and manometric measurements
      indicated that mean pressure gradients (r = 0.98; SEE = +/- 2.4 mm Hg) correlate
      better than peak pressure gradients (r = 0.90; SEE = +/- 16.5 mm Hg). Doppler
      gradients were higher than manometer gradients. Overestimation was 13% for mean
      pressure gradients and ranged from 10% to 150% for peak pressure gradients.
      Explanation for the difference between mean Doppler and catheter gradient may be
      the pressure recovery occurring in the relaminarized poststenotic regions.

PMID- 1619709
TI  - Congenital pelvic arteriovenous malformations: long-term follow-up in two cases
      and a review of the literature.
AB  - Congenital arteriovenous malformations confined to the soft tissues of the pelvis
      are rare and challenging lesions. Multitudinous embryonic macrocommunication and
      microcommunication between the arterial and venous systems, with resultant
      shunting of blood to the low-resistance veins, produce massive venous and tissue
      engorgement. No well-established guidelines exist concerning their management.
      Percutaneous arterial embolization and surgery are associated with high
      recurrence rates. Surgical excision is frequently not possible and can result in
      massive hemorrhage. Only 52 cases have been reported in the English-language
      literature, and only two patients were followed for longer than 6 years. This
      report presents two additional patients with massive pelvic arteriovenous
      malformations monitored for 9 and 17 years. One patient was initially treated
      with arterial percutaneous embolization and the other with attempted operative
      ablation. A review of the literature has allowed us to develop the following
      management guidelines: Asymptomatic, nonenlarging lesions require no intervention
      and can be safely followed by clinical and radiologic (ultrasonography, CT
      scanning) examinations every 6 months. Symptomatic or rapidly enlarging lesions
      should be treated with preoperative arterial embolization and surgical excision
      attempted only if the arteriovenous malformation is localized and does not
      involve adjacent organs. Arterial embolizations may be repeated to provide
      symptomatic relief of diffuse, large lesions that involve the bladder or bowel.
      This protocol will avoid unnecessary and frequently life-threatening surgery in
      the management of pelvic arteriovenous malformations.

PMID- 1619711
TI  - Small-bowel obstruction from an extruded Greenfield filter strut: an unusual late
      complication.
AB  - Recently interest has been shown in liberalizing the indications for insertion of
      vena caval filters. The convenience of percutaneous insertion by radiologists may
      further perpetuate this trend. However, filter placement is not without
      morbidity. We report a unique late complication in which a small-bowel
      obstruction occurred as a result of volvulus around an extruded filter strut.

PMID- 1619710
TI  - Acute mesenteric ischemia caused by isolated superior mesenteric artery
      dissection.
AB  - Isolated dissection of a peripheral artery is a rare event. Only 11 reports exist
      in the literature of dissection of the superior mesenteric artery, most of which
      have been fatal. This is the first documented case of the successful treatment of
      an acute ischemic event caused by a superior mesenteric artery dissection. In
      addition, the new technique of right gastroepiploic artery-to-superior mesenteric
      artery bypass is introduced as a satisfactory method of revascularization.

PMID- 1619712
TI  - Intermittent claudication caused by compression of tibial vessels as a result of
      calf muscle hypertrophy: case report.
AB  - We present a case with findings suggestive of popliteal artery entrapment in a
      patient with intermittent claudication and localized muscle hypertrophy in the
      calf muscles after removal of a herniated disk. Angiography failed to demonstrate
      popliteal artery entrapment but instead revealed compression of the tibial
      vessels caused by calf muscle hypertrophy. The concept of muscle hypertrophy
      caused by denervation is also discussed.

PMID- 1619713
TI  - Thorascopic dorsal sympathectomy for hyperhidrosis: a new approach.

PMID- 1619714
TI  - A prospective randomized trial of autologous platelet-derived wound healing
      factors for treatment of chronic nonhealing wounds: a preliminary report.

PMID- 1619715
TI  - A prospective randomized trial of autologous platelet-derived wound healing
      factors for treatment of chronic nonhealing wounds: a preliminary report.

PMID- 1619716
TI  - A prospective randomized trial of autologous platelet-derived wound healing
      factors for treatment of chronic nonhealing wounds: a preliminary report.

PMID- 1619717
TI  - Saddle embolism complicating Candida parapsilosis aortic valve endocarditis: cure
      with aortic valve replacement and prompt extraction of multiple mycotic emboli.

PMID- 1619718
TI  - Right subhepatic approach for inflammatory aortic aneurysm in a patient with
      scoliosis.

PMID- 1619719
TI  - Vascular complications of cardiac catheterization.

PMID- 1619720
TI  - Clinical, hemodynamic, and anatomic predictors of long-term outcome of lower
      extremity venovenous bypasses.

PMID- 1619721
TI  - Misdiagnosis of ruptured abdominal aortic aneurysms.
AB  - Ruptured abdominal aortic aneurysm is a surgical emergency with a high mortality
      rate even when diagnosed and repaired immediately. We retrospectively reviewed
      152 cases of ruptured abdominal aneurysms to identify the incidence of
      misdiagnosis leading to a delay in treatment, the most frequent misdiagnoses, and
      the outcome in this group of patients. Forty-six (30%) were initially
      misdiagnosed. The most common misdiagnoses were renal colic, diverticulitis, and
      gastrointestinal hemorrhage. The most common initial physical findings in
      misdiagnosed patients were abdominal pain (70%), shock (57%), and back pain
      (50%). A pulsatile abdominal mass was found in only 26% of misdiagnosed patients
      versus 72% of patients correctly diagnosed (p less than 0.005). Misdiagnosed
      ruptured abdominal aneurysm had a 44% mortality rate, which was not significantly
      different from patients correctly diagnosed (58%, p = 0.34). The lack of
      difference in mortality rates is most likely due to preselection of those
      misdiagnosed patients who were able to withstand the delay in diagnosis and
      survive to surgical treatment. The 30% incidence of misdiagnosis in this series
      suggests that it is frequently a difficult diagnosis to make and must be
      considered in elderly patients, especially men, who are admitted with abdominal
      pain and/or back pain.

PMID- 1619722
TI  - The profunda femoris: a durable outflow vessel in aortofemoral surgery.
AB  - Aorta-common femoral artery bypass is the standard operation for relief of
      aortoiliac occlusive disease. When extensive superficial femoral artery disease
      coexists, the profunda femoris, even in its distal portion, may be used as the
      outflow vessel. To test this assumption we compared cumulative patency, limb
      salvage, and the need for distal bypass of 134 aorta-profunda femoris and 151
      aorta-common femoral artery bypasses performed consecutively for aortoiliac
      occlusive disease over a 12-year period. We also analyzed results of proximal (n
      = 103) and distal (n = 31) aortoprofunda bypasses. Angiographic and noninvasive
      studies showed greater disease in limbs undergoing aorta-profunda femoris bypass.
      However, no difference was observed in cumulative patency (91% +/- 6% vs 96% +/-
      3%) or limb salvage (90% +/- 6% vs 94% +/- 3%) at 5 years. Seventeen distal
      bypasses in the group undergoing profunda femoris bypass and 20 distal bypasses
      in the group undergoing common femoral artery bypass were required to maintain
      limb salvage. Proximal and distal aorta-profunda femoris bypasses showed no
      difference in cumulative patency (91% +/- 9% vs 95% +/- 6%) or limb salvage (94%
      in each group) at 3 years. Standard aorta-common femoral artery and aorta
      profunda femoris bypass provide cumulative patency and limb salvage exceeding 90%
      at 5 years; concomitant or subsequent distal bypass was required in 12% or limbs
      undergoing aorta-profunda femoris bypasses. Both proximal and distal profunda
      femoris arteries provide a durable outflow tract when aortoiliac and
      femoropopliteal occlusive disease are combined.

PMID- 1619723
TI  - Medial calf perforators in venous disease: the significance of outward flow.
AB  - The role of medial calf perforators in the initiation or promotion of venous
      disease is incompletely understood. The purpose of this study was to define the
      direction of blood flow in the perforating vein of the calf in normal limbs and
      in those limbs of patients with venous disease under defined laboratory
      conditions. Both lower limbs of 57 patients, (32 women and 25 men, median age, 56
      years; range, 40 to 62 years) were examined by duplex ultrasonography. In 10
      patients no clinical or duplex evidence existed of venous disease. In 60 legs we
      found evidence of superficial venous insufficiency, complicated by
      lipodermatosclerosis in 29. In 15 limbs we found deep venous insufficiency.
      Finally, in 19 limbs no evidence existed of venous disease, but venous reflux was
      present in the contralateral limb. The direction of blood flow in the medial calf
      perforators was assessed during compression of the foot and calf, by a cuff that
      inflated to 60 mm Hg. Blood flow was also assessed during deflation of the cuff.
      We found that the direction of blood flow within medial calf perforators can be
      both inward or outward, even in limbs without evidence of venous disease. Outward
      flow could be demonstrated in 21% of perforators in normal limbs. Flow on release
      of distal compression occurred in 33% to 44% of perforators in limbs with
      evidence of venous disease but in none of the perforators in limbs without
      evidence of venous disease. We found that flow, during the relaxation phase,
      within medial calf perforators was associated with venous disease elsewhere in
      the limb.

PMID- 1619724
TI  - Heparin-mediated reductions of the toxic effects of protamine sulfate on rabbit
      myocardium.
AB  - Protamine sulfate causes direct myocardial suppression when used to reverse
      heparin anticoagulation. Protamine's excessive positive charge accompanying its
      surface arginine groups appears to be responsible for this toxicity. This study
      was designed to assess the hypothesis that negatively charged heparin given after
      protamine exposure may enhance the recovery of protamine-induced myocardial
      dysfunction. Isolated rabbit hearts (n = 20) were perfused with physiologic
      saline solution at 80 to 90 mm Hg containing high dose protamine, 250
      micrograms/ml, until heart contraction essentially ceased (baseline). Hearts were
      then randomly reperfused for 15 minutes with either physiologic saline solution
      (group I, n = 10) or heparin plus physiologic saline solution (group II, n = 10)
      at a dose of 0.1 IU/1.0 microgram of previously administered protamine. Developed
      left ventricular blood pressure, heart rate, pulmonary artery PaO2, contractility
      (+dp/dt), oxygen extraction (AvO2), oxygen consumption (VO2), and rate x pressure
      product were assessed. A protective, beneficial response accompanied heparin
      administration (group II) in all functions assessed except blood pressure.
      Maximum changes, comparing group I with II, were heart rate (beats/min) -72
      versus -1, p less than 0.001; +dp/dt -64% versus -51%, p less than 0.01; PaO2
      +86% versus +9%, p less than 0.001; AvO2 -37% versus -4%, p less than 0.001; VO2 
      50% versus -28%, p less than 0.008; and rate x pressure product -73% versus -51%,
      p less than 0.001. These data suggest a separation of protamine's hemodynamic
      effects (blood pressure) and metabolic effects (VO2). Furthermore, these data
      support the tenet that heparin is able to markedly lessen the toxic myocardial
      effects of protamine.

PMID- 1619725
TI  - Assessment of quality of life of patients with severe ischemia as a result of
      infrainguinal arterial occlusive disease.
AB  - The purpose of this cohort study was to assess the quality of life of patients
      with severe ischemia as a result of infrainguinal arterial occlusive disease.
      Spitzer's QL-INDEX was selected to measure quality of life at baseline and at 3,
      6, and 12 months. On the basis of initial treatment, 61 patients were grouped as
      follows: IC (conservative, n = 31), IR (arterial reconstruction, n = 14), and IA
      (major amputation, n = 16). After 12 months of follow-up, 48 patients were
      similarly regrouped according to ultimate treatment as follows: UC (n = 19), UR
      (n = 9), and UA (n = 20). At 12 months the mean score was significantly higher
      than the baseline in IC (6.43 vs 3.84, p less than 0.0001) as well as IR (5.64 vs
      3.57, p less than 0.01), but not in IA (4.43 vs 3.62). The QL-INDEX mean score
      was lower in UA than in UC (4.15 vs 6.58, p less than 0.01) or UR (4.15 vs 7.11,
      p less than 0.0001). The correlation between QL-INDEX and an arbitrary scale was
      also high (r = 0.726, p less than 0.001). In conclusion, quality of life of
      patients with limb ischemia can be confidently assessed, improves during the
      first year of follow-up if major amputation is avoided, and improves and is
      sustained by a functioning graft.

PMID- 1619726
TI  - Fibromuscular dysplasia of the brachial artery: a case report and review of the
      literature.
AB  - Fibromuscular dysplasia is a nonatherosclerotic, noninflammatory vascular disease
      that involves primarily medium-sized and small arteries. Fibromuscular dysplasia
      is characterized by medical fibrosis with or without smooth muscle cell
      hyperplasia and may produce luminal impingement with severe turbulence. Secondary
      aneurysmal deformity with or without thrombosis may also contribute to the
      obstruction. Fibromuscular dysplasia most commonly involves the renal and carotid
      arteries, with upper-extremity disease rarely reported. This case report
      describes a patient with digital embolization from brachial artery fibromuscular
      dysplasia. Angiography demonstrated significant narrowing and irregularity with a
      characteristic "string-of-beads" appearance of the right midbrachial artery. The
      abnormal segment was resected and reconstructed with a reversed saphenous vein
      graft. Histologic studies revealed disruption of the internal elastic lamina and
      disorientation of the hyperplastic medial smooth muscle cells characteristic of
      fibromuscular dysplasia.

PMID- 1619727
TI  - Mycotic aneurysm of the tibioperoneal trunk: case report and review of the
      literature.
AB  - Peripheral mycotic aneurysms can occur when septic emboli lodge in either the
      lumen or the vasa vasorum of a peripheral vessel. Such aneurysms have become rare
      after the widespread use of aggressive antibiotic treatment for bacterial
      endocarditis. We report the case of a large mycotic aneurysm of the tibioperoneal
      trunk 18 months after an episode of Streptococcus viridans bacterial
      endocarditis. Treatment included complete resection of the aneurysmal sac with
      restoration of circulation to the posterior tibial artery with a reversed
      saphenous vein graft. To our knowledge, this is the first case of a mycotic
      aneurysm of the tibioperoneal trunk reported in the English literature. It also
      represents the first case in which a mycotic aneurysm of an infrapopliteal vessel
      was managed successfully with restoration of circulation.

PMID- 1619728
TI  - Thoracoabdominal aortic aneurysm associated with umbilical artery
      catheterization: case report and review of the literature.
AB  - Aneurysms in infants and children are rare and are usually associated with
      cardiovascular malformations or connective tissue disorders. A new subgroup of
      patients has become recognized over the past two decades--those with aneurysms
      associated with umbilical artery catheterization. Critically ill newborns who
      have required umbilical artery catheterization and have developed sepsis, usually
      staphylococcal, are at risk for the development of mycotic aneurysm disease of
      the aorta or its major branches or both. Since first described in 1970, 34 cases
      have been reported in the literature, 14 involving the descending thoracic aorta,
      10 the abdominal aorta, 6 the iliac arteries, and 4 either the thoracoabdominal
      aorta or multiple aneurysms involving both the thoracic and abdominal aorta. This
      report presents a case we recently treated of a 15-month-old-boy with a large
      thoracoabdominal aortic aneurysm and aneurysms of the infrarenal abdominal aorta
      and proximal right common iliac artery. It includes a review of the recent
      literature to analyze pathogenesis, clinical manifestations, and to formulate
      methods of treatment.

PMID- 1619729
TI  - Blunt traumatic iliac vein laceration without pelvic fracture: a rare entity.
AB  - Most blunt traumatic pelvic venous injuries are associated with pelvic fractures.
      We report the case of a 32-year-old man who suffered a common iliac vein
      laceration, without a pelvic fracture, during a motor vehicle accident.
      Laparotomy and venous repair were undertaken.

PMID- 1619730
TI  - Aortoesophageal fistula: report of a successfully managed case and review of the
      literature.
AB  - Aortoesophageal fistula is a rare, frequently fatal cause of upper
      gastrointestinal bleeding. Although several causes have been described, it
      appears that the most common cause is rupture of a thoracic aortic aneurysm into
      the esophagus, occurring in approximately 12% of thoracic aneurysm ruptures.
      Although the entity was originally described in 1818, the diagnosis has rarely
      been made before death, and until 1983 no one survived surgery for aneurysm
      associated aortoesophageal fistulas. Since that report of two cases, only two
      other survivors, including this patient, have been reported. Included herein is
      the report of a successfully managed case, along with a discussion of the causes,
      clinical features, and diagnostic approach to the disease, as well as the
      management of both the aortic and esophageal components of the fistula.

PMID- 1619731
TI  - A complication of the Greenfield filter: fracture and distal migration of two
      struts--a case report.
AB  - This is a case report of a 41-year-old woman who required surgical removal of a
      Greenfield filter 7 months after placement. The filter developed several
      complications. Two struts were noted to be completely separated from the filter
      and lodged in the infrarenal vena cava. The filter had migrated to a resting
      position in the right renal, vein with two struts perforating the renal vein and
      inferior vena caval junction. The perforating struts were intraperitoneal and
      were found to impinge on the right ureter with seromuscular involvement of the
      second portion of the duodenum. No free perforation was noted at the time of
      exploration.

PMID- 1619732
TI  - Violence decreases with gang truce.

PMID- 1619733
TI  - 'Critical moment' at hand in HIV/AIDS pandemic, new global strategy to arrest its
      spread proposed.

PMID- 1619734
TI  - From the Centers for Disease Control. Selected tobacco-use behaviors, dietary
      patterns among high school students--United States, 1991.

PMID- 1619735
TI  - From the Centers for Disease Control. Unintentional firearm-related fatalities
      among children, teenagers--United States, 1982-1988.

PMID- 1619736
TI  - From the Centers for Disease Control. Public health focus: mammography.

PMID- 1619737
TI  - A piece of my mind. Monday morning clinic.

PMID- 1619739
TI  - DEXA.

PMID- 1619738
TI  - The quality of mercy is not strained.

PMID- 1619740
TI  - A survey of occupational blood contact and HIV infection among orthopedic
      surgeons. The American Academy of Orthopaedic Surgeons Serosurvey Study
      Committee.
AB  - OBJECTIVE: To study the seroprevalence of human immunodeficiency virus (HIV)
      among orthopedic surgeons, and correlate the results with occupational and
      nonoccupational risk factors. Orthopedic surgeons are one of several groups of
      health care workers at risk for occupationally acquired HIV infection; however,
      few HIV seroprevalence studies in health care workers, and none in surgeons, have
      been performed to assist in estimating the extent of occupational risk. DESIGN: A
      voluntary, anonymous HIV serosurvey at an annual meeting. To assess the
      representativeness of participants, a mail survey of orthopedic surgeons was
      conducted 5 months prior to the annual meeting. SETTING: The 1991 annual meeting
      of the American Academy of Orthopaedic Surgeons held in Anaheim, Calif.
      PARTICIPANTS: United States or Canadian orthopedic surgeons in training, in
      practice, or retired from practice who attended the annual meeting. MAIN OUTCOME
      MEASURES: Participants' HIV serostatus and reporting of occupational and
      nonoccupational risk factors for HIV infection. RESULTS: Of 7147 eligible
      orthopedists at the annual meeting, 3420 (47.9%) participated. Compared with the
      10,411 orthopedic surgeons responding to the mail survey, serosurvey participants
      had at least as many opportunities for occupational contact with blood and with
      HIV-infected patients. Among participants, 87.4% reported a blood-skin contact
      and 39.2% reported a percutaneous blood contact in the previous month. Among 3267
      participants without reported nonoccupational risk factors for HIV infection,
      none was positive for HIV antibody (0%; upper limit of the 95% confidence
      interval [CI] = 0.09%); among 108 participants with reported nonoccupational HIV
      risk factors, two were positive for HIV antibody (1.9%; upper limit of the 95% CI
      = 5.7%). CONCLUSION: Although these findings may not be generalizable to all
      orthopedic surgeons, we found no evidence of HIV infection among serosurvey
      participants without nonoccupational risk factors. The high rates of self
      reported blood contact underscore the importance of compliance with infection
      control precautions and of development of new techniques and equipment to
      minimize the risk of exposures to blood during surgical procedures.

PMID- 1619741
TI  - Population-based monitoring of an urban HIV/AIDS epidemic. Magnitude and trends
      in the District of Columbia.
AB  - OBJECTIVE: To assess the extent of the human immunodeficiency virus
      (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic in the District of
      Columbia and demonstrate an approach to monitoring HIV infection and projecting
      AIDS incidence at a community level. DESIGN: Backcalculation methods to
      reconstruct HIV incidence from AIDS incidence in subgroups. Results were compared
      with directly measured HIV seroprevalence in selected sentinel populations:
      childbearing women, civilian applicants for military service, and hospital
      patients admitted for conditions unrelated to HIV infection. RESULTS: Between the
      start of the epidemic in 1980 and January 1, 1991, one in 57 District of Columbia
      men aged 20 to 64 years was diagnosed with AIDS. Unlike the plateau projected for
      the nation, AIDS incidence for the District of Columbia was projected to increase
      by 34% between 1990 and 1994. Models of HIV infection incidence suggested two
      broad epidemic waves of approximately equal size. The first occurred in men who
      have sex with men and peaked during the period from 1982 through 1983. The second
      began in the mid-1980s in injecting drug users and heterosexuals. We estimated
      that among District of Columbia residents aged 20 to 64 years, 0.3% of white
      women, 2.9% of white men, 1.6% of black women, and 4.9% of black men were living
      with HIV infection as of January 1, 1991. These estimates are broadly consistent
      with survey data: among black childbearing women in their 20s, HIV prevalence
      doubled to 2% between the fall of 1989 and the spring of 1991; from military
      applicant data, we estimated that over 5% of black men born from 1951 through
      1967 were HIV-positive; in the sentinel hospital, HIV prevalence rates among male
      patients aged 25 to 34 years were 11.3% in white men and 16.9% in black men.
      CONCLUSION: Backcalculation and surveys yielded quantitatively consistent
      estimates of HIV prevalence. Many injecting drug users and heterosexuals in the
      District of Columbia were infected after January 1, 1986. Similar monitoring of
      the epidemic in other localities is needed to focus efforts to reduce the
      incidence of HIV transmission.

PMID- 1619742
TI  - High risk of active tuberculosis in HIV-infected drug users with cutaneous
      anergy.
AB  - OBJECTIVES: To determine the incidence of active tuberculosis in human
      immunodeficiency virus (HIV)-seropositive and HIV-seronegative drug injectors
      with cutaneous anergy and to examine the effectiveness of isoniazid
      chemoprophylaxis in preventing tuberculosis among drug injectors with positive
      tuberculin test results. DESIGN AND SETTING: Prospective observational study
      linked to an ongoing study of HIV infection within a New York City (NY) methadone
      program; subjects also underwent routine intradermal tuberculin testing and
      multiple-antigen delayed-type hypersensitivity skin testing. The 31-month study
      period ended December 31, 1990. METHODS: Anergic subjects and tuberculin reactors
      who were HIV seropositive were compared by HIV disease status and CD4+ T
      lymphocyte levels. Tuberculosis incidence was calculated for anergics (none
      treated with isoniazid) and for treated and untreated tuberculin reactors, by HIV
      serological status. RESULTS: Among those seropositive for HIV, anergic subjects
      had more advanced HIV disease and fewer CD4+ cells (median 0.33 vs 0.56 x
      10(9)/L, P less than .01) compared with tuberculin reactors, although neither
      clinical status nor CD4+ cell counts consistently predicted anergy. Five (7.6%)
      of 68 anergic subjects who were HIV seropositive and none of 52 anergic subjects
      who were HIV seronegative (n = 18) or of unknown (n = 34) HIV serological status
      developed active tuberculosis during the study period (P less than .05). The
      tuberculosis incidence rate among anergic subjects who were HIV seropositive was
      6.6 cases per 100 person-years (95% confidence interval [Cl], 2.1 to 15.3). Of 25
      HIV-seropositive tuberculin reactors who did not receive or complete 12 months of
      isoniazid prophylaxis, tuberculosis incidence was 9.7 cases per 100 person-years
      (95% Cl, 2.6 to 24.7; P = 0.56, compared with the rate among anergic HIV
      seropositives); there were no cases of tuberculosis in 53.4 person-years of
      follow-up for 27 HIV-seropositive tuberculin reactors who received 12 months of
      prophylaxis (rate difference between treated and untreated groups, 9.7 cases per
      100 person-years, 95% Cl, 1.3 to 18.0). CONCLUSION: Drug injectors with cutaneous
      anergy who are seropositive for HIV are at high risk of active tuberculosis,
      similar to that among untreated HIV-seropositive tuberculin reactors. A decreased
      incidence of active tuberculosis was seen in HIV-seropositive tuberculin reactors
      receiving 12 months of isoniazid chemoprophylaxis, compared with untreated or
      partially treated subjects. These results support the routine use of delayed-type
      hypersensitivity testing to accompany tuberculin testing for drug injectors with
      known or suspected HIV infection, and consideration of isoniazid prophylaxis for
      anergic as well as tuberculin-reactive subjects who are HIV seropositive, in
      populations with a high prevalence of coexisting HIV and Mycobacterium
      tuberculosis infection.

PMID- 1619743
TI  - Residents' experiences in, and attitudes toward, the care of persons with AIDS in
      Canada, France, and the United States.
AB  - OBJECTIVE: To evaluate resident physicians' experiences in, and attitudes toward,
      the care of persons with the acquired immunodeficiency syndrome (AIDS) in Canada,
      France, and the United States. DESIGN: Cross-sectional survey, using a self
      administered, mailed questionnaire to residents in 10 American states, three
      French regions, and all 10 Canadian provinces, with follow-up surveys of
      nonresponders in France and the United States. SUBJECTS: Systematic samples of
      residents in the last year of internal medicine or family medicine residencies
      prior to subspecialization or entry into medical practice. RESULTS: While the
      majority of residents had provided inpatient and outpatient care to persons with
      AIDS, most believed that their training in ambulatory care of persons with AIDS
      had been deficient. The rate of blood-contaminated needle-sticks from human
      immunodeficiency virus-infected patients ranged from 4% for internal medicine
      residents in Canada to 14% in the United States (P less than .05). The majority
      recognized an ethical obligation to treat AIDS, but 4% in France, 14% in Canada,
      and 23% in the United States indicated that they would not care for persons with
      AIDS if they had a choice (P less than .001). A substantial minority of US
      physicians reported that a patient of theirs had been refused care by a medical
      specialist (19%) or a surgeon (39%), but less than 10% of French physicians
      reported such refusals (P less than .001). CONCLUSION: Concerns about caring for
      AIDS patients were common and many physicians reported that patients were refused
      care. While most residents acknowledged an obligation to treat human
      immunodeficiency virus infection, many did not, and viewpoints varied
      considerably across the countries studied. The lower level of reluctance to treat
      AIDS patients in France and Canada makes it clear that the higher rate in the
      United States is far from optimal and needs to be addressed.

PMID- 1619744
TI  - The history of malariotherapy for neurosyphilis. Modern parallels.

PMID- 1619745
TI  - A retreat in the tobacco war.

PMID- 1619746
TI  - [Autonomic nervous system from a basic aspect].
AB  - The autonomic nervous system was reviewed from a basic aspect with particular
      emphasis on (1) cooperation between the autonomic and somatic nervous systems,
      (2) necessity for a concept of functional unit of the central and peripheral
      autonomic nervous systems, and (3) realization of the existence of afferent
      fibers in the peripheral autonomic nerves. In addition, some recent topics
      related to the autonomic nervous system on (1) parasympathetic innervation of
      blood vessels, (2) receptors and intracellular signal transduction system, (3)
      autonomic regulation of hormonal and immune organs, (4) intracranial neural
      regulation of cerebral blood flow, and (5) neurotrophic factors are reviewed.

PMID- 1619747
TI  - [Autonomic reflexes: focusing on the arterial baroreceptor-vasoconstrictor
      reflex].
AB  - The arterial baroreceptor-sympathetic vasoconstrictor reflex (baroreceptor
      reflex), among autonomic reflexes, is summarized. Arterial baroreceptor afferents
      terminate in the caudal part of the nucleus tractus solitarius. Excitation of the
      baroreceptor afferents activates neurons in the caudal ventrolateral medulla that
      send axonal projections to the rostral ventrolateral medulla. These neurons (CVLM
      neurons) then inhibit tonic activity of sympathoexcitatory reticulospinal neurons
      in the rostral ventrolateral medulla (RVLM neurons). Tonic activity of RVLM
      neurons are responsible for tonic activity of the peripheral vasoconstrictors.
      These two kinds of neurons are essential neuronal components for the baroreceptor
      reflex. Both the neurons may also participate in various vasoconstrictor
      reflexes, such as the somato-and viscero-sympathetic vasoconstrictor reflexes.

PMID- 1619748
TI  - [Concept and classification of autonomic failure].
AB  - The autonomic nervous system innervates every visceral and peripheral organs in
      the body. It has as complex a neural organization in the brain, spinal cord, and
      periphery as the somatic nervous system, but remains largely involuntary or
      automatic. Accurate diagnosis is essential for proper management of autonomic
      failure but in attempting to classify autonomic disease there is a philosophical
      point to be borne in mind. Since it is very difficult to comprehend and evaluate
      systematically the aspect of autonomic dysfunction in each organ in various
      diseases, little works have been performed to classify autonomic diseases. We
      introduce several comprehensible works of classification of autonomic failure. We
      also presented some typical autonomic diseases according to those classifications
      in this paper.

PMID- 1619749
TI  - [Diseases of the autonomic nervous system. General aspect of symptomatology].
AB  - The human internal environment is regulated by the autonomic nervous system
      (ANS), endocrine glands and neuropeptides as well as the integrated activity of
      these three systems. The ANS is divided into thoraco-lumbar (sympathetic) and
      cranio-sacral (parasympathetic) divisions. They comprise two neurons: pre- and
      post-ganglionic fibers. The limbic system and hypothalamus are known to regulate
      the peripheral ANS through descending pathways in the brain stem and spinal cord.
      Cardinal semiologies of the ANS disorders are classified as follows:
      cardiovascular (orthostatic hypotension, a variety of syncopes, postprandial
      hypotension, Raynaud's phenomenon), pupillomotor (paralytic mydriasis, Adie's
      tonic pupil, Horner's syndrome), urodynamic (urinary retention and incontinence),
      and sexual (impotence, hyper- and hyposexuality).

PMID- 1619750
TI  - [Evaluation of autonomic nervous function by pupil dynamics recording].
AB  - Pupil is richly innervated by autonomic nerves. Therefore, its size or movement
      well reflects the autonomic nervous function. By analyzing dynamics of pupil
      movement for light stimulus followed by infrared video-pupillography, the
      abnormality of autonomic nervous system can be expressed in a quantitative
      manner. Clinical applications of pupillography and pharmacological examination to
      Horner syndrome, Adie syndrome, diabetes mellitus, pupillary involvement of
      Behcet disease, pupil of brain death and patients with chemical sensitivity have
      been described. Segmental spasm of iris in Horner and Aide syndrome, especially,
      nasal side of iridoplegia was seen in early stage of Aide syndrome from pupillary
      dynamics to light stimulus. An involvement of sympathetic nerve subserving iris
      dilator muscle was confirmed from pupillography, drug reaction to topically
      applied l-epinephrine in the diabetics. An involvement of cholinergic nerve which
      subserve the iris sphincter muscle was seen in Behcet disease when there was no
      manifest eye involvement. Mild mydriasis in brain death patients was seen under
      denervation of central nervous system. Dysfunction of sympathetic nerve from
      pupillary light reflex in chemically sensitive patients for cholinated
      hydrocarbon pesticides.

PMID- 1619751
TI  - [Heart rate variability].
AB  - Heart rate variability (HRV) has become a useful parameter for the quantification
      of autonomic nervous function. HRV has been quantified, either by time domain or
      frequency domain analysis. Time domain measures, such as CVRR and RR50, are easy
      to calculate but they only provide information related to parasympathetic
      activity. The spectral analyses, on the other hand, give us information
      concerning 3 oscillatory components. The high frequency band (the frequency
      between 0.15-0.5 Hz) is known as the respiratory sinus arrhythmia (RSA), and the
      middle frequency band (0.88-0.15 Hz) is attributed to baroreflex components. The
      low frequency band (0.01-0.08 Hz) may be of various origins, such as blood flow
      rhythm, periodic respiration (including Cheyne-Stokes respiration), renin
      angiotensin, and thermal regulation. The efferent nerve to the high frequency
      band is totally operated by the parasympathetic system. The low frequency band is
      regulated by both sympathetic and parasympathetic nervous systems. We
      demonstrated that the diurnal variation of HRV may afford additional information,
      such as ultradian changes of autonomic activity, possibly due to REM/NREM cycles.
      It is believed that simultaneous monitoring of other physiological parameters
      such as EEG, EOG, respiration, and blood pressures, might give us information
      concerning the dynamic nature of autonomic nervous function.

PMID- 1619753
TI  - [Diurnal blood pressure variation and autonomic nervous function].
AB  - We studied the relationship between diurnal blood pressure variation (DBPV) and
      autonomic nervous function in various diseases, such as, diabetes mellitus (DM),
      Parkinson's disease (PD), Shy-Drager syndrome (SDS) and cerebrovascular disease
      (CVD). Abnormal DBPV was found in those diseases. We speculated that dysfunction
      of autonomic nervous system might contribute to the abnormal DBPV in DM, CVD, PD,
      and SDS. The DBPV relates not only to the autonomic nervous system but also the
      endocrine system, renal function, mental and physical activity, and biological
      rhythm. From this viewpoint, there is a limitation in studying DBPV as an
      autonomic nervous function.

PMID- 1619752
TI  - [The significance and limit of thermography at present].
AB  - Thermography has been reported to be usefull in the detection and
      characterization of nervous diseases. Recently, however, some papers report that
      it is not useful. In this paper, problems including its history, and measures to
      solve them are discussed. It is proposed that methods to distinguish patients
      from normal subjects and information that cannot be obtained by other tests, are
      needed.

PMID- 1619754
TI  - [Gastrointestinal motility and autonomic nerve dysfunction].
AB  - Gastrointestinal motility is greatly influenced by both the autonomic nervous
      system (ANS) and the enteric nervous system (ENS). Dysfunction of ANS and/or ENS
      produces various kinds of dysmotility from the esophagus to the colon.
      Generalized autonomic dysfunction, often seen in diabetics, causes abnormal
      peristaltic waves in the esophagus, abnormal electrical activity of the stomach,
      delayed gastric emptying and delayed intestinal transit. Localized disorders of
      the enteric nervous system is seen in patients with achalasia and Hirschsprung's
      diseases. Functional disorders, without evidence of organic disorders, like non
      cardiac chest pain, non-ulcer dyspepsia, irritable bowel syndrome, can be partly
      caused by abnormal function of autonomic nervous system.

PMID- 1619755
TI  - [Tests for autonomic functions: sudomotor function].
AB  - Sudomotor function tests provide information on the functional state of the
      sympathetic system innervating skin, the postganglionic fibers of which are
      cholinergic. Various methods for sweat elicitation and its qualitative or
      quantitative detection are described here, but most practical combinations vary
      depending on the purpose of testing and possible pathophysiology of each patient;
      1) hyperhidrosis vs. hypo- or anhidrosis, 2) central vs. peripheral or
      postganglionic lesions, 3) generalized vs. focal disturbances. When these are
      unknown, thermal sweating of the whole body is most informative. Comparison of
      thermal and pharmacological sweating enables one to estimate the extent and
      possible site of sympathetic disturbance. In evaluating the results of sudomotor
      function tests, factors due to employed methods, age, sex, posture, medication,
      etc must be taken into consideration. In general, hyperhidrosis is more difficult
      than hypohidrosis to estimate its underlying mechanism, since the functional
      relation between the facilitatory hypothalamo-spinal pathway and other central
      structures still remains largely unknown.

PMID- 1619756
TI  - [Sympathetic skin response (SSR)].
AB  - The sympathetic skin response (SSR) is a slow wave resulting from activation of
      the sudomotor sympathetic efferent fibers. Records are usually made with surface
      electrodes on hand or foot after the electrical stimulation. Either the amplitude
      or the latency of the response varies greatly on consecutive stimulations and
      there is also a remarkable tendency to habituation. Therefore SSR is considered
      abnormal if no significant responses are detected. SSR is well correlated with
      other autonomic function tests and its abnormality is documented in a variety of
      neurologic disorders such as diabetic neuropathy, cerebrovascular disease and
      Parkinson's disease. In good methodological conditions, SSR is a simple, reliable
      indicator of sympathetic sudomotor outflow in central and peripheral nervous
      system disorders.

PMID- 1619757
TI  - [Erectile function and urinary function].
AB  - In recent years, with the great advance in neuro-urophysiological concept, the
      evaluation and limitations of clinical investigation for sexual (erection)
      function and bladder (urinary) function are continuously changing, so they should
      be correctly recognized at the time of actual interpretation. The common problems
      on these functional tests are standardization of terminology and of methodology,
      and difference of individual sensitivity. From a viewpoint of respective
      evaluation and limitations, AVSS, NPT, papaverine test, BCR for erectile function
      tests and CM, UFM, EMG, complex urodynamics for urinary function tests are
      reviewed.

PMID- 1619758
TI  - [Clinical application of micro-vibration to autonomic function test].
AB  - Microvibration (MV) is the minute vibration observed on surface of the human
      body. MV on the thenar eminence has been used as an autonomic function test, and
      is one of the important psychophysiological methods in psychosomatic medicine
      because the measurement of MV is not invasive. Although the mechanism generating
      MV has not been definitely clarified, there seems to be two major components, a
      ballistocardiographic one and a muscular one. The analysis of MV focuses on
      frequency characteristics. To broaden the clinical application of MV measurement,
      it is necessary to improve the analyzing method and to develop a way for
      evaluating MV comprehensively by combining it with other examinations.

PMID- 1619759
TI  - [Clinical significance of plasma catecholamines in autonomic nerve diseases].
AB  - Although it was well known that noradrenaline was secreted from the terminal of
      sympathetic nervous system, we supposed that plasma noradrenaline does not always
      indicate sympathetic nervous activity. This was the reason, why we need at least
      10 ml of plasma for noradrenaline measurement and so, many plasma sample could
      not be collect continuously from the same person, 15 years ago. Now, plasma
      noradrenaline was be analyzed from 0.05 ml of plasma for single isotope
      radioenzymatic assay. Blood samples of noradrenaline measurements could be
      collected through venous catheter inserted in cubital vein every 20 min 24 hours.
      We can study the relationship between circadian rhythm of plasma noradrenaline
      and that of blood pressure, etc.

PMID- 1619761
TI  - [Idiopathic orthostatic hypotension (IOH) and sympathotonic orthostatic
      hypotension (SOH)].
AB  - IOH occurs as progressive autonomic failure (PAF) without any neurologic symptoms
      indicating multiple system atrophy or Parkinson's disease. The responsible lesion
      for IOH is yet obscure but has been suggested to be in the peripheral sympathetic
      nerves, since postganglionic sympathetic neurons in IOH fail to release
      norepinephrine and there present extensive supersensitivities to exogenous
      pressors. SOH is characterized as marked tachycardia induced by hypotensive
      stress like standing, and is less sensitive to the administered catecholamines.
      Careful examinations by some pharmacological studies are essential to diagnose
      IOH and SOH in patients with orthostatic hypotension.

PMID- 1619760
TI  - [Shy-Drager syndrome].
AB  - Shy-Drager syndrome is characterized by severe orthostatic hypotension and other
      autonomic dysfunctions, cerebellar ataxia, parkinsonism, and upper and lower
      motor neuron symptoms. The disease starts in the 4th to 6th decades with severe
      dizziness, blackout or syncopi on standing up, and the duration of the illness is
      6-7 years in the majority of the cases. The pathological lesions responsible for
      the autonomic dysfunctions are in the hypothalamus, locus saeruleus, Edinger
      Westphal and other nuclei in the brain stem, intermediolateral column and Onuf's
      nuclei in the spinal cord. Oppenheimer has postulated a concept of multiple
      system atrophy to such widely distributed degenerative neurological disorders.
      However, olivopontocerebellar atrophy of Dejerine and Thomas, striatonigral
      degeneration and this syndrome can be distinguished clinically as well as
      pathologically.

PMID- 1619762
TI  - [Progressive autonomic failure with Parkinson's disease].
AB  - Progressive or primary autonomic failure (AF) is a disease of unknown-etiology,
      and presents generalized and extensive autonomic disturbances because of
      selective neuronal degeneration in the whole of autonomic nervous system. AF is
      classified into three categories; (1) pure autonomic failure, without associated
      neurological disorders, (2) AF with Parkinson's disease (PD), and (3) AF with
      multiple system atrophy (Shy-Drager syndrome) (Bannister, 1988). AF with PD is
      pathologically characterized by neuronal cell degeneration in the
      intermediolateral column and the substantia nigra, together with Lewy bodies
      mainly in the pigmented nuclei in the brain stem. Patients with PD occasionally
      develop syncope or dizziness due to orthostatic hypotension and/or postprandial
      hypotension as well as urorectal disturbances as the initial symptoms, and are
      followed by parkinsonism. Levodopa is usually effective for parkinsonism but the
      prognosis is rather poor. AF with PD could be regarded as a form of 'the Lewy
      body disease' according to Kosaka's clinicopathological entity (1984).

PMID- 1619763
TI  - [Autonomic dysfunction of central nervous system disorders].
AB  - Central nervous system disorders, such as cerebrovascular or spinal cord lesions
      often cause dysfunctions of the autonomic nervous system. In most cases of acute
      cerebrovascular accidents, blood pressure is transiently elevated. Some patients,
      especially with pontine or thalamic hemorrhage, suffer from extremely high fever.
      In patients with large lesions in the cerebral hemisphere or lesions in the
      brainstem, cardiopulmonary state may be affected. In spite of absence of acute
      myocardial infarction, electrocardiogram may show ST-T changes resembling acute
      myocardial infarction. Cheyne-Stokes respiration or sleep apnea can occur.
      Lesions in the medulla oblongata cause dysfunctions of automatic respiration.
      Patients with large cerebrovascular lesions in the unilateral hemisphere often
      show transient hyperhidrosis on the contralateral side. Prognosis of patients
      with these autonomic failures is poor. In patients with spinal shock, blood
      pressure and heart rate are reduced. In chronic stage, autonomic hyperreflexia,
      such as attacks of episodic hypertension can occur. Lesions in the high cervical
      cord often bring nonsymptomatic perforating gastric ulcer.

PMID- 1619764
TI  - [Secondary autonomic diseases--diabetes mellitus].
AB  - Diabetic autonomic neuropathy is an established disease entity. Nevertheless, it
      was not until 1945 that diabetic autonomic neuropathy became a target for
      extensive systemic research works. This is partly because of insidious progress
      of this disorder and lack of precise techniques of examinations. In this review
      article, signs and symptoms of diabetic autonomic disorders characteristic of
      each visceral organ are described. Among them, such symptoms as painless
      myocardial infarction and hypoglycemia without warning symptoms deserve special
      attention. It is essential for clinical doctors to realize that autonomic
      neuropathy is the most important part for understanding diabetic pathology.

PMID- 1619765
TI  - [Autonomic dysfunction in metabolic diseases].
AB  - Among many metabolic disorders, porphyrias and Fabry disease are known to affect
      autonomic nervous system. In patients with acute intermittent porphyria,
      hereditary coproporphyria, and variegate porphyria, autonomic symptoms such as
      abdominal pain, vomiting, hypertension and tachycardia are among the most
      prominent clinical manifestations. Fabry disease is clinically characterized by
      severe limb pain, hypohidrosis, angiokeratomas and various autonomic symptoms. In
      both porphyrias and Fabry disease, pathological changes in the central and
      peripheral autonomic nervous system have been documented. In porphyrias, a loss
      of myelinated fibers, axonal degeneration, and segmental demyelination in
      peripheral autonomic nerves as well as chromatolysis of several brain stem nuclei
      have been found. In Fabry disease, abnormal amount of the substrates of alpha
      galactosidase, i.e. ceramide di- and trihexoside, are found to be accumulated in
      the central and peripheral autonomic nerves.

PMID- 1619766
TI  - [Autonomic nerve disorders in generalized amyloidosis].
AB  - Various autonomic disturbances are usually seen in systemic amyloidosis with
      polyneuropathy, especially in familial amyloid polyneuropathy (FAP). In this
      paper we summarized the clinicopathological features of these autonomic symptoms.
      Orthostatic hypotension and bowel dysfunctions are two major autonomic
      manifestations of FAP, and at autopsy severe deposition of amyloid is observed in
      an extensive area of peripheral autonomic nervous system including sympathetic
      ganglia. Remarkable depletion of the extrinsic nerves with relative preservation
      of the intrinsic nerves is a characteristic finding in the gastrointestinal tract
      of the patients with FAP, and this abnormal innervation may produce the peculiar
      bowel disorders. Oral administration of L-threo-3,4-dihydroxyphenylserine, a
      precursor of noradrenaline, is effective for the treatment of these autonomic
      symptoms of FAP patients.

PMID- 1619767
TI  - [Autoimmune disease among secondary autonomic disease--acute demyelinating
      polyneuropathy (Guillain-Barre syndrome)].
AB  - Acute demyelinating polyneuropathy (Guillain-Barre syndrome) among secondary
      autonomic diseases was described as a representative disorder due to autoimmune
      mechanism. The possible roles of preceding vital infection, cellular and/or
      humoral immune abnormalities in developing the disease have been considered. A
      comparison was made between acute demyelinating polyneuropathy and experimental
      allergic neuritis in respects of their causes. Polyneuropathy associated with M
      proteinemia and Rowland's syndrome was also briefly reviewed.

PMID- 1619769
TI  - [Riley-Day syndrome (familial dysautonomia)].
AB  - Riley-Day syndrome (RDS, familial dysautonomia) is reviewed from a viewpoint of
      autonomic disturbance. RDS shows pandysautonomia, including alacrima, orthostatic
      hypotension, gastrointestinal paresis, and paroxysmal hyperautonomic state, such
      as hypertension, vomiting crisis, and blotchy erythema. Sensory disturbances,
      including absence of taste and pain sensation, are common. Fungiform papillae on
      the tongue are sparse. Tests of autonomic function reveal postganglionic
      dysfunction. Sural nerve biopsy reveals depletion of small myelinated fibers and
      unmyelinated fibers, which corresponds well with the sensory and autonomic
      disturbances. As to the pathogenesis of RDS, dysgenesis of neurons from the
      neural crest or abnormality of nerve growth factor has been suggested, but this
      remains undetermined.

PMID- 1619768
TI  - [Abnormalities of autonomic nervous systems in intoxications, including alcohol
      and drugs].
AB  - Disorders in the autonomic nervous system occur frequently in cases with
      alcoholism or various intoxications. Drugs, especially those related to
      neurotransmitters may induce complicated symptoms in the sympathetic or
      parasympathetic nervous system. Some of these symptoms are accompanied by
      peripheral neuropathy. Intoxication, especially alcoholism is often are combined
      with a malnutrition, such as avitaminosis. Dysautonomic symptoms change
      successively; at an early stage, drugs or toxins stimulate sympathetic or
      parasympathetic receptors, while the same receptors are inhibited at a later
      stage when the concentration of the substances rises in the blood. Frequent
      stimulations of the same receptor may produce change in the sensitivity of
      receptors, decreased metabolism or addiction. These changes suggest that a
      different approach towards the acute and chronic autonomic disorders caused by
      intoxications is needed.

PMID- 1619770
TI  - [Acute autonomic neuropathy and the other related diseases].
AB  - In 1969, Young et al. described a patient with an acquired, pure pan-dysautonomia
      of unknown etiology, involving both the sympathetic and the parasympathetic
      nervous systems without other neurological manifestations. Since then, a number
      of similar cases have been described. More recently, reports have appeared of
      predominantly cholinergic dysautonomia, of dysautonomia associated with
      infection, and of dysautonomia with other impairment of nervous function. As an
      etiology, immunological disorder has been suggested but the precise mechanism has
      not been clarified. By accumulating more cases, a more accurate etiology and more
      satisfactory therapy will be developed.

PMID- 1619771
TI  - [Autonomic nerve dysregulation syndrome].
AB  - There is no established disease concept to define so-called autonomic
      dysregulation syndrome. 1) Recently, cases of this disease are being screened by
      examining autonomic nerve function in patients showing various symptoms that may
      have been induced by abnormal autonomic nervous system regulation. Based on the
      test results, dysfunctional cases are classified as autonomic dysregulation
      syndrome, excluding those cases where dysfunction results from psychiatric
      diseases, organic diseases of the autonomic nervous system, or endocrinopathy.
      The disease concept is problematic in that the clinical and pathophysiological
      condition of the idiopathic and essential autonomic dysregulation syndrome,
      screened through the above procedure, is unclear. 2) Useful methods are being
      developed to examine autonomic-nerve function. These methods may provide new
      materials to establish a concept for autonomic dysregulation syndrome. It is
      believed that it is time to etiologically classify cases from the standpoint of
      autonomic nerve dysregulation syndrome.

PMID- 1619773
TI  - [Localized disturbance of autonomic nervous system--reflex sympathetic
      dystrophy].
AB  - Clinical aspects of the reflex sympathetic dystrophy (RSD) are summarized, along
      with a review of basic works concerning its pathophysiology. RSD is important not
      only as a cause of limb pain after trauma and other triggers, but also as a cause
      aggravating the pain which already has an apparent cause, but is
      disproportionally severe.

PMID- 1619772
TI  - [Autonomic facio-cephalalgia].
AB  - Autonomic facio-cephalalgia was first described by Brickner et al. in 1935. At
      that time, it's clinical picture was characterized as pain seizure in the head or
      face unilaterally with various autonomic signs, such as swelling, redness and
      hyperthermia of the painful regions. After the first case was described, few
      cases have been reported, including our two cases. Thus, it's definite clinical
      entity can not be determined at present. In this review, the history, symptoms,
      signs, differential diagnosis of this disease and details of two our cases are
      described. The clinical entity of this disease, on bases of present knowledge is
      discussed.

PMID- 1619774
TI  - [Molecular pharmacology of polymorphic arylamine N-acetyltransferase involved in
      the metabolism of arylamine drugs].
AB  - Polymorphic arylamine N-acetyltransferase in the liver determines the N
      acetylation rate of arylamines, which has been implicated in the effects and
      toxicity of amine- and hydrazine-containing drugs. Recently we have demonstrated
      that there are four types of gene for polymorphic N-acetyltransferase and that
      gene 1 gives rise to high N-acetyltransferase activity, while gene 2, 3, and 4
      correspond to low N-acetyltransferase activity. Analysis of four genes revealed
      that the point mutations in genes 2, 3, and 4 result in a loss of a restriction
      site: a BamHI site for gene 2, a TaqI site for gene 3, and a KpnI site for gene
      4. Therefore all four genes can be discriminated by genomic Southern blot
      analysis and also by PCR amplification of the respective site followed by
      digestion with an appropriate endonuclease.

PMID- 1619775
TI  - [Chronic fatigue syndrome].
AB  - Chronic fatigue syndrome (CFS), which is characterized by devastating fatigue,
      mild fever, lymphadenopathy, headache, myalgia, insomnia and neuropsychiatric
      disorders, now has drawn much attentions from many physicians, researchers and
      even peoples in general society world wide. The pathogenesis of CFS is still
      remains to be clarified and clinico-pathological difference between CFS and mood
      disorder is controversial. In this paper, CFS would be reviewed in detail.

PMID- 1619776
TI  - [Structure, function and pathophysiology of mucociliary transport system].
AB  - There has been growing appreciation of the significant role played by the
      mucociliary transport system in the body. The mucociliary transport system is an
      important defense mechanism by which the human body usually maintains its
      "homeostasis" by protecting the body against invading particles, including
      bacteria. This system includes two major functional mechanisms; i.e., ciliary
      transport and mucous secretional systems, each of which is usually complimentary
      and cooperative. Three hereditary disorders, primary ciliary dyskinesia (immotile
      cilia syndrome), cystic fibrosis and Young's syndrome, have been shown to be
      systemically associated with mucociliary transport failure, leading to male
      infertility and chronic sinopulmonary infections. Localized mucociliary transport
      failure, however, is observed in respiratory diseases, especially chronic
      sinusitis, chronic bronchitis, bronchiectasis and bronchial asthma. We aim, in
      this review, to draw together those developments in the study of ciliary
      transport and mucous secretion, the interactions between them and their
      pathophysiology that can provide a better understanding of the mucociliary
      transport system of the human body.

PMID- 1619777
TI  - [The etiopathogenesis of amyotrophic lateral sclerosis--recent development].
AB  - In spite of extensive studies of amyotrophic lateral sclerosis (ALS) for the past
      decades, its cause still remains obscure. Based on the clinicopathological
      observations and experimental studies of sporadic and endemic ALS cases,
      etiologic hypothesis encompass a wide range of postulated pathophysiological
      mechanisms in the various fields. Reviewing briefly these, recent concern on
      genetic hypothesis, of familial ALS, background of case aggregation in the
      Western Pacific and immune hypothesis has been discussed. Although there is no
      unifying theory explanatory for ALS process at present, accumulated results
      through basic and clinical neurological science may provide a better
      understanding for the pathogenesis of ALS.

PMID- 1619778
TI  - [Neuro-immunomodulation].
AB  - Recent evidence has provided information that the immune system can be activated
      by non-antigenic stimulus e.g. stress. Information on the bidirectional
      communication between the neuronal and immune systems has been growing, while
      increasing evidence suggests that neuromodulators, released from the neuronal
      systems, influence the immune cells. Conversely, the activated immune cells
      release an array of immunomodulators that influence the physiologic function of
      the nervous system. An attempt was made to restore the altered immune function
      following exposure to stress by the treatment of the olfactory system with
      various fragrances. From the data in experimentally designed mouse models, it was
      found that the individual sensitivity to the fragrances was restricted by the
      genetic background (H-2) of the mice. The adaptation to the fragrances with
      regard to the recovery of the immune response to stress, was also characterized.
      The ability of the adaptation to the fragrances was found to differ not only due
      to the genetic background of the mice but also different fragrances.

PMID- 1619779
TI  - Bladder reconstruction with ileum after cystoprostatectomy for bladder cancer:
      analysis of the micturition and continence of 44 consecutive patients.
AB  - From October, 1987, to August, 1990, 47 patients underwent an ileal low pressure
      bladder replacement using the Hautmann procedure after radical cystoprostatectomy
      for bladder cancer. The qualities of micturition and continence were evaluated
      from a questionnaire mailed to the patients and by urodynamic examinations in 44
      consecutive patients over a follow-up period of more than 3 (mean 10.7) months.
      The 44 patients (100%) were perfectly dry during the daytime and voided every 4
      (2-6) h with a micturitional volume of 357 (200-500) ml. Forty-two of the 44
      patients had no residual urine. Thirty-three of the 44 patients (75%) were
      perfectly dry at night with a voiding frequency of 1.5 (0-3). Seven of the 44
      patients (16%) were occasionally incontinent (spotting less than 2/week). Four of
      the 44 patients (9%) had night incontinence and used as external device. Only two
      patients showed high pressure waves of greater than 50 cm H2O. The maximum
      urethral pressure was 59.07 +/- 13.6 (30-80) cm H2O. The maximum flow rate was
      17.2 +/- 9.7 (4.5-35) ml/sec. The different factors responsible for the new
      micturitional balance were discussed. With its very good functional results and
      its ease of performance, the ileal neobladder is, for us, the procedure of choice
      for bladder reconstruction after cystectomy.

PMID- 1619780
TI  - Skull base malignant lymphoma: a case report and review of the literature.
AB  - A case of primary malignant lymphoma of the skull base is reported. A 62-year-old
      man was admitted with headache and diplopia. Computed tomography and magnetic
      resonance imaging showed an abnormal mass in the right parasellar region. The
      final diagnosis after surgery was primary malignant lymphoma of the skull base.
      Primary malignant lymphomas sometimes occur in the central nervous system but
      those in the skull base are exceptional. The present paper presents just such a
      rare case of malignant lymphoma of the skull base. Diagnosis and combined therapy
      consisting of surgery, radiotherapy and chemotherapy for the disease are
      discussed, and the literature on recent clinical problems of central nervous
      system lymphomas is reviewed.

PMID- 1619781
TI  - Early extramedullary plasmacytoma confined to the lamina propria of the gastric
      mucosa: case report.
AB  - A case of early gastric plasmacytoma in a 51-year-old woman is reported. The
      demonstration of monotypic IgM-kappa immunoglobulin in biopsy specimens by an
      immunoperoxidase technique contributed to the histological diagnosis. The patient
      had non-ulcerative lesions (of approximately 15 x 16 cm) of a superficially
      spreading type of gastric plasmacytoma. Extensive histological analysis of the
      resected stomach showed the IgM-kappa monoclonal proliferation of plasmacytic
      tumor cells to infiltrate merely into the lamina propria of the gastric mucosa
      and not to extend deeply into the submucosa, proper muscle and serosa of the
      stomach.

PMID- 1619782
TI  - Effect of Krestin (PSK) on the induction of IL-2 activated killer cells.
AB  - The effects of Krestin (PSK) on the generation of lymphokine-activated killer
      (LAK) cells were examined in tumor-bearing mice. BALB/c mice were inoculated
      subcutaneously with methylcholanthrene-induced fibrosarcoma (Meth A) cells, and
      PSK was administered intraperitoneally every other day. The reduced LAK activity
      in tumor-bearing mice was restored by the administration of PSK. Since
      involvement of the humoral immunosuppressive factor in the impairment of LAK
      activity has been suggested, the effect of PSK on the impaired LAK activity in
      the presence of an immunosuppressive factor isolated from the ascites of X5563
      (plasmacytoma)-inoculated mice was examined. The activity reduced by the
      immunosuppressive factor in an in vitro induction of LAK was restored by
      incubation with PSK. The antimetastatic effect of IL-2 was also augmented by its
      combined use with PSK. The data provide a rational basis for using PSK in
      combination with recombinant IL-2 in cancer immunotherapy.

PMID- 1619783
TI  - Carcinoid tumor of the lung: clinicopathological study of 32 cases.
AB  - A retrospective study was conducted on 32 patients who had had bronchial
      carcinoid tumors between 1965 and 1989. The average age of the patients was 48.5
      years, with a male to female ratio of 3.6:1. Of the 32 patients, 28 were
      diagnosed pathologically to have typical bronchial carcinoid tumors and the other
      four, atypical bronchial carcinoid tumors. Twenty-two of the 28 typical bronchial
      carcinoid tumors were classified as stage I, but only one of the four atypical
      bronchial carcinoid tumors was at stage I. Two typical carcinoid tumor patients
      and two atypical carcinoid tumor patients were found, pathologically, to have
      lymph node metastasis. The typical carcinoid tumors showed a more significant
      endobronchial polypoid growth than the atypical carcinoid tumors (P = 0.0138).
      The five-year-survival rate was 100% in patients with typical carcinoid tumors
      and 25% in those with atypical carcinoid tumors. The difference between the five
      year-survival rate for the typical carcinoid and atypical carcinoid patients was
      statistically significant (P = 0.001).

PMID- 1619784
TI  - An evaluation of serum microelement concentrations in lung cancer and matched non
      cancer patients to determine the risk of developing lung cancer: a preliminary
      study.
AB  - In a case-control study to determine the risk of developing lung cancer, the
      serum levels of vitamins A and E, carotene and selenium were determined in 31
      patients, newly diagnosed as having lung cancer, and in matched controls, the
      said controls being selected from outpatients with no cancer. A significant,
      inverse association was found between serum vitamins A and E and lung cancer. The
      relative risk for the low vs high tertiles were, respectively, 5.94 for serum
      vitamin A and 8.44 for serum vitamin E. Taking histological cancer subtype into
      account, no relation was revealed between the microelements and squamous cell
      carcinoma of the lung. The relative risk for lung cancer was 6.50, however, when
      three, or all four, microelement levels were in the lowest tertile, compared with
      there being fewer than three in the lowest tertile. Even when three
      microelements, excluding vitamin E which had the most significant inverse
      association with lung cancer, were considered, the relative risk was 7.50 when
      any two or all three were in the lowest tertile, compared with there being just
      one microelement or none at all in the lowest tertile. A combined effect of
      vitamins A and E, carotene and selenium on the development of lung cancer has,
      therefore, been suggested. Further studies will thus be necessary to elucidate
      the cumulative effect of the serum micronutrients and trace elements, as well as
      the effect of single elements, on the development of lung cancer.

PMID- 1619785
TI  - [Effects of external systemic irradiation on changes in immunoreactivity of
      radiolabeled monoclonal antibody].
AB  - Effects of external systemic irradiation on changes of immunoreactivity by
      radiolabeled monoclonal antibody administrated intravenously to the nude mice
      were pursued with the method of cell binding assay in vitro. Enhancement of tumor
      localization and biodistribution of radiolabeled antibody following systemic
      irradiation were performed in tumor bearing mice. Results obtained were as
      follows: 1) Immunoreactivity of monoclonal antibody administrated to the nude
      mice showed the tendency of a gradual fall in comparison with that of pre
      administrated. While there found to be no changes of immunoreactivity preserved
      37 degrees C in vitro. 2) Systemic irradiation could prevent immunoreactivity of
      post-administrated antibody from falling gradually, and there found to be
      dependent upon a dose of irradiation. 3) In an animal model tumor localized
      activity was significantly made higher than in the not irradiated control group
      dependent upon a dose of irradiation and tumor to tissue ratio was in the same
      way. 4) These results indicated that external systemic irradiation for tumor
      bearing mice would also be beneficial for practical use and clinical application
      of radiolabeled monoclonal antibodies, besides contributed to the improvement of
      systemic irradiation-bone marrow transplantation therapy.

PMID- 1619786
TI  - [Attempt to cause hepatitis in duck hepatitis B virus carrier ducks by
      immunization with DHBV protein].
AB  - In order to investigate the hypothesis that viral hepatitis is a host immune
      response against viral protein presented on hepatocytes, we attempted to cause
      hepatitis in DHBV carrier ducks by immunization with DHBV protein. While ducks
      injected with Freund Complete Adjuvant (FCA) showed only weak hepatitis, those
      immunized with DHBV particle protein showed severe hepatitis. This same procedure
      could not cause significant inflammation in the liver of ducks without DHBV
      infection. The severity of hepatitis was well associated with the frequency of
      the immunization. However, the degree of hepatitis activity was different among
      same times immunized ducks. Occurrence of hepatitis assumed to have close
      association with host immune response against viral protein.

PMID- 1619787
TI  - [Morphological comparison between pm-carcinoma and minute ss-carcinoma of the
      gallbladder].
AB  - Eleven cases of pm-carcinoma and thirty cases of minute ss-carcinoma of the
      gallbladder were compared with their morphologies and biological behavior with
      reference to the assessment of pm-carcinoma as early carcinoma. The vascular
      permeation and lymph nodal metastasis was 9% and 0%, respectively, in the pm
      carcinoma and 43% and 9% in the minute ss-carcinoma. The 5-year survival rate of
      the pm-carcinoma was better (100%) than the minute ss-carcinoma (73.3%). The
      poorly differentiated adenocarcinoma or well differentiated adenocarcinoma with
      high grade atypia in the invasive-area was higher in incidence in the minute ss
      carcinoma. From these findings it is concluded that the pm-carcinoma should be
      defined as early carcinoma in the gallbladder. The both carcinomas were hardly
      distinguishable macroscopically. Therefore, the careful examination of resected
      gallbladder by stepwise sections is important.

PMID- 1619788
TI  - [Relationship between juxtapapillary duodenal diverticula and biliopancreatic
      disease--evaluation by endoscopic biliary manometry].
AB  - Endoscopic biliary manometry was performed to evaluate the motor activity of the
      sphincter of Oddi (SO) in 28 patients, 13 with juxtapapillary duodenal
      diverticula (8 with biliopancreatic disease) and 15 without diverticula (10 with
      biliopancreatic disease). So pressure and the rate of irregular wave pattern of
      phasic contraction in patients with diverticula were significantly higher than
      those in patients without diverticula. Especially all the patients with both
      diverticula and biliary stones had motor disorders of the SO. The patients with
      diverticula were also divided into three groups by endoscopic findings for the
      location of diverticular; The papilla of Vater was located close to diverticula
      (within about 4 cm) in group A, on the edge of diverticula in group B, in the
      diverticula in group C. Diverticula could have more direct effect on the motor
      activity of the SO in group C. Those results suggest juxtapapillary diverticula
      have close relationship with the motor activity of the SO and biliopancreatic
      disease, especially in cases which the papilla of Vater located in the
      diverticula. We conclude that the motor disorders of the SO might be responsible
      for biliopancreatic disease in patients with juxtapapillary diverticula.

PMID- 1619789
TI  - [Microspectrophotometric analysis of DNA content in duct epithelial proliferation
      and invasive carcinoma of the pancreas].
AB  - Nuclear DNA content of 131 pancreatic duct epithelial lesions, including 10
      normal ducts, 30 intraductal proliferations with mild atypia (groups I-II), 30
      with moderate atypia (group III), 24 with severe atypia (group IV), 14 of
      carcinoma in situ (group V), and 23 invasive carcinomas, was analyzed using
      microspectrophotometry. DNA histograms were classified into diploid, polyploid
      and aneuploid patterns. All of normal duct epithelia showed diploidy. Polyploid
      patterns were observed in 3 (10%) lesions of groups I-II, 17 (56.7%) of group
      III, 14 (58.4%) of group IV, 7 (50%) of group V, and 6 (26.1%) of invasive
      carcinomas, and aneuploid patterns were observed in 0%, 10%, 33.3%, 50% and
      73.9%, respectively. This distribution of ploidy patterns revealed a gradual
      shift to the main ploidy from diploid to polyploid followed by aneuploid in
      proportion to the increase of the degree of epithelial atypia. The frequencies of
      polyploid cells in each lesion were determined. Their averages were 0.2% in
      groups I-II, 1.9% in group III, 3.4% in group IV, 4.4% in group V, and 6.7% in
      invasive carcinoma. The S+G2M phase fractions were significantly higher in
      proliferative epithelia than in normal. The results of this study suggest that
      duct epithelial proliferations of the pancreas have "genetic instability" leading
      to a serial clonal evolution and play a significant role in the progression of
      pancreatic duct cell carcinoma.

PMID- 1619790
TI  - [A case report of drug-resistant gastric ulcer caused by celiac axis compression
      syndrome].

PMID- 1619791
TI  - [A case of malakoplakia of the colon].

PMID- 1619792
TI  - [A case of hepatic angiomyolipoma mimicking a small liver cancer].

PMID- 1619793
TI  - [A case of splenic malignant lymphoma with severe liver dysfunction].

PMID- 1619794
TI  - [Percutaneous anterior approach under ultrasonic guidance for the celiac plexus
      block].

PMID- 1619795
TI  - [Coexistence of foreign worker and industrial health].

PMID- 1619796
TI  - [Health effects of non-occupational exposure to asbestos].
AB  - Mesothelioma has occurred in a relative large number not only among miners but
      also among non-occupationally exposed persons living in the northwestern region
      of Cape State of South Africa, where crocidolite is mined and transported. The
      long-term residents of Thetford Mines in Quebec Province, Canada, who have never
      engaged in mining and milling of chrysolite have not shown an excess mortality of
      respiratory diseases. Tremolite in soil is responsible for mesothelioma among
      residents of certain geologic regions such as Cyprus, Corcica, northwestern
      Greece and Turkey. An increased prevalence of malignant mesothelioma has been
      reported among residents of three Turkish villages due to exposure to erionite
      fibers having a high carcinogenic potency. Mesothelioma has infrequently
      developed in wives who were exposed while washing the work clothes of their
      husbands contaminated with asbestos, especially amphiboles. The levels of
      airborne asbestos in public buildings and schools in the U.S.A. and England
      having walls and ceilings constructed with asbestos containing materials are
      approximately 1/100 of the permissible concentration of 0.2 f/cm3. The estimated
      risk from asbestos exposure in schools and buildings is lower than the level of
      other risks in other society. During the work of removing asbestos from buildings
      the asbestos concentration is remarkably increased and this persists for many
      weeks thereafter. The level of asbestos fibers released from brake linings of
      motor vehicles is higher along roads with heavy traffic, at intersections, and
      near toll booths than elsewhere. The concentration of asbestos fibers released
      from motor vehicles is generally low and not of the level to induce mesothelioma.

PMID- 1619797
TI  - [Development of posture measuring apparatus using goniometer and inclinometer. 2.
      Fixation, precision and calibration of goniometer].
AB  - A new posture measuring apparatus was developed for time and motion study in the
      field of industrial health. This apparatus records working postures by measuring
      angles of joints and trunk inclination. The angles of joints were measured by the
      newly developed goniometers which use the bending loss of rubber optical fibers.
      This paper presents results of studies made on the fixation, precision and
      calibration of goniometers which are important in the actual application of this
      apparatus. Six freedoms of five joints were examined, i.e. elbow
      (flexion/extension), shoulder (abduction/adduction and horizontal
      adduction/abduction), hip (flexion/extension), knee (flexion/extension), ankle
      (dorsi-flexion/plantar-flexion). The results obtained were as follows; 1)
      Goniometers should be fixed according to the characteristics of each joint. 2)
      The output errors were calculated from the measured data, excluding the effects
      of flexed angles, subjects and fixations. The mean output error of all joints was
      0.189 V (14.3 degree). 3) The output errors by the three calibration methods
      using logistic curves were calculated. The output errors for 2-point method
      (calibrated by the data of minimum and maximum angles) and 3-point method
      (calibrated by the data of minimum, medium and maximum angles) were 1.34 and 1.22
      times larger than the output errors (0.139 V) for all-point method (calibrated by
      all measured data), respectively.

PMID- 1619798
TI  - [Studies on fatigue and shift work in nurses].
AB  - Effects of shift work on physiological parameters and autonomic nervous-adrenal
      system were studied on six hospital nurses. Their body temperature, heart rate,
      blood pressure, fluctuation in ECG R-R intervals, serum catecholamines and
      cortisol, and subjective fatigue ratings before and after day, evening and night
      shift were determined. Furthermore, mean heart rates, walk steps, estimated
      energy expenditure, and urinary catecholamine excretion were determined three
      times for eight hours each during each shift work day. The following results were
      obtained: 1) No significant changes were detected in the physiological parameters
      before and after each shift work, except for elevation in plasma adrenaline level
      after night shift. 2) Heart rate, blood pressure and subjective fatigue rating
      tended to be higher, though not significantly, at the beginning of night shift,
      when compared with the data obtained on the some time of day, i.e., at the end of
      evening shift. 3) On the other hand, the plasma cortisol level tended to be
      suppressed after night shift, suggesting that even one night shift work may
      change the circadian rhythm of plasma cortisol. 4) Statistical analyses showed
      that in contrast to day and evening shift, in night shift there was no
      significant positive correlation between eight-hour walk steps, and eight-hour
      mean heart rate and urinary adrenaline excretion, suggesting an altered circadian
      rhythm in heart rate and urinary adrenaline excretion and also a possible
      additional psychological load in night shift. These results suggest that even one
      night shift work could modulate the autonomic nervous-adrenal activity of
      hospital nurses, compared with day or evening shift, and indicate that it is
      necessary to lengthen the time interval before and after night shift work.

PMID- 1619799
TI  - [Determination of protoporphyrins in blood using HPLC. Standardization of
      protoporphyrins and interlaboratory comparison of analyses].
AB  - 1) In order to compare the results of determination of protoporphyrin IX (PP) and
      zinc protoporphyrin IX (ZP) using HPLC, the preparation procedures for standard
      solutions of PP and ZP were studied at four laboratories. According to the
      methods mutually agreeable to the four laboratories, the absorption values using
      UV-Vis spectrometer from the 4 laboratories were found to be identical. 2) The
      total of 28 whole blood samples obtained from the same workers whose Pb-B levels
      ranged from 2.9 to 87.9 micrograms/dl were sent to the 4 laboratories for
      determination of PP and ZP. The laboratories were allowed to use their own HPLC
      apparatus, column, mobile phase and fluorometric detectors, although the same
      procedures were used to prepare the standard solutions of PP and ZP. The results
      showed that significant biases in ZP and PP levels were found between two out of
      the 4 laboratories, but the ZP values corrected by the recovery rate showed no
      statistical difference among the laboratories. 3) Blood levels of ZP, total
      protoporphyrin (TP, calculated by PP+ZP/1.1), and PP determined by HPLC method
      correlated well with free erythrocyte protoporphyrin (FEP) determined by the
      method of extraction into the acidic solvent. The correlation coefficients
      between Pb-B and log TP, ZP, FEP or PP were 0.82-0.84, 0.80-0.83, 0.786, or 0.70
      0.73, respectively. 4) The coincident ratios of PP/TP obtained at 4 laboratories
      ranged from 12.1 to 19.0%. These values were within a relatively narrow range,
      although two different kinds of organic solvents (DMF: N',N'-dimethylformamide or
      Methanol/triton-X 100) were used in the extraction steps.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1619800
TI  - [Determination of acetone, methanol, and methyl ethyl ketone in urine using head
      space gas chromatography (HS.GC)].
AB  - Using HS.GC, We have succeeded in simultaneous determination of Ac, MeOH and MEK
      in urine without any complicated pretreatment or correction by internal standard.
      Moreover, in order to lower the detection limits of these materials, study was
      made on the salting out effect using 14 kinds of salts. As pretreatment, 2.0 ml
      of urine, 3.0 g of sodium sulfate and small sized magnetic stirrer are put into
      vial, which is sealed by septum. This is then heated for 10 min in warm bath of
      50 degrees C. In order to dissolve the added salts as much as possible, the
      specimen is stirred by the stirrer. After cooling the liquid to room temperature,
      the specimen is analysed by HS.GC. The results showed that sodium sulfate was
      excellent synthetically. 1) Using the urine of workers not exposed to organic
      solvents three kinds of urine having specific gravity of 1.010, 1.024 and 1.034
      were prepared and mixed standard organic solvents (Ac, MeOH and MEK) were added.
      Recovery percentages and coefficients of variation were calculated. The results
      showed that recovery percentages ranged from 92.0 to 101.7% and coefficients of
      variation from 0.2 to 4.6%. 2) The regression equations of standard curves were
      satisfactory with y = 9053x - 200(r = 0.999, n = 12) for Ac, y = 801x - 400 (r =
      0.999, n = 12) for MeOH, and y = 15488x - 277 (r = 0.999, n = 12) for MEK. 3) The
      detection limits calculated by IUPAC formula were 0.0092 mg/l for Ac, 0.11 mg/l
      for MeOH and 0.0063 mg/l for MEK. These results indicated that this method is
      superior to other methods because the pretreatment is very simple, specificity is
      excellent, analysis by standard curves is possible, and this method is not
      affected by specific gravity of the urine.

PMID- 1619801
TI  - [Fatigue symptoms and their related factors of workers in institutions for the
      mentally retarded].
AB  - This study examined the fatigue symptoms and their relative factors in a group of
      nursery teachers and guidance workers (n = 480) belonging to institutions for the
      mentally retarded. 1) More than 50% of the respondents complained of neck
      stiffness and/or backache. The mean scores of the physical symptoms were higher
      than the standard cumulative fatigue symptoms index, while those of the mental
      symptoms were lower. 2) Analysis of variance showed that physical fatigue
      symptoms were higher in females, younger workers, those with longer years of
      service, those with more night duties per month, and those who expressed more
      dissatisfaction with their co-workers, wages, working hours, and work shift.
      Physical fatigue symptoms were not related to the severity of the mental disease
      of their clients. 3) Analysis of variance also showed that mental fatigue
      symptoms were higher in females, younger workers, and persons who expressed more
      dissatisfaction with their jobs, supervisors, co-workers, wages, working hours,
      and work shift. The severity of the mental disease of their clients was directly
      related to the mental fatigue symptoms. Furthermore, multiple classification
      analysis showed that those working with children had both higher irritability and
      morale than those working with adults.

PMID- 1619802
TI  - [Recovery study from anemia and alterations of glutathione metabolism in
      erythrocytes induced by chronic inhalation of ethylene oxide].
AB  - A study was made on the recovery from anemia induced by chronic exposure of
      ethylene oxide. When rats were exposed to ethylene oxide at a concentration of
      500 ppm, 6 h a day, 3 d a week for 13 wk, macrocytic normochromic anemia with a
      high reticulocyte count was observed. The hematological values were also
      evaluated 4 and 13 wk after the end of exposure and the values were found to have
      already recovered at 4 wk. We reported previously that anemia induced by ethylene
      oxide was accompanied with a decrease in glutathione reductase activity and
      instability of glutathione. In this study, alterations of glutathione redox cycle
      after the end of exposure were examined. The recovery in the decrease of
      glutathione reductase was slow and the speed of recovery seemed to be dependent
      on the life span of erythrocytes of the rats. The decrease in glutathione content
      completely recovered at 4 wk after the exposure. It was concluded from these
      observations that anemia induced by ethylene oxide is reversible.

PMID- 1619803
TI  - [Nondestructive synchrotron radiation X-ray fluorescence imaging of trace
      elements in human kidney tumours].

PMID- 1619804
TI  - [Self-judged work activity level and nutritional intake in 30-year-old males].

PMID- 1619805
TI  - [Effect of seasonal and intermittent work at high altitude on health status].
AB  - Health status of 7 men was examined in order to study the effect of duty work
      cycle of 3-d stay at the altitude of 2,000 m and one-day holiday at 600 m for a
      period of 6 months from May to October. Their usual works were desk work and road
      patrol. Total hemoglobin concentration in blood increased significantly after
      work at high altitude, which was considered to be a compensatory response to the
      hypoxic state. Subjective symptoms were obtained by a self-administered
      questionnaire before (April), during (June and October) and after (November) work
      at high altitude. Fatigue was observed in three out of the seven subjects in
      June, which subsequently disappeared in October. Dyspnea was observed also in
      June in three of the subjects, which disappeared in two, persisted in one, and
      newly appeared in another subject in November. In contrast, a tendency of
      favorable effects of the work environment on nausea and lumbago was observed.
      Blood pressure and pulse rate were measured for 24 h. The mean systolic blood
      pressure during 24 h decreased in two of five subjects in October and November,
      and the mean values during the working hours decreased in two in October from 145
      to 131 mmHg and from 147 to 129 mmHg, respectively. The blood pressure measured
      at health examination correlated well with the mean blood pressure during 24 h
      and working hours. The mean pulse rate during 24 h and working hours increased in
      one in June, October and November. These results indicate that adaptive responses
      to low barometric pressure environment developed during a work period of 5 months
      at high altitude.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619806
TI  - Radioimmunoassays for melatonin using an antiserum raised against a novel
      antigen.
AB  - The highly specific antiserum to melatonin (MT) was produced, and the sensitivity
      and specificity of the radioimmunoassays (RIAs) using this antiserum was
      investigated. An immunogen was synthesized by binding 6-hydroxy-melatonin (6-OH
      MT) to bovine serum albumin with a spacer of 6-bromohexanoic acid ethyl ester.
      Rabbits were immunized subcutaneously once a month with 1.0 mg of the immunogen
      for 7 months. The antiserum was characterized by a crossreactivity test by RIA
      using 125I-labelled MT. The antiserum specifically recognized MT but hardly did
      other analogues except for 6-OH-MT with a crossreactivity of only 0.4%. Two RIAs
      were established using [o-methyl-3H]MT and 2-[125I]iodo MT. In both RIAs,
      inhibition curves for MT were obtained in the range of 10 pg to 10 ng and 1-2 ng
      of MT inhibited the value of the assay at "0" by half. The similarity of the RIAs
      in sensitivity and inhibition by unlabelled MT is discussed on the basis of the
      structures of radioactive MTs and that of the immunogen.

PMID- 1619807
TI  - The use of mass fragmentography for the detection of tetrodotoxin in human body
      fluids.
AB  - The authors report on a convenient electron impact ionization-mass
      fragmentographic method for determining the amount of tetrodotoxin (TTX) present
      in body fluids. To explain this method briefly, the TTX present in body fluids
      was purified with activated charcoal and transformed into 2-amino-6-hydroxymethyl
      8-quinazoline (C9-base) with alcoholic KOH (1%). Then the C9-base was injected
      into a gas chromatograph-mass spectrometer in the form of trimethylsilyl
      derivative. In this manner the minimum detectable amount of TTX in body fluids
      was found to be about 0.01 microgram/g. When this method was applied to sera,
      urine, and the stomach contents of 2 decedents suspected of puffer fish
      poisoning, 0.053 microgram/g of TTX was detected in stomach contents of one
      victim. This new analytic method is simpler and more sensitive than other assay
      methods and thus is considered useful in forensic work.

PMID- 1619808
TI  - The effect of cyanide on isolated perfused rat heart.
AB  - Using Langendorff isolated perfused rat hearts, we demonstrated direct effects of
      cyanide on the heart. A heart from a sacrificed male rat was placed on a
      Langendorff apparatus and perfused with Tyrode solution containing 2.0 mM NaCN
      (CN-TS), following with normal Tyrode solution (TS) at 37 degrees C. During
      perfusion we monitored the heart beat, and the state of inorganic phosphate (Pi),
      creatine phosphate (CrP) and adenosine triphosphate (ATP) by 31P-NMR spectrometer
      equipped with a surface coil probe. After the beginning of the CN-TS perfusion,
      the heart was initially excited, and ceased beating completely seventy seconds
      later. During CN-TS perfusion, the CrP immediately disappeared, but the ATP level
      was maintained considerably. The peak of Pi shifted to the right, indicating
      acidosis in the heart. These results suggest that the ATP level in a heart during
      exposure of cyanide is maintained by activation of anaerobic glycolysis in
      compensation for cellular oxygen utilization.

PMID- 1619809
TI  - Teratogenic effects of methamphetamine in mice.
AB  - Eight-day pregnant Jcl:ICR mice were administered methamphetamine hydrochloride
      i.p. at doses of 11, 13, 14, 15, 17, 19 and 21 mg/kg. The number of animals that
      died after the treatment increased dose-dependently. The highest maternal
      mortality rate (50%) was observed in the 21 mg/kg group. On day 18 of gestation,
      the animals were killed and fetuses were examined for external and skeletal
      malformations. The mortality and malformation rates of fetuses increased with the
      increase in dose, but both rates reached their highest levels at a dose of 19
      mg/kg. Exencephaly, open eyelids, cleft palate and rib anomaly were frequently
      observed malformations. The single teratogenic dose was estimated to be 19 mg/kg
      for both external and skeletal malformations. This amount was about ten times the
      daily intake of many Japanese abusers. The risk of malformed infants being born
      to female abusers was considered to be high. More crowded conditions have been
      reported to increase the fetal malformation rate. The higher malformation rate in
      the 19 mg/kg group than in the 21 mg/kg group was considered to be due to fewer
      surviving mice in the 21 mg/kg group, because of a higher mortality rate.

PMID- 1619811
TI  - [Morphometric and pathologic studies of the brain in autopsied cases of Alzheimer
      type dementia].
AB  - Human brain sections were analysed by computer-assisted quantitative morphometry.
      The brains, autopsied at the Department of Legal Medicine, Kobe University School
      of Medicine and the Medical Examiner's Office of Hyogo Prefecture, included 63
      cases of acute death consisting of 49 cases of non-demented and 14 cases of
      Alzheimer's disease (AD) or senile dementia of Alzheimer-type (SDAT). As for
      patients of AD and SDAT, they were clinically diagnosed at some medical
      facilities in their life time. Histopathological diagnosis for AD and SDAT was
      confirmed by the presence of abundant senile plaques and neurofibrillary tangles.
      In the non-demented control aging, a modest atrophy occurred throughout the
      cerebral cortex except the occipital cortex, whereas no sign of atrophy was seen
      in the medullary white matter. In the AD and SDAT cases, both cortical gray and
      medullary white matter showed significantly higher degrees of atrophy than in the
      controls. A further detailed study indicated that the parietotemporal association
      cortex was specifically affected in the demented brain as compared with the
      normal aging.

PMID- 1619810
TI  - [The effect of a p-phenylenediamine containing hair dye on the Ca2+ mobilization
      in the chemically skinned skeletal muscle of the rat].
AB  - In order to clarify the mechanism of a p-phenylenediamine (PPD)-related
      occurrence of rhabdomyolysis, the pharmacological effects of PPD, a main
      component of hair dyes, on the function of the contractile proteins and the
      sarcoplasmic reticulum (SR) have been investigated in single skeletal muscle
      fibers of the rat by using the skinned fiber method. The results of our findings
      are enumerated below 1) A positive contraction of the skinned fibers by the PPD,
      and a complete suppression of the contraction by Mg2+, and a negative contraction
      by caffeine while under conditions with 50 mM of PPD were noted, suggesting that
      the contraction of the muscle by PPD is caused by the release of Ca2+ from the
      SR. 2) PPD inhibited the Ca2+ uptake by the SR in a concentration-dependent
      manner. 3) PPD greatly accelerated Ca2+ leakage from the SR, and the number of
      Ca2+ remnants 3 minutes after the administration of 50 mM of PPD amounted to only
      3%. 4) The calcium-induced calcium release (CICR) was accelerated in areas with a
      low Ca2+ concentration, and the amount of Ca2+ released at a pCa of 7.5 showed an
      increase of up to 63% on PPD administration of 50 mM. 5) PPD did not influence
      the Ca2+ sensitivity of the contractile system. It thus has been speculated that
      PPD can bring about rhabdomyolysis by promoting the CICR and leakage of Ca2+ from
      the SR, this being followed by an increase in the Ca2+ concentration and by
      consequent changes that develop in the muscle, such as continuous contraction, an
      irreversible change in the muscle's structure and/or a hypermetabolic change.

PMID- 1619812
TI  - [A case of death due to neurogenic shock].
AB  - An autopsy case of death due probably to neurogenic shock (primary shock) is
      reported. A 14-year-old boy got into a fight with his elder brother and received
      blows against the chest and abdomen. The young boy fell down senseless on the
      floor and had a spasm. An ambulance was called, but he was dead on arrival at a
      hospital. An autopsy revealed no external injuries on the chest and abdomen.
      There was no evidence of preexisting disease. On histological examination, there
      were signs of acute cardiac failure; edema of the lungs, liver and gall bladder,
      partial myofibrillar degeneration and cytoplasmic vacuoles in the media of a
      small coronary artery. Thus, the autopsy did not give any explanation of the
      fatality. It seems probable, however, that the blow(s) against the abdomen (the
      solar plexus) caused a fatal shock (vagal inhibition). In addition, the adrenal
      cortices (especially the zona fasciculata) were narrowed and the aorta was
      slightly narrow in caliber. It is likely that these hypoplasia might affect the
      fatal shock consequent to very slight injuries.

PMID- 1619813
TI  - [Laryngeal fractures due presumably to tracheal intubation in resuscitation].
AB  - In three autopsy cases performed in our department, we observed the throat
      skeleton fractures occurring presumably during the tracheal intubation in
      resuscitation. Case 1. 63-year-old man died of acute hemorrhagic pancreatitis
      shortly after the quarrel with a suspected person. The autopsy examination showed
      the fractured hyoid bone with haemorrhage at the fracture site. The question
      whether direct pressure on his neck by the suspected person results the fracture
      of the hyoid bone was investigated. Case 2. 75-year-old man treated for senile
      dementia was clubbed with a walking stick by the other patient treated for same
      disease and he died of traumatic shock. The fracture of the hyoid bone was also
      noted like case 1. The strike in the throat and/or the neck compression by the
      assailant were suspected of being the cause of this fracture. Case 3. 47-year-old
      man got the severe head injury during the quarrel. He died about two weeks after
      operation and the cause of death was multiple organ failure. The autopsy findings
      revealed the fracture of the superior thyroid horn. The neck compression by the
      suspected person was the questionable cause of this fracture. In all these cases,
      the asphyxia findings and the signs of the direct pressure on the neck by the
      assailants were not recognized other than the above-mentioned laryngeal
      fractures. From the autopsy findings, together with the criminal investigation,
      we consider collectively that the tracheal intubation in resuscitation induced
      presumably these laryngeal injuries. In general, throat-skeleton fractures seem
      to be the signs of homicidal violence against the neck.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1619814
TI  - [The results and problems of reoperation for coronary artery disease].
AB  - In six hundred and six consecutive patients undergoing coronary artery bypass
      grafting (CABG) within the past 17 years (May 1974 to March 1991), repeated CABG
      were performed on 10 patients (1.65%). The main reasons for repeated CABG were
      graft failure (GF) in 8, progression of native disease (NP) in 5 and incomplete
      revascularization (IR) in 3 patients. The incidence of GF was high either within
      a half year or around 5 years after CABG. Although all patients survived from
      reoperation, four patients continued to have mild angina pectoris. When the
      recurrence of angina is noted after CABG, coronary arteriography and if necessary
      PTCA should be done as soon as possible. If a second surgery is inevitable,
      maximum utilization of arterial graft and accomplishment of complete
      revascularization are emphasized.

PMID- 1619815
TI  - [Clinical study of paragangliomas in the thorax].
AB  - Four cases of paraganglioma in the thorax, consisted of 3 cases originating from
      the mediastinum and a case of pulmonary metastasis from the posterior peritoneum,
      were clinically investigated. Three were malignant and one was benign with
      noradrenaline secretion. On surgical excision, preoperative arterial embolization
      was assumed to be useful for reducing hemorrhage during procedure. Pre and intra
      operative circulatory management was also mandatory in case of functioning
      paraganglioma. Of the 3 malignant cases, 2 survived for more than 10 years with
      radiotherapy alone or surgical resection of multiple metastatic nodules in the
      bilateral lungs. The other one, though inoperable due to extensive invasion to
      right and left atria, showed highly sensitivity to intra-arterial infusion
      chemotherapy of CDDP. These results suggested that long term survival might be
      expected even in metastatic or inoperable cases. There were no reliable
      histologic features distinguishing malignant from benign tumors, however 2
      malignant cases with local invasion showed aneuploid patterns in the DNA
      histograms, which might offer a adjunct possibility in the assessment of
      malignancy.

PMID- 1619816
TI  - [Surgical treatment of active infective endocarditis and prosthetic valve
      endocarditis].
AB  - Fifteen patients with active native valve endocarditis (NVE) and 5 with
      prosthetic valve endocarditis (PVE) were subjected to this study. Among the
      patients with NVE, one of 10 with simple destruction of leaflets and 2 of 5 with
      annular infection died postoperatively of cerebral bleeding and persistent
      infection. Five patients with annular infection, whose microorganisms were
      Streptococcus faecalis, Staphylococcus epidermidis and gram-negative coccus, had
      a shorter duration from onset to operation (mean 38 days) compared with the
      others (mean 85 days). A patient with NVE requires an urgent operation,
      especially when these microorganisms are identified. Among those with PVE, 3
      underwent operation at the active phase and one at the chronic phase. Two
      patients with mechanical valve endocarditis by Staphylococcus and Candida died,
      but the other 2 with bioprosthetic valve endocarditis by alpha-Streptococcus
      survived, because infection was localized in the leaflets. Another patient with
      mechanical valve endocarditis by alpha-Streptococcus survived with conservative
      management. While a patient with bioprosthetic valve endocarditis requires an
      early operation as well as NVE, a patient with mechanical valve endocarditis
      requires selected management considering the microorganism and general condition.

PMID- 1619817
TI  - [Method to make the tricuspid extracardiac conduit by heterogeneous pericardium].
AB  - We described here, how to make tricuspid extracardiac conduit by heterogeneous
      pericardium for Rastelli procedure. We have developed some ingenious devices
      which allow to obtain good hemodynamics. One of the devices is large valvular
      leaflets as long as 130% of the circumference of the conduit. Another device is
      the commissural suture as figure of eight. We used 121 tricuspid extracardiac
      conduits between January 1985 and March 1991. There were two reoperations: One
      from stenosis at the suture with ventricle and the other from infective
      endocarditis. This hand-made conduit has the advantages of flexibility, fitness
      with the pulmonary artery, wide range of size and very little regurgitation.
      These advantages indicate that the tricuspid extracardiac conduit made by
      heterogeneous pericardium is a valved conduit substitute of choice for Rastelli
      procedure. The durability of the conduit is to be further evaluated.

PMID- 1619818
TI  - [Congenital lobar emphysema successfully treated by right upper lobectomy at five
      hours after delivery: a case report].
AB  - Lobar emphysema is a rare disease and one of the causes of respiratory
      disturbance in the newborn and infancy. A case report is presented and compared
      with related data in the literature in Japan. Maternal echographic findings
      indicated the cystic lung disease of the fetus. The cystic space was punctured
      and aspirated three times. The baby was delivered by caesarean section after
      having taken sufficient precaution to prevent respiratory failure. Since the baby
      developed dyspnea gradually, at five hours following the delivery, right upper
      lobectomy was performed and the major symptoms were eliminated. The pathological
      diagnosis was congenital lobar emphysema and the etiology was concluded to be
      bronchiectasis.

PMID- 1619819
TI  - [Surgery versus detachable balloon embolization of pulmonary arteriovenous
      fistula: clinical experience].
AB  - We experienced 4 pulmonary arteriovenous fistula cases 2 of which were treated
      surgically and 2 were subjected to detachable balloon embolization therapy.
      Favorable results were obtained in the detachable balloon embolization therapy.
      In treating pulmonary arteriovenous fistula, if the lesion is in the position
      where the catheter can be reached easily and is composed of a single afferent
      efferent vessel unit, it would be advisable to perform the embolization therapy
      first, and then to apply an operative procedure preserving lung tissue as much as
      possible.

PMID- 1619820
TI  - [Closure of median sternotomy incision with EPTFE sutures].
AB  - EPTFE (CV-0) suture was utilized for closure of median sternotomy incision in 100
      patients under 6 years of age who underwent open heart surgery. During 3 years
      follow up, except for one dislocation of sternum, all patients have healed
      without complication. EPTFE suture is swanged to a needle that has the same
      diameter as the thread, which reduces bleeding from the needle hole. It is
      radiologically lucent, and therefore does not disrupt chest X-ray, angiography or
      MRI investigations, in contrast to sternal wires. In addition, in the case of
      life threatening postoperative complication, EPTFE suture allows rapid and simple
      access to the heart, without the need to cut wires. We concluded that EPTFE
      suture can be utilized for closure of median sternotomy in patients under the age
      of six, without an increased risk of postoperative or long-term complications.

PMID- 1619821
TI  - [Delayed sternal closure; a simple sternal splint].
AB  - A simple and inexpensive sternal splint for delayed sternal closure was
      described. Sternal edges were splinted open using an edge-cut disposable syringe.
      This method has been employed successfully in 10 patients (one adult, 9
      children). This syringe splint is a simple, inexpensive and effective method for
      delayed sternal closure.

PMID- 1619822
TI  - [Repair of two cases of partial anomalous pulmonary venous return by draining
      total right pulmonary venous blood to the left atrium through dilated atrial
      septal defect].
AB  - Two cases of partial anomalous pulmonary venous return were reported in whom
      right pulmonary veins were totally drained to the coronary sinus and to the right
      atrium respectively. Re-routing of pulmonary veins was done by dilated atrial
      septal defect and making intra-atrial tunnel using equine pericardial patch.
      Postoperative courses were uneventful. MRI was useful to identify the pathway
      from right pulmonary veins to the left atrium.

PMID- 1619823
TI  - [Two cases of atrial septal defect with absence of right superior vena cava and
      persistent left superior vena cava].
AB  - Two women (16-year-old, 54-year-old) of atrial septal defect with absence of
      right superior vena cava and persistent left superior vena cava were successfully
      operated on. Electrocardiographic findings show coronary sinus rhythm and atrial
      fibrillation. When we closed atrial septal defect cannulated to persistent left
      superior vena cava via the coronary sinus directly, sick sinus syndrome was not
      appeared postoperatively.

PMID- 1619824
TI  - [Clinical analysis of 6 cases of pericardial cysts].
AB  - We present a clinical analysis of 6 cases of pericardial cysts. There were two
      males and four females. Only one case of them had complaint of persistent cough.
      Four of 6 were observed in right costo-phrenic angle, and 2 were in left costo
      phrenic angle. Surgical excision was performed in 6 cases, and all patients
      recovered good health. We suggest that in cases of pericardial cysts, surgical
      treatment should be performed, even if patients would not have remarkable
      complaint.

PMID- 1619825
TI  - [A case report: Rastelli operation for double outlet right ventricle associated
      with a chordae insertion to the infundibular septum].
AB  - A successful Rastelli operation for double outlet right ventricle (DORV) with a
      chordae insertion of the tricuspid valve to the infundibular septum was reported.
      A patient was a 6-year-old boy and the diagnosis was DORV, d-malposition of the
      aorta and pulmonary stenosis. The infundibular septum was not resected but
      mobilized with two incision, one anterior and vertical, and other one subaortic.
      This procedure allowed the construction of the tunnel similar to the closure of a
      large, subarterial VSD and of the straight unobstractive left outflow tract. The
      postoperative echocardiographic and angiographic examination revealed neither the
      pressure gradient in the left ventricular outflow tract nor the tricuspid
      regurgitation.

PMID- 1619827
TI  - [A successful resection of recurrent right ventricular myxoma].
AB  - A successful surgical treatment of right ventricular myxoma of twenty-year-old
      male was presented, who healed already previous resection of left atrial myxoma
      two year and eight months prior to this operation. He has been followed up
      closely after the first resection of left atrial myxoma for the recurrence in the
      left atrium. Follow-up echocardiography demonstrated the development of myxoma in
      the free wall in the right ventricle. The resection for this myxoma was found to
      be relatively easy at the second operation. The tumor was removed with the stark,
      without any postoperative problem. According to the literature, this case seems
      to be the second Japanese case of surgical treatment of right ventricular myxoma
      following the removal of left atrial myxoma.

PMID- 1619826
TI  - [Successfully treated intraoperative coronary artery spasm in a patient with type
      B dissecting aortic aneurysm: a case report].
AB  - A 65-year-old man with chronic type B dissecting aortic aneurysm, complicated by
      variant from of angina pectoris without any coronary artery obstructed disease on
      preoperative angiogram was operated upon through left posterolateral thoracotomy
      under the left heart bypass with Bio-pump system using preoperative Ca
      antagonists and intraoperative nitroglycerin infusion. Shortly before the end of
      operation the patient suddenly developed shock status definitely due to coronary
      artery spasm, associated with ST-elevation in II, III, aVF and bradycardia, then
      ventricular tachycardia, finally cardiac arrest. The patient was resuscitated by
      cardiac massage and administration of nifedipine and nitroglycerin. Such attacks
      repeated five times at ten or twenty minutes intervals. The coronary artery spasm
      could be successfully suppressed with the additive use of noradrenaline infusion.
      The patient had no attacks at all postoperatively and was discharged with good
      success. This case suggests that the prevention of intraoperative coronary artery
      spasm is essential, but if it occurs, additive use of noradrenaline infusion is
      effective for the cessation of coronary artery spasm.

PMID- 1619828
TI  - [A case report of thoracic ectopia cordis].
AB  - Complete type of thoracic ectopia cordis was diagnosed with prenatal ultrasound
      study. Just after birth of female baby with 2,750 g body weight, a silastic mesh
      was selected for covering the heart because of no space for putting the heart
      into the mediastinum. Protrusion of the liver towards the mediastinum was one of
      main causes of lifting the heart outside the chest wall. The baby died 7 days
      after her birth due to heart failure. Soft silastic mesh was not good enough to
      sustain the ectopic heart constantly and caused paradoxical respiratory movement
      of mediastinal side of the lung. It is concluded that hard shell coverage of the
      extremely ectopic heart is necessary to sustain it constantly and to prevent
      paradoxical respiratory movement of mediastinal side of the lung.

PMID- 1619829
TI  - [A surgically treated case of acute pulmonary embolism owing to deep vein
      thrombosis of the leg mainly caused by uterine myoma].
AB  - A 49-year-old woman with deep vein thrombosis of the left leg suddenly complained
      of slight dyspnea during her hospitalization. Enhanced chest CT and pulmonary
      arterial DSA revealed pulmonary emboli, while phlebography of the left leg and
      lower abdominal CT showed a uterine myoma compressing the left external iliac
      vein, which was regarded as a chief cause of deep vein thrombosis of the left
      leg. The patient became dyspneic severely with a rapid increase of pulmonary
      arterial pressure and a decrease of arterial oxygen pressure. Therefore,
      pulmonary embolectomy and deep vein thrombectomy of the left leg and pelvis was
      performed using a cardiopulmonary bypass. Hysterectomy was also performed after
      weaning the bypass. The postoperative course was uneventful without recurrence of
      pulmonary embolism. This was a very rare case of pulmonary embolism, because, as
      far as we investigated, no literature has reported deep vein thrombosis of the
      leg caused by uterine myoma. We emphasize the availability of the enhanced CT for
      diagnosis of pulmonary embolism.

PMID- 1619830
TI  - [A case of acute extrinsic malfunction of prosthetic valve due to suture tag
      causing incomplete closure of the disc].
AB  - A 56-year-old woman who had suffered from both aortic and mitral valve stenosis
      and regurgitation was treated by replacement of valves with 23 mm and 27 mm Bjork
      Shiley valves respectively. After weaning from cardiopulmonary bypass, the
      arterial systolic pressure rose to 100 mmHg but the diastolic pressure fell to 40
      to 50 mmHg. Studies including transesophageal echocardiogram and fluoroscopy
      during operation revealed the valves functioning normally. Because low diastolic
      pressure and low cardiac output continued during postoperative period,
      fluoroscopy was carried out again. It showed incomplete diastolic closure of the
      disc of the prosthetic aortic valve. The emergency operation was performed. At
      reoperation, it was found that one of the end of suture knots located between the
      valve ring and the disc prevented the occluder from seating completely and caused
      aortic regurgitation. The suture end was cut shorter and the prosthesis within
      the sewing ring was rotated so that the occluder was kept away from the suture
      end.

PMID- 1619832
TI  - [Functional pulmonary atresia: a case report].
AB  - A male neonate, two days of age, was admitted with cyanosis and tachypnea. Chest
      roentgenograms showed massive cardiomegaly and decreased pulmonary vasculatures.
      Echocardiographic and the right ventriculographic findings were interpreted as
      showing primary pulmonary atresia with secondary tricuspid incompetence. At a
      Brock operation, however, there was no resistance in passing the instrument
      through the pulmonary valve. The baby died twelve hours after surgery. Postmortem
      examination showed that the tricuspid regurgitation was a cause of the functional
      pulmonary atresia (FPA). It is important to distinguish FPA from pure pulmonary
      atresia because conservative therapy is the first choice for the FPA.

PMID- 1619831
TI  - [A case of extra-anatomic bypass for ruptured thoracoabdominal aortic aneurysm
      with tuberculosis].
AB  - Now aneurysmectomy and graft replacement is the most popular surgical method of
      aortic aneurysm, but there are many opinions about surgical methods and assist
      circulation for emergency operation of ruptured aortic aneurysm. We experienced
      the case of ruptured thoracoabdominal aortic aneurysm with tuberculosis, and
      rescued the patient by extra-anatomic bypass (EAB). A 60-year-old woman, who had
      been treated with tuberculosis for about 40 years, was operated on for cold
      abscess of her left psoas muscle by other orthopedic surgeons. At that time,
      massive bleeding happened, and she was transferred to us under diagnosis of
      ruptured thoracoabdominal aortic aneurysm. EAB, as emergency operation, was done
      because we considered it was dirty and dangerous to replace the prosthesis beside
      the abscess. The postoperative course was almost uneventful except the evidence
      of Gaffky's first stage. We considered EAB was an useful method for emergency
      cases and some infectious aortic aneurysms.

PMID- 1619833
TI  - [A case of coronary artery bypass for bilateral coronary ostial stenosis in
      aortitis syndrome with occlusion of bilateral subclavian arteries].
AB  - A 52-year-old female with bilateral coronary ostial stenosis in aortitis syndrome
      underwent CABG. Vein grafts were used instead of arterial grafts, because of the
      occlusion of bilateral subclavian arteries. Proximal anastomosis of the grafts
      was performed after oval stomas larger than usual were created on the aortic wall
      to prevent late graft occlusion due to intimal proliferation of the aorta. On
      postoperative CAG, all grafts to RCA, LAD and Cx were patent. The patient left
      the hospital 3 weeks after surgery. We believe that CABG is preferable to the
      transaortic endarterectomy in the surgical treatment for coronary ostial stenosis
      associated with aortitis syndrome, because of the prevalence of technical
      difficulty and postoperative morbidity in the latter.

PMID- 1619834
TI  - Chief complaints.

PMID- 1619835
TI  - Pending lawsuits and judgment liens.

PMID- 1619836
TI  - Cooperation is key to solving health-care woes, she says. Governor Joan Finney.

PMID- 1619837
TI  - Women physicians increase their numbers and their clout. Not for men only.

PMID- 1619838
TI  - Intra-abdominal lymphangioma.
AB  - Intra-abdominal lymphangiomas are rare occurrences. Of the few cases reported,
      most are in infants or young children. This case was in a 13-year-old boy with no
      previous history of problems. The etiology is probably a primary malformation of
      the lymphatics, which may cause blockage or inflammatory responses and subsequent
      enlargement of the lymphatic channels. Clinically, the patient presents with
      features typical of a space-occupying lesion, as in this case. This patient
      presented with symptoms of an obstruction or pressure from the growing mass. In
      diagnosis, a sonogram or CT scan is helpful. The recommended treatment is
      complete excision, if possible.

PMID- 1619839
TI  - True composite lymphoma: non-Hodgkin's lymphoma and Hodgkin's disease.

PMID- 1619840
TI  - The cardiovascular risk of general anesthesia.

PMID- 1619841
TI  - [Initial steps in the aid project of Mother-Child-Development in Mtwara].

PMID- 1619842
TI  - [Modern intensive care for the prevention of infant mortality].

PMID- 1619843
TI  - [Soder Hospital--a good alternative].

PMID- 1619844
TI  - [Pain--a quality of life in parturient women].

PMID- 1619845
TI  - [Is hormone contraception a time bomb?].

PMID- 1619847
TI  - Katilo ammatinharjoittajana [the profession of midwifery.

PMID- 1619846
TI  - [The hormone diaphragm affords safe contraception and relief from menstrual
      pain].

PMID- 1619848
TI  - [Introduction to the Pirkanmaa Midwifery College and its curriculum].

PMID- 1619849
TI  - Investigational methodologies for the effects of brain maturation on energy
      transport.
AB  - Intracellular kinetics of high energy phosphate (HEP) is of fundamental
      importance in cellular biochemical physiology. In mammalian brain, intracellular
      HEP transport from the production site (mitochondria) to the consumption site
      (plasma membrane) is dependent on passive diffusion of HEP through the cytosol.
      Diffusivity of a substrate in a solution correlates inversely to the viscosity of
      the solution. The maturational process of mammalian brain involves dramatic
      changes in the cytosolic amino acid profile. Since the viscosity of a solution is
      a function of the diffusion coefficients of solutes and their concentrations,
      changes in the cytosolic amino acid composition should result in significant
      alteration in cytosol viscosity and hence, HEP diffusivity. Such a system is
      especially suitable for mathematical modeling and correlative analysis by in vivo
      nuclear magnetic resonance (NMR) spectroscopy. This brief review is written to
      provide a fundamental background for investigational methodologies on
      developmental neurobiology of cellular energetics.

PMID- 1619850
TI  - Control of constitutively-expressed developmentally-activated rat hepatic
      cytochrome P450 genes.
AB  - Cytochromes P450 (P450) collectively refer to a superfamily of heme-containing
      enzymes that use O2 and electrons from NADPH to insert a single atom of oxygen
      into any one of a large number of substrates. Two general classes of P450s exist;
      a relatively limited number of P450 forms, expressed in specialized tissues that
      are associated with pathways of steroidogenesis and a large number of forms
      responsible for metabolism of foreign compounds. Most of the latter P450s are
      expressed in liver, the primary site for metabolism of drugs, unusual dietary
      compounds and environmental pollutants. Numerous forms of P450 are expressed in
      liver of untreated animals and these are regulated quite differently. Both
      developmentally-programmed and sex-specific expressions have been observed. In
      this review, I will summarize recent findings on the mechanisms by which two P450
      genes are regulated in livers of developing rats. The CYP2E1 gene is
      transcriptionally activated within a few hours after birth while the CYP2C6 gene
      is activated just prior to rats reaching puberty. These genes are under control
      of two transcription factors, HNF-1 alpha and DBP, respectively, that themselves
      are developmentally controlled.

PMID- 1619851
TI  - Usefulness of hemilaminectomy for microsurgical management of intraspinal
      lesions.
AB  - Hemilaminectomy is a limited, unilateral approach to the spinal cord that
      provides excellent exposure of the dorsolateral and ventral portions of the
      spinal canal. This approach is most suitable for microsurgical management of the
      majority of extramedullary tumors. Contrary to conventional laminectomy, the
      posterior supporting structures of the spine are completely preserved on the
      contralateral side with this access route. The procedure has been applied in 3
      patients who harbored a cervical neurilemmoma, a cervical lipoma, and a thoracic
      neurilemmoma, respectively. Optimal exposure of the lesion was achieved in each
      case, and each patient's symptoms improved or completely resolved
      postoperatively. There were no surgical complications. It is concluded that
      hemilaminectomy combined with microsurgical techniques should be given priority
      over standard laminectomy in the surgical management of extramedullary lesions
      arising in the spinal canal.

PMID- 1619852
TI  - Detection of H-ras gene point mutations in transitional cell carcinoma of human
      urinary bladder using polymerase chain reaction.
AB  - It has been reported that the H-ras gene is activated as oncogene in human
      bladder cancer cases, and that codon 12 and codon 61 are the major "hot spots" of
      its activation. A simple method to detect point mutations in these codons of H
      ras gene was established for the use of clinical diagnosis. In this method, the
      DNA segments including codon 12 or codon 61 were amplified by polymerase chain
      reaction (PCR), and the reaction products were examined for their susceptibility
      to the restriction enzyme NaeI or BstNI, and by dot blot hybridization assay with
      oligonucleotide probes. Point mutations were detectable in small amounts of DNAs
      isolated from fresh or frozen tumor tissues, urine cells and paraffin sections.
      The method was applied for a clinical sample and a case that had a point mutation
      at codon 12 of H-ras gene was detected. The point mutation was existed in DNAs of
      primary tumor tissue, all recurrent tumor tissues and cells isolated from urine
      of this case.

PMID- 1619853
TI  - Deficits of problem-solving ability in patients with focal brain damage:
      neuropsychological investigation of prediction and hypothesis behavior.
AB  - Deficits of problem-solving ability in focal brain-damaged patients, with special
      reference to frontal lobe dysfunction, were investigated by two
      neuropsychological tests: Temporal rule induction test and Hypothesis-testing
      measure. Subjects consisted of 84 chronic brain-damaged patients (31 with
      anterior cerebral lesions and 53 with posterior lesions). The study's aim was to
      investigate the effects of frontal lobe damage on two aspects of inductive
      reasoning, prediction and hypothesis behavior. When prediction was examined by
      Temporal rule induction test, patients with anterior lesions showed deficits in
      predicting a rule, even in the memory-aid condition in which memory factors were
      excluded. The poor results on Temporal rule induction test in frontal patients
      did not appear to be related to deficits in temporal integration, which is
      generally interpreted as frontal dysfunction. Rule induction may be impaired by
      frontal damage whenever complicated information-processing is required, even when
      temporal succession is not involved. Second, two stages of hypothesis behavior,
      hypothesis-formation and hypothesis-testing, were evaluated. Patients with
      anterior lesions showed impairment in hypothesis-formation. Their decreased
      fluency in hypothesis production affected the hypothesis-testing process.
      However, frontal patients committed fewer errors, most of which were
      perseverative (lose-stay errors) on hypothesis-testing. Patients with posterior
      lesions revealed other characteristic errors, such as inconsistent responses and
      divergent-type errors (improper lose-shift errors). The hemispheric site of the
      lesion affected only the ability to maintain a hypothesis (win-shift errors). The
      results illustrated the differences in problem-solving deficits in these two
      groups of patients. Disturbed prediction of future events, decreased hypothesis
      fluency, and abnormal lose-stay behavior in patients with frontal lobe damage may
      be crucial factors in coping with daily problem-solving situations.

PMID- 1619854
TI  - Acute hepatic failure in a 49-year-old man succeeding to a surgery for malignant
      thymoma.

PMID- 1619855
TI  - [Use of antiprotein donor plasma for specific detoxication therapy of children
      with severe burns].
AB  - Antiproteic donor plasma was included into the complex of treatment of 54
      severely burned children, who had their clinical state, immunologic and
      hematologic indices been studied. A pronounced therapeutic effect of antiproteic
      immunotherapy was noted.

PMID- 1619856
TI  - [The effect of antiprotein plasma on humoral resistance in children with severe
      burns].
AB  - In severely burned children, depending on severity of injury, the anti-triptic
      activity of blood serum, alpha 2-macroglobulin level, fibronectin, activity of an
      arginase decrease at the acute period of toxemia and septic toxemia. The content
      of the products of fibrin-fibrinogen degradation increases considerably.
      Alteration of the indices studied is of informative value and is associated with
      dynamics of the toxic syndrome development. Use of donor antiproteic plasma has a
      positive therapeutic effect.

PMID- 1619857
TI  - [Bleeding from acute gastric and intestinal ulcers in surgical treatment of
      cholecystitis].
AB  - The experience with treatment of 33 patients who developed hemorrhage from acute
      ulcers of the alimentary canal at the early period after cholecystectomy has been
      analysed. The clinical, biochemical and instrumental criteria of likelihood of
      the development of such a complication have been established. The methods for its
      prevention and treatment with the use of the techniques developed by the authors,
      which permitted to reduce the incidence of this complication from 13.7 to 6.9%,
      are described.

PMID- 1619858
TI  - [State, effectiveness and improvement of the quality of care for burn patients].
AB  - The data on the incidence of burns in Ukraine, provision with a specialized
      hospital stock, level of specialized aid, terms of transfer of the burned
      patients from the central district hospital, central city hospital, specific
      weight of the operative interventions performed for thermal injuries, general
      operative activity, lethality both of the adults and children with burns are
      presented. The ways for improving the quality of a specialized aid are outlined,
      new techniques of skin plasty operations are suggested. Particular attention is
      given to quality of rendering help in central district hospital, central city
      hospital. The ways for reduction of lethality in burns are shown. The importance
      of conservative and operative rehabilitation of burn convalescents, possibility
      of essential enhancing their social and vocational rehabilitation are stressed.

PMID- 1619859
TI  - [Experimental and clinical foundation of the effectiveness of the use of an
      extracorporeal "auxiliary liver"].
AB  - For extracorporeal detoxication in treatment of experimental burn disease and
      hepatic failure in patients, the dispersed hepatic tissue was used. Restoration
      of the processes of biotransformation and detoxication, normalization of content
      of different metabolites, decrease in activity of transaminases, improvement of
      general state of the patients were noted.

PMID- 1619860
TI  - [Prediction of bleeding from esophageal and gastric varices in patients with
      liver cirrhosis].
AB  - A course of the disease was studied in 190 patients with hepatic cirrhosis and
      portal hypertension without bleeding as well as in 107 patients with bleeding
      from esophageal and gastric varices. The Wald's consecutive analysis with
      derivation of a summary diagnostic coefficient on the basis of 13 clinical signs
      was used. Effectiveness of the method was assessed by means of retrospective
      analysis of 150 case records and long-term results of treatment of 30 patients.
      The method permits to predict the development of gastroesophageal bleeding in
      95.4% of cases.

PMID- 1619861
TI  - [Use of therapeutic discrete plasmapheresis in combination with extracorporeal
      blood irradiation with ultraviolet rays in the treatment of patients with
      obliterative disease of blood vessels of the lower extremities].
AB  - The results of treatment of 440 patients with obliterative diseases of the
      arteries of the lower extremities are presented. Use of the ultra-violet rays for
      extracorporeal irradiation of the blood in combination with discrete
      plasmapheresis has a pronounced therapeutic effect, contributes to improvement in
      regional blood flow and shortening the duration of patients' staying in the
      hospital by 5-7 days.

PMID- 1619862
TI  - [Microwave therapy of frostbite of the extremities].
AB  - In the experiment, frostbite of the hind legs in rabbits was induced for 3 hours.
      The extremities of 12 animals of the experimental group were influenced with UHF
      field with a wavelength of 12.6 cm of nonthermal intensity (3 W) for 10 minutes
      one time after termination of cold influence. The extremities of 18 rabbits of
      the control group were warmed in a natural way. The milder course of cold trauma
      in animals of the experimental group manifesting itself in higher temperature of
      a skin of the damaged extremity, more rapid disappearance of edema and lesser
      spreading of cyanosis, tissue necrosis of an extremity--(7.6 +/- 2.5) and (11.7
      +/- 1.2) cm, respectively--was noted. The authors consider that microwave therapy
      can be included into the complex of measures at the early period of treatment of
      local cold trauma.

PMID- 1619863
TI  - [A method for improvement of blood circulation in composite grafts in the
      preventive and reconstructive surgery of burns].
AB  - In 58 patients after performance of plasty with fatty-cutaneous and
      fasciocutaneous grafts, the state of circulation in the flaps was studied. The
      level of ischemic disorders was defined. The medicamentous complexes contributing
      to improvement of circulation in the grafts are suggested.

PMID- 1619864
TI  - [Specifics of dermotensive skin reconstruction in children].
AB  - The technique of dermotension, peculiarities and expediency of its use in
      postburn and mechanical skin deformation in 50 children ranging in age from 2 to
      14 years are described. It is expedient to perform operative elimination of the
      postburn alopecia, severe contracture of the neck, cicatricial bandage of the
      chest and abdomen by means of the dermotensive flaps. This permits to reduce a
      number of operative steps, create a sufficient reserve of healthy tissue
      identical to the lost one both in texture and in colour. Dermotension has the
      advantages over the pediculate plasty and can be widely used in children with the
      burn sequelae.

PMID- 1619865
TI  - [Specifics of wound healing in patients with extremely severe burns as effected
      by various methods of treatment].
AB  - Peculiarities of the course of a wound process in 52 patients ranging in age from
      16 to 60 years with the extremely severe burns were studied. Suppression of the
      vascular reaction and deceleration of the cellular reactions of the extravascular
      phases of inflammation, alteration of protease-antiprotease activity at the
      region of injury in dynamics of a wound process were revealed. Antiinflammatory
      action of the combined methods of general and local sorptive detoxication were
      substantiated. Certain mechanisms of increase in anti-infective resistance of the
      organism of the sufferers were elucidated.

PMID- 1619866
TI  - [The use of protease inhibitors in the treatment of burn wounds].
AB  - The results of experimental and clinical studies of the effect of contrykal and
      aminocaproic acid on tissue regeneration in deep burns are presented. In the
      experiment, by means of planimetric, histologic, histochemical and biochemical
      methods of investigation, the positive effect of inhibitors on healing of the
      burn wounds is shown. In treatment of 272 patients with deep burns, it was
      established that use of protease inhibitors at the phase of regeneration
      contributed to 2-fold acceleration of marginal epithelization, shortening of time
      of would preparation to autodermoplasty by 3-4 days, increase in effectiveness of
      survival of the cutaneous flaps. A possibility of wide clinical use of
      proteolysis inhibitors predominantly in combination with antibiotics is shown.

PMID- 1619867
TI  - [Early surgical treatment of deep burns].
AB  - Twenty four patients with deep burns were treated. Survival of free transplants
      was noted in excision of the necrotic tissues to fascia. An unsatisfactory result
      of plasty was noted in perifocal inflammation and leaving a necrotized crust
      along the periphery. In use of mesh transplants with an enlargement coefficient
      1:2, the optimal survival was achieved.

PMID- 1619868
TI  - [Immunocorrective therapy of patients with mandibular fractures].
AB  - The authors have summarized their experience with local use of lysozyme in the
      treatment of patients with mandibular fractures.

PMID- 1619869
TI  - [The use of helium-neon laser radiation in the treatment of trophic disorders in
      patients with diabetes mellitus].
AB  - The effectiveness of laser therapy in trophic skin disorders (ulcer, diabetic
      bulla, hematoma, skin chap) in patients with diabetes mellitus was studied. The
      foci of trophic disorders and biologically active points were irradiated by means
      of heliumneon laser installations. The technique was employed in a hospital and
      in out-patient treatment in the complex with medicamentous therapy and without
      that in patients resistant to medicamentous therapy. A high effectiveness of
      laser therapy has been established.

PMID- 1619870
TI  - [Treatment of purulent-necrotic diseases in patients with diabetes mellitus].
AB  - The experience with treatment of 214 patients suffering from diabetic angiopathy
      complicated by purulent-necrotic tissue lesion, which included intraarterial
      administration of antibiotics, insulin, novocaine, vasodilators, antiaggregants,
      anticoagulants, vitamins, is summarized. In soft tissue necrosis, gangrene of the
      toes, or foot, the necrotized tissues were excised, exarticulation, or amputation
      of toes, metatarsals, in extreme cases, amputation of a leg at the thigh level,
      were performed.

PMID- 1619871
TI  - [Relaparotomy after appendectomy].
AB  - A result of 70 relaparotomies performed after the operative intervention for
      acute appendicitis has been analysed. The causes and indications for reoperation,
      an outcome, nature of complications which required performance of relaparotomy
      have been considered. A classification of relaparotomies depending on time of
      their performance is suggested.

PMID- 1619872
TI  - [Isoniazid content of lungs in patients with pulmonary tuberculosis depending on
      the method of its administration as part of a comprehensive preoperative
      preparation].
AB  - Isoniazid concentration in the resected areas of a lung was studied in 47
      patients with tuberculosis. It has been proved that galvanization of the chest
      against the background of intermittent intravenous chemotherapy allows to create
      a high concentration of the preparation in the damaged part of a lung situated at
      the interelectrode space. Isoniazid content in the wall of the caverna and
      paracavernous tissues in patients after the direct current influencing was (5.3
      +/- 1.0) and (15.2 +/- 1.2) mukg/g. These indices were significantly higher than
      in patients, who sustained enteral, or intravenous drip administration of the
      preparation 3 times a week. Intravenous intermittent chemotherapy in combination
      with galvanization is indicated at the time of preoperative preparation of the
      patients.

PMID- 1619873
TI  - [Diagnosis and surgical treatment of complicated acute cholecystitis in elderly
      and very old patients].

PMID- 1619874
TI  - [Free bodies of the abdominal cavity].

PMID- 1619876
TI  - [A method for tying a double knot].

PMID- 1619877
TI  - [The surgical needle].

PMID- 1619875
TI  - [Preparation of porcine spleen for splenosorption in children].

PMID- 1619878
TI  - [A method for surgical treatment of pathologic mobility of the kidney].

PMID- 1619879
TI  - [Multiple recurring necrosis of skin resulting from radiation therapy].

PMID- 1619880
TI  - [Treatment of a child with burns complicated by sepsis and gastrointestinal
      bleeding].

PMID- 1619881
TI  - [Free transfer of the latissimus dorsi flap to sites with decompensated regional
      blood flow in burn and vascular surgery].
AB  - In the experiment, a sluggish wound of an extremity against the background of
      chronic ischemia was modelled in white rats. Then, a scapular muscle was
      transferred onto a wound defect. Free transfer of the latissimus dorsi flap (LDF)
      aimed at closure of the extensive wound defect and revascularization of the
      tissue ischemia area was performed in 29 patients: for high-voltage electric burn
      (12 cases), frostbite (5), radiation ulcer (4) and obliterative diseases of the
      lower extremities (8). Complications--partial, or total necrosis of a flap-
      occurred in 11 patients. Risk of free LDF transfer is justified because of
      absence of the other methods for prevention of amputation of the extremities.

PMID- 1619882
TI  - [Prediction of the severity of the course of a pathologic process at various
      stages of burns using phytolectins].
AB  - To predict the course of a pathological process in burn patients, the possibility
      for using the agglutinative capacity of erythrocytes caused by presence of
      lectins in the aqueous-saline extracts of the 12 species of drug plants permitted
      for use in medicine was studied. The activity of lectins was judged about by the
      intensity of agglutination of erythrocytes in 21 donor and in 26 patients with
      III-IV degree burns at different stages of the disease. A significant decrease in
      total agglutinative activity of erythrocytes in burn convalescents as compared
      with that in healthy patients was established.

PMID- 1619883
TI  - Comparison between natural and immunized anti-GM1 antibodies analyzed by marker
      releasing rate assay with liposome.
AB  - Naturally occurring rabbit anti-GM1 was compared with immunized induced anti-GM1
      antibody in the same individual rabbits by the characterization of immune potency
      determined by complement-dependent damage to liposomes containing GM1 as antigen.
      Antigen-antibody reaction was the rate determining step in this assay. The
      maximum rate was measured by the first derivative conversion monitoring in
      spectrophotometry and the maximum level of marker released was measured by the
      conventional method described previously. When the concentration of sera required
      to get fifty percent of maximum values in each assay were compared, the ratios
      (rate assay/conventional assay) were 5.7 to 10.0 in natural antibodies and 3.2 to
      2.3 in immunized induced antibodies, respectively. Furthermore, the maximum rate
      of marker release from liposome was not correlated with the maximum level of
      marker released depended on the sources of antibodies. These results suggest that
      natural antibody, even the titer was high in conventional liposome assay, has
      different characteristics compared with the immunized induced antibody.

PMID- 1619884
TI  - Massive gastric cancer in a patient with a negative Gregory antigen (Gy (a-)), a
      rare blood group.
AB  - A case of a massive advanced gastric cancer of the Borrmann type III in a patient
      with the rare blood group of negative Gregory antigen (Gregory (a-)) is reported.
      On admission, he was found to have a severe anemia (Hb 6.1 g/dl) requiring a
      direct blood infusion. He had never received a blood infusion, previously. In
      blood crossmatching tests, his blood was agglutinated by all the antisera for the
      common antigens, and he was discovered to have a rare blood type of Gregory (a-).
      There was no appropriate blood donor in his family. Before the operation, only
      600 ml (6 i.u.) of frozen red blood cells could be found in storage from only 2
      people with Gregory (a-), O blood type and Rh (+) in Japan. To increase the RBC,
      erythropoietin (3000 i.u.) was administered 6 times; and the Hb increased to 7.4
      g/dl. However, the anemia remained and 200 ml (2 i.u.) Gregory (a-) blood was
      infused, preoperatively. The final preoperative Hb was 7.8 g/dl and the RBC was
      283 x 10(4)/mm3. A massive gastric cancer directly infiltrated the pancreas, the
      transverse colon and the mesocolon. A palliative subtotal gastrectomy with
      combined resection of the transverse colon was performed. The intraoperative
      blood loss was 460 ml and the volume of blood infused was 400 ml (4 i.u.). The
      postoperative Hb was 7.9 g/dl, and more blood was needed. However, there was no
      more Gregory (a-) donor blood in storage in Japan.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1619885
TI  - Anomalous multifocal ossification of the os calcis--case report.
AB  - A three-month-old female baby was diagnosed by roentgenograms as having bilateral
      multifocal ossification of the os calcis. Five ossification centers in the
      bilateral calcaneus were recognized. However, at one year of age the
      roentgenograms showed only three ossification centers, with cleft separating on
      both sides the anterior third from the posterior two-thirds of the bone. At two
      years of age, the three ossification centers had coalesced into a single
      composite ossification center and the cleft at the calcaneus disappeared.

PMID- 1619886
TI  - Modified De Vega's annuloplasty for functional tricuspid regurgitation--early and
      late results.
AB  - From 1978 through 1987, 321 patients who had functional tricuspid regurgitation
      (TR) associated with mitral or combined mitral and aortic valve disease underwent
      tricuspid annuloplasty with our modification of the original De Vega's
      annuloplasty technique. The modified De Vega's annuloplasty consisted of two
      separate semicircular sutures placed around the anterior and lateral aspect of
      the tricuspid valve. Preoperatively, 229 (71.3%) of the 321 patients were in New
      York Heart Association functional class III or IV. There were nineteen early
      deaths (5.9%), and 15 patients died during a follow-up period of 15 to 126 months
      (mean follow-up, 26 months). Five patients (1.5%) required reoperation because of
      biological mitral valve failure and recurrence of mitral stenosis. The severity
      of TR was evaluated by two-dimensional and pulsed Doppler echocardiography, and
      was classified on a scale of 0 to Grade 3 according to the maximal distance and
      the flow pattern of the regurgitant signals in the right atrium. Postoperative
      echocardiographic evaluation of TR was performed in 121 randomly selected
      patients late after operation. TR reduced to Grade 1 or less in 107 (88.4%) of
      the 121 patients after operation. Ninety-six percent of the survivors were in New
      York Heart Association functional class I or II, postoperatively. The actuarial
      survival rate for the 321 patients with the modified De Vega's annuloplasty
      including early deaths was 88.2% at 10 years and the actuarial rate of freedom
      from reoperation on the tricuspid valve was 97.6%. Our surgical experience
      indicated that the modified De Vega's annuloplasty, as the method of first
      choice, is a simple, reliable procedure and resulted in reduction of the severity
      of TR in 88.4% of the patients with functional TR.

PMID- 1619887
TI  - Surface charge of fractionated guinea pig keratinocytes measured by free-flow
      cell electrophoresis.
AB  - Keratinocytes differentiate from basal cells to spinous, granular, and horny
      layer cells. It is known that alterations in the surface charge of cell membranes
      in most cases reflect the processes of differentiation. By using a continuous
      colloidal silica (Percoll) density gradient, keratinocytes may be separated into
      three fractions which correspond to their arrangement in vivo. Using a free-flow
      cell electrophoretic technique, we measured the electrophoretic mobility of
      guinea pig keratinocytes. Electrophoretic mobility histograms of basal and
      granular cells showed slow and fast monophasic patterns, respectively. In spinous
      cells, a biphasic pattern of slow and fast electrophoretic mobility was present.
      The electrophoretic mobility level of guinea pig keratinocytes was slightly
      reduced with neuraminidase digestion. Those of human red blood cells and
      lymphocytes, however, were markedly decreased. These results indicate that
      membrane charge density is lower in basal cells and higher in granular cells and
      that the membrane charge density of guinea pig keratinocytes involves not only
      neuraminic acid residues but also other substance(s). Our results illustrate the
      alterations of cell membrane charge properties during epidermal cell
      differentiation.

PMID- 1619888
TI  - Clinicopathologic study of perineural invasion in rectal cancer.
AB  - Perineural invasion (PNI) in rectal cancer was studied, prospectively. One
      hundred patients (20%) were identified as having tumors with PNI. The incidence
      of PNI was significantly increased in tumors with moderate or marked venous
      invasion (30%, 64%), with moderate or marked lymphatic permeation (37%, 72%),
      with liver metastasis (50%) and with peritoneal dissemination (64%). In cases of
      curative surgery, the incidence of PNI was significantly increased in MAC stage
      C2m+g or C3 (28%, 35%). There was no significant difference in the recurrence or
      survival rates between the patients with PNI and without PNI in MAC stage B2m+g.
      However, there was a significant increase in local recurrence in the patients
      with both PNI and lymph node metastasis (p less than 0.05). Also, the patients
      with PNI in MAC stage C2m+g had a significantly lower 8-year survival rate
      (29.1%, p less than 0.001). Multivariate analysis using Cox regression models
      demonstrated that PNI was an independent prognostic factor for survival.

PMID- 1619889
TI  - Distal enhancement of the occluded vessels on MRI in acute embolic cerebral
      infarction--intravascular enhancement sign.

PMID- 1619890
TI  - [Head injuries in children].

PMID- 1619891
TI  - [Subarachnoidal hemorrhage--pathophysiology, symptoms and therapy].

PMID- 1619893
TI  - [Decubitus ulcer--a theme without end?].

PMID- 1619892
TI  - [Stress testing and work therapy in a phase II hospital].

PMID- 1619894
TI  - [Cost effectiveness in hydrocolloid dressings compared to conventional
      dressings].

PMID- 1619895
TI  - [Nursing standards shown for decubitus ulcers].

PMID- 1619896
TI  - [Hygiene specialist--a profession is developing].

PMID- 1619897
TI  - [Directions for appropriate relations with cancer patients and for the
      psychohygiene of the caregivers].

PMID- 1619898
TI  - [In Africa as a nurse].

PMID- 1619899
TI  - [Chaplaincy for the mentally ill].

PMID- 1619900
TI  - Gender and ethnic differences in adolescents' attitudes toward condom use.
AB  - This secondary analysis from the National Adolescent Student Health Survey
      (NASHS) examined relationships between adolescents' personal and perceived peer
      attitudes toward condom use with gender and self-reported ethnic background.
      Descriptive results revealed general personal support and perceived peer support
      for condom use. Results from multivariate analysis of variance (MANOVAs)
      demonstrated significant interaction effects for the eighth grade sample [F = (4,
      2383228) = 3530.01 p = .000], and the 10th grade sample [F = (4, 2636878) =
      2594.41073, p = .000]. Contrasts revealed significant differences among all
      ethnic groups for both belief variables for the entire sample, eighth grade
      students, and 10th grade students. Though general support exists for condom use
      among U.S. eighth and 10th grade students, conviction varies among groups perhaps
      indicating a need for tailored messages about condom use, especially for Hispanic
      students. Implications for health education include the need for cultural
      sensitive and gender-sensitive STD education.

PMID- 1619901
TI  - Is school nursing really the "invisible practice"?

PMID- 1619902
TI  - The longevity of Growing Healthy: an analysis of the eight original sites
      implementing the School Health Curriculum Project.
AB  - The status of the Growing Healthy curriculum (School Health Curriculum Project
      [SHCP]) was examined in the eight sites selected in 1969 by the National
      Clearinghouse on Smoking and Health to receive funded training and implementation
      support. A contact person from each site completed and returned a questionnaire
      pertaining to the district's continued implementation (institutionalization) of
      the SHCP. Most districts had not continued to implement the program. Reasons for
      discontinuation included loss of the "program champion" and insufficient
      administrative leadership. Districts continuing to implement the program
      generally were smaller in size, and employed a part-time coordinator for the
      SHCP. Recommendations for institutionalizing future instruction programs include
      identifying replacement program coordinators and other administrators to ensure
      continuity and support for the program over time, and conducting process and
      impact evaluations on program effects.

PMID- 1619903
TI  - The status of school-based nutrition education at the state agency level.
AB  - The status of school-based nutrition education at the state agency level was
      examined. Telephone interviews with agencies in all 50 states revealed that nine
      states mandated nutrition be taught and another 21 included nutrition as a
      required topic in mandated subjects, frequently health. The other states had
      initiatives to promote school-based nutrition education but it was not required.
      Published requirements for teacher certification in elementary education, home
      economics, and health education seldom (two to three states) specified nutrition
      as a requirement. However, follow-up investigations revealed many states
      indirectly promote nutrition preparation for home economics and health education
      teachers through guidelines for approval of college programs in these areas. An
      inventory of nutrition education curricular materials revealed they were most
      frequently directed to grades K-6 and focused mainly on general foods and
      nutrition or that related to health. Given the links that emerged between health
      and nutrition, incorporating nutrition into health education may help promote
      school-based nutrition education.

PMID- 1619904
TI  - Comprehensive school-based services for pregnant and parenting adolescents in
      West Dallas, Texas.
AB  - A cohort of 339 Black (n = 210), Hispanic (n = 118), and other (n = 11)
      adolescent mothers in Dallas, Texas, were followed from the start of their
      pregnancy through the school year of the delivery to assess differences in
      numbers of prenatal care visits, postpartum care, repeat deliveries, and school
      continuation rates. Approximately one-half the teens received reproductive
      services at a comprehensive, school-based clinic and one-half at a categorical
      (Title XX) family planning and prenatal care clinic. Adolescents attending the
      school-based clinic were more likely to be in school at conception and averaged
      more prenatal visits than those served by the categorical provider. However,
      during the pregnancy and following the delivery, school dropout rates for the two
      sets of teens converged. School continuation rates were higher among a subset of
      adolescents attending the Dallas Independent School District school for pregnant
      teens than among other teens. Hispanic teens were two times more likely than
      their Black counterparts to drop out of school. No differences were found in
      repeat birth rates, by ethnicity, clinic site, or school attended.

PMID- 1619906
TI  - Papers presented at the Annual Meeting of the Association for Academic Surgery.
      Colorado Springs, Colorado, November 20-23, 1991.

PMID- 1619905
TI  - Multiple pathways in the rejection of skin grafts.
AB  - We have analyzed the ability of CD4+ and CD8+ T cells to cause rejection of skin
      grafts in an Ir gene high responder strain. (DA.RT1u x DA.RT1c)F1 B rats
      (thymectomized, lethally irradiated, reconstituted with fetal liver cells) were
      grafted with ear skin of the recombinant strain, DA.RT1rl. The only allogeneic
      difference was a single class I MHC antigen. The B rats, which do not reject
      these grafts due to the absence of T cells, were reconstituted at various time
      intervals after skin grafting with either unsorted lymph node cells (LNCs), CD4+,
      CD8+ or CD4+ and CD8+ T cells. Unsorted LNCs given any time after graft placement
      always caused rejection (MST = 15d). CD4+ cells alone never caused rejection (MST
      greater than 60d, n = 8). CD8+ cells alone caused rejection if given within 3
      weeks of graft placement. Thereafter, CD8+ cells alone lost their ability to
      cause rejection (MST greater than 60d, n = 6). B rats with grafts in place more
      than 3 weeks, when CD8+ cells alone were ineffective, rejected their skin grafts
      when given both CD8+ and CD4+ cells. These data suggest that there may be two T
      cell pathways in skin graft rejection. The first requires only CD8+ cells and
      causes rejection of a recently placed graft. The second pathway requires both
      CD4+ and CD8+ cells to reject long-standing grafts in which donor antigen
      presenting cells have been putatively depleted and, therefore, may be dependent
      on host antigen-presenting cells.

PMID- 1619907
TI  - Evaluation of endothelium-derived nitric oxide mediated vasodilation utilizing ex
      vivo perfusion of an intact vessel.
AB  - The traditional evaluation of the endothelium-derived nitric oxide (EDNO) pathway
      involves isolated aortic rings with attached strain gauges. This model is
      nonphysiologic and does not permit studies lasting longer than several hours. Our
      objective was to overcome the limitations of these "traditional" methods
      utilizing a physiologic, whole vessel model as a reproducible assay of EDNO.
      Canine carotid arteries (n = 4) were removed (maintaining in vivo arterial
      geometry), mounted in a specially designed, continuous-flow circuit, and perfused
      at 100 ml/min, 80 mm Hg with Medium-199/10% canine serum. Physiologic pH, pCO2,
      pO2, and temperature were precisely regulated. A non-contacting, helium-neon
      laser micrometer was interfaced with the current system to provide continuous
      measurement of vessel external diameter and to quantitate changes in vessel wall
      geometry in response to epinephrine (EPI; 2 x 10(-5) to 2 x 10(-3) mg/ml) and
      acetylcholine (ACh; 0.1 to 100 microM) challenge. Further characterization of the
      perfusion system included the use of a competitive inhibitor to EDNO production,
      NG-monomethyl-L-arginine (L-NMMA), and the effect of this compound on ACh-induced
      vasodilation. The reversibility of this blockade was verified via the sequential
      addition of L-arginine (L-ARG; 0 to 3 mM). Data are expressed as the ratio of
      steady-state vessel cross-sectional area (CSA) following administration of
      vasoactive substance to the CSA prior to vasoactive challenge. Our results
      indicate that EPI and ACh produced significant dose-dependent vasoconstrictive
      and vasodilatory responses, respectively (P less than 0.001, ANOVA).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1619908
TI  - Kupffer cell autoregulation of IL-1 production by PGE2 during hepatic
      regeneration.
AB  - The mammalian liver possesses the ability to regenerate to its original size
      after a 70% partial hepatectomy (PHx). The capacity of rat Kupffer cells (KC)
      isolated at specific intervals following PHx to produce interleukin-1 (IL-1) and
      prostaglandin E2 (PGE2) in response to endotoxin (LPS) was evaluated in standard
      RPMI-1640 (1200 microM L-arginine) and arginine-depleted RPMI-1640 (10 microM L
      arginine) media. Regenerating liver KC 48-120 hr following PHx responded to LPS
      with a significantly greater (p less than 0.05) production of IL-1 in standard
      RPMI-1640. When 10 microM L-arginine RPMI-1640 was used to simulate the high
      arginase activity low L-arginine levels of the hepatic microenvironment,
      regenerating liver KC production of IL-1 was further increased (p less than
      0.05). During the same time period, regenerating liver KC also produced
      significantly (p less than 0.01) more PGE2 than sham KC in both high and low
      arginine media. When the cyclooxygenase inhibitor indomethacin (10 microM) was
      added to low arginine cultures, the PGE2 production was inhibited, and IL-1
      production was upregulated (p less than 0.05). We conclude that during hepatic
      regeneration KC IL-1 production is elevated but controlled in an autoregulatory
      fashion by KC PGE2 production.

PMID- 1619909
TI  - Mast cell degranulation inhibits IL-2-induced microvascular protein leakage.
AB  - The therapeutic efficacy of interleukin-2 (IL-2) in the treatment of cancer has
      been limited by a "vascular leak syndrome" and related toxicities. To better
      understand the pathophysiology of the "vascular leak syndrome," we tested a
      hypothesis that mast cell degranulation mediated the acute increase in
      microvascular protein leakage seen immediately following IL-2 administration.
      After the cremaster muscle was prepared for intravital microscopy, anesthetized
      Sprague-Dawley rats were injected with fluorescein isothiocyanate-labeled albumin
      for fluorescent microscopy. Animals were treated by the intravenous injection of
      IL-2 (1 x 10(6) U/kg) (n = 6), the control IL-2-vehicle (n = 5), or IL-2 (1 x
      10(6) U/kg) after mast cell degranulation with compound 48/80 (n = 6). Relative
      interstitial fluorescent intensity was quantitated by a computerized image
      analysis system as an index of microvascular protein leakage. IL-2 acutely
      induced protein leakage from the microcirculation. Mast cell degranulation with
      48/80 prior to IL-2 treatment prevented protein leakage, but did not alter IL-2
      induced leukocyte-endothelial adherence. These data suggest that mast cell
      mediated events may be responsible for the acute increase in microvascular
      permeability seen with IL-2 administration and that leukocyte-endothelial
      adherence alone is not solely responsible.

PMID- 1619910
TI  - Gut ischemia/reperfusion-induced liver dysfunction occurs despite sustained
      oxygen consumption.
AB  - We have previously shown that gut ischemia/reperfusion (I/R) causes liver
      dysfunction in vivo (increased [I125]albumin leak, decreased mitochondrial redox
      potential). Our purpose was to investigate liver dysfunction due to gut I/R in an
      ex vivo model where oxygen delivery (DO2) could be controlled. Rats underwent
      laparotomy (sham) or 45 min of superior mesenteric artery (SMA) occlusion (I/R)
      and 6 hr later the gut and liver were isolated in situ. Pressures were monitored
      while recirculating blood was perfused via the hepatic artery (2.5 ml/min) for 90
      min and the SMA (7.5 ml/min) for the first 30 min, then the portal vein (7.5
      ml/min) for 60 min. Both gut and liver DO2 and VO2 (Fick method) were maintained
      throughout the study period in the gut I/R as well as sham groups. Despite
      maintenance of liver VO2, however, gut I/R resulted in a marked and persistent
      reduction in bile flow. In conclusion, dysfunctional bile production after gut
      I/R is not due to impaired VO2, but rather gut-liver signaling yet to be defined.

PMID- 1619911
TI  - Upregulation of nutrient transport in fetal rabbit intestine by transamniotic
      substrate administration.
AB  - Delivery of nutrients to the developing fetal gastrointestinal tract has been
      advocated as a potential prenatal treatment for intrauterine growth retardation.
      To examine the effect of intrauterine nutrient administration on the uptake
      capacity of the intestine, 16 maternal rabbits underwent bilateral ovarian-end
      transamniotic catheter placement on gestational Day 24. Study fetuses received a
      galactose solution; the contralateral controls received mannitol, a
      physiologically inert carbohydrate. Infusions were continued until Day 30 when an
      everted sleeve technique was used to measure radiolabeled uptake of both
      galactose and glucose in the proximal, middle, and distal small intestine.
      Mucosal scrapes were obtained, weighed, and the percentage of weight was
      calculated. Results were analyzed by ANOVA and Student's t test with P less than
      0.05 being considered significant. There were 2 maternal deaths with 11 fetal
      pairs surviving (79%). There was increased uptake of galactose in the study
      fetuses compared to controls reaching significance in the middle and distal
      segments. Similarly, glucose uptake was significantly increased in the proximal
      and distal segments. Mucosal weight was increased in all regions, reaching
      significance in the proximal segment. Total intestinal uptake of galactose and
      glucose was significantly increased in the study fetuses compared to controls.
      Intraamniotic galactose infusion caused not only upregulation of its own mucosal
      transport but also that of glucose, along the entire fetal small intestine,
      achieving statistical significance particularly in distal segments. Fetal
      implications for transamniotic feeding are under investigation.

PMID- 1619912
TI  - Newcastle disease virus selectively kills human tumor cells.
AB  - Newcastle disease virus (NDV), strain 73-T, has previously been shown to be
      cytolytic to mouse tumor cells. In this study, we have evaluated the ability of
      NDV to replicate in and kill human tumor cells in culture and in athymic mice.
      Plaque assays were used to determine the cytolytic activity of NDV on six human
      tumor cell lines, fibrosarcoma (HT1080), osteosarcoma (KHOS), cervical carcinoma
      (KB8-5-11), bladder carcinoma (HCV29T), neuroblastoma (IMR32), and Wilm's tumor
      (G104), and on nine different normal human fibroblast lines. NDV formed plaques
      on all tumor cells tested as well as on chick embryo cells (CEC), the native host
      for NDV. Plaques did not form on any of the normal fibroblast lines. To detect
      NDV replication, virus yield assays were performed which measured virus particles
      in infected cell culture supernatants. Virus yield increased 10,000-fold within
      24 hr in tumor and CEC supernatants. Titers remained near zero in normal
      fibroblast supernatants. In vivo tumoricidal activity was evaluated in athymic
      nude Balb-c mice by subcutaneous injection of 9 x 10(6) tumor cells followed by
      intralesional injection of either live or heat-killed NDV (1.0 x 10(6) plaque
      forming units [PFU]), or medium. After live NDV treatment, tumor regression
      occurred in 10 out of 11 mice bearing KB8-5-11 tumors, 8 out of 8 with HT-1080
      tumors, and 6 out of 7 with IMR-32 tumors. After treatment with heat-killed NDV
      no regression occurred (P less than 0.01, Fisher's exact test). Nontumor-bearing
      mice injected with 1.0 x 10(8) PFU of NDV remained healthy. These results
      indicate that NDV efficiently and selectively replicates in and kills tumor
      cells, but not normal cells, and that intralesional NDV causes complete tumor
      regression in athymic mice with a high therapeutic index.

PMID- 1619913
TI  - Site-specific variations in basal and meal-stimulated intestinal absorption.
AB  - The ingestion of a meal increases water and electrolyte absorption in the
      proximal jejunum. The purpose of these experiments was to elucidate any site
      specific variations in intestinal absorption, comparing jejunum to ileum, in both
      the basal and the meal-stimulated states. Twenty-five-centimeter proximal jejunal
      and distal ileal Thirty-Vella fistulae were constructed in four dogs.
      Simultaneous jejunal and ileal absorption studies were performed using [14C]PEG
      to calculate net absorption of water and electrolytes. Two groups were studied:
      in Group 1 no meal was ingested, while in Group 2, the animals ingested a mixed
      meal. Each study consisted of a 1-hr basal period and a 3-hr experimental period.
      In the basal state ileal absorption significantly exceeded jejunal absorption (P
      less than 0.0001). The ingestion of mixed meal significantly increased water and
      electrolyte absorption in both the jejunum and the ileum, (P less than 0.001),
      with the magnitude of meal-stimulated ileal absorption significantly exceeding
      the magnitude of meal-stimulated jejunal absorption (P less than 0.001). These
      studies demonstrate distinct site specific variations in intestinal water and
      electrolyte absorption in both the basal and the meal-stimulated states.

PMID- 1619914
TI  - Pulmonary arterial impedance after single lung transplantation.
AB  - Single lung transplantation (SLT) is emerging as definitive therapy for end-stage
      pulmonary disease of varying etiology, yet a complete description of the
      hemodynamic properties of the transplanted lung has not been reported. In this
      study, Fourier analysis was used to calculate the pulmonary arterial (PA)
      impedance spectrum before and immediately after SLT to define precisely the
      pulmonary pressure-flow relationship. Median sternotomies were performed in 18
      dogs (donors): an ultrasonic flow probe was placed around the PA and
      micromanometers were placed in the PA and left atrium (LA). Control PA pressure
      and flow (PAQ) and LA pressure were measured during transient occlusion of the
      right PA. The lungs were harvested using cold modified Euro-Collins solution for
      preservation. After thoracotomy and pneumonectomy, left SLT was performed in 18
      recipient dogs with a mean ischemic time of 179 +/- 6 min. After reperfusion for
      1 hr, PA pressure and flow data were again collected. Characteristic impedance
      (Z0), a measure of resistance to pulsatile flow, was compared to input resistance
      (Rin), a measure of resistance to mean flow, and pulmonary vascular resistance
      (PVR), the conventional index. Rin is defined as the zeroth harmonic of the
      impedance spectrum and Z0 as the mean of impedance moduli from 2-12 Hz. All
      recipients survived transplantation. Both PVR and Rin increased significantly
      after transplantation (11 +/- 1 vs 19 +/- 3 Wood U, P less than 0.05, and 1352 +/
      121 vs 1964 +/- 244 dyne.sec.cm-5, P less than 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1619916
TI  - Molecular mechanism of contractile dysfunction in cardiac allograft rejection.
AB  - Alterations in the beta-adrenergic receptor adenylyl cyclase pathway are well
      known in heart failure. To determine if an alteration in this pathway occurs
      during the reversible phase of cardiac allograft rejection, we used a rat
      heterotopic heart transplant model. Lewis rats received either isografts or Lewis
      Brown Norway allografts. Cardiac grafts and native hearts were explanted 4, 5, or
      6 days later. Receptor-mediated modulation of adenylyl cyclase activity was
      investigated using isoproterenol, forskolin, and the muscarinic and adenosine
      receptor agonists carbachol and R-N6-(C2-phenyl-isopropyl)-adenosine (R-PIA),
      respectively. Allografts demonstrated evidence of histological rejection and a
      significantly impaired response to forskolin and isoproterenol on all days:
      [table: see text] (% increase in cAMP in response to forskolin or isoproterenol
      +/- standard error. All results P less than 0.03 except Day 4 forskolin and Day 5
      isoproterenol.) No significant difference was noted between isografts and
      allografts stimulated with carbachol and R-PIA. These data suggest that a primary
      alteration in adenylyl cyclase activity may be a component of the molecular basis
      of reversible contractile dysfunction in cardiac allograft rejection.

PMID- 1619915
TI  - Correlation of hepatic injury, synthetic function, and mitochondria energy level
      in orthotopic liver transplantation.
AB  - The arterial ketone blood ratio (AKBR) of acetoacetate to b-hydroxybutyrate was
      previously shown to reflect hepatic mitochondria oxidation/reduction (redox)
      state and energy level. In this study we correlated AKBR to the degree of liver
      injury immediately following orthotopic liver transplantation (OLT). Serial
      measurements of AKBR in 209 patients undergoing OLT, during the anhepatic phase,
      and up to 60 hr following reperfusion demonstrated direct correlation between
      mitochondria Redox state (AKBR), hepatocyte injury (SGOT), and hepatic synthetic
      function (prothrombin time). AKBR levels less than 0.7 were seen in primary
      nonfunction grafts and were associated with raising SGOT (greater than 1000) and
      prolonged PT (greater than 18). Acute occlusion of arterial blood supply to the
      graft was seen in conjunction with low AKBR (less than 0.7). However, hepatic
      synthetic function and serum enzyme were stabilized or returned to normal within
      24-48 hr postreperfusion. IN CONCLUSION: (1) AKBR measurements are useful in
      predicting graft survival, (2) reduction in liver mitochondria Redox state is
      seen in primary hepatocyte dysfunction and correlates well to synthetic function,
      and (3) acute occlusion of the arterial supply to the liver graft is associated
      with decreased redox state. However, with intact portal blood flow, it is still
      possible to preserve adequate hepatic synthetic function.

PMID- 1619917
TI  - High energy phosphate depletion in leaflet matrix cells during processing of
      cryopreserved cardiac valves.
AB  - Preimplantation preparation of cardiac valves includes three major steps: (1)
      harvesting with accompanying ischemia (warm time from cessation of donor heart
      beat), (2) antibiotic disinfection, and (3) controlled-rate cryopreservation. To
      define the interdependent injury effects of these manipulations on leaflet matrix
      cells and specifically the potential for prolonged harvest-related ischemia to
      predispose greater injury by the subsequent steps, 96 semilunar valves were
      harvested from pigs in a manner analogous to human heart valve retrievals and
      randomly allocated to study groups as follows: 48 control valves were exposed to
      increasing harvested-related ischemic times, (2, 6, 12, 24 hr) and immersed in
      liquid nitrogen to arrest metabolic activity (i.e., prior to cryopreservation)
      and conclude the ischemia; another 48 were similarly harvested, subjected to
      identical ischemic times, then disinfected in 4 degrees C RPMI medium with
      standard antibiotics for 24 hr and dimethylsulfoxide cryopreserved at -1 degrees
      C/min to -170 degrees C (i.e., formal cryopreservation protocol). At thawing,
      each valve was extracted in 12% trichloroacetic acid and assayed by high
      performance liquid chromatography for components of the adenine nucleotide pool
      including ATP, lower energy nucleotides (total adenine nucleotides, [TAN] = [ATP]
      + [ADP] + [AMP]), adenosine, and the diffusible purines. Results are reported as
      nanomoles metabolite/milligram of leaflet cell protein (Lowry) and reflect a
      maintenance of total high energy phosphates in the control groups (5.41 +/- 0.29
      nmole TAN at 2 hr; 8.34 +/- 0.67 nmole TAN at 24 hr), which fell significantly in
      all cryopreserved groups (1.27 +/- 0.33 nmole TAN at 2 hr; 0.34 +/- 0.22 nmole
      TAN at 24 hr).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619918
TI  - Endotoxin suppresses matrix protein-induced upregulation of PMN candicidal
      activity: an effect reversed by low-dose TNF-alpha.
AB  - We investigated the relationship of polymorphonuclear leukocyte (PMN) candicidal
      activity, matrix proteins, and lipopolysaccharide (LPS) to determine how LPS
      modulates the normal enhancing effect of matrix proteins on PMN candicidal
      activity. LPS reduced PMN candicidal activity when PMN were adhered in the
      presence of either fibronectin or laminin. In the presence of fibronectin or
      laminin, LPS reduced CD11b/CD18 expression (the fibronectin receptor) as assessed
      using sheep erythrocytes coated with C3bi. Experiments with 125I-fibronectin and
      125I-RGDS (Arg-Gly-Asp-Ser) demonstrated that LPS reduced both the binding of
      fibronectin and the bioavailability of the binding epitope on the PMN surface.
      Stimulating the PMN oxidative burst with PMA but not FMLP also reduced
      fibronectin and RGDS binding. Incubation of LPS-treated PMN with staurosporine
      blocked the decrease in fibronectin and RGDS binding. Exposure of PMN to LPS plus
      low-dose TNF-alpha restored both fibronectin and RGDS binding with a concomitant
      increase in CD11b/CD18 surface expression. Low-dose TNF-alpha restored PMN
      candicidal activity in the presence of LPS and was most effective if PMN were
      preadhered to fibronectin. These results demonstrate that: (1) matrix proteins
      enhance normal PMN candicidal activity, (2) LPS reduces PMN candicidal activity
      in the presence of matrix proteins, (3) stimulation of the PMN oxidative burst in
      particular via protein kinase c activation reduces the bioavailability of the
      fibronectin receptor, and (4) low-dose TNF-alpha may restore PMN candicidal
      activity in part by upregulating the surface receptor for fibronectin binding.

PMID- 1619919
TI  - Intestinal blood flow is restored with glutamine or glucose suffusion after
      hemorrhage.
AB  - Intestinal blood flow has been shown to be impaired after resuscitated
      hemorrhagic shock. Enteral feeding has been proposed as an adjunct for preserving
      mucosal integrity and decreasing translocation-related morbidities during stress.
      The purpose of this study was to determine if an ileal mucosal suffusion with an
      isotonic glucose or glutamine solution begun after resuscitation would prevent
      development of this blood flow impairment. The distal ileum of anesthetized
      Sprague-Dawley rats was prepared for in vivo videomicroscopy. Animals were bled
      to 50% of baseline blood pressure for 60 min and then resuscitated with their
      shed blood and an equal volume of lactated Ringer's. After resuscitation was
      complete, the mucosa was suffused with isotonic glucose, glutamine, or saline
      (control). Resuscitation restored cardiac output and mean arterial pressure to
      baseline in all groups; however, first-order arteriolar blood flow remained 50%
      below baseline in the saline group. Glucose-treated animals demonstrated a 34%
      increase over baseline in first-order arteriolar blood flow 120 min after
      resuscitation due to submucosal and previllus arteriolar dilation. This effect
      became evident 30 min after initiating the suffusion, suggesting an effect
      mediated via locally generated vasodilators. Glutamine suffusion attenuated the
      flow impairment by dilation of previllus arterioles but to a lesser degree than
      that observed in glucose-treated animals. These data demonstrate that mucosal
      suffusion with an isotonic glucose solution overrides the residual effects of
      hemorrhagic shock on the intestinal microcirculation and suggest a mechanism for
      preserving mucosal integrity with the addition of glutamine to standard enteral
      formulations.

PMID- 1619920
TI  - In vivo [31P]NMR assessment of early hepatocellular dysfunction during
      endotoxemia.
AB  - Hepatocellular dysfunction, as a result of sepsis or endotoxemia, plays a
      critical role in the pathogenesis of multiple systems organ failure. Conventional
      methods to assay hepatic ATP require large tissue samples, making repeat
      measurements in the same animal impossible, and are unable to detect the minimal
      changes in metabolism consistent with early or reversible cellular injury. 31P
      NMR is a modality available for the in vivo measurement of high energy
      phosphates. Inorganic phosphate (Pi) and phosphomonoester (PME) ratios (markers
      of cellular metabolism and viability) as well as fractionated ATP may be
      repeatedly quantitated. To assess the early effects of endotoxemia on hepatic
      function, phosphorus spectra of the liver were obtained using a 1.7-cm surface
      coil in six rats after the ip administration of 4 mg/kg Escherichia coli
      lipopolysaccharide. Conventional assay was performed on 24 matched controls. Pi,
      PME, alpha-, beta-, and gamma-ATP peaks (expressed as percentage total signal
      area) were collected over 20 min, integrated, and analyzed. Pi/beta-ATP decreased
      over time until 6 hr reflecting ongoing uptake of inorganic phosphate and
      continued cellular metabolism. PME/beta-ATP ratios, which indicate cellular
      viability, became significantly elevated at 6 hr. Using 31P NMR, beta-ATP best
      reflected the early subtle energy changes present prior to cell death and
      subsequent organ failure with significant decreases at 2, 4, and 6 hr.
      Conventional assay for ATP confirmed similar trends. We conclude that 31P NMR is
      a valuable tool for the study of reversible hepatic energy changes during early
      endotoxemia.

PMID- 1619921
TI  - Interleukin 1 beta improves survival following cecal ligation and puncture.
AB  - Despite antibiotic therapy intra-abdominal sepsis following major surgery is a
      significant cause of mortality. We sought to determine if interleukin-1 beta (IL
      1) could improve survival in a murine model of intra-abdominal infection. Groups
      of 10 BDF1 mice received a single subcutaneous (sc) injection of recombinant
      human IL-1 beta 24 hr prior to cecal ligation and puncture (CLP) and were
      assessed twice daily for survival. Mice that received a single injection of IL-1
      beta 24 hr prior to CLP had a dose-dependent improval in survival compared to
      controls. The beneficial effect of IL-1 treatment may have been related to its
      ability to stimulate myelopiesis. The addition of indomethacin, in an effort to
      limit possible toxicity of IL-1, did not further improve survival. Appropriate
      timing of specific immunomodulators may provide an additional strategy for the
      treatment of infections.

PMID- 1619922
TI  - Lymphocyte migration to tumors after hyperthermia and immunotherapy.
AB  - We have previously shown that the combination of immunotherapy with interleukin 2
      (IL-2) and local hyperthermia (LHT) abrogates the growth of murine subcutaneous
      tumors significantly more than either modality alone. This study was undertaken
      to investigate whether the beneficial effect of combined modality therapy could
      be attributed to increased trafficking of effector cells to the tumor. After
      inducing MCA-105 sarcomas in the hindlimbs of C57BL/6 mice, animals were given no
      therapy, LHT, IL-2, or IL-2 + LHT followed by an iv injection of 51Cr-labeled
      syngeneic splenocytes or LAK cells. Select organs and the tumor-bearing extremity
      were counted in a gamma counter. IL-2 or LHT alone did not affect lymphocyte
      migration, while IL-2 + LHT significantly decreased trafficking (P less than
      0.001) to the tumor. LAK cells showed increased migration to the tumor site
      compared to splenocytes in all treatment groups (P less than 0.02). IL-2 caused
      increased migration of LAK cells but not splenocytes to the lung; this was not
      affected by LHT. LAK cell trafficking to the spleen was decreased by IL-2 and IL
      2 + LHT, while splenocyte migration was decreased in the LHT and combined
      treatment groups. LHT and IL-2 had no effect on trafficking of either effector
      cell type to liver or kidney. These results show that the beneficial effect of
      combined modality therapy may not be due to increased trafficking of lymphocytes
      to the tumor area. In addition, LAK cells traffic more to subcutaneous tumors
      than splenocytes, and this cannot be explained by the differential trafficking to
      other organs. The results of this study will be important in the planning of
      future experiments with combined adoptive immunotherapy and hyperthermia.

PMID- 1619923
TI  - The reduction of health care costs associated with alcoholism treatment: a 14
      year longitudinal study.
AB  - This study utilized two separate research designs to examine whether the
      initiation of alcoholism treatment is associated with a change in overall medical
      care cost in a population of alcoholics enrolled under a health plan sponsored by
      a large midwestern manufacturing corporation. In the longest longitudinal study
      of alcoholism treatment costs to date, a review of claims filed from 1974 to 1987
      identified 3,729 alcoholics (3,068 of whom received treatment and 661 of whom did
      not). In one design, a time-series analysis found that following treatment
      initiation the total health care costs of treated alcoholics--including the cost
      of alcoholism treatment--declined by 23% to 55% from their highest pretreatment
      levels. Costs for identified but untreated alcoholics rose following
      identification. In a second design, analysis of variance was used to control for
      group differences including pretreatment health status and age. This analysis
      indicated that the posttreatment costs of treated alcoholics were 24% lower than
      comparable costs for untreated alcoholics. The study provides considerable
      evidence that alcoholism treatment can reduce overall medical costs in a
      heterogeneous alcoholic population (white collar/blue collar; fee-for
      service/HMO).

PMID- 1619924
TI  - Drinking among homeless and marginally housed adults in New York State.
AB  - The drinking patterns of 412 homeless and marginally housed adults in New York
      State are described, and compared with 5,952 domiciled adults. The homeless and
      marginally housed persons interviewed were randomly selected from a
      representative group of public shelters and low-price hotels in New York City and
      upstate New York. They showed transience in their sleeping arrangements, and in
      recent months many had slept with friends or in public places. They are
      disproportionately male (71%), aged 18-34 (61%) and black or Hispanic (74%). Many
      of the homeless and marginally housed are abstainers (40%, as opposed to 26% in
      the state as a whole), but a startling 13% drink more than 20 drinks a day, as
      opposed to less than 1% in the state as a whole. They also reported high rates of
      dependence signs such as blackouts or loss of control. Among the homeless and
      marginally housed, heavy drinking is higher among men than women, and higher
      among blacks than whites or Hispanics. For homeless and marginally housed men,
      those with the poorest sleeping arrangements (e.g., slept in public places) have
      higher rates of heavy drinking. A causal model supports the hypothesis that, for
      a minority of the homeless, drinking is a contributory cause of their
      homelessness.

PMID- 1619925
TI  - Recruiting a community sample of adolescent children of alcoholics: a comparison
      of three subject sources.
AB  - Although there has been substantial research interest in adolescent children of
      alcoholics, the generalizability and consistency of previous findings have been
      limited by the specialized nature of the research samples (e.g., treatment
      samples, school-based samples). However, attempting to address this problem by
      recruiting subjects from community sources raises a variety of sampling issues,
      including the comparability and accessibility of subjects from different sources.
      This article compares the recruitment rates and characteristics of families
      enrolled from three sources--DUI records, HMO records and telephone surveys.
      Implications for research on children of alcoholics are discussed.

PMID- 1619926
TI  - Familial alcoholism and premorbid cognitive deficit: a failure to replicate
      subtype differences.
AB  - Recent evidence suggests that offspring of alcoholics are heterogeneous in many
      areas of functioning. This study focuses on extending our understanding of the
      vulnerability and resilience of young adults with a positive family history of
      alcoholism (FH+) within the domain of neurocognitive functioning. Specifically,
      we test the hypothesis that cognitive vulnerability is linked to genetic pedigree
      by systematically examining a broad range of cognitive abilities in several
      distinct family history subtypes represented by alcoholism on the part of a first
      degree relative only, a second-degree relative only, or both a first- and second
      degree relative. Compared to an age-matched control group with no family history
      of alcoholism (FH-), FH+ subjects, on the average, reported somewhat less formal
      education than did FH- subjects. However, no substantive differences in cognitive
      functioning were obtained among any family history subtypes. Nor were any
      predicted yet nonsignificant trends in the ordering of mean cognitive performance
      levels observed across groups. These results strongly suggest that cognitive
      deficits do not generally obtain in community samples of premorbid FH+ subjects,
      and, further, that specific genetic pedigrees, as defined in this study, do not
      contribute to variability in neuropsychological functioning. A typological
      approach wherein subtypes of FH+ individuals are defined multidimensionally may
      be necessary to capture sources of neurocognitive vulnerability in premorbid
      offspring.

PMID- 1619927
TI  - Laboratory evaluation of two passive alcohol sensors.
AB  - Passive alcohol sensors are screening devices designed to sample nonintrusively
      the exhaled breath of a person to determine whether or not it contains alcohol
      and if so approximately how much. Two production passive alcohol sensors (NPAS
      passive alcohol sensor and the Life-Loc PBA 2000) were evaluated in a laboratory
      environment to establish appropriate threshold measurements that indicate
      probable alcohol impairment. The laboratory evaluation was conducted using both
      instrument types with 12 drinking subjects. Both sensors were able to identify
      alcohol in exhaled breath with sufficient accuracy to identify persons with high
      blood alcohol concentrations (BACs). The accuracy of both sensors was related to
      the distance from the subject's mouth: the further away they were from a
      subject's mouth the greater the chance that high BACs would not be detected.
      Under ideal conditions, it was estimated that the Life-Loc sensor could be
      expected to correctly detect 80% of drivers at 0.10% BAC (99% at 0.15% BAC) as
      being impaired while incorrectly identifying only about one in eight drivers with
      BACs of 0.02% (false positives). In comparison, the NPAS sensor could be expected
      to correctly detect about 75% of drivers at 0.10% BAC (97% at 0.15% BAC) while
      incorrectly identifying one in five drivers at 0.02% BAC.

PMID- 1619928
TI  - Convicted impaired drivers and high-risk drivers: how similar are they?
AB  - The present study was a partial replication of one by D.M. Donovan (1980).
      Donovan's results indicated that convicted impaired drivers (DWIs) and high-risk
      drivers were overlapping populations with shared deviant characteristics. The
      present study, like Donovan's, compared three types of drivers: DWI, high-risk
      (either high-accident or high-violation) and general population control. Unlike
      Donovan, the present study attempted to match the age and sex distributions of
      the groups. Data were obtained from personal interviews and driver records. The
      DWI group was the most deviant on behavioral and personality measures and had
      more accidents and traffic convictions than did controls. High-risk drivers were
      more deviant than controls on several measures but the two groups were quite
      similar in other respects. The results suggest that some of the deviance
      attributed to high-risk drivers by Donovan may have been exaggerated by
      confounding with age. Secondly, the heterogeneity within the DWI and high-risk
      driving populations appears to outweigh their differences.

PMID- 1619929
TI  - Variability in behavioral impairment involved in the rising and falling BAC
      curve.
AB  - The purpose of this pilot study was to measure variability in behavior impairment
      at specific levels of the rising and falling blood alcohol concentration (BAC)
      curve. Behavior impairment was measured for anticipation and reaction time in
      addition to a variety of visual skills. Also of interest was the variability in
      impairment involved at specific BAC levels under single-dose and double-dose
      conditions. The experimental design was a variation on a 2 x 2 factorial with
      repeated measures on the dose of alcohol. All subjects took part in two
      experimental sessions, single-dose and double-dose. Sixteen (8 male and 8 female)
      paid subjects ages 21-40 participated in the study. Testing procedures included
      repeated measures on reaction time, anticipation time, perceptual vision acuity
      and depth perception. Breath-alcohol measures were sampled continuously at 5
      minute intervals and used to plot absorption time, peak BAC and elimination time.
      Results showed that the average peak BAC for the double-dose was significantly
      higher than that of the single-dose condition. However, there were no significant
      differences between the single-dose and double-dose condition in either
      absorption time or elimination time. The performance pattern for reaction time,
      anticipation time and depth perception showed more impairment in the rising BAC
      limb than in the falling BAC limb. It is noteworthy that specific individuals
      exhibited different levels of impairment at a given BAC level, depending on
      whether the session was single- or double-dose, suggesting that one's current BAC
      level is less a measure of impairment than is the total quantity of alcohol
      consumed. A follow-up procedure to examine practice effects was conducted on
      eight volunteer students. Identical testing procedures, using no alcohol,
      produced no significant practice effects after a 3-hour period.

PMID- 1619930
TI  - Combat-related posttraumatic stress disorder and severity of substance abuse in
      Vietnam veterans.
AB  - This study examined the effects of Vietnam war-zone duty and combat-related
      posttraumatic stress disorder (PTSD) on severity of drug- and alcohol-abuse
      disorders among veterans seeking treatment for substance dependence. Combat
      exposed Vietnam-theater veterans (N = 108) were compared with Vietnam-era
      veterans without war-zone duty (N = 151) on psychometric measures of drug and
      alcohol abuse. There were no differences between theater and era veterans on
      these measures. However, Vietnam-theater veterans with PTSD experienced more
      severe drug- and alcohol-abuse problems than did theater veterans without PTSD
      and were at greater risk for having both forms of substance abuse. Further
      analyses showed that PTSD was significantly related to some dimensions of drug-
      and alcohol-abuse problems but not to other dimensions. These findings indicate
      that PTSD, rather than combat stress per se, is linked to severity of substance
      abuse. Finally, reexperiencing and avoidance/numbing components of PTSD were more
      strongly associated with drug abuse than alcohol abuse, but physiological arousal
      symptoms of PTSD were more highly correlated with alcohol abuse.

PMID- 1619931
TI  - The effect of acculturation on drinking attitudes among Japanese in Japan and
      Japanese Americans in Hawaii and California.
AB  - Data from a joint Japan-U.S. collaborative study were examined to determine the
      relationship of acculturation to drinking attitudes among Japanese in Japan and
      Japanese Americans in Hawaii and California. Drinking attitudes (i.e., self
      reported acceptable or appropriate levels of drinking) among ethnic groups
      differed significantly for the nine situations studied: (1) at a bar with
      friends, (2) at a party at someone else's house, (3) as a parent, spending time
      with small children, (4) during working hours, (5) visiting in-laws, (6) with
      friends at home, (7) with friends after work, (8) with people at sports events
      and (9) before driving a car. Factor analysis was used to determine the
      differences in drinking attitudes among these ethnic groups. Japanese and
      Japanese Americans differentiated drinking situations into different categories.
      The major difference between the two groups was that the Japanese associated
      spending time with small children with a situation appropriate for drinking, such
      as being with friends at home, whereas Japanese Americans associated spending
      time with small children with a situation inappropriate for drinking, such as
      before driving.

PMID- 1619932
TI  - Cardiac responsivity in individuals at high risk for alcoholism.
AB  - Heart rate was recorded from male siblings over the age of 30 who were members or
      either alcoholic or control families. Brothers from alcoholic families included
      both those with a diagnosis of alcoholism (n = 66) and those without such a
      diagnosis (n = 18). Control brothers (n = 33) were chosen for absences of any
      Axis I psychopathology including alcoholism in all first- and second-degree
      relatives. Subjects were engaged in two auditory tasks. All subjects were
      presented with high- and low-pitched tones with varying probabilities. In the
      first task (counting), subjects were told to count only the number of high tones.
      In the second task (choice reaction), subjects were asked to perform a simple
      motor response to each high or low tone. Prestimulus levels, anticipatory
      deceleration and acceleration were compared between the three groups. All members
      of the affected families, whether alcoholic themselves or not, were found to have
      a significantly higher baseline heart rate than members of control families. In
      addition, differences in the anticipatory deceleration were greater in control
      brothers than in brothers from the affected families for the counting task.

PMID- 1619933
TI  - Detection of the relationship between moderate alcoholic beverage consumption and
      serum levels of estradiol in normal postmenopausal women: effects of alcohol
      consumption quantitation methods and sample size adequacy.
AB  - The purpose of this study was to evaluate the detectability of an effect of
      moderate alcoholic beverage consumption on the biologic correlate of
      postmenopausal estradiol levels. Total weekly consumption and beverage-specific
      intake were assessed using both self-reported usual consumption information and
      prospective food record data. In terms of total weekly drinks, discrepancies were
      observed in 35 of the 101 women who reported alcohol use; no consistent pattern
      of overreporting/underreporting was seen. Although the two alcohol estimates were
      highly correlated, the relationship between estradiol levels and total weekly
      alcohol intake was found to be detectable when alcohol consumption based on the
      food record data was analyzed, but not when the self-report data were examined in
      a two-tailed hypothesis-testing situation. Evaluating the association between
      postmenopausal estradiol levels and the two estimates of alcohol intake in random
      samples of varying sample sizes generated from the mother population of 128
      normal postmenopausal women confirmed the finding that the prospectively obtained
      alcohol data better predict the relationship. Based on the results of this study,
      it must be concluded that self-reported usual alcohol consumption data must be
      used with caution when examining an association between alcohol intake and a
      biologic effect.

PMID- 1619935
TI  - Adjuvant immunotherapy in melanoma: a new approach.
AB  - Patients with metastatic cutaneous melanoma to two or more regional lymph nodes
      have an extremely poor prognosis despite radical lymphadenectomy. In an attempt
      to improve the survival and to determine the safety of a new method of tumor
      specific adjuvant immunotherapy in such a high risk group of patients, nine
      patients were studied. Three to four weeks after regional lymphadenectomy, each
      of them received a single intradermal injection of Bacillus Calmette-Guerin.
      Three weeks later, they were immunized by allogenic melanoma cells obtained from
      live donors with distant metastases. Each patient received three vaccinations,
      each from a different donor (except in one), to avoid development of HLA
      response, but maintaining exposure to melanoma antigens. No cultured melanoma
      cells were used. Each vaccine consisted of mitomycin-C treated tumor cells mixed
      with purified protein derivative (PPD) of tuberculin given intradermally once per
      month for 3 months. The patients were then observed with no further treatment.
      Utilizing the leukocyte migration inhibition test, there was some in vitro
      evidence of tumor specific cell mediated response which seemed to disappear 1-2
      months postimmunization. At 5 years, five of the nine patients (55%) were alive
      free of disease. No autoimmune diseases were detected in any of the immunized
      patients. A major hindering factor for such an approach was the limited
      availability of the allogenic melanoma cells.

PMID- 1619934
TI  - Primary malignant tumors of the small intestine: analysis of 40 Japanese
      patients.
AB  - Forty Japanese patients with primary malignant tumors of the small intestine were
      reviewed. Adenocarcinoma was the most common tumor type comprising 19 patients
      (47%), followed by malignant lymphoma, 11 (30%), leiomyosarcoma, 8 (20%) and
      carcinoid tumor, 1 (3%). Adenocarcinomas and leiomyosarcomas were primarily
      located in the duodenum or jejunum, whereas lymphomas were more common in the
      jejunum or ileum. Abdominal pain (65%) and nausea or vomiting (35%) were the most
      common symptoms with these tumors. Barium contrast studies were able to detect
      83% of these tumors. Our results also suggest that computed tomography and
      ultrasonography are not reliable for diagnosing jejunal tumors while superior
      mesenteric angiography is effective for diagnosing ileal tumors. The duodenal and
      ileal tumors tended to metastasize to lymph nodes while jejunal ones tended to
      penetrate the serosa or to disseminate into the peritoneal cavity. The percentage
      of tumors potentially cured by surgery and the 5 year survival rates of the
      leiomyosarcomas (75% and 57%, respectively) were higher than those of
      adenocarcinomas (42% and 10%, respectively) and lymphomas (42% and 32%,
      respectively).

PMID- 1619936
TI  - Functional results following esophagogastrectomy for carcinoma of the esophagus.
AB  - Fifty patients underwent esophagogastrectomy for histologically proven carcinoma
      of the esophagus from January to December 1989. The Ivor Lewis procedure was
      performed in 29 patients and 21 resections were performed by a left
      thoracoabdominal approach. There was one anastomotic leak which could not be
      salvaged and was responsible for the sole mortality within 30 days of surgery.
      The hospital stay averaged 12 days, ranging from 8-26 days. Swallowing was
      resumed by the 6th postoperative day for liquids and 8th day for soft solids.
      Following surgery, 5 patients developed dysphagia, 4 of whom responded to
      dilatation. The anastomosis was hand sutured in all cases except one. The suture
      material used had no relation to the incidence of leak or stricture formation.
      Eight patients complained of reflux that settled with medical management. Most
      patients were eating without dysphagia at the last follow-up or death.
      Esophagogastrectomy can be performed with a low morbidity and mortality and
      provides adequate palliation of the patient's most distressing symptom,
      dysphagia.

PMID- 1619937
TI  - Comparison of flow cytometric DNA content in primary gastric carcinoma and
      metastases.
AB  - Nuclear DNA contents were comparatively determined by flow cytometry in primary
      and metastatic lesions from 112 cases with stomach cancer. Aneuploidy frequency
      and mean DNA index were higher in lymph node metastatic lesions than in primary
      lesions, both resected synchronously. In these lymph node metastatic lesions, DNA
      ploidy patterns did not change in 79% (89/112 cases), and did change in 21%
      (23/112 cases). Concordance of the DNA index between primary lesions and
      synchronous liver metastatic lesions was seen in 63% (5/8 cases), but the
      concordance rate was only 25% (4/16 cases) for primary lesions and metachronous
      liver metastatic lesions and 0% (0/8) for primary lesions and lung metastases.
      DNA ploidy changes in metastatic lesions were marked in distal metastatic
      lesions, or more marked in metachronous metastases than in synchronous ones. The
      results of the present study suggested the possibility of detecting changes in
      biological characteristics of metastatic lesions by flow cytometric DNA analysis.

PMID- 1619938
TI  - Substituting ornithine for arginine in total parenteral nutrition eliminates
      enhanced tumor growth.
AB  - Total parenteral nutrition (TPN) may enhance the growth of some tumors: this
      enhanced growth is associated with an increase in the erythrocyte polyamine
      levels. The effect of arginine in TPN on tumor growth was compared with ornithine
      using rats with a transplantable Ward colon tumor. The relationship of
      circulating arginine, ornithine, glutamine, and polyamines with tumor growth was
      investigated. For rats fed chow ad libitum, increasing tumor weights were
      associated with a linear decrease in the plasma arginine levels which was
      consistently lower than that of age-matched non-tumor bearing (NTB) rats;
      ornithine and lysine levels were not affected. Subsequent experiments suggest
      that plasma glutamine levels were also lower in tumor bearing rats. Pair-fed NTB
      rats had reduced arginine but not glutamine levels in plasma. TPN regimens with
      arginine or with ornithine substituted for arginine at two levels (equimolar [Orn
      Em] or isonitrogenous [Orn-IN]) were given to colon tumor bearing rats for 8
      days. The final tumor weight of rats which received the arginine-containing
      regimen (19.8 +/- 5.7 g, n = 4) (P less than 0.05) was significantly greater than
      the tumor weight of rats fed chow ad libitum (12.1 +/- 3.3 g, n = 6). The final
      tumor weights of Orn-EM (11.2 +/- 2.6 g, n = 4) or Orn-IN (11.6 +/- 0.8 g, n = 6)
      were similar to the chow-fed controls. The plasma arginine levels were elevated,
      compared with the control, when arginine was present in the regimen. The plasma
      arginine levels of rats which received Orn-EM or Orn-IN were lower than the
      controls. The plasma ornithine levels were not affected by arginine in the
      regimen but were elevated with increasing levels of ornithine in TPN. Plasma
      glutamine levels were decreased when arginine was present in the regimen but were
      elevated when ornithine was substituted for arginine. Erythrocyte putrescine was
      increased when either arginine or ornithine was included in the TPN regimens.
      These results demonstrate that while arginine in a parenteral regimen stimulates
      tumor growth, substituting ornithine for arginine in TPN does not enhance the
      growth of a transplantable colon tumor.

PMID- 1619939
TI  - Prognostic significance of DNA measurement determined by image analysis in human
      breast carcinoma.
AB  - The nuclear DNA of human breast carcinoma cells was studied by image analysis
      using archival paraffin-blocked tissues from two groups of patients with breast
      cancers. One group had survived greater than 10 years (N = 20) and the other less
      than 3 years (N = 26) after the initial diagnosis. Cellular preparations were
      made from pepsin-digested deparaffinated sections. The nuclear DNA was stained
      with Feulgen stain and measured by a computerized image analysis system. The data
      show that in addition to nodal status the pattern of DNA histograms obtained from
      image analysis can provide powerful prognostic information in breast carcinoma.
      The prognostic value of DNA histogram patterns may be independent of nodal
      status.

PMID- 1619940
TI  - Biodistribution of monoclonal antibody A7 and its F(ab')2 fragment in athymic
      nude mice bearing human pancreatic carcinoma.
AB  - Xenografts of a human pancreatic carcinoma cell line, HPC-YS, which reacted with
      the monoclonal antibody (MAb) A7, were used to investigate the in vivo
      localization of radioiodinated MAb A7 after intraperitoneal injection. MAb A7
      localized to the tumor 4 days and 8 days after injection with a tissue/blood
      ratio of 1.45 +/- 0.18 and 2.04 +/- 0.20, respectively. The accumulation of MAb
      A7 in the tumor was 5%/g and 3.3%/g of the injected dose on day 4 and on day 8,
      respectively. In contrast, the F(ab')2 fragment of MAb A7 localized to the tumor
      4 days after intravenous injection with a tissue/blood ratio of 14.2. The
      accumulation of the F(ab')2 fragment in the tumor was 1.2%/g of the injected
      dose. These results suggested that MAb A7 might be a suitable carrier of
      anticancer drugs for immunotargeting chemotherapy and that the F(ab')2 fragment
      might be potentially useful for the immunodetection of human pancreatic
      carcinomas.

PMID- 1619941
TI  - Cancer of the esophagus in young adults.
AB  - Clinicopathological features and survival data of squamous cell carcinoma of the
      esophagus were analyzed from the viewpoint of age differences in 453 patients
      treated at the Tata Memorial Hospital, Bombay, India. Two groups were studied:
      group A, aged 35 years or less; and group B, aged above 35 years. There was no
      significant difference among the two groups with regard to sex distribution, site
      and length of the tumor, operability, morphology, histological grade, vascular
      and lymphatic invasion, and lymph node metastasis. The primary lesion was more
      advanced and the rate of incomplete resections was higher in younger patients.
      The incidence of cardiopulmonary complications and postoperative deaths was
      significantly lower in younger patients. Recurrence of the disease following
      complete resection was more frequent in the younger age group (chi 2 = 2.61; P =
      .1063), although the pattern of recurrence remained the same in both groups.
      Disease-free survival in younger patients following complete resection of the
      tumor was poorer as compared to the older patients, but the difference is
      statistically not significant (chi 2 = 1.882; P = .1701). These findings suggest
      either a delayed diagnosis or a biologically sinister disease in the younger
      group; further studies of the two groups vis-a-vis their biologic parameters (DNA
      ploidy, etc.) are in progress and will form the subject of another communication.

PMID- 1619942
TI  - Serum squamous cell carcinoma antigen levels in invasive squamous vulvar cancer.
AB  - Squamous cell carcinoma (SCC) antigen levels were studied in 34 patients with
      primary (N = 27) or recurrent (N = 7) SCC of the vulva. In primary disease, the
      SCC antigen level was greater than 2.5 ng/ml in only four patients (15%).
      Elevated antigen levels ranged from 2.7-18.0 ng/ml. All of these patients had
      advanced disease by either clinical or surgical staging systems. Four of twelve
      patients with inguinal metastasis had elevated SCC antigen levels. In two of
      these patients the inguinal nodes were abnormal to palpation. No association of
      the SCC level and the degree of tumor differentiation was observed. SCC antigen
      levels were increased slightly (2.7-4.5 ng/ml) in three of six patients with
      locally recurrent disease. In one patient with distant recurrence the SCC antigen
      was 15.3 ng/ml. In both primary and recurrent disease all elevated SCC antigen
      levels decreased with effective therapy. Vulvar cancer is primarily a local
      disease that is easily assessed by physical examination. An effective tumor
      marker in vulvar cancer would benefit only the rare patient with distant but not
      local disease.

PMID- 1619943
TI  - A trial of adjuvant chemoimmunotherapy with mitomycin C and OK-432 for stage III
      gastric carcinoma.
AB  - We previously found that the ability to generate cytotoxic cells induced by in
      vitro activation of peripheral blood mononuclear cells (PBM) with OK-432, a
      bacterial immunopotentiator, was markedly increased following intravenous
      administration of a single dose of mitomycin C (MMC) in cancer patients. On the
      basis of this clinical finding, we designed a treatment regimen that consisted of
      MMC 12 mg/m2 intravenously on day 1 and OK-432 5 Klinische Einheit (KE)
      intradermally on days 6, 8, and 11, when the generation of OK-432 activated
      killer cells had been shown to be significantly augmented. Then, it was followed
      by long-term tegafur. Fifteen patients with stage III gastric carcinoma who had
      undergone curative resection were treated with the above regimen. The survival of
      these patients was significantly better than that of 26 comparable stage III
      patients concurrently treated with MMC 12 mg/m2 alone, followed by long-term
      tegafur (P less than 0.01). The results indicate that OK-432 combined with MMC
      may be effective against stage III gastric carcinoma, when these agents are used
      probably in an appropriate combination.

PMID- 1619944
TI  - Schedule dependent inhibition of thymidylate synthase and tumor growth by 5
      fluorouracil in Yoshida sarcoma bearing rats.
AB  - Schedule dependent inhibition of thymidylate synthase (TS) and tumor growth by 5
      fluorouracil (FUra) was examined in Yoshida sarcoma (YS) bearing Donryu rats.
      After implantation of YS cells (1 x 10(4), FUra (20 mg/kg/day) was continuously
      (group C) or daily bolus injection (group B) administered for 6 days. On day 7,
      tumor weight was 1.57 +/- 0.58 g in group C and 0.45 +/- 0.10 g in group B (P
      less than 0.01), free TS was 2.23 +/- 83 fmol/mg protein in group B and 96 +/- 55
      fmol/mg protein in group C (P less than 0.05), and inhibition rate of TS was 88.3
      +/- 5.3% in group C and 94.7 +/- 3.0% in group B (P less than 0.05). A
      significant correlationship was found between free TS and tumor weight (P less
      than 0.05). As the next step, continuous infusion (group C) or daily bolus
      injection (group B) for 6 days was started on day 5 after implantation of YS
      cells. The relative increase of tumor on day 9 was 256 +/- 111% in group C and
      112 +/- 22.1% in group B (P less than 0.05). On day 11, total TS of the resected
      tumor was 650 +/- 153 fmol/mg protein in group C and 391 +/- 124 fmol/mg protein
      in group B (P less than 0.05), and inhibition rate of TS was 78.8 +/- 12.4% in
      group C and 84.4 +/- 8.6% in group B. Daily bolus injection of FUra causes a
      superior antitumor and antimetabolic effect. The schedule dependent cytotoxicity
      of FUra should be taken into account when a chemotherapeutic protocol is
      designed.

PMID- 1619945
TI  - Adenocarcinoma of the urachus.
AB  - During the past 5 years, three patients with adenocarcinoma of the urachus were
      treated at our hospital. Abdominal ultrasonography helped clinch the diagnosis in
      all cases. All patients underwent surgical excision of the neoplasm with partial
      cystectomy. The clinical, radiological, and histological findings, as well as the
      pathogenesis of this rare neoplasm are discussed along with the surgical
      management.

PMID- 1619946
TI  - Thyroid and thymic malignancy following childhood irradiation.
AB  - Synchronous thyroid and thymic malignancy following childhood thymic irradiation
      has only been reported in two known cases previously, with a third case
      identified here. A rationale is presented for following these radiated patients
      as they age with thyroglobulin and thyroid-stimulating hormone (TSH) levels as a
      measure of risk of the development of nodular thyroid disease and, if such
      occurs, for an aggressive surgical approach. There exists a growing population at
      risk attributable to the success of radiation treatment of Hodgkin's and
      pediatric head and neck tumors. The question is raised regarding the theoretical
      benefits of thyroid suppressive therapy in this group at risk. With the
      instructive case presented, radical surgery for either thymic or thyroid
      carcinoma and careful monitoring for decades-late local recurrences of thymoma
      are suggested.

PMID- 1619947
TI  - Variability of HIV infections.
AB  - Genetic variation is the hallmark of infections with lentiviruses in general and
      the human immunodeficiency viruses (HIV-1, HIV-2) in particular. This article
      reviews both experimental evidence for the variability of the HIV genome during
      the course of an individual infection and mathematical models that outline the
      potential importance of antigenic variation as a major factor to drive disease
      progression. The essential idea is that the virus evades immune pressure by the
      continuous production of new mutants resistant to current immunological attack.
      This results in the accumulation of antigenic diversity during the asymptomatic
      period. The existence of an antigenic diversity threshold is derived from the
      asymmetric interaction between the virus quasispecies and the CD4 cell
      population: CD4 cells mount immune responses some of which are directed against
      specific HIV variants, but each virus strain can induce depletion of all CD4
      cells and therefore impair immune responses regardless of their specificity.
      Therefore, increasing HIV diversity enables the virus population to escape from
      control by the immune system. In this context the observed genetic variability is
      responsible for the fact that the virus establishes a persistent infection
      without being cleared by the immune response and induces immunodeficiency disease
      after a long and variable incubation period. Mathematical biology has revealed a
      novel mechanism for viral pathogenesis.

PMID- 1619948
TI  - A selection model to estimate the interaction between food particles and the post
      canine teeth in human mastication.
AB  - Food comminution during chewing is the composite result of selection and
      breakage. In the selection process, every food particle has a chance of being
      placed between the antagonistic post-canine teeth and being subjected to
      subsequent breakage. The selection chance, being the ratio between the number of
      selected and offered particles, has been mathematically described as a function
      of the number of particles offered, in terms of the number of breakage sites
      available on the teeth and particle affinity, i.e. the fraction of breakage sites
      occupied by one particle. The assumption has been made that particles are
      successively selected during a jaw-closing phase and that the selection chance of
      subsequent particles having the opportunity to occupy a breakage site
      proportionally decreases with the unoccupied fraction of the breakage sites left.
      The number of selected particles of a single size then asymptotically approaches
      the total number of breakage sites available for that size, when the number of
      particles offered increases. The critical particle number, derived from the
      measure of particle affinity, indicates the number of particles by which the
      breakage sites become saturated. The selection model for single particle sizes
      has been successfully applied to describe one-chew experiments, using various
      numbers and sizes of particles made of a silicone-rubber. After pseudo-chewing
      movements the subjects were unexpectedly instructed to carry out a real chew on
      particles (half-cubes). Undamaged, hence non-selected half-cubes could afterwards
      be distinguished from broken particles. The model has been extended to a particle
      mixture to describe the selection of particles of a certain size while other
      particles of different sizes are present. If a two-way competition between
      smaller and larger particles is assumed, the model predicts that the ratios of
      the selection chances between different particle sizes do not depend upon the
      numbers of the particles in the mixture.

PMID- 1619949
TI  - The hypothesized hormonal control of mammalian sex ratio at birth--a second
      update.
AB  - Further evidence is adduced to support the hypothesis that the sexes of mammalian
      (including human) offspring are partially controlled by parental hormone levels
      at the time of conception. The evidence relates to variation of sex ratios at
      birth with (1) time of insemination within the cycle of several species, (2)
      excision of accessory sex glands in rodents, (3) occupation of parents, (4)
      dominance rating of human mothers and (5) the ordinal rank of wives in polygynous
      marriages. Much medical research will stem from the hypothesis if it proves to be
      true. (a) If it were, there would be implications for the testing of causes of
      many diseases: and it is noted here that the sex ratios of offspring of victims
      of two types of cancer (prostatic cancer and non-Hodgkin's lymphoma) are
      consistent with the suspected causes of these diseases. (b) There are a large
      number of rheumatic diseases associated with the HLA markers B 27 and B 8. These
      markers are apparently associated respectively with high testosterone levels in
      men and low testosterone levels in women. If these finding should be confirmed, a
      causal role for this hormone seems likely in some of these diseases. It will be
      interesting to examine sex ratios of relatives of probands with these diseases.

PMID- 1619950
TI  - An application of maximum entropy techniques to determine homogeneous sets of
      nucleotidic sequences.

PMID- 1619951
TI  - Computer modeling of gibberellin-DNA binding.
AB  - Computer modeling and molecular mechanics performed on the intercalation
      complexes of selected gibberellins or biosynthetic precursors with DNA
      dinucleotides revealed that under appropriate conditions the ligands insert
      (intercalate) between the base-paired double-stranded dinucleotide, 5'-dTdA-3'.
      Stabilization of the double-stranded dinucleotide after docking of a gibberellin
      between base pairs is inferred by the sum negative energy of hydrogen bonding and
      van der Waals contacts and the entropic changes which accompany the formation of
      each ligand-dinucleotide complex. In addition, the interactions of the
      gibberellins and dinucleotides, with the gibberellic acid-dinucleotide complex
      serving as the prototype, show optimum geometry and stereochemical hydrogen
      bonding recognition which are dependent upon the complementary chirality and
      stereochemistry of the individual components. Whether or not the gibberellins
      directly influence the uncoiling of DNA or gene expression at the transcriptional
      level via an intercalation mechanism is a matter of conjecture, albeit one that
      warrants intensive investigation.

PMID- 1619952
TI  - Models of interactions between HIV and other pathogens.
AB  - We investigate possible interactions between HIV and other pathogens that would
      arise if HIV replication were enhanced by the activation of T helper cells
      specific to other pathogens. Using mathematical models of the population dynamics
      of T helper cells, HIV and other pathogens we address three facets of the
      interactions between HIV and other pathogens: enhanced HIV replication due to
      immune stimulation by other pathogens; modified immune control of other pathogens
      due to immunosuppression by HIV; and the vicious circle formed by positive
      feedback between these two effects. The models predict that there is a
      correlation between higher levels of activated TH cells and disease progression
      and that there is a threshold number of activated TH cells above which the HIV
      infected immune system is unable to control pre-established pathogens. This
      threshold marks the boundary between a suppressed but still functioning immune
      system and the vicious circle of CD4 cell depletion that marks the final stages
      of AIDS.

PMID- 1619953
TI  - Markovian processes in aneuploids: I. Diploid populations.
AB  - The case of diploid selfing organisms which present monosomy and nullisomy for a
      certain pair of homologous chromosomes is considered. Three cases of dominance
      for fitness (i) no dominance, (ii) complete dominance and, (iii) overdominance
      are considered. Expressions for the average, coefficient of variation and
      coefficient of asymmetry for distribution which represent the number of
      generations needed to reach an absorbing state for a process which begins in a
      transient state are obtained. Expressions for the parameters are from by the
      application of Markov's theory of chains which was developed by Kemeny & Snell
      (1960, Finite Markov Chains, Princeton, NJ: Van Nostrand) and Bosso et al. (1969,
      Biometrics 22, 17-26).

PMID- 1619954
TI  - Non-planar structure of nitrous bases and non-coplanarity of Watson-Crick pairs.
AB  - We discuss the non-planar structural stability of the NH2-group in formamide,
      cytosine, adenine, guanine and aniline molecules. Based on the microwave data
      available on small amino derivatives and on the results of PCILO conformation
      study it is shown that the slope of the amino group HNH plane to the molecular
      plane in nitrous bases should be close to 40 degrees. One of the main
      consequences of the non-planar structure of bases is a comparatively large
      (approximately equal to 15 degrees) propeller twisting of purine and pyrimidine
      planes in the complementary adenine-thymine and guanine-cytosine pairs. It is
      concluded that the non-coplanarity of single Watson-Crick base pairs is their
      intrinsic property. The specificity of hydrogen bonding in pairs along with
      stacking is believed to be the original cause of their peculiar packing in
      crystals and in DNA and RNA structures.

PMID- 1619955
TI  - Pattern formation in one- and two-dimensional shape-space models of the immune
      system.
AB  - A large-scale model of the immune network is analyzed, using the shape-space
      formalism. In this formalism, it is assumed that the immunoglobulin receptors on
      B cells can be characterized by their unique portions, or idiotypes, that have
      shapes that can be represented in a space of a small finite dimension. Two
      receptors are assumed to interact to the extent that the shapes of their
      idiotypes are complementary. This is modeled by assuming that shapes interact
      maximally whenever their coordinates in the space-space are equal and opposite,
      and that the strength of interaction falls off for less complementary shapes in a
      manner described by a Gaussian function of the Euclidean "distance" between the
      pair of interacting shapes. The degree of stimulation of a cell when confronted
      with complementary idiotypes is modeled using a log bell-shaped interaction
      function. This leads to three possible equilibrium states for each clone: a
      virgin, an immune, and a suppressed state. The stability properties of the three
      possible homogeneous steady states of the network are examined. For the
      parameters chosen, the homogeneous virgin state is stable to both uniform and
      sinusoidal perturbations of small amplitude. A sufficiently large perturbation
      will, however, destabilize the virgin state and lead to an immune reaction. Thus,
      the virgin system is both stable and responsive to perturbations. The homogeneous
      immune state is unstable to both uniform and sinusoidal perturbations, whereas
      the homogeneous suppressed state is stable to uniform, but unstable to
      sinusoidal, perturbations. The non-uniform patterns that arise from perturbations
      of the homogeneous states are examined numerically. These patterns represent the
      actual immune repertoire of an animal, according to the present model. The effect
      of varying the standard deviation sigma of the Gaussian is numerically analyzed
      in a one-dimensional model. If sigma is large compared to the size of the shape
      space, the system attains a fixed non-uniform equilibrium. Conversely if sigma is
      small, the system attains one out of many possible non-uniform equilibria, with
      the final pattern depending on the initial conditions. This demonstrates the
      plasticity of the immune repertoire in this shape-space model. We describe how
      the repertoire organizes itself into large clusters of clones having similar
      behavior. These results are extended by analyzing pattern formation in a two
      dimensional (2-D) shape-space.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1619956
TI  - Effect of methyl substitution on protein tertiary structure.
AB  - Biological effects caused by the post-translational methylation of certain side
      chains in proteins has been thought to be due solely to changes in charge, steric
      relations or hydrophobicity at the site of the methyl group. However, there is
      increasing evidence that the presence of CH3 can also induce a "global" effect on
      the protein molecule. Some of the evidence is described in this paper.

PMID- 1619957
TI  - Direct simulation of yeast 2-microns circle plasmid amplification.
AB  - The 2-microns circle is a plasmid found in most strains of the yeast
      Saccharomyces cerevisiae at approximately 60-100 copies per cell. The plasmid
      possesses the novel capacity for replicative amplification induced by site
      specific recombination. To address the question of whether the recombination
      model is adequate to account for observed rates of 2-microns circle
      amplification, we developed a direct computational simulation of the
      amplification system. Results of this simulation show that theoretically at least
      six copies per plasmid can be produced in each generation, and that previously
      unanticipated replication intermediates contribute largely to this degree of
      amplification.

PMID- 1619958
TI  - Schematic methods for probabilistic enzyme kinetics.
AB  - The theory of steady-state enzyme processes which avoids using the mass action
      law of chemical kinetics and consistently describes catalytic mechanisms by
      probabilistic concepts has recently been proposed (Mazur, 1991, J. theor. Biol.
      148, 229-242). To facilitate the analysis of complex reaction graphs by this
      theory the possibility of constructing schematic rules similar to those used in
      classical kinetics is studied. It is found that due to the similarity of
      algebraic procedures the popular method of King & Altman can be applied in
      probabilistic kinetics in addition to the earlier proposed rule based on
      enumeration of cycles of the reaction graph. This similarity also allows one to
      adapt many other shortcut methods of classical kinetics for probabilistic
      reaction graphs. The paper considers separately the possibility of transforming
      reaction mechanisms so that the initial graph is replaced by a simpler but
      equivalent one. It is shown that there are few cases when a group of states can
      be replaced by one united state, with earlier known rules such as the rule of Cha
      for equilibrium stages being particular cases of a more general procedure. In
      addition a novel method is proposed which performs step-by-step reduction of any
      reaction graph. All the new methods can be adapted for traditional kinetics as
      well. The results obtained demonstrate that many schematic rules of classical
      kinetics are of probabilistic origin.

PMID- 1619959
TI  - An absolute rate theory model for tension control of axonal elongation.
AB  - This paper extends our previous thermodynamic model for the effect of mechanical
      force on the microtubule assembly that accompanies axonal (neurite) elongation of
      neurons. Based on the previous treatment, experimental data, and the formalism of
      absolute rate theory, we derive an exact expression for how tension on the
      neurite affects mechanical force in the microtubule, and in turn, how these
      affect the rate of microtubule assembly and neurite outgrowth in cultured
      neurons. This prediction approximates the experimentally observed linear
      relationship between growth rate and experimentally applied tension, and predicts
      the previously postulated three-position integral control.

PMID- 1619960
TI  - The insulin receptor--single function and dual effect.
AB  - Net effects of insulin on glucose entry, metabolism and other cellular processes
      have been well documented over the past 30-40 years. Although it is known that
      insulin binds to a specific cell membrane receptor protein which undergoes
      autophosphorylation and tyrosine kinase activation, the individual reactions
      following receptor activation that cause the metabolic changes remain unknown. It
      is well documented that the isolated insulin receptor has a high degree of basal
      autophosphorylation capacity and externally directed tyrosine kinase. There is
      also evidence that some in vivo autophosphorylation can take place in the total
      absence of insulin. If receptor activity does exist in the absence of insulin,
      then receptor function needs to be reanalyzed. It will be proposed here that the
      insulin binding membrane protein functions mainly to inhibit glucose transport
      under low physiological levels of insulin. Evidence of basal receptor enzymatic
      activity in the absence of insulin supports this theory. Under metabolically
      sufficient conditions, enough insulin receptors are functionally active to
      interact with the glucose transport system in an inhibitory manner, providing
      membrane control of internal glucose metabolism. Insulin acts by aggregating this
      inhibitory system. If inhibitory insulin receptors are aggregated following
      insulin elevation, their inhibitory action is prevented and glucose transport
      increases. This increase in transport will be in direct proportion to the
      temporal inhibitory level of the receptor and to the area of the cell membrane
      cleared of their inhibitory effect. When insulin receptor protein is confined to
      small areas of the cell membrane through aggregation, any potential inhibitory
      function is negated and glucose entry increases dramatically. This is the
      classical insulin effect. Both of these concepts were suggested 37 years earlier.
      Randle & Smith (1957, Biochem. Biophys. Acta 25, 442; 1958, Biochem. J. 70, 490)
      proposed that the internal supply of energy rich compounds limited glucose entry
      and that the effect of insulin was to inhibit this process which was inhibiting
      glucose entry. The present report provides a mechanism for this.

PMID- 1619961
TI  - Stimulated and co-operative electron transfer in energy conversion and catalysis.
AB  - A new mechanism of electron transfer, stimulated electron transfer, is
      postulated, in which an electronic feedback is drastically increasing both the
      rate of electron transfer and the propagation of free energy along electron
      transferring molecular pathways. In principle, the idea of pushing a system far
      from equilibrium to achieve a high reaction rate and co-operative phenomena is
      applied to molecular electron transfer. The effect is calculated from a
      semiclassical kinetic model of a chain redox reaction with autocatalytic feedback
      on individual rate constants, where the steps have subsequently been minimized to
      obtain a continuous electron transfer pathway with electronic feedback. The
      influence of inhomogeneities and asymmetries in the electron transfer path and of
      vectorial components (electrical field, gradient of redox potential) are
      discussed as well as the acceleration of individual and multiple electron
      transfer as a function of feedback. Examples of autocatalytic feedback are
      provided including mechanisms involving electron transfer proteins and multi
      centre electron transfer catalysts. Such a phenomenon can be described for
      molecular and interfacial electron transfer in analogy to stimulated and coherent
      light emission. The results suggest that autocatalytic or stimulated electron
      transfer may be a key to the understanding of efficient electron transfer and co
      operative multi-electron transfer catalysis in biology and a challenge for fuel
      production mechanisms in artificial photosynthesis and fuel cycles.

PMID- 1619962
TI  - Human disease mortality kinetics are explored through a chain model embodying
      principles of extreme value theory and competing risks.
AB  - The distributions for human disease-specific mortality exhibit two striking
      characteristics: survivorship curves that intersect near the longevity limit;
      and, the clustering of best-fitting Weibull shape parameter values into groups
      centered on integers. Correspondingly, we have hypothesized that the distribution
      intersections result from either competitive processes or population partitioning
      and the integral clustering in the shape parameter results from the occurrence of
      a small number of rare, rate-limiting events in disease progression. In this
      report we initiate a theoretical examination of these questions by exploring
      serial chain model dynamics and parameteric competing risks theory. The links in
      our chain models are composed of more than one bond, where the number of bonds in
      a link are denoted the link size and are the number of events necessary to break
      the link and, hence, the chain. We explored chains with all links of the same
      size or with segments of the chain composed of different size links
      (competition). Simulations showed that chain breakage dynamics depended on the
      weakest-link principle and followed kinetics of extreme-values which were very
      similar to human mortality kinetics. In particular, failure distributions for
      simple chains were Weibull-type extreme-value distributions with shape parameter
      values that were identifiable with the integral link size in the limit of
      infinite chain length. Furthermore, for chains composed of several segments of
      differing link size, the survival distributions for the various segments
      converged at a point in the S(t) tails indistinguishable from human data. This
      was also predicted by parameteric competing risks theory using Weibull underlying
      distributions. In both the competitive chain simulations and the parametric
      competing risks theory, however, the shape values for the intersecting
      distributions deviated from the integer values typical of human data. We conclude
      that rare events can be the source of integral shapes in human mortality, that
      convergence is a salient feature of multiple endpoints, but that pure competition
      may not be the best explanation for the exact type of convergence observable in
      human mortality. Finally, while the chain models were not motivated by any
      specific biological structures, interesting biological correlates to them may be
      useful in gerontological research.

PMID- 1619963
TI  - Study of the relationship between estimates of enzyme kinetic parameters.
AB  - Previous indications of an intrinsic relationship between estimates of Km and
      Vmax calculated from the Michaelis-Menten equation have been explored further. A
      mathematically linear relationship could be established for the estimates of the
      two parameters. The relationship--the trend line--holds whether or not the
      experimental error is linked to the rate of reaction, the substrate concentration
      or both, provided that the distribution of errors is symmetrical. The practical
      implication is that enzyme variants with low values of Km and Vmax may not be
      distinguishable from those with high values of Km and Vmax.

PMID- 1619964
TI  - Gaps in the erythrocyte membrane skeleton: a stretched net model.
AB  - The geometry of spectrin-free regions in the erythrocyte membrane skeleton is
      modeled using Monte Carlo calculations for an incomplete triangular lattice of
      entropy springs under tension. Intact springs correspond to normal spectrin
      molecules, and cut springs correspond to spectrin that is missing or unable to
      associate normally. As springs are cut and the network is allowed to relax to
      mechanical equilibrium, gaps in the network appear. Geometrical properties of
      these gaps are obtained as a function of the fraction of springs cut. The most
      important property modeled is the area of the largest spectrin-free region; this
      area increases approximately exponentially as the fraction of normal spectrin
      decreases from 100% to approximately 50%. The effect of these gaps on lateral
      diffusion and vesiculation is discussed.

PMID- 1619965
TI  - The discovery of DuP 753, a potent, orally active nonpeptide angiotensin II
      receptor antagonist.

PMID- 1619966
TI  - Strain differences in regional brain histamine levels between genetically
      epilepsy-prone and resistant rats.
AB  - In order to further elucidate the possible role of histamine in the seizure
      model, we determined the histamine levels in different brain regions of
      genetically epilepsy-prone Krushinski-Molodkina (KM) rats. Histamine levels in
      the striatum, hippocampus, amygdala, midbrain, thalamus and hypothalamus of KM
      rats were significantly lower than in the epilepsy-resistant Wistar rats.
      Previously, we have reported that the audiogenic seizures of KM rats were reduced
      by metoprine, which can markedly increase brain histamine. These findings are in
      agreement with the hypothesis that central histamine neuron system may be
      involved in the inhibitory mechanism of seizures.

PMID- 1619967
TI  - Effect of aging on the renin angiotensin system in patients with renovascular
      hypertension.
AB  - The effect of aging on the renin angiotensin system (RAS) was studied in 30
      patients with renovascular hypertension and 33 patients with essential
      hypertension. Plasma renin decreased with age in patients with renovascular
      hypertension and essential hypertension. However, in patients with renovascular
      hypertension, the change was not statistically significant. Plasma aldosterone
      concentration showed a tendency to decrease with age in both groups. Stimulated
      plasma renin activity and the net increase in plasma renin activity after
      captopril administration in patients with essential hypertension showed a
      significant decrease with age. In patients with renovascular hypertension,
      exaggerated response of renin secretion was observed in younger patients, but
      middle-aged and elderly patients did not demonstrate this hyper-responsiveness.
      The degree of decrease in blood pressure by administration of an angiotensin
      (Ang) II analog ([Sar1,Ile8] Ang II) was the same in both younger and elderly
      patients with either disease. These results suggest that the effect of aging on
      the RAS occurs not only in patients with essential hypertension, but also in
      patients with renovascular hypertension. Furthermore, although the Ang II analog
      infusion test and captopril stimulation test are considered to be useful
      screening tests for renovascular hypertension, we consider that the combination
      of Ang II analog test and captopril test may be favorable to screen renovascular
      hypertension, since the captopril stimulation test had a lower sensitivity in
      younger (under 35 years old) patients.

PMID- 1619968
TI  - Comparative pharmacokinetics of propofol in Chinese adults and children.
AB  - The pharmacokinetics of propofol were studied in 14 healthy young male Chinese
      adults, aged 18-38 years, undergoing minor orthopedic surgery. All patients who
      received a single bolus dose of propofol 2.5 mg/kg were paralyzed with atracurium
      and mechanically ventilated. Anesthesia was maintained with 67% nitrous oxide
      plus 1-2% isoflurane in oxygen with alfentanil 5 micrograms/kg intravenously as a
      bolus injection. Blood concentrations of propofol over the subsequent 24 hours
      were measured using high pressure liquid chromatography with fluorimetric
      detection. Data were consistently described by a three compartment model but
      analysis revealed two significantly different blood propofol concentration-time
      profiles (p less than 0.05). Five patients, designated "fast" metabolizers,
      demonstrated a mean elimination half-life which was shorter than that described
      in Chinese children, while their total body clearance was similar. Nine other
      patients, designated "slow" metabolizers, had a longer mean elimination half-life
      and slower total body clearance than those in elderly Caucasian patients. This
      may be suggestive of propofol metabolism at some extra-hepatic site in some
      patients, while other patients demonstrate marked lipophilicitic constraint of
      the drug by the deep compartment.

PMID- 1619969
TI  - Injections of kainic acid into the raphe dorsal nucleus in freely moving cats:
      electroencephalographic, behavioral and histopathological consequences.
AB  - Results are presented concerning the functional and morphological changes
      occurring after kainic acid injections into raphe dorsal nucleus in freely moving
      cats. The effects of kainic acid at two doses, 4 and 12 nmol, on
      electroencephalographic activity, behavior and cell morphology were examined on
      the day of injection, and on the 1st, 3rd, 6th, 15th, 30th and 65th day. A well
      pronounced dose-dependent effect of kainic acid was established: in 50% of the
      animals injected with 4 nmol of kainic acid and in 85.7% of the animals injected
      with 12 nmol electroencephalographic and behavioral seizures appeared. The
      strength of the seizures in the animals receiving 12 nmol of kainic acid was
      different--from focal single epileptiform patterns first in raphe dorsal nucleus
      and then in other brain regions to generalized high-voltage ictal activity and in
      some animals to epileptic state. In all animals receiving 4 nmol of kainic acid
      and in 75% of the animals receiving 12 nmol of kainic acid, the electrical
      activity and behavior returned to normal several hours after or within two days
      following the kainic acid injection. The histopathological data obtained by light
      microscopy showed a dose-dependent cytoarchitectural disorganization (mainly
      chromatolytic changes) not only at the injection site but also in many other
      brain structures. The present results confirm our previous studies on cats in
      acute conditions showing enhancement of brain excitability level up to
      hyperexcitation (seizures) after kainic acid injection into the raphe dorsal
      nucleus.

PMID- 1619970
TI  - Modulation of glucose homeostasis by doxepin.
AB  - Blood glucose level (BGL) was estimated up to 4 h (3 h in case of GTT) in 18-h
      fasted albino rabbits following acute and chronic (one month) feeding of doxepin
      and thereafter for another 8 days together with either insulin or glibenclamide
      or adrenaline. A single dose of doxepin produced significant hypoglycemia which
      peaked at 4 h and lasted up to 10 h. On chronic doxepin feeding there was
      complete attenuation of initial hypoglycemia on the 7th and 14th days,
      culminating into frank hyperglycemia on the 21st day. However, there was complete
      recovery on the 29th day exhibiting tolerance to initial hypo-as well as delayed
      hyperglycemia. Similarly, glucose intolerance was accentuated on the 8th day
      followed by a gradual recovery on the 15th and 22nd days, culminating in
      disappearance of glucose intolerance on the 30th day. The hypoglycemic effect of
      insulin was markedly potentiated in chronically doxepin fed animals which was
      further enhanced on continuing administration of both agents. Profound
      hypoglycemia was observed during GTT in such animals. The hyperglycemic effect of
      adrenaline was enhanced in chronically doxepin fed animals, which may be due to
      TCA induced enhancement of the response of exogenous adrenaline. Suppression of
      this hyperglycemia with continued administration of both drugs seems to be due to
      subsensitivity of alpha 2-adrenoceptors. Additive hyperglycemia was observed
      during GTT in such animals.

PMID- 1619971
TI  - [Control of exocrine pancreatic secretion--which mediators are more important:
      nerves or hormones?].

PMID- 1619972
TI  - [Effect of pancreatic innervation on exocrine secretory performance of the
      pancreas].
AB  - In the present study we examined the influence of extrinsic pancreatic
      innervation on exocrine pancreatic response to secretin, caerulein, tryptophan
      and fat, and furthermore the amino acid- and fat-stimulated release of
      neurotensin and CCK in dogs. Denervation of the pancreas did not alter secretory
      response to secretin and caerulein, whereas transsection of the extrinsic nerves
      significantly diminished the protein response to tryptophan and fat. Release of
      CCK was not altered by pancreatic denervation. However, fat-evoked neurotensin
      plasma levels were significantly increased after denervation of the pancreas.

PMID- 1619973
TI  - [Massive gastrointestinal hemorrhage from a hepaticojejunostomy in pancreatogenic
      mesenteric vein thrombosis. Diagnosis and therapy].
AB  - Gastrointestinal hemorrhage in a patient with a biliodigestive anastomosis
      necessitates exclusion of a bleeding source in the region of the choledocho- or
      hepaticojejunal anastomosis. This cannot be achieved by endoscopic methods. The
      source of bleeding can sometimes, though rarely, be localised by performance of
      selective angiography during hemorrhage. Laparotomy with exploration of the
      anastomosis during such an episode is at the same time a diagnostic and a
      therapeutic intervention. The surgical procedure of choice is de-anastomosis,
      resection of the bypassed jejunal loop and formation of a hepatico-duodenostomy.

PMID- 1619974
TI  - [Changes in liver function and morphology after various portocaval bypass
      operations].
AB  - Using an experimental animal model consequences of operatively changed modes of
      liver perfusion on hepatic function could be demonstrated. Three groups of 5
      animals each (swine) had the following operations: Group I received a portocaval
      shunt. In group II in addition to the portocaval shunt a vein graft was
      interposed between the vena cava and the portal vein. In group III an
      arterialization of this graft was performed in addition to the two operations
      mentioned above. Follow-up at defined time intervals included clinical,
      laboratory and histological data. It could be demonstrated that animals in group
      II and III showed normal parameters as far as behavior and controlled lab data
      are concerned. Animals of group I had significantly poorer results in all tests.
      In this study we found that direct portal perfusion was not necessary for a
      normal liver function and could be fully compensated both by caval venous blood
      and by arterialized caval venous blood.

PMID- 1619975
TI  - [Exulceratio simplex Dieulafoy].
AB  - "Exulceratio simplex Dieulafoy" is a rare cause of massive upper gastrointestinal
      haemorrhage from a submucosal artery. Dieulafoy's disease is rarely recognized.
      We present 9 cases of Dieulafoy's lesion and have collected 176 cases described
      in the literature.

PMID- 1619976
TI  - [Cystic parathyroid gland adenomas: pathologic-anatomic variants of parathyroid
      gland adenomas or a separate disease entity?].
AB  - Between 01.01.1987 and 31.12.1990 a primary operation was performed on 126
      patients in the Dept. of General Surgery, University of Marburg Hospital for
      primary hyperparathyroidism due to a parathyroid adenoma. Their clinically
      relevant data were prospectively documented. In 6 patients (4.8%) a total of 7
      cystic parathyroid adenomas was found. While there was no difference in age- and
      sex-distribution, patients with cystic adenomas were found to have markedly
      higher serum parathormone and alkaline phosphatase levels than patients with
      solid adenomas. Calcium levels were similar in both groups. Cystic adenomas were
      much heavier than solid adenomas. A significant number of cystic adenomas was
      found to be displaced into the posterior mediastinum. The property of cystic
      parathyroid adenomas to be frequently located away from their usual anatomical
      position can make the intraoperative search for them difficult.

PMID- 1619977
TI  - [The value of clinical, laboratory and sonographic findings in acute appendicitis
      -effect of surgical experience and bacteriologic diagnosis on the rate of wound
      healing disorders].
AB  - A total of 361 patients were admitted to the Department of Surgery of the
      University of Heidelberg between January 1989 and April 1990 for acute
      appendicitis. Neither the physical examination nor laboratory results were
      unequivocally diagnostic in a third of the patients. The ultrasonographic
      visualization of the inflamed appendix could confirm the diagnosis in 50% of the
      clinically doubtful cases (predictive value: 84%). Further diagnostic procedures
      were rarely necessary. The perforation rate was independent of the duration of
      the preoperative hospitalization due to the rapid surgical treatment. Contrary to
      previous reports, the likelihood of an intraoperatively innocent appendix
      increased with delayed surgery. Wound infection rates were similar after
      appendectomies by surgeons in training and by fully qualified surgeons although
      perforated appendices were typically removed by the latter ones. Antibiotic
      therapy was usually administered for severely inflamed appendices depending on
      the intraoperative findings and for perforated appendices and reduced the rate of
      wound infections if more than two bacteria had been cultured from a routine
      intraoperative swab. The documentation used in Baden-Wurttemberg for quality
      control should include the result of an intraoperative appendiceal swab.

PMID- 1619978
TI  - [The long-term prognosis of breast cancer. Retrospective study of 973 patients].
AB  - In this study the outcome after 40 years of primary breast cancer therapy was
      analysed. 973 patients admitted between 1943-1964 were examined. At the time of
      evaluation 900 (92.5%) of these patients were deceased. The mean survival time
      was 7.02 years. Tumor stage was the most important prognostic factor. In stage I
      patients after 40 years 17% of the patients were still alive. In stage II
      patients the prognosis was significantly worse. After 3.5 years 50% of the
      patients were dead. Young patients under 40 years of age showed a significantly
      lower survival rate during the first 5 years after therapy. The histological type
      did not show any influence on the outcome. In 91.5% of all patients a radical
      mastectomy was performed. Therefore the different operative procedures can not be
      compared in this study. 560 patients received postoperative adjuvant
      radiotherapy. Patients with radiotherapy showed a higher survival rate only
      during the first 5 years. After this time the survival rate of patients with
      radiotherapy was significantly lower. This was found already after 2 years in
      stage I patients. 85% of the deceased patients died with or because of breast
      cancer. 98.2% of breast cancer related deaths were observed during the first 10
      years. After 26 years no breast cancer death was observed. Considering the 7.5%
      surviving patients at least 22% of the breast cancer patients did not show a
      breast cancer recurrence over the 40 year period. This demonstrates that the
      biological characteristics of breast cancer can not be explained by the theory of
      B. Fisher or the Halsted theory alone.

PMID- 1619979
TI  - [Effect of cecostomy on the pathophysiology and prognosis of acute experimental
      pancreatitis].
AB  - In 76 male wistar rats with a median weight of 340 g acute pancreatitis was
      induced by injection of 2% sodium taurocholate into a temporarily closed duodenal
      loop. 40 animals received an additional cecostomy (group B), the others served as
      controls (group A). The postoperative figures for amylase, leucocyte count, and
      hemoglobin were nearly identical in both groups. According to histologic criteria
      acute pancreatitis was comparable in both groups, too. In nine rats endotoxin was
      found elevated postoperatively (13.4%). Seven animals belonged to the control
      (22.6%) and only two to the cecostomy group (5.6%). The difference was
      statistically significant (p less than 0.05). Also the differences between the
      median serum endotoxin levels reached statistic significance (79 ng/l in group B
      vs. 219 ng/l in group A). Mortality was significantly increased in endotoxin
      positive animals (42.9% vs. 19.4%). Additionally, among the animals of the
      control group alterations of the colonic mucosa were observed more frequently
      than in the cecostomy group. The results are in favour of a translocation of
      endotoxin from the gut lumen into the circulation during acute experimental
      pancreatitis.

PMID- 1619980
TI  - [The effect of taurolin on endogenous immunity and pathogen elimination in human
      peritonitis].
AB  - The influence of taurolin on phagocytosis-related defense functions and on the
      elimination of bacteria has been investigated in a controlled study. Particle
      opsonisation, a prerequisite for sufficient phagocytosis, was undisturbed in
      presence of up to 0.1% taurolin. Intraabdominal taurolin application did not
      diminish the leukocyte influx into the abdominal cavity. Opsonic capacity of
      peritoneal exudate was low in the taurolin group. These exudates contained more
      severe bacterial contamination, suggesting that this deficit was due to enhanced
      specific consumption of opsonins. Taurolin treatment resulted in a marked
      reduction of bacterial growth. Thus the substance provides antiseptic capacities
      without afflicting the physiological defense systems.

PMID- 1619981
TI  - [Esophagojejunoplication with the stapler technique. Results of a controlled
      study].

PMID- 1619982
TI  - Host and tissue tropism of hepatitis B virus.

PMID- 1619983
TI  - A method for sequential excision biopsies of rat liver in an isolated perfused
      system.
AB  - We describe a simple method of performing sequential excision biopsies during
      liver reperfusion in the isolated perfused rat liver. After hepatectomy, four
      ligatures (5.0 silk) tied with a slip knot are placed around the pedicles of: (1)
      the inferior and (2) the superior parts of the caudate lobe, as well as (3) the
      inferior and (4) the superior parts of the right lateral lobe. At the time of
      biopsy, the prepared 5.0 silk ties are tightened with sufficient force to occlude
      the vascular pedicle, preventing leakage of circulating perfusate. The procedure
      provides four biopsies of more than 350 mg each without alteration of perfusate
      transaminases and tissue ATP contents. The total tissue removed by this method
      comprises 20-25% of the whole liver weight.

PMID- 1619984
TI  - Role of septal fibrosis in development of hepatic circulatory disturbance in the
      presence of liver cell enlargement.
AB  - The effect of septal fibrosis on hepatic circulation was examined in rats with
      enlarged liver cells. Septal fibrosis was produced by horse serum injections and
      liver cell enlargement by a choline-deficient diet. Septal fibrosis alone did not
      induce any disturbance of hepatic circulation. In fatty livers, a slight increase
      in sinusoidal vascular resistance and a slight elevation of portal vein pressure
      were found. However, in fatty livers with septal fibrosis, portal hypertension
      and sinusoidal vascular resistance were higher than in fatty livers without
      septal fibrosis. These experimental data clearly demonstrate that septal fibrosis
      alone has no effect on hepatic circulation, but septal fibrosis in the presence
      of liver cell enlargement markedly affects sinusoidal circulation and induces
      portal hypertension. The augmentation of sinusoidal vascular resistance by septal
      fibrosis in the presence of liver cell enlargement might be due to the severe
      deformation of the sinusoids by enlarged liver cells in the limited spaces
      surrounded by septal fibrous bands.

PMID- 1619985
TI  - The effect of ephedrine/caffeine mixture on energy expenditure and body
      composition in obese women.
AB  - Treatment with beta 2-agonists promotes fat loss and muscle growth in numerous
      species, but human studies are lacking. We studied the effect of a compound with
      beta 2-agonistic properties (ephedrine 20 mg/caffeine 200 mg [E + C]). Fourteen
      obese women were treated with a 4.2-MJ/d diet and either E + C or placebo (P)
      three times per day for 8 weeks in a double-blind study. Weight-loss was not
      different in the groups, but the E + C group lost 4.5 kg more body fat and 2.8 kg
      less fat-free mass (FFM). The decrease in 24-hour energy expenditure (EE) seen in
      the P group was 10% at day 1 and 13% at day 56, but was only 7% and 8% in the
      treated group (P = .044). The higher EE in the E +C group was entirely covered by
      fat oxidation. These findings provide evidence that promotion of fat loss and
      preservation of FFM during weight reduction may also be achieved
      pharmacologically in humans.

PMID- 1619986
TI  - Reversal of steroid-induced insulin resistance by a nicotinic-acid derivative in
      man.
AB  - A recent report suggested that the glucose-free fatty acid (FFA) cycle may
      contribute to steroid-induced insulin resistance in rats, and that glucose
      tolerance could be restored to normal when FFA levels were lowered with nicotinic
      acid. To test this hypothesis in man, we measured insulin sensitivity (by
      euglycemic insulin clamp in combination with indirect calorimetry and infusion of
      tritiated glucose) before and after short-term administration of a nicotinic-acid
      derivative (Acipimox) in 10 steroid-treated, kidney transplant patients with
      insulin resistance. Thirty-five healthy subjects served as controls. Six of them
      received Acipimox. Total body glucose metabolism was reduced in steroid-treated
      patients compared with control subjects (41.7 +/- 3.3 v 50.0 +/- 2.2 mumol/kg
      lean body mass [LBM].min, P less than .05). The reduction in insulin-stimulated
      glucose uptake was mainly due to an impairment in nonoxidative glucose metabolism
      (primarily glucose storage as glycogen) (18.3 +/- 2.8 v 27.2 +/- 2.2 mumol/kg
      LBM.min, P less than .01). Acipimox lowered basal FFA concentrations (from 672 +/
      63 to 114 +/- 11 mumol/L, P less than .05) and the rate of lipid oxidation
      measured in the basal state (1.5 +/- 0.2 to 0.6 +/- 0.1 mumol/kg LBM.min, P less
      than .01) and during the clamp (0.7 +/- 0.2 to 0.03 +/- 0.2 mumol/kg LBM.min, P
      less than .05). In addition, Acipimox administration normalized total glucose
      disposal (to 54.4 +/- 4.4 mumol/kg LBM.min), mainly due to enhanced nonoxidative
      glucose metabolism (to 28.9 +/- 3.9 mumol/kg LBM.min) in steroid-treated patients
      (both P less than .05 v before Acipimox).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619987
TI  - Influence of omega-3 fatty acids on splanchnic blood flow and lactate metabolism
      in an endotoxemic rat model.
AB  - Alteration in regional blood flow is important in the pathogenesis of organ
      failure during endotoxemia and sepsis. In particular, intestinal ischemia is
      thought to enhance the translocation of bacteria into the systemic circulation.
      We used radioactive microspheres to measure the influence of two intravenous (IV)
      dietary fats (vegetable oil containing high levels of omega-6 fatty acids, and
      fish oil containing high levels of omega-3 fatty acids) on regional blood flow
      during low-dose Escherichia coli endotoxin infusion (0.1 mg/100 g body weight
      [BW]) in a rat model. Despite absence of changes in the cardiac output, blood
      flow rates to the small and large intestines, stomach, and pancreas, and also to
      the skin and skeletal muscle were significantly reduced after 18 hours of
      endotoxin infusion in the rats fed standard vegetable oil. Short-term IV feeding
      during a period of 40 hours with an isonitrogenous, isocaloric nutrient solution
      containing fish oil as the only lipid source normalized intestinal perfusion and
      increased blood flow to the liver and spleen. Low-dose endotoxin infusion also
      resulted in significant increases in glucose, lactate, and pyruvate
      concentrations. In comparison to standard vegetable fat emulsion, fish oil
      significantly reduced these parameters. A second experiment was conducted to
      measure lactate kinetics. Based on the dilution of U-14C-lactate, fish oil
      feeding was associated with higher lactate clearance than standard vegetable oil
      feeding during the endotoxin infusion. We conclude that short-term IV feeding
      with fish oil improves intestinal perfusion and portal blood flow, improves
      glucose tolerance, and increases lactate clearance in a low-dose endotoxin rat
      model.

PMID- 1619988
TI  - Time course of plasma free fatty acid concentration in response to insulin:
      effect of obesity and physical fitness.
AB  - This study examines the relationships between parameters of the time course of
      plasma free fatty acid (FFA) concentration during a euglycemic, hyperinsulinemic
      clamp (100 mU/m2.min) and the age, body composition, and physical fitness,
      indexed as maximal aerobic capacity (VO2 max), of three groups of healthy men:
      (A) 20 obese older men (32% +/- 1% fat, aged 60 +/- 2 years, mean +/- SEM); (B)
      11 lean older men (19% +/- 1% fat, aged 63 +/- 2 years); and (C) 11 lean younger
      men (16% +/- 2% fat, aged 27 +/- 2 years). The time course was modeled as a
      delayed exponential decline from an initial level to a plateau level. The plateau
      level was 72% +/- 2%, 72% +/- 2%, and 68% +/- 3% of the initial level in groups
      A, B, and C, respectively. The delay was shorter in the younger men than in the
      older men (7.6 +/- 0.9 minutes in group C v 13.2 +/- 1.0 in group A and 11.9 +/-
      1.6 minutes in group B), but correlated more strongly with percent fat, waist to
      hip ratio (WHR), or VO2max than with age. The magnitude of the rate constant of
      the exponential, k, was smaller in obese than in lean men (3.2 +/- 0.2 h-1 in
      group A v 5.3 +/- 0.6 h-1 in group B and 6.4 +/- 0.6 h-1 in group C), and was
      independently predicted only by percent fat in the older men and only by VO2max
      when the older and younger groups were combined.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619989
TI  - Regional cerebral blood flow in normal man during insulin-induced hypoglycemia
      and in the recovery period following glucose infusion.
AB  - The effect of moderate hypoglycemia (p-glucose, 2.0 +/- 0.3 mmol/L; mean +/- SD)
      on regional cerebral blood flow (rCBF) was studied in a group of 10 healthy,
      right-handed men (aged 23 to 28 years) using an intravenous xenon 133 single
      photon emission computed tomography technique (SPECT). After 10 minutes of
      hypoglycemia, global CBF had increased to 46.3 +/- 9.6 mL/100 g/min compared with
      the initial normoglycemic flow of 38.6 +/- 6.8 mL/100 g/min (P less than .01).
      The relative distribution of the rCBF changed significantly (P less than .05,
      ANOVA) from before to during hypoglycemia. Of the 10 regions analyzed, the
      highest increments in rCBF during hypoglycemia were found in the frontal (21.5%
      +/- 15.2%) and parietal (20.6% +/- 14.2%) lobes, and the lowest (10.7% +/- 9.4%)
      were found in the pons/brainstem regions. The increase in rCBF persisted for 15
      minutes after normalization of blood glucose. The persisting high flow after
      hypoglycemia affected all regions, but a further 10.1% +/- 7.2% increase was
      observed in the pons/brainstem area (P less than .05). The CBF was significantly
      higher in the right compared with the left hemisphere (2.8%, 1.2%, and 3.9%,
      respectively; P less than .05) in all measurements. A decrease in brain volume
      was found at the final examination, compared with the hypoglycemic state (2.6%; P
      less than .05). It is concluded that moderate hypoglycemia leads to a marked
      increase in CBF and in the relative distribution of rCBF, which persists in the
      immediate period after normalization of the blood glucose level.

PMID- 1619990
TI  - Metabolic changes during early starvation in rats fed a low-protein diet in the
      postweaning growth period.
AB  - Metabolic changes during the first 24 hours of starvation were studied in rats
      previously adapted for 3 weeks during the postweaning growth period to a low
      protein diet using lactalbumin as a dietary protein source. Previous adaptation
      to a high-quality, low-protein diet reduced the effects of early starvation on
      the loss of body and liver weight. In rats fed a low-protein diet (6%
      lactalbumin, LP rats), free triiodothyronine (T3) concentration remained higher
      than in control rats (13% lactalbumin, C rats) throughout the experiment (+38%,
      24 hours), and the plasma insulin concentration, which was lower than in C rats
      during the first 6 hours (-56%), was not different thereafter. Plasma insulin to
      glucagon molar ratio was lower (-54%) and liver cyclic adenosine monophosphate
      (cAMP) concentration was higher (+28%) in LP than in C rats in the fed state, but
      these were not different at 24 hours of starvation. Plasma glucose concentration
      was slightly lower in LP than in C rats (-15%) in the fed state, but it was not
      different in both groups during starvation. Whereas they were unchanged in the
      fed state, plasma lactate concentration was lower (-57%) and free fatty acid and
      total ketone body concentrations were higher (+38% and +183%, respectively) in LP
      than in C rats at 24 hours of starvation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619991
TI  - Effects of growth hormone administration on fuel oxidation and thyroid function
      in normal man.
AB  - In a randomized, double-blind, placebo-controlled, cross-over study, we examined
      the effects of 14 days of growth hormone (GH) administration (12 IU/d
      subcutaneously) on energy expenditure (EE), respiratory exchange ratio (RER), and
      thyroid function in 14 normal adults of normal weight (eight men and six women).
      EE (kcal/24 h) was significantly elevated after GH administration (2,073 +/- 392,
      [GH], 1,900 +/- 310, [placebo], P = .01). RER was significantly lowered during GH
      administration (0.73 +/- 0.04 v 0.78 +/- 0.06, P = .02), reflecting increased
      oxidation of lipids. Total triiodothyronine (TT3) (nmol/L) and free T3 (FT3)
      (pmol/L) increased significantly during GH (TT3: 1.73 +/- 0.06 [GH], 1.48 +/-
      0.08 [placebo], P = .01; FT3: 6.19 +/- 0.56 [GH], 5.49 +/- 0.56 [placebo], P =
      .01). Concomitantly, an insignificant decrease in reverse T3 (rT3) (nmol/L) was
      observed (0.07 +/- 0.01 [GH], 0.15 +/- 0.01 [placebo], P = .08). GH caused a
      highly significant increase in T3/thyroxine (T4) (x 100) ratio (1.84 +/- 0.12
      [GH], 1.37 +/- 0.06 [placebo]). Serum thyrotropin (TSH) was not significantly
      changed by GH. No changes in total thyroxine (TT4) (nmol/L) (98 +/- 6 [GH], 111
      +/- 8 [placebo], P = .40) and free thyroxine (FT4) (pmol/L) (17.4 +/- 1.3 [GH],
      18.6 +/- 1.1 [placebo], P = .37) after 14 days of GH administration were
      observed. In conclusion, 2 weeks of GH administration increases EE and
      lipidoxidation. This finding may partly be mediated by an increase in peripheral
      T4 to T3 conversion.

PMID- 1619992
TI  - Effect of human growth hormone (GH)-binding protein in human serum on GH binding
      to rabbit liver membranes.
AB  - The sequence identity of growth hormone-binding protein (GH-BP) with the
      extracellular domain of GH receptors raised the possibility that circulating GH
      BP might affect the binding of human GH (hGH) to its receptors, and thus, its
      biological effects. To test this hypothesis, we tested the effects of sera with
      low GH-BP levels (obtained from prepubertal children, girls with anorexia nervosa
      [AN], and patients with hepatic cirrhosis), normal control sera, and sera with
      high GH-BP levels (obtained from obese patients) on hGH binding to its receptors.
      GH-BP activity in patients' sera was measured by incubation with [125I]hGH and
      the separation of bound hGH from free hGH with dextran-coated charcoal. The
      effect of GH-BP was studied by preincubation of patients' sera with increasing
      concentrations of hGH, followed by incubation with [125I]hGH and a rabbit liver
      membrane preparation known to be rich in GH receptors, and finally by measuring
      hGH bound to the receptors. In this study, we report on the ability of GH-BP to
      reduce the inhibitory capacity (IC50) of hGH on [125I]hGH binding to GH
      receptors. The concentration of GH-BP in serum is positively correlated with the
      IC50 of hGH incubated with different sera on [125I]hGH binding to its receptors
      (n = 21; r = .886, P less than .001). In the presence of high serum GH-BP levels,
      such as those observed in obesity (20.13% +/- 0.71%/0.05 mL serum), the IC50
      values were significantly higher than those obtained with sera containing GH-BP
      levels lower than those measured in human control subjects, such as from
      prepubertal children, AN patients, and cirrhotic patients.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1619993
TI  - Total energy expenditure and energy requirements in healthy elderly persons.
AB  - To investigate energy requirements in healthy elderly subjects, we assessed the
      association of total energy expenditure (TEE) with resting metabolic rate (RMR),
      physical activity, body composition, and energy intake in 13 individuals (aged 56
      to 78 years, six women and seven men). Free-living TEE was measured using doubly
      labeled water, RMR was measured by respiratory gas analysis, and energy
      expenditure of physical activity (EEPA) was derived from the difference between
      TEE and RMR, assuming the thermic response to feeding contributes 10% of TEE. Fat
      mass (FM) and fat-free mass (FFM) were obtained from underwater weighing, VO2max
      was determined from a bicycle test to exhaustion, energy intake was obtained from
      a 3-day food diary, and leisure time activity (LTA) was determined by structured
      interview. TEE was 2,406 +/- 438 kcal/d (range, 1,856 to 3,200 kcal/d, or 1.25 to
      2.11 times RMR) and was related to VO2max (r = .79, P = .001), LTA (r = .74, P =
      .004), FFM (r = .69, P = .009), and FM (r = -.64, P = .018). The association
      between TEE and VO2max persisted after adjustment for FFM (partial r = .58, P =
      .036). EEPA was related to LTA (r = .83, P less than .0001) and FM (r = -.58, P =
      .039). Energy intake underestimated TEE by 31% +/- 18% in women and by 12% +/-
      11% in men. Using stepwise regression, TEE was best predicted by VO2max and LTA
      (total adjusted r2 = .86). We conclude the following: (1) TEE varies greatly
      within healthy elderly subjects due to variations in physical activity; (2)
      VO2max has an important role in predicting energy requirements in older
      individuals; and (3) healthy older individuals underreport energy intake.

PMID- 1619994
TI  - Reliability of the measurement of postprandial thermogenesis in men of three
      levels of body fatness.
AB  - To determine the reliability of the measurement of postprandial thermogenesis by
      indirect calorimetry and to clarify further the relationship of obesity to
      thermogenesis in men, the thermic effect of a 720-kcal, mixed liquid meal was
      compared in 13 lean men (mean +/- SEM, 11.2% +/- 1.4% body fat), 10 average men
      (22.4% +/- 1.6% body fat), and 12 obese men (33.4% +/- 1.6% body fat) on two
      occasions. Resting metabolic rate (RMR) was measured for 3 hours: (1) in the
      fasted state, and (2) after a 720-kcal mixed liquid meal, on two occasions. The
      thermic effect of the meal, calculated as the postprandial energy expenditure
      minus the fasting RMR (kcal/3h), was greater for the lean and average men than
      for the obese men during both trials (P less than .001), but was only marginally
      different between the lean and average groups (P = .16). The mean values for the
      two trials were similar and the measurement of thermogenesis was highly
      reproducible with a reliability coefficient of r = .932 (P less than .001).
      Across all groups, thermogenesis correlated strongly with percent body fat (r = 
      .64, P less than .01), but within the average men, thermogenesis was uncorrelated
      with percent body fat (r = .09) but highly correlated with the glucose response
      to the meal (r = -.75, P less than .05). Thus, factors other than body fatness,
      such as insulin sensitivity, may determine thermogenesis within this
      heterogeneous middle group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619995
TI  - The role of the opioid peptides in the development of hyperinsulinemia in obese
      women with abdominal body fat distribution.
AB  - In this study, we investigated the hypothesis that increased opioid activity may
      be involved in the development of hyperinsulinemia in women with obesity and
      abdominal body fat distribution. Two groups of nine obese body (body mass index
      [BMI], 30 to 40 kg/m2) women with abdominal (A-ob) (waist to hip ratio [WHR]
      greater than 0.85) or gluteo-femoral (F-ob) (WHR greater than or equal to 0.80)
      fat distribution were examined and compared with eight normal-weight controls.
      Basal beta-endorphin levels were higher in the A-ob group than in the other
      groups. Each woman underwent two oral glucose tolerance tests (OGTT, 75 g
      glucose). A bolus of naloxone (0.8 mg) followed by a constant infusion of
      naloxone (0.04 mg/kg/h) or saline was also administered during the glucose
      challenge in random order, and blood samples for glucose, insulin, and C-peptide
      were collected at regular times after glucose administration. No difference was
      observed in basal or stimulated glucose concentrations between the three groups,
      nor between the saline or naloxone study. However, basal and stimulated insulin
      levels were significantly higher in obese women (particularly in the A-ob group)
      than in controls. Naloxone administration, however, did not significantly modify
      insulin and C-peptide glucose-stimulated concentrations in controls and in the F
      ob group, whereas it significantly reduced (by approximately 47%) insulin levels
      in the A-ob group. Partial correlation coefficients showed a significant negative
      correlation between percent variation of glucose-stimulated insulin incremental
      areas during the naloxone study and the WHR in all women considered together (r =
      .544, P less than .025).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1619996
TI  - The effects of chromium supplementation on serum glucose and lipids in patients
      with and without non-insulin-dependent diabetes.
AB  - Seventy-six patients with established atherosclerotic disease were treated daily
      with either 250 micrograms of chromium orally as chromium chloride or a placebo
      for a period of 7 to 16 months (mean, 11.1 months). Serum chromium increased from
      2.69 +/- 0.09 to 12.12 +/- 0.77 nmol/L (mean +/- SE, P less than .005). Serum
      triglycerides were lower (1.68 +/- 0.11 and 2.10 +/- 0.14 nmol/L, respectively; P
      less than .02) in the chromium-treated patients than in the patients who received
      placebo, and serum high-density lipoprotein (HDL) increased (from 0.94 +/- 0.05
      to 1.14 +/- 0.07 mmol/L, P less than .005) in the patients who received chromium.
      There was no change in serum cholesterol or blood glucose during the study.

PMID- 1619997
TI  - Intracellular free-magnesium levels in vascular smooth muscle and striated muscle
      cells of the spontaneously hypertensive rat.
AB  - In humans with essential hypertension and in spontaneously hypertensive rats
      (SHR), insulin resistance may be present even in lean individuals. As the basis
      for this abnormality is unknown, we have used a newly developed fluorophore to
      measure intracellular free-Mg2+ concentrations in cultured aortic vascular smooth
      muscle cells and striated muscle cells from SHR and normotensive Wistar Kyoto
      (WKY) rats. Intracellular free-Mg2+ levels were lower in both striated muscle
      cells (SHR, 0.423 +/- 0.077 mmol.L-1 v WKY, 0.559 +/- 0.068 mmol.L-1; P less than
      .001) and vascular smooth muscle cells (SHR, 0.406 +/- 0.067 mmol.L-1 v WKY,
      0.625 +/- 0.077 mmol.L-1; P less than .001) from hypertensive animals. This
      widespread, intrinsic defect in the regulation of intracellular Mg2+ may explain
      the increased vascular resistance and reduced insulin sensitivity present in
      hypertension.

PMID- 1619998
TI  - Red blood cell uridine sugar nucleotide levels in patients with classic
      galactosemia and other metabolic disorders.
AB  - While dietary galactose restriction eliminates the life-threatening complications
      of classic galactosemia, central nervous system and ovarian disease are still
      evident in these patients, despite milk restriction. Because of the possibility
      that reduced tissue levels of uridine diphosphate galactose (UDPgalactose), the
      product of the deficient enzyme, galactose-1-phosphate uridyltransferase, are the
      cause of these unexplained complications, we have measured the concentration of
      red blood cell (RBC) uridine sugar nucleotides in these patients, comparing their
      values not only with those of normal subjects, but also with those of children
      who have other metabolic disorders. RBC UDPgalactose and uridine diphosphate
      glucose (UDPglucose) levels were measured by high-performance liquid
      chromatography (HPLC) in 35 control subjects, 24 galactosemic patients, and 19
      patients with inborn errors of amino acid, organic acid, or ammonia metabolism.
      The last group of patients served as dietary controls, as they were all on
      special low-protein diets that restricted milk intake. The mean levels of
      UDPgalactose in galactosemic children and adults were 38% and 54% lower,
      respectively, than the levels in normal children and adults. While only six of 19
      galactosemic children had levels below the 95% confidence limit for normals, four
      of five galactosemic adults had levels of UDPgalactose in the low range. The mean
      UDPgalactose level in children with other metabolic diseases who were on a low
      milk diet was also reduced by 38%, with a mean not significantly different from
      galactosemics. Compared with normal adults, the level of UDPglucose in
      galactosemic adults was also reduced by 29%, with three of five affected adults
      having UDPglucose values below the 95% confidence limit.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1619999
TI  - Effect of fatty acids on rat liver nuclear T3-receptor binding.
AB  - The effects of selected fatty acids (linoleic, oleic, and palmitic) on
      triiodothyronine (T3)-receptor binding were compared in isolated rat hepatocytes,
      rat liver nuclei, and receptor protein. Scatchard analysis indicated that the
      inhibition of T3-receptor binding by fatty acids was characterized by an increase
      in Kd and no change in maximum binding capacity (MBC). In isolated receptors, the
      rank order of potency for inhibition was linoleic acid greater than oleic acid
      greater than palmitic acid. The Ki for oleic acid in isolated receptors was the
      same as that for whole nuclei (15.4 +/- 1.3 v 16.3 +/- 1.9 mumol/L,
      respectively), indicating that the inhibition of nuclear T3 binding is probably
      at the level of the receptor protein itself. In isolated hepatocytes, linoleic
      acid was more potent than oleic acid in inhibiting T3 binding to nuclear
      receptors. Cell-associated T3 was not affected by the presence of fatty acids,
      implying that cellular uptake of T3 was not inhibited. High concentrations of
      fatty acids were necessary for inhibition of T3-receptor binding in isolated
      hepatocytes, with linoleic acid being one to two orders of magnitude less potent
      in isolated hepatocytes compared with isolated receptors (Ki, 179 +/- 12 v 4.4 +/
      0.5 mumol/L, respectively). It is concluded that the inhibitory effect of fatty
      acids on T3-receptor binding in isolated rat hepatocytes probably occurs at the
      level of the nuclear receptor, and does not involve an inhibition of the access
      of T3 to the receptor. However, in vivo it seems unlikely that fatty acids will
      have access to the nuclear receptors in sufficiently high concentrations to
      affect T3-receptor binding in liver cells.

PMID- 1620000
TI  - Detection and hormonal regulation of the mRNA for cytosolic phosphoenolpyruvate
      carboxykinase in rat lung.
AB  - We have studied the presence of the messenger RNA (mRNA) for the cytosolic
      enzyme, phosphoenolpyruvate carboxykinase (PEPCK), in rat lung by Northern blot
      hybridization to a complementary DNA (cDNA) probe. Lung from normal rats
      contained substantial amounts of this mRNA, although its relative concentration
      was approximately six times lower than in liver. Fasting produced an eightfold
      increase in the content of the enzyme mRNA in lung, which could be reverted to
      normal values by glucose refeeding. Induced diabetes also resulted in a sevenfold
      increase of the levels of PEPCK mRNA in lung. Dexamethasone, thyroid hormone,
      dibutyryl cyclic adenosine monophosphate (cAMP), histamine, and serotonin also
      induced important accumulations of the enzyme mRNA without affecting the
      concentration of beta-tubulin mRNA measured as reference. Thus, the PEPCK gene
      appears to be regulated in a similar manner in lung and liver. The results
      suggest that PEPCK may be involved in lung metabolism in starvation, diabetes,
      and other specific hormonal situations.

PMID- 1620001
TI  - AMA continues to work on RBRVS implementation.

PMID- 1620002
TI  - Affordable healthcare. The big issue.

PMID- 1620003
TI  - MSMS reimbursement roundup.

PMID- 1620004
TI  - BCBSM service to physicians improving, MSMS survey reveals. MSMS Committee still
      seeking more improvements.

PMID- 1620005
TI  - Accent and the international medical graduate. Education, not legislation, is the
      answer.

PMID- 1620006
TI  - Medicine in the UP. Part II.

PMID- 1620007
TI  - Rural health problems plague western UP.

PMID- 1620008
TI  - Your vote and the future of medicine.

PMID- 1620009
TI  - Bloodborne pathogens and right to know: a physician's guide to MIOSHA
      regulations.

PMID- 1620010
TI  - Glass ceiling.

PMID- 1620011
TI  - Fine needle aspiration biopsy of the thyroid.

PMID- 1620012
TI  - Immediate management of the burned patient.

PMID- 1620013
TI  - Transdermal oestrogen replacement therapy.

PMID- 1620014
TI  - Effectiveness, efficiency and the use and misuse of radiology.

PMID- 1620015
TI  - HIV risk behaviour among injecting drug users in Perth: the Australian National
      AIDS and Injecting Drug Use Study.
AB  - OBJECTIVE: This study was carried out in 1989 to examine behaviour involving risk
      of human immunodeficiency virus (HIV) infection and to measure the prevalence of
      HIV antibodies in a sample of injecting drug users (IDUs) in Perth. DESIGN: The
      study was a cross-sectional survey with a sample of convenience of 196 IDUs drawn
      from drug treatment (54%) and non-treatment (46%) populations. RESULTS: Sixty
      five per cent of the sample were men and 35% women. Subjects were predominantly
      heterosexual, were in their late twenties, had not completed secondary school,
      and were on sickness, unemployment or pension benefits. The majority were poly
      drug users, but heroin and amphetamines were the only drugs that had been
      injected by more than 20% of the sample more than once a month. Respondents
      reported injecting an average of 43.6 (SD 83.6) times a month and using 33.7 (SD
      55.4) new needles a month. The majority (70%) had injected within weeks of the
      interview. Sixty-seven per cent had shared needles within months. Respondents
      claimed to pass on used needles more frequently than to accept them, and were
      most likely to share with close friends or lovers when clean needles were
      unavailable and/or when they were withdrawing. While most respondents cleaned
      used needles, few used bleach all or most of the time. Most (78%) respondents had
      been tested for HIV seropositivity at least once. Most had multiple sexual
      partners and 92.3% had engaged in at least one unsafe sexual practice during the
      previous six months. Sixty-four per cent had changed some aspect of drug using,
      and 38% some aspect of sexual behaviour since hearing about the acquired
      immunodeficiency syndrome (AIDS). HIV seroprevalence for the 179 respondents who
      were tested was 2.2%, but this figure should not be taken as an estimate of
      seroprevalence for the Perth IDU population. CONCLUSION: Respondents' behaviour
      placed them at a high level of risk for HIV infection. Based on reported
      behaviour, it is recommended that education for IDUs in Perth should emphasise,
      among other things: not passing on used needles; cleaning used needles and
      syringes with bleach; planning ahead so that sterile equipment is available; and
      further risk reduction, particularly the adoption of safer sexual practices.

PMID- 1620017
TI  - Medical records in general practice.

PMID- 1620016
TI  - Infection with Nocardia species in Queensland. A review of 102 clinical isolates.
AB  - OBJECTIVE: To review the species distribution, pathologic significance and
      disease associations of clinical isolates of Nocardia and related bacteria in
      Queensland, and to examine the characteristics, treatment and outcome of patients
      infected with these organisms. DESIGN AND SETTING: A retrospective review of
      Queensland State Health Laboratory records provided microbiological data for
      Nocardia isolates referred from other laboratories during the period January 1983
      to December 1988. Clinical information was extracted from hospital case notes, or
      obtained from detailed questionnaires completed by attending physicians. Nocardia
      isolates were classified as "significant" if specific treatment for nocardiosis
      was given, or on the basis of autopsy findings. PATIENTS: One hundred and two
      patients had a Nocardia species or a related organism isolated from clinical
      specimens during the study period. RESULTS: The 102 isolates included Nocardia
      asteroides (45), N, brasiliensis (35), N. caviae (5) and N. transvalensis (5).
      Clinical results were available for 93 patients, of whom 74 (80%) had a
      significant isolate recovered. Primary pulmonary or disseminated disease occurred
      in 35 patients, and was caused mainly by N. asteroides. Significant infections of
      skin and soft tissues, primarily due to N. brasiliensis, were found in 39
      patients. Preexisting lung disease and treatment with steroids and
      immunosuppression were risk factors for pulmonary and disseminated nocardiosis. A
      history of inoculation in an outdoor setting was frequent in patients with
      cutaneous disease. Antibiotic regimens that included trimethoprim
      sulfamethoxazole or another sulfonamide agent were used to treat the majority of
      patients with significant infection. Deaths were confined to those with pulmonary
      and disseminated disease, with a case fatality rate of 40% in that group.
      CONCLUSION: Infection with Nocardia species appears to be more common than is
      generally appreciated. The local species distribution and disease spectrum are
      similar to those described elsewhere. A high index of suspicion for nocardiosis
      should be maintained in susceptible hosts with pulmonary infiltrates,
      particularly when there is evidence for metastatic infection, and in patients
      with superficial infections and a history of outdoor injury.

PMID- 1620018
TI  - Assessment of medical students in general practice.
AB  - Assessment of medical students in general practice provides a unique challenge to
      medical educators as it has an extremely broad and varied curriculum. This paper
      discusses some of the main challenges and choices presented to educators and
      outlines and one model of assessment currently used at the University of
      Melbourne. Integration of a variety of assessment tools and a greater
      contribution to the final examination are important considerations for the future
      of general practice and assessment in Australian medical schools.

PMID- 1620019
TI  - Non-dilated urinary tract obstruction.
AB  - OBJECTIVE: To describe the occurrence of obstructive uropathy in the absence of
      dilatation of the urinary tract. CLINICAL FEATURES: Five cases of non-dilated
      obstructive nephropathy are described. All patients were uraemic on presentation.
      Obstruction was caused by retroperitoneal malignancy in two patients and uric
      acid lithiasis in the remaining three. All patients had at least one ultrasound
      examination. Isotope renography and computed tomography were performed in three
      and four patients respectively. None of these imaging techniques suggested
      obstruction in any of the cases. Radionuclide scans were characterised by
      unusually poor perfusion and parenchymal phase images. INTERVENTION AND OUTCOME:
      An immediate diuresis and a rapid return of normal renal function occurred after
      relief of the obstruction in all cases. CONCLUSION: The absence of dilatation in
      obstructive nephropathy is uncommon but may be responsible for delayed diagnosis
      and management of a readily treatable cause of acute renal failure.

PMID- 1620020
TI  - Drug-induced renal disease.
AB  - OBJECTIVE: To review drug-induced renal disease with emphasis on current issues
      and practical problems with commonly used agents. DATA SOURCES: English language
      literature search using MEDLINE, Index Medicus, textbook articles and relevant
      reviews. STUDY SELECTION: Drugs in common use were reviewed in detail. Uncommonly
      used drugs or those with only a few reports of nephrotoxicity were excluded from
      this review. DATA SYNTHESIS: The clinical patterns of nephrotoxicity include an
      episode of acute deterioration of renal function, chronic renal failure and
      proteinuria which may be severe enough to cause the nephrotic syndrome. Diagnosis
      is made by clinical suspicion, distinctive clinical patterns and usually
      improvement in renal function on drug withdrawal. CONCLUSION: A high index of
      suspicion is necessary to detect drug-induced renal disease particularly with
      increasing availability of over-the-counter drugs. Drugs should always be
      suspected of causing renal disease where no alternative cause is obvious. When
      any doubt exists the agent in question should be withdrawn.

PMID- 1620021
TI  - Why does Australia have no national drug policy?

PMID- 1620022
TI  - Trematode eggs in faeces of aboriginal and islander children.

PMID- 1620023
TI  - The cost of cervical screening by general practitioners.

PMID- 1620024
TI  - Emergency department experience of a Scout jamboree.

PMID- 1620026
TI  - Overseas medical practitioners and "racial discrimination".

PMID- 1620025
TI  - Myocardial lesions in SIDS.

PMID- 1620027
TI  - Malaria in Townsville.

PMID- 1620028
TI  - Non-prescription use of bronchodilator aerosols.

PMID- 1620029
TI  - Of spines, braces and steel rods.

PMID- 1620030
TI  - Analgesia for day surgery.

PMID- 1620031
TI  - Hormone replacement therapy and common sense.

PMID- 1620032
TI  - In search of the pathogenesis of refractory cervicobrachial pain syndrome.

PMID- 1620033
TI  - Blue-green algae (cyanobacteria)

PMID- 1620034
TI  - The occurrence of chickenpox.

PMID- 1620036
TI  - A review of electronic portal imaging devices (EPIDs).
AB  - On-line electronic portal imaging devices are beginning to come into clinical
      service in support of radiotherapy. A variety of technologies are being explored
      to provide real-time or near real-time images of patient anatomy within x-ray
      fields during treatment on linear accelerators. The availability of these devices
      makes it feasible to verify treatment portals with much greater frequency and
      clarity than with film. This article reviews the physics of high-energy imaging
      and describes the operation principles of the electronic portal imaging devices
      that are under development or are beginning to be used clinically.

PMID- 1620035
TI  - Treatment of candida epididymo-orchitis with oral fluconazole.

PMID- 1620037
TI  - The spatial and energy dependence of bremsstrahlung production about beta point
      sources in H2O.
AB  - A Monte Carlo simulation was performed to characterize the spatial and energy
      distribution of bremsstrahlung radiation from beta point sources important to
      radioimmunotherapy (RIT). Using the EGS4 Monte Carlo code, the isotropic emission
      and transport of monoenergetic 0.1-, 0.5-, 1.0-, 2.0-, and 3.0-MeV electrons and
      32P and 90Y beta particles was simulated in an infinite, homogeneous H2O phantom.
      The probability of bremsstrahlung production for each Monte Carlo-simulated
      electron step was accumulated in energy intervals not exceeding 5 keV and stored
      as a function of radial position. To validate this scheme, the EGS4 code was
      tested in the continuous slowing down approximation (csda) mode, with resulting
      radiation yields seen to agree with values in ICRU Report No. 37 (ICRU, Bethesda,
      MD, 1984) to better than 1.6%. The radiation yield calculated with the simulation
      of secondary particles is seen to be 3%-5% greater than the csda yield. The
      photon energy distributions are characterized by a typically broad bremsstrahlung
      spectrum with the probability of photon generation decreasing with radial
      distance. In the energy range 0.05-0.511 MeV, the probability for bremsstrahlung
      production from 90Y (2.76 x 10(-2) decay-1) is twice that from 32P (1.35 x 10(-2)
      decay-1). When passed through 10 cm of H2O and put upon a standard NaI
      scintillation camera, count rates of 2.3 x 10(-6) and 1.2 x 10(-6) counts s-1 Bq
      1 are estimated from point sources of 90Y and 32P. These results predict the
      inherent spatial resolution limitation and provide the initial data required for
      modeling and analyzing the scatter, attenuation, and image formation processes in
      quantitative imaging of bremsstrahlung for RIT dosimetry.

PMID- 1620038
TI  - Electron bolus design for radiotherapy treatment planning: bolus design
      algorithms.
AB  - Computer algorithms to design bolus for electron beam radiotherapy treatment
      planning were investigated. Because of the significant electron multiple scatter,
      there is no unique solution to the problem of bolus design. However, using a
      sequence of operators, a bolus can be designed that attempts to meet three
      important criteria: adequate dose delivery to the target volume, avoidance of
      critical structures, and dose homogeneity within the target volume. Initial
      calculation of bolus shape was based upon creation operators forcing either the
      physical or the effective depths of the distal surface of the target volume to a
      specified value. Modification operators were then applied to the bolus to alter
      the shape to better meet the design criteria. Because the operators each address
      a single dosimetric issue, they can often adversely affect some other attribute
      of the dose distribution. In addition, an extension operator is used to design
      the bolus thickness outside the target volume. Application of these operators is
      therefore carried out in certain sequences and each may be used more than once in
      the design of a particular bolus. The effects of these operators on both the
      bolus and the resulting dose distribution are investigated for test geometries
      and patient geometries in the nose, parotid, and paraspinal region.

PMID- 1620039
TI  - Optimal electron-beam treatment planning for retinoblastoma using a new three
      dimensional Monte Carlo-based treatment planning system.
AB  - Electron-beam treatment planning for retinoblastoma was investigated and an
      optimal treatment plan was devised for a particular case using a new three
      dimensional Monte Carlo-based treatment planning system known to be capable of
      correctly predicting dose perturbations caused by body surface obliquities and
      tissue heterogeneities. Computed tomography (CT) data files were used to
      construct a three-dimensional eye phantom representing the anatomy of a child's
      orbit. Dose distributions in sagittal, transverse, and coronal planes were
      predicted with 1-mm resolution. Study of these distributions led to an optimal
      treatment plan consisting of an anterior-lateral pair, with the anterior field
      being a 10-MeV, 30-mm-diam circular field, centrally blocked by a 10-mm-diam
      lucite lens shield and the lateral field being a 16-MeV, 30 x 25-mm D-shaped
      field. The anterior field delivers a therapeutic dose to the ora serrata, but it
      underdoses the posterior retinal surface behind the lens shield; the lateral
      field provides the necessary boost dose to the posterior retinal surface. An
      equally weighted combination of the two fields produces a dose distribution in
      which the entire retinal surface receives a therapeutic dose, with less than 10%
      of that dose being delivered to the lens, brain, and the contralateral orbit.

PMID- 1620040
TI  - Some considerations regarding w values for heavy charged-particle radiotherapy.

PMID- 1620042
TI  - Generation and use of measurement-based 3-D dose distributions for 3-D dose
      calculation verification.
AB  - A 3-D radiation therapy treatment planning system calculates dose to an entire
      volume of points and therefore requires a 3-D distribution of measured dose
      values for quality assurance and dose calculation verification. To measure such a
      volumetric distribution with a scanning ion chamber is prohibitively time
      consuming. A method is presented for the generation of a 3-D grid of dose values
      based on beam's-eye-view (BEV) film dosimetry. For each field configuration of
      interest, a set of BEV films at different depths is obtained and digitized, and
      the optical densities are converted to dose. To reduce inaccuracies associated
      with film measurement of megavoltage photon depth doses, doses on the different
      planes are normalized using an ion-chamber measurement of the depth dose. A 3-D
      grid of dose values is created by interpolation between BEV planes along
      divergent beam rays. This matrix of measurement-based dose values can then be
      compared to calculations over the entire volume of interest. This method is
      demonstrated for three different field configurations. Accuracy of the film
      measured dose values is determined by 1-D and 2-D comparisons with ion chamber
      measurements. Film and ion chamber measurements agree within 2% in the central
      field regions and within 2.0 mm in the penumbral regions.

PMID- 1620041
TI  - An interactive beam-weight optimization tool for three-dimensional radiotherapy
      treatment planning.
AB  - A computer software tool has been developed to aid the treatment planner in
      selecting beam weights for three-dimensional radiotherapy treatment planning. The
      program consists of a feasibility search algorithm embedded in an interactive,
      user-friendly driving program. The feasibility search algorithm is based on the
      iterative relaxation algorithm of Cimmino [La Ricerca Scientifica, Vol. I, pp.
      326-333 (1938)] as applied to the radiotherapy inverse problem by Altschuler et
      al. [Med. Phys. 13, 590 (1986)]. Relative importances of structures based upon
      clinical considerations can be incorporated into the algorithm. In order to speed
      convergence, the relaxation parameter is made to vary, with its value based upon
      a measure of deviation from feasibility. The interactive driving program is
      designed so that the treatment planner can make reasonable judgments regarding
      the acceptability of a plan in the event that the dose constraints yield no
      feasible solution. An example of the use of this program applied to a problem in
      three-dimensional radiotherapy treatment planning is illustrated.

PMID- 1620043
TI  - Investigation of the nonlinear aspects of imaging through a highly scattering
      medium.
AB  - The edge-spread function that is expected when imaging a sharp edge in a highly
      scattering medium using a time-of-flight imaging system has been investigated.
      Experimental results have been compared with computer simulations. The effect of
      scattering is to broaden the image of the edge, accompanied by an offset of the
      midpoint (50% transmission) of the edge. Small random errors in the measurement
      of the time of flight results in an increase in the offset of the edge position
      at very short times of flight. The offset in the midpoint of the edge is evidence
      of the nonlinear nature imaging process, in view of which we conclude that
      nonlinear algorithms will be necessary to maximize the image information
      available from measured intensities.

PMID- 1620044
TI  - Coordinate transformation as a primary representation of radiotherapy beam
      geometry.
AB  - An approach to both geometric specification of radiotherapy beams and
      computerized solution of geometric treatment planning problems using coordinate
      transformations is presented. It is demonstrated that the specification of the
      geometric relationship of a treatment beam to a patient can be uniquely given by
      a 4 x 4 coordinate transformation matrix, and that the matrix representation can
      be translated from (and to) the more conventional machine-based specification of
      geometry. This approach enables a compact representation of the patient/beam
      geometry which is independent of the specific labeling conventions of the
      treatment machine and which can be directly exploited in the solution of
      treatment planning problems. Beam geometry can be easily described either in
      terms of the natural degrees of freedom of a therapy machine or in terms of
      alternative, problem-specific frames of reference. The ability to use these
      various frames of reference interchangeably allows the designer of treatment
      design software to present appropriate task-specific user interfaces for
      arbitrarily complex tasks, and thus reduce the cognitive burden on users of the
      software.

PMID- 1620045
TI  - Stereotactic radiosurgery: dose-volume analysis of linear accelerator techniques.
AB  - Stereotactic radiosurgery of the brain may be accomplished with a linear
      accelerator by performing several noncoplanar arcs of a highly collimated beam
      focused at a point. The shape of the radiation distribution produced by this
      technique is affected by the beam energy, field size, and the number and size of
      the arcs. The influence of these parameters on the resulting radiation
      distributions was analyzed by computing dose volume histograms for a typical
      brain. Dose volume functions were computed for: (a) the energy range of 4-24 MV x
      rays; (b) target sizes of 1-4 cm; and (c) 1-11 arcs and dynamic rotation. The
      dose volume histograms were found to be dependent on the number of arcs for
      target sizes of 1-4 cm. However, these differences were minimal for techniques
      with 4 arcs or more. The influence of beam energy on the dose volume histogram
      was also found to be minimal.

PMID- 1620046
TI  - Dosimetric characteristics of wedges mounted beyond the blocking tray.
AB  - In a beam accessory configuration for a linear accelerator using a prototype
      multileaf collimator, newly designed wedges were mounted beyond the blocking
      tray. The isodose curves, depth of maximum dose, surface dose, and wedge
      transmission factors were measured for the wedges designed for this unique
      configuration. The same set of wedges was used for both 6- and 18-MV x rays. The
      shape of the wedged isodose curves was essentially unchanged from those produced
      by the conventional wedges located above the blocking tray. The isodose curves
      exhibited the desired wedge angles over the range of field sizes from 5 x 5 to 15
      x 40 cm. In the 10 x 10-cm field, the average difference between the observed
      wedge angle and the desired wedge angle was 3.8 degrees. The surface doses ranged
      from 18% to 35% for the wedged 10 x 10-cm fields as compared with about 15% for
      the same open field. Dosimetrically the wedges were acceptable for clinical use.

PMID- 1620047
TI  - High-energy x-ray beam calibrations using scaling.
AB  - When calibrating high-energy x-ray beams, it is convenient to measure in a
      plastic phantom and convert the result to absorbed dose in water at a specified
      depth, field size, and distance from the source. By combining the scaling theorem
      with the observation that TAR is independent of the distance to the source, it is
      demonstrated that the measurement in plastic can be made at the same source
      detector distance but scaling depth and field size. Experiments to support this
      were made in acrylic and water with 6- and 25-MV x rays and at different
      distances from the source. The agreement between the calibrations in acrylic and
      water was comparable to that using the current national protocol, which
      recommends the scaling of depth only while using the same field size and source
      detector distance in the two media and correcting for the difference in scatter
      dose. It was confirmed that the scaling factor may be the ratio between the
      electron densities of acrylic and water, or the ratio between the linear
      attenuation coefficients. A method to determine this factor directly is also
      described.

PMID- 1620048
TI  - Radial dose distribution from 192Ir seeds at distances far from the source.
AB  - Most current tissue attenuation and scattering factors for 192Ir are valid only
      to distances of 15 cm or less. Monte Carlo calculations using the EGS4 computer
      code were used to calculate tissue attenuation and scattering factors for 192Ir
      seed sources with both stainless steel encapsulation and with Pt encapsulation
      out to a distance of 32 cm from the sources. The data clearly show that
      polynomial tissue attenuation and scattering factors cannot be extrapolated
      beyond their range. Encapsulation specific factors are presented here that are
      valid at large distances from the source.

PMID- 1620049
TI  - Long-term use of an isotope check source for verification of ion chamber
      calibration.
AB  - A radioactive check source is recommended for operational and constancy checks of
      dosimetry systems used for the calibration of therapeutic x-ray generators,
      including linear accelerators. Eight years of data have been analyzed for two ion
      chambers (and their associated electrometers) irradiated at fixed geometry in
      such a device. These dosimetry systems have also been calibrated every 2 years at
      a single Accredited Dosimetry Calibration Laboratory. Our analysis suggests that
      when a check source is used, and the results are consistent, the interval between
      formal calibrations can be lengthened.

PMID- 1620050
TI  - A chamber and electrometer calibration factor as determined by each of the five
      AAPM accredited dosimetry calibration laboratories.
AB  - The same calibration grade ionization chamber and electrometer were sequentially
      sent to all five currently AAPM Accredited Dosimetry Calibration Laboratories
      (ADCL). A Cesium-137 based check device was utilized to ensure chamber and
      electrometer factor constancy and showed a maximum deviation of 0.32% (typically
      less than 0.1%) over the 227 days needed to complete the intercomparison. The
      chamber and electrometer calibration factor provided by each of the five ADCLs
      were analyzed for consistency. The maximum percent difference in reported chamber
      factor between all five ADCLs was 1.40%. The reported electrometer factor had a
      maximum discrepancy of only 0.50%. System (chamber plus electrometer) factors as
      provided by three of the five ADCLs had a maximum discrepancy of 1.51%.

PMID- 1620051
TI  - Chamber replacement correction in absorbed dose calibrations.

PMID- 1620052
TI  - Comparison of IAEA 1987 and AAPM 1983 protocols for dosimetry calibration of
      radiotherapy beams.

PMID- 1620053
TI  - Acceptance testing of magnetic resonance imaging systems: report of AAPM Nuclear
      Magnetic Resonance Task Group No. 6.

PMID- 1620054
TI  - Recommendations on performance characteristics of diagnostic exposure meters:
      report of AAPM Diagnostic X-Ray Imaging Task Group No. 6.
AB  - Task Group 6 of the Diagnostic X-Ray Imaging Committee of the American
      Association of Physicists in Medicine (AAPM) was appointed to develop performance
      standards for diagnostic x-ray exposure meters. The recommendations as approved
      by the Diagnostic X-Ray Imaging Committee and the Science Council of the AAPM are
      delineated in this report and provide specifications on meter precision,
      calibration accuracy, calibration reference points, linearity, energy dependence,
      exposure rate dependence, leakage, amplification gain settings, directional
      dependence, the stem effect, constancy checks, and calibration intervals. The
      report summarizes recommendations for meters used in mammography, general purpose
      radiography including special procedures, computed tomography, and radiation
      safety surveys for x-ray radiography.

PMID- 1620055
TI  - Systematic bias in basis material decomposition applied to quantitative dual
      energy x-ray imaging.
AB  - Basis material decomposition represents dual-energy x-ray attenuation
      measurements in terms of the attenuation coefficients or thickness of two
      standard materials which, when combined, produce attenuation equivalent to the
      object being measured. In tomographic imaging, the reconstructed attenuation
      coefficient is calculated in terms of the attenuation coefficients of the basis
      materials, while in projection imaging, the thicknesses of two materials can be
      specified in terms of the basis materials. This analysis shows that basis
      material decomposition is exact in a dual-monoenergetic system, but for broad
      spectra, x-ray beam hardening introduces a bias into quantitative measurements.
      The error is small enough that it can be ignored when dual-energy imaging is used
      primarily to enhance the contrast of one material over another. The magnitude of
      the error in quantitative measurements depends on the details of the specific
      application including the energy of the x-ray beam, and the composition and
      thickness of the materials included in the object. The magnitude of the error for
      dual-energy bone densitometry has been analyzed using a first-order propagation
      of error analysis and the calculations verified by computer simulation. This
      analysis shows that the magnitude of the systematic error can be as high as 3%
      for 1 g/cm2 of bone mineral when aluminum and acrylic basis materials are used
      for the calibration. This systematic error is eliminated when the basis materials
      are the same as the materials that are being quantified (i.e., bone mineral and
      water).

PMID- 1620056
TI  - Evaluation of a new set of calibration standards for the measurement of fat
      content via DPA and DXA.
AB  - A simulation study was performed to evaluate a new set of calibration standards
      for estimating the fat content of the body via dual-photon absorptiometry (DPA)
      and dual-energy x-ray absorptiometry (DXA). The standards, proposed by Nord and
      Payne [presented at the 2nd meeting of The Bath Conference on Bone Mineral
      Measurement (1990)] consist of stearic acid (100% fat) and 0.6% NaCl in water
      (100% lean). They were compared with other standards consisting of average
      composition adipose/muscle tissues and fatty adipose/lean muscle tissues. Source
      and detector properties of a Gd-153 DPA system and three commercial DXA systems
      were modeled. For each system and calibration set, rms errors in the calculated
      fat contents of simulated tissues having fat mass percentages that ranged from
      about 4%-44% and thicknesses that ranged from 5-20 cm were determined. Beam
      hardening errors for the systems were evaluated as was a calibration technique
      employed by one of the manufacturers to correct for such errors. In general, the
      smallest rms errors (2% or less when the calibration standards and tissues were
      of equal thickness) were obtained with the average adipose/muscle standards.
      Equivalent results were obtained with standards consisting of stearic acid and
      0.8% NaCl. The latter is a higher salt content than proposed by Nord and Payne
      and results from differences in the x-ray attenuation coefficients that were
      employed in calculating the fat equivalence of water. Other, more convenient
      standards, such as lucite and water may be employed by using appropriate fat
      equivalences (approximately 69% for lucite and approximately 10% for water). Beam
      hardening errors for the DXA systems are considerable, and the simulated
      correction technique was shown to be effective.

PMID- 1620057
TI  - Fluoroscopic performance tests using a portable computer/frame grabber: Wiener
      spectra measurements.
AB  - Currently, routine tests of fluoroscopic image quality in common use are highly
      subjective. As part of an effort to develop more quantitative routine tests of
      fluoroscopic image quality, a method was developed to quickly and easily measure
      Wiener spectra (WS) of TV-viewed fluoroscopic systems that considers both spatial
      and temporal noise correlations. A PC-mounted frame grabber captures images at
      the TV frame rate to form a three-dimensional (3-D) array of pixels. Scans of a
      "two-dimensional slit" are then synthesized from which a one-dimensional central
      section of a 3-D WS is calculated. To avoid errors due to coarse (8-bit)
      quantization, a video amplifier is used to expand a portion of the signal to the
      full digitizer range. A reference signal (2 mm of aluminum) is then used to
      normalize image contrast. Ensemble averages of 250 spectra were obtained in
      approximately 1 min, including all processing. Results are presented to
      demonstrate reproducibility, sensitivity, and behavior of the WS. The eventual
      goal of this work is to use this method in conjunction with measurements of an
      MTF to calculate fundamental descriptors of image quality, such as SNR and NEQ.

PMID- 1620058
TI  - Describing the signal-transfer characteristics of asymmetrical radiographic
      screen-film systems.
AB  - The measurement of modulation transfer function for radiographic screen-film
      systems depends critically upon a proper linearization of the measured line
      spread function. This is normally done by photographic photometry (i.e., using
      the measured density versus log exposure relationship to transform the density
      line spread function into an exposure line spread function). It has been long
      appreciated that this procedure may fail for asymmetrical dual screen systems
      that use film with emulsion coated on both sides of the support. The advent of
      asymmetrical and near-zero crossover films that can be used with highly
      asymmetric screen pairs has prompted a reinvestigation of these concerns about
      the definition and measurement of modulation transfer function. For such cases,
      it is useful to define the contrast transfer function, which is a function of
      exposure and spatial frequency. When normalized by its zero frequency value the
      contrast transfer function can serve as the "effective MTF" for low-contrast
      input signals in such systems. In the limit of symmetrical systems this quantity
      approaches the conventionally measured MTF. The utility of this approach is
      demonstrated by applying it to a commercially available asymmetrical screen-film
      combination.

PMID- 1620059
TI  - Density related errors encountered with an electrostatically coupled film
      digitizer tablet.

PMID- 1620060
TI  - Broad line quantitative chemical shift spectroscopy.
AB  - Proton NMR spectroscopy was applied to quantitate the measurement of total body
      water/fat distributions in vivo. A special MR protocol was developed to excite a
      thick slab of tissue and display the magnitude NMR spectrum of the collected
      response signal. Very short echo time TE (8 ms) and long repetition time TR (4000
      ms) were used to minimize relaxation damping of the signal intensities. The
      spectrum was then decomposed into individual lines and proton densities of
      different species were calculated. Proton density information was converted into
      weight percentage data using stoichiometrical and physiological information. The
      technique was validated using phantoms that contained different mixtures of
      water/maize oil. A high-resolution NMR spectrum of maize oil samples was used to
      determine the stoichiometric information. The test results showed good agreement
      with the known composition of the phantom within the whole range of water content
      (0-100%). This method is very fast since no phase encoding of data is required.
      Preliminary results for monkeys show promising potential in clinical
      applications.

PMID- 1620061
TI  - Automated lesion detection and lesion quantitation in MR images using
      autoassociative memory.
AB  - Previous efforts concerning lesion extraction in radiologic images indicated that
      autoassociative memory models can be a valuable tool in automated lesion
      detection. Preliminary results are expanded to resolve the technical problems of
      image registration and magnification. Instead of operating on selected portions
      of the MR images, each entire image matrix is operated upon as image vector
      comprising all stacked columns of the matrix. Spin density weighted images (TR =
      3000 ms and TE = 40 ms) of 42 normal subjects were remapped and standardized with
      respect to location and magnification. All image vectors were orthonormalized to
      span a linear manifold. Standardized abnormal image vectors were then tested by
      the stored autoassociative memory and the abnormalities (novelties) were
      extracted by application of an autocorrelation matrix to the input vector. The
      autocorrelation matrix is computed using image vectors from normal subjects. The
      lesions (multiple sclerosis and tumors) are then identified as the orthogonal
      component to the linear manifold spanned by the basis vectors of the normal brain
      scans. Lesion extraction has been achieved with the intention of quantitating and
      staging diseased parenchyma after automated edge detection.

PMID- 1620062
TI  - Quantitative phase-velocity MR imaging of in-plane laminar flow: effect of fluid
      velocity, vessel diameter, and slice thickness.
AB  - Quantitative MR phase imaging is frequently used to measure spin velocities. A
      potential difficulty may arise, however, when in-plane phase images are acquired
      of a vessel carrying laminar flow, for which the fluid velocity profile is
      parabolic. In that case, depending on the flow velocity (v), the vessel diameter
      (D), and the chosen MR slice thickness (ST), a spin velocity gradient will be
      present to some extent within each intraluminal voxel. The resulting intravoxel
      phase dispersion may be expected to affect the net pixel phase value, and hence
      compromise the assumed linear correlation between phase shift and velocity. In
      this study, the effects of alterations of v, D, and ST on the apparent image
      phase are investigated for the case of laminar flow directed parallel to the
      sequence read gradient. A theoretical model is developed and the conclusions
      experimentally tested using a flow phantom. The data demonstrate that when
      quantitating inplane phase-flow images, significant velocity underestimations may
      occur when the net flow-induced phase shifts are small and the MR slice thickness
      is an appreciable fraction of the vessel diameter.

PMID- 1620063
TI  - Nuclear magnetic relaxation characterization of irradiated Fricke solution.
AB  - The spin-lattice relaxation rate R1(= T1(-1) of irradiated Fricke solution was
      studied as a function of the absorbed dose D. The R1 increases linearly with dose
      up to D approximately 400 Gy after which the response saturates. A model
      describing the R1 of a solution of either ferrous (Fe2+) or ferric (Fe3+) ions is
      presented; it is based on the spin relaxation of protons on water molecules in
      the bulk and protons on water molecules in the coordination shells of the ions
      with fast exchange occurring between the two water environments. All inherent
      relaxation parameters of the different proton groups are determined empirically
      at NMR frequencies of 9 and 25 MHz. An extension of the model is made to describe
      the spin-lattice relaxation behavior of irradiated Fricke solution. Good
      agreement between model predictions and experimental results is observed. The
      model relates the spin-lattice relaxation rate of a Fricke dosimeter to the
      chemical yield of ferric ion, thus potentially creating an absolute NMR dosimetry
      technique. Various practical aspects of the NMR-Fricke system, such as the
      optimal initial ferrous concentration and the NMR frequency dependence of the
      sensitivity, are described.

PMID- 1620064
TI  - Localized beta dosimetry of 131I-labeled antibodies in follicular lymphoma.
AB  - The purpose of this study is to assess the multicellular dosimetry of 131I
      labeled antibody in follicular lymphoma based on histological measurements on
      human tumor biopsy tissue. Photomicrographs of lymph node specimens were analyzed
      by first-order treatment to determine the mean values and statistical variations
      of the radii of follicles (260 +/- 90 microns), interfollicular distances (740 +/
      160 microns), and the number density of follicles [60 +/- 18 in a volume of (2 X
      1480 microns)3]. Based on these measurements, two geometrical models were
      developed for localized beta dosimetry. The first, a regular cubic lattice model,
      assumes no variation in follicular radius of follicles and interfollicular
      distance. The second, a randomized distribution model, is a more complicated but
      more realistic representation of observed histological specimens. In this model,
      Monte Carlo methods were used to reconstruct the spatial distribution of
      follicles by simulating the distribution of the radii of follicles,
      interfollicular distances, and the number density of follicles. Dose calculations
      were performed using Berger's point kernels for absorbed-dose distribution for
      beta particles in water, assuming the 131I-labeled antibodies as point sources.
      It was assumed that the activity concentration of the labeled antibody within the
      follicles was ten times the activity concentration in the interfollicular spaces.
      The spatial distribution of localized dose was calculated for a tumor having an
      average dose of 40 Gy. The localized dose was found to be highly nonuniform,
      ranging from 20 to 90 Gy, and varying by a factor of about 2 from the average
      tumor dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620065
TI  - Satellite RNAs of plant viruses: structures and biological effects.
AB  - Plant viruses often contain parasites of their own, referred to as satellites.
      Satellite RNAs are dependent on their associated (helper) virus for both
      replication and encapsidation. Satellite RNAs vary from 194 to approximately
      1,500 nucleotides (nt). The larger satellites (900 to 1,500 nt) contain open
      reading frames and express proteins in vitro and in vivo, whereas the smaller
      satellites (194 to 700 nt) do not appear to produce functional proteins. The
      smaller satellites contain a high degree of secondary structure involving 49 to
      73% of their sequences, with the circular satellites containing more base pairing
      than the linear satellites. Many of the smaller satellites produce multimeric
      forms during replication. There are various models to account for their formation
      and role in satellite replication. Some of these smaller satellites encode
      ribozymes and are able to undergo autocatalytic cleavage. The enzymology of
      satellite replication is poorly understood, as is the replication of their helper
      viruses. In many cases the coreplication of satellites suppresses the replication
      of the helper virus genome. This is usually paralleled by a reduction in the
      disease induced by the helper virus; however, there are notable exceptions in
      which the satellite exacerbates the pathogenicity of the helper virus, albeit on
      only a limited number of hosts. The ameliorative satellites are being assessed as
      biocontrol agents of virus-induced disease. In greenhouse studies, satellites
      have been known to "spontaneously" appear in virus cultures. The possible origin
      of satellites will be briefly considered.

PMID- 1620066
TI  - Sequestered end products and enzyme regulation: the case of ornithine
      decarboxylase.
AB  - The polyamines (putrescine, spermidine, and spermine) are synthesized by almost
      all organisms and are universally required for normal growth. Ornithine
      decarboxylase (ODC), an initial enzyme of polyamine synthesis, is one of the most
      highly regulated enzymes of eucaryotic organisms. Unusual mechanisms have evolved
      to control ODC, including rapid, polyamine-mediated turnover of the enzyme and
      control of the synthetic rate of the protein without change of its mRNA level.
      The high amplitude of regulation and the rapid variation in the level of the
      protein led biochemists to infer that polyamines had special cellular roles and
      that cells maintained polyamine concentrations within narrow limits. This view
      was sustained in part because of our continuing uncertainty about the actual
      biochemical roles of polyamines. In this article, we challenge the view that ODC
      regulation is related to precise adjustment of polyamine levels. In no organism
      does ODC display allosteric feedback inhibition, and in three types of organism,
      bacteria, fungi, and mammals, the size of polyamine pools may vary radically
      without having a profound effect on growth. We suggest that the apparent
      stability of polyamine pools in unstressed cells is due to their being largely
      bound to cellular polyanions. We further speculate that allosteric feedback
      inhibition, if it existed, would be inappropriately responsive to changes in the
      small, freely diffusible polyamine pool. Instead, mechanisms that control the
      amount of the ODC protein have appeared in most organisms, and even these are
      triggered inappropriately by variation of the binding of polyamines to ionic
      binding sites. In fact, feedback inhibition of ODC might be maladaptive during
      hypoosmotic stress or at the onset of growth, when organisms appear to require
      rapid increases in the size of their cellular polyamine pools.

PMID- 1620068
TI  - Establishment and expression of cellular polarity in fucoid zygotes.
AB  - Zygotes of fucoid algae have long been studied as a paradigm for cell polarity.
      Polarity is established early in the first cell cycle and is then expressed as
      localized growth and invariant cell division. The fertilized egg is a spherical
      cell and, by all accounts, bears little or no asymmetry. Polarity is acquired
      epigenetically a few hours later in the form of a rhizoid/thallus axis. The
      initial stage of polarization is axis selection, during which zygotes monitor
      environment gradients to determine the appropriate direction for rhizoid
      formation. In their natural setting in the intertidal zone, sunlight is probably
      the most important polarizing vector; rhizoids form away from the light. The
      mechanism by which zygotes perceive environmental gradients and transduce that
      information into an intracellular signal is unknown but may involve a
      phosphatidylinositol cycle. Once positional information has been recorded, the
      cytoplasm and membrane are reorganized in accordance with the vectorial
      information. The earliest detectable asymmetries in the polarizing zygote are
      localized secretion and generation of a transcellular electric current. Vesicle
      secretion and the inward limb of the current are localized at the presumptive
      rhizoid. The transcellular current may establish a cytoplasmic Ca2+ gradient
      constituting a morphogenetic field, but this remains controversial. Localized
      secretion and establishment of transcellular current are sensitive to treatment
      with cytochalasins, indicating that cytoplasmic reorganization is dependent on
      the actin cytoskeleton. The nascent axis at first is labile and susceptible to
      reorientation by subsequent environmental vectors but soon becomes irreversibly
      fixed in its orientation. Locking the axis in place requires both cell wall and F
      actin and is postulated to involve an indirect transmembrane bridge linking
      cortical actin to cell wall. This bridge anchors relevant structures at the
      presumptive rhizoid and thereby stabilizes the axis. Approximately halfway
      through the first cell cycle, the latent polarity is expressed morphologically in
      the form of rhizoid growth. Elongation is by tip growth and does not appear to be
      fundamentally different from tip growth in other organisms. The zygote always
      divides perpendicular to the growth axis, and this is controlled by the
      microtubule cytoskeleton. Two microtubule-organizing centers on the nuclear
      envelope rotate such that they align with the growth axis. They then serve as
      spindle poles during mitosis. Cytokinesis bisects the axial spindle, resulting in
      a transverse crosswall. Although the chronology of cellular events associated
      with polarity is by now rather detailed, causal mechanisms remain obscure.

PMID- 1620070
TI  - [Immunologic changes in diabetic ketoacidosis].
AB  - We studied 13 children and adolescents during diabetic ketoacidosis; the duration
      of diabetes ranged from 1.4 to 6.0 years. A group of 13 diabetic sex, age and
      duration of disease-matched children served as control. Patients in ketoacidosis
      showed important abnormalities of T subset percentages (OKT3: 63.4 +/- 1.87% vs
      72.1 +/- 3.4; p less than 0.001. OKT4: 37.18 +/- 1.85% vs 44.6 +/- 3.9; p less
      than 0.01. OKT8: 28.5 +/- 6.51% vs 28.1 +/- 1.9; p less than 0.04) and impaired
      neutrophil chemotaxis (53.10 +/- 3.3 vs 88.1 +/- 7.2; p less than 0.001). The
      patients showed normal levels of all classes of immunoglobulins. No correlation
      was observed between these abnormalities and the degree of ketoacidosis or
      glycaemia. When the patients were re-evaluated out of ketoacidosis, the values of
      the immunological parameters were normal and similar to those of the control
      group.

PMID- 1620071
TI  - [24-hour esophageal pH-metry in the evaluation of gastroesophageal reflux
      pathology].
AB  - Gastro-esophageal reflux (GER) in infants was studied using 24-hour esophageal pH
      monitoring. Gastro-esophageal reflux was detected in 32/41 subjects. In our
      patients the main symptoms were vomiting, regurgitation, failure-to-thrive,
      chronic respiratory problems such as asthma, apnea, recurrent pneumonia. All
      patients with GER were treated appropriately with prone positioning and medical
      therapy (prokinetic agent and, eventually, ranitidine). Successful treatment of
      the reflux was obtained in all patients. In our opinion the 24-hour
      intraesophageal pH monitoring is a highly diagnostic test to identify the
      presence of GER and evaluate its gravity.

PMID- 1620072
TI  - [Acute nonbacterial bronchopneumopathies in the 1st years of life. Diagnostic
      strategies and clinico-epidemiological peculiarities].
AB  - The authors summarise diagnostic strategies an clinical epidemiologic
      peculiarities of non-bacterial bronchopneumopathies in children. The role of
      classic viral agents (virus influenzal A-B, virus parainfluenza 2-3, RVS) is
      stressed without neglecting the role of other etiologic agents such as Chlamydia
      trachomatis, Mycoplasma pneumoniae and Pneumocystis carinii. The Authors point
      out the necessity of direct investigation (viral cultures, direct investigation
      in IF and ELISA, investigation with DNA probe use, etc.) and indirect serologic
      investigation to obtain the greatest possible accuracy an early diagnosis.

PMID- 1620069
TI  - Oxygen relations of nitrogen fixation in cyanobacteria.
AB  - The enigmatic coexistence of O2-sensitive nitrogenase and O2-evolving
      photosynthesis in diazotrophic cyanobacteria has fascinated researchers for over
      two decades. Research efforts in the past 10 years have revealed a range of O2
      sensitivity of nitrogenase in different strains of cyanobacteria and a variety of
      adaptations for the protection of nitrogenase from damage by both atmospheric and
      photosynthetic sources of O2. The most complex and apparently most efficient
      mechanisms for the protection of nitrogenase are incorporated in the heterocysts,
      the N2-fixing cells of cyanobacteria. Genetic studies indicate that the controls
      of heterocyst development and nitrogenase synthesis are closely interrelated and
      that the expression of N2 fixation (nif) genes is regulated by pO2.

PMID- 1620067
TI  - Mechanism and regulation of eukaryotic protein synthesis.
AB  - This review presents a description of the numerous eukaryotic protein synthesis
      factors and their apparent sequential utilization in the processes of initiation,
      elongation, and termination. Additionally, the rare use of reinitiation and
      internal initiation is discussed, although little is known biochemically about
      these processes. Subsequently, control of translation is addressed in two
      different settings. The first is the global control of translation, which is
      effected by protein phosphorylation. The second is a series of specific mRNAs for
      which there is a direct and unique regulation of the synthesis of the gene
      product under study. Other examples of translational control are cited but not
      discussed, because the general mechanism for the regulation is unknown. Finally,
      as is often seen in an active area of investigation, there are several
      observations that cannot be readily accommodated by the general model presented
      in the first part of the review. Alternate explanations and various lines of
      experimentation are proposed to resolve these apparent contradictions.

PMID- 1620073
TI  - [Growth hormone secretion in response to the administration of thyrotropin
      releasing hormone (TRH) in children with insulin-dependent diabetes mellitus].
AB  - In this study the Authors examined the response in growth hormone (GH) to
      thyrotrophin releasing hormone (TRH) administration in a group composed of 29
      children (17 males, 12 females) suffering from insulin-dependent diabetes
      mellitus (IDDM) (group 1). All subjects were prepubertal, had a chronological age
      of 8.82 +/- 1.76 years (m +/- SD), a bone age of 8.60 +/- 1.65 years; the time
      elapsed since the diagnosis was 2.45 +/- 1.51 years, glycosylated hemoglobin
      (HbA1c) was 7.33 +/- 1.80%. Some of the same subjects (all those with a response
      in GH to TRH higher than 4 ng/ml; no. 11; group 2) were examined again 12-18
      months later; as controls, 13 short children were also examined (group 3). All
      the subjects of the three groups showed a TSH peak ranging from 10-25 microU/ml,
      whereas GH peak resulted higher than 4 ng/ml ("paradoxical" response) in 6
      subject of the group 1 and in an only subjects of the group 2. All the responders
      of the 3 groups showed a value in HbA1c higher than 8%. A significant difference
      was not present between males and females in GH and TSH values. Cortisol levels
      and glycaemia remained almost constant during the performance of the tests. By
      considering all the groups, TSH and GH values during TRH-test were not correlated
      with glycaemia, chronological age, bone age, the time elapsed since the
      diagnosis, height, height velocity, HbA1c values. In conclusion, our data
      demonstrated that "paradoxical" response in GH to TRH administration was present
      only in some subjects and particularly in those with a poor metabolic control of
      the disease.

PMID- 1620074
TI  - [Clinical implications of sensitization to inhalants in atopic dermatitis].
AB  - In 104 children with atopic dermatitis (AD) and RAST tests for 2 inhalant and 9
      food allergen mixtures, RAST results, severity of skin involvement and presence
      of respiratory symptoms by history were analyzed in addition to total serum IgE
      values available in 66 children. Overall frequency of sensibilization was high
      (74%) with more positive RAST results for foods than inhalants, although of the
      latter the only two tested were among the more frequently positive. When the
      subjects positive for inhalants were considered alone, the frequency of
      respiratory symptoms was significantly higher in those sensitized to both
      inhalant mixtures tested (dermatophagoides and graminaceae) and the presence of
      more severe skin lesions was more common among those sensitized to graminaceae.

PMID- 1620075
TI  - [Ehlers-Danlos syndrome. Description of 2 clinical cases].
AB  - The paper describes the clinical symptoms and biochemical tests carried out in
      two girls suffering from Ehlers-Danlos syndrome. The most typical clinical
      feature, which is common to both cases, was the presence of skin alterations at
      the extensor surface level of elbows and, above all, knees. These alterations
      appeared to be delimited areas with irregular margins where the skin was thin,
      dry, hyperpigmented, wrinkled, with scanty or absent subcutaneous tissue.
      Biochemical tests carried out on cutaneous fibroblast cultures excluded the
      presence type I collagen alterations and an altered secretion of type I or III
      procollagen secretion. The Authors discuss the attribution of cases presented
      within the context of the various forms of Ehlers-Danlos syndrome in relation to
      clinical findings and the results of the biochemical tests.

PMID- 1620077
TI  - [AIDS in the world].

PMID- 1620076
TI  - [Use of intravenous immunoglobulins in Guillain-Barre syndrome].
AB  - The aim of the study was to assess the utility of intravenous integral molecule
      immunoglobulin treatment in Guillain-Barre syndrome. The etiopathogenesis of this
      syndrome is still unclear but it seems increasingly likely that immune phenomena
      are involved in the genesis of the neurological lesions. This would explain the
      efficacy of iv immunoglobulin treatment even if the effective mechanism of action
      can still only be hypothesised.

PMID- 1620078
TI  - [Several aspects of the treatment of HIV infections].

PMID- 1620079
TI  - [AIDS in transplant recipients].

PMID- 1620080
TI  - [Nocardiosis and AIDS].

PMID- 1620081
TI  - Taking the guesswork out of bloodborne pathogen regulations?

PMID- 1620082
TI  - BNDD complaints.

PMID- 1620083
TI  - Fast, good, and cheap.

PMID- 1620084
TI  - Cry of the heart. Reflections of a practitioner.

PMID- 1620085
TI  - HCFA survey form.

PMID- 1620086
TI  - Research on ticks and tickborne pathogens in Missouri--an interim research
      report.

PMID- 1620087
TI  - A blueprint for reform in medical education.

PMID- 1620088
TI  - Isolated traumatic accessory splenic rupture: a case report and literature
      review.
AB  - Although small and relatively protected, an accessory spleen can be the cause of
      acute intraabdominal symptoms following minimal trauma. Although a splenic
      fracture or laceration may not be apparent on by CT scan, the scan cannot rule
      out the possibility. The diagnosis of splenic injury should be entertained in
      light of appropriate history and physical findings. The case we present and prior
      similar cases are a useful review of isolated accessory splenic rupture due to
      blunt trauma.

PMID- 1620089
TI  - Kayaking as a risk factor for leptospirosis.
AB  - Leptospirosis is a common zoonosis present throughout Missouri. Previously
      regarded as an occupational illness of farmers and sewer workers, it is now
      primarily acquired from exposure to water polluted with the bacteria Leptospira.
      We present a case report of leptospirosis acquired through kayaking and review
      both the disease and the risk factor associated with kayaking.

PMID- 1620090
TI  - Aggressive rehabilitation following anterior cruciate reconstruction: an update
      and protocol.
AB  - Dramatic changes in anterior cruciate ligament (ACL) reconstruction surgery and
      rehabilitation methods have occurred during the past few years. These
      developments are reviewed briefly, and a rapid rehabilitation protocol is
      presented which facilitates the safe return of the patient to his or her pre
      operative functional level in sports and activities of daily living.

PMID- 1620091
TI  - Mutagenesis after exposure of bacteria to ultraviolet light and delayed
      photoreversal.
AB  - The induction of mutations by ultraviolet light and delayed photoreversal in
      bacteria defective for SOS mutagenesis is discussed in terms of two models: the
      two-step misincorporation and bypass model, and the model involving simple
      deamination of cytosine-containing dimers. In phage S13 the latter appears to be
      the predominant mechanism. In Escherichia coli there is little evidence that the
      simple deamination mechanism is of any significance except in ung strains lacking
      uracil glycosylase where uracils left after photoreversal are not removed.
      Deamination might, however, occur during the operation of translesion synthesis
      via the two-step model and if it did, subsequent photoreversal would lead to the
      "mutation" being extended from one to both strands by uracil glycosylase repair
      rather than being removed.

PMID- 1620092
TI  - Survival of phage M13 with uracils on one or both DNA strands.
AB  - The survival of M13 DNA was studied after partial replacement of thymine by
      uracil in the bacteriophage. Uracils carry the same genetic information as the
      thymines. Nevertheless in Escherichia coli wild-type cells, uracils in DNA are
      replaced by thymines by excision repair initiated by uracil-DNA glycosylase
      (UDG). Thus inactivation of uracil-containing phage DNA is solely due to repair
      initiated by UDG. Incorporation of uracils was achieved in one or in both
      strands, either randomly or site-specifically using differently uracylated
      oligonucleotides. The results show that up to 580 uracils can be repaired without
      a significant decrease in survival if the uracils are localized in the (-) strand
      only. Incorporation of 246 uracils into the (+) strand leads to approximately 30%
      or approximately 10% survival when expressed in Escherichia coli strains CMK and
      JM103, respectively. However, when uracils are distributed over both strands a
      sharp decrease in survival occurs. This shows that the repair of two uracils
      localized in close proximity on opposite strands of the DNA by the excision
      repair mechanism is difficult, whereas uracils occurring in one strand are
      repaired more efficiently, irrespective of their number.

PMID- 1620093
TI  - Identification of a site required for DNA replication fork blocking activity in
      the rRNA gene cluster in Saccharomyces cerevisiae.
AB  - The yeast genome has DNA replication fork blocking sites, that we have named sog
      sites, in the ribosomal RNA gene (rDNA) cluster. These are located at the 3' end
      of the 35S rRNA transcription unit and they block replication fork movement in a
      direction opposite to that of RNA polymerase I. We cloned this replication
      blocking site into a YEp-type plasmid and analyzed DNA replication intermediates,
      using two-dimensional (2D) agarose gel electrophoresis. The blocking activity
      remained even on a plasmid not involved in 35S rRNA transcription and inhibited
      fork movement in the same polar fashion as on the yeast chromosome. To define the
      site further, smaller fragments were subcloned into the YEp-type plasmid. A small
      109 bp region exhibited sog activity and was located near the enhancer region for
      35S rRNA transcription. It overlaps an essential element of the recombinational
      hot spot HOT1.

PMID- 1620094
TI  - A new member of the adenylate kinase family in yeast: PAK3 is highly homologous
      to mammalian AK3 and is targeted to mitochondria.
AB  - Making use of the polymerase chain reaction primed by oligonucleotides
      corresponding to regions conserved between members of the nucleoside
      monophosphate kinase family, we have isolated the yeast gene PAK3. Pak3p belongs
      to the subgroup of long-form adenylate kinase isozymes (deduced molecular mass
      25.3 kDa) and exhibits highest sequence similarity to bovine AK3 rather than to
      the yeast isozyme, Aky2p. The gene is shown to be non-essential because haploid
      disruption mutants are viable, both in the presence and absence of a functional
      AKY2 allele. It maps on chromosome V upstream of RAD3. Its expression level is
      low when cells are grown on glucose or other fermentable carbon sources and about
      threefold higher on glycerol, but can be significantly induced by ethanol. A
      PAK3/mouse dihydrofolate reductase fusion construct expressed in yeast is
      targeted to mitochondria. Transformation with PAK3 on a multicopy plasmid
      complements neither adenylate kinase deficiency in an aky2-disrupted yeast strain
      nor in Escherichia coli cells conditionally defective in adenylate kinase.

PMID- 1620095
TI  - Regulated transcription of the maize Bronze-2 promoter in electroporated
      protoplasts requires the C1 and R gene products.
AB  - The putative maize transcription factor genes R and C1 are required for
      expression of reporter genes with promoters from the Bz1 and A1 genes, which
      encode enzymes required for anthocyanin biosynthesis in maize. Bz2 is another
      anthocyanin biosynthetic gene; we show that expression of a reporter gene from
      the Bz2 promoter also requires R and C1 when the fusion construct is introduced
      into maize kernels by particle gun bombardment. When electroporated into maize
      protoplasts from a suspension cell line not synthesizing anthocyanins, reporter
      genes with Bz2, Bz1, and A1 promoters are expressed only when both R and C1
      expression plasmids are co-electroporated. Electroporation of R and C1 expression
      plasmids also induces the endogenous genes required for anthocyanin synthesis,
      resulting in pink protoplasts within 24 h. RNase protection analysis demonstrates
      that accumulation of mRNA from the endogenous Bz1 and Bz2 genes absolutely
      requires introduced R and C1. In time-course experiments there is a delay of 3-6
      h before the Bz2 promoter is activated, supporting the proposed role for R- and
      C1-encoded proteins in transcriptional control. An excess of R relative to C1
      suppresses expression of A1, Bz1, and Bz2 promoters, suggesting an interaction
      between the R and C1 proteins.

PMID- 1620096
TI  - Immunity and resistance to the KP6 toxin of Ustilago maydis.
AB  - The KP6 toxin of Ustilago maydis, encoded by segmented double-stranded (ds) RNA
      viruses, is lethal to sensitive strains of the same species and related species.
      The toxin consists of two polypeptides, alpha and beta, synthesized as a single
      preprotoxin, which are not covalently linked. Neither polypeptide alone is toxic,
      but killer activity can be restored by in vitro and in vivo complementation.
      Killer-secreting strains are resistant to the toxin they produce. Resistance is
      conferred by a single recessive nuclear gene. This study describes a search for
      cytoplasmic factors that may confer resistance, also referred to as immunity. The
      approaches used to detect cytoplasmic immunity included transmission of dsRNA and
      transmission of virus particles to sensitive cells by cytoduction, cytoplasmic
      mixing in diploids and infection with viruses. An alternative approach was also
      used to express cloned cDNAs of the KP6 toxin-encoding dsRNA and of the alpha and
      beta polypeptides. The results indicated that no immunity to KP6 can be detected.
      While KP6, alpha and beta polypeptides were expressed by resistant cells, neither
      KP6 nor beta were expressed in sensitive strains. The alpha polypeptide was
      expressed in sensitive cells, but it did not confer immunity. These results
      suggest that neither the preprotoxin nor the alpha or beta polypeptides confer
      immunity and thus beta may be the toxic component of the binary toxin.

PMID- 1620097
TI  - Analysis of an upstream regulatory sequence required for activation of the
      regulatory gene xylS in xylene metabolism directed by the TOL plasmid of
      Pseudomonas putida.
AB  - Transcription from the promoter of a positive regulatory gene, xylS, on the TOL
      plasmid of Pseudomonas putida is activated by another positive regulator, XylR,
      in the presence of m-xylene and is dependent on RNA polymerase containing the
      NtrA protein (sigma 54). Deletion analysis of the upstream region of the xylS
      gene revealed an upstream regulatory sequence (URS), located between 145 and 188
      bp upstream from the transcription start site. The URS is active in either
      orientation and can be placed 3.9 kb further upstream without loss of activity.
      Dependence of activation on helical periodicity was observed in the region
      between the URS and the promoter of the xylS gene, suggesting DNA loop formation
      between these two sites, which are located about 100 bp apart. The expression of
      xylR was autogenously repressed by XylR protein. This autogenous repression is
      decreased in an NtrA- background, irrespective of the presence of the xylS
      promoter in cis, indicating that NtrA protein, or NtrA-containing RNA polymerase
      that is not bound to the xylS promoter, is involved in the binding of XylR
      protein to the URS.

PMID- 1620099
TI  - The switching gene swi6 affects recombination and gene expression in the mating
      type region of Schizosaccharomyces pombe.
AB  - The products of 11 switching (swi) genes are required for efficient mating-type
      (MT) switching in homothallic (h90) strains of Schizosaccharomyces pombe. The MT
      region of h90 comprises three cassette genes: the expression site mat1:1 and two
      silent loci, mat2:2 and mat3:3. Besides reducing MT switching, the swi6 mutation
      leads to deletions in the MT region caused by intrachromosomal cross-overs
      between two paired cassettes. These deletions only arise if DNA double-strand
      breaks are present at mat1:1, which initiate MT switching. Furthermore, swi6
      allows meiotic recombination in the K region, a region of 16 kb between mat2:2
      and mat3:3; in wild-type strains no recombination occurs in K. swi6 also allows
      the simultaneous expression of two different cassettes in the same haploid cell.
      Thus swi6 may have an influence on the general chromatin structure in the MT
      region.

PMID- 1620098
TI  - Herbicide resistance due to amplification of a mutant acetohydroxyacid synthase
      gene.
AB  - We have selected a tobacco cell line, SU-27D5, that is highly resistant to
      sulfonylurea and imidazolinone herbicides. This line was developed by selection
      first on a lethal concentration of cinosulfuron and then on increasing
      concentrations of primisulfuron, both sulfonylurea herbicides. SU-27D5 was tested
      against five sulfonylureas and one imidazolinone herbicide and was shown, in
      every case, to be two to three orders of magnitude more resistant than wild-type
      cells. The acetohydroxyacid synthase (AHAS) of SU-27D5 was 50- to 780-fold less
      sensitive than that of wild-type cells to herbicide inhibition. The specific
      activity of AHAS in the SU-27D5 cell lysate was 6 to 7 times greater than that in
      wild-type cells. Using Southern analysis, we showed that cell line SU-27D5 had
      amplified its SuRB AHAS gene about 20-fold while maintaining a normal diploid
      complement of the SuRA AHAS gene. Genomic clones of both AHAS genes were isolated
      and used to transform wild-type tobacco protoplasts. SuRB clones gave rise to
      herbicide-resistant transformants, whereas SuRA clones did not. DNA sequencing
      showed that all SuRB clones contained a point mutation at nucleotide 588 that
      converted amino acid 196 of AHAS from proline to serine. In contrast, no
      mutations were found in the SuRA clones. The stability of SuRB gene amplification
      was variable in the absence of selection. In one experiment, the withdrawal of
      selection reduced the copy number of the amplified SuRB gene to the normal level
      within 30 days. In another experiment, amplification remained stable after
      extended cultivation on herbicide-free medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620101
TI  - Transfer of defined numbers of chloroplasts into albino protoplasts by
      subprotoplast/protoplast microfusion: chloroplasts can be "cloned", by using
      suitable plastome combinations or selective pressure.
AB  - Defined numbers (1-5) of (donor) chloroplasts were transferred into (acceptor)
      protoplasts of plastid albino mutants by subprotoplasts/protoplast microfusion.
      Single transferred plastids gave rise to new organelle populations in the progeny
      of the fusion products when suitable combinations of plastomes were used or when
      selective pressure for the plastome transferred was applied. This process is
      termed "chloroplast cloning" and is the first reported case of "cloning" a cell
      organelle. The plastome combination and the presence or absence of selective
      pressure were found to influence the frequencies with which cell lines,
      containing both plastomes or acceptor or donor only, were obtained, and the
      number of cell generations needed for complete segregation - as measured by the
      duration of culture before the green donor plastome could be detected. The high
      frequency of cell lines and regenerated shoots recovered with donor plastome
      only, even when only a single chloroplast was transferred, leads to the
      conclusion that all organelles present in the fusion product contribute to the
      organelle population of the progeny, i.e. organelle death or loss are not
      regularly occurring events during plant regeneration from protoplasts in
      Nicotiana tabacum.

PMID- 1620100
TI  - Molecular characterisation of inter- and intra-specific somatic hybrids of potato
      using randomly amplified polymorphic DNA (RAPD) markers.
AB  - Protoplast fusion allows the transfer of both mono- and polygenic traits between
      species that are sexually incompatible. This approach has particular relevance
      for potato, and somatic hybridisation has been used to introduce a range of
      disease resistance genes from sexually incompatible wild species into the
      cultivated potato gene pool. In addition, protoplast fusion allows the
      resynthesis of tetraploid genotypes from preselected diploid or dihaploid donor
      parents. A limiting factor for the efficient exploitation of this technology in
      potato breeding is the difficulty of unequivocally identifying nuclear hybrids
      (heterokaryons). In order to facilitate the identification of hybrids at an early
      stage following fusion, Randomly Amplified Polymorphic DNA markers (RAPDs) have
      been used to characterise molecularly both inter- and intra-specific somatic
      hybrids of potato. RAPD markers detect naturally occurring polymorphism in the
      donor genotypes and utilise short oligonucleotide primers of arbitrary nucleotide
      sequence in combination with the polymerase chain reaction (PCR). The
      exploitation of RAPDs in the characterisation of both somatic and sexual hybrids
      is discussed.

PMID- 1620102
TI  - Riboflavin operon of Bacillus subtilis: unusual symmetric arrangement of the
      regulatory region.
AB  - Seventeen cis-dominant mutations leading to riboflavin overproduction in Bacillus
      subtilis were localized to the region between nucleotides +37 and +159 relative
      to the transcription initiation site of the riboflavin operon. This region
      displays an unusual structure for regulatory sequences. The main part of it
      represents clusters of A/T and G/C-rich sequences that symmetrically blank a
      short inverted repeat.

PMID- 1620103
TI  - The two genes encoding protein synthesis initiation factor eIF-5A in
      Saccharomyces cerevisiae are members of a duplicated gene cluster.
AB  - Translation initiation factor eIF-5A is an abundant protein in which a lysine
      residue is modified by spermidine to form the amino acid derivative, hypusine.
      The factor is encoded by two genes in Saccharomyces cerevisiae, called TIF51A and
      TIF51B, which are regulated reciprocally by oxygen and by heme. TIF51B, also
      called ANB1, is located on chromosome X in a region called COR. We physically
      mapped TIF51A and its associated serine tRNA2 gene by the method of chromosome
      fragmentation and pulsed-field gel electrophoresis. TIF51A maps 90 kb from the
      left end of chromosome V in a region called ARC. The COR and ARC regions contain
      CYC1 and CYC7, respectively, and appear to be duplications carrying numerous
      related genes. The arrangements of related genes in the two regions are
      incompatible with a duplication mechanism involving a circular intermediate.

PMID- 1620104
TI  - Molecular structure and evolution of double-minute chromosomes in methotrexate
      resistant cultured mouse cells.
AB  - To determine whether microscopically visible double-minute chromosomes (DMs) are
      derived from submicroscopic precursors, we monitored the amplification of the
      dihydrofolate reductase (DHFR) gene in 10 independent isolates of methotrexate
      (MTX)-resistant mouse cells. At every other doubling in MTX concentration, the
      cells were examined both microscopically, to detect the presence of
      microscopically visible DMs, and by pulsed-field gel electrophoresis and
      hybridization to a DHFR-specific probe, to detect submicroscopic DMs. One of the
      cloned MTX-resistant isolates was examined in detail and was shown to originally
      contain amplified DHFR genes on circular DMs measuring 1 and 3 Mb in size;
      additionally, metaphase chromosome preparations from this cloned isolate were
      examined and were shown to contain microscopically visible DMs too large to enter
      a pulsed-field gel. During stepwise selection for increasing levels of MTX, the
      smaller DMs (not microscopically visible) were shown to be preferentially
      amplified, whereas the larger (microscopically visible) ones decreased in
      relative numbers. Rare-cutting NotI digestion patterns of total genomic DNA that
      includes the DMs containing the DHFR gene suggest that the DMs increase in copy
      number without any further significant rearrangements. We saw no evidence from
      any of the 10 isolates to suggest that microscopically visible DMs are formed
      from smaller submicroscopic precursors.

PMID- 1620105
TI  - High-fidelity gene targeting in embryonic stem cells by using sequence
      replacement vectors.
AB  - Mutations were targeted to the Hprt locus in murine embryonic stem cells by using
      sequence replacement vectors. When the vector was designed such that the mutated
      sequences were flanked on both sides by several kilobases of DNA homologous to
      the target locus, replacement of chromosomal sequences with the exogenous DNA
      occurred with precision. If, on the other hand, the target-homologous DNA on one
      arm of the vector was reduced to below 1 kb in length, the fidelity of
      recombination was diminished.

PMID- 1620106
TI  - U-rich sequence-binding proteins (URBPs) interacting with a 20-nucleotide U-rich
      sequence in the 3' untranslated region of c-fos mRNA may be involved in the first
      step of c-fos mRNA degradation.
AB  - Rapid decay of the c-fos transcript plays a critical role in controlling
      transforming potential of the c-fos proto-oncogene. One of the mRNA instability
      determinants is a 75-nucleotide AU-rich element (ARE) present in the 3'
      untranslated region of the c-fos transcript. It appears to control two steps in
      the process of c-fos mRNA degradation: removal of the poly(A) tail, which does
      not require the AUUUA motifs, and subsequent degradation of deadenylated mRNA,
      which appears to be dependent on the AUUUA motifs. In this study, we report the
      identification of four U-rich sequence binding proteins (URBPs) that specifically
      interact with a 20-nucleotide U-rich sequence within the c-fos ARE. Gel mobility
      shift assay and competition experiments showed that these protein factors form
      three specific band-shifted complexes with the c-fos ARE. Binding activity of one
      of the protein factors, a 37-kDa protein, is significantly affected by serum
      induction and by pretreatment of cells with drugs known to stabilize many of the
      immediate-early gene mRNAs. Combining UV cross-linking with a new approach,
      designated sequential RNase digestion, we were able to better determine the
      molecular masses of these cellular proteins. The binding sites for the four
      proteins were all mapped to a 20-nucleotide U-rich sequence located at the 3'
      half of the c-fos ARE, which contains no AUUUA pentanucleotides but stretches of
      uridylate residues. Single U-to-A point mutations in each of the three AUUUA
      motifs within the c-fos ARE have little effect on formation of the mobility
      shifted complexes. Our data indicate c-fos ARE-protein interaction involves
      recognition of U stretches rather than recognition of the AUUUA motifs. We
      propose that UTBP binding may be involved in the first step, removal of the
      Poly(A) tail, in the c-fos ARE-mediated decay pathway.

PMID- 1620107
TI  - Control of mRNA turnover as a mechanism of glucose repression in Saccharomyces
      cerevisiae.
AB  - We have examined the expression of the gene encoding the iron-protein subunit
      (Ip) of succinate dehydrogenase in Saccharomyces cerevisiae. The gene had been
      cloned by us and shown to be subject to glucose regulation (A. Lombardo, K.
      Carine, and I. E. Scheffler, J. Biol. Chem. 265:10419-10423, 1990). We discovered
      that a significant part of the regulation of the Ip mRNA levels by glucose
      involves the regulation of the turnover rate of this mRNA. In the presence of
      glucose, the half-life appears to be less than 5 min, while in glycerol medium,
      the half-life is greater than 60 min. The gene is also regulated
      transcriptionally by glucose. The upstream promoter sequence appeared to have
      four regulatory elements with consensus sequences shown to be responsible for the
      interaction with the HAP2/3/4 regulatory complex. A deletion analysis has shown
      that the two distal elements are redundant. These measurements were carried out
      by Northern (RNA) analyses of Ip mRNA transcripts as well as by assays of beta
      galactosidase activity in cells carrying constructs of the Ip promoter linked to
      the lacZ coding sequence. These observations on the regulation of mRNA stability
      were also extended to the mRNA of the flavoprotein subunit of succinate
      dehydrogenase and in some experiments of iso-1-cytochrome c.

PMID- 1620108
TI  - Putative GTP-binding protein, Gtr1, associated with the function of the Pho84
      inorganic phosphate transporter in Saccharomyces cerevisiae.
AB  - We have found an open reading frame which is 1.1 kb upstream of PHO84 (which
      encodes a Pi transporter) and is transcribed from the opposite strand. In
      Saccharomyces cerevisiae, this gene is distal to the TUB3 locus on the left arm
      of chromosome XIII and is named GTR1. GTR1 encodes a protein consisting of 310
      amino acid residues containing, in its N-terminal region, the characteristic
      tripartite consensus elements for binding GTP conserved in GTP-binding proteins,
      except for histidine in place of a widely conserved aspargine residue in element
      III. Disruption of the GTR1 gene resulted in slow growth at 30 degrees C and no
      growth at 15 degrees C; other phenotypes resembled those of pho84 mutants and
      included constitutive synthesis of repressible acid phosphatase, reduced Pi
      transport activity, and resistance to arsenate. The latter phenotypes were shown
      to be due to a defect in Pi uptake, and the Gtr1 protein was found to be
      functionally associated with the Pho84 Pi transporter. Recombination between
      chromosome V (at the URA3 locus) and chromosome XIII (in the GTR1-PHO84-TUB3
      region) by using a plasmid-encoded site-specific recombination system indicated
      that the order of these genes was telomere-TUB3-PHO84-GTR1-CENXIII.

PMID- 1620109
TI  - Role of the PU.1 transcription factor in controlling differentiation of Friend
      erythroleukemia cells.
AB  - Both viral and cellular genes have been directly implicated in pathogenesis of
      Friend viral erythroleukemia. The virus-encoded gp55 glycoprotein binds to
      erythropoietin receptors to cause mitogenesis and differentiation of
      erythroblasts. However, if the provirus integrates adjacent to the gene for the
      PU.1 transcription factor, the cell loses its commitment to terminally
      differentiate and becomes immortal, as indicated by its transplantability and by
      its potential for indefinite growth in culture (C. Spiro, B. Gliniak, and D.
      Kabat, J. Virol. 63:4434-4437, 1989; R. Paul, S. Schuetze, S. L. Kozak, and D.
      Kabat, J. Virol. 65:464-467, 1991). To test the implications of these results, we
      produced polyclonal antiserum to bacterially synthesized PU.1, and we used it to
      analyze PU.1 expression throughout leukemic progression and during chemically
      induced differentiation of Friend erythroleukemia (F-MEL) cell lines. This
      antiserum identified three electrophoretically distinct PU.1 components in
      extracts of F-MEL cells and demonstrated their nuclear localization. Although
      PU.1 proteins are abundant in F-MEL cells, they are absent or present in only
      trace amounts in normal erythroblasts or in differentiating erythroblasts from
      the preleukemic stage of Friend disease. Furthermore, chemicals (dimethyl
      sulfoxide or N,N'-hexamethylenebisacetamide) that overcome the blocked
      differentiation of F-MEL cells induce rapid declines of PU.1 mRNA and PU.1
      proteins. The elimination of PU.1 proteins coincides with recommitment to the
      program of erythroid differentiation and with loss of immortality. These results
      support the hypothesis that PU.1 interferes with the commitment of erythroblasts
      to differentiate and that chemicals that reduce PU.1 expression reinstate the
      erythropoietic program.

PMID- 1620110
TI  - Transcription of the gene for a pepsinogen, PEP1, is regulated by white-opaque
      switching in Candida albicans.
AB  - Cells of Candida albicans WO-1 spontaneously switch between a white and opaque
      CFU, and this phase transition involves a dramatic change in cellular phenotype.
      By using a differential hybridization screen, an opaque-specific cDNA, Op1a,
      which represents the transcript of a gene regulated by switching, has been
      isolated. The gene for Op1a is transcribed by opaque but not by white cells. The
      nucleotide sequence of the Op1a cDNA reveals over 99% base homology with an acid
      protease gene of C. albicans, and the predicted amino acid sequence demonstrates
      that the product of this gene is a member of the family of pepsinogens, which
      possess a hydrophobic leader sequence for secretion and two catalytic aspartate
      domains. Southern blots of both genomic DNA digested with 14 different
      endonucleases and electrophoretically separated chromosomes were probed with the
      Op1a cDNA. No polymorphisms were detected in either case between white and opaque
      cells, suggesting that no genomic reorganization occurs in the proximity of the
      gene during the white-opaque transition. Although transcription of Op1a
      correlates with the high levels of extracellular protease activity in opaque cell
      cultures and the absence of activity in white cell cultures, stimulation of
      extracellular protease activity by addition of serum albumin is not accompanied
      by Op1a transcription in cultures of WO-1 white cells or cultures of two
      additional clinical isolates of C. albicans, suggesting that expression of one or
      more other protease genes is stimulated in these cases. The results demonstrate
      that transcription of the Op1a gene is under the rigid control of switching in
      strain WO-1.

PMID- 1620111
TI  - Fused protein domains inhibit DNA binding by LexA.
AB  - Many studies of transcription activation employ fusions of activation domains to
      DNA binding domains derived from the bacterial repressor LexA and the yeast
      activator GAL4. Such studies often implicitly assume that DNA binding by the
      chimeric proteins is equivalent to that of the protein donating the DNA binding
      moiety. To directly investigate this issue, we compared operator binding by a
      series of LexA-derivative proteins to operator binding by native LexA, by using
      both in vivo and in vitro assays. We show that operator binding by many proteins
      such as LexA-Myc, LexA-Fos, and LexA-Bicoid is severely impaired, while binding
      of other LexA-derivative proteins, such as those that carry bacterially encoded
      acidic sequences ("acid blobs"), is not. Our results also show that DNA binding
      by LexA derivatives that contain the LexA carboxy-terminal dimerization domain
      (amino acids 88 to 202) is considerably stronger than binding by fusions that
      lack it and that heterologous dimerization motifs cannot substitute for the
      LexA88-202 function. These results suggest the need to reevaluate some previous
      studies of activation that employed LexA derivatives and modifications to recent
      experimental approaches that use LexA and GAL4 derivatives to detect and study
      protein-protein interactions.

PMID- 1620112
TI  - Modulation of ferritin H-chain expression in Friend erythroleukemia cells:
      transcriptional and translational regulation by hemin.
AB  - The mechanisms that regulate the expression of the H chain of the iron storage
      protein ferritin in Friend erythroleukemia cells (FLCs) after exposure to hemin
      (ferric protoporphyrin IX), protoporphyrin IX, and ferric ammonium citrate (FAC)
      have been investigated. Administration of hemin increases the steady-state level
      of ferritin mRNA about 10-fold and that of ferritin protein expression 20-fold.
      Experiments with the transcriptional inhibitor actinomycin D and transfection
      studies demonstrate that the increment in cytoplasmic mRNA content results from
      enhanced transcription of the ferritin H-chain gene and cannot be attributed to
      stabilization of preexisting mRNAs. In addition to transcriptional effects,
      translational regulation induces the recruitment of stored mRNAs into functional
      polyribosomes after hemin and FAC administration, resulting in a further increase
      in ferritin synthesis. Administration of protoporphyrin IX to FLCs produces
      divergent transcriptional and translational effects. It increases transcription
      but appears to suppress ferritin mRNA translation. FAC treatment increases the
      mRNA content slightly (about twofold), and the ferritin levels rise about
      fivefold over the control values. We conclude that in FLCs, hemin induces
      ferritin H-chain biosynthesis by multiple mechanisms: a transcriptional mechanism
      exerted also by protoporphyrin IX and a translational one, not displayed by
      protoporphyrin IX but shared with FAC.

PMID- 1620113
TI  - Temporal expression of the human alcohol dehydrogenase gene family during liver
      development correlates with differential promoter activation by hepatocyte
      nuclear factor 1, CCAAT/enhancer-binding protein alpha, liver activator protein,
      and D-element-binding protein.
AB  - The human class I alcohol dehydrogenase (ADH) gene family consists of ADH1, ADH2,
      and ADH3, which are sequentially activated in early fetal, late fetal, and
      postnatal liver, respectively. Analysis of ADH promoters revealed differential
      activation by several factors previously shown to control liver transcription. In
      cotransfection assays, the ADH1 promoter, but not the ADH2 or ADH3 promoter, was
      shown to respond to hepatocyte nuclear factor 1 (HNF-1), which has previously
      been shown to regulate transcription in early liver development. The ADH2
      promoter, but not the ADH1 or ADH3 promoter, was shown to respond to
      CCAAT/enhancer-binding protein alpha (C/EBP alpha), a transcription factor
      particularly active during late fetal liver and early postnatal liver
      development. The ADH1, ADH2, and ADH3 promoters all responded to the liver
      transcription factors liver activator protein (LAP) and D-element-binding protein
      (DBP), which are most active in postnatal liver. For all three promoters, the
      activation by LAP or DBP was higher than that seen by HNF-1 or C/EBP alpha, and a
      significant synergism between C/EBP alpha and LAP was noticed for the ADH2 and
      ADH3 promoters when both factors were simultaneously cotransfected. A hierarchy
      of ADH promoter responsiveness to C/EBP alpha and LAP homo- and heterodimers is
      suggested. In all three ADH genes, LAP bound to the same four sites previously
      reported for C/EBP alpha (i.e., -160, -120, -40, and -20 bp), but DBP bound
      strongly only to the site located at -40 bp relative to the transcriptional
      start. Mutational analysis of ADH2 indicated that the -40 bp element accounts for
      most of the promoter regulation by the bZIP factors analyzed. These studies
      suggest that HNF-1 and C/EBP alpha help establish ADH gene family transcription
      in fetal liver and that LAP and DBP help maintain high-level ADH gene family
      transcription in postnatal liver.

PMID- 1620114
TI  - Stable and specific association between the yeast recombination and DNA repair
      proteins RAD1 and RAD10 in vitro.
AB  - The RAD1 and RAD10 genes of Saccharomyces cerevisiae are two of at least seven
      genes which are known to be required for damage-specific recognition and/or
      damage-specific incision of DNA during nucleotide excision repair. RAD1 and RAD10
      are also involved in a specialized mitotic recombination pathway. We have
      previously reported the purification of the RAD10 protein to homogeneity (L.
      Bardwell, H. Burtscher, W. A. Weiss, C. M. Nicolet, and E. C. Friedberg,
      Biochemistry 29:3119-3126, 1990). In the present studies we show that the RAD1
      protein, produced by in vitro transcription and translation of the cloned gene,
      specifically coimmunoprecipitates with the RAD10 protein translated in vitro or
      purified from yeast. Conversely, in vitro-translated RAD10 protein specifically
      coimmunoprecipitates with the RAD1 protein. The sites of this stable and specific
      interaction have been mapped to the C-terminal regions of both polypeptides. This
      portion of RAD10 protein is evolutionarily conserved. These results are the first
      biochemical evidence of a specific association between any eukaryotic proteins
      genetically identified as belonging to a recombination or DNA repair pathway and
      suggest that the RAD1 and RAD10 proteins act at the same or consecutive
      biochemical steps in both nucleotide excision repair and mitotic recombination.

PMID- 1620115
TI  - Genome digestion is a dispensable consequence of physiological cell death
      mediated by cytotoxic T lymphocytes.
AB  - We examined virally transformed murine fibroblast clones as targets for cytotoxic
      T lymphocyte (CTL)-triggered lysis and genome digestion. Strikingly, while all
      clones were essentially equivalent in the ability to be lysed, one clone, SV3T3
      B2.1, failed to exhibit genome digestion associated with CTL attack. Other
      aspects of the physiological cell death process, including loss of adhesion and
      nuclear envelope breakdown (lamin phosphorylation and solubilization), were not
      altered in this clone. The absence of genome digestion associated with CTL
      induced cell death correlated with the absence of endodeoxyribonuclease activity
      in the nuclei of that clone. Characterization of the activity affected identifies
      a calcium-dependent, DNase I-like endonuclease of approximately 40 kDa, normally
      present constitutively in all cell nuclei, as the enzyme responsible for genome
      digestion associated with CTL-mediated cell death. These observations indicate
      that neither genome digestion per se nor its consequences [such as activation of
      poly(ADP-ribose) polymerase] are essential for cell death resulting from the
      triggering of this cell suicide process.

PMID- 1620117
TI  - In vivo function of regulatory DNA sequence elements of a major
      histocompatibility complex class I gene.
AB  - Major histocompatibility complex class I genes are expressed in nearly all
      somatic tissues, although their level of expression varies. By analysis of a set
      of promoter deletion mutants introduced into transgenic mice, a complex
      regulatory element, consisting of overlapping enhancer and silencer activities,
      is demonstrated to function as a tissue-specific regulator of class I expression.
      The enhancer activity predominates in lymphoid tissues but not in nonlymphoid
      tissues. In contrast to the tissue-specific functions of the complex regulatory
      element, a second novel silencer element is shown to function in both lymphoid
      and nonlymphoid tissues. The complement of DNA-binding factors in different cell
      lines is shown to correlate with the levels of class I expression.

PMID- 1620116
TI  - Transcriptional repression by a novel member of the bZIP family of transcription
      factors.
AB  - We describe here a novel member of the bZIP family of DNA-binding proteins,
      designated E4BP4, that displays an unusual DNA-binding specificity which overlaps
      that of the activating transcription factor family of factors. When expressed in
      a transient transfection assay with a suitable reporter plasmid, E4BP4 strongly
      repressed transcription in a DNA-binding-site-dependent manner. Examination of a
      series of deletion mutants revealed that sequences responsible for the repressing
      potential of E4BP4 lie within the carboxyl-terminal region of the protein. No
      similarity was found between this region and the repressing domains of other
      known eukaryotic transcriptional repressors.

PMID- 1620118
TI  - The RxxRxRxxC motif conserved in all Rel/kappa B proteins is essential for the
      DNA-binding activity and redox regulation of the v-Rel oncoprotein.
AB  - The v- and c-Rel oncoproteins bind to oligonucleotides containing kappa B motifs,
      form heterodimers with other members of the Rel family, and modulate expression
      of genes linked to kappa B motifs. Here, we report that the RxxRxRxxC motif
      conserved in all Rel/kappa B family proteins is absolutely required for v-Rel
      protein-DNA contact and its resulting transforming activity. We also demonstrate
      that serine substitution of the cysteine residue conserved within this motif
      enables v-Rel to escape redox control, thereby promoting overall DNA binding.
      These mutant proteins retained the ability to competitively inhibit kappa B
      mediated transcriptional activation of the human immunodeficiency virus long
      terminal repeat but failed to efficiently transform chicken lymphoid cells both
      in vitro and in vivo. Our data indicate that reduction of the conserved cysteine
      residue in the RxxRxRxxC motif may be required for optimal DNA-protein
      interactions. These results provide direct biochemical evidence that the DNA
      binding activity of v-Rel is subject to redox control and that the conserved
      cysteine residue in the RxxRxRxxC motif is critical for this regulation. These
      studies suggest that the DNA-binding, transcriptional, and biological activities
      of Rel family proteins may also be subject to redox control in vivo.

PMID- 1620119
TI  - Oct2 transactivation from a remote enhancer position requires a B-cell-restricted
      activity.
AB  - Previous cotransfection experiments had demonstrated that ectopic expression of
      the lymphocyte-specific transcription factor Oct2 could efficiently activate a
      promoter containing an octamer motif. Oct2 expression was unable to stimulate a
      multimerized octamer enhancer element in HeLa cells, however. We have tested a
      variety of Oct2 isoforms generated by alternative splicing for the capability to
      activate an octamer enhancer in nonlymphoid cells and a B-cell line. Our analyses
      show that several Oct2 isoforms can stimulate from a remote position but that
      this stimulation is restricted to B cells. This result indicates the involvement
      of either a B-cell-specific cofactor or a specific modification of a cofactor or
      the Oct2 protein in Oct2-mediated enhancer activation. Mutational analyses
      indicate that the carboxy-terminal domain of Oct2 is critical for enhancer
      activation. Moreover, this domain conferred enhancing activity when fused to the
      Oct1 protein, which by itself was unable to stimulate from a remote position. The
      glutamine-rich activation domain present in the amino-terminal portion of Oct2
      and the POU domain contribute only marginally to the transactivation function
      from a distal position.

PMID- 1620120
TI  - Activation domains of L-Myc and c-Myc determine their transforming potencies in
      rat embryo cells.
AB  - Members of the Myc family of proteins share a number of protein motifs that are
      found in regulators of gene transcription. Conserved stretches of amino acids
      found in the N-terminal transcriptional activation domain of c-Myc are required
      for cotransforming activity. Most of the Myc proteins contain the basic helix
      loop-helix zipper (bHLH-Zip) DNA-binding motif which is also required for the
      cotransforming activity of c-Myc. L-Myc, the product of a myc family gene that is
      highly amplified in many human lung carcinomas, was found to cotransform primary
      rat embryo cells with an activated ras gene. However, L-Myc cotransforming
      activity was only 1 to 10% of that of c-Myc (M. J. Birrer, S. Segal, J. S.
      DeGreve, F. Kaye, E. A. Sausville, and J. D. Minna, Mol. Cell. Biol. 8:2668-2673,
      1988). We sought to determine whether functional differences between c-Myc and L
      Myc in either the N-terminal or the C-terminal domain could account for the
      relatively diminished L-Myc cotransforming activity. Although the N-terminal
      domain of L-Myc could activate transcription when fused to the yeast GAL4 DNA
      binding domain, the activity was only 5% of that of a comparable c-Myc domain. We
      next determined that the interaction of the C-terminal bHLH-Zip region of L-Myc
      or c-Myc with that of a Myc partner protein, Max, was equivalent in transfected
      cells. A Max expression vector was found to augment the cotransforming activity
      of L-Myc as well as that of c-Myc. In addition, a bacterially synthesized DNA
      binding domain of L-Myc, like that o c-Myc, heterodimerizes with purified Max
      protein to bind the core DNA sequence CACGTG. To determine the region of L-Myc
      responsible for its relatively diminished cotransforming activity, we constructed
      chimeras containing exons 2 (constituting activation domains) and 3 (constituting
      DNA-binding domains) of c-Myc fused to those of L-Myc. The cotransforming
      potencies of these chimeras were compared with those of full-length L-Myc of c
      Myc in rat embryo cells. The relative cotransforming activities suggest that the
      potencies of the activation domains determine the cotransforming efficiencies for
      c-Myc and L-Myc. This correlation supports the hypothesis that the Myc proteins
      function in neoplastic cotransformation as transcription factors.

PMID- 1620121
TI  - Growth-regulated expression of rhoG, a new member of the ras homolog gene family.
AB  - Cellular transition from the resting state to DNA synthesis involves master
      switches genes encoding transcriptional factors (e.g., fos, jun, and egr genes),
      whose targets remain to be fully characterized. To isolate coding sequences
      specifically accumulated in late G1, a differential screening was performed on a
      cDNA library prepared from hamster lung fibroblasts stimulated for 5 h with
      serum. One of the positive clones which displayed a sevenfold induction, turned
      out to code for a protein sharing homology to Ras-like products. Cloning and
      sequence analysis of the human homolog revealed that this putative new small
      GTPase, referred to as rhoG, is more closely related to the rac, CDC42, and TC10
      members of the rho (ras homolog) gene family and might have diverged very early
      during evolution. rhoG mRNA accumulates in proportion to the mitogenic strength
      of various purified growth factors used for the stimulation, as a consequence of
      transcriptional activation. G1-specific RNA accumulation is impaired upon
      addition of antimitogenic cyclic AMP and is enhanced when protein synthesis is
      inhibited, mainly as a result of RNA stabilization. rhoG mRNA expression is
      observed in a wide variety of human organs but reaches a particularly high level
      in lung and placental tissues.

PMID- 1620122
TI  - Induction of the POU domain transcription factor Oct-2 during T-cell activation
      by cognate antigen.
AB  - Oct-2 is a transcription factor that binds specifically to octamer DNA motifs in
      the promoters of immunoglobulin and interleukin-2 genes. All tumor cell lines
      from the B-cell lineage and a few from the T-cell lineage express Oct-2. To
      address the role of Oct-2 in the T-cell lineage, we studied the expression of Oct
      2 mRNA and protein in nontransformed human and mouse T cells. Oct-2 was found in
      CD4+ and CD8+ T cells prepared from human peripheral blood and in mouse lymph
      node T cells. In a T-cell clone specific for pigeon cytochrome c in the context
      of I-Ek, Oct-2 was induced by antigen stimulation, with the increase in Oct-2
      protein seen first at 3 h after activation and continuing for at least 24 h. Oct
      2 mRNA induction during antigen-driven T-cell activation was blocked by
      cyclosporin A, as well as by protein synthesis inhibitors. These results suggest
      that Oct-2 participates in transcriptional regulation during T-cell activation.
      The relatively delayed kinetics of Oct-2 induction suggests that Oct-2 mediates
      the changes in gene expression which occur many hours or days following antigen
      stimulation of T lymphocytes.

PMID- 1620123
TI  - Differential binding of zinc fingers from Xenopus TFIIIA and p43 to 5S RNA and
      the 5S RNA gene.
AB  - Zinc fingers are usually associated with proteins that interact with DNA. Yet in
      two oocyte-specific Xenopus proteins, TFIIA and p43, zinc fingers are used to
      bind 5S RNA. One of these, TFIIIA, also binds the 5S RNA gene. Both proteins have
      nine zinc fingers that are nearly identical with respect to size and spacing. We
      have determined the relative affinities of groups of zinc fingers from TFIIIA for
      both 5S RNA and the 5S RNA gene. We have also determined the relative affinities
      of groups of zinc fingers from p43 for 5S RNA. The primary protein regions for
      RNA and DNA interaction in TFIIIA are located at opposite ends of the molecule.
      All zinc fingers from TFIIIA participate in binding 5S RNA, but zinc fingers from
      the C terminus have the highest affinity. N-terminal zinc fingers are essential
      for binding the 5S RNA gene. In contrast, zinc fingers at the amino terminus of
      p43 are essential for binding 5S RNA.

PMID- 1620124
TI  - Differential binding of heterogeneous nuclear ribonucleoproteins to mRNA
      precursors prior to spliceosome assembly in vitro.
AB  - We have investigated the composition of the earliest detectable complex (H)
      assembled on pre-mRNA during the in vitro splicing reaction. We show that most of
      the proteins in this complex correspond to heterogeneous nuclear
      ribonucleoproteins (hnRNP), a set of abundant RNA-binding proteins that bind
      nascent RNA polymerase II transcripts in vivo. Thus, these studies establish a
      direct parallel between the initial events of RNA processing in vitro and in
      vivo. In contrast to previous studies, in which total hnRNP particles were
      isolated from mammalian nuclei, we determined the hnRNP composition of complexes
      assembled on individual RNAs of defined sequence. We found that a unique
      combination of hnRNP proteins is associated with each RNA. Thus, our data provide
      direct evidence for transcript-dependent assembly of pre-mRNA in hnRNP complexes.
      The observation that pre-mRNA is differentially bound by hnRNP proteins prior to
      spliceosome assembly suggests the possibility that RNA packaging could play a
      central role in the mechanism of splice site selection, as well as other
      posttranscriptional events.

PMID- 1620125
TI  - Transcriptional regulation of the apolipoprotein B100 gene: purification and
      characterization of trans-acting factor BRF-2.
AB  - Apolipoprotein B100 (apoB), the only protein of low-density lipoprotein, is
      produced primarily in the liver and serves as a ligand for the low-density
      lipoprotein receptor. Hepatic cell-specific expression of the human apoB gene is
      controlled by at least two cis-acting positive elements located between positions
      128 and -70 (H. K. Das, T. Leff, and J.L. Breslow, J. Biol. Chem. 263:11452
      11458, 1988). The distal element (-128 to -85) appears to be liver specific since
      it shows positive activity in HepG2 cells and negative activity in HeLa cells.
      The proximal element (-84 to -70) acts as a positive element in both these cell
      lines, and two rat liver nuclear proteins, BRF-1 and C/EBP, bind to two
      overlapping sites (-84 to -60 and -70 to -50, respectively). By gel mobility
      shift assay, we have identified a rat liver nuclear protein (BRF-2) which binds
      to the distal element (-128 to -85) of the apoB gene. This putative trans-acting
      factor has been purified to apparent homogeneity by DEAE-cellulose, heparin
      agarose, and DNA-specific affinity chromatography. The purified BRF-2 has an
      apparent molecular mass of 120 kDa and was found to specifically recognize
      sequence -128 to -85; BRF-2 also produced a strong hypersensitive site at
      nucleotide position -95 with copper-orthophenanthroline reagent. A double
      stranded oligonucleotide (-128 to -85) containing a 3-nucleotide (TTC) insertion
      between position -95 and -94 was found to abolish DNA binding by BRF-2. This
      result suggests that the region surrounding the hypersensitive site -95 is
      important for protein-DNA interaction. By using apoB promoter fragments
      containing various internal deletions as templates for gel mobility shift assay,
      the region between -104 and -85 was identified to be crucial for binding by BRF
      2. We propose that BRF-2 may play an important role in the tissue-specific
      regulation of apoB gene transcription.

PMID- 1620126
TI  - In vivo splicing of the beta tropomyosin pre-mRNA: a role for branch point and
      donor site competition.
AB  - The chicken beta tropomyosin gene contains two sets of alternatively spliced,
      mutually exclusive exons whose utilization is developmentally regulated. Exons 6A
      and 6B are used in nonmuscle cells (or undifferentiated muscle cells) and
      skeletal muscle cells, respectively. A complex arrangement of cis-acting sequence
      elements is involved in alternative splicing regulation. We have performed an
      extensive mutational analysis on the sequence spanning the region from exon 6A to
      the constitutive exon 7. A large number of mutant minigenes have been tested in
      transfection assays of cultured myogenic cells, and the splicing products have
      been analyzed by cDNA polymerase chain reaction. We demonstrate that in
      undifferentiated myoblasts, exon 6B is skipped as a result of a negative control
      on its selection, while exon 6A is spliced as a default choice. We provide
      evidence that the focal point of such a regulation is localized in the intron
      upstream of exon 6B and probably involves the blockage of its associated branch
      point. In differentiated myotubes, in contrast, both exons are accessible to the
      splicing machinery. We show that the preferential choice of exon 6B in this
      splicing environment depends on the existence of a competition between the two
      exons for the flanking constitutive splice sites. We demonstrate that both the
      donors and the branch points of the two exons are involved in this competition.

PMID- 1620127
TI  - Semidominant suppressors of Srs2 helicase mutations of Saccharomyces cerevisiae
      map in the RAD51 gene, whose sequence predicts a protein with similarities to
      procaryotic RecA proteins.
AB  - Eleven suppressors of the radiation sensitivity of Saccharomyces cerevisiae
      diploids lacking the Srs2 helicase were analyzed and found to contain codominant
      mutations in the RAD51 gene known to be involved in recombinational repair and in
      genetic recombination. These mutant alleles confer an almost complete block in
      recombinational repair, as does deletion of RAD51, but heterozygous mutant
      alleles suppress the defects of srs2::LEU2 cells and are semidominant in Srs2+
      cells. The results of this study are interpreted to mean that wild-type Rad51
      protein binds to single-stranded DNA and that the semidominant mutations do not
      prevent this binding. The cloning and sequencing of RAD51 indicated that the gene
      encodes a predicted 400-amino-acid protein with a molecular mass of 43 kDa.
      Sequence comparisons revealed homologies to domains of Escherichia coli RecA
      protein predicted to be involved in DNA binding, ATP binding, and ATP hydrolysis.
      The expression of RAD51, measured with a RAD51-lacZ gene fusion, was found to be
      UV- and gamma-ray-inducible, with dose-dependent responses.

PMID- 1620128
TI  - Nucleotide sequence and transcriptional regulation of the yeast recombinational
      repair gene RAD51.
AB  - The RAD51 gene of Saccharomyces cerevisiae is required both for recombination and
      for the repair of DNA damage caused by X rays. Here we report the sequence and
      transcriptional regulation of this gene. The RAD51 protein shares significant
      homology (approximately 50%) over a 70-amino-acid with the RAD57 protein (J.A.
      Kans and R.K. Mortimer, Gene 105:139-140, 1991), the product of another yeast
      recombinational repair gene, and also moderate (approximately 27%), but
      potentially significant, homology with the bacterial RecA protein. The homologies
      cover a region that encodes a putative nucleotide binding site of the RAD51
      protein. Sequences upstream of the coding region for RAD51 protein share homology
      with the damage response sequence element of RAD54, an upstream activating
      sequence required for damage regulation of the RAD54 transcript, and also contain
      two sites for restriction enzyme MluI; the presence of MluI restriction sites has
      been associated with cell cycle regulation. A 1.6-kb transcript corresponding to
      RAD51 was observed, and levels of this transcript increased rapidly after
      exposure to relatively low doses of X-rays. Additionally, RAD51 transcript levels
      were found to that of a group of genes involved primarily in DNA synthesis and
      replication which are thought to be coordinately cell cycle regulated. Cells
      arrested in early G1 were still capable of increasing levels of RAD51 transcript
      after irradiation, indicating that increased RAD51 transcript levels after X-ray
      exposure are not solely due to an X-ray-induced cessation of the cell cycle at a
      period when the level of RAD51 expression is normally high.

PMID- 1620129
TI  - Overlapping and CpG methylation-sensitive protein-DNA interactions at the histone
      H4 transcriptional cell cycle domain: distinctions between two human H4 gene
      promoters.
AB  - Transcriptional regulation of vertebrate histone genes during the cell cycle is
      mediated by several factors interacting with a series of cis-acting elements
      located in the 5' regions of these genes. The arrangement of these promoter
      elements is different for each gene. However, most histone H4 gene promoters
      contain a highly conserved sequence immediately upstream of the TATA box (H4
      subtype consensus sequence), and this region in the human H4 gene FO108 is
      involved in cell cycle control. The sequence-specific interaction of nuclear
      factor HiNF-D with this key proximal promoter element of the H4-FO108 gene is
      cell cycle regulated in normal diploid cells (J. Holthuis, T.A. Owen, A.J. van
      Wijnen, K.L. Wright, A. Ramsey-Ewing, M.B. Kennedy, R. Carter, S.C. Cosenza, K.J.
      Soprano, J.B. Lian, J.L. Stein, and G.S. Stein, Science, 247:1454-1457, 1990).
      Here, we show that this region of the H4-FO108 gene represents a composite
      protein-DNA interaction domain for several distinct sequence-specific DNA-binding
      activities, including HiNF-D, HiNF-M, and HiNF-P. Factor HiNF-P is similar to
      H4TF-2, a DNA-binding activity that is not cell cycle regulated and that
      interacts with the analogous region of the H4 gene H4.A (F. LaBella and N.
      Heintz, Mol. Cell. Biol. 11:5825-5831, 1991). The H4.A gene fails to interact
      with factors HiNF-M and HiNF-D owing to two independent sets of specific
      nucleotide variants, indicating differences in protein-DNA interactions between
      these H4 genes. Cytosine methylation of a highly conserved CpG dinucleotide
      interferes with binding of HiNF-P/H4TF-2 to both the H4-FO108 and H4.A promoters,
      but no effect is observed for either HiNF-M or HiNF-D binding to the H4-FO108
      gene. Thus, strong evolutionary conservation of the H4 consensus sequence may be
      related to combinatorial interactions involving overlapping and interdigitated
      recognition nucleotides for several proteins, whose activities are regulated
      independently. Our results also suggest molecular complexity in the
      transcriptional regulation of distinct human H4 genes.

PMID- 1620130
TI  - Topology and functional domains of Sec63p, an endoplasmic reticulum membrane
      protein required for secretory protein translocation.
AB  - SEC63 encodes a protein required for secretory protein translocation into the
      endoplasmic reticulum (ER) of Saccharomyces cerevisiae (J. A. Rothblatt, R. J.
      Deshaies, S. L. Sanders, G. Daum, and R. Schekman, J. Cell Biol. 109:2641-2652,
      1989). Antibody directed against a recombinant form of the protein detects a 73
      kDa polypeptide which, by immunofluorescence microscopy, is localized to the
      nuclear envelope-ER network. Cell fractionation and protease protection
      experiments confirm the prediction that Sec63p is an integral membrane protein. A
      series of SEC63-SUC2 fusion genes was created to assess the topology of Sec63p
      within the ER membrane. The largest hybrid proteins are unglycosylated,
      suggesting that the carboxyl terminus of Sec63p faces the cytosol. Invertase
      fusion to a loop in Sec63p that is flanked by two putative transmembrane domains
      produces an extensively glycosylated hybrid protein. This loop, which is
      homologous to the amino terminus of the Escherichia coli heat shock protein,
      DnaJ, is likely to face the ER lumen. By analogy to the interaction of the DnaJ
      and Hsp70-like DnaK proteins in E. coli, the DnaJ loop of Sec63p may recruit
      luminal Hsp70 (BiP/GRP78/Kar2p) to the translocation apparatus. Mutations in two
      highly conserved positions of the DnaJ loop and short deletions of the carboxyl
      terminus inactivate Sec63p activity. Sec63p associates with several other
      proteins, including Sec61p, a 31.5-kDa glycoprotein, and a 23-kDa protein, and
      together with these proteins may constitute part of the polypeptide translocation
      apparatus. A nonfunctional DnaJ domain mutant allele does not interfere with the
      formation of the Sec63p/Sec61p/gp31.5/p23 complex.

PMID- 1620131
TI  - Conditional defect in mRNA 3' end processing caused by a mutation in the gene for
      poly(A) polymerase.
AB  - Maturation of most eukaryotic mRNA 3' ends requires endonucleolytic cleavage and
      polyadenylation of precursor mRNAs. To further understand the mechanism and
      function of mRNA 3' end processing, we identified a temperature-sensitive mutant
      of Saccharomyces cerevisiae defective for polyadenylation. Genetic analysis
      showed that the polyadenylation defect and the temperature sensitivity for growth
      result from a single mutation. Biochemical analysis of extracts from this mutant
      shows that the polyadenylation defect occurs at a step following normal site
      specific cleavage of a pre-mRNA at its polyadenylation site. Molecular cloning
      and characterization of the wild-type allele of the mutated gene revealed that it
      (PAP1) encodes a previously characterized poly(A) polymerase with unknown RNA
      substrate specificity. Analysis of mRNA levels and structure in vivo indicate
      that shift of growing, mutant cells to the nonpermissive temperature results in
      the production of poly(A)-deficient mRNAs which appear to end at their normal
      cleavage sites. Interestingly, measurement of the rate of protein synthesis after
      the temperature shift shows that translation continues long after the apparent
      loss of polyadenylated mRNA. Our characterization of the pap1-1 defect implicates
      this gene as essential for mRNA 3' end formation in S. cerevisiae.

PMID- 1620132
TI  - Role of protein kinase C in T-cell antigen receptor regulation of p21ras:
      evidence that two p21ras regulatory pathways coexist in T cells.
AB  - T-lymphocyte activation via the antigen receptor complex (TCR) results in
      accumulation of p21ras in the active GTP-bound state. Stimulation of protein
      kinase C (PKC) can also activate p21ras, and it has been proposed that the TCR
      effect on p21ras occurs as a consequence of TCR regulation of PKC. To test the
      role of PKC in TCR regulation of p21ras, a permeabilized cell system was used to
      examine TCR regulation of p21ras under conditions in which TCR activation of PKC
      was blocked, first by using a PKC pseudosubstrate peptide inhibitor and second by
      using ionic conditions that prevent phosphatidyl inositol hydrolysis and hence
      diacylglycerol production and PKC stimulation. The data show that TCR-induced
      p21ras activation is not mediated exclusively by PKC. Thus, in the absence of PKC
      stimulation, the TCR was still able to induce accumulation of p21ras-GTP
      complexes, and this stimulation correlated with an inactivation of p21ras GTPase
      activating proteins. The protein tyrosine kinase inhibitor herbimycin could
      prevent the non-PKC-mediated, TCR-induced stimulation of p21ras. These data
      indicate that two mechanisms for p21ras regulation coexist in T cells: one PKC
      mediated and one not. The TCR can apparently couple to p21ras via a non-PKC
      controlled route that may involve tyrosine kinases.

PMID- 1620133
TI  - Analysis of a tissue-specific enhancer: ARF6 regulates adipogenic gene
      expression.

PMID- 1620135
TI  - Machado-Joseph disease: an autosomal dominant motor system degeneration.
AB  - Machado-Joseph disease is an autosomal dominant spinocerebellar degeneration. It
      expresses itself clinically with variable expression. Type one patients have
      early onset with a rapid progression of symptoms including spasticity, rigidity
      and myokymia. Type two patients are the most common phenotype with ataxia and
      spasticity. Type three patients develop progressive ataxia with variable
      amyotrophy. All patients have ophthalmoparesis and normal mental status. The
      neuropathology consists of neuronal loss and gliosis in the substantia nigra,
      motor cranial nuclei, dentate nucleus of the cerebellum, and variable neuronal
      loss with gliosis in the cerebellar cortex and neostriatum. The cerebral cortex
      is normal histologically. The inferior olivary nuclei are normal, thus separating
      this disease from olivopontocerebellar atrophy (OPCA). The disease has a
      worldwide distribution including families described in Portugal, the Azores,
      Spain, Italy, United States, Canada, Brazil, China, Taiwan, and Japan. The gene
      has not been mapped for this disease but the locus on chromosome 6p mapped for
      most families with OPCA has been excluded for this disorder.

PMID- 1620134
TI  - Mechanism and consequences of the duplication of the human C4/P450c21/gene X
      locus.

PMID- 1620136
TI  - Machado-Joseph disease in New England: clinical description and distinction from
      the olivopontocerebellar atrophies.
AB  - Experience is described in 25 patients from southern New England with Machado
      Joseph Disease, examined serially at annual screening clinics. The disorder is
      dominantly inherited, with a wide range of phenotypic variation. Core clinical
      features described include ataxia, nystagmus, dysarthria, facial fasciculations,
      and lid retraction, producing a characteristic staring expression. In addition,
      young onset patients have spasticity, extrapyramidal rigidity, and dystonic
      manifestations. Late onset patients often have distal atrophy and sensory loss.
      Postural instability is often an early feature. We discuss the distinction of
      this entity from the olivopontocerebellar atrophies.

PMID- 1620137
TI  - Cortical mechanisms mediating asterixis.
AB  - We describe a patient with chronic renal failure who suffered multifocal action
      induced jerks. Electromyography (EMG) recorded the typical silence of asterixis.
      Back-averaging the EEG activity preceding the EMG silent periods in the forearm
      showed a biphasic wave antedating the asterixis by 23 ms. Somatosensory evoked
      potentials (SEPs) after median nerve stimulation were pathologically enlarged on
      both hemispheres. Brain-mapping of the biphasic wave preceding asterixis and the
      giant SEPs indicated a common origin in the sensorimotor cortex. This observation
      provides further documentation of a cortical origin for some types of asterixis
      in humans.

PMID- 1620138
TI  - Severe generalised dystonia associated with a mosaic pattern of striatal gliosis.
AB  - A mosaic pattern of striatal pathology is described in a male who developed
      severe generalised dystonia from the age of 10 years, and died at the age of 18
      years. There was no family history of dystonia, and extensive investigations
      during his life failed to identify a cause for the dystonia. The caudate nucleus
      and putamen showed a network of cell loss and gliosis surrounding islands of
      preserved striatum. Dorsal parts showed confluent gliosis, and ventral parts were
      spared. The pattern suggested a correlation with patch-matrix organisation, but
      there was no correlation with the distribution of calbindin immunoreactive cells,
      which are present in the matrix of the classical striosome-matrix organisation.
      The pathological findings were unlike those in status marmoratus, perinatal
      hypoxia-ischaemia, Huntington's disease, and neuroacanthocytosis, but similar to
      those reported in a 44-year-old man with predominantly cranial dystonia.

PMID- 1620139
TI  - Influence of cholinergic system on myoclonus in myoclonic epilepsies.
AB  - The effect of two drugs upon multifocal myoclonic jerks was evaluated. The drugs
      influence the central cholinergic system in opposite ways. Eight patients with
      progressive and nonprogressive myoclonic epilepsy were tested. The single blind
      test was used. The number of myoclonic jerks after intravenous physostigmine
      (mean dose 0.02 mg/kg) and that after atropine (0.04 mg/kg) was compared to
      number of myoclonic jerks in the drug-free periods and with placebo. Placebo was
      without an effect. Physostigmine slightly increased the number of jerks. Atropine
      decreased the number significantly. In most patients the results were not
      striking. It is suggested that the cholinergic system may participate in the
      physiopathology of the studied myoclonus in a rather indirect, perhaps modulating
      way.

PMID- 1620140
TI  - Effect of aging and dopaminomimetic therapy on mitochondrial respiratory function
      in Parkinson's disease.
AB  - Oxygen consumption and enzyme activity were evaluated in platelet mitochondria
      from 17 patients with Parkinson's disease. In comparison with age-matched
      controls, no consistent abnormality could be discerned in complex I, complex II
      III, or complex IV oxygen consumption, or in the enzyme activity of these
      respiratory chain complexes. Neither chronic therapy with levodopa/carbidopa
      alone nor in combination with deprenyl significantly affected any measure of
      mitochondrial respiratory function. There was no discernible relationship between
      patient age or disease severity and any parameter of mitochondrial respiration.
      Moreover, blood lactate levels following glucose loading were not different in
      patients and controls. These results fail to support the occurrence of a
      generalized defect in any mitochondrial respiratory function in Parkinson's
      disease.

PMID- 1620141
TI  - Impairment of high-contrast visual acuity in Parkinson's disease.
AB  - Several studies have shown that the visual system is affected in Parkinson's
      disease (PD) with reduced contrast sensitivity, low-contrast acuity, and flicker
      sensitivity, as well as altered electroretinograms (ERGs) and pattern visual
      evoked potentials (VEPs). Apparently, however, no study has yet specifically
      determined whether visual acuity to high-contrast stimuli is impaired in PD.
      Visual acuity was measured in a group of 16 patients with PD, both on and off
      drugs (for 24 h), and 16 age- and sex-matched normal control subjects. Acuity was
      impaired in the PD group both on standard Snellen chart and on a screen in a
      computerized test of visual resolution. The degree of impairment was 24 and 25%,
      respectively, in the two tests. The PD patients had marginally better acuity on
      both tests while receiving drugs, but the differences were not significant. The
      difference between the two groups was consistent with impaired resolution and
      could not be accounted for by any perceptual dysfunction that may also have been
      present in the PD group. Conversely, however, impaired acuity may be implicated
      in studies that have reported mild deficits of visuospatial/visuoperceptual
      function in PD. Reduced acuity appears to be a subtle sequela of dopaminergic
      deficiency in the visual system.

PMID- 1620142
TI  - Kinetic-dynamic relationship of oral levodopa: possible biphasic response after
      sequential doses in Parkinson's disease.
AB  - The potential difference in the concentration-effect relationship of oral
      sequential doses of levodopa was explored in six Parkinsonian patients with
      complex fluctuating response. These patients showed "wearing-off phenomena"
      characterized by a transient worsening of motor function at the end of the first
      morning dose response to below baseline values and complained of a progressive
      reduction of levodopa effect during the day. A first standard levodopa dose was
      given in the morning, after an overnight fast and levodopa withdrawal. A second
      equal levodopa dose was administered immediately at the end of the first dose
      deterioration phase. Postimprovement worsening of motor response was also
      observed after the second levodopa dose in all patients. No significant
      difference in the pharmacokinetics of levodopa or in duration or magnitude of
      motor response could be appreciated between the two doses. These results further
      support the suggestion that, under controlled dietary conditions, plasma levodopa
      levels and effects relationship is reproducible between doses. Moreover, even
      when transient deterioration of motor function occurs between levodopa doses, the
      central dopaminergic system appears to remain responsive to the drug.

PMID- 1620143
TI  - Intravenous boluses and continuous infusions of L-dopa methyl ester in
      fluctuating patients with Parkinson's disease.
AB  - In six patients with Parkinson's disease exhibiting severe "on-off" phenomena, a
      200-mg intravenous bolus of either L-DOPA or of its methyl ester were equally
      effective in reversing motor deficits, although the duration of action of the
      methyl ester was shorter. There were no marked differences in pharmacokinetic
      parameters for L-DOPA plasma levels after administration of L-DOPA and the methyl
      ester. In three patients, optimal infusion rates for the maintenance of mobility
      were established for L-DOPA and L-DOPA methyl ester. Both drugs were able to
      maintain patients "on" throughout a 12-h infusion period. However, on average the
      optimal infusion rate of L-DOPA methyl ester was 2.7 times greater than that for
      L-DOPA. There was no marked difference in the plasma levels of L-DOPA achieved,
      but 3-O-methyl DOPA levels increased more after infusion of L-DOPA methyl ester
      than after infusion of L-DOPA itself. The half-life of elimination and volume of
      distribution of L-DOPA formed from the methyl ester were markedly increased
      compared with values obtained after either an intravenous bolus of methyl ester
      or after an intravenous infusion of L-DOPA itself. An intravenous bolus of L-DOPA
      methyl ester produces an equivalent magnitude of clinical response to the same
      dose of L-DOPA. However, higher optimal infusion rates of methyl ester than L
      DOPA are required to produce continuous effect. The pharmacokinetic handling of L
      DOPA methyl ester given by intravenous infusion may differ from that of L-DOPA
      when given by the same route.

PMID- 1620144
TI  - Voluntary stimulus-sensitive jerks and jumps mimicking myoclonus or pathological
      startle syndromes.
AB  - Five patients who presented with stimulus-induced jerking as part of an apparent
      myoclonic or pathological startle syndrome are reported. Neurophysiological
      observations in these patients suggested the jerks were voluntary in origin.
      These included (a) variable latencies to the onset of stimulus induced jerks, (b)
      latencies were greater than that seen in reflex myoclonus of cortical or
      brainstem origin, and were (c) longer than the fastest voluntary reaction times
      of normal subjects, (d) variable patterns of muscle recruitment within each jerk
      and, (e) significant habituation with repeated stimulation. It is argued that
      these features are consistent with a voluntary origin for the jerks and enable
      them to be distinguished from the stereotyped electrophysiological
      characteristics of myoclonus of cortical and brainstem origin.
      Electrophysiological recordings may help identify patients with this form of
      psychogenic movement disorder.

PMID- 1620145
TI  - Dystonia following head trauma: a report of nine patients and review of the
      literature.
AB  - We report nine patients who developed dystonia following head trauma. The most
      frequent form was hemidystonia only (six patients). One patient presented with
      hemidystonia plus torticollis, one with bilateral hemidystonia and one with
      torticollis only. Seven patients sustained a severe head injury, and two had a
      mild head injury. At the time of injury, six were younger than 10 years, two were
      adolescents, and the patient with torticollis only was an adult. Except in the
      patient with torticollis only, the onset of dystonia varied considerably from
      months to years. All patients with hemidystonia had posthemiplegic dystonia of
      delayed onset. Seven out of 8 patients with hemidystonia had lesions involving
      the contralateral caudate or putamen, as demonstrated by CT and MR. The patient
      with hemidystonia plus torticollis had no lesion to the basal ganglia, but a
      contralateral pontomesencephalic lesion. Response to medical treatment was
      generally poor. Functional stereotactic operations were performed in seven
      patients. A variety of factors may be responsible for the vascular or nonvascular
      posttraumatic basal ganglia lesions, which may lead to dystonia. The
      pathophysiology seems to be more complex than thought previously. We believe that
      dystonia following head injury is not as rare as is assumed. Awareness of its
      characteristics and optimized diagnostic procedures will lead to wider
      recognition of this entity.

PMID- 1620146
TI  - Postural axial tremor in a patient with cerebellar atrophy.
AB  - A patient affected by low-frequency postural tremor of the trunk and limbs is
      reported. Apart from mild dysarthria and gait ataxia, no other neurological
      abnormalities were present. Cerebellar atrophy was demonstrated by means of
      magnetic resonance imaging. The tremor was associated with alternating activity
      in antagonistic muscles; it was triggered whenever a contraction of lumbar back
      extensor muscles occurred. Electrical stimulation of the cerebellum did not
      produce the normal suppression phases of motor responses evoked by a magnetic
      stimulation of the cerebral cortex.

PMID- 1620147
TI  - "Rubral" tremor induced by a neuroleptic drug.
AB  - "Rubral" tremor is a rare movement disorder that occurs typically with midbrain
      damage. It is defined by its presence at rest, with sustained posture, and with
      movement. Whether it is a single-tremor disorder or a combination of two distinct
      tremors is debated. This report chronicles a severe neuroleptic induced "rubral"
      tremor in a patient who had had a stable posttraumatic ataxia. The dramatic
      response to benztropine and bromocriptine is illustrated in the videotape.

PMID- 1620148
TI  - Levodopa-induced diphasic dyskinesias improved by subcutaneous apomorphine.

PMID- 1620150
TI  - Induction of mania by apomorphine in a depressed parkinsonian patient.

PMID- 1620149
TI  - Temporary deterioration in parkinsonian signs after modest alcohol intake.

PMID- 1620151
TI  - [The role of histidine in regulating the synthesis of purine nucleotides in
      Escherichia coli cells].
AB  - Coordination of GTP and 5-aminoimidazole-4-carboxamide riboside 5'-phosphate
      pools changes was studied. The CTP pool is an important component of Escherichia
      coli metabolism, while AICAR 5'-phosphate being one of alarmones controls the
      synthesis of GTP. Main attention was paid to histidine, the biosynthesis of which
      is connected with formation of purine nucleotides. The expression of the
      histidine operon and biosynthesis of histidine are shown to change the AICAR pool
      and help the formation of the GTP pool. The ribosomal antibiotics streptomycin
      and chloramphenicol may cause the temporary deficiency of GTP eliminated by the
      increase of alarmone AICAR pool. The latter event is concluded to cause the
      increase in GTP pool independent of the means of AICAR accumulation (C1
      pholatedependent restriction of metabolization or, vice versa, the stimulation in
      the histidine biosynthesis pathway).

PMID- 1620152
TI  - [Study of phage BBL1 of Brevibacterium flavum and construction of a plasmid
      containing the cos-sequence of BBL1].

PMID- 1620153
TI  - [Mutations in Francisella tularensis, decreasing the virulence of these bacteria
      and leading to a change in the immune response upon infection of experimental
      animals with them].
AB  - The research was aimed at isolation of Francisella tularensis mutants possessing
      the decreased virulence for experimental animals and mediating the changes in the
      animal immune response. A number of spontaneous and induced mutants of the
      American and European subtypes of Francisella tularensis were selected for
      antibiotics resistance or detergent sensitivity. All the obtained mutants have
      the decreased virulence and differ in their ability to induce the protective
      antitularemia immunity or ability to induce the humoral immune response in the
      laboratory animals. The dimeric immunoprecipitation in gel as well as
      immunoblotting have shown the mutations decreasing the virulence to cause the
      loss by bacteria of a number of antigenic structures (in case the virulence is
      completely lost) or changes in antigenic structure resulting in inability of
      bacteria to induce the humoral immune response when immunizing the laboratory
      animals. The latter occurs in partially virulent mutants of the vaccine mutant
      type. The concomitant changes in virulence, ability to cause protective immunity
      or humoral immune response of the mutants is discussed.

PMID- 1620154
TI  - [DNA-protein interactions in chromatin particles differing in electrophoretic
      mobility].
AB  - The chromatin particles from Ehrlich carcinoma differing in the electrophoretic
      mobility were divided to a transcription active (c-particles) and transcription
      inactive (a-particles) fractions. Analysis of the DNA-protein interaction
      strength by the nucleoprotein-celite-chromatography has demonstrated that the
      majority of DNA-protein relationships in the a-particles is destroyed at NaCl
      concentrations exceeding 2 M, while in the c-particles at 1 M of NaCl. The study
      of NPC-chromatographic position of DNA depending on the particle size has shown
      that in slightly fragmented by streptococcal nuclease preparations of chromatin
      the DNA-protein relationships are destroyed at 3 M and 1 M of NaCl. Nevertheless,
      the position of the DNA spike on the chromatogram is not definitely dependent on
      the particle size.

PMID- 1620155
TI  - Pyrimethamine resistant mutations in Plasmodium falciparum.
AB  - Three mutations in Plasmodium falciparum yielding increased resistance to
      pyrimethamine were obtained following treatment with chemical mutagens and
      selection in presence of pyrimethamine. From parasite clone TM4/8.2 a mutant,
      TM4/8.2/4.1, was produced which raised pyrimethamine resistance about 500 times
      and was found to involve an amino acid change in the DHFR-TS enzyme molecule from
      Ser108 to Asn108. A clone of another isolate, T9/94, yielded a mutant,
      T9/94/300.300, raising pyrimethamine resistance about 10 times and involving an
      amino acid change from Ile164 to Met164. However, another mutant from T9/94,
      T9/94/M1-1(b3), although it raised the pyrimethamine resistance 100 times, did
      not involve any changes in the coding sequence of the DHFR-TS gene, but resulted
      in the production of about twice as much DHFR-TS enzyme as the original clone
      T9/94. No amplification of the DHFR-TS gene was detected. It is concluded that
      changes in pyrimethamine resistance of malaria parasites may arise in at least 2
      ways: (1) by structural changes in the DHFR domain of the DHFR-TS gene (as
      previously found by other workers); (2) by other changes, possibly affecting the
      expression of the DHFR-TS gene. The relative importance of these 2 mechanisms in
      causing resistance in wild populations of P. falciparum is discussed.

PMID- 1620156
TI  - Difference spectroscopic characterisation of the cytochrome complement in
      Acanthocheilonema viteae.
AB  - (Dithionite-reduced) minus (ferricyanide-oxidised) difference spectra of 600 x g
      and 12,000 x g subcellular pellet fractions of adult male Acanthocheilonema
      viteae exhibited alpha-absorption maxima (296 K) attributable to Cyt c555, Cyt
      b562 and aa3 (600-605 nm). The gamma(Soret) maximum of both fractions was evident
      at 427 nm, with a shoulder at 432-434 nm. 600 x g and 12,000 x g pellet fractions
      of adult female and mixed-sex adult A. viteae exhibited similar absorption
      maxima. (Succinate-reduced)--(ferricyanide-oxidised) difference spectra of the
      12,000 x g pellet fraction of mixed-sex adult A. viteae showed absorption maxima
      at 555 and 562 nm, 600 and 630 nm, suggesting the reduction of Cyt c555, Cyt
      b562, Cyt aa3 (600 nm) and an unidentified species (630 nm peak) Antimycin A (10(
      6) M) induced the disappearance of the maxima at 555, 600 and 630 nm
      corresponding to Cyt c555, Cyt aa3 and the unidentified species; the maximum at
      562 nm prevailed in the presence of antimycin A. These antimycin A induced
      changes can be cited as classical evidence for the functional involvement of
      these a, b and c type cytochromes in respiratory electron transport. (Dithionite
      reduced + CO)--(dithionite reduced) difference spectra suggest that adult A.
      viteae may have one or more CO-binding-species, one of which appears to be a low
      spin-haemoprotein with a b-type or c-type haem, which has essentially an electron
      carrier function rather than a ligand binding function.

PMID- 1620157
TI  - Inhibitors of the major cysteinyl proteinase (GP57/51) impair host cell invasion
      and arrest the intracellular development of Trypanosoma cruzi in vitro.
AB  - Peptidyl diazomethane (PDAM) derivatives, a class of irreversible inhibitors for
      cysteine proteinase, were screened for the ability to impair Trypanosoma cruzi
      invasion and intracellular development in primary cultures of heart muscle cells
      (HMC). T. cruzi GP57/51, a purified cysteinyl proteinase, and the substrate Z-Phe
      Arg-NHMec were used to determine inhibition rate constants (k'+2) by continuous
      kinetic assays. The k'+2 values ranged from 25,400 to 2,800. The best inhibitors
      of GP57/51 had bulky hydrophobic residues in the P1 position (in addition to P2),
      the S1 sub-site specificity of the enzyme being thus similar to mammalian
      cathepsin L. The effects of these PDAM on parasite infectivity were then
      investigated. The ability to invade HMC was markedly impaired when
      trypomastigotes were briefly exposed to 10 microM of Z-(S-Bzl)Cys-Phe-CHN2.
      Striking effects were observed when PDAM were added to HMC cultures that had been
      previously infected with trypomastigotes: Z-(S-Bzl)Cys-Phe-CHN2 with an IC50 of
      0.4 microM, and less markedly Z-Phe-Phe-CHN2 and Z-Tyr-Phe-CHN2 (or Z-Phe-Tyr
      CHN2) blocked amastigote replication as well as their transformation into
      trypomastigotes, thereby arresting intracellular development. Bz-Phe-Gly-CHN2, in
      contrast, failed to display antiparasite activity. Direct characterization of the
      target cysteinyl proteinase was sought, by incubating viable amastigotes or
      infected HMC with Z-[125I]Tyr-Phe-CHN2. Affinity labeling implicated GP57/51 as
      the major cysteinyl proteinase target for this probe. We propose that T. cruzi
      intracellular development is critically dependent on GP57/51 (cruzipain).
      Selective inhibitors for this cysteinyl proteinase may have therapeutic
      potential.

PMID- 1620159
TI  - Isolation and characterization of a cyclic nucleotide-independent protein kinase
      from Leishmania donovani.
AB  - We describe here a protein kinase from the promastigote form of the parasitic
      protozoan, Leishmania donovani, purified to near homogeneity to a single-subunit,
      34-kDa protein. This enzyme does not require a cofactor, and has several
      characteristics in common with the catalytic subunit of mammalian cAMP-dependent
      protein kinase, for example, preference for kemptide as a substrate,
      phosphorylation of serine residues of protamine and inhibition by the mammalian
      heat-stable inhibitor. The leishmanial enzyme can associate with the regulatory
      subunit of mammalian cAMP-dependent protein kinase to form an inactive holoenzyme
      that is activated by cAMP and is protected from inhibition by thiol reagents.
      From these results it is concluded that L. donovani promastigotes possess a
      protein kinase which has similar characteristics with the mammalian catalytic
      subunit of cAMP-dependent protein kinase.

PMID- 1620158
TI  - p-Aminobenzoic acid transport by normal and Plasmodium falciparum-infected
      erythrocytes.
AB  - De novo folate biosynthesis is required for the growth of malarial parasites and
      is inhibited by several important antimalarial agents. We show here that
      exogenous p-aminobenzoic acid (pABA) can be utilized by malaria parasites to
      synthesize folates. The transport of pABA into parasite infected red cells was
      therefore characterized. Normal red cells transport pABA in a saturable and
      energy-dependent manner, with a dissociation constant of 83 nM. pABA transport in
      parasite-infected red cells may use the same mechanism, as demonstrated by
      similarities in time course, concentration-response, and dissociation constant
      (111 nM). The transport capacity of red cells is temperature-, energy- and pH
      dependent. It is inhibited by the proton ionophore, carbonylcyanide m
      chlorophenylhydrazone (CCCP), but not by the sodium ionophores nigericin and
      monensin. p-Aminosalicylic acid (PAS) inhibits pABA transport competitively, with
      a inhibition constant of 378 nM. Phloritin, flufanamic acid, and 4,4'
      diisothiocyanatostilbene-2,2'-disulfonic acid (DITS), which are inhibitors of the
      anion transporter (band 3), and oxalic acid, a substrate of this transporter,
      partially inhibit pABA transport into both normal and infected red cells.
      Interestingly, in both normal and infected red cells, the inhibitory effects of
      PAS and the anion transport inhibitors are additive, suggesting the involvement
      of 2 independent mechanisms.

PMID- 1620160
TI  - Transcribing and replicating particles in a double-stranded RNA virus from
      Leishmania.
AB  - During the replicative cycle of many double-stranded RNA viruses, transcription
      of particles with a double-stranded RNA genome alternates with replication of
      particles containing a single-stranded genome. In virions infecting some strains
      of Leishmania guyanensis the putative transcriptase and replicase activities of
      the RNA-dependent RNA polymerase were previously detected in vitro. Northern
      hybridization to RNA of known polarity demonstrates that the single-stranded RNA
      products are of positive polarity and, by definition, are the products of the
      viral transcriptase. Re-evaluation of previously published data in the light of
      these findings suggests that transcription in Leishmania viruses is conservative.
      Sedimentation in sucrose gradients revealed two types of viral particles; single
      stranded RNA particles comprised a small fraction of the virus population and
      sedimented more slowly than the peak of double-stranded RNA particles. In
      agreement with the replicative model of other dsRNA viruses, these single
      stranded particles co-purified with the viral replicase activity that resulted in
      double-stranded RNA synthesis. In virus-infected promastigote extracts replicase
      activity decreased with increasing parasite density in culture, suggesting a
      correlation between cell division and viral replication.

PMID- 1620161
TI  - Synthesis and secretion of proteins by released malarial parasites.
AB  - Controlled mechanical homogenization of Plasmodium falciparum-infected
      erythrocytes releases parasites of a quality sufficient for studying the export
      of newly synthesized plasmodial proteins. Protein synthesis occurs within intact
      released parasites as defined by resistance of acid-insoluble incorporation of
      radiolabel to high levels of exogenously added EDTA, hexokinase, and RNaseA.
      While exogenously added ATP and erythrocyte cytosol were not essential for
      biosynthetic activity at levels comparable to that seen in infected erythrocytes,
      the addition of an extracellular ATP regenerating system (ARS) stimulated the
      synthesis of parasite proteins. Conversely, parasite viability and biosynthetic
      activity are decreased by the addition of a non-hydrolyzable ATP analogue (ATP
      gamma S), ADP, or ATP in the absence of a regenerating system. These data suggest
      a metabolic interdependence between extracellular energy metabolism and
      biosynthetic functions within the parasite. The export of a predominant subset of
      proteins was retarded in the presence of Brefeldin A, indicating the existence of
      a classical secretory pathway characteristic of that seen in higher eukaryotic
      cells. Interestingly, a Brefeldin A-insensitive component of export was also
      consistently observed; this may suggest the existence of an additional
      alternative secretory mechanism in malaria.

PMID- 1620162
TI  - Genes selectively expressed in the infectious (metacyclic) stage of Leishmania
      major promastigotes encode a potential basic-zipper structural motif.
AB  - Complementary DNA clones representing transcripts selectively expressed in the
      non-dividing, infective (metacyclic) stage of Leishmania major promastigotes (MP)
      were identified by differential and subtractive screening. The majority of the
      selected clones hybridized on Northern blots to a set of transcripts highly
      expressed by MP, but to a much lower extent in proliferating and stationary-phase
      attenuated promastigotes. Stationary, but not log-phase cultures, of each of 5 L.
      major strains showing a potential for differentiation to metacyclics, expressed
      these transcripts (MAT-1; MP-associated transcripts). From sequence analysis of
      full-length cDNA clones corresponding to the predominating MAT-1 species, an open
      reading frame encoding a 139 aa polypeptide (15.4 kDa) was predicted and
      supported by immunoprecipitation by kala-azar sera of reticulocyte extract
      translation products using in vitro transcribed RNA. Although no significant
      primary sequence homology to database nucleic acid and protein sequences was
      found, the sequence displays similarities to the basic-zipper families of
      transcription regulatory proteins.

PMID- 1620163
TI  - Calcium homeostasis in Trypanosoma cruzi amastigotes: presence of inositol
      phosphates and lack of an inositol 1,4,5-trisphosphate-sensitive calcium pool.
AB  - The permeabilization of Trypanosoma cruzi amastigotes with digitonin allowed the
      study of Ca2+ fluxes between intracellular organelles in situ. In addition, fura
      2 was used to determine the cytosolic Ca2+ concentration in the intact cells.
      When amastigotes were permeabilized in a reaction medium containing MgATP,
      succinate and 3.5 microM Ca2+, they lowered the medium Ca2+ concentration to the
      submicromolar level, a range which correlates favorably with that detected in the
      intact cells with fura-2. The presence of 1 microM FCCP strongly decreased the
      initial rate of Ca2+ sequestration by these permeabilized cells. This FCCP
      insensitive Ca2+ uptake, probably represented by the endoplasmic reticulum, was
      completely inhibited by 500 microM vanadate. On the other hand, when vanadate
      instead of FCCP was present, the initial rate of Ca2+ accumulation was decreased
      and the Ca2+ set point was increased to about 0.8 microM. The succinate
      dependence and FCCP sensitivity of the later Ca2+ uptake indicate that it may be
      exerted by the mitochondria. Despite the presence of inositol phosphates, as
      determined by [3H]inositol incorporation, and of a large extramitochondrial Ca2+
      pool, no IP3-sensitive or thapsigargin-sensitive Ca2+ release could be detected
      in either amastigotes or epimastigotes.

PMID- 1620164
TI  - The GMP reductase gene of the nematode Ascaris lumbricoides var. suum.

PMID- 1620165
TI  - Molecular cloning of a 16-kilodalton Cu/Zn superoxide dismutase from Schistosoma
      mansoni.

PMID- 1620167
TI  - Isolation of skeleton-associated knobs from human red blood cells infected with
      malaria parasite Plasmodium falciparum.

PMID- 1620166
TI  - Comparison of the carboxy-terminal, cysteine-rich domain of the merozoite surface
      protein-1 from several strains of Plasmodium yoelii.

PMID- 1620168
TI  - Characterization of a possible tRNA synthetase gene from Onchocerca volvulus.

PMID- 1620169
TI  - Treatment of preterm labor with the beta-adrenergic agonist ritodrine.
AB  - BACKGROUND: Beta-adrenergic agonists are commonly used to arrest premature labor.
      Although treatment of preterm labor with these agents can delay delivery by 24 to
      48 hours, the potential risks and benefits to the mother and infant before and
      after delivery have not been adequately assessed. METHODS: We randomly assigned
      708 women with preterm labor at six hospitals to receive an intravenous infusion
      of either the beta-adrenergic agonist ritodrine (n = 352) or placebo (n = 356).
      Assignment was made with stratification according to four categories of
      gestational age (20 to 23 weeks, 24 to 27 weeks, 28 to 31 weeks, and 32 to 35
      weeks). The primary objective was to assess the effect of ritodrine on perinatal
      mortality. Secondary objectives were the evaluation of the causes of perinatal
      death, the extent to which delivery was delayed with ritodrine, and the effects
      on birth weight, maternal morbidity, neonatal morbidity, and infant morbidity at
      18 months of postnatal age, corrected for preterm delivery. RESULTS: Among the
      771 infants born to the women in the study (including 63 pairs of twins), there
      were 23 deaths (6.1 percent) in the ritodrine group and 25 deaths (6.4 percent)
      in the placebo group (event-rate difference, -0.3 percent; 95 percent confidence
      interval, -3.7 percent to 3.1 percent). There was no difference between the
      groups in the extent of delay of delivery, the incidence of delivery before 37
      weeks' gestation, the proportion of babies weighing less than 2500 g, or measures
      of neonatal morbidity. Maternal morbidity (such as chest pain and cardiac
      arrhythmias) occurred more frequently but not exclusively in the ritodrine group.
      One infant born to a woman in the ritodrine group and five infants born to women
      in the placebo group had cerebral palsy (P = 0.09). There was a slight but not
      significant trend toward an improved score on the Bayley Psychomotor Development
      Index at 18 months of age among the infants of the ritodrine-treated women.
      CONCLUSIONS: We found that the use of ritodrine in the treatment of preterm labor
      had no significant beneficial effect on perinatal mortality, the frequency of
      prolongation of pregnancy to term, or birth weight.

PMID- 1620170
TI  - Treatment of supraventricular tachycardia due to atrioventricular nodal reentry
      by radiofrequency catheter ablation of slow-pathway conduction.
AB  - BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT), the most common
      form of supraventricular tachycardia, results from conduction through a reentrant
      circuit comprising fast and slow atrioventricular nodal pathways. Antiarrhythmic
      drug therapy is not consistently successful in controlling this rhythm
      disturbance. Catheter ablation of the fast pathway with radiofrequency current
      eliminates AVNRT, but it can produce heart block. We hypothesized that catheter
      ablation of the site of insertion of the slow pathway into the atrium would
      eliminate AVNRT while leaving normal (fast-pathway) atrioventricular nodal
      conduction intact. METHODS AND RESULTS: Eighty patients with symptomatic AVNRT
      were studied. Retrograde slow-pathway conduction (in which the earliest
      retrograde atrial potential was recorded at the posterior septum, close to the
      coronary sinus) was present in 33 patients. The retrograde atrial potential was
      preceded by a potential consistent with activation of the atrial end of the slow
      pathway (ASP). In 46 of the 47 patients without retrograde slow-pathway
      conduction, a potential with the same characteristics as the ASP potential was
      recorded during sinus rhythm. Radiofrequency current delivered through a catheter
      to the ASP site (in the posteroseptal right atrium or coronary sinus) abolished
      or modified slow-pathway conduction in 78 patients, eliminating AVNRT without
      affecting normal atrioventricular nodal conduction. In the single patient without
      ASP, the application of radiofrequency current to the proximal coronary sinus
      ablated the fast pathway and AVNRT: Atrioventricular block occurred in one
      patient (1.3 percent) with left bundle-branch block, after inadvertent ablation
      of the right bundle branch. AVNRT has not recurred in any patient during a mean
      (+/- SD) follow-up of 15.5 +/- 11.3 months. Electrophysiologic study 4.3 +/- 3.3
      months after ablation in 32 patients demonstrated normal atrioventricular nodal
      conduction without AVNRT: CONCLUSIONS: Catheter ablation of the atrial end of the
      slow pathway using radiofrequency current, guided by ASP potentials, can
      eliminate AVNRT with very little risk of atrioventricular block.

PMID- 1620171
TI  - Breast cancer (1)

PMID- 1620172
TI  - Metabolic disturbances and wasting in the acquired immunodeficiency syndrome.

PMID- 1620173
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 31-1992. A 68-year-old man with acute mitral regurgitation.

PMID- 1620175
TI  - Pharmaceutical promotions--a free lunch?

PMID- 1620174
TI  - Is insulin-dependent diabetes mellitus environmentally induced?

PMID- 1620176
TI  - The active management of labor.

PMID- 1620177
TI  - The active management of labor.

PMID- 1620178
TI  - The active management of labor.

PMID- 1620179
TI  - Early versus late treatment with zidovudine.

PMID- 1620180
TI  - Early versus late treatment with zidovudine.

PMID- 1620181
TI  - Clinical problem-solving: how sure is sure enough?

PMID- 1620182
TI  - Clinical problem-solving: how sure is sure enough?

PMID- 1620183
TI  - Clinical problem-solving: how sure is sure enough?

PMID- 1620184
TI  - Use of phentolamine for cocaine-induced myocardial ischemia.

PMID- 1620185
TI  - Selective decontamination of the digestive tract.

PMID- 1620186
TI  - Selective decontamination of the digestive tract.

PMID- 1620187
TI  - Fecal incontinence.

PMID- 1620188
TI  - Education or promotion?

PMID- 1620189
TI  - Methodological issues in prevention research on drug use and pregnancy.

PMID- 1620190
TI  - Methodological issues in epidemiological, prevention, and treatment research on
      drug-exposed women and their children. Technical review meeting. Baltimore,
      Maryland, July 25-26, 1990.

PMID- 1620191
TI  - Who is it going to be? Subject selection issues in prenatal drug exposure
      research.

PMID- 1620192
TI  - Subject recruitment and retention for longitudinal research: practical
      considerations for a nonintervention model.

PMID- 1620193
TI  - Subject recruitment and retention issues in longitudinal research involving
      substance-abusing families: a clinical services context.

PMID- 1620194
TI  - Perinatal substance abuse and AIDS: subject selection, recruitment, and
      retention.
AB  - Studies that involve subjects who are HIV infected as well as chemically
      dependent present special challenges to the study team. HIV infection is now so
      common in many parts of the country and infection can potentially influence so
      many commonly used endpoints for perinatal chemical dependence studies that HIV
      must be considered in these studies. Some of the factors that need to be taken
      into account in the design of studies include the staging of HIV illness, the
      consequences of HIV-induced CNS disease, the effects of HIV treatment, and the
      biases in subject selection that arise due to inaccurate information about risk
      factors and imbalance in sources of subjects and controls. In addition, the study
      team needs to remember the community and staff fear and bias that are often
      encountered in the care of HIV-infected patients. Fruitful sources of subjects
      for perinatal studies include prenatal clinics and delivery rooms, chemical
      dependence programs, and the network of community social agencies. Retention of
      this challenging group is strongly aided by the establishment of a seamless
      system of services that includes all aspects of general medical care, HIV
      specialty care, access to treatment protocols, and psychosocial care.

PMID- 1620195
TI  - Measurement issues in the evaluation of experimental treatment interventions.
AB  - The final discussion of followup measurement highlights earlier discussions of
      patient and treatment measurement. Followup is the best assessment of the
      efficacy of a treatment intervention. Therefore, it is critical to have a clear
      set of baseline measures on the patient in those areas that are expected to be
      able to improve with the intervention and to repeat these measures at followup to
      assess improvement and outcome. The measures that are collected at followup are
      essentially identical to the measures that were collected at the time of
      treatment admission but in abbreviated form. However, the same methodological
      issues, techniques, and considerations apply. As at the time of the initial
      assessment, the patient should be measured in all those areas that are expected
      to be changed, the patient should be assessed with multiple methods (interview
      questionnaire and objective laboratory data), and all care should be taken to
      assure the patient that the information will be treated in a professional manner
      and that her privacy and confidentiality will be protected. An effective
      posttreatment evaluation requires effective tracking, locating, and
      reinterviewing each patient following treatment. The ability to recontact these
      patients after treatment is almost entirely dependent on the level of
      information, patient preparation, and interagency cooperation established during
      the time the patient was in treatment. Followup is an important but difficult job
      that must be coordinated from the very start of treatment and must involve the
      patient, followup staff, clinical program, and sponsoring agency or agencies.

PMID- 1620196
TI  - Discussion: subject selection, recruitment, and retention in longitudinal studies
      involving perinatal substance abuse and human immunodeficiency virus infection.

PMID- 1620197
TI  - Measures of pregnant, drug-abusing women for treatment research.

PMID- 1620198
TI  - Assessing acute and long-term physical effects of in utero drug exposure on the
      perinate, infant, and child.

PMID- 1620199
TI  - Methodological issues in the assessment of the mother-child interactions of
      substance-abusing women and their children.

PMID- 1620200
TI  - Discussion: measurement issues in the study of effects of substance abuse in
      pregnancy.

PMID- 1620201
TI  - Studies of prenatal drug exposure and environmental research issues: the benefits
      of integrating research within a treatment program.

PMID- 1620202
TI  - How the environment affects research on prenatal drug exposure: the laboratory
      and the community.
AB  - This has been a brief overview of some of the many ways in which the environment
      in which prenatal drug research is carried out affects the process of research
      and its outcome. In many ways, this chapter is a review of factors that many
      people know about but rarely discuss in public. Most scholarly articles present
      research in this area as though it is a smooth and orderly process not much
      troubled by environmental constraints. The extent to which research flaws are
      criticized, even those that are inevitable to the process, discourages frank
      discussion of these problems that are familiar to most investigators who attempt
      to conduct clinical research in difficult areas. The purpose of this chapter is
      to make some of these issues more explicit so that they can be planned for in
      future work and taken into account when current work is reviewed.

PMID- 1620203
TI  - Discussion: research environment and use of multicenter studies in perinatal
      substance abuse research.

PMID- 1620204
TI  - Discussion: statistical analysis in treatment and prevention program evaluation.

PMID- 1620205
TI  - Process measures in interventions for drug-abusing women: from coping to
      competence.
AB  - As a guide to the selection of process and outcome measurement in interventions
      with drug-abusing women, we have offered a model of fundamental coping processes.
      Three coping processes--reinforcer management, challenge management, and affect
      management--appear critical to women's competence and physical hardiness. When
      these processes go awry, substance abuse is a likely result. For successful
      recovery from substance abuse, good fortune or purposeful intervention must
      promote these coping processes. To measure the impact of any intervention with
      drug-abusing women, methods of assessing fundamental coping processes during
      intervention (process measures) and repeatedly after intervention (outcome
      measures) are needed. We have described multiple methods of measuring fundamental
      coping processes from diverse vantage points: self-report, behavioral
      observation, biochemistry, and physiology. We have discussed how these measures
      relate to the theoretical model. Finally, we have indicated measures favored and
      used in our longitudinal and intervention research on adolescent and perinatal
      substance abuse. The final set of measures, as summarized in the list of
      recommended process and outcome measures on pages 324-325, is somewhat lengthy
      because the process of intervention is complex. Given the financial and
      structural limitations of research in drug treatment settings, it may not be
      possible for a single investigator to employ all the recommended measures. An
      adequate research design would employ two measures from each of the domains
      outlined. If resources allow, more extensive measurement procedures would be
      possible.

PMID- 1620206
TI  - Discussion: dilemmas in research in perinatal addiction--intervention issues.

PMID- 1620207
TI  - Alcohol- and drug-dependent pregnant women: laws and public policies that promote
      and inhibit research and the delivery of services.

PMID- 1620208
TI  - Mandatory reporting of child abuse and research on the effects of prenatal drug
      exposure.

PMID- 1620209
TI  - Discussion: effect of legal stipulations on the conduct of treatment and
      prevention research.

PMID- 1620210
TI  - Role of biologic markers in epidemiologic studies of prenatal drug exposure:
      issues in study design.

PMID- 1620211
TI  - Detection of prenatal drug exposure in the pregnant woman and her newborn infant.

PMID- 1620212
TI  - Methodological issues in obtaining and managing substance abuse information from
      prenatal patients.

PMID- 1620213
TI  - Discussion: caveats in testing for drugs of abuse.
AB  - Four mass screening techniques for drugs of abuse (TLC, RIA, EMIT, and FPI) have
      been described. For small-scale screening, TLC is the most cost-effective.
      Although it cannot achieve the sensitivity of the other three immunologically
      based techniques, TLC is sufficient for many purposes. All screening techniques
      are subject to interferences that can generate false-negatives or false
      positives. These results must be taken into account in analysis of the research
      data. In applying technology in new areas of research, one has to be aware of the
      basis and limits of that technology. Testing of drugs of abuse in urine is a well
      known technology in which most of the problems have been discovered. This
      technology is less proven for other media, such as hair, saliva, or meconium,
      leaving potential pitfalls for the unwary researcher.

PMID- 1620214
TI  - Drug abuse treatment in prison and jails. Technical review meeting. Rockville,
      Maryland, May 24-25, 1990.

PMID- 1620215
TI  - The challenge of drug abuse treatment in prisons and jails.

PMID- 1620216
TI  - Comprehensive system development in corrections for drug-abusing offenders: the
      Wisconsin Department of Corrections.

PMID- 1620217
TI  - Outcome evaluation of a prison therapeutic community for substance abuse
      treatment.

PMID- 1620219
TI  - Management of the drug-abusing offender.

PMID- 1620218
TI  - Evaluation of in-jail methadone maintenance: preliminary results.

PMID- 1620220
TI  - A coordinated approach for drug-abusing offenders: TASC and parole.

PMID- 1620221
TI  - Methodological issues: drug abuse treatment research in prisons and jails.

PMID- 1620222
TI  - Evaluation of the Federal Bureau of Prisons' drug treatment programs.

PMID- 1620223
TI  - Directions for practice and research.

PMID- 1620224
TI  - Program models.

PMID- 1620225
TI  - Drug treatment services in jails.

PMID- 1620226
TI  - HIV-1 infection in the correctional setting.
AB  - The correctional setting provides an opportunity to serve IV drug users who might
      otherwise be difficult to access. Interventions--including education, counseling,
      treatment for HIV-1 infection, and treatment for drug abuse--conducted in the
      correctional setting could have benefits for individual inmates and the
      surrounding community.

PMID- 1620227
TI  - Drug abuse treatment programs in the Federal Bureau of Prisons: initiatives for
      the 1990s.
AB  - Developing high-quality treatment programs is a foreboding challenge in any
      setting, particularly within a correctional setting. The groundwork has been
      established for one of the most comprehensive, longitudinal evaluations ever
      conducted with correctional populations regarding the effectiveness of
      professionally managed treatment programs. The long-term outcome evaluations
      should provide information regarding the effectiveness of a multitiered
      intervention strategy within the correctional setting. This kind of evaluation is
      reflected in the proposal for the evaluation of the BOP Drug Abuse Treatment
      Programs, submitted to NIDA (Federal Bureau of Prisons 1990). In the months and
      years ahead the study is expected to yield important information that will
      advance knowledge of substance abuse treatment.

PMID- 1620228
TI  - Correctional drug abuse treatment in the United States: an overview.

PMID- 1620229
TI  - Amity righturn: a demonstration drug abuse treatment program for inmates and
      parolees.

PMID- 1620230
TI  - Substance abuse services in juvenile justice: the Washington experience.

PMID- 1620231
TI  - Effects of 5-HT4 receptor stimulation on basal and electrically evoked release of
      acetylcholine from guinea-pig myenteric plexus.
AB  - The effects of 5-methoxytryptamine and 5-hydroxytryptamine (5-HT) on both basal
      and electrically evoked outflow of tritium were studied in guinea-pig myenteric
      plexus preparations preincubated with [3H]-choline. Basal outflow. 5
      Methoxytryptamine caused a transient and calcium-dependent increase in basal
      outflow of [3H]acetylcholine that was abolished by tetrodotoxin. Ondansetron (1
      mumol/l) did not affect the stimulatory response of 5-methoxytryptamine but ICS
      205-930 (1 and 3 mumol/l) produced parallel rightward displacements of the
      concentration-response curve to 5-methoxytryptamine. The pKB value for ICS 205
      930 was 6.6 suggesting an involvement of 5-HT4 receptors. 5-HT caused an increase
      in basal outflow of [3H]acetylcholine and a biphasic concentration-response curve
      was obtained. The maximal response of the first phase to 5-HT (release of 0.98%
      of tissue tritium) and the maximal response to 5-methoxytryptamine (0.94% of
      tissue tritium) were similar but 5-methoxytryptamine (-log EC50: 6.9) was less
      potent than 5-HT (-log EC50 of the high affinity component: 7.9). ICS 205-930
      (0.01-1.0 mumol/l) acted as a competitive antagonist against the low affinity
      component of the 5-HT concentration-response curve with a pA2 value of 8.0. It is
      concluded that stimulation of both 5-HT4 receptors (by 5-methoxytryptamine and
      submicromolar concentrations of 5-HT) and 5-HT3 receptors (by micromolar
      concentrations of 5-HT) causes a release of acetylcholine which in turn leads to
      smooth muscle contraction. Electrically evoked outflow. This outflow of [3H]
      acetylcholine was concentration-dependently inhibited by both 5-methoxytryptamine
      and 5-HT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620232
TI  - Effect of tianeptine on the central cholinergic system: involvement of serotonin.
AB  - The effect of tianeptine on in vivo acetylcholine (ACh) release from brain
      hemispheric regions of freely moving rats was investigated using the
      microdialysis technique coupled with a sensitive radioenzymatic method.
      Tianeptine, at the dose of 30 mg/kg i.p., reduced ACh release from dorsal
      hippocampi by 40% in 40 min, and induced a 30% decrease of ACh output from
      frontal cortices while at the doses of 10 and 20 mg/kg it had no effect. In
      striata the drug did not significantly affect ACh release although it showed a
      tendency to increase it. The ACh content in the three areas considered was not
      affected by tianeptine at above doses. The drug did not alter choline-o
      acetyltransferase and acetylcholinesterase activities suggesting that it did not
      influence the cholinergic system through direct action on the ACh metabolism;
      furthermore, it did not influence the sodium-dependent high-affinity uptake of
      choline in striatum, cortex and hippocampus. Impairment of serotonergic (5-HT)
      neurotransmission by chemical lesion of the median raphe nucleus or by
      metergoline, a blocker of 5-HT receptors, antagonized the cholinergic effect of
      tianeptine. The involvement of the serotonergic system is specific because
      lesions of the noradrenergic dorsal bundle failed to prevent the inhibitory
      action of tianeptine. The present data suggest that 5-HT may mediate the effect
      of tianeptine on the cholinergic system in dorsal hippocampi.

PMID- 1620233
TI  - SDZ ENS 163 is a selective M1 agonist and induces release of acetylcholine.
AB  - In the present study some pharmacological properties of the new muscarinic
      agonist SDZ ENS 163; (+)-(3S,cis)-3-ethyldihydro-4-[(1-methyl-1H-imidazol-5-yl)
      methyl-2(3H)-thiophenonedihydrogenphosphate] have been investigated. In the rat
      superior cervical ganglion, a model for M1 muscarinic receptors, SDZ ENS 163
      induced concentration-dependent depolarizations (pD2 = 6.5 +/- 0.3; efficacy =
      128 +/- 4.2% compared to carbachol). SDZ ENS 163 was a very weak partial agonist
      with respect to M2 receptor-induced decrease in contractile force in rat left
      atria (efficacy = 14 +/- 2.9%). In addition, SDZ ENS 163 competitively
      antagonized the effect of carbachol in rat left atria (pA2 = 5.8 +/- 0.2). In the
      guinea-pig ileum SDZ ENS 163 was a partial agonist with respect to force of
      contraction mediated by M3 receptors (pD2 = 5.3 +/- 0.1; efficacy = 72 +/- 4.2%).
      The oxotremorine-induced inhibition of the electrically stimulated release of
      acetylcholine (ACh) in rat hippocampal slices was reversed by SDZ ENS 163 (pA2 =
      5.5 +/- 0.1). In addition after oral administration SDZ ENS 163 (3-10 mumol/kg)
      reduced brain ACh levels, which is indicative of increased ACh turnover. Finally,
      increases in energy of the low frequency band (2-5 Hz) were observed in rat
      hippocampal EEG after intraperitoneal administration of SDZ ENS 163 (0.3-30
      mumol/kg). We conclude that SDZ ENS 163 is a selective M1 agonist in vitro with
      an additional M2 antagonistic effect. The in vivo effects of SDZ ENS 163 may
      result both from postsynaptic M1 agonistic as well as M2 receptor antagonistic
      activity. The unique pharmacological profile of SDZ ENS 163 may prove clinically
      favourable for treatment of cognitive deficits.

PMID- 1620234
TI  - Carbachol potentiates isoprenaline-induced mucin secretion by rat submandibular
      gland.
AB  - We studied the effects of carbachol on isoprenaline-induced secretion of
      3[H]glucosamine-labeled high molecular weight protein from in vitro fragments of
      rat submandibular gland. The concentration-response curve for isoprenaline was
      determined alone and in the presence of one of two concentrations of carbachol.
      Isobolic interaction indices were calculated from the resulting curves. The role
      of extracellular calcium on this interaction was assessed by examining the effect
      of increasing concentrations of [Ca2+]e on secretion induced by a fixed
      concentration of isoprenaline alone and in the presence of carbachol. Carbachol
      alone caused a small, but statistically significant, protein secretion. Carbachol
      markedly shifted the isoprenaline concentration-response curve to the left in a
      dose-dependent manner. In the absence of extracellular calcium, carbachol did not
      increase isoprenaline-induced secretion, but secretion increased as the [Ca2+]e
      was increased. The carbachol-induced increase in secretion reached a maximal
      level at approximately 2.0 mM [Ca2+]e. We conclude that carbachol's increase of
      isoprenaline-induced secretion of 3[H]glucosamine-labeled high molecular weight
      protein is not additive, but is true potentiation. This potentiation requires
      extracellular calcium, and may be maximal at physiological [Ca2+]e.

PMID- 1620235
TI  - Radiolabeling of dopamine uptake sites in mouse striatum: comparison of binding
      sites for cocaine, mazindol, and GBR 12935.
AB  - This study addressed the possibility of a unique binding interaction between
      cocaine and the dopamine transporter as compared with other blockers of dopamine
      uptake. Cocaine binding sites in a fresh P2 fraction of mouse striatum were
      labeled with [3H]CFT, a phenyltropane analog of cocaine also known as WIN 35,428,
      and compared with sites labeled with [3H]mazindol or [3H]GBR 12935. Under the
      conditions used, homogeneous binding was observed that was inhibited
      monophasically by cocaine, CFT, and mazindol; the same potencies were observed
      with the three radioligands. Saturation analysis in the presence and in the
      absence of unlabeled inhibitor (CFT, mazindol, cocaine) indicated a change in the
      Kd but not the Bmax, consonant with a competitive mechanisms. Tris-HCl reduced
      the affinity of each radioligand and unlabeled inhibitor without changing the
      Bmax. N-Ethylmaleimide reduced the binding of all radioligands equally and
      cocaine offered protection. The dissociation rate of [3H]CFT and [3H]mazindol
      binding was not affected by the presence of mazindol and CFT, respectively. The
      Bmax of [3H]CFT and [3H]mazindol binding was the same; the relatively higher
      value for [3H]GBR 12935 binding in analyses involving varying tritiated GBR 12935
      only, was due primarily to an underestimation of the specific activity of [3H]GBR
      12935. All results are in agreement with a one-site model in which cocaine, CFT,
      mazindol, and GBR 12935 share a common binding site in mouse striatum.

PMID- 1620236
TI  - Different and common intracellular calcium-stores mobilized by noradrenaline and
      caffeine in vascular smooth muscle.
AB  - Noradrenaline (NA) 1 microM and caffeine (CAF) 10 mM induce a contractile
      response in isolated rat aorta maintained at 37 degrees C either in the presence
      or absence of extracellular calcium. In Ca-free media the contractile response
      was reduced and contractile activity of CAF only occurred at 25 degrees C. NA
      induced a biphasic response in Ca-free medium, with a fast phasic contraction
      followed by a smaller more sustained contraction. The response induced by CAF
      consisted of a fast transient contraction which returned to a level below the
      resting tone. After washing, further addition of NA or CAF evoked no increase in
      smooth muscle tension. The influence of Mg-depletion in the extracellular medium
      on the contractile responses induced by NA and CAF in Ca-free medium was
      determined: similar response to NA or CAF in media with or without Mg after 2 min
      loading were observed, but after 15 min loading in Mg, Ca-free solution, the
      responses to NA or CAF were significantly higher than after incubation in Ca-free
      medium containing Mg. Differences were observed when contractile response to NA
      was elicited after the refilling process by loading the aortic strip in Ca
      containing Mg-free solution. In this case, instead of recovering the magnitude of
      contraction there was a significant decrease. The existence of two independent
      intracellular Ca-pools releasable by NA, one of them also sensitive to CAF, is
      postulated. The refill of the Ca-store specific to NA is dependent on the
      presence of Mg in the extracellular medium. In contrast, the refill of the common
      Ca-pool releasable by NA and CAF is independent of the extracellular Mg, but its
      spontaneous emptying is temperature-, and Mg-dependent. This suggests the
      intermediacy of an enzymatic process to extrude the Ca-content of this store to
      the extracellular space.

PMID- 1620237
TI  - Difference between aortic and renal vascular reactivity in cyclosporin A treated
      rats and the effect of cicletanine.
AB  - 4 Groups of 2 month-old male Wistar rats were treated with a) cyclosporin A (CyA)
      30 mg/kg/day alone, b) CyA plus cicletanine (Cic) 60 mg/kg/day, c) vehicle
      (vegetable oil) 1 ml/100 g rat/day and d) no treatment for 8 weeks. The
      reactivity of isolated papillary muscle to isoprenaline and Ca2+ was not altered
      in any of the treated groups. Endothelium-dependent relaxation induced by
      acetylcholine was inhibited in aorta ring segments from CyA-treated rats as
      compared to that of control and CyA + Cic-treated rats. The relaxation induced by
      acetylcholine in rat aortas was similar in all groups in the presence of 10
      microM indomethacin. Noradrenaline sensitivity of aortic segments was not
      affected by any treatments applied. The Ca(2+)-concentration response curves of
      aorta segments from CyA-treated and CyA + Cic-treated rats were shifted to the
      right as compared to control rats. In interlobar renal arteries the endothelium
      dependent relaxation induced by acetylcholine was not affected by any form of
      treatment. In renal arteries 10 microM indomethacin increased the maximal
      relaxation induced by acetylcholine about 50%. In these vessels noradrenaline
      sensitivity in CyA and CyA + Cic treated rats was higher than in controls.
      Cocaine, 3 microM, shifted the noradrenaline concentration response curve to the
      left about 0.4 log units in all renal vessel groups, thus renal vascular smooth
      muscle sensitivity to noradrenaline was significantly greater in vessels from
      rats receiving CyA than in vessels from control rats. Administration of CyA
      induced only slight renal morphological changes. Cic was without effect on CyA
      induced morphological abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620238
TI  - Characterization of nicotinic acetylcholine receptors on cultured bovine adrenal
      chromaffin cells using modified L-[3H]nicotine binding assay.
AB  - To characterize the properties of nicotinic acetylcholine receptors (nAChRs) in
      autonomic ganglia, we examined L-[3H]nicotine binding to membrane fraction
      prepared from cultured bovine adrenal chromaffin cells, using a modified
      filtration method. Binding of L-[3H]nicotine to non-treated glass fiber filters
      interfered with the detection of specific binding to the membrane fraction.
      Presoaking glass fiber filters in 3% or higher concentrations of
      polyethyleneimine (PEI) solution (sixty times higher than earlier used
      concentration) for at least 5 h could reduce the binding of L-[3H]nicotine to the
      filters to the background level. Specific L-[3H]nicotine binding to the membrane
      fraction was detected only when the membrane fraction was prepared in Ca(2+)-and
      Mg2+ (EDTA, EGTA and protease inhibitors were added) -free buffer. Specific
      binding of L-[3H]nicotine was saturable and reversible. Both computer program and
      Scatchard analysis revealed a single class of high affinity binding sites with an
      average Kd of 8.9 nM and a Bmax of 42.5 fmol/mg protein. The Hill coefficient was
      0.98. In inhibition studies, both cholinergic agonists (carbachol and L-nicotine)
      and ganglionic agonists (lobeline and 1,1-dimethyl-4-phenylpiperazinium iodide)
      were much effective in inhibiting L-[3H]nicotine binding, whereas both
      neuromuscular blocking (alpha-bungarotoxin and d-tubocurarine) and ganglionic
      blocking agents were less effective. These results suggest that high affinity
      nicotinic binding sites on adrenal chromaffin cells are nAChRs of the ganglion
      type, which have properties different from nAChRs on the neuromuscular junction
      but similar to nAChRs in the brain.

PMID- 1620239
TI  - NPY and carbachol raise Ca2+ in SK-N-MC cells by three different mechanisms.
      Evidence for inositol phosphate-independent Ca2+ mobilization by NPY.
AB  - We have compared the mechanism of NPY- and carbachol-stimulated Ca2+ increases in
      SK-N-MC cells. NPY stimulated Ca2+ mobilization via a pertussis toxin-sensitive
      mechanism. Carbachol stimulated Ca2+ mobilization and influx via pertussis toxin
      insensitive and -sensitive mechanisms, respectively. Carbachol but not NPY
      stimulated inositol phosphate accumulation by a pertussis toxin-insensitive
      mechanism. We conclude that carbachol promotes Ca2+ influx via a pertussis toxin
      sensitive G protein and Ca2+ mobilization via a pertussis toxin-insensitive G
      protein coupling to inositol phosphate generation; NPY stimulates Ca2+
      mobilization via a pertussis toxin-sensitive G protein without apparent
      involvement of inositol phosphates.

PMID- 1620240
TI  - The action of (+/-)L-660,863 [(+/-)3-(3-amino-1,2,4-oxadiazole-5-yl)
      quinuclidine] at muscarinic receptor subtypes in vitro.
AB  - 1. The muscarinic pharmacology of a novel oxadiazole muscarinic agonist, (+/-) L
      660,863, [+/-3-(3-amino-1,2,4-oxadiazole-5-yl)-quinuclidine] has been studied
      using pharmacological, radioligand binding and biochemical techniques, in vitro.
      2. In isolated tissue experiments, (+/-)L-660,863 was a more potent agonist than
      carbachol in all preparations studied, being most potent at muscarinic receptors
      mediating negative chronotropy in guinea-pig right, spontaneously beating atria
      and least potent at receptors mediating contractions in canine saphenous vein and
      endothelial denuded rabbit aorta (-log EC50 values were 8.8, 6.6 and 6.3,
      respectively. The apparent affinities (-log KA) of (+/-)L-660,863) estimated by
      receptor inactivation, showed some selectivity toward the atrial M2 muscarinic
      receptor (-log KA = 7.6) in comparison to the M1 or M3 muscarinic receptors (-log
      KA = 5.4 and 6.2) respectively. This degree of selectivity was also observed in
      competition radioligand binding studies. 3. At M3 muscarinic receptors mediating
      inositol phosphates (IPs) accumulation in longitudinal muscle of guinea-pig
      ileum, the potency of (+/-)L-660,863 (-log EC50 value = 6.2) was similar to the
      apparent affinity calculated at M3 muscarinic receptors in the functional studies
      (see above). In contrast, at muscarinic receptors mediating IPs accumulation in
      guinea-pig atria and ventricles, the potency for (+/-)L-660,863 (-log EC50 = 6.2
      and 6.4, respectively) was lower than the apparent affinity calculated at M2
      muscarinic receptors from inotropic and binding studies in cardiac tissue (see
      above).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620241
TI  - SDZ 205-557, a selective, surmountable antagonist for 5-HT4 receptors in the
      isolated guinea pig ileum.
AB  - A selective antagonist for the recently characterized 5-HT4 receptor is lacking.
      The only surmountable antagonist available, ICS 205-930, is a weak antagonist and
      is far more potent at 5-HT3-than at 5-HT4 receptors. In this paper, SDZ 205-557
      (2-methoxy-4-amino-5-chloro-benzoic acid 2-(diethylamino) ethyl ester) is
      characterized as the first potent, selective and surmountable antagonist at 5-HT4
      receptors in the isolated guinea pig ileum. SDZ 205-557 was investigated in the
      non-stimulated and in the field-stimulated guinea pig ileum longitudinal muscle
      preparation for its affinity for 5-HT4-, 5-HT3-, muscarine-, nicotine- and
      histamine H1 receptors. The affinity for 5-HT1-, 5-HT2-, alpha 1-, alpha 2- and
      opiate (mu) receptors was determined by binding assays. SDZ 205-557 was devoid of
      substantial affinity (pKD values below 5.6) for all receptors investigated except
      for 5-HT3- and 5-HT4 receptors. At these two receptors, SDZ 205-557 acted as an
      antagonist without measurable intrinsic activity. At the 5-HT4 receptors of the
      non-stimulated guinea pig ileum, responses to 5-HT and 5-methoxytryptamine were
      antagonized by SDZ 205-557 with identical pA2 values of 7.4. The effect of
      renzapride was also blocked with no significant change in the maximum response;
      Schild analysis, however, revealed that the interaction was not competitive with
      an "apparent" pA2 value of 7.6. A pA2 of 6.8 was obtained using zacopride as a
      contractile agent; this value differed significantly from 7.4, the value obtained
      for 5-HT and 5-methoxytryptamine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620242
TI  - Relative contributions of ATP and noradrenaline to the nerve evoked contraction
      of the rabbit jejunal artery. Dependence on stimulation parameters.
AB  - Isotonic contractions of the rabbit jejunal artery were evoked by perivascular
      nerve stimulation with trains of 10 or 100 stimuli at 2 Hz or 10 Hz. Short trains
      of stimuli elicited contractions that were totally resistant to alpha
      adrenoceptor blockade (0.1 mumol/l prazosin) but blocked by alpha,beta-methylene
      ATP (1 mumol/l). A substantial noradrenergic component of contraction comprising
      about 50% of the total could be evoked by adjusting the stimulation parameters
      (increasing the frequency and/or number of stimuli in a train). The noradrenergic
      and the purinergic components are derived from sympathetic nerves as both were
      blocked by TTX and the adrenergic neurone blocker guanethidine (3 mumol/l). It is
      concluded that the contraction of the rabbit jejunal artery to short trains of
      stimuli is predominantly purinergic, a noradrenergic component only being
      revealed at higher frequencies of stimulation or during longer trains of stimuli.
      The purinergic component of contraction is derived from sympathetic nerves and
      not from a separate population of purinergic nerves.

PMID- 1620243
TI  - Is neuropeptide Y co-released with catecholamines in experimental arterial
      hypertension following sinoaortic denervation?
AB  - The release of catecholamines and their coneurotransmitter neuropeptide Y (NPY)
      was investigated in conscious dogs with neurogenic arterial hypertension elicited
      by sinoaortic denervation. One month after denervation, an elevation of
      catecholamine levels (measured by HPLC) without elevation of NPY-like
      immunoreactivity (NPY-LI) levels in plasma (evaluated by RIA) has been found.
      This dissociation could be explained by 1) a transient release of NPY during the
      first weeks after surgery, 2) a depletion of neuronal NPY due to the permanent
      sympathetic stimulation, or 3) an insufficient increase in sympathetic tone. To
      test these hypotheses, we investigated the time courses of catecholamine and NPY
      LI levels in arterial plasma during the first five weeks after sinoaortic
      denervation and responses to yohimbine (an alpha 2 antagonist which enhances
      transmitter release). Resting NPY-LI levels in plasma remained normal during the
      first five weeks after sinoaortic denervation. In normal dogs, a high dose of
      yohimbine (0.5 mg/kg i.v.) elevated both catecholamine (6-fold) and NPY-LI levels
      (1.5-fold), whereas a lower dose (0.05 mg/kg i.v.) induced a two fold elevation
      of catecholamine levels without changing NPY-LI concentrations. In sinoaortically
      denervated dogs, yohimbine elicited elevation of both catecholamines and NPY-LI
      whatever the dose used. Thus, neurogenic arterial hypertension in dogs seems to
      involve catecholamines but not NPY. Moreover, the present work suggests that a
      high level of sympathetic stimulation is required for a co-release of
      catecholamines and NPY.

PMID- 1620244
TI  - The force driving the extraneuronal transport mechanism for catecholamines
      (uptake2).
AB  - Recently, uptake2 was shown to exist in the clonal Caki-1 cell line. The aim of
      this study was two-fold: a) to determine, in Caki-1 cells, the intracellular fate
      of 3H-noradrenaline after its translocation by uptake2 and b) to analyse the
      force driving uptake2. Caki-1 cells have the characteristics of a "metabolizing
      system" in which the activity of catechol-O-methyl transferase (COMT) greatly
      exceeds that of monoamine oxidase (MAO). In all subsequent experiments these
      enzymes were inhibited. The determination of initial rates of uptake2 into Caki-1
      cells at an extracellular pH between 6.9 and 7.9 indicated that the protonated
      species of 3H-noradrenaline is transported. Depolarization of Caki-1 cells (by
      three different procedures) inhibited the inward transport. Determination of the
      time course of the specific accumulation of 3H-noradrenaline in Caki-1 cells and
      of 3H-isoprenaline in the perfused rat heart (both mediated by uptake2) revealed
      that depolarization (by high K+) reduced the rate constant for inward transport
      (kIN) and increased that for outward movement (kOUT). Consequently,
      depolarization reduced the steady-state factor of accumulation. It is proposed
      that, as the protonated species of the substrates of uptake2 is transported, the
      membrane potential is likely to provide the driving force for uptake2. The fact
      that depolarization decreased kIN and increased kOUT agrees with this proposal,
      as do the magnitudes of the steady-state accumulation factors determined in Caki
      1 cells and perfused rat heart.

PMID- 1620245
TI  - Inhibitory effects of the psychoactive drug modafinil on gamma-aminobutyric acid
      outflow from the cerebral cortex of the awake freely moving guinea-pig. Possible
      involvement of 5-hydroxytryptamine mechanisms.
AB  - The effects of modafinil on acetylcholine and GABA outflow from the cerebral
      cortex of awake freely moving guinea pigs provided with an epidural cup were
      studied. In the dose range of 3-30 mg/kg s.c. modafinil produced a dose dependent
      significant inhibition of GABA outflow without influencing cortical acetylcholine
      release. Methysergide (2 mg/kg, i.p.) and ketanserin (0.5 mg/kg, i.p.) but not
      prazosin (0.14 mg/kg, i.p.) counteracted the inhibitory action of modafinil on
      cortical GABA outflow. Modafinil both acutely and chronically in the same dose
      range increased striatal 5-HIAA levels and 5-HT utilization in the rat (acute)
      and mouse (chronic). The action on cortical GABA release may be dependent on
      activity at 5-HT2 receptors, since the action of modafinil in this respect is
      blocked by the non-selective 5-HT antagonist methysergide and the 5-HT2
      antagonist ketanserin. The involvement of 5-HT mechanisms in the inhibitory
      action of modafinil on cortical GABA release is also suggested by the findings
      that 5-HT metabolism may become increased by modafinil at least in the striatum.
      The reduction of cortical GABA outflow via 5-HT2 receptors by modafinil is
      probably related to some of its actions on the central nervous system including
      behavioural effects.

PMID- 1620246
TI  - Attenuation of the morphine withdrawal syndrome by inhibition of catabolism of
      endogenous enkephalins in the periaqueductal gray matter.
AB  - We have investigated the effects of the local administration into the
      periaqueductal gray matter of thiorphan, a selective inhibitor of endopeptidase
      24.11 "enkephalinase", kelatorphan, (R)-3-(N-hydroxy-carboxamido-2
      benzylpropanoyl)- L-alanine, and RB 38 A, (R)-3-(N-hydroxy-carboxamido-2
      benzylpropanoyl)-L-phenylalanine, two almost complete inhibitors of enkephalin
      metabolism, on the naloxone-precipitated morphine withdrawal syndrome in rats.
      Local administration of these inhibitors decreased the severity of the withdrawal
      syndrome. Jumping, chewing, diarrhea, piloerection, salivation and hypothermia
      were decreased by all drugs. Lacrimation and weight loss were reduced by
      kelatorphan and RB 38 A whereas teeth chattering, tremor, eye twitch and
      rhinorrhea were decreased only by RB 38 A. The rise in plasma corticosterone
      levels was only slightly reduced by the three inhibitors. Wet dog shakes and
      ptosis remained unchanged. These results indicate that during the morphine
      withdrawal syndrome in rats there is a tonic or/and naloxone evoked release of
      opioid peptides, presumably enkephalins, into the periaqueductal gray matter and
      that inhibition of their degradation strongly decreases the severity of the
      withdrawal syndrome.

PMID- 1620247
TI  - LG 6-101 and LG 6-102, two new propafenone-related antiarrhythmic agents with
      good oral activity in rats.
AB  - LG 6-101 (1-[3-(2-methoxy-3-(2-methylpropylamino)-propoxy)-4-methyl- 2-thienyl]-3
      phenyl-1-propanon hydrochloride; MW: 426.02) and LG 6-102 (2-(2-methoxy-3
      propylamino-propoxy)-3-phenyl-propiophenon hydrochloride; MW: 391.92) are two new
      antiarrhythmic substances. They are structurally related to propafenone which is
      a widely used class Ic-antiarrhythmic drug. In man the oral bioavailability of
      propafenone is only about 5-40%. Therefore the development of compounds with
      similar mode of action but higher oral bioavailability seems to be meaningful.
      Both, LG 6-101 and LG 6-102 proved to be effective in isolated auricles and in
      experimental animals after intravenous administration. In the present study we
      tested the antiarrhythmic effects of LG 6-101 and LG 6-102 in rats after oral
      administration. Animals were treated with LG 6-101 (16, 32, 64, 128, 256 mg kg-1
      bodyweight), LG 6-102 (4, 8, 16, 32, 64 mg kg-1 bodyweight) and propafenone (32,
      64, 128, 256 mg kg-1 bodyweight) by gavage twice daily during 4 days. Both, LG 6
      101 and LG 6-102 showed strong antiarrhythmic effects against arrhythmias induced
      on the fifth day by infusion of aconitine (10 micrograms kg-1 min-1). LG 6-102
      was significantly more effective against cardiac arrest caused by infusion of
      aconitine (P less than or equal to 0.05) than LG 6-101. Both substances had good
      effects on the delay of ventricular premature beats.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1620248
TI  - Effect of dilazep dihydrochloride against ischemia and reperfusion-induced
      disruption of blood-brain barrier in rats: a quantitative study.
AB  - The effect of dilazep dihydrochloride (dilazep) against ischemia and reperfusion
      induced disruption of blood-brain barrier (BBB) was quantitatively investigated
      in Slc:Wistar strain rats using Evans blue dye as a BBB destruction indicator.
      The forebrain of sham-operated animal had a small amount of the dye. A treatment
      of 3.5-h ischemia plus 2-h reflow extravasated the dye into the brain and
      markedly increased the dye content as compared with that of sham group (P less
      than 0.01 vs. sham group). Continuous infusion (i.v.) of dilazep during cerebral
      ischemia dose-dependently reduced the increase of the dye content, and a
      significant reduction was found at 3 mg/kg/h (P less than 0.05 vs. control
      group). Evans blue dye extravasation after ischemia was also greatly reduced in
      saline-perfused brains by the treatment with dilazep. Dilazep has been reported
      to inhibit edema formation in cerebral ischemia model of spontaneously
      hypertensive rats. These results suggest that dilazep prevents the ischemic
      damage of BBB, which may contribute to reduction of the brain edema.

PMID- 1620249
TI  - [Achalasia and the possibility of cancer of the esophagus].

PMID- 1620250
TI  - [Traumatology in The Netherlands].

PMID- 1620251
TI  - [Indications and contraindications for artificial delivery].

PMID- 1620252
TI  - [Hypercalcemia and malignancies; pathogenesis, differential diagnosis and
      treatment].

PMID- 1620253
TI  - [Increased risk of heart and vascular diseases in fisherman from Urk].
AB  - In order to assess physicians' preconceived ideas about unhealthy lifestyle of
      North Sea fishermen from Urk, the prevalence of five important risk factors for
      cardiovascular disease: hypertension, hypercholesterolaemia, smoking, obesity and
      diabetes mellitus was determined in a cross-sectional study in this population.
      In addition, the use of the Primetest device, a newly developed desk top
      analyser, was evaluated. Out of 646 people invited at the community centre at
      Urk, Flevoland, 384 (59%) fishermen were investigated using Primetest, which
      contains an electronic sphygmomanometer and colometrically determines total
      cholesterol and glucose levels. 87 laboratory determinations (with HDL
      cholesterol and triglyceride determinations) were used when Primetest cholesterol
      determination proved insufficiently reliable. Male cardiovascular mortality in
      Urk was also compared with mortality in the Netherlands. Hypertension prevalence
      (last of six readings) corresponded with that of the nearby town of Lelystad, 6%
      and 8% respectively. The average total:HDL-cholesterol ratio was not higher than
      recent values from elsewhere in the Netherlands. Fifty per cent of the fishermen
      had a high risk (ratio greater than 4.5). Of these, 18% had hypertriglyceridaemia
      (greater than or equal to 2.3 mmol/l). Smoking rates were very high (58%) and 60%
      had moderate to severe obesity (Body Mass Index greater than or equal to 26
      kg/m2). 2% had diabetes mellitus, corresponding with the prevalence in the
      Netherlands. Absolute and proportional male cardiovascular mortality in Urk did
      not differ from the Netherlands. CONCLUSION: two risk factors had a high
      prevalence among Urk fishermen. Blood pressure measurements and glucose
      determination with Primetest are simple and reliable. For technical reasons
      reliable cholesterol determination was not yet possible.

PMID- 1620254
TI  - [Arterial injuries in lower leg fractures, a rare but severe complication].
AB  - Vascular injuries of the popliteal or crural arteries complicating tibial
      fractures are rare. They often lead to acute critical limb ischaemia requiring
      immediate invasive diagnostic procedures and surgical repair. To illuminate the
      acute situation of this combined injury two case histories are presented. A
      comprehensive surgical approach is mandatory to salvage the injured limb.

PMID- 1620255
TI  - [Cardiovascular abnormalities in Marfan syndrome].
AB  - During the period February to December 1990, 52 adult patients were referred to
      our clinic for evaluation of the presence of the Marfan syndrome. In 24 out of 52
      patients the Marfan syndrome was diagnosed. Cardiac abnormalities were found in
      all patients: mitral insufficiency because of mitral valve prolapse (83%), aortic
      dilatation (67%), aortic insufficiency (38%), tricuspid valve insufficiency with
      or without tricuspid valve prolapse (17%) and atrial septal defect (4%). In 3
      patients an aneurysm of the ascending aorta was found. Early recognition of the
      Marfan syndrome is relevant for prevention of the life threatening complication
      of aortic dissection. In patients with valve abnormalities endocarditis
      prophylaxis is advised. A Marfan outpatient clinic offers optimal diagnostic
      possibilities.

PMID- 1620256
TI  - [Villous adenoma of Vater's papilla; a therapeutic dilemma].
AB  - After a cholecystectomy in 1980, local excision of a villous adenoma of the
      ampulla of Vater was performed in 1983 in a 69-year-old female; this had to be
      repeated in 1990 because of recurrence. In case of a tumour of this kind,
      pancreaticoduodenectomy should be considered because of the relatively high risk
      of recurrence or malignant degeneration. After a radical local excision regular
      duodenal endoscopy and if possible endoscopic ultrasonography should be
      performed.

PMID- 1620257
TI  - [Gluten as food additive in The Netherlands; Snowhite's apple?].

PMID- 1620258
TI  - [Radio-synovectomy of the knee in chronic arthritis: a simple and sensible
      treatment].

PMID- 1620259
TI  - [Medical activities under adverse conditions. Stimezo International].

PMID- 1620260
TI  - [The thrombosis service as a source of information for studies in patients with
      heart valve prostheses].

PMID- 1620261
TI  - [Influenza vaccination; encourage or wait and see?].

PMID- 1620262
TI  - [Primary pneumococcal abscess in the Psoas muscle].

PMID- 1620264
TI  - On changing relations with the PRO or belling the cat.

PMID- 1620263
TI  - [Urination problems following total hip arthroplasty: indwelling catheter or
      not?].

PMID- 1620265
TI  - Endarterectomy for symptomatic carotid stenosis. Review of the European and North
      American Symptomatic Carotid Surgery Trials.
AB  - The recent results of two major multicenter trials, ECST (European Carotid
      Surgery Trialists') and NASCET (North American Symptomatic Carotid Endarterectomy
      Trial), show benefit of carotid endarterectomy for patients with recent (4-6
      months), nondisabling, carotid distribution, cerebral ischemic events
      (hemispheric and retinal TIA or stroke) and ipsilateral severe (70-99%) carotid
      stenosis provided that perioperative mortality remains low. ECST, in addition,
      failed to demonstrate the benefit of surgery for patients with mild stenosis (0
      29%). The comparisons between the studies in regards to methodology,
      measurements, and complications are discussed.

PMID- 1620266
TI  - Regression and stabilization of coronary artery lesions. Angiographic trials move
      beyond the NCEP treatment guidelines.
AB  - National Cholesterol Education Program Guidelines for the diagnosis and treatment
      of hypercholesterolemia have been formulated from population studies relating
      coronary events to blood lipids. Such population studies may not be relevant to
      patients with established coronary disease. Recent coronary angiographic studies
      allow meaningful comparisons of small groups of patients. These studies suggest
      that atherosclerotic lesions in coronary arteries can be stabilized, and further,
      that regression of coronary lesions can occur. The cholesterol and LDL levels
      achieved in angiographic studies are well below NCEP guidelines. Careful
      attention to correcting lipid abnormalities in patients with established coronary
      disease may alter the course of their illness.

PMID- 1620267
TI  - The effect of age on lipid composition and order of rat cerebral microvessels.
AB  - To determine if alterations in lipid composition and/or membrane order of
      cerebral microvessels may contribute to the age-related changes in blood-brain
      barrier (BBB) function, cerebral microvessels isolated from male Fischer 344 rats
      at 3 (young), 12 (intermediate age), and 24 (aged) months of age were studied.
      The steady state fluorescence polarization of diphenylhexatriene incorporated
      into isolated cerebral microvessel membranes at 35 degrees C, in aged rats was
      not different compared to young rats (0.2787 +/- 0.0029 vs 0.2847 +/- 0.0049). In
      addition, the thermotropic transition temperature of these membranes was not
      altered with age. Moreover, the fatty acid composition, the double bond index as
      well as cholesterol to phospholipid molar ratios were not significantly altered
      with age. In contrast, the concentration of conjugated dienes in lipid extracts
      of cerebral microvessels of aged rats (10.04 +/- 1.10 O.D./mg phospholipids) was
      significantly increased compared to the concentration in young rats (6.98 +/-
      0.52 O.D./mg phospholipids) (p less than 0.01). It is concluded that aging is not
      associated with significant changes in lipid composition or membrane order of
      cerebral microvessels. However, the increased concentration of conjugated dienes
      in cerebral microvessels of aged rats is indicative on ongoing free radical
      damage in these microvessels which may contribute to the age-related changes in
      BBB function.

PMID- 1620268
TI  - 4-Bromoacetamidoprocaine: an affinity ligand for brain muscarinic and nicotinic
      cholinergic receptors.
AB  - This study describes the synthesis, receptor binding characteristics, and some
      behavioral effects of p-bromoacetamidoprocaine (BAP), a new affinity ligand for
      brain muscarinic and nicotinic cholinergic receptors. The reversible binding of
      [3H]QNB to rat brain membranes was inhibited in a concentration dependent and
      saturable manner by both procaine and BAP, with Ki values of 4 x 10(-6) and 3 x
      10(-7) M, respectively, and complete inhibition at 1 x 10(-5) M. Both procaine
      and BAP, although at much concentrations, inhibited the binding of
      [3H]methylcarbamylcholine in a concentration dependent manner, with Ki values of
      5 x 10(-5) and 1 x 10(-5) M, respectively, and complete inhibition for both at 1
      x 10(-3) M. Plots of the % irreversible inhibition of [3H]QNB, [3H]nicotine, and
      [3H]MCC vs [BAP] yielded Ki values of 7 x 10(-8), 1 x 10(-4), and 6 x 10(-5) M,
      respectively. In behavioral studies BAP was able to antagonize the QNB-induced
      hyperactivity in mice; however, BAP did not appear to alter nicotine-induced
      seizure activity or other behavioral effects in mice. A plot of the time course
      of inhibition by BAP for [3H]QNB binding revealed that the inhibition was almost
      complete within 10 min exposure at 37 degrees. The findings indicate that BAP is
      a useful affinity ligand for examining the biochemical and functional
      characteristics of brain cholinergic receptors, particularly the muscarinic which
      has an affinity near the nM concentration range.

PMID- 1620269
TI  - Glutamate decarboxylase in developing rat neocortex: does it correlate with the
      differentiation of GABAergic neurons and synapses?
AB  - Postnatal development of glutamate decarboxylase was studied in the rat cerebral
      cortex. Two methods were used: estimation of the enzymatic activity of glutamate
      decarboxylase in homogenates of developing cortical tissue and visualization of
      structures containing glutamate decarboxylase-like immunoreactivity. Glutamate
      decarboxylase-like immunoreactivity appeared first in perikarya and dendrites and
      only later in axons and axon varicosities. The most rapid increase in the
      glutamate decarboxylase activity took place during the second postnatal week and
      this coincided with a rapid increase in the density of axon varicosities
      containing glutamate decarboxylase-like immunoreactivity but preceded the most
      rapid phase in the formation of GABAergic synapses by several days. However,
      there was a change in the characteristics of glutamate decarboxylase which
      correlated with GABA synaptogenesis: two fractions of glutamate decarboxylase
      with different sensitivities to the activating effects of Triton X-100 could be
      distinguished as from about the time when most of the GABAergic synapses are
      formed.

PMID- 1620270
TI  - Effect of corticosterone on noradrenergic nuclei in the pons-medulla and [3H]NA
      release from terminals in hippocampal slices.
AB  - The aim of the present study was to investigate possible membrane and genomic
      effects of corticosterone on the noradrenergic system of the rat brain.
      Corticosterone effects were studied in vivo by treating rats s.c. with 10 mg/kg
      corticosterone for 7 or 14 days. In the first two experiments corticosterone
      significantly decreased the noradrenaline (NA) and dopamine (DA) levels in the
      pons-medulla, an area which contains the A1-A7 noradrenergic cell groups, while
      the NA and DA levels in the dorsal hippocampus remained unchanged. In a third
      experiment where the locus coeruleus (LC) and the A1 and A2 nuclei (A1,A2) were
      analysed separately, NA levels were unchanged but total MHPG levels and the total
      MHPG/NA ratio were decreased in the A1,A2 area. Chronic corticosterone treatment
      (14 days) did not alter the alpha 2-adrenoceptor-mediated modulation of [3H]NA
      release from dorsal hippocampal slices. Neither the spontaneous outflow nor the
      electrically stimulated release of [3H]NA from dorsal hippocampal slices of
      untreated rats was affected by exposure of the slices to corticosterone (10(-7) M
      - 10(-4) M) in the superfusion buffer. Thus, chronic corticosterone treatment of
      rats altered the noradrenergic system of the pons-medulla, but did not change the
      alpha 2-adrenoceptor-mediated modulation of NA release in the dorsal hippocampus,
      a major terminal area of the LC neurons. Corticosterone also did not appear to
      have a direct membrane effect on the NA terminals in the dorsal hippocampus of
      the rat.

PMID- 1620272
TI  - Developmental change of an enzyme activity oxidizing gamma-aminobutyraldehyde to
      gamma-aminobutyric acid in the chick embryonic brain.
AB  - An enzyme activity oxidizing gamma-aminobutyraldehyde (ABAL) to GABA reflecting
      an alternative pathway for GABA synthesis was assayed in the developing chick
      embryonic brain and was compared with glutamate decarboxylase (GAD) activity. An
      enzyme activity oxidizing ABAL to GABA showed almost constant level during
      development in the chick embryonic brain, and was present at low levels compared
      with GAD activity. The results indicate that GABA synthesis via an alternative
      pathway is always much less than synthesis via the GAD-dependent pathway in the
      developing chick embryonic brain.

PMID- 1620271
TI  - Primary structure of an agonist binding subunit of the nicotinic acetylcholine
      receptor from bovine adrenal chromaffin cells.
AB  - Activation by acetylcholine of a nicotinic acetylcholine receptor on the membrane
      of bovine chromaffin cells leads to membrane depolarization and to the subsequent
      triggering of catecholamine secretion. It is evident that acetylcholine receptors
      play a central role in the initial phase of the secretion process and, therefore,
      an extensive characterization of their molecular components and properties is of
      fundamental interest. With this intention, we have screened bovine adrenal
      medullary cDNA libraries with a probe coding for a fragment of the rat muscle
      acetylcholine receptor alpha subunit. Several cDNA clones were isolated. The
      longest cDNA had an open reading frame encoding a 495-amino acid protein with a
      molecular weight of 56,911. The deduced primary structure contains features that
      indicate that the encoded protein is an alpha or acetylcholine binding subunit,
      and, in fact, it manifests significant sequence similarity to previously cloned
      alpha subunits. Sequence identity is particularly high with the alpha 3 subunit,
      which is expressed in the rat pheochromocytoma PC12 cell line and in several
      brain areas, and, consequently, it is considered a component of a neuronal
      acetylcholine receptor. Accordingly, the present results suggest that the agonist
      binding subunit of the nicotinic acetylcholine receptor from bovine chromaffin
      cells is an alpha 3-type subunit, corroborating previous immunological and
      pharmacological evidence for the presence of a neuronal nicotinic receptor in
      chromaffin cells.

PMID- 1620274
TI  - Quantifying the pattern of beta/A4 amyloid protein distribution in Alzheimer's
      disease by image analysis.
AB  - We have undertaken a study of the distribution of the beta/A4 amyloid deposited
      in the cerebral cortex in Alzheimer's disease. Previous studies which have
      examined the differential distribution of amyloid in the cortex in order to
      determine the laminar pattern of cortical pathology have not proved to be
      conclusive. We have developed an alternative method for the solution of this
      problem. It involves the immunostaining of sections followed by computer-enhanced
      image analysis. A mathematical model is then used to describe both the amount and
      the pattern of amyloid across the cortex. This method is both accurate and
      reliable and also removes many of the problems concerning inter and intra-rater
      variability in measurement. This method will provide the basis for further
      quantitative studies on the differential distribution of amyloid in Alzheimer's
      disease and other cases of dementia where cerebral amyloidosis occurs.

PMID- 1620273
TI  - Cerebral vasculopathy in divers.
AB  - Brains from 12 amateur and 13 professional divers, all but one of whom died
      accidentally, were examined neuropathologically. Grossly distended, empty vessels
      (presumably caused by gas bubbles) were found in the brains of 15 out of 22
      divers who died from diving accidents. Perivascular lacuna formation was found in
      cerebral and/or cerebellar white matter in three amateurs and in five
      professionals. In addition to lacuna formation, hyalinization of vessel walls was
      present in the brains of three amateurs and five professionals. Necrotic foci in
      grey matter occurred in seven cases and perivascular vacuolation of white matter
      occurred in seven cases. The vascular changes probably arose from intravascular
      gas bubble formation. In one professional diver, there was also unilateral
      necrosis of the head of the caudate nucleus.

PMID- 1620275
TI  - Ultraviolet irradiation induced brain oedema in rats. A microgravimetric study.
AB  - The cerebral cortex of 36 anaesthetized Wistar rats were exposed to ultraviolet
      irradiation (UV-I) for 6 min through a 2 x 2 mm left parietal craniotomy. Animals
      were killed at different times and brains were removed immediately after death.
      Three consecutive coronal sections were obtained and sampled for gravimetric
      study. The density of the samples was measured using a continuous gradient of
      organic solvents. Gravimetric results showed significant differences between
      brain samples. The irradiated left hemisphere was less dense than the right one,
      and maximum differences in density were found in the medial coronal section. Grey
      and white matter oedema in the non-irradiated hemisphere was compared with the
      irradiated hemisphere. Early and delayed onset of odema was observed in both
      hemispheres but it was more marked in the irradiated hemisphere. In conclusion,
      brain oedema induced by ultraviolet irradiation in various animals is also
      reproducible in rats with all the advantages involved in the use of these
      experimental animals. Microgravimetric study correlated with topographical
      analysis using this model may lead to an understanding of some of the dynamic
      aspects of cerebral oedema.

PMID- 1620276
TI  - Molecular genetic study showing that the IN/157 'oligodendroglioma' cell line has
      been contaminated by rhabdomyosarcoma (RD) cells.
AB  - The IN/157 cell line was originally isolated from a human oligodendroglioma
      biopsy and has been used in recent years to study aspects of glioma cell biology.
      We established that IN/157 cells carry a relatively infrequent mutation at
      position three of codon 61 of the N-ras gene, suggesting that such a mutation may
      have contributed towards the genesis of the original tumour. However, the
      mutation was not detectable within the original paraffin-embedded glioma biopsy
      from which the cell line was supposedly derived. We thus considered the
      possibility that the cells had been contaminated by another cell line and, by
      means of DNA fingerprinting, have demonstrated that the contaminating cell line
      is the rhabdomyosarcoma line RD. We feel that this study makes several important
      points regarding experiments which make use of cell lines. We discuss the
      possible implications of contamination events with regard to erroneous
      conclusions about the biology of the cell lines and tumour types from which they
      supposedly derive. We also suggest ways in which future contamination-related
      errors can be minimized.

PMID- 1620277
TI  - Neuropathological findings in chronic relapsing experimental allergic neuritis
      induced in the Lewis rat by inoculation with intradural root myelin and treatment
      with low dose cyclosporin A.
AB  - Experimental allergic neuritis (EAN) was induced in Lewis rats by inoculation
      with bovine intradural root myelin and adjuvants. Rats treated with subcutaneous
      cyclosporin A (CsA) (4 mg/kg on 3 days per week from the day of inoculation until
      day 29) developed a chronic relapsing course. Tissues from the spinal cord, nerve
      roots, dorsal root ganglia and sciatic nerve of CsA-treated rats sampled during
      relapses and remissions were studied by light and electron microscopy. Control
      rats that were not treated with CsA were studied during or after episodes of
      acute EAN. Both control and CsA-treated animals studied in the first episode of
      EAN had evidence of inflammation and primary demyelination of the nerve roots and
      dorsal root ganglia. In control and CsA-treated animals that had recovered from
      the first episode there was evidence of remyelination. In CsA-treated animals in
      the second episode there was severe inflammation and demyelination and
      remyelination of the nerve roots and dorsal root ganglia, and in addition there
      was significant demyelination and remyelination in the spinal nerves and sciatic
      nerves and dorsal columns of the spinal cord, particularly in later stages of
      disease. In later episodes there was less inflammation, but there was continuing
      demyelination and onion bulbs were present. In animals sampled after recovery
      from chronic relapsing EAN onion bulbs were present. Occasional small onion bulbs
      were also observed in control animals that were inoculated with higher doses of
      myelin. Plasma cells were present in the inflammatory lesions of later episodes.
      Mast cells were also observed at different stages of the disease. We conclude
      that the CsA form of chronic relapsing EAN has clinical and pathological
      similarities with the human disease, chronic inflammatory demyelinating
      polyradiculoneuropathy.

PMID- 1620278
TI  - The behaviour of meningeal cells following glial cell transplantation into
      chemically-induced areas of demyelination in the CNS.
AB  - Following transplantation of cultures of CNS glia containing leptomeningeal cells
      into ethidium bromide-induced demyelinating lesions, meningeal cells adopt either
      compacted or diffuse arrangements. The compacted arrangements involved no
      interactions with other cellular components of the remyelinating environment, and
      were particularly prominent following transplantation of cultures containing a
      high proportion of fibronectin-positive meningeal cells. The diffuse arrangements
      involved interactions with astrocytes, Schwann cells and endothelial cells, and
      contributed to a fragmented appearance of the lesion. Such observations indicate
      that meningeal cell contamination should be avoided when attempts are being made
      to repopulate glial-deficient lesions in the CNS by transplanting central glial
      cells, since their effect is to partition the glial environment.

PMID- 1620279
TI  - Acute bilateral ballism in a patient with intravascular dissemination of gastric
      carcinoma.
AB  - An 84-year-old woman presented with an acute onset of violent bilateral ballism
      chorea. She was admitted to the local neurology unit, but not definite diagnosis
      could be made of the underlying condition, although she did appear to have
      bronchopneumonia. At autopsy the stomach wall was thickened, and the lesser curve
      lymph nodes were firm and enlarged. A single nodule was noted in the liver while
      the lungs appeared consolidated. Histology revealed a moderate-to-poorly
      differentiated gastric adenocarcinoma with extensive intravascular dissemination
      which included the central nervous system (CNS). Numerous small infarcts related
      to vessels occluded by tumour were present throughout the brain, and we feel that
      this was the underlying mechanism for the acute onset of ballism.

PMID- 1620280
TI  - Desmoplastic spindle-cell glioblastoma or gliosarcoma?

PMID- 1620281
TI  - The polymerase chain reaction and its applications in neuropathology.
AB  - The polymerase chain reaction (PCR) provides a means of generating large numbers
      of copies of selected segments of DNA. Once amplified, the DNA can be
      characterized by determination of its size and sequence. For many applications,
      routinely-processed biopsy and autopsy material is an adequate substrate for the
      reaction. PCR can be used to amplify sequences of DNA that are uniquely
      characteristic of particular micro-organisms, allowing their rapid detection in
      samples of tissue or cerebrospinal fluid. The technique allows clones of cells
      with gene rearrangements or translocations to be detected with great sensitivity
      and is proving a useful way to monitor the effects of tumour therapy,
      particularly in patients with lymphomas and leukaemias. Further applications
      include the identification of gene deletions and mutations, and the assessment of
      cell lineage by amplification and analysis of highly polymorphic gene loci (DNA
      fingerprinting). Because the degree of amplification resulting from PCR is so
      great, even a single molecule of contaminating DNa may be detected and its
      significance misinterpreted. Great care, therefore, should be taken to prevent
      contamination of samples, particularly by the products of previous reactions, and
      every series of reactions should include appropriate controls.

PMID- 1620283
TI  - Differences in extracellular calcium involvement mediating the secretion of
      gonadotropin and growth hormone stimulated by two closely related endogenous GnRH
      peptides in goldfish pituitary cells.
AB  - Two endogenous gonadotropin-releasing hormone (GnRH) peptides, salmon GnRH
      (sGnRH) and chicken GnRH II (cGnRH II), stimulate gonadotropin (GtH) and growth
      hormone (GH) secretion in the goldfish. The extracellular calcium (e-Ca2+)
      dependence of the GtH and GH response to the two GnRH peptides were compared
      using static incubations of dispersed goldfish pituitary cells. Incubation with
      Ca(2+)-depleted medium (without the addition of Ca2+ salts and in the presence of
      EGTA) did not alter basal GtH secretion, but reduced the GtH response to sGnRH,
      and abolished the cGnRH II-induced GtH release. Blockade of e-Ca2+ entry by low
      concentrations of CoCl2 had no effect on basal GtH secretion but reduced cGnRH II
      and sGnRH stimulated GtH release when applied at 0.1 and 0.5 mM concentrations,
      respectively. In general, treatments with voltage-sensitive Ca2+ channel (VSCC)
      antagonists, verapamil, nifedipine and nicardipine, did not alter basal GtH
      release but attenuated GnRH-stimulated GtH responses. cGnRH II-induced GtH
      release was decreased by 10 nM verapamil and 1 nM nifedipine, whereas the
      reduction of GtH responses to sGnRH required 100 times higher concentrations of
      these VSCC antagonists. cGnRH II but not sGnRH stimulation of GtH secretion was
      also abolished by 10 microM nicardipine. In contrast to GtH release, exposure to
      Ca(2+)-depleted medium reduced basal GH release and abolished the GH responses to
      both GnRH peptides. sGnRH and cGnRH II-stimulated GH responses were both
      abolished by 0.1 mM CoCl2, decreased by 1 nM verapamil, and reduced by 10 nM
      nicardipine. Addition of 0.1 and 10 microM nifedipine inhibited the GH responses
      to sGnRH and cGnRH II, respectively. Basal GH release was not affected by the
      VSCC antagonists tested. Results from this study indicate that entry of e-Ca2+,
      in part through VSCC, is involved in GnRH stimulation of GtH and GH release from
      goldfish gonadotropes and somatotropes; however, the e-Ca2+ dependence of the GtH
      and GH responses to the two endogenous GnRHs differ. The stimulatory effects of
      cGnRH II on GtH secretion is more dependent on and sensitive to e-Ca2+ than
      sGnRH. Whereas the sensitivity of GH responses to manipulations of e-Ca2+
      availability is, in most instances, similar for both GnRH peptides. These results
      further suggest that basal secretion of GH is more sensitive to e-Ca2+ than basal
      GtH release; however, VSCC are not involved in the maintenance of basal release
      of either hormone.

PMID- 1620282
TI  - Immunocytochemical study of GnRH and GnRH-associated peptide in male Syrian
      hamsters as a function of photoperiod and gonadal alterations.
AB  - Hypothalamic luteinizing-hormone-releasing hormone (GnRH) and gonadotropin
      releasing-hormone-associated peptide (GAP) biosynthesis and storage were
      estimated by immunocytochemistry in male golden hamsters maintained in different
      photoperiods. Intact or castrated male hamsters with subcutaneously inserted
      testosterone implants were exposed to long-day (14:10) or short-day photoperiods
      (10:14) for 4-8 weeks. Exposure to short photoperiod for 4 weeks, an interval
      characterized by a suppression of gonadotropin secretion but not gonadal
      regression, was associated with an increase in the number of GnRH- and GAP
      immunoreactive cells in the diagonal band of Broca/medial septum. Furthermore,
      morphometric analysis revealed that these animals displayed significantly more
      GnRH but not GAP immunoreactivity in the median eminence as opposed to hamsters
      exposed to long-day photoperiods. In additional studies, gonadally regressed
      hamsters exposed to short day lengths for 8 weeks had equal numbers of GnRH cells
      as did the long-day controls. These patterns suggest that reproductive quiescence
      in golden hamsters is not the result of depletions of neuronal GnRH stores
      available for secretion.

PMID- 1620285
TI  - Steroid hormones and steroid hormone binding globulins in cerebrospinal fluid
      studied in individuals with intact and with disturbed blood-cerebrospinal fluid
      barrier.
AB  - We measured in simultaneously withdrawn cerebrospinal fluid (CSF) and serum
      samples from 56 endocrinologically grossly normal patients the concentrations of
      several lipophilic unconjugated steroids [i.e. dehydroepiandrosterone (DHEA),
      androstenedione, cortisol, progesterone, testosterone] and their hydrophilic
      counterparts, i.e. DHEA-sulfate, or hydrophilic binding proteins, i.e. albumin,
      sex hormone-binding globulin (SHBG) and corticosterone-binding globulin (CBG).
      CSF levels of total (i.e. free plus protein-bound) DHEA, androstenedione,
      cortisol, progesterone, and testosterone were found to be in the 0.02-2 nM range
      and only cortisol reached levels approximately 20 nM. These values were of the
      same order of magnitude as the reported and calculated free serum levels of these
      steroids. In patients with disturbed (abnormally leaky) blood-CSF barrier (BCB)
      function, CSF levels of these steroids were not different from those with intact
      BCB, in contrast to DHEA-sulfate, CBG and SHBG whose CSF levels were
      significantly elevated, that is similar (i.e. 2-5) fold as those of albumin. In
      vitro demonstrated low affinity (micromolar) interactions of steroids with
      neuronal membrane-bound neurotransmitter receptors should be considered in
      perspective to the here reported finding that steroids occur in vivo at best in
      nanomolar concentrations in the CSF. Whether in other extracellular fluid
      compartments of the brain higher levels of steroids than in CSF can accumulate is
      as yet not clear. Very probably, pathological production or excessive dosage of
      steroids that are negligibly bound to SHBG or CBG will produce CSF and brain
      levels in the near micromolar range.

PMID- 1620284
TI  - Estradiol regulation of proopiomelanocortin gene expression and peptide content
      in the hypothalamus.
AB  - Previous studies have shown that the hypothalamic concentrations of beta
      endorphin (beta-EP) and other proopiomelanocortin (POMC)-derived peptides change
      in the female rat following castration and gonadal steroid replacement. In this
      study we have measured POMC mRNA by solution hybridization assay in the medial
      basal hypothalamus (MBH) of ovariectomized rats treated with a regimen of
      estradiol (E2) that we have previously shown alters brain beta-EP peptide
      content. In addition the effect of progesterone (P) was also studied. In the
      first experiment the concentration of beta-EP and alpha-melanocyte-stimulating
      hormone (alpha-MSH) in the MBH of castrated rats decreased significantly after 3
      weeks of E2 treatment compared to castrated unreplaced rats: beta-EP decreased
      from 6.00 +/- 0.46 to 4.32 +/- 0.38 ng/mg protein and alpha-MSH decreased from
      3.00 +/- 0.23 to 2.35 +/- 0.15 ng/mg protein (p less than 0.05). A similar
      decrease in peptide content was noted in the anterior hypothalamus/preoptic area.
      A parallel reduction in the concentration of POMC mRNA was measured in the MBH of
      the E2-replaced animals: 1.17 +/- 0.14 vs. 0.72 +/- 0.08 pg/microgram RNA (p less
      than 0.02). In a second study castrated rats were studied after 2 weeks of E2 or
      E2 plus P treatment. After 2 weeks, POMC peptide levels did not change
      significantly in the MBH of either the E2- or E2 plus P-treated rats. POMC mRNA,
      however, was significantly reduced from 1.10 +/- 0.10 pg/micrograms RNA in the
      unreplaced rats to 0.58 +/- 0.05 and 0.61 +/- 0.06 pg/microgram RNA after E2 or
      E2 plus P, respectively (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620286
TI  - Contribution of the region anterior and ventral to the third ventricle to opiate
      withdrawal excitation of oxytocin secretion.
AB  - Virgin female or lactating rats were given infusion into a lateral cerebral
      ventricle (i.c.v.) of either morphine to produce tolerance and dependence or
      vehicle from a subcutaneous osmotic minipump for 5 days, then they were
      anaesthetized with urethane. In virgins either an electrolytic or sham lesion of
      the region anterior and ventral to the third ventricle (AV3V region) was made.
      Initial blood plasma concentrations of oxytocin, measured by radioimmunoassay
      were similar in i.c.v. morphine- and i.c.v. vehicle-infused rats (20.6 +/- 2.7
      and 19.0 +/- 4.3 pg/ml, respectively). Naloxone (5 mg/kg i.v.) significantly
      increased oxytocin secretion in all groups for at least 60 min; oxytocin
      concentration at 6 min after naloxone was in the order: sham-lesioned i.c.v.
      morphine group (mean 1,839 +/- 809 pg/ml, n = 6), greater than AV3V-lesioned
      i.c.v. morphine group (326 +/- 65 pg/ml, n = 6), = sham-lesioned i.c.v. vehicle
      group (251 +/- 66 pg/ml, n = 6), greater than AV3V-lesioned i.c.v. vehicle group
      (47.2 +/- 12.4 pg/ml, n = 6). Thus in both intact and lesioned rats naloxone
      increased oxytocin secretion much more in morphine-dependent rats than in the
      respective controls; in both morphine-naive and morphine-dependent rats, the AV3V
      lesion reduced the effect of naloxone with respect to plasma oxytocin
      concentration, but not with respect to the increase relative to the lower
      prenaloxone concentrations in the lesioned rats (prenaloxone values in the
      lesioned rats were: i.c.v. vehicle group, 15.8 +/- 6.8 pg/ml; i.c.v. morphine
      group, 24.3 +/- 7.8 pg/ml; and in the sham-lesioned rats: i.c.v. vehicle group,
      67.3 +/- 31.2 pg/ml, i.c.v. morphine group, 65.5 +/- 15.0 pg/ml). Thus the AV3V
      region is not essential for withdrawal excitation of oxytocin secretion in
      morphine-dependent rats. In lactating morphine-dependent rats, i.c.v. infusion of
      the angiotension II antagonist saralasin (2.5 micrograms/min) decreased plasma
      oxytocin concentration after 10 min (5.7 +/- 1.1 pg/ml, n = 7 vs. 13.2 +/- 3.2
      pg/ml, n = 8), but did not prevent naloxone-provoked excitation of oxytocin
      secretion, measured by radioimmunoassay (6 min after naloxone in the i.c.v.
      saralasin group 402.8 +/- 124.5 pg/ml, n = 7 vs, in controls, 1,009 +/- 382
      pg/ml, n = 7) or assessed by continuous recording of intramammary pressure. These
      results indicate that centrally acting angiotensin II is not an important
      mediator of naloxone-induced oxytocin hypersecretion in morphine-dependent
      rats.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1620287
TI  - Neurotrophic effects of fibroblast growth factors on peptide-containing neurons
      in culture from postnatal rat hypothalamus.
AB  - Basic fibroblast growth factor (bFGF) has been thought to act as a neurotrophic
      factor during early developmental stages in various brain regions, including the
      hypothalamus. In the present paper, we have studied the effect of bFGF on peptide
      containing neurons cultured from the postnatal (1-3 days and 14 days after birth)
      rat hypothalamus. The addition of bFGF, or acid FGF (aFGF), to serum-free culture
      medium increased both survival and neurite growth of growth hormone-releasing
      factor (GRF)-containing neurons. The potency of bFGF was more than 10 times as
      great as that of aFGF. Insulin-like growth factor I (IGF-I) did not have any
      significant effect on the survival of GRF neurons. Further, neither IGF-I nor
      aFGF modified the survival-promoting effect of bFGF on GRF neurons. bFGF promoted
      the survival of somatostatin- and vasoactive intestinal polypeptide-containing
      neurons, too.

PMID- 1620288
TI  - Binding sites for interleukin-6 in the anterior pituitary gland.
AB  - Interleukin-6 (IL-6) binding site in the rat anterior pituitary gland was
      characterized using radioiodinated human recombinant (hr) IL-6. Results showed
      that the anterior pituitary gland contained 170 binding sites per cell of a
      single class with a dissociation constant of 2.7 x 10(-9) M. The binding of 125I
      hrIL-6 to the rat anterior pituitary gland was competitively inhibited by
      unlabeled hrIL-6, but not by hrIL-1 alpha, hrIL-1 beta, hrIL-2 or hr-interferon
      gamma, indicating these binding sites are specific for IL-6. We also demonstrated
      mouse IL-6 receptor gene expression in the rat anterior pituitary gland by
      Northern blot analysis. Furthermore, the IL-6 receptor was detected on human
      gonadotrophs by the double immunofluorescence method. Our findings demonstrate
      the presence and expression of IL-6 binding site in the rat anterior pituitary
      gland and the presence of IL-6 binding site on human gonadotrophs, suggesting the
      important role of IL-6 binding site in pituitary hormone release in both species.

PMID- 1620289
TI  - Opiate modulation of growth hormone secretion is compromised during the steroid
      induced luteinizing hormone surge.
AB  - Earlier studies from our laboratory have shown that treatments with gonadal
      steroids which cause a surge of luteinizing hormone (LH) blunt the effects of
      morphine on LH secretion, locomotor activity, nociception and temperature
      regulation. The present study was conducted to determine if the growth hormone
      (GH) response to morphine sulfate (MS) was also affected during steroid-induced
      LH surges. Adult ovariectomized female rats were primed with estradiol benzoate
      (EB: -49 h prior to P4 or oil injection) and/or progesterone (P4; 10.00 h). Seven
      and one half hours after P4 treatment, at the time of the steroid-induced LH
      surge, the GH response to an intravenous dose of 0.5, 2.0 or 5.0 mg/kg MS was
      determined. A GH peak response occurred at 15 min after drug administration and
      was maximal at the dose of 2 mg/kg MS in all groups. Although the timing of the
      GH rise was not altered in either EB/oil- or EB/P4-treated animals, a significant
      blunting of MS-induced GH secretion was observed across all doses of MS with a
      greater reduction being observed in EB/P4-treated animals. In a second study the
      GH response to opiates was investigated prior to and following the steroid
      induced LH surge to determine if the suppression of opiate-induced GH secretion
      was confined to the time of the preovulatory LH surge. Before the LH surge (2.5
      h), a mild suppression of opiate-induced GH secretion was observed only in EB/oil
      treated animals. After the LH surge (13 h after P4 administration), morphine
      induced GH secretion was similar in all groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620290
TI  - Purification and characterization of urotensin II and parvalbumin from an
      elasmobranch fish, Scyliorhinus canicula (common dogfish).
AB  - The caudal portion of the spinal cord of elasmobranch fish incorporates a diffuse
      neuroendocrine system. Using an antiserum raised against urotensin II from a
      teleost fish (goby) to facilitate purification, a peptide structurally related to
      urotensin II was isolated in pure form from an extract of neuroendocrine tissue
      from the spinal cord of the European common dogfish, Scyliorhinus canicula. The
      primary structure of the peptide was established as: Asn-Asn-Phe-Ser-Asp-Cys-Phe
      Trp-Lys-Tyr-Cys-Val. The amino acid sequence was confirmed by chemical synthesis.
      A comparison of this sequence with those of the known teleost urotensin II
      peptides shows that the cyclic region of the molecule has been fully conserved
      between species and suggests that the presence of an acidic residue at position 5
      and a hydrophobic residue at position 12 are important features for the
      biological activity of the peptide. The dogfish spinal cord extract also
      contained a high concentration of the calcium-binding protein, parvalbumin and
      the amino acid sequence at its NH2 terminus [residues (1-50)] was determined.

PMID- 1620291
TI  - Sustained release of nerve growth factor from biodegradable polymer microspheres.
AB  - Although grafted adrenal medullary tissue to the striatum has been used both
      experimentally and clinically in parkinsonism, there is a definite need to
      augment long-term survival. Infusion of nerve growth factor (NGF) or implantation
      of NGF-rich tissue into the area of the graft prolongs survival and induces
      differentiation into neural-like cells. To provide for prolonged, site-specific
      delivery of this growth factor to the grafted tissue in a convenient manner, we
      fabricated biodegradable polymer microspheres of poly(L-lactide)co-glycolide
      (70:30) containing NGF. Biologically active NGF was released from the
      microspheres, as assayed by neurite outgrowth in a dorsal root ganglion tissue
      culture system. Anti-NGF could block this outgrowth. An enzyme-linked
      immunosorbent assay detected NGF still being released in vitro for longer than 5
      weeks. In vivo immunohistochemical studies showed release over a 4.5-week period.
      This technique should prove useful for incorporating NGF and other growth factors
      into polymers and delivering proteins and other macromolecules intracerebrally
      over a prolonged time period. These growth factor-containing polymer microspheres
      can be used in work aimed at prolonging graft survival, treating experimental
      Alzheimer's disease, and augmenting peripheral nerve regeneration.

PMID- 1620292
TI  - The role of immediate operative intervention in severely head-injured children
      with a Glasgow Coma Scale score of 3.
AB  - In an attempt to improve and expedite the care of head-injured children, data
      have been published recommending burr hole exploration in lieu of computed
      tomography for children with signs of brain stem compression or with a Glasgow
      Coma Scale score of 3. Exploratory burr holes revealed a high incidence of
      subdural hematomas, and removal of the hematomas improved survival. We are
      reporting 19 consecutive children with Glasgow Coma Scale scores of 3. Coma score
      evaluation was confounded by intubation, sedation, pharmacological paralysis, and
      posttraumatic seizures. We found no radiographical or postmortem pathological
      evidence of intracranial hemorrhage, which would warrant operative intervention.
      A high incidence of multisystem injuries and high cervical spine injuries would
      have made early intervention both dangerous and inappropriate. Although there is
      a definite role for emergency trephination, routine exploratory burr holes for
      children with a Coma score of 3 is not justified.

PMID- 1620293
TI  - Microsurgical and magnetic resonance imaging anatomy of the cerebello-medullary
      fissure and its application during fourth ventricle surgery.
AB  - The cerebellomedullary fissure, the only entrance or exit to the fourth
      ventricle, is surrounded rostrally by the cerebellar tonsils and the biventral
      lobules and caudally by the medulla oblongata, the tela choroidea, and the
      lateral recesses. This fissure is an important route in operations on the fourth
      ventricle. We studied the microsurgical and magnetic resonance imaging (MRI)
      anatomy of the fissure by using autopsied normal cerebellum. MRI revealed that
      the fissure is visible as a slit and is indicated by the enhanced choroid plexus
      and the flocculus. Oriented by the anatomical information thus obtained, we have
      surgically treated nine patients with a tumor either in or around the fourth
      ventricle. Preoperative MRI clearly demonstrated the tumors in relation to the
      cerebellomedullary fissure. It revealed the precise anatomical location and
      extension of the tumor, not only its inferior extension but also its lateral one.
      The MRI findings and microsurgical anatomy of the cerebellomedullary fissure were
      quite useful for the removal of the tumors in the fourth ventricle.

PMID- 1620294
TI  - The permeability change of major cerebral arteries in experimental vasospasm.
AB  - The influence of vasospasm on the permeability of the major cerebral arteries was
      studied using horseradish peroxidase (HRP). Experimental vasospasm was produced
      in canine basilar arteries by successive injections, 2 days apart, of autologous
      blood into the cisterna magna. HRP was injected intravenously or intracisternally
      48 hours after the second injection of autologous blood, and all animals were
      killed by perfusion fixation 60 minutes after the injection of HRP. The
      distribution of HRP was observed by transmission electron microscopy. In 10 dogs
      injected intracisternally with HRP, 5 control dogs demonstrated a moderate amount
      of HRP in the intermuscular space through the adventitia. Five dogs with
      subarachnoid hemorrhages (SAHs) showed a moderate amount of HRP in the
      intermuscular space. In 11 dogs injected intravenously with HRP, 5 control dogs
      showed no leakage of HRP into vessel walls. Six dogs with SAHs showed HRP in the
      interendothelial space. These findings suggest that, despite SAHs, HRP seems to
      be able to circulate in the cerebrospinal fluid and makes contact with the
      cerebral vessels. This study suggests the possibility that spasmogenic substances
      may penetrate the vessel wall from the extraluminal side more easily than from
      the intraluminal side.

PMID- 1620295
TI  - Accelerated nonmuscle contraction after subarachnoid hemorrhage: culture and
      characterization of myofibroblasts from human cerebral arteries in vasospasm.
AB  - Cell culture lines from human cerebral arteries showing vasospasm after
      subarachnoid hemorrhage were established from three autopsy cases. Each culture
      line showed the ultrastructural characteristics of myofibroblasts. Decreased
      alpha-actin antigenicity, demonstrated using the anti-smooth muscle cell alpha
      actin antibody, was observed in cultured cells possessing abundant F-actin. When
      incorporated into the three-dimensional collagen matrix in vitro, the cultured
      cells compacted the collagen lattice at a rate equivalent to that of human dermal
      fibroblasts. Lattice compaction was significantly accelerated by cerebrospinal
      fluid taken from patients with symptomatic vasospasm. Compaction was completely
      inhibited by the addition of 10(-6) mol/L verapamil or 100 U/mL heparin. Neither
      nimodipine (10(-5) mol/L) nor nicardipine (10(-5) mol/L) inhibited compaction,
      and endothelin (10(-6) mol/L) and potassium chloride (40 mmol/L) had no effect.
      The morphological change of cells in the collagen lattice suggests that both
      verapamil and heparin affect cellular motility, filopodial protrusion, and cell
      attachment. These data suggest that myofibroblasts in human cerebral arteries
      differ from medial smooth muscle cells and can generate a force rearranging the
      proliferated collagen matrix present after subarachnoid hemorrhage. This
      reorganization can contribute to, or be responsible for, sustained
      vasoconstriction. Consequently, current treatment for vasospasm may need to be
      reevaluated to include the nonmuscle components in the vessel wall.

PMID- 1620296
TI  - Time course of changes in concentration of intracellular free calcium in cultured
      cerebrovascular smooth muscle cells exposed to oxyhemoglobin.
AB  - A culture of smooth muscle cells obtained from monkey middle cerebral arteries
      was developed to allow quantitative assessment of intracellular calcium and
      immunofluorescence analysis after various periods of exposure to oxyhemoglobin.
      Intracellular calcium concentration was examined for up to 7 days after a single
      exposure to oxyhemoglobin. Intracellular calcium concentrations were measured
      with the fluorescent dye fura-2 and were significantly elevated for 7 days after
      exposure to oxyhemoglobin (P less than 0.01). Less than 2 minutes after
      application of oxyhemoglobin, there was marked elevation of intracellular calcium
      from the control value of 75 +/- 2 nmol/L to 240 +/- 28 nmol/L (P less than 0.01
      by analysis of variance). Intracellular calcium concentration of cells exposed
      for 24 hours to oxyhemoglobin and then grown in normal oxyhemoglobin-free medium
      fell close to normal levels on Days 3 and 7. On Day 3, the increase in
      intracellular calcium that followed repeated daily exposure to oxyhemoglobin was
      greater than that resulting from a single application of oxyhemoglobin (P less
      than 0.01 by Student's t test), but by Day 7 the elevation produced by these
      different approaches was similar. Smooth muscle cells exposed to oxyhemoglobin
      showed a reduction in immunoreactivity to alpha-actin. These data support the
      hypothesis that disruption of intracellular calcium regulation and calcium
      overloading may be important in the process of cell injury, which results in
      vasoconstriction and sometimes cell death, after exposure to oxyhemoglobin.

PMID- 1620297
TI  - Preventive effect of synthetic serine protease inhibitor, FUT-175, on cerebral
      vasospasm in rabbits.
AB  - The effect of the synthetic multiserine protease inhibitor FUT-175 on cerebral
      vasospasm after subarachnoid hemorrhage (SAH) was investigated in rabbits. The
      SAH in rabbits was simulated by a single injection of autologous arterial blood
      into the cisterna magna, and, for 7 days, the caliber of each basilar artery was
      examined several times via angiogram. In 10 SAH rabbits, the peak of the arterial
      narrowing was observed on Day 2. In this model, the effect of intravenous
      administrations of FUT-175 was examined. Twenty-seven SAH rabbits were randomly
      divided into three groups, and 3 doses of 1, 2, or 3 mg of FUT-175 were
      administered intravenously. Angiographic arterial narrowing on Day 2 in
      nontreated SAH rabbits (Control) was 35% compared with 21, 5, and 14% in rabbits
      treated with a total of 3 (Group A; n = 9), 6 (Group B; n = 13), and 9 mg (Group
      C; n = 5) of FUT-175, respectively. There were statistically significant
      differences in the arterial calibers between Group A and the Control on Days 1
      and 2, between Group B and the Control from days 1 to 4, and between Group C and
      the Control from days 1 to 4. In three other rabbits, after vasospasm reached its
      maximum on Day 2, no vasodilatory effect was observed when a total of 6 mg of FUT
      175 was administered intravenously. The results indicate that the inhibition of
      the plasma serine protease cascades at an early stage of SAH prevents the
      development of cerebral vasospasm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620298
TI  - Therapeutic trial of cerebral vasospasm with the serine protease inhibitor, FUT
      175, administered in the acute stage after subarachnoid hemorrhage.
AB  - The therapeutic effect of the synthetic serine protease inhibitor, FUT-175, on
      cerebral vasospasm after subarachnoid hemorrhage (SAH) was investigated. Twenty
      three patients with severe SAH who were admitted between February and July 1990
      and who underwent surgery within 48 hours of the initial aneurysmal rupture were
      treated with an intravenous administration of FUT-175 soon after the operation.
      The patients were divided randomly into three groups, each receiving a different
      dose of FUT-175 (Group A, 20 mg every 12 hours for 4 days; Group B, 20 mg every 6
      hours for 4 days, Group C, 40 mg every 6 hours for 4 days). The results were
      compared with another group of twenty-two patients with severe SAH who were
      admitted before February 1990 and received equivalent treatment, except they were
      not treated with FUT-175. In 64% of all the patients treated with FUT-175 (Groups
      A, B, C), and in 85% of those treated with higher doses of FUT-175 (Groups B and
      C), there was no spasm or only mild vasospasm on the angiogram. The incidence of
      a delayed ischemic neurological deficit significantly decreased from 55% in the
      control group to 13% in all patients treated with FUT-175 and to 7% in the
      patients treated with higher doses (P less than 0.05). The incidence of cerebral
      infarction resulting from vasospasm significantly decreased from 43% in the
      control group to 9% in patients treated with FUT-175. In the patients treated
      with higher doses of FUT-175 (Groups B and C), none developed cerebral
      infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620299
TI  - Reconstruction of peripheral nerves: the phenomenon of bilateral reinnervation of
      muscles originally innervated by unilateral motoneurons.
AB  - It is well known that after reconstruction of sectioned peripheral nerves in
      adult mammals, denervated muscles are reinnervated by the axotomized motoneurons
      lying in the original motonucleus. It is less well known that these muscles can
      also be reinnervated by uninjured motoneurons lying in the homologous
      contralateral motonucleus. Therefore, after nerve reconstruction, bilateral
      motoneuron reinnervation of muscles can occur. Contralateral motoneurons sprout
      axons that cross the midline, grow in the reconstructed nerve, and reach muscle
      targets. This phenomenon was observed after reconstruction of several different
      peripheral nerves in adult mammals, including the oculomotor nerve in guinea pigs
      and the facial and sciatic nerves in rats. The retrograde axonal transport of
      horseradish peroxidase was used for the study of the organization of the
      brainstem and spinal cord motonuclei. Horseradish peroxidase was injected into
      the medial rectus muscle, the stylohyoid muscle, and the trunk of the sciatic
      nerve. The distance between the homologous motonuclei of both sides influenced
      the occurrence of this phenomenon. In fact, bilateral reinnervation of muscles
      after nerve reconstruction was found in 36% (sciatic nerve), 50% (facial nerve),
      and 100% (oculomotor nerve) of the operated animals. The total number of
      contralateral motoneurons found were 14% (oculomotor nerve), 8% (facial nerve),
      and 5% (sciatic nerve). Bilateral reinnervation of muscles was evoked by both
      immediate and delayed peripheral nerve repair and was a stable phenomenon, seen
      between 3 and 21 months after facial nerve reconstruction.

PMID- 1620300
TI  - Computed tomography and cerebral blood flow correlations of mental changes in
      chronic subdural hematoma.
AB  - To elucidate the pathophysiology of mental disturbances associated with chronic
      subdural hematoma, we performed quantitative and three-dimensional measurements
      of cerebral blood flow (CBF) on xenon-enhanced computed tomographic scans in 12
      patients who had chronic subdural hematomas and manifested mental disturbances.
      In 2 patients who had no headache or hemiparesis, minimal mass effect, and severe
      multiple infarctions on computed tomographic scan, mentation did not improve
      after surgery. The CBF reduction was severe, and it further deteriorated after
      surgery. On the other hand, mentation improved to a varied extent in the other 10
      patients, who had headache and/or hemiparesis and minimal, moderate, or severe
      mass effect and minimal or moderate multiple infarctions on computed tomographic
      scan. The CBF reduction was diffuse on both sides, but was more marked in the
      thalamus and putamen than it was in the cortex and subcortex. It was restored
      after surgery, but insufficiently. The restoration rate was statistically
      significant only in the thalamus, on both sides (with and without hematoma) (P
      less than 0.05). Dementia scores and CBF values after surgery were correlated on
      the side with the hematoma in the frontal cortex and thalamus (P less than 0.01)
      and in the hemisphere and temporoparietal cortex (P less than 0.05). There was no
      correlation on the side with the hematoma in the occipital cortex, putamen, and
      frontal and temporoparieto-occipital subcortices or on the side without the
      hematoma. The thalamus undergoes displacement and distortion by the hematoma,
      which in turn leads to changes in consciousness. Postoperative residual mental
      deficits consist primarily of dementia related to preexisting multiple
      infarctions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620301
TI  - Translamino-pedicular screw fixation with bone grafting for symptomatic isthmic
      lumbar spondylolysis.
AB  - Anterior or posterolateral spondylodesis has been reported and used widely as a
      surgical treatment for lumbar spondylolysis or spondylolisthesis. Although spinal
      fusion is necessary when there is extensive vertebral slippage or spinal
      instability, the direct repair of the defect is thought to be anatomical,
      logical, and less invasive as a surgical treatment for symptomatic lumbar
      spondylolysis or a minimal degree of spondylolisthesis. This operation, with a
      few modifications, has been performed since 1985 in our clinic. The results,
      using Henderson's criteria, were excellent in 64.5% and good in 25.8% of the
      patients thus treated. For younger patients with symptomatic lumbar
      spondylolysis, direct repair of the defect using translamino-pedicular
      instrumentation with bone grafting is recommended, as degenerative changes have
      not usually occurred in the vertebral discs.

PMID- 1620302
TI  - Pediatric spinal cord and vertebral column injury.
AB  - Between January 1, 1970, and December 31, 1988, 179 children (birth to age 16)
      were treated for spinal cord and/or vertebral column injury by the Neurosurgical
      Service at the University of Iowa Hospitals and Clinics. Pediatric injuries
      accounted for 9% of all spinal trauma seen during this period. The mean age was
      10.2 years. Sixty-two children were between birth and 8 years of age and 117 were
      between ages 9 and 16. The cause, distribution, type of injury, and severity of
      neurological injury varied with age. Neurological outcome was dependent on the
      severity of the initial neurological injury. Children with complete or severe
      incomplete myelopathy uniformly remained with severe neurological dysfunction;
      children with mild to moderate injuries recovered normal or nearly normal
      neurological function. Surgical versus nonoperative management had no bearing on
      neurological outcome. Twelve percent of the children with severe spinal cord
      injuries developed posttraumatic spinal deformity. We conclude that spinal injury
      patterns differ between preadolescent and older children. Most injuries can be
      successfully managed with nonoperative therapy. Prognosis is primarily correlated
      with the severity of the initial neurological insult. Finally, children with
      severe spinal cord injury must have close, long-term follow-up to monitor the
      development of posttraumatic spinal deformity.

PMID- 1620303
TI  - Optic nerve decompression surgery improves visual function in patients with
      pseudotumor cerebri.
AB  - Papilledema from pseudotumor cerebri can cause severe loss of visual acuity and
      visual field. We performed optic nerve decompression surgery on 17 patients with
      pseudotumor cerebri who, despite maximum conventional therapy, developed
      progressive loss of visual acuity and/or visual field. Postoperatively, visual
      acuity improved or stabilized in 33 of 34 eyes (97%). Visual fields improved in
      20 of 21 eyes that underwent surgery. Optic nerve decompression surgery relieves
      local cerebrospinal fluid pressure on the optic nerve. Progressive loss of visual
      function associated with pseudotumor cerebri can be reversed or stabilized with
      optic nerve sheath decompression surgery.

PMID- 1620304
TI  - Experimental evaluation of a collagen-coated vicryl mesh as a dural substitute.
AB  - Dural substitutes must provide immediate restitution of a membranous covering for
      the brain without inducing any adverse reaction in the host or provoking
      adhesions to underlying nervous tissues. Ideally, the material should disappear
      completely and be replaced by tissues similar to the dura mater. In this study,
      parietal dural defects were created in 12 beagle dogs and closed with a vicryl
      mesh prosthesis made watertight by a film of bovine collagen. Clinical and
      biological tolerances were satisfactory. There was one case of early local
      infection. Gross and microscopic examinations performed between 7 days and 9
      months after implantation showed degradation of the prosthetic mesh and
      connective tissue growth into the implant mimicking dura mater as early as 15
      days after implantation. There was no attendant inflammatory reaction or cortical
      adhesions or other adverse reactions. The authors conclude that collagen-embedded
      vicryl mesh provides satisfactory biological function and compatibility when used
      as a substitute for dura mater in the dog.

PMID- 1620305
TI  - A comparison between magnetic resonance imaging and computed tomography for
      stereotactic coordinate determination.
AB  - The spatial accuracy of magnetic resonance imaging (MRI) has not been established
      for stereotactic surgery. Magnetic susceptibility artifacts may lead to
      anatomical distortion and inaccurate stereotactic MRI coordinates, especially
      when targets are in regions of the brain out of the center of the magnetic field.
      MRI-guided stereotactic localization, however, provides better multiplanar target
      resolution than is available with computed tomographic (CT) scanning. Therefore,
      we compared the accuracy of stereotactic coordinates determined by MRI and CT
      studies in 41 patients (53 targets). Coordinates were measured in each plane and
      as vector distances between the target and the center of the stereotactic frame
      on axial or coronal MRI studies. Absolute axial plane MRI and CT distances varied
      an average of 2.13 +/- 1.59 mm. The mean difference in measurements in the X
      (left-right) dimension was 1.19 mm and 1.55 mm in the Y (anterior-posterior)
      dimension. Central targets (located less than 2 cm from the frame center) had a
      mean MRI-CT difference of 2.09 +/- 1.79 mm; peripheral targets (greater than 2 cm
      from the frame center) differed by 2.17 +/- 1.3 mm. The voxel volumes were
      calculated for all compared images. Although differences between the physical
      properties of data acquisition with each imaging modality could explain the
      observed CT-MRI discrepancies, a 1-pixel difference in target selection could
      account totally for all the variance observed. MRI field strength (0.5 vs. 1.5 T)
      did not correlate with coordinate determination accuracy. We conclude that MRI
      guided stereotactic localization can be used with confidence for most diagnostic,
      functional, and therapeutic stereotactic procedures.

PMID- 1620306
TI  - Stereotactic, angiography-guided clipping of a distal, mycotic intracranial
      aneurysm using the Cosman-Roberts-Wells system: technical note.
AB  - We describe the use of stereotactic, angiographic guidance for localization and
      clipping of a small, distal intracranial bacterial aneurysm. The technique uses
      the commercially available Suetens-Gybels-Vandermeulen angiographic localizer
      with the widely used Cosman-Roberts-Wells stereotactic system. This method is
      simple and easy to use and significantly decreased the operative time. It may be
      quite useful for surgically treating mycotic and other peripheral aneurysms.

PMID- 1620307
TI  - Cauda equina syndrome secondary to an improperly placed nucleotome probe.
AB  - Automated percutaneous lumbar discectomy has been shown to be a low morbidity
      procedure in the treatment of contained herniated lumbar discs. Described in this
      paper is a complication, i.e., a cauda equina syndrome secondary to a Nucleotome
      probe improperly placed in the thecal sac. The authors reemphasize the landmarks
      for the thecal sac, i.e., the medial border of the pedicles, and discuss the
      preventable nature of this type of complication.

PMID- 1620309
TI  - Reversible arteriovenous malformation-induced venous hypertension as a cause of
      neurological deficits.
AB  - A case of a dural arteriovenous malformation with prominent localizing
      neurological deficits is reported. The venous drainage of the lesion and the lack
      of a significant pial supply implicate venous hypertension as the mechanism of
      neurological dysfunction. This mechanism is supported further by the angiographic
      changes and the prompt resolution of the deficits after endovascular treatment.
      This case illustrates the potential for this frequently postulated but rarely
      confirmed pathophysiological mechanism to cause reversible neurological
      dysfunction.

PMID- 1620308
TI  - Lichen simplex chronicus as the initial manifestation of intramedullary neoplasm
      and syringomyelia.
AB  - Neurogenic causes of pruritus and a rash are uncommon. We report a patient with
      dermatomal pruritus and a rash who had a cervicothoracic syrinx and a thoracic
      spinal cord tumor. We believe the syrinx interrupted fibers subserving itch,
      resulting in dermatomal pruritus with secondary scratching and a rash.

PMID- 1620310
TI  - Osteomyelitis of the skull base.
AB  - Three cases of osteomyelitis of the skull base with associated problems in
      diagnosis and therapy are discussed. Patients with atypical skull base
      osteomyelitis are difficult to diagnose as they have no ear abnormalities, but
      they often develop multiple cranial nerve deficits mimicking symptoms of a
      posterior fossa mass. We conclude that computed tomographic scans, magnetic
      resonance imaging studies, bone scans indium-labeled white blood cell scans, and
      gallium scans are useful in making the diagnosis. A biopsy of the bony lesion
      often is needed to identify the causative organism and to rule out a tumor.
      Intravenously administered antibiotics are the mainstay of therapy and should be
      continued until 1 week after the gallium scan shows no abnormalities. Follow-up
      gallium scans then are done at 1 week and 3 months after the cessation of
      antibiotic therapy to search for a recurrence.

PMID- 1620311
TI  - Benign intracerebral cysts treated with internal shunts: review and report of two
      patients.
AB  - Two elderly women with symptomatic benign intracerebral cysts are reported.
      Before treatment, they both had developed moderate, but slowly increasing,
      symptoms from a cyst in the left hemisphere, which included epileptic seizures
      and right hemiparesis. During local anesthesia, an internal cystosubarachnoid
      shunt was inserted. After the operation, the cyst size was reduced markedly, with
      a corresponding improvement in the symptoms. A review of reported cases of benign
      intracerebral cysts is given. The average age of these patients is surprisingly
      high for a presumed congenital condition. There is a female preponderance, but
      the previously reported overrepresentation of left-sided lesions is not found in
      cases described after the introduction of computerized tomographic imaging.

PMID- 1620312
TI  - Multiple cerebral hydatid disease: case report with magnetic resonance imaging
      study.
AB  - A case of multiple hydatid cysts of the brain is reported. Computed tomographic
      and magnetic resonance imaging scanning revealed a thick and calcified
      pericystium. These findings allowed appropriate surgical planning, with a marked
      recovery of the neurological deficits and absence of relapse in the follow-up
      period.

PMID- 1620313
TI  - Meningioma and sagittal craniosynostosis in an infant: case report.
AB  - The occurrence of a frontal base meningioma in a 3-month-old infant seen for the
      treatment of sagittal craniosynostosis is reported. The association of the two
      lesions is of interest both because it is unique and may lend support to theories
      of the cause of some forms of craniosynostosis.

PMID- 1620314
TI  - The radiological differentiation of acoustic neurinoma and meningioma occurring
      together in the cerebellopontine angle.
AB  - A patient with right hearing loss, in whom computed tomographic scanning
      demonstrated a mass in the right cerebellopontine angle with widening of and
      extension into the internal auditory canal, but with important posterior
      extension and broad implantation on the surface of the petrous bone, is reported.
      On both T2-weighted and gadolinium-enhanced T1-weighted magnetic resonance
      images, there were clearly two separate tumoral lesions: an acoustic neurinoma
      extending into the internal auditory canal and a meningioma with broad
      implantation on the petrous apex. These findings were confirmed at surgery.

PMID- 1620315
TI  - Meningeal hemangiopericytoma of the posterior fossa and thoracic spinal epidural
      space: case report.
AB  - The rare combination of spinal and intracranial meningeal hemangiopericytomas in
      the same patient is reported. The coexistence of cerebral and spinal meningiomas
      of all histological subtypes is distinctly uncommon with only nine cases found in
      the literature.

PMID- 1620317
TI  - Craniopharyngioma of the posterior fossa.

PMID- 1620318
TI  - Cyst of the ligamentum flavum: report of six cases.

PMID- 1620316
TI  - Informed consent: is it a myth?
AB  - The issue of informed consent at it relates to neurosurgical professional
      malpractice liability and litigation has been of concern for 20 years or more.
      The problem persists, and the subject has been addressed by providing patient
      education with full disclosure regarding neurosurgical procedures. In the process
      of imparting informed consent, the authors studied the effectiveness of specific
      neurosurgical health care teaching. One hundred six persons undergoing anterior
      cervical fusion or lumbar laminectomy were instructed by a neurosurgeon and
      clinical nurse specialist with a master's degree in neurosurgery. Written testing
      was performed in each case immediately after a formal teaching session before
      surgery. Questions were simple and covered only four general topics: 1) diagnosis
      and surgical techniques; 2) operative risks; 3) postoperative care; and 4) goals
      and benefits relating to surgery. The mean score on testing immediate retention
      of information revealed a 43.5% overall performance rate. When patients were
      tested approximately 6 weeks later, the score dropped to 38.4%. This was
      statistically significant (chi 2, P less than 0.05). The authors encourage the
      concept of patient education. The data in the current study, however, suggest
      that the reasonable and prudent neurosurgeon making a concerted effort at patient
      education, with the assistance of a professional educator, cannot necessarily
      expect accurate patient or family recall or comprehension. Fulfillment of the
      doctrine of informed consent by neurosurgeons may very well be mythical.

PMID- 1620319
TI  - Functional recovery after traumatic transtentorial herniation.

PMID- 1620320
TI  - Spinal man after declaration of brain death.

PMID- 1620321
TI  - Levels of processing for visual stimuli in an "extinguished" field.
AB  - Volpe et al. (Nature 282, 722, 1979 [19]) described an experimental study of four
      patients with parietal tumours who were able to judge whether two simultaneous
      stimuli were identical or different, even when they were unable to name the
      stimulus contralateral to their brain injury. We report the case of another
      patient, E.M., in whom we have investigated this phenomenon further. E.M. had
      undergone a right temporal lobectomy to prevent recurrent seizures. She could
      correctly name photographs of objects presented in isolation to either the left
      or right visual field, at 150 msec exposure (although she was impaired for single
      objects on the left at 10 msec exposures). She was able to judge correctly
      whether two simultaneous objects on the left and right had the same or different
      names, even though she was often unable to name the object on the left. These
      judgements remained above chance when same-name pairs of stimuli showed the same
      object but seen from two different viewpoints, or even when they showed visually
      dissimilar exemplars of the same name category. This implies that the patient
      based her same-different judgements on categorical information about the pair of
      objects, even though she was often unable to name the contralateral object.

PMID- 1620322
TI  - Investigation of the role of sex hormones in alcoholics' visuospatial deficits.
AB  - This study investigated whether an alcohol-related disturbance in the functioning
      of the hypothalamic-pituitary-gonadal axis was a factor in alcoholics'
      visuospatial impairment. One month detoxified male alcoholics (n = 58) performed
      significantly poorer than peer controls (n = 30) on a battery of visuospatial and
      verbal tests. Serum concentrations of testosterone, estradiol, luteinizing
      hormone and follicle stimulating hormone were obtained at three times during
      cognitive testing. Previously reported correlations in healthy young male adults
      between visuospatial performance with testosterone and follicle stimulating
      hormone concentrations were replicated in control subjects. These correlations
      were not significant in the alcoholics. The results suggest that chronic
      alcoholism may disrupt the normal relationships between the hypothalamic
      pituitary-gonadal axis and cognitive functioning.

PMID- 1620323
TI  - Delayed matching to sample and concurrent learning in nonamnesic humans with
      alcohol dependence.
AB  - Small samples of alcohol-dependent subjects who showed no clinical signs of
      Wernicke-Korsakoff syndrome were compared with nonalcohol-dependent controls on
      two animal memory tests which are performed poorly by human amnesics. Compared to
      the control subjects, the alcohol-dependent subjects' performance was impaired on
      a version of the delayed matching to sample task. On concurrent discrimination
      learning the overall group difference just failed to reach significance. The
      results are interpreted as suggesting that behavioural impairment may occur in
      alcohol-dependent subjects who are not clinically amnesic, and that the
      impairment is similar in type to that observed in cases of severe Wernicke
      Korsakoff syndrome.

PMID- 1620324
TI  - A re-appraisal of a case of persistent global amnesia following right temporal
      lobectomy: a clinico-pathological study.
AB  - We report a reappraisal of patient NT who became severely amnesic after a right
      temporal lobectomy for intractable epilepsy (DINSDALE et al., Neuropsychologia 1,
      287, 1964 [6]). Histological examination, albeit incomplete, indicated that there
      was no abnormality in the resected temporal lobe. At autopsy a sclerotic lesion
      of the unoperated left hippocampal formation was found. This case is therefore
      not an exception to the general rule that a severe and global amnesic state is
      only observed with bilateral lesions. Her performance on a wide range of memory
      tests is shown to be indistinguishable from patients with an amnesic syndrome due
      to Korsakoff's psychosis.

PMID- 1620325
TI  - Verbal learning and memory in language impaired children.
AB  - The present study investigated patterns of verbal learning and memory in Language
      Impaired (LI) and normal children, using the California Verbal Learning Test-
      Children's Version. The LI children showed a normal immediate memory span;
      however, they were impaired in the total number of correct responses that they
      generated across repeated trials. They reported significantly more
      perseverations, but not intrusions, relative to the controls. The LI children
      were not impaired on a delayed free recall task, but they were significantly
      impaired relative to the controls on semantically cued recall. The implications
      of these findings for future research and for remediation are discussed.

PMID- 1620326
TI  - Are specific reading and writing difficulties causally connected with
      developmental spatial inability? Evidence from two cases of developmental agnosia
      and apraxia.
AB  - Two cases studies of subjects suffering from severe developmental constructional
      apraxia are presented. These two subjects demonstrated normal to high ability in
      reading, writing and arithmetical tests. The analysis of cognitive tests
      performed by them indicates that extreme developmental, perceptual, spatial and
      motor deficits may be dissociated from the acquisition of efficient reading
      ability.

PMID- 1620327
TI  - Pathological left-handedness revisited: dichotic listening in children with left
      vs right congenital hemiplegia.
AB  - Thirty-one children with right (n = 18) and left (n = 13) congenital hemiplegia
      were compared for incidence of hand- and foot-preference, eye-dominance, and
      familial sinistrality. In addition, they were tested with dichotic listening for
      correct reports of consonant-vowel syllables. The two groups of children were
      closely matched on IQ and sensory functioning. Children with mental retardation,
      or epileptic seizures were not included. The results showed that 89% of the left
      hemisphere impaired (LHI) children were left-handed, all of them preferred the
      left foot, and 72% were left eye-dominant. In the right hemisphere impaired (RHI)
      group, everyone (100%) preferred the right hand and foot, and 62% were right eye
      dominant. The dichotic listening results showed a significant right ear advantage
      (REA) in the RHI-group, and a significant left ear advantage (LEA) in the LHI
      group. The results are discussed in the framework of pathological handedness and
      shifts in hemisphere control of language in children with early brain injury. It
      is argued that the homogeneous samples, except for the site of lesion, provides
      an interesting possibility to compare cognitive effects of left and right
      hemisphere impairment in children.

PMID- 1620328
TI  - Hand preference, prematurity and developmental outcome at school age.
AB  - Information was obtained on the hand preference of 88 premature and 80 matched
      full-term children at 7-8 years old. These children were also evaluated for
      neurologic status, IQ, attention-deficit hyperactivity disorder, and learning
      disabilities. Although the difference on hand preference was not significant, 12%
      more of the premature children than the full-term children were left- or mixed
      handed. Results showed that, among premature children, there is an association
      between non-right-handedness and cognitive and behavioral deficits and that left
      handed children show relative clumsiness with the non-preferred hand.

PMID- 1620329
TI  - Memory impairment and depression in patients with Lyme encephalopathy: comparison
      with fibromyalgia and nonpsychotically depressed patients.
AB  - Lyme encephalopathy, primarily manifested by disturbances in memory, mood, and
      sleep, is a common late neurologic manifestation of Lyme disease. We compared 20
      patients with Lyme encephalopathy with 11 fibromyalgia patients and 11
      nonpsychotically depressed patients using the California Verbal Learning Test,
      Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Minnesota Multiphasic
      Personality Inventory (MMPI), and Beck Depression Inventory. Compared with
      patients with fibromyalgia or depression, the Lyme encephalopathy group showed
      mild, but statistically significant, memory deficits on two of the three memory
      tests. In contrast, the patients with fibromyalgia scored significantly higher
      than both other groups on the MMPI scale most sensitive to somatic concerns
      (scale 1), while the depressed patients scored higher than the Lyme patients on
      the scales most sensitive to depression (scale 2) and anxiety (scale 7). Physical
      complaints and depression were not major factors in memory performance among Lyme
      patients. These data support the hypothesis that Lyme encephalopathy is caused by
      CNS dysfunction and cannot be explained as a psychological response to chronic
      illness.

PMID- 1620330
TI  - Lyme borreliosis in Bell's palsy. Long Island Neuroborreliosis Collaborative
      Study Group.
AB  - Lyme borreliosis (LB) causes a range of neurologic manifestations, the most
      common of which is facial nerve paralysis. To evaluate nervous system LB, we
      organized a neurologic collaborative study group in Suffolk County, NY, a region
      of high LB incidence. Between July and September 1989, LB serologies were
      performed on all patients with new-onset Bell's palsy. Seven of 32 had serologic
      evidence of LB at onset. One, initially seronegative, was highly seropositive 5
      weeks later. In the five in whom we examined CSF, there was no evidence of
      intrathecal synthesis of specific antibody. In highly endemic areas, LB may be
      responsible for 1/4 of cases of Bell's palsy. Rarely, the palsy may occur prior
      to the development of a measurable antibody response, indicating a need for
      follow-up serologic testing.

PMID- 1620331
TI  - Pupillary escape.
AB  - I performed a pupillographic study of pupillary escape to determine its
      effectiveness in detecting optic nerve and retinal disease. Fourteen patients and
      39 normal subjects were included in the study. Only one patient had abnormal
      pupillary escape, even though 13 patients had relative afferent pupillary
      defects. Testing for pupillary escape is not a reliable clinical technique.

PMID- 1620332
TI  - Frontal lobe partial seizures and psychogenic seizures: comparison of clinical
      and ictal characteristics.
AB  - Of all partial seizures, those of frontal lobe origin (FLPS) are most bizarre and
      are often mistaken for psychogenic seizures (PS). The reverse can also be true.
      To clarify the confusing clinical presentation of these different seizure types,
      we compared the clinical ictal characteristics of 63 FLPS in 11 patients with 29
      PS in 12 patients. Patients with PS had significantly later age at onset and
      longer ictal duration. There was no statistically significant difference between
      the two groups with respect to history of psychiatric disorder, ictal pelvic
      thrusting, rocking of body, side-to-side head movements, or rapid postictal
      recovery, all of which previously have been reported as characteristic features
      of PS. Turning to a prone position during the seizure occurred only in FLPS.
      Nocturnal occurrence, short ictal duration, younger age at onset, stereotyped
      patterns of movements, and MRI and EEG abnormality suggested FLPS.

PMID- 1620333
TI  - Seizures in children with congenital hydrocephalus: long-term outcome.
AB  - We documented seizures in 33 of 68 (48.5%) children with congenital hydrocephalus
      not associated with myelomeningocele. Mental retardation (MR) and CNS
      malformations correlated with seizure occurrence; age at shunt insertion and
      number of shunt revisions and infections were not significant variables in
      predicting seizures. Of 11 patients seizure free for 2 or more years on
      medication, six had therapy discontinued without seizure recurrence. Among those
      33 children with seizures, 14 (42.4%), including five who had failed withdrawal
      of medication, have adequately controlled seizures on anticonvulsants. Frequent
      convulsions despite treatment occur in 13 (39.4%) of the 33 children with
      seizures. Absence of MR, older age and nonparoxysmal EEG at seizure onset, and
      absence of CNS malformation correlated with seizure remission. Longer time
      without seizures while on medication did not predict successful discontinuation
      of therapy. In contrast, MR correlated significantly with seizure recurrence
      following cessation of treatment. Our study indicates that medication can be
      safely discontinued in children with congenital hydrocephalus who are of normal
      intelligence and have been seizure free on anticonvulsants for 3 years.

PMID- 1620334
TI  - Syphilitic cerebral gumma with HIV infection.
AB  - We describe two human immunodeficiency virus (HIV)-infected patients with
      syphilitic cerebral gummas. Both patients presented with a seizure disorder
      associated with an isolated, peripherally located, contrast-enhancing lesion of
      the brain on CT. Cranial MRI performed on one patient revealed dural thickening
      in the region of the lesion. A brain biopsy in that patient revealed a
      lymphoplasmacytic infiltrate with extensive perivascular inflammation. Clinical
      manifestations, radiographic resolution of the lesions, and a decline in
      nontreponemal serologic tests for syphilis followed high-dose aqueous penicillin
      therapy in both patients. These patients illustrate that (1) cerebral mass
      lesions occurring with HIV infection may result from syphilis; (2) seizures may
      be the presenting manifestation of this form of neurosyphilis; and (3) high-dose,
      intravenous, aqueous penicillin is effective in treating these lesions.

PMID- 1620335
TI  - Time interval between repeated injections conditions the duration of motor
      improvement to apomorphine in Parkinson's disease.
AB  - Behavioral hyposensitivity to repeated apomorphine administration occurs in
      fluctuating parkinsonian patients. To determine to what extent the interval
      between doses influences the response, we administered equal paired apomorphine
      injections to 10 fluctuating parkinsonian patients. Subjects received two
      apomorphine injections at 2-hour and at 4-hour intervals on different days after
      a 10- to 12-hour overnight period without levodopa. Following apomorphine doses
      at 2-hour intervals, the duration of response was reduced by 40% (61 versus 42
      minutes, p less than 0.001) but was of equal duration when the doses were given
      at 4-hour intervals. These findings indicate that the interval between doses is a
      critical determinant of motor response. We postulate a time-dependent period of
      partial hyposensitivity to pulsatile DA stimulation.

PMID- 1620336
TI  - Neuropsychological and structural brain lesions in multiple sclerosis: a regional
      analysis.
AB  - Quantified lesion scores derived from MRI correlate significantly with
      neuropsychological testing in patients with multiple sclerosis (MS). Variables
      used to reflect disease severity include total lesion area (TLA), ventricular
      brain ratio, and size of the corpus callosum. We used these general measures of
      cerebral lesion involvement as well as specific ratings of lesion involvement by
      frontal, temporal, and parieto-occipital regions to quantify the topographic
      distribution of lesions and consequent effects upon cognitive function. Lesions
      were heavily distributed in the parieto-occipital regions bilaterally.
      Neuropsychological tests were highly related to all generalized measures of
      cerebral involvement, with TLA being the best predictor of neuropsychological
      deficit. Mean TLA for the cognitively impaired group was 28.30 cm2 versus 7.41
      cm2 for the cognitively intact group (p less than 0.0001). Multiple regression
      analyses revealed that left frontal lobe involvement best predicted impaired
      abstract problem solving, memory, and word fluency. Left parieto-occipital lesion
      involvement best predicted deficits in verbal learning and complex visual
      integrative skills. Analysis of regional cerebral lesion load may assist in
      understanding the particular pattern and course of cognitive deficits in MS.

PMID- 1620337
TI  - The diagnostic reliability of magnetically evoked motor potentials in multiple
      sclerosis.
AB  - In a prospective study, we evaluated the technique of magnetically evoked motor
      potentials (MEP) in the diagnosis of multiple sclerosis (MS). We consecutively
      included 68 patients with symptoms or signs compatible with a demyelinative CNS
      affection. We subjected all patients to CSF analysis, MRI studies of the brain
      and brainstem, visual evoked potentials (VEP), brainstem auditory evoked
      potentials (BAEP), and somatosensory evoked potentials (SSEP). We then used the
      results to categorize the patients according to the Poser criteria of multiple
      sclerosis. Blinded from the results of the above investigations, one of the
      authors made MEP recordings from three muscles in the upper limbs and two in the
      lower limbs in all 68 patients. Forty patients received an MS diagnosis, and in
      these, MRI was positive in 88%, MEP in 83%, VEP in 67%, SSEP in 63%, and BAEP in
      42%. As to the diagnosis of MS, the reliability of a prolonged central motor
      conduction time (CMCT) was 0.83 (0.73 to 0.93), while the reliability of a normal
      CMCT was 0.75 (0.61 to 0.98). The information gained by MRI was best supplemented
      by VEP. Of the neurophysiologic tests, the MEP was in closest agreement with the
      MRI with a concordance of 85%.

PMID- 1620338
TI  - Rapid reversible modulation of human motor outputs after transient
      deafferentation of the forearm: a study with transcranial magnetic stimulation.
AB  - Reorganization of corticospinal pathways after spinal cord injury and amputations
      leads to increased excitability of motor pathways targeting muscles proximal to
      the level of interruption of efferents from the CNS. To study the timing of these
      changes, we have recorded motor evoked potentials (MEPs) in the arm muscles of
      three normal subjects before, during, and after anesthetic block of the forearm
      and hand. The amplitudes of MEPs from biceps, which was the muscle immediately
      proximal to the block, gradually increased with anesthesia and then returned to
      preanesthesia levels within approximately 20 minutes after anesthesia was ended.
      MEPs from the contralateral arm were unaffected. Such rapid changes strongly
      suggest unmasking of preexisting synaptic connections, due to disinhibition at
      cortical or subcortical levels, as the mechanism underlying acute modulation of
      motor outputs.

PMID- 1620339
TI  - Dysphagia after botulinum toxin injections for spasmodic torticollis: clinical
      and radiologic findings.
AB  - We prospectively evaluated the frequency, severity, and radiologic features of
      swallowing abnormalities following Botox treatment of spasmodic torticollis. We
      performed both clinical and radiologic evaluations of swallowing before and
      following Botox in 18 consecutive cervical dystonia patients receiving their
      first Botox treatment. Before Botox, 11% of the patients had clinical symptoms of
      dysphagia and 22% had radiologic signs of a peristaltic abnormality. After Botox,
      the signs and symptoms of dysphagia in these patients did not change, but an
      additional 33% developed new dysphagic symptoms and 50% of the patients developed
      new peristaltic abnormalities by radiologic studies. Complaints of swallowing
      difficulty were always associated with abnormal radiologic findings. Neither the
      total Botox dose nor Botox into particular muscles differed between those with
      dysphagia and those without.

PMID- 1620340
TI  - Blinded evaluation confirms long-term asymmetric effect of unilateral thalamotomy
      or subthalamotomy on tremor in Parkinson's disease.
AB  - In the past, stereotactic surgery was a regular treatment for prominent
      unilateral tremor in Parkinson's disease (PD), but follow-up studies were usually
      short-term and always unblinded. We examined 17 PD patients in long-term follow
      up (mean, 10.9 years after surgery) and used videotapes and the Unified
      Parkinson's Disease Rating Scale to blindly compare tremor ipsilateral and
      contralateral to the side of surgery. Since the patients were specifically
      selected for stereotactic surgery because of asymmetric tremor, and the surgical
      side chosen was contralateral to the predominant tremor, a sign of long-term
      efficacy would be current postoperative reversal of tremor side predominance.
      Upper extremity tremor was significantly better contralateral to the surgery
      compared with the ipsilateral side. We conclude that stereotactic surgery
      improved the absolute magnitude of tremor or ameliorated its rate of progression.
      Since asymmetric bradykinesia and dyskinesia were not a prerequisite for the
      choice of surgical side, we cannot make any conclusion about long-term impact of
      surgery on these features.

PMID- 1620341
TI  - Levodopa-nonresponsive Lewy body parkinsonism: clinicopathologic study of two
      cases.
AB  - We report two patients with a primarily akinetic form of parkinsonism who were
      nonresponsive to treatment with levodopa. At autopsy, both patients had many Lewy
      bodies in brainstem and diencephalic nuclei, with sparse Lewy bodies in
      association cortices and more numerous Lewy bodies in the limbic cortices,
      consistent with the transitional form of Lewy body disease. These cases emphasize
      that (1) Lewy body Parkinson's disease cannot be excluded on the basis of
      atypical presentation or levodopa nonresponsiveness, and (2) the
      clinicopathologic spectrum of Lewy body disease is varied.

PMID- 1620342
TI  - Parkinson's disease and exposure to agricultural work and pesticide chemicals.
AB  - This population-based case-control study of 130 Calgary residents with
      neurologist-confirmed idiopathic Parkinson's disease (PD) and 260 randomly
      selected age- and sex-matched community controls attempted to determine whether
      agricultural work or the occupational use of pesticide chemicals is associated
      with an increased risk for PD. We obtained by personal interviews lifetime
      occupational histories, including chemical exposure data, and analyzed the data
      using conditional logistic regression for matched sets. In the univariate
      analysis, a history of field crop farming, grain farming, herbicide use, or
      insecticide use resulted in a significantly increased crude estimate of the PD
      risk, and the data suggested a dose-response relation between the PD risk and the
      cumulative lifetime exposure to field crop farming and to grain farming. However,
      in the multivariate analysis, which controlled for potential confounding or
      interaction between the exposure variables, previous occupational herbicide use
      was consistently the only significant predictor of PD risk. These results support
      the hypothesis that the occupational use of herbicides is associated with an
      increased risk for PD.

PMID- 1620343
TI  - Content of the neurotoxins cycasin (methylazoxymethanol beta-D-glucoside) and
      BMAA (beta-N-methylamino-L-alanine) in cycad flour prepared by Guam Chamorros.
AB  - Exposure to cycad seed kernel is an etiologic factor for the western Pacific
      amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia complex (PDC).
      Traditionally processed cycad flours (n = 17) obtained from Chamorro residents of
      Guam and the adjacent island of Rota at risk for neurodegenerative disease were
      extracted and analyzed by high-performance liquid chromatography for content of
      beta-N-methylamino-L-alanine (BMAA) and methyl-azoxymethanol beta-D-glucoside
      (cycasin). Cycasin (detection limit: picomole) was present in concentrations of
      0.004 to 75.93 micrograms/g (mean, 12.45 +/- 5.0 micrograms/g), and levels of
      BMAA (detection limit: subpicomole) ranged from 0.00 to 18.39 micrograms/g (mean,
      5.44 +/- 1.56 micrograms/g). On average, cycasin content was approximately 10
      times higher than that of BMAA. The largest concentrations of cycasin were found
      in samples from villages with a high reported prevalence of ALS/PDC. Ingestion of
      cycad-derived food would result in estimated human exposure to milligram amounts
      of cycasin per day. The cytotoxic properties of cycasin merit consideration in
      relation to the etiology of western Pacific ALS/PDC.

PMID- 1620344
TI  - Borrelia burgdorferi and other related spirochetes bind to galactocerebroside.
AB  - Spirochetes are agents of neurologic disease that may utilize specific neural
      cell surface molecules for adhesion. Borrelia burgdorferi, the etiologic agent of
      Lyme disease, bound to galactocerebroside (GalCer) in numbers that were two- to
      threefold greater than to ceramide and glucocerebroside, and four- to fivefold
      greater than to sphingosine, psychosine, sulfatide, cholesterol, and three
      membrane phospholipids. The adherence was greater to GalCer and ceramide with a
      higher content of alpha-hydroxyl fatty acids. Treponema phagedenis Reiter and
      Borrelia hermsii also bound to GalCer. The binding of B burgdorferi to GalCer was
      inhibited in a concentration-dependent manner by rabbit polyclonal and murine
      monoclonal antibodies to this glycosphingolipid component of myelin. The
      monoclonal antibody to GalCer also inhibited adhesion of the organisms to Schwann
      cells. Neither free D or L monosaccharides nor the lectin peanut agglutinin
      inhibited binding. Since B burgdorferi and other spirochetes cause neurologic
      disease, these results suggest a role for GalCer as a binding site in both the
      central and peripheral nervous systems.

PMID- 1620345
TI  - Spectroscopic imaging of stroke in humans: histopathology correlates of spectral
      changes.
AB  - Previous studies of human stroke by 1H nuclear magnetic resonance spectroscopy
      have shown elevation of lactate lasting 3 to 6 months. Complete metabolic
      turnover of the elevated lactate pool has been demonstrated 5 weeks after a
      stroke. Its cellular localization is among the first questions requiring
      clarification. Information pertinent to this question came to us from a patient
      with a 2-week-old stroke by 1H nuclear magnetic resonance spectroscopic imaging 1
      week before his death led to neuropathologic examination of the brain. 1H spectra
      from voxels including the infarcts showed increased lactate and decreased N
      acetylaspartate. Histopathology showed sheets of foamy macrophages in the
      infarct, but few neurons. Macrophage density ranged from 196 cells/mm2 near the
      surface of the infarct to 788 near its medial margin. Glial density was 500 to
      800 cells/mm2. Lactate concentration in voxels including portions of the infarct
      was estimated at 7 to 14 mM. Voxels showing low N-acetylaspartate and high
      lactate on spectroscopic imaging were associated with histopathologic sections
      containing foamy macrophages. Brain macrophages--which begin to appear 3 days
      after infarction and gradually disappear over several months--could be a major
      source of elevated lactate signals that persist for months after stroke.

PMID- 1620346
TI  - Protease nexin I, thrombin- and urokinase-inhibiting serpin, concentrated in
      normal human cerebrospinal fluid.
AB  - Protease nexin I (PNI), a 43,000- to 50,000-dalton glycoprotein, is a potent
      thrombin and urokinase inhibitor produced by many mammalian cells, including
      human glia, in tissue culture. PNI is a member of the growing superfamily of
      serine protease inhibitors now known as serpins, but, unlike many others of this
      family, it has not yet been detected in normal human plasma. Of interest to
      neurobiology and neurologic disease, PNI is identical to a glia-derived neurite
      promoting factor, glia-derived nexin (GDN). Antibody to PNI stains the periphery
      of senile amyloid plaques in brain tissue from patients with Alzheimer's disease
      (AD), along with another serpin, alpha 1-antichymotrypsin (alpha 1-ACT). A
      soluble form of the beta-amyloid precursor protein (beta APP), containing a
      Kunitz-type trypsin inhibitor domain, the beta APP751 form, is identical to
      protease nexin II (PNII), a 100,000-dalton serine protease inhibitor present in a
      number of tissues besides the brain. PNII/beta APP is also found in normal and AD
      CSF. We found a 47,000-dalton PNI, a thrombin- and urokinase-inhibiting serpin,
      in normal human CSF by Western blotting using a monospecific antibody. We also
      demonstrated biologically active PNI capable of forming complexes with serine
      proteases 125I-urokinase or 125I-thrombin.

PMID- 1620347
TI  - Dose response, coasting, and differential fiber vulnerability in human toxic
      neuropathy: a prospective study of pyridoxine neurotoxicity.
AB  - We administered either 1 or 3 g/d of pyridoxine (vitamin B6) to five healthy
      volunteers and repeatedly followed serum pyridoxal phosphate levels, clinical
      symptoms and signs, quantitative sensory thresholds (QSTs), and sural nerve
      electrophysiology. Pyridoxine was discontinued at the first sign of either
      clinical or laboratory abnormality. In all subjects, sensory symptoms and QST
      abnormalities occurred concurrently. Subjects receiving higher doses became
      symptomatic earlier than low-dose subjects. Elevation of thermal QSTs preceded or
      exceeded that for vibration in the three low-dose subjects; vibration and thermal
      QST became abnormal simultaneously in the higher-dose subjects. A reduction in
      the amplitude of the sural sensory potential lagged behind QST changes in two of
      three subjects. Symptoms continued to progress ("coasting") for 2 to 3 weeks
      despite stopping pyridoxine administration and the return of serum pyridoxal
      phosphate levels to normal. This study suggests that (1) there is a clear dose
      percent relationship for pyridoxine-induced neuropathy, (2) QST is a sensitive
      measurement for detecting early peripheral neuropathy; QST abnormalities may
      precede changes in nerve conduction studies, (3) coasting appears unrelated to
      persistently elevated blood levels of the toxin, and (4) a dose-dependent
      vulnerability may exist among nerve fibers of different caliber when exposed to
      an axonal toxin, such as pyridoxine.

PMID- 1620348
TI  - Polysomnographic features of REM sleep behavior disorder: development of a
      scoring method.
AB  - REM sleep behavior disorder (RBD) is characterized by the intermittent absence of
      REM sleep EMG atonia and the appearance of elaborate motor activity associated
      with dream mentation. There are no specific diagnostic criteria for RBD based
      upon polysomnographic findings. We describe a new scoring method and show its
      sensitivity to treatment with clonazepam. An increased phasic submental EMG
      density occurs in RBD patients, but REM density is similar to that of controls.
      Clonazepam selectively decreases REM sleep phasic activity but exerts no effect
      on REM sleep atonia. Periodic limb movements in sleep (PLMS) occur equally in
      both REM and NREM sleep in RBD patients, suggesting that normal suppression of
      PLMS in REM sleep is due to motor inhibition.

PMID- 1620349
TI  - Causal heterogeneity in isolated lissencephaly.
AB  - We report clinical, cytogenetic, and molecular studies in 65 patients with
      isolated lissencephaly sequence (ILS). All had type I lissencephaly of varying
      severity and a grossly normal cerebellum. Some had additional brain
      abnormalities. Facial appearance was essentially normal. All had severe to
      profound mental retardation, seizures, hypotonia that evolved into spasticity,
      and feeding difficulties. Clinical and laboratory studies demonstrated etiologic
      heterogeneity. Molecular studies detected microdeletions in chromosome band
      17p13.3 in six of 44 patients tested, confirming that deletion of all or part of
      this "critical region" is the cause of ILS in some cases. There were slightly
      larger deletions in the same region in a majority of patients with Miller-Dieker
      syndrome. One patient had an apparently balanced, de novo reciprocal
      translocation with breakpoints at Xq22 and 2p25. Four sibs from two families had
      a new, autosomal recessive syndrome of ILS with neonatal death. Other causes
      supported by clinical observations include autosomal recessive inheritance,
      intrauterine infection, and intrauterine perfusion failure. Those ILS probands in
      whom no etiology could be established had 41 sibs of whom three were affected,
      giving an empiric recurrence risk of 7%.

PMID- 1620350
TI  - Rate and types of fractures in corticosteroid-treated multiple sclerosis
      patients.
AB  - In a retrospective study of 103 corticosteroid-treated MS patients, the average
      rate of fracture events was 3.2% of the patients per year over 7.1 (+/- 5.7 SD)
      years at risk. Fractures of the ribs, pelvis, hip, or vertebrae occurred in 11
      patients and became most common 5 years after starting steroids. Relatively high
      or low cumulative doses of steroids did not correlate predictably with the
      occurrence of fractures.

PMID- 1620351
TI  - Botulinum toxin treatment of supranuclear ocular motility disorders.
AB  - We treated one patient with bilateral internuclear ophthalmoplegia and another
      with skew deviation with extraocular muscle botulinum toxin injection. Both
      patients had pre-injection symptomatic diplopia in primary position, one for 1
      month and the other for 12 months. Resolution of diplopia and complete and
      permanent binocular fusion in primary position was obtained within 3 to 4 days in
      both cases.

PMID- 1620352
TI  - The effect of acetazolamide on essential tremor: an open-label trial.
AB  - We studied the effect of the carbonic anhydrase inhibitor acetazolamide on 24
      patients with essential tremor by patient self-evaluation of functional
      disability, rating of motor task function, and clinical rating of tremor
      severity. Acetazolamide significantly reduced tremor severity, but there was no
      statistically significant change in patient self-assessment of function or motor
      task rating. Although side effects were common, over half the patients elected to
      remain on the drug.

PMID- 1620353
TI  - Familial cluster headache: occurrence in three generations.
AB  - We report the occurrence of cluster headache in three generations of one family:
      an 8-year-old boy with primary chronic cluster headache, his 42-year-old father
      with secondary chronic cluster headache, and his 73-year-old paternal grandfather
      with episodic cluster headache.

PMID- 1620354
TI  - Hair loss after prolonged EEG/video monitoring.
AB  - We report five patients who experienced delayed patchy hair loss after prolonged
      EEG monitoring. The location of the patches corresponded to the electrode sites
      in four. The hair loss was temporary and most probably was due to traumatic
      noncicatricial alopecia. The frequency of hair loss was approximately 2% of
      monitored patients.

PMID- 1620355
TI  - Memantine prevents HIV coat protein-induced neuronal injury in vitro.
AB  - Studies with in vitro model systems suggest that at least part of the neurologic
      deficits of human immunodeficiency virus (HIV)-1-associated cognitive/motor
      complex may stem from neuronal injury mediated by the HIV-1 coat protein gp120.
      Concurrent activation of N-methyl-D-aspartate (NMDA) receptors is also necessary
      for gp120 to induce neuronal damage. We studied memantine, a drug that blocks
      NMDA receptor-operated ion channels, for possible protective effects from gp120
      induced neuronal injury. In identified rat retinal ganglion cells in culture, we
      found that 2 microM memantine completely prevented the injury engendered by 20 pM
      gp120. These data suggest that memantine has therapeutic potential as an NMDA
      antagonist capable of ameliorating neuronal damage associated with gp120.

PMID- 1620357
TI  - Report of the MDA Gene Therapy Conference, Tucson, Arizona, September 27-28,
      1991.
AB  - C. Thomas Caskey, in summarizing the meeting, noted that phenotypic correction of
      DMD is likely to require restoration of the dystrophin protein; thus, this
      disease is a logical target for consideration of gene replacement therapy. A
      number of tools are available to the experimenter, including the dystrophin gene
      and cDNA, several viral vectors, and various animal models of the human disease.
      In addition, detailed knowledge is now becoming available about the mechanisms of
      muscle-specific gene expression. However, a number of uncertainties have yet to
      be resolved. The dystrophin gene has an extremely complex pattern of expression,
      with more than one promoter and a number of alternative splicing events; what are
      the reasons for this variety? The dystrophin-glycoprotein complex has been
      described but its function is unclear. The role of the satellite cell is
      uncertain. It is not yet clear whether viral delivery or direct injection of DNA
      will be the method of choice for gene transfer into muscle. If delivery methods
      do not target the appropriate tissues, then appropriate use of tissue-specific
      control elements will be required for selective gene expression. Which animal
      model system should be used? What role can myoblast transplantation (with or
      without gene transfer) play in the treatment of DMD and other inherited
      myopathies? It is hoped that in further meetings on this topic, some of these
      issues will have been resolved.

PMID- 1620356
TI  - Clinical and neuroradiologic findings of congenital hydrocephalus in infant born
      to mother with HTLV-I-associated myelopathy.
AB  - We describe clinical and neuroradiologic findings in a male infant with
      congenital hydrocephalus born to a mother who developed human T-cell lymphotropic
      virus type I (HTLV-I)-associated myelopathy. Ultrasonography at age 20 days
      showed multiple cysts in the subependymal germinal matrix and enlarged lateral
      ventricles. Elevation of serum HTLV-I antibody suggested that his hydrocephalus
      was probably due to intrauterine HTLV-I infection. HTLV-I may cause neurotropic
      infection in utero.

PMID- 1620358
TI  - Thoracic aortic aneurysm presenting as paraparesis: a case report.

PMID- 1620359
TI  - Syringomyelia as a late complication of paralytic poliomyelitis.

PMID- 1620360
TI  - Clinical and electrophysiologic improvement in Lambert-Eaton syndrome with
      intravenous immunoglobulin therapy.

PMID- 1620361
TI  - Eosinophilic meningitis due to Angiostrongylus cantonensis.

PMID- 1620362
TI  - Paraneoplastic syndromes.

PMID- 1620363
TI  - Transcranial stimulation.

PMID- 1620364
TI  - Neurodegenerative disorders.

PMID- 1620365
TI  - Neurodegenerative disorders.

PMID- 1620366
TI  - Neurodegenerative disorders.

PMID- 1620367
TI  - Neurodegenerative disorders.

PMID- 1620369
TI  - Slit-like ventricles.

PMID- 1620368
TI  - Essential tremor.

PMID- 1620370
TI  - Anabolic steroids and muscular dystrophy.

PMID- 1620371
TI  - Diagnosing subarachnoid hemorrhage in the ED.

PMID- 1620372
TI  - Limb salvage in war.

PMID- 1620373
TI  - 1991 Federal Nursing Service Award recipient. The effect of increased atmospheric
      pressure on glucose reagent strip accuracy.
AB  - Hyperbaric oxygen (HBO) is currently being used throughout the world as an
      adjunctive therapy for non-healing diabetic wounds. Anecdotal accounts of
      diabetic patients experiencing hypoglycemic reactions with HBO necessitated
      glucose testing by fingerstick during treatment dives to 2.4 atmospheres
      absolute. This study looked at four glucose testing methods and the accuracy of
      their readings using high and low control solutions at both sea level and at
      depth. A one-way analysis of variance showed significant differences with all of
      the high and 75% of the low control solutions when comparing sea level readings
      to depth readings. The significance varied between reaction rate and end point
      reading methods, with the reaction rate technology performing better.

PMID- 1620375
TI  - 1991 New York-Tidewater Chapters History of Military Medicine Essay Award
      recipient. A snapshot of an army nurse leader in the great war.

PMID- 1620374
TI  - 1991 Mary J. Nielubowicz Award recipient. The nursing diagnosis: decreased
      cardiac output--a clinical diagnosis validation study.

PMID- 1620376
TI  - Health service support in Operations Desert Shield and Desert Storm.
AB  - Operations Desert Shield and Desert Storm have brought into focus a number of
      difficulties with the medical support of U.S. Army tactical forces. These
      difficulties include inadequate preparation of Medical Corps officers for
      command, inadequate medical training of field medical unit personnel, and
      problems utilizing available equipment to support Operation Desert Storm tactical
      operations. This paper will discuss these difficulties, potential solutions for
      these difficulties, and some unresolved issues created by or despite these
      potential solutions.

PMID- 1620377
TI  - Development of an extracorporeal liver support system: initial results.
AB  - A pilot study was undertaken to determine the feasibility of extracorporeal
      normothermic perfusion of the porcine liver. Seven donor hepatectomies were
      performed in small 10 kg pigs and the livers were placed in a perfusion cassette
      of the author's design. Four perfusions were technical failures. Three successful
      perfusions had several factors in common: hepatic artery inflow roller pump,
      prompt "pinking up" of the perfused liver, a centrifugal vena cava outflow pump
      with partial diversion of the outflow into the portal vein with the remaining
      outflow returned to the anesthetized animal, and production of bile during the
      perfusion experiment. Successful perfusions lasted 50, 65, and 90 minutes.

PMID- 1620378
TI  - Diagnostic strategy for thalassemias and other hemoglobinopathies: a program
      applied to the Hellenic Army recruits.
AB  - A program for the detection of thalassemias and other hemoglobinopathies in high
      risk populations is described. This program, based on two screening tests, was
      applied to the Hellenic Army recruits and was found to work well. Red cell one
      point osmotic fragility was used for the detection of thalassemic samples and
      hemoglobin electrophoresis for screening of other hemoglobinopathies. Samples
      with decreased red cell osmotic fragility and/or abnormal electrophoretic pattern
      were submitted for further detailed investigation. Following this program, 64,814
      recruits, representing 0.651% of the total Greek population and 9.917% of the 20
      year-old Greek male population, were tested. beta-Thalassemia was found with an
      average incidence of 5.476% and alpha-Thalassemia with an incidence of 0.201%.
      Hemoglobinopathy Lepore was detected in 51 samples (0.079%) and hemoglobinopathy
      S in 352 samples (0.543%).

PMID- 1620379
TI  - Ability of the Army Circumference Method to detect changes in subcutaneous fat
      over a 9-week period.
AB  - The Army Circumference Method (ACM), used to estimate percent body fat for
      soldiers, has been shown to have questionable validity as applied to women. This
      study's primary purpose was to examine the ability of this method to detect
      changes in subcutaneous fat over a 9-week period with men (N = 55) and women (N =
      51) enrolled in a weight management program. Changes in percent body fat, based
      on the ACM, were correlated with the corresponding ones from the Jackson/Pollock
      skinfold method. Results indicated that the male ACM (r2 = 0.548) could more
      satisfactorily detect changes in subcutaneous fat than the female ACM (r2 =
      0.135).

PMID- 1620380
TI  - Fat distribution: its physiological significance, health implications, and its
      adaptation to exercise training.
AB  - Recently, fat distribution has become of clinical interest in assessing one's
      risk for coronary heart disease (CHD). Investigations have shown stronger
      relationships between abdominal, or central adiposity, and various well known
      risk factors for CHD, than peripheral and/or total adiposity. The simple waist-to
      hip ratio, shown to be a valid index of such fat distribution, should be
      considered for use by professionals in military medicine in assessing one's risk
      for relevant diseases. Consideration must also be made of the role of exercise as
      an intervention in improving one's fat distribution profile.

PMID- 1620381
TI  - Battle fatigue intervention: a vital role for nursing.
AB  - From both a strategic military point of view and in terms of the potential for
      long-term psychiatric disability, the impact of battle fatigue is extremely
      significant. Using the basic management principles of Brevity, Immediacy,
      Centrality, Expectancy, Proximity, and Simplicity, all members of the health team
      can provide successful intervention, returning as many as 80% of battle fatigue
      casualties to combat. These intervention techniques can be mastered by members of
      all specialties, not just mental health providers. With its health education
      mission, professional nursing has the distinct opportunity to take a leading role
      in educating, not just the medics and corpsmen who will most likely be the first
      to encounter battle fatigue casualties, but the line community as well. It is the
      line commanders who can institute preventive measures to minimize the risk of
      battle fatigue as well as recognize early signs and initiate intervention. This
      paper examines the many aspects of battle fatigue from contributing factors to
      management principles to prevention to assist professional nurses in
      understanding and carrying out their role.

PMID- 1620382
TI  - The cosleeping habits of military children.
AB  - Cosleeping is a topic frequently of concern to parents; however, little objective
      evidence exists to support the historical prohibition against children sleeping
      in the same bed with their parents. Surveys from the parents of 86 children in
      the clinics of pediatrics and child psychiatry were analyzed to describe patterns
      of cosleeping in a group of military dependents aged 2 to 13 years. Shown is a
      significant increase in cosleeping with father absence and that cosleeping is
      less frequent in the psychiatric subpopulation.

PMID- 1620383
TI  - Impact of dental sick call on combat effectiveness: the Dental Fitness Class 3
      soldier.
AB  - Dental sick call can have a significant impact on combat effectiveness, a loss of
      up to 18,720 man days per division per year. This study identified two target
      populations that interceptive dental treatment could best be directed toward.
      They are the E-1 to E-3 pay grades and soldiers in combat arms units. This study
      also offers dental resources needed to treat various target populations.

PMID- 1620384
TI  - Predictability of the individual outcome of a physical training program of an
      Army Special Forces Unit.
AB  - In a search for parameters that could predict the chances of success in a 3-month
      basic training program of a Special Forces unit, 293 conscripts were studied
      before the start of the training period. Physical activities, smoking habits, and
      dietary and drinking habits were evaluated by questionnaire. Anthropometric
      values were noted. A blood sample was taken for determination of serum
      cholesterol, high-density lipoprotein (HDL)-cholesterol and gamma
      glutamyltranspeptidase (GGT). Physical capacity was assessed by bicycle
      ergometry. Sixty-five trainees were discontinued from the program for
      intercurrent diseases or trauma, 132 went successfully through the whole program
      (group S), and 96 trainees failed (group F). More candidates of group S stated
      that they participated in sports (p less than 0.01) and fewer smoked (p less than
      0.01) than in group F. Trainees of group F had a higher consumption of spirits (p
      less than 0.05) than trainees of group S. There was no difference between the two
      groups in weight, percentage body fat, physical capacity, total serum
      cholesterol, and GGT values. HDL-cholesterol was higher in group S compared to
      group F (p less than 0.01). Stepwise discriminant analysis applied to
      anthropometric, biochemical, and cycloergometric data indicated HDL-cholesterol,
      height, resting heart rate, heart frequency at maximal exercise, and serum
      cholesterol as significant discriminating variables (p less than 0.001), giving
      only a 63% chance of correctly classifying the candidates.

PMID- 1620385
TI  - Effects of heat-exercise stress, NBC clothing, and pyridostigmine treatment on
      psychomotor and subjective measures of performance.
AB  - This study investigated the effects of pyridostigmine pretreatment, NBC
      protective gear, and heat-exercise exposure on psychomotor performance and
      subjective sensations in eight healthy male volunteers. Exercise in heat enhanced
      performance of vertical addition (+7.3%, p less than 0.001) but prolonged the
      reaction time (+4.4%, p less than 0.01). The effects of pyridostigmine,
      protective gear, and the interactions between the various stressors were not
      significant. Cognitive performance was not dependent on body core temperature.
      Multiple complaints of subjective discomfort arose from wearing the protective
      garment. The results suggest the existence of a significant subjective discomfort
      but an absence of major cognitive decrements in a multiple-stresses state of
      chemical warfare alertness.

PMID- 1620386
TI  - Attendance and referral patterns in a health promotion program for soldiers.
AB  - We studied referral patterns among 505 active duty Army participants in a heath
      promotion program at Fort Lewis, Washington. Over one-third (35.6%) were referred
      to health care providers for confirmation of cholesterol or blood pressure
      screening results. Fifty-two (10.3%) had elevated blood pressure screening
      measurements, of whom 30% had been previously diagnosed as hypertensive. One
      hundred forty-six had cholesterol levels greater than or equal to 200 mg/dl,
      22.8% of whom were already aware of hypercholesterolemia. Referral for follow-up
      was not associated with race, sex, or rank after controlling for age. Screening
      resulted in a large number of referrals for previously unrecognized
      abnormalities.

PMID- 1620387
TI  - Who should command? The debate continues.

PMID- 1620388
TI  - Who should command? The debate continues.

PMID- 1620389
TI  - Who should command? The debate continues.

PMID- 1620390
TI  - Youth attempted suicide.

PMID- 1620391
TI  - A brief survey of chemical defense, crew rest, and heat stress/physical training
      issues related to Operation Desert Storm.
AB  - A brief questionnaire was administered to 148 soldiers, over two-thirds of whom
      were aviators, at the conclusion of Desert Storm. Questions were asked about
      chemical defense, work/rest schedules, an aspect of pharmacological support, and
      heat stress/physical training during Operations Desert Shield and Desert Storm.
      Follow-up face-to-face interviews also were conducted with some respondents. Some
      of the most noteworthy findings concerned (1) training issues and side effects
      related to pyridostigmine bromide, (2) problems with chemical defense clothing,
      (3) suggestions for improving crew rest, and (4) facts about the ways in which
      heat-related difficulties were minimized.

PMID- 1620392
TI  - A new Streptococcus group A M-29 variant isolated during a suspected common
      source epidemic.
AB  - In the summer of 1988, a large epidemic of acute pharyngitis occurred in an
      Israeli military base. The clinical features were those of acute pharyngitis. The
      epidemic curve was characteristic of a common-source outbreak, possibly food
      borne. Throat swabs from a sample of cases were positive for group A
      streptococci. Nine isolates from the epidemic were further evaluated at the local
      reference laboratory and serotyping showed that all were of the same strain with
      a distinct M protein that is a hitherto undescribed variant of M-29. We discuss
      the significance of unusual strains of beta-hemolytic Streptococcus appearing in
      food-borne outbreaks.

PMID- 1620393
TI  - Joint task force "forward care" multicomponent health service support for an Army
      Reserve separate infantry brigade (mechanized)--Part III.
AB  - At the conclusion of 4 years' careful study of the health services support of a
      separate infantry brigade (mechanized) during the unit's annual training periods,
      the authors report on the effectiveness of a support team consisting of Army
      Reserve medical elements, an Active Army field unit, and a Public Health Service
      Clearing/Staging unit joining forces in a field environment to provide real world
      medical care to the same unit in a follow-on annual training period. The emphasis
      of the team created was on validating the forward care concept of field medical
      support. The result of this effort was "state of the art" medical service to the
      troops in the most forward areas, and a savings of 0.66 training days per soldier
      out of 10 days possible field training time. The cross-training of joint elements
      was enhanced by providing hands-on treatment of soldiers in a tactical
      environment, training that cannot be adequately replaced by simulated training.

PMID- 1620394
TI  - The utilization of medical and nonmedical specialties in the assessment of child
      abuse in the military community.
AB  - The Family Advocacy Program is a Department of Defense-mandated program that is
      administered individually by the branches of the U.S. Armed Forces. Factors were
      sought that may influence the ultimate disposition of a suspected abuse case on a
      given base. Navy Child Abuse Subcommittees were exclusively chaired by
      pediatricians, while the Army and the Air Force used social workers and
      psychologists. The Army and Air Force used the same medical specialists to run
      the larger Family Advocacy Programs, while the Navy used non-medical active duty
      officers. Base authorities made the final judgment to implement a treatment plan
      more frequently at Navy and Army commands. The implications of overutilization of
      medical specialists and increased legal liability of non-medical personnel are
      discussed.

PMID- 1620395
TI  - Phases of dental fear for four treatment procedures among military personnel.
AB  - Dental fear is a significant problem in the delivery of dental care. This study
      examined the phases of dental fear in 488 military conscripts scheduled to
      receive four categories of dental treatment for the first time. Results showed
      that the level of fear increased gradually from the day before treatment and
      peaked while receiving it. A significant reduction occurred after completing the
      treatment. Among the different types of procedures, tooth extraction elicited the
      highest degree of fear, while having the teeth cleaned registered the lowest.
      Military servicemen showed a pattern of dental fear similar to those other
      population groups.

PMID- 1620396
TI  - Civil unrest and ocular trauma.
AB  - The incidence and causes of ocular trauma among Israeli troops serving in the
      West Bank and Gaza between 1987 and 1989 was investigated. Of the 985 soldiers
      who were reported injured, 11.3% (111) were reported to have suffered from
      injuries to the eye. Although most of the soldiers were supplied with some kind
      of protective gear, only 27% reported that they received eye protection; none
      used this protection at the time of injury. Fifty-seven percent of the injuries
      were caused by stones and 38% by flying glass; 14.6% of soldiers suffered
      bilateral eye injuries. Only 12.1% of those injured wore corrective lenses.
      Although only 5% were originally reported to have suffered moderate to severe
      injuries, 38% complained of residual vision impairment. Better eye protection and
      enforcement of orders to use such gear would reduce the number and severity of
      ocular injuries.

PMID- 1620397
TI  - A mass casualty while in garrison during Operation Desert Storm.
AB  - In the theater of operations, rear echelon hospitals by doctrine receive patients
      who have been stabilized by forward hospitals. Occasionally, mass casualties will
      occur in the rear area, but rarely from combat causes. This report documents a
      mass casualty occurring in garrison from an anti-tank weapon misfiring. All rear
      echelon hospitals, regardless of their mission, must be prepared for the acute
      care of combat mass casualties.

PMID- 1620398
TI  - Anatomy of a contract.
AB  - Medical planners are constantly searching for new initiatives to solve the health
      care provider shortage. One of the most widely used methods to meet this need is
      contracting. This article focuses on the essential steps necessary to develop a
      successful contract using the Direct Health Care Provider Program. It also
      outlines the differences between personal services and non-personal services
      contracts.

PMID- 1620399
TI  - Pharmacoepidemiology and military medical automation: opportunity for excellence.
AB  - Fielding of the Composite Health Care System (CHCS) brings an unparalleled
      opportunity for medical research. This sophisticated automated medical record
      system promises pharmacoepidemiologic research of a quality and quantity never
      before possible. Pharmacoepidemiology provides answers about the validity of
      beneficial and adverse drug events and aids in individualizing drug therapy. When
      CHCS eventually encompasses an estimated 9.1 million patients at 166 military
      hospitals and 588 clinics around the world, it will provide a database capable of
      supporting sophisticated automated research. In addition to the unprecedented
      size of this resource, advantages of pharmacoepidemiology performed with the CHCS
      database include integration of inpatient and outpatient care records, the
      completeness of prescription and medical records, and the wide socioeconomic
      spectrum covered in a defined population. Limitations and potential biases of
      such a database include separate drug formularies at each medical treatment
      facility, only limited information about nonprescription drug use and single-dose
      drug orders in clinics, and the mobility of military service members and their
      families. Pharmacoepidemiology is a tool that will benefit individual members of
      the military family, as well as advancing the sciences of pharmacy and medicine.
      Using the CHCS database for this form of research is in the best tradition of
      military medical research.

PMID- 1620400
TI  - Reaction of Army families with grade school children to the Active Duty
      Dependents Dental Insurance Plan.
AB  - In March-May 1988, we collected data on enrollment of 1,445 Army families with
      grade school children in the Active Duty Dependents Dental Insurance Plan at two
      Army posts. We also surveyed their reactions to the plan. Results show that,
      although nearly two-thirds of families are enrolled in the plan, most consider
      the plan a loss of benefits and coverage inadequate. Queues and limited services
      at military clinics are primary reasons for joining; poor coverage of the dental
      insurance plan is the main reason for not. A majority of families are willing to
      pay more for expanded coverage.

PMID- 1620401
TI  - Peer review: determining what's best for patients by professional self
      assessment.
AB  - Many influences outside of physician control have begun to undermine traditional
      physician autonomy. Studies of physician practices reveal differences not based
      on patient case mix alone, but on variations in decisions and lack of intra
      physician accountability. Failure of physicians to be accountable to each other
      is related to inadequate due process understanding, fear of legal recriminations
      from peers, and a traditional long-standing history of individuality and
      accountability. The malpractice crisis and the advent of a National Practitioner
      Data Bank of physicians whose privileges or licenses have been modified serves as
      an impetus to rebuild accountability into a new emphasis on peer review based on
      optimum patient-focused outcome. To get physician buy-in, a five-step process is
      described which is separate from professional review of privileges and is seen as
      collegial, educational, and patient focused.

PMID- 1620402
TI  - The National Practitioner Data Bank: an introduction.
AB  - The National Practitioner Data Bank, mandated by law, has created a great deal of
      anxiety in the medical community. The author describes the origin, development,
      and operation of the bank. Army implementation procedures emphasize safeguards
      for practitioners and are also felt to be fully consistent with patient
      protection. Potential problems and areas for further research are described.
      Linking practitioner entry to standard of care or setting a dollar cut-off for
      entries are two possible solutions.

PMID- 1620403
TI  - The Klippel-Feil syndrome: implications for Naval service.
AB  - The Klippel-Feil anomaly is usually discovered by serendipity on cervical spine X
      rays. Although it may encompass many vertebrae, the typical case is an isolated
      fusion of two vertebrae. Nearly 1% of the general population has this anomaly and
      its incidence in the Navy is likely similar. Increased susceptibility to spinal
      cord injury has been reported in individuals with the Klippel-Feil syndrome.
      Unusual stress on the head and neck inherent to various aspects of naval service
      place such persons at risk for debilitating or fatal injury. An algorithm for
      evaluating suspected Klippel-Feil syndrome is provided.

PMID- 1620404
TI  - Graphite tattoo: report of a case and differential diagnosis.
AB  - A case report underlining the necessity of the biopsy procedure for a pigmented
      lesion of unknown origin. A female patient was referred for evaluation of a
      pigmented lesion on the facial keratinized gingiva coronal to the free gingival
      margin above tooth No. 7. An excisional biopsy revealed a graphite tattoo. A
      discussion and differential diagnosis of pigmented lesions follows.

PMID- 1620405
TI  - Displaced stress fracture of the femoral shaft: a report of three cases.
AB  - Three cases of displaced stress fracture of the femoral shaft are reported. All
      patients were young conscripts. Before displacement, the patients had suffered
      from knee and distal femoral pains for 2-6 weeks. All fractures were located at
      the border of the middle and distal third of the femoral shaft and had a short
      oblique form. Plating was performed in two and intramedullary nailing in one
      case. A fast bony union into a good position was achieved in all cases.
      Scintigraphy is indicated for an early diagnosis, which enables conservative
      treatment and prevention of the fracture displacement.

PMID- 1620406
TI  - One medical center's journey into continuous quality improvement.

PMID- 1620407
TI  - [Catheterization of the pulmonary artery in 1,207 patients].
AB  - The pulmonary artery catheterization has been reviewed in 1207 patients submitted
      to cardiovascular surgery. The feasibility of the technique in skilled hands has
      been outlined and a routine and prophylactic use of pulmonary artery monitoring
      as a safe way to manage critically ill patients has been advocated.

PMID- 1620408
TI  - [Anesthesiology problems in the surgery of cervico-mediastinal goiter. Our
      clinical experience].
AB  - The Authors, after explaining the difficulties that an anaesthetist finds in
      cervical-mediastinum goitre surgery, report their own experience. Even if
      limited, it shows the full validity of a methodology of using a very efficacious
      drug for good cardiovascular stability. Moreover, we must take into account the
      constant attention the anaesthetist must pay in some essential moments of general
      anaesthesia such as intubation, patient position and monitoring.

PMID- 1620409
TI  - [Tetanus disease. Experience with 2 intensive treatments during 13 years].
AB  - The Authors present a retrospective analysis of 58 cases of tetanus hospitalized
      in two ICU in 13 years of activity. The mortality reported (39.7%) is comparable
      to other Authors or statistical analysis but it is better if correlated to
      patient age. Patients of the highest classes (III and IV classes of Edmonson e
      Flowers) had the highest mortality but no significant variation was seen between
      patients of the III and IV class. The most frequent cause of death has been
      cardiac arrhythmia. Cardiac arrhythmias happened in most cases in the first 15
      days of hospitalization. 37.9% of patients developed pneumonia: prolonged
      hospitalization (more than 15 days) and high classes of the disease have been the
      most important risk factors for Hospital-acquired pneumonia in tetanic patients.

PMID- 1620410
TI  - [Propofol, fentanyl, nitrous oxide: useful and current combination?].
AB  - The introduction of use of propofol in the anesthetists' pharmacopoeia has
      reinvigorated the research for a totally intravenous anaesthesia, for which the
      Authors propose a diagram. However, in experience related to the supplementary
      use of N2O, in virtue of its analgesic power, demonstrates yet another utility,
      permitting an easier anesthetical administration with minor consumption of
      intravenous drugs.

PMID- 1620411
TI  - [Propofol in gynecologic ambulatory minor surgery].
AB  - We have reported the results of 700 general anesthesia induced and maintained by
      Propofol in women who have undergone IVG operation. The anesthesia-method used
      has guaranteed an adequate level of anesthesia with the characteristics of a
      quick induction, non significant variations of the cardiovascular parameters, a
      quick recovery of consciousness, low incidence of side effects, the abolition of
      the azote-peroxide and the halogen-anesthetics, a quick discharge of the
      patients.

PMID- 1620412
TI  - [Sedation with continuously infused propofol in caudal block for elective
      pediatric surgery].
AB  - Twenty-nine patients aged between 2 months and 6 years, undergoing general
      surgery under regional analgesia (caudal block) combined with continuous infusion
      of propofol (3 mg/kg/h), were studied. During anesthesia the heart rate, the
      arterial pressure, the SaO2 and respiratory rate were recorded; the
      electrocardiogram was continuously displayed and all side-effects occurring
      during maintenance and recovery from anesthesia were noted. Satisfactory sedation
      without significant respiratory and cardiovascular depression and a rapid
      recovery, was observed. In conclusion, we feel that the use of combined caudal
      block and continuous infusion of propofol for paediatric surgery is rational.

PMID- 1620413
TI  - [Loco-regional analgesia with continuous peridural technique in labor. Evaluation
      of 4 years of experience].
AB  - The Authors report on the results of their experience using local-regional
      analgesia performed with the continuous peridural technique over four years of
      activity with 503 pregnant women. Protocols used over the years called for
      morphine-fentanyl association, but bupivacaine 0.25% plus fentanyl and
      bupivacaine 0.125% plus fentanyl mixtures were then employed. In order to
      evaluate the efficiency of this procedure, the following data were recorded for
      each patient undergoing the analgesia: duration of labor prior to the effect of
      the analgesia; time to reach complete dilatation from a 3 cm dilatation; the
      length of time of the expulsive phase; manifestation of side effects and
      complications; vacuum utilization. Furthermore, Apgar scores were taken for all
      newborn babies at 1st and 5th minutes. The data were then compared with those
      recorded for a group of women with the same obstetrical characteristics who were
      not treated with analgesia. The comparison showed that the length of time of the
      dilatation phase (from 3 to 10 cms) was significantly less in the group of
      treated patients, while the expulsive phase was basically similar in both groups,
      thus showing that labor mean time had significantly decreased in the group of
      patients treated with analgesia. The number of vacuum births was basically the
      same in both groups and comparable to the data available in the literature. These
      were practically no side effects or complications. In conclusion, our experience
      confirms the fact that this method is the most reliable in terms of safety,
      effectiveness and acceptability on the part of women compared to any other
      analgesic treatment employed during labor.

PMID- 1620414
TI  - [Oxycodone versus paracetamol in oral premedication in cholecystectomy].
AB  - This double-blind study was carried out at random on 2 groups of 10 women,
      comparable by age and weight, all having to undergo a cholecystectomy as a result
      of gall-bladder stones. Group A received 10 mg os of oxycodone, while group B
      received 1000 mg os of paracetamol. The level of sedation before the operation,
      post-operative pain, canalization and the side effect were recorded. The results
      showed that the group treated with oxycodone presented a greater degree of pre
      operative sedation. As far as the post-operative pain is concerned, no
      significant differences were seen between the two groups based on both what was
      expressed by the patients and what was reported by a visual analog. Furthermore,
      no significant differences were noted as far as the side effects and canalization
      are concerned.

PMID- 1620415
TI  - [Benzodiazepine and flumazenil in elective electric cardioversion].
AB  - The Authors report on the use of Flumazenil (Antagonist of the benzodiazepines in
      the CNS) in patients awakening from benzodiazepine induced necrosis for
      defibrillation. When used in these circumstances, the normal side effects of the
      narcosis (arrhythmia, rebound hypertensive convulsions, states of paradoxical
      anxiety) were almost completely absent. Furthermore, given the optimal quality of
      the rapid awakening, in about 5 minutes, the antagonistic qualities of the drug
      were confirmed making further development of the therapeutic uses of the
      benzodiazepines possible.

PMID- 1620416
TI  - [The use of systemic phosphocreatine in heart surgery].
AB  - Phosphocreatine (PC) has been widely used in cardiac surgery as a component of
      cardioplegic solutions because of its positive effects in preventing ischemic
      heart damage; we have researched the efficacy of PC in cardiac surgery when
      infused through the intravenous route before and after cardiac arrest. Two groups
      of patients who had undergone aortocoronary by-pass grafts were matched: group A
      (20 patients) did not receive any particular treatment; PC was administered
      intravenously to patients in group B after the induction of anaesthesia,
      immediately prior to cardiac arrest and after the release of aortic cross-clamp.
      To test the efficacy of the drug, the following parameters were evaluated: the
      recovery as the incidence of low cardiac output and/or need of inotropic drugs;
      dysrhythmias; electrocardiographic signs of myocardial ischemia or infarction;
      release of cardiac necrosis enzymes. Treated patients were found to have a better
      recovery, a lower incidence of dysrhythmias, an easier resumption of normal sinus
      rhythm with a lower number of electric defibrillations and a significantly lower
      release of cardiac enzymes. It can be therefore said that PC has a marked
      protective effect on myocardial anoxia in cardiac surgery, even when administered
      intravenously.

PMID- 1620417
TI  - [Comparative study of the effects of famotidine and omeprazole in the prevention
      of the aspiration of gastric contents syndrome in elective surgery].
AB  - This study compares the efficacy of omeprazole and famotidine in reducing gastric
      volume and activity. Sixty patients scheduled to undergo elective orthopaedic
      surgery were randomly allocated to receive famotidine 40 mg or omeprazole 40 mg
      at 22 hours, the night before surgery, or omeprazole at 22 hours the night before
      and 20 mg at 6 hours on the morning of surgery, 20 patients served as control and
      received no drugs. Intragastric volume and pH were measured immediately after
      induction anaesthesia and after surgery. Either drug reduces gastric volume.
      Famotidine reduces at maximum volume. Omeprazole reduces at maximum pH.
      Omeprazole 40 mg in some cases doesn't sufficiently reduced pH, because the
      interval from drug administration to induction of anaesthesia is too long. The
      comparably high volume of gastric content after omeprazole in single or double
      dose doesn't represent a risk.

PMID- 1620418
TI  - [Diagnostic usefulness of BAEPs. A clinical case].
AB  - We report the clinical case of a patient operated for a right extracerebral
      haematoma. In the immediate post-operative period, although no clinical signs
      were present, a BAEP examination (showing the lack of the V) warned of a
      pathological condition which was ascertained by CT. A second haematoma was
      observed, contralateral to the first, and immediately removed. In this case,
      therapy was based on the neuroelectrophysiological findings.

PMID- 1620419
TI  - [Isolated postoperative myoglobinuria as the only sign of malignant hyperthermia.
      Value of spinal anesthesia with bupivacaine in a posterior surgical
      intervention].
AB  - The Authors report a case of biopsy-proven malignant hyperthermia in a pediatric
      patient who underwent general anesthesia with halothane and succinylcholine for
      foot surgery, in whom the presenting symptom was isolated postoperative
      myoglobinuria. The above syndrome, in the absence of a positive family history,
      may present itself with a set of minor and atypical symptoms, thus being often
      underestimate. The need for further investigating all the cases of postoperative
      myoglobinuria is stressed by the Authors, which also consider muscular biopsy for
      inclusion among routine investigations. In the case reported here, six months
      later, a new surgical operation was done safely with spinal anesthesia using
      hyperbaric bupivacaine.

PMID- 1620420
TI  - [The use of propofol in a female patient predisposed to malignant hyperthermia
      (central core disease)].
AB  - In this paper the Authors describe the anesthetic techniques used for abdominal
      surgery in a 19 year-old woman with "central-core disease". This uncommon
      congenital neuromuscular disorder is frequently related to malignant hyperthermia
      syndrome. Total intravenous anesthesia with the association propofol-fentanyl was
      well tolerated by the patient. There was no evidence of malignant hyperthermia
      during the procedure and cardiovascular stability was excellent.

PMID- 1620421
TI  - [The use of intravenous nifedipine for the treatment of severe hypertensive
      crisis. A clinical case].
AB  - Nifedipine is a calcium channel antagonist. Hypertensive crisis during
      anaesthesia may be elicited during the induction period or by the surgical
      manipulating of intrapelvic viscera. We report a case in which nifedipine given
      intravenously (currently an investigational dosage form) was effective in
      controlling a severe hypertensive crisis at dose averaging 3.4 mcg/kg/min
      initially and half as much for maintenance. Arterial pressure was controlled as
      quickly as with nitroprusside, but with no change in heart rate or cardiac output
      and without other untoward effects during anaesthesia.

PMID- 1620423
TI  - [7th Italian-French Meeting of Neuroanesthesia and Resuscitation. Positano, May
      18-20, 1992].

PMID- 1620422
TI  - [Acute pulmonary edema after intravenous naloxone].
AB  - We present one case of pulmonary edema following intravenous naloxone
      administration for antagonism of residual narcotic drugs. The patient was a young
      man without cardiopulmonary or neurologic disease. Pathogenesis results from a
      massive sympathetic discharge which leads to neurogenic pulmonary edema.

PMID- 1620424
TI  - [Peri-operative complications of intravascular treatment of cerebral aneurysms
      and extra- and intracranial vascular malformations].

PMID- 1620425
TI  - [Intra- and postoperative anesthesiologic management in cerebral arteriovenous
      malformations].
AB  - The authors analyze the anesthetic management of 59 cases of "large"
      arteriovenous malformation (more than 20 cm3), all completely removed by
      microsurgical technique. The discussion is focused on immediate pre-operative,
      intra-operative and post-operative pharmacological treatments in order to reduce
      the hemodynamic effects in the surrounding brain after excision of angiomas.

PMID- 1620426
TI  - [Risk of postoperative epilepsy in acute surgery of cerebral aneurysms].
AB  - Forty-nine patients operated during an early clipping phase of cerebral aneurysm
      were reviewed; none had an associated ventricular flooding and/or
      intraparenchymal hematoma. Starting from the day of operation 37 patients were
      treated with anticonvulsant drugs using methods and dosages where were unlikely
      to guarantee efficacious cover. Forty-two patients made a satisfactory recovery,
      5 patients died and 2 had severe neurological sequelae; 2 patients (4.4%) had
      early seizures during the first week after operation. In view of the inadequate
      cover of the anticonvulsant drugs and the homogeneous clinical characteristics of
      patients included in the study, the low number of attacks suggests an overall re
      evaluation of anticonvulsant treatment and the need to select patients with a
      higher risk of an epileptic attack.

PMID- 1620428
TI  - [Intracranial meningioma in patients over 65 years old. Risk factors and
      complications in a consecutive series of 124 cases].

PMID- 1620427
TI  - [Complications during preoperative embolization in intracranial meningioma].
AB  - We report a rare case of meningioma of the parieto-occipital convexity
      accompanied by hemorrhage in the tumor and in the subdural space that occurred
      while pre-operative embolization was being applied. The patient, a 48 year old
      woman, presented sudden headache and, in a few minutes, comatose status and
      decerebrate rigidity. A quick diagnosis with CT-scan of acute intratumoral and
      subdural hemorrhage and a rapid intervention on the patient led to complete
      recovery. The possible reason for the hemorrhage is the sudden change in blood
      pressure of pathologic small vessels triggered by embolization.

PMID- 1620429
TI  - [Total intravenous anesthesia in neurosurgical patients].
AB  - The authors present an anesthesiologic technique, consisting of the use of
      propofol + fentanyl + O2. The main advantages, described in 82 neurosurgically
      treated patients, are the following: moderate decrease both of ICP and MAP,
      absence of frequency, modifications rapid recovery both of consciousness and of
      motility, which allows a preliminary valuation of neurological status.

PMID- 1620430
TI  - [Randomized study on the use of propofol for anesthesia in intracranial tumors.
      Comparison with balanced anesthesia].
AB  - There is currently no anesthesiological technique which enables volume, cerebral
      blood flow and spinal fluid pressure to be kept constant. The aim of the present
      study was to compare two techniques of anesthesia in patients with cerebral
      tumours: one of a balanced type (AB) and the other of a continuous ev type (AEC)
      using propofol in order to assess which guaranteed the greatest cerebral
      protection. The results of the study have shown that the use of propofol may
      represent a useful alternative in intracranial tumour surgery since changes in
      systolic pressure and heart rate observed during AEC anesthesia were
      statistically lower in comparison to AB anesthesia. No statistically significant
      differences were observed in relation to changes in diastolic pressure, PVC,
      ApCO2 and the incidence of bleeding or cerebral edema. The quality of awakening
      was better in patients in the AEC group in terms of renewed breathing and
      spontaneous motility, verbal response and space-time orientation.

PMID- 1620431
TI  - [Anesthesia for thermocoagulation of the trigeminal nerve. Use of propofol].
AB  - Propofol has been used in anesthesia for trigeminal nerve thermocoagulation. 9
      patients were studied. This anesthetic agent allows speedy arousal of good enough
      quality for patient questioning. No cardiovascular or respiratory complications
      were noted.

PMID- 1620433
TI  - [Trans-sphenoid surgery of hypophyseal adenoma. Postoperative water-electrolyte
      complications].

PMID- 1620432
TI  - [Tracheal intubation: increase of arterial pressure and cerebral blood flow
      velocity. Effect of thiopentone and propofol].
AB  - Induction of anaesthesia in intracranial surgery, especially for vascular
      diseases, must minimize haemodynamic changes: blood pressure and cerebral blood
      flow must not be increased to a high degree. Our work compares increases in blood
      pressure and in the speed of cerebral blood flow during endotracheal intubation
      in two groups of patients, who received propofol or thiopentone for the induction
      of anaesthesia. We studied 30 patients, without intracranial diseases, who
      underwent lumbar slipped disk surgery. Half of the patients received thiopentone
      and curare before intubation and the other half propofol and curare. Increase in
      blood pressure after intubation was lower with propofol than with thiopentone in
      a statistically significant way. Also the increase in the speed of cerebral blood
      flow, measured with doppler technique, was lower when induction with propofol was
      used, though not statistically relevant.

PMID- 1620434
TI  - [Pansinusitis of the face caused by Streptococcus milleri with cerebral
      thrombophlebitis after naso-sphenoid surgery of the pituitary gland].
AB  - The authors report a patient operated on trans-nasosphenoidally for a pituitary
      adenoma (Cushing's disease) in whom a severe infection occurred with cavernous
      thrombophlebitis responsible for neurological complications.

PMID- 1620435
TI  - [Postoperative complications of transcranial surgery for hypophyseal adenomas].

PMID- 1620436
TI  - [Urapidil: hypotension induced in neuroanesthesia].
AB  - The authors report their experience on the use of urapidil in 31 patients,
      submitted to neurosurgical procedures. Urapidil, administered both in the
      inductive (0.7-1 mg/kg) and in preoperative phases (0.6-0.8 mg/kg/h), produced a
      MAP decrease of about 25% without significant variations in cardiac frequency or
      of other monitored parameters.

PMID- 1620437
TI  - [Labetalol in the prophylaxis of postoperative arterial hypertension in surgery
      of the posterior cranial fossa].
AB  - Increased catecholamines are one of the factors responsible for post-operative
      arterial hypertension. In order to prevent this severe complication labetalol, an
      alpha and beta blocking drug, was infused following the closure of the dura mater
      in half of the patients studied. For two hours after surgery blood pressure
      values in treated patients were constantly lower than those recorded in the
      control group, thus confirming the efficacy of this drug in preventing the
      cardiocirculatory effects of increased adrenalin and noradrenalin.

PMID- 1620438
TI  - [Early epilepsy in surgery of extra-axial supratentorial neoplasms].
AB  - A retrospective study was performed to evaluate the incidence of seizure and
      anticonvulsant prophylaxis in 138 patients operated from september 1987 to august
      1989 for extra-axial supratentorial tumors. 15 patients (10.9%) developed
      seizures in the early post-operative period. We have considered the importance of
      histological type and side of lesions, a previous history of epilepsy and the pre
      and intraoperative prophylaxis. We can say that there is a statistical
      significance between sellar and middle cranial fossa tumors and the frequency of
      post-operative epilepsy and that anticonvulsant prophylaxis can reduce post
      operative seizure. There is no statistical significance between the previous
      history of epilepsy the type of anesthesia and post-operative seizure.

PMID- 1620439
TI  - [Postoperative complications in neurosurgery].
AB  - Hemorrhage, ischemia and ischemic edema are among the complications which may
      occur following neurosurgery and they represent the most frequent cause of
      neurological deterioration. The mechanisms predisposing vascular complications
      (hemorrhage, ischemia) are described and discussed in relation to systemic
      alterations associated with surgery and anesthesia. In addition, the
      physiopathology of these complications is discussed in the various pathologies:
      cancer, vascular malformations, trauma and the intra-operative diagnostic
      possibilities which prevent their onset.

PMID- 1620440
TI  - [Postoperative epilepsy. Experience with 300 cases of cerebral neoplasms].

PMID- 1620441
TI  - [Postoperative epilepsy].

PMID- 1620442
TI  - [Psychic disorders. An unknown complication of surgery of the posterior cranial
      fossa].
AB  - Psychic trouble is not generally recognised as a possible complication of
      posterior fossa surgery. Reviewing a series of 63 pediatric patients operated on
      for posterior fossa intraxial tumors, the Authors found 21 cases of psychic
      troubles in the post-operative period. The incidence was higher in: a)
      medulloblastoma; b) rostral vermis location; c) supracerebellar infratentorial
      and transvermian approach. The neuropathophysiological basis of the phenomenon is
      discussed.

PMID- 1620443
TI  - [Increasing the pressure of cerebral perfusion to control intracranial pressure].
AB  - ICP control can be achieved removing the surgical masses and manipulating the
      intracranial compartments; in the intensive care setting that can be attempted
      using CSF withdrawal or changing the cerebrovascular resistances, the
      intracranial blood content and the cerebral water content. The reduction of the
      ICP and the maintenance of a good cerebral perfusion pressure are the main aims
      of the therapy; when any standard treatment fails to control ICP a further
      attempt to preserve cerebral perfusion should be done by increasing the mean
      arterial pressure. In 10 patients with severe brain damage (GCS on admission
      ranging from 3 to 7, mean 5) from subarachnoid hemorrhage (3 cases) or trauma an
      infusion of dopamine (25-150 mg/h) and noradrenaline (0.4-2.4 mg/h) was started
      in case of intractable ICP. The ICP was defined intractable when the pressure was
      more than 40 mmHg for more than 5 m' after maximum therapy, as evaluated using
      the Therapy Intensity Level score. The infusion obtained a raise of the MAP of
      approximately 25% and a variable response on ICP. In 9 cases ICP dropped, in one
      case, instead, the ICP increased together with the arterial pressure. The
      reduction of ICP was 20-30%, with a good improvement of the CPP. The patients
      with a good response survived, the only patient without control of the ICP died.
      The physiopathologic mechanisms of this treatment are discussed; the most
      suitable explanation is indicated in an autoregulatory process. The infusion of
      cathecolamines can be harmful, and the patients eligible for this treatment must
      be carefully chosen. Notwithstanding this approach deserves further studies for
      the cases of intractable ICP.

PMID- 1620444
TI  - [The risk of pulmonary embolism in neurosurgery].
AB  - Pulmonary embolism (PE) is a frequent necroscopic finding in neurosurgical
      patients and this contrasts with the difficult diagnosis of it when the patient
      is still alive. Such a lack of diagnosis has promoted numerous studies into deep
      vein thrombosis (DVT) which is, in most cases, the cause of pulmonary embolism.
      However, a prophylaxis of DVT cannot be indiscriminately carried out in
      neurosurgical patients because it is not without potential risks. For this reason
      we considered it useful to investigate whether among the risk factors for DVT
      there were any particularly responsible for the development of PE in
      neurosurgical patients. Our case study was carried out retrospectively on 144
      patients hospitalised in the Neurosurgical Institute of Pisa University suspected
      of PE. In 88 of the cases the suspicion had been confirmed by perfusion lung
      scanning; in 56, on the other hand, it had been excluded. These two groups of
      patients resulted homogeneous for sex, age, blood group, and for the presence of
      any risk factors of cardiovascular diseases. An important difference between the
      two groups was the pathology which had motivated their hospitalisation; in fact,
      50% of the patients with PE were affected by neoplastic pathologies of the CNS,
      against 28% of the others. The anamenestic evidence of previous neoplastic
      pathology in different sites of the CNS was much more frequent in patients who
      had developed PE. As far as the other risk factors we examined are concerned, it
      resulted that only 12.5% of the patients with PE had presented clinical signs or
      symptoms of phlebitis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620445
TI  - [Hypertensive pneumocephalus, postoperative complication of chronic subdural
      hematomas].
AB  - The authors report 3 cases of subdural tension pneumocephalus developed after
      surgery for subdural chronic hematomas. The mechanisms involved in the
      pathogenesis of this complication are discussed; the importance of the computed
      tomography in the assessment of the subdural tension pneumocephalus is stressed.
      Surgery is always indicated in cases of increased tension of the air collection
      and generally resolves the neurological deficits.

PMID- 1620446
TI  - [Neuroanesthesia during carotid thromboendarterectomy interventions].
AB  - The paper describes two techniques of anesthesia used during carotid
      thromboendarteriectomy surgery. The first technique utilises a mixture of O2-N2O,
      isofluorane and fentanyl as analgesic; the halogenate compound is not
      administered during carotis clamping and fentanyl is used for maintenance. The
      second technique is predominantly intravenous and utilises differing doses of
      propofol during the entire operation with fentanyl as an analgesic. The two
      techniques are comparable in terms of management and efficacy; the use of ECG
      monitoring is vital to identify possible intraoperative cerebral ischemic
      phenomena.

PMID- 1620447
TI  - [Operative posture in pediatric neurosurgery].
AB  - Proper placement of the pediatric neurosurgical patient is strictly correlated to
      age (newborn, toddler, infant, juvenile). Each age group is reviewed on the basis
      of different morphological and pathophysiological aspects of typical
      neurosurgical positions (prone, supine, sitting, lateral).

PMID- 1620448
TI  - [Complications of the surgical treatment of traumatic lesions of the cervical
      spine].

PMID- 1620449
TI  - [Prevention of postoperative complications in vertebro-spinal cord pathology].
AB  - In 352 patients, affected by vertebral-medullary pathology, we evaluated the role
      played by the prevention or by the treatment of postoperative complications. We
      also evaluated their influence on the clinical outcome and neurological recovery.
      In every case we recorded a scrupulous post-operative neurological monitoring of
      the eventual complications, on the basis of the type, gravity and duration. From
      our results it appears that the complications, mostly secondary to infectious
      diseases, have an influence on the clinical and neurological recovery. We
      highlight the importance of an adequate nutritive management to prevent the
      complications, specifically those secondary to infectious diseases and cutaneous
      lesions.

PMID- 1620450
TI  - [Postoperative lumbar discitis].
AB  - The authors report our experience on 19 cases of discitis developed after
      operations for herniated lumbar disc. Because of the negativity of the
      neuroradiological studies in the acute stage, the recognition of the typical
      syndrome (severe back pain, spasm of the paravertebral lumbar muscles, limited
      spinal motility, fever) beginning 3-30 days post-operatively and the study of
      some laboratory tests (elevated Erythrocyte sedimentation rate (ESR) and midly to
      moderately elevated white blood cells (WBC) are very important for diagnosis. The
      first radiographic findings (disc space narrowing, ecc.) are detectable only 4 to
      6 weeks after the first symptoms; other X-ray findings are not seen post
      operatively before 6 months-2 years. The CT-scan is diagnostic of discitis only
      when the following three specific signs are present: a) anterior paravertebral
      soft tissue swelling with obliteration of paravertebral fat planes; b)
      fragmentation or erosion of vertebral end plates; c) paravertebral fluid
      collection (abscess). In our experience a period of immobilization of the spine
      with a plaster body jackets and the use of adequate antibiotic therapy are the
      more effective treatment. Undoubtedly the discits are the results of an infection
      that must be prevented adhering to the aseptic principles not only during surgery
      but also during the procedures performed in the radiology suite.

PMID- 1620451
TI  - [Cranial trauma and prehospital care. Evaluation of the effectiveness of early
      treatment].
AB  - The role of pre-hospital care is still to be stressed especially in case of head
      injuries. We compared two groups of head injuries (total 50 patients, 38
      politrauma) transported by traditional ambulance (28 patients) or by EMS
      helicopter (22). The two populations had similar values of the considered indices
      (TS, ISS, GCS, TRISS). They significantly were different only for the "free
      therapy time". Patients transported by ambulance showed an higher incidence (p
      less than 0.01) of acute complications (like hemorrhage and hypovolemic shock)
      despite the same gravity score indices. The index applied for the follow-up
      valuation, does not show any difference in the two groups. This may be due to the
      unreliability of the used scores if they are applied without any correlation with
      the quality of care during the transport.

PMID- 1620452
TI  - [Severe head trauma in the pediatric patient. Our experience].
AB  - A retrospective study in a pediatric population of 324 severe head trauma
      patients hospitalized at Santobone Children's Hospital has been carried out;
      diagnostic investigations and therapeutic aspects are stressed on the baw of
      pathophysiological features of such patients.

PMID- 1620453
TI  - [Continuous monitoring of O2 saturation in cerebral blood. A guide for the
      nursing of brain trauma patients in coma].
AB  - Manual ventilation is frequently performed by nurses to control increases in
      intracranial pressure (ICP) or during physiotherapy in head injured comatose
      patients. The effects of manual ventilation (n = 251) on ICP, cerebral perfusion
      pressure (CPP) and EEG have been studied in 18 mechanically ventilated patients.
      A fall in ICP was easily obtained but a fall in arterial blood pressure was often
      present at the same time. Thus a reduction in CPP resulted in 36% of occasions.
      Prophylactic boluses of thiopental (n = 67) before noxious stimuli obtained a
      fall in ICP in 99% of occasions but resulted in a decrease in CPP in 46%. The
      fall in ICP, due to the decrease in cerebral blood flow (CBF) by hypocapnia or
      metabolic depression and/or arterial hypotension, may be beneficial in hyperaemic
      brains but may precipitate cerebral hypoxia in ischaemic lesions. Relevant
      information about cortical metabolism (CMR) may be obtained from EEG monitoring
      by Cerebral Function Monitor but, unfortunately, no data about CBF are clinically
      available. The Authors suggest that the continuous monitoring of jugular bulb
      oxygen saturation (SjO2) may offer a clinically useful index of CBF adequacy to
      CMR. Findings from a preliminary study in 5 patients demonstrate that a severe
      decrease in SjO2 has been frequently caused by manual ventilation, hypothetically
      related to severe cerebral ischemia. High levels of SjO2 have been induced by
      endotracheal suction and physiotherapy, probably related to severe hyperemia. As
      prevention of ischaemic and hyperaemic insults is a major goal of treatment, the
      A. suggest that these undesirable effects of nursing might be avoided if nurses
      could take advantage of continuous monitoring of SjO2.

PMID- 1620454
TI  - [Complications of trans-sphenoidal surgery of the sellar lesions].
AB  - Trans-sphenoidal surgery has a very low rate of complications despite a series of
      apparently negative anatomo-topographical factors. Complications may be either
      mechanical or functional, transitory or permanent. The most important
      complications are: hematoma of the focus, sub-arachnoid hemorrhage, empty sella,
      liquoral fistula, opto-chiasmatic lesions, arterial lesions, lesions of the
      cavernous sinus, parenchymal damage, nasal and paranasal mechanical lesions,
      insipid diabetes, hypopituitarism. The overall mortality rate is 0.4-1% and is
      always associated with predisposing factors, such as previous treatment,
      voluminous extrasellar growth, concomitant causes of disease; the most frequent
      causes of death are: hemorrhagic phenomena in the extrasellar portion of large
      size adenomas; vascular lesions involving the intracavernous carotid artery; and
      hypothalamic lesions. The frequency of major complications is in the region of
      2.3%. Predisposing factors are: volume, consistency, invasiveness, previous
      treatment, intratumoral necrotic-hemorrhagic phenomena, age. Surgery is only
      indicated for some of the above complications, including hematoma of the focus,
      acute postoperative empty sella, rhinoliquorrhea resistent to conservative
      treatment, excessive filling of the sellar cavity. All the other possible
      complications are results or functional alterations which must be treated
      medically, even if a specific therapy only exists for some (such as early
      hypotonic polyuria). The series of patients reported here refers to the period
      1978-1989 and accounts for a total of 259 trans-sphenoidal operations performed
      in 245 patients. Of the secondary operations, 6 were due to postoperative
      complications (hematoma of the focus in 2 cases, rhinoliquorrhea in 2 cases;
      empty sella and hemorrhagic infarction of a large suprasellar site in the 2
      remaining cases). There were 2 deaths related to direct mechanical complications
      (both caused by hemorrhagic infarction of large tumoural residues and the
      surrounding cerebral parenchyma). Complications which did not require re
      operating were observed in 11 further cases: 6 cases of persistent
      rhinoliquorrhea which required protracted spinal drainage; 2 cases of
      deterioration of previous visual deficits unrelated to either hematoma of the
      focus or empty sella but caused by trauma to optic structures, either directly or
      on a vascular basis; 3 cases of dyplopia due to oculomotory deficiency. In terms
      of hypophyseal function, the ex-novo onset of postoperative pan-hypopituitarism
      and insipid diabetes was only observed in one case.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1620455
TI  - [Infective complications of external ventricular shunts].
AB  - Since the sixties at our Department of Neurosurgery, we use an original method
      for external ventricular shunts. To verify the effectiveness for reduction of
      infections risks the Authors have retrospectively analyzed 95 patients: only 4
      cases of meningitis have been observed. The Authors consider the utility of the
      proper method and the importance of the duration of ventriculostomy placement.

PMID- 1620456
TI  - [Intravenous immunoglobulin in the prevention of infections in high-risk
      pediatric neurosurgery].
AB  - Sixty-four children undergoing "high risk" neurosurgery, were submitted in a
      comparative study performed to investigate the prophilactic effect of IgIv in
      reducing the risk of postoperative sepsis. Patients were divided in two groups
      that weren't different as to underlying disease, age and sex. 32 patients
      received IgIv 0.2 g/kg on day 0, day 2, day 5, day 12 and 32 placebo. IgIv
      reduced the number of postoperative respiratory and urinary infective events,
      thus resulting in a marked reduction of the therapeutic use of antibiotics. No
      side effects of administration of IgIv were observed.

PMID- 1620458
TI  - Malignant hyperthermia.

PMID- 1620457
TI  - [Cerebral edema: osmotic therapy in clinical practice].
AB  - Having described the therapeutic protocol to be followed in cases of cerebral
      edema, starting with aspecific measures (hyperventilation in a position of 30
      degrees, etc.) for slight cases and progressing to specific therapy (osmotherapy,
      barbiturates) for more severe cases, the paper focuses on osmotherapy and
      illustrates the theoretical principles on which it is based and its use in
      clinical practice.

PMID- 1620459
TI  - [Complications of intracranial neoplastic pathology].
AB  - Post-surgical complications in the treatment of intracranial tumors,
      independently of their location, are summarized in 5 essential points: a) edema;
      b) hemorrhages; c) ischemias; d) infections; e) alterations of the liquoral
      dynamics. According to our experience, it is possible to minimize these
      complications by using convenient intraoperative surgical procedures. On this
      subject, in addition to the traditional microsurgical techniques, the use of the
      high technologies (Cusa, laser) is very advantageous. In conclusion the important
      role of neuroanaesthesia and of the post-operative intensive care is underlined.

PMID- 1620460
TI  - [Postoperative cerebral edema. Physiopathology of the edema and medical therapy].
AB  - Cerebral edema complicates many neurosurgical conditions, such as head injuries,
      neoplasms and infections, and is the direct result of operative trauma. The
      recognition and the treatment of brain edema are of great practical importance,
      particularly in those conditions leading to brain herniations and/or intracranial
      hypertension. Brain edema can be distinguished into two major categories, based
      on the integrity of the blood brain-barrier (BBB). With intact BBB edema, the
      crucial pathogenic event is related to disturbances of cellular metabolism and
      ionic transport. All the cellular elements of brain may undergo swelling, with a
      concomitant reduction of the extracellular-fluid space of the brain. Open BBB
      edema, the most common form of brain edema, is characterized by increased
      permeability of the brain endothelial cells. Brain edema results from the oncotic
      forces generated from a serum protein influx into the nervous tissue, and edema
      fluid accumulates primarily in the extracellular space. The non-operative
      management of brain edema requires attention to the causes that have induced
      brain edema. Specific pharmacologic therapy with corticosteroids, hyperosmolar
      agents and furosemide or acetazolamide depend upon accurate assessment of BBB
      integrity.

PMID- 1620461
TI  - [Water-electrolyte imbalance following neurosurgery].

PMID- 1620462
TI  - [The physiopathology of oxygen venous saturation].
AB  - The paper underlines the importance of continuous SvO2 monitoring by means of the
      insertion of a modified Swan-Ganz optic fibre catheter into the pulmonary artery.
      Following an analysis of the factors which regulate O2 transport and ATP
      formation, together with metabolism self-regulating mechanisms which intervene in
      periods of stress to guarantee cellular metabolic activity, the Authors underline
      the importance of SvO2 as an indicator of the balance between O2 demand and
      supply. Real-time SvO2 monitoring is therefore considered a valuable and early
      marker of rapidly degenerating biological processes in critical patients.

PMID- 1620463
TI  - [Postoperative infective complications in neurosurgery].

PMID- 1620464
TI  - [Epileptogenic complications of neurosurgical interventions].
AB  - Epileptogenic complications after supratentorial intracranial surgery are,
      strictly defined, the events which promote a further complication, i.e. seizures
      in any form, partial, simple or complex, or generalized. The most common
      epileptogenic complications are, therefore, electrolyte imbalance, hypoxia,
      hypoglycemia, hypocapnia, and intracerebral or extradural hematoma. However, also
      inadequate anticonvulsant prophylaxis and use of convulsant drugs can yield to
      the onset of post-operative seizures. Anesthetic drugs have been each time
      defined pro or anti-convulsant: however, data from the literature show that it is
      not possible to certainly define the role of general anesthetics in the genesis
      of post-operative seizures.

PMID- 1620465
TI  - [Metabolic and water-electrolyte changes as postoperative complications in
      aneurysms of the anterior communicating artery].
AB  - A study was performed on hydroelectrolytic changes in neurosurgical patients
      operated for clipping anterior communicating artery aneurysm. The patients were
      observed during a seven day period in ICU, between the preoperative day and the
      sixth post-operative day. No statistically significant changes were observed,
      except for hyponatriemia on the day of surgery. The etiology of this phenomenon
      is not clear: it could be a change of ADH or "cerebral salt wasting syndrome". A
      wider number of patients and repeated haematological tests are necessary.

PMID- 1620466
TI  - [Anuric postoperative acute renal insufficiency in neurosurgery. Importance of
      continuous arteriovenous hemodialysis. Report of a case].
AB  - Post-operative acute oliguric renal failure was treated over a period of 17 days
      by continuous arterio-venous haemodialysis in man operated on for intracranial
      tumor. The Authors dwell on the advantages of this dialysis system in
      neurosurgery.

PMID- 1620467
TI  - [Postoperative neurosurgical complications in brain tumors operated in the
      elderly].
AB  - 200 patients of geriatric age, operated on for cerebral neoplasm, have been
      studied in order to estimate the most important factors influencing the post
      operative course. We have considered the "Volume of the tumour", the "Pre
      operative and at-discharge Karnofsky Score", the possible "Pre-existent
      pathologies" and the checked "Post-operative complications". As a conclusion we
      have considered relevant over the final outcome the following factors: a) the
      presence of general pre-existent pathologies, first of all diabetes and
      hypertension; b) the volume, more than the site and nature, of the neoplasm
      subject of the operation; c) the nature and the importance of local post
      operative complications.

PMID- 1620468
TI  - [Postoperative complications of trans-sphenoidal surgery].
AB  - One hundred and thirty three patients of both sexes were operated on for
      pituitary tumors with transphenoidal microsurgery. Postoperative complications
      are discussed.

PMID- 1620469
TI  - [Reduction of coronary risk using anesthesia quantified with EEG during carotid
      surgery].

PMID- 1620470
TI  - [Effects of "new" anesthetics on intra-cranial pressure].

PMID- 1620471
TI  - [Benzodiazepines and antagonists. Effect on intracranial pressure].

PMID- 1620472
TI  - [Postoperative hydrocephalus. Automatic control of intracranial pressure in
      patients treated with external drainage].
AB  - An experimental analogical device is described; it is able to stabilize the
      intracranial pressure (ICP) at an adjustable value in subjects exhibiting
      hydrocephalus. The mean ICP is measured by the intraventricular catheter, using a
      pressure measurement apparatus of conventional electric design. The result and
      two practical examples are presented.

PMID- 1620473
TI  - [Hyperbaric oxygen therapy in the treatment of benign intracranial hypertension.
      Follow-up of a preliminary study].
AB  - Preliminary experience of hyperbaric oxygen (HBO) in the treatment of benign
      intracranial hypertension (BIH) is reported. Fifty-three patients with BIH were
      observed. They were treated with antiedema non steroid drugs plus rachicentesis,
      with steroid drugs plus rachicentesis, with lumbar peritoneal shunt and only 8
      with HBO. Each patient underwent HBO with 100% oxygen at 2 atmospheres absolute a
      day for 15 days. In all patients a gradual disappearance of signs and symptoms of
      elevated intracranial pressure was observed. No lasting effect of treatment were
      seen after concluding therapy. The effect of HBO in the treatment of BIH has not
      yet been clarified, but the results can encourage further experience and studies.

PMID- 1620474
TI  - [The importance of monitoring the auditory evoked potentials after neurosurgery].

PMID- 1620475
TI  - [Reinterventions for arterial reconstruction in anastomotic aneurysm].
AB  - We reviewed our experience on the surgical treatment of anastomotic false
      aneurysms from 1979 through 1990: two groups of patients were identified. Group 1
      (31 patients) included patients who had been previously operated on at our
      Institute and then routinely followed-up with physical examination and
      ultrasonographic studies. The incidence of anastomotic aneurysm in this group was
      4.03%; the interval between insertion of the prosthesis and detection of the
      false aneurysm varied from 5 to 144 months, with a median interval of 58 month.
      The surgical treatment of choice (false aneurysm resection and graft
      interposition) has been successfully performed (97% of cases) without mortality.
      Group 2 (8 patients) included patients with complications of false aneurysm
      (emergency operations); in this group radical treatment was not always
      applicable; mortality and amputations rate were significantly increased
      (respectively 25% and 37%). We conclude that, after prosthetic reconstructions,
      only a careful long-term follow-up (also with use of ultrasonic and/or CT-scan
      studies) may allow reduction in morbidity and improvement in late survival.

PMID- 1620476
TI  - [Femoral non-infected anastomotic pseudoaneurysm. Clinical contribution].
AB  - The femoral region is the most common site of development of anastomotic
      pseudoaneurysms that represent a relatively frequent complication of
      reconstructive vascular surgery. Clinical examination alone generally is
      sufficient to diagnose these lesions because they usually appear as a pulsatile
      inguinal mass not accompanied by pain. Echography and angiodynography permit a
      better evaluation of size and blood flow. CT is useful to evaluate proximal
      aortic anastomosis specially in pseudoaneurysms with septic pathogenesis. Rupture
      or thrombosis are rare clinical presentations. Vascular reconstructive surgery is
      always suggested in this sort of pathology. In this paper the Authors report the
      clinical experience acquired from 1980 to 1990 in the General and Cardiovascular
      Surgery Department of the University of Milan (Head: Prof. Ugo Ruberti) is 34
      cases of femoral anastomotic aseptic pseudoaneurysms, analyzing the pathogenesis
      of this sort of lesion, describing the surgical solutions adopted and reporting
      the immediate and late results.

PMID- 1620477
TI  - [Asymptomatic lithiasis of the common bile duct: diagnostic difficulty and
      essentiality of intraoperative cholangiography].
AB  - Biliary lithiasis is a widespread pathology the diagnosis of which, following the
      introduction of ultrasonography, is increasingly easy. The frequent possibility
      of association between gallstones and choledocholithiasis, demands pre- or
      intraoperative recognition. The inadequacy of ultrasonography in excluding
      lithiasis of the common biliary tract with certainty, notwithstanding its other
      unquestionable advantages, and the disproportionate costs and risks of other
      investigations (cholangiography, ERCP, ecc.) which are such as to discourage
      routine use, confirm the role of operative cholangiography in the diagnosis of
      asymptomatic choledocholithiasis, so permetting its treatment. Personal
      experience of 100 consecutive cases of gallstones which showed fully 10 of them
      to be negative to preoperative investigation were found to have lithiasis of the
      common biliary tract.

PMID- 1620478
TI  - [Postoperative morbidity and mortality in patients undergoing additional
      cholecystectomy during digestive surgery].
AB  - A retrospective case-control study was carried out to assess whether additional
      cholecystectomy in patients undergoing digestive surgery caused increased
      postoperative morbidity and mortality. During the period 1983-90, 70 patients
      underwent cholecystectomy at the same time as other surgery (25 gastric
      resections, 23 colon resections, 17 total gastrectomies, 2 fundoplicatio using
      Nissen's technique, 2 cases of Heller's operation, 1 truncular vagotomy and
      pyloroplasty). These cases were matched for sex, age (+/- 5 years) and type of
      primary operation with 70 controls (patients without additional cholecystectomy).
      Complications were significantly more frequent among the former group compared to
      controls (28.6% vs 11.4%, p = 0.02), in particular in the group of patients
      undergoing colon resection (34.8% vs 8.7%, p = 0.04). The frequencies of
      reoperation and mortality were also higher in patients undergoing additional
      cholecystectomy than in controls (10% vs 1.4%), but the difference was not
      statistically significant (p = 0.06). In conclusion, additional cholecystectomy
      during digestive surgery increases the risk of postoperative complications, in
      particular in colorectal surgery.

PMID- 1620480
TI  - [Loco-regional anesthesia in ambulatory surgery].
AB  - Following a brief review of the various types of local anesthesia, including a
      recent method using EMLA cream, the paper focuses on the different complications
      which arise in relation to the technique used. Treatment protocols are also
      analysed in relation to the toxic stage.

PMID- 1620479
TI  - [Non-epithelial benign gastric neoplasms].
AB  - The Authors report five cases of benign neoplasm of the stomach: 2
      leiomyoblastomas, 2 leiomyomas and 1 ganglioneuroblastoma, underlining its
      rarity. After a review of the literature, the anatomo-pathological, clinical and
      therapeutical findings are described. The difficulty of early diagnosis is
      underline and the need for surgical therapy states.

PMID- 1620481
TI  - [A difficult diagnosis: retroperitoneal rupture of the duodenum caused by closed
      trauma of the abdomen].
AB  - The Authors report two cases of sub-peritoneal rupture of the duodenum following
      blunt abdominal trauma. The diagnostic difficulties are explained in detail.
      Emphasis is placed on the importance of prompt recognition of the duodenal injury
      and early surgical treatment to ensure a successful outcome.

PMID- 1620482
TI  - [Persistent multiple urachal complex. Echographic-surgical correlations].
AB  - Urachus is a tubular structure lined between foetal bladder and the umbilicus and
      is susceptible to complete or partial involution after birth. Persistence of the
      urachus results in a wide spectrum of anomalies: patent urachus, vesicourachal
      diverticulum, urachal sinus and cysts are more frequently seen than rare multiple
      urachal remnants. This kind of pathology focuses the problem of differential
      diagnosis (tumours, omental and ovarian cysts, vesical diverticulum or
      duplication) and may be complicated by a superinfection. The Authors discuss a
      bizarre multiple urachal remnant, presenting with urinary tract symptoms, which
      may be clinically confused with acute appendicitis or Meckel's diverticulitis.
      Contribution of sonography for a complete diagnosis is stressed, such as the
      precise correlation with surgical findings.

PMID- 1620483
TI  - [A case of retroperitoneal leiomyosarcoma].
AB  - Leiomyosarcoma is a rare malignant tumour originating from the smooth muscular
      tissue in any part of the organism, including retroperitoneum where it is
      particularly aggressive. It is nearly always characterized by a silent
      development causing diagnostic delay. The results of the primary therapy, which
      is always surgical, are limited because of the tumoral mass extension and the
      high local aggressiveness. The Authors present a clinical case which was under
      their observation and seize the opportunity of making a revision of the
      literature about it.

PMID- 1620484
TI  - [A case of intestinal occlusion caused by malignant ileal lymphoma].
AB  - The Authors review a case of intestinal non-Hodgkin lymphoma, whose clinical
      feature was an intestinal obstruction caused by ileoileal intussusception. Some
      findings which make it unusual are compared with those mentioned in the
      international literature.

PMID- 1620485
TI  - [Elastofibroma of the back. Considerations on 2 cases].
AB  - Two cases of fibroelastoma of the back are reported. It is pointed out that
      probability diagnosis in mainly entrusted to the objective examination and to the
      typical site of tumefaction, backed by echotomography, xeroradiography and
      computerised tomography and demonstrated by histological examination of the
      operative piece. Differential diagnosis has to be established versus
      fibrosarcoma, liposarcoma, desmoid tumour and malignant tumour of the synovia.
      The need for surgical removal is reiterated.

PMID- 1620486
TI  - Dunston and Riggs call for HIV testing.

PMID- 1620487
TI  - Chronic steroid dependent asthma.

PMID- 1620488
TI  - The silicone bust.

PMID- 1620489
TI  - What about Prozac?

PMID- 1620490
TI  - Applications of MRI for diagnosis of cardiovascular diseases.
AB  - Magnetic resonance imaging (MRI) acquires high spatial resolution images of the
      heart from any part of the cardiac cycle and in any planar configuration without
      use of contrast. Sequential images through the cardiac cycle can be viewed as a
      cine.

PMID- 1620491
TI  - OSHA knocking on doctors' doors.
AB  - New regulations by the Federal Occupational Safety and Health Administration
      require every medical office to train staff, offer hepatitis vaccinations, and
      impose universal precautions. An "occupational exposure control plan" is required
      of every office.

PMID- 1620492
TI  - SBME overhauls health care delivery structure.
AB  - SBME requires office manuals and additional paperwork, and limits dispensing of
      drugs and medical equipment. Multispecialty facilities with physicians and other
      health care professionals are permitted in the same professional corporation,
      with private investors funding the company.

PMID- 1620493
TI  - Angucycline group antibiotics.

PMID- 1620495
TI  - The biosynthesis of shikimate metabolites.

PMID- 1620494
TI  - The microbiological transformation of diterpenoids.

PMID- 1620496
TI  - New Zealand suicides 1984-8.
AB  - AIMS: to determine regional differences in suicide with special attention to
      inpatients and prisoners. METHODS: all cases of suicide 1984-8 were identified
      from coroners' register and age, sex, method of suicide, date of death, place of
      inquest, occupation and prisoner or inpatient status were recorded. RESULTS:
      between 1984 and 1988 there were 2019 suicides. Subjects were usually male and
      hanging was the commonest method of achieving death. Northland-Auckland had the
      highest regional suicide rate and the highest prison suicide rate; and Wellington
      Wairarapa had the lowest regional suicide rate, the lowest prison suicide rate
      but the highest inpatient suicide rate of the five regions studied. CONCLUSIONS:
      the high regional and prison rates of suicide in Northland-Auckland were probably
      because the largest city in New Zealand lies within its boundaries. The high
      inpatient suicide rate in Wellington-Wairarapa could not be explained by the
      regional rate, nor by controlling for the number of admissions. This pointed to
      regional differences in the delivery of psychiatric care.

PMID- 1620497
TI  - The relationship between body mass index and socioeconomic status in New Zealand:
      ethnic and occupational factors.
AB  - AIMS: the relationship between body mass index (BMI) and socioeconomic status
      (SES) was examined in a multiracial New Zealand workforce in order to investigate
      ethnic variations. METHODS: an employed population of 5673 people were measured
      for weight and height and BMI calculated. Socioeconomic status was assigned using
      the UK Registrar General's scale. RESULTS: both European women and men showed an
      inverse relationship of increasing BMI with decreasing SES which is typical of
      developed societies. Maori, Pacific Islanders and Asians did not, but neither did
      they show the direct relationship of developing societies. Examination of the
      components of SES showed that combined family income did not influence BMI in any
      ethnic group but that education was strongly associated with BMI in Europeans (p
      = 0.0001) and weakly associated in Maori (p = 0.0603), and occupation was
      strongly associated with BMI in Europeans (p = 0.0001) and weakly associated in
      Pacific Islanders (p = 0.0148) independently of education. CONCLUSIONS: ethnic
      variations are partly explained by educational levels and occupation, but not by
      income. Increased education may decrease prevalence of obesity. Some occupational
      factors are discussed.

PMID- 1620498
TI  - The place of ultrasound imaging in pregnancy.

PMID- 1620499
TI  - Changes in sexual practices and some HIV related attitudes in New Zealand: 1987
      9.
AB  - Two fully national samples of 1000 New Zealanders aged 16-60 were interviewed in
      1987 and in 1989 about their sexual practices and related attitudes to HIV/AIDS
      matters. The data were gathered by means of a self completed questionnaire which
      was part of a larger interview undertaken in the respondents' own homes.
      Precautions were taken to ensure confidentiality, anonymity and privacy. There
      were significant differences in the reporting of sexual behaviour during the two
      year study period. The proportion of the sexually active reporting three or more
      sex partners in the previous year fell from 12% to 8%. The proportion reporting
      "always" or "often" using condoms rose from 13% to 18% and those reporting
      permanent changes to sexual behaviour because of AIDS rose from 16% to 26%.
      Changes towards safer sexual practices were more common amongst males, the young,
      the unmarried and those with multiple sex partners. Findings concerning attitudes
      to HIV/AIDS related matters showed an increase in the population's perceived risk
      of the virus to both themselves and others. For example the proportion who felt
      everyone was at risk rose from 71% in 1987 to 80% in 1989. There was also
      evidence of increased victim blaming of the person who caught HIV infection or
      other sexually transmitted diseases. Finally there was evidence of the need for
      more action on AIDS. In 1987 35% felt that enough was being done whereas this had
      dropped to 27% by 1989.

PMID- 1620500
TI  - The costs of smoking revisited.
AB  - AIMS: a previous study of the cost of smoking to the New Zealand health services
      estimated that the excess hospital resource use generated by smoking amounted to
      $81 million in 1986 dollars. The present study refined and updated the figures
      for hospital resource use, and extended the costing exercise to include aspects
      of primary health care. METHODS: excess hospital costs attributable to smoking
      were estimated from the 1987 national hospital discharge data (both public and
      private hospitals), and figures obtained from the Otago resource utilisation
      system (RUS). The costs of excess prescription medicines use and general
      practitioner consultations were estimated from existing data sources. RESULTS:
      the excess hospital costs attributable to smoking totalled $128.3 million. A
      further $37.8 million was consumed in excess prescription medicines use, plus
      $19.3 million in general practitioner consultations. The total cost to the health
      services of cigarette smoking was therefore conservatively estimated at $185.4
      million (in 1989 dollars). CONCLUSIONS: previous estimates substantially
      underestimate the external costs imposed by smoking. The figure of $185.4 million
      contrasts with the $7.5 million of sponsorship support which the tobacco industry
      is estimated to provide for New Zealand sports. Politicians who intend to repeal
      Part 2 of the Smokefree Environments Act (1990) should consider these external
      costs imposed on society by cigarette smoking.

PMID- 1620501
TI  - Intermittent supervised treatment of tuberculosis at Green Lane Hospital, 1987-8.
AB  - AIMS: to assess the results of the first two years experience with intermittent
      supervised treatment of tuberculosis (IST) in Auckland, looking especially at
      practical problems. METHOD: the hospital records of the 16 patients who received
      IST during 1987-8 were reviewed retrospectively, and public health nurses who
      administered the medications were questioned about problems that were
      encountered. RESULTS: two-thirds of those who were given IST were Polynesian. In
      retrospect, the need for IST could have been anticipated in eight of the 12
      patients (67%) who failed to comply with daily treatment. Five of the 16 IST
      patients presented major problems to the nurses supervising the twice weekly
      treatment. Poor motivation, itinerancy and alcohol abuse were the most common
      factors causing difficulty. IST was successfully completed in 13/16 patients
      (81%) and was abandoned in only one patient. Only two patients completed IST with
      a drug regimen for resistant organisms. Health nurse supervision resulted in
      improvements in understanding and attitude to tuberculosis, eventually enabling
      two patients to self medicate without supervision. CONCLUSIONS: IST is a
      practical treatment method in New Zealand, permitting curative therapy in a group
      of tuberculosis patients who would otherwise create risks of drug resistance,
      disease reactivation and spreading the disease.

PMID- 1620502
TI  - Sea anemone sting while SCUBA diving.

PMID- 1620503
TI  - Giant T wave inversion.

PMID- 1620504
TI  - Urinary tract infections in adults: Part 2--Prophylactic regimens of treatment.

PMID- 1620505
TI  - Cot deaths.

PMID- 1620506
TI  - Campylobacter infection 1991.

PMID- 1620507
TI  - Cost effectiveness of treatments for alcoholism--you can't compare apples with
      cabbages.

PMID- 1620508
TI  - Effects of a physical conditioning programme on asthmatic patients.
AB  - AIMS: to determine whether moderate/severe asthmatics can improve their physical
      fitness using standard commercial gymnasium fitness programmes and to examine the
      effect on their asthma. METHODS: eight moderate to severe asthmatics and seven
      nonasthmatic controls were tested before and after 12 weeks indoor circuit
      training at a commercial gymnasium. The aerobic fitness of both groups was
      assessed before, during and after the conditioning period. Measures of asthma
      severity, habitual activity levels and psychological status were also assessed.
      RESULTS: peak oxygen uptakes increased significantly in both asthmatics and
      controls, mean and 95% confidence interval (95% CI) values rising from 27.5 (21.9
      33.0) to 31.3 (23.5-39.1) and 29.2 (25.9-32.5) to 32.2 (28.5-35.9) mL.min-1.kg-1
      respectively. Following training, minute ventilation at high workloads was
      significantly reduced in the asthmatic subjects. In all participants subjective
      ratings of the ability to perform physical tasks was significantly increased as
      was the amount of habitual physical activity reported. Although the asthmatics'
      bronchial responsiveness to histamine, medication usage and symptom scores did
      not change, the daily recorded peak expiratory flow (PEFR) increased slightly,
      and its variability declined. CONCLUSIONS: these findings demonstrate that with
      proper management severe asthmatics can engage in vigorous circuit training and
      enjoy the health benefits of regular exercise.

PMID- 1620509
TI  - Carcinoma of the glottic larynx: the Christchurch experience.
AB  - AIMS: to establish the local control and survival rates for glottic laryngeal
      cancer, and to determine the incidence of second primary cancers after treatment
      of the original tumour. METHODS: a retrospective review of all patients with
      glottic cancers treated in Christchurch over a five year period, with a minimum
      follow up of five years. RESULTS: between 1979 and 1984, 83 patients with
      laryngeal cancer were treated in Christchurch Hospital. Forty-seven of these
      patients had cancers of the glottic larynx. Overall, 39 of 45 patients were free
      of their laryngeal cancer at five years (two were lost to follow up). Eight of 45
      developed a second primary cancer, usually lung or oesophagus, and this was
      invariably fatal. CONCLUSION: with multidisciplinary management of head and neck
      cancers satisfactory control rates can be achieved, but since these patients are
      usually heavy smokers and drinkers, they are at high risk of developing a second
      primary cancer. The use of chemopreventative agents is mentioned.

PMID- 1620510
TI  - A testing time for heart disease.

PMID- 1620511
TI  - Condom use in anal intercourse amongst people who identify as homosexual,
      heterosexual or bisexual.
AB  - AIMS: to study condom use amongst those who practice anal intercourse. METHODS: a
      sample of 814 clients attending anonymously for pretest counselling for HIV
      infection at the Burnett Clinic, Auckland, gave detailed information about their
      sexual behaviour. RESULTS: insertive or receptive anal intercourse was reported
      in 39% of clients. This included 89% among homosexual men, 78% among bisexual
      men, 17% among heterosexual men and 21% among heterosexual women. In those
      practising anal intercourse concomitant condom use was reported by 71% of
      homosexual men, 53% of bisexual men, 16% of heterosexual men and 7% of
      heterosexual women. Those most likely to use condoms were homosexual men,
      prostitutes, those with multiple partners and those with an HIV infected partner.
      Those least likely to use condoms were heterosexual men or women. CONCLUSIONS:
      whilst substantial changes in sexual practices appear to have been made in the
      homosexual community, heterosexuals practising anal intercourse have made few
      such changes. More explicit AIDS education may be necessary which acknowledges
      that anal intercourse is practised by heterosexuals and advises condom use
      accordingly.

PMID- 1620512
TI  - Asthma knowledge and management in primary schools in south Auckland.
AB  - AIMS: to examine the management of asthma in primary schools and the school
      teachers' knowledge, confidence and attitude in managing the pupils with asthma.
      METHODS: forty-two primary schools in south Auckland were randomly selected to
      participate. Questionnaires were posted out to the principals and another
      questionnaire was given randomly to 253 teachers from these primary schools.
      RESULTS: 76% of the school principals surveyed returned the questionnaire; and
      66% of the school teachers surveyed returned a separate questionnaire. The
      average incidence of asthma reported by school principals and school teachers was
      9.9% and 12.6% respectively, which suggests underreporting of the diagnosis of
      asthma. In 81% of the schools a questionnaire was used to identify students with
      asthma when they first join the school. School teachers had good basic knowledge
      on asthma, however 33% of teachers did not know that Ventolin (salbutamol) is for
      symptomatic treatment and 58% and 65% of teachers did not know that Becotide
      (beclomethasone) and Intal (sodium cromoglycate) are prophylactic medications.
      CONCLUSIONS: we suggest that primary school teachers should receive further
      education on asthma, especially on practical aspects of asthma management.

PMID- 1620513
TI  - A clinical audit of patients on an orthopaedic waiting list for greater than two
      years.
AB  - AIMS: the aims of this paper were to review a group of 142 patients who had been
      on an orthopaedic waiting list for more than two years, both by postal audit and
      by clinical assessment, and to determine the fates of these patients. METHOD: all
      patients who had been on the orthopaedic waiting list for more than two years
      were written to, asking them to attend a preadmission clinic if they still
      required surgery. Those who attended the clinic were reassessed with regard to
      their orthopaedic problem and general state of health. Preadmission summaries,
      radiographs and waiting list details were analysed with respect to time spent on
      the waiting list, changes in clinical and radiographic findings and changes in
      diagnosis or proposed operation. The number of patients removed from the waiting
      list and the reason for removal was noted. RESULTS: One hundred and thirty-four
      of 142 patients replied. One hundred and three attended the preadmission clinic.
      A change of diagnosis was made for four patients and nine patients underwent a
      different operation than that originally proposed. Thirty-four patients were
      removed from the waiting list after reassessment. Of the 142 original patients
      only 69 (49%) remained on the waiting list. A number of patients deteriorated
      significantly while on the waiting list. CONCLUSION: a significant number of
      patients on a long orthopaedic waiting list may no longer require surgery. A
      number of patients can be expected to deteriorate significantly while on the
      waiting list. Postal audits alone are insufficient to determine who on the
      waiting list still requires surgery.

PMID- 1620514
TI  - Varicose vein avulsion incisions: any need for sutures?

PMID- 1620515
TI  - New Zealanders--why let this medical experiment proceed?

PMID- 1620516
TI  - The National Women's Hospital settlement.

PMID- 1620517
TI  - Unaware hypoglycaemia and human insulin.

PMID- 1620518
TI  - Insulin resistance and hypertension.

PMID- 1620519
TI  - Iron deficiency.

PMID- 1620520
TI  - Early results of endometrial resections using a simple criteria for patient
      selection.

PMID- 1620521
TI  - Getting the figures right.

PMID- 1620522
TI  - Hearing damage from a cordless telephone.

PMID- 1620523
TI  - Treatment for gardnerella vaginitis.

PMID- 1620524
TI  - Technique for total abdominal hysterectomy: historical and clinical perspective.
AB  - Since the first refined total abdominal hysterectomy was performed by Wilhelm
      Alexander Freund of Breslau on January 30, 1878, various techniques have been
      introduced over the past 110 years. Hysterectomy, numbering over 650,000
      procedures annually, is the most commonly performed major surgical procedure next
      to cesarean section in the United States. Although CREOG (Council on Resident
      Education in Obstetrics and Gynecology) emphasizes the importance of basic pelvic
      surgical skills and competency in gynecological surgical procedures, cost
      effective patient management dictates the shortest hospitalization and most
      uncomplicated procedure possible. Various techniques of abdominal hysterectomy
      have been reappraised in view of present-day medical practice concepts. It seems
      that we are entering a new age wherein a simplified, cost-effective alternative
      to a classical total abdominal hysterectomy is indeed needed for some cases, and
      if a hysterectomy is planned, it should be performed in the safest way in the
      shortest possible operating time for a well-indicated case. Keeping this
      objective in mind, one Japanese technique of total abdominal hysterectomy and its
      modification are described with the intent that this will assist Ob/Gyn resident
      physicians in surgical skill development and also help gynecologists in practice
      to meet rapidly changing practice patterns of the specialty.

PMID- 1620525
TI  - A review of the microbiology, immunology, and clinical implications of Chlamydia
      trachomatis infections.

PMID- 1620526
TI  - A macroscopical study of the inferior phrenic artery of female rats, with
      reference to the embryological background of occurrence of the genital artery
      from this artery.
AB  - The principal aim of this study was to elucidate the general features of the
      inferior phrenic artery (IPA) of female rats which retain the original embryonic
      configuration of this artery. The artery of the right side was found to be
      detached from the renal artery, while that of the left side arose from the aorta.
      Between these fellow arteries, however, no essential morphological differences
      were discernible. At some point not far from their origin, they were found to
      break up into the ascending, suprarenal, suprareno genital and descending
      arteries. The ascending artery of the right side coursed along with the phrenic
      nerve, and vascularized a greatest portion of the total area of the partes
      sternalis et costalis of the diaphragm. Furthermore, the artery was found to be
      intimately associated with the inferior caval vein. Thus, it could be assumed
      that this artery of adult rats has been embryologically related to the musculus
      diaphragmaticus, transverse septum, ventral pleuroperitoneal fold, and the caval
      venous mesentery. The suprarenal artery took its course along the superior margin
      of this gland to reach the lateroinferior part of the pars costalis of the
      diaphragm. Its course and destination strongly indicates that in its development
      the suprarenal artery has been intimately related to the formation of the ventral
      pleuroperitoneal fold. The suprarenogenital artery was characterized as giving
      off a genital branch which entered first the diaphragmogenital ligament, and then
      took a descending course toward the ovary, in a quite similar manner of origin
      and course to those of the aberrant gonadal (testicular and gonadal) arteries
      observed in Japanese human adults (Shinohara et al., 1990; Hanie, to be
      published). The descending artery was observed to be closely associated with the
      major splanchnic nerve and the celiac ganglion. The variability of arteries of
      the IPA of female rats and also of humans, seems to reflect dramatic changes
      which have occurred in the early stages of development, and have influenced more
      or less the morphology of the uppermost abdominal anlages of the followings:
      transverse septum, musculus diaphragmaticus, dorsal and ventral pleuroperitoneal
      folds, suprarenal gland and celiac ganglion, urogenital organs, inferior caval
      vein in the caval venous mesentery. In conclusion, it could be said that the
      anatomy of female rats provide us valuable clues as to the essential
      configuration of the IPA of humans and the relationships of the IPA to structures
      which are thought to be directly involved in the development of this artery.

PMID- 1620527
TI  - The first capitular joint in primates: Cebidae, Cercopithecidae and Homo.
AB  - As for the first capitular joint, Ohman (1986) claimed that a univertebral type
      is unique to modern and fossil hominids among primates. Stern and Jungers (1990)
      compiled the data in a wider range of primate and demonstrated as follows. The
      univertebral type, rather than being unique to hominids, is common among siamang,
      occurs in an occasional gibbon, and is typical of the larger indriids. We added
      the data of genera of Cebidae and Cercopithecidae to that observation, and found
      that the univertebral type is also typical of the Pithecia in Cebidae and Papio
      and Cercopithecus in Cercopithecidae. We also found that the bivertebral type
      occurs in 19.4% of Homo. Gloobe and Nathan (1970) had already observed that most
      mammals have a full facet for the first rib and a hemifacet for the second in the
      first thoracic vertebra. Accordingly, it seems that Ohman's claim is not
      applicable for nonhominoid primates and for mammals.

PMID- 1620528
TI  - Histological and histochemical investigations on Japanese lizard esophagus.
AB  - The authors previously investigated the bottle-shaped glands distributed in the
      lamina propria mucosae of the Japanese lizard and gecko. We made two sets of
      sections of the Japanese lizard at that time. The numerical values of the
      physical dimensions of the two individuals were as given table 1, showing that
      No. 2 was slightly smaller. Moreover we found very unusual tissue in the lower
      portion of the esophagus of No. 2. Therefore we excluded this individual from the
      preceding investigations. However, we made various observations, and the results
      of these investigations are as follows. 1. The lumen of the upper portion of the
      esophagus has no fold. However, the middle and lower portions formed very
      complicated folds. Therefore, the lumen was remarkably narrow. 2. The epithelium
      of the esophageal mucous membrane consisted of simple columnar cells and
      throughout each part, reacted strongly to PAS and moderately to AB (pH 2.5 and
      0.5). It presented a dark blue (R18-B13 of Blue-Purple-Red) color in response to
      PAS-AB (pH 2.5) and contained no pepsinogen granules. The esophageal upper
      portion of small individuals only exhibited the PAS reaction in this
      investigation. 3. A number of bottle-shaped glands were distributed in the lamina
      propria mucosae of the lower portion of the esophagus of each material. The
      glandular cells in the basal portion were most differentiated and contained a
      great number of pepsinogen granules. 4. The above-mentioned glands were extremely
      simple and glands of this type could not be found in textbooks and theses.
      Accordingly, we previously described them with the tentative name of shimple
      branched tubular glands, but subsequently found this to be erroneous. We assume
      that these glands are esophageal gastric glands. 5. Compound tubular glands are
      formed in the lamina propria mucosae of the human esophagus, but do not exist in
      the Japanese macaque, crab-eating monkey, horse, cow, swine, dog, cat, rabbit,
      mouse and rat. Dellmann-Brown also described the absence of such glands in the
      esophagus of the horse, swine, cow, goat, sheep, dog and cat. 6. We subsequently
      found compound tubular glands distributed in the lamina propria mucosae of the
      fowl, goose and wild duck esophagus. They similarly secreted pepsinogen granules.
      7. We assume that these glands of the Japanese lizard and gecko have a phylogenic
      relation with the glands in the bird. The pepsinogen-granule-secreting cells in
      the snake do not extend into the lamina propria mucosae.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1620529
TI  - On the organization of the Plexus lumbalis. I. On the recognition of the three
      layered divisions and the systematic description of the branches of the human
      femoral nerve.
AB  - The arrangement of the nerve bundles at the branching point of the femoral nerve
      (F), the interrelations of the branches each other and toward other nerves in the
      anterior region of the thigh, and the patterns and the anatomical features of
      both the running courses and the distributions of the branches were
      macroscopically studied, whereby some special findings were observed and the
      following results were obtained: 1) The periphery of the femoral nerve was
      fundamentally divided into superficial-deeply arranged three-layered divisions.
      Including the femoral branch of the genitofemoral nerve (Rf) and the femoral
      lateral cutaneous nerve (Cfl), the nerve branches at the anterior region of the
      thigh were totally divided into five-layered divisions. 2) The cutaneous branches
      of each division including Rf or Cfl could be classified in three groups: the
      medial cutaneous branches (m), the anterior cutaneous branches (a), and the
      lateral cutaneous branches (l). Based on the above results, the branches could be
      described systematically. Parallelly, several accessory bundles of F penetrating
      the psoas major muscle were observed, and two types of accessory femoral nerves
      (F') could be distinguished: One was higher on the segmentation and mainly flew
      into the 1st division of F. While the other distributed only to the medial region
      of the thigh. To clarify the segmental or stratifical natures of the branches of
      each division, F', and the interrelations among them, analyses of the nerve
      fibers were undertaken under the operational microscope. Consequently, the
      segmental differences between the divisions were distinct, and the medial
      branches or F'm obviously contained ventral components. Thus, when a component
      originated from the higher segments, it distributed to the proximal region
      generally taking a superficial course; when it originated from the lower ones, it
      distributed to the distal region of the thigh forming the deeper division; when
      it belonged to the ventral stratum, it distributed to the medial region; and when
      it belonged to the dorsal stratum, it distributed to the lateral region. On the
      occasion of the fiber analysis, it was found that each root of the lumbar nerve
      was generally divided into two or three subsegmentally-arranged subroots that
      divided themselves into some fasciculi arranged micro-segmentally. A minute
      analysis of the segmentations of the nerves became possible because of the above
      characteristics.

PMID- 1620530
TI  - A silver impregnation method for neurons in the central nervous system of the
      small laboratory animals.
AB  - Brains of small, adult laboratory animals, fixed by formalin-perfusion, and cut
      into pieces usually 2-3 mm thick X 3-5 mm2 are placed into a solution containing:
      7% aqueous solution of potassium dichromate 100 ml, 99.5% ethyl alcohol 40 ml,
      concentrated formalin 10 ml, distilled water 50 ml, for 24 hours. The process is
      repeated with a freshly prepared solution for another 24 hours. The pieces are
      then transferred to a 3.5% aqueous solution of potassium dichromate for 48 hours,
      and then to a 1% aqueous solution of silver nitrate for 48 hours. Frozen or
      celloidin sections 70-100 microns in thickness are put into 90% and then into
      100% ethyl alcohol for 30 minutes respectively, creosote-benzene (1:1), benzene
      and mounted with or without cover glass applying Entellan neu. This procedure
      gives high quality impregnation and it takes about one week to complete.

PMID- 1620531
TI  - The degenerative neck.

PMID- 1620532
TI  - Natural history and pathogenesis of cervical disk disease.
AB  - As the cervical spine ages, degenerative processes occur that involve the
      intervertebral disk as well as facet joints. Some individuals experience pain as
      this process evolves. In many instances, it can be difficult to correlate a
      patient's symptoms with the associated changes. This article reviews the
      appropriate anatomy and biochemistry of the cervical spine and presents the
      pathologic entities that are encountered.

PMID- 1620533
TI  - The syndromes of degenerative cervical disease.
AB  - Senescence of the cervical spinal motion segment is manifest by changes in each
      anatomic component. The pathoanatomical change that predominates varies from one
      person to the next. Sufficient compromise of local neural structures will
      precipitate the onset of symptoms. The pattern of symptoms and any associated
      physical signs will vary according to which structures are stimulated or
      compressed. Radicular and myelopathic syndromes are produced by nerve root and
      spinal cord compression, respectively. These patterns can occur individually or
      in combination. Other less clearly understood patterns of local and referred
      symptoms may be mediated by the sinu-vertebral nerves or the medial branches of
      the posterior ramus. Techniques for the precise diagnosis of these syndromes are
      needed. Separating patterns of symptomatic degenerative cervical disease from
      other causes of neck, shoulder, and arm symptoms rests on an awareness of the
      broad spectrum of subjective complaints, a thorough physical examination, and
      confirmatory diagnostic studies. Clear delineation of the etiology will increase
      the likelihood of successful treatment.

PMID- 1620534
TI  - Radiographic evaluation of the degenerative cervical spine.
AB  - Despite some claims to the contrary, the use of plain film radiography can be an
      inexpensive initial means of evaluating the degenerative cervical spine if viewed
      in the context of the patient's clinical history and physical examination and may
      serve as a guide for further imaging techniques. This article presents a
      systematic approach for evaluating cervical spine radiographs for the spectrum of
      degenerative changes, followed by a brief discussion of differential diagnoses.

PMID- 1620535
TI  - Diagnosis of nerve root compression. Myelography, computed tomography, and MRI.
AB  - Current technology and published studies support the preferential use of MRI in
      the diagnosis of cervical myelopathy. In cervical radiculopathy, data support the
      use of either contrast-enhanced CT or MRI. We prefer MRI as the initial
      diagnostic test because of the obvious advantage of its noninvasive nature.
      Similar to myelography, MRI permits visualization of the entire cervical canal
      and spinal cord. Unlike routine CT, MRI visualizes the spinal cord and nerve
      roots in two planes and is better in detecting unsuspected pathology at other
      cervical segmental levels. Because the quality of MRI scans in the cervical spine
      is subject to more variation than in the lumbar spine, anticipated pathology is
      sometimes not clearly visualized by cervical MRI. Under such circumstances, we
      obtain a water-soluble myelogram followed by contrast-enhanced CT. Because
      inaccurate radiographic diagnosis is one of the identifiable causes of poor
      outcome in surgical therapy for cervical spondylosis, accurate visualization of
      pathology in terms of its location, nature, and extent is imperative before
      performing decompressive cervical spine surgery.

PMID- 1620536
TI  - Analysis of medications used in the treatment of cervical disk degeneration.
AB  - This review focuses on the scientific design and concepts of drug management of
      cervical disk disorders. Steroids, nonsteroidal anti-inflammatory medicines,
      narcotics, antidepressants and muscle relaxants are discussed.

PMID- 1620537
TI  - Role of physical therapy in the treatment of cervical disk disease.
AB  - Table 4 summarizes how physical therapy should be implemented during the acute
      and chronic phase of cervical disk disease. From the outset of treatment, the
      patient should be encouraged to return to work or other productive activities and
      should be taught how to be responsible for their own recovery. If passive
      modalities are used, they must be an adjunct to the active modalities. As soon as
      the patient is able to continue with an active program without unbearable pain,
      the passive modalities should be discontinued gradually. If neck pain becomes
      chronic, the accompanying psychosocial dysfunction must be addressed through
      behavioral modification techniques, preferably in a multidisciplinary setting.
      Modification of the work place, work habits, and lifestyles must be emphasized at
      both the acute and chronic stages. The modalities presented in this article are
      commonly used by physical therapists. Unfortunately, the clinical efficacy of
      most of these modalities has yet to be proved. A literature search on the
      effectiveness of various physical therapy modalities by Sievers et al showed that
      only 4% of the studies published from 1979 to 1985 were controlled clinical
      trials. This scientific output of physical therapists needs to be corrected.

PMID- 1620538
TI  - Surgical management of cervical radiculopathy. Indication, techniques, and
      results.
AB  - Cervical radiculopathy can be surgically approached either posteriorly or
      anteriorly and the anterior approach has been described with or without fusion.
      The choice of approach and technique must be based upon anatomic,
      pathophysiologic, and biomechanical principles in addition to the familiarity of
      the surgeon with the procedures. The authors discuss the use of the posterior
      approach for lateral soft-disk disease because it minimizes disruption of soft
      and bony tissues and does not markedly disrupt the biomechanics of the cervical
      spine. The anterior approach is preferred for radiculopathy involving osteophytic
      hard-disk disease, and when properly and carefully performed, the addition of an
      interbody fusion holds significant advantages over diskectomy without fusion.

PMID- 1620539
TI  - Types of anterior cervical grafts.
AB  - Anterior cervical diskectomy and fusion provide satisfactory results in most
      instances of cervical disk herniation and cervical spondylosis. A variety of
      interpositioned grafts have been described for such problems at one or two
      levels. Multiple level anterior decompression and fusion for patients with
      spondylotic myelopathy produce satisfactory results in most instances and are
      particularly effective when a degenerative kyphosis is present. Appropriate
      patient selection and attention to technical aspects of exposure, neural
      decompression, and graft procurement and placement directly influence the
      surgical outcome.

PMID- 1620541
TI  - Surgical management of myelopathy.
AB  - We have presented a comparative analysis of the ability of four surgical
      procedures to address adequately the problems sustained by a patient with
      symptomatic cervical myelopathy. AIA is a safe procedure whose effectiveness may
      be limited when the extent of disease is more than three intervertebral disk
      levels. ACA permits more direct and extensive access to the spinal cord and is
      the procedure of choice for cervical spondylotic myelopathy associated with
      spinal deformity. However, rigid external immobilization is necessary, and
      operative morbidity may be greater. Cervical laminectomy may be effective for
      decompressing the spinal cord when no associated spinal deformity or instability
      is present, provided that extensive resection of facet joints is avoided.
      Cervical laminaplasty is ideally suited for the patient with three or more levels
      contributing to a cervical myeloradiculopathy. Mild instability may be addressed
      by performing arthrodesis on the hinge side.

PMID- 1620540
TI  - Cervical spondylotic myelopathy. Clinical syndrome and natural history.
AB  - A wide-based spastic gait is the classical presentation of the patient with
      cervical spondylotic myelopathy. A complete neurologic evaluation is needed to
      determine the degree of involvement and to classify the clinical syndrome. The
      natural history seems to be one of static neurologic deficit or episodic
      progression.

PMID- 1620542
TI  - Postlaminectomy kyphosis. Causes and surgical management.
AB  - Postlaminectomy instability of the cervical spine can be managed either
      anteriorly or posteriorly. The posterior procedures that have been described are
      best performed at the time of the original decompressive procedure. Thus, the
      development of a kyphotic deformity is prevented. Generally, it is technically
      easier to achieve anterior stabilization and arthrodesis if a postlaminectomy
      kyphosis develops.

PMID- 1620543
TI  - Two antisense promoters in the immunoglobulin mu-switch region drive expression
      of c-myc in the Burkitt's lymphoma cell line BL67.
AB  - In the Burkitt's lymphoma (BL) cell line BL67 the first exon of the c-myc gene is
      fused to the mu-switch region of the immunoglobulin heavy-chain gene (IgH). BL67
      cells express IgH/c-myc hybrid RNAs which are initiated in the immunoglobulin
      locus, transcribed across the chromosomal breakpoint into the first exon of c-myc
      and spliced using the physiological splice donor and acceptor sites of the c-myc
      gene. We have isolated cDNAs of these hybrid RNAs and characterized the start
      points in the Ig heavy-chain gene. Two promoters were identified in the mu-switch
      region of BL67 cells which give rise to antisense transcription of the mu-gene.
      These promoters are also active in other BL cell lines, in B cells without Ig
      translocation and in a T-cell line. Both promoters co-localize with DNAase I
      hypersensitive sites, HNF and HSW, in the mu-switch region. The structures of
      IgH/c-myc hybrid RNAs and of the corresponding promoters are described.

PMID- 1620544
TI  - The ras and protein kinase A pathways are mutually antagonistic in regulating rat
      prolactin promoter activity.
AB  - In an attempt to characterize the ras signaling pathway, we studied the effects
      of expression vectors encoding the valine 12 mutant ras oncogene on rat prolactin
      (rPRL) promoter activity. Using this approach we have been able to dissect the
      interplay between the ras and the protein kinase A (PKA) pathways as they relate
      to neuroendocrine gene activation. Here we show that the ras oncogene product
      induces rPRL promoter activity selectively from 5- to 14-fold in GH4 rat
      pituitary tumor cells, whereas it has a minimal effect on the SV40 early promoter
      and no effect on the Rous sarcoma virus (RSV) or rat growth hormone promoters. By
      contrast, an inactivated form of ras (N-17 ras) did not stimulate the rPRL
      promoter, but rather inhibited it to 40% of control. Of note, activation of the
      PKA pathway by two different methods decreased the fold activation mediated by
      ras by at least 50%, whereas inhibition of the PKA pathway accentuated ras
      activation of the rPRL promoter. Although rPRL promoter activity is consistently
      induced by PKA activation in control GH4 cells, acute ras oncogene expression
      inhibited forskolin induction of rPRL promoter activity. Moreover, this ras
      mediated interference of the forskolin activation of rPRL promoter activity was
      also noted in GH4 cells stably expressing ras. Taken together, these data show
      that the valine 12 ras oncogene activates the rPRL promoter selectively and, more
      importantly, that the ras and PKA signaling pathways are mutually antagonistic
      with respect to specific transcriptional activation of a neuroendocrine gene.

PMID- 1620545
TI  - Dependence of SV40 large T-antigen cell cycle regulation on T-antigen expression
      levels.
AB  - Simian virus 40 (SV40) large T antigen (Tag) expression results in reduced
      percentages of G1-phase cells and increased percentages of S- and G2+M-phase
      cells in exponentially growing fibroblast populations as compared with identical
      cell populations not expressing Tag. This effect is the result of reduced G1 and
      increased G2+M cell cycle phase durations caused by Tag [Sladek, T.L. &
      Jacobberger, J.W. (1992). J. Virol., 66, 1059-1065]. Using recombinant
      retroviruses to manipulate Tag expression over a 25-fold range, it is shown here
      that the magnitude of this cell cycle phenotype increases as a function of
      increasing intracellular Tag concentration. This effect of Tag on the cell cycle
      is not independent of negative regulation by cellular mechanisms since
      exponentially growing cell populations producing high and increasing levels of
      Tag, increase the fraction of cells residing in G1 and decrease the fraction in S
      and G2+M as a function of cell density. Therefore, the data in this paper show,
      first, that Tag is a concentration-dependent, positive cell cycle regulator in
      exponentially proliferating cells and, second, that endogenous cellular
      mechanisms negatively regulating the cell cycle in response to cell density
      override the effect of Tag.

PMID- 1620546
TI  - Quail neuroretina c-Rmil(B-raf) proto-oncogene cDNAs encode two proteins of 93.5
      and 95 kDa resulting from alternative splicing.
AB  - c-Rmil is the cellular allele of the v-Rmil oncogene transduced during in vitro
      passaging of Rous-associated virus type 1 in chicken embryonic neuroretina (NR)
      cells. The c-Rmil proto-oncogene is the avian homolog of the mammalian B-raf gene
      and belongs to the mil/raf oncogene family of serine/threonine protein kinases.
      The c-Rmil/B-raf gene is preferentially expressed in avian and mammalian neural
      tissues. Two c-Rmil cDNA species, resulting from an alternative splicing
      mechanism, were isolated from quail embryonic NR cDNA libraries. They encode two
      proteins of 767 and 807 amino acids that differ by the presence of an alternative
      exon, located upstream of the kinase domain. Expression of these cDNAs in COS-1
      cells leads to the synthesis of two proteins with apparent molecular weights of
      93.5 and 95 kDa, recognized by an Rmil-specific antiserum. Both proteins are
      phosphorylated in an immune complex kinase assay. A protein of 94 kDa is also
      immunoprecipitated in avian NR cells and is identical to the 93.5-kDa protein
      expressed in COS-1 cells, as shown by Staphylococcus aureus V8 protease mapping.
      The c-Rmil proteins contain the three conserved regions previously identified in
      mil/raf protein kinases. In addition, they contain amino-terminal sequences that
      are not present in the other mil/raf proteins identified to date. These
      additional sequences may define a novel functional domain for c-Rmil/B-raf and
      could play a role in signal transduction in neural cells.

PMID- 1620547
TI  - Detection of the PTC/retTPC oncogene in human thyroid cancers.
AB  - We have investigated the PTC/retTPC oncogene, an activated form of ret proto
      oncogene with a specific rearrangement, in thyroid malignancies. Southern
      analysis was used to screen 36 thyroid papillary carcinomas (PC), 22 normal
      thyroid tissues from glands with PC elsewhere, three follicular carcinomas, eight
      follicular adenomas and 30 other non-malignant thyroids. Rearrangements were
      detected in four PCs (11%) using probes derived from the ret proto-oncogene.
      Genomic breakpoints from a PC and a PC cell line (TPC-1) were cloned and
      sequenced. The rearrangement points of ret proto-oncogene were found in the
      intron between the exon for the transmembrane domain and the first exon for the
      tyrosine kinase domain. Furthermore, the PTC/retTPC chimeric transcripts were
      detected in two PCs with the rearrangement by reverse transcription polymerase
      chain reaction. Distant metastases were present in 50% (2/4) of PCs with the
      rearrangement, but in only two out of 32 PCs without a detectable rearrangement
      (P = 0.05, Fisher exact test). Our study suggests that the rearrangement of the
      ret proto-oncogene may be involved in the development of distant metastases in
      patients with papillary thyroid carcinomas. However, a larger clinical study will
      be required to verify this observation.

PMID- 1620548
TI  - JAK2, a third member of the JAK family of protein tyrosine kinases.
AB  - We have isolated cDNA clones encoding a third, widely expressed, member of the
      JAK family of protein tyrosine kinases (PTKs). The anticipated amino acid
      sequence of JAK2 predicts the presence of two kinase-related domains, a feature
      characteristic of this family of PTKs. The structural similarity of JAK2 to the
      other members of this family extends towards their N-termini, beyond the two
      kinase-related domains, and reveals five further domains of substantial amino
      acid similarity. The C-terminal portion of one of these domains, the JH4 domain,
      bears an intriguing, albeit tenuous, similarity to the core element of the SH2
      domain, whereas the remaining JAK homology domains do not appear to be a feature
      of other known proteins.

PMID- 1620549
TI  - Phosphorylation of the p53 tumour-suppressor protein at three N-terminal sites by
      a novel casein kinase I-like enzyme.
AB  - Wild-type mouse p53, expressed in Escherichia coli, was phosphorylated by highly
      purified casein kinase I (CKI) from rabbit muscle. The major site of
      phosphorylation in the p53 was identified as serine 6, which is known to be
      phosphorylated in vivo. Serines 4 and 9 were also phosphorylated. To determine
      whether CKI is likely to be a physiological p53 kinase, SV3T3 cell lysates were
      fractionated on a Mono Q column and assayed for p53 kinase and casein kinase
      activities. Four p53 kinase activities were detected, one of which co-purified
      with CKI activity. This p53 kinase (designated PK270) further co-purified with
      CKI on sucrose gradients and had a native molecular weight, like CKI, in the
      range of 35,000-45,000. However, PK270 was separated from the bulk of CKI
      activity on a phosvitin-Sepharose affinity column, and was therefore likely to be
      a CKI-related kinase. In support of these conclusions, phosphorylation of p53, by
      both CKI and PK270, was inhibited by a peptide corresponding to a consensus CKI
      target sequence, but not by a non-specific peptide. Moreover, phosphopeptide
      analyses of p53 phosphorylated by CKI or by PK270 gave similar results,
      indicating that these two kinases phosphorylate the same sites in p53.

PMID- 1620550
TI  - Correlation between the conformational phenotype of p53 and its subcellular
      location.
AB  - In order to obtain insight into the parameters determining the subcellular
      localization of mutant and wild-type forms of p53, we analysed the subcellular
      distribution of p53 in four Balb/c mouse-derived cell lines ranging in their
      cellular phenotypes from normal (3T3), via minimal transformant (T3T3), to
      maximally transformed (3T3tx, Meth A). Epitope mapping showed the p53 proteins in
      3T3 and in T3T3 cells to be in a wild-type conformation, as they reacted with
      PAb246, whereas p53 in 3T3tx and in Meth A cells were PAb246 negative and thus
      displayed a mutant conformation. Despite its reactivity with PAb246, p53 in T3T3
      cells had an extended half-life and accumulated to abnormally high levels. We
      show that the conformationally wild-type p53 in 3T3 and T3T3 cells predominantly
      localized to the cell nucleus, with about half of it being tightly associated
      with nuclear structures. In contrast, approximately 60% of mutant p53 in 3T3tx
      and Meth A cells localized to the cytoplasm, the rest residing in the cell
      nucleus; all the nuclear p53 in these cells appeared to be structurally bound.
      The cytoplasmic location of mutant p53 in 3T3tx and Meth A cells was not seen by
      immunofluorescence microscopic analysis, and required cell fractionation for its
      detection. Both cytoplasmic and nuclear p53 of the mutant phenotype bound to hsc
      proteins with a similar stoichiometry, suggesting that hsc binding is not
      directly related to the subcellular distribution of these proteins. We suggest
      that the conformational phenotype of p53 is a major determinant of its
      subcellular location.

PMID- 1620551
TI  - Evidence for synergistic interactions between ras, myc and a mutant form of p53
      in cellular transformation and tumor dissemination.
AB  - Mouse 10T1/2 cells were transfected with combinations of T24 H-ras, human c-myc
      and the proline 193 mutant form of p53. The three-gene ras/myc/p53 combination
      was significantly more efficient than single genes or double gene combinations in
      inducing transformed foci in vitro. An analysis of cell lines isolated after
      transfections with ras, ras/myc, ras/p53 and ras/myc/p53 indicated that the last
      combination contained significantly higher levels of ras protein than the other
      combinations, produced tumors in syngeneic mice with a shorter latency period,
      and exhibited an increased ability to form lung tumors in an in vivo experimental
      metastasis assay. Synergistic interactions between ras, myc and mutant p53 genes
      were observed in focus formation and metastasis assays, suggesting that the
      action of the three oncogenes in malignant transformation occurs along separate
      but interactive pathways. These results support a working model of oncogene
      cooperativity in which alterations in myc and p53 permit elevated expression of
      ras, which is important in a mechanism affecting both cellular transformation in
      vitro and tumor dissemination in vivo.

PMID- 1620552
TI  - Differences in GTPase-activating protein activity between liver tumors and normal
      liver tissue in mice.
AB  - The intrinsic GTPase activity of the cellular protein p21ras is strongly
      increased by two cytosolic proteins, the GTPase-activating protein (GAP) produced
      by the neurofibromatosis type 1 gene (NF1-GAP) and a GAP of 120 kDa molecular
      mass (p120-GAP). The GAP-mediated stimulation of p21ras GTPase activity was
      measured in cytosol obtained from carcinogen-induced liver tumors and normal
      liver tissues of mice of two strains, namely C3H/He and C57BL/6J. For this
      purpose, cytosolic extracts were incubated with recombinant human p21ras
      complexed to [gamma-32P]GTP and the time-dependent decrease in p21ras bound
      radioactivity was measured. Liver cytosolic extracts mediated an increase in the
      GTPase activity of wild-type p21ras. There were great differences between tumor
      and normal tissues in the maximal velocity (Vmax) and in the apparent Michaelis
      constant (KM) of the p21ras GTPase reaction. Both Vmax and apparent KM were
      decreased in the liver tumors. Cytosolic extracts isolated from liver tumors that
      harbored point mutations in codon 61 of the c-H-ras gene did not differ in their
      activity from extracts obtained from non-mutated liver tumors. Since both GAP
      proteins are important cellular regulators of the ras signaling pathway and
      probably also effectors of p21ras, the observed differences in GAP activity may
      be of relevance for the tumorigenic process in mouse liver.

PMID- 1620553
TI  - Diet-dependent carcinogenesis of pancreatic islets and liver in transgenic mice
      expressing oncogenes under the control of the L-type pyruvate kinase gene
      promoter.
AB  - The liver-type pyruvate kinase (L-PK) gene is controlled positively by insulin
      and carbohydrates, negatively by glucagon and fasting. Diet-inducible models of
      carcinogenesis were obtained using the L-PK gene promoter and regulatory
      sequences to control the expression of c-myc and SV40 T oncogenes in transgenic
      mice. L-PK/c-myc and L-PK/Tag animals fed a carbohydrate-rich diet developed
      hepatocarcinomas. In addition, L-PK/Tag animals developed diet-dependent,
      aggressive endocrine pancreatic tumors, preceded by islet hyperplasia involving
      the different analysed cell populations (alpha, beta and delta). Expression of
      the L-PK gene was demonstrated in pancreatic tumors, in rat isolated islets and
      in rat insulinoma-derived cells (RIN line), revealing a new tissue specificity of
      the L-PK gene. Our results suggest that this gene may be expressed in islet
      progenitor cells from which the different mature endocrine cells derive.

PMID- 1620554
TI  - Phylogeny of the p68c-ets-1 amino-terminal transactivating domain reveals some
      highly conserved structural features.
AB  - The chicken c-ets-1 locus gives rise to two distinct transcription factors
      differing only in their structurally and functionally unrelated N-termini. One of
      these transcription factors, p54c-ets-1, contains a specific, short (27 amino
      acids), hydrophilic N-terminus encoded by a single exon, I54, that is widely
      conserved among vertebrates. The other one, p68c-ets-1, the cellular counterpart
      of the viral ets oncogene product, differs in the replacement of the I54 by two
      exons, termed alpha and beta, encoding a larger (71 amino acids), hydrophobic N
      terminus which, in contrast to I54, exhibits properties of a transactivating
      domain. To date the alpha and beta exons have only been found in chicken. Here,
      we demonstrate the existence of the alpha and beta exons in other avian species
      (quail and duck) and the existence of the alpha exon in reptiles (turtle).
      However, none of them could be detected in mammals. Our results strongly suggest
      that, in contrast to the phylogenetically well-conserved I54 exon, the alpha exon
      is restricted to reptilian species (birds and 'true' reptiles), whereas the beta
      exon is detectable so far only in birds. Comparison of their amino acid sequences
      reveals that the alpha exon and to a much greater extent the beta exon have
      diverged faster than the I54 exon. In addition, we show that the N- and C
      terminal thirds of the alpha exon and the highly hydrophobic nature of the alpha
      beta-encoded sequence are heavily conserved features and thus likely to be
      required for function as a transactivating domain in p68c-ets-1 and possibly in
      the viral P135gag-myb-ets transforming protein.

PMID- 1620555
TI  - Detection of phosphorylated retTPC oncogene product in cytoplasm.
AB  - The product of the retTPC oncogene, an activated form of the ret proto-oncogene
      found in human papillary thyroid carcinomas, was identified as a 57-kDa protein
      (p57retTPC) by Western blotting with a polyclonal antibody raised by an
      oligopeptide corresponding to the carboxy-terminal region of the ret proto
      oncogene product. Subcellular fractionation experiments using NIH3T3 cell
      transformants induced by the retTPC cDNA showed that p57retTPC was localized in a
      soluble cytoplasmic fraction, whereas the ret proto-oncogene products expressed
      in a neuroblastoma cell line were present in a membrane fraction. Immunostaining
      also demonstrated that p57retTPC is localized in the cytoplasm.
      Immunoprecipitation with anti-phosphotyrosine antibody followed by Western
      blotting revealed that p57retTPC is constitutively phosphorylated, whereas the
      ret proto-oncogene products are not. These findings suggest that p57retTPC has an
      aberrant tyrosine kinase activity resulting in autophosphorylation associated
      with change in its location.

PMID- 1620556
TI  - Annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery
      Foundation, Inc. Washington, D.C., September 13-17, 1992. Instructional Course
      program.

PMID- 1620557
TI  - A pediatrician's view. A lead balloon.

PMID- 1620558
TI  - Advances in neonatal neurology.

PMID- 1620559
TI  - Clinical evaluation of the floppy infant.
AB  - The list of possible diagnoses for floppiness in infancy is extensive, with
      potentially hundreds of rare diseases. Nonetheless, most floppy infants have
      distinctive features in the history, the family history, or the physical
      examination that quickly narrow the list to central or motor unit disorders, and
      often to specific diagnoses within these broad groups. Accurate diagnosis is
      important, as outcomes are similarly protean, genetic implications are frequent,
      and in some cases specific treatments are possible.

PMID- 1620560
TI  - What have we learned from febrile seizures?
AB  - What have we learned from febrile seizures? We have learned that there is a
      natural history to different seizure types, what some have taken to calling
      "seizure syndromes." We have learned that understanding these "natural histories"
      may be helpful in making decisions about treatment. We have learned that seizures
      themselves, while unpleasant, may not be harmful and don't always have to be
      treated. We have learned that sometimes the treatment is worse than the disease
      and that the side effects of medication may have more consequences than the
      occurrence of another seizure. We have learned that the determination of the
      "risks" and consequences of the seizures should be made by the patient or the
      family, and that they may assess the risks and benefits quite differently than
      the physician. Similarly, the benefits and consequences of anticonvulsant
      medication may be assessed quite differently by different people. We have learned
      that all seizures do not need to be treated, and we have learned that those that
      are treated should be treated for the shortest time possible. I believe that
      these are important lessons that should affect our management of afebrile
      seizures as well.

PMID- 1620561
TI  - Chronic recurrent headaches in children.
AB  - Chronic recurrent headaches in children can be classified into distinct
      categories based on a careful history and physical examination. Migraine and
      muscle contraction headaches are common in the pediatric population. Laboratory
      studies should be limited to those individuals who have other signs or symptoms
      accompanying headaches that raise concern. Reassurance about the underlying
      pathophysiology of vascular or muscle contraction headaches, their benign nature,
      and favorable prognosis may not only relieve associated anxiety that may produce
      or prolong headache, but also may relieve the headache itself. Symptomatic mild
      analgesics and behavioral medicine therapy are often sufficient, although
      occasionally prophylactic pharmacotherapy is required. The long-term prognosis
      for children with chronic recurrent headaches is generally favorable.

PMID- 1620562
TI  - Ischemic stroke syndromes in childhood.
AB  - Cerebral ischemic injury is uncommon in children, but the effects are long
      lasting with significant implications for the child's development. The
      precipitating event in ischemic infarct is generally occlusion of the cerebral
      vessels. This occlusion may the result of direct injury of the cerebral
      vasculature, thrombus formation, or emboli from more distant sources. A wide
      variety of conditions are known to predispose to cerebral infarcts in children.
      However, even in recent studies, the underlying condition is unknown in as many
      as half the children who suffer an ischemic stroke. To care for these children
      effectively, it is imperative that extensive evaluations be performed to
      determine the cause of the cerebral infarct. Furthermore, increasing attention
      will need to be directed toward the metabolic events of cerebral ischemia. A
      better understanding of these mechanisms may provide clues to some of the causes
      of ischemic injury and should lead to more effective treatments.

PMID- 1620563
TI  - Neurologic concepts of lead poisoning in children.

PMID- 1620564
TI  - Hysteresis, cooperativity, and depth averaging in dynamic random-dot stereograms.
AB  - Experiments were performed to assess the response of the human visual system to
      dynamic random-dot patterns composed of disparity mixtures. In Experiment 1, the
      perceived depth and relative stability of two patterns were compared; one pattern
      depicted two transparent layers of dots, and the other depicted a volume of dots.
      Two effects were found: (1) the volume pattern exhibited a large degree of
      disparity averaging; and (2) asymmetries were observed in the relative stability
      of these two patterns. Experiment 2 was designed to determine whether these
      findings could be attributed to spatially localized processes occurring at the
      location of disparity discontinuities. This was accomplished by introducing
      unpaired noise points localized either along the disparity discontinuities or in
      the center of the layered and volume patterns. The amount of depth averaging and
      the direction of the asymmetry did not appear to depend on processes localized
      along the disparity discontinuities. Results of these experiments, taken in
      conjunction with those of previous studies, suggest that hysteresis is
      independent of cooperative persistence mechanisms.

PMID- 1620565
TI  - A comparison of generalization functions and frame of reference effects in
      different training paradigms.
AB  - Six experiments were carried out to compare go/no-go and choice paradigms for
      studying the effects of intradimensional discrimination training on subsequent
      measures of stimulus generalization in human subjects. Specifically, the purpose
      was to compare the two paradigms as means of investigating generalization
      gradient forms and frame of reference effects. In Experiment 1, the stimulus
      dimension was visual intensity (brightness); in Experiment 2, it was line
      orientation (line-angle stimuli). After learning to respond (or to respond
      "right") to stimulus value (SV) 4 and not to respond (or to respond "left") to
      SV2 (in Experiment 1) or SV1 (in Experiment 2), the subjects were tested for
      generalization (recognition) with an asymmetrical set of values ranging from SV1
      to SV11. Go/no-go training produced peaked gradients, whereas choice training
      produced sigmoid gradients. The asymmetrical testing resulted in a gradual shift
      of the peak of responding (go/no-go group) or in the point of subjective
      indifference (PSI; choice group) toward the central value of the test series;
      thus, both paradigms revealed a frame of reference effect. The results were
      comparable for the quantitative (intensity) and the qualitative (line-angle)
      stimulus dimensions. Experiment 3 compared the go/no-go procedure with a yes/no
      procedure in which subjects responded "right" to SV4 and "left" to all other
      intensities and found no differences between these procedures. Thus the
      difference in gradient forms in go/no as opposed to (traditional) choice
      paradigms depends on whether one or two target stimuli are used in training. In
      Experiment 4, in which visual intensity was used, the shift in the PSI following
      choice training varied positively with the range of asymmetrical test stimuli
      employed. In Experiment 5, also with visual intensity, the magnitude of the peak
      shift following go/no-go training varied as a function of overrepresenting a high
      or a low stimulus value during generalization testing. Experiment 6, with line
      angles, showed that the PSI following choice training varies in a similar way.
      The frame of reference effects obtained in these experiments are consistent with
      an adaptation-level model.

PMID- 1620566
TI  - Size-distance invariance: kinetic invariance is different from static invariance.
AB  - The static form of the size-distance invariance hypothesis asserts that a given
      proximal stimulus size (visual angle) determines a unique and constant ratio of
      perceived object size to perceived object distance. A proposed kinetic invariance
      hypothesis asserts that a changing proximal stimulus size (an expanding or
      contracting solid visual angle) produces a constant perceived size and a changing
      perceived distance such that the instantaneous ratio of perceived size to
      perceived distance is determined by the instantaneous value of visual angle. The
      kinetic invariance hypothesis requires a new concept, an operating constraint, to
      mediate between the proximal expansion or contraction pattern and the perception
      of rigid object motion in depth. As a consequence of the operating constraint,
      expansion and contraction patterns are automatically represented in consciousness
      as rigid objects. In certain static situations, the operation of this constraint
      produces the anomalous perceived-size-perceived-distance relations called the
      size-distance paradox.

PMID- 1620567
TI  - The effect of orientation on tactual braille recognition: optimal touching
      positions.
AB  - Subjects in five experiments matched tangible braille against a visible matching
      code. In Experiment 1, braille recognition suffered when entire lines of braille
      characters were tilted in varying amounts from the upright. Experiment 2 showed
      that tilt lowered performance for tangible, large embossed letters, as well as
      for braille. However, recognition was better for print letters than it was for
      braille. In Experiment 3, subjects attempted to match the upright array against
      embossed braille that was left/right reversed, inverted up/down, or rotated +180
      degrees. Performance was close to that for normal braille in the left/right
      reversal condition, and very low for the +180 degrees rotation group. These
      results on braille tilt in the "picture plane" may reflect difficulty in
      manipulating the tangible "image." Braille recognition performance was not
      lowered when the visible matching array was tilted -45 degrees or -90 degrees
      from the upright but the tangible stimuli were upright. In Experiment 4,
      recognition of left/right reversed braille that was physically horizontal (on the
      bottom of a shelf) was compared with that of braille left/right reversed due to
      its location on the back of a panel, in the vertical plane. Braille recognition
      accuracy was higher with braille located vertically. An additional experiment
      showed the beneficial effect of locating braille in the vertical, frontoparallel
      plane, obtained with +90 degree rotated braille. It is proposed that optimal
      tactual performance with tangible arrays might depend on touching position, and
      on the physical position of stimuli in space. Just as there are good and poor
      viewing positions, there may be optimal touching positions.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1620568
TI  - Active regulation of altitude as a function of optical texture.
AB  - Two empirical studies are reported that examine active regulation of altitude as
      a function of the type of ground texture. Three ground textures were examined:
      lines perpendicular to the direction of motion, lines parallel to the direction
      of motion, and the combination (i.e., square or checkerboard texture). Although
      subjects only controlled altitude, disturbances were introduced on three axes:
      vertical, lateral, and fore-aft. The results show a clear advantage for texture
      parallel to the direction of motion. However, in considering these results in the
      context of previous research on altitude control, the argument is made that there
      is no compelling evidence that suggests either parallel (splay) or perpendicular
      (density) texture is privileged with regard to altitude control. Rather, the most
      effective display for altitude control will be the one that best isolates the
      optical activity associated with changing altitude from the optical activity
      arising from other sources of disturbance (such as forward locomotion). Such a
      display will make it easier for the observer to distinguish and respond
      specifically to the disturbances of altitude.

PMID- 1620569
TI  - Visually controlled matching of pattern movement.
AB  - Subjects were asked to match the speeds of two moving random-dot patterns seen
      through circular apertures. The speed of one pattern that moved horizontally
      toward the right of a computer screen changed continuously. The speed of this
      pattern represented the target. It was to be matched with the speed of the second
      pattern, which moved in the opposite direction. The subject controlled the speed
      of the second pattern by means of an isometric joystick. The distance between the
      apertures on the screen as well as the subject's distance from the screen served
      as experimental parameters. In this way, the effects of both spatial and temporal
      transients of pattern speed on human tracking performance were studied. To avoid
      anticipation by the subject, the amplitude and the frequency of the target
      pattern speed changed pseudorandomly. The accuracy with which the subject
      performed the matching task was influenced by the mean pattern speed and the
      parameters of the visual field. Within lower velocity ranges, the subject's
      sensitivity to the instantaneous speed differences varied according to Weber's
      law. The cross-correlation of the velocity time courses decreased when the mean
      speed of the target pattern was increased. Two stimulus parameters had a strong
      influence on the modulation of the correlation value: (1) the angular size of the
      stimulus on the retina and (2) the retinal eccentricity of the stimulus.

PMID- 1620570
TI  - Haptic probing: perceiving the length of a probe and the distance of a surface
      probed.
AB  - Knowing about the properties of objects by wielding them and knowing about the
      distances of surfaces by striking them with objects as probes are examples of
      dynamic or effortful touch. Six experiments focused on the invariant mechanical
      parameters that couple the time-varying states (displacements, velocities) of
      hand-held rods to the time-varying torques and forces imposed upon them by
      wielding and probing. There were three major conclusions. First, when a probe is
      wielded without contact, perceived probe length is a function of the probe's
      rotational inertia; however, with contact, perceived probe length is affected by
      the rotational inertia and the distance of the point of contact from the probe's
      center of percussion. Second, when a surface is struck with a probe, perceived
      surface distance is affected by the probe's rotational inertia and the angle of
      inclination of the probe at contact. Third, under seemingly identical conditions
      of probing, either probe length or surface distance can be perceived selectively
      without confusion. Results were discussed in terms of haptic information, haptic
      attention, and the dynamics of probing.

PMID- 1620571
TI  - Perceptual selectivity for color and form.
AB  - Three visual-search experiments tested whether the preattentive parallel stage
      can selectively guide the attentive stage to a particular known-to-be-relevant
      target feature. Subjects searched multielement displays for a salient green
      circle that had a unique form when surrounded by green nontarget squares or had a
      unique color when surrounded by red nontarget circles. In the distractor
      conditions, a salient item in the other dimension was present as well. As an
      extension of earlier findings (Theeuwes, 1991), the results showed that complete
      top-down selectivity toward a particular feature was not possible, not even after
      extended and consistent practice. The results reveal that selectivity depends on
      the relative discriminability of the stimulus dimensions: the presence of an
      irrelevant item with a unique color interferes with parallel search for a unique
      form, and vice versa.

PMID- 1620572
TI  - Expectancy and stimulus frequency: a comparative analysis in rats and humans.
AB  - We examined whether expectancy, one of several factors influencing attention, is
      similarly affected in rats and humans by manipulation of relative stimulus
      frequency. A two-choice reaction time (RT) task was developed for rats, and an
      analogous task was used for humans. Errors, RTs, discriminability, and response
      bias were measured. Both rats and humans shifted their response bias to the more
      frequent stimulus, with no change in overall discriminability. As stimulus
      probability or stimulus repetition increased, RTs and errors decreased. These
      results illustrate the similarity of expectancy in rats and humans. This two
      choice RT task for rats can be used in future studies to examine the neuronal
      mechanisms of expectancy and attention.

PMID- 1620573
TI  - High impedance mechanical ventilator for small animals: use of programmable
      controller.
AB  - We built a simple high impedance ventilator, which generates a pattern of flow
      largely independent of respiratory mechanics, to mechanically ventilate
      anaesthetized small animals. The system includes a source of compressed gas with
      an electronic valve and a flow controller on the inspiratory side and a second
      valve on the expiratory side. The two valves are driven by a programmable
      controller. To assess the performance of this ventilator we measured the
      delivered tidal volume while the ventilator was connected to an external,
      gradually varying resistance. This resistance was progressively increased to
      simulate bronchoconstriction of the respiratory system. Comparison with a volume
      controlled ventilator was made. The use of a programmable controller also allows
      control of different patterns of mechanical ventilation, such as end-inspiratory
      pause or the static pressure-volume relationship, which can be used to perform
      lung function tests. The system is a simple, versatile device allowing both
      reliable mechanical ventilation and lung function assessment in small rodents and
      is suitable for routine use in laboratories.

PMID- 1620574
TI  - Role of endothelium in the response of the vein wall to magnesium withdrawal.
AB  - Complete absence of magnesium has a two-fold effect on the arterial tone: direct
      smooth muscle contraction and relaxation via endothelium-derived relaxing factor
      (EDRF) release. In the present study performed on a systemic vein we investigated
      (1) which of these effects dominates following reduction of magnesium
      concentration from 1.2 mM to 0.8 and 0.4 mM and (2) whether the vessel segments
      asymmetrically respond when the magnesium concentration is reduced on either the
      intra- or extraluminal side. The effects of reducing magnesium concentration on
      both the isometric tension of isolated ring preparations and the diameter of
      isolated, perfused and superfused feline femoral veins were investigated. In
      noradrenaline-precontracted rings, rapid decreases in the extracellular magnesium
      concentration from 1.2 mM to 0.8 and 0.4 mM caused relaxation, whereas total
      omission of magnesium returned the tone to the level of the initial tone induced
      by noradrenaline. Both in the presence of haemoglobin (5 x 10(-6) M), and in
      vessels without endothelium, lowering the magnesium concentration caused a dose
      dependent elevation of the noradrenaline-induced tone. In perfused and superfused
      noradrenaline-contracted vein segments, each reduction of extraluminal magnesium
      concentration caused contraction of the vessels, regardless of whether the
      endothelium was intact or not. A decrease in intraluminal magnesium concentration
      did not alter the diameter of the vessel when the endothelium was intact, but
      caused contraction when the endothelium was disrupted. The results of the present
      study demonstrate that both the reduction of magnesium concentration or its
      complete absence cause an EDRF-mediated relaxation and a directly mediated smooth
      muscle contraction in the femoral vein of the cat.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1620575
TI  - Tubular sodium handling and tubuloglomerular feedback in compensatory renal
      hypertrophy.
AB  - Tubular sodium handling and tubuloglomerular feedback (TGF) activity were
      assessed in established compensatory renal hypertrophy in Sprague Dawley rats.
      Hyperfiltration at the level of the single nephron was confirmed 4-6 weeks
      following a reduction in renal mass. TGF activity, determined as the difference
      between late proximal and early distal measurements of single-nephron glomerular
      filtration rate (SNGFR), was significantly increased in compensatory renal
      hypertrophy, being 7.8 +/- 1.0 vs 23.3 +/- 1.9 vs 25.5 +/- 2.6 nl/min (P for
      analysis of variance less than 0.05) following sham operation, unilateral
      nephrectomy, and 1 1/3 nephrectomy, respectively. Enhanced net tubular Na
      transport was also observed, with total Na reabsorption up to the late proximal
      site being 1.8 +/- 0.2 vs 2.7 +/- 0.1 vs 3.1 +/- 0.3 nmol/min (P less than 0.05),
      and to the early distal site being 3.4 +/- 0.5 vs 5.8 +/- 0.6 vs 7.9 +/- 0.8
      nmol/min (P less than 0.05) in the three animal groups respectively. Comparison
      of proximal tubular length demonstrated a 71.9 +/- 8.1% increase in
      uninephrectomised vs sham-operated animals. This increase was proportionately
      greater than the increase in proximal Na reabsorption (50.0 +/- 4.0%) observed in
      the corresponding animal groups. Concurrent electron microprobe experiments in
      uninephrectomised and sham-operated animals demonstrated that the proximal
      tubular intracellular Na concentration was significantly lower following
      uninephrectomy (16.8 +/- 0.6 vs 18.9 +/- 0.5 mmol/kg wet weight, P less than
      0.01), in association with evidence of reduced basolateral Na/K-ATPase
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620576
TI  - Immunological rejection of heart transplant: how lytic granules from cytotoxic T
      lymphocytes damage guinea pig ventricular myocytes.
AB  - We investigated the mechanism by which lytic granules extracted from cytotoxic T
      lymphocytes (CTL) damage guinea pig ventricular myocytes in order to determine
      whether their actions can be related to the overall immunological rejection of
      the transplanted heart. Granule-induced myocyte morphological changes and final
      destruction were preceded by shortening of action potential duration (APD) and
      reductions of the resting potential and the action potential amplitude. APD
      shortening was probably caused by a granule-induced increase in outward current
      (most likely non-specific). Ryanodine, which blocks Ca2+ release from the
      sarcoplasmic reticulum, did not interfere with the morphological and
      electrophysiological effects of lytic granules. Fura-2 imaging indicated that
      [Ca2+]i initially increased about 2-fold from 90.0 +/- 11.5 nM, while cell length
      decreased less than 5% from a mean value of 99.0 +/- 9.0 microns. A further
      increase in [Ca2+]i (greater than 10 fold) was associated with progressive
      contracture and destruction, suggesting that the structural damage inflicted by
      lytic granules is caused by [Ca2+]i overload. The results indicate that the
      cytocidal action of CTL-derived lytic granules may be involved in immunologically
      induced damage, even to the extent of rejection of the transplanted heart.

PMID- 1620577
TI  - Role of external Ca2+ and K+ in gating of cardiac delayed rectifier K+ currents.
AB  - We sought to determine whether extracellular Ca2+ (Ca2+e) and K+ (K+e) play
      essential roles in the normal functioning of cardiac K+ channels. Reports by
      others have shown that removal of Ca2+e and K+e alters the gating properties of
      neural delayed rectifier (IK) and A-type K+ currents, resulting in a loss of
      normal cation selectivity and voltage-dependent gating. We found that removal of
      Ca2+e and K+e from the solution bathing guinea pig ventricular myocytes often
      induced a leak conductance, but did not affect the ionic selectivity or time
      dependent activation and deactivation properties of IK. The effect of [K+]e on
      the magnitude of the two components of cardiac IK was also examined. IK in guinea
      pig myocytes is comprised of two distinct types of currents: IKr (rapidly
      activating, rectifying) and IKs (slowly activating). The differential effect of
      Ca2+e on the two components of IK (previously shown to shift the voltage
      dependence of activation of the two currents in opposite directions) was
      exploited to determine the role of K+e on the magnitude of IKs and IKr. Lowering
      [K+]e from 4 to 0 mM increased IKs, as expected from the change in driving force
      for K+, but decreased IKr. The differential effect of [K+]e on the two components
      of cardiac IK may explain the reported discrepancies regarding modulation of
      cardiac IK conductance by this cation.

PMID- 1620578
TI  - Role of nitric oxide in local blood flow control in the anaesthetized dog.
AB  - Intravenous infusion of NG-nitro-L-arginine methyl ester (L-NAME), a potent
      inhibitor of nitric oxide (NO) formation from L-arginine, provokes marked rises
      in arterial blood pressure by increasing peripheral resistance. In order to
      further evaluate the contribution of basal NO-formation to control of organ blood
      flow, regional blood flow distribution within the myocardium, kidney and brain
      areas was assessed using the tracer-microsphere technique in anaesthetized dogs.
      After L-NAME (20 mg kg-1 i.v.) kidney perfusion was homogeneously reduced by 55%
      in the entire cortex and the outer medulla. Within the left ventricular
      myocardium regional blood flow significantly decreased only in subepicardial
      layers (-12%), whereas within the entire right ventricle regional blood flow was
      reduced by 19-24%. A close inverse relationship was found between all changes in
      regional myocardial blood flows observed after L-NAME and the respective control
      values. No significant changes in regional blood flow in different areas of the
      brain were detectable after L-NAME. It is concluded that the contribution of
      basal NO formation varies greatly between different organs and exhibits
      significant regional differences within the heart. It is possible that local
      metabolic mechanisms may compensate functionally for the inhibition of NO
      synthesis.

PMID- 1620579
TI  - Mechanism of intracellular calcium oscillations in fibroblasts expressing the ras
      oncogene.
AB  - In NIH fibroblasts expressing the ras oncogene bradykinin leads to sustained,
      calcium-dependent oscillations of cell membrane potential by oscillating activity
      of calcium sensitive potassium channels. The present study has been performed to
      further analyse the underlying mechanisms. In cells expressing the oncogene, but
      not in NIH fibroblasts not expressing the oncogene, bradykinin elicits calcium
      oscillations, which are detected by fura-2 fluorescence and amplified by a
      decrease of extracellular sodium activity. These calcium oscillations are
      dependent on the presence of extracellular calcium and are inhibited by lanthanum
      ions. It is concluded that in cells expressing the ras oncogene, bradykinin
      activates lanthanum sensitive calcium entry from the extracellular space. Ras
      oncogene expression leads to enhanced bradykinin-induced formation of both, 1, 4,
      5 inositoltrisphosphate and 1, 3, 4, 5 inositoltetrakisphosphate, an effect
      probably accounting for the oscillations of intracellular calcium activity.

PMID- 1620581
TI  - Development, refinement, and future directions of the model.

PMID- 1620580
TI  - Activation of different pathways for calcium elevation by bradykinin and ATP in
      rat pheochromocytoma (PC 12) cells.
AB  - We have studied the pathways by which extracellular bradykinin and adenosine 5'
      triphosphate (ATP) elicit changes in intracellular free calcium ([Ca2+]i) in
      nerve-growth-factor(NGF)- treated rat pheochromocytoma (PC 12) cells. Both
      substances caused a significant rise in [Ca2+]i as assessed by fura-2 based
      microfluorimetry. The bradykinin-induced response consisted of an initial Ca2+
      mobilization from an internal pool followed by a sustained increase in [Ca2+]i,
      which was due to activation of a small inward current. The initial response
      always started at a localized site opposite to the cell nucleus. The inward
      current was partially carried by Ca2+ and began with a time lag of about 4 s
      after the start of the initial transient signal. Stepwise hyperpolarization of
      the plasma membrane, after activation of the inward current by bradykinin, caused
      a simultaneous increase in current amplitude and in [Ca2+]i, due to an increase
      in the driving force for Ca2+ influx. With ATP as an agonist the onset of inward
      current coincided with an increase in [Ca2+]i. Inward current and [Ca2+]i were
      enhanced during hyperpolarizing steps indicating a substantial Ca2+ influx
      through ATP-activated channels. No release of Ca2+ from internal stores, but a
      large Na+ inward current, was observed in Ca(2+)-free external solution after
      addition of ATP. While the bradykinin-induced responses were much more pronounced
      in cell bodies than in growth cones, the ATP effects were somewhat variable in
      cell bodies and more homogeneous in growth cones.

PMID- 1620582
TI  - Models for the next century.
AB  - The Loomis/Wood Model offers potential to influence what hangs in the balance for
      the future. It is a model that encompasses conceptual and ideological diversity.
      It is a model that encourages the use of empirical data applied within a
      framework of nursing's conceptual and ethical tradition. It is a model that can
      incorporate rapidly changing demands for more and sometimes different
      information. It does not prescribe; rather, it encourages contextual and
      situationally relevant choice on the part of the user. In my view, these are the
      types of features that will be critical for the next century.

PMID- 1620583
TI  - Application and utilization of the Loomis/Wood Model as the conceptual framework
      for curriculum design.

PMID- 1620584
TI  - Application and utilization of the Loomis/Wood Model as the conceptual framework
      for the conduct of nursing research.

PMID- 1620585
TI  - Application of the Loomis/Wood Model as a conceptual framework in nursing
      practice.

PMID- 1620586
TI  - Observations on guided tissue regeneration.

PMID- 1620587
TI  - Self-destruction and tolerance in resistance of mammalian cells to alkylation
      damage.

PMID- 1620588
TI  - Differential binding of human nuclear proteins to Alu subfamilies.
AB  - Several diagnostic differences that distinguish human Alu subfamilies are
      clustered just downstream from the B box of the RNA polymerase III promoter; we
      tentatively refer to this diagnostic region as the DB box. Assuming that this
      region might determine the relative transcriptional activity of Alu subfamilies,
      we examined the interaction of nuclear proteins with DB box sequences
      representing different Alu subfamilies. Gel mobility shift assays suggest the
      existence of two factors which discriminate among the DB boxes of different Alu
      subfamilies: 1) An abundant, ca. 50 kd, protein binds more stably to a young 'PV'
      Alu subfamily (PVS) than to the older major subfamily (MS). 2) Methylation of CpG
      dinucleotides stimulates the binding of a less abundant, ca. 70 kd, protein to
      the DB boxes of younger Alu subfamilies.

PMID- 1620589
TI  - Alternative 3' processing of Xenopus alpha-tubulin mRNAs; efficient use of a
      CAUAAA polyadenylation signal.
AB  - The Xenopus laevis alpha-tubulin gene X alpha T14 produces two mRNAs of 1.7 and
      2.15 kb and we have shown that this is due to the use, at approximately equal
      frequency, of alternative 3' processing sites. Unusually, the hexanucleotide
      polyadenylation signal responsible for use of the downstream site, pA2, is CAUAAA
      in contrast to the consensus AAUAAA used at the upstream site, pA1. Since such a
      variant hexanucleotide would normally be expected to reduce drastically the
      efficiency of 3' processing, we have examined the 3' flanking sequences involved
      in pA2 usage in injected oocytes. In deletion mutants with 40 bp or 440 bp of 3'
      flanking DNA use of pA2 was almost totally abolished whereas when 770 bp of the
      natural flank was present pA2 was used normally. This polyadenylation signal
      therefore requires an unexpectedly large amount of flanking DNA and we have
      identified in the required region a member of a novel family of 450 bp
      interspersed repeats that we have termed Pir elements. We speculate that because
      of the variant hexanucleotide efficient use of pA2 has to be potentiated by the
      Pir element, perhaps through an effect on transcriptional pausing or termination.

PMID- 1620590
TI  - Expression of the arylsulfatase gene from the beta 2-tubulin promoter in
      Chlamydomonas reinhardtii.
AB  - Arylsulfatase, produced by Chlamydomonas reinhardtii during sulfur-limited
      growth, is secreted into the periplasmic space and is readily assayed using a
      chromogenic substrate. To assess the usefulness of the gene encoding
      arylsulfatase (ars) as a reporter gene in C. reinhardtii, we have fused the
      promoter region of the beta 2-tubulin gene (tubB2) to the coding region of an ars
      genomic clone to form a tubB2/ars chimeric sequence. This construct was
      introduced into C. reinhardtii, strain CC425 (cw-15, arg-2), via cotransformation
      with the argininosuccinate lyase gene (which complements the arg-2 lesion) (1).
      Transformants expressing arylsulfatase (Ars) in sulfur-sufficient medium were
      isolated and subsequently shown to contain the tubB2/ars gene. RNA analysis
      determined that tubB2/ars transcripts accumulated in these cells. Abundance of
      the chimeric transcript increased immediately following deflagellation in a
      manner similar to that of the endogenous tubB2 transcript. Thus, chimeric genes
      incorporating ars coding sequences and heterologous promoters can be used to
      examine regulated gene expression in C. reinhardtii.

PMID- 1620591
TI  - Targeted integration of neomycin into yeast artificial chromosomes (YACs) for
      transfection into mammalian cells.
AB  - Vectors have been constructed for the introduction of the neomycin resistance
      gene (neo) into the left arm, right arm or human insert DNA of yeast artificial
      chromosomes (YACs) by homologous recombination. These vectors contain a yeast
      selectable marker Lys-2, i.e. the alpha-aminoadipidate reductase gene, and a
      mammalian selection marker, neo, which confers G418 resistance. The vectors can
      be used to modify YACs in the most commonly used yeast strain for YAC library
      construction, AB1380. Specific targeting can be carried out by transfection of
      restriction endonuclease treated linear plasmids, with highly specific
      recombinogenic ends, into the YAC containing yeast cells. Analysis of targeted
      YACs confirmed that all three vectors can target correctly in yeast. Introduction
      of one of the targeted YACs into V79 (Chinese hamster fibroblast) cells showed
      complete and intact transfer of the YAC.

PMID- 1620592
TI  - The two main rDNA size classes of Ascaris lumbricoides: comparison of
      transcription termination and spacer organization.
AB  - Structural and functional analyses were carried out to compare transcription
      termination and intergenic spacer organization between the two heterogeneous
      ribosomal DNA size classes of Ascaris lumbricoides. By performing mung bean
      nuclease mapping in vivo, we localized the 3' end of the mature 26S rRNA to the
      same position in both forms. This site coincides with the in vivo and in vitro
      transcription termination site of the 40S-precursor rRNA from both rDNA size
      classes. We demonstrate that the 3' boundary of sequences necessary for faithful
      transcription termination extends 35 bp beyond the end of the 26S rRNA gene and
      that these sequences are perfectly conserved within the two size classes. The
      intergenic spacers of both rDNA size classes have been completely sequenced; they
      are 2410 bp and 1937 bp long and show a sequence homology of 92.8%. There is no
      evidence for the presence of reiterated termination sites or promoters within the
      relatively short intergenic spacers of the two rRNA gene classes.

PMID- 1620593
TI  - Multiple mRNA species generated by alternate polyadenylation from the rat
      manganese superoxide dismutase gene.
AB  - The mitochondrial enzyme, manganese superoxide dismutase (MnSOD) is an integral
      component of the cell's defense against superoxide-mediated cellular damage. We
      have isolated and characterized four cDNA clones and the structural gene for rat
      MnSOD. Northern analyses using MnSOD cDNA probes detected at least five mRNAs in
      all tissues and cell types examined. Southern and Northern analysis using a 3'
      non-coding sequence probe, common to all the cDNAs, showed hybridization only to
      genomic restriction fragments that correspond to our genomic clone and the five
      MnSOD mRNAs. These data demonstrate that all of the rat MnSOD transcripts are
      derived from a single functional gene. Primer extension data indicate that
      transcription initiation is clustered within a few bases. Northern analysis using
      intron probes demonstrates that all five transcripts are fully processed.
      Northern analysis using cDNA and genomic probes from sequences progressively 3'
      to the end of the coding sequence indicates that size heterogeneity in the MnSOD
      transcripts results from variations in the length of the 3' non-coding sequence.
      From this data and the location of potential polyadenylation signals near the
      expected sites of transcript termination, we conclude that the existence of
      multiple MnSOD mRNA species originate as the result of alternate polyadenylation.

PMID- 1620594
TI  - Activity of chimeric RNAs of U6 snRNA and (-)sTRSV in the cleavage of a substrate
      RNA.
AB  - U6 small nuclear RNA is one of the spliceosomal RNAs essential for pre-mRNA
      splicing. Discovery of mRNA-type introns in the highly conserved region of the U6
      snRNA genes led to the hypothesis that U6 snRNA functions as a catalytic element
      during pre-mRNA splicing. The highly conserved region of U6 snRNA has a
      structural similarity with the catalytic domain of the negative strand of the
      satellite RNA of tobacco ring spot virus [(-)sTRSV], suggesting that the highly
      conserved region of U6 snRNA forms the catalytic center. We examined whether
      synthetic RNAs consisting of the sequence of the highly conserved region of U6
      snRNA or various chimeric RNAs between the U6 region and the catalytic RNA of (
      )sTRSV could cleave a substrate RNA that can partially base-pair with them and
      have a GU sequence. Chimeric RNAs with 70 to 83% sequence identity with the
      conserved region of S. pombe U6 snRNA cleaved the substrate RNA at the 5' side of
      the GU sequence, which is shared by the 5' end of an intron in a pre-mRNA. We
      found that the highly conserved region of U6 snRNA and the catalytic domain of (
      )sTRSV are strikingly similar in structure to the catalytic core region of the
      group I self-splicing intron in cyanobacteria. These results suggest that U6
      snRNA, (-)sTRSV and the group I self-splicing intron originated from a common
      ancestral RNA, and support the hypothesis that U6 snRNA catalyzes pre-mRNA
      splicing reaction.

PMID- 1620595
TI  - Post-transcriptional regulation of transferrin receptor mRNA by IFN gamma.
AB  - IFN gamma inhibits the rise in transferrin receptor mRNA level which is normally
      observed when stationary WISH cells are stimulated to proliferate. This effect is
      not attributable to a change in the transcription rate of the transferrin
      receptor gene or in the cytoplasmic stability of the mRNA. The IFN gamma-induced
      reduction of the transferrin receptor mRNA content is already present at the
      nuclear level to an extent comparable to that observed in whole cells. Thus, IFN
      gamma does not impair the passage of this mRNA from the nuclear to the
      cytoplasmic compartment but probably interferes with a nuclear post
      transcriptional event during the processing of the immature transferrin receptor
      mRNA. Two different levels of regulation of transferrin receptor mRNA have been
      previously reported. Iron modulates the cytoplasmic stability of this mRNA
      through the binding of a specific cytoplasmic factor, whereas cell growth
      variation influences the transcription of this gene. Our results suggest the
      existence of another mechanism of regulation for transferrin receptor gene
      expression not so far considered. Furthermore, the distinction between the
      mechanism of regulation exerted by IFN gamma and that exerted by cell
      proliferation on transferrin receptor gene expression suggests that, in WISH
      cells, the IFN-induced transferrin receptor decay is not a consequence of cell
      growth arrest but rather one of the causes of the antiproliferative effect of IFN
      through iron deprivation.

PMID- 1620596
TI  - Nonenymatic ligation of double-helical DNA by alternate-strand triple helix
      formation.
AB  - Nonenzymatic ligation of double-stranded DNA has been performed using an
      alternate-strand binding oligodeoxyribonucleotide template to juxtapose the
      duplex termini in a triple helical complex. The template associates with the
      duplex termini by Hoogsteen hydrogen bonding to alternate strands on opposite
      sides of the ligation site. Intermolecular and intramolecular ligation of
      linearized plasmid DNA are observed in the reaction, which depends on the
      template oligodeoxyribonucleotide and a condensing agent, N-cyanoimidazole.
      Intramolecular ligation products include those in which both strands are
      covalently closed in a circle. Ligation of the two strands is sequential and
      occurs at comparable rates for the first and second strands ligating. The
      covalent linkages formed in the reaction can be cleaved by the restriction
      endonuclease Stu I, supporting their identification as phosphodiesters.

PMID- 1620597
TI  - Hoogsteen G-G base pairing is dispensable for telomere healing in yeast.
AB  - The G-rich strands of most eukaryotic telomeres are capable of forming highly
      folded structures in vitro, mediated, in part, through Hoogsteen G-G base
      pairing. The ability of most telomeres to form these structures has led to the
      suggestion that they play an important role in telomere addition. I have
      investigated this possibility in the yeast Saccharomyces cerevisiae through the
      use of an in vivo assay that measures healing via poly(G1-3T) addition onto
      plasmid substrates containing synthetic telomeres. Synthetic telomere healing is
      a highly size- and sequence-specific process that allows the discrimination of
      telomeres of differing efficiency. Plasmids containing synthetic telomeres with
      differing abilities to form secondary structures were tested in this assay for
      healing in vivo. The results of this study demonstrate that telomeres incapable
      of forming Hoogsteen base pairs nonetheless serve as efficient substrates for
      poly(G1-3T) addition, indicating that intramolecular Hoogsteen G-G base pairing
      is not essential for this process.

PMID- 1620598
TI  - Different effects of mioC transcription on initiation of chromosomal and
      minichromosomal replication in Escherichia coli.
AB  - The mioC gene, which neighbors the chromosomal origin of replication (oriC) in
      Escherichia coli, has in a number of studies been implicated in the control of
      oriC initiation on minichromosomes. The present work reports on the construction
      of cells carrying different mioC mutations on the chromosome itself. Flow
      cytometry was employed to study the DNA replication control and growth pattern of
      the resulting mioC mutants. All parameters measured (growth rate, cell size,
      DNA/cell, number of origins per cell, timing of initiation) were the same for the
      wild type and all the mioC mutant cells under steady state growth and after
      different shifts in growth medium and after induction of the stringent response.
      It may be concluded that the dramatic effects of mioC mutations reported for
      minichromosomes are not observed for chromosomal replication and that the mioC
      gene and gene product is of little importance for the control of initiation. The
      data demonstrate that a minichromosome is not necessarily a valid model for
      chromosomal replication.

PMID- 1620599
TI  - Presence of distinct transcriptional regulatory elements in the 5'-flanking
      region shared by the chicken H3 histone gene homopair.
AB  - The chicken H3 histone gene family contains nine members belonging to two major
      histone gene clusters. Six of these genes have been sequenced and shown to encode
      two different H3 protein variants. Five H3 genes (H3-I, -II, -IV, -V, and -VI)
      encode the same amino acid sequence (class I) and another H3 gene (H3-III)
      differs from class I in a single amino acid (IIe113-Met) (class II). H3-II and H3
      III have inverted orientations and share a 5' intergenic region of about 900 bp.
      To understand the regulation of expression of these two genes, we fused the 5'
      flanking region to the CAT gene in inverted orientations to generate two chimeric
      plasmids, pH3-II-900 and pH3-III-900. Transient CAT assays using these constructs
      indicated that the promoter of H3-III is more active than that of H3-II. CAT
      assays with deletion mutants showed that H3-II and H3-III each possess a
      particular transcription regulatory sequence 5' adjacent to their coding
      sequence. In addition, the functional sequences of H3-II have no effect on
      expression of H3-III and vice versa. These results suggest that the regulations
      of expression of the two H3 genes are distinct.

PMID- 1620600
TI  - Extension of the DNA binding consensus of the chicken c-Myb and v-Myb proteins.
AB  - The chicken c-myb gene and the v-myb oncogene transduced by avian myeloblastosis
      virus (AMV) encode DNA binding transcription activators. The DNA binding domain
      of AMV v-Myb displays a number of amino acid changes relative to c-Myb; v-Myb
      proteins in which one or more of three crucial residues in the DNA binding domain
      are mutated to resemble the c-Myb sequence display altered transformation
      phenotypes. In order to establish whether the spectrum of DNA binding sites which
      AMV v-Myb can recognise is different from that seen by chicken c-Myb, a site
      selection protocol was used to derive consensus binding sequences for three
      variant Myb proteins made in vitro, and also using nuclear extract from the v-myb
      transformed cell line BM2. The results show that the original consensus binding
      site defined for v-Myb, YAA-CKG, can be extended to YAACKGHH, and that this new
      consensus holds for both v-Myb and chicken c-Myb.

PMID- 1620601
TI  - A sequence element associated with the Plasmodium falciparum KAHRP gene is the
      site of developmentally regulated protein-DNA interactions.
AB  - The Plasmodium falciparum gene encoding the knob associated histidine-rich
      protein (KAHRP) is shown to be transcriptionally regulated during its expression
      in the intraerythrocytic cycle as demonstrated by stage specific nuclear run-on
      analysis. The genomic organization of the KAHRP gene was determined and the
      structural basis for the stage specific transcription investigated. A sequence
      motif with two-fold symmetry was found 160 bp upstream of the RNA initiation
      site. This sequence element interacts with parasite derived nuclear extracts in a
      stage specific manner that correlates with the transcriptional activity of the
      KAHRP gene. These studies suggest a functional role for this structural element
      in the developmental regulation of a P. falciparum erythrocytic gene.

PMID- 1620602
TI  - Chromosome-size variation in Giardia lamblia: the role of rDNA repeats.
AB  - Giardia lamblia trophozoites contain at least five sets of chromosomes that have
      been categorized by chromosome-specific probes. Pulsed field separations of G.
      lamblia chromosomes also demonstrated minor bands in some isolates which stained
      less intensely with ethidium than the major chromosomal bands. Two of the minor
      bands of the E11 clone of the ISR isolate, MBa and MBb, were similar to each
      other and to chromosomal band I by hybridization to total chromosomal DNA and by
      hybridization of specific probes. In order to determine the extent of this
      similarity, I have developed a panel of probes for many of the Pacl restriction
      fragments and have shown that most of the Pacl and Notl fragments found in MBa
      are also present in MBb. The differences are found in both telomeric regions. At
      one end, MBb contains a 300 kb region not found in MBa. At the other end of MBb
      is a 160 kb region containing the rDNA repeats which is bounded on one end by the
      telomeric repeat and on the other by sites for multiple enzymes that do not
      digest the rDNA repeats. The corresponding region of MBa is 23 kb in size. The
      size difference is consistent with the eightfold greater number of rDNA repeats
      in MBb than MBa and suggests that 30% of the size difference is accounted for by
      different numbers of copies of the rDNA repeat. MBa of another ISR clone (ISR G5)
      is 150 kb larger in size than MBa of ISR E11. The data suggest that MBa and MBb
      are homologous chromosomes of different sizes and that a portion of the size
      difference is accounted for by different copy numbers of the rDNA repeat.

PMID- 1620603
TI  - Dbp73D, a Drosophila gene expressed in ovary, encodes a novel D-E-A-D box
      protein.
AB  - Proteins of the D-E-A-D family of putative ATP-dependent RNA helicases have been
      implicated in translation initiation and RNA splicing in a variety of organisms
      from E. coli to man. The Drosophila vasa protein, a member of this family, is
      required in the female germ line for fertility and for specification of germ line
      and posterior positional information in progeny embryos. We report the isolation
      of another D-E-A-D gene from Drosophila, which, like vasa, is expressed in germ
      line tissue. The predicted amino acid sequence of this new gene, Dbp73D, contains
      all of the highly conserved helicase motifs, but is otherwise the farthest
      diverged member of the family so far identified.

PMID- 1620604
TI  - Transgenic mice generated by pronuclear injection of a yeast artificial
      chromosome.
AB  - Transgenic mice have become invaluable for analysing gene function and regulation
      in vivo. However, the size of constructs injected has been limited by the cloning
      capacity of conventional vectors, a constraint that could be overcome with yeast
      artificial chromosomes (YACs). We investigated the feasibility of making
      transgenic mice with YACs by pronuclear injection of a small YAC carrying a gene
      encoding tyrosinase. Use of a vector with a conditional centromere allowed
      fifteenfold amplification of the YAC in yeast and its recovery in high yield. The
      albino phenotype of the recipient mice was rescued demonstrating the correct
      expression of the tyrosine gene from the construct. Furthermore, the telomeric
      sequences added by the yeast integrated into the mouse genome and did not reduce
      efficiency of integration. Using this technique future experiments with longer
      YACs will allow the expression of gene complexes such as Hox and the globin gene
      clusters to be analysed in transgenic animals.

PMID- 1620606
TI  - The c4 repressor of bacteriophage P1 is a processed 77 base antisense RNA.
AB  - The c4 repressors of the temperate bacteriophages P1 and P7 inhibit antirepressor
      synthesis and are essential for establishment and maintenance of lysogeny. Using
      in vivo complementation tests we have previously shown that c4 is an antisense
      RNA acting on a target, ant mRNA, which is transcribed from the same promoter.
      Here we identify the c4 repressor molecule of P1 as a 77 +/- 1 base RNA by
      mapping its termini and show that the c4 RNA in P7 lysogens has the same or a
      similar size. P1 c4 RNA is encoded in a region shown to be sufficient for c4
      complementation. It covers exactly the 74 bases previously suggested to fold into
      a stem-loop secondary structure essential for c4 function. Furthermore, we
      demonstrate that the 5' end of c4 RNA is generated by processing. Thus, c4 is the
      first example of an antisense RNA to be processed. A possible mechanism of
      processing is discussed.

PMID- 1620605
TI  - Biological properties of imidazole ring-opened N7-methylguanine in M13mp18 phage
      DNA.
AB  - Guanine residues methylated at the N-7 position (7-MeGua) are susceptible to
      cleavage of the imidazole ring yielding 2,6-diamino-4-hydroxy-5N-methyl
      formamidopyrimidine (Fapy-7-MeGua). The presence of Fapy-7-MeGua in DNA template
      causes stops in DNA synthesis in vitro by E. coli DNA polymerase I. The
      biological consequences of Fapy-7-MeGua lesions for survival and mutagenesis were
      investigated using single-stranded M13mp18 phage DNA. Fapy-7-MeGua lesions were
      generated in vitro in phage DNA by dimethylsulfate (DMS) methylation and
      subsequent ring opening of 7-MeGua by treatment with NaOH (DMS-base). The
      presence of Fapy-7-MeGua residues in M13 phage DNA correlated with a significant
      decrease in transfection efficiency and an increase in mutation frequency in the
      lacZ gene, when transfected into SOS-induced JM105 E.coli cells. Sequencing
      analysis revealed unexpectedly, that mutation rate at guanine sites was only
      slightly increased, suggesting that Fapy-7-MeGua was not responsible for the
      overall increase in the mutagenic frequency of DMS-base treated DNA. In contrast,
      mutation frequency at adenine sites yielding A----G transitions was the most
      frequent event, 60-fold increased over DMS induced mutations. These results show
      that treatment with alkali of methylated single-stranded DNA generates a
      mutagenic adenine derivative, which mispairs with cytosine in SOS induced
      bacteria. The results also imply that the Fapy-7-MeGua in E. coli cells is
      primarily a lethal lesion.

PMID- 1620607
TI  - The liver-specific promoter of the human insulin-like growth factor II gene is
      activated by CCAAT/enhancer binding protein (C/EBP).
AB  - The human gene coding for insulin-like growth factor II (IGF-II) contains four
      promoters (P1-P4), that are subjected to tissue-specific and development
      dependent regulation. Expression of promoter P1 is detected only in adult liver
      tissue, whereas promoter P3 is the major IGF-II promoter in fetal liver and is
      further expressed in other fetal tissues and in adult non-hepatic tissues. C/EBP
      is a tissue- and development-specific transcription factor that is expressed
      predominantly in adult liver, adipose tissue and lung. The effect of C/EBP on the
      expression of constructs containing IGF-II promoter P1 or P3 linked to the
      luciferase gene was investigated in cotransfection assays using Hep3B cells. We
      found that promoter P1 can be activated by C/EBP, whereas this transcription
      factor has no effect on the expression of promoter P3. By gel retardation and
      DNasel footprinting it was demonstrated that C/EBP can bind to a region of P1
      located between 82 and 109 basepairs upstream of the cap site. Furthermore, we
      showed that deletion of this C/EBP binding region strongly reduces the ability of
      C/EBP to stimulate transcription from P1. These results indicate that C/EBP is a
      major component in the specific activation of the human IGF-II promoter P1 in
      adult liver.

PMID- 1620609
TI  - Joints formed by RecA protein from oligonucleotides and duplex DNA block
      initiation and elongation of transcription.
AB  - In the presence of the non-hydrolyzable analog of ATP, ATP gamma S, RecA protein
      can polymerize on an oligodeoxy-ribonucleotide to form a stable
      oligonucleoprotein filament that can find its homologous sequence in double
      stranded DNA. The homologous joint formed by the oligonucleotide and duplex DNA
      is stable only if RecA protein is not removed. Such a nucleoprotein joint,
      covering a part or all of the promoter region of T3 or T7 phage RNA polymerase,
      blocked transcription directed by those polymerases. The same kind of joint,
      located downstream of the RNA polymerase promoter, also inhibited elongation of
      transcription and caused accumulation of truncated transcripts. These
      observations suggest that RecA protein can be used to shut off transcription from
      any promoter of known sequence.

PMID- 1620608
TI  - Two cytotoxic cell proteinase genes are differentially sensitive to sodium
      butyrate.
AB  - The 5'-flanking regions of two cytotoxic cell protease genes, CCP1 and 2, are
      sufficient to confer cytotoxic T lymphocyte-specific expression when fused to a
      reporter gene. The two regulatory regions are, however, differentially sensitive
      to treatment of the recipient cell, MTL 2.8.2, with sodium butyrate. With CCP1 a
      six-fold increase in cat expression was observed, whereas CCP2 was insensitive to
      the butyrate treatment. One major butyrate-sensitive regions was defined in the
      CCP1 5'-flanking sequence between -243 to -112 and another less effective one
      between-682 to -427. These fragments of DNA were also able to confer
      responsiveness to butyrate when ligated to a heterologous fos promoter. These
      sequences within the 5' flank of CCP1 share homology with other elements that
      have been defined as butyrate-responsive. We believe that our results argue
      against a pleiotropic affect of butyrate such as histone acetylation. More likely
      sodium butyrate is mediating a specific stimulation of transcription through
      modification of the activities of selected transcriptional regulatory proteins
      that in turn affect their interactions with proteins bound to the promoter.

PMID- 1620610
TI  - Generating compatible translation initiation regions for heterologous gene
      expression in Escherichia coli by exhaustive periShine-Dalgarno mutagenesis.
      Human glutathione reductase cDNA as a model.
AB  - Adaptation of eucaryotic cDNA to heterologous expression was studied by mutating
      the translation initiation (TI) region upstream (mTI) and downstream (MTI) of the
      start codon. In the mTI subregion the 8 bases flanking the invariant Shine
      Dalgarno motif GG-AG were mutagenized exhaustively, while the MTI subregion was
      subjected to random silent mutations at the wobble positions. The quality of a
      given TI sequence was judged on the basis of expressed enzyme activity. Low-yield
      and high-yield mutants of both TI subregions were selected and recombined
      systematically. The analysis of these double cartridges gave the following
      results: 1. As a rule, an unfavourable MTI subregion can be compensated for by
      mutations in the mTI subregion and vice versa. 2. The compatibility between mTI
      and MTI subregion is explainable at least in part by a low interaction tendency;
      a delta G(o)'-value of -10.7 kcal/mol appears to be a physical threshold for
      heterologous cDNA expression. 3. On the basis of periShine-Dalgarno mutations,
      the expression yield for different cDNA sequences could be increased by 1 to 2
      orders of magnitude. One of these sequences encoded delta(1-15)human glutathione
      reductase, a mutant lacking the flexible N-terminal extension of the protein. In
      conclusion, to study and overcome TI region-based expression problems it is
      worthwhile to start out with a versatile vector containing exhaustive mutations
      in the periShine-Dalgarno sequences; as a rule the coding MTI subregion can be
      kept unchanged.

PMID- 1620611
TI  - Mitotic recombination of yeast artificial chromosomes.
AB  - Large regions of human DNA can be cloned and mapped in yeast artificial
      chromosomes (YACs). Overlapping YAC clones can be used in order to reconstruct
      genomic segments in vivo by meiotic recombination. This is of importance for
      reconstruction of a long gene or a gene complex. In this work we have taken
      advantage of yeast protoplast fusion to generate isosexual diploids followed by
      mitotic crossing-over, and show that it can be an alternative simple strategy for
      recombining YACs. Integrative transformation of one of the parent strains with
      the construct pRAN4 (containing the ADE2 gene) is used to disrupt the URA3 gene
      contained within the pYAC4 vector arm, providing the markers required for forcing
      fusion and detecting recombination. All steps can be carried out within the
      commonly used AB1380 host strain without the requirement for micromanipulation.
      The method was applied to YAC clones from the human MHC and resulted in the
      reconstruction of a 650 kb long single clone containing 18 known genes from the
      MHC class II region.

PMID- 1620612
TI  - Quantitation of transient gene expression after electroporation.
AB  - The combination of a photometric reporter-gene assay, with transfection by
      electroporation, is potentially a rapid and sensitive tool for the study of
      genetic regulatory elements in many types of cells. We have found that the
      sensitivity, accuracy, and reproducibility of the technique is greatly improved
      by the inclusion of appropriately chosen carrier DNA as the primary DNA species
      present during electroporation. By using high levels of carrier, the activities
      of constructs of differing sizes can be quantitatively compared, active
      constructs can be assayed with sub-microgram amounts of plasmid, and the
      activities of the constructs are linear over a wide concentration of DNA. In
      addition, the activity of miniprep DNA can be screened without purification on
      CsCl gradients giving activities equal to CsCl-purified DNA. This is extremely
      useful when doing preliminary screening of large numbers of constructs for
      promoter or enhancer activities. We report the results of testing various types
      of DNA as carrier, and the parameters for optimizing its use.

PMID- 1620613
TI  - DNA sequence selectivity of guanine-N7 alkylation by nitrogen mustards is
      preserved in intact cells.
AB  - Nitrogen mustard alkylating agents react with isolated DNA in a sequence
      selective manner, and the substituent attached to the drug reactive group can
      impose a distinct sequence preference. It is not clear however to what extent the
      observed DNA sequence preferences are preserved in intact cells. The highly
      reiterated sequence of human alpha DNA has been used to determine the sites of
      guanine-N7 alkylation following treatment of cells with three nitrogen mustards,
      mechlorethamine, uracil mustard and quinacrine mustard, known to react in
      isolated DNA with distinctly different sequence preferences. Alpha DNA from drug
      treated cells was extracted, purified, end-labeled, and a 296 base pair, singly
      end-labelled, fragment isolated. Following the quantitative conversion of
      alkylation sites to strand breaks the fragments were separated on DNA sequencing
      gels. Clear differences were observed between the alkylation patterns of the
      three compounds, and the selectivities were qualitatively similar to those
      predicted and observed in the same sequence alkylated in vitro. In particular the
      unique preferences of uracil and quinacrine mustards for 5'-PyGC-3' and 5'-GT/GPu
      3' sequences, respectively, were preserved in intact cells suggesting that the
      pattern of sequence dependent reactivity is not grossly affected by the nuclear
      milieu.

PMID- 1620614
TI  - Type 1 ribosome-inactivating proteins depurinate plant 25S rRNA without species
      specificity.
AB  - Four different type 1 ribosome-inactivating proteins (RIPs) with RNA N
      glycosidase activity were tested for their ability to attack the large rRNA of
      plant ribosomes derived from tobacco plants, as well as from the plant species
      from which the particular RIP had been isolated. Incubation of tobacco ribosomes
      with RIPs isolated from either Phytolacca americana L. (pokeweed), Dianthus
      barbatus L. (carnation), Spinacia oleracea L. (spinach) or Chenopodium
      amaranthicolor Coste and Reyn. (chenopodium) rendered the 25S rRNA sensitive to
      aniline-catalyzed hydrolysis, generating a single rRNA-fragment of about 350
      nucleotides. The same fragment was generated when rRNAs from pokeweed, carnation,
      spinach or chenopodium ribosomes were aniline-treated without any deliberate
      treatment of the ribosomes with the respective RIP. This indicated that ribosomes
      from all RIP-producing plants were already inactivated by their own RIPs during
      preparation. These results demonstrate that plant ribosomes are generally
      susceptible to RIP attack, including modification by their own RIPs. Direct
      sequencing of the newly generated fragments revealed that a single N-glycosidic
      bond at an adenosine residue within the highly conserved sequence 5'-AGUACGAGAGGA
      3' was cleaved by all of the RIPs investigated, a situation also found in animal,
      yeast and Escherichia coli ribosomes.

PMID- 1620615
TI  - Characterization of the testes-specific pim-1 transcript in rat.
AB  - The pim-1 proto-oncogene encodes a serine/threonine protein kinase and is
      expressed in cells of hematolymphoid origin and in the germ cell lineages. In
      somatic cells, the pim-1 gene is expressed as a 2.8 kb transcript while a shorter
      sized transcript (2.3 kb) is expressed in rat testes. We have determined that the
      shorter testes-specific pim-1 transcript arises through the use of an alternate
      polyadenylation signal present in the 3' untranslated region of the gene. This
      alternate polyadenylation event results in the removal of an A/U-rich regulatory
      element located in the 3' untranslated region of the pim-1 gene. This A/U-rich
      motif has been shown by a number of laboratories to destabilize the transcripts
      of genes that contain this sequence. Consistent with these findings, we have
      demonstrated that the shortened testes-specific pim-1 transcript is more stable
      than the longer A/U-rich containing somatic transcript. We suggest that the
      functional significance of different sized pim-1 transcripts may be directly
      related to their different stabilities and that the greater stability of the
      testes-specific transcript may be essential for the translational delay observed
      in post-meiotic male germ cells.

PMID- 1620616
TI  - Intron requirement for expression of the human purine nucleoside phosphorylase
      gene.
AB  - Abbreviated purine nucleoside phosphorylase (PNP) genes were engineered to
      determine the effect of introns on human PNP gene expression. PNP minigenes
      containing the first intron (complete or shortened from 2.9 kb down to 855 bp),
      the first two introns or all five PNP introns resulted in substantial human PNP
      isozyme expression after transient transfection of murine NIH 3T3 cells. Low
      level human PNP activity was observed after transfection with a PNP minigene
      containing the last three introns. An intronless PNP minigene construct
      containing the PNP cDNA fused to genomic flanking sequences resulted in
      undetectable human PNP activity. Heterogeneous, stable NIH 3T3 transfectants of
      intron-containing PNP minigenes (verified by Southern analysis), expressed high
      levels of PNP activity and contained appropriately processed 1.7 kb message
      visualized by northern analysis. Stable transfectants of the intronless PNP
      minigene (40-45 copies per haploid genome) contained no detectable human PNP
      isozyme or mRNA. Insertion of the 855 bp shortened intron 1 sequence in either
      orientation upstream or downstream of a chimeric PNP promoter-bacterial
      chloramphenicol acetyltransferase (CAT) gene resulted in a several-fold increase
      in CAT expression in comparison with the parental PNP-CAT construct. We conclude
      that human PNP gene expression at the mRNA and protein level is dependent on the
      presence of intronic sequences and that the level of PNP expression varies
      directly with the number of introns included. The disproportionately greatest
      effect of intron 1 can be explained by the presence of an enhancer-like element
      retained in the shortened 855 bp intron 1 sequence.

PMID- 1620617
TI  - Gene clusters for ribosomal proteins in the mitochondrial genome of a liverwort,
      Marchantia polymorpha.
AB  - We detected 16 genes for ribosomal proteins in the complete sequence of the
      mitochondrial DNA from a liverwort, Marchantia polymorpha. The genes formed two
      major clusters, rps12-rps7 and rps10-rpl2-rps19-rps3-rpl16-rpl5- rps14-rps8- rpl6
      rps13-rps11-rps1, very similar in organization to Escherichia coli ribosomal
      protein operons (str and S10-spc-alpha operons, respectively). In contrast, rps2
      and rps4 genes were located separately in the liverwort mitochondrial genome (the
      latter was part of the alpha operon in E. coli). Furthermore, several ribosomal
      proteins encoded by the liverwort mitochondrial genome differed substantially in
      size from their counterparts in E. coli and liverwort chloroplast.

PMID- 1620618
TI  - The distribution of 5-methylcytosine in the nuclear genome of plants.
AB  - We have determined the 5-methylcytosine (5mC) content in high molecular weight
      DNA, from two dicot (tobacco and pea) and two monocot (wheat and maize) plant
      species, fractionated according to base composition. The results show that the
      proportion of 5mC in the genomic fractions increases linearly with their guanine
      + cytosine (G + C) content while the proportion of non-methylated cytosine
      remains almost constant. This can be interpreted as a consequence of a difference
      in mutation pressure related to spontaneous deamination of 5mC to thymine between
      the different compartments of plant genomes.

PMID- 1620619
TI  - Purification of components required for accurate transcription of ribosomal RNA
      from Acanthamoeba castellanii.
AB  - The components required for specific transcription of ribosomal RNA were isolated
      from logarithmically growing Acanthamoeba castellanii. The transcription
      initiation factor fraction, TIF, and RNA polymerase I were extracted from whole
      cells at 0.35 M KCl. The extract was fractionated with polyethylenimine, then
      chromatographed on phosphocellulose (P11) which resulted in the separation of TIF
      from RNA polymerase I. The fractions containing TIF were further chromatographed
      on DEAE cellulose (DE52), Heparin Affigel, and Matrex green agarose, followed by
      sedimentation through glycerol gradients. TIF was purified approximately 17,000
      fold, and shown to have a native molecular weight of 289 kD, and to bind
      specifically to rRNA promoter sequences by DNase I footprinting. The addition of
      homogeneous RNA polymerase I to this complex permitted the initiation of specific
      transcription in vitro. The phosphocellulose fractions containing RNA polymerase
      I were chromatographed on DEAE cellulose, Heparin-Sepharose, DEAE-Sephadex, and
      sedimented through sucrose gradients. Polymerase I was purified to apparent
      homogeneity with a yield of 8.1% and a specific activity of 315. It contained one
      fewer subunit than previously reported. DNase I protection experiments
      demonstrated that in both partially purified and homogeneous fractions, RNA
      polymerase I was capable of stable binding to the TIF-rDNA complex, and correctly
      initiating transcription on rDNA templates.

PMID- 1620620
TI  - Binding of the EcoRII methyltransferase to 5-fluorocytosine-containing DNA.
      Isolation of a bound peptide.
AB  - The properties of the interaction of 5-fluorocytosine-containing DNA with the
      EcoRII methyltransferase were studied. The DNA used was either a polymer
      synthesized in vitro, or a 20-mer containing one CCA/TGG sequence. The DNA could
      be methylated by the enzyme. In the process the enzyme formed a tight binding
      adduct with the DNA that could be identified by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. Enzyme activity was inhibited by this
      interaction. The 20-mer could be used to titrate the active site of the enzyme.
      The DNA polymer formed a tight binding complex that could be identified following
      digestion of the DNA with pancreatic deoxyribonuclease or micrococcal nuclease. A
      peptide-DNA adduct could be isolated after digestion of the EcoRII-DNA adduct
      with staphylococcal protease V8 by high pressure liquid chromatography and
      polyacrylamide gel electrophoresis. Sequencing of the peptide indicated the DNA
      bound to a region of the protein that is conserved in all procaryotic
      DNA(cytosine-5)-methyltransferases. We have previously shown that this region
      contains a cysteine that can be photomethylated with adenosylmethionine. This
      region, in addition to forming part of, or being adjacent to, the AdoMet binding
      site, also forms part of the DNA binding site.

PMID- 1620621
TI  - Complete nucleotide sequence of a neuropathogenic variant of Friend murine
      leukemia virus PVC-211.

PMID- 1620622
TI  - RNA polymerase II initiation factor alpha from rat liver is almost identical to
      human TFIIB.

PMID- 1620623
TI  - The cohesive ends of mycobacteriophage L5 DNA.

PMID- 1620624
TI  - Numbering system for the hammerhead.

PMID- 1620625
TI  - The INO2 gene of Saccharomyces cerevisiae encodes a helix-loop-helix protein that
      is required for activation of phospholipid synthesis.

PMID- 1620626
TI  - Application of galactose-sensitive E. coli strains as selective hosts for LacZ-
      plasmids.

PMID- 1620627
TI  - The use of uracil-N-glycosylase in the preparation of PCR products for direct
      sequencing.

PMID- 1620628
TI  - Mapping of mRNA isoforms with an oligonucleotide probe: exonuclease VII compared
      with endonucleases.

PMID- 1620630
TI  - P9: advocacy. Part (i): The 'what' and 'when' of advocacy.

PMID- 1620631
TI  - Rebuilding the centre.

PMID- 1620633
TI  - Conflict of interest.

PMID- 1620632
TI  - Rationing care?

PMID- 1620634
TI  - How to help the child.

PMID- 1620629
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1620635
TI  - Goodbye to Rambo.

PMID- 1620636
TI  - Decision time for midwives.

PMID- 1620637
TI  - Consumers, continuity and control.

PMID- 1620638
TI  - Primary panacea?

PMID- 1620639
TI  - Home is best.

PMID- 1620640
TI  - Project 2000--research on its implementation.
AB  - Project 2000 is a major innovation in the preparation of pre-registration nurses.
      It introduces a Common Foundation Programme with specialisation after 18 months,
      increased links with higher education, supernumerary status and bursaries for
      students and a diploma level qualification. This paper is concerned with research
      design and management issues emerging from the NFER study of the implementation
      of Project 2000.

PMID- 1620641
TI  - Working up a thirst.

PMID- 1620642
TI  - Finding their own way.

PMID- 1620643
TI  - A sense of duty.

PMID- 1620644
TI  - Involving nurses in prison therapy.

PMID- 1620645
TI  - Conversion blues.

PMID- 1620646
TI  - Taking women seriously.

PMID- 1620647
TI  - Reducing the risk of assault.

PMID- 1620648
TI  - Unacceptable advances.

PMID- 1620649
TI  - Impairment of cold-induced increase in thyroxine 5'-deiodinase activity in mouse
      brown adipose tissue by the intracerebroventricular administration of bombesin.
AB  - Effects of bombesin on brown adipose tissue (BAT) thyroxine (T4) 5'-deiodinase
      (5'D) activity and rectal temperature were examined in male mice. Immediately
      following an intracerebroventricular (ICV) or intravenous (IV) injection of
      bombesin (0.1-100 ng/animal) or vehicle (20 mM bacitracin dissolved in 0.9%
      saline), the mice were placed in a room at 4 degrees C or 22 degrees C for 30,
      60, 120 or 240 min. The ICV injection of bombesin dose-dependently lessened cold
      induced increase in BAT 5'D activity and increased hypothermia determined at 120
      min of cold exposure, whereas the IV injection of bombesin was without effect.
      Bombesin (ICV)-induced hypothermia preceded the inhibition of BAT 5'D activity by
      at least 30 min at 4 degrees C. BAT 5'D activity was not affected by ICV
      injection of bombesin in mice kept at 22 degrees C, although the rectal
      temperature was significantly decreased. Bombesin thus appears to prevent cold
      induced increase in T4 5'D activity in mouse BAT by its central effect. Bombesin
      induced excessive hypothermia itself and/or the decrease in sympathetic tone of
      BAT by bombesin might decrease cold-induced increase in BAT 5'D activity.

PMID- 1620650
TI  - The levels and biologic action of the human neutrophil granule peptide HP-1 in
      lung tumors.
AB  - HP-1 is the most abundant human representative of a recently discovered class of
      neutrophil cystine- and arginine-rich peptides. These peptides have many
      potentially regulatory activities expressed at nanomolar concentrations. To
      establish the levels of HP-1 that can accumulate in human lung tumors and
      nondiseased lung fragments, tissues were extracted for their peptide content. The
      extracts were purified on reverse phase HPLC, and HP-1 and related peptides were
      identified by sequence analysis and their concentrations in the tissue
      quantitated by amino acid analysis. Immunohistochemistry was performed and
      strongly suggests that HP-1 is confined to granulocytes under most circumstances,
      and indicates that the levels of HP-1 measured in the tumors reflect the levels
      obtained when solid tissue is infiltrated by neutrophils. The maximum observed
      levels were 26 nanomoles per gram wet weight of tissue. Attempts were then made
      to correlate this level to the cytotoxic potential of HP-1 by performing in vitro
      cytotoxicity dose-response curves on several cell lines. Most cells were killed
      at between 1 and 8 microM, and the response depended on the growth conditions of
      the cells. The levels of HP-1 that accumulate in tumors can exceed the in vitro
      cytolytic concentrations. The levels are also considerably in excess of those
      required to exert in vitro regulatory actions.

PMID- 1620651
TI  - Effects of BCH 325 (Pro-D-Phe-Pro-Gly) on open field behavior after chronic
      stress procedure.
AB  - The chronic stress model is an animal model relevant to clinical depression. The
      chronic stress rat group showed a significant decrease in motor activity. The
      reduced open field activity could be restored by subchronic treatment with
      imipramine and doxepine. Subchronic treatment with haloperidol, amphetamine and
      methylglucamine orotate was not able to alter the reduced open field activity.
      Previous treatment with a beta-casomorphin derivative (BCH 325) significantly
      antagonized the effect of chronic stress. The findings point out an
      antidepressant-like effect of BCH 325.

PMID- 1620652
TI  - Primary structure of frog PYY: implications for the molecular evolution of the
      pancreatic polypeptide family.
AB  - A peptide belonging to the pancreatic polypeptide (PP) family was isolated in
      pure form from the intestine of the European green frog (Rana ridibunda). The
      primary structure of the peptide was established as: Tyr-Pro-Pro-Lys-Pro-Glu-Asn
      Pro-Gly-Glu10-Asp-Ala- Ser-Pro-Glu-Glu-Met-Thr-Lys-Tyr20-Leu-Thr-Ala-Leu-Arg-His
      Tyr-Ile- Asn-Leu30-Val - Thr-Arg-Gln-Arg-Tyr-NH2. This amino acid sequence shows
      moderate structural similarity to human PYY (75% identity) but stronger
      similarity to the PP family peptides isolated from the pancreas of the salmon
      (86%) and dogfish (83%). The data suggest that the two putative duplications of
      an ancestral PP family gene that have given rise to PP, PYY and NPY in mammals
      had already taken place by the time of the appearance of the amphibia. In fish,
      however, only a single duplication has occurred, giving rise to NPY in nervous
      tissue and a PYY-related peptide in both pancreas and gut.

PMID- 1620653
TI  - Effects of CCK antagonists on CCK-induced suppression of locomotor activity in
      mice.
AB  - Sulfated cholecystokinin octapeptide (CCK-8) was administered either
      intraperitoneally or into the cerebral ventricle of fully conscious mice, and
      locomotor activity was quantified. CCK-8 administered by either route suppressed
      locomotor activity. Subcutaneously administered selective CCK-A receptor
      antagonist, L-364,718 (1 mg/kg), reversed the inhibitory effect of centrally as
      well as peripherally administered CCK-8, but the selective CCK-B receptor
      antagonist, L-365,260 (1 mg/kg), did not. These results demonstrate that
      centrally as well as peripherally administered CCK-8 suppresses locomotor
      activity in mice through an interaction with CCK-A, but not CCK-B, receptors.

PMID- 1620654
TI  - Activation of CCK-A receptors induces elevation of plasma corticosterone in rats.
AB  - Cholecystokinin octapeptide (CCK-8) and ceruletide (1 microgram/kg) produced a
      pronounced increment of plasma corticosterone levels at 30 min after
      intraperitoneal administration. The response to these peptides was suppressed by
      pretreatment with a selective antagonist for CCK-A receptors, (-)L-364,718, in a
      dose-related manner, but not with an antagonist for CCK-B receptors, (+)L
      365,260. However, (-)L-364,718 itself had no effect on basal levels of plasma
      corticosterone. These results indicate that peripheral administration of CCK-8
      and ceruletide stimulates the hypothalamo-pituitary adrenal axis through the
      activation of CCK-A receptors, but not CCK-B receptors.

PMID- 1620655
TI  - Gonadotropin-releasing hormone in elasmobranch (electric ray, Torpedo marmorata)
      brain and plasma: chromatographic and immunological evidence for chicken GnRH II
      and novel molecular forms.
AB  - Gonadotropin-releasing hormone (GnRH) peptides in the brain, testis and plasma of
      an electric ray (Torpedo marmorata) were investigated by gel filtration
      chromatography, reverse phase high performance liquid chromatography and
      radioimmunoassay with region-specific antisera. In the brain, two major forms of
      GnRH were demonstrated. One form had identical chromatographic and immunological
      properties to chicken GnRH II, and the second, novel, molecular form had
      structural features in common with mammalian, chicken II and salmon GnRHs. A
      minor, early-eluting immunoreactive peak, possibly also a novel GnRH, was also
      evident. Immunoreactive GnRH was not detected in the testis. In the plasma, a
      single major early-eluting immunoreactive peak was demonstrated. This peak,
      identical to the minor peak observed in the brain, is likely to represent a novel
      form of GnRH which has immunological properties in common with mammalian, chicken
      II and salmon GnRHs. Immunoreactive GnRH was not detected in the plasma of
      species from other vertebrate classes, including rabbit, chicken, monitor lizard,
      clawed toad, frog, cichlid fish and lamprey. The finding of chicken GnRH II in a
      species of Chondrichthyes adds further support to our hypothesis that this
      widespread structural variant may represent an early-evolved and conserved form
      of GnRH. The presence of a GnRH molecular form in the plasma of the electric ray
      suggests that GnRH may reach target organs (pituitary and gonads) via the general
      circulation in some species of Chondrichthyes.

PMID- 1620656
TI  - In vitro penetration of des-tyrosine1-D-phenylalanine3-beta-casomorphin across
      the blood-brain barrier.
AB  - The blood-brain barrier transport and metabolism of the synthetic beta
      casomorphin (beta CM) derivative des-tyrosine1-D-phenylalanine3-beta-casomorphin
      (DT-D-Phe3-beta CM) were investigated using an in vitro model consisting of
      primary cultures of bovine cerebrovascular endothelial cells. DT-D-Phe3-beta CM
      was transported across the endothelial monolayer without significant metabolism.
      The endothelial permeability expressing the transport rate ranged between 1.4 and
      2.2 cm x 10(-3)/min and was neither affected by luminal concentration changes (1
      nM and 1 microM) nor different after luminal and abluminal administration. The
      metabolic inhibitor 2-desoxy-D-glucose did not affect the permeability of DT-D
      Phe3-beta CM. These results suggest that DT-D-Phe3-beta CM is able to cross the
      blood-brain barrier by paracellular transport without using a carrier system.

PMID- 1620657
TI  - Prolonged antinociceptive activity of pseudodipeptide analogues of Lys-Trp(Nps)
      and Trp(Nps)-Lys.
AB  - Peptide bond substitution in the molecules of Lys-Trp(Nps) (LTN) and Trp(Nps)-Lys
      (TNL) by an aminomethylene and ketomethylene bond, respectively, afforded
      pseudodipeptides with analgesic activity. The new compounds Lys psi(CH2NH)
      Trp(Nps)-OMe (LTNAM) and Trp(Nps)psi(COCH2)(R,S)-Lys (TNLKM) induced a dose
      dependent and naloxone-reversible analgesia following intracerebroventricular
      (ICV) administration to mice. The antinociceptive effects were longer lasting
      compared to those induced by the parent compounds. The pseudodipeptides protected
      Met-enkephalin degradation by rat striatal slices and, combined with an
      ineffective dose of the opioid peptide, induced analgesia. LTNAM and TNLKM were
      as potent as LTN to inhibit brain aminopeptidase in vitro and ex vivo. An
      increased resistance to proteolysis of the pseudodipeptides may explain their
      prolonged analgesic activity.

PMID- 1620658
TI  - Influence of modified casomorphins on yawning behavior of rats.
AB  - Apomorphine-induced yawning was completely suppressed in animals treated with 5
      nmol [D-Pro4]casomorphin (CM) (ICV), 10 nmol [D-Phe3]CM (ICV) or 10 nmol [D
      Pip4]CM (ICV). The apomorphine-induced yawning was also decreased, by des-Tyr
      analogs, but only by about 50%. Physostigmine (0.15 mg/kg, IP) induced yawning.
      The physostigmine-induced yawning was suppressed by 5 nmol [D-Pro4]CM and 10 nmol
      [D-Phe3]CM. Both [des-Tyr-D-Phe3]CM and [des-Tyr-D-Pip4]CM were without effect,
      whereas [des-Tyr-D-Pro4]CM increased significantly the physostigmine-induced
      yawning. The results suggest that dopaminergic transmission can be modulated by
      beta-casomorphin derivatives, thus resulting in a decrease in yawning. In the
      case of the des-tyrosine derivatives, we can assume a dopaminergic modulation,
      too. An increase in serotonergic activity might be supposed for [des-Tyr-D
      Pro4]CM.

PMID- 1620659
TI  - dTyr-D-Phe3 (Pro-D-Phe-Pro-Gly) interacts specifically with amygdaloid-kindled
      seizures and is capable of preventing the learning deficit occurring after
      kindling.
AB  - In amygdala-kindled rats a deficit in learning brightness discrimination was
      found. We concluded that this result provides a reliable basis for creating an
      animal model of cognitive dysfunctions in epileptics. Recently, a des-tyrosine D
      amino acid substituted derivative of bovine beta-casein(1-5) was reported to
      exhibit anticonvulsant as well as antidepressant activity. Therefore, we tested
      the effect of this peptide on kindled seizures and the learning deficit after
      kindling. It was found that the peptide suppressed the duration of seizures
      whereas seizure severity was not influenced. Furthermore, the learning
      performance of peptide-treated rats was significantly higher than that of kindled
      controls.

PMID- 1620661
TI  - The effect of vasoactive intestinal peptide (VIP) and naloxone combination on
      survival rates in rats exposed to severe hemorrhage.
AB  - In this experiment, the effects of different doses of vasoactive intestinal
      peptide (VIP) and naloxone (NLX) combinations on survival rates were investigated
      in rats exposed to 40% hemorrhage. A combination of 25 ng.kg-1 VIP+5 mg.kg-1 NLX
      showed the best results on survival. The important prospect of this combination
      is to have the most potent inhibitory effect on mast cell degranulation. When
      this combination was given together with shed blood reperfusion and 7.5% NaCl,
      survival rate increased relative to the administration of shed blood alone and of
      7.5% NaCl. These findings suggest that inhibition of mast cell degranulation has
      a beneficial effect on severe hemorrhage.

PMID- 1620660
TI  - Peripheral factors in the mediation of cholecystokinin-induced satiety as
      assessed by comparative potencies of cholecystokinin antagonists.
AB  - Cholecystokinin COOH-terminal octapeptide (CCK-8) produces a satiating effect in
      the rat and other animals upon peripheral administration. Although it has been
      demonstrated that the receptors which mediate this action are located in the
      periphery and are of the CCK-A subtype, their anatomical location has not been
      firmly established. A dense population of CCK receptors in the pyloric sphincter
      has been suggested as a candidate. We here quantify the potency of several CCK
      antagonists to inhibit the contractile effect of CCK-8 on the rat pyloric
      sphincter in vitro. The potent and selective antagonist MK-329 has a Schild pK of
      8.85; the less potent but selective antagonist lorglumide (CR-1409) a pK of 6.37;
      the related antagonist phenoxyacetylproglumide (phi oAc proglumide) a pK of 5.1;
      and the weak parent compound proglumide a pK of about 3.3. These data can be
      compared with the potencies of these compounds to inhibit the actions of CCK-8 to
      produce satiety in the rat; this comparison supports the contention that CCK
      receptors of the rat pyloric sphincter could in part mediate the satiety effect
      produced by exogenous CCK-8.

PMID- 1620662
TI  - The behavioral treatment of cigarette smoking.

PMID- 1620663
TI  - Stages of change in the modification of problem behaviors.

PMID- 1620664
TI  - A behavioral approach to the prevention of school dropout: conceptual and
      empirical strategies for children and youth.

PMID- 1620665
TI  - Body image: extent of disturbance, associated features, theoretical models,
      assessment methodologies, intervention strategies, and a proposal for a new DSM
      diagnostic category--body image disorder.

PMID- 1620666
TI  - Cognitive therapy of personality disorders.

PMID- 1620667
TI  - Childhood enuresis: etiology, assessment, and current behavioral treatment.

PMID- 1620668
TI  - Pediatric neurodiagnostic tests: a modern perspective.

PMID- 1620669
TI  - Office care of wounds.

PMID- 1620670
TI  - Case 1: Chronic meningococcemia.

PMID- 1620671
TI  - Case 2: Sepsis with purpura.

PMID- 1620672
TI  - Case 3: Rocky mountain spotted fever.

PMID- 1620673
TI  - Diagnosis of the unknown poison.

PMID- 1620674
TI  - [Reactions and neoplasms of the lymphatic system. On the 76th Congress of the
      German Society of Pathology 09-13 June 1992].

PMID- 1620675
TI  - [Functions of specialized pathologic-anatomic tumor registries].

PMID- 1620676
TI  - [Current status of grading in breast cancer].

PMID- 1620677
TI  - [Media structure, media width and pressure related elasticity of the carotid
      sinus in man. A study of the importance of local factors for development of
      sclerotic plaques].

PMID- 1620678
TI  - [Arrhythmogenic right ventricular dysplasia].

PMID- 1620679
TI  - [Placental findings in congenital syphilis].

PMID- 1620680
TI  - [Exogenous ochronosis after L-dopa treatment].

PMID- 1620681
TI  - [Fatal thrombosis of the basilar artery after minor blunt skull and brain
      injury].

PMID- 1620683
TI  - [Niels Stensen (1638-1686)--a universal scientist].

PMID- 1620682
TI  - [Congenital rhabdoid tumor in the mediastinum and liver. Case report and review
      of the literature].

PMID- 1620684
TI  - Purifying nuclei.
AB  - Nuclear isolation methods exist since over 50 years and even today new procedures
      and amendments of standard methods are published. They can be classified into
      nonaqueous and aqueous methods. The latter can be subdivided into isotonic,
      hypertonic and hypotonic systems. In most cases the aqueous isolation renders
      nuclei closer to their physiological status in the cell. A standard method for
      the hypotonic isolation of nuclei is presented and the methodology of nuclear
      isolation is discussed.

PMID- 1620685
TI  - High resolution of multiple forms of red blood cell enzymes using a Toyopearl
      DEAE 650 S.
AB  - We have investigated a new anion exchange chromatographic support (Toyopearl DEAE
      650 S) which simultaneously allows easily to remove hemoglobin from hemolysates
      and to obtain a very high resolution of enzymes present in multiple forms. The
      results obtained are better than those obtainable using an anion-exchange HPLC
      column. The data obtained at analytical level suggest a wider use of this new
      matrix also for preparative purposes without significant changes in the
      resolution.

PMID- 1620686
TI  - Preparative purification of pig red blood cell hexokinase type III using a new
      efficient chromatographic support.
AB  - In this paper we report the purification of pig erythrocyte hexokinase type III,
      at preparative level, using 52 liters of starting material (hemolysate). This was
      possible using a new efficient anion exchanger support, the Toyopearl DEAE 650 M
      which allows completely to change the strategy of removing hemoglobin from
      hemolysates, permitting to handle large amounts of starting material and reducing
      work would have required months using conventional anion exchanger supports, to
      only 2-3 days. Furthermore, we have tested the binding of other red blood cell
      enzymes to the Toyopearl DEAE 650 M, showing a wider potential use of this
      chromatographic support for their purification at a preparative level.

PMID- 1620687
TI  - Large scale extraction of alpha-lactalbumin and beta-lactoglobulin from bovine
      whey by precipitation with polyethylene glycol and partitioning in aqueous two
      phase systems.
AB  - The milk proteins alpha-lactalbumin and beta-lactoglobulin have been isolated
      from bovine whey by fractional precipitation with polyethylene glycol (PEG) and
      hydrophobic partitioning in aqueous PEG-hydroxypropylstarch two-phase systems
      using PEG-bound palmitate as hydrophobic ligand. The possible use of this
      combination for large scale purification of these whey proteins is discussed.

PMID- 1620688
TI  - Purification and characterization of kallikrein-like serine proteases from rat
      submandibular glands.
AB  - The purification and characterization of kallikrein-like proteases from rat
      submandibular glands is described. The proteolytic activity of each fraction
      during purification was monitored on the synthetic substrate N-alpha-tosyl-L
      arginine methyl ester (TAME). The purification scheme involved ammonium sulfate
      precipitation, chromatography on columns of DEAE-Sepharose and Sephadex G-100 and
      chromatofocusing. Three TAME-hydrolytic activity peaks were eluted from DEAE
      Sepharose as unbound fraction (Pool 1), at 125 mM NaCl (Pool 2) and at 250 mM
      NaCl concentration (Pool 4). Pool 1 further resolved into two protease fractions
      (1A1 and 1A2), pool 2 into three protease fractions (2A1, 2A2 and 2A3) and pool 4
      gave a single major protease peak (4A1) by chromatofocusing on PBE-94. Protease
      pools 2A2, 2A3, and 4A1 each gave a single band on SDS-polyacrylamide gel
      electrophoresis with an estimated molecular weight of 34 kDa, 46 kDa and 46 kDa
      respectively. Pools 1A1, 1A2, 2A1 and 2a2 gave a single precipitin line with anti
      rat glandular kallikrein antibodies. 2A3 and 4A1 did not react with these
      antibodies. Synthetic substrates DL-val-leu-arg-pNA and Bz-pro-phe-arg-pNA,
      specific for kallikrein-like proteases, were hydrolyzed preferentially by 2A3 and
      4A1 but were poor substrates for 1A1, 1A2, 2A1 and 2A2.

PMID- 1620689
TI  - Effects of temperature, flow rate and composition of binding buffer on adsorption
      of mouse monoclonal IgG1 antibodies to protein A Sepharose 4 Fast Flow.
AB  - The binding capacity of protein A Sepharose 4 Fast Flow for mouse IgG1 monoclonal
      antibodies (mabs) appears to be highly dependent on the buffer composition with
      respect to both concentration and ion type. Depending on the particular mab
      dynamic binding capacities up to 20 mg mab per ml gel could be obtained, when
      these mabs were isolated from supernatants of protein free hollow fibre cell
      culture systems. Variation of linear flow rate from 10 up to 300 cm/h and
      temperature (4 degrees C versus 25 degrees C) had a slight effect on the dynamic
      binding capacity, when a high ionic strength buffer was used during adsorption.
      Applying optimum binding conditions, final IgG fractions with a purity of more
      than 95% monomeric IgG were obtained. However, as side effect of the use of
      binding buffers with high ionic strength, the binding of acid proteases was also
      promoted.

PMID- 1620690
TI  - Two methods to avoid the effect of endogenous protein inhibitors during the assay
      of protein kinase C activity in tissue extracts.
AB  - Using H1 as substrate the protein kinase C activity of rat liver cell sap was
      increased about fourfold by treatment with DEAE-cellulose at pH 7.5 at an
      intermediate ionic strength due to removal of protein inhibitors. The activity of
      cell sap from rat spleen, brain or muscle was about doubled by the same
      treatment. In contrast, when a specific synthetic peptide substrate was used the
      corresponding increase of enzyme activity was not obtained when the inhibitors
      were removed. This shows that this type of substrates should be preferred for
      reliable assays of protein kinase C in crude extracts. The possible role of the
      protein inhibitors for the substrate specificity of protein kinase C is briefly
      discussed.

PMID- 1620691
TI  - Isolation and purification of extracellular matrix vesicles from blood vessels.
AB  - Extracellular membrane-bound vesicles (called matrix vesicles) which occur in
      abundance in atherosclerotic blood vessels are believed to be associated with
      lipid accumulation and calcification. A technique has been developed to isolate
      them from experimental aneurysms in sheep in which they are known to be
      plentiful. The matrix vesicles were isolated by differential centrifugation
      following extraction by hypotonic salt solution. Most of the vesicles were
      pelleted at 30,000g and fell within the size range of matrix vesicles in situ in
      the aneurysmal wall. Preliminary characterization of the enzymatic activities
      indicates that many of these vesicles are formed from cell membranes rather than
      being derived from lysosomes, mitochondria or endoplasmic reticulum.
      Morphologically they are similar to matrix vesicles of other mineralizing
      tissues.

PMID- 1620692
TI  - Molecular mechanics simulations of a conformational rearrangement of D-xylose in
      the active site of D-xylose isomerase.
AB  - A proposed reaction mechanism for the enzyme D-xylose isomerase involves the ring
      opening of the cyclic substrate with a subsequent conformational rearrangement to
      an extended open-chain form. Restrained energy minimization was used to simulate
      the rearrangement. In the ring-opening step, the substrate energy function was
      gradually altered from a cyclic to an open-chain form, with energy minimization
      after each change. The protein/sugar contact energy did not increase
      significantly during the process, showing that there was no steric hindrance to
      ring opening. The conformational rearrangement involves an alteration in the
      coordination of the substrate to metal ion [1], which was induced by gradually
      changing restraints on metal/ligand distances. By allowing varying amounts of
      flexibility in the protein and examining a simplified model system, the
      interactions of the sugar with metal ion [1] and its immediate ligands were found
      to be the most important contributors to the energy barrier for the change. Only
      small changes in the positions of protein atoms were required. The energy barrier
      to the rearrangement was estimated to be less than the Arrhenius activation
      energy for the enzymatic reaction. This is in accordance with experimental
      indications that the isomerization step is rate determining.

PMID- 1620693
TI  - Characterization of HIV-1 p24 self-association using analytical affinity
      chromatography.
AB  - Analytical affinity chromatography (AAC) was used to detect and quantitate the
      self-association of p24gag, the major structural capsid protein of human
      immunodeficiency virus (HIV-1). p24gag was immobilized on a hydrophilic polymer
      (methacrylate) chromatographic support. The resulting affinity column was able to
      interact with soluble p24, as judged by the chromatographic retardation of the
      soluble protein upon isocratic elution under nonchaotropic binding conditions.
      The variation of elution volume with soluble protein concentration fit to a
      monomer-dimer model for self-association. The soluble p24-immobilized p24
      association process was observed using both frontal and zonal elution AAC at
      varying pH values; the dissociation constant was 3-4 x 10(-5) M at pH 7. That p24
      monomer associates to dimers was determined in solution using analytical
      ultracentrifugation. The solution Kd was 1.3 x 10(-5) M at pH 7. AAC in the zonal
      elution mode provides a simple and rapid means to screen for other HIV-1
      macromolecules that may interact with p24 as well as for modulators, including
      antagonists, of HIV p24 protein assembly.

PMID- 1620694
TI  - Continuum electrostatics of the C-peptide: anatomy of the problem.
AB  - A computational study of the role of all ionizable groups of the C-peptide in its
      helix-coil transition is performed within the framework of continuum
      electrostatics. The method employed in our computations involves a numeric
      solution of the Poisson equation with the Boundary Element Method. Our
      calculations correctly predict the experimentally observed trends in the helix
      coil equilibrium of the C-peptide, and suggest that the mechanisms involved are
      more complex than usually presumed in the literature. Our results suggest that
      electrostatic interactions in the unfolded conformation are often more important
      than in the helix, total electrostatic contribution to the helix-coil transition
      due to the side chains of the C-peptide destabilizes the helix, changes in the
      helix stability produced by the changes in the ionization state of the side
      chains are dominated by side chain effects, the effect of the helix dipole on the
      energetics of the helix-coil transition of the C-peptide is either minor or
      similar to other contributions in magnitude; while the formation of a salt bridge
      is electrostatically favorable, formation of the hydrogen bond between a charged
      and a polar side chains is not. Factors limiting the accuracy of the computations
      are discussed.

PMID- 1620695
TI  - Structural and energetic differences between insertions and substitutions in
      staphylococcal nuclease.
AB  - In a previous study, the small protein staphylococcal nuclease was shown to
      readily accommodate single alanine and glycine insertions, with average losses in
      stability comparable to substitutions at the same sites (PROT. 7:299-305, 1990).
      To more fully explore this unexpected adaptability to changes in residue spacing,
      2 double amino acid insertions (alanyl-glycine, glycyl-glycine) and 3 additional
      single amino acid insertions with dissimilar side chains (proline, leucine, and
      glutamine) were constructed at 10 of the sites previously studied. At 8 of these
      sites, the type of amino acid side chain on the inserted residue significantly
      influenced the stability of the mutant protein. However, at 9 of the 10 sites,
      the double insertions were found to be no more destabilizing than the single
      alanine or glycine insertions. In contrast, double substitution mutations of
      staphylococcal nuclease, which replace two adjacent residues with alanine, do not
      show this striking degree of non-additivity. A comparison of the effects of
      single glutamine and single glycine insertions with alanyl-glycine insertions
      indicates that insertion of alanine into the peptide backbone is, on average,
      less destabilizing than appending the equivalent atoms onto the side chain of a
      glycine insertion. To explain their very different energetic effects, we propose
      that, unlike most substitutions, the inserted residue(s) must induce lateral
      displacements of the polypeptide chain, forcing the folded conformation away from
      that of wild type. The resulting obligatory shifts in the positioning of residues
      flanking the insertion generate a large number of degrees of freedom around which
      the mutant structure can relax.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620697
TI  - Crystallization and preliminary X-ray diffraction analysis of staphylococcal
      enterotoxin type C.
AB  - The Type C staphylococcal enterotoxin produced by Staphylococcus aureus strain
      FRI-909 has been crystallized using a combination of two precipitants, ammonium
      sulfate and polyethylene glycol 400, with the addition of small amounts of
      detergent. Two related crystal forms have been obtained, one triclinic, and one
      tetragonal, both with one toxin molecule per asymmetric unit. These crystals are
      stable for at least 75 hr in the X-ray beam and diffract to at least 2.2 and 2.6
      A, respectively. The triclinic crystals have unit cell parameters a = 38.5 A, b =
      43.7 A, c = 36.9 A, and interaxial angles alpha = 99.9 degrees, beta = 95.8
      degrees, and gamma = 98.5 degrees. The tetragonal crystals are of space group
      P4(1)22 with unit cell parameters a = 43.4 A and c = 278.0 A.

PMID- 1620696
TI  - Michaelis complexes of porcine pancreatic elastase with 7-[(alkylcarbamoyl)amino]
      4-chloro-3-ethoxyisocoumarins: translational sampling of inhibitor position and
      kinetic measurements.
AB  - A step leading to the formation of the covalent complexes between porcine
      pancreatic elastase (PPE) and 7-[(alkylcarbamoyl)amino]-4-chloro-3
      ethoxyisocoumarins (alkylHNCO-EICs) is the formation of the noncovalent Michaelis
      complex. No average structures are available for the Michaelis complexes of PPE
      with alkylHNCO-EICs. We present the results of an initial step in obtaining these
      structures and have determined kinetic constants as well. The kinetic results
      indicate that formation of the Michaelis complex is what differentiates the
      effectiveness of these inhibitors in inactivating PPE. The structural and kinetic
      results together suggest that the structure of the Michaelis complex is necessary
      for the design of potent alkylHNCO-EIC inhibitors of PPE. Two novel alkylHNCO
      EICs are predicted to be the best inhibitors of this series. An alternate
      mechanism for serine protease inhibition is also proposed. Evidence for, and
      studies that may add support to, the hypothesized mechanism are discussed.

PMID- 1620698
TI  - Crystallization and preliminary X-ray diffraction studies of two mutants of
      lactate dehydrogenase from Bacillus stearothermophilus.
AB  - Bacillus stearothermophilus lactate dehydrogenase, one of the most thermostable
      bacterial enzymes known, has had its three-dimensional structure solved, the gene
      coding for it has been cloned, and the protein can be readily overexpressed. Two
      mutants of the enzyme have been prepared. In one, Arg171 was changed to Trp
      (R171W) and Gln102 was changed to Arg (Q102R). In the other, the mutation Q102R
      was maintained, but Arg171 was changed to Tyr (R171Y). In addition, an
      inadvertent C97G mutant was present. Both mutants have been crystallized by the
      hanging drop vapor diffusion method at room temperature. Bipyrimidal crystals
      have been obtained against (NH4)2SO4 in 50 mM piperazine HCl buffer. The crystals
      belong to space group P6(2)22 (P6(4)22) (whereas the native enzyme, the structure
      of which has been solved by Piontek et al., Proteins 7:74-92, 1990) crystallized
      in the space group P6(1)) with a = 102.3 A, c = 168.6 A for the R171W, Q102R,
      C97G triple mutant, and a = 98.2 A; c = 162.1 A for the R171Y, Q102R, C97G
      mutant. These crystal forms appear to contain one-quarter of a tetramer (M(r)
      135,000) in the asymmetric unit and have VM values of 3.8 and 3.3 A3/dalton,
      respectively). The R171W mutant diffracts to 2.5 A and the R171 Y mutant to
      approximately 3.5 A.

PMID- 1620699
TI  - Activation of the ras oncogene in gamma radiation and neutron radiation induced
      thymic lymphomas.

PMID- 1620700
TI  - Experimental models of benzene carcinogenesis.

PMID- 1620701
TI  - Oxidation and conjugation of aflatoxins by humans and experimental animals.

PMID- 1620703
TI  - Alkylating agents relating to carcinogenesis in man.

PMID- 1620702
TI  - Carcinogenic effects of chemotherapeutic compounds.

PMID- 1620704
TI  - DNA adducts induced by platinum drug chemotherapeutic agents in human tissues.

PMID- 1620705
TI  - Cancer enhancement by cell proliferation.

PMID- 1620706
TI  - Phenobarbital and related compounds: approaches to interspecies extrapolation.

PMID- 1620707
TI  - Multistage hepatocarcinogenesis in the rat: insights into risk estimation.

PMID- 1620708
TI  - Comparisons of human cancer potency projections for dieldrin based on human data
      with those based on animal data.

PMID- 1620709
TI  - Multi-site regulation of estrogen receptor by 2,3,7,8-tetrachlorodibenzo-p
      dioxin.

PMID- 1620710
TI  - Specific mechanistic aspects of animal tumor promoters: the okadaic acid pathway.

PMID- 1620711
TI  - Evaluation of sustained hyperplasia and other short-term tests as predictors of
      tumorigenic potential in oil products.
AB  - Some oil products are known to cause skin tumors following long-term application
      while others do not. The ability to predict which ones might cause tumors is
      important. Development of reliable short term tests which can accurately predict
      tumorigenic potential of oil products is needed to avoid the high cost and long
      time required for traditional animal bioassays. Several short term tests were
      evaluated for their ability to predict tumorigenic potential of 10 coded oil
      samples and results were compared to results of mouse bioassays. Analytical
      determinations of PAC content (DMSO extraction) and 3-6 ring PAC content were
      also made for each of the 10 samples for further comparison. Tests which showed
      good correlation with bioassay results and thus were considered good predictors
      of tumorigenic potential were: Sustained Epidermal Hyperplasia as measured by
      epidermal thickness, Nuclear Area of epidermal basal cells, Modified Ames Test
      and DMSO extraction for PAC content. Tests which did not show good correlation
      with bioassay results and which were not considered good predictors of
      tumorigenic potential were: Polymorphonuclear leukocyte (PMN) infiltration into
      the dermis, Unscheduled DNA Synthesis in epidermal cells and Changes in Nuclear
      DNA Content of CHO cells.

PMID- 1620712
TI  - Differences in animal and human responses to carcinogenic metals.

PMID- 1620713
TI  - Animal models of mesothelioma induced by mineral fibers: implications for human
      risk assessment.

PMID- 1620714
TI  - Interspecies sensitivity to chemical carcinogens.

PMID- 1620715
TI  - Animal studies in potency ranking of carcinogens in Norway.

PMID- 1620716
TI  - Mechanisms of human carcinogens.
AB  - Mutational mechanisms can be proposed as contributing to the activity of most
      human carcinogens. Many of these chemicals are electrophilic or are metabolically
      activated to reactive molecules that can alter DNA. Even human carcinogens that
      do not exhibit direct chemical interaction with DNA, e.g., hormones and asbestos,
      have been shown to induce genetic effects when in vitro assays for chromosomal
      mutations are employed. Since these chemicals are usually inactive in the
      Salmonella assay and other gene mutational assays, more emphasis has been placed
      on their nonmutational mechanisms. Evidence exists that these carcinogens alter
      gene expression and stimulate cell proliferation by epigenetic mechanisms; such
      properties almost certainly contribute to the carcinogenic activity of these
      chemicals. Although less well studied, DNA reactive, genotoxic carcinogens also
      alter gene expression and cell proliferation by epigenetic mechanisms. These
      findings are consistent with the current understanding of the molecular basis of
      multistep carcinogenesis. The neoplastic evolution of most common human cancers
      occurs as the result of multiple mutational events. The molecular basis for these
      mutations is varied and includes point mutations, deletion mutations, chromosome
      rearrangements, gene amplification, and chromosome losses and gains. Therefore,
      different mutational activities of carcinogens may influence the carcinogenic
      process at different steps. In addition, chemical influences on gene expression
      and cell proliferation are important in allowing clonal expansion of
      preneoplastic cells and in disrupting the suppressive effects of surrounding
      normal cells on preneoplastic cells (Dotto et al., 1988). Therefore, the
      mechanisms of action of human carcinogens, and very likely many rodent
      carcinogens, will include both genetic and epigenetic processes.

PMID- 1620717
TI  - Relevance of quantitation of benzo(a)pyrene metabolites in animal excretes to
      evaluate individual human cancer risk.

PMID- 1620718
TI  - Animal models in the assessment of fiber carcinogenesis.

PMID- 1620719
TI  - DNA adduct formation and aromatic amine tumorigenesis.

PMID- 1620720
TI  - Benzene dosimetry in experimental animals: relevance for risk assessment.
AB  - The findings of the studies summarized in this report provide some understanding
      of the possible role of dosimetry in the different response of the rats and mice
      to benzene in the long-term bioassay studies. The more sensitive species, the
      mice, definitely has a higher capacity to metabolize benzene and to metabolize it
      to more of the putative toxic metabolites than do rats. A major finding of these
      studies is that in three different animal species, from mice to monkeys, the
      metabolic pathways leading to production of the putative toxic metabolites appear
      to be low-capacity, high-affinity pathways that are saturated at relatively low
      exposure concentrations. This does not prove, but suggests, that the same may be
      true in humans. If the total formation of the putative toxic metabolites is
      predictive of the toxicity of benzene, then the animal studies suggest that
      calculations of the risk associated with low dose exposures based on the results
      of animal studies conducted at high doses would underestimate the toxicity of
      benzene. The current report concerns only dosimetry. Another problem in assessing
      the risk to humans from benzene exposure is the fact that the animal models do
      not respond to benzene in the same way as humans. The major concern for humans
      exposed to benzene, based on epidemiology studies, is the risk of developing
      acute myelogenous leukemia (Rinksy, 1987). The cancers developed by the rodents
      on the long-term bioassay studies were at other sites (liver, lung, Zymbal's
      gland, lymph tissue, ovaries, and mammary gland). There is as yet no good animal
      model for benzene-induced leukemia. However, it has been suggested that benzene
      may also increase the incidence of Hodgkin's disease, malignant lymphoma,
      multiple myeloma and lung cancer in humans, although a statistical basis for this
      is lacking (Askoy, 1985). It is not unreasonable to assume that whatever form of
      cancer is induced, the induction is most likely through the reactive metabolites
      produced from benzene. Therefore, the dosimetry of these metabolites is
      pertinent. Our studies indicate that benzene metabolite dosimetry data obtained
      in animals provides data relevant to the estimation of human risks.

PMID- 1620721
TI  - Divergent selection for pentobarbital-induced sleeping times in mice.
AB  - A pharmacogenetic model for sensitivity of mice to pentobarbital is being
      developed by selection for sleep-time response. One generation of divergent
      selection for long and short sleep-time in mice resulted in a 19% increase in the
      long-sleep line and a 15% decrease in the short-sleep line. Calculated
      heritability estimates averaged 0.49 and realized heritabilities averaged 0.24.
      The extent of the selection progress and the heritability values indicate that
      genetic constitution plays a major role in controlling variations of sleep-time
      response to pentobarbital.

PMID- 1620722
TI  - Diamine oxidase activity in the duodenal mucosa of rats with cysteamine-induced
      ulceration.
AB  - Cysteamine administration to rats is followed by a high incidence of duodenal
      ulceration. The effect of cysteamine on the activity of diamine oxidase (DAO,
      histaminase) in the duodenal mucosa of the rat was investigated. Rats were
      injected subcutaneously with cysteamine on 2 successive days at doses of 10, 20
      and 40 mg/100 g body weight and killed 24 h after the second dose. The results
      indicated that cysteamine at a dose of 40 mg/100 g body weight inhibited enzyme
      activity by about 27% (p less than 0.05). Lower doses of cysteamine did not
      significantly affect enzyme activity. In another experiment, rats were injected
      subcutaneously with either saline (control) or cysteamine at a single dose of 40
      mg/100 g body weight and killed 4, 8, 12, 24, 48 and 60 h thereafter. The
      ulcerogen produced progressive reductions in enzyme activity, which were
      significant at 12 h (22% reduction) and 24 h (25% reduction). At 60 h, enzyme
      activity was not significantly different from that of control.

PMID- 1620723
TI  - The interconversion of prednisone and prednisolone in human and rabbit organs in
      vitro is a function of tissue integrity.
AB  - The interconversion and elimination of prednisone (PO) and prednisolone (POH)
      were examined in human and rabbit liver, kidney, lung and skeletal muscle
      preparations to determine the effect of organ disruption on in vitro metabolism
      within multiple organs of two species. Results from microsomes, homogenates and
      minces were compared to determine the effect of various stages of tissue
      disruption on the reversible and irreversible metabolism of the glucocorticoids.
      Oxidation of POH to PO was enhanced by homogenization of all the organs examined;
      further disruption by subcellular fractionation to microsomes reduced oxidation
      relative to homogenates but yielded values greater than the original minces. The
      reverse reaction, reduction of PO to POH, was also enhanced by homogenization,
      but microsomal preparations were less active than the minces. The irreversible
      elimination of the glucocorticoids was progressively diminished by disruption of
      normal architecture in all organs. Results of in vitro studies of glucocorticoid
      metabolism have provided discrepant results, as a function of the laboratory, the
      species, the organ and the organ preparation examined. These results provide
      insights into the source of discrepant results regarding steroid metabolism, as
      it appears that results of experimentation with glucocorticoid conversion and/or
      elimination may be a function of the method used. Additionally, the data support
      the hypothesis that the enzyme system involved in the interconversion of the
      glucocorticoids may not be a simple single protein which acts bidirectionally.

PMID- 1620724
TI  - Effects of calcium channel blockers on formalin-induced nociception and
      inflammation in rats.
AB  - The possible anti-inflammatory and antinociceptive effects of nitrendipine,
      nicardipine, diltiazem and verapamil were examined with formalin test in the rat
      paw. Pretreatment with these calcium channel blockers 1 h before formalin
      injection diminished formalin-induced inflammatory changes and nociceptive
      responses. Formalin-induced nociceptive responses were inhibited 20-90% by the
      calcium channel blockers. Nitrendipine and nicardipine were found to be highly
      effective in inhibiting the inflammatory changes, whereas the effects of
      verapamil and diltiazem were partial. Administration of naloxone affected neither
      the inflammatory changes and nociceptive responses induced by formalin nor the
      antiinflammatory and antinociceptive effects of the calcium channel blockers. The
      results suggest the possible anti-inflammatory and naloxone-insensitive
      antinociceptive properties of calcium channel blockers.

PMID- 1620725
TI  - Photobleaching of merocyanine 540: involvement of singlet molecular oxygen.
AB  - The purpose of this study was to assess the mechanism of merocyanine 540 (MC540)
      photobleaching in a liposomal system. Broad based visible irradiation of MC540 in
      unilamellar dilauroylphosphatidylcholine (DLPC) vesicles resulted in dye
      bleaching that was strictly O2 dependent. The rate of self-sensitized
      photobleaching was enhanced in D2O and inhibited by both azide and histidine,
      consistent with 1O2 intermediacy (Type II chemistry). Supportive evidence for
      this mechanism was obtained by using a Type II sensitizer, aluminum
      phthalocyanine tetrasulfonate (AlPcS lambda max = 678 nm). Irradiation of AlPcS
      and MC540 in DLPC with lambda greater than 630 nm (absorbed only by AlPcS) light
      resulted in rapid bleaching of MC540, which was stimulated by D2O and inhibited
      by azide. A rate constant of 10(7) M-1 s-1 was determined for the chemical
      quenching of 1O2 by MC540. The rate constant for physical quenching of 1O2 by
      MC540 was estimated to be ca 10(9) M-1 s-1.

PMID- 1620726
TI  - Photoacoustic detection of triplet state and singlet oxygen in highly absorbing
      samples.
AB  - A photoacoustic (PA) effect theory taking into account two heat sources
      corresponding to the radiationless relaxation processes of two states of
      different lifetimes and to the heat diffusion across the sample is herewith
      presented. Results obtained demonstrate that the amplitude and the phase of the
      PA signal depend on the sample's thermal properties, on its optical absorption
      coefficient, on the lifetime of the long-lived excited state, and on the ratio of
      the two heat sources. This ratio can be expressed as a function of the product of
      the energy of the excited state times the quantum yield of its production.
      Simulations of PA amplitude and phase variations vs light modulation frequency
      exhibit new features of the PA signal:phase inversion and fast decrease of the
      amplitude. Experimental verifications were carried out on solutions and gels.
      Fitting of the amplitude and phase variations allow us to measure the lifetime
      and conversion yield of the intermediate state which can be a triplet state or
      singlet oxygen, O2(1 delta g). The addition of an acceptor, specific to O2(1
      delta g), induces changes in the amplitude of the PA signal which can be used to
      study the production and deactivation of this excited form of oxygen. This work
      demonstrates the usefulness of PA in the detection of metastable excited states
      such as the triplet state and singlet oxygen and in their quantitative analysis.

PMID- 1620727
TI  - Synthetic carotenoids, novel polyene polyketones and new capsorubin isomers as
      efficient quenchers of singlet molecular oxygen.
AB  - Novel synthetic polyene polyketones and new synthetic capsorubin isomers were
      examined for their ability to quench singlet molecular oxygen (1O2) generated by
      the thermodissociation of the endoperoxide of 3,3'-(1,4-naphthylene) dipropionate
      (NDPO2). C28-polyene-tetrone (1) exhibits the highest physical quenching rate
      constant with 1O2 (kq = 16 x 10(9) M-1 s-1). For comparison, the rate constant
      for the most efficient biological carotenoid, lycopene (3) is kq = 9 x 10(9) M-1
      s-1 and that of beta-carotene (5) kq = 5 x 10(9) M-1 s-1. The presence of two
      oxalyl chromophores at the ends of the polyene chain seems to enhance the 1O2
      quenching ability in the C28-polyene-tetrone (1). C28-polyene-tetrone-diacetal
      (2) (kq = 9 x 10(9) M-1 s-1) and C40-epiisocapsorubin (4) (kq = 8 x 10(9) M-1 s
      1) also have high 1O2 quenching abilities. Two carotenoids from plants, phytoene
      and phytofluene, were much less efficient, kq values being below 10(7) M-1 s-1.
      Due to the very high singlet oxygen quenching abilities, C28-polyene-tetrone (1),
      C28-polyene-tetrone-diacetal (2) and C40-epiisocapsorubin (4) may have potential
      use in preventing 1O2-induced damage in biological and non-biological systems.

PMID- 1620728
TI  - In vivo spectrophotometric evaluation of neoplastic and non-neoplastic skin
      pigmented lesions. II: Discriminant analysis between nevus and melanoma.
AB  - Reflectance spectrophotometry from 420 to 780 nm on 31 primary melanoma and 31
      benign nevi has been performed by using an external integrating sphere coupled to
      a spectrophotometer. Measurements show that reflectance spectra of melanoma and
      nevi manifest dissimilar patterns. From these spectra four variables, whose
      physical and/or physiological meanings remain to be investigated, have been
      derived. All of them are significantly different when compared between melanoma
      and nevi. A discriminant function between the two groups of lesions has been
      determined by using a stepwise discriminant analysis, resulting in a test with a
      sensitivity of 90.3% and a specificity of 77.4%. This method of discrimination
      between melanoma and nevi seems to have a discriminating power almost equal to
      that of a clinical judgement from a specialized medical doctor, thus suggesting a
      new method for screening skin pigmented lesions.

PMID- 1620729
TI  - Quenching of singlet oxygen by biomolecules from L1210 leukemia cells.
AB  - Singlet oxygen lifetimes for detergent-dispersed L1210 leukemia cells in
      deuterium oxide buffer were measured by following the decay of 1270 nm
      phosphorescence. Four photosensitizers and two detergents were studied. Stern
      Volmer plots were linear over the cell concentration range studied (0-10(7)
      cells/mL). The singlet-oxygen quenching constants obtained depended somewhat upon
      the specific combination of detergent and photosensitizer used. Extrapolation of
      the singlet-oxygen lifetime data to "100%" cell concentration (1.39 +/- 0.04 x
      10(9) cells/mL) and correction for the contribution of the water solvent gave a
      singlet-oxygen lifetime between 0.17 and 0.32 microseconds for the L1210 leukemia
      cell. The theoretical contributions of various types of biological molecules
      within the L1210 cell to the total singlet-oxygen quenching were calculated from
      their concentrations and their quenching constants. These calculations suggest
      that proteins will quench most of the singlet-oxygen. Only about 7% of the
      singlet-oxygen is quenched by water.

PMID- 1620731
TI  - Wavelength dependence (150-290 nm) of the formation of the cyclobutane dimer and
      the (6-4) photoproduct of thymine.
AB  - The action cross sections for the formation of the cyclobutane dimer and the (6
      4) photoproduct of thymine as well as the absorption cross sections of thymine
      were determined in the wavelength region between 150 and 290 nm. Thymine films
      sublimed on glass plates were irradiated by monochromatic photons in a vacuum;
      the induced photoproducts were quantitatively analyzed by high-performance liquid
      chromatography (HPLC). Under our conditions, two major peaks appeared on the HPLC
      chromatograms of irradiated samples. The two peaks were identified as being the
      cis-syn cyclobutane dimer and the (6-4) photoproduct, based on their HPLC
      retention times, absorption spectra in the effluent, and photochemical
      reactivity. The fractions of the two photoproducts increased linearly with the
      fluence at low fluences over the entire wavelength range. Their action cross
      sections were determined by the slopes of the linear fluence response curve at 10
      nm intervals between 150 and 290 nm. The two action spectra showed a similar
      wavelength dependence and had a maximum at 270 nm as well as two minor peaks at
      180 and 220 nm, at which wavelengths the peaks of the absorption spectrum of
      thymine sublimed on a CaF2 crystal plate appeared. The quantum yields had
      relatively constant values of around 0.008 for the dimer and 0.013 for the (6-4)
      photoproduct above 200 nm, decreasing to 0.003 and 0.006, respectively, at 150 nm
      as the wavelength became shorter.

PMID- 1620730
TI  - The photobiological activity of 5-geranoxypsoralen and its photoproducts.
AB  - 5-geranoxypsoralen (Bergamottin) does not photosensitize bacteria or a bacterial
      virus. It does, however, photosensitize mammalian cells in tissue culture.
      Irradiation with either black light (300-400 nm) or fluorescent ceiling lights
      produced at least four photobiologically active degradation products, the
      chemical nature of which still remains to be elucidated. Prolonged exposure to
      black light resulted in the formation of inactive molecule(s).

PMID- 1620732
TI  - Multiple modality treatment of carcinoma cells with Pt(Rh-123)2 plus x-ray plus
      light.
AB  - A complex of platinum tetrachloride with two molecules of rhodamine-123 (Rh-123),
      Pt(Rh-123)2, has been reported to act as hypoxic cell radiosensitizer of
      carcinoma cells in vitro and in vivo. In the present paper we report that Pt(Rh
      123)2 photosensitizes human mammary carcinoma (MCF-7) cells and cis-platinum
      resistant human mammary carcinoma (MCF-7/CP) cells to 400-800 nm light in vitro.
      The efficiency of photosensitization by Pt(Rh-123)2 was 10 times greater than for
      Rh-123. Combination therapy using Pt(Rh-123)2 plus x-ray plus light was also much
      more effective compared to the combination therapy using Rh-123 plus x-ray plus
      light. After 15 microM of Rh-123 plus x-ray (0-8 Gy) plus light (5 J/cm2)
      treatment, cell survival curve was parallel to the x-ray cell survival curve with
      an initial decrease in the surviving fraction corresponding to the drug plus
      light mediated killing. Cell killing caused by Rh-123 (15 microM) plus x-ray (0-8
      Gy) plus light (5 J/cm2) was additive as determined by the product of the
      surviving fraction after Rh-123 plus light and x-ray. In contrast, for 15 microM
      of Pt(Rh-123)2 plus x-ray (8 Gy) plus light (5 J/cm2) treatment, whereas additive
      killing predicts a survival fraction of approximately 0.024, in reality, the
      combination therapy caused the survival fraction to decrease to 0.0012, implying
      that the cell killing was enhanced by a factor of 20. Using Pt(Rh-123)2 plus x
      ray plus light, supra-additive cell killing was also observed under hypoxic
      conditions, although compared to normally oxygenated conditions the degree of
      cytotoxicity was significantly reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620733
TI  - Photoaging effects on spectral transmittance of plastic filters.
AB  - We examined the effects of ultraviolet (UV) radiation in combination with high
      levels of infrared (IR) radiation on the spectral transmittance of plastic
      filters. The biological action spectrum for damage to the human eye and skin
      changes dramatically in the 300-400 nm wavelength range. Cut-off filters used in
      this region to shape the spectrum of exposure sources are thus critical to the
      design of experiments which use broadband light sources. The changes in
      transmittance of three types of plastic filters were observed over an exposure
      period of 1000 h. One set of three filters was exposed mainly to UV radiation,
      while the other set was exposed to UV radiation plus IR radiation. Filters
      exposed to both UV and IR radiation showed spectral changes in their
      transmittance, while the filters exposed to UV only showed no measurable changes.

PMID- 1620734
TI  - Comparative pharmacological investigations of Allium ursinum and Allium sativum.
AB  - Extracts of wild garlic (Allium ursinum) and garlic (A. sativum) with defined
      chemical compositions were investigated for their in vitro inhibitory potential
      on 5-lipoxygenase (LO), cyclooxygenase (CO), thrombocyte aggregation (TA), and
      angiotensin I-converting enzyme (ACE). The inhibition rates as IC50 values of
      both extracts for 5-LO, CO, and TA showed a good correlation with the %-content
      of the major S-containing compounds (thiosulfinates and ajoenes) of the various
      extracts. In the 5-LO and CO test the garlic extracts are slightly superior to
      the wild garlic extracts whereas, in the TA test, no differences could be found.
      In the ACE test the water extract of the leaves of wild garlic containing
      glutamyl-peptides showed the highest inhibitory activity followed by that of the
      garlic leaf and the bulbs of both drugs. The comparative studies underline the
      usefulness of wild garlic as a substitute of garlic.

PMID- 1620735
TI  - Antibacterial diterpenes from the aerial parts of Premna oligotricha.

PMID- 1620736
TI  - Alkaloids of Thalictrum glandulosissimum.

PMID- 1620737
TI  - Pharmacologically active phenylpropanoids from Senra incana.
AB  - Coniferaldehyde, scopoletin, sinapaldehyde, and syringaldehyde were isolated from
      an aqueous extract of Senra incana. All four compounds inhibited prostaglandin
      synthetase in a dose-dependent way. Compared to aspirin, the potency of
      coniferaldehyde and scopoletin was about five times higher, whereas
      syringaldehyde and sinapaldehyde had about half the potency of this reference
      compound. On topical application, sinapaldehyde and scopoletin dose-dependently
      inhibited ethyl phenylpropiolate-induced edema of the rat ear. The active dose
      range was 1-10 micrograms/ear. Higher doses had a lower effect. Syringaldehyde
      was active in the range 20-100 micrograms/ear, whereas the effect of
      coniferaldehyde was inconclusive. Coniferaldehyde and sinapaldehyde inhibited
      electrically induced contractions of the guinea pig ileum in a dose-dependent
      way. Syringaldehyde showed a weak inhibition at a concentration of 550 microM.

PMID- 1620738
TI  - Antispasmodic activity of beta-damascenone and E-phytol isolated from Ipomoea pes
      caprae.
AB  - The crude extract (IPA) of the plant Ipomoea pes-caprae (L.) R. Br. has
      previously been shown to antagonize smooth muscle contractions induced by several
      agonists via a non-specific mechanism. Bioassay-guided fractionation of IPA
      resulted in isolation of the antispasmodically acting isoprenoids beta
      damascenone and E-phytol. Their antispasmodic potencies were found to be in the
      same range as that of papaverine, a general spasmolytic agent. This effect was
      suggested to play a role in the previously observed anti-inflammatory activity of
      IPA by interfering with the contraction of endothelial cells. Severe vascular
      contraction has been shown to be involved in the dermatitis caused by toxic
      jellyfishes. It is possible that beta-damascenone and E-phytol, by interfering
      with the contraction of vascular smooth muscle cells, are partly responsible for
      the previously reported effectiveness of IPA in the treatment of such dermatitis.

PMID- 1620739
TI  - An evaluation of Lawsonia alba extract as hepatoprotective agent.
AB  - The hepatoprotective activity of an ethanol-water (1:1) extract of Lawsonia alba
      has been studied against CCl4-induced liver toxicity. The effects of the extract
      on hexobarbitone-induced sleep, BSP clearance, and on certain biochemical
      parameters indicated its protective role. There was no effect on bile flow. The
      extract did not show any signs of toxicity and the minimum lethal dose was
      greater than 2.0 g/kg p.o. in mice.

PMID- 1620740
TI  - The effect of N-deacetylcolchiceine on serum lipoproteins in rats.
AB  - N-Deacetylcolchiceine (DAC) administered i.p. to rats decreased the level of
      serum cholesterol and apoB. It was accompanied by the fall of HDL-C due to the
      decrease of both HDL subfractions HDLa and HDLb, and by a rather weaker decrease
      of LDL-C. The levels of serum and lipoprotein triacylglycerols were not
      significantly affected. The "clearing reaction" to heparin in DAC rats differed
      from controls with regard to plasma cholesterol resulting in its accumulation in
      HDLa and LDL simultaneously with an increased activity of post-heparin
      lipoprotein lipase. These results suggest that the DAC accelerates the
      lipoprotein cholesterol metabolism.

PMID- 1620741
TI  - Antitumor activity of cell wall beta-1,3/1,6-glucans from Phytophthora species.
AB  - From the cell walls of various Phytophthora species (Oomycetes) different water
      soluble beta-1,3/1,6-glucans were isolated and characterized. The glucans with
      relative molecular masses between 13 and 50 kd exhibited varying degrees of
      branching in the beta-1,3-linked glucan backbone ranging from 14 to 50%. The dose
      dependent antitumor activity of the glucans against allogeneic sarcoma-180 was
      investigated. It could be demonstrated that beta-1,3/1,6-glucans with relative
      molecular masses below 50 kd can exhibit a prominent antitumor activity
      (inhibition rate up to 99%), being comparable to that of the high relative
      molecular mass (450 kd) beta-1,3/1,6-glucans. Biological activity of the glucans
      could be shown to be correlated with a low degree of branching. The most potent
      glucan with a degree of branching of 14% also was active against the syngeneic
      DBA/2-MC.SC-1 fibrosarcoma (inhibition rate up to 90%) and in combination with a
      suboptimum dose of diethylstilbestrol against Nobel-Nb prostate carcinoma
      (inhibition rate up to 90%).

PMID- 1620742
TI  - Indole alkaloids with in vitro antiproliferative activity from the ammoniacal
      extract of Nauclea orientalis.
AB  - Nine angustine-type alkaloids were isolated from ammoniacal extracts of Nauclea
      orientalis L. (Rubiaceae). Three of them, 10-hydroxyangustine and the two
      diastereoisomeric 3,14-dihydroangustolines, have not been described in the
      literature thus far. The structures of the isolates were determined with
      spectroscopic methods, mainly 1D- and 2D-NMR spectroscopy. The compounds were
      found to exhibit in vitro anti-proliferative activity against the human bladder
      carcinoma T-24 cell line and against EGF (epidermal growth factor)-dependent
      mouse epidermal keratinocytes. By using overpressure layer chromatography, it was
      shown that minor quantities of these alkaloids occur in dried Nauclea orientalis
      leaves. The use of ammonia in the extraction process results in a significant
      increase in the formation of angustine-type alkaloids from strictosamide-type
      precursors.

PMID- 1620743
TI  - On the influence of the sugar moiety on the antigonadotropic activity of
      luteoline glycosides.
AB  - Luteolin-7-glucoside and luteolin-7-glucuronide were isolated from Lycopus
      europaeus L. (Lamiaceae) and identified by 1H- and 13C-NMR spectroscopy. Luteolin
      7-glucuronide proved to be active against PMSG in vitro as well as in vivo,
      whereas the other flavone glycosides occurring in the plant were completely
      inactive.

PMID- 1620744
TI  - Molluscicidal constituents of Calophyllum from Madagascar: activity of some
      natural and synthetic neoflavonoids and khellactones.
AB  - Crude extracts of seeds, leaves and barks of four Madagascan Calophyllum species:
      C. inophyllum, C. recedens, C. chapelieri, and C. verticullatum, have been tested
      for molluscicidal activity against Biomphalaria glabrata. All seed extracts
      showed significant activity. The major constituents of the most active
      Calophyllum species were examined. Some related coumarinic derivatives were
      synthesized in order to improve the biological activity. Among the compounds
      prepared, 5,7-dihydroxy-6-(2-methylbutyryl)-4-phenyl-coumarin presented an
      interesting molluscicidal activity.

PMID- 1620745
TI  - Tyromycin A: a novel inhibitor of leucine and cysteine aminopeptidases from
      Tyromyces lacteus.
AB  - Tyromycin A, a new inhibitor of leucine and cysteine aminopeptidases has been
      isolated from mycelial cultures of the basidiomycete Tyromyces lacteus (Fr.)
      Murr. Its structure was established as 1,16-bis-[4-methyl-2,5-dioxo-3
      furyl]hexadecane (1) by spectral analysis and transformation into ester and imide
      derivatives.

PMID- 1620746
TI  - Chemical structure and biological activity of polysaccharides from Hibiscus
      sabdariffa.
AB  - Three water-soluble polysaccharides have been isolated from flower buds of
      Hibiscus sabdariffa L. (HIB 1,2,3). The neutral polysaccharides (HIB 1 and 2) are
      composed of arabinans and arabinogalactans of low relative molecular mass. The
      major fraction was investigated by methylation analysis, pectinase-treatment,
      mild acid hydrolysis and NMR studies, and it was shown to be a pectin-like
      molecule (Mr = 10(5)d). The main chain is composed of alpha-1,4-linked GalA (24%
      methyl-esterified) and alpha-1,2-linked Rha. Side chains are built of Gal and Ara
      and are connected to the main chain via C-4 of every third Rha. Its structure
      seems to be different from polysaccharide structures described in other species
      of the Hibiscus genus and the Malvaceae family. All fractions were assayed for
      possible immune-modulating effects. All fractions showed some activity, but the
      main acidic fraction was contaminated with lipopolysaccharide, and therefore its
      shown activity has to be discussed carefully.

PMID- 1620747
TI  - Monoclonal antibody-based enzyme immunoassay for the quantitative determination
      of the tropane alkaloid, scopolamine.
AB  - A monoclonal antibody (SP1-4-A2) against scopolamine was produced, characterized,
      and used to develop a sensitive and selective, competitive enzyme immunoassay for
      the quantitation of the alkaloid. The assay uses nor-scopolamine-N-beta-propionic
      acid coupled to alkaline phosphatase as tracer and is linear from 10 pg to 10 ng
      of scopolamine. As little as 10 pg of scopolamine can be quantitated in an
      unprocessed plant extract or in human serum after suitable dilution,
      corresponding to detection limits of 0.1 ng scopolamine/ml of plant extract or
      0.5 ng/ml of serum. The assay is more selective for scopolamine (percent cross
      reactions for hyoscyamine = 0.21%, 6-hydroxy-hyoscyamine = 0.17%) than previously
      reported immunoassays. The assay format was designed to minimize intra- and inter
      plate variabilities which are, on an average, all below 3% (coefficients of
      variation). The assay reported here has been validated against an HPLC-based
      technique using plant samples and was shown to correlate closely (y = 0.959 x +
      0.14, r = 0.982).

PMID- 1620748
TI  - Pharmacokinetics of vinyldithiins, transformation products of allicin.
AB  - The pharmacokinetic behaviour of vinyldithiins, the main constituents of oily
      preparations of garlic (Allium sativum L.), was investigated after oral
      administration of 27 mg 2-vinyl-4H-1,3-dithiin and 9 mg 3-vinyl-4H-1,2-dithiin to
      rats. In serum, kidney, and fat tissue, both vinyldithiins could be detected by
      GC-MS over a period of 24 h, whereas in liver only 1,3-vinyldithiin was found.
      Pharmacokinetic parameters (t1/2, ke, Cltot, AUC, and Vd) were determined using
      compartment models, elucidating the different pharmacokinetic behaviour of both
      vinyldithiins. 1,3-Vinyldithiin seems to be less lipophilic and is rapidly
      eliminated from serum, kidney, and fat tissue, whereas 1,2-vinyldithiin is more
      lipophilic and shows a tendency to accumulate in fat tissue. Experiments with
      liver homogenate confirmed the in vivo findings on the different degradation
      rates of both vinyldithiins. Allicin, the precursor of the vinyldithiins, is
      metabolized more rapidly in liver homogenate than the vinyldithiins.

PMID- 1620749
TI  - [Isolation and structure elucidation of further new saponins from Solidago
      canadensis].
AB  - Four new main saponins (canadensis-saponins 5-8) (compounds 5-8) were isolated
      from Solidago canadensis L. (Asteraceae). Using GC/MS, FAB-MS, and mainly 2D-NMR
      techniques their structures were identified as 3-O-[beta-D-glucopyranosyl(1----3)
      beta-D- glucopyranosyl]-28-O-[beta-D-galactopyranosyl(1----2)-alpha-L-
      rhamnopyranosyl-(1----3)-beta-D-xylopyranosyl-(1----4)-[beta-D- xylopyranosyl-(1-
      --3)]-alpha-L-rhamnopyranosyl-(1----2)-[beta-D-apio  -D- furanosyl-(1----3)]-beta
      D-6-deoxyglucopyranosyl-(1----)]-bayog  enin(5),3-O- [beta-D-glucopyranosyl-(1---
      3)-beta-D-glucopyranosyl]-28-O-[beta-D- galactopyranosyl-(1----2)-alpha-L
      rhamnopyranosyl-(1----3)-beta-D- xylopyranosyl-(1----4)-[beta-D-xylopyranosyl-(1-
      --3)]-alpha-L- rhamnopyranosyl-(1----2)-[beta-D-apio-D-furanosyl-(1----3)]-
      arabinopyranosyl-(1----)]bayogenin(6),3-O-[beta-D-glucopy ran osyl-(1----3)- beta
      D-glucopyranosyl]-28-O-[beta-D-galactopyranosyl-(1----2)- alpha-L-rhamnopyranosyl
      (1----3)-beta-D-xylopyranosyl-(1----4)-[beta-D- xylopyranosyl-(1----3)]-alpha-L
      rhamnopyranosyl-(1----2)-[alpha-L- rhamnopyranosyl-(1----3)]-beta-D-6
      deoxyglucopyranosyl-(1----)]-++ +bayogenin (7), and 3-O-[beta-D-glucopyranosyl-(1
      ---3)-beta-D-glucopyranosyl]-28-[O- beta-D-galactopyranosyl-(1----2)-alpha-L
      rhamnopyranosyl-(1----3)-beta-D - xylopyranosyl-(1----4)-[beta-D-xylopyranosyl-(1
      ---3)]-alpha-L- rhamnopyranosyl-(1----2)-[alpha-L-rhamnopyranosyl-(1---
      3)]arabinopyr  anosyl - (1----)[-bayogenin (8).

PMID- 1620750
TI  - Two new saponins from the roots of Phytolacca esculenta.
AB  - Two triterpenoidal saponins having phytolaccagenin as the aglycone were isolated
      from the roots of Phytolacca esculenta (Phytolaccaceae). The structures of two
      new saponins, esculentoside I and esculentoside N, were established to be 3-O
      [beta-D-glucopyranosyl-(1----4)-beta-D- glucopyranosyl]-28-O-beta-D
      glucopyranosyl-phytolaccagenin and 3-O-[beta-D-glucopyranosyl(1----4)-beta-D
      xylopyranosyl(1----4)-beta-D- glucopyranosyl]-28-O-beta-D
      glucopyranosylphytolaccagenin, respectively, on the basis of spectroscopic and
      chemical evidence.

PMID- 1620752
TI  - A modified Regressive Coping Checklist: some Australian data.
AB  - The Regressive Coping Checklist has been used to measure the extent to which
      individuals cope with stress by denying, minimizing, or avoiding stressful
      situations. In this study, the checklist was modified to include the frequency of
      use of regressive coping strategies and was shown to be a moderately reliable
      instrument (alpha = .57) when used with a sample of 750 Australian postprimary
      teachers.

PMID- 1620751
TI  - A diagnostic analysis of the Casebooks of Ticehurst House Asylum, 1845-1890.
AB  - Ticehurst House, a private asylum, flourished during the nineteenth century as
      the most expensive of such establishments, being owned and run by the Drs
      Newington over five successive generations. The discovery of the full set of
      patient casebooks begun in 1845-6 made it possible to review in detail the
      clinical features of a complete cohort of patients admitted to the asylum between
      1845 and 1890. Six-hundred-and-one patients were thus analysed in terms of their
      age, sex, length of stay, symptoms, treatment and outcome. Modern operational
      diagnoses were used, and 80% of the cohort were found to conform to Research
      Diagnostic Criteria, in particular to the categories for schizophrenia and manic
      depressive disorder. An additional finding was the high prevalence of movement
      and postural disorder among the schizophrenic group, as well as a significant
      trend towards the selection of a treatable, good-outcome group of patients with
      manic-depressive illness. These results are discussed by comparison with other
      modern studies of the asylum period, and in the contemporary context of Victorian
      psychological medicine. It is suggested that the violence, physicality and
      chronicity of psychotic illness must be seen as central to the debate about the
      rise of the asylum in nineteenth-century Britain. Furthermore, the similarity in
      core symptoms found in such patients and those seen in the 1980s indicates that
      the categories 'schizophrenia' and 'manic-depressive disorder' have a robust
      validity that is not confined to the social parameters of a particular time
      period.

PMID- 1620753
TI  - Testing Gibbs and Martin's theory of suicide.
AB  - Over 32 nations, status integration correlated more strongly with suicide rates
      than two other social variables. Over 30 states of the United States of America,
      status integration performed worse than the percent born out-of-state and better
      than the divorce rates.

PMID- 1620754
TI  - Psychological attributes of young adult smokers.
AB  - To study the psychological aspects of cigarette-smoking in community adults, we
      examined longitudinal data from a sample of young people (from age 15 to 23
      years). Questions on smoking behavior had been asked during the last five years
      of the study, and information on self-esteem, depressive affect, negative mood,
      hopelessness, psychological disturbance, locus of control, social alienation and
      health was also available. Current smokers in the last year of the study had
      differed from nonsmokers nine years previously by having more external locus of
      control and now were less likely to report their health as excellent. Most
      smokers also drank alcohol, but cigarette consumption did not differ for drinkers
      and nondrinkers. Contrary to expectations, current smokers showed no distinctive
      psychological attributes, and those who started or stopped smoking were similarly
      undistinctive in psychological terms. Results suggest that efforts to stress the
      self-destructive or antisocial nature of tobacco use have not been accepted by
      the smokers in this age group (M = 23.6 yr.).

PMID- 1620755
TI  - Personality profile of conference-going clergy in England.
AB  - The Eysenck Personality Questionnaire was completed by 40 male clergy attending a
      residential conference in England. The data suggest that conference-going clergy
      are more extraverted than clergy in general.

PMID- 1620756
TI  - Relationship between boredom proneness and impulsivity.
AB  - As part of a larger investigation, the relationship between boredom proneness and
      impulsiveness was investigated among 381 undergraduates. A significant positive
      correlation of .56 obtained between boredom proneness and impulsivity.
      Significant positive associations were also found between scores on boredom
      proneness and impulsiveness subscales.

PMID- 1620757
TI  - The Rotter I-E scale as a predictor of relapse in a population of compulsive
      gamblers.
AB  - Profile surveys, completed Rotter I-E scales, and questionnaires on past relapse
      behavior were collected from 108 New Jersey compulsive gamblers who attended
      Gamblers Anonymous, and an attempt was made, based on the findings, to predict
      incidence of compulsive gamblers' relapse. Relationships between I-E scores and
      extent of relapse-free periods, and I-E scores and relapse, with the variables of
      religious background, age, marital status, education, type of work, and childhood
      physical abuse were investigated. In every instance the relationship found was
      statistically non-significant.

PMID- 1620758
TI  - Changes in learning-style preferences: comments on Geiger and Pinto.
AB  - Geiger and Pinto reached unwarranted conclusions regarding changes in learning
      style preferences over a two-year period. Problems with the instrument and data
      analysis require a revision of their conclusions.

PMID- 1620759
TI  - Reply to Duryea.

PMID- 1620760
TI  - Influence of involuntary migration on children's perception of control.
AB  - The present study was done to explore the influence of involuntary migration on
      children's perception of control. Three groups of 50 black South African children
      each were randomly selected from three types of migrant populations. A control
      group of 50 nonmigrant children was also formed. To this sample a
      multidimensional measure of children's perception of control was administered.
      Analysis showed differences in perception of control by migrant and nonmigrant
      children as well as among the various groups of migrant children. Such variations
      were attributed to migration process and differences in educational and
      socioeconomic status.

PMID- 1620761
TI  - Development and application of a writing attitude survey for grades 1 to 3.
AB  - The purpose of these studies was to develop and use a writing attitude survey for
      students in Grades 1 to 3 modeled after the survey developed and used with
      students in Grades 4 to 8 in 1991. A 19-item survey was administered to 394
      children in Grades 1, 2, and 3. The instrument was then used in an experiment to
      assess the effect of instructional treatment, grade, and participation on 112
      students' attitudes toward writing. There were no significant main effects for
      treatment or for time of measurement. There were no significant interactions, but
      there was a significant main effect for grade. Follow-up of significant main
      effects using Tukey tests indicated that 52 third graders had significantly more
      positive attitudes toward writing than 60 fifth graders.

PMID- 1620762
TI  - Culture, environment: value judgments about cognitive development.
AB  - Cross-cultural studies have suggested cultural and environmental influences in
      cognitive development. Such differences have been described as value free and do
      not imply that one group is better than another. In this paper such a stance is
      challenged as unrealistic.

PMID- 1620763
TI  - Longitudinal survey of anxiety and depression in drug users and addicts.
AB  - As a follow-up to our 1990 study of anxiety and depression among drug users,
      after two years 44 men differed in their experience with drugs and from the first
      phase of the study five of the 20 controls became drug users, two of the 20 drug
      users became addicts, and one of the 20 drug abusers died from AIDS. These
      findings do not confirm the 1989 thesis of Newcomb and Bentler on the etiology of
      addiction, that depression and anxiety imply greater drug use. Positive
      correlations were found for drug use with anxiety and depression. Such data
      confirm those found by De Moja in 1990.

PMID- 1620765
TI  - Hispanic-American MMPI research (1949-1992): a comprehensive bibliography.
AB  - The purpose of this article is twofold. The first is to outline key events in the
      history of Hispanic MMPI research. Since 1949, researchers have documented the
      MMPI performance of Hispanic-Americans in a variety of clinical and nonclinical
      settings. The second purpose is to present a comprehensive bibliography of
      Hispanic MMPI research by research setting. A total of 86 studies are listed in
      this bibliography.

PMID- 1620764
TI  - Correlations between scores on a continuous performance test and parents' ratings
      of attention problems and impulsivity in children.
AB  - This is a study of the relationship between a continuous performance test and
      parents' behavioral ratings of attention problems and impulsivity in 45 boys who
      had been referred to a clinic for learning and behavioral problems. No
      significant correlations obtained between these two methods of assessment.
      Perhaps the lack of congruence is due to the multidimensional nature of both
      attention problems and impulsivity. Suggestions for clinical practice and further
      research are discussed.

PMID- 1620766
TI  - Humor in counseling and psychotherapy: a 20-year retrospective.
AB  - This article briefly annotates the development of research and theorizing on the
      use of humor in psychotherapy. Beginning in 1970 and continuing through 1990, the
      main literature was cursorily scanned. A total of 67 sources are offered for
      bibliographic use. Sadly, tangential forms of humor such as fun, mirth,
      frivolity, songs, jokes, puns, witticisms, and other forms of humor are not as
      readily addressed or investigated.

PMID- 1620767
TI  - Personality factors in Psy.D. students: empirically derived comparisons between
      men and women.
AB  - A total of 180 students in a Doctor of Psychology program of an APA-accredited
      Professional School of Psychology (55 men and 125 women) took the MMPI for course
      requirements. A larger subgroup (43 men and 88 women) also completed the
      Adjective Check List. Men scored higher than women on the MMPI dimensions of
      Assertion (Pd), Organization (Pt), and Imagination (Sc). Women scored higher on
      the Ego Strength Scale (Es). Men scored higher on the Check List scale of
      Dominance. Data were compared with a previous report of MMPIs of Ph.D. students,
      and few differences were observed. Findings were discussed in terms of
      stereotypical role behaviors from which doctoral students are not yet immune.

PMID- 1620768
TI  - Sources of bias in perception of HIV risk by injecting drug-users.
AB  - The role of bias in assessments of personal susceptibility to threat is a central
      concept in research on perception of risk. The current study aimed to clarify the
      association between perceived personal susceptibility to infection with HIV/AIDS
      and injecting risk behaviour with injecting drug-users' perception of the
      baseline rate of infection with HIV/AIDS. 1262 injecting drug-users from
      Australian cities were interviewed. The injecting drug-users were divided into
      high- and low-risk groups depending on the HIV/AIDS risk associated with their
      injecting behaviour. Subjects were subdivided into low-, medium-, and high
      perceived personal susceptibility groups. Analysis indicated that injecting drug
      users in the high-risk group underestimated the prevalence of HIV/AIDS infection
      relative to those in the low-risk group and that perceived personal
      susceptibility was rationally related to estimates of the baseline rate of
      infection.

PMID- 1620769
TI  - Investigating the relationship between the Millon Adolescent Personality
      Inventory and the Personality Inventory for Children with a sample of learning
      disabled adolescents.
AB  - The present study involved a preliminary evaluation of the correlations between
      subscales on the Personality Inventory for Children and the Millon Adolescent
      Personality Inventory with 25 learning disabled adolescents. Analysis yielded a
      number of significant correlations between these two scales, using the
      Personality Inventory for Children as the anchor scale, and showed that these
      adolescents as a group scored within clinically acceptable ranges on both
      diagnostic scales. Both scales need further psychometric and clinical
      investigation, and as such, the limitations of the study and the research needed
      are addressed, including the need for more multitrait, multimethod studies.

PMID- 1620770
TI  - Correlation between rates of rape and abortion.
AB  - To test the argument made by abortion advocates that increases in unwanted
      pregnancies that are due to rape justify the need for legal abortions, a Pearson
      correlation was calculated between the forcible rape rates and the legal abortion
      rates in the USA for 1985. The calculation gave an r of .21, a nonsignificant
      value.

PMID- 1620771
TI  - When is couples therapy necessary and sufficient?
AB  - Couples therapy is not a unified form of treatment but draws on a heterogeneous
      range of influencing processes. When distressed couples are relatively stable and
      interested in effecting a harmonious modus vivendi, didactic training will
      usually achieve salubrious outcomes. When individual agendas, hidden or
      otherwise, undermine the relationship, individual therapy is often essential
      before the couple can benefit from conjoint therapy. Those who insist on working
      only within dyadic, triadic, or family contexts may fail to achieve desirable
      goals.

PMID- 1620772
TI  - Prediction of endocrine stress reactions by means of personality variables.
AB  - The study examined the predictability of endocrine stress indicators on the basis
      of personality measures. The subjects were 83 computer operators (63 men, 20
      women; mean age 28 years) who by means of an experimental situation were
      confronted with a mild stressor (a cognitive two-channel task with a high
      information load). Using scores on personality questionnaires (comprising scales
      for defense mechanisms, neuroticism, and 2 achievement motivation variables),
      subjects were classified into extreme groups of stress-resistant (17 subjects)
      versus nonstress-resistant (13 subjects). Immediately after the experiment blood
      samples were taken to assay the norepinephrine metabolites plasma-free 3-methoxy
      4-hydroxy-phenylglycol (MHPG) and MHPG sulfate (MHPG.SO4), which formed the
      dependent variables. Personality measures and endocrine stress indicators were
      until the final analysis of the data kept apart by a double-blind strategy. A
      significant difference was noted in the MHPG level between the stress-resistant
      and the nonstress-resistant group. The value and applicability of these results
      for stress prevention is discussed.

PMID- 1620773
TI  - Prescribing therapy for depression: the role of learned resourcefulness, a
      failure to replicate.
AB  - Work in 1985 by Simons, Lustman, Wetzel, and Murphy showed that a patient's score
      on Rosenbaum's self-control scale predicted differential response to treatments
      for depression, with a high score predicting a good outcome with talking therapy
      and a low score a good outcome with drug therapy. This study of 37 patients did
      not replicate those findings. Using the same paradigm, we predicted response
      correctly 7 times and incorrectly 16 times, a clear failure. A valid method for
      choosing the best treatment for a patient with major depression remains to be
      found.

PMID- 1620774
TI  - Neurolinguistic programming training, trait anxiety, and locus of control.
AB  - Training in the neurolinguistic programming techniques of shifting perceptual
      position, visual-kinesthetic dissociation, timelines, and change-history, all
      based on experiential cognitive processing of remembered events, leads to an
      increased awareness of behavioral contingencies and a more sensitive recognition
      of environmental cues which could serve to lower trait anxiety and increase the
      sense of internal control. This study reports on within-person and between-group
      changes in trait anxiety and locus of control as measured on the Spielberger
      State-Trait Anxiety Inventory and Wallston, Wallston, and DeVallis' Multiple
      Health Locus of Control immediately following a 21-day residential training in
      neurolinguistic programming. Significant with-in-person decreases in trait
      anxiety scores and increases in internal locus of control scores were observed as
      predicted. Chance and powerful other locus of control scores were unchanged.
      Significant differences were noted on trait anxiety and locus of control scores
      between European and U.S. participants, although change scores were similar for
      the two groups. These findings are consistent with the hypothesis that this
      training may lower trait-anxiety scores and increase internal locus of control
      scores. A matched control group was not available, and follow-up was
      unfortunately not possible.

PMID- 1620775
TI  - Another look at the aptitude-achievement distinction.
AB  - 48 high school students were administered the Arithmetic subtest of the Wechsler
      Adult Intelligence Scale--Revised, the Mathematics subtest of the Peabody
      Individual Achievement Test--Revised, and the Stanford Diagnostic Mathematics
      Test. Correlations, of about .80 among the three tests, were interpreted as
      supporting a part of the continuum theory of Humphreys, Anastasi, and Cronbach
      for conceptualizing the distinction between aptitude and achievement tests.

PMID- 1620776
TI  - Personality disorder concept scales and 16 PF dimensions.
AB  - Using 148 clients from a private practice sample, concurrent scores on the Morey,
      Waugh, and Blashfield Minnesota Multiphasic Personality Inventory Scales and the
      Sixteen Personality Factor Questionnaire were factor analyzed in an attempt to
      map the Axis II disorders within a circumplex of interpersonal behavior.
      Individual predictions about the 16 PF primaries were made and then equations
      were developed to predict the Morey, Waugh, Blashfield MMPI scales from the 16 PF
      scores. Using a separate sample of 43 clients and 21 students, a cross-validation
      of concepts was performed by using the 16 PF to generate the MMPI scores and
      correlating the predicted scores with concurrent Millon Clinical Multiaxial
      Inventory scores. Concordance of the personality disorder characterizations
      across the instruments was high. Many of the predicted personality disorder
      characteristics were supported by the research, and 10 of 11 correlations with
      the Millon were significant. This research suggests the 16 PF is useful for
      generating hypotheses about personality disorders and that the Axis II
      conceptualizations fit as expected within normal personality space.

PMID- 1620777
TI  - Relationships among hope, psychosocial development, and locus of control.
AB  - 29 male and 79 female undergraduate and graduate students took the 1986 Miller
      Hope Scale, Beck's 1988 Hopelessness Scale, Erikson's Psychosocial Stage
      Inventory, Levenson's 1972 Locus of Control Scale and rated their present state
      of hopefulness on a 10-point scale. As expected, scores on both the Miller Hope
      Scale and the self-rated hope scale were negatively correlated with scores on
      Beck's Hopelessness Scale, but positively with scores on Erikson's Psychosocial
      Stage Inventory. Thus, greater hopelessness was associated with more successful
      resolution of psychosocial issues. The Miller Hope Scale was negatively and
      Beck's Hopelessness Scale was positively associated on the Locus of Control Scale
      with viewing control as from powerful others or chance. Therefore, lack of
      hopefulness was related with the perception that external factors control one's
      life. The Miller Hope Scale and scores on self-rated hopefulness were not
      significantly correlated. The concept of hope is more complex than currently
      measured by any single scale and requires further refinement.

PMID- 1620778
TI  - Academic and nonacademic self-concepts: influence of recent life-change
      experiences and demographic, social, and health variables.
AB  - For 150 undergraduate students (50 men, 100 women) the influences of demographic,
      social, health, and recent life-change experiences were examined on four facets
      of academic self-concept and nine facets of nonacademic self-concept. Multiple
      regression analyses showed that, in general, past academic performance, family
      structure, and family satisfaction were important predictors of academic self
      concept. Family structure, family satisfaction, social satisfaction, mental
      stress associated with recent life-change experiences, and health factors in
      general were important predictors of nonacademic self-concept. Recent life-change
      experiences and mental health were significantly associated, more prominently
      among subjects who were low on emotional self-concept than those who scored high.

PMID- 1620779
TI  - Subtest scatter is not an indicator of inaccuracy for short-form estimates of IQ.
AB  - The range of scaled scores does not provide information about the inaccuracy of
      estimates of IQ based on short forms of the test. Subtest scatter on a short form
      of an intelligence test may justify the complete administration for elaborative
      or clinical reasons. The criteria for reliable and abnormal ranges of scores for
      estimates based on short forms are calculable and should be examined to evaluate
      their usefulness.

PMID- 1620780
TI  - Geophysical variables and behavior: LXX. Testing electromagnetic explanations for
      a possible psychokinetic effect of therapeutic touch on germinating corn seed.
AB  - Designs used to test claims for psychic healing of living systems not amenable to
      suggestion may produce artifact in the results when there is failure to control
      for other possible explanations. Some experimental methods in psychokinesis may
      produce electromagnetic field flux which could lead to erroneous conclusions.
      This study adds electrical and magnetic controls to assess their effect, leading
      to the conclusion that therapeutically touched corn seeds did not recover from
      saline injury significantly better than untreated controls.

PMID- 1620781
TI  - Conditional stimulus control of childrens' sequence production.
AB  - Normally capable children were first taught to touch in sequence each of a set of
      five physically dissimilar stimuli (Sequence A). Another set of stimuli was then
      used to train sequence B. Next, direct training established conditional control
      of the production of the A sequence and its reversal: in the presence of one
      printed word, touching the stimuli in the order A1----A2----A3----A4----A5 was
      reinforced; in the presence of another word, touching the stimuli in the order A5
      ---A4----A3----A2----A1 was reinforced. During probe sessions, the printed words
      also exercised conditional control over production of the B sequence and its
      reversal for five of six subjects, suggesting the formation of stimulus classes.
      Four of these five subjects also performed mixed sequences under conditional
      control of the words (e.g., A1----B2----A3----B4----A5 and its reversal),
      verifying that the stimuli which occupied the same position in each sequence were
      members of the same class.

PMID- 1620782
TI  - Prevalence of undetected alcohol dependence in the mental health diagnostic
      interview.
AB  - The prevalence of undetected alcohol dependence was examined utilizing the
      Michigan Alcohol Screening Test for 118 (68 women) users of community mental
      health services as part of a Quality Assurance Review. Clinicians did not
      uniformly request information about substance abuse in the diagnostic interview
      and did not uniformly address alcohol abuse in the treatment plan when alcohol
      dependence was diagnosed. Other programs may have similar problems.

PMID- 1620783
TI  - Beyond FIRO-B--three new theory-derived measures--Element B: behavior, Element F:
      feelings, Element S: self.
AB  - Although the FIRO-B instrument has been used widely for a large number of
      purposes, it was not designed as a general purpose instrument. Several years ago,
      after revising the FIRO theory underlying the instrument based on over 20 years'
      experience with the instrument and related activities, the author revised the
      FIRO-B extensively, so extensively it was given a new name, Element B. The new
      instrument is much stronger both theoretically and psychometrically while at the
      same time retaining the simplicity and shortness of the original. In addition,
      two new instruments based on the same theory were designed, developed, and
      tested. They measure feelings (Element F) and self-concept (Element S). All three
      instruments have, over the past 10 years, been used primarily as training
      instruments. When given in conjunction with other methods, they have been used
      for improving self-awareness, teamwork, morale, and productivity in such
      organizations as Procter & Gamble, AT&T, NASA, Amdahl Corporation, the Swedish
      Army, and about 100 companies in Japan. Included is a comment on scales anchored
      both logically, using methods such as facet design and unidimensional scaling,
      and empirically, such as the "big five."

PMID- 1620784
TI  - An exploratory study of funeral cost for suicides.
AB  - Funeral cost was less for younger people and for cremation. Among 156 funerals
      examined, after matching for sex, age, and cremation/burial, the funerals of a
      small sample of 6 suicides cost less than those of the controls.

PMID- 1620785
TI  - Identifying Hispanic gifted children using the Screening Assessment for Gifted
      Elementary Students.
AB  - We examined the utility of the Screening Assessment for Gifted Elementary
      Students (SAGES) for identifying Hispanic gifted students among 162 third through
      fifth graders, of whom 75% were Anglo-American and 25% Hispanic. Direct
      discriminant analysis of subscale scores of the SAGES classified 93.2% of the
      sample as Anglo-American, including 35 of the 41 Hispanic children. This
      indicated that the subscale scores did not predict group membership. A validation
      procedure yielded similar results on an independent sample of 25 Anglo-American
      and 14 Hispanic children. Also, a multivariate profile analysis indicated small
      score differences between the two groups and reflected similar cognitive
      processes being assessed. The screening device appears to function fairly within
      both ethnic groups.

PMID- 1620786
TI  - Relationship of the MacAndrew Scale to sensation seeking.
AB  - Findings of Baker, Beer, and Beer on use of the MacAndrew Scale in relating
      sensation seeking to alcoholism require comment. It is argued that the MacAndrew
      Scale does not provide interval level data below the cut-off score so
      correlations on such data should be point biserial.

PMID- 1620787
TI  - Informational feedback and self-esteem among male and female athletes.
AB  - The self-esteem of male and female competitive athletes was compared after each
      was provided either positive or negative (verbal) informational feedback on a
      nonathletic task, a series of single-solution anagrams. Subjects were 50 men and
      50 women, aged 18 to 25 years, who were tested on the semantic differential to
      estimate athletes' self-esteem before and after receiving the informational
      feedback. Over-all, female athletes responded more strongly to both feedback
      conditions, with both groups being more influenced by negative rather than by
      positive feedback.

PMID- 1620788
TI  - Comment on Witherspoon, Long, and Nickell's study of speaking anxiety, self
      esteem, crime, and educational achievement.
AB  - Witherspoon, Long, and Nickell (1991) did not convincingly demonstrate that
      anxiety about speaking was related to dropping out of school or to the types of
      crimes that inmates commit. These authors did not control for variables related
      to these behaviors, and they did not compare the anxiety levels of the most
      appropriate groups of persons.

PMID- 1620789
TI  - Personality and scientific promise.
AB  - This study examined personality characteristics of 21 boys and 11 girls, children
      gifted in science and attending a junior high school. Differences between these
      boys and girls in Grade 6 were noted. Implications for teaching and directions
      for future research are noted.

PMID- 1620790
TI  - Infantile stimulation produces mild enhancement in a primary humoral response of
      adult albino rats.
AB  - Rat pups from 12 litters were handled daily, once every three days, or never
      touched between postnatal Days 5 and 20. At 100 days of age, 20 days after
      inoculation with human serum albumin, trunk blood was obtained to measure the
      antigen binding capacity (ABC). Rats handled as infants displayed relative
      immunofacilitation compared to those that had not been handled; the effect
      explained 7% of the variance in ABC values. In comparison, sex differences
      explained 14% of the variance. The results support the hypothesis that early
      disruptions in mother-infant bonding increase the likelihood of developing
      allergic responses following exposure to novel antigens during adulthood.

PMID- 1620791
TI  - The malevolent personality disorder?
AB  - The identification of any new psychopathology or syndrome has been based on
      numerous clinical enquiries and theoretical discussions and has assumed an
      important place in the literature of psychology and psychiatry. Using two case
      descriptions and the subject described in a recent book, this report presents a
      theoretical discussion of an unusual personality organization, referred to as the
      malevolent personality disorder. Differential diagnosis, theorizing about
      pathogenesis, clarification of salient psychodynamics, and treatment
      considerations are explored.

PMID- 1620792
TI  - Shyness, egocentricity, and psychopathology: their relationships among
      nonhospitalized individuals and mental hospital patients.
AB  - To investigate the relationship between shyness and egocentricity in both
      psychiatric (hospitalized) and nonhospitalized groups, 162 adult men and women
      diagnosed as paranoid or undifferentiated schizophrenic, and a control group of
      162 nonhospitalized individuals matched for age and gender were studied. Shyness
      was assessed on the Social Reticence Scale and egocentricity by the Self-focus
      Sentence Completion. Analysis indicated that the patients were more shy than
      nonhospitalized individuals. Paranoid schizophrenics were not different from
      undifferentiated schizophrenics on egocentricity and the Self-focus Sentence
      Completion subscales. Nonhospitalized individuals and the mental hospital
      patients were egocentric on the Self-focus Sentence Completion. For this reason,
      relationships among shyness, egocentricity, and psychopathology could not be
      demonstrated.

PMID- 1620793
TI  - The generation effect in primed word-fragment completion reexamined.
AB  - Two experiments were designed to test a claim made by Gardiner (1988) that there
      are generation effects in implicit memory as measured by word-fragment
      completion. Subjects either read words at study or generated the words from
      fragments. As in previous research, fragments were completed to a greater extent
      if they were identical at study and test than if they differed. In Experiment 1
      it was found that subjects could recognize explicitly the exact form of fragments
      that had been used for self-generation and distinguish these from other forms of
      fragments. An analysis of the contingency relations between recognition of
      fragments and fragment completion showed a high degree of dependence between the
      two tests. In Experiment 2 it was found that the match of surface features
      between study and test was a necessary, but not sufficient, condition to produce
      enhancement of priming. The results are interpreted as supporting the claim that
      generation does involve a data-driven component in addition to semantic
      elaboration.

PMID- 1620794
TI  - Memory monitoring and memory performance: linked closely or loosely?
AB  - An experimental test of the metamemory hypothesis claiming a substantive positive
      relationship between memory monitoring and memory performance is provided. Forty
      eight university students learned a set of abstract nouns. They were either
      instructed to make use of monitoring activities (experimental group), simply to
      learn the words (control-1) or to use non-metacognitive learning strategies
      (control-2). Prior to recall, the subjects had to predict the number of items
      they expected to remember. The experimental predictions were derived on two
      levels. First, prediction accuracy should be best for the experimental group.
      This is a necessary prerequisite for a valid test of the second prediction,
      namely that memory performance, too, should be best for the experimental group.
      Whereas the first prediction was confirmed, the second, vital for the metamemory
      hypothesis, was not. Thus, this hypothesis did not stand up to an experimental
      test, but would have been confirmed if tested by the correlation between
      prediction accuracy and memory performance.

PMID- 1620795
TI  - Productive and perceptual constraints on speech-error correction.
AB  - Two incentives underlie the present study on speech-error detection and
      correction. First, this area of research has up to now almost completely been
      approached through experimental techniques. Since it is not all clear whether
      speakers' detection and correction behaviour is identical inside and outside the
      laboratory, a comparison is made between experimental and naturalistic data.
      While the experimental materials are taken from the literature, the naturalistic
      findings are based upon the analysis of a corpus of more than 6,000 German slips
      of the tongue. It is shown that the same trends emerge in both data sets, thereby
      confirming the ecological validity of the experimental, and the reliability of
      the naturalistic, results. Secondly, the question arises as to the reasons for
      error correction and its occasional failure. Two working hypotheses are explored.
      Speakers fail to correct their errors because they have not detected them or
      because they assume that the error does not interfere with the listener's
      decoding process. The former reason is understood as a productive, the latter as
      a perceptual, constraint on the correction of self-produced errors. The empirical
      analysis discloses a large overlap between the effects of perceptual and
      productive constraints. However, whereas perceptual constraints can be subsumed
      under productive ones, the reverse is not possible. On the basis of this outcome
      it is argued that productive constraints are primary, and perceptual constraints
      secondary, reference points for error correction. Although the empirical data do
      not require the postulation of perceptual constraints, it is suggested that both
      speaker- and listener-based aspects form part of a highly integrated processing
      system.

PMID- 1620796
TI  - The effect of one night without sleep on problem-solving and immediate recall.
AB  - The aim of the study was to investigate the effect of spending one night without
      sleep on the performance of complex cognitive tasks, such as problem-solving, in
      comparison with a purely short-term memory task. One type of task investigated
      was immediate free recall, assumed to reflect the holding capacity of the working
      memory. The other type of task investigated was represented by syntactical
      reasoning and problem-solving tasks, assumed to reflect the processing (the
      mental transformation of input) and monitoring capacity of the working memory.
      Two experiments with a repeated-measures design were performed. Experiment 1
      showed a significant decline in performance as a function of sleep loss on
      Raven's progressive matrices, a problem-solving task. No other main effect of
      sleep loss was found. Experiment 2 had a different order between tasks than
      Experiment 1 and the time without sleep was increased. A number-series induction
      task was also used in Experiment 2. A significant, negative effect of sleep loss
      in performance on Raven's progressive matrices was found in Experiment 2. The
      effects of sleep loss on the other tasks were nonsignificant. It is suggested
      that Raven's progressive-matrices task reflects the ability to monitor encoding
      operations (selective attention) and to monitor mental "computations".

PMID- 1620797
TI  - The right-hemisphere bias in conditional reasoning: a short report on multiple
      failures to replicate previous findings.
AB  - The present set of studies attempted to replicate Gellatly's (1985) findings that
      were supportive of Evan's (1982) hypothesis that the right hemisphere produces a
      selective bias towards the incorrect solution of a complex reasoning task.
      Subjects solved problems of the form "if p then q." In four studies, participants
      simultaneously performed a bottle--balancing task on each hand to interfere with
      processing of the reasoning task in the right hemisphere. In the fifth study, the
      bottle--balancing task was replaced by a finger--sequencing task. The results of
      the five studies did not show that the interference with right-hemisphere
      activity resulted in better performance on the conditional-reasoning task. It is
      concluded that the hypothesis of a right-hemisphere bias in conditional reasoning
      is still in need of reliable findings.

PMID- 1620798
TI  - Asymmetry of perceived key movement in chorale sequences: converging evidence
      from a probe-tone analysis.
AB  - In a probe-tone experiment, two groups of listeners--one trained, the other
      untrained, in traditional music theory--rated the goodness of fit of each of the
      12 notes of the chromatic scale to four-voice harmonic sequences. Sequences were
      12 simplified excerpts from Bach chorales, 4 nonmodulating, and 8 modulating.
      Modulations occurred either one or two steps in either the clockwise or the
      counterclockwise direction on the cycle of fifths. A consistent pattern of probe
      tone ratings was obtained for each sequence, with no significant differences
      between listener groups. Two methods of analysis (Fourier analysis and regression
      analysis) revealed a directional asymmetry in the perceived key movement conveyed
      by modulating sequences. For a given modulation distance, modulations in the
      counterclockwise direction effected a clearer shift in tonal organization toward
      the final key than did clockwise modulations. The nature of the directional
      asymmetry was consistent with results reported for identification and rating of
      key change in the sequences (Thompson & Cuddy, 1989a). Further, according to the
      multiple-regression analysis, probe-tone ratings did not merely reflect the
      distribution of tones in the sequence. Rather, ratings were sensitive to the
      temporal structure of the tonal organization in the sequence.

PMID- 1620799
TI  - A perceptual investigation of polytonality.
AB  - Four experiments investigated the perception of tonal structure in polytonal
      music. The experiments used musical excerpts in which the upper stave of the
      music suggested a different key than the lower stave. In Experiment 1, listeners
      rated the goodness of fit of probe tones following an excerpt from Dubois's
      Circus. Results suggested that listeners were sensitive to two keys, and weighted
      them according to their perceived importance within the excerpt. Experiment 2
      confirmed that music within each stave reliably conveyed key structure on its
      own. In Experiment 3, listeners rated probe tones following an excerpt from
      Milhaud's Sonata No. 1 for Piano, in which different keys were conveyed in widely
      separate pitch registers. Ratings were collected across three octaves. Listeners
      did not associate each key with a specific register. Rather, ratings for all
      three octave registers reflected only the key associated with the upper stave.
      Experiment 4 confirmed that the music within each stave reliably conveyed key
      structure on its own. It is suggested that when one key predominates in a
      polytonal context, other keys may not contribute to the overall perceived tonal
      structure. The influence of long-term knowledge and immediate context on the
      perception of tonal structure in polytonal music is discussed.

PMID- 1620800
TI  - The effect of a non-informative cueing signal in a three-choice reaction-time
      task.
AB  - Many studies have shown that in a simple reaction-time (RT) task a non
      informative leading cue decreases RT to a subsequent target presented in the same
      region as the cue. This facilitation lasts about 150 ms; it is then replaced by a
      sustained inhibition. Experiment 1 tests the hypothesis that the initial
      facilitation is due to motor, rather than perceptual, processes by using choice
      RT. Facilitation is greater and lasts longer in choice than in simple tasks, thus
      supporting the hypothesis. Experiment 2 shows that facilitation occurs even when
      the subject actively orients his or her attention away from the cue.

PMID- 1620801
TI  - Subitizing: magical numbers or mere superstition?
AB  - It is widely believed that humans are endowed with a specialized numerical
      process, called subitizing, which enables them to apprehend rapidly and
      accurately the numerosity of small sets of objects. A major part of the evidence
      for this process is a purported discontinuity in the mean response time (RT)
      versus numerosity curves at about 4 elements, when subjects enumerate up to 7 or
      more elements in a visual display. In this article, RT data collected in a
      speeded enumeration experiment are subjected to a variety of statistical
      analyses, including several tests on the RT distributions. None of these tests
      reveals a significant discontinuity as numerosity increases. The data do suggest
      a strong stochastic dominance in RT by display numerosity, indicating that the
      mental effort required to enumerate does increase with each additional element in
      the display, both within and beyond the putative subitizing range.

PMID- 1620802
TI  - Reading isolated words: no evidence for automatic incorporation of the phonetic
      code.
AB  - Backward masking with a homophonic mask induces better target recognition than
      backward masking with a graphemic mask that shares the same letters with the
      target as the homophonic mask. From this, the existence of automatic prelexical
      phonological recoding in silent word reading has been inferred. The present
      experiments, however, show that the advantage of homophonic masks in a backward
      masking task only arises if a considerable proportion of the masks are
      phonologically related to the targets (at least for Dutch). The results are in
      line with findings of lexical-decision tasks and number-processing tasks, and
      constitute a further argument for the dominance of the orthographic route over
      the phonological route in processing isolated written words.

PMID- 1620803
TI  - In-hospital injuries of medical and surgical patients: the predictive effect of a
      prior injury.
AB  - Four hundred three consecutive injury victims admitted via emergency ward over a
      3-month period were tracked with 403 contemporaneous controls with medical
      illness and blindly assessed for in-hospital accidents. There was a high
      frequency of "incidents" (n = 161 in 107 patients, mainly falls and medication
      errors), but injury victim admissions resembled medically ill controls when
      compared by the Kaplan-Meier method for cumulative probability of occurrence of
      an in-hospital incident. Accelerated failure/time models using the Weibull method
      to compute average times from admission to incident showed little difference
      between groups. Admission type (injury victim vs. control) did not predict
      psychiatric consultation, incident type, or multiple incidents in hospital.
      Although the injury group had a larger proportion of males and lower mean age,
      stratification to control for age and sex did not significantly discriminate
      injury victims from controls in production of incidents: Over all risk of
      incidents was random. By studying patients during a hospital stay, the effects of
      differences in individual environment and drug and alcohol intoxication are
      largely factored out; under these conditions the predictive effect of a prior
      injury becomes insignificant. In-hospital injury is associated with host factors
      long known to promote falls: increasing age, debility-cum-mobility, and central
      nervous system depressant medication.

PMID- 1620804
TI  - Anxiety and endocrine responses to surgery: paradoxical effects of preoperative
      relaxation training.
AB  - It has been argued that surgery is a form of psychological stress, and that the
      response to it should therefore be modifiable by psychological means. To test
      this hypothesis, we assessed the effect of preoperative relaxation instructions
      on endocrine, cardiovascular, and subjective responses in 21 patients undergoing
      minor abdominal surgery. Controls (N = 19) received general procedural
      information. In the relaxation group only, there was a significant increase in
      cortisol and adrenaline concentration from immediately before induction of
      anesthesia to immediately after surgery. Noradrenaline values were unaffected by
      relaxation. In contrast, relaxation reduced state-anxiety on the preoperative day
      and the two postoperative days; maximal peroperative systolic and diastolic blood
      pressures were also reduced. The results are consistent with previous evidence
      that adrenaline and cortisol responses to surgery are greater in less anxious
      patients.

PMID- 1620805
TI  - Lactate infusion induces panic attacks in patients with premenstrual syndrome.
AB  - A sodium lactate test was performed during the premenstrual phase in 35 women
      suffering from prospectively confirmed premenstrual syndrome (PMS) and in 16
      controls in order to assess whether these patients were sensitive to this test
      and whether this sensitivity was accounted for primarily by the presence of
      concomitant panic disorder. Patients with PMS also underwent the Structured
      Clinical Interview for the DSM-III-R (SCID) to determine the presence of co
      morbid anxiety and/or mood disorders. Only 31% of the PMS patients were free from
      a depressive/anxiety disorder, while nine patients met criteria for panic
      disorder, and the remaining 15 subjects were diagnosed as having anxiety and/or
      mood disorders. Lactate infusion induced panic attacks in 22 subjects (62.9%) and
      two controls (12.5%). Panickers were equally distributed among PMS patients with
      or without a concurrent anxiety/mood disorder. Although cardiovascular responses
      to lactate were similar among PMS patients regardless of the presence of
      concomitant anxiety/mood disorders, both plasma cortisol levels and panic and
      mood scores were higher during the test in those patients with concomitant panic
      disorder. These results suggest that PMS patients display an increased
      sensitivity to lactate, which is not primarily accounted for by the presence of
      co-morbid panic disorder.

PMID- 1620806
TI  - Gender, anger expression style, and opportunity for anger release determine
      cardiovascular reaction to and recovery from anger provocation.
AB  - This study represents an extension of Hokanson's research, which showed that for
      men anger release after provocation tends to accelerate cardiovascular recovery.
      The objective of this study was to investigate how gender and habitual style for
      anger-in or anger-out behavior modulate the effect of anger provocation and
      release. Male and female subjects (N = 105) were classified as anger-in/anger-out
      only when a double criterion (i.e., self-report and peer evaluation) was
      satisfied. Following a state anger rating at pre-test, subjects were harassed
      during the performance of a 12-minute math task. After task completion, subjects
      were randomly assigned to one of two 10-minute recovery protocols a) having an
      opportunity to release negative affect, and b) not not having such an
      opportunity. All groups (including the anger-ins) that had an opportunity to
      express negative affect did in fact express similar levels of anger. Men reacted
      more strongly to the math task performed under anger provocation on all
      cardiovascular indices. Anger expression style as a trait-type disposition was
      important for the recovery process in women whereas the situational manipulation
      (i.e., the opportunity to release anger) had specific effects on the recovery
      process of men. Opportunity to release anger facilitated heart rate recovery (and
      to a lesser degree diastolic pressure recovery) in men but not in women. Women
      with anger-in tendencies on the other hand displayed better systolic pressure
      recovery than female anger-outs whereas no such effects were observed in men.

PMID- 1620807
TI  - Dimensions of hostility in men, women, and boys: relationships to personality and
      cardiovascular responses to stress.
AB  - Ratings of Potential for Hostility and Hostile Style based on responses during
      the Type A Structured Interview (SI) are related to incidence of coronary heart
      disease morbidity and mortality. As there are very limited data on what precisely
      the SI ratings of hostility mean, the present study evaluated, in a sample of
      middle-aged men and women, and adolescent boys, a) the distributions of SI
      ratings of hostility according to gender and age group; b) their relationships to
      other hostility and personality scores; and c) their relationships to heightened
      cardiovascular responses to psychological stressors, which are thought to be a
      major mechanism linking behavior and coronary heart disease. Results showed that
      men are higher than women and boys in Potential for Hostility and Hostile Style
      ratings, which are, by and large, unrelated to standardized questionnaire
      measures of hostility and anger expression. Men (but not women or boys) who
      exhibited elevated systolic blood pressure during standardized laboratory
      stressors tended to be rated as high on Hostile Style. We conclude that SI
      Hostile Style ratings are measuring a unique aspect of personality, one with
      apparent importance for coronary heart disease and perhaps for men's
      cardiovascular responses during stress.

PMID- 1620808
TI  - Social support in social interaction: a moderator of cardiovascular reactivity.
AB  - This study examines the possibility that social support operates as a moderator
      of cardiovascular reactivity, which may be a factor in the development of heart
      disease and hypertension. An experiment was performed in which each of 40
      subjects was the object of verbal attack in a discussion of a controversial
      issue. In each session, one subject and three confederates participated. Two of
      the confederates argued with the subject; in half the groups, a third confederate
      defended the subject's position (social support condition); in the other half,
      the third confederate sat quietly (no support condition). The subject's blood
      pressure and heart rate were continuously monitored. Subjects in the social
      support condition showed significantly smaller increases in cardiovascular
      measures than subjects in the no support condition. The results are discussed in
      terms of small group dynamics and Social Comparison Theory.

PMID- 1620809
TI  - The relationship between job strain and blood pressure at work, at home, and
      during sleep.
AB  - Eleven normotensive workers in "high strain" jobs, defined by the combination of
      high psychological work load and low worker control, were compared with 26
      normotensive workers in "low strain" jobs on ambulatory blood pressure (BP) at
      work, at home in the evening, and during sleep. High strain workers' systolic BP
      was higher at work and at home in the evening, after adjusting for prework casual
      BP, body mass index, gender. Type A behavior, and caffeine consumption. Under
      certain conditions, systolic BP during sleep and diastolic BP at work were higher
      as well. Men and women, and Type A and Type B workers, were indistinguishable in
      job strain effects on BP. Type A workers tended to hold "active" (high demand,
      high control) jobs, and Type B workers "passive" jobs. More research is needed to
      distinguish more clearly job strain as 'cause' of observed BP effects from job
      strain as mere 'correlate.'

PMID- 1620810
TI  - Effects of coffee on cardiovascular responses to stress: a 14-week controlled
      trial.
AB  - We studied the cardiovascular responses to orthostatic and mental stress of 43
      healthy subjects who daily received six cups of boiled or filtered coffee and of
      21 healthy subjects who abstained from caffeine-containing beverages. All 64
      subjects first received six cups of filtered coffee/day for 2 weeks. Then blood
      pressure (BP) and heart rate (HR) were recorded before, during, and after a
      "stand upright" test and a mental arithmetic test. Subjects were then randomized
      to either complete abstinence from caffeine-containing beverages (n = 21), or
      consumption of six cups of filtered coffee (n = 21), or consumption of six cups
      of boiled coffee/day (n = 22). The stress tests were repeated after subjects had
      been on these regimens for 8 weeks. Abstinence from coffee did not affect the
      responses of BP or HR to orthostatic stress, or the response of BP to mental
      stress. The increase in HR caused by mental stress was five beats/min less (p =
      0.02) in the no-coffee group than in the filtered- (95% confidence interval -8.8
      to -1.2) or boiled- (95% confidence interval -8.4 to -0.8) coffee group. It is
      concluded that elimination of caffeine decreases the HR response to mental
      stress.

PMID- 1620811
TI  - Further analysis of the psychometric properties of the Levine Denial of Illness
      Scale.
AB  - This study contributes cross-validational data with regard to the Levine Denial
      of Illness Scale from a sample of 152 hospitalized myocardial infarction
      patients. A factor analysis and subsequent examination of the data yielded four
      usable factors of denial termed: Cognitive Denial of Illness, Denial of Impact on
      Future, Denial of Need for Care, and Affective Denial. In an analysis of subscale
      correlations, these four factor-based scales were related, but distinguishable,
      thus supporting the idea of the multidimensionality of denial. Furthermore, these
      factors were not related to demographic variables. Correlating these four scales
      with standardized measures of affect indicated that it can be useful in research
      to distinguish between several types of denial of illness in myocardial
      infarction patients.

PMID- 1620813
TI  - Epidemiology of Crohn's disease in Indian migrants and the indigenous population
      in Leicestershire.
AB  - A retrospective, epidemiological community study of Crohn's disease was performed
      in Leicestershire from 1972 to 1989. The county population of 930,000 includes
      93,000 South Asians. Potential cases were identified from hospital departments of
      pathology, endoscopy and medical records, in addition to general practitioners.
      There were 582 cases in Europeans and 28 in South Asians. The incidence of
      Crohn's disease in Europeans and South Asians has increased, particularly in
      Muslims. The standardized incidence in South Asians during the 1980s was
      2.4/10(5)/year in Hindus, 3.4/10(5)/year in Sikhs and 5.4/10(5)/year in Muslims.
      The standardized incidence in Europeans has risen significantly to 4.7/10(5)/year
      from 3.4/10(5)/year in the 1970s (chi 2 = 8.1, p less than 0.005). In Leicester
      this increase can be accounted for entirely by new cases of colonic disease. All
      ethnic groups had a similar disease distribution. Small bowel disease was
      inversely associated with age, whilst colonic disease increased with age.
      However, the difference in age-specific incidence of Crohn's disease for
      different age bands at various sites was not significant. Overall, Hindus have a
      much lower incidence of Crohn's disease than Europeans.

PMID- 1620812
TI  - Type II essential mixed cryoglobulinaemia: presentation, treatment and outcome in
      13 patients.
AB  - The long-term clinical course of patients with primary Type II essential mixed
      cryoglobulinaemia is unclear as many reports fail to separate this group from
      patients with Type III disease. We have reviewed 13 patients with Type II
      essential mixed cryoglobulinaemia who presented to the Hammersmith Hospital
      between 1976 and 1990. All patients had a cryoglobulin level greater than 0.1
      mg/ml (range 0.27-6.50 mg/ml), and characterization of the cryoglobulin in all
      cases revealed the presence of a monoclonal IgM kappa component with rheumatoid
      factor activity together with polyclonal IgG. All patients had evidence of
      activation of the classical pathway of complement with greatly reduced levels of
      C4, while C3 levels were moderately reduced in three patients. All patients had
      skin disease and joint symptoms were reported by nine patients, with erosive
      arthritis in one. Eight patients had peripheral sensorimotor neuropathy. Renal
      disease was observed in 10 patients, manifesting as raised creatinine level,
      proteinuria or haematuria. Renal tissue was examined in eight patients: in six
      the appearances were those of a mesangiocapillary glomerulonephritis Type I while
      in the other two patients there was a mesangioproliferative glomerulonephritis,
      in one diffuse and in the other focal and segmental. Glomerular capillary
      'hyaline thrombi' were found in six biopsies, extracapillary proliferation was
      found in three and evidence of vasculitis was found in all eight. Liver biopsy
      showed macronodular cirrhosis in one patient, while a second with recurrent
      episodes of jaundice showed only chronic inflammatory changes. No patient was
      positive for hepatitis B surface antigen; however one patient had low titre anti
      hepatitis B surface antibody. Normochromic normocytic anaemia was present in nine
      patients. Bone marrow examination was carried out in 13 patients at presentation
      to our unit: 10 showed no evidence of a lymphoproliferative disorder, while three
      suggested the presence of a non-Hodgkin's lymphoma (some years after original
      presentation in all three). Unusual clinical features included one patient with
      retinal vasculitis and one patient with severe pulmonary haemorrhage.

PMID- 1620814
TI  - Mortality in systemic sclerosis (scleroderma).
AB  - Two hundred and thirty-seven patients with systemic sclerosis were followed
      prospectively in a scleroderma clinic. The overall 3, 6, and 9-year survival
      rates were 86, 76 and 61 per cent respectively. Renal, cardiac and pulmonary
      disease, and older age at enrollment were adverse prognostic factors associated
      with reduced survival. There were no significant differences in survival between
      males and females or in patients with restricted compared to those with diffuse
      skin thickening. Death from systemic sclerosis was most frequently due to
      pulmonary hypertension, with fewer than expected deaths from renal or cardiac
      causes. Twenty-eight per cent of deaths were due to causes unrelated to systemic
      sclerosis, most commonly cancer and ischaemic heart disease, and in older
      patients.

PMID- 1620815
TI  - Risk stratification for dissemination of tuberculosis in HIV-infected patients.
AB  - The location of tuberculosis (TB) early in the course of HIV-induced
      immunosuppression was located, and an attempt was made to determine the
      correlation between the degree of immune suppression and prognostic variables to
      stratify the risk for dissemination of TB in HIV-infected patients. Clinical and
      laboratory characteristics were reviewed in 73 HIV-infected patients with TB
      admitted between 1984 and 1990. The presence of Mycobacterium tuberculosis was
      investigated in different clinical samples to verify the diagnostic yield of
      different sources. TB was extrapulmonary in 46.6 per cent of patients in whom it
      was their first opportunistic infection, and in 46.7 per cent of patients with
      previously diagnosed AIDS (p = NS). TB was frequently associated with other
      opportunistic infections, particularly oesophageal candidiasis (p = 0.006).
      Patients with localized extrapulmonary or disseminated TB presented more often
      with cytopenias, hypoalbuminaemia and oral thrush. The existence of
      extrapulmonary TB or another opportunistic coinfection allowed AIDS to be
      diagnosed in the same admission in 30 patients and a mean of 8.4 months later in
      another eight. Extrapulmonary TB was found to be as common in early HIV infection
      as in patients with established AIDS. Haematological derangements were common in
      these patients, and cytopenias, hypoalbuminaemia and oral thrush were useful
      predictors of TB dissemination. The location of TB and its dissemination were not
      significantly linked to a more advanced CDC stage of HIV infection or a more
      profound fall in CD4 count.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620816
TI  - The diagnosis of intra-abdominal abscesses in patients with severe Crohn's
      disease.
AB  - A series of 24 patients with severe relapses of Crohn's disease responding poorly
      to conventional treatment with corticosteroids was studied to determine the
      incidence of intra-abdominal abscesses and the best means to detect them.
      Ultrasound scans proved to be difficult to interpret and unreliable. Computed
      tomography demonstrated abnormal bowel thickening in most cases, and showed seven
      of the eight intraabdominal abscesses. 111In leucocyte scintigraphy always
      demonstrated inflamed areas of bowel, but underestimated the extent of disease in
      three patients and overestimated it in five. All eight abdominal abscesses were
      detected, and there were no false-positive results. It was always possible to
      distinguish the abscess from inflamed bowel wall. Intra-abdominal abscess is not
      uncommon in patients with severe relapses of Crohn's disease which are not
      responsive to corticosteroid therapy, being present in about one-third of
      patients. 111In leucocyte scintigraphy is a simple and helpful test for
      differentiating between active inflammatory bowel disease and complicating
      abscesses, contributing significantly to the management of patients with severe
      Crohn's disease.

PMID- 1620817
TI  - An outbreak of multiresistant Salmonella typhi in South Africa.
AB  - Typhoid fever caused by Salmonella typhi remains endemic to many parts of South
      Africa, including Natal and KwaZulu, Northern Transvaal and the Transkei. Until
      recently, the majority of S. typhi isolates from South Africa have remained
      susceptible to ampicillin/amoxycillin and chloramphenicol, and only three cases
      of typhoid due to multi-antibiotic resistant strains of S. typhi have been
      documented. Ampicillin/amoxycillin and chloramphenicol are, therefore, still
      recommended as first line therapy for patients with typhoid fever in this
      country. We describe a cluster of six cases of typhoid caused by S. typhi that
      was resistant to ampicillin, chloramphenicol and trimethoprim-sulphamethoxazole.
      All these patients presented over a 3-month period; the patients were from three
      adjacent districts in the Northern Natal area of South Africa. The high rate of
      intestinal perforation (two of six) was a direct consequence of inappropriate
      antibiotic treatment. Failure of surgical intervention, renal impairment as well
      as delay in starting appropriate antibiotic treatment were factors contributing
      to the high mortality (three of six). The good clinical outcome in the remaining
      three patients probably resulted from treatment with appropriate antibiotics;
      however, mild disease in two of these patients may have been a contributing
      factor. All isolates showed high minimal inhibitory concentrations (MIC) of
      greater than or equal to 256 micrograms/ml to ampicillin, chloramphenicol and
      trimethoprim-sulphamethoxazole. The isolates were all highly sensitive to the
      third generation cephalosporins (MIC less than or equal to 0.06 micrograms/ml)
      and quinolones (MIC less than or equal to 0.03 micrograms/ml). Conjugation
      studies suggest a genetic transfer of resistance, probably plasmid mediated. The
      presence of beta-lactamase and chloramphenicol acetyl transferase enzymes in all
      six isolates tested would account for the resistance to ampicillin and
      chloramphenicol respectively. The transfer of such plasmids to erstwhile
      sensitive strains could conceivably occur in this typhoid-endemic area, where
      sanitary conditions are poor and living conditions crowded, thus further
      exacerbating the problem. It is recommended that in areas where such
      multiresistant strains are encountered, the third generation cephalosporins or
      quinolones be used as empiric therapy for typhoid fever.

PMID- 1620818
TI  - Small bowel malabsorption: clinical and radiologic perspectives. How we see it.

PMID- 1620819
TI  - To follow or not to follow, that is the question.

PMID- 1620820
TI  - Doppler US evaluation of renal artery stenosis: past, present, and future.

PMID- 1620821
TI  - 1991 RSNA special focus session on "the new health care": impact on radiologists.

PMID- 1620822
TI  - Relationships between radiology and industry: accomplishments, opportunities, and
      ethical concerns.

PMID- 1620823
TI  - Chemoirradiation: a new initiative in cancer treatment. 1991 RSNA annual oration
      in radiation oncology.
AB  - The use of concomitant continuous infusion chemotherapy and radiation therapy in
      the treatment of a variety of tumors has produced, in relatively limited clinical
      experience, substantial improvements in complete response and survival rates.
      Although there is still a need to establish the most effective combinations,
      concentrations, and scheduling of drugs, as well as optimum dose and
      fractionation of radiation, a number of benefits have already been recorded with
      this approach. Organ preservation is maximized in all but the most advanced
      cancers of the anus, esophagus, and bladder. In advanced head and neck cancers,
      particularly in the paranasal sinuses when bone destruction and infiltration have
      occurred, the total dose required for effective therapy can be reduced by 15%
      30%, which substantially lowers the rate of complications. Therapeutic gains have
      also been seen in the treatment of other primary and recurrent gastrointestinal
      and gynecologic malignancies and their hepatic metastases. Finally, there is
      considerable potential for this approach in the treatment of bulky or recurrent
      soft-tissue sarcomas, particularly in the extremities.

PMID- 1620824
TI  - Results of radical perineal prostatectomy with adjuvant brachytherapy.
AB  - Retrospective analysis of outcome in 137 patients who underwent radical perineal
      prostatectomy and bilateral injection of gold-198 implants into the periprostatic
      tissues and/or neurovascular pedicles as treatment for prostatic adenocarcinoma
      was performed. Patients had undergone treatment between 1975 and 1985. Local
      recurrence developed in 22 patients (16.1%) and distant metastases developed in
      33 (24.1%). Clinical and surgical staging of disease and Gleason grading of
      pathologic specimens were performed retrospectively. Kaplan-Meier local
      recurrence, freedom from relapse (FFR), and survival rates decreased with
      increasing stage and pathologic grade. With clinical staging, these rates were
      not statistically different from previous rates achieved with external beam
      radiation therapy, and with pathologic staging, they were not statistically
      different from previous rates achieved with prostatectomy. The authors conclude
      that (a) 5-year follow-up is inadequate to determine local control rates after
      prostatectomy; (b) use of implants did not improve local control, FFR, or
      survival rates of 10 years; and (c) method of staging probably has more effect on
      local control, FFR, and survival rates than does treatment modality.

PMID- 1620825
TI  - Patent ductus arteriosus: transcatheter closure with a transvenous technique.
AB  - Transvenous closure is described of the patent ductus arteriosus with a conical
      device that consists of polyurethane foam mounted on a stainless steel frame.
      Since 1981, the procedure has been performed in 273 patients in Russia. Permanent
      complete ductus closure was achieved in 258 (95%) patients. In eight cases (3%),
      the occlusion was incomplete. Complications occurred in 10 patients (4%), seven
      of whom required emergency surgery. The new technique combines certain advantages
      of both alternative methods. The conical shape of the occlusion device is well
      suited for the anatomic structure of the ductus. The possibility of selecting the
      size of the device permits reduction in the rate of incomplete closure while
      still taking advantage of transvenous delivery to avoid entry-site problems. In
      the initial 10 years of experience, the described technique proved effective,
      safe, and applicable in the vast majority of patients older than 2 years.

PMID- 1620826
TI  - Short-term response to thrombolytic therapy in deep venous thrombosis: predictive
      value of venographic appearance.
AB  - To determine whether the response to thrombolytic therapy for lower-extremity
      deep venous thrombosis (DVT) can be predicted from the venographic appearance,
      139 thrombosed venous segments were analyzed. Initial and follow-up venograms
      were obtained in 62 patients randomized to 24-hour infusions of recombinant human
      tissue-type plasminogen activator (rTPA) (n = 34), rTPA plus heparin (n = 16), or
      heparin alone (n = 12). Segmental response to therapy was evaluated by means of
      blinded review of the paired venograms. The response (50%-100% lysis) to rTPA
      alone was significantly greater in venous segments involved with nonobstructive
      thrombi than in those with obstructive thrombi (12 of 23 vs five of 51; P less
      than .005). Results were similar for the combination of rTPA and heparin (five of
      six vs six of 30, P less than .01). No significant difference was seen in the
      response of either obstructive or nonobstructive thrombus to heparin alone.
      Thrombotic tails responded substantially (greater than 50% decrease in size) to
      rTPA with or without heparin in 22 of 24 patients. The venographic appearance of
      DVT appears to help in predicting the therapeutic response to thrombolytic
      therapy.

PMID- 1620827
TI  - Gadolinium-enhanced magnitude contrast MR angiography of popliteal and tibial
      arteries.
AB  - To evaluate the efficacy of gadopentetate dimeglumine in MR angiography of the
      lower extremities, a flow phantom, seven healthy volunteers, and seven patients
      with peripheral vascular disease were studied with a magnitude contrast (MC)
      technique. The combination of an MC rephase-dephase gradient-refocused-echo pulse
      sequence, a 40-cm-long transmit-receive coil, and intravenous administration of a
      bolus of gadopentetate dimeglumine improved MR angiographic quality in the
      phantom, volunteers, and patients. Gadolinium enhancement decreased deleterious
      saturation effects and improved images of the popliteal and tibioperoneal
      arteries in the volunteers and patients. However, in some cases, venous overlap,
      imaging artifacts, and suboptimal visualization of subtle lesions limited
      interpretation. The authors conclude that gadolinium enhancement combined with an
      MC subtraction pulse sequence appreciably improves MR angiography of lower
      extremity arteries.

PMID- 1620828
TI  - Assessment of intracardiac shunts with gadolinium-enhanced ultrafast MR imaging.
AB  - Dye dilutional techniques are widely accepted for the assessment of intracardiac
      shunts, but current techniques require arterial access or radioisotope injection.
      Ultrafast (less than 500 msec) magnetic resonance (MR) imaging is ideally suited
      for the evaluation of an indicator during passage through the heart. Twenty
      patients were studied, including 13 with shunts. Four-chamber, T1-weighted images
      were obtained during bolus injection of gadopentetate dimeglumine. A single image
      was obtained in 420 msec, with repetitive images acquired after each QRS complex.
      After the contrast material was injected, there was pronounced signal intensity
      enhancement in the right atrium, followed by the right ventricular cavity, left
      atrium, left ventricular cavity, and descending aorta. Patients with substantial
      intracardiac shunts demonstrated early recirculation. First-pass contrast
      material-enhanced MR imaging is a promising new technique for the rapid
      assessment of intracardiac shunts. Combined with anatomic and functional MR
      imaging techniques, it can help provide a comprehensive noninvasive evaluation of
      suspected intracardiac shunts or provide follow-up in patients with known shunts.

PMID- 1620829
TI  - Peripheral transcatheter embolization with platinum microcoils.
AB  - Embolotherapy with platinum microcoils delivered through the Tracker-18
      microcatheter (Target Therapeutics, San Jose, Calif) was performed in 16 patients
      when peripheral superselective catheterization with standard angiographic
      catheters was not possible. The Tracker-18 catheter could be directed distally
      into small peripheral vessels for delivery of the microcoils. These microcoils,
      with attached fiber strands, resulted in vascular occlusion within a few minutes
      in all cases. Embolotherapy was technically successful in all patients. The
      procedures were clinically successful in 15 of 16 patients (94%), and no
      complications were encountered. Embolization with platinum microcoils through the
      Tracker-18 catheter is useful when standard methods of embolization are not
      possible.

PMID- 1620830
TI  - Corrosive esophageal stricture: safety and effectiveness of balloon dilation.
AB  - The safety and long-term effectiveness of fluoroscopically guided balloon
      dilation for corrosive esophageal stricture was evaluated in 22 patients with a
      follow-up period of more than 1 year (range, 13-52 months). The average interval
      between corrosive agent ingestion and initial balloon dilation was 18 years
      (range, 2 months to 51 years). Balloons with a diameter of 5-8 mm were used in
      the initial attempt. The caliber of the balloon catheter was increased gradually
      over subsequent dilations, up to a diameter that allowed patients to swallow
      solid foods. Dilation of more than 17 mm in diameter was performed in five
      patients. Patients underwent one to five sessions. Esophageal rupture occurred in
      seven patients and was treated nonoperatively in five and surgically in two. With
      exclusion of these latter two, 11 of 20 could tolerate swallowing all kinds of
      food and nine could tolerate swallowing most foods. Balloon dilation in corrosive
      esophageal strictures is effective, but the high rupture rate indicates the need
      for extra caution.

PMID- 1620831
TI  - Effect of varying rates of low-osmolarity contrast media injection for hepatic
      CT: correlation with indocyanine green transit time.
AB  - Contrast enhancement in hepatic computed tomography (CT) is related to multiple
      factors, including the amount of iodine injected, the rate of injection, and body
      weight. Fifty patients were randomized into two groups: 19 patients (group 1)
      received a 160-mL dose of Optiray 320 (ioversol) at 3.0 mL/sec, and 31 (group 2)
      received the same dose at 4.5 mL/sec. Indocyanine green dye transit time, peak
      enhancement, delayed enhancement, time to peak enhancement, age, and weight were
      statistically analyzed. Time to peak enhancement was significantly shorter in
      group 2 than in group 1 (62 seconds vs 73 seconds, respectively; P less than
      .01). Peak contrast enhancement averaged 88 HU +/- 19 in group 1 and 99 HU +/- 17
      in group 2 (P = .06). Circulation time did not correlate with peak enhancement
      and thus does not assist in tailoring contrast medium injection for hepatic CT.
      Injection of contrast material at 3.0 and 4.5 mL/sec provides greater hepatic CT
      contrast enhancement than previously reported, with no significant risk of
      subcutaneous extravasation when injection is monitored carefully. These higher
      levels of contrast enhancement may assist in detecting and characterizing hepatic
      lesions.

PMID- 1620832
TI  - Comparative randomized double-blind study of hydroxyzine versus placebo as
      premedication before injection of iodinated contrast media.
AB  - The use of ionic contrast media in radiologic examinations may cause a wide
      variety of anaphylactoid reactions. The aim of this double-blind randomized study
      was to determine whether a simple and inexpensive premedication based on an
      antihistamine could reduce the number of idiosyncratic reactions in 400 patients
      (251 men and 149 women) without a clinical history of allergy who were to receive
      an intravenous injection of a low-osmolality iodinated contrast medium. Twelve
      hours before examination, a group of 200 patients was given one 100-mg tablet of
      hydroxyzine; another group of 200 was given a placebo tablet under the same
      conditions. Results in the two groups were comparable at the .05 level of
      significance. Twenty-five patients in the placebo group had a reaction (mainly
      urticaria); only two patients in the hydroxyzine group had a reaction (P less
      than .0001; odds ratio, 14.1). No severe reaction occurred in either group.
      Because hydroxyzine and placebo were allocated at random, it is concluded that
      hydroxyzine reduces the frequency of minor anaphylactoid reactions in patients at
      low risk.

PMID- 1620833
TI  - Ionic iodinated contrast medium and amobarbital sodium mixtures: potential for
      precipitation.
AB  - When a small amount of diatrizoate meglumine, an ionic iodinated contrast medium,
      is left in a catheter system before injection of amobarbital sodium or when the
      contrast medium is intentionally mixed with amobarbital sodium, a potentially
      dangerous situation occurs. The authors showed in vitro that a dense precipitate
      forms in this situation. This is due to an acid-base reaction between the
      relatively acidic contrast medium and basic barbiturate and the subsequent
      formation of insoluble amobarbital.

PMID- 1620834
TI  - Ameloblastoma in the maxillomandibular region: MR imaging.
AB  - Nine patients suspected of having primary ameloblastoma of the mandible or
      maxilla and five patients with clinical and/or radiologic indications of
      postoperative recurrence of ameloblastoma were examined with magnetic resonance
      (MR) imaging. In the former, results were compared with those of conventional
      radiography, computed tomography (CT), and pathologic analysis. Seven tumors were
      multilocular; two were unilocular. MR imaging showed a mixed pattern of solid and
      cystic components (n = 9), irregularly thick walls (n = 9), and papillary
      projections (n = 6). MR imaging was superior to conventional radiography and CT
      in demonstrating these findings. However, shell-like bulgings of the bone cortex
      were demonstrated more effectively with conventional radiography and/or CT in six
      cases, and soft-tissue invasion was overestimated with MR imaging in four cases.
      All tumors except one showed strong enhancement of solid components including
      papillary projections, walls, and septa at enhanced MR imaging. In the latter
      group of patients, MR imaging correctly demonstrated recurrence in two and no
      recurrence in three.

PMID- 1620835
TI  - Improved time-of-flight MR angiography of the brain with magnetization transfer
      contrast.
AB  - The authors hypothesized that magnetization transfer contrast (MTC) could be used
      to improve flow contrast in time-of-flight (TOF) magnetic resonance (MR)
      angiography. Two- and three-dimensional flow-compensated gradient-echo images
      were obtained with and without MTC. MTC images were obtained by applying low
      power radio-frequency (RF) radiation with a frequency offset from the bulk "free"
      water resonance frequency before the excitation RF pulse. The signal intensity of
      stationary tissue decreased as the power applied for the MTC pulse was increased.
      A smaller decrease occurred in venous signal intensity as measured in the
      superior sagittal sinus, and less change was seen in the arterial signal
      intensity as measured in the middle cerebral artery. Cerebrospinal fluid showed
      no MTC effect. The use of MTC improved small-vessel depiction on maximum
      intensity projection images. The authors conclude that use of MTC can
      substantially enhance the quality of TOF MR angiography of the brain.

PMID- 1620836
TI  - Carotid arteries: evaluation with low-field-strength MR angiography.
AB  - Magnetic resonance (MR) angiography of neck vessels was performed with a 0.2-T
      permanent magnet by using a two-dimensional, time-of-flight technique. Thirty-one
      patients were included in the study. The imaging parameters used included a
      repetition time of 60 msec, an echo time of 10 msec, a 90 degrees flip angle, and
      a 192 x 256 matrix; 40-50 sequential two-dimensional sections were acquired
      through the neck. Stenosis was graded on a scale of 1-5. Correlation of digital
      and MR angiography was made in the clinically nonrelevant cases (stenoses of
      grades 1 and 2), with overestimation to grade 3 in six cases. Two grade 3
      stenoses were overestimated as grade 4. Severe stenoses were correctly
      characterized in all but one case, which was underestimated because of a
      segmental short extension of the stenotic lesion. Obstructions were found in two
      cases. Areas with a lack of signal were observed in four patients with severe
      stenosis and in two with tortuous arteries. Correct diagnosis, however, was
      achieved with analysis of the maximum intensity projection animation display. Low
      field-strength MR angiography has the same clinical value as that performed with
      high field strengths.

PMID- 1620837
TI  - Proximal cervical spinal nerve: MR appearance.
AB  - An interradicular cleft and a segment of nerve containing fascicles have recently
      been described in the cervical spinal nerve. This study was performed to
      determine whether the fascicles and the interradicular cleft have a distinctive
      appearance on magnetic resonance (MR) images. The proximal spinal nerves and
      nerve roots of C-4 and C-8 were removed from cadavers, imaged with MR, sectioned,
      and stained. Cervical neural foramina were imaged with MR and then sectioned. The
      MR images demonstrated a division of the root sheaths into ventral and dorsal
      portions, separated by fat within the interradicular cleft and located proximal
      to the dorsal root ganglion. Distal to the dorsal root ganglion, the proximal
      portion of the cervical spinal nerve containing multiple fascicles gave the
      proximal portion of the spinal nerve an inhomogeneous appearance on the MR
      images. This study suggests an anatomic explanation for the variable appearance
      of the cervical spinal nerves with MR imaging.

PMID- 1620838
TI  - Nonpalpable, probably benign lesions: role of follow-up mammography.
AB  - Of 21,855 consecutive women prospectively studied with mammography, physical
      examination, and high-resolution ultrasonography when appropriate, 558 received a
      diagnosis of nonpalpable, probably benign lesions. Follow-up mammography was
      recommended for these patients. Characteristically benign lesions and palpable
      masses were excluded from analysis. The positive predictive value for detection
      of a nonpalpable, probably benign breast lesion was 0.017. Nine patients
      ultimately proved to have carcinoma; two of them had noninvasive carcinoma, and
      two had axillary node metastases. The positive predictive value for detection of
      a nonpalpable, probably malignant lesion was 0.47. The policy of recommending
      mammographic surveillance for nonpalpable, probably benign lesions, a viable
      option for radiologists, has the capability of lowering the rate and therefore
      the costs of biopsy procedures with negative results.

PMID- 1620839
TI  - Mobile mammographic screening of self-referred women: results of 22,540
      screenings.
AB  - In this mass screening mammography program, self-referred women are accepted for
      screening only if part of a sponsoring organization. Screening is performed with
      mobile equipment, often at the work site. Of the first 22,540 screenings, 61% (n
      = 13,784) were of women aged 35-49 years. Eighty-nine percent (n = 20,025) of the
      screenings were normal. Of 51 women in whom cancer was found, 38 (75%) were
      recommended for biopsy on the basis of their initial two-view mammogram. The
      prevalence of breast cancer generally increased with advancing age but was
      similar between women aged 35-39 years and those aged 40-49 years. Of the 28
      women with complete histologic studies, 43% (n = 12) had pure intraductal cancer
      and another 43% had negative findings at axillary node dissection. Program costs
      dictated a $65 fee. Within the design of this program it has been possible to
      screen large numbers of self-referred women and detect early carcinomas. Program
      design, however, may make screening more expensive than in a fixed screening site
      accepting only physician-referred women.

PMID- 1620840
TI  - Enlarging fibroadenoma in a postmenopausal woman: case report.
AB  - The authors describe mammographic and pathologic evidence of the growth of a
      fibroadenoma in an 82-year-old obese woman, 44 years after menopause, who had
      never been treated with hormone therapy. The patient's obesity is hypothesized as
      the causal factor for increased estrogen levels leading to growth of the
      fibroadenoma.

PMID- 1620841
TI  - In vivo relaxation times and hydrogen density at 0.063-4.85 T in rats with
      implanted mammary adenocarcinomas.
AB  - Magnetic resonance (MR) imaging at 0.063 T, 0.17 T, 0.35 T, 2.94 T, and 4.85 T
      was performed in rats with implanted mammary adenocarcinomas (and in control
      rats) to study hydrogen density and the effects of magnetic field strength on T1
      and T2 relaxation times in vivo. T1 increased by an order of magnitude and T2
      decreased by a factor of two between the lowest and highest field strengths. Only
      about half of the increased water content of tumor, compared with that of muscle,
      was reflected in increased hydrogen density. The sensitivity of relaxation time
      change was increased at the lower field strengths. These results are of
      significance in understanding the effects of field strength on lesion
      detectability, contrast, and signal-to-noise ratio.

PMID- 1620842
TI  - Pulmonary nodular opacities after transbronchial biopsy in patients with lung
      transplants.
AB  - Focal nodular opacities were seen on 26 of 74 (35%) postbiopsy radiographs
      obtained in 39 patients who underwent lung transplantation. The subsequent
      clinical course and diagnostic evaluation suggested that the opacities were due
      to focal hemorrhage at the biopsy sites. This finding was evident on only three
      of 40 (8%) postbiopsy radiographs obtained in 40 control patients who underwent
      transbronchial biopsy for diffuse interstitial lung disease. The differential
      diagnosis of new pulmonary nodular opacities in lung transplantation patients
      should include focal postbiopsy hematomas, because of their relatively frequent
      occurrence in this clinical situation.

PMID- 1620843
TI  - Tracheal and bronchial cartilaginous rings: warfarin sodium-induced
      calcification.
AB  - Progressive calcification of the cartilaginous rings (CCR) of the trachea and
      bronchi has been observed in patients undergoing prolonged prophylactic
      anticoagulant therapy with warfarin sodium. The purpose of this study was to
      validate the relationship of warfarin sodium and CCR, as well as to present the
      appearance and sex and age distribution of the normal degenerative CCR seen in
      the elderly. Chest radiographs were scrutinized for evidence of CCR in 92
      patients who underwent warfarin sodium therapy and in 105 patients used as a
      control group. CCR was classified as not present (scored as 0), subtle (scored as
      1), and extensive (scored as 2). In the warfarin sodium study group, 47% of
      patients (43 of 92) exhibited level 1 or level 2 CCR. This proportion was 19% (20
      of 105) in the control group. The difference was statistically significant (P
      less than .001). A significant positive correlation (P less than .001) was also
      present between the duration of warfarin sodium therapy and increased levels of
      CCR.

PMID- 1620844
TI  - Solitary pulmonary nodules: detection of malignancy with PET with 2-[F-18]-fluoro
      2-deoxy-D-glucose.
AB  - It is estimated that nearly one-third of solitary pulmonary nodules (SPNs) may
      represent bronchogenic carcinoma. The noninvasive imaging methods used currently
      (ie, plain radiography, computed tomography) are not reliable for accurate
      detection of malignancy in most SPNs. The authors prospectively evaluated use of
      positron emission tomography (PET) with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose
      (FDG) for identification of malignancy in 20 patients with noncalcific,
      radiographically indeterminate SPNs. PET-FDG imaging demonstrated focal
      hypermetabolism in 13 biopsy-proved malignant nodules, whereas no increased FDG
      uptake was seen in the seven benign SPNs. Semiquantitative analysis with
      computation of differential uptake ratios also helped clearly differentiate
      benign nodules (mean +/- standard deviation, 0.56 +/- 0.27) from malignant
      nodules (mean +/- standard deviation, 5.63 +/- 2.38) (P less than .001). Thus,
      PET-FDG imaging may be a potentially useful noninvasive technique for accurate
      differentiation of benign and malignant SPNs that are radiographically
      indeterminate.

PMID- 1620845
TI  - Fibrosing alveolitis: chest radiography and CT as predictors of clinical and
      functional impairment at follow-up in 26 patients.
AB  - Findings on the original and follow-up chest radiographs and computed tomographic
      (CT) scans were correlated with clinical and functional parameters in 26 patients
      with fibrosing alveolitis. Assessment of chest radiographs included determination
      of a standard profusion score and an average profusion score. The CT assessment
      included pattern, extent, and distribution of disease. The standard profusion
      score showed no significant correlation with clinical or functional parameters (P
      greater than .05). However, the average profusion score of the six lung zones
      correlated with severity of dyspnea and with static lung volumes (P less than
      .01). Extent of irregular linear opacities on CT scans correlated with severity
      of dyspnea and impairment in gas transfer (carbon monoxide-diffusing capacity) (P
      less than .01). The profusion of ground-glass opacities on the radiograph showed
      no significant correlations (P greater than .05). The profusion and extent of
      ground-glass opacities on CT scans correlated with severity of dyspnea,
      impairment in gas transfer, and reduction in static lung volumes (P less than
      .01). Ground-glass opacities on CT scans preceded and predicted the development
      of irregular linear opacities on follow-up CT scans and correlated with an
      increase in the average profusion score of the chest radiograph (P less than
      .01).

PMID- 1620846
TI  - Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high
      resolution CT.
AB  - To evaluate the prognostic implication of ground-glass attenuation at high
      resolution computed tomography (HRCT) in assessing response to treatment in
      fibrosing alveolitis, the authors correlated HRCT findings with the improvement
      in pulmonary function, as represented by the increase in percentage predicted
      values on pulmonary function tests after corticosteroid therapy. Nineteen
      patients underwent HRCT before treatment and pulmonary function testing before
      and after treatment. The HRCT scans were reviewed by two independent observers.
      Areas of ground-glass attenuation were quantified subjectively by using a 0%-100%
      scale with 10% increments. The extent of ground-glass attenuation at HRCT was
      significantly correlated with improvement in diffusing capacity for carbon
      monoxide (r = .67, P = .0019), forced vital capacity (r = .71, P = .0007), and
      forced expiratory volume in 1 second (r = .64, P = .0034) after steroid
      treatment. These results suggest that ground-glass attenuation at HRCT is a good
      predictor of response to treatment in fibrosing alveolitis.

PMID- 1620847
TI  - Prospective validation of the stripe sign in ventilation-perfusion scintigraphy.
AB  - The data base of the Prospective Investigation of Pulmonary Embolism Diagnosis
      (PIOPED) was used to test the accuracy of the stripe sign for the exclusion of
      embolic perfusion defects on lung scintigrams. Lung scan readings showed the
      presence and location of this sign in 50 (4.7%) of 1,064 patients. Perfusion
      defects showing the stripe sign were not associated with pulmonary embolism in
      the same lung zone (upper, middle, or lower third of each lung) in 93% (79 of 85)
      of instances. Thirty-eight percent (n = 32) of lung zones with the stripe sign
      had associated chest radiographic abnormalities, and 69% (n = 59) had ventilation
      scan abnormalities. Formulation of the scan diagnosis according to PIOPED
      criteria showed fewer indeterminate readings in patients with the stripe sign and
      without pulmonary embolism when the stripe sign was used. Use of the sign changed
      diagnosis in less than 1% of the total population, however, because of its low
      overall prevalence. The stripe sign is a useful adjunct to standard criteria in
      the interpretation of pulmonary scintigrams for evaluation of suspected acute
      pulmonary embolism.

PMID- 1620848
TI  - Communication between the two pleural cavities after major cardiothoracic
      surgery: relevance to percutaneous intervention.
AB  - The authors describe evidence of communication between the two pleural cavities
      after major cardiothoracic surgery (combined heart and lung transplantation,
      heart transplantation, and correction of complex congenital heart disease)
      performed in three patients. In two patients, unilateral lung biopsy caused a
      symptomatic bilateral pneumothorax. This was successfully treated with insertion
      of a single chest tube in one patient and two chest tubes in the other patient.
      In the third patient, simultaneous evacuation of large bilateral pleural
      effusions was performed by means of unilateral thoracentesis because of the
      presence of a common pleural cavity.

PMID- 1620849
TI  - Neuroblastoma: dose-related sensitivity of MIBG scanning in detection.
AB  - Iodine-131 metaiodobenzylguanidine (MIBG) has shown effectiveness as a systemic
      radiotherapeutic agent in neuroblastoma. The authors postulated a likely dose
      related relationship of MIBG sensitivity when it was administered for
      neuroblastoma detection. They studied this relationship in neuroblastoma patients
      who underwent scanning after receiving diagnostic and therapeutic doses of MIBG
      in temporal proximity. Seven patients with stage IV disease received a total of
      14 therapeutic administrations of I-131 MIBG (150-350 mCi [5,550-12,950 MBq]/m2
      per treatment). Posttherapy scans were obtained at 3 and at 5-7 days. Diagnostic
      MIBG scans had been obtained no more than 4 weeks before the start of therapy.
      Use of diagnostic MIBG scanning led to underestimation of the tumor burden by 50%
      compared with use of posttherapy scanning. This difference may be an important
      consideration in selecting therapeutic strategies for individual patients. It
      further suggests that use of much larger diagnostic doses of MIBG is a rational
      strategy in histologically confirmed cases of advanced disease.

PMID- 1620850
TI  - Age dependency of the renal resistive index in healthy children.
AB  - It has recently been suggested that the resistive index (RI) in native kidneys of
      healthy children is age dependent; however, this relationship has not been
      completely defined or explained. In 110 kidneys in 71 healthy children aged
      newborn to 11 years, RIs were determined from peripheral sites (presumed to be
      arcuate, cortical, or distal interlobar arteries). The authors found the normal
      renal RI (the mean RI in each kidney) to be age dependent. The renal RI in
      children is commonly elevated above the upper normal limit in adults (0.70) in
      the 1st year of life, and the overall trend shows a decrease with age. From 4
      years on, the likelihood is low (2% probability) that the RI is above 0.70.
      Variability of the renal RI from individual to individual was most marked in the
      first 6 months of life, with 51% (19 of 37) of these kidneys having an RI that
      would be considered abnormal by adult standards. It is concluded that the normal
      renal RI is age dependent, with an overall decreasing trend with increasing age.
      This age dependency of the renal RI and, hence, of the renal vascular resistance
      might be dependent on levels of active renin, as the maturational profile of the
      renal RI more closely parallels that of active renin than those of other renal
      functional parameters.

PMID- 1620851
TI  - Renal arterial stenosis: slowed systole in the downstream circulation-
      experimental study in dogs.
AB  - To test the effect of stenosis of the renal artery on the downstream intrarenal
      blood flow, a snare was placed around the renal artery in 10 dogs and compressed
      to create stenosis while Doppler curves were obtained from interlobar arteries.
      Pulsed Doppler examination of the segmental and interlobar arteries was performed
      by means of placement of a 7.5-MHz mechanical sector transducer directly on the
      surface of the kidney. The following calculations were made: degree of stenosis
      (evaluated with aortography), acceleration index (AI) (the acceleration of
      systole), and resistive index. The Doppler measurements were compared with
      findings on angiograms. The AI for normal arteries ranged from 2.2 to 4.3, and
      for arteries with 75% or greater stenosis, from 1.0 to 1.3. Systolic peaks
      disappeared as near occlusion was achieved. These changes were reversible within
      seconds of release of the arterial snare. Such change is identical to change in
      the pulsus tardus and parvus waveforms seen in both acute and chronic severe
      stenosis of the renal artery in humans.

PMID- 1620852
TI  - Stenosis of the renal artery: assessment of slowed systole in the downstream
      circulation with Doppler sonography.
AB  - Slowing and dampening of systole in the arterial network distal to stenosis is a
      well-known Doppler sign of severe arterial stenosis. To determine whether this
      sign is present in boys and girls with such stenosis, intrarenal Doppler curves
      (acceleration index [AI] and resistive index [RI]) were compared with findings on
      renal arteriograms in 20 boys and girls; the AI was also measured in 10 boys and
      girls without renal disease. Statistical analysis of AI and RI measurements was
      performed. Eleven of 32 renal arteries were normal. The normal AI was 4.0-7.0; in
      arteries with greater than 75% stenosis, the AI was 0.7-1.7. In five arteries
      studied after angioplasty, the AI had changed from 0.7-1.5 to 4.0-5.6 at the
      first posttreatment examination (performed 28 hours to 1 week after angioplasty),
      and it remained normal during the 3-year follow-up period. In kidneys with
      stenotic arteries, the RIs were lower (0.43-0.54) than in healthy subjects (0.56
      0.63). Regression and correlation coefficients of AI and RI measurements were
      statistically significant, and discrimination between normal arteries and those
      with greater than 75% stenosis was excellent.

PMID- 1620853
TI  - Segmental stenosis of the renal artery: pattern recognition of tardus and parvus
      abnormalities with duplex sonography.
AB  - Segmental renal artery branches within the renal sinus were prospectively
      evaluated with color Doppler imaging and pulsed-Doppler spectral analysis in 56
      patients before angiography. Waveforms were evaluated for the tardus and parvus
      abnormalities of prolonged acceleration time, diminished acceleration index, and
      loss of the normal early systolic compliance peak/reflective-wave complex (ESP).
      Findings obtained with these parameters were compared with the subsequent
      findings on angiograms to ascertain their efficacy in detection of
      hemodynamically significant (greater than or equal to 60%) renal arterial
      stenosis (RAS), which was present in 32 kidneys in 26 patients. Simple pattern
      recognition analysis of ESP proved to be the best of the three parameters. Loss
      of ESP enabled identification of RAS with 95% sensitivity, 97% specificity, a 92%
      positive predictive value, a 98% negative predictive value, a 96% overall
      accuracy. On the basis of the high technical success rate, high sensitivity and
      specificity, and short examination time, waveform analysis for detection of
      tardus-parvus abnormalities, especially loss of ESP, of the segmental artery is
      recommended as an alternative to direct examination of the main renal arteries
      for evaluation of RAS.

PMID- 1620854
TI  - Small renal cell carcinoma: pathologic and radiologic correlation.
AB  - The authors correlated the radiologic and pathologic findings of 36 patients with
      small renal cell carcinoma (less than or equal to 3 cm in diameter). Tumors were
      discovered incidentally or by means of mass surveys with ultrasound (US).
      Computed tomography (CT) and angiography were performed before surgery. Of the 36
      tumors, 24 were of solid (alveolar) architecture, five were of papillary
      architecture, three were of tubular architecture, and four were of multilocular
      cystic architecture. Cell arrangement was closely correlated with radiologic
      appearance, especially in regard to tumor vascularity and echogenicity.
      Histologically homogeneous tumors of solid architecture were hypoechoic at US and
      hypervascular at angiography and contrast medium-enhanced CT. Tumors of
      papillary, tubular, and multilocular cystic architecture were hyperechoic at US
      and hypovascular at angiography. There was no correlation of cell differentiation
      and cell architecture with echogenicity or tumor vascularity. Tumors with
      hemorrhage showed marked hyperattenuation at CT. A tumor capsule was observed in
      25 patients (69%); this was demonstrated as a rim at US or angiography.

PMID- 1620855
TI  - MR imaging of the most commonly injured ankle ligaments. Part I. Normal anatomy.
AB  - To determine the optimum foot position and imaging plane at magnetic resonance
      (MR) imaging of each ankle ligament, 10 cadaver ankles were dissected to
      visualize the orientation, precise attachment sites, and relationships of each
      ligament. Then eight cadaver ankles were studied with MR imaging and were
      cryosectioned in the optimum imaging planes. The ankles of 12 healthy volunteers
      were imaged to ensure consistency in identifying the normal ligaments. With the
      foot taped into full dorsiflexion of 10 degrees-20 degrees, axial imaging
      provided optimum views of the anterior, posterior, and inferior tibiofibular
      ligaments and of the anterior and posterior fibulotalar ligaments and provided an
      overview of the deltoid ligament. Coronal images provided full-length views of
      the tibiospring, tibiocalcaneal, and posterior tibiotalar parts of the deltoid
      ligament. With the foot taped into full plantar flexion of 40 degrees-50 degrees,
      axial imaging optimized visualization of the fibulocalcaneal ligament and of the
      tibionavicular and anterior tibiotalar parts of the deltoid ligament. Sagittal
      images provided the best full-length views of the spring ligament.

PMID- 1620856
TI  - MR imaging of the most commonly injured ankle ligaments. Part II. Ligament
      injuries.
AB  - Thirteen patients with clinically diagnosed sprained ankles underwent magnetic
      resonance (MR) imaging. Five of these cases are presented to illustrate the
      potential of MR imaging to enable identification of both primary and associated
      ligament injury sites, grading of the severity of the injuries, and visualization
      of the associated findings of tendon sheath and joint effusion. The appropriate
      combination of foot position and imaging plane is essential to achieve full
      length visualization of each ligament. Two patients demonstrated findings
      compatible with total gross disruption of the anterior fibulotalar ligament; two,
      with injury to the fibulocalcaneal ligament with effusion of the overlying
      peroneus tendon sheath; and one, with thinning, lengthening, and fibrotic changes
      involving the anterior fibulotalar ligament. MR imaging can provide a noninvasive
      means to evaluate the site and severity of ankle ligament injuries (a) in acute
      ankle injuries that demonstrate significant instability, (b) in stable acute
      injuries involving athletes or litigation, or (c) in patients with repeated
      injuries or instability in whom surgery is contemplated.

PMID- 1620857
TI  - SLAP lesions of the glenoid labrum: CT arthrographic and arthroscopic
      correlation.
AB  - Tears in the superior part of the glenoid labrum in the anterior and posterior
      directions (SLAP, superior labrum anterior, posterior) result from injuries that
      place excessive stress on the tendon of the long head of the biceps brachii
      muscle. The intimate relationship of the tendon and the superior glenoid labrum
      promotes injury to the latter structure. Four types of SLAP lesions are seen at
      arthroscopy. Images from 17 patients with surgically proved SLAP lesions who had
      undergone preoperative computed tomographic (CT) arthrography were
      retrospectively reviewed to evaluate the value of CT arthrography in the
      detection and accurate depiction of these labral injuries. The authors compared
      the findings at videotaped arthroscopic surgery with those from CT arthrography
      and found that abnormalities of the labral-capsular apparatus could be detected
      with CT arthrography in 16 of the 17 patients. Furthermore, the CT arthrographic
      criteria developed during this review helped determine the type of tear in 15 of
      the 17 patients. CT arthrography appears to be useful in the evaluation of
      patients with suspected SLAP lesions.

PMID- 1620858
TI  - MR imaging of the normal shoulder: variants and pitfalls.
AB  - In 30 volunteers with normal shoulders, the following conclusions were made with
      regard to normal anatomic features at magnetic resonance (MR) imaging: (a) The
      supraspinatus tendon has low signal intensity, except for a 1-cm area with
      intermediate signal intensity in the region of the "critical zone." (b) The
      deltoid tendon attachment on the inferior surface of the acromion may simulate a
      subacromial spur if not imaged in continuity. (c) Fluid in the long head of the
      biceps tendon sheath is normal if not completely surrounding the tendon. (d) The
      anterolateral branch of the anterior humeral circumflex vessels in the proximal
      bicipital groove adjacent to the biceps tendon mimics fluid in the tendon sheath.
      (e) Continuity or obliteration of the subacromial-subdeltoid bursal fat plane is
      an unreliable diagnostic sign since the fat plane is often focally absent. (f)
      Fluid is not detected in subacromial-subdeltoid bursae. (g) Undercutting of the
      anterior glenoid labrum by hyaline cartilage or a closely apposed middle
      glenohumeral ligament may simulate an anterior labral tear.

PMID- 1620859
TI  - MR imaging of the elbow.
AB  - Of 27 patients who underwent magnetic resonance (MR) imaging of the elbow, 11
      underwent elbow arthroscopy and/or an open surgical procedure. Surgical findings
      were compared with those from MR imaging. Five healthy volunteers also underwent
      MR imaging to demonstrate anatomic relationships. Transchondral fracture
      (osteochondritis dissecans) was identified in three of the 11 patients and was
      proved at surgery. Loose bodies were suspected at MR imaging in the three
      patients but were found in only two. One complete avulsion of the ulnar
      collateral ligament (UCL) and four cases of intact, thickened UCLs were
      identified at MR imaging and surgery. Loose bodies from the olecranon tip were
      found in three patients at surgery but were seen on MR images in only two. MR
      imaging depicted olecranal osteophytes in three cases, which were confirmed at
      surgery. Two complete avulsions of the biceps tendon and one partial triceps
      tendon tear were identified with MR imaging and proved at surgery. A
      postoperative soft-tissue infection and a synovial cyst were also seen at MR
      imaging and surgery. These results suggest that MR imaging is useful in the
      evaluation of the elbow.

PMID- 1620860
TI  - Reflex sympathetic dystrophy in the foot: clinical and scintigraphic criteria.
AB  - To establish strict clinical criteria for reflex sympathetic dystrophy (RSD) of
      the foot and to characterize any associated scintigraphic pattern, the authors
      performed three-phase radionuclide bone scanning in 51 patients prospectively
      referred because RSD was a diagnostic consideration. To establish sensitivity and
      specificity data, the cases of an additional 100 consecutive patients referred
      for a variety of foot problems were retrospectively reviewed. The authors defined
      RSD of the foot as a pain syndrome characterized by diffuse nonanatomic, often
      unrelenting pain; autonomic-vasomotor signs including warm or cool skin
      temperatures and moist-sweaty or dry-scaly skin; and a positive response to a
      lumbar sympathetic block. Patients with RSD have a characteristic delayed bone
      scan pattern consisting of diffuse increased tracer throughout the foot, with
      juxta-articular accentuation of tracer uptake. Overall, sensitivity in this study
      was 100%; specificity, 80%; positive predictive value, 54%; and negative
      predictive value, 100%. False-positive images were obtained in patients with
      infection, diabetes, and chronic pain. Specificity was 66% in the subgroup of
      patients who underwent sympathetic block, with a positive-predictive value of
      88%. There were no differences in scan pattern related to duration of symptoms
      prior to imaging.

PMID- 1620861
TI  - Salmonella colitis: assessment with double-contrast barium enema examination in
      seven patients.
AB  - To completely rule out the possibility of ulcerative colitis, Crohn disease, and
      other diseases, the authors analyzed the radiographic findings at double-contrast
      barium enema examination performed in seven patients with colitis caused by
      Salmonella organisms. In all patients, bacteriologic confirmation of nontyphoid
      Salmonella infection and radiographs of the upper gastrointestinal tract were
      obtained. Total colonoscopy was performed in five patients and sigmoidoscopy in
      one patient. In all patients, the radiographic findings were retrospectively
      analyzed. The descending colon and sigmoid colon were affected in six patients,
      whereas the rectum was affected in none. The findings included fine mucosal
      granularity (seven patients), loss of haustration (six patients), many fine
      ulcerations (five patients), and multiple ulcers (two patients). The radiographic
      features simulated those of ulcerative colitis, except for absence of rectal
      abnormality. It is concluded that double-contrast barium enema examination is
      useful for detection of fine mucosal changes.

PMID- 1620862
TI  - Crohn disease of the small intestine: accuracy and relevance of enteroclysis.
AB  - The accuracy and clinical relevance of enteroclysis in the evaluation of 138
      patients referred for enteroclysis for suspected Crohn disease of the small
      intestine are reported. The original prospective interpretations of enteroclysis
      results were assessed after a clinical follow-up period of 2 or more years. With
      all patients considered, enteroclysis had a sensitivity, specificity, and
      accuracy of 100%, 98.3%, and 99.3%, respectively, with only one false-positive
      diagnosis and no false-negative diagnoses. Thirty-one percent (n = 43) of the
      patients had lesions of early Crohn disease. All patients who required surgery (n
      = 23) had advanced lesions of the disease, according to enteroclysis criteria.
      Clinical evidence of Crohn disease did not develop in the 58 patients in whom
      enteroclysis revealed no abnormality. There were no complications related to the
      procedure. It is concluded that enteroclysis is an accurate method for diagnosis
      and exclusion of Crohn disease of the small intestine and provides detailed
      structural information relevant to appropriate management of the disease.

PMID- 1620863
TI  - Pelvic prolapse: assessment with evacuation proctography (defecography)
AB  - The contribution of evacuation proctography (EP) to the evaluation of pelvic
      prolapse was assessed in 74 consecutive patients. A rectocele was demonstrated in
      73 patients (99%); large rectoceles frequently showed barium trapping, but there
      was no correlation between these findings and rectal symptoms. An enterocele was
      detected at evacuation proctography in 13 patients (18%) (including two
      enteroceles seen only retrospectively), and a sigmoidocele was shown in four
      patients (5%). Physical examination resulted in detection of only seven
      enteroceles and of none of the sigmoidoceles. In 48 patients (65%), additional
      findings were evident at EP, including excessive pelvic floor descent, anal
      incontinence, rectal intussusception, and spastic pelvic floor. These data
      suggest that EP is particularly useful in the preoperative evaluation of pelvic
      prolapse if the patient has anorectal symptoms or is at risk for an enterocele.
      EP contributes to surgical planning by enabling identification of clinically
      unsuspected enteroceles and sigmoidoceles and coexistent disorders of rectal
      evacuation.

PMID- 1620864
TI  - Perirectal lymph nodes in rectal cancer: in vitro correlation of sonographic
      parameters and histopathologic findings.
AB  - Preoperative staging of lymph nodes in patients with rectal cancer is essential
      for selecting the most appropriate therapy. To determine the discriminating value
      of all ultrasound parameters described in the literature, the authors obtained
      high-frequency sonograms of 43 lymph nodes in 21 resected rectal specimens,
      thereby simulating the in vivo situation. Univariate analysis revealed that
      inhomogeneity (P less than .0005), short axis diameter (P less than .005), and
      hilar reflection (P less than .01) were helpful in differentiating between
      metastatically involved and noninvolved lymph nodes. A prognostic trend was seen
      for long-axis diameter (P = .05), roundness index (P = .09), and echogenicity (P
      = .05). With stepwise logistic regression analysis, inhomogeneity and hilar
      reflection were selected as being independently discriminative. Inhomogeneity is
      a parameter with a high specificity; hilar reflection is particularly sensitive.
      No clear differentiation could be made, however, in a sizable proportion of lymph
      nodes (60%). The prospective use of especially these significant parameters in
      vivo is recommended to determine their ultimate value in preoperative staging.

PMID- 1620865
TI  - Gaucher disease: abdominal MR imaging findings in 46 patients.
AB  - Abdominal magnetic resonance imaging findings were reviewed in 46 patients with
      Gaucher disease. All patients had hepatosplenomegaly at the time of initial
      imaging. Splenic nodules were present in 14 patients (30%) and varied in signal
      intensity. These nodules were isointense on T1-weighted and hypointense on T2
      weighted images. Splenic infarcts were seen in 15 patients (33%), and four of
      these patients (9%) also had subcapsular fluid collections. Both nodules and
      infarcts were present in the spleen in four patients (9%). Pathologic correlation
      was performed with specimens from two patients who underwent partial splenectomy.
      Focal areas of abnormal signal intensity were noted in the liver in nine patients
      (20%). They were either stellate or segmental, and may represent fibrotic septa
      with ischemic changes associated with aggregates of Gaucher cells. No changes
      were noted in the kidneys or abdominal lymph nodes.

PMID- 1620866
TI  - Solid and papillary epithelial neoplasm of the pancreas: MR imaging and
      pathologic correlation.
AB  - Correlation of magnetic resonance (MR) imaging findings and those at pathologic
      evaluation was attempted in six cases of solid and papillary epithelial neoplasm
      of the pancreas. All patients were female, and the mean patient age was 26 years
      (range, 13-73 years). On T1-weighted spin-echo images, tumors were well
      demarcated, and areas of high signal intensity were evident within them. At
      macroscopic examination, these areas corresponded to solid portions with marked
      hemorrhagic necrosis or cystic portions filled with hemorrhagic debris. In three
      of four masses surrounded by macroscopically evident fibrous capsules, a rim of
      low intensity was revealed at T1-weighted imaging. When T1-weighted spin-echo
      imaging reveals obvious areas of high intensity within a sharply marginated tumor
      of the pancreas, especially in a young woman, solid and papillary epithelial
      neoplasm might be a primary diagnostic consideration.

PMID- 1620867
TI  - Use of film duplicator to lighten dark radiographs.
AB  - The authors introduce a simple technique for lightening overexposed or
      overdeveloped dark radiographs. With the technique, an increase of exposure time
      in film duplicator allows production of duplicate radiographs with an appropriate
      tone. With this manipulation, image details are greatly improved, and the
      original radiograph is not damaged.

PMID- 1620868
TI  - Kinematic MR imaging of the patellofemoral joint: comparison of passive
      positioning and active movement techniques.
AB  - Thirteen patients underwent magnetic resonance (MR) imaging of the patellofemoral
      joint in an evaluation of passive positioning and active movement kinematic MR
      imaging techniques. Sixteen joints were symptomatic, and 10 were not. Delineation
      of normal and abnormal patellar alignment and tracking was similar with the two
      techniques, but kinematic MR imaging performed with active movement allowed a
      substantial reduction in examination time while permitting evaluation of the
      contribution of associated activated muscles and soft-tissue structures to
      patellofemoral joint function.

PMID- 1620869
TI  - Improving acceptance of barium by children by using milk for dilution.

PMID- 1620870
TI  - Percutaneous drainage of hydatid liver cysts.

PMID- 1620871
TI  - Cerebellar dimensions in assessment of gestational age in neonates.

PMID- 1620872
TI  - The nature of science and discovery.

PMID- 1620873
TI  - Radiologists, clinicians, and patient care.

PMID- 1620874
TI  - Metabolic needs, utilization and dietary sources of fatty acids in childhood.
AB  - Fatty acids are molecules that differ in the length of their carbon chain and the
      number of double bonds within them. Each of the resulting "families" has its own
      peculiarities as regards energy, structure and metabolism. Passing from the
      short, saturated chains to the very long polyunsaturated ones produces an
      increasing degree of specialization in metabolic and structural functions
      important for the body's development and general homeostasis. The fetus and
      neonate (especially if preterm), the breast-fed and weaning baby all need fatty
      acids in the right amounts and ratios to achieve full expression of their genetic
      growth potential, especially of nerve tissues. Intake in these age groups depends
      on dietary factors such as the mother's diet during pregnancy, the type of milk
      (human or artificial), and the weaning schedule. Later in childhood and in
      adolescence not only must the body's somatic growth needs be covered, but intake
      must be adequate to lay the basis for prevention of chronic-degenerative
      pathologies. Dietary recommendations are therefore based on encouraging a
      normocaloric feeding pattern, with a controlled total and saturated lipid
      proportion and balanced intake of unsaturated fatty acids.

PMID- 1620875
TI  - Nutrition challenge for Asia.

PMID- 1620876
TI  - Nephrocalcinosis in the rat: a literature review.
AB  - Nephrocalcinosis is a common disorder in female rats. Various etiological factors
      are involved in the pathogenesis, e.g. sex, age, genetical and dietary factors.
      Dietary phosphorus concentration appears to be of crucial importance in the
      induction of nephrocalcinosis. The pathological changes in calcinotic kidney
      tissue are described. Possible mechanisms underlying nephrocalcinogenesis are
      discussed. Phosphorus concentration within the proximal tubule may be the major
      determinant of nephrocalcinogenesis.

PMID- 1620877
TI  - [Molecular mechanism for the induction of cyclooxygenase].

PMID- 1620878
TI  - [Molecular structure and evolution of cyclooxygenase and lipoxygenase].

PMID- 1620879
TI  - [Prostaglandin and cell differentiation].

PMID- 1620880
TI  - [Molecular/regulatory mechanisms of the action of prostaglandins and related
      compounds in the central nervous system].

PMID- 1620881
TI  - [Regulation of chromatin structure and its transcriptional activity by histone
      acetylation].

PMID- 1620882
TI  - An updated dose-response analysis in Hodgkin's disease.
AB  - Although radiotherapy cures a very high percentage of early stage patients with
      Hodgkin's disease (HD), there is a controversial dichotomy in the dose
      recommendations believed necessary to achieve greater than 95% local control:
      Whereas one school of thought is to administer 40-44 Gy, other reports claim
      equal results with about 36 Gy. It is also not clear what doses are required for
      various tumor cell burdens. The original recommendation of 40-44 Gy was derived
      from a retrospective analysis of in-field control of disease from mostly
      kilovoltage data three decades ago. However, there have been many advances in the
      evaluation of the extent of the disease and in the practice of radiotherapy since
      the 1960s. Many more dose-control studies have been published in recent years,
      necessitating a revisit to the dose-response question in HD. Here we have
      compiled the dose-control data from the 60s to the 90s and analyzed the original
      and the updated data with the same statistical method to see any differences. We
      also have performed similar analysis of dose-control information for subclinical
      disease, less than 6 cm and greater than 6 cm disease. Whereas original analysis
      (1040 sites at risk) suggested 98% in-field control with 44 Gy, our re-analysis
      including modern megavoltage data (4117 sites at risk) shows that similar in
      field control rates could be achieved with 37.5 Gy. With megavoltage
      radiotherapy, the doses required for 98% in-field control for subclinical disease
      and disease of less than 6 cm and greater than 6 cm are, 32.4 Gy (1426 sites at
      risk), 36.9 Gy (1005 sites at risk) and 37.4 Gy (98 sites at risk), respectively.
      The results of current updated analysis will provide in-field disease control
      probabilities for different disease burdens and can serve as a guide in deciding
      dose prescriptions for practicing radiation oncologists.

PMID- 1620883
TI  - Localized extradural lymphoma: survival, relapse pattern and functional outcome.
      The Princess Margaret Hospital Lymphoma Group.
AB  - Between 1967 and 1988, 22 patients were treated at The Princess Margaret Hospital
      (PMH) for localized (stage IE) non-Hodgkin's lymphoma (NHL) presenting with
      spinal extradural compression. The median age of the patients was 55 years (range
      18-76). Back pain (20 patients) and leg weakness (18 patients) were the commonest
      complaints at presentation. Seven patients (30%) were non-ambulatory (paraplegic
      or severely paretic) and four had imparied sphincter function. Diffuse
      histiocytic lymphoma (12 cases) was the commonest histology. All patients
      initially had laminectomy decompression and were referred to PMH post
      operatively. One patient (with coincident metastatic carcinoma of the breast) was
      treated palliatively. The remaining 21 patients received radical post-operative
      treatment: radiation therapy (XRT) alone in 12 cases (25-45 Gy), radiation
      therapy plus systemic combination chemotherapy (combined modality therapy, CMT)
      in 9 cases. The overall actuarial survival for the radically treated patients was
      55% at 10 years and there was a significant difference (p = 0.037) between those
      treated by XRT alone (33%) and those who received CMT (86%). Only one patient
      from each treatment group failed locally but the distant recurrence-free survival
      for the XRT group was 32% compared to 100% for the CMT group (p = 0.017). One
      patient developed primary central nervous system (CNS) relapse. The functional
      results of treatment were excellent: 19 of the 21 radically treated patients
      regained or retained normal ambulatory status and the remaining two patients had
      only minor disability. Decompressive surgery and radiotherapy for localized
      extradural lymphoma ensures a high rate of local control and functional
      recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620884
TI  - Post-irradiation hyperamylasemia as a biological dosimeter.
AB  - Serum alpha-amylase was measured before and 24 h after either total body (31
      patients) or localized irradiation including the salivary glands (40 patients) or
      the pancreatic area (22 patients). A significant increase in amylasemia was
      observed for doses to the parotid glands larger than 0.5 Gy. A sigmoid function
      of dose was fitted to the data and predicted a maximum amylasemia level for doses
      larger than 4 Gy and smaller than 10 Gy. The raw data from other published series
      were adequately described by the same model. However, the confidence limits of
      the parameters remained wide, because of a considerable interindividual
      variability. Post-irradiation hyperamylasemia appears to provide a good criterion
      for triage of accidentally irradiated patients: 24 h after a dose larger than 2
      Gy to the parotid glands, 91% of the patients had an amylasemia level higher than
      2.5-fold the upper normal value (sensitivity). Conversely, 96% had their serum
      amylasemia lower than 2.5-fold the upper normal value when dose was smaller than
      2 Gy (specificity). However, a retrospective estimation of the absorbed dose
      (dosimetry) is not likely to be very precise because of the large interindividual
      variability.

PMID- 1620885
TI  - Preoperative radiation therapy and surgery in the treatment of "bulky" squamous
      cell carcinoma of the uterine cervix (stage Ib, IIa, and IIb operable tumors).
AB  - Forty-two women with "bulky" squamous cell carcinoma of the uterine cervix,
      larger than 5 cm, were treated between 1982 and 1988. The median follow-up was 5
      years (from 37 to 106 months). The age range was from 25 to 77 years (mean: 49).
      There were 14 stage Ib, 5 stage IIa, and 23 stage IIb operable patients. Forty
      grays were delivered at mid-plane of the pelvis (23 fractions in 31 days) using
      the four-field technique (6-18 MV). External beam radiation therapy was followed
      by 20 Gy of intracavitary radiation therapy. Forty-eight days later total
      abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) and
      bilateral pelvic lymphadenectomy were performed. The 3- and 5-year disease-free
      survival was 83 and 81%, respectively. The 5-year locoregional control rate was
      83%. Thirteen patients suffered from mild to severe complications (31%) but there
      were only two long-term (5%) complications.

PMID- 1620886
TI  - The value of postoperative irradiation in renal cell cancer.
AB  - This is a retrospective analysis of 147 evaluable patients, with histologically
      proven renal cell carcinoma, who were referred to our center between 1977 through
      1988. All patients with disease limited to the kidney underwent nephrectomy. Post
      operative megavoltage irradiation, with a median dose of 46 Gy, was given to 56
      patients, using parallel opposing portals, or multiple field technique. Five and
      10 year actuarial survivals in irradiated patients (Rt+) were 50 and 44%,
      respectively, and in non-irradiated patients (Rt-) 40 and 32%, respectively. The
      disease recurred locally in a total of 19 patients; 16 had tumor bed recurrence
      and three had scar recurrence. Local recurrence by stage was as follows: T2 N0M0:
      RT+ 0/17, RT- 2/28; T3 N0M0: RT+ 4/37 (10%), RT- 11/30 (37%) (p less than 0.05);
      T4 N0M0: RT+ 1/2, RT- 1/5. Two of the local recurrences in irradiated patients
      developed in a surgical scar which was not included in the treatment volume.
      Significant toxicity developed in three patients (5%). It is concluded that post
      operative irradiation can reduce local recurrence rate in T3 N0M0 renal cell
      carcinoma. It is recommended that the surgical scar should always be included in
      the treatment volume and irradiated to a full dose.

PMID- 1620887
TI  - Routine clinical on-line portal imaging followed by immediate field adjustment
      using a tele-controlled patient couch.
AB  - We have evaluated the fluoroscopic on-line portal imaging (OPI) system developed
      by Siemens (Beamview-1, Concord, CA, U.S.A.) in routine clinical radiotherapy,
      involving the treatment of 883 fields (559 patient set-ups for treatment) on 21
      patients. The image was typically generated by delivering 10 monitor units when
      used in single exposure or 1-2 monitor units on a large open field followed by 8
      10 monitor units on the actual field when double exposure was used. Comparison
      between the portal image and the simulator film was done by eye. A region of
      tolerance was drawn on the simulator film and the field edges on the portal image
      had to project within this region. If this criterion was not met, adjustments
      followed by verification portal images were done before the remaining field dose
      was delivered. If possible, these adjustments were performed by moving the
      patient couch by remote control. The image quality was insufficient for
      evaluation in 75/883 (8.5%) fields. The abovementioned criterion was not met in
      95/808 (11.8%) of the evaluable fields (26/559 patient set-ups were not
      evaluable). Of the 533 evaluable patient set-ups, 92 had to be adjusted (17.2%)
      including three (pelvic irradiations) set-ups that were adjusted on both field
      irradiated during the same radiotherapy session. In one case an incorrect tray
      (with wrong blocks) was detected and replaced. In one case (a 5.5 x 6.0 cm
      rectangular larynx field) the x and y axis of the field were interswitched. In
      one case incorrect focusing of a block was shown by the portal image. To make
      adjustments, the couch longitudinal position was changed 20 times (range -10 to
      +15 mm). The lateral position was changed 73 times (range -15 to +16 mm). The
      height position was changes 6 times (range -7 to +6 mm). Diaphragma rotation
      changes were performed 5 times (1 degree). The fraction of treatment time that
      was related to the use of OPI was 30.7% median (mean 32.4%, S.D. 14.1%). The
      range was 4.1 to 78.6%. On the basis of calculations assuming no OPI would have
      been used, field treatment time was increased by a median of 44.2% (mean 55.8%;
      S.D. 41.2%) by using OPI. The fraction of monitor units (fraction of the dose) to
      generate a satisfactory image was 10% median.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1620888
TI  - Influence of shielding blocks on the output of photon beams as a function of
      energy and type of treatment unit.
AB  - The influence of field-defining shielding blocks on the output of a cobalt unit
      and of seven different accelerators (one with dual energy output) has been
      investigated. The quality indices range from 0.57 (cobalt-60) to 0.79. The loss
      in output due to shielding blocks has been calculated taking into account loss in
      phantom scatter only. Comparison with experimental results shows that the
      calculation algorithm is correct in most of the clinical conditions. However, for
      quality indices of 0.70 and higher, for blocks close to the central beam axis, an
      overestimation of the output by the algorithm has been found. The maximum
      deviation observed is about 5% for the highest energy and for block positions
      corresponding to those applied, e.g. for inverted Y-fields with narrow lumbo
      aortic block spacing.

PMID- 1620889
TI  - Additive effects of cisplatin and radiation in human tumor cells under oxic
      conditions.
AB  - The interaction of cisplatin and irradiation was studied in vitro in four human
      cell lines. Additive effects were observed for the combination given either
      simultaneously or sequentially. No influence on recovery was seen in split-dose
      experiments. It is concluded that radiosensitization cannot be presumed in every
      clinical setting of combined treatment with radiation and cisplatin.

PMID- 1620890
TI  - [Stereotaxic surgery in Parkinson's disease. A preliminary report of 2 cases].
AB  - Two patients presenting Parkinson's disease underwent thalamotomy by a
      stereotactic procedure at San Fernando Clinic. These patients were selected using
      a strict protocol. The surgical procedures and the results have been described.
      Review of potential complications are also discussed. Thalamotomy by stereotactic
      surgery is a method that offer excellent results in patients presenting movement
      disorders. Specifically in Parkinson's disease, it has demonstrated a great
      effectiveness in abolishing tremor and in controlling hypertonia. Bradykinesia
      does not seem to respond to this procedure.

PMID- 1620891
TI  - [The coexistence of the intermetamorphosis and Foley syndromes: an
      interhemispheric disconnection or a limbic hyperconnection?].
AB  - The case of a patient with both, the intermetamorphosis and the Foley syndromes
      is studied. Both of these syndromes are extremely infrequent and their
      coexistence in a single patient points up to a common etiopathogenic mechanism.
      The relevant literature is discussed and a limbic hyperconnection syndrome is
      proposed to explain the clinical findings as well as the positive response to
      valproic acid.

PMID- 1620892
TI  - [A preliminary report on penile cancer in the Instituto Oncologico Nacional from
      1982 to 1990].
AB  - Cancer of the penis is not to common disease and its incidence varies between 0.5
      and 5%. In Panama, 70 cases were registered from 1982 to 1990 and it is
      considered an important social problem in the rural population. Phimosis and poor
      hygiene are important factors in its etiology. Of 70 cases seen at the National
      Institute of Oncology from 1982 to 1990, 51 cases were analyzed comparing two
      approaches in regard to lymph node metastasis: (1) an expectant approach in those
      without clinically suspected lymph node metastasis, and (2) lymph node biopsy
      using the Cabanas technique in those clinically suspected followed by
      lymphadenectomy if the biopsy was positive. The high percentage biopsies (Cabanas
      technique) as well as the significant morbidity (31.6%) in these patients,
      compared with no morbidity and the high accuracy of the expectant approach (90%)
      lead the authors to recommend the Cabanas biopsy technique only for patients of
      low educational level and difficult follow-up as outpatients. Others patients
      should be followed clinically for signs of tumor activity.

PMID- 1620893
TI  - [Single craniotomy by trephining and closed-circuit external drainage for the
      treatment of chronic subdural hematoma].
AB  - Chronic subdural hematoma is one of the most frequent pathological entities in
      the adult. Therapeutic approaches have ranged from craniotomy with excision of
      the membrane to close external drainage placed, under local anesthesia, at the
      bedside. The authors report the results of treatment of twelve (12) patients by
      craniotomy with placement of a closed external drainage for the gradual emptying
      of the chronic subdural hematoma.

PMID- 1620894
TI  - [A leiomyosarcoma of vascular origin. A case report].
AB  - Leiomyosarcomas arising from the wall of the blood vessels, are highly malignant
      tumours. Although 75% of the cases have been reported in the inferior vena cava,
      nevertheless scanty mention is made in the literature of an analogous tumor
      originating from smaller blood vessels. This paper deals with a 53-year-old man
      with a tumor in the right axilla. Surgery consisted in wide local excision.
      Histopathology revealed a mesenchymal tumor in an axillary blood vessel. Electron
      microscopy revealed tumor cell with all the characteristics of a leiomyosarcoma.
      The patient refused adjuvant therapy and died 10 months later with local
      recurrence and lung metastases.

PMID- 1620895
TI  - [An ectopic ureter which drained into the perianal area].
AB  - The author reviews the clinical record of a 6-year-old boy, who had urinary
      incontinence with wetting of his underwear in the posterior part. IVP,
      Cystoscopy, Cystogram, Left Retrograde Pyelogram and Surgery showed a double
      distal ureter on the left side. The normal ureter drained in the bladder in the
      orthotopic ureteral orifice. The medial dilated ectopic ureter, in the form of an
      H, was connected to the normal ureter and drained in the perianal area. The
      incontinence stopped after the resection of the ectopic ureter.

PMID- 1620897
TI  - [The Earl Silas Tupper Research and Conference Center].

PMID- 1620896
TI  - [The cholera epidemic in Panama 1991].
AB  - The authors studied the epidemiology of the outbreak of cholera (due to Vibrio
      cholerae 01, Inabe serotype) which occurred in Panama in 1991, during which 1179
      probable cases were reported, with 292 hospitalizations, 29 deaths and 51
      confirmed cases. There was an average of 24.7% hospitalizations and a 2.5%
      mortality. The epidemic involved 21 of 24 "corregimientos' in Darien, 2 of 4 in
      San Blas, 5 of 15 in Panama East, 3 of 40 in Colon and one of 19 in the
      metropolitan area of Panama City. The incidence of infected patients was seen in
      infants less than 1 year old and in children 1 to 4 years of age. Taking into
      account the population in each 'corregimiento', it can be said that less than 1%
      of the population was infected, but that in San Blas, where few communities have
      aqueduct and latrines, 10% of the population was infected.

PMID- 1620898
TI  - [Intestinal perforation by Angiostrongylus costaricensis. A report of 2 cases].
AB  - Two cases of abdominal angiostronylosis with terminal ileum perforation are
      reported. The first two cases diagnosed in Panama of a well established
      eosinophilic granulomatous process which affects mostly children in Costa Rica.
      The parasite Angiostrongylus costaricensis has been demonstrated in cases with a
      geographic range, from Mexico down to Brazil. The parasite has been found in
      rodents in Panama (Sigmodon hispidus and Rattus rattus) with an still pending
      further epidemiological and serological studies in order to determine the true
      disease morbidity.

PMID- 1620899
TI  - [The premenstrual tension syndrome. The role of molimina].
AB  - The author reviews the premenstrual syndrome, from its aetiological and
      physiopathological characteristics, as well as considerations in regards to its
      clinical manifestation and therapeutical possibilities. The concept of "molimina"
      and its hormonal characteristic is defined, as well as its manifestations within
      the PMS.

PMID- 1620900
TI  - [Creutzfeldt-Jakob disease. The first case with histopathological study in
      Panama].
AB  - We studied the clinical and histopathology findings of the first proved case of
      Creutzfeldt-Jakob disease in Panama. A sixty-five-years-old female patient
      referred from Santiago de Veraguas was admitted to Santo Tomas Hospital with a
      progressive clinical picture of dementia, incoordination and generalized
      myoclonia. The electroencephalogram showed periodic paroxysmal activity. The
      patient died eight months after initiated the disease. The cerebral
      histopathologic study was characteristic of Creutzfeldt-Jakob disease: status
      spongiform, neuronal loss and non-inflammatory gliosis was found.

PMID- 1620902
TI  - Vascular factors in bronchial hyperresponsiveness and asthma.

PMID- 1620901
TI  - [Urethral lengthening with a tube flap (Kropp's operation) and
      gastrocystoplasty].
AB  - Gastrocystoplasty associated to a Kropp procedure in our experience has been an
      excellent alternative to improve the quality of life and renal function in
      patients with severe bladder dysfunction and urinary incontinence. Technically
      offers easy development of a gastrointestinal segment not requiring ureteral
      reimplantation or detubularization with the consequent excess of sutures required
      traditionally in these procedures. Also the postoperative care was smoother and
      shorter than previously using with the obvious advantage of less mucus production
      and no metabolic disturbances often present. Further catheterization might be
      performed through a physiological way obviating abdominal stomas.

PMID- 1620903
TI  - The abnormal oropharyngeal carrier state: symptom or disease?

PMID- 1620904
TI  - Emphysema revisited.

PMID- 1620905
TI  - Postoperative pulmonary function abnormalities after coronary artery bypass
      surgery.
AB  - In 18 patients, postoperative effects of coronary bypass surgery were evaluated.
      Pulmonary function studies were conducted preoperatively, and 1 and 6 weeks
      postoperatively, by means of spirometry, respiratory pressures, body
      plethysmography and impedance measurement of the respiratory system using the
      forced oscillation technique. One week postoperatively, total lung capacity (P
      less than 0.0001), inspiratory vital capacity (P less than 0.0001) forced
      expiratory volume (P less than 0.0001) and functional residual capacity (P less
      than 0.01) decreased significantly, while residual volume remained unchanged.
      This restrictive respiratory impairment was accompanied by significant decreases
      in inspiratory (P less than 0.0001) and expiratory (P less than 0.01) mouth
      pressures and significant decreases in respiratory resistance values (P less than
      0.01). Six weeks postoperatively, significant differences in total lung capacity
      (P less than 0.0001), inspiratory vital capacity (P less than 0.0001) and forced
      expiratory volume (P less than 0.0001) persisted, while respiratory pressures
      returned to the preoperative values. It is concluded that respiratory muscle
      weakness contributes to the immediate postoperative restrictive lung function
      loss. Furthermore, structural alterations of chest wall mechanics have to be
      supposed for the persisting late restrictive pulmonary impairment.

PMID- 1620906
TI  - Utility of squamous cell carcinoma antigen (SCC Ag) as a tumour marker in
      pulmonary malignancy.
AB  - Squamous cell carcinoma antigen (SCC Ag), a recently developed tumour marker, has
      shown some promise, particularly in squamous cell carcinoma (SCC) of the uterine
      cervix. To evaluate its usefulness in SCC of the lung, serum SCC Ag levels were
      measured in 52 patients with a variety of respiratory diseases (both benign and
      malignant), 17 patients with renal failure and 56 healthy controls. SCC Ag was
      elevated in 11 of 25 patients with SCC lung and one patient with a mixed adeno
      squamous tumour, but in no patients with other malignancies or benign respiratory
      disease. SCC Ag levels appeared unrelated to either tumour stage or the degree of
      differentiation. False-positive results were noted in patients with renal
      failure, with six of eight patients with a plasma creatinine greater than 0.7
      mmol l-1 having an elevated SCC Ag level. Because SCC Ag was highly specific in
      the presence of normal renal function, an elevated level would support early
      investigation of a patient with suspected pulmonary malignancy. The potential of
      SCC Ag in typing large cell lung carcinomas (where light microscopic features of
      SCC are uncertain) warrants further investigation.

PMID- 1620907
TI  - Postoperative chest infection after upper abdominal surgery: an important problem
      for smokers.
AB  - The incidence and risk factors for postoperative chest infection have been
      studied in 127 patients undergoing elective upper abdominal surgery. The overall
      incidence of postoperative chest infection was 20.5%. Mean length of
      postoperative stay was extended from 7.8 to 10.7 days in those developing
      infection (P less than 0.05). Patients who smoked cigarettes and those with
      smoking related diseases had a considerably higher risk of infection. Patients
      with chronic bronchitis and airflow obstruction had an incidence of infection of
      85.7%, those with chronic bronchitis alone 83.3% and those with airflow
      obstruction and no chronic bronchitis 50%. Patients with a smoking history of
      greater than or equal to 20 pack years but no chronic bronchitis or airflow
      obstruction had an incidence of 20.8%. All three were independently significant
      risk factors for infection. Patients without respiratory disease and who were non
      smokers had an incidence of infection of only 7.1%. Smoking and its sequelae are
      the principal risk factors for postoperative chest infection. This study shows
      that the high risk patient can readily be identified by enquiry into respiratory
      symptoms, smoking history and by spirometry. This is the group in whom
      prophylactic measures are especially important, and they require close
      supervision to enable early identification and therapy of infection.

PMID- 1620908
TI  - Effects of pulmonary function of oral high frequency oscillation in normal and
      asthmatic subjects.
AB  - High frequency jet devices are not only used as 'internal percussors' to aid
      clearance of pulmonary secretions, but are also a mode of ventilatory support. As
      physical stimuli can cause bronchospasm in asthmatic individuals, we hypothesized
      that direct airway vibration may induce bronchospasm. To ascertain whether an
      airway vibration jet device could cause bronchoconstriction, we exposed eight
      asthmatic and six normal subjects to 5 min of jet-induced airway vibration or
      placebo treatment with cross-over at 3 h. Subjects breathed spontaneously for 5
      min through an open mouthpiece into which either jet (10 Hz, 25 psi) or sham
      pulsations (same device, pressure vented to room at compressor) were delivered in
      a double-blind, random order. A constant-volume body plethysmography measured
      functional residual capacity and specific airway conductance (SGAW) and a water
      seal spirometer measured forced expiratory volume in 1 s (FEV1) and forced vital
      capacity (FVC). These pulmonary function measurements were taken before and at 5,
      10, 20, 30, 60, 90 and 120 min after each exposure. In the normal subjects there
      was no significant change in any pulmonary function. There was not statistically
      significant change in the pulmonary function in the asthmatic patients. However,
      the oral high frequency oscillator induced a clinical asthmatic attack in one
      asthmatic patient. In this one patient, the FEV1 fell 35% from its initial value
      at 5 min following exposure to a maximum of 49% decline from initial value at 1 h
      following exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1620909
TI  - The role of inexperience in measuring tuberculin skin reaction (Mantoux test) by
      the pen or palpation technique.
AB  - We have shown previously that experienced readers can use the palpation or pen
      method for reading the Mantoux tuberculin skin test with accuracy. In order to
      investigate if the inexperienced reader can use both methods with the same degree
      of accuracy, we performed Mantoux tests in 539 healthy subjects, aged 20-57 years
      (mean 33 years), using the PPD-RT 23 in dose 2 I.U. (1/5000). In random order and
      a double-blind fashion, an experienced and an inexperienced reader measured the
      induration after 48 h by the palpation method initially and then by the pen
      method, without knowing the identity of the subject. Results of the study did not
      show any significant difference in any range of measurements by the two readers,
      using either the pen or palpation method (P greater than 0.1). A highly
      statistically significant linear relationship was found between the measurements
      by the pen method used by experienced and inexperienced readers (r = 0.823, P
      less than 0.0001) and between the palpation measurements by the two readers (r =
      0.939, P less than 0.0001). We conclude that the effects of an inexperienced
      examiner in the measurement of of tuberculin skin induration are minimal.
      Inexperienced readers can use the pen method as accurately as the traditional
      palpation method.

PMID- 1620910
TI  - An investigation of the relationship between microbial and particulate indoor air
      pollution and the sick building syndrome.
AB  - The sick building syndrome has been the subject of research for approximately 10
      years. Although it is often suggested that symptoms in office workers are due to
      circulating micro-organisms or particles, epidemiological studies investigating
      the relationship between them have been lacking. This cross-sectional study has
      combined medical and aerobiological assessments of offices in Great Britain and
      has found that, although airborne particulates and micro-organisms are unlikely
      to be the sole cause of the sick building syndrome, positive associations between
      symptom prevalence rates and levels of airborne viable bacteria and fungi within
      groups of buildings with similar ventilation systems, suggest a possible causal
      link that should be explored.

PMID- 1620911
TI  - A clinically relevant modification to existing inhaler therapy.
AB  - A modified formulation of inhaled salbutamol and a new inhaler device were
      studied in a group of 11 moderate-to-severe asthmatic patients. Changes in airway
      calibre (FEV1, Vmax30) were measured before and after inhalation of the new
      formulation, and compared with changes following inhalation of conventional
      salbutamol. A standard Rotahaler was used as a reference for the new inhaler. The
      study was conducted as a two-part randomized, double-blind cross-over trial. We
      found a significantly greater bronchodilatation of the larger airways using the
      modified drug in the Rotahaler. The new inhaler did not show any superiority over
      the Rotahaler, contrary to expectations from in vitro work. A slightly shorter
      model may better reflect the in vitro results. The study has implications for
      inhalation therapy in general.

PMID- 1620912
TI  - The value of bronchoalveolar lavage and bronchial washings in the diagnosis of
      invasive pulmonary aspergillosis.
AB  - The objective of this study was to clarify conflicting reports of the sensitivity
      and specificity of bronchoalveolar lavage or bronchial washings for diagnosing
      invasive pulmonary aspergillosis. The study was a retrospective review of 300
      consecutive patients in a tertiary referral centre subjected to 343 fiberoptic
      bronchoscopic procedures for the evaluation of pulmonary infiltrates.
      Classification of paired fungal culture and cytologic examination of
      bronchoalveolar lavage or bronchial washing fluid according to clinical,
      radiographic, histological and autopsy evidence of invasive pulmonary
      aspergillosis. One-hundred and fifteen deaths occurred, with a 58% autopsy rate.
      A diagnosis of invasive pulmonary aspergillosis was made in 21 immunosuppressed
      patients with 16 deaths. Bronchoalveolar lavage cytology showed aspergillus in 19
      specimens (invasive pulmonary aspergillosis in 16), cultures yielded aspergillus
      in 41 (invasive pulmonary aspergillosis in ten), with both tests positive in
      nine. Cytology sensitivity was 64.0%, specificity 99.1%, positive predictive
      value 84.2%, and negative predictive value 97.2%. Culture sensitivity was 40.0%,
      specificity 90.3%, positive predictive value 24.4%, and negative predictive value
      95.0%. Concordant cytology and culture sensitivity was 32.0%, specificity 99.7%,
      positive predictive value 88.9%, and negative predictive value 94.9%. In
      conclusion, when characteristic hyphae are visualized in bronchoalveolar lavage
      specimens from immunosuppressed patients with compatible clinical data, it is
      advisable to treat for presumptive invasive pulmonary aspergillosis.

PMID- 1620913
TI  - Necrotizing fasciitis: is it a fatal complication of tube thoracostomy?--Report
      of three cases.

PMID- 1620914
TI  - Low carbon monoxide transfer factor (TLCO) in HIV-infected patients without lung
      disease.

PMID- 1620915
TI  - The use of thermography in clubbing.

PMID- 1620916
TI  - Assessment of portable oxygen therapy.

PMID- 1620917
TI  - [Advances in the diagnosis of digestive diseases].

PMID- 1620918
TI  - [Value of the determination of CA 15-3 in the diagnosis of malignant pleural
      effusion].
AB  - In 160 consecutive patients with pleural shedding, antigen CA 15-3 values in
      pleural fluid were determined, in a prospective way using monoclonal antibodies
      (115D8 and DF3). In 49 patients with malignant pleural shedding, the mean value
      of CA 15-3 (47.6 U/ml) was significantly higher (p less than 0.01) to the values
      in the 111 benign ones (12.9 U/ml). Its sensibility for malignity, with a trough
      level of 27 U/ml, was of 37% with an specificity of 96%. When a specificity of
      100% was required its sensibility (18%) was significantly lower to the
      carcinoembryonic antigen (CEA) (33%), measured simultaneously with comparative
      purposes. The simultaneous determination of both markers raised sensibility to
      39%, without reaching statistical signification. In the ten patients whose
      pleural sheddings was secondary to breast carcinoma, both minimum (15 U/ml) as
      medium (110 U/ml) values, as well as CA 15-3 sensibility (80%), were higher to
      the ones found in the rest of patients with shedding of malignant origin, but
      without a clear superiority over the values obtained with CEA. Based on these
      results, we conclude that the usefulness of the determination, as a tumoral
      marker, in pleural fluid, of CA 15-3 is lower than CEA and that its simultaneous
      determination seems not justified. We think that its specific usefulness in
      pleural sheddings secondaries to breast carcinomas deserves a study with a bigger
      sample.

PMID- 1620919
TI  - [Long-term results of endoscopic sphincterotomy in the treatment of
      residual/recurrent choledocholithiasis].
AB  - Endoscopic sphincterotomy is widely accepted as the technique of choice in the
      treatment of residual or recidivant choledocholithiasis since the results
      obtained with this technique are favorable when compared to biliary surgery in
      most series. However, the experience of long term follow up of patients with
      choledocholithiasis in whom this technique would have been applied as the only
      treatment is still scarce up to date. We have studied 40 patients (mean age 65.6
      +/- 11.1 years) with residual or recidivant choledocholithiasis who had undergone
      endoscopic treatment successfully before the 30th of June 1985, who could be
      contacted by a mailed questionnaire or by phone by August 1990. The follow up
      time 70.7 +/- 19.4 months (mean +/- typical deviation). Out of them, 36 (90%) had
      been asymptomatic up to the contact date (30 cases) or up to death due to causes
      not related to biliary pathology (6 patients). Out of the 4 remaining patients, 2
      presented mild dyspepsia and another patient has probably developed recidivant
      choledocholithiasis (according to I.V. cholangiography). The fourth patient
      presented a severe episode of cholangitis and acute pancreatitis, related to a
      new episode of choledocholithiasis and died 5 and a half years after the
      endoscopic sphincterectomy. This represents a 2.5% mortality. These long term
      results of endoscopic sphincterotomy in patients with residual or recidivant
      choledocholithiasis are an other point in favour of using this technique as the
      single treatment of choice in patients above 60 years old.

PMID- 1620920
TI  - [Antibodies against mycobacterial antigens in patients with non-tuberculous
      pathology].
AB  - Antibodies (type IgG) against the A 60 antigen (Mycobacterium bovis, BCG) and an
      antigen of Mycobacterium tuberculosis were studied by ELISA in 79 patients with
      not tuberculous disease: 16 lung carcinoma, 16 hepatic cirrhosis and 47 patients
      with pulmonary disease. 59.5% and 50.6% of the patients showed antibodies against
      antigen A 60 and M. tuberculosis antigen respectively; more 25% were strongly
      positive against antigen A 60; in the patients with lung carcinoma this results
      were 62.5%. It is concluded than when this methods are use in the serologic
      diagnostic of tuberculosis the number of cirrhotic and not tuberculous pulmonary
      disease patients with antibodies against this antigens, obliges a careful study
      of the individual characteristics of each patient, and it is very important
      previously to discard a lung neoplastic pathology.

PMID- 1620921
TI  - [Antiphospholipid antibodies and cerebral infarction].
AB  - The antiphospholipid antibodies syndrome is clinically characterized by the
      presence of thrombosis, repetitive abortions and/or thrombopenia. During the past
      years, thanks to the development of techniques for its detection, its
      relationship with cerebrovascular accidents has become of special interest. Two
      patients with antiphospholipid antibodies and multiple cerebral infarcts are
      presented and the clinical and pathogenic aspects of this association are
      reviewed.

PMID- 1620922
TI  - [Bochdalek hernia with gastric incarceration and volvulus].
AB  - Bochdalek's hernia is infrequent in adults. We communicate the case of a 22 year
      old male that was admitted at hospital because of a thoracic pain of sudden
      onset. In the exploration there was pain in left hypochondrium non tolerating
      decubitus. Thorax radiology showed an "arched" image in left pulmonary base and
      pleural shedding. The patient underwent a surgical procedure in which a great
      gastric herniation was found, which forced a total gastrectomy.

PMID- 1620923
TI  - [Squamous cell carcinoma of the tongue and HIV infection].
AB  - It is reported the case of a 39 year old male, non homosexual, seropositive to
      HIV due to polytransfusion, without AIDS diagnostic criteria and with a severe
      depression in cellular immunity, expressed as lowering in CD4+ T cells, and in
      the CD4+/CD8+ ratio, who showed, without having any risk-factors, a squamous cell
      carcinoma of the tongue. We review the cases reported in the scientific
      literature on the association between squamous-cell carcinoma and AIDS or HIV
      infection.

PMID- 1620924
TI  - [Periodic health examination].
AB  - A literature search has been made on the examinations to be performed during the
      "periodic health exam" on the healthy adult. These examinations shall be
      performed bearing in mind the prevalence and morbility data of the specific
      diseases, individual risk factors and the quality (sensibility and specificity)
      of the diagnostic procedure. The value of regular blood pressure determination,
      breast exam and cervical cytology with Papanicolaou stain, is well established.
      However, there is no consensus regarding other determinations, due to the fact
      that different authors use different approaches. The skin, mouth and thyroid
      examination for cancer screening is limited only to individuals having risk
      factors. Heart auscultation for the diagnosis of valvulopathies that could
      required antibiotic prophylaxis for bacterial endocarditis is important. In
      individuals over sixty years old, vision acuity and hearing capabilities should
      be explored, also abdomen should be explored to detect aortic aneurysms.
      Hypercholesterolemia should be determined in individuals over 20 years old, and
      PPD should be performed before 35 years old. Concerning the rest of explorations
      (rectal taction, testicular exploration, etc.) its efficacy has not been clearly
      established in the screening.

PMID- 1620925
TI  - [New gamut: cavitated pulmonary nodules and localized deformity of the cardiac
      region].

PMID- 1620926
TI  - [Acute pancreatitis of biliary origin].

PMID- 1620927
TI  - [Cryptococcal meningitis in patients with AIDS: combined treatment with
      amphotericin B and fluconazole, and high levels of adenosine deaminase in
      cerebrospinal fluid].

PMID- 1620928
TI  - [Lethal meningitis caused by varicella-zoster virus in a patient with AIDS].

PMID- 1620929
TI  - [Determination of anti-HIV antibodies at the autopsy table].

PMID- 1620930
TI  - [Pulmonary cavity caused by Pneumocystis carinii in an HIV+ patient].

PMID- 1620931
TI  - [Thymic carcinoma: report of a case].

PMID- 1620932
TI  - [Lemierre syndrome--post-angina sepsis].

PMID- 1620933
TI  - [Recurrent alveolar infiltrates: a form of radiologic spontaneous clinical course
      of bronchiolitis obliterans].

PMID- 1620934
TI  - [Brucellosis with pleural involvement].

PMID- 1620935
TI  - [Familial mediterranean fever or the need for an early diagnosis].

PMID- 1620936
TI  - [Chyluria and lymphangioleiomyomatosis].

PMID- 1620937
TI  - [Cutaneous epithelial necrosis in a patient in coma].

PMID- 1620938
TI  - [Octreotide: clinical experience].

PMID- 1620939
TI  - [1991. The year of PET?].

PMID- 1620940
TI  - [A clinical study of human leptospirosis. Apropos 215 cases].
AB  - 215 cases diagnosed of human leptospirosis in the Camaguey Province, Cuba, are
      studied, for the period between 1986 and 1990. The clinical and epidemiological
      features are studied, together with the anatomopathological study of the
      decreased. The most frequent complications and the treatment employed, including
      prophylactic measures, are analyzed. It is concluded that the disease is more
      frequent in young males, from a rural origin and with a farming job. Acute kidney
      failure was the main complication, and as for the therapeutic approach,
      penicillin was the antibiotic of election, prophylactic measures are important,
      specifically vaccination.

PMID- 1620941
TI  - [Kufs' disease. A review of the literature apropos a case].

PMID- 1620942
TI  - [Intraoperative echography as an aid in the therapy of Caroli's disease. A case
      report].
AB  - Congenital polycystic dilatation of the intrahepatic biliary ways (Caroli's
      disease) is a rare disease. The "pure" type and the one associated with
      congenital hepatic fibrosis are accepted. Although the current exploration
      methods, its diagnosis is rare before the surgical procedure. Treatment of the
      diffuse pure types and the ones associated with hepatic fibrosis is difficult and
      the outcome is bad. A case of the less frequent type is communicated, in which,
      as a novelty, intrasurgical echography was used in its treatment.

PMID- 1620943
TI  - [Carney's triad: a short review apropos a case].
AB  - We communicate a case with the Carney triad (gastric leiomyosarcoma, pulmonary
      chondromatosis and extra-adrenal paraganglioma). It is, to our knowledge, the
      first case to be communicated in the Spanish scientific literature. We discuss
      some peculiar aspects of the debut and clinical evolution of this syndrome,
      together with its prognosis. We conclude that in clinical practice, the
      appearance in a young subject, specifically females, of multiple gastric myogenic
      tumors, should elicit the performance of further noninvasive procedures, needed
      to discard the diagnosis of the Carney triad.

PMID- 1620945
TI  - [A man of 68 with infectious endocarditis who died suddenly].

PMID- 1620944
TI  - [An obstruction of a valve prosthesis implanted in the tricuspid position].
AB  - Dysfunction of a prosthesis implanted in tricuspid position is a severe
      complication that may develop with minimal symptoms. A patient who presented
      clinical manifestations of heart failure for two weeks due to obstruction of a
      mechanical prosthesis in tricuspid position is described. Fibrinolytic treatment
      was given unsuccessfully, therefore prosthetic replacement was performed. In the
      removed prosthesis, a fibrotic pannus which developed in the strut and disc was
      seen. We review the clinical manifestations, the diagnosis and treatment of the
      dysfunction of a prosthesis implanted in tricuspid position.

PMID- 1620946
TI  - [Prognostic factors in HIV-infected heroin addicts: a multivariate analysis of
      nonspecific serological factors in the evolution of the infection].
AB  - We present a prognostic analysis of the quantifying of serum levels of beta 2
      microglobulin, neopterina, IL-2 soluble receptor and three major classes of
      immunoglobulins, in a group of 68 heroin-addicts infected by the human immune
      deficiency virus, type I, clinically assessed for a period of at least three
      years. High levels of any of these unspecific serologic factors were correlated
      with the illness progression. Survival curves were generated with the categorized
      variables, showed a significant decrease on the time interval prior to the
      diagnosis of AIDS, in the patients with these variables assigned on the higher
      groups, being neopterine and IgA the more predictive factors when the Cox
      proportional regression model is applied. We conclude that the quantifying of
      these unspecific serum factors provides a useful information regarding the
      clinical evolution of heroin-addicts with HIV infection.

PMID- 1620947
TI  - [A fever syndrome of long evolution as the first manifestation of secondary
      syphilis].

PMID- 1620948
TI  - [Leukocytoclastic vasculitis and acute cardiorespiratory insufficiency].

PMID- 1620949
TI  - [Spontaneous rupture of the spleen in infectious mononucleosis].

PMID- 1620950
TI  - [Listeria monocytogenes: the cause of cholangitis in a liver transplant?].

PMID- 1620951
TI  - [A cerebral infarct as the initial manifestation of hypertrophic cardiomyopathy
      in a young patient].

PMID- 1620952
TI  - [An idiopathic segmental infarct of the greater omentum: a new case with massive
      hemoperitoneum].

PMID- 1620953
TI  - [Marchiafava-Bignami disease with a favorable clinical evolution].

PMID- 1620954
TI  - [Hypophyseal apoplexy simulating a parasellar aneurysm].

PMID- 1620955
TI  - [Temporal arteritis with involvement of the subclavian arteries].

PMID- 1620956
TI  - [Mixed community-acquired pneumonia due to anaerobic bacteria].

PMID- 1620957
TI  - [An intracranial epidural abscess].

PMID- 1620958
TI  - The effect of experimental infection with Corynebacterium pseudotuberculosis on
      reproduction in adult ewes.
AB  - Fifteen ewes were inoculated subcutaneously with 2 x 10(6) cells of
      Corynebacterium pseudotuberculosis seven days before mating, during the embryonic
      stage of gestation and during the fetal stage of gestation. The clinical signs,
      antibody response and the consequences of the infection on reproduction were
      studied. None of the ewes showed any change in general condition during
      pregnancy. The effects of experimental infection during gestation were evident
      after incubation periods that ranged from 25 to 140 days after inoculation and
      were dependent on the time of the inoculation in relation to the period of
      gestation. Ewes inoculated before gestation can resolve infection. Ewes
      inoculated during the embryonic stage were severely affected and some aborted. In
      others lambs were stillborn or, if born alive, infected. Ewes inoculated during
      the fetal stage of gestation did not show reproductive disorders although some
      remained chronically infected.

PMID- 1620959
TI  - Bioassay of bovine interleukin-1-like activity.
AB  - A bioassay for bovine interleukin-1 (IL1) activity is described. The assay is
      based on the IL1-stimulated proliferation of a mouse T-lymphocyte cell line,
      D10(N4)M. Bovine mononuclear cells stimulated with lipopolysaccharide produce an
      interleukin-1-like activity which stimulated the growth of the D10(N4)M cell line
      in a dose-dependent manner. The stimulatory activity was neutralised by a
      combination of both anti-human IL1 alpha and anti-human IL1 beta sera. The
      quantity of IL1-like activity released from the mononuclear cells increased
      asymptotically with increasing lipopolysaccharide dose.

PMID- 1620960
TI  - Aetiopathogenesis of canine elbow osteochondrosis: a study of loose fragments
      removed at arthrotomy.
AB  - Twenty-five ununited coronoid processes (UCP) and 24 osteochondritis dissecans
      (OD) flaps were examined by light and transmission electron microscopy.
      Chondrocytes showed degenerative changes but remained viable and continued to
      secrete matrix components, even though the organisation of the matrix was
      altered. Differences in the histological and ultrastructural appearance of the
      two lesions tend to suggest that they are two separate disease entities, although
      they may occur together in the same joint. It is hypothesised that OD results
      from incorrect cartilage maturation and endochondral ossification. The aetiology
      of UCP is unclear but there is a possibility of its being a subchondral fracture,
      with an ineffective fibrous repair in some cases.

PMID- 1620961
TI  - Comparative studies on N'Dama and zebu cattle following repeated infections with
      Trypanosoma congolense.
AB  - Twenty N'Dama and eight zebu cattle were inoculated intradermally with
      bloodstream forms of a cloned strain of Trypanosoma congolense originating from
      East Africa. All inoculated cattle became parasitaemic. Zebus showed consistently
      higher levels of parasitaemia and lower packed red cell volume (PCV) percentages
      than did N'Damas. Three of the eight zebus required treatment when high numbers
      of trypanosomes were present in the blood and PCV values dropped below 15 per
      cent. None of the N'Dama cattle needed treatment. Statistical analysis was
      performed on the data to assess the variability of parasitaemia and PCV levels
      before and during infection of the N'Dama cattle. The variation in PCV values was
      large between individuals during the early stages of the disease and diminished
      as infection continued. After trypanocidal drug treatment and a recovery period
      of 14 months, the same animals were inoculated intradermally with T congolense
      bloodstream forms isolated and cloned in The Gambia. Differences in
      susceptibility to the ensuing disease were apparent when comparing N'Dama and
      zebu cattle. Five zebu cattle needed trypanocidal drug treatment, while none of
      the N'Damas needed drug intervention. Ranking the 20 infected N'Damas according
      to average PCV levels revealed that the animals responded similarly to both
      infections.

PMID- 1620962
TI  - Comparison of the pathogenicity for pregnant sheep of Rift Valley fever virus and
      a live attenuated vaccine.
AB  - A live attenuated mutant of Rift Valley fever virus, MV P12, was previously shown
      to be non-pathogenic in young lambs, but capable of producing protective
      immunity. The studies reported here show that the abortion in sheep caused by an
      infection with virulent virus is the result of necrosis of the maternal villi and
      cotyledons arising from an acute inflammation of the maternal caruncles. Pregnant
      ewes infected with the attenuated mutant virus MV P12 showed none of these
      lesions in the placenta and gave birth to healthy lambs. Colostrum from ewes
      infected with MV P12 virus was able to induce protective immunity in the
      offspring. These data along with previously published results suggest that the
      mutant virus MV P12 is an excellent candidate for use as a live attenuated
      veterinary vaccine.

PMID- 1620963
TI  - Epidermal and hepatic glucocorticoid receptors in cats and dogs.
AB  - Low capacity, high affinity [3H] dexamethasone binding receptors were identified
      in cytosolic preparations of liver (mean number 45 +/- 10.1 fmol mg-1 protein,
      apparent dissociation constant 0.4 +/- 0.1 nM) and skin (mean number 46.4 +/-
      23.8 fmol mg-1 protein, apparent dissociation constant 1 +/- 0.2 nM) of
      clinically normal dogs. For clinically normal cats, approximately half these
      numbers of receptors with a lower affinity, were detected in liver (mean number
      23.1 +/- 10.4 fmol mg-1 protein, apparent dissociation constant 3.2 +/- 0.9 nM)
      and skin (mean number 23.90 +/- 10.9 fmol mg-1 protein, apparent dissociation
      constant 2.2 +/- 1.5 nM). This difference between dogs and cats in [3H]
      dexamethasone binding receptors may contribute to the relative glucocorticoid
      resistance observed in cats.

PMID- 1620964
TI  - Cardiovascular response to acute hypoxia in double-muscled calves.
AB  - Hypoxic-induced pulmonary hypertension is known to be intensive in the bovine
      species and sometimes leads to pathological cardiac repercussions. On the other
      hand, doubled-muscled cattle are predisposed to develop hypoxaemia during
      exercise and with respiratory diseases. Therefore the purpose of this study was
      to investigate the cardiovascular response to acute hypoxia in double-muscled
      calves compared with calves of standard conformation. Pulmonary arterial
      pressure, electrocardiogram and blood temperature were simultaneously recorded,
      arterial blood was sampled for blood gas analysis and cardiac output was
      determined in six Friesian calves and six double-muscled calves of the Belgian
      White and Blue breed(BWB) when breathing air (fractional inspiratory oxygen
      concentration [FIO2]: 21 per cent) and when breathing a hypoxic gas mixture
      (FIO2: 10 per cent). All the absolute values of the measured parameters were
      significantly (P less than or equal to 0.001) different between the two breeds,
      except heart rate and arterial blood gas values. The pattern of hypoxic-induced
      decrease in arterial PO2 was similar in the two breeds of calves, suggesting that
      the pulmonary exchange capacities during hypoxia are no less efficient in double
      muscled calves than in calves of standard conformation. Similarly, the percentage
      of variation of the mean pulmonary arterial pressure from its normoxic to its
      hypoxic value was the same in the two breeds of calves, suggesting that double
      muscled calves are not predisposed to develop a more precocious or more intense
      pulmonary hypertension for a given level of hypoxaemia. The significantly smaller
      normoxic and hypoxic cardiac index and stroke index found in BWB compared with
      Friesian calves was interpreted as a less efficient cardiac function in double
      muscled subjects.

PMID- 1620965
TI  - Bovine spongiform encephalopathy: case-control studies of calf feeding practices
      and meat and bonemeal inclusion in proprietary concentrates.
AB  - Following the identification of meat and bonemeal as the most likely source of
      exposure for the occurrence of bovine spongiform encephalopathy (BSE) in Great
      Britain case-control studies were initiated to investigate this hypothesis. These
      involved a comparison of the consumption of specific proprietary calf feedstuffs,
      and whether or not meat and bonemeal had been included, between animals born in
      1983-84 in BSE-unaffected herds and confirmed cases of BSE also born in 1983-84.
      The feeding of proprietary concentrates containing meat and bonemeal was found to
      be a statistically significant risk factor for the occurrence of BSE. These
      studies therefore support the initial hypothesis that BSE occurred as a result of
      exposure to a scrapie-like agent via meat and bonemeal.

PMID- 1620966
TI  - Bovine spongiform encephalopathy: detection of fibrils in the central nervous
      system is not affected by autolysis.
AB  - The effect of autolysis on the electron microscopic detection of the
      characteristic abnormal fibrils, originally called 'scrapie-associated fibrils',
      was investigated in four different areas of the central nervous system (CNS) from
      10 clinically suspect BSE cattle after post mortem delay and compared with the
      histopathological diagnosis. The tissues for fibril detection were subjected to
      controlled incubations to simulate autolysis. Fibril detection in all areas
      sampled from nine animals in which BSE was confirmed by histopathology was not
      affected by combined post mortem delays and specific controlled treatments.
      Detection of fibrils from the cervical spinal cord was no less sensitive than
      from brain areas. Fibrils were not detected in the one suspect case in which
      histopathology did not reveal lesions of BSE. The study confirms that fibril
      detection is of diagnostic value in BSE when post mortem autolysis renders CNS
      material unsuitable for histopathology.

PMID- 1620967
TI  - Effect of pantothenic acid on disposition kinetics and tissue residues of
      sulphadimidine in chickens.
AB  - Sulphadimidine was administered to chickens via the intracrop route to determine
      plasma concentrations of the unchanged sulphonamide and its acetylated
      derivatives, kinetic disposition, tissue residues and acetylation. The
      sulphadimidine was given alone (group 1) at a dose of 200 mg kg-1 bodyweight.
      Pantothenic acid was given via the intracrop route at a dose of 100 mg kg-1
      bodyweight one hour before (group 2) and six hours after (group 3) sulphadimidine
      administration (200 mg kg-1 bodyweight intracrop). The highest plasma
      concentrations of sulphadimidine in groups 1, 2 and 3 were reached in 1.73, 1.62
      and 1.71 hours, respectively, following intracrop administration. In birds of
      groups 1, 2 and 3 no sulphadimidine was detected at 72, 24 and 48 hours,
      respectively, following its administration. Estimation of sulphadimidine in most
      of the body tissues revealed that all tissues examined had lower concentrations
      than plasma. In chickens given pantothenic acid (groups 2 and 3) before and after
      sulphadimidine administration, an increase in the concentration of N4 acetylated
      derivatives of sulphadimidine was observed compared with birds given
      sulphadimidine alone (group 1).

PMID- 1620968
TI  - Interleukin-1 stimulation of equine articular cells.
AB  - Prostaglandin E2 (PGE2) and stromelysin are produced by equine chondrocytes and
      synovial cells in vitro in response to recombinant human (rh) interleukin-1 (IL
      1) alpha and beta, and equine mononuclear cell supernatants (MCS) containing IL
      1. However, culture conditions are important. PGE2 concentrations increase in
      proportion to the concentration of fetal calf serum (FCS) in the culture medium,
      whereas stromelysin concentrations are inversely proportional to the
      concentration of FCS. Equine MCS, containing a lower concentration of IL-1 than
      the concentration of rhIL-1 used in these experiments, stimulated production of
      much higher levels of PGE2 than rhIL-1. In addition, equine MCS induced the
      production of broadly similar levels of PGE2 by both chondrocytes and synovial
      cells, whereas rhIL-1 was more active on equine synovial cells than equine
      chondrocytes. Although equine MCS induced both stromelysin and PGE2 production by
      equine articular cells, on the whole rhIL-1 failed to induce stromelysin
      production. This supports previous observations of species restrictions in the
      activity of human IL-1 on equine cells. Therefore, experiments using mammalian
      cells and heterologous IL-1 should be interpreted with caution.

PMID- 1620969
TI  - Cortisol binding capacity of corticosteroid binding globulin in
      hyperadrenocorticoid and healthy dogs.
AB  - Corticosteroid binding globulin (CBG) binding capacity and plasma cortisol
      concentration were determined in 27 dogs with hyperadrenocorticism and in 17
      healthy control dogs. Cortisol concentrations were significantly higher in
      hyperadrenocorticoid dogs than in controls. CBG binding capacity did not differ
      between the two groups. It is concluded that excessive endogenous cortisol
      secretion does not induce an increase in CBG binding capacity. Consequently, the
      determination of CBG binding capacity provides no additional information for the
      diagnosis of canine Cushing's syndrome.

PMID- 1620970
TI  - Reciprocal translocation (13;20)(q12;q22) in an Icelandic sheep.
AB  - Cytogenetic examination of G-banded lymphocyte chromosomes of an Icelandic ram
      from a line with a history of poor fertility revealed a rcp (13;20) (q12;q22)
      translocation. Meiotic studies showed a quadrivalent configuration at diakinesis
      and this was confirmed by C-banding.

PMID- 1620971
TI  - Total venous inflow occlusion in the normothermic dog: a study of haemodynamic,
      metabolic and neurological consequences.
AB  - The acute haemodynamic and metabolic repercussions of total venous inflow
      occlusion were evaluated in six normal dogs, each of which underwent two four
      minute occlusions and one eight minute occlusion at normothermia. A further three
      dogs underwent a single eight minute period of occlusion and were allowed to
      recover from anaesthesia. Total venous inflow occlusion was well tolerated by all
      animals. They remained in sinus rhythm at the completion of occlusion, and
      unassisted haemodynamic recovery occurred rapidly. Recovery was quicker after
      four minutes than after eight minutes. There was no clinically detectable
      neurological impairment in three dogs which were allowed to recover.

PMID- 1620972
TI  - A new technique for surgery of the caudal vena cava in dogs using partial venous
      inflow occlusion.
AB  - The haemodynamic and metabolic effects of caudal vena cava occlusion were
      evaluated in six normal anaesthetised dogs. Each animal underwent a single eight
      minute episode of caudal vena cava occlusion. The procedure was well tolerated by
      all the dogs. Systolic arterial pressure was reduced by 62 +/- 5 per cent and the
      heart rate increased by 11 +/- 3 per cent. There was rapid haemodynamic recovery
      after the release of occlusion, all cardiovascular parameters returning to normal
      spontaneously within five minutes. Caudal vena cava occlusion is therefore safe
      for periods of up to eight minutes in normal dogs. This technique allows repair
      of caudal vena caval lesions without necessitating systemic heparinisation and
      the use of cavoatrial conduits.

PMID- 1620973
TI  - Effect of feed type on the pharmacokinetic disposition of oxfendazole in sheep.
AB  - The plasma concentration profiles of oxfendazole (OFZ), fenbendazole (FBZ) and
      FBZ sulphone (FBZ.SO2) were measured followed intraruminal administration of OFZ
      at 5 mg kg-1 to Merino weaners fed either dry forage or grazed on pasture lucerne
      clover. Plasma concentrations of OFZ and FBZ were significantly lower in sheep
      given the dry forage.

PMID- 1620974
TI  - A disc ELISA for the detection of Salmonella group D antibodies in poultry.
AB  - An ELISA using lipopolysaccharide antigens prepared from Salmonella gallinarum
      and S enteritidis was developed for the serological diagnosis of fowl typhoid and
      S enteritidis infection in poultry. There was good agreement between the results
      of the ELISA and conventional serological tests when samples from naturally
      infected birds and S enteritidis immunised birds were tested. Some cross
      reactions were observed when serum samples from S typhimurium infected birds were
      tested by ELISA. Subsequently a disc ELISA, using filter paper discs, was
      developed to facilitate sampling and testing of poultry. There was good
      correlation between the results of the disc and serum ELISAs and the test is
      recommended for the field testing of birds.

PMID- 1620975
TI  - Neuromata in docked lambs' tails.
AB  - Docked and undocked lambs tails obtained after slaughter were examined grossly
      and histopathologically. Stump and complex neuromata were identified in docked
      tails.

PMID- 1620976
TI  - Penetration of tinidazole into the gingival crevicular fluid in dogs.
AB  - Tinidazole was administered as a single oral dose of 15 mg kg-1 to 12 dogs, and
      its concentration in the plasma and gingival crevicular fluid (GCF) was measured
      at one and two hours by high performance liquid chromatography. Tinidazole was
      detectable in GCF in five dogs at one hour (6.8 +/- 2.6 micrograms ml-1) and in
      six dogs at two hours (9.2 +/- 1.4 micrograms ml-1) and in all plasma samples. In
      those animals with no detectable tinidazole in GCF, either the concentration of
      tinidazole in plasma was low or the volume of the GCF sample was insufficient for
      determination. The observed tinidazole levels in GCF exceeded the minimal
      inhibitory concentration values for most anaerobic oral bacteria.

PMID- 1620977
TI  - Effect of a M1-selective muscarinic receptor antagonist (pirenzepine) on basal
      bronchomotor tone in young women.
AB  - To examine the role of muscarinic M1-receptors in vagally mediated basal
      bronchomotor tone, we studied the effects of inhaled pirenzepine, which is a M1
      receptor antagonist, on basal bronchomotor tone in 8 young women. To obtain dose
      response curves to inhaled pirenzepine, we measured partial and full flow-volume
      curves before and 30 min after inhalation of each concentration of pirenzepine
      (3.25-200 micrograms/ml). Maximum expiratory flow on partial flow-volume curve at
      25% forced vital capacity (PEF25) was measured as an index showing basal
      bronchomotor tone. The dose-response curve of the percent increase in PEF25 by
      pirenzepine was biphasic in shape. PEF25 was significantly increased by 3.12
      (14.5 +/- 5.8%), 6.25 (15.5 +/- 4.2%), 12.5 (20.0 +/- 0.29%) and 200
      micrograms/ml (17.3 +/- 5.9%) of pirenzepine, but not by 25 (9.6 +/- 5.6%), 50
      (9.4 +/- 6.2%) and 100 micrograms/ml (14.4 +/- 6.2%) of pirenzepine. The percent
      increase in PEF25 by 40 micrograms of ipratropium bromide was 66.2 +/- 14.2%.
      These results suggest that the role of M1-receptors in vagally mediated basal
      bronchomotor tone may be significant but little compared with M3-receptors in
      normal humans.

PMID- 1620978
TI  - Effect of histamine treatment on dopamine tachyphylaxis of canine tracheal smooth
      muscle.
AB  - In order to understand how histamine-sensitized airways may react to exogenous
      dopamine, we investigated the effect of histamine treatment on the dopamine
      induced contractions of canine tracheal smooth muscle. The results showed that
      preconstricting muscle strips with histamine (10(-6) M to 10(-4) M) not only
      increased the amplitude of dopamine-induced contraction, but also lowered the
      concentration of dopamine required to provoke contraction from 10(-4) M to 10(-6)
      M. In muscle strips desensitized by repeated challenges of 10(-3) M dopamine, a
      15-min treatment with 10(-4) M histamine transiently restored the response. The
      restored contractions were decreased by the dopaminergic antagonist, domperidone,
      and the alpha 2-adrenoceptor antagonist, yohimbine, and increased by the beta 1
      adrenoceptor antagonist, atenolol. It is concluded that in addition to its role
      in mediating airway constriction, histamine can promote and enhance the
      contractile response of canine tracheal smooth muscle to dopamine. Histamine
      treatment restored the dopamine response of desensitized tracheal muscle with
      resensitization of the adrenoceptors.

PMID- 1620979
TI  - Case report of desquamative interstitial pneumonia: documentation of preserved
      pulmonary function after twelve clinical relapses.
AB  - We describe a case of desquamative interstitial pneumonia diagnosed in a 25-year
      old woman who relapsed 12 times during a 20-year follow-up period. In each
      relapse, the involved sites were different and the patient ultimately recovered
      without resultant pulmonary ventilatory defects. Bronchoalveolar lavage performed
      during the 12th relapse revealed a remarkable increase in the number of total
      cells and showed a low CD4+/CD8+ ratio in the lymphocyte subset.

PMID- 1620980
TI  - Wegener's granulomatosis--treatment under revision?
AB  - A 44-year-old man with nasal and respiratory symptoms combined with positive
      serum antibodies to neutrophil cytoplasmic antigens (ANCA) suggestive of
      Wegener's granulomatosis was treated with antibacterial agents. Complete clinical
      response was achieved with co-trimoxazole, and the titer of ANCA declined. After
      a 12-month treatment period, the patient contracted fever and respiratory
      symptoms and fatigue again, and he had proteinuria and hematuria. After the
      institution of conventional treatment with oral prednisolone and
      cyclophosphamide, a favorable response was achieved. Wegener's-like
      granulomatosis is difficult to diagnose at its early stage, but the presence of
      ANCA may be helpful. We suggest that co-trimoxazole should be considered as a
      first-line treatment, under careful supervision, for young patients whose disease
      is limited to the respiratory organ.

PMID- 1620981
TI  - Leukemic pneumonitis as a poor prognostic factor in chronic myelomonocytic
      leukemia.
AB  - We report the case of a 69-year-old man with chronic myelomonocytic leukemia
      (CMML) that was complicated by fatal respiratory failure. Bilateral pulmonary
      infiltrates were demonstrated by chest roentgenograms and worsened with an
      increase in the leukocyte count. Postmortem examination confirmed the presence of
      leukemic monocyte infiltration of the pulmonary interstitial spaces. In CMML with
      marked monocytosis, respiratory failure may be one of the important causes of
      death in addition to infection and bleeding.

PMID- 1620982
TI  - A case of bronchiolitis obliterans organizing pneumonia associated with primary
      Sjogren's syndrome who died of superimposed diffuse alveolar damage.
AB  - Bronchiolitis obliterans organizing pneumonia (BOOP) developed in association
      with primary Sjogren's syndrome in a 69-year-old female. She died of diffuse
      alveolar damage superimposed on BOOP in spite of corticosteroid therapy.

PMID- 1620983
TI  - A case of cyclophosphamide-induced interstitial pneumonitis diagnosed by
      bronchoalveolar lavage.
AB  - A successfully treated case of cyclophosphamide pneumonitis, which developed
      during treatment for a leukemic phase of B-cell non-Hodgkin's lymphoma, is
      documented. Subtyping of lymphocytes in the peripheral blood and the
      bronchoalveolar lavage fluid easily excluded a possible diagnosis of pulmonary
      involvement of lymphoma. Bronchoalveolar lavage is a useful approach to determine
      the correct etiology of pneumonitis.

PMID- 1620984
TI  - Nonvagal modulation of hypoglossal neural activity.
AB  - Upper airway dilating muscle activity is characterized by an early-peaking
      pattern which serves to dilate or stiffen the upper airway at the time when the
      greatest negative intraluminal pressure is generated by contraction of chest wall
      muscles. This pattern has been attributed to phasic afferent inputs from
      pulmonary stretch receptors. The present study examines the hypothesis that
      nonvagal factors may also influence the discharge pattern and coordination of
      upper airway and chest wall muscle activities. Therefore, in anesthetized,
      paralyzed, vagotomized and artificially ventilated cats, we examined the effects
      of changes in respiratory drive produced by activation of cholinergic and GA
      BAergic (gamma-aminobutyric acid) receptors at the ventrolateral aspects of the
      medulla oblongata on phasic intrabreath discharge patterns of hypoglossal and
      phrenic nerves. Cholinergic agents (acetylcholine, carbachol, methacholine,
      physostigmine) applied directly to chemoreceptive areas on the ventral medullary
      surface increased hypoglossal activity, and in addition converted inspiratory
      discharge from an augmenting to a decrementing pattern of activity. The reverse
      effect on the discharge pattern of hypoglossal activity was observed with a
      decrease in respiratory drive. While the amplitude of the phrenic nerve discharge
      was also affected by these interventions, the augmenting discharge pattern of
      phrenic nerve activity did not change. These results suggest that the early
      peaking pattern of hypoglossal nerve discharge in vagotomized cats also depends
      on the level of respiratory drive, and is not solely dependent on vagal afferent
      inputs. In addition, the data suggest that structures near the ventral surface of
      the medulla are influential in shaping the pattern of hypoglossal nerve activity
      and maintaining balanced activity of upper airway and chest wall muscles.

PMID- 1620985
TI  - Inhibition of mouse alveolar macrophage production of tumor necrosis factor alpha
      by acute in vivo and in vitro exposure to tobacco smoke.
AB  - We investigated the effects of tobacco smoke exposure on the production of tumor
      necrosis factor alpha (TNF alpha) by alveolar macrophages (AM) in mice (C57BL/6).
      The results obtained are as follows: (1) In vivo tobacco smoke exposure caused a
      significant decrease in the production of TNF alpha by AM with the stimulation of
      lipopolysaccharide (LPS; control group: 19.32 +/- 5.52 U/ml, smoked group: 4.28
      +/- 0.98 U/ml; p less than 0.05). (2) In vitro exposure of AM to tobacco smoke
      extracts (water-soluble extracts) also caused a decrease in the production of TNF
      alpha up to 93% of control with stimulation of LPS (p less than 0.05) without any
      decrease in cellular viability. We concluded that the production of TNF alpha by
      AM was impaired by smoking via direct action of the factors present in tobacco
      smoke.

PMID- 1620986
TI  - Analysis of respiratory impedance characteristics in chronic bronchitis.
AB  - Impedance measurements of the respiratory system were performed by means of the
      technique of forced oscillations to study the mechanical characteristics of the
      respiratory system in 33 patients with chronic bronchitis without spirometric
      evidence of airway obstruction (FEV1 greater than or equal to 70% predicted). In
      23 patients (69.7%) impedance was found to be abnormal. Inhalation of a beta 2
      adrenergic drug (terbutaline) resulted in acute reversibility of these findings.
      In the 10 patients (30.3%) with a normal baseline respiratory impedance,
      isocapnic hyperventilation with cold air resulted in impedance characteristics
      similar to the abnormalities spontaneously occurring in the other group. These
      changes were found to be completely reversible after the inhalation of
      terbutaline. On the basis of these findings we conclude that impedance
      measurements of the respiratory system by means of the technique of forced
      oscillations allow the determination of mechanical airway abnormalities in
      patients with chronic bronchitis.

PMID- 1620987
TI  - Influences of the cellular and humoral immune system in bronchoalveolar lavage on
      lung function in pulmonary sarcoidosis.
AB  - We investigated the changes in the cellular and humoral immune system in
      bronchoalveolar lavage (BAL) performed in 22 patients with pulmonary sarcoidosis
      and in 14 normal control subjects and their interactions with lung function
      parameters. Lymphocytosis, the increase in OKT4+ lymphocytes and OKT4+OKDR+
      lymphocytes correlated with the increase in immunoglobulins, especially IgG, IgA
      and kappa chain assembled immunoglobulins. The transferrin levels obtained in BAL
      were found to be higher in patients with sarcoidosis, and they correlated with
      the cellular and, more closely, with other humoral findings. A negative
      correlation existed between the ventilatory parameters and the cell count and
      humoral findings. In addition, we found a negative correlation between the
      diffusing capacity for carbon monoxide and other cellular findings, which was
      most pronounced with reference to lymphocytes, OKT4+ lymphocytes and the
      OKT4+/OKT8+ ratio. These results underscore the role of OKT4+ lymphocytes,
      activated OKT4+OKDR+ lymphocytes and transferrin in the increase in
      immunoglobulins, mainly kappa chain isotypes. Because of the relationship between
      these changes and ventilatory parameters, and the diffusing capacity, the above
      results also reveal the clinical relevance of our findings.

PMID- 1620988
TI  - Herpes zoster in patients with sarcoidosis.
AB  - 108 patients with sarcoidosis were retrospectively studied for the development of
      herpes zoster. Five of these patients (4.6%), 2 of whom were in their twenties,
      developed herpes zoster. Only 1 patient had been treated with an oral steroid.
      All 5 had extrathoracic lesions. Zoster tended to occur during the inactive stage
      of sarcoidosis and did not exacerbate the activity of the sarcoidosis. The
      clinical course of their zoster infection was typically benign. There have been
      few reports of herpes zoster in patients with sarcoidosis. Further studies are
      required to determine whether sarcoidosis predisposes to herpes zoster infection.

PMID- 1620989
TI  - [Molecular and cellular biology in the bronchopulmonary development].

PMID- 1620990
TI  - [Coronary thrombolysis in patients with acute myocardial infarction].

PMID- 1620991
TI  - [Non-invasive pulmonary function tests].

PMID- 1620992
TI  - [Epidemiology and biostatistics in medical research. 4. Validity, reliability,
      and multiple comparison].

PMID- 1620993
TI  - [P0.1 as an indicator for weaning].

PMID- 1620994
TI  - [Heart diseases in the elderly. (1) Treatment of cardiac arrhythmia in the
      elderly].

PMID- 1620995
TI  - [Early diagnosis of the site of infarction and the infarct-related coronary
      artery in patients with acute inferior myocardial infarction].
AB  - We evaluated the site and infarct-related arteries from electrocardiograms (ECGs)
      recorded early after the onset in cases of inferior infarction (IMI). The
      subjects were 80 patients with IMI admitted within 6 hours from the onset. We
      analyzed the ECGs on admission, at 24 hours, at 4 weeks. All patients underwent
      ventriculography and coronary angiography at 4-6 weeks from the onset. Regional
      wall motion and ejection fraction (FF) were measured. The infarct-related artery
      was decided on by the site of the asynergy. Patients were allocated into 2 groups
      according to the infarct-related artery; ie right (RCA, n = 52) and left
      circumflex (LCX, n = 52). Parameters measured were leads showing ST elevation (ST
      increases), width of R waves and R/S ratio in V1,2. Amplitude of U waves in V1-3.
      We defined U greater than or equal to 0.5mm as abnormal (GU). A significantly
      greater number of patients with GU showed asynergy in posterolateral and
      posterobasal segments compared to those without GU. The EF was significantly
      lower in patients with GU. As to the infarct-related arteries, a significantly
      greater number of patients with LCX disease showed concomitant posterior
      infarction (PMI) than those with RCA disease. Also a significantly greater number
      of those with LCX disease showed GU and ST increases in V5,6 than those with RCA
      disease. Therefore, we conclude that GU in V1-3 is a new marker suggesting
      posterolateral and posterobasal damage, and GU in V1-3, ST increases in V5,6 and
      electrocardiographic PMI are specific markers for the diagnosis of LCX related
      infarction.

PMID- 1620997
TI  - [Usefulness of magnetic resonance imaging (MRI) in evaluation of left ventricular
      apical aneurysm].
AB  - Twenty three consecutive cases of left ventricular aneurysm due to antero-septal
      myocardial infarction in normal sinus rhythm were studied to decide whether or
      not magnetic resonance imaging (MRI) can evaluate aneurysm of the left
      ventricular apex. The apex, as well as the base, of the left ventricle was
      clearly imaged in 21 out of 23 cases. Poor images were obtained in two cases who
      showed frequent premature ventricular beats during this procedure. Two
      dimensional echocardiography has weak points when visualizing left ventricular
      apex because, for one thing, the sector angle is maximally 90 degrees, and for
      another, the cardiac apex is too near the probe for observation of the
      characteristic of the left ventricular apical wall. However, MRI can make up for
      the above weak points and can provide supportive information by visualizing the
      entire left ventricular apex.

PMID- 1620996
TI  - [Extravascular thermal volume in pulmonary emphysema].
AB  - The extravascular thermal volume of the lung (ETVL) was measured by the heat
      sodium double indicator dilution technique in 10 patients with chronic pulmonary
      emphysema. ETVL was 4.99 +/- 1.23 ml/kg, and correlated significantly with TLC(r
      = 0.747), %VC(r = 0.664), PaO2(r = 0.779), AaDO2(r = -0.796), shunt ratio(r = 
      0.7), and total pulmonary vascular resistance(r = 0.698). ETVL tended to decrease
      with the progression of the severity of emphysema as assessed by computed
      tomography. These results suggest that 1) the extravascular thermal volume
      decreases in chronic pulmonary emphysema parallel with an increase in the
      severity of the complaint, and that 2) the decrease of extravascular thermal
      volume may reflect a decrease in the size of the pulmonary capillary bed. It is
      concluded that the measurement of extravascular thermal volume may be useful for
      the evaluation of the severity of pulmonary emphysema.

PMID- 1620998
TI  - [Hypertrophic cardiomyopathy with rapid development of giant negative T-wave
      within a year: a case report].
AB  - A 61-year-old female was admitted to our hospital, presenting hypertension and
      giant negative T-wave (GNT) on an electrocardiogram (ECG). The ECG taken one year
      prior to the admission showed left ventricular hypertrophy (LVH) without GNT.
      Hypertension had been poorly treated during the year previous to her admission.
      These had been almost no administration of antihypertensive drugs.
      Echocardiograms, left ventriculograms and magnetic resonance imaging revealed
      concentric and diffuse LVH. Endomyocardial biopsy of bilateral ventricles
      disclosed a degeneration of myocytes and their bizarre hypertrophy with
      disorganization. This pathologic finding was compatible with that of hypertrophic
      cardiomyopathy (HCM). Although GNT has frequently been noted in apical type of
      HCM, the alteration from normal T-wave to GNT within a year has rarely been
      reported. The present case exhibited GNT on an ECG which showed no apical
      hypertrophy. Since GNT had developed within a year while hypertension was poorly
      treated, the rapid development of GNT might have been precipitated by
      hypertension, which possibly altered the hypertrophic pattern of the left
      ventricle.

PMID- 1620999
TI  - [A case of successful repair of aorto-pulmonary artery fistula secondary to
      aortic arch aneurysm].
AB  - A report of a rare case of successful repair of rupture of an aortic aneurysm
      into the pulmonary artery. A 55-year-old male was transferred to our hospital
      because of dyspnea with sudden onset, hemoptysis and palpitation. A loud,
      continuous, "machine-like" murmur was heard on the anterior wall of the chest.
      Various examinations revealed an acquired shunt between the thoracic aortic
      aneurysm and the pulmonary artery and high-output heart failure. Aortic arch
      replacement was performed expeditiously and the patient recovered, and was able
      to return to work. 108 cases of rupture of a thoracic aortic aneurysm into the
      pulmonary artery have been reported in the literature. Operation for repair was
      performed in only thirteen of these. Only four cases have been reported in the
      literature in which the patients were successfully treated.

PMID- 1621000
TI  - [A case of atrial standstill associated with combined valvular disease].
AB  - A 62-year-old man was admitted to our hospital because of general malaise. The
      chest X-ray film showed severe cardiomegaly (CTR = 81%). The electrocardiogram
      demonstrated absence of P wave in 12-leads and regular junctional rhythm with
      incomplete right bundle branch block. Echocardiogram and color Doppler led to the
      diagnosis of mitral stenosis and regurgitation, tricuspid regurgitation with
      enlarged left and right atrium. Cardiac catheterization study revealed elevation
      of the pulmonary artery wedge pressure and the right atrial pressure without A
      wave. In the electrophysiologic study, no atrial electrical activity was recorded
      in the right atrium and the coronary sinus. However, when atrial pacing was
      attempted at multiple sites with stimulum strength of 10 V, there was no atrial
      activity at various sites. We considered that the atrial overload due to combined
      valvular disease for seventeen years had resulted in total and persistent atrial
      standstill. In this report, we discussed atrial standstill in 67 cases recorded
      in the medical literatures in our country.

PMID- 1621001
TI  - Current research in side effects of high-dose chemotherapy.
AB  - The toxicities of chemotherapy continue to hamper dose escalation of specific
      chemotherapeutic agents. The impact of dose intensification upon survival will be
      assessed as clinical studies continue. Strategies to support chemotherapy dose
      intensification include BMT, use of CSFs and antiemetic drug combinations.
      Advances in symptom management will hopefully enhance quality of life for
      patients, whereas the development of chemoprotectant agents may allow specific
      organ toxicities to be avoided.

PMID- 1621002
TI  - Chemotherapy-induced myelosuppression.
AB  - Chemotherapy-induced myelosuppression is the most common dose-limiting and
      potentially fatal complication of cancer treatment. Prior attempts to lessen
      chemotherapy-induced myelosuppression have been minimally effective. The new
      hematopoietic growth factors show promise, especially for patients requiring
      intensely myelotoxic chemotherapy. However, a cautious approach should be used
      with growth factors because their clinical uses and how best to apply each use
      needs to be defined.

PMID- 1621003
TI  - Chemotherapy and pregnancy.
AB  - There are still unanswered questions concerning long-term effects of intrauterine
      exposure to antineoplastics. It is possible that a mechanism of follow-up such as
      a national registry could be formalized. Although pregnancy in the women with
      cancer is a rare event, it may occur more frequently in the future. The nurse
      must be knowledgeable concerning the issues in decision-making and confident in
      his or her ability to mobilize resources for the patient and family. Overall, the
      use of cytotoxic agents during the first trimester offers the greatest potential
      for spontaneous abortion and fetal malformations. In contrast, chemotherapy
      administered in the second and third trimesters appears to offer minimal risk.
      What effect this exposure will have on future generations is only speculative. It
      would be safer if fetal drug exposure could be avoided completely, but when this
      is not prudent and the mother's life is at stake, careful consideration and
      thoughtful guidance is appropriate for the pregnant patient with cancer.

PMID- 1621004
TI  - Long-term central venous catheters: issues for care.
AB  - Long-term central venous catheters allow the safe administration of chemotherapy,
      blood and blood products, total parenteral nutrition, fluids, and other
      medications. Despite their benefits, the risk of certain complications (e.g.,
      fibrin sleeve and mural thrombus formation, infection, catheter occlusion,
      extravasation, and catheter malposition) exist for every person who has a
      catheter. Thus, preventative measures, recognition of early signs and symptoms of
      complications, and adequate care of utmost importance.

PMID- 1621005
TI  - Clinical trials: impact evaluation and implementation considerations.
AB  - It is commonplace for oncology nurses to care for patients entered on clinical
      trials. However, clinical research can impose a significant impact on the
      resources of sponsoring institutions or agencies, especially in today's
      environment of cost containment. Thus, institutions and nurses are increasingly
      involved in systematic resource impact evaluations to determine their commitment
      to cancer clinical trials. It is important for nursing to evaluate the impact of
      proposed clinical research and define the parameters for the participation of
      nursing service.

PMID- 1621006
TI  - Barriers and strategies for effective chemotherapy.
AB  - Chemotherapy offers the potential for cure or substantial palliation of numerous
      malignancies. However, its effective use requires a carefully developed strategy
      to overcome the barriers presented by a variety of neoplasms. Curative treatment
      for those human malignancies that show sensitivity to the available drugs
      requires combinations of drugs in "dose intense" regimens. Autologous bone marrow
      transplants and cytokines allow larger doses of drugs and possibly will improve
      the cure rates. Maximum compliance and prevention of drug toxicity are essential.

PMID- 1621007
TI  - The next generation: new chemotherapy agents for the 1990s.
AB  - The progress in cancer chemotherapy since the 1940s has been tremendous with over
      40 cytotoxic agents, excluding hormones, that have undergone clinical trials and
      been approved by the Food and Drug Administration (FDA). Preclinical drug
      development and clinical trials have made this progress possible. Several new
      agents that are either undergoing clinical trials or have recently been approved
      by the FDA include idarubicin, ICRF-187, piroxantrone, all-trans-retinoic acid,
      fludarabine phosphate, taxol, and suramin.

PMID- 1621008
TI  - Drug interactions in the oncology patient.
AB  - Cancer patients receiving chemotherapy often require a wide range of drugs to
      manage symptoms of their cancer, the side effects of the chemotherapy or
      radiation therapy, and other concomitant illnesses. The greater number of drugs
      the patient receives the greater the chance of adverse reactions. Clinical drug
      interactions may be direct, indirect, and additive. Toxicity or an altered
      therapeutic response secondary to a drug interaction may affect the cancer
      patient's ability to tolerate and safely receive chemotherapy.

PMID- 1621009
TI  - [Characteristics of education of UOEH--towards further development in
      occupational health].

PMID- 1621010
TI  - From research to practice. Role of a research institution in the development of
      the work environment.
AB  - To conclude, all the signals from the future working life and the society at
      large speak for the growing importance of research in the areas of environmental
      health and occupational health. This research, in order to have the best impact,
      should be guided by solid strategy based on the soundest health values presenting
      clear priorities, and directed to the preventive impact-oriented actions, and
      using the competence of highly motivated researchers. The researchers should be
      well supported by their research institutes with good operational capacity and
      facilities and be provided with close contacts with the consumers of the
      research. This would facilitate the application of research results in the
      practical work environment. If all these criteria are met we can also expect an
      impact. We are all called upon to take part in this exciting effort, and I am
      happy to state that the response of UOEH during its over 13 years of activity has
      been a most beautiful example for all of us. Let me transmit the warmest
      congratulations to UOEH for the past and wishes of success in the future.

PMID- 1621011
TI  - The mechanism of the action of IFN-gamma and TPA on the modulation of epidermal
      growth factor receptors of human amnion cells.
AB  - We have examined the mechanism of synergistic action occurring between interferon
      (IFN)-gamma and 12-0-tetradecanoylphorbol-13-acetate (TPA) with respect to the
      reduction of 125I-epidermal growth factor (125I-EGF) binding to human amnion
      (WISH) cells [Karasaki Y et al (1989) J Biol Chem 264: 6158-6163]. The cells were
      treated with protein kinase C (PKC) inhibitors (H7, staurosporine) to investigate
      the role of PKC in the synergism between IFN-gamma and TPA, since TPA is a strong
      activator of PKC. The combined effect of IFN-gamma and TPA was blocked by the PKC
      inhibitor, suggesting that PKC plays an important role in the synergistic action
      of TPA and IFN-gamma on the inhibition of EGF binding to the cells. The prolonged
      incubation (24 h) of the cells with TPA resulted in the restoration of EGF
      binding to the cells. A 24 h treatment of WISH cells with both IFN-gamma and TPA,
      however, still exhibited greater than 50% inhibition of EGF binding. No PKC
      activity, however, was observed in the WISH cells treated with both IFN-gamma and
      TPA for 24 h as well as with TPA alone for 24 h, indicating that IFN-gamma may
      synergize with the second mediator induced by PKC rather than PKC itself in the
      reduction of EGF binding to WISH cells. In addition, IFN-gamma showed the
      synergistic action with calcium ionophores on the reduction of EGF binding to the
      cells, suggesting that Ca2+ may be one of the second mediators which was induced
      by TPA and which cooperated with IFN-gamma.

PMID- 1621012
TI  - [The effect of the thyrotropin releasing hormone (TRH) on the motor speech
      disorder in spinocerebellar degeneration].
AB  - A prospective study regarding the effect of TRH on the motor speech disorder of
      three patients with spinocerebellar degeneration (SCD), the first with hereditary
      cortical cerebellar atrophy, the second and third with sporadic olivo-ponto
      cerebellar atrophy, was performed. The effect was analyzed by using speech
      evaluation, such as the auditory impression, the questionnaire of the
      consciousness for verbal communication, the phonetic evaluation and the acoustic
      analysis. The results of the analysis and the mechanism of the improvement of the
      motor speech disorder are discussed. Only the first patient showed a remarkable
      improvement subjectively. In addition, the improvement of phonation and
      articulation was demonstrated quantitatively in the evaluation of the first
      patient. On the other hand, by phonation analysis using VISI-PITCH, it was seen
      that there were a decrease in the perturbation of the voice pitch and an increase
      in voice range in all three patients. Therefore, it was concluded that the
      improvement of phonation plays a major role in the improvement of the motor
      speech disorder. Such improvement of the phonation seems to have resulted from
      the improvement of coordination, mainly due to the normalization of the muscle
      tone of the larynx by TRH administration. Although a remarkable beneficial effect
      of TRH may be obtained in exceptional patients of SCD, the mechanism of such an
      effect of TRH should be more extensively studied using the quantitative clinical
      evaluation of phonation and articulation.

PMID- 1621013
TI  - ["Toxins" and nerve--a discussion on the pathogenesis of acrylamide intoxication,
      giant axonal neuropathy and Krabbe disease].
AB  - A common mechanism appears to play a pathogenetic role in acrylamide
      intoxication, which is due to an exogenous cause, and in giant axonal neuropathy,
      an intrinsic disorder. In giant axonal neuropathy, a genetic defect in the
      processing of an intrinsic acrylamide or acrylamide-like substance may be
      postulated. On the other hand, the devastating pathology in Krabbe disease (a
      genetic disorder affecting almost exclusively the nervous system) appears to be
      due to the effects of psychosine, a toxic lipid produced in the nervous system.
      These suggest that the "toxicological approach" can be more diverse and of
      greater use than usually considered.

PMID- 1621014
TI  - [Quantitative study of the secretion, action and metabolism of insulin in man].

PMID- 1621015
TI  - [Congenital arteriovenous malformations of the limbs: apropos of 4 cases].

PMID- 1621016
TI  - [Ablation of accessory bundles using radiofrequency current].

PMID- 1621017
TI  - [Tinea of the scalp in the region of the river Meuse: a current renaissance?].

PMID- 1621018
TI  - [Infestational delirium: entomophobia, acarophobia, parasitic dermatophobia.
      Psychopathology and therapy].

PMID- 1621019
TI  - Sleep architecture and continuity measures of neonates with chronic lung disease.
AB  - Electroencephalographic (EEG) sleep studies of 25 preterm neonates with chronic
      lung disease (CLD) corrected to a fullterm postconceptional age were compared
      with recordings from two groups of neonates without CLD: a fullterm appropriate
      for gestational age group (9 patients) and a preterm group studied at a corrected
      term postconceptional age (15 patients). Electrographic/polygraphic studies were
      obtained using 21-channel EEG recordings. Scores were tabulated based on minute
      by-minute visual analyses of sleep state, number and duration of arousals, body
      movements and rapid eye movements (REM). A significant reduction in the
      percentage of active sleep was noted in the CLD group compared to both control
      groups (31.15% vs. 47.01% and 52.9%, respectively). The mean percentage of
      indeterminate sleep was significantly increased in the study group as compared to
      both control groups (31.23% vs. 15.18% and 11.5%). In addition, significant
      differences were noted between the CLD group and the healthy preterm control
      group with respect to the number (0.29/minute vs. 0.13/minute) and duration (4.8
      seconds vs. 2.94 seconds) of arousals as well as the total number of body
      movements (1.57/minute vs. 0.74/minute). These data suggest that
      neurophysiological organization of the immature brain, as reflected in neonatal
      sleep architecture and continuity measures, is adversely affected in neonates
      with CLD. EEG sleep architecture and continuity measures may be helpful in
      predicting the longitudinal outcome of infants with CLD as this group is at risk
      for adverse neurodevelopmental outcome.

PMID- 1621020
TI  - Cognitive and motor performance of narcoleptic and normal subjects living in
      temporal isolation.
AB  - Six unmedicated narcoleptic subjects and nine normal controls lived in a temporal
      isolation laboratory for 18-22 days. They were permitted to "free-run" for the
      last 9-13 days. Brief cognitive and motor performance tests were repeated on
      average six times per subjective day. They consisted of serial search, complex
      verbal reasoning tasks and manual dexterity of each hand. Only minor differences
      in performance were found between the narcoleptic subjects and controls.
      Narcoleptic subjects showed mild impairment of accuracy on the search task that
      could be explained by occasional lapses and an afternoon dip in performance.
      Narcoleptic subjects also tended to perform some tasks more slowly, but the group
      differences were not significant. Neither speed nor accuracy of performance of
      narcoleptic subjects decreased over the course of the experiment. By one standard
      of performance, therefore, all or nearly all of the sleep need of these subjects
      was met by the sleep they obtained in the laboratory. That amount, in turn, did
      not exceed the total sleep obtained by the normal controls. Significant time-of
      day effects were found in narcoleptic subjects for speed of verbal reasoning
      (progressive slowing over the course of the day), manual dexterity (fluctuations
      in speeds) and accuracy of serial search (afternoon dip). These variations in
      performance could not be attributed to changes in core body temperature or to
      occurrences of naps or meals.

PMID- 1621021
TI  - Short-term triazolam use improves nocturnal sleep of narcoleptics.
AB  - This study was undertaken to determine whether the use of triazolam by
      narcoleptic patients leads to improvement of nighttime sleep or excessive
      sleepiness. Ten narcoleptic patients, 5 males and 5 females, with complaints of
      sleep disturbance and aged between 18 and 60 years, were assigned to a single
      blind within-subject crossover-designed study comparing placebo with 0.25 mg
      triazolam. All subjects completed sleep questionnaires and underwent 6 nights of
      polysomnographic testing. Following an adaptation night, subjects received either
      triazolam or placebo for 2 nights. Objective tests of sleepiness (multiple sleep
      latency testing/maintenance of wakefulness test) were performed. Sleep efficiency
      and overall sleep quality were improved on all triazolam nights. Daytime
      excessive sleepiness was not reduced objectively after triazolam. This study
      demonstrates that the short-term use of triazolam improves nocturnal sleep
      quality in narcoleptics. Studies of long-term administration of triazolam are
      required to determine if the improvement of nocturnal sleep is maintained.

PMID- 1621022
TI  - Isolated sleep paralysis elicited by sleep interruption.
AB  - We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal
      sleep interruption schedule. On four experimental nights, 16 subjects had their
      sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes
      of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid
      eye movement (REM) sleep in the first or third sleep cycle. This schedule
      produced a sleep onset REM period (SOREMP) after the interruption at a high rate
      of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep
      interruptions performed (9.4%). All episodes of ISP except one occurred from
      SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal
      reports about ISP experiences and recorded the polysomnogram (PSG) during ISP.
      All of the subjects with ISP experienced inability to move and were
      simultaneously aware of lying in the laboratory. All but one reported
      auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP
      were characterized by a REM/W stage dissociated state, i.e. abundant alpha
      electroencephalographs and persistence of muscle atonia shown by the tonic
      electromyogram. Judging from the PSG recordings, ISP differs from other
      dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep
      behavior disorders. We compare some of the sleep variables between ISP and non
      ISP nights. We also discuss the similarities and differences between ISP and
      sleep paralysis in narcolepsy.

PMID- 1621023
TI  - Prominent eye movements during NREM sleep and REM sleep behavior disorder
      associated with fluoxetine treatment of depression and obsessive-compulsive
      disorder.
AB  - The clinical polysomnographic (PSG) reports of 2,650 consecutive adults studied
      during 41 months were reviewed retrospectively to identify all patients treated
      with fluoxetine or tricyclic antidepressants. The PSG reports of four other adult
      groups were also reviewed: periodic limb movement (PLM) disorder (n = 28); sleep
      terror/sleepwalking (ST/SW) (n = 54); rapid eye movement (REM) sleep behavior
      disorder (RBD) (n = 70); patients with clinically unremarkable sleep during two
      consecutive PSG studies (n = 30). Standard PSG recording and scoring methods were
      employed. A total of 1.5% (n = 41) and 2.0% (n = 52) of patients were receiving
      fluoxetine or tricyclics (amitriptyline or nortriptyline, n = 31; imipramine or
      desipramine, n = 16; protriptyline or trimipramine, n = 5). A selective
      association between fluoxetine and extensive, prominent eye movements in nonrapid
      eye movement (NREM) sleep was detected, utilizing Fisher's exact one-tailed
      statistic (p less than 0.00001 for each comparison). The detection rates were
      fluoxetine, 48.8% (20/41); tricyclics, 5.8% (3/52); RBD, 4.3% (3/70); objectively
      normal sleepers, 3.3% (1/30); PLM, ST/SW, 0% (0/82). These groups had similar
      mean ages (31.5-45.4 years) and gender distributions (50.0-60.7% male), apart
      from RBD. The effect of fluoxetine, a potent and specific serotonin reuptake
      inhibitor, on NREM eye movements is postulated to derive from potentiation of
      serotonergic neurons that inhibit brainstem "omnipause neurons", which, in turn,
      inhibit saccadic eye movements, thus resulting in disinhibited release of
      saccades. In addition, a 31-year-old man with obsessive-compulsive disorder
      developed RBD soon after starting fluoxetine therapy, which persisted at PSG
      study 19 months after fluoxetine discontinuation.

PMID- 1621024
TI  - The evoked K-complex: all-or-none phenomenon?
AB  - The functional significance and topographical variation of the different
      components of the evoked K-complex were examined. In the first experiment, the
      intensity of the stimulus (80 and 60 dB SPL) and its rise-and-fall time (2 and 20
      milliseconds) were manipulated during nonrapid eye movement sleep. In the second
      experiment the tonal frequency (500, 1,000 and 2,000 Hz) of the stimulus was
      manipulated. In the first experiment, nine stimuli were presented every 10
      seconds, whereas in the second, 20 consecutive stimuli were presented. The evoked
      K-complex consisted of two different negative components peaking at approximately
      350 and 550 milliseconds, respectively, and followed by a positive component
      peaking at approximately 900 milliseconds. K-complexes were easier to elicit for
      high-intensity fast rise-and-fall time stimuli than for low-intensity slow rise
      and-fall time stimuli. The probability of occurrence was not affected by the
      tonal frequency of the stimulus. When a K-complex was evoked, the amplitude and
      latency of N350, N550 and P900 remained invariant regardless of its intensity,
      rise-and-fall or its tonal frequency. The N550-P900 portion of the K-complex
      therefore appears to be an all-or-none phenomenon. On trials in which a K-complex
      could not be elicited, N350 was still visible although much attenuated. In these
      trials, its amplitude was further reduced when stimulus intensity was lowered.
      N350 might need to reach a certain critical threshold before the much larger N550
      P900 complex is elicited.

PMID- 1621025
TI  - Sleep in normal late pregnancy.
AB  - Twelve women in their third trimester of pregnancy and 10 age-matched nonpregnant
      controls underwent complete polysomnography for one night in the laboratory.
      Seven of the original women returned for a second study 3-5 months postpartum.
      During late pregnancy, women showed increased wake after sleep onset (WASO) and a
      lower sleep efficiency in comparison with the control group. The percentage of
      rapid eye movement (REM) sleep was significantly decreased and the percentage of
      stage 1 significantly increased compared to the nonpregnant group. At 3-5 months
      postpartum, a significant reduction in WASO and increased sleep efficiency were
      noted. However, only a slight increase was noted in REM sleep during the
      postpartum period compared to the prepartum period. The most frequent sleep
      complaints in the pregnant group were restless sleep, low back pain, leg cramps
      and frightening dreams. In summary, in accordance with their complaints, women in
      their third trimester demonstrated polysomnographic patterns of sleep maintenance
      insomnia.

PMID- 1621026
TI  - Biperiden administration during REM sleep deprivation diminished the frequency of
      REM sleep attempts.
AB  - Sixteen subjects were assigned to a group using either placebo or biperiden, with
      eight subjects in each group. Both groups were studied for one acclimatization
      night, one baseline night, four nights of rapid eye movement (REM) sleep
      deprivation and two recovery nights. All the subjects received either placebo or
      4 mg biperiden 1 hour before sleep during the four nights of REM sleep
      deprivation. During the baseline and the recovery nights both groups received
      placebo capsules. The results showed that REM sleep time during the REM sleep
      deprivation was reduced by 70-75% below the baseline night in both groups. The
      number of attempts to enter REM sleep was significantly reduced by biperiden as
      compared to placebo for each of the four REM sleep deprivation nights. Because
      the total sleep time in the biperiden group was reduced, the number of REM sleep
      attempts was corrected by the total sleep time. The adjusted number of REM sleep
      attempts was also significantly reduced in the biperiden group. REM sleep latency
      showed a reduction in the placebo group, whereas in the biperiden group REM sleep
      latency was unchanged throughout the deprivation nights. In the recovery night
      REM sleep time was increased in both groups, with no differences between the
      groups. The REM sleep latency showed a reduction in the first recovery night in
      both groups that persisted through the second recovery night. The above findings
      support the role of biperiden as a REM sleep suppressive drug.

PMID- 1621028
TI  - Preliminary report: validity of symptom analysis and daytime polysomnography in
      diagnosis of sleep apnea.
AB  - The aim of this study was twofold: first, to see if the prevalence of the sleep
      apnea syndrome (SAS) in a given population could be fairly estimated by our
      patient questionnaire, mainly based upon the 1979 American Sleep Association
      definition of SAS; and second, to investigate whether the severity of SAS could
      be similarly accurately measured by daytime polysomnography (DPSG), as an
      alternative to the more demanding all-night polysomnography (NPSG). Of 42
      patients consecutively examined due to rhonchopathy, 18 had the clinical
      diagnosis of SAS, which was based on the three symptoms--snoring, sleep
      disturbances and diurnal hypersomnia--if reported to occur habitually. In 11
      patients the diagnosis was established by NPSG [apnea index (AI) greater than
      10]. However, in only 10 of the 18 cases NPSG indicated the diagnosis giving a
      positive predictive value of 56%. When comparing DPSG versus NPSG in 36 patients,
      the AI ranged from -23 to +65, and the mean AI value was found to be twice as
      high in the former (mean difference 9.0 +/- 18.4; p less than 0.01). The positive
      predictive value of DPSG was 63% (10/16). Both the self-report and DPSG were
      burdened with some 25% false-positive results, and DPSG gave far too variable AI
      values to be reliable in staging the disease. On the other hand, the negative
      predictive values were high, 96% (23/24) and 100% (20/20), respectively,
      indicating their usefulness for screening purposes.

PMID- 1621027
TI  - Accuracy and significance of scoring hypopneas.
AB  - We previously reported that the best definition of hypopneas in the sleep
      apnea/hypopnea syndrome (SAHS) is based on reduction in thoracoabdominal
      movement. However, the repeatability of scoring hypopneas from thoracoabdominal
      movement has not been assessed, nor has the need to record flow as well as
      thoracoabdominal movement. Thus, two polysomnographers independently scored both
      apneas and hypopneas on all-night polysomnograms of patients with SAHS. There was
      close agreement between the polysomnographers for the number of hypopneas (r =
      0.98; mean difference 11%) and for the number of apneas (r = 0.99; mean
      difference 8%). The agreement was similar for the durations of both hypopneas (r
      = 0.99; mean difference 13%) and apneas (r = 0.99; mean difference 11%). There
      was also close agreement between the total number of respiratory events scored
      with and without reference to the flow signal (r = 0.99; mean difference 1.4%)
      with a maximum under-recognition of 18 events per night in a subject with 237
      apneas per night. Thus, hypopneas can be scored reproducibly. In addition, the
      value of always recording and scoring flow as well as thoracoabdominal signals is
      questioned.

PMID- 1621029
TI  - Charles Dickens: observer of sleep and its disorders.
AB  - Using the characters of his novels as the canvas, Charles Dickens painted vivid
      word pictures of a variety of manifestations of sleep and its disorders. These
      were presumably based on the author's own experiences and those of family and
      friends. Dickens was, himself, a self-confessed episodic insomniac. For this he
      devised the unique therapy of long night walks. This article illustrates, by a
      few selected quotations, this hitherto unpublicized aspect of the author's life
      and works.

PMID- 1621030
TI  - The clinical use of the Multiple Sleep Latency Test. The Standards of Practice
      Committee of the American Sleep Disorders Association.

PMID- 1621031
TI  - Bibliography of recent literature in sleep research.

PMID- 1621032
TI  - [Duodenal peptic ulcer].

PMID- 1621033
TI  - [Late complication of diabetes mellitus of pancreatic origin].
AB  - At Instituto Nacional de la Nutricion SZ in Mexico City, we reviewed 30 years of
      experience and selected 46 patients with Pancreatic Diabetes (PD), without family
      history of Diabetes Mellitus (DM) with at less two years of follow-up. Alcoholic
      chronic pancreatitis (CP) was found in 36 patients, in seven it was idiophatic
      and in three was secondary to pancreatectomy. We compared the evolution of this
      patients with a group of (DM) patients similar in age, sex, glucemic control and
      time of onset. There were no statistical differences between groups in the follow
      up of diabetic complications, only it was found a tendency to have higher lipid
      levels, macroangiopathy and retinopathy in those with DM. We concluded that CP
      have similar evolution as DM and could have deleterous complications in the large
      follow up.

PMID- 1621034
TI  - [Crohn disease. Medico-surgical experience. A 10-year retrospective study].
AB  - Crohn's disease is rare in Mexico. The regarding of this pathology at
      Gastrointestinal Unit of the General Hospital of Mexico city, between january
      1980 and december 1989, is presented. There were six cases of Crohn's disease,
      two women (33%) and four men (66%). The definitive diagnosis was done
      preoperatively only in one case, the other were diagnosed postoperatively. In
      all, intestinal obstruction was the surgical indication. A patient died (16.6%),
      three cases were followed for 12 months, only two patients are still under
      surveillance after 15 months.

PMID- 1621035
TI  - [Neoplastic polyps of the colon].
AB  - We report all patients with neoplastic polyps endoscopically excised during 10
      years, performed in different hospitals in Mexico City. All ages, both sexes and
      socio-economic levels were seen in several endoscopy services both, public and
      private. We find 190 patients (100 females) with 268 polyps and a mean age of
      54.5 (range 18-86). Tubulo-villous adenomas have the less frequency (8%). Villous
      adenomas were the largest and had a 11% frequency, almost all were confined to
      recto-sigmoid region its mean age was 6 years. Villous adenomas were the most
      frequent (69%) distributed in all colonic segments, its mean age was 54.5 years
      with the widest range (18-80 years); they have highest dysplasia rate (8.1%).
      Carcinomas arising in polyps were all located in recto-sigmoid region, with
      female predominance (2.3:1) and oldest mean age of presentation (66.3 years).
      Neoplastic polyps in Mexico City general population has a low frequency;
      endoscopic polypectomy is safe and had a low morbi-mortality rate.

PMID- 1621036
TI  - [Surgical treatment of achalasia].
AB  - Primary achalasia is a motor dysfunction of the esophagus with unknown aetiology.
      We present our results obtained in 39 patients treated by Heller's Cardiomyotomy.
      The procedure was successful in 92.3% of the cases and when it is performed in
      conjunction with an antirreflux technique, it offers excellent results with a
      very low frequency of gastroesophageal reflux symptoms and complications.

PMID- 1621037
TI  - [Peptic acid disease associated with Helicobacter pylori in children. Report of a
      case].
AB  - We studied a child with peptic acid disease which was associated with H. pylori.
      The identification of H. pylori was done by biopsy and for antibody test.
      Clinical improvement was observed only with the use of amoxocilin and Bismuth
      subsalycilate.

PMID- 1621038
TI  - [Cholera: history, diagnosis and clinical management].

PMID- 1621039
TI  - [Once an ulcer, always an ulcer? Therapy and management of duodenal ulcer].

PMID- 1621040
TI  - The changing face of orthodontics.

PMID- 1621041
TI  - [Drug addiction and pregnancy].
AB  - In drug-addicted women pregnancy is always at risk and difficult to supervise
      owing to the social and psycological profiles of these women. At the moment, we
      are dealing in France mainly with pregnancies that occur in heroin addicts and
      frequently have the following complications: lack of follow-up, prematurity,
      short child stature, infections (notably HIV infection) and weaning syndrome in
      the newborn. Due to improvements in the management of these patients, the
      neonatal mortality has been considerably reduced and has become exceptional. In
      the USA the number of pregnancies occurring in cocaine addicts has increased, and
      complications similar to those of heroin addicts have been observed, particularly
      with crack. It is not impossible that we might soon be confronted with this type
      of drug addiction.

PMID- 1621042
TI  - [Consensus conference on the screening of congenital hip dislocation. Paris 4
      November 1991].

PMID- 1621043
TI  - [What "clandestin" abortion was. Medical aspects].

PMID- 1621044
TI  - [Retinal detachment. Etiology, diagnosis, principles of preventive and
      therapeutic measures].

PMID- 1621045
TI  - [Trigeminal neuralgia. Diagnosis].

PMID- 1621046
TI  - [Bacterial endocarditis. Etiology, physiopathology, diagnosis, development,
      prognosis, principles of the treatment].

PMID- 1621047
TI  - [Nasal obstruction. Diagnostic orientation].

PMID- 1621048
TI  - [Multiple trauma. Management ot the site of the accident].

PMID- 1621049
TI  - [Agitation state. Diagnostic orientation and principles of emergency treatment].

PMID- 1621050
TI  - [Asthma. Physiopathology, diagnosis, development, prognosis, principles of the
      treatment].

PMID- 1621051
TI  - [When should eye infection be suspected?].
AB  - During simple inspection of an inflamed eye it is often difficult to diagnose an
      infection. However, infection must be suspected, notably in cases with
      facilitating factors. Eye infection requires management by specialists to prevent
      complications which might endanger vision.

PMID- 1621052
TI  - [Principles of the treatment of ocular infections].
AB  - Ocular infections are still quite common and their clinical presentation is
      variable; some of them may lead to blindness. In this paper only severe
      infections like keratitis and endophthalmitis are considered. The rationale for
      treatment and prophylaxis is based upon bacteriological findings, understanding
      of ocular barriers and pharmacokinetics of antibacterial agents.

PMID- 1621053
TI  - [Conjunctivitis and lacrimal apparatus infections].
AB  - The term conjunctivitis covers all inflammatory processes affecting the
      conjunctiva. Bacterial and viral infections are the most frequent causes.
      Infectious conjunctivitis is rarely severe in industrialized countries, but
      trachomatous kerato-conjunctivitis is still the main cause of blindness all over
      the world. Most cases of bacterial conjunctivitis are treated with topical
      antibiotics. Viral conjunctivitis is frequent and, with the exception of herpetic
      conjunctivitis, has no specific treatment. Canaliculitis and dacryocystitis are
      rare but require specialized examination, treatment and follow-up.

PMID- 1621054
TI  - [Ocular herpes simplex].

PMID- 1621055
TI  - [Non herpetic keratitis].
AB  - Nonherpetic keratitis includes keratitis caused by other viruses, and bacterial,
      fungal, and acanthamoebic keratitis. Epidemic keratoconjunctivitis, one of the
      most common corneal manifestations induced by nonherpetic viruses, has usually a
      good outcome. Conversely, non viral keratitis has more severe complications.
      Early clinical and microbial diagnosis are the keystones to treat successfully
      these keratitis. Diagnostic and therapeutic principles are detailed in this
      review.

PMID- 1621056
TI  - [Infectious endophthalmitis].
AB  - Bacterial endophtalmitis is a disastrous postoperative complication of any
      intraocular surgery which can lead to blindness. With prompt endocular taps for
      appropiate laboratory investigations, the use of large spectrum antibiotics with
      good intraocular penetration, the intraocular injections of antibiotics, most of
      the eyes can be salvaged. Although it is unlikely that postoperative microbial
      endophthalmitis can be avoided entirely, all efforts should be made to reduce the
      incidence of this complication. Under this point of view, in addition to the
      available sterile techniques during the surgery, the topical and systemic
      antibiotic prophylaxis requires that carefully controlled studies be performed on
      very large numbers of patients to attain statistical validity.

PMID- 1621057
TI  - [Ocular infections in immunodepressed patients].
AB  - Two kinds of immunosuppression must be distinguished: malignant diseases on one
      hand, and acquired immunodeficiency syndrome on the other hand. Ocular infections
      can involve any part of the eye and they can lead to blindness. They usually
      attest of a systemic infection. Their treatment consist of an induction course to
      provide complete healing of the lesions, immediately followed by a maintenance
      course to prevent relapses. Retinitis are the most common posterior involvement,
      especially the retinitis due to cytomegalovirus and Toxoplasma gondii. Zoster
      ophtalmicus is the most common anterior involvement. Mucormycosis is rare but
      very severe. A closed collaboration between ophtalmologists and internists is
      mandatory to provide the most appropriate management of these infections.

PMID- 1621058
TI  - [Hematopoietic cell growth factors. What are the expectations today?].

PMID- 1621059
TI  - [Epidemiology of type 2 diabetes. Elements of prevention].

PMID- 1621060
TI  - [Nasopharyngeal fibroma. A mysterious tumor with unusual treatment].

PMID- 1621061
TI  - [Salivary calculi].
AB  - Salivary calculi are frequent and revealed by very painful signs, which need an
      urgent therapy. These calculi are more often localized in the submaxillary gland,
      sometimes in the parotid gland, and unfrequently in the sublingual glands. Their
      clinical signs include an increased volume of the gland (salivary hernia), pain
      of infectious complication. Diagnosis is confirmed by standard x-ray and
      sialography, which also predicate the localization of the calculi. The treatment
      is symptomatic including antispasmodic, sympatholytic and parasympathomimetic
      drugs and washings of the canal with antibiotic solutions. After few months of
      this treatment, the surgical treatment is indicated if the calculi stays in the
      canal. Depending on the localization of the calculi, the access way will be
      either endobuccal or external.

PMID- 1621063
TI  - Abstracts of papers presented at the 25th Scandinavian Conference on
      Gastroenterology and the 16th Scandinavian Meeting on Gastrointestinal Endoscopy.
      Bergen, Norway, 4-6 June 1992. Abstracts.

PMID- 1621062
TI  - [Immunology and psychiatry].
AB  - This review of scientific literature comes within the interest arisen from ten
      years by psychoneuroimmunology, a field connecting several disciplines and
      illustrating in a new way the psychosomatic relationships. A first category of
      works has been dedicated to the study of psychiatric disorders associated with
      various diseases concerning immunity (systemic diseases, endocrine diseases,
      cancers, infectious diseases), but also to the possible effect of distressing
      life events on the upset activation of immune functions, or even to the discovery
      of predisposing personality profiles (type C profile, depressive vulnerability).
      A second category of works concerns the analysis of the immune disturbances
      associated with certain psychiatric diseases, such as depression or
      schizophrenia, but also with some distressing life conditions, like bereavement.
      Animal experimentation and human experimentation provide various informations on
      the factors conditioning the immunomodulating effects of stress, sometimes in the
      direction of an inhibition, sometimes in the direction of an activation of immune
      functions. Finally, several papers shed light on the immunomodulating effects of
      psychotropic drugs. All these works open new horizons to the scientific knowledge
      and let us glimpse an extension to the use of psychologic therapeutics, as well
      of pharmacological ones as of non pharmacological.

PMID- 1621064
TI  - Are we overestimating the genetic contribution to schizophrenia?
AB  - That genetic factors contribute to the etiology of schizophrenia is no longer
      debated; the nature and magnitude of that contribution, however, are still open
      for discussion. In this article, concordance rates for twin studies of
      schizophrenia are reviewed as one means of assessing the magnitude of the genetic
      contribution. Using only those studies in which representative samples were used
      and zygosity was determined with reasonable certainty, the pairwise concordance
      rate for schizophrenia was found to be 28 percent for monozygotic (MZ) and 6
      percent for dizygotic (DZ) twins. Review of twin studies of other central nervous
      system diseases reveals that schizophrenia is most similar to multiple sclerosis
      (MZ concordance rate 27%). Although genetics remains as the single most clearly
      defined etiological factor in schizophrenia, the question remains whether we are
      overestimating the magnitude of the genetic contribution.

PMID- 1621065
TI  - When assessing twin concordance, use the probandwise not the pairwise rate.
AB  - Geneticists and twin researchers have long debated the relative merits of two
      alternative measures of twin concordance: the pairwise and probandwise
      concordance rates. The results of this debate are now quite clear, for almost
      every application the probandwise rate is preferred over the pairwise rate. In a
      recent review of schizophrenia twin studies, however, Torrey (1992) chose to
      analyze pairwise rather than probandwise rates. Torrey's use of pairwise rates
      led him to conclude that the monozygotic twin concordance for schizophrenia is
      weaker than what is widely accepted, and that, by implication, the magnitude of
      the genetic contribution to schizophrenia has been overestimated. In this brief
      commentary, we review the relative strengths and weaknesses of the pairwise and
      probandwise rates and show that Torrey's conclusion is based upon his incorrect
      use of pairwise rates. Twin studies of schizophrenia continue to support the
      existence of a strong genetic influence on the development of schizophrenia.

PMID- 1621066
TI  - First-episode psychosis: Part I. Editors' introduction.
AB  - Until recently, there has been a conspicuous lack of studies regarding the
      earliest phases of psychotic illness, with most research on schizophrenia and
      related disorders focusing on chronically ill patients. Currently, however, a
      number of investigators have turned their attention toward this topic, exploring
      the conceptual issues involved in defining the onset of psychosis, using case
      registers and population-based samples to do crucial epidemiologic studies on the
      course of schizophrenia, and developing mechanisms for identifying patients with
      first-episode psychosis and entering them into active research protocols. The
      issue of the Schizophrenia Bulletin is devoted to articles representing this full
      range of conceptual and empirical work on first-episode psychosis. The ultimate
      goal is for researchers working in this area to develop a network to enhance the
      sharing of concepts and data, with the eventual possibility of developing
      combined data bases and collaborative studies.

PMID- 1621067
TI  - Research on first-episode psychosis: report on a National Institute of Mental
      Health Workshop.
AB  - The need to focus increased research on patients experiencing their first episode
      of psychosis was emphasized in A National Plan for Schizophrenia Research. To
      develop strategies for enhancing research in this area, a National Institute of
      Mental Health Workshop on First-Episode Psychosis was held in 1991. The topics
      discussed at that workshop are summarized, with key issues including the
      following: (1) the need for better operational definitions of onset, end of an
      episode, and relapse of psychosis; (2) careful consideration of inclusion and
      exclusion criteria related to age, gender, prior treatment, comorbid substance
      abuse, and similar issues; (3) the challenge of finding patients never exposed to
      neuroleptics and the value of entering first-episode patients into standardized
      treatment protocols; (4) the design of followup studies; (5) strategies to
      increase the pool of applicants; and (6) approaches for increasing power through
      data sharing and collaboration between groups.

PMID- 1621068
TI  - The natural course of schizophrenia: a review of first-admission studies.
AB  - In this article, research on the natural course of illness among first-admission
      schizophrenic patients is reviewed from an epidemiological perspective. Three
      types of studies are considered: statistical reports dating primarily from the
      preneuroleptic era; long-term followback studies; and more recent prospectively
      designed cohort studies. Although relatively more first-admission patients have a
      positive course than do multiple admissions patients, the findings confirm the
      substantial heterogeneity in course and outcome. Methodological improvements in
      first-admission research are suggested, including separating the analyses of
      first-episode patients from those with past psychotic experiences; employing
      longitudinal methods for deriving diagnosis; including patients with drug and
      alcohol problems where appropriate; enlarging the samples either by multisite or
      multicenter collaborations or by pooling data across studies; and obtaining
      better data on treatment experiences in naturalistic research.

PMID- 1621069
TI  - Long-term course of hospitalization for schizophrenia: Part I. Risk for
      rehospitalization.
AB  - The probability of rehospitalization following the initial discharge on which a
      diagnosis of schizophrenia was made is described using data from psychiatric case
      registers in Victoria, Australia; Maryland, U.S.A.; Denmark; and Salford,
      England. The percentage eventually rehospitalized, after followup intervals as
      long as two decades, varies from about 50 to 80 percent in the four service
      systems. Survival curves for duration in the community without rehospitalization
      bend sharply in the period between 2 and 3 years following discharge in all four
      cohorts and are almost flat after 20 years. Early age of onset predicts higher
      risk for rehospitalization in multivariate proportional hazards models in each
      cohort. When age of onset is included as a covariate, neither gender nor marital
      status has consistent or statistically significant effects on risk for
      rehospitalization.

PMID- 1621070
TI  - Long-term course of hospitalization for schizophrenia: Part II. Change with
      passage of time.
AB  - This analysis examines the notion of progressive deterioration in schizophrenia,
      using long-term followup data on hospital episodes in defined cohorts from
      psychiatric case registers in Victoria, Australia; Denmark; and Salford, England.
      The analyses differentiate heterogeneity existing at the first hospitalization
      for schizophrenia, which produces a widely varying natural course, from
      heterogeneity that develops over time, as episodes of hospitalization occur.
      Episodes of hospitalization for schizophrenia tend to cluster earlier rather than
      later in the treatment career, suggesting a progressive amelioration rather than
      deterioration. When overall chronicity is adjusted, each additional episode of
      hospitalization lowers the risk for a further hospitalization by about 10
      percent.

PMID- 1621071
TI  - The epidemiology of psychosis: the Suffolk County Mental Health Project.
AB  - This article describes the rationale, aims, and methodology of an epidemiological
      study of psychosis being conducted in Suffolk County, New York. A sample of first
      admission patients is drawn from 10 inpatient and 25 outpatient facilities.
      Diagnostic psychosocial interviews are conducted shortly after admission to
      treatment, and at 6- and 24-month followup. Consensus diagnoses are made after
      each interview. Demographic and clinical background characteristics of the first
      250 subjects enrolled over a 2-year period are presented here. The response rate
      was 76 percent. Based on the initial interview, 75 percent of subjects received a
      diagnosis involving psychosis. The three most common diagnoses were
      schizophrenia, bipolar disorder with psychotic features, and major depression
      with psychotic features. Among subjects with psychosis, 58 percent of males and
      29 percent of females had a history of substance abuse/dependence. Gender
      differences were found on several background and clinical characteristics. Males
      were somewhat younger, less likely to have ever married, and had less education.
      Although the median length of hospitalization was the same for females and males
      (27 days), females were more likely to be hospitalized within 1 month of the
      occurrence of their first psychotic symptom (60% of females compared to 37% of
      males). Subjects with schizophrenia-related disorders were significantly more
      impaired on an assessment of negative symptoms than were affectively ill
      subjects, but clinical ratings of depression were not significantly different
      across diagnostic groups.

PMID- 1621072
TI  - Anomalous lateral sulcus asymmetry and cognitive function in first-episode
      schizophrenia.
AB  - This study examines the cognitive functioning of first-episode schizophreniform
      patients within several weeks of hospitalization and at 2 years into the illness.
      Differences between patients and controls are also reported for measurements of
      the length of the lateral sulcus, which borders the planum temporal, an area of
      the brain integral to language function. Neuropsychological test results are also
      correlated to magnetic resonance imaging structural variables at the time of
      first hospitalization. Findings on neuropsychological summary scales reveal a
      diffuse pattern of cognitive impairment in schizophreniform patients compared to
      controls, which appears to improve over time. An atypical pattern of anatomic
      lateral symmetry is found in female schizophreniform patients, with female
      appearing to have a reduction in the normally occurring left greater than right
      length of the lateral sulcus. Such atypical asymmetry of the lateral sulcus is
      also associated with better cognitive function, particularly in schizophreniform
      patients. These findings suggest that atypical lateralization in an area critical
      to language function may be related to cognitive function in schizophreniform
      illness.

PMID- 1621073
TI  - The McLean First-Episode Psychosis Project: six-month recovery and recurrence
      outcome.
AB  - The McLean First-Episode Psychosis project began in 1989. The authors describe
      the study design, diagnostic distribution, and recovery and relapse data on the
      first 102 recruited subjects. Fifty-nine percent of the subjects had a diagnosis
      of bipolar disorder, 15 percent psychotic depression, 10 percent schizophrenic
      spectrum, 9 percent delusional disorder, and 8 percent other psychotic disorders.
      By 6 months, 80 percent recovered syndromically but only 55 percent recovered
      functionally, and only 50 percent recovered both functionally and syndromically.
      Non-white and male patients were more likely to have a recurrence. Men were less
      likely and bipolar patients were more likely to recover functionally. Patients
      with nonaffective psychosis had longer hospitalizations and lower rates of
      functional recovery 6 months after discharge.

PMID- 1621074
TI  - Neuropsychological and eye movement abnormalities in first-episode and chronic
      schizophrenia.
AB  - It is well known that neurobehavioral deficits are associated with schizophrenia.
      Little is known, however, about whether these disturbances becomes more severe
      over the course of the illness. In the present study, 101 patients with
      schizophrenia, of whom 45 were first-episode cases, performed pursuit eye
      tracking tasks. A subset of 60 of these patients, including 27 first-episode
      cases, were administered a battery of neuropsychological tests. Patients with a
      history of prior psychotic episodes demonstrated more severe pursuit eye movement
      dysfunction than first-episode patients and more severe disturbances on
      neuropsychological tests sensitive to prefrontal and left temporal cortical
      dysfunction. Longitudinal studies of patients ascertained close to the point of
      illness onset are needed to determine whether these findings reflect a
      progressive deterioration in neurobehavioral functioning over the course of
      schizophrenia.

PMID- 1621075
TI  - Electrodermal anomalies in recent-onset schizophrenia: relationships to symptoms
      and prognosis.
AB  - Electrodermal activity was measured in recent-onset schizophrenic patients (n =
      98) and matched normal control subjects (n = 40) as part of an ongoing
      longitudinal study. Results at the initial inpatient test were generally
      consistent with the current consensus in the literature. A large subgroup of the
      patients was found to be nonresponsive with the phasic skin conductance orienting
      response measure, whereas the remaining subgroup of patients was found to be
      electrodermally tonically hyperaroused. Heightened electrodermal activity at the
      inpatient test was associated with a number of symptoms in male patients and with
      poor recovery from the acute schizophrenic episode. Followup tests conducted when
      the patients were in states of remission and psychotic relapse revealed that
      tonic electrodermal arousal measures qualify as state-sensitive episode
      indicators, whereas phasic nonresponding may qualify as an atypical vulnerability
      indicator. Moreover, preliminary data from three patients suggest that increases
      in tonic electrodermal arousal may temporally precede psychotic relapses. The
      principal findings are consistent with a vulnerability/stress model that posits
      that electrodermal hyperarousal is part of a transient intermediate state that
      may lead to a psychotic episode in a vulnerable individual.

PMID- 1621076
TI  - Are gender effects being neglected in schizophrenia research?
AB  - Research on schizophrenia published in four professional journals--Journal of
      Abnormal Psychology, Archives of General Psychiatry, Journal of Nervous and
      Mental Disease, and American Journal of Psychiatry--over a 5-year period from
      January 1985 through December 1989 was examined for gender composition of subject
      samples and gender analyses of findings. Results indicate a continued
      predominance of male subjects in schizophrenia research, with males outnumbering
      females two to one, and frequent neglect of possible gender differences within
      mixed-sex samples. Possible explanations for the male bias are considered and
      greater research and editorial attention to possible gender effects are urged.

PMID- 1621077
TI  - First person account: portrait of a schizophrenic.

PMID- 1621078
TI  - [Somatostatin analog (octreotide) in clinical use: current and potential
      indications].
AB  - The long-acting somatostatin analogue octreotide is a synthetic cyclic peptide
      consisting of 8 amino acids. Depending on the organ, it acts either as a hormone
      or as a neurotransmitter. The effect on various physiological functions in the
      brain and the gastrointestinal tract is mainly inhibitory. Due to its inhibitory
      actions, the possibility of intravenous and subcutaneous administration and the
      lack of serious side-effects, octreotide offers a broad spectrum of possible
      indications. Today octreotide is recommended in acromegaly patients and for the
      treatment of hormone dependent symptoms in patients with gastroenteropancreatic
      tumours. New indications are enterocutaneous and pancreatic fistulas and the
      prevention of complications in major pancreatic surgery. In patients with dumping
      and short-bowel syndrome, octreotide may be helpful until dietary regimens are
      established. In Aids patients with severe diarrhea, octreotide can be used to
      stabilize patients with severe dehydration and malnutrition. The clinical
      effectiveness on upper GI-bleeding due to gastric ulcer and oesophageal varices
      is still controversial. Future studies must prove whether octreotide may be
      helpful in treating diabetic retino- and nephropathy because of the possibility
      of suppressing growth hormone and IGF-I. The antiproliferative effect of
      octreotide also allows its use in patients with somatostatin-receptor-positive,
      non-endocrine solid tumors (e.g. brain, breast and small-cell lung cancer). A
      promising area is the scintigraphic visualization of somatostatin-receptor
      positive tumors with a radio-labelled octreotide analogue and the possible target
      irradiation of these tumors by beta-particle emitting isotopes attached to such
      analogues.

PMID- 1621079
TI  - [Identification of crystals in synovial fluid: joint-specific identification rate
      and correlation with clinical preliminary diagnosis].
AB  - The diagnostic clarification of joint effusions of unknown origin is a challenge
      to every primary-care physician. Important diagnostic procedures are
      arthrocentesis and analysis of the aspirated synovial fluid. Synovial fluid
      analysis frequently allows differentiation between harmless effusions due to
      osteoarthritis and crystal induced inflammation, or the more devastating septic
      arthritis. 4475 synovial fluids were evaluated retrospectively to calculate the
      identification rate of crystals compatible with calcium pyrophosphate dihydrate
      (CPPD) and monosodium urate monohydrate (MSUM). 40.8% (1827) of synovial fluids
      were taken from females and 59.2% (2648) from males. The frequency of crystal
      identification varied considerably: 13.2% CPPD crystal identification in females,
      10.9% in males; MSUM was identified in 1.5% of females, and in 10.9% of males.
      The spectrum of joint involvement was nearly identical in CPPD and MSUM positive
      synovial fluids. Exceptions were the higher frequency of CPPD identification in
      shoulder joints (CCPD:MSUM = 15.6:1), the higher frequency of MSUM identification
      in the ankle (MSUM:CPPD = 15.6:1) and the first metatarsophalangeal joints
      (MSUM:CPPD = 8:1). Clinical suspicion correlated well with crystal identification
      in MSUM positive samples (60%), but was poor in CPPD positive samples (36%). The
      poor correlation between clinical suspicion and crystal identification in CPPD
      positive synovial fluids is explicable by the less characteristic clinical
      presentation of pyrophosphate arthropathy in contrast to classical gout. A high
      percentage of crystal identification was found in joints or periarticular
      swellings in which aspiration is difficult and therefore rare (e.g. tendon
      sheaths, first metatarsophalangeal and first metacarpophalangeal joints),
      underlining the importance of synovial fluid aspiration despite the difficulty of
      arthrocentesis.

PMID- 1621080
TI  - [Single cusp homograft implantation in the reconstruction of right ventricular
      outflow tract in the correction of tetralogy of Fallot].
AB  - From 1987 to 1990, 37 children underwent surgical correction for tetralogy of
      Fallot. The mean age was 38.2 months (2-156 months). The indication for right
      ventricular outflow tract (RVOT) obstruction in 19/37 (51%) children was:
      hypoplastic pulmonary valve (n = 10), annular hypoplasia (n = 12), RVOT
      obstruction and hypoplastic pulmonary artery (n = 10). In 18/37 (49%) children,
      the repair of the RVOT was done without homograft. The RVOT morphology was the
      only indication for reconstruction with homograft. All other pre-, intra- and
      postoperative data were identical for both groups. There was no operative or late
      death. After a mean follow-up of 4.4 months, all 19 children with homograft were
      in NYHA class I and echocardiographic evaluation showed mild and moderate
      pulmonary regurgitation in 8 and 4 children respectively. Out of the 18 children
      without homograft, 16 were in NYHA class I and 2 in NYHA class II. Two children
      had early postoperative right heart failure. The mean follow-up time in this
      group was 5.5 months. Echocardiography revealed residual pulmonary regurgitation
      in 4 children, pulmonary stenosis in 6 and combined residual pulmonary valve
      defect in 6. If severe malformation of the RVOT or the pulmonary artery is
      present, a valved homograft is recommended for repair of tetralogy of Fallot.
      Good morphological and functional results may be achieved.

PMID- 1621081
TI  - [Is premedication in gastroscopy hazardous?].
AB  - Premedication for gastroscopies is still controversial. Most gastroenterologists
      use premedication routinely, often without control of vital signs. However, even
      if rarely, serious (mainly cardiorespiratory) complications still occur. In 101
      patients in whom a gastroscopy had been performed, oxygen saturation before,
      during and after the endoscopy was investigated. A fall in saturation was seen in
      most of the patients but was usually minor. However, severe hypoxemia occurred in
      some patients, especially if premedication was used. Older patients and patients
      with severe anemia were particularly at risk. These results emphasize that
      premedication should not be used without precaution and special surveillance,
      especially in high risk patients. Prophylactic oxygen administration
      significantly diminishes the risk.

PMID- 1621082
TI  - [Fundus plication with or without proximal selective vagotomy?].
AB  - The aim of this study was to determine the influence of proximal gastric vagotomy
      on the outcome after fundoplication. Of 141 patients operated on for reflux
      disease between 1972 and 1988, 53 had fundoplication alone (group A) and 88
      fundoplication combined with proximal gastric vagotomy (group B). The two groups
      were similar with regard to the severity of the reflux disease (esophagitis: A
      69%, B 73%) but had a different incidence of concomitant ulcer disease (A 2%, B
      55%). After a mean follow-up of 9 years, 111 patients (79%) were evaluated by
      clinical examination and 57 patients (40%) by endoscopy. Perioperative morbidity
      was similar (A 22%, B 19%). Successful reflux control (A and B 81%) and overall
      clinical outcome (Visick I and II: A 78%, B 80%) were identical. The frequency of
      adverse side effects was approximately the same in both groups (dysphagia: A 28%,
      B 26%; gas-bloat: A 52%, B 37%). We conclude that the long term results after
      fundoplication are not improved by additional proximal gastric vagotomy. The
      combined procedure is therefore only justified if both reflux disease and ulcer
      disease are present.

PMID- 1621083
TI  - Infection of Macaca nemestrina by human immunodeficiency virus type-1.
AB  - After observations that Macaca nemestrina were exceptionally susceptible to
      simian immunodeficiency virus and human immunodeficiency virus type-2 (HIV-2),
      studies of HIV-1 replication were initiated. Several strains of HIV-1, including
      a recent patient isolate, replicated in vitro in peripheral blood mononuclear
      cells (PBMCs) and in CD4-positive M. nemestrina lymphocytes in a CD4-dependent
      fashion. Eight animals were subsequently inoculated with either cell-associated
      or cell-free suspensions of HIV-1. All animals had HIV-1 isolated by
      cocultivation, had HIV-1 DNA in their PBMCs as shown by polymerase chain
      reaction, and experienced sustained seroconversion to a broad spectrum of HIV-1
      proteins. Macaca nemestrina is an animal model of HIV-1 infections that provides
      opportunities for evaluating the pathogenesis of acute HIV-1 replication and
      candidate vaccines and therapies.

PMID- 1621084
TI  - Distributed neural network underlying musical sight-reading and keyboard
      performance.
AB  - Music, like other forms of expression, requires specific skills for its
      production, and the organization and representation of these skills in the human
      brain are not well understood. With the use of positron emission tomography and
      magnetic resonance imaging, the functional neuroanatomy of musical sight-reading
      and keyboard performance was studied in ten professional pianists. Reading
      musical notations and translating these notations into movement patterns on a
      keyboard resulted in activation of cortical areas distinct from, but adjacent to,
      those underlying similar verbal operations. These findings help explain why brain
      damage in musicians may or may not affect both verbal and musical functions
      depending on the size and location of the damaged area.

PMID- 1621085
TI  - Malignant hyperthermia.

PMID- 1621086
TI  - Scientists take one last swing.

PMID- 1621087
TI  - HHS cancels Gallo's moment in the sun.

PMID- 1621088
TI  - Do antidepressants promote tumors?

PMID- 1621089
TI  - Congress focuses on job discrimination.

PMID- 1621090
TI  - Fetal tissue. Congress considers testing Bush's plan.

PMID- 1621091
TI  - Researchers find organism they can really relate to.

PMID- 1621092
TI  - The challenge of malaria.

PMID- 1621093
TI  - Chance and statistical significance in protein and DNA sequence analysis.
AB  - Statistical approaches help in the determination of significant configurations in
      protein and nucleic acid sequence data. Three recent statistical methods are
      discussed: (i) score-based sequence analysis that provides a means for
      characterizing anomalies in local sequence text and for evaluating sequence
      comparisons; (ii) quantile distributions of amino acid usage that reveal general
      compositional biases in proteins and evolutionary relations; and (iii) r-scan
      statistics that can be applied to the analysis of spacings of sequence markers.

PMID- 1621094
TI  - Neurexins: synaptic cell surface proteins related to the alpha-latrotoxin
      receptor and laminin.
AB  - A family of highly polymorphic neuronal cell surface proteins, the neurexins, has
      been identified. At least two genes for neurexins exist. Each gene uses
      alternative promoters and multiple variably spliced exons to potentially generate
      more than a 100 different neurexin transcripts. The neurexins were discovered by
      the identification of one member of the family as the receptor for alpha
      latrotoxin. This toxin is a component of the venom from black widow spiders; it
      binds to presynaptic nerve terminals and triggers massive neurotransmitter
      release. Neurexins contain single transmembrane regions and extracellular domains
      with repeated sequences similar to sequences in laminin A, slit, and agrin,
      proteins that have been implicated in axon guidance and synaptogenesis. An
      antibody to neurexin I showed highly concentrated immunoreactivity at the
      synapse. The polymorphic structure of the neurexins, their neural localization,
      and their sequence similarity to proteins associated with neurogenesis suggest a
      function as cell recognition molecules in the nerve terminal.

PMID- 1621095
TI  - Fatty acid biosynthesis redirected to medium chains in transgenic oilseed plants.
AB  - Medium-chain fatty acids (FAs), found in storage lipids of certain plants, are an
      important renewable resource. Seeds of undomesticated California bay accumulate
      laurate (12:0), and a 12:0-acyl-carrier protein thioesterase (BTE) has been
      purified from this tissue. Sequencing of BTE enabled the cloning of a
      complementary DNA coding for a plastid-targeted preprotein. Expression of the
      complementary DNA in the seeds of Arabidopsis thaliana resulted in BTE activity,
      and medium chains accumulated at the expense of long-chain (greater than or equal
      to 16) FAs. Laurate became the most abundant FA species and was deposited in the
      storage triacylglycerols. These results demonstrate a mechanism for medium-chain
      FA synthesis in plants.

PMID- 1621096
TI  - Evidence that eukaryotes and eocyte prokaryotes are immediate relatives.
AB  - The phylogenetic origin of eukaryotes has been unclear because eukaryotic nuclear
      genes have diverged substantially from prokaryotic ones. The genes coding for
      elongation factor EF-1 alpha were compared among various organisms. The EF-1
      alpha sequences of eukaryotes contained an 11-amino acid segment that was also
      found in eocytes (extremely thermophilic, sulfur-metabolizing bacteria) but that
      was absent in all other bacteria. The related (paralogous) genes encoding
      elongation factor EF-2 and initiation factor IF-2 also lacked the 11-amino acid
      insert. These data imply that the eocytes are the closest surviving relatives
      (sister taxon) of the eukaryotes.

PMID- 1621097
TI  - Conformation of the TAR RNA-arginine complex by NMR spectroscopy.
AB  - The messenger RNAs of human immunodeficiency virus-1 (HIV-1) have an RNA hairpin
      structure, TAR, at their 5' ends that contains a six-nucleotide loop and a three
      nucleotide bulge. The conformations of TAR RNA and of TAR with an arginine analog
      specifically bound at the binding site for the viral protein, Tat, were
      characterized by nuclear magnetic resonance (NMR) spectroscopy. Upon arginine
      binding, the bulge changes conformation, and essential nucleotides for binding,
      U23 and A27.U38, form a base-triple interaction that stabilizes arginine hydrogen
      bonding to G26 and phosphates. Specificity in the arginine-TAR interaction
      appears to be derived largely from the structure of the RNA.

PMID- 1621098
TI  - An unlikely sugar substrate site in the 1.65 A structure of the human aldose
      reductase holoenzyme implicated in diabetic complications.
AB  - Aldose reductase, which catalyzes the reduced form of nicotinamide adenine
      dinucleotide phosphate (NADPH)-dependent reduction of a wide variety of aromatic
      and aliphatic carbonyl compounds, is implicated in the development of diabetic
      and galactosemic complications involving the lens, retina, nerves, and kidney. A
      1.65 angstrom refined structure of a recombinant human placenta aldose reductase
      reveals that the enzyme contains a parallel beta 8/alpha 8-barrel motif and
      establishes a new motif for NADP-binding oxidoreductases. The substrate-binding
      site is located in a large, deep elliptical pocket at the COOH-terminal end of
      the beta barrel with a bound NADPH in an extended conformation. The highly
      hydrophobic nature of the active site pocket greatly favors aromatic and apolar
      substrates over highly polar monosaccharides. The structure should allow for the
      rational design of specific inhibitors that might provide molecular understanding
      of the catalytic mechanism, as well as possible therapeutic agents.

PMID- 1621099
TI  - Harpin, elicitor of the hypersensitive response produced by the plant pathogen
      Erwinia amylovora.
AB  - A proteinaceous elicitor of the plant defense reaction known as the
      hypersensitive response was isolated from Erwinia amylovora, the bacterium that
      causes fire blight of pear, apple, and other rosaceous plants. The elicitor,
      named harpin, is an acidic, heat-stable, cell-envelope-associated protein with an
      apparent molecular weight of 44 kilodaltons. Harpin caused tobacco leaf lamina to
      collapse and caused an increase in the pH of bathing solutions of suspension
      cultured tobacco cells. The gene encoding harpin (hrpN) was located in the 40
      kilobase hrp gene cluster of E. amylovora, sequenced, and mutated with Tn5tac1.
      The hrpN mutants were not pathogenic to pear, did not elicit the hypersensitive
      response, and did not produce harpin.

PMID- 1621100
TI  - Increased osteoclast development after estrogen loss: mediation by interleukin-6.
AB  - Osteoclasts, the cells that resorb bone, develop from hematopoietic precursors of
      the bone marrow under the control of factors produced in their microenvironment.
      The cytokine interleukin-6 can promote hematopoiesis and osteoclastogenesis.
      Interleukin-6 production by bone and marrow stromal cells is suppressed by 17
      beta-estradiol in vitro. In mice, estrogen loss (ovariectomy) increased the
      number of colony-forming units for granulocytes and macrophages, enhanced
      osteoclast development in ex vivo cultures of marrow, and increased the number of
      osteoclasts in trabecular bone. These changes were prevented by 17 beta-estradiol
      or an antibody to interleukin-6. Thus, estrogen loss results in an interleukin-6
      mediated stimulation of osteoclastogenesis, which suggests a mechanism for the
      increased bone resorption in postmenopausal osteoporosis.

PMID- 1621101
TI  - No requirement for p56lck in the antigen-stimulated clonal deletion of
      thymocytes.
AB  - Activation of protein-tyrosine kinases (PTKs) is required for signal transduction
      during T cell activation, although the pathway used during thymic selection is
      unknown. An in vitro system was established in which T cell receptor transgenic
      thymocytes underwent clonal deletion in response to peptide antigen. The effects
      of two PTK-specific inhibitors, herbimycin A and genistein, on the clonal
      deletion of immature thymocytes and the activation of mature thymocytes were
      examined. Clonal deletion occurred while T cell activation was inhibited and when
      no p56lck activity was evident. Thus, p56lck is not required for the antigen
      stimulated step of clonal deletion of immature thymocytes, and negative selection
      proceeds via a distinct pathway.

PMID- 1621102
TI  - In vivo calcium elevations in thymocytes with T cell receptors that are specific
      for self ligands.
AB  - Selection of the T cell receptor (TCR) repertoire in the thymus probably involves
      TCR-mediated signals transduced in developing thymocytes after interaction with
      thymic stromal cells bearing self ligands. TCR-transduced signals should have
      identifiable consequences that would distinguish thymocytes whose TCRs have been
      engaged by self ligands from those whose TCRs have not. Among thymocytes
      expressing a transgenic TCR of defined specificity, a large number had elevated
      intracellular calcium concentrations but only when resident in a negatively
      selecting thymus in which their self ligand was expressed. Thus, developing
      thymocytes are stimulated by endogenous ligands in vivo to mobilize intracellular
      calcium, and increased intracellular calcium concentrations may reflect the
      consequences of intrathymic signaling associated with thymic negative selection.

PMID- 1621103
TI  - [Effect of brain osmoreceptor stimulation on the function of superficial nephrons
      in the rat].
AB  - Our previous work with lithium clearance method indicated that the diuresis and
      natriuresis induced by intracerebroventricular administration of hypertonic
      saline (icv. HS) resulted from an increase in glomerular filtration rate and a
      decrease in water and sodium reabsorption in the proximal tubules. In the present
      study, we further observed the effect of icv. HS on the glomerular filtration
      rate and proximal convoluted tubular and loop reabsorption in the superficial
      nephrons with micropuncture technique. After icv. HS, single nephron glomerular
      filtration rate increased from 39.6 +/- 1.9 nl/min to 48.8 +/- 2.0 nl/min (P less
      than 0.001), late proximal convoluted tubular fluid flow rate increased from 20.5
      +/- 1.4 nl/min to 28.4 +/- 2.0 nl/min (P less than 0.01), and the ratio of
      tubular fluid inulin concentration to plasma inulin concentration decreased from
      1.98 +/- 0.08 to 1.69 +/- 0.05 (P less than 0.01). Calculated fractional proximal
      convoluted tubular fluid reabsorption decreased from 49.2 +/- 2.2% to 41.7 +/-
      1.8% (P less than 0.001), while calculated absolute proximal convoluted tubular
      fluid reabsorption did not change significantly. These results coincided with the
      observation with lithium clearance method. In addition, icv. HS increased
      absolute loop fluid reabsorption but decreased fractional loop fluid
      reabsorption. The present data suggest that stimulation of the brain osmoreceptor
      increases the glomerular filtration rate and decreases the reabsorption capacity
      of the proximal convoluted tubule in the superficial nephrons, both these
      responses result in an increase in the load of the loop of Henle with a secondary
      change in loop reabsorption. However, the results of the present study do not
      rule out the possibility that icv. HS may also inhibit the loop reabsorption
      directly.

PMID- 1621104
TI  - [Cardiovascular effect of norepinephrine in the habenular nucleus and the
      underlying mechanism in rats].
AB  - Cardiovascular effect of norepinephrine (NE) in the habenular nucleus (Hb) and
      the underlying mechanism were investigated in urethane-anesthetized rats. NE
      microinjection into Hb produced a dose-dependent increase in mean arterial blood
      pressure and heart rate, an effect that could be attenuated by the pretreatment
      in Hb with alpha-receptor blocker phentolamine, but not by the pretreatment with
      beta-receptor blocker propranolol or physiological saline. Microinjection of
      kainic acid into Hb gave rise to a marked increase in mean arterial blood
      pressure and heart rate, but microinjection of lidocaine did not elicit
      significant cardiovascular effect. The above results suggest that NE in Hb plays
      an important role in cardiovascular control as a result of Hb excitation through
      activation of alpha-receptor.

PMID- 1621105
TI  - [Effect of the central noradrenergic system on carotid sinus reflex in rats].
AB  - In order to study the effect of central noradrenergic system on the regulation of
      mean arterial pressure (MAP) by intracarotid sinus pressure (ISP), ISP-MAP
      relationship curves were constructed using isolated carotid sinus under the
      condition of injection of 6-OHDA (200 micrograms) into lateral ventricle or
      cauterization of locus coeruleus (LC) and compared with that obtained under the
      condition of control. All ISP-MAP curves can be fitted by a logistic functional
      plot whose characteristics can be defined by two parameters, i.e. coordinates of
      the inversion point of the slope of the curve and the MAP range related to the
      rate of change of slope factor with which carotid sinus pressure exerts its
      control. The results were as follows: After injection of 6-OHDA, the rate of
      change of the slope of the ISP-MAP curve is considerably slower than that of the
      normal control, thus showing a much compressed range of MAP by ISP, while the
      abscissa (i.e. position of ISP) of the slope inversion point of the curve shows
      practically no change. In comparison with the control, cauterization of LC causes
      a similar but less striking change of ISP-MAP curve than that of 6-OHDA injection
      experiment. All such differences were illustrated in Fig. 3. The above results
      indicated that the central noradrenergic system facilitates carotid sinus reflex
      and LC plays a dominant role.

PMID- 1621106
TI  - [Depressor effect of nucleus arcuatus stimulation in chronic stress-induced
      hypertensive rat].
AB  - Hypertension was induced by chronic foot-shock and noise stress in adult male
      Sprague-Dawley rats. Microinjection of 0.3 microliters (150 mmol) sodium
      glutamate (Glu) into the nucleus arcuatus (ARC) elicited a significant depressor
      effect in rats with chronic stress-induced hypertension. The depressor effect
      induced by excitation of ARC neurons was attenuated significantly by
      microinjection of 0.3 microliters beta-endorphin antiserum (beta-EPAS) into the
      dorso-medial periaqueductal gray (PAG) or 0.1 microliters into the area of locus
      coeruleus (LC) due to blockage of beta-endorphinergic fibres from ARC to PAG or
      LC.

PMID- 1621107
TI  - [Effects of electrical cauterization of nucleus raphe magnus on gastric acid
      output and serum gastrin level in rats].
AB  - Medullary raphe nucleus complex plays an important role in the regulation of
      visceral function. The effects of electrical damage of the nucleus raphe magnus
      on gastric acid output and serum gastrin level in anesthetized rats were
      observed. The experiments showed that damage of nucleus raphe magnus increased
      gastric acid output and serum gastrin level, which could be prevented by vagotomy
      but not by coeliac and superior mesenteric ganglionectomy.

PMID- 1621108
TI  - [Estimation of glucocorticoid membrane binding sites in synaptic plasma membrane
      isolated from porcine brain].
AB  - Using radioligand binding assay, we measured the Bmax and Kd of glucocorticoid
      membrane binding sites (GCMBS) in the synaptic plasma membranes isolated from
      different regions of porcine brain. The Kds of GCMBS in cerebrum, cerebellum,
      midbrain, thalamus, nuclei caudatus and hypothalamus are all around 200 nmol/L.
      The Bmax of GCMBS in the mentioned brain regions ranges from 218.98 fmol/mg to
      486.95 fmol/mg protein.

PMID- 1621109
TI  - [Effect of intraventricular injection of 6-hydroxydopamine on the initiation of
      hibernation in ground squirrels].
AB  - The effect of forced depletion of brain norepinephrine (NE) on the onset of
      hibernation was observed in the ground squirrel (Citellus dauricus) by
      intraventricular injection of 6-hydroxydopamine (6-OHDA). The results showed: (1)
      Intraventricular injection of 100-200 micrograms 6-OHDA, which depleted 50-60%
      NE, markedly facilitated the onset of hibernation, i.e. the average induction
      period for hibernation in the treated animals was significantly shorter than that
      of the natural hibernating animals. (2) The average total torpor time in the
      treated animals was longer than that of natural hibernating animals. (3) All
      hibernating animals treated with 6-OHDA were able to wake up from deep
      hibernation spontaneously and undergo normal hibernation bouts. The results
      indicate the decrease of NE system activity in brain is one important factor in
      triggering the onset of hibernation.

PMID- 1621110
TI  - [Changes in plasma interleukin-1 and their possible relationship with the changes
      in glucocorticoid receptor in aged long-distance runner].
AB  - For the study of the changes in plasma interleukin-1 (IL-1) and their possible
      relationship with the changes in glucocorticoid receptor (GR), plasma IL-1 and GR
      in peripheral blood leukocytes in aged long-distance runner were measured
      simultaneously. The activity of IL-1 was expressed as its ability to stimulate 3H
      TdR incorporation in the thymocytes of C57 mice. GR was determined by whole cell
      assay with 3H-Dex. The results showed that the activity of plasma IL-1 in aged
      long-distance runner was 209%, 223% and 145% of the control at 14.7-18.7, 3.8-7.0
      and 1.5-2.6 KD fractions. The GR in peripheral blood leukocytes in aged runner
      was 65% of the control. Possible relationship between the changes in IL-1 and GR
      in aged long-distance runner and its physiological significance are discussed.

PMID- 1621111
TI  - [Protective effect of indomethacin on alloxan-induced diabetes in rat].
AB  - Changes of concentration of serum glucose, insulin and glucagon induced by
      preadministration of indomethacin were observed in normal rats and diabetic rats
      induced by alloxan. The results demonstrated that the level of serum glucose in
      diabetic rats was lowered significantly after preadministration of indomethacin
      (10 mg/kg) dose-dependently. After preadministration of 5, 10, 15 mg/kg of
      indomethacin the level of serum glucose 48 h after injecting alloxan was
      decreased from the control value of 591.5 +/- 38.2 mg% to 559.1 +/- 53.2, 436 +/-
      16.6 and 266.6 +/- 29.9 mg% respectively. The concentration of serum insulin was
      increased from the control 10.5 +/- 2.7 microU/ml to 31.9 +/- 7.0 microU/ml and
      glucagon from 550.0 +/- 27.0 pg/ml to 303.1 +/- 22.9 pg/ml after
      preadministration of 10 mg/kg indomethacin. Histologic observation showed that
      alloxan induced beta cell lesion in pancreatic islet could indeed be prevented by
      indomethacin to a significant extent.

PMID- 1621112
TI  - [Protective effect of verapamil against alloxan-induced damage on pancreatic
      islet beta-cells in rats].
AB  - An experimental diabetes model was produced by intravenous injection of alloxan.
      Verapamil (40 mg/kg) administered intraperitoneally 30 minutes prior to alloxan
      was able to decrease serum glucose from 22.93 +/- 1.37 mmol/L to 8.79 +/- 0.83
      mmol/L after 48 hours of injection of alloxan. Histological findings showed that
      the number of secretory granules in beta cells of the pancreatic islet of rats
      pretreated with verapamil was markedly increased as compared to rats treated with
      alloxan alone.

PMID- 1621113
TI  - Sepsis in young infants--rational approach to early diagnosis and treatment.

PMID- 1621114
TI  - Clinical features and haematological indices of bacterial infections in young
      infants.
AB  - The clinical features and haematologic indices of 100 young infants aged 3 months
      and below, admitted with suspected bacterial infections, were analysed. Fever,
      lethargy, hepatomegaly, poor feeding and irritability were the commonest features
      for suspecting a bacterial infection in these infants. However, the features
      significantly associated with bacterial infections were respiratory distress and
      cyanosis. Of the haematologic indices commonly associated with bacterial
      infections, only C-reactive protein and erythrocyte sedimentation rate were
      significantly predictive compared to leukocyte counts, absolute neutrophil counts
      and nitro-blue tetrazolium tests. When used in combination, a raised C-reactive
      protein with erythrocyte sedimentation rate, a raised erythrocyte sedimentation
      rate with abnormal leukocyte counts and a raised C-reactive protein with abnormal
      leukocyte counts were significantly associated with bacterial infections.

PMID- 1621115
TI  - Use of intracranial neurophysiologic recording techniques in the evaluation for
      epilepsy surgery in children.
AB  - Resective surgery is an accepted treatment modality for medically intractable
      focal epilepsy in children as well as in adult. During the presurgical evaluation
      processes, intracranial neurophysiologic recording of epileptiform abnormalities
      have been used much more commonly in adults and older adolescents than in infants
      and children. However, as infants and children are increasingly referred for
      early surgery in many centres, it may be necessary to study complex cases in some
      children with invasive electrodes in order to plan a safe and effective
      resection. This article gives first an overview of the rationale and indications,
      with case illustrations, for using these techniques. This is followed by general
      discussions on individual electrodes and their use in infants and children.

PMID- 1621116
TI  - The role of urodynamics in evaluating incontinent females.
AB  - A total of 84 patients had urodynamic evaluations. Twenty-two patients complained
      of stress incontinence, 41 patients complained of stress incontinence with other
      urinary symptoms and 21 complained of other urinary symptoms but not stress
      incontinence. Of those complaining of stress incontinence alone, 4 (18.2%) had
      detrussor instability, 11 (50%) had genuine stress incontinence and 7 (31%) had
      neither condition. Of those complaining of stress incontinence with other
      symptoms, 16 (39%) had detrussor instability, 19 (46.3%) had stress incontinence
      and 6 (14.6%) had neither condition. Of those complaining of other urinary
      symptoms except stress incontinence, 5 (23.8%) had detrussor instability, 3
      (14.3%) had stress incontinence and 13 (61.9%) had neither condition. Urinary
      symptoms were found to have little correlation with the final diagnosis except
      for enuresis which was associated with detrussor instability.

PMID- 1621117
TI  - The current status of intracoronary stent: an overview.
AB  - Intracoronary stenting is a relatively new therapeutic interventional modality
      conceived to address the 2 major pitfalls of conventional balloon angioplasty,
      namely that of acute closure and restenosis. Much progress has been made since
      its clinical application in 1986. Its place amongst the multitude of novel
      devices currently available in the treatment of coronary obstructive disease
      seems secure. The challenge for investigators now is to develop a stent without
      the inherent problem of acute thrombosis.

PMID- 1621118
TI  - Neuropsychological testing: how it can benefit clinical neuroscience in
      Singapore.
AB  - Neuropsychological testing is a relatively new field in the area of clinical
      neuroscience. It has proven to be an effective and essential aid in the
      diagnostic process of brain-injured patients, especially in lesions of the
      cerebral cortex. More advanced countries have incorporated neuropsychological
      assessments in their standard neurological examinations of the brain damaged.
      Clinical neuropsychology is only beginning to be used in Singapore. Research
      using neuropsychological methods have also shown to be useful in providing a
      greater understanding of the brain-behaviour relationship in humans. Problems
      confronting the use of neuropsychological testing in Singapore are identified and
      the possible solutions discussed.

PMID- 1621119
TI  - Computerised scoring and graphing of the Farnsworth-Munsell 100 Hue test of
      colour vision--a program written in Pascal.
AB  - The Farnsworth Munsell 100 Hue test is the best test for diagnosing and assessing
      colour vision defects. A computer program written in Pascal which automatically
      scores, plots and analyses the results of the Farnsworth Munsell 100 Hue test is
      presented.

PMID- 1621120
TI  - The Mentakab Hypertension Study Project Part VI--Blood pressure measurement and
      hypertension: a questionnaire survey of medical staff.
AB  - A questionaire concerning various aspects of blood pressure measurement and
      hypertension was answered by 84 out of 98 (86%) doctors and 73 out of 100 (73%)
      nurses working in various parts of the state of Pahang. 59% and 85% of doctors
      and nurses respectively agreed that blood pressure should be measured routinely
      in all out-patients. 48% of medical staff were taught to use and 38% were
      actually using phase 4 as the diastolic blood pressure despite the general
      agreement that phase 5 should be used to denote diastolic pressure. 52% of
      doctors believed that hypertensive patients present with symptoms, the common
      symptoms cited were headache and dizziness, although it is well documented that
      hypertension is essentially asymptomatic. 93%, 80%, 69% and 82% of doctors
      believed that treatment of hypertension can prevent cerebrovascular disease,
      heart failure, renal failure and coronary artery disease respectively, although
      prevention of the last complication is yet unproven. Most doctors would begin
      treating a patient at rather low level of blood pressure, for example, for a man
      in the age group 40-49, 40% of doctors would begin drug treatment at diastolic
      pressure of 90 mmHg and 55% at diastolic pressure 95 mmHg. 79% of nurses and 55%
      of doctors were dissatisfied with the sphygmomanometer they have, the most common
      complaint was that the cuff-bladder 'blow up' on being inflated.

PMID- 1621121
TI  - Abnormalities of chromosome 11Q in three cases of acute myeloid leukemia.
AB  - The haematological findings and case history of 3 patients with the association
      of acute myeloid leukemia and translocation involving the long arm of chromosome
      no. 11 are presented. The recipient chromosome for the translocated material from
      chromosome 11 differs in all the three cases being namely chromosomes 1, 10 and
      17.

PMID- 1621122
TI  - Clinical applications of salivary cortisol measurements.
AB  - The clinical applications of salivary cortisol measurements were evaluated by
      radioimmunoassay of time-matched saliva and plasma samples. Salivary cortisol
      levels of normal subjects exhibited a significant (p less than 0.001) diurnal
      variation with a mean (+/- SD) concentration of 8.7 +/- 4.8 nmol/L at 0800-1000 h
      and 2.4 +/- 1.1 nmol/l at 1500-1700 h. After an overnight dexamethasone
      suppression test, morning salivary cortisol levels decrease to 2.7 +/- 0.7 nmol/L
      (p less than 0.001 vs normal). An excellent correlation (r = 0.805) of cortisol
      measurements with time-matched saliva and plasma samples was obtained (y = 0.03x
      + 0.88, p less than 0.001, n = 91). Hypercortisolism was confirmed by raised
      salivary cortisols in only half of patients with elevated total plasma levels,
      thereby indicating that salivary cortisol measurements is a better index of
      adrenal status.

PMID- 1621123
TI  - Morbidity associated with asthma and audit of asthma treatment in out-patient
      clinics.
AB  - A study was undertaken to determine the extent of morbidity associated with
      asthma and to audit the management of asthma in two out-patient clinics of two
      district hospitals. Patients were recruited for the study during a 3-month period
      from December 1990 to February 1991. Seventy asthmatic patients were studied.
      Eighty-six percent of the patients had their sleep disturbed by asthma, 77% took
      daily medication regularly, 63% felt that their activities were restricted by
      asthma, 60% had at least one acute exacerbation in the preceding six months. Of
      those who had their peak expiratory flow rate (PEFR) measured, 40% had a PEFR
      below 50% predicted, and only 11% had normal PEFR (greater than 80% predicted).
      The morbidity of asthma was thus considerable. On the other hand, the drug
      treatment of these asthmatics was grossly inadequate. They were prescribed on
      average 2.1 item of drugs, which for most patients comprised an oral beta agonist
      and a theophylline. Only 43% of the patients received inhaler therapy, but no
      patients were given steroids, inhaled or oral. The drug treatment was unrelated
      to the severity of patients' asthma. Further, objective measurement of severity
      was under-used in the assessment of asthma, only 8.5% of patients ever had their
      PEFR recorded. This study has found that asthma is poorly managed in out-patient
      clinics. We need to improve the training of doctors in the optimal management of
      asthma.

PMID- 1621124
TI  - Association of diabetic autonomic neuropathy with painless myocardial ischaemia
      induced by exercise.
AB  - Silent myocardial ischaemia is now well-recognised in patients with symptomatic
      coronary artery disease. Its pathogenesis remains speculative, though diminished
      sensitivity to pain is thought to be one of the mechanisms involved. Because
      cardiovascular autonomic dysfunction occurs frequently in diabetic patients, we
      postulate that it contributes towards painless myocardial ischaemia among them.
      Forty consecutive diabetic (type II) male patients and ten normal volunteers were
      studied. Using 5 previously-validated noninvasive tests for autonomic
      dysfunction, 14 of these diabetic men had definite autonomic neuropathy (at least
      2 abnormal tests). All 50 subjects were then exercised on a motor-driven
      treadmill to either exhaustion or chest pains. Thirty-three diabetic subjects
      were tested positive, with significant (greater than 1 mm) ST segment depression
      over at least 2 contiguous leads. Of these, 18 were associated with typical
      angina but the other 15 stopped because of fatigue or exhaustion (ie painless).
      Thirteen subjects who had definite autonomic neuropathy (AN+) had positive
      exercise ECG tests-10 had painless ischaemia, and only 3 had angina. This
      contrasted with 15 patients who had painful ischaemia and 5 who had painless
      ischaemia among the group without (AN-)autonomic dysfunction (p = 0.0047,
      Fisher's exact test). There were no significant differences among the various
      groups for peak rate-pressure-product, all subjects attaining similar maximal
      oxygen consumption states during which ischaemic ST segment changes were noted
      (painful AN+: 21917 +/- 4753; painless AN+: 20117 +/- 6752; painful AN-: 16544 +/
      4063; painless AN-: 22220 +/- 4341, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621125
TI  - Male and female transsexuals: a comparison.
AB  - The aim of this study is to describe and compare the characteristics of 320 male
      and 130 female transsexuals in Singapore. The subjects were given a
      semistructured psychiatric interview. The results showed that the males were
      slightly younger, had less education and held lower level jobs. Their
      occupational preferences were reversed. The male transsexuals started petting,
      sexual intercourse and having partners about one to two years earlier, but they
      cross-dressed four to seven years later. Both males and females were homosexually
      orientated. Other studies showed that late maternal age was associated with
      homosexuality, but not with transsexualism. These studies also confirmed that
      transsexualism had its onset in early childhood, and that cross-dressing was an
      early feature. The Singapore 'transsexuals went through a "homosexual" and a
      "transvestite" phase before they became a transsexual. Western transsexuals
      exhibited both homosexual and heterosexual behaviour, and some were married to
      the opposite sex partners. Male prostitution was reported in many studies.

PMID- 1621126
TI  - Inflammatory myopathies.
AB  - Inflammatory myopathies encompass a wide range of disorders. This article deals
      with the idiopathic inflammatory myopathies. Classification and diagnostic
      criteria proposed by Bohan and Peter are still widely used. Diagnosis is based on
      clinical features, muscle enzyme abnormalities, electromyographic findings and
      muscle biopsy results. There are known associations with malignancy and lung
      disease which may affect the prognosis. Management consists of the prudent use of
      corticosteroids. In refractory cases, cytotoxic agents, cyclosporin and
      plasmapheresis have been used.

PMID- 1621127
TI  - Systemic sclerosis.
AB  - Systemic Sclerosis is a multisystemic disease characterized by sclerosis of the
      skin and visceral organs, vasculopathy (Raynaud's phenomenon) and autoantibodies.
      The criteria for the classification of the disease requires either proximal
      scleroderma (major criteria) or the presence of 2 of the 3 minor features namely
      sclerodactyly, digital pitting scars and bibasilar pulmonary fibrosis. There are
      3 subsets of this condition--diffuse variant, limited variant (CREST syndrome)
      and Overlap Syndrome (where patients have features of other rheumatic diseases).
      There are localized forms of scleroderma and pseudoscleroderma states. The
      presenting features of Systemic Sclerosis are usually Raynaud's, skin changes and
      arthralgia. Systemic complaints like breathlessness, dyspepsia, etc depending on
      the organ involved may be present. Management starts with patient education
      regarding the disease, skin care, exercises and regular medical check-up. There
      is no miracle cure but much can be done to improve the quality of life of the
      patient. Nifedepine and other drugs may improve Raynaud's phenomenon. Drugs can
      be used to treat other complications. Various medication have been tested as
      disease modifying drugs for scleroderma. These include drugs which inhibit
      collagen like D-penicillamine, colchicine, and immunosupressive drugs like
      cyclosporin. Ketotifen, a mast cell stabilizer has been reported to be effective
      in scleroderma. As it is a relatively safe drug, clinical trials are underway.

PMID- 1621129
TI  - Tall precordial T waves: normal variant or acute myocardial infarction?

PMID- 1621128
TI  - Soft tissue "rheumatism" in sports.
AB  - Pain and stiffness of the injured region after prolonged periods of inactivity is
      commonly encountered following soft tissue injuries in sports. The injury in most
      of these instances is due to stress failure although occasionally an acute injury
      with a protracted course in recovery may develop similar symptoms. The most
      common of these condition are the enthesopathies, that include tendonitis and
      fasciitis, sprains and strains, bursitis, tenovaginitis and the fibrositis
      syndrome.

PMID- 1621130
TI  - A case of Dandy Walker cyst with porencephaly.
AB  - A 27-year-old gravida two para one mother delivered a term male baby by caesarean
      section. The baby was referred for enlarged head. This neonate with large head
      was found to have Porencephalic cyst with dilated Triventricular system. There
      was a posterior fossa cyst communicating with fourth ventricle. A diagnosis of
      Dandy Walker Cyst with Porencephaly was made. Ventriculo-Peritoneal shunt was
      done on the ninth day of life. The baby had an uneventful postoperative period
      and was subsequently discharged.

PMID- 1621131
TI  - A case of primary diffuse tracheobronchial amyloidosis treated by laser therapy.
AB  - We report a case of primary diffuse tracheobronchial amyloidosis in a 72-year-old
      lady who presented with a long history of recurrent cough, dyspnoea, wheezing,
      haemoptysis and chest infection. She was treated successfully with three sessions
      of laser therapy. There were improvements in both clinical symptoms and
      measurements of airway obstruction. Bronchodilators and oral prednisolone were
      not required after treatment.

PMID- 1621132
TI  - Primary psoas abscess: case report and review of the literature.
AB  - A case of primary non-tuberculous psoas abscess is reported and the literature
      reviewed. The aetiology of psoas abscess is varied and there is a worldwide
      variation in the aetiology. Primary psoas abscess is due to Staphylococcal
      infection. The pathophysiology, clinical features, diagnosis and treatment are
      discussed with emphasis on the changing pattern in the aetiology and diagnosis.

PMID- 1621133
TI  - Difficult intubation stylohyoid ligament calcification.
AB  - Intubation was difficult and traumatic in a 40-year-old patient presented for
      emergency oesophagoscopy because the diagnosis of stylohyoid ligament
      calcification was not suspected. High probability of stylohyoid ligament
      calcification should be suspected when there is difficulty in lifting the
      epiglottis and fibre-optic laryngoscopy is suggested as the best way to tackle
      this problem to prevent trauma and possible risk of regurgitation and aspiration
      especially in emergency situation.

PMID- 1621134
TI  - A triaxial classification of health problems presenting in primary health care. A
      World Health Organization multi-centre study.
AB  - Over the past two decades, research in a variety of countries and settings has
      revealed the extent to which psychological morbidity and social problems
      constitute an important proportion of primary health care contacts, either in
      their own right or in association with physical ill-health. The development of
      appropriate responses, medical and non-medical, to such problems is, in part,
      hindered by the relatively low level of awareness concerning the significance of
      such problems and by currently inappropriate methods of describing and
      classifying health care problems in the primary care setting. There is a pressing
      need for an appropriate, relatively simple and flexible classification or list of
      problems presenting in primary care. This study describes the development, under
      WHO auspices and in an international setting, of a triaxial classification of
      health problems and the testing and modification of the classification by means
      of an international case vignette rating exercise. A psychological problem list
      and a social problem list, together with detailed glossaries, suitably modified
      in the light of experience derived from the study, are described, and proposals
      enumerated of possible ways in which these lists might be further developed and
      used in research and clinical undertakings in primary care.

PMID- 1621135
TI  - Gender differences in schizophrenia in three cultures. Results of the WHO
      collaborative study on psychiatric disability.
AB  - As part of a systematic research project on the influence of gender factors on
      age at onset, symptomatology, and course of schizophrenia, data on gender
      differences in age at onset and symptomatology of schizophrenia from the WHO
      Collaborative Study "On Assessment and Reduction of Psychiatric Disability" were
      compared between seven research centres of three different cultural regions.
      Results on age at onset of five European centres confirmed the well known fact of
      an earlier onset in men. The earlier onset in women seen in Khartoum and Ankara
      could be attributed to patient selection because male/female differences in age
      at onset and male/female ratios in the various samples covary. In the Islamic
      centres no relevant gender differences in real age at onset and in symptomatology
      could be detected as probable causes of earlier hospitalisation of women. Major
      gender differences in symptomatology were found in the Balkan centres of Sofia
      and Zagreb with a high prevalence of delusional symptoms in women and depression
      in men. In Western Europe centres, nuclear schizophrenic symptoms were equally
      prevalent in either sex, while nonspecific symptoms like irritability and
      tiredness (more frequent in women) and maladaptive illness behaviours like
      alcohol abuse and social withdrawal (more frequent in men) differed between the
      sexes. Explanatory hypotheses and the implications of these results are
      discussed.

PMID- 1621136
TI  - Is age of onset in schizophrenia influenced by marital status? Some remarks on
      the difficulties and pitfalls in the systematic testing of a "simple" question.
AB  - Schizophrenia is a disease characterized by a distinctly higher age at onset and
      at first admission in females than in males. In a systematic study on gender
      differences in schizophrenia we have confirmed this finding using different sets
      of data, in particular through the examination of a large and representative
      sample of first-admitted patients. The question addressed in this paper is
      whether marital status influences this sex-specific age difference. Assuming that
      marriage or a stable relationship is a protective factor in schizophrenia,
      delaying the onset of the disease or first hospitalization, the hypothesis was
      formulated that the later age of onset in women is at least partly explained by
      their generally earlier age of marriage. Testing this hypothesis illustrates some
      of the methodological problems that often occur when a causal analysis of social
      data is attempted. The problems emerge especially when both the dependent
      variable (age of onset/first admission) and the independent variable (marital
      status) are essentially related to age. First results appearing to indicate an
      influence of marital status on age at first admission did not bear a critical
      interpretation.

PMID- 1621137
TI  - Social outcome in schizophrenia: a 13-year follow-up.
AB  - The cohort consists of all psychiatric patients (n = 53) admitted for the first
      time in 1972 from a well-defined catchment area with a population of 582,000
      inhabitants aged 15 years and over. Furthermore, they were all registered with
      the diagnosis schizophrenia in the nation-wide psychiatric register at least once
      during an observation period from the day of the first admission in 1972 until
      August 31, 1983. The entire cohort was followed up on average 13 years after
      their first admission. Poor employment outcome (79%), poor social contact outcome
      (55%), and poor overall social outcome (76%) characterized the living conditions
      of the 42 patients alive at follow-up. Good employment outcome was predicted by
      "born in rural area." Good social contact outcome was predicted by full remission
      at first discharge and poor outcome by male sex. Good overall social outcome was
      predicted by "born in rural area" and of marginal significance by high social
      status at first admission. A comparison of parents' highest social group and
      patients' social group at follow-up supports previous findings on social drift.

PMID- 1621139
TI  - The high incidence of psychiatrically treated disorders in the inner city of
      Mannheim. Susceptibility of German and foreign residents.
AB  - In earlier investigations in the city of Mannheim we examined the spatial
      distribution of the incidence of treated mental disorders in 1965 and 1974-80. In
      studying the ecology of psychiatric disorders over time, it is important to
      consider major demographic developments. In Mannheim between the mid-sixties and
      1980 the most striking demographic change was the increase of foreign residents,
      whose proportion almost trebled during this period. In this study we test the
      hypothesis whether the excess morbidity in the inner city where housing
      conditions are relatively poor and the percentage of foreign residents is far
      above average can be explained by the high proportion of immigrants, mainly from
      Turkey, living there. Due to motivational and administrative factors, most
      immigrant workers being recruited on the basis of good physical and mental
      health, the age-adjusted incidence of treated psychiatric disorders between 1974
      and 1980 among the German population exceeded that of foreign residents. The high
      concentration of psychiatric disorders in the inner city is due solely to the
      German and not to the foreign residents. The most plausible explanation for this
      is provided by the segregation hypothesis. Individuals with vulnerable
      personalities tend to move to socially disorganized districts of the city.
      Furthermore, the health status of those Germans who left areas of poor
      environmental conditions was probably better in comparison to those who remained
      in the inner city.

PMID- 1621138
TI  - Center differences and cross-national invariance in help-seeking for panic
      disorder. A report from the cross-national collaborative panic study.
AB  - Help-seeking behaviour for treatment of panic disorder was investigated in the
      sample of the Cross-National Collaborative Panic Study Second Phase. A total of
      1168 patients were entered into this trial in 14 countries. Although there were
      significant center differences in prior treatment and utilization of health
      services there were also similarities. Treatment had been provided mainly by
      general practitioners. Drug treatment consisted mostly of prescription of
      classical tranquilizers and had a longer duration than treatment by
      psychotherapy. Patients with agoraphobic avoidance, past major depression and
      longer duration of illness used medical and psychiatric treatment facilities more
      intensely. Older and more severely disabled subjects were more frequently treated
      by medical health care providers and were more likely to receive psychotropic
      drugs. The results indicate that general practitioners carry an important load in
      the treatment of panic disorders but may need more information about recent
      development in pharmacotherapy for this condition.

PMID- 1621140
TI  - A psychiatric unit in a general hospital in Brazil: predictors of length of stay.
AB  - The planning and organization of mental health care in developing countries
      frequently lacks empirical data. The World Health Organization recommended
      psychiatric brief inpatient programs in general hospitals for these countries as
      a cost-effective alternative to the traditional mental hospital. Length of
      hospital stay is a crucial factor in a cost-effective mental health care
      organization. In a newly organized psychiatric inpatient unit in a general
      teaching hospital in Brazil we investigated the influence of 16 socio-demographic
      and clinical variables on the length of stay. Distance from residence to hospital
      (P less than 0.10), clinical diagnosis (P less than 0.05) and religious
      affiliation (P less than 0.05) were significantly related to length of stay.
      Possible mental health care implications of this short stay program are
      discussed.

PMID- 1621141
TI  - Influence of having a hospitalized mentally ill member in the family on attitudes
      toward mental patients in Turkey.
AB  - The influence of having a mentally ill member in the family on various attitudes
      was assessed. An exposed group (those having a mentally ill member) was compared
      with a no-exposure group. The attitudes assessed toward two vignettes included
      recognition of mental illness, social distance, expected burden, expected
      influence on one's health, treatment choice, and prognosis. The total sample
      consisted of 84 subjects selected from the family members of patients from
      psychiatric (exposed) and other (no-exposure) clinics. Direct experience with a
      mentally ill family member did not make a significant difference in the attitudes
      toward the vignettes, but the type of psychopathology did. The results were
      discussed within the context of findings from Western cultures.

PMID- 1621142
TI  - Patients in the care of private psychiatric practitioners. Comparison with public
      hospital patients and the background districts' population.
AB  - In Western societies, the number of psychiatric hospital beds has decreased
      markedly in the past decades. The reduction in hospital beds has resulted in a
      relatively large number of mentally ill individuals residing in the community.
      They experience varying degrees of success. One form of treatment available to
      such patients is private psychiatric consultation. In Denmark and England (two
      countries with public supported health care systems) the number of psychiatrists
      in private practice (PPPs) has increased in recent years. These private
      practioners may offer a mode of treatment which may meet the needs of a subgroup
      of the psychiatric patients in the community. The fees of the PPPs are paid by
      the National Health Service. In this study we report on the characteristics of
      the patients attending the consultation of private psychiatrists and the
      treatment which they are offered. We compare the patients of the PPPs with 1.
      psychiatric patients residing in the same districts who are cared for by the
      public hospital system and 2. the background populations of these same districts.
      The results suggest that the patients in private psychiatric practice are
      distinct in a number of ways. Neurosis is the dominant diagnosis. Of the
      patients, 71% are women; the patients tend to be younger than the background
      districts population; after controlling for age, the marital status of the
      patients in PPPs' care does not differ significantly from that of the background
      population, and they are comparable to the background population in level of
      employment. These patients are more able to care for themselves than the
      psychiatric patients treated in the public hospital system. The results suggest
      that PPP is a means of caring for a subgroup of the psychiatric patients in urban
      settings.

PMID- 1621143
TI  - Cervical spine motion in the sagittal plane. II. Position of segmental averaged
      instantaneous centers of rotation--a cineradiographic study.
AB  - Anteflexion and retroflexion movements of the cervical spine were recorded
      cineradiographically during three measuring sessions to determine reproducibility
      as well as intraindividual and interindividual variability of segmental
      instantaneous centers of rotation (recorded as "averaged" and "standard").
      Segmental averaged instantaneous centers of rotation were based on data obtained
      from all frames of the cineradiographic film by the use of the average pentagon
      and moving average method. Only the first and last frame were used to construct
      the segmental standard instantaneous centers of rotation. Contrary to segmental
      range of motion, a parameter of quantity of motion, the position of the averaged
      instantaneous centers of rotation (better than the standard), a parameter of
      quality of movement, shows a variability of such low extent that it seems
      feasible to use it to diagnose abnormal mobility or in assessing therapy in the
      neck region.

PMID- 1621144
TI  - Radiologic evaluation of dens fracture. Role of plain radiography and tomography.
AB  - A retrospective study of 50 dens fractures was performed. In 47 of 50 cases
      (94%), plain radiographs disclosed the fracture. Initial cross-table lateral view
      alone showed the fracture in 43 cases. In the remaining four cases, routine plain
      films revealed the fracture: open-mouth view in three cases and lateral skull
      view in one case. In 3 of 50 cases (6%), plain films were negative, and fractures
      were seen only on tomography. Conventional circular tomography was performed in
      26 cases; results were divided into 3 categories according to the significance of
      the findings: Category I, tomography confirmed plain radiographic findings, but
      added no further information; Category II, tomography detected additional
      findings or showed the extent of injury better than plain radiography; Category
      III, fracture was only seen by tomography. There were 19 cases in Category I, 4
      in Category II, and 3 in Category III. Careful evaluation of plain radiographs
      remains the primary method for diagnosis of dens fractures. Tomography should be
      performed whenever plain radiographs or clinical symptoms are suspicious for dens
      fracture. In addition, tomography is useful to define the fracture level and
      pattern, which are important factors in the management of these injuries.

PMID- 1621145
TI  - Biomechanical evaluation of four different posterior atlantoaxial fixation
      techniques.
AB  - Four different techniques for posterior atlantoaxial fusion were tested in vitro:
      1) wire fixation with one median graft (Gallie type); 2) wire fixation with two
      bilateral grafts (Brooks type); 3) transarticular screw fixation (Magerl); and,
      4) two bilateral posterior clamps (Halifax). The experiment was designed to
      determine the immediate three-dimensional stability of the spinal construct. Ten
      fresh human cadaveric specimens were tested intact, injured, and instrumented
      with each of the fixation techniques. The injury consisted of a severe soft
      tissue injury model, in which the alar, transverse, and capsular ligaments were
      transected. The three-dimensional motions of C1 relative to C2 were measured as
      the specimens were subjected to loads of pure moments in flexion-extension, axial
      rotation, and lateral bending. Each fixation technique significantly decreased
      motion in all directions, as compared to the intact and injured spines. We found
      that the Gallie system generally allowed significantly more rotation in flexion,
      extension, axial rotation, and lateral bending than the other three fixation
      techniques. There was generally no significant difference between the amount of
      rotation with the other three fixation techniques. However, the Magerl technique
      tended to allow the least rotation. The anteroposterior translation of two points
      on C1 were about equal for all fixation techniques.

PMID- 1621146
TI  - Expansive laminoplasty with reattachment of spinous process and extensor
      musculature for cervical myelopathy.
AB  - Since 1986 we have performed expansive laminoplasty with reattachment of the
      spinous processes and extensor musculature in cases of cervical myelopathy, to
      avoid the late postoperative complications of extensive laminectomy. The
      operative procedure and results are given in detail. Forty cases (24 men, 16
      women) were followed for a mean of 28 months. Postoperative results were
      satisfactory, with no major complications according to the evaluation criteria of
      the Japanese Orthopaedic Association. No instability or malalignment was seen on
      postoperative radiographs.

PMID- 1621147
TI  - Effects of altering core body temperature on somatosensory and motor evoked
      potentials in rats.
AB  - The effects of core temperature on three potentials--somatosensory spinal evoked
      potential, somatosensory cortical evoked potential, and spinal motor evoked
      potential--were studied in rats. Hyperthermia reduced the latency and increased
      the conduction velocity of all three potentials. Somatosensory spinal evoked
      potential amplitude was unchanged, whereas somatosensory cortical and spinal
      motor evoked potentials deteriorated above 42 C. Hypothermia increased latency
      and decreased conduction velocity in all three potentials. The amplitude of the
      spinal motor evoked potential decreased, and the somatosensory cortical and
      spinal motor evoked potentials disappeared below 28 C. Hyperthermia and
      hypothermia caused significant changes in the latency of all three potentials.
      The latency change of all three potentials became significant at 2-2.5 C above or
      below baseline, suggesting a range within which evoked potential studies should
      be performed.

PMID- 1621148
TI  - "Backfiring" in spinal cord monitoring. High thoracic spinal cord stimulation
      evokes sciatic response by antidromic sensory pathway conduction, not motor tract
      conduction.
AB  - Spinal cord stimulation has been advocated as an alternative to motor cortex
      stimulation for motor tract activation. To test this theory, evoked responses
      were recorded from lumbar spinal cord (L2; n = 14), spinal roots (L4-L7; n =
      112), peripheral nerves (sciatics; n = 28), and hind limb muscles (n = 28) after
      epidural stimulation of the T1-T2 segment of the spinal cord in dogs (n = 12),
      cats (n = 2), and monkeys (n = 2). The spinal response evoked by spinal cord
      stimulation was resistant to a dorsal hemisectioning (depth, 7-8 mm) of the
      midthoracic spinal cord. A minimal attenuation of latency and amplitude occurred
      with dorsal hemisectioning, suggesting signal transmission through descending or
      ascending pathways in the ventrolateral and ventral quadrants of the spinal cord.
      The sciatic nerve response was abolished by a dorsal column transection (depth, 3
      4 mm) or ipsilateral lumbar dorsal rhizotomy (four dorsal roots). This shows that
      the evoked response recorded from the sciatic nerve in our animals was not
      travelling, as we expected, through the ventral roots, but rather was conducted
      antidromically through sensory fibers in dorsal roots.

PMID- 1621149
TI  - The use of instant moire photographs to reduce exposure from scoliosis
      radiographs.
AB  - A total of 258 patients with some degree of idiopathic scoliosis was monitored
      with both radiographs and moire photography to determine the degree of
      progression of spinal curvature. The use of polaroid photography to document
      moire fringe patterns proved to be a rapid and useful process for placing an
      instant photographic record in patient charts while conducting routine physical
      examinations. Standardization of procedures for making and evaluating moire
      photographs reduced patient exposure to X-rays.

PMID- 1621150
TI  - Measurement error in assessment of vertebral rotation using the Perdriolle
      torsionmeter.
AB  - The Perdriolle torsionmeter assesses vertebral rotation on a spinal radiograph.
      It is frequently used to measure improvement in spinal derotation following
      Cotrel-Dubousset instrumentation for scoliosis. In this study, intraobserver and
      interobserver measurement error was examined during use of the torsionmeter.
      Intraobserver error was as follows: 53% of the measurements were accurate to
      within 5 degrees, and 21% erred greater than 10 degrees. Error from the actual
      value averaged 6 degrees. Interobserver error was as follows: Among six
      observers, only one third of the radiographs had measurements within 5 degrees of
      each other. Another one third erred by more than 10 degrees. Because of this
      significant intraobserver and interobserver error, precise measurements of
      rotation using the torsionmeter cannot be expected. Efforts to quantify spinal
      derotation with the torsionmeter after Cotrel-Dubousset instrumentation may not
      be valid.

PMID- 1621151
TI  - Diagnostic findings in painful adult scoliosis.
AB  - The purpose of this study was to document the diagnostic findings in a group of
      adult patients presenting with both scoliosis and pain. Fifty-five adults were
      evaluated by medical history, physical examination, radiography, myelography
      followed by computed tomography, discography followed by computed tomography, and
      single- and dual-photon densitometry. Curves were 49% adult degenerative onset,
      44% idiopathic. The older degenerative patients had myelographic defects most
      commonly within the primary curve and multiple abnormal, not necessarily painful,
      discs throughout the lumbar spine on discography. The idiopathic group had
      myelographic defects most commonly in a compensatory lumbar or lumbosacral curve.
      On discography, all idiopathic patients had at least one abnormal, painful disc,
      and 88% had their pain reproduced. Pain-producing pathology was frequently
      identified in areas that would not have been included in the fusion area
      according to accepted rules for treatment of idiopathic scoliosis.

PMID- 1621152
TI  - Scoliosis Research Society. Multicenter spine fracture study.
AB  - This study consisted of 1,019 spinal fracture patients followed prospectively for
      2 years. Sixty-four physicians from 12 countries participated. The purpose of the
      study was to determine: 1) the relationship between neurologic deficit and
      fracture type, level, and spinal canal compromise; 2) the neurologic outcome
      comparing surgical versus nonsurgical treatment and anterior versus posterior
      surgery; and 3) the relationship of pain to both kyphotic deformity and to
      surgical and nonsurgical treatment. The main findings of this study are as
      follows: 1) seat belts reduced the incidence of severe neurologic injury; 2)
      there was a higher incidence of neurologic deficit with fracture-dislocations and
      a higher incidence of neurologically intact patients with compression and flexion
      distraction injuries; 3) there was a greater incidence of complete neurologic
      deficits caused by fractures at the spinal cord level, and a diminished incidence
      at the cauda equina level; 4) for burst fractures there was a weakly positive
      relationship between canal compromise and neurologic deficit, including bladder
      function; 5) surgical intervention led to a greater percentage of improved
      neurologic function than nonoperative treatment, but the rate of improvement was
      not statistically different; 6) anterior surgery was not more effective than
      posterior surgery in improving the neurologic function when function was assessed
      using the Frankel or Motor Index scales, but it was statistically significant
      when compared to the Manabe scale; 7) in patients who deteriorated before surgery
      and underwent surgery, there was a greater improvement neurologically,
      particularly for anterior surgery, compared to those patients treated
      nonoperatively or to the overall surgically treated group; 8) There was a
      statistically significant relationship between bladder function and fracture
      type, with an increased incidence of absent function seen with fracture
      dislocations, of impaired function with burst fractures, and of intact bladder
      function with compression and flexion-distraction injuries; 9) anterior surgery
      was more beneficial in improving complete bladder impairment to partial
      impairment compared to posterior surgery; 10) a kyphotic deformity of greater
      than 30 degrees at 2-year follow-up was associated with an increased incidence of
      significant back pain; 11) patients who had surgery complained less of severe
      pain than those who were treated without surgery.

PMID- 1621153
TI  - Magnetic resonance imaging of trauma to the thoracic and lumbar spine. The
      importance of the posterior longitudinal ligament.
AB  - Magnetic resonance imaging was used to evaluate 24 patients with injuries to the
      thoracic, thoracolumbar (T12-L1), or lumbar spine. Correlation of the magnetic
      resonance imaging findings to surgical therapy and outcome was evaluated, with
      particular attention to the longitudinal ligaments. The ability of the magnetic
      resonance imaging to detect the extent of trauma to the spinal cord parenchyma
      and to the anterior and posterior longitudinal ligaments was found to be
      important in guiding the surgical approach to these spine fractures.

PMID- 1621154
TI  - Junctional burst fractures.
AB  - Twenty-two patients with burst fractures in this mechanically and neurologically
      distinct region (T11-L2) were studied at injury and after acute surgical
      reduction and stabilization (antikyphosis and ligamentotaxis concept). Canal
      compromise averaged 42% (10-82%) before surgery, and at follow-up 14% (0-46%),
      segmental kyphosis 15 degrees (4 degrees-27 degrees) and 3 degrees (0 degree-15
      degrees), and vertebral segment height 62% (41-85%) and 86% (60-100%),
      respectively. Incomplete patients gained an average of 1.8 Frankel subgrades. The
      described treatment can predictably recanalize the spine, correct deformity, and
      stabilize neurologic compromise. A significant correlation between postoperative
      neurologic status and the radiographic criteria under study could not be
      established.

PMID- 1621155
TI  - Canal clearance in burst fractures using the AO internal fixator.
AB  - The purpose of this study was to evaluate the ability of posterior distraction
      delivered by the AO internal fixator to effect a satisfactory reduction of the
      intraspinal fragments in burst fractures. The overall decompression achieved was
      from an initial compromise of 54% to a residual encroachment of 40%. Canal
      clearance proved most effective when carried out in the first 4 days, with an
      initial canal compromise of between 34 and 66%. The extent of improvement, even
      in this group, was not dramatic, with an average of 31% encroachment still
      remaining, with some cases as high as 50%. Therefore, we recommend that when
      canal clearance is essential, anterior decompression is the treatment of choice.

PMID- 1621156
TI  - Percutaneous needle biopsy of the spine.
AB  - The results of 75 percutaneous needle biopsies of the spine were analyzed. There
      were 8 cervical, 25 thoracic, 27 lumbar, and 15 sacral biopsies. An accurate
      diagnosis was made in 92% of all cases. Metastatic disease yielded the best
      accuracy rate (96%). The lowest accuracy rate (82%) was noted with benign primary
      tumors and fractures. The results were better in female patients than male (97%
      vs. 86%). Larger needles gave slightly better accuracy (97%). No relationship
      between accuracy and spine level was found. There were two complications: one
      pneumothorax and an episode of self-limited hemorrhage. Percutaneous needle
      biopsy is a safe and reliable method of obtaining a diagnosis in many different
      spine lesions.

PMID- 1621157
TI  - The use of freeze-dried fibular allograft in anterior cervical fusion.
AB  - Eighty-three segmental fusions were performed on 42 patients who underwent
      anterior cervical discectomy and fusion with freeze-dried fibular allograft for
      cervical spondylosis. Fusions were carried out over one to four levels. The mean
      follow-up period was 22.1 months (range, 9-47 months). The patients had both
      clinical and radiographic follow-up. Eighty-eight percent of the patients were
      found to have excellent or good clinical results. Radiographic follow-up revealed
      that 92% of the grafts obtained complete or partial union by 6 months after
      surgery. Forty patients were shown to be radiographically stable on lateral
      flexion and extension films by 8 weeks after surgery. The use of freeze-dried
      fibular allograft is a safe and efficacious procedure.

PMID- 1621158
TI  - Lumbar facet joint asymmetry. Intervertebral disc herniation.
AB  - A study of 136 patients with lumbar intervertebral disc herniation was undertaken
      to test the hypothesis that asymmetry of the facet joints is associated with the
      level, type, and side of herniation. Fifty cases of central herniation and 86
      cases of lateral herniation, all at the L4-5 or L5-S1 levels, were studied by
      computed tomographic scans. Adjacent (nonherniated) levels were used as controls.
      The facet joint angles were measured at the L4-5 and L5-S1 levels of the control,
      central, and lateral herniated levels. The results showed a similar degree of
      facet joint asymmetry at all levels. In cases of lateral herniation, there was a
      significant difference in the facet angle between the herniated and nonherniated
      side at the L5-S1 level, but not the L4-5 level. The mean difference, however,
      was less than 3 degrees and not considered to be clinically relevant. There was
      no difference in the distribution of the more coronally or sagittally facing
      facet joints with respect to the side of lateral herniation. These results do not
      support the hypothesis that facet asymmetry is associated with lumbar
      intervertebral disc herniation.

PMID- 1621159
TI  - The Luque trolley revisited. Review of nine cases requiring revision.
AB  - This study is a retrospective review of nine patients who underwent Luque
      instrumentation without fusion from 1982-1984. Average age at surgery was 9
      years. Average preoperative curve was 51 degrees (30 degrees-70 degrees). All
      nine patients have had at least one revision. All of the revisions were
      technically difficult secondary to extensive fibrosis and weakened laminar bone.
      Spontaneous fusion was documented in all nine patients, limiting further
      correction. Final follow-up curves averaged 51 degrees (25 degrees-90 degrees).
      Average gain in spinal height was 5.8 cm (2.3 in) but only a small portion was
      derived from the instrumented levels. Segmental spinal instrumentation without
      fusion in immature patients was not effective in control of spinal deformity, nor
      did it allow anticipated growth under the instrumented regions.

PMID- 1621160
TI  - Latent psoas abscess after anterior spinal fusion.
AB  - This case is presented to emphasize that late infection should be considered in
      all postoperative patients as a cause of pain. A psoas abscess may remain dormant
      for many years after an anterior spinal procedure. It should be considered in the
      differential diagnosis of back pain and lumbar radiculopathy after anterior
      spinal fusion. The lumbar nerve plexus lies within the psoas muscle, and referred
      pain patterns may occur in the lumbar nerve distribution. In this case,
      dysesthesias occurred in the distribution of the genitofemoral nerve. The
      diagnosis and treatment of a psoas abscess has been greatly aided by use of CT
      and ultrasound. Either of these modalities may be used for directed percutaneous
      drainage of the abscess. The presence of metal fixation devices necessitates
      removal of the hardware in order to ensure eradication of the infection.

PMID- 1621161
TI  - Spinal epidural abscess as a complication of duodenolumbar fistula. A case
      report.
AB  - The characteristic delay in diagnosis and treatment of spinal epidural abscess of
      unusual presentation in a patient with significant comorbidities often results in
      permanent neurologic deficits. Fortunately, in the case reported here, the
      patient made a complete recovery. Rapid diagnosis and intervention are essential,
      because degree of recovery is proportional to the extent of the neurologic
      deficit present before surgery.

PMID- 1621162
TI  - The use of dynamic magnetic resonance imaging to identify cervical spine disc
      herniation and cord compression. A case report.

PMID- 1621163
TI  - Brown-Sequard syndrome and herniated cervical disc.

PMID- 1621164
TI  - Unilateral blindness as a complication of patient positioning for spinal surgery.
      A case report.
AB  - Extreme care must be used in positioning patients for surgery in a prone
      position. A padded Mayfield headrest may not be appropriate for all patients
      undergoing spinal surgery, as exophthalmus or a flattened nasal bridge may allow
      transmission of pressure to the globe. Our current approach is to use
      supplementary foam rubber support, with repeated, meticulous attention to keeping
      the eyes free from all pressure. Finally, unexplained intraoperative occurrence
      of a bradyarrhythmia or conduction disturbance may signal increased intraorbital
      pressure during general anesthesia.

PMID- 1621165
TI  - Unusual sign of a Jefferson fracture. A case report.

PMID- 1621166
TI  - Migraine.

PMID- 1621167
TI  - Rural medicine--a specialty in its own right?

PMID- 1621168
TI  - Findings and implications from research on student learning.
AB  - This paper sets out a number of important conclusions drawn from research on
      student learning in higher education. Although there is an emphasis on medical
      education, most of the research conclusions presented are relevant to
      undergraduate education in general. The conclusions and accompanying questions
      are intended to promote debate among academic practitioners and students on how
      to improve the quality of student learning. In conjunction with the complementary
      research review by Entwistle on how departments may influence the quality of
      student learning, the conclusions and questions presented here formed the basis
      of a workshop presented at the 1991 Conference of the South African Association
      for Medical Education held at the University of Cape Town.

PMID- 1621169
TI  - Influences on the quality of student learning--implications for medical
      education.
AB  - This paper reviews recent research into the ways in which departments influence
      the quality of student learning. A substantial literature has developed which
      describes differences in the ways in which students learn and study in higher
      education. These differences emphasise the distinction between seeking personal
      understanding and reproducing information or procedures. The research indicates
      that certain departments, and some lecturers, are much better than others in
      encouraging students to look for deep levels of meaning. The quality of teaching
      and the methods of assessment are particularly influential, but so is the extent
      to which students are helped to develop effective studying and learning
      strategies. Some students have been shown to have major problems in the way they
      perceive and utilise the opportunities for learning provided by departments.
      While much of the research is not drawn directly from medical faculties, the
      relevance to medical education is pointed up and supported by specific examples
      of relevant research.

PMID- 1621170
TI  - Dermatoses in the canning industry--the roles of glove use and non-occupational
      exposures.
AB  - Primary prevention is the mainstay of management of occupational dermatoses.
      Despite the high rates of dermatoses found in a study of 686 female workers in a
      canning factory in March 1990, use of protective gloves was extremely low, even
      though there was evidence that they prevented acute paronychia and intertrigo.
      Reasons associated with low glove use were unavailability, discomfort and
      workers' failure to perceive a protective role for gloves. Difficulties with
      replacement of damaged gloves were an important cause of unavailability. Domestic
      and other non-occupational exposure at the workplace appeared to be unimportant
      in the development of dermatoses. Important preventive interventions are possible
      in the industry to reduce the rates of dermatoses among the workforce.

PMID- 1621171
TI  - Collagenous colitis--a rare cause of chronic watery diarrhoea. A case report.
AB  - Collagenous colitis is a clinicopathological syndrome occurring predominantly in
      middle-aged females presenting with chronic watery diarrhoea. Histologically the
      disorder is characterised by a mononuclear cell mucosal inflammatory infiltrate
      and subepithelial collagen thickening. The condition was first described in 1976
      and since then approximately 100 cases have been reported in the literature. We
      present here the first reported case of this rare disorder in South Africa.

PMID- 1621172
TI  - Membranous lipodystrophy. Clinical and electrophysiological observations in the
      first South African case.
AB  - A 37-year-old white man with membranous lipodystrophy (ML), the first case from
      Africa, is reported. Two years before presentation a diagnosis of presenile
      dementia of uncertain aetiology had been made. The diagnosis of ML was confirmed
      on histological examination of bone fragments obtained during surgery for
      reduction of pathological fractures. Computed tomography of the head showed
      typical cerebral atrophy and basal ganglia calcification. Electrophysiological
      observations included normal peripheral and central conduction studies.

PMID- 1621173
TI  - Acute benign pulmonary histoplasmosis--comparative costs of management.

PMID- 1621174
TI  - SimpliRED--a rapid and reliable test for HIV.

PMID- 1621175
TI  - Hepatic sinusoidal fibrosis associated with the use of cytotoxic drugs.

PMID- 1621176
TI  - Biopsy technique can influence treatment outcome in head and neck cancer.

PMID- 1621177
TI  - [Lymphomas in the acquired human immunodeficiency syndrome. Clinical,
      histological, immunological, and developmental study of 26 patients].
AB  - PURPOSE: To assess in a retrospective fashion the appearance of lymphoid
      malignancies in subjects infected by the human immunodeficiency virus, or
      included in any risk-group, between January 1984 and June 1991. MATERIAL AND
      METHODS: Twenty-six patients with AIDS-related lymphoma (23 non-Hodgkin's
      lymphoma (NHL) and 3 Hodgkin's disease (HD) cases) were entered in the study. Of
      them, 25 were males, with a mean age of 27 years. Eleven were intravenous drug
      abusers, eight were homosexuals, five were haemophiliacs and two were
      heterosexuals. RESULTS: The NHL histologic subtypes found were: small, non
      cleaved cell (Burkitt's), 14 cases; immunoblastic, 2 cases; diffuse, large cell,
      1 case; anaplastic, 1 case; extramedullary plasmacytoma, 1 case, and high grade,
      unclassifiable, 4 cases. The malignant cell immunophenotype was B in 95% of the
      cases. The pathological stage at diagnosis was IV-B in 16 cases, IV-A in 3, III-B
      in 1 and I-E in 3. Extranodal involvement was seen in 95% of the patients, mainly
      extended to the bone marrow (53%), liver (48%) central nervous system (35%) and
      digestive tract (22%). The three HD patients (2 with lymphocytic depletion and 1
      with mixed cellularity) were in stage IV-B at diagnosis, with bone marrow
      involvement. Twenty-three patients received chemotherapy, 7 were treated with
      radiotherapy, and 4 underwent surgery. Complete remission (CR) was attained in
      35% of the cases and partial response in 55%. The median survival of the series
      is 7 months, and that of the CR patients is 20 months (p less than 0.001). The
      series mortality was 77%, mostly related to disease progression or opportunistic
      infection. CONCLUSION: The general characteristics of AIDS-related lymphoma were
      confirmed here: aggressive clinical course, poor response to therapy and high
      risk of opportunistic infections. The possibility of achieving CR may justify the
      use of combination chemotherapy in patients with good functional status.

PMID- 1621178
TI  - [Pernicious anemias with subtle or atypical presentation].
AB  - PURPOSE: To assess the prevalence and clinico-biologic characteristics of
      pernicious anaemia (PA) showing subtle or atypical onset. MATERIAL AND METHODS:
      One-hundred and twenty-four patients were found to fulfill criteria for PA (serum
      vitamin B12 deficiency due to absence of intrinsic factor secretion because of
      severe gastric atrophy). Of them were disclosed those lacking macrocytosis (MCV
      less than 98 fL), with or without anaemia (Hb less than 120 g/L in women and less
      than 14 f/L in men), but showing decreased serum B12 rates (less than 150
      pmol/L). RESULTS: Macrocytosis was absent in 15 out of the 124 cases (12.1%);
      either they had anaemia or not, serum B12 rates were decreased in all cases.
      Eight patients had concurrent iron deficiency, one had secondary anaemia, two had
      polycythaemia and four were normal from a haematological standpoint. Serum B12
      assays were performed because of neuropsychiatric impairment (2 cases),
      polycythaemia study (3 cases), or positive anti-parietal cell antibodies found in
      an immunologic study (4 cases). The remaining patients were studied for chronic
      atrophy of the gastric mucosa (2 cases), and Plummer-Vinson syndrome, leucopenia
      and nutritional assessment (1 case of each condition). CONCLUSIONS: Atypical
      presentation of pernicious anaemia, whose frequency is probably underestimated,
      was confirmed in our environment. This condition must be suspected and ruled out
      in patients with characteristics similar to those described above.

PMID- 1621179
TI  - [Possible immunological effects of transfusion in the cancer patient].

PMID- 1621180
TI  - [Hematological repercussions of human immunodeficiency virus infection and their
      treatment].

PMID- 1621181
TI  - [Cytogenetic marker del(12p) in a case of acute myeloid leukemia M4 with
      eosinophilia and inv(16)].
AB  - A 35-year-old Spanish female having acute myelomonocytic leukaemia with marrow
      eosinophilia is reported. The karyotype revealed the specific chromosomal
      abnormality associated with this disorder, inv(16), and a less-specific
      myelodysplastic cytogenetic marker, del(12p). We have reviewed the published
      cases in order to elucidate the possible significance of presenting a 12p
      deletion (nonrandomly associated with chronic myelomonocytic leukaemia) together
      with other chromosomal rearrangements.

PMID- 1621182
TI  - [In vitro formation of fibroblast colony-forming units in the bone marrow of
      patients with solid malignant tumors].
AB  - The number of bone marrow fibroblast colony-forming cells (CFU-F) were studied in
      twelve healthy donors, four colon (CP) and nine lung cancer patients (LP). A
      liquid culture system has been used to characterize human bone marrow CFU-F. The
      results showed any recognizable CFU-F in three patients with colon cancer and in
      two patients of the other group. One of the four CP and five of the nine LP
      presented a CFU-F value of 17 and 2, 8, 22, 29, 32, respectively compared to 65
      from normal subjects. Two LP reached normal CFU-F values (normal range = 33-191).
      These data support the conclusion that the 84.6% of these solid tumor cancer
      patients study produced less number of proliferative status of fibroblast colony
      forming cells.

PMID- 1621183
TI  - Familial thrombotic thrombocytopenic purpura in a Bedouin family.
AB  - A 24-year-old Beduin pregnant woman in her 22nd week of gestation was treated
      successfully by plasmaphereses and steroids as soon as the diagnosis of TTP was
      confirmed by the clinical and laboratory criteria needed. Her sister died due to
      complications of TTP in pregnancy five years earlier while her other sister
      recuperated from TTP during pregnancy. However, fetal loss ensued. Thus, family
      history in pregnant women presenting with toxemia of pregnancy--like--syndrome
      may be the first clue to familial TTP.

PMID- 1621184
TI  - [Meningeal myelomatosis. Presentation of a case].
AB  - The case of a 36-year old man with IgA kappa multiple myeloma in whom meningeal
      myelomatosis developed is reported, and a brief review of previously published
      cases is made. Meningeal involvement develops in patients with high tumoral mass
      myeloma. Because of its poor prognosis, central nervous system chemoprophylaxis
      based on clinical and cerebrospinal fluid data, and systemic treatment according
      to severity, is suggested.

PMID- 1621185
TI  - [Seroprevalence of antibodies against Plasmodium falciparum in volunteer donors
      from various cities in Venezuela].
AB  - The prevalence of antibodies to Plasmodium falciparum was studied in 890 blood
      donors from different geographical areas of Venezuela. The overall prevalence, as
      established by ELISA, was (1.7%). Seropositivity was higher in those samples
      obtained in Sucre (2.5%) and Apure (1.7%) states both with foci of malaria
      transmission. It is proposed that medical history should be reinforced by
      screening antimalarial antibodies in donors at risk.

PMID- 1621186
TI  - [Cavernous hemangioma of the spleen with a localized intravascular coagulation
      syndrome (Kasabach-Merritt syndrome). Ultrastructural study].
AB  - Haemangioma is the commonest non-malignant tumour of the spleen. Cytopenia and
      coagulopathy, secondary to cell trapping and coagulation factors consumption
      inside the haemangioma, respectively. May occasionally occur as accompanying
      phenomena. A woman is presented who had splenic haemangioma associated with
      leucopenia and thrombocytopenia along with decrease fibrinogen and prolonged
      prothrombin time as well as low complement rates. She had massive splenomegaly
      with portal hypertension, and the partial oxygen pressure values in mesenteric
      and portal blood were concurrent with the presence of arteriovenous shunts. The
      leucocyte and platelet count, the serum complement, the fibrinogen rate and the
      prothrombin time recovered after splenectomy. The cavernous characteristics of
      the spleen, containing multiple thrombi, were confirmed upon scanning electron
      microscope examination. The pathophysiology of the cytopenias and clotting
      factors consumption is discussed, stress being laid on the ultrastructural
      findings. A review is presented of the clinical aspects, differential diagnosis
      and treatment.

PMID- 1621187
TI  - [Appearance of different panmyelopathies in the same patient].

PMID- 1621189
TI  - [Mortality from childhood and adolescent leukemia in Spain (1951-1985)].
AB  - PURPOSE: To study the mortality due to leukaemia during childhood and youth in
      Spain in the period 1951-1985. MATERIAL AND METHODS: The mortality for all types
      of leukaemia in that period was studied in three aspects: (a) By reviewing the
      rates of specific mortality for ages under 20 years, at quinquennial intervals
      and per millions of inhabitants of those ages. (b) Studying the mortality per
      cohorts of births at five-year intervals from 1951-1955 to 1981-1985. (c)
      Attaining the statistical value, "observed deceased" of leukaemia in people under
      15 years of age for the period studied and on each year of that period, and
      comparing such value with the number of "expected deceased", with regard to the
      reference year, 1965. RESULTS: A decreasing trend was observed along the whole
      period. As for ages, there seems to be some tendency to stabilisation of the
      mortality in the last five-year period, 1981-1985 (there is a decrease only in
      the 15-18 age-group). These data were confirmed when assessing the mortality per
      "birth cohorts" or generations, and after plotting the figures of "observed" and
      "expected" mortality in accordance with the previous evolution. CONCLUSION: It
      was inferred that regard to the mortality of childhood and youth leukaemia, in
      Spain the situation has improved markedly, doubtless as a result of better
      therapeutical approach. This evolution closely resembles the patterns of the most
      developed countries from a sanitary standpoint.

PMID- 1621188
TI  - [Late recurrence (11 years) in a case of ALL. Recurrence or a second disease?].

PMID- 1621190
TI  - [Evaluation of the Coulter STKS hematologic autoanalyzer].
AB  - PURPOSE: To express the results of an evaluation of the Coulter STKS blood cell
      counter. MATERIAL AND METHODS: The following data were collected: inaccuracy,
      carry-over, linearity, comparison with other systems, suspect morphology alarms,
      stability of calibration, time-stability of samples and working velocity. The
      protocol recommended by the ICSH was followed for the first four of the above.
      RESULTS: Good results were achieved for cell counts and derived parameters. The
      leucocyte differential count showed fair results for neutrophils, lymphocytes,
      monocytes and eosinophils; false basophilia was usually associated with the
      presence of abnormal lymphocytes. No differences were found between adult and
      paediatric samples. The usefulness of the suspect morphology alarms was also
      evaluated; they were found fairly sensitive for the presence of stabs, large
      amounts of atypical lymphocytes and blast cells, and moderately sensitive for
      erythroblasts and platelet clumps. The predictive value of alarms was found high
      in any type of pathology, but scarcely valuable when considering the pathology
      indicated by the alarm, such predictive value being noticeably increased upon
      associated alarms. CONCLUSION: The Coulter STKS cell counter appears as adequate
      for the haematology laboratory running daily high number of samples with high
      pathologic rates.

PMID- 1621191
TI  - Income, assets, and health insurance: economic resources for meeting acute health
      care needs of the aged.
AB  - In this article, the authors use data from the Survey of Income and Program
      Participation (SIPP) to examine the relationship between economic resources and
      acute health care needs among the aged. The circumstances of individuals who rely
      on Medicare as their only form of health insurance are considered in detail
      because they are potentially more vulnerable when faced with health care
      expenses. Particular attention is given to the amount of family income and
      personal contingency assets held by this group and the level of out-of-pocket
      liability for acute care they might have been expected to face in 1984. The
      authors point out that their research findings would be strengthened by linkage
      of a more current SIPP data set to Medicare program records and the development
      of Medicaid eligibility simulation capability in the SIPP context.

PMID- 1621192
TI  - The Social Security Administration's 10-percent sample file of OASDI
      beneficiaries.
AB  - This is another in a series of technical articles describing Social Security
      Administration sample files and statistical systems. The focus of this article is
      the 10-percent sample file that provides program and demographic information on
      Social Security beneficiaries under the Old-Age, Survivors, and Disability
      Insurance program. The article explains the contents and availability of the 10
      percent sample and presents several statistical tabulations as examples of the
      wide variety of data that can be developed from the file.

PMID- 1621193
TI  - The role of prophylactic subtotal colectomy in metachronous carcinoma of the
      colon and rectum.
AB  - The risk of metachronous carcinoma of the colon and rectum at 40 year follow-up
      evaluation is as high as 30 percent. Because of this risk, we reviewed a series
      of 767 patients treated surgically for carcinoma of the colon and rectum to
      define a possible prophylactic role for subtotal colectomy. Patients being
      treated for metachronous carcinoma of the colon and rectum represented 1.6
      percent of all patients undergoing surgical treatment for carcinoma of the colon
      and rectum during this period. There was an early group (less than 2.5 years) and
      a late group (greater than eight years); with respect to time interval between
      lesions, the early group possibly representing missed synchronous lesions. Forty
      six percent of the patients had associated adenomas. Evaluation of the colon with
      preoperative colonoscopy may eliminate the "early" metachronous lesions that are
      probably missed synchronous lesions. The presence of adenomas in a younger
      patient with a primary carcinoma of the colon and rectum represents a high risk
      of future carcinoma. Subtotal colectomy should be considered in these patients
      and may also improve the life-long follow-up evaluation required by allowing
      proctosigmoidoscopy alone to evaluate effectively the remaining colon and rectum.

PMID- 1621194
TI  - Lower survival rate for patients with carcinoma of the stomach of Borrmann type
      IV after gastric resection.
AB  - Between 1965 and 1985, 194 of 1,113 patients (17.4 percent) with advanced
      carcinoma of the stomach who underwent gastric resection had Borrmann type IV
      carcinoma of the stomach, a macroscopically evident and diffusely spreading
      tumor. These patients tended to be younger and female and to have larger tumors
      that involved the entire stomach, as compared with patients with other types of
      carcinomas. Tissues were commonly undifferentiated, serosal invasion was
      prominent with infiltrative growth and high rates of metastasis to the lymph
      nodes and peritoneal dissemination were evident. In most instances, the disease
      was advanced; therefore, total gastrectomy was performed upon 82.0 percent of the
      patients and a palliative resection was done in 64.4 percent. The survival rate
      was lower than for patients with carcinoma of the stomach of other types (p less
      than 0.01). A multivariate analysis indicated that curative resection is an
      independent favorable prognostic event, while other factors are dependent
      covariates. Early detection of this carcinoma is crucial to extend survival time
      of patients with Borrmann type IV carcinoma of the stomach. Aggressive
      postoperative chemotherapy should be considered when a noncurative resection is
      done.

PMID- 1621196
TI  - V-Y plasty for perianal reconstruction after resection of tumor.
AB  - A patient with combination of perianal condylomas and Bowen's disease is
      described. After resection of the tumor, the defect was repaired by use of V-Y
      plasty using triangular island skin flaps and split thickness skin grafts. After
      repair and reconstruction of the perianal area, the patient regained full
      continence.

PMID- 1621195
TI  - Surgical approach to segment I for malignant tumors of the liver.
AB  - Seven complete and 13 partial resections of segment I (caudate lobe) were
      performed for malignant tumors. In all except one instance, removal of segment I
      was combined with other types of hepatic resection for technical or carcinologic
      reasons. Six were iterative hepatic resections for recurrent hepatic metastases.
      In two, the future remaining left lobe was hypertrophied by right portal venous
      embolization preoperatively. Hepatectomies were performed with intermittent
      portal triad clamping (mean total duration of 63 minutes, range of 20 to 120
      minutes) and after preparation for total vascular exclusion. Associated partial
      resection of the inferior vena cava was necessary in three instances. Mean
      duration of operation was 285 minutes (range of 60 to 540 minutes) and mean blood
      loss was 1,749 milliliters (range of 200 to 5,200 milliliters). There was no
      postoperative mortality and the morbidity rate was low. Surprisingly, we
      discovered retrospectively that free margins were small (less than 5 millimeters)
      in 83 percent of the patients. Regardless of limited free margins and six
      iterative hepatectomies, eight patients were free of disease with a mean follow
      up examination period of 19.2 months. Technical problems were different for each
      patient and a patient by patient adaptation was necessary. Left, right and
      central approaches were used accordingly. If resection of segment I associated
      with a right or left hepatectomy can be currently considered as a standard
      hepatic resection, isolated complete resection of segment I remains a real
      technical challenge.

PMID- 1621197
TI  - The influence of an attachable subcutaneous cuff for preventing triple lumen
      catheter infections in critically ill surgical and trauma patients.
AB  - One hundred and ninety-one triple lumen central venous catheters were placed into
      107 sites in 81 surgical and trauma patients who were prospectively studied to
      determine the rate of catheter related infection using a subcutaneous cuff of
      biodegradable collagen containing bactericidal silver and a guide wire exchange
      protocol. Thirty-seven sites in 36 nonseptic patients (group 1) were compared
      with 70 sites in 45 septic patients (group 2). The data were also compared with
      data consecutively collected one year earlier, using the same exchange protocol
      without the cuff. Fourteen of 70 sites in group 2 had catheter related
      infections, with seven causing bloodstream infection. Five of 14 were the result
      of fungus, with three causing fungemia. Two of 37 sites in group 1 had catheter
      related infections (p = 0.044), with no associated bacteremia. The number of
      triple lumen catheter related infections and associated bacteremia or fungemia
      are higher in septic patients compared with nonseptic critically ill surgical and
      trauma patients. The cuff significantly prolongs time of catheter site use in
      patients who are nonseptic, but may be of no benefit in reducing infection rates
      or prolonging site use time in patients who are septic and may predispose to
      fungal colonization.

PMID- 1621198
TI  - A study of cholelithiasis during pregnancy and its relationship with age, parity,
      menarche, breast-feeding, dysmenorrhea, oral contraception and a maternal history
      of cholelithiasis.
AB  - We prospectively studied 512 consecutive women attending the antenatal clinic of
      the Rotunda Hospital of Dublin, Ireland, to assess the prevalence of gallstones
      among them and to describe the characteristics of those women found to be
      gallstone-positive (group 1), compared with the negative-control population
      (group 2). Real-time ultrasound scanning of the pelvic area was extended to the
      upper part of the abdomen. Cholelithiasis was detected in 23 patients. No
      substantial difference was found in parity of group 1 as compared with group 2.
      Also, early pregnancies, age at menarche and oral contraception did not have any
      significant difference between the two groups. However, we recorded a
      significantly higher prevalence of cholelithiasis in older women and in patients
      with dysmenorrhea. A positive trend was found in patients who had a history of
      previous breast-feeding and in women with a positive maternal history of
      symptomatic gallstones.

PMID- 1621199
TI  - A prospective study on intermittent pneumatic compression in the prevention of
      deep vein thrombosis in patients undergoing total hip or total knee replacement.
AB  - Three hundred and forty-six consecutive patients undergoing total hip or total
      knee replacement were prospectively studied to evaluate the effectiveness of
      intermittent pneumatic compression of the legs for the prevention of
      postoperative deep vein thrombosis. All patients were serially studied using
      impedance plethysmography and duplex ultrasound with color flow preoperatively
      and on the fourth and seventh postoperative day. The incidence of postoperative
      deep vein thrombosis in this series was 4 percent. Each patient with a
      postoperative duplex ultrasound had positive impedance plethysmography. Of the 14
      patients who had postoperative deep vein thrombosis, seven had positive test
      results on postoperative day four and seven had positive tests on postoperative
      day seven. No patients were symptomatic. The results suggest that the high
      incidence of postoperative deep vein thrombosis after extensive orthopedic
      operation is significantly lowered by the use of intermittent pneumatic
      compression. Intermittent pneumatic compression, therefore, may be the preferred
      approach in prophylaxis of postoperative deep vein thrombosis.

PMID- 1621200
TI  - A prospective study of the effect of cholecystectomy on duodenogastric reflux in
      humans using 24 hour gastric hydrogen monitoring.
AB  - Duodenogastric reflux (DRG) was quantified with continuous 24 hour monitoring of
      gastric pH in 30 patients, 12 of whom underwent operation for repair of an
      inguinal or femoral hernia used as a control group. The remaining 18 patients
      with noncomplicated gallstone disease underwent a simple cholecystectomy. Eight
      weeks after the operation, the tests were repeated. We found that patients with
      cholelithiasis were accompanied with DGR or alkaline shift more often than the
      patients in the control group and cholecystectomy decreased the percentage of
      time that gastric pH was less than two and increased the time at four and six.
      Although cholecystectomy itself does cause DGR, most patients with DGR may be
      asymptomatic.

PMID- 1621201
TI  - Short term treatment with leuprolide acetate is a successful adjunct to surgical
      therapy of leiomyomas of the uterus.
AB  - Gonadotropin releasing hormone analogs (GnRHa) have been used to induce a
      reduction in the size of leiomyomas of the uterus after three to six months of
      therapy. However, none of the studies have noted a significant decrease in size
      by the first month. Additionally, the results of two reports have suggested long
      term therapy with GnRHa induced significant aberrations of serum lipoproteins. To
      evaluate whether or not analog treatment for a short course (two months) would be
      efficacious, 27 patients with leiomyomas documented by examination of the pelvic
      area and vaginal ultrasound, who desired to preserve reproductive potential, had
      myomectomies two and one-half months after commencing depot leuprolide acetate
      therapy. The reduction in size of the uterus was 35 percent by the first month
      and the average reduction in the total volume was 44 percent after two months of
      treatment (474 +/- 364 to 265 +/- 173 milliliters; p less than 0.01).
      Furthermore, the size of the uterus, determined by examination, decreased
      significantly from 13.6 +/- 4.0 weeks initially to 10.1 +/- 3.0 weeks
      preoperatively (p less than 0.0001). Estradiol levels became menopausal by one
      month of therapy and remained suppressed preoperatively. Menopausal symptoms were
      well tolerated. Cholesterol, high density lipoprotein, extremely low density
      lipoprotein and triglyceride levels were not altered by analog treatment,
      although low density lipoprotein increased from 117 to 130 milligrams per
      deciliter. A short course of depot leuprolide acetate reduced the size of
      leiomyomas and surgical tissue planes were preserved, facilitating removal of
      leiomyomas, and furthermore, there was no significant clinical alteration in
      lipoprotein or triglyceride levels.

PMID- 1621202
TI  - Modified highly selective vagotomy.
AB  - After highly selective vagotomy, the conversion to a positive Hollander test with
      time is associated with an increased incidence of recurrent duodenal ulceration.
      In 24 consecutive patients (20 men and four women with an average age at the time
      of operation of 41 years) with refractory symptomatic duodenal ulceration, a
      polytetrafluoroethylene patch placed against the esophagogastric parts denervated
      by highly selective vagotomy completely prevented ulcer recurrence. All of the
      patients had negative Hollander test results for a five year period.

PMID- 1621203
TI  - Creation of a pericardial window using thoracoscopic techniques.
AB  - The aforementioned minimally invasive technique allows the surgeon to create a
      large pericardial window with minimal morbidity. Adequate long term drainage is
      provided and sufficient specimen for pathologic examination is obtained.

PMID- 1621204
TI  - A simple method of preparation of autologous fibrin glue by means of ethanol.
AB  - We describe herein a new system for the preparation of autologous fibrin glue by
      means of ethanol. The system produces a good yield of fibrin glue with a high
      concentration of fibrinogen in a short period of time, making the glue an
      efficient hemostatic agent and surgical sealant, and autologous fibrin glue has
      the obvious advantages of safety from transmission of viral agents and from
      immunologic reactions.

PMID- 1621205
TI  - Care of the wounded of the United States Army from 1775 to 1991.

PMID- 1621207
TI  - Appraisal of anti-idiotypic antibodies in the treatment of solid tumors in
      humans.
AB  - Anti-idiotypic antibodies may be valuable in the induction of antitumor immunity
      in two ways--they can serve as a ready source of antigen when the appropriate TAA
      is difficult or impossible to purify. More importantly, regulatory anti-idiotypic
      antibodies can activate specific T-helper cells, bringing all the components of
      cellular immunity to bear on neoplastic process. Although the results in studies
      in animals have demonstrated resistance to tumor challenge after immunization
      with anti-idiotypic antibodies, studies of humans with advanced malignancies have
      failed to produce substantial clinical results. Nevertheless, immunization with
      anti-idiotypic antibodies has influenced some tumors. These studies represent
      important, initial steps toward understanding the immune network and modulating
      it in favor of the host, against human tumors. As a continued understanding of
      the immune network evolves and strategies for activating and suppressing specific
      immune responses are developed, it should be possible to design vaccines for
      specific uses. Although current anti-idiotypic vaccines do not seem promising for
      the treatment of established solid tumors in humans, we can look with
      anticipation to studies of polyvalent vaccines for the prevention of carcinoma in
      high risk groups.

PMID- 1621206
TI  - Diagnosis of acute diffuse pulmonary infiltrates in immunosuppressed patients by
      open biopsy of the lung.
AB  - Herein is a review of the results of open biopsies of the lung performed upon
      immunosuppressed patients between the years 1982 and 1988. The goal was to assess
      the safety and value of the procedure on a group of patients who are many times
      in extremis because of multiorgan failure. Obtaining the correct diagnosis and
      establishing treatment poses a challenge. The study includes 74 patients. Fifty
      four had malignant tumors; 20 had various diseases associated with
      immunosuppression. The biopsy was obtained from the left side in 65 instances. An
      adequate thoracotomy was done to permit exploration of the thoracic cavity and
      obtain a representative sample of tissue. The mortality rate related to the
      operation was 1.4 percent and the complication rate was 11.0 percent. Forty-six
      percent of the infiltrates were the result of infection. In 42 percent, a change
      in treatment was made. Thirty-two percent survived and were discharged from the
      hospital. Patients with adverse drug reaction, with nonspecific pneumonitis and
      with bacterial infection had a favorable prognosis and benefited most from open
      biopsy of the lung.

PMID- 1621208
TI  - International abstracts of surgery.

PMID- 1621209
TI  - Phase I study of hyperfractionated accelerated radiation and simultaneous
      Carboplatin therapy for advanced head and neck carcinomas.
AB  - From 1990 to 1991 15 patients with advanced head and neck carcinomas underwent
      hyperfractionated accelerated radiotherapy (2 x 1.6 Gy/day, five days/week, total
      dose 64.0 to 67.2 Gy) and simultaneous intravenous application of Carboplatin (60
      mg/m2, days 1 to 5 and 29 to 33) in a pilot study. Eleven patients had T4 and
      four had T3 tumours. At the end of treatment twelve patients had a complete
      tumour remission and in the others a partial tumour involution was seen. Although
      acute side-effects were more pronounced compared to conventional irradiation this
      treatment regimen is feasible and the initial complete remission rate of 80% is
      encouraging.

PMID- 1621210
TI  - Radiation therapy for the esophageal carcinoma: external irradiation versus high
      dose rate intraluminal irradiation.
AB  - From September 1977 through December 1989, 149 patients with esophageal carcinoma
      were treated with external irradiation (EI) with or without high-dose rate
      intraluminal irradiation (HDRII) using remote afterloading system. Two-year
      relapse-free survival rates were 52% in sage I (n = 23), 24% in stage II (n = 61)
      and 19% in stage III (n = 65). Two-year survival rates were 66% in complete
      response (CR) group (n = 65) and 7 to 9% in non-CR group (n = 84). Concerning CR
      group external irradiation alone (mean +/- S. D.: 66.5 +/- 5.2 Gy) showed higher
      local control rate than EI (60.0 +/- 0.4 Gy) + HDRII (10 Gy) (30/38 versus 15/27,
      p = 0.044), especially in ulcerative type (17/19 versus 5/11, p = 0.009). This
      preliminary result suggests that HDRII is not effective for the local control of
      the ulcerative lesion as a boost therapy.

PMID- 1621211
TI  - Radiotherapy of local recurrence following radical prostatectomy.
AB  - Between 1977 and 1991, 20 patients with radical prostatectomy for adenocarcinoma
      of the prostate and palpable, biopsy-proven local recurrence without evidence of
      metastases underwent radiotherapy. Of these patients 16 were treated with
      orchiectomy combined with irradiation and four patients underwent irradiation
      alone. Local control, as determined by rectal palpation was achieved in 19/20
      patients. Eleven patients are still alive without disease. Disease-free survival
      (determined since 1987 including PSA) was 68% for five years and 41% for ten
      years. 6/9 patients have died with cancer, three patients died intercurrent free
      of disease. Overall survival remained 51% for five years and 31% for ten years.
      Prevention of local recurrence is of great importance and these data support the
      adjuvant post-operative irradiation in defined patients at risk.

PMID- 1621212
TI  - Subsequent malignancies in patients treated with 131-iodine for thyroid cancer.
AB  - I-131 was administered to 298 patients with thyroid cancer, and there has been a
      follow-up of at least two years. Follow-up periods were: 2.5 to 30 years (median
      14.5) in living patients, 2.5 to 15 years (median 5.5) in patients dead of tumour
      greater than or equal to 2 years after first treatment and 2.5 to 23 years
      (median nine) in patients dead without tumour. Person-years at risk were (total
      applied activity of I-131): 1119 (3 to 21 GBq), 1477 (22 to 65 GBq), 521 (61 to
      170 GBq). 33 subsequent malignancies in 31 patients were observed, compared to an
      expected number of 17. The relative risk of subsequent malignancies is therefore
      1.94 with a 95% confidence interval of 1.15 to 3.05. This increase in the
      incidence of subsequent malignancies after I-131 treatment is largely due to the
      significantly increased incidence of leukemia and bladder cancer. Estimated
      radiation doses to the bone marrow in the patients with leukemia were 301 cGy to
      792 cGy and the doses to the bladder in patients with bladder cancer were 2250
      cGy to 10, 350 cGy. After a total activity of less than 37 GBq I-131, no cases of
      bladder cancer or leukemia were observed. The observed number of subsequent
      malignancies are compared with the expected number according to several dose
      effect estimations.

PMID- 1621213
TI  - [Hypertension as risk factor for increased rate of side effects in the framework
      of breast carcinoma irradiation].
AB  - The rate of radiation-induced side-effects is dependent from exogenous technical
      and endogenous factors. Widespread endogenous factors are arterial hypertension
      and other cardiovascular diseases. 130 breast cancer patients were
      retrospectively evaluated for side-effects to estimate the influence of arterial
      hypertension. All were treated with mastectomy and irradiation (telecobalt) and
      consecutively followed. 79 patients had normal blood pressure, 51 showed arterial
      hypertension. Hypertension proved to be the strongest endogenous factor for the
      development of side-effects. In contrast to the patients with normal blood
      pressure those with hypertension showed significant more arm lymphedema (p less
      than 0.005) and telangiectasia (p less than 0.0001). Other endogenous factors,
      like cardiovascular diseases or obesity, taken together led only to a higher rate
      of subcutaneous fibrosis (p less than 0.002). Patients with arterial hypertension
      should receive axillary radiation only for strict indications and perhaps with a
      reduced dosage.

PMID- 1621214
TI  - [High-voltage radiotherapy of cavernous giant hemangioma? An impressive case
      example].
AB  - Because of multifonus of therapeutic possibilities in treating cavernous
      haemangioma, we mostly, but primarily due to frequent spontaneous regression
      tendency, we exercise restraint. However, if irradiation is taken into
      consideration, it is mainly with "soft" X-rays (100 kV). The application of high
      voltage X-rays (1 MeV) by means of linear accelerator is seldom and rarely found
      in literature. That this method can be effective and indication for this is
      absolutely in order and life-saving, is described in an impressive case example
      of a congenital giant haemangioma on the right facial half of an infant, where
      all other previous forms of therapeutical procedures had failed.

PMID- 1621215
TI  - [Electron microscopic studies on the effects of irradiation and mitoxantrone
      hydrochloride (Novantrone), alone and in combination, on cells of Harding-Passey
      melanoma in monolayer culture].
AB  - 2 Gy or 4 Gy irradiation of cultured Harding-Passey melanoma cells revealed
      electronmicroscopically none or little cell damage. 48 hour exposure of cultures
      to mitoxantrone concentrations of 1 x 10(-8) M or 3.3 x 10(-8) M also exhibited
      little cell damage. However, combination of these treatments--in comparison with
      single treatment--resulted in increased cell damage. The present paper describes
      the extent of Harding-Passey melanoma cell damage following a radiation exposure
      (2 or 4 Gy) or a mitoxantrone treatment (1 x 10(-8) M or 3 x 10(-8) M) for 48
      hours alone or in combination.

PMID- 1621216
TI  - Prophylaxis against perioperative cardiac ischemia-reperfusion injury.

PMID- 1621217
TI  - Gangrenous cholecystitis as a complication of hepatic artery embolization: case
      report.
AB  - Ischemic injury to the gallbladder has been described after hepatic artery
      embolization but has not been considered a clinically significant complication of
      this procedure. We present three cases in which therapeutic embolization resulted
      in symptomatic gangrenous cholecystitis requiring urgent surgical intervention.
      Clinical parameters that distinguish this infrequent ischemic septic process from
      the more common postembolization syndrome are discussed and recommendations
      concerning the diagnosis and management of these complicated patients are
      outlined.

PMID- 1621218
TI  - Immunosuppression in patients with Barrett's esophagus.
AB  - BACKGROUND: Patients with Barrett's esophagus have a higher incidence of
      esophageal cancer than has the general population. Local tissue injury and
      exposure to carcinogens presumably play a role in malignant transformation, but
      the possibility of altered host immune surveillance must also be considered.
      METHODS: The level of immunoreactivity was investigated in six healthy control
      subjects; 14 patients with gastroesophageal reflux, seven with and seven without
      esophagitis; and nine patients with Barrett's esophagus. Parameters studied were
      (1) T-cell and B-cell function with mitogen-stimulated lymphocyte blastogenesis,
      (2) immunosuppressive properties of autologous serum, and (3) interleukin-2
      production by peripheral blood mononuclear cells. Nutritional status as a
      possible cause for immunosuppression was assessed by measurement of serum
      albumin, transferrin, and prealbumin. RESULTS: Patients with Barrett's esophagus
      had a significant suppression of all T-cell (p less than 0.01) and B-cell
      function (p less than 0.01) and interleukin-2 production (p less than 0.001) when
      they were compared to the controls. Interleukin-2 production was also reduced
      significantly compared to that in patients with gastroesophageal reflux with and
      without esophagitis (p less than 0.05). No differences were observed in serum
      immunosuppression or nutritional factors. CONCLUSIONS: Although the
      immunosuppression observed in the patients with Barrett's esophagus was milder
      than that found in other immunocompromised states, it may be sufficient to
      encourage the malignant transformation of Barrett's mucosa.

PMID- 1621219
TI  - Restoration of general surgery in an age of subspecialties: an educational
      proposal.

PMID- 1621220
TI  - General surgery--the wellspring of surgery.

PMID- 1621221
TI  - Immunosuppression in patients with Barrett's esophagus: one piece of the puzzle?

PMID- 1621222
TI  - Changes in growth factor levels in human wound fluid.
AB  - BACKGROUND: It has been suggested that platelet-derived growth factor (PDGF)
      plays a central role in wound healing. Analysis of human wound fluid revealed the
      presence of PDGF AA (30 kd) and monocyte/macrophage-derived growth factor (MDGF)
      (12 to 14 kd) in the immediate postoperative period. METHODS: The amount of PDGF
      AA present was assayed by Western blot analysis. The chemotactic and mitogenic
      potential of purified wound fluid containing PDGF AA and MDGF was determined on a
      responsive cell line. The biologic activity of MDGF was assayed with a cell line
      that is unresponsive to the PDGF AA found in wound fluid. RESULTS: Both the
      concentration and the biologic activity were highest in the immediate
      postoperative period and declined to negligible levels by 24 hours after surgery.
      The chemotactic activity of MDGF was highest in the immediate postoperative
      period and declined during the first 24 hours in a manner similar to that of the
      combined PDGF AA and MDGF activity. CONCLUSIONS: These data demonstrate the
      changing levels of PDGF and MDGF in human wound fluid over time, supporting the
      cascade model of wound repair. By demonstrating that MDGF acts on cell lines
      unresponsive to the PDGF AA found in wound fluid, these data suggest that MDGF
      may also play an important role in wound healing.

PMID- 1621224
TI  - Xenografts: is there a future?

PMID- 1621223
TI  - Prophylaxis of infection with intravenous immunoglobulins plus antibiotic for
      patients at risk for sepsis undergoing surgery for colorectal cancer: results of
      a randomized, multicenter clinical trial.
AB  - BACKGROUND: The results of a randomized, multicenter clinical trial with
      perioperative short-term antibiotic plus intravenous immunoglobulins (IVIG + A)
      versus antibiotic alone (A) for prevention of postoperative infections in
      patients at risk for sepsis undergoing surgery for colorectal cancer are
      presented. METHODS: The patients at risk for sepsis were selected by an original
      multiparametric test based on delayed-hypersensitivity skin testing and serum
      protein electrophoretic subfractions. This screening had shown 76% positive
      predictability in a previous validation assessment. Eighty patients at risk for
      sepsis were selected prospectively from 210 patients undergoing surgery for
      colorectal cancer; 43 patients were randomly assigned to the IVIG + A group and
      37 to the A group. IVIG was administered on the day before operation, on the
      first and fifth postoperative days. RESULTS: There was a clear-cut reduction of
      postoperative infections in the IVIG + A group: 21 infections in 20 patients
      versus 37 infections in 29 patients in the A group (p less than 0.004). With
      regard to serum immunoglobulin (Ig) G monitoring, basal IgG levels were
      significantly lower in patients given IVIG + A who had postsurgical infections (p
      less than 0.005) compared with patients with a regular outcome, whereas the same
      was not true in the A group of patients. CONCLUSIONS: A significant decrease (p
      less than 0.001) of postoperative IgG was evidenced in the A group of patients
      who had infections as opposed to a significant increase (p less than 0.001) of
      postoperative IgG in IVIG + A patients with a normal outcome.

PMID- 1621226
TI  - In situ saphenous vein for lower extremity revascularization.
AB  - BACKGROUND: During a 6-year period, 349 in situ saphenous vein bypass grafts were
      performed for limb salvage by three surgeons. METHODS: Outflow anastomoses were
      constructed to the infrageniculate popliteal (25%), posterior tibial (20%),
      peroneal (20%), anterior tibial (19%), and dorsal pedal arteries (7%). Mean
      patient age was 70 1/2 years. RESULTS: The 30-day mortality rate was 3.2%, and
      19% died during the ensuing 68-month interval. At 1, 24, and 60 months primary
      graft patency was 89%, 77%, and 74%, secondary graft patency was 91%, 80%, and
      78%, and cumulative limb survival was 94%, 88%, and 84%, respectively. Cumulative
      patency rates at 60 months depending on outflow site were as follows: popliteal
      (85%), anterior tibial (80%), posterior tibial (70%), dorsal pedal (68%), and
      peroneal (60%). Patency at the peroneal position was significantly inferior to
      that of other infrapopliteal sites combined (p less than 0.05). Cumulative limb
      survival at 60 months, according to outflow site, was as follows: popliteal
      (95%), anterior tibial (85%), posterior tibial (78%), dorsal pedal (73%), and
      peroneal (67%). There was no significant difference in limb salvage among
      infrapopliteal outflow sites. However, patency rates and limb salvage were
      significantly better for the popliteal outflow site than the infrapopliteal
      outflow sites (p less than 0.01). CONCLUSIONS: (1) A 5-year graft patency rate of
      78% and a limb salvage rate of 84% are achievable, (2) peroneal bypass is
      associated with a lower rate for graft patency but not limb salvage, and (3)
      popliteal bypass has the best graft patency and limb salvage rates.

PMID- 1621225
TI  - Oxygen kinetics in experimental sepsis.
AB  - Systemic oxygen delivery (DO2) is normally four to five times higher than oxygen
      consumption (VO2), and VO2 is independent of DO2. If DO2 is decreased to less
      than twice VO2, a state of anaerobic metabolism and supply dependency occurs.
      Some authors have reported that this biphasic relationship is altered in the
      adult respiratory distress syndrome or sepsis to a condition of continuous supply
      dependency. If that were true, it would affect both our understanding and
      management of metabolism during sepsis. Therefore we measured VO2 and DO2 in a
      dog peritonitis model. DO2 was regulated with controlled pericardial tamponade.
      During sepsis VO2 increased 28% from a mean baseline of 5.6 to 7.3 cc O2/kg/min
      (p less than 0.005). As progressive cardiac tamponade was applied during sepsis,
      the DO2/VO2 ratio fell. When the DO2/VO2 ratio was greater than 2.4, VO2 remained
      independent of DO2. At DO2/VO2 ratios less than 2.4, VO2 was dependent on the
      level of DO2, and it diminished rapidly as DO2 decreased. Oxygen saturation in
      mixed venous blood (SvO2) consistently reflected the DO2/VO2 ratio in a fashion
      similar to that in normal dogs. A ratio of DO2/VO2 of 2.4 corresponded with an
      SvO2 of 42% +/- 12%, which was identified as a statistically significant critical
      SvO2 that marked onset of VO2 supply dependence. In this dog septic model, VO2 is
      independent of DO2 when DO2 is adequate. A state of continuous supply dependency
      does not exist. SvO2 reflects the status of the DO2/VO2 relationship in the
      septic state.

PMID- 1621227
TI  - Lung injury produced by pancreatic proteases in dogs.
AB  - With an isolated, blood-perfused canine lung-lobe preparation, the potential role
      of reactive oxygen metabolites and neutrophils in pancreatic protease (alpha
      chymotrypsin)-induced acute lung injury was studied. Administration of alpha
      chymotrypsin caused a low-pressure pulmonary edema (mean lung lobe weight
      increased from 71 to 197 gm). Pretreatment with superoxide dismutase alone did
      not attenuate the injury (58 to 166 gm), but when combined with catalase, the
      injury was significantly ameliorated (64 to 107 gm). However, depletion of
      circulating leukocytes did not attenuate the injury (69 to 200 gm). These
      findings suggest that circulatory proteases can cause lung injury by a mechanism
      that is mediated, at least in part, by toxic oxygen metabolites that are not of
      neutrophil origin.

PMID- 1621228
TI  - Comparison of laser-assisted fibrinogen-bonded and sutured canine arteriovenous
      anastomoses.
AB  - The effect of laser-assisted fibrinogen bonding (LAFB) on the development of
      intimal hyperplasia was studied with stress-strain profiles and histologic
      evaluation of canine arteriovenous fistulas (AVFs). In 19 animals femoral AVFs
      were created with an 808 nm diode laser after topical application of fibrinogen
      mixed with indocyanine green dye; in the contralateral limb a sutured AVF was
      created. The animals were divided into three groups. Group 1 dogs (n = 6) were
      killed serially up to 4 weeks after surgery to examine the healing of the
      anastomoses created with LAFB. Group 2 dogs (n = 6) were killed 1 month after
      surgery, and the fresh specimens were strained axially to produce a stress-strain
      profile graph. Group 3 dogs (n = 7) were killed 7 months after surgery, and the
      AVFs were infused with formalin under pressure and histologically prepared to
      allow comparison of the ratio of maximum to minimum intimal hypertrophy.
      Fibrinogen used for LAFB was resorbed during the first month after operation
      without evidence of foreign body reaction or inflammation. Tensile break force
      was not significantly different in the laser-bonded group (4.6 +/- 2.4 pounds)
      and the sutured group (4.3 +/- 1.7 pounds). The modulus (tensile break force per
      square inch), a measure of elasticity, identified the laser-bonded AVF (149 +/-
      44 pounds per square inch) to be less rigid than the sutured AVF (203 +/- 35
      pounds per square inch) (p less than 0.05). No significant differences in the
      degree of intimal hyperplasia were noted in any area of the anastomoses. Use of
      LAFB neither accelerates nor prevents intimal hyperplasia in a canine AVF
      model.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621230
TI  - Nasogastric tube "suction-buster holes" release mucosal occlusion despite high
      suction.
AB  - Aspiration devices can persistently malfunction if moderate (not just high)
      suction causes mucosal occlusion of every opening. The standard pattern of
      uniformly large orifices was modified by supplementing half the nasal tubes with
      smaller (one tenth of the area) openings. Ten pairs of postoperative patients
      sipped water while suction applied to their nasal tubes varied from 40 to 300 mm
      Hg. Unmodified tubes consistently functioned only when applied vacuum was below
      60 mm Hg. At 60 mm Hg, 20% (2/10) of tubes malfunctioned, with swallows failing
      to return on three consecutive attempts even at this gentle level. The failure
      rate rose with increasing applied suction. All 10 devices evidenced persistent
      occlusion when the vacuum exceeded 90 mm Hg. Each adverse result was confirmed by
      continued malfunction when suction was increased by another 10 mm Hg. The brisk
      flow through large esophageal openings dramatically differs from restricted
      inflow. Supplementing the standard set of uniform, large-bore aspiration orifices
      with additional small openings results in unimpeded function over the full range
      of available hospital vacuum. The additional small openings permitted the
      turbulent evacuation characteristic of large-bore patency. No device with
      accessory "suction-buster" orifices malfunctioned at even the highest available
      suction (300 mm Hg).

PMID- 1621229
TI  - Brachiocephalic revascularization: a comparison between carotid-subclavian artery
      bypass and axilloaxillary artery bypass.
AB  - Sixty-seven patients who underwent carotid-subclavian bypass (CSBP) (28 CSBPs
      only and eight with carotid endarterectomy) or axilloaxillary artery bypass (n =
      31) with polytetrafluoroethylene grafts were followed up for a mean of 69.2 and
      71.9 months, respectively. Indications for surgery in the CSBP group included
      hemispheric transient ischemic attack (TIA)/cerebrovascular accident in five,
      nonhemispheric TIA in seven, upper extremity ischemia in 15, and combined TIA and
      arm ischemia in nine patients. In the axilloaxillary artery group, two patients
      had hemispheric TIA, five had nonhemispheric TIA, 12 had upper extremity
      ischemia, and 12 had combined TIA and arm ischemia. Graft patency was determined
      clinically and confirmed by segmental Doppler pressures, duplex ultrasonography,
      or angiography. The 30-day mortality rate was approximately 3% in both groups.
      The 30-day complication rate was 3% for the axilloaxillary artery group and 8%
      for the CSBP group (not statistically significant). Relief of symptoms was
      achieved in 100% of patients in both groups; however, 20% of the patients in the
      axilloaxillary artery group had a recurrence of symptoms, in contrast to 5.6% in
      the CSBP group. The cumulative 10-year primary and secondary patency rates,
      calculated by life-table analysis, were 66% and 84.6% for the axilloaxillary
      artery procedures and 93.8% and 93.8% for the CSBP procedures, respectively
      (statistically significant). Concomitant carotid endarterectomy with CSBP did not
      influence graft patency. In conclusion, both bypasses have comparable morbidity
      and mortality rates; however, the CSBP has a statistically significantly better
      primary patency rate than the axilloaxillary artery bypass. Therefore CSBP should
      be the procedure of choice and the axilloaxillary artery bypass should be
      restricted to high-risk patients.

PMID- 1621231
TI  - Temporomandibular joint dysfunction and systemic joint laxity.
AB  - The purpose of this thesis was to study an inherited disposition, systemic joint
      laxity, in patients with temporomandibular joint (TMJ) dysfunction. The
      importance of systemic joint laxity for TMJ dysfunction compared with other
      supposed etiological factors, such as bruxism and jaw trauma, was analysed in TMJ
      patients and in non-patient groups. Collagen distribution and mitral valve
      function were investigated in hypermobile TMJ patients and normal controls.
      General joint mobility was assessed in 360 participants. Comparing 74 female
      craniomandibular dysfunction (CMD) patients with 73 controls of the same sex and
      age, more hypermobile individuals were found in the patient group. Patients with
      TMJ dysfunction had significantly more hypermobile joints than other patients at
      a clinic for CMD patients. A multiple stepwise regression analysis established
      that hypermobility was a more important factor than bruxing for TMJ dysfunction.
      Trauma to the head and jaw was significantly correlated to TMJ dysfunction only
      in non-hypermobile patients. TMJ patients had significantly more musculoskeletal
      complaints than other CMD patients or controls. A non-patient investigation
      comprising about 200 adolescents showed the females to be significantly more
      hypermobile than the males. Another indication of a systemic disposition in
      hypermobile TMJ patients compared with controls was more insufficient mitral
      valve function in an echocardiographic investigation of 10 hypermobile TMJ
      patients and 10 normal controls. Skin biopsy revealed lower values of total
      collagen and a higher ratio of collagen type III to III + I in TMJ patients than
      in normal controls.

PMID- 1621232
TI  - [Drug treatment of cholestatic liver diseases].
AB  - After a brief summary of the pathophysiology and natural history of different
      cholestatic disorders novel forms of treatment are considered. Treatment of
      different syndromes with ursodeoxycholic acid is considered in some depth. While
      the substance has clearly proven its efficacy in the symptomatic treatment, its
      influence on hard parameters such as survival and transplantation requirements
      remains to be documented. S-adenoylmethionine has shown to be efficaceous in some
      but not all studies on pruritus of pregnancy. The substance holds promise in
      other cholestatic disorders as well, but clearly more studies are needed before
      its therapeutic potential can be appreciated. Finally, nowadays orthotopic liver
      transplantation should be considered early in patients with progressive
      cholestatic liver disorders.

PMID- 1621233
TI  - [Alcoholic hepatitis].
AB  - Alcoholic hepatitis presents as an acute hepatitis in an alcoholic. No specific
      laboratory tests for alcoholic hepatitis exist. Therefore, the diagnosis must be
      based on the clinical presentation, histology and exclusion of other causes of a
      similar clinical picture such as viruses and drugs. Patients with elevated
      bilirubin, encephalopathy and coagulopathy have a poor prognosis. Steroids,
      infusion of insulin and glucagon, supplementation of amino-acids and other
      experimental therapies do not appear to be helpful with the exception of steroids
      which may benefit the sickest patients. Long-term prognosis depends on the extent
      of cirrhotic changes present after the acute episode and on the drinking habits
      of the patient.

PMID- 1621234
TI  - [Imaging procedures and fine needle puncture of focal liver lesions].
AB  - Ultrasonography, as screening method of choice, answers questions as to the size
      of the liver, the structure of the parenchyma, focal lesions and the dilatation
      of the biliary system. To characterize focal lesions, to stage tumors and for a
      better topographic localization, computed tomography or magnetic resonance
      imaging is useful. The differential diagnosis of focal lesions, such as cysts,
      hemangioma or focal nodular hyperplasia is achieved by the combination of
      laboratory, imaging and nuclear medicine methods. In other cases, needle-biopsy
      under sonographic or CT guidance is decisive.

PMID- 1621235
TI  - [Indications and results of liver resection].
AB  - A liver resection should only be performed after complete investigation of a
      detected hepatic lesion and represents a choice between other possible
      treatments. This choice is influenced by the natural history of the lesion and
      its extension, by its precise intrahepatic localization by the general condition
      and symptoms of the patient, and by the results expected from therapeutic
      alternatives. The most usual indications for hepatectomies are discussed.

PMID- 1621236
TI  - [Liver biopsy in suspected alcoholic liver damage].
AB  - Alcohol can induce a wide spectrum of histological changes in the liver. Three
      morphologic patterns of alcoholic liver injury are now generally accepted, i.e.
      fatty change, alcoholic hepatitis and alcoholic cirrhosis, but a broad array of
      lesions has been added to this list in recent years. These damage patterns differ
      considerably in their significance as to indication and diagnostic power of liver
      biopsies. Liver biopsy is recommended in patients with clinically suspected
      alcoholic liver disease for diagnostic and prognostic reasons. Moreover,
      clinicians want to exclude nonalcoholic liver diseases that might otherwise be
      missed. Alcoholic hepatitis, which is associated with increased morbidity and
      mortality, has the highest degree of diagnostic specificity in biopsies, because
      its features are well-defined and are mimicked by a rather small group of other
      causes. When associated with perivenular and pericellular fibrosis, it may
      provide prognostic parameters. In contrast, fatty liver, which may be induced by
      alcohol as well as other etiologies, usually does not need liver biopsy, with
      some exceptions. It may lead to cholestasis severe enough to mimic obstructive
      jaundice, or may result in abnormal imaging studies suggesting metastases.
      Verification of histological findings may be important when these circumstances
      arise. Cirrhosis is easily verified in biopsies of appropriate quality; however,
      advanced cirrhosis is a morphologically nonspecific alteration, because cirrhotic
      tissue patterns converge irrespective of their cause. Liver biopsy may help to
      identify nonalcoholic liver disease in patients suspected of harboring alcoholic
      liver disease. In fact, up to 20% of biopsies may show other, potentially
      treatable disorders, thus extending the indication for liver biopsy in situations
      of complex clinical and laboratory patterns.

PMID- 1621237
TI  - [Who are the candidates for liver transplantation?].
AB  - Over the past 12 years, new immunosuppressive agents, better knowledge of
      anesthesiology and postoperative reanimation as well as refinement in surgical
      technics modified the indications for and results of orthotopic liver
      transplantation (OLT). At the beginning of the OLT era, liver tumors that could
      only be removed by total hepatectomy were one of the most frequent indications.
      Nowadays, this indication is mostly abandoned in view of a high rate of
      recurrence and poor long-term results. In contrast, the prognosis of fulminant
      hepatic failure has been dramatically improved by OLT, once efficient
      organization systems allowed adequate organ supply and emergency transplantation
      within a few hours. Three main groups of diseases (cholestatic diseases, inborn
      errors of metabolism and parenchymal diseases) can be treated by OLT with
      excellent results (actuarial survivals of 80 to 90% have been reported at one and
      2 years). Later graft dysfunction is rare except for virus B recurrence. Primary
      biliary cirrhosis and the group of inborn errors of metabolism are regarded as
      the optimal indications of OLT in adults and children respectively. Precocious
      evaluation of patients, before advanced stages of the disease associated with
      multiple complications, should prevent them from dying on a waiting list and
      decrease operative as well as early postoperative risks. Not only does OLT
      provide mere survival (among 5 patients with lethal hepatic disease, 4 are alive
      at 2 years from OLT), it also provides a regained quality of life with a
      virtually normal (for the price of a daily medication intake) family,
      professional and sportive life. Such achievements prompt us today to propose
      early transplantation to these patients.

PMID- 1621238
TI  - Type I congenital plasminogen deficiency is not a risk factor for thrombosis.
AB  - The risk of thrombosis in type I congenital plasminogen (PLG) deficiency has been
      suggested, but is still not confirmed. We studied 40 members of two unrelated
      families with this disease, and found that 21 were heterozygotes of type I
      congenital PLG deficiency. Three of them had thrombosis, but the other 18 had no
      thrombosis. The percentages of family members with no history of thrombosis up to
      a given age among subjects with type I congenital PLG deficiency and healthy
      controls were analyzed by the Kaplan-Meier method. No significant difference
      between the two groups was observed by the generalized Wilcoxon test (p = 0.23).
      These results suggest that there is no significant correlation between type I
      congenital PLG deficiency and thrombosis.

PMID- 1621239
TI  - A randomised, double-blind, placebo-controlled trial of dermatan sulphate for
      prevention of deep vein thrombosis in hip fracture.
AB  - Dermatan sulphate (MF 701) is a natural glycosaminoglycan that catalyses thrombin
      inhibition by heparin cofactor II. The aim of the study was to evaluate the
      efficacy and safety of MF 701 for prevention of deep vein thrombosis (DVT) in
      patients with hip fracture. A randomised, double-blind, placebo-controlled design
      was used to assess two dose regimens of MF 701 in two consecutive study phases.
      Treatment was started within 48 h from the trauma and continued for 14 days for
      non-operated patients or until the 10th postoperative day. Bilateral mandatory
      venography was used to assess the end-point. Eighty patients were included in the
      first phase (40 MF 701, 40 placebo). MF 701, 100 mg IM b.i.d., did not reduce
      incidence of DVT from that on placebo and did not induce any bleeding. In the
      second phase 126 patients were included, with a randomisation ratio of 2:1 (84 MF
      701, 300 mg IM b.i.d., 42 placebo). Bilateral venography was obtained for 110
      patients. The incidence of DVT was 64% (23/36) in the placebo group and 38%
      (28/74) in the MF 701 group (p = 0.01; odds ratio [OR] = 0.34, 95% confidence
      limits [CL] = 0.15-0.80p; proximal DVTs were 42% (15/36) and 20% (15/74),
      respectively (p = 0.02; OR = 0.36, CL = 0.15-0.89). No significant differences
      were found in haemorrhagic complications (2.4% in each group), blood loss from
      drains, blood transfusions, haemoglobin and haematocrit values. This study is the
      first demonstration that dermatan sulphate is a clinically effective
      antithrombotic agent without bleeding effects. It also provides evidence of the
      biological role of heparin cofactor II.

PMID- 1621240
TI  - A decrease in plasminogen activator inhibitor-1 activity after successful
      percutaneous transluminal coronary angioplasty is associated with a significantly
      reduced risk for coronary restenosis.
AB  - To determine a possible relation of changes in plasma levels of plasminogen
      activator inhibitor 1 (PAI-1) and tissue plasminogen activator (t-PA) to the
      development of coronary restenosis after successful coronary angioplasty (PTCA),
      we followed 104 patients with a low grade residual stenosis after PTCA (less than
      30%) for a period of 12 months. PAI-1 plasma levels (functional activity) and t
      PA antigen were determined 1 day before PTCA and 3 days, 3 months and 6 months
      thereafter. Thirty-four patients (32.69%) developed angiographically proven
      coronary restenosis (group A) within a time range of 4-48 weeks (median 12.5
      weeks) after PTCA while the remaining patients (group B) had neither clinical
      signs nor angiographic evidence of restenosis after 6 months. No significant
      differences could be demonstrated in t-PA antigen or PAI-1 activity (plasma
      levels between the two groups of patients the day before PTCA). During the whole
      observation period t-PA plasma levels were not significantly different between
      the two groups; however, PAI-1 plasma levels were significantly higher at 3
      months and 6 months after PTCA in patients of group A (p less than 0.005). When
      the pattern of PAI-1 plasma levels over time (increase or decrease between two
      consecutive time points of blood collection) was used to discriminate between the
      two study groups only 3.5-18% of patients with a decrease in PAI-1 developed
      coronary restenosis within the following observation period in contrast to 25-58%
      of patients with an increase in PAI-1 plasma levels (p less than 0.05 to p less
      than 0.0005).

PMID- 1621241
TI  - The predictive value of the hemostasis parameters in the development of
      preeclampsia.
AB  - In order to find out which hemostasis parameters would have the predictive value
      for the development of preeclampsia, modified antithrombin III (ATM,
      representative of the antithrombin III-serine esterase complex), tissue
      plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), beta
      thromboglobulin (BTG), antithrombin III (AT III), fibrinogen, fibrin(ogen)
      degradation product (FDP), FDP D-dimer and euglobulin lysis time (ELT) were
      measured in 20 normal non-pregnant women, 21 normal pregnant women, 6 high-risk
      pregnant women, 14 preeclampsia pregnant women, and 5 patients with disseminated
      intravascular coagulation (DIC). Only tPA and AT III were found significantly
      different between the preeclampsia and the normal or high-risk pregnant women:
      tPA was found progressively and significantly increased from the normal pregnant,
      to the high-risk pregnant, then to the preeclampsia women (p less than 0.05). AT
      III was significantly lower in the preeclampsia than in the normal pregnant (p =
      0.0001) or in the high-risk pregnant women (p = 0.002). In the 2nd trimester,
      tPA, PAI, fibrinogen and FDP were significantly higher, and AT III was
      significantly lower in the preeclampsia than in the normal pregnant women,
      whereas in the 3rd trimester, tPA and AT III were significantly higher or lower,
      respectively, in the preeclampsia than in the normal pregnant women. No
      significant difference of ATM could be found between the preeclampsia and the
      normal or high-risk pregnant women. From the present study, we suggest that tPA
      and AT III would be used as the main predictors, and FDP and D-dimer as the
      complementary predictors for the development of preeclampsia and should be
      detected in the normal or high-risk pregnant women.

PMID- 1621242
TI  - Functional characterization of a variant factor XII (F XII Locarno) in a cross
      reacting material positive F XII deficient plasma.
AB  - The plasma of a healthy woman was found to contain half normal factor XII (FXII)
      antigen level (0.46 U/ml) without any FXII clotting activity (less than 0.01
      U/ml). The variant FXII in this plasma, denoted as FXII Locarno, was partially
      characterized by immunological and functional studies on the proposita's plasma.
      FXII Locarno is a single chain molecule with the same size (Mr = 80 kDa) as
      normal FXII. Isoelectric focusing suggested an excess of negative charge in the
      variant FXII as compared to normal FXII. In contrast to FXII in normal plasma,
      FXII Locarno was not proteolytically cleaved upon prolonged incubation of
      proposita's plasma with dextran sulfate. Adsorption to kaolin was similar for
      both, abnormal and normal FXII. Incubation of the proposita's plasma with dextran
      sulfate and exogenous plasma kallikrein showed normal cleavage of FXII Locarno
      outside of the tentative disulfide loop Cys340-Cys467, but only partial cleavage
      within this disulfide loop. Furthermore, plasma kallikrein-cleaved abnormal FXII
      showed neither amidolytic activity nor proteolytic activity against factor XI and
      plasma prekallikrein. These results suggest a structural alteration of FXII
      Locarno, affecting the plasma kallikrein cleavage site Arg353-Val354 and thus
      formation of activated FXII (alpha-FXIIa).

PMID- 1621243
TI  - Determinants of induction of increased synthesis of plasminogen activator
      inhibitor type-1 in human endothelial cells by t-PA.
AB  - Tissue-type plasminogen activator (t-PA) induces synthesis of a rapidly acting
      inhibitor, plasminogen activator inhibitor type-1 (PAI-1) in human umbilical vein
      endothelial cells (HUVEC) in culture. In vivo, an analogous process may induce
      negative feedback on the fibrinolytic system. To define specific determinants in
      the t-PA molecule contributing to the induction, PAI-1 synthesis was
      characterized in 35S-methionine labeled HUVEC in response to several molecular
      variants of t-PA. Catalytically active variants devoid of several specific
      structural domains in the A-chain retained the capacity to form complexes with
      PAI-1 and to induce increased concentrations of total PAI-1 (free and complexed)
      in conditioned media without depleting PAI-1 from the extracellular matrix.
      Surprisingly, a mutant t-PA with markedly reduced catalytic activity reflecting
      replacement of the active site serine with threonine (S478T) formed complexes
      with PAI-1 and induced increased PAI-1 synthesis as well. However, in contrast to
      wild-type t-PA and A-chain variants, it did not release 35S-methionine labeled
      PAI-1 from the extracellular matrix. Thus, its effects appeared to reflect
      increased secretion exclusively. Our results suggest that induction of PAI-1
      synthesis in HUVEC by t-PA depends on its protease domain but that an active site
      serine is not a requirement.

PMID- 1621244
TI  - Biochemical and biological properties of a recombinant tissue-type plasminogen
      activator derived from the rat JMI-229 cell line.
AB  - Recombinant tissue-type plasminogen activator (rt-PA), produced by expression of
      the genomic t-PA DNA from the JMI-229 cell line, which is of rat origin, in the
      host cell line, was purified to homogeneity. JMI-229 rt-PA was obtained
      essentially as a single chain molecule which was quantitatively converted to a
      two-chain moiety by treatment with plasmin. The plasminogen activating potential
      of single chain JMI-229 rt-PA was 5-fold lower than that of commercially
      available human rt-PA (Actilyse) in the absence of fibrin, but comparable in the
      presence of fibrin; it showed a concentration-dependent binding to fibrin, with a
      significantly more pronounced binding than Actilyse at low fibrin concentration
      (85 +/- 8% versus 20 +/- 7% at 0.025 mg/ml fibrin; p = 0.004). In human plasma in
      the absence of fibrin, the concentrations of both single chain and two-chain JMI
      229 rt-PA required to induce 50% fibrinogen degradation in 2 h, were about 15
      fold higher than those of Actilyse. Both single chain and two-chain forms of JMI
      229 rt-PA and of Actilyse induced a similar time- and concentration-dependent
      lysis of a 125I-fibrin-labeled plasma clot immersed in human plasma, in the
      absence of significant systemic fibrinolytic activation. Equally effective
      concentrations (causing 50% clot lysis in 2 h) were 0.11 or 0.10 micrograms/ml
      for single chain or two-chain JMI-229 rt-PA, as compared to 0.11 or 0.15
      micrograms/ml for single chain or two-chain Actilyse.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1621245
TI  - Human platelets contain scinderin, a Ca(2+)-dependent actin filament-severing
      protein.
AB  - A large body of biochemical and morphological evidence suggests that actin
      polymerizes in response to various stimuli which activate platelets. Previous
      work has shown the presence in platelets of gelsolin, a Ca(2+)-dependent
      regulator of actin filament length. This present work demonstrates that human
      platelets contain scinderin, another Ca(2+)-dependent actin filament-severing
      protein recently discovered in our laboratory. Extracts prepared from platelets
      were subjected to DNase-I-Sepharose 4B affinity chromatography. EGTA eluates from
      the affinity columns contained scinderin as demonstrated by mono and two
      dimensional polyacrylamide gel electrophoresis and immunoblotting with scinderin
      antibodies. The concentration of scinderin in platelets was 75 fmol/mg total
      protein. This might represent 11% of the total actin filament-severing activity
      if both proteins are equally potent, on a molar basis, in severing actin
      filaments. Double staining immunocytochemical studies with antibodies against
      scinderin and rhodamine phalloidin, a probe for F-actin, also demonstrated the
      presence of scinderin in platelets. These findings suggest that scinderin may
      participate in the regulation of platelet actin networks.

PMID- 1621246
TI  - Binding of human platelet glycoprotein Ib and actin to fragments of actin-binding
      protein.
AB  - Actin-binding protein (ABP) is degraded into fragments of 190 and 90 kDa by
      calpain. A monoclonal antibody (MAb TI10) against the 90 kDa fragment of ABP
      coprecipitated with the glycoprotein Ib (GP Ib) peak observed on crossed
      immunoelectrophoresis of Triton X-100 extracts of platelets prepared without
      calpain inhibitors. MAb PM6/317 against the 190 kDa fragment was not
      coprecipitated with the GP Ib peak under such conditions. The 90 kDa fragment was
      adsorbed on protein A agarose from extracts that had been preincubated with
      antibodies to GP Ib. This supports the idea that the GP Ib-ABP interaction
      resides in the 90 kDa region of ABP. GP Ib was sedimented with the Triton
      insoluble actin filaments in trace amounts only, and only after high speed
      centrifugation (100,000 x g, 3 h). Both the 190 kDa and the 90 kDa fragments of
      ABP were sedimented with the Triton-insoluble actin filaments.

PMID- 1621247
TI  - The d-enantiomer form of indobufen totally accounts for the anti-cyclooxygenase
      and antiplatelet activity ex vivo and for the increase in bleeding time by
      indobufen in man.
AB  - Indobufen is an antiplatelet drug able to inhibit thromboxane production and
      cyclooxygenase-dependent platelet aggregation by a reversible inhibition of
      cyclooxygenase. Indobufen exists in two enantiomeric forms, of which only d
      indobufen is active in vitro in inhibiting cyclooxygenase. In order to verify
      that also inhibition of platelet function is totally accounted for by d
      indobufen, ten patients with proven coronary artery disease (8 male, 2 female,
      age, mean +/- S.D., 58.7 +/- 7.5 years) were given, in random sequence, both 100
      mg d-indobufen and 200 mg dl-indobufen as single administrations in a double
      blind crossover design study with a washout period between treatments of 72 h. In
      all patients thromboxane (TX) B2 generation after spontaneous clotting (at 0, 1,
      2, 4, 6, 8, 12, 24 h), drug plasma levels (at the same times), platelet
      aggregation in response to ADP, adrenaline, arachidonic acid, collagen, PAF, and
      bleeding time (at 0, 2, 12 h) were evaluated after each treatment. Both
      treatments determined peak inhibition of TXB2 production at 2 h from
      administration, with no statistical difference between the two treatments (97 +/-
      3% for both treatments). At 12 h inhibition was 87 +/- 6% for d-indobufen and 88
      +/- 6% for dl-indobufen (p = NS). Inhibition of TXB2 production correlated
      significantly with plasma levels of the drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621248
TI  - Normalization of the haemostatic plugs of dogs with haemophilia A (factor VIII
      deficiency) following the infusion of a combination of factor Xa and
      phosphatidylcholine/phosphatidylserine vesicles.
AB  - The bolus intravenous infusion of factor Xa in combination with
      phosphatidylcholine/phosphatidylserine (PCPS) vesicles, at a dose of 2.6 x 10(
      11) moles and 4.0 x 10(-8) moles/kg body weight respectively, has previously been
      shown to correct the bleeding diathesis of haemophilic (factor VIII deficient)
      dogs (Br J Haematol 1988; 69: 491-7). The cuticle bleeding time (CBT) was used as
      the test to evaluate objectively this response. Transmission electron microscopy
      was performed to document the evolution of haemostatic plugs forming in the
      vascular bed of the injured cuticles of both normal and factor VIII deficient
      dogs with and without treatment with factor Xa/PCPS. The dosage previously shown
      to normalize the CBT in haemophilic and significantly shorten it in normal
      animals was used. Subjective and objective observations, using morphometric
      techniques, were made over a period of 25 min following injury induction. The
      administration of factor Xa/PCPS was associated with complete and sustained
      normalization of haemostatic plug development in the haemophiliacs including
      platelet recruitment, activation and compaction and subsequently fibrinous
      transformation. In the case of the normals, platelet activation, etc, was
      exaggerated and fibrinous transformation appeared to be accelerated. The
      haemostatic plugs forming in the treated haemophiliacs were indistinguishable
      from those forming in the normals and significantly different, with regard to all
      parameters measured, from the morphological appearances noted in the untreated
      haemophiliacs. These data suggest that the correction of the haemostatic defect
      previously observed results from the normalization of haemostatic plug formation
      and that this is sustained despite the promotion of systemic fibrinolysis that is
      also known to occur.

PMID- 1621249
TI  - Alternative splicing is responsible for the presence of two tissue factor mRNA
      species in LPS stimulated human monocytes.
AB  - Although normally absent from the surface of all circulating cell types, tissue
      factor (TF) can be induced to appear on circulating monocytes by stimulants like
      bacterial lipopolysaccharide (LPS) and phorbolesters. Northern analysis of RNA
      isolated from LPS stimulated human monocytes demonstrates the presence of 2.2 kb
      and 3.1 kb TF mRNA species. The 2.2 kb message codes for the TF protein. As
      demonstrated by Northern blot analysis with a variety of TF gene probes, the 3.1
      kb message arises from an alternative splicing process which fails to remove 955
      bp from intron 1. Because of a stop codon in intron 1 no TF protein is produced
      from the 3.1 kb transcript. This larger transcript should therefore not be taken
      into account when comparing TF gene transcription and TF protein levels.

PMID- 1621250
TI  - The poor reliability of factor X chromogenic assays in coumarin treated patients.

PMID- 1621251
TI  - Subcutaneous heparin therapy during pregnancy: a need for concern at the time of
      delivery.

PMID- 1621252
TI  - Extensive venous thrombosis in a case of Behcet's disease associated with
      heterozygous protein C deficiency.

PMID- 1621253
TI  - Increase in fibrinolytic activity after erythropoietin therapy.

PMID- 1621254
TI  - Peri-operative replacement therapy with factor VII concentrate in a patient with
      severe factor VII deficiency.

PMID- 1621255
TI  - Metabolism of estradiol and estrone in organ cultures of dorsolateral and ventral
      prostate of untreated and sex hormone-implanted rats.
AB  - Since dorsolateral but not ventral prostate undergoes estrogen-induced dysplasia
      in the androgen-supported Noble rat in 16 weeks, we studied estrogen metabolism
      by these tissues from untreated and sex hormone-implanted animals. We incubated
      8.5 nM [6,7-3H]-labeled estradiol (E2) and estrone (E1) for 21 hours in serum
      free, prostate-lobe cultures and 8.5 nM [2-3H]E2 with explants from untreated
      rats and animals treated with testosterone, 5 alpha-dihydrotestosterone, or E2
      plus testosterone. Untreated rat ventral prostate metabolized 3.7 times as much
      E2 to E1 as dorsolateral prostate, whereas the latter tissue converted 2.5 times
      as much E1 to E2 as the former. After dorsolateral prostate culture with 8.5 nM
      [6,7-3H]-labeled E2 or E1, 0.6 M KCl-extracted, Sephadex G25-excluded nuclear
      protein bound preponderantly E2, whereas the counterpart nuclear protein fraction
      from ventral prostate explants incubated with E2 bound substrate and E1 almost
      equally. The combination sex hormone treatment decreased E2 metabolism and
      increased its uptake by the dysplastic dorsolateral prostate. Implantation of 5
      alpha-dihydrotestosterone, but not of testosterone, also decreased E2 metabolism
      to E1 by dorsolateral prostate cultures. Treatments with E2 plus testosterone and
      with 5 alpha-dihydrotestosterone changed E2 uptake/E1 retention in dorsolateral
      prostate explants from 2.4 to 7.4 and 8.5, respectively. C-2 tritium release
      marking the 2,3-catechol estrogen pathway was greater for ventral than
      dorsolateral prostate, but was unaffected by the sex hormone treatments.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1621257
TI  - Three new D-ring unsaturated sterols from the Mediterranean sponge Topsentia
      aurantiaca: structure determination and complete nuclear magnetic resonance
      assignment.
AB  - Three novel sterols with a rare D-ring unsaturation were isolated from the marine
      sponge Topsentia aurantiaca and identified as 5 alpha-cholest-14-ene-3 beta,16
      alpha-diol (2), 24R-ethyl-5 alpha-cholest-14-ene-3 beta,16 alpha-diol (3), and
      24S-ethyl-5 alpha-cholest-14-ene-3 beta,16 alpha-diol (4). The sponge also
      elaborates a further D-ring unsaturated sterol, 5 alpha-cholest-15-en-3 beta-ol
      (1), which has been previously described only as a synthetic product. All the 1H
      and 13C nuclear magnetic resonances of compounds 1 and 2 were assigned to the
      relevant protons and carbons by bidimensional COSY, HETCOR, and HMQC nuclear
      magnetic resonance experiments.

PMID- 1621256
TI  - Effects of a phytoestrogen diet on estrogen-dependent reproductive processes in
      immature female rats.
AB  - The study reported here examined the effects of a phytoestrogen diet on progestin
      receptor induction, vaginal opening, and the onset and maintenance of vaginal
      cycles in developing female rats. A natural dietary concentration (0.01%) of the
      isoflavonoid coumestrol was incorporated into the AIN semipurified diet and fed
      from 21 to 24 days (acute treatment) or from 22 to 60 days (chronic treatment).
      Progestin receptor induction was observed in the uterus, pituitary, and
      hypothalamus-preoptic area following acute treatment. Responses were more marked
      in the uterus and pituitary than in the hypothalamus-preoptic area. Vaginal
      opening was accelerated by 4 days during chronic coumestrol treatment and
      occurred at a lighter body weight. Vaginal cycles began on vaginal opening and
      did not differ in regularity from those of control animals. However, irregular
      cycles were observed in coumestrol-treated animals at 116 to 131 days, suggesting
      that chronic coumestrol treatment may have induced some permanent changes in
      reproductive function. These findings demonstrate that plant estrogens, at
      natural dietary levels, produce significant, agonistic actions in several
      estrogen-dependent tissues and processes.

PMID- 1621258
TI  - Studies of the synthesis of biomarkers. X. Synthesis of 13,17-secodiacholestanes.
AB  - 13,17-Secodiacholestanes (6) were synthesized from cholesterol (1) in six steps.
      The key intermediates, (20R)- and (20S)-diacholest-13(17)-enes (3a and 3b),
      underwent ozonization and reduction to provide (20R)- and (20S)-13,17
      secodiacholesta-13,17-dione (5a and 5b), respectively. On Clemmensen reduction,
      the diones (5a and 5b) yielded the target molecule 6. The structure of an unknown
      biomarker was shown to be different from the proposed 6 by gas
      chromatographic/mass spectrometric comparison.

PMID- 1621259
TI  - Racial/ethnic variations in male testosterone levels: a probable contributor to
      group differences in health.
AB  - Racial and ethnic variations in serum testosterone levels were investigated among
      a large sample of male Vietnam era veterans. Based on geometric means,
      significant average differences were found between 3,654 non-Hispanic white and
      525 black individuals. The geometric mean for testosterone levels among 200
      Hispanic individuals was similar to that of non-Hispanic white individuals.
      Regarding two other racial/ethnic groups (Asian/Pacific Islanders and Native
      Americans), no significant differences were found, due perhaps to small sample
      sizes. Results were interpreted as having considerable potential for explaining
      some of the race differences in the incidences of cardiovascular diseases,
      hypertension, and prostate cancer.

PMID- 1621260
TI  - Adrenal steroidogenesis in the guinea pig: effects of androgens.
AB  - In humans, the onset of adrenache has been found to occur with the appearance of
      the zona reticularis, the inner zone of the adrenal cortex. Since an increase in
      the volume of adrenal cortex during maturation in the guinea pig has been
      associated with the growth of the zona reticularis, we were interested in
      investigating the changes in adrenal steroidogenesis during maturation in this
      species. In addition, the effect of androgens on adrenal steroidogenesis was
      studied. We demonstrated that between 1 and 10 weeks of age, a period of maximal
      growth of the adrenals in the guinea pig, there is a decrease in the
      concentrations of adrenal pregnenolone, cortisol, dehydroepiandrosterone,
      testosterone, androstenedione, and 11 beta-hydroxyandrostenedione, suggesting
      lower steroid production by the guinea pig adrenals. In plasma, we observed that
      the concentration of 11 beta-hydroxyandrostenedione (the sole C19 steroid present
      after castration) remained unchanged during maturation, while cortisol and
      corticosterone were lower between 1 and 4 weeks of age. Although castration as
      well as the administration of the antiandrogen flutamide had no effect on adrenal
      steroidogenesis, dihydrotestosterone caused an inhibition of cortisol and
      corticosterone levels in the adrenals while the concentrations of progestins
      (namely, pregnenolone, 17-hydroxypregnenolone, progesterone, and 17
      hydroxyprogesterone) tended to increase in the adrenals, thus suggesting that
      dihydrotestosterone induces a blockade in the steroidogenic pathway.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1621261
TI  - Production of a monoclonal antibody to cortisol: application to a direct enzyme
      linked immunosorbent assay of plasma.
AB  - Cortisol mouse monoclonal antibodies were produced and characterized. Of the four
      clones studied, supernatant from one clone (A2), compared with other cortisol
      monoclonal antibodies, showed minimal cross-reactivity to other C21 steroids and
      was suitable for the direct determination of cortisol in plasma by enzyme-linked
      immunosorbent assay using a standard 96-well microtiter plate. The enzyme-linked
      immunosorbent assay uses the immobilized antigen approach, in which cortisol in
      plasma samples or standards competes with immobilized steroid for antibody
      binding sites. After washing, the cortisol antibody bound to the wells of the
      microtiter plate is detected with antimouse immunoglobulin conjugated to
      horseradish peroxidase. Following further washing, o-phenylenediamine substrate
      is added. The enzyme-linked immunosorbent assay is robust and semiautomated. The
      mean +/- SD recovery from plasma was 97% +/- 6%. Precision studies on three
      different plasma pools showed mean coefficients of variation of 7.6% and 8.6% for
      within- and between-assay variation, respectively. The satisfactory performance
      criteria allow its use in the routine laboratory.

PMID- 1621262
TI  - Subnormal serum testosterone levels in male internal medicine residents.
AB  - The consequences of sleep deprivation and stress in residency training have not
      been quantified. In the course of assembling a control group for other studies,
      we unexpectedly observed a significant (P less than 0.005) and marked depression
      of serum testosterone levels in healthy male internal medicine residents (means =
      11.8 +/- 1.1 nmol/L, n = 7) compared with other hospital personnel (means = 20.6
      +/- 5.3 nmol/L, n = 18). Testosterone concentrations in the two groups were
      entirely nonoverlapping, while luteinizing hormone levels were not significantly
      different. We conclude that the stress of residency training leads to a
      quantifiable depression of gonadal function, and that gonadal steroid
      concentrations may be useful in evaluating measures intended to reduce that
      stress.

PMID- 1621263
TI  - Adrenocorticosteroid excretion in salt-sensitive and salt-resistant spontaneously
      hypertensive rats.
AB  - Two strains of spontaneously hypertensive rats (SHRs) differ in their
      susceptibility to the hypertensive effects of dietary NaCl. One strain exhibits a
      significant elevation of blood pressure after dietary NaCl loading (SHR-S),
      whereas the other does not (SHR-R). Since differences in adrenocortical steroid
      production may contribute to NaCl sensitivity, we compared 19
      nordeoxycorticosterone (DOC), 18-OH-DOC, aldosterone, and corticosterone
      excretion in 6-week-old male rats from the SHR-S (n = 24) and SHR-R (n = 24)
      strains. The rats were housed in metabolic cages (two rats per cage) and given
      either basal (1%) or high (8%) NaCl diet. Urinary steroids were analyzed using
      thin-layer chromatography and radioimmunoassay methods. The high NaCl diet
      elevated the urinary excretion of the four corticosteroids in both rat strains.
      19-nor-DOC decreased with time in both the SHR-S and SHR-R strains, and was not
      different between strains on either diet. Aldosterone was increased in the SHR-S
      strain compared with the SHR-R strain on the low NaCl diet, but aldosterone was
      not different between the two strains on the high NaCl diet. Corticosterone and
      18-OH-DOC did not differ between strains. These data confirm that 19-nor-DOC is
      higher in young prehypertensive SHRs and decreases with age. Aldosterone
      excretion is higher in the SHR-S strain compared with the SHR-R strain on the low
      NaCl diet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621264
TI  - Synthesis of 3 alpha,6 beta,7 alpha,12 beta- and 3 alpha,6 beta,7 beta,12 beta
      tetrahydroxy-5 beta-cholanoic acids.
AB  - Chemical synthesis of 3 alpha,6 beta,7 alpha,12 beta- and 3 alpha,6 beta,7
      beta,12 beta-tetrahydroxy-5 beta-cholan-24-oic acids is described. 3 alpha,12
      beta-Dihydroxy-5 beta-chol-6-en-24-oic acid used as the starting material in the
      synthesis was prepared via oxidation of 3 alpha,12 alpha-dihydroxy-5 beta-chol-6
      en-24-oic acid 3-hemisuccinate at C-12 followed by reduction with
      potassium/tertiary amyl alcohol. alpha-Epoxidation of the ester diacetate of 3
      alpha,12 beta-dihydroxy-5 beta-chol-6-en-24-oic acid with m-chloroperbenzoic acid
      followed by cleavage of the epoxide with acetic acid and alkaline hydrolysis
      yielded 3 alpha,6 beta,7 alpha,12 beta-tetrahydroxy-5 beta-cholan-24-oic acid
      (overall yield 25%). N-Methylmorpholine-N-oxide-catalyzed osmium tetroxide
      oxidation of the ester diacetate of 3 alpha,12 beta-dihydroxy-5 beta-chol-6-en-24
      oic acid followed by alkaline hydrolysis yielded 3 alpha,6 beta,7 beta,12 beta
      tetrahydroxy-5 beta-cholan-24-oic acid (overall yield 33%). The structures of the
      synthesized bile acids were confirmed from their proto nuclear magnetic resonance
      and mass spectral fragmentation patterns.

PMID- 1621265
TI  - Influence of different combinations of antibodies and penicillinase-labeled
      testosterone derivatives on sensitivity and specificity of immunoassays.
AB  - Three antisera raised against bovine serum albumin (BSA) conjugates of
      testosterone-3-(O-carboxy-methyl)-oxime (T-3-CMO), 11 beta-hydroxytestosterone-11
      carboxymethyl ether (T-11 beta-O-CME) and 19-hydroxytestosterone-19-carboxymethyl
      ether (T-19-O-CME) were evaluated in enzyme immunoassays (EIAs) in combinations
      with penicillinase-labeled T-3-CMO, T-11 beta-O-CME, T-19-O-CME, and testosterone
      17 beta-hemisuccinate (T-17 beta-HS) for their influence on the sensitivity and
      specificity of EIAs. Of the various combinations, anti-T-3-CMO antiserum along
      with T-11 beta-O-CME-penicillinase showed no cross-reaction with any of the
      closely related steroids, although the same antibody had 21.6% binding to 5 alpha
      dihydrotestosterone (5 alpha-DHT) in radioimmunoassay. All the homologous
      combinations appeared to be less sensitive due to their low affinity for
      testosterone. It was also apparent that of all the heterologous systems tested,
      only two combinations, (a) anti-T-19-O-CME antiserum and T-3-CMO-penicillinase
      and (b) anti-T-3-CMO antiserum and T-11 beta-O-CME-penicillinase, were found to
      be more sensitive. The former was less specific; it showed 70% cross-reaction
      with 5 alpha-DHT. The ability of testosterone to displace the hapten-enzyme
      conjugate and the specificity of the assay appear to depend on the position of
      the enzyme label on the steroid molecule as well as on the availability of
      antigenic sites in particular combinations of antibody and hapten-enzyme
      conjugates.

PMID- 1621266
TI  - 4,4-Dimethyl-5 alpha-ergosta-8,24(28)-dien-3 beta-ol from the fungus Marasmius
      oreades.
AB  - From the fruit body of the fungus Marasmius oreades (family Tricholomataceae),
      4,4-dimethyl-5 alpha-ergosta-8,24(28)-dien-3 beta-ol (1), probably a biogenetic
      precursor of ergosterol, has been isolated along with ergosterol. Its
      stereostructure has been established unequivocally by spectroscopic methods,
      including 13C nuclear magnetic resonance.

PMID- 1621267
TI  - Synthesis and characterization by 1H and 13C nuclear magnetic resonance
      spectroscopy of 17 alpha-hexanoic derivatives of 5 alpha-dihydrotestosterone and
      testosterone.
AB  - The synthesis and characterization of 17 alpha-(6'-hexanoic acid) derivatives of
      5 alpha-dihydrotestosterone and testosterone, useful as ligands for affinity
      chromatography purification or as precursors for affinity-labeling of androgen
      binding proteins, is described. Alkynylation of 3-ethylenedioxy-, 3 beta-hydroxy
      , and 3 beta,5-dihydroxy-5 alpha-androstan-17-one precursors with the potassium
      derivative of 5-hexyn-1-ol led to the corresponding 17 alpha-(6'-hydroxyhex-1'
      ynyl) derivatives, which were hydrogenated over 10% Pt-C catalyst to give 17
      alpha-(6'-hydroxyhexyl) derivatives. Chromic acid oxidation of the primary
      hydroxy group of the 3-ethylenedioxy-17-hexyl intermediate into carboxylic acid
      followed by acid cleavage of the 3-ketal group gave 17 alpha-(5'-carboxypentyl)-5
      alpha-dihydrotestosterone, which was also obtained directly by chromic acid
      oxidation of the 3 beta-hydroxy intermediate. Chromic acid oxidation of the
      primary hydroxy group of the 3 beta,5 alpha-dihydroxy precursor resulted in a 5
      alpha-hydroxy-3-oxo intermediate, which was dehydrated to give 17 alpha-(5'
      carboxypentyl)testosterone. The 17 alpha configuration of these derivatives and
      of synthetic precursors was established by comparing their molecular rotations
      and their 1H and 13C nuclear magnetic resonance (NMR) spectra including solvent
      effects, with data reported for 17 alpha- or 17 beta-substituted steroid analogs
      as well as with 1H and 13C NMR reference data recorded in this work for 17 alpha
      ethynyltestosterone, 17 alpha-ethynyl-19-nortestosterone, 17 alpha-ethyl-19
      nortestosterone, 17 alpha-methyltestosterone, and 17 alpha-methyl-5 alpha
      dihydrotestosterone.

PMID- 1621268
TI  - Synthesis of 25-hydroxy-[6,19,19'-2H3]vitamin D3 and 1 alpha,25-dihydroxy
      [6,19,19'-2H3]vitamin D3.
AB  - Synthesis of polydeuterated analogs of 25-hydroxyvitamin D3 and 1 alpha,25
      dihydroxy vitamin D3 are described. These analogs, containing stable isotope
      atoms at metabolically stable positions, are potentially useful in studies
      involving catabolism of hydroxylated metabolites of vitamin D3.

PMID- 1621269
TI  - Effects of a normal, human-concentration, phytoestrogen diet on rat uterine
      growth.
AB  - The estrogenic action of the prototype natural phytoestrogen coumestrol was
      examined in rats in in vitro and in vivo tests. To establish the binding
      specificity of coumestrol and its relation to biological activities, saturation
      analyses and uterine weight assays were performed. These assays indicated that
      coumestrol competitively inhibited binding to the estrogen receptor and induced
      increases in uterine weight in keeping with its estrogen receptor affinity
      constant. Most importantly, coumestrol was uterotrophic when incorporated in a
      semipurified diet at natural dietary concentrations. Significant increases
      occurred in both uterine wet weight and dry weight, indicating that coumestrol
      produces true uterine growth. Effects appeared to be cumulative, raising
      questions of time-related interactions with other estrogen-sensitive mechanisms
      and clearance of isoflavonoids. Coumestrol induced uterine growth over a 90-hour
      period at dietary concentrations of 0.01 to 0.1%. Lower doses not active over
      this period were active when provided over a longer period of time: a 0.005%
      concentration was not active over a 90-hour period, but was active when provided
      over a 180-hour period. Coumestrol-induced uterine growth was accompanied by the
      induction of cytosolic progestin receptors and increases in nuclear estrogen
      binding. Scatchard analyses verified that these changes were due to changes in
      receptor number. These studies show that the naturally occurring phytoestrogens
      have dramatic estrogenic effects at natural dietary levels. These actions may be
      expressed via traditional receptor-mediated actions and therefore may have the
      same implications for development, health, and disease as do the steroidal
      estrogens produced by the body. Because rats have no sex hormone-binding
      globulin, further studies must be conducted in humans. However, these findings
      suggest that the natural dietary phytoestrogen coumestrol is a potent estrogen
      that must be considered in calculating the total estrogenic load to which humans
      are exposed during normal life.

PMID- 1621270
TI  - Rollerball endometrial ablation: new treatment options for women.
AB  - 1. Endometrial ablation with a rollerball electrode is an alternative to
      hysterectomy for selected women with menorrhagia. Patients are usually discharged
      the same day and recover more quickly than women who undergo hysterectomy. 2.
      Preoperative patient preparation includes endometrial suppression through drug
      therapy and placement of a laminaria tent in the uterine cervix. 3. Because large
      amounts of irrigating solution are used during the procedure, careful monitoring
      of fluid balance is essential to avoid fluid overload. 4. Diagnostic hysteroscopy
      is useful for evaluating abnormal bleeding.

PMID- 1621271
TI  - Personal protective equipment in aseptic technique and universal precautions.
AB  - 1. Although some of the basic principles of aseptic technique are fundamentally
      similar, their roles in terms of protection is reversed. 2. Whereas the use of
      the surgical mask has often been abused, ie, being saved by hanging around the
      neck, there is reason to believe that masks may only be necessary in those
      instances where the wearer is exposed to splashes, spray, or spatter of
      infectious materials. 3. Materials that are liquid-resistant may possess various
      degrees of resistance. On the other hand, the performance of a material that is
      liquid-proof is absolute--it is impenetrable and can be accurately described as
      impervious.

PMID- 1621272
TI  - Variable segmental plating for the treatment of spinal instability.
AB  - 1. Posterior lumbar interbody fusion (PLIF) incorporates variable screw placement
      and slotted plates with transpedicular screws to correct spondylolisthesis, a
      subluxation or displacement of the vertebrae. 2. The indications for PLIF include
      degenerative disc disease, recurrent disc herniation, spinal stenosis including
      the central and lateral foraminal varieties, various forms of instability
      associated with these disorders, and cases of asymptomatic spondylolysis with or
      without spondylolisthesis. 3. Complications include infection, fracture of the
      pedicle, nerve root impingement associated with the bone graft, and screw
      breakage. In cases where infection does occur, the hardware must be removed.

PMID- 1621273
TI  - Preparing for life after work.
AB  - 1. For retirement to be fulfilling and satisfying, hopes and dreams must be
      designed in early and middle adult life. Long before retirement, the adult must
      practice healthy living with the future in mind. 2. Saving and investing wisely
      is important and requires discipline and risk. A regular savings plan should
      start in the 30s and continue carefully throughout 2, 3 and 4 decades. 3. The
      transition to retirement is facilitated if interests are planned and friendships
      for retirement are cultivated in adult life. One of the best ways to prepare for
      retirement is to live the kind of life expected in retirement.

PMID- 1621274
TI  - Using the gold standard for OR instrument processing.

PMID- 1621275
TI  - Communication techniques.
AB  - OR managers become aware of vast amounts of information while carrying out job
      functions. It is important to use the information carefully and to select what
      information to share, when to share it, and with whom it should be shared.
      Appropriate communication can promote efficiency as well as job satisfaction.

PMID- 1621276
TI  - The OR experience during operation Desert Storm.
AB  - 1. Setting up an operating room from scratch tests basic OR knowledge. The usual
      high-technology equipment was absent in the desert. The hospital had to make due
      with the basics, including a bovie machine, suction machine, Gigli saw, minor
      orthopedic setup, and a basic laparoscopy set-up. 2. Much training focused on
      erecting and taking down the hospital; once the war began, urgency was a crucial
      factor. 3. The majority of the patients were Iraqi prisoners of war with shrapnel
      wounds to the abdomen, broken bones, and chest injuries; the Americans who were
      treated were seriously injured. Most of the procedures were orthopedic, thoracic,
      vascular, and general surgery cases.

PMID- 1621277
TI  - The demand for medical education in New York after World War II.

PMID- 1621278
TI  - Caring for the constitution: medical planning in revolutionary France.

PMID- 1621279
TI  - Every prospect of a healthy summer: the 1839 outbreak of yellow fever in
      Charleston, South Carolina.

PMID- 1621280
TI  - Making it.

PMID- 1621281
TI  - [Ultracytochemical study of adenylate cyclase activity in Hela cell culture
      exposed to fluorine].
AB  - Electron microscopy has been used to study the adenylate cyclase activity in Hela
      cells after the incubation with 1.5 p. p. m. of fluoride for 5.30 and 60 minutes.
      It is established that the action of fluoride is accompanied by the increased
      enzyme activity in cell plasmalemma. Besides, the adenylate cyclase activity is
      revealed in the membrane of lipid droplets. In the mitotic cells a decrease of
      the enzyme activity in plasma membrane is observed parallel with its simultaneous
      increase in the metaphase chromosomes.

PMID- 1621282
TI  - [Effect of gene db dose on the development of beta-cytotropic and immunotropic
      effects of long-term glibenclamide administration in C57BL/KsJY mice].
AB  - The studies have revealed a modifying influence of gene db on the expressivity of
      damaging beta-cytotropic effect of long-term sulphanilamide therapy and on the
      development of autoimmune cell response to antigens of pancreatic islets. It is
      substantiated as promising to study a significance of individual genes and their
      doses in determining the variations of reactivity to beta-cytotropic and
      immunotropic effects of the chemical nature factors.

PMID- 1621283
TI  - [Role of exogenous fibrinogen in the processes of degranulation of thrombocytes
      stimulated with thrombin. Ultrastructural study using fibrinogen labeled with
      colloidal gold].
AB  - Using colloidal gold-conjugated fibrinogen (F-Au) it is shown that exogenous
      fibrinogen can participate in the platelet release reaction. In the absence of F
      Au, internal secretory vacuoles readily formed in human platelets stimulated with
      thrombin, but extrusion of their content was delayed. Upon incubation with F-Au,
      endocytic channels induced by F-Au-receptor interactions, fused with internal
      vacuoles, thus establishing spatial communications of the latter with the outer
      medium.

PMID- 1621284
TI  - [Current status and perspectives for genetic consultation and prophylactic
      medical examination of risk groups with malignant neoplasms of the female
      reproductive system and breast].
AB  - It is shown as necessary to create specialized aid to cancer families in the
      general structure of oncological service. The results of 2-year clinical-genetic
      monitoring of high-risk group relative to ovarian, breast and endometrial cancer
      are presented.

PMID- 1621285
TI  - [Intensity of 3H-uridine incorporation in hepatocytes of various degrees of
      ploidy].
AB  - The intensity of 3H-uridine incorporation, DNA content and number of nucleoli
      were measured in the same cells on charted preparations of isolated rat
      hepatocytes. It is shown that intensity of 3H-uridine incorporation and the
      number of nucleoli increases proportionally with the cell ploidy.

PMID- 1621286
TI  - [G. J. Meller in the USSR].

PMID- 1621287
TI  - [Cytological features of the development of multi-organ failure induced by
      exposure of the body to tumor necrosis factor].
AB  - Morphologic analysis of the changes in the internal organs after i.v. injection
      of 20 micrograms per mice of tumor necrosis factor (TNF) revealed the development
      of signs of multiorgan failure (interstitial and intraalveolar edema in the lung,
      acute fatty liver, tubular necrosis in kidney, brain edema) during first 24 h.
      The microvascular endothelial cells played a particular role in the state
      development. Results of investigation proved that endothelial cells were one of
      the major cellular targets for TNF action in vivo.

PMID- 1621288
TI  - Doppler ultrasound technique for measuring capillary-speed flow velocities with
      strong stationary echoes.
AB  - Ultrasound Doppler is widely used for low measurement in both medicine and
      industry, having the advantages of being non-invasive and comparatively simple
      and therefore inexpensive. The technique has not however been used for capillary
      blood flow measurement, because of the relatively low velocities encountered and
      because of the presence of strong interfering signals from the encompassing
      tissue. An ultrasound Doppler system capable of measuring flow velocities of one
      millimetre per second in the presence of one thousand times stronger interfering
      signals is described, as well as test results using both thread and flow
      phantoms.

PMID- 1621289
TI  - Prenatal diagnosis of cystic adenomatoid malformation of the lung in a twin
      pregnancy.

PMID- 1621290
TI  - An aluminium foreign body in the oesophagus.

PMID- 1621291
TI  - The air-fluidised bed in the management of chronic varicose leg ulceration.

PMID- 1621292
TI  - Breast lymphoma: fine needle aspiration biopsy.

PMID- 1621293
TI  - Eosinophilic fasciitis presenting as psoriatic arthropathy.

PMID- 1621294
TI  - Brain abscess ten years after penetrating glass injury to the skull.

PMID- 1621295
TI  - Pseudogout, chondrocalcinosis and the early recognition of haemochromatosis.

PMID- 1621296
TI  - Deliberate self-poisoning presenting at Craigavon Area Hospital: 1976 and 1986.
AB  - Deliberate self-poisoning presenting at Craigavon Area Hospital was compared in
      the years of 1976 and 1986. A decline in the use of benzodiazepines and increase
      in other agents, notably paracetamol, is reported. Alcohol is frequently
      associated with deliberate self-poisoning, while severe mental illness is less
      common. Diagnostic practice may have effects on bed occupancy in this group.

PMID- 1621297
TI  - The changing pattern of cervical cancer in Northern Ireland 1965-1989.
AB  - There was a change in pattern of an increased prevalence of cervical cancer in
      Northern Ireland from 1965 to 1989, characterised by an increased incidence in
      women under 40 years. These changes occurred despite special screening of younger
      women, although the screening programme has probably prevented an even greater
      increase in incidence of the disease. To reduce the incidence of cervical cancer,
      not only systematic screening but also cervical smears at more frequent intervals
      would be required.

PMID- 1621298
TI  - Renal transplantation in Northern Ireland 1968-1990.

PMID- 1621299
TI  - Educational supervision of pre-registration house officers.
AB  - An annual survey of the educational supervision of pre-registration house
      officers has been carried out since 1987 by the Northern Ireland Council for
      Postgraduate Medical Education and the Queen's University of Belfast. Educational
      supervision was considered by house officers to be unsatisfactory in 27% of
      medical posts and 52% of surgical posts. Regular teaching was provided at least
      weekly in 77% of the posts, but 50% of house officers wanted mor experience of
      managing common medical emergencies. Over one-third felt administrative duties
      were excessive. There is a strong argument that hospitals should designate within
      clinical units a consultant with responsibility for educational supervision of
      the pre-registration house officers. Creation of the hospital counterpart of the
      General Practitioner trainer--the educational supervisor--would enhance the
      educational value of the pre-registration year. This might avoid withdrawal of
      approval for training purposes from some pre-registration posts.

PMID- 1621300
TI  - Junior medical posts in the NHSSB: what the doctors think.
AB  - This survey of house officers in the Northern Health and Social Services Board in
      Northern Ireland demonstrated that they have complaints not just about the number
      of hours they work. Thirty-nine per cent noted poor standards of food and/or
      accommodation. Many complained about doing routine "non-medical" work and thought
      that their working conditions would be improved by nurses having more
      responsibility for managing intravenous medication and the employment of
      phlebotomists. Doctors expressed concerns about a lack of career counselling and
      availability of training in research methods in their posts.

PMID- 1621301
TI  - Acoustic neurinoma surgery in Belfast 1986-1989.
AB  - Forty-seven acoustic neurinoma tumours have been operated on in 46 patients in
      the years 1987-1989. This is a considerable increase over the prevalence in the
      preceding ten years. Twenty-six were classified as large tumours, 18 as medium
      and one was small. Surgical excision was complete in 16 and incomplete in 31
      cases. Two patients died in the early postoperative period. Facial nerve function
      was preserved in 36 (80%) of cases; of these 27 (60%) had good function and nine
      (20%) fair function. Useful hearing was prevented in only two patients. The
      overall complication rate has been low and often of a transitory nature.

PMID- 1621302
TI  - Communication of discharge information for elderly patients in hospital.
AB  - The delivery of the discharge note to the general practitioners following
      discharge of elderly patients from a geriatric medical unit was studied over a
      two-month period. Handwritten discharge notes were received by the general
      practitioners in 75% of cases, and the delay was reduced to a median of two days
      by the use of a pre-printed envelope. Postal communications were also received by
      89% of general practitioners after a median delay in two days. A dual system of
      hand-delivery and postal delivery would ensure faster and more complete receipt
      of information.

PMID- 1621303
TI  - A personal view of the hospital service.

PMID- 1621304
TI  - "Who fears to speak of ninety-eight"?

PMID- 1621305
TI  - Cinderella had a champion.

PMID- 1621306
TI  - The Royal Medical Benevolent Fund Society of Ireland.

PMID- 1621307
TI  - Central pontine myelinolysis without hyponatraemia.

PMID- 1621308
TI  - Radiation therapy in prostate cancer: whole pelvis with prostate boost or small
      field to prostate?
AB  - The purpose of this retrospective study is to identify prostate cancer patients
      who would benefit from pelvic nodes irradiation (whole pelvis) as opposed to the
      small-field irradiation to the prostate only. Between 1975 and 1983, 126 patients
      were treated by whole pelvis (4,600-5,000 cGY) with prostate boost (2,000 cGY)
      radiation (WP + P). Median follow-up was six years and six months. Comparison was
      made with historic control of 116 patients irradiated at the same institutions
      between 1971 and 1977 by small field to the prostate (P) to a dose of 7,000-7,500
      cGY. There was a significant five-year survival improvement in the current WP + P
      radiation in Stage C (72% vs 40%, p = 0.0004) and Stage B (92% vs 70%, p = 0.025)
      but not in Stage A2 patients. However, WP + P radiation significantly improved
      disease-free survival (DFS) in only well and moderately but not in poorly
      differentiated carcinoma with a combined well and moderately differentiated five
      year DFS of 63 percent compared with the 45 percent in P radiation (p = 0.0228).
      Local tumor control was significantly improved in WP + P radiation in only Stage
      C cancers with their local recurrence rate 16 percent as compared with the 34
      percent in P radiation (p = 0.0172). Although acute radiation reactions were more
      frequent in WP + P than P radiation (61% vs 41%, p = 0.0022), chronic radiation
      morbidity in both series were similar. Thus, whole pelvis with prostate boost
      radiation should be utilized in Stage B and Stage C cancers as this has shown to
      increase the survival of the patient without increasing chronic radiation
      morbidity.

PMID- 1621309
TI  - Fracture of penis: diagnosis and management.
AB  - Fracture of the penis is a rupture of the rigid corporeal body. Nine consecutive
      patients with this malady were managed by an operative repair, which included
      degloving of the penis, evacuation of the hematoma, and closure of the corporeal
      tear. Postoperatively all patients reported excellent rigidity of a straight
      penis. We conclude that operative management of a fractured corporeal body is
      safe and effective.

PMID- 1621310
TI  - Factors predicting efficacy of phentolamine-papaverine intracorporeal injection
      for treatment of erectile dysfunction in diabetic male.
AB  - Thirty-three diabetic men were instructed in the use of phentolamine-papaverine
      injections for the treatment of erectile dysfunction over a two-year period. Of
      these, 12 reported a satisfactory response and 21 reported a nonsatisfactory
      response. The responders and the nonresponders were retrospectively studied to
      identify characteristics that would predict a satisfactory response. No
      difference was found between the two groups in the duration of diabetes, the
      presence of retinopathy, neuropathy, nephropathy, peripheral vascular disease, or
      ischemic heart disease. The utilization of insulin, the prevalence of type II
      diabetes, or the use of drugs which would cause impotence, did not differ between
      the two groups. There was no difference in the serum testosterone levels between
      the two groups. Age was the only predictive factor. Only 1 of 14 patients over
      age sixty had a satisfactory response to treatment while 11 of 19 patients under
      age sixty had a satisfactory response. Five of the responders and 2 of the
      nonresponders proceeded to penile implant surgery and reported satisfactory
      results. While older diabetic men may choose a trial of intracorporeal
      injections, they should be counselled regarding the high failure rate and
      alternative forms of therapy.

PMID- 1621311
TI  - Extracorporeal shock-wave lithotripsy in hypertensive patients. Importance of
      pretreatment cardiac evaluation.

PMID- 1621312
TI  - Pressure response to rapid dilation of resting urethra in healthy women.
AB  - Rapid urethral dilations were performed by a balloon mounted on a double-tip
      transducer catheter for simultaneous measurement of pressure in urethra and
      bladder. The cross sectional area of the urethra was measured according to the
      field gradient principle. Pressure and cross sectional area were recorded
      synchronously. The response of the female urethra to rapid dilation is a typical
      stress relaxation effect with a pressure peak followed by a pressure decay over a
      few seconds. The peak pressure response represents the bladder pressure required
      in producing a corresponding urethral dilation by the ingression of urine. The
      increase in pressure response was statistically significant by increasing rate as
      well as size of dilation. The method enables experimental simulation of stress
      urinary incontinence in vivo which may bring further insight into the physiology
      of the urethral closure function and the pathophysiology of stress incontinence.
      For comparative studies rapid dilation should be performed under standardized
      circumstances.

PMID- 1621313
TI  - Solitary cerebellar metastasis from transitional cell carcinoma of bladder.
AB  - Brain metastasis from transitional cell carcinoma of the bladder is unusual,
      occurring most often in the presence of widespread systemic metastases. We report
      on a patient who presented with an isolated cerebellar metastasis and recurrent
      carcinoma of the bladder, after treatment with local excision and intravesical
      thiotepa. Further evaluation failed to demonstrate other distant metastases.
      Excision of the cerebellar lesion revealed transitional cell carcinoma identical
      to the original bladder tumor. In a review of the literature, we found reports of
      two similar patients in whom a solitary cerebellar lesion was the first sign of
      metastasis from carcinoma of the bladder; neither patient had evidence of other
      distant metastases, and neither previously had received systemic chemotherapy.
      These observations indicate that central nervous system metastasis from carcinoma
      of the bladder, while rare, should be considered in the differential diagnosis of
      solitary intracerebellar lesions in such patients.

PMID- 1621314
TI  - Massive retroperitoneal hemorrhage from adrenal gland metastasis.
AB  - We report an unusual case of spontaneous massive retroperitoneal hemorrhage from
      an adrenal gland metastasis. After medical therapy failed to stabilize the
      patient's condition, surgical exploration revealed a large retroperitoneal
      hematoma arising from a right adrenal gland metastasis. At the time of
      thoracoabdominal exploration in the lower lobe of right lung a small tumor nodule
      was palpated and resected. Pathologic examination of both lung and abdominal
      lesions revealed squamous cell carcinoma thought to have been primary in the
      lung. A review of the literature reveals that metastatic lesions to the adrenal
      gland are infrequently encountered clinically and rarely hemorrhage; the first
      such case in which massive retroperitoneal hemorrhage was a complication is
      reported in the urologic literature.

PMID- 1621315
TI  - Mycobacterium bovis vertebral osteomyelitis and psoas abscess after intravesical
      BCG therapy for bladder carcinoma.
AB  - Systemic complications of intravesicular BCG for bladder carcinoma are uncommon,
      and include fever, pneumonia, hepatitis, arthralgias, or skin rash. Local
      complications of BCG therapy for bladder cancer include cystitis, prostatitis,
      epididymo-orchitis, granulomatous lymphadenitis, or ureteral obstruction. We
      believe this is the first case of Mycobacterium bovis vertebral osteomyelitis and
      psoas abscess complicating intravesicular BCG therapy for bladder carcinoma.

PMID- 1621316
TI  - Extramedullary plasmacytoma (EMP) of urinary bladder.
AB  - An extramedullary plasmacytoma (EMP) is presented with an isolated lesion in the
      urinary bladder accompanying an IgG-K paraproteinemia. After a short-term oral
      melphalan administration, the tumor soon regressed together with the paraprotein,
      and has never recurred during the two-year follow-up. This is the fourth case of
      primary EMP of the urinary bladder reported in the literature.

PMID- 1621317
TI  - Computed tomography of primary transitional cell carcinoma of upper urinary
      tracts.
AB  - Preoperative computed tomography (CT) was utilized to evaluate 20 patients with
      primary transitional cell carcinoma of the upper urinary tracts. Of the 20
      patients, 18 (90%) had CT visualization of the tumor as either a discrete mass or
      local ureteral and/or renal pelvic wall thickening; 2 (10%) had false-negative
      examinations. Seven of the 20 patients (35%) had CT evidence of tumor extension
      demonstrated by frank tumor invasion beyond the urothelium or by perirenal pelvic
      and/or periureteral fat streaks. Of the 4 patients with fat streaks, 2 (50%) had
      superficial tumors (T(A)T2), 1 had a T1 (25%) tumor, and 1 had a T3 (25%) tumor.
      All 3 patients with CT findings of direct extension of tumor through the wall of
      the ureter or renal pelvis had T3 tumors. Among the 13 with localized noninvasive
      tumor on CT, 5 (38%) had superficial tumors (TA, TIS, T1), 5 (38%) had T2 tumors,
      and 3 (21%) had T3 tumors. Of the 5 patients with enlarged regional lymph nodes
      (greater than or equal to 1.5 cm) on CT, 2 had tumor confirmed histologically, 2
      had subsequent negative CT-guided biopsies, and 1 had a negative lymphadenectomy.
      Distant metastasis was discovered in 1 patient. The data suggest that when CT
      demonstrates direct tumor extension through the renal pelvic or ureteral wall, it
      is a sensitive indicator of high-stage disease. However, in the absence of this
      finding, CT is of limited value in staging patients with primary transitional
      cell carcinoma of the pyeloureteral system.

PMID- 1621318
TI  - Management of intraoperative penile erections with diluted epinephrine solution.

PMID- 1621319
TI  - Effects of multiple injections of HCG on testis blood flow.
AB  - In attempting to determine whether or not multiple injections of human chorionic
      gonadotropin (hCG) augment testis blood flow, adult male rats were injected with
      three doses of 10 IU of hCG every other day and testis blood flow was determined
      on day 5, the day of the final injection. Testis blood flow (mL/100 g testis
      tissue/min +/- SEM) as measured by the 133Xe washout method increased from 10.8
      +/- 1.3 to 20.4 +/- 4.5 (p less than 0.05) after the three doses of hCG. These
      observations suggest that multiple injections of hCG appear to have the same
      effect as a single dose of hCG in increasing testis blood flow. This supports the
      hypothesis that hCG should be administered to all patients undergoing orchiopexy
      in the hope that the increased perfusion of the gonad will make it less
      susceptible to ischemia during the surgical procedure.

PMID- 1621320
TI  - Complications of enterocystoplasty.
AB  - Bladder reconstruction, either by augmentation or substitution enterocystoplasty,
      is a safe alternative to supravesical urinary diversion providing careful
      attention to preoperative selection, surgical technique, and postoperative review
      is observed. However, under the most optimal conditions an untoward outcome may
      occur. We reviewed our series of 100 intestinocystoplasties to categorize the
      types of complications encountered, and to identify preoperative risk factors
      that could potentially develop into an unfavorable sequela. Twenty-seven patients
      required either early or late surgical intervention, while 30 were managed
      nonoperatively. In our review we identified two groups, those with myelodysplasia
      and those with a solitary functioning kidney, who are at a higher risk for an
      unfavorable outcome to develop.

PMID- 1621321
TI  - Absorption of irrigating fluid during TURP.

PMID- 1621322
TI  - Ureteral stent removal sutures.

PMID- 1621323
TI  - [The relative risk of environmental exposure].

PMID- 1621324
TI  - [Survival in HIV infection and AIDS].
AB  - Duration of the AIDS-free period after HIV-infection and survival time vary to a
      wide extent. About 50 percent of the patients develop AIDS within 10 years. The
      most important prognostic factor is the CD4-lymphocyte count. The risk of AIDS
      increases significantly after CD4-lymphocyte counts drop below 400/microliters.
      Another prognostic factor is age. In older patients disease progresses more
      rapidly. AIDS often is preceded by an AIDS-Related-Complex characterized for
      example by Oral Candidiasis, Hairy Leukoplakia or Zoster of more than one
      dermatome. AIDS mostly develops 1/2 to 1 year after AIDS-Related-Complex. After
      AIDS is diagnosed the median survival time is not longer than 1 1/2 years. Single
      patients live much longer. Prognosis is influenced by the disease defining AIDS.
      Kaposi's Sarcoma often occurs early in the course of immunodeficiency and median
      survival is longer than after other opportunistic diseases. Survival also is
      longer after Pneumocystis Carinii Pneumonia since it is well treatable. A very
      short survival has been noticed after Non-Hodgkin-Lymphoma. During the last few
      years survival after HIV-infection and AIDS has been prolonged a little by
      sufficient prophylaxis of Pneumocystis Carinii Pneumonia which is the most
      frequent opportunistic disease, by antiretroviral treatment with Zidovudine and
      by increase of knowledge which makes early diagnosis and treatment of
      opportunistic diseases possible.

PMID- 1621325
TI  - [Administration of an HIV contaminated blood unit and hospital liability].

PMID- 1621326
TI  - [Growth factors in therapy of life threatening leukopenia].
AB  - We have tested granulocyte/macrophage-colony-stimulating-factor (rhGM-CSF, fully
      glycosylated, Sandoz, Schering/Plough) in 40 patients with chemotherapy-induced
      neutropenia. The drug enhanced leukocyte recovery in 5 different dose levels (2
      32 micrograms/kg body weight) if given by continuous intravenous infusion or
      subcutaneously for 5 days. Patients who received rhGM-CSF during neutropenic
      infections (n = 32) survived significantly better if they recovered leukocytes to
      at least 1.5 x 10(9)/l. In patients with myelodysplastic syndromes and excess of
      blasts (n = 82) remission could be induced in nearly 50% if the drug was given
      together with low dose cytosine arabinoside (LD-AraC). The results of these phase
      II-studies show that rhGM-CSF is a safe drug which may save many patients from
      life-threatening situations during haematopoietic insufficiency.

PMID- 1621327
TI  - [The prognosis of conservatively treated lumbar intervertebral disk
      displacement].
AB  - 72 out of 120 patients who where treated conservatively for proven lumbar disc
      prolapse over a seven-year-period were reexamined. Questionnaires could be
      obtained and evaluated for 91 patients. The date of reexamination was an average
      of 44.5 months after the end of inpatient-treatment. Results are given for the
      duration of inability to work and the "return to work" (RTW)-rate. The ability to
      work of 54 patients was regained after an average of 11.1 weeks, 95% of patients
      could return to their previous workplace.

PMID- 1621328
TI  - [Rehabilitation of the aged].
AB  - It is common knowledge that in the light of demographic and social developments
      in the years to come our society will have to rise to the enormous challenge of
      medical care for the old, sick and needy. In order to shorten long-time nursing
      periods for old people in need of medical care preventive treatment and medical
      rehabilitation must be the main priority of all measures. Geriatric
      rehabilitation is subdivided into prophylactic rehabilitation (medical care,
      social sector), general rehabilitation and target-specific rehabilitation. Both
      the rehabilitation team and the motivation to rehabilitate are of particular
      importance during geriatric rehabilitation. On the whole, it has to be reckoned
      that older people need a distinctly longer period of recuperation, in which the
      clinical picture rather than the age is the decisive factor of a successful
      rehabilitation. As for Germany, that is only the beginning of stationary
      geriatric rehabilitation.

PMID- 1621329
TI  - Classification of 1,198 cases of bovine lymphoma using the National Cancer
      Institute Working Formulation for human non-Hodgkin's lymphomas.
AB  - A retrospective histologic study was made of 1,198 cases of bovine lymphoma using
      the National Cancer Institute Working Formulation for human non-Hodgkin's
      lymphoma. This classification scheme was found to be readily applicable to bovine
      lymphoma. Most of the cell types described in the National Cancer Institute
      Working Formulation occurred in this series of bovine lymphomas, but the
      distribution of cell types varied markedly compared to that of human beings.
      Eighty-nine percent (1,067/1,198) of bovine lymphomas were high-grade tumors. The
      diffuse large cell type and its cleaved variant comprised 65.9% of all bovine
      lymphomas. Similar to the dog, but in marked contrast to human beings where at
      least 34% of non-Hodgkin's lymphomas were follicular, follicular tumors were
      found to be extremely rare in cattle (0.3% or 4/1,198). The prevalence of cell
      types varied significantly between the enzootic and sporadic lymphomas. The
      cleaved variant of the diffuse large cell type constituted 38% (406/1,072) of
      enzootic lymphomas versus 14% (18/126) of sporadic lymphomas. The mitotic index
      (100 x oil immersion field, 175 microns in diameter) of enzootic lymphomas (3.72
      +/- 0.06, mean +/- standard error) was significantly greater than the mitotic
      index of sporadic lymphomas (2.82 +/- 0.17). We concluded that the cleaved
      variant of the diffuse large cell type with high mitotic index is characteristic
      of enzootic lymphoma. This characteristic high-grade cell type may be a
      consequence of the viral etiology of the enzootic form of bovine lymphoma.

PMID- 1621330
TI  - Intracranial meningioma with pulmonary metastasis in three dogs.
AB  - Extracranial metastasis of primary central nervous system neoplasms is uncommon
      and has not been described in the dog. We report the clincopathologic features of
      intracranial meningioma with pulmonary metastasis in three dogs (case No. 1: 13
      year-old castrated male Boxer dog; case No. 2: 14-year-old spayed female
      Dachshund; case No. 3: 6-year-old spayed female German Shepherd Dog). Case No. 1
      presented with ataxia, lethargy, vomiting, and leaning and falling to the right,
      and had a transient remission following radiation and corticosteroid therapy;
      case No. 2 had a history of seizures that were unresponsive to primidone, left
      sided postural reaction deficits, ataxia, and circling to the right; case No. 3
      had only intermittent episodes of vomiting Computed tomography of case Nos. 1 and
      2 revealed peripherally located homogeneous contrast-enhancing intracranial
      masses. Postmortem examination revealed intracranial masses with single or
      multiple pulmonary nodules in all three cases. Histologically, the intracranial
      and pulmonary masses were meningotheliomatous meningiomas with atypical features
      including brain infiltration, necrosis, nuclear atypia, prominent nucleoli, and
      moderate cell density. All of the primary meningiomas had low mitotic rates. The
      current interest in early diagnosis and aggressive clinical/surgical management
      of canine patients with meningioma and other primary central nervous system
      neoplasms will likely result in an increased detection of extracranial
      metastases.

PMID- 1621331
TI  - Ultrastructural findings in congenital anemia, dyskeratosis, and progressive
      alopecia in Polled Hereford calves.
AB  - Ultrastructural evidence of dyserythropoiesis was found in ten calves (ages 1 to
      16 months) previously diagnosed as having congenital anemia, dyskeratosis, and
      progressive alopecia. Morphologic abnormalities found in erythroid precursors of
      all calves were associated with the nucleus. Rubriblast nuclei were irregular
      with numerous blebs, indentations, and deep clefts. Elongated blebs appeared as
      satellite nuclei in some sections. Nuclear membranes had numerous defects or
      gaps, which were frequently present in, but not limited to, recently divided
      cells. Cytoplasmic material could be found within these gaps and extending into
      the nucleus. Rubricytes had chromatin that was abnormally condensed and
      hyperosmiophilic, with numerous translucent vacuoles present. Binucleate
      rubricytes occurred frequently in affected calves. These changes resemble those
      of type I congenital dyserythropoiesis in human beings, and we suggest congenital
      anemia, dyskeratosis, and progressive alopecia of Polled Hereford calves as the
      appropriate diagnostic terms to describe this disease.

PMID- 1621332
TI  - Vascular lesions in lungs of Bali cattle with Jembrana disease.
AB  - Jembrana disease is an acute infectious disease of unknown etiology enzootic
      among Bali cattle (Bos javanicus) in Indonesia. Morphologic examination of 75
      female Bali cattle between 18 months and 4 years old affected with Jembrana
      disease consistently revealed pulmonary granulomatous vascular lesions. The
      lesions were diffusely distributed throughout the lung. The principal lesion was
      the presence of a large number of intravascular macrophages that filled the
      lumina of pulmonary veins and pulmonary arteries of a vascular diameter of 20-200
      microns, excluding the rest of blood cellular components. Concentric layers of
      perithelial cells also with plasma cells and macrophages were occasionally
      present around both veins and arteries. Infiltration of polymorphonuclear
      leukocytes or small lymphocytes was not seen. Destruction or necrosis of tissues
      or blood vessels was rarely seen. Because this vascular lesion was found in the
      lungs of all affected cattle examined, this change is useful for the postmortem
      diagnosis of Jembrana disease. Moreover, its presence could be used to
      distinguish Jembrana disease from malignant catarrhal fever and other
      lymphoreticular proliferative conditions that are frequently found among cattle
      in Indonesia.

PMID- 1621333
TI  - Transplantation of large granular lymphocyte leukemia in congenitally athymic
      rats.
AB  - Twenty-two congenitally athymic nude (rnu/rnu) rats were transplanted with large
      granular lymphocyte leukemia derived from F344 rats and then compared with ten
      similar rats inoculated with a suspension of normal F344 rat spleen cells. The
      normal spleen cells and tumor cells from a spontaneous, naturally occurring
      leukemia did not grow or cause clinical disease in any of the rats. All rats
      inoculated with a serially passaged leukemia cell inoculum had local growth at
      the inoculation site that spread widely and resulted in progressive tumor growth.
      Death occurred between 16 and 38 days after inoculation. The 22 rats that
      received passaged tumor cells developed leukemia and splenomegaly. Spleens were
      diffusely infiltrated by tumor cells and had severe depletion of lymphocytes in
      the white pulp. Leukemic rats were thrombocytopenic and had hemolytic anemia
      characterized by increased osmotic fragility, red cell width, and many nucleated
      erythrocytes. The disease syndrome appears similar to that of F344 rats
      transplanted with the same inoculum. Because the host rats lacked T cells, it is
      concluded that the hemolytic anemia and thrombocytopenia that develop in
      transplanted rats are independent of T cell function.

PMID- 1621334
TI  - Ultrastructural changes in articular cartilages of immature beagle dogs dosed
      with difloxacin, a fluoroquinolone.
AB  - The ultrastructural features of quinolone-induced arthropathy were studied in the
      humeral and femoral heads of nine skeletally immature Beagle dogs (3 months old)
      that were dosed orally with difloxacin at 300 mg/kg body weight and euthanatized
      24, 36, or 48 hours later in groups of three. Three age-matched dogs were given a
      placebo and euthanatized after 48 hours. Mitochondria in chondrocytes had
      significantly greater cross-sectional areas (P less than 0.05) in electron
      micrographs from dogs euthanatized after 48 hours of treatment than did those in
      other groups. There was also a significantly greater percentage of chondrocytes
      with swollen mitochondria in treated dogs than in the controls (P less than
      0.05). These changes preceded the necrosis observed in some chondrocytes in the
      dogs of the 48-hour group. Disruption of extracellular matrix was first observed
      in the pericellular matrix of necrotic chondrocytes, indicating that this change
      was secondary to the changes in chondrocytes. Fissures within cartilages
      apparently resulted from the loss of the normal association of proteoglycans with
      collagen fibrils.

PMID- 1621335
TI  - Colonization of the small intestine of weaned pigs by enterotoxigenic Escherichia
      coli that lack known colonization factors.
AB  - Intestinal colonization of 3-week-old weaned pigs by enterotoxigenic Escherichia
      coli (ETEC) strains that were originally isolated from weaned pigs with fatal
      diarrhea and that lacked K88, K99, F41, and 987P adhesins (4P- ETEC) was studied
      by histologic, immunofluorescent, and electron microscopic techniques. In the
      first experiment, 16 principal pigs were inoculated orogastrically with ETEC
      strain 2134 (serogroup O157: H19) or 2171 (serogroup 0141:H4), and eight control
      pigs were not inoculated. In the second experiment, 24 principals were inoculated
      with ETEC strain 2134, and 12 controls were inoculated with a nonenterotoxigenic
      strain of E. coli. Principal and control pigs were necropsied at intervals from
      24 to 72 hours after inoculation of principals to provide the tissues used for
      this report. Results from the two experiments and with both ETEC strains were
      similar and therefore were combined. Adhesion by 4P- ETEC was demonstrated in
      ileum but not in cecum or colon in 22/40 principal pigs sampled at 24 to 72 hours
      after orogastric inoculation. Adherent bacteria were most apparent on the
      intestinal villi covering Peyer's patches. Only occasional adherent bacteria were
      detected in ileal sections from a few (4/20) of the control pigs. Adherence by 4P
      ETEC was characterized by "patches" of bacteria closely associated with the
      lateral surfaces and less frequently with the tips and the bases of intact villi.
      In most cases, the adherent bacteria were separated from epithelial cell
      microvilli and other bacterial cells by a 50-400-nm space. Filamentous bacterial
      appendages bridged this space and formed a network among adjacent
      bacteria.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621336
TI  - Epicardial and corneal mineralization in clinically normal severe combined
      immunodeficiency (SCID) mice.

PMID- 1621337
TI  - Ultrastructure of lipid storage cells in the adrenal cortex and the ovary in
      female Mastomys (Praomys coucha).

PMID- 1621338
TI  - Desmin and vimentin immunocharacterization of feline muscle tumors.

PMID- 1621339
TI  - Multicentric lymphosarcoma associated with pulmonary adenomatosis (Jaagsiekte),
      pulmonary lymphoid hyperplasia, and lymphoid interstitial pneumonia in a ewe.

PMID- 1621340
TI  - Eosinophilic-mastocytic arteriolofibrosis in a cow.

PMID- 1621341
TI  - Congenital urinary incontinence in cats: a review of 19 cases.
AB  - Nineteen cases of feline congenital urinary incontinence (10 cats with ureteral
      ectopia and nine with incompetence of the urethral sphincter mechanism) are
      reviewed. The 10 cats with ureteral ectopia are considered together with 13 from
      previous reports. There was no apparent breed predisposition. Most of the 23 cats
      were presented for urinary incontinence but two of them were continent. Thirteen
      were females and ectopia was unilateral in 13 and bilateral in 10. Twenty-eight
      of 31 ectopic ureters terminated in the urethra. The commonest complication was
      hydroureter/hydronephrosis (10 cases). Eighteen of the cats were treated
      surgically, 13 by ureteral transplantation, four by ureteronephrectomy and one by
      ligation of the renal blood vessels; 16 of them were cured by surgery. Congenital
      urethral sphincter mechanism incompetence has not been reported previously in the
      cat. Nine cases are presented and the urethras of all were markedly hypoplastic.
      A common concomitant abnormality was vaginal aplasia, with the uterine horns
      terminating in the dorsum of the bladder. Bacteriuria was more common in this
      group than in the cats with ureteral ectopia.

PMID- 1621342
TI  - A microlarval development assay for the detection of anthelmintic resistance in
      sheep nematodes.
AB  - A microlarval development test for the detection of anthelmintic resistance in
      nematodes is described. Haemonchus contortus, Teladorsagia circumcincta and
      Trichostrongylus colubriformis eggs were cultured to third stage larvae in the
      presence of Earle's balanced salt solution, yeast extract and bacteria in a total
      volume of 150 microliters. Good dose-response data were obtained with
      thiabendazole, levamisole, pyrantel tartrate and ivermectin allowing the
      determination of the 50 per cent lethal concentration and of resistance factors
      when resistant strains were available. The test was found to be accurate,
      sensitive, easy to carry out and applicable to the routine detection of
      resistance.

PMID- 1621343
TI  - Isolation of Leptospira interrogans from kidneys of Zimbabwe beef cattle.
AB  - Four hundred and eighty bovine kidneys were collected from an abattoir near
      Harare between December 1987 and November 1988, and leptospires were recovered
      from 50 (10.4 per cent) of them. The isolates were identified to serogroup level
      by the microscopic agglutination test; 32 belonged to serogroup Sejroe, seven
      were Pyogenes, four Hebdomadis, two Tarassovi, and one isolate each belonged to
      serogroups Australis, Bataviae, Grippotyphosa, Icterohaemorrhagiae and Pomona.

PMID- 1621344
TI  - Unusual mass mortality of juvenile kittiwakes (Rissa tridactyla).

PMID- 1621345
TI  - Anti-canine distemper virus antibodies in common and grey seals.

PMID- 1621346
TI  - Use of a transcervical technique for embryo recovery in sheep.

PMID- 1621347
TI  - Crenosoma vulpis infection in a dog.

PMID- 1621348
TI  - Care of wild and non-domestic species.

PMID- 1621349
TI  - Importance of benzimidazole-resistant Ostertagia circumcincta.

PMID- 1621350
TI  - Use of Xylocaine pump spray for intubation in cats.

PMID- 1621351
TI  - Chronic superficial keratitis in German shepherd dogs.

PMID- 1621352
TI  - Ovarian fusion in ewes.

PMID- 1621353
TI  - Placental transfer of fluoride in Holstein cows.
AB  - Placental transfer of fluoride was studied in 40 Holstein cows and related to a
      previous 7 1/2 y study for comparative purposes. Animals were randomly assigned
      to fluoride dosage groups of control, 0.51, 1.31 or 2.66 sodium fluoride/d (10,
      25, 50 or 100 ug/g feed). Each animal received the dose daily via gelatin bolus
      for 4-14 d prior to parturition. Maternal heparinized blood samples were
      collected before dosing and after parturition. Placental cotyledon and calf blood
      samples were collected from each animal immediately after parturition. Maternal
      and calf plasma and placental cotyledon fluorine concentrations were determined.
      Increased levels of fluoride given to pregnant cows resulted in significantly
      increased (p less than 0.05) maternal plasma and placental cotyledon fluorine
      concentrations. Calf plasma fluorine concentrations at birth did not
      significantly increase in relation to the fluoride treatment level of dams. The
      data support the concept that under normal circumstances in cattle there is a
      partial placental barrier to fluoride that operates to limit fluoride
      concentrations in the fetal circulation and tissues.

PMID- 1621354
TI  - Parathion transfer and acetylcholinesterase activity in an in-vitro perfused term
      human placenta.
AB  - Organophosphate transport through the placenta was investigated in an in-vitro
      placental perfusion system. The system consisted of maternal and fetal reservoirs
      in which Krebs Ringer bicarbonate buffer with heparin, albumin and glucose was
      circulated at a constant pH, temperature and pO2. Parathion was analysed by means
      of gas chromatography with a N-P detector. 14C Antipyrine, a lipid soluble salt,
      was used as an internal standard, which allowed for the difference in placental
      size and permeability. A certain amount of parathion passed the placenta and
      reached the fetal compartment. Glucose consumption was not influenced by the
      introduction of parathion; neither was the water content of the placental tissue.
      Acetylcholinesterase activity in placental tissue decreased 50%. The amount of
      parathion transferred was not negligible and could have caused damage to a fetus.

PMID- 1621355
TI  - Container residue after activated charcoal administration in the emergency
      department.
AB  - We hypothesized that sources of activated charcoal (AC) used as a form of gut
      decontamination in the treatment of drug overdose may deliver significantly less
      charcoal than expected because of retained charcoal and sorbitol (ACS) from the
      treatment of 50 consecutive overdose patients were collected. Health care
      personnel delivering the dose were unaware of the study hypothesis. A total of 82
      containers were obtained in this manner. Each container was labelled to contain
      25 g AC and 48 g sorbitol. Five unused containers of ACS were obtained as
      controls. Each container was thoroughly cleaned, and the contents vacuum filtered
      and washed with 1 L of tap water. The tared filter paper and charcoal was dried
      for 24 h and weighed. The average amount of charcoal retained in each used
      container (retained) was 0.549 g (range 0.318-1.637 g). This accounts for 2.2% of
      the 25 g dose expected to be delivered. The average amount of charcoal found in
      each unused container (actual) was 25.892 g. The delivered dose (actual minus
      retained) may be calculated as 101.4% of the expected 25 g dose. When using this
      formulation of ACS there is no significant difference between the amount of
      charcoal given to an overdose patient and the amount ordered for gut
      decontamination. Despite the poor suspension of charcoal in sorbitol and the less
      than ideal conditions under which it is given, the patient receives an adequate
      dosage of AC if it is ordered.

PMID- 1621356
TI  - Subacute toxicity of paraquat in beagle dogs: clinicopathology and pathologic
      examinations.
AB  - Beagle dogs were allocated to 4 groups, each consisting of 3 males and 3 females,
      which received 0.055, 0.165 or 0.495 mg paraquat (PQ)/kg/day sc for 4 w to
      investigate subacute toxicity. Recovery 4 and 8 w postadministration was studied.
      In the early stage there was vomiting, decreased activity and undernourishment.
      Induration and ulcers at the injection sites were seen. The group receiving 0.495
      mg PQ/kg had reduced food ingestion and occasional decreases in water consumption
      until the end of the 4-w injection period. Three animals in the 0.495 mg PQ/kg
      group were sacrificed in the moribund stage with marked decreases in body weight.
      Ophthalmologic examination at 4 w of recovery detected hemorrhage around the
      nasalis vein of the left fundus in 1 animal that received 0.495 mg PQ/kg. No
      abnormal changes in electrocardiography (ECG) were noted throughout the
      experimental period. Slightly increased urinary protein, reticulocyte counts, and
      fibrinogen were observed in a few animals in each group. A few animals that
      received 0.165 or 0.495 mg PQ/kg had increased phospholipid, blood urea nitrogen,
      and creatine phosphokinase. The lungs of the moribundly sacrificed animals had
      moderate atelectasis, localized atelectasis, moderate thickening of alveolar wall
      and pleura, proliferation of fibroblast-like cells, and abundant fibers in
      interstitium and alveoli. In the liver there was slight hemorrhage along the
      gallbladder. On electron microscopy of the lung, proliferation of fibroblasts,
      myofibroblasts and type II alveolar cells, and some mast cells were observed in
      thickened alveolar walls. Abundant collagen fibers, destroyed cell debris and
      mitotic figures of spindle-shaped fibroblasts were also observed in the dilated
      interstitium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621357
TI  - The effects of administering methylmercury in combination with ethanol in the
      rat.
AB  - Methylmercury (MeHg) is a potent neurotoxicant and nephrotoxicant in several
      animal species including humans. Although the in vivo toxicity of MeHg per se is
      well known, the interaction between MeHg and other pollutants and with
      nutritional factors is not well understood. Since ethanol (EtOH) is a widely
      consumed toxicant which has been shown to enhance the histopathologic effects of
      MeHg on renal tissues, a study was undertaken to examine the effects of the
      combined administration to rats of MeHg and EtOH on renal function and on mercury
      distribution in body tissues. Forty-eight rats were divided into 6 treatment
      groups of 8 rats each. Rats in groups 1, 2 and 3 were given feed ad libitum, a
      restricted liquid diet of 70 mL/d or distilled water orally, respectively. Rats
      in groups 4, 5 and 6 were given 1.5 mg MeHg/kg bw, 2.0 g EtOH/kg bw, or 1.5 mg
      MeHg + 2.0 g EtOH/kg bw, respectively, by oral gavage daily for 45 d. All rats
      except those in group 1 (ad libitum) were fed 70 mL of liquid diet/d for the
      entire study period. The ingestion of MeHg + EtOH in combination induced a
      greater increase in renal weight compared to treatment with either MeHg + EtOH
      alone. Only those rats given MeHg in combination with EtOH exhibited oliguria and
      elevated blood urea nitrogen levels. Despite this antidiuresis, urinary
      concentrating ability was impaired in those rats given both MeHg and EtOH. In
      contrast, the ingestion of MeHg by itself caused the most rapid loss of glucose
      in urine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621358
TI  - Case reports of lead poisoning in dogs from the National Animal Poison Control
      Center and the Centre National D'Informations Toxicologiques, Veterinaires:
      anecdotes or reality?
AB  - This paper presents case reports of lead toxicoses from 2 major animal poison
      control centers in Europe and North America, gathered from 1985 through 1989. All
      results examined here involved cases assessed as "toxicosis" or "suspected
      toxicosis" by the National Animal Poison Control Center (NAPCC) or the Centre
      National d'Informations Toxicologiques Veterinaries (CNITV). 537 cases were
      reported to the NAPCC, most of them concerning dogs (59%). In France, most of the
      362 cases involved cattle (57.2%). There was an increased number of cases
      reported during late summer and early fall, and a decreased number of cases in
      November and December, in both centers. Dogs intoxicated were predominantly young
      animals (60% were less than 2 years old). No sex difference was noted. Pure bred
      dogs appeared more often involved than mixed-breed ones, but the breed
      distribution closely resembles dog breed distribution in the US. The source of
      lead was usually unknown and, when information was available, paint seemed to be
      the most common cause of poisoning. Clinical signs reported to the animal poison
      control centers involved the CNS and GI tract. Results from the French and the
      American database showed similar trends. They are compared to data from
      veterinary clinics and veterinary colleges in the US and Australia. In each case,
      data are very similar to what was reported to the CNITV and the NAPCC. It is
      concluded that animal poison control centers databases can provide a useful tool
      for better knowledge of animal poisoning. They can also help identify unexpected
      toxicologic problems related to drug administration or pesticide use.

PMID- 1621359
TI  - Effect of vitamin B6 supplementation on gentamicin nephrotoxicity in rabbits.
AB  - Therapeutic use of gentamicin (GM) in a clinical setting may result in
      nephrotoxicity, most commonly presenting as acute tubular necrosis (ATN). We have
      previously observed decreased plasma pyridoxal 5'-phosphate (PLP) levels in
      rabbits given therapeutic doses of GM and endeavor in this study to determine if
      vitamin B6 supplementation (B6S) could protect against the nephrotoxicity of GM.
      Twenty-one rabbits were randomly assigned to 1 of 7 treatment groups of 3 rabbits
      each. Three of the groups received 10 mg GM/kg with either 10 mg B6S, 100 mg B6S
      or 0.9% saline. Three of the groups received 40 mg GM/kg with either 10 mg B6S,
      100 mg B6S, or normal saline. The control group only received 100 mg B6S. All
      treatments were administered im once daily for 5 d. Blood was drawn for chemical
      assays on day 0 prior to any treatments and 2 h after each respective treatment
      on days 1, 3 and 5. After 5 d, the rabbits were euthanatized and kidneys were
      excised for histological evaluation by light microscopy. At the 40 mg GM/kg/d
      dose, significant mild to moderate ATN was observed in the saline controls, which
      was prevented by either dose of B6S. Only a few animals given 10 mg GM/kg/d
      showed any renal pathology and that was minimal. Unexpectedly, 1 rabbit given
      only 100 mg B6S/d but no GM had interstitial nephritis with focal ATN. We
      conclude that vitamin B6 can protect against the nephrotoxicity of GM in rabbits,
      but that further study is needed on the possible nephrotoxicity of high doses of
      B6S.

PMID- 1621360
TI  - The toxicokinetics of 1,3-butylene glycol versus ethanol in the treatment of
      ethylene glycol poisoning.
AB  - Ethylene glycol (EG) is a toxic chemical found in antifreeze and heat exchangers.
      Standard therapy for EG intoxication in administration of ethanol (ETOH) to
      inhibit its metabolism by alcohol dehydrogenase (ADH). Studies indicate 1,3
      butylene glycol (BG) binds to ADH more efficiently than EG and is orally less
      toxic than EG or ETOH. Male rats were divided into 5 groups of 6 animals. Groups
      received by oral intubation a single dose of EG (32 mmole/kg), BG (39 mmole/kg)
      initially and every 6 h up to 72 h, ETOH (39 mmole/kg) initially and every 6 h up
      to 72 h, or EG initially and then either BG or ETOH every 6 h up to 72 h.
      Administration of ETOH produced hepatotoxicity and pulmonary pathology as
      indicated by changes in clinical chemistry, urinalysis, and histopathology, while
      BG did not. Neither ETOH nor BG produced any apparent nephrotoxicity. ETOH
      produced ataxia, lethargy and central nervous system depression while BG did not.
      BG produced a higher concentration of urinary EG indicating a better inhibition
      of ADH metabolism of EG. Ethanol produced a higher EG blood concentration than
      BG. Ethanol's higher EG blood concentration may be partially attributed to
      dehydration and a decreased urine output as well as inhibition of ADH metabolism.
      Ethanol produced mortality in all animals prior to 72 h. The EG/ETOH combination
      produced mortality more quickly due to additive toxicity of the combination. Lack
      of any significant toxicity produced by BG and the production of significant
      toxicities by ETOH indicates that BG is potentially a better antidote than ETOH.

PMID- 1621362
TI  - Inhibition of DNA synthesis and decreased reproductive capacity in cattle
      maintained on semi-arid rangeland with Acacia species as a major component of
      available browse.
AB  - The ability of bovine lymphocytes to initiate in vitro blastogenesis in response
      to mitogen stimulation or to initiate DNA excision repair after treatment with a
      mutagen was evaluated as a function of the differing environmental conditions
      under which donor animals were maintained. Crossbred Brahman-Hereford F1 females
      were held on either a humid, coastal bermudagrass, improved pasture at Overton,
      TX, or in low or high grazing pressure herds on a semi-arid rangeland (Acacia
      dominated shrubland) at Uvalde, Tx. Peripheral blood lymphocytes (PBL) from these
      animals were examined to determine their in vitro ability to engage in
      phytohemagglutinin (PHA)-stimulated blastogenesis and to initiate excision repair
      of DNA damage after exposure of the cells to the model polynuclear hydrocarbon
      carcinogen 7,8-dihydrodiol-9, 10-epoxy-benzo(a) pyrene (BPDE). PBL from cattle at
      both locations were compared, with significantly decreased blastogenesis and DNA
      excision repair observed in PBL from Uvalde high grazing pressure cattle. Cattle
      in the Uvalde high grazing pressure herd also exhibited significantly decreased
      reproductive efficiency. The data indicate that ingestion of sufficient
      quantities of palatable, but toxic, forage species available at the Uvalde test
      site is sufficient to decrease DNA synthesis associated with either mitogen
      stimulated blastogenesis or DNA excision repair in bovine PBL, and suggest that
      the reduction in PBL DNA synthesis may be correlated with the changed
      reproductive efficiency in animals ingesting an increased ratio of forage from
      Acacia species.

PMID- 1621361
TI  - Dermal exposure of hexachlorophene to guinea pigs.
AB  - The skins of guinea pigs were exposed to 50 mg/kg hexachlorophene (HCP) for 7, 15
      or 30 days. The activities of skin marker enzymes (beta-glucuronidase, histidase,
      tyrosinase) increased, but glutathione decreased. Lipid peroxidation and
      histamine contents increased during different time intervals. The
      histopathological changes showed damage to epidermis and dermis. Depending on the
      duration of exposure, HCP produces biochemical and histopathological damage to
      skin.

PMID- 1621363
TI  - Aesculus glabra intoxication in cattle.

PMID- 1621364
TI  - Toxic epidermal necrolysis associated with flea dips.
AB  - A 5-y-old intact female Himalayan cat was dipped with an organophosphate-based
      compound for flea infestation. The animal subsequently died of organophosphate
      intoxication. Skin lesions present at necropsy were diagnosed microscopically as
      toxic epidermal necrolysis. A 5-y-old spayed female Corgi dog was dipped with a d
      limonene-based compound for flea infestation. The dog subsequently developed a
      bullous skin disorder which rapidly progressed to severe coalescing necrotizing
      dermatitis with large areas of skin sloughing. The dog was treated for a
      tentative diagnosis of toxic epidermal necrolysis with a short course of
      corticosteroids and extensive supportive care and recovered completely. Flea dip
      preparations have the potential to induce severe immune-mediated dermatopathies
      such as toxic epidermal necrolysis.

PMID- 1621365
TI  - Emergency department external decontamination for hazardous chemical exposure.
AB  - Although external decontamination is an integral aspect of the emergency
      management of hazardous chemicals exposure, no standard protocol or report of
      human experience is available. We performed a retrospective review of all
      patients decontaminated in our emergency department over a 6-y period for
      hazardous chemicals exposure. Patients were treated by a universal substances
      protocol in a specially designed decontamination area. Ocular irrigation
      utilizing 1500 ml of normal saline po was employed in 27 patients. Oral mucosal
      irrigation utilizing 1500 ml water was employed in 2 patients. All 72 patients
      received skin and hair decontamination. Skin was washed 3 times with detergent
      and cornmeal mixture, and water irrigation or shower for 3 min. Hair was
      shampooed 3 times with mild soap for 3 min. A subset of patients (n = 31)
      received pre-decontamination and post-decontamination skin swabbing. Swabs were
      analyzed by a certified analytical chemistry laboratory utilizing gas
      chromatography/mass spectrometry. Positive pre-decontamination swabs were seen
      for pesticides and PCBs. All post-decontamination swab analyses were negative,
      indicating that the method utilized was effective.

PMID- 1621366
TI  - Bitter cassava poisoning in eight children: a case report.
AB  - Bitter cassava poisoning in 8 children is reported. The incidence of bright
      cherry-red blood is emphasized. These patients were in bad condition, but they
      survived although they received different therapies. Four of them were treated
      with sodium nitrite and thiosulfate and the remainder with hydroxocobalamin
      alone. This latter drug may be useful in less severe circumstances.

PMID- 1621367
TI  - The veterinary importance of the toxic syndrome induced by ionophores.
AB  - Monensin, lasalocid, salinomycin, narasin and maduramicin are carboxylic
      ionophores intended for use as anticoccidial drugs for poultry and as growth
      promotants for ruminants. Generally, ionophores have been found safe and
      effective in the target animals receiving recommended dosage levels. However,
      toxic syndromes can result from overdosage and misuse situations. More
      information and reports of adverse reactions are available for monensin than the
      other ionophores because of monensin's longstanding and widespread use in the
      poultry and livestock industries. Care must be exercised in the diagnosis of
      ionophore toxicoses since clinical signs and lesions are not pathognomic.
      However, a feed-related problem characterized clinically by anorexia, diarrhea,
      dyspnea, ataxia, depression, recumbency and death, and pathologically by focal
      degenerative cardiomyopathy, skeletal muscle necrosis, and congestive heart
      failure may warrant a presumptive diagnosis of ionophore toxicity. Confirmatory
      diagnosis will require considerations of differential diagnoses and laboratory
      assays to determine the specific ionophore involved. Presently, there is no
      antidote or treatment for toxicoses induced by the ionophores. Judicious use,
      avoidance of overdosing, and adherence to species recommendation will help
      prevent the occurrence of adverse effects associated with this class of
      compounds.

PMID- 1621368
TI  - Lack of effectiveness of several chelators in removing internally deposited
      strontium from mice following repeated parenteral strontium administration.
AB  - Diethylenetriaminepentaacetic acid (DTPA), ethylenglycolbis-(beta-amino
      ethylether)-N,N-tetraacetic acid (EGTA), tartaric acid, KRYPTOFIX 222, and
      KRYPTOFIX 5 were evaluated for their efficacy in mobilization of strontium from
      the body of mice which had received 20 sc injections of strontium nitrate (95
      mg/kg/injection) for 4 w. Twenty-four hours after the last strontium injection,
      ip administration of 1 of the various chelators or 0.9% saline was initiated and
      continued daily for 5 d. Mice were housed in metabolic cages, and urine and feces
      were collected daily for 5 d. After this period, the animals were killed and
      tissues removed. Tartaric acid, KRYPTOFIX 222, and KRYPTOFIX 5 had no effect on
      urinary or fecal strontium elimination, whereas DTPA and EGTA significantly
      decreased the fecal strontium excretion. The concentration of strontium in bone
      was only lowered in tartaric-treated mice. This study indicates the use of the
      above chelators is not an effective treatment to enhance the removal of strontium
      following repeated parenteral strontium administration.

PMID- 1621369
TI  - A review of toxicity factors in some food and feedingstuffs in the nutrition of
      man and livestock in Nigeria.
AB  - A review of the toxicity factors in some food and feedingstuffs in the nutrition
      of man and livestock in Nigeria was conducted. The crops reviewed were cassava,
      cocoyam, guinea corn, cottonseed, soyabean, bambara, groundnut and cowpea. These
      crops provide cheap sources of carbohydrate and protein in the diets of humans
      and livestock. However, antinutritional factors inhibit their use.
      Antinutritional or toxic factors associated with them are reviewed and means of
      detoxifying them for human and livestock feeding are enumerated.

PMID- 1621370
TI  - [Vitamins and endogenous regulatory factors].

PMID- 1621371
TI  - [Status of nitrogen metabolism in reducing-diet therapy].

PMID- 1621372
TI  - [Effectiveness of diet therapy in patients with ischemic heart disease and a
      history of myocardial infarction at young age].
AB  - To elucidate the effect of dietetics on the onset and course of coronary heart
      disease (CHD) patients who survived myocardial infarction at young age were
      investigated. The analysis of clinical and metabolic changes, psycho-vegetative
      disorders permitted the authors to distinguish two groups of patients: group 1-
      patients with normal body mass, and group 2--those with excessive body mass who
      received, respectively, A1 (basic) and Ar (reduced) variants of theanti-
      arteriosclerotic diet. It was established that the Ar diet produced positive
      effects on the dynamics of body mass reduction, on the cardiovascular system, on
      parameters of lipid metabolism, hemostasis and psycho-physiologic parameters of
      group 2 patients. Diet therapy combined with tranquilizers is recommended for
      group 1 patients.

PMID- 1621373
TI  - [Effect of food on blood levels of insulin, glucagon and C-peptide in
      gastroduodenal pathology].
AB  - Insulin, glucagon and C-peptide content in the blood was assayed with the use of
      commercial radioimmune kits (Diagnostic, USA, and Oris, France). A total of 93
      peptic ulcer patients (35 with duodenal peptic ulcer, 28 with gastric ulcer, 16
      after Billroth-I resection, and 14 after Billroth-II resection) and 25 patients
      with chronic gastritis attended by secretory insufficiency were investigated. The
      study was conducted on empty stomach and after a test breakfast containing 57 g
      of protein, 63 g of fat, 103 g of carbohydrates that comprised 1212 kcal. The
      highest changes in hormone incretion were recorded in patients with peptic ulcer
      disease after Billroth-I and Billroth-II resection, the lowest--in patients with
      chronic gastritis attended by secretory insufficiency.

PMID- 1621374
TI  - [Characteristics of lipid metabolism in deep mine workers and the ways of its
      alimentary correction].
AB  - Lipid and antioxidant state of clinically normal subjects working in deep mines
      was studied under natural conditions during one month. Disorders in lipid
      metabolism and intensified peroxidation were recorded in these subjects. A
      prophylactic ration has been recommended considering the food status, alimentary
      risk factors and extreme conditions of miners' labour.

PMID- 1621375
TI  - [Nutrition of boys aged 14-15 years from 2 regions of Moscow].
AB  - Representative sampling of boys (n-577) aged 14-15 years was used to study their
      nutrition structure. The results obtained have evidenced the atherogenic
      character of nutrition due to insufficient consumption of vegetable oils, complex
      carbohydrates, excessive consumption of animal fats and sugar. These data can be
      used as the basis of nutrition correction for prevention of such risk factors of
      atherosclerosis as arterial hypertension, excessive body mass,
      dyslipoproteinemia.

PMID- 1621376
TI  - [Selenium intake by the population of Lithuania].
AB  - The level of selenium was assayed in the blood and food products to study the
      providing of the Lithuanian population with this trace element. It was shown that
      imported wheat containing high levels of selenium played a significant role in
      providing with this trace element of the population of Lithuania, Estonia and
      Latvia where home-produced foods are deficient in selenium. The mean level of
      selenium in the blood serum of the Lithuanian population comprised 90
      micrograms/l (96 micrograms/l was most frequent). Selenium consumption was 100
      micrograms/man.

PMID- 1621377
TI  - [Vitamin B 12 metabolism and the status of sulfhydryl groups in protein-choline
      deficiency in rats. Effects of methyl- and adenosylcobalamins].
AB  - The effect of low protein choline-deficient diet on total vitamin B12 content and
      individual cobalamin level in the blood serum and liver of rats was determined.
      Moreover the total and non-protein SH-group content and glutathione transferase
      activity in the liver of rats were studied. Total cobalamin content increased in
      the blood serum, but it did not change in the liver of rats fed choline-deficient
      low protein diet. Total and non-protein SH-group level as well as glutathione
      transferase activity in the liver decreased significantly. The causes of changes
      revealed are discussed. Methylcobalamin (but not adenosylcobalamin)
      administration normalized individual cobalamin level in the blood serum.
      Administration of both methylcobalamin and adenosyl-cobalamin resulted in total
      SH-group content restoration whereas non-protein SH-group level and glutathione
      transferase activity were restored only in methylcobalamin-treated rats.

PMID- 1621378
TI  - [Increasing the effectiveness of thiamine by its administration together with
      methionine and vitamin E].
AB  - The influence of methionine and vitamin E, compounds intensifying thiol
      metabolism, on thiamine-phosphate level and thiamine-dependent dehydrogenase
      activity was studied in the liver of rats with varying thiamine providing: in
      case of its alimentary deficiency, and intensified thiamine consumption due to
      rat feeding with high-carbohydrate food. Methionine administration to vitamin B1
      deficient rats led to a significant rise in thiamine-phosphate content and
      normalized alpha-ketoacid dehydrogenase acidity and non-protein SH-group level.
      Combined administration of thiamine with methionine and vitamin E increased the
      level of parameters studied. Methionine and vitamin E administered with thiamine
      intensified the regulatory action of thiamine on pyruvate dehydrogenase activity
      in the animals fed high-carbohydrate ration.

PMID- 1621379
TI  - [Effect of polyvitamin preparations on blood coagulation in experimental
      hypercoagulation].
AB  - The influence of polyvitamin compounds on the course and outcome of experimental
      hypercoagulemia was studied. "Hendevitum", "Aerovitum" and "Undevitum" proved to
      be most effective in reducing negative results of thromboplastemia.
      "Glutamevitum" was insignificantly effective, while "Quadevitum" and
      "Complevitum" did not reduce animals' death rate after intravascular injection of
      thromboplastin in LD50. Positive effects of polyvitamin compounds might be
      associated with their capacity for stimulating anticoagulation potential,
      especially, in accelerated continuous intravascular blood coagulation.

PMID- 1621380
TI  - [Effect of carbohydrate structure on glucose utilization and biosynthesis of
      lipids, proteins and glucagon in rats].
AB  - It was established that utilization of labelled glucose depended on food
      carbohydrate structure. Saccharose increased 1.5-fold the labelling of lipids in
      the liver and lowered insignificantly glycogen labelling. Similar quantity of
      invert sugar sharply reduced glycogen labelling. When starch was substituted for
      corn syrup lipid labelling increased two-fold, while glycogen labelling decreased
      down to 26% of the control level. Lipid/glycogen labelling ratio in saccharose
      feeding was 2, in invert sugar--4, in corn syrup--17.

PMID- 1621381
TI  - [Hydrolysis and absorption of lysozyme in the small intestine].
AB  - Preparations of chicken small intestine were used in the experiment in vitro
      simulating processes of membranous digestion (inverted intestinal segments) and
      absorption (inverted intestinal myasis). It was established that lysozyme was
      hydrolyzed on the internal mucosa surface regardless of its concentration in the
      gastro-intestinal tract, and only insignificant quantity of lysozyme (0.027%)
      penetrates the intestinal wall. The method of lysozyme determination through its
      action on the cellular wall of Micrococcus lisodeicticus, and highly efficient
      liquid chromatography were used to study the transport process. The data
      presented have evidenced that lysozyme is well hydrolyzed under the action of
      intestinal peptide hydrolyses, and only insignificant amounts of non-splitted
      lysozyme can penetrate the blood.

PMID- 1621382
TI  - [Stochastic component of the effect of food, its nutritive value and the
      structure of nutrition of the population].

PMID- 1621384
TI  - [Chemical composition of a protein concentrate from Saccharomyces and its effect
      on immunologic response].
AB  - The content of the main nutrients, as well as amino-acid, fatty-acid and mineral
      composition of a protein concentrate prepared from yeast-Saccharomyces grown in
      molasses were studied. It was found that the product contained a significant
      amount of protein, all essential amino acids, insignificant quantity of lipids in
      which saturated fatty acids prevailed. The concentrate ash was rich in calcium,
      phosphorus, magnesium, silicon, iron and other elements. The protein product
      included into experimental rations during a month produced no significant effect
      on the B-system immunity and did not induce sensitization.

PMID- 1621383
TI  - [Effect of a new sweetening agent from Stevia rebaudiana on animals].
AB  - Animals received saccharol adequate (by sweetness) to sugar, and in 10- and 50
      fold increased amounts. The data of chronic 10-month experiments studied in the
      time course after 2, 5, 10 months have permitted a conclusion that saccharol
      included into the ration during long periods, does not produce a significant
      effect on the parameters of metabolic processes and morphological picture of the
      internal organs in test animals. Saccharol in 50-fold increased amounts inhibits
      the activity of oxidative phosphorylation in the hepatic tissue of rats.

PMID- 1621385
TI  - [Vitamin C stability in vitamin-fortified syrups].
AB  - Factors influencing ascorbic acid stability in syrups were studied. It has been
      found that the vitamin stability depends on its concentration and the syrup
      composition. It is shown that vitamin C stability can be increased in some syrups
      by substitution of ascorbic acid for sodium ascorbinate.

PMID- 1621386
TI  - [Determining the level of riboflavin in food products by using riboflavin-binding
      apoprotein].

PMID- 1621387
TI  - [Production technology and the glycemic index of bread].

PMID- 1621388
TI  - [Reply to a reader's letter "Salt as a cause of various diseases"].

PMID- 1621389
TI  - [Reply to a reader's letter "Preventive" salt].

PMID- 1621390
TI  - [Effect of the LDL-/HDL-cholesterol quotient on progression and regression of
      arteriosclerotic lesions. An analysis of controlled angiographic intervention
      studies].
AB  - The importance of hypercholesterolemia for the development of atherosclerotic
      lesions is undebatable. It is less evident, however, whether the progression of
      established lesions can be influenced by modifying lipid levels. The review of
      seven controlled angiographic intervention trials shows that different criteria
      are used to define progression of lesions. The relation of progression to
      regression (progression/regression ratio), however, is a useful marker for the
      activity of coronary artery disease. Patients with familial hypercholesterolemia
      have a progression/regression ratio of between 3 and 7. There is a consistent
      relationship between the progression/regression ratio and the LDL-/HDL
      cholesterol ratio in both control and intervention groups in these trials. Groups
      with a LDL-/HDL-cholesterol ratio of 5 have six times more progression than
      regression. If the LDL-/HDL-cholesterol ratio is less than 2.5 regression occurs
      more often than progression (i.e. progression/regression ratio less than 1).
      Thus, in the management of hyperlipidemic patients a LDL-/HDL-cholesterol ratio
      of less than 2.5 should be achieved if regression of atherosclerotic lesions is
      desired.

PMID- 1621391
TI  - [Characterization of LDL receptors in mononuclear cells of healthy probands and
      patients with familial hypercholesterolemia].
AB  - Temperature-dependence, time-course, competition studies and saturation kinetics
      of the binding of either 123I-LDL or 111In-LDL to peripheral blood mononuclear
      cells (lymphocytes and monocytes) were determined in normolipemic controls and
      heterozygous familial hypercholesterolemia (FH) patients. Radioligand binding
      studies with 123I-LDL and 111In-LDL revealed similar binding characteristics. The
      maximal binding capacity was significantly reduced in FH patients (p less than
      0.01) whereas the binding equilibrium dissociation constant was virtually
      unchanged as compared to healthy controls.

PMID- 1621392
TI  - The technique of taking brush biopsies of the nasal mucosa for electron
      microscopy.
AB  - Patients suffering from symptoms suggestive of a disorder of mucociliary
      clearance should be subjected to electron microscopic examination of the ciliated
      respiratory epithelium. Provided that all crucial points regarding technique and
      storage are adhered to, brush biopsy of the nasal mucosa is a reliable method
      facilitating the electron microscopical diagnosis of primary disorders of the
      ciliated epithelium.

PMID- 1621393
TI  - Diagnosis of tuberculous meningitis by detection of tuberculostearic acid in
      cerebrospinal fluid.
AB  - Tuberculous meningitis still poses a major diagnostic problem. Recently, several
      new techniques for rapid diagnosis of tuberculous meningitis have been developed.
      One of these newer techniques is the detection of mycobacterial fatty acids,
      using gas chromatography--mass spectroscopy. In this study we evaluated the
      sensitivity and specificity of this recently reported method in a blind trial.
      The sensitivity was found to be 100%, specificity only 91%. The number of false
      positive results limits the value of this test in the primary diagnosis of
      tuberculous meningitis. Nonetheless, we consider this method to be a valuable
      tool for establishing the diagnosis in culture-negative patients presenting with
      signs and symptoms suggestive of tuberculous meningitis.

PMID- 1621395
TI  - [Comment on the review article: Brosch, R., Buchrieser, C., Sixl, W., Rocourt,
      J.: 10 years food transmitted listeriosis--an evaluation].

PMID- 1621394
TI  - [Polyglandular type I autoimmune syndrome].
AB  - Two HLA-identical sisters have developed the full picture of type I polyglandular
      autoimmune syndrome over a period of 12 years. Both girls have hypoparathyroidism
      and Addison's disease. One of them additionally developed diabetes mellitus,
      hypergonadotropic hypogonadism and hypothyroidism. Autoantibodies to the adrenal,
      parathyroid and thyroid glands are present in both patients, as well as
      antinuclear antibodies. HLA associations have been described recently for the
      type I polyglandular autoimmune syndrome, but this could not be confirmed in the
      present two cases. Although we assume that the same genetic defect is present in
      both girls, additional factors to the genetic disposition are important for the
      clinical expression of the disease. The linkage of the disease-causing gene with
      the HLA region is not very close.

PMID- 1621396
TI  - [New, in Austria registered specialty drugs. Glucobay (acarbose)].

PMID- 1621397
TI  - [Modern and general practice-oriented lipid and lipoprotein diagnosis].

PMID- 1621398
TI  - [The cardiovascular effects of fish oil].

PMID- 1621399
TI  - [Disappointments and hopes in tumor therapy with biological response modifiers].

PMID- 1621400
TI  - [Modern wound dressings. 1: Alginates].

PMID- 1621401
TI  - [The panorama of illnesses in advanced age. On the possibilities and reality of
      therapy].

PMID- 1621402
TI  - [The historical medical instrument collection in the Kaiserin Friedrich House in
      Berlin (1907-1947). On the connection between medical education and the history
      of instruments in medicine in Germany in the 1st half of the 20th century].

PMID- 1621403
TI  - [Sudden cardiac death--possibilities and limits of drug therapy].
AB  - Sudden cardiac death is a challenge for primary prevention efforts, the rescue
      system, and the prophylactic antiarrhythmic medical therapy. A prerequisite for
      the successful prevention is insight into the pathophysiologic interaction of the
      arrhythmogenic substrate, the ischemic events, the autonomous nervous system,
      ventricular premature beats, left-ventricular function, etc. Latest results of
      prophylactic antiarrhythmic therapy indicate that the benefit under a specific
      antiarrhythmic treatment depends on the ratio of antiarrhythmic to proarrhythmic
      effects and the prevalence of sudden cardiac death in a given population. In
      diseased hearts with ventricular tachycardia or ventricular fibrillation the
      chance of sudden cardiac death is high, therefore, antiarrhythmic therapy is
      indicated and should be controlled by programmed stimulation. In patients with a
      low likelihood of sudden cardiac death after myocardial infarction, beta receptor
      blockers should be given; in certain higher risk patients (non-sustained
      ventricular tachycardia, reduced left-ventricular function) class-III
      antiarrhythmic agents are recommended. In hypertrophic cardiomyopathy (less in
      dilative cardiomyopathy) a beneficial effect of amiodarone becomes apparent in
      subgroups with high risk. Treatment of symptomatic ventricular premature beats
      remains empiric; in case of no or minimal structural heart disease, the
      arrhythmogenic potential is low. For the management of recurrent ventricular
      tachycardia new concepts are proposed that include antiarrhythmic agents and
      magnesium.

PMID- 1621404
TI  - [Sudden cardiac death: possibilities of interventional therapy].
AB  - There is, at present, no method to prevent sudden cardiac death. However, in
      patients with documented high risk the implantable automatic cardioverter
      defibrillator is the only reliable alternative. However, the electrical
      discharges of high energy may cause discomfort and pain. Antitachycardia pacing
      is effective for most episodes of ventricular tachycardia and can effectively
      reduce the number of electrical shocks to be delivered.

PMID- 1621405
TI  - [Catheter ablation of septal accessory conduction pathways with high frequency
      electric current].
AB  - In 58 symptomatic patients with septal accessory atrioventricular pathways,
      attempts at catheter ablation of the pathway were made using 500-kHz
      radiofrequency current. The methodological approach (introduction and final
      positioning of the ablation catheter) was dependent on the anatomical site of the
      accessory pathway. Right anteroseptal pathways were accessed via a jugular venous
      route, whereas a femoral venous route was used for right mid- and posteroseptal
      pathways. In these pathways, ablation was attempted from an atrial catheter
      position. Left posteroseptal pathways were located via mapping of the coronary
      sinus and were ablated either from the left ventricle or (in 3 cases) from the
      vena cordis media. Utilizing a deflectable catheter with a 4-mm tip electrode,
      ablation attempts were successful in 54 patients (93%) with a median of 12
      radiofrequency current pulses of an average 24.9 W of power and 23.2 s length.
      The mean duration of the sessions was 4.6 h. Impairment of physiological
      conduction (first-degree AV block) was observed in 1 patient; complete heart
      block was never induced. Recurrences after initially successful ablation
      necessitated a repeat session in 2 patients. One patient died 3 days after
      successful ablation of a posteroseptal accessory pathway. Septal accessory
      pathways may be ablated using radiofrequency current with an efficacy and safety
      comparable to free-wall accessory pathways and with good preservation of
      physiological AV node-His bundle conduction.

PMID- 1621406
TI  - [Long-term follow-up of patients after interruption of the atrioventricular
      conduction by electrode catheter and DC shock: experiences with 100 patients].
AB  - Long-term follow-up (44 +/- 21 months) was studied in 100 patients (pts) (mean
      age 56 +/- 12 years) who underwent direct current ablation because of drug
      resistant supraventricular arrhythmias. In 85 pts (85%) complete atrioventricular
      (AV) block was initially achieved. During the follow-up period, AV conduction
      resumed in 15 pts (15%). Thirteen pts underwent another ablation session and
      complete AV block was achieved in 11/13 pts (85%). After catheter ablation
      complete AV-block was achieved in 96 pts and the remaining four pts had second
      degree AV-block. Complications like pericardial effusion, arterial hypotension or
      ventricular arrhythmias occurred in 18 pts. Total mortality was 13% (13 pts): one
      patient died suddenly, and seven pts died from cardiac causes (heart failure in
      six pts, reinfarction in one patient). Transcatheter direct-current ablation is
      an effective method to interrupt AV conduction and to treat patients with drug
      resistant supraventricular arrhythmias. Although there is a small risk of severe
      complications, this procedure should be reserved for pts with supraventricular
      arrhythmias who do not respond to conventional drug treatment.

PMID- 1621407
TI  - [Additive effects of milrinone and dobutamine in severe heart failure].
AB  - The hemodynamic effects of dobutamine, milrinone, and a combination of both drugs
      were compared intra-individually in 14 patients with severe heart failure (NYHA
      III: n = 9; NYHA IV: n = 5). Dobutamine (maximum dose: 9 micrograms/kg/min) and
      milrinone (0.5 micrograms/kg/min) each induced a comparable increase in stroke
      volume index (21 to 29 resp. 21 to 30 ml/m2; mean values; p less than 0.001) and
      reduction in pulmonary capillary wedge pressure (29 to 22 resp. 28 to 21 mm Hg; p
      less than 0.001), as well as in systemic (1846 to 1218 resp. 1858 to 1276 dyn
      s/cm5; p less than 0.001) and pulmonary vascular (301 to 195 resp. 293 to 216 dyn
      s/cm5; p less than 0.001) resistances. The heart rate rose significantly after
      dobutamine (92 to 107 min-1; p less than 0.05), but did not change after
      milrinone (94 to 95 min-1; ns). Neither drug had a significant effect on systemic
      arterial pressures. The combination of milrinone and dobutamine induced a further
      significant rise in stroke volume index (37 ml/m2; p less than 0.01) when
      compared to either drug alone. The combination also caused an additional fall in
      pulmonary capillary wedge pressure (14 mm Hg; p less than 0.01), as well as in
      systemic (799 dyn s/cm5; p less than 0.001) and pulmonary (133 dyn s/cm5; p less
      than 0.001) vascular resistances. When compared to dobutamine alone, the combined
      therapy did not significantly change the heart rate and systemic arterial
      pressures. The combined administration of a beta-adrenergic agonist and a
      phosphodiesterase inhibitor induces beneficial hemodynamic effects.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1621408
TI  - Short-term reproducibility of gas exchange measurements during bicycle exercise
      in patients with mild to moderate congestive heart failure.
AB  - A series of 45 patients with congestive heart failure due to coronary disease had
      semisupine bicycle exercise tests (ramp protocol, 10 W/min) on two occasions
      separated by 3 to 7 days in order to determine the short-term reproducibility of
      gas exchange measurements during symptom-limited exercise. The percentage
      difference (PD) between each pair of measurements (m1, m2; PD = 100%.(m2-m1): m1)
      were calculated. The mean PD values (+/- 1 sigma) and the single determination
      standard deviations (SDSD) for exercise tolerance (ET, W), peak heart rate (pHR,
      1/min), peak oxygen uptake (pVO2, ml/min/kg), peak carbon dioxide output (pVCO2,
      ml/min/kg), and peak minute ventilation (pVE, l/min) were as follows: [table: see
      text] No patient reached a plateau of oxygen uptake during the last portion of
      the ramp exercise test. Thus, pVO2 is not an objective endpoint. The single
      determination standard deviations show that exercise tolerance and peak oxygen
      uptake do not differ as to their reproducibility. The absolute values of PD were
      not a function of exercise tolerance for any of the parameters studied. The PD
      values for ET and pVO2 were normally distributed. The data suggest that a change
      in ET and pVO2 must exceed 27% and 28% between two sequential studies in an
      individual patient in order to be significant at the 5% level, respectively. For
      the one-tailed test situation, the changes in ET or pVO2 must be greater than 23%
      in order to be significant.

PMID- 1621409
TI  - [Peri-graft reaction. A complication after implantation of a prosthesis shunt in
      children with congenital cyanotic heart defects].
AB  - Two different clinical manifestations of perigraft-reactions complicating the
      implantation of prosthetic aortopulmonary shunts in children with cyanotic
      congenital heart disease are described and discussed. The incidence of this
      complication in the past 5 years in our own patients was 3%. The appearance of a
      localized mass on the chest film surrounding the prosthesis requires the
      exclusion of a hematoma, aneurysm or inflammation. In the case of a massive
      serous pleural effusion examination of the ingredients leads to diagnosis.
      Concerning our own patients the fluid is identical with serum; the leakage
      through the prosthesis can therefore be called plasmapheresis. The claimed
      pathogenetic causes are discussed intensively, including a chylothorax promoting
      this complication in the second case. Local variations in porosity and structure
      of the implanted prosthesis may play a critical role in the pathogenesis of
      perigraft-reaction, as indicated by both our reported cases. In the event of
      unsuccessful observation of a localized perigraft seroma or of unsuccessful chest
      drainage of a massive pleural serous effusion, graft replacement and placement of
      a different graft material are found to have the best results.

PMID- 1621410
TI  - [Contrast media in cardiology. Report of a randomized, double-blind multicenter
      comparative study of the side effects of ionic and non-ionic roentgen contrast
      media].

PMID- 1621411
TI  - Immunization in the UK: policy review and future economic options.
AB  - Vaccination is one of the most effective health promotion activities, but
      specific targets have been difficult and costly to achieve, and have frequently
      fallen short of the desired aims, leaving some vulnerable groups unprotected.
      Policy in the UK has differed for the childhood diseases and in some cases, for
      example diphtheria and poliomyelitis, has been successful in almost eliminating
      the disease. In other cases, such as that of pertussis, there has been public
      opposition, and for other diseases, for example, measles, sufficient numbers of
      the susceptible population have only recently been reached. Although the World
      Health Organization target of 90% uptake for the childhood diseases has been
      reached for all except pertussis, the figures conceal lower uptake rates in some
      areas, particularly the inner cities. The introduction of target payments to
      general practitioners appears to have had some effect in increasing uptake rates,
      particularly in some inner city areas, although the change in immunization
      schedules may also have had an impact. Target payments fail to take account of
      the difficulties faced by inner city GPs and, in effect, favour those who need to
      make least effort, since, in some areas, high uptake rates may already have been
      achieved before targets were introduced. It is suggested that there is a case for
      special local development programmes in inner city areas which will provide help
      with improving record keeping and recall systems for immunization. An alternative
      policy, which might be more difficult to implement, would be to have targets
      which could be set at different levels in different areas so that uptake rates
      could be progressively improved.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621412
TI  - Clinical and bacteriological studies of El Tor cholera after ingestion of known
      inocula in Thai volunteers.
AB  - Twenty-six healthy adult Thai volunteers were recruited for clinical and
      bacteriological studies of cholera induced by oral inoculation with Vibrio
      cholerae El Tor Inaba strain N16961. Vibrio dosages of 0.3 x 10(4), 1.6 x 10(5)
      and 1.9 x 10(6) c.f.u. were given to three groups of five volunteers, and 2.0 x
      10(7) c.f.u. to 11 volunteers. Diarrhoeal attack rates correlated positively with
      the size of the inocula (p less than 0.01). It was estimated that a diarrhoeal
      attack rate of 90% (ED90) would be achievable by inoculation of 1.3 x 10(7)
      c.f.u. of the organisms. There were no significant differences between the groups
      in the latent period to positive stool culture, maximum vibrio count per gram of
      stool and duration of stool positivity. The ED90 of V. cholerae obtained may be
      used as a challenge dose in subsequent studies on protective efficacy of cholera
      vaccines in Thai adult volunteers.

PMID- 1621413
TI  - Local and systemic influenza haemagglutinin-specific antibody responses following
      aerosol and subcutaneous administration of inactivated split influenza vaccine.
AB  - An easily administered and safe vaccine is required to produce the herd immunity
      necessary to control influenza epidemics worldwide. A commercial quadrivalent
      inactivated split influenza vaccine was administered intranasally in aerosol form
      to a group of 46 volunteers; other groups were given the same vaccine
      subcutaneously and saline intranasally. The results show that mucosal stimulation
      via intranasal vaccination resulted in a marked increase in local HA-specific IgA
      antibodies, and that this stimulation was necessary for serum HA-specific IgA
      responses. Serum HA-specific IgA antibody levels can be used as indicators of
      local antigenic stimulation, providing a method for evaluating potency and
      antigenicity in humans of intranasal influenza vaccine. This vaccination route
      shows much promise for the future.

PMID- 1621414
TI  - Immunization of pigs against Actinobacillus pleuropneumoniae with two recombinant
      protein preparations.
AB  - Two Actinobacillus pleuropneumoniae serotype 7 antigens were expressed in
      Escherichia coli and tested for their protective efficacy in an experimental pig
      model. The antigens used were a fusion protein containing the carboxy-terminal
      70% of the +/- 103 kDa cytolysin and a full length 60 kDa protein which has been
      shown previously to bind transferrin. Pigs were immunized twice with 25
      micrograms of either or both preparations. All pigs developed a strong humoral
      immune response comparable to that induced by infection. Upon challenge with an
      A. pleuropneumoniae serotype 7 strain, all immunized groups were less affected by
      the disease and showed significantly lower mortality than the controls (p less
      than 0.1). Pigs receiving both antigens had a tendency to recover faster than the
      controls or animals which were vaccinated with only one antigen. Protection was
      serotype-specific since no cross-protection was detected following challenge with
      an A. pleuropneumoniae serotype 1 strain. A dose-response experiment using the
      single antigens at 200, 50 or 12.5 micrograms per dose showed no difference in
      protection among the groups.

PMID- 1621415
TI  - Recent observations regarding the pathogenesis of recurrent respiratory syncytial
      virus infections: implications for vaccine development.
AB  - Respiratory syncytial virus (RSV) and influenza virus are common pathogens for
      all age groups. Currently licensed influenza virus vaccines generally provide
      protection from clinically detectable disease caused by antigenically matched
      challenging viruses. In contrast, vaccine development for RSV has been hampered
      by the inability of candidate vaccines to induce protective immunity to naturally
      occurring infection. The precise mechanism(s) responsible for the RSV vaccine
      failures have not been determined. We raise the possibility that infection by RSV
      is associated with attenuation of both proliferative and non-proliferative RSV
      specific responses by human mononuclear leucocytes that results in the
      suppression or delay of host anamnestic defences, allowing development of
      recurrent clinical illness despite pre-existing immunity.

PMID- 1621416
TI  - Potential pathogenicity for rodents of vaccines intended for oral vaccination
      against rabies: a comparison.
AB  - Different oral vaccines intended to control fox rabies were administered to 271
      wild rodents. Vaccines were administered orally or by the mucosal route to four
      different European species belonging to the genera Apodemus, Arvicola,
      Clethrionomys and Microtus. These rodents are likely to consume baits and to have
      contact with the vaccine. Two genetically engineered vaccines were tested: SAG1
      (an avirulent mutant of the rabies virus) and V-RG (vaccinia recombinant virus
      expressing the rabies glycoprotein gene). Both were found to be completely
      innocuous when administered orally or by the mucosal route. The residual
      pathogenicity of conventional modified live vaccines derived from the SAD strain
      was confirmed.

PMID- 1621417
TI  - Development of a live cell culture camelpox vaccine.
AB  - A Saudi isolate of camel orthopoxvirus was serially propagated on monolayers of
      camel kidney cell cultures. The attenuation of the 78th passage was tested in two
      susceptible camels. Two other susceptible camels were inoculated with vaccinia
      virus four times propagated in camel kidney cell cultures. The four inoculated
      camels showed no postinoculation clinical symptoms and formed neutralizing
      antibodies against both the camel orthopox and vaccinia viruses. No postchallenge
      clinical symptoms were observed in these four camels, while two non-inoculated
      contact control camels showed typical symptoms of generalized camelpox. These
      results indicated the safety and potency of the 78th passage of the Saudi isolate
      of camel orthopoxvirus (designated Jouf-78) to be used for production of live
      attenuated cell culture camelpox vaccine. The field testing of the vaccine was
      carried out on two farms using at least 10(3) TCID50 as a recommended field dose.
      None of the inoculated camels showed any postvaccination reaction and the
      serological tests showed seroconversion of many vaccinated field camels. The
      relationship between camel orthopoxvirus and vaccinia virus as well as the
      advantages of the live attenuated camelpox vaccine are discussed.

PMID- 1621418
TI  - Antibody responses stimulated in rabbits, guinea-pigs and mice by recombinant and
      synthetic portions of a 75 kDa malarial merozoite protein.
AB  - The 75 kDa heat-shock-related protein (p75) of Plasmodium falciparum is an
      abundant, highly conserved, merozoite surface protein. A bacterial clone, C7,
      produces a polypeptide (C7Ag) of approximately 30 kDa representing the C-terminal
      40% of p75. In several species of animals, the C7Ag stimulated high titre IgG
      antibodies which cross-react with p75. Two major portions of the C7Ag,
      theoretically predicted to have strong secondary structural preferences, were
      modelled with four synthetic peptides. An alpha-helical, hydrophilic region,
      modelled with a 28-mer, proved a poor immunogen in guinea-pigs and several
      strains of inbred mice, even though it had been a strong immunogen in rabbits. A
      disulphide-bonded region of the C7Ag was modelled with three peptides of
      increasing length, namely 49-, 64- and 76-amino acid residues. In general, the
      order of immunogenicity was 49 less than 64 less than 76-mer. Antibodies to the
      76-mer and the 64-mer reacted strongly with the native parasite protein. The data
      also suggested that the 76-mer was a good model for the region of the molecule it
      was made to represent.

PMID- 1621419
TI  - Changes and challenges in health insurance.

PMID- 1621420
TI  - Dental model storage--a new and efficient system.

PMID- 1621421
TI  - Mouthguards, nightguards, palliatives and collaboration.

PMID- 1621422
TI  - Radiation protection & regulations. Subject: reducing exposure with rare earth
      intensifying screens.

PMID- 1621423
TI  - Recurrent aphthous ulcerations.

PMID- 1621424
TI  - Vital tooth bleaching--home use review and evaluation.

PMID- 1621425
TI  - Direct and indirect veneers.

PMID- 1621426
TI  - Composite resin inlays.

PMID- 1621427
TI  - Quality in the service of patients: the paradigm of the 90s and beyond.

PMID- 1621428
TI  - Clinical information content of transcutaneous oxymetry (tcpO2) in peripheral
      arterial occlusive disease (a review of the methodological and clinical
      literature with a special reference to critical limb ischaemia).
AB  - About 160 publications (1978-1992) dealing either directly or indirectly with
      transcutaneous oxygen partial pressure measurements (tcpO2) in peripheral
      arterial occlusive disease (PAOD) are reviewed. Thereby, various clinical
      applications and results are related to the theory and methodology of the tcpO2
      technique. In PAOD patients, the tcpO2 reflects local hyperemic skin blood
      supply. The clinically relevant intersection of the tcpO2-flow hyperbola is of
      considerably non-linear shape and partially insensitive to flow. In view of
      macrocirculatory pathology, tcpO2 values depend particularly on PAOD staging,
      hemodynamic compensation, and calf artery patency. Pathophysiological and
      pharmacological microcirculatory effects, however, cannot be read unequivocally
      from corresponding tcpO2 responses due to the heat-induced local vasoparalysis.
      In daily practice, the tcpO2 does not provide substantial information in patients
      with asymptomatic obstructions (Fontaine stage I) or intermittent claudication
      (stage II) but is of clinical impact in limbs with rest pain and skin lesions
      (stages III and IV). In such a complicated PAOD, diagnostic and prognostic
      capabilities can be essentially improved by provocational manoeuvres which narrow
      the flow-insensitive range. A critical limb ischaemia may be assumed if supine
      and dependent foot tcpO2 values exceed neither 10 mmHg nor 45 mmHg, respectively.

PMID- 1621429
TI  - [Expression of induced atherosclerosis in the rabbit model].
AB  - Atherosclerosis in rabbits was induced by administering a 2% cholesterol diet and
      additional endothelial denudation of the aorta and iliac artery as a model for
      vascular surgery. In addition, the serum cholesterol-, serum triglyceride-, and
      HDL-cholesterol values were examined. After 22 weeks the intima and most often
      the media showed atheromatosis and fibrosis, in most of the arteries with intimal
      necroses. All arteries developed marked to pronounced stenoses, calcium deposits
      were only observed in single cases. The intensity of the arterial lesions was
      found to be similar to the appearance of human atherosclerosis.

PMID- 1621430
TI  - Vasomotion in the leg skin of patients with chronic venous insufficiency.
AB  - The characteristics of vasomotor activity in patients with lipodermatosclerosis
      (LDS) were studied using Laser Doppler fluxmetry and frequency analysis. Laser
      Doppler flux in the skin was recorded in the goiter region in 17 patients with
      LDS due to venous disease and in 16 normal control subjects. The Laser Doppler
      signals were analysed to give mean levels of flux and the frequency and amplitude
      of vasomotion were found using a fast Fourier transform (FFT). The results show
      significantly greater basal flow (p less than .001), and vasomotor frequency (p
      less than .001) and amplitude (p less than .001) in venous disease. The altered
      vasomotor activity is not due simply to the increased flow in LDS since
      increasing the flow in normal skin using the vasodilator pilocarpine does not
      produce as noticeable a difference.

PMID- 1621431
TI  - Immunofluorescence studies of atrophie blanche with antibodies against
      fibrinogen, fibrin, plasminogen activator inhibitor, factor VIII-related antigen,
      and collagen type IV.
AB  - In and around ulcers complicating the chronic venous insufficiency syndrome and
      atrophie blanche a pericapillary cuff of fibrinoid material has been described.
      The aim of the present study was to find out whether pericapillary cuffs are
      present in atrophie blanche ulcerations, whether they consist of fibrinogen
      and/or fibrin in comparison to normal controls, and whether this cuff is composed
      of other components. Skin biopsies from ten patients adjacent to atrophie blanche
      ulcers, and from ten controls were taken. In all patients pericapillary cuffs
      consisting of fibrin were found. However, no fibrinogen was found in these cuffs.
      In the controls no cuffs were found. In this fibrin network factor VIII-related
      antigen and collagen type IV were also present. The finding of plasminogen
      activator inhibitor-I in the pericapillary cuff in several cases may indicate
      that breakdown of this fibrin cuff is impaired. The possible diffusion barrier
      caused by the pericapillary cuff together with the pattern of vascularization may
      be an important event in ulcer formation and impaired ulcer healing.

PMID- 1621432
TI  - Skin microcirculation and laser Doppler blood flow in patients supported by the
      Berlin heart biventricular assist device.
AB  - Microcirculatory forearm cutaneous blood flow was monitored continuously and non
      invasively by laser-doppler-flowmetry (LDF) in 10 patients treated with the
      Berlin Heart biventricular assist device (BVAD) system for end-stage heart
      failure (BVAD-pts). Ten normal human subjects served as controls (C). The
      cutaneous blood flow was measured before, during, and after external brachial
      artery occlusion to evaluate the postocclusive reactive hyperemia (PORH) as a
      standardized response. To examine micro-vasculatory responses to macro
      hemodynamic changes the cardiac output (CO) was decreased by reducing the BVAD
      pump rate by 20%. No significant differences in base-line LDF measurements were
      ascertained in the two groups. After sudden cuff pressure release (1 min later) a
      statistically significant (p less than 0.004) three- to fourfold blood flow
      increase (PORH) occurred in both groups. The period of the PORH response was
      altered in all BVAD-pts. The time to peak PORH values were significantly
      diminished (p less than 0.05) A markedly delayed return to base-line level
      occurred in the BVAD-pts. The 20% reduction in the BVAD-pump rate significantly
      decreased CO (p 0.05) and increased systemic vascular resistance (SVR) (p less
      than 0.01), whereas LDF levels remained unchanged.

PMID- 1621433
TI  - The value of arterial, venous and arteriovenous levels of lipid metabolism
      parameters in healthy individuals and patients with peripheral arterial occlusive
      disease (PAOD).
AB  - For a group of 28 patients with PAOD (mean age, SD 63.7 +/- 10.2 years) and 16
      healthy subjects (61.7 +/- 11.9 years) we examined several lipid analytes in
      femoral arterial and venous blood. Compared with healthy controls, PAOD patients
      showed significantly lower HDL cholesterol levels (p less than 0.01) and
      significantly higher levels of triglycerides (p less than 0.01). In addition, a
      significant negative A-V difference in triglycerides (p less than 0.05) and a
      significant inverse association between arterial HDL cholesterol and A-V
      difference in triglycerides (r = -0.48; p less than 0.01) were present.
      Predominantly the last two unexpected findings are discussed in this study.

PMID- 1621434
TI  - IgG-anticardiolipin-antibodies are markers for cerebral and peripheral artery
      disease.
AB  - Anticardiolipin-antibodies are antibodies to phospholipids which were first
      detected in patients with arterial thrombosis and lupus erythematosus. In this
      prospective study, IgG- and IgM-anticardiolipin-antibodies were determined in
      patients with cerebral and/or peripheral artery disease but without autoimmune
      disorders. 123 randomly selected patients (88 males, 35 females; mean: 65 +/- 10,
      range: 41-85 years) were included and divided into four groups: 18 patients with
      isolated cerebrovascular disease (group A), 35 patients with peripheral artery
      disease only (group B), 35 patients suffering from cerebral and peripheral artery
      disease (group C) and 35 patients as controls (group D). In family history,
      cholesterol, blood sugar and prothrombin time the four patient groups did not
      differ significantly, whereas patients of group B and C were more often smokers
      than those in groups A and D. However, IgG-anticardiolipin-antibody-levels were
      significantly elevated in patients with cerebral and peripheral artery disease
      compared to controls (p less than 0.01). The highest values were seen in group C
      where patients suffered from cerebral and peripheral artery disease (n.s.). On
      the other hand, IgM-anticardiolipin-antibody-levels did not show any differences
      in the four groups. Furthermore, there was no correlation between vascular risk
      factors and/or laboratory findings with IgG- and IgM-antibody-levels. Thus,
      elevated IgG-anticardiolipin-antibodies appear to be independent markers for
      severe cerebral and peripheral artery disease and should be determined in
      patients at increased risk.

PMID- 1621435
TI  - Retinal duplex scanning in cerebrovascular disease and hypertension.
AB  - Using Doppler duplex scanning retinal flow velocity was evaluated in 100 patients
      with carotid plaques, in 40 with hypertension and in 200 normal subjects. The
      reproducibility of the test was good. Peak systolic velocity was 12.5 cm/s in
      normals and significantly lower in patients with carotid plaques (9.8 +/- 6) and
      in patients with hypertension (8.3 +/- 6). The end diastolic velocity was also
      lower in both groups of patients. The ratio between the systolic and diastolic
      component was 2.3 in normals. It was increased in cerebrovascular disease (3.5)
      and in hypertension (5.5) as a consequence of the decrease in the diastolic
      component. In conclusion duplex retinal flow velocity evaluation is easy and
      reproducible and may be possibly used to study retinal flow in patients with
      cerebrovascular disease and in hypertension.

PMID- 1621436
TI  - Evaluation of patients with thoracic aortic dissection by intraarterial digital
      subtraction angiography.
AB  - In 17 patients (mean age 60 years) a thoracic aortic dissection could be revealed
      by intraarterial digital subtraction angiography with exact delineatin of the
      proximal and distal extent. Furthermore a visualisation of the true and false
      lumen and hereby especially the blood flow and its direction in the false lumen
      could be made. The disclosure of the intimal flap could be seen in patients with
      flow in both channels, separating the true and the false lumen. In 4 patients the
      entry could be seen sharply as a hole, but not corresponding to the proximal
      extent. In 11 patients the entry was seen over a longer area and in 2 patients
      neither entry nor reentry could be seen. The most distal part of the intimal flap
      might correspond to the reentry. One anonymous artery, five renal arteries and
      one coeliac trunc were involved by the dissection. The exact anatomical and
      pathophysiological nature of the dissection made it possible to decide whether or
      not the patients should be operated upon and if so, what kind of operation should
      be chosen.

PMID- 1621438
TI  - [Results of vascular surgery treatment of vertebrobasilar insufficiency].
AB  - A retrospective analysis of the data of 64 patients with vertebral-basilar
      insufficiency is presented who were operated between 1980 to 1919 in our
      institution. Surgery for vertebral-basilar insufficiency comprises only 5.2% of
      all 1422 supra-aortic reconstructions performed during this period. The leading
      symptom was vertigo which was present in 41%. Disturbances of vision occurred in
      9.8%. 29 bypass procedures and 35 arterial transpositions were performed. A mean
      follow up of 5.1 years revealed a patency rate of 83.3% in bypass procedures,
      92.8% in subclavian transpositions and 100% in vertebral artery transpositions.
      These good haemodynamic results correlated with marked improvement of the
      clinical symptoms in 80% of the patients.

PMID- 1621439
TI  - Deep venous thrombosis: results of thrombectomy versus medical therapy. Presented
      at the 5th European-American Symposium on Venous Diseases, Vienna, Austria, Nov.
      7-11, 1990.
AB  - Between 1.1.1985 and 1.1.1988, 158 patients were referred because of acute deep
      venous thrombosis. They were 82 women (median age 48.5) and 76 men (median age
      56.5). On admission, 4 patients had already a pulmonary embolism in 3 others
      embolism occurred during hospitalisation. The segment involved was the isolated
      iliac in 10, iliofemoral in 53, isolated femoral in 7, femorotibial in 47 and
      isolated tibial in 41 patients. Anticoagulation and compression therapy was
      undertaken in 102 and mortality was 21%. At follow-up 63% had at least 1 sign of
      venous insufficiency, in all 16% had no sequelae and were subjectively symptom
      free. Thrombolytic therapy was carried out in 25, mortality was 8%. At follow-up,
      72% had at least one sign of venous insufficiency. Venous thrombectomy was
      performed in 31, combined in 4 with balloon dilatation of an iliac spur.
      Mortality was low with 3%, 58% had at least one sign of venous insufficiency at
      follow-up and 39% were subjectively symptom-free. Our results show that an
      objective assessment is insofar difficult because subjective and clinical results
      do not correlate; 51% with clinically verified post-therapeutic venous
      insufficiency had normal venous drainage in strain-gauge plethysmography, whilst
      41% without subjective discomforts demonstrated an insufficient drainage. Our
      results show that a full restitution is seldom achieved, thrombectomy does not
      prevent chronic venous insufficiency. Best results were observed in isolated
      iliac thrombosis. We conclude that thrombectomy should be restricted to the
      phlegmasia caerulea dolens form of DVT, while floating thrombus and ascending
      thrombus extending into the vena cava should be treated with a cava filter or
      ligation.

PMID- 1621437
TI  - [Five years experience with infra-inguinal arterial reconstruction: a comparison
      of venous with PTFE bypass].
AB  - Since January 1983 one surgeon of our team has performed 200 infrainguinal
      arterial reconstructions. Our patients had a mean age of 72 years and suffered
      from multiple concomitant diseases (coronary heart disease 35%, cerebro-vascular
      insufficiency 15%, hypertension 49% and diabetes mellitus 34%). The indication
      for arterial reconstruction was a chronic critical ischemia in every case. 154
      autologous veins and 46 PTFE prosthesis had to be implanted. The former consisted
      in 64% in a femoropopliteal and in 35% femorodistal bypass graft; respective
      values of the latter group were 80% and 20%. The cumulative survival rates of two
      collectives were nearly identical. More than 50% of our patients died in the 4
      years observation period. The life table patency rates differed statistically
      significant (p less than 0.001). The cumulative 5 year patency amounted to 85% in
      case of a vein graft and to 43% if a PTFE prosthesis was inserted. Extremely poor
      results were achieved in case of a PTFE prosthesis with a distal anastomosis to a
      single crural artery; just one out of 6 procedures was successful after two
      years.

PMID- 1621440
TI  - Medical edema protection--clinical benefit in patients with chronic deep vein
      incompetence. A placebo controlled double blind study.
AB  - In a randomized placebo controlled parallel double blind study on 40 patients
      suffering from venous edema in chronic deep vein incompetence, the edema-reducing
      effect of horse chestnut seed extract vs. placebo, being the main test variable,
      was demonstrated by hydroplethysmography to be statistically significant. In
      addition, measurements of leg volume under aggravated conditions (edema
      provocation) were conducted, which yielded the same results. Additional
      measurements of leg circumference tendentially confirm the demonstrated clinical
      efficacy of verum, as is true for phlebody-namometric measurements (pressure at
      rest, minimum pressure, replenishment time) as well. By measuring the leg volume
      before and after edema provocation, it could be shown that the clinical benefit
      for the patient is present in all everyday situations (in movement as well as on
      sitting or standing). Treatment with an edema protective agent of the horse
      chestnut seed extract type is thus a useful adjunct to compression therapy. The
      tested preparation were well tolerated.

PMID- 1621442
TI  - The effect of elastic compression on the venous tone in patients with varicose
      veins.
AB  - The long term effect of elastic compression, with an emphasis on the changes in
      venous wall elasticity, was studied in 10 limbs with varicose veins. By
      simultaneously measuring venous volume, using the air plethysmograph (APG), and
      venous pressure, while the venous outflow was occluded, the pressure/volume (P/V)
      relationship of the venous system of the leg could be studied and the elastic
      modulus calculated. These measurements were performed prior to the application of
      elastic stockings and 6 weeks later, one day after the stockings had been
      removed. Statistically significant improvements were noted in the APG parameters
      studied and in the P/V curve derived elastic modulus calculations. The limbs
      could be divided into two groups based on the response of the P/V curves to
      elastic stockings and the severity of disease. Those limbs with milder disease
      tended to shift their P/V curves downward and to the right after compression
      (giving them a more normal pattern). Limbs with more severe disease showed
      evidence of a similar pattern of improvement at low but not at high venous
      pressures.

PMID- 1621441
TI  - Elastic stockings in diabetic microangiopathy. Long-term clinical and
      microcirculatory evaluation.
AB  - One hundred and forty nine diabetics with microangiopathy were followed up for 4
      years and studied by laser-Doppler flowmetry - measuring skin blood flux at rest
      [RF] and the venoarteriolar response [VAR]. Seventy four patients were advised to
      wear elastic stockings and 75 were kept as controls with the aim of evaluating
      the effects of stockings on the evolution of diabetic microangiopathy. After 4
      years a significant deterioration was found in RF (increased) and VAR (decreased)
      in the untreated group in comparison with controls. Also 10 ulcerations developed
      in the untreated subjects (6.6% of limbs) in comparison with 3 ulcerations
      (2.02%) in the treated group. The difference was statistically significant.
      Therefore elastic stockings appear to be useful in diabetics with microangiopathy
      as they protect against the deterioration of the microcirculation and reduce the
      development of ulcerations.

PMID- 1621443
TI  - Venous function during late pregnancy, the effect of elastic compression hosiery.
AB  - Venous function was investigated in 29 women during late pregnancy before and
      after short term treatment with graduated compression hosiery. A significant
      improvement of venous emptying was found, combined with a subjective decrease of
      leg problems such as swelling, tiredness and pain.

PMID- 1621444
TI  - [Exercise for venous insufficiency 1992].
AB  - A program of seven body exercises which was developed at our clinic in 1969, is
      presented in a new and adapted version. These exercises support the natural
      drainage function of the venous and lymphatic reflux system. The posture
      (elevated position of the pelvic area) and an adequate respiration during the
      exercises are of paramount importance. Exercises supporting the drainage function
      are only part of several components of the individually adapted therapy program.
      Within these limits they represent one of the most valuable measures, because
      they are carried out entirely by the patient himself.

PMID- 1621445
TI  - Present management of hepatic artery aneurysms. Symptomatic left hepatic artery
      aneurysm; right hepatic artery aneurysm with erosion into the gallbladder and
      simultaneous colocholecystic fistula--a report of two unusual cases and the
      current state of etiology, diagnosis, histology and treatment.
AB  - A left hepatic artery aneurysm has an incidence of 0.8% among the splanchnic
      artery aneurysms. 20% of splanchnic artery aneurysms are hepatic artery
      aneurysms. Atherosclerosis (32%) is the most prevalent etiology, followed by
      trauma (22%) and inflammatory lesions (10%). The average age is 40 (10-83) years,
      the male to female ratio 2:1. In 64-80% of cases rupture of the aneurysm is the
      first clinical manifestation. The mortality is then about 35%. The case of a 64
      years old female with a symptomatic aneurysm of the left hepatic artery and the
      case of a 70 years old female, who underwent emergency laparotomy for acute
      colorectal hemorrhage, with a right hepatic artery aneurysm, which perforated
      into the gallbladder, with simultaneous colocholecystic fistula is reported and
      the etiology, histology, and present diagnostic and therapeutic management of
      hepatic artery aneurysms is discussed.

PMID- 1621446
TI  - [Acute ischemia of the lower extremity in an adolescent with Crohn disease].
AB  - The authors report a case with a rare form of peripheral ischaemia. A 25-year-old
      man with Crohn's disease suffers from sudden ischaemia of his right leg. There is
      no evidence of entrapment of the popliteal artery, of arterial embolism or
      Buerger's disease. Thrombocytosis in combination with hypercoagulability as
      described previously in patients with Crohn's disease seems to be the most
      probable cause. - In this case percutaneous transluminal thrombectomy and
      thrombolysis were more successful than surgical thrombectomy using balloon
      catheters.

PMID- 1621447
TI  - [Schorsch Gaggo visits a continuing education event].

PMID- 1621448
TI  - Aluminium determination in food matrices IUPAC check sample survey of analytical
      performance.
AB  - Aluminum has been determined by 24 laboratories in the context of a check sample
      survey. Samples studied were two duplicate diets, one of which was spiked with
      15.87 mg Al/kg, and two blind duplicate milk powders. Target values for the
      duplicate diets were 11.80 and 27.90 mg Al/kg, respectively, and 15.65 mg Al/kg
      for the milk powders. Participants were requested to make only single
      determinations per sample. A two-step approach was used to assess the raw data.
      In the first step, those data were excluded that were outside a +/- 50% range of
      the duplicate diet spike and the target value for milk powder. Likewise, only one
      single data set per participant was accepted and results were ruled out stemming
      from procedures that have a detection limit of greater than 5 mg Al/kg. The
      remaining data were evaluated both statistically and in the context of the method
      performance parameters available. Best scores for aluminium were from
      laboratories applying wet-pressurized digestion in combination with
      electrothermal atomic absorption spectrometry. Results for laboratories applying
      dry-ashing for sample decomposition were unreliable. The overall performance for
      aluminium is very disappointing given the relatively high aluminium levels of the
      samples studied. Out of 24 laboratories 11 have one or more major problems with
      their aluminium determination. They should dramatically improve or replace their
      methodology for this element.

PMID- 1621449
TI  - Action of gamma-irradiated patulin on Saccharomyces cerevisiae.
AB  - The action of gamma-irradiated patulin on Saccharomyces cerevisiae LOCK 2144 in
      liquid culture was studied. Patulin irradiated in an aqueous solution with doses
      ranging over 0.34-1.36 kGy inhibited the yeast growth in a proportion to the
      concentration of undestroyed toxin. Patulin disappearance in the growth medium
      occurred between 12-72 h of incubation at 30 degrees C. The patulin content did
      not essentially change in the period of log phase of yeast growth which is
      accompanied by rapid glucose uptake.

PMID- 1621450
TI  - [Determination of vitamin D in food using high performance liquid chromatography
      (HPLC). Results of collaborating studies of the working group "Vitamin Analysis"
      according to section 35 of the German Food Act].
AB  - A standardized method to determine the vitamin D content of food by means of HPLC
      is described. After the test material was homogenized and saponified with
      ethanolic aqueous potassium hydroxide solution, vitamin D was extracted using n
      hexane. Using HPLC on a silica gel column, the fraction containing vitamin D is
      separated from the nonsaponifiable residue. After the fraction was reduced, the
      residue was dissolved in methanol and the vitamin D content determined after HPLC
      separation on an RP-C18 column. For evaluation, either a conventional external
      standard method using laboratory and matrix specific recovery rates as correction
      factors, or an internal standard method using vitamin D2, and D3, respectively as
      internal standards were employed. The method was developed and standardized by
      the working group "Vitamin Analysis" in accordance with section 35 LMBG (German
      Food Act). Repeatability and comparability of the results were checked in
      collaborative studies (14 laboratories) in milk powder and gruel that had been
      enriched with vitamin D3. Applicability of the method to other food (eggs, milk,
      fish, margarine) was checked separately. The statistical evaluation of the
      results of the collaborative studies has shown that the method is reliable enough
      to be included into the "Amtliche Sammlung" (official collection of analytical
      methods) according to section 35 LMBG. The present method may be used to
      determine the content of vitamin D2 and D3 in natural and vitaminized food. It is
      specific for the vitamins D2 and D3 released during saponification of food, but
      does not allow separate determination of the pre-vitamins D already present in
      the sample.

PMID- 1621451
TI  - Baking stability of acesulfame K.
AB  - The stability of acesulfame K during baking was investigated at different baking
      temperatures and baking times. The contents of acesulfame K in baked and unbaked
      doughs were determined by HPLC. The recovery rate of acesulfame K was independent
      of the baking conditions chosen and correlated with the recovery rate of
      acesulfame K in the unbaked doughs. As the stability of acesulfame K cannot only
      be affected by baking temperature and baking time but also by pH value and
      moisture content of the baked goods, additional stability investigations were
      performed with acidic fillings and apple pie. Even under these extreme baking
      conditions no decomposition of acesulfame K could be detected.

PMID- 1621452
TI  - [Anti-phospholipid antibodies in gynecology and obstetrics].
AB  - Anti-phospholipid-antibodies are connected with many diseases. In gynecology and
      obstetrics they are related to habitual abortion, preeclampsia, intrauterine
      retardiation and thrombembolic events. Pathogenetic conceptions, the diagnosis,
      problems in contraceptions, pregnancies and puerperium are explained. Their
      search and an individual trial of therapy should be done in spite of unknown
      mechanism of effectiveness.

PMID- 1621453
TI  - [Changes in the blood coagulation and fibrinolysis system in the course of normal
      pregnancy].
AB  - In the present study we investigated several factors of hemostasis and
      fibrinolysis during the normal pregnancy in 52 women. Whereas the Thrombin-Time
      did not show any change, the increase of the Hepato-Quick and the decrease of the
      Partial Thromboplastin-Time was significant. During pregnancy we observed a
      significant increase of the activity of fibrinogen, factor XII and prekallikrein
      as well as of the von-Willebrand-factor-antigen (VIIIR:Ag). The activity of
      factor II and X remained constantly. The increased activity of factors of
      hemostasis was accompanied by an increase of activity and concentration of
      antithrombin-III. In contrast to the activity of the hemostatic system we could
      not find any significant alteration of the fibrinolytic system. The cause must be
      searched in the observed increase of plasminogen-activator-inhibitor (PAI)--likly
      in combination with a decrease of the tissue-type plasminogen activator (t-PA).
      Our data indicate, that the highest risk for thrombosis already might exist in
      week 24 of pregnancy, because a distinct increase of hemostatic activity is
      combined with a nearly unchanged fibrinolytic activity.

PMID- 1621454
TI  - [Choroid plexus cysts in the 2d trimester--an indication for trisomy 18].
AB  - The application of high resolution ultrasound in the prenatal diagnosis enables a
      detailed differentation of the intracerebral structures in the fetus. In a period
      of 16 months (Jan. 1990-June 1991) we diagnosed at the "Center for prenatal
      diagnosis and therapy" at the Charite's Hospital in 14 fetuses among 1800
      investigated plexus chorioideus cysts. A rapid karyotyping after cordocentesis
      was performed in 11 cases. In 3 of them a trisomy 18 could be detected. In one
      fetus having a normal karyotype we could find besides the cysts multiple
      structural anomalies. In these 4 cases the termination of pregnancy was
      performed. In the other 10 pregnancies we could observe a spontaneous regression
      of the plexus cysts. These results suggest that the prenatal diagnosis of plexus
      chorioideus cysts is a indication for cytogenetic evaluation in order to detect a
      trisomy 18.

PMID- 1621455
TI  - [Fetal teratoma--diagnosis and management].
AB  - Fetal and neonatal teratoma is rare, but it is the most common tumor of the fetus
      and meonate. We report seven cases with fetal sacrococcygeal teratoma and two
      cases with craniocervical teratoma. The diagnosis, further management of
      pregnancy and birth are described and compared with recent literature. While
      craniocervical teratoma is associated with very poor prognosis, there are
      sacrococcygeal teratoma with good survival rate and postoperative good functional
      results. Very important is prolongation of pregnancy near to term.

PMID- 1621456
TI  - [Type and incidence of cytogenetic abnormalities in unfertilized or uncleaved
      human oocytes within the scope of in vitro fertilization].
AB  - Human oocytes remaining unfertilized or uncleaved during in vitro fertilization
      (IVF) yield valuable information on the kind and frequency of numerical and
      structural chromosome aberrations after their fixation. This enables us to assess
      the maternal contribution to perturbations in the course of fertilization and
      early embryonic development. Therefore, 566 unfertilized or uncleaved oocytes
      from our IVF programme were processed for cytogenetic examination. 223 gametes
      were not analyzable. 260 oocytes were completely karyotyped and chromosome counts
      could be established for 83 cells. 243 eggs had the normal haploid chromosome
      complement whereas 100 cells (29.2%) were abnormal. In detail, we found the
      following aberrations: hypohaploidy = 10.2%, hyperhaploidy = 4.7%, diploidy =
      9.0%, tetraploidy = 1.2%, structural anomalies = 2.6%, prematurely condensed
      sperm chromosomes = 3.2%. Six cells had to be considered in two of these
      categories. Our results and comparisons with other publications imply that the
      total rate of anomaies in human oocytes from stimulated cycles amounts to 20 to
      30%. This high frequency might be one of the limiting factors for the success
      rate of IVF.

PMID- 1621457
TI  - [Histomorphology of pelvic floor muscles in women with urinary incontinence].
AB  - Success of urinary incontinence surgery so far depended primarily on the
      intensity and quality of preoperative diagnosis, the resulting choice of
      techniques, suture material, and the surgeon's skills. The role played by tissue
      available from the patient herself, however, had not been adequately considered,
      although such an assessment would have been of major relevance to all methods
      using autogenic tissue. Preliminary histological-histochemical and morphometric
      investigations of pubococcygeal muscles of ten patients revealed unambiguous
      right-left differences with regard to muscle quality and fibre typing, mean cross
      section area of muscle fibres, and connective tissue response up to degeneration
      and also concerning replacement of striated muscles by smooth muscles. Further
      studies into collagen metabolism are likely to enable more reliable prognosis of
      operations for urinary incontinence.

PMID- 1621458
TI  - [Treatment of stress incontinence].
AB  - This is an introducing survey at the symposium "New techniques in gynaecology and
      obstetrics" held 25th and 26th of October, 1990, in Rostock. Surgery of urinary
      incontinence is not sufficient despite improving choice of methods. Therefore
      each new solution is welcome. In our times suprapubic colposuspension operations
      are the most interesting ones. Using fibrin sealing could be advantageous, if it
      would be possible, to limit sealing area and following tissue consolidation to
      the pubourethral ligaments. Sealing of fascial sutures and avoiding of vaginal
      adhesions in cases of vaginal repair would be imaginable. As alternative mobile
      vaginal suspension by means of fascial strips is demonstrated.

PMID- 1621459
TI  - [Prenatal diagnosis of truncus arteriosus communis (type I) in diabetic
      pregnancy].
AB  - Recently Ferencz et al. [6] using the datas of the Baltimore-Washington Infant
      Study found a predominance of double outlet righ ventricle and truncus arteriosus
      communis among the congenital heart diseases of newborns of diabetic mothers.
      This paper reports about the prenatal diagnosis of a truncus arteriosus communis
      Type I in a 23 year old pregnant with insulin-dependent diabetes mellitus (White
      B). The diagnosis was performed in the 25th week using Real-Time- and Color
      Doppler-sonography. The important features in the prenatal differentialdiagnosis
      from a tetralogy of Fallot are explained. The optimal management of pregnancy,
      the delivery at a perinatal center with subsequent operative correcture could
      improve the prognosis of the newborn.

PMID- 1621460
TI  - [Josef Hirsch--pioneer of breast saving therapy of breast cancer].

PMID- 1621461
TI  - [115 years Berlin Society of Obstetrics and Gynecology: Carl Ludwig Ernst
      Schroder, progress and effect. Part III].
AB  - 115 years age (1876) in Berlin the Society of obstetrics and gynaecology was
      founded by fusion of the society of obstetrics (1844) and the society of
      gynaecology (1873). As first president was elected Carl Schroder, the new
      ordinarius of the Gynaecological Department (Universitats-Frauenklinik). The
      present paper descirpt the live and work of Carl Schroder on the background of
      Berlin Gynaecology in last decades of the XIX. century.

PMID- 1621462
TI  - [4th Congress of the International Perinatal Doppler Society 29-31 August 1991 in
      Malmo].

PMID- 1621463
TI  - Gross and histopathological observations on the effects of therapeutic ultrasound
      in experimental acute chemical arthritis in calves.
AB  - Acute chemical arthritis was induced in right radiocarpal joints of eight cow
      calves by intraarticular injections of turpentine oil. They were randomly divided
      into two groups A and B of four calves each. Group A served as control. Group B
      was given therapeutic ultrasound at 2.0W/cm2 for 7 minutes daily for 7 days
      starting on day 5. On day 19, all the calves of both the groups were slaughtered.
      Grossly as well as microscopically, joint tissues of group A calves showed severe
      inflammatory and degenerative changes. Joint capsule of group B calves showed
      regeneration of synovial membrane and articular cartilage was normal grossly as
      well as microscopically.

PMID- 1621464
TI  - [Evaluation of the postoperative "state of health" using the example of the body
      core temperature rhythms of sheep].
AB  - A postoperative (p.op.) estimation of "healthiness"--especially an estimation of
      duration of possible existing changes, caused by surgical treatment--is important
      not only for the ongoing of the healing up process. A re-activation of treated
      farm or laboratory animals which is set up too early might produce reduction of
      efficiency or falsification of experimental results. Investigations on p.op. de
      synchronisation have proved that "healthiness" means--besides the absence of
      clinical symptoms--also stable relations among the circadian rhythms. As the
      ultradian rhythms (wavelength less than 24 h) which exist beside the circadian
      ones depend on endogenic and exogenic factors much more than the circadian
      rhythms do, the aim of this study was to investigate strength and especially
      duration of changes p.op. in using core temperature rhythms of sheep as example,
      by setting great value on investigating ultradian rhythms. The core temperatures
      of 5 Merino-mixed sheep were permanently measured for 4 weeks p.op. by special
      radiotelemetric equipment, under controlled circumstances. All recorded data have
      been expertised "macroscopically" and Fourier-analysis was employed for judging
      phase shift and intensity of existing rhythms. Though no signs for systemic
      disturbances could be found and the recorded temperature always was in between
      the physiological range, important shifts of phases and variations in intensities
      in the ultradian scope as well as in the circadian one occurred. The "normal" or
      final phase relations and the constant daily pattern of intensities in sheep were
      reached 16 days p.op. earliest.

PMID- 1621465
TI  - The effect of additional feeding on the fertility of high-yielding dairy cows.
AB  - One hundred and ninety three pairs of cows were selected from 38 herds, and the
      numbers of each pair were assigned at random to experimental and control groups.
      Each control cow was fed according to its yield with the feedstuffs normally used
      by the herd. Each experimental cow was fed in the same way and, in addition,
      received 500 g of a feed additive twice daily from the 40th day of lactation
      until first insemination or to the 75th day of lactation if no visible oestrus
      had been observed between days 40 and 75. One kg of the feed additive contained
      glucogenic substances (glycerol and Ca-propionate) equivalent to 1.90 moles of
      glucose, 13.6 MJ metabolizable energy, and 180 g digestible crude protein. There
      were no significant differences between the groups with respect to their mean
      daily milk yield, their plasma glucose concentrations at first insemination, or
      the interval between calving and first insemination. However, the experimental
      cows had a significantly shorter interval between calving and last insemination
      (mean difference 11.0 days). The pregnancy rate was significantly higher among
      cows with high than among cows with low plasma glucose concentrations. There was
      also a tendency towards a reduced pregnancy rate among cows with either high
      (greater than 7.0 mmol/litre) or low (less than 4.0 mmol/litre) milk urea
      concentrations.

PMID- 1621466
TI  - Comparison of staple and Gambee techniques for enterotomy closure in the normal
      bovine jejunum.
AB  - Two suturing techniques for closure of jejunal enterotomies--the stapling and the
      Gambee technique--were compared in 7 bulls. Stapling was less time consuming (P
      less than 0.0001) and reduced the overall duration of surgery by 15%.
      Furthermore, the lumen diameter was significantly less decreased in the stapled
      intestine at 8 weeks after surgery (P less than 0.05). The diameter of the
      intestine increased significantly between 8 and 13 weeks after the Gambee suture
      had been applied (P less than 0.05) and the difference in diameter between
      intestines sutured according to Gambee and the stapled intestines disappeared.
      The intestinal diameter did not change significantly between 13 and 18 weeks in
      both techniques. The application of Gambee sutures resulted in fewer adhesions (P
      less than 0.01) and less thickening of the intestinal wall (P less than 0.0001).
      The surgery did not seem to affect the performance of the bulls significantly.

PMID- 1621467
TI  - Influence of hypertonic saline solution 7.2% on different hematological
      parameters in awake and anaesthetized ponies.
AB  - The influence of hypertonic NaCl 7.2% infusion (4 ml/kg of body weight [BWT]) on
      plasma (PV) and blood (BV) volumes, sodium (Na), chloride (Cl), potassium (K)
      plasma concentrations, osmolality (Osm), total protein content (TP), packed cell
      volume (PCV) and red blood cell count (RBC) was studied in five standing and
      anaesthetized ponies (standard halothane anaesthesia). Arterial blood gases were
      followed in the anaesthetized ponies. Isotonic NaCl 0.9% (4 ml/kg of BWT) was
      used as a placebo in the standing ponies. Isotonic solution in the standing
      ponies induced few changes: only small decreases in K, TP, PCV and RBC were
      observed. Na, Cl and Osm increased significantly after the NaCl 7.2% infusions in
      the standing and anesthetized ponies. Significant decreases in PCV, RBC and TP
      after the administration of hypertonic solutions were determined and were in both
      groups clear indications of an occurring hemodilution although no significant
      increase in PV and BV could be demonstrated. An increase in diuresis
      characterized by numerous micturitions was observed in the standing ponies and
      during the recovery period after anaesthesia. Apparently, the occurring fluid
      shift towards the intravascular compartment was partly compensated by an increase
      in diuresis. The decreases in PCV, RBC and TP were less severe in the
      anaesthetized ponies compared to the changes observed in the standing ponies.
      Stress responses during anaesthesia might explain this finding. K increased
      abnormally at the end of anaesthesia, probably due to minimal muscle damage
      induced by the dorsal recumbent position. Arterial blood gases did not change
      after the administration of NaCl 7.2% solution during anaesthesia. No specific
      clinical side-effects related to the use of hypertonic solution could be observed
      in the standing and anaesthetized ponies. Further studies are necessary to
      investigate the effects of hypertonic NaCl solution in horses with a disturbed
      fluid balance (hypovolemia).

PMID- 1621468
TI  - Cardiorespiratory parameters in draught horses before and after short term
      draught work pulling loads.
AB  - In order to establish the relationship between draught force and
      cardiorespiratory responses to exercise heart rate (HR), respiratory rate (RR),
      arterial and venous blood gases, pH, hemoglobin concentration and temperature
      were measured in five draught horses during rest, immediately after exercise and
      30 min post-exercise under field conditions. A wagon equipped with an odometer
      and a hydraulic dynamometer was used for measuring distance and draught force.
      The wagon was loaded with 946 kg for the low load, 1,979 kg for the medium load
      and 2,994 kg for the high load, and drawn for a distance of 1,500 m. Draught
      force and load weight were linearly related. The response of the draught horse to
      low and medium load exercise was characterized by a moderate increase in HR, RR
      and temperature with no significant changes in arterial blood gases and pH. An
      increase in HR, RR and temperature was observed, whereas no changes in arterial
      PO2 and increases in venous PO2 were noticed after high load exercise. Slight
      increase in venous lactic acid concentration as a result of high load exercise
      was observed, suggesting that some anaerobic work was performed. However this was
      insufficient to produce changes in blood pH. The increase in metabolic
      requirements during the three levels of draught exercise was associated with
      increases in arterial hemoglobin concentration and oxygen content of blood.

PMID- 1621469
TI  - The metabolism and urinary excretion of orotic acid in hyperargininaemic sheep.
AB  - The synthesis, blood plasma turnover and urinary excretion of the orotic acid in
      normo- and hyperargininaemic sheep was investigated. The whole-body orotate
      formation was evaluated indirectly by the measurement of urinary orotate
      excretion after blockage of pyrimidine pathway with 6-azauridine (4 hour i.v.
      infusion of 0.2 mg.kg-1.min-1). Simultaneous infusion of L-arginine (2.5
      mumols.kg-1.min-1) significantly elevated the blood plasma arginine, ornithine
      and urea level, however, it did not significantly influence urinary orotate
      excretion. In normoargininaemia blood plasma turnover of exogenous orotic acid
      amounted to 4.9 min and 67% of this compound was eliminated through the kidneys.
      The renal clearance of orotic acid amounted to 21.7 ml.min-1.kg-0.75.
      Hyperargininaemia elevated blood plasma turnover to 8.2 min, and diminished the
      renal clearance of this metabolite to 13.7 ml.min-1.kg-0.75. These results
      indicate that hyperargininaemia and hyperornithinaemia do not change the whole
      body synthesis of orotic acid in sheep but they can affect renal excretion of
      this metabolite, particularly at the rate of tubular secretion close to
      saturation.

PMID- 1621470
TI  - [Recording the feeding behavior of freely moving animals using the example of
      freely diving Weddell seals (Leptonychotes weddellii)].
AB  - During the antarctic summer 1990, the pattern of food intake in comparison to
      diving-activity was investigated on adult Weddell seals. Diving depths were
      recorded by a time-depth recorder (TDR). The TDR is a free programmable
      electronic datalogger, which can store data on up to 5 channels. It was fixed on
      the fur of the seal, ensuring that no longer lasting irritation of the animal was
      caused. The pattern of food-intake was monitored by measuring the jaw-movements,
      using strain gauges for recording the deformation of the muscles by mastication.
      After electronic amplification and filtering, the frequency of jaw-activity
      within a measuring period was recorded one channel of the TDR. By simultaneously
      observing the diving depths, these data may lead to conclusions about chewing
      patterns of the seal in water depths where they catch prey. The graph of these
      data and the mathematical evaluation by Fourier analysis and Plexogramme show a
      close correlation between diving depth and jaw-activity.

PMID- 1621471
TI  - Atlanto-occipital fusion in two polled Hereford calves.
AB  - Two cases of atlanto-occipital fusion were diagnosed in Polled Hereford calves.
      The cause, genetic or environmental, of this abnormality could not be determined.
      Since relatively minor traumatic forces during birth can cause severe injury in
      the head region, atlanto-occipital fusion should be ruled out in calves dying
      acutely after assisted parturition.

PMID- 1621472
TI  - Diagnosis of avian chlamydiosis: specificity of the modified Gimenez staining on
      smears and comparison of the sensitivity of isolation in eggs and three different
      cell cultures.
AB  - For the diagnosis of chlamydiosis in dead and live birds different methods were
      compared for their sensitivity and specificity. The specificity of the modified
      Gimenez staining and the direct immunofluorescence (DIF) test for direct
      demonstration of Chlamydia psittaci in organ, cloacal and/or conjunctival smears
      was examined. The sensitivity of the isolation of Chlamydia psittaci in 6 days
      embryonated specific pathogen free (SPF) chicken eggs, Buffalo Green Monkey (BGM)
      cell line, McCoy cell line and Vero cell line was compared. On smears, the direct
      immunofluorescence test was more specific than the modified Gimenez staining. The
      concordance between the results of both detection methods was 80%. The BGM cell
      culture was the most sensitive artificial host for isolation of Chlamydia
      psittaci, followed by the embryonated eggs, the Vero cell line and the McCoy cell
      line. The concordance between the results of isolation in BGM cell culture and
      eggs was 96.5%, while it was 86% between the results of isolation in BGM cell
      culture and Vero cell culture and only 65.5% between the results of isolation in
      BGM cell culture and McCoy cell culture. For dead bird species, chlamydiosis
      could be diagnosed more often using DIF on smears than with isolation. The
      concordance between the results of the DIF on smears and isolation followed by
      DIF was 91%.

PMID- 1621473
TI  - Occurrence of Campylobacter spp. in young gulls, duration of Campylobacter
      infection and reinfection by contact.
AB  - Two groups of three week old Herring Gulls (Larus argentatus) were held to
      observe the carrier state with Campylobacter. All 27 birds of group I excreted
      Campylobacter jejuni biotype III when they were caught from their colony. Four
      weeks later all but one were negative, indicating that the carrier state lasts
      until about the seventh week of life, with self-elimination if infection with
      another Campylobacter species is prevented by housing in a closed environment as
      in this study. Only one bird became reinfected one year later when gulls from
      group I were brought into contact with gulls from group II, consisting of ten
      freshly caught gulls, four of which were infected with the same biotype of
      Campylobacter, indicating that there might be some kind of immunity protection
      against infection with the same biotype of Campylobacter spp.

PMID- 1621474
TI  - Relationship between pathological findings and values of haematological and blood
      chemistry variables in apparently healthy finishing pigs at slaughter.
AB  - The present study was performed to study possibilities of early decision making
      for appropriate conveyor-line at future slaughtering of normal, clinically
      healthy finishing pigs. Blood was collected at slaughter from barrows (n = 112).
      A meticulous examination for subclinical pathological lesions was performed,
      revealing 5 groups of subjects listed in order of increasing disease-activity: 1-
      no real disease-activity; 2--with mild subchronic lesions; 3--with subacute
      lesions; 4--with abscesses; and 5--with fibrinous-necrotic lesions. Significant
      differences for values of erythrocyte sedimentation rate (ESR), protein, albumin,
      globulins, and plasma viscosity appeared to occur in this series. It is suggested
      that measuring acute phase reactants in blood of slaughtered pigs in the near
      future may reveal appropriate modern tools for meat inspection and predicting
      slaughtered animal quality.

PMID- 1621475
TI  - Cell surface hydrophobicity of Actinomyces pyogenes determined by hexadecane
      adherence- and salt aggregation studies.
AB  - Cell surface hydrophobicities of Actinomyces pyogenes were determined by
      measuring the adherence of the bacteria to hexadecane droplets and by salt
      aggregation tests. Among 42 A. pyogenes cultures tested 25 (60%) adhered strongly
      (adherence greater than or equal to 75%) and 17 (40%) less pronounced (adherence
      between 25-75%) to the hexadecane droplets. Pre-treatment of the bacteria with
      proteolytic enzymes completely eliminated the adherence properties whereas heat
      treatment had no effect. The salt aggregation studies revealed that 4 (10%)
      cultures aggregated in ammonium sulfate solutions of a molarity of 0.05 mol/l, 5
      (12%), 14 (33%) and 3 (7%) cultures in ammonium sulfate solutions with molarities
      of greater than or equal to 1.5 mol/l, greater than or equal to 3 mol/l and
      greater than or equal to 4.5 mol/l, respectively. No aggregation at all could be
      observed with 16 (38%) of the cultures. Pronase treatment completely eliminated
      the salt aggregation reactions, trypsin- and heat treatment had no effect. The
      results from hexadecane adherence and salt aggregation did not correspond. The
      differences in surface hydrophobicities, possibly related to adherence properties
      of A. pyogenes, could be used for epidemiological typing of individual cultures
      of this bacterial species.

PMID- 1621476
TI  - Hemolytic interactions of Dermatophilus congolensis.
AB  - The strains of Dermatophilus congolensis grew on blood agar with washed sheep
      erythrocytes with marked total hemolysis. In testing for hemolytic interactions
      they gave a significant synergistic effect of a characteristic shape with
      Rhodococcus equi and Streptococcus agalactiae, whereas with Staphylococcus aureus
      producing beta hemolysin and with Staphylococcus aureus producing delta hemolysin
      a simultaneous synergistic as well as antagonistic effect were observed. First of
      all a conspicuous inhibition of in the beta hemolysin zone began and then the
      hemolytic effect of D. congolensis was enhanced. A similar double reaction was
      also observed with Listeria ivanovii. With delta hemolysin there was an
      inhibition of the hemolytic effect of D. congolensis and at the same time a
      synergistic effect could be observed. Also D. congolensis gave a weak synergistic
      effect with Micrococcus lylae and Listeria monocytogenes, and a further weak
      antagonistic effect with alpha hemolysin of Staphylococcus aureus, Staphylococcus
      hyicus, Staphylococcus chromogenes and Micrococcus luteus. No interaction of D.
      congolensis was established with Corynebacterium pseudotuberculosis.

PMID- 1621477
TI  - Production of staphylococcal enterotoxins and TSST-1 by coagulase negative
      staphylococci isolated from ruminant mastitis.
AB  - The production of staphylococcal enterotoxins (SE) and toxic shock syndrome toxin
      1 by 40 coagulase negative staphylococci isolated from sheep, goat and cow
      mastitis was studied. Both ELISA double sandwich and Western blot were used to
      detect the production of these toxins. Only two strains of S. xylosus were
      enterotoxigenic, producing SEC. TSST-1 was seen to be produced by 5 strains of S.
      xylosus, 1 S. sciuri and 2 S. epidermidis. Results obtained by ELISA and by
      Western blot agreed in all cases except in one strain of S. epidermidis which was
      only positive using ELISA.

PMID- 1621478
TI  - Pathogenicity of Beauveria bassiana in mice.
AB  - The potential pathogenicity of Beauveria bassiana was examined by intramuscular
      injection of high (2 x 10(8)) or low (2 x 10(5)) concentrations of conidia
      spores, into the left or right quadriceps muscles of CD-1 mice, respectively. The
      injection sites were monitored over a period of 28 days by both microbiological
      and histopathological methods. Focal muscle necrosis, edema and inflammation
      occurred rapidly (within 12 hours) at the high dose application (2 x 10(8)) site,
      but such lesions were far less severe with the low dose spore application (2 x
      10(5)). Fungal spores in the high dose site persisted in normal shape for 2
      weeks, after which time they began to degenerate. Almost all spores were cleared
      from the injection site within the 28-day observation period. Spread to other
      organs of the body was not observed, except by macrophage transport to regional
      lymph nodes. At the low dose rate, most spores were cleared within 12 h to 2 d,
      leaving only mild focal edema and inflammation. Viable fungal colonies could be
      recovered up to 3 d after injection from the high dose site, but only up to 12 h
      from the low dose site. It was concluded that B. bassiana does not cause
      infection, nor multiply, nor survive for more than 3 days when injected
      intramuscularly into healthy mice.

PMID- 1621479
TI  - Seroprevalence survey for Anaplasma marginale-infection of Austrian cattle.
AB  - A serologic survey study of 5,076 Austrian cattle farming herds was carried out
      in the period of December 1988 till March 1990. One animal was randomly selected
      from each herd and the antibody titer against Anaplasma marginale in blood serum
      samples was evaluated by means of the complement fixation test. The number of
      these tested blood samples was 3.6% of 140,081 cattle herd farms of Austria. 109
      (2.1%) of the tested animals showed positive titers (1:10) against Anaplasma
      marginale, in relation to the 140,081 cattle herds 0.08%, 4,786 (94.3%) blood
      serum samples were sero-negative, 188 (3.8%) reacted anticomplementary. The
      highest number of antibody-positive animals of 8 tested Austrian districts could
      be found in Carinthia (46 = 5.7%). In Burgenland all tested sera turned out to be
      negative. Concerning the distribution of sero-positive animals in Austria it can
      be stated that a decrease of positive reactors from southern to northern region
      is evident. A connection between the occurrence of anaplasmosis in Italy,
      Yugoslavia, Switzerland and Hungary, is postulated as a result of the different
      systems of keeping cattle in the provinces and the regional increase of tick
      invasion. Possibly an intensive animal transportation is of importance due to the
      introduction of the disease mentioned before. The results obtained show that
      anaplasmosis does occur in different areas of Austria. For control of this
      disease in Austria it is proposed that all imported cattle should be tested
      serologically for antibodies against Anaplasma marginale. Other diseases in
      connection with anemia should be excluded by clinical, serological, blood-, as
      well as pathological examinations.

PMID- 1621480
TI  - Potent effect of recombinant growth hormone on bone mineral density and body
      composition in adults with panhypopituitarism.
AB  - Six patients (21-50 years) with growth hormone deficiency and panhypopituitarism
      were given recombinant growth hormone, somatotropin, 0.04-0.1 U.kg.body wt-1.day
      1, for 12 months. All patients reported improved well-being with increased
      working capacity. Bone mineral density, as measured by single photon
      absorptiometry at two sites on the forearm, showed increased values in 5/6
      patients after 12 months when measured at the most distal site (predominantly
      trabecular bone) and in 4/6 at the more proximal site (predominantly cortical
      bone). Five patients continued therapy for an additional year and after 18 months
      a significant increase in bone mineral density was seen at both the distal and
      proximal sites. The mean annual increase in bone mineral density was 12.0 +/- 0.6
      (SEM)% and 3.8 +/- 1.3% at the distal and proximal sites, respectively. In a
      growth hormone deficient control group without growth hormone therapy, the
      corresponding values were -2.4 +/- 0.6% and -1.9 +/- 0.4%, respectively. Lean
      body mass, estimated anthropometrically, increased significantly after 12 months
      and total body potassium, measured by whole body counting technique, increased in
      4/6 patients. During growth hormone treatment, the IGF-1 values were above the
      mean values for age and 50% of the values were above the mean +2 SD. B-glucose, P
      insulin, serum IGF-2, procollagen-III peptide and phosphate increased and urea,
      creatinine and IGF-binding protein-1 decreased during treatment. The beneficial
      effects of growth hormone substitution, especially on bone mineral density,
      indicate that growth hormone substitution should be considered in all patients
      with hypopituitarism and growth hormone deficiency, irrespective of age.

PMID- 1621481
TI  - Humoral immunity and retrobulbar fibroblasts in endocrine ophthalmopathy.
AB  - The exact role of retrobulbar fibroblasts in the immunopathogenesis of endocrine
      ophthalmopathy still remains to be elucidated. To evaluate the in vitro influence
      of humoral immunity on retrobulbar fibroblasts, the effects of immunoglobulin G
      as well as of the sera of 50 euthyroid patients with endocrine ophthalmopathy and
      30 controls on both porcine and human (patients' and controls') retrobulbar
      fibroblasts were measured by means of several assays: a colorimetric test
      involving a heterocyclic chemical, a tetrazolium bromide, was applied to quantify
      the activity of mitochondrial dehydrogenases; the incorporation of 3H-thymidine
      was determined as a sensitive parameter for cell proliferation, and an enzyme
      linked immunosorbent assay was to reveal specific binding of antibodies to the
      cells. There was consistently no significant difference between patients'
      (untreated or treated) and controls' IgG to bind to, to activate or to stimulate
      the proliferation of porcine and human (patients and controls) retrobulbar
      fibroblasts. The effects of patients' heat-inactivated and non-inactivated sera
      were indistinguishable from those of the controls. Incubation of autologous sera,
      however, led to an activation of retrobulbar fibroblasts which was both higher
      than the median caused by the patients' group and that engendered by incubation
      of autologous IgG. Yet, a significant role that humoral immunity might play
      directly on retrobulbar fibroblasts could not be detected in the experiments
      conducted in this study.

PMID- 1621482
TI  - Arginine-vasopressin and endothelium-associated proteins in thyroid disease.
AB  - Plasma concentrations of endothelium-derived proteins (fibronectin and von
      Willebrand factor), liver synthesized proteins (haptoglobin, transferrin,
      ceruloplasmin, alpha 1-antitrypsin, antithrombin III and factor VIII-coagulant)
      and plasma arginine-vasopressin (AVP) were measured in 12 hyperthyroid, 9
      hypothyroid and 15 age- and sex-matched normal controls. In hyperthyroid patients
      the plasma concentrations of AVP and endothelium-associated proteins (EAP) were
      significantly higher than in the control group (p less than 0.05 and p less than
      0.01 respectively). Rendering hyperthyroid patients into the euthyroid state
      significantly lowered AVP (p less than 0.01), fibronectin (p less than 0.05) and
      von Willebrand factor (p less than 0.01) compared with pretreatment levels.
      Hypothyroid patients were studied at diagnosis and after replacement therapy with
      levothyroxine. Compared with pretreatment values, significant increases were
      noted in plasma concentrations of von Willebrand factor, fibronectin and AVP (p
      less than 0.01). With the exception of factor VIII-coagulant, the concentrations
      of hepatic synthesized proteins did not deviate from normal values in
      hyperthyroid and hypothyroid patients. Significant correlations were found
      between serum-free thyroxine on the one hand and the plasma concentrations of
      fibronectin (p less than 0.005), von Willebrand factor (p less than 0.001) and
      AVP (p less than 0.0001). Similarly, there was significant correlation between
      the plasma concentrations of AVP on the one hand and fibronectin (p less than
      0.002) and von Willebrand factor (p less than 0.01). The results demonstrate
      elevated plasma levels of AVP in hyperthyroid patients and an increase during
      levothyroxine treatment of hypothyroid patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621483
TI  - An investigation of LH pulsatility in burned men by bioassay and
      radioimmunoassay.
AB  - LH pulsatility studies were performed in six burned patients by removing blood
      samples at 10 min intervals over a 6 h period. All samples were assayed for LH by
      bioassay (B-LH), LH by radioimmunoassay (I-LH) and testosterone. Mean serum
      testosterone concentrations of the burned patients were low (6.7 +/- 1.6 nmol/l).
      I-LH levels were lower than B-LH in all samples. Frequency of bioactive or
      immunoreactive pulses as well as mean B-LH and I-LH concentrations were similar
      to previously published data from normal men examined in the same laboratory. The
      mean biological activity of LH (expressed as the ratio of B-LH to I-LH, the B:I
      ratio) was lower in burned subjects (1.9 +/- 0.1) than previously reported in
      normal men. The B:I ratios of burned men were lower (p less than 0.01) at pulse
      peaks than at nadirs (1.8 +/- 0.1 vs 2.0 +/- 0.1) and an increase in serum
      testosterone concentration did not follow an LH peak. Serum testosterone
      concentrations did not cross-correlate with B-LH or I-LH. This contrasts with the
      findings in normal subjects where the B:I ratios have been found to be higher at
      pulse peaks than at nadirs and an increase in serum testosterone concentration
      follows a pulse peak and serum testosterone cross-correlates with B-LH and I-LH.
      LH secreted in a pulse peak in normal men may contain a particularly biologically
      potent form of the molecule but this may not be the case in burned men.

PMID- 1621484
TI  - Ovulation induction with a single-blind treatment regimen comparing naltrexone,
      placebo and clomiphene citrate in women with secondary amenorrhea.
AB  - Secondary amenorrhea is often associated with emotional stress, weight loss,
      eating disorders or polycystic ovary-like disease. Involvement of the endogenous
      opioids in the pathophysiology of hypothalamic amenorrhea, by inhibition of
      hypothalamic GnRH secretion, has been demonstrated in some cases. Chronic
      blockade of the endogenous opioids with the long-acting opioid antagonist
      naltrexone could result in increased gonadotropin secretion and ovulation
      induction in these cases. A single-blind ovulation induction protocol comparing
      naltrexone, placebo and clomiphene citrate was evaluated in eight patients with
      secondary amenorrhea. Naltrexone proved not to be more effective than placebo in
      our study. Only one patient ovulated on naltrexone, one on placebo and four on
      clomiphene citrate. The latter therapy caused a better endocrine response. In
      conclusion, although ovulation could be incidentally induced by naltrexone, this
      drug did not appear to be more successful than placebo and clomiphene citrate for
      ovulation induction in this population of patients.

PMID- 1621485
TI  - Evidence of intrathyroidal accumulation of TSH receptor antibody in Graves'
      disease.
AB  - To clarify the intrathyroidal accumulation of TSH receptor antibody (TR-ab)
      produced in the thyroid, adrenalin was injected directly into the thyroid artery
      of patients with Graves' disease during surgery, allowing serial determination of
      the TR-ab levels in the thyroidal venous blood. Nine surgical patients (3M and
      6F) with Graves' disease and receiving anti-thyroid drugs preoperatively for a
      period of one to four years were enrolled in this study. Comparison between pre-
      and posttreatment TR-ab levels revealed continuous increments from the
      pretreatment levels within 15 min of the injection in five (55.6%) of the nine
      patients. In three of the five patients, TR-ab levels that had been negative
      before adrenalin injection became positive 1 min after injection. It is assumed
      that the increase in the TR-ab level is due to adrenalin-induced constriction of
      the capillaries in the thyroid tissues, resulting in a voluminous flow of the TR
      ab retained in the thyroid into the vein. These findings indicate that the TR-ab
      level in the peripheral blood does not necessarily reflect precisely the abnormal
      immunological condition in the Graves' thyroid.

PMID- 1621486
TI  - Hormonal gradients between inferior petrosal sinuses in various pituitary
      diseases.
AB  - The aim of this retrospective study was to evaluate the existence of a
      multihormonal gradient between the inferior petrosal sinuses in various pituitary
      diseases: Cushing's disease (8 cases), acromegaly (4 cases), prolactinomas (7
      cases), GH, PRL-secreting adenoma (1 case), functionless adenoma (2 cases), empty
      sella (3 cases) and in non-tumoral hyperprolactinemia (5 cases). A significant
      intersinus gradient (more than 1.4:1) was recorded for GH, ACTH and PRL in 16
      patients (80%), but in only 9 patients (45%) out of the 20 with hormone-secreting
      tumors for TSH, FSH and LH. Moreover, of the 10 patients in the remaining groups,
      only in two cases was a significant intersinus gradient present: one for GH and
      one for LH. In conclusion, the finding of a multihormonal release in the inferior
      petrosal sinus ipsilateral to the adenoma is reported, for the first time, in
      patients with GH- and PRL-secreting adenomas. The possible explanation for such a
      finding may be either an increased blood flow in this site of sampling or a
      pituitary multihormone release through a paracrine mechanism primed by the
      tumoral hypersecreted hormone. In addition, the pulsatile secretory pattern and
      the short half-life of polypeptide hormones may contribute to better demonstrate
      this phenomenon in respect to glycoprotein hormones.

PMID- 1621487
TI  - Plasma oxytocin during the first and second stages of spontaneous human labour.
AB  - A technique for complete oxytocinase inhibition has been combined with a rapid
      serial sampling strategy to determine plasma oxytocin concentrations in twelve
      women during the early and late first stage and in eight women throughout the
      second stage of labour. The progress of labour is not related to an increase in
      oxytocin concentration, uterine contractions are not associated with changes in
      plasma oxytocin concentration and hypocontractile labour does not appear to be
      the result of a deficit of oxytocin. The majority of patients do not demonstrate
      an increase in plasma oxytocin concentration during the second stage of labour;
      however, a minority produce a large surge immediately before delivery. The
      results do not support a role for oxytocin during spontaneous labour unless
      uterine activity is controlled by extremely low plasma hormone concentrations or
      the uterus becomes sensitive to a constant oxytocin concentration.

PMID- 1621488
TI  - Brown adipose tissue thermogenesis in testosterone-treated rats.
AB  - The participation of sexual hormones in body weight regulation is partly
      accomplished by altering food intake. Nonetheless, female sexual hormones also
      alter brown adipose tissue thermogenesis in females. This study was aimed to find
      out if male hormones could alter brown adipose tissue thermogenesis in male rats.
      Testosterone was administered by means of Silastic capsules in adult male rats
      acclimated either at 28 degrees C (thermoneutrality) or at 6 degrees C (cold),
      treatment lasting 15 days. Food intake and body weight gain were reduced by
      hormonal treatment. However, brown adipose tissue mass, protein content,
      mitochondrial mass and GDP-binding were unchanged at both environmental
      temperatures. Accordingly, testosterone participation in body weight regulation
      is thought to be carried out without altering brown adipose tissue thermogenesis.
      A reduction in the weight of the sex accessory glands was also observed after
      cold acclimation.

PMID- 1621489
TI  - Dose-dependent stimulatory effect of human growth hormone on the strength and
      collagen deposition of colonic anastomoses in the rat.
AB  - The effects of treatment with four different doses of biosynthetic human growth
      hormone (b-hGH; 0.125 mg kg-1 d-1, 0.5 mg kg-1 d-1, 2.0 mg kg-1 d-1, 8.0 mg kg-1
      d-1) on the bursting strength and collagen deposition of rat colonic anastomoses
      were studied. Rats receiving 2.0 mg and 8.0 mg b-hGH demonstrated increases in
      the pre- and postoperative body weights, and the bursting strength and
      hydroxyproline content of the anastomotic segments in these groups were
      significantly higher than controls on day 4 postoperatively. The serum levels of
      insulin-like growth factor I (IGF-I) were significantly higher than the controls
      after four days of preoperative treatment in the groups receiving 2.0 mg and 8.0
      mg b-hGH, and postoperatively the IGF-I levels were significantly higher than
      those of the controls in the groups receiving 0.5 mg, 2.0 mg and 8.0 mg b-hGH per
      kg. Consequently, positive correlations were found between treatment doses of b
      hGH and anastomotic defatted dry weight, hydroxyproline content and bursting
      strength of colonic anastomoses.

PMID- 1621490
TI  - Fetal resorption in rats treated with an antiestrogen in relation to luteal phase
      nidatory estrogen secretion.
AB  - Centchroman was administered to rats in relation to luteal phase nidatory
      estrogen secreted between 21.00 on day 4 and 10.00 on day 5 of pregnancy. A
      single oral dose of 1.25 mg/kg before the secretion of nidatory estrogen, i.e.
      until 21.00 on day 4, prevented implantation in 100% of the rats without altering
      plasma estradiol or progesterone concentration. Administration of a dose of up to
      62.5 mg/kg at 10.00 on day 5 even failed to inhibit implantation, but caused dose
      dependent resorption of implantations. Resorption of all implantations at a dose
      of 62.5 mg/kg was associated with a decrease in circulating progesterone levels,
      but was only partially reversed by progesterone or progesterone + estrone
      supplementation. Apparently normal morulae and blastocysts recovered between days
      4 and 10 from rats treated with anti-implantation doses before release of
      nidatory estrogen, when transferred to the uteri of control rats exhibited lower
      pregnancy, implantation and development rates with increasing confinement in the
      genital tract of treated donors. None of the embryos recovered from control or
      centchroman treated females implanted in the uteri of treated rats. Centchroman
      administration on day 1, but not on day 5, abolished endometrial receptivity to
      an artificial stimulus for decidualization. All term fetuses were apparently
      normal and their weight comparable to that of control fetuses. The study provides
      evidence of post-implantation fetal resorption, occurring primarily between days
      10 and 19 post-coitum, in rats treated with a potent antiestrogen before or
      immediately after the prenidatory estrogen secretion.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1621491
TI  - High-dose intravenous immunoglobulin treatment in Graves' ophthalmopathy.

PMID- 1621492
TI  - Mechanisms of baclofen action on spasticity.
AB  - This investigation estimated the mechanisms of baclofen action on spasticity
      using a battery of electromyographic methods. Thirty patients with old post
      stroke spastic hemiparesis took part in the investigation. They were treated with
      baclofen-mean daily dose 54.3 alpha 11.6 mg for a mean of 26.3 alpha 4.9 days. A
      questionnaire for assessment of subjective improvement after treatment used a 5
      point scale. For standardization of the neurological examination 5-point scales
      were used to assess muscle tone, muscle force and tendon reflexes. A battery of
      electromyographic methods was used to analyse different mechanisms of spasticity:
      for alpha motoneurone activity--the F wave parameters; for gamma motoneurone
      activity--the T/H reflex amplitude ratio; for presynaptic inhibition--the ratio
      of H reflex amplitudes before and after vibration on the achilles tendon
      (Hvibr./Hmax); for common interneurone activity--the flexor reflex parameters.
      Our results revealed that baclofen reduces spastically increased muscle tone and
      Babinski sign. It has no influence on muscle force, tendon reflexes and ankle
      clonus. Baclofen acts by normalizing the altered interneurone activity and
      decreasing of alpha motoneurone activity. When spasticity has altered
      interneurone activity and increased motoneurone activity, it is better to treat
      with baclofen.

PMID- 1621493
TI  - Cerebral blood flow findings in moyamoya disease in adults.
AB  - Three adult patients with moyamoya disease are described. They presented with
      intracerebral hematoma, cerebral infarction and subarachnoid hemorrhage,
      respectively. Subarachnoid hemorrhage is rare in moyamoya and is usually the
      result of aneurysm rupture. No aneurysm was found in our patient. Regional
      cerebral blood flow (rCBF) and the cerebral perfusion reserve assessed by the
      acetazolamide test, were significantly reduced in all three patients. The areas
      with most reduced baseline rCBF and most impaired vasoreactivity did not always
      correspond to the site of the vascular accident, indicating that these CBF
      changes were at least in part due to the moyamoya disease and/or its underlying
      causes, and not solely to the vascular accidents.

PMID- 1621494
TI  - Allelic heterogeneity in group A xeroderma pigmentosum.
AB  - The molecular basis of Group A xeroderma pigmentosum was investigated by
      restriction fragment length polymorphism analysis of PCR-amplified DNA sequences
      using the two restriction enzymes, endonucleases AlwN I and Hph I. The clones of
      a patient with Group A xeroderma pigmentosum who had typical symptoms showed a G
      C substitution at the 3' splice acceptor site of intron 3. However, of the two
      atypical Group A xeroderma pigmentosum patients with mild skin lesions and
      minimal neurological abnormalities, the milder one showed homozygosity for the
      nonsense mutation of exon 6, while the other patient with slightly greater
      central nervous involvement was shown to be a compound heterozygote for the
      splicing mutation of intron 3 and the nonsense mutation of exon 6, thus
      indicating an allelic heterogeneity in group A xeroderma pigmentosum.

PMID- 1621495
TI  - Neurological complications after thrombolytic treatment for acute myocardial
      infarction: emphasis on unprecedented manifestations.
AB  - We examined 348 patients who underwent thrombolytic treatment for acute
      myocardial infarction. Nine patients (2.58%) developed neurological complications
      related directly or indirectly to this procedure. Cerebral hemorrhage occurred in
      3 patients; 2 patients had transient ischemic attacks, 1 had syncope, another had
      psychomotor agitation and 2 patients presented seizures during the infusion of
      the thrombolytic agent, without hemodynamic abnormalities. This latter feature
      had never been described before.

PMID- 1621496
TI  - Effects of perineural opioids on nerve conduction of N. suralis in man.
AB  - In this study the effects of agonist acting drugs (morphine sulphate, fentanyl
      citrate and meperidine hydrochloride) on nerve conduction were studied in 43
      healthy young volunteers divided into four groups randomly. According to
      analgesic equivalent doses, the first group received 2 mg morphine sulphate, the
      second group 0.02 mg fentanyl citrate, the third group 20 mg meperidine
      hydrochloride, and as control the fourth group received 2 ml of saline. The
      latencies, amplitudes of the responses and nerve conduction velocities were
      obtained immediately before and every 5 min after injections up to 30 min. No
      significant change was observed within or among the morphine sulphate, fentanyl
      citrate and saline groups whereas in the meperidine hydrochloride group the
      amplitudes diminished significantly and this finding was still apparent at 30
      min. Four of the cases displayed complete blocks. Nerve conduction velocity did
      not change in the other 6 cases. The significant decrement of the amplitude of
      the compound nerve action potential in the meperidine hydrochloride group is
      probably due to local anesthetic-like action of this drug. Morphine sulphate,
      fentanyl citrate or saline did not show this effect.

PMID- 1621497
TI  - Variations of homovanillic acid levels in ventricular cerebrospinal fluid.
AB  - We studied the nycterohemeral variations of homovanillic acid (HVA) in
      ventricular cerebrospinal fluid (CSF) in 24 patients undergoing monitoring of
      intracranial pressure as part of the normotensive hydrocephalus (NTH) work-up.
      CSF samples were obtained every 4 h in each patient. The mean individual values
      of HVA in the ventricular CSF ranged from 133 to 421 ng/ml, and they could not be
      correlated to any clinical feature. The intraindividual levels of HVA were stable
      throughout 24 hours, with a variation coefficient inferior to 10% in 63% of
      cases, and inferior to 20% in all the patients.

PMID- 1621498
TI  - Endocrine function in multiple sclerosis.
AB  - In 31 patients with multiple sclerosis (MS) the endocrine functions of the
      hypothalamus, the pituitary and several peripheral endocrine glands were assessed
      with a combined pituitary test; 3/31 patients had an endocrine disease: one
      primary hypothyroidism, one primary amenorrhea and one primary male hypogonadism.
      We found no patient with endocrine disease of the hypothalamus, the pituitary or
      the adrenals. However, the poststimulatory secretion of cortisol, growth hormone
      or thyroid-stimulating hormone was impaired in 7/31 patients, suggesting a
      possible preclinical endocrine insufficiency in these patients.

PMID- 1621499
TI  - Attentional processing in cervical spine syndromes.
AB  - Fifty-four patients suffering from "common whiplash" were compared with 28
      patients complaining of cervical spine syndrome caused by rheumatism (Barre-Lieou
      syndrome). All patients underwent clinical interview and formal testing. Formal
      testing included personality profile, self ratings of cognitive impairment and
      well-being, and tasks on divided attention and speed of information processing.
      In the "common whiplash" group higher relative incidences of adjustment disorder
      were found. In both groups scoring for divided attention was low. With regard to
      self-ratings, the group suffering from Barre-Lieou syndrome hardly indicated any
      problems while the "common whiplash" group showed significant impairment. This
      difference of self-ratings was assumed to reflect the different modes of
      development of the investigated syndromes: in the group with cervical syndrome
      due to rheumatism the condition gradually developed giving the patient the
      possibility to adapt, while in the "common whiplash" group cervical pathology
      emerged abruptly by impact injury. Adaptation in the latter group was inadequate
      which in particular explains the appearance of adjustment disorders amongst
      "common whiplash" patients. Results indicated that headache due to cervical
      pathology is likely to be responsible for impaired attentional functioning of
      "common whiplash" patients.

PMID- 1621500
TI  - Opsoclonus in a patient with Guillain-Barre syndrome.
AB  - A 54 year-old woman showed the unusual association of a Guillain-Barre syndrome
      and opsoclonus, a rare eye movement characterized by involuntary bursts of
      jerking, ataxic and multidirectional saccades, without an intersaccadic interval.
      Since opsoclonus is a phenomenon described exclusively in CNS diseases, the case
      reported supports the hypothesis of CNS involvement in some cases of Guillain
      Barre syndrome. The latter is generally considered an immune-mediated disease and
      an immune pathogenesis is also supposed in opsoclonus associated with systemic
      malignancies; besides, in the patient reported, the self-limiting nature of the
      disturbance and the lack of MRI lesions suggest that opsoclonus may result from
      an immune-related phenomenon causing a functional and transitory dysfunction of
      the CNS.

PMID- 1621501
TI  - Immunoreactive leukotriene C4 levels in CSF of MS patients.
AB  - Using a sensitive and specific radioimmunoassay levels of leukotriene (LT)C4-like
      material were estimated in lumbar cerebrospinal fluid (CSF) samples from patients
      with multiple sclerosis (MS) in comparison to control patients with or without
      inflammatory processes in the central nervous system (CNS). Levels of LTC4-like
      material were significantly elevated (p less than 0.01) in CSF from patients with
      inflammatory diseases such as meningitis, polyradiculitis or meningoencephalitis
      (57 +/- 53 pg/ml, n = 16) as compared to those from control patients without
      inflammatory or immunological CNS diseases (21 +/- 16 pg/ml, n = 42). By
      contrast, LTC4-like material was 16 +/- 7 pg/ml in first manifestations of MS (n
      = 7). 21 +/- 16 pg/ml in remitting-relapsing MS (n = 15) and 10 +/- 6 pg/ml in
      chronic progressive MS (n = 8). These results argue against a significant
      pathophysiological role of cysteinyl-LT in MS.

PMID- 1621502
TI  - Malignant meningioma metastasizing through the cerebrospinal pathway.
AB  - A case of malignant meningioma metastasizing through the cerebrospinal pathway is
      presented. The primary tumor was a parasagittal malignant meningioma invading
      into the brain. The tumor seeded to the cerebellopontine angle cistern and
      thoracic spine after multiple operations. Although this type of tumor borders the
      CSF, metastasis through the cerebrospinal pathway is rare, and only 18 such cases
      have been reported (2, 3, 10, 12).

PMID- 1621503
TI  - The adult and a new late adult forms of neuronal ceroid lipofuscinosis.
AB  - Three cases of the late adult form of neuronal ceroid lipofuscinosis (NCL) are
      reported. Two of these are siblings with a late clinical onset at ages 26 and 44
      years. The third case, sporadic, has the oldest reported age for the onset of
      NCL, at 63 years and may be regarded as the first example of the "presenile" form
      of NCL. The clinical, morphological, histochemical, ultrastructural and genetic
      features of these three cases are discussed. The literature of the
      clinicopathological NCL cases with an onset at age of 25 and older is reviewed.
      The clinical and morphological differences between the late adult form and the
      presenile form of NCL as well as the difficulties in making the diagnosis are
      discussed.

PMID- 1621504
TI  - The role of extracellular matrix in peripheral nerve regeneration: a wound
      chamber study.
AB  - A wound chamber model was used for the study of the interaction between axon,
      Schwann cell and extracellular matrix during peripheral nerve regeneration.
      Impermeable silicone tubes, 8 mm long and 1.4 mm in internal diameter were
      sutured to transected rat sciatic nerve and the contents of the tubes were
      removed at intervals for chemical, histological, immunocytochemical and electron
      microscopic studies. There was an initial phase of fluid accumulation and the
      formation of a fibrin/fibronectin clot or cable which connected the cut ends of
      the nerve. The chamber fluid was shown to have a protein profile similar to that
      of rat serum. Schwann cells, endothelial cells and fibroblasts migrated first
      into the cable, apparently mediated by cell-fibrin interaction. Axons buried
      within the Schwann cell cytoplasm were led into the cable but an axon-fibrin
      interaction was not observed. After 1 week, the fibrin matrix underwent
      dissolution, with replacement by collagen. This marked the onset of myelination
      and the organization of nerve fibers into fascicles. The findings from the
      present study suggest that the interactions between axon and Schwann cell and
      between Schwann cell and a changing extracellular matrix are the essential
      driving force in nerve growth and differentiation during peripheral nerve
      regeneration.

PMID- 1621505
TI  - The changing pattern of human immunodeficiency virus-associated cerebral
      toxoplasmosis: a study of 46 postmortem cases.
AB  - Frequency, pathogenesis and morphological features of toxoplasmosis were assessed
      in a consecutive autopsy study. Among 204 patients who died from AIDS in Zurich
      during 1981-1990, 46 (23%) showed morphological evidence of cerebral
      toxoplasmosis. In 38 out of 46 cases (83%), toxoplasmosis was restricted to the
      central nervous system (CNS) and, therefore, pathogenetically classified as
      reactivation of a latent infection. Acute, systemic toxoplasmosis most frequently
      involved heart and lungs in addition to the CNS and was observed in 7 cases
      (15%). These patients probably acquired the infection during HIV-induced
      immunosuppression. Latent infection with intracerebral tissue cysts but no
      inflammatory response was present in only one case. Diffuse, necrotizing
      toxoplasma encephalitis with widespread, confluent areas of necrosis was mainly
      observed during the early period of the AIDS epidemic and restricted to 6
      patients (13%) who did not receive chemotherapy. The majority of patients (83%)
      had multiple, macroscopically well-circumscribed abscesses with preferential
      location in the cerebral hemispheres. Of all CNS regions, the rostral basal
      ganglia were most frequently affected (78% of cases). Since 1989, chronic, burnt
      out lesions were observed. These were mainly composed of lipid-laden macrophages
      and immunocytochemistry for Toxoplasma gondii usually failed to detect the
      parasite. This changing pattern of CNS lesions probably reflects improved
      clinical management of patients with AIDS.

PMID- 1621506
TI  - Formation of "dark" (argyrophilic) neurons of various origin proceeds with a
      common mechanism of biophysical nature (a novel hypothesis).
AB  - Based on recent findings described in accompanying reports as well as on relevant
      observations in the literature we hypothesize that: (1) the fundamental elements
      in the mechanism of the formation of "dark" (argyrophilic) neurons are
      independent of the causative conditions including post-mortem or in vivo
      mechanical injuries and various in vivo pathometabolic processes such as blood
      recirculation following ischemia; (2) the causative conditions, each in its own
      mechanical or metabolic way, induce the same morphopathological damage at one
      point only within each affected neuron; (3) this damage spreads throughout the
      respective somato-dendritic or axonal domain and entails type III argyrophilia;
      (4) the intraneuronal spread of the morphopathological damage consumes mechanical
      energy stored by the neurofilaments in the form of a metastable inner structure,
      and (5) is propagated by a process working, in certain structural and energetical
      respects, on the domino principle; and (6) the primary neuronal damage caused in
      the above manner might be secondarily modified in different directions by
      different postcausation conditions.

PMID- 1621507
TI  - The effect of age and Alzheimer's disease on pyramidal neuron density in the
      individual fields of the hippocampal formation.
AB  - Pyramidal neuron density was determined at autopsy in the brains of 12
      neurologically normal patients (age range 6-87 years) and 18 patients with
      histopathologically confirmed Alzheimer's disease (AD; age range 62-89 years).
      Paraffin wax sections were cut at the level of the central part of the cornu
      ammonis and stained with cresyl fast violet. Pyramidal neuron density was
      determined in the stratum pyramidale of the presubiculum, subiculum, prosubiculum
      and CA1-4. The width of the stratum pyramidale in these areas was also
      determined. There was no significant effect of age on pyramidal neuron density in
      any of the fields of the hippocampal formation. However, there was a significant
      decrease in pyramidal neuron density in the subiculum (44%), prosubiculum (28%)
      and CA1 (41%) of AD brains compared to controls. There was no significant effect
      of AD on pyramidal neuron density in the presubiculum, CA2 and CA3, but in CA4 it
      increased (23%) significantly. Pyramidal band width decreased significantly with
      age in the presubiculum but there was no effect of age on any other region of the
      hippocampal formation investigated. The width of the stratum pyramidale was
      significantly lower in the presubiculum (19%), subiculum (30%) and CA3 (17%) of
      AD compared with control brains. These data suggest that a reduction in pyramidal
      neuron density within the hippocampal formation does not occur in the absence of
      underlying pathology. In AD, pyramidal neuron loss predominantly occurs from that
      sector of the hippocampal formation which comprises the subiculum, prosubiculum
      and CA1.

PMID- 1621508
TI  - Hippocampal pathology in fatal non-missile human head injury.
AB  - The hippocampus has been known to be involved in fatal non-missile human head
      injury, although detailed histopathology of this lesion has yet to be described.
      This report documents the frequency and distribution of hippocampal damage in a
      consecutive series of 112 fatal human non-missile head injuries. Damage to the
      hippocampus was noted in 94 cases (84%). Lesions always involved the CA1 subfield
      and were bilateral in 70 cases. Other subfields of the hippocampus were involved
      less frequently. Lesions were focal in the majority of cases (58%). Pathological
      evidence of high intracranial pressure was present in 86% of the cases. Hypoxic
      brain damage in other regions of the brain was present in 74% of cases. Thus, the
      hippocampus is frequently damaged in fatal non-missile human head injury. The
      pattern of this damage is similar to that observed in experimental head injury.
      Hypoxia and high intracranial pressure are likely to contribute to the occurrence
      of human traumatic hippocampal damage but other mechanisms, such as
      excitotoxicity, are likely to be operative.

PMID- 1621509
TI  - Affection of the hippocampal granule cells in pontosubicular neuron necrosis.
AB  - The dentate fascia of the hippocampus was studied in 25 infants with
      pontosubicular necrosis and in 21 control cases without hypoxic cerebral lesions.
      Of the control cases 19 were completely normal and 2 showed one single necrotic
      cell in the granule cell layer. In contrast 15 of the cases with pontosubicular
      necrosis showed varying degrees of neuronal karyorrhexis in the dentate fascia.
      The severity of these changes largely parallelled those in the subiculum but
      there were exceptions to this rule. It is concluded that the dentate fascia is
      frequently involved in pontosubicular necrosis.

PMID- 1621510
TI  - Primary leptomeningeal glioma: ultrastructural and laminin immunohistochemical
      studies.
AB  - We studied a case of primary leptomeningeal glioma (PLG) on the left parietal
      lobe of a 74-year-old woman and compared the tissue with heterotopic glial tissue
      from another case. The PLG tumor consisted of spindle-shaped cells with marked
      nuclear atypism, which tended to be arranged in a fascicular pattern, and the
      majority of its cells were positive for glial fibrillary acidic protein.
      Ultrastructural examination demonstrated that most of the tumor cells contained
      intermediate filaments and often junctional complexes were present on their
      plasma membranes. Frequently, basal lamina-like structures surrounding the tumor
      cell surfaces were observed. Laminin immunohistochemistry clearly demonstrated a
      fine network of linear positive staining around the cytoplasm and processes of
      the tumor cells. The ultrastructure of the heterotopic glial tissue consisted of
      many astrocytes partially surrounded by basal lamina. These findings strongly
      suggest that PLG is a distinct tumor, which arises from the heterotopic
      astrocytes within the subarachnoid space.

PMID- 1621511
TI  - Giant axonal neuropathy: report on a case with focal fiber loss.
AB  - We report on a 5 1/2 year-old boy with chronic progressive polyneuropathy,
      ataxia, and pyramidal signs. His hair was not curled. Sural nerve biopsy
      disclosed many axons enlarged by accumulation of 10-nm neurofilaments and a
      marked variability in the number of myelinated fibers as well as in the amount of
      axonal enlargements among different fascicles. These findings and the
      electrophysiological data were consistent with a giant axonal polyneuropathy with
      a multifocal fiber loss.

PMID- 1621512
TI  - Creutzfeldt-Jakob disease with amyloid angiopathy: diagnosis by immunological
      analyses and transmission experiments.
AB  - It was difficult to make a definite pathological diagnosis in a 73-year-old man
      with Creutzfeldt-Jakob disease (CJD) due to extensive amyloid angiopathy which
      lacked any severe spongiform changes. Immunostaining using anti-prion protein
      (PrP) antibody revealed fine granular deposits in the gray matter, after
      hydrolytic autoclaving pretreatment on tissue sections. Western blotting also
      revealed an abnormal isoform of PrP, but PrP gene analysis did not show any
      abnormalities. The primary transmission experiments were repeated three times and
      induced spongiform encephalopathy in a few mice after a long incubation period.

PMID- 1621513
TI  - Prepontine cyst lined by respiratory epithelium with squamous metaplasia:
      immunohistochemical and ultrastructural study.
AB  - An 8.5-year-old female presented with multiple episodes of aseptic meningitis and
      was found to have a cystic lesion in the prepontine region. Microscopic
      examination revealed a respiratory-type epithelium with squamous metaplasia. Like
      its normal analogue in the respiratory tract, the epithelium of these
      intracranial cysts can undergo squamous metaplasia when chronically irritated.
      The ultrastructural and immunohistochemical characteristics of the transition
      from ciliated epithelium to squamous metaplasia are described.

PMID- 1621514
TI  - The acoustic cortex in Alzheimer's disease.
AB  - The morphology of the acoustic cortex was studied in light and electron
      microscopy, in 6 post mortem cases of Alzheimer's disease. Silver impregnation
      techniques and routine stainings were applied for the study of the
      cytoarchitecture and the cellular morphology of the acoustic cortex. Samples from
      every part of the acoustic cortex were processed for electron microscopy. The
      morphological findings were correlated with those of normal controls of relevant
      age, as well as with the temporal isocortex of the anterior part of the superior
      temporal gyrus. Silver impregnation techniques revealed a marked loss of
      dendritic spines in the second, third and fourth cortical layers. An obvious
      decrease of the axonic collaterals of the large triangular and round neurons was
      also seen. Neurofibrillary tangles were found in the soma and the initial part of
      the axon in a large number of neurons, being more prominent in the neurons of the
      second and third cortical layers. Senile plaques were dispersed all over the
      acoustic cortex. Electron microscopy revealed numerous paired helical filaments
      (PHF) located mostly in the soma and the axons of the large neurons as well as
      numerous Hirano bodies. Synaptic alterations, such as polymorphism of the
      synaptic vesicles in the presynaptic terminals, dilatation of the synaptic cleft
      and accumulation of osmiophilic material in the postsynaptic terminals were seen
      in numerous synaptic profiles in the acoustic cortex. The rare dendritic spines
      developed synaptic contact practically only with one presynaptic terminal, in
      contrast to the normal controls which demonstrated numerous dendritic spines
      developing synapses with more than one presynaptic terminal. The morphological
      alterations in the acoustic cortex might explain the profound deficit in verbal
      memory and the language disturbances that are hallmarks in early cases of
      Alzheimer's disease.

PMID- 1621515
TI  - Vitamin K deficiency in infancy: the Japanese experience.

PMID- 1621516
TI  - Prophylaxis of vitamin K deficiency in infancy.
AB  - A prospective study was performed in Okazaki, Japan, to attempt to establish a
      more effective system of prophylaxis for vitamin K deficiency in infancy (VKDI).
      During the first year, a Normotest (Hepaplastintest) was performed in all infants
      at one week and at one month of age. Two mg of vitamin K was administered orally
      to those whose Normotest values were below 40%. i.e., the non-prophylactic
      administration of vitamin K (NPVK). During the second year of the study, all
      newborn infants received prophylactic vitamin K (PVK) within 24 hours of birth
      and at one week of age. The dosage was repeated at one month of age depending on
      the Normotest value. A total of 7,059 infants, comprising 93.3% of the live
      births in the city of Okazaki, were enrolled in this study. Data from 5,431 of
      these infants were used in the analysis of the results. In the NPVK group, 20 of
      the 2,791 infants had Normotest values below 40% at one month of age while 20 of
      the 2,640 in the PVK group had low values despite the prophylactic administration
      of vitamin K. Considering the prevalence of low Normotest values (less than or
      equal to 40%) at one month of age and the predicted Normotest values, it was
      concluded that the month of birth (June-September), the age of the mother (21-29
      years), the birth order (first-born) and male sex are risk factors for vitamin K
      deficiency in infancy.

PMID- 1621517
TI  - Analysis of blood spot 17 alpha-hydroxyprogesterone concentration in premature
      infants--proposal for cut-off limits in screening for congenital adrenal
      hyperplasia.
AB  - Blood Spot 17 alpha-hydroxyprogesterone (17-OHP) concentrations in neonates,
      especially in premature babies, were determined in relation to 1) the gestational
      age at birth, 2) the equivalent age of gestation at blood sampling and 3) the
      birth weight. The 17-OHP concentrations were found to be higher with prematurity.
      Accordingly, the cut-off limit in screening for congenital adrenal hyperplasia
      (CAH) in premature infants is proposed as 20 ng/ml. Ideal cut-off limits were set
      by the equivalent age of gestation at blood sampling. Cut-off limits on the basis
      of gestational age at birth and birth weight are also suggested, where the
      sampling age is not so advanced. The rate of false positivity in premature
      infants can be reduced by this method.

PMID- 1621518
TI  - Development of sound localization.
AB  - Perceptual sound localization is determined from differences in time and loudness
      of signals arriving separately at bilateral ears, with the time difference being
      the more important one. The author examined the development of sound
      lateralization using a self-recording device developed by Sato. It measures the
      sensitivity of sound lateralization on the basis of time and loudness differences
      separately. Subjects were 59 children aged 2 to 18 years and 12 adults who were
      audiologically and neurologically normal. Sound stimulus was 500 Hz continuous
      band noise. (1) The testable rate was increased in children older than the age of
      4, and all children over 7 years of age could be tested. (2) Children over 4
      years of age could lateralize sound on the basis of time difference. Sensitivity
      to time differences improved rapidly, showing a steep curve, in children from the
      ages of 4 to 6, and then increased slowly until adulthood. (3) Sensitivity to
      loudness differences increased and standard deviation decreased with age. There
      is a possibility that children aged 4 can discriminate loudness difference almost
      as well as adults.

PMID- 1621519
TI  - Severe neonatal nemaline myopathy--histological and histochemical studies of
      respiratory muscles.
AB  - The histological and histochemical findings in the respiratory muscles of a
      patient with severe neonatal nemaline myopathy are described. The patient
      suffered from frequent pneumonia associated with vomiting due to gastroesophageal
      reflux and died at 3 months from respiratory failure. The diaphragm was
      moderately involved and the intercostal muscles mildly involved. Core/targetoid
      structures were observed in the diaphragm and intercostal muscles.

PMID- 1621520
TI  - Methicillin-resistant Staphylococcus aureus empyema in children.
AB  - Over a 14 year period, there were 20 patients who presented with staphylococcal
      empyema from whom methicillin-resistant Staphylococcus aureus (MRSA) was
      isolated. Twelve cases were community-acquired and 8 were hospital-acquired
      infections. Patients were treated with penicillinase-resistant penicillin,
      cephalosporin or carbapenem in combination with or without aminoglycoside. They
      were also treated with drainage or thoracentesis. However, they were refractory
      to treatment and 7 patients, 6 of whom were suffering from bacteremia, died. One
      bacteremic patient was treated with vancomycin and was cured. In an area of
      endemic MRSA, vancomycin may be the first choice in the initial treatment of
      staphylococcal empyema until antimicrobial susceptibility can be determined.

PMID- 1621521
TI  - An unusual variant of chromosome 16 in three generations.
AB  - An unusual variant of chromosome 16, 16p+, in three generations is described.
      This is the first clinical report of 16p+ in Japan.

PMID- 1621522
TI  - Inherited deficiency of the ninth component of complement associated with
      streptococcal infection.
AB  - A 7 year old boy, who presented with streptococcal infection, was found to have a
      low serum complement level (CH50). The C9 component was undetectable. His CH50
      rose to the normal value and remained normal for at least three weeks, but
      decreased to one-third of the normal level three months later. Family studies
      were consistent with a familial C9 deficiency, with autosomal co-dominant
      inheritance.

PMID- 1621523
TI  - Meningeal malignant melanoma in a child: immunocytological diagnosis.
AB  - A 10 year old boy, who was thought to have had a traumatic intracranial
      hemorrhage, was transferred to our Children's Medical Center. In spite of
      conservative treatment, he developed dysarthria, systemic convulsions,
      unconsciousness, quadriplegia, and consecutive paralysis of the cranial nerves.
      Magnetic resonance imaging scans demonstrated areas of increased signal intensity
      around the brain stem. The cerebrospinal fluid (CSF) contained a few large cells
      with abundant melanin-like granules, and numerous bizarre cells. The latter were
      considered to be malignant melanoma cells on immunocytological examination.
      Chemotherapy with dimethyltriazenoimidazole carboxamide (DTIC) and interferon
      beta (IFN-beta) was ineffective and he expired. Autopsy revealed diffuse
      infiltration of malignant melanoma cells into the meninges. We think that
      immunocytological examination of CSF is advisable for correct and rapid
      diagnosis.

PMID- 1621524
TI  - Intravenous gamma-globulin therapy in Diamond-Blackfan anemia.
AB  - Pure red cell aplasia (PRCA) is a rare disorder of erythrocyte production which
      is believed to have an autoimmune basis in most cases. Diamond-Blackfan anemia
      (DBA) is one type of congenital PRCA. Since PRCA has been reported to respond to
      intravenous gamma-globulin (IVGG) therapy, we administered IVGG to a 2 year old
      girl with DBA resistant to corticosteroids and observed slight therapeutic
      effect.

PMID- 1621525
TI  - Estrogen therapy in Turner's syndrome.
AB  - Girls with Turner's syndrome are born short, grow slowly, and usually fail to
      enter puberty spontaneously and to undergo a pubertal growth spurt. The goal of
      estrogen therapy is to correct estrogen deficiency in a manner that optimizes
      height potential, permits attainment of normal bone mass, and provides
      appropriate feminization with minimal risk of adverse effects. The issues to be
      resolved include the age at which treatment should be begun, the preparation,
      route of administration, and dosage to be given, the effect on concurrent growth
      hormone administration, the rate of dose increase during treatment, the timing
      and nature of progestin administration, and the total duration of treatment. The
      available data suggest that treatment should be initiated between the ages of 12
      and 14 years. The dose-response relationship between growth rate and estrogen
      dose is biphasic. Optimal growth stimulation for ethinyl estradiol occurs at
      approximately 100 ng/kg body weight per day, which is below the dose that
      produces full feminization. Although suboptimal doses of estrogen and growth
      hormone appear to have additive effects, estrogen causes only a minor increase in
      the short-term growth response to an optimal dose of growth hormone. The long
      term effects of estrogen combined with growth hormone are unknown. In the absence
      of data concerning the outcome of different dose schedules, we treated for 2
      years at 100 ng/kg/day of ethinyl estradiol, then double the dose annually until
      menstruation, at which time cyclic monthly progestin therapy is added
      (medroxyprogesterone acetate 10 mg daily from days 16 to 25). The importance of
      estrogen in maintaining normal bone mass suggests that treatment should be
      lifelong. Current research in our clinic is assessing the long-term effect on
      adult height of ultra-low-dose treatment (25 to 50 ng/kg/day of ethinyl
      estradiol) during the childhood years (ages 5 to 11), alone or in conjunction
      with supplemental growth hormone.

PMID- 1621526
TI  - Standards for growth and growth velocity in Turner's syndrome.
AB  - Turner-specific natural growth and growth velocity curves based on the
      retrospectively surveyed growth data of 704 Japanese patients in a mixed cross
      sectional and longitudinal mode are reported. There was no significant difference
      in growth between the patients with karyotype 45,X and non-45,X. Twenty-three
      patients had a history of genital bleeding between the ages of 11 and 14 years
      (12 years +/- 9 months). The mean height of the patients with genital bleeding
      did not differ significantly from that without bleeding from birth until 1 year 3
      months of age but thereafter the former were always significantly taller than the
      latter. The former ceased growing after 18 years; on the other hand the latter
      were still growing after 18 years and then the final height of each group of
      patients became almost the same (139.6 +/- 3.5 cm in the former and 139.1 +/- 5.6
      cm in the latter). A slight and gentle growth spurt was observed during the
      expected adolescent period in both groups, with and without genital bleeding.
      However, the mean height of peak (1.3 +/- 0.95 cm/year) and the mean peak
      velocity (5.2 +/- 1.1 cm/year) in the patients with genital bleeding were
      significantly higher than those (0.7 +/- 0.36 and 3.8 +/- 0.6 cm/year,
      respectively) in the patients without genital bleeding.

PMID- 1621527
TI  - Characteristics of pubertal growth in Japanese children from the standpoint of
      skeletal growth.
AB  - Since the end of the 2nd World War, Japan has seen quite rapid socioeconomical
      development. With this development the physical size of Japanese children has
      increased, but the final size, especially the stature, is still shorter than that
      of Americans or Europeans. Bone maturation velocities were compared among
      Japanese and Chinese children and adolescents aged 7 to 18 (in 1986) and English
      TW2-subjects, using the TW2 method. Asian children and adolescents may have a
      different tempo of skeletal maturation during pubertal growth from that of
      English children and adolescents. This, probably genetic, difference in the tempo
      of skeletal maturation, especially that of RUS, between Japanese and English
      during pubertal growth may be one of the main causes of the final difference in
      the stature of the two groups.

PMID- 1621528
TI  - Combined human chorionic gonadotropin (HCG) and human menopausal gonadotropin
      (HMG) treatment in gonadotropin-deficient males with pituitary dwarfism.
AB  - The effects of hCG-hMG treatment in 13 boys with pituitary dwarfism associated
      with gonadotropin deficiency, were assessed. No patients except one showed signs
      of puberty at a bone age of 13 years or above. The one patient with some signs of
      puberty did not become fully mature. The hCG-hMG was started at a mean age of
      20.4 years. The hCG at a dose of 5,000 IU was injected intramuscularly twice a
      week and the hMG at a dose of 75 IU was given once a week at first. During
      treatment, the frequency of hMG injections was increased to twice a week in six
      patients who still had not produced normal sperm counts. After a mean duration of
      19.23 months, spermatozoa appeared in eight patients, of whom four showed more
      than 20 x 10(6) sperm/ml. Among six patients who did not have normal sperm counts
      and had increased hMG injections, one produced a pregnancy and four achieved
      sperm counts of more than 35 x 10(6)/ml. One patient had refractory azoospermia.
      In 13 boys with growth hormone and gonadotropin deficiency, hCG-hMG treatment
      produced normal spermatogenesis in nine patients, one of whom fathered a girl.
      Thus, hCG-hMG treatment, especially twice-a-week injections of both hCG and hMG,
      appears to be effective for gonadotropin deficiency in males.

PMID- 1621530
TI  - The roles of community practice-based research.

PMID- 1621529
TI  - Sports medicine: a research agenda for primary care.

PMID- 1621531
TI  - Single-subject experimental designs: a practical research alternative for
      practicing physicians.
AB  - Single-subject research designs offer a viable alternative to the more customary
      group-comparison designs. The flexibility and practicality of these designs make
      them particularly well suited for practicing family physicians interested in
      testing their clinical hunches. Three designs are described that are feasible in
      a practice setting: ABAB (reversal), multiple-baseline, and the alternating
      treatment design. Either visual inspection or statistical approaches can be used
      to evaluate these designs. By being aware of their limitations and by following
      simple practical steps, the practicing physician can use these designs to improve
      care of individual patients while simultaneously contributing to our general
      knowledge.

PMID- 1621532
TI  - Community and university--partners in research.
AB  - Community-based and university-based family practice researchers must come
      together and merge into a synergistic partnership. Community-based researchers
      often need the special expertise of university statisticians, epidemiologists,
      and research methodologists, and the enthusiasm of fellow researchers. University
      based researchers look to the community for subjects and the all-important factor
      of generalizability. We must no longer rely on serendipity to bring community-
      and university-based researchers together. Community-based people must
      acknowledge their needs and actively seek out assistance. The university-based
      departments can respond by deliberately starting outreach programs, setting up
      buddy systems, engaging community research consultants, and tracking residents
      and urging them to continue to do research. Sentinel networks can increase the
      depth of involvement community researchers have with their own, and others',
      projects. Such efforts will lead to a creative interrelationship that will be
      rewarding and enjoyable for us all.

PMID- 1621534
TI  - Expectations and satisfaction of runners with injury treatments.
AB  - Seventy-eight runners competing in three Iowa races were surveyed concerning
      their most recent running injury for which they sought medical care from a family
      physician, an orthopedic surgeon, or a podiatrist. Their reasons for choosing a
      doctor, expectations of care, and satisfaction with treatment received were
      assessed. Most patients selected the orthopedic (50%) or podiatric (42%)
      physicians upon the recommendation of other runners; only 13% of the family
      physicians were selected from recommendations. Orthopedic and podiatric patients
      were more likely than family physician patients to expect x-rays. There was no
      difference in overall patient satisfaction with treatment received from the three
      groups of physicians. The runners felt that all physician groups treated their
      running injuries equally well.

PMID- 1621533
TI  - High-school football injuries: effects of a post-halftime warm-up and stretching
      routine.
AB  - There are 300,000 to 1,215,000 high-school football injuries each year in the
      United States. These injuries have an important effect on player participation
      and health care costs. This study investigates what portion of injuries occur
      during the third quarter of a game, and if completing a warm-up and stretching
      routine after halftime reduces the incidence of third-quarter injuries.
      Intervention-group teams participated in a prescribed three-minute warm-up and
      stretching routine following the halftime break. The control group received no
      warm-up and stretching intervention. Fifty-five games with 108 total injuries
      were examined. Overall, ligament sprains and muscle strains were the most common
      type of injury (38%). In the nonintervention group, injuries occurred most often
      in the third quarter. Intervention teams sustained significantly fewer third
      quarter sprains and strains per game (p less than 0.05), although no significant
      difference in total third-quarter injuries was noted. These findings suggest an
      association between post-halftime warm-up and stretching and reduced third
      quarter sprain and strain injuries. We suggest a larger-scale, randomized
      confirmatory study.

PMID- 1621535
TI  - Diagnostic and therapeutic tools for the family physician's office of the 21st
      century.
AB  - Several new technologies are available to family physicians; however, numerous
      factors influence a physician's decision to adopt them. This study sought to
      determine interests and problems related to adopting new technology. The survey
      population was a group of family physicians who visited our scientific exhibit at
      the 1990 meeting of the American Academy of Family Physicians (AAFP). A 13-item
      questionnaire collected information on their use of and/or interest in
      technological procedures and equipment. Respondents were interested in a variety
      of new technological procedures. The most important criteria when considering new
      technology were training, costs, and office scheduling. The emphasis on
      outpatient care makes it increasingly important for family physicians to use
      modern technology in their offices and for departments of family medicine to
      offer training in these procedures. Our study provides a springboard for a
      broader discussion of the problems involved in selecting and implementing new
      technology in family practice.

PMID- 1621536
TI  - Do-not-resuscitate discussions: a qualitative analysis.
AB  - The literature to date on Do-Not-Resuscitate (DNR) decision-making is based upon
      data derived from structured questionnaires, hypothetical scenarios, descriptive
      epidemiology, or simulated discussions. Lacking in the literature has been a
      critical examination of the health care professional-patient-family relationship
      and its impact on decision-making regarding resuscitation. The purpose of this
      study is to identify and describe organizational and communication factors that
      affect the process and outcome of DNR discussions and decision-making. Individual
      and focus-group interviews were conducted with sixteen key informants
      professionally knowledgeable about resuscitative issues. Thematic analysis of
      these interviews revealed that a variety of cultural and professional values, as
      well as previous personal experiences, influenced the assumptions that providers
      made when engaging in DNR decision-making. Specific recommendations are made to
      help family physicians identify communication strategies that foster
      understanding and lead to participatory decisions about resuscitation among
      patients and families.

PMID- 1621537
TI  - Failures to keep primary care appointments in Saudi Arabia.
AB  - A prospective study of sociodemographic characteristics and morbidity of 3,292
      patients given appointments at the primary care clinics of King Khalid and King
      Abdulaziz University Hospitals was conducted in 1990. The appointments were made
      from one to four weeks before the scheduled visit. After the first visit the
      patients were then followed up for 4 months to record their characteristics and
      reasons for failing to keep the appointments. The study showed an appointment
      failure rate of 29.5%. Telephone calls were made to 15.4% of the nonattenders to
      ask about their reasons for nonattending. Patients over 65 years old and those in
      the more highly educated group had the highest rates of default. Failures to keep
      appointments increased for afternoon sessions and toward the end of the week. The
      128 nonattenders variously cited transport difficulties (particularly among
      women), unclear appointment details, and forgetfulness as main reasons for
      defaulting.

PMID- 1621538
TI  - Does practice location or academic connection affect recruitment of patients as
      research subjects?
AB  - Recruitment rates of study subjects are important planning and validity issues
      for many research projects. The Community Cholesterol Survey Project (CCSP)
      offered an opportunity to examine recruitment rates by type of study practice.
      The CCSP used six primary care practices (2 urban, 2 suburban, 2 rural),
      including a suburban academic residency program. Recruitment into the study was
      performed by a single dietician who followed the same procedure at each site. The
      overall recruitment rate of subjects was 79%. The residency site had the lowest
      recruitment rate (59%), which was significantly lower than any of the other sites
      (79% to 90%, average 84%, p less than 0.001). No demographic factors provided an
      explanation for this finding. The demographic factors examined included patient
      age, gender, race, social status, marital status, years in the practice, and
      presence of underlying medical conditions. These results add to the evidence that
      recruitment rates in nonacademic practices may be substantially better than those
      in residency practices and other academic sites.

PMID- 1621539
TI  - Can NBME scores distinguish students who choose a practice-based clerkship?
AB  - The National Board of Medical Examiners (NBME) examination Part II scores of
      students taking a two- to three-month community practice-based third-year family
      practice clerkship were compared with the scores of comparison students who had
      been matched on the basis of NBME Part I results. No significant differences
      between groups were seen for the total score or the scores in medicine or
      surgery. Significantly higher scores were seen for the clerkship students in the
      public health section. Significantly lower scores were obtained by this group on
      the psychiatry section, probably since many of the clerkship students did not
      take the regular psychiatry clerkship prior to taking the NBME Part II
      examination. No significant changes were seen in the scores for medicine or
      surgery. The results for ob/gyn and pediatrics were inconsistent. Taking this
      community practice-based clerkship appears to provide an equivalent amount of
      cognitive information.

PMID- 1621540
TI  - Screening for alcohol abuse in primary care: current status and research needs.
AB  - Alcohol dependence and abuse are current problems for about 10% of the American
      population. Patients with alcohol involvement are over-represented in primary
      care settings. However, a number of these patients may not be detected as being
      alcohol abusing/dependent by their physicians. Current alcohol screening measures
      are reviewed. It is likely that a systematic combination of psychosocial self
      report data and biomedical information can improve detection of alcohol-abusing
      patients. Future directions for primary care research include further development
      of psychosocial screening measures, determining common clinical presentations of
      alcohol-abusing patients, and evaluating the effectiveness of brief counseling
      and physician education.

PMID- 1621541
TI  - An epidemiologic study of neural tube defects: Delta County, Michigan, 1969-1988.
AB  - We determined the incidence of neural tube defects (anencephaly, spina bifida,
      hydrocephalus) in a rural county in the Upper Peninsula of Michigan because
      several local physicians perceived that the incidence in this area might be high.
      To assure that all neural tube defects that occurred were noted, data for the
      study were collected from hospital birth-log books, patient records of all neural
      tube defect births, all stillbirth records, and from records of babies
      transferred to other regional hospitals. A reference group consisting of 10% of
      all nonneural tube defect births during the 20 years of the study was selected at
      random and used to make comparisons to the case group. During the twenty-year
      period 1969-1988, the incidence of neural tube defects (NTDs) was found to be
      2.09 per 1000 total births. The incidence of anencephaly was 1.05/1000; of spina
      bifida, 0.56/1000; and for hydrocephalus, 0.48/1000. Seasonal variations by month
      of conception were noted for anencephaly and spina bifida, confirming previous
      findings in the literature. Study results showed that between 1972 and 1976 there
      was a cluster of NTDs, but the NTD incidence was not statistically different from
      what might be expected over a twenty-year period. The incidence of NTDs in Delta
      County was found to be normal for this part of North America. The results of this
      study indicate that physicians should be cautious when attempting to interpret
      rare events, which often occur in clusters, leaving the impression that their
      incidence is excessive.

PMID- 1621542
TI  - Family practice specialty preference before and after a required clerkship.
AB  - Medical students' specialty preferences before and after participation in a
      required third-year family practice (FP) clerkship were compared to National
      Resident Matching Program (NRMP) results. Of 714 students studied, 18 (2.5%)
      changed their specialty preference away from FP during the clerkship and 66 (9%)
      changed their preference to FP. Sixty-nine (70%) of students who maintained a
      preference for FP pre- and post-clerkship matched in FP. Seventy-two students
      changed their specialty preference to FP and 19 changed their preference from FP
      during the clerkship; 32% of each of these groups matched in FP. Those with both
      pre- and post-clerkship preferences for other specialties matched in FP at a rate
      of only 4% but constituted 18% of everyone entering the specialty.

PMID- 1621543
TI  - [Diagnostic evaluation of closed renal trauma].
AB  - Renal traumatism is a relevant entity, its early and precise diagnosis having
      great weight in the initiation of appropriate treatment and its success. All 189
      contained renal traumatisms seen in our service between 1981 and 1989, are
      studied. The purpose of the present work is to determine the diagnostic
      reliability of the different tests available, chiefly comparing echography versus
      urography, as well as CT. The method used is measurement of Sensitivity,
      Specificity and Predictive values, arranged by grades and compared using the
      squared-chi method (Fisher's exact test). Regarding the primary results we must
      emphasise the rejection of a void hypothesis in grades II and III with an error
      level lower than 0.01 for positive predictive values in echography vs. urography;
      as well as the high values of sensitivity and specificity of CT in high degree
      traumatisms. To conclude, those traumas where a complementary study is necessary
      urography may provide more information than echography; although in traumatisms
      where high degree lesions are suspected, CT will provided the most valuable
      information.

PMID- 1621544
TI  - [Renal carcinoma. Our experience of 20 years].
AB  - Review of 174 renal parenchyma adenocarcinoma surgically removed over a period of
      20 years with follow-up ranging from 1 to 20 years. Age, sex, time from onset of
      symptoms and treatment, tumour size and cell type did not influence survival.
      This was improved the lower the stage was at surgery (80% at 5 years in I, 56% in
      II, 55.5% in III-A, 11% in III-B+C, 0% in IV). The lack of differences in
      survival between stages II and III-A is conditioned by the fact that III-A
      included cases with and without perirenal fat involvement but with a common
      factor of renal vein involvement. Such factor modifies survival with equal local
      size (80% at 5 years for T1-2 VO and 83% for T1-2 V1; 56% for T3 VO and 44% for
      T3 V1. Survival for G1+2 was 66% at 5 years, versus 33% for G3+4. Initial therapy
      was radical nephrectomy with hilar lymphadenectomy, and there was no difference
      in survival with regard to the access route used.

PMID- 1621545
TI  - [Prospective study of the effectiveness and side effects of intracavernous
      prostaglandin E1 versus papaverine or papaverine phentolamine in the diagnosis
      and treatment of erection dysfunction. Review of the literature].
AB  - E1 prostaglandins (E1-PG) by intracavernous injection has been given for
      diagnostic purposes to 70 randomly selected patients visiting the practice with
      erectile dysfunction (ED). Sixty-one were suggested to begin a weekly
      intracavernous self-injection (WICSI) according to the established protocol.
      Fifty-one patients (83.6%) started the therapy and within an 18-months follow-up
      interval only 2 (3.27%) preferred to return to papaverine, since 20 patients had
      previously undergone the papaverine test and 6 were on WICSI with this
      preparation. Fifty-three patients (75%) achieved complete erection, 8 (11.4%)
      enough erection to penetrate without manual help, representing a total efficacy
      of 87%. E1-PG dosage varied from 10 to 40 mcg based on diagnosis, and was
      readjusted in 6 of the 9 patients which in the initial tests had not obtained
      sufficient erection, therefore bringing about a final 91.4% erections of
      sufficient characteristics for intercourse to be considered normal. During the
      year and a half follow-up a total of 2,880 E1-PG self-injections were injected
      without during this time cases of priapism, systemic reactions, cavernous bodies
      infections, arteriovenous fistulae, fibrosis of the cavernous bodies, etc, being
      observed. Two patients showed prolonged erections of 3-5 hours during the E1-PG
      tests which remitted spontaneously without sequelae and now continue the WICSI
      programme after dosage readjustment. In our experience, E1-PG intracavernous
      injection has proven to be more effective than papaverine in the treatment of
      erectile dysfunction and therefore, added to its safety and degree of acceptance,
      we consider it a first choice approach in the diagnosis and treatment of erectile
      dysfunction in males.

PMID- 1621546
TI  - [Carcinoma of the penis. Our experience with 22 cases].
AB  - The penis carcinoma is a neoplasia representing 0.7% of all male neoplasias, with
      an annual incidence between 1 and 2 cases per 100,000 inhabitants/year. The
      present study compiles the authors' experience in treating 22 patients presenting
      this neoplasia in the period between 1977-90. The procedures carried out included
      local resection, partial amputation, radical penectomy with lymphadenectomy plus
      radiotherapy, and palliative surgery plus radiotherapy all based on staging made
      following TNM grading. Therapy complications, follow-up, and survival results are
      explained. There were 5 occasions of spinocellular carcinoma co-existing with
      other neoplasias: 1 colon adenocarcinoma, 1 prostate carcinoma, 1 cleaved small
      cell centrocytic diffuse lymphoma, and 2 skin epithelioma in other sites, and
      relevant literature was reviewed. A background of psoriasis treated with
      psoralens plus UV was present in 4 cases, and caution was advised towards genital
      protection in patients undergoing UV radiations whether for therapeutic,
      recreational or cosmetic reasons.

PMID- 1621547
TI  - [Management of pancreatic lesions in urologic surgery].
AB  - Surgical trauma of the pancreas cauda can occur when the renal hilum is dissected
      during left radical nephrectomy, mainly when normal anatomy is altered by the
      tumoral or inflammatory pathology. This lesion can be appreciated during the
      surgical procedure or else a pseudocyst or pancreatic fistula can become evident
      post-operatively. The urologist's knowledge of what the correct management both
      intra-operatively and postoperatively of this pathology should include will
      lessen the significant morbidity it implies. Presentation of a series of 6
      patients presenting pancreatic trauma during left radical nephrectomy. Comments
      on the pathophysiology of this disorder, intra-operative management and post
      operative treatment, specifically emphasizing the use of Total Parenteral
      Nutrition and Momatostatin IV.

PMID- 1621548
TI  - [Predisposing factors for the development of acute severe tubular necrosis in the
      immediate post-transplantation period].
AB  - Retrospective study on the incidence of severe acute tubular necrosis (ATN),
      defined as the need for dialysis on the first week post-transplantation ruling
      out acute rejection or technical complication, in our series of 81 renal
      transplantations from corpse donor. It includes an evaluation of the influence on
      severe ATN presentation of parameters such as recipient and donor's age, level of
      plasma creatinine prior to extraction, whether the corpse had hypotension,
      duration of both vascular anastomosis and procedure, type of removal (single or
      multiorgan) and cold ischaemia. We conclude that in our experience, cold
      ischaemia of the graft is the only determining factor among the cases studied for
      ATN presentation conditioning a reduced long-term survival of the graft (0.758 vs
      0.971 at 18 months: p.05). Peripheral blood typing of corpse donor would allow us
      to shorten cold ischaemia duration, and thus achieve a low rate of severe ATN
      (13.6%).

PMID- 1621549
TI  - [True value of the liquid supply and its quality, in the lithiasic population].
AB  - The chemical composition of 29 of the bottled mineral waters available in the
      Spanish market are analyzed, including composition of the tap water supplied by
      Canal de Isabel II, which provides drinkable water to Madrid with a population
      close to 5 million inhabitants. The literature relevant to the influence water
      and its composition may have on the lithiatic prophylaxis is reviewed, exploring
      data related to our waters, and offering an approach on their use in the
      different types of lithiasis.

PMID- 1621550
TI  - [Non-radical treatment and bladder conservation in infiltrating tumor of the
      bladder].
AB  - The fate of some infiltrant tumours of the bladder locally advanced (pT2-3NxM0)
      which were radically resected, with or without association to other treatments,
      has been similar to those in which initial radical treated was used. To carry out
      simultaneously a radical RTU as a local action plus systemic chemotherapy (M
      VAC), for microscopic metastasis, clinically undetected, seems to us the most
      effective combination. In our Urology Unit, the evolution (September 88-January
      91) of 9 patients presenting this tumour and preservation of the bladder is being
      followed-up. The primary tumour was treated with radical RTU in 7 cases and
      partial cystectomy in 2. There are 5 tP2, 1 pT2 + "in situ" carcinoma (Ca) and 3
      pT3, 4 G1, 4 G2 and 1 G3. All tumours were single, small (2-4 cm), with varied
      location and nearly all with medium to low differentiation. Later all patients
      underwent systemic chemotherapy with M-VAC (3 cycles). Following RTU and QMT
      every three months, the likely local and systemic progression of the disease has
      been evaluated through cystoscopy and multiple biopsies including from the
      prostatic urethra, RTU of anterior scar, two-hand palpation, urinary cytology,
      blood testing, CAT, abdominal ECO, chest X-ray and laparoscopic lymphadenectomy
      (coinciding with its development within the Unit) in the last case. Average
      follow-up (at the time of the review) has been 15.77 months (6-28
      months).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621551
TI  - [Chyluria of non-parasitic origin. Presentation of a case and review of the
      literature].
AB  - Chyluria is defined as the lymph reflux to the urinary collecting system through
      fistulous communications secondary to lymphatic stasis caused by obstruction of
      the lymphatic flow. Filariasis is the most frequent cause of chyluria, which is
      endemic in some areas, mainly in the Asian continent. In our environment chyluria
      is extremely rare, most cases being due to non-parasitical causes: tumours,
      abscesses, trauma, tuberculosis, congenital, etc. A patient case of chyluria in a
      39 year-old male with background of chest trauma in which the source of chyluria
      was discovered to be an obstruction of the chest duct due to post-traumatic
      aneurysm of the aortic notch. The picture of chyluria ceased immediately after
      surgery, an aneurysmal resection with replacement with an aortic prosthesis.
      Considering the infrequency of chyluria in our environment, a literature review
      is made, explaining the most frequent etiological data, as well as accompanying
      clinical signs, diagnostic means and conservative and surgical procedures in the
      treatment of this process.

PMID- 1621552
TI  - [Cutaneous metastasis of epithelioid sarcoma of the penis: report of a case].
AB  - Exposition of one case of skin metastasis in a 35 year-old patient, diagnosed 10
      years previously with epithelioid sarcoma of the penis, which was treated with
      total penectomy. The singularity of this case lies in the rarity of a pineal site
      for this tumour, as well as the infrequency of the skin metastasis. It should be
      noted the significance of long-term follow-up in this patients, since quite
      frequently they develop metastasis following a long asymptomatic period.

PMID- 1621553
TI  - [Drug-induced fever caused by prophylactic isoniazid in bladder instillations
      with BCG].
AB  - We present of one patient with isolated pharmacological fever probably caused by
      Isoniazid given prophylactically 24 hours prior to each vesical instillation with
      BCG as maintenance therapy for in situ vesical carcinoma. The fever appeared in
      two occasions before the instillation and did not returned once the drug was
      discontinued. We Review this adverse effect which may lead to diagnostic error.

PMID- 1621554
TI  - [Kidney pelvis tumor in ectopic kidney. Report of a case].
AB  - A case of urothelial carcinoma in pelvic ectopic kidney is described. The low
      incidence of both pathologies and their rare association justifies the
      description.

PMID- 1621555
TI  - [Sjogren's syndrome associated with renal lithiasis. Report of a case and review
      of the literature].
AB  - Presentation of a case of Sjogren syndrome associated to urinary lithiasis. This
      is a very rare association, of which only 4 cases have been described worldwide,
      ours being the second report in Spain. Discussion of the pathogenic mechanisms
      responsible for the urolithiasis, including distal renal tubular acidosis,
      hypercalciuria and hypocitraturia, as well as therapy followed in this case.
      Finally, a review is made of the scarce literature available on this rare
      association, and renal involvement of the syndrome is discussed.

PMID- 1621556
TI  - [Intradiverticular lithiasis in female urethra. Report of a case].
AB  - Presentation of one case of lithiasis as complication of female urethra
      diverticulum. Etiopathogenic factors, signs and symptoms, diagnosis,
      complications and therapy options are commented.

PMID- 1621557
TI  - [Metastasis in maxillary sinus as presentation form of adenocarcinoma of the
      prostate].
AB  - Presentation of one case of prostate adenocarcinoma its initial clinical
      manifestation being the appearance of facial tumour secondary to metastatic
      affectation of left maxillar sinus. After stressing its rarity, the relevance of
      immunohistochemical studies for the specific prostatic antigen and acid
      phosphatase in determining the unconnected origin of metastatic lesions is
      addressed.

PMID- 1621558
TI  - The relationship of assertiveness to college students' safer sex behaviors.
AB  - Educational programs designed to curtail the present sexually transmitted disease
      (STD) epidemic emphasize the role of assertiveness in reducing personal risk.
      This study investigated the relationship between assertiveness tendencies and
      safer sex behaviors in heterosexual college students. It was predicted that
      assertiveness would vary positively, and nonassertiveness negatively, with three
      types of precautionary behaviors: caution about engaging in sexual intimacy,
      inquiry about a potential partner's STD risk history, and frequency of condom
      use. A convenience sample of 253 undergraduates (159 females and 94 males)
      anonymously completed a sexual behavior/demographic questionnaire and the
      Intimate Relationships Questionnaire (IRQ), designed for this study and involving
      assertive, nonassertive, and aggressive responses to scenarios relevant to safer
      sex. The findings confirmed the hypothesized relationships between IRQ
      assertiveness tendencies and safer sex practices. Gender differences were
      discovered on the IRQ and in the health-protective behaviors of using caution and
      inquiring about a prospective partner's STD risk history. Implications for STD
      prevention strategies are discussed.

PMID- 1621559
TI  - The Code Blue report: call to action, or unwarranted "dirism"?
AB  - The Code Blue report, recently issued by a distinguished panel formed by national
      medical and educational associations, paints a dire picture of the state of
      adolescent health and recommends far-reaching measures to reverse "dangerous
      trends." However, analysis of the report's findings reveals serious flaws in its
      presentation of nearly every youth problem cited, and its recommendations are
      much less original and workable than portrayed. A more moderate and positive
      approach toward youth problems is suggested.

PMID- 1621560
TI  - Deviant adolescent subcultures: assessment strategies and clinical interventions.
AB  - Alienation is a contributing factor in adolescents' participation in Satanism,
      the neo-Nazi skinhead movement, and violent street gangs. Many of their needs are
      met by gang and/or cult affiliation, including a sense of belonging, self-worth,
      companionship, and excitement. Emphasizing prevention may minimize deviant
      subculture involvement, but some adolescents require clinical intervention,
      ranging from a few outpatient sessions to lengthy inpatient hospitalization.
      Therapists must be knowledgeable about adolescents' involvement, empathic to
      their circumstances, and sophisticated in the approach to treatment.

PMID- 1621561
TI  - Educational effects of interscholastic athletic participation on African-American
      and Hispanic youth.
AB  - This study examined the educational effects of interscholastic athletic
      participation on a national, stratified, probability sample of African-American
      and Hispanic boys and girls drawn from the High School and Beyond Study (U.S.
      Department of Education, 1987). This two-year longitudinal analysis was based on
      questionnaire data from 3,686 minority youth who were sophomores in 1980 and
      seniors in 1982. The independent variable was athletic participation, and the
      dependent variables included senior year popularity, extracurricular involvement,
      grades, achievement test performance, dropout rates, and educational
      expectations. The control variables were socioeconomic status, school location,
      and sophomore measures of the dependent variables. In general, athletic
      participation enhanced popularity and contributed to greater involvement in
      extracurricular activities. Sports participation was generally unrelated to
      grades and standardized test scores. Depending on school location (i.e., urban,
      suburban, rural), athletic participation was significantly related to lower
      dropout rates for some minority youth. High school athletic participation was
      unrelated to educational expectations in the senior year. These findings show
      that high school athletic participation was a social resource for many minority
      youth, but only a modest academic resource for others. Equally clear, however, is
      the fact that not all racial or ethnic groups reap the same benefits from sport.
      More importantly, these findings strongly suggest that high school sport should
      only be considered one of many institutional forces converging in the lives of
      American minority youth. To assign sport more significance than these findings
      call for is to run the risk of oversimplifying and trivializing the very complex
      psychosocial processes which attend high school athletic participation.

PMID- 1621562
TI  - Psychopathology in incarcerated juvenile delinquents: does it extend beyond
      externalizing problems?
AB  - The present study attempted to delineate factors that are associated with and may
      contribute to juvenile delinquency. Delinquents were compared to a matched
      control group of nonoffenders on a measure of mental health problems. Twenty-four
      male and female incarcerated juvenile offenders and 24 nonoffending adolescents
      were evaluated on the Revised Behavior Problem Checklist (RBPC). As expected, the
      offenders scored higher (an indication of more psychopathology) on the subscales
      of the RBPC which represent externalizing types of problems. The offenders also
      scored significantly higher on the subscales reflecting internalizing problems
      and psychotic behavior. The results of this study point to the importance of
      assessing and treating offenders, especially those who are incarcerated, for
      difficulties other than externalizing problems.

PMID- 1621563
TI  - Perceptions of parenthood: similarities and differences between 15-year-old girls
      and boys.
AB  - Similarities and differences between the contributions of both parents, and some
      reasons for these similarities and differences, are explored through the
      responses of a cohort of Dunedin teenagers to questions about their expectations
      of becoming parents, their relevant experience and knowledge, and their future
      needs for information. It is concluded that both sexes have a commitment to
      parenting and expectations of sharing the tasks of parenthood, and that they
      expect the basis of sharing to be expediency as dictated by economic and other
      factors rather than any inherent superiority of one sex for the tasks.

PMID- 1621564
TI  - Development of self-monitoring behavior from early to late adolescence.
AB  - The purpose of this study was to examine the development of self-monitoring
      behavior during adolescence. Due to limitations of the widely used Revised Self
      Monitoring Scale (Lennox & Wolfe, 1984), the construct of self-monitoring has not
      been successfully examined in individuals younger than college age. For the
      purpose of expanding our knowledge regarding the developmental aspects of self
      monitoring, the Adolescent Self-Monitoring Scale (ASMS) was developed,
      administered to young (junior high) adolescents, and found to be internally
      consistent and highly correlated with the Revised Self-Monitoring Scale. Factor
      analysis identified two subscales: (1) Ability to Modify Self-Presentation and
      (2) Sensitivity to Expressive Behavior of Others. An examination of 490
      adolescents from 12 to 18 years of age provided support for the hypothesis that
      self-monitoring behavior does increase from early to late adolescence. ANOVAs
      produced a significant difference by age in overall self-monitoring behavior and
      in sensitivity to the expressive behavior of others. No age differences in the
      ability to modify self-presentation were found. The development of behavioral
      measures is suggested to determine more accurately the developmental aspects of
      the ability to modify self-presentation.

PMID- 1621565
TI  - Psychosocial characteristics of institutionalized adolescents: resilient or at
      risk?
AB  - The primary purpose of this investigation was to provide a psychosocial
      description of 187 institutionalized adolescents (ages 11-17). The findings
      suggest that these adolescents may not be as psychologically dysfunctional as is
      commonly surmised, considering their accumulated life events, family problems,
      and current displacement. Although the literature is replete with studies that
      describe characteristics purported to typify at-risk adolescents, there is no
      substantive demographic base concerning institutionalized adolescents. The
      authors acknowledge the limitations inherent in their sample and, consequently,
      offer their findings as a "place to start," and encourage others to follow this
      line of research.

PMID- 1621566
TI  - A comparison of the psychological profiles of teenage mothers and their nonmother
      peers: II. Responses to a set of TAT cards.
AB  - In Part I of this investigation (Oz, Tari, & Fine, 1992), it was found that, in
      comparison with nonmother peers, teenage mothers demonstrated a higher degree of
      ego development. This was in contradiction to most of the literature on the
      subject. In the second part of the study, the Thematic Apperception Test was
      employed to examine defenses and motivations which may impact upon the young
      girls' functioning within family and heterosexual relationships. Results
      confirmed reports in the literature which have indicated that adolescent mothers
      attempt to resolve autonomy-dependence conflicts in heterosexual relationships,
      whereas nonmothers do so within the family of origin. Consistent with their
      enhanced ego maturity, teenage mothers were more likely to confront their
      conflicts than were nonmothers. However, whereas nonmothers reacted to
      environmental stressors by rejecting the source of the stress, teenage mothers
      tended to react with self-abasement. It is recommended that further research be
      directed toward uncovering the emotional and cognitive resources of teenage
      mothers rather than focusing on their more obvious weaknesses.

PMID- 1621567
TI  - Student evaluation of sex education programs advocating abstinence.
AB  - This research examined the attitudes of students who were enrolled in three
      different sex education programs that emphasize abstinence. Data were examined to
      determine whether secondary school students responded positively to the programs.
      The programs examined were Values and Choices, Teen Aid, and Sex Respect. Results
      of the study indicated that all three programs were rated positively, with
      female, younger (junior high school age), and virgin-naive students rating the
      programs more highly.

PMID- 1621568
TI  - Predisposition factors in anorexia nervosa.
AB  - Since its first recognition, a number of researchers have endeavored to link
      anorexia nervosa to underlying pathology. For example, in the past, attempts were
      made to associate anorexia with such psychiatric disturbances as schizophrenia,
      anxiety disorders, and obsessive-compulsive and antisocial personality disorders.
      Most recent efforts have focused on the possible link between anorexia nervosa
      and affective disorders. This article reviews the literature concerned with
      investigating psychiatric disturbances and genetic variables hypothesized as
      predisposing factors in the etiology of anorexia nervosa. Particular emphasis is
      given to research which discusses the association between anorexia nervosa and
      depression. Psychopharmacological evidence and family genetics studies are
      reviewed. Suggestions for future research are also made.

PMID- 1621569
TI  - Runaway girls in distress: motivation, background, and personality.
AB  - This paper deals with girls aged 13 to 21 who have run away from home. Social
      workers who work with such girls point out that they are not a homogeneous
      population and that their motives can be very different. This study divides their
      motives for running away into two types, "running from" and "running to," and
      describes the specific personality traits associated with each. Findings indicate
      that girls who "run to" are younger, more impulsive, have an internal locus of
      control and a history of more runaways and longer periods of staying away from
      home. Girls who "run from," on the other hand, are older, more reflective, have
      an external locus of control and a history of fewer runaways and shorter periods
      away from home.

PMID- 1621570
TI  - Attitudes of American youth concerning military and civilian jobs.
AB  - This study of 306 youths compared the attitudes toward military and civilian jobs
      among blacks, Hispanics, whites, and Asian-Americans, and for males versus
      females. Results indicated that blacks and Hispanics, but not Asian-Americans,
      had a more favorable attitude toward military service than did whites, and males
      viewed military service more favorably than did females. Military service was
      seen as patriotic and providing leadership training, while civilian jobs were
      seen as allowing for more freedom and being more enjoyable.

PMID- 1621571
TI  - Comparison of public and parochial school patterns of student affect.
AB  - The MAACL-R scores of 139 middle and senior high public school students (76
      females, 63 males) were compared with those of 403 parochial school students (196
      females and 207 males). Parochial school students scored significantly higher on
      depression, hostility, and dysphoria, and significantly lower on positive affect
      and overall positive mood. Possible explanations for this pattern are discussed.

PMID- 1621572
TI  - Adolescent parental affinity-seeking: age- and gender-mediated strategy use.
AB  - The focus of the present study was the use of parental affinity-seeking
      strategies by adolescents. Both the type of strategies used and the degree to
      which age and gender factors mediated their use were examined. The results were
      consistent with Bell and Daly's (1984) constraints dimension of the affinity
      seeking process, with adolescents employing a narrower range of strategies with
      the parent as a familiar target. Additionally, significant differences in the use
      of strategies were apparent on the basis of adolescent's age and gender and
      parent's gender.

PMID- 1621573
TI  - The psychosocial characteristics of at-risk high school students.
AB  - This study examined differences between high school students who were at risk for
      school failure and a control group of peers. Statistically significant
      differences were found with respect to locus of control, self-concept, and
      personal styles of learning. Implications focused upon approaches and suggestions
      regarding the use of such knowledge in facilitating improved adjustment and
      achievement in at-risk students.

PMID- 1621574
TI  - Treating the adolescent victim-turned-offender.
AB  - Many juvenile sex offenders are also victims of sexual abuse. However, treatment
      primarily focuses on the juvenile's criminal acts in a confrontational,
      nonsympathetic manner. In the present paper, a survey of professionals in the
      sexual abuse treatment field assessed attitudes toward juvenile sex offender
      treatment. Those in the corrections field were the greatest supporters of
      confrontational and punitive therapy methods, while the majority favored
      flexibility in treatment.

PMID- 1621575
TI  - Dropout--Mertonian or reproduction scheme?
AB  - This article reports on dropouts in four schools in Israel. Two main research
      questions were addressed: (1) Is it possible to identify a potential dropout
      through examination of his/her attitudes and competence before the actual act of
      leaving school? (2) Is there a difference between dropouts and persistent
      students in different educational settings (academic, vocational, agricultural,
      and comprehensive high schools)? Significant differences were found in the
      attitudes of persistent students and dropouts even before the act of dropping out
      occurred. In the vocational, comprehensive, and agricultural schools, the
      dropouts scored more positively on the self-estrangement, meaninglessness, and
      misfeasance scales. In the academic school, the dropouts scored positively on the
      anxiety scale. Results were interpreted in light of the Mertonian scheme of ends
      and means as well as the reproduction scheme. The Mertonian scheme was deemed
      more applicable.

PMID- 1621576
TI  - Sources of stress and coping responses of high school students.
AB  - A series of focus group interviews was used to identify major sources of stress
      and coping responses of Grade 10 students. Relationships with parents and family,
      work, and lack of money were found to be important sources of stress. Major
      coping responses included substance use and diversionary activities. Differences
      between academic streams (tracks) in sources of stress and coping responses were
      examined.

PMID- 1621577
TI  - Adolescent sexual and emotional intimacy.
AB  - Teenage pregnancy is a major societal concern. Adolescents are sexually active at
      younger ages and many become mothers and fathers before age sixteen. While much
      has been written on adolescent sexual intimacy, little has been said about the
      issue of mature, appropriate, interpersonal emotional intimacy. The present paper
      addresses this issue and calls for emotional education in addition to sex
      education.

PMID- 1621578
TI  - Chinese teenagers' concerns about the future: a cross-national comparison.
AB  - Teenagers in the U.S., U.S.S.R., Eastern Europe, Western Europe, and New Zealand
      have consistently rated death of a parent and nuclear war as their greatest
      concerns about the future. In the present study, however, Chinese teenagers rated
      overpopulation and environmental pollution as their greatest concerns; these were
      usually rated quite low by teenagers in other countries. While still of concern
      to Chinese teenagers, nuclear war seemed more remote to them than it did to U.S.
      and U.S.S.R. teenagers and therefore more survivable. Speculation is offered as
      to how teenagers' concerns reflect those of a country's general population.

PMID- 1621579
TI  - [Vitreous surgery and eye research].

PMID- 1621580
TI  - [Gene organization of HLA and its association with ocular disease].
AB  - It is now evident that the human major histocompatibility complex (MHC), human
      leucocyte-associated antigen (HLA), regulates the immune response through
      discrimination between autologous and non autologous substances thereby
      displaying a high degree of genetic polymorphism. In recent years, the three
      dimensional structure of HLA has been clarified by crystal analysis and provides
      the attractive hypothesis, the so-called hotdog model, explaining the
      interactions of foreign antigens (or autologous antigens), HLA and T cell
      receptors and has a great impact on various studies on immunogenetic mechanisms
      underlying the development of many diseases. Thus, several HLA-associated ocular
      diseases such as Behcet's disease and Harada's disease have also been analyzed
      from this point of view by means of recombinant DNA techniques, enabling
      elucidation of molecular mechanisms of susceptibility to these diseases. This
      paper describes a general outline of HLA, especially its genetical structure, as
      well as recent analysis of molecular mechanisms of the predisposition to
      representative ocular diseases.

PMID- 1621581
TI  - [Immunoresponses to the external antigen in conjunctival-associated lymphoid
      tissue].
AB  - The local immunity of the ocular surface is governed by conjunctival-associated
      lymphoid tissue (CALT), secretory IgA and immunocytes. The authors performed a
      histological investigation of the time-course changes in CALT caused by invasion
      of antigen to the ocular surface through the instillation of horseradish
      peroxidase (HRP) into the guinea pig eye. We used PAS staining, peroxidase
      staining, alkaline phosphatase staining. The lymphoepithelial cells of CALT
      phagocytized HRP 30-60 min after the instillation, and formed intraepithelial
      pockets 24 hours after instillation. The follicular area of CALT was strongly
      positive for alkaline phosphatase 2 weeks after instillation. These changes were
      considered to be the first step in the manifestation of local immunity on the
      ocular surface. Each staining technique revealed differences between the
      lymphoepithelium and conjunctival epithelium, suggesting that lymphoepithelium
      has characteristics different from those of conjunctival epithelium.

PMID- 1621582
TI  - [Differences in cataractogenesis according to neodymium-YAG laser injury site].
AB  - The author examined morphological changes of the lens induced by mechanical
      damage with a Q-switch Nd-YAG laser (anterior capsule, anterior subcapsular deep
      cortex, posterior capsule). In the ruptured anterior capsule group, epithelial
      cell proliferation covered the ruptured capsule, and separation of posterior
      subcapsular sutures and swelling of the posterior subcapsular end of lens fiber
      cells were observed. In the ruptured subcapsular deep cortex group, swollen lens
      fiber cells were observed in both the anterior subcapsular and the posterior
      subcapsular cortex. In the ruptured posterior capsule group, the ruptured cortex
      was not repaired. Swollen lens fiber cells were first recognized in areas
      surrounding the ruptured capsule, then at the posterior side of the equator, and
      finally at the anterior subcapsular cortex. The continuity of the lens capsule
      and lens fiber cells themselves is very important part to maintain lens clarity.
      The destruction of this feature induced swelling of fiber cells on the opposite
      side of the injury area.

PMID- 1621583
TI  - [Effects of prostaglandin E2 on intraocular pressure, anterior chamber depth and
      blood flow volume of the iris and the ciliary body in rabbit eyes].
AB  - The effects of prostaglandin E2 (PGE2) on intraocular pressure (IOP), anterior
      chamber depth, and blood flow volume of the iris and the ciliary body of albino
      rabbits were investigated. Swelling and marked capillary dilatation of the
      ciliary body were observed after topical application of PGE2. IOP increased
      immediately by 200 micrograms, 400 micrograms, and 1,000 micrograms of PGE2,
      reached a peak within 30 minutes; then decreased gradually. The anterior chamber
      depth decreased only at 5 and 10 minutes after 1,000 micrograms of PGE2. The
      blood flow volume of the iris and the ciliary body immediately increased, and
      kept it up for 3 hours. Changes of IOP may be associated with an increase of
      blood flow attendant upon capillary dilatation of the ciliary body, and an
      increase of aqueous outflow due to breakdown of the blood-aqueous barrier. In
      addition to morphological and functional changes of the ciliary body, further
      factors which promote vitreous volume expansion may play an essential part in the
      development of malignant glaucoma.

PMID- 1621584
TI  - [The intraocular pressure lowering effects of UF-021, a novel prostaglandin
      related compound, in animals].
AB  - The ophthalmic solution of UF-021, a novel prostaglandin (PG) related compound,
      was investigated for its intraocular pressure (IOP) reducing activity and local
      ocular side effects in different species of animals. UF-021 ophthalmic solution
      (0.03 to 0.24%), when topically applied to the eyes of rabbits, caused dose
      dependent IOP reduction (2.8 to 5.2 mmHg), without transient IOP rise. Both in
      cats and monkeys, UF-021 ophthalmic solution (0.12%) elicited rapid, significant
      IOP reduction (ca. 9 mmHg and 2 mmHg, respectively), without any controversial,
      local ocular side effects being revealed. On the other hand, PGE2, PGF2 alpha
      isopropyl ester all brought about marked increases in IOP prior to development of
      their IOP reducing activities. In addition, these primary PGs showed intense
      local ocular irritation, which presented a striking contrast with UF-021.
      Enhancement of IOP reducing activity, coupled with freedom from any significant
      ocular side effects, as described above, suggests that UF-021 ophthalmic solution
      could be promising as a new anti-glaucoma agent.

PMID- 1621585
TI  - [Effects of endothelin on retinal blood vessels].
AB  - Endothelins (ETs), which are one of the most potent vasoconstrictors, were
      discovered in 1988. ETs are involved in the regulation of vascular smooth muscle
      and are thought to function like a local hormone. In this study, we measured
      changes in the caliber of retinal blood vessels caused by the intravitreal
      injection of ET 1 in rabbits, using fundus photography. The retinal artery showed
      an immediate vasoconstriction after the injection (0.1 ml) of ET 1 at 10(-6)M.
      However, ET 1 in lower concentrations (10(-7)M and 10(-8)M) caused vasodilations
      initially and subsequently vasoconstrictions. A dose-response relation was found.
      The blood vessel caliber reduced maximumly to 53% the value before injection. The
      vasoconstriction due to ET 1 may induce retinal ischemia and hypoxia. We
      speculate that ET 1 may be involved in the regulation of retinal blood vessels.

PMID- 1621586
TI  - [Light response of the interphotoreceptor matrix in inherited degenerative
      retina].
AB  - The light-evoked distributional changes of the interphotoreceptor matrix (IPM) in
      mice with three types of inherited retinal degeneration were examined by
      histochemistry using fluorescence isocyanate-labeled wheat germ agglutinin. In
      mice with nervous and Purkinje cell degeneration, the light response of the IPM
      was still somewhat preserved during the early stage of photoreceptor
      degeneration, whereas it became extinct when the outer segments (OS) became
      moderately or markedly shortened. In mice with slow retinal degeneration mice
      without development of OS, the light response of the IPM was absent throughout
      the developmental stages. These findings suggest that the presence of normal OS
      is necessary for the light response of the IPM to occur.

PMID- 1621587
TI  - [Retinochoroidal adhesions of diode laser endophotocoagulation lesions. 1.
      Histopathology of rabbit eyes].
AB  - I experimented with a prototype diode laser in order to determine how effective
      it is for intraocular endophotocoagulation of the retina and how much energy is
      required to produce chorioretinal adhesions. Retinal endophotocoagulation was
      performed in all 8 eyes of 4 rabbits. I used power settings at 100-140, 200 and
      300 mW and an exposure time of 0.2 seconds. The lesions produced with powers of
      100-140 mW were faint whitish spots surrounded by grayish rings. One month after
      photocoagulation, there were chorioretinal adhesions histologically. The lesions
      produced with powers of 200-300 mW were characterized by intense whitish spots
      surrounded by grayish rings and histologically they were over-irradiated ones.
      One month after photocoagulation, rupture of the internal limiting membrane could
      be seen in one of the 300 mW lesions. It can be said that the retinal burn which
      appeared ophthalmoscopically as a faint whitish spot surrounded by a grayish ring
      may be the most useful to produce chorioretinal adhesion.

PMID- 1621588
TI  - [Age effects of topical tyramine and cocaine on the pupil].
AB  - In order to obtain the age distribution of normal values of the effects of
      topical tyramine or cocaine on the pupil, we measured the pupillary light
      reflexes of 50 normal volunteers before and 45 minutes (tyramine) or 90 minutes
      (cocaine) after the topical instillation in right eyes. Left eyes were used as
      controls. An infrared videopupillogram (HTV-C301) was used. Topical tyramine as
      well as cocaine caused mydriasis, increase of maximum %-velocity of dilatation (%
      VDmax), reduction of %-amplitude of constriction (%-A) and decrease of maximum %
      velocity of constriction (%-VCmax). These alternations of pupillary parameters
      coincided with the changes induced by topical epinephrine. The effects of
      tyramine or cocaine significantly increased as the age of the subjects increased,
      though the increase of %-VDmax caused by cocaine was only related to age. Age
      related augmentation of pupillary changes were also been observed in a previous
      study using topical epinephrine or topical pilocarpine which concluded that the
      effects of any topical autonomics were increased by aging. No physiological
      senile Horner's syndrome was detected. It was concluded that the age-related
      augmentation of pupillary changes caused by topical autonomics probably resulted
      from the increment of corneal permeability in the aged which was confirmed in the
      previous fluorophotometric study by the authors following topical fluorescein
      administration. It is possible to assess the pupillary sensitivity to topical
      adrenergics of the patients with bilateral Horner's syndrome by comparing the age
      related normal values obtained in this study.

PMID- 1621589
TI  - [Subjective detection of visual field defects using the noise-field on a home TV
      set in low-tension glaucoma].
AB  - The usefulness of the Noise-Field Test was studied in 196 normal eyes and 146
      eyes of low-tension glaucoma patients (including 74 eyes of early glaucoma) who
      had never perceived their filed defects. The noise-field spontaneously generated
      on a 21-inch home television screen through a non-transmitting channel was
      utilized for the test. A white mark 5 mm in diameter was stuck on the center of
      the screen as a fixation point. At a distance of 30 cm, the subjects were asked
      to watch the screen, gazing at the fixation point with one eye for 3-5 seconds,
      checking to see whether the flickering area on the noise-field diminished or
      disappeared. The test was performed 3 times on each eye. In 136 glaucoma eyes,
      the field defects detected by static perimetry (Humphrey) were clearly identified
      in the Noise-Field Test. In normal eyes, a scotoma was noted on the blind spot in
      6 eyes, The sensitivity and specificity was 93.2% and 96.9%, respectively. The
      Noise-Field Test can be an excellent method in screening for low-tension glaucoma
      which is easily missed by tonometric screening only.

PMID- 1621590
TI  - [A mechanism for reducing intraocular pressure in normal volunteers using UF-021,
      a prostaglandin-related compound].
AB  - The mechanism of reduction of intraocular pressure (IOP) and other ocular effects
      were studies after topical application of prostaglandin (PG) F2 alpha and UF-021,
      a new PG related compound, in eight normal volunteers. IOP, aqueous humor flow
      rate and outflow rate were evaluated during a period of four hours after the
      application. Both PGF2 alpha and UF-021 caused significant and similar IOP
      reduction for four hours. Neither compound produced any significant change in the
      aqueous humor flow rate or outflow rate, suggesting the increase of
      unconventional outflow rate as being the possible mechanism of IOP reduction in
      normal human eyes.

PMID- 1621591
TI  - [The diagnosis of sarcoidosis based on ocular manifestations].
AB  - A total of 131 patients with typical ocular manifestations of sarcoidosis were
      studied. From systemic examinations, 56 cases were confirmed histologically as
      sarcoidosis, 59 cases were clinically diagnosed as sarcoidosis and 16 cases were
      not diagnosed as sarcoidosis. There were no differences among the three groups in
      terms of laterality of eye involvement, sex distribution, ocular findings and
      prognosis. The only difference was that the age of patients not diagnosed as
      sarcoidosis was lower than the other two groups. In systemic examinations,
      patients diagnosed as sarcoidosis histologically or clinically had higher ratios
      of positive findings of bilateral hilar lymphadenopathy, 67Ga scanning,
      bronchoalveolar lavage fluid and serum angiotensin converting enzyme than
      patients who were not diagnosed as sarcoidosis. Some cases of the third group may
      be diagnosed as sarcoidosis in the future by repeated systemic examinations. The
      difficulty of diagnosis of sarcoidosis from ocular findings alone was discussed.

PMID- 1621592
TI  - [The immunosuppressive acidic protein in the vitreous of fundus diseases].
AB  - Immunosuppressive acidic protein (IAP) is known to be a useful marker for
      malignant tumors and inflammatory diseases. We have previously reported that
      serum IAP level was increased in cases of Behcet's disease, especially in the
      acute phase, and those of retinoblastoma with extraocular infiltration. We
      assayed IAP levels in the vitreous body of various ocular diseases, including
      five cases of proliferative vitreoretinopathy (PVR), five cases of vitreous
      hemorrhage including four cases of branch retinal vein occlusion (BRVO) and one
      case of Terson's syndrome, four cases of proliferative diabetic retinopathy (PDR)
      and five cases of acute retinal necrosis syndrome. The single radial
      immunodiffusion method was used. The vitreous IAP level ranged from 5 to 130
      micrograms/ml according to each case. Statistical analysis revealed that the
      vitreous IAP level was significantly higher in the group of PDR (p less than
      0.05) and in the group of acute retinal necrosis syndrome (p less than 0.01)
      compared to the group of vitreous hemorrhage. In all cases, serum IAP levels were
      within normal limits. These results suggested that IAP might be produced within
      the ocular tissue, possibly by the activation of suppressor macrophages and
      migration of polymorphonuclear leukocytes in the vitreous with pathologic
      condition.

PMID- 1621593
TI  - [Vitreous oxygen tension of proliferative diabetic retinopathy].
AB  - The authors investigated the vitreous oxygen tension in 30 eyes of 29 cases of
      proliferative diabetic retinopathy patients in order to determine the
      distribution of oxygen tension and the possible role of neovascular tissue in
      tissue oxygenation. Vitreous oxygen tension was measured using a polarographic
      oxygen electrode and a PO2 monitoring system (PO-2080). Prior to pars plana
      vitrectomy, the oxygen electrode was inserted into the vitreous cavity under
      microscopic observation with dim illumination transmitted fiberoptically. The
      respective oxygen tension at the mid-vitreous cavity, above the optic disc, above
      the macula, above the neovascular tissue, in the peripheral vitreous, above the
      photocoagulated retina and above the non-photocoagulated retina were 15.8 +/- 4.7
      mmHg, 31.2 +/- 10.0 mmHg, 17.1 +/- 4.0 mmHg, 32.0 +/- 9.9 mmHg, 15.6 +/- 5.1
      mmHg, 16.5 +/- 5.5 mmHg and 18.6 +/- 4.9 mmHg. The oxygen tension values above
      the neovascular tissue and above the optic disc showed statistically
      significantly higher values than that of midvitreous cavity. We assume this to be
      due to differences between the oxygen demand and supply on the neovascular
      tissue, because in these tissues there are large amounts of vessels and blood
      flow compared to oxygen consumption. Therefore residual oxygen causes oxygen flow
      from the neovascularization to the mid-vitreous. This outcome is one of the facts
      which supports the hypothesis that neovascular tissues develop in order to
      compensate for retinal ischemia by releasing oxygen.

PMID- 1621594
TI  - [Electrically evoked responses in patients with macular holes].
AB  - The Electrically Evoked Response (EER) was analyzed in 7 patients with macular
      holes in order to determine whether EER reflects macular function. The EER was
      recorded from an occipital electrode (Oz) by applying a constant electric current
      of 1.0 mA with a duration of 5 msec and frequency of 1.85 Hz. In five patients
      with unilateral complete break of macula, each amplitude for the P2 component
      from the affected eyes was significantly smaller than that from contralateral
      eyes. However there was no such difference in both eyes of two patients with
      bilateral macular holes. No significant difference was shown in the amplitude for
      the P1 and P3 components of EER. These results strongly suggest that the retinal
      origin of P2 may mainly be in the macular area and that analysis of P2 might be
      useful to determine further clinical applications of EER.

PMID- 1621595
TI  - [The properties of visual functions and familial analysis in blue cone
      monochromatism].
AB  - The diagnosis of blue cone monochromatism (BCM) is based on severely affected
      color vision with preserved blue function, nearly absent photopic ERG, and a
      family pedigree compatible with X-linked inheritance. In the past, there has been
      no familial report of BCM in Japan. We found a Japanese family with BCM and
      studied the ocular findings of three affected members and a female carrier. Two
      of three affected members showed unique properties of BCM in their visual
      functions, including color vision and ERG. One affected member, a brother of
      their mother (43 years old), showed achromatic color vision. He had diabetic
      retinopathy and moderate cataract, which, might have disturbed his preserved blue
      cone function, resulting in the achromatic vision. A female carrier showed normal
      visual function, except that her photopic ERG was slightly reduced in amplitude.

PMID- 1621597
TI  - [The cytopathological features of the pseudohypopyon in a patient with acute
      monoblastic leukemia].
AB  - The authors cytopathologically examined pseudohypopyon in a 10 year-old boy with
      acute monoblastic leukemia. The ultrastructural investigation showed that the
      stage of leukemic cells was monoblastic, which resembled promonocytes. The
      ultrastructural findings of pseudohypopyon in acute monoblastic leukemia has
      never been reported.

PMID- 1621596
TI  - [Control of blood pressure by a calcium antagonist during cataract surgery].
AB  - The authors evaluated the systemic and ocular hypotensive effects of nicardipine
      hydrochloride (Perdipine:NH) in 31 cases with acute hypertension (over 160/95
      mmHg) during cataract surgery. All cases received an intravenous bolus injection
      of NH 30 micrograms/kg. Blood pressure and intraocular pressure were compared
      with level at rest, a preoperatively and 5 minutes after the administration of
      NH. Blood pressure significantly elevated from 136.9 +/- 10.6/73.4 +/- 10.2 mmHg
      at rest to 187 +/- 11.5/98 +/- 13.1 mmHg preoperatively (p less than 0.001), but
      it significantly reduced to 125.6 +/- 13.1/67.1 +/- 8.3 mmHg 5 minutes after the
      administration of NH (p less than 0.001). On the other hand, in the same way an
      blood pressure changed, intraocular pressure significantly elevated from 13.3 +/-
      2.8 mmHg at rest to 19.8 +/- 2.9 mmHg preoperatively (p less than 0.001), but
      significantly reduced 17.1 +/- 3.0 mmHg 5 minutes after administration of NH (p
      less than 0.001). The hypotensive effect of NH continued for over 90 minutes.
      There were no side effects apart from mild tachycardia in all cases. NH is safe,
      easy to administer and useful for control of acute hypertension during limited
      period surgery such as cataract surgery.

PMID- 1621598
TI  - [Two cases of isolated avulsed retinal vessels].
AB  - Two cases of isolated avulsed retinal vessels without retinal breaks or any other
      vitreoretinal disorders are reported. Case 1: a 57-year-old woman developed acute
      vitreous hemorrhages in the right eye associated with an avulsed retinal artery
      in the superior equatorial region. Case 2: a 74-year-old man had an asymptomatic
      avulsed retinal vein in the superior midperiphery. Repeat argon laser
      photocoagulation resulted in uncomplicated occlusion of the avulsed retinal
      vessels and reduced the risk of recurrent vitreous hemorrhage.

PMID- 1621599
TI  - [Experimental autoimmune uveitis].

PMID- 1621600
TI  - [Studies on ocular alkali burn estimated by the component change of tear fluid
      and aqueous humor].
AB  - In this report, we aimed at examining biochemically the ocular surface damage
      caused by alkali burn. We used a low concentration of NaOH (less than 0.1 N) and
      examined the relationship between the ocular surface damage and the concentration
      of NaOH by examining the changes in components that have been released from
      corneoconjunctival tissues to the tear fluids by alkali burns, and we also
      examined the effects of eye rinsing and using topical ophthalmic agents. As a
      result, NaOH of more than 0.03 N was proven to cause the ocular surface damage.
      The changes of glutathione in tear fluids showed two peaks during the repair
      process and that coincided with the morphological changes. By measuring the
      released quantities of three components (glutathione, ascorbic acid and protein)
      with the use of three methods of alkali burns (corneoconjunctival pooling method,
      corneal cylinder method and conjunctival pooling method), we could estimate the
      slight corneoconjunctival damage using one sample biochemically. Moreover, the
      importance of eye rinsing was quantitatively demonstrated.

PMID- 1621601
TI  - [Epidermal growth factor receptor in conjunctiva].
AB  - Epidermal growth factor receptor (EGFR) was studied in conjunctiva. Two specimens
      of normal conjunctiva and eleven of diseases ones, consisting of 2 pingueculas, 4
      healing traumatic conjunctiva , and 5 proliferative disorders, were studied
      immunohistochemically using rabbit anti-human EGFR antibody with avitin-biotin
      and diaminobentizin method. These investigations revealed that the immunoreactive
      EGFR was identified only in the conjunctiva of 2 of the 3 cases of granuloma
      following pterygium surgery but not in the other specimens, including the normal
      conjunctiva. This fact suggests that abnormal expression of the EGFR could play a
      role in pathological status of conjunctiva.

PMID- 1621602
TI  - [Power spectral analysis of electromyograms in fast and slow fibers of cats
      extraocular muscles].
AB  - Electromyogram (EMG) was recorded from the muscle fibers in the orbital layers
      through the global layers of superior rectus muscle of the cat. Power spectrum
      analysis was applied to investigate the quantitative differences between EMG
      patterns in both layers. The median of the power spectrum in frequency from the
      global layers was 400-700 Hz, which was considered to be an EMG pattern of the
      fast fibers. On the other hand, EMG from the orbital layers showed a small
      amplitude of 35-70 microV and two different types of power spectrum; one had the
      median frequency of more than 1,000 Hz and the other, about 500 Hz. It was
      suggested that the high frequency component was due to multi-innervated slow
      fibers and the low frequency component was due to singly innervated and
      intermediate fibers. The study of the power spectrum of interference
      electromyograms provides an advantage to differentiate the electrical activities
      of the slow fibers from the fast ones.

PMID- 1621603
TI  - [Effects of atropine on acetylcholine levels in the rat iris-ciliary body].
AB  - In an attempt to estimate the in vivo acetylcholine level in rat iris-ciliary
      body, animals were sacrificed by microwave irradiation which rapidly inactivates
      metabolic enzymes. Acetylcholine levels in the iris-ciliary body were determined
      by high-performance liquid chromatography with electrochemical detection. The
      acetylcholine level in rat iris-ciliary body per gram tissue protein was 58.8 +/-
      5.0 nmol/g (mean +/- SEM, n = 9). A single instillation of 5 microliters of an
      0.05% atropine to one eye of a rat decreased acetylcholine level in the iris
      ciliary body by 17% half an hour after administration (p less than 0.02).

PMID- 1621604
TI  - [A novel model of autoimmune uveo-retinitis in nude mice grafted with embryonic
      rat thymuses].
AB  - When the T cell functions of congenitally athymic nude (nu/nu) mice were
      reconstituted by implantation of embryonic rat thymi (thymus grafted nude mice),
      uveoretinitis histologically characterized by complete loss of photoreceptor
      layer was found to develop spontaneously in 4.0, 18.2, 42. 9 and 70.4% of the
      mice at 3, 5, 7 and 12 months of age, respectively. In mice with uveoretinitis
      serum IgG antibody reacted with the retinal photoreceptor layer, and with
      interphotoreceptor retinoid-binding protein, but not with retinal S-antigen by
      immunoblot analysis and ELISA. The lesions could be transferred to syngeneic nude
      mice by splenic CD4+ T cells. This suggest that an autoimmune response to IRBP
      induced the uveoretinitis in thymus grafted nude mice.

PMID- 1621605
TI  - [Suppression of interphotoreceptor retinoid-binding protein (IRBP)-induced
      experimental autoimmune uveitis by pretreatment with anti-idiotypic monoclonal
      antibody].
AB  - In an experimental model of interphotoreceptor retinoid binding protein (IRBP)
      induced experimental autoimmune uveitis (EAU) in Lewis rats, EAU onset was
      suppressed by pretreatment with anti-idiotypic antibody (TRD3). In the pretreated
      group, the titers of anti-IRBP antibody and idiotypic antibody were lower and the
      titer of anti-idiotypic antibody was higher than in the control group, and the
      skin test (DTH) against IRBP was also suppressed. Histopathological findings of
      the control group showed destruction of retinal outer granular layer, loss of the
      outer segment and lymphocytic infiltration, although no definite inflammatory
      signs appeared in the pretreated group. We suppose that the mechanism of
      idiotypic suppression is via induction of idiotype-specific or idiotype-related
      suppressor T cells.

PMID- 1621606
TI  - [Experimental proliferative vitreoretinopathy in rabbits after intravitreous gas
      injection and creation of retinal hole: ophthalmic findings and localization of
      fibronectin].
AB  - An animal model of rhegmatogenous retinal detachment and proliferative
      vitreoretinopathy (PVR) has been developed by the creation of a retinal hole (4
      disc diameter) 4 days after the intravitreous injection of 0.4 ml of 100% of
      perfluoropropane (C3F8) in pigmented rabbits. Ophthalmic and histological
      examination showed detached retina with associated preretinal, intravitreous
      membranes containing pigmented fibroblast-like cells. Fibrovascular membranes
      were noted within the puckered medullary wings. Fluorescein angiography revealed
      profuse leakage from detached medullary wings. Using immunofluorescence,
      fibronectin was localized on preretinal, intravitreous, and fibrovascular
      membranes. These results suggested that the breakdown of the blood-retinal
      barrier and fibrovascular proliferation in addition of previously recognized cell
      types may be the important factors in this reliable model of PVR.

PMID- 1621607
TI  - [Histopathology of retinochoroidal adhesions of diode laser endophotocoagulation
      lesions in monkey eyes].
AB  - Retinochoroidal coagulation effect of 810 nm diode laser was studied using monkey
      eyes to determine the energy necessary to produce retinochoroidal adhesion
      safely. Power settings were at 100, 200 and 300 mW. The lesions produced with a
      power of 100 mW were faint grayish spots. One month after photocoagulation, there
      was degeneration from the outer granular layer to the superficial choroidal
      layer. However, chorioretinal adhesion was not obtained due to external limiting
      membrane formation. The lesions produced with a power of 200 mW were
      characterized by small whitish spots surrounded by grayish rings and
      retinochoroidal adhesions were produced by proliferated cells. However choroid
      were intensely coagulated, and there was a rupture of Bruch's membrane in one
      lesion. The lesions produced with a power of 300 mW were intense white spots
      surrounded by grayish rings. Histologically, severe cell loss of the retina was
      seen and three was no retinochoroidal adhesion. It can be said that it is
      difficult for 810 nm diode laser to obtain adequate retinochoroidal adhesion
      safely.

PMID- 1621608
TI  - [The viability of the detached retina of the rabbit eye--electrophysiological
      observation of influence of duration of the detachment].
AB  - The influence of the duration of the retinal detachment on the function of
      detached retina was electrophysiologically investigated in the rabbit eye.
      Experimental retinal detachment with a diameter of 4 mm was made by injecting
      sodium hyaluronate into the subretinal space. The transretinal ERG (TR-ERG) was
      recorded from the detached retina between a pair of double-barreled
      microelectrodes of which the longer tip was positioned into the subretinal space,
      penetrating the detached retina and the shorter tip in the vitreous body. The
      vitreal ERG (VERG) from the undetached retina was simultaneously recorded between
      the shorter tip and a scleral electrode. The amplitude of the TR-ERG b-wave
      significantly decreased 2 hours after the onset of the detachment, and was
      gradually reduced to minimal value until 96 hours after the detachment. The
      amplitude of the VERG b-wave remained unchanged. The slow P III amplitude of the
      TR-ERG gradually decreased and extinguished 96 hours after the detachment, while
      the c-wave amplitude of the VERG showed no significant changes. The results
      suggested that the viability of the detached retina reduces rapidly and
      extinguishes within 96 hours in the rabbit eye.

PMID- 1621609
TI  - [Changing glucose concentration affects rod-mediated response in the perfused cat
      eye].
AB  - The effects of changing glucose concentration on the ERG b-wave and optic nerve
      response (ONR) were studied in dark adapted, arterially perfused cat eyes.
      Changes in glucose concentration in the perfusate induced remarkable effects on
      both electrical responses. The ERG b-wave and ONR amplitudes were enhanced with
      increasing the glucose concentration above the standard level (5.5 mM), and were
      transiently decreased below the control after termination of the increase in
      glucose. Furthermore, a control perfusate with higher glucose concentrations (8
      10 mM) was used, transient addition of glucose failed to elicit consistent
      increase in amplitudes of the b-wave and ONR. We conclude that the optimal supply
      of glucose to the mammalian retina is crucial for recording b-wave and ONR in
      vitro under dark adaptation. A higher glucose level (8-10 mM) than 5.5 mM in the
      standard tissue culture medium is suggested for maintaining the retinal function
      in-vitro.

PMID- 1621610
TI  - [Conductivity of sodium hyaluronate solution].
AB  - In order to elucidate the property of water contained by the stereoic network in
      the vitreous gel, the conductivity of sodium hyaluronate solutions was measured
      in various concentrations at 25 degrees C and the relationship between
      concentrations of sodium hyaluronate and conductivity was evaluated. Each
      conductivity curve was divided into three stages. Equivalent conductivity was
      highly dependent upon the concentration of sodium hyaluronate at high and low
      concentrations, but was rather independent of it in intermediate concentrations.
      These results suggest that there are three types of water dependent upon the
      concentration of sodium hyaluronate, indicating physical variety, and that sodium
      hyaluronate solution in the intermediate concentration may possibly have a buffer
      homeostatic action on the ionic environment in the vitreous body.

PMID- 1621611
TI  - [A pupillographical study on the effects of cataract surgery on the contralateral
      eye].
AB  - In order to estimate the effect of cataract surgery on the contralateral eye, we
      examined pupillary light reflex and performed laser flare-cell measurement. The
      subjects were nine patients who underwent extracapsular cataract extraction
      (ECCE) and fourteen patients who underwent ECCE with intraocular lens
      implantation. Pupillary light reflexes of the contralateral eyes were examined
      using a computerized videopupillogram (HTV C-301). Aqueous cells and flare of
      both eyes were measured by a laser flare-cell meter (KOWA FC 100). The author
      performed five successive measurements before and 1, 3 days, 1, 2 weeks and 1, 2,
      3 months after surgery and statistically estimated the consensual effect of
      cataract surgery. As a result of contralateral cataract surgery, pupils became
      significantly miotic from the first postoperative day for more than 3 months
      without any alteration of other parameters of light reflex. On the contrary
      aqueous cells and flare significantly raised from the first postoperative day and
      disappeared within 3 months. Consensual miosis was considered to be sensitive
      indicator of postoperative inflammation of cataract surgery as well as
      contralateral increase of aqueous cells and flare.

PMID- 1621612
TI  - [Presence of human epidermal growth factor (hEGF), basic fibroblast growth factor
      (bFGF) in human aqueous].
AB  - Thirty-eight cataract eyes and 15 artificial aphakic or pseudophakic eyes were
      enrolled in this study to determine levels of human epidermal growth factor
      (hEGF) and basic fibroblast growth factor (bFGF) in human aqueous, using a
      radioimmunoassay. Neither hEGF nor bFGF were detected in either congenital
      cataract eyes or senile cataract eyes without any complication. In cases of
      senile cataract complicated with glaucoma and traumatic cataract, bFGF range from
      0.4 to 0.8 ng/ml whereas hEGF was not detected. In cases of senile cataract with
      myocardial or brain infarction and anterior subcapsular cataract, bFGF was
      detected ranging from 0.4 to 1.0 ng/ml and in some of the cases hEGF was detected
      at a level of 1.0 ng/ml. hEGF was detected at 1.0 ng/ml in some cases of
      secondary cataract after uveitis, cataract complicated with retinal detachment,
      cataract after scleral buckling or vitrectomy, and aphakic or pseudophakic eyes
      after extracapsular cataract extraction or phacoemulsification. These results
      showed that hEGF and bFGF exist at a level of about 1 ng/ml in human aqueous in
      some pathological states and it seems possible that proliferation of lens
      epithelial cells is promoted by the growth factors, with the result that after
      cataract, anterior capsular opacities and shrinkage become severe.

PMID- 1621613
TI  - [Effects of aging on fluorescein iris and angle photography in normal subjects].
AB  - In the present study we took the fluorescein iris and angle photography of normal
      eyes and studied them according to different age groups. The range of age in 108
      eyes of 92 subjects was from 20 to 93 years. They were free from any systemic
      diseases or ophthalmic diseases which would cause iris rubeosis. Fluorography was
      carried out using a Mizuno Trabeculens to determine the leakage points of
      fluorescence from the iris and the angle. In the angle there were gonio vessels
      which revealed no leakage of fluorescein. They were observed in 8 of 30 eyes
      (27%) for subjects in the fifth decade of life or less and in 24 of 78 eyes (31%)
      for subjects aged 50-90. No significant difference was seen between the two age
      groups. As to variations of gonio vessels, radial ciliary body vessel was found
      in 23 eyes, radial iris vessel or trabecular vessel in 10 eyes, and circular
      ciliary band vessel in 7 eyes. In the pupillary margin no leakage was seen in 30
      eyes of 30 cases in the fifth decade of life or less, while leakage was found in
      33 of 78 eyes, 42 of 62 cases over the fifth decade of life. In the angle leakage
      was seen in 4 of 30 eyes, 13 of 30 cases in the fifth decade of life or less,
      while leakage was observed in 43 of 78 eyes over the fifth decade of life. These
      results suggested that leakage of fluorescence from the pupillary margin, the
      angle or both increases with age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621614
TI  - [In vivo observation of crystalline lens changes in the early post-vitrectomy
      stage].
AB  - Crystalline lens changes of 17 cases of eye undergoing simple vitrectomy were
      observed from the post-operative 1st to 21st month. Changes in the crystalline
      lenses were detected through a slitlamp microscope or by methods of image
      analysis, the Opacity Lensmeter and the laser scattering spectroscopy. Increases
      of the scattering light intensity of the anterior and posterior deep cortical
      layers were observed from the early post-operative stage in 9 cases. Seven cases
      progressed to nuclear opacification during the observation period, however, one
      case showed no nuclear changes even at the 12 post-operative month. No
      relationships were observed between the early cortical changes and surgical
      invasion, patient age, or cause of vitreous opacification. Quantitative
      evaluation by image analysis revealed early post-operative crystalline lens
      changes in cases undergoing vitreous surgery.

PMID- 1621615
TI  - [Retinal circulation and ocular blood barrier in diabetic retinopathy].
AB  - Macular capillary blood flow velocity, the score of fluorescein angiography in
      posterior region and aqueous flare intensity were investigated in 38 diabetics
      (41 eyes) and 6 normal subjects (6 eyes) to clarify the relationship among
      retinal circulation, blood-retinal barrier and blood-aqueous barrier. Macular
      capillary blood flow velocity was measured by means of the blue field entoptic
      phenomenon, the score of fluorescein angiography was graded by the extent of
      edema in the posterior region, aqueous flare intensity was measured with a flare
      cell meter. The results showed that the reduction of macular capillary blood flow
      is significantly associated with an increase in fluorescein angiography score and
      aqueous flare intensity via diabetic retinopathy (p less than 0.01).

PMID- 1621616
TI  - [De novo retinal break associated with excessive cryotherapy].
AB  - Three patients who had been treated with transscleral cryotherapy for retinal
      breaks and associated retinal detachment developed de novo retinal breaks and/or
      retinal thinning at the site of cryotherapy in the early postoperative period.
      Additional surgical interventions were required because retinal detachment had
      extended or remained unchanged postoperatively. We think that this may be due to
      excessive cryotherapy and is an early postoperative complication transscleral
      cryotherapy that to our knowledge has not previously been reported. This would
      suggest that when performing cryotherapy for retinal breaks and associated
      retinal detachment, care should be taken not to treat excessively.

PMID- 1621617
TI  - 'The tort system is the problem'.

PMID- 1621618
TI  - A procedure to assist impaired colleagues.

PMID- 1621619
TI  - Our great heritage.

PMID- 1621620
TI  - Life after medicine.

PMID- 1621621
TI  - Fitness and Healthy Alabama 2000 health objectives.

PMID- 1621622
TI  - Addressing Alabama advocacy for the impaired physician.

PMID- 1621623
TI  - Under pressure. Soaring costs in health care will require some tough decisions.

PMID- 1621624
TI  - Diary from a week in practice.

PMID- 1621625
TI  - Responses to questions about family practice as a career.

PMID- 1621626
TI  - Temporomandibular joint disorder.
AB  - Temporomandibular joint disorder is a common clinical entity with diverse
      etiologies and symptoms. The hallmarks on physical examination are reduced or
      dysfunctional mandibular range of motion, malocclusion, and joint or preauricular
      tenderness. The diagnosis is made when a history of craniofacial symptoms or
      headache is linked with temporomandibular joint dysfunction. Temporomandibular
      joint disorders usually respond to medical treatment with anti-inflammatory
      medications, soft diet and occlusal therapy, without the need for surgical
      intervention. These disorders must be considered in the differential diagnosis of
      chronic headache, facial pain and compromised mandibular movement.

PMID- 1621627
TI  - Managing tricyclic antidepressant overdose.
AB  - Tricyclic antidepressant overdose is the most common cause of death from
      prescription drugs. Clinical presentation of overdose from the tricyclic agents
      includes cardiac arrhythmias, hypotension, seizures, coma and anticholinergic
      signs such as hyperthermia, flushing and intestinal ileus. The highly
      toxic/lethal level (greater than 1,000 ng per mL) is manifested on
      electrocardiograms as prolongation of the QRS interval to 100 milliseconds or
      more. Treatment includes establishment of an airway, proper oxygenation and
      ventilation, fluid replacement at maintenance levels, cardiac monitoring, gastric
      lavage and charcoal administration, alkalinization to a blood pH of 7.5 with
      intravenous sodium bicarbonate, supportive therapy and continued cardiac
      monitoring after clinical recovery.

PMID- 1621628
TI  - Common skin tumors in the elderly.
AB  - Skin tumors can have an epidermal, melanocytic or mesodermal origin. Lesions
      frequently encountered in elderly patients include benign tumors such as
      seborrheic keratoses, lentigo, keratoacanthoma, epidermal cyst and sebaceous
      hyperplasia. Premalignant and malignant tumors that often occur in the elderly
      include actinic keratosis, Bowen's disease, basal cell carcinoma, squamous cell
      carcinoma and melanoma. Diagnosis depends on the tumor's characteristics and
      morphology, although in some cases biopsy is required. Treatment depends on the
      character of the lesion, its location and the patient's general condition and
      includes curettage, cryosurgery, chemosurgery, excision and radiotherapy.

PMID- 1621629
TI  - Pectus excavatum.
AB  - Pectus excavatum is a congenital chest wall defect that can cause a marked
      cosmetic defect with attendant psychologic trauma and limitations of peak
      physical performance. Close observation of pectus excavatum is indicated, because
      this condition may improve or even disappear without treatment in some patients.
      However, in appropriate patients, timely surgical repair can give good cosmetic
      results and improve cardiorespiratory function, providing both physical and
      psychologic benefits.

PMID- 1621631
TI  - Recognition of retropharyngeal abscess in children.
AB  - Retropharyngeal abscess is a rare deep-neck infection that usually affects young
      children. Swelling in the neck can lead to sudden and fatal airway obstruction.
      Enlargement of lymph nodes located between the posterior pharyngeal wall and the
      prevertebral fascia occurs secondary to infection of the nasopharynx, paranasal
      sinuses or middle ear. Penetrating trauma or foreign-body penetration may also
      lead to abscess formation. Common symptoms include fever, swollen neck, difficult
      swallowing, muffled voice and hyperextension of the head and neck. Lateral neck
      radiographs confirm the diagnosis. Early surgical treatment prevents serious
      complications, such as mediastinal spread, aspiration of pus, airway obstruction
      or erosion into a major vessel.

PMID- 1621630
TI  - Methemoglobinemia: nitrate toxicity in rural America.
AB  - Nitrates are frequently found in vegetables and ground water. Nitrate levels in
      ground water have increased over the past two decades because of the heightened
      use of nitrogenous fertilizers. Following ingestion, nitrates are converted to
      nitrites by fecal organisms. Nitrites are absorbed and form methemoglobin, which
      interferes with the oxygen-carrying capacity of hemoglobin. Infants are
      particularly susceptible to nitrate poisoning because fetal hemoglobin is more
      readily oxidized to methemoglobin. In infants, the most common source of nitrate
      exposure is well water, which is mixed with infant formula. Affected infants may
      present with asymptomatic cyanosis, which can progress to dyspnea and lethargy or
      coma. Blood methemoglobin concentrations are elevated. Treatment consists of the
      administration of oxygen and intravenous and oral methylene blue.

PMID- 1621632
TI  - Human ehrlichiosis: a newly recognized tick-borne disease.
AB  - Human ehrlichiosis was first described in the United States in 1986. Since then,
      more than 215 cases have been reported, including some fatalities. Ehrlichia
      species belong to the same family as the organism that causes Rocky Mountain
      spotted fever. Human ehrlichiosis occurs most frequently in the southern mid
      Atlantic and south-central states, during spring and summer months. The clinical
      presentation is similar to that seen in Rocky Mountain spotted fever although,
      with ehrlichiosis, leukopenia is more often found and skin rash is less often
      noted. Definitive diagnosis is based on acute and convalescent serum antibody
      titers. Ehrlichiosis cannot reliably be distinguished from other common febrile
      illnesses on the basis of clinical, epidemiologic or laboratory features. Therapy
      must be initiated empirically in suspected cases. Both ehrlichiosis and Rocky
      Mountain spotted fever respond well to tetracycline and chloramphenicol, but not
      to penicillins or cephalosporins.

PMID- 1621633
TI  - Peptic ulcer disease.
AB  - Peptic ulcer disease affects between 5 percent and 10 percent of Americans during
      their lifetime. There are a variety of predisposing factors, including
      nonsteroidal anti-inflammatory drug (NSAID) use, Helicobacter pylori infection,
      tobacco use and, possibly, certain dietary practices. While H2-receptor
      antagonists remain the mainstay of therapy, the selection of an antiulcer drug
      should be individualized. Famotidine is preferred in persons who use alcohol,
      sucralfate may be preferred for maintenance therapy in smokers and omeprazole is
      useful in hypersecretors of acid and in patients with resistant ulcers. Antacids
      remain an effective treatment for uncomplicated duodenal ulcer in motivated
      patients. Eradication of H. pylori using a bismuth preparation plus one or two
      antibiotic agents should be considered in patients who have frequent recurrences
      and evidence of infection. Finally, risk factors such as tobacco or NSAID use
      should be modified whenever possible to reduce the risk of ulcer recurrence.

PMID- 1621634
TI  - Surfactant: clinical applications.
AB  - Pulmonary surfactant is an important chemical component of the lung. It decreases
      surface tension in the alveolar cells to help stabilize the alveoli, and it may
      help prevent pulmonary edema. Currently, naturally and synthetically derived
      surfactants are being used to treat neonatal respiratory distress syndrome, a
      leading cause of death in premature infants. Surfactant is recommended for
      prophylactic therapy in infants weighing less than 1,350 g (3 lb) and in infants
      weighing more than 1,350 g who show signs of pulmonary immaturity and for rescue
      therapy in infants with respiratory distress syndrome. Surfactant is administered
      by endotracheal tube, and the recommended dose is 5 mg per kg. Three doses, given
      12 hours apart, is the recommended regimen for prophylactic therapy. Rescue
      therapy consists of one dose of surfactant given at the onset of respiratory
      distress and another dose given 12 hours later.

PMID- 1621635
TI  - ACIP issues statement on acellular pertussis vaccine.

PMID- 1621636
TI  - Low-dose interferon alpha and HIV infection.

PMID- 1621637
TI  - Adolescent sexuality.

PMID- 1621638
TI  - LDH as a marker for P. carinii pneumonia.

PMID- 1621639
TI  - Questions about family practice.

PMID- 1621640
TI  - AHCPR clinical practice guidelines.

PMID- 1621641
TI  - Monitoring physician use of new CPT codes by Medicare.

PMID- 1621642
TI  - Violence: a public health problem.

PMID- 1621643
TI  - An act of faith.

PMID- 1621644
TI  - Responding to tragedy in Evansville, Indiana.

PMID- 1621645
TI  - Mechanical rotational atherectomy.
AB  - Percutaneous transluminal coronary angioplasty (PTCA) is practiced widely in the
      United States and is indicated for the majority of stenosed vessels that have de
      novo, type A lesions. Despite extensive experience with the procedure and
      improvements in balloon technology, periprocedural dissection and restenosis
      remain major limitations of PTCA. Research indicates that certain lesion types
      and patient populations may be treated more effectively with other technologies.
      New mechanical devices have been designed to help improve the safety of PTCA and
      hold promise for correcting coronary dissection and abrupt closure--the sources
      of such angioplasty complications as myocardial infarction, urgent bypass
      surgery, and death. Among the results achieved with the new atherectomy
      techniques are a more stable lumen after atherectomy; a decrease in elastic
      recoil; a smoother, less thrombogenic lumen; and the feasibility of extensive
      debulking or endarterectomy. Experience indicates that mechanical rotational
      atherectomy will be an extremely useful addition to the armamentarium for
      percutaneous revascularization.

PMID- 1621646
TI  - Cardiopulmonary support.
AB  - Cardiopulmonary support (CPS) has been shown to be a useful addition to
      interventional cardiology when considering alternatives for high-risk patients.
      Cardiopulmonary support systems are capable of up to 6 liters/min output and can
      be used prophylactically to prevent hemodynamic collapse following balloon
      occlusions or acute vessel closure. The technique, supported angioplasty, results
      in reductions of preload and afterload and allows prolonged balloon inflations in
      critical coronary vessels. Although it provides excellent support for most high
      risk patients, CPS is a technically challenging and expensive procedure
      associated with significant patient morbidity. Standby CPS patients are prepared
      for institution of CPS, but bypass is not actually initiated unless the patient
      sustains irreversible hemodynamic compromise. In this study, standby and
      prophylactic patients had comparable success and major complication rates, but
      procedural morbidity was more frequent in prophylactic patients. Further study
      will better define appropriate patient selection for standby versus prophylactic
      CPS.

PMID- 1621647
TI  - Complex angioplasty: a surgeon's perspective.
AB  - Surgeons commonly have reacted with skepticism to the introduction of catheter
      based interventional approaches to treating coronary artery disease, prompted
      apparently, by a desire to protect what had been exclusively their turf.
      Reasonable surgeons now largely accept the concept of nonoperative mechanical
      treatment of coronary heart disease, and their constructive criticisms regarding
      amelioration of coronary anatomy without thoracotomy remains valuable. The value
      of catheter-based techniques compared with operative or noninterventional
      treatment has not been defined in many clinical settings. The complexity of
      evaluating these rival technologies increases as the complexity of cases
      progresses from simple 1-vessel disease to more extensive coronary artery
      disease. Ongoing randomized trials may help define indications for these
      procedures, but patients entering these trials represent a highly select subset.
      Therefore, applications to broader patient populations will likely require
      analysis of observational data. Newer catheter-based technologies introduce modes
      of injury to the coronary arterial system that have not been encountered
      previously in medical practice. As technologies evolve, decisions about the need
      for operative intervention become increasingly complex. In the many clinical
      settings resulting from efforts to improve angioplasty, optimal patient care
      occurs in environments with good communication and cooperation between all
      physicians involved in interventional treatment of coronary artery disease.

PMID- 1621648
TI  - Changing trends for surgical standby in patients undergoing percutaneous
      transluminal coronary angioplasty.
AB  - In 1988 the American College of Cardiology/American Heart Association (ACC/AHA)
      task force subcommittee on Guidelines for Percutaneous Transluminal Coronary
      Angioplasty (PTCA) recommended that an experienced cardiovascular surgical team
      be available within the institution for emergency surgery for all angioplasty
      procedures. The subcommittee felt strongly that this requirement allowed for no
      exception, stating that it could not condone existing arrangements that required
      the transportation of patients to off-site surgical facilities for emergency
      cardiac surgery. Such arrangements failed to meet the necessary standards of care
      exercised by prudent physicians. Interventional cardiologists are recognizing
      that it may be prudent for the ACC/AHA task force to revise its 1988 guidelines.
      Improved operator technique and new technologic advances, such as lasers,
      atherectomy devices, stents, and perfusion pumps and balloons, have helped extend
      the reach of PTCA to more seriously ill patients. With new technologies for
      angioplasty and an increased awareness of risk factors, active standby can be
      markedly reduced, thereby resulting in enormous cost reductions and in more
      appropriate patient care.

PMID- 1621649
TI  - Excimer laser coronary angioplasty.
AB  - Recent experience with excimer laser coronary angioplasty (ELCA) has shown the
      safety and efficacy of the technique in the treatment of coronary stenosis, with
      results similar to percutaneous transluminal coronary angioplasty (PTCA). Several
      advantages of the excimer laser for intravascular use have been identified by the
      ELCA Registry, a group of 15 institutions nationally that have pooled data on
      their cooperative experience with ELCA. Advantages include the ability of the
      laser to ablate atheroma with microscopic precision without thermal injury and
      the ability of vessel surfaces to heal without scarring. The initial results of
      the multicenter investigation of ELCA in 958 patients indicate that ELCA may be
      indicated particularly for long, diffuse lesions. With the advent of larger
      diameter catheters, ELCA is a viable alternative to PTCA. Restenosis was seen as
      a significant problem, and it remained problematic at 6-month follow-up. In
      comparison with conventional balloon angioplasty, ELCA may eliminate that
      component of restenosis due to inadequate dilation or elastic recoil, but it does
      not appear to affect restenosis caused by smooth muscle proliferation. Catheter
      design and energy delivery continue to evolve and may affect future results of
      laser coronary angioplasty.

PMID- 1621650
TI  - FNA identification of familial breast disease.

PMID- 1621651
TI  - A second look at breast-feeding and full-time maternal employment.

PMID- 1621652
TI  - Fluid management and arginine vasopressin in bacterial meningitis.

PMID- 1621653
TI  - Working hours for pediatric residents.

PMID- 1621654
TI  - The role of general pediatrics in an academic department.

PMID- 1621655
TI  - Safety and immunogenicity of high-dose Edmonston-Zagreb measles vaccine in
      children with HIV-1 infection. A cohort study in Kigali, Rwanda.
AB  - OBJECTIVE: To compare the reactogenicity and immunogenicity of high-dose
      Edmonston-Zagreb (EZ) measles vaccine in children with and without human
      immunodeficiency virus, type 1 (HIV-1), infection. DESIGN: Prospective cohort
      study. SETTING: General pediatric clinic and home visits in Kigali, the capital
      of Rwanda. PARTICIPANTS: Infants born to HIV-1-seropositive and -seronegative
      mothers were vaccinated with a 10(5.0) 50% tissue culture infective dose of EZ
      measles vaccine at 6 months of age. Control visits were made 10 and 14 days later
      to monitor local and general reactions. Measles serum antibodies were measured by
      an enzyme-linked immunosorbent assay technique at birth and at 6 and 9 months of
      age. Three groups were compared: infected children (n = 43), uninfected children
      born to seropositive mothers (n = 135), and uninfected children born to
      seronegative mothers (n = 194). RESULTS: Three hundred twenty-three children
      (86.8%) were available for the reactogenicity study. No statistically significant
      difference between the three groups was found in the occurrence of minor adverse
      reactions. No severe adverse reaction was observed. One hundred ninety children
      (51.1%) were available for the immunogenicity study. The percentage of infants
      negative for measles antibody at 6 months was significantly higher (P = .021) in
      HIV-infected children (85%) and in uninfected children born to seropositive
      mothers (90%) than in uninfected children born to seronegative mothers (75%). The
      overall seroconversion rate at 9 months was 90% (95% confidence interval, 85.7%
      to 94.3%), without any statistically significant difference between the three
      groups. CONCLUSION: High-dose EZ vaccine administered at 6 months of age is safe
      and highly immunogenic in both HIV-infected and uninfected children.

PMID- 1621656
TI  - Clinical reactions and immunogenicity of the BIKEN acellular diphtheria and
      tetanus toxoids and pertussis vaccine in 4- through 6-year-old US children.
AB  - OBJECTIVE--To compare the immunogenicity and reactogenicity of a two-component
      acellular pertussis vaccine with a whole-cell diphtheria and tetanus toxoids and
      pertussis vaccine (W-DTP) when administered as a booster to children 4 through 6
      years of age. DESIGN--This was a randomized, double-blind study. SETTING-
      Children in this study were from three general pediatric practices (two were
      private, one was university-affiliated). PARTICIPANTS--Three hundred and sixteen
      4- through 6-year-old children who had received four previous W-DTP immunizations
      at the recommended times were studied. SELECTION PROCEDURES AND INTERVENTIONS-
      Children were randomly assigned in a 1:3 ratio to receive either W-DTP or one of
      three lots of acellular diphtheria and tetanus toxoids and pertussis vaccine (A
      DTP). The A-DTPs contained 3.75 micrograms each of lymphocytosis promoting factor
      and filamentous hemagglutinin protein nitrogen per 0.5 mL and the same
      concentrations of diphtheria and tetanus toxoids as W-DTP. Serum samples were
      obtained on the day of immunization and 4 to 6 weeks later. Adverse reactions
      were recorded by parents at 6, 24, 48, and 72 hours. MEASUREMENTS AND RESULTS--An
      indirect enzyme-linked immunosorbent assay (ELISA) method determined IgG antibody
      response to lymphocytosis promoting factor, filamentous hemagglutinin, and
      tetanus toxoid; a CHO cell assay measured neutralizing antibodies to pertussis
      toxin; and serum neutralization on VERO cells assayed diphtheria antitoxin. One
      month after booster doses were administered, the geometric mean antibody levels
      for A-DTP vs W-DTP were IgG filamentous hemagglutinin, 362 vs 104 ELISA U/mL; IgG
      lymphocytosis promoting factor, 408 vs 81 ELISA U/mL; CHO cell, 210 vs 107;
      diphtheria, 21.7 vs 12.1 U/mL; and tetanus, 2.86 vs 2.04 Eq/mL. Following
      immunization with A-DTP, local and systemic adverse experiences were 30% to 50%
      and 20% to 30% fewer, respectively, as compared with W-DTP. CONCLUSIONS--The
      BIKEN A-DTP vaccine used in this study demonstrates enhanced immunogenicity to
      lymphocytosis promoting factor, filamentous hemagglutinin, and other measured
      antigens and less reactogenicity compared with licensed W-DTP [corrected].

PMID- 1621657
TI  - Severity and frequency of sequelae of bacterial meningitis in Alaska Native
      infants. Correlation with a scoring system for severity of sequelae.
AB  - OBJECTIVES: To (1) determine the frequency and severity of sequelae of
      Haemophilus influenzae type b and Streptococcus pneumoniae meningitis in Alaska
      Native children, (2) compare morbidity and mortality of H influenzae b and S
      pneumoniae meningitis, and (3) evaluate the applicability of the Herson-Todd
      prognostic score (HTPS) to both H influenzae b and S pneumoniae meningitis in
      this population. DESIGN: A retrospective study of all cases of H influenzae b and
      S pneumoniae meningitis in Alaska Native children younger than age 5 years. Data
      on meningitis sequelae, obtained from medical charts and records of the Infant
      Learning Program, were collected, and incidence of sequelae tabulated. Data
      obtained on admission to the hospital were used to calculate HTPS. SETTING:
      Indian Health Service facility for the Yukon-Kuskokwin Delta region of southwest
      Alaska. STUDY SUBJECTS: 51 of 63 Alaska Native children with H influenzae b
      meningitis and 13 of the same 63 Alaska Native children with S pneumoniae
      meningitis occurring between 1980 and 1988. One child was infected with both
      organisms, producing a total of 64 cases for study. SELECTION PROCEDURES: Cases
      were identified by surveillance for these diseases between January 1, 1980, and
      December 31, 1988, maintained by the Arctic Investigations Program, Centers for
      Disease Control. MEASUREMENTS AND RESULTS: Sequelae of bacterial meningitis
      caused by H influenzae b were equal to or exceeded rates of sequelae described in
      other children in the United States. After H influenzae b meningitis, motor
      abnormalities (29%) and hydrocephalus (7%) occurred two to four times more often
      in Alaska Native children than in children in other parts of the United States.
      Differences in severity of H influenzae b sequelae could not be accounted for by
      microbiologic markers of the H influenzae b strain, including ampicillin
      sensitivity, biotype, outer membrane protein type, or electropherotype. Numbers
      of cases of S pneumoniae meningitis were too small for statistically valid
      comparison, but sequelae of S pneumoniae meningitis occurred in roughly equal
      proportion as sequelae of H influenzae b meningitis. The HTPS was applied to
      Alaska Native children with H influenzae b meningitis and was found to be very
      accurate in predicting children with major sequelae. Analysis of the prognostic
      factors used in deriving the HTPS revealed a unique set of predictors for
      sequelae in Alaska Native children: seizures at admission, glucose levels in
      cerebrospinal fluid of less than 1.1 mmol/L; and male gender, with a significant
      predictive interaction between male gender and age less than 6 months at
      admission. CONCLUSIONS: Alaska Native children suffer greater neurologic
      morbidity as a result of H influenzae b meningitis than do their non-Native
      counterparts. The HTPS was a good predictor of major sequelae in Alaska Native
      children with H influenzae b or S pneumoniae meningitis and could be useful in
      determining which patients need referral to a tertiary care center.

PMID- 1621658
TI  - Long-term outcome of neonatal meningitis.
AB  - OBJECTIVE: To determine the long-term outcome of neonatal bacterial meningitis
      and the relationship between the outcome and specific features in the acute stage
      of the disease; and to compare the outcome between infants with neonatal
      meningitis and high-risk infants without meningitis. DESIGN: Prospective clinical
      evaluations of 21 survivors of meningitis and 21 matched controls who were
      retrospectively selected from a high-risk patient population. SETTING: Program of
      follow-up performed at the Children and Youth Project's High Risk Center of the
      Department of Pediatrics, University of Louisville, Louisville, Ky. Neonates were
      inborn at a university hospital with a high-risk obstetric unit and level III
      nursery. PATIENTS: Twenty-six consecutive neonates born between 1970 and 1980
      with culture-proven bacterial meningitis, excluding neonates with congenital
      neurologic defects. Nineteen of 21 survivors and 21 controls matched by age, sex,
      race, birth weight, and gestational age were followed up from 1 to 14 years
      (mean, 7.8 years). Both survivors and controls fell below the federal poverty
      guidelines. RESULTS: Gram-positive meningitis was twice as common as gram
      negative meningitis with co-occurrence of meningitis and sepsis in half of the
      cases. Neonates with gram-positive meningitis and higher birth weight had a
      higher survival rate, but this finding was not statistically significant. The
      mortality rate in neonates with gram-negative meningitis was almost three times
      higher than that of neonates with gram-positive meningitis, but no significant
      difference was observed between their morbidity rates. Eight (38%) of 21
      survivors were normal, while another eight (38%) and five (24%) had mild and
      moderate to severe sequelae, respectively. Survivors of meningitis had lower IQ
      scores and more severe sequelae than matched controls. CONCLUSION: Neonatal
      bacterial meningitis results in poorer long-term outcome than in controls, but
      improved outcome compared with previous studies of neonatal meningitis.

PMID- 1621659
TI  - Factors influencing the choice of a residency training program. A student's
      perspective.
AB  - Current trends in pediatric residency training have shown that a growing number
      of programs have been unable to fill their available positions through the
      National Resident Matching Program, Evanston, Ill. This has caused a competitive
      climate among programs to attract medical students as potential residents. The
      purpose of this study was to learn what factors are important to all students in
      determining the rank order of the residency training programs to which they have
      applied. Analysis of data obtained from 600 survey respondents (40%) showed that
      program curriculum was most important. Factors, such as night call and benefits,
      took on much less importance. Differences did exist between students who applied
      for pediatric vs other residencies. The balance between primary and tertiary care
      and a university setting are examples of variables that had a greater influence
      on aspiring pediatricians. This information has important implications for
      training program directors.

PMID- 1621660
TI  - Effect of somatotropin of mammalian cell origin in growth hormone deficiency.
AB  - Sixty-nine growth hormone-deficient patients were treated for 1 year with
      somatotropin (recombinant DNA-derived human growth hormone) produced in mouse
      cells. The growth velocity of the 50 patients (72%) in whom the effectiveness of
      this growth hormone could be evaluated increased from a mean (+/- SD) of 3.5 +/-
      1.1 to 8.7 +/- 1.6. cm/y. An enhanced rate of weight gain was also observed. Bone
      age was not unduly accelerated. One of 66 patients developed antibodies to
      recombinant growth hormone, which did not affect the response to therapy. No
      patient developed antibodies to host cell proteins. An increased insulin response
      to a standard glucose load, without any change in glucose tolerance, was observed
      after 1 year of treatment. This authentic sequence human growth hormone
      preparation produced in mammalian cells is both effective and safe in the
      treatment of children with growth hormone deficiency.

PMID- 1621661
TI  - Calcium and zinc retention from protein hydrolysate formulas in suckling rhesus
      monkeys.
AB  - OBJECTIVE: To determine calcium and zinc retention from infant formulas based on
      protein hydrolysates. DESIGN: Randomized, crossover. SETTING: Newborn nursery at
      the California Primate Research Center, Davis. PARTICIPANTS: Suckling infant
      rhesus monkeys (N = 7), aged 6 weeks at the beginning of the study. Each infant
      received seven different formulas. INTERVENTIONS: Fasted infant monkeys were fed
      diets radiolabeled with calcium 47 and zinc 65. Retention was determined by
      counting whole body radioactivity immediately after dosing and 7 days after
      dosing. MEASUREMENTS AND RESULTS: Retention of 47Ca was a mean (+/- SEM) of 79%
      +/- 4% from casein hydrolysate and 72% +/- 6% from the whey protein hydrolysate
      formula. Calcium 47 retention from hydrolysates based on whey protein/casein
      mixtures (a ratio of 60:40 or 50:50) was similar despite differences in protein
      sources and calcium content. Calcium 47 retention from two types of soy/collagen
      hydrolysate formula was found to be 68% +/- 6% and 59% +/- 4%, respectively,
      which is significantly lower than retention from casein hydrolysate. Considering
      the different calcium content of these formulas, total calcium retention from
      milk protein hydrolysates was higher than from soy/collagen products. Retention
      of 65Zn from milk protein hydrolysates ranged from 18% +/- 3% to 29% +/- 4% and
      was higher than that from soy/collagen formulas with a mean retention of 7% +/-
      3% and 10% +/- 4%, respectively. Despite these differences in 65Zn retention,
      total zinc retention from all soy/collagen formulas was similar due to their
      higher zinc content. CONCLUSIONS: Calcium and zinc bioavailability was high from
      formulas based on milk protein hydrolysate, but was considerably lower from soy
      hydrolysates. Higher levels of calcium and zinc provided in soy hydrolysate
      formula compensated for the lower bioavailability and resulted in similar amounts
      of calcium and zinc retained.

PMID- 1621662
TI  - Male pseudohermaphroditism resulting from 17 alpha-monooxygenase (P-450C17)
      deficiency in two unrelated Guamanians.
AB  - OBJECTIVE: To report the cases of and to describe two unrelated Guamanian
      patients with an unusual form of congenital adrenal hyperplasia resulting from 17
      alpha-monooxygenase deficiency (P-450C17). DESIGN: Patient series. SETTING:
      Referral center. PATIENTS: Two phenotypic females of Guamanian descent,
      unrelated, and referred for evaluation of hypertension and delayed sexual
      development. INTERVENTIONS: Diagnosis by measurement of specific adrenocortical
      precursors and initiation of therapy with dexamethasone. Documentation of
      response by decrease in circulating concentrations of metabolites and decrease in
      blood pressure. CONCLUSIONS: The finding of a rare autosomal recessive disorder
      in two unrelated persons from a small genetic pool in Guam suggests that this may
      result from the same molecular defect and may be present in this population at an
      unexpectedly high incidence. Lack of suspicion frequently leads to unnecessary
      delay in diagnosis of this condition.

PMID- 1621663
TI  - The pediatrician's documentation of child maltreatment.
AB  - Pediatricians are increasingly involved in the assessment of suspected child
      maltreatment. These assessments are a crucial component of the overall evaluation
      of the patient and provide the basis for interventions to protect the child. An
      accurate documentation of the pediatrician's assessment is important to convey
      the information to professionals in the public agencies involved, including the
      legal system. However, there may be uncertainty among pediatricians concerning
      what should be documented in the medical record in cases of child maltreatment.
      The objectives of this article are to provide a detailed but generic description
      of the information that should be gathered during the evaluation of children who
      show signs of any form of child abuse and neglect and to provide clear guidelines
      for the proper written documentation of child maltreatment.

PMID- 1621664
TI  - Lacerations involving glass. The role of routine roentgenograms.
AB  - OBJECTIVE: To determine, when evaluating a laceration caused by glass, whether
      seeing that the bottom of the wound is free of glass eliminates the possibility
      that glass is present in the wound. RESEARCH DESIGN: Prospective patient series.
      SETTING: Two pediatric emergency departments. PARTICIPANTS: 226 children with
      lacerations due to glass occurring in a period of 21 months. SELECTION
      PROCEDURES: Consecutive sample. INTERVENTIONS: Before obtaining a roentgenogram,
      the triage nurse or the managing physician visually inspected each wound and
      recorded whether the bottom of the wound was seen, if glass was seen in the
      wound, and the length and depth of the wound. Further treatment of the wound was
      at the discretion of the managing physician. MEASUREMENTS/MAIN RESULTS: Glass was
      seen in the wounds of 10 children on initial inspection. Of the remaining 216
      injuries, glass was contained in 12 (21.4%) of the 56 lacerations when the bottom
      of the wound was not visualized, and in 11 (6.9%) of the 160 lacerations when the
      bottom of the wound was visualized. There was a significant association between
      the depth of the wound and an inability to see the bottom of the wound, and
      deeper wounds were significantly more likely to contain glass. All but one of the
      lacerations containing glass had a depth of at least 0.5 cm. CONCLUSIONS: In the
      population studied, seeing that the bottom of the laceration was free of glass
      reduced, but did not eliminate, the possibility that glass was present in the
      wound. In addition, superficial lacerations (less than 0.5 cm) rarely contained
      undetected glass fragments. We recommended that further investigation concerning
      the mechanism of injury, the depth of the wound, and the type of glass involved
      is needed before physicians abandon routine roentgenography for lacerations due
      to glass.

PMID- 1621665
TI  - The physical health of children in kinship care.
AB  - OBJECTIVE: The objectives of this study were to assess the current and chronic
      health problems and the adequacy of primary health care of children placed with a
      relative (kinship care) by a public agency. RESEARCH DESIGN: Population survey.
      SETTING: Children in kinship care in Baltimore, Md. PARTICIPANTS: Four hundred
      seven (78%) of 524 children in kinship care in 1989. INTERVENTIONS: None.
      MEASUREMENTS/MAIN RESULTS: Information on the child's health status and care was
      obtained via a review of medical records; questionnaires sent to primary care
      physicians, parents, care givers, and caseworkers; and clinical assessment of the
      child by a nurse, pediatrician, and child psychologist. The children were found
      to have health problems similar to those in foster and poor children, but more
      problems than American children in general. Frequent diagnoses included impaired
      visual acuity and hearing, obesity, dental caries, and asthma; often, these
      problems had not been identified or treated. Gaps in the medical records
      precluded firm conclusions concerning the children's primary care, but suggest an
      inadequate system for ensuring their health care. CONCLUSIONS: There is a need
      for improving the system of health care for children in kinship care. There is
      also a need for additional research on this high-risk group of children.

PMID- 1621666
TI  - Equestrian injuries in children and young adults.
AB  - We reviewed the English language scientific literature about equestrian injuries
      among children and young adults. All studies showed that more females than males
      were injured, with falls from horses being the most common cause of injury.
      Fractures were common, and head injuries were associated with the vast majority
      of deaths (72% to 78%) and hospitalizations (55% to 100%). Although the overall
      injury rate was low, equestrian athletes are at risk for serious injuries.
      Pediatricians should know the medical contraindications for participation in
      equestrian sports and encourage riders to obtain horse safety training and use
      protective headgear (helmets) approved by the American Society for Testing
      Materials when riding or working around horses. Pediatricians can play an active
      role in increasing public awareness of equestrian injuries and in reducing risk
      of injury.

PMID- 1621667
TI  - School-based adolescent health care. Review of a clinical service.
AB  - OBJECTIVE: To provide recommendations regarding the establishment and maintenance
      of school-based clinics, based on analysis of data from a clinic located in a New
      York City high school. DESIGN: Review of demographic, medical, and psychosocial
      data collected during student visits. SUBJECTS: During 2 1/2 years, 1283 students
      were seen. The students were 53% girls and 47% boys; 65% black and 25% Hispanic;
      and 65% grades 9-10 and 35% grades 11-12. RESULTS: There were 7920 visits. Visits
      were for acute or chronic medical problems (44%), physical examinations and
      immunizations (25%), gynecologic or sexuality-related issues (17%), and mental
      health concerns (14%). Psychosocial characteristics of the 378 students who
      enrolled during the 1989-1990 academic year indicated that only 27% lived with
      both natural parents, 55% were foreign-born, 37% had repeated a grade at least
      once, 44% were sexually active, 13% drank alcohol, and 14% had past or present
      suicidal ideation. CONCLUSIONS: These data demonstrate that a school-based clinic
      can be involved in the management of a wide range of health care needs for large
      numbers of at-risk youth. In addition, school-based clinics can serve as a major
      site for the teaching of medical students and residents, and as a valuable
      resource for clinical research.

PMID- 1621668
TI  - Antipyretic efficacy of ibuprofen vs acetaminophen.
AB  - OBJECTIVE: To compare the antipyretic efficacy of ibuprofen, placebo, and
      acetaminophen. DESIGN: Double-dummy, double-blind, randomized, placebo-controlled
      trial. SETTING: Emergency department and inpatient units of a large,
      metropolitan, university-based, children's hospital in Michigan. PARTICIPANTS: 37
      otherwise healthy children aged 2 to 12 years with acute, intercurrent, febrile
      illness. INTERVENTIONS: Each child was randomly assigned to receive a single dose
      of acetaminophen (10 mg/kg), ibuprofen (7.5 or 10 mg/kg), or placebo.
      MEASUREMENTS/MAIN RESULTS: Oral temperature was measured before dosing, 30
      minutes after dosing, and hourly thereafter for 8 hours after the dose. Patients
      were monitored for adverse effects during the study and 24 hours after
      administration of the assigned drug. All three active treatments produced
      significant antipyresis compared with placebo. Ibuprofen provided greater
      temperature decrement and longer duration of antipyresis than acetaminophen when
      the two drugs were administered in approximately equal doses. No adverse effects
      were observed in any treatment group. CONCLUSION: Ibuprofen is a potent
      antipyretic agent and is a safe alternative for the selected febrile child who
      may benefit from antipyretic medication but who either cannot take or does not
      achieve satisfactory antipyresis with acetaminophen.

PMID- 1621669
TI  - Comparison of multidose ibuprofen and acetaminophen therapy in febrile children.
AB  - OBJECTIVE: To determine whether febrile children receiving 2.5-, 5-, or 10-mg/kg
      ibuprofen therapy via a liquid or 15-mg/kg acetaminophen therapy via an elixir
      every 6 hours for 24 to 48 hours show equivalent fever reduction or suffer
      adverse effects of the drug administered. DESIGN: Randomized, double-blind,
      multidose, parallel-group, variable-duration (24 to 48 hours) clinical trial.
      SETTING: The academically affiliated Children's Hospital in Columbus, Ohio.
      PARTICIPANTS: 64 febrile (defined as oral or rectal temperature of 39 degrees C
      to 40.5 degrees C) but otherwise healthy children aged 6 months to 11 years 7
      months randomly assigned to one of the four drug regimens. INTERVENTIONS:
      Treatment with either ibuprofen or acetaminophen as described above.
      Administration of antibiotics or intravenous fluids was allowed only after at
      least 24 hours of treatment with the assigned drug. MEASUREMENTS/MAIN RESULTS: In
      61 of the 64 evaluable patients, treatments were effective and well tolerated
      during the entire study. While the rates of temperature reduction and maximal
      reduction of fever after administration of the initial dose were equal for
      patients receiving 10-mg/kg ibuprofen therapy and 15-mg/kg acetaminophen therapy,
      and both regimens were more effective than smaller doses of ibuprofen in reducing
      fever, after the second dose (and continuing to the end of the study) there were
      no statistically significant differences in temperature response among the
      treatment groups. Six children were withdrawn from the study, two because of
      dosing errors, three because of hypothermia (temperature of less than 35.6
      degrees C; all three patients were in the acetaminophen group), and one because
      of gastrointestinal distress (this child was in the group receiving 2.5-mg/kg
      ibuprofen therapy). No other significant symptoms or adverse laboratory or
      physical findings were noted. While further confirmatory studies are needed,
      ibuprofen liquid (10 mg/kg) and acetaminophen elixir (15 mg/kg) administered
      every 6 hours for 24 to 48 hours appeared to be most effective in reducing fever.
      These two regimens were equally effective and equally tolerated in febrile
      children. Lower ibuprofen doses (2.5 and 5 mg/kg) were less effective than
      acetaminophen and 10-mg/kg ibuprofen therapy after the initial dose but were at
      least equally effective as these two higher-dose regimens thereafter.

PMID- 1621670
TI  - Radiological case of the month. Pica.

PMID- 1621671
TI  - Radiological case of the month. Extensive neonatal subarachnoid hematoma.

PMID- 1621672
TI  - Picture of the month. Erythema marginatum in acute rheumatic fever.

PMID- 1621673
TI  - Pathological case of the month. Chronic granulomatous disease with histologic
      features of pulmonary sequestration.

PMID- 1621674
TI  - Tubulointerstitial changes as a major determinant in the progression of renal
      damage.
AB  - Tubulointerstitial injury is an invariant finding in the chronically diseased
      kidney, irrespective of the type of disease or the compartment in which the
      disease originates. Such histologic changes are functionally significant in that
      scores for such damage, rather than glomerular injury, correlate with decline of
      renal function. This review summarizes (1) clinical evidence attesting to
      tubulointerstitial changes as an index of functional impairment, (2) mechanisms
      by which tubulointerstitial injury impairs renal function, and (3) interactions
      of pathologic processes in the vascular, glomerular, tubular, and interstitial
      compartments that culminate in tubulointerstitial injury. This report concludes
      with a review of interstitial fibrosis, a pathologic process regarded as an
      irreversible outcome from tubulointerstitial injury.

PMID- 1621675
TI  - The Modification of Diet in Renal Disease Study: design, methods, and results
      from the feasibility study.
AB  - The Modification of Diet in Renal Disease (MDRD) Study is a multicenter clinical
      trial designed to assess acceptance, safety, and efficacy of restricted protein
      and phosphorus diets in patients with progressive renal disease. The Feasibility
      Study was designed to test procedures and recruitment strategies and to estimate
      sample size for the Full-Scale Trial. The Feasibility Study was not designed to
      compare rates of progression of renal disease among diet groups. Patients aged 18
      to 75 years, with a glomerular filtration rate (GFR; measured by 125I-iothalamate
      clearance) between 7.5 and 80 mL/min/1.73 m2, and a previous progressive increase
      in serum creatinine, were eligible for enrollment. Compliance with prescribed
      dietary protein intake was calculated from urea nitrogen appearance (UNA).
      Nutritional status was monitored by anthropometry and serum proteins. Progression
      of renal disease was calculated as the rate of decline of GFR. Ninety-six
      patients met all of the eligibility requirements and were randomized to study
      diets. Follow-up was conducted for a mean duration of 14 months (range, 2 to 22
      months). Although most patients did not achieve the prescribed protein intake,
      marked changes in intake were observed among patients assigned to the low-protein
      diets, and mean estimated protein intake differed significantly among diet
      groups. No patients became malnourished. Mean rates of decline in GFR were
      relatively slow, and variability among individuals was high. As expected, the
      number of patients enrolled was too small to determine if the rate of decline in
      GFR was significantly slower among patients assigned to the restricted protein
      and phosphorus diets. The rate of decline in GFR was significantly inversely
      correlated with long-term average mean arterial blood pressure (MAP), even among
      patients whose blood pressure was controlled to levels within the normal range.
      However, because patients were not randomly assigned blood pressure goals, it was
      not possible to determine whether a causal relationship exists. Based on the
      experience gained during the Feasibility Study, the design for the Full-Scale
      Study includes two studies of defined by patients' baseline levels of renal
      function. Within each study, patients will be assigned randomly to one of two
      diets, and within each diet group, to one of two levels of blood pressure
      control. Based on variability of rates of decline in GFR slopes observed during
      the Feasibility Study, 800 patients with follow-up periods of up to 4 years will
      be required for the Full-Scale Trial.

PMID- 1621676
TI  - Long-term follow-up and response to chemotherapy in patients with light-chain
      deposition disease.
AB  - Nineteen patients with light-chain deposition disease (LCDD) were studied
      retrospectively. This report presents data on long-term patient and renal
      survival and the response to intermittent administration of melphalan and
      prednisone. Immunoelectrophoresis or immunofixation demonstrated a monoclonal
      protein in the serum of 78% and in the urine of 84% of the patients; 16% had no
      demonstrable monoclonal protein in serum or urine. The median age at presentation
      was 51 years (range, 37 to 77 years). Twelve (63%) of the patients had a
      monoclonal protein of undetermined significance without evidence of myeloma. The
      typical glomerular lesion was a diffuse mesangial nodular lesion that was
      positive for periodic acid-Schiff (PAS) stain with acute and chronic
      tubulointerstitial changes. Fifteen patients had kappa light-chain deposition and
      four had lambda light-chain deposition. Five-year actuarial patient survival and
      survival free of end-stage renal disease were 70% and 37%, respectively.
      Seventeen patients received melphalan and prednisone, and one patient received
      chlorambucil and prednisone. All of the patients had some impairment of renal
      function at presentation, and 58% had a serum creatinine concentration greater
      than 354 mumol/L (4.0 mg/dL). There was either stabilization or improvement in
      renal function after chemotherapy in five of eight patients who had a serum
      creatinine concentration less than 354 mumol/L (4.0 mg/dL) at the initiation of
      therapy. Of the 11 patients with a high serum creatinine concentration (greater
      than 354 mumol/dL [4.0 mg/dL]), 82% progressed to end-stage renal disease despite
      therapy. Follow-up urine protein studies demonstrated at least a 50% decrease in
      urine protein excretion in five of 15 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621677
TI  - Effects of ascorbic acid and pyridoxine supplementation on oxalate metabolism in
      peritoneal dialysis patients.
AB  - We studied the effect of vitamin C and B6 supplementation on oxalate metabolism
      in seven patients receiving chronic peritoneal dialysis therapy. The study was
      divided into three phases, each lasting 4 weeks. Plasma oxalate, total ascorbic
      acid, and pyridoxal-5'-phosphate (PLP) were measured at the end of each phase.
      Twenty-four-hour urinary excretion and dialysate removal rates of oxalate were
      also obtained. At the end of phase I (supplement-free period), plasma oxalate
      levels were markedly elevated at 47.6 +/- 7.1 mumol/L (437 +/- 66 micrograms/dL)
      (normal, 3.4 +/- 0.4 mumol/L [30.3 +/- 1.6 micrograms/dL]). Plasma total ascorbic
      acid levels were 62 +/- 6 mumol/L (1.0 +/- 0.1 mg/dL) (normal, 45 to 57 mumol/L
      [0.8 to 1.0 mg/dL]), while plasma PLP levels were markedly reduced to 24 +/- 5
      nmol/L (normal, 40 to 80 nmol/L). Daily supplements of 0.57 mmol (100 mg)
      ascorbic acid orally (phase II) resulted in a 19% increase in the plasma oxalate
      levels to 57.8 +/- 6.1 mumol/L (520 +/- 55 micrograms/dL) (P less than 0.03),
      with a concomitant 60% increase in the plasma ascorbate levels (91 +/- 6 mumol/L
      [1.6 +/- 0.1 mg/dL], P less than 0.01). Plasma PLP values remained low. Finally,
      during phase III (0.57 mmol or 100 mg ascorbic acid plus 59.6 mumol or 10 mg
      pyridoxine HCI orally daily), plasma oxalate levels declined by 17% to 47.9 +/-
      5.2 mumol/L (431 +/- 47 micrograms/dL) (P greater than 0.05 v phase II).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1621678
TI  - Modest reduction of serum albumin in continuous ambulatory peritoneal dialysis
      patients is common and of no apparent clinical consequence.
AB  - It is commonly assumed that a reduction in serum albumin is a reliable sign of
      nutritional inadequacy affecting prognosis in continuous ambulatory peritoneal
      dialysis (CAPD) patients. We studied prospectively 19 patients starting CAPD and
      monitored them for a minimum of 15 months. Serum albumin, changes in dry weight,
      morbid events, and, where possible, protein catabolic rates (PCR) and urea
      nitrogen appearance (UNA) were determined. A modest reduction in serum albumin
      (25 to 33 g/L [2.5 to 3.3 g/dL]) was found in the majority of patients 3 months
      after starting CAPD, which persisted for 12 months. Most of these patients gained
      weight and were not hospitalized in that period. PCR and UNA values showed
      adequate nutrition. Two patients developed serious medical problems leading to
      clinical malnutrition and serum albumin rapidly falling below 20 g/L. A modest
      reduction in serum albumin (25 to 33 g/L) is common in healthy CAPD patients and,
      if stable, does not indicate a poor prognosis or nutritional inadequacy.

PMID- 1621679
TI  - Patterns of low incidence of treated end-stage renal disease among the elderly.
AB  - We present US county-level maps of the 1983 to 1988 incidence of treated end
      stage renal disease (ESRD) among white and nonwhite persons 65 years of age and
      older (N = 66,129). Recent statistical advances permit the investigation of
      geographical patterns of unusually low disease incidence. Our maps highlight
      those US counties which have been determined to have rates of ESRD treatment
      incidence that are low relative to those of all counties, revealing several
      interesting geographic patterns. For whites, low rates are found in the
      Northwest, the Midwest, and the South. Nonwhite rates are seen to be low
      primarily in the South and Alaska. Low treatment incidence could be due to a
      combination of (1) low true incidence, (2) lack of access to health care
      services, (3) insufficient diagnosis and referral, and (4) patients' reluctance
      to accept ESRD therapy, due to cultural or personal concerns. A state-level
      regression of elderly rates on those aged 40 to 64 years indicates the variation
      in treatment incidence among the elderly may be due to factors other than
      variation in true incidence, which the middle-aged rates reflect more closely.
      Residual analysis corroborates the visual impression of the maps of low ESRD
      treatment incidence in several southern states, where referral to dialysis may be
      as much as 40% lower than the national level. Further research on factors
      contributing to low treatment incidence, including competing risks, regional lags
      relative to the national trend to dialyze more elderly patients, and lack of
      access to health care resources, is indicated.

PMID- 1621680
TI  - Patients with a low income have reduced renal allograft survival.
AB  - The impact of socioeconomic factors on long-term outcome after renal
      transplantation is unknown. We examined the effects of family income among 202
      patients transplanted between 1976 and 1982 who had an allograft that functioned
      for at least 1 year. Compared with patients with an adequate income, recipients
      of medical assistance at the time of transplantation were more likely to return
      to dialysis after 1 year (16/45 [36%] v 26/157 [17%], P less than 0.01), or after
      5 years of graft function (10/38 [26%] v 12/116 [10%], P less than 0.01).
      Patients who complied with fewer than 85% of visits during the first 2 years were
      also more likely to return to dialysis after 1 year (17/49 [35%] v 25/153 [16%],
      P less than 0.01), or after 5 years (8/31 [26%] v 14/123 [11%], P less than 0.05)
      than were more compliant patients. However, noncompliance was not different in
      patients with and without a low income (37/157 [24%] v 12/45 [27%], P greater
      than 0.05). The relative risk for returning to dialysis after 5 years was 2.4 (P
      less than 0.05) for low income and 3.0 (P less than 0.05) for less than 85%
      compliance using a Cox proportional hazards model. These effects were independent
      of prior transplantation, mismatches, pre-formed antibodies, delayed graft
      function, age, sex, diabetes, alcohol or drug abuse, education, race, distance
      from the transplant center, and living in an urban environment (relative risk =
      2.5, P less than 0.05). Neither income nor compliance could be linked to
      death.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621681
TI  - The effect of aging on glomerular hemodynamics in the rat.
AB  - Glomerular hemodynamics were measured in male Sprague-Dawley rats, aged 4 to 5
      months (young) or 20 to 22 months (old). Body weight (BW) and left kidney weights
      (KW) were higher in old rats than young (BW: 507 +/- 12 g v 342 +/- 11 g, P less
      than 0.001; KW: 2.0 +/- 0.1 g v 1.3 +/- 0.1 g, P less than 0.001). Arterial blood
      pressure (AP) was slightly higher in old rats, but within the normotensive range
      (106 +/- 4 mm Hg v 94 +/- 4 mm Hg, P less than 0.05). Glomerular filtration rate
      (GFR; factored for KW) was lower in old versus young rats (0.67 +/- 0.05
      mL/min/gKW v 1.00 +/- 0.08 mL/min/gKW, P less than 0.02). The cortical surface of
      the kidney in old (but not young) rats showed marked heterogeneity and single
      nephron (SN)GFR was measured only in filtering nephrons and was higher and more
      variable in old versus young rats. Glomerular blood pressure (PGC) was unchanged
      in old compared with young rats (53 +/- 4 mm Hg v 55 +/- 2 mm Hg). There was a
      significantly greater level of glomerular sclerosis (in outer cortical glomeruli)
      in old versus young rats, and glomerular volume was substantially greater in old
      rats. This study suggests that age-related glomerulopathy is not primarily
      mediated by glomerular capillary hypertension.

PMID- 1621682
TI  - The albumin dilemma.

PMID- 1621683
TI  - Looking upon the water. It's our Gummit and we're stuck with it!

PMID- 1621684
TI  - Diabetic glomerulosclerosis and chronic renal failure with absent-to-minimal
      microalbuminuria.
AB  - We report the case of an elderly black woman with a 20-year history of insulin
      independent diabetes mellitus (IDDM), chronic renal failure, hypertension,
      proliferative retinopathy, and classical histologic features of diabetic
      glomerulosclerosis on renal biopsy. Repeat determinations of urinary albumin
      excretion rates failed to disclose significant microalbuminuria. This
      presentation should remind the clinician that a small minority of patients with
      IDDM of long duration may have severe diabetic glomerulosclerosis and renal
      insufficiency without detectable microalbuminuria.

PMID- 1621685
TI  - Glomerulonephritis and non-Hodgkin's lymphoma: a report of two cases and review
      of the literature.
AB  - Two cases of glomerulonephritis associated with non-Hodgkin's lymphoma (NHL) are
      described. The first patient presented with the nephrotic syndrome and normal
      renal function, whereas the second suffered from recurrent acute renal failure
      together with a unique pattern of IgM deposition within glomerular capillaries.
      Our review of the literature suggests that this association, although rare, has
      been documented in a sufficient number of cases to show that it is more than
      coincidental. Whereas the most common renal lesion associated with Hodgkin's
      disease is minimal change disease, more advanced glomerular changes are found in
      the patients with NHL. This is reflected in the higher incidence of renal failure
      in the latter patients. Treatment of the lymphomas has been shown to result in
      improvement or even cure of the renal disease, although long-term follow-up is
      rarely available in the reported cases.

PMID- 1621686
TI  - Erosive spondyloarthropathy in primary hyperparathyroidism without renal failure.
AB  - A patient with erosive spondyloarthropathy (ESA) and primary hyperparathyroidism
      is described. In the past, ESA has been described exclusively in patients with
      chronic renal failure (CRF) and has been attributed to crystal deposition,
      amyloidosis, severe secondary hyperparathyroidism, or other abnormalities of
      chronic renal failure. This patient with normal renal function suggests that
      secondary hyperparathyroidism plays the major pathogenetic role in ESA in
      patients with renal failure.

PMID- 1621687
TI  - Acute glomerulonephritis following infection with Chlamydia psittaci.

PMID- 1621688
TI  - A strategy for delineating risks due to exposure to neurotoxic chemicals.
AB  - A method for delineating the risks due to exposure to neurotoxic chemicals based
      upon the linkage of four national computer-based registers is described. The four
      registers are: the Danish Product Register database, PROBAS; Register of air
      pollution measurements in Danish workplaces, ATABAS; Register of notified
      occupational diseases; and Register of work force. Based on the information from
      the four registers, risk profiles for neurotoxic chemicals in 69 industrial
      groups were generated. The risk profiles describe the number of neurotoxic
      chemicals, their potency, the number of exposure measurements exceeding the
      occupational exposure limit (OEL), and the total and relative number of diseases
      caused by the chemicals in each group. Based on this linkage, twelve industries
      are noted to be potentially at high risk due to exposure to neurotoxic chemicals;
      therein, 18 chemicals are identified as "risk chemicals," primarily used in 8
      main groups of products. The goal of the evaluation is to develop a tool for
      priority setting of preventive measures. The evaluation may also serve as a tool
      for assessing improvements and selecting areas for further epidemiological
      studies.

PMID- 1621689
TI  - Assessment of occupational exposure to cadmium in The Netherlands, 1980-1989.
AB  - One thousand five hundred fifty urine samples and 1,295 blood samples, collected
      from 919 workers, were analyzed for cadmium (Cd). The workers were employed at 16
      different types of workplaces. In about 7.5% of the samples, the concentration of
      Cd exceeded the biological limit values proposed by the Dutch Expert Committee
      for Occupational Standards. Levels higher than these values were measured in both
      urine samples and blood samples of workers involved in electrochemical plating,
      in production of Cd-stabilizers and enamels, and in soldering with silver-cadmium
      solder. Significantly higher concentrations of beta 2-microglobulin (MG) were
      found in urine samples with CdU greater than 10 micrograms/g creatinine. Cd
      levels in urine increased with age.

PMID- 1621690
TI  - Lung cancer risk among workers exposed to man-made mineral fibers (MMMF) in the
      Swedish prefabricated house industry.
AB  - Mortality and cancer incidence was investigated among 2,807 workers, employed for
      at least one year before 1972, at 11 Swedish companies manufacturing
      prefabricated wooden houses. A total of 1,068 workers had been exposed to man
      made mineral fibers (MMMF) used for insulation. Mortality was followed from 1969
      to 1988 and cancer incidence from 1969 to 1985. Exposure conditions were
      investigated at all plants. There were 14 deaths from lung cancer in the total
      cohort, whereas 20.7 would be expected (SMR = 68; 95% CI:37-113), based on
      regional mortality. After a latency of 20 years of more, two lung cancer cases
      had occurred among all workers exposed to MMMF, whereas 4.3 would be expected
      (SMR = 46; 95% CI: 5-168). The exposure levels that have prevailed do not seem to
      be associated with an increased lung cancer rate, but extended follow-up is
      necessary for a definitive evaluation.

PMID- 1621691
TI  - Accelerated loss of lung function and alveolitis in a longitudinal study of non
      smoking individuals with occupational exposure to asbestos.
AB  - Long-term asbestos workers who insulate pipes and boilers may develop
      interstitial lung disease associated with loss of lung function. To quantitate
      annual loss of lung function, 77 individuals with chest X-rays greater than or
      equal to 1/0 ILO category who were life-long non-smokers or ex-smokers for
      greater than 5 years were evaluated. Study parameters included pulmonary function
      tests and bronchoalveolar lavage for a mean of 3 visits over 30 +/- 2 months. The
      study participants were 56 +/- 1 years old and had 31 +/- 1 years' occupational
      exposure to asbestos. At the first visit, multiple regression analysis revealed
      significant associations between rales or radiographic opacities and VC, FEV1,
      and total lung capacity; significant associations were also found between
      neutrophils/ml lavage fluid with FEV1 and diffusing capacity (all p less than
      0.05). Annual declines for the asbestos-exposed were VC -92 +/- 28 ml/yr and FEV1
      -66 +/- 21 ml/yr. Declines in VC and FEV1 were less in those with reduced lung
      function at the initial visit. There were no significant associations between any
      of the annual declines and cells recovered by bronchoalveolar lavage. Compared to
      other asbestos-exposed cohorts followed longitudinally, asbestos insulators with
      radiographs greater than or equal to 1/0 and exposure greater than or equal to 20
      years have larger rates of FVC and FEV1 decline for both non-smokers and ex
      smokers.

PMID- 1621692
TI  - Irregular opacities in the lung, occupational asthma, and airways dysfunction in
      aluminum workers.
AB  - We examined chest X-rays, measured expiratory flows and FVC by spirometry and TLC
      by projected lung area, ascertained respiratory data by questionnaires, and
      performed chest examinations in 670 Southeastern aluminum workers and 659
      unexposed regional controls. Both groups were asbestos exposed. More aluminum
      workers had irregular opacities and fewer had pleural abnormalities than did
      regional pipefitter referents. The pulmonary function tests were expressed as
      percentage of predicted to adjust for height, age and duration of smoking based
      on a randomly selected U.S. reference population. Data from aluminum workers were
      compared to regional controls with students "t" tests run for unequal size
      groups. Aluminum workers had significant reductions in FEV1 of 3.2% predicted (p
      less than .003), FEF25-75 of 11.3% predicted (p less than .0001), FEF75-85 of
      22.5% predicted (p less than .0001), and an increased TLC of 2.0% predicted (p
      less than .005). The 145 who had never smoked (NS) were compared with 124 NS
      controls and showed this same pattern of differences; but in smokers, the
      differences were significant for mid and terminal flows, but not for FEV1. In
      aluminum workers who never smoked, asthma prevalence by history was 7.6% vs. 4.0%
      in controls, and wheezes were heard in 21.4% vs. 2.4% in controls. In aluminum
      workers who were current smokers, asthma prevalence was 16.4% vs. 9.4% in
      controls, and wheezes were heard in 43.7% vs. 21.1% in controls. Aluminum workers
      had significantly more asthma, wheezing, airways obstruction, and pulmonary
      parenchymal abnormalities similar to asbestosis than did regional blue collar
      controls not melting and casting aluminum.

PMID- 1621693
TI  - Chest radiographs in subjects with asbestos-related abnormalities: comparison
      between ILO categorizations and clinical reading.
AB  - The findings of a previous chest X-ray screening, determined without using
      standardized criteria, were reassessed by means of the ILO classification. Of 470
      radiographs that had been determined as showing asbestos-related changes, 430
      were categorized according to the ILO Classification. Small opacities with
      profusion greater than or equal to 1/0 were described in 39 (52%) of 75
      participants who, on the original clinical reading, had been determined as having
      lung fibrosis, and in 45 (12.7%) of 355 who were determined as having pleural
      changes only. When considering circumscribed pleural thickening at the chest wall
      or diaphragm, as categorized by the ILO Classification, such changes were present
      in 401 (93.7%) of 428 subjects with pleural changes as determined on the clinical
      reading. In addition to the improved sensitivity and specificity achieved, the
      ILO Classification also allows comparison with other studies. The most apparent
      disadvantage of the ILO system is that it cannot firmly separate the various
      types of asbestos-related pleural changes. The study revealed that the previous
      asbestos exposure of the case subjects had occurred in many different workplaces
      and occupations.

PMID- 1621695
TI  - Renal cell cancer among architects and allied professionals in Sweden.
AB  - The Swedish Cancer-Environment Registry was used to evaluate a recent report of a
      large excess risk of renal cell cancer among architects in Los Angeles. We
      identified 131 renal cell cancers among male Swedish architects and allied
      professionals during a 19-year follow-up period (1961-1979). Compared with the
      Swedish population, there was no significant excess of renal cell cancer among
      architects and allied professionals (standardized incidence ratio (SIR) = 1.15;
      131 cases). Although it was not possible to estimate the risk for architects
      alone, the SIR was only 1.06 (16 cases) in a subset of professionals employed in
      architectural and engineering firms. However, a significant increase in risk (SIR
      = 1.38) was observed in a related group of workers employed as engineers and
      construction supervisors in the home construction industry.

PMID- 1621694
TI  - A mortality cohort study of seamen in Italy.
AB  - A total of 2,208 male subjects, enrolled as merchant marine seamen at the
      Civitavecchia (Italy) harbor from 1936 to 1975 were followed up through 1989 in
      order to evaluate their mortality experience. Available information about the
      number of sailings made it possible to divide subjects into two subgroups: 948
      workers with at least one sailing (cohort A) and 1,260 with no reported sailing
      (cohort B). Fewer than expected overall deaths were observed in both cohorts
      (cohort A: SMR = 0.83; cohort B: SMR = 0.81), mainly due to a lower mortality
      from circulatory, respiratory, and digestive diseases. Lung cancer deaths were
      significantly increased in cohort A (O = 30, SMR = 1.71, 95% CI = 1.15-2.44),
      whereas no excess was observed in cohort B (O = 6, SMR = 0.57, 95% CI = 0.21
      1.26). Among subjects employed aboard ship, a trend in SMRs for lung cancer
      increasing with duration of employment was observed. Furthermore, three neoplasms
      of other parts of the respiratory system (including one mesothelioma) were
      detected in cohort A (SMR = 5.87), and one in cohort B. The study substantiates
      an increased risk of respiratory cancer among subjects with an occupational
      history of sailing; past exposure to asbestos and to other environmental
      carcinogens aboard could be implicated.

PMID- 1621696
TI  - Bladder cancer and occupation in Shanghai, 1980-1984.
AB  - To investigate occupational determinants of bladder cancer in the urban area of
      Shanghai, occupation and industry information for 1,219 incident bladder cancer
      cases diagnosed during the period 1980 to 1984 were compared with 1982 census
      data on employment. Standardized incidence ratios (SIR) for bladder cancer were
      estimated for occupation and industry classifications. Significant excess risks
      were observed for plastic products workers (male: SIR = 432; female: SIR = 368);
      textile bleachers, dyers, and finishers (male: SIR = 169); metal refining and
      processing workers (male: SIR = 139; female: SIR = 197); petroleum refining
      workers (male: SIR = 2152); railway engine drivers and firemen (male: SIR = 683);
      and workers employed in industries of apparel and other textile products
      manufacturing (female: SIR = 204); paper processing (male: SIR = 146; female: SIR
      = 226); organic chemical manufacturing (male: SIR = 186); plastic product
      manufacturing (male: SIR = 218; female: SIR = 272); and metallurgy (male: SIR =
      107; female: SIR = 561). This study indicates that many of the industries and
      occupations that are responsible for increased risk throughout the world are also
      associated with occupational bladder cancer in Shanghai.

PMID- 1621697
TI  - Exposure to diesel exhaust in the trucking industry and possible relationships
      with lung cancer.
AB  - We previously reported that long-term truck drivers and mechanics in the
      Teamsters Union had higher lung cancer risks than Teamsters outside the trucking
      industry. We now summarize results from an industrial hygiene survey of current
      exposures to diesel exhaust in the trucking industry, and relate these to our
      prior results pertaining to lung cancer risk.

PMID- 1621698
TI  - On the need for reform of the OSHAct.

PMID- 1621699
TI  - Epidemiology of work-related musculoskeletal disorders of the neck and upper
      limbs: a response.

PMID- 1621700
TI  - Non-back occupational injuries.

PMID- 1621701
TI  - Case comment: Moore v. Regents of the University of California.
AB  - The increasing use of human tissues in medical research has spawned a host of
      ethical and legal debates. Legal analysis in this area has almost exclusively
      focused on the question of property rights in both the tissues used in research
      and in the resulting products. One illustrative case is Moore v. Regents of the
      University of California, in which a patient sued his doctor for conversion of
      his spleen which had been removed for therapeutic purposes. The doctor later used
      the spleen to develop a patented and profitable cell-line. This Comment examines
      and rejects the property law approach to this issue. Instead, this Comment
      proposes two legislative changes which would 1) eliminate any trade in human
      tissues and 2) require doctors to inform their patients of any research interest
      in proposed medical procedures. These proposals resolve the problem presented in
      Moore, and avoid the misleading, and inevitably unanswerable, question of
      property rights.

PMID- 1621702
TI  - Medically futile care: the role of the physician in setting limits.
AB  - In an effort to clarify the concept of "medically futile care," two types of
      futile care are identified: 1) care that produces no demonstrable effect; and 2)
      care that produces an effect that is believed by the speaker to be of no net
      benefit. It is the second type of futile care, when a patient or surrogate and
      the clinician disagree over the benefit that the patient will receive from an
      intervention, that is most interesting morally and that cannot properly be
      labelled medically futile. As such, decisions to limit access to care deemed
      futile should not rest with medical professionals. This Article argues for a
      limited duty of clinicians to provide life-prolonging and some other fundamental
      care that is equitably funded and desired by the patient while competent, even if
      the clinician believes that such interventions will produce no net benefit.

PMID- 1621703
TI  - Denial of health care and informed consent in English and American law.
AB  - Health care rationing has gained greater visibility in the United States and the
      United Kingdom, for quite different reasons. As patients in both countries become
      more aware that potentially beneficial medical services can be denied them on
      economic--as opposed to purely medical--grounds, they are beginning to seek help
      from the judiciary. This Article contends that as rationing becomes more
      explicit, the doctrine of informed consent will come under increased pressure.
      The Article suggests that courts and legislatures consider imposing a legal
      obligation on physicians to inform their patients when potentially effective
      treatment is to be withheld for economic or other non-clinical reasons.

PMID- 1621704
TI  - Emerging parallels in the American health care and legal-judicial systems.
AB  - The structure and principal decision-making processes of the American health care
      system have, in recent years, evolved to closely resemble those of the legal
      judicial system. This transformation reflects important common values that
      underlie both systems, including the values of life and liberty. This Article
      analyzes quasi-legal features of the health care system and draws conclusions
      about how those features might be used to address the problem of health care
      rationing. It concludes that coverage rules, if properly developed, can provide
      the sort of objective framework necessary to evaluate claims of health care
      needs. This Article also demonstrates that by defining legitimate health care
      needs, society can thereby potentially eliminate or forestall the need to ration
      necessary care. This can be achieved by using carefully developed coverage rules,
      rather than the informal rules currently in place, in conjunction with already
      existing due process methods for interpreting and implementing those rules.

PMID- 1621706
TI  - Patient care compromised in college athletics programs.

PMID- 1621707
TI  - Hospital told to hire HIV+ pharmacist.

PMID- 1621708
TI  - Electronic cap device helps medication compliance in hypertensive patients.

PMID- 1621705
TI  - Mothers and children last: the Oregon Medicaid experiment.
AB  - In 1989 and 1991, the Oregon legislature enacted a series of initiatives to
      extend health coverage to uninsured state residents. Among these initiatives is
      an act that seeks to extend a modified set of Medicaid benefits to state
      residents with family incomes below the federal poverty level. This act also
      reduces benefits the state is now required to provide to Medicaid-enrolled women
      of childbearing age and children. This Article explores the legal context in
      which the Oregon Medicaid experiment must be evaluated. It argues that by
      reducing the level of coverage to which tens of thousands of exceedingly poor,
      Medicaid-eligible women and children are entitled, the experiment falls outside
      the scope of valid research that the United States Department of Health and Human
      Services may either sanction or fund. The Article also discusses the implications
      of the Oregon experiment, if approved, for the future direction of the Medicaid
      program in particular, and for health care reform for the poor, generally.

PMID- 1621709
TI  - Searle starts telephone reminder program for patients taking verapamil product.

PMID- 1621710
TI  - Lederle program promotes pharmacist's role in helping smokers quit.

PMID- 1621712
TI  - Schering report looks at pharmacist's role in improving patient compliance.

PMID- 1621711
TI  - To help curb TB, New York workers will watch patients take their medicine.

PMID- 1621713
TI  - Acceptability of a deemed-signed policy for oral orders.

PMID- 1621714
TI  - Making the transition from intern to pharmacist.

PMID- 1621715
TI  - Overcoming resistance to change.

PMID- 1621716
TI  - How to achieve teamwork between pharmacists and technicians: a pharmacist's
      perspective.

PMID- 1621717
TI  - Cisplatin overdosage.

PMID- 1621718
TI  - Pharmacists as managers of risk, quality, and cost.

PMID- 1621719
TI  - Planning for financial impact of antiendotoxin monoclonal antibodies.

PMID- 1621720
TI  - Department of pharmacy practice chairpersons' opinions of the joint statement.

PMID- 1621721
TI  - Pharmacists and postmarketing restriction of drug products.

PMID- 1621722
TI  - AJHP's mission as a membership journal.

PMID- 1621723
TI  - Effects of pharmaceutical care on medication cost and quality of patient care in
      an ambulatory-care clinic.
AB  - The effects of pharmaceutical care on medication cost and quality of care in a
      university-based family-practice clinic were studied. Prognostic indicators were
      used to target patients who should receive pharmaceutical care. Those patients
      who received care. Those patients who received pharmaceutical care over a 14
      month period during 1988-89 were included in the study. A pharmacist interviewed
      each targeted patient, obtained the patient's medication history, made
      therapeutic recommendations to the patient's physician, and counseled the patient
      on his or her therapy. The pharmacist's recommendations were noted, and the
      outcome of each recommendation was documented on subsequent patient visits. For
      each recommendation, drug cost avoidance was calculated and patient outcome was
      analyzed. For quality assessment, a panel of three health-care professionals
      reviewed the pharmacist's recommendations for 25% of the study patients (randomly
      selected) and noted their agreement or disagreement with the pharmacist's
      actions. Over the study period, 184 targeted patients received pharmaceutical
      care. Clinic physicians accepted 297 (82.5%) of 360 pharmacist recommendations.
      Annual extrapolated cost avoidance associated with the pharmacist's
      recommendations was $19,076. For 213 (80.4%) of the 265 accepted recommendations
      for which outcome data were available, improvement or resolution of the patient's
      disease state occurred. For 8 (16%) of 50 unaccepted recommendations, the
      patient's status declined. The peer review panel agreed with 86% of the
      pharmacist's recommendations. The provision of comprehensive pharmaceutical care
      in an ambulatory-care clinic can both reduce medication costs and improve quality
      of care.

PMID- 1621724
TI  - Drive-up prescription refill service at a large Navy medical facility.
AB  - A drive-up prescription refill service at a large naval medical facility is
      described. A pharmacy drive-up refill service was created to reduce customer
      congestion, to reduce demand for parking, and to improve customer service. The
      drive-up program is staffed by a full-time pharmacy technician, a full-time
      volunteer, and a part-time pharmacy technician who assists during lunches,
      breaks, and peak hours. Customers must request refills by telephone, and requests
      are recorded by a pharmacy answering machine. Recorded requests are transcribed,
      processed, and checked by a pharmacist in the main pharmacy. Refills ready for
      pickup are transported to the drive-up site twice daily. If a refill is missing,
      the customer is asked to park, fill out a missing refill form, and pick up the
      refill at the main pharmacy. Approximately 700 prescription refills are processed
      and filled daily at the drive-up service. The addition of a drive-up refill
      service reduced customer visits to the outpatient pharmacy department by about
      one third and reduced demand for parking by a projected 360-400 parking spaces
      per day. The error rate for missing refills is less than 0.5%. The only negative
      consequence of the drive-up service is less interaction between the customer and
      the pharmacy staff for counseling. A drive-up refill service at a large naval
      medical facility reduced customer congestion, reduced parking demand, and
      improved customer service at the outpatient pharmacy department.

PMID- 1621725
TI  - Use of prescription-refill records to assess patient compliance.
AB  - Prescription-refill records were used to assess patient compliance, to evaluate
      factors previously associated with compliance, and to determine the association
      between selected drugs and compliance. Records were selected from a computerized
      database containing prescription-coverage claims, based on the following
      criteria: (1) the prescriptions were refilled during 1987-1989 and within two
      times the days' supply after the dispensing date, (2) they involved any of 12
      drugs selected for study, (3) they required one to four doses per day, and (4) at
      least 20 records with the same regimen were available. Compliance was defined as
      refill within 0.2 times the days' supply after the refill-due date, and it was
      assessed by calculating the compliance rate and the compliance index (which
      describes the relationship between the refill-due date and the actual refill
      date). Data from 19,118 prescription-refill records were analyzed. The compliance
      index improved slightly as the number of concurrent medications increased,
      worsened as the number of doses per day increased, and improved as the immediacy
      of the risk of noncompliance increased. Different medications and indications
      were associated with different degrees of compliance. Medication compliance
      generally improves as the number of daily doses decreases, may improve slightly
      as the number of concurrent medications increases, and varies with the particular
      drug and indication.

PMID- 1621726
TI  - Drug-related emergency department visits and hospital admissions.
AB  - The incidence and causes of drug-related hospital admissions and visits to an
      emergency department were evaluated. A retrospective chart review was conducted
      to identify drug-related visits and admissions for all patients who visited the
      emergency department of a 517-bed tertiary-care institution during a four-month
      period. Drug-related illnesses were classified as adverse drug reaction (ADR),
      overdose or abuse, noncompliance, drug interaction, or toxicity. Patient data
      included demographic characteristics, medication history, serum drug
      concentrations, length of hospital stay, and hospital admission charges. Of
      10,184 patients who visited the emergency department, 293 (2.9%) had drug-related
      illnesses; 71 (24%) of these patients were admitted. The drug classes most
      commonly involved were drugs of abuse (23.2%), anticonvulsants (17.1%),
      antibiotics (12.6%), respiratory drugs (8.9%), and pain medications (8.9%). The
      most common category of drug-related illness was overdose or abuse (35%) followed
      by noncompliance (28%), ADR (28%), toxicity (8%), and drug interaction (1%). The
      average length of stay for patients who were admitted was 5.8 days, and the
      average cost of admission was $8888. Drug-related illnesses accounted for 2.9% of
      hospital admissions and visits for patients in the emergency department. The most
      commonly identified drug-related illnesses were overdose or abuse, noncompliance,
      and ADRs; the drug classes most commonly implicated were drugs of abuse,
      anticonvulsants, and antibiotics.

PMID- 1621727
TI  - Pharmacy-based antimicrobial-monitoring service.
AB  - A pharmacy-based antimicrobial-monitoring service at a university teaching
      hospital is described. The service was developed and implemented by the pharmacy
      department in 1987. Antimicrobial drugs that can be misused, that are expensive,
      or for which bacterial resistance is a concern were targeted. When a pharmacist
      receives an order for a targeted antimicrobial, an antimicrobial-monitoring card
      is completed. Monitored drugs meeting approved criteria are dispensed as ordered.
      When the antimicrobial does not meet the criteria, the pharmacist contacts the
      physician and suggests an alternative. If the alternative is not accepted, the
      infectious diseases service is contacted and then informs the pharmacy department
      about the status of the drug. The agent is dispensed if no response is received
      within two hours. Qualified staff pharmacists rotate through the position of
      antimicrobial pharmacist, whose responsibilities include reviewing antimicrobial
      use throughout the hospital, checking relevant laboratory test results, and
      recommending adjustments to regimens. From July 1989 to June 1990, 3546 orders
      for monitored antimicrobials were reviewed; of these, 86% met the criteria, 9%
      did not meet the criteria but were approved, 2% were for drugs that were replaced
      by alternative therapies, 1% were for agents that were dispensed because the
      pharmacist was not contacted, and 2% represented medical staff overrides or drugs
      dispensed inappropriately. Pharmacist and physician compliance with the
      monitoring policy has been high. A positive, constructive, and educational
      relationship exists between pharmacists and physicians vis-a-vis the service. A
      pharmacy-based antimicrobial-monitoring service has been accepted by pharmacists
      and physicians and appears to be having a positive impact on prescribing habits.

PMID- 1621728
TI  - Hospital selection of home infusion therapy companies as preferred providers.
AB  - The process by which a hospital selected home infusion therapy providers is
      described. Administrators at a 379-bed teaching hospital decided to attempt to
      reduce the high mean length of stay by expanding the use of home infusion
      therapy. Direct diversification into this field by the hospital was not feasible,
      so it was decided to establish contractual agreements with providers. A task
      force was appointed to evaluate and choose vendors in the area and to increase
      the number of patient referrals. The task force examined reports on past
      experience with providers, price lists, the range and level of services offered,
      and the amount of free care given and visited the companies' facilities. The
      group designated three providers as preferred and two as unacceptable. The number
      of patients referred increased from 21 during the 12 months before the task force
      was convened to 46 in the first 9 months afterward, for a saving of 2198 patients
      days. After one year the task force met again to consider company requests for
      evaluation or reevaluation, establish a plan for publicizing the benefits of home
      infusion therapy, and replace the site visits with a requirement for
      accreditation by the Joint Commission. After two years, the task force developed
      provider-evaluation criteria to streamline the process and reflect the experience
      gained. The responsibility for reviewing providers was transferred to the P&T
      committee. When a direct venture into home infusion therapy is not fiscally
      desirable, contracting for services can still offer the advantages of reduced
      length of stay and decreased drug expenses.

PMID- 1621729
TI  - Evaluation of a disposable, elastomeric infusion device in the home environment.
AB  - The use of a disposable, elastomeric infusion device was evaluated in 55 patients
      receiving home antimicrobial therapy. During a 30-day period, all patients
      referred to five service centers to receive home antimicrobial therapy for at
      least one week were enrolled in the study. Pharmacists used an automated pump to
      fill 110-mL, 100-mL/hr elastomeric devices (Homepump; Block Medical, Carlsbad,
      CA). Nurses trained patients to use the device. Nurses and pharmacists completed
      an evaluation form for each patient. Fifty-five patients received a total of 1938
      doses; a fresh device was used to administer each dose. Nurses described patient
      teaching for the device as easy (51) or no different from that for other devices
      (4). Patient acceptance was reported to be good in 54 patients and poor in 1
      patient. A total of 91 restarts were required; 36 patients needed more than one
      restart. The failure rate of the device was 1.6%; 25 of 44 reported problems
      occurred in devices that were frozen and thawed before use. The Homepump was
      determined to be an acceptable device for the intermittent infusion of small
      volume antimicrobial solutions in the home environment because of its low failure
      rate and high degree of patient and nursing preference; its drawbacks include
      high cost and slowed infusion rates for units that are not thawed properly after
      freezing.

PMID- 1621730
TI  - Stability of procainamide hydrochloride in an extemporaneously compounded oral
      liquid.
AB  - The stability of procainamide hydrochloride 5, 50, and 100 mg/mL in an
      extemporaneous oral liquid formulation was studied. Oral liquids containing
      procainamide hydrochloride 5, 50, or 100 mg/mL were compounded from procainamide
      hydrochloride capsules, sterile water for irrigation, and cherry syrup or a 70:30
      mixture of 1% methylcellulose and cherry syrup. The pH values of the liquids were
      6 (unadjusted) and 5 (adjusted). The liquids were stored at 4-6 degrees C or 24
      25 degrees C and tested for drug concentration by stability-indicating high
      performance liquid chromatography at 0, 7, 14, 21, 28, 34, 147, and 180 days. The
      relationships among the variables drug concentration, type of vehicle, pH, and
      temperature and their effects on drug stability were analyzed by using repeated
      measures analysis of variance. With respect to effects on stability across time,
      there was a significant three-way interaction among drug concentration, type of
      vehicle, and temperature. The effect of concentration on stability seemed to
      depend on the vehicle used, but this dependence was different for different
      temperatures and different pH values. When trends over time were considered, a
      significant interaction among time, vehicle type, and temperature was found. This
      reflected the stability of the concentration of procainamide hydrochloride over
      time under refrigeration for both vehicles, compared with the steady decline in
      drug concentration at room temperature. Overall, drug concentration was fairly
      stable over time in the 5- and 50-mg/mL oral liquids but declined steadily in the
      100-mg/mL liquid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621731
TI  - Pharmacist's responsibility for providing drug information to be used for
      questionable purposes.

PMID- 1621732
TI  - Pharmacy-based medication administration program.

PMID- 1621733
TI  - U.S. system for organ procurement and transplantation.
AB  - The establishment and responsibilities of the organ procurement and
      transplantation network in the United States are discussed, and the process of
      receiving an organ transplant through the system is described. The National Organ
      Transplant Act of 1984 provided for a federally funded network for organ
      procurement and transplantation, which would function as a private, non-profit
      organization. This organization is the United Network for Organ Sharing (UNOS).
      UNOS monitors the activities of and provides service to transplant centers and
      organ procurement organizations (OPOs). The names of all candidates awaiting
      cadaveric organ transplants are placed on a central waiting list maintained by
      UNOS; UNOS also is responsible for maintaining a scientific registry to collect
      relevant data from transplant centers on the recipients of organ transplants.
      Although there is a national list of more than 25,000 persons waiting at any
      given time for a cadaveric organ, there are far fewer actual organ donors (less
      than 5000 in 1991). The hospital's best resource with respect to the donation
      process is the local OPO, which provides services related to organ donor
      referral, evaluation, and surgical recovery. The organ donation process consists
      of eight components: donor identification, referral, evaluation, consent,
      management, recovery of organs, allocation, and follow-up. An organ recovery
      coordinator from the local OPO helps the hospital staff in determining donation
      potential, seeking consent from the next of kin, and managing the donor after
      consent has been obtained. The OPO--never the donor's family or their insurer--is
      billed for charges relating to the donation. The OPO then bills the costs
      associated with the donation to the transplant centers receiving each organ for
      implantation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621734
TI  - Guidelines for performing a pharmacoeconomic analysis.
AB  - The fundamentals of pharmacoeconomics are presented. Pharmacoeconomic research is
      used to identify, measure, and compare the costs, risks, and benefits of
      programs, services, or therapies and determine which alternative produces the
      best health outcome for the resources invested. Each pharmacoeconomic method
      measures costs in monetary terms; the differences lie in the valuation of
      outcomes. In cost-minimization analysis, the outcomes are considered to be equal
      and therefore are not measured. Cost-benefit analysis measures outcomes in
      dollars, whereas cost-effectiveness analysis measures outcomes in nonmonetary
      units. In cost-utility analysis, outcomes expressed in nonmonetary units are
      adjusted for health-related quality of life. A well-designed pharmacoeconomic
      analysis involves 10 steps: (1) defining the problem, (2) determining the study's
      perspective, (3) determining the alternatives and outcomes, (4) selecting the
      appropriate pharmacoeconomic method, (5) placing monetary values on the outcomes,
      (6) identifying study resources, (7) establishing the probabilities of the
      outcomes, (8) applying decision analysis, (9) discounting costs or performing a
      sensitivity or incremental cost analysis, and (10) presenting the results, along
      with any limitations of the study. By adhering to the analytic steps described,
      the pharmacist undertaking a pharmacoeconomic evaluation has the greatest
      likelihood of obtaining valid and useful results.

PMID- 1621735
TI  - Government liable for failure to monitor a patient's serum gentamicin
      concentration in an Army hospital.

PMID- 1621736
TI  - Pharmacy, politics, and public policy.

PMID- 1621737
TI  - Pharmacy implications of clinical guideline development.

PMID- 1621739
TI  - Advances in outpatient antimicrobial therapy: loracarbef. June 12-15, 1991, San
      Francisco, California. Proceedings.

PMID- 1621738
TI  - Programs for monitoring inappropriate prescribing of controlled drugs: evaluation
      and recommendations.

PMID- 1621740
TI  - Pharmacokinetic profile of loracarbef.
AB  - Loracarbef, the first beta-lactam antibiotic of the carbacephem class to undergo
      clinical evaluation, has been the subject of extensive clinical pharmacology
      studies. Loracarbef is well absorbed: virtually all of an orally administered
      dose is excreted in the urine unchanged. Following administration of a 400 mg
      capsule to adults twice a day for 10 days, no accumulation of drug is noted. In
      one study in children, following the administration of 15 mg/kg of loracarbef
      suspension, the mean maximum plasma concentration (Cmax) was 20.3 micrograms/mL.
      In adults, the Cmax following administration of the suspension or solution
      formulations is higher than that achieved following administration of the capsule
      formulation, and the time to reach peak concentration (Tmax) is increased when
      loracarbef is administered as a capsule; however, the area under the curve,
      plasma half-life, and percentage of oral dose excreted in the urine are
      comparable among all formulations. The ingestion of food decreases the Cmax and
      delays the Tmax compared with the fasting state. The pharmacokinetic profile of
      loracarbef in adults is comparable with that in children or the elderly. Because
      loracarbef is eliminated primarily by the kidney, dosage must be reduced in
      patients with moderate-to-severe renal insufficiency. Loracarbef achieves middle
      ear and interstitial-fluid levels that generally exceed the minimum inhibitory
      concentrations for common bacterial pathogens. Loracarbef possesses a
      pharmacokinetic profile consistent with the efficacy and safety profile
      documented in controlled clinical trials.

PMID- 1621741
TI  - The carbacephems: a new beta-lactam antibiotic class.
AB  - The carbacephems are a new class of beta-lactam antibiotics that are similar in
      structure to the cephalosporins. Carbacephems differ from cephalosporins,
      however, in the substitution of a sulfur atom in the dihydrothiazine ring with a
      methylene group to form a tetrahydropyridine ring. The result of this structural
      difference is the carbacephem class. Carbacephems have remarkable chemical
      stability that allows for structural manipulation in a manner that could not be
      done previously with the cephalosporin ring system. Potent broad-spectrum
      antibiotics result from the incorporation at the 3 position of substituents that
      include quaternary pyridinium or imidazole, sulfones, and heterocyclic thiazole
      structures. Because of the chemical stability of the carbacephems, these highly
      electronegative side chains can be added to the 3 or 3' position of the
      tetrahydropyridine ring system. Increasing the electronegativity of these side
      chains can increase the microbiologic activity of the compounds. In addition,
      utilizing the side chains that have traditionally conferred good oral absorption
      on the cephalosporins offers the possibility of a new series of broad-spectrum
      oral antibiotics. Loracarbef is the first carbacephem to undergo clinical
      development, and other experimental carbacephems are being produced with the aim
      of developing potent oral antibiotics that can be used against pathogens that
      cause infections commonly found in the outpatient setting.

PMID- 1621742
TI  - The safety profile of loracarbef: clinical trials in respiratory, skin, and
      urinary tract infections.
AB  - The efficacy and safety of the antibiotic loracarbef have been demonstrated in a
      series of 22 clinical trials involving over 9,000 patients. The data compiled
      from these trials indicate that loracarbef is well tolerated by the majority of
      patients, including children and elderly patients. Most adverse events in
      patients receiving loracarbef were mild and transient in nature; only 1.5% of
      patients discontinued therapy because of drug-related adverse events. The
      frequency of adverse events associated with this agent compares favorably with
      that reported for the other antibiotics in these trials. The most commonly
      reported adverse reaction in the loracarbef study group was diarrhea, but this
      condition occurred less frequently in patients who received loracarbef than in
      those treated with the comparative agents. Other gastrointestinal events, such as
      nausea and vomiting, were reported infrequently. Headache was the second most
      common adverse event reported and occurred at a slightly higher frequency in the
      loracarbef-treated group than in patients receiving comparative antibiotics. No
      clinically significant alterations in laboratory parameters or gastrointestinal
      flora were observed following loracarbef administration. The compiled data
      indicate that loracarbef is a safe therapeutic option for the treatment of a wide
      spectrum of bacterial infections.

PMID- 1621743
TI  - Pathogenesis of fibrosis in acute lung injury.
AB  - The anatomic changes that occur in response to acute lung injury significantly
      impair gas exchange. As is the case with skin wounds, a fibroproliferative
      response follows lung injury. In the lungs, however, this can result in life
      threatening obliteration of alveolar air spaces. A better understanding of the
      mechanisms involved in lung repair may allow the development of therapies that
      regulate the fibroproliferative response. Studies from our laboratory have
      identified a peptide in bronchoalveolar lavage fluid from patients with acute
      lung injury that promotes the migration and replication of lung fibroblasts. This
      peptide is related to platelet-derived growth factor (PDGF) antigenically as well
      as by receptor-binding criteria; its molecular weight is 14 kilodaltons (kDa) as
      compared to 29 kDa for PDGF. Despite the potent activity of the 14 kDa peptide,
      however, such a growth signal may not be absolutely required for tissue
      granulation. The possibility that lung fibroblasts from patients with acute lung
      injury might be capable of dividing without exogenous stimulation will be
      examined. Another theoretical consideration is the signals that regulate
      termination of the fibroproliferative response. Insights into the molecular
      mechanisms involved in lung repair may result in therapies that modulate the
      sometimes maladaptive fibroproliferative response following acute lung injury.

PMID- 1621744
TI  - Gene therapy strategies for pulmonary disease.
AB  - The two most common hereditary lung disorders in Caucasians, alpha 1-antitrypsin
      (alpha 1-AT) deficiency and cystic fibrosis, have their major clinical
      manifestations in the lung. Rapid advances in biotechnology have resulted in a
      variety of gene therapy strategies for the potential treatment of these
      disorders. Three vector systems--plasmid, retrovirus, and adenovirus--have been
      evaluated for their possible utility in transferring genes in a fashion that
      would either alter the milieu of the lung or directly alter the genetic program
      of lung parenchymal cells. Two general strategies can be used: ex vivo
      modification of autologous cells with subsequent transplantation to the patient
      and in vivo modification with an appropriate vector containing the exogenous
      gene. Studies carried out in experimental animals show that it is theoretically
      possible to treat both alpha 1-AT deficiency and cystic fibrosis with gene
      therapy if the safety hurdles can be overcome to minimize the risks involved.

PMID- 1621745
TI  - Acute bronchitis: results of U.S. and European trials of antibiotic therapy.
AB  - Acute bronchitis, an illness frequently encountered by primary-care physicians,
      is an inflammation of the tracheobronchial tree that results from a respiratory
      tract infection. It is characterized by persistent cough and sputum production
      and is occasionally accompanied by fever and/or chest pain. Acute bronchitis may
      have a viral or bacterial origin and is often treated with antibiotics. Four
      clinical trials were conducted to compare high and low doses of loracarbef, a new
      oral beta-lactam antibiotic, with three agents commonly used to treat acute
      bronchitis: amoxicillin/clavulanate, cefaclor, and amoxicillin. Results of these
      studies indicated that loracarbef, 400 and 200 mg twice daily, had clinical and
      bacteriologic efficacy against the common respiratory pathogens Streptococcus
      pneumoniae, Haemophilus influenzae, and Moraxella (Branhamella) catarrhalis that
      was comparable with that of the comparative agents. Loracarbef was as well
      tolerated as cefaclor and amoxicillin; moreover, it produced a significantly
      lower incidence of diarrhea than did amoxicillin/clavulanate. Loracarbef may be
      considered a safe and effective alternative agent for the treatment of patients
      with acute bronchitis.

PMID- 1621746
TI  - Loracarbef (LY163892) in the treatment of acute exacerbations of chronic
      bronchitis: results of U.S. and European comparative clinical trials.
AB  - Two controlled clinical trials compared loracarbef (LY163892 with
      amoxicillin/clavulanate or amoxicillin in the treatment of acute exacerbations of
      chronic bronchitis. Collectively, of 1,057 patients enrolled, 390 qualified for
      analysis: group 1 comprised 200 patients treated with loracarbef (400 mg twice
      daily); group 2, 120 patients treated with amoxicillin/clavulanate (500 mg three
      times daily); and group 3, 70 patients treated with amoxicillin (500 mg three
      times daily). Symptomatic and bacteriologic outcomes were assessed at post
      therapy (within 72 hours of therapy completion), and at late-posttherapy (10-14
      days after therapy completion). These evaluations were combined to provide an
      "overall" evaluation that accounted for all unfavorable outcomes occurring at
      either the posttherapy or late-posttherapy visit. At the posttherapy evaluation,
      93.0% of group 1 patients, 95.0% of group 2 patients, and 88.6% of group 3
      patients demonstrated favorable clinical outcomes (cure or improvement).
      "Overall" favorable clinical outcomes were achieved in 88.0% of group 1 patients,
      90.0% of group 2 patients, and 81.4% of group 3 patients. Bacteriologic results
      from the two studies could not be merged due to marked differences in how
      posttherapy bacteriologic results were assessed. The clinical significance of
      positive posttherapy sputum cultures was doubtful: 90% of patients with a
      positive sputum culture at the posttherapy visit who returned for the late
      posttherapy visit had successful clinical outcomes documented at the late
      posttherapy evaluation. Loracarbef was associated with a lower incidence of
      diarrhea and a higher incidence of headache as compared with
      amoxicillin/clavulanate. These results suggest that 400 mg loracarbef twice daily
      for 7 days is effective and safe in the treatment of acute exacerbations of
      chronic bronchitis.

PMID- 1621748
TI  - In vitro activity of loracarbef and effects of susceptibility test methods.
AB  - Loracarbef is a new oral antimicrobial of the carbacephem class with in vitro
      activity against the common pathogens associated with skin infections, otitis
      media, sinusitis, bronchopulmonary infections, and urinary tract infections. A
      review of the literature shows the following ranges for 90% minimum inhibitory
      concentration (MIC90) values (microgram/mL) against the organisms that commonly
      cause these illnesses: Streptococcus pneumoniae, 0.25-2.0; Moraxella
      (Branhamella) catarrhalis (beta-lactamase positive), 0.5-8.0; M. catarrhalis
      (beta-lactamase negative), 0.12-0.25; Haemophilus influenzae (beta-lactamase
      positive), 0.5-16.0; H. influenzae (beta-lactamase negative), 0.25-8.0;
      Escherichia coli, 2.0-25; Klebsiella pneumoniae, 0.25-8.0; Proteus mirabilis, 1.0
      8.0; Streptococcus pyogenes, less than or equal to 0.06-1.0; Staphylococcus
      aureus (beta-lactamase positive), 8.0; S. aureus (beta-lactamase negative), 1.0
      2.0. The in vitro activity of loracarbef against these common outpatient
      pathogens is similar to that of other oral antimicrobials such as cefaclor,
      cefuroxime axetil, cefixime, amoxicillin/clavulanate, and
      trimethoprim/sulfamethoxazole. The results of in vitro susceptibility tests with
      any antimicrobial, including loracarbef, are somewhat dependent on the specific
      test method that is employed in the laboratory. This is particularly true with H.
      influenzae. Furthermore, the results of loracarbef susceptibility tests are of
      uncertain value in predicting therapeutic outcome.

PMID- 1621747
TI  - Efficacy and safety of loracarbef in the treatment of pneumonia.
AB  - The treatment of bacterial pneumonia requires an agent with activity against a
      wide range of bacterial pathogens, including pathogens that produce beta
      lactamase. Loracarbef, a member of the carbacephem class of antibiotics, was
      tested in a series of clinical trials for its efficacy and safety in the
      treatment of lobar and bronchial bacterial pneumonia. Successful clinical
      responses were achieved in 97.6% of the evaluable patients receiving 400 mg twice
      daily of loracarbef. This compared favorably with the respective response rates
      of 92.3% for patients receiving 500 mg three times a day of
      amoxicillin/clavulanate and 95.0% for patients receiving 500 mg three times a day
      of amoxicillin for the same illnesses. Proven or presumed elimination of the
      pretherapy pathogen was found in 89% of the patients receiving loracarbef, 92.3%
      of the amoxicillin/clavulanate-treated patients, and 70.0% of those receiving
      amoxicillin. Loracarbef was also well tolerated, although nausea and vomiting
      were associated with the use of all three agents. Nevertheless, treatment with
      loracarbef resulted in the lowest rate of discontinuation of therapy due to drug
      related adverse events. Thus, these clinical trials support the conclusion that
      loracarbef is a safe and effective treatment for bacterial pneumonia.

PMID- 1621749
TI  - Acute bacterial maxillary sinusitis: results of U.S. and European comparative
      therapy trials.
AB  - Loracarbef, which is the first agent of the carbacephem class of beta-lactam
      antibiotics to be developed, provides good activity against a broad spectrum of
      bacteria. A single-blinded, randomized, parallel clinical trial in 10 centers in
      the United States compared the efficacy and safety of loracarbef with that of
      amoxicillin/clavulanate potassium in the treatment of acute bacterial maxillary
      sinusitis. A 7-10-day regimen of loracarbef (400 mg twice daily) was as effective
      as amoxicillin/clavulanate (500/125 mg three times a day) and resulted in
      somewhat fewer side effects. The results of a European trial in Sweden, Finland,
      and Iceland showed that loracarbef was clinically more effective than doxycycline
      in the treatment of acute bacterial maxillary sinusitis.

PMID- 1621750
TI  - Loracarbef versus penicillin VK in the treatment of streptococcal pharyngitis and
      tonsillitis in an adult population.
AB  - Loracarbef, a member of the carbacephem class of beta-lactam antibiotics, is a
      potent anti-bacterial agent. In a double-blind, randomized clinical trial to
      assess the efficacy and safety of loracarbef in the treatment of streptococcal
      pharyngitis and tonsillitis, 107 adult patients were treated with loracarbef (200
      mg capsules twice a day or 15 mg/kg/day suspension) and 111 patients were treated
      with penicillin VK (250 mg capsules four times a day or 20 mg/kg/day suspension)
      for 10 days. In the loracarbef treatment group, 96.6% of the evaluable patients
      had a favorable clinical response 3-5 days after therapy, a result that compared
      favorably with the 93.9% response rate achieved in the penicillin group. The
      clinical failure/relapse rates were 3.4% for loracarbef-treated patients and 6.1%
      for patients receiving penicillin. Bacteriologic response data approximated the
      clinical results, with a successful response in 89.9% of the loracarbef-treated
      patients and 91.5% of the penicillin recipients. Two (1.9%) loracarbef-treated
      patients with rash and one (0.9%) penicillin-treated patient with diarrhea
      discontinued the study early because of these adverse events. The incidence of
      adverse events was comparable in the two treatment groups except for increased
      cough, which was reported by 3.7% of the loracarbef-treated patients and none of
      the penicillin recipients. These data support the conclusion that loracarbef is
      comparable to penicillin VK in the treatment of streptococcal pharyngitis and
      tonsillitis in adults.

PMID- 1621751
TI  - Loracarbef (LY163892) versus cefaclor in the treatment of bacterial skin and skin
      structure infections in an adult population.
AB  - Loracarbef (LY163892), a member of the class of beta-lactam antibiotics known as
      carbacephems, is characterized by a high level of chemical stability and a broad
      spectrum of antibacterial activity that persists in the presence of beta
      lactamase. The efficacy and safety of loracarbef, 200 mg (twice daily), and
      cefaclor, 250 mg (three times daily) (one patient received 178 mg of cefaclor
      suspension, three times daily), were compared in a randomized, double-blind,
      multicenter trial conducted in adults with skin and skin-structure infections due
      predominantly to Staphylococcus aureus. Examination within 72 hours after the
      completion of therapy indicated a favorable clinical response in 84 (93.3%) of
      the 90 loracarbef-treated patients evaluable for efficacy and in 79 (95.2%) of
      the 83 evaluable patients treated with cefaclor. Pathogens were eradicated in 83
      (92.2%) of the patients in the loracarbef group and 74 (89.2%) of those in the
      cefaclor group. Only four adverse events--headache/migraine, diarrhea, abdominal
      pain, and nausea--occurred in greater than 2% of the total study population. The
      overall incidence of adverse events in the 201 loracarbef-treated and 192
      cefaclor-treated patients evaluated for safety was 19.9% and 24.5%, respectively.
      Adverse events that required hospitalization or discontinuation of treatment
      occurred in four patients in the cefaclor group but in none of those treated with
      loracarbef. There were no statistically significant differences in the clinical
      or bacteriologic response or the incidence of side effects between the two
      treatment groups. These findings indicate that loracarbef given twice daily is
      comparable in safety and efficacy to cefaclor given three times daily in the
      treatment of adults with skin and skin-structure infections.

PMID- 1621752
TI  - Loracarbef (LY163892) versus cefaclor and norfloxacin in the treatment of
      uncomplicated pyelonephritis.
AB  - Optimal therapy for pyelonephritis requires the immediate administration of an
      effective broad-spectrum antibiotic. Because conventional oral antibiotics such
      as the sulfonamides and the aminopenicillins are limited by the development of
      resistant bacteria associated with this common disease, the therapeutic
      effectiveness of a new oral carbacephem antibiotic was investigated. Two double
      blind, randomized clinical trials of loracarbef (LY163892) were conducted. A
      total of 245 patients (greater than or equal to 18 years old) with uncomplicated
      pyelonephritis were enrolled in parallel studies. One study compared loracarbef
      with cefaclor; the other compared loracarbef with norfloxacin. In the combined
      patient population, 119 patients were treated with loracarbef (400 mg twice
      daily), 43 with cefaclor (500 mg three times daily), and 83 with norfloxacin (400
      mg twice daily). All treatment regimens continued for greater than or equal to 14
      days. A total of 68 patients in the loracarbef group, 25 in the cefaclor group,
      and 43 in the norfloxacin group qualified for efficacy analysis. Escherichia coli
      was the causative pathogen in 85.0% of these patients. Successful posttherapy
      clinical and bacteriologic responses were similar for all three study drugs: 94.1
      and 86.8%, 96.0 and 80.0%, 97.7 and 88.4% for loracarbef, cefaclor, and
      norfloxacin, respectively. Late posttherapy clinical responses were 87.4, 83.3,
      and 91.7% for the loracarbef, cefaclor, and norfloxacin groups, respectively.
      Bacteriologic responses for the three groups were 79.6, 60.0, and 88.9%. The most
      frequent adverse effects (headache, diarrhea, and nausea) were experienced by
      three patients (2.5%) in the loracarbef group; headaches were noted in two (4.7%)
      cefaclor patients, diarrhea was noted in three (7.0%) patients in the cefaclor
      group, and nausea was noted in four (9.3%). Gastrointestinal events were noted in
      four patients (4.8%) in the norfloxacin group. The data demonstrate that
      loracarbef is comparable in efficacy and safety to both cefaclor and norfloxacin
      as oral therapy for uncomplicated pyelonephritis.

PMID- 1621753
TI  - Antibiotic therapy for urinary tract infections.
AB  - Loracarbef, a member of the carbacephem class of beta-lactam antibiotics, was
      tested in randomized, double-blind, parallel studies for the treatment of
      uncomplicated urinary tract infections (UTIs). In one study conducted in the
      United States, a 7-day course of once-daily doses of loracarbef (200 mg) was
      compared with a 7-day course of multiple daily doses of cefaclor (250 mg three
      times a day). Analysis of data from a small, homogeneous patient population of
      108 college-aged women showed that loracarbef produced clinical and bacteriologic
      responses similar to those produced by cefaclor. At 5-9 days posttherapy,
      bacteriologic cure was observed in 96% of patients in the loracarbef group and
      90% of patients in the cefaclor group (p = 0.614); at 4-6 weeks post-therapy, the
      same cure rate (81%) was observed in both groups. Analysis of the larger (333
      patients) and more heterogeneous study population containing several male and
      elderly female patients showed that loracarbef again produced responses similar
      to those produced by cefaclor, with no statistically significant differences seen
      between the groups at 5-9 days or at 4-6 weeks posttherapy. The adverse events
      reported by the loracarbef and cefaclor groups were also comparable in both the
      small and large patient populations analyzed. Similarly favorable results were
      seen when a 7-day regimen of loracarbef (200 mg once a day) was compared with a 7
      day regimen of norfloxacin (400 mg twice a day) in a large European study of
      approximately 300 patients with uncomplicated cystitis. These studies demonstrate
      that the safety and efficacy of once-daily loracarbef are comparable to the
      safety and efficacy of multiple-dose/day therapy with other antimicrobial agents
      commonly used in the treatment of uncomplicated UTIs.

PMID- 1621754
TI  - Hypothesis: Jadassohn nevus phakomatosis: a paracrinopathy with variable
      phenotype.
AB  - It has been postulated that the phakomatoses are paracrine growth regulation
      disorders (paracrinopathies). To determine how Jadassohn nevus phakomatosis (JNP)
      may fit such a pathogenetic model, a phenotype analysis of 13 propositi with JNP
      and a review of most reported JNP patients were done. The phenotypes of the
      propositi and the reviewed patients showed a great variability from a solitary
      congenital epidermal nevus to extensive cutaneous lesions with associated severe
      non-cutaneous anomalies. Review of long-term observations of JNP patients
      demonstrated considerable phenotypic changes within and beyond the boundaries of
      the nevi. The changes included a multitude of postnatal rare benign and/or
      malignant tumors and unusual manifestations: renal rickets, hepatomegaly,
      visceral cysts, vasculopathy, and even gangrene. Thus, a life-long predisposition
      to dysregulation of paracrine growth factors (GFs, regulatory peptides, peptide
      regulatory factors, and cytokines), foremost somatomedin-C (Sm-C, IGF-I),
      epidermal, fibroblast, platelet-derived GFs, and transforming GF-beta is implied.
      Laboratory evidence for the presumed GF dysregulation in the phakomatoses came
      from tissue culture study of patients with neurofibromatosis type 1 (NF-1).
      Compared to controls their "normal" skin showed ultrastructural changes of
      markedly increased number of melanin macroglobuli within the melanocytes.
      Paracrine GFs as relevant to hamartomatous growth were incriminated by
      radioimmunoassays of cutaneous neurofibromas showing two-fold or greater increase
      of Sm-C levels compared to the levels in the adjacent skin. Thus, NF-1 appears to
      be a paracrinopathy. JNP shows many more dynamic changes throughout the life span
      of the patients than NF-1. In the near future paracrinology may aid endocrinology
      and oncology in treating patients with disorders of these three growth mechanisms
      in man.

PMID- 1621755
TI  - Encephalocraniocutaneous lipomatosis and the Proteus syndrome: distinct entities
      with overlapping manifestations.
AB  - We have studied three children with cutaneous (epidermal nevi), subcutaneous
      (lipomas, plantar skin thickening), vascular (hemangioma, lymphangioma), skeletal
      (osteoma, exostosis, localized hypertrophy), and neurological (hydrocephaly,
      lissencephaly, partial agenesis of the corpus callosum) developmental defects
      associated with the Proteus syndrome and related hamartoneoplastic conditions. We
      compared our findings in these three patients with those of 50 others with
      Proteus syndrome and nine with encephalocraniocutaneous lipomatosis (ECCL)
      reported in the literature. We found that Proteus syndrome and ECCL have distinct
      identities even though some clinical manifestations are shared by both and a few
      patients have manifestations of both conditions.

PMID- 1621756
TI  - Variability versus heterogeneity in syndromal hypothalamic hamartoblastoma and
      related disorders: review and delineation of the cerebro-acro-visceral early
      lethality (CAVE) multiplex syndrome.
AB  - We report on a case of neonatal hypothalamic hamartoblastoma with
      holoprosencephaly, Hirschsprung disease, and tetramelic postaxial polydactyly.
      Twenty-seven previous cases of congenital hypothalamic embryonic tumours with
      associated congenital defects are reviewed. A classification in isolated,
      associated, and syndromal forms is proposed. The difficulties encountered in
      differential diagnosis between the syndromal form (mainly represented by the
      Pallister-Hall syndrome) and related diseases as Smith-Lemli-Opitz type II,
      holoprosencephaly-polydactyly, orofaciodigital type VI and hydrolethalus
      syndromes are outlined. Two pathogenic mechanisms are discussed: a classical
      pleiotropic model and single sequence model. The latter is sufficient to
      delineate syndromal hypothalamic hamartoblastoma. With the former, syndromal
      hypothalamic hamartoblastoma cannot be clearly recognized in the absence of a CNS
      tumour, a child with syndromal hypothalamic hamartoblastoma cannot be reliably
      diagnosed as Pallister-Hall rather than another MCA syndrome, and, ultimately,
      the existence of Pallister-Hall syndrome could be questioned, as it could only be
      the extreme expression of one or several other syndromes. As this hypothesis
      cannot be proven or disproven at this point, the authors suggest creating the
      concept of multiplex phenotype. "Cerebro-Acro-Visceral Early lethality multiplex
      syndrome" is suggested to encompass all the ambiguous cases. Within this complex,
      an operative classification key is proposed.

PMID- 1621757
TI  - New multiple congenital anomalies: mental retardation syndrome (MCA/MR) with
      facio-cutaneous-skeletal involvement.
AB  - Five unrelated patients (a male and 4 females) were affected with a previously
      undefined multiple congenital anomalies/mental retardation syndrome which has
      been designated the facio-cutaneous-skeletal (FCS) syndrome and which includes
      mental retardation with specific sociable, humorous behavior, characteristic
      facial appearance, excessive generalized skin, postnatal growth failure, and
      skeletal involvement. Consanguinity was noted in 2 patients, thus autosomal
      recessive inheritance is suggested.

PMID- 1621758
TI  - Craniosynostosis associated with partial duplication of 15q and deletion of 2q.
AB  - We report on an infant with multiple congenital anomalies including complex
      craniosynostosis associated with an unbalanced karyotype, 46,XY,
      2,+der(2),t(2;15)(q37;q26)pat. The previous report of a child with cloverleaf
      skull and partial duplication of 15q25----qter and the Man-on-Mouse Homology map
      suggests that a critical segment for synostosis of sutures may be in this region.

PMID- 1621759
TI  - Nail-patella syndrome in a spontaneously aborted 18-week fetus: ultrastructural
      and immunofluorescent study of the kidneys.
AB  - Nail-patella syndrome (NPS), hereditary onycho-osteodysplasia, is an autosomal
      dominant disorder of nail dystrophy, patellar absence or hypoplasia, incomplete
      elbow extension, conical posterior iliac horns, and nephropathy. We studied the
      kidneys of an 18-week spontaneously aborted fetus of a mother with the NPS.
      Ultrastructural examination of the kidney showed thickening of the capillary
      walls of the glomeruli and mesangium. There was irregular thickening of basement
      membranes with subendothelial fibrillar electron-dense deposits.
      Immunofluorescence showed fibrinogen deposition in glomerular basement membranes.
      Fibrinogen deposition in utero may ultimately lead to glomerular fibrosis and
      intrabasement membrane collagen deposition as seen in the adult renal lesion of
      this syndrome. This is the first report of the NPS in which the renal
      abnormalities have been studied in a fetus. These findings provide support for
      possible prenatal diagnosis of NPS by intra-uterine kidney biopsy.

PMID- 1621760
TI  - Trisomy 8: an additional case with unique manifestations [correction].
AB  - We report on an infant with multiple congenital anomalies and mosaic trisomy 8
      [corrected]. Clinical findings are presented, and compared with those of the 24
      cases previously reported. Some unusual characteristics found in this patient
      include macrocephaly, an extreme degree of palatal hypoplasia, and abnormally
      shaped long bones.

PMID- 1621761
TI  - Interstitial deletion of 10q: clinical features and literature review.
AB  - We report on a patient with interstitial deletion of 10q and compare her to 8
      previously described patients, 2 of whom have chromosomal breakpoints similar to
      our patient. Minor anomalies including broad forehead, hypertelorism, strabismus,
      prominent philtrum, and "dysplastic" pinnae are present in our patient.
      Psychomotor retardation and hypotonia are universal findings in 10q interstitial
      deletion. Growth retardation, not present in our patient, is seen in some. These
      clinical findings are sufficiently distinct to suggest early chromosome studies.

PMID- 1621762
TI  - Cervical spine in the Apert syndrome.
AB  - Radiographs of the cervical spine--in many cases longitudinal--were available for
      study in 68 cases of Apert syndrome. Autopsy material was available in one of
      these cases, and a 3-dimensional reconstruction from a CT scan was also studied
      in one case. Variable degrees of fusion were observed, involving the articular
      facets, the neural arch or transverse processes, or block fusion of the vertebral
      bodies. Ossification may not always be evident in some early radiographs.
      However, early radiographic signs of impending fusion may be irregularity in
      vertical orientation of the vertebral bodies and narrowing of the involved
      intervertebral spaces. Cervical fusions occurred in 68%, single fusions being
      found in 37%, and multiple fusions in 31%. C5-C6 fusion was most common, alone or
      in combination with other fusions. In contrast, cervical fusions are known to
      occur in 25% of Crouzon patients, most commonly involving C2-C3 only. It appears
      that when fusions are present, C5-C6 involvement in the Apert syndrome and C2-C3
      involvement in the Crouzon syndrome separate the 2 conditions in most cases.
      Because cervical anomalies may complicate an already compromised airway in any
      form of acrocephalosyndactyly, it is imperative to initiate radiographic study of
      the cervical spine before undertaking anesthesia for surgery.

PMID- 1621763
TI  - Pigmentary dysplasias and chromosomal mosaicism: report of 9 cases.
AB  - Chromosomes were studied in 9 individuals with pigmentary dysplasias of the skin
      and other abnormalities. Of the 9 individuals, 5 were chromosomal mosaics in both
      blood lymphocytes and skin fibroblasts (46,XY/47,XY, + 13;46,XX/47,XX, +
      14;46,XY/47,XY, + 18;46,XX/47,XX, + 18;46, XX/47,XX, + mar), while the other 4
      individuals were chromosomally normal in both tissues studied. The pigmentary
      dysplasias involved hypo- or hyperpigmented patches/flecks or lines/whorls. The
      latter ran along Blachko lines on the back, abdomen and the limbs. These patterns
      varied not only between individuals but also between different regions of an
      individual. The possibility of chimerism was studied but ruled out (1/32 to
      1/256) in 7 individuals, using chromosomal heteromorphisms in the patients and
      their parents as markers.

PMID- 1621764
TI  - Reciprocal translocation t(1;15)(p36.2;p11.2): confirmation of a suggestive
      cytogenetic diagnosis by in situ hybridization and clinical case report on
      resulting monosomy (1p).
AB  - A newborn girl with generalized muscular hypotonia and minor anomalies was
      referred for chromosome analysis. Cytogenetic investigation showed a satellite
      and an Ag-positive NOR on the distal short arm of one chromosome 1, thus
      indicating an unbalanced translocation involving the short arm of an acrocentric
      chromosome. The phenotypically normal mother had the same satellited chromosome 1
      with Ag-positive NOR. One chromosome 15 was the only acrocentric chromosome in
      her karyotype lacking recognizable satellites and an Ag-positive NOR. Thus a
      balanced reciprocal translocation between the short arms of chromosomes 1 and 15
      in the mother was suggested. The cytogenetic diagnosis was confirmed by
      nonradioactive in situ hybridization with the most distal DNA probe on chromosome
      1, the probe p1-79, localized at chromosome band 1p36.3. The probe was
      biotinylated by nick-translation, and detection was done by FITC labelled avidin
      binding. Hybridization signals were observed on both the mother's normal
      chromosome 1 and the derivative chromosome 15 but not on her derivative
      chromosome 1. Consequently, the index patient has an unbalanced karyotype with
      monosomy (1p36.3). Comparing their clinical reports shows that patients with
      similar terminal deletions of 1p share several manifestations.

PMID- 1621765
TI  - Craniorachischisis totalis and sirenomelia.
AB  - We report on a male infant with craniorachischisis totalis and sirenomelia, an
      association that seems to have been observed only 5 times before. In addition to
      these anomalies, the patient had hypoplasia of the phalanges of the right thumb.
      The pattern of associated malformations in infants with anencephaly and
      sirenomelia is reviewed. This condition, which combines cephalic and caudal
      defects of the embryo, could be considered an example of the "axial mesodermal
      dysplasia spectrum" and may be related to the midline developmental field
      concept.

PMID- 1621766
TI  - Hans-Rudolf Wiedemann: an appreciation.

PMID- 1621767
TI  - Hans-Rudolf Wiedemann in a half century of German pediatric genetics.

PMID- 1621768
TI  - Two patients with chromosome 6q terminal deletions with breakpoints at q24.3 and
      q25.3.
AB  - We report on 2 patients with de novo terminal deletion of 6q. The first was a 4
      month-old boy whose karyotype was 46,XY,del(6)(q24.3); the second a 2-year-old
      girl whose karyotype was 46, XX, del(6)(q25.3). The main anomalies in both
      patients included mental retardation, minor craniofacial and cerebral anomalies,
      and cardiac defects. The characteristic manifestations were imperforate anus in
      the first patient, and retinitis proliferans and a triatrial heart in the other.
      Comparison of clinical findings of our 2 patients with those of 18 previously
      reported patients with similar phenotypes suggests that terminal deletion of the
      6q23 or 6q25 band is critical in producing the main anomalies of del(6q)
      syndrome.

PMID- 1621769
TI  - Paraplegia and congenital contractures as a consequence of intrauterine trauma.
AB  - We present a newborn infant with paraplegia and contractures of the lower limbs,
      consistent with neurologic injury rather than malformation. The mother was
      involved in a severe motor vehicle accident during the sixth month of pregnancy.
      We propose that this infant's injuries are a result of that accident.

PMID- 1621770
TI  - Trisomy 18 and a constitutional maternal translocation (2;18).
AB  - Parental chromosomes are usually not analyzed in cases of trisomy 18 because the
      extra 18 is assumed to have arisen through a meiotic nondisjunctional event. We
      report on a case of a trisomy 18 and a maternal translocation (2;18)(q34;q12).

PMID- 1621771
TI  - Familial aplasia cutis congenita and coarctation of the aorta.
AB  - We report on the association of aplasia cutis congenita (ACC) in the midline of
      the scalp vertex and coarctation of the aorta (CA) in mother and son. The acronym
      of ACCCA syndrome is proposed for this condition. Autosomal dominant inheritance
      is most commonly implicated in the familial cases of ACC. The familial
      aggregation of CA is attributed, in general, to a multi-factorial causation, with
      a few reported families suggesting autosomal dominant inheritance. The ACCCA
      syndrome could be due to a Mendelian mutation.

PMID- 1621773
TI  - Therapeutic index of pilocarpine, carbachol, and timolol with nasolacrimal
      occlusion.
AB  - We assessed the effect of nasolacrimal occlusion on the therapeutic index of
      various antiglaucoma medications in healthy volunteers and patients with
      glaucoma. Nasolacrimal occlusion used with pilocarpine 2% every 12 hours gave the
      maximal ocular hypotensive response. Carbachol 1.5% every 12 hours with
      nasolacrimal occlusion gave the maximal response for this drug. For timolol,
      nasolacrimal occlusion collapsed the dose-response curve and extended the
      duration of action. A final trial of carbachol added to timolol with nasolacrimal
      occlusion showed that timolol 0.25% and carbachol 1.5% every 12 hours gave the
      maximal response for this combination. Our findings suggest that most of the
      commercially used ocular hypotensive agents can achieve the same maximal effect
      with lower concentrations and less frequent administration (never exceeding every
      12 hours) than are currently recommended should nasolacrimal occlusion be
      performed. Furthermore, nasolacrimal occlusion should markedly decrease the
      systemic absorption of topical ocular drugs and lessen the chance of systemic
      side effects.

PMID- 1621772
TI  - Albright hereditary osteodystrophy with hypothyroidism, normocalcemia, and normal
      Gs protein activity: a family presenting with congenital osteoma cutis.
AB  - The syndrome of Albright hereditary osteodystrophy (AHO),
      pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP) is
      clinically and genetically heterogeneous. Classically, patients with PHP have the
      skeletal features of AHO, resistance to multiple hormones that work via cAMP such
      as parathyroid hormone and thyroid stimulating hormone, and deficient activity of
      Gs protein, the guanine nucleotide-binding protein that stimulates adenylate
      cyclase. However, patients without hormone resistance but with AHO and Gs
      deficiency were described (PPHP), as well as patients with multiple hormone
      resistance but without AHO or Gs deficiency. In a few patients with deficient Gs
      activity, hypothyroidism rather than hypocalcemia was the initial presentation of
      the disorder. We describe here a new variant of the syndrome, affecting 5
      individuals in a 3 generation family with AHO, normal Gs activity and
      hypothyroidism. In the first 2 generations, mild features of AHO were present.
      The 2 sibs in the third generation had severe manifestations of AHO, including
      mild mental retardation as well as hypothyroidism. Diagnosis of congenital
      osteoma cutis at birth of the proband led to the diagnosis of the family.
      Elucidation of the molecular defect will shed light on the relationship between
      hormone resistance and AHO, as well as on the physiological mechanism of hormonal
      signal transduction.

PMID- 1621774
TI  - Ocular injuries caused by misuse of an immersion heater.

PMID- 1621775
TI  - Removable ligature during Molteno implant procedure.

PMID- 1621777
TI  - Localized distichiasis after tarsorrhaphy.

PMID- 1621776
TI  - Multifunction endolaser probe.

PMID- 1621778
TI  - Paroxysmal eyelid retractions.

PMID- 1621779
TI  - Position-dependent Parinaud's syndrome.

PMID- 1621780
TI  - Trabeculectomy without conjunctival incision.

PMID- 1621781
TI  - Argon laser gonioplasty in the treatment of angle-closure glaucoma.
AB  - We used argon laser gonioplasty to treat angle-closure glaucoma unrelieved by
      patent iridectomy. Laser energy (mean; 30 spots, 723 mW, and 0.2 second) was
      applied to the peripheral iris stroma to open the anterior chamber angle. Twenty
      of 32 eyes were successfully treated. After a median follow-up period of 18
      months, 17 of these 20 successfully treated eyes (85%) had an intraocular
      pressure less than or equal to 19 mm Hg, and 19 of these 20 successfully treated
      eyes (95%) had an intraocular pressure less than or equal to 21 mm Hg. The 20
      successfully treated eyes had a median duration of angle closure of 12 days.
      Twelve unsuccessfully treated eyes had a median duration of angle closure of 90
      days. All successfully treated eyes had more than 50% of the treated angle opened
      by argon laser gonioplasty and all but three successfully treated eyes had more
      than three clock hours opened by argon laser gonioplasty. Argon laser gonioplasty
      may be successful in treating angle-closure glaucoma unrelieved by iridectomy,
      especially in cases that are recognized and treated soon after onset.

PMID- 1621782
TI  - Successful therapy for trilateral retinoblastoma.
AB  - Trilateral retinoblastoma, the intracranial malignancy associated with bilateral
      retinoblastoma, is an uncommon and clinically aggressive malignancy with a
      uniformly fatal outcome. Three children with newly diagnosed trilateral
      retinoblastoma were treated with systemic (cyclophosphamide and vincristine) and
      intrathecal (methotrexate, hydrocortisone, and cytarabine) chemotherapy, as well
      as craniospinal irradiation (one patient) in addition to therapy of the eye
      lesions. All three patients have had partial or complete response of the pineal
      tumors to chemotherapy, with no active disease eight or more years, 33 or more
      months, and 12 or more months, respectively, after diagnosis of the lesions.

PMID- 1621783
TI  - Hereditary microphthalmia with colobomatous cyst.
AB  - We examined five members of a highly inbred kinship who had isolated
      microphthalmia associated with colobomatous cysts and various other ocular
      lesions. They were all offspring of consanguineous (first cousins) and unaffected
      parents. Microphthalmia in this kindred was transmitted as an autosomal recessive
      trait. Ultrasonography was effective for prenatal diagnosis in two pregnancies at
      risk.

PMID- 1621784
TI  - A new, band-shaped and whorled microcystic dystrophy of the corneal epithelium.
AB  - Five family members and three unrelated patients (four women, four men, 23 to 71
      years old) had a dystrophy of the corneal epithelium. Direct slit-lamp
      examination showed bilateral or unilateral, gray, band-shaped, and feathery
      opacities that sometimes appeared in whorled patterns. Retroillumination showed
      intraepithelial, densely crowded, clear microcysts. Light and electron microscopy
      disclosed diffuse vacuolization of the cytoplasm of epithelial cells in the
      affected area. Visual acuity was so reduced in three patients that abrasion of
      the corneal epithelium was performed. The corneal abnormalities recurred within
      months, with the same reduction in visual acuity as before. The corneal opacities
      were progressive in two patients but diminished noticeably in another after he
      began using a hard contact lens. We found no other ophthalmic irregularities or
      associated systemic abnormalities and no indication of drug-induced keratopathy.

PMID- 1621785
TI  - Corneal sensitivity after photorefractive keratectomy.
AB  - Corneal anesthesia or hypesthesia can complicate refractive surgical procedures
      such as epikeratophakia and radial keratotomy. An esthesiometer was used to
      measure the corneal sensitivity in unoperated-on corneas and fellow corneas after
      excimer laser photorefractive keratectomy. Decrease in corneal sensitivity was
      noted within six postoperative weeks, with mean sensitivity being 75.2% +/- 13.3%
      of normal. Within the first three postoperative months, the patients operated on
      for correction of compound astigmatism recovered 95.7% +/- 5.3% of the corneal
      sensitivity, whereas the patients operated on for correction of severe myopia
      recovered 86.2% +/- 11.2% (P = .07). None of the patients had delayed epithelial
      healing or recurrent corneal erosions during the time of decreased corneal
      sensitivity. In otherwise normal myopic eyes, photorefractive keratectomy
      measurably reduced corneal sensitivity for several postoperative weeks.

PMID- 1621786
TI  - Six cases of scleritis associated with systemic infection.
AB  - Isolated scleritis (without keratitis) associated with infections is uncommon,
      and correct diagnosis and appropriate therapy for it are often delayed. Six
      patients with infection-associated scleritis were seen at our institution between
      May 1983 and May 1990 (these patients represented 4.6% of all patients with
      scleritis [six of 130 patients] in that period). Three of these cases were
      associated with systemic infections. One was associated with syphilis, one was
      associated with tuberculosis, and one was associated with toxocariasis. Three
      cases resulted from local infections. One was associated with infection with
      Proteus mirabilis, one was associated with infection with herpes zoster virus,
      and one was associated with infection with Aspergillus. The Aspergillus infection
      developed after trauma and the P. mirabilis-induced infection developed after
      strabismus surgical procedures. Four of the six cases were initially misdiagnosed
      and inappropriately managed. Correct diagnosis was made seven days to four years
      after onset of symptoms. Review of systems, scleral biopsy, culture, and
      laboratory investigation were used to make the diagnosis. Differential diagnosis
      of scleritis must include infective agents.

PMID- 1621787
TI  - Visual outcome after penetrating keratoplasty with double continuous or combined
      interrupted and continuous suture wound closure.
AB  - We reviewed the consecutive records of 296 patients who underwent corneal
      transplantation at our institution to compare visual outcome between those who
      underwent double continuous suture wound closure and those who underwent a
      combination of interrupted and continuous suture wound closure. Of 156 patients
      on whom one of these closure techniques was performed, 33 patients satisfied our
      inclusion and exclusion criteria. Visual outcome between the two groups was
      compared at three, six, and 12 months. We found significant differences (P less
      than .05) in average corneal curvature and refractive spherical equivalents
      (steeper and more myopic, respectively, for double continuous suture wound
      closure); keratoscopic astigmatism, refractive cylindrical error; and average
      number of postoperative visits (greater for combined interrupted and continuous
      suture wound). Visual acuity without correction was significantly better at three
      months in the group that received double continuous sutures (P = .026). We found
      no marked difference in best-corrected visual acuity, frequency of graft
      rejection, requirement for contact lens fit, ratio of refracted vs potential
      visual acuity, or intraocular pressure. Patients who underwent double continuous
      suture closure had more rapid visual rehabilitation, had steeper corneas, and
      less astigmatism than patients who underwent the combined technique suture
      closure.

PMID- 1621788
TI  - Superior rectus muscle overaction after cataract extraction.
AB  - Four patients with an ipsilateral hypertropia after cataract extraction
      consistent with superior rectus muscle overaction were identified between March
      1990 and April 1992. Operative trauma was the most likely causative factor, as
      other likely conditions were excluded. The proposed pathogenesis for all cases is
      similar to that of botulinum type-A toxin therapy: a transient postoperative
      weakness of the ipsilateral inferior rectur muscle leads to a contracture or
      strengthening of the ipsilateral antagonist (the superior rectus muscle).
      Possible mechanisms of injury that would result in a transient inferior rectus
      muscle palsy would include anesthetic myotoxicity or direct trauma to the muscle
      and related structures from the retrobulbar injection (or subconjunctival
      injection). Surgical intervention consisting of an ipsilateral superior rectus
      muscle recession and posterior fixation sutures (when the vertical incomitance
      was large) yielded excellent results in restoring single binocular vision.
      Possible preventive measures would include using a minimal volume of anesthetic
      along with careful needle placement.

PMID- 1621789
TI  - Therapeutic index of epinephrine and dipivefrin with nasolacrimal occlusion.
AB  - We assessed the effect of nasolacrimal occlusion on the therapeutic index of the
      adrenoreceptor agonists in healthy volunteers and patients with glaucoma.
      Nasolacrimal occlusion did not significantly alter the response to 2% epinephrine
      or to 0.1% dipivefrin in healthy subjects, suggesting that both 2% epinephrine
      and 0.1% dipivefrin are at the top of the dose-response curve. When 0.5%
      epinephrine with nasolacrimal occlusion was tested in patients with glaucoma,
      effects were noticeable at four and eight hours (P less than .05), but not at 12
      hours. For 2% epinephrine, there was no significant difference at any measurement
      time. Epinephrine (1%) with and without nasolacrimal occlusion gave results
      similar to those of 2% epinephrine, suggesting that 1% epinephrine is also at the
      top of the dose-response curve. Nasolacrimal occlusion did not increase the
      ocular hypotensive effect of either of these concentrations. Because dipivefrin,
      the most widely used formulation in this class, is a prodrug of epinephrine that
      has a corneal penetration approximately 17 times that of epinephrine, 0.05%
      dipivefrin, every 12 hours, might be an adequate dosage for maximal effect.
      Although nasolacrimal occlusion did not alter the drug effect of 0.1% dipivefrin,
      preventing as much drug as possible from reaching the systemic circulation is
      desirable.

PMID- 1621790
TI  - Vitrectomy for perforating eye injuries from shotgun pellets.
AB  - Pars plana vitrectomy and scleral buckling were performed on 22 eyes of 19
      patients for treatment of perforating eye injuries from shotgun pellets. We
      reviewed the intraoperative findings at the time of vitrectomy to determine what
      factors might influence final visual acuity. The presence of a total retinal
      detachment at vitrectomy portended a poor prognosis when compared with eyes
      without total retinal detachment, as only one of ten eyes with total retinal
      detachment obtained useful vision (P = .002). Preoperative separation of the
      posterior vitreous was associated with a favorable outcome when compared with the
      absence of posterior vitreous detachment (P = .035), as ten of 16 eyes with
      posterior vitreous detachment at the time of vitrectomy ultimately achieved
      functional vision. The locations of the exit wounds did not affect visual success
      in the overall series of patients. However, in the patients who achieved visual
      success, exit wounds outside the vascular arcades were more likely to be
      associated with final visual acuities of, or better than, 20/70 than were those
      within the arcades (P = .022). Other prognostic factors, such as the number of
      perforations and the use of cryotherapy, were also examined for their effects on
      final visual outcome. However, these factors did not appear to affect visual
      outcome statistically.

PMID- 1621791
TI  - Streptococcus viridans-induced crystalline keratopathy and fungal keratitis.

PMID- 1621792
TI  - Intraocular trauma from a microwave oven.

PMID- 1621793
TI  - Occupational therapy entry-level program applicants: a survey of northwest
      schools.
AB  - Recruitment of occupational therapy students requires both expansion and
      broadening of ethnic, cultural, age, sex, and geographic distribution.
      Information used to guide recruitment activities can be limited, quickly
      outdated, and regionally nonspecific. Applicants to all entry-level programs in
      the Northwest were surveyed to assess trends that could influence recruitment
      practices. One hundred thirty-five (82.8%) of the 163 applicants surveyed
      responded to a questionnaire that probed for sources of exposure to occupational
      therapy, career goals, and educational preferences. Applicants indicated having
      an initial interest in allied health or education fields, yet only 36% began
      college with occupational therapy education in mind. Volunteer or work experience
      in specific practice settings was identified by approximately 80% of the
      applicants as an influence in seeking an education in occupational therapy.
      Career influences, goals, and educational program preferences did not differ
      among applicants based on age, residential background, grades, or previous
      degree. An absence of applicants of ethnic minority allows limited application of
      findings to these targeted groups.

PMID- 1621794
TI  - Relaxation training: a self-help approach for children with headaches.
AB  - Children and adolescents frequently complain about recurrent nonmalignant
      headaches. Relaxation exercises are one possible treatment for these headaches.
      As the role of occupational therapy in pediatric pain management emerges,
      relaxation training is becoming one of the treatment activities. The present
      study investigated the efficacy of progressive relaxation exercises in reducing
      headache complaints, particularly those headaches of a mixed variety. Ten
      subjects with a mean age of 11.5 years completed the 6-week self-help program. A
      multiple-baseline across-subjects design was used. Baseline periods were randomly
      assigned and ranged from 7 to 25 days with treatment introduced in a time
      staggered fashion across subjects. After completing their treatment, 8 of the 10
      subjects had a mean increase of 15% in headache-free days. Specific guidelines
      for relaxation training are provided in the outlined treatment program.

PMID- 1621795
TI  - A validity study of the posture and fine motor assessment of infants.
AB  - This study investigated the concurrent and construct validity of the Posture and
      Fine Motor Assessment of Infants (PFMAI) (Case-Smith, 1991). The subjects were 90
      infants, 65 of whom were healthy and full-term and 25 of whom were premature and
      had medical risk factors. Concurrent validity was investigated through
      administration of the Peabody Developmental Motor Scales (Folio & Fewell, 1983)
      and the PFMAI (n = 25). Strong positive correlations resulted between the Peabody
      Gross Motor scale and PFMAI Posture scale and between the Peabody Fine Motor
      scale and PFMAI Fine Motor scale. Concurrent validity was also measured through
      correlation scores on the Bayley Scales of Infant Development (Bayley, 1969) with
      scores on the PFMAI. The correlations between the Bayley Motor scale and the
      PFMAI Posture scale and between the Bayley Mental scale and the PFMAI Fine Motor
      scale were high. Construct validity was estimated through an evaluation of how
      accurately the PFMAI discriminated between the premature subjects and the full
      term subjects. A discriminant analysis indicated that the PFMAI accurately
      classified 78% of the subjects as being either premature or full-term (i.e., 80%
      of the full-term subjects and 72% of the premature subjects). When the premature
      subjects were categorized as low-risk or high-risk according to their medical
      histories, the PFMAI accurately classified 66.7% of the total subject population
      as full-term, low-risk premature, or high-risk premature. These results indicate
      that the PFMAI has the adequate reliability and validity necessary for use as a
      clinical and a research instrument.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621796
TI  - Comparison of performance in materials-based occupation, imagery-based
      occupation, and rote exercise in nursing home residents.
AB  - Materials-based occupation, imagery-based occupation, and rote exercise have been
      examined individually by several researchers. The present study compares all
      three approaches with one another (i.e., kicking a balloon, imagining kicking a
      balloon, and a control rote exercise) in nursing home residents. The dependent
      variable was the number of exercise repetitions. The subjects were 12 women and 3
      men between 56 and 93 years of age residing in two nursing homes. All subjects
      experienced the three approaches but in different orders. One-way analysis of
      variance for related measures indicated a significant difference among conditions
      (p = .004). The Tukey procedure (Stevens, 1986) determined that the materials
      based occupation condition elicited significantly more repetitions than the other
      two conditions. The difference between the imagery-based occupation and rote
      exercise was not statistically significant. These findings support our
      profession's historical emphasis on the use of physical materials to enhance
      performance.

PMID- 1621797
TI  - Occupational therapists in private practice.
AB  - Although increasing numbers of occupational therapists are choosing to work in
      private practice, little data exist describing this sector of the profession. In
      the present study, experienced occupational therapists were asked about their
      moves into private practice, including (a) their motivation, (b) their
      preparation, and (c) their perceptions of the move's risks and benefits before
      and after the move. A survey was sent to a national random sample of 105
      occupational therapists, 74 of whom responded. According to the survey, autonomy
      was the most important motivating factor for occupational therapists moving into
      private practice. However, once they were in private practice, the occupational
      therapists noted that increased income was a major benefit. These occupational
      therapists had planned for the risks of reimbursement, referral sources, and
      overhead but had not anticipated problems with staffing shortages. Incomes
      increased for occupational therapists who moved into private practice. The survey
      compared the incomes of occupational therapists before and after they entered
      private practice. It also compared their income and educational levels. Other
      comparisons included income and work experience, income and work role, and income
      and geographic location. Autonomy and financial considerations appear to be the
      overriding issues for occupational therapists choosing careers in private
      practice. Almost unanimously, the survey respondents said that private practice
      was a good career choice.

PMID- 1621798
TI  - Outcomes assessment and program evaluation: partners in intervention planning for
      the educational environment.
AB  - Accountability of educational institutions is a current trend in academia.
      Outcomes assessment provides a method of evaluating educational programs to
      ensure they are meeting their objectives. This paper presents an overview of
      outcomes assessment and describes its relationship to and integration with
      program evaluation. It also describes the implementation of an outcomes
      assessment program at Kean College of New Jersey, Union, New Jersey. A model for
      assessment within occupational therapy programs, which parallels a model for
      intervention planning, is introduced and discussed.

PMID- 1621799
TI  - Why students choose occupational therapy as a career.
AB  - To recruit students to occupational therapy, we need to know what prospective
      students seek in careers. A survey consisting of an attitude inventory was sent
      to 403 current occupational therapy students with a response rate of 54%. Earlier
      research identified that students had primarily altruistic goals in selecting
      occupational therapy as a profession, and this study continued to find that
      students wanted to help others; however, this was not a predictor of their
      favoring the profession. A factor analysis of the inventory revealed that
      students chose occupational therapy as a career because they liked the salaries,
      nationwide job availability, regular hours, and prestige that is associated with
      the profession. Students were more positive about the profession if they had
      experience working in occupational therapy departments, and 40% reported that no
      specific persons had influenced their career decision.

PMID- 1621800
TI  - Treatment choices: rehabilitation services used by patients with multiple
      personality disorder.
AB  - This article identifies mental health rehabilitation services for patients with
      multiple personality disorder. Through the use of a literature review and a
      retrospective examination of 20 patients' records, the frequency of discipline
      specific services is noted in occupational therapy, art therapy, movement
      therapy, vocational counseling, and recreational therapy. Recommendations for
      practice and program development include ongoing education about multiple
      personality disorder and continual assessment of the patient's functional level
      to identify subsequent treatment needs and services.

PMID- 1621801
TI  - Stability of the Jebsen-Taylor Hand Function Test across three test sessions.

PMID- 1621802
TI  - Views on physical agent modalities and specialization within occupational
      therapy: a rebuttal.

PMID- 1621803
TI  - Structuring education: development of the first educational standards in
      occupational therapy, 1917-1930.
AB  - The movement to standardize educational preparation in occupational therapy grew
      as the profession developed following World War I. This paper explores the
      debates that surrounded the evolution of occupational therapy's first sanctioned
      educational system. A variety of professionals involved in the formation of
      occupational therapy engaged in these debates. They focused their attention
      primarily on whether education should be regulated and, if so, how that education
      might be structured. Each coveted different views about how the fledgling
      profession might develop. These early debates signify one of the first attempts
      to identify a vision for the evolution of occupational therapy.

PMID- 1621804
TI  - Universities, accreditation, essentials, and the American Occupational Therapy
      Association.

PMID- 1621805
TI  - Specialization is not narrow.

PMID- 1621806
TI  - Regulation of glutamine metabolism in dog kidney cortex: effect of pH and chronic
      acidosis.
AB  - To examine the interrelationships of proton compartmentation and ammoniagenesis,
      experiments were performed in tubules and mitochondria isolated from dog kidney
      cortex. Tubules were incubated in Krebs-Henseleit buffer at different pH (pHe),
      and cytosolic pH (pHi) was estimated with the fluorescent probe 2',7'-bis(2
      carboxyethyl)-5(6)-carboxyfluorescein. Mitochondrial pH (pHm) was determined
      simultaneously in intact tubules by use of dimethyloxazolidine-2,4-dione. Over
      the pHe range 6.9-7.7, pHi was similar in control and acidotic dogs and linearly
      related to pHe. At pHe 7.4 in control tubules. pHm was 7.78 +/- 0.07, and varied
      little over the pHe range of 7.0-7.7. The pH gradient across the mitochondrial
      membrane rose at acid pHe. pHm was more alkaline when estimated in tubules from
      acidotic dogs compared with controls. Ammonium and glucose productions from
      glutamine were inversely related to pHe and pHi in tubules from both control and
      acidotic animals and were higher in acidosis. In contrast, ammonium production by
      isolated mitochondria did not vary as pHe was altered. Enzyme fluxes, calculated
      from metabolite changes, demonstrated that glutamate dehydrogenase (GDH) flux was
      altered. Enzyme fluxes, calculated from metabolite changes, demonstrated that
      glutamate dehydrogenase (GDH) flux was inversely and glutaminase (PDG) flux was
      linearly related to pHe. Ammonium production was significantly greater in
      mitochondria from acidotic dogs because of accelerated flux through PDG but not
      GDH. The present study demonstrates significant difference between proton
      compartmentation and regulation of ammoniagenesis in kidneys from acidotic dog
      compared with rat.

PMID- 1621807
TI  - Increased distal nephron EGF content and altered distribution of peptide in
      compensatory renal hypertrophy.
AB  - Epidermal growth factor (EGF) precursor is synthesized within kidney in the thick
      ascending limbs of Henle's loop and in distal tubule. Under baseline conditions
      EGF precursor is localized to the luminal membrane. In contrast, functional EGF
      receptors are present in basolateral membranes of sensitive renal cells.
      Immunostainable EGF is increased in contralateral kidneys following
      uninephrectomy of rats. To confirm this increase and determine whether the
      distribution of EGF changes in this setting, we measured immunostainable EGF in
      kidneys originating from rats 1, 2, 5, or 14 days following unilateral
      nephrectomy or sham surgery. There was a suggestion of an increase in
      immunostainable EGF in distal tubules 5 days postnephrectomy and a definite
      increase 14 days postnephrectomy. At 1 or 2 days postnephrectomy, and following
      sham surgery, immunostainable EGF was present predominantly at luminal membranes.
      In contrast, immunostainable EGF was present more diffusely throughout distal
      tubular cells at 5 and 14 days postnephrectomy and clearly localized adjacent to
      both luminal and antiluminal membranes in kidneys obtained 14 days
      postnephrectomy. EGF extractable from kidneys was increased significantly 5 and
      14 days postnephrectomy. This material is the size of mature EGF. The altered
      localization of immunostainable peptide indicates that a redistribution of
      intracellular EGF accompanies increased synthesis postnephrectomy. Antiluminal
      EGF precursor or mature EGF present within kidney could act as a paracrine growth
      factor.

PMID- 1621808
TI  - Substrate responses to acid-base alterations in dog renal proximal tubules.
AB  - Proximal tubules from dog kidney were incubated for 2-6 min with low
      concentrations of pyruvate, glutamine, and malate. When initial medium citrate
      was between 0 and 0.5 mM and alpha-ketoglutarate was between 0 and 0.1 mM,
      concentrations of these two substrates in tubules and media after incubation were
      lower with 10 than with 40 mM HCO3-. Malate levels in tubules and media changed
      in the opposite direction. CO2 formation from labeled citrate or alpha
      ketoglutarate was greater at low than at high HCO3-. In tubules treated with
      digitonin to disrupt the cell membrane, differences in citrate and alpha
      ketoglutarate concentrations in tubules at high and low HCO3- were eliminated.
      The effects of acid-base changes seen in intact tubules on malate levels and on
      the rate of oxidation of labeled citrate persisted after digitonin pretreatment.
      These results show that acute effects of acid-base changes on citrate, alpha
      ketoglutarate, and malate levels observed in intact renal cortex can be
      reproduced in isolated tubules. They suggest that these changes are related to
      changes in levels of citrate and alpha-ketoglutarate in cytoplasm without
      corresponding changes within mitochondria.

PMID- 1621809
TI  - Renal effects of endogenous prostaglandin synthesis promoter ONO-3122.
AB  - The renal effects of a prostaglandin synthesis agonist, 1-iodo-3-aminomethyl
      5,6,7,8-tetrahydro-2-naphthol (ONO-3122), were investigated in anesthetized rats.
      ONO-3122 (0.3 mg/kg + 0.3 mg.kg-1.h-1 iv) doubled the urinary excretion of the
      main metabolites of prostaglandin F, and induced transient increases in renal
      blood flow and glomerular filtration rate (GFR) with a marked, stable
      natriuresis. Indomethacin suppressed the natriuresis. When the diuretic fluid
      losses were replaced, micropuncture showed an unaltered reabsorption of sodium in
      the proximal tubule but reductions in the loop of Henle (86 +/- 1 vs. 76 +/- 1%)
      and in the more distal segments (98 +/- 1 vs. 83 +/- 3%) with comparable
      reductions in water reabsorption. Potassium secretion was seen in the distal and
      collecting tubules. Without fluid replacement, sodium reabsorption was reduced in
      the loop and more distal nephron but increased in the proximal tubule.
      Differences between proximal and distal nephron GFR were unaffected by systemic
      ONO-3122. Loop perfusion with ONO-3122 did not change tubuloglomerular feedback
      responses, which were, however, completely suppressed by furosemide. It is
      concluded that ONO-3122 stimulates renal prostaglandin biosynthesis, transiently
      dilates renal vasculature, and induces natriuresis mainly by suppressing sodium
      and water reabsorption in the loop of Henle and the more distal nephron. Luminal
      ONO-3122 does not affect the tubuloglomerular feedback.

PMID- 1621810
TI  - Characteristics of osmolarity-stimulated urea transport in rat IMCD.
AB  - Urea transport across the terminal inner medullary collecting duct (IMCD) is
      mediated by a urea transporter that is stimulated by vasopressin (AVP) or
      hyperosmolarity. To determine whether hyperosmolarity stimulates urea transport
      by an adenylyl cyclase-dependent or -independent mechanism, terminal IMCDs were
      perfused with 10 microM forskolin followed by an increase in osmolality or with
      increasing osmolality followed by 10 nM AVP. In both protocols, stimulating
      adenylyl cyclase caused an additive increase in urea permeability (Purea) to that
      stimulated by hyperosmolarity. Next, we investigated whether hyperosmolarity
      stimulates the same urea transporter as AVP by studying the inhibitor profile and
      IMCD subsegment response of hyperosmolarity-stimulated urea transport and
      comparing it to properties already demonstrated for AVP-stimulated urea
      transport. In terminal IMCDs, luminal phloretin (250 microM) reversibly inhibited
      Purea by 63%. Thiourea (100 mM) inhibited Purea by 73% at two different levels of
      osmolality, 690 and 290 mosmol/kgH2O. The half-maximal inhibitory concentration
      (K1/2) for thiourea at 690 mosmol/kgH2O was not significantly different from the
      K1/2 value at 290 mosmol/kgH2O, suggesting that stimulation by hyperosmolarity is
      related to an increase in the Vmax for the urea transporter. Finally, we found
      that hyperosmolarity did not stimulate Purea in the initial IMCD. In summary, the
      data suggests that hyperosmolarity stimulates urea transport by an adenylyl
      cyclase-independent mechanism. However, the inhibitor profile and the IMCD
      subsegment response for hyperosmolarity-stimulated and AVP-stimulated Purea are
      similar, suggesting that both hyperosmolarity and AVP stimulate the same urea
      transporter.

PMID- 1621811
TI  - Role of paraventricular nucleus in control of blood pressure and drinking in
      rats.
AB  - The present investigation examined the abilities of angiotensin (ANG) II and III
      to produce increases in blood pressure and drinking when microinfused into the
      paraventricular nucleus (PVN) of the hypothalamus of the Sprague-Dawley rat. Dose
      dependent elevations in systemic blood pressure and heart rate were measured to
      both ANG II and III in the anesthetized rat, with ANG II more potent than ANG III
      at the two highest doses examined. Pretreatment with the specific ANG receptor
      antagonist [Sar1,Thr8]ANG II (sarthran), blocked subsequent ANG II- and III
      induced elevations in blood pressure, suggesting that these responses were
      dependent on the activation of ANG receptors. A similar analysis in awake rats
      yielded nearly equivalent results. A final experiment demonstrated that
      microinfusions of ANG II and III into the PVN produced drinking in a dose
      dependent manner, with greater consumption to ANG II than ANG III. Again,
      sarthran was found to block the dipsogenic response. Histological examination
      revealed that the location of the injection site was linked to the character of
      the ANG-dependent response. These data suggest that the PVN may play a critical
      role in mediating central ANG effects on body water homeostasis and blood
      pressure regulation. Furthermore, it appears that subnuclei of the PVN may
      participate differentially in ANG-mediated actions.

PMID- 1621812
TI  - Luminal influences on potassium secretion: chloride, sodium, and thiazide
      diuretics.
AB  - In the presence of Cl-, K+ secretion by the distal tubule saturates with
      increasing luminal Na+ concentration. Apparent maximal K+ secretion is attained
      with luminal Na+ concentrations of 40 mM. The results of the present study show
      that lowering the Cl- concentration of luminal fluid can increase the level of
      Na(+)-stimulated K+ secretion beyond the maximal level attained in the presence
      of Cl-. The effect of lowering luminal Cl- concentration to less than 10 mM on K+
      secretion is greater with higher Na+ concentration. Under these conditions,
      chlorothiazide decreases K+ secretion. When chlorothiazide is present, changing
      the Na+ concentration does not affect K+ secretion. Because in rats a thiazide
      effect is attributed primarily to the distal convoluted tubule (DCT), we
      postulate that it is primarily DCT cells that increase K+ secretion when Na+
      concentration is raised in the presence of low luminal Cl- concentration. We
      propose that the rat DCT cells have both an absorptive Na(+)-Cl- cotransport
      mechanism and a secretory K(+)-Cl- cotransport mechanism in the luminal membrane
      that can mediate the apparent exchange of Na+ for K+.

PMID- 1621813
TI  - Role of nucleoside uptake in renal postischemic ATP synthesis.
AB  - The role of nucleoside uptake in the enhanced metabolic recovery seen with
      postischemic ATP.MgCl2 was assessed by determining the effect of S-(p
      nitrobenzyl)-6-thioinosine (NBTI) on postischemic ATP recovery in rats given
      normal saline (NS), ATP.MgCl2, or adenosine after 45 min of bilateral renal
      ischemia. In NS-infused animals, postischemic administration of NBTI (250 nmol)
      had no significant effect on the pattern of ATP recovery. In animals given 50
      mumol ATP.MgCl2, coinfusion of NBTI significantly reduced the renal ATP content 2
      h after reperfusion but blocked only one-half of the enhancement in renal ATP
      content compared with animals given ATP.MgCl2 alone. In animals postischemically
      infused with [2,5,8-3H]ATP.MgCl2 (50 mumol) there was significant labeling of
      nucleotides, nucleosides, and bases after 2 h of reperfusion. The specific
      activity of the adenosine pool was consistent with significant label uptake in
      the form of adenosine. Coinfusion of NBTI led to a significant reduction in label
      incorporation into renal ATP and total adenine nucleotide pools. These data are
      consistent with an important role for an NBTI-sensitive nucleoside uptake
      mechanism in the enhanced metabolic and functional recovery observed in
      ischemically injured kidney treated by postischemic infusion of ATP.MgCl2.

PMID- 1621814
TI  - Cyclic nucleotides alter intracellular free Mg2+ in renal epithelial cells.
AB  - Intracellular Mg2+ plays an important role in cell physiology. Studies were
      performed on MDCK cells and primary cortical thick ascending limb (CTAL) cells to
      determine hormonal influences on intracellular Mg2+ control. Free Mg2+ ([Mg2+]i)
      was measured by fluorescence with mag-fura-2. Addition of 8-bromoguanosine 3',5'
      cyclic monophosphate (8-BrcG-MP, 10(-4) M) to subconfluent MDCK cells resulted in
      rapid increases in [Mg2+]i from basal levels of 552 +/- 6 microM to peak
      concentrations of 682 +/- 5 microM, whereas 8-BrcAMP (10(-4) M) led to
      significant decreases in [Mg2+]i from 538 +/- 5 to 362 +/- 17 microM. These
      effects of cyclic nucleotides were dose dependent with half-maximal
      concentrations (EC50) of approximately 10(-5) M for both increments in [Mg2+]i
      with cGMP and decrements in [Mg2+]i with cAMP. Atrial natriuretic peptide (ANP)
      and cGMP increased Mg2+ in porcine primary CTAL cells from 525 +/- 12 to 592 +/-
      18 microM and from 538 +/- 8 to 609 +/- 18 microM, respectively. The increment in
      [Mg2+]i with ANP was dose responsive with EC50 values of approximately 10(-11) M
      suggesting that these effects may be of physiological importance. Parathyroid
      hormone and calcitonin and their second messenger, cAMP, diminished Mg2+ by
      approximately 80 microM. The EC50 value for calcitonin was in the order of 10(-9)
      M. The changes in [Mg2+]i, whether increases with ANP or cGMP and decreases with
      PTH, calcitonin, or cAMP, were rapid in nature and independent of changes in
      intracellular free Ca2+ concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621815
TI  - cDNA cloning of a renal Na(+)-Ca2+ exchanger.
AB  - In the present study, the polymerase chain reaction (PCR) and library screening
      were used to clone a cDNA for a rabbit kidney Na(+)-Ca2+ exchanger on the basis
      of homology with the canine cardiac sarcolemmal sequence (D. A. Nicoll, S.
      Longoni, and K. D. Philipson. Science Wash. DC 250:562-565, 1990). There is a
      high degree of similarity between the two sequences, with nucleotide identities
      of 95, 89, and 90% in the hydrophobic membrane-associated domain, cytoplasmic
      domain, and 3'-untranslated region, respectively. The rabbit kidney cDNA encodes
      a predicted protein of 941 amino acids, 29 amino acids shorter than the canine
      sequence, with a relative molecular weight of 105,121. The deduced amino acid
      sequence is 96% identical in the membrane-associated domain and 94% identical in
      the cytoplasmic domain. Northern blot analysis reveals that the cDNA is expressed
      in the renal cortex. No expression is detected in the medulla. This result is in
      agreement with micropuncture studies that show Na(+)-Ca2+ exchanger activity in
      cortical but not medullary nephron segments.

PMID- 1621816
TI  - Glomerular basement membrane: in vitro studies of water and protein permeability.
AB  - The glomerular basement membrane (GBM) is an integral structural component of the
      glomerular filter, but its contribution to the hydraulic and macromolecular
      permeability properties of the glomerulus has been the subject of much
      controversy. We have modified previously reported methods to develop a technique
      with which to study filtration properties of microgram quantities of isolated GBM
      in vitro at physiological pressures. Rat glomeruli were sieved, and cells were
      removed with N-laurylsarcosine and DNase. GBM (150 micrograms; greater than 95%
      pure) were added to a mini-ultrafiltration cell and consolidated under pressure
      to form a continuous filter at the base of the cell. Water flux was identical to
      inulin clearance at applied pressures less than 150 mmHg and increased with
      progressive increments in the transmembrane pressure. Hydraulic conductivity of
      GBM was inversely related to the prevailing transmembrane pressure gradient. The
      hydraulic conductivity depended on albumin concentration in a manner that was not
      monotonic, with the conductivity being lower at 4 g/dl albumin than at 0 or 8
      g/dl. When plasma was utilized as the retentate, the fractional clearance of
      albumin was over twice that of immunoglobulin G, and the fractional clearance of
      each protein was much higher than that in the intact glomerulus. On the basis of
      these results, both the hydraulic and macromolecular permeability of an
      individual layer of GBM are much greater than that reported for the intact
      glomerulus. The large quantitative differences between GBM permeability and that
      of intact glomeruli suggest a major contribution of cellular elements to
      glomerular permeability properties.

PMID- 1621817
TI  - Corticosterone 6 beta-hydroxylation correlates with blood pressure in
      spontaneously hypertensive rats.
AB  - Evidence for increased glucocorticoid 6 beta-hydroxylation (enhanced family 3A
      cytochrome P-450 activity) is found in certain reversible forms of human
      hypertension. This association was investigated in the spontaneously hypertensive
      rat (SHR). The proportion of injected [3H]corticosterone excreted in urine as 6
      beta-[3H]OH-corticosterone was four- to fivefold higher in SHR than in control
      Wistar-Kyoto rats, before and after development of overt hypertension. Both
      hypertension and 6 beta-hydroxylation were inhibited by troleandomycin (a
      selective inhibitor of family 3A cytochromes P-450), consistent with a role for
      increased steroid 6 beta-hydroxylation in the genesis of hypertension in the SHR.

PMID- 1621818
TI  - Endothelium modulates renal blood flow but not autoregulation.
AB  - Inhibition of the production of the endothelium-derived relaxing factor (EDRF)
      nitric oxide using N omega-nitro-L-arginine methyl ester (L-NAME) increases blood
      pressure (BP) and decreases renal blood flow (RBF), suggesting that basal EDRF
      can modulate both systemic resistance and renal perfusion. We tested whether L
      NAME inhibition of EDRF could also change the autoregulation of RBF. Blood
      pressure and RBF were measured in Inactin-anesthetized Sprague-Dawley rats. A
      bolus of 10 mg/kg body wt of L-NAME produced the maximum pressor response (23 +/-
      3 mmHg) and blocked acetylcholine-induced renal vasodilation. In control rats,
      sequential changes in renal perfusion pressure showed that RBF was well
      autoregulated down to 95 +/- 2 mmHg. L-NAME increased BP, decreased RBF by 33% (P
      less than 0.005), and increased renal vascular resistance twofold. Although RBF
      was decreased, the kidney was still able to autoregulate RBF, although reset
      around the lower flow. Acute hypertension by carotid occlusion and vagotomy
      increased BP by 26 +/- 6 mmHg (P less than 0.005) and slightly increased RBF,
      while autoregulation was maintained. The pressor response to L-NAME was amplified
      to 38 +/- 6 mmHg (P less than 0.001), but RBF decreased by 35% (P less than
      0.01). Autoregulation of RBF was maintained, although reset around the lower
      flow. We conclude that, although endothelial EDRF production may help maintain
      RBF, it does not seem to mediate the intrinsic autoregulatory responses of the
      renal vasculature to altered renal perfusion pressure.

PMID- 1621819
TI  - Signal transduction events whereby PGF2 alpha inhibits the ammoniagenic response
      to acute acidosis.
AB  - Subconfluent cultures of LLC-PK1 cells were incubated for 1 h in Krebs-Henseleit
      buffer (KHB) of pH 7.4 or 6.8 to investigate the signal transduction events
      associated with prostaglandin F2 alpha (PGF2 alpha) inhibition of ammonia
      metabolism. Exposure of these cultures to PGF2 alpha (0.1 ng/ml) inhibited the
      acute low pH stimulation of ammonia production and to a lesser degree alanine
      formation in a manner analogous to the response exhibited with the phorbol ester
      12-O-tetradecanoylphorbol-13-acetate (TPA). Pretreatment with an inhibitor of
      protein kinase C [1-(5-isoquinolinylsulfonyl)-2-methylpiperazine, i.e., H-7] or
      utilization of cultures with downregulated protein kinase C activity abolished
      the inhibitory response to PGF2 alpha. Exposure to PGF2 alpha for 10 min in KHB
      of pH 6.8 resulted in an activation of protein kinase C, as demonstrated by a
      significant increase in membrane-bound enzyme activity. Incubation of the cells
      with PGF2 alpha in KHB of pH 6.8 also resulted in a significant increase in
      inositol trisphosphate formation. Treatment of the cultures with verapamil in
      calcium-containing medium or removal of calcium from the incubating medium
      resulted in a significant loss of the PGF2 alpha inhibitory response on both
      ammonia and alanine production. Furthermore, under conditions of calcium-free
      incubation, PGF2 alpha had no significant effect on protein kinase C activity.
      Because both PGF2 alpha- and TPA-induced inhibition of ammoniagenic response to
      acute acidosis was prevented by amiloride, the underlying mechanism may involve
      protein kinase C-mediated changes in intracellular pH. These results indicate
      that the activation of protein kinase C plays a key role in mediating PGF2 alpha
      inhibition of ammoniagenesis.

PMID- 1621820
TI  - Sequential changes in renal oxygen consumption and sodium transport during
      hyperdynamic sepsis in sheep.
AB  - The sequence of changes in systemic and renal oxygen delivery (QO2) and
      consumption (VO2) and renal function in an ovine model of progressive
      hyperdynamic sepsis was investigated. Nine chronically instrumented awake sheep
      were given a continuous intravenous Escherichia coli endotoxin infusion (20 ng.kg
      1.min-1) for 3 days. After 8 h of the infusion, systemic arterial blood pressure
      and vascular resistance stayed decreased by 30% (P less than 0.001). Systemic QO2
      progressively increased to a maximum of 157% of baseline values at 24 h and was
      associated with a decreased O2 extraction ratio from 33 +/- 2 (SE) to 23 +/- 2%
      (P less than 0.05), resulting in an unchanged systemic VO2. Renal blood flow and
      renal QO2 decreased by 40% during the first 12 h, returning to and staying at
      baseline values after 24 h. Renal VO2 decreased significantly by 35% at 12 h and
      then partially recovered to baseline values. Plasma creatinine clearance was
      maximally reduced to 25% of baseline values at 12 h and thereafter remained
      significantly (P less than 0.01) below 50% of baseline values. Both total and
      fractional sodium excretion fell at 12 h by 95 and 74%, respectively, and
      remained reduced over time, indicating conserved tubular function. The ratio of
      moles of sodium reabsorbed to moles of O2 consumed by the kidney was transiently
      reduced, from 33.4 +/- 4.1 to 12.4 +/- 3.6 at 12 h (P less than 0.05), indicating
      a relative increase in energy expenditure for tubular transport or renal
      synthetic activities, but recovered to baseline values after 24 h.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1621821
TI  - Dynamics of TGF-initiated nephron-nephron interactions in normotensive rats and
      SHR.
AB  - Proximal tubular pressure, glomerular filtration rate, and early distal tubule Cl
      oscillate at 35 mHz in normotensive rats because of tubuloglomerular feedback
      (TGF); the oscillation bifurcates to chaos in spontaneously hypertensive rats
      (SHR). To examine the importance of TGF-initiated vascular interactions between
      nephrons in these dynamics, we measured tubular pressure simultaneously in two or
      more nephrons. The oscillations were synchronized in nephrons supplied by a
      common cortical radial artery. The correlation coefficient of pressure records
      from coupled nephrons was 0.86 +/- 0.02. Intratubular furosemide perfusion
      diminished the oscillation in both the perfused and the coupled nephron; total
      autospectral power in each of the nephrons and cross-spectral power were reduced
      to 45% of control. The correlation between noncoupled nephrons was not
      significant, and intratubular furosemide perfused in one nephron had no effect on
      adjacent but noncoupled nephrons. In SHR, the correlation coefficient of tubular
      pressure records was high from coupled nephrons only; furosemide diminished the
      autospectral power of pressure fluctuations to approximately 60-75% of control in
      both perfused and coupled nephrons, and cross-spectral power was affected by a
      similar amount. Nephron-nephron interactions, specific to vascular connectivity,
      persist in SHR and appear to be stronger than in normotensive rats.

PMID- 1621822
TI  - Time course of renal glutamate dehydrogenase induction during NH4Cl loading in
      rats.
AB  - To study mechanisms involved in renal glutamate dehydrogenase (GDH) regulation in
      response to systemic acid loading, we have measured blood pH, ammonium excretion,
      renal GDH mRNA levels, and GDH activity in rats. Acid intake (0.28 M NH4Cl in
      drinking water for 3 days) increased GDH mRNA levels in the renal cortex, but had
      no effect in the outer stripe of the outer medulla, inner stripe of the outer
      medulla, or the inner medulla. Rats were subjected to a step change in acid
      intake by alkali loading for 3 days (7.2 meq NaHCO3 per day in food slurry) and
      shifting to acid loading for up to 7 days (7.2 meq NH4Cl in food slurry).
      Ammonium excretion rose rapidly, increasing by 14-fold in the first 24-h period
      and 38-fold in the second 24-h period. Cortical GDH mRNA levels were increased
      relative to alkali-loaded values by 3.7-fold in 24 h, 4.3-fold in 4 days, but
      only 2.2-fold in 7 days. GDH activity was unchanged after 24 h of acid intake,
      but was significantly increased after 48 h. We concluded the following: 1) GDH
      mRNA is present in all regions of the kidney, but levels increase in response to
      acid loading only in the renal cortex; 2) GDH mRNA levels increase within 1 day
      after the initiation of acid loading, but the associated increase in functional
      enzyme activity takes 2 or more days; and 3) the large increases in ammonium
      excretion that occur in the first day after initiation of acid loading are not
      dependent on increased GDH activity.

PMID- 1621823
TI  - Ca2+ signaling mechanisms of vascular endothelial cells and their role in oxidant
      induced endothelial cell dysfunction.
AB  - Endothelial cell function may be compromised in disease states as a result of
      oxidative injury, which may arise from a variety of sources. Oxidant stress
      appears to influence vascular reactivity and permeability via alteration in the
      production, release, or effect of endothelium-derived paracrine substances. An
      early event associated with endothelial cell dysfunction involves alteration in
      transmembrane signaling mechanisms. In particular, substantial evidence suggests
      that oxidant stress alters Ca2+ homeostatic mechanisms of the endothelial cell.
      Because an increase in the free cytosolic Ca2+ concentration ([Ca2+]i) of the
      endothelial cell is important for release of paracrine factors responsible for
      regulation of vascular tone and reactivity, oxidant stress-induced changes in
      Ca2+ signaling could explain much of the observed pathophysiology associated with
      oxidative injury. Under normal conditions, agonists such as bradykinin and ATP
      cause a biphasic increase in [Ca2+]i of the endothelial cell; an initial
      transient component reflects release of Ca2+ from internal stores, whereas a more
      long-lasting elevation in [Ca2+]i reflects Ca2+ influx from the extracellular
      space. After incubation with tert-butyl hydroperoxide, a time-dependent
      inhibition of the agonist-stimulated changes in [Ca2+]i is observed. The
      underlying molecular mechanisms associated with normal Ca2+ signaling and how
      these may be altered in the endothelial cell by oxidative stress is the subject
      of this review.

PMID- 1621824
TI  - Single perturbed beat vs. steady-state beats for assessing systolic function in
      the isolated heart.
AB  - Single-beat and steady-state techniques for evaluating end-systolic pressure
      volume relationship (ESPVR) and Frank-Starling mechanism (FSM) in the crystalloid
      perfused isolated rabbit heart were compared. In the single-beat technique, a
      train of stable isovolumic beats was interrupted with a single perturbed beat
      that either ejected against various levels of imposed isobaric load (ESPVR
      protocol) or beat isovolumically against various levels of end-diastolic volume
      (V(ED); FSM protocol). In steady-state technique, sustained beating was
      established, isobarically, at each of various loads (ESPVR protocol) or,
      isovolumically, at each of various V(ED) values (FSM protocol). ESPVR from steady
      state technique lay above and to the left of that from single-beat technique.
      Contractile state was not uniform within steady-state technique, whereas it was
      uniform within single-beat technique. In the FSM protocol, single-beat technique
      exhibited the following features relative to steady-state technique: 1) greater
      range of developed pressures, 2) steeper ascending limb and more sharply defined
      maxima, 3) higher maximal developed pressure (Pdmax), and 4) greater volume at
      Pdmax(Vmax). Again. a common contractile state existed within single-beat
      technique but not within steady-state technique. It was concluded that single
      beat technique was preferable to steady-state technique for evaluating ESPVR and
      FSM because 1) single-beat technique required less time for obtaining data, 2)
      single-beat technique allowed identification of uncomplicated values of Pdmax and
      Vmax, and 3) single-beat technique provided a common contractile-state reference
      for all data, whereas steady-state technique did not.

PMID- 1621825
TI  - Endothelial dysfunction of hindquarter resistance vessels in experimental heart
      failure.
AB  - Local vascular alterations may contribute to increased peripheral
      vasoconstriction in chronic heart failure. To test whether endothelial
      dysfunction might be involved, the effect of acetylcholine, nitroglycerin, and NG
      monomethyl-L-arginine (L-NMMA) was investigated in a constant-flow perfused
      hindquarter of rats with and without chronic heart failure (CHF) due to
      myocardial infarction. Changes in perfusion pressure were measured as an index of
      changes in hindlimb vascular resistance. The endothelium-dependent vasodilator
      effect of acetylcholine was significantly reduced in rats with large infarcts
      (greater than 40% of the left ventricle). However, the endothelium-independent
      vasodilator effect of nitroglycerin and the vasoconstrictor effect of L-NMMA were
      similar for infarct and normal animals. The vasodilator response to acetylcholine
      was partially inhibited by pretreatment with L-NMMA. Thus the basal release of
      nitric oxide from hindquarter resistance vessels is preserved in CHF. However,
      the endothelium-mediated dilation in response to acetylcholine is attenuated, in
      part, due to a depressed stimulated release of nitric oxide. The latter mechanism
      might be involved in the impaired vasodilatory capacity in the peripheral
      circulation in CHF, e.g., during exercise.

PMID- 1621826
TI  - Elevation of organ resistance due to leukocyte perfusion.
AB  - Leukocytes are larger and considerably less deformable than erythrocytes, thereby
      causing a disproportionate effect on local blood flow, which despite their low
      concentration, may be significant at the organ level. To investigate the degree
      to which circulating leukocytes affect whole organ resistance, a hemodynamically
      isolated rat gracilis muscle was perfused in situ under well-controlled
      conditions. Comparison of organ pressure-flow data from vasodilated vasculature
      using normal physiological cell concentrations and perfusion pressures indicates
      that leukocytes (60-75% neutrophils) provide approximately 22% of the whole blood
      resistance despite their relatively small cell volume fraction of approximately
      0.1%. On a single cell basis, each leukocyte imposes a resistance elevation
      equivalent to that of approximately 750 erythrocytes. Furthermore, when
      leukocytes are activated via pretreatment using N-formyl-methionyl-leucyl
      phenylalanine or endotoxin, they show a higher resistance, accounting for 50-60%
      of the total resistance. These findings indicate that leukocytes play a
      significant role in normal skeletal muscle organ perfusion and may be a major
      determinant of organ perfusion during disease states.

PMID- 1621827
TI  - Endothelial modulation of porcine coronary microcirculation perfused via immature
      collaterals.
AB  - Porcine hearts have relatively few native collateral vessels and lack the
      propensity to develop normal perfusion to the collateral-dependent myocardium. To
      examine microvascular responses in the collateral-dependent region, collateral
      vessels were stimulated in pigs by the Ameroid constrictor technique. After 4-7
      wk, isolated microarterial vessels (90-170 microns ID) were studied in a
      pressurized (40 mmHg), no-flow state. Microvessels from noninstrumented pigs were
      used as controls for vascular studies. Although myocardium in the collateral
      dependent region showed minimal evidence of infarction, percent systolic
      shortening was reduced at rest and after pacing compared with myocardium in the
      normally perfused region. Relaxations to the receptor-mediated endothelium
      dependent agents ADP and bradykinin were impaired in collateral-dependent
      coronary microvessels. Relaxations to the calcium ionophore A23187, which acts
      through a non-receptor-mediated mechanism, were similar in control and Ameroid
      microvessels. Relaxations to the endothelium-independent agent sodium
      nitroprusside were markedly enhanced in microvessels from the collateral
      dependent region compared with microvessels from control hearts. In conclusion,
      receptor-mediated endothelium-dependent relaxation is impaired and endothelium
      independent relaxation to sodium nitroprusside is enhanced in microvessels from
      myocardium perfused by immature collateral vessels.

PMID- 1621828
TI  - Different endothelial mechanisms involved in coronary responses to known
      vasodilators.
AB  - The role of the endothelium in mediating flow responses to acetylcholine (ACh),
      bradykinin (BK), adenosine (Ado), and the poorly hydrolyzable ATP-derivative
      beta,gamma-methylene-ATP (MeATP) was evaluated in the intact coronary system of
      the isolated perfused guinea pig heart. In the presence of superoxide anions,
      known to inactivate the endothelium-derived relaxing factor nitric oxide (NO),
      only steady-state dilatation induced by ACh (1 microM) was fully inhibited and
      that of BK (0.1 nM) attenuated. Similar effects were obtained with methylene blue
      and N omega-nitro-L-arginine; however, the latter also reduced the actions of Ado
      (0.1 microM) and MeATP (0.5 microM). Conversely, perfusion with the NO precursor
      L-arginine (10 microM) resulted in a potentiated relaxation by ACh, whereas
      steady-state responses to BK and Ado remained unchanged. Pretreatment of hearts
      with hydroxyl radicals (.OH) elevated vascular permeability. Under this
      condition, flow increases induced by ACh, BK, and Ado were enhanced by 130, 89,
      and 47%, respectively, whereas the effect of MeATP (0.5 microM) was reduced by
      45%. Preexposure of hearts to the oxidant hypochlorous acid (HOCl) prevented
      dilatations by ACh, BK, MeATP and Ado (0.1 microM), and the response to Ado (5
      microM) was reduced by 68%; postischemic hyperemia was attenuated. Glyburide, an
      inhibitor of ATP-sensitive K+ channels, halved the flow response to infused Ado
      (0.1 and 5 microM), inhibited MeATP, and abolished reactive hyperemia. We
      conclude that in the guinea pig coronary system ACh, BK, MeATP, and Ado (0.1
      microM) induce endothelium-dependent vasodilatation, some step(s) of the signal
      transmission being vulnerable to oxidative attack by HOCl.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1621829
TI  - Effect of coronary stenosis on phasic pattern of septal artery in dogs.
AB  - To analyze the effect of coronary stenosis on the phasic pattern of blood flow
      velocity into the myocardium, we measured septal artery blood velocities under
      control conditions, i.e., no stenosis (N), with moderate (S1) and severe (S2)
      proximal coronary arterial stenosis, and during complete occlusion. In eight
      anesthetized open-chest dogs, the blood velocity measurements were performed
      using our 20-MHz multichannel pulsed Doppler method before and after
      intracoronary adenosine administration. Under N, the coronary perfusion pressure
      was set to approximately 100 mmHg, with S1 the poststenotic pressure was
      approximately 60 mmHg, and with S2 it was decreased to 35 mmHg. Septal arterial
      blood velocity area, which is the time-integrated envelope of the velocity, was
      divided into three components; systolic retrograde velocity area, systolic
      anterograde velocity area, and diastolic anterograde velocity area. There were no
      significant changes from N to S1 in any of the three velocity areas, which is a
      measure of the flow. Total inflow decreased from N to S2 by 52% (P less than
      0.05). Diastolic anterograde flow decreased from N to S2 by 32% (P less than
      0.05). Systolic retrograde flow increased from N to S2 by 75% (P less than 0.05).
      Systolic anterograde flow was almost unchanged by increasing stenosis. After
      complete occlusion, the septal artery exhibited a to-and-fro flow pattern.
      Adenosine-induced vasodilation reduced poststenotic pressure (P less than 0.05)
      and enhanced systolic retrograde flow without a significant increase in diastolic
      anterograde flow. Systolic retrograde flow increased at S1 by 49% (P less than
      0.05) and at S2 by 27% (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621830
TI  - Effect of general anesthesia on cardiac vagal tone.
AB  - Although it is accepted that general anesthetics alter cardiac vagal tone, the
      magnitude of this effect was difficult to quantify by noninvasive methods until
      recently. Twenty-eight mongrel dogs were anesthetized using one of four
      representative anesthetics: pentobarbital sodium (25 mg/kg iv), morphine (1 mg/kg
      sc) with alpha-chloralose (50 mg/kg iv), urethan (500 mg/kg iv), thiopental
      sodium (25 mg/kg iv), and halothane (2% inhalation). Heart period (R-R interval)
      was recorded, from which the amplitude of the respiratory sinus arrhythmias
      (RSAs; frequency 0.24-1.04 Hz) was determined by time-series analysis. Morphine
      with alpha-chloralose-urethan significantly (P less than 0.01) increased RSA
      (control 8.3 +/- 0.6 ln ms2, anesthesia 9.4 +/- 0.3 ln ms2), whereas thiopental
      and halothane both significantly (P less than 0.01) decreased RSA (control 8.7 +/
      0.4 ln ms2, thiopental 1.3 +/- 0.4 ln ms2; and control 8.5 +/- 0.6 ln ms2,
      halothane 3.6 +/- 0.8 ln ms2). Pentobarbital failed to elicit a consistent change
      in RSA. These data suggest that vagal tone was maintained during morphine with
      alpha-chloralose-urethan anesthesia but was reduced during thiopental and
      halothane anesthesia.

PMID- 1621831
TI  - Restraining effect of intact pericardium during acute volume loading.
AB  - To determine the effect of the intact pericardium on ventricular end-diastolic
      pressures (EDP) during acute volume loading, we measured left ventricular (LV)
      and right ventricular (RV) micromanometer pressure and LV volume using a
      conductance catheter in eight open-chest, anesthetized dogs. A range of LV
      pressure and volume was obtained by intravascular volume expansion with the
      pericardium intact and then over a similar range after removal of the
      pericardium. Pericardial pressure (Pper) was calculated using static equilibrium
      analysis as the difference between LVEDP with the pericardium present and absent
      at a constant LV volume. At the beginning of the fluid infusion (LVEDP 7.3 +/-
      1.7 mmHg and RVEDP 4.4 +/- 2.6 mmHg, mean +/- SD), Pper was not different from
      zero (-1.0 +/- 2.3 mmHg, P not significant). The onset of pericardial restraint
      (Pper greater than or equal to 0 mmHg) occurred when LVEDP was 9.1 +/- 2.9 mmHg
      and RVEDP was 4.1 +/- 2.9 mmHg. At low cardiac volumes before fluid infusion, RV
      transmural pressure was positive and significantly greater than the near zero
      Pper. After the onset of pericardial restraint, however, RVEDP and Pper increased
      similarly and were related according to Pper = 1.1 (+/- 0.34) RVEDP - 4.2 (+/-
      2.6) mmHg, standard deviation 0.6 +/- 0.8 mmHg, r = 0.98 +/- 0.10. These data
      indicate that the intact pericardium behaves in two functionally distinct ways.
      At low cardiac volumes, Pper is zero and the pericardium does not affect LV
      filling. RV transmural pressure is positive and greater than Pper.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1621832
TI  - Comparable efficiencies of chemomechanical energy transduction between beating
      and fibrillating dog hearts.
AB  - We have recently proposed a mechanical index, equivalent pressure-volume (PV)
      area (ePVA), as a measure of the total mechanical energy during ventricular
      fibrillation (VF). ePVA, an analogue of the PV area (PVA) of a beating heart, is
      the area surrounded by the isobaric line drawn at the VF pressure, the end
      systolic and end-diastolic PV relations of the beating state. In the present
      study, using a closed-air chamber system, we actually produced isobaric
      contractions, PVAs of which were identical with ePVAs during VF. Myocardial O2
      consumption (VO2) during VF was measured and compared with the estimated value
      from VO2 of isobaric contraction with identical PVA and equivalent heart rate
      (eHR). eHR, an estimate of the contraction frequency of each myocyte during VF,
      was determined from unloaded VO2 in beating and fibrillating states. The
      efficiency of the energy conversion from VO2 for mechanical purposes to the total
      mechanical energy (contractile efficiency) during VF was calculated as the
      reciprocal of the slope of the VO2-ePVA relation. The estimated VO2 during VF
      agreed with measured VO2 (r = 0.96, regression coefficient = 1.13). The slope of
      the VO2-ePVA relation during VF was not different from that in the beating state
      in all hearts by analysis of covariance, and mean contractile efficiency during
      VF (51 +/- 23%) was not significantly different from that in the beating state
      (40 +/- 12%). We conclude that 1) ePVA is considered to represent the total
      mechanical energy during VF, and 2) contractile efficiency during VF is
      comparable to that in the beating state.

PMID- 1621833
TI  - Pressure-maximal coronary flow relationship in regionally stunned porcine
      myocardium.
AB  - In view of variable results on maximal coronary blood flow in stunned myocardium,
      we studied the pressure-maximal coronary flow (PMCF) relationship in stunned
      myocardium in 12 anesthetized swine by using intracoronary adenosine (20
      micrograms/kg). Subendocardial systolic segment shortening (SS) measured with
      sonomicrometry was 19 +/- 5% (means +/- SD) at baseline and 7 +/- 6% (P less than
      0.01) at 30 min of reperfusion after 15 min of low-flow ischemia, at which time
      postsystolic shortening was present. Myocardial stunning increased the slope of
      the PMCF regression line (alpha PMCF) from 3.34 +/- 1.03 to 3.89 +/- 1.33 ml.min
      1.mmHg-1 (P less than 0.01). Atrial pacing at 40 beats/min above spontaneous
      heart rate (n = 6) further reduced subendocardial SS to 6 +/- 6% (P less than
      0.05). Dobutamine (4 micrograms.kg-1.min-1; n = 6) increased subendocardial SS to
      13 +/- 5% (P less than 0.05) and abolished postsystolic shortening. Both
      interventions left alpha PMCF unchanged. In conclusion, myocardial stunning was
      associated with an increase in alpha PMCF that most likely resulted from the
      decreased contractile function. The absence of an effect of dobutamine may be due
      to its predominant action on diastolic function.

PMID- 1621834
TI  - Does systolic subepicardial perfusion come from retrograde subendocardial flow?
AB  - To examine the influence of cardiac contraction on systolic coronary flow and
      transmural blood flow distribution, we measured phasic blood flow velocity in
      distal extramural coronary arteries by Doppler velocimeter and regional
      myocardial blood flow by radiolabeled microspheres while the heart was beating
      and during prolonged diastoles in 12 dogs. A servo-controlled coronary perfusion
      circuit allowed mean coronary pressure to be selected and maintained during
      beating and diastolic conditions. In epicardial arteries just proximal to their
      entrance into the myocardium, blood flow was either negligible or reverse in
      direction during systole. When the heart was beating, subepicardial blood flow
      was 24.2 +/- 12.3% higher than during asystole (5.05 +/- 0.91 and 4.11 +/- 0.79
      ml.min-1.g-1 for beating and prolonged diastoles, respectively; P less than
      0.01). In the subendocardium, flow was 49.8 +/- 14.7% lower in the beating
      condition than during prolonged diastoles (4.23 +/- 1.46 and 8.26 +/- 1.71 ml.min
      1.g-1 for beating and asystole, respectively; P less than 0.01). When heart rate
      was increased stepwise from 60 to 150 beats/min, subendocardial flow fell
      approximately linearly; flow to the superficial layer was relatively unaffected.
      In beating hearts, lowering mean left main coronary artery (LMCA) pressure from
      80 to 50 mmHg resulted in more systolic reverse flow and a fall in inner-to-outer
      flow ratio from 0.82 +/- 0.18 to 0.66 +/- 0.34 (P less than 0.05). Because mean
      LMCA pressure was held constant when the heart was stopped, differences in
      regional blood flow between beating and diastolic conditions were primarily due
      to cardiac contraction. Because little or no blood entered the myocardium from
      the extramural arteries during systole, we conclude that the decrease in
      subendocardial flow and the increase in subepicardial flow were caused by
      retrograde pumping of blood from the deep layer to the superficial layer of the
      left ventricle. Systolic retrograde flow to the subepicardium may help explain
      this layer's relative protection from ischemia.

PMID- 1621835
TI  - Cellular mechanisms of ventricular failure: myocyte kinetics and geometry with
      age.
AB  - To determine whether heart failure is a consequence of alterations in cardiac
      cellular performance, myocytes were isolated from Fischer 344 rats at 4, 12, 20,
      and 29 mo of age and studied mechanically and morphometrically. Left ventricular
      myocyte length increased by 14.5, 14.4, and 24.0% at 12, 20, and 29 mo when
      compared with 4-mo-old animals. An 11.4 and 14.2% increase in length was seen for
      right ventricular myocytes from 4 to 12 mo and from 20 to 29 mo, respectively.
      Although no change in cell width was seen in either ventricle as a function of
      age, myocardial cells were more irregular in shape and consistently longer in the
      left ventricle at 20 and 29 mo. Left myocytes at 29 mo revealed diminished
      velocities of shortening (31.7%) and relengthening (59.5%). Contraction duration
      increased due to a 28.9% prolongation of time to peak shortening and a 26.5%
      increase in time to relengthening, resulting in a 25.8% decrease in myocyte
      shortening at 29 mo. Similar changes were observed in right ventricular myocytes,
      but they occurred later in life. Thus the alterations in myocyte geometry and
      depression in contractile performance seen here are major contributors to the
      eccentric dilated ventricular chamber and diminished pump function previously
      documented in the age-related transition from normal cardiac dynamics to left
      ventricular dysfunction and failure.

PMID- 1621836
TI  - Effects of endothelin on resistance arteries of DOCA-salt hypertensive rats.
AB  - The effect of endothelin (ET)-1 was investigated on resistance arteries of less
      than 300-microns lumen diameter from the mesenteric circulation, mounted on a
      wire myograph, in deoxycorticosterone acetate (DOCA)-salt hypertensive rats
      within 2 wk of developing hypertension and in uninephrectomized controls.
      Arteries from DOCA-salt hypertensive rats presented a significantly reduced
      external and lumen diameter and increased media width and wall cross-sectional
      area. Vessels from DOCA-salt hypertensive rats responded to ET-1 with lower
      active wall tension and media stress. Because the lumen diameter was
      significantly decreased in DOCA-salt hypertensive rats, the active pressure
      developed in response to ET-1 was similar in both groups. In contrast, the
      maximal tension response to arginine vasopressin was enhanced in DOCA-salt
      hypertensive rats. The sensitivity to both peptides and norepinephrine (NE) was
      similar in both groups. After removal of endothelium by exposure to the nonionic
      detergent 3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate, ET-1
      elicited tension responses that were also lower in DOCA-salt hypertensive rats,
      whereas NE responses were similar in both groups. These results demonstrate
      significant morphological and functional changes in small arteries of DOCA-salt
      hypertensive rats within 2 wk of developing hypertension and blunted reactivity
      to ET-1. Because similar results were found after removal of endothelium, it is
      likely that neither prior receptor occupation by endogenous ET nor acute effects
      of other endothelial cell products play a role in the reduced responsiveness to
      ET of vascular smooth muscle of small resistance arteries of DOCA-salt
      hypertensive rats.

PMID- 1621837
TI  - Transforming growth factor-beta 1 inhibits L-arginine-derived relaxing factor(s)
      from smooth muscle cells.
AB  - The effects of human recombinant interleukin-1 beta were investigated on the
      release of nonprostanoid relaxing substances from cultured aortic smooth muscle
      cells from Wistar rats. Cells cultured on microcarrier beads were packed in
      columns. The perfusate over these beads was bioassayed by measuring changes in
      isometric tension of contracted arteries without endothelium. The perfusates from
      interleukin-1 beta-treated smooth muscle cells, but not from control cells,
      evoked relaxations. The relaxations persisted when the transit time between the
      cultured smooth muscle cells and the detector was increased to 5 min. The effect
      of relaxing substance(s) was inhibited by cycloheximide, nitro-L-arginine,
      methylene blue, and transforming growth factor-beta 1. L-Arginine but not D
      arginine overcame the blockade by nitro-L-arginine. Superoxide dismutase
      potentiated the relaxations. In cells cultured in multiwell plates, interleukin-1
      beta evoked a time- and concentration-dependent accumulation of nitrite in the
      extracellular medium that was inhibited dose dependently by transforming growth
      factor-beta 1. These studies demonstrate that cultured smooth muscle cells can be
      stimulated to produce nitric oxide-related substances and that the inducible
      pathway is modulated by transforming growth factor-beta 1.

PMID- 1621838
TI  - Effect of exogenous fatty acids on reperfusion arrhythmias in isolated working
      perfused hearts.
AB  - Exogenous fatty acids may promote arrhythmias during ischemia and reperfusion,
      perhaps by increasing myocardial concentrations of long-chain acylcarnitines. We
      therefore studied the effects of high concentrations of fatty acids on
      reperfusion arrhythmias and acylcarnitine accumulation in isolated working rat
      hearts subjected to regional ischemia and reperfusion. Hearts were perfused with
      buffer containing 3% albumin, 5.9 mM K+, and either 11 mM glucose or 11 mM
      glucose plus 1.2 mM palmitate. After 15 min of aerobic work, the left anterior
      descending artery was reversibly ligated for 10 min and released, and the hearts
      were subsequently reperfused for 3 min. Although ischemic zone acylcarnitine
      accumulation after reperfusion was significantly greater in glucose plus
      palmitate-perfused hearts (247 +/- 149 vs. 717 +/- 176 nmol/g dry wt in glucose-
      vs. palmitate-perfused hearts, respectively), no significant differences in the
      incidence (67 vs. 44%) or duration (95 +/- 17 vs. 56 +/- 17 s) of ventricular
      fibrillation (VF) were seen in glucose or glucose plus palmitate hearts,
      respectively. Because low K+ concentration ([K+]) has been reported to increase
      reperfusion arrhythmias in similar models, we reduced perfusate [K+] to 4.0 mM.
      This significantly increased the incidence and duration of VF in hearts perfused
      with glucose alone but had no effect in palmitate-perfused hearts. We conclude
      that acylcarnitine accumulation is not arrhythmogenic in this model and that
      fatty acids may actually have antiarrhythmic effects if exogenous [K+] is low.

PMID- 1621839
TI  - Hemodynamic studies in DOCA-salt hypertensive rats after opening of an
      arteriovenous fistula.
AB  - We determined the cardiovascular responses in normal and deoxycorticosterone
      acetate (DOCA)-salt hypertensive rats with reduced total peripheral resistance
      due to an arteriovenous (a-v) fistula. Animals were divided into four groups:
      control, fistula, DOCA-salt, and DOCA-salt fistula. The fistula was made by
      anastomosing the aorta and vena cava below the renal arteries. Four weeks after
      the creation of the fistula both DOCA-salt and DOCA-salt fistula animals received
      DOCA and salt for 6-8 wk. At the end of 10-12 wk we measured mean arterial
      pressure, cardiac output, tissue flows, and right atrial pressure. Flow
      measurements using radioactive microspheres were made in anesthetized animals.
      Cardiac index (CI) was 202% higher in the fistula group than in the control
      animals and 165% higher in the DOCA-salt fistula than in the DOCA-salt animals.
      There was no difference in cardiac output between the control and DOCA-salt
      animals. The increase in cardiac output was due to the fistula flow as evidenced
      by a significant increase in the number of microspheres in the lung. Mean
      arterial pressure was 115 +/- 4 mmHg (control) and 108 +/- 5 mmHg (fistula) in
      non-DOCA rats but increased in both DOCA groups, 159 +/- 3 mmHg (DOCA-salt) and
      145 +/- 5 mmHg (DOCA-salt fistula). Right atrial pressure was increased above
      control in both fistula animals but was normal in DOCA-salt animals. Total
      peripheral resistance (TPR) was higher than control in DOCA-salt animals, but TPR
      in both the fistula and DOCA-salt fistula animals was lower than
      control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621840
TI  - Kidney cross transplants in Dahl salt-sensitive and salt-resistant rats.
AB  - Previous kidney cross-transplant studies have demonstrated that the genotype of
      the kidney plays a role in determining the blood pressure of the recipient in
      Dahl salt-sensitive (S) and salt-resistant (R) rats. The present studies were
      designed to elucidate this role. Kidney cross transplants were performed in
      unilaterally nephrectomized male recipients (John Rapp strains), such that each
      rat had a native kidney and a transplanted kidney of the opposite genotype. S and
      R rats with a native kidney and a transplanted kidney of the same genotype served
      as controls. After 4 wk on a 7.8% NaCl diet, rats were anesthetized and renal
      clearance studies were performed. S kidneys had lower glomerular filtration rate
      (GFR) and renal plasma flow (RPF) than R kidneys, and these differences were
      determined by the kidney's genotype rather than the recipient's, since S kidneys
      in R recipients tended to have lower GFR and RPF than R kidneys in S recipients.
      In contrast, independent of the kidney's genotype, the kidneys in S rats tended
      to have higher fractional excretion of H2O and Na (FEH2O and FENa) than the
      kidneys in R rats. Thus there were genetically determined differences in renal
      function between S and R rats; some (RPF and GFR) were intrinsic to the kidney,
      whereas others (FEH2O and FENa) were intrinsic to the host.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1621841
TI  - Mechanism of impaired energy metabolism during acidosis: role of oxidative
      metabolism.
AB  - Isolated perfused rat hearts were used to study the effects of metabolic acidosis
      on energy metabolism. Hearts perfused with different substrates (glucose,
      pyruvate, and succinate) were subjected to metabolic acidosis. With all
      substrates, there were comparable decrements in oxygen consumption (approximately
      35%), cardiac function (decrease in first derivative of pressure of 65%), and
      similar changes in high-energy phosphates (approximately 150% increases in
      inorganic phosphate and 25% decreases in phosphocreatine concentrations) with
      metabolic acidosis. To further investigate the metabolic effects of acidosis,
      isolated cardiac mitochondria were exposed to different incubation media pH
      conditions and given simple metabolites (glutamate/malate, succinate, or
      pyruvate) or fatty acids (octanoate). Reduction of incubation media pH to 6.0 did
      not significantly affect either coupled respiration rate or the respiratory
      control ratio (RCR) with any substrate. These data suggest that metabolic
      acidosis induces decreases in energy production in the isolated perfused heart by
      inhibiting mitochondrial substrate utilization and not by impairing glycolysis.
      However, this impairment of mitochondrial function is not a direct effect of
      acidosis itself but appears to occur secondarily to some other effects of
      acidosis which are, as yet, incompletely understood.

PMID- 1621842
TI  - Endotoxin impairs flow-induced vasodilation of porcine coronary arterioles.
AB  - The purpose of this study was to test the hypothesis that endotoxemia impairs
      endothelium-dependent (both receptor-mediated and flow-induced) vasodilation in
      porcine coronary arterioles. Coronary arterioles were isolated from three groups
      of 4- to 8-wk old (10.3 +/- 0.8 kg) pigs: endotoxemic (E; 250 micrograms/kg
      endotoxin iv), control (C; equal volume of saline), and untreated pigs (UT).
      Subepicardial arterioles (60-120 microns) were isolated and cannulated with two
      micropipettes that were connected to two independent reservoir systems.
      Intraluminal pressure was set at 60 cmH2O throughout the experiments. All C
      vessels developed spontaneous tone and exhibited flow-induced vasodilation from
      65 to 95% maximal diameter. Spontaneous tone developed in only three of five
      arterioles from E pigs, and flow-induced vasodilation was not observed in any
      arteriole from E pigs. Spontaneous tone developed in all six arterioles isolated
      from UT pigs but disappeared in four of these vessels as a result of 1 h of in
      vitro incubation with endotoxin (2.5 micrograms/ml). Flow-induced vasodilation
      was also abolished in these vessels after 1 h of endotoxin exposure. Incubation
      with 3 mM L-arginine, in vitro, restored flow-induced vasodilation in E
      arterioles and endotoxin-treated UT arterioles. Vasoconstriction induced by
      acetylcholine (ACh) and vasodilation induced by nitroprusside (NP) and bradykinin
      (BK) were similar in arterioles from all groups. In contrast, endotoxin impairs
      flow-induced vasodilation of coronary arterioles. The mechanism responsible for
      the impairment of flow-induced vasodilation seems to reside in disruption of the
      L-arginine/nitric oxide pathway.

PMID- 1621843
TI  - Training effects on the regional blood flow response to exercise in myocardial
      infarcted rats.
AB  - The regional blood flow (BF) response to submaximal exercise was determined for
      sedentary and trained myocardial infarcted (MI) rats. Training consisted of
      treadmill running (10% grade, 30 m/min) for 1 h/day, 5 days/wk for 12-14 wk and
      produced decreases in resting heart rate and increases in maximal O2 uptake and
      endurance capacity. BF determined at 2 and 6 min of exercise (via radiolabeled
      microspheres) demonstrated that trained rats maintained greater BF to organs
      found in the abdominal region when compared with their sedentary counterparts. BF
      to the total hindlimb musculature at 2 min of exercise was greater in sedentary
      rats when compared with their trained counterparts and was the consequence of
      greater BF to 10 of the 27 muscle or muscle parts investigated. At 6 min of
      exercise, BF to the total hindlimb musculature was similar between trained and
      sedentary rats, as BF in 9 of 27 muscles or muscle parts investigated decreased
      from 2 to 6 min of exercise for the sedentary group. In general, the BF patterns
      within and among the individual muscles of the hindlimb were different between
      the two groups. Trained rats tended to maintain greater BF to the predominantly
      red muscles, whereas the sedentary rats maintained greater BF to the
      predominantly white muscles at 6 min of exercise. In conclusion, the training
      induced changes in BF found in this study are similar to those found previously
      for normal rats, and they demonstrate that endurance training produces changes in
      the regional distribution of BF during exercise in MI rats.

PMID- 1621844
TI  - Interaction of lysophosphatidylcholine with aortic endothelial cells.
AB  - To better understand the vascular actions of lysophosphatidylcholine (lysoPC), we
      studied the interaction of [1-14C]palmitate-labeled lysoPC with bovine aortic
      endothelial cells. These cells took up lysoPC from media containing albumin, low
      density lipoproteins (LDL), or acetyl-LDL. Uptake occurred faster than conversion
      to phosphatidylcholine (PC), leading to some lysoPC accumulation in endothelial
      lipids. Endothelial cell monolayers grown on micropore filters took up lysoPC
      from both apical and basolateral surfaces, preventing substantial amounts from
      passage across the endothelial monolayer. However, lysoPC present in the
      interstitial medium of an endothelial-smooth muscle coculture was incorporated
      primarily by the smooth muscle cells. Endothelial cells grown on filters released
      lysoPC into both the apical and basolateral medium in the presence of albumin or
      lipoproteins. Exposure to 50 microM lysoPC produced no evidence of endothelial
      cytotoxicity, but prostaglandin (PG)I2 production was reduced. These studies
      suggest that the endothelium can participate in the processing of circulating
      lysoPC and, through basolateral uptake, can facilitate the removal of lysoPC
      formed within the arterial wall. By decreasing PGI2 output, however, exposure to
      high concentrations of lysoPC may reduce the antithrombotic and vasodilator
      capacity of the endothelium.

PMID- 1621845
TI  - Effects of chronic hypoxia on capillary flow and hematocrit in rat skeletal
      muscle.
AB  - The cremasteric microcirculation was studied in rats exposed to chronic hypoxia.
      Control male weanling Sprague-Dawley rats (n = 8) were raised for 42-49 days at
      752 mmHg. Hypoxic rats (n = 9) were reared for 3 days at 551 mmHg, 4 days at 461
      mmHg, 3 days at 371 mmHg, and 31-38 days at 311 mmHg (6,000 m). Red blood cells
      labeled with fluorescein isothiocyanate were injected. The exposed cremaster was
      observed using fluorescence microscopy. Rats acutely breathed 10, 21, and 30% O2
      spontaneously in random order. Hypoxia-adapted animals had greater (P less than
      0.01) red cell flux (10.6 +/- 1.0 vs. 5.7 +/- 0.4/s), capillary hematocrits,
      capillary-to-systemic hematocrit ratios (0.42 +/- 0.02 vs. 0.33 +/- 0.02), and
      reduced red cell spacing (11.4 +/- 1.3 vs. 22.3 +/- 2.0 microns) than controls
      under 21% O2. Chronically hypoxic rats also demonstrated significantly (P less
      than 0.05) larger capillary diameters (6.52 +/- 0.04 vs. 6.15 +/- 0.06 microns)
      and greater perfused (135 +/- 5 vs. 94 +/- 3 mm/mm3) and anatomic (182 +/- 5 vs.
      151 +/- 8 mm/mm3) microvessel length-densities at 21% O2. Results were generally
      similar for 10 and 30% O2. Bulk capillary blood flow was significantly (P less
      than 0.01) greater in controls (2.75 +/- 0.32 vs. 1.87 +/- 0.12 pl/s) only under
      30% O2. Our experiments demonstrate that numerous physiological, in addition to
      anatomic, alterations can occur in the cremasteric microcirculation in response
      to chronic hypoxia.

PMID- 1621846
TI  - Beat-to-beat changes in AV nodal refractory and recovery properties during
      Wenckebach cycles.
AB  - The roles of changes in refractory and recovery properties of the
      atrioventricular node as affected by facilitation and fatigue in the genesis of
      Wenckebach periodicity were studied in isolated rabbit heart preparations. The
      contribution of nodal recovery time, facilitation, and fatigue to beat-to-beat
      changes in nodal conduction time (NCT) and effective (ERPN) and functional
      refractory periods of node (FRPN) occurring during stable 4:3 Wenckebach cycles
      was determined with premature stimulation protocols performed during these
      cycles. Fatigue prolonged, equally for each beat, NCT, ERPN, and FRPN, and
      therefore did not contribute to Wenckebach periodicity. Beat-to-beat increases in
      facilitation broadened the range of recovery times for which conduction was
      successful and decreased NCT, ERPN, and FRPN below the values expected from
      fatigue alone. However, ERPN and NCT increased overall from beat to beat because
      of NCT-induced (effects of NCT on ensuing refractoriness) increases in nodal
      refractoriness and consequent shortenings of the recovery time. These findings
      establish a complementary role for the recovery and refractory properties in
      generating the Wenckebach periodicity and demonstrate the modulating roles of
      facilitation and fatigue on this phenomenon.

PMID- 1621847
TI  - Effects of graded hypotension on cerebral blood flow, blood volume, and mean
      transit time in dogs.
AB  - This study tested the hypothesis that cerebral blood flow (CBF) is maintained by
      vasodilation, which manifests itself as a progressive increase in mean transit
      time (MTT) and cerebral blood volume (CBV) when cerebral perfusion pressure is
      reduced. Cerebral perfusion pressure was decreased in 10 pentobarbital
      anesthetized dogs by controlled hemorrhage. Microsphere-determined CBF was
      autoregulated in all tested cerebral regions over the 40- to 130-mmHg cerebral
      perfusion pressure range but decreased by 50% at approximately 30 mmHg. MTT and
      CBV progressively and proportionately increased in the right parietal cerebral
      cortex over the 40- to 130-mmHg cerebral perfusion pressure range. Total
      hemoglobin content (Hb1), measured in the same area by an optical method,
      increased in parallel with the increases in CBV computed as the (CBF.MTT)
      product. At 30 mmHg cerebral perfusion pressure, CBV and Hb were still increased
      and MTT was disproportionately lengthened (690% of control). We conclude that
      within the autoregulatory range, CBF constancy is maintained by both increased
      CBV and MTT. Outside the autoregulatory range, substantial prolongation of the
      MTT occurs. When CBV is maximal, further reductions in cerebral perfusion
      pressure produce disproportionate increases in MTT that signal the loss of
      cerebral vascular dilatory hemodynamic reserve.

PMID- 1621848
TI  - Mathematical modeling of human cardiovascular system for simulation of
      orthostatic response.
AB  - This paper deals with the short-term response of the human cardiovascular system
      to orthostatic stresses in the context of developing a mathematical model of the
      overall system. It discusses the physiological issues involved and how these
      issues have been handled in published cardiovascular models for simulation of
      orthostatic response. Most of the models are stimulus specific with no
      demonstrated capability for simulating the responses to orthostatic stimuli of
      different types. A comprehensive model incorporating all known phenomena related
      to cardiovascular regulation would greatly help to interpret the various
      orthostatic responses of the system in a consistent manner and to understand the
      interactions among its elements. This paper provides a framework for future
      efforts in mathematical modeling of the entire cardiovascular system.

PMID- 1621849
TI  - Cardiac microdialysis in isolated rat hearts: interstitial purine metabolites
      during ischemia.
AB  - Cardiac microdialysis is a recently developed technique that allows
      intramyocardial interstitial fluid (ISF) to be sampled via the implantation and
      perfusion of a small, hollow dialysis fiber within the myocardium. The purpose of
      this paper is to describe initial studies using cardiac microdialysis in the
      isolated perfused heart. Microdialysis probes, constructed in the laboratory,
      were implanted in the left ventricular myocardium of isolated perfused rat hearts
      and perfused at 0.5 microliter/min with Krebs-Henseleit buffer. The effluent
      dialysate, assayed for adenosine, inosine, hypoxanthine, xanthine, and uric acid,
      was used as an index of intramyocardial levels of these purine metabolites. All
      metabolites were elevated initially after implantation, declined rapidly in the
      first 45 min, and were then stable for the next 90 min. Based on in vitro percent
      recovery data, baseline dialysate concentrations were extrapolated to yield
      estimates of intramyocardial ISF (in microM) 0.47 adenosine, 0.85 inosine, 0.29
      hypoxanthine, 0.49 xanthine, and 8.6 uric acid. During global zero-flow ischemia
      (37 degrees C), dialysate levels of all purine metabolites were elevated, with
      inosine being the predominant compound. Pretreatment of the hearts with 50 microM
      erythro-9-(2-hydroxy-3-nonyl)adenine, an adenosine deaminase inhibitor, markedly
      enhanced ISF adenosine accumulation and attenuated the accumulation of inosine,
      hypoxanthine, and xanthine. The simplicity and versatility of cardiac
      microdialysis in the isolated perfused heart suggest that this technique may be a
      valuable adjunct to the many studies performed using this preparation.

PMID- 1621850
TI  - Simple circuit for pacing hearts of experimental animals.
AB  - In this paper we describe a simple pacing circuit which can be used to drive the
      heart over a wide range of rates. The circuit is an astable multivibrator, based
      on an LM555 integrated circuit. It is powered by a 9-V battery and is small
      enough for use in rabbits. The circuit is easily constructed and inexpensive,
      making it attractive for numerous applications in cardiovascular research.

PMID- 1621851
TI  - Novel technique to load indo-1 free acid into single adult cardiac myocytes to
      assess cytosolic Ca2+.
AB  - This report introduces a novel method to load indo-1 "free acid" selectively into
      the cytosol of cardiac myocytes, presumably by diffusion through momentarily
      permeable gap junction sites during mechanical dissociation after low-Ca2+
      collagenase treatment. Calibration of indo-1 fluorescence in these cells has been
      accomplished after subtracting average autofluorescence (AF) from time-matched
      non-indo-loaded cells, taking into account apparent changes in cell AF due to
      indo-1. There is wide variation in the degree of uncertainty of individual
      intracellular Ca2+ concentration ([Ca2+]i) determinations among cells, related
      principally to differences in cellular indo-1 content, to nonlinear aspects of
      the [Ca2+]-to-fluorescence ratio relationship, and to the uncertainty in the AF
      subtraction. Consequently, a quantitative estimate of uncertainty also may be
      employed in formulating weighted estimates of cytosolic [Ca2+]i. The following
      [Ca2+]i values in rat ventricular cells (nM; in 1 mM bathing extracellular Ca2+
      concentration, 25 degrees C) are given as weighted means +/- 95% confidence
      intervals (unweighted values in parentheses): 138 +/- 5 (136 +/- 6, n = 44) in
      quiescent cells, 435 +/- 74 (482 +/- 76, n = 43) at the [Ca2+]i-transient peak
      during 0.5 Hz steady-state stimulation, and 760 +/- 124 (1,027 +/- 250, n = 42)
      at the [Ca2+]i-transient peak, postrest. Moreover, these peak [Ca2+]i values fall
      near the steepest portion of the force-Ca2+ curve (from intact cardiac muscle),
      consistent with sensitive inotropic regulation and maximal contractile reserve.

PMID- 1621852
TI  - In vivo 31P-NMR spectroscopy of right ventricle in pigs.
AB  - The energy metabolism of the right ventricle (RV) in vivo has been largely
      unexplored. The goal of this study was to develop and implement techniques for in
      vivo 31P nuclear magnetic resonance (NMR) spectroscopy of the RV free wall. A two
      turn, crossover-design elliptical surface coil was constructed to provide high
      sensitivity across the thin RV wall but minimal sensitivity in the blood-filled
      RV cavity. In 36 open-chest, anesthetized pigs, 31P spectroscopy of the RV free
      wall was performed with this coil at a field strength of 2 Tesla. Spectra were
      obtained from 800 acquisitions in 24 min with an average signal-to-noise ratio of
      13.2 for phosphocreatine (PCr). The PCr-to-ATP (PCr/ATP) ratio of porcine RV was
      1.42 +/- 0.05 (mean +/- SE), uncorrected for saturation at a repetition time of
      1.8 s. With the use of literature values of the time constant of longitudinal
      relaxation (T1) to correct for partial saturation, the RV PCr/ATP was estimated
      to lie between 1.7 and 2.3. Decreased RV PCr/ATP was observed during RV ischemia
      and pressure overload. Thus in vivo 31P spectroscopy of the RV is readily
      accomplished with an appropriate surface coil and can provide new information
      about RV energy metabolism.

PMID- 1621853
TI  - Food deprivation and refeeding in the camel (Camelus dromedarius).
AB  - Camels thrive in arid and semiarid areas, although food and water frequently are
      scarce. However, the mechanisms enabling camels to withstand food deprivation are
      poorly understood. In this study four female camels were totally deprived of food
      for 4 days. Their body weight decreased by 6%. Food deprivation caused no change
      in total plasma protein concentration in the camel, indicating that no
      alterations in plasma volume occurred. When the first meal was withheld water
      intake was unchanged. Next day the camels showed signs of hydration with a
      decreased plasma Na+ concentration and an increased excretion of diluted urine.
      In the afternoon water intake decreased. Urine K+ excretion fell the first day
      and urine volume and Na+ excretion from the third day. No activation of the renin
      angiotensin-aldosterone system (RAAS) was observed. Plasma and urine urea
      concentration increased during food deprivation. Plasma glucose concentration and
      plasma cortisol and thyroxine levels did not change. Body temperature decreased
      during food deprivation. After refeeding, total plasma proteins increased
      temporarily by 12%, and a threefold increase in RAAS was seen, implying that both
      plasma volume and RAAs changed rapidly. Our results show that fluid balance was
      only slightly affected in the food-deprived camel. We suggest that strategies for
      the camel to endure food deprivation include maintenance of plasma volume and
      glucose concentration and a lowering of the body temperature.

PMID- 1621854
TI  - The 10-Hz rhythm in sympathetic nerve discharge.
AB  - Frequency-domain analysis was used to characterize the relationships among the
      rhythmic discharges recorded simultaneously from two to four sympathetic nerves
      in unanesthetized decerebrate cats. The major new findings were as follows. 1)
      The 10-Hz rhythmic discharges of different nerves cohered strongly in
      baroreceptor-innervated and -denervated cats. 2) The interval between the
      discharges of two nerves was frequency dependent in the 10-Hz band in some cats,
      supporting the view that the 10-Hz rhythm is generated by multiple central
      circuits that are coupled. 3) In some cases the central circuits responsible for
      the 10-Hz rhythms nonuniformly affected different nerves. 4) In baroreceptor
      innervated cats the coherence values for the cardiac-related discharges of any
      two nerves were significantly higher than those for the 10-Hz rhythms. 5) In
      baroreceptor-denervated cats the 10-Hz rhythmic discharges of different nerves
      cohered more strongly than the 2- to 6-Hz rhythms. 6) The 10-Hz rhythm usually
      was not a harmonic of the 2- to 6-Hz or cardiac-related rhythm. Thus these
      rhythms are generated independently.

PMID- 1621855
TI  - Effects of brain stem lesions on 10-Hz and 2- to 6-Hz rhythms in sympathetic
      nerve discharge.
AB  - We studied the effects of brain stem lesions or transection on the 10-Hz and 2-
      to 6-Hz rhythms in sympathetic nerve discharge (SND) in baroreceptor-denervated
      unanesthetized decerebrate cats. The results indicate that these two rhythms
      depend in part on different brain stem regions. The 10-Hz rhythm was eliminated
      by ablation of the rostral ventrolateral medulla (RVLM), medullary raphe complex,
      or pontine parabrachial and Kolliker-Fuse complex (PB/KF) or by pontomedullary
      border transection. Except for RVLM lesions, these procedures did not disrupt the
      2- to 6-Hz rhythm in SND. In fact the power in SND at frequencies less than 6 Hz
      was increased by raphe or PB/KF lesions. Total power in SND was not significantly
      affected by raphe or PB/KF lesions, but mean arterial pressure was significantly
      reduced. Field potentials recorded from the RVLM (11 of 26 sites) and raphe (10
      of 20 sites) were correlated to the 10-Hz rhythm in SND, further supporting a
      role of these areas in either generating or relaying this rhythm to sympathetic
      nerves. In contrast, field potentials recorded from the PB/KF were not correlated
      to the 10-Hz rhythm in SND. Thus this region may provide a tonic drive to the 10
      Hz generator located elsewhere in the brain stem.

PMID- 1621856
TI  - Dietary obesity in nine inbred mouse strains.
AB  - The effect of 7 wk consumption of a diet containing 32.6% of kilocalories as fat
      [condensed milk (CM) diet] on body composition and energy intake was evaluated in
      nine strains of inbred mice (AKR/J, C57L/J, A/J, C3H/HeJ, DBA/2J, C57BL/6J,
      SJL/J, I/STN, and SWR/J). Control animals were fed a high-carbohydrate diet
      containing 11.6% of energy as fat (Purina Rodent Chow diet). Relative to Chow
      diet controls, the CM diet significantly increased carcass lipid content in six
      strains (AKR/J, C57L/J, A/J, C3H/HeJ, DBA/2J, and C57BL/6J), but had no or a
      marginal effect on adiposity in three strains of mice (SJL/J, I/STN, and SWR/J).
      The obesity produced by the CM diet in six strains was not due to hyperphagia.
      Only one of six (AKR/J) of the strains that increased adiposity on the CM diet
      consumed more energy than controls during the 7 wk of the experiment. The
      identification of inbred mouse strains that are sensitive to dietary obesity, vs.
      others that are resistant, provides a useful tool to pursue the metabolic and
      genetic basis of this trait in the mouse.

PMID- 1621857
TI  - Metabolism and ventilation in acute hypoxia: a comparative analysis in small
      mammalian species.
AB  - O2 consumption (VO2), CO2 production (VCO2), and minute ventilation (VE) have
      been measured during normoxia and hypoxia (10-20 min in 10% O2) in specimens of
      27 species from 6 mammalian orders, ranging in body mass (M) from a few grams to
      several kilograms. In normoxia, both metabolism and VE scaled close to M3/4,
      VE/VO2 and VE/VCO2 therefore being independent of M. In hypoxia, VE/metabolism
      increased in all species (on average greater than 100%), mostly because of a drop
      in VO2. On average, VE was 23% above the normoxic value but in some species
      decreased below normoxia. VO2 dropped in all but one species, on average 35%.
      Body temperature decreased by variable amounts, usually more in the smallest
      species. The decrease in metabolism during hypoxia was positively correlated with
      the resting metabolic rate of the species in a manner very similar to what can be
      calculated from data of previously studied newborn mammals. Hence hypoxia may
      decrease metabolic rate by decreasing thermogenesis, with larger effects in
      smaller animals, whether newborns or adults, because of their higher thermogenic
      requirements. We conclude that 1) hypoxic hypometabolism is a general
      characteristic of the mammalian response to hypoxia and cannot be neglected in
      the interpretation of ventilatory and cardiovascular responses and 2) its
      magnitude is inversely related to the resting VO2 of the species and therefore
      could be less prominent or possibly absent in adults of larger species.

PMID- 1621858
TI  - Concentration thresholds for fetal swallowing and vasopressin secretion.
AB  - In adults, plasma osmolality thresholds for hypernatremia-induced arginine
      vasopressin (AVP) secretion are similar or less than thresholds for stimulation
      of thirst. In the fetus, the thresholds for swallowing stimulation and AVP
      secretion have not been defined. Fetal swallowing and AVP secretory responses to
      hypertonic NaCl and urea were determined in six fetuses (130 +/- 1 1 days)
      chronically prepared with thyrohyoid, nuchal and thoracic esophagus, and
      diaphragm electromyograms (EMG), an esophageal flow probe, and vascular
      catheters. Fetuses received intracarotid injections (0.15 ml/kg) of increasing
      concentrations of NaCl (0.15, 0.30, 0.45, 0.60, 0.75, and 0.90 M), administered
      at 2-min intervals. A swallow was defined as a coordinated time-sequence of fetal
      thyrohyoid, nuchal esophagus, and thoracic esophagus EMG activity. The threshold
      saline concentration for swallowing was defined as the minimum NaCl dose
      eliciting swallow responses (within 20 s) after four of five injections at each
      dose. During a 2-h control period swallowing averaged 25.0 +/- 10.1 ml/h and 39.4
      +/- 14.6 swallows/h. The mean NaCl threshold concentration for swallowing
      stimulation was 0.56 +/- 0.06 M. Fetal plasma AVP (2.6 +/- 0.9 pg/ml) increased
      significantly at the maximum subthreshold (7.6 +/- 4.0 pg/ml) and the threshold
      NaCl concentration (8.2 +/- 4.0 pg/ml) that stimulated swallowing. On a
      subsequent day, equiosmolar urea injections increased plasma AVP (from 2.2 +/-
      0.7 to 7.6 +/- 2.6 pg/ml) but had no effect on swallowing activity. Fetal mean
      arterial blood pressure increased after injections of threshold saline and urea
      concentrations. Fetal arterial blood osmolality and sodium concentration did not
      change during any study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621859
TI  - Central nervous system catecholamine content and norepinephrine release after
      AV3V ablation.
AB  - Electrolytic ablation of the periventricular tissue surrounding the anteroventral
      third cerebral ventricle (AV3V-X) results in immediate increases in
      norepinephrine release in the paraventricular hypothalamic nucleus/anterior
      hypothalamus (P/A) and in the dorsomedial medulla (DM) and depletion of
      norepinephrine and epinephrine throughout the brain. The present study determined
      whether catecholamine depletion and/or altered norepinephrine release persisted
      after recovery from the acute effects of AV3V-X. Fourteen to eighteen days after
      surgery, catecholamine concentrations throughout the brain and norepinephrine
      release in the P/A and DM during hemorrhage were measured in control-operated and
      AV3V-X rats. AV3V-X decreased epinephrine content only in the midbrain, increased
      norepinephrine only in the cortex, and produced no differences in central nervous
      system dopamine. Hemorrhage-induced norepinephrine release was significantly
      greater in the P/A of AV3V-X rats than in control animals, whereas norepinephrine
      release in the DM increased equally in both groups. Thus AV3V-X does not result
      in chronic global central nervous system catecholamine depletion and enhances
      norepinephrine release in the P/A during hemorrhage.

PMID- 1621860
TI  - Sham feeding in intact and chronic decerebrate rats.
AB  - In the traditional sham-feeding paradigm, the amount of sugar solution consumed
      by the rat is influenced by its concentration and the open or closed condition of
      the gastric fistula. The present experiments examine: 1) whether sham intake
      effects obtained under the "intraoral intake" paradigm, developed to explore
      controls of ingestion in otherwise aphagic preparations such as the decerebrate,
      are similar to those of previous studies in which intact rats obtained the fluid
      stimulus by spout licking; and 2) whether chronic decerebrate and intact rats
      show a similar elevation of their sucrose intake when ingesting with an open
      (sham intake) vs. closed gastric fistula. Experiment 1 showed that sham intraoral
      intake exceeded intake in the closed condition only for sucrose concentrations
      greater than 0.1 M. After it was established that the results obtained with the
      intraoral paradigm were consistent with those reported in the literature, the new
      paradigm was applied to the chronic decerebrate rat in experiment 2 to determine
      whether forebrain structures are necessary for sham-feeding effects. The effect
      of sucrose concentration and fistula condition on the behavior of chronic
      decerebrates was similar to that of intact rats. Like intact rats, decerebrate
      rats consumed more sucrose in the open condition but only for concentrations
      exceeding 0.1 M. This concentration-dependent sham sucrose intake of chronic
      decerebrate rats provides compelling evidence that the integration of sucrose's
      taste and postingestive effects that modulates ingestive behavior can be
      accomplished by the caudal brain stem.

PMID- 1621861
TI  - Expiratory bulbospinal neurons of dogs. I. Control of discharge patterns by
      pulmonary stretch receptors.
AB  - To better understand expiratory bulbospinal (EBS) neuronal processing of afferent
      patterns from slowly adapting pulmonary stretch receptors (PSRs), the responses
      of these caudal medullary neurons to various inflation patterns were analyzed in
      thiopental sodium-anesthetized paralyzed dogs. Normocapnic ventilation was
      obtained from lung inflations delivered during the neural inspiratory phase of
      control respiratory cycles by a solenoid ventilator triggered by the onset of
      phrenic nerve activity. Test inflation patterns, delivered during the neural
      expiratory (E) phase of specific cycles, were separated by 6-10 control cycles
      and consisted of slow augmenting and decrementing ramps and steps. Transpulmonary
      pressure (Pt) was used as an index of PSR activity, and the discharge patterns of
      single EBS neurons were quantified using cycle-triggered histograms. Based on the
      time course of the discharge pattern during no-inflation cycles, two types of
      neurons were identified. Type D, the most common, exhibited a decrementing-like
      pattern, while type A exhibited an augmenting-plateau pattern. Plots of discharge
      frequency vs. Pt for type D neurons consisted of a linear excitatory phase (1
      less than Pt less than 4.6 mmHg) and a linear inhibitory phase (4.6 less than Pt
      less than 12 mmHg). Type A neurons exhibited only a linear inhibitory phase for
      3.3 less than Pt less than 12 mmHg. Because the responses to step inflations (4 s
      duration) exhibited only a small amount of time dependency, and the activation Pt
      of PSRs, but not of the other pulmonary receptors with vagal fibers, is in the
      proper range, it appears that PSRs may mediate both excitatory and inhibitory
      components of the neuronal response. These data suggest that discharge patterns
      of the caudal EBS neurons in dogs are highly dependent on the time course of Pt
      in a predictable manner, and implicate the importance of instantaneous lung
      volume in the control of the E musculature and the optimization of the breathing
      pattern.

PMID- 1621862
TI  - Expiratory bulbospinal neurons of dogs. II. Laterality of responses to spatial
      and temporal pulmonary vagal inputs.
AB  - Pulmonary mechanoreceptors with vagal fibers produce a combination of excitation
      and inhibition in the majority of the expiratory bulbospinal (EBS) neurons of
      dogs. Both aspects of this transpulmonary pressure-dependent neuronal response
      appear to be slowly adapting and activated at low pressure levels, suggesting the
      involvement of the slowly adapting pulmonary stretch receptors (PSRs). The
      purpose of the present study was to determine the contribution of different
      afferent pathways to each of the response components and to characterize the
      spatial and temporal processing of ipsi-, contra-, and bilateral vagal afferent
      inputs by two types of EBS neurons. For this purpose low-intensity electrical
      stimulation of the intact, desheathed, vagus nerves was used in thiopental sodium
      anesthetized paralyzed dogs. The phrenic neurogram was used to synchronize both
      ventilation and stimulation. During test respiratory cycles, pulse trains (4-5 s
      duration) were applied during the neural expiratory phase to each and both vagus
      nerves. The mean discharge frequency (Fn) during the stimulus period was obtained
      from cycle-triggered histogram data. Plots of Fn vs. stimulus strength and Fn vs.
      stimulus frequency suggest that inhibition of both type D and type A EBS neurons
      is mediated mainly by the ipsilateral vagus nerve, and that the excitation of
      type D neurons is mediated bilaterally. These conclusions are also supported by
      inflation responses obtained before and after unilateral vagotomies. Differences
      in latencies and spatial and temporal summation characteristics suggest the
      possible involvement of different 1) types of PSRs, 2) central pathways, and/or
      3) synaptic mechanisms in the biphasic response of the caudal ventral EBS neurons
      to lung inflation.

PMID- 1621863
TI  - Estradiol phase-shifts circannual rhythms of golden-mantled ground squirrels.
AB  - Ovariectomized golden-mantled ground squirrels (Spermophilus lateralis) were
      implanted with estradiol benzoate (EB)-filled or empty capsules. Body weight was
      monitored for at least 1 yr before, during, and after hormone treatment. EB
      treatment of 6-7 mo duration, restricted to the weight-gain phase, decelerated
      weight gain and delayed attainment of peak weight by 34 days; the period of the
      circannual rhythm, measured between successive trough weights, was 36 days longer
      in squirrels treated with estradiol than in untreated animals. EB treatment of 2-
      to 4-mo duration, restricted to the weight-loss phase, accelerated weight loss,
      advanced attainment of trough weights by 57 days, and decreased the period of the
      circannual rhythm by 66 days. Estradiol-induced phase delays and advances were
      preserved in the year after discontinuation of hormone treatment. These results
      favor the existence of circannual phase-response curves to hormones and provide a
      system for pharmacological manipulation of circannual rhythms.

PMID- 1621864
TI  - Effect of sinoaortic denervation on pressor responses in pregnant rats.
AB  - We tested the hypothesis that augmented arterial baroreflex activity contributes
      to attenuation of pressor responses in intact pregnant animals by comparing
      changes in blood pressure and heart rate during infusions of angiotensin II,
      phenylephrine, and vasopressin in chronically instrumented pregnant and virgin
      rats approximately 5 wk after sinoaortic denervation (SAD) or sham surgery.
      Baseline mean arterial pressure was significantly lower in pregnant animals in
      both the sham-operated (pregnant 91.7 +/- 1.7 mmHg, virgin 103.7 +/- 2.5 mmHg)
      and SAD states (pregnant 107.3 +/- 4.0 mmHg, virgin 114.1 +/- 4.0 mmHg). Pressor
      responses to all three agents were significantly blunted in pregnant animals
      compared with similarly treated virgins, with the magnitude of attenuation
      similar in both sham and SAD states. Heart rate decreased similarly in reflex
      intact pregnant and virgin animals during pressor infusions. These findings
      suggest that attenuated pressor responses in the pregnant rat are due primarily
      to mechanisms other than augmentation of arterial baroreflex activity and are
      consistent with a generalized reduction in vascular sensitivity during gestation.

PMID- 1621865
TI  - Mifepristone (RU 486), a blocker of type II glucocorticoid and progestin
      receptors, reverses a dietary form of obesity.
AB  - The effect of mifepristone (RU 486), a blocker of type II glucocorticoid
      receptors on the development of obesity that follows the feeding of a high-fat
      (HF) diet to Osborne-Mendel (OM) rats, has been investigated. OM rats fed a HF
      diet gained more weight and had larger retroperitoneal and parametrial fat pads
      than OM rats fed a high-carbohydrate low-fat (LF) diet. RU 486 (30 mg.kg-1.day-1)
      for 14 days completely reversed the body weight gain and the increase in fat pad
      size of OM rats fed a HF diet. RU 486 had no effect on body weight of OM rats fed
      a LF diet, but did reduce fat pad weights. The data suggest that type II
      glucocorticoid receptor activity modulates body fat deposition and is essential
      for the development of obesity, although a minor role for progestin receptor
      activity cannot be ruled out.

PMID- 1621866
TI  - Differential inhibition of fat intake in two strains of rat by the peptide
      enterostatin.
AB  - The effect of enterostatin, the amino-terminal pentapeptide of pancreatic
      procolipase, on food intake was investigated in two strains of rat, the dietary
      fat-sensitive Osborne-Mendel (OM) rat and the dietary fat-resistant S5B/Pl rat.
      After an overnight fast, enterostatin inhibited intake of high-fat (HF) but not
      low-fat (LF) diets in OM rats, but had no effect in S5B/Pl rats. When fed a
      macronutrient three-choice diet, OM rats selected fat preferentially, whereas
      S5B/Pl rats selected carbohydrate. Enterostatin specifically inhibited the intake
      of fat in OM rats but not S5B/Pl rats fed a three-choice macronutrient diet. The
      activity of pancreatic colipase was increased in S5B/Pl rats on both HF and LF
      diets compared with OM rats. Pancreatic colipase activities were negatively
      related to the voluntary intake of fat on three-choice macronutrient diets. The
      data support the hypothesis that enterostatin may control the intake of dietary
      fat.

PMID- 1621867
TI  - Effects of intravenous saline infusion on fetal ovine lung liquid secretion.
AB  - These studies were designed to investigate the relationship between body fluid
      volume expansion and secretion of lung liquid in fetal sheep. Twelve fetal
      animals were used for saline infusion studies after providing them with
      indwelling vascular catheters and an exteriorized tracheal loop. An additional 10
      animals were used as controls. Lung liquid production was measured using an
      impermeant tracer technique (Blue Dye Dextran). Saline infusion at 1.6, 4.0,
      15.6, and 19.2 ml.kg-1.h-1 did not alter significantly lung liquid secretion
      rates. These results demonstrate that 1) intravenous infusion of saline at
      relatively high rates in the ovine fetus does not affect net fetal lung liquid
      formation rate, and 2) the lungs of chronically catheterized, unanesthetized
      fetal sheep probably do not participate in regulation of excess fluid and
      electrolytes.

PMID- 1621868
TI  - Models of neurohypophyseal homeostasis.
AB  - Rats subject to prolonged (3-6 days) hypernatremia show significantly decreased
      pituitary vasopressin content as well as increased levels of hypothalamic
      vasopressin mRNA; these values return to baseline levels after the stimulus is
      removed. In this paper, we tested whether a single cellular mechanism for
      regulation of synthesis could account for the experimental observations of both
      pituitary hormone depletion-repletion and hypothalamic mRNA content. We developed
      several "minimal" models of vasopressin synthesis in which control of hormone
      synthesis was regulated exclusively by transcription, translation, or mRNA decay
      and tested each model to see which best emulated the dynamics of neuro
      hypophyseal vasopressin content and hypothalamic vasopressin mRNA. Experimental
      data provided parameters for pituitary content, baseline and stimulated release
      rates, mRNA decay, transcription, and translation. Models based exclusively on
      translation and mRNA decay failed to produce predictions similar to experimental
      observations. Of the models tested, the transcription model provided predictions
      most consistent with laboratory data, although some quantitative differences
      remain. The results of the computer modeling strongly suggest that transcription
      represents the predominant means by which magnocellular neurons regulate
      vasopressin synthesis.

PMID- 1621869
TI  - Verapamil prevents insulin antinatriuresis in euglycemic rats.
AB  - To determine whether calcium entry is necessary for insulin antinatriuresis,
      urinary sodium excretion was determined before and during euglycemic insulin
      administration in rats receiving verapamil (10 micrograms.kg-1.min-1) or vehicle.
      In vehicle rats, insulin reduced sodium excretion from 2.7 +/- 0.5 to 0.98 +/-
      0.2 mu eq/min (P less than 0.05) without altering arterial pressure or inulin
      clearance. Insulin did not reduce sodium excretion in rats receiving verapamil.
      Baseline mean arterial pressure was lower in verapamil rats than in vehicle rats.
      To exclude the possibility that lower baseline arterial pressures prevented
      insulin antinatriuresis, insulin's effect on sodium excretion was determined in
      rats receiving captopril at a dose that reduced arterial pressure to the level
      observed in verapamil rats, and in verapamil rats with angiotensin II levels
      fixed to maintain arterial pressure equivalent to vehicle rats. In captopril
      rats, insulin reduced (P less than 0.05) sodium excretion from 1.07 +/- 0.3 to
      0.3 +/- 0.01 mu eq/min, even though arterial pressure was not different from that
      in verapamil rats. Insulin failed to reduce sodium excretion in verapamil rats
      receiving angiotensin II. Thus verapamil prevents insulin antinatriuresis by
      renal mechanisms related to inhibition of calcium entry. Additionally, insulin
      antinatriuresis is independent of angiotensin II.

PMID- 1621870
TI  - Two families of phase-response curves characterize the resetting of the hamster
      circadian clock.
AB  - Phase-response curves (PRCs) have been reported for a wide variety of agents that
      induce phase shifts in the circadian rhythm of locomotor activity in the golden
      hamster. Many of these PRCs appear to be quite similar to one another. Because of
      the important role that the interpretation of PRCs has played in understanding
      the dynamics of the mammalian circadian pacemaker, a review of PRCs for the
      golden hamster reported from 1964 to 1991 was conducted to systematically
      summarize the common characteristics among these PRCs. Plots of phases associated
      with the peak of the advance portions, or of phases associated with the
      transitions between the delay and advance portion of the PRCs, revealed bimodal
      distributions of PRCs 11-13 h apart. Mardia-Watson-Wheeler circular test
      statistics indicated that the PRCs were distributed as two distinct populations.
      PRCs were either characteristic of those for light pulses (L-PRCs), or of those
      for dark pulses (D-PRCs). Taken with anatomical and physiological evidence, these
      data suggest that either one or two final common pathways may exist to mediate
      the phase-shifting effects of different stimuli.

PMID- 1621871
TI  - CCK-A receptors mediate the effect of cholecystokinin on vasopressin but not on
      cortisol in pigs.
AB  - Bolus intravenous injections of cholecystokinin (CCK) octapeptide induce a rapid
      rise in plasma vasopressin and a later increase in cortisol in the prepubertal
      pig. To determine whether these endocrine responses involve CCK-A or CCK-B
      receptors, this experiment investigated the effect of CCK (1 microgram/kg) in
      pigs (n = 7) pretreated with the CCK-A antagonist L 364718 (70 microgram/kg) or
      the CCK-B antagonist L 365260 (10 ng/kg and 10 micrograms/kg). The animals were
      prepared with jugular vein catheters and given the antagonist vehicle, L 364718,
      or L 365260 10 min before administration of CCK or saline. Analysis of hormone
      concentrations in blood samples taken 2, 5, 10, and 20 min after the second
      injection indicated that an abrupt rise in vasopressin, detectable within 2 min
      of CCK administration, occurred after vehicle or L 365260 pretreatment but not
      when CCK was preceded by L 364718. In contrast, the rise in plasma cortisol that
      was observed approximately 15 min after CCK injection was not prevented by either
      antagonist. Thus peripherally administered CCK induces vasopressin release by CCK
      A receptor activation, in agreement with its inhibitory effect on food intake in
      this species. However, the effect of CCK on cortisol secretion does not appear to
      involve either CCK-A or CCK-B receptors.

PMID- 1621872
TI  - Short-term effect of aldosterone on Na-Cl transport across equine colon.
AB  - In ponies fed concentrated (pelleted) meals, postprandial increases of plasma
      aldosterone have been temporally associated with a decrease in colonic fluid
      volume that parallels the conclusion of postfeeding fermentation. To determine
      the significance of short-term increases of plasma aldosterone on the rate of
      colonic Na absorption, in vitro transport studies were conducted on the mucosae
      of three morphologically distinct colonic segments (i.e., ventral, dorsal, and
      small colons) from ponies infused with a high physiological concentration of
      aldosterone for an 8-h period. In control ponies, basal NaCl absorption across
      the proximal colon (ventral and dorsal colons) was amiloride-insensitive and
      electroneutral. In aldosterone-treated ponies, the rate of electroneutral Na
      absorption was doubled in both segments and a small, amiloride-sensitive current
      was detected in the dorsal colon. However, consistent with previous observations
      [Clarke and Argenzio. Am. J. Physiol. 259 (Gastrointest. Liver Physiol. 22): G62
      G69, 1990], expression of electroneutral Na absorption in the ventral colon
      required pretreatment of the tissues with an inhibitor of prostaglandin
      synthesis, i.e., indomethacin. In the distal (small) colon, basal absorption was
      entirely electrogenic and amiloride-sensitive, and aldosterone treatment tripled
      the rate of absorption. The above findings are consistent with the notion that
      postprandial hyperaldosteronism can significantly increase colonic Na absorption
      and, thereby, may facilitate colonic fluid absorption during the concluding
      period of meal-induced fermentation (8-12 h postfeeding). However, in the ventral
      colon (i.e., the principal site of fermentation), mineralocorticoid action does
      not dominate control of electroneutral Na transport because accelerated
      absorption could be abolished by the antiabsorptive effect of local prostanoids.

PMID- 1621873
TI  - Absence of focal glomerulosclerosis in aging analbuminemic rats.
AB  - The Nagase analbuminemic rat (NAR), a mutant of the Sprague-Dawley (SD) strain,
      exhibits high levels of plasma cholesterol (Chol), thrombocytosis, and enhanced
      platelet aggregability, which might promote glomerulosclerosis (GS). To determine
      whether NAR are more susceptible than SD rats to aging GS, young (3-mo-old) and
      aging (18-mo-old) SD rats and NAR were studied. In young NAR, glomerular pressure
      and glomerular volume were lower, whereas total and high-density lipoprotein
      plasma Chol levels were higher than in young SD rats. Aging SD rats developed
      glomerular hypertension and hypertrophy. Less glomerular enlargement and
      subnormal glomerular pressures were seen in aging NAR. Enhanced platelet
      aggregation developed in aging SD rats, approaching the values seen in NAR.
      Similarly elevated levels of low-density lipoprotein Chol were seen in additional
      SD rats and NAR studied at 12 mo of age. Plasma triglyceride (TG) levels were
      lower in NAR at this age. Only SD rats developed proteinuria and exhibited GS and
      glomerular lipid deposits at 18 mo of age. Reduced glomerular wall stress due to
      lower glomerular pressure and volume as well as lower TG levels may explain the
      absence of GS in aging NAR despite plasma lipid and platelet abnormalities.

PMID- 1621874
TI  - Geometry of blood-tissue exchange in bat flight muscle compared with bat hindlimb
      and rat soleus muscle.
AB  - We investigated the relationship between capillary-to-fiber geometry and muscle
      aerobic capacity by comparing the bat flight muscle (pectoralis muscle), i.e., an
      ultimate case of extreme O2 demand in a mammalian skeletal muscle, with bat
      hindlimb and rat soleus muscles. At a given sarcomere length (2.1 microns), fiber
      cross-sectional area was considerably smaller in bat muscles (pectoralis 318 +/-
      10 microns 2, hindlimb 447 +/- 35 microns 2) than in rat soleus muscle (2,027 +/-
      125 microns 2). Capillary number per fiber cross-sectional area was much greater
      in bat pectoralis (6,394 +/- 380/mm2) than in bat hindlimb and rat soleus muscle
      (2,865 +/- 238 and 1,301 +/- 129/mm2, respectively; all values normalized to 2.1
      microns sarcomere length). At the same sarcomere length (2.1 microns), the degree
      of tortuosity and branching of capillaries were significantly greater in bat
      pectoralis than in bat hindlimb and rat soleus muscle. In bat flight muscle,
      capillary length per fiber volume was very high (9,025 +/- 342/mm2). It was 2.2-
      and 5.4-fold larger than in bat hindlimb and rat soleus, respectively.
      Mitochondria occupied 35.3 +/- 1.2, 16.5 +/- 1.3, and 6.1 +/- 0.9% of the muscle
      fiber volume in bat pectoralis, hindlimb, and rat soleus muscles, respectively.
      There was a strong correlation between capillary length (as well as capillary
      surface) per fiber volume and mitochondrial volume density in all muscles.
      Considering capillary supply and mitochondrial volume on an individual fiber
      basis, we found that 1) the number of capillaries around a fiber was linearly
      related to mitochondrial volume per micron length of fiber in the muscles but
      that 2) capillary surface per fiber surface, at given mitochondrial volume per
      micron length of fiber, was about twice as large in bat pectoralis as in rat
      soleus muscle, whereas in bat hindlimb it was intermediate between that in bat
      pectoralis and that in rat soleus muscle. This was due to the differences in
      fiber size (rat soleus greater than bat muscles) and capillary-to-fiber ratio
      (bat pectoralis greater than hindlimb) between the muscles. It is notable that in
      the bat, the substantially greater O2 transfer capacity of the flight muscle
      compared with hindlimb was achieved by increasing the size of the capillary-to
      fiber interface, i.e., capillary-to-fiber surface, via an increase in capillary
      number rather than by substantially reducing fiber size.

PMID- 1621875
TI  - Human placental vitamin B6 (pyridoxal) transport: normal characteristics and
      effects of ethanol.
AB  - The aims of this study were to define normal human placental transport of
      pyridoxal, an important form of vitamin B6 in pregnancy, and to determine the
      effect of short-term alcohol on this process. Our studies used the isolated
      single cotyledon from the term placenta. Pyridoxal crossed the human placenta
      readily in both directions, but the transfer was a little less than half that of
      antipyrine and was significantly greater in the direction of the fetus.
      Pyridoxine appeared to have a similar clearance from the maternal compartment as
      pyridoxal, but transport of intact pyridoxal 5'-phosphate was much smaller. There
      was no saturable transfer of pyridoxal, and it was not transferred from the
      maternal to fetal compartments against a concentration gradient. Placental
      concentration of pyridoxal exceeded both maternal and fetal perfusate pyridoxal
      concentrations, but this concentration was equal for both perfusion directions.
      These composite data are most suggestive of passive transport of pyridoxal across
      the placenta, binding of the vitamin in the placenta as an explanation for its
      concentration there, and greater phosphorylation of pyridoxal in the placenta
      when the compound is transferred in the fetal direction, possibly displacing
      pyridoxal from its binding sites and permitting its greater release into the
      fetal compartment. Alcohol, 400-250 mg/dl over 2.5 h, inhibited the transport of
      pyridoxal from the maternal to fetal compartments by approximately 42% (P = 0.03)
      and resulted in a lower transfer of pyridoxal 5'-phosphate into the fetal
      perfusate (P = 0.02).

PMID- 1621876
TI  - Individual, but not simultaneous, glucagon and cholecystokinin infusions inhibit
      feeding in men.
AB  - Pancreatic glucagon and cholecystokinin octapeptide (CCK-8) were intravenously
      infused (1 ml/min for 10 min) alone or in combination beginning 15 min after
      normal-weight men had eaten a 500-ml tomato soup preload and 5 min before they
      were served a lunch of macaroni and beef with tomato sauce. Infusion of
      approximately 3 ng.kg-1.min-1 glucagon or approximately 2 ng.kg-1.min-1 CCK-8
      each reduced test meal size. However, simultaneous infusion of these peptide
      doses reduced meal size less than the sum of the peptides' individual effects.
      Infusions of approximately 1.5 ng.kg-1.min-1 glucagon or approximately 1 ng.kg
      1.min-1 CCK-8 had neither individual nor interactive effects on meal size.
      Psychophysical ratings failed to detect nonspecific side effects after any of the
      infusions. That exogenous glucagon and CCK-8 each reduced meal size without side
      effects suggests that these peptides may participate in the physiological control
      of human appetite; that their simultaneous infusion resulted in an infra-additive
      reduction in meal size suggests that they can interact antagonistically.

PMID- 1621877
TI  - Exercise-induced sympathetic FFA mobilization in VMH-lesioned rats is normalized
      by fasting.
AB  - This study investigates whether reduced sympathetic responses during physical
      exercise in ventromedial hypothalamus (VMH)-lesioned obese rats are the direct
      result of damage to hypothalamic circuits or a secondary effect of the altered
      metabolism in obesity. Obese, VMH-lesioned rats and lean controls were deprived
      of food for 48 h and submitted to 15 min of swimming. Food-deprived lean and
      obese rats displayed increased free fatty acid mobilization and utilization,
      whereas blood glucose concentrations were decreased. Basal plasma insulin levels
      were reduced by fasting in both groups, when compared with the ad libitum
      situation, but remained higher in the obese animals. Fasting augmented the
      norepinephrine response of the obese rats, resulting in equal profiles in lean
      and obese animals. These results indicate that VMH-lesioned animals are able to
      increase the sympathetic activation of adipose tissue during exercise to overcome
      an energy deficiency. Therefore, the function of the VMH in the regulation of the
      sympathetic nervous system controlling metabolism can be taken over by redundant
      mechanisms. The reduced sympathetic activity in ad libitum fed VMH-lesioned
      animals is therefore likely to be the result of the altered metabolism.

PMID- 1621878
TI  - Mechanism of intracardiac shunting in the turtle Pseudemys scripta.
AB  - Two principal hypotheses account for right-left (R-L) intracardiac shunting in
      reptiles. The "pressure shunting" hypothesis proposes no functional separation
      between the ventricular cava during systole. The "washout shunting" hypothesis
      suggests that during systole, the cavum pulmonale (CP) is functionally separate
      from the rest of the ventricle. The purpose of this study was to test these
      hypotheses during control, after acetylcholine (ACh) administration, after
      epinephrine (Epi) administration, and during apnea. Anesthetized (pentobarbital)
      turtles (Pseudemys scripta) were mechanically ventilated and three nonocclusive
      catheters were implanted into the right atrium (RAt), left atrium (LAt), and CP.
      In addition, three blood gas catheters connected to a mass spectrometer were
      implanted into the RAt, LAt, and right or left aortic arch for measurement of
      PO2. A tracer gas, He dissolved in saline, was sequentially injected into the
      three cardiac chambers and was detected by the mass spectrometer. The presence of
      R-L shunting was assessed with the blood PO2 and PHe measurements. ACh produced R
      L shunting in all animals. No R-L shunting occurred after Epi administration and
      20 min of apnea. In all animals after ACh administration, He was detected in an
      aorta after He infusion in the RAt and LAt, but never after infusion of He into
      the CP. These results from this preparation are inconsistent with the pressure
      hypothesis and support the washout hypothesis of intracardiac shunting.

PMID- 1621879
TI  - Automaticity and the ACT* theory.
AB  - An explanation of automaticity within the framework of the Adaptive Control of
      Thought (ACT*) production system theory (Anderson, 1983, 1987) is presented.
      There is no automaticity mechanism per se in ACT*. This is as we would expect it
      to be. It would be the exception rather than the rule that we would find in a
      scientific theory mechanisms that directly correspond to natural language
      concepts. The critical question is whether ACT* can give an account of the
      phenomena associated with the term automaticity. This article is structured as
      follows: First, I will try to identify the phenomena of automaticity to be
      explained, then give a brief overview of the ACT* theory, and finally explain how
      these phenomena of automaticity are to be understood in terms of the theory.

PMID- 1621880
TI  - The ecology of automaticity: toward establishing the conditions needed to produce
      automatic processing effects.
AB  - In the past 15 years, the single term automatic has been applied to a diversity
      of laboratory phenomena that differ as to the preconditions necessary for their
      occurrence. Several major strains of automaticity are distinguished, based on the
      experimental conditions under which they are obtained: preconscious automatic
      processes, requiring only the proximal stimulus event; postconscious automatic
      processes, similar to preconscious effects but needing a recent activation or
      "priming" event for their operation; and goal-dependent automatic processes,
      which occur only when a specific, intentional processing goal is in place. It is
      argued that to more accurately specify the conditions under which an automatic
      effect will occur in the natural environment, greater attention needs to be given
      to aspects of the experimental paradigm (e.g., subjects' task goal, questionnaire
      administrations, previous tasks) that might be necessary to produce the effect.

PMID- 1621881
TI  - Automaticity and cognitive anatomy: is word recognition "automatic"?
AB  - Recent progress in neural imaging technologies such as positron emission
      tomography and dense-array recording of event-related potentials has greatly
      increased the capacity for in vivo measurement of cognitively relevant processing
      activity within the human brain. Data from these neural imaging technologies can
      be combined with behavioral data from standard chronometric techniques to enhance
      computational modeling of human cognition. Applications of neural data to issues
      of attention and automaticity are illustrated in the domain of visual word
      recognition, addressing the question "Is word recognition automatic?"

PMID- 1621882
TI  - A parallel distributed processing approach to automaticity.
AB  - We consider how a particular set of information processing principles, developed
      within the parallel distributed processing (PDP) framework, can address issues
      concerning automaticity. These principles include graded, activation-based
      processing that is subject to attentional modulation; incremental, connection
      based learning; and interactivity and competition in processing. We show how
      simulation models, based on these principles, can account for the major phenomena
      associated with automaticity, as well as many of those that have been troublesome
      for more traditional theories. In particular, we show how the PDP framework
      provides an alternative to the usual dichotomy between automatic and controlled
      processing and can explain the relative nature of automaticity as well as the
      fact that seemingly automatic processes can be influenced by attention. We also
      discuss how this framework can provide insight into the role that bidirectional
      influences play in processing: that is, how attention can influence processing at
      the same time that processing influences attention. Simulation models of the
      Stroop color-word task and the Eriksen response-competition task are described
      that help illustrate the application of the principles to performance in specific
      behavioral tasks.

PMID- 1621883
TI  - Automatization and training in visual search.
AB  - In several search tasks, the amount of practice on particular combinations of
      targets and distractors was equated in varied-mapping (VM) and consistent-mapping
      (CM) conditions. The results indicate the importance of distinguishing between
      memory and visual search tasks, and implicate a number of factors that play
      important roles in visual search and its learning. Visual search was studied in
      Experiment 1. VM and CM performance were almost equal, and slope reductions
      occurred during practice for both, suggesting the learning of efficient attentive
      search based on features, and no important role for automatic attention
      attraction. However, positive transfer effects occurred when previous CM targets
      were re-paired with previous CM distractors, even though these targets and
      distractors had not been trained together. Also, the introduction of a demanding
      simultaneous task produced advantages of CM over VM. These latter two results
      demonstrated the operation of automatic attention attraction. Visual search was
      further studied in Experiment 2, using novel characters for which feature overlap
      and similarity were controlled. The design and many of the findings paralleled
      Experiment 1. In addition, enormous search improvement was seen over 35 sessions
      of training, suggesting the operation of perceptual unitization for the novel
      characters. Experiment 3 showed a large, persistent advantage for CM over VM
      performance in memory search, even when practice on particular combinations of
      targets and distractors was equated in the two training conditions. A multifactor
      theory of automatization and attention is put forth to account for these findings
      and others in the literature.

PMID- 1621884
TI  - Attention and preattention in theories of automaticity.
AB  - The theoretical relation between preattentive processes and automatic processes
      is different in different approaches to attention and automaticity. In the modal
      view, automatic and preattentive processes are one and the same; automatic
      processing is preattentive. In recent views that treat automaticity as a memory
      phenomenon, automatic processing is postattentive. These views are described and
      evidence for them is discussed. Two experiments are reported that test whether
      the training that makes processing automatic also makes it preattentive. The data
      suggest a dissociation between automatic and preattentive processes that is more
      consistent with the memory view of automaticity than with the modal view.

PMID- 1621885
TI  - Automaticity and preattentive processing.
AB  - The characteristics of automatized performance resemble those of preattentive
      processing in some respects. In the context of visual search tasks, these include
      spatially parallel processing, involuntary calling of attention, learning without
      awareness, and time-sharing with other tasks. However, this article reports some
      evidence suggesting that extended practice produces its effects through different
      mechanisms from those that underlie preattentive processing. The dramatic changes
      in search rate seem to depend not on the formation of new preattentive detectors
      for the task-relevant stimuli, nor on learned abstracted procedures for
      responding quickly and efficiently, but rather on changes that are very specific
      both to the particular stimuli and to the particular task used in practice. We
      suggest that the improved performance may depend on the accumulation of separate
      memory traces for each individual experience of a display (see Logan, 1988), and
      we show that the traces differ for conjunction search in which stimuli must be
      individuated and for feature search where a global response to the display is
      sufficient.

PMID- 1621886
TI  - Introduction of the Soper Lecture.

PMID- 1621887
TI  - Results of a community-based Aedes aegypti control program in Merida, Yucatan,
      Mexico.
AB  - This report describes the results of a community-based Aedes aegypti control
      program in Merida, Yucatan, Mexico. Baseline surveys concerning knowledge,
      beliefs, and practices of 577 women and a larval survey of 616 house lots were
      carried out in October 1989. Following development of a public health
      communication intervention from this data, the program was implemented in six
      communities. Evaluation used an untreated control group design with pretest and
      two post-tests, one at completion and one six months later. Significant changes
      in knowledge and behavior were seen in the treatment group in both post-tests.
      Women in the intervention group were able to identify the Ae. aegypti mosquito,
      the larval production sites of the mosquito, and appropriate control methods. A
      behavior change proxy was measured by examining changes in the Breteau (number of
      positive containers/100 houses surveyed) and container indices. The Breteau index
      remained the same in the intervention group while it increased significantly in
      the comparison group. Changes were also seen with respect to individual
      containers. This project demonstrated that a community-based communication
      program aimed at larval production site elimination or control can be effective
      in changing behavior and reducing larval production sites.

PMID- 1621888
TI  - Malaria chemoprophylaxis using proguanil/dapsone combinations on the Thai
      Cambodian border.
AB  - The Thai-Cambodian border is a difficult area in which to provide adequate
      malaria chemoprophylaxis because of multiple drug-resistant Plasmodium
      falciparum. In 1990-1991, Thai soldiers were randomly selected to receive
      proguanil (200 mg/day) combined with dapsone (4 mg or 12.5 mg/day) (n = 184) or
      pyrimethamine/dapsone (12.5 mg and 100 mg/week) (n = 177). Doxycycline (100
      mg/day) was given to men with glucose-6-phosphate dehydrogenase deficiency (n =
      77). Falciparum malaria attack rates were the same whether proguanil/dapsone
      (10.3%) or pyrimethamine/dapsone (11.3%) was used. However, proguanil/dapsone was
      more effective than pyrimethamine/dapsone in preventing vivax malaria (1.6%
      versus 12.4%). Men receiving doxycycline had falciparum malaria (3.9%) and vivax
      malaria (1.3%) at low rates. Adjusting the dapsone component from 4 mg to 12.5 mg
      did not improve the prophylactic effectiveness. Hematologic toxicity was not
      observed with the proguanil/dapsone combination. We conclude that
      proguanil/dapsone is not a useful alternative for malaria chemoprophylaxis on the
      Thai-Cambodian border.

PMID- 1621889
TI  - First reported outbreak of classical dengue fever at 1,700 meters above sea level
      in Guerrero State, Mexico, June 1988.
AB  - An outbreak of classical dengue fever occurred from March to August 1988 in the
      city of Taxco, Guerrero State, Mexico. Taxco is at an elevation of 1,700 meters
      above sea level, and this study represents the highest altitude at which an
      outbreak of dengue has been documented. An investigation was conducted to obtain
      serologic confirmation of dengue infection, determine the extent of the outbreak,
      and identify risk factors for dengue illness. Toxorhynchites cell lines were used
      for viral isolation, and hemagglutination inhibition was used to measure anti
      dengue antibody titers. The case definition used in the investigation was any
      person with fever, headache, myalgias, and arthralgias, or rash or retroocular
      pain. Dengue virus type 1 was isolated from five acute cases. Of 1,686 persons
      living in the affected area, 42% (715) met the case definition. Large (200-liter)
      water containers were significantly associated with infection (relative risk =
      1.7, 95% confidence interval 1.5-1.9). The effect of altitude on epidemic
      transmission is most likely modulated by seasonal temperatures. The epidemiologic
      and serologic confirmation of a dengue outbreak at 1,700 meters above sea level
      represents the capability of Aedes aegypti to adapt to new environments, and the
      potential for epidemic spread in cities at comparable altitudes or higher.

PMID- 1621890
TI  - Outbreak of fatal illness among captive macaques in the Philippines caused by an
      Ebola-related filovirus.
AB  - Following the detection of an Ebola-like virus in cynomolgus macaques recently
      imported into the United States from The Philippines, studies were initiated to
      document transmission at export facilities located in the latter country. At one
      export facility, 52.8% of 161 monkeys that died over a 2.5-month period were
      shown to be infected with this virus using an enzyme-linked immunosorbent assay
      to detect antigen in liver homogenates. A case fatality rate of 82.4% was
      documented for the infected monkeys. The initial anti-viral antibody prevalence
      among the captive macaques at this facility was 25.9% (indirect fluorescent
      antibody titer greater than or equal to 1:16). Followup documented infection of
      24.4% of initially seronegative animals and 8.7% of initially seropositive
      monkeys. Being held in a gang cage versus a single cage was found to be a
      significant risk factor for subsequent virus infection, and the presence of IFA
      antibody was shown to predict protection. This study documents unequivocally for
      the first time the presence of an Ebola-related filovirus in Asia.

PMID- 1621891
TI  - Population dynamics of Loa loa and Mansonella perstans infections in individuals
      living in an endemic area of the Congo.
AB  - A follow-up of Loa loa and Mansonella perstans microfilaremia was carried out in
      an adult population living in a highly endemic area of the Congo. Infection rates
      and parasite loads were found to be stable in the general population, both in the
      short-term (two months) and long-term (3-4 years) followup. The microfilarial
      status of most of the subjects examined did not change between tests. At the
      individual level, the microfilarial densities of L. loa and M. perstans also
      remained remarkably constant over time. This results in a qualitative and
      quantitative stability of the parasitic material available for the vectors.

PMID- 1621893
TI  - Mortality trends of American missionaries in Africa, 1945-1985.
AB  - Mortality trends of missionary staff serving in sub-Saharan Africa were tracked
      for the period 1945-1985. For 1945-1970, when more complete incidence data were
      available, the missionary death rate was approximately 40% lower, after
      adjustment, than would be expected in a comparable US population. This trend
      persisted through 1985. Between 1945 and 1970, the largest number of fatalities
      was attributable to malignancy, atherosclerosis, accidents, and infectious
      disease, and the greatest mortality risks, compared with the US experience, were
      from homicides, the complications of pregnancy, and infections, notably malaria,
      hepatitis, and polio. Beginning in the late 1950s, motor vehicle accidents became
      the leading cause of death. Since the 1960s, accidental causes of death have been
      approximately 50% higher than in the US, and homicides have been four times
      higher. During this same period, the infectious disease death rate decreased to
      approximately that within the US. Currently, the leading causes of mortality are
      motor vehicle accidents, malignancy, and atherosclerosis, followed by other
      accidental causes, notably aircraft mishaps and drownings. Viral hepatitis is
      presently the leading infectious disease cause of death. Other contemporary
      lethal infections include malaria, rabies, typhoid, Lassa fever, and retroviral
      infection. It was concluded that missionaries in sub-Saharan Africa had a death
      rate approximately half that expected in a comparable domestic control
      population. Preventive strategies, particularly relative to accident and
      infectious disease prevention, could effectively reduce mortality risk further.

PMID- 1621892
TI  - Prevalence and risk factors for Taenia solium taeniasis and cysticercosis in
      humans and pigs in a village in Morelos, Mexico.
AB  - In a Mexican village in which Taenia solium infection was known to be endemic, we
      selected a cluster sample of 368 households (21% of the total) for demographic,
      environmental, and diagnostic surveys, and medical histories for taeniasis and
      cysticercosis. Coproparasitologic studies of 1,531 participants revealed
      infection by Taenia sp. in four (0.3%) individuals; however, 5.8% of the
      respondents reported a history of having passed tapeworm proglottids in feces. Of
      1,552 human serum specimens, 10.8% tested positive in the cysticercosis
      immunoblot assay. Seropositivity increased with age and reached a maximum in
      subjects ages 46-55 years. Risk factors associated with seropositivity included a
      history of passing tapeworm proglottids, frequent consumption of pork, and poor
      personal and household hygiene (P less than 0.05). A history of seizures was also
      significantly associated with seropositivity (P less than 0.05); approximately
      one-third of persons with such histories were seropositive. Of 571 pigs examined
      by tongue inspection, 23 (4.0%) had cysticerci; infection rates increased with
      the age of pigs, and were higher in pigs that habitually ran loose or were fed
      human feces (P less than 0.05). Goodness of fit analysis confirmed that
      seropositive persons (but not infected pigs) were significantly clustered within
      households, particularly, in households in which a member reported a history of
      having passed tapeworm proglottids. The results of this study have identified
      community behavioral and environmental practices that must be modified to prevent
      continued transmission of cysticercosis and taeniasis.

PMID- 1621894
TI  - Immunogenicity and efficacy trials in Aotus nancymai monkeys with model compounds
      representing parts of a 75-kD merozoite surface antigen of Plasmodium falciparum.
AB  - We tested the ability of a recombinant DNA-encoded fragment (C7Ag) of a
      Plasmodium falciparum merozoite protein (p75) and of two carrier-free peptide
      models (28-mer and 76-mer) to stimulate boostable antibody responses in Aotus
      nancymai monkeys. In addition, we evaluated protection against challenge with the
      Uganda Palo Alto (FUP) strain of this parasite. The data indicate that C7Ag
      elicited a strong and boostable IgG antibody response in all the monkeys
      immunized. However, studies with the peptide models demonstrated that various
      animals produce antibodies to different portions of this structure. When the post
      boost sera from monkeys immunized with C7Ag were analyzed for reactivity against
      two major portions of C7Ag, most of the antibody response was observed against
      the disulfide-bonded 76-residue region that forms a conformational immunogenic
      epitope. In the same sera, antibody levels against the charged helical region
      modeled with a 28-mer were generally low. Immunization with synthetic peptides
      revealed that the 76-mer stimulated an antibody response almost as strong as
      C7Ag, with substantial cross-reactivity against the parasite antigen. The 28-mer
      evoked a response that was not efficient or uniform, and showed little reactivity
      with the authentic parasite antigen. Aotus nancymai was shown to be susceptible
      to infection with the Uganda Palo Alto strain of P. falciparum; however, maximum
      parasitemia varied markedly in both immunized and control monkeys. Statistical
      analysis failed to recognize differences in maximum parasitemia between the
      vaccine and control groups. The variation in maximum parasitemia suggests that
      the FUP strain in this species of Aotus is a poor model for the detection of
      differences in efficacy based on maximum parasitemia. This initial study with
      structures based on parts of the 75-kD merozoite surface antigen of P. falciparum
      indicated that both the recombinant-produced protein C7 and the 76-mer synthetic
      peptide, when combined with a Syntex adjuvant formulation, were safe and
      immunogenic in A. nancymai monkeys. However, the data emphasize the problems of
      using animal models to evaluate the potential effects of immunogens in humans.

PMID- 1621895
TI  - Prevalence of antibody to the variant repeat of the circumsporozoite protein of
      Plasmodium vivax in Peru.
AB  - Individuals living in a malaria-endemic area in northern Peru were found to have
      antibodies to the variant repeat sequence of the circumsporozoite (CS) protein of
      Plasmodium vivax. The presence of IgG antibody to the predominant repeat sequence
      GDRAA/DGPA represented by the recombinant protein NS1(81) V20 (V20), and the
      variant repeat sequence ANGAGNQPG contained in the synthetic peptide Pvk247, was
      determined by enzyme-linked immunosorbent assay. IgG antibodies to the repeats
      were present in 78 (26%) of 298 serum samples; 56% of the positive serum samples
      had antibodies to V20 and 60% had antibodies to Pvk247. These findings stress the
      importance of considering the variant epitope in designing a vaccine based on the
      repeat region of the vivax CS protein. In a malaria-endemic area such as the one
      in this study, in which exposure to the variant repeat epitope may be as frequent
      as exposure to the predominant repeat, a vaccine based solely on the predominant
      repeat epitope may be ineffective against the variant form.

PMID- 1621896
TI  - Low frequency of anti-Plasmodium falciparum circumsporozoite repeat antibodies
      and rate of high malaria transmission in endemic areas of Rondonia State in
      northwestern Brazil.
AB  - In areas studied in the Rondonia State of Brazil, a high rate of malaria
      transmission and a low prevalence of anti-(NANP)4 antibodies are reported. The
      entomologic data are comparable to those observed in some malaria-endemic areas
      of Africa and Asia. However, the frequency of individuals with antibodies to the
      immunodominant epitope of the circumsporozoite protein of Plasmodium falciparum
      recorded in the four localities of Rondonia state was very low when compared with
      the frequencies recorded in other African and Asian endemic areas. Most of the
      studies performed in Africa and Asia concerned the native population of
      hyperendemic areas, whereas we studied a migrant population who were mostly from
      malaria-free areas of Brazil and living in Rondonia State for 2-4 years. In
      positive individuals the antibody production was influenced by previous malaria
      experience, suggesting that infective bites must occur in cumulative numbers
      before anti-(NANP)4 antibodies are detected. Therefore, it is possible that the
      individuals described in this report have not been exposed long enough to malaria
      infection to develop detectable levels of anti-(NANP)4 antibodies.

PMID- 1621897
TI  - Ultrasonography as a diagnostic aid for a district hospital in the tropics.
AB  - To improve diagnostic capabilities, an ultrasound unit was installed at a major
      hospital in Wad Medani, Sudan. During the implementation period (October 1986 to
      March 1987) of ultrasound service, 863 patients were examined cooperatively by
      Sudanese and German physicians. The service covered internal medicine (47.5%),
      obstetrics and gynecology (31.6%), surgery (12.5%), and pediatrics (8.4%).
      Pathologic findings were seen in 75% of the patients. In obstetrics, the rate of
      pathologic findings was 40%. Five hundred eighty-three pathologic findings were
      detected in organ systems that constituted the primary indication for
      ultrasonography (of a total of 1,009 indications). The clinical benefit of
      ultrasonography was evaluated in 289 randomly selected patients in a standardized
      questionnaire completed by the attending physicians. The final clinical diagnosis
      was established or substantially revised in 21.5% of the patients, based on the
      ultrasonographic report. The previously reported diagnosis was supported in 69.5%
      of the patients. Medical management was directly influenced in 26% of the
      patients. We conclude that the clinical benefit of ultrasonography at a district
      hospital in the tropics is substantial, providing cost-effective, immediate
      therapeutic benefits in 25% of the patients examined. The technique thereby
      contributes to better and more rational patient management in institutions with
      limited resources.

PMID- 1621898
TI  - Evaluation of eosinophiluria in the diagnosis of schistosomiasis hematobium: a
      field-based study.
AB  - Using Hansel's stain, eosinophiluria greater than 5% of total urinary white blood
      cells was found in 59% of a randomly selected population sample in an area
      endemic for schistosomiasis hematobium. The prevalence and mean level of
      eosinophiluria were significantly higher in infected subjects than in noninfected
      subjects (P less than 0.05). The sensitivity (80%), specificity (86%), and
      positive predictive value (82%) of eosinophiluria as a diagnostic index for
      schistosomiasis hematobium were significantly higher (Youdin index 0.66; P less
      than 0.05) than those of proteinuria, hematuria, and leukocyturia taken singly or
      in combination. However, unlike the latter three measurements, this method
      involves microscopy. There is a great need for a chemical method for measuring
      eosinophiluria.

PMID- 1621899
TI  - Circulating schistosomal antigen in diagnosis and assessment of cure in
      individuals infected with Schistosoma mansoni.
AB  - The effectiveness of praziquantel in treating schistosomiasis is most commonly
      assessed by quantitating egg production or anti-schistosome antibodies in serum.
      We have used a monoclonal antibody (MAb)-based antigen-capture enzyme-linked
      immunosorbent assay (ELISA) for the serologic diagnosis of schistosomiasis, and
      to monitor the efficacy of praziquantel therapy in 49 individuals with
      parasitologically proven schistosomiasis. The MAb used, 128C3/3/21, recognizes a
      repeating carbohydrate epitope expressed at all stages of parasite development,
      and antibodies recognizing this epitope are found in the serum of infected
      humans. The overall sensitivity of the ELISA was 78%, with a sensitivity of 100%
      for patients excreting greater than 100 eggs/g of feces and 72% for those
      excreting less than 100 eggs/g of feces. The positivity of the ELISA was directly
      related to the fecal egg counts obtained on days -3, -2, and -1 before treatment
      with praziquantel, but there was no correlation between antigen levels and the
      clinical stage of the disease. After praziquantel treatment, we observed a highly
      significant correlation (P less than 0.0001) between the time elapsed since
      treatment and the decrease in antigenemia. Furthermore, although no eggs were
      detected in any of the stool specimens at week 12 after treatment, the antigen
      was detected in 21% of the treated patients (seven of 33 ELISA-positive
      patients). Antigen levels decreased over the 12-week period in six of these
      patients, whereas the antigen level increased with time in one individual. The
      persistence of antigenemia suggests that these individuals are either still
      clearing antigen or remain infected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621900
TI  - Renal abnormalities in microfilaremic patients with Bancroftian filariasis.
AB  - To determine the frequency of renal abnormalities occurring with Bancroftian
      filarial infections and to assess the effects of treatment on such abnormalities,
      we initiated a prospective, hospital-based study of 20 microfilaremic and five
      amicrofilaremic patients with Wuchereria bancrofti infections. Thorough clinical
      evaluations and detailed renal assessments were made prior to treatment and at
      multiple time points for 60 days following a standard twelve-day course of
      treatment with diethylcarbamazine (DEC). There were two important findings.
      First, even prior to DEC treatment, almost half of the microfilaremic patients
      had hematuria and/or proteinuria. Second, treatment with DEC induced these same
      abnormalities in almost all of the remaining microfilaremic patients. However,
      this DEC-induced hematuria and/or proteinuria was transient, and the long-term
      response to DEC in all of the microfilaremic patients was resolution of the
      abnormal renal findings during the two-month followup period. In the
      amicrofilaremic study patients, no hematuria or proteinuria was detected before,
      during, or after treatment with DEC.

PMID- 1621901
TI  - Amebiasis complicating carcinomas: a diagnostic dilemma.
AB  - Two black African women and one black American man had carcinomas of cervix,
      perineum, and sigmoid colon, respectively. In each of these patients,
      trophozoites of Entamoeba histolytica had invaded the surface of the tumor, and
      in some areas had invaded more deeply into the stroma between the tumor cells.
      Although it is well known that cutaneous amebiasis of anus, penis, vulva, and
      cervix can mimic squamous cell carcinoma, it may be, perhaps, less well known
      that carcinomas at these sites may be colonized by trophozoites of E.
      histolytica. In patients with amebiasis but without an associated carcinoma, a
      correct diagnosis of amebiasis spares the patient unnecessary and sometimes
      mutilating surgery. But a diagnosis of amebiasis, when there is an unrecognized
      underlying carcinoma, delays effective treatment of the carcinoma. A smear that
      establishes a diagnosis of cutaneous amebiasis, therefore, should be followed by
      biopsy to exclude or confirm an underlying carcinoma.

PMID- 1621902
TI  - [A biological rhythm approach to psychological correction of postural tone
      disorders in pregnant women with arterial hypotension].
AB  - The studies have demonstrated a correcting and synchronizing effect of
      differentiated psychotherapy and dosed exercise on the maternal and fetal
      reactions to active postural load in women with gestational arterial hypotension,
      developing a blood circulatory disadaptation in the mother-fetus system and
      circadian desynchronization of the postural tone. Traditional
      physiopsychoprophylactic preparation to labor, carried out in the reference group
      of pregnant women, was of no avail in this respect.

PMID- 1621903
TI  - [Prevention of disorders of the functional state of blood coagulation and
      fetoplacental complex in pregnant women with late toxicosis].
AB  - Analysis of the basic parameters of coagulogram and the fetoplacental system in
      pregnant women with late gestosis has lead the authors to a conclusion that
      chronic disseminated intravascular blood coagulation (DIC syndrome), frequently
      resulting in abnormal blood loss in the early postpartum period, develops in
      severe gestosis. Combined therapy with estrogens, rheopolyglucin, heparin,
      curantil, essentiale, administered for 6-8 days before delivery, normalized the
      hemostasis system and reduced uterine bleedings.

PMID- 1621904
TI  - [Circulating immune complexes and immunoglobulins A, M and G in the mother-fetus
      system in normal pregnancy and gestosis].
AB  - Circulating immune complexes (CIC) and immunoglobulins A, M, and G were measured
      in the maternal peripheral blood, mixed umbilical blood, and amniotic fluid in
      women with normal pregnancy and gestosis. CIC concentrations in the examined
      fluids did not surpass the levels typical of healthy donors. Maternal blood CIC
      levels were higher in gestosis than in normal pregnancy, and CIC levels in the
      umbilical blood and amniotic fluid were always lower than in maternal blood
      serum. IgG levels were found the most shifted. These data evidence changes of the
      humoral immunity in normal pregnancy, this being, probably, one of the mechanisms
      providing its favorable course.

PMID- 1621905
TI  - [Doppler-metric and Doppler echocardiographic study of the nature and stage of
      disorders of fetal hemodynamics in intrauterine fetal growth retardation].
AB  - Pregnancy course, labor outcome, and doppler-metric findings were analyzed in 174
      women, 98 with normal pregnancy (controls) and 76 with small-for-date fetuses
      when examined on weeks 28-41; the aim of the study was to analyze the pattern of
      hemodynamic disorders in small-for-date fetuses. A classification of fetal
      hemodynamic disorders has been developed, that distinguishes three types of
      disorders differing in severity: first degree--disordered fetoplacental
      circulation not reaching the critical values and satisfactory fetal hemodynamics;
      second degree--compensated disorders of fetal hemodynamics; third degree-
      critical state of fetal hemodynamics. Use of this classification in clinical
      practice will help define rational strategy of pregnancy follow-up.

PMID- 1621906
TI  - [Biophysical activity of the fetus during labor in EPH-gestosis].
AB  - Fetal respiratory and motor activities were studied in 105 parturients with EPH
      gestosis of varying severity and in 25 reference ones. The results evidence that,
      in contrast to the antenatal period, normal fetal condition in labor is
      associated with biophysical inertness, this fact confirming the known viewpoint
      on the intranatal fetal hibernation. Active management of labor in parturients
      with doubtful and abnormal biophysical parameters on the eve of delivery impairs
      the natural mechanisms of fetal defense in labor. Respiratory or motor activity
      of the fetus should be regarded as a prognostically unfavorable sign in respect
      of hypoxic involvement of the CNS and the newborn aspiration syndrome.

PMID- 1621907
TI  - [WHO activities in the area of adolescent reproductive health protection].

PMID- 1621908
TI  - [Experience in the use of vaginal and intracervical enzaprost suppositories in
      preparation for labor].
AB  - To improve the efficacy of prelabor treatment of pregnant women with some
      obstetrical abnormalities, such as over-term pregnancy, AB0- and Rh
      isosensitization, anemia, gestosis of the second half of pregnancy, vaginal and
      intracervical suppositories containing 0.1 mg of enzaprost were administered to
      102 women for 1-5 days. In 30 (29.4%) cases such treatment induced spontaneous
      labor. In 64 (62.7%) women labor was induced by deoxy-amino oxytocin, and in 8
      (7.8%) women this latter drug had to be administered repeatedly to induce labor.
      The babies born to the women under observation had the Apgar score of 6-10, 92
      (90.2%) of them had the score of 8-10. No stillbirths or early infant mortality
      cases were recorded. Therefore prelabor treatment with vaginal or intracervical
      suppositories with enzaprost is effective and safe for both mother and newborn.

PMID- 1621909
TI  - [Effects of leukinferon on the phagocytic function of puerperal blood].
AB  - Leukinferon effects on the phagocytic activities of the monocytes and
      polymorphonuclear leukocytes of 12 pregnant women and puerperants with various
      chronic infectious diseases were studied in vitro. Blood samples of 5 female
      donors were examined for control. It was found possible to stimulate and correct
      phagocytic function by leukinferon, proceeding from the initial function of the
      blood cells and the presence of serum factors. The immunocorrecting properties of
      leukinferon were found particularly valuable in cases with immunodeficiencies,
      for infectious diseases and labor complications could thus be prevented in this
      high-risk group of puerperants.

PMID- 1621910
TI  - [A combined reflex method in the treatment of suppurative-infectious diseases in
      the postpartum period].
AB  - The purpose of this study was to develop an effective pathogenetically validated
      method for the treatment of puerperants with pyoseptic diseases, making use of
      reflex therapy, and clinical assessment of this method. The study has involved
      190 puerperants, in 50 of them the postpartum period ran a normal course and the
      rest 140 developed pyoseptic complications. Case histories were analyzed,
      clinical and laboratory tests (blood proteins, Mancini's test for
      immunoglobulins, Dorofeichuk's blood plasma lysozyme test) were carried out.
      Vegetative regulation was studied with the use of a vegetative test kit. A method
      for reflex therapy of the detected disorders of the vegetative regulation
      associated with puerperal pyoseptic diseases has been developed, resulting in
      strengthening of the defense potential of the body. Clinical assessment of the
      method has confirmed its high efficacy.

PMID- 1621911
TI  - [Clinical-morphological parallels in postpartum endometritis].
AB  - Clinicomorphologic parallels were studied in 45 puerperants with postpartum
      endometritis. This condition was histologically confirmed in 42 of the 45
      patients with its clinical symptoms (in 100% of patients with the grave, in 95%
      with the medium-severity, and in 83% of those with the benign form of the
      disease). The authors came to the conclusion that the severity of postpartum
      endometritis was directly dependent on the extent and depth of the uterine wall
      involvement in the inflammatory process. By the end of treatment the morphologic
      signs of inflammation persisted in 40% of patients even without clinical signs of
      endometritis. Such women should be referred to a group at high risk of developing
      chronic endometritis.

PMID- 1621912
TI  - [Significance of catecholamine levels in the diagnosis and prognosis of
      dysadaptation of preterm newborn infants].
AB  - Analysis of the clinical status of preterm newborns and the results of
      histochemical studies of the red cell catecholamine depositing function has led
      the authors to a conclusion that the Apgar score is reliable only in case of the
      newborn's critical condition. In slight and medium-severity asphyxia high red
      cell satiation with catecholamine granules was associated with a favorable
      outcome for the newborns. The authors claim that analysis of red cell
      catecholamine-depositing function is a sufficiently reliable diagnostic and
      prognostic criterion for the assessment of a preterm newborn's status.

PMID- 1621913
TI  - [Morphological analysis of the state of the ovaries of the newborn infants].
AB  - Studies of 98 newborn ovaries included measurements of their mass, estimation of
      follicle number in a standard section size, of the integral parameter reflecting
      the total number of follicles in the ovary and the count of follicular cells
      adjacent to the oocyte in the primary follicle. The count of follicular cells was
      found to be a permanent value, not related to the newborn's mass; ovarian mass,
      number of follicles in a standard section, and the integral parameter were
      growing together with the newborn's mass, changing within the range from 900-1000
      to 2500-4000 g, increasing particularly intensively within the body mass range of
      1000 to 2500 g. In fetuses weighing 2500-4000 g, dead from multiple developmental
      defects, these characteristics are essentially lower than in those dead from
      birth injuries.

PMID- 1621914
TI  - [Fibrinogen metabolism in juvenile uterine bleeding].
AB  - The levels of fibrinogen, monomeric fibrin soluble complexes (MFSC), fibrin
      fibrinogen degradation products (FDP), and the status of blood coagulation and
      fibrinolytic systems were studied in girls suffering from juvenile uterine
      bleedings. Fibrinogen and MFSC levels were found lowered and FDP concentration
      increased in such bleedings. Fibrinogen concentration correlated with the
      activities of the coagulating and fibrinolytic systems, and the MFSC level only
      with the coagulating system activity. Mathematical analysis has revealed a
      relationship between blood fibrinogen metabolism and the activities of the
      coagulating and fibrinolytic systems, whose functions in this condition are
      relatively autonomous.

PMID- 1621915
TI  - [Criteria for singling out groups of pregnant women at risk of obstetric
      complications].

PMID- 1621916
TI  - [General principles of the pathogenesis of vegetovascular and psychoemotional
      disorders during menstrual cycle and methodological approaches to their study].
AB  - Analysis of charts filled in by 79 women (mean age 31.5 +/- 4.0 years) over the
      course of 2-3 menstrual cycles has demonstrated the regular manifestation of
      various psychosomatovegetative symptoms over the entire course of the cycle (in
      the follicular, lutein phases, and during ovulation). Study of the brain electric
      activity and of the function of various sections of the autonomic nervous system,
      as well as examination of the emotional and mental sphere of the patients has
      revealed the contribution of the brain suprasegmental sections to the
      pathogenetic mechanisms of these disorders.

PMID- 1621917
TI  - [Incidence of gynecologic diseases in multiparae during the climacteric period].
AB  - The structure and incidence of gynecologic diseases were studied in 796 women
      aged 40 to 60. The results were computer-processed. A significant (by 3.5 times)
      increase of the incidence of atrophic changes of the vagina and vulva and genital
      dystopia were revealed in multiparae, which fact evidenced unqualified labor
      management and neglect of hygienic measures in the postpartum period. Cervix
      uteri abnormalities were also more often detected in multiparae. A direct
      correlation between the number of pregnancies, deliveries, and abortions, on the
      one hand, and incidence of diseases of the cervix uteri, on the other, was
      revealed; uterine myoma was more frequently found in multiparae than in women who
      had one or two deliveries. A direct relationship was established between the
      duration of lactation period and incidence of ovarian tumors. Mammary diseases
      were more frequently detected in women with a history of one or two deliveries.

PMID- 1621918
TI  - [Macromastia].

PMID- 1621919
TI  - [Ovarian and endometrial status in tubal and peritoneal sterility].
AB  - A total of 97 patients with laparoscopically confirmed tubal and peritoneal
      sterility were examined. Thirty-six patients presented with a normal biphasic
      menstrual cycle, the rest 61 with the lutein phase insufficiency. Follicular
      presence and size were examined by ultrasonography, the dominant follicle and
      endometrium volumes were estimated. Only in 17 of the 97 examinees all the
      examined parameters were found normal, in the rest deviations from the normal
      echographic picture were revealed. More marked changes were detected in the
      patients with the lutein phase insufficiency. The findings evidenced a direct
      correlation between ultrasonic data and rectal temperature, adhesion process
      severity and the results of ovarian biopsy specimen histologic examination. The
      authors recommend ultrasonic examination for the assessment of ovarian function
      in patients suffering from tubal and peritoneal sterility.

PMID- 1621921
TI  - [Management of pregnancy and labor in obese women].

PMID- 1621920
TI  - [Rectosigmoid vaginoplasty in children and adolescents].
AB  - The authors analyze the results of vaginal plasty with grafts from the
      rectosigmoid portion of the large intestine, carried out in 279 girls aged 3 to
      18 with abnormalities of the genitals and vaginal aplasia, including that with a
      functioning uterus. They have developed new modifications of such surgery, that
      facilitate sexual social adaptation of the patients when they reach puberty.

PMID- 1621922
TI  - [Moscow delivery asylums at the end of the 19th and beginning of the 20th
      centuries].

PMID- 1621923
TI  - [Methodological approaches to early detection of benign epithelial tumors of the
      ovaries].

PMID- 1621924
TI  - Neurological impairment in congenital bilateral ptosis with ophthalmoplegia.
AB  - A case is described of congenital bilateral ptosis and ophthalmoplegia due to
      incomplete bilateral paralysis of the third cranial nerve associated with
      dysmorphisms, brain malformations and epileptiform EEG abnormalities. We
      hypothesize that in our case the ophthalmological disturbance is due to
      mesencephalic impairment. In literature there are few reports of congenital
      bilateral paralysis of the third cranial nerve and they lack detailed MRI
      findings. We stress in patients with congenital third cranial nerve palsy the
      importance of thorough neurological investigations including prolonged wake-sleep
      EEG monitoring as well as CT scan and MRI to establish the origin of the
      disorder.

PMID- 1621925
TI  - Color Doppler flow imaging of CSF flow in an infant with intraventricular
      hemorrhage.
AB  - Evaluation of CSF flow was performed by means of the color Doppler flow imaging
      (CDFI) technique. The motion of CSF was examined in an infant with
      intraventricular hemorrhage (IVH). With the aid of CDFI, CSF flow in the
      aqueduct, 3rd ventricle and foramen of Monro could be demonstrated. CSF flow in
      both upward and downward directions was clearly visualized, primarily reflecting
      cardiac pulsation and respiration. When he was subjected with intermittent
      positive pressure ventilation, during inspiration there was upward flow in the
      aqueduct, while during expiration there was downward flow. Our experience
      indicates that CDFI is a useful technique for examining the CSF circulation in
      infants with IVH.

PMID- 1621926
TI  - Congenital focal muscle dysplasia in the lower extremities from probable abnormal
      innervation: a case report.
AB  - A two-year-seven-month-old girl with pes equinovarus congenita, muscle hypotonia
      and weakness limited to the lower extremities is presented. Upon admission to our
      hospital, she could stand with support but could not walk alone. Serum creatine
      kinase level was normal and the electromyogram was nondiagnostic. The muscle CT
      disclosed an almost total absence of bilateral vastus lateralis and medialis,
      rectus femoris and gastrocnemius muscles. The biopsied vastus lateralis muscle
      was almost completely replaced by fat tissue, and a small amount of muscle tissue
      showed uniform type 1 fiber and an aggregate of atrophic fibers in one fascicle.
      Because of an absence of progressive muscle weakness and neurogenic EMG findings,
      the authors conclude that the muscle pathology was due to the congenital
      anomalous condition of probable abnormal innervation to developing muscles.

PMID- 1621927
TI  - Hyperthyroid-induced chorea in an adolescent girl.
AB  - Hyperthyroidism is invariably accompanied by nervous system dysfunctions.
      Irritability, emotional lability and hyperkinesia are the signs and symptoms most
      frequently observed. Chorea or choreoathetosis are only rarely associated with
      hyperthyroidism. It is the purpose of this work to describe the case of a young
      girl in whom chorea was the main manifestation of thyrotoxicosis. The chorea
      receded and disappeared as the patient became euthyroid. Hyperthyroidism,
      therefore, is to be considered an unusual cause of chorea and every patient with
      choreiform movements should be examined also for thyroid function.

PMID- 1621928
TI  - Tongue dyskinesia in Wilson disease.

PMID- 1621929
TI  - Carrier detection of Duchenne/Becker muscular dystrophy: computer-assisted direct
      quantitation of gene amplification products.
AB  - An improved method by quantitative dystrophin gene deletion analysis was
      developed for the detection of Duchenne/Becker muscular dystrophy (DMD/BMD)
      carriers. Exon 52, which had been found to be deleted in DMD probands, was
      amplified for female family members, together with exon 60 as a reference, at the
      exponential phase of polymerase chain reaction. The products were separated by
      electrophoresis, the band intensities on gel photographs were quantitated, and
      the target/control ratios were calculated. The values for three heterozygous
      mothers were approximately half those for normal individuals and two definite non
      heterozygous mothers. This procedure is easy, rapid and useful for the carrier
      diagnosis of DMD/BMD.

PMID- 1621930
TI  - Selective involvement of the quadriceps muscle in congenital muscular
      dystrophies: an ultrasonographic study.
AB  - Muscle ultrasound scanning is a non-invasive and painless technique for
      evaluating muscle disorders in childhood. We have performed ultrasound scans of
      the quadriceps muscle in 26 children with various forms of congenital muscular
      dystrophies. There were 8 patients clearly showing selective involvement within
      the components of the quadriceps. In all cases showing selective involvement, the
      rectus femoris was spared and the vastus muscles were the affected group. Our
      findings support the concept of heterogeneity, often encountered in congenital
      muscular dystrophies.

PMID- 1621931
TI  - Factors influencing the clinical type and course of myasthenia gravis.
AB  - Myasthenia gravis is considered to be an autoimmune disease in which several
      factors reciprocally influence the clinical type and course. We investigated the
      relative importance of the following factors: anti-acetylcholine receptor
      antibody (AChR Ab), HLA, age at onset, autoimmunity, thymic abnormality, duration
      of treatment, change in AChR Ab titer and immunosuppressive therapy. The
      pretreatment-AChR Ab titer and HLA were shown to significantly influence the
      clinical type. On the other hand, the age at onset significantly influenced the
      clinical course. The finding that with an onset at less than 5-year-old there was
      a tendency for a good prognosis suggests an association between the immaturity of
      the muscle and immune systems, and the clinical course.

PMID- 1621932
TI  - Reduced brainstem size in children with autism.
AB  - Recently, structural brain abnormalities as well as functional abnormalities of
      the brainstem have been reported in autistic children. The authors undertook an
      analytic study of the brainstem in autistic children by means of magnetic
      resonance imaging (MRI). The MRI scans of 29 autistic children were compared with
      15 control MRI scans. The autistic children were divided into two groups
      according to DQ (IQ) level: the DQ (IQ) greater than or equal to 80 group and the
      DQ (IQ) less than 80 group. The midbrain and pons were measured, and the ratio of
      the midbrain and pons sizes versus the cranium size were calculated. The
      brainstem size was found to be significantly smaller in the autistic group. In
      particular, the reduction in brainstem size tended to be greater in the low DQ
      (IQ) group when compared with the high DQ (IQ) one, though there was no
      significant difference (p less than 0.1). This suggests that the brainstem is
      anatomically altered in autistic children.

PMID- 1621933
TI  - The Rett girls with preserved speech.
AB  - In addition to a total population of 102 classic Rett syndrome girls who visited
      our department in the last 8 years, 3 were observed showing some of the features
      typical of this syndrome, including hand-washing activities, but also some
      atypical features, the most notable of which was their ability to speak in fully
      formed phrases. One of these girls has a sister with the typical features of
      classic Rett syndrome. Atypical variants of the Rett syndrome are discussed and
      the possibility of a "speaking" variant is considered.

PMID- 1621934
TI  - International Consensus Report on Diagnosis and Management of Asthma.
      International Asthma Management Project.

PMID- 1621935
TI  - A quality improvement process team.

PMID- 1621936
TI  - Successful implementation of a CQI process.
AB  - Managers and CQI facilitators must be equipped to understand both the pain and
      joy inherent in the organizational change process. The organizational caveats
      associated with successful implementation of CQI include the following: Expect
      resistance to change, especially if your current situation is comfortable. Be
      patient--the change process is an evolution, not a revolution. Plan well in a
      multidimensional format--you are changing more than policies and procedures when
      adopting CQI. Shape a culture that will support CQI, actively plan to expand
      communication opportunities, enhance training programs, and increase recognition
      modalities. Anticipate and deal with the stress that will accompany change. Don't
      forget to celebrate successes as transformation occurs!

PMID- 1621938
TI  - Approaches to quality improvement.

PMID- 1621937
TI  - Overcoming skepticism about quality improvement.

PMID- 1621939
TI  - From QA to CQI: a retrospective review.

PMID- 1621940
TI  - Some implications of CQI for nursing administration.

PMID- 1621941
TI  - A quality initiative for enterostomal therapy nursing.

PMID- 1621942
TI  - Quality improvement: the nurse's role.
AB  - Continuous quality improvement is a concept which includes: Quality assurance-
      the provision of services that meet an appropriate standard. Problem resolution-
      including all departments involved in the issue at hand. Quality improvement--a
      continuous process involving all levels of the organization working together
      across departmental lines to produce better services for health care clients.
      Deming (1982b) and others have espoused total system reform to achieve quality
      improvement--not merely altering the current system, but radically changing it.
      It must be assumed that those who provide services at the staff level are acting
      in good faith and are not willfully failing to do what is correct (Berwick,
      1991). Those who perform direct services are in an excellent position to identify
      the need for change in service delivery processes. Based on this premise, the
      staff nurse--who is at the heart of the system--is the best person to assess the
      status of health care services and to work toward improving the processes by
      which these services are provided to clients in the health care setting. The
      nurse manager must structure the work setting to facilitate the staff nurse's
      ability to undertake constructive action for improving care. The use of quality
      circles, quality councils, or quality improvement forums to facilitate the
      coordination of quality improvement efforts is an effective way to achieve
      success. The QA coordinator assists departments in documenting that the quality
      improvement efforts are effective across all departments of the organization, and
      aggregates data to demonstrate that they meet the requirements of external
      regulatory agencies, insurers, and professional standards. The nurse executive
      provides the vision and secures the necessary resources to ensure that the
      organization's quality improvement efforts are successful. By inspiring and
      empowering the staff in their efforts to improve the process by which health care
      is provided, nurse managers participate in reshaping the health care environment.
      The professional nurse plays a vital role in the quality improvement of health
      care services. However, nurses cannot make these improvements in a vacuum; they
      must include other professionals and ancillary personnel in their efforts. Total
      quality commitment must include all levels of an organization's structure.
      Quality patient care services will be achieved as the result of positive
      interactions among departments working together to build a dynamic mechanism that
      continuously improves the processes and outcomes of health care services.

PMID- 1621943
TI  - From QA to QI in a home health agency.

PMID- 1621944
TI  - Measurement and standards in continuous quality improvement.
AB  - So where does all of this lead us? Many QA professionals are currently concerned
      that CQI will displace their role. Nurses are concerned that they will have to
      learn an entirely new process and language. In a National Association of Quality
      Assurance Professionals position paper, Martin (1990) points out that CQI builds
      on and strengthens the weaknesses of traditional quality assurance approaches.
      Quality improvement is not a substitute for quality assurance; it is a supplement
      to expand health care providers' understanding of the components of excellent
      patient care. Change and variation surrounds us at all times. Continuous quality
      improvement teaches the premises of variation and change. Through a better
      understanding of variation and application of this understanding to continuous
      improvement of the system of care, we will help assure better outcomes for our
      clients. Nurse administrators and staff nurses should endorse the arrival of
      continuous quality improvement. As leaders in QA, we are indeed positioned to
      become leaders in CQI.

PMID- 1621945
TI  - Using the long-term care minimum data set as a tool for CQI in nursing homes.

PMID- 1621946
TI  - Purification of sheep immunoglobin G using protein A trapped in sol-gel glass.
AB  - An effective method for purifying immunoglobulins has been developed utilizing a
      sol-gel glass support system. Sol-gel glass is an effective support for
      chemically active ligands entrapped in this medium at room temperature. There are
      two problems associated with the utilization of such sol-gel glasses for
      entrapping macromolecules. One is the phenomenon of nonspecific absorption of
      proteins onto the glass. The second is that only a portion of the entrapped
      molecules may retain their biological activity. In the present study a sol-gel
      glass was treated with gamma-aminopropyltriethoxysilane to provide a matrix that
      eliminated nonspecific absorption of proteins. The method of entrapping molecules
      was modified to increase the proportion of entrapped molecules that retained
      their reactivity. Protein A was entrapped in the modified sol-gel glass column
      and used to purify IgG from sheep sera by affinity chromatography. The purity of
      the IgG, as determined by SDS-PAGE, was comparable to that obtained from
      commercially available protein A columns and, if the capacity of the column was
      not exceeded, the yield approached 100%. Although the quality and quantity of the
      yields were comparable, the methodology described herein can be accomplished more
      rapidly and with greater ease. Furthermore, the sol-gel glass ligand preparation
      is extremely stable and can be reused for isolation of gamma-globulin. The
      technique has great potential for isolating macromolecules utilizing various
      ligands.

PMID- 1621947
TI  - Subtraction of background fluorescence in multiharmonic frequency-domain
      fluorimetry.
AB  - Background fluorescence is a major concern in time-resolved microfluorimetry
      studies of biological samples. A general method for subtraction of an arbitrary
      background signal in measurements of lifetime and anisotropy decay by
      multiharmonic Fourier transform spectroscopy is presented. Multifrequency phase
      and modulation values are measured in parallel by transformation of digitized
      time-domain waveforms into the frequency domain. For subtraction of background,
      time-domain waveforms are acquired for emission and reference photomultipliers
      for sample (e.g., cell containing fluorophore) and blank (e.g., unlabeled cell).
      Time-domain waveforms obtained in a series of measurements (e.g., sample and
      blank for parallel and perpendicular orientations of an emission polarizer) are
      time-justified by least-squares fitting of reference channel waveforms or by
      phase comparison of the first Fourier harmonics of the reference channel.
      Background is then subtracted directly in the time domain, and the subtracted
      waveform is Fourier transformed to the frequency domain for analysis of lifetime
      or anisotropy decay. This approach yielded excellent background correction over a
      wide range of background intensities and decay profiles. The method was tested in
      cuvette fluorimetry with fluorescein and acridine orange and in fluorescence
      microscopy with living MDCK cells loaded with the pH indicator BCECF. Sample
      lifetimes and rotational parameters could be recovered accurately with greater
      than 50% of the signal arising from background. These results establish a direct
      and practical approach to subtraction of background in complex biological and
      chemical samples studied by frequency-domain fluorimetry.

PMID- 1621948
TI  - Monitoring gene expression in Chinese hamster ovary cells using secreted
      apoaequorin.
AB  - A luminescence method for monitoring gene expression in Chinese hamster ovary
      cells using apoaequorin as a secreted reporter enzyme is described. In this
      method, the cell is not disrupted prior to assay as in the earlier aequorin
      procedure and in the firefly method. The apoaequorin secretion vector is
      constructed by fusing the DNA fragment of the signal peptide sequence of human
      follistatin to the apoaequorin gene. Transfection of Chinese hamster ovary cells
      with the vector causes the apoaequorin to be secreted directly into the culture
      medium. Assay is carried out by removing a small aliquot of the culture medium,
      incubating it with coelenterazine, and adding Ca2+ to trigger light emission from
      the regenerated aequorin. The light intensity is measured with a photomultiplier
      photometer and is proportional to the amount of apoaequorin present. The method
      is highly specific and sensitive and can be carried out in a relatively short
      period of time.

PMID- 1621949
TI  - Bound and determined: a computer program for making buffers of defined ion
      concentrations.
AB  - A computer program that allows the preparation of buffers containing known
      concentrations of metal-ligand complexes at defined pH values and temperatures is
      described. Ligands are defined as compounds that bind metals and may include AMP,
      ADP, ATP, GMP, GDP, GTP, EGTA, EDTA, BAPTA, phosphate, sulfate, chloride,
      monocarboxylic acids, dicarboxylic acids, organophosphates, and/or citric acid.
      Metals may include sodium, potassium, magnesium, calcium, and/or manganese. The
      program uses association constants corrected for temperature and ionic strength
      so that solutions between 0 and 40 degrees C and between pH values of 4 and 10
      can be defined. The program can perform the following: (i) calculate the
      concentration of all metal-ligand complexes when total metal and total ligand
      concentrations are known, (ii) calculate the concentration of metal ion required
      to make a solution of known free metal ion concentration when total ligand
      concentrations are known, (iii) calculate the concentration of ligand required to
      make a solution of known free metal ion concentration when total metal
      concentrations are known, and (iv) calculate the total concentrations of metal
      and ligand required to make a buffer of known metal-ligand concentration. Options
      i-iii are useful for making buffers of defined free metal ion concentrations;
      option iv is useful for making buffers of defined metal-nucleotide
      concentrations.

PMID- 1621950
TI  - Detection of 8-hydroxyguanine in small amounts of DNA by 32P postlabeling.
AB  - A method for the sensitive detection of 8-hydroxyguanine residues in small
      amounts of DNA (0.2-2 micrograms) was developed. It comprises (i) the enzymatic
      hydrolysis of DNA to 2'-deoxyribonucleotide 3'-monophosphates, (ii) degradation
      of the bulk amount of normal purine and pyrimidine deoxyribonucleotides in the
      DNA digest by treatment with trifluoroacetic acid and hydrazine, respectively,
      under conditions retaining the structure of d(8-OH-G)p necessary for 5'
      phosphorylation by T4 polynucleotide kinase (PNK), (iii) 5' phosphorylation of
      d(8-OH-G)p by T4 PNK-catalyzed transfer of 32P from [gamma-32P]ATP, and (iv) 2D
      thin-layer chromatography on polyethyleneimine-cellulose sheets to purify and
      resolve 32P-postlabeled d(8-OH-G)p. Model experiments with mixtures composed of
      synthesized d(8-OH-G)p and DNA hydrolysate indicate that it is possible to detect
      one 8-hydroxyguanine residue out of 2 x 10(6) normal bases starting with 1
      microgram DNA. The methodology, which allows for a further decrease of this
      detection limit, might be very useful for the sensitive detection of DNA damage
      induced by activated oxygen species in small amounts of DNA. We demonstrate the
      formation of 8-OH-G in DNA in vitro by low doses of 60Co gamma-rays.

PMID- 1621951
TI  - One-hour downward alkaline capillary transfer for blotting of DNA and RNA.
AB  - The downward alkaline capillary transfer of DNA and RNA from agarose gel to a
      hybridization membrane was performed using a transfer solution containing 3 M
      NaCl and 8 mM NaOH. Under mild alkaline conditions, DNA and RNA were completely
      eluted from the agarose gel and bound to a hybridization membrane within 1 h. On
      the basis of this new method of transfer a blotting protocol, downward alkaline
      blotting, was elaborated. It provides a fast and efficient alternative to
      commonly used Southern and Northern blotting protocols. The downward alkaline
      blotting of DNA and RNA can be completed in 2.5 and 1.5 h, respectively, and can
      be used with both plastic and nitrocellulose membranes. In addition, the downward
      alkaline blotting protocol allows for a hybridization efficiency of DNA and RNA
      higher than that of the standard blotting protocols performed at neutral pH.

PMID- 1621952
TI  - The synthesis of high-specific-activity UDP-[6-3H]galactose, UDP-N-[6
      3H]acetylgalactosamine, and their corresponding monosaccharides.
AB  - Tritiated uridine-5'-diphosphogalactose (UDP-[3H]Gal) has been widely used to
      study oligosaccharide biosynthesis and structure. It can be synthesized either
      chemically or enzymatically using galactose oxidase to oxidize the hydroxyl
      moiety at C-6 to an aldehyde (6-aldo-UDP-Gal), which is then reduced back to the
      alcohol with tritiated sodium borohydride. Although the enzymatic approach is
      simple and efficient, there are several problems associated with it. First,
      incomplete oxidation to the aldehyde reduces the final specific activity. Second,
      if the galactose oxidase is not removed from the 6-aldo-UDP-Gal prior to
      reduction, the resulting UDP-[6-3H]Gal can be reoxidized to 6-aldo-UDP-[6-3H]Gal.
      We present evidence for the occurrence of this compound in one commercially
      obtained preparation of UDP-[6-3H]Gal. Finally, if an excess of 6-aldo-UDP-Gal is
      used for good yield, it is necessary to quench the reduction with nonradioactive
      borohydride, again reducing the final specific activity. We have devised a rapid,
      inexpensive, and efficient synthesis of UDP-[6-3H]Gal that circumvents all of
      these problems. Galactose oxidase is used to produce 6-aldo-UDP-Gal and the
      completeness of this reaction is confirmed on polyethyleneimine (PEI) cellulose
      TLC plates. The 6-aldo-UDP-Gal is purified on silica gel 60 TLC plates. This
      purified compound is then reduced with tritiated sodium borohydride, with the
      aldehyde present in excess. Unreacted 6-aldo-UDP-Gal is then purified away from
      the product UDP-[6-3H]Gal by chromatography on PEI cellulose. Radiochemically
      pure UDP-[6-3H]Gal with a specific activity of 10 Ci/mmol was obtained using the
      above scheme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1621953
TI  - Determination of cysteine plus half-cystine in protein and peptide hydrolysates:
      use of dithiodiglycolic acid and phenylisothiocyanate derivatization.
AB  - Cysteine and half-cystine in proteins and peptides can be determined by acid
      hydrolysis in the presence of dithiodiglycolic acid, derivatization with phenyl
      isothiocyanate, and HPLC separation of the phenylthiocarbamyl amino acids. The
      determination requires no additional sample handling, oxidation, reduction,
      alkylation, or desalting. Samples containing cystine are treated in the same
      manner as those containing cysteine. Derivatization of cysteine or half-cystine
      by dithiodiglycolic acid has no effect on any other amino acids. Recovery of the
      PTC-cysteine derivative is greater than 90% over the linear range of 5 pmol to 1
      nmol. Precision of the cysteine plus half-cystine determination is equivalent to
      that observed for all other amino acids. Structure work on the derivative
      indicates that it is a mixed disulfide containing cysteine and thioglycolic acid.

PMID- 1621954
TI  - Detection and possible origins of aminomalonic acid in protein hydrolysates.
AB  - Aminomalonic acid (Ama) was first detected in alkaline hydrolysates of proteins
      in 1984. In this work we describe our search for the origin of aminomalonic acid
      in alkaline hydrolysates of proteins. We have developed a technique for
      quantitation of aminomalonic acid based upon gas chromatography/mass
      spectrometry. Using this technique, we find approximately 0.3 Ama/1000 amino
      acids in hydrolysates of Escherichia coli protein. We have demonstrated that Ama
      is not formed from any of the 20 major amino acids during the hydrolysis
      procedure. Furthermore, the amount of Ama found does not depend on the presence
      of small amounts of O2 during the hydrolysis. Thus far, we have not been able to
      demonstrate an artifactual origin for Ama. The results described above suggest
      that Ama may indeed be a constituent of proteins before the hydrolysis procedure.
      Possible origins of Ama include errors in protein synthesis and oxidative damage
      to amino acid residues in proteins.

PMID- 1621955
TI  - Magnetic bead purification of M13 DNA sequencing templates.
AB  - A method for the preparation of multiple M13 DNA sequencing templates is
      described. No phenol extraction is required and the procedure can be carried out
      in Eppendorf tubes or 96-well microtiter plates. Starting with a phage
      supernatant, the entire procedure is carried out in the same reaction vessel and
      all separation steps are based on a novel application of magnetic bead
      separation. The design of a 96-well magnetic separator is presented and the
      application of the method for large-scale sequencing is discussed.

PMID- 1621956
TI  - A semi-micromethod for the determination of the extinction coefficients of duplex
      and single-stranded DNA.
AB  - We have developed a rapid and convenient procedure for the determination of
      concentrations and extinction coefficients of oligo- and polynucleotides. It
      offers significant advantages over other methods in terms of precision and the
      ability to detect artifactual or erroneous results. Samples are first completely
      digested with appropriate enzymes to mononucleotides and nucleosides. Using the
      multicomponent linear regression capabilities of commonly available spreadsheet
      programs, the absorbance spectrum of the digest can be analyzed as a linear
      combination of the contribution of the possible constituent monomers. If all the
      spectral components present have been included, the analysis yields the
      concentration of each of the monomer species whose sum is the concentration (in
      monomer units) of the original undigested sample. When combined with the
      predigest absorbance spectrum, the extinction coefficients of the intact sample
      can then be calculated. The analysis also yields the fractional base composition
      of the oligomer or polymer. The extensive spectral data provided by digital read
      outs of modern spectrophotometers permit the application of sensitive tests of
      the goodness of fit, thus facilitating the detection of artifacts and sample
      inhomogeneity. Both single-strand and duplex structures can be analyzed
      comfortably in sample sizes of 25 to 35 nmol (total) of mononucleotides with a
      precision of 1%. The concentrations obtained by this method agree, on the
      average, within 0.2% with those determined by phosphate analysis of the same
      sample. The method also yields the base composition with an accuracy of ca. 5%
      for high-molecular-weight polymers and 2% for short oligomers (15-20 bp) when
      compared to the predicted values.

PMID- 1621957
TI  - Sulfone-aromatic ligands for thiophilic adsorption chromatography: purification
      of human and mouse immunoglobulins.
AB  - New thiophilic matrices and new procedures were used for the purification of
      immunoglobulins both from human serum and from hybridoma cell cultures containing
      fetal calf serum. A range of aromatic and heteroaromatic ligands containing
      hydroxyl or amino groups have been coupled to divinyl sulfone-activated agarose.
      The resulting affinity matrices have the general formula M-O-CH2-CH2-SO2-CH2-CH2
      X-Y, where M is the agarose matrix, X is oxygen or nitrogen, and Y is an aromatic
      or heteroaromatic compound. Contrary to earlier expectations these matrices
      showed pronounced thiophilic binding patterns when tested for the selective
      binding of immunoglobulins from human serum. The binding is influenced by the
      structure of the aromatic part of the ligand, the ligand concentration, and the
      concentration and type of lyotropic salt. 2-Hydroxypyridine coupled to divinyl
      sulfone-activated agarose was used to purify murine monoclonal antibodies (IgG1
      and IgM) from hybridoma cell cultures containing fetal calf serum. Compared to
      previous methods, significantly increased binding capacity (300-1500%) was
      obtained by using 1.0-1.2 M ammonium sulfate. Purity of the monoclonal antibody
      may be optimized for each individual clone by washing the column with either a
      low concentration of ammonium sulfate or polyethylene glycol before elution.

PMID- 1621958
TI  - Simultaneous electroelution of proteins from denaturing or native gels into a
      well matrix.
AB  - An electroelution device that is based on a semidry blotter and that allows the
      simultaneous elution of proteins or other charged macromolecules from one
      dimensional gels is described. It consists of a central plate that has a matrix
      of oblong wells arranged in eight columns of 32 wells each, such that when a gel
      is placed on the plate each lane of bands is underlaid by a column of wells. The
      plate is placed between the electrodes of a semidry blotter and the wells are
      sealed by a dialysis membrane resting on polyacrylamide gel block, prior to being
      filled with transfer buffer. Using radiolabeled molecular weight standards
      resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, elution is
      shown to require 30-60 min for 90% or better of proteins between 10 and 120 kDa
      to be removed from the gel. The recovery volume is 200 microliters per well and
      losses due to adsorption onto the dialysis membrane are minimal. beta
      Galactosidase eluted from a nonreducing, nondenaturing gel was shown to be
      quantitatively active. The advantages of the device include its ease of assembly
      and operation, its speed, its reproducibility, and the fact that no gel slicing
      is required since all proteins are eluted simultaneously, allowing large-scale
      screening of multiple protein fractions.

PMID- 1621959
TI  - A colorimetric method for the quantitation of uronic acids and a specific assay
      for galacturonic acid.
AB  - A method of quantitating uronic acids and uronic acids from pectin in particular
      is described. The method uses carbazole in 80% sulfuric acid with borate ions
      added. The assay is carried out at 60 degrees C. This assay has some cross
      reactivity with aldose sugars and must be timed precisely. A further method that
      is specific for galacturonic acid is also described. This method uses
      concentrated sulfuric acid and carbazole only. Of the biological substances
      tested, only formaldehyde and glyceraldehyde showed a reactivity of more than 10%
      that of galacturonic acid on a weight to weight basis.

PMID- 1621960
TI  - para-sulfobenzoyloxybromobimane: a new membrane-impermeable reagent useful for
      the analysis of thiols and their export from cells.
AB  - para-Sulfonylbenzoyloxybromobimane (sBBr) was shown to be similar to the
      fluorescent labeling agent monobromobimane (mBBr) in reacting rapidly and
      selectively with thiols to produce stable derivatives which are readily separated
      by HPLC. Chromatography of the sBBr derivative provides a useful means of
      confirming the identification of an unknown thiol based upon the chromatography
      of its mBBr derivative and can be useful for quantitative determination of
      polycationic thiols for which chromatography of the mBBr derivative is
      unsatisfactory. Unlike mBBr, which readily penetrates cells, sBBr was found not
      to be taken up by cells. These characteristics allow sBBr to be used, in
      conjunction with mBBr, to quantify the export of thiols from cells, as
      illustrated for GSH and the radioprotective drug WR1065, from V79 cells.
      Simultaneous determination of GSH and glutathione disulfides in cell culture
      medium could be achieved by labeling of thiols with sBBr followed by reduction of
      disulfides with dithiothreitol, labeling of the resulting thiols with mBBr, and
      HPLC analysis for both glutathione derivatives.

PMID- 1621961
TI  - Deuterium exchange on micrograms of proteins by attenuated total reflection
      Fourier transform infrared spectroscopy on silver halide fiber.
AB  - We illustrate the use of polycrystalline silver halide fibers (2-20 microns
      transparency range) for attenuated total internal reflection Fourier transform
      infrared (IR) spectroscopic measurements of microsamples (10 micrograms of
      protein). A powerful adjunct technique is a simple method for carrying out
      deuterium for proton exchange. Spectra of trypsin, soybean trypsin inhibitor, and
      their complex are easily obtained. Two kinds of difference spectra (DS) are
      revealing: DS1 (changes in protein on combination with ligand), IR of the trypsin
      soybean trypsin inhibitor complex (T.SBTI complex)--sigma [IR of trypsin (T) + IR
      of soybean trypsin inhibitor (SBTI)], the small values at all wavelengths
      indicating no conformational change of the proteins upon complexation, and DS2
      (changes in materials on deuteration), IR of protioprotein--IR of
      deuterioprotein, which reveals the infrared bands affected by deuteration. The
      rate and the extent of the exchange are additional valuable parameters readily
      measured with this technique. In the present instance, the rate and the amount of
      the exchange for T.SBTI complex after 30 min was substantially less than that
      expected from the simple sum of the same parameters for the two individual
      proteins, T and SBTI. The enzymatic activity of trypsin on the fiber survived for
      more than a day, no autodegradation being detected by SDS-gel electrophoresis.

PMID- 1621962
TI  - The determination of intracellular sodium concentration in human red blood cells:
      nuclear magnetic resonance measurements.
AB  - The intracellular sodium concentration and intracellular volume of human red
      blood cells were determined from 23Na and 1H NMR spectra. It is shown that sodium
      dissolved in the intracellular water has a concentration higher than that
      previously published. The intracellular sodium concentration measured was 11.4 +/
      3.1 mM. A comparison of different NMR methods used to determine sodium
      concentration is given.

PMID- 1621963
TI  - Radioactive assay of 2,4-dienoyl-coenzyme A reductase.
AB  - A radioactive method for assaying 2,4-dienoyl-CoA reductase, also referred to as
      4-enoyl-CoA reductase (EC 1.3.1.34), is described. The assay measures the
      incorporation of tritium from [4B-3H]NADPH into 2-trans,4-cis-decadienoyl-CoA or
      2-trans,4-trans-decadienoyl-CoA which, after cleavage of the thioester bond with
      hydroxylamine, can be separated from the radioactive coenzyme by extraction with
      toluene. This assay is at least 30 times more sensitive than the
      spectrophotometric assay, even though rates determined by the radioactive method
      are 10 times lower than rates obtained spectrophotometrically due to a primary
      kinetic isotope effect. The linearity of this assay with respect to time and
      protein concentration is sufficient for determining 2,4-dienoyl-CoA reductase
      activities in extracts from small samples of human fibroblasts, which were found
      to contain reductase activities between 1.8 and 5.8 mU/mg of protein.

PMID- 1621964
TI  - Mechanical detection of interaction of small specific ligands with proteins and
      DNA in cross-linked samples.
AB  - Cross-linked crystalline and amorphous films of different proteins and cross
      linked DNA gels were found to change their mechanical properties when soaked in
      solutions of specific ligands at nearly physiological concentrations. This
      chemomechanical effect may be used to rapidly (within a few minutes) detect the
      ability of macromolecules to bind small (less than 1 kDa) ligand molecules, to
      measure concentrations of ligands (higher than 10 nM), and to estimate binding
      constants (lower than 10(7) M-1). Only 0.1-1 mg of protein or DNA is needed to
      prepare more than 10 samples sufficient for a large number of tests, provided
      binding is reversible. The method is recommended for rapid primary screening in
      search of new drugs, in biochemical studies, and as a basis for designing
      biosensors and other analytical instruments.

PMID- 1621965
TI  - Quantification and comparison of chloramphenicol acetyltransferase activity in
      transformed plant protoplasts using high-performance liquid chromatography- and
      radioisotope-based assays.
AB  - Rice and petunia leaf and cell suspension protoplasts were transformed by
      electroporation in the presence of pDW2. This plasmid contains a chloramphenicol
      acetyltransferase (CAT) coding region under the control of a promoter constructed
      from sequences of the cauliflower mosaic virus genome. We have compared two
      different approaches to measuring CAT activity in this system, namely high
      performance liquid chromatography (HPLC) and a radioisotope-based method. Our
      results show that both techniques have a similar detection limit of 10 mU CAT and
      (with an activity greater than 10 mU CAT) the standard error for measuring known
      amounts of CAT activity was less than +/- 12% for both assays. The HPLC
      technique, however, has a greater linear response range of 10-600 mU CAT than the
      radioisotope method, which has a range of 10-400 mU CAT. The HPLC assay also
      requires a shorter assay time. As a result of this work we believe that HPLC is a
      viable alternative to the radioisotope-based assay described.

PMID- 1621966
TI  - Evaluation of aminolysis of anilinothiazolinones to phenylthiocarbamoyl amino
      acid methyl amides as an alternative conversion method in protein sequencing.
AB  - The aminolysis of products of sequential degradation of proteins and peptides by
      methylamine is an alternative method of conversion of the unstable 5-alkyl-2
      anilino-4-thiazolinones into the stable methyl amides of N alpha
      phenylthiocarbamoyl amino acids. The volatility of methylamine permits use in the
      gas phase during both manual and automatic sequential degradation. Two procedures
      were studied: (mode A) aminolysis by methylamine in the sequencer reaction
      chamber after liberation of the thiazolinones by trifluoroacetic acid and (mode
      B) aminolysis by methylamine vapors passed through a 1-chlorobutane solution of
      thiazolinones in the conversion flask of the sequencer. The sequencing program
      was modified for both procedures by making use of the standard sequencer
      functions. The yields of aminolysis in the conversion flask (mode B) are
      comparable to those obtained by standard conversion in 25% trifluoracetic acid
      and the procedure does not affect the repetitive yield. Aminolysis on the glass
      filter (mode A) requires a major modification of the degradation process, yet
      gives higher yields of the degraded amino acid derivatives. A disadvantage of
      both procedures, especially of mode A, is the presence of N-methyl-N'
      phenylthiourea in the methyl amide samples. We have not been able to achieve the
      expected improvement of the yields of degraded hydroxy amino acids. Therefore the
      replacement of acid conversion of anilinothiazolinones to phenylthiohydantiones
      by aminolysis for routine degradation cannot be recommended. High yields of
      methyl amides make aminolysis a promising candidate for the incorporation of
      fluorescent or other labels in the products of sequencing degradation.

PMID- 1621967
TI  - The structure of glutaraldehyde in aqueous solution determined by ultraviolet
      absorption and light scattering.
AB  - The structure of glutaraldehyde (GA) in aqueous solutions has been the subject of
      much debate. Since there were fundamental problems in the experiments in the
      preceding studies, in this article, the structure of GA was investigated with uv
      absorption and light scattering to avoid those problems. It was discovered that
      70% glutaraldehyde solution contains a large quantity of polymeric species with
      cyclic hemiacetal structure. On dilution, the polymerized glutaraldehyde slowly
      converted to monomers. In dilute solution, glutaraldehyde is almost monomeric at
      pH 3-8, the major portion taking the cyclic hemiacetal structure. The structure
      of GA in 20% solution is similar to that in more dilute solution. alpha, beta
      Unsaturated structure does not exist in aqueous solution regardless of the
      concentration of glutaraldehyde.

PMID- 1621968
TI  - Microanalysis of beta-cyclodextrin and glucosyl-beta-cyclodextrin in human plasma
      by high-performance liquid chromatography with pulsed amperometric detection.
AB  - High-performance liquid chromatography with pulsed amperometric detection was
      applied to the determination of beta-cyclodextrin (beta-CD) and glucosyl (G)-beta
      CD in human plasma. They were well resolved from each other and from background
      components of plasma on a polymer-based reversed-phase column with 0.6%
      acetonitrile aqueous solution containing 1 mM sodium hydroxide as an eluent. The
      samples in the effluent were detected with a pulsed amperometric detector after
      postcolumn alkalization. The detection limits of beta-CD and G-beta-CD in plasma
      at a signal-to-noise ratio of 3 were 11 and 5 pmol, respectively.

PMID- 1621969
TI  - Trypsin-induced lysis of lipid vesicles: effect of surface charge and lipid
      composition.
AB  - We have made a curious observation that the proteolytic enzyme, trypsin, induced
      a rapid and complete release of the contents of vesicles composed of
      dioleoylphosphatidylethanolamine (DOPE) and oleic acid (OA). Content release at
      37 degrees C, monitored by the release of an entrapped fluorescence marker
      (calcein), was accompanied by an extensive vesicle aggregation. The lytic
      activity of trypsin on the vesicles depended on pH and liposome composition. The
      optimal pH for vesicle lysis was below pH 7.4, which was different from the
      optimal pH for catalytic activity of trypsin. The lytic activity of trypsin was
      specific for vesicles composed of DOPE and fatty acids such as OA and palmitoleic
      acid; vesicles composed of dioleoylphosphatidylcholine, N-methyl-DOPE, and OA, or
      DOPE combined with other negatively charged lipids such as phosphatidylserine and
      phosphatidic acid were not sensitive to trypsin. Inhibition of enzyme activity by
      trypsin inhibitors did not abolish the lytic activity, suggesting that the lytic
      activity of trypsin is not related to the catalytic activity. However, the lytic
      activity of trypsin on vesicles composed of DOPE and OA was inhibited in the
      presence of excess vesicles containing negative charges, or by a pretreatment of
      trypsin with acylating reagent to reduce the positive-charge content of trypsin.
      These data demonstrate that vesicle aggregation and lysis are the results of
      electrostatic interactions of positive charges on trypsin and negative charges on
      the vesicles. Phase separation and transition to nonbilayer phases of the vesicle
      lipids are likely involved.

PMID- 1621970
TI  - Design and implementation of a particle concentration fluorescence method for the
      detection of HIV-1 protease inhibitors.
AB  - A critical step in the replicative cycle of the human immunodeficiency virus HIV
      1 involves the proteolytic processing of the polyprotein products Prgag and Prgag
      pol that are encoded by the gag and pol genes in the viral genome. Inhibitors of
      this processing step have the potential to be important therapeutic agents in the
      management of acquired immunodeficiency syndrome. Current assays for inhibitors
      of HIV-1 protease are slow, cumbersome, or susceptible to interference by test
      compounds. An approach to the generation of a rapid, sensitive assay for HIV-1
      protease inhibitors that is devoid of interference problems is to use a capture
      system which allows for isolation of the products from the reaction mixture prior
      to signal quantitation. In this paper, we describe a novel method for the
      detection of HIV-1 protease inhibitors utilizing the concept of particle
      concentration fluorescence. Our approach involves the use of the HIV-1 protease
      peptide substrate Ser-Gln-Asn-Tyr-Pro-Ile-Val which has been modified to contain
      a biotin moiety on one side and a fluorescein reporter molecule on the other side
      of the scissile Tyr-Pro bond. This substrate is efficiently cleaved by the HIV-1
      protease and the reaction can be readily quantitated. Known inhibitors of the
      protease were readily detected using this new assay. In addition, this approach
      is compatible with existing instrumentation in use for broad screening and is
      highly sensitive, accurate, and reproducible.

PMID- 1621971
TI  - 31P NMR analysis of red blood cell UDPGlucose and UDPGalactose: comparison with
      HPLC and enzymatic methods.
AB  - The levels of uridine diphosphogalactose (UDPGal) and uridine diphosphoglucose
      (UDPGlu) in trichloroacetic acid extracts of human red blood cells (RBC) were
      measured by 31P NMR spectroscopy. Individual determinations were compared to
      results obtained by enzymatic and high-pressure liquid chromatographic (HPLC)
      methods. The characteristic doublet of the P beta resonance signals of both
      UDPGal and UDPGlu were detected in proton-decoupled spectra of extracts.
      Quantitative analyses were obtained by employing a standard, methylene
      diphosphonate, in an external capillary tube during data acquisition for periods
      of 14 to 24 h using an "inverse-gated" pulse sequence. The ratio of the
      integrated area of each of the uridine sugar nucleotide doublets to the area of
      the external reference peak was linear with concentrations between 0.03 and 0.50
      mM. There was no difference between the mean value obtained by 31P NMR of 6.6 +/-
      1.4 mumol UDPGlu/100 g Hgb or 2.1 +/- 0.6 mumol UDPGal/100 gHgb and the
      corresponding levels determined enzymatically or by HPLC in identical RBC
      extracts. When analyzed as paired data, only UDPGlu by NMR was found to be lower
      than the value obtained by HPLC. As a quantitative analytical tool, NMR
      spectrometry validated both the enzymatic and HPLC methods used for measurement
      of uridine sugar nucleotides in our laboratories.

PMID- 1621972
TI  - Detection of nicotinic receptor ligands with a light addressable potentiometric
      sensor.
AB  - The nicotinic acetylcholine receptor, purified from Torpedo electric organ, was
      coupled to a light addressable potentiometric sensor (LAPS) to form a LAPS
      receptor biosensor. Receptor-ligand complexes containing biotin and urease were
      captured on a biotinylated nitrocellulose membrane via a streptavidin bridge and
      detected with a silicon-based sensor. Competition between biotinylated alpha
      bungarotoxin and nonbiotinylated ligands formed the basis of this assay. This
      biosensor detected both agonists (acetylcholine, carbamylcholine,
      succinylcholine, suberyldicholine, and nicotine) and competitive antagonists (d
      tubocurarine, alpha-bungarotoxin, and alpha-Naja toxin) of the receptor with
      affinities comparable to those obtained using radioactive ligand binding assays.
      Consistent with agonist-induced desensitization of the receptor, the LAPS
      receptor biosensor reported a time-dependent increase in affinity for the agonist
      carbamylcholine as expected, but not for the antagonists.

PMID- 1621973
TI  - A specific and inexpensive assay of radiolabeled long-chain acyl-coenzyme A in
      isolated hepatocytes.
AB  - A simple procedure for determining radiolabeled long-chain acyl-CoA levels in
      isolated rat hepatocytes has been developed. It consists of a classical
      extraction of long-chain acyl-CoAs after preliminary removal of the excess
      labeled free fatty acid. A two-step TLC purification ensures elimination of long
      chain acylcarnitine, the main interferent in most methods, and other common
      lipids. The purity of the acyl-CoA was confirmed by a second TLC system and by
      spectral analysis. Overall recovery was approximately 70%.

PMID- 1621974
TI  - A group additivity model for analyzing absorption spectra of organic compounds:
      applications to partial structural analysis and molecular weight determinations
      of polymers, nucleotides, and peptides.
AB  - A new method for the analysis of organic structural groups from absorption
      spectra is described. The method is based on the integrated intensity of
      absorption. It requires only micrograms of analyzed compound, which may be fully
      recovered after analysis from its solution. The method can be used for different
      kinds of structural and/or kinetic studies. For example, the reaction kinetics
      and tautomeric equilibria can be easily studied by this method. The method can
      also be used for the determination of molecular weight and quantitative
      composition of polymers, nucleotides, and/or peptides. Hydrolysis or
      derivatization of the studied compounds is not necessary. On the basis of this
      method, automatic molecular weight, nucleotide, and peptide analyzers can be
      constructed.

PMID- 1621975
TI  - Solid-phase time-resolved fluorescence detection of human immunodeficiency virus
      polymerase chain reaction amplification products.
AB  - A new assay system for the detection of polymerase chain reaction (PCR)
      amplification products is presented. This single-pot sandwich assay system
      employs solid-support oligonucleotide-coated capture beads, a rare earth metal
      chelate-labeled probe, and a time-resolved fluorescence detection. The new assay
      system was evaluated for various reaction conditions including, DNA denaturation
      time, hybridization salt concentration, probe concentration, and hybridization
      time, all of which are important in designing an assay with a high level of
      sensitivity for the detection of duplex DNA. This nonisotopic assay system was
      applied to the detection of purified human immunodeficiency virus (HIV) DNA and
      sensitivity was compared with agarose gel electrophoresis and slot blot
      hybridization using a 32P-labeled probe. We were able to detect the amplified
      product from one copy of HIV DNA after 35 cycles of PCR amplification in less
      than 30 min using this assay, which compared with one copy by gel electrophoresis
      after 40 cycles of PCR amplification and one copy by slot blot hybridization
      after 35 cycles of PCR amplification and an overnight exposure of the
      autoradiogram. Thus, this assay is rapid, sensitive, and easy to use.

PMID- 1621976
TI  - HPLC analysis of free amino acids and amino acids of total proteins in cultured
      cells: an application to the study of rat Sertoli cell protein metabolism.
AB  - A simple, rapid and, sensitive HPLC method, coupled with fluorometric detection,
      has been worked out and employed to determine the intracellular free amino acid
      concentrations and the amino acid composition of total proteins in rat Sertoli
      cell primary culture. Sertoli cells were isolated enzymatically from testes of 20
      and 28-day-old rats and cultured at 32 degrees C in Eagle's minimum essential
      medium. On the second day of culture, cell monolayers were quickly rinsed with
      ice-cold saline, immediately frozen in liquid nitrogen, accurately harvested, and
      homogenized in 10% trichloroacetic acid. Tissue free amino acids were determined
      in the acidic soluble fraction following neutralization, while the precipitate
      was hydrolyzed for the evaluation of the fractional content of amino acids into
      total proteins. Amino acid samples were derivatized with o-phthaldialdehyde/3
      mercaptopropionic acid and resolved by a linear one-step acetonitrile gradient in
      12.5 mM sodium phosphate buffer, pH 7.2, employing a 5-microns particle size
      reversed-phase column. Fluorescence was monitored with excitation at 330 nm and
      emission at 450 nm. Under these conditions all major physiological amino acids
      could be satisfactory separated, identified, and subsequently quantified with the
      aid of standards. The run time was about 50 min; the linearity was excellent over
      a large range of concentrations (1-800 pmol) and the lower limit of sensitivity
      appeared to be 0.5 pmol. This method permits us to demonstrate age-dependent
      modifications in the intracellular amino acid pool and to adequately evaluate the
      process of protein synthesis in cultured Sertoli cells.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1621977
TI  - Recombination and amplification of multiple portions of genomic DNA by a modified
      polymerase chain reaction.
AB  - A novel method, a modified polymerase chain reaction (mPCR), is reported for in
      vitro recombination and amplification of two or more regions of DNA located in
      distinct parts of a genome such as exons of a gene. The reaction consists of
      three stages. In the first stage, the portions are amplified individually with
      the aid of four or more primers. Of the primers, two (outside primers) are
      complementary to 3'-terminal parts of the objective, recombinant DNA, and the
      others (inside primers) are complementary to 3'-terminal parts of the other
      portions. Some of the inside primers have extra nucleotide sequences at their 5'
      termini which are complementary to 5'-terminal parts of the portions to be
      recombined. In the second stage, the strands with complementary sequences in
      their 3'-terminal parts are annealed sequentially to one another and are
      converted to recombinant DNA with DNA polymerase. In the final stage, the
      objective DNA is amplified with the excess outside primers. The application of
      this method for in vitro recombination and amplification of three exons of the
      gene for human muscle-specific phosphoglycerate mutase is described.

PMID- 1621978
TI  - Solubilized substrates for the on-line measurement of lipases by flow injection
      analysis during chromatographic enzyme purification.
AB  - A flow injection analysis (FIA) system for the on-line measurement of lipases in
      chromatographic processes has been developed. The photometrically detectable
      substrates para-nitrophenylpalmitate, S,O,O'-tripropyryl-1-thioglycerol, and 1,2
      O-dilauryl-rac-glycero-3-glutaric-resorufinester were investigated. Different
      detergents and qualities of assay emulsions were tested for optimal results in
      FIA applications. Emphasis was placed on increasing the stability of the assay
      emulsion. Lipases of different origin and specificity were detected. The linear
      detection range was adapted to the requirements of the chromatographic
      purification procedures. The connection of the FIA with a fast protein liquid
      chromatography system permitted the automatization of lipase purification by
      monitoring protein content, salinity, and enzyme activity of the effluent from
      column chromatography.

PMID- 1621979
TI  - Evaluation of a procedure for the simultaneous determination of oxidized and
      reduced pyridine nucleotides and adenylates in organic phenol extracts from
      mitochondria.
AB  - An extraction procedure using mixtures of phenol, chloroform, and isoamyl alcohol
      originally applied to quench mitochondria for determining adenylates proved
      suitable also for the quantification of reduced and oxidized pyridine nucleotides
      yielding recoveries of more than 90%. In combination with HPLC, this approach
      allows the simultaneous determination of NAD+, NADP+, NADH, and NADPH as well as
      of adenylates within one extract. A comparison of this extraction method with
      fluorimetric measurements of pyridine nucleotide reduction in intact mitochondria
      revealed that about 30% of the fluorescence signal in the resting state of liver
      mitochondria is caused by NADPH.

PMID- 1621980
TI  - Lectin-based homogeneous enzyme-linked binding assay for estimating the type and
      relative amount of carbohydrate within intact glycoproteins.
AB  - The feasibility of using a new lectin-based homogeneous enzyme-linked binding
      assay for estimating the type and relative amount of specific carbohydrate
      structures within intact glycoproteins is examined. Malate dehydrogenase
      galactose, -mannose, and -N-acetylglucosamine conjugates are utilized in
      conjunction with Jacalin, concanavalin A, and wheat germ agglutinin,
      respectively. The catalytic activity of the glyco-enzyme conjugates is inhibited
      significantly (greater than 60%) in solution in the presence of the respective
      lectins. The observed inhibition for each reagent set is reversed in proportion
      to the type and relative amount of specific carbohydrates present within test
      glycoproteins added to the assay mixture. Competitive binding ED50 values for a
      number of synthetic and native model glycoproteins correlate well with the known
      carbohydrate content of these species. The proposed method is much faster than
      previous solid-phase lectin-based enzyme-linked methods used to probe
      carbohydrate content/structure (less than 15 min) and has the potential to be
      fully automated.

PMID- 1621981
TI  - Polyisobutylmethacrylate modifies glycolipid binding specificity of verotoxin 1
      in thin-layer chromatogram overlay procedures.
AB  - Verotoxins (or Shiga-like toxins) are a family of closely related toxins
      elaborated by Escherichia coli. At least three toxins have been described, VT1,
      VT2, and SLTII, in addition to Shiga toxin itself, and all bind to globotriaosyl
      ceramide, Gb3. Some discrepancies exist in the literature regarding the binding
      of the toxins to Gb4 as monitored by TLC overlay procedures. These procedures are
      widely used to investigate the specificity of carbohydrate-binding ligands.
      Polyisobutylmethacrylate, PIBM, is generally used in TLC overlay procedures to
      prevent silica loss and orient carbohydrate moieties for the binding of various
      ligands to glycolipids. We now report that pretreatment of chromatograms with
      PIBM modifies binding of VT1 to include Gb4 and decreases binding to Gb3 and the
      P1 glycolipid. We suggest that PIBM can alter the conformation of the glycolipid
      oligosaccharide, and therefore caution is advised in analysis of ligand binding
      to glycolipids after treatment with this compound.

PMID- 1621982
TI  - The 5'-terminal phosphates slow migration of single-stranded DNA fragments during
      electrophoresis in nondenaturing acrylamide gels.
AB  - Removal of the 5'-terminal phosphate results in an observable acceleration of the
      migration of single-stranded DNA fragments in the course of electrophoresis in
      nondenaturing acrylamide gels. This effect was observed with fragments 30-450
      nucleotides in length. The relative difference in the migration of
      dephosphorylated and phosphorylated fragments depends on their length and primary
      structure and on the conditions of electrophoresis. The distinct mobility can
      advantageously be used to determine the level of terminal phosphorylation of DNA
      fragments during the work with phosphatases and polynucleotide kinases.

PMID- 1621983
TI  - Use of Marfey's reagent to quantitate racemization upon anchoring of amino acids
      to solid supports for peptide synthesis.
AB  - A chromatographic assay has been developed to quantitate racemization occurring
      during attachment of protected amino acids to peptide synthesis resins.
      Acidolytic cleavage of deprotected amino acids from supports and subsequent
      derivatization with 1-fluoro-2,4-dinitrophenyl-5-L-alanine amide (Marfey's
      reagent) gave diastereomers separable by reverse-phase HPLC using aqueous
      acetonitrile. The assay is reliable to 0.1% racemate with a detection limit of
      approximately 100 pmol. The technique was applied to several acid-labile resins
      and was used to evaluate the racemizing characteristics of various anchoring
      methods.

PMID- 1621984
TI  - Detection, isolation, and characterization of oligo/poly(sialic acid) and
      oligo/poly(deaminoneuraminic acid) units in glycoconjugates.
AB  - We have evaluated methods for separation, preparation, and characterization of
      alpha-2----8-linked oligomers of sialic acids (Neu5Ac and Neu5Gc) and deaminated
      neuraminic acid (KDN; 2-keto-3-deoxy-D-glycero-D-galacto-nononic acid) recently
      found as a naturally occurring novel type of sialic acid analogue. (A) We
      examined preparative anion-exchange chromatography for fractionation and
      preparation of oligo(Neu5Ac), oligo(Neu5Gc), and oligo(KDN). (B) We also examined
      the TLC method for separation and differentiation of the partial acid
      hydrolysates of colominic acid, as well as polysialoglycoproteins (PSGP) and
      poly(KDN)-glycoproteins (KDN-gp) isolated from rainbow trout eggs, and for
      discrimination of lower oligomers of Neu5Ac, Neu5Gc, and KDN. (C) We developed
      the high-performance adsorption-partition chromatographic method for (a)
      separation of monomers and oligomers of three nonulosonates according to the
      difference in substituents at C-5 and the presence or absence of 9-O-acetyl
      groups in oligo(KDN) and (b) separation of three homologous series of lower
      oligomers according to the degree of polymerization. (D) We examined and compared
      high-performance anion-exchange chromatographic separation of 3H-labeled
      oligo(Neu5Ac), oligo(Neu5Gc), and oligo(KDN) alditols by using Mono-Q HR 5/5
      resin. (E) We examined a method of selective and quantitative microprecipitation
      for separation and purification of oligomers and polymers of Neu5Ac by treating
      them with cetylpyridinium chloride. We also used PSGP and KDN-gp to test both the
      sensitivity and the selectivity of this method.

PMID- 1621985
TI  - Detection of catalytic monoclonal antibodies.
AB  - Several laboratories have now shown that monoclonal antibodies having enzyme-like
      properties can be generated. The generation of catalytic antibodies makes use of
      the same basic procedures that have been used for the generation of binding
      monoclonal antibodies, yet the process involves an additional crucial step:
      screening for catalytic activity. In this paper we address the unique problems
      involved in the detection of inefficient catalytic activity that is accompanied
      by uncatalyzed background reaction. An analysis that allows optimization of assay
      conditions and estimation of the minimal antibody concentration required to
      observe catalysis is presented. The results indicate that the structure of the
      substrate should be optimized to increase its affinity (i.e., decrease its Km)
      and reduce its concentration to pseudo-first-order conditions (S(O) much less
      than Km) so that the signal observed in the presence of a catalytic antibody
      (delta Pcat) is significantly higher than that of the background (delta
      P(uncat)). Other factors involved in the screening procedures, e.g., sensitivity
      of the assay, solubility and reactivity of the substrate, and purity of the
      antibody preparation, are also discussed. The effect of these assay parameters on
      the ability to detect catalytic activity is demonstrated with p-nitrophenyl ester
      hydrolyzing antibodies.

PMID- 1621986
TI  - A general method for preparation of peptides biotinylated at the carboxy
      terminus.
AB  - A method for the preparation of a biotinylated resin that can be elongated by
      standard methods of solid-phase peptide synthesis to give peptides biotinylated
      at the carboxy terminus is described. This methodology is particularly important
      for the preparation of biotinylated peptides in which a free amino terminus is
      required. Coupling of N epsilon-9-fluorenylmethoxycarbonyl-(Fmoc)-N alpha-tert
      butyloxycarbonyl(Boc)-L- lysine to p-methylbenzhydrylamine resin, followed by
      removal of the Fmoc protecting group and reaction with (+)-biotin-4-nitrophenyl
      ester yielded N alpha-Boc-biocytin-p-methyl-benzhydrylamine resin. The utility of
      this resin was tested by the synthesis of a biotinylated peptide, Gly-Asn-Ala-Ala
      Ala-Ala-Arg-Arg-biocytin-NH2, for use as an in vitro substrate for myristoyl
      CoA:protein N-myristoyltransferase (NMT), the enzyme that catalyzes protein N
      myristoylation. Analysis of the peptide derivative by HPLC and mass spectrometry
      revealed a single major product of the expected mass, indicating that the biotin
      group survived cleavage and deprotection with HF. The biotinylated peptide served
      as a substrate for NMT, and the resulting myristoylated peptide could be
      quantitatively recovered by adsorption to immobilized avidin.

PMID- 1621987
TI  - Characterization of human follicle-stimulating hormone binding to human granulosa
      cells by an immunoenzymological method.
AB  - An original, nonradiometric method has been developed for studying the binding
      parameters of native follicle-stimulating hormone (FSH) to its specific receptors
      in human ovarian granulosa cells. After binding and washing of the cells, hFSH
      was desorbed from its receptors and quantitatively measured by a specific enzyme
      immunoassay (EIA) in which nonspecific binding was estimated in the presence of
      an excess of equine chorionic gonadotropin (eCG/PMSG), which binds to human FSH
      receptors but does not interfere in the hFSH EIA. This method makes use of native
      nonmodified hFSH molecules (in contrast to radiometric methods) and permits
      direct estimation of the binding parameters (Kd and total number of sites). The
      Kd of hFSH for its human granulosa receptors measured by this technique (4.8 +/-
      0.3 x 10(-10) M) is close to that determined by other methods. However, we found
      a total number of specific FSH receptors per granulosa cell (1 to 6 x 10(4)
      higher than that reported by others by Scatchard analysis of competition dose
      response curves in radioreceptor assays. The method is also sensitive enough to
      measure the in vivo occupancy of receptors by endogenous hFSH, which was found to
      be less than 6% in women undergoing hormonal treatment for in vitro
      fertilization.

PMID- 1621988
TI  - Detection of amplified HTLV-I/-II viral sequences using time-resolved
      fluorometry.
AB  - Since its discovery, the polymerase chain reaction (PCR) has been used for
      different purposes in the field of DNA research. We tested the PCR for the
      diagnosis of HTLV-I/-II infections. PCR was used to amplify 141- and 149-base
      pair regions from the HTLV-I and HTLV-II virus genomes, respectively. The
      annealing temperature in the PCR amplification was optimized using 20%
      polyacrylamide gels and silver staining. Even a slight change (3 degrees C) in
      the annealing temperature had an effect on the specificity of the reaction. The
      PCR products were detected with biotin and Eu-labeled oligonucleotide probes in a
      solution hybridization format. The linearity of the assay was tested with serial
      dilutions of purified chromosomal DNA containing integrated HTLV-II sequences.
      The linearity was found to be dependent on the number of cycles used in the PCR
      amplification. The best linearity, at a target level of a few copies, was
      achieved using a low number of cycles. The specificity of the assay was tested
      using HTLV-I and HTLV-II-infected lymphocytes from the cell lines Hut102 and
      MO480, respectively. No cross reactivity between these analytes was observed.

PMID- 1621989
TI  - Synthesis of (6S)-5-formyltetrahydropteroyl-polyglutamates and interconversion to
      other reduced pteroylpolyglutamate derivatives.
AB  - 5-Formyltetrahydropteroylpolyglutamates can be synthesized and purified directly
      from dihydropteroylpolyglutamates in a single-step procedure without purification
      of intermediates and with yields greater than 90%. The procedure involves a
      coupled enzymatic synthesis of 10-formyltetrahydropteroylpolyglutamates using the
      enzymes dihydrofolate reductase, serine hydroxymethyltransferase, and C1
      tetrahydrofolate synthase with catalytic amounts of NADPH. The 10
      formyltetrahydropteroylpolyglutamates are subsequently converted to 5
      formyltetrahydropteroylpolyglutamates at 90 degrees C with near quantitative
      yields. 5-Formyltetrahydropteroylpolyglutamates are the only stable reduced
      derivatives of tetrahydropteroylpolyglutamates and can be purified and stored
      indefinitely without decomposition. Additionally, 5
      formyltetrahydropteroylpolyglutamates can be readily converted to other
      derivatives of tetrahydropteroylpolyglutamates with yields greater than 95%. Also
      described is the synthesis of tetrahydropteroylglutamates labeled at C-11 with
      either 14C or 13C. Rapid purification procedures for serine
      hydroxymethyltransferase and C1-tetrahydrofolate synthase from frozen rabbit
      livers are presented.

PMID- 1621990
TI  - Extraction and isolation of mRNA from adult articular cartilage.
AB  - We have developed a method to isolate RNA in high yield from adult articular
      cartilage. Homogenization of the articular cartilage with a freezer mill,
      extraction with 4 M guanidinium isothiocyanate/acid-phenol, and
      ultracentrifugation in cesium trifluoroacetate was found to be an effective and
      practical method for isolating a high yield of intact RNA from adult canine
      articular cartilage. The total RNA was suitable for Northern blot analysis. The
      mRNA that could then be isolated by oligo-dT affinity chromatography was found to
      be a suitable substrate for in vitro translation, for making a cDNA library, and
      for PCR amplification.

PMID- 1621991
TI  - A transfer membrane method for in situ detection and quantification of trehalase.
AB  - A method for the detection and quantification of trehalase activity (EC 3.2.1.28)
      by immobilization to a membrane support has been developed. Protein samples
      partly enriched for porcine and Galleria mellonella wax moth larvae trehalase
      activities were fractionated by polyacrylamide gel electrophoresis, followed by
      electrophoretic transfer to PVDF membranes, and incubated in a solution
      containing trehalose (20 mg/ml), glucose oxidase (40 U/ml), phenazine
      methosulfate (0.06 mg/ml), and nitro blue tetrazolium (0.24 mg/ml) in 20 mM
      sodium phosphate buffer, pH 6.5. The intensity of the red-colored bands,
      developed directly on the membrane, was quantified using a computing, laser
      densitometer and shown to be linearly proportional to the original enzyme
      activity in extracts determined by liquid assay. The temperature inactivation
      profile of wax moth trehalase was measured. Alteration of the electrophoresis
      sample buffer composition further revealed the presence of putative trehalase
      isoforms in wax moth larval extracts whose relative levels of activity were
      altered during the course of starvation and infection with Tipula iridescent
      virus.

PMID- 1621992
TI  - Polymeric porogens used in the preparation of novel monodispersed macroporous
      polymeric separation media for high-performance liquid chromatography.
AB  - A novel approach to monosized macroporous polymeric separation media with vastly
      enhanced pore size distributions and chromatographic properties has been
      developed. Key to this approach is the combined use of monodispersed polymeric
      particles and suitable solvents as porogens in the copolymerization of styrene
      and divinylbenzene. Following polymerization, the polymeric porogen is dissolved,
      leaving behind the monosized beads with a controlled pore structure. The exact
      pore size and pore size distribution of the final beads are largely controlled by
      the amount of soluble polymer in the polymerizing mixture: the larger the
      proportion of soluble polymer in the system, the larger the pores. The uniformly
      sized macroporous beads prepared with an optimized ratio of polymeric and low
      molecular weight porogens proved to be very efficient even in short columns for
      the separation of polystyrene standards in the SEC mode and the separation of
      proteins in the reversed-phase mode. The relationship between pore size and
      specific surface area, on one hand, and chromatographic properties of the
      stationary phase, on the other, have been clearly documented.

PMID- 1621993
TI  - Electrochemical characteristics of amino acids and peptides derivatized with
      naphthalene-2,3-dicarboxaldehyde: pH effects and differences in oxidation
      potentials.
AB  - The electrochemical oxidations of the cyanobenz[f]isoindole (CBI) derivatives of
      18 amino acids and 15 peptides, including enkephalins and several enkephalin
      fragments, were studied. Cyclic voltammetry indicated that the oxidation
      potentials of derivatized amino acids were virtually independent of pH. The
      utility of this pH-independence was demonstrated by controlling, through varying
      the pH, the selectivity with which CBI derivatives could be detected in the
      presence of phenolic compounds. In addition, hydrodynamic voltammograms of
      derivatized amino acids and peptides were constructed from chromatographic data
      and compared. The E1/2 values among the derivatized amino acids covered a range
      of 215 mV, with the derivatives of the basic amino acids being the easiest to
      oxidize and those of the acidic amino acids being the most difficult to oxidize.
      The E1/2 values of the derivatized peptides examined varied by 270 mV, with minor
      variations in structure capable of producing marked changes in oxidation
      potential. These results indicate that voltammetry can aid in identification or
      selective detection of CBI derivatives of amino acids or peptides.

PMID- 1621994
TI  - Evaluation of transient responses of ammonia-selective potentiometric electrodes
      for quantitative applications.
AB  - An error-compensating, predictive kinetic method is adapted and evaluated for
      quantitative applications based on transient responses from an ammonia-selective
      electrode. Transient data collected during the early part of the electrode
      response are used with a curve-fitting method and appropriate mathematical models
      to predict the signal that would be measured if the response were monitored to
      equilibrium. Several different theoretical and empirical models were evaluated,
      and all but one of the models tested permitted reliable prediction of equilibrium
      potentials for most responses. Predicted values of equilibrium signal were close
      to measured values and exhibited the expected logarithmic dependence on ammonia
      concentration in the range from 0.1 to 100 mmol/L. Slopes of calibration plots E
      infinity vs log C, varied from about 50.5 to 65.0 mV per decade with an average
      value of 56.9 +/- 4.2 mV per decade. Quantitative data are used to rank the
      different models in terms of their utility for kinetic-based determinations of
      ammonia by using the ammonia-selective electrode.

PMID- 1621996
TI  - Random breakage.

PMID- 1621995
TI  - Steric factors affecting the discrimination of isomeric and structurally related
      olefin gases and vapors with a reagent-coated surface acoustic wave sensor.
AB  - An investigation of steric factors affecting the olefin-olefin selectivity of a
      surface acoustic wave (SAW) sensor coated with reagents of the general formula
      trans-PtCl2(ethylene)-(substituted-pyridine) is described. Detection is based on
      the mass increase accompanying replacement of ethylene by other gas-phase olefins
      to form the corresponding olefin-substituted products. Selectivity depends on the
      relative reaction rates of the different olefins. Within series of structurally
      similar butenes, acrylates, and aromatic olefins, unusually high selectivity is
      observed for the less hindered olefins and complete discrimination of isomers is
      achieved in certain cases. Replacing pyridine by 2-methylpyridine and 2,6
      dimethylpyridine in the reagent complex progressively reduces the sensor
      response. Sensitivities increase with increasing temperature and limits of
      detection ranging from about 2 to 70 micrograms/L are achieved with modest
      heating (30-40 degrees C) using a 30-MHz SAW oscillator. Initial results with a
      52-MHz sensor shows a 3.4-fold increase in sensitivity compared to the 30-MHz
      sensor in rough agreement with theory.

PMID- 1621997
TI  - Collisionally induced dissociation in the study of A-ring hydroxylated vitamin D
      type compounds.
AB  - Collisionally induced dissociation (CID) is often used to determine the structure
      of ions based on comparison with the CID spectra of known ions. The latter are
      generated from judiciously selected compounds taking into account basic
      principles of ion chemistry. We report here on the use of this approach toward
      determination of the site of A-ring hydroxylation of vitamin D. Although not
      intrinsically an aromatic compound, vitamin D gives rise in its mass spectrum to
      an aromatic methylstyryl cation at m/z 118. A-ring hydroxylated metabolites of
      vitamin D would thus incorporate the extra OH group on the ion at m/z 118,
      shifting it to m/z 134. The position of substitution of the extra OH group on a
      metabolite could then be ascertained by comparing the CID spectrum of its m/z 134
      fragment to those of the four possible (hydroxymethyl)styryl cations generated
      from synthesized authentic compounds. Because of their propensity to polymerize,
      these cations were generated in situ via the McLafferty rearrangement of the
      corresponding (hydroxyphenyl)ethanols. For optimum differentiation of isomeric
      ions, preparation of permethylated derivatives of vitamin D was necessary. The
      validity of the hypothesis was verified using 1,25-dihydroxy-vitamin D3 as a test
      compound. This method provides a viable approach for the characterization of A
      ring hydroxylated metabolites of vitamin D as well as for related aromatic
      compounds.

PMID- 1621998
TI  - Supercritical carbon dioxide extraction of 2,4-dichlorophenol from food crop
      tissues.
AB  - Supercritical fluid extraction with carbon dioxide has been found to be effective
      for the isolation of residue levels (0.1-1 ppm) of 2,4-dichlorophenol from
      selected plant tissues. The 2,4-dichlorophenol residues were incompletely
      extracted with supercritical CO2 alone, since a substantial fraction of the 2,4
      dichlorophenol was covalently attached to the plant matrix. An acid pretreatment
      procedure was developed to partially hydrolyze the plant tissue prior to
      extraction, releasing the bound 2,4-dichlorophenol residues. Steam distillation
      showed higher residue levels for field-treated straw samples. This is attributed
      to the greater degree of hydrolysis inherent in the steam distillation procedure.
      Supercritical CO2 extraction of field-treated seed samples showed higher levels
      of 2,4-dichlorophenol residues than did steam distillation. The supercritical
      fluid extractant was able to solvate 2,4-dichlorophenol residues in the interior
      of the seed and transport them to the surface for collection. The aqueous medium
      used in steam distillation was unable to penetrate the hydrophobic seed matrix to
      the same degree. While the actual extraction time experienced in supercritical
      fluid extraction was far less than that of steam distillation (45 min vs 6 h,
      respectively), the total sample preparation time was similar in both methods.

PMID- 1622000
TI  - Development of an eluotropic series for the chromatography of Lewis bases on
      zirconium oxide.
AB  - Ligand-exchange interactions, which dominate the retention characteristics of
      Lewis base solutes on zirconium oxide, can be strongly attenuated by the addition
      of a competing Lewis base to the eluent. The chromatographic effects of these
      competing bases vary significantly in their thermodynamics and kinetics depending
      on their structure and Lewis basicity. An eluotropic scale of mobile-phase
      strength for ligand-exchange/ion-exchange chromatography on zirconia has been
      developed which ranks the overall elution strength of a variety of Lewis bases in
      terms of their ability to elute a wide variety of benzoic acid derivatives. This
      series generally holds true for similar solutes; however, deviations are noted
      with some solutes and eluents where chelation and steric factors alter the
      kinetic and thermodynamic characteristics of the retention process.

PMID- 1621999
TI  - The role of Lewis acid-base processes in ligand-exchange chromatography of
      benzoic acid derivatives on zirconium oxide.
AB  - Porous microparticulate zirconium oxide shows very different selectivities and pH
      dependencies for the separation of benzoic acid derivatives than do conventional
      bonded-phase anion-exchange supports. This results from a very significant ligand
      exchange contribution to the retention of hard Lewis bases on the surface of
      transition-metal oxide supports. We have found that the capacity factors of a
      wide variety of derivatives of benzoic acid are closely correlated with their
      Bronsted acidities. The eluent pH is also a critical factor in determining the
      magnitude of the capacity factor, but it does not have much influence on
      chromatographic selectivity. The differential selectivity of this phase in
      comparison to conventional polymeric and bonded-phase anion exchangers can be
      attributed to complexation and steric effects which profoundly alter the elution
      patterns of certain solutes.

PMID- 1622001
TI  - Peptide mapping of complex proteins at the low-picomole level with capillary
      electrophoretic separations.
AB  - A variety of different peptide-mapping schemes are presented, with emphasis on
      the development of procedures which can be done with limited quantities (i.e. 5
      pmol) of protein. Results are obtained from model proteins which contain
      disulfide bonds, which must be broken prior to fragmentation of the protein. A
      reaction involving the simultaneous use of tributylphosphine and 2
      methylaziridine to reduce and alkylate the disulfide bonds is employed, due to
      favorable attributes of these reagents for the scaled-down procedure. The
      traditional performic acid oxidation reaction to cleave cystine groups is also
      successfully used with low-picomole quantities of protein. Three different
      protein digestion reagents are used: trypsin, chymotrypsin, and cyanogen bromide.
      Each reagent produces a unique mixture of peptides. Capillary electrophoresis is
      used to separate the peptides, offering high separation efficiencies, short
      analysis times, and compatibility with small sample sizes. In addition to the
      conventional use of UV detection for underivatized peptides, laser-induced
      fluorescence detection is employed in conjunction with an arginine-selective
      derivatization reaction. This latter procedure for derivatization and detection
      offers an alternative peptide-mapping mode, in which only the arginine-containing
      peptides are detected, and is useful in simplifying the peptide maps of large
      proteins.

PMID- 1622002
TI  - Hartley/Hilbert transform spectroscopy: absorption-mode resolution with magnitude
      mode precision.
AB  - Fourier transformation (FT) of an N-point time-domain discrete signal produces,
      after phase correction, two independent data sets: an N/2-point absorption
      spectrum, A(omega), and an N/2-point dispersion spectrum, D(omega), each with the
      same information content. Usually only A(omega) is kept. The dispersion-mode
      information has conventionally been recovered in either of two ways. First, the
      N/2-point magnitude-mode spectrum, M(omega) = ([A(omega)]2 + [D(omega)]2)1/2,
      offers a square root of 2 improvement in precision compared with the original N/2
      point absorption spectrum, but with poorer resolving power (factor ranging from
      square root of 3 to 2 for unapodized data). Alternatively, zero-filling the
      initial time-domain data to 2N data points prior to Fourier transformation
      results in an N-point absorption-mode spectrum with the same peak width and peak
      height-to-noise ratio as the original N/2-point absorption spectrum, but with a
      square root of 2 improvement in precision. Thus, magnitude-mode display improves
      FT spectral precision at the expense of a loss in resolving power, whereas zero
      filling improves precision at the expense of having to store twice as many data
      points. In this paper, we present a third method of recovering the dispersion
      information.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622003
TI  - Tandem mass spectrometric analysis of peptides at the femtomole level.
AB  - In the sequential analysis of peptides by fast atom bombardment (FAB) tandem mass
      spectrometry (MS/MS), the principal obstacle to decreasing sample quantities was
      determined to be the signal-to-background ratio of the ionization/desorption
      process. By decreasing the background ion current, continuous-flow FAB allows
      complete analysis (both MS and MS/MS) to be performed on 25-75% less sample than
      required for a conventional FABMS/MS experiment alone. The combination of CF-FAB
      with array detection permitted sequential analysis of several peptides (900-2000
      Da) at the 900 fmol to 5.8 pmol level, without interference from the background.
      These levels do not produce a molecular ion species easily discernible above the
      background in conventional FAB.

PMID- 1622004
TI  - Raman spectrometry with metal vapor filters.

PMID- 1622005
TI  - Sensitive, laser-assisted determination of complex oligosaccharide mixtures
      separated by capillary gel electrophoresis at high resolution.

PMID- 1622006
TI  - Technique for packing the perineal wound after a wide perineal dissection for
      adenocarcinoma of the rectum.
AB  - A technique for packing the perineal wound after a wide perineal dissection
      performed as part of an abdominoperineal resection is described. An isolation bag
      is filled with rolled gauze and positioned in the pelvis beneath the sacral
      promontory. The packing and the bag are removed on the fifth postoperative day.
      This technique is safe and more tolerable to patients with an open perineal wound
      after an abdominoperineal resection.

PMID- 1622007
TI  - Selective versus routine antibiotic use in acute appendicitis.
AB  - Whether prophylactic antibiotics should be employed routinely in all patients
      with presumed appendicitis rather than be administered selectively to those with
      suspected perforation remains a controversial issue. The outcome of 312 adult
      patients undergoing appendectomy during periods of selective (I, n = 153) and
      routine (II, n = 159) antibiotic use were compared. Although the rates of
      misdiagnosis were comparable (9% vs 13%), significantly more patients with
      appendicitis in Period II had perforated appendicitis (29 of 139 vs 44 of 139, P
      less than 0.05). Prophylactic antibiotics were given to 43 (28%) patients in
      Period I compared to 132 (83%) in Period II (P less than 0.001). This, increased
      frequency was true for both simple (21% vs 81%, P less than 0.001) and perforated
      (66% vs 86%, P less than 0.05) appendicitis. A single antibiotic, most frequently
      a cephalosporin, was used significantly more often in Period II (44% vs 82%, P
      less than 0.001). There was no significant difference in the methods of wound
      closure between the two periods. The incidence of infectious complications was
      similar in patients with simple appendicitis in both periods (8% vs 11%), but it
      was significantly greater during Period I in patients with perforated
      appendicitis (45% vs 20%, P less than 0.05). The overall infection rate was
      similar in both periods (16% vs 22%). Thus, high-risk patients with perforated
      appendicitis were more likely to receive antibiotics and had a lower infection
      rate with routine antibiotic use. Furthermore, there was no overall change in the
      infection rate during this period, despite the use of less toxic, single drug
      regimens and a greater percentage of perforated appendicitis.

PMID- 1622008
TI  - Gangrenous cholecystitis: five patients with intestinal obstruction.
AB  - Gangrenous cholecystitis, a disease more common in older patients and diabetics,
      may be complicated by perforation, pericholecystic abscess, and fistula.
      Intestinal obstruction has rarely been reported as a complication and only in
      cases involving perforation or acute, nongangrenous cholecystitis. A
      retrospective review of hospital records between 1961 and 1989 identified 126
      patients with gangrenous cholecystitis, five of whom came to the hospital with
      intestinal obstruction. Three were cases of paralytic ileus and two of simple
      mechanical obstruction without perforation. The latter group may represent the
      first such cases reported. Gallbladder perforation occurred in two patients and
      cholelithiasis was found in three. The mean age of the total patient cohort was
      70.6 years; patients were predominantly male and black. Hypertension and diabetes
      were common concomitant diseases. Patients commonly came to the hospital with
      nausea and vomiting, increasing abdominal girth, and obstipation. A leukocytosis
      on admission was more common than fever or hyperbilirubinemia. The clinical
      presentation of intestinal obstruction and the lack of objective data specific
      for gangrenous cholecystitis made a preoperative diagnosis impossible. Thus, a
      high index of suspicion should increase diagnostic accuracy. The incidence of
      intestinal obstruction (at presentation) in cases of gangrenous gallbladders was
      4 per cent. Morbidity and mortality are reduced with early operation.

PMID- 1622009
TI  - Perforated ulcers related to smoking "crack" cocaine.
AB  - This article describes four patients with perforated gastroduodenal ulcers
      related to smoking "crack" cocaine. All patients came to the hospital with acute
      abdominal pain; only one patient had a history of ulcer disease. Only one patient
      had an elevated white blood cell count, and two patients had depressed white
      blood cell counts. In three patients, the x ray showed that pneumoperitoneum was
      present. Upon surgical exploration of the abdomen, all patients were found to
      have extensive peritoneal contamination. Operative repair consisted of omental
      patching with or without primary closure of the perforation. A history of cocaine
      smoking should be sought in patients with unexplained abdominal pain or
      pneumoperitoneum. In patients with acute abdominal pain and a history of smoking
      cocaine, a perforated gastroduodenal ulcer may be present, despite normal or low
      white blood cell counts and the lack of pneumoperitoneum on x-ray examination.

PMID- 1622010
TI  - Subtotal colectomy as a last resort for unrelenting, unlocalized, lower
      gastrointestinal hemorrhage: experience with 12 cases.
AB  - A 7-year experience involving 12 cases of massive, unrelenting lower
      gastrointestinal hemorrhage is presented. In these patients, the bleeding could
      not be localized by multiple diagnostic modalities and was managed by blind
      subtotal colectomy. While the procedure was efficacious in arresting bleeding in
      all cases, a resultant mortality of four cases (33%) ensued. Morbidity among the
      survivors was significant. Only three patients (25%) survived without
      complications, which enabled an early discharge from the hospital. Diverticulosis
      was the most common cause (83%) of uncontrollable and preoperatively undiagnosed
      bleeding in this group of patients. These 12 cases of blind subtotal colectomy
      for massive lower gastrointestinal bleeding represent one of the larger series in
      the literature. These data are consistent with more recent reports that indicate
      that subtotal colectomy for lower gastrointestinal bleeding is an effective but a
      formidable procedure. This is contrary to the earlier published results.

PMID- 1622012
TI  - Absence of intestinal bile promotes bacterial translocation.
AB  - Previously, the authors documented that extrahepatic biliary obstruction promotes
      the systemic translocation of bacteria from the intestine to visceral tissues.
      The current experiments were performed to determine whether it was the absence of
      intestinal bile or the presence of biliary obstruction that promoted bacterial
      translocation. Four groups of rats were studied: 1) nonoperated controls (n =
      20), sham common bile duct-ligated (n = 22), common bile duct-ligated (n = 25),
      and common bile duct-diverted (choledochovesical bypass) (n = 23). The sham
      ligated group underwent laparotomy and manipulation of the portal region; whereas
      the ligated group had their common bile ducts ligated, while the
      choledochovesical group had a silastic tube placed from the common bile duct to
      the bladder. Seven days later, at death, the incidence of bacterial translocation
      was higher in the groups of rats subjected to common bile duct ligation (41%) or
      diversion (32%) than in the control (3%) or sham-ligated (5%) groups (P less than
      0.05). Histologic sections of ileums of ligated and diverted animals both showed
      subepithelial edema. These findings suggest that it is primarily the absence of
      bile in the intestine that promotes mucosal injury and bacterial translocation
      and not biliary obstruction.

PMID- 1622011
TI  - Management of benign, giant gastric ulcers.
AB  - Giant gastric ulcers (greater than 3 cm in diameter) have traditionally been
      considered to be refractory to medical therapy and were commonly thought to
      initially appear as life-threatening hemorrhage requiring emergent operative
      therapy. This study was undertaken to evaluate the results of medical and
      surgical treatment of benign, giant gastric ulcers and the validity of these
      traditional teachings. A retrospective review of 44 patients with giant gastric
      ulcers was performed to evaluate the results of medical and surgical therapy at
      Hartford Hospital (Hartford, CT). The majority of these patients received medical
      therapy. Over 57 per cent received only medical therapy, while 25 per cent
      received primary, operative therapy. Contrary to popular belief, the authors
      found that patients who received initial medical therapy did not have high
      morbidity or mortality rates. Therefore, while the necessity of early surgical
      intervention following perforation or in patients with signs of hemorrhagic shock
      can not be refuted, the authors conclude that medical therapy of benign, giant
      gastric ulcers is often effective and not unduly hazardous. Giant gastric ulcers,
      in and of themselves, are not an indication for surgery.

PMID- 1622013
TI  - Leiomyosarcoma of the rectum.
AB  - Leiomyosarcoma of the rectum is a rare entity. Approximately 150 cases have been
      described in the literature. Differentiation from its benign counterpart,
      leiomyoma, and other connective-tissue tumors is often difficult, but it is
      important because each tumor has an entirely different prognosis. The case of a
      patient in whom an 11 x 5.5 cm leiomyosarcoma of the rectum was surgically
      excised by abdominoperineal resection is presented. Literature review shows
      disagreement over the therapeutic approach, most likely due to the lack of a
      large series of patients with this disease. At present, a selective treatment
      approach appears to be the most advocated. Lesions less than 2.5 cm in size and
      limited to the bowel wall can still be treated by wide local excision. More
      radical surgical resection is indicated for larger tumors and those extending
      outside the bowel wall.

PMID- 1622014
TI  - Contemporary management of amebic liver abscess.
AB  - In a retrospective review covering 16 years divided into two time periods, 133
      patients with amebic liver abscess were evaluated. Most of the patients were
      young, Hispanic men, and one-third had coexistent disease. A reliable diagnosis
      can be established in 24 hours using ultrasound or computed tomography scans.
      Over the entire time period, antiparasitic therapy was evolved to occupy a
      primary role and surgery was reserved for management of abscess complications.

PMID- 1622015
TI  - Changes in biliary bacteria after endoscopic cholangiography and sphincterotomy.
AB  - This prospective study consisted of 32 patients. In each patient, bile was
      collected during two separate endoscopic retrograde cholangiopancreatographies
      (ERCP) to study changes in biliary bacteriology and cytology. The mean interval
      between ERCPs was 20 months (15-29 months). Twenty-three patients had gallstones
      in the gallbladder, bile ducts, or both. Nineteen of them had bactibilia compared
      to none of the 9 patients with normal ERCP (P less than 0.001). Fifteen patients
      had normal bile ducts in ERCP (Group 1). Four of these patients (27%) had
      bactibilia initially and 9 (60%) at follow-up (P = 0.069). Seventeen patients had
      bile duct stones and underwent endoscopic sphincterotomy (Group II). Fifteen of
      these patients (88%) had bactibilia initially, and 15 (88%) also had bactibilia
      at follow-up. Initially, anaerobic bacteria were detected in 37 per cent of Group
      I patients with bactibilia and in 50 per cent of Group II patients with
      bactibilia. At follow-up, the bile in Group I patients infrequently (11%)
      contained anaerobes, whereas in Group II patients anaerobes predominated (67%; P
      less than 0.011). Clear correlation between the biliary cytology and bacteriology
      could not be observed. The authors conclude that ERCP may result in increased
      incidence of long-term bactibilia and suggest that contamination occurred during
      ERCP. The bactibilia associated with bile duct stones does not subside after
      endoscopic treatment of the common duct stones.

PMID- 1622016
TI  - Noncompression unicortical miniplate osteosynthesis of mandibular fractures.
AB  - The use of transoral noncompression unicortical miniplates in treating 42
      consecutive patients with 64 displaced mandibular fractures (excluding
      subcondylar) was reviewed. Titanium miniplates (Wurzburg) were used for fixation.
      The principles set forth by Champy and colleagues, with two plates for body and
      symphyseal fracture fixation and one plate superiorly along the oblique ridge for
      angle fractures, were performed. Intermaxillary fixation was not used
      postoperatively. Results compared favorably with other forms of treatment with no
      evidence of postoperative malocclusion, with an overall complication rate of 3%.
      The advantage of no external incision, avoidance of intermaxillary fixation, and
      normal postoperative incisal opening and occlusion make this technique our
      treatment of choice.

PMID- 1622017
TI  - Thyroid disorders masquerading as aging changes.
AB  - Some (2.6%) patients seeking aesthetic blepharoplasty had undiagnosed
      hypothyroidism contributing to periorbital aging changes; 0.3% had undiagnosed
      hyperthyroidism. Characteristic features suggesting the possibility of
      hypothyroidism were edema, "festoons," and "secondary" bags. The characteristic
      features of hyperthyroidism were proptosis and edema. Treatment of the underlying
      medical condition reversed the changes to a variable extent. Aesthetic surgery
      was not necessary in some patients.

PMID- 1622018
TI  - Rhinoplasty and facial expression.
AB  - Based on the philosophical concept that facial beauty is not merely harmony of
      static anatomical structures but also the dynamic expression of the face
      (especially when one smiles), I propose that plastic surgeons approach the
      problem of aesthetic improvement of the human face not only in response but also
      when the face moves. I call this "surgery of the facial expression." I describe
      here the use of a new surgical procedure to correct a certain condition with
      which plastic surgeons are frequently confronted when patients consult and
      request rhinoplasty. Many patients have added defects that are exposed only when
      they begin to make facial movements and gestures; moreover, these added defects
      become even more manifest when they smile. I call this phenomenon "rhino
      gingivolabial syndrome of the smile," and describe the technique I have used not
      only to improve the form of the nose but also to enhance the patient's smile.

PMID- 1622019
TI  - Total lower lip reconstruction in advanced squamous carcinoma: application of the
      gate-flap technique.
AB  - During the years 1986 to 1988, seven patients with advanced squamous cancer of
      the lower lip were operated on in our department and the defects were
      reconstructed by the gate-flap technique. We found that this method affords
      satisfactory total reconstruction of the lower lip. Better results may be
      obtained if more attention is given to details such as the thickness of the
      pedicles, the opening of Stensen's duct, and advancement of the mucosa to form
      the vermilion. Late distortion due to scar contracture can be corrected by
      defatting and W plasty.

PMID- 1622020
TI  - Panniculus morbidus.
AB  - Eight patients with large panniculi are described where severe problems with
      hygiene, immobility, and chronic infection were caused by the lymphedematous,
      chronically infected pannus. Protracted nonsurgical management of the infected
      panniculus had failed in all 8 patients. Wedge resection without fat undermining
      removed diseased tissue. Infection and sepsis were eliminated and ambulation was
      restored in all patients. Formerly immobile patients were returned to normal
      activity. Significant self-induced weight loss was not observed in a 2-year
      follow-up period; weight gain, however, was not experienced. The primary
      anesthetic method was thoracic epidural reducing the requirements for general
      endotracheal anesthesia. The chronically infected pannus is a surgical problem
      deserving earlier recognition and resection.

PMID- 1622021
TI  - Experience with novel uses of tissue expanders in burn reconstruction of the face
      and neck.
AB  - Total or subtotal resurfacing of the face with suitable, well-matched skin from
      the upper trunk and neck is usually difficult because of the dearth of unscarred
      donor site. Tissue expanders have been used primarily to construct local
      advancement flaps of tissue immediately adjacent to a tissue defect or deformity.
      These flaps often lack adequate mobility to allow coverage of large areas. In
      this report, I describe a clinical experience of 11 patients followed for 27 to
      75 months in whom tissue expanders were used to develop large, full-thickness
      skin grafts or transposition flaps for total or subtotal resurfacing of the face
      and neck. Large, full-thickness skin grafts were developed from relatively small
      donor sites using tissue expanders. They behaved identically to unexpanded full
      thickness skin grafts. They were found not to shrink with storage. The donor
      sites were closed primarily, obviating the need to graft the donor site. The
      tissue expander-enhanced transposition flaps appeared to have enhanced
      vascularity and provided ample, suitable tissue for reconstruction of the face
      and neck. Tissue expansion resulted in very mobile, thin, hearty flaps that
      provided excellently matched skin cover for the face and neck. Complications,
      some of which are unique to these techniques, and indications for the techniques
      are reviewed.

PMID- 1622022
TI  - Two devastating complications of carpal tunnel surgery.
AB  - Two devastating complications of carpal tunnel release are presented. In 1
      patient, the median nerve was completely transected; in another, massive necrosis
      of the palm required free flap coverage.

PMID- 1622023
TI  - Plantar fibromatosis and bilateral flexion contractures: a review of the
      literature.
AB  - Plantar fibromatosis is a benign multinodular lesion occurring in the plantar
      fascia. It is generally an asymptomatic lesion or may occasionally cause
      discomfort or pain in the foot. We present a man who has bilateral flexion
      contractures of his great toes as a result of his plantar fibromatosis. A review
      of the literature indicates that this is a very rare presentation of plantar
      fibromatosis.

PMID- 1622024
TI  - Subdermal liposuction to enhance skin contraction: a preliminary report.

PMID- 1622025
TI  - Nipple-areola reconstruction with a custom-made silicone ectoprosthesis.
AB  - The use of a custom-made silicone ectoprosthesis of the nipple-areola complex is
      presented. It is suggested, after completion of breast mound reconstruction, for
      those women who cannot undergo or refuse to undergo any further surgical
      procedure, or else for the interim until the final reconstruction is performed.
      It is convenient to use and the aesthetic appearance is pleasing.

PMID- 1622026
TI  - Temporary tarsorrhaphy "zipper".
AB  - Reconstructive eyelid procedures on occasion justify the concomitant use of a
      temporary, reversible tarsorrhaphy to provide corneal protection. A dilemma
      ensues in the trauma patient when frequent neurological evaluations
      simultaneously requires examination of the pupils. To circumvent the
      inconvenience of repeated suturing of the eyelids as in an occlusive suture, a
      technique with the facility of the opening and closing of a zipper is reviewed
      that allows rapid removal and reestablishment of the desired temporary
      tarsorrhaphy.

PMID- 1622027
TI  - Silicone breast implants and immune disease.
AB  - Silicone was originally regarded as inert in the human body. Silicone medical
      devices have been associated with various complications that may involve an
      immune reaction to silicone or a silicone organic complex. There have been more
      than 80 cases reported in the medical literature of a varied systemic autoimmune
      illness in patients who have had various foreign materials placed in the breast.
      Controversy exists as to which complications have a cause and effect
      relationship, and which represent coincidental findings. It is difficult to
      distinguish between nonspecific local reactions and reactions that have an
      immunological basis. Approximately 1,000,000 to 2,000,000 women in the United
      States have had silicone breast implants inserted for reconstruction or
      augmentation mammaplasty; 28 of those patients have been reported to have
      developed a systemic autoimmune disease. Data on the 28 reported cases do not in
      any way prove a causal relationship between breast implants and immune disease.
      Given the natural incidence of autoimmune diseases, we would expect a
      coincidental occurrence in the United States of more than 1,000 cases of
      autoimmune disease in women who had undergone breast implant surgery. Additional
      information must be obtained to resolve the question. The true incidence of
      autoimmune disease in patients with implants needs to be determined. A
      prospective registry of implant patients should be established and comprehensive
      retrospective information obtained on the implant patient population. Further
      experimental work is necessary on the bioreactivity of silicone. Patients with
      implants and autoimmune disease, once identified, must be carefully evaluated by
      physicians who are experienced in the treatment of autoimmune disease.

PMID- 1622028
TI  - Re: Firestorm fibrosis: the fast fibrotic phenomenon.

PMID- 1622029
TI  - Re: Buccal fat pad excision: aesthetic improvement of the midface.

PMID- 1622030
TI  - The role of cutaneous lymphoscintigraphy in determining regional lymph node
      drainage of truncal melanomas.
AB  - In the absence of clinically positive regional nodes, any value of prophylactic
      dissection in malignant melanomas depends on accurate preoperative determination
      of the pathway of lymphatic drainage. We report on the use of noninvasive
      radionuclide lymphoscintigraphy in the determination of regional patterns of
      lymph node drainage in patients with melanomas. Ten patients were studied;
      treatment was altered by test results in 2. Eleven node groups were excised in 7
      patients. There have been no metastatic melanomas found in any nodal basins not
      detected by lymphoscintigraphy 23 to 42 months after operation.

PMID- 1622031
TI  - Muscle flap monitoring in a rat model with a variable gain quantitative
      fluorometer.
AB  - A variable gain dermofluorometer with a wide range of sensitivities capable of
      quantifying fluorescein emission from both skin and muscle was tested in a rat
      latissimus dorsi island muscle flap model. Quantitative fluorometric readings
      directly from muscle and skin sites that did not undergo surgery were taken at
      intervals over 2 hours after intravenous fluorescein injection. Muscle flaps with
      intact pedicles gave an inflow-outflow pattern. A no-outflow pattern was seen in
      muscle flaps with ligated pedicle veins and a no-inflow pattern was seen in
      muscle flaps with ligated pedicle arteries. These patterns were similar to the
      flow pattern seen with quantitative fluorometric monitoring in flaps with
      cutaneous components. These results suggest that quantitative fluorometry may be
      applicable to circulation monitoring in muscle flaps.

PMID- 1622032
TI  - Elliptical breast reconstruction: an improved and simplified technique.
AB  - An improved and simplified postmastectomy reconstruction by tissue expansion is
      presented. Utilizing a uniquely designed matched tissue expander and prosthesis,
      the technique is based on an elliptical concept of breast shape and corresponding
      volumetric relationships and permits controlled expansion of the lower chest
      skin. Horizontal and vertical base dimensions and the volume of the contralateral
      breast are used to determine the size and volume of the appropriate elliptically
      shaped tissue expander and, subsequently, of the mammary implant. This approach
      permits surgeons to achieve symmetry more readily by matching the implant to the
      patient, rather than the patient to the implant.

PMID- 1622033
TI  - Ciprostene and indomethacin partially reverse the mechanisms of distal end
      necrosis in the rat random skin flap.
AB  - Survival of random skin flap distal end depends on hemodynamic, cellular, and
      coagulation mechanisms. This study was designed to evaluate whether
      administration of ciprostene, a stable prostaglandin I2 analogue, and
      indomethacin, a cyclooxygenase-hydroperoxydase enzyme inhibitor, would improve
      the survival rate of random skin flaps. Forty-five male rats were divided into
      nine groups and injected with sesame oil (control), ciprostene (20
      micrograms/kg/day), and/or indomethacin (2 mg/kg/day). Injections were done
      before (pretreatment for 4 days), after (posttreatment for 6 days), and
      before/after (pre/posttreatment for 4 and 6 days, respectively) the elevation of
      random dorsal skin flaps. In the pretreatment and pre/posttreatment studies, the
      flap survival rate of all drug-injected groups was significantly higher than that
      of the control group (p less than 0.02). In addition administration of ciprostene
      alone yielded a trend of better flap survival rate, which, however, was not
      statistically significant (p less than 0.12). Of interest in the posttreatment
      study, only the simultaneous administration of ciprostene and indomethacin
      significantly increased skin flap viability compared with the other groups (p
      less than 0.02). Therefore, the results demonstrated that administration of
      ciprostene and indomethacin either alone or together partially reversed the
      pathophysiological mechanisms that cause necrosis of random skin flap distal end.
      These pharmacological changes significantly improved random skin flap survival
      rate.

PMID- 1622034
TI  - Macrophage interleukin 1 response to injected silicone in a rat model.
AB  - Observations of silicone granuloma formation and migration of silicone to
      regional lymph nodes have indicated a need for more research into the possible
      immunological responses to silicone. The present study was undertaken to assess
      the effect of injected silicone particles on the ability of splenic macrophages
      to produce interleukin 1 (IL-1) and to determine the relative quantities
      produced. Lewis rats were divided into 4 groups: Group 1 animals (n = 3) were
      injected subcutaneously with sterile saline (2.5 ml) and served as control
      animals; Group 2 animals (n = 3) also served as control subjects, but macrophages
      isolated from these animals were exposed to lipopolysaccharide (LPS); Group 3
      animals (n = 3) were injected subcutaneously with Freund's complete adjuvant
      (FCA) (2.5 ml) to serve as FCA control animals; and Group 4 animals (n = 3)
      received a subcutaneous injection of a sonicated slurry of equal parts FCA and
      silicone (2.5 ml each). IL-1 production was not significantly increased in
      splenic macrophages from animals exposed to the silicone slurry (p greater than
      0.20) 8 months after injection as compared with control animals or animals given
      FCA alone. Macrophages exposed to LPS, a known mitogen, had significantly
      elevated IL-1 production. Subcutaneously injected silicone particles did not
      elicit an increase in IL-1 production in rat macrophages.

PMID- 1622035
TI  - Strain differences in autotomy in rats undergoing sciatic nerve transection or
      repair.
AB  - The degree of self-mutilation (autotomy) following sciatic nerve injury was
      assessed in 6 rat strains. Experimental groups included sciatic nerve transection
      with and without repair and crush lesions. The degree of autotomy was measured
      using a standard grading system. There were statistically significant differences
      between the strains in the transected group in terms of both degree of autotomy
      and the time of onset of its appearance. The repair group showed a shorter mean
      time of onset, lower maximal scores, and lower percentage of affected animals.
      Autotomy was absent in the nerve crush group and in all Lewis rats. In
      experimental studies when the status of the foot is critical (e.g., to evaluate
      functional walking patterns) Lewis rats appear to be the most appropriate strain
      to utilize. These results suggest that there are definite strain differences in
      the degree of autotomy following nerve transection or repair.

PMID- 1622036
TI  - Evaluation of failed sphincter pharyngoplasties.
AB  - A review of 30 failed sphincter pharyngoplasties is presented. Failure may be
      caused by inappropriate surgical planning, inadequate surgical technique, or
      inappropriate patient selection. Problems with surgical planning and technique
      that lead to failure were low flap placement, flap dehiscence, and flaps not
      approximated in midline. Problems with patient selection that lead to failure
      were large velopharyngeal gap on videofluoroscopy, and residual speech
      (articulation) deficits. Careful pre- and postoperative evaluation has led to
      refinement of the surgical procedure and improved outcome. Success rate improved
      from 67.65% in the first 5 years to 86% in the last 5 years of this 15-year
      series.

PMID- 1622037
TI  - Hand rejuvenescence by fat filling.
AB  - The advantages of fat filling for hand rejuvenescence are discussed. Seventy-two
      patients treated by this method are presented, including their follow-up,
      complication rate, and details of combined operations. Preference is given to
      local anesthesia when no other major surgeries are associated with the method. A
      highly satisfactory rate was obtained (98.62%) with a low complication rate
      (4.15%).

PMID- 1622038
TI  - Free ascending scapular flap.
AB  - Four patients with free tissue transfer using ascending cutaneous branches of
      circumflex scapular vessels are herein presented. The free ascending scapular
      flap is located on the superior vertical axis, differentiated with the scapular
      flap horizontally and the parascapular flap vertically designed. The flap is an
      excellent choice because of easy dissection, a constant artery and venous system,
      2- to 3-mm-diameter vessels, and sufficient length of the vascular pedicle. All
      flaps survived completely with a fairly thin skin. The shoulder donor site could
      be closed primarily. No functional deficit of the shoulder was observed.

PMID- 1622039
TI  - Management of traumatic supraorbital neuroma.
AB  - Traumatic neuromas represent proliferative overgrowth of axons, Schwann cells,
      and fibroblasts at the proximal end of nerve injury or transsection. Although
      common elsewhere, traumatic neuromas have rarely been noted in the orbits. All
      but one of these reported lesions occurred after orbital surgery. We present a
      patient with a painful traumatic neuroma of the supraorbital nerve due to
      application of a halo fixation device. Neuroma resection and microneural repair
      resulted in prompt resolution of symptoms without compromise of nerve function.

PMID- 1622040
TI  - Embolization in high-flow arteriovenous malformations of the face.
AB  - Five patients with arteriovenous malformations of the face (4 males and 1 woman;
      age range, 11-38 years) were treated by selective embolization through the
      feeding arteries with polyvinyl alcohol particles. Immediate gross angiographical
      obliteration was obtained in 4 patients, with pronounced reduction of the
      arteriovenous shunt in the fifth. Clinical symptoms including bleeding, swelling,
      pulsations, bruit, and disfigurement improved in all the patients followed up for
      a period of 6 to 21 months. Polyvinyl alcohol particle embolization, without
      surgical resection, though palliative could be useful in select patients. The
      classification and diagnosis of congenital vascular malformations is briefly
      reviewed and treatment discussed.

PMID- 1622041
TI  - Reconstruction of children's scalp defects with the Orticochea flap.
AB  - From January 1985 to February 1990, 4 children with scalp defects were selected
      for use of the Orticochea flap technique for reconstruction. The ages ranged from
      15 months (the youngest in the literature) to 7 years. The defects ranged from 6
      x 7 to 11 x 13 cm. Three defects were traumatic and 1 was acute lymphocytic
      leukemia septic emboli in cause. All these children got satisfactory results with
      follow-up periods ranging from 5 months to more than 5 years. With these
      preliminary experiences, we have verified that the Orticochea flap scalp
      reconstruction surgery described 20 years ago can be performed safely even in
      children, especially when tissue expansion is not suitable or readily available.

PMID- 1622042
TI  - Re: Which dressing for split-thickness skin graft donor sites?

PMID- 1622043
TI  - Re: Traumatic hemipelvectomy.

PMID- 1622044
TI  - Re: Plastic surgery endeavors in Estonia.

PMID- 1622045
TI  - Haemostatic responses to desmopressin acetate after primary coronary artery
      bypass surgery.
AB  - Previous studies have suggested that the administration of desmopressin (DDAVP)
      may reduce blood loss after cardiac surgery. The present double-blind,
      randomized, placebo-controlled trial was performed to determine the effect of
      DDAVP on haemostasis during and after primary coronary artery bypass surgery.
      Fifteen patients received an infusion of DDAVP 0.3 microgram/kg and 15 patients
      received a placebo infusion over 15 min after cardiopulmonary bypass. Following
      DDAVP administration, the increase in factor VIII:C plasma level was greater than
      after placebo (the increase at 90 min after treatment 1.10 +/- 0.11 vs. 0.45 +/-
      0.09 IU/ml, P less than 0.01). A difference between the treatments tended to
      occur also in the increase of von Willebrand antigen (0.64 +/- 0.08 vs. 0.23 +/-
      0.07 IU/ml, P = 0.0556). A detailed evaluation of various haemostatic parameters
      showed no significant changes towards hypercoagulability or fibrinolysis. Inspite
      of the observed potential haemostatic effect of DDAVP, patients treated with
      DDAVP and placebo had similar postoperative blood losses (950 +/- 185 vs. 1034 +/
      321 ml), similar total haemoglobin losses (45.9 +/- 11.1 vs. 54.7 +/- 25.9 g)
      and similar red cell transfusion requirements (1.3 (range 0-2) vs. 1.1 (range 0
      3) units). The plasma concentrations of factor F VIII:C and von Willebrand factor
      antigen after cardiopulmonary bypass may explain the failure to achieve a
      therapeutic effect with DDAVP.

PMID- 1622046
TI  - Peripheral excimer laser-assisted angioplasty. Preliminary clinical experience.
AB  - A non-thermal Xenon-Chloride excimer laser was used for peripheral arterial
      recanalization in eight patients with obliterating atherosclerosis of the
      superficial femoral artery. All patients had a total occlusion with severe
      claudication or pain at rest. There were three complications, which all led to
      thrombosis of the irradiated artery. In one, the puncture site in the artery had
      to be closed operatively. All vessels were followed up radiographically three
      months after the procedure. In seven patients the vessel was patent. Several
      investigators have warranted caution in using thermal lasers (continuous wave
      Nd:YAG or argon) for angioplasty. The non-thermal excimer laser is a viable
      alternative--although not without problems. Initial experiences with the new
      device are described.

PMID- 1622047
TI  - Septic complications of endoscopic laser treatment of gastrointestinal diseases.
AB  - This study was designated to establish the incidence of septic complications
      associated with Nd:YAG-laser treatment of varied gastrointestinal lesions. A
      total of 30 laser procedures were performed for 27 patients with both upper and
      lower gastrointestinal diseases. Thirty minutes after the completion of laser
      therapy, blood culture was obtained from each patient. Only one patient developed
      sepsis with fever, chills and positive blood culture, the organism isolated was
      Streptococcus mitis. All the other patients tolerated the treatment well and
      without signs of septic complications. According to this study, antibiotic
      prophylaxis is not necessary for gastrointestinal laser treatment. However, the
      conclusions must be cautious due to the small number of patients included in this
      study.

PMID- 1622048
TI  - Complications of endoscopic retrograde cholangiopancreatography in jaundiced and
      cholestatic patients.
AB  - The purpose of this prospective study was to investigate the complication rate of
      endoscopic retrograde cholangiopancreatography (ERCP) in the management of
      jaundiced and unjaundiced patients with laboratory findings suggesting
      cholestasis. ERCP was performed in 144 jaundiced patients and in 27 patients with
      unjaundiced cholestasis (age range 18-89 years, mean 66 years). Endoscopic
      papillotomy was performed in 45 patients, three for spasm of the sphincter of
      Oddi and the rest for choledochal stones. Seven bile duct prostheses were
      inserted endoscopically, all for treatment of malignant obstruction. The
      complications of ERCP were as follows: four cases of pancreatitis (2.3%), five
      cases of cholangitis (2.9%), two cases of bleeding (1.2%) and two perforations
      (1.2%). The overall complication rate was thus 7.6% (13/171) and there was no
      primary mortality. ERCP seems to be a safe and effective method in the diagnostic
      study and management of bile duct obstruction even in the elderly patients with
      jaundice or unjaundiced cholestasis.

PMID- 1622049
TI  - Acute surgical treatment of bleeding peptic ulcer. A retrospective analysis of
      193 patients.
AB  - A retrospective analysis of 193 consecutive patients over an 11 year period
      operated on for continued bleeding from gastric or duodenal ulcer is presented.
      All patients were operated on within the first 48 hours after hospitalization.
      Preoperative endoscopic examination was performed in 108 patients and it was
      diagnostic in 79% of the cases. A sole duodenal ulcer was responsible for
      bleeding in 59 patients (31%) and in 50 patients (26%) the bleeding ulcer was
      located in the lesser curvature of the stomach. Other gastric ulcerations were
      scattered irregularly in different parts of the stomach. Gastric resection and
      Billroth II reconstruction were the most common procedures performed. Vagotomy,
      either truncal or gastric, was added to the resection in 31 (16%) cases. Primary
      mortality rate within 45 days from the operation was 15%. The survivors were on
      the average ten years younger (mean 58 years) than those who died. Forty one
      (21%) of the patients were operated on as emergency cases. These patients
      survived significantly better than those operated on after an observation period.
      It is concluded, that aggressive surgical treatment immediately after fluid
      resuscitation was associated with a reduction in mortality and morbidity rates in
      patients with bleeding peptic ulcer.

PMID- 1622050
TI  - Management of fulminating ulcerative colitis.
AB  - A series of 69 patients with fulminating ulcerative colitis (UC), treated in 1976
      89, was reviewed to evaluate the lines of conservative and surgical methods used.
      Fifty-six of the patients (81%) were operated on during the first hospitalization
      period: 33 patients (48%) underwent an emergency or urgent operation, and 23
      (33%) received elective surgical treatment. The mortality rate was 4.3%; three
      patients died after emergency operations. Excluding the 14 patients who underwent
      immediate surgery within the first 48 hours, a significant difference could be
      observed in the response to conservative treatment with and without TPN: with TPN
      remission was achieved in 34 of 44 cases (77%), without it in only two cases of
      11 (18%), P less than 0.001. Proctocolectomy used as an emergency or urgent
      measure resulted in two deaths, and 93% of the patients showed complications,
      whereas subtotal colectomy with ileostomy resulted in no deaths and significantly
      fewer patients (31%) had complications, P less than 0.001. The findings suggest
      that TPN and bowel rest, in addition to corticosteroid treatment, may be
      advantageous in all cases of fulminant UC. If this 'Oxford regimen' is
      insufficient, subtotal colectomy with ileostomy is the safest emergency
      operation.

PMID- 1622051
TI  - Anorectal function in Crohn's disease.
AB  - Anorectal function was assessed in 63 patients with Crohn's disease and in 10
      controls. Eleven patients with Crohn's disease (17%) were partially and three
      (5%) totally incontinent. The results of anal sphincter function studies of
      continent patients with Crohn's disease were similar to those of partially
      incontinent patients and controls. Incontinent patients had significantly lower
      maximal basal pressure (P less than 0.01) and significantly lower maximal squeeze
      pressure (P less than 0.05) as compared to controls. There was no significant
      difference in rectal capacity between continent, partially incontinent and
      totally incontinent patients and controls. There were significantly more patients
      with symptoms of anal incontinence in the group of patients with anal Crohn's
      disease as compared to the Crohn's group with normal anorectum (P less than
      0.001). Risk factors for total anal incontinence in Crohn's disease were severe
      anorectal stenosis and previous surgery for anal abscesses. The most important
      reason for partial incontinence was diarrhoea. In conclusion, Crohn's disease
      without macroscopic lesions in the anorectum and without diarrhoea does not
      affect anorectal function.

PMID- 1622052
TI  - Stapling in thyroid surgery. A prospective study.
AB  - In a prospective study, resection of the thyroid gland by means of a linear
      stapling device was compared with the conventional resection technique in 12
      consecutive patients with thyreotoxicosis. The median time for resection of the
      stapled lobe was shorter than for the conventionally resected right lobe,
      although the difference was not statistically significant. The median
      preoperative bleeding during resection of the stapled left lobe was 42 ml (range
      15-126 ml), compared with 78 ml (range 34-247 ml) during the conventional
      resection of the right lobe (P less than 0.05). Median postoperative bleeding was
      somewhat less from the stapled side compared with the conventionally resected
      side, but did not reach statistical significance. The study thus demonstrates the
      feasibility of carrying out resection of the thyroid gland with a linear stapling
      device. The technique minimizes peroperative bleeding. It could therefore be used
      in thyroid surgery.

PMID- 1622053
TI  - Aortic valve replacement in patients aged over 70 years.
AB  - During a 12-year period, 58 patients aged over 70 years underwent aortic valve
      replacement. Sixty-six % of them had pure stenosis, 24% were with combined aortic
      valve disease, and six patients had only regurgitation. Preoperatively, 81% were
      in NYHA III and the remaining in NYHA IV. The pressure gradient in the AS-group
      was 105 +/- 27 mmHg and in combined-group, 99 +/- 32 mmHg. The mean ejection
      fraction was 54 +/- 14%. Thirty-seven mechanical and 21 biological prostheses
      were placed. Concomitant procedures consisted of annular dilating plasty for five
      patients while 16 others had coronary by-pass grafting. Hospital mortality was
      12%, with the leading causes being low output syndrome and infection
      complications. The causes of all late deaths were non-cardiac. During the follow
      up period of 2.8 +/- 2.5 years, 74% of patients with mechanical valves and 62% of
      patients with bioprostheses were free from late complications. Prosthetic valve
      endocarditis (two patients) and valve failure (one patient) occurred only in
      patients with tissue valves. Embolic complications were equally distributed
      between the groups. All patients with mechanical valves were placed on permanent
      anticoagulation therapy, with two of them developing significant complications.
      On echocardiographic examination, moderate periprosthetic leakage was found in
      three patients, two of them having mechanical valves. There was a significant
      increase in EF and regression of left ventricular hypertrophy. At follow-up
      examination, all 47 living patients found their performance capacity improved.

PMID- 1622054
TI  - Lumbar disc herniation in the elderly: a rare and rewarding object for surgery.
AB  - We carried out a four to twelve year follow-up study in thirteen patients aged 63
      years and over who were operated on for lumbar disc herniation. In eleven cases
      the herniation was at the L 4-5 level and in two at the L 5--S 1 level.
      Additional bony entrapment was present in eight cases. Simple disc removal
      through a small laminotomy was performed in eight patients, with a good or
      excellent result in four cases. Disc removal through a hemilaminectomy or
      laminectomy with the necessary lateral decompression of the bony entrapment gave
      a good or excellent result in each of the five patients. It is concluded that
      disc operation in the elderly usually gives acceptable late results. When even a
      minor bony stenosis is present at the disc herniation level, hemilaminectomy or
      even laminectomy should be considered.

PMID- 1622055
TI  - Should the glenoid be replaced in shoulder arthroplasty with an unconstrained
      Dana or St. Georg prosthesis?
AB  - Twenty-six patients, 11 with rheumatoid arthritis and 15 with osteoarthritis,
      have been operated on with an unconstrained total shoulder arthroplasty. Mean
      follow-up was 47 months. Three prostheses have been extracted. All patients
      stated that they had pain relief after surgery. At three year follow-up all
      except one had developed radiolucent zones around the glenoid component. No zones
      were observed around the humeral component. In shoulders with preserved glenoid
      surface replacement of only the humeral head might provide better long-term
      results than a total shoulder arthroplasty.

PMID- 1622056
TI  - Histology and histomorphometry of bone regeneration after experimental injuries.
AB  - Reparative callus formation upon tubular bone was studied after surgical injuries
      of different degrees. Thirty-seven young rats were divided into three groups. In
      the periosteum group the bone was scraped, in the fissure group we made a slit
      reaching the medulla, and in the defect group a standard defect was sawn. Rats
      were killed at 6, 12 and 18 days. The formed callus was studied histologically
      and histomorphometrically. The results suggest than even the primary
      osteochondrogenic callus formation is dependent on the mode of injury. At six
      days the three groups differed both qualitatively and quantitatively in regard to
      callus formation. At 12 and 18 days the total area of woven bone was proportional
      to the degree of trauma according to the linear regression line Y = 0.883 x X +
      0.226 (r = 0.876, P less than 0.001). In the fissure and defect groups reparative
      bone filled the hole proportionally to the same extent. Periosteal and endosteal
      woven bone formed round the bone. Medullary bone formation was limited mainly to
      the area immediately adjacent to the trauma, the result being a cylinder-shaped
      callus. Cartilage formation was most abundant at six days and was related to the
      amount of woven bone in the external callus (r = 0.854, P less than 0.001) and to
      the trauma area (r = 0.707, P less than 0.05).

PMID- 1622057
TI  - Clinical features and walking ability in the early postoperative period after
      treatment of trochanteric hip fractures. Results with special reference to
      fracture type and surgical treatment.
AB  - The purpose of this study was to analyze the functional outcome during the early
      postoperative period (six weeks) in patients with trochanteric fractures. A
      consecutive series of 149 patients were randomized to treatment with either the
      DHS or Ender operative technique. 120 patients were available at review six weeks
      after surgery. Groups were comparable with respect to age (mean 77 years), sex
      ratio (73% women), type of fracture (59% and 55% unstable), experience level of
      the surgeon, prefracture health condition and ambulatory status. During follow-up
      eight patients died and there were 19 complications of neurologic and
      cardiovascular types equally spread among the two groups. All four infections
      were found in the DHS group. Orthopaedic hospital stay averaged 19 days and more
      patients in the Ender group could return to their previous home at time of
      discharge. At the six week visit 14% in the Ender group compared to 33% in the
      DHS group had not recovered functional walking distance (less than 15 m). All
      patients in the Ender group managed to walk, but 11% of the patients in the DHS
      group could not walk. Walking ability was most impaired for unstable fractures.
      It is concluded that the Ender technique will involve less operative trauma
      (shorter operations with less blood loss) and in the early postoperative period
      it can provide better conditions for walking and less need for further
      hospitalization than the DHS technique.

PMID- 1622058
TI  - Effect of perivascular sympathectomy on distal blood flow in the rabbit forepaw.
      A dynamic isotope experiment with Tc99m.
AB  - Perivascular sympathectomy, used for treating patients suffering from vasospastic
      disorders of the hand, is believed to cause an increase in the distal blood flow.
      Its effects were examined here by performing the operation on the metacarpal
      arteries of the left forepaw of ten New Zealand White rabbits, the right forepaw
      serving as a control. Blood flow was measured by Tc99m radionuclide angiography
      five days before the operation and three days and two and a half weeks after it.
      There was no statistically significant postoperative increase in blood flow in
      the distal parts, so that it may be concluded that at least in this experimental
      model, the distal sympathectomy did not have any such effect.

PMID- 1622059
TI  - Effect of risk factors on outcome in patients with peripheral arterial occlusive
      disease.

PMID- 1622060
TI  - Thrombogenic and vasoactive effects of smoking--with special reference to
      peripheral arterial occlusive disease.

PMID- 1622061
TI  - Differential diagnosis of intermittent claudication and the adequacy of
      epidemiological studies.

PMID- 1622062
TI  - Detection of asymptomatic arterial disease.

PMID- 1622063
TI  - Assessment of the microcirculation and its value for the vascular surgeon.

PMID- 1622065
TI  - Angiography--a diagnostic tool or a road map.

PMID- 1622064
TI  - Etiology and assessment of ischemia in the diabetic.

PMID- 1622066
TI  - Diagnosis of multilevel disease.

PMID- 1622067
TI  - Optimal evaluation before infrapopliteal bypass surgery.

PMID- 1622068
TI  - Venous evaluation for in situ bypass surgery.

PMID- 1622069
TI  - Differentiation between acute and acute on chronic limb ischaemia.

PMID- 1622071
TI  - Carotid surgery without angiography.

PMID- 1622070
TI  - How to select the treatment of choice in critical leg ischaemia.

PMID- 1622072
TI  - Optimal method for imaging of abdominal aortic aneurysms.

PMID- 1622073
TI  - Preoperative risk factors among vascular surgical patients.

PMID- 1622074
TI  - Decision analysis in vascular surgery.

PMID- 1622075
TI  - Intraoperative Doppler.

PMID- 1622076
TI  - Intraoperative angiography and endovascular ultrasound imaging.
AB  - Endovascular ultrasound imaging is a new technique that can be used to monitor
      intraoperatively the effects of balloon angioplasty or to inspect the quality of
      vascular reconstruction, such as endarterectomy or bypass surgery. The technique
      is based on high frequency ultrasonic imaging (30-40 MHz) using a rotating single
      element transducer mounted in an 8F catheter tip, providing 360 degrees cross
      sectional real time images. The clinical application is based on the high
      correlation between the ultrasonic images and the histological characteristics of
      the corresponding vessel wall tissue and lumen geometry, as has been established
      in previous in vitro studies. Endovascular ultrasound assessment of percutaneous
      angioplasty procedures or intraoperative vascular reconstruction has become an
      adjunct to angiographic and/or angioscopic monitoring.

PMID- 1622077
TI  - Outflow resistance measurements.

PMID- 1622078
TI  - Intraoperative flow measurements in vascular reconstruction.

PMID- 1622079
TI  - Angioscopy after carotid endarterectomy.

PMID- 1622080
TI  - Choice of intraoperative diagnostic methods.

PMID- 1622081
TI  - Prerequisites for screening.

PMID- 1622082
TI  - Is screening for abdominal aortic aneurysms worth while?

PMID- 1622083
TI  - Why asymptomatic carotid artery stenoses should be screened.

PMID- 1622084
TI  - Why asymptomatic carotid artery stenoses should not be screened.

PMID- 1622085
TI  - Follow-up after vascular surgery--a life-time commitment?

PMID- 1622086
TI  - Surveillance for failing graft.

PMID- 1622088
TI  - Frequency and clinical implications of recurrent carotid artery stenosis.

PMID- 1622087
TI  - Noninvasive impedance in graft surveillance.

PMID- 1622089
TI  - Smoking and factors influencing the outcome of arterial reconstruction.

PMID- 1622090
TI  - Who needs vascular registers?

PMID- 1622091
TI  - Experiences from Swedvasc/VRISS.

PMID- 1622092
TI  - Vascular registers in Denmark based on personal computers.

PMID- 1622093
TI  - National vascular registry in Finland--FINNVASC. FINNVASC Study Group.

PMID- 1622094
TI  - Vascular register within a well defined geographic area.

PMID- 1622096
TI  - Special issue on diagnosis, screening and follow-up in vascular surgery.

PMID- 1622095
TI  - Diagnosis, screening and follow-up in vascular surgery.

PMID- 1622097
TI  - Natural history of patients with peripheral occlusive arterial disease.

PMID- 1622098
TI  - Natural history of carotid artery disease.

PMID- 1622099
TI  - Natural course of abdominal aortic aneurysm.

PMID- 1622100
TI  - Natural history of renal artery stenosis.
AB  - The natural history of various types of renal artery stenosis is reviewed.
      Atherosclerotic renal artery stenosis is obviously a progressive disease, with a
      relatively high incidence of occlusions, particularly when the stenosis is
      narrow. Much less is known about other types of renal artery stenosis. Medial
      fibroplasia is obviously a disease which progresses during fertile life, but the
      course is rather unpredictable. Very little is known about the developmental
      types of renal artery stenosis.

PMID- 1622101
TI  - [Digestive echography is not only a diagnostic method anymore].

PMID- 1622102
TI  - [Gastroduodenal tuberculosis. Report of 6 cases].
AB  - The authors report a retrospective study of 6 cases suffering from gastroduodenal
      tuberculosis which occurred in our gastroenterology department during a period of
      14 years. This affection is rare and set a lot of diagnosis problems with a
      gastroduodenal neoplastic affection because of its clinical polymorphism and its
      radio endoscopic aspects which are very confusing. The association with a
      localisation of another tuberculosis has been found in all cases and this allowed
      us to guide the diagnosis. The specific medical treatment by antibacillaires rely
      on histologic evidence, either by epidemiologic arguments, clinic, paraclinic and
      therapeutic evidence.

PMID- 1622103
TI  - [Diagnostic value of abdominal echography in cirrhosis of the African black. A
      study of 99 cases].
AB  - We reviewed sonographic findings and evaluated the impact of conventional
      ultrasound (US) in the management of 99 consecutive black africans with liver
      cirrhosis. Patients were studied in the University teaching Hospital of Yaounde
      (Cameroon). There were 73 males and 26 females, with a mean age of 49 years
      (range 15 to 71 years). 90 p. cent patients presented with symptoms suggestive of
      liver disease. The commonest sonographic liver abnormalities were: echo
      coarseness with poor depiction of intrahepatic vessels, irregularity of the liver
      surface, hypertrophy of caudate lobe, hepatomegaly, and decreased beam
      penetration through the liver. Ascitis and other signs of portal hypertension
      were present respectively in 44 p. cent and 33 p. cent of subjects. 15 p. cent of
      subjects had hepatocellular carcinoma. Choletithiasis was seen in 6 subjects
      (6%), and chronic pancreatitis in 3 patients (3 p. cent). For 21 patients (21 p.
      cent), US depicted significant abdominal disease which was not clinically
      suspected, and for 10 patients (10 p. cent), it discovered silent liver
      cirrhosis. Our findings suggest that conventional US may be a useful tool in the
      management of some black african subjects with liver cirrhosis.

PMID- 1622104
TI  - [Biermer anemia associated with Kahler disease].
AB  - The authors report a simultaneous observation of Biermer's anaemia and myeloma in
      a 77 year old woman. There are now 22 cases known to this association. A
      relationship between the two immunological diseases was suggested but the authors
      think that there is no proof of such a relationship.

PMID- 1622105
TI  - [Isolated intramural hematoma of the sigmoid. A rare complication of
      anticoagulant treatment].
AB  - The authors report a case of intra-mural hematoma of the sigmoid associated with
      anticoagulant therapy. The small intestine is the site of predilection for intra
      mural hematoma and the colonic site is very unusual. Our case was revealed by an
      obstructive syndrome. The diagnosis, suggested by the increased prothrombin time,
      was confirmed by ultrasonography and endoscopy. The treatment was symptomatic
      with nasogastric suction and correction of any hemostatic disorders.

PMID- 1622106
TI  - [Hemorrhagic pseudo-cyst of the pancreas caused by erosion of the gastroduodenal
      artery during chronic calcifying pancreatitis].
AB  - A hemorrhagic pseudo cyst of pancreas, due to a gastro duodenal artery erosion,
      is presented in a patient presenting a chronic pancreatitis. The diagnosis was
      suspected by means of clinical, ultrasound, TDM signs and was confirmed by
      coeliomesenteric angiography. The surgical treatment was successfully performed
      by local hemostasis and cystojejunal Roux-loop anastomosis.

PMID- 1622107
TI  - [Crohn disease and enteral nutrition: elemental or non-elemental?].
AB  - Analysis of controlled trials from the literature shows that enteral nutrition is
      an effective treatment of active Crohn's disease. Elemental and non-elemental
      diets are both effective, and studies comparing the two types of mixtures have
      failed to reveal any significant difference. However, elemental diets appear to
      act more rapidly and have a more marked effect on the inflammatory syndrome and
      exudative enteropathy. They should therefore be preferred whenever enteral
      nutrition is used with the aim of influencing the inherent progression of Crohn's
      disease.

PMID- 1622108
TI  - [Current status and perspectives in intestinal transplantation].

PMID- 1622109
TI  - [Development of genetic and molecular approaches for the diagnosis and the study
      of the pathogenic power of Helicobacter pylori, agent of inflammatory gastric
      diseases].
AB  - Helicobacter pylori (H. pylori) is a small Gram negative bacillus, recently
      discovered, found in the stomach of patients with active chronic gastritis and
      duodenal ulcers. Production of a potent urease has been described as a trait
      common to all H. pylori so far isolated. To clarify the role of urease in the
      pathogenic process, as well as to engineer genetic tools useful for the diagnosis
      of H. pylori, we cloned the genes responsible for urease activity. A genomic
      library was constructed in Escherichia coli (E. coli) from the chromosomal DNA of
      the H. pylori stain 85P using a shuttle cosmid vector that we constructed in
      vitro capable of replicating both in E. coli and Campylobacter jejuni (C.
      jejuni). The genes responsible for the urease biosynthesis were cloned into E.
      coli host, then mobilized into C. jejuni where they were expressed. At least six
      different genes were shown to be required for the expression of the synthesis of
      an active enzyme: these genes belong to the same cluster and are regulated at the
      transcriptional level. The two genes encoding the two subunits of the urease
      enzyme were identified and sequenced; the products of these genes were compared
      to be other bacterial ureases. The genetic approach allowed to determine the
      amino-acid sequence of the most immunogenic antigens of H. pylori. In addition,
      it provides us with genetic tools: a 294-base pairs (bp) DNA fragment internal to
      one of the urease genes, was shown to be specific of H. pylori strains.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1622110
TI  - [Hirschsprung disease].
AB  - From fourty years new knowledges about Hirschsprung's disease have dramatically
      transformed classical concepts of congenital megacolon. The author emphasizes
      successive steps of knowledges from his personal experience of 500 patients
      observed at Pediatric Surgical Department, Hopital des Enfants Malades, Paris,
      and his own contribution at several research programs on this topic. They concern
      Radiology, Manometry, Histochimy, Immunocytochimy. Using technics of molecular
      biology, recent progress in knowledge of neural crest cells migration towards
      myenteric plexus, light etiopathogenesis of the disease. Several pathological
      associations suggest the genetic origin of the neuro transducers defect. Whatever
      be the scientific interest of it, clinical lethal risk of early enterocolitis
      remains a daily evidence. Simple routine precocious deflation of colonic
      hyperpression is still the most important message to be stressed.

PMID- 1622111
TI  - Immunohistochemistry, in situ hybridization and polymerase chain reaction (PCR)
      in detecting c-myc expression in human malignancies.
AB  - The assessment of oncogene expression at cellular level is important in
      understanding the role of those genes in carcinogenesis. Using in situ
      hybridization and immunohistochemistry, the expression of oncogenes can be
      visualized in topographic relation to tissue morphology. In the present study, c
      myc overexpression was studied in ten carcinomas of different origin (6 mammary
      adenocarcinomas, 2 vulvar and 2 bronchial squamous cell carcinomas) by in situ
      hybridization (ISH) with 35S-labeled RNA probes and by immunohistochemistry
      (IHC). DNA amplification and transcription of c-myc oncogene were also studied
      with polymerase chain reaction (PCR) using beta-globin as an intrinsic standard
      for DNA amplification. The effect of formalin fixation of c-myc expression was
      simultaneously studied. Half of the tumours (5/10) demonstrated c-myc mRNA
      overexpression by ISH performed on frozen sections and two of the samples were
      shown to over-express c-myc protein by IHC. Only two samples fixed in formalin
      showed positive signals for c-myc mRNA. None of the biopsies showed DNA
      amplifications either with ISH or PCR. The present results suggest that ISH with
      RNA probes is a useful method for detecting the transcription of activated
      oncogenes in malignant tissues, especially when applied on frozen sections. The
      results also indicate that in some cases, c-myc gene may be adequately
      transcribed to mRNA but the latter is not translated to the appropriate
      oncoprotein.

PMID- 1622112
TI  - Peritumoural IL-4 treatment induces systemic inhibition of tumour growth in
      experimental melanoma.
AB  - We have examined the ability of interleukin-4 (IL-4) to inhibit the growth of the
      B.16 melanoma in C57BL/6 mice. Tumours were allowed to become established and
      then treated locally with 50 ng/day IL-4. Treatment was continued for 7 days and
      then the tumours were removed and weighed. The results showed that recombinant
      murine IL-4 (rmIL-4) strongly inhibited tumour growth, with some complete
      resolutions. In addition, the effect of IL-4 treatment was seen to be systemic;
      in mice bearing two tumours (neck and thigh), which had been innoculated
      simultaneously, treatment at the neck site resulted in reduced tumour growth at
      both sites. This effect was accompanied by an increase in the proportion of
      lymphocytes in the spleen, particularly T-cells, although tumours at neither site
      showed much evidence of leucocytic infiltration. These results suggest that local
      treatment with IL-4 is able to profoundly reduce the rate of tumour growth, even
      of nodules not receiving treatment directly.

PMID- 1622114
TI  - Antiestrogenic effects of Z-1, 1-dichloro-2,3 diphenyl-2-(4
      methoxyphenyl)cyclopropane(5a) on human breast cancer cells in culture.
AB  - Compound 5a ([Z]-1, 1-Dichloro-2,3 diphenyl-2-(4-methoxyphenyl)cyclopropane) is a
      novel cyclopropyl compound which was shown to be a pure antiestrogen. In the
      present study, the antiproliferative activity of 5a was examined on estrogen
      receptor (ER)-positive MCF-7 and ER-negative MDA-MB-231 human breast cancer cells
      and A-549 human lung cancer cells using the hemocytometric trypan blue exclusion
      method. Compound 5a inhibited the growth of MCF-7 cells in a dose-related manner
      over a concentration range of 10(-9) to 10(-5) M, but did not alter the growth of
      MDA-MB-231 or A-549 cells. Co-administration of estradiol (10(-8) M) reversed the
      antiproliferative activity of 5a (10(-7) M) on MCF-7 cells. Further, an ER
      dependent mechanism of action is supported by the specific ER binding of 5a in
      MCF-7 cells observed in this study. The influence of 5a on the cell surface
      morphology of MCF-7 and MDA-MB-231 cells was studied using scanning electron
      microscopy (SEM). Compound 5a at 10(-6) M reduced the length and density of
      microvilli (MV) on MCF-7 cells, which was reversed by co-administration of
      estradiol (10(-8) M). This compound did not alter the cell surface morphology of
      ER-negative MDA-MB-231 cells. In conclusion, 5a and tamoxifen inhibited the
      growth of ER-prositive MCF-7 cells in an estradiol-reversible manner, and had no
      effect on ER-negative MDA-MB-231 cells. The results of this study with human
      breast cancer cells suggest that 5a may be highly effective in the treatment of
      estrogen-dependent breast cancer and/or in the prophylactic treatment of women
      with a high risk of breast cancer development.

PMID- 1622113
TI  - Response of subpopulations of the FSall C fibrosarcoma to low dose x-rays and
      various potential enhancing agents.
AB  - The effectiveness of various oxygen carrying treatments in sensitizing
      subpopulations of the FSallC fibrosarcoma to low doses of radiation was assessed,
      and compared with survivals obtained with the same cells after in vivo
      irradiation under normally oxygenated or hypoxic conditions. FSallC tumors were
      treated with 2-10 Gray then the Hoechst 33342 dye diffusion method was used to
      separate the tumor into bright (enriched in normally oxygenated cells) and dim
      (enriched in hypoxic cells) subpopulations. There was good agreement between the
      survival of normally oxygenated cells in culture and bright cells from tumors and
      between hypoxic cells in culture and dim cells from tumors over a radiation
      dosage range of 2-5 Gray. At 10 Gray bright cells from tumors were minimally less
      sensitive to the radiation dose than normally oxygenated cells in vivo. When
      maximally effective doses of perfluorochemical emulsions (F44E at 4 g PFC/kg or
      Fluosol-DA at 2.4 g PFC/kg) or a purified bovine hemoglobin solution (PBHS at
      1.32 g protein/kg) were administered 1 hr. prior to radiation therapy with
      carbogen (95% O2, 5% CO2) breathing prior to and during radiation delivery, low
      single doses of x-ray (2-5 Gray) were measurably more cytotoxic toward both
      FSallC tumor cell subpopulations. These results indicate that perfluorochemical
      emulsions or purified bovine hemoglobin preparations along with carbogen
      breathing may be able to increase tumor radiosensitivity to the relatively low
      radiation doses per fraction used in the clinic.

PMID- 1622115
TI  - Weekly regimen of 5-FU vs 5-FU + intermediate dose folinic acid in the treatment
      of advanced colorectal cancer.
AB  - Sixty-four patients with advanced colorectal cancer were randomized to receive 5
      fluorouracil (5-FU) at the dose of 600 mg/sm weekly or the same regimen of 5-FU
      administered halfway through a 1 hour i.v. infusion of folinic acid (FA) at the
      dose of 200 mg/sm. A partial remission (PR) was obtained in 1/30 patients (3%)
      treated with 5-FU and in 9/34 patients (26%) treated with 5-FU + FA (P = 0.028).
      The objective response was accompanied by an improvement in subjective status and
      general conditions. The median duration of PR in 5-FU + FA arm was 10 months
      (range: 6-17). The median time to progression was 5 and 6 months in patients
      treated with 5FU and 5FU + FA, respectively (not a statistically significant
      difference). There were no cases of grade 4 toxicity. A higher, but not
      statistically significant, incidence and intensity of diarrhoea was observed in
      the 5-FU + FA arm. However, 14 patients on 5-FU + FA as opposed to 3 on 5-FU had
      to stop the treatment temporarily because of side-effects (P = 0.011). Median
      survival was higher with 5-FU + FA treatment (10 vs 7 months), but the difference
      is not statistically significant. This study confirms that the addition of an
      intermediate dose of FA enhances the cytotoxicity of 5-FU. Although its clinical
      advantage was limited, this weekly 5-FU + FA regimen appears useful in the
      treatment of advanced colo-rectal cancer on a outpatient basis.

PMID- 1622116
TI  - Amplification of the N-myc oncogene in an adenocarcinoma cell line of the lung.
AB  - Myc gene abnormalities were studied in 30 human lung cancer cell lines. N-myc
      gene amplification was found in an adenocarcinoma cell line, VMRC-LCD. Neither c-
      or L-myc gene amplifications nor K-ras codon 12, 13, 61 point mutations were
      observed in this tumor. Cytomorphologically the VMRC-LCD cells had positive
      characteristics of typical adenocarcinoma, and the carcinoembryonic antigen in
      the culture medium was strongly positive. N-myc gene amplification in
      adenocarcinoma of the lung is extremely rare, therefore we report herein on this
      case.

PMID- 1622117
TI  - Fluorescent location of abnormal cells in cell smears obtained from the lungs of
      patients with lung cancer.
AB  - A bronchoscope fitted with a brush was used to collect cells from patients with
      lung tumours. The cells were either made into smears or deposited as monolayers
      on microscope slides. Using a fluorescent probe for the cell surface enzyme,
      referred to as guanidinobenzoatase, abnormal cells were readily distinguished
      from normal cells which lacked this enzyme.

PMID- 1622118
TI  - The effect of Dilazep on F10 cells in vitro.
AB  - Experiments on F10 cell growth, colony ability, cell adhesion and ultramorphology
      at SEM have been performed. The effect of Dilazep (DIL) has been compared with
      that of well known modulating agents such as Flunarizine (FLU) and Verapamil
      (VER) on cells cultured in high Ca++ medium (HCM) and in low calcium medium
      (LCM). While in HCM there is no difference among the three drugs, FLU and VER had
      a stronger effect on cell growth inhibition in LCM. Cell adhesion to the growth
      substratum, evaluated by the technique of spontaneous detachment in culture
      medium, is reduced in DIL treated cells in comparison to the controls.

PMID- 1622119
TI  - Interaction of cytotoxic agents: a rule-based system for computer-assisted cell
      survival analysis.
AB  - The actual effectiveness of environmental noxious agents or anticancer drugs can
      be fully determined only by knowing if the effects (in the present case, the
      cytotoxic effects) induced by a given agent are enhanced by exposure to another
      (or other) agent(s). Given a certain combination of agents, it is possible to
      distinguish three types of interaction: (a) zero interaction or additivity; (b)
      positive interaction or synergism; and (c) negative interaction or antagonism. In
      this work, the methodological problems involved in evaluating the type and level
      of interaction between biologically active agents are discussed and an
      "intelligent" approach to the problem is proposed. In particular, a prototype of
      a computer-assisted rule based system, named CISA (Cytotoxic Interaction and
      Survival Analysis), designed in a KES environment (Knowledge Engineering System)
      and implemented on a personal computer, is described. By constructing isoboles
      based on experimental cell survival data and taking into account the relative
      confidence intervals, the system can indicate the appropriate combinations of
      dosages to be tested and finally determine the type and level of interaction. The
      system, which represents an attempt to administer "intelligently" the
      experimental data, is therefore able to identify the best strategy of analysis,
      to carry out the data processing and to offer suggestions to the investigator
      about the usefulness of the data and the planning of further experiments.

PMID- 1622120
TI  - Postoperative adjuvant immunochemotherapy and infiltration of dendritic cells for
      patients with advanced gastric cancer.
AB  - To determine the group of patients for whom a biological response modifier is
      useful, the efficacy of postoperative adjuvant immunotherapy was investigated
      with regard to infiltration of dendritic cells (DC) in patients with advanced
      gastric cancer who underwent absolute curative resection. The infiltration of DC
      was classified into marked and slight. The chemotherapy group was prescribed
      mitomycin C and tegafur, while for the immunochemotherapy group a biological
      response modifier, PSK, was also prescribed in survival between the chemotherapy
      and immunochemotherapy groups. In patients with slight infiltration, however, the
      5 - year survival rates were 0% in the chemotherapy and 15% in the
      immunochemotherapy group. Patients given PSK survived longer than those given
      chemotherapy only (P less than 0.05). Therefore, adjuvant immunotherapy may be
      considered for patients with advanced gastric cancer with slight infiltration of
      DC.

PMID- 1622121
TI  - Multidrug resistance in Yoshida rat ascites hepatoma cell lines.
AB  - Rat ascites hepatoma (AH) cell lines that were induced by dimethylaminoazobenzene
      and established as transplantable tumors had different sensitivities to
      vinblastine (VBL). The most VBL-resistant cells, AH66, showed more cross
      resistance to vincristine and anthracyclines than AH66F cells. The resistance of
      AH66 cells was significantly decreased by verapamil. VBL-resistance of AH66 cells
      was inhibited by other drugs reported as overcoming acquired multidrug
      resistance, while the sensitivity of AH66F cells was hardly influenced by these
      drugs. The lowered uptake and enhanced extrusion of the antitumor drug in AH66
      cells were suppressed by verapamil. M(r) 160,000 protein in the plasma membrane
      from AH66 was labeled with a photoactive VBL analog and was immunopositive to a
      monoclonal antibody against P-glycoprotein, C219. The sensitive cells had barely
      detectable levels of the surface membrane components. Specific photo-labeling
      with a VBL analog of P-glycoprotein of AH66 cell membrane was inhibited by
      reserpine and verapamil which restored the VBL resistance. These results indicate
      that AH66 cells are a naturally acquired multidrug-resistant cell line
      overexpressing a P-glycoprotein, and AH cell lines are useful to study multidrug
      resistance of hepatic carcinomas and development of counteracting drugs.

PMID- 1622122
TI  - Increasing peak levels of vinblastine given in repeated divided doses.
AB  - Pharmacokinetics of vinblastine were assayed in 9 patients, using a high pressure
      liquid chromatography method. Patients were treated in three different ways: the
      first 3 patients received bolus injections of vinblastine at a fixed dose of 2
      mg/day for 5 consecutive days. Three other patients were treated with 3 mg/m2
      vinblastine as a bolus injection on day 1, day 3 and day 8. The remaining 3
      patients received a bolus injection of vinblastine of 6 mg/m2 on day 1, day 8 and
      15. Blood samples were taken on days 1, 3 and 5 for the first group and on every
      treatment day for the other groups. The early phase peak levels obtained during
      the 5 day-treatment increased progressively during repeated treatments, probably
      due to decreased central compartment volumes and not to drug accumulation. There
      was no relation between vinblastine levels and orosomucoid levels. The rise in
      peak level was less predictable during the other methods of treatment (once or
      twice weekly). This observation calls attention to the necessity of performing
      drug level monitoring at very early time points, as increasing peak levels during
      repeated administration may explain unexpected toxicities.

PMID- 1622123
TI  - Stable expression of a cDNA encoding rat brain protein kinase C-beta I confers a
      multidrug-resistant phenotype on rat fibroblasts.
AB  - Protein kinase C (PKC) is a Ca++- and phospholipid-dependent protein kinase that
      plays an important role in signal transduction pathways that regulate cell
      growth. Tumor cells selected for a multidrug resistant (MDR) phenotype often
      express elevated levels of PKC activity. To directly test whether PCK
      overexpression can produce an MDR phenotype, we studied rat embryo fibroblasts
      that were infected with the full-length cDNA clone RP58 encoding the beta I form
      of rat brain PKC. The PKC-beta I gene recipient R6-PKC3 cells are stable,
      overproduce PKC, and express an elevated level of PKC activity. R6-PKC3 cells
      exhibited significant resistance to adriamycin, actinomycin D, vinblastine, and
      vincristine but not to 5-fluorouracil. Intracellular accumulation of adriamycin,
      vinblastine, and vincristine was decreased in the R6-PKC3 cells, but this was not
      associated with an altered level of P-glycoprotein expression. Moreover, the
      reduction in drug accumulation appeared to be a consequence of a decreased rate
      of drug uptake. The data indicate that overexpression of PKC in rat fibroblasts
      produces an MDR phenotype without altering P-glycoprotein expression.

PMID- 1622124
TI  - The immunomodulatory beta-galactoside-specific lectin from mistletoe: partial
      sequence analysis, cell and tissue binding, and impact on intracellular
      biosignalling of monocytic leukemia cells.
AB  - Nanogram quantities of the beta-galactoside-specific lectin from mistletoe (ML-I)
      that is composed of two different types of subunits exhibit immunomodulatory
      potency and enhance cytokine secretion in vitro and in vivo. Partial sequence
      analysis of the carbohydrate-binding B chain revealed a ragged N-terminus and
      overall homologies to the B subunit of Ricin D and Ricin E. Two evolutionarily
      neutral substitutions were apparent in the otherwise identical N-terminal
      sequences of the two toxic chains within the lectin preparation. On the basis of
      the influence of chemical modification by group-specific reagents on ligand
      binding, the lectin was biotinylated with biotinyl-N-hydroxysuccinimide ester to
      allow monitoring of cell binding. Monocytic leukemia cells (THP-1) specifically
      bound the lectin with positive cooperativity at low lectin concentrations.
      Radiolabelled lectin could be found in several organs and in an experimental
      solid tumor in biodistribution in mice. Its presence in a notable amount in
      spleens is especially noteworthy with respect to the already reported
      immunomodulation. To determine intracellular responses that precede the lectin
      dependent augmentation of cytokine secretion, phosphorylation of proteins and
      phospholipids as well as Ca(2+)-mobilization were assessed in THP-1 cells.
      Quantitative increases of [32P]-phosphate incorporation were determined for a 28
      kDa protein and for phosphatidylinositol-4,5-biphosphate. Similarly, the
      fluorescence activity of the intracellular Ca(2+)-indicator fluo-3 is elevated by
      approximately 25% after lectin treatment. Apparently, cell binding of the lectin
      is followed by modulation of biosignalling processes.

PMID- 1622125
TI  - Sex steroid receptors, S-phase fraction and DNA ploidy as determinants of the
      risk of relapse and death of female breast cancer.
AB  - S phase fraction (SPF) and DNA ploidy were related to disease outcome by a
      separate analysis of sex steroid receptor positive and negative tumours in a
      series of 232 patients with breast carcinoma followed-up for over 8 years in our
      clinic. SPF was significantly higher in receptor-negative tumours than in
      receptor-positive ones (p = 0.037). SPF predicted recurrence only in ER+ or PR+
      patients (p = 0.02-0.003). Recurrence-free survival (RFS) was significantly
      related to SPF only in ER+ (p = 0.001) and PR+ (p less than 0.001) tumours. In
      survival analysis, ER+ (p = 0.002) and PR+ (p less than 0.001) patients were
      efficiently divided into prognostic groups by SPF, whereas in ER- and in PR-
      tumours SPF had only suggestive predictive value. In N- tumours, SPF predicted
      recurrence-free survival and disease-related survival in ER+ (p = 0.003) (p =
      0.039) and in PR+ (p = 0.003) (p = 0.012) tumours, respectively, whereas in ER-,
      PR-, tumours, SPF had no predictive value. In pN+ tumours, SPF also predicted
      survival in ER+ (p = 0.03) and in PR+ (p = 0.024) tumours. Thus the prognosis of
      ER+ or PR+ tumours with an SPF less than 9% is favourable with a risk of death of
      about 20%, in contrast to that of about 70% in tumours with an SPF greater than
      9% during the follow-up period. To conclude, the proliferation rate as measured
      by S phase fraction by FCM is a highly significant prognostic factor in breast
      cancer. The prognostic value of S phase fraction is confined to steroid receptor
      positive tumours, whereas in receptor-negative tumours SPF has no predictive
      value. The results thus suggest that all women with steroid receptor-negative
      breast tumours and those receptor-positive tumours with an SPF higher than 9%
      should be subjected to postoperative adjuvant chemotherapy immediately.

PMID- 1622126
TI  - Interrelation between Western type cancers and non-Western type cancers as
      regards their risk variation in time and space. IV. Hormonal transition of
      Japanese women from the pro-cervical cancer age through the pro-endometrial
      cancer age to the pro-hypogonadism age.
AB  - Chronological trend of urinary steroid excretions in Japanese women was
      investigated during the period of June 1972 to August 1986 using healthy women of
      urban and rural origins, patients with breast cancer and patients with either
      cervical cancer or endometrial cancer. The excretions of 14 neutral steroids were
      estimated by gas liquid chromatography, and the obtained data were tentatively
      correlated with the epidemiological backgrounds. In the course of the
      chronological transition from the 1st stage (1972-1974) to the 2nd stage (1975
      79), the urinary steroid pattern of Japanese women with and without cancer
      experienced a common change to produce specific deviations that were in agreement
      with the hormonal characteristics of a pill user or of an endometrial cancer
      patient. At the 3rd stage (1980-86), patients with either cervical cancer or
      endometrial cancer were distinguished from 1st stage controls by non-specific
      depression of all androgens, progestins and corticosteroids in urine. Throughout
      the whole period, both the risk for cervical cancer and the reproductive activity
      (birth rate) were found to decrease continuously in Japanese women. Evidence was
      presented to suggest that the above deterioration of the hormonal environment in
      Japanese women could be related to the stress of modern life rather than to
      defects in the diet. On the basis of the above findings, the 1st, 2nd and 3rd
      stages of our investigation were tentatively termed the pro-cervical cancer age,
      the pro-endometrial cancer age and the pro-hypogonadism age. The relation between
      the chronological change of urinary steroids and that of the epidemiological
      background was analyzed from the view point of population ecology.

PMID- 1622127
TI  - Cytosolic and nuclear androgen receptors in colorectal adenomas.
AB  - The aim of this study was to verify the presence of androgen receptors (AR) in
      human colorectal adenomas and in normal adjacent mucosa, and to determine whether
      there is any difference in AR tissue content between females and males. Our data
      show higher levels of nuclear AR in normal mucosa than in adenomas (p less than
      0.001). A significant difference was also present in males between normal and
      pathological tissue both in cytosolic (p less than 0.05) and nuclear receptors (p
      less than 0.01). In female subjects this difference was also evident, but not
      significant. Our results seem to support the hypothesis of protective effects of
      androgens in colonic mucosa.

PMID- 1622128
TI  - Circulating mucins as tumor markers in ovarian cancer (review).
AB  - Because a highly sensitive and specific serum marker for ovarian carcinoma has
      not been reported, it is unlikely that there will be an application of serum
      markers for screening for this disease in asymptomatic women. However, many
      oncologists use serum tumor markers initially to differentiate epithelial ovarian
      carcinoma from benign gynecological conditions prior to surgery, so as to ensure
      appropriate surgical referral, and then to monitor the clinical course of disease
      during and after adjuvant therapy. The most commonly performed tumor marker assay
      in ovarian cancer (CA125) has been extremely valuable in patient management, but
      this marker is also elevated in a considerable proportion of patients with benign
      gynecologic diseases and endometriosis, and a relatively small proportion of
      patients with early stage disease. A new class of serum tumor markers, the highly
      glycosylated, high molecular weight mucins, have enormous potential in the
      management of ovarian cancer patients, since the use of assays for these markers
      may overcome many of the problems associated with CA125. Indeed, when used in
      combination with CA125, some mucin-based assays have increased the sensitivity
      and specificity of detection, thereby eliminating many false positive results
      seen with patients with benign disease and endometriosis, and also predicted
      disease recurrence in the majority of patients before clinical symptoms became
      apparent. These markers are the subject of this review, with particular attention
      to the commercially-available mucin-based assays.

PMID- 1622129
TI  - An evaluation of CA 549, a circulating marker of breast cancer using a procedure
      for comparison with CA 15.3.
AB  - A serum assay of CA 549 (Hybri-BREScan CA 549 degrees, Hybritech), a new tumor
      marker, was performed in 129 patients with breast cancer and 35 healthy women, in
      parallel with CA 15.3 (ELSA-CA 15.3 degrees, CIS Biointernational). Comparing 95
      women with primary breast carcinoma and 35 controls, Relative (or Receiver)
      Operating Characteristic (ROC) analysis revealed that the Area Under ROC Curve
      (AUC) of CA 15.3 was significantly higher than that of CA 549, indicating that,
      for our population, the first marker was more effective. Parallel and series
      analyses were also performed using ROC AUC and revealed that the combination of
      these two tests did not give more information than the CA 15.3 test alone;
      however, they did not in any way constitute diagnostic tools. In our experience,
      the best field of application for CA 549 seems to be the therapeutic monitoring
      and early detection of breast cancer recurrences. However, further investigations
      on a larger scale are necessary to assess more precisely the place of CA 549 in
      following the clinical course of breast cancer patients.

PMID- 1622130
TI  - Prognostic significance of flow cytometric and clinical variables in endometrial
      adenocarcinoma stages I and II.
AB  - In a prospective study comprising 447 women with endometrial carcinoma stages I
      II, the prognostic significance of clinical and flow cytometric variables was
      evaluated in univariate and multivariate analyses. The parameters studied
      included age, uterine cavity depth, clinical stage, histopathologic grade,
      myometrial invasion, weight, body mass index (BMI), parity, diabetes, oestrogen
      treatment, DNA - content and S-phase fraction. Patient selection for surgery
      influenced prognosis with a better survival in operated patients. In the
      univariate analysis the following parameters correlated with survival: age,
      grade, myometrial invasion, DNA - content and S- phase fraction. In the
      multivariate analyses which included clinical variables only, age, grade and
      myometrial invasion remained significant, but when flow cytometric variables were
      added, only S-phase fraction and myometrial invasion contained prognostic
      information. S-phase fraction also generally correlated with time of recurrence.

PMID- 1622131
TI  - Large scale expansion of human tumor infiltrating lymphocytes with surface
      modified stimulator cells for adoptive immunotherapy.
AB  - Expansion of tumor infiltrating lymphocytes (TIL) in vitro is hampered by several
      factors, including a limited amount of lymphocytes obtained from different
      tumors, unknown target antigens and limited supply of antigen-presenting cells
      (APC) which are generally believed to be essential in the classical way of T cell
      stimulation and expansion. In approaching these difficulties, we have recently
      used surface-oxidized allogeneic PBL to stimulate the TIL periodically in the
      presence of a low dose of rIL-2 (200 IU/ml). TIL derived from 22 (out of 23)
      tumor specimens could be expanded with 20 -10(7) fold increases over 6-16 weeks
      to a sufficient amount of 10(9) -10(11) cells for adoptive immunotherapy. In
      contrast, only 2-100 fold increase were observed in six tumor specimens (out of
      23) when 200 IU/ml rIL-2 was used only. The phenotypes, autologous tumor
      reactivity and cytolytic capability of TIL propagated with surface-oxidized
      stimulators were similar to those expanded in the presence of IL-2 alone. These
      data suggest that expanding TIL with surface-modified stimulator cells could be a
      useful alternative method to obtain a large amount of tumor specific cytolytic T
      cells for clinical immunotherapeutic use, irrespective of tumor-antigen
      stimulation and MHC restriction.

PMID- 1622132
TI  - Chlorophyllin, an antimutagen, acts as a tumor promoter in the rat
      dimethylhydrazine colon carcinogenesis model.
AB  - Chlorophyllin (CHL), the water soluble sodium/copper salt of chlorophyll, was
      investigated for its effect on colorectal cancer risk in the rat-dimethyldrazine
      colon carcinogenesis model. Ninety weanling Fisher 344 male rats were treated
      with five weekly injections of 1,2 dimethylhydrazine (DMH), 20 mg base/kg body
      weight. Rats had been previously divided into three groups, consuming either rat
      chow and water (Group I), rat chow and CHL 1.5 mM in water throughout the
      experiment (Group II), or water and rat chow during DMH injection, adding CHL 1.5
      mM to the drinking water after completion of the DMH treatments. At sarcifice,
      the incidence and yield of colorectal tumors were as follows: Group I 10% and
      0.1; Group II, 23% and 0.27; and Group III, 47% and 0.53 (p less than 0.005 for
      incidence and = 0.003 for yield). These data demonstrate that, though it is well
      established that CHL is an antimutagen, CHL in this colorectal carcinogenesis
      model acted as a tumor promoter.

PMID- 1622133
TI  - Evaluation of the safety of recombinant interleukin-2 (rIL-2) and rIL-2 plus 5
      fluorouracil (5-FU) in the adjuvant treatment of gastric cancer patients.
AB  - Eight patients received either recombinant Interleukin-2 (rIL-2) alone or rIL-2
      plus 5-Fluorouracil (5-FU) by constant infusion after undergoing potentially
      curative surgery for gastric cancer. rIL-2, given at a dose of 18 x 10(6)
      IU/m2/24 hours, was safely tolerated and only two episodes of WHO grade 3
      toxicities occurred, both of which promptly responded to treatment and temporary
      interruptions of rIL-2 infusions. 5-FU infusions given at 12.5 mg/kg/24 hours did
      not alter the rebound lymphocytosis seen after completion of rIL-2 infusions. We
      conclude that the administration of rIL-2 and rIL-2 plus 5-FU to cancer patients
      recovering from major surgery is safe and well tolerated.

PMID- 1622134
TI  - Dopa inhibits induced proliferative activity of murine and human lymphocytes.
AB  - L-DOPA, the product of enzymatic hydroxylation of L-tyrosine, is released by
      melanotic melanoma cells in vivo and in vitro. Here we report that DOPA at
      pharmacologically relevant micromolar doses dramatically inhibits the stimulation
      of DNA synthesis by lipopolysaccharide and concanavalin A in murine splenocytes
      and human lymphocytes, having little or no effect on unstimulated (control)
      lymphocytes or proliferating fibroblasts. Therefore we propose that
      melanogenically active melanoma cells can inhibit the host's immune response via
      the release of DOPA and/or its oxidation products.

PMID- 1622135
TI  - Stress response, survival and enhancement of heat sensitivity in a human melanoma
      cell line treated with L-canavanine.
AB  - L-Canavanine, like other aminoacid analogs, induces the synthesis of heat shock
      proteins (HPSs) but, unlike heat or other stressing agents, it fails to induce
      thermotolerance. We have studied the synthesis and the intracellular distribution
      of HSPs induced by canavanine, the effects of this analog on the viability and
      thermal sensitivity of a human melanoma cell line (M14) and the capacity of
      canavanine-induced HSPs to self regulate their own synthesis. Evidence indicates
      that the HSP induction is time--and dose--dependent and, also in the presence of
      arginine, is not associated with the development of thermotolerance. On the
      contrary, cells become more heat sensitive and are less efficient in the control
      of the feed-back mechanism that regulates HSP synthesis. The possible utilization
      of this substance as a potential aid for the treatment of tumors, in association
      with heat, was examined.

PMID- 1622136
TI  - Induction of HLA class II antigens in osteosarcoma cells by interferons and tumor
      necrosis factor alpha.
AB  - In this study we have evaluated the ability of interferons (IFNs) alpha, beta,
      gamma and Tumor Necrosis Factor (TNF) alpha to modulate the expression of the
      Major Histocompatibility Complex (MHC) antigens in human osteosarcoma cells. The
      osteosarcoma cell lines Saos-2 and U-2 OS, treated in vitro with IFNs and TNF
      alpha, showed an increased expression of class I HLA antigens. However, only IFN
      gamma and, to a lower extent, IFN beta induced the expression of class II HLA
      antigens. These effects were dose and time-dependent. Simultaneous treatment with
      IFN gamma and IFN beta or TNF alpha, which by itself was unable to induce the
      expression of class II HLA antigens, produced different effects on the two
      osteosarcoma cell lines: in Saos-2 IFN beta and TNF alpha amplified the effects
      obtained with IFN gamma alone; in U-2 OS, TNF alpha increased the expression
      induced by IFN gamma on class II HLA antigens, whereas IFN beta antagonized the
      effects of IFN gamma. IFN alpha did not influence the induction of class II HLA
      antigens by IFN gamma in the two osteosarcoma cell lines. IFNs have been
      introduced in some clinical protocols for the treatment of osteosarcoma, based on
      their antiproliferative activity. Our findings may contribute to a better
      knowledge of the effects of IFNs and TNF alpha in osteosarcoma by showing the
      existence of more complex interactions.

PMID- 1622137
TI  - The induction of apoptosis by chemotherapeutic agents occurs in all phases of the
      cell cycle.
AB  - A1.1 T-cell hybridoma cells exposed to either actinomycin D (1 microgram/ml),
      camptothecin (200 ng/ml) or aphidicolin (10 micrograms/ml) for 16 hrs at 37
      degrees C die via apoptosis. The cell death was independent of RNA synthesis, in
      contrast to previous data reported for other forms of apoptosis in murine
      lymphocyte cells and their derived lines. Each of the three agents described
      appeared to induce death in all phases of the cell cycle in asynchronously
      proliferating cells. G1 cells appeared to be more susceptible to the effects of
      camptothecin and contrasts with other reports which detail its selectivity for S
      and G2 phase cells. This might indicate that cells are progressing into S phase
      before dying or, alternatively, cells may indeed be dying in G1. When elutriated
      synchronised cells were exposed to each of the three cytotoxic agents cell death
      occurred in all phases of the cell cycle. In view of the fact that G1 and S phase
      cells did not cycle to any appreciable extent during drug exposure, it was likely
      that ensuing death, occurred specifically from these phases. G2/M cells, however,
      moved rapidly into G1 in the presence of each drug, thus making it difficult to
      determine whether G2/M cells were capable of undergoing drug-induced apoptosis.
      To overcome this problem, nocodazole (50 ng/ml) was used to block asynchronous
      cells in M phase. When these cells were exposed to actinomycin D, aphidicolin or
      camptothecin, cell death ensued via apoptosis.

PMID- 1622138
TI  - Growth factor-like activity of phenol red preparations in the MCF-7 breast cancer
      cell line.
AB  - Hormonal responsiveness of the estrogen-sensitive MCF-7 human breast cancer cell
      line is known to vary between laboratories although the causes and implications
      of these variations remain unclear. Our findings lead us to conclude that the pH
      indicator phenol red (PHR) has growth factor-like effects in addition to its well
      known estrogen-like effects. To demonstrate this hypothesis, we have assessed the
      importance of PHR either in the absence or in the presence of the estrogens
      contained in the serum added to the culture medium. The basal growth rate of MCF
      7 cells was significantly reduced by short-term or long-term withdrawal of PHR.
      The stimulatory effects of estradiol and the inhibitory effects of the
      antiestrogen 2-CH3,4-OH-tamoxifen (MHT) were not significantly affected by long
      term withdrawal of the dye. Moreover, long-term cell maintenance without PHR
      alone or in complete estrogen-depleted medium did not change their basal steroid
      receptor content. The molecular structure of the estrogen receptor which is
      usually modified under estrogenic stimulation remained identical whether or not
      the cells were maintained in the presence of the dye. Maintaining cells without
      the dye in the presence of serum estrogens led to the death of the cell line
      after 50 transfers. Lastly, addition of PHR had clearcut growth stimulatory
      effects on the hormono-independent cell line Evsa-T.

PMID- 1622139
TI  - Reduction of VX2 transplanted tumor by granulocyte depletion using extracorporeal
      circulation on rabbit models.
AB  - To investigate the role of granulocytes and the effect of granulocytosis on
      malignancies, we studied the relationship between white blood cell and
      granulocyte (Gr) counts, and tumor size. As we have reported that cancer patients
      with high granulocyte (G/L) ratio have a poor clinical prognosis, normalization
      of the G/L ratio could contribute to improvement in their condition. Tumor
      bearing rabbits treated with the extracorporeal granulocytte depletion device
      showed a decrease in tumor size and no tumor necrosis. Tumor-bearing rabbits with
      no extracorporeal granulocyte depletion showed a remarkable tumor progression and
      an increase in Gr count. Depletion of granulocytes considerably improved the
      survival ratio of tumor-bearing animals. The device used in this study could be a
      potential treatment for malignant tumors.

PMID- 1622140
TI  - Hyperthermochemoradiotherapy for esophageal cancer (review).
AB  - Hyperthermia is effective for the treatment of cancer when applied concomitantly
      with chemotherapy and irradiation. However, it is difficult to heat deep portions
      of the body including the esophagus. Cancer of the esophagus still poses
      considerable treatment problems, with a poor 5-year survival rate after surgery,
      an even worse outlook after radiation and surgery, and a not very satisfactory
      response to chemotherapy. We, therefore, devised an electrode for radio
      frequency, and we have been successfully using this electrode in the treatment of
      esophageal cancer. The 5-year survival rates of patients with esophageal cancer,
      given either preoperative hyperthermochemoradiotherapy or chemoradiotherapy, were
      43.2 and 14.7%, respectively. Immediate improvement of subjective complaints and
      decrease or elimination of the cancer lesion are so distinct that this treatment,
      by means of an endotract antenna, shows promise as a modality for esophageal
      lesions.

PMID- 1622141
TI  - Recombinant human interleukin-3 opposes the effects of vitamins A and D on HL-60
      human myeloid leukaemia cells.
AB  - Interleukin-3 (IL-3), retinoic acid (RA) and 1,25-dihydroxyvitamin D3
      (calcitriol) (vitamin D) have achieved objective responses in phase I/II clinical
      trials in myeloid leukaemia and preleukaemia patients. In an effort to explore
      any additive or synergistic interactions between these biological agents which
      could provide the basis for improved therapeutic regimens for myeloid leukaemia
      patients, we have investigated the effects of IL-3 on both RA- and vitamin D
      induced actions in HL-60 human myeloid leukaemia cells, which have receptors for
      these three agents, in both clonogenic microassays and liquid suspension
      cultures. The proliferative stimulus of IL-3 overrode and reversed the
      antiproliferative actions of both RA and vitamin D, the latter being more
      sensitive to the counter-acting effect of IL-3. Whereas only high concentrations
      of IL-3: 1000 or more U/ml were able to oppose the antiproliferative effect of
      RA, all concentrations of IL-3 including the low concentration of 10 U/ml,
      significantly counteracted the anti-proliferative action of vitamin D. RA
      restrained the proliferative stimulus of IL-3 partly at low physiological
      concentrations and almost completely at high pharmacological concentrations. The
      same results were reproduced in liquid suspension culture. Whereas RA restrained
      the proliferative stimulus of IL-3, vitamin D failed to restrain it. However, IL
      3 did not induce differentiation or affect RA- or vitamin D-induced
      differentiation of HL-60 cells. The present results suggest that the clinical use
      of the combination of low concentration of IL-3 with RA and not with vitamin D
      might restrain the progression of myeloid leukaemia incurred during the treatment
      with IL-3 in some preleukaemic patients.

PMID- 1622142
TI  - Effect of hypoxia and acidosis on the cytotoxicity of mitoxantrone, bisantrene
      and amsacrine and their platinum complexes at normal and hyperthermic
      temperatures.
AB  - In an effort to synthesize drugs which would become much more cytotoxic at
      clinically achievable hyperthermic temperatures, complexes of the tetrachloro
      platinum(II) dianion were made with two anthracene dye derivatives, MITOX and
      BISANT, and the acridine dye derivative m-AMSA. As compared with the parent drug,
      PtCl4(MITOX)2 was less cytotoxic at 37 degrees C and more cytotoxic at 42 degrees
      C and 43 degrees C especially at pH 6.45. In contrast, the PtCl4(BISANT)2 was
      more cytotoxic than BISANT under all conditions. M-AMSA was again shown to be
      less cytotoxic at elevated temperatures but PtCl4(m-AMSA)2 was more cytotoxic
      especially at 43 degrees C and pH 6.45. Platinum levels in cells treated for 1 hr
      with 25 microM at 37 degrees C, 42 degrees C and at pH 7.40 versus pH 6.45
      demonstrated no significant differences depending on temperature or pH except for
      PtCl4(MITOX)2 where approximately 4 times higher intracellular platinum levels
      were present at pH 6.45 versus pH 7.40, although this finding did not correlate
      with cytotoxicity. These results suggest that PtCl4(MITOX)2 and PtCl4(m-AMSA)2
      may be highly interactive drugs with local hyperthermia.

PMID- 1622143
TI  - Antitumor agent, physalin F from Physalis angulata L.
AB  - Physalin F and physalin D were isolated and characterized from the ethanolic
      extract of the whole plant of Physalis angulata L. (Solanaceae). Systematic
      fractionation of the ethanolic extract of the plant led to characterization of
      physalin F from the fraction PAIV-2 as an active ingredient which showed
      cytotoxicity in vitro by DEA and MTT assays on 8 cancer cell lines, five human
      cancer cell lines: HA22T(hepatoma), HeLa(cervix uteri), KB(nasopharynx), Colo
      205(colon) and Calu-1(lung); and three animal cancer cell lines: H1477(melanoma),
      Hep-2(laryngeal) and 8401(glioma). It was found that the anti-hepatoma action is
      the strongest, and the anti-HeLa is the next. Physalin F also had an antitumor
      effect in vivo against P388 lymphocytic leukemia in mice whereas physalin D was
      inactive both in vitro and in vivo.

PMID- 1622144
TI  - A role for plasma membrane potential in doxorubicin--induced cytotoxicity.
AB  - Using a modifier of membrane function, we have shown that plasma membrane
      potential plays an important role in doxorubicin (DOX) - induced cytotoxicity
      through its connection with cell metabolism and through its effect on drug
      accumulation. Membrane potential of K562 cells, measured using 3, 3'-dihexyl
      oxacarbocyanine (DiOC6 (3)), was increased in the presence of non-toxic
      cepharanthin or N-1379 and decreased in the presence of non-toxic K252a.
      Correlated with the level of the potential, DOX efficacy was enhanced by
      cepharanthin or N-1379 and decreased by K252a associated with an increase or
      decrease of the percentage of cells in S-phase and of intracellular DOX
      accumulation.

PMID- 1622145
TI  - Combination of beta-interferon and tamoxifen as a new way to overcome clinical
      resistance to tamoxifen in advanced breast cancer.
AB  - This paper shows that the response to tamoxifen (T) can be improved and the
      resistance to the antiestrogen can be overcome, in advanced breast cancer, by a
      pretreatment with natural beta-interferon (nIFN-beta) followed by the association
      of nIFN-beta with T. Forty-three patients with advanced breast cancer, both
      progressive (group A) and stable or partially responsive (group B) to previous
      treatment with T received nIFN-beta i.m. 3 x 10(6) IU/day for 14 days and,
      subsequently, T30 mg/day and nIFN-beta once a week. The overall objective
      response rate was 26% (95% Confidence Interval = 13-39) with 8 PR obtained in
      group A and 3 CR in group B. The median duration of response was 6 months (range
      3-12+). Stabilization of disease was observed in 44% of cases. Toxicity was mild.

PMID- 1622146
TI  - Tolerance to long-term treatment of malignant midgut carcinoid with a highly
      purified human leukocyte alpha-interferon.
AB  - We report here the long-term toleration of treatment with a highly purified human
      leukocyte alpha-interferon (Interferon Alfanative) in patients with midgut
      carcinoid tumours with liver metastases. During an 18-month period, 13
      consecutive patients with this diagnosis commenced treatment with a-interferon.
      Five patients died during the first 2 years of treatment due to tumour
      progression, and in 2 patients the treatment with a-interferon had to be stopped
      due to severe adverse effects (mainly joint pain and tiredness). Hence, 6
      patients tolerated the treatment for a long-term period (greater than 2 years),
      and in these patients the treatment has continued for more than 3 years; in 3 of
      them for more than 4 years. In these 6 patients, adverse effects of mild or
      moderate degree have been observed in 2 patients: itching and hair loss in one
      and joint pain and hair loss in another. Except for a significant reduction in
      the blood number of WBC and thrombocytes (although in no patient did
      leukocytopenia or thrombocytopenia develop) and the development of hypothyroidism
      in one patient, no biochemical tests have shown significant changes during the
      long-term treatment. In these 6 patients, objective tumour regression has been
      observed in 2 patients, stable disease in 3 patients and progression in 1
      patient. We conclude that, of the patients initiated on treatment with a
      interferon for midgut carcinoids with liver metastases, only approximately 50%
      are still on the treatment after 2 years. These patients, on the other hand, may
      continue for a longer period of time with a low degree of adverse effects.

PMID- 1622147
TI  - The expression of mRNA for glucocorticoid receptor gene and functional
      glucocorticoid receptors detected in PA-III rat prostate adenocarcinoma cells.
AB  - The metastatic capacity of PA-III rat prostate adenocarcinoma cells has been well
      documented, although little is known about the biological and biochemical
      characteristics of PA-III cells. This study characterizes PA-III cells with
      regard to the presence or absence of glucocorticoid and androgen receptors.
      Cytosols of PA-III cells possessed [3H]-dexamethasone binding sites with
      association constant (Ka) 0.46 +/- 0.17 x 10(9) M-1 and number 341 +/- 175
      fmols/mg protein. Displacement of [3H]-dexamethasone binding from PA-III cytosols
      achieved by increasing doses of unlabelled dexamethasone, corticosterone,
      cortisol, progesterone, deoxycorticosterone and aldosterone documented
      glucocorticoid binding specificity. Northern and dot blot analyses detected the
      expression of mRNA for glucocorticoid receptor using a 750 bp cDNA probe of the
      glucocorticoid receptor gene. Twenty-four hours incubation of PA-III cells with
      increasing amounts of dexamethasone resulted in a remarkable inhibition of the
      growth of PA-III cells. Binding studies with [3H]-R1881 as well as dot blot and
      Northern blot analyses using a 500 bp cDNA probe of androgen receptor gene could
      not detect the presence of androgen receptors in PA-III cells. The present study
      documented functional glucocorticoid receptors in the androgen-independent PA-III
      rat prostate adenocarcinoma cells. These results suggest that glucocorticoids may
      regulate important aspects of androgen-independent prostate cancer cells growth
      and functions.

PMID- 1622148
TI  - Penta-acetyl geniposide: isolation, identification and primary effect on C6
      glioma cells in vitro.
AB  - A new compound, penta-acetyl geniposide [(Ac)5-GP], was obtained from modified
      extract of Gardenia Fructus (San-jee-chee in Chinese). Spectral studies including
      ultraviolet (UV), mass (MS), nuclear magnetic resonance (NMR), infrared (IR) and
      elemental analysis (EA) have suggested the chemical structure of the compound as
      1-(beta-D-2',3',4',6'-tetraacetyl- glucopyranosyloxy)-1,4a,5,7a-tetrahydro-7
      (acetomethyl)-c yclopentapyran-4-carboxylic acid methyl ester. The antitumor
      bioactivity of (Ac)5-GP in vitro was studied. It exhibited the activities of
      reduced plating efficiency and inhibition of DNA synthesis in cultured C-6 glioma
      cells, but had little effect on RNA and protein synthesis. These results implied
      that the acetylated iridoid glycoside of Gardenia Fructus is biologically active
      as an antitumor agent against C-6 glioma cells in culture.

PMID- 1622149
TI  - Growth inhibitory and differentiating effects of sodium butyrate on human
      neuroblastoma cells in culture.
AB  - The effect of sodium butyrate (NaB) on cell growth and expression of
      morphological and biochemical properties was examined in the human neuroblastoma
      cell lines AF8 and SJ-N-KP. The obtained data show that NaB induced a marked
      growth inhibition and morphological differentiation, while it was ineffective in
      inducing biochemical differentiation.

PMID- 1622150
TI  - Therapeutic efficacy of interleukin-2 activated killer cells against adriamycin
      resistant mouse B16-BL6 melanoma.
AB  - Development of multidrug-resistance (MDR) remains a major cause of failure in the
      treatment of cancer with chemotherapeutic agents. In our efforts to explore
      alternative treatment regimens for multidrug-resistant tumors we have examined
      the sensitivity of MDR tumor cell lines to lymphokine activated killer (LAK)
      cells. Adriamycin (ADM) resistant B16-BL6 melanoma, L1210 and P388 leukemic cell
      lines were tested for sensitivity to lysis by LAK cells in vitro. While ADM
      resistant B16-BL6 and L1210 sublines were found to exhibit at least 2-fold
      greater susceptibility to lysis by LAK cells, sensitivity of ADM-resistant P388
      cell was similar to that of parental cells. Since ADM-resistant B16-BL6 cells
      were efficiently lysed by LAK cells in vitro, the efficacy of therapy with LAK
      cells against the ADM-resistant B16-BL6 subline in vivo was evaluated. Compared
      to mice bearing parental B16-BL6 tumor cells, the adoptive transfer of LAK cells
      and rIL2 significantly reduced formation of experimental metastases (P less than
      0.009) and extended median survival time (P less than 0.001) of mice bearing ADM
      resistant B16-BL6 tumor cells. Results suggest that immunotherapy with LAK cells
      and rIL2 may be a useful modality in the treatment of cancers with the MDR
      phenotype.

PMID- 1622151
TI  - Effect of metabolic inhibitors, methylxanthines, antioxidants, alkali metals, and
      corn oil on 1,2-dimethylhydrazine carcinogenicity in rats.
AB  - The effect of the oral administration of 10 compounds on 1,2-dimethylhydrazine
      (DMH) carcinogenesis was investigated in 180 male Wistar rats and 510 male BD6
      rats. DMH, administered s.c. once per week for 20 consecutive weeks (20 mg/kg
      body wt/dose), produced intestinal (mainly colon) tumors of various histological
      type in 100% of both rat strains and, in addition, caused Zymbal gland carcinomas
      in 79.7% of Wistar rats. Pretreatment with disulfiram (DSF, 500 mg/kg), a known
      inhibitor of DMH metabolism, totally prevented intestinal and Zymbal gland tumors
      in Wistar rats. When DSF treatment started after the first DMH injection, the
      protective effect was not total, the incidence and multiplicity of both types of
      tumors being comparable to those observed following a single injection of the
      carcinogen alone. This confirms the involvement of DSF in the initiation stage
      only of DMH carcinogenesis. A complete prevention of intestinal tumors in BD6
      rats was also produced not only by the DSF metabolite carbon disulfide (250
      mg/kg) but also by the hepatotoxic agent carbon tetrachloride (1.5 ml/kg), which
      suggests that the block of DMH metabolism in rat liver is not an exclusive
      property of thiono-sulfur compounds. Butylated hydroxytoluene (BHT) decreased the
      multiplicity of intestinal tumors, but not to a significant extent. BHT and the
      aforementioned metabolic inhibitors were administered by gavage in corn oil,
      which per se did not significantly decrease intestinal or Zymbal gland tumors.
      All remaining modulators were administered with drinking water. Two additional
      antioxidants triggered opposite effects on the multiplicity of intestinal tumors.
      In fact, sodium selenite (10 mg/l) significantly decreased the number of tumors,
      whereas ascorbic acid (10 g/l), irrespective of its combination with CaCl2,
      produced a marked enhancement. The alkali metal salts CaCl2 and KCl (both at 5
      g/l) as well as the methylxanthines caffeine and theophylline (both at 600 mg/l)
      were devoid of significant effects. Neither treatment with DMH alone nor its
      association with test modulators was accompanied by significant changes in body
      weight gain or survival of animals. On the whole, depending on the mechanisms
      involved, the comparative study of test compounds led to a broad array of effects
      on DMH carcinogenesis, ranging from complete inhibition to significant
      enhancement. The resulting picture can be visualized at a glance in Figure 1 of
      this article.

PMID- 1622152
TI  - Morphologic differences in leukemic cells (L1210) exposed to 1-beta-D
      arabinofuranosylcytosine and daunorubicin.
AB  - To compare the morphologic differences in leukemic cells exposed to a nucleotide
      synthesis inhibitor and a DNA strand damage inducer, L1210 cells incubated with 1
      beta-D-arabinofuranosylcytosine (ara-C) or daunorubicin (DNR) were investigated
      by time-lapse video microscopy, flow cytometry and transmission electron
      microscopy. At 1.0 microgram/ml of ara-C, cells could be separated into two
      populations, with some becoming ballooned and deformed, i.e. irreversibly
      damaged, and others remaining unchanged, i.e. in a proliferative state. In
      contrast, at 0.10 microgram/ml of DNR, nearly all cells were remarkably enlarged
      and did not proliferate during 72 hours of observation. Such morphologic changes
      induced at clinically achievable concentrations of each agent seemed to reflect
      their differing mechanisms of action on the synthesis of DNA. The methods
      described may allow the characterization of antileukemic agents as well as the
      development of clinical designs for their rational application in leukemia
      patients.

PMID- 1622154
TI  - Experimental tumor inhibitory and toxic properties of the mitomycin A analogue 7
      (2-hydroxyethoxy) mitosane (BMY-25551).
AB  - BMY-25551, 7-(2-hydroxyethoxy)mitosane, was selected from a series of mitomycin A
      (MMA) analogues for more detailed study. As with other members of this class, it
      was shown to be 8 to 20 times more potent than mitomycin C (MMC) in cytotoxicity
      to murine and human tumor cell lines in vitro, in causing DNA cross links in
      vitro, and in dose levels for tumor inhibition in vivo. BMY-25551 appeared to be
      more effective in tumor inhibition than MMC against P388 leukemia and B16
      melanoma in mice and comparable to MMC against L1210 leukemia and Madison 109
      lung carcinoma. BMY-25551 was also comparable to MMC in hematologic depression in
      mice. Factors affecting its possible utility in humans are discussed.

PMID- 1622153
TI  - Immunomodulators from Paris formosana Hayata.
AB  - Eight glycosides PF-1 to PF-8 were isolated from the leaves and stems of Paris
      formosana Hayata (Liliaceae), of which PF-3 (III) was the main compound. It was
      found that PF-1 to PF-3 (I-III) caused proliferative responses of mouse
      lymphocytes to concanavalin A and augmentation of mouse granulocyte/macrophage
      colony forming cells in mouse fibroblast cell L929 conditioned medium. PF-4(IV)
      and PF-8 showed significant immunomodulatory effects with very low toxicity: they
      not only caused the same immune responses as PF-1, 2 & 3 but also enhanced the
      proliferative response of human peripheral whole blood to phytohemagglutinin. PF
      5 (V) also increased 3H-thymidine incorporation in ConA-stimulated lymphocytes
      and in PHA-stimulated human peripheral whole blood, and enhanced the
      proliferative response of granulocyte/macrophage colony stimulating activity. PF
      6(VI) and PF-7(VII) augmented 3H-thymidine incorporation in
      granulocyte/macrophage colony-forming cells and mitogenic response of PHA
      stimulated human peripheral whole blood cells from healthy adults. However, PF-1,
      2 and 3 showed hemolytic action, while PF-4 to PF-8 had no hemolytic action at
      all. On the other hand, the hemolytic action of PF-3 derivatives was reduced as
      compared with PF-3 but their immune responses did not equal those of PF-3, only
      showing granulocyte/macrophage colony stimulating activity.

PMID- 1622155
TI  - Activation and phenotyping of LAK generated by exposure to product of cells
      transformed by interleukin 2 cDNA.
AB  - It has been previously found that local administration of X63-m-IL-2 cells
      transformed by interleukin 2 (IL-2) cDNA and constitutively producing large
      quantities of IL-2 mediated regressions of murine plasmacytomas and 3-methyl
      cholanthrene-induced sarcomas transplanted in syngeneic mice. Here we show that
      killer cells generated by cultivation of spleen cells in supernatants from X63-m
      IL-2 cultures (LAK) or by co-cultivation of murine splenocytes with X63-m-IL-2
      cells were cytolytic for natural killer (NK)-sensitive as well as NK-resistant
      target cells, including the IL-2-producing X63-m-IL-2 cells. Spleen cells
      cultured in X63-m-IL-2 supernatants or co-cultivated with X63-m-IL-2 cells
      yielded predominantly Thy 1.2+, CD3+, LFA-1+ lymphocytes. The in vitro results
      suggest that the LAK cells generated due to the IL-2 production by genetically
      engineered cells probably help to terminate the treatment by killing the IL-2
      producers.

PMID- 1622156
TI  - Growth inhibition of human malignant glioma cells in vitro by agents which
      interfere with biosynthesis of eicosanoids.
AB  - In an attempt to find new methods for the treatment of malignant gliomas a number
      of tests have been performed to learn whether growth of such cells in vitro may
      be affected by agents which interfere with the biosynthesis of eicosanoids. It
      was observed that DNA-synthesis of short-term monolayer cultures could be blocked
      by compounds which inhibit cyclooxygenase and/or lipoxygenase dependent
      arachidonic acid metabolism. The strongest inhibitory activities were noted in
      serum-free culture medium using compounds interfering with the activity of
      lipoxygenases. One explanation of these results could be that the growth of human
      malignant gliomas is dependent on certain eicosanoids which may be synthesized by
      the malignant cells themselves.

PMID- 1622157
TI  - Neoglycoprotein binding to normal urothelium and grade-dependent changes in
      bladder lesions.
AB  - Chemical conjugation of carbohydrate derivatives to a labelled carrier protein
      makes it possible to monitor the presence of specific sugar-dependent binding to
      routinely processed tissue sections. Different levels of cytoplasmic staining
      were observed in normal urothelium for the applied probes that expose a beta-D
      galactoside, alpha- or beta-N-acetyl-D-galactosaminide, beta-N-acetyl-D
      glucosaminide, alpha-D-mannoside, alpha-L-fucoside or a-D-glucoside,
      respectively. These moieties are crucial parts of the recognition sites in
      cellular glycoconjugates for plant lectins. The extent of staining invariably
      increased from the basal to the luminal cell layer. No nuclear staining was
      observed. Within the 18 cases of bladder lesions studied, the appearance of
      nuclear staining was characteristic of transitional cell carcinoma, its
      correlation to the histologic grade being dependent on the type of
      neoglycoprotein. Cytoplasmic staining revealed at least two patterns of grade
      dependent variations, namely rather constant expression for lactose-mannose-,
      fucose- and maltose-specific sites and an initial increased followed by a loss of
      binding activity at the highest level of cellular atypia for the other three
      types of probe. Intratumoral heterogeneity was especially visible in tumors of
      this group. Interestingly, the known positive correlation of presence of the
      Thomsen-Frieden rich antigen with the level of cellular atypia, monitored with
      peanut agglutinin, could be extended to the expression of respective receptor
      sites, which was experimentally feasible due to the synthesis of this
      disaccharide structure and its immobilization to the carrier protein.

PMID- 1622158
TI  - 1H-NMR spectroscopy of urinary components of SHN mice in the course of
      spontaneous mammary tumourigenesis.
AB  - Proton nuclear magnetic resonance (1H-NMR) spectroscopy of urine was studied
      before and after the development of spontaneous mammary tumours in SHN mice.
      Urinary allantoin and lactic acid levels declined from 2 weeks before mammary
      tumour appearance and increased with the tumour growth after its appearance. The
      level of component at 3.4 ppm, which reacted with Ninhydrin and was possibly
      assigned to taurine, continued to decline beginning 2 weeks before tumour
      appearance. No considerable changes were observed in urinary levels of creatine
      and creatinine before and after tumour development, however, these components as
      well as allantoin or lactic acid had positive correlations with mammary tumour
      size. A negative correlation was observed between the level of 3.4 ppm component
      and tumour size. Surgical removal of tumours resulted in an apparent decline in
      urinary levels of allantoin and lactic acid. At all stages, urinary allantoin
      level was approximately 4 times as high as the levels of lactic acid and 3.4 ppm
      component. All results suggest that urinary allantoin would be a good indicator
      for the development of spontaneous mammary tumours of mice.

PMID- 1622159
TI  - Identification of a clustering of chromosomal breakpoints in the analysis of 203
      human primary solid tumor non specific karyotypic rearrangements.
AB  - The distribution of 271 chromosomal breakpoints involved in 203 clonal structural
      non "specific" rearrangements identified in 82 human primary solid tumors of
      various histologies has been analyzed. According to the "mean + 1 SD" criterion
      the normalized breakpoint frequency was significantly higher for chromosomes 1p,
      3p, 3q, 4q, 6q, 7q, and 11p. Clusters of 3 or more breakpoints were assigned to
      only 24 of the 329 bands (7%) of the standard karyotype, and 9 high density
      breakpoint segments have been identified. These results indicate that a nonrandom
      pattern of chromosomal rearrangements can be extracted from the complex
      karyotypic changes observed in solid tumors, which suggest that the involved
      regions play a general role in tumorigenesis.

PMID- 1622160
TI  - Bactericidal titers of loracarbef (LY 163892) in serum and killing rates in
      volunteers receiving 400 versus 200 milligrams.
AB  - In a randomized crossover trial, six volunteers received 200- and 400-mg doses of
      loracarbef (LY 163892), a new oral cephalosporin. Mean +/- standard error of the
      mean concentrations in serum obtained after 1.5 and 3 h were 13.2 +/- 2.8 and 4.3
      +/- 0.7 mg/liter, respectively, after the 400-mg dose and 6.9 +/- 1.0 and 1.7 +/-
      0.2 mg/liter, respectively, after the 200-mg dose. Bactericidal reciprocal titers
      measured against respiratory pathogens in serum suggested that loracarbef would
      be highly effective against Streptococcus pneumoniae and Streptococcus pyogenes
      (median titers, 8 to 128 at 1.5 h and less than 2 to 32 at 3 h) and beta
      lactamase-negative Haemophilus influenzae (median titers, 4 at 1.5 h and 2 to 4
      at 3 h). Other species (Branhamella catarrhalis, Streptococcus anginosus,
      Staphylococcus aureus) were associated with lower bactericidal titers. Killing
      curves performed against 12 strains demonstrated that the bioactivity of
      loracarbef (measured by the reduction in the area under the control growth curve)
      was significantly correlated with the concentration/MIC ratio, whereas the
      initial rate of killing was not, once the concentration was greater than the MIC.
      Our results suggest that administration of 400 mg of loracarbef every 8 h might
      be associated with more favorable pharmacodynamic parameters against target
      bacteria.

PMID- 1622161
TI  - Construction of a water-soluble form of penicillin-binding protein 2a from a
      methicillin-resistant Staphylococcus aureus isolate.
AB  - The mecA gene from methicillin-resistant Staphylococcus aureus 27r, which encodes
      the membrane-bound penicillin-binding protein 2a (PBP 2a), was cloned, sequenced,
      and expressed in Escherichia coli. PBP 2a is the major factor that mediates
      methicillin resistance in staphylococci. The DNA sequence of the mecA gene from
      strain 27r was greater than 99% identical to the DNA sequence of other S. aureus
      mecA genes and the mecA gene from Staphylococcus epidermidis. Analysis of the
      deduced amino acid sequence of PBP 2a from strain 27r revealed a hydrophobic
      region at the amino terminus that possessed characteristics of an uncleaved
      signal peptide such as those found in type II integral membrane proteins. Site
      specific mutagenesis was used to modify the strain 27r mecA gene to permit
      removal of the region encoding the putative transmembrane region (amino acids 2
      to 22). When it was expressed in E. coli, the modified mecA gene from strain 27r
      encoded a water-soluble form of PBP 2a that was detectable in the cytoplasm of
      transformants. The water-soluble form of PBP 2a protein from S. aureus 27r
      retained the same binding efficiency for beta-lactam antibiotics as the
      unmodified membrane-bound PBP 2a from S. aureus 27r.

PMID- 1622162
TI  - Correlation of various in vitro testing methods with clinical outcomes in
      patients with Bacteroides fragilis group infections treated with cefoxitin: a
      retrospective analysis.
AB  - There is limited information regarding the correlation of anaerobic
      susceptibility testing and outcome in the treatment of Bacteroides fragilis
      infections. We retrospectively analyzed the clinical outcomes of B. fragilis
      infections in patients treated with cefoxitin; the analysis was blinded for
      susceptibility results. Isolates of B. fragilis were tested by multiple agar
      dilution methods, disk elution, and commercial broth microdilution methods. Of 19
      patients analyzed, 11 were cured and 8 were treatment failures. No significant
      differences existed between the groups with respect to age, sex distribution,
      weight, APACHE II score, dose of cefoxitin, or bacteremia. Failure was associated
      with a longer cefoxitin dosing interval (P = 0.019), a longer duration of
      hospitalization (P = 0.038), and decreased duration of cefoxitin treatment (P =
      0.05). Four agar dilution systems (brucella plus blood, Wilkins-Chalgren, Wilkins
      Chalgren plus blood, brain heart infusion plus blood) and two broth systems
      (Wilkins-Chalgren microdilution and a commercial system [Micromedia; Beckman,
      Carlsbad, Calif.]) all demonstrated lower geometric mean MICs for isolates from
      the group of patients that could be cured. Only the commercial broth
      microdilution medium (Micromedia) demonstrated a significantly reduced geometric
      mean MIC (P = 0.056). By using a logistic regression analysis, the shorter
      cefoxitin dosing interval (P = 0.0004) and the lower geometric mean MIC (P =
      0.0088) in the commercial broth microdilution system were shown to be independent
      predictors of treatment success. These data suggest that the time that the
      concentration of cefoxitin is over the MIC for B. fragilis may be an important
      predictor of treatment success.

PMID- 1622163
TI  - Duration of rifampin chemoprophylaxis for contacts of patients infected with
      Haemophilus influenzae type B.
AB  - Rifampin is recommended as a prophylactic treatment for intimate contacts of
      young children who develop invasive infections with Haemophilus influenzae type B
      (Hib). A 4-day course of rifampin (20 mg/kg of body weight per day, not to exceed
      600 mg as a maximum single daily dose) is 95% effective in eradicating pharyngeal
      colonization with Hib, thus effectively reducing the risk of both associated
      patients and recurrent illness in index patients less than 2 years old. This
      study compares rates of eradication of pharyngeal colonization with Hib for 2-
      and 4-day courses of rifampin therapy. One hundred sixty-three patients with Hib
      infection were treated at Children's Hospital of Pittsburgh between January 1986
      and December 1988; prophylaxis was recommended for 128. Participating families
      were randomized to receive either 2- or 4-day therapy. Throat swabs were obtained
      from contacts prior to therapy. Repeat cultures were obtained from colonized
      contacts 2 days after completing rifampin and again on all contacts 7 to 10 days
      after completing therapy. Of 68 participating families, 34 received 2-day and 34
      received 4-day therapy with rifampin. Twenty-two of 24 colonized contacts in the
      2-day group and 17 of 18 in the 4-day group had negative cultures for Hib on
      follow-up. Two-day therapy with rifampin appears to be as effective as 4-day
      treatment in the eradication of Hib pharyngeal colonization.

PMID- 1622164
TI  - Antagonism between isoniazid and the combination pyrazinamide-rifampin against
      tuberculosis infection in mice.
AB  - Mice that had been inoculated intravenously with 6.30 log10 Mycobacterium
      tuberculosis H37Rv 14 days earlier were administered one of three combinations of
      drugs, i.e., isoniazid (INH)-rifampin (RMP)-pyrazinamide (PZA), INH-RMP, and RMP
      PZA, during an initial 2-month period to mimic the initial phase of chemotherapy
      for human tuberculosis and during a later 4-month period to mimic the
      continuation phase of chemotherapy. At the end of the initial phase, all three
      combined regimens were found to have been highly effective in terms of the number
      of CFUs in the spleens of infected mice. The bactericidal activities of INH-RMP
      PZA and INH-RMP were similar, whereas that of RMP-PZA was significantly greater.
      The spleens of all of the mice that had been treated initially with INH-RMP-PZA
      were culture negative by the end of 6 months of treatment, regardless of the
      regimen employed during the continuation phase. However, after an additional
      period of 6 months without treatment, the proportion of spleen culture
      positivity, or relapse rate, was significantly smaller in the subgroup treated
      with RMP-PZA during the continuation phase than in the subgroups treated with INH
      RMP-PZA or INH-RMP; the relapse rate did not differ significantly between the
      latter two subgroups. These results suggest that antagonism occurs between INH
      and the combination RMP-PZA during both the initial and continuation phases of
      chemotherapy, compromising the benefit conferred by the addition of PZA to the
      combined regimen. The preliminary pharmacokinetic analysis suggested that the
      pharmacological interaction between INH and RMP was very likely to be involved in
      the mechanism of antagonism, as concomitant treatment with INH had significantly
      reduced the peak serum level and the area under the serum concentration-time
      curve of RMP in mice.

PMID- 1622165
TI  - Pharmacokinetics of cefepime after single and multiple intravenous
      administrations in healthy subjects.
AB  - The pharmacokinetics of cefepime in 31 young, healthy volunteers were assessed
      after the administration of single and multiple 250-, 500-, 1,000-, or 2,000-mg
      intravenous doses. Each subject received a single dose of cefepime via a 30-min
      intravenous infusion on day 1 of the study. Starting from day 2, subjects
      received multiple doses of cefepime every 8 h for 9 days, and on the morning of
      day 11, they received the last dose. Serial blood and urine samples were
      collected after administration of the first dose and on days 1, 6, and 11.
      Cefepime concentrations in plasma and urine were assayed by using reverse-phase
      high-performance liquid chromatography with UV detection. Data were evaluated by
      noncompartmental methods to determine pharmacokinetic parameters. The mean half
      life of cefepime was approximately 2 h and did not vary with the dose or duration
      of dosing. The regression analyses of peak levels (Cmax) in plasma at the end of
      the 30-min intravenous infusion and the area under the plasma concentration
      versus-time curve (AUCo-infinity) showed a dose-proportional response. The steady
      state volume of distribution (Vss) was approximately 18 liters and was
      independent of the administered dose. The multiple-dose pharmacokinetic data are
      suggestive of a lack of accumulation or change in clearance of cefepime on
      repeated dosing. Cefepime was excreted primarily unchanged in urine. The recovery
      of intact cefepime in urine was invariant with respect to the dose and accounted
      for over 80% of the dose. The values for renal clearance ranged from 99 to 132
      ml/min and were suggestive of glomerular filtration as the primary excretion
      mechanism. It is concluded that cefepime linear pharmacokinetics in healthy
      subjects.

PMID- 1622166
TI  - Nucleotide sequence and phylogeny of the tet(L) tetracycline resistance
      determinant encoded by plasmid pSTE1 from Staphylococcus hyicus.
AB  - The nucleotide sequence of the tetracycline resistance (tet) gene and its
      regulatory region, encoded by the plasmid pSTE1 from Staphylococcus hyicus, was
      determined. The tet gene was inducible by tetracycline and encoded a hydrophobic
      protein of 458 amino acids. Comparisons between the predicted amino acid
      sequences of the pSTE1-encoded Tet from S. hyicus and the previously sequenced
      Tet K variants from Staphylococcus aureus, Tet L variants from Bacillus cereus,
      Bacillus stearothermophilus, and Bacillus subtilis, Tet M variants from
      Streptococcus faecalis and Staphylococcus aureus as well as Tet O from
      Streptococcus mutans were performed. An alignment of Tet amino acid sequences
      revealed the presence of 30 conserved amino acids among these Tet variants. On
      the basis of the alignment, a phylogenetic tree was constructed. It demonstrated
      large evolutionary distances between the Tet M and Tet O variants on one hand and
      the Tet K and Tet L variants on the other hand. The pSTE1-encoded Tet proved to
      be closely related to the Tet L proteins originally found on small Bacillus
      plasmids. The observed extensive similarities in the nucleotide sequences of the
      tet genes and in the deduced Tet amino acid sequences allowed the assignment of
      the pSTE1-encoded Tet to the Tet proteins of class L.

PMID- 1622167
TI  - In vitro evaluation of E1077, a new cephalosporin with a broad antibacterial
      spectrum.
AB  - E1077 is a novel parenteral cephalosporin with a wide spectrum of potent
      antibacterial activity against aerobic and anaerobic gram-positive and gram
      negative bacteria. Against methicillin-susceptible Staphylococcus aureus, E1077
      was twice as active as cefpirome, with an MIC for 90% of strains tested (MIC90)
      of 0.78 micrograms/ml. Methicillin-resistant S. aureus was moderately to highly
      resistant to E1077, but E1077 was at least twice as active as other beta-lactams
      tested. Against Enterococcus faecalis, E1077 was the most active of the
      cephalosporins tested (MIC90, 12.5 micrograms/ml) and was at least fourfold more
      active than cefpirome and ceftazidime. At concentrations of less than or equal to
      0.78 micrograms/ml, E1077 inhibited 90% of streptococci and most of the members
      of the family Enterobacteriaceae tested, with the exceptions of Serratia
      marcescens and Proteus vulgaris, for which the MIC90s of E1077 were both 3.13
      micrograms/ml. Against Pseudomonas aeruginosa, E1077 was two- to fourfold more
      active than cefpirome and ceftazidime. For the anaerobes, E1077 was as active
      against Bacteroides fragilis as was cefuzonam, and its activity was fourfold
      higher than those of cefpirome and ceftazidime. E1077 was at least as resistant
      as cefpirome to hydrolysis by various beta-lactamases, and these enzymes had a
      low affinity for E1077.

PMID- 1622168
TI  - Effects of cefetamet (Ro 15-8074) on Treponema pallidum and experimental
      syphilis.
AB  - Cefetamet pivoxil (Ro 15-8075) is a newly developed, expanded-spectrum
      cephalosporin that is orally active. In vitro, the active form, cefetamet (Ro 15
      8074), at a concentration of 0.05 micrograms/ml killed and lysed Treponema
      pallidum. Rabbit serum did not diminish its effectiveness. The antibiotic rapidly
      entered the circulation following intramuscular injection into rabbits, attaining
      its highest levels of 24 to 37 micrograms/ml within 10 to 30 min. Animals were
      infected intradermally with T. pallidum and then treated with different doses of
      cefetamet. Accelerated healing was detected following treatment with 15 and 30
      mg/kg of body weight. The antibiotic was also effective in killing organisms that
      had disseminated to distant tissues. In three separate sets of experiments,
      rabbits were infected with treponemes and then treated with cefetamet
      intramuscularly at 1, 15, or 30 mg/kg as follows: (i) after lesions had just
      become clinically apparent, (ii) after lesions were enlarged and well developed,
      or (iii) prior to the appearance of clinical lesions. Antibiotic effectiveness
      was determined by sacrificing the animals 1 week after antibiotic treatment and
      examining splenic tissue for residual, disseminated treponemes. Cefetamet was
      treponemicidal in all three situations. Maximum effects occurred when the
      antibiotic was injected before lesions had become clinically apparent (incubation
      period). These results suggest that cefetamet pivoxil might be useful for
      treating syphilitic infections.

PMID- 1622169
TI  - Assay of fluconazole by high-performance liquid chromatography with a mixed-phase
      column.
AB  - A mixed-phase liquid chromatographic column was used to assay fluconazole in
      plasma, serum, and cerebrospinal fluid. The assay was linear from 0.2 to 20
      micrograms/ml, with an average coefficient of variation of less than 5%. The
      partitioning of the drug between serum and cerebrospinal fluid was determined for
      34 patients. The method was demonstrated to be suitable for both pharmacokinetic
      studies and monitoring of patients receiving treatment with this antifungal
      agent.

PMID- 1622170
TI  - Pharmacokinetics of L-671,329 in rhesus monkeys and DBA/2 mice.
AB  - The time course of plasma drug levels and urinary recovery for two lipopeptide
      antifungal antibiotics, L-671,329 and cilofungin, were measured in male rhesus
      monkeys (Macaca mulatta) and in female DBA/2 mice. The antibiotics were
      administered intravenously at 10 mg/kg of body weight in phosphate-buffered
      saline-26% polyethylene glycol for the rhesus monkeys and in 5% dimethyl
      sulfoxide for the mice. Plasma and urine drug concentrations were determined by
      high-pressure liquid chromatography and/or a microbiological assay versus
      Aspergillus niger, and pharmacokinetic parameters were determined for both
      species. In each of the two rhesus crossover tests as well as in the mouse
      studies, the pharmacokinetics of the two compounds were similar; however, a
      marked difference was evident between species. The half-lives of L-671,329 and
      cilofungin in plasma were 39 and 34 min in the mice and averaged 1.8 and 2 h in
      the rhesus monkeys, respectively. In mice and rhesus monkeys, urinary recovery
      was less than 4% for both compounds.

PMID- 1622171
TI  - Identification and cloning of a tetracycline resistance gene from the fish
      pathogen Vibrio salmonicida.
AB  - Vibrio salmonicida is the causative agent of cold-water vibriosis in farmed
      Atlantic salmon. We cloned a 6.9-kb PstI fragment from the 170-MDa plasmid
      (pRVS1) containing a tetracycline resistance determinant. A subcloned 1.96-kb
      HindIII fragment was found to mediate the tetracycline resistance. The 2.5-kb
      ClaI-PvuI fragment carrying the Tet E determinant from Escherichia coli
      hybridized under stringent conditions with the cloned 1.96-kb HindIII fragment
      from V. salmonicida. The 1.96-kb HindIII fragment codes for a protein of 26.5 kDa
      which represents a candidate for the structural TetA protein of the class E
      determinant. Deletion of a 0.28-kb BalI fragment from the middle of the HindIII
      fragment resulted in the loss of tetracycline resistance. We were able to show
      that when E. coli carries the cloned 6.9-kb PstI fragment, expression of
      tetracycline resistance is regulated by the concentration of tetracycline in the
      medium. In contrast, tetracycline resistance was constitutively expressed in the
      E. coli isolate carrying the 1.96-kb HindIII fragment. The tetracycline
      resistance gene isolated from the 170-MDa R plasmid of the marine fish pathogen
      V. salmonicida was characterized and shown to be a class E determinant.

PMID- 1622172
TI  - Influence of angiotensin II-induced alterations in renal flow on excretion of
      cefonicid in isolated perfused rat kidneys.
AB  - The effects of variations in renal perfusate flow on the excretion of cefonicid
      was examined in isolated perfused rat kidneys. Cefonicid, an expanded-spectrum
      cephalosporin, is primarily eliminated by active tubular secretion and is neither
      metabolized nor reabsorbed in the isolated kidney. We used angiotensin II (AII),
      a strong vasoconstrictor hormone of the afferent and the efferent arterioles in
      the kidney, to determine whether the renal and secretion clearances, as well as
      the excretion ratio (ER = CLR/[fu x GFR], where CLR is renal clearance, fu is the
      unbound fraction, and GFR is glomerular filtration rate), of this low-extraction
      compound can be altered by a decreased perfusion flow. Control studies were
      performed in the absence (n = 5) and presence (n = 4) of AII; cefonicid studies
      were performed in the absence (n = 4) and presence (n = 5) of AII. AII (1 to 4
      ng/min) and cefonicid (5 to 10 micrograms/min) were infused into the perfusate.
      Cefonicid was assayed by high-performance liquid chromatography, and its protein
      binding was determined by ultrafiltration. AII decreased the perfusate flow rate
      and increased the renal vascular resistance and filtration fraction of the
      isolated kidney in the presence and absence of cefonicid. The glomerular
      filtration rate remained unchanged among the groups. The fractional excretion of
      glucose was low and steady, indicating a well-preserved tubular function.
      Although the unbound fraction was unchanged between treatments, the renal and
      secretion clearances and the excretion ratio of cefonicid were reduced by about
      40% in the presence of AII (excretion ratios, 10.3 without AII versus 6.03 with
      AII). These results suggest that the altered clearance parameters of cefonicid
      are the result of a flow-induced change in the intrinsic secretory transport of
      the drug.

PMID- 1622173
TI  - Addition of rifampin to combination antibiotic therapy for Pseudomonas aeruginosa
      bacteremia: prospective trial using the Zelen protocol.
AB  - A multicenter, prospective randomized trial was conducted to determine if the
      addition of rifampin to a combination therapy of an antipseudomonal beta-lactam
      agent and aminoglycoside improves the outcome of patients with Pseudomonas
      aeruginosa bacteremia. The Zelen protocol for randomized-consent design was used.
      Consent was sought only from patients randomized to the experimental therapy
      (rifampin+). If the experimental therapy was refused, the patient would then
      receive the standard combination therapy (control); however, when outcome was
      evaluated, all patients randomized to the rifampin+ group, including those that
      declined rifampin, were compared with the control group. One hundred twenty-one
      consecutive hospitalized patients with positive blood cultures for P. aeruginosa
      were enrolled. Entry was stratified for prior use of empiric antipseudomonal
      antibiotics, neutropenia, severity of illness, and presence of pneumonia. Fifty
      eight patients were randomized to receive rifampin (600 mg orally every 8 h for
      the first 72 h and then every 12 h for a total of 10 days) plus a beta-lactam
      agent plus an aminoglycoside. Sixty-three received the standard therapy of a beta
      lactam plus an aminoglycoside agent (control). Bacteriologic cure occurred
      significantly more frequently in patients randomized to the rifampin+ regimen.
      Breakthrough or relapsing bacteremias occurred in 2% of the three-drug
      (rifampin+) group, compared with 14% for the two-drug (standard therapy) group.
      Despite this favorable trend in bacteriological response, no significant
      differences in survival were seen for the two treatment groups. Rifamycin
      derivatives warrant further clinical study as antipseudomonal agents. The Zelen
      protocol appears well suited for comparative trials of antimicrobial agents.

PMID- 1622174
TI  - Effect of glycerol monolaurate on bacterial growth and toxin production.
AB  - Glycerol monolaurate (GML) is a naturally occurring surfactant that has potential
      use as an additive to tampons and wound dressings to reduce the incidence of
      certain bacterial toxin-mediated illnesses. In vitro studies were undertaken to
      evaluate the effect of GML on the growth of and toxin production by potentially
      pathogenic bacteria. GML inhibited the growth of clinical isolates of group A, B,
      F, and G streptococci at concentrations of 10 to 20 micrograms/ml. Exotoxin
      production, including that of pyrogenic exotoxins and hemolysins, was reduced by
      concentrations of GML that were below those inhibitory for growth as well as
      growth inhibitory. The growth of Staphylococcus aureus strains from patients with
      toxic shock syndrome and scalded skin syndrome was inhibited or delayed in the
      presence of 100 to 300 micrograms of GML per ml. Growth inhibition by GML could
      be overcome by the production of lipase. S. aureus elaboration of hemolysin,
      toxic shock syndrome toxin 1, and exfoliative toxin A was inhibited at GML
      concentrations below those necessary to inhibit growth. Results similar to those
      for S. aureus were obtained in tests of S. hominis. Escherichia coli growth and
      Salmonella minnesota growth were unaffected by GML, but an S. minnesota Re mutant
      was susceptible to growth-inhibitory activity. Endotoxin release into the medium
      from E. coli cells was also unaffected by GML, but the release or activity of E.
      coli hemolysin was increased by GML. Streptococcal pyrogenic endotoxin A
      production by an E. coli clone was not affectd by GML. These studies indicate
      that GML is effective in blocking or delaying the production of exotoxins by
      pathogenic gram-positive bacteria.

PMID- 1622175
TI  - Fleroxacin pharmacokinetics in patients with liver cirrhosis.
AB  - In this open-label study, the disposition of fleroxacin in liver disease in 12
      healthy male volunteers, 6 male cirrhotics without ascites (group A), and 6 male
      cirrhotics with ascites (group B) was evaluated. Fleroxacin (400 mg) was
      administered orally and intravenously to each subject in a random crossover
      fashion. Fleroxacin was completely absorbed and achieved similar peak
      concentrations in plasma in all three study groups (P greater than 0.05). The
      volume of distribution exceeded 1 liter/kg in healthy controls and was not
      affected by liver impairment (P greater than 0.05). Only group B demonstrated
      differences in the pharmacokinetic parameters evaluated: the systemic and renal
      clearances of fleroxacin and the renal clearances and clearances of the two major
      metabolites of fleroxacin formed, N-demethyl fleroxacin and fleroxacin N-oxide,
      were significantly lower and the half-lives of the parent drug and its
      metabolites were significantly longer in group B than in healthy controls and
      group A (P less than 0.05). The elimination of the two metabolites appeared to be
      formation rate limited in all three study groups. It was concluded from this
      study that a 50% reduction in the fleroxacin maintenance dose in patients with
      liver disease appears justified only in patients with ascites. However, no change
      in the fleroxacin loading dose is needed in patients with compromised liver
      function.

PMID- 1622176
TI  - Inducible expression of ribosomal clindamycin resistance in Bacteroides vulgatus.
AB  - The abilities of erythromycin and clindamycin to act as inducers of clindamycin
      resistance in the strain Bacteroides vulgatus RYC18F6 is evaluated in vivo
      (efficiency of plating of inhibitory clindamycin concentrations) and in vitro
      [efficiency of poly(U)-directed polypeptide synthesis by ribosomes]. Uninduced
      cells failed to grow during the first 72 h, even at a very low clindamycin
      concentration (0.1 microgram/ml); after induction with erythromycin or
      clindamycin, cells were able to form colonies at 32 micrograms/ml after 48 h. The
      in vitro polymerization test with B. vulgatus RYC18F6 ribosomes (S-30 extract)
      showed that ribosomes from uninduced cells were fully sensitive to the inhibitory
      effect of clindamycin. Ribosomes obtained from erythromycin- or clindamycin
      induced cells presented a reduced sensitivity to clindamycin inhibition. These
      results show that resistance to clindamycin in B. vulgatus RYC18F6 is an
      inducible phenomenon involving a ribosomal modification, probably similar to that
      previously described for gram-positive bacteria.

PMID- 1622177
TI  - Effects of immunoglobulin G and low-dose amphotericin B on Candida albicans
      infections in burned mice.
AB  - Candidiasis causes serious problems for compromised hosts. Effective treatments
      for Candida albicans infections are few. To see if immunoglobulin (Ig) therapy
      could be beneficial, burn-immunocompromised mice were treated intravenously with
      2.5 mg of five different IgG preparations 48 h postburn and post-C. albicans
      challenge. Despite up to fourfold differences in titer (1:1,600 to 1:6,400) to C.
      albicans, all preparations improved 10-day survival about 30% (P less than
      0.0001). Treatment with a low dose of amphotericin B (AmB; 0.09 mg/kg of body
      weight) intravenously 24 and 48 h after burn and challenge improved survival 9 to
      45% (P less than 0.0001). Treatment with a low dose of AmB plus IgG showed the
      same results as treatment with AmB alone and better results than treatment with
      IgG alone. Quantitative renal cultures from burned mice treated with AmB plus one
      IgG preparation, Sandoglobulin, showed that C. albicans counts decreased in sham
      treated mice from 7.21 +/- 0.15 log10 CFU/g (mean +/- standard error of the mean)
      to 5.31 +/- 0.34, which was significantly less than counts with AmB (6.11 +/-
      0.35) or Sandoglobulin (6.39 +/- 0.18) treatment alone. We conclude that (i) by
      using decreases in mortality and in renal fungal load as end points, treatment
      with IgG preparations alone or with a low dose of AmB alone protected burn
      immunocompromised mice from candidiasis; (ii) though AmB plus one IgG preparation
      significantly decreased renal fungal load, the combination did not significantly
      decrease mortality beyond that found with AmB alone; and (iii) survival data did
      not correlate with IgG titers to C. albicans.

PMID- 1622178
TI  - Rapid and sensitive assay for fluconazole which uses gas chromatography with
      electron capture detection.
AB  - Fluconazole, an orally active antifungal agent, has been shown to be clinically
      beneficial for maintenance therapy of cryptococcal meningitis. A sensitive gas
      liquid chromatographic assay with electron capture detection, which required only
      a single extraction step and precluded any pretreatment of the chromatographic
      column, was developed for fluconazole. The assay was linear from 0.1 to 20
      micrograms/ml, with a correlation coefficient of 0.999. The intraassay and
      interassay coefficients of variation were less than 9%. The measured values on
      average were within 8% of the target values. The extraction recoveries ranged
      from 87 to 106%. Steady-state plasma fluconazole levels (mean +/- standard
      deviation) in three AIDS patients with cryptococcal meningitis receiving 200 mg
      of fluconazole per day ranged from 8.95 +/- 1.32 to 11.41 +/- 0.63 micrograms/ml
      and were within the expected range for this dosing rate, on the basis of previous
      studies. The ratio of fluconazole concentration in cerebrospinal fluid to
      fluconazole concentration in plasma in one patient receiving 400 mg/day was 0.73
      at steady state and was consistent with published reports.

PMID- 1622179
TI  - Penetration of fleroxacin and ciprofloxacin into skin blister fluid: a
      comparative study.
AB  - The penetration of multiple-dose concentrations of oral fleroxacin (400 mg every
      24 h) and ciprofloxacin (500 mg every 12 h) into skin blister fluid in 12 healthy
      volunteers was determined in a randomized crossover study. Serum, blister fluid,
      and paper disk samples were analyzed by large-plate microbiologic assay. The mean
      areas under the concentration-time curve (AUC) for serum were 88.6 and 18.2
      micrograms.h/ml/70 kg for fleroxacin and ciprofloxacin, respectively. The mean
      AUC for blister fluid and paper disks were 71.2 and 15.0 micrograms.h/ml/70 kg
      and 77.8 and 15.4 micrograms.h/ml/70 kg for fleroxacin and ciprofloxacin,
      respectively. Calculated penetration into interstitial fluid ranged from 74 to
      92% for fleroxacin and 56 to 96% for ciprofloxacin; penetration was calculated by
      using the ratio of maximum drug concentration or AUC in blister fluid and paper
      disks to maximum drug concentration or AUC in serum. There was no significant
      difference between fleroxacin and ciprofloxacin in the percent penetration into
      skin blister fluid.

PMID- 1622180
TI  - Characterization of penicillin-binding protein 2 of Staphylococcus aureus:
      deacylation reaction and identification of two penicillin-binding peptides.
AB  - Penicillin-binding protein (PBP) 2 is the major PBP of five that have been
      identified in susceptible strains of Staphylococcus aureus. Beta-lactam
      antibiotic binding to PBP 2 is important for the antibacterial effect. Antibiotic
      binding to PBP 2 in strain 209P was examined with sodium dodecyl sulfate
      polyacrylamide gel electrophoresis in competition assays using [3H]penicillin as
      the radiolabel. Clavulanic acid, which is specifically bound by PBP 2, and
      cefaclor, which is specific for PBP 3, were studied. Cefaclor, which alone
      appeared not to bind PBP 2, in combination inhibited PBP 2 binding of clavulanic
      acid. By varying the temperature during radiolabeling with [3H]penicillin in
      cefaclor competition assays and in direct radiolabeling assays with [3H]cefaclor,
      it was shown that cefaclor was bound by PBP 2 with high affinity (50% inhibitory
      concentration, less than or equal to 0.1 microgram/ml) and that the apparent low
      affinity binding (50% inhibitory concentration, greater than 10 micrograms/ml) in
      competition assays performed at 37 degrees C was due to rapid deacylation. Two
      penicillin-binding peptides of PBP 2 also were identified in fluorographs of PBPs
      separated by nonequilibrium pH gradient gel and two-dimensional electrophoresis.
      Rapid deacylation for some antibiotics and the presence of two penicillin-binding
      peptides are two properties of PBP 2 that should be considered when correlating
      results of binding assays with effects of beta-lactam antibiotics on S. aureus.

PMID- 1622181
TI  - Resistance of Peptostreptococcus spp. to macrolides and lincosamides: inducible
      and constitutive phenotypes.
AB  - The activities of erythromycin and clindamycin against 350 Peptostreptococcus
      strains were studied during a 5-year period (1986 to 1991). In 5.1% of the
      Peptostreptococcus strains, which presented dissociated resistance (clindamycin
      MIC, less than or equal to 1 microgram/ml; erythromycin MIC, greater than 8
      micrograms/ml), evidence of inducible macrolide-lincosamide resistance was shown.
      A total of 17.7% of the strains presented a constitutive phenotype; the
      clindamycin and erythromycin MICs for these strains were greater than 8
      micrograms/ml.

PMID- 1622182
TI  - Lack of pharmacokinetic interaction between intravenous 2',3'-dideoxyinosine and
      3'-azido-3'-deoxythymidine in rats.
AB  - We investigated the pharmacokinetic interaction between 3'-azido-3'
      deoxythymidine (AZT) and 2',3'-dideoxyinosine (ddI), given to rats by intravenous
      injection. For both compounds, the clearances, terminal half-lives, and fractions
      of the dose excreted unchanged in urine were not altered by the other drug (P
      greater than 0.05), indicating no pharmacokinetic interaction between the two
      drugs.

PMID- 1622183
TI  - Susceptibility of Xanthomonas maltophilia to six quinolones and study of outer
      membrane proteins in resistant mutants selected in vitro.
AB  - The in vitro susceptibilities of 75 clinical isolates of Xanthomonas maltophilia
      to nalidixic acid, five fluoroquinolones, latamoxef, and doxycycline were
      determined. Spontaneous mutants were selected, at a frequency of about 10(-5) to
      10(-7) from four strains by culturing the strains in the presence of each
      quinolone. Selection in the presence of nalidixic acid provided mutants that were
      either resistant only to that compound or that exhibited cross-resistance to all
      the fluoroquinolones tested. Cross-resistance was always observed for mutants
      selected on any of the five fluoroquinolones. It was always associated with
      chloramphenicol resistance and, frequently, with doxycycline resistance. The
      electrophoretic alterations of the outer membrane proteins of the mutants suggest
      that different mechanisms may be involved in quinolone resistance in X.
      maltophilia.

PMID- 1622184
TI  - Distribution of ciprofloxacin in ascitic fluid following administration of a
      single oral dose of 750 milligrams.
AB  - The penetration of ciprofloxacin into the ascitic fluid of eight patients was
      studied. Serum and ascitic fluid samples were obtained before and at 1, 2, 3, 6,
      and 12 h following administration of a single oral dose of 750 mg. Peak levels
      (mean +/- standard deviation) were 4.0 +/- 0.7 micrograms/ml in serum and 2.6 +/-
      0.6 micrograms/ml in ascitic fluid; the areas under the curve (0 to 12 h) were
      29.1 +/- 6.5 micrograms.h/ml in serum and 20.7 +/- 5.0 micrograms.h/ml in ascitic
      fluid. The concentrations that were achieved are well above the MICs of
      ciprofloxacin for the members of the family Enterobacteriaceae that cause
      spontaneous bacterial peritonitis.

PMID- 1622185
TI  - Variation in the pharmacokinetics of gentamicin and tobramycin in patients with
      pleural effusions and hypoalbuminemia.
AB  - The pharmacokinetic parameters of gentamicin and tobramycin were evaluated and
      compared for 260 patients with pleural effusions and 1,049 patients without
      pleural effusions by chest radiograph. Pharmacokinetic data were collected
      prospectively and analyzed by using our aminoglycoside data base. Univariate
      analysis revealed that the patients with pleural effusions demonstrated
      significantly lower serum albumin concentrations, greater aminoglycoside volumes
      of distribution, longer elimination half-lives, and lower peak and higher trough
      concentrations in serum than the patients without pleural effusions. Patients
      with pleural effusions were significantly older and had lower total body weight.
      Stepwise multiple linear regression analysis revealed that lower total body
      weight and serum albumin concentration, presence of pleural effusion, and greater
      age were associated with significantly greater volumes of distribution.
      Calculated creatinine clearance, age, total body weight, and shock were
      associated with reduced aminoglycoside clearance in these patients.

PMID- 1622186
TI  - In vitro activity of E1040 against imipenem-resistant Pseudomonas aeruginosa
      strains.
AB  - E1040 showed the most potent activity (MIC for 90% of strains, 6.25
      micrograms/ml) among beta-lactams tested against 70 strains of imipenem-resistant
      Pseudomonas aeruginosa. Two strains showed high-level resistance to E1040; one
      strain produced a type II oxyiminocephalosporin-hydrolyzing beta-lactamase (group
      3), and the other produced an enzyme similar to a type II penicillinase (OXA-1).
      Both beta-lactamases contributed to resistance to E1040.

PMID- 1622187
TI  - Absolute bioavailability of cefprozil after oral administration in beagles.
AB  - The absolute bioavailability of cefprozil, a new oral cephalosporin, in four
      beagles was evaluated. In this two-way crossover study, each dog received a 125
      mg dose of cefprozil either as an oral aqueous solution or as a 15-min
      intravenous infusion. A high-performance liquid chromatographic assay with UV
      detection was employed for the determination of cefprozil concentrations in
      plasma and urine. Key pharmacokinetic parameters were calculated by
      noncompartmental methods. Cefprozil was well absorbed after oral administration,
      and peak concentrations of 17.6 to 26.6 micrograms/ml were attained at 60 min
      after drug administration. The apparent elimination half-life of cefprozil was
      about 70 min. The renal clearance was about 60% of total body clearance and is
      suggestive of significant nonrenal clearance. The absolute bioavailability of
      cefprozil ranged from 67.1 to 79.1% in the dogs.

PMID- 1622188
TI  - Use of high-dose fluconazole as salvage therapy for cryptococcal meningitis in
      patients with AIDS.
AB  - Eight patients with AIDS were treated orally with 800 mg of fluconazole daily for
      cryptococcal meningitis for a mean duration of 4.5 months. Previous antifungal
      treatment had failed for all of the patients. No major toxicity was observed.
      Three patients died from cryptococcal infection. High-dose fluconazole may be
      effective salvage therapy for cryptococcal meningitis.

PMID- 1622189
TI  - Let's give the feds credit for useable, credible clinical practice guidelines.

PMID- 1622190
TI  - Proposed recommended practices. Universal precautions.

PMID- 1622191
TI  - Issues regarding parents in the operating room during their children's care.
AB  - The presence of parents in the operating room does have possible legal
      ramifications. Taking an upset child from a parent's arms, however, is not a
      positive situation either. Perioperative nurses should not automatically weigh
      legal implications more heavily than the patient benefit that may be derived from
      the presence of parents. Whether parents should or should not be allowed to
      accompany their children into the operating room should be a carefully considered
      institutional policy.

PMID- 1622192
TI  - Symposium offers nurses from around the country valuable information,
      opportunities to network with colleagues. May 7 to 9, 1992.

PMID- 1622193
TI  - States address a variety of health care issues.

PMID- 1622194
TI  - Cancer of the penis. Perioperative interventions.

PMID- 1622195
TI  - Number of new AIDS cases increasing.

PMID- 1622196
TI  - Kidney cancer. An overview of the disease, treatment.

PMID- 1622197
TI  - Cytoreductive surgery and intraperitoneal chemotherapy. Treatment for peritoneal
      carcinomatosis.

PMID- 1622198
TI  - Head and neck cancer. An overview for the perioperative nurse.

PMID- 1622199
TI  - Getting students into the OR is only half the battle.

PMID- 1622200
TI  - Documenting nursing process in the perioperative setting. Continuity of care,
      patient evaluation.
AB  - Using our Perioperative Nursing Process form in addition to intraoperative and
      PACU flow sheets allows us to document the nursing process in a manner that
      satisfies the goals for documentation established by our committee. Because we
      place all forms in the patients' medical records, they are available for review
      by the JCAHO to prove that we comply with their standards and the standards of
      AORN and ANA. The nurses have been satisfied with the documentation system
      because it can be used efficiently and does not require redundant documentation
      as the patient transfers into each perioperative area.

PMID- 1622201
TI  - Hemicellulose bioconversion to polyanionic heteropolysaccharides.
AB  - Anionic polysaccharides, traditionally obtained from plant or algal sources, have
      a variety of commercial uses. Such gums from microorganisms have received
      increased recent interest. We have initiated a program to investigate the
      bioconversion of pentosans to rheologically useful anionic extracellular
      polysaccharides (AEPS). A number of earlier-described species, including
      Cryptococcus laurentii, Klebsiella pneumoniae, Arthrobacter viscosus, and
      Pseudomonas ATCC 31260, appear to have potential in this regard. These organisms
      can individually convert either xylose, enzymatic oligomeric hemicellulose
      digests, dilute mineral acid hemicellulose ("TVA") hydrolysates, or a five
      monosaccharide mixture simulating sulfite process liquors to AEPS. The formation
      parameters, compositions, mol-wt distributions, and the intrinsic viscosities of
      these purified AEPS are exemplified. Substitution of pentose as the major
      substrate for glucose can result in changes in mol-wt distribution or in the
      percentage of noncarbohydrate substituents in some AEPS. Pursuit of these
      observations may lead to interesting structure-property relationships and toward
      rheological applications for pentosan-derived AEPS.

PMID- 1622202
TI  - Enhancement of 1,3-propanediol production by cofermentation in Escherichia coli
      expressing Klebsiella pneumoniae dha regulon genes.
AB  - 1,3-Propanediol (1,3-PD) is an intermediate in chemical and polymer synthesis. We
      have previously expressed the genes of a biochemical pathway responsible for 1,3
      PD production, the dha regulon of Klebsiella pneumoniae, in Escherichia coli. An
      analysis of the maximum theoretical yield of 1,3-PD from glycerol indicates that
      the yield can be improved by the cofermentation of sugars, provided that kinetic
      constraints are overcome. The yield of 1,3-PD from glycerol was improved from
      0.46 mol/mol with glycerol alone to 0.63 mol/mol with glucose cofermentation and
      0.55 mol/mol with xylose cofermentation. The engineered E. coli also provides a
      model system for the study of metabolic pathway engineering.

PMID- 1622203
TI  - Effect of acetic acid on xylose conversion to ethanol by genetically engineered
      E. coli.
AB  - Efficient utilization of the pentosan fraction of hemicellulose from
      lignocellulosic feedstocks offers an opportunity to increase the yield and to
      reduce the cost of producing fuel ethanol. During prehydrolysis (acid hydrolysis
      or autohydrolysis of hemicellulose), acetic acid is formed as a consequence of
      the deacetylation of the acetylated moiety of hemicellulose. Recombinant
      Escherichia coli B (ATCC 11303), carrying the plasmid pLO1297 with pyruvate
      decarboxylase and alcohol dehydrogenase II genes from Zymomonas mobilis (CP4),
      converts xylose to ethanol with a product yield that approaches theoretical
      maximum. Although other pentose-utilizing microorganisms are inhibited by acetic
      acid, the recombinant E. coli displays a high tolerance for acetic acid. In
      xylose fermentations with a synthetic medium (Luria broth), where the pH was
      controlled at 7, neither yield nor productivity was affected by the addition of
      10.7 g/L acetic acid. Nutrient-supplemented, hardwood (aspen) hemicellulose
      hydrolysate (40.7 g/L xylose) was completely fermented to ethanol (16.3 g/L) in
      98 h. When the acetic acid concentration was reduced from 5.6 to 0.8 g/L, the
      fermentation time decreased to 58 h. Overliming, with Ca(OH)2 to pH 10, followed
      by neutralization to pH 7 with sulfuric acid and removal of insolubles, resulted
      in a twofold increase in volumetric productivity. The maximum productivity was
      0.93 g/L/h. The xylose-to-ethanol conversion efficiency and productivity in
      Ca(OH)2-treated hardwood prehydrolysate, fortified with only mineral salts, were
      94% and 0.26 g/L/h, respectively. The recombinant E. coli exhibits a xylose-to
      ethanol conversion efficiency that is superior to that of other pentose-utilizing
      yeasts currently being investigated for the production of fuel ethanol from
      lignocellulosic materials.

PMID- 1622204
TI  - Purification and characterization of a xylanase from the thermophilic ascomycete
      Thelavia terrestris 255B.
AB  - Thielavia terrestris 255B, a thermophilic ascomycete, produced two major forms of
      xylanase with pIs of 4.6 (xylanase I) and 6.1 (xylanase II). The latter enzyme
      could be purified to greater than 99% homogeneity using anion-exchange
      chromatography and gel filtration. Xylanase II had a mol wt of 25.7 kDa (SDS
      PAGE) and a pH and a temperature optimum of 3.6-4.0 and 60-65 degrees C,
      respectively. The ratio of the enzyme's activity against xylan and
      carboxymethylcellulose was 500-1000 to 1, indicating a possible application of
      this enzyme in biobleaching processes. The amino acid sequence of this protein is
      being determined, and initial data suggest that the enzyme belongs to a group of
      low-mol wt xylanases that have been isolated from both bacteria and fungi.

PMID- 1622205
TI  - Properties of the seed gum of Strypnodendron barbatiman (barbatimao).

PMID- 1622207
TI  - Isolation and characterization of an acidophilic, heterotrophic bacterium capable
      of oxidizing ferrous iron.
AB  - A heterotrophic bacterium, isolated from an acidic stream in a disused pyrite
      mine which contained copious growths of "acid streamers," displayed
      characteristics which differentiated it from previously described mesophilic
      acidophiles. The isolate was obligately acidophilic, with a pH range of 2.0 to
      4.4 and an optimum pH of 3.0. The bacterium was unable to fix carbon dioxide but
      oxidized ferrous iron, although at a slower rate than either Thiobacillus
      ferrooxidans or Leptospirillum ferrooxidans. Elemental sulfur and manganese(II)
      were not oxidized. In liquid media, the isolate produced macroscopic streamerlike
      growths. Microscopic examination revealed that the bacterium formed long (greater
      than 100 microns) filaments which tended to disintegrate during later growth
      stages, producing single, motile cells and small filaments. The isolate did not
      appear to utilize the energy from ferrous iron oxidation. Both iron (ferrous or
      ferric) and an organic substrate were necessary to promote growth. The isolate
      displayed a lower tolerance to heavy metals than other iron-oxidizing
      acidophiles, and growth was inhibited by exposure to light. There was evidence of
      extracellular sheath production by the isolate. In this and some other respects,
      the isolate resembles members of the Sphaerotilus-Leptothrix group of filamentous
      bacteria. The guanine-plus-cytosine content of the isolate was 62 mol%, which is
      less than that recorded for Sphaerotilus-Leptothrix spp. and greater than those
      of L. ferrooxidans and most T. ferrooxidans isolates.

PMID- 1622206
TI  - Purification and characterization of a new bacteriocin isolated from a
      Carnobacterium sp.
AB  - A bacteriocin-producing Carnobacterium sp. was isolated from fish. The
      bacteriocin, termed carnocin UI49, was purified to homogeneity by a four-step
      purification procedure, including hydrophobic interaction chromatography and
      reverse-phase chromatography. Carnocin UI49 has a bactericidal mode of action. It
      was shown to be heat tolerant and stable between pH 2 and 8. At pH above 8,
      carnocin UI49 was rapidly inactivated. Amino acid analysis revealed a composition
      of about 35 to 37 amino acids in addition to an unidentified peak which migrates
      at the position of lanthionine. Sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis analysis suggests a molecular weight of about 4,500 to 5,000.
      Mass spectrometry gave a molecular weight of 4,635, which is about 1,000 larger
      than that calculated from the amino acid analysis data. Performic acid oxidation
      of carnocin UI49, followed by amino acid hydrolysis, revealed the presence of
      cysteic acid. The sequence of the first seven amino acid residues was determined
      to be N-Gly-Ser-Glu-Ile-Gln-Pro-Arg. After the seventh amino acid, carnocin UI49
      was not available for further Edman degradation. The results suggest that
      carnocin UI49 belongs to the class of bacteriocins termed lantibiotics.

PMID- 1622208
TI  - Lactococcus lactis release from calcium alginate beads.
AB  - Cell release during milk fermentation by Lactococcus lactis immobilized in
      calcium alginate beads was examined. Numbers of free cells in the milk gradually
      increased from 1 x 10(6) to 3 x 10(7) CFU/ml upon successive reutilization of the
      beads. Rinsing the beads between fermentations did not influence the numbers of
      free cells in the milk. Cell release was not affected by initial cell density
      within the beads or by alginate concentration, although higher acidification
      rates were achieved with increased cell loading. Coating alginate beads with poly
      L-lysine (PLL) did not significantly reduce the release of cells during five
      consecutive fermentations. A double coating of PLL and alginate reduced cell
      release by a factor of approximately 50. However, acidification of milk with
      beads having the PLL-alginate coating was slower than that with uncoated beads.
      Immersing the beads in ethanol to kill cells on the periphery reduced cell
      release, but acidification activity was maintained. Dipping the beads in aluminum
      nitrate or a hot CaCl2 solution was not as effective as dipping them in ethanol.
      Ethanol treatment or heating of the beads appears to be a promising method for
      maintaining acidification activity while minimizing viable cell release due to
      loosely entrapped cells near the surface of the alginate beads.

PMID- 1622209
TI  - Pathovar-specific requirement for the Pseudomonas syringae lemA gene in disease
      lesion formation.
AB  - The lemA gene is conserved among strains and pathovars of Pseudomonas syringae.
      In P. syringae pv. syringae B728a, a causal agent of bacterial brown spot disese
      of bean, the lemA gene is required for lesion formation on leaves and pods. Using
      lemA-containing DNA as a probe, we determined that 80 P. syringae pv. syringae
      strains isolated from bean leaves could be grouped into seven classes based on
      restriction fragment length polymorphism. Marker exchange mutagenesis showed that
      the lemA gene was required for lesion formation by representative strains from
      each restriction fragment length polymorphism class. Hybridization to the lemA
      locus was detected within six different P. syringae pathovars and within
      Pseudomonas aeruginosa. Interestingly, a lemA homolog was present and functional
      within the nonpathogenic strain P. syringae Cit7. We cloned a lemA homolog from a
      genomic library of P. syringae pv. phaseolicola NPS3121, a causal agent of halo
      blight of bean, that restored lesion formation to a P. syringae pv. syringae lemA
      mutant. However, a lemA mutant P. syringae pv. phaseolicola strain retained the
      ability to produce halo blight disease symptoms on bean plants. Therefore, the
      lemA gene played an essential role in disease lesion formation by P. syringae pv.
      syringae isolates, but was not required for pathogenicity of a P. syringae pv.
      phaseolicola strain.

PMID- 1622210
TI  - Purification and characterization of two alpha-L-arabinofuranosidases from
      Streptomyces diastaticus.
AB  - A nonsporulating strain of Streptomyces diastaticus producing alpha-L
      arabinofuranosidase activity (EC 3.2-1.55) was isolated from soil. Two alpha-L
      arabinosidases were purified by ion-exchange chromatography and chromatofocusing.
      The enzymes had molecular weights of 38,000 (C1) and 60,000 (C2) and pIs of 8.8
      and 8.3, respectively. The optimum pH range of activity for both enzymes was
      between 4 and 7. The apparent Km values with p-nitrophenyl arabinofuranoside as
      the substrate were 10 mM (C1) and 12.5 mM (C2). C1 retained 50% of its activity
      after 8 h of incubation at 25 degrees C, while C2 retained 80% activity. After 3
      h of incubation at 50 degrees C, C1 lost 90% of its initial activity while C2
      lost only 40%. The purified enzymes hydrolyzed p-nitrophenyl alpha-L
      arabinofuranoside and liberated arabinose from arabinoxylan and from a debranched
      beta-1,5-arabinan.

PMID- 1622211
TI  - Production of citric and oxalic acids and solubilization of calcium phosphate by
      Penicillium bilaii.
AB  - An isolate of Penicillium bilaii previously reported to solubilize mineral
      phosphates and enhance plant uptake of phosphate was studied. Using agar media
      with calcium phosphate and the pH indicator alizarin red S, the influence of the
      medium composition on phosphate solubility and medium acidification was recorded.
      The major acidic metabolites produced by P. bilaii in a sucrose nitrate liquid
      medium were found to be oxalic acid and citric acid. Citric acid production was
      promoted under nitrogen-limited conditions, while oxalic acid production was
      promoted under carbon-limited conditions. Citric acid was produced in both growth
      and stationary phases, but oxalic acid production occurred only in stationary
      phase. When submerged cultures which normally produce acid were induced to
      sporulate, the culture medium shifted toward alkaline rather than acid reaction
      with growth.

PMID- 1622212
TI  - Effect of inoculant strain and organic matter content on kinetics of 2,4
      dichlorophenoxyacetic acid degradation in soil.
AB  - We monitored rates of degradation of soluble and sorbed 2,4-dichlorophenoxyacetic
      acid (2,4-D) in low-organic-matter soil at field capacity amended with 1, 10, or
      100 micrograms of 2,4-D per g of wet soil and inoculated with one of two
      bacterial strains (MI and 155) with similar maximum growth rates (mu max) but
      significantly different half-saturation growth constants (Ks). Concentrations of
      soluble 2,4-D were determined by analyzing samples of pore water pressed from
      soil, and concentrations of sorbed 2,4-D were determined by solvent extraction.
      Between 65 and 75% of the total 2,4-D was present in the soluble phase at
      equilibrium, resulting in soil solution concentrations of ca. 8, 60, and 600
      micrograms of 2,4-D per ml, respectively. Soluble 2,4-D was metabolized
      preferentially; this was followed by degradation of both sorbed (after
      desorption) and soluble 2,4-D. Rates of degradation were comparable for the two
      strains at soil concentrations of 10 and 100 micrograms of 2,4-D per g; however,
      at 1 microgram/g of soil, 2,4-D was metabolized more rapidly by the strain with
      the lower Ks value (strain MI). We also monitored rates of biodegradation of
      soluble and sorbed 2,4-D in high-organic-matter soil at field capacity amended
      with 100 micrograms of 2,4-D per g of wet soil and inoculated with the low-Ks
      strain (strain MI). Ten percent of total 2,4-D was present in the soluble phase,
      resulting in a soil solution concentration of ca. 30 micrograms of 2,4-D per
      ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622213
TI  - Modelling of mixed chemostat cultures of an aerobic bacterium, Comamonas
      testosteroni, and an anaerobic bacterium, Veillonella alcalescens: comparison
      with experimental data.
AB  - A mathematical model of mixed chemostat cultures of the obligately aerobic
      bacterium Comamonas testosteroni and the anaerobic bacterium Veillonella
      alcalescens grown under dual limitation of L-lactate and oxygen was constructed.
      The model was based on Michaelis-Menten-type kinetics for the consumption of
      substrates, with noncompetitive inhibition of V. alcalescens by O2. The growth
      characteristics of the aerobic and anaerobic organisms were determined
      experimentally with pure cultures of the individual species in (oxygen-limited)
      chemostats. Using these pure-culture data in the model of the mixed culture
      resulted in a good description of the actual mixed cultures of the two bacteria.
      In the actual mixed-culture experiments, coexistence of the two species occurred
      only when the cultures were oxygen limited. With increasing oxygen supply (the
      actual oxygen concentration in the culture remaining at less than 0.2 microM),
      the biomass of C. testosteroni increased, whereas that of V. alcalescens
      decreased. Apparently, C. testosteroni protected V. alcalescens from inhibition
      by oxygen by maintaining sufficiently low oxygen concentrations. The model
      calculations indicated that competition between the aerobic and the anaerobic
      bacterium for common substrates (L-lactate and oxygen) occurred and that the
      anaerobe was the better competitor. Analysis of the culture fluid indicated that
      C. testosteroni grew primarily at the expense of the fermentation products of V.
      alcalescens, i.e., propionate and acetate. The model further indicated that with
      different values of several growth parameters (e.g., substrate affinity and/or
      inhibition constants), the affinity of the aerobic organism for oxygen and the
      sensitivity of the anaerobic organism for oxygen were the most important
      properties determining the coexistence of these two physiologically different
      types of bacteria.

PMID- 1622214
TI  - Characterization of two nisin-producing Lactococcus lactis subsp. lactis strains
      isolated from a commercial sauerkraut fermentation.
AB  - Two Lactococcus lactis subsp. lactis strains, NCK400 and LJH80, isolated from a
      commercial sauerkraut fermentation were shown to produce nisin. LJH80 was
      morphologically unstable and gave rise to two stable, nisin-producing (Nip+)
      derivatives, NCK318-2 and NCK318-3. NCK400 and derivatives of LJH80 exhibited
      identical morphological and metabolic characteristics, but could be distinguished
      on the basis of plasmid profiles and genomic hybridization patterns to a DNA
      probe specific for the iso-ISS1 element, IS946. NCK318-2 and NCK318-3 harbored
      two and three plasmids, respectively, which hybridized with IS946. Plasmid DNA
      was not detected in NCK400, and DNA from this strain failed to hybridize with
      IS946. Despite the absence of detectable plasmid DNA in NCK400, nisin-negative
      derivatives (NCK402 and NCK403) were isolated after repeated transfer in broth at
      37 degrees C. Nisin-negative derivatives concurrently lost the ability to ferment
      sucrose and became sensitive to nisin. A 4-kbp HindIII fragment containing the
      structural gene for nisin (spaN), cloned from L. lactis subsp. lactis ATCC 11454,
      was used to probe genomic DNA of NCK318-2, NCK318-3, NCK400, and NCK402 digested
      with EcoRI or HindIII. The spaN probe hybridized to an 8.8-kbp EcoRI fragment and
      a 10-kbp HindIII fragment in the Nip+ sauerkraut isolates, but did not hybridize
      to the Nip- derivative, NCK402. A different hybridization pattern was observed
      when the same probe was used against Nip+ L. lactis subsp. lactis ATCC 11454 and
      ATCC 7962. These phenotypic and genetic data confirmed that unique Nip+ L. lactis
      subsp. lactis strains were isolated from fermenting sauerkraut.

PMID- 1622215
TI  - Novel paired starter culture system for sauerkraut, consisting of a nisin
      resistant Leuconostoc mesenteroides strain and a nisin-producing Lactococcus
      lactis strain.
AB  - Nisin-resistant Leuconostoc mesenteroides NCK293 and nisin-producing Lactococcus
      lactis subsp. lactis NCK401 were evaluated separately and in combination for
      growth and nisin production in a model sauerkraut fermentation. Strains were
      genetically marked and selectively enumerated by using antibiotic-containing
      media. The growth and survival of L. mesenteroides were similar in the presence
      and absence of Lactococcus lactis subsp. lactis. The growth of Lactococcus lactis
      subsp. lactis was not inhibited, although the maximum cell density was reduced
      and the population decline was more pronounced in the presence of L.
      mesenteroides. Nisin was detected within 24 h, and levels were relatively
      constant over the 12-day test period. The maximum cell populations and nisin
      level achieved could be altered by changing the initial cell ratios of L.
      mesenteroides and lactococcus lactis subsp. lactis. Isogenic nisin-producing and
      nisin-negative Lactococcus lactis subsp. lactis derivatives were used in
      combination with nisin-resistant L. mesenteroides to demonstrate that nisin
      levels produced in mixed culture were sufficient to retard the onset of the
      growth of nisin-sensitive, homofermentative Lactobacillus plantarum ATCC 14917.

PMID- 1622216
TI  - Production of manganic chelates by laccase from the lignin-degrading fungus
      Trametes (Coriolus) versicolor.
AB  - Many ligninolytic basidiomycete fungi have been shown to secrete a group of
      peroxidase isozymes whose sole function appears to be the peroxide-dependent
      oxidation of manganous [Mn(II)] to manganic [Mn(III)] ions. Manganic chelates and
      these Mn peroxidases have been implicated as central to the degradation of
      various natural and synthetic lignins and lignin-containing effluents by white
      rot (ligninolytic) fungi. Another group of enzymes, the laccases, are commonly
      secreted by wood-rotting fungi, but are generally regarded as being able to
      oxidize (and usually polymerize) only phenolic substrates. In this report it is
      shown that in the presence of appropriate oxidizable phenolic accessory
      substances or primary substrates, a variety of laccases and peroxidases
      catalyzing one-electron oxidations can also produce Mn(III) chelates from Mn(II).

PMID- 1622217
TI  - Bacterial migration along solid surfaces.
AB  - An in vitro system was developed to study the migration of uropathogenic
      Escherichia coli strains. In this system an aqueous agar gel is placed against a
      solid surface, allowing the bacteria to migrate along the gel/solid surface
      interface. Bacterial strains as well as solid surfaces were characterized by
      means of water contact angle and zeta potential measurements. When glass was used
      as the solid surface, significantly different migration times for the strains
      investigated were observed. Relationships among the observed migration times of
      six strains, their contact angles, and their zeta potentials were found.
      Relatively hydrophobic strains exhibited migration times shorter than those of
      hydrophilic strains. For highly negatively charged strains shorter migration
      times were found than were found for less negatively charged strains. When the
      fastest-migrating strain with respect to glass was allowed to migrate along solid
      surfaces differing in hydrophobicity and charge, no differences in migration
      times were found. Our findings indicate that strategies to prevent catheter
      associated bacteriuria should be based on inhibition of bacterial growth rather
      than on modifying the physicochemical character of the catheter surface.

PMID- 1622218
TI  - Persistence of Vibrio vulnificus in tissues of Gulf Coast oysters, Crassostrea
      virginica, exposed to seawater disinfected with UV light.
AB  - Vibrio vulnificus is an estuarine bacterium which can cause opportunistic
      infections in humans consuming raw Gulf Coast oysters, Crassostrea virginica.
      Although V. vulnificus is known as a ubiquitous organism in the Gulf of Mexico,
      its ecological relationship with C. virginica has not been adequately defined.
      The objective of the present study was to test the hypothesis that V. vulnificus
      is a persistent microbial flora of oysters and unamenable to traditional methods
      of controlled purification, such as UV light depuration. Experimental depuration
      systems consisted of aquaria containing temperature-controlled seawater treated
      with UV light and 0.2-microns-pore-size filtration. V. vulnificus was enumerated
      in seawater, oyster shell biofilms, homogenates of whole oyster meats, and
      tissues including the hemolymph, digestive region, gills, mantle, and adductor
      muscle. Results showed that depuration systems conducted at temperatures greater
      than 23 degrees C caused V. vulnificus counts to increase in oysters, especially
      in the hemolymph, adductor muscle, and mantle. Throughout the process, depuration
      water contained high concentrations of V. vulnificus, indicating that the
      disinfection properties of UV radiation and 0.2-microns-pore-size filtration were
      less than the rate at which V. vulnificus was released into seawater.
      Approximately 10(5) to 10(6) V. vulnificus organisms were released from each
      oyster per hour, with 0.05 to 35% originating from shell surfaces. These surfaces
      contained greater than 10(3) V. vulnificus organisms per cm2. In contrast, when
      depuration seawater was maintained at 15 degrees C, V. vulnificus was not
      detected in seawater and multiplication in oyster tissues was inhibited.

PMID- 1622219
TI  - Enhanced heterologous gene expression in novel rpoH mutants of Escherichia coli.
AB  - Extragenic temperature-resistant suppressor mutants of an rpoD800 derivative of
      Escherichia coli W3110 were selected at 43.5 degrees C. Two of the mutants were
      shown to have a phenotype of enhanced accumulation of heterologous proteins.
      Genetic mapping of the two mutants showed that the mutation conferring
      temperature resistance resided in the rpoH gene. P1-mediated transduction of the
      rpoD+ gene into both of the rpoD800 rpoH double mutants resulted in viable rpoH
      mutants, MON102 and MON105, that retained temperature resistance at 46 degrees C,
      the maximum growth temperature of W3110. The complete rpoH gene, including the
      regulatory region, from MON102, MON105, and the parental W3110 was cloned and
      sequenced. Sequencing results showed that a single C----T transition at
      nucleotide 802 was present in both MON102 and MON105, resulting in an Arg(CGC)---
      Cys(TGC) substitution at amino acid residue 268 (R-268-C; this gene was
      designated rpoH358). Heterologous protein accumulation levels in both MON102 and
      MON105, as well as in rpoH358 mutants constructed in previously unmanipulated
      W3110 and JM101, were assessed and compared with parental W3110 and JM101 levels.
      Expression studies utilizing the recA or araBAD promoter and the phage T7 gene
      10L ribosome-binding site (g10L) showed that increased accumulation levels of a
      number of representative heterologous proteins (i.e., human or bovine insulin
      like growth factor-1, bovine insulin-like growth factor-2, prohormone of human
      atrial natriuretic factor, bovine placental lactogen, and/or bovine prolactin)
      were obtained in the rpoH358 mutants compared with the levels in the parental
      W3110 and JM101. The mechanism of enhanced heterologous protein accumulation in
      MON102 and MON105 was unique compared with those of previously described rpoH
      mutants. Pulse-chase and Northern (RNA) blot analyses showed that the enhanced
      accumulation of heterologous proteins was not due to decreased proteolysis but
      was instead due to increased levels of the respective heterologous mRNAs
      accompanied by increased synthesis of the respective heterologous proteins. The
      plasmid copy number remained unaltered.

PMID- 1622220
TI  - Rapid detection of members of the family Enterobacteriaceae by a monoclonal
      antibody.
AB  - Six monoclonal antibodies directed against enterobacteria were produced and
      characterized. The specificity of one of these antibodies (CX9/15; immunoglobulin
      G2a) was studied by indirect immunofluorescence against 259 enterobacterial
      strains and 125 other gram-negative bacteria. All of the enterobacteria were
      specifically recognized, the only exception being Erwinia chrysanthemi (one
      strain tested). Bacteria not belonging to members of the family
      Enterobacteriaceae were not detected, except for Plesiomonas shigelloides (two
      strains tested), Aeromonas hydrophila (five strains tested), and Aeromonas sobria
      (one strain tested). This recognition spectrum strongly suggested that CX9/15
      recognized the enterobacterial common antigen. By sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and Western blot (immunoblot) experiments, the
      six antienterobacteria antibodies presented similar specificities; they all
      revealed only one band with an apparent molecular weight of about 20,000 from the
      crude extract of an enterobacterium. The six monoclonal antibodies, and
      especially CX9/15, can be used to develop new tests for rapid and specific
      detection of enterobacteria.

PMID- 1622221
TI  - Comparison of an in vitro method and an in vivo method of Giardia excystation.
AB  - An in vitro method and an in vivo method of excystation were compared to
      determine the most useful method for the retrieval of Giardia duodenalis
      isolates. Cysts from 11 Giardia strains were used. In vitro excystation produced
      motile trophozoites in 16 sets, while in vivo excystation produced trophozoites
      in all of the 21 comparative sets of excystations. Few cultures were lost because
      of contamination by either method (17% of in vitro-derived trophozoites versus
      23% of in vivo-derived trophozoites; P greater than 0.05). Both methods
      demonstrated comparable isolate retrieval rates (15% of in vitro-derived
      trophozoites adapting to culture compared with 29% of in vivo-derived
      trophozoites; P greater than 0.05), although analysis of the strains retrieved
      showed that two isolates were retrieved from in vitro excystation alone, compared
      with four from in vivo excystation. Analysis that included results of extra in
      vivo cultures showed that a total of nine isolates were retrieved by using this
      type of excystation. Despite the disadvantages of cost and labor, in vivo
      excystation appears to be more useful than in vitro excystation for isolate
      retrieval at the present time.

PMID- 1622222
TI  - Analysis of proteins associated with growth of Bacteroides ovatus on the branched
      galactomannan guar gum.
AB  - Bacteroides ovatus, a gram-negative obligate anaerobe from the human colon, can
      ferment the branched galactomannan guar gum. Previously, three enzymes involved
      in guar gum breakdown were characterized. The expression of these enzymes
      appeared to be regulated; i.e., specific activities were higher in extracts from
      bacteria grown on guar gum than in extracts from bacteria grown on the
      monosaccharide constituents of guar gum, mannose and galactose. In the present
      study, we used two-dimensional gel analysis to determine the total number of B.
      ovatus proteins enhanced during growth on guar gum. Twelve soluble proteins and
      20 membrane proteins were expressed at higher levels in guar gum-grown cells than
      in galactose-grown cells. An unexpected finding was that the expression of the
      two galactomannanases was induced by glucose as well as guar gum. Three other
      proteins, one membrane protein and two soluble proteins, had this same expression
      pattern. The remainder of the guar gum-associated proteins seen on two
      dimensional gels and the guar gum-associated alpha-galactosidase were induced in
      cells grown on guar gum but not in cells grown on glucose. Two transposon
      generated mutants (M-5 and M-7) that could not grow on guar gum were isolated.
      Both mutants still expressed the galactomannanases and the alpha-galactosidase.
      They also still expressed all of the guar gum-associated proteins that could be
      detected in two-dimensional gels of glucose-grown or galactose-grown cells. A
      second transposon insertion that suppressed the guar gum-negative phenotype of M
      5 was isolated and characterized. The characteristics of this suppressor mutant
      indicated that the original transposon insertion was probably in a regulatory
      locus.

PMID- 1622223
TI  - Cloning and partial characterization of two chromosomal loci from Bacteroides
      ovatus that contain genes essential for growth on guar gum.
AB  - Previously, we isolated three transposon insertion mutants of Bacteroides ovatus
      (M-4, M-5, and M-7) that were unable to grow on the branched polysaccharide guar
      gum. In this study, we used a tetracycline resistance gene on the transposon to
      clone chromosomal DNA adjacent to the transposon insertions in each of the three
      mutants. Restriction analysis of the flanking chromosomal DNA in M-4 and M-7
      revealed that the insertions in these two mutants were in the same location. The
      cloned DNA adjacent to the insertions in M-5 and M-7 was used as a hybridization
      probe to clone the wild-type loci. Two clones of about 10 kbp in size were
      obtained. Restriction analysis showed that these two clones did not overlap. The
      clone of the M-5 locus appeared to contain all of the genes affected by the M-5
      insertion, but we were unable to demonstrate complementation of the M-5 mutation
      because of the instability of the clone in this background. Analysis of the clone
      of the M-7 locus showed that it contained a guar gum-regulated promoter, but the
      transcript originating from this promoter was not affected by the transposon
      insertion. Thus, the M-7 locus apparently contains at least two separate
      transcriptional units, the one defined by this promoter and the one interrupted
      by the transposon insertion. Insertion mutations downstream of the guar gum
      regulated promoter demonstrated that there were essential guar gum utilization
      genes in this region. The M-7 mutant was eliminated by the wild type in the
      intestinal tracts of germfree mice.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622224
TI  - Comparison of contact angles and adhesion to hexadecane of urogenital, dairy, and
      poultry lactobacilli: effect of serial culture passages.
AB  - The aim of this study was to examine the hydrophobicities of 23 urogenital,
      dairy, poultry, and American Type Culture Collection isolates of lactobacilli and
      to determine the effect on hydrophobicity of serially passaging the strains in
      liquid medium. To this end, strains were grown after isolation and identification
      and then serially passaged up to 20 times. Hydrophobicity was assessed through
      contact angle measurements on lawns of cells by using water, formamide, methylene
      iodide, 1-bromonaphthalene, and hexadecane as wetting agents and through
      measurement of their partitioning in a hexadecane-water system. The
      hydrophobicities of these strains varied widely, with Lactobacillus casei strains
      being predominantly hydrophilic and L. acidophilus strains being mostly
      hydrophobic. For some isolates, serial passaging was accompanied by a clear loss
      of hydrophobic surface properties, whereas for other strains, cultures became
      heterogeneous in that some cells had already lost their hydrophobic surface
      properties while others were still hydrophobic. Adhesion of this collection of
      lactobacilli to hexadecane droplets in microbial adhesion to hexadecane (MATH)
      tests was driven by their aversion to water rather than by their affinity for
      hexadecane, as concluded from the fact that hexadecane contact angles were zero
      for all strains. Furthermore, adhesion of the lactobacilli to hexadecane in MATH
      tests occurred only when the water contact angle on the cells was above 60
      degrees.

PMID- 1622225
TI  - Mineralization of glucose and lignocellulose by four arctic freshwater sediments
      in response to nutrient enrichment.
AB  - Microbial biomass and activity were examined in four different arctic sediments:
      littoral lake sediment and profundal lake sediment from Toolik Lake, Alaska, thaw
      pond sediment, and eroding river bank peat. The thaw pond sediment had the
      largest viable microbial biomass, while the profundal sediment had the smallest.
      Rates of glucose or acetate incorporation into lipids, glucose mineralization,
      and lignocellulose mineralization (all normalized per unit of biomass) were
      highest in the river peat sample, however. The kinetics of glucose mineralization
      in the profundal sediment were very different from those in the other three
      samples: although the initial rate of mineralization was five times lower than
      that in the peat and two times lower than that in the littoral and thaw pond
      sediments, the maximum amount of 14CO2 evolved from [14C]glucose eventually
      equaled that in the peat and exceeded that in the littoral and thaw pond
      sediments by 2.0 and 3.5 times, respectively. Carex aquatilis [14C-cellulose]-
      and [14C-lignin]lignocellulose mineralization rates in the profundal sediment
      equaled or exceeded those in the littoral sediment after 16 and 46 days, but the
      pattern of nutrient limitation differed: the profundal sediment was the only one
      sampled that exhibited nitrogen limitation, while the other three sediments
      appeared to be limited primarily by phosphorus. The addition of nitrogen and
      phosphorus together had no cumulative effects on lignocellulose mineralization.
      When the rates of mineralization or incorporation of glucose are compared with
      those of lignocellulose, the results of this study indicate that profundal
      sediment communities may be better able to utilize the more recalcitrant
      substrates relative to the labile substrates than microbial communities from
      sediments rich in detritus and standing macrophytes.

PMID- 1622226
TI  - Use of polymerase chain reaction for detection of Listeria monocytogenes in food.
AB  - A previously described polymerase chain reaction (PCR) assay (B. Furrer, U.
      Candrian, C. Hofelein, and J. Luthy, J. Appl. Bacteriol. 70:372-379, 1991) was
      used to analyze food for the presence of Listeria monocytogenes. Food samples
      were artificially contaminated to develop two procedures to detect the organism
      following enrichment steps. Procedure A was based on dilution of the enrichment
      broth followed by lysis of the bacteria and direct analysis of the lysate with
      PCR. With procedure A and artificially contaminated food samples, it was possible
      to detect fewer than 10 bacteria per 10 g of food. In procedure B, centrifugation
      was used to concentrate bacteria before lysis and PCR. With procedure A, 330
      naturally contaminated food samples of several types were analyzed. Twenty
      samples were found to be positive for L. monocytogenes, which was in agreement
      with the classical culture technique. By using procedure B on a subset of 100
      food samples, 14 were found to be positive by PCR whereas the classical culture
      method detected only 13. Analysis times, including enrichment steps, were 56 and
      32 h with procedures A and B, respectively.

PMID- 1622227
TI  - Styrene formation by the decomposition by Pichia carsonii of trans-cinnamic acid
      added to a ground fish product.
AB  - It is not well known how the formation of styrene by microorganisms can occur in
      foods. In this study, we described and characterized the production of styrene by
      a yeast isolated from chikuwa fish paste. The styrene was not detected in fresh
      and normal food products nor in the food package's plastic film. The food
      containing styrene contained cinnamic acid as an antimicrobial agent and spice,
      and it was contaminated by 5.4 x 10(6) CFU of a yeast per gram. On the basis of
      morphological and biochemical features, the yeast isolated was determined to be a
      strain of Pichia carsonii, now designated strain CHI. Strain CHI, which was able
      to grow on cinnamic acid, had the ability to form styrene from trans-cinnamic
      acid via trans-p-coumaric and caffeic acids. The MIC of trans-cinnamic acid
      against strain CHI was 230 micrograms/ml. Strain CHI thrived well at pH 5.0 and
      26.0 degrees C and was tolerant to 20% NaCl. Styrene was subsequently produced in
      ground fish meat containing cinnamic acid into which strain CHI had been
      inoculated. The yeast was found to be an environmental contaminant in food
      processing plants of the chikuwa manufacturer.

PMID- 1622228
TI  - Insecticidal properties of genetically engineered baculoviruses expressing an
      insect juvenile hormone esterase gene.
AB  - Exploring the possibility of enhancing the properties of baculoviruses as
      biological control agents of insect pests, we tested the effect of expressing an
      insect gene (jhe) encoding juvenile hormone esterase. Juvenile hormone esterase
      inactivates juvenile hormone, which regulates the outcome of an insect molt. A
      cDNA encoding the juvenile hormone esterase of Heliothis virescens was inserted
      into the genome of Autographa californica nuclear polyhedrosis virus such that
      the gene was expressed under the control of a strong, modified viral promoter.
      This virus, however, naturally encodes an ecdysteroid UDP-glucosyltransferase
      which inactivates ecdysone, the hormone which initiates molting. Since
      ecdysteroid UDP-glucosyltransferase could mask the effects of jhe expression by
      blocking molting entirely, jhe-expressing viruses in which the ecdysteroid UDP
      glucosyltransferase gene was deleted or disrupted were constructed. Sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis analysis of proteins from
      infected cells revealed several intracellular proteins and two major secreted
      proteins which reacted with antibodies to authentic juvenile hormone esterase.
      Western blot analysis coupled with tunicamycin treatment indicated that
      differential glycosylation was responsible for the multiple products. Hemolymph
      of recombinant virus-infected fourth-instar Trichoplusia ni larvae contained
      levels of juvenile hormone esterase activity 40-fold higher than maximal levels
      found in uninfected larvae. However, little or no difference in developmental
      characteristics, weight gain, or time of mortality was observed between insects
      infected with the jhe-expressing viruses and control viruses.

PMID- 1622229
TI  - Heavy metals alter the electrokinetic properties of bacteria, yeasts, and clay
      minerals.
AB  - The electrokinetic patterns of four bacterial species (Bacillus subtilis,
      Bacillus megaterium, Pseudomonas aeruginosa, and Agrobacterium radiobacter), two
      yeasts (Saccharomyces cerevisiae and Candida albicans), and two clay minerals
      (montmorillonite and kaolinite) in the presence of the chloride salts of the
      heavy metals, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, and of Na and Mg were determined by
      microelectrophoresis. The cells and kaolinite were net negatively charged at pH
      values above their isoelectric points (pI) in the presence of Na, Mg, Hg, and Pb
      at an ionic strength (mu) of 3 x 10(-4); montmorillonite has no pI and was net
      negatively charged at all pH values in the presence of these metals. However, the
      charge of some bacteria, S. cerevisiae, and kaolinite changed to a net positive
      charge (charge reversal) in the presence of Cd, Cr, Cu, Ni, and Zn at pH values
      above 5.0 (the pH at which charge reversal occurred differed with the metal) and
      then, at higher pH values, again became negative. The charge of the bacteria and
      S. cerevisiae also reversed in solutions of Cu and Ni with a mu of greater than 3
      x 10(-4), whereas there was no reversal in solutions with a mu of less than 3 x
      10(-4). The clays became net positively charged when the mu of Cu was greater
      than 3 x 10(-4) and that of Ni was greater than 1.5 x 10(-4). The charge of the
      cells and clays also reversed in solutions containing both Mg and Ni or both Cu
      and Ni (except montmorillonite) but not in solutions containing both Mg and Cu
      (except kaolinite) (mu = 3 x 10(-4)). The pIs of the cells in the presence of the
      heavy metals were at either higher or lower pH values than in the presence of Na
      and Mg. Exposure of the cells to the various metals at pH values from 2 to 9 for
      the short times (ca. 10 min) required to measure the electrophoretic mobility did
      not affect their viability. The specific adsorption on the cells and clays of the
      hydrolyzed species of some of the heavy metals that formed at higher pH values
      was probably responsible for the charge reversal. These results suggest that the
      toxicity of some heavy metals to microorganisms varies with pH because the
      hydrolyzed speciation forms of these metals, which occur at higher pH values,
      bind on the cell surface and alter the net charge of the cell.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1622230
TI  - VIRTUS, a model of virus transport in unsaturated soils.
AB  - As a result of the recently proposed mandatory groundwater disinfection
      requirements to inactivate viruses in potable water supplies, there has been
      increasing interest in virus fate and transport in the subsurface. Several models
      have been developed to predict the fate of viruses in groundwater, but few
      include transport in the unsaturated zone and all require a constant virus
      inactivation rate. These are serious limitations in the models, as it has been
      well documented that considerable virus removal occurs in the unsaturated zone
      and that the inactivation rate of viruses is dependent on environmental
      conditions. The purpose of this research was to develop a predictive model of
      virus fate and transport in unsaturated soils that allows the virus inactivation
      rate to vary on the basis of changes in soil temperature. The model was developed
      on the basis of the law of mass conservation of a contaminant in porous media and
      couples the flows of water, viruses, and heat through the soil. Model predictions
      were compared with measured data of virus transport in laboratory column studies
      and, with the exception of one point, were within the 95% confidence limits of
      the measured concentrations. The model should be a useful tool for anyone wishing
      to estimate the number of viruses entering groundwater after traveling through
      the soil from a contamination source. In addition, model simulations were
      performed to identify parameters that have a large effect on the results. This
      information can be used to help design experiments so that important variables
      are measured accurately.

PMID- 1622231
TI  - Some growth and metabolic characteristics of monensin-sensitive and monensin
      resistant strains of Prevotella (Bacteroides) ruminicola.
AB  - New strains with enhanced resistance to monensin were developed from Prevotella
      (Bacteroides) ruminicola subsp. ruminicola 23 and P. ruminicola subsp. brevis
      GA33 by stepwise exposure to increasing concentrations of monensin. The resulting
      resistant strains (23MR2 and GA33MR) could initiate growth in concentrations of
      monensin which were 4 to 40 times greater than those which inhibited the parental
      strains. Resistant strains also showed enhanced resistance to nigericin and
      combinations of monensin and nigericin but retained sensitivity to lasalocid.
      Glucose utilization in cultures of the monensin-sensitive strains (23 and GA33)
      and one monensin-resistant strain (23MR2) was retarded but not completely
      inhibited when logarithmic cultures were challenged with monensin (10 mg/liter).
      Monensin challenge of cultures of the two monensin-sensitive strains (23 and
      GA33) was characterized by 78 and 51% decreases in protein yield (milligrams of
      protein per mole of glucose utilized), respectively. Protein yields in cultures
      of resistant strain 23MR2 were decreased by only 21% following monensin
      challenge. Cell yields and rates of glucose utilization by resistant strains
      GA33MR were not decreased by challenge with 10 mg of monensin per liter.
      Resistant strains produced greater relative proportions of propionate and less
      acetate than the corresponding sensitive strains. The relative amounts of
      succinate produced were greater in cultures of strains 23, GA33, and 23MR2
      following monensin challenge. However, only minor changes in end product
      formation were associate with monensin challenge of resistant strain GA33MR.
      These results suggest that monensin has significant effects on both the growth
      characteristics and metabolic activities of these predominant, gram-negative
      ruminal bacteria.

PMID- 1622232
TI  - Long-term starvation survival of Yersinia ruckeri at different salinities studied
      by microscopical and flow cytometric methods.
AB  - Cultures of three strains of the fish pathogenic bacterium Yersinia ruckeri
      survived starvation in unsupplemented water for at least 4 months. At salinities
      of 0 to 20/1000 there were no detectable changes in CFU during the first 3 days
      of starvation and only a small decrease during the following 4 months, whereas at
      35/1000 salinity, the survival potential of the cultures was markedly reduced.
      These results suggest that Y. ruckeri may survive for long periods in freshwater
      and brackish environments after an outbreak of enteric redmouth disease. Survival
      was also examined by use of the direct viable count method, and we show that this
      method can be combined with flow cytometry for automatic counting of viable
      bacteria. By flow cytometry, it was shown that genome replication initiated
      before the onset of starvation was completed, during the initial phase of
      starvation, and that starved cells could contain up to six genomes per cell.

PMID- 1622233
TI  - Enrichment and properties of an anaerobic mixed culture reductively
      dechlorinating 1,2,3-trichlorobenzene to 1,3-dichlorobenzene.
AB  - Hexachlorobenzene (HCB), pentachlorobenzene (QCB), all three isomers of
      tetrachlorobenzene (TeCB), 1,2,3-trichlorobenzene (1,2,3-TCB), and 1,2,4-TCB were
      reductively dechlorinated by enrichment cultures in the presence of lactate,
      glucose, ethanol, or isopropanol as the electron donor. The enrichment cultures
      originated from percolation columns filled with Rhine River sediment in which
      dechlorination of TCBs and dichlorobenzenes (DCBs) occurred. A stable consortium
      obtained by transfer on lactate as the energy and carbon source in the presence
      of 1,2,3-TCB dechlorinated this isomer stoichiometrically to 1,3-DCB.
      Dechlorinating activity could only be maintained when an electron donor was
      added. Lactate, ethanol, and hydrogen appeared to be the best substrates. Optimal
      temperature and pH for dechlorination were 30 degrees C and 7.2, respectively.
      The specificity of the enrichment on lactate and 1,2,3-TCB was tested after
      approximately 60 transfers (after 2.5 years). HCB and QCB were stoichiometrically
      dechlorinated to 1,3,5-TCB and minor amounts of 1,2,4-TCB. 1,3,5-TCB was the sole
      product formed from 1,2,3,5-TeCB, while 1,2,3,4-TeCB and 1,2,4,5-TeCB were
      converted to 1,2,4-TCB. 1,2,4-TCB, 1,3,5-TCB, and the three isomers of DCB were
      not dechlorinated during 4 weeks of incubation. For further enrichment of the
      1,2,3-TCB-dechlorinating bacteria, a two-liquid-phase (hexadecane-water) system
      was used with hydrogen as the electron donor and 1,2,3-TCB or CO2 as the electron
      acceptor. Methanogens and acetogens were the major substrate-competing (H2-CO2)
      microorganisms in the two-liquid-phase system. Inhibition of methanogenesis by 2
      bromoethanesulfonic acid did not influence dechlorination, and acetogens which
      were isolated from the enrichment culture did not have dechlorinating
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622234
TI  - Characteristics of a new cellulolytic Clostridium sp. isolated from pig
      intestinal tract.
AB  - Gram-positive, spore-forming, motile, cellulolytic rods were isolated from 10(7)
      dilutions of pig fecal samples. The pigs had previously been fed pure cultures of
      the ruminal cellulolytic organism Clostridium longisporum. Isolates formed
      terminal to subterminal spores, and a fermentable carbohydrate was required for
      growth. Besides cellulose, the isolates utilized cellobiose, glycogen, maltose,
      and starch. However, glucose, fructose, sucrose, pectin, and xylose were not used
      as energy sources. Major fermentation products included formate and butyrate. The
      isolates did not digest proteins from gelatin or milk. Unlike C. longisporum,
      which has limited ability to degrade cell wall components from grasses
      (switchgrass, bromegrass, and ryegrass), the swine isolates were equally
      effective in degrading these components from both alfalfa and grasses. The extent
      of degradation was equal to or better than that observed with the predominant
      ruminal cellulolytic organisms. On the basis of morphology, motility, spore
      formation, fermentation products, and the ability to hydrolyze cellulose, the
      isolates are considered to be a new species of the genus Clostridium. It is
      unclear whether C. longisporum played a role in the establishment or occurrence
      of this newly described cellulolytic species. This is the first report of a
      cellulolytic Clostridium sp. isolated from the pig intestinal tract.

PMID- 1622235
TI  - Cloning and expression of the cryIVD gene of Bacillus thuringiensis subsp.
      israelensis in the cyanobacterium Agmenellum quadruplicatum PR-6 and its
      resulting larvicidal activity.
AB  - A mosquitocidal cyanobacterium has been developed by introducing the mosquito
      toxic cryIVD gene from Bacillus thuringiensis subsp. israelensis into the
      unicellular cyanobacterium Agmenellum quadruplicatum PR-6 (Synechococcus sp.
      strain PCC 7002). The cryIVD gene was introduced into the cyanobacterium on a
      derivative of the PR-6 expression vector pAQE19 delta Sal in which the cryIVD
      gene was translationally fused to the initial coding sequence of the highly
      expressed PR-6 cpcB gene. Coomassie blue staining and immunoblot analysis of gel
      fractionated cell extract polypeptides indicate that the cpcB-cryIVD gene fusion
      is expressed at high levels in the cyanobacterial cells, with little or no
      apparent degradation of the cryIVD gene product. Larvicidal assays revealed that
      freshly hatched Culex pipiens mosquito larvae readily ingested the transformed
      cyanobacteria and that the cells proved to be toxic to the larvae.

PMID- 1622236
TI  - Isolation and characterization of acetic acid-tolerant galactose-fermenting
      strains of Saccharomyces cerevisiae from a spent sulfite liquor fermentation
      plant.
AB  - From a continuous spent sulfite liquor fermentation plant, two species of yeast
      were isolated, Saccharomyces cerevisiae and Pichia membranaefaciens. One of the
      isolates of S. cerevisiae, no. 3, was heavily flocculating and produced a higher
      ethanol yield from spent sulfite liquor than did commercial baker's yeast. The
      greatest difference between isolate 3 and baker's yeast was that of galactose
      fermentation, even when galactose utilization was induced, i.e., when they were
      grown in the presence of galactose, prior to fermentation. Without acetic acid
      present, both baker's yeast and isolate 3 fermented glucose and galactose
      sequentially. Galactose fermentation with baker's yeast was strongly inhibited by
      acetic acid at pH values below 6. Isolate 3 fermented galactose, glucose, and
      mannose without catabolite repression in the presence of acetic acid, even at pH
      4.5. The xylose reductase (EC 1.1.1.21) and xylitol dehydrogenase (EC 1.1.1.9)
      activities were determined in some of the isolates as well as in two strains of
      S. cerevisiae (ATCC 24860 and baker's yeast) and Pichia stipitis CBS 6054. The S.
      cerevisiae strains manifested xylose reductase activity that was 2 orders of
      magnitude less than the corresponding P. stipitis value of 890 nmol/min/mg of
      protein. The xylose dehydrogenase activity was 1 order of magnitude less than the
      corresponding activity of P. stipitis (330 nmol/min/mg of protein).

PMID- 1622237
TI  - Conjugal transfer in Lactococcus lactis of a 68-kilobase-pair chromosomal
      fragment containing the structural gene for the peptide bacteriocin nisin.
AB  - Nisin-producing transconjugants were generated by mating nisin-producing strains
      of Lactococcus lactis subsp. lactis with derivatives of L. lactis subsp. lactis
      LM0230. The sucrose-utilizing ability and reduced bacteriophage sensitivity were
      also transferred with the nisin-producing character. Pulsed-field gel
      electrophoretic analysis of genomic DNA from donor, recipient, and nisin
      producing transconjugants indicated that 68 kbp of DNA was transferred from the
      chromosome of the donor into the chromosome of the recipient in the conjugation
      process. The location of the transferred nisin structural gene spaN in the
      transconjugant HID500 was not stable, and cultures of strain HID500 were a
      mixture of different genotypes in which spaN was located at different positions
      in the chromosome on different SmaI fragments. ApaI, BglI, BssHII, NciI, SalI,
      and SmaI digests of genomic DNA were used to map the location of spaN in a donor
      (DL11) and a nisin-producing transconjugant (HID504).

PMID- 1622238
TI  - Overproduction of threonine by Saccharomyces cerevisiae mutants resistant to
      hydroxynorvaline.
AB  - In this work, we isolated and characterized mutants that overproduce threonine
      from Saccharomyces cerevisiae. The mutants were selected for resistance to the
      threonine analog alpha-amino-beta-hydroxynorvalerate (hydroxynorvaline), and, of
      these, the ones able to excrete threonine to the medium were chosen. The mutant
      strains produce between 15 and 30 times more threonine than the wild type does,
      and, to a lesser degree, they also accumulate isoleucine. Genetic and biochemical
      studies have revealed that the threonine overproduction is, in all cases studied,
      associated with the presence in the strain of a HOM3 allele coding for a mutant
      aspartate kinase that is totally or partially insensitive to feedback inhibition
      by threonine. This enzyme seems, therefore, to be crucial in the regulation of
      threonine biosynthesis in S. cerevisiae. The results obtained suggest that this
      strategy could be efficiently applied to the isolation of threonine-overproducing
      strains of yeasts other than S. cerevisiae, even those used industrially.

PMID- 1622239
TI  - Bioremediation of soils contaminated with the herbicide 2-sec-butyl-4,6
      dinitrophenol (dinoseb).
AB  - A novel soil treatment method for achieving the removal of dinoseb (2-sec-butyl
      4,6-dinitrophenol) from contaminated soils was investigated. One soil contained
      dinoseb as the major contaminant, although several other hazardous compounds were
      also present. A second soil was highly contaminated with dinoseb. Dinoseb was not
      degraded in these soils under the aerobic conditions at each site. Pretreatment
      of the soils by the addition of a starchy potato-processing by-product and
      flooding with phosphate buffer stimulated the consumption of oxygen and nitrate
      from the soils, thereby lowering the redox potential and creating anaerobic
      conditions. Anaerobiosis (Eh less than -200 mV) promoted the establishment of an
      anaerobic microbial consortium that degraded dinoseb completely, without the
      formation of the polymerization products seen under aerobic or microaerophilic
      conditions. When dinoseb was present at low concentrations in a chronically
      contaminated soil, the natural microflora was capable of establishing anaerobic
      conditions and degrading dinoseb as a result of starch degradation. Inoculation
      of this soil with an aerobic starch-degrading microorganism and then an
      acclimated, anaerobic, dinoseb-degrading consortium did not improve dinoseb
      degradation. In a second acutely contaminated soil, these inoculations improved
      dinoseb degradation rates over those of uninoculated controls.

PMID- 1622240
TI  - Effect of bacterial extracellular polymers on the saturated hydraulic
      conductivity of sand columns.
AB  - Columns were packed with clean quartz sand, sterilized, and inoculated with
      different strains of bacteria, which multiplied within the sand at the expense of
      a continuous supply of fresh nutrient medium. The saturated hydraulic
      conductivity (HCsat) of the sand was monitored over time. Among the four
      bacterial strains tested, one formed a capsule, one produced slime layers, and
      two did not produce any detectable exopolymers. The last two strains were
      nonmucoid variants of the first two. Only one strain, the slime producer, had a
      large impact on the HCsat. The production of exopolymers had no effect on either
      cell multiplication within or movement through the sand columns. Therefore, the
      HCsat reduction observed with the slime producer was tentatively attributed to
      the obstruction of flow channels with slime. Compared with the results with
      Arthrobacter sp. strain AK19 used in a previous study, there was a 100-fold
      increase in detachment from the solid substratum and movement through the sand of
      the strains used in this study. All strains induced severe clogging when they
      colonized the inlet chamber of the columns. Under these conditions, the inlet end
      was covered by a confluent mat with an extremely low HCsat.

PMID- 1622241
TI  - Acyloin formation by benzoylformate decarboxylase from Pseudomonas putida.
AB  - Whole cells and cell extracts of Pseudomonas putida grown in a medium containing
      ammonium mandelate have the capacity to produce the acyloin compound 2
      hydroxypropiophenone when incubated with benzoylformate and acetaldehyde.
      Benzaldehyde and benzyl alcohol were formed as reaction by-products. The
      enantiomeric excess of the 2-hydroxypropiophenone product was found to be 91 to
      92%. The absolute configuration of the enzymatically prepared product at the
      carbinol carbon was found to be S. The thiamine PPi-linked enzyme benzoylformate
      decarboxylase, purified to give a single protein band on polyacrylamide gel
      electrophoresis, was shown to be responsible for the catalysis of this novel
      condensation reaction.

PMID- 1622242
TI  - Isoliquiritigenin, a strong nod gene- and glyceollin resistance-inducing
      flavonoid from soybean root exudate.
AB  - Isoflavonoid signal molecules from soybean (Glycine max (L.) Merr.) seed and root
      exudate induce the transcription of nodulation (nod) genes in Bradyrhizobium
      japonicum. In this study, a new compound with symbiotic activity was isolated
      from soybean root exudate. The isolated 2',4',4-trihydroxychalcone
      (isoliquiritigenin) is characterized by its strong inducing activity for the nod
      genes of B. japonicum. These genes are already induced at concentrations 1 order
      of magnitude below those required of the previously described isoflavonoid
      inducers genistein and daidzein. Isoliquiritigenin is also a potent inducer of
      glyceollin resistance in B. japonicum, which renders this bacterium insensitive
      to potentially bactericidal concentrations of glyceollin, the phytoalexin of G.
      max. No chemotactic effect of isoliquiritigenin was observed. The highly
      efficient induction of nod genes and glyceollin resistance by isoliquiritigenin
      suggests the ecological significance of this compound, although it is not a major
      flavonoid constituent of the soybean root exudate in quantitative terms.

PMID- 1622243
TI  - Excretion of ammonium by a nifL mutant of Azotobacter vinelandii fixing nitrogen.
AB  - A mutation in the gene upstream of nifA in Azotobacter vinelandii was introduced
      into the chromosome to replace the corresponding wild-type region. The resulting
      mutant, MV376, produced nitrogenase constitutively in the presence of 15 mM
      ammonium. When introduced into a nifH-lacZ fusion strain, the mutation permitted
      beta-galactosidase production in the presence of ammonium. The gene upstream of
      nifA is therefore designated nifL because of its similarity to the Klebsiella
      pneumoniae nifL gene in proximity to nifA, in mutant phenotype, and in amino acid
      sequence of the gene product. The A. vinelandii nifL mutant MV376 excreted
      significant quantities of ammonium (approximately 10 mM) during diazotrophic
      growth. In contrast, ammonium excretion during diazotrophy was much lower in a K.
      pneumoniae nifL deletion mutant (maximum, 0.15 mM) but significantly higher than
      in NifL+ K. pneumoniae. The expression of the A. vinelandii nifA gene, unlike
      that of K. pneumoniae, was not repressed by ammonium.

PMID- 1622244
TI  - Chlorobenzene degradation by bacteria isolated from contaminated groundwater.
AB  - Bacterial isolates were obtained from groundwater and soils contaminated with
      chlorobenzene (CB). The isolates were tested to determine whether the natural
      community could remove the groundwater contaminants. These isolates were
      identified and characterized as to their ability to grow on CB and related
      aromatic compounds. The complete consortium could mineralize approximately 54% of
      the CB within 7 days, with no accumulation of 3-chlorocatechol. Metabolic
      pathways were evaluated for several isolates. One phenotype was characterized by
      the ability to degrade CB by the modified ortho pathway. One strain also degraded
      p-dichlorobenzene by using the same pathway. Isolates exhibiting a second
      phenotype degraded p-cresol, benzene, and phenol by the classical ortho pathway
      and accumulated 3-chlorocatechol when grown in the presence of CB. Strains of the
      third phenotype grew on complex media in the presence of CB but did not transform
      any of the aromatic compounds tested. The results suggest that the indigenous
      microbial community at the contaminated site would be able to degrade CB if
      provided with the appropriate conditions.

PMID- 1622245
TI  - Immunocytochemical localization of laccase L1 in wood decayed by Rigidoporus
      lignosus.
AB  - The cellular distribution of laccase L1 during degradation of wood chips by
      Rigidoporus lignosus, a tropical white rot fungus, was investigated by using anti
      laccase L1 polyclonal antisera in conjunction with immunolabeling techniques. The
      enzyme was localized in the fungal cytoplasm and was associated with the
      plasmalemma and the fungal cell wall. An extracellular sheath, often observed
      around fungal cells, often contained laccase molecules. Diffusion of laccase
      within apparently unaltered wood was seldom observed. The enzyme penetrated all
      degraded cell walls, from the secondary wall toward the primary wall, including
      the middle lamella. Xylem cells showing advanced stages of decay were sometimes
      devoid of significant labeling. These data suggest that the initial attack on
      wood was not performed by laccase L1 of R. lignosus. Previous alteration of the
      lignocellulose complex may facilitate the movement of laccase within the wood
      cell walls. This immunogold study revealed that laccase localization during wood
      degradation seems limited not in space but in time.

PMID- 1622246
TI  - Determination of the respiration kinetics for mycelial pellets of Phanerochaete
      chrysosporium.
AB  - In mycelial pellet cultures of the white rot basidiomycete Phanerochaete
      chrysosporium, low oxygen concentration negatively affects the production of the
      extracellular lignin peroxidases and manganese peroxidases which are key
      components of the lignin-degrading system of this organism. To test the
      hypothesis that oxygen limitation in the pellets is responsible for this effect,
      oxygen microelectrodes were used to determine oxygen concentration gradients
      within the mycelial pellets of P. chrysosporium. Pellets were removed from
      oxygenated cultures, allowed to equilibrate with air, and probed with oxygen
      microelectrodes. The oxygen profiles were modelled assuming that O2 uptake
      follows a Michaelis-Menten relationship. The Vmax and Km values for oxygen uptake
      were 0.76 +/- 0.10 g/m3 of pellet per s and 0.5 +/- 0.3 g/m3, respectively. These
      kinetic values were used to predict respiration rates in air-flushed cultures,
      oxygen-flushed cultures, and cultures with large pellets (diameter greater than 6
      mm). The predicted respiration rates were independently validated by
      experimentally measuring the evolution of carbon dioxide from whole cultures.

PMID- 1622247
TI  - Inhibition of existing denitrification enzyme activity by chloramphenicol.
AB  - Chloramphenicol completely inhibited the activity of existing denitrification
      enzymes in acetylene-block incubations with (i) sediments from a nitrate
      contaminated aquifer and (ii) a continuous culture of denitrifying groundwater
      bacteria. Control flasks with no antibiotic produced significant amounts of
      nitrous oxide in the same time period. Amendment with chloramphenicol after
      nitrous oxide production had begun resulted in a significant decrease in the rate
      of nitrous oxide production. Chloramphenicol also decreased (greater than 50%)
      the activity of existing denitrification enzymes in pure cultures of Pseudomonas
      denitrificans that were harvested during log-phase growth and maintained for 2
      weeks in a starvation medium lacking electron donor. Short-term time courses of
      nitrate consumption and nitrous oxide production in the presence of acetylene
      with P. denitrificans undergoing carbon starvation were performed under optimal
      conditions designed to mimic denitrification enzyme activity assays used with
      soils. Time courses were linear for both chloramphenicol and control flasks, and
      rate estimates for the two treatments were significantly different at the 95%
      confidence level. Complete or partial inhibition of existing enzyme activity is
      not consistent with the current understanding of the mode of action of
      chloramphenicol or current practice, in which the compound is frequently employed
      to inhibit de novo protein synthesis during the course of microbial activity
      assays. The results of this study demonstrate that chloramphenicol amendment can
      inhibit the activity of existing denitrification enzymes and suggest that caution
      is needed in the design and interpretation of denitrification activity assays in
      which chloramphenicol is used to prevent new protein synthesis.

PMID- 1622248
TI  - Tannin-protein complex-degrading enterobacteria isolated from the alimentary
      tracts of koalas and a selective medium for their enumeration.
AB  - Tannin-protein complex (T-PC)-degrading enterobacteria (T-PCDE) were isolated
      from the feces and from a layer of bacteria attached to the cecal wall of koalas.
      The T-PCDE were facultatively anaerobic, gram-negative, pleomorphic, nonmotile
      bacilli. The bacteria were also oxidase and catalase negative and resistant to
      vancomycin, reduced nitrates to nitrites, and grew on MacConkey agar. Growth on
      tannin-treated agar media showed a distinctive clear zone around the colony. From
      these observations, a selective agar plate medium (vancomycin- and tannin-treated
      Wilkins-Chalgren anaerobe agar) was developed to enumerate T-PCDE isolated from
      the feces of koalas. This medium was highly selective in the enumeration of the
      fecal T-PCDE and inhibited the growth of concomitant T-PC-degrading Streptococcus
      bovis. The T-PCDE were isolated from 10 of the 12 captive koalas studied; in 8 of
      these 10 koalas, the facultatively anaerobic bacterial flora was dominated (more
      than 60%) by T-PCDE. Viable numbers of T-PCDE were, in most of the animals, much
      larger (more than 100 times) than the numbers of T-PC-degrading S. bovis,
      suggesting that T-PCDE played a more active role in digesting T-PC in the
      alimentary tracts of koalas.

PMID- 1622249
TI  - Dipstick immunoassay to detect enterohemorrhagic Escherichia coli O157:H7 in
      retail ground beef.
AB  - A sensitive and easy-to-perform dipstick immunoassay to detect Escherichia coli
      O157:H7 in retail ground beef was developed by using a sandwich-type assay (with
      a polyclonal antibody to E. coli O157 as the capture antibody and a monoclonal
      antibody to E. coli O157:H7 as the detection antibody) on a hydrophobic
      polyvinylidine difluoride-based membrane. E. coli O157:H7 in ground beef could be
      detected within 16 h, including incubation for 12 h in enrichment broth and the
      immunoassay, which takes 4 h. Pure culture cell suspensions of 10(5) or 10(6) E.
      coli O157:H7 organisms per ml produced intense color reactions in the
      immunoassay, whereas faint but detectable reactions occurred with 10(3) CFU/ml.
      The sensitivity of the combined enrichment-immunoassay procedure as determined by
      using ground beef inoculated with E. coli O157:H7 was 0.1 to 1.3 cells per g,
      with a false-positive rate of 2.0%. A survey of retail ground beef using this
      procedure revealed that 1 of 76 samples was contaminated by E. coli O157:H7.

PMID- 1622250
TI  - Rapid genomic fingerprinting of Lactococcus lactis strains by arbitrarily primed
      polymerase chain reaction with 32P and fluorescent labels.
AB  - Arbitrarily primed polymerase chain reaction, with incorporation of either
      radioactive or fluorescent labels, was used as a rapid and sensitive method for
      obtaining genomic fingerprints of strains of Lactococcus lactis. Closely related
      strains produced almost identical fingerprints. Fingerprints of other strains
      showed only some similarities.

PMID- 1622251
TI  - Degradation of triglycerides by a pseudomonad isolated from milk: molecular
      analysis of a lipase-encoding gene and its expression in Escherichia coli.
AB  - Psychrotrophic lipolytic bacteria represent a significant problem in the storage
      of refrigerated dairy products. A lipase-encoding gene has been cloned and
      characterized from a highly lipolytic strain of Pseudomonas. The nucleotide
      sequence of the gene predicts a polypeptide of M(r) 49,905, which was identified
      when the gene was expressed in Escherichia coli.

PMID- 1622252
TI  - Evidence for a correlation between auxin production and host plant species among
      strains of Pseudomonas syringae subsp. savastanoi.
AB  - Auxin production by 131 strains of Pseudomonas syringae subsp. savastanoi was
      investigated with the aim of looking for correlations among this characteristic
      and the origin of the strains, the types of symptoms, and the host plant. Most of
      the P.syringae subsp. savastanoi strains, except those isolated from ash,
      produced auxin and harbored iaa genes. Among ash strains, which were pathogenic
      only on ash, only 2 out of 33 were found to produce auxin and to harbor iaa
      genes.

PMID- 1622253
TI  - Demonstration of cel operon expression of Escherichia coli, Salmonella
      typhimurium, and Pseudomonas aeruginosa at elevated temperatures refractory to
      their growth.
AB  - When Escherichia coli was incubated at the growth-refractory temperatures of 48
      and 54 degrees C, expression of the cel operon was demonstrated by phospho-beta
      glucosidase activity. This enzyme activity was also detected at the growth
      refractory temperatures in Salmonella typhimurium and Pseudomonas aeruginosa.
      Thermotolerant and mesothermophilic mutants of E. coli, S. typhimurium, and P.
      aeruginosa, able to grow with generation times of 30 to 40 min at 48 and 54
      degrees C, exhibited phospho-beta-glucosidase activity at their growth
      temperatures of 48 and 54 degrees C. Thus, the cel operon previously described as
      a cryptic operon in E. coli and S. typhimurium was found to be expressed at
      growth-refractory temperatures of the mesophilic parent and growth-permissive
      temperatures (48 and 54 degrees C) of the thermotolerant and mesothermophilic
      mutants.

PMID- 1622254
TI  - Antimicrobial action of nisin against Salmonella typhimurium lipopolysaccharide
      mutants.
AB  - The antimicrobial activity of nisin against outer membrane lipopolysaccharide
      mutants of Salmonella typhimurium LT2 was investigated. Nisin sensitivity was
      associated with the extent of saccharide deletions from the outer membrane core
      oligosaccharide. The results indicated that the core oligosaccharide in
      lipopolysaccharide plays a role in nisin sensitivity.

PMID- 1622255
TI  - High-pressure, high-temperature bioreactor for comparing effects of hyperbaric
      and hydrostatic pressure on bacterial growth.
AB  - We describe a high-pressure reactor system suitable for simultaneous hyperbaric
      and hydrostatic pressurization of bacterial cultures at elevated temperatures.
      For the deep-sea thermophile ES4, the growth rate at 500 atm (1 atm = 101.29 kPa)
      and 95 degrees C under hydrostatic pressure was ca. three times the growth rate
      under hyperbaric pressure and ca. 40% higher than the growth rate at 35 atm.

PMID- 1622256
TI  - Use of a fluorescent redox probe for direct visualization of actively respiring
      bacteria.
AB  - The redox dye 5-cyano-2,3-ditolyl tetrazolium chloride (CTC) was employed for
      direct epifluorescent microscopic enumeration of respiring bacteria in
      environmental samples. Oxidized CTC is nearly colorless and is nonfluorescent;
      however, the compound is readily reduced via electron transport activity to
      fluorescent, insoluble CTC-formazan, which accumulates intracellularly. Bacteria
      containing CTC-formazan were visualized by epifluorescence microscopy in wet
      mount preparations, on polycarbonate membrane filter surfaces, or in biofilms
      associated with optically opaque surfaces. Counterstaining of CTC-treated samples
      with the DNA-specific fluorochrome 4',6-diamidino-2-phenylindole allowed
      enumeration of active and total bacterial subpopulations within the same
      preparation. Municipal wastewater, groundwater, and seawater samples supplied
      with exogenous nutrients yielded CTC counts that were generally lower than total
      4',6-diamidino-2-phenylindole counts but typically equal to or greater than
      standard heterotrophic (aerobic) plate counts. In unsupplemented water samples,
      CTC counts were typically lower than those obtained with the heterotrophic plate
      count method. Reduction of CTC by planktonic or biofilm-associated bacteria was
      suppressed by formaldehyde, presumably because of inhibition of electron
      transport activity and other metabolic processes. Because of their bright red
      fluorescence (emission maximum, 602 nm), actively respiring bacteria were readily
      distinguishable from abiotic particles and other background substances, which
      typically fluoresced at shorter wavelengths. The use of CTC greatly facilitated
      microscopic detection and enumeration of metabolically active (i.e., respiring)
      bacteria in environmental samples.

PMID- 1622257
TI  - Cell-associated pectinolytic and cellulolytic enzymes in Rhizobium leguminosarum
      biovar trifolii.
AB  - The involvement of Rhizobium enzymes that degrade plant cell wall polymers has
      long been an unresolved question about the infection process in root nodule
      symbiosis. Here we report the production of enzymes from Rhizobium leguminosarum
      bv. trifolii that degrade carboxymethyl cellulose and polypectate model
      substrates with sensitive methods that reliably detect the enzyme activities: a
      double-layer plate assay, quantitation of reducing sugars with a bicinchoninate
      reagent, and activity gel electrophoresis-isoelectric focusing. Both enzyme
      activities were (i) produced commonly by diverse wild-type strains, (ii) cell
      bound with at least some of the activity associated with the cell envelope, and
      (iii) not changed appreciably by growth in the presence of the model substrates
      or a flavone that activates expression of nodulation (nod) genes on the resident
      symbiotic plasmid (pSym). Equivalent levels of carboxymethyl cellulase activity
      were found in wild-type strain ANU843 and its pSym-cured derivative, ANU845,
      consistent with previous results of Morales et al. (V. Morales, E. Martinez
      Molina, and D. Hubbell, Plant Soil 80:407-415, 1984). However, polygalacturonase
      activity was lower in ANU845 and was not restored to wild-type levels in the
      recombinant derivative of pSym- ANU845 containing the common and host-specific
      nod genes within a 14-kb HindIII DNA fragment of pSym from ANU843 cloned on
      plasmid pRt032. Activity gel electrophoresis resolved three carboxymethyl
      cellulase isozymes of approximately 102, 56, and 33 kDa in cell extracts from
      ANU843. Isoelectric focusing activity gels revealed one ANU843 polygalacturonase
      isozyme with a pI of approximately 7.2. These studies show that R. leguminosarum
      bv. trifolii produces multiple enzymes that cleave glycosidic bonds in plant cell
      walls and that are cell bound.

PMID- 1622258
TI  - Biodegradation of bisphenol A and other bisphenols by a gram-negative aerobic
      bacterium.
AB  - A novel bacterium designated strain MV1 was isolated from a sludge enrichment
      taken from the wastewater treatment plant at a plastics manufacturing facility
      and shown to degrade 2,2-bis(4-hydroxyphenyl)propane (4,4'-isopropylidenediphenol
      or bisphenol A). Strain MV1 is a gram-negative, aerobic bacillus that grows on
      bisphenol A as a sole source of carbon and energy. Total carbon analysis for
      bisphenol A degradation demonstrated that 60% of the carbon was mineralized to
      CO2, 20% was associated with the bacterial cells, and 20% was converted to
      soluble organic compounds. Metabolic intermediates detected in the culture medium
      during growth on bisphenol A were identified as 4-hydroxybenzoic acid, 4
      hydroxyacetophenone, 2,2-bis(4-hydroxyphenyl)-1-propanol, and 2,3-bis(4
      hydroxyphenyl)-1,2-propanediol. Most of the bisphenol A degraded by strain MV1 is
      cleaved in some way to form 4-hydroxybenzoic acid and 4-hydroxyacetophenone,
      which are subsequently mineralized or assimilated into cell carbon. In addition,
      about 20% of the bisphenol A is hydroxylated to form 2,2-bis(4-hydroxyphenyl)-1
      propanol, which is slowly biotransformed to 2,3-bis(4-hydroxyphenyl)-1,2
      propanediol. Cells that were grown on bisphenol A degraded a variety of bisphenol
      alkanes, hydroxylated benzoic acids, and hydroxylated acetophenones during
      resting-cell assays. Transmission electron microscopy of cells grown on bisphenol
      A revealed lipid storage granules and intracytoplasmic membranes.

PMID- 1622259
TI  - Oxidative degradation of phenanthrene by the ligninolytic fungus Phanerochaete
      chrysosporium.
AB  - The ligninolytic fungus Phanerochaete chrysosporium oxidized phenanthrene and
      phenanthrene-9,10-quinone (PQ) at their C-9 and C-10 positions to give a ring
      fission product, 2,2'-diphenic acid (DPA), which was identified in
      chromatographic and isotope dilution experiments. DPA formation from phenanthrene
      was somewhat greater in low-nitrogen (ligninolytic) cultures than in high
      nitrogen (nonligninolytic) cultures and did not occur in uninoculated cultures.
      The oxidation of PQ to DPA involved both fungal and abiotic mechanisms, was
      unaffected by the level of nitrogen added, and was significantly faster than the
      cleavage of phenanthrene to DPA. Phenanthrene-trans-9,10-dihydrodiol, which was
      previously shown to be the principal phenanthrene metabolite in nonligninolytic
      P. chrysosporium cultures, was not formed in the ligninolytic cultures employed
      here. These results suggest that phenanthrene degradation by ligninolytic P.
      chrysosporium proceeds in order from phenanthrene----PQ----DPA, involves both
      ligninolytic and nonligninolytic enzymes, and is not initiated by a classical
      microsomal cytochrome P-450. The extracellular lignin peroxidases of P.
      chrysosporium were not able to oxidize phenanthrene in vitro and therefore are
      also unlikely to catalyze the first step of phenanthrene degradation in vivo.
      Both phenanthrene and PQ were mineralized to similar extents by the fungus, which
      supports the intermediacy of PQ in phenanthrene degradation, but both compounds
      were mineralized significantly less than the structurally related lignin
      peroxidase substrate pyrene was.

PMID- 1622260
TI  - Conversion of cis unsaturated fatty acids to trans, a possible mechanism for the
      protection of phenol-degrading Pseudomonas putida P8 from substrate toxicity.
AB  - A trans unsaturated fatty acid was found as a major constituent in the lipids of
      Pseudomonas putida P8. The fatty acid was identified as 9-trans-hexadecenoic acid
      by gas chromatography, argentation thin-layer chromatography, and infrared
      absorption spectrometry. Growing cells of P. putida P8 reacted to the presence of
      sublethal concentrations of phenol in the medium with changes in the fatty acid
      composition of the lipids, thereby increasing the degree of saturation. At phenol
      concentrations which completely inhibited the growth of P. putida, the cells were
      still able to increase the content of the trans unsaturated fatty acid and
      simultaneously to decrease the proportion of the corresponding 9-cis-hexadecenoic
      acid. This conversion of fatty acids was also induced by 4-chlorophenol in
      nongrowing cells in which the de novo synthesis of lipids had stopped, as shown
      by incorporation experiments with labeled acetate. The isomerization of the
      double bond in the presence of chloramphenicol indicates a constitutively
      operating enzyme system. The cis-to-trans modification of the fatty acids studied
      here apparently is a new way of adapting the membrane fluidity to the presence of
      phenols, thereby compensating for the elevation of membrane permeability induced
      by these toxic substances.

PMID- 1622261
TI  - API Listeria, a new and promising one-day system to identify Listeria isolates.
AB  - API Listeria is a new 10-test strip for 24-h biochemical identification of
      Listeria isolates. With this commercial system, 85% of 646 Listeria strains,
      including atypical isolates selected for this study, were recognized at the
      species and subspecies level without a complementary test. A new test
      differentiates Listeria monocytogenes from L. innocua on the basis of the absence
      of arylamidase from the former. With this system, 97.7% (252 of 258) of the L.
      monocytogenes strains tested were correctly identified and differentiated from
      99.4% (175 of 176) of the L. innocua strains also tested. Gram-positive bacteria
      other than Listeria spp. gave quite different biochemical patterns. This system
      considerably reduced the time needed for conventional identification, since
      results were available within 18 to 24 h.

PMID- 1622262
TI  - Heat susceptibility of aquatic mycobacteria.
AB  - An investigation was carried out to measure the heat susceptibility of
      opportunistic mycobacteria frequently isolated from domestic water supply
      systems. The study was conducted under standardized conditions designed to
      resemble those found in oligotrophic aquatic habitats. Strains of the following
      species were tested: Mycobacterium avium, M. chelonae, M. fortuitum, M.
      intracellulare, M. kansasii (two strains), M. marinum, M. phlei, M. scrofulaceum,
      and M. xenopi. Suspensions of the test strains were exposed to temperatures of
      50, 55, 60, and 70 degrees C; samples were taken at defined intervals to
      determine the concentration of survivors. From these data, the decimal reduction
      times were calculated for each test strain and test temperature. The results
      indicate that M. kansasii is more susceptible to heat than Legionella
      pneumophila, whereas the heat susceptibilities of M. fortuitum, M.
      intracellulare, and M. marinum lie in the same order of magnitude as that of L.
      pneumophila. The strains of M. avium, M. chelonae, M. phlei, M. scrofulaceum, and
      M. xenopi were found to be more thermoresistant than L. pneumophila, with the
      highest resistance being found in M. xenopi. Thermal measures to control L.
      pneumophila may therefore not be sufficient to control the last five
      mycobacterial species in contaminated water systems.

PMID- 1622263
TI  - Naphthalene degradation via salicylate and gentisate by Rhodococcus sp. strain
      B4.
AB  - Rhodococcus sp. strain B4, isolated from a soil sample contaminated with
      polycyclic aromatic hydrocarbons, grows with naphthalene as the sole source of
      carbon and energy. Salicylate and gentisate were identified as intermediates in
      the catabolism of naphthalene. In contrast to the well-studied catabolic pathway
      encoded by the NAH7 plasmid of Pseudomonas putida, salicylate does not induce the
      genes of the naphthalene-degradative pathway in Rhodococcus sp. strain B4. The
      key enzymes of naphthalene degradation in Rhodococcus sp. strain B4 have unusual
      cofactor requirements. The 1,2-dihydroxynaphthalene oxygenase activity depends on
      NADH and the salicylate 5-hydroxylase requires NADPH, ATP, and coenzyme A.

PMID- 1622264
TI  - Hyperreiterated DNA regions are conserved among Bradyrhizobium japonicum
      serocluster 123 strains.
AB  - We have identified and cloned two DNA regions which are highly reiterated in
      Bradyrhizobium japonicum serocluster 123 strains. While one of the reiterated DNA
      regions, pFR2503, is closely linked to the B. japonicum common and genotype
      specific nodulation genes in strain USDA 424, the other, pMAP9, is located next
      to a Tn5 insertion site in a host-range extension mutant of B. japonicum USDA
      438. The DNA cloned in pFR2503 and pMAP9 are reiterated 18 to 21 times,
      respectively, in the genomes of B. japonicum serocluster 123 strains. Gene probes
      from the reiterated regions share sequence homology, failed to hybridize (or
      hybridized poorly) to genomic DNA from other B. japonicum and Bradyrhizobium spp.
      strains, and did not hybridize to DNA from Rhizobium meliloti, Rhizobium fredii,
      Rhizobium leguminosarum biovars trifolii, phaseoli, and viceae, or Agrobacterium
      tumefacians. The restriction fragment length polymorphism hybridization profiles
      obtained by using these gene probes are useful for discriminating among
      serologically related B. japonicum serocluster 123 strains.

PMID- 1622265
TI  - Study on the epidemiology and control of Campylobacter jejuni in poultry broiler
      flocks.
AB  - Broiler flocks are frequently infected with Campylobacter jejuni. The origin of
      the infection is still unclear. The question of whether colonization of flocks
      results from transmission of C. jejuni from breeder flocks to progeny (vertical
      transmission) or from environmental sources (horizontal transmission) remains to
      be answered. Therefore, in this study samples were taken from successive broiler
      flocks in two broiler houses (house A on farm A and house B1 on farm B) as well
      as from the environment of the houses. All C. jejuni isolates were typed by using
      the Penner serotyping system, and part of the isolates from farm B were typed by
      using a randomly amplified polymorphic DNA-typing system. In poultry house A, C.
      jejuni was isolated from the first flock but not from subsequent flocks. In
      poultry house B1, C. jejuni strains of the same Penner serotypes and exhibiting
      identical DNA profiles were isolated from successive flocks. Infection of the
      flocks from a common source via horizontal pathways is suspected, while a
      vertical route of infection is not likely to exist. Application of measures to
      control horizontal transmission of C. jejuni on farm B was successful.

PMID- 1622266
TI  - Extracellular protease from the antarctic yeast Candida humicola.
AB  - The psychrotrophic, dimorphic yeast Candida humicola, isolated from Antarctic
      soil, secretes an acidic protease into the medium. The secretion of this protease
      by C. humicola was found to be dependent on the composition of the medium. In YPD
      or yeast nitrogen base medium containing either amino acids or ammonium sulfate
      as the nitrogen source, the activity of the protease in the medium was low (basal
      level). However, when yeast nitrogen base medium was depleted of amino acids or
      ammonium sulfate and supplemented with proteins, the activity of the enzyme
      increased. The secretion of the enzyme was greater during exponential growth at
      low temperatures than during growth at higher temperatures. The purified protease
      had a molecular mass of 36,000 Da and was inhibited by pepstatin, iodoacetamide,
      and sodium dodecyl sulfate. Despite the prevalent cold temperatures in
      Antarctica, this extracellular protease of the psychrotrophic yeast C. humicola
      was active at temperatures ranging from 0 to 45 degrees C, with an optimum
      activity at 37 degrees C.

PMID- 1622267
TI  - Monoclonal antibody specific for Listeria monocytogenes associated with a 66
      kilodalton cell surface antigen.
AB  - A monoclonal antibody (MAb), EM-7G1, specific for Listeria monocytogenes was
      developed by using a previously developed MAb, C11E9 (A. K. Bhunia, P. H. Ball,
      A. T. Fuad, B. W. Kurz, J. W. Emerson, and M. G. Johnson, Infect. Immun. 59:3176
      3184, 1991), to mask epitopes shared by L. monocytogenes and Listeria innocua in
      a 66-kDa cell surface protein. MAb EM-7G1 was an immunoglobulin subclass G1
      antibody with kappa light chains. This MAb reacted with all 34 strains of L.
      monocytogenes tested and showed no cross-reaction with other Listeria spp. or
      other gram-positive or gram-negative organisms tested by enzyme-linked
      immunosorbent assay, dot blotting, and colony blotting. A second MAb, EM-6E11,
      reacted with all Listeria spp. tested but no other bacteria. In a Western blot
      (immunoblot) assay, EM-7G1 reacted with a crude cell surface protein of 66 kDa
      with a pI value of 6.7, while EM-6E11 reacted with two protein bands of 43 and 94
      to 97 kDa with pI values of 4.0 and 4.3, respectively. Results with trypsin or
      pronase treatments indicated that the cell antigen reacting with EM-7G1 was on
      the surface of L. monocytogenes V7 and Scott A cells.

PMID- 1622268
TI  - Transformation of Bacillus subtilis by DNA bound on montmorillonite and effect of
      DNase on the transforming ability of bound DNA.
AB  - The equilibrium adsorption and binding of DNA from Bacillus subtilis on the clay
      mineral montmorillonite, the ability of bound DNA to transform competent cells,
      and the resistance of bound DNA to degradation by DNase I are reported. Maximum
      adsorption of DNA on the clay occurred after 90 min of contact and was followed
      by a plateau. Adsorption was pH dependent and was greatest at pH 1.0 (19.9
      micrograms of DNA mg of clay-1) and least at pH 9.0 (10.7 micrograms of DNA mg of
      clay-1). The transformation frequency increased as the pH at which the clay-DNA
      complexes were prepared increased, and there was no transformation by clay-DNA
      complexes prepared at pH 1. After extensive washing with deionized distilled
      water (pH 5.5) or DNA buffer (pH 7.5), 21 and 28%, respectively, of the DNA
      remained bound. Bound DNA was capable of transforming competent cells (as was the
      desorbed DNA), indicating that adsorption, desorption, and binding did not alter
      the transforming ability of the DNA. Maximum transformation by bound DNA occurred
      at 37 degrees C (the other temperatures evaluated were 0, 25, and 45 degrees C).
      DNA bound on montmorillonite was protected against degradation by DNase,
      supporting the concept that "cryptic genes" may persist in the environment when
      bound on particulates. The concentration of DNase required to inhibit
      transformation by bound DNA was higher than that required to inhibit
      transformation by comparable amounts of free DNA, and considerably more bound
      than free DNase was required to inhibit transformation by the same amount of free
      DNA. Similarly, when DNA and DNase were bound on the same or separate samples of
      montmorillonite, the bound DNA was protected from the activity of DNase.

PMID- 1622269
TI  - Application of ribotyping for differentiating aeromonads isolated from clinical
      and environmental sources.
AB  - We have investigated the usefulness of ribotyping for the differentiation of
      aeromonads isolated from five patients with gastroenteritis and from the source
      water, treatment plant, and distribution system of a small public water supply.
      Aeromonas hydrophila and Aeromonas caviae were isolated from fecal specimens
      preserved in Cary-Blair transport medium by using blood ampicillin agar or
      alkaline peptone water (pH 8.4) subcultured to blood ampicillin agar plates. A.
      hydrophila, Aeromonas sobria, and A. caviae were isolated from duplicate 100-ml
      water samples by the membrane filter technique by using ampicillin dextrin agar
      for quantitative determination of growth and alkaline peptone water enrichment
      for detection of the presence or absence of aeromonads below the detection limit
      of the membrane filter method. In addition, free chlorine residuals and pH values
      were determined for all water samples and heterotrophic plate counts and total
      and fecal coliform analyses were performed on them. Ribotyping patterns of
      aeromonads recovered from well 1, detention basin, sand filter, softener, and
      distribution samples were compared with those of the five clinical isolates. All
      patient strains were unique; however, identical ribotypes of A. hydrophila and A.
      sobria isolated from multiple sites in the water system indicated colonization of
      a well, sand filters, and the softener, with the potential for sporadic
      contamination of distribution water. Plant operational deficiencies were noted
      and corrected. Ribotyping can effectively differentiate otherwise
      indistinguishable strains of bacteria, thus providing a powerful tool for
      investigation of waterborne diseases and bacteriological problems within water
      treatment plants and distribution systems.

PMID- 1622270
TI  - Reduction of nitroaromatic compounds mediated by Streptomyces sp. exudates.
AB  - Exudates from Streptomyces griseoflavus Tu 2484 effectively mediated electron
      transfer between hydrogen sulfide and various nitrobenzenes. In general, pseudo
      first-order kinetics were observed, except for the initial phase of the reaction
      at higher pH values. Under fixed pH and Dh conditions, linear free energy
      relationships were found between the logarithms of the reaction rate constants
      and the one-electron reduction potentials of the nitroaromatic compounds. No
      competition was observed between various compounds. Comparison of the results of
      this study with the results of experiments conducted with model quinones and an
      iron porphyrin suggest that the secondary metabolites cinnaquinone and
      dicinnaquinone, excreted by strain Tu 2484 on the order of 100 mg/liter, are
      responsible for the catalytic activity of the exudate. Further support for this
      hypothesis comes from the facts that the catalytic activity of the exudate became
      prominent only after the growth phase of the microorganisms and that the
      mediating substances have a molecular weight of less than 3,000.

PMID- 1622271
TI  - Molecular analyses of the lactococcin A gene cluster from Lactococcus lactis
      subsp. lactis biovar diacetylactis WM4.
AB  - The genes responsible for bacteriocin production and immunity in Lactococcus
      lactis subsp. lactis biovar diacetylactis WM4 were localized and characterized by
      DNA restriction fragment deletion, subcloning, and nucleotide sequence analysis.
      The nucleotide sequence of a 5.6-kb AvaII restriction fragment revealed a cluster
      with five complete open reading frames (ORFs) in the same orientation. DNA and
      protein homology analyses, combined with deletion and Tn5 insertion mutagenesis,
      implicated four of the ORFs in the production of and immunity to lactococcin A.
      The last two ORFs in the cluster were the lactococcin A structural and immunity
      genes, lcnA and lciA. The two ORFs immediately upstream of lcnA and lciA were
      designated lcnC and lcnD, and the proteins that they encoded showed similarities
      to proteins of signal sequence-independent secretion systems. lcnC encodes a
      protein of 716 amino acids that could belong to the HlyB family of ATP-dependent
      membrane translocators. LcnC contains an ATP binding domain in a conserved C
      terminal stretch of approximately 200 amino acids and three putative hydrophobic
      segments in the N terminus. The lcnD product, LcnD, of 474 amino acids, is
      essential for lactococcin A expression and shows structural similarities to HlyD
      and its homologs. On the basis of these results, a secretion apparatus that is
      essential for the full expression of active lactococcin A is postulated.

PMID- 1622272
TI  - An enzyme immunoassay of phaseolinone and its application in estimation of the
      amount of toxin in Macrophomina phaseolina-infected seeds.
AB  - A microtiter plate-based enzyme immunoassay has been developed for phaseolinone,
      a phytotoxin isolated from the culture filtrate of the plant-pathogenic fungus
      Macrophomina phaseolina (Tassi) Goid. The smallest amount of phaseolinone
      detectable by the method is 5 pg per well. The method is validated by comparison
      with high-performance liquid chromatography and used to confirm and estimate
      phaseolinone production in seeds infected with the fungus. The degree of seed
      inhibition correlated well with the amount of toxin produced in infected seeds,
      50% inhibition being observed at a toxin concentration of 0.60 micrograms/g of
      wet tissue.

PMID- 1622273
TI  - Characterization of form variants of Xenorhabdus luminescens.
AB  - From Xenorhabdus luminescens XE-87.3 four variants were isolated. One, which
      produced a red pigment and antibiotics, was luminescent, and could take up dye
      from culture media, was considered the primary form (XE-red). A pink-pigmented
      variant (XE-pink) differed from the primary form only in pigmentation and uptake
      of dye. Of the two other variants, one produced a yellow pigment and fewer
      antibiotics (XE-yellow), while the other did not produce a pigment or antibiotics
      (XE-white). Both were less luminescent, did not take up dye, and had small cell
      and colony sizes. These two variants were very unstable and shifted to the
      primary form after 3 to 5 days. It was not possible to separate the primary form
      and the white variant completely; subcultures of one colony always contained a
      few colonies of the other variant. The white variant was also found in several
      other X. luminescens strains. DNA fingerprints showed that all four variants are
      genetically identical and are therefore derivatives of the same parent. Protein
      patterns revealed a few differences among the four variants. None of the variants
      could be considered the secondary form. The pathogenicity of the variants
      decreased in the following order: XE-red, XE-pink, XE-yellow, and XE-white. The
      mechanism and function of this variability are discussed.

PMID- 1622274
TI  - Development of a gene transfer system for curing of plasmids in the marine fish
      pathogen Vibrio salmonicida.
AB  - All reported natural isolates of the marine fish pathogen Vibrio salmonicida
      contain plasmids, and in another marine fish pathogen, Vibrio anguillarum, it has
      been shown that a plasmid is important for expression of virulence by the
      organism. To study the function of the plasmids in V. salmonicida, we developed a
      gene transfer system based on the plasmid RSF1010 replicon. The gene transfer
      system was used to construct a plasmid-free strain, and this strain was found to
      behave similarly to the wild type in a fish pathogenicity test based on
      intraperitoneal injection of the bacteria. We were unable to detect any other
      phenotypic differences between the two strains. It could therefore be concluded
      that at least in the V. salmonicida strain tested, extrachromosomal DNA is not
      required for expression of virulence.

PMID- 1622275
TI  - Biological suppression of potato ring rot by fluorescent pseudomonads.
AB  - Three strains of fluorescent pseudomonads (IS-1, IS-2, and IS-3) isolated from
      potato underground stems with roots showed in vitro antibiosis against 30 strains
      of the ring rot bacterium Clavibacter michiganensis subsp. sepedonicus. On the
      basis of morphological and biochemical tests and fatty acid analysis, IS-1 and IS
      2 were identified as Pseudomonas aureofaciens and IS-3 was identified as P.
      fluorescens biovar III. IS-1 was the most inhibitory to C. michiganensis subsp.
      sepedonicus strains in vitro, followed by IS-3 and IS-2. Suppression of ring rot
      by these antagonists was demonstrated in greenhouse trials with stem-cultured
      potato (cv. Russet Burbank) seedlings. Although each antagonist significantly
      reduced C. michiganensis subsp. sepedonicus populations, only IS-1 reduced
      infection by C. michiganensis subsp. sepedonicus. In a second experiment,
      treatment with IS-1 (10(9) CFU/ml) significantly reduced ring rot infection by
      23.4 to 26.7% after 5 to 8 weeks. The average C. michiganensis subsp. sepedonicus
      population was also significantly reduced by 50 to 52%. Application of different
      combinations of antagonist strains was not more effective than single-strain
      treatment.

PMID- 1622276
TI  - Growth phase, cellular hydrophobicity, and adhesion in vitro of lactobacilli
      colonizing the keratinizing gastric epithelium in the mouse.
AB  - Lactobacillus strains of numerous species isolated from several animal sources
      exhibited cellular hydrophobicities that differed from those expected on the
      basis of their abilities to colonize the keratinizing stratified squamous
      epithelium in the mouse stomach. Cells of Lactobacillus fermentum 100-33, grown
      to either exponential or stationary phase, were strongly hydrophilic. By
      contrast, cells of L. fermentum RI and six transformant derivatives of strain RI
      and 100-33, strains DM101 through DM106, were hydrophobic to various degrees in
      either growth phase. Most of them were less hydrophobic, however, when in the
      stationary phase than in the exponential phase. Cells of strains RI and 100-33 in
      the exponential phase adhered in the same number in vitro to disks of keratinized
      mouse gastric mucosa. By contrast, when in stationary phase, strain RI and two
      transformants, DM103 and DM104, adhered to the surface in higher numbers than 100
      33. In contrast to their cellular progenitor, 100-33, the transformant strains
      share with their DNA donor, RI, the capacity to colonize the keratinizing gastric
      epithelium in mice. These findings indicate that lactobacilli able to colonize
      the surface of the keratinocytes in the murine stomach can adhere to that surface
      by either hydrophilic or hydrophobic molecules.

PMID- 1622277
TI  - Complete biological reductive transformation of tetrachloroethene to ethane.
AB  - Reductive dechlorination of tetrachloroethene (perchloroethylene; PCE) was
      observed at 20 degrees C in a fixed-bed column, filled with a mixture (3:1) of
      anaerobic sediment from the Rhine river and anaerobic granular sludge. In the
      presence of lactate (1 mM) as an electron donor, 9 microM PCE was dechlorinated
      to ethene. Ethene was further reduced to ethane. Mass balances demonstrated an
      almost complete conversion (95 to 98%), with no chlorinated compounds remaining
      (less than 0.5 micrograms/liter). When the temperature was lowered to 10 degrees
      C, an adaptation of 2 weeks was necessary to obtain the same performance as at 20
      degrees C. Dechlorination by column material to ethene, followed by a slow ethane
      production, could also be achieved in batch cultures. Ethane was not formed in
      the presence of bromoethanesulfonic acid, an inhibitor of methanogenesis. The
      high dechlorination rate (3.7 mumol.l-1.h-1), even at low temperatures and
      considerable PCE concentrations, together with the absence of chlorinated end
      products, makes reductive dechlorination an attractive method for removal of PCE
      in bioremediation processes.

PMID- 1622278
TI  - Incubation of water samples containing amoebae improves detection of legionellae
      by the culture method.
AB  - Some protozoans isolated from aquatic habitats, including domestic water
      supplies, can support the intracellular replication of autochthonous legionellae
      in vitro. We studied the effect of incubating water samples containing amoebae on
      the sensitivity of culture for legionellae. Samples collected during
      investigations of legionellosis epidemics and shown by conventional culture
      procedures to contain amoebae, but not legionellae, were incubated at 35 degrees
      C and replated. Legionellae were recovered from 59 of 144 such samples. Species
      isolated included L. pneumophila, L. anisa, L. bozemanii, L. gormanii, L.
      micdadei, L. rubrilucens, L. sainthelensi, L. steigerwaltii, and an unnamed
      species. Acanthamoeba polyphaga, Acanthamoeba hatchetti, a Rosculus sp.,
      Hartmannella vermiformis, and Vahlkampfia spp. were among the autochthonous
      amoebae identified. Legionellae were recovered by this procedure from only 3 of
      63 samples that were negative for amoebae by conventional culture procedures.
      These results show that water samples negative for legionellae, but positive for
      amoebae, by standard culture techniques should be incubated and replated to
      maximize the sensitivity of culture for legionellae.

PMID- 1622279
TI  - 1,3-Propanediol:NAD+ oxidoreductases of Lactobacillus brevis and Lactobacillus
      buchneri.
AB  - In the cofermentation of glycerol with a sugar by Lactobacillus brevis and
      Lactobacillus buchneri, a 1,3-propanediol:NAD+ oxidoreductase provides an
      additional method of NADH disposal. The enzyme has been purified from both L.
      brevis B22 and L. buchneri B190 and found to have properties very similar to
      those reported for the enzyme from Klebsiella pneumoniae. The enzymes required
      Mn2+ and are probably octamers with a molecular mass of 350 kDa. Although not
      absolutely specific for 1,3-propanediol when tested as dehydrogenases, the
      enzymes have less than 10% activity with glycerol, ethanol, and 1,2-propanediol.
      These properties contrast sharply with those of a protein isolated from another
      Lactobacillus species (L. reuteri) that ferments glycerol with glucose and
      previously designated a 1,3-propanediol dehydrogenase.

PMID- 1622280
TI  - Evaluation of the Organon-Teknika MICRO-ID LISTERIA system.
AB  - The MICRO-ID LISTERIA system, designed to identify Listeria isolates to species
      level within 24 h, was compared with conventional biochemical identification.
      MICRO-ID LISTERIA used in combination with the CAMP test correctly identified 409
      (98.8%) of 414 strains isolated from human, animal, food, and environmental
      sources belonging to the seven species currently defined within the genus
      Listeria. The kit was easy to use and simple to interpret. However, 8 of the 15
      tests (i.e., phenylalanine deaminase, hydrogen sulfide, indole, ornithine
      decarboxylase, lysine decarboxylase, malonate, urease, and o-nitrophenyl-beta-D
      galactopyranoside) were considered superfluous for the differentiation of
      Listeria spp. The CAMP test was indispensable when using the MICRO-ID LISTERIA
      system, in particular to differentiate CAMP test-positive L. monocytogenes from
      the nonhemolytic, rhamnose-positive L. innocua. The hemolytic L. seeligeri and L.
      ivanovii strains and the nonhemolytic, non-rhamnose-acidifying L. welshimeri
      strains could also be differentiated from one another only on the basis of their
      CAMP test results. The very few strains of L. grayi and L. murrayi were easily
      differentiated from the other nonhemolytic species. Catalase-negative cocci
      should not be tested, because 12 out of 19 catalase-negative strains (all
      enterococci) in our test were misidentified as Listeria spp. The MICRO-ID
      LISTERIA system identified strains within 18 to 24 h and is thus less time
      consuming than conventional tests. The system could, therefore, be used together
      with correctly done CAMP tests for the rapid identification of Listeria isolates,
      especially food and environmental isolates, for which rapid species
      differentiation is important.

PMID- 1622281
TI  - Utilization of cyanide as nitrogenous substrate by Pseudomonas fluorescens NCIMB
      11764: evidence for multiple pathways of metabolic conversion.
AB  - The growth of Pseudomonas fluorescens NCIMB 11764 on cyanide as the sole nitrogen
      source was accomplished by use of a modified fed-batch cultivation procedure.
      Previous studies showing that cyanide metabolism in this organism is both an
      oxygen-dependent and an inducible process, with CO2 and ammonia representing
      conversion products, were confirmed. However, washed cells (40 mg ml-1 [dry
      weight]) metabolized cyanide at concentrations far exceeding those previously
      described; 85% of 50 mM KCN was degraded in 6 h. In addition, two other C1
      metabolites were detected in incubation mixtures; their identities were confirmed
      as formamide and formate by 13C nuclear magnetic resonance spectrocopy, high
      pressure liquid chromatography, radioisotopic trapping experiments, and other
      analytical means. The relative yields of all four metabolites (CO2, formamide,
      formate, and ammonia) were shown to be dependent on the KCN concentration and
      availability of oxygen; at 0.5 to 10 mM substrate, CO2 was the major C1 product,
      whereas at 20 and 50 mM substrate, formamide and formate were principally formed.
      The latter two metabolites also accumulated during prolonged anaerobic
      incubation, suggesting that P. fluorescens NCIMB 11764 can elaborate several
      pathways of cyanide conversion. One is formally similar to that proposed
      previously (R. E. Harris and C. J. Knowles, FEMS Microbiol. Lett. 20:337-341,
      1983), involving the oxygen-dependent conversion of cyanide to CO2 and ammonia.
      The other two, occurring in the presence or absence of oxygen, involve separate
      reactions to yield, respectively, formate plus ammonia or formamide.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1622282
TI  - Protein-mediated adhesion of Lactobacillus acidophilus BG2FO4 on human enterocyte
      and mucus-secreting cell lines in culture.
AB  - The adhesion of Lactobacillus acidophilus BG2FO4, a human stool isolate, to two
      human enterocytelike cell lines (Caco-2 and HT-29) and to the mucus secreted by a
      subpopulation of mucus-secreting HT29-MTX cells was investigated. Scanning
      electron microscopy revealed that the bacteria interacted with the well-defined
      apical microvilli of Caco-2 cells without cell damage and with the mucus secreted
      by the subpopulation of HT29-MTX cells. The adhesion to Caco-2 cells did not
      require calcium and involved an adhesion-promoting factor that was present in the
      spent supernatant of L. acidophilus cultures. This factor promoted adhesion of
      poorly adhering human Lactobacillus casei GG but did not promote adhesion of L.
      casei CNRZ 387, a strain of dairy origin. The adherence components on the
      bacterial cells and in the spent supernatant were partially characterized.
      Carbohydrates on the bacterial cell wall appeared to be partly responsible for
      the interaction between the bacteria and the extracellular adhesion-promoting
      factor. The adhesion-promoting factor was proteinaceous, since trypsin treatment
      dramatically decreased the adhesion of the L. acidophilus strain. The adhesion
      promoting factor may be an important component of Lactobacillus species that
      colonize the gastrointestinal tract.

PMID- 1622283
TI  - Application of DNA probes to analysis of bacteriophage distribution patterns in
      the environment.
AB  - Radiolabeled bacteriophage DNA probes have been used in this study to determine
      the distribution of Pseudomonas aeruginosa-infecting bacteriophages in natural
      samples of lake water, sediment, soil, and sewage. The sensitivity of detection
      of bacteriophage with the DNA probes was between 10(3) and 10(4) PFU and 10(6) to
      10(7) CFU of lysogenized bacteria detectable with a homologous phage DNA probe.
      Analyses of environmental samples suggest that up to 40% of P. aeruginosa in
      natural ecosystems contain DNA sequences homologous to phage genomes. By using
      different bacteriophage DNA probes, the diversity of the bacteriophage population
      in sewage was estimated to be higher than that in other natural samples. The
      indication that transducing phages and prophages are widely distributed in the
      Pseudomonas populations investigated has considerable implications for the
      frequency of natural gene transfer by transduction and of lysogenic conversion of
      host bacteria in natural ecosystems.

PMID- 1622284
TI  - Temperature and structural effects on transfer of double-stranded RNA among
      isolates of the chestnut blight fungus (Cryphonectria parasitica).
AB  - Cryphonectria parasitica is a unique fungus which can serve as a model for
      understanding transfer of genes between eukaryotic microorganisms. We studied
      transfer of double-stranded RNA (dsRNA) between compatible and incompatible
      strains of C. parasitica to determine whether hyphal types or temperature could
      restrict that exchange. Hyphal connections between incompatible strains occurred
      at about 30% of the frequency of connections between compatible strains and
      differed morphologically. Gel electrophoresis and in situ hybridization confirmed
      that dsRNA was transferred through substrate hyphae but not through aerial
      hyphae. Freezing temperatures resulted in the loss of dsRNA from the new mycelium
      of the donor colony and stimulated the production of virulent pycnidiospores.
      These temperature and structural restrictions may help to explain the lack of
      spread of the dsRNA despite its presence in the field.

PMID- 1622285
TI  - An inducible, nondegradative phytoalexin resistance mechanism in Dictyostelium
      discoideum is suppressed by mutations that alter membrane sterol composition.
AB  - Pretreatment of Dictyostelium discoideum amoebae with a sublethal concentration
      of the pea phytoalexin pisatin was shown to induce nondegradative resistance to
      subsequent challenges with inhibitory concentrations. An alteration of membrane
      sterol composition either with the azasterol A25822B or by mutations in nysC that
      confer resistance to the polyene antibiotic nystatin suppressed the induction of
      pisatin resistance. Wild-type cells grown on pisatin medium acquired resistance
      to nystatin; however, after transfer to nystatin medium, they lost their pisatin
      resistance phenotype but remained nystatin resistant. To account for this
      asymmetry in the induction and maintenance of cross-resistance after growth on
      pisatin and nystatin media, we propose a model in which the two resistance
      phenotypes are governed by distinct mechanisms. This model presumes that growth
      on pisatin induces membrane alterations that predispose cells to acquire nystatin
      resistance but that the pisatin-induced membrane alterations are not maintained
      in the absence of pisatin.

PMID- 1622286
TI  - Acid adaptation promotes survival of Salmonella spp. in cheese.
AB  - Salmonella typhimurium was adapted to acid by exposure to hydrochloric acid at pH
      5.8 for one to two doublings. Acid-adapted cells had increased resistance to
      inactivation by organic acids commonly present in cheese, including lactic,
      propionic, and acetic acids. Recovery of cells during the treatment with organic
      acids was increased 1,000-fold by inclusion of 0.1% sodium pyruvate in the
      recovery medium. Acid-adapted S. typhimurium cells survived better than
      nonadapted cells during a milk fermentation by a lactic acid culture. Acid
      adapted cells also showed enhanced survival over a period of two months in
      cheddar, Swiss, and mozzarella cheeses kept at 5 degrees C. Acid adaptation was
      found in Salmonella spp., including Salmonella enteritidis, Salmonella
      choleraesuis subsp. choleraesuis serotype heidelberg, and Salmonella choleraesuis
      subsp. choleraesuis serotype javiana, associated with food poisoning. These
      observations support the theory that acid adaptation is an important survival
      mechanism enabling Salmonella spp. to persist in fermented dairy products and
      possibly other acidic food products.

PMID- 1622287
TI  - Acquisition of a sucrose utilization system in Escherichia coli K-12 derivatives
      and its application to industry.
AB  - An Escherichia coli strain, B-62, that was isolated from a clinical source and
      was epidemiologically unrelated to E. coli K-12 was the source of chromosomal DNA
      for a sucrose utilization system (Scr+) in the construction of a plasmid, pST621.
      The cloned insert of a gene encoding Scr+ in pST621 conferred a sucrose-positive
      phenotype onto transformed cells of E. coli K-12 derivatives. Sucrase activity of
      the transformants was as high as that which would correspond to a "gene dosage
      effect" of a vector plasmid pBR322, whereas the transformants' sucrose uptake
      activity was always lower than that of E. coli B-62. A region within an XhoI-SacI
      fragment (3.2 kb) of pBR322-glyA was replaced in the construction of another
      plasmid, pST5R7, by a fragment (about 2.6 kb) of pST622 containing the gene
      encoding Scr+. A genetically stable Scr+ derivative of E. coli K-12 was obtained
      by introducing the gene encoding Scr+ onto E. coli chromosome via homologous
      recombination between pST5R7 and the chromosome and subsequent plasmid
      segregation. The use of low-copy-number plasmid RP4 as a cloning vector was also
      effective for enhancing the stability of Scr+. Tryptophan producers E. coli
      SGIII1032S, in which the gene encoding Scr+ was cloned onto the chromosome, and
      E. coli SGIII1032, which carried Scr+ plasmid RP4.5R7, produced from 6% sucrose
      in shake flasks (33 degrees C, 96 h) 2.3 and 5.7 g of tryptophan per liter,
      respectively.

PMID- 1622288
TI  - Thermotolerance of heat-shocked Listeria monocytogenes in milk exposed to high
      temperature, short-time pasteurization.
AB  - The effect of prior heat shock (48 degrees C for 15 min) on the thermotolerance
      of Listeria monocytogenes at the minimal high-temperature, short-time (71.7
      degrees C for 15 s) parameters required by the Pasteurized Milk Ordinance was
      examined. The mean D71.7 degrees C value for heat-shocked L. monocytogenes was
      4.6 +/- 0.5 s (control D = 3.0 +/- 1.0 s); the ratio of D to control D was 1.5.
      The increased thermotolerance of heat-shocked Listeria cells was not significant
      and appeared unlikely to have practical implications, in terms of risk
      assessment, for the safety of pasteurized milk.

PMID- 1622289
TI  - The family as an advocate for the mentally ill.

PMID- 1622290
TI  - Biological psychiatry and psychiatric nursing in America.
AB  - First psychiatry and then psychiatric nursing have moved into an era of
      psychobiology. In many cases, psychiatric nurses are leaving behind their
      appreciation of the mind-body-brain connection in favor of a purely biological
      approach to the etiology and treatment of mental illness. This article is an
      attempt to show the interrelatedness of these concepts and includes a clinical
      case example of an "endogenously" depressed man who was treated for a period of
      15 years.

PMID- 1622291
TI  - Researching and evaluating model geriatric mental health programs. Part III:
      Statistical analysis issues.
AB  - The third and final article in this three-part series on researching and
      evaluating geriatric mental health programs focuses on statistical analysis
      issues. Analysis of data from experimental and quasi-experimental studies is
      discussed involving inferential statistical techniques such as t test, analysis
      of variance, chi-square, and analysis of covariance, and interrupted time series
      techniques.

PMID- 1622292
TI  - Nurses as patient assault victims: an update, synthesis, and recommendations.
AB  - The literature documenting the incidence and reactions of nursing staff who have
      been assaulted by patients is increasing. Before 1980 very little work was done
      in the area. What did appear generally indicated that patient violence against
      staff was infrequent, and on the rare occasion when it did occur the staff member
      was usually in some way responsible. Current research shows that assault is a
      serious risk factor for nurses. The incidence of assault is high and vastly
      underreported. Staff members experience short- and long-term emotional, social,
      biophysiological, and cognitive reactions to being assaulted. Interventions to
      help the staff victim in the recovery process are increasingly used.

PMID- 1622293
TI  - Sense of belonging: a vital mental health concept.
AB  - Sense of belonging is a concept that has not been researched in psychiatric
      nursing practice. Using a concept-analysis strategy proposed by Walker and Avant,
      the authors present a detailed description of the concept that evolved from a
      series of inductive and deductive strategies. Sense of belonging is defined as
      the experience of personal involvement in a system or environment so that persons
      feel themselves to be an integral part of that system or environment. Sense of
      belonging has important applicability for clinical use as well as continued
      theory development in psychiatric nursing.

PMID- 1622294
TI  - Self-destructive and impulsive behavior in the patient with a borderline
      personality disorder: rethinking hospital treatment and management.
AB  - This article reconsiders current approaches to the inpatient treatment and
      management of the patient with a borderline personality disorder. It is suggested
      that current approaches tend to be reactive rather than proactive. An alternative
      model based on a behavioral therapy program for chronic parasuicidal borderline
      women, is suggested. The approach reframes self-destructive behavior as a
      habitual response to overwhelming affect. By targeting core problems such as self
      destructive and impulsive behaviors, nurses can help patients begin to consider
      alternative behavioral responses to intense stress.

PMID- 1622295
TI  - Maintenance of therapeutic community principles in an age of biopharmacology and
      economic restraints.
AB  - The therapeutic community has changed significantly since its development in
      England more than 40 years ago. However, the hallmarks of the therapeutic milieu,
      such as patient participation in decision making, a multidisciplinary staff, and
      a belief that the environment is the treatment agent, remain part of many
      psychiatric settings. The therapeutic community will continue to undergo
      alteration to adapt to changes in society. It will continue to be a viable
      treatment modality as long as the value system of the organizational culture and
      the internal structure of the community are included as basic concepts. Systems
      theory and organizational culture concepts are used to explore the factors that
      enhance the functioning of a therapeutic community in an era of biological
      treatment and rising health care costs.

PMID- 1622296
TI  - Overcoming stigmatization: social and personal implications of the human
      immunodeficiency virus diagnosis.
AB  - All diseases have attached metaphors. Social and personal reactions to people
      with human immunodeficiency virus are influenced by the metaphor, "fear of
      polluting people," and have in common with sexually transmitted diseases, the
      irrational fear of easy contagion. These issues negatively affect clients'
      response to their diagnosis and their treatment and care. Many clients have
      suffered as a result of receiving care from professionals who are condemning of
      the person with the disease. Others, though have found supportive care givers and
      have experienced positive reactions to the diagnosis through achieving emotional
      and spiritual development. The response of nursing to this stigmatized disease is
      explicated.

PMID- 1622297
TI  - An examination of factors influencing the diagnosis and treatment of black
      patients in the mental health system.
AB  - The Civil Rights Movement, which began in the 1950s and lasted through the mid
      1970s played a major role improving the quality of life for black Americans.
      Although much has changed since the 1950s the roots of racism are deep and change
      occurs slowly. Race exerts an overwhelming influence on popular ideology and
      medical thinking. Many researchers have speculated that a strong association
      exists between race and diagnosis. Understanding the sociocultural background of
      the patient would aid in the distinguishing culturally bound behavior from
      behavior that reflects actual psychopathology. This review examines the
      professional literature on racial and ethnic factors as they pertain to the
      diagnosis and treatment of black patients in the mental health system.

PMID- 1622298
TI  - Applying psychometric criteria to functional assessment in medical
      rehabilitation: II. Defining interval measures.
AB  - The use of functional assessment total scores in arithmetic operations has
      proliferated despite the lack of evidence supporting their use as interval
      measures of patient ability. Such evidence is minimally necessary to assure the
      validity of functional assessment total scores for clinical and management
      decision-making. Two requirements of interval measurement are explained and a set
      of Rasch analyses of 5,500 assessments using the Patient Evaluation and
      Conference System (PECS) are presented. The analyses were performed to determine
      the extent to which four item subsets identified in a previously reported factor
      analysis of the PECS comprise interval measures of functional independence
      status. Results indicate that the PECS scales meet these requirements to varying
      degrees. The analyses also identify areas in which measurement quality can be
      improved.

PMID- 1622299
TI  - Quantifying handicap: a new measure of long-term rehabilitation outcomes.
AB  - According to the World Health Organization (WHO), handicaps exist when
      individuals are unable to fulfill expected social roles. Although ameliorating
      handicaps is one of the prime goals of rehabilitation, its effectiveness in this
      area is poorly measured and has not been documented empirically. Therefore, the
      Craig Handicap Assessment and Reporting Technique (CHART) was designed to
      quantify the extent of handicap in individuals. Using dimensions of handicap
      identified and described by the WHO, CHART uses measurable, behavioral terms to
      compare such individuals with the norms of able-bodied members of society. Test
      retest, proxies, and independent raters have established the validity and
      reliability of CHART. Rasch analysis has verified the CHART scaling and scoring
      procedures. In addition, an initial application of CHART, with a group of 342
      spinal cord injured individuals, is described. Beyond demonstrating the
      instrument's effectiveness in assessing the extent of handicap or social
      disadvantage, this application, by documenting rehabilitation outcomes,
      demonstrates the potential usefulness of CHART for program evaluation.

PMID- 1622300
TI  - Upper extremity functional assessment scales in children with Duchenne muscular
      dystrophy: a comparison.
AB  - Twenty-three subjects were assessed using the already established Brooke Upper
      Extremity Functional Rating Scale and the timed Jebsen Hand Function Test to
      determine whether the Jebsen test was a more discriminative measure of upper
      extremity function in patients with Duchenne muscular dystrophy (DMD). The data
      were analyzed using univariate and forced-entry multiple regression analyses to
      determine the relationship between the Jebsen and Brooke scales while removing
      the effects of the other independent variables: age, hand dominance, and visit
      number. The univariate regression results suggested a positive relationship
      between the Brooke and Jebsen scales. Discrete sublevels of time on the Jebsen
      Hand Function Test were not found within the Brooke functional levels. However,
      the Jebsen test was found to be a more sensitive assessment of hand function than
      the Brooke scale among the DMD population. Parametric data were gathered,
      nondominant and dominant hand functions were differentiated, and a constant set
      of muscle groups was used to complete the tasks of the Jebsen Hand Function Test.
      The Jebsen Hand Function Test might be used instead of the Brooke scale as a more
      discriminative method of following DMD patient progress over time, both
      clinically and during drug treatment trials.

PMID- 1622301
TI  - Validity and reliability of a hand-held dynamometer applied to adults with mental
      retardation.
AB  - The purpose of this study was to determine the validity and reliability of the
      Nicholas Manual Muscle Tester (MMT) as applied to ten adults with mild to
      moderate mental retardation between the ages of 18 to 39 years with an
      intelligence quotient (IQ) range of 36 to 69. Using stabilization techniques,
      isometric torque values were taken of knee extension and elbow flexion on
      separate days with the Nicholas MMT and a Cybex II dynamometer. Pearson product
      moment correlations of these two instruments ranged from .64 to .76 (p less than
      0.05). Based on 1 day of testing intrarater correlation coefficients for the
      Nicholas (MMT) ranged from .97 to .99 (p less than 0.05). In like fashion
      interrater generalizability coefficients were quite high (G = .97 - 98).
      Measurements of adults with mental retardation taken by two experienced
      evaluators with a Nicholas MMT seem to evaluate the component-isometric strength.
      Highly reliable measurements with stabilization techniques were obtained with
      this instrument.

PMID- 1622302
TI  - Severity of pediatric traumatic brain injury and early neurobehavioral outcome: a
      cohort study.
AB  - Traumatic brain injury (TBI) is a major cause of pediatric disability. Its
      neurobehavioral sequelae can often be difficult to distinguish from premorbid
      problems. To establish the early neurobehavioral consequences of TBI, we compared
      a cohort of brain injured children with controls, individually matched on
      premorbid characteristics. Ninety-eight children, aged 6 to 15 years, with mild,
      moderate, and severe closed head injuries, were consecutively identified on
      presentation to two regional medical centers. Individually selected controls were
      matched for age, gender, school grade, behavior, and academic performance.
      Intellectual, neuropsychologic, and academic assessments were undertaken 3 weeks
      after full orientation was achieved. No significant case-control differences were
      found on 20 variables measuring premorbid status. The pattern of decline in
      performance with increasing severity of brain injury was consistent for measures
      assessing intelligence, memory, speeded motor performance, adaptive problem
      solving, and academic performance. Moderately and severely injured patients
      performed at normal levels in reference to standardized intellectual norms, but
      they showed impairment when compared with their matched controls. The impairments
      uncovered in this study place moderately and severely brain injured children at
      risk for problems in the acquisition of academic skills and higher-order
      cognitive abilities.

PMID- 1622303
TI  - Factors influencing reintegration to normal living after amputation.
AB  - This study identified factors affecting reintegration to normal living (RNL)
      after lower extremity amputation. A questionnaire was used to evaluate RNL at a
      veterans' medical center and private rehabilitation clinic. The patients were 42
      elderly individuals (68 +/- 1.5 years). Eighty-eight percent were men and 76% had
      additional health problems. Unilateral below-knee amputations, unilateral above
      knee amputations, and bilateral amputations accounted for 38%, 36%, and 26% of
      subjects, respectively. Eleven questions were asked to evaluate mobility, self
      care, work, recreation, social activities (daily functioning), relationships,
      social self, and life events (perception of self). The median overall RNL score
      was 16 of 22 (range, 5 to 22). Poor reintegration occurred in community mobility,
      work, and recreation. Perception of self questions showed satisfactory
      reintegration. Examination of variables impacting reintegration showed only
      additional illness significantly reducing the RNL score. It was concluded that
      current rehabilitative efforts regarding home mobility and psychological
      adjustment are satisfactory. More attention to community mobility, recreation,
      and additional illnesses would improve RNL after amputation.

PMID- 1622304
TI  - Relationship of life satisfaction to impairment, disability, and handicap among
      persons with spinal cord injury living in the community.
AB  - The level and correlates of the life satisfaction of persons with spinal cord
      injury who are residing in the community were investigated. One hundred men and
      40 women were chosen randomly from a cohort of 640 persons with spinal cord
      injury residing in a 13-county area in southeast Texas. The mean Life
      Satisfaction Index-A (LSIA-A) was lower than reported previously for persons in
      the general population. The LSIA-A was not correlated significantly with
      chronologic variables, the ASIA Total Motor Index Score, or a self-report version
      of the Functional Independence Measure. The LSIA-A was associated positively with
      self-assessed health, perceived control, and social support, as well as with the
      Social Integration, Occupation, and Mobility dimensions of the Craig Handicap
      Assessment and Reporting Technique. From the standpoint of an augmented version
      of the World Health Organization model of disablement, the life satisfaction of
      persons with spinal cord injury appears to be influenced, albeit indirectly, by
      selective aspects of their social role performance (handicap), but not by their
      degree of impairment or disability.

PMID- 1622305
TI  - Mortality after spinal cord injury: a four-year prospective study.
AB  - Research has suggested that mortality after spinal cord injury (SCI) is
      correlated with lower levels of social and vocational activities and lower life
      satisfaction. The purpose of this study was to use prospective data from a 1985
      SCI follow-up study to identify predictors of survival status four years later.
      In 1985, responses to the revised Life Situation Questionnaire were obtained from
      347 participants with SCI. Survival status was ascertained in 1989; 89% (n = 309)
      were known to be alive and 6% (n = 22) were deceased. Multivariate ANOVA was used
      to compare the surviving and deceased participant groups using the 1985 data.
      Results suggested that survivors had superior adjustment on many of the variables
      tested in 1985. In particular, the survivors were more active, rated their
      adjustment as better, were more satisfied with many areas of life, and reported
      fewer problems (especially with emotional distress). Recent medical history (ie,
      nonroutine doctor visits and hospitalizations) was not related to survival. This
      study reaffirms the importance of psychologic, social, and vocational variables
      as predictors of survival. A call is made for rehabilitation psychologists to
      address tough issues (eg, substance abuse) and to thoroughly study more specific
      health behaviors as they relate to survival after SCI.

PMID- 1622306
TI  - Longitudinal changes in adjustment after spinal cord injury: a 15-year study.
AB  - Research on changes in adjustment after spinal cord injury (SCI) has produced
      mixed results. Whereas cross-sectional research has suggested that adjustment
      declines with increasing age, but improves with greater time since injury,
      longitudinal research has suggested that some limited positive changes in
      adjustment occur over an 11-year period. The purpose of the current study was to
      identify the stability of adjustment over a 15-year period after SCI. One hundred
      thirty-five participants with SCI completed Life Situation Questionnaires (LSQ)
      in both 1974 and 1989. T-test comparisons were made on five adjustment scales and
      15 individual items. The results suggested several positive changes in adjustment
      during the 15 years including increased sitting tolerance, more years of
      education, greater satisfaction with finances and employment, and a higher
      percentage of persons working. Decreases were noted in the number of
      hospitalizations and the number of days hospitalized. Given the average number of
      years since injury (9.3 years in 1974; 24.3 years in 1989), the results suggest
      that adjustment will at worst be stable, and at best will improve significantly
      with time.

PMID- 1622307
TI  - Postural organization in patients with hereditary motor and sensory neuropathy.
AB  - The postural organization in patients with hereditary motor and sensory
      neuropathy (HMSN) type I or II was studied clinically by means of a force
      platform. Balance was registered in 14 barefooted HMSN patients and healthy
      matched control subjects during quiet stance. The effect of visual deprivation
      was tested to determine the degree of visual dependency. The effect of the
      simultaneous performance of a concurrent attention-demanding task (Stroop task)
      was tested to estimate the level of balance automaticity. In comparison with
      control subjects, the HMSN patients showed a basically decreased efficiency of
      postural control (p less than .01) as well as an increased visual control of
      posture (p less than .05) in both directions of sway. No loss of balance
      automaticity was found, which suggested an on-line central adaptation to the
      slowly developing peripheral impairments. The results provide a starting point
      for understanding the balance problems and gross motor disabilities in HMSN
      patients.

PMID- 1622308
TI  - Social support intervention after stroke: results of a randomized trial.
AB  - The purpose of this study was to determine if social support intervention would
      improve the support experienced by stroke survivors and if improvement would
      result in better psychosocial outcome. Subjects were drawn from a community-based
      sample that had received rehabilitation services in the hospital and at home. The
      study was a randomized trial (n = 48 experimental group, n = 40 control group),
      and measures were taken at entry into the study, immediately after intervention
      (or, at a comparable time for the control group), and again 3 months later. No
      significant differences were found between groups either on social support
      measures or psychosocial outcomes. Secondary analyses showed that significant
      changes in support had been experienced within the sample as a whole in relation
      to the subjects' gender, living situation, marital status, and employment status.
      Findings are discussed in terms of methodologic and programmatic concerns, and
      recommendations are made for further research with this potentially valuable
      intervention.

PMID- 1622309
TI  - Geriatric rehabilitation: perspectives from the United Kingdom.
AB  - Although rehabilitation professionals acknowledge the need for more services for
      the aging American society, only recently has there been large-scale discussion
      on the state of geriatric rehabilitation in the United States. In contrast,
      geriatric rehabilitation has been a central component of British health planning
      since the beginning of the National Health Service in 1948. In the hope of
      stimulating discussion, this article examines geriatric rehabilitation services
      in the United Kingdom. Contrasts between the UK and US are drawn to highlight the
      relative strengths and weaknesses of each system of care. The importance of
      cultural determinants to health care services is emphasized.

PMID- 1622310
TI  - Emotional dysfunction in a geriatric population: staff observations and patients'
      reports.
AB  - This study was designed to determine the following about a geriatric
      rehabilitation population: (1) the relationship between patients' self-reports of
      depression and anxiety and staff observations of compromised participation in
      treatment secondary to emotional dysfunction; (2) the relationship of
      observations among different disciplines; and (3) changes that may occur to staff
      observations during the patient's hospitalization. The Geriatric Depression
      Scale, the depression and anxiety subtests of the Brief Symptom Inventory, and
      the Modified Mini-Mental State Exam were administered to geriatric patients on
      admission to and discharge from two DRG-exempt acute rehabilitation units. In
      addition, day nurses, evening nurses, occupational therapists, and physical
      therapists rated the same geriatric patients on how frequently their emotional
      functioning interfered with rehabilitation. Significant correlations were
      obtained between staff observations and patients' reports of emotional
      dysfunction, with occupational therapists' ratings generally the most highly
      correlated with patients' reports. At admission, day and evening nurses reported
      significantly greater patient emotional dysfunction than did occupational
      therapists, who reported significantly greater emotional dysfunction than did
      physical therapists. These differences, however, were not evident by time of
      discharge. Thus, staff members can provide reliable information to mental health
      professionals in determining the effect of emotional functioning on
      rehabilitation participation. However, level of compromised participation
      secondary to emotional dysfunction reported by staff appears to be contingent on
      which rehabilitation discipline is asked and when during the patient's
      hospitalization the inquiry is made. Also, patients who generally participated
      less in treatment tended to be older, depressed women with less education and
      greater cognitive impairment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622311
TI  - Spontaneous coping strategies to manage acute pain and anxiety during
      electrodiagnostic studies.
AB  - Electrodiagnostic studies produce both anxiety and pain, which can prevent
      adequate examination and limit the usefulness of test results. This study
      examined the spontaneous coping strategies used to manage the pain and anxiety
      experienced during electrodiagnostic testing. Fifty patients (26 women and 24
      men) evaluated in our electrodiagnostic laboratory were administered visual
      analogue scale (VAS) pain and anxiety measures and the Spielberger State-Trait
      Anxiety Inventory (STAI) before the procedure. Immediately after the procedure,
      subjects reported pain, anxiety, and coping strategies used during
      electrodiagnostic testing using the VAS, the STAI, and a situation-specific
      version of the Coping Strategies Questionnaire (CSQ-S). The CSQ-S appears to be a
      valid and reliable measure of spontaneous coping strategies. Multiple-regression
      analyses revealed that frequent use of catastrophizing, diverting attention, and
      coping self-statement strategies was significantly and positively correlated with
      pain, whereas reinterpreting pain was significantly and negatively associated
      with pain. Judgments of control over pain were also significantly and negatively
      associated with anxiety experienced during electrodiagnostic studies. Physicians'
      ratings of pain and anxiety were highly correlated with patients' self-reports.
      This study suggests that ineffective coping strategies may enhance the pain and
      anxiety experienced during electromyography. Alternatively, teaching subjects
      active self-control skills and increasing patients' self-efficacy beliefs may
      help manage this situation-specific acute anxiety and, possibly, the associated
      pain.

PMID- 1622312
TI  - Coronal computerized tomography and cerebrospinal fluid rhinorrhea.
AB  - Accurate diagnosis of cerebrospinal fluid rhinorrhea (CSFR) is a challenge for
      physicians caring for patients with traumatic brain injury. Failure to recognize
      this condition may result in significant medical complications and prolong
      hospitalization. Two male patients who developed CSFR within 2 months of severe
      head injury are described. A clear nasal discharge was noted on examination
      approximately 30 and 35 days after head injury in both patients and a CSF fistula
      was suspected. High-resolution computerized tomography (CT) with coronal sections
      confirmed the diagnosis. Both patients underwent neurosurgical intervention to
      repair the fistulous tracts without recurrence. Sequelae of CSFR in one case
      included meningitis and pneumocephalus. Literature review shows water-soluble
      contrast CT cisternography (CTC) to be the gold standard for the diagnosis of
      CSFR. However, other diagnostic studies may include immunoelectrophoresis of
      rhinorrhea, use of isotope tracers, plain x-rays, tomography, and noncontrast
      high-resolution CT. More invasive studies like CTC are often recommended in the
      diagnosis of this condition, but are more costly, painful, and carry a small risk
      of infection. Our two case reports emphasize that high-resolution CT may be
      performed as a primary noninvasive diagnostic procedure before more invasive
      studies, and the results obtained may be sufficient for therapeutic planning.

PMID- 1622313
TI  - Physical training effects on the fitness and habitual activity patterns of
      elderly women.
AB  - This study investigated the effect of a twice-weekly, six-month progressive
      walking program on 80 healthy women aged 60 to 70 years. Aerobic fitness, blood
      pressure, skinfold thickness, spirometric variables, and activity profile were
      studied. No significant differences existed between the training group (TG) and
      the control group (CG) at the commencement of the study. However, after 26 weeks
      of training, the TG registered significantly lower heart rates than the CG, both
      at rest (p = .019) and during the five to six minutes of an ergometer work test
      (p = .003). A Mann-Whitney U test on the difference scores (26 weeks-0 week)
      indicated higher scores for the TG compared with the CG for Maximum Current
      Activity (p = .001) and Normative Impairment Index (p = .002), which are both
      components of the Human Activity Profile. These data suggest that adherence to a
      low-frequency training program can elicit positive physiologic changes in elderly
      women. Furthermore, increased habitual activity patterns are likely to be
      indicative of improvements in functional ability, lifestyle, and independence.

PMID- 1622314
TI  - Biomechanical analysis of the sit-to-stand motion in elderly persons.
AB  - The sit-to-stand motion of ten healthy subjects, 65 to 76 years old, was
      evaluated using kinematic, force plate, and electromyographic data to
      characterize the sit-to-stand motion. Kinematic data collected by video, muscle
      activity monitored by surface electromyography, and ground reaction forces
      analyzed by a piezoelectric force plate were used for analysis. Using these
      synchronized data, three phases of the sit-to-stand motion were identified--phase
      1, weight shift; phase 2, transition; and phase 3, lift. A consistent pattern of
      trunk and lower extremity motion was observed, and two distinct upper extremity
      movement strategies were identified. The onset of muscle activity occurred in the
      following order: erector spinae, rectus femoris, and vastus medialis (phase 1);
      biceps femoris, gluteus maximus, and rectus abdominus (phase 2). This
      characterization of the sit-to-stand motion for a small population of healthy
      elderly subjects serves as a basis for identifying problems in elderly patients
      who demonstrate difficulty getting up from a chair.

PMID- 1622315
TI  - Sensory root level recovery in patients with Frankel A quadriplegia.
AB  - This prospective study was designed to demonstrate root level recovery of
      sensation in the zone of partial preservation in patients with C4 through C8,
      Frankel A spinal cord injuries. Subjects were evaluated for pin (n = 18) and
      light touch (n = 17) sensation. All subjects had normal sensation at the level of
      injury, and decreased or absent sensation at all levels caudal to that level
      within the zone of partial preservation; they had absent sensation at all levels
      below the zone of partial preservation. After the initial examination, patients
      were evaluated weekly for four weeks, and then at 2, 3, 6, 12, 18, and 24 months
      postinjury. Six of 18 patients recovered pin sensation and five of 17 recovered
      light touch within three months of injury. Most subjects who recovered had
      injuries from C5 through C8. Eleven of 12 C4 patients did not recover pin
      sensation, and 11 of 11 failed to recover light touch. However, five of six C5 to
      C8 patients recovered both pin and light touch. The p values (Fisher-Exact tests)
      for the C4 vs C5 to C8 groups were .004 and .001 for pin and light touch,
      respectively. In conclusion, approximately 30% of the total population improved
      one sensory root level, with the C5 to C8 injured patients comprising the
      majority of this improvement.

PMID- 1622316
TI  - Hypoxia episodes during sleep in high tetraplegia.
AB  - To determine whether oxygen desaturation occurs during sleep in high
      tetraplegics, 10 neurologically stable male patients (aged 17 to 55 years) with
      complete motor lesions (C4 to C6) had continuous pulse oximetry recordings and
      sleep observations on two nights. The patients were studied during admissions for
      nonrespiratory problems (eg, pressure sores, urinary infection, respite). Lung
      function tests and daytime arterial blood gases were also measured. Mean forced
      vital capacity was 46% of predicted, but mean awake PaO2 and PaCO2 were normal
      (95.0 mmHg and 42.8 mmHg, respectively). Three subjects showed severe nocturnal
      oxygen desaturation spending greater than 10% of the time overnight with arterial
      oxyhaemoglobin saturation (SaO2) levels of less than 90%. For the group as a
      whole, the percentage of time spent under 90% SaO2 correlated with body mass
      index. Mean overnight SaO2 correlated inversely with body mass index and directly
      with maximal expiratory pressure, a measure of respiratory muscle strength. Low
      overnight SaO2 was also associated with higher levels of injury. The pattern of
      nocturnal oxygen desaturation observed was episodic and was suggestive of
      obstructive sleep apnoea during rapid eye movement (REM) sleep. Levels of
      nocturnal oxygen desaturation similar to those observed in the three most
      severely affected patients have been shown, in other disorders, to be associated
      with cognitive impairment, cardiovascular disease and increased mortality. Our
      results suggest up to a third of high tetraplegics may be at risk of potentially
      serious nocturnal hypoxic episodes.

PMID- 1622317
TI  - Evaluation of coma and vegetative states.
AB  - The Coma/Near-Coma (CNC) scale was designed to measure small clinical changes in
      patients with severe traumatic and nontraumatic brain injuries who were
      functioning at very low levels characteristic of near-vegetative and vegetative
      states. In 20 patients followed for 16 weeks the scale identified 25% who
      ultimately showed modest improvement. Interrater reliability was high (r = .95);
      validity was supported by significant correlations between CNC- and brain
      multimodality evoked potential abnormality scores as well as between scores on
      the CNC and the Disability Rating Scale. The CNC scale was easily learned and it
      could be completed quickly and cost effectively. Staff found it useful in
      recognizing among relatively homogeneous low-level patients those most likely to
      respond to further rehabilitation care. The CNC appears to be useful for
      justifying ongoing intensive rehabilitation and for preventing premature transfer
      to lower levels of care.

PMID- 1622318
TI  - Early intervention in severe head injury: long-term benefits of a formalized
      program.
AB  - With traumatic brain injuries numbering more than two million per year, health
      professionals are faced with the challenges of restoring and maximizing quality
      of life. This study quantifies the benefits of a formalized head injury program,
      including the concept of trauma rehabilitation, defined as early, aggressive
      rehabilitation during acute hospitalization. Thirty-eight severely head injured
      patients received treatment at the same rehabilitation facility. Twenty-one of
      these patients received acute care services at ten different hospitals without
      formalized traumatic brain injury programs, and 17 received services at a
      hospital with a formalized early intervention program. Comparison of outcome data
      for the two programs revealed that patients in the formalized program had comas
      and rehabilitation stays approximately one third the length of patients in
      nonformalized programs (18.9 vs 53.8 days and 106.5 vs 239.5 days, respectively).
      Mean cognitive levels at discharge from the acute hospitals (5.6 vs 4.0) and the
      rehabilitation facility (7.4 vs 6.7) were significantly higher for the formalized
      program, and they facilitated a significantly higher percentage of discharges to
      home vs extended care facility (94% vs 57%).

PMID- 1622319
TI  - Value of gait analysis in the assessment of surgery in cerebral palsy.
AB  - Twenty-three ambulatory children with cerebral palsy were assessed preoperatively
      by a detailed clinical examination and by gait analysis using a video-based gait
      analysis system (VICON). Surgery was then performed based on either the clinical
      assessment alone or a combination of clinical evaluation and gait analysis. About
      one year after surgery, a postoperative clinical and gait analysis assessment was
      performed. Sixteen children had improved and seven children had not improved
      after surgery. Most of the children who had not improved were found to have had
      operations that differed from those recommended by gait analysis. Dynamic EMG
      studies were found to be useful in preoperative planning but did not show any
      consistent improvement even in the children with good results. The combination of
      a careful clinical assessment and gait analysis can produce better results in
      surgery for children with cerebral palsy.

PMID- 1622320
TI  - Effect of lower limb on body propulsion.
AB  - The purpose of this study was to analyze and compare the effects of the leg
      during swing and stance phases of forward propulsion of the body for both men and
      women. Twelve able-bodied subjects, six men and six women, were studied with a
      Vicon(a) gait-analysis system. A two-dimensional, sagittal-plane biomechanical
      analysis featuring a link-segment model was used to determine the force at the
      hip in the horizontal direction. Integrating this force curve over time during
      the swing and stance gait phases produced linear impulses, representing swing and
      stance contributions to the propulsion of the body, and it allowed quantitative
      comparisons using student t and Fisher tests. The deceleration of the swing leg
      was found to be the major contributor to the forward propulsion of the body. The
      stance leg initially exerted the major restraining or negative impulse during
      early stance; then it generated a positive impulse during push-off in late
      stance. A typical pattern of gait impulses was defined for normal gait. Male and
      female gait impulses were not significantly different for all gait phases.

PMID- 1622321
TI  - Complications of intracavernous injections and penile prostheses in spinal cord
      injured men.
AB  - Erectile dysfunction is a common complication in men who have had spinal cord
      injury (SCI). This retrospective study focuses on the complications encountered
      at our institution with both penile prostheses and intracavernous injections in
      men with SCI. Seventy-two men with SCI were treated with intracavernous
      injections for erectile dysfunction, and 30 penile prostheses were implanted in
      19 men with SCI. Twenty-two of the 72 patients in the intracavernous injection
      program had adverse effects; none were severe. Prolonged erections lasting four
      to six hours and ecchymosis were the most common complications. No complication
      required discontinuation of treatment. There were 23 inflatable prostheses and
      seven semirigid rods. Mechanical failures occurred in 15 instances, infection
      occurred in nine, and late erosion occurred in three. Although multiple revisions
      and replacements were necessary, 14 of the 19 patients had satisfactorily
      functioning implants at their last outpatient visit. Patients were selected
      carefully for penile implant placement and yet significant complications and
      expense were incurred to obtain satisfactory results. Although follow-up has been
      relatively short, the intracavernous injections of vasoactive medications appear
      to be a more attractive initial means of treating the erectile dysfunction in men
      with SCI. The complications are relatively minor and the incidence of prolonged
      erections has decreased with increased experience. Furthermore, the cost of
      treatment will be considerably less than that with implant surgery, particularly
      in view of the high drop-out rate. Although improved implants have decreased the
      occurrences of mechanical failure, it seems likely that infection and extrusion
      will continue to be significant problems among men with SCI.

PMID- 1622322
TI  - Low-dose ultrasound effects on wound healing: a controlled study with Yucatan
      pigs.
AB  - This study reports on the effect of low-dose ultrasound in accelerating wound
      healing in matched pairs of surgically induced incisions and full-thickness and
      partial-thickness lesions in 11 Yucatan mini-pigs after 7 days of healing and 5
      days of sonation. Tensile strength, collagen deposition (hydroxyproline),
      reduction in wound size (full-thickness lesion), and mast-cell degranulation were
      significantly greater in the sonated lesions than in the sham-treated controls (p
      = 0.01). Sonation enhanced strength by 24% and collagen deposition by 29%, when
      compared with controls. There were no significant differences in the quality of
      healing as measured by an ordinal scale. The results suggest that within the
      first week of healing, low-dose ultrasound facilitates wound healing. More
      research is needed to confirm the most effective dose, frequency, and treatment
      duration and intervention time for maximum healing.

PMID- 1622323
TI  - Functional electric stimulation: its efficacy and safety in improving pulmonary
      function and musculoskeletal fitness.
AB  - The efficacy and safety of functional electric stimulation (FES) in improving
      cardiovascular and musculoskeletal fitness in individuals with spinal cord injury
      was evaluated. Ten males and two females aged 16 to 46 years began an FES program
      from three months to 22 years after injury. Seven patients had paraplegia and
      five had quadriplegia. The FES protocol consisted of three phases: (1) leg
      extension, the stimulation of the quadriceps muscle group only, first without and
      then with weights; (2) ergometry, the stimulation of quadriceps, hamstrings, and
      gluteal muscles to produce a bicycling motion; and (3) resistance, the addition
      of resistance during the bicycling motion described in phase 2. Values for tidal
      volume, oxygen consumption, and the respiratory quotient were obtained during
      each phase. Tidal volume and oxygen consumption levels increased significantly (p
      less than .001) from the start of FES to both the ergometry and the resistance
      phases. The respiratory quotient improved significantly (p less than .001) from
      the start of FES to resistance but not from the start of FES to ergometry. Thigh
      and calf girths were measured at the start of FES and during resistance. Thigh
      girths increased significantly from the beginning of the program to the
      resistance phase, p less than .002 for the right leg and p less than .001 for the
      left. Calf girth, however, showed no significant increase. Based on these
      improvements and the absence of any serious complications, we believe that FES is
      an effective and safe method to improve cardiovascular and musculoskeletal
      fitness in individuals with spinal cord injury.

PMID- 1622325
TI  - Anger management training for brain injured patients and their family members.
AB  - Anger dyscontrol is a common occurrence after brain injury. The anger problems of
      brain injured persons create a burden for their caretakers who most frequently
      are their family members. Two single-case design studies are presented that
      demonstrate the efficacy of behavioral interventions for the control of anger
      problems in brain injured adults. Anger control was accomplished by training the
      patients in skills to control their own anger, and teaching family members
      behavior modification principles. In each case, the patient was taught to
      implement a self-talk method to decrease tension during the escalation period of
      an anger episode and to execute a time-out when aware of increased anger. Family
      members were trained in ways to monitor such problems and to identify antecedents
      to an outburst. They were given feedback and suggestions to modify their
      communication style with the patient so as to reduce patient irritability, and
      were taught ways to use a verbal cue to remind the patient to use pretrained self
      control methods. Patients and family members were also asked to increase the
      number of pleasant events in which they engaged as a general means to decrease
      the patients' anger outbursts. These cases showed evidence that the treatment
      program reduced the frequency of anger outbursts and, in one case, increased the
      social participation by the patient immediately after treatment and at one-month
      and three-month follow-up assessments. The importance of having key family
      members involved in anger management training for brain injured patients is
      underscored, particularly when cognitive impairment limits patients' ability to
      benefit from and to retain the content of psychotherapy.

PMID- 1622324
TI  - Interdisciplinary management of hemicorporectomy after spinal cord injury.
AB  - Hemicorporectomy (HCP) is infrequently used, but its effects can devastate the
      patient's body image, autonomic function, and physical abilities even more than a
      spinal cord injury of comparable level. Interdisciplinary management is of the
      utmost importance. This report describes the 2 year course, including four
      separate rehabilitation admissions, of a patient who was initially paraplegic,
      and then underwent a HCP for complications secondary to a cauda equina
      ependymoma. The patient's expectations for functional independence were
      established by his successful initial spinal cord rehabilitation. The HCP was
      performed 6 months after initial discharge secondary to infected Harrington rods
      and rapid spread of the tumor. Extensive use of the interdisciplinary team
      approach allowed comprehensive analysis and treatment of the patient's comfort,
      mobility, skin tolerance, and upper extremity functional abilities. Four
      successive prostheses were developed and modified, until all concerns were
      successfully addressed. The patient ultimately became completely independent at
      the wheelchair level. The evaluations, treatment plan, and emphasis of each
      discipline, including physical therapy, occupational therapy, rehabilitation
      nursing, therapeutic recreation, social work, vocational rehabilitation, and
      physiatry are summarized. Differences between the patient's course and standard
      spinal cord rehabilitation are detailed.

PMID- 1622326
TI  - Laryngeal diversion in the treatment of intractable aspiration in motor neuron
      disease.
AB  - Motor neuron disease/amyotrophic lateral sclerosis (MND/ALS) often causes bulbar
      palsy with subsequent aspiration. Laryngeal diversion procedures are not commonly
      mentioned in the literature. However, they are viable but infrequently used
      surgical treatment options that have several advantages over a routine
      tracheostomy. We report a case of a 67-year-old man with MND/ALS and severe
      aspiration. He underwent a laryngeal diversion procedure with complete relief of
      signs and symptoms of aspiration. Laryngeal diversion, unlike tracheostomy,
      completely eliminates the possibility of aspiration as well as the need for
      suctioning. The primary disadvantage is complete loss of phonation. These
      procedures appear worthy of trial in patients with MND/ALS, and may ultimately be
      the preferred treatment in this setting.

PMID- 1622327
TI  - Evaluation of a vocational robot with a quadriplegic employee.
AB  - A vocational robotic workstation capable of performing activities of daily living
      (ADL) and vocational tasks was placed for 18 months in the work site of an
      employee with C4 to C5 quadriplegia. A single-subject study was conducted to
      evaluate the performance of the robot vs that of a human attendant. The employee
      preferred the robot over the attendant for performance of all vocational tasks
      and ADLs, with the exception of feeding. Results indicated that the robot was
      capable of safely replacing the attendant for two five-hour periods during the
      workday, thus proving to be a cost-effective alternative to full-time, on-the-job
      attendant care. The study demonstrated the potential of robotics technology for
      returning independence and control to disabled employees and for offering
      corporate employers a solution to the problem of reasonable accommodation in the
      workplace.

PMID- 1622328
TI  - Cervical flexor strength.

PMID- 1622330
TI  - [Outbreaks of asthma attack and meteorological parameters--comparison between two
      areas].
AB  - The correlation between patient visits and meteorological parameters were
      analyzed regarding asthmatic children who visited the outpatient emergency
      clinics at Teikyo University Hospital in Tokyo and Ogaki Municipal Hospital in
      Gifu, during the two years of 1986 and 1987. The yearly climatological changes
      are quite similar in both areas. Moreover, variations in the number of patient
      visits were also remarkably similar in both areas. High temperatures and high
      vapor pressure significantly correlated with increased numbers of visits in both
      areas. High humidity and high barometric pressure had some correlation with
      increased numbers of visits in both areas. As for wind direction, northerly
      synoptic winds had a significant correlation with increased numbers of visits in
      Tokyo, while contrarily, southerly winds produced the same effect in Ogaki.
      Precipitation and cloud density showed no correlation with the number of patient
      visits in either area.

PMID- 1622329
TI  - [Standardization of allergens].

PMID- 1622331
TI  - [Infection and asthma. V. Study of childhood asthma and viral infection by
      cytological analysis of nasal smears].
AB  - Cytological analysis of nasal smears was carried out for 295 asthmatic children
      aged 2 to 15 years old at the time of asthma attack and non-attack, in
      combination with blood tests and chest roentgenograms. Damaged ciliated cells
      (ciliocytophhthoria, CCP) were looked for as a marker of viral infections. The
      appearance rate of greater than 2+ of CCP was higher among children during attack
      (38/70, 54.3%) than that among children not suffering an attack (6/29, 20.7%);
      this was pronounced among young children under five. However, the results of
      blood examinations and chest roentgenograms did not correlate with the rate of
      positive signs of infections in CCP positive- or negative-attack. These results
      suggest that the cytological examination of nasal smears in useful in evaluating
      the presence of viral infections during asthma aggravation among young children,
      whereas evaluation of these infections may be difficult by blood tests or chest
      roentgenograms.

PMID- 1622332
TI  - [Asthma classification by score calculated from clinical findings and
      examinations. Comparison between clinical diagnosis and score diagnosis].
AB  - Asthma classification by clinical symptoms and signs (clinical diagnosis) was
      compared with the classification by score calculated from clinical findings and
      examinations (score diagnosis) in 25 patients with bronchial asthma. 1. Ten
      subjects classified as Ia (simple bronchoconstriction type) by clinical diagnosis
      were divided into 6 cases with expectoration of less than 49 ml a day and 4 cases
      with expectoration of between 50 and 99 ml. The level of serum IgE and number of
      eosinophils in BALF were significantly higher in the latter cases than in the
      former cases. The cases whose expectoration was from 50 to 99 ml a day were
      classified as Ib (bronchoconstriction with hypersecretion type) by score
      diagnosis. 2. The six subjects who were classified as type Ib by clinical
      diagnosis were also evaluated as type Ib by score diagnosis. 3. Nine of the 10
      subjects classified as type II by clinical diagnosis were evaluated as type II by
      score diagnosis. One case, whose score was under 12 points, was evaluated as
      questionable type II by score diagnosis.

PMID- 1622333
TI  - [Graduated psychosomatic treatment and quality of life in asthmatics].
AB  - We investigated the quality of life (QOL) in 72 patients with bronchial asthma
      who are under our gradational psychosomatic treatment (GPT) by means of an 11
      item questionnaire. The results were summarized as follows: 1) Ninety-two percent
      of the subjects showed a good understanding of mind-body relations and modified
      their stressful adaptive patterns. 2) Asthmatic symptoms improved in 86 percent
      of the subjects. Other symptoms also improved in 72 percent of the subjects. 3)
      In 81 percent of the subjects, their daily life improved. Furthermore 96 percent
      of the subjects obtained some advantages through GPT. 4) There were various
      improvements in psychological states, personal relations and life style in most
      of the subjects. 5) The attitudes of their families toward the patients improved
      in 46 percent of the subjects, however 71 percent of the families developed a
      better understanding of the cause of asthma from the psychosomatic point of view.
      6) Most of the subjects with moderate or severe symptoms were considered to have
      reduced the grade of severity of their symptoms from the doctor's standpoint.

PMID- 1622334
TI  - [Basic research into the measurement of eosinophil cationic protein (ECP) in
      blood samples].
AB  - Eosinophil cationic protein (ECP), which is one of the eosinophil granule
      proteins, can now be measured with a radioimmunoassay kit. However, the level of
      ECP in blood samples is affected by the method of treatment of the samples. We
      investigated the effect on ECP level of a variety of treatment methods to
      establish the fundamental condition for the measurement of ECP level in blood
      samples. ECP levels in serum or heparin plasma increased time-dependently until 2
      hr. This increase was considered to be due to active in vitro release of ECP from
      eosinophils. Serum ECP level at 1 hr was temperature-dependent, being higher at
      37 degrees C than at 25 degrees C. On the other hand, ECP level in EDTA plasma
      did not change significantly during a 3 hr period, and this level of ECP was
      considered to be that which had been released into the blood in vivo. ECP levels
      were always in the order of serum greater than heparin plasma greater than EDTA
      plasma. Though there was a positive correlation between serum ECP level and
      peripheral blood eosinophil count, the degree of correlation was not strong (r =
      0.46, 6, 0.05 greater than p less than 0.01). This suggests that the serum level
      of ECP, or the "releasibility" of ECP from eosinophils, may reflect the
      activation of eosinophils.

PMID- 1622335
TI  - [Induction of IL2 responsiveness in allergen-stimulated lymphocytes from children
      with post respiratory syncytial virus (RSV) infection].
AB  - Induced interleukin 2 (IL2) responsiveness in allergen-stimulated lymphocytes
      from children with post respiratory syncytial virus (RSV) infection was studied.
      Induction of IL2 responsiveness in the patients lymphocytes was observed upon
      stimulation with allergens such as Dermatophgoides farinae (Df) antigen,
      ovalbumin (OVA) and alpha-casein. Such responses were not induced in age-matched
      normal lymphocytes. Maximum response was shown in lymphocytes from children who
      had been suffering from the infection for approximately one month, and the
      response gradually decreased over the course of eight months. The frequency of
      induced IL2 responsiveness was unrelated to family history of atopic diseases,
      although there was a high incidence (67%) of family history among the patients.
      These results indicate that RSV-sensitized lymphocytes from the patients have
      acquired hypersensitivity to allergens such as food and mite antigens, factors
      which are commonly involved in the onset of atopic diseases.

PMID- 1622336
TI  - Effects of maternal caffeine intake during lactation on molar enamel surfaces in
      new-born rats.
AB  - Dams were fed normal laboratory chow until delivery. At birth, the litters were
      combined, and eight pups were randomly assigned to each dam. Dams with the
      recombined litters were divided into two groups. Dams of group 1 were fed a 20%
      protein diet as a control; dams of group 2 were fed a 20% protein diet
      supplemented with caffeine (2 mg/100 g of the dam's weight). On day 22, the dams
      of group 2 were anaesthetized with ether. They were injected with 2 iu of
      oxytocin in order to collect milk. Blood was collected from pups and dams to
      determine its caffeine concentration. The first and second molars were removed
      from each pup's mandible and maxilla. Radiographs were taken of 10 randomly
      selected first or second molars from each group. Four randomly selected molars
      from each litter were placed in a specially designed chamber and bathed with a
      constant flow of acid solution to determine the amount of mineral dissolved from
      the enamel surfaces. The remaining non-acid exposed molars were pulverized in
      freezer mills. A small portion of this powder was then analysed for the total
      amount of minerals. No differences were found in the radiographic density of
      enamel between the groups. The amount of dissolved calcium, phosphorus and
      magnesium from enamel surfaces in the caffeine group was consistently greater
      than that of the non-caffeine group in the first molars, whereas, in the second
      molars, there was no difference between the groups.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1622337
TI  - Physical examination of caffeine's effects on the enamel surface of first molar
      in new-born rats.
AB  - Samples of the first molars of offspring whose dams were fed a diet supplemented
      with caffeine were examined by scanning electron microscopy, X-ray diffractometry
      and electron microprobe analysis. Scanning microscopy of the enamel surface of
      the caffeine group revealed a consistently rougher surface than in the non
      caffeine controls, both before and after acid exposure. X-ray diffraction
      analysis of the pulverized whole tooth in the caffeine group showed broader
      diffraction peaks for the lattice plane reflections (202) and (300), indicating
      smaller crystallites. Pure enamel samples of the caffeine group examined with a
      Gandolfi X-ray camera also revealed more diffuse diffraction lines than in the
      non-caffeine controls, further indicating smaller crystallites in the enamel. The
      calcium and phosphorus contents of the acid-exposed samples in both control and
      caffeine groups were lower than the non-acid exposed control and caffeine groups
      by electron microprobe analysis. After exposure to acid, the calcium and
      phosphorus contents of the outer surface of the enamel in the caffeine group were
      greatly reduced as compared to that of the non-caffeine controls. Thus various
      methods consistently indicate that caffeine ingestion during early growth affects
      the enamel surface of the first molars, resulting in impaired mineralization.
      Caffeine intake may therefore have a negative effect on amelogenesis and possibly
      increases susceptibility to dental caries.

PMID- 1622338
TI  - Short-term dentinogenic response of dog dental pulp tissue after its induction by
      demineralized or native dentine, or predentine.
AB  - The events initiating the expression of odontoblastic potential by pulpal
      ectomesenchymal cells were investigated by exposing the pulp to demineralized,
      native and unmineralized autogenous dentine. The pulp responses to implants were
      histologically evaluated 3, 7 and 10 days postoperatively, while the surface
      structure of the newly mineralized matrices was examined 12 and 28 days after
      implantation. Differentiation of odontoblast-like cells in close proximity to the
      implanted matrix was consistently demonstrated after exposure to predentine.
      Scattered columnal cells undergoing polarization, characterized ultrastructurally
      by the orientation of their rough endoplasmic reticulum, were also found in
      direct contact with the demineralized dentine. However, in response to
      demineralized implants, groups of differentiated odontoblast-like cells were
      clearly seen only in association with a zone of matrix secreted in a polar,
      predentine-like pattern, indicating an asynchronous inductive influence of this
      type of implant on pulp cells. Further, the response of pulp cells to native
      dentine was characterized by the elaboration of a two-layered matrix (a fibrous
      and a polarly deposited matrix) before initiation of secondary dentinogenesis.
      Scanning electron microscopy of the newly deposited matrices revealed differences
      between the indirect matrix synthesis, observed in short-term response to
      implants of demineralized or native dentine, and the specific, dentinogenic
      function of the odontoblast-like cells. These observations indicate that the
      dentine-induced dentinogenesis is initiated by two mechanisms--direct induction
      of odontoblast-like cells as well as indirect matrix synthesis, which further
      controls cell polarization. Immobilization of the cells on implanted matrix seems
      to be the critical requirement for direct expression of the odontoblastic
      phenotype.

PMID- 1622339
TI  - Alteration of murine odontogenic patterning and prolongation of expression of
      epidermal growth factor mRNA by retinol in vitro.
AB  - Retinoids alter the patterning of murine odontogenesis in vivo and stimulate
      epithelial proliferation. Because odontogenesis is dependent on proliferation of
      mandibular epithelium, the effects of retinol on the patterning of odontogenic
      epithelium were studied. These experiments control for developmental stage,
      applied retinoid concentration and duration of exposure. Explants exposed for 24
      h to 0.1 micrograms/ml of retinol exhibited enhanced odontogenesis. Day-9
      mandibles exposed to retinol at 1-5 micrograms/ml had altered epithelial patterns
      consistent with those in previous in vivo experiments, including supernumerary
      epithelial buds in regions associated with supernumerary incisors in vivo. These
      changes were associated with a dose-dependent increase in epithelial
      proliferation and a prolonged expression of epidermal growth factor (EGF) mRNA.
      Altered expression of EGF mRNA may be responsible for the disrupted pattern of
      the dental lamina. This is the first report of a retinoid-induced alteration in
      EGF mRNA expression.

PMID- 1622340
TI  - Synergistic effects of dexamethasone on platelet-derived growth factor
      mitogenesis in vitro.
AB  - Platelet-derived growth factor (PDGF) and insulin-like growth factor-I (IGF-I)
      interact to stimulate proliferation of fibroblasts in culture. Glucocorticoids
      variably effect the response of cultured fibroblasts to polypeptide growth
      factors. This study determined the effects of dexamethasone on growth-factor
      stimulation of gingival, periodontal ligament and pulp fibroblast proliferation
      in vitro. Cultures of quiescent, low-passage, human fibroblasts were treated for
      varying periods of time with transforming growth factor-beta 2 (TGF-beta 2), PDGF
      and IGF-I: (1) alone, (2) in combination with each other, (3) singly plus
      dexamethasone, (4) in combination plus dexamethasone. Combinations of human,
      recombinant PDGF and IGF-I (10-1000 ng/ml) induced significantly higher rates of
      cell proliferation than either factor alone. Dexamethasone at doses ranging from
      10(-5) to 10(-8) M substantially enhanced cell proliferation induced by these
      combinations and by PDGF without IGF-I but not IGF-I alone. By 6 days after a
      single application, 2-3 times as many cells were present in the PDGF and
      dexamethasone cultures as compared to PDGF without IGF-I. TGF-beta 2 specifically
      blocked the effects of dexamethasone added to PDGF-stimulated cells. Collagen and
      non-collagenous protein synthesis was not affected by the addition of PDGF and
      IGF-I with or without dexamethasone. These data suggest that dexamethasone may
      substitute for IGF-I in PDGF stimulation of cell proliferation.

PMID- 1622341
TI  - Analysis of major histocompatibility complex (MHC) class I antigen in the rat
      salivary gland.
AB  - This antigen was examined in rats of different ages (new-born, 3, 5, 7, 10, 12
      and 14 days after birth and adult) by immunofluorescence and immunoelectron
      microscopy. Changes in each kind of salivary gland when graft versus host disease
      was induced in recipient rats were also investigated. Monoclonal antibodies (HAM
      2 or OX 18) specific to rat MHC class I antigen were used and these were detected
      by FITC-conjugated anti-mouse immunoglobulin. With HAM 2, MHC class I antigen in
      the submandibular gland was mostly located in the secretory duct cells; this
      expression was first found 10 days after birth. The antigen was found on the cell
      surfaces of the secretory duct cells by immunoelectron microscopy. With OX 18,
      MHC class I antigen was mainly found in the secretory duct cells, but weak
      expression was also found in the acinar cells. Localization of the antigen, by
      HAM 2 and OX 18 was less evident in the secretory duct cells of parotid and
      sublingual glands. When graft versus host disease was induced, MHC class I
      antigen (HAM 2) was observed in both acinar and secretory duct cells of the
      submandibular gland.

PMID- 1622342
TI  - Bioassay of interleukin 1 (IL-1) in human gingival crevicular fluid during
      experimental gingivitis.
AB  - The cytokine IL-1 was demonstrated in crevicular fluid during a 14- and 21-day
      experimental gingivitis in healthy human volunteers. A sensitive and specific
      bioassay allowed detection of biologically active IL-1 at levels ranging from
      0.18 ng/microliters at baseline to 1.70 ng/microliters in inflamed gingiva.
      Levels of IL-1 increased rapidly with plaque accumulation and in advance of the
      subsequent gingival inflammation, peaking within 7 days of the start of
      gingivitis. As changes in IL-1 were detected before clinically recognizable
      gingival changes, IL-1 may have potential as an early marker of gingival
      inflammatory changes.

PMID- 1622343
TI  - Immunocytochemical localization of growth hormone receptor in rat maxillary
      teeth.
AB  - To address the question of what role growth hormone may have in stimulating tooth
      formation, the distribution of its receptor/binding protein in developing rat
      incisors and molars was studied immunocytochemically using well-characterized
      monoclonal antibodies. Ten female 45-day-old Wistar rats were perfused with 4%
      paraformaldehyde. Five-microns paraffin sections of the growing end of maxillary
      incisors and molars were cut, deparaffinized and incubated with mouse anti-growth
      hormone receptor antibodies or control antibodies. A three-layer streptavidin
      peroxidase technique was used to detect bound antibody. Immunoreaction product
      was associated primarily with the cytoplasm of cells at certain stages of
      differentiation. Dividing cells, differentiating preameloblasts and
      preodontoblasts, secretory ameloblasts and odontoblasts showed immunoreactivity.
      Undifferentiated dental epithelium cells, stellate reticulum, external dental
      epithelial cells, mature odontoblasts, and most of cells in the dental papilla
      were non-reactive. However, at certain stages of tooth development, the stratum
      intermedium and the external dental epithelium also stained positively. The
      presence of growth hormone receptor/binding protein in tooth cells at different
      stages of their development indicates that growth hormone may influence cell
      proliferation, differentiation and differentiated functions of ameloblasts,
      odontoblasts and cementoblasts independent of a systemic mediator, and thus may
      be involved in stimulating odontogenesis directly.

PMID- 1622344
TI  - Epithelial expression of major histocompatibility complex (MHC) antigens in
      normal rat salivary and lacrimal glands.
AB  - The presence and distribution of MHC class I and class II antigens within these
      glands of Wistar and Lewis rats was studied using monoclonal antibodies and an
      indirect immunoperoxidase technique. In rats of both strains and sexes, MHC class
      1 antigens were expressed by ductal epithelium in addition to vascular
      endothelium and other connective tissue elements. Except for a small proportion
      of secretory cells within lacrimal glands, acini were uniformly negative for
      class I antigen. MHC class II immune response-associated (Ia) antigens were
      expressed by stromal dendritic cells in all glands. Glandular expression of Ia
      was limited to submandibular glands of the two strains. In Lewis rats, staining
      was detected in some striated and collecting ducts, whereas positive glandular
      reactivity in Wistar rats was predominantly within the granular-cell tubules.
      Quantitative histomorphometric studies of Wistar submandibular glands, taken from
      2.5-60-week-old male and female animals, demonstrated a close relationship
      between the extent of glandular Ia reactivity and postnatal granular-cell tubule
      development. These results indicate that whilst constitutive expression of Ia is
      a feature of rat submandibular epithelium, the glandular components involved are
      strain dependent.

PMID- 1622345
TI  - Latex agglutination test for detection of mutans streptococci in relation to
      dental caries in children.
AB  - A simple and rapid system based on a latex agglutination (LA) reaction was
      devised for the detection of mutans streptococci in dental plaque. Latex
      particles were sensitized with antibodies against whole cells of Streptococcus
      mutans strains MT8148 (serotype c), MT703R (e) and OMZ175 (f) and Strep. sobrinus
      strains B13 (d) and 6715 (g). These sensitized particles were agglutinated within
      a few minutes after addition of 1.0-10 ng serotype-specific antigen from the
      homologous organisms or the nitrous acid extract of whole cells at 10(5)-10(6)
      c.f.u. The LA test specifically differentiated not only mutans streptococci from
      the other oral streptococci but also Strep. sobrinus from Strep. mutans. The LA
      test was also applicable to extracts of plaque from 206 human subjects who
      harboured mutans streptococci. In clinical trials, the outcome of the LA test
      correlated significantly with the number of mutans streptococci found in plaque
      (p less than 0.0001), which was quantified by the selective cultivation of mutans
      streptococci. Furthermore, the LA test discriminated between Strep. mutans and
      Strep. sobrinus from human dental plaque. The sensitivity and the specificity of
      the LA test for detection of mutans streptococci were 78.9 and 100%. The degree
      of reactivity in the LA test correlated significantly with the number of decayed
      tooth surfaces (p less than 0.0001) and decayed and filled tooth surfaces (p less
      than 0.0001). These results suggest that the LA test could be useful clinically
      for the detection of mutans streptococci in dental plaque as well as serving as a
      caries-activity test.

PMID- 1622346
TI  - The effect of an educational intervention on the use of peri-operative
      antimicrobial agents.
AB  - The objective of this study was to evaluate the effect of an educational
      intervention on the prescribing behaviour of doctors who order antimicrobial
      therapy for patients undergoing abdominal surgery. Two confidential criterion
      audits were separated by the intervention which involved completion of a 10-item
      questionnaire followed by a fully referenced answer sheet. The results showed a
      significant improvement in the prescribing habits of the junior surgical staff
      after the educational intervention. The overall error rate decreased from 50% to
      20% (P = 0.003).

PMID- 1622347
TI  - Child-care needs of patients at the Royal Women's Hospital, Brisbane.
AB  - Eight hundred and ninety-eight patients of the Royal Women's Hospital, Brisbane
      were surveyed by phone and questionnaire to identify their hospital related child
      care needs. In addition, staff in acute admitting areas of the hospital were
      asked to provide details of child-care problems. Twenty-five (5.2%) of the sample
      reported hospital related child-care problems, 166 (39.7%) respondents stated
      that they would use a hospital child-care service on a casual basis and 45
      (10.8%) that they would use one for the duration of their stay.

PMID- 1622348
TI  - The application of continuous quality improvement tools in reducing the length of
      stay for hip replacement patients: a base hospital's experience.
AB  - The quality assurance (QA) initiative has been slow to show results. Quality
      assurance tools have been underdeveloped, and quality by inspection unacceptable
      to clinicians. A base hospital's experience with continuous quality improvement
      (CQI) as a means to more effective quality assurance is described. Discharge data
      grouped into diagnosis related groups (DRG) and analysed for inter-hospital
      comparison provided reliable statistical data with which to monitor the
      hospital's performance. The CQI tools were used to analyse the nature of the
      problem, and correct the deficiency. The new methodology would seem to indicate
      greater promise for successful quality assurance programmes in the future.

PMID- 1622350
TI  - Administering non-restricted medications in hospital: the implications and cost
      of using two nurses.
AB  - In an effort to improve patient safety, some hospitals require that two nurses
      rather than one administer all medications. Such a policy has not been subjected
      to an economic evaluation. The authors conducted a cross-over study comparing
      error rates when medication was administered by two nurses as against a single
      nurse. During a 46 week study period, 319 errors were detected among 129,234
      medications administered in a geriatric assessment and rehabilitation unit,
      giving an overall error rate of 2.5 per 1000 medications. The vast majority of
      errors detected were relatively minor and had no serious adverse consequences.
      The error rate per 1000 medications administered by a single nurse was 2.98 (95%
      CI: 2.45-3.51) and was statistically significantly higher than 2.12 (95% CI: 1.69
      2.55) per 1000 for two nurses. A time and motion study indicated that when two
      nurses rather than one administered medication an additional 17.1 h of nursing
      time was required per 1000 medications administered. The authors conclude that
      the use of two nurses to administer medication does statistically significantly
      reduce the medication error rate, but the clinical advantages are dubious and in
      our view such a policy cannot be recommended.

PMID- 1622349
TI  - Colonoscopy in a private hospital: continuous quality improvement in practice.
AB  - This paper documents serial audits on technical aspects of the performance of
      fibre-optic examination of the large intestine by a number of proceduralists, in
      one institution, over 7 years. The completeness of the procedure and the
      associated morbidity are recorded and compared with results reported in the world
      literature. The study provides a clear demonstration of continuous quality
      improvement in practice.

PMID- 1622351
TI  - Concurrent case note screening: failure to demonstrate benefit.
AB  - In 1991 the third of a series of trials of concurrent case note screening was
      conducted over a 4 month period in one surgical and one medical unit of a busy
      metropolitan public teaching hospital in South Australia. The conclusion reached
      was that there is insufficient evidence of consistent improvement to justify the
      continuation of this expensive method of quality assurance. Traditional
      monitoring of performance by consultants, perhaps with the aid of computer
      assisted management information, should achieve similar results.

PMID- 1622352
TI  - The paediatric hospital medical record: a quality assessment.
AB  - The objective of this study was to assess the quality of the medical contribution
      to patient records in a children's department. It was carried out in a tertiary
      level teaching hospital. A structured audit of 100 randomly selected case
      records, with independent observers using a grading system for 3 of the measures,
      was performed. The outcome provides a comparison with the hospital's guidelines
      for case histories and notes. The results of this study show inadequate
      documentation of basic information. Communication was hindered by poor hand
      writing and the use of abbreviations. Overall comprehension of the course of the
      patients' illnesses was regarded as only fair to average. Recording of diagnosis
      and initial plans of management were present in over 70% of records. While
      discharge information was well recorded, the recommendation for the duration of
      drug therapy was inadequate. Mediocre handwriting and poor documentation are
      still prevalent in medical records. Strict supervision of this important area of
      medical practice is mandatory.

PMID- 1622354
TI  - Serial killers and sexual violence. The whys and wherefores.

PMID- 1622355
TI  - Are you seeing a mass killer?
AB  - Whatever the underlying reasons, we have to be prepared for more episodes of this
      nature, and as medical practitioners do what we can to prevent them. With the
      wisdom of hindsight it is possible to suggest that the Knight and Vitkovic
      killings could have been avoided. Knight had a history of violence causing him to
      leave Duntroon Military College. Despite this, he was not prevented from holding
      a shooter's licence in his own State, and in particular nothing was done to stop
      him having a collection of weapons. Vitkovic sought help from a university
      psychology clinic and from the Church of Scientology. Coroner Hal Hallenstein
      criticised the Church of Scientology for failing to help Vitkovic after he failed
      their personality test on 8 October 1987, and also suggested that a general
      obligation be placed on psychologists to refer to a psychiatrist if they think
      that is required. Practitioners' concern for their own safety must be considered.
      It would have been an extraordinarily difficult and possibly risky task to try to
      deter Julian Knight from persisting in his adoration of aggression and love of
      weapons, or to talk Frank Vitkovic out of watching violent films and videos and
      later purchasing a semi-automatic weapon. Nevertheless, the practitioner's
      responsibility remains, and as a last resort notification to police of the risk
      posed by the person might have to be considered. Unfortunately the anonymity of a
      practitioner making such a notification might not be able to be guaranteed, given
      current freedom of information legislation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622353
TI  - Adult discharge planning and nursing home placement: a study of risk factors for
      quality assurance.

PMID- 1622356
TI  - The prediction of violence.
AB  - Violence is prevalent in Australian society. Victims often present to general
      medical practitioners for care of the physical, psychological and social
      consequences. It is, therefore, important to be able to identify potential
      offenders in order to anticipate aggression and prevent it, if possible. A
      motivational cycle for violence is proposed, some common predictors examined and
      the problem of reliable prediction discussed.

PMID- 1622357
TI  - On understanding homicide.
AB  - There are many faces of homicide, and there are no simple preventive cures. There
      is scarce comfort in knowing the homicide is, in fact, rare (there being roughly
      60 cases per year in Victoria), or that a person is several times more likely to
      die by his or her own hand than that of someone else. Our current research
      suggests that there are some consistent patterns in the form that homicide takes.
      Hopefully, the more we understand these scenarios, the better we will be able to
      recognise the underlying conditions that push people to the point where they will
      think the unthinkable, and knowingly take the life of another person.

PMID- 1622358
TI  - 'No longer nineteen'. A review of Vietnam veterans in everyday practice.
AB  - After working with a number of Vietnam veterans I was confronted with my
      ignorance of the war and its aftermath. I hope this article helps others wishing
      to improve their understanding of these patients.

PMID- 1622359
TI  - Management of the traumatised patient.
AB  - I have tried to present a range of suggestions for the therapeutic management of
      traumatised victims and have used illustrations based on my work with victims of
      armed robbery. In general, however, I believe that the principles outlined are
      applicable to a wide range of trauma and I have found these ideas valuable in
      dealing with victims of crime in general, in counselling staff involved in
      industrial accidents and in providing support to those involved in natural or man
      made disasters. The key principles include: a prompt and timely intervention; the
      use of properly trained professional staff to provide a structured debriefing
      programme that focuses on the opportunity to discuss feelings; providing
      information and education about normal responses to trauma and helping to
      normalise the individual's response to the situation. Re-establishing a normal
      lifestyle as soon as possible has been shown to be critical to speedy recovery;
      as has professional support, continuing follow up and reassurance that most
      victims recover without going on to develop a post traumatic stress disorder. An
      integrated team approach to the management of traumatised victims is critical and
      there must be communication between the general practitioner, any counsellors
      involved in providing services to the traumatised person and, of course, the
      victim. The general practitioner is often the primary link in the management
      chain and the positive relationship that many people have with their general
      practitioner can be used to great effect in helping to manage a recovery from
      crisis.

PMID- 1622360
TI  - Carbamazepine and sciatica.
AB  - Carbamazepine is useful in the management of various painful conditions. The
      mechanism of its action is not known. Whatever its mechanism, Carbamazepine
      appears to have a good chance of relieving painful disorders with episodic,
      flashing pain. Two cases of sciatica responding favourably to carbamazepine are
      presented in detail.

PMID- 1622362
TI  - The first 100 independent quality assurance options.
AB  - The independent option route to quality assurance is attracting projects from
      general practitioners interested in a wide variety of clinical, educational and
      community roles. Despite the worthwhile increase in confidence and satisfaction
      claimed by participants, few projects attempt to measure objectively the impact
      on patient care. Following an analysis of the first 100 completed independent
      option projects, the Quality Assurance Unit is in a position to offer better
      guidelines to help future participants gain maximum benefit from their projects.

PMID- 1622361
TI  - Communication problems of the chronically ill.
AB  - Patients with severe pain have a reduced capacity to communicate with doctors.
      These patients have depleted resources. Doctors are pressed for time. Patients
      not responding to treatment present doctors with communication tasks. Doctors
      need to persist gently in telling the 'unacceptable' bad news until it is
      reluctantly accepted.

PMID- 1622363
TI  - Injection for Achilles tendinitis.

PMID- 1622365
TI  - Great expectations.

PMID- 1622364
TI  - Neil Edwin Carson. Academic general practitioner, leader and achiever.
AB  - Professor Neil Carson, who is to retire as Chairman of Monash University's
      Department of Community Medicine at the end of this year, has completed a
      significant and successful term marked by many achievements. His energy, vision
      and ability to acquire and channel resources have helped develop a vibrant and
      productive department. His wise counsel and negotiating skills have led to
      important achievements for the cause of general practice in both the political
      sphere and in academic institutions. He was the founder and first president of
      the Australian Association for Academic General Practice. His impact on medical
      education, especially for general practice in Australia, has been far reaching.

PMID- 1622366
TI  - Attitudes of Victorian rural GPs to country practice and training.
AB  - This article reports findings from a study undertaken in early 1991 about
      attitudes of rural general practitioners in Victoria to country practice and
      training. A questionnaire was sent to all rural general practitioners and two
      random samples of metropolitan GPs: one group in suburban practice and another
      group in fringe metropolitan areas. A 75% response rate was achieved providing
      information representative of most general practitioners in Victoria. Study
      findings cover aspects of rural GPs' personal background including training;
      practice description including continuing education; reasons for choosing country
      practice; reasons for staying in country practice; reasons for leaving country
      practice; and suggestions for improving recruitment, training and retention of
      rural GPs.

PMID- 1622368
TI  - Patient education. Hiatus hernia.

PMID- 1622367
TI  - Basic management of myocardial infarction.

PMID- 1622369
TI  - Excision of lipomas.

PMID- 1622370
TI  - Awakenings from within and without.

PMID- 1622371
TI  - Atrio-ventricular (A-V) block.

PMID- 1622372
TI  - The mouth ulcer that would not heal.

PMID- 1622374
TI  - Hip and buttock pain in adults.
AB  - Hip and buttock pains in adults require careful evaluation to determine exactly
      what anatomical structure the patient is referring to when presenting with 'pain
      in the hip'. Pain in the posterior hip region and buttocks usually originates
      from dysfunction of the lumbosacral spine. Osteoarthritis of the hip is an
      important disorder that can refer pain to the anteromedial aspect of the knee.

PMID- 1622373
TI  - Slowing up--it's just old age ... or is it?

PMID- 1622375
TI  - Sampling bias in asthma surveys of patients attending general practitioners in
      south-western Sydney.
AB  - Results from asthma surveys in patients attending general practitioners were
      compared with data from population-based samples. The prevalence of asthma
      symptoms and optimal asthma management were more common in the GP attenders.
      Attention should be paid to potential sources of sampling bias in chronic disease
      prevalence research in primary care settings.

PMID- 1622376
TI  - Breastfed infants.

PMID- 1622377
TI  - [Latent Chlamydia infections as the cause of health disorders in swine, cattle
      and sheep breeders in Czechoslovakia].
AB  - For a twelve year period the health condition of a large group of pig-, cattle-
      and sheep-breeder was controlled and at the same time an inquiry was carried out
      why these people suffer from high occurrence of specific health problems which
      among the rest of the population appear in smaller extent. The performed
      investigation shows that the primary cause of the specific problems is a latent
      infection caused by the chlamydia microorganism, namely by the Chlamydia
      trachomatis group, that can be transferred from animals on people. These
      microorganisms survive permanently and parasite in the living cells of animals
      and people and they cause a wide range of specific health difficulties, often
      subjective, painful and very unpleasant ones, without any manifestation of
      clinical symptoms which could suggest an infectious disease. These properties of
      the agent and the fact, that neither human nor veterinary medicine inquire the
      problems of the relationship between the latent infection and the health of
      people, makes Chlamydia an extremely dangerous factor affecting people's health.
      Our paper includes anamnestic data of specific health problems of 746 breeders
      from 31 farms and results of serological examinations of a group of people with
      antigens Chlamydia psittaci and Chlamydia trachomatis. The paper also includes a
      biological experiment which the rise of antibodies of a guinea pig kept and fed
      with table scraps in the family of one the afflicted breeders as well as the
      results of serological examinations of a group of animals, the most frequent
      health problems at the latent course of disease, the course of the disease itself
      and the author's opinions on necessity of further investigation of the human
      medicine problems.

PMID- 1622378
TI  - [The effect of a restriction of nutrient intake on the composition of the blood
      and on the development and composition of different tissues of sheep during
      growth. 1. The level of the hematocrit and hemoglobin in the blood, that of
      protein, alpha amino-N, remaining N, glucose, FFA, insulin, beta-hydroxybutyrate,
      Na, K, Ca, Mg, Pa, Fe, iron-binding capacity, Cu and Zn and the activities of
      ALT, AST, LDH, GGT and AP in plasma at slaughter].
AB  - In lambs after weaning with a body weight of 16.3 +/- 1.5 kg (group 1) and in
      sheep after a period of fattening with an increase of the body weight of 72.2 +/-
      13.6 (group 2), of 184.4 +/- 12.2 (group 3) respectively of 302.1 +/- 24.3 g per
      day (group 4) the concentration of the components mentioned in the title was
      analysed in blood and plasma. The hematocrit, the concentration of Hb in the
      blood and that of total protein, of nonprotein-N, of Na, of Ca, of the iron
      binding capacity and of Zn as well as the activity of the 5 enzymes in the plasma
      of the sheep of group 4 were higher than that of the group 2. Stress by the
      transport and stunning increased the concentration of free fatty acids in the
      plasma. The significance of the results for the clinical-chemical diagnosis is
      discussed.

PMID- 1622379
TI  - [The significance of small mammals in the epizootiology of leptospirosis in
      livestock].
AB  - 1. Favourite species of rodents in sheds and their surroundings are rats (Rattus
      norvegicus, R. rattus) and house mouse (Mus musculus). From the epizootiological
      point of view only R. norvegicus is important as the maintenance host of L.
      copenhageni. 2. In surrounding of sheds vole (Microtus arvalis) and back-striped
      field mouse (Apodemus agrarius) are sources of infection for livestock. 3.
      Transmission of leptospira occurs via infected environment. The tenacity of
      Leptospira mozdok and L. grippotyphosa under field conditions suffices to
      maintain the chain of infections.

PMID- 1622380
TI  - [Bacterial studies on the occurrence of Mycobacterium paratuberculosis in fecal
      samples of zoo ruminants].
AB  - Mycobacterium (M.) paratuberculosis was isolated from fecal samples of 3 (21.4%)
      from 14 mouflons, of 10 (20.4%) from 49 dwarf goats, of 5 (14.3%) from 35
      Cameroon sheep and of 1 (9.1%) from 11 alpine ibex. M. paratuberculosis could not
      found by cultural method in fecal samples of 22 Pinzgauer goats, of 15 bantengs,
      of 9 wild goats, of 9 skuddens, of 6 four-horned sheep, of 3 red-head sheep, and
      of 1 chamois. From all 19 animals with cultural positive fecal samples complement
      binding antibodies against M. paratuberculosis could not be found in the
      corresponding serum samples. The results confirm that M. paratuberculosis is more
      frequently in small zoo ruminants than up to now was suspected. The cultural
      examination of fecal samples has been proved to be a better method for detecting
      animal excretors than serological investigations by means of the complement
      fixation test.

PMID- 1622381
TI  - [Scanning electron microscopic studies of the odontoblasts and the pulpodentinal
      border in domestic sheep (O. ammon aries Linnaeus, 1758)].
AB  - In order to investigate odontoblasts and predentin surfaces using SEM techniques,
      teeth of sheep with one or several roots were subjected to critical point drying.
      The odontoblasts of the root pulp are distinguished in their shape and
      arrangement pattern from those in the crown pulp. They regularly are detaching
      only one process of Tomes, which is extending up to the border between dentin and
      enamel and which shows a dendritic ramification in the dentin next to the enamel.
      The distal cell portions of the odontoblasts are joined together by a system of
      terminal bars. The collagen structures observed between the odontoblasts and
      predentin are considered to be von Korff's fibres as found in man.

PMID- 1622382
TI  - [Friedrich Ludwig Urban--from blacksmith to veterinarian. The history of his
      life].
AB  - Friedrich Ludwig Urban lived from 1808 to 1879. There is documentary evidence
      that he worked as a veterinary surgeon in Berlin and fought here on the
      barricades in 1848. Little is known about either his professional career or his
      private life. The author uses hitherto unpublished facts to present a detailed
      picture of the professional work and private life of Friedrich L. Urban, making a
      contribution to the historiography of veterinary surgery.

PMID- 1622383
TI  - Targeting proteins to mitochondria: a current overview.

PMID- 1622384
TI  - Stimulation of NADH oxidase activity from rat liver plasma membranes by growth
      factors and hormones is decreased or absent with hepatoma plasma membranes.
AB  - Plasma membranes of rat liver isolated by aqueous two-phase partition exhibited
      basal levels of NADH oxidase activity that were increased approx. 2-fold by
      addition of hormones and growth factors to which liver cells were known to
      respond. In contrast, hepatoma plasma membranes demonstrated an intrinsically
      increased level of NADH oxidase, which was not stimulated further by addition of
      growth factors. The results suggest that the NADH oxidase of the hepatoma plasma
      membrane is no longer correctly coupled to hormone and growth-factor receptors.
      This biochemical defect may parallel the loss of growth control that is
      characteristic of neoplastic transformation in hepatocarcinogenesis and other
      transformation systems.

PMID- 1622385
TI  - Leukoregulin down-regulates type I collagen mRNA levels and promoter activity in
      human dermal fibroblasts, and counteracts the up-regulation elicited by
      transforming growth factor-beta.
AB  - Leukoregulin (LR), a T-cell-derived growth factor, modulates fibroblast functions
      in vitro [Mauviel, Redini, Hartmann, Loyau & Pujol (1991) J. Cell Biol. 113, 1455
      1462]. In the present study, incubation of human dermal fibroblasts with LR (0.1
      2 units/ml) resulted in decreases in the mRNA steady-state levels for alpha 1(I),
      alpha 2(I) and alpha 1(III), but not alpha 2(V), collagen genes. LR also down
      regulated alpha 2(I) collagen promoter activity in transient cell transfections
      of control cells as well as those incubated with transforming growth factor-beta,
      a potent up-regulator of collagen type I gene expression. Thus LR is a strong
      inhibitor of type I collagen gene expression, acting at the level of
      transcription.

PMID- 1622386
TI  - Identification of cytosolic protein tyrosine kinases of human prostate by
      renaturation after SDS/PAGE.
AB  - The identification of protein tyrosine kinases (PTKs) was successfully achieved
      by renaturation in gels after SDS/PAGE. To this effect, samples were mixed with a
      PTK substrate, namely the polydispersed co-polymer of glutamic acid and tyrosine
      [poly(Glu, Tyr), M(r) from 30,000 to 94,000], and were simultaneously submitted
      to electrophoresis. Following guanidine hydrochloride denaturation, renaturation
      and phosphorylation with [gamma-32P]ATP, kinase activity was detected by
      autoradiography. When applied to cytosol from human hyperplastic prostate, eleven
      protein kinases were detected, among which one major (M(r) 50,000) and two minor
      proteins (M(r) 40,000 and 38,000) were identified as PTKs by the presence of
      phosphotyrosine. Incubation of the gel in hot alkali after glutaraldehyde cross
      linking almost completely eliminated the detection of non-PTK enzymes. On the
      other hand, in the absence of poly(Glu,Tyr), no PTK activity was detected.
      Partial purification of cytosolic PTKs indicates that the native M(r) of the
      major phosphotransferase was 44,000, as estimated by gel filtration following
      ammonium sulphate precipitation and anion-exchange chromatography. Upon
      renaturation after electrophoresis, this fraction showed only one major band
      active on poly(Glu,Tyr) which was associated with the polypeptide of M(r) 50,000.
      This enzyme was also identified following two-dimensional electrophoresis and
      renaturation in the presence of poly(Glu,Tyr), allowing the determination of a pI
      in the range 7.5-7.8. Thus PTKs can be easily renatured following electrophoresis
      and rapidly identified on the basis of their M(r) and pI in both crude or
      partially purified preparations. With the crucial role played by PTKs in the
      activation of cell function and carcinogenesis, this procedure could be useful in
      the identification of such enzymes and in distinguishing them from their
      substrates in gels.

PMID- 1622387
TI  - Effect of permethylation on the haemolytic activity of melittin.
AB  - The cytolytic activity of the bee venom toxin, melittin, is abolished on
      permethylation of the ammonium groups into quaternary trimethylammonium groups.
      The loss of activity in permethylated melittin may result partly from the absence
      of the hydrogen bonding potential and partly from steric effects involving the
      bulky trimethylammonium groups. Displacing the trimethylammonium groups away from
      the backbone to relieve steric effects (by acylating melittin with glycine or 5
      aminopentanoic acid followed by permethylation) restored moderate activity at 5
      fold increase in concentration.

PMID- 1622388
TI  - Polyclonal antibody-catalysed amide hydrolysis.
AB  - 1. The activated amide (4-nitroanilide), N-(4-nitrophenyl) N'-butyl-1,4
      phenylenediacetamide (III) was synthesized. 2. A polyclonal antibody preparation
      (PCA 270-29) was elicited in a multigeneration cross-bred sheep (no. 270) and
      isolated 29 weeks into the immunization schedule by procedures described
      previously for PCA 270-22 [Gallacher, Jackson, Searcey, Badman, Goel, Topham,
      Mellor & Brocklehurst (1991) Biochem J. 271, 871-881]. These involved the use of
      an amide conjugate bonded through the carboxy group of 4-nitrophenyl 4'
      carboxymethylphenyl phosphate and an amino group of keyhole-limpet haemocyanin as
      the immunogen. 3. PCA 270-29 was shown to catalyse the hydrolysis of both the
      carbonate ester substrate 4-nitrophenyl 4'-(3-aza-2-oxoheptyl)phenyl carbonate
      (I) and the amide substrate (III). Both catalyses obeyed the Michaelis-Menten
      equation with the following values of the parameters at 25 degrees C: for the
      hydrolysis of (I) at pH 8.0, Km = 3.96 +/- 0.28 microM and k(cat.) = 0.135 +/-
      0.004 s-1 (k(non-cat.) = 1.99 x 10(-4) s-1); for the hydrolysis of (III) at pH
      9.0, Km = 5.4 +/- 1.4 microM and k(cat.) = (5.95 +/- 0.75) x 10(-5) s-1 (k(non
      cat.) = approx. 2 x 10(-7) s-1). 4. The finding that PCA 270-29 is almost equally
      effective as a catalyst for the hydrolysis of the amide (III) as for that of the
      carbonate ester (I) when allowance is made for the different intrinsic
      reactivities of the two types of substrate is discussed. The catalytic
      characteristics of PCA 270-29, the first example of a polyclonal catalytic
      antibody preparation shown to catalyse the hydrolysis of an amide and the first
      example of an antibody preparation (monoclonal or polyclonal) with such catalytic
      character to be produced by use of a phosphate immunogen, are compared with those
      of the small number of other antibody-mediated hydrolyses of amides in the
      literature.

PMID- 1622389
TI  - Identification of a protein transiently phosphorylated by activators of
      endothelial cell function as the heat-shock protein HSP27. A possible role for
      protein kinase C.
AB  - Several agonists of endothelial cell function (thrombin, histamine,
      dioctanoylglycerol, phorbol 12-myristate 13-acetate, interleukin-1) have
      previously been shown to enhance the level of phosphorylation of an undefined
      29,000-M(r) protein (P29). Comparison of this protein with other phosphoproteins
      suggested that it may be related to the mammalian heat-shock protein HSP27.
      Immunoprecipitation and immunoblot analysis with antibodies specific for human
      HSP27 demonstrated that P29 was immunochemically identical with HSP27. Further
      characterization of agonist-induced phosphorylation of HSP27 indicated that
      phosphorylation occurred exclusively on serine residues, and phosphopeptide
      analysis of tryptic- and chymotryptic-cleavage products demonstrated that the
      phosphopeptides generated were identical for each agonist and okadaic acid. Down
      regulation of protein kinase C-alpha by prolonged treatment with phorbol esters
      eliminated the ability of phorbol 12-myristate 13-acetate, dioctanoylglycerol,
      thrombin and histamine to phosphorylate HSP27 above background levels and
      deceased interleukin-1-stimulated HSP27 phosphorylation by 60%. These data
      suggest that the various agonists employed stimulate HSP27 phosphorylation
      through similar mechanisms and that protein kinase C is probably involved.

PMID- 1622390
TI  - Mammary development and milk secretion in transgenic mice expressing the sheep
      beta-lactoglobulin gene.
AB  - Mammary development and milk secretion were studied in transgenic mice which
      exhibited mammary tissue-specific expression of the sheep beta-lactoglobulin
      gene, and secreted significant quantities of the foreign protein in milk. Mammary
      development was unaffected by transgenesis. Tissue DNA content and the activities
      of several key enzyme markers of cell differentiation were similar in transgenic
      mice and non-transgenic controls. Milk yield, whether estimated by pup weight
      gain or measured by a 3H2O-dilution method, was unchanged by foreign gene
      expression. Gross milk composition, including milk protein concentration, was
      also similar in transgenic and non-transgenic animals, even though beta
      lactoglobulin accounted for 29% of total milk protein. Therefore the foreign gene
      product was synthesized at the expense of endogenous milk proteins. However,
      transgenic mammary tissue in vitro exhibited a significantly higher rate of total
      protein synthesis than did control tissue. This suggested that a factor limiting
      milk protein synthesis or secretion in transgenic mice in vivo may have been
      removed by short-term explant culture of mammary tissue. The results emphasize
      that the use of transgenesis for manipulating milk composition may depend not
      only on high-level mammary-specific expression of the foreign gene, but also on
      the biosynthetic capacity of the mammary gland itself.

PMID- 1622391
TI  - Variations in hepatic carbon flux during unrestricted feeding.
AB  - Previous findings have established a pivotal role for hepatic pyruvate
      dehydrogenase complex (PDH) in regulating hepatic carbon flux during the starved
      to-fed and fed-to-starved nutritional transitions [Holness, McLennan, Palmer &
      Sugden (1988) Biochem. J. 252, 325-330; Holness & Sugden (1990) Biochem. J. 268,
      77-81]. We have therefore examined liver PDH activities during the light and dark
      phases of the feeding cycle in the adult rat in relation to hepatic glycogenesis,
      fatty acid synthesis and cholesterogenesis. There was significant synchronous
      suppression of lipogenesis and glycogenesis during the light phase; rates were
      restored asynchronously during the dark (feeding) phase. Glycogen concentrations
      declined during the light phase and increased during the dark phase. Despite
      quite dramatic changes in rates of glycogen and lipid synthesis and hepatic
      glycogen concentrations during the light and dark phases, hepatic PDHa (active
      form) activity remained relatively unchanged. Qualitative and quantitative
      differences in the pattern of change in rates of synthesis of fatty acid and
      cholesterol suggested regulation at pathway-specific sites distal to PDH.

PMID- 1622392
TI  - Novel linear and branched polyamines in the extremely thermophilic eubacteria
      Thermoleophilum, Bacillus and Hydrogenobacter.
AB  - Novel tertiary branched tetra-amines, quaternary branched penta-amines, linear
      penta-amines and linear hexa-amines were distributed as the major polyamines in
      six obligately extremely thermophilic eubacteria belonging to Thermoleophilum,
      Bacillus or Hydrogenobacter. The major polyamine of Thermoleophilum album and
      Thermoleophilum minutum was identified as a quaternary branched penta-amine, 4,4
      bis(3-aminopropyl)-1,8-diamino-4-azaoctane (NH2[CH2]3N+([CH2]3NH2)2[CH2]4NH2) by
      h.p.l.c., t.l.c. and g.c.-m.s. Hydrogenobacter thermophilus and Hydrogenobacter
      halophilus contained another quaternary branched penta-amine, 4,4-bis(3
      aminopropyl)-1,7-diamino-4-azaheptane (NH2[CH2]3N([CH2]3NH2)2[CH2]3NH2) as the
      major polyamine, and tertiary branched tetra-amines (4-(3-aminopropyl)-1,7
      diamino-4-azaheptane (NH2[CH2]3N([CH2]3NH2)[CH2]3NH2), 4-(3-aminopropyl)-1,8
      diamino-4-azaoctane (NH2[CH2]3N([CH2]3NH2)[CH2]4NH2)) and 4,4-bis(3-aminopropyl)
      1,8-diamino-4-azaoctane were confirmed as minor components. Bacillus schlegelii
      contained a branched tetra-amine, 4-(3-aminopropyl)-1,8-diamino-4-azaoctane, a
      branched penta-amine, 4,4-bis(3-aminopropyl)-1,8-diamino-4-azaoctane, a linear
      penta-amine, 1,16-diamino-4,8,13-triazahexadecane
      (NH2[CH2]3NH[CH2]3NH[CH2]4NH[CH2]3NH2) and linear hexa-amine(s), 1,20-diamino
      4,8,12,17-tetra-azaeicosane (NH2[CH2]3NH[CH2]3NH[CH2]3NH[CH2]4NH[CH2]3NH2 )
      and/or 1,20-diamino-4,8,13,17-tetra-azaeicosane
      (NH2[CH2]3NH[CH2]3NH[CH2]4NH[CH2]3NH[CH2]3NH2 ).

PMID- 1622393
TI  - Activation of calpain I in thrombin-stimulated platelets is regulated by the
      initial elevation of the cytosolic Ca2+ concentration.
AB  - The source and concentration of Ca2+ required to activate calpain I were
      investigated in thrombin-stimulated platelets. The concentration of cytosolic
      free Ca2+ ([Ca2+]i) was measured in platelets containing fura-2-AM, and exhibited
      a biphasic response after stimulation with 0.05, 0.1 or 0.5 NIH units of
      thrombin/ml. An initial transient elevation, which was predominantly dependent
      upon Ca2+ released from the internal stores into the cytosol, peaked at 15 s
      after stimulation, and a secondary sustained elevation, which was due to Ca2+
      influx, was observed following the initial elevation. Calpain I was present at
      about 540 ng/10(8) unstimulated platelets, as measured by immunoblotting using
      rabbit anti-(human calpain I) IgG. Calpain I was activated 10 s after thrombin
      stimulation, as determined by the appearance of the 78 kDa and 76 kDa forms on
      immunoblots. The activation ratio of calpain I was calculated as the amount of
      the 78 + 76 kDa forms as a percentage of the total (80 + 78 + 76 kDa), and was
      influenced by the extent of the initial transient [Ca2+]i elevation after
      stimulation. An initial increase in [Ca2+]i of 300 nM was required to achieve the
      maximal activation (60%) of calpain I, and half-maximal activation occurred at
      160 nM- Ca2+]i. These results suggest that the activation of calpain I in
      platelets is regulated by the initial elevation in Ca2+]i after thrombin
      stimulation, and does not necessarily require a Ca2+ influx.

PMID- 1622394
TI  - A novel mechanism for isoprenaline-stimulated proliferation of rat parotid acinar
      cells involving the epidermal growth factor receptor and cell surface
      galactosyltransferase.
AB  - Chronic injections of epidermal growth factor (EGF) or the beta-adrenergic
      receptor agonist isoprenaline resulted in rat parotid gland hypertrophy and
      hyperplasia. Introduction of a polyclonal antibody to EGF or the EGF-receptor
      (EGF-R) caused a specific retardation of acinar cell proliferation when injected
      along with the growth factor. Meanwhile, only the antibody to EGF-R caused a dose
      dependent retardation of proliferation on co-administration with isoprenaline
      both in vivo and in vitro. The antibody injected alone had no effect on cell
      growth. When cells were incubated in the presence of EGF, plasma membranes from
      isoprenaline-treated and control animals showed phosphorylation of the EGF-R
      tyrosine moieties and transient increases in membrane-associated phospholipase C
      gamma. Isoprenaline did not stimulate phosphorylation of the EGF-R in isolated
      plasma membranes. However, activation of the phosphotyrosine-signalling pathway
      could be duplicated by incubating isoprenaline-treated acinar cells, but not
      control cells, with bovine galactosyltransferase. Immunopurified EGF-R
      demonstrated variations in reactivity with two different lectins after treatment
      of the cells with the beta-agonist as well as increased galactosyltransferase
      substrate capacity in vitro. In addition, incubation of intact acinar cells and
      isolated plasma-membrane fractions from isoprenaline-treated rats with UDP
      [14C]galactose resulted in an increased incorporation of label into the EGF-R.
      The results suggest that the carbohydrate moiety of the EGF-R has been altered in
      isoprenaline-treated animals allowing galactosyltransferase now to recognize this
      receptor. This interaction may in part mediate proliferation of parotid acinar
      cells. Indeed, we have previously shown that an antibody to galactosyltransferase
      is capable of blocking isoprenaline-mediated acinar cell proliferation in vivo
      [Humphreys-Beher, Schneyer, Kidd & Marchase (1987) J. Biol. Chem. 262, 11706
      11713].

PMID- 1622395
TI  - Mechanism linking glycogen concentration and glycogenolytic rate in perfused
      contracting rat skeletal muscle.
AB  - The influence of differences in glycogen concentration on glycogen breakdown and
      on phosphorylase activity was investigated in perfused contracting rat skeletal
      muscle. The rats were preconditioned by a combination of swimming exercise and
      diet (carbohydrate-free or carbohydrate-rich) in order to obtain four sub-groups
      of rats with varying resting muscle glycogen concentrations (range 10-60 mumol/g
      wet wt.). Pre-contraction muscle glycogen concentration was closely positively
      correlated with glycogen breakdown over 15 min of intermittent short tetanic
      contractions (r = 0.75; P less than 0.001; n = 56) at the same tension
      development and oxygen uptake. Additional studies in supercompensated and
      glycogen-depleted hindquarters during electrical stimulation for 20 s or 2 min
      revealed that the difference in glycogenolytic rate was found at the beginning
      rather than at the end of the contraction period. Phosphorylase alpha activity
      was approximately twice as high (P less than 0.001) in supercompensated muscles
      as in glycogen-depleted muscles after 20 s as well as after 2 min of
      contractions. It is concluded that glycogen concentration is an important
      determinant of phosphorylase activity in contracting skeletal muscle, and
      probably via this mechanism a regulator of glycogenolytic rate during muscle
      contraction.

PMID- 1622396
TI  - Effects of calmodulin antagonists on antibody binding to calmodulin. Distinct
      conformers of calmodulin induced by the binding of drugs.
AB  - An indirect enzyme-linked immunosorbent assay has been used to study the
      interactions between calmodulin and two calmodulin antagonists, trifluoperazine
      and a neuropeptide isolated from the hypothalamus. The binding of a monospecific
      anti-calmodulin antibody, raised in rabbit against dinitrophenylated calmodulin,
      to calmodulin was tested at various concentrations of these drugs under
      equilibrium conditions. Trifluoperazine at low concentrations stimulated, but at
      relatively high concentrations inhibited, immunocomplex formation. The
      neuropeptide displaced the antibody from calmodulin at nanomolar concentrations.
      Enzyme-linked immunosorbent assays were also carried out with the large tryptic
      fragments of calmodulin. The results suggest that (i) the C-terminal fragment
      binds the antibody with an affinity which is comparable with that of intact
      calmodulin; (ii) the neuropeptide can form complexes with both N- and C-terminal
      fragments, but with two orders of magnitude less activity in case of the C
      terminal fragment; and (iii) trifluorperazine does not stimulate antibody binding
      to the C-terminal fragment. Therefore the tertiary structure of calmodulin must
      be intact to ensure long-distance interactions between the binding sites of
      trifluoperazine, the neuropeptide and the antibody. These interactions may
      produce distinct conformers of calmodulin which may exhibit altered potency, not
      only for antibody binding but also for stimulation/inhibition of target enzymes.

PMID- 1622397
TI  - Purification and characterization of variants of acyl-CoA-binding protein in the
      bovine liver.
AB  - Four differently modified forms of acyl-CoA-binding protein (ACBP) were
      identified in ACBP purified from bovine liver. The majority of the purified ACBP
      was focused at pH 5.9 in isoelectric focusing and could be shown to be N
      acetylated ACBP without any further modifications. Two minor peaks were focused
      at pH 5.25 and 4.85 respectively. Mass spectrometry and sequence determination
      showed that the pI 5.25 form was acetylated at Lys18 and that the pI 4.85 form
      was malonylated in the same position. Furthermore, it could be shown that non
      enzymic glycosylation occurred during purification. The acetylated and
      malonylated variants of ACBP were only found in adult cattle.

PMID- 1622398
TI  - Differential polypeptide expression in adipose tissue of lean and obese Zucker
      rats. Evidence of specifically repressed peptides in 7-day-old pre-obese rats.
AB  - Using two-dimensional electrophoresis on total extracts of adipose tissue from
      young lean (Fa/fa) and obese (fa/fa) Zucker rats, we have investigated the
      existence of early events at the protein level, before obvious obesity. Our
      results indicate that the two genotypes do not differ at 3 days of age in terms
      of polypeptide pattern. By 7 days of age, two polypeptides are transiently
      repressed in the fatty genotype, leading us to suggest their potential
      involvement in the onset of obesity. However, most of the differences between the
      lean and obese rats are detected at 30 days of age, characterized by an increase
      in the accumulation of several peptides in the adipose tissue of obese rats, in
      good agreement with the multiple biochemical changes previously identified at
      this stage of the disease. These results present evidence of new peptides that
      may be of interest in the study of the obesity syndrome.

PMID- 1622399
TI  - Some properties of murine selenocysteine synthase.
AB  - Selenocysteine (Scy) was synthesized on natural opal suppressor tRNA(Ser) by
      conversion from seryl-tRNA. We studied the mechanisms of the synthesis of
      mammalian Scy-tRNA using hydro[75Se]selenide (H75Se-). We found Scy synthase
      activity in the 105,000 g supernatant of a murine liver extract. The supernatant
      was chromatographed on DEAE-cellulose, and the activity was eluted at 0.12 M-KCl.
      The reaction mixture for synthesis of Scy-tRNA contained suppressor tRNA, serine,
      ATP, seryl-tRNA synthetase (SerRS), HSe- and the enzyme to synthesize Scy-tRNA.
      These are all essential for the synthesis of Scy-tRNA. Scy in the tRNA product
      was confirmed by five t.l.c. systems. The conversion from seryl-tRNA to Scy-tRNA
      was also confirmed with the use of [14C]- and [3H]-serine. The apparent Km values
      for the substrates serine, tRNA, ATP and HSe- were 30 microM, 140 nM, 2 mM and 40
      nM respectively. The active eluates from DEAE-cellulose contained no tRNA kinase.
      This result showed that Scy-tRNA was not synthesized through phosphoseryl-tRNA.
      ATP was necessary when Scy-tRNA was synthesized from seryl-tRNA and HSe-.
      Therefore ATP is used for not only the synthesis of seryl-tRNA but also for the
      synthesis of Scy-tRNA from seryl-tRNA. The active fraction from DEAE-cellulose
      was chromatographed on Sephacryl S-300, but the activity disappeared. However,
      the activity was recovered by mixing the eluates corresponding to proteins of 500
      kDa and 20 kDa. In order to examine the binding of HSe- to proteins, a mixture of
      the active fraction, H75Se- and ATP was analysed by chromatography on Sephacryl S
      300. The 75Se radioactivity was found at the position of a 20 kDa protein in the
      presence of ATP. Thus the 20 kDa protein plays a role in binding HSe- in the
      presence of ATP. The 500 kDa protein must have a role in the synthesis of Scy
      tRNA. There are two natural suppressor serine tRNAs, tRNA(NCA) and tRNA(CmCA), in
      cell cytosol. The present paper shows that the suppressor tRNA fraction, eluted
      later on benzoylated DEAE-(BD-)cellulose, is a better substrate with which to
      synthesize Scy-tRNA. Thus we consider that murine Scy-tRNA is synthesized from a
      suppressor seryl-tRNA on the 500 kDa protein with the activated HSe-, which is
      synthesized with ATP on the 20 kDa protein. This mammalian mechanism used to
      synthesize Scy is similar to that seen in Escherichia coli.

PMID- 1622400
TI  - Prenylated protein methyltransferases do not distinguish between farnesylated and
      geranylgeranylated substrates.
AB  - Proteins that are post-translationally modified by prenylation can be either
      farnesylated (C-15) or geranylgeranylated (C-20) by separate prenyltransferase
      enzymes. Prenylated proteins are also methylated at their C-terminal residue by S
      adenosylmethionine-linked methylation. In this paper we show that the methylation
      of farnesylated and geranyl-geranylated substrates can be accounted for by the
      presence of a single enzyme. It is demonstrated that the Km and Vmax. values for
      the retinal rod outer segment methyltransferase, measured with small molecule
      farnesylated and geranylgeranylated substrates, are identical. These substrates
      mutually inhibit each other's methylation, with KI values being equal to their Km
      values. The Km for S-adenosylmethionine was measured to be the same with either
      farnesylated or geranylgeranylated substrates. Competitive inhibitors of the
      methyltransferase containing either a geranylgeranyl or a farnesyl group equally
      block the methylation of synthetic geranylgeranylated and farnesylated substrates
      of the enzyme. Importantly, these inhibitors are also equipotent at inhibiting
      the methylation of the physiological substrates of the rod outer segment
      methyltransferase. These substrates are both farnesylated and geranylgeranylated.
      One of these substrates had previously been identified as the farnesylated gamma
      subunit of transducin. Therefore it appears that the same enzymic activity can
      methylate both farnesylated and geranylgeranylated substrates.

PMID- 1622401
TI  - Expression of rat liver NAD(P)H:quinone-acceptor oxidoreductase in Escherichia
      coli and mutagenesis in vitro at Arg-177.
AB  - A prokaryotic expression plasmid, pKK-DT2, containing the cDNA of rat liver
      NAD(P)H:quinone-acceptor oxidoreductase (EC 1.6.99.2; DT-diaphorase) was
      constructed and used to transform Escherichia coli strain JM109. The rat liver
      quinone reductase was expressed in strain in JM109 and was inducible with
      isopropyl beta-D-thiogalactopyranoside (IPTG). The expressed rat protein was
      purified by affinity chromatography and had kinetic and physical properties
      identical with the protein purified from rat liver in that it could utilize
      either NADH or NADPH as the electron donor and its activity was inhibited by
      dicoumarol. In addition, we have generated four mutants, Arg-177----His (R177H),
      Arg-177----Ala (R177A), Arg-177----Cys (R177C) and Arg-177----Leu (R177L), using
      this expression system. Several of the mutants behaved anomalously on SDS/PAGE,
      but all of the mutant proteins had the expected M(r) as determined by
      electrospray m.s. These results and those obtained from enzyme kinetic analysis,
      u.v./visible absorption spectral analysis, and flavin and tryptophan fluorescence
      analysis of the wild-type enzyme and four mutants indicated that mutations at Arg
      177 changed the conformation of the enzyme, resulting in a decrease in enzyme
      activity. Replacing Arg-177 with leucine altered the protein conformation and
      decreased FAD incorporation.

PMID- 1622402
TI  - Duck liver 'malic' enzyme. Expression in Escherichia coli and characterization of
      the wild-type enzyme and site-directed mutants.
AB  - A cDNA for duck liver 'malic' enzyme (EC 1.1.1.40) was subcloned into pUC-8, and
      the active enzyme was expressed in Escherichia coli TG-2 cells as a fusion
      protein including a 15-residue N-terminal leader from beta-galactosidase coded by
      the lacZ' gene. C99S and R70Q mutants of the enzyme were generated by the M13
      mismatch technique. The recombinant enzymes were purified to near homogeneity by
      a simple two-step procedure and characterized relative to the enzyme isolated
      from duck liver. The natural duck enzyme has a subunit molecular mass of approx.
      65 kDa, and the following kinetic parameters for oxidative decarboxylation of L
      malate at pH 7.0: Km NADP+ (4.6 microM); Km L-malate (73 microM); kcat (160 s-1);
      Ka (2.4 microM) and Ka' (270 microM), dissociation constants of Mn2+ at 'tight'
      (activating) and 'weak' metal sites; and substrate inhibition (51% of kcat. at 8
      mM-L-malate). Properties of the E. coli-derived recombinant wild-type enzyme are
      indistinguishable from those of the natural duck enzyme. Kinetic parameters of
      the R70Q mutant are relatively unaltered, indicating that Arg-70 is not required
      for the reaction. The C99S mutant has unchanged Km for NADP+ and parameters for
      the 'weak' sites (i.e. inhibition by L-malate, Ka'); however, kcat. decreased 3
      fold and Km for L-malate and Ka each increased 4-fold, resulting in a catalytic
      efficiency [kcat./(Km NADP+ x Km L-malate x Ka)] equal to 3.7% of the natural
      duck enzyme. These results suggest that the positioning of Cys-99 in the sequence
      is important for proper binding of L-malate and bivalent metal ions.

PMID- 1622403
TI  - Alterations in the mucosal processing of iron in response to very-short-term
      dietary iron depletion and repletion.
AB  - The transfer of control rats to a low-iron diet for only 24 h resulted in a 2
      fold increase in iron uptake by brush-border membrane vesicles. Extension of the
      low-iron feeding period to 72 h or 2 weeks resulted in only small additional
      increases in iron uptake by vesicle preparations. In contrast, the transfer of
      iron-deficient rats to a control diet resulted in a progressive decrease in iron
      uptake by vesicles that reached a level equivalent to that of control rats in 2
      weeks. 59Fe labelling of detergent extracts of these vesicle preparations
      provided evidence for the presence of an iron-binding protein composed of
      subunits of 52,000 Da. The changes in the 59Fe labelling of this protein
      component were consistent with the changes observed in iron uptake by intact
      brush-border membrane vesicles. The 59Fe-labelling profiles of mucosal ferritin
      and transferrin from a test dose also were changed substantially in response to
      very-short-term alterations in dietary iron. Even though changes in dietary iron
      rapidly altered iron uptake by brush-border membrane vesicles and the
      incorporation of 59Fe from the test dose into mucosal transferrin, changes in the
      incorporation of 59Fe into mucosal ferritin best reflected the actual changes in
      the transfer of iron from dose to plasma.

PMID- 1622404
TI  - Characterization of two dipeptidases purified from hepatic schistosome egg
      granulomas in mice. Leukotriene D4 hydrolases of granulomatous tissue.
AB  - Extracts prepared from tissue with granulomatous inflammation experimentally
      produced in liver of CBA-strain mice showed increased hydrolysis of leukotriene
      D4 (LTD4), Leu-Leu and Ala-Gly as compared with normal hepatic cells. Two
      dipeptidases, Leu-Leu dipeptidase and Ala-Gly dipeptidase, were purified from
      hepatic granulomas, and quantitative conversion of LTD4 into leukotriene E4
      (LTE4) by both enzymes was demonstrated. M(r) values of the purified enzymes were
      178,000 for Leu-Leu dipeptidase and 183,000 for Ala-Gly dipeptidase. The enzymes
      showed homogeneity, appearing as a single band on SDS/PAGE, and the M(r) values
      of the subunits were 56,000 and 57,000 for Leu-Leu and Ala-Gly dipeptidase
      respectively. The amino acid compositions of the two enzymes differed
      considerably from each other. The activity of Leu-Leu dipeptidase was inhibited
      by bestatin and captopril and stabilized with MnCl2. The Km for LTD4 was 25
      microM with a V(max.) of 49.0 mumols/min per mg. In contrast, the activity of Ala
      Gly dipeptidase was inhibited by cilastatin, cytinylglycine, EDTA and
      dithiothreitol, and also by captopril. The Km for LTD4 was 5.3 microM with a
      V(max.) of 50.4 mumols/min per mg. The findings indicate that the conversion of
      LTD4 into LTE4 by microsomal dipeptidases is elevated during granulomatous tissue
      reaction. This enzyme activity may become useful for biochemical quantification
      of the pathological tissue reaction that occurs in organized granulomas.

PMID- 1622405
TI  - Direct demonstration that increased phosphorylation of 3-hydroxy-3-methylglutaryl
      CoA reductase does not increase its rate of degradation in isolated rat
      hepatocytes.
AB  - Increased phosphorylation of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase
      has been suggested to target the protein towards an increased rate of
      degradation. Our previous observations [Zammit & Caldwell (1990) Biochem. J. 269,
      373-379] suggested that, although Ca(2+)-mobilizing hormones and other effectors
      can alter both the phosphorylation state of the enzyme and its total activity in
      isolated rat hepatocytes, there appears to be no causal correlation between the
      two parameters. In the present paper we set out to make direct measurements of
      the specific rate of degradation of 35S-labelled HMG-CoA reductase in hepatocytes
      treated with agents that produced very marked and prolonged increases in the
      degree of phosphorylation of the protein, through different mechanisms. Okadaic
      acid (which inhibits phosphatases 1 and 2A), fructose (which increases cellular
      AMP through its metabolism to fructose 1-phosphate) and the Ca2+ ionophore A23187
      (which also raises cellular AMP through an unknown mechanism) were all unable to
      alter the rate of HMG-CoA reductase degradation. We conclude that the basal rate
      of degradation of HMG-CoA reductase is unaffected by its phosphorylation state
      and that a transiently increased degree of phosphorylation cannot be the
      mechanism through which mevalonate increases the rate of degradation of the
      enzyme in rat hepatocytes and other cell types.

PMID- 1622406
TI  - Oligomeric tumour necrosis factor alpha slowly converts into inactive forms at
      bioactive levels.
AB  - The stability of oligomeric human tumour necrasis factor alpha (TNF) at bioactive
      levels has been studied by two immunoenzymatic assays: one able to specifically
      detect oligomeric and not monomeric TNF (O-e.l.i.s.a.) and the other able to
      detect both forms (OM-e.l.i.s.a.). The selectivity of O-e.l.i.s.a. and OM
      e.l.i.s.a. for oligomeric and monomeric TNF was demonstrated with isolated forms
      prepared by partial dissociation of recombinant TNF with 10% (v/v) dimethyl
      sulphoxide and gel-filtration h.p.l.c. Evidence for instability of oligomeric TNF
      were obtained in physiological buffers, as well as in serum and cell-culture
      supernatants, as a function of TNF concentration. In particular, only a half of
      the TNF antigen was recovered in the oligomeric form after 72 h incubation (37
      degrees C) at 0.12 nM, whereas no apparent dissociation was detected at 4 nM. The
      structural changes observed at picomolar concentrations were rapidly reversed by
      raising the concentration of TNF to about 2 nM by ultrafiltration, suggesting
      that subunit dissociation and reassociation reactions occur in the picomolar and
      nanomolar range respectively. The cytolytic activity of L-M cells correlates with
      oligomeric-TNF levels after incubation at picomolar concentrations. Moreover,
      isolated oligomeric TNF was cytotoxic towards L-M cells, whereas monomeric TNF
      was virtually inactive. In conclusion, the results suggest that bioactive
      oligomeric TNF is unstable at picomolar levels and slowly converts into inactive
      monomers, supporting the hypothesis that quaternary-structure changes in TNF may
      contribute to the fine regulation of TNF cytotoxicity.

PMID- 1622408
TI  - Mechanism of action of purpuromycin.

PMID- 1622407
TI  - Functional implications of tyrosine protein phosphorylation in platelets.
      Simultaneous studies with different agonists and inhibitors.
AB  - During activation of platelets by agonists, a number of proteins become
      phosphorylated at tyrosine residues. Using immunoblotting with a monoclonal anti
      phosphotyrosine antibody, we have compared the different phosphotyrosine-protein
      (PTP) profiles of platelets stimulated with thrombin, collagen, ADP, arachidonic
      acid, phorbol myristate acetate and P256, an anti-glycoprotein-IIb-IIIa (GPIIb
      IIIa) monoclonal antibody (mAb). Only a few PTPs were observed in resting
      platelets, of molecular masses 130, 64, 56-60 and 36 kDa. After stimulation by
      different agonists these proteins were more intensely phosphorylated and
      additional PTPs appeared with molecular masses of 170, 150, 140, 120, 105/97
      (doublet), 85, 80, 75 and 45 kDa. The kinetics of phosphorylation differed from
      one agonist to another, but no significant differences in the overall patterns
      were detected, except in presence of ADP and P256-F(ab')2, which induced only the
      additional tyrosine phosphorylation of the 64 kDa protein and to a lesser extent
      that of a 75 kDa protein. The use of various agonists and the inhibitors
      (staurosporine, ajoene and RGDS) permitted a better characterization of the
      relationship between the different steps of activation and phosphorylation on
      tyrosine residues. The studies suggest the following conclusions: (i) stimulation
      of tyrosine phosphorylation occurs after activation of protein kinase C; (ii)
      there is a relationship between ligand binding to GPIIb-IIIa and the tyrosine
      phosphorylation of the 64 kDa protein; and (iii) there is a close relationship
      between PTP formation and the intensity of platelet activation and aggregation.

PMID- 1622409
TI  - The importance of the T cell in initiating and maintaining the chronic synovitis
      of rheumatoid arthritis.
AB  - We hope that this short review has produced convincing, although indirect,
      evidence that in the case of rheumatoid synovitis, the T cell is the conductor of
      an orchestra playing a tune written by an antigen-presenting cell. The tune
      develops and becomes modified with time, so that it is difficult to discern with
      clarity much of the original melody. We believe that it may be possible to
      substitute a new score that will bring this symphony to a harmonious end. We also
      strongly believe that this is preferable to augmenting the string section or
      suppressing the percussion section of the orchestra in the vain hope that in the
      end harmony can be achieved. The final musical analogy must be the hope that the
      first page of the score can be found, so that we may discover the main theme, the
      leitmotif, of the rheumatoid-specific antigenic peptide.

PMID- 1622410
TI  - Precision of the Larsen and the Sharp methods of assessing radiologic change in
      patients with rheumatoid arthritis.
AB  - OBJECTIVE: To compare the sensitivity of Sharp's and Larsen's radiographic
      scoring methods for detecting change in rheumatoid arthritis (RA) over time.
      METHODS: Radiographs of the hands and wrists were taken at the beginning and at
      the end of a 2-year followup period, in 42 patients with active RA. Films were
      scored blindly using both scoring methods. Patients were under treatment with
      methotrexate (intramuscular injections). RESULTS: Radiographic evidence of
      progression or amelioration was detected in 25 patients by Larsen's method and in
      35 patients by Sharp's method. The relative sensitivity to change over time was
      greater for Sharp's method (0.01 less than P less than 0.025). CONCLUSION:
      Sharp's radiographic scoring method seems to be more sensitive to change over
      time than is Larsen's method. The clinical importance of the change needs to be
      definitively established.

PMID- 1622411
TI  - Glucocorticoid receptors in rheumatoid arthritis.
AB  - OBJECTIVE: Increasing evidence suggests that there is a close interrelationship
      between the immune system and the hypothalamic-pituitary-adrenal axis. One way
      these systems are linked is through specific receptor proteins for glucocorticoid
      hormones in lymphocytes. We sought to determine whether the levels of these
      receptors differ in patients with rheumatoid arthritis (RA), compared with levels
      in healthy subjects. METHODS: We determined the density and affinity of
      lymphocyte glucocorticoid receptors, as well as basal cortisol levels, in 90
      patients with active RA and in 200 healthy controls, using a whole cell binding
      assay. RESULTS: The number of glucocorticoid receptors in RA patients was
      significantly lower than in controls (mean +/- SD 2,144 +/- 500 per cell versus
      5,619 +/- 1,373 per cell; P less than 0.001), whereas there were no differences
      in binding affinity or cortisol levels. Glucocorticoid receptor density did not
      correlate with inflammatory disease activity. CONCLUSION: Since glucocorticoids
      are potent immunosuppressive agents, the decrease in their receptors suggests an
      impairment of the immune-hypothalamic-pituitary-adrenal axis in patients with RA.

PMID- 1622412
TI  - Rheumatoid arthritis in Greek and British patients. A comparative clinical,
      radiologic, and serologic study.
AB  - OBJECTIVE: To compare the clinical, radiologic, and serologic expression of
      rheumatoid arthritis (RA) in 2 different populations. METHODS: Standard protocols
      and assessment criteria were used in this study of 108 Greek and 107 British
      patients with RA. RESULTS: British patients had more severe articular involvement
      than did Greeks, as judged by the duration of morning stiffness (P less than
      0.005), grip strength (P less than 0.0001), and the numbers of swollen (P less
      than 0.001) and tender (P less than 0.0001) joints. The British RA patients also
      had more severe joint damage on radiologic examination, as evidenced by
      Steinbrocker stage III (P less than 0.005) and IV (P less than 0.025) disease and
      had more extraarticular manifestations (P less than 0.0001), including rheumatoid
      nodules (P less than 0.0001) and Raynaud's phenomenon (P less than 0.05). Greek
      RA patients, however, more frequently presented with sicca manifestations (P less
      than 0.001) and serum antibodies to Ro/SS-A (P less than 0.025). Furthermore,
      Ro/SS-A antibodies were associated with a high incidence of side effects to D
      penicillamine only in the Greeks. CONCLUSION: Genetic and environmental factors
      may be responsible for these striking differences in disease expression between
      these 2 European populations with RA.

PMID- 1622413
TI  - The effect of food on the absorption of methotrexate sodium tablets in healthy
      volunteers.
AB  - OBJECTIVE: To examine the effect of food on the absorption and bioavailability of
      low-dose orally administered methotrexate sodium tablets. METHODS: In this
      randomized, 2-way crossover study, a 7.5-mg dose of methotrexate (three 2.5-mg
      tablets) was administered to 12 healthy male volunteers after an overnight fast
      or within 10 minutes of consuming a high fat-content breakfast. Serum
      methotrexate concentrations over the next 24 hours were used to determine the
      area under the concentration-time curve (AUC), the maximum concentration, the
      time to maximum concentration (tmax), and the serum half-life for each phase.
      RESULTS: Food delayed the tmax by approximately 30 minutes, but the extent of
      absorption, as measured by the AUC, for both phases was similar. CONCLUSION:
      These results demonstrate that the bioavailability of low-dose orally
      administered methotrexate sodium tablets is not influenced by food.

PMID- 1622414
TI  - Isolated diffusing capacity reduction in systemic sclerosis.
AB  - OBJECTIVE: To determine the long-term outcome of patients with systemic sclerosis
      (SSc) and an isolated reduction in the diffusing capacity for carbon monoxide
      (DLCO) at the time of initial evaluation. METHODS: Patients with an isolated
      reduction in DLCO (i.e., normal forced vital capacity [FVC] and normal ratio of
      the forced expiratory volume in one second [FEV1] to the FVC) on initial
      evaluation were identified from among 815 patients with SSc who were carefully
      followed up throughout their illness. We requested that patients have repeat
      pulmonary function testing (PFT), and the outcomes of these tests, as well as
      cardiopulmonary and survival outcomes, were determined. RESULTS: An isolated
      reduction in DLCO, with a normal FVC was detected in 152 (19%) of the 815
      patients. A subset of those with an isolated reduction in DLCO (11%) developed
      isolated pulmonary hypertension and had severely reduced survival rates.
      Pulmonary hypertension was strongly associated with an initial DLCO of less than
      55% of predicted normal and a FVC (% predicted)/DLCO (% predicted) ratio of
      greater than 1.4. Among all patients in whom this ratio was greater than 1.4, 22%
      developed isolated pulmonary hypertension, compared with only 2% of those whose
      ratio was less than 1.4 (P less than 0.01). Of the 152 patients with isolated
      DLCO reduction, 73 (48%) underwent PFTs a mean of 5.4 years (range 2.0-13.2)
      after the initial PFT. Only 6 (8%) of these 73 patients ever had serious
      pulmonary disease: 5 had isolated pulmonary hypertension, and 1 had severe
      pulmonary fibrosis. Half of the patients with a low initial DLCO demonstrated a
      significant improvement (greater than 20%) at followup testing that could not be
      explained by the demographic, clinical, or laboratory findings at the first
      visit. CONCLUSION: Isolated reduction in DLCO is a frequent abnormality in SSc.
      Overall, it is associated with a good prognosis for survival and for pulmonary
      morbidity. A small subset of patients (11%) who have a very low DLCO (less than
      55% of predicted) have developed isolated pulmonary hypertension, all of whom had
      limited scleroderma.

PMID- 1622415
TI  - Adhesion of peripheral blood mononuclear cells to vascular endothelium in
      patients with systemic sclerosis (scleroderma).
AB  - OBJECTIVE: Perivascular infiltrates in skin, subcutaneous tissue, and internal
      organs are a characteristic feature of early systemic sclerosis (SSc). We studied
      the first step of migration of peripheral blood mononuclear cells (PBMC) through
      the vessel wall to the extravascular space, i.e., adhesion of PBMC to endothelial
      cells (EC), in patients with various forms of SSc (limited scleroderma, diffuse
      scleroderma, and the transitional form). METHODS: Radioisotope-labeled patient
      PBMC were coincubated with umbilical cord EC in vitro, and the percentage
      adhesion was measured. RESULTS: Adhesion of PBMC to EC was markedly decreased,
      while adhesion of isolated active rosette-forming cells (ARFC) was significantly
      increased, in SSc patients compared with healthy controls. Decreased adhesion of
      PBMC to EC was found to correlate with a diminished percentage of ARFC in the
      peripheral blood. Preincubation of PBMC from healthy donors with interleukin-2
      (IL-2) enhanced their adhesion to EC, while preincubation of PBMC from SSc
      patients with this cytokine resulted in a decrease in adhesion in 10 of 14
      individuals. IL-1, interferon-gamma, and transforming growth factor beta had no
      significant effect on adhesion of SSc patient PBMC to EC. Differences in adhesion
      of PBMC to EC among the SSc subgroups were not significant. CONCLUSION: Our
      findings suggest that in SSc, activation of subpopulations of PBMC leads to their
      enhanced adhesion to vascular endothelium in vivo and to migration of these cells
      to the extravascular space, resulting in the elimination from the peripheral
      blood of those PBMC with high ability to adhere to EC.

PMID- 1622416
TI  - A controlled study of the prevalence of cognitive dysfunction in randomly
      selected patients with systemic lupus erythematosus.
AB  - OBJECTIVE: To investigate the prevalence of cognitive dysfunction in randomly
      selected patients with systemic lupus erythematosus (SLE). METHODS: Randomly
      selected, ambulatory patients with SLE (n = 49) or with rheumatoid arthritis (RA)
      (n = 40) completed neuropsychological tests. These included Associate Learning,
      Switching Attention, Continuous Performance, Associate Recall, Hand-Eye
      Coordination, Pattern Comparison, Pattern Memory, the Stroop Color and Word Test,
      and the Symptoms Checklist-90R. Results were evaluated by multiple linear
      regression analysis. RESULTS: SLE patients had poorer performance than RA
      patients on the test of attention (P = 0.002) and tests of visuospatial ability
      (P = 0.03) and P = 0.04), independent of age, education, or steroid use. The
      conservative level of statistical significance, adjusting for multiple
      comparisons, was 0.005. SLE patients reported more symptoms of cognitive
      difficulty. CONCLUSION: Cognitive dysfunction is common in ambulatory SLE
      patients as measured by standardized tests and is a cause of distress and
      impaired functioning. Self-reported cognitive difficulty appears to correlate
      with objective performance.

PMID- 1622417
TI  - Connective tissue activation. XXXV. Detection of connective tissue activating
      peptide-III isoforms in synovium from osteoarthritis and rheumatoid arthritis
      patients: patterns of interaction with other synovial cytokines in cell culture.
AB  - OBJECTIVE: To determine whether extracts of unincubated osteoarthritis (OA) and
      rheumatoid arthritis (RA) synovial tissue contain connective tissue activating
      peptide-III (CTAP-III) isoforms and prostaglandin E2 (PGE2), and whether such
      extracts have growth-promoting activity, and to determine whether binary
      combinations of CTAP-III with other cytokines reported to be present in synovial
      tissue lead to synergistic, additive, or inhibitory effects on growth. METHODS:
      Acid-ethanol extracts of human synovium were examined for growth-promoting
      activity by measuring formation of 14C-glycosaminoglycan (14C-GAG) and 3H-DNA in
      synovial cell cultures; PGE2 was measured by enzyme immunoassay, and CTAP-III
      isoforms were identified by Western blotting of extracted proteins separated by
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Growth-promoting
      activity of CTAP-III and other cytokines was tested in synovial cultures treated
      with the agonists singly and in binary combination, by measuring changes in
      synthesis of 14C-GAG and 3H-DNA. RESULTS: Platelet-derived CTAP-III and a
      cleavage isoform with the electrophoretic mobility of CTAP-III-des 1
      15/neutrophil-activating peptide-2 (NAP-2) and PGE2 were found in biologically
      active extracts of synovial samples from patients with RA and OA. Five growth
      factors (recombinant epidermal growth factor [rEGF], recombinant interleukin-1
      beta [rIL-1 beta], basic fibroblast growth factor [bFGF], PGE1, and PGE2) in
      binary combination with CTAP-III showed synergism in stimulating GAG synthesis;
      two (recombinant platelet-derived growth factor type BB [rPDGE-BB] and
      recombinant transforming growth factor beta [rTGF beta]) had an additive effect.
      In combination with CTAP-III, rEGF and rPDGF-BB had a synergistic effect in
      promoting DNA synthesis, rTGF beta and rbFGF had an additive effect, and rIL-1
      beta, PGE1, and PGE2 were antagonistic. CONCLUSIONS: The results suggest that, in
      addition to endogenous factors, CTAP-III and other platelet-derived cytokines may
      play roles in regulating synovial cell metabolism in RA and OA, and that
      combinations of growth factors may be more significant than single agents in
      amplification or suppression of important cell functions.

PMID- 1622418
TI  - Are we losing focus on the internal elastic lamina in giant cell arteritis?

PMID- 1622419
TI  - Type X collagen synthesis in human osteoarthritic cartilage. Indication of
      chondrocyte hypertrophy.
AB  - OBJECTIVE: To investigate the appearance of hypertrophic chondrocytes in
      osteoarthritic (OA) cartilage, using type X collagen as a specific marker.
      METHODS: The biosynthesis of type X collagen was examined by metabolic labeling
      of freshly isolated articular chondrocytes with 3H-proline, immunoprecipitation,
      and sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the synthesized
      collagens. Extracellular deposition of types X and II collagen was analyzed
      immunohistochemically. RESULTS: Immunostaining revealed an irregular distribution
      of type X collagen, which was localized around chondrocyte clusters in
      fibrillated OA cartilage, but was absent from the noncalcified region of normal
      articular cartilage. Freshly isolated OA chondrocytes synthesized predominantly
      type X collagen, while control chondrocytes synthesized mostly type II collagen.
      CONCLUSION: Our findings indicate focal premature chondrocyte differentiation to
      hypertrophic cells in OA cartilage.

PMID- 1622420
TI  - Progressive aortic valve inflammation occurring despite apparent remission of
      relapsing polychondritis.
AB  - We describe a patient with relapsing polychondritis in whom aortic valve
      inflammation developed 3 years after diagnosis, when the polychondritis had been
      in apparent remission for an extended period of time. Infection and cardiac
      involvement can be significant complications of relapsing polychondritis.
      Recommendations for monitoring and treatment of patients with this disease are
      discussed.

PMID- 1622421
TI  - Antibodies to glycyl-transfer RNA synthetase in patients with myositis and
      interstitial lung disease.
AB  - OBJECTIVE: We have previously described anti-EJ antibodies, and provided evidence
      that these antibodies react with glycyl-transfer RNA (gly-tRNA) synthetase. The
      aim of the present study was to identify patients with anti-EJ antibodies and
      describe the clinical associations of the antibody, in particular, whether it is
      associated with the syndrome of myositis and interstitial lung disease (ILD) that
      has been previously associated with autoantibodies to the aminoacyl-tRNA
      synthetases for histidine, threonine, and alanine. METHODS: Sera from patients
      with suspected or proven polymyositis or dermatomyositis (DM), sera with
      anticytoplasmic patterns, and control sera were tested for anti-EJ antibodies by
      immunoprecipitation (IPP). Positive sera and controls were tested for the ability
      to inhibit gly-tRNA synthetase by preincubation of the enzyme source with the
      serum. RESULTS: Anti-EJ antibodies were demonstrated in the sera of 5 patients,
      by IPP of characteristic tRNAs and protein. Original serum EJ and each of the new
      sera significantly inhibited the enzymatic activity of gly-tRNA synthetase but
      not histidyl-tRNA synthetase. All 5 of the new patients had inflammatory
      myopathy, a typical DM rash, and ILD. One, who had an overlap syndrome with
      systemic lupus erythematosus, had anti-EJ at least 4 months before the
      development of clinical myositis. Arthritis and Raynaud's phenomenon, other
      features associated with antisynthetases, were also seen. CONCLUSION: Anti-EJ is
      associated with the syndrome of myositis and lung disease that is seen in
      association with other antisynthetases. The finding of specific inhibition of gly
      tRNA synthetase by all anti-EJ-positive sera strongly supports the identification
      of EJ antigen as gly-tRNA synthetase.

PMID- 1622422
TI  - FDA Arthritis Advisory Committee meeting: guidelines for clinical evaluation of
      therapies for scleroderma.

PMID- 1622423
TI  - Does tumor necrosis factor protect against lupus in west Africans?

PMID- 1622424
TI  - Relationship between interleukin-6 levels and platelet counts in systemic
      juvenile rheumatoid arthritis: comment on the article by De Benedetti et al.

PMID- 1622425
TI  - Comment on the study of deflazacort versus prednisone in the treatment of chronic
      inflammatory disorders.

PMID- 1622426
TI  - Pharmacologic desensitization by intravenous protocols.

PMID- 1622427
TI  - Interpreting brain scans of lupus patients taken after seizures or migraines.

PMID- 1622428
TI  - The use of classification criteria in the diagnosis of rheumatoid arthritis:
      comment on the article by Katz and Liang.

PMID- 1622429
TI  - DR-DQ variants in rheumatoid arthritis and Felty's syndrome: comment on the
      article by Wallin et al.

PMID- 1622430
TI  - Entry criteria influence conclusions about rates of flare in lupus pregnancy:
      comment on the article by Petri et al.

PMID- 1622431
TI  - Levofloxacin, a new quinolone antibacterial agent. An introductory overview.

PMID- 1622432
TI  - Levofloxacin (DR 3355), a new quniolone antibacterial agent.

PMID- 1622433
TI  - Acute oral toxicity of the new quinolone antibacterial agent levofloxacin in
      mice, rats and monkeys.
AB  - Acute oral toxicity of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4- methyl-1
      piperazinyl)-7-oxo-7H-pyrido [1,2,3-de][1,4]benzoxazine-6-carboxylic acid
      hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4), a new quinolone
      antibacterial agent, was studied in ddy mice, SD rats and cynomolgus monkeys.
      LD50 values were 1,881 mg/kg for males and 1,803 mg/kg for females in mice, 1,478
      mg/kg for males and 1,507 mg/kg for females in rats and more than 250 mg/kg in
      females monkeys. Toxic signs included the decrease in locomotor activity, ptosis,
      tremor, tonic convulsion and respiratory depressed in rodents and soft feces or
      vomiting in monkeys. At necropsy, no treatment-related changes were observed in
      any species except for the enlargement of the cecum in rats.

PMID- 1622434
TI  - Twenty-six-week oral toxicity of the new quinolone antibacterial agent
      levofloxacin in rats and cynomolgus monkeys.
AB  - The oral 26-week toxicity of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4- methyl
      1-piperazinyl)-7-oxo-7H-pyrido [1,2,3-de][1,4]benzoxazine-6-carboxylic acid
      hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4) was investigated in rats and
      monkeys. Rats receiving higher doses of DR-3355 exhibited an increased number of
      larger fecal pellets, salivation, lower neutrophil counts, enlargement of the
      cecum and prominent goblet cells in the cecal mucosa. Monkeys did not show any
      changes due to DR-3355 treatment. Therefore, a no-effect dose of DR-3355 under
      these conditions was determined as 20 mg/kg in the rat and 62.5 mg/kg in the
      cynomolgus monkey.

PMID- 1622435
TI  - Reproductive toxicity of the new quinolone antibacterial agent levofloxacin in
      rats and rabbits.
AB  - The reproductive toxicity of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4- methyl
      1-piperazinyl)-7-oxo-7H-pyrido [1,2,3-de][1,4]benzoxazine-6-carboxylic acid
      hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4) was investigated in rats and
      rabbits. DR-3355 was administered orally prior to and in the early stage of
      pregnancy to male and female rats at doses of up to 360 mg/kg. No adverse effects
      on fertility or teratogenicity were noted at any dose. DR-3355 elicited no
      evidence of teratogenicity when administered during the fetal organogenesis
      period to pregnant rats at doses of up to 810 mg/kg, or to pregnant rabbits at
      doses of up to 50 mg/kg. However, female rats receiving 810 mg/kg showed
      salivation, soiled coats, soft stools and decreases in body weight and food
      intake. Rat fetuses in the 810 mg/kg group exhibited decreased body weight and
      retardation of ossification, and showed increases in mortality and skeletal
      variations. Decreases in maternal body weight and food intake were observed in
      rabbits in the 50 mg/kg group. No adverse effects were observed in perinatal and
      postnatal toxicity studies in rats using doses of up to 360 mg/kg.

PMID- 1622436
TI  - Mutagenicity of the new quinolone antibacterial agent levofloxacin.
AB  - A new quinolone antibacterial agent (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10- (4
      methyl-1-piperazinyl)-7-oxo-7H-pyrido[1,2,3-de][1,4]benzoxazine-6- carboxylic
      acid hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4), was studied for
      mutagenicity using the following short-term in vitro and in vivo tests. 1. IN
      VITRO STUDIES: reverse mutation test (Ames method) on S. typhimurium and E. coli;
      and HGPRT forward mutation test, cytogenetic test, and sister chromatid exchange
      (SCE) test, all on Chinese hamster cells. 2. In vivo studies: mouse micronucleus
      test, SCE test on mouse bone marrow cell, in vivo-in vitro unscheduled DNA
      synthesis (UDS) test on rat primary hepatocytes, and dominant lethal test in BDF1
      mice. In the in vitro tests for SCE and for chromosomal aberration, DR-3355 gave
      dose-dependent positive responses, but no mutagenicity was observed in the same
      indicators of the in vivo studies, even at the maximum tolerated doses. This
      strongly suggested that DR-3355 would have no mutagenic effects when used in the
      treatment of infectious diseases. DR-3355 did not show any positive response in
      the reverse mutation test, the HGPRT mutation test, the in vivo-in vitro UDS test
      or the dominant lethal test. These results suggest that chemotherapy with DR-3355
      should have no mutagenic effect in man.

PMID- 1622437
TI  - Antigenicity of the new quinolone antibacterial agent levofloxacin.
AB  - An antigenicity study of a new quinolone antibacterial agent, (-)-(S)-9-fluoro
      2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo- 7H-pyrido[1,2,3
      de][1,4]benzoxazine-6-carboxylic acid hemihydrate (lefovloxacin, DR-3355, CAS
      100986-85-4), was carried out in mice, guinea pigs and rabbits with passive
      cutaneous anaphylaxis (PCA), systemic anaphylaxis (SA) and enzyme linked
      immunosorbent assay (ELISA). Mice were sensitized with DR-3355 (1-100 mg/kg) or
      DR-3355-ovalbumin (OA) conjugate (DR-3355-OA; 500 micrograms/kg). No IgE
      antibodies to DR-3355 were detected in the sera obtained from the DR-3355
      sensitized mice, indicating that DR-3355 has no immunogenicity in mice. By using
      DR-3355-OA as a sensitizing antigen, DR-3355-specific IgE was produced
      successfully in 7 out of 10 sera, and 4 sera showed positive responses in 24-h
      PCA on intravenous injection of DR-3355 (40 mg/kg). These responses disappeared
      on challenge with a dose of 2.5 mg/kg. Guinea pigs or rabbits were sensitized
      with DR-3355 (2-100 or 2-20 mg/kg) or DR-3355-OA (2 mg/kg). No SA was observed in
      the sensitized guinea pigs after the intravenous injection of DR-3355 (40 mg/kg).
      No antibodies to DR-3355 were detected in the sera obtained from the sensitized
      guinea pigs and rabbits by PCA or ELISA. These results suggest that DR-3355 may
      not possess antigenicity in guinea pigs and rabbits. On the other hand, the
      results of PCA in mice suggest that DR-3355 may have eliciting antigenicity
      potential.

PMID- 1622438
TI  - Effect of the new quinolone antibacterial agent levofloxacin on multiple organ
      carcinogenesis initiated with wide-spectrum carcinogens in rats.
AB  - A multiple organ carcinogenesis model was used in male F344 rats to test the
      carcinogenic potential of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1
      piperazinyl)-7-oxo- 7H-pyrido[1,2,3-de][1,4] benzoxazine-6-carboxylic acid
      hemihydrate (levofloxacin, DR-3355, CAS 10086-85-4). After sequential treatment
      with diethylnitrosamine (DEN: carcinogen for the liver), N-methylnitrosourea
      (MNU: carcinogen for the esophagus, forestomach and thyroid) and dihydroxy-di-N
      propylnitrosamine (DHPN: carcinogen for the lungs, kidney and urinary bladder),
      rats were treated with DR-3355, N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN), N
      methyl-N'-nitro-N-nitrosoguanidine (MNNG), catechol (CC) or phenobarbital (PB) to
      examine whether these compounds modified the carcinogenesis in multiple organs.
      As a result of histopathological examinations at study week 20, DR-3355 did not
      induce neoplastic lesions, nor did it enhance the occurrences of proliferative
      preneoplastic lesions. In contrast, BBN increased the incidences of hyperplasias
      and papillomas of the urinary bladder. CC enhanced the occurrences of
      hyperplasias and papillomas of the forestomach as well as submucosal glandular
      growth for the glandular stomach. PB increased the number of altered cell foci in
      the liver and the incidence of follicular cysts and hyperplasias of the thyroid.
      These results indicate that DR-3355 is not capable of promoting the development
      of tumors in rat multiple organs.

PMID- 1622439
TI  - Lack of nephrotoxic effects of the new quinolone antibacterial agent levofloxacin
      in rabbits.
AB  - The nephrotoxicity of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-
      piperazinyl)-7-oxo-7H-pyrido [1,2,3-de][1,4]benzoxazine-6-carboxylic acid
      hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4), a new quinolone
      antibacterial agent, was evaluated in male New Zealand White (NZW) rabbits after
      oral administration of 30 or 120 mg/kg for 10 days. Although reduced body weight
      gain was observed in the 120 mg/kg, DR-3355 induced no change in function and
      morphology of the kidneys at both doses.

PMID- 1622441
TI  - Phototoxic potential of the new quinolone antibacterial agent levofloxacin in
      mice.
AB  - The phototoxic potential of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4- methyl-1
      piperazyl)-7-oxo-7H-pyrido[1,2,3-de][1,4]benzoxazine-6- carboxylic acid
      hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4) was evaluated by the mice
      ear swelling reaction. Results were compared with those for enoxacin (ENX). Mice
      were orally administered DR-3355 or ENX and immediately exposed to ultraviolet-A
      for 4 h. Phototoxicity was determined by measuring ear thickness developing 24 h
      after irradiation. DR-3355 provided no changes in the ear at 200 mg/kg, but
      caused ear swelling at 800 mg/kg. ENX caused severe phototoxicity in a dose
      dependent manner from 50 mg/kg. These data suggest that DR-3355 has minor
      phototoxic potential, but is approximately 4-fold less toxic than ENX in these
      experimental conditions.

PMID- 1622440
TI  - Ophthalmotoxicity and ototoxicity of the new quinolone antibacterial agent
      levofloxacin in Long Evans rats.
AB  - An ophthalomo- and ototoxicity study of a new quinolone antibacterial agent, (-)
      (S)-9-fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1- piperazinyl)-7-oxo-7H
      pyrido[1,2,3-de] [1,4]benzoxazine-6-carboxylic acid hemihydrate (levofloxacin, DR
      3355, CAS 100986-85-4) was investigated in Long Evans rats. The rats were orally
      administered 100 mg/kg of DR-3355, ciprofloxacin (CPFX), norfloxacin (NFLX) or
      nalidixic acid (NA) for 2 weeks, and the effects on visual and auditory functions
      were examined. Examination of electroretinograms (ERGs) revealed a decrease in
      the amplitudes of the a- and b-waves, a prolongation of the latency and
      diminution or disappearance of oscillatory potential waves in NA treated rats.
      Similar but milder changes were also noted in the NFLX treated rats. ERGs from DR
      3355 or CPFX treated rats were normal. Histopathological examination revealed no
      changes suggestive of ophthalmotoxicity or ototoxicity in the rats treated with
      DR-3355, CPFX or NFLX. On the other hand, NA treated rats showed partial loss of
      the outer hair cells of the organ of Corti in the cochlea, suggesting that NA had
      slight ototoxicity. DR-3355 did not show any deleterious visual or auditory
      effects at the dose used in this study.

PMID- 1622442
TI  - Interaction of the new quinolone antibacterial agent levofloxacin with fenbufen
      in mice.
AB  - The interaction of (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-
      piperazinyl)-7-oxo-7H-pyrido[1,2,3-de] [1,4]benzoxazine-6-carboxylic acid
      hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4) with fenbufen, a
      nonsteroidal anti-inflammatory agent, in mice was assessed by convulsive seizure
      and subsequent death in comparison with that of other new quinolones such as DR
      3354 (the R-(+)-isomer of ofloxacin), ofloxacin, norfloxacin, enoxacin and
      ciprofloxacin. Although treatment with each quinolone or fenbufen alone at a
      dosage level tested in mice showed no changes, coadministration of a large dose
      of all quinolones and fenbufen caused convulsant death. When compared with the
      severity of this interaction, it was in the order of enoxacin greater than
      norfloxacin greater than ciprofloxacin greater than DR-3354 greater than
      ofloxacin greater than or equal to DR-3355 under these experimental conditions.

PMID- 1622444
TI  - Get involved: multiculturally.

PMID- 1622443
TI  - General pharmacology of the new quinolone antibacterial agent levofloxacin.
AB  - The general pharmacological properties of (-)-(S)-9-fluoro-2,3-dihydro-3- methyl
      10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido[1,2,3-de][1,4] benzoxazine-6
      carboxylic acid hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4), an
      optically active isomer of ofloxacin, were examined. 1. Central nervous system
      (CNS): DR-3355 at 200-600 mg/kg p.o. showed depressant activity on the CNS, as
      was indicated by the depressant syndrome (mice), decreased spontaneous motor
      activity (mice) and hypothermia (mice and rabbits). In the cat behavior and EEG
      experiments, it had both stimulant and depressant effects at 30-100 mg/kg i.p.,
      and caused transient slow waves followed by seizures at 20-30 mg/kg i.v. DR-3355
      had no effect on convulsion, hexobarbital anesthesia, pain reaction to a tail
      pinch, or conditioned avoidance response, except that it showed mild analgesic
      activity in acetic acid writhing at 600 mg/kg p.o. 2. Respiratory and
      cardiovascular system: DR-3355 produced a hypotensive and a bradycardiac effect
      after the rapid i.v. injection of 6 mg/kg or more in anesthetized dogs,
      accompanied by an increase in plasma histamine concentration. Both changes were
      markedly reduced when the test drug was administered by continuous i.v. infusion.
      3. Autonomic nervous system: DR-3355 inhibited nictitating membrane contraction
      induced by both pre- and post-ganglionic stimulation, and inhibited the depressor
      response to acetylcholine at 20 mg/kg i.v. It had no influence on pupil size or
      on pressor response to norepinephrine. 4. Gastrointestinal system: DR-3355 at 600
      mg/kg p.o. inhibited gastric secretion. Dog gastrointestinal motility was
      slightly inhibited, and was then stimulated over the dose range of 2-20 mg/kg
      i.v. It had no influence on gastrointestinal propulsion, the gastric emptying
      rate or the gastric mucosa. 5. Isolated smooth muscle: At a concentration of 5 x
      10(-4) g/ml, DR-3355 was devoid of spasmogenic or smasmolytic activity, except
      for showing a slight relaxation effect (trachea), inhibition of nicotine-induced
      contraction (ileum) and spontaneous or oxytocin-induced motility (pregnant
      uterus). 6. Miscellaneous: DR-3355 inhibited the urine output and carrageenin
      induced paw edema at 600 mg/kg p.o. It had no effect on skeletal muscle
      contraction or the corneal reflex.

PMID- 1622446
TI  - National health reform: a national debate.

PMID- 1622445
TI  - Use of laryngeal imaging procedures.

PMID- 1622447
TI  - Undergraduate education. The beginning of the educational continuum.

PMID- 1622448
TI  - The AuD discussion.

PMID- 1622449
TI  - The AuD discussion.

PMID- 1622450
TI  - The AuD discussion.

PMID- 1622451
TI  - The AuD discussion.

PMID- 1622452
TI  - The AuD discussion.

PMID- 1622454
TI  - Make room for language.

PMID- 1622453
TI  - The AuD: another approach.

PMID- 1622455
TI  - Support for AuD.

PMID- 1622456
TI  - Support for AuD.

PMID- 1622457
TI  - Support for AuD.

PMID- 1622458
TI  - Animal research.

PMID- 1622459
TI  - New RPO.

PMID- 1622460
TI  - Vision screening.

PMID- 1622461
TI  - A new pocket camera with macro facility.

PMID- 1622462
TI  - HIV scheme.

PMID- 1622463
TI  - Vasospasm and transient monocular blindness.

PMID- 1622464
TI  - Re: Postoperative follow-up of patients with colorectal cancer.

PMID- 1622465
TI  - "Fast track" admission for acute myocardial infarction.

PMID- 1622466
TI  - Topical application of bichloroacetic acid.

PMID- 1622467
TI  - Children and smoking: how doctors can help.

PMID- 1622468
TI  - Frequent-user subgroups.

PMID- 1622469
TI  - Overuse syndrome?

PMID- 1622470
TI  - RBRVS: objections to Maloney, II.

PMID- 1622471
TI  - A comparison of repair and replacement for mitral stenosis with partially
      calcified valve.

PMID- 1622472
TI  - Premedication before antivenom therapy.

PMID- 1622473
TI  - Lip enlargement.

PMID- 1622475
TI  - Dysphagia in the elderly.

PMID- 1622474
TI  - Priority regarding transconjunctival blepharoplasty.

PMID- 1622476
TI  - Antidiarrhoeal drugs for acute diarrhoea in children.

PMID- 1622477
TI  - Airs, waters, places, and doctors.

PMID- 1622478
TI  - Bronchodilator treatment in asthma: continuous or on demand?

PMID- 1622479
TI  - Sexual selection and MHC genes.

PMID- 1622480
TI  - Conduction block in vasculitic neuropathy.

PMID- 1622481
TI  - Histochemistry of tartrate-resistant acid phosphatase and carbonic anhydrase
      isoenzyme II in osteoclast-like giant cells in bone tumours.

PMID- 1622482
TI  - Is pentane produced by colonic bacteria?

PMID- 1622483
TI  - Colonic motility and functional diarrhea.

PMID- 1622484
TI  - Seidlmayer's syndrome: postinfectious cockade purpura of early childhood.

PMID- 1622485
TI  - Few are malingering.

PMID- 1622486
TI  - Neurobehavioral sequelae of fetal cocaine exposure.

PMID- 1622487
TI  - Re: Odontogenic myxoma. Report of a periodontally-located case.

PMID- 1622488
TI  - The association of antiphospholipid antibodies with pregnancies complicated by
      fetal growth restriction.

PMID- 1622489
TI  - Orbital inflammation and inflammatory bowel disease.

PMID- 1622490
TI  - Treatment of tendonitis in horses.

PMID- 1622491
TI  - Provocative test for chronic mesenteric ischemia.

PMID- 1622492
TI  - Severe endobronchial hemorrhage.

PMID- 1622493
TI  - 'Orthodontic relapse'.

PMID- 1622494
TI  - Acute infectious erythemas in children.

PMID- 1622495
TI  - Statistical aspects of research methodology.

PMID- 1622496
TI  - Report of a national workshop on screening for cancer of the cervix.

PMID- 1622497
TI  - Effects of digitalis and dobutamine.

PMID- 1622498
TI  - Effects of amrinone in patients recovering from cardiac surgery.

PMID- 1622499
TI  - Study of aortic stenosis.

PMID- 1622500
TI  - Total peripheral parenteral nutrition in pregnancy.

PMID- 1622501
TI  - New schizophrenia booklet.

PMID- 1622502
TI  - Effect of alcohol on action myoclonus in Lance-Adams syndrome and progressive
      myoclonus epilepsy.

PMID- 1622503
TI  - Confidential HIV testing.

PMID- 1622504
TI  - Cholesterol screening.

PMID- 1622505
TI  - The understandings of common health terms by doctors, nurses and patients.

PMID- 1622506
TI  - Contemporary results of carotid endarterectomy.

PMID- 1622507
TI  - Residual intrascleral and intraretinal melanoma. A concern with lamellar
      sclerouvectomy for uveal melanoma.

PMID- 1622508
TI  - Anterior uveitis and hypopyon.

PMID- 1622509
TI  - Diabetic ketoacidosis in an Addis Abeba children's hospital.
AB  - A retrospective study was carried out to determine the precipitating factors and
      clinical profiles of diabetic ketoacidosis (DKA) among 46 paediatric patients
      (mean age 9 yrs) with 52 episodes admitted to the Ethio-Swedish Children's
      Hospital (ESCH) from January 1, 1982 to December 30, 1988. Thirty (58%) episodes
      occurred in newly diagnosed diabetics and 22 (42%) episodes in known diabetics.
      The most common precipitating factors were infection (52%), omission of insulin
      (16%) and parasitic infection (12%). The mortality rate was 6%, with all fatal
      cases occurring in previously undiagnosed diabetics. Several of these episodes of
      DKA may have been prevented by prompt and effective treatment of infections and
      proper health education.

PMID- 1622510
TI  - Changes in sexual behavior and condom use associated with a risk-reduction
      program--Denver, 1988-1991.
AB  - Human immunodeficiency virus (HIV) risk-reduction programs have been developed to
      discourage homosexual/bisexual men (i.e., men who have sex with men) from
      engaging in anal and oral sexual intercourse with partners who are infected with
      HIV or whose infection status is unknown (1). The consistent and proper use of
      latex condoms with adequate lubrication may reduce the risk for HIV transmission
      during intercourse (2). To assist these men in understanding and following
      "safer" sexual behaviors, the Denver Disease Control Service conducted a
      longitudinal cohort study as part of CDC's Demonstration Projects for HIV
      Prevention and Risk Reduction. This report describes the effects of individual
      counseling sessions--including a basic introduction to the availability and
      proper use of condoms and lubricants--on short- and long-term behavior change
      among a group of homosexual/bisexual men in Denver during 1988-1991.

PMID- 1622511
TI  - Role of human fetal ependyma.
AB  - Fetal ependyma is an active secretory structure for the programming of
      developmental events, including the arrest of neuronogenesis, the guidance of
      axonal growth cones, motor neuron differentiation, and probably also the
      maintenance and transformation of radial glial cells that guide migratory
      neuroblasts. The floor plate, induced by the notochord, is the first part of the
      neuroepithelium to differentiate. It establishes polarity and growth gradients of
      the neural tube and has immunohistochemical features that differ from all other
      regions of the ependyma. The dorsal and ventral median septa, formed by floor and
      roof plate ependymal processes, prevent aberrant decussations of developing long
      tracts, but permit the passage of commissural axons. Fetal ependyma synthesizes
      several intermediate filament proteins absent from mature ependymal cells,
      although some are also expressed in undifferentiated neuroepithelial cells. Fetal
      ependyma also produces diffusible molecules, such as neural cell adhesion
      molecule, proteoglycans, nerve growth factor, and S-100 protein, all in specific
      temporal and spatial distributions. Maturation of the ependyma is not complete
      until the postnatal period. An abnormal fetal ependyma may play a primary role in
      the pathogenesis of some cerebral malformations, such as lissencephaly/pachygyria
      and holoprosencephaly.

PMID- 1622512
TI  - Nephrocalcinosis complicating medical treatment of posthemorrhagic hydrocephalus.
AB  - Furosemide and acetazolamide are often used concurrently to treat posthemorrhagic
      hydrocephalus in premature infants with intraventricular hemorrhage. Eleven
      premature infants with posthemorrhagic hydrocephalus were monitored for the
      development of hypercalciuria during treatment using urine calcium/creatinine
      (Ca/Cr) ratios (normal: less than or equal to 0.21). Seven of 11 infants (64%)
      developed hypercalciuria; 5 of those 7 infants had nephrocalcinosis on renal
      ultrasonography. Infants who developed nephrocalcinosis had urine Ca/Cr ratios of
      0.5-4.0. In all 5 infants with nephrocalcinosis, renal calculi decreased and
      urine Ca/Cr improved after drug therapy was discontinued. The combined use of
      acetazolamide and furosemide as therapy for posthemorrhagic hydrocephalus places
      premature infants at high risk for nephrocalcinosis. It is suggested that urine
      Ca/Cr be monitored closely in infants receiving these drugs and that other
      treatment modalities be considered when the urine Ca/Cr ratio exceeds 0.21.

PMID- 1622513
TI  - Developmental change in type VI collagen in human cerebral vessels.
AB  - Vascular development in the human brain was studied by immunohistochemistry using
      an anti-type VI collagen antibody. Positive vessels were evident from an early
      gestational age in the meninges, from 21 weeks gestation in the basal ganglia and
      deep white matter, and from 38 weeks gestation in the cerebral cortex and
      superficial white matter; however, type VI collagen never appeared in the
      subependymal germinal layer. The absent or scarce type VI collagen in the
      subependymal germinal layer may be one of the important factors of
      subependymal/intraventricular/periventricular hemorrhage in premature neonates.
      The earlier appearance of positive vessels in the deep white matter than in the
      cortex and superficial white matter suggests that the medullary vein develops
      earlier than the cortical and subcortical veins and arteries. These
      characteristics of the developing vascular structure may be one cause of
      perinatal brain damage.

PMID- 1622514
TI  - Utility of serial EEGs in neonates during extracorporeal membrane oxygenation.
AB  - We found electroencephalographic (EEG) studies to be useful for monitoring
      cerebral function, for confirming seizure activity, and for limited prediction of
      short-term outcome in 145 neonates who required extra-corporeal membrane
      oxygenation (ECMO) of reversible respiratory failure. The EEG tracings were
      classified as normal or as mildly, moderately, or markedly abnormal; abnormal
      recordings were further classified as focal, diffuse, or predominantly
      lateralized. A significant decrease in frequency and degree of EEG abnormalities
      was observed in recordings obtained after ECMO compared to those obtained prior
      to (P = .001) or during ECMO (P = .001). There was no significant increase in
      marked EEG abnormalities when recordings obtained before and during ECMO were
      compared (P = 0.41). Of 11 infants with electrographic seizures during ECMO, 7
      (64%) either died during their nursery courses or were developmentally
      handicapped at age 1 year which is a significantly greater adverse outcome than
      that observed in infants without EEG seizure activity (P less than .003). No
      consistently lateralized EEG abnormalities were observed during or after ECMO
      when compared to tracings obtained before cannulation of the right common carotid
      artery. There was no acute change in EEG rhythm or amplitude over the right
      cerebral hemisphere during right common carotid artery cannulation. Our
      observations support the value of serial EEG in the assessment of cerebral
      function in critically ill infants undergoing ECMO. They further suggest that, in
      this patient population, cannulation of the right common carotid artery is a safe
      procedure that does not result in lateralized abnormalities of cerebral
      electrical activity.

PMID- 1622515
TI  - Handwringing in Rett syndrome: a normal developmental stage.
AB  - Handwringing, a characteristic clinical finding in Rett syndrome, appears
      typically after the loss of hand function. Available data suggest that original
      hand function never proceeds beyond elementary grasping. Handwringing and hand
      mouthing are normal developmental stages occurring at about 14 weeks of age in
      normal infants. The distressed behavior that characterizes the clinical onset of
      the disorder often turns attention away from the underlying severe apraxia. The
      confusion is further compounded by the fact that handwringing is also an
      elementary expression of stress in normal individuals.

PMID- 1622516
TI  - Internal carotid arterial blood flow velocity in infants.
AB  - The differences in the velocity and pulsatility indexes in the internal carotid
      artery were evaluated in 62 normal controls, 42 infants with cerebral palsy, and
      22 infants with mental retardation, all within the first year of life. In the
      normal controls, the average maximal blood flow velocity (A/L), and the maximal
      end-diastolic flow velocity increased during the first year of life. Pulsatility
      index decreased significantly between the ages of newborn to 2 mos and 3-5 mos,
      and remained constant thereafter. Compared with normal controls, the average
      maximal blood flow velocity and the maximal end-diastolic flow velocity values
      were significantly reduced in infants with cerebral palsy during the first 6
      months of life, while no differences in these values were observed in infants
      with mental retardation. There were no differences in the pulsatility index
      values in the 3 subject groups throughout the first year of life. Flow velocity
      in the internal carotid artery could reflect the status of the cerebral
      circulation in infants within the first year of life.

PMID- 1622517
TI  - Etiologies and distribution of neonatal leukomalacia.
AB  - Neonatal leukomalacia was classified into 4 groups: focal (F), widespread (W),
      diffuse (D), and multicystic encephalomalacia (MCE) according to the distribution
      of ischemic necrosis in the cerebral hemisphere. The highest and lowest values of
      PaCO2, PaO2, and pH and the lowest systolic and diastolic blood pressures were
      compared among each group and controls. The lowest PaCO2 values were
      significantly lower in MCE than in the F, W, and D (F + W + D) group or controls.
      The lowest values of systolic and diastolic blood pressures in the W and F + W +
      D groups were significantly lower than in the controls; therefore, hypocarbia can
      be an etiologic factor of MCE rather than periventricular leukomalacia.
      Hypotension may be closely related to a causal factor of neonatal leukomalacia.

PMID- 1622518
TI  - Aerobic and anaerobic bacteriology of intracranial abscesses.
AB  - The bacteriologic and clinical findings of 39 pediatric patients with
      intracranial abscess are presented. Twenty-three children presented with brain
      abscess and 16 with subdural empyema. Predisposing conditions were present in all
      instances. Sinusitis was present in 25 children and 4 patients each had chronic
      otitis media, dental abscess, and congenital heart disease. The abscess was
      located in the frontal area in 14 patients, parietal in 13, and temporal in 12.
      Anaerobic organisms alone were recovered in 22 patients (56%), aerobic bacteria
      alone in 7 (18%), and mixed aerobic and anaerobic bacteria in 10 (26%) patients.
      There were 79 anaerobic isolates (2 per specimen). The predominant anaerobes were
      anaerobic Gram-positive cocci (29 isolates); Bacteroides sp. (12, including 5
      Bacteroides fragilis group), Fusobacterium sp. (14 isolates); and Prevotella sp.
      and Actinomyces sp. (6 isolates each). A total of 17 aerobic or facultative
      isolates (0.4 per specimen), including 11 Gram-positive cocci and 6 Haemophilus
      sp., were recovered. Antimicrobial therapy was administered to all patients. Nine
      patients (i.e., 6 with sinusitis and subdural empyema, 3 with sinusitis and brain
      abscess) did not respond to antimicrobial therapy and aspiration of the abscess,
      and required surgical drainage of inflamed sinuses. These findings indicate the
      major role of anaerobic organisms in the polymicrobial etiology of intracranial
      abscess in children.

PMID- 1622519
TI  - Midazolam in treatment of epileptic seizures.
AB  - Midazolam (Versed), the first water-soluble benzodiazepine, has had widespread
      acceptance as a parenteral anxiolitic agent. Its antiepileptic properties were
      studied in adult patients with good results. Midazolam was administered
      intramuscularly to 48 children, ages 4 months to 14 years, with 69 epileptic
      episodes of various types. In all but 5 epileptic episodes, seizures stopped 1-10
      min after injection. These results suggest that midazolam administered
      intramuscularly may be useful in a variety of epileptic seizures during
      childhood, specifically when attempts to introduce an intravenous line in
      convulsing children are unsuccessful.

PMID- 1622520
TI  - Neurologic complications in galactosemia.
AB  - Two siblings, a 27-year-old man and his 24-year-old sister were diagnosed with
      classic transferase deficiency galactosemia at birth and were treated with strict
      lactose restriction. Despite well-documented dietary management, both siblings
      are mentally retarded and manifest a progressive neurologic condition
      characterized by hypotonia, hyperreflexia, dysarthria, ataxia, and a postural and
      kinetic tremor. Magnetic resonance imaging revealed moderate cortical atrophy, a
      complete lack of normal myelination, and multifocal areas of increased signal in
      the periventricular white matter on T2-weighting. These patients suggest that
      even with early diagnosis and treatment, individuals with galactosemia may have
      significant neurologic morbidity with abnormalities of white matter development.
      This finding raises the possibility of biochemical heterogeneity within the
      classic transferase deficiency group, as well as the possibility of a lack of
      available galactose metabolites necessary for glycolipid synthesis causing a
      disruption of normal myelin development.

PMID- 1622521
TI  - Hyperekplexia and sudden neonatal death.
AB  - Fifteen patients with hyperekplexia were identified in 3 families; diagnostic
      clinical characteristics were defined which allowed for early recognition and
      treatment. During the first 24 hours of life, spontaneous apnea and sluggish
      feeding effort were observed. After the first 24 hours, surviving infants
      exhibited the hyperekplexic startle response to nose tapping. This startle
      response is characterized by sudden muscular rigidity, feeding-induced
      oropharyngeal incoordination, and poor air exchange often with apnea, persisting
      with repetitive nose tapping. Untreated infants experienced recurring apnea until
      1 year of age. Three of 15 patients died unexpectedly during the neonatal period.
      Patients treated with clonazepam (0.1-0.2 mg/kg/day) had no serious apneic
      episodes and startle reflexes were diminished. The pathophysiologic mechanism for
      hyperekplexia remains obscure. Electroencephalographic studies were consistently
      normal. The response to and tolerance of benzodiazepines are striking in newborns
      and infants and suggest an aberrant central nervous system reflex as the
      etiology; therefore, hyperekplexia should be considered in the evaluation of
      neonates and infants with apnea, aspiration pneumonia, episodic muscular
      rigidity, hyperexcitability, and near-miss sudden infant death syndrome. The need
      for immediate monitoring of at-risk infants, observation for signs of
      hyperekplexia, and initiation of clonazepam in these patients are emphasized.
      Hyperekplexic startle response to nose tapping should be included in the routine
      examination of all newborns.

PMID- 1622522
TI  - Benign familial neonatal convulsions: generalized epilepsy?
AB  - A 3-year-old girl is presented with benign familial neonatal convulsions. She had
      seizures during the neonatal period and at age 3 months. Seizure manifestations
      and ictal electroencephalography indicated that she had not experienced
      generalized seizures but partial seizures, although international classifications
      of epilepsy define benign familial neonatal convulsions as generalized epilepsy.

PMID- 1622523
TI  - Pubertal arrest associated with valproic acid therapy.
AB  - Valproic acid has previously been demonstrated to decrease the secretion of
      multiple pituitary hormones; however, clinical symptoms associated with decreased
      hormone secretion have not been described. A girl is reported with complex
      partial seizures who was treated with valproic acid from age 10 years, 7 months
      to 12 years, 1 month and during this time had an arrest of both growth and
      secondary sexual development. Two months after discontinuing valproic acid she
      had resumption of both pubertal growth and maturation. A prospective controlled
      study is needed to determine more precisely the effects of valproic acid on
      growth and development.

PMID- 1622524
TI  - Autosomal recessive cerebellar hypoplasia and tapeto-retinal degeneration: a new
      syndrome.
AB  - Two sisters with autosomal recessive cerebellar hypoplasia and severe
      nonprogressive retinal pigmentary disease are presented. This syndrome has been
      previously described in only 1 patient. The retinal changes may be difficult to
      discern and we suggest that all patients with congenital ataxia have a detailed
      ophthalmologic assessment, including electroretinography.

PMID- 1622525
TI  - Asymptomatic cerebral infarction in Kawasaki disease.
AB  - Meningitis, facial palsy, subdural effusion, and cerebral infarction have been
      reported to be some of the nervous system complications of Kawasaki disease which
      usually are clinically obvious. A 22-month-old boy with Kawasaki disease, who
      developed asymptomatic cerebral infarction, is reported. Hyperpyrexia persisted
      for 57 days; echocardiography and magnetic resonance imaging revealed the
      presence of aneurysms in the coronary, axillary, and internal iliac arteries.
      This study indicates that patients with Kawasaki disease may have silent cerebral
      infarction.

PMID- 1622526
TI  - Internal carotid artery occlusion associated with Mycoplasma pneumoniae
      infection.
AB  - A 12-year-old girl with serologically-proved Mycoplasma pneumoniae infection
      developed right-sided hemiparalysis 10 days after the onset of the disease.
      Cerebral infarction was documented by cranial computed tomography; cerebral
      angiography revealed left carotid artery occlusion. Cerebrospinal fluid
      examination was normal. Cerebral infarction is a rare central nervous system
      complication of M. pneumoniae infection; however, occlusion of the internal
      carotid artery near the bifurcation has never been demonstrated; therefore, this
      patient with central nervous system complication of M. pneumoniae infection is
      unique.

PMID- 1622527
TI  - Central nervous system tuberculosis.

PMID- 1622528
TI  - Greenlandization of the Greenland Health Service.

PMID- 1622529
TI  - Substance abuse among Greenlandic school children.
AB  - 1934 school children 12 to 19 years of age answered anonymously a questionnaire,
      which was sent to all towns and the larger settlements in Greenland. The
      questionnaire was administered by teachers in the classroom to all pupils in
      grades seven to eleven. The survey was conducted in November 1990. 1557 students
      were Greenlandic and 377 were Danish. There were 774 Greenlandic boys and 783
      girls. There were 208 Danish boys and 169 girls. The questionnaire had questions
      about age, sex, social background and use of substance. The substances surveyed
      for were tobacco, alcohol, hashish/marihuana and different substances for
      sniffing. 26% of the Danish boys and 45% of the Greenlandic boys were smokers
      compared to 39% of the Danish girls and 61% of the Greenlandic girls. In the 15
      19 age group about 75% were smokers. 71% of the smokers smoked more than three
      cigarettes a day. 87% of the Danish pupils and 63% of the Greenlandic had used
      alcohol. Greenlandic students had more often used beer than any other beverage,
      Danish students had wine more often than the Greenlanders. Out of the total 13%
      of the boys and 4% of the girls regularly took more than ten times 2cc of pure
      alcohol on each occasion. 6% of the Danish students and 25% of the Greenlandic
      students had tried sniffing. They mostly used lighter-gas or glue. Boys used
      sniffing more often than girls. 25% of the Greenlandic students had tried smoking
      hashish, in the age group 16-17 about 50%. Cigarette smokers more often than non
      smokers used other substances.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622530
TI  - Men who never married. A socio-medical study in northern Sweden.
AB  - In a population-based study 50 never-married men aged 40-64 years were compared
      with 503 similarly aged other men (married, co-habitant, divorced or widowed).
      The never-married had shorter education than other men, and had been unemployed
      more often. The never-married mens' emotional relationships were of lower
      quality. There was modest tendency towards higher blood pressures and higher
      serum cholesterol levels among the never-married men, but the differences did not
      reach statistical significance. In conclusion, never-married men were found to be
      worse off in terms of social support, education, employment status and health
      knowledge. Differences in health status, however, were small. It is possible that
      positive factors, not fully elucidated in this study, counterbalance the adverse
      socio-medical characteristics. Another possibility is that differences will
      become manifest at an older age which could be surveyed in a follow-up study.

PMID- 1622531
TI  - Saami and Norwegian clients' use of a treatment facility for drug and alcohol
      problems in northern Norway.
AB  - Saami people ("Lapps") and Norwegians make different use of primary health care
      services, and Larsen and Nergard (1) reported an under-representation of Saami
      clients at a treatment facility for drug and alcohol problems in Northern Norway
      in the years 1986-1988. However, Saami and Norwegian groups did not differ in
      number of days in treatment, number of treatment incidents, mean age or self
      reported years of problem drinking. Since it is believed that Saami clients are
      under-represented in Norwegian treatment facilities because of cultural
      differences, the location of treatment facilities within a Saami municipality was
      expected to increase the incidence of Saami clients. The present study
      investigated the incidence of Saami clients at Karasjok treatment facility during
      1988 and 1989, 8 and 9 years after the opening of this treatment centre. All
      clients registered at Finnmark County's treatment facility for drug and alcohol
      problems during 1988-89 were categorized as either Saami or Norwegian by their
      language preference. Unfortunately, the Saami group was still under-represented
      among clients at this treatment facility. In addition, a significant difference
      in the sex-ratio between the two groups was found, indicating that Saami women do
      not use the institution at all. Results are discussed in terms of availability of
      health services for minority groups.

PMID- 1622532
TI  - Mortality among the Baffin Inuit in the mid-80s.
AB  - This article proposes to describe mortality among the Inuit of the Baffin region
      during the 1983-1987 period and to compare it with that of Canadians as a whole.
      Mortality among the Baffin Inuit is clearly higher than that of the Canadian
      population as a whole. Life expectancy at birth is 66.6 years, approximately 10
      years lower than that for the general Canadian population (76.3 years). Injuries
      and poisoning, neoplasms, and diseases of the respiratory system are the leading
      causes of death observed among the Baffin Inuit. For each of these causes, the
      rates obtained for the Inuit are significantly higher than those for the total
      population of Canada.

PMID- 1622534
TI  - Adaptive changes of membrane lipid composition in humans living in the north.
AB  - Some parameters of red cell membrane lipid composition as well as intensiveness
      of lipid peroxidation and activity of its regulatory factors were assessed in
      northern aborigines, newcomers and alcohol abusers. It is proposed that the
      increased lipid peroxidation is responsible for the cholesterol and monoenic
      fatty acid accumulation in membranes of all groups studied. The data obtained
      make it possible to consider the lipid peroxidation as a mechanism for adaptive
      membrane lipid modification in humans.

PMID- 1622533
TI  - Primary angle-closure glaucoma and mononuclear blindness. Clinical pattern in 2
      Inuit women from Greenland.
AB  - Primary angle-closure glaucoma (PACG) occurs in various clinical forms and is a
      permanent challenge for medical personnel responsible for eye care in elderly
      persons, for medical officers in the Arctic in particular. A clinical report is
      given of two cases: one with a destructive attack of classical acute glaucoma in
      a 46 year old woman versus another with a totally symptomless, gradual monocular
      blindness in a woman, aged 56. In both patients the fellow eye showed incipient
      chamber angle synechia formation. Peripheral iridectomy has given fully normal
      fellow eye function in the first woman, now for 22 years. The other had a recent
      YAG laser iridotomy in her fellow eye. The patients are described on the
      background of PACG population studies performed in Greenland since the 1960'ies,
      including gonioscopy and extensive anterior chamber depth measurements as
      attempts of early PACG detection.

PMID- 1622535
TI  - An educational program for school nurses caring for the pediatric client with a
      tracheostomy. Training the school nurse to care for a child re-entering the
      public education system with a tracheostomy.

PMID- 1622536
TI  - Pressure ulcers and the elderly. A review of the literature, 1980-1990.

PMID- 1622537
TI  - Product notebook: a new fecal containment device. A case study describing one use
      of the Bard FCD fecal containment device.

PMID- 1622538
TI  - Evaluation and cost analysis of a pressure reduction mattress. One hospital's
      study of a pressure reduction mattress and its effectiveness.

PMID- 1622539
TI  - The power to influence politics.

PMID- 1622540
TI  - Controlling cancer pain with patient-controlled analgesia.

PMID- 1622541
TI  - Platelets and blood vessels: the adhesion event.
AB  - Circulating blood platelets attach to damaged blood vessels by specific adhesion
      molecules. In the human arterial circulation, a unique 'shear-dependent'
      mechanism governs adhesion by a single receptor-ligand (glycoprotein Ib-von
      Willebrand factor) pair. Here, Gerald Roth reviews recent data that provide
      insights into the functions of these molecules.

PMID- 1622542
TI  - Lymphocyte interactions with endothelial cells.
AB  - Adhesion of lymphocytes to endothelium is vital to lymphocyte migration into
      lymphoid tissue and into inflammatory sites. In this review, Yoji Shimizu and
      colleagues identify the molecules that mediate lymphocyte-endothelial cell
      adhesion, describe the underlying principles of lymphocyte migration, and discuss
      a model of the sequence of events that allow a lymphocyte to successfully attach
      to endothelium and migrate into the surrounding tissue.

PMID- 1622543
TI  - T-cell-targeted immunotherapy.
AB  - The pace of T-cell research is matched only by the speed with which fundamental
      advances are being developed as new therapies. This report from a recent meeting
      updates developments in a number of immunointervention strategies.

PMID- 1622544
TI  - A case for chaperones in antigen processing.
AB  - The assembly of peptide-MHC-class-II molecule complexes by antigen-presenting
      cells is far more efficient than would be predicted from studies of peptide
      binding to purified MHC class II molecules in vitro. One possible explanation for
      this discrepancy is that proteins in the antigen-presenting cell facilitate the
      assembly process. Here, Diane DeNagel and Susan Pierce present the case for
      involvement of members of the chaperone/heat shock protein 70 family in the
      intracellular assembly of processed-antigen-MHC-class-II-molecule complexes.

PMID- 1622545
TI  - The regulation and function of p21ras in T cells.
AB  - In T cells, activation of the guanine-nucleotide-binding proteins encoded by the
      p21ras proto-oncogenes is a common response to triggering of the T-cell antigen
      receptor, the adhesion molecule CD2 and the receptor for the cytokine interleukin
      2. This article by Julian Downward and colleagues describes the mechanisms of
      p21ras regulation and the potential function of p21ras in T cells, and discusses
      the evidence that multiple intracellular pathways may be involved in the coupling
      of cell surface receptors to p21ras.

PMID- 1622546
TI  - Imaging features of infiltrating renal lesions.

PMID- 1622547
TI  - CT and MR evaluation of posterior mediastinal masses.

PMID- 1622548
TI  - Ultrasound of the scrotum.
AB  - High-resolution real time ultrasound of the scrotum, including gray-scale and
      color Doppler sonography is presented. The normal anatomy of the scrotum with
      sonographic correlation is reviewed. The sonographic features of scrotal
      pathology, including congenital, neoplastic, inflammatory, and traumatic
      conditions are presented.

PMID- 1622549
TI  - Behaviourally derived estimates of excitability in striatal and medial prefrontal
      cortical self-stimulation sites.
AB  - The refractory periods of the substrate underlying brain-stimulation reward were
      investigated in three rats with moveable electrodes implanted in the rostral
      caudate-putamen and the medial prefrontal cortex. Acquisition of caudate-putamen
      self-stimulation occurred within the first session, while self-stimulation for
      medial prefrontal cortex was observed only after three sessions of caudate
      putamen stimulation. The currents required for self-stimulation ranged from 300
      to 800 microA (0.1 ms pulse duration) across animals; the maximum response rates
      averaged roughly 40 bar presses per minute for both structures. Refractory period
      estimates were obtained from ten caudate-putamen and four medial prefrontal
      cortex sites. The time course of recovery had the following profile: the curves
      began to rise at 0.65 ms and 0.95 ms for caudate-putamen and medial prefrontal
      cortex stimulation, respectively, thereafter increasing to approach an asymptote
      at 6.00 ms for the caudate-putamen and 6.25 ms for the medial prefrontal cortex.
      The mean effectiveness value corresponding to the asymptotic portion of the
      curves was 73% for the caudate-putamen and 69% for the medial prefrontal cortex.
      Like other forebrain structures, the behaviourally derived refractory periods
      underlying caudate-putamen and medial prefrontal cortex stimulation, at least at
      these particular sites, are significantly longer than those observed in most
      medial forebrain bundle areas, both beginning and ending later. One
      interpretation for the similarity in their refractory period profiles and the
      apparent facilitating effect of caudate-putamen stimulation on acquisition of
      medial prefrontal cortex self-stimulation is that these two regions form part of
      the same reward substrate.

PMID- 1622550
TI  - Hippocampal nerve growth factor levels are related to spatial learning ability in
      aged rats.
AB  - Brain nerve growth factor (NGF) was determined in two groups of aged rats: 'good'
      and 'poor' performers. The animals were selected out of a population of 40 aged
      rats (26-28 months old) trained in a spatial learning task. Animals performing
      well in the test had significantly higher NGF in the hippocampus when compared to
      'poor' performers. No differences in the levels of NGF were found in the cortex,
      septum and cerebellum. The results implicate hippocampal NGF in cognitive
      functioning of aged rats, and suggests that the forebrain cholinergic neuronal
      atrophy which has been observed in cognitively impaired aged rats may be due to
      reduced availability of target-derived NGF.

PMID- 1622551
TI  - Muscle activity during unconditioned and conditioned eye blinks in the rabbit.
AB  - EMGs were recorded from the orbicularis oculi, retractor bulbi and superior
      rectus muscles in rabbits to investigate the time course of muscle activation
      during unconditioned and conditioned eye blinks. EMGs from the three muscles
      showed two responses, with the responses of the orbicularis oculi and retractor
      bulbi showing the same latency, and the responses of the superior rectus lagging.
      The latency of responses to periorbital electrostimulation was about 5 ms, and to
      air puff stimulation about 10 ms. Results showed a tight coupling of activity
      between muscles, with cross-correlograms peaking at 0.65 to 0.85 and showing
      little time shift. Stimulus-response curves showed clear non-linearities in the
      response of the muscle to changes in stimulus strength. Local anesthesia of the
      cornea had little effect on unconditionally evoked responses. The form of
      unconditionally evoked responses was similar with periorbital electrostimulation
      and air puff stimuli but differed in latency. These results show the form of the
      eye blink reflex response and will be of importance in interpreting
      electrophysiological studies of the classically conditioned eye blink of rabbits.

PMID- 1622552
TI  - Motor activity and the mesotelencephalic dopamine function. II. Multivariate
      analysis of genetically segregating generations.
AB  - Previous experiments on genetically different inbred strains of mice demonstrated
      parallel variations between the activity of regional brain tyrosine hydroxylase
      (TH) and locomotor behavior. Based on these associations, it was hypothesized
      that genetic variations in mesotelencephalic TH activity, an index of dopamine
      neurotransmitter function, would correlate positively with exploratory and
      locomotor behavior. In order to test this hypothesis, open-field motor behaviors
      and mesencephalic and striatal TH activities were analyzed by multivariate
      statistical methods in genetically segregating (C57BL/6ByJ X BALB/cJ)F2 and
      (C57BL/6ByJ X CXBI/ByJ)F2 generations. Factor analysis, based on correlation
      matrices of variables with significant genetic dominance or additive effects,
      demonstrated that locomotor activity and frequency of occurrence of various motor
      patterns were not correlated with mesencephalic and striatal TH activity. These
      results indicate that the assumption of a positive phenotypic correlation between
      spontaneous motor activity and mesotelencephalic TH activity does not hold in
      genetically segregating populations. Strategies and problems in revealing the
      behavioral consequences of genetically based variations in the mesotelencephalic
      DA system are briefly discussed.

PMID- 1622553
TI  - New insights into behavioral evaluation of audiogenic seizures. A comparison of
      two ethological methods.
AB  - Wistar male rats were tested for susceptibility to audiogenic seizures (AS) and
      classified into sensitive (S) and resistant (R) groups by means of a severity
      index (SI). Susceptible animals were those which displayed wild running behavior
      (gyri, jumping and atonic falling) followed by generalized tonic-clonic seizures
      and consequently had an SI = 0.85 (maximum; n = 10). Resistant animals were
      considered those with no convulsive response to the acoustic stimulation having
      an SI = 0 (n = 10). Behavioral sequences of susceptible and resistant animals
      were recorded and analyzed using two ethological methods which basically
      considered behavior item frequency and statistical interactions of sequential
      patterns. Both methods include the concept of cluster analysis but do not include
      a simultaneous analysis of behavior frequency and time spent in each behavior.
      Thus, a third method is proposed to graphically display both frequency and
      temporal patterns in a more complex cluster analysis. The methods discussed here
      allow comparisons of behavioral sequences in a given experimental situation such
      as susceptible against resistant animals, acute and chronic seizures, comparison
      of pre- and postdrug effects, etc. Consequently, they may be the micro-behavioral
      substrate for correlation with contemporary molecular analysis of epileptic
      seizures.

PMID- 1622554
TI  - Locomotor development in undernourished rats.
AB  - The effects of undernutrition on the development of locomotion were studied in
      fourteen rats. Mothers received about 40% of normal quantities of standard
      laboratory food from the 5th day of gestation until weaning at the 21st day after
      birth. Qualitative as well as quantitative aspects of locomotion were studied
      from the 12th to the 30th day and compared to data from ten control rats.
      Undernutrition leads to delayed and prolonged developmental changes in
      locomotion. The adult type of locomotion, which in normal rats develops from the
      14th day occurs after the 15th or 16th day in undernourished rats and this
      development also lasts longer. Locomotion remains mildly abnormal, at least until
      the 30th day. Especially at lower speeds, walking is clumsy because of an unusual
      brisk onset, a slightly unsteady gait and non-fluent paw movements. These results
      are discussed in the perspective of data on brain and muscle development in rats
      after early undernutrition.

PMID- 1622555
TI  - Functional dissociation of acute and persistent cognitive deficits accompanying
      amygdala-kindled seizures.
AB  - The effects of amygdala-kindled seizures on cognitive function were examined
      using long-delay flavor-aversion and passive-avoidance conditioning paradigms in
      rats. Experiments were conducted to compare the functional consequences of
      unilateral and bilateral kindled seizures (transient deficits) with those due to
      a kindling history only (persistent deficits). Animals with a history of
      unilateral or bilateral kindling demonstrated flavor-aversion conditioning that
      varied inversely with the delay separating saccharin (CS) and lithium (US).
      Unilateral stimulation during the CS-US interval produced an attenuation of
      flavor-aversion conditioning that was independent of delay value; bilateral
      stimulation eliminated conditioning all together. The effects of kindling and
      kindled seizures on passive-avoidance conditioning were functionally identical.
      Animals with a history of unilateral kindling demonstrated strong evidence of
      conditioning with no effect of posttraining seizures. In contrast, animals with a
      history of bilateral kindling were impaired in a passive-avoidance task. The
      impairment was evident in the presence or absence of seizure induction during
      training. Electrographic and behavioral indices of epileptiform activity produced
      by unilateral and bilateral stimulation failed to reveal any differences in
      seizure duration or severity. The results support the conclusion that cognitive
      disruption by amygdala-kindled seizures is task-dependent, does not show a
      temporal dependence, and cannot be explained on the basis of electrographic or
      behavioral measures of seizure severity alone.

PMID- 1622556
TI  - Behavioural strategies, sensorial processes and hippocampal mossy fibre
      distribution in radial maze performance in mice.
AB  - Eight isogenic mice groups (6 inbred strains and 2 F1 hybrid generations) were
      tested on an eight-arm radial maze, using either a procedure of confinement (C)
      or a non-confinement (NC) to the central platform between trials, in order to
      control for the use of response strategies in learning. On the 6th day of
      training, the spatial surrounding was impoverished by removing the most salient
      visual cues of the room; thus allowing testing for the effective use of spatial
      cues during learning. Results showed that learning profiles and performance
      levels varied between strains within each procedure. These variations could
      correspond to a heterogeneity of the underlying perceptual processes involved in
      learning, since only some strains in each procedure were disturbed by the removal
      of spatial cues. Correlations between behavioural results and the distribution of
      mossy fibres in the hippocampus were analysed. The intercorrelation matrix
      revealed that correlations between the size of the infra-intrapyramidal synaptic
      field (IIP-MF) and some behavioural indices occurred only during the first trial
      on the maze, whatever the procedure. Learning performances on the 5th day of
      training did not correlate with any hippocampal measure. When the spatial
      surrounding was impoverished, on the 6th day of training, correlations with mossy
      fibres appeared only in the confinement procedure.

PMID- 1622557
TI  - Vestibular-neck interaction of human ocular counterroll.
AB  - Compensatory rolling of the eye about the line of sight (ocular counterroll, OCR)
      was studied in four normal human subjects during 10 min of lateral tilt (20
      degrees to the left/right) of body, head and trunk. OCR was objectively measured
      at 1-min intervals by determining the rotation of a circular sample of iris
      pattern using a videocamera and digital image processing. Body and head tilt
      caused symmetrical OCR (range 2.4 to 9.5 degrees) to either side, whereas trunk
      tilt induced no significant change in torsional eye position. No adaptation in
      OCR was found during the time spent in tilted orientation in neither paradigm
      though unsystematic torsional fluctuation was a regular finding in all subjects.
      These findings are taken as evidence that only the non-adapting otolith system,
      as opposed to the proprioceptive system of the neck, contributes to the
      generation and maintenance of OCR.

PMID- 1622558
TI  - Hemispheric specialization for the control of copulation in the young chick and
      effects of 5 alpha-dihydrotestosterone and 17 beta-oestradiol.
AB  - After intramuscular treatment with either oestradiol (1 mg/day for 4 days) or 5
      alpha-dihydrotestosterone (0.5 mg/day for 7 days) the copulatory behaviour of
      young male chicks was tested monocularly using removable eye-patches. From day 11
      to 14 copulation scores were significantly elevated in chicks treated with
      oestradiol or 5 alpha-dihydrotestosterone (5 alpha-DHT) and tested either
      binocularly or monocularly using the left eye. There was no elevation of
      copulation when the treated chicks were tested monocularly using the right eye.
      Thus, in the binocular condition neural circuits receiving input from the left
      eye, and therefore likely to be on the right side of the brain, are specialized
      for the activation of copulation. This result confirms previous findings using
      chicks treated with testosterone. On day 14 the eye-patches were changed to the
      other eye. For chicks treated with oestradiol, those now tested using the left
      eye showed significantly higher levels of copulation than those now using the
      right. In other words, there was very little interocular transfer from left eye
      to right eye. However, after transferring the eye patches, the chicks treated
      with 5 alpha-DHT had high copulation scores irrespective of the eye used. This
      suggests that there may be an interaction between prior copulatory experience and
      5 alpha-DHT levels which leads to either interocular transfer of copulation
      behaviour or equal access of both eyes to the brain regions which control
      copulation.

PMID- 1622559
TI  - C-fos protooncogene expression in rat brain after long-term training of two-way
      active avoidance reaction.
AB  - C-fos nuclear protooncogene encodes a regulatory protein (Fos), able to directly
      influence both expression of itself and other genes. It has been repeatedly shown
      that c-fos expression coincides with different forms of cell activation, probably
      being functionally involved in the coupling of extracellular ligands to long-term
      cellular responses. In this study it has been found that c-fos mRNA accumulation
      in rat brain, as measured by northern blotting coincides with increase of
      performance level of learned behavior of a two-way active avoidance task. We have
      previously reported (Nikolaev et al., Brain Res. Bull., in press) that a single
      training session of two-way active avoidance strongly induces c-fos mRNA
      accumulation but that after long-term training up to the asymptotic level of
      performance no c-fos expression was detectable. In this paper we show that c-fos
      still remains inducible even after long-term, asymptotic training to darkness as
      conditioned stimulus (CS), provided that a novel stimulus, wide band noise, which
      elevated performance level, was given together with darkness as compound CS.

PMID- 1622560
TI  - Behavioral factors in stress-induced immunomodulation.
AB  - Individual differences in the exploratory response to novelty were found to be
      related with the vulnerability to develop stress-induced immunological
      alterations. We studied the effect of exposure to inescapable shock on antibody
      formation against sheep red blood cells (SRBC) in rats selected according to
      their locomotor activity in a novel situation. Interestingly, antibody titers
      were only enhanced in shocked animals with the highest locomotor activity. These
      results emphasize the importance of taking into account individual differences
      for the study of the mechanisms involved in stress-induced immunomodulation,
      suggesting a behavioral procedure (novelty reactions) to deal with individual
      variability in the effects of stress on the immune system.

PMID- 1622561
TI  - The role of ozone in tracheal cell transformation.
AB  - This project examined the potential role of ozone as a respiratory carcinogen by
      characterizing its ability to induce or modulate the preneoplastic transformation
      of rat tracheal epithelial cells. The chemical reactivity of ozone and the types
      of damage it can cause suggest that it may have a role in environmental
      carcinogenesis. Previous reports have described an increase in the incidence and
      number of lung tumors per animal in strain A mice exposed to ozone. However, the
      role of ozone in the development of the tumors has not been clear. Ozone also has
      been reported to act alone and synergistically with ionizing radiation to induce
      changes related to neoplasia in primary hamster embryo cells and in the mouse
      C3H/10T1/2 cell line in culture. Few other studies have examined the direct
      cytotoxic or transforming effects of ozone after in vivo or in vitro exposure of
      cells, and no studies have been reported on the comparative effects of ozone on
      respiratory cells exposed in vivo or in vitro. The induction of early
      preneoplastic changes in populations of rat tracheal epithelial cells by
      carcinogens can be detected and quantified in vitro after exposures in vivo or in
      vitro of tracheal epithelial cells. This cell culture and transformation system
      was used to characterize the transforming potency of ozone. Tracheal epithelial
      cells were isolated from Fischer-344/N rats that had been exposed for six hours
      per day, five days per week for one, two, or four weeks to 0, 0.12, 0.5, or 1.0
      parts per million (ppm)* ozone (sea-level equivalents). Cell populations were
      examined in culture for increases in the frequency of preneoplastic variants.
      Rats exposed to ozone did not exhibit an increase in the frequency of
      preneoplastic tracheal cells, although exposed tracheas did exhibit dose
      dependent morphological changes. Rat tracheal epithelial cells were given single,
      40-minute in vitro exposures to concentrations of ozone that did not result in
      any detectable decrease in colony-forming efficiency (approximately 0.7 ppm) and
      to concentrations that resulted in approximately a 40% decrease (approximately 10
      ppm). Exposed cultures were examined for increases in the frequency of
      preneoplastic variants. The results of these experiments, like those for the in
      vivo experiments described above, suggest that a single ozone exposure does not
      induce preneoplastic variants of rat tracheal epithelial cells. In contrast,
      cultures of rat tracheal cells exposed to 0.7 ppm ozone twice weekly for about
      five weeks exhibited approximately a twofold increase in the frequency of
      preneoplastic variants compared with control cultures.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1622562
TI  - Basics of instrument sterilization.

PMID- 1622563
TI  - Disinfection in the dental office.

PMID- 1622564
TI  - Perilous root canals.

PMID- 1622565
TI  - Associateships: is there an end in sight. 2.

PMID- 1622566
TI  - Aseptic techniques for dental radiology.

PMID- 1622567
TI  - Dentists nationwide are finding a new way to help tobacco chewers practice safe
      snuff.

PMID- 1622568
TI  - An overview of dental office infection control.

PMID- 1622569
TI  - The W-5 dilemma of medical waste in the dental office: Who, What, When, Where and
      Why?

PMID- 1622570
TI  - Curved root canals: treating the most common endodontic complexity.

PMID- 1622571
TI  - Immediate-load implant quickens integration.

PMID- 1622572
TI  - Single tooth implants: difficult, yet overused.

PMID- 1622573
TI  - Enamel microabrasion in conjunction with carbamide peroxide bleaching.

PMID- 1622574
TI  - Patient-centered practices.

PMID- 1622575
TI  - Non productive staff meetings. The beginning of the end.

PMID- 1622576
TI  - Mandatory sterilization. Washington State forces dentists to autoclave handpieces
      after every use.

PMID- 1622577
TI  - High-copper casting alloys stir debate.

PMID- 1622578
TI  - Troubleshooting problem bonding cases.

PMID- 1622579
TI  - Power bleaching attempts to make a comeback.

PMID- 1622580
TI  - All-porcelain bonded restorations.

PMID- 1622581
TI  - An aesthetic alternative to crown and bridge.

PMID- 1622582
TI  - Aesthetics and function meet to "bridge" a molar gap.

PMID- 1622583
TI  - Snoring and obstructive sleep apnea.

PMID- 1622585
TI  - Guided tissue regeneration.

PMID- 1622584
TI  - Advancements usher in new era of periodontal care.

PMID- 1622586
TI  - Using the laser for implant maintenance.

PMID- 1622587
TI  - Choosing an ideal practice model.

PMID- 1622588
TI  - The team approach to cosmetic dentistry.

PMID- 1622590
TI  - Fear and AIDS: a deadly duo.

PMID- 1622589
TI  - Patient newsletters: why do they work for some practices and not for others.

PMID- 1622591
TI  - Custom mouthguards increase may increase player strength.

PMID- 1622592
TI  - The Wolfe nerve block: a modified high mandibular nerve block.

PMID- 1622593
TI  - The perfect material. The restorative maturation of resin inlays and onlays.

PMID- 1622594
TI  - Thermoplastic impression and temporary matrix materials.

PMID- 1622595
TI  - Eliminating sensitive composites.

PMID- 1622596
TI  - The keys to successful endodontics.

PMID- 1622598
TI  - Salaries--what is the normal limit?

PMID- 1622597
TI  - Pain control: dentistry's everyday challenge.

PMID- 1622599
TI  - Advances in the use of in vivo sensors.

PMID- 1622600
TI  - Biosensors based on the energy metabolism of living cells: the physical chemistry
      and cell biology of extracellular acidification.
AB  - The silicon microphysiometer is a biosensor-based instrument that detects changes
      in the physiological state of cultured living cells by monitoring the rate at
      which the cells excrete acidic products of metabolism. This paper discusses the
      chemical and biological factors that determine the performance and applications
      of such a system. Under typical culture conditions, extracellular acidification
      is dominated by the excretion of lactic and carbonic acids formed during the
      energy metabolism, using glucose and glutamine as carbon sources. The maintenance
      of transmembrane ionic gradients is an important use of energy, as is cell
      growth. The activation of cellular receptors usually causes transient or
      sustained increases in acidification rate. The energetic cost of generating
      second messengers is probably too small to account for either change, so events
      more distal to the receptor-activation process must be responsible. The opening
      of ion channels may cause the increases in some cases. In others, changes in
      intracellular pH and loose coupling between ATP hydrolysis and synthesis may be
      involved; models for these processes are presented.

PMID- 1622602
TI  - Covalent immobilization of avidin on glassy carbon electrodes as the basis for
      multivalent biosensors.
AB  - One of the most crucial steps for the successful construction of a biosensor is
      the appropriate and reproducible coupling of the biological part (e.g. enzyme,
      antibody) to the inorganic moiety of the device (e.g. electrode, microchip). In
      this paper three methods of immobilization of avidin to a glassy carbon electrode
      are described. Depending on the type of immobilization, avidin may lose its
      biological activity as determined by an enzyme immunoassay, using biotinylated
      reagents. If avidin is covalently bound to the glassy carbon electrode via the
      bridge molecule 4.4'-diaminodiphenylamine, the biological activity is retained.
      About 1.5 pmol of avidin can be bound to the electrode (3 mm in diameter),
      resulting in a nearly complete monolayer of protein.

PMID- 1622601
TI  - A novel microbial sensor using luminous bacteria.
AB  - A novel microbial sensor system that uses luminous bacteria was developed for the
      determination of both glucose and toxic compounds. The sensor system consisted of
      a membrane with luminous bacteria immobilized upon it and a photomultiplier.
      Measurements were based on the in vivo intensity of the light emitted by the
      bacteria, as this is affected by their environment. A linear relationship was
      observed between increased luminescence and concentrations of glucose between
      0.05 mM and 0.55 mM. The relative standard deviation was 10% for 0.55 mM glucose
      (n = 10). Toxic compounds such as benzalkonium chloride, sodium dodecyl sulphate
      and chromium(VI) were also detected by measuring the decrease in luminescence in
      their presence.

PMID- 1622603
TI  - The electrical conductivity of phospholipid films as an iodine-sensing mechanism.
AB  - The d.c. electrical conductivity of dry phospholipid films is increased by some 8
      11 orders of magnitude by the adsorption of iodine vapor. The conductivity of
      these films has been found to increase as a function of iodine 'vapor pressure'
      and the quantitative relationship between electrical conductivity and the
      adsorbed iodine has been determined. Films composed of phospholipids with
      unsaturated hydrocarbon chains are some three orders of magnitude more
      electrically conductive than are films of phospholipids containing saturated
      hydrocarbon chains. Optical spectroscopic measurements show the development of
      absorption bands centered near 294 nm and 365 nm, upon iodine adsorption. These
      bands are much more intense for unsaturated phospholipids than for saturated
      ones. X-ray diffraction studies show that exposure to iodine decreases the
      thickness of phospholipid bilayers containing unsaturated hydrocarbon chains but
      does not change the thickness of bilayers containing only saturated chains. The
      electrical response of the lipid films, upon exposure to iodine, suggests their
      possible use as iodine sensors.

PMID- 1622604
TI  - A new approach to the construction of potentiometric immunosensors.
AB  - An electrochemical immunosensor based on a new detection principle was developed.
      Laccase, which is able to catalyse the electroreduction of oxygen via the direct
      (mediatorless) mechanism was used as an enzyme label. The new detection method
      does not require the presence of an electrochemically active mediator, and the
      reaction substrates are atmospheric oxygen and electrons, the latter being taken
      by the active site of the enzyme label directly from the electrode. The formation
      of the complex between laccase-labelled antibody and antigen on the electrode
      surface resulted in a considerable (more than 300 mV) shift of the electrode
      potential. The rate of the increase of the electrode potential was inversely
      proportional to the concentration of the free antigen in the sample. The non
      specific adsorption of conjugate and other proteins on the electrode could be
      eliminated by using a polyethylenimine-based polymer on the electrode surface.
      Insulin was used as a model analyte. The sensitivity limit for this antigen was
      approximately 3 micrograms ml-1.

PMID- 1622605
TI  - Ellipsometric immunosensors for the determination of gamma-interferon and human
      serum albumin.
AB  - Ellipsometric immunosensors for gamma-interferon (gamma-INF) and human serum
      albumin (HSA) have been developed using gamma-INF and HSA covalently immobilized
      onto silicon plates. Detection is achieved by measuring the adsorption decrease
      (gamma, mg m-2) of monoclonal immunoglobulin G against gamma-INF or
      immunoglobulin fraction of rabbit blood serum against HSA when the concentration
      of antigen in mixtures of antibody-antigen is increased. The time of analysis is
      50 min, the detection limit of gamma-INF is 15 nM (sensitivity -0.01 mg m-2 nM-1)
      and of HSA 2.5 nM (-0.06 mg m-2 nM-1).

PMID- 1622606
TI  - In-vitro binary release kinetics of sulphamethoxazole and trimethoprim
      microcapsules.
AB  - Sulphamethoxazole and trimethoprim are separately microencapsulated with
      polyacrylic resin: Eudragit RS 100. The data so obtained from the drug release
      have been analyzed according to the different existing kinetic models (1) Zero
      order (2) First order and (3) Higuchi Matrix Kinetics. It is observed that in
      both the cases of single component and binary release of sulphamethoxazole (SMZ)
      and trimethoprim (TMP), Higuchi mechanism predominates. Lastly, a comparative
      study is made between The Single and Binary release kinetics to correlate the
      diffusivity rate constant (KBL) and diffusion Coefficient (Da) which have been
      estimated according to Baker-Lonsdale method at pH 1.2.

PMID- 1622607
TI  - Validation of a HPLC method for the determination of bendazac and its main
      metabolite 5-hydroxybendazac in human plasma.
AB  - The purpose of this study was to validate an analytical method for the
      determination of bendazac and its main metabolite 5-hydroxybendazac in human
      plasma. The results obtained indicate that the method is reproducible, accurate,
      precise, sensitive and specific for the measurement of bendazac and 5
      hydroxybendazac in the human plasma. Therefore it can be considered suitable for
      experimental purposes, routine application for drug monitoring and regulatory
      requirements.

PMID- 1622608
TI  - [Photostability of drugs].

PMID- 1622609
TI  - [Transgenic animal systems in the expression of recombinant proteins of
      pharmaceutical interest].

PMID- 1622610
TI  - Mechanism of physiologic and pathologic S3 gallop sounds.
AB  - Although the S3 gallop sound has long been used clinically as an indicator of
      left ventricular systolic dysfunction, the mechanism responsible for its
      production remains controversial. The same sound is often found in young healthy
      individuals, and whether a similar mechanism is responsible is also unknown. The
      relationship of the S3 gallop sound to the dynamics of left ventricular filling
      was compared in 18 healthy young triathletes and 15 older subjects with cardiac
      disease. Twenty healthy normal subjects without an S3 were included as controls.
      Phonocardiographic, two-dimensional echocardiographic, and Doppler
      echocardiographic analysis of left ventricular inflow were evaluated. The S3 in
      both groups always occurred close to peak early filling velocity (E), during
      early flow deceleration. Mean E deceleration rate was higher in the subjects with
      S3 (726 +/- 153 cm/sec2 in the triathletes and 819 +/- 274 cm/sec2 in those with
      cardiac disease) than in control subjects (563 +/- 131 cm/sec2, p less than 0.001
      in both cases). Ten triathletes underwent examination both before and immediately
      after 30 degrees head-up tilt. E deceleration rate dropped significantly with
      head-up tilt (720 +/- 137 vs 590 +/- 174 cm/sec2, p less than 0.01), while
      concurrently the S3 disappeared or was diminished in amplitude. Similar changes
      were seen in subjects with cardiac disease. We conclude that both the
      "pathologic" and "physiologic" S3 are related to abnormally rapid deceleration of
      early diastolic left ventricular inflow. Although the presence of the S3 is not
      dependent on the state of left ventricular systolic function, diastolic filling
      is characterized by a predominance of early inflow with a rapid flow deceleration
      rate.

PMID- 1622611
TI  - Doppler-derived aortic flow measurements during and after heavy isometric
      exercise in healthy men versus men with myocardial infarction.
AB  - Doppler echocardiography is a useful noninvasive determination of left
      ventricular function during dynamic exercise. Scarce data are available for the
      use of this technique during heavy isometric exercise. Therefore, Doppler-derived
      aortic flow indexes were assessed during and after 50% maximal upper-body
      isometric exercise in 25 healthy men (aged 47 +/- 6 years) and compared with
      those of 22 men (aged 48 +/- 9 years) who had suffered myocardial infarction. The
      heart rate increased (p = 0.01) in each of the groups from a mean of 68 +/- 12 at
      rest to 84 +/- 11 during isometric exercise. At rest, systolic blood pressure was
      higher (p = 0.05) in the patients with coronary artery disease. During exercise,
      the patients with cardiac disease, compared with the healthy volunteers,
      demonstrated a lesser reduction in flow velocity integral, stroke volume, and
      cardiac indexes (p = 0.001). Immediately on recovery, the patients with cardiac
      disease, compared with the healthy group, showed significantly greater (p =
      0.001) increase in stroke volume and cardiac indexes. At 3 minute's recovery, the
      stroke volume index continued to increase in the patients with cardiac disease,
      while the healthy group showed a decrease to below its resting value. Although
      50% of maximal upper-body isometric exercise caused similar heart rate and
      systolic blood pressure responses in healthy patients and patients with cardiac
      disease, there were significant group differences in Doppler-derived left
      ventricular systolic function indexes, which were greatest on immediate and 3
      minute's recovery. The results suggest that this novel isometric test may be
      useful in clinical testing.

PMID- 1622612
TI  - Exercise Doppler echocardiography as an aid to clinical decision making in mitral
      valve disease.
AB  - The timing of valve replacement in patients with mitral valve disease, severe
      resting pulmonary hypertension, and severe symptoms is usually straightforward.
      However, this may not be true for patients with mild to moderate resting
      pulmonary pressures and symptoms that are difficult to evaluate. The measurement
      of hemodynamic parameters with exercise has been useful during cardiac
      catheterization. The purpose of this study was to evaluate the hemodynamic
      significance of dyspnea provoked by exercise in patients with mitral valve
      disease using exercise Doppler echocardiography. Nineteen tests were done in 17
      patients (two patients had repeat studies 1 year after the first test). Dyspnea
      developed in patients during exercise in 11 tests, and the others were limited by
      fatigue (and angina in one patient). There was a significantly greater increment
      in pulmonary artery systolic pressure during exercise in the patients who
      developed dyspnea (24 mm Hg) than in those who did not (15 mm Hg, p = 0.04). The
      two groups exercised to approximately the same heart rate and blood pressure, but
      the dyspneic patients had a significantly shorter exercise capacity (p = 0.04).
      Furthermore, clinical decision making was affected by the test results in 84%
      (only three tests did not affect patient management) and included a decision to
      proceed to invasive testing and surgery in seven patients, and a decision to
      treat the patient medically in nine. In conclusion, exercise Doppler
      echocardiography is a useful adjunct in the diagnosis and treatment of patients
      with mitral valve disease and an aid to clinical decision making.

PMID- 1622613
TI  - Diagnosis of coronary artery disease using exercise echocardiography and positron
      emission tomography: comparison and analysis of discrepant results.
AB  - Both exercise echocardiography and rubidium-82 positron emission tomography are
      used in the detection and characterization of coronary artery disease. This study
      compared results of both in 74 patients with known coronary anatomy, by use of
      exercise echocardiography before and after treadmill exercise and positron
      emission tomography with intravenous dipyridamole-handgrip stress. Significant
      (greater than 50%) coronary stenoses were present in 70 patients; exercise
      echocardiography and positron emission tomography each identified 63 patients
      (sensitivity 90%). Significant stenoses without previous myocardial infarction
      were present in 34 patients; 29 (85%) were identified by exercise
      echocardiography and 28 by positron emission tomography (82%, p = NS). Four
      patients had no significant coronary disease, and were all identified as normal
      by both methods. Segments were classified as either normal or showing stress or
      resting abnormalities, and the diagnoses were compared in the territories of the
      three major coronary arteries. Results were concordant with respect to the
      presence or absence of coronary disease in 185 of 222 territories (83%). The
      remaining 37 regions had abnormalities by exercise echocardiography or positron
      emission tomography but not both. Stress defects were identified by only one of
      the tests in 24 areas (in 12 [50%], angiographic findings correlated with
      positron emission tomography). Resting defects were diagnosed by only one
      modality in 13 regions (angiographic findings correlated with the results of
      positron emission tomography in 9 [69%] of these). Both exercise echocardiography
      and positron emission tomography are sensitive for the identification of coronary
      artery disease, although on a regional basis, positron emission tomography
      appears to be more specific for the diagnosis of resting perfusion defects.

PMID- 1622614
TI  - Value of pulmonary venous flow characteristics in the assessment of severity of
      native mitral valve regurgitation: an angiographic correlated study.
AB  - To evaluate the relation between left ventricular angiography and pulmonary
      venous flow velocity in native mitral valve regurgitation, 28 patients with sinus
      rhythm and valvular and/or coronary artery disease underwent transesophageal
      echocardiography within 24 hours after cardiac catheterization. Group I consisted
      of 17 patients, seven patients without (grade 0) and 10 patients with
      angiographically mild to moderate mitral regurgitation (grades 1 and 2). Group II
      consisted of 11 patients with angiographically severe mitral regurgitation
      (grades 3 and 4). Mitral regurgitation by transesophageal echocardiography was
      evaluated by measuring the regurgitant jet sizes and color-guided pulsed Doppler
      pulmonary venous flow velocities. Multivariate analysis revealed that the most
      powerful predictor (p less than 0.001) of angiographically severe (grades 3 and
      4) mitral regurgitation was reversed systolic flow into the left upper pulmonary
      vein (sensitivity 82%, specificity 100%, positive predictive value 100%). If this
      variable was excluded from analysis, jet area and jet length (p less than 0.001)
      were the next best predictors for angiographically severe mitral regurgitation.
      Mean values of systolic peak pulmonary venous flow velocities were significantly
      lower in patients from group II, 13.0 +/- 11.1 cm/s versus 43.4 +/- 20.6 cm/s
      (group I) with p less than 0.005. This finding was also true for systolic time
      velocity integral, 1.3 +/- 1.3 cm (group II) versus 7.8 +/- 5.3 cm (group I) with
      p less than 0.005.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622615
TI  - Attachment of a balloon to a transesophageal echocardiographic transducer for
      improvement of contact with the esophageal wall.
AB  - We attached a water-inflated balloon to a transesophageal probe to improve
      contact of the transducer with the esophageal wall and used it in 26 patients
      with congenital heart disease. Balloons for this study were made for use in
      hemostatic therapy for esophageal varix. The contact of the transducer with the
      esophageal wall was successfully improved in all the patients, which resulted in
      improvement of the signal-to-noise ratio in both two-dimensional and Doppler
      echocardiography. The appropriate filling volume of water was within 5 ml to
      avoid compression of the left pulmonary vein and to avoid the artifact of
      multiple reflection.

PMID- 1622616
TI  - Cardiovascular changes in pregnancy evaluated by two-dimensional and Doppler
      echocardiography.
AB  - During pregnancy significant cardiovascular changes occur. To study these
      anatomic and physiologic changes we performed two-dimensional and Doppler
      echocardiography in 28 women during the third trimester (34.4 +/- 1.9 weeks) of
      pregnancy and then again after delivery (7.8 +/- 2.2 weeks). Fourteen nonpregnant
      age- and sex-matched subjects served as controls. Left ventricular diastolic and
      systolic dimensions were similar among pregnant, postpartum, and control
      subjects. Left atrial area as determined by two-dimensional echocardiography was
      significantly larger during pregnancy (16.7 +/- 4.0 cm2) compared with
      measurements postpartum (13.8 +/- 3.1 cm2) and with controls (15.5 +/- 3.5 cm2)
      (p less than 0.01). Doppler study showed that the ratio of early diastolic flow
      velocity to late diastolic flow velocity (E/A max) and E/A integral were lower
      among pregnant subjects (1.3 +/- 0.3, 2.0 +/- 0.5) compared with postpartum
      subjects (1.6 +/- 0.4, 2.5 +/- 1.5) and controls (1.9 +/- 0.5, 3.0 +/- 0.8) (p
      less than 0.05). Heart rate was higher among pregnant subjects (84 +/- 10
      beats/min) compared with postpartum subjects (70 +/- 16) and controls (69 +/- 13)
      (p less than 0.05). In summary, in pregnant subjects during late third trimester
      left ventricular chamber dimensions were similar to these postpartum measurements
      in control subjects; however, the left atrium is dilated during pregnancy.
      Although there are significant alterations in Doppler-derived left ventricular
      diastolic parameters during the third trimester, increased heart rate and a
      dilated left atrium may explain these findings.

PMID- 1622617
TI  - Patent foramen ovale: a nonfunctional embryological remnant or a potential cause
      of significant pathology?
AB  - A patent foramen ovale (PFO) is an embryological remnant found in 27% of adults.
      It is a potential right-to-left intracardiac shunt. Shunting may be the result of
      reversal in the interatrial pressure gradient or abnormal streaming of blood in
      the right atrium. The pathologic consequences of right-to-left shunting include
      hypoxemia and paradoxical embolism. PFO may exacerbate preexisting hypoxemia or
      be its primary cause. Paradoxical embolism through a PFO is well documented. Its
      role in cryptogenic stroke remains controversial. A PFO may be detected by both
      invasive and noninvasive techniques. Contrast transesophageal echocardiography
      with provocative maneuvers is the diagnostic method of choice allowing
      visualization of the shunt. Patients with cryptogenic stroke should be screened
      for a PFO. If detected, noninvasive studies for deep vein thrombosis are
      recommended. Treatment must be tailored to the presentation. Surgical or
      transcatheter closure is recommended for hypoxemia. Prevention of venous embolism
      (air or thrombus) with or without closure of the PFO is recommended for
      paradoxical embolism.

PMID- 1622618
TI  - Embolization of a left atrial ball thrombus during transesophageal
      echocardiography.
AB  - We report a case of systemic embolization of a left atrial ball thrombus during
      transesophageal echocardiography (TEE). A 49-year-old man with rheumatic mitral
      stenosis and atrial fibrillation underwent TEE to evaluate a transient cerebral
      ischemic attack. TEE demonstrated a free-floating left atrial thrombus.
      Disappearance of the thrombus during the study occurred after tachycardia and was
      associated with acute hemiplegic stroke and an absent radial pulse. The possible
      mechanism of embolization and the implications for the selection and management
      of patients undergoing TEE are discussed.

PMID- 1622619
TI  - Free vortex ring formation in the left atrium originating in the left auricle.
AB  - An 80-year-old woman was evaluated by transesophageal echocardiography after
      coronary artery bypass surgery and subsequent cardioembolic stroke. In addition
      to spontaneous echo contrast demonstrating a counterclockwise rotating blood flow
      pattern, we observed free vortex ring formation in the left atrium, originating
      in the left auricle. To our knowledge, this is the first reported case of
      abnormal free vortex ring type flow pattern in the left atrium.

PMID- 1622620
TI  - Coronary artery fistula: diagnosis by biplane transesophageal echocardiography.
AB  - A 56-year-old man underwent coronary angiography during evaluation of severe
      mitral regurgitation. A right coronary artery fistula was incidentally discovered
      but its site of termination was uncertain. Transthoracic echocardiography also
      did not reveal the location of its drainage. The correct diagnosis of a right
      coronary artery to left atrial fistula was made using biplane transesophageal
      echocardiography. This case demonstrates the utility of biplane transesophageal
      echocardiography in the diagnosis of the origin and termination of congenital
      coronary artery anomalies.

PMID- 1622621
TI  - Cardiac assessment in Turner's syndrome: a case for the inclusion of coronary
      angiography.
AB  - This case reveals a 25-year-old woman presenting with a supraventricular
      tachycardia who was found to have Turner's syndrome. Color flow Doppler
      echocardiography revealed diastolic jets, which cardiac arteriography confirmed
      as coronary artery-pulmonary artery fistulas.

PMID- 1622622
TI  - Prophylaxis or no prophylaxis before transesophageal echocardiography?

PMID- 1622624
TI  - Extraordinary spring meeting of the Spanish Society of Neurology and the 1st
      joint meeting of the Spanish Society of Neurology and the Neurological Section of
      the Austrian Society of Neurologists and Psychiatrists. Platja d'Aro, 3-6 June
      1992.

PMID- 1622623
TI  - Critical appraisal of transesophageal echocardiography: limitations, pitfalls,
      and complications.
AB  - Because transesophageal echocardiography is invasive, it has the potential for
      serious complications. Limitations occur because of the restricted transducer
      mobility within transducers for special situations. Pitfalls (potential erroneous
      diagnoses resulting from misinterpretation of normal and abnormal anatomy) are
      prevalent with this new technology. This report critically reviews
      transesophageal echocardiography and discusses and illustrates commonly
      encountered limitations, pitfalls, and complications.

PMID- 1622625
TI  - The biology of breast tumor progression. Acquisition of hormone independence and
      resistance to cytotoxic drugs.
AB  - Many breast tumors appear to follow a predictable clinical pattern, being
      initially responsive to endocrine therapy and to cytotoxic chemotherapy but
      ultimately exhibiting a phenotype resistant to both modalities. Using the MCF-7
      human breast cancer cell line as an example of an 'early' phenotype (estrogen and
      progesterone receptor positive, steroid responsive, low metastatic potential), we
      have isolated and characterized a series of hormone-independent but hormone
      responsive variants (MIII and MCF7/LCC1). However, these variants remain
      responsive to both antiestrogens and cytotoxic drugs (methotrexate and
      colchicine). MIII and MCF7/LCC1 cells appear to mimic some of the critical
      aspects of the early progression to a more aggressive phenotype. An examination
      of the phenotype of these cells suggests that some hormone-independent breast
      cancer cells are derived from hormone-dependent parental cells. The development
      of a hormone-independent phenotype can arise independently of acquisition of a
      cytotoxic drug resistant phenotype.

PMID- 1622626
TI  - Biological and clinical significance of cathepsin D in breast cancer.
AB  - Cathepsin D, an aspartyl protease of lysosomes, is overproduced and hypersecreted
      by breast cancer cells. The prognostic value of its immunoassay in breast cancer
      cytosol is reviewed from the first retrospective clinical studies available,
      which show a strong correlation between high concentrations of cathepsin D in the
      cytosol of primary tumor and further occurrence of metastasis. This new
      prognostic factor is induced by estrogen in hormone dependent breast cancer but
      expressed at a high level in hormone independent breast cancer and appears to be
      independent of other more classical factors. Its value in node negative patients
      varies according to the studies. In nude mice, transfection of cathepsin D cDNA
      into tumor cells increases their metastatic potential, suggesting that
      overexpression of this protease may be one of the factors responsible for
      metastasis in human breast cancer. The mechanism by which this protease might
      facilitate metastasis in vivo is still unknown, even though cathepsin D has the
      potential to initiate a proteolytic cascade, to degrade extracellular matrix and
      to liberate FGFs like growth factors from the matrix. These studies should
      stimulate the search for new therapeutical agents in order to inhibit cathepsin D
      action.

PMID- 1622627
TI  - Effect of estrogen and antiestrogens on cell proliferation and synthesis of
      secreted proteins in the human breast cancer cell line MCF-7 and a tamoxifen
      resistant variant subline, AL-1.
AB  - The human breast cancer cell line MCF-7 contains estrogen receptors and responds
      to estrogens with an increase in growth rate and to antiestrogens with a decrease
      in growth rate. Estrogen stimulation of cell proliferation is concomitant with an
      increase in the synthesis and secretion of three proteins with mol. wt 52 kDa, 61
      kDa and 66 kDa and a decrease in the synthesis and secretion of a 42 kDa protein.
      The antiestrogen ICI 164,384 has a complete estrogen antagonistic effect on the
      synthesis of these secreted proteins, whereas the antiestrogen tamoxifen has an
      agonistic effect on the synthesis and secretion of the 52 kDa protein. We believe
      that the above mentioned estrogen regulated secreted proteins are either directly
      or indirectly involved in control of cell proliferation, and the less pronounced
      inhibitory effect of tamoxifen on cell proliferation compared to ICI 164,384 may
      be due to agonistic effects of tamoxifen. A tamoxifen resistant variant of the
      MCF-7 cell line, the AL-1 subline, can be growth inhibited by ICI 164,384,
      although a higher concentration is needed to inhibit the AL-1 cells compared to
      the parent MCF-7 cells. Tamoxifen has no effect on secreted proteins from the AL
      1 cells, whereas ICI 164,384 has a complete estrogen antagonistic effect on
      secreted proteins, indicating that the mechanisms by which estrogens and
      antiestrogens influence cell proliferation may be via up and down regulation of
      secreted proteins with growth regulatory functions.

PMID- 1622628
TI  - Analysis of hormone receptors and proliferation fraction in fine-needle aspirates
      from primary breast carcinomas during chemotherapy or tamoxifen treatment.
AB  - Twelve postmenopausal women (54-93 years) with primary breast carcinoma were
      treated with tamoxifen due to infirmity or refusal to undergo surgery. Seven
      premenopausal patients (32-50 years) were given preoperative chemotherapy because
      of large tumors or inflammatory carcinoma. Fine-needle aspiration biopsy was used
      to procure tumor cells for diagnosis, hormone receptor determination and analysis
      of proliferation fraction. Aspirations were repeated every 3 months in the
      tamoxifen group and each month in patients receiving chemotherapy. Two patients
      who responded to tamoxifen had tumors with more than 75% estrogen receptor
      positive cells. A decreased proliferation fraction was observed in two tumors
      responding to tamoxifen. Eight patients, all with estrogen receptor positive
      tumors, had stable disease. Progressive disease was observed in two patients with
      less than 25% receptor positive cells. In these tumors the percentage of
      proliferating cells remained high during therapy. Objective response was recorded
      for six patients treated with chemotherapy. The clinical response was reflected
      in a decreased proliferation fraction. No correlation was observed between
      response and percentage of proliferating cells in the untreated tumor. The
      results suggest that analysis of tumor cell characteristics such as hormone
      receptor content and proliferation fraction can be used to predict and monitor
      response to endocrine treatment and chemotherapy in breast carcinomas.

PMID- 1622629
TI  - Role of genetic factors in breast cancer susceptibility.
AB  - Hereditary breast cancer is common and accounts for approximately 10-14% of all
      breast cancers. Knowledge of a family history of breast cancer may significantly
      influence diagnosis and therapy. Genetic heterogeneity has been demonstrated in
      familial breast cancer. Recently inherited mutations in the tumor suppressor gene
      p53, have been shown to be the underlying defect in the Li-Fraumeni syndrome. We
      have shown that defects in this gene also play a role in the predisposition to
      other familial breast cancers. The gene responsible for early onset familial
      breast and ovary cancer has recently been mapped to chromosome 17q21. For most of
      the sporadic breast cancers a multifactorial model, including variable genetic
      and environmental factors, has been considered. Two genetic risk factors which
      may predispose for a considerable portion of breast cancers are the gene causing
      ataxia telangiectasia (AT) and the gene that gives rise to proliferative breast
      disease (PBD). Identification of distinct genes enhancing the risk of breast
      cancer will give us the opportunity to identify high risk individuals. Such
      individuals may benefit from periodic examination affording the possibility of
      early diagnosis and treatment.

PMID- 1622630
TI  - Flow cytometric DNA index and S-phase fraction in breast cancer in relation to
      other prognostic variables and to clinical outcome.
AB  - One frequently used classification of flow cytometric DNA ploidy status (diploid
      versus nondiploid) was compared with a division into seven ploidy classes based
      on DNA index (DI) and number of cell populations (hypodiploid, diploid, near
      hyperdiploid, hyperdiploid, tetraploid, hypertetraploid, and multiploid). The
      latter ploidy classification showed a better correlation with prognosis and other
      prognostic factors (i.e., lymph node involvement, estrogen and progesterone
      receptor status, and S-phase fraction). The improvement in correlation was mainly
      due to the identification of near-hyperdiploid cases (DI 1.00-1.14) which could
      be combined with the diploid cases to form a group with favourable prognosis. In
      contrast to cases with a small increase in DNA content (near-hyperdiploid), those
      with a small decrease of DNA content (hypodiploid) manifested a more aggressive
      disease. In multivariate analysis, S-phase fraction (SPF) was a more important
      prognostic factor than both the improved or the conventional ploidy
      classification.

PMID- 1622632
TI  - Oral contraceptives and breast cancer. A review with some comments on
      mathematical models.
AB  - The relationship between oral contraceptive use and breast cancer is discussed on
      the basis of information given in review articles, meta-analyses and editorials
      emphasizing methodological problems related to bias and confounding. Over the
      last few years a shift in opinion has taken place. Most reviewers now consider
      that long-term use of oral contraceptives is associated with an increased risk of
      premenopausal breast cancer and no effect among postmenopausal breast cancer.
      This result is compatible with an additive effect (in rate measure scale) of oral
      contraceptive use on breast cancer risk.

PMID- 1622631
TI  - The prevention of breast cancer through reduced ovarian steroid exposure.
AB  - Analysis of epidemiologic data on cancers of the breast, ovary and endometrium;
      the effects of endogenous hormones on cell proliferation; and current
      carcinogenesis concepts, suggest that hormonal contraceptives can be developed
      that will reduce lifetime risk of all 3 cancers. The 'unopposed-estrogen
      hypothesis' accounts for endometrial cancer risk factors. Ovarian cancer risk is
      closely related to the total frequency of ovulation. The risk of breast cancer
      can be explained by an 'estrogen-plus-progestogen hypothesis'. On the basis of
      this analysis an hormonal contraceptive regimen has been developed consisting of
      a gonadotropin-releasing hormone agonist (GnRHA) plus continuous low-dose add
      back estrogen and a short course of progestogen every fourth month. The total
      dose of add-back estrogen is estimated to be approximately 38% that in present
      day low-dose combination-type oral contraceptives (COCs). The total dose of
      progestogen is approximately 15% that in COCs. This regimen prevents ovulation
      and should thus reduce ovarian cancer risk. It also reduces the exposure of the
      endometrium to unopposed estrogen, and the exposure of the breast to estrogen
      plus-progestogen. It is estimated that use of such a regimen for 10 years will
      only reduce lifetime risk of endometrial cancer by one-sixth, but lifetime risk
      of ovarian cancer is estimated to be reduced by two-thirds, and lifetime risk of
      breast cancer is estimated to be reduced by one-half.

PMID- 1622633
TI  - Reproductive factors in breast cancer epidemiology.
AB  - There is abundant epidemiologic evidence showing that early menarche, late
      menopause, low parity and late age at first birth are related to increased risk
      of breast cancer. However, in younger age groups, uniparous women seem to be at
      higher risk than nulliparous, and the effect of later pregnancies is less clear
      in this group. Intervals between pregnancies may modify the general protective
      effect. Some studies have indicated an adverse effect of late age at pregnancies
      after the first. Further studies are necessary to determine if the general
      protective effect of pregnancies after the first is preceded by a transient
      increase in breast cancer risk. No clear association has been established with
      number of abortions. Results from two large prospective studies suggest that
      breast feeding is not strongly related to risk of breast cancer among Western
      populations.

PMID- 1622634
TI  - Prospective study of height, body mass index and risk of breast cancer.
AB  - The associations of breast cancer risk with height and body mass index have been
      examined in 291 cases of breast cancer that occurred among 25,967 Norwegian women
      during a mean follow-up of approximately 14 years (range 12-16 years). There was
      an overall increased risk of breast cancer with increasing body height, and the
      relative risk of women in the fourth quartile of height (mean = 170 cm) was 1.43
      (95% confidence limits, 1.18-1.73) compared to women in the lowest quartile (mean
      = 155 cm), after adjusting for age, parity, age at first birth, and county of
      residence. Simultaneously, there was an overall inverse relation between body
      mass index (BMI) and breast cancer risk, which, however, was confined to women 50
      years or younger. After adjustment for age, parity, age at first birth, and
      county of residence, the relative risk of women (less than or equal to 50 years)
      in the highest quartile of BMI (mean Quetelet = 30) was 0.63 (95% confidence
      limits, 0.48-0.82), compared to women in the lowest (mean Quetelet = 21). We
      propose that the lower breast cancer risk in shorter women may reflect caloric
      restriction during the pre- and peripubertal period, which may affect
      hyperplastic growth, and lead to a reduced number of breast tissue cells. The
      negative association with BMI may be related to a lower rate of cell division of
      breast tissue among obese premenopausal women.

PMID- 1622635
TI  - Risk of breast cancer among female teachers of physical education and languages.
AB  - A retrospective follow-up study on 924 physical education (PE) and 3,239 language
      (L) teachers was performed to study whether life-long high physical activity
      affects the risk of breast cancer. The Finnish Cancer Registry found 128
      malignant breast cancers among these women in a follow-up during 1967-1987. The
      standardized incidence ratio (SIR) for all PE teachers was 1.28 (n.s.) and for L
      teachers 1.59 (p less than 0.001). Before the menopause (below age 50) SIR for PE
      teachers was 0.93 (n.s.) and for L teachers 1.51 (p less than 0.05). These
      results suggest that before menopause the risk of breast cancer in physically
      active PE is smaller than in the less active L. A Poisson regression analysis,
      taking into account the reproductive factors together with age and observation
      period, did not show any significant difference between PE and L teachers,
      probably due to the relatively small number of cases (n = 22) in the PE teacher
      group.

PMID- 1622636
TI  - Indications for cytostatic therapy in metastatic breast cancer.
AB  - Generalized breast cancer is always incurable. The heterogeneity of this disease
      is reflected by wide variation in treatment response and survival duration. No
      well-defined factors have been found which can distinguish the patients most
      likely to benefit from chemotherapy. No superior drug combination or schedule has
      been convincingly established, and basic facts on quality of life issues are
      still lacking. The most important treatment goal is to provide meaningful
      palliation for the individual patient. Indications for chemotherapy are life
      threatening disease, distant metastases in receptor-negative disease, and
      clinically hormone resistant disease. In future trials the importance of
      potentially relevant biological factors for treatment should be evaluated, and
      such analyses should, at least partly, replace the presently conducted phase II
      and phase III studies.

PMID- 1622637
TI  - Cytotoxic treatment of metastatic breast cancer. Which drugs and drug
      combinations to use?
AB  - Although the optimal efficacy of cytotoxic therapy plateaued in the 1970s, no
      consensus yet exists regarding which cytotoxic combination to offer as first-line
      therapy for metastatic breast cancer. Comparison of a combination of CAF/CEF with
      other cytotoxic combinations reveals that an anthracycline-containing regimen not
      only increases response rate, but also improves time to progression and survival.
      Regarding appropriate duration of cytotoxic therapy, randomized trials indicate
      that therapy in excess of 6 months is beneficial. Although the main objective of
      cytotoxic therapy in patients with metastatic disease is to palliate symptoms at
      the least toxic cost, the finding that adjuvant cytotoxic therapy improves
      survival provides a clinical and ethical rational for continued research into new
      drugs and combinations in the hope that new strategies can be employed not only
      against metastatic breast cancer but may be applied with benefit also in the
      adjuvant situation.

PMID- 1622638
TI  - Site-specific effect of chemotherapy in patients with breast cancer.
AB  - The efficacy of cytotoxic therapy in different anatomical sites can be studied by
      analyzing the anatomical distribution of recurrences following adjuvant therapy
      or the rate of response according to site of metastasis. Cumulated data from 7
      adjuvant studies showed that the relative reduction in the rate of recurrence was
      37% for local and regional recurrences versus 25% for distant metastases. There
      are only sparse and inconclusive data concerning the anatomical pattern of
      recurrence according to type of adjuvant chemotherapy. Thus, the majority of
      trials have not demonstrated significant differences in distribution of
      metastases in patients receiving different types of adjuvant systemic therapy.
      The available data on the rate of response in relation to metastatic site showed
      higher response rates in soft tissue metastases (55%), compared to visceral and
      bone metastases (40%). Cumulated data from 12 trials showed no differences in
      response rates between different soft tissue lesions (skin, subcutaneous tissue,
      lymph nodes, breast), or between metastases demonstrated by paraclinical tests
      (lung, liver, bone). However, there was a tendency for soft tissue lesions to
      have a higher response rate (55-60%) than visceral and bone metastases (31-44%).
      The reason for the observed differences is unknown. At the time of diagnosis soft
      tissue lesions may be smaller (with better blood supply) than visceral lesions.
      This might increase the likelihood of response, since experimental data show that
      the response rate is inversely correlated with tumour burden and tumour size.
      Another explanation is based on the hypothesis of site-specific clonal selection
      of tumour cells, which differ with respect to sensitivity to cytotoxic agents.
      However, the observed differences can also be ascribed to methodological errors
      or differences in assessing response of tumours at specific sites. Thus, the
      false positive response rate in soft tissue lesions, evaluated by physical
      examination, is approximately 20% compared with less than 10% in lung lesions
      evaluated by x-rays.

PMID- 1622639
TI  - FEC (5-fluorouracil-epirubicin-cyclophosphamide) monthly versus FEC weekly in
      metastatic breast cancer. First results of a randomized trial.
AB  - Patients (n = 174) with metastatic breast cancer previously untreated with
      anthracycline cytotoxic agents were randomized into two groups: Group 1 received
      FEC (5-fluorouracil 500 mg/m2, epirubicin 60 mg/m2 and cyclophosphamide 500
      mg/m2) once every fourth week and group 2 received the treatment once weekly in
      the same monthly dosage. Treatment was recommended to continue until disease
      progression or to a cumulative epirubicin dose of 1,000 mg/m2, but could be
      discontinued at any time at the patient's request or at the treating physician's
      judgement. An interim analysis was made when 131 patients were evaluable for
      response, and 128 patients for toxicity. Hematological toxicity was significantly
      more severe in the monthly group, as was nausea and vomiting. Of the monthly
      treated patients 76% had total alopecia compared to 14% in the weekly group.
      There were no statistically significant differences in the occurrence of
      mucositis. Monthly FEC gave significantly higher response rate than weekly
      treatment (52 vs 34%, p = 0.01). Time to progression was significantly (p =
      0.004) longer with monthly FEC. Patients in the monthly treated group lived
      significantly (p = 0.02) longer than patients in the weekly group. These results
      indicate that both toxicity and efficacy of epirubicin-containing combination
      therapy in breast cancer is dependent on the treatment schedule, not merely on
      dosage. Both efficacy and toxicity increased when the treatment was given once
      monthly compared to the weekly schedule.

PMID- 1622640
TI  - Late effects of radiotherapy in the treatment of breast cancer.
AB  - Late effects after radiotherapy for breast cancer include radiation induced
      malignancy and changes in irradiated tissues leading to e.g. edema of the arm,
      decreased mobility of the shoulder joint, brachial plexus neuropathy, pulmonary
      fibrosis, telangiectasia or atrophic ulceration of the skin. While radiation
      induced malignancy depends on the volume of tissue irradiated and the total dose,
      other late effects are also fractionation dependent. Several reports have shown
      increased rates of such late effects after changes of the fractionation schedule
      which should be isoeffective according to the mathematical models commonly used
      to predict early effects. Although knowledge of the relation between total dose,
      number of fractions and radiation effects in late responding tissues has
      increased, extrapolations from the models should be used cautiously. The dose
      response curve seems to be steeper for late effects than for tumour control. The
      possibility of late effects should be included in the decision as to when and how
      to treat breast cancer with radiotherapy.

PMID- 1622641
TI  - Long-term effects of adjuvant chemotherapy in breast cancer.
AB  - Late effects of adjuvant chemotherapy (ACT) may include second malignant
      neoplasms (SMN), cardiotoxicity and ovarian suppression. Effects on the biology
      of residual tumour may be important in protocol design. Studies of SMN need large
      and reliable data sets. The leukaemia risk with current ACT is likely to be less
      than a five-fold increase. Leukaemia is predominantly a result of alkylating
      agents and peaks before 10 years. Solid SMN result also from radiotherapy and
      this risk continues after 10 years. Cardiotoxicity can be caused by
      anthracyclines but should not be a problem with current ACT regimens. It can be
      reduced by careful monitoring and by the cardioprotector ICRF-187. Amenorrhoea is
      a crude marker of ovarian suppression which may explain conflicting data on its
      relationship to outcome after ACT. Ovarian suppression following ACT is more
      likely and more permanent in older premenopausal women, but only explains a part
      of the ACT effects on outcome. Effects of early ACT on residual tumour are
      important for planning retreatments and combined modality protocols.

PMID- 1622642
TI  - Results of the Cancer Research Campaign Adjuvant Trial for Perioperative
      Cyclophosphamide and Long-Term Tamoxifen in Early Breast Cancer reported at the
      tenth year of follow-up. Cancer Research Campaign Breast Cancer Trials Group.
AB  - Over 2,000 patients with early breast cancer were recruited into a trial between
      1980 and 1985. This trial was of a factorial 2 x 2 design to investigate the
      benefits of a short course of perioperative cyclophosphamide or tamoxifen 20 mg
      daily for 2 years. At the tenth year of follow-up no significant benefit is noted
      for perioperative cyclophosphamide, however the main effect analysis for adjuvant
      tamoxifen demonstrates a significant improvement in disease-free survival which
      increases with time during the follow-up period. These results are in keeping
      with the World Overview of Trials of Adjuvant Tamoxifen. However, this study is
      unique, having a large number of node negative patients and over 500
      premenopausal women in a comparison of tamoxifen and control. The relative risk
      reductions for the node negative patients for disease-free survival are greater
      than for the node positive patients. This might suggest that the absolute benefit
      for adjuvant tamoxifen is similar in both groups of patients, bearing in mind the
      increased risk of relapse with the node positive patients. No trend for
      interaction emerges according to age or menopausal status suggesting an identical
      benefit for premenopausal women. Of particular interest is the development of
      contralateral breast cancer. The initial overall effect which emerged at the
      third year of follow-up ceases to be apparent. However, subgroup analysis
      according to menopausal status suggests a trend for interaction with a reduction
      in the risk of contralateral breast cancer in the postmenopausal women and an
      increase in the risk of contralateral breast cancer in premenopausal women.
      Plausible mechanisms exist to explain this difference in outcome and these data
      need to be checked against other large trials of adjuvant tamoxifen at a time
      when we are considering the chemoprophylaxis of breast cancer in high risk
      premenopausal women.

PMID- 1622643
TI  - Carcinogenic effects of adjuvant tamoxifen treatment and radiotherapy for early
      breast cancer.
AB  - The occurrence of new primary tumours among postmenopausal patients with primary
      breast cancer subsequent to adjuvant treatment in Denmark was assessed by linkage
      to the cancer registry. Following primary surgery, patients in low risk of
      recurrence (n = 1,828) received no further treatment while patients in high risk
      randomly received either adjuvant radiotherapy alone (n = 846) or radiotherapy +
      tamoxifen 30 mg daily for 48 weeks (n = 864). With a median follow-up of 8 years,
      the incidence of tumours in the contralateral breast was similar among tamoxifen
      treated, and non-treated high-risk patients even after adjusting for tumours
      arising within the first year. The standardized incidence ratio for endometrial
      cancer was 1.9 (95% confidence interval 0.8-3.9) among tamoxifen treated, the
      cumulative incidence 1% compared to 0.3% among non-treated patients (p = 0.11).
      The cumulative risk of non-lymphocytic leukaemia was 0.9% and 0.1% among
      irradiated and non-irradiated patients respectively (p = 0.4). Prolonged follow
      up of tamoxifen-treated patients with regard to new tumours is recommended.

PMID- 1622644
TI  - Randomized trial of adjuvant tamoxifen in node negative postmenopausal breast
      cancer. Stockholm Breast Cancer Study Group.
AB  - The paper presents long-term results of a randomized trial of adjuvant tamoxifen
      (40 mg daily for 2 or 5 years) versus surgery alone including 1,347
      postmenopausal patients with histologically negative axillary nodes and a tumour
      diameter less than or equal to 30 mm. Data on the estrogen receptor status of the
      primary tumour were available in 1,136 patients (84%). At a median follow-up of 7
      years (range 1.7-13.0 years) there was a significant prolongation of the
      recurrence-free survival among those allocated to tamoxifen (p less than 0.01),
      significantly fewer deaths due to breast cancer (p = 0.02) and a trend towards
      improved overall survival (p = 0.11). The treatment benefit was restricted to
      patients with ER-positive tumours. There was no significant reduction of breast
      cancer recurrences in the tamoxifen group among patients whose tumours were
      classified as ER-negative. The results support and extend previous studies in
      showing a long-term benefit of tamoxifen in postmenopausal breast cancer patients
      with node-negative, estrogen receptor positive disease.

PMID- 1622645
TI  - Long-term effects of adjuvant tamoxifen and/or radiotherapy. The South Sweden
      Breast Cancer Trial.
AB  - In a multicenter trial of adjuvant therapy in stage II breast cancer, 719
      postmenopausal patients were randomized to one of three treatment regimens:
      radiotherapy only or in combination with adjuvant tamoxifen for one year, or
      adjuvant tamoxifen without radiotherapy. At twelve years of follow-up (median 9
      years), no statistically significant differences in survival or recurrence-free
      survival were observed. However, the rate of loco-regional recurrency was lower
      among patients treated with both radiotherapy and tamoxifen. The rate of
      bilateral breast cancer was reduced in tamoxifen-treated patients whereas the
      rate of new primary malignancies other than breast cancer was somewhat higher in
      tamoxifen-treated patients. Adjuvant therapy in breast cancer may influence not
      only breast cancer recurrences and mortality but also later disease patterns and
      cause-specific mortality.

PMID- 1622646
TI  - Lymphoma incidence in a Swedish county during 1969-1987.
AB  - The incidence of lymphoid malignancies (acute leukemias and myelomatosis
      excluded) during 1969-1987 in the County of Uppsala was calculated on the basis
      of the regional cancer register and local registers from the only oncological,
      hematological, dermatological and pathological departments in this well-defined
      geographical area. Of the 774 patients included, 639 had histopathological
      specimens available, all of which were re-examined. Seventy-nine patients were
      diagnosed on the basis of bone marrow investigations (greater than 70% re
      examined, all had a low-grade non-Hodgkin's lymphoma = NHL) and 54 on fine-needle
      aspiration biopsies (not re-examined). Seventy-nine of the lymphoma diagnoses
      were based on autopsy specimens. The overall age standardized incidence was
      16.2/100,000/year (NHL: 13.6, Hodgkin's disease = HD: 1.5) according to the
      Swedish 1970 census (according to world standard population: 10.2); male: 20.9
      (12.9) and female: 12.4 (7.9). The annual change in trend was +3.0% +/- 2.6 (NHL:
      +3.6% +/- 2.4, HD: no change). The omission of the 54 'fine needle cases' led to
      an overall incidence of 15.0 (9.7) and an annual change in trend of +3.5% +/-
      1.9. Among the histopathological specimens, an NHL was found in 524 patients and
      HD in 69. In 46 registered patients, the diagnosis malignant lymphoma was wrong.
      The diagnosis changed to NHL in 43 patients registered as HD.

PMID- 1622647
TI  - Interrelations between cellular DNA content, S-phase fraction, hormone receptor
      status and age in primary breast cancer. A series of 1,342 consecutively detected
      tumors. South-East Sweden Breast Cancer Group.
AB  - Estrogen and progesterone receptors were assessed by an immuno-biochemical method
      and DNA content was analysed by flow cytometry in a consecutive series of 1,342
      frozen breast cancer samples. Forty-six percent of the ER-positive tumors were
      DNA diploid compared to 23% among ER-negative cases. The proportion of ER-/PR-
      cases was highest among hypertetraploid tumors (45%) and lowest among DNA
      diploids (13%). While receptor positivity and DNA ploidy were strongly related,
      no differences in mean receptor levels were detected when comparing DNA diploid
      and aneuploid cases of receptor positive tumors. In receptor positive tumors ER
      content--but not PR content--increased with age. S-phase fraction (SPF) was
      estimated in 1,165 cases (87%) with an overall mean of 8.6%. Tumors with high S
      phase levels and DNA hypodiploid tumors were significantly more often found in
      younger than in older patients. The frequency of DNA hypodiploidy was less than
      1% among women older than 75 years, while it was 8% among those aged 40 years or
      younger. S-phase fraction was inversely related to ER and PR status. However,
      while mean SPF gradually decreased with increasing levels of PR, no significant
      difference in S-phase fraction was seen for ER concentrations just above the cut
      off level for receptor positivity. Tumors positive for both receptors showed the
      same pattern of DNA ploidy as ER+/PR- tumors while differences in S-phase
      fraction were observed between the groups. These results support that PR status
      better than ER status reflects hormone dependent growth in breast cancer.

PMID- 1622648
TI  - Identification of subgroups with favorable prognosis in breast cancer.
AB  - The prognostic significance of 16 factors was investigated in a series of 311
      women with unilateral, invasive breast carcinoma without distant metastases (M0)
      and treated with mastectomy. The series consisted of 93% of such cases diagnosed
      histologically in the city of Turku, Finland, from 1980 to 1984. Mitotic count,
      histological and nuclear grades, extent of tumor necrosis, axillary nodal status
      (pN), tumor size (pT), estrogen and progesterone receptor (PR) contents, and S
      phase fraction were the most powerful single factors (p = 0.0001 or less).
      Axillary node negative cancers with no or only spotty tumor necrosis (92% of all
      pN0 cases) were associated with a 96% 5-year survival rate corrected for
      intercurrent causes. Among the axillary node positive cases the combination of
      high PR content (greater than 60 fmol/mg protein) and a low mitotic count could
      identify a subgroup with a 96% 5-year corrected survival rate (25% of all pN+
      cases). It is concluded that both pN0 and pN+ breast cancer contain identifiable
      subgroups with greatly different prognosis.

PMID- 1622649
TI  - External and interstitial radiation therapy of locally advanced carcinoma of the
      breast.
AB  - The present report concerns 164 cases of locally advanced breast cancer (stage
      III), treated between December 1977 and January 1987. The local therapy consisted
      exclusively of radiation therapy including external beam irradiation (60Co) up to
      45-50 Gy supplemented with a boost, delivered either by interstitial 192Ir (30-40
      Gy) or by external irradiation from limited fields (15-22 Gy). Eighty-one
      patients also received adjuvant systemic chemotherapy. A total of 51 local
      failures (31%) occurred. The actuarial rate of survival with local tumor control
      was 53% at 5 years and 49% at 6.5 years. A total of 69 patients developed distant
      metastases (42%). The actuarial survival without distant failure was 43% at 5
      years and 37% at 6 years. The actuarial survival rate at 5 years was 53% and 38%
      at 7 years. The cosmetic results were excellent in 58 patients and poor in 13
      patients (9.7%). The result suggests that stage III breast cancer can be
      satisfactorily treated with radiation therapy alone as local treatment.

PMID- 1622650
TI  - Getting free of breast cancer. An eight-year perspective of the relapse-free
      patients.
AB  - Twenty-two breast cancer patients who were relapse-free and had no need for
      cancer-related treatment were interviewed 8 years after mastectomy in order to
      evaluate their feelings of getting free of breast cancer and the meaning of
      breast cancer in their lives. The study is a part of an intervention and follow
      up study of 57 breast cancer patients. Half of the 22 patients still had frequent
      or occasional thoughts of recurrence and over two-thirds still thought they had
      not been 'cured' of cancer. More than half of the patients admitted that going
      through breast cancer had made them more mature. Women who had less thoughts of
      recurrence belonged to a group that had gone through an eight-week group
      psychotherapy intervention, were less depressed and had more other illnesses.
      Women who felt 'cured' had less limitations and restrictions due to cancer and
      belonged more often to higher social classes than the others.

PMID- 1622651
TI  - Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item
      version and a diagnosis-specific module for head and neck cancer patients.
AB  - A cancer-specific self-reporting quality of life questionnaire has been
      validated. The questionnaire is designed to assess physical functioning, role
      functioning, cognitive functioning, emotional functioning, social functioning,
      pain, fatigue, emesis and quality of life by means of multi-item scales, and
      other disease- and treatment-related symptoms by means of single items. The
      questionnaire was completed by 126 head and neck cancer patients with a mean age
      of 67 years. The internal consistency (scale reliability) was satisfactory for
      all scales but one. Correlations between scales and items assessing the same
      underlying dimension were also satisfactory. The questionnaire discriminates
      between patient subgroups and between acute, subacute and late toxicity. Patient
      compliance was high. The questionnaire provided valuable information, and most of
      the scales/items functioned well. A few problems were found, especially with the
      modified visual analogue scales, and minor modifications will be made.

PMID- 1622652
TI  - Emotional and social aspects of cancer pain.
AB  - The emotional and social consequences of pain were studied in 93 consecutive in
      patients, 44 males and 49 females, suffering from cancer-related pain. The
      methods used were Visual Analogue Scales (VAS), standardized interviews and
      comprehensive self-questionnaires. Forty-seven patients (51%) experienced certain
      or pronounced anxiety (4-6 or 7-9 on a 9-grade scale) because of their pain and
      66 patients (71%) expressed depressive pain-associated symptoms, which had a high
      correlation with the intensity of their pain. Physical activities such as
      movements, dressing/undressing, washing, cooking were hampered in about 2/3 of
      the patients and mental activities such as reading were significantly disturbed
      in 48% of the cases. For every social activity listed in the questionnaires
      (hobbies, seeing friends, etc) most patients reported a decreased activity
      because of pain and in most cases the decrease correlated significantly with the
      intensity of the pain. The family roles had changed since the patient could not
      participate in a usual manner. The study underlines the profound consequences of
      pain: physical suffering, emotional distress, social handicap and altered family
      roles. Thus, pain control should be a high-priority matter in palliative care.

PMID- 1622653
TI  - Urinary polyamines in patients with advanced cervical cancer or pelvic cancer
      recurrence during and after radiotherapy.
AB  - The urinary excretion of polyamines was evaluated before, during and after
      radiotherapy in 16 patients with advanced squamous cell carcinoma of the uterine
      cervix (stage IIb or IIIb) and in 7 cases with pelvic recurrence after surgery
      for various types of carcinoma. The concentration of spermidine was significantly
      higher in the patients with primary tumors than in those with recurrent tumors.
      After the first radiation fractions putrescine increased in the patients with
      primary tumors whereas it decreased in patients with recurrent tumors. The values
      tended to return to baseline levels with time following treatment initiation.
      Polyamine increased markedly during treatment in patients who remained disease
      free for at least 5 years but not in the patients with progressive disease or
      relapse. The results suggest a different polyamine metabolism and a different
      response to radiotherapy of recurrent tumors compared to primary tumors. The
      increase of urinary polyamines, but not the baseline values, seemed to be
      correlated to the response after radiotherapy.

PMID- 1622654
TI  - Carcinoembryonic antigen in anal carcinoma.
AB  - Patients with squamous cell carcinoma of the anal canal occasionally present with
      an elevated level of carcinoembryonic antigen (CEA) in serum. The present study
      was performed to evaluate the clinical importance of this observation. Serum CEA
      was measured in 106 patients prior to chemo- and radiotherapy and during follow
      up. Twenty patients had elevated serum CEA level before treatment. In 6 of 12
      cases, serum CEA did not normalize after successful treatment and in 4 of 7 cases
      it rose no further despite progressive disease. CEA-positive tumours were more
      often poorly differentiated than CEA-negative tumours. There was no significant
      correlation between serum CEA, tumour CEA and prognosis. We conclude that
      measurement of serum CEA and staining of tumour CEA lack clinical importance.

PMID- 1622655
TI  - Weekly oral idarubicin in advanced prostatic cancer. A phase II study.
AB  - Twenty-five patients with advanced prostatic cancer progressing after one course
      of endocrine treatment entered a phase II study of weekly administration of 30 mg
      Idarubicin orally. Twenty-two patients were evaluable for response and partial
      response (PR) was noted in 2 patients and stable disease (NC) in 10 patients.
      Median survival was 31 weeks and median time to progression was 14 weeks. Twenty
      three patients were eligible in a score system combining analgetic consumption
      and pain reduction measured on a Visual Analogue Scale (VAS) and 30% achieved a
      subjective response. Fifteen patients fulfilled treatment with the planned dose
      and 10 patients had dose reduction to a median of 23.8 mg Idarubicin.
      Haematological toxicity was greater than or equal to grade 3 (WHO) in 20% of the
      patients. Non-haematological toxicity was dominated by nausea/vomiting with 48%
      grade 3 (WHO). In conclusion, Idarubicin seems of limited value in the treatment
      of patients refractory to first line endocrine treatment.

PMID- 1622656
TI  - Squamous cell carcinoma of the oropharynx. Results of primary radiotherapy.
AB  - During the six-year period in 1979 through 1985, 226 patients (67 females and 159
      males) with squamous cell carcinoma of the oropharynx were treated at the Finsen
      Institute in Copenhagen. Ages ranged from 35 to 86 years with an average of 64
      years for females and 61 years for males. The primary tumour was most often
      situated in the lateral wall (55%) and the anterior wall (25%). Thirty-nine per
      cent of the tumours were in stage III and 40% in stage IV. The primary treatment
      was radiotherapy, in this period given with three different treatment schedules,
      one continuous and two split-course. The 5-year crude survival rate in the total
      material was 36% and the corrected 5-year survival rate 45%. Females had a higher
      loco-regional control rate than males, but there was no significant differences
      between the sexes concerning survival. The tumour stage (IUCC, 1978) was an
      important prognostic factor for both loco-regional control and survival. No
      significant differences could be found between the three treatment schedules
      concerning loco-regional control or survival.

PMID- 1622657
TI  - Cisplatin and hyperthermia treatment of a C3H mammary carcinoma in vivo.
      Importance of sequence, interval, drug dose, and temperature.
AB  - The effect of combining cisplatin and hyperthermia was investigated in a C3H
      mammary carcinoma in vivo, using a regrowth delay assay. Cisplatin (6 mg/kg) was
      given i.p. at intervals ranging from 24 h before to 24 h after a 43.5 degrees
      C/60 min treatment. A supra-additive effect was obtained by giving cisplatin 15
      min before heat, whereas an additive effect was obtained at all other intervals.
      The importance of cisplatin dose and heating temperature were investigated by
      giving variable cisplatin doses (2-8 mg/kg) 4 h or 15 min before a 60 min heating
      at temperatures in the range 40.5-43.5 degrees C. Linear relationships between
      length of regrowth delay and cisplatin dose were obtained both for cisplatin
      alone and for the combined treatment. The effect of the combined treatment could
      therefore be quantitated by a ratio (ER) between the slopes of dose-response
      curves. The ER values for cisplatin give 4 h before a 60 min heating at 42.5 or
      43.5 degrees C were not significantly different from 1 (p greater than 0.5). In
      contrast, significant ER values were obtained above 40.5 degrees C (p less than
      0.05) for cisplatin given 15 min before heat. The data demonstrates the
      possibility of achieving chemosensitization at clinically relevant temperatures.

PMID- 1622658
TI  - Fractionated irradiation and early changes in noradrenaline induced potassium
      efflux (86Rb+) in rat parotid gland.
AB  - The effects of fractionated irradiation on the electrolyte fluid secretion from
      rat parotid gland were studied. Secretion was measured as noradrenaline
      stimulated potassium efflux in vitro with 86Rb+ as tracer for potassium. The
      irradiation was delivered either as a five-day schedule (total dose 20, 25, 30,
      35, 40, 45 Gy) or a two-day schedule (total dose 24, 32 Gy). The noradrenaline
      stimulated efflux was decreased in comparison with contralateral controls 10 days
      after the last irradiation. The effect was dose-dependent. Based on the data
      available, alpha/beta ratio of the used system was calculated to about 20 Gy,
      which corresponds to other results regarding early radiation effects.

PMID- 1622659
TI  - Treatment response to natural leukocyte interferon-alpha in relapsing malignant
      insulinoma with severe hypoglycemia.

PMID- 1622660
TI  - Cardiac tamponade in testis cancer--an autopsy case.

PMID- 1622662
TI  - 'References'.

PMID- 1622661
TI  - 'Post-qualification training for dental hygienists'.

PMID- 1622663
TI  - 'The Sick Dentist Trust'.

PMID- 1622664
TI  - 'Community dentistry in the dental faculties'.

PMID- 1622665
TI  - 'Cut in the GDS fee scale'.

PMID- 1622666
TI  - Community dentistry in the dental faculties.

PMID- 1622667
TI  - 'Osteomyelitis following third molar surgery'.

PMID- 1622668
TI  - 'The prescription and timing of bitewing radiography in the diagnosis and
      management of dental caries: contemporary recommendations'.

PMID- 1622669
TI  - Needle guard.

PMID- 1622670
TI  - Oral infections in the immunocompromised patient.
AB  - The number of immunocompromised patients is increasing because of iatrogenic
      immunosuppression and HIV infection. Most have T lymphocyte defects and are prone
      to develop persistent and severe fungal and viral infections. Oral candidosis and
      peri-oral herpes simplex infections are particularly common. Other oral lesions
      may be seen: mouth ulceration is common and periodontal health is impaired.

PMID- 1622671
TI  - The Scottish Health Boards' Dental Epidemiological Programme: initial surveys of
      5- and 12-year-olds.
AB  - The Scottish Health Boards' Dental Epidemiological Programme, a joint venture
      between the Scottish Chief Administrative Dental Officers and the Dental Health
      Services Research Unit at the University of Dundee, was instigated in 1987 in
      response to the Chief Dental Officer's concern at the lack of any coordinated
      dental health information about children residing in the 15 Scottish Health Board
      areas. Each year a standardised dental survey of a random sample of children is
      now undertaken across Scotland. This paper reports, principally, the caries
      results of the first three surveys of 5, 12 and 5-year-olds undertaken at the end
      of 1987, 1988 and 1989, respectively. Marked variations in caries prevalence were
      found in different parts of Scotland, higher levels being recorded in the
      urbanised central belt and in the West. While there have been overall
      improvements since 1983, caries prevalence in Scotland remains substantially
      higher than in many other parts of the UK (mean DMFT for 12-year-olds in 1988 =
      2.23, mean dmft for 5-year-olds in 1989 = 2.82), with 67.8% of 12-year-olds and
      59.2% of 5-year-olds (in 1988 and 1989, respectively) still suffering from
      dentinal caries or past caries experience (DMFT/dmft greater than 0) when
      assessed by clinical examination alone. No continued improvement in caries
      prevalence was seen in the 1989 survey of 5-year-olds compared to the 1987
      examination. Continued monitoring of this situation is indicated.

PMID- 1622672
TI  - Prevention of endocarditis: communication between doctors and dentists.
AB  - Successful implementation of guidelines to prevent infective endocarditis (IE)
      depends upon the dental practitioner being aware of which of his patients are at
      risk. This was studied by sending a questionnaire to at risk patients and their
      dentists in the Grampian area. Of 145 respondents (53% response rate) with
      predisposing cardiac disorders, only 63 reported having seen their dentist in the
      past 2 years, although for dentate patients 47/61 had seen a dentist in the past
      2 years. The dentists of 59 of these cases were then surveyed and replies
      received in 53 cases. Nineteen had no record of the patient having a cardiac
      disorder. In only 17 of the remaining cases was information on the cardiac
      disorder well enough recorded to warrant prophylaxis for at risk procedures. The
      dentist was usually told of the disorder only by the patient. Sixty-three per
      cent of dentists felt that communication between them and the patient's doctor
      was unsatisfactory. It is necessary to improve doctor/patient/dentist
      communication so that current recommendations on prophylaxis can be implemented
      to the full. This should be done through the patient's GP or consultant, who
      should communicate directly with the dentist. Details could also be inserted on
      warfarin cards and 'cardiac alert cards' expanded.

PMID- 1622674
TI  - 'Orthodontic relapse'.

PMID- 1622673
TI  - The specialisation of oral surgery in general practice.
AB  - Much has been written recently on the subject of introducing a specialist title
      in oral surgery and the establishment of specialist oral surgery practices. The
      aim of my elective was to conduct a literature review, interview general
      practitioners involved in oral surgery, and examine the feasibility of
      undertaking oral surgery in a specialist practice.

PMID- 1622675
TI  - Fit to train?

PMID- 1622676
TI  - Light check.

PMID- 1622677
TI  - The pathophysiology of cardiorespiratory arrest and principles of post
      resuscitation intensive care.
AB  - Oxygen supply to the tissues is dependent on both cardiac output (which is
      determined by blood volume and myocardial function) and the oxygen tension of
      arterial blood (which reflects respiratory status). Abnormalities of these
      parameters may occur individually or together to progress ultimately to combined
      cardiorespiratory collapse. Life support measures are then required to restore
      the oxygen supply to vital organs, such as the brain, heart, kidneys and liver
      while attempts to restore normal cardiorespiratory status are made. Survival
      following cardiorespiratory arrest is enhanced if resuscitation is promptly
      instituted by skilled resuscitators, and a clear understanding of the mechanisms
      of cardiorespiratory collapse are essential to the efficient management of these
      patients.

PMID- 1622678
TI  - Compliance with infection control procedures in a dental hospital clinic.
AB  - Dental hospital staff and students were observed during clinical work for their
      compliance with infection control procedures, as recommended by the British
      Dental Association. A total of 183 contacts between health care worker and
      patient were scrutinised during December 1990. Nearly all health care workers
      (96%) wore gloves to carry out dental treatment, but in some cases gloves were
      neither changed nor hands washed between patients. Only one half wore protective
      eyewear and about one third (38%) wore no mask. Some dental surgery assistants
      used heavy duty gloves and some even scrubbed dirty dental instruments without
      wearing any gloves. Strict audit is clearly needed in every clinical setting in
      order to ensure compliance with infection control.

PMID- 1622679
TI  - Dentistry in Dohnavur, 1955-1992.
AB  - In October 1955 I arrived here in Dohnavur, India, as a young, reluctant dental
      missionary! My first hurdle was to learn the language--Tamil--said to be one of
      the most difficult languages in the world. For the first year I was given one
      hour 'off' language study to do dentistry. In that hour I began to see our large
      family, which then numbered about 900. In the second year, still in a room with
      only the dental chair and a foot engine for temporary use, I spent half the time
      in dentistry and continued to learn Tamil the rest of the time. The dental
      surgery was built, and the equipment that I had brought with me from UK had been
      installed, and on December 17, 1957, we had the dedication of the dental surgery
      and I had the joy of having my parents with me from the UK for that special day.

PMID- 1622680
TI  - A new dental health project in Zambia.
AB  - In Zambia's population of 8 million, 69% are under 24 years of age. The country
      has a crippling foreign debt, and consequently public services are poorly funded.
      From March this year my wife and I have been working in Zambia. I have been asked
      to establish and develop a dental service based at Mukinge Hospital in the North
      Western Province. Zambia borders eight other countries on the central African
      plateau and lies at an altitude of between 3000 and 6000 feet.

PMID- 1622681
TI  - 'Low-energy lasers in dentistry'.

PMID- 1622682
TI  - 'Alternatives to toothpaste'.

PMID- 1622683
TI  - Hazards in the dental surgery and safe practices.

PMID- 1622684
TI  - Team tactics.

PMID- 1622685
TI  - 2-(Trimethylsilyl)ethyl glycosides. Synthesis of the asialo-GM1-tetrasaccharide,
      spacer glycoside, and BSA and Sepharose glycoconjugates.
AB  - The tri and tetra-saccharide glycosides beta-D-GalNAc-(1-4)-beta-D-Gal-(1-4)-beta
      D-Glc-1-OTMSEt and beta-D-Gal-(1-3)-beta-D-GalNAc-(1-4)-beta-D-Gal-(1-4)-beta-D
      Glc-1-OT MSEt (asialo-GM1) have been synthesized by sequential glycosylations of
      a suitably protected 2-(trimethylsilyl)ethyl (TMSEt) lactoside with 3,4,6-tri-O
      acetyl-2-deoxy-2-phthalimido-beta-D-galactopyranosyl chloride and 2,3,4,6-tetra-O
      acetyl-beta-D-galactopyranosyl bromide. The tetrasaccharide glycoside was
      transformed into the corresponding hemiacetal sugar as well as the 1-chloro
      sugar. The latter was used for glycosylation of 2-bromoethanol. The resulting
      glycoside was used to alkylate methyl 3-mercaptopropionate and the resulting
      spacer glycoside was used for the preparation of the title glycoconjugates.

PMID- 1622686
TI  - Intracoronary stents.

PMID- 1622687
TI  - Diagnostic techniques in suspected thoracic aortic dissection.

PMID- 1622688
TI  - Exercise training as therapy for chronic heart failure.

PMID- 1622689
TI  - Occurrence of valvar heart disease in acute rheumatic fever without evident
      carditis: colour-flow Doppler identification.
AB  - OBJECTIVE: To determine the frequency of occurrence of mitral and aortic valvar
      regurgitation in rheumatic children in whom there was no evidence of carditis
      acutely or at an earlier attack. DESIGN: Colour flow Doppler imaging was used in
      a non-randomised study of sequentially admitted children who met the criteria for
      acute rheumatic fever without clinically evident carditis and patients in whom
      the disease was quiescent after a previous attack of rheumatic fever. Two
      separate control groups were used for comparison of the echocardiographic
      findings, and a group of patients with confirmed rheumatic carditis was included
      for comparison of acute phase and antistreptococcal reactants. SETTING: A general
      hospital with the only paediatric inpatient department in Qatar. PATIENTS: From
      November 1988 to October 1990, 11 children were studied during the acute
      rheumatic period. In seven additional children the disease was quiescent when
      they were studied 18 to 36 months after a documented episode of acute rheumatic
      fever in which there was no evidence of carditis. The control patients were all
      studied during the same period. MAIN OUTCOME MEASURE: Detection of mitral and
      aortic regurgitation in patients without clinical evidence of rheumatic carditis
      in the acute or quiescent stages of the disease. RESULTS: Mitral or mitral and
      aortic regurgitation was found in 10 of the 11 children studied in the acute
      rheumatic period. None had a murmur or other evidence of carditis. In all the
      cases studied the valvar insufficiency was mild. Four of the children studied
      late in the quiescent period had either aortic or mitral insufficiency by colour
      flow Doppler evaluation; two children who had previously had valvar insufficiency
      no longer showed this, and one child without positive findings in the acute phase
      remained without insufficiency. None of the non-rheumatic control subjects showed
      mitral or aortic regurgitation. CONCLUSIONS: Colour flow Doppler imaging is a
      useful method of identifying subclinical mitral and aortic valvar disease at all
      stages of rheumatic fever when carditis cannot be otherwise detected and is a
      valuable addition to current diagnostic criteria.

PMID- 1622690
TI  - Aortic valve regurgitation and the congenitally bicuspid aortic valve: a clinico
      pathological correlation.
AB  - OBJECTIVE: To investigate the morphology of congenitally bicuspid aortic valves
      causing pure valve regurgitation. DESIGN: A case series collected over five
      years. SETTING: An academic hospital. PATIENTS AND METHODS: One hundred and forty
      eight excised congenitally bicuspid aortic valves. The morphological findings
      were correlated with sex, age, clinical history, and data on haemodynamic
      function before operation. Pure valve regurgitation was defined as grade 3-4/4
      with a gradient less than 30 mm Hg. Aortic root dilatation was evaluated
      angiographically or echocardiographically or both. RESULTS: Three types were
      recognised: valves that were purely bicuspid (23%), bicuspid valves with a raphe
      (34%), and valves with an additional indentation of the free edge of the
      conjoined cusp (43%). In 14 cases pure valve regurgitation was present.
      Dilatation of the aortic root was present in 47 cases. The relative risk for
      regurgitation when the aortic root was dilated (compared with no dilatation) was
      3.99. The relative risk for valve regurgitation when there was indentation of the
      conjoined cusp (compared with no indentation) was 4.95. The mean age at operation
      in patients with pure regurgitation was 56 years, which is significantly younger
      (p = 0.0008) than that of patients with a congenitally bicuspid valve with
      combined valve stenosis and regurgitation (64.7 years). CONCLUSIONS: Congenitally
      bicuspid aortic valves with a central indentation of the free edge of the
      conjoined cusp seem particularly likely to develop pure aortic valve
      regurgitation.

PMID- 1622691
TI  - Can mitral regurgitation after balloon dilatation of the mitral valve be
      predicted?
AB  - OBJECTIVE: To determine which factors predict the occurrence of mitral
      regurgitation after balloon dilatation of the mitral valve for rheumatic
      stenosis. DESIGN: Analysis of a case series of patients with rheumatic mitral
      valve stenosis who had had successful balloon dilatation of the mitral valve.
      SETTING: A tertiary care centre with an experience of over 150 balloon
      dilatations of the mitral valve. PATIENTS: 70 young patients with non-calcified
      rheumatic mitral stenosis, who had undergone successful balloon dilatation of the
      mitral valve. No patient had mitral regurgitation or atrial fibrillation before
      dilatation. INTERVENTION: Dilatation of the mitral valve by the transvenous,
      transatrial double balloon technique. MAIN OUTCOME MEASURE: Development of mitral
      regurgitation after balloon dilatation of the mitral valve and its relation to
      age, mitral valve area before dilatation and after dilatation, the degree of
      mitral subvalvar pathology, and the size of balloon used for dilatation. RESULTS:
      In 10 patients (14%) mitral regurgitation developed after balloon dilatation of
      the mitral valve. No statistically significant differences were found between
      patients who did not develop regurgitation and those who did in terms of age
      (mean (SD)) (19.9 (6.46) v 19.4 (5.5)), mitral valve area before dilatation (1.05
      (0.33) v 0.94 (0.4) cm2) and after dilatation (2.52 (1.06) v 2.45 (1.1) cm2),
      mitral subvalvar pathology assessed by the mitral subvalvar distance ratio (0.116
      (0.03) v 0.118 (2.32), or balloon diameter corrected for body surface area (21.37
      (3.5) v 20.57 (2.32) mm/m2. CONCLUSIONS: In this subset of children and young
      adults with non-calcified mitral stenosis, none of the morphological, technical,
      or patient characteristics studied predicted the development of mitral
      regurgitation after balloon dilatation. The low incidence of mitral regurgitation
      may have reduced the discriminatory power of this study. None the less, the means
      and standard deviation for each factor in each group suggest that even in a
      larger sample size the variables would have little predictive capacity.

PMID- 1622692
TI  - Histological changes in the aortic valve after balloon dilatation: evidence for a
      delayed healing process.
AB  - OBJECTIVE: To investigate whether balloon dilatation of the aortic valve induces
      long-term macroscopic or histological changes or both to explain the restenosis
      process. DESIGN: Prospective study of 39 consecutive patients. Sixteen later
      (mean (SD) 12 (10) months) required operation. This non-randomised subgroup was
      compared with 10 patients who had aortic valve replacement without prior
      dilatation. SETTING: University cardiology and cardiac surgery centre and
      pathology department. PATIENTS: 16 patients who had aortic valve replacement
      because of failure of or restenosis after balloon dilatation of the aortic valve.
      Twelve resected valves were examined. INTERVENTIONS: Percutaneous balloon
      dilatation of the aortic valve (maximal balloon size: trefoil 3 x 12 mm balloon
      or bifoil 2 x 19 mm balloon) and surgical inspection before excision of the
      aortic valve leaflets during open-chest aortic valve replacement. Fixation,
      decalcification, and staining for histology. MAIN OUTCOME MEASURES: Presence of
      long-term pathological changes in the resected valve and their relation to
      restenosis after balloon dilatation. RESULTS: Macroscopically the previously
      dilated valves were indistinguishable from valves from the patients who had valve
      replacement only. Microscopically, the dilated aortic valves showed areas of
      young scar tissue that were not seen in a control group of surgically excised
      stenotic aortic valves. This persistent scarring reaction was seen around small
      tears or lacerations of the collagenous valve stroma, fractures in calcified
      areas, and splits in commissures. Young scar tissue without collagenisation was
      still present 24 months after dilatation. CONCLUSION: Organisation and
      collagenisation of scar tissue develops slowly after balloon dilatation of the
      aortic valve. This prolonged scarring reaction may explain the late development
      of restenosis in some patients.

PMID- 1622693
TI  - Failure of balloon dilatation of the pulmonary valve in carcinoid pulmonary
      stenosis.
AB  - BACKGROUND: Carcinoid heart disease typically results in pulmonary stenosis and
      tricuspid incompetence. Percutaneous balloon dilatation is an effective treatment
      for congenital pulmonary stenosis and has been applied successfully to tricuspid
      stenosis caused by carcinoid heart disease. The value of balloon dilatation of
      the pulmonary valve in carcinoid pulmonary stenosis was assessed. METHODS: Two
      patients with severe congestive heart failure secondary to carcinoid heart
      disease and with documented pulmonary stenosis had balloon dilatation of the
      pulmonary valve. In both cases tricuspid regurgitation was also present together
      with reduced cardiac output. RESULTS: The procedure was technically successful in
      both patients. One patient experienced symptomatic benefit for two months and the
      other experienced no improvement. Both patients subsequently required combined
      tricuspid and pulmonary valve replacement from which good results and symptomatic
      improvement were obtained. CONCLUSION: Though balloon dilatation of the pulmonary
      valve is technically feasible it is unlikely to provide useful palliation in
      carcinoid heart disease. Valve surgery should be considered in patients in whom
      the malignancy is controlled but carcinoid heart disease is producing drug
      resistant congestive heart failure.

PMID- 1622695
TI  - Closing sounds and related complaints after heart valve replacement with St Jude
      Medical, Duromedics Edwards, Bjork-Shiley Monostrut, and Carbomedics prostheses.
AB  - OBJECTIVE: To measure the noise produced and related subjective complaints after
      implantation of four different mechanical heart valve prostheses and to identify
      further factors related to the patient and prosthesis that influence noise
      generation and complaints. DESIGN: Sound pressure was measured 5 and 10 cm and 1
      m from the point of maximal impulse on the body surface by a calibrated meter in
      quiet rooms with either a decibel(A) filter or octave filters. The patients were
      asked about their complaints and examined physically. SETTING: The measurements
      were conducted in silent rooms of ear, nose, and throat departments. The patients
      had been operated on either in a university hospital or a community hospital.
      MAIN OUTCOME MEASURES: Sound pressures of frequency bands and sound pressures
      measured in dB(A) at various distances. Complaints registerd were: sleep
      disturbance, disturbance during daytime, "wants a less noisy prosthesis," and
      "can hear the closing click". PATIENTS: 143 patients after heart valve
      replacement with St Jude Medical (n = 35), Duromedics Edwards (n = 38),
      Carbomedics (n = 34) and Bjork-Shiley Monostrut (n = 36) prostheses operated on
      between 1984 and 1988 were matched for valve position, ring size, and body
      surface area. RESULTS: Duromedics Edwards (33.5 (6) dB(A)) and Bjork-Shiley
      Monostrut valves (31 (4) dB(A)) were significantly louder than St Jude Medical
      (24 (4) dB(A)) and Carbomedics (25 (6) dB(A)) prostheses (p = 0.0001) (mean
      (SD)). The louder valves were significantly more often heard by the patients (p =
      0.0012) and caused more complaints both during sleep (p = 0.024) and during the
      daytime (p = 0.07). Patients with these valves were more likely to want a less
      noisy valve (p = 0.0047). Patients with symptoms were younger, had better
      hearing, and were more likely to be in sinus rhythm. As well as the type of
      prostheses, the valve diameter and body height also had an effect on sound
      emission. CONCLUSIONS: The intensity of the closing click of mechanical valve
      prostheses was significantly different for various designs. Patient complaints
      were related to the objectively measured sound pressure. Noise production should
      be considered when a mechanical valve is selected.

PMID- 1622694
TI  - Percutaneous balloon dilatation of the mitral valve in patients who were
      unsuitable for surgical treatment.
AB  - OBJECTIVE: To assess the effects on haemodynamic function and symptoms of
      percutaneous balloon dilatation of mitral stenosis in patients unable to undergo
      surgical treatment because of associated medical/cardiac problems. DESIGN: A
      review of clinical outcome in 28 patients (of 108 undergoing balloon dilatation
      of the mitral valve) who were unsuitable for surgery. SETTING: A tertiary cardiac
      referral centre: some patients referred were from other cardiac centres in
      Scotland. PATIENTS: 28 patients judged by cardiac surgeons to be unsuitable for
      valve replacement or valvotomy because of respiratory disease (15 patients),
      nonmitral cardiac disease (6), multi-organ impairment (5), psychiatric problems
      (1) or dense intrathoracic adhesions (1). INTERVENTIONS: Percutaneous anterograde
      balloon dilatation of the mitral valve with polyethylene/polyvinyl balloons in 20
      patients and the Inoue balloon in eight patients. MAIN OUTCOME MEASURES:
      Haemodynamic variables were measured before and immediately after mitral valve
      dilatation. Patient survival and symptom class (New York Heart Association) were
      followed for a year after the procedure. RESULTS: Dilatation at the mitral
      orifice was achieved in all cases. The mean (SD) pressure drop across the valve
      fell from 13.9 (5.3) to 5.6 (2.5) mm Hg, cardiac output rose from 3.18 (1.02) to
      3.96 (2.5) l/min, and valve area increased from 0.78 (0.32) to 1.58 (0.56) cm2.
      The procedure was well tolerated by most patients, even those with
      metabolic/electrolyte disturbance, severe obstructive airways disease, myocardial
      impairment, and coronary disease. In three patients a small shunt developed at
      the atrial level: none developed severe mitral reflux. The two patients who
      required assisted ventilation died soon after the procedure and in one patient
      with severe coronary artery disease myocardial infarction developed and she died
      in cardiogenic shock. Early symptomatic improvement was reported by 23 of the 25
      survivors, though the increase in exercise capacity was often limited by their
      non-mitral disease. At one year follow up a further 6 patients had died because
      of their additional disease: 15 continued to show symptomatic improvement.
      CONCLUSIONS: Percutaneous balloon dilatation of the mitral valve is a useful new
      option in patients who are too ill to undergo cardiac surgery; but longer term
      benefit can be limited by the associated disease.

PMID- 1622696
TI  - Doppler sonographic evaluation of mechanical and bioprosthetic mitral valve
      prostheses during exercise with a rate corrected pressure half time.
AB  - OBJECTIVE: To compare the effect of exercise on pressure half time in patients
      with mechanical or bioprosthetic mitral valves. A relative pressure half time
      (pressure half time as a percentage of RR interval) was used in an attempt to
      correct for the shortening of the diastolic time interval caused by the increase
      in heart rate during exercise and thus to uncover the effects of valve design on
      pressure half time during exercise. PATIENTS: Twenty clinically stable (New York
      Heart Association grade I-II) patients with mechanical (n = 12) or bioprosthetic
      (n = 8) mitral valves (median age 51) years. The median time since valve
      replacement was 42 months. METHODS: Continuous wave Doppler echocardiography from
      the apical view at rest and during moderate supine bicycle exercise (50 W).
      RESULTS: During exercise the mean (SD) heart rate increased from 79 (12) to 101
      (12) beats per minute (95% confidence interval (95% CI) of difference, 15 to
      29/min) and the peak pressure gradient from 11 (5) to 18 (6) mm Hg (95% CI of
      difference 5 to 9 mm Hg). The pressure half time decreased from 114 (30) to 78
      (26) ms (95% CI of difference (30-42 ms). There was no difference between the
      valve types. The relative pressure half time remained unchanged in patients with
      mechanical valves during exercise (13 (4) rest and 13 (5)% exercise,
      respectively) and decreased in patients with bioprostheses (17 (3) and 12 (3)%,
      respectively (95% CI of difference 2 to 8%, p = 0.025). CONCLUSIONS: In patients
      with mechanical mitral valves the decrease in the pressure half time during
      exercise is probably mostly the result of the shortening of the diastolic time
      interval with increasing heart rate whereas in patients with bioprosthetic valves
      an increase in functional valve area may contribute to the shortening of pressure
      half time during exercise.

PMID- 1622697
TI  - Exercise capacity after complete repair of tetralogy of Fallot: deleterious
      effects of residual pulmonary regurgitation.
AB  - OBJECTIVE: To determine the effects of residual pulmonary regurgitation on
      exercise tolerance after complete repair of tetralogy of Fallot. DESIGN:
      Prospective study of symptom free patients more than five years after complete
      repair. Graded exercise performance was measured with standard Bruce protocol.
      Maximal oxygen uptake and ventilatory anaerobic threshold were measured by
      respiratory mass spectrometry. Measurement of pulmonary regurgitant fraction was
      from pressure-volume loops constructed from measurements of right ventricular
      volume obtained from biplane angiograms and simultaneous pressures measured with
      a micromanometer. SETTING: Tertiary referral centre. PATIENTS: 16 patients were
      studied. Two patients had been excluded because of residual cardiac lesions or
      inadequate data from cardiac catheterisation. Four were later excluded because
      they failed to reach a respiratory quotient of greater than 1.0 during graded
      exercise. RESULTS: There was a significant negative correlation between the
      degree of residual regurgitation and both total duration of exercise and maximal
      heart rate achieved. Maximal heart rate and total duration of exercise were
      significantly lower in the patients than in normal controls. Patients with an
      abnormal maximal oxygen uptake (less than 85% of the predicted normal value) had
      significantly greater residual pulmonary regurgitation than those in whom oxygen
      uptake was normal. CONCLUSIONS: Impaired exercise capacity after complete repair
      of tetralogy of Fallot is directly related to the degree of residual pulmonary
      regurgitation. These data should be taken into account when deciding the optimal
      timing and nature of corrective surgery.

PMID- 1622698
TI  - Regional blood flow in chronic heart failure: the reason for the lack of
      correlation between patients' exercise tolerance and cardiac output?
AB  - BACKGROUND: In patients with chronic heart failure there is no relation between
      cardiac output and symptom limited exercise tolerance measured on a bicycle or
      treadmill. Furthermore, the increase in cardiac output in response to treatment
      may not be matched by a similar increase in exercise tolerance. More important in
      determining exercise capability is blood flow to skeletal muscle. This implies
      that the reduction in skeletal muscle blood flow is not directly proportional to
      the reduction in cardiac output and that there are regional differences in blood
      flow in patients with heart failure. METHODS: Cardiac output and regional blood
      flow measured in 30 patients with chronic heart failure were compared with values
      obtained from 10 healthy controls. Measurements were made at rest and in response
      to treadmill exercise and were all made non-invasively. RESULTS: Cardiac output
      was lower in the patients at rest and during exercise. Blood flow in the superior
      mesenteric and renal arteries was also lower in the patients and represented a
      different proportion of cardiac output than in the controls. In response to
      exercise the increase in blood flow to the calf and therefore to skeletal muscle,
      was reduced in the patients. In the patients there was no correlation between
      resting cardiac output and blood flow in the superior mesenteric artery, renal
      artery, or calf. CONCLUSIONS: Because blood flow to skeletal muscle and to the
      kidneys is likely to be important in determining patients' symptoms this factor
      may explain why central haemodynamic variables do not correlate with the exercise
      tolerance in patients with chronic heart failure.

PMID- 1622699
TI  - Decreased cardiac parasympathetic activity in chronic heart failure and its
      relation to left ventricular function.
AB  - BACKGROUND: Activation of the sympathetic nervous system has been extensively
      studied in patients with chronic heart failure, but the parasympathetic nervous
      system has received relatively little attention. The objective in this study was
      to investigate cardiac parasympathetic activity in chronic heart failure and to
      explore its relation to left ventricular function. METHODS: Heart rate
      variability was measured from 24 hour ambulatory electrocardiograms by counting
      the number of times each RR interval exceeded the preceding RR interval by more
      than 50 ms (counts). This method provided a sensitive index of cardiac
      parasympathetic activity. RESULTS: Mean (range) of counts were: waking 48 (1
      275)/h, sleeping 62 (0-360)/h, and total 1310 (31-7278)/24 h. These were lower
      than expected, and in 26 (60%) of the 43 patients counts fell below the lower 95%
      confidence intervals (95% CI) for RR counts in normal subjects. A significant
      correlation between total 24 hour RR counts and left ventricular ejection
      fraction was present (r = 0.49, p less than 0.05). CONCLUSIONS: These results
      indicate that most patients with chronic heart failure have reduced heart rate
      variability and therefore reduced cardiac parasympathetic activity. The degree of
      parasympathetic dysfunction is related to the severity of left ventricular
      dysfunction. This may be relevant to the high incidence of ventricular
      arrhythmias and poor prognosis of patients with chronic heart failure.

PMID- 1622700
TI  - Lack of variation in venous tone potentiates vasovagal syncope.
AB  - OBJECTIVE: To investigate the peripheral venous response to head up tilting in
      malignant vasovagal syndrome. PATIENTS: 31 Patients with unexplained syncope or
      dizziness referred from the cardiology department. METHODS: Changes in calf
      venous volume were studied by a radionuclide technique during 45 degrees head up
      tilt testing. RESULTS: During tilt testing six patients became syncopal but 25
      were symptom free. The syncopal group had greater increases in calf venous volume
      after the change in posture and perhaps more importantly considerably less
      variability in the venous volume during the tilted period. CONCLUSIONS: The
      venous response was different in the syncopal patients. The lack of response of
      the peripheral venous circulation to changes in the central circulation may be
      responsible for triggering the Bezold-Jarisch reflex and malignant vasovagal
      syncope.

PMID- 1622702
TI  - Streptokinase treatment of a thrombosed Bjork-Shiley prosthesis in the aortic
      position.
AB  - Dysfunction of a mechanical prosthetic valve caused by thrombus formation is
      usually treated surgically. A patient with a thrombosed Bjork-Shiley valve in the
      aortic position was treated successfully with intravenous streptokinase. The
      considerable improvement in the patient's clinical condition and the
      phonocardiographic, echocardiographic, and cinefluoroscopic evidence of
      normalisation of prosthetic valve function established the efficacy of
      thrombolytic therapy of a thrombosed prosthetic valve in this patient.

PMID- 1622701
TI  - Short-term and long-term treatment with propafenone: determinants of arrhythmia
      suppression, persistence of efficacy, arrhythmogenesis, and side effects in
      patients with symptoms.
AB  - OBJECTIVE: To assess the clinical criteria predicting the short and long-term
      efficacy of propafenone, an agent with class IC antiarrhythmic activity and a
      broad pharmacological profile. DESIGNS: Prospective study of propafenone at doses
      of 450 to 900 mg/day during a six week dose titration period (including a placebo
      phase with two separate 24 Holter recordings). Responders to treatment were
      followed for one year. PATIENTS: One hundred patients with frequent ventricular
      arrhythmias (greater than 30 extrasystoles/h) of Lown class III and IVA/B and
      without evidence of myocardial infarction within the past six months. ANALYSIS:
      Multivariate regression analysis of spontaneous arrhythmia variability and of
      different clinical variables to determine the short and long-term efficacy and
      safety of propafenone. MEASUREMENTS AND MAIN RESULTS: Propafenone 450 mg/day was
      effective in 30/100 patients (30%), and at 600 mg/day another 14 responded. The
      efficacy of propafenone correlated with a low spontaneous arrhythmia variability
      and, as shown by multivariate analysis, with a lower patient age (p less than
      0.05). When the dose was increased to 900 mg/day a further six (12%) patients
      responded. However, with increasing doses of propafenone, the one year
      probability of effective treatment decreased from 86% (450 mg/day) to 67% (600
      mg/day) and to 44% (900 mg/day). After restudying the patients at three, six, and
      12 months and after dose adjustment in 11/44 patients (25%), 31 patients (70%)
      remained responders. Loss of permanent antiarrhythmic efficacy was best predicted
      by the initial dose that achieved a response. No patient died suddenly or had
      arrhythmogenic effects during Holter monitoring. Side effects occurred in 36% of
      patients but these rarely limited long-term treatment. CONCLUSIONS: A younger
      age, low spontaneous arrhythmia variability, and particularly a low titration
      dose were the best predictors of the short and long term efficacy of propafenone.
      All other responders should have repeated Holter recordings during the first year
      of treatment.

PMID- 1622703
TI  - Infected interventricular Teflon patch: repair and closure of fistula with
      omentum.
AB  - A pericardiocutaneous fistula five years after repair of a rupture of the
      ventricular septum was managed by removing all foreign material (Teflon). The
      resulting defect was repaired with part of the central tendon of the diaphragm
      and a pedicle of omentum was used to cover the heart. This radical approach was
      found necessary after other measures, including surgical excision of the fistula,
      had failed.

PMID- 1622704
TI  - Subaortic stenosis caused by an unusual fibrous blood-filled cyst of the left
      ventricle with outflow tract obstruction associated with a ventricular septal
      defect.
AB  - A large blood-filled cyst formed from a fibrous tissue tag of a right ventricular
      septal aneurysm was successfully resected. This cyst, which was causing subaortic
      stenosis, was attached to the margin of the closed ventricular septal defect and
      not to the mitral valve itself nor the papillary muscle of the left ventricle.

PMID- 1622705
TI  - The natural course of osteoarthritis of the hip due to subluxation or acetabular
      dysplasia.
AB  - In 59 patients, 86 hips with subluxation or hip dysplasia were examined to
      determine the natural course of the condition and select suitable treatment.
      Thirty-three percent of the joints (13/39 hips) developed early osteoarthritis
      from pre-osteoarthritis within an average term of 9.2 years, while the remaining,
      sixty-six percent (31/47 hips) developed advanced-stage osteoarthritis from early
      osteoarthritis within an average term of 7.8 years. Patients were classified into
      advanced and non-advanced groups according to radiographic analysis of the
      advanced groups according to radiographic analysis of the advance of the disease
      and statistical analysis was performed. In pre-osteoarthritis, centre-edge angle,
      slope of the acetabular roof, acetabular head index, acetabular depth ratio and
      Japanese Orthopaedic Association (JOA) hip score were significant predictors,
      while in early osteoarthritis, a broken Shenton's line, cranial joint space and
      JOA score were significant. On the basis of multiple parameters, formulas for
      predicting development in patients with pre-osteoarthritis, those with early
      osteoarthritis, and all patients together were established, with an accuracy of
      87%, 71%, and 68%, respectively.

PMID- 1622706
TI  - A surgical approach in total shoulder arthroplasty.
AB  - The long deltopectoral approach promoted by Neer is the standard for performing a
      total shoulder arthroplasty. However, this exposure is inadequate for preparation
      and bone grafting of the glenoid cavity or repairing an associated large rotator
      cuff tear. In the anatomy laboratory we looked for an alternative approach to the
      glenohumeral joint which would accommodate these difficulties. Afterwards we used
      this approach in 7 of 13 patients in whom a Biomet Bio-modular shoulder
      arthroplasty was planned. The study is prospective with a 1-year follow-up of 12
      cases.

PMID- 1622707
TI  - Bad results after anterior advancement of the tibial tubercle for patello-femoral
      pain syndrome.
AB  - Seventy-one patients with patello-femoral pain syndrome were re-examined an
      average of 10 (range 8-12) years after anterior advancement of the tibial
      tuberosity. The clinical results were excellent in 8 (11%), good in 20 (28%),
      fair in 16 (23%), and poor in 27 (38%). Twenty patients had had a second
      operation. The results were worse in patients with Outerbridge grade III-IV
      cartilage damage. Since the clinical results deteriorated with time, this
      surgical procedure should no longer be used to treat patients with patello
      femoral pain syndrome.

PMID- 1622708
TI  - Training in basic microsurgical techniques without experiments involving animals.
AB  - Until recently, anaesthetised rats have been the usual material employed for
      learning basic microvascular and microneurosurgical techniques. However, ethical
      considerations, the costs involved and legislation controlling experiments with
      animals allow training in microsurgery for extended periods of time at a few
      medical centres only. This paper reports on our experience of an alternative
      training programme largely conducted without using live animals. As the basic
      material we selected legs of slaughtered pigs. According to the developing skill
      of the trainee, basic microsurgical techniques can be practised on arteries and
      veins of various sizes in these legs. To verify positive results, the vessels are
      subsequently perfused with human blood under pressure. The model described is
      particularly suited to the acquiring of skills in microneurosurgery. Mono-, oligo
      and polyfascicular nerves, structurally similar to the configurations found in
      human extremities, are found in pig legs. The ever-increasing importance of
      microsurgery in modern medicine requires more and more surgeons and orthopaedists
      to familiarize themselves with these techniques. The model we propose for
      teaching and training substantially facilitate such further professional training
      in an efficient way, and at the same time allows a substantial reduction in the
      number of experiments conducted on animals.

PMID- 1622709
TI  - Three-dimensional kinematics of total knee replacement systems.
AB  - In an in vitro study we collected data relating to three-dimensional kinematics
      and stability patterns in 40 knee joint specimens. The specimens were tested in
      an apparatus: the femur was flexed on a fixed transverse axis, while a freely
      mobile tibial assembly allowed measurement of all passive translational and
      rotational movements. Translational forces, torques and compression forces were
      introduced and the results compared with the measurements taken after
      implantation of different arthroplasty devices. This study compares the
      kinematics of a knee with mobile meniscal bearings (low contact stress, LCS) with
      the data relating to a more constrained system (Tricon M). The LCS knee showed
      the better kinematic behavior compared to the natural knee.

PMID- 1622710
TI  - Complications of high tibial osteotomy and internal fixation with staples.
AB  - Osteotomy for osteoarthritis of the knee has established itself well since its
      first description by Jackson and Waugh [8, 9]. Internal fixation with staples
      allows early functional treatment with only a minimum of operative intervention.
      Removal of the metal is optional. In the 5-year period from 1986 to 1990, 182
      high tibial osteotomies were performed at the Orthopaedic Department of the
      University Hospital of Freiburg. In four cases internal fixation was done with
      plates; in 178 cases two or more staples were used; in 3 cases a screw was
      additionally inserted for better hold. The staples became loose intraoperatively
      in eight cases (4.5%); only once did a dislocated staple have to be reoperated on
      post-operatively. Further complications which are independent of the method of
      internal fixation are summarized in the article. Complications of surgery on the
      long bones of the leg are inevitable, but with only one postoperatively
      dislocated staple and one case of non-infected pseudarthrosis (i.e. a method
      related complication rate of 1.1%), internal fixation with staples for high
      tibial osteotomy presents itself as a reliable and safe procedure.

PMID- 1622711
TI  - Physiopathology of the knee joint after distal iliotibial band transfer.
AB  - In an experimental study of 14 cadaver knee joints, the pressure load on the
      joint surface after distal iliotibial band transfer was measured using Fuji
      Prescale foils. With an intact anterior cruciate ligament, increases of up to
      153% for the average pressure load and of 225% for the total pressure in the
      lateral compartment were found in relation to the fixation point chosen. At point
      P3--slightly dorsal to the insertion of the lateral collateral ligament--the area
      loaded with maximum pressure increased to six-fold. Fixation at the transition of
      the lateral femoral condyle to the femoral shaft at the start of the linea aspera
      was associated with the least pressure increases in both the lateral and the
      medial compartments. Under all experimental conditions, lateral extra-articular
      stabilization with fixation at the insertion of the fibular collateral ligament
      was shown to be associated with significantly higher load increases. While a
      shift of pressure load to the dorsal third was seen in the lateral compartment,
      the mid-third remained the focus of the pressure load in the medial compartment.
      After transection of the anterior cruciate ligament and iliotibial band transfer
      at the "over-the-top" point, a significant shift of pressure towards the medial
      compartment was seen, while the lateral pressure load decreased. Medially, the
      area loaded with peak pressure remained constant, while the corresponding area in
      the lateral joint space showed a highly significant decrease to nearly one-third
      of normal. After additional bilateral meniscectomy this tendency was even more
      pronounced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622712
TI  - The transgluteal approaches to the hip.
AB  - The transgluteal approach to the hip, first described by Bauer et al. in 1979,
      has since become a recognized routine method. Its longitudinal incision of the
      fibers of the gluteus medius and minimus and the vastus lateralis muscles takes
      advantage of the tendinous junction of these muscles over the greater trochanter.
      This paper describes the modifications of the transgluteal approach described in
      the literature and compares them to the original procedure. In 52 hip specimens,
      including attached muscles, the insertions and different variations of the
      junction of the gluteus medius, minimus and vastus lateralis muscles over the
      greater trochanter are described and statistically analysed. In 59.6% of all
      specimens there proved to be a united tendinous junction of all the muscles
      referred to above, while in 40.4% autonomous insertions of the gluteus medius
      and/or gluteus minimus were seen. In accordance with the anatomical results, the
      form of incision described by the original authors can be considered the most
      favourable. In roughly one-third of all hip operations, autonomous insertions of
      gluteus medius and minimus must be taken into account, since otherwise total or
      partial upward displacement of the autonomous muscle insertions could occur.

PMID- 1622713
TI  - Non-invasive treatment of long-bone pseudarthrosis by shock waves (ESWL).
AB  - Non-invasive treatment of non-union of diaphyses by application of the shock
      waves known from lithotripsy has proved successful in three out of four cases.
      Two thousand shock waves with a single-wave energy of 18 kV were applied by the
      MFL 5000 and HM3 Lithotripters of the Dornier Medizintechnik Company with manual
      detection of the lesion. The shock waves induced a kind of callus formation in
      the non-union soft tissue within about 6 weeks, which was successfully maintained
      and transformed into bony union in all cases but one by dynamic fixation less
      rigid than a plaster cast. Four cases are documented and the effects of the shock
      waves and principles of bony union discussed.

PMID- 1622714
TI  - Relationship between the pivot shift and the configuration of the lateral tibial
      plateau.
AB  - Twenty patients with a chronic anterior cruciate ligament tear were studied.
      First they were interviewed on the preoperative history of unexpected giving way
      (pivot shift), then they were tested for clinical pivot shift sign, and last, the
      configuration of the lateral tibial plateau was studied using magnetic resonance
      imaging. A connection could be noticed between the history of instability
      symptoms and the pivot shift sign at clinical examination (P less than 0.001).
      Interestingly, there was also a link between the instability history and the
      configuration of the lateral tibial plateau (P = 0.0021), and, further, between
      the clinical pivot shift sign and the configuration of the lateral tibial plateau
      (P = 0.0002). The variation in the shape of the convexity of the lateral tibial
      plateau seems to be associated with the symptoms and prognosis of the patients
      with rupture of the anterior cruciate ligament.

PMID- 1622715
TI  - Radiographic assessment of cup migration in bipolar hip arthroplasty: intra
      observer and interobserver errors and tolerance limits.
AB  - Statistical methods were used to calculate the possible observer error in
      measuring cup migration in bipolar hip arthroplasty from follow-up radiographs.
      Finding the "tolerance limits" by such methods helped in assigning the true
      significance of any observed change.

PMID- 1622716
TI  - Treatment of femoral supracondylar unstable comminuted fractures. Comparisons
      between plating and Grosse-Kempf interlocking nailing techniques.
AB  - A prospective study was done of 66 consecutive unstable comminuted supracondylar
      femoral fractures in adults, fixed with either plates (28 cases) or Grosse-Kempf
      interlocking nails (38 cases). Patients were followed up for at least 1 year
      (average 44 months). Interlocking nails led to a higher union rate and more
      satisfactory functional results. Nevertheless, the first distal transverse screw
      hole took a potential risk of breakage due to stress concentration. The authors
      conclude that for a cooperative patient, a closed static interlocking nail with
      strict non-weight-bearing should be the treatment of choice, and for an
      uncooperative patient, a closed static interlocking nail should be supplemented
      with a cast brace to reduce the complication rate.

PMID- 1622717
TI  - Intra-articular injections and articular cartilage metabolism. An experimental
      study in rabbits.
AB  - We studied the effects of repeated intra-articular injections of sterile 140 mM
      NaCl solution on articular cartilage in adult rabbits. After 20 injections into
      the knee joints over a period of 4 weeks, chondrocyte glucosaminoglycan synthesis
      was evenly reduced in all cartilage layers, accompanied by a significant
      proteoglycan depletion of the matrix which was most marked in the superficial
      half of the cartilage. These and other changes only partially reversed during a
      further 4-week period after the injections had been stopped. Our data underline
      the need for a clear-cut indication for intra-articular injections. The
      microtrauma caused by injection, in conjunction with the introduction of a
      carrier solution into the joint, may, at least when repeated at short intervals,
      lead to measurable damage to the articular cartilage.

PMID- 1622718
TI  - Bilateral thoracic outlet syndrome with bilateral radial tunnel syndrome: a
      double-crush phenomenon. Case report.
AB  - A case of bilateral thoracic outlet syndrome combined with bilateral radial
      tunnel syndrome is reported. Persisting complaints in the upper extremities after
      bilateral first-rib resection and scalenotomy were due to radial nerve entrapment
      in the radial tunnel. Although this bilateral double-crush phenomenon is
      extremely rare, and has not been reported previously, persistence of symptoms
      after initial treatment of a nerve entrapment is an indication to search for
      another site of compression.

PMID- 1622719
TI  - Irreducible palmar epiphyseal fracture-dislocation of the distal interphalangeal
      joint of a finger.
AB  - A case of irreducible palmar epiphyseal fracture-dislocation of the distal
      interphalangeal joint is reported. The intact collateral ligaments and flexor
      digitorum profundus tendon did not permit adequate distraction of the joint,
      thereby preventing reduction of a displaced epiphyseal fracture.

PMID- 1622720
TI  - S. Suzuki et al.: Ultrasound diagnosis of pathology of the anterior and posterior
      cruciate ligaments of the knee joint.

PMID- 1622721
TI  - Neuronurses bask in certification glory--can Canadian nursing afford the growing
      demands?

PMID- 1622722
TI  - Providing hemodialysis to a schizophrenic patient--an ethical dilemma.

PMID- 1622723
TI  - Standardized teaching plans: the best way to document patient teaching.

PMID- 1622724
TI  - Inadequate funding of r-HuEPO treatment for anemia in dialysis patients.

PMID- 1622725
TI  - Perfusion and mechanical analysis with technetium-99m 2-methoxy-isobutyl
      isonitrile in a case of dilated cardiomyopathy.
AB  - With technetium-99m 2-methoxy-isobutyl-isonitrile (99mTc-MIBI), regional wall
      thickening in a patient with dilated cardiomyopathy was analyzed by the first
      component Fourier method. The regional wall thickening was compared with thallium
      201 and 99mTc-MIBI SPECT imaging. Thallium-201 SPECT images showed mildly reduced
      perfusion in the posterior wall and redistribution in the septum, whereas 99mTc
      MIBI images showed heterogeneous accumulation around the left ventricular
      circumference. By means of phase analysis, diffusely decreased wall thickening
      and discontinuity of percent wall thickening in neighboring segments were
      observed throughout the left ventricle. Regional wall motion and wall thickening
      correlated roughly. However, discrepancies between the mechanical function and
      myocardial perfusion, and discrepancies in regional myocardial perfusion between
      thallium-201 and 99mTc-MIBI were observed.

PMID- 1622726
TI  - Transient thyrotoxicosis in a patient with a functioning nodule; a possible
      occurrence of silent thyroiditis.
AB  - A 48-year-old woman with diffuse goiter presented with typical symptoms and signs
      of thyrotoxicosis. Thyroid scanning with I-123 revealed a localized accumulation
      of the radionuclide in the left lobe which corresponded to a small nodule later
      detected by ultrasonography, with suppression of the remaining tissues. Owing to
      the overall reduced radioactivity in the thyroid, she was suspected of having
      silent thyroiditis causing thyrotoxicosis. Meanwhile, the thyrotoxicosis subsided
      concurrently with an increase in radioactivity in the extranodular area that had
      initially been suppressed. The histology of thyroid tissues obtained at the time
      of operation revealed follicular adenoma or hyperplasia in the area of the
      localized I-123 uptake and findings similar to those in Hashimoto's thyroiditis
      in the remaining tissues, supporting our clinical diagnosis of silent thyroiditis
      together with a functioning nodule.

PMID- 1622728
TI  - Serum thymidine kinase, a possible marker for monitoring the effect of bone
      marrow transplant treatment in early recovery phase.
AB  - We measured serum thymidine kinase (TK) activity with a radioenzyme assay system
      employing [I-125]-iododeoxyuridine as the tracer on serial specimens from five
      bone marrow transplant (BMT) patients before and after transplantation. The serum
      level of TK activity in the 4 patients with effective BMT treatment ranged from
      3.0 to 16.9 U/L (mean, 7.80 U/L) before transplantation and from 27.3 to 236.1
      U/L (mean, 82.95 U/L) after the BMT treatment. Mean serum TK activity increased
      13.17-fold (range, 1.68 to 29.14-fold). In contrast, the activity in the patient
      with ineffective BMT treatment was not significantly different during, before, or
      after BMT treatment. In addition, serum TK activity in BMT patients was well
      correlated with the change in the number of leukocytes before and after BMT
      treatment [r = +0.709 (p less than 0.01), y = 0.012 x +0.87]. We conclude that
      the determination of serum TK activity in BMT patients is very useful in
      monitoring the course of bone marrow transplantation in the early recovery phase.

PMID- 1622729
TI  - Esophageal clearance scintigraphy, in diabetic patients--a preliminary study.
AB  - The aim of this preliminary study was to evaluate the predictive value of
      esophageal clearance scintigraphy (ECS) in the diagnosis of esophageal autonomic
      neuropathy in diabetic patients without any esophageal symptoms. A single swallow
      ECS was performed in 12 diabetic patients and 15 normal volunteers, and
      esophageal transit time (ETT) and esophageal (Es) T 1/2 values were calculated.
      ETT and Es T 1/2 were found to be significantly prolonged in the diabetic group
      (p less than 0.01 and p less than 0.05, respectively). In this preliminary study,
      our results strongly suggest that ECS may be an important noninvasive diagnostic
      tool in the evaluation of diabetic patients with asymptomatic esophageal
      autonomic neuropathy.

PMID- 1622727
TI  - Quantitative phase analysis of myocardial wall thickening by technetium-99m 2
      methoxy-isobutyl-isonitrile SPECT.
AB  - Regional wall thickening was assessed by ECG-gated SPECT using technetium-99m 2
      methoxy-isobutyl-isonitrile (99mTc-MIBI). For myocardial segments with an optimal
      short axis, regional count changes from end-diastole to end-systole were used to
      calculate the regional wall thickening. Functional images displaying amplitude, %
      wall thickening (% WT), and phase were generated by a fundamental Fourier
      analysis. In the control subjects, % WT analysis showed heterogeneous contraction
      among the left ventricular wall segments. The amplitude values showed a similar
      pattern to the %WT values. Phase images demonstrated that the timing of
      ventricular contraction was almost homogenous between the various wall segments.
      In the CAD patients, regional decreases in amplitude and %WT corresponding to
      zones of reduced perfusion were shown in the ischemic segments. Phase images also
      indicated asynchronous contraction in these segments. Phase analysis of regional
      wall thickening in 99mTc-MIBI scintigraphy seems to be useful for understanding
      regional myocardial function in combination with perfusion scanning.

PMID- 1622730
TI  - Demonstration of systemic lymphnodes by bone scintigraphy in amyloidosis.
AB  - We report a case of primary amyloidosis with calcification of systemic lymphnodes
      which were demonstrated as positives by bone scintigraphy. Positive sites
      delineated by bone scintigraphy would seem likely to reflect avid calcification
      of amyloid deposits. The discovery of positive systemic lymphnodes by bone
      scintigraphy is very rare in a routine study and may allow for amyloidosis in a
      differential diagnosis.

PMID- 1622731
TI  - SPECT demonstration of splenosis.
AB  - Splenosis is defined as the heterotopic autotransplantation of splenic tissue.
      The main cause of splenosis is splenic rupture following abdominal trauma, in
      which fragments of splenic tissue are seeded throughout the peritoneal cavity.
      Demonstration of splenosis by scintigraphy or CT imaging has been reported, but
      there is no previous report of simultaneous demonstration by SPECT and CT
      imaging. Autotransplantation of splenic tissue in the abdominal cavity forms a
      solid tumor-like image on CT and is difficult to differentiate from other
      abdominal masses. In such cases, SPECT demonstration of splenosis is very
      important for identification of its exact site. A case report of splenosis is
      presented, in which simultaneous demonstration by SPECT and CT was performed.
      This was confirmed at laparotomy for gastrectomy.

PMID- 1622732
TI  - The combined effect of lymphokine activated killer cell and radiation therapy on
      rat brain tumor in vitro.
AB  - The in vitro effect of a combined treatment with lymphokine activated killer
      (LAK) cell and radiation therapy on rat brain tumor was examined using 51Cr
      release assay. The tumor cell-line used in this experiment was 9L rat brain tumor
      derived from a Fischer 344 rat. LAK cells were obtained by culturing rat
      lymphocytes with recombinant human interleukin 2 for at least 3 days. The
      cytotoxic activity of the LAK cells was examined by 51Cr release assay.
      Irradiation was done by exposing the microtiter plate in which the 51Cr labeled
      9L cells and LAK cells were cultured to a 137Cs gamma cell unit. Without
      irradiation, there was 18% cytotoxicity in the 1:100 tumor-to-LAK cell ratio
      specimen after 24 hrs cocultivation. However, if 5 Gy of irradiation was given,
      followed by 12 hrs incubation, the cytotoxicity was enhanced significantly at the
      same cell ratio (30%). This enhancement effect was the most prominent when the
      cell ratio was 1:100 and the irradiation dose was 5 Gy. To generate the
      enhancement effect, an incubation time of over 8 hrs both before and after
      irradiation was required. The supernatant of the LAK cells showed 19.8% and 11.4%
      cytotoxicity with and without irradiation, respectively. This result indicates
      the participation of a cytotoxic factor released from LAK cells.

PMID- 1622733
TI  - Immunomodulation by orally administered protein-bound polysaccharide PSK in
      patients with gastrointestinal cancer.
AB  - The present study was designed to assess the effects of the protein-bound
      polysaccharide PSK on the immunological status of patients with gastrointestinal
      cancer. Twenty-nine gastric and 18 colorectal cancer patients were randomly
      assigned to either the control or PSK group. Patients in the PSK group were given
      3.0 g of PSK orally before surgery, either daily or every other day. Patients in
      the control group received no PSK. The data of peripheral blood lymphocytes (PBL)
      were compared before and after administration of PSK, and those of the regional
      node lymphocytes (RNL) were compared between the control and the PSK group. The
      results indicate that the effects of PSK were significantly influenced by the
      duration of administration, but not by the frequency of administration. In the
      patients belonging to the short term PSK group (administration less than 14
      days), the response of the PBL to PSK and Con A become significantly stronger
      compared to before the administration of PSK, whereas the cytotoxicity against
      K562 and KATO-3, and the proportion of CD16+ cells increased significantly in
      those patients belonging to the long term PSK group (greater than or equal to 14
      days). In addition, the proportion of CD9 + 11b + suppressor T cells decreased in
      the RNL of the short term PSK group, whereas the proportion of CD4 + Leu8 -
      helper T cells in the RNL increased in the long term PSK group. These results
      suggest that the oral administration of PSK leads to the suppression of
      suppressor cells in the RNL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622734
TI  - Antitumor effect of RBS (rice bran saccharide) on ENNG-induced carcinogenesis.
AB  - We examined whether orally administered RBS (rice bran saccharide), prepared from
      rice bran by hot water extraction, increases immunocompetence, inhibits
      gastrointestinal carcinogenesis with N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG)
      or shows an antitumor effect. After the administration of RBS, phytohemagglutinin
      (PHA)- and pokeweed mitogen (PWM)-stimulated blastogenesis of lymphocytes derived
      from the mesenteric lymph nodes and peripheral blood was enhanced, and the
      helper/suppressor T-cell ratio was elevated, and migration activity of peritoneal
      macrophages was also increased in rats treated continuously with ENNG. ENNG
      induced gastrointestinal carcinomas were observed in 43% of those administered
      RBS (ENNG-RBS) as compared with 88% in the control (ENNG) and 94% in the
      prednisolone (PRD) group (ENNG-PRD). The 12-month survival rate of rats bearing
      gastrointestinal cancer was 58% in the ENNG-RBS group as compared with 25% in the
      ENNG group and 15% in the ENNG-PRD group. RBS prevented the reduction in
      immunocompetence in the course of carcinogenesis, suppressed carcinogenesis, and
      prolonged the survival of rats with gastrointestinal cancer. Antitumor activities
      of RBS are thought to be a kind of host mediated action. The growth inhibition
      ratio of transplantable ENNG-induced cancer in Wistar rats was 42.1% in the RBS
      and 51.8% in the 5-FU group. Since little is known about the potent antitumor
      activity of alpha-glucan, it would be interesting to consider the relationship
      between the structure and the biological activities of polysaccharides.

PMID- 1622735
TI  - Human blood monocyte activation by Nocardia rubra cell wall skeleton for
      productions of interleukin 1 and tumor necrosis factor-alpha.
AB  - Human blood monocytes were obtained from peripheral blood of healthy donors by
      counter-flow centrifugal elutriation. Functional integrity of monocytes for
      production of interleukin 1 (IL-1) and tumor necrosis factor alpha (TNF-alpha) in
      response to Nocardia rubra cell wall skeleton (N-CWS) was examined by bioassay
      and enzyme immunoassay. Monocytes treated with N-CWS at more than 0.5
      microgram/ml produced IL-1 and TNF-alpha extracellularly. Extracellular TNF
      activity appeared within 4 h, and maximally, 16 h after N-CWS stimulation,
      whereas longer time was needed for IL-1 activity to appear, the peak production
      being at 24 h. The neutralizing experiment also showed that anti TNF-alpha
      antibody did not affect IL-1 production by the monocytes treated with N-CWS,
      suggesting independency of IL-1 production of TNF-alpha. These results suggest
      that the therapeutic antitumor effect of N-CWS is due, in part at least, to the
      augmented production of these monokines.

PMID- 1622736
TI  - Combination therapy of radiation and Sizofiran (SPG) on the tumor growth and
      metastasis on squamous-cell carcinoma NR-S1 in syngeneic C3H/He mice.
AB  - The efficacy of Sizofiran(SPG), a highly purified beta-1,3-D-glucan from the
      culture broth of basidiomycetes Schizophyllum commune Fries, in combination with
      local irradiation was investigated using squamous-cell carcinoma NR-S1 and
      syngeneic hosts of C3H/He mice. NR-S1 tumor was implanted sc in the thigh of
      C3H/He mice. When tumor grew to 4 mm in diameter, the local irradiation of 55 Gy
      was delivered. SPG was injected im at a dose of 5 mg/kg. When SPG was
      administered after irradiation, remarkable inhibition of tumor growth was
      observed in comparison with the radiation alone group. Furthermore, the
      combination effect of radiation and active immunotherapy using mitomycin C
      treated NR-S1 cells as vaccine was examined. When radiotherapy and active
      immunotherapy were combined with SPG, suppression of tumor growth was observed
      from an early stage in comparison with the group which was not administered SPG.
      SPG also inhibited the pulmonary metastasis of NR-S1 tumor after radiotherapy.

PMID- 1622737
TI  - Therapeutic evaluation of interleukin-1 for stimulation of hematopoiesis in
      primates after autologous bone marrow transplantation.
AB  - A multiple dose IL-1 therapy was evaluated for its capability to stimulate
      hematopoiesis in normal primates and to restore hematopoiesis after autologous
      bone marrow transplantation. The administration of IL-1 to normal animals over a
      dose range of 0.5 to 10 micrograms/kg/d led to a 7-12 fold increase in peripheral
      blood neutrophil and monocyte counts after 24 hours. This increase in the mature
      peripheral blood myeloid cells was followed by changes in the myeloid composition
      of the bone marrow, where the percentage of myeloid elements increased along with
      a transient increase in myeloid progenitor cell activity. IL-1 treatment also led
      to an initial decrease in platelet counts of 10-30% during the first 3 days of
      treatment. However, a striking finding was a significant and long lasting
      stimulation of increased platelet production with platelet counts increasing to
      77% of baseline 3 days after cessation of treatment and remaining elevated for
      the next 10 days. The therapeutic potential of the IL-1 regimen to restore
      hematopoiesis was further evaluated in an established autologous bone marrow
      transplantation model. In monkeys receiving IL-1 doses, 1.0 and 5.0 ug/kg/d,
      neutrophil counts recovered to greater than 0.5 x 10e9/1 on day 16, one day
      earlier than control, but the recovery to baseline neutrophil counts occurred 5
      days sooner than control. IL-1 therapy had its greatest effect on the restoration
      of platelet counts after transplantation, reaching greater than 100 x 10e9/1 by
      day 21, two weeks earlier than control. This work demonstrates that IL-1 therapy
      stimulates myelopoiesis but its most promising clinical application is the
      stimulation of platelet production.

PMID- 1622738
TI  - Endolymphatic delivery of IL2 in patients with melanoma and lymphoma.
AB  - During this phase I/II study, enodolymphatic cannulae were placed in the iliac
      lymphatics under general anaesthesia. IL2 was then infused via this route at
      escalating doses until the highest tolerated dose was achieved; then, continuous
      infusion was maintained for 2 to 3 weeks. Seven patients with advanced cancer (3
      lymphoma, 4 melanoma), resistant to all other modalities of treatment received
      such therapy. Most patients tolerated 4 to 5 x 10(6) u/day of IL2 for 2 to 3
      weeks with less toxicity as compared to the equivalent dosage given
      intravenously. No severe perioperative morbidity was experienced. One melanoma
      patient had a minor clinical response. Changes in circulating lymphocyte numbers
      and cytotoxicity demonstrated a systemic effect of endolymphatic IL2 therapy.
      CONCLUSIONS: The endolymphatic administration of IL2 is associated with less
      toxicity than the intravenous route but still achieves a systemic effect; a lower
      tumour burden may prove more responsive to this therapy.

PMID- 1622739
TI  - Clinical trials of intrasplenic arterial infusion of interleukin-2 (IS-IL-2) to
      patients with advanced cancer.
AB  - We tried a infusion of interleukin-2 (IL-2) of a relatively low dose via an
      intrasplenic arterial catheter connected to a chronometric infusion (IS-IL-2).
      Eighteen patients of colorectal cancer with metastases to the liver or lung or of
      unresectable hepatoma received a 24 hour continuous infusion with low dose
      recombinant of IL-2 (mainly 8 x 10(5) JRU/day) for 25-40 days. All patients
      tolerated this protocol of the therapy and the main toxic effects were fever and
      general fatigue. Such serious toxicity as previously reported by high dose IL-2
      therapy was not observed. Data of hepatic and renal functions were normal. IS-IL
      2 therapy induced a high incidence of eosinophilia (12/18) and thrombocythemia
      (12/18). Peripheral natural killer (NK) and LAK activities were augmented in all
      patients and total white blood cell counts were increased during IS-IL-2 therapy.
      An increase in IL-2 receptor expression of peripheral blood mononuclear cells and
      significant rises in numbers of Leu11 (CD16)+, OKM1(CD11)+ and OKIa1(HLA-DR)+
      were observed. Of 18 patients 12 were evaluable for their response to therapy.
      Partial response (PR) was observed in one unresectable hepatoma and 11
      demonstrated no change (NC) or progressive disease (PD). Six patients were not
      evaluable because of additional therapy (3 cases) or decreasing tumor cell
      markers having no measurable lesions (3 cases). Three patients of colorectal
      cancer from an unresectable group were presumed to have micrometastases to the
      liver as suggested by an elevated serum CEA level. After receiving IS-IL-2
      therapy they demonstrated a decrease in the serum CEA level for more than 3 years
      after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622740
TI  - Inhibition of proliferation of retrovirus-immortalized macrophages by LPS and IFN
      gamma: possible autocrine down-regulation of cell growth by induction of IL1 and
      TNF.
AB  - The GG2EE macrophage tumor cell line was previously established by
      immortalization of C3H/HeJ mouse bone marrow cells with the J2 retrovirus which
      contains the v-myc and v-raf oncogenes. Studies on the control of GG2EE cell
      proliferation in vitro have recently been performed. We observed that the
      combination of 5-25 U/ml recombinant mouse interferon-gamma (rmIFN-gamma) plus
      0.03-0.3 micrograms/ml lipopolysaccharide (LPS) markedly inhibited the
      proliferation of GG2EE cells (by greater than 95%) in vitro, while either agent
      alone inhibited only by less than 40% and 0-10%, respectively. Subsequent studies
      established that biologically active IL1-like (2-4 U/ml) and TNF alpha-like (50
      100 U/ml) activities were released into the supernatants of LPS-treated GG2EE
      cells. The combination of IFN-gamma + LPS induced more (6-8 U/ml) IL1 release.
      These results suggested that the inhibition of proliferation of GG2EE cells by
      IFN-gamma + LPS could have been mediated in part by cytokines produced by the
      cells themselves. rhIL1 alpha at a concentration of 10 U/ml inhibited GG2EE
      proliferation by 25-30%, while rmIFN-gamma (25 U/ml) + rhIL1 alpha (10 U/ml)
      inhibited proliferation by 98%. Thus, 10 U/ml rhIL1 alpha could completely
      replace LPS in the LPS + rmIFN-gamma combination. Further, the combination of low
      doses of rhIL1 alpha (0.1 to 1 U/ml) plus rmTNF alpha (250 U/ml), which together
      inhibited proliferation by less than 20% synergized with doses of 5 to 25 U/ml
      rmIFN-gamma to inhibit proliferation of GG2EE cells by 98-99%. These results
      suggest that cytokines produced by the cells themselves can synergize with rmIFN
      gamma to inhibit the oncogene-driven proliferation of GG2EE cells.

PMID- 1622741
TI  - Effect of a 12 Hz and of a 460 Hz pulsed magnetic field on the weight of AKR
      mice.
AB  - AKR mice were exposed to a 6 mT, 12 Hz or 460 Hz pulsed magnetic field (PMF) 30
      minutes twice a week. The exposure took place in utero and/or during the life
      span for four consecutive generations. The adult mice exposed to the 460 Hz PMF
      only after the birth time were lighter than the controls; for the two frequencies
      the decrease in weight with the ageing was less pronounced than in the controls.
      When the exposure took place in utero the exposed new-born mice were heavier than
      the controls. The difference in weight progressively disappeared when the mice
      were exposed to the 12 Hz PMF, persisted when the mice were exposed to the 460 Hz
      PMF.

PMID- 1622742
TI  - Treatment with tumour infiltrating lymphocytes and interleukin-2 in patients with
      metastatic melanoma: a pilot study.
AB  - Tumour infiltrating lymphocytes (TIL) were isolated and expanded from biopsy
      samples of 4 patients with metastatic melanoma. The patients were treated with
      autologous expanded TIL and continuous or bolus infusion of Interleukin 2 (IL-2)
      at a dose of 18 x 10(6) International Units/m2/day for 5 days starting 36-48
      hours after administration of cyclophosphamide at a dose of 1 g/m2. The number of
      TIL infused ranged from 10(10) to 5.56 x 10(10) cells. Two patients had stable
      disease (SD) lasting for 2 1/2 and 4 months respectively and they died 24 and 13
      months after therapy. One patient died during therapy due to a pseudomonas
      septicaemia and another patient developed progressive disease (PD). He died 3
      months after the start of therapy. The side effects were substantial but most of
      them were reversible upon cessation of the treatment. The majority of the
      expanded TIL of all patients were of the CD8+ phenotype. Cutaneous metastases
      from two patients, removed after treatment with IL-2 and TIL, showed moderate
      lymphocytic infiltration also mainly of CD8+ T cells. The treatment with IL-2 and
      TIL is feasible, but further investigations should continue in an attempt to
      improve the efficacy of the therapy, to reduce toxicity and to diminish the costs
      and labour of the culture methods.

PMID- 1622743
TI  - Predictive indicators for the therapeutic effect of OK-432 in patients with
      chronic active type B hepatitis.
AB  - Twenty-two patients with chronic type B hepatitis were treated with OK-432.
      Immunological parameters were serially measured to find predictive indicators for
      the seroconversion from hepatitis B envelope antigen (HBe Ag) to anti-HBe. In
      patients who achieved the disappearance of HBe Ag associated with or without the
      appearance of anti-HBe, the numbers of CD8+DR+ and CD4+DR+T cells in peripheral
      blood increased gradually during OK-432 therapy and then reduced subsequently to
      the seroconversion from HBe Ag positive to anti-HBe positive. Increases of DR
      positive T cells in numbers were significantly correlated with increased amounts
      of IFN-gamma produced in response to in vitro OK-432 stimulation. In vitro OK-432
      stimulated IFN-gamma production and the increase of CD8+DR+T cells in number in
      peripheral blood could be proposed as predictive indicators for the disappearance
      of HBe Ag.

PMID- 1622744
TI  - Hyperthermia in cancer growth regulation.
AB  - With present techniques, hyperthermia used alone can cause complete clinical
      regression in 10-15% of tumours but the duration of response is very short. The
      greatest advantage for hyperthermia at the present time appears to be in
      combination with radiation in the local control of cancer growth. Currently,
      large randomised phase III studies are in progress to determine whether the
      addition of local hyperthermia to radiation or chemotherapy yields significant
      advantage. Phase III studies of wholebody hyperthermia in combination with
      chemotherapy are planned for the future and will include tumours with a high
      growth fraction such as small cell lung cancer and high grade non Hodgkins
      lymphoma.

PMID- 1622745
TI  - The M20 IL-1 inhibitor prevents onset of adjuvant arthritis.
AB  - Cytokines, specifically IL-1 and TNF, have been implicated as important mediators
      of joint destruction in rheumatoid arthritis (RA). Elevated levels of IL-1 in the
      joint fluid of patients with RA have been reported, as well as the presence of IL
      1 inhibitory activity. We have reported the characterization of an inhibitor
      derived from a myelomonocytic cell line cloned in our laboratory which is
      specific for IL-1. This IL-1 inhibitor is protein in nature which specifically
      inhibits activity in vitro and in vivo. Previous studies showed that the
      inhibitor reduced acute inflammatory reactions associated with IL-1 (fever,
      leukocytosis, local foot pad swelling, lymph node enlargement and acute phase
      reactants). Thus it was of interest to study whether the M20 IL-1 inhibitor could
      modify adjuvant-induced chronic inflammation in rats, which is often used as a
      model for human RA. Administration of complete Freund's adjuvant (CFA) into Lewis
      rats, resulted in a severe adjuvant arthritis (AA) which reached peak severity
      after 14 days. Daily administration of IL-1 inhibitor, beginning after injection
      of CFA, abolished the appearance of AA. The parameters investigated were: joint
      swelling (the increase in diameter of joints), peri-articular erythema, limping
      of the rats and histological examination. The effect of the M20 IL-1 inhibitor
      was shown to be dose dependent and the IL-1 inhibitor alone had no adverse
      effects. These results indicate that the M20 IL-1 inhibitor may have a role in
      the treatment of AA and may be used to reduce pathological processes in joint
      inflammation.

PMID- 1622746
TI  - Control of the transmission of Vibrio cholerae and other enteropathogens by foods
      originating from endemic areas in South America and elsewhere as a model
      situation.
AB  - The cholera-pandemic raging in South and Middle America and endemic cholera in
      other countries call for measures of health protection of the local population,
      but particularly with respect to the young, old, pregnant and immunocompromised
      citizens of countries importing food from the areas where the disease has struck.
      Instead of harshly barring importation, a more humanitarian policy is
      recommended, relying on assistance of areas presenting risks, with the
      introduction of and adherence to rigorous measures of longitudinally integrated
      microbiological safety assurance. This model is equally applicable to other
      enteric diseases transmitted by food. Examples are given of how canned foods of
      neutral pH, fishery products, vegetables and certain fruits should be processed
      for safety. Importation monitoring strategies, linked to this proactive approach
      to consumer protection, are briefly summarized.

PMID- 1622748
TI  - Efficacy of prolonged (48 h) selective enrichment for the detection of foodborne
      Salmonella.
AB  - The effect of prolonged (48 h) incubation on the productivity of five enrichment
      temperature conditions (tetrathionate brilliant green, 35 and 43 degrees C;
      Muller-Kauffman tetrathionate brilliant green, 43 degrees C; Rappaport
      Vassiliadis, 43 degrees C; selenite cystine, 35 degrees C) was compared to
      homologous results obtained under standard (24 h) conditions of selective
      enrichment. Of 797 high moisture and 166 low moisture foods tested, 171 (21.5%)
      and 80 (48.2%), respectively, were found to contain salmonellae by one or more
      analytical condition. Combined results of the five enrichment conditions after 24
      and 48 h of incubation identified 247 (98.4%) and 250 (99.6%) of the 251
      contaminated samples identified in this study. Our results are at variance with
      earlier reports on the greater method sensitivity with extended (greater than or
      equal to 48 h) periods of selective enrichment. The productivities of individual
      enrichment conditions after each period of incubation varied markedly where
      recovery rates with TBG43 and MKTBG43 exceeded that obtained with SC35 and TBG35.
      Our findings also underline the determinant role of enrichment at an elevated
      temperature (43 degrees C), and use of multiple enrichment and plating media for
      the optimal recovery of foodborne Salmonella.

PMID- 1622747
TI  - Sites of action by propionate on Listeria monocytogenes.
AB  - Exposure of Listeria monocytogenes to a solution of sodium propionate (8% w/v)
      for 60 min caused 87% of the population to be injured. Injury was evidenced by
      inability of the bacterium to tolerate 6% sodium chloride in tryptose agar as
      compared to ability to grow on tryptose agar with no added salt. Injured cells
      were allowed to repair in tryptose broth and the repair process was studied by
      addition to tryptose broth of sublethal amounts of metabolic or synthetic
      inhibitors. Repair of injured cells did not require electron transport or
      synthesis of cell wall components, mRNA or protein. No changes which may have
      occurred in the cell membrane of injured cells, allowed leakage of proteins or
      nucleotides into the medium. Exogenous cation salts enhanced the rate of recovery
      of injured cells. The specific activity of lactic dehydrogenase was reduced in
      propionate-injured L. monocytogenes.

PMID- 1622749
TI  - Application of predictive microbiology to assure the quality and safety of fish
      and fish products.
AB  - Predictive microbiology offers an alternative to traditional microbiological
      assessment of food quality and safety. The concept is that a detailed knowledge
      of the microbial ecology of a food product can be expressed as a mathematical
      model to enable objective evaluation of the effect of processing, storage and
      distribution operations on microbial development. Experience to date indicates
      the need initially to derive a mathematical model in laboratory studies, to
      validate the model in food products and to incorporate the information into
      monitoring devices. These may be chemical or physical indicators or electronic
      integrators or loggers. To enable a correct decision on quality or safety, it is
      essential that the response of the monitoring device to environmental changes
      mimics exactly that of the organism of concern. Most monitoring devices currently
      available record temperature history, but not other environmental factors that
      influence growth and that, in some circumstances, change during storage. The next
      generation of monitoring devices may be required to monitor several parameters to
      take full advantage of increasingly accurate and sophisticated models.

PMID- 1622750
TI  - Evaluation of a commercial process for collection and cooling of beef offals by a
      temperature function integration technique.
AB  - The hygienic adequacy of a commercial process for the collection and cooling of
      beef offals was assessed by a temperature function integration technique. The
      diverse operations for collection of offals were inspected. The rates of product
      movement through those operations, and the temperatures of products at the time
      of their being packed, were determined. From that information, four of the nine
      product types were selected for examination of their temperature histories during
      the assembly and cooling of the cartoned products. The products selected
      encompassed product at near-body and near-air-ambient temperatures at the time of
      packaging, product in the largest and smallest cartons used in the process, and
      product with relatively short and long residence times in an unchilled carton
      stack assembly area. Twenty-one temperature histories were collected for each of
      the products, and the possible proliferation of an indicator organism,
      Escherichia coli, calculated for each temperature history. The results were
      assessed against a temperature function integration criterion derived from
      studies of beef carcass and cartoned meat cooling processes. Products packaged at
      near-ambient temperature readily met with the criterion, but products packed at
      near-body temperatures did not comply. The latter non-compliance was extreme for
      product packaged in large cartons. However, the principal cause of non-compliance
      was identified as highly variable cooling conditions in the carton freezing
      facility. A brief survey of air speeds and temperatures within that facility
      indicated means by which product cooling could be better controlled.

PMID- 1622751
TI  - Headspace flavour compounds produced by yeasts and lactobacilli during
      fermentation of preferments and bread doughs.
AB  - Production of volatile flavour compounds during fermentation with pure cultures
      of Saccharomyces cerevisiae and Candida guilliermondii, Lactobacillus brevis and
      Lactobacillus plantarum have been investigated, using wheat doughs and several
      preferements as substrates. For yeast, preferments consisted of 10% (w/v)
      glucose, maltose and sucrose solutions, whereas for lactobacilli they consisted
      of supplemented and unsupplemented (3% and 10% (w/v)) glucose solutions, and a
      10% (w/v) wheat flour slurry. Seven volatile compounds (acetaldehyde, acetone,
      ethyl acetate, ethanol, hexanal+isobutyl alcohol, and propanol) were detected
      when using yeasts. All these compounds, except propanol, appeared for all the
      substrates assayed, with ethanol as the predominant component. Generally, S.
      cerevisiae produced higher amounts of the different components than C.
      guilliermondii. Both yeasts produced larger amounts of volatile flavour compounds
      during fermentation in glucose and sucrose solutions than in maltose or wheat
      dough. In general the yeasts examined produced more flavour components than the
      lactobacilli. For the lactobacilli the highest number of volatile flavour
      compounds were observed for substrates containing flour.

PMID- 1622752
TI  - Campylobacter jejuni non-culturable coccoid cells.
AB  - The behaviour of Campylobacter jejuni in the environment is poorly documented.
      Rapid loss of viability on culture media is reported. This phenomenon is
      associated with the development of so-called coccoid cells. It has been suggested
      that these cells can be infective to animals and man. Results obtained with ATP
      measurements of coccoid cells and Direct Viable Count (DVC) support this
      hypothesis. Introduction of coccoid cells into simulated gastric, ileal and colon
      environments did not result in the presence of culturable cells. Oral
      administration to laboratory animals and volunteers caused no typical symptoms of
      campylobacteriosis. Until 30 days after uptake of the cells antibodies against C.
      jejuni could not be detected in the blood, and the presence of this microorganism
      in stool samples could not be demonstrated.

PMID- 1622753
TI  - Testing multiple variables on the growth of a mixed inoculum of Salmonella
      strains using gradient plates.
AB  - Six Salmonella strains were grown on two-dimensional sodium chloride-pH and
      temperature-pH gradient plates. Using image analysis the results were expressed
      in the form of three-dimensional wire frame graphs. On the temperature-pH
      gradient plates the optimum growth range was 20-30 degrees C and the minimum pH
      for visible growth was ca. pH 4, except for strain S. typhimurium CRA63 which
      grew over a narrower temperature and pH range. On the NaCl-pH gradient plates
      (whose NaCl gradient began at 2.75% (w/v) NaCl) the maximum concentration of salt
      at which growth was visible varied from 3.9% to 6.0%, and the minimum pH at which
      growth was observed varied from pH 4.7 to 5.4 according to the strain used. The
      incorporation of 0.02% (w/v) sodium nitrite reduced the maximum salt
      concentration and increased the minimum pH at which the strains could grow. The
      strains were combined and used in a mixed inoculum on NaCl-pH gradient plates
      containing 6 different concentrations of NaNO2 incubated at 6 different
      temperatures. Comparison of the data from the mixed inoculum with data from
      individual strains showed that, apart from one case, the mixed inoculum
      represented the extremes of the growth domains of the individual strains. The
      effect of NaNO2 on the ability of the strains to grow at different pH, NaCl
      concentrations and temperatures, was more clearly shown by subtracting the data
      of plates containing NaNO2 from the data of plates without NaNO2.

PMID- 1622754
TI  - The effect of resuscitation and the incubation-temperature on recovery of
      uninjured, heat injured and freeze injured enterococci.
AB  - Five strains of enterococci were inoculated on the Slanetz and Bartley
      enterococcus agar (EA), and incubated at 37 degrees C and 44 degrees C following:
      no injury, heat-injury and freeze-injury. The experiments were repeated
      introducing a 2 h resuscitation step in Tryptic Soy Agar (TSA) at 37 degrees C
      and subsequent overlay with EA (TSA/EA) followed by incubation at both 37 degrees
      C and 44 degrees C. The TSA/EA method gave a significantly better recovery (1%
      confidence level) than the EA method at both 37 degrees C and 44 degrees C. The
      effect of incubation-temperature was only significant for two strains of
      Enterococcus durans, as one strain showed no growth at 44 degrees C and the other
      strain was recovered significantly (5% confidence level) better at 37 degrees C
      that at 44 degrees C when employing the EA method. Interpretation of the results
      using TSA/EA method was easier than that of the EA. Different lactic streptococci
      and lactobacilli commonly employed in the dairy industry did not develop false
      positive colonies in TSA/EA incubated at 37 degrees C.

PMID- 1622755
TI  - Bacteriological composition of pigskin surfaces during cold storage at various
      degrees of relative humidity.

PMID- 1622756
TI  - Contamination of pig hindquarters with Staphylococcus aureus.
AB  - Swab specimens from 4357 pig hindquarters provided for production of cured raw
      ham were contaminated with Staphylococcus aureus in 22.7%. The bacterial counts
      for S. aureus on the rind surface of the raw, uncured ham were between 10(1) and
      10(3) cfu/cm2 in 89% of the positive samples. In the remaining 11% of
      contaminated ham counts of 10(3) to 10(6) cfu/cm2 were determined. There were
      major differences in the rate of contamination between pork from different
      suppliers. Questioning the suppliers revealed that pork highly contaminated with
      S. aureus could be traced back to certain abattoirs. This suggests that the
      technique of slaughter, concomitant hygiene precautions and the subsequent
      refrigeration of the carcasses affect the contamination of the meat with
      staphylococci.

PMID- 1622757
TI  - Development and use of the HACCP concept in fish processing.

PMID- 1622758
TI  - Distribution and numbers of Campylobacter in newly slaughtered broiler chickens
      and hens.
AB  - If Campylobacter is present in the intestinal tract, broiler carcasses become
      extensively contaminated during the slaughter process. To determine the
      distribution and numbers of Campylobacter jejuni/coli in newly slaughtered
      broiler chickens and hens, a total of 100 birds from six Campylobacter-positive
      flocks were sampled at three Swedish processing plants. Campylobacters were
      isolated in 89% of neck skins, 93% of peritoneal cavity swab samples and in 75%
      of subcutaneous samples. Muscle samples were only very sparsely contaminated. It
      is likely that the feather follicles are the orifices where C. jejuni/coli is
      introduced into the subcutis layer.

PMID- 1622760
TI  - Isolation and characterization by conventional methods and genetic transformation
      of Psychrobacter and Acinetobacter from fresh and spoiled meat, milk and cheese.
AB  - Of 126 samples of fresh and spoiled meat and dairy products, 40% were positive
      for the presence of Moraxella-like bacteria and 64% of Acinetobacter; 279 and 466
      strains, respectively, were isolated and a part of these were tested by
      biochemical methods and DNA transformation assays. In some cases, the
      Moraxellaceae in the samples examined reached considerable quantitative levels,
      but their percentage in the microflora was generally low. Moraxella-like bacteria
      were predominant in fresh meat, Acinetobacter in spoiled meat and milk. Most
      acinetobacters belonged to biotype lwoffii (sensu lato) and all 90 strains tested
      were positive for DNA transformation with an auxotrophic Acinetobacter. Moraxella
      like bacteria were identified as Psychrobacter immobilis in 96% of 103
      transformation assays. Moraxellaceae show lipolytic activity but they are
      considered of low incidence in food spoilage. Only 3.7% of acinetobacters from
      dairy sources was able to produce ropy milk. Unlike strains from clinical
      isolates, psychrobacters and acinetobacters isolated from food often do not grow
      at 37 degrees C.

PMID- 1622759
TI  - Characterisation of Danish isolates of Listeria monocytogenes by multilocus
      enzyme electrophoresis.
AB  - A total of 84 strains of Listeria monocytogenes were analysed by multilocus
      enzyme electrophoresis at twelve enzyme loci. Eight enzyme loci were polymorphic
      with between 2 and 4 alleles per locus. Fourteen electrophoretic types (ETs) were
      identified. Among 62 human clinical isolates from Denmark, 8 different ETs were
      defined. Two ETs, designated ET 1 and ET 6, accounted for 77% of the human
      clinical isolates investigated. These ETs are identical with those responsible
      for several epidemics in Switzerland and in the United States. Comparison of 58
      isolates of L. monocytogenes, typed by MEE, in relation to phage typing showed
      that phage typing was more discriminatory than MEE. The ability of MEE to
      distinguish between phage types of Epi-type and other phage types, however, was
      almost optimal. MEE typed 23 of 24 strains of Epi-type as belonging to ET 1. In
      contrast ET 1 was not found in 26 strains with phage types other than the Epi
      type.

PMID- 1622761
TI  - Evaluation of substrates and storage conditions for preparing and maintaining
      starter cultures for tempeh fermentation.
AB  - Heat-pasteurized cassava root, cowpeas, partially defatted peanuts, rice and
      soybeans were evaluated for their suitability to support growth and sporulation
      of the tempeh mold, Rhizopus microsporus var. oligosporus, and the oncom mold,
      Neurospora intermedia, at 25, 30 and 37 degrees C. The molds grew best and
      sporulated most luxuriantly on cassava and rice incubated at 37 degrees C.
      Viability of molds remained high for up to 30 weeks when dried (a(w) 0.48),
      powdered substrates on which the molds had been cultured, were stored at 5, 25
      and 37 degrees C. Survival was best when powders were stored at 5 degrees C,
      although storage at 25 degrees C did not cause a marked decline in CFU/g. R.
      microsporus var. oligosporus starter cultures produced on rice and then stored
      for 20 weeks at these temperatures compared most favorably with commercial
      starter cultures for preparing high-quality soybean tempeh. The simple technology
      required to prepare these starter cultures enhances the potential for their
      application in developing countries where the introduction of nontraditional
      fermented legume foods to low-protein diets could help to ameliorate
      malnutrition.

PMID- 1622762
TI  - Purification of X-prolyl dipeptidyl aminopeptidase from Lactobacillus casei
      subspecies.
AB  - Prolyl dipeptidylaminopeptidases from two subspecies of Lactobacillus casei were
      purified and biochemically characterized. L. casei ssp. casei UL21 (a debittering
      strain) and L. casei ssp. rhamnosus UL26 (a non-debittering strain) were the
      source bacteria for this study. Purification of the enzymes from both the sources
      was effected by a gel filtration step through Sephacryl S-300 followed by ion
      exchange chromatography through DEAE Sephacel. This rendered an
      electrophoretically homogeneous enzyme preparation. The purified enzymes from
      both the sources showed similar temperature optimum (45 degrees C) and pH optimum
      (7.0). Their activity profiles on various substrates and the nature of inhibition
      by different inhibitors were also found to be similar, indicating that this
      enzyme is perhaps not significantly involved in the debittering process during
      the maturation of cheese.

PMID- 1622763
TI  - Chemical, microbial and sensory changes during the anaerobic cold storage of beef
      inoculated with a homofermentative Lactobacillus sp. or a Leuconostoc sp.
AB  - Slices of beef were inoculated with about 3.5 log cfu/cm2 of Lactobacillus sp. 93
      SMRICC 235 (homofermentative) or Leuconostoc sp. 89 SMRICC 189 and stored in 5%
      CO2 + 95% N2 at 4 degrees C. The microbial, chemical (glucose, L-lactate, D
      lactate, acetate, formate, ethanol, H2S) and sensory changes of the beef slices
      were studied. For beef inoculated with Lactobacillus sp. 93 the flavour score
      started to decrease when the maximum bacterial count was reached. Leuconostoc sp.
      89 caused a rapid decrease in the flavour score before reaching the maximum
      bacterial count. Concentrations of acetate and D-lactate increased while glucose
      and L-lactate decreased in beef slices inoculated with Lactobacillus sp. 93. In
      the presence of Leuconostoc sp. 89 ethanol and D-lactate increased while glucose
      decreased. Lactobacillus sp. 93 formed the highest level of H2S, and a sulphurous
      off-odour was noted only in the presence of this strain. D-Lactate and acetate
      indicated high numbers of Lactobacillus sp. 93 on the meat surface, while D
      lactate and ethanol indicated high numbers of Leuconostoc sp. 89. More studies
      are needed in order to correlate levels of D-lactate, acetate and ethanol with
      sensory changes.

PMID- 1622764
TI  - 19F NMR studies of enflurane elimination and metabolism.
AB  - The elimination and metabolism of enflurane, a fluorinated ether anaesthetic, was
      studied by 19F NMR in vivo in both rat liver and brain as well as human body
      fluids. In the liver of thiobarbitone-anaesthetized rats the half-life for
      enflurane following exposure to 0.15% (v/v) for 30 min was 76 min but this could
      be decreased to 39 min by pretreatment of the animals with isoniazid (0.1% in the
      drinking water for 7 days), an agent known to enhance enflurane metabolism. In
      these animals the major organic metabolite difluoromethoxy difluoroacetate
      (DFMDFA) was also detected by 19F NMR in vivo. This metabolite was detected along
      with fluoride ion in rat and human urine and plasma by high resolution 19F NMR.
      Human urine also contained signals from a probable DFMDFA conjugate and
      unexpectedly from trifluoroacetate.

PMID- 1622765
TI  - Assessment of magnesium concentrations by 31P NMR in vivo.
AB  - 31P NMR spectra obtained in vivo reveal the presence of a few reasonably well
      defined chemical species, namely, ATP, orthophosphate (Pi), and, in brain,
      phosphocreatine. The chemical shifts of these resonances respond to changes in
      concentrations of ions such as H+ and Mg2+ in a manner that depends on both the
      chemical shifts intrinsic to individual complexes and the formation or binding
      constants for the several complexes. Values of the appropriate formation
      constants are well established in the literature. We have derived estimates of
      the chemical shifts intrinsic to the individual complexes by analyzing high
      resolution spectra of solutions whose composition brackets the domain of
      physiological relevance. This provides information sufficient to estimate
      intracellular concentrations of H+ and Mg2+ from chemical shifts seen with in
      vivo spectra. The primary finding is an estimate of 0.3 mM for the concentration
      of free magnesium in human brain. Differing values are obtained from other
      tissues.

PMID- 1622766
TI  - Perfluorocarbon temperature measurements using 19F NMR.
AB  - Measuring the T1 of the fluorine resonances of perfluorocarbons (PFC) is a unique
      method for monitoring oxygen tension in vivo. However, because T1 is also
      temperature sensitive, error in the pO2 determination due to animal-to-animal
      temperature variation may arise. Pathophysiologic conditions, such as ischemia,
      where temperature is not known a priori may also introduce error. Thus, measuring
      the PFC temperature is clearly desirable in order to correct for tissue
      temperature variations during the pO2 determination. Because the fluorine
      chemical shift of various fluorinated compounds has a significant temperature
      dependence, we evaluated the effect of temperature on the chemical shift of the
      fluorine resonances of perfluorotributylamine (FTBA). A linear relationship was
      found between chemical shift and temperature in vitro. In addition, the relative
      FTBA chemical shifts were essentially independent of pO2. Chemical shift
      temperature measurements in vivo, obtained from a 10 microL FTBA bubble in the
      preretinal vitreous space of the rabbit eye, were in good agreement (+/- 0.5
      degrees C) with thermocouple measurements from the same location. Good agreement
      between the NMR determined temperature and core body temperature was also found.
      The implication of such temperature measurements for the ultimate accuracy of the
      pO2 determination based on PFC T1 measurements is discussed. To the best of our
      knowledge, this report describes the first absolute temperature measurement in
      vivo by NMR.

PMID- 1622767
TI  - Comparison of double and zero quantum NMR editing techniques for in vivo use.
AB  - Several multiple quantum editing techniques for in vivo proton NMR are discussed
      and compared using simulated and experimental data. Extensions of these
      techniques for improved editing are given. Relative S/N ratios, modulation
      characteristics, metabolite selectivity, B0 and B1 inhomogeneity and motion
      effects are considered. Frequency selective read pulses can be used for signal
      enhancement and lipid suppression. Extra suppression of undesired signals can be
      obtained with a two-shot t1 cycle which gives good results for both the zero and
      double quantum sequences. These sequences give at most 50% signal intensity and
      lipid suppression factors of ca 2000 and 7000, respectively. A sequence which
      selects zero and double quantum coherences yields 100% signal intensity but only
      gives a good lipid suppression factor (7000) in combination with phase cycling.
      It is shown that the multiple quantum modulation can be used to obtain specific
      metabolite editing. Corrections can be made for the effects of B0 inhomogeneity
      on the multiple quantum coherences; B1 inhomogeneity affects the investigated
      multiple quantum sequences in about the same way and decreases the volume of
      interest. In vivo measurements show the good performance of the proposed zero and
      double quantum sequences for lactate.

PMID- 1622768
TI  - Quantitative magnetic resonance spectroscopy by optimized numerical curve
      fitting.
AB  - A technique is reported for generating the quantitative area under selected peaks
      within a 31P NMR spectrum. A numerical iterative method generates the fitted
      curve so as to minimize the RMS deviation between the fit and the experimental
      data. The curve is constructed from elemental grains of spectral density
      ('spexels'), each of which represents an elemental Lorentzian distribution, where
      the centre frequency and line width of the spexel may be varied within
      predetermined limits. This provides a fit that in principle is not restricted to
      a Lorentzian model. The method allows peak areas to be estimated, including the
      case of overlapping peaks. The method has been tested using simulated spectra
      containing six overlapping spectral lines each of known amplitude (ranging from
      367 to 661 mV) and area; together with additional Gaussian noise with a standard
      deviation ranging from 30 to 646 mV. The results of fitting both unfiltered and
      filtered spectra were compared. The variation of quality of fit with spectral
      noise and filtering has been evaluated. In all cases, the method fitted the peak
      amplitudes to within 1% of the simulated value. The optimization processes
      provide an excellent non-linear spectrum filtering algorithm. Provided the noise
      in the spectra did not exceed ca 400 mV, prefiltered data could be adequately
      fitted.

PMID- 1622769
TI  - A two-point volume localized T1 measurement sequence for in vivo spectroscopy
      using a surface coil.
AB  - A technique for obtaining T1 values from well localized regions using surface
      coils and with a clinically practicable measurement time is described. The method
      uses a two-point Inversion-Recovery/Saturation-Recovery (IR/SR) sequence in
      conjunction with the image-selected in vivo spectroscopy localization scheme. T1
      values are obtained by comparing the ratio of peak areas with those in a pre
      computed look-up table. The method was tested by measuring the T1s of six
      calibrated water phantoms doped with different concentrations of gadolinium. This
      indicated an accuracy of 3% for T1 values in the range 400-1500 ms. 31P spectra
      and T1 values of Pi, phosphocreatine and alpha-, beta- and gamma-NTP metabolites
      from the calf muscle of healthy volunteers were obtained with the sequence
      employing beta 1-insensitive excitation pulses and a surface coil. The T1 values
      fall within the range of published values obtained by other techniques.

PMID- 1622770
TI  - Rabies. Oral immunization of foxes in Europe.

PMID- 1622772
TI  - Migration and health. Immigrant suicide rates: a comparative study.

PMID- 1622771
TI  - Suicide attempts.

PMID- 1622773
TI  - Rubella. Winter outbreak in the Australian Capital Territory (ACT).

PMID- 1622774
TI  - Magnetization transfer contrast in magnetic resonance imaging.
AB  - Magnetization transfer contrast (MTC) in magnetic resonance imaging (MRI) is the
      result of selectively observing the interaction of bulk water protons with the
      protons contained in macromolecules of a tissue. Since different tissues have
      different macromolecular compositions, the MTC can generate very high tissue
      contrast that is based on well-defined physiochemical properties. This is
      accomplished by combining a saturation transfer technique with standard MRI
      procedures. The specific practical and theoretical aspects of saturation transfer
      as it applies to the generation of MTC are reviewed and discussed. In the last 3
      years, MTC has been applied to the study of the body, with useful applications
      demonstrated in evaluating the morphology of the knee joint, eye, brain, breast,
      and heart. The application of MTC to accentuate MR angiography and contrast agent
      studies has also been demonstrated. Thus, MTC is becoming another tool towards
      maximizing the quality and diagnostic potential of MRI. Recent studies on
      isolated macromolecules have suggested that the MTC effect is specific to the
      surface chemistry and correlation time of the macromolecules. These latter
      results indicate that the magnetization transfer process may provide a unique
      quantitative method of MR tissue characterization based on macromolecule dynamics
      and chemistry.

PMID- 1622775
TI  - Magnetic resonance imaging of the wrist.
AB  - Magnetic resonance (MR) imaging has developed rapidly as a diagnostic tool in the
      evaluation of the wrist. In this article, the authors review simple high
      resolution technique and appropriate surface coils to aid in wrist evaluation.
      Evaluation of the wrist is facilitated by an understanding of the anatomy of the
      carpal ligaments, the triangular fibrocartilage, and the carpal tunnel, and the
      anatomic features of the distal radioulnar joint. Triangular fibrocartilage
      tears, which represent an important cause of ulnar wrist pain, are well evaluated
      on MR. These appear as a linear band of increased signal on the short repetition
      time/echo time (TR/TE), proton density weighted spin echo, or gradient echo
      images. True tears should be differentiated from degenerative changes, which do
      not demonstrate increase in signal on T2 or T2* weighted images. With good
      technique, accuracies approaching 90% have been reported. MR is also useful in
      evaluating injuries of the interosseous ligaments and volar and dorsal
      radiocarpal ligaments and distal radioulnar joint instability. MR also has a role
      in evaluating the carpal tunnel syndrome. This is especially true with patients
      for whom symptoms suggest the diagnosis of carpal tunnel syndrome but for whom
      few objective findings exist. Findings suggestive of carpal tunnel syndrome
      include diffuse swelling of the median nerve, flattening of the median nerve at
      the level of the hamate, and increased signal of the median nerve on the long
      TR/TE images. MR is also indicated in avascular necrosis of the carpal bones and
      occult carpal fractures. MR is useful in evaluating bone tumors, particularly
      with regard to their extent. With the advent of more rapid scanning techniques,
      kinematic studies are feasible. For these, fast gradient echo techniques are
      employed and serial images are acquired during radial and ulnar deviation. These
      images may be helpful in observing integrity of intercarpal ligaments and
      evaluating dynamic instability. With proper attention to technique, and an
      understanding of wrist pathophysiology, MR is a valuable diagnostic tool.

PMID- 1622776
TI  - Magnetic resonance imaging of the foot and ankle.
AB  - Technical considerations for the magnetic resonance imaging of the foot and ankle
      are discussed, including the selection of the appropriate surface coil, the
      importance of stabilizing the anatomic region, and the principles guiding the
      choice of pulse sequences. The anatomy of the foot and ankle are reviewed, and
      the normal appearance and important variations of the different structures on
      magnetic resonance images are discussed. Pathology of the foot and ankle are then
      discussed. Topics covered include osteochondral and radiographically occult
      fractures, tears and inflammation of the Achilles and posterior tibial tendons,
      tears of the lateral collateral ligaments and sinus tarsi syndrome, primary
      tumors (in particular, those of the foot), synovial diseases such as pigmented
      villonodular synovitis, congenital abnormalities, and disorders such as tarsal
      tunnel syndrome and plantar fasciitis.

PMID- 1622777
TI  - Mental health: living in two worlds.

PMID- 1622778
TI  - Learning is for life.

PMID- 1622779
TI  - Health Visitors' Association: thriving on challenge.

PMID- 1622780
TI  - IV drugs: assessing pupils in Botswana.
AB  - This small study set out to establish the abilities of a group of pupil nurses in
      a rural hospital in Botswana to accurately calculate intravenous driprates and
      drug dosages, and how targeted teaching could improve their performance. Thirteen
      pupils were asked to complete a seven-item questionnaire comprising set questions
      on intravenous therapy, then take a second questionnaire after receiving targeted
      teaching. Comparison revealed that two specific problems, related to dripsets and
      dilutent displacement, remained after teaching, but that improvements in scores
      in the 'incorrect with little immediate risk' and 'correct' categories had been
      achieved. The author suggests that formal testing and targeted teaching are
      appropriate methods of helping pupil nurses evaluate and improve their skills and
      knowledge base.

PMID- 1622781
TI  - Developing nurse and midwife teachers.

PMID- 1622782
TI  - Complementary therapy: using music in hospital settings.
AB  - The therapeutic use of music in hospitals has been explored within the context of
      highly specific situations. Here, the author explores the place of music in
      improving the general ambience of the clinical scene, and investigates the
      sometimes conflicting results from research into its physiological benefits to
      patients. Music in hospitals, he argues, is an area ripe for further exploration.

PMID- 1622783
TI  - Vivisection: points of view.

PMID- 1622784
TI  - Empathy: relative nursing care.

PMID- 1622785
TI  - Living-in: this abode's not well.

PMID- 1622786
TI  - Practice: soup nurse or supernurse?

PMID- 1622787
TI  - A day in the life--who was that caped person?

PMID- 1622788
TI  - Informed consent: New formula Zealand.

PMID- 1622789
TI  - Education: mixed-ability tutors.

PMID- 1622790
TI  - Little chance of HIV from health workers.

PMID- 1622791
TI  - UKCC: new statement launched on HIV/AIDS.

PMID- 1622792
TI  - Heart health (continuing nursing education).

PMID- 1622793
TI  - Assessing elderly people (continuing nursing education).
AB  - Community nurses are increasingly likely to be involved in assessing the health
      status of elderly people in a number of care settings. It is important that the
      assessment is relevant and useful, not only for the primary health care team, but
      also for the elderly person and any involved carers.

PMID- 1622794
TI  - Quality assurance. Winning support.

PMID- 1622795
TI  - Quality assurance. Stateside standards.

PMID- 1622796
TI  - Quality assurance. Homing in on quality care.

PMID- 1622797
TI  - Quality assurance. Working towards change.

PMID- 1622798
TI  - Escape from riot zone.

PMID- 1622799
TI  - Secure environments: out of the dark age.

PMID- 1622800
TI  - Information technology: implementing a nurse information system.
AB  - This article explains the remit of a specially designated project nurse in
      preparing for the implementation of a nurse information system. The main
      components of a system--rostering/staff planning, workload/dependency levels and
      care planning--are defined and the project nurse's role in educating ward-based
      staff is described. The key to successful management of the necessary changes,
      the author argues, is adopting a 'bottom-up' approach to implementation in which
      nurses are encouraged to develop a sense of ownership of the selected system.

PMID- 1622801
TI  - Malignant disease of the prostate gland.
AB  - The incidence of prostate cancer is rising in the West, but information about
      developing treatment options and nursing care is limited. The author examines
      early disease detection and treatment, and discusses care for patients with
      locally advanced disease. The need for emotional support for sufferers and their
      families is stressed, and the importance of good patient education is
      highlighted.

PMID- 1622802
TI  - The role of the nurse in rehabilitation.
AB  - Although nurses make a valuable contribution to the process of rehabilitation,
      the parameters of that contribution have yet to be defined. This article
      describes a small study, undertaken on a care of elderly people ward, designed to
      elicit nurses' understanding of their role in rehabilitation. Interdisciplinary
      relations and patient care, the authors conclude, would be improved if nurses
      were taught, and developed the confidence, to implement rehabilitation techniques
      in practice.

PMID- 1622803
TI  - Nurse mobility and employment patterns.
AB  - There are a number of answers to the question 'what happened to nursing
      shortages?', says James Buchan in his regular monthly column.

PMID- 1622804
TI  - Managing mass casualties in Israel.
AB  - The author relates her experiences as an observer at an Israeli mass casualty
      simulated exercise in a general hospital. Israeli people, who have seen their
      country engaged in several major wars over the last 40 years and who live with
      the potential for terrorist atrocity as a daily threat, treat such exercises with
      great seriousness. The scale and realistic nature of the exercise was impressive,
      and while such activities may not be directly translatable to a British
      situation, the energy, commitment and systematic approach of the Israeli
      personnel are qualities which British hospital and military staff could adopt.

PMID- 1622805
TI  - Guidelines on staff with HIV.

PMID- 1622807
TI  - Project 2000. Be proud of the project.

PMID- 1622806
TI  - Reviews must be viewed positively.

PMID- 1622808
TI  - Project 2000. Growing pains and gains.

PMID- 1622809
TI  - Mental health. Psychiatric nursing in the nineties.

PMID- 1622810
TI  - Mental health. Nurses responding to substance misuse.

PMID- 1622811
TI  - Mental health. The effectiveness of community teams.

PMID- 1622812
TI  - The value of nursing: invisible mending.

PMID- 1622813
TI  - In her own right. Interview by Charlotte Alderman.

PMID- 1622814
TI  - Romania: story of a lost life.

PMID- 1622815
TI  - Foot problems in people with diabetes.
AB  - People with diabetes are liable to suffer potentially disastrous foot problems,
      including gangrene with subsequent amputation. This article describes the risk
      factors, management, and ulcer-prevention methods which are essential knowledge
      for nurses working with this patient group.

PMID- 1622816
TI  - Management. Setting priorities in health: the Oregon experiment (Part 1).
AB  - Increasing emphasis on obtaining consumer opinion in relation to needs assessment
      and decision making has led to interest in this country about the Oregon
      experiment in the US. Despite controversies over the efficacy of such approaches,
      it seems likely that future emphasis will be placed on devising systematic means
      of gathering information about societal preferences for care. In two articles,
      Ann Bowling reviews the evidence from America and relates it to the ongoing
      changes in the British health service. Part 1 introduces the ideas behind the
      Oregon experiment and examines similar initiatives in the UK.

PMID- 1622817
TI  - Psychiatric nurses' use of working time.
AB  - How nurses spend their time at work is an issue increasingly under scrutiny. This
      small study, undertaken by a nursing development team, examined the activities of
      staff and patients on five admission, rehabilitation and continuing care
      psychiatric wards. The results, sure to stimulate debate and encourage further
      research, suggest nurses spend less time than might have been expected doing the
      job for which they were trained.

PMID- 1622818
TI  - Improving library services for nurses.
AB  - Developments in pre- and post-registration nurse education mean greater demands
      on library resources. This article describes a survey undertaken to elicit
      nurses' views on the provision of library services, and includes their
      suggestions for improving those services. The author suggests the demands nurses
      make on existing resources will, in part, shape the future of nursing libraries.

PMID- 1622819
TI  - Trevor Clay: the Clay column.

PMID- 1622820
TI  - Information technology: data day implementation.

PMID- 1622821
TI  - Nursing in Europe: applying French dressings.

PMID- 1622822
TI  - Professional status: is professionalism a con?

PMID- 1622823
TI  - Employment: doling out patient care.

PMID- 1622824
TI  - Diet and nutrition (continuing nursing education).
AB  - Nurses, midwives and health visitors are ideally placed to give individualised
      dietary advice to patients and clients. Supporting people as they try to alter
      their eating behaviour requires up to date knowledge of nutrition and an
      awareness of the process of change.

PMID- 1622825
TI  - Wound care (continuing education nursing).
AB  - Nurses have the potential for preventing wounds in many of the most vulnerable
      patients, and improving the quality of life for patients with wounds by applying
      management techniques which meet the patient's actual needs.

PMID- 1622826
TI  - Members demand fast action on HIV spread.

PMID- 1622827
TI  - Anal intercourse risk of HBV in women.

PMID- 1622828
TI  - Community care: raising the alarm.

PMID- 1622829
TI  - Community care: prepared for change?

PMID- 1622830
TI  - Contracting for a continence service.

PMID- 1622831
TI  - Management. Setting priorities in health: the Oregon experiment (Part 2).
AB  - Increasing emphasis on obtaining consumer opinion in relation to needs assessment
      and decision making has led to interest in this country about the Oregon
      experiment in the US. In spite of controversies over the efficacy of such
      approaches, it seems likely that future emphasis will be placed on devising
      systematic means of gathering information about societal preferences for care. In
      two articles, Ann Bowling reviews the evidence from America and relates it to the
      ongoing changes in the British health service. Part 2 examines the methods,
      results and controversies generated by the Oregon experiment.

PMID- 1622832
TI  - Gestalt therapy: theory and practice.
AB  - Gestalt therapy, a particular type of psychotherapy, draws on existential and
      various Eastern philosophies, and aims to enable the individual to seek his or
      her own solutions to personal problems. Literally translated as 'whole', Gestalt
      focuses the individual to appreciate and experience the present. This article
      examines the Gestalt theory and considers its application to a terminally ill
      client and his wife.

PMID- 1622833
TI  - Oncology/quality assurance: a quality system for oncology nursing.
AB  - The benefits of three quality monitoring systems, Monitor, Qualpacs and the
      Dynamic Standards Setting System are explored in relation to oncology nursing.
      The author concludes that the flexibility provided by the 'bottom-up' design of
      the Dynamic Standards Setting System is admirably suited to the needs of nurses
      working with cancer patients.

PMID- 1622834
TI  - A specialist role in patient nutrition.
AB  - This article explores the role of the nurse as a clinical specialist in patient
      nutrition. The author, who also holds the position of sister in charge of a
      medical ward, explains the benefits of nursing input to a multidisciplinary
      nutrition team with a hospital-wide remit. Research carried out by the team shows
      that improvements in patient care and financial savings can be made through
      skilled management of patient nutritional needs.

PMID- 1622835
TI  - General practitioner contracts do not fragment individuals' care.

PMID- 1622836
TI  - Working parents: turning against rotation.

PMID- 1622837
TI  - Nursing founders on basics.

PMID- 1622838
TI  - Psychiatry: European freedoms.

PMID- 1622839
TI  - AIDS focus. Positive at school.

PMID- 1622840
TI  - AIDS focus. The South African dimension to caring.

PMID- 1622841
TI  - Differential metastatic capacity of three AKR lymphoma variants.
AB  - The comprehension of tumour progression has advanced due to the use of various
      models, the most rewarding being probably the study of malignancy variants
      derived from the same tumour. In the present study the biological behaviours of
      three AKR lymphoma variants were compared. The three variants, TAU-33, TAU-38 and
      TAU-39, differed markedly in biological behaviour. The TAU-39 variant formed very
      large 'primary tumours', TAU-33 produced local growths of intermediate size, and
      TAU-38 formed small s.c. tumours. However, the metastatic potentials of the
      variants were inversely related to their ability to produce local tumours.
      According to various parameters (spread to organs, cachexia and mice mortality
      rate), the variant of highest metastatic potential was TAU-38, the one of
      intermediate ability TAU-33 and the TAU-39 had the least aggressive behaviour. A
      lack of difference in invasive capacity as well as a similar ranking of
      malignancy by both s.c. and i.v. inoculation indicate a differential behaviour in
      late metastasis phase. Tumour progression models may contribute to a better
      understanding of this threatening process and to testing of new treatment
      modalities suitable for cancer at different stages.

PMID- 1622843
TI  - Enzyme histochemical reactions at the demarcation line in frostbite: an
      experimental study on rabbits.
AB  - Eleven frostbites were induced on the ears of seven New Zealand White rabbits and
      specimens were taken from the lesion after 1, 4 and 8 hours, and from ten further
      frostbites on the ears of six rabbits for examination 1, 3 and 7 days later. The
      specimens were taken at the border between the frozen and non-frozen skin. NADH
      diaphorase, alkaline phosphatase and esterase were demonstrated histochemically
      in the sample, which was also studied by haematoxylin and eosin staining. Five
      ears served as controls. Some granulocytes could be seen accumulating in the
      vessels and in the dermis at the border of the frostbite area after only 1 hour,
      and other enzyme rich cells (macrophages) also began to appear. After 4 hours the
      inflammation was quite obvious with the enzyme reactions clearly observable in
      the sections. After 8 hours there was no marked difference compared with the 4
      hour picture. It was only after 3 days that the line of demarcation between the
      normal and frostbite tissue could be seen clearly. This was oblique in some
      specimens and vertical in others. The degeneration in the lesion could best be
      demonstrated by the NADH-diaphorase and esterase reactions and the early
      inflammation by the alkaline phosphatase reaction.

PMID- 1622842
TI  - Acute serum sickness in normal and C6 deficient rabbits: role of membrane attack
      complex.
AB  - Acute serum sickness was induced in New Zealand White (NZW) and in C6 deficient
      (C6D) rabbits, to compare the histology, immunofluorescence, especially
      distribution of poly C9 (MAC), and electron microscopic characteristics of the
      disease in each strain. Glomerulonephritis and albuminuria of comparable extent
      occurred in 13/17 NZW and 4/8 C6D rabbits. In NZW rabbits with albuminuria an
      early intense glomerular infiltration by mononuclear cells was associated with
      focal small fine granular glomerular basement membrane (GBM) deposits of IgG and
      BSA and more diffuse and larger deposits of C3 and MAC. After the disappearance
      of monocytes and decrease in mesangial cell proliferation, development of large
      subepithelial GBM deposits rich in all immune reactants was observed in NZB
      rabbits. In C6D rabbits with albuminuria a similar monocytic infiltrate occurred,
      but no association with IgG and C3 GBM immune deposits was noted. No deposits of
      MAC and no large subepithelial GBM 'humps' were observed in C6D rabbits. We
      conclude that the exudative (monocytic) phase of glomerular injury and
      albuminuria in acute serum sickness nephritis are not dependent upon terminal
      complement components, but the subsequent formation of large subepithelial GBM
      deposits does not occur in this model in the absence of MAC.

PMID- 1622844
TI  - Lung protein leakage in respiratory failure induced by a hybridoma making
      monoclonal antibody to the hydrophobic surfactant-associated polypeptide SP-B.
AB  - Adult mice were inoculated intraperitoneally with a hybridoma (8B5E) making
      monoclonal antibody to the porcine surfactant-associated polypeptide SP-B; this
      antibody cross-reacts with the corresponding polypeptide in the mouse surfactant
      system. Respiratory failure, developing 7-9 days after inoculation, was
      associated with a decrease in lung-thorax compliance determined during artificial
      ventilation, and an increase in the amount of protein including the specific
      antibody in lung lavage fluid. There was a statistically significant negative
      correlation between the compliance and the amount of protein as well as antibody
      recovered by lung lavage: r (log scale) = -0.69 and -0.82, respectively (P less
      than 0.01, both), but no decrease in the amount of phospholipids in lung lavage
      from animals inoculated with the hybridoma. Treatment with a large dose of
      porcine surfactant (about 320 mg phospholipids/kg body weight) had no positive
      effect on lung-thorax compliance during artificial ventilation; on the contrary,
      surfactant-treated animals showed a decrease in compliance similar to that seen
      in control animals after instillation of a similar volume of saline into the
      airways. We conclude that respiratory failure developing after inoculation with
      this hybridoma is probably at least in part mediated by flooding of the airspaces
      with antibody interfering with surfactant function.

PMID- 1622845
TI  - Effects of microbial stimulation on the number, size and activity of bronchus
      associated lymphoid tissue (BALT) structures in the pig.
AB  - The development of bronchus-associated lymphoid tissue (BALT) was investigated in
      the pig, which is a species in which BALT is not found constantly. Different
      routes of contact with a specifically lung-pathogen bacterium Actinobacillus
      (Haemophilus) pleuropneumoniae were tested. Pigs, selected by bacteriological
      screening methods and the number of granulocytes in the bronchoalveolar lavage
      (BAL), were infected by aerosol. They were compared to previously enterally
      immunized pigs using active and inactivated bacteria. The development of BALT
      after the infection was compared to that in pigs with a single enteral, or no,
      contact with the bacterium. BALT was less frequent in these groups than in the
      infected pigs. Previously immunized pigs developed the highest number and the
      largest BALT with the most prominent morphological signs of activation.
      Immunization with living or inactivated bacteria did not cause histological
      differences. BALT was preferentially located around bronchioli and small bronchi.
      Additional BALT predominantly occurred in the walls of larger bronchi. Definite
      compartments of T and B lymphocytes were not found in immunohistological studies
      of BALT. It was concluded that the development of BALT can be induced by
      different modes of microbial stimulation.

PMID- 1622846
TI  - Epithelial-mesenchymal interactions in experimental oral mucosal carcinogenesis:
      establishing a technique.
AB  - The carcinogen 4-nitroquinoline-1-oxide was applied to the palatal mucosa of rats
      for varying periods of time. This tissue was separated into epithelial and
      connective components and then recombined in various combinations and implanted
      into hypothymic mice. Seventy-two per cent of the implants were recovered and
      were suitable for detailed histological analysis. The technique provides a
      suitable model for the assessment of epithelial-connective tissue interactions in
      experimental oral mucosal carcinogenesis.

PMID- 1622847
TI  - Chronic rejection of rat renal allograft. III. Ultrastructure of vascular and
      glomerular changes.
AB  - The main histological features for 'chronic' rejection of rat renal allograft are
      ongoing perivascular and interstitial inflammation, vascular intimal hyperplasia
      and glomerular sclerosis. In this communication we have investigated the
      ultrastructural features of renal parenchyma by comparing chronically rejecting
      rat renal allografts immunosuppressed initially with cyclosporine to similarly
      immunosuppressed syngeneic transplants. Electron microscopy confirmed that the
      primary arterial change was smooth muscle cell proliferation in media, thickening
      and focal destruction of the internal elastic lamina, and influx of smooth muscle
      cells and their proliferation in the intima, leading to a nearly complete
      occlusion of the lumen. In the glomeruli, the most prominent features were
      mesangial matrix increase, narrowing of capillary lumen, and basement membrane
      thickening with a double contour appearance in capillary walls. A thin membrane,
      similar to lamina densa, appeared beneath the endothelium in some segments.
      Mesangial interposition, formation of new basement membrane and mesangial
      widening due to increase of basement membrane-like material was nearly always
      present. As none of these vascular and glomerular changes were observed in
      similarly immunosuppressed syngeneic transplants, we consider these
      ultrastructural alterations characteristic for chronic rejection in a rat renal
      allograft.

PMID- 1622848
TI  - Present trends on osteosarcoma and adult soft tissue sarcomas.

PMID- 1622849
TI  - Postoperative radiation therapy for adult soft tissue sarcomas: a retrospective
      study.
AB  - From 1977 to 1988, 81 adult patients with localized soft tissue sarcomas at
      different sites received postoperative external beam radiotherapy (55 Gy median
      dose) following primary conservative surgery. Sixty were new referrals after
      primary surgery and 21 were irradiated after excision of recurrent disease. With
      a median follow-up of 4 years (range: 2-13) the 5-year overall survival (Kaplan
      Meier) and local control were 55.5% and 56% respectively, while 5-year disease
      free survival is 49%. There were 26 (32%) local relapses and 22 (27%) distant
      failures. Local recurrence was the sole pattern of failure in 16 patients (20%).
      Functional and cosmetic results were good to excellent in most cases. In our
      series local control is the main prognostic variable influencing survival (P less
      than 0.0001), and its probability seems to show a link with the type of surgical
      procedure, with a trend (P less than 0.13) in favor of wide total excision.
      Postoperative radiation therapy represents an acceptable treatment strategy for
      ASTS, but further improvements are expected from future controlled clinical
      trials, aiming at the achievement of the definitive cure of these tumors.

PMID- 1622850
TI  - Osteosarcomas and adult soft tissue sarcomas: is there a place for high LET
      radiation therapy?
AB  - The treatment policy for non-operable or unresectable osteosarcoma and adult soft
      tissue sarcoma remains unclear or controversial, despite the progress achieved in
      multimodality treatments. The poor results obtained by radiotherapy alone led to
      consider these tumours as radioresistant and to use high Linear Energy Transfer
      (LET) particles, such as neutrons. These particles benefit from a higher Relative
      Biological Efficiency (RBE) and other biological properties tending to decrease
      radioresistance phenomenas. From the non randomized studies previously published,
      neutron-therapy seems to give better local control rates, compared to photons
      and/or electrons. But these results are not strongly convincing, due to the large
      heterogeneities in patient recruitment, histological types, sizes, sites and
      moreover to the high complication rates encountered in some studies, even if they
      are mainly imputable to the use of low energy machines. The use of high-energy
      hospital-based accelerators combined to the possibilities of accurate dose
      distribution offered by conformal therapy, the potential value of light ion beam
      therapy combining the dose distribution advantages of protons to the biological
      properties of high LET particles, represent the directions in which progresses
      might be made for further improvement of non-operable or unresectable
      osteosarcoma and soft tissue sarcomas treatment results.

PMID- 1622851
TI  - Adriamycin in hyperthermic perfusion for advanced limb sarcomas.
AB  - From February 1989 to April 1991, 12 hyperthermic limb perfusions (HLP) with
      adriamycin (ADR) were performed in 12 patients with high grade soft tissue
      sarcomas (9 in the leg and 3 in the arm); two were at A.J.C. stage IIb, eight
      stage IIIb and two stage IV. ADR (0.7-1.5 mg/kg) was administered in bolus at a
      mean temperature of 41.5 degrees C and perfused for 60 min. No systemic toxicity
      was reported; seven patients had grade II locoregional toxicity, another four
      grade III and one grade IV. Tumor necrosis (radiological evaluation) was less
      than 25% in two patients, 25% to 50% in two, 50% to 75% in five and greater than
      75% in three. Limb sparing surgery was feasible in ten patients. At present eight
      patients are alive; three had local recurrence and four distant metastases.

PMID- 1622852
TI  - Feasibility and efficacy of arginine 2-mercaptoethanesulfonate (ARGIMESNA) in the
      prevention of hemorragic cystitis from ifosfamide (IFO).
AB  - Tolerability and efficacy of the new uroprotective agent ARGIMESNA was assessed
      within a randomized cross-over study comparing it to
      sodiummercaptoethanesulfonate (MESNA), in patients treated with IFO. MESNA i.v.,
      20% of IFO dose, was given to all patients before chemotherapy; 4 h later, at
      random, they received ARGIMESNA p.o., 20% of IFO dose every 2 h x 4, or MESNA
      p.o., 40% of IFO dose every 4 h x 2. Overall, 78 cycles of oral uroprotection
      were administered: 37 for ARGIMESNA capsules; 41 for MESNA vials p.o. ARGIMESNA
      was subjectively better tolerated, determining gastro-intestinal discomfort in
      only 12 out of 37 cycles versus 34/41 of MESNA p.o. (p less than 0.001). Both
      preparations were equivalent for subjective and objective efficacy since no
      cycles were complicated by urinary symptoms (dysuria, stranguria, or hematuria).
      Nevertheless, 2 patients (7.7%) refused further oral assumption of both
      uroprotectors, whereas MESNA i.v. was added in other 7 patients because of nausea
      and vomiting caused by chemotherapy. In conclusion, this new oral preparation of
      mercaptoethanesulfonate turned out to be well tolerated, safe and active in the
      prevention of haemorrhagic cystitis from IFO.

PMID- 1622853
TI  - Doxorubicin (or epidoxorubicin) combined with ifosfamide in the treatment of
      adult advanced soft tissue sarcomas.
AB  - The results of the association of doxorubicin plus ifosfamide in the treatment of
      locally advanced and/or metastatic adult soft tissue sarcomas as reported in the
      literature from 1986 up to the present time are reviewed. The data confirm the
      effectiveness of the association doxorubicin plus ifosfamide, with an objective
      response rate of 33.25% (range, 22% to 42%), with 9.3% of complete responses. The
      highest percentages were reported in studies using doses of doxorubicin of 60
      mg/m2 or higher, with a suggested dose-response correlation. The pattern is
      generally well tolerated, with a prevalently haematological toxicity. Results
      being equal, the use of epidoxorubicin seems to allow a lower incidence of high
      grade leukopenia, and an higher dose-intensity of the drug administered. The two
      randomized studies by EORTC and ECOG indicate superiority of this combination
      compared to doxorubicin on its own or with other polychemotherapeutic regimens
      containing doxorubicin, without ifosfamide. However, the actual contribution of
      ifosfamide deserves further investigation. The impact on long-term disease-free
      survival is, however, poor and median survival time ranges from 8 to 12 months in
      responder patients. Future studies should be aimed at increasing the dosages of
      the drugs without a significant increase of toxicity, by administering them in
      continuous infusion or by the use of growth factors.

PMID- 1622854
TI  - Epirubicin plus ifosfamide and dacarbazine (EID) in advanced soft tissue
      sarcomas.

PMID- 1622855
TI  - Neoadjuvant intraarterial chemotherapy of soft tissue sarcomas.
AB  - A group of 51 patients with extremity sarcomas of soft-tissue origin received
      preoperative intraarterial (i.a.) chemotherapy via a percutaneously placed
      catheter. Treatments were performed as a series of chemotherapy cycles, giving a
      total of 129, and were carried out in the form of short-term infusions consisting
      of doxorubicin and cisplatin, which lasted for 20-40 min. These i.a. infusions
      were combined with complementary methods, such as a tourniquet, occlusion
      infusion and chemoembolization. In 3 patients complete remission and in 21
      partial remission was registered, while in 27 patients only minimal response
      could be achieved, although in this latter group necrosis of eight tumors proved
      to be of significant value. In 43 of 51 patients successful limb salvage surgery
      was carried out.

PMID- 1622856
TI  - The treatment of localized osteosarcoma of the extremities: the Italian
      experience. Studies of the National Research Council.

PMID- 1622857
TI  - Treatment of pelvic osteosarcoma.
AB  - Pelvic osteosarcoma is a very rare disease, with poor prognosis affecting young
      people. Since June 1987 we have observed 26 patients, F/M: 12/14, median age 23
      years (range 14-55), 7 with lung metastases at diagnosis. Four patients underwent
      surgery as first line treatment; 4 patients received intravenous (i.v.)
      chemotherapy; eighteen out of 26 received 1-3 cycles of neoadjuvant chemotherapy
      consisting of high dose i.v. methotrexate plus leucovorin rescue, intraarterial
      cisplatin and i.v. epidoxorubicin. We obtained 8 PR, 9 SD, 1 PD. Hemipelvectomy
      has been performed in 4 cases (0%, 0%, 50%, 70% necrosis). The other 14 patients,
      judged not operable, received radiotherapy plus daily low doses of cisplatin. All
      patients have been treated with i.v. epidoxorubicin, ifosfamide, high dose
      methotrexate, cisplatin and etoposide. Two out of four patients who underwent
      surgery died at 17 and 18 months, 2 are alive and free of disease at 28+ and 17+
      months from surgery. Among the 14 patients treated with radiotherapy, 9 died with
      a median survival of 18 months (5-22); 5 are alive with a median survival of 20
      months (14-31). Although pelvic osteosarcoma has a limited cure rate at present,
      results could be improved in the future by means of earlier diagnosis and better
      combined treatment.

PMID- 1622858
TI  - Limb sparing versus amputation in osteosarcoma. Correlation between local
      control, surgical margins and tumor necrosis: Istituto Rizzoli experience.
AB  - Three hundred fifty-five patients with osteosarcoma were surgically managed at
      the Istituto Ortopedico Rizzoli between 1983 and 1988. Three hundred two patients
      performed two cycles of neoadjuvant chemotherapy according to two different
      protocols consecutively activated; the remaining 53 patients were immediately
      operated on without neoadjuvant treatment. Follow-up ranged from 19 to 88 months,
      with a mean of 51 months. Demolitive surgery was performed in 116 patients (33%),
      while conservative in 239 patients (67%). A radical margin was achieved only in
      patients undergoing amputations: no radical surgical margins were achieved by
      local resection: 174 resected patients (73%) had wide margins, while 34 (14%) had
      marginal margins; 20 patients had contaminated margins and 11 patients (5%) had
      intralesional margins. Wide or marginal margins were achieved in 208 (87%) of the
      patients managed by local resection. Local recurrence was identified in 24 of 355
      patients (7%). Incidence of local recurrence is strictly related to surgical
      margin, but above all, to tumor necrosis induced by neoadjuvant chemotherapy. In
      fact, neoadjuvant chemotherapy makes limb salvage feasible in the majority of
      cases without increasing the risk of local recurrence: in the group of patients
      immediately operated on without neoadjuvant chemotherapy, the incidence of local
      recurrence is dramatically high even when the surgical margins are adequate.

PMID- 1622859
TI  - SARG: a new human osteosarcoma cell line. Expression of bone markers and of major
      histocompatibility antigens.
AB  - A new cell line (SARG) was established from a human radiation-induced
      osteosarcoma (OSA). It showed an epithelial-like morphology with polymorphous and
      sometimes bizarre nuclei. SARG had an osteoblastic differentiation pattern:
      almost 100% of the cells were positive for alkaline phosphatase, type I and III
      collagens and osteonectin. The expression of class I HLA antigens was detectable
      even after 40 in vitro passages. The expression of MHC antigens was greatly
      increased after in vitro treatment with interferon gamma (IFN-gamma), whereas
      interferon alpha (IFN-alpha) and tumor necrosis factor alpha (TNF-alpha)
      increased the expression of class I antigens, but not of class II antigens. SARG
      was tumorigenic after subcutaneous injection in nude mice. Experimental
      metastases were never detected.

PMID- 1622860
TI  - Preoperative chemotherapy for osteosarcoma with intravenous adriamycin and intra
      arterial cis-platinum.
AB  - Ninety-seven patients with primary osteosarcoma of the extremities, all age 16 or
      older, were treated with adriamycin, 90 mg/m2, continuous i.v. infusion over 96
      h, followed by cis-platinum, 120-160 mg/m2 by intra-arterial infusion. The first
      37 patients, treated from 1979-1982, had a 59% complete response rate and a 54% 5
      year continuous disease free survival (CDFS). Patients with complete response had
      an 85% 5-year CDFS compared with 13% for patients with partial and poor response.
      Patients treated between 1983-1988 with an intensified regimen have a 68%
      complete response rate and a 69% 3-year CDFS. Those who did not achieve complete
      remission were switched to an alternating chemotherapy program emphasizing the
      use of high-dose methotrexate. Limb salvage has been accomplished in 59% of
      patients in the first group and 80% in patients of the second group. Preoperative
      chemotherapy allows informed decisions to be made in postoperative management
      which can influence overall cure rates. Long-term follow-up is essential before
      final interpretation of the data.

PMID- 1622861
TI  - Osteonectin in osteosarcomas: a marker for differential diagnosis and/or
      prognosis?
AB  - Seventy-five osteosarcomas at various grades of histologic differentiation were
      investigated for evidence of osteonectin. According to the results of the study,
      osteonectin was present in all osteosarcomas. An association between the
      intensity of the osteonectin antibody reaction and prognosis could not be
      established. Evidence of osteonectin was also found in other bone tumors.
      Osteonectin is therefore unsuitable for differential diagnosis, cannot be
      regarded as a bone specific protein and has not prognostic value.

PMID- 1622862
TI  - Chemofiltration and chemoembolization: new techniques in advanced pelvic bone
      malignancies. Case report on three cases.
AB  - The survival time and the quality of life in patients with advanced pelvic bone
      malignancies are still challenges for oncologists. In order to ameliorate the
      poor results that surgery and chemotherapy can routinely offer, we developed new
      loco-regional approaches like intra-arterial chemotherapy, alone or combined with
      chemofiltration of venous return, and chemoembolization. Chemofiltration makes it
      possible to cut off the high systemic drug peaks by filtering the venous drainage
      of a body area arterially infused. Chemoembolization causes a reduction of blood
      flow and therefore a prolongation of the transit time through the neoplasm
      vascular bed; this will increase the contact time between the drugs and the tumor
      cells. Three patients were treated with our loco-regional treatments and the
      results are reported below.

PMID- 1622863
TI  - Primary chemotherapy and delayed surgery for osteosarcoma of the extremities with
      synchronous metastases.
AB  - From September 1986 to September 1989 11 patients affected by osteosarcoma of the
      extremities with synchronous metastases were treated with two cycles of high-dose
      methotrexate i.v., cisplatin i.a. and adriamycin i.v. followed by simultaneous
      resection of the primary and metastatic tumor. A complete histological
      examination of the resected specimens was always performed to evaluate the
      percentage of necrosis produced by chemotherapy on both the primary and
      metastatic tumor. After surgery the patients received 3 more cycles of the same
      drugs as used preoperatively plus ifosfamide. The histological response of the
      primary tumor was 'good' (90% or more tumor necrosis) in 4 patients and 'poor'
      (less than 90% of tumor necrosis) in 7, while in the 34 metastatic nodules the
      resulting necrosis was good in 8 and poor in 26. A good correlation between the
      histological response in the primary and metastatic tumor was observed,
      particularly for poor responders (91% of poor responses also in metastatic
      nodules). At an average follow-up of 42 months, only 3 patients are alive, 2
      disease-free, and one with uncontrolled disease. These data suggest that the
      prognosis of osteosarcoma of the extremities with synchronous metastases remains
      poor, even with a very aggressive treatment. Our results also seem to confirm the
      validity of the present strategy in the treatment of non-metastatic osteosarcoma:
      introducing new drugs post-operatively in poor responding patients can allow a
      better treatment of microscopic disease and can improve the prognosis for these
      patients.

PMID- 1622864
TI  - Primary childhood osteosarcoma: the role of salvage surgery.
AB  - The overall results of salvage surgery for lung metastases were evaluated on 174
      consecutive patients with primary osteosarcoma below the age of 20, resected in
      Milan between 1970 and 1988. Seventy-two children treated in the years 1970-1981
      were compared with 102 children treated in the years 1982-1988. In the latter
      period, adjuvant chemotherapy was replaced by neo-adjuvant programs and salvage
      surgery was applied systematically to all patients with resectable lung
      metastases through median sternotomy. During the last period, the overall 5 year
      survival improved significantly from 35% to 58% (P less than 0.001), while the
      disease free survival rose from 38% to 45% (median 15 vs. 33 months, P = 0.3).
      The proportion of patients with completely resected lung metastases rose from 17%
      (7/42) to 55% (27/49), without operative mortality, and the overall survival from
      detection of lung metastases (including unresected cases) improved from 0 to 28%
      at 5 years (P less than 0.001). The survival benefit was observed only in the
      group of children with resected metastases. These data indicate that systematic
      bilateral pulmonary resection, combined with neoadjuvant chemotherapy, has
      contributed to improve the final cure rate of childhood osteosarcoma.

PMID- 1622865
TI  - Osteosarcoma of the facial bones.
AB  - Maxillo-facial osteosarcoma is a rare primary tumor in adults. Between 1980 and
      1990, 11 patients were considered; 6 had primary tumors in mandible and 5 in the
      maxillo-paranasal region. All cases were treated with surgery as the primary
      modality. Resection was radical in 8 patients and palliative in the other 3.
      Adjuvant postoperative chemotherapy with adriamycin was administered for 6 months
      in the 8 patients treated with complete resection. After a median follow-up of 3
      years, 7 patients are still alive and 4 died of progressive disease. In the group
      of patients treated with radical surgery and adjuvant chemotherapy only one died
      for distant metastases, and 7 are living free of disease. With complete surgical
      resection long term local tumor control was achieved in all patients. No patient
      treated with incomplete resection achieved local tumor control with subsequent
      radiotherapy. The possibility of performing a complete surgical resection of the
      primary appears to be an essential step to obtain long term local control and
      survival in maxillo-facial osteosarcoma. Our series is, however, too limited to
      evaluate the therapeutic benefit of adjuvant chemotherapy.

PMID- 1622866
TI  - The value of immunohistochemistry in the diagnosis of soft tissue sarcomas.
AB  - Histological classification of soft tissue sarcomas can be made by light
      microscopy alone for those tumors with unique appearances, while a significant
      proportion of sarcomas require the implementation of electron microscopy or
      immunohistochemistry to obtain a final diagnostic classification. Immunostaining
      methods are particularly valuable in certain classes of sarcomas such as
      epithelioid sarcomas, malignant schwannomas, hemangiosarcomas, clear cell
      sarcomas, rhabdomyosarcomas, pleomorphic liposarcomas, leiomyosarcomas and
      synovial sarcomas through documentation of their cellular products.
      Immunohistochemistry is not a substitute for skilled interpretation of
      conventionally stained microscopic specimens; however, the availability of more
      specific determinants in the soft tissue neoplasms will expand the value of this
      approach in this area of diagnostic pathology.

PMID- 1622867
TI  - Soft tissue sarcomas. Imaging: an integrated approach.

PMID- 1622868
TI  - Soft tissue lesions in adults: biopsy--yes or no?

PMID- 1622869
TI  - Surgical approach to soft tissue sarcomas of the extremities.
AB  - Authors emphasize the primary role of surgery in the treatment of soft tissue
      sarcoma, confirming the recent acquisition that conservative surgery and adjuvant
      therapy yield results comparable to those of more extensive surgery.
      Subsequently, the authors delineate the general guidelines in the surgical
      treatment of soft tissue sarcoma, depending on the anatomic location of the
      tumor, and point out the main goals: first to provide local control of the tumor,
      and second to preserve as much function as possible without jeopardizing the
      adequacy of the procedure.

PMID- 1622870
TI  - Soft tissue sarcomas: experience with intraoperative brachytherapy in the
      conservative management.
AB  - Forty-eight patients with soft tissue sarcomas were treated with Iridium implant
      after wide local excision between 1980 and 1990 at our institution. External
      irradiation was also given postoperatively in 33 patients with initially
      resectable tumours (treatment A) and preoperatively in 3 with initially
      unresectable tumours (treatment C); brachytherapy was the only treatment in 12
      patients presenting small superficial tumours or recurring after previous
      irradiation (treatment B). Median follow up was 51 months (range 6-148). Fifteen
      patients (31%) failed; local recurrence was present in 9 (18.8%) and distant
      metastases in 11 (22.9%). Local failures were 3/33 (9%) after the treatment A,
      4/12 after the treatment B, 3/2 after the treatment C. The incidence of local
      failures was affected by the tumor size, the presence of positive histology at
      the resection margins, and the total radiation dose. There was no impairment of
      wound healing and no necrosis; a severe sclerosis was observed only in the 3
      patients receiving preoperative irradiation probably because large size fractions
      were used. We concluded that brachytherapy should be included in the radiation
      program for soft tissue sarcomas when a satisfactory geometry may be achieved and
      in particular when the tumor is located in sites where external irradiation only
      has a higher probability of producing major side effects.

PMID- 1622871
TI  - Intra-arterial induction chemotherapy for soft tissue sarcomas.
AB  - One hundred-one patients were treated in our institution with intra-arterial
      preoperative adriamycin (i.a. ADR) for large soft tissue sarcomas of the
      extremities, 45% recurrent at entry. Of the 78 high grade evaluable patients 38%
      had clinical and 45% had pathological responses to chemotherapy. Limb
      conservative surgery was performed in 80% of cases, with about 10% improvement
      made possible by the preoperative treatment. The local recurrence rate was 29%,
      and 50% five-year actuarial survival with a median follow-up of 68 months. These
      poor results are related to the severe selection of high risk cases. The clinical
      parameter of response was highly predictive of survival: 63% versus 36% (p =
      0.01) 5-year survival in the group of responders and non-responders,
      respectively, whereas the pathological parameter of response was not so
      predictive. The improved effect of delivering the drug intra-arterially is
      theoretically expected but not proved in our experience. The major practical
      effect of this induction chemotherapy is the selection of patients with better
      prognosis and the possibility of perform, in some cases, easier limb salvage
      procedures. The last regimen combining i.a. ADR + i.v. Ifosfamide seems to
      provide little better but not yet significant results.

PMID- 1622872
TI  - The treatment of osteosarcoma: present trends. The Scandinavian Sarcoma Group
      experience.
AB  - The study comprised 97 patients treated by the Scandinavian Sarcoma Group for
      high-grade, extremity-localized osteosarcoma. Chemotherapy was according to the T
      10 protocol, with four courses of high-dose methotrexate (HDMTX) given
      preoperatively at weekly intervals. Seventeen percent of the patients obtained a
      good (grade III or IV) histologic response, 62% a moderate (grade II) response
      and 21% a poor (grade I) response. Grade II-IV responders had significantly
      higher serum MTX levels than grade I responders. Good responders had
      significantly better survival than moderate/poor responders, and had a trend
      towards both lower recurrence rate and longer time to recurrence. Five-year
      overall and relapse-free survival for all patients was 63% and 53%, respectively.
      Within a group of patients with similar primary tumour response, there was a
      trend for better survival with increasing serum MTX levels, indicating that
      individualization of MTX doses according to renal excretion rates may be
      indicated. The present results underline the importance of introducing effective
      chemotherapy from the start of osteosarcoma treatment, and that HDMTX alone seems
      to be insufficient preoperative therapy. The toxicity of HDMTX is generally mild,
      but we have by cerebral MRI found signal changes in white matter in 14/22
      patients; changes that may represent subclinical MTX CNS toxicity. In the
      subsequent SSG osteosarcoma protocol, cisplatin and doxorubicin has been added to
      HDMTX from the start of treatment. Our data also suggest that an aggressive
      approach involving second-line chemotherapy and surgery is indicated for
      metastatic disease and that such an approach may lead to long-term survival in up
      to 30% of patients.

PMID- 1622873
TI  - Hyperthermic antiblastic perfusion for the treatment of soft tissue limb sarcoma.
AB  - Eighty patients with locally advanced, high grade soft tissue sarcoma of the
      extremities were studied prospectively in order to determine the efficacy of
      hyperthermic antiblastic perfusion (H.A.P.) as the first step of a combined
      multimodality therapy. All of the patients have been evaluated in terms of
      functional results, loco-regional control and survival according to the different
      treatment schedules adopted. The first clinical trial employed H.A.P., followed
      by surgery alone. Because the results obtained were unsatisfactory, the protocol
      was modified to include a continuous intra-arterial (i.a.) infusion of
      doxorubicin (dx) or radiotherapy before surgery. The best results have been
      obtained with the radiotherapy-including protocol showing a conservative surgery
      rate of 100% and a 94% rate of loco-regional control. The disease-free, distant
      disease-free and overall survival rates were 68%, 75% and 70%, respectively. The
      importance of the treatment protocol has been confirmed in a multivariate
      analysis which demonstrated that the treatment protocol adopted is one of the
      prognostic factors with an independent value (p = 0.06).

PMID- 1622874
TI  - Chemotherapy in the multidisciplinary approach to soft tissue sarcomas. EORTC
      Soft Tissue and Bone Sarcoma Group studies in perspective.

PMID- 1622875
TI  - Standard and high dose chemotherapy for advanced soft tissue sarcomas.
AB  - While significant improvements have been made in the management of localized soft
      tissue sarcomas, enabling the realization of better functional results and a
      better overall outcome, progress in metastatic disease has been less than
      impressive. Adriamycin and DTIC based chemotherapy programs have resulted in
      response rates of upto 50%, with a small but finite cure fraction, especially in
      conjunction with surgical resection of residual abnormalities. The decade of the
      80s experienced a considerable amount of enthusiasm in exploring the role of
      ifosfamide and mesna, and identified its definite usefulness as an effective
      salvage regimen with response rates of approximately 25%-30% in adriamycin
      failures. Studies evaluating the role of ifosfamide as up-front line agent in
      combination with adriamycin have met with increased toxicities without a
      significant additive therapeutic benefit, probably as a result of compromised
      dose intensity of each individual agent. The steep linear log-dose response
      relationship of alkylating agents and adriamycin constitutes the theoretical
      rationale for use of higher doses of chemotherapy, which have become feasible,
      with the advent of growth factors for bone marrow support. While this approach
      seems promising in its infancy, with improved complete and overall response, its
      ultimate effect on survival is anxiously awaited. The limited experience
      available in the literature with even more aggressive approaches like marrow
      ablative doses of chemotherapy followed by bone marrow transplantation, have been
      uniformly disappointing, with extremely short lived responses and extremely high
      morbidity and cost. As clinical research continues to improve our understanding
      and ability to implement the currently available therapeutic armamentarium, the
      search for newer and better drugs needs to continue.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1622876
TI  - Risk factors for adult soft tissue sarcoma in northern Italy.
AB  - The role of several potential risk factors in the etiology of soft-tissue sarcoma
      (STS) was examined in a hospital-based case-control study, conducted in the
      Friuli-Venezia Giulia region, northeast Italy, between 1985 and 1991. A total of
      93 STS cases (53 males and 40 females, median age: 52 years) and of 721 controls
      (371 males and 350 females, median age: 54 years) were interviewed. Significant
      increased risks were associated with a history of herpes zoster infection (odds
      ratio (OR): 2.3, 95% confidence interval (CI): 1.1-4.9), chicken-pox (OR: 2.1,
      95% CI: 1.2-4.1) and mumps (OR: 2.0, 95% CI: 1.1-3.8). None of the other medical
      conditions investigated - socio-economic and anthropometric indicators, tobacco
      smoking, consumption of alcoholic beverages, coffee and tea - seemed to affect
      STS risk. No risk elevation was found in subjects employed in agriculture (OR -
      for greater than 10 years employment = 0.8, 95% CI: 0.4-1.5), nor in those who
      reported exposure to pesticides or herbicides (OR = 0.4, 95% CI: 0.1-1.2).
      Workers who reported exposure to chemical agents or to benzene or other solvents
      for more than 10 years had, respectively, a 1.8-fold (95% CI: 0.7-4.4) and a 2.2
      fold (95% CI: 0.9-5.5) higher risk of developing STS.

PMID- 1622877
TI  - The prognostic value of DNA content measured by image cytometry in soft tissue
      sarcomas.
AB  - Nuclear DNA content in soft tissue sarcoma was determined by image cytometry
      using archival, paraffin embedded material. In a retrospective study 138
      specimens of 81 patients have been analysed. The ploidy level was correlated to
      clinical outcome regarding tumor volume and histological grading, the most
      important prognostic parameters. Ploidy has a significant prognostic value and
      correlates well with histological grading (p = 0.01). Tumour volume was found to
      be an independent prognostic factor (p = greater than 0.1) [chi 2 test]. The DNA
      content of the primary tumour and of multiple local recurrences remained similar.

PMID- 1622878
TI  - Surgery and radiation therapy in the treatment of soft tissue sarcomas of
      extremities.
AB  - Between January 1979 and December 1987, 99 patients (pts.) with a diagnosis of
      localized soft tissue sarcoma of the extremities received preoperative radiation
      therapy (Preop. RT, 50 pts.) or postoperative irradiation (Postop. RT, 49 pts.).
      In the preop. RT group, doses ranged from 42 Gy/17 fractions to 51 Gy/17
      fractions; pts. treated with RT after surgery, received a dose comprised between
      46 Gy/23 fractions to 66 Gy/33 fractions. The surgical procedure consisted of
      making a wide resection of the mass with preservation of the affected limb, in
      each patient. The main cause of failure was dissemination of the disease (33.3%).
      The incidence of local failures was low (7.1%). Recurrences were related to the
      size of the disease (5 cm: 0/12; 5-10 cm: 2/45 2.3%; 10 cm: 5/42, 11.9%), as were
      also distant metastases. The incidence of distant failures was higher in the
      group treated with preop. RT (44.0% vs. 22.4%), probably because a higher
      percentage of patients in this group had large volume diseases. Late sequelae
      were evaluable in 59 pts. with a follow up longer than 24 months. The incidence
      of complications was low (10.1%, 6/59); it was higher in the preoperative than in
      the postoperative group (15.4% vs. 6.1%); this observation is probably related to
      the different modalities of fractionation.

PMID- 1622879
TI  - Radiation therapy and conservative surgery for soft tissue sarcomas of the
      extremities, torso and head and neck.
AB  - Between May 1985 and July 1990, 45 patients (pts.) with primary (39) or recurrent
      (6) soft tissue sarcomas of the extremities (82%), torso (11%) and head and neck
      (7%) were treated with radiation therapy and conservative surgery. Seven pts. not
      amenable to conservative surgery underwent preoperative radiation therapy whereas
      38 pts. underwent local excision and post-operative radiation therapy. Out of the
      38 pts. managed by postoperative radiation, 24 (63%) showed negative surgical
      margins and 14 (37%) positive margins, their tumor being adjacent to vital
      structures. Preoperative radiation allowed conservative surgery in all 7 pts.
      with initially inoperable tumor; surgical margins were negative in 5 and positive
      in 2 pts. Twenty-six pts. (58%) had tumor greater than or equal to 5 cm (5-24)
      and 19 (42%) less than 5 cm (2.5-4.5) in diameter. High grade tumors (G2-G3) were
      reported in 41 pts. (90%). In pts. treated postoperatively the radiation dose was
      64-66 Gy/32-33 fractions and the pts. treated preoperatively received a dose of
      50 Gy/25 fractions. Median follow-up was 33 months and all pts. had a minimum
      follow-up of 12 months (12-72). Three pts. (6.5%) had local failure and 9 (20%)
      developed distant metastases with local tumor control. All distant metastases
      occurred in AJC stage IIIB, 9/18 (50%), with an increased frequency by tumor
      size. Overall local control and disease free survival rates at 5 years (product
      limit method) were 93% and 73%, respectively. An evident decrease in disease-free
      survival rate (33%) was noted for stage IIIB pts.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1622880
TI  - Training in clinical oncology: results of a Junior Radiologists' Forum
      Questionnaire.

PMID- 1622881
TI  - Sites of relapse in seminoma treated with single agent carboplatin chemotherapy:
      implications for further management.
AB  - Between 1983 and 1990, 66 patients were treated with single agent carboplatin for
      advanced seminoma, and sites of relapse have been analysed with respect to sites
      involved before chemotherapy. Fourteen relapses were evaluable, and relapse was
      confined to node groups affected before chemotherapy, or those immediately
      adjacent, in seven patients. At present it is unclear whether single agent
      carboplatin should be the initial chemotherapy for seminoma, but if it is
      employed there may be a role for local adjuvant radiotherapy after carboplatin
      chemotherapy.

PMID- 1622882
TI  - The problem of cigarette smoking in radiotherapy for cancer in the head and neck.
AB  - Smoking cigarettes during radiotherapy prolongs the period of reaction and may
      reduce the chance of cure. Of a group of 48 patients with advanced head and neck
      cancer 35 were smoking at the time of diagnosis, but 17 were persuaded to stop,
      although 7 relapsed later. Interviews conducted in 35 of the 48 patients revealed
      the problems which must be overcome if such patients are to cease smoking.

PMID- 1622883
TI  - Primary radiotherapy for T4 breast cancer.
AB  - In Edinburgh in 1982, radiotherapy for patients with T4 breast cancer was
      modified by an increase in tumour absorbed dose from 42.5-45.0 Gy to 60-75 Gy by
      using tumour boosts and changing from alternate day to daily fractions. To assess
      whether this improved local control or survival, the records of all females with
      T4-N0-3M0 breast cancer referred between January 1978 and December 1985, who
      received radiotherapy without initial mastectomy or adjuvant chemotherapy, were
      reviewed. There were 193 patients in the study. Minimum follow-up was 36 months.
      Actuarial survival at 5 years was 27.1% and median survival 29 months. Local
      control was achieved by 25.9%. On multivariate analysis, the probability of
      survival fell with increasing tumour size, advanced clinical node status and the
      presence of inflammatory change. Radiotherapy technique also affected prognosis.
      Four-field techniques were associated with a better chance of survival than the
      breast and axillary jig or other treatment methods. The probability of local
      control increased with reduced tumour size and showed the same relationship to
      radiotherapy technique as did survival. Dose was not a significant variable for
      either survival or local control. No improvement in survival or local control was
      apparent in comparison with a previous study. It is concluded that radiotherapy
      alone at a dose of 60 Gy is insufficient to produce durable local control for the
      majority of women with T4 breast cancer.

PMID- 1622884
TI  - The use of isodose curves on radiographs and on CT scans in interstitial
      brachytherapy.
AB  - In brachytherapy an accurate dose distribution is usually not definable, and
      therefore not required. If flexible catheters are implanted, such as in head and
      neck cancer, resulting isodose curves only rarely fit exactly to radiographic
      films, and the target volume is not easily reconstructed. Usually no clear
      relationship exists between the three-dimensional (3D) dose distribution and
      target volume on the one hand and the two-dimensional (2D) radiographic films on
      the other. Dose distributions on radiographs are not sufficient to define the
      target absorbed dose and doses that critical areas will receive. A 3D imaging
      system, like computed tomographic (CT) scans, is needed in order to visualize
      underdosage inside the target volume and non-tolerable hot spots outside the
      tumour. Large-scale and expensive techniques exist to tackle these problems. Our
      inexpensive and verifiable approach to solve these problems combines localization
      radiographs with CT scans. Whereas tumour and critical areas are displayed on CT
      scans, flexible catheters loaded with dummy sources are best seen on radiographic
      films. With the help of a self-developed computer program, dose distributions are
      superimposed on CT scans. Doses to the target and critical organs are easily read
      and verified by external and internal detectors.

PMID- 1622885
TI  - The role of a radiographer counsellor in a large centre for cancer treatment: a
      discussion paper based on an audit of the work of a radiographer counsellor.
AB  - It is widely accepted that cancer patients have unmet psychosocial needs. There
      are as yet few guidelines on the appropriate role of a counsellor in centres for
      cancer treatment. In this study the activities of a radiographer counsellor were
      audited to try to identify the proportion of patients who would benefit from
      seeing a counsellor, to estimate the cost of such a service, and to obtain
      indications of how the effects of counselling could be evaluated. The study
      suggested that 44% of patients attending for routine radiotherapy have abnormally
      high levels of anxiety and might benefit from counselling. The Hospital Anxiety
      and Depression Scale (HADS) is proposed as an objective measure of benefit.
      Costing and resource allocation are discussed.

PMID- 1622886
TI  - Irradiation of the pinna with superficial kilovoltage radiotherapy.
AB  - Excellent local control can be achieved by treating superficial carcinomas of the
      skin with superficial kilovoltage radiotherapy. The results of this study support
      the use of 100-140 KV photons to treat carcinomas of the skin of or around the
      pinna. This achieves a local control rate of 97% and the radionecrosis rate of
      10% could be halved if all patients were treated with 3500 cGy in 5 fractions
      over one week, or to a maximum area of 5 cm2 of irradiated pinna. An audit of the
      running cost reveals that this method of treating superficial carcinomas is
      highly cost effective and can be recommended for all suitable patients.

PMID- 1622888
TI  - The 1991 George Edelstyn Memorial Lecture: needles, wires and chips--advances in
      brachytherapy.
AB  - The majority of quantitative data on the effects of dose-rate come from
      experiments with cultured cells in vitro. These data are reviewed, and it is
      concluded that results obtained from the in vitro experience may be carried over,
      in a quantitative manner, to guide clinical radiotherapeutic design. As an
      example, there are contradictory guidelines suggested to compensate for changes
      in dose-rate in interstitial wire-implant brachytherapy. The Paris group has
      suggested no dose correction is required for implant times from 3 to 8 days,
      while the Paterson/Ellis school suggests a significant correction. It is shown
      that, based on known radiobiological principles, this controversy can be
      resolved. These same radiobiological notions, as well as advances in computer
      technology, have led to the technique of pulsed brachytherapy, which allows the
      average dose-rate to be maintained at a constant rate, even when the wire
      activities have decayed.

PMID- 1622887
TI  - The management of tumours arising in the maxillary antrum.
AB  - Eighty-eight cases of tumours arising in the maxillary antrum undergoing
      treatment between 1967 and 1989 are reported. The series comprised 34 females and
      54 males. Sixty-two patients had squamous cell carcinoma (SCC). Forty of those
      with SCC were treated by XRT only, four cases by surgery only, while the
      remaining 18 patients had surgery and post-operative XRT as a combined modality
      treatment. Early SCC (T2N0) was adequately controlled by radical radiotherapy
      alone with a 5-year survival of 69.1%. In more advanced SCC (T3N0 and (T4N0)
      radical radiotherapy alone was less successful with the 5-year survival falling
      to 19%. Combined modality treatment comprising radical surgery followed by
      radical postoperative radiotherapy improved 5-year survival in advanced SCC to
      61%. It is therefore recommended that if patients are treated for cure, major
      surgery followed by radical postoperative radiotherapy is preferable in advanced
      squamous tumours ((T3/T4) of the maxillary antrum.

PMID- 1622889
TI  - Are we winning the war against cancer? A review in memory of Keith Durrant.

PMID- 1622890
TI  - Hypertrichosis lanuginosa acquisita following cytotoxic chemotherapy.
AB  - Hypertrichosis lanuginosa acquisita (HLA) refers to abnormal and excessive growth
      of fine downy hair. It is a rare condition which has been reported in association
      with both malignancy and certain drug therapy. We report three cases occurring
      after administration of cytotoxic chemotherapy for cancer. A possible
      relationship is discussed and previous literature reviewed.

PMID- 1622891
TI  - Demonstration of the requirement for self antigen in the activation of
      autoreactive T cells.
AB  - An HLA-DR4-restricted T cell clone (26G11), which was reactive to autologous non
      T cells without any nominal antigens, was established from an unimmunized normal
      subject that was DR1/4 positive. The reactivity of the clone was examined against
      L cells (LDR4) transfected with the particular DR4 genes obtained from the same
      subject. 26G11 cells proliferated slightly in response to LDR4 cells, but the
      proliferation was markedly augmented by the addition of cell lysate from an
      autologous B cell line. In addition, 26G11 cells killed LRD4 cells sensitized by
      preincubation with the cell lysate more efficiently than LDR4 cells without
      treatment. When LDR4 cells were preincubated with cell lysate from allogenic B
      cell lines, effective killing of the target cells by clone 26G11 was also
      observed. These data strongly suggest that this autoreactive T cell clone (26G11)
      recognizes endogenous antigen in the context of the DR4 molecule. This directly
      demonstrates the requirement for self antigen in the activation of human
      autoreactive T cells from a normal subject.

PMID- 1622892
TI  - Characterization of private and cross-reactive idiotypes associated with human
      antibodies to hepatitis B surface antigen.
AB  - Four mouse monoclonal anti-idiotypic antibodies (anti-Id) were generated against
      human monoclonal and polyclonal antibodies to hepatitis B surface antigen
      (HBsAg). These monoclonal anti-Id, along with a polyclonal anti-Id raised in
      rabbits, were used to characterize the idiotype (Id) specificity of the human
      antibody response to HBsAg (anti-HBs). The anti-Id reagents identified distinct
      private and cross-reactive Id expressed on monoclonal and polyclonal human anti
      HBs preparations respectively. The anti-Id recognized both HBsAg combining site
      and non-combining site related private Id, and HBsAg combining site related cross
      reactive Id. The Id specificities recognized by two of the monoclonal anti-Id
      were associated with the H chain alone, whereas two of the monoclonal anti-Id,
      along with the polyclonal anti-Id appeared to recognize Id determinants
      associated with both isolated H and L chains. These data suggest that Id
      heterogeneity exists within the human antibody response to HBsAg. The knowledge
      that Id heterogeneity exists is of importance in understanding the observed
      variability in the immune response during hepatitis B virus infection.

PMID- 1622893
TI  - Antigen recognition by the T cell receptor is enhanced by CD8 alpha-chain binding
      to the alpha 3 domain of MHC class I molecules, not by signaling via the
      cytoplasmic domain of CD8 alpha.
AB  - The binding specificities and function of mouse CD8 were studied using a CD4-CD8-
      allospecific T cell hybridoma, chimeric class I MHC molecules, and a CD8 alpha
      deletion mutant. By transfecting the mouse CD8 alpha gene into a IL-2 producing,
      H-2Kb specific hybridoma, IL-2 production was increased when L cells expressing
      Kb were used as stimulators. However, no increase in IL-2 was observed when a
      KbKbB7 hybrid molecule, composed of the alpha 1 and alpha 2 domains of H-2Kb, and
      the alpha 3 domain of HLA-B7, was used as a stimulator. Comparison between T cell
      hybridomas that expressed full-length CD8 alpha and a deletion mutant lacking
      part of the cytoplasmic domain revealed identical responsiveness for H-2Kb. The
      data suggest that the mouse CD8 alpha homodimer does not bind to the alpha 3
      domain of HLA class I molecules and that CD8 alpha acts as a co-receptor with the
      TCR by binding the same MHC molecule for alloantigen recognition. Our data also
      provide evidence that CD8 alpha signal transduction through its cytoplasmic tail
      by association with p56lck is not an absolute requirement for antigen recognition
      by T cells.

PMID- 1622894
TI  - Development and follicular localization of tolerant B lymphocytes in
      lysozyme/anti-lysozyme IgM/IgD transgenic mice.
AB  - To analyse mechanisms of immunological self-tolerance, a detailed comparison of
      the development and fate of lysozyme-specific B lymphocytes was carried out in
      transgenic mice expressing rearranged anti-lysozyme IgM/IgD Ig transgenes in the
      absence or presence of an additional transgene encoding lysozyme itself. In the
      absence of lysozyme, B cell development, localization, and differential
      expression of transgene-encoded IgM and IgD occurred in the normal sequence in Ig
      transgenic mice, establishing that these animals provide a physiological model
      for studies of B cell selection in vivo. By contrast, in lysozyme-expressing
      double-transgenic mice, tolerant lysozyme-reactive B cells persisted within the
      follicular mantle zones in the spleen, lymph nodes, and Peyer's patches, but were
      eliminated from the splenic marginal zones. It could be shown that lysozyme
      binding and induction of tolerance occurred as soon as surface Ig was expressed
      on immature B cells in the bone marrow of the double-transgenic mice although
      this did not prevent maturation, emigration from the bone marrow, and
      localization in peripheral lymphoid follicles. These findings, together with
      recent examples of aborted maturation of self-reactive B cells, indicate two
      functionally distinct antigen receptor signalling events in immature B cells and
      suggest a unique role for the follicular microenvironment.

PMID- 1622895
TI  - Characterization of lymphoid cell lines from murine spleen which can localize in
      thymus.
AB  - Several murine lymphoid cell lines have been tested for specific capacity to
      localize in thymus. These are all continuous, cloned Radiation leukemia virus
      induced cell lines which have a common phenotype resembling lymphoid stem cells
      or immature T cells. Since each of these cell lines has a cloning efficiency
      approaching 100%, the number of cells which enters thymus during a 3 h homing
      assay has been estimated by limit dilution cloning analysis taking into account
      extra-binomial variation caused by individual mice. Only two out of seven of
      these cell lines have been found to have this specific property. These two cell
      lines, 16C1 and 5C2B, have been characterized as immature lymphoid cells, bearing
      no rearrangement at the TCR gamma and beta loci, and having the phenotype of
      CD3+CD4-CD8-, immature T cells. A maximum number of 2000 16C1 cells and 2500 5C2B
      cells can enter thymus during a 3 h homing assay, suggesting a limited number of
      sites in thymus to which these cells can bind. The capacity of 16C1 to enter
      thymus in low frequency has been found to be a stable property and was not
      increased by repetitive passage through mouse thymus. Using this assay, we have
      also been able to confirm that entry of 16C1 cells into thymus can be inhibited
      by antibody specific for the Ly24 (Pgp-1) molecule.

PMID- 1622896
TI  - Effect of in vivo hyperthermia on thymocyte maturation and selection.
AB  - Two-month-old male mice were exposed to whole-body hyperthermic treatment in a
      circulating water bath. After 1 h exposure to 41 degrees C, mice were kept at
      room temperature for 24, 48, 72, and 96 h before thymus examination. The total
      thymocyte number progressively decreased after 24 and 48 h, reached a minimum
      value at 72 h, and returned to almost normal value after 96 h. Similar changes
      occurred in the CD4+CD8+ cell subset. Conversely, the percentage of CD4-CD8-
      cells rose to a maximum at 48 h and then declined to normal value at 96 h. The
      percentage of CD4-CD8+ and CD4+CD8- cell subsets increased to a maximum at 48 h
      and then declined to normal value at 96 h. These variations in single positive
      cell subsets correlated well with similar changes in the thymocyte mitotic
      response to concanavalin A. The observed effects on thymocytes were heat dose
      dependent, and suggest that hyperthermia induces the development of the most
      primitive thymocytes and positively selects mature T cells with high mitotic
      responsiveness. It is proposed that heat shock proteins might be involved in the
      hyperthermia-induced alterations of thymocyte maturation and selection.

PMID- 1622897
TI  - The effect of p56lck, a lymphocyte specific protein tyrosine kinase, on the
      syncytium formation induced by human immunodeficiency virus envelope
      glycoprotein.
AB  - A human CD4+ T cell line, Jurkat, was transfected with a constructed plasmid,
      which has the envelope gene of the human immunodeficiency virus (HIV) under the
      transcriptional control of the human metallothionein IIA promoter, and these
      transfected cells were then cloned. JME2, one of the cloned cell lines,
      expressing the envelope glycoprotein after induction with metal ions, showed the
      ability to form syncytia involving other CD4+ cells not expressing the HIV
      envelope protein. When several CD4+ cell lines were examined for their
      susceptibility to syncytium formation by JME2 cells, the p56lck-expressing cell
      lines were found to be more susceptible to syncytium formation than the p56lck
      non-expressing cell lines. To substantiate the role of p56lck in the syncytium
      formation, a CD4+, p56lck-non-expressing monocytoid cell line, U937 clone 2, was
      transfected with an lck-expressing construct. Using such transfectant cell
      clones, it was demonstrated that p56lck-positive cells are markedly more
      susceptible to the syncytium formation than p56lck-negative cells, implying a
      regulatory role for p56lck in syncytium formation mediated by the HIV envelope
      and CD4 molecule. Moreover, it was suggested, in the experiments using CD45 cross
      linking or a protein tyrosine kinase inhibitor, genistein, that p56lck affects
      syncytium formation through its protein tyrosine kinase activity. A putative
      mechanism by which p56lck affects the syncytium formation is also discussed.

PMID- 1622898
TI  - Characterization and partial purification of a high molecular weight tumoricidal
      activity secreted by murine bone marrow macrophages.
AB  - Cultured murine bone marrow-derived macrophage (BMM phi) can be induced to
      secrete tumoricidal activity in vitro when activated with recombinant IFN-gamma
      and bacterial lipopolysaccharide (LPS). We have analyzed this activity for tumor
      specificity, relationship to tumor necrosis factor-alpha (TNF-alpha), serine
      proteases, and reactive nitrogen intermediates, and partially purified this
      activity by high pressure liquid chromatography. Cytolytic activity was recovered
      in conditioned culture supernatants of serum-free cultivated BMM phi treated with
      a combination of IFN-gamma and LPS but was not inducible by either stimulant
      alone. It selectively affected tumor cells of murine as well as human origin
      irrespective of sensitivity towards recombinant murine TNF-alpha (r-muTNF-alpha),
      but did not significantly affect non-tumorigenic cells of either species. It was
      inactivated by 56 degrees C, trypsin, and neuraminidase treatment, but could not
      be inhibited by neutralizing antibodies against r-muTNF-alpha or serine protease
      inhibitors. Tumoricidal activity was purified approximately 10-fold by gel
      filtration and eluted as a major peak with a Mr of 170 kDa, containing a single
      predominant protein band of approximately 170 kDa on SDS-PAGE analysis, which is
      shown to be a disulfide linked glycoprotein heterodimer of 110 and 58 kDa
      subunits (gp170). Expression of this glycoprotein was strongly dependent on
      activation of BMM phi by a combination of IFN-gamma and LPS but was only
      marginally induced by either stimulant alone. Furthermore, the level of gp170
      expression was quantitatively correlated with the tumoricidal activity of BMM phi
      culture supernatants, whereas no such correlation was found with respect to the
      amount of secreted TNF-alpha or reactive nitrogen intermediates. These data
      demonstrate that activated murine BMM phi secrete a tumoricidal activity, which
      is not related to TNF-alpha, serine proteases, or reactive nitrogen
      intermediates, but is closely associated with a 170 kDa glycoprotein composed of
      two subunits with Mr's of 110 and 58 kDa.

PMID- 1622899
TI  - Binding of low concentration of peptide to H-2Kd produced in insect cells
      requires mouse beta 2-microglobulin co-expression.
AB  - A recombinant baculovirus expressing the murine class I MHC heavy chain H-2Kd
      cDNA under the transcriptional control of Autografa californica nuclear
      polyhedrosis virus (AcNPV) polyhedrin promoter has been isolated and used to
      infect Sf9 lepidopteran cells either alone or in association with a previously
      isolated virus expressing mouse beta 2-microglobulina (beta 2-ma). When infected
      with the heavy chain-encoding virus alone, H-2Kd was produced in a beta 2-m-free
      conformation detected on the surface of infected cells by conformation
      independent antibodies. When Sf9 cells were co-infected with both viruses,
      approximately 10% of the heavy chain pool was engaged in the formation of native
      heterodimeric MHC class I molecules, which were glycosylated and transported to
      the cell surface as demonstrated by radio-binding experiments and flow cytometry.
      The assembly of the recombinant class I molecule was dependent on peptide, since
      heterodimer formation was brought about by H-2Kd-specific peptide ligands both in
      vivo, upon incubation with dually infected cells, and in vitro, in cell-free
      detergent extracts. In addition, a change in heavy chain conformation was brought
      about upon incubation with high concentrations (100 microM) of an H-2Kd
      restricted octapeptide epitope from Plasmodium berghei. Furthermore, using low
      concentrations (3 nM) of a photoaffinity label derivative of this peptide, we
      show direct binding to cells co-expressing class I heavy chain and mouse beta 2-m
      but not to cells expressing free heavy chain only.

PMID- 1622900
TI  - Isolation of human minor histocompatibility peptides.
AB  - Incompatibility of human minor histocompatibility (hmH) antigens induces
      rejection of grafts in organ transplantation and graft versus host disease in
      bone marrow transplantation if donor and recipient are matched for human
      leukocyte antigen (HLA) genes. These antigens are recognized only by T cells. We
      describe here the isolation of hmH peptides recognized by a hmH antigen specific,
      HLA-B35 restricted CTL clone which was derived from a patient who rejected the
      kidneys from two HLA-identical sisters. Naturally occurring hmH peptides were
      isolated from a donor derived B cell line and an HLA-B35 transfected human B cell
      line by acid elution. Analysis of various HLA class I transfectant cells
      demonstrated that MHC class I molecules themselves determine the peptides which
      are naturally processed and presented to T cells.

PMID- 1622901
TI  - Eclampsia in the United Kingdom. The 'BEST' way forward.

PMID- 1622902
TI  - Terminology used in early pregnancy loss.

PMID- 1622903
TI  - Action in international medicine and maternal health care in developing
      countries.

PMID- 1622904
TI  - A randomized prospective study comparing delivery with metal and silicone rubber
      vacuum extractor cups.
AB  - OBJECTIVE: To determine the relative benefits and complications of assisted
      vaginal delivery with metal and silicone rubber vacuum extractor cups. DESIGN:
      Prospective randomized controlled study. SETTING: A busy referral maternity
      hospital in Kathmandu, Nepal. SUBJECTS: 101 women were assigned to delivery with
      the Silc-cup and 98 to delivery with the metal cup. MAIN OUTCOME MEASURES:
      Success rate at achieving delivery with the assigned instrument and incidence of
      neonatal trauma. Analysis was by 'intention to deliver' with women remaining in
      their original group regardless of the eventual mode of delivery. RESULTS:
      Randomization resulted in two groups of women similar in respect of age, parity,
      gestation and indication for delivery. The overall success rate was similar for
      the two instruments (Silc-cup 85% and metal cup 87%). The Silc-cup was more
      likely to fail if there was excessive caput (seven failures compared with one in
      the metal cup group). The frequency of clinically significant maternal trauma was
      low in both groups. There were fewer babies with clinically significant scalp
      trauma in the Silc-cup group (22%), compared with the metal cup group (37%).
      CONCLUSIONS: The data indicate a greater tendency for the Silc-cup to fail when
      excessive caput is present but that metal cups are associated with increased
      scalp injuries.

PMID- 1622905
TI  - Intra-operative blood loss during elective lower segment caesarean section.
AB  - OBJECTIVE: To measure intra-operative blood loss at elective lower segment
      caesarean section and to compare estimated with measured blood loss. DESIGN:
      Prospective observational study. Blood loss was measured in patients who
      underwent lower segment caesarean section in the course of routine hospital
      activity. SETTING: Tsan Yuk Hospital (Hong Kong), which is affiliated to the
      University of Hong Kong, 1990-1991. SUBJECTS: Forty women (mean age 29 years)
      with singleton pregnancies (mean gestation 38 weeks) delivered by elective lower
      segment caesarean section under general anaesthesia (mean birthweight 3177 g).
      MAIN OUTCOME MEASURE: Intra-operative blood loss measured by the alkaline
      haematin method (intra-assay co-efficient of variation 2.2%). RESULTS: The mean
      measured blood loss was 487 ml (SE 40, range 164-1438). The mean estimated blood
      loss was 425 ml (SE 31) range 100-1300; mode 400). Observer error in estimating
      blood loss was higher if measured blood loss greater than 600 ml. One patient
      received a blood transfusion and another had a post-operative haemoglobin level
      less than 10.0 g/dl. CONCLUSION: Blood loss at elective lower segment caesarean
      section was usually less than 500 ml and was estimated with reasonable accuracy.
      However, there was a tendency to under-estimate blood loss when the measured loss
      exceeded 600 ml.

PMID- 1622906
TI  - Thyroxine dosage during pregnancy in women with primary hypothyroidism.
AB  - OBJECTIVE: To assess whether pregnancy changes the thyroxine requirements of
      hypothyroid women. DESIGN: A retrospective, longitudinal study. SETTING: Queen
      Charlotte's and Chelsea Hospital for Women. SUBJECTS: 32 women referred for
      antenatal care during 35 pregnancies. MAIN OUTCOME MEASURES: Changes in thyroid
      stimulating hormone (TSH) and free thyroxine (fT4) levels as pregnancy
      progresses. RESULTS: In most of the pregnancies (80%), no change in thyroxine
      dose was required (mean dose 129 micrograms). The mean TSH levels in early (1.8
      mU/l) and in late pregnancy (1.5 mU/l) were unchanged (P greater than 0.5). In
      the remaining pregnancies, thyroxine dose was increased after the first antenatal
      clinic appointment, on the basis of thyroid function test results, from a mean of
      104 micrograms to a mean of 172 micrograms (P less than 0.01). These women had a
      mean early pregnancy TSH of 12.3 mU/l, which decreased by 95% to 1.3 mU/l (P less
      than 0.01). CONCLUSIONS: Most of the hypothyroid patients presenting to an
      antental booking clinic are well controlled in early pregnancy and will remain so
      throughout pregnancy. The dose of thyroxine does not need to be changed, and
      further assessments of thyroid function should not be necessary. It is unlikely
      that the patients were all 'overtreated' before conception, since they were
      referred to us by a large number of independent doctors. Women who are under
      treated before the pregnancy are likely to require both increased thyroxine dose
      and further thyroid function assays. They can generally be easily detected,
      biochemically, at the first hospital visit.

PMID- 1622907
TI  - A randomized placebo-controlled study of the effect of low dose aspirin on
      platelet reactivity and serum thromboxane B2 production in non-pregnant women, in
      normal pregnancy, and in gestational hypertension.
AB  - OBJECTIVE: To investigate the effect of 60 mg aspirin daily on platelet
      reactivity and prostaglandin production in various groups of patients. Similar
      regimens, which are thought to act through inhibition of platelet thromboxane
      production, are currently undergoing clinical assessment for the prevention of
      pre-eclampsia and intrauterine growth retardation. DESIGN: A prospective
      randomized placebo controlled study. SETTING: University Hospital, Nottingham.
      SUBJECTS: 12 non-pregnant female volunteers, 18 normal primigravidae before 16
      weeks gestation and 16 pregnant women admitted with gestational hypertension (GH)
      at a mean gestation of 38 weeks. INTERVENTIONS: In the non-pregnant women blood
      samples were taken before and after a 10-day course of 60 mg aspirin daily. The
      primigravidae had blood samples taken at 16 weeks and then they were randomized
      to receive either 60 mg aspirin daily or a matched placebo. Further blood samples
      were obtained at 28, 32 and 36 weeks. MAIN OUTCOME MEASURES: Changes in platelet
      reactivity and release reaction, and serum thromboxane production, were estimated
      in whole blood. RESULTS: 60 mg aspirin daily significantly inhibited cyclo
      oxygenase dependent platelet aggregation, release reaction and serum thromboxane
      production in non-pregnant and pregnant women, and in women with GH (P less than
      0.01). When adrenaline was used as the aggregating agent, the cyclo-oxygenase
      pathway was recruited in the increased reactivity seen in the third trimester of
      normal pregnancy, and was sensitive to inhibition by low dose aspirin.
      CONCLUSION: Low dose aspirin would appear to be an appropriate agent for the
      inhibition of platelet reactivity associated with hypertensive pregnancy.

PMID- 1622908
TI  - The characteristics of the second stage of labour in 25,069 singleton deliveries
      in the North West Thames Health Region, 1988.
AB  - OBJECTIVE: To define the contemporary characteristics of the second stage of
      labour in one Health Region. DESIGN: Retrospective analysis of a regional
      obstetric database. SETTING: Seventeen maternity units in the North West Thames
      Health Region. SUBJECTS: Selected from 36,727 consecutive singleton deliveries in
      1988. The analysis was confined to the 25,069 women delivered of an infant of at
      least 37 weeks gestation with a cephalic presentation following the spontaneous
      onset of labour. MAIN OUTCOME MEASURES: Second stage duration, obstetric
      intervention and maternal and fetal morbidity. RESULTS: The duration of the
      second stage and the use of operative intervention were strongly negatively
      associated with parity and positively associated with the use of epidural
      analgesia. Maternal age, fetal birthweight and maternal height were also
      independently associated with the duration of the second stage. There were small
      but significant differences in the characteristics of women using epidural
      analgesia and those using alternative methods of pain relief. Parous women using
      epidural analgesia behaved in a similar manner to nulliparae without epidurals.
      Despite the longer second stages observed in women using epidural analgesia there
      appeared to be no significant increase in fetal morbidity. Within the region the
      epidural rate in individual units positively correlated with the overall forceps
      rate, the rate of caesarean section in the second stage of labour and the
      duration of the second stage. CONCLUSIONS: In our study the duration of the
      second stage in women not using epidural analgesia was similar to previous
      findings, but in those using epidural analgesia, the duration of the second stage
      was longer than has been reported previously, possibly reflecting a more
      conservative approach to operative intervention. Survival analysis indicates that
      in multiparae not using epidural analgesia the likelihood of spontaneous vaginal
      delivery after 1 h in the second stage was low, but in those multiparae using
      epidural analgesia and in all nulliparae there was no clear cut-off point for
      expectation of spontaneous delivery in the near future; they continue to give
      birth at a steady rate over several hours. While maternal and fetal conditions
      are satisfactory, intervention should be based on the rate of progress rather
      than the elapsed time since full cervical dilatation.

PMID- 1622909
TI  - Neonatal and maternal morbidity in relation to the length of the second stage of
      labour.
AB  - OBJECTIVE: To investigate the relation between the duration of the second stage
      of labour and subsequent early neonatal and maternal morbidity. DESIGN:
      Retrospective analysis of a regional obstetric database. SETTING: 17 maternity
      units in the North West Thames Health Region. SUBJECTS: Selected from 36,727
      consecutive singleton deliveries in 1988. The analysis was confined to the 25,069
      women delivered of an infant of at least 37 weeks gestation with a cephalic
      presentation following the spontaneous onset of labour. MAIN OUTCOME MEASURES:
      The relative risk of early maternal morbidity, postpartum haemorrhage (PPH) and
      postpartum infection, and neonatal morbidity, as judged by low Apgar scores or
      admission to the special care baby unit (SCBU), in relation to anthropomorphic
      characteristics (parity and birthweight), interventions (epidural analgesia,
      episiotomy and operative delivery), signs of fetal compromise (meconium staining
      of the amniotic fluid or abnormal cardiotocography (CTG)), maternal morbidity in
      labour (pyrexia) and the duration of the second stage of labour. RESULTS: The
      duration of the second stage of labour had a significant independent association
      with the risk of both PPH and maternal infection after adjustment for other
      factors. However, there was a similar or greater risk of PPH in association with
      operative delivery or a birthweight greater than 4000 g. Both maternal pyrexia in
      labour and primiparity were associated with a greater risk of post partum
      maternal infection than was the duration of the second stage, although all these
      factors were statistically significant. In contrast, the duration of the second
      stage was not significantly associated with the risk of a low Apgar score or
      admission to SCBU after adjustment for other factors. CONCLUSIONS: The duration
      of the second stage of labour has a positive independent association with early
      maternal morbidity. We could show no such relation between time spent in the
      second stage of labour and the frequency of low Apgar scores or the rate of
      admission to SCBU. With current management approaches, in the absence of factors
      suggesting fetal compromise, second stage labours of up to 3 h duration do not
      seem to carry undue risk to the fetus.

PMID- 1622910
TI  - Falling incidence of hypoxic-ischaemic encephalopathy in term infants.
AB  - OBJECTIVE: To examine trends in the incidence of hypoxic-ischaemic encephalopathy
      over a 13-year period. DESIGN: A retrospective analysis of medical records of all
      infants admitted in the years 1976-1980 and 1984-1988. SETTING: A large non
      teaching district health authority in central England. SUBJECTS: Infants admitted
      to a district general hospital neonatal unit with clinical features of hypoxic
      ischaemic encephalopathy. MAIN OUTCOME MEASURES: Incidence of three grades of
      hypoxic-ischaemic encephalopathy, handicap and mortality. RESULTS: During the
      first 5-year period the overall incidence of hypoxic-ischaemic encephalopathy was
      7.7 per 1000 live births with 2.6 per 1000 live births being severely affected
      (grades II and III). In the second 5-year period the overall incidence was 4.6
      per 1000 live births with 1.8 per 1000 live births being severely affected. The
      difference in the overall rate is statistically significant. Of the infants with
      severe encephalopathy 61% had Apgar scores below 4 at 1 min and 60% were born by
      instrumental or operative delivery. CONCLUSIONS: The fall in incidence of hypoxic
      ischaemic encephalopathy has occurred during a period of falling perinatal
      mortality rate. It was instructive to find that infants born vaginally and
      without obstetric intervention formed a larger fraction of the severely affected
      infants in the later period.

PMID- 1622911
TI  - Abdominal irradiation in childhood; the potential for pregnancy.
AB  - OBJECTIVE: To investigate the impact of premature ovarian failure due to whole
      abdominal radiotherapy (DXT) in childhood on uterine physical characteristics and
      blood flow and measuring the uterine response to exogenous sex steroid
      replacement. DESIGN: A comparative observational study SUBJECTS: 10 women with
      premature ovarian failure due to treatment with whole abdominal irradiation in
      childhood. A comparison group of 22 women with premature ovarian failure who had
      not received whole abdominal DXT. MAIN OUTCOME MEASURES: Uterine length and
      uterine blood flow measurement plus serial assessment of endometrial thickness
      during a cycle of exogenous sex steroid replacement. RESULTS: Uterine length was
      significantly less (P less than 0.01) in women who had been exposed to whole
      abdominal DXT in childhood (mean 4.1 cm, 2SE 0.8) compared with a mean of 7.3 cm
      (2SE 0.6) in the comparison group. The three women in the DXT group who were
      studied serially had no increase in endometrial thickness in response to
      physiological sex steroid replacement therapy and most of the 10 irradiated women
      had no detectable uterine blood flow with Doppler ultrasound. CONCLUSIONS:
      Uterine musculature and blood flow are irreversibly affected by high dose
      irradiation in childhood. Non-invasive assessment of this nature may predict
      potential for pregnancy following ovum donation and embryo transfer.

PMID- 1622912
TI  - Epidermal growth factor receptor expression in normal endometrium and
      endometriosis: an immunohistochemical study.
AB  - OBJECTIVE: To study epidermal growth factor (EGF) receptor expression in
      endometrium throughout the menstrual cycle and to compare EGF-receptor expression
      in endometrium from patients with endometriosis with receptor expression in
      synchronously sampled endometriosis and in endometrium from healthy women.
      DESIGN: An immunohistochemical study of receptor expression using murine
      monoclonal antibodies and timed endometrial and endometriotic biopsies. SUBJECTS:
      25 healthy women and 27 patients with a diagnosis of endometriosis. RESULTS:
      Positive staining for EGF receptors was observed in 24 of 25 samples from normal
      women and in 26 of 27 endometrial samples from patients with endometriosis. In
      neither group was there any variation in the intensity of staining throughout the
      menstrual cycle and both glands and stroma were stained. EGF-receptor expression
      was observed in the glands of 15 out of 17 endometriotic lesions and in 12 of
      these biopsies positive staining was also present within endometriotic stroma.
      CONCLUSION: This study shows no difference in the intensity of staining of EGF
      receptors in endometrium throughout the menstrual cycle or between the glands of
      normal endometrium and those of endometriosis.

PMID- 1622913
TI  - The epidemiology of hysterectomy: findings in a large cohort study.
AB  - OBJECTIVE: To examine patterns of hysterectomy in the Oxford-Family Planning
      Association (Oxford-FPA) study in relation to age, parity, social class and
      calendar period (-1974, 1975-79. 1980-84, 1985-89). DESIGN: The Oxford-FPA study
      is a large scale prospective study of 17,032 women recruited from 1968-74 and
      still under observation. SETTING: Seventeen family planning centres throughout
      England and Scotland. SUBJECTS: At recruitment the 17,032 women were all white,
      British, married, aged 25-39 and willing to co-operate. In addition, they were
      using the pill or an intrauterine device or a diaphragm as their method of
      contraception. MAIN OUTCOME MEASURE: Hysterectomy rates per 1000 woman-years of
      observation in various subclasses of the data. RESULTS: Up to the end of 1989,
      1885 (11.1%) of the 17,032 women in the study were known to have undergone
      hysterectomy. Fibroids were the most common cause followed closely by menstrual
      disturbances in the absence of fibroids (hereafter referred to as 'menstrual
      disturbances'). Social class had a modest influence on hysterectomy rates.
      Hysterectomy for fibroids, prolapse, endometriosis and 'other reasons' showed
      little trend with calendar period while hysterectomy for menstrual disturbances
      and for cancer showed a sharp increase with calendar time especially at ages 30
      39. Hysterectomy generally tended to increase with age and showed a strong
      relation to parity; in particular, hysterectomy for fibroids fell with parity and
      hysterectomy for menstrual disturbances rose sharply with parity. Using lifetable
      methods, it was estimated that almost 20% of the women in the study would have
      had a hysterectomy by age 55. CONCLUSIONS: The results give insights into factors
      affecting hysterectomy rates. Of particular interest is the modest influence of
      social class, the strong influence of parity and the rise in rates with calendar
      time at ages 30-39 for those undergoing hysterectomy for menstrual disturbances
      or cancer, but since the cohort is not directly representative of the population,
      some caution is required in extrapolating these findings. The estimated
      hysterectomy rate of about 20% by age 55 is in line with other similar estimates
      for the United Kingdom.

PMID- 1622914
TI  - Study of the birthweight of parents experiencing unexplained recurrent
      miscarriages.
AB  - OBJECTIVE: To examine birthweight and preterm birth rates in couples with
      unexplained recurrent miscarriages. DESIGN: A case control study. Birth data of
      couples with recurrent miscarriages were obtained from midwife records. Time and
      sex-matched births from the same records served as controls. SETTING: A Regional
      Hospital in Denmark. SUBJECTS: 79 singleborn women with recurrent miscarriages
      and 60 of their male partners comprised the main study groups. Two control groups
      comprised 474 female and 360 male singleborn infants who survived day 7
      postpartum. MAIN OUTCOME MEASURES: Mean birthweight in the two main study groups
      and in subgroups with histories of 3, 4 and greater than or equal to 5
      miscarriages. RESULTS: The mean birthweight of the women with recurrent
      miscarriages was 3265 g (SE 70) and in female controls 3414 g (SE 23) (P less
      than 0.025). The 17 women with five or more miscarriages had a mean birthweight
      of 2991 g (SD 140) (P less than 0.001 compared with controls). Of the women in
      the study group 10.8% were born preterm compared with 2.9% of the controls (P =
      0.01). The mean birthweight of the male partners in the study group, 3470 g (SE
      68), did not differ significantly from that of 3504 g (SE 31) in the male
      controls (P less than 0.5). CONCLUSIONS: Women suffering unexplained recurrent
      miscarriages have on average had a significantly lower than normal birthweight
      themselves, whereas this was not observed in their male partners. This points
      towards the existence of a birthweight-reducing trait associated with recurrent
      miscarriages, the trait being manifest only in the woman.

PMID- 1622915
TI  - Calcium homeostasis in pregnancy during long-term heparin treatment.
AB  - OBJECTIVE: To investigate the effect of subcutaneous heparin treatment on calcium
      homeostasis in pregnancy. DESIGN: A longitudinal case-control observational
      study. SETTING: Department of Obstetrics and Gynaecology, Karolinska Hospital,
      Stockholm, Sweden. SUBJECTS: 36 pregnant women with previously verified
      thromboembolic complications and 23 healthy pregnant control women similar in
      age, parity, weight, and smoking habit. INTERVENTIONS: Thromboprophylaxis during
      pregnancy and 6 weeks post partum was given with subcutaneous heparin twice daily
      to the 36 women with a history of thromboembolic complications, 16 received an
      average dose of 24,500 IU/day and 20 a mean dose of 17,300 IU/day. Venous blood
      and urine samples were obtained every 4 weeks. MAIN OUTCOME MEASURES: Serum
      concentrations of total calcium, ionized calcium, calcitonin and urinary calcium.
      RESULTS: Women on high-dose heparin treatment showed significantly higher
      concentrations of total and ionized calcium and of calcitonin in serum and
      significantly lower concentrations of calcium in urine than did 23 normal
      pregnant controls. The differences were most pronounced in the third trimester.
      The results obtained in the low-dose heparin group were between those in the high
      dose and the control groups. At 8 weeks postpartum there were no significant
      differences between the heparin-treated women and the controls. No significant
      differences were found during pregnancy in haematocrit, liver or renal function,
      serum levels of albumin, phosphate, magnesium, alkaline phosphatase, parathyroid
      hormone or urinary cyclic AMP. CONCLUSIONS: Heparin treatment during pregnancy
      results in changes in calcium homeostasis and a dose-dependent response is
      suggested.

PMID- 1622916
TI  - Vaginosonographic velocimetry in uterine arteries before and after administration
      of beta-mimetics.
AB  - OBJECTIVE: To investigate the effect of surgical procedures at 15 weeks gestation
      (amniocentesis or cervical cerclage), with or without post-operative ritodrine
      prophylaxis, on uterine blood flow velocity waveforms and maternal heart rate.
      DESIGN: A quasi-randomized observational study. SETTING: University Department of
      Obstetrics and Gynaecology, Vienna. SUBJECTS: Sixty women having a genetic
      amniocentesis for advanced maternal age and 57 women having elective cervical
      cerclage for previous preterm labour or recurrent miscarriage. INTERVENTIONS: The
      women in each group were allocated either to receive prophylactic ritodrine
      postoperatively or to receive no ritodrine treatment. Allocation used the year of
      birth of the woman (odd years received ritodrine, even years received no
      treatment). All the women had vaginal ultrasound velocimetry studies in both
      mainstem uterine arteries through the parametrium before the surgical procedure
      and again after the procedure. The ritodrine-treated women in the cerclage group
      received intraveneous ritodrine hydrochloride (0.2 mg/min) and those in the
      amniocentesis group received 60 mg ritodrine/day orally. MAIN OUTCOME MEASURES:
      Uterine artery blood flow velocity waveform indices: A/B ratio and pulsatility
      index (PI) and maternal heart rate before and after the surgical procedure.
      RESULTS: The only statistically significant difference in haemodynamic values
      between those obtained before the procedure and those obtained after the
      procedure with or without prophylactic ritodrine was seen in the women who had
      cervical cerclage with postoperative intravenous ritodrine. The mean A/B ratio
      decreased from 2.69 (SD 1.17) to 2.11 (SD 0.44), and the mean PI from 1.62 (SD
      0.47) to 1.21 (SD 0.3) and the mean maternal heart rate increased from 82.6 (SD
      11.1) to 99.4 (SD 15.7). There were no other statistically significant
      differences between before and after haemodynamic values. CONCLUSIONS: There are
      no clinically relevant effects of amniocentesis and cervical cerclage on uterine
      blood flow velocity waveforms.

PMID- 1622917
TI  - Length and variation in the menstrual cycle--a cross-sectional study from a
      Danish county.
AB  - OBJECTIVE: To investigate the current epidemiology of menstrual patterns among
      women of fertile age. DESIGN: Cross-sectional postal questionnaire study.
      SETTING: County of Copenhagen, Denmark. SUBJECTS: 3743 women, aged 15-44,
      selected at random from a Danish county, who were asked to provide information on
      menstrual pattern during the preceding year, 1981. The response rate was 78%.
      Information from non-responders was obtained via telephone interviews. RESULTS:
      In women with regular menstrual cycles, the 5th-95th centile range of usual cycle
      length decreased from 23-35 days in the 15-19 years age group to 23-30 days in
      the 40-44 years age group. Only 0.5% of regular menstruating women had a usual
      cycle length of less than 21 days and 0.9% had a usual cycle length of greater
      than 35 days. At least one cycle length of less than 21 days was experienced by
      18.6%, whereas 29.5% had at least one cycle of greater than 35 days. Menstrual
      cycle variation of greater than 14 days was present in 29.3% of all women. Cycle
      length variation of greater than 14 days was 2.7 times more frequent in women
      from lower social groups (controlled by age). CONCLUSION: The study confirmed the
      normally used definitions of polymenorrhoea (cycle length less than 21 days) and
      oligomenorrhoea (cycle length between 36 and 90 days), as these very short or
      long menstrual cycle lengths were very seldom recorded for a longer period.
      However, the high frequency in a normal population of large menstrual cycle
      length variation challenges the view that an intra-individual variation of
      greater than 5 days should be regarded as a sign of disease in the woman.

PMID- 1622918
TI  - Secondary amenorrhoea: prevalence and medical contact--a cross-sectional study
      from a Danish county.
AB  - OBJECTIVE: To examine the prevalence of secondary amenorrhoea and the patterns of
      seeking medical advice for secondary amenorrhoea in an unselected population.
      DESIGN: Cross-sectional postal questionnaire study. SETTING: County of
      Copenhagen, Denmark. SUBJECTS: 3743 women, aged 15-44, selected at random from a
      Danish county who were asked to provide information on menstrual patterns for the
      preceding year, 1988. The response rate was 78%. Information from non-responders
      was obtained via telephone interviews. RESULTS: One-year period prevalence of
      secondary amenorrhoea of more than 3 months duration was 4.6% and was 7.6%, 3.0%,
      and 3.7% in women aged 15-24, 25-34, and 35-44 respectively. The duration of
      secondary amenorrhoea was 6 months or less in 75% aged 15-34 years, but longer
      than 6 months in 55% of those aged 35-44 years. A social gradient was found of
      the prevalence of secondary amenorrhoea (odds ratio 3.3, 95% CI 1.5-8.3) in the
      lowest social group compared with the highest social group; controlled by age.
      Only 39% of women with secondary amenorrhoea had contacted a doctor. Educational
      level or social status did not seem to influence the frequency of medical contact
      in women with amenorrhoea. CONCLUSION: Spontaneous return of the menstrual cycle
      occurs within 6 months in many amenorrheic women below the age of 35. The
      detailed investigation of secondary amenorrhoea in this age group can be
      postponed until it is of 6 months duration, unless there is clinical suspicion of
      disease. The relative infrequency with which women with secondary amenorrhoea
      seek medical advice constitutes an important source of selection bias in hospital
      based clinical research on this topic.

PMID- 1622919
TI  - A double-blind randomized study of the effect of erythromycin in preventing
      pelvic inflammatory disease after first trimester abortion.
AB  - OBJECTIVE: To assess the prophylactic use of erythromycin in prevention of post
      abortal pelvic inflammation disease (PID) in first trimester abortion. DESIGN:
      Double-blind, randomized controlled trial. SETTING: Department of Surgery, County
      Hospital, Denmark. SUBJECTS: Four hundred and thirty two women who were to
      undergo induced abortion before 12 weeks gestation were randomized to be treated
      either with prophylactic erythromycin or a placebo. INTERVENTION: The women were
      randomized to receive a placebo or erythromycin, 500 mg twice a day for 7 1/2
      days starting the evening before the abortion. All the women were investigated
      for Chlamydia trachomatis and Neisseria gonorrhoea before the abortion. MAIN
      OUTCOME MEASURES: Frequency of cervical C. trachomatis and N. gonorrhoea and
      frequency of PID after abortion. RESULTS: Fifty four women were excluded after
      randomization. The frequency of PID was 11% (20/189) in the erythromycin group
      and 16% (30/189) in the placebo group (P = 0.13, chi 2-test). The prevalence of
      C. trachomatis was 19% (15/78) in women less than or equal to 20 years of age,
      13% (14/109) in women between 21 and 25 years and 2% (5/241) in women greater
      than or equal to 26 years of age. In women positive for C. trachomatis
      erythromycin prophylaxis significantly reduced the frequency of PID to 8% (1/13)
      compared with 43% (6/14) in the placebo group (P = 0.051, logistic regression
      analysis). Erythromycin had no effect on other potential high risk groups (first
      pregnancy, nulliparous, less than 20 years of age, and women with previous PID).
      CONCLUSION: Prophylactic erythromycin is not warranted for all women having an
      abortion. Cervical C. trachomatis is a risk factor for postabortal PID, and
      prophylaxis with erythromycin significantly reduces the frequency of PID.
      However, only a few women with PID had cervical C. trachomatis, and the
      prevention of post-abortal PID remains a major challenge requiring further
      studies.

PMID- 1622920
TI  - Ovarian hyperstimulation syndrome and deep cerebral venous thrombosis.

PMID- 1622921
TI  - The flying squad--an expensive and potentially dangerous practice in modern
      obstetrics.

PMID- 1622922
TI  - The flying squad. Commentary.

PMID- 1622923
TI  - The flying squad. Commentary.

PMID- 1622924
TI  - The Stamey endoscopic bladder neck suspension: a clinical and urodynamic
      investigation, including actuarial follow-up over four years.

PMID- 1622925
TI  - Colposcopically directed punch biopsy: a potentially misleading investigation.

PMID- 1622926
TI  - Vaccine development: necessity as the mother of invention.

PMID- 1622927
TI  - The Y-box factors: a family of nucleic acid binding proteins conserved from
      Escherichia coli to man.
AB  - The Y-box factors interact specifically with both DNA and RNA. Biologically they
      have roles in both transcriptional and translational regulation. Conserved
      through evolution from prokaryotic to eukaryotic organisms they represent a new
      family of nucleic acid binding proteins.

PMID- 1622928
TI  - DNA damage, mutations, cancer, and aging. American Association for Cancer
      Research Special Conference: Cellular Responses to Environmental DNA Damage,
      Banff, AB, Canada, December 1-6, 1991.

PMID- 1622929
TI  - Cell cycle regulation of vertebrate p34cdc2 activity: identification of Thr161 as
      an essential in vivo phosphorylation site.
AB  - The protein kinase p34cdc2 is a key regulator of the cell cycle in all
      eukaryotes. Its activity is controlled by cell cycle-dependent interactions with
      other proteins, notably cyclins, and by changes in its phosphorylation state. Two
      inhibitory phosphorylation sites in chicken p34cdc2 have previously been mapped
      to threonine 14 and tyrosine 15. Here we describe the identification of threonine
      161 as an additional in vivo phosphorylation site in vertebrate p34cdc2.
      Phosphorylation of this site is cell cycle dependent and likely to be required
      for p34cdc2 activity.

PMID- 1622930
TI  - DNA binding, multimerization, and transcription stimulation by the Xenopus Y box
      proteins in vitro.
AB  - The Y box factors bind to a specific DNA sequence (the Y box, containing a
      reverse CCAAT element) and have been implicated in the regulation of
      transcription. We have used deletion mutagenesis to define the protein domains of
      two Xenopus Y box factors, FRG Y1 and FRG Y2, that are essential for DNA binding,
      multimerization, and transcription. A domain of the Y box factors homologous to
      an Escherichia coli cold shock protein is required for DNA binding. Both the E.
      coli protein and the Y box factors recognize DNA sequences with similar
      selectivity. The conserved region between these proteins does not contain any
      previously defined DNA-binding motifs. The hydrophilic C-terminal tail of the
      proteins contributes to the assembly of nucleoprotein complexes. This region
      contains an unusual pattern of basic and acidic amino acids and represents a new
      type of domain mediating protein-protein interactions in transcription factors.
      Both the DNA-binding and the multimerization domains are important for
      stimulating transcription from the Xenopus hsp70 promoter in vitro.

PMID- 1622931
TI  - Dominant negative mutants of transcription factor mXBP (CRE-BP1, ATF-2).
AB  - Transcription factors of the CREB/ATF family bind to a consensus DNA sequence
      TGACGTCA (cyclic AMP response element) found in the promoters of numerous genes.
      Transcriptional activation by one of these proteins, CREB, has been extensively
      analyzed, but the function of the other family members is not well understood. We
      have analyzed the function of mXBP (CRE-BP1, ATF-2), one member of the CREB/ATF
      family of transcription factors. Overexpression of mXBP resulted in the
      transcriptional activation of a promoter containing cAMP response elements which
      bind mXBP. Mutagenesis of the mXBP DNA-binding domain identified residues
      important for binding to the cyclic AMP response element. Mutants that did not
      bind specifically to DNA were not able to activate transcription. Several of
      these mutants suppressed both DNA binding and transcriptional activation by wild
      type mXBP. These dominant negative mutants will be useful in further analysis of
      mXBP function.

PMID- 1622932
TI  - Multiple SP1 binding sites confer enhancer-independent, replication-activated
      transcription of HIV-1 and globin gene promoters.
AB  - We demonstrate that multiple SP1 protein:DNA binding sites confer enhancer
      independent activation on the HIV-1 and globin gene promoters. This activation
      process can be achieved either by DNA replication of the promoter-containing
      plasmid or by high concentrations of input plasmid DNA used in the transfections.
      In the case of HIV-1, the three SP1 sites adjacent to the promoters TATA box are
      essential for this activation process. Furthermore, the human beta globin gene,
      which is normally dependent on a linked enhancer for transcriptional activity,
      can be made enhancer independent by insertion of SP1 binding sites adjacent to
      its TATA box. We speculate that (SP1)n-TATA type RNA polymerase II promoters may
      be generally permissive when present on actively replicating DNA templates and
      that this property of the HIV-1 promoter may be of importance to the activation
      of the DNA provirus in latently infected T cells.

PMID- 1622933
TI  - The product of unr, the highly conserved gene upstream of N-ras, contains
      multiple repeats similar to the cold-shock domain (CSD), a putative DNA-binding
      motif.
AB  - We show that the open reading frame transcribed from the unr gene (immediately
      upstream of N-ras) in mammals consists of multiple repeats similar to the cold
      shock domain (CSD), a putative DNA-binding motif found in prokaryotic cold-shock
      proteins, and eukaryotic DNA-binding proteins. Alignment of the CSD sequences of
      unr with those from other proteins reveals a core of similarity for which a
      consistent secondary structure prediction can be derived. This prediction
      suggests that the CSD consists primarily of beta-sheet, in contrast to most known
      eukaryotic DNA-binding proteins. Sequence analysis of the 3' end of the guinea
      pig unr gene shows that the core of one CSD repeat is encoded in a single exon,
      consistent with the modular assembly of the gene from ancestral CSD-coding units.

PMID- 1622934
TI  - Molecular model for DNA recognition by the family of basic-helix-loop-helix
      zipper proteins.
AB  - The basic-helix-loop-helix-zipper (bHLH-Zip) motif is a conserved region of
      approximately 70 amino acids that mediates both sequence-specific DNA binding and
      protein dimerization. This motif is found in protein sequences from many
      eukaryotic organisms and is contained in the protein sequence of the oncogene myc
      and its partner max, and a shortened version of the motif (bHLH) is found in the
      muscle determination factor myoD and its partner E12. An evaluation of the
      conserved amino acids that define the motif coupled with the published mutagenic
      studies of this region has led to our formulation of a molecular model for the
      binding of this motif as a dimer to specific sequences of DNA. This model has the
      dimeric protein interacting with an abutted, dyad-symmetric DNA sequence. Helix 2
      of each monomer is modeled as a coiled-coil extension of the C-terminal "leucine
      zipper." Helix 1 does not interact with helix 1 from its partner in the dimer but
      with the hydrophobic surface created when the helix 2 regions of the dimer
      interact with each other as a coiled-coil. Sequence-specific interactions are
      proposed between the basic region and the invariant cis elements that all bHLH
      Zip proteins bind.

PMID- 1622935
TI  - Hypothesis: is eukaryotic initiation factor 2 the scanning factor?

PMID- 1622936
TI  - Novel repetitive sequence motifs in the alpha and beta subunits of prenyl-protein
      transferases and homology of the alpha subunit to the MAD2 gene product of yeast.

PMID- 1622937
TI  - Cataract management.

PMID- 1622938
TI  - The sensitive period in infancy.

PMID- 1622939
TI  - Current practice of cataract extraction and anaesthesia.
AB  - A questionnaire regarding preferred methods of cataract extraction and
      anaesthesia was sent to 456 consultant ophthalmologists in England and Wales.
      Replies were received from 86% (n = 392), 83% (n = 380) having completed the
      questionnaire in full. The most frequently employed surgical approach was non
      automated extracapsular cataract extraction. Only 2% of surgeons (n = 8) used
      phacoemulsification routinely and 2% (n = 7) used intracapsular extraction.
      Intraocular lens implantation was the standard practice of 99% of surgeons (n =
      376). There has been a dramatic increase in the popularity of local anaesthesia,
      which was employed routinely (in more than three-quarters of their cases) by 20%
      of surgeons (n = 76). Retrobulbar infiltration remains the most common method of
      administration. Sedation was given routinely by 45% of surgeons (n = 171) when
      using local anaesthesia. Medical contraindications and patient preference were
      considered the most important reasons for selecting local anaesthesia rather than
      general. The exclusive use of general anaesthesia in cataract surgery appears to
      be diminishing.

PMID- 1622940
TI  - Clinical evidence for the onset of the sensitive period in infancy.
AB  - Seven neonates had a IIIrd or VIth nerve palsy or afferent visual pathway
      pathology at birth. These abnormalities resolved within 6 weeks and the children
      have developed normal visual acuity, motor fusion, and stereopsis. We conclude
      that there is a latent period of 6 weeks before the onset of the sensitive
      period.

PMID- 1622941
TI  - Sequential argon-YAG laser iridotomies in dark irides.
AB  - Laser iridotomies in dark coloured irides are associated with higher complication
      and failure rates. A prospective clinical study to evaluate the use of the argon
      and Nd:YAG laser in sequential combination for iridotomy was carried out on 20
      eyes of 13 patients with dark irides. Patent iridotomies were achieved in single
      treatment sessions for all the eyes. Iridotomy closure was observed in one eye
      during a mean follow-up period of 14 months (range 6-20 months). Complications
      from the treatment occurred in five eyes and were minor. Total mean energy used
      for the argon and Nd:YAG stages respectively were a third of most studies on pure
      argon and Nd:YAG iridotomies. Sequential argon-YAG laser iridotomy combines most
      of the advantages of both laser types while avoiding some of their disadvantages.
      We find it a safe and effective tool for iridotomy in otherwise difficult dark
      irides.

PMID- 1622942
TI  - Dapsone therapy for the acute inflammatory phase of ocular pemphigoid.
AB  - Oral dapsone was used to treat five patients who presented in the acute
      inflammatory phase of ocular pemphigoid. The diagnosis was made clinically by
      identifying cicatricial changes which were in some cases difficult to find. In
      all cases it was the inflammatory rather than the cicatricial features which
      responded to treatment. An initial dose of 100 mg/day was effective without
      toxicity. When 150 mg/day was used patients experienced side effects. A clinical
      response was obtained after 1-4 weeks and could be maintained on a dose of
      between 50 mg on alternate days and 100 mg/day. Therapy was withdrawn during
      remissions which lasted up to 32 weeks but all cases required continuing therapy
      which has remained effective. Immunopathological examination was carried out on
      two occasions in all cases and although positive on at least one occasion the
      results did not correlate with disease activity or treatment. The inflammatory
      phase of ocular pemphigoid should be added to the list of diseases responsive to
      dapsone.

PMID- 1622943
TI  - Diffractive multifocal intraocular lens implants for unilateral cataracts in
      prepresbyopic patients.
AB  - Multifocal intraocular lenses allow pseudophakic patients to obtain good near and
      distance visual acuities without an additional near correction. We report our
      experiences in implanting diffractive multifocal intraocular lenses in
      prepresbyopic patients with acquired unilateral cataracts and assess their
      postoperative visual acuities and stereoscopic vision. Accommodative function in
      patients following cataract surgery is discussed.

PMID- 1622944
TI  - Synthesis of interleukin-1 and prostaglandin E2 by lens epithelial cells of human
      cataracts.
AB  - To test our hypothesis that pseudophakic inflammation, including the fibrin
      reaction, may be caused by cytokines, prostaglandins (PG), or both, synthesised
      by residual lens epithelial cells (LECs), we measured interleukin-1 alpha (IL-1
      alpha) and PGE2 in the incubation medium of cultures of human LECs obtained by
      capsulotomy during cataract surgery. After 1 week radioimmunoassay showed that
      there were 1.46 (0.62) ng of PGE2/10(6) cells (mean (SD) six cultures), and after
      4 weeks, there were 5.50 (2.20) ng of PGE2/10(6) cells (seven cultures). During
      culture the cells proliferated and underwent fibroblast-like cell changes on
      exposure to the plastic of the wells. In the medium of control plates to which
      sodium diclofenac had been added PGE2 was not detected. Some IL-1 alpha was found
      in four of 10 samples, each of which contained media from 12 cultures; 207
      pg/10(6) cells in one of the two pools of 2-week cultures, 120 pg/10(6) cells in
      one pool and 139 pg/10(6) cells in another of the three pools of 3-week cultures,
      and 111 pg/10(6) cells in the one pool of 4-week cultures. PGE2 and IL-1 alpha
      may therefore be produced in vivo by residual LECs after cataract surgery, and
      may be involved in postoperative inflammation, including the fibrin reaction.

PMID- 1622945
TI  - Outcome of strabismus surgery in congenital esotropia.
AB  - The results of squint surgery in 40 children with congenital esotropia are
      analysed. A 'favourable outcome' was achieved in 23 (57.5%) children. The factors
      affecting the final outcome including ocular alignment in the immediate
      postoperative period, age at the time of surgery, amblyopia, associated inferior
      oblique overaction, dissociated vertical deviation, latent or manifest latent
      nystagmus, and the surgical procedures used are discussed.

PMID- 1622946
TI  - Full thickness macular breaks in rhegmatogenous retinal detachment with
      peripheral retinal breaks.
AB  - Between 1975 and 1989, 11 eyes were treated for retinal detachments with both
      peripheral and full thickness macular breaks. Long term retinal reattachment was
      dependent on successful closure of peripheral retinal breaks. Direct treatment of
      the macular break was necessary in only one case, which redetached 3 months after
      vitrectomy. Vitrectomy is not the initial treatment of choice for uncomplicated
      retinal detachments with both peripheral and full thickness macular breaks,
      unless required for the closure of the peripheral retinal breaks.

PMID- 1622947
TI  - Management of traumatic optic neuropathy--a study of 23 patients.
AB  - Twenty three patients with traumatic optic neuropathy were managed by medical and
      surgical treatment as follows. High dose intravenous steroids were initiated in
      all patients. If visions did not improve significantly after 24 to 48 hours
      decompression of an optic nerve sheath haematoma by medial orbitotomy and
      neurosurgical decompression of the optic canal were considered based on computed
      tomographic scan findings. Nine of 16 patients who received steroids only showed
      significant improvement. One of three showed improvement on optic nerve
      decompression after steroid failure; three or four showed improvement on optic
      nerve decompression after steroid failure; three or four showed improvement with
      combined optic nerve sheath decompression by the medial orbitotomy and
      decompression of the optic canal by frontal craniotomy. A lucid interval of
      vision after injury and an enlarged optic nerve sheath were associated with an
      improved prognosis. Five of the 23 patients had a lucid interval and all five had
      a final improved vision, while only five of 18 patients without a lucid interval
      improved. Similarly seven of the nine with an enlarged optic nerve sheath showed
      improvement while only three of 10 patients (three bilateral cases) who presented
      with no light perception improved with medical and surgical treatment. While a
      prospective controlled study of the management of traumatic optic neuropathy is
      necessary this preliminary study suggests that treatment of traumatic optic nerve
      sheath haematoma by optic nerve sheath decompression should be considered in
      selected patients.

PMID- 1622948
TI  - Modification of trabeculectomy to avoid postoperative hyphaema. The 'guarded
      anterior fistula' operation.
AB  - The effect of varying the position of a trabeculectomy fistula on the rate of
      postoperative hyphaema was studied in a prospective randomised trial. One eye of
      each of 78 consecutive patients with primary open angle glaucoma and exfoliation
      glaucoma was allocated to one of two groups. In group A the fistula was fashioned
      anterior to the scleral spur, entirely in corneal tissue. In group B the fistula
      included cornea and sclera with trabecular meshwork and scleral spur. Seven out
      of 39 eyes (18%) in group A developed a postoperative hyphaema with detectable
      blood level, compared with 22 out of 39 eyes (56%) for group B (p less than
      0.001). In addition, the severity of the bleeding was greater in group B, and the
      three cases of recurrent bleeding were all in this group. Group B patients
      remained in hospital for an average of 3.9 days, which was significantly longer
      (p = 0.004) than the average of 2.9 days for group A. This difference was related
      to the frequency and severity of the hyphaema. The type of dissection or the
      occurrence of hyphaema did not influence the intraocular pressure at 4 months
      after surgery.

PMID- 1622950
TI  - Nasal and orbital recurrence of conjunctival melanoma 21 years after
      exenteration.
AB  - In our experience 5% of invasive malignant melanomas of the conjunctiva arising
      from areas of primary acquired melanosis with atypia spread to the ipsilateral
      nasal cavity and paranasal sinuses. Twenty one years after orbital exenteration
      for multicentric conjunctival melanoma an 82-year-old man was seen with an
      orbital recurrence, which had extended to the nasal cavity and paranasal sinuses
      through the nasolacrimal duct without invading the mucosa. This previously
      undescribed way of spread after the longest symptom-free interval following
      exenteration ever reported is illustrated.

PMID- 1622949
TI  - Microwave plaque thermoradiotherapy for choroidal melanoma.
AB  - Microwave thermoradiotherapy was used as a primary treatment for 44 patients with
      choroidal melanoma. An episcleral dish-shaped microwave antenna was placed
      beneath the tumour at the time of plaque brachytherapy. While temperatures were
      measured at the sclera, the tumour's apex was targeted to receive a minimum of 42
      degrees C for 45 minutes. In addition, the patients received full or reduced
      doses of plaque radiotherapy. No patients have been lost to follow-up. Two eyes
      have been enucleated: one for rubeotic glaucoma, and one for uveitic glaucoma.
      Though six patients have died, only one death was due to metastatic choroidal
      melanoma (39 months after treatment). Clinical observations suggest that the
      addition of microwave heating to plaque radiation therapy of choroidal melanoma
      has been well tolerated. There has been a 97.7% local control rate (with a mean
      follow-up of 22.2 months). We have reduced the minimum tumour radiation dose
      (apex dose) to levels used for thermoradiotherapy of cutaneous melanomas (50
      Gy/5000 rad). Within the range of this follow-up period no adverse effects which
      might preclude the use of this microwave heat delivery system for treatment of
      choroidal melanoma have been noted.

PMID- 1622951
TI  - Pseudopapilloedema in the linear naevus syndrome.
AB  - This case report describes the ophthalmic findings in a child with the linear
      naevus syndrome. The patient was referred by the Department of Paediatric
      Neurology with 'unilateral papilloedema'. This was thought to be a form of
      pseudopapilloedema, a finding that has not been previously described in this
      syndrome.

PMID- 1622952
TI  - Fundus albipunctatus associated with cone dystrophy.
AB  - We describe five unrelated patients in whom the typical signs of fundus
      albipunctatus were accompanied by colour vision defects, bull's eye or similar
      macular lesions, and severely diminished full-field cone electroretinograms
      indicating widespread damage to cones outside the macula. All patients had
      noticed night blindness from childhood. Signs of retinitis punctata albescens, a
      disease of similar appearance but with characteristics resembling retinitis
      pigmentosa, were absent. We cannot be sure whether these patients represent a
      process of fundus albipunctatus or a distinct disease entity or a casual
      combination of fundus albipunctatus and cone dystrophy.

PMID- 1622954
TI  - Alternative method for laser treatment of superior retinal tears in eyes with gas
      tamponade.

PMID- 1622953
TI  - Titanium tetrachloride burns to the eye.
AB  - We present eight cases of chemical burns of the eyes from titanium tetrachloride,
      an acidic corrosive liquid. However it causes severe chemical burns which have a
      protracted course and features more akin to severe alkali burns. Injuries related
      to titanium tetrachloride should be treated seriously and accordingly appropriate
      management is suggested.

PMID- 1622955
TI  - Workload in oral and maxillofacial surgery: analysis of time trends from linked
      statistics in a defined population.
AB  - Data from the Oxford Region were used to study trends in hospital admission rates
      and demographic profiles of hospital care in the National Health Service in oral
      and maxillofacial surgery. In a defined population of 1.9 million people,
      admission rates for inpatient care, day case care, and outpatient attendance
      rates all almost doubled between 1975-1985. Population-based age-specific
      admission rates were much higher in teenagers and young adults than in other age
      groups. In these age-groups admission rates for females were about double those
      for males. Whilst perhaps not surprising to the oral and maxillofacial surgeon,
      these demographic profiles of workload are strikingly different from those found
      in most other hospital specialties.

PMID- 1622956
TI  - The use of mandibular symphyseal bone in maxillofacial surgery.
AB  - Mandibular symphyseal bone (MSB) is useful in alveolar cleft grafting and
      orthognathic surgery. This paper reports on the application and techniques using
      MSB.

PMID- 1622957
TI  - Topical application of 5% eutectic mixture of lignocaine and prilocaine (EMLA)
      before removal of arch bars.
AB  - The analgesic effect of topical application of a 5% eutectic mixture of
      lignocaine and prilocaine (EMLA) was studied in 45 patients undergoing removal of
      oral arch bars used for the treatment of mandibular fractures. Employing a double
      blind technique, either 4 g of the eutectic mixture (EMLA group, n = 15) or 4 g
      of a similar emulsion containing no local anaesthetic (placebo group, n = 15) was
      applied to the gingivae using a toothbrush and a standardised technique. In the
      control group (n = 15), infiltration anaesthesia with lignocaine was used only if
      requested by the patient during the removal of the arch bars. The patients in the
      EMLA group had significantly better analgesia (P less than 0.005) of the gingivae
      just before removal of the arch bars than patients in the placebo group, but by
      the end of the procedure the difference in analgesia was not significant. The
      number of patients who found the procedure pain-free was significantly higher in
      the EMLA group (7/14) than in the placebo group (2/15) (P less than 0.005). The
      plasma concentrations of both lignocaine and prilocaine were well below the toxic
      levels. Topical application of EMLA can be recommended for short procedures as an
      alternative to infiltration.

PMID- 1622958
TI  - A prospective study of 134 consecutive patients requiring diagnosis, excision and
      repair of a facial cutaneous lesion.
AB  - A prospective study of 134 patients undergoing excision of a facial lesion was
      undertaken. Considerable clinical diagnostic difficulty was experienced, with 21%
      of clinical diagnoses being incorrect. A tendency towards a clinical over
      diagnosis of basal cell carcinoma was noted and whilst this is not unreasonable,
      a number of benign lesions inevitably were diagnosed as malignant with
      unnecessary sacrifice of tissue. Incisional biopsy of lesions should be
      considered when sited close to important anatomical structures to enable accurate
      diagnosis prior to definitive surgery. Although a few definite indications for a
      particular reconstructive technique exist (Table 1), a choice is more often
      available. Repair of the excisional defect with a local flap as opposed to a skin
      graft resulted in a reduced length of hospital admission with fewer postoperative
      complications and better final cosmesis. As a consequence, a local flap is
      recommended as the method of repair where direct closure is not feasible.

PMID- 1622959
TI  - Oral carcinoma in pregnancy.
AB  - Oral cancer presenting in pregnancy is a rare combination which, because of
      current epidemiological changes in the disease, may present more often in the
      future. Treatment of the condition can be very difficult. Decisions have to be
      made about terminating the pregnancy or finding a balance between the treatment
      of the mother and protecting the foetus from the effects of various treatment
      modalities. This may result in a compromise treatment of the disease. To
      illustrate the problems, we discuss a case of carcinoma of the tongue presenting
      in a 23-week pregnant Gravida 1 Para 0 lady, and review the literature.

PMID- 1622960
TI  - Gram negative aerobic bacillus pneumonia in oral and maxillofacial surgery--a
      case for comment.
AB  - A case illustrating the potentially fatal complication of endogenous Gram
      Negative Aerobic Bacillus (GNAB) septicaemia secondary to nosocomial pneumonia is
      presented along with current theories as to its aetiology. The technique of
      selective decontamination of the digestive tract is designed and advocated to
      prevent such occurrences; oral and maxillofacial surgeons should be aware of this
      approach. It may be, however, that by using much simpler manoeuvres such as
      changes in policy regarding gastric stress ulcer prophylaxis, the already small
      risk of such an occurrence will be further reduced. Awareness of this condition
      will allow a higher index of suspicion when presented with catastrophic septic
      complications on the ITU and aid in more rational planning of antimicrobial
      therapy.

PMID- 1622961
TI  - Orbital lymphoma: blindness as a presenting symptom.
AB  - A case of isolated orbital lymphoma presenting as blindness is reported. An
      unusual feature of bone erosion is highlighted and the difficulty in the
      histological interpretation is discussed.

PMID- 1622962
TI  - Effects of bilateral jugular vein ligation on intracranial pressure and
      cerebrospinal fluid outflow resistance in cats.
AB  - In order to study the effect of jugular venous outflow obstruction on
      intracranial pressure and cerebrospinal fluid (CSF) reabsorption capability,
      changes in epidural pressure (EDP) and CSF outflow resistance (Ro) were examined
      following bilateral jugular vein ligation in cats. EDP increased significantly (P
      less than 0.01) immediately after ligation from the control value of 4.9 +/- 0.5
      mmHg (mean +/- SEM) to 15.9 +/- 0.9 mmHg. Thereafter, EDP gradually decreased
      back toward the control value. The pressure level had decreased to 6.7 +/- 0.5
      mmHg by 20 minutes after ligation. The mean Ro was significantly (P less than
      0.01) higher in the ligation group (200.4 +/- 9.7 mmHg/ml/min) that in the non
      ligation group (120.0 +/- 9.9 mmHg/ml/min). These results suggest that bilateral
      jugular vein ligation impairs CSF reabsorption.

PMID- 1622963
TI  - The caudal mandibular reconstruction plate: a radiographic and histologic study
      of an autopsy specimen.
AB  - During autopsy, a reconstructed partial mandibular resection was recovered and
      subjected to histological examination. The mandible had been reconstructed 12
      weeks earlier with a caudal plate and autologous cancellous bone from the iliac
      crest. Undecalcified microsections showed that the plate was firmly anchored by
      screws on both sides and on one side there was bony union. However, most of the
      free transplant bone had undergone 'unreplaced resorption.' Nevertheless, this
      method offers advantages over the conventional method of seating the plate on the
      buccal aspect and has interesting potential for further development.

PMID- 1622964
TI  - An evaluation of bone healing in cavities in the jaws implanted with a collagen
      matrix.
AB  - Bony defects in the jaws after surgery may show poor healing especially in the
      maxilla and the area may never completely be replaced by bone. 50 patients with
      pathological bony cavities in the jaws were used to assess the efficacy of a
      collagen matrix implanted into the treated bony defect and 50 patients in whom no
      material was implanted were used as controls. The results were assessed
      radiographically at 3, 6 and 12 months. At 3 months, bone deposition in the
      control group was in advance of the implanted group, but after 6 and 12 months
      healing appeared to be similar in both groups. No adverse effects were found due
      to the presence of the collagen implant. Collagen delayed the early osteogenic
      healing period, indicating that only when it has been resorbed can the area heal
      with osteogenic granulation tissue. As some radiolucent areas still remained in
      the healed implant group after 12 months it must be assumed that the collagen
      implant has only been replaced by host fibrous tissue and therefore does not
      possess osteoinductive properties.

PMID- 1622965
TI  - Report of an audit into third molar exodontia.
AB  - A postal audit of the main surgical variables in third molar exodontia under
      general anaesthesia was undertaken on consultants holding a National Health
      contract within the British Isles. This first paper presents the results. A
      response rate of 175 returned questionnaires from the 247 consultants was
      obtained (70.9%). Analysis revealed that the majority of consultants use
      antibiotics, mouthwashes, sutures, analgesics and postoperative review and the
      minority steroids and peroperative local anaesthetic, routinely in the majority
      of cases. Approximately half routinely use a chisel as opposed to a bur for bone
      removal. The consultants who gave all their patients steroids were significantly
      (p less than 0.01) more likely to possess a medical qualification than the
      consultants who did not.

PMID- 1622966
TI  - Complications of use of carbon fibre in the temporomandibular joint: a case
      report.
AB  - The aetiology of recurrent temporomandibular joint dislocation is numerous. A
      case is described of frequent dislocation which was finally treated using a
      carbon fibre sling. However this was removed 3 years later due to the presence of
      a radiolucency in the head of the condyle. Radiographic and photographic
      appearances of this carbon fibre induced radiolucency are shown.

PMID- 1622967
TI  - Intra-masseteric actinomycosis: report of a case.
AB  - A case of actinomycosis arising within the masseter following extraction of a
      lower second molar is reported. The most likely cause was a needle tract
      infection from the planned administration of the local anaesthetic.

PMID- 1622968
TI  - Intramuscular haemangioma of the orbicularis oris muscle.
AB  - The intramuscular haemangioma is a relatively uncommon benign vascular tumour
      which accounts for less than 1% of all haemangiomas. It is a rare lesion in the
      orofacial muscles. A case is reported arising in the orbicularis oris muscle
      presenting in a 9-month-old child.

PMID- 1622969
TI  - A modified arch bar for use in patients with anterior crowns or bridgework.

PMID- 1622970
TI  - Our experiences with monocortical wire osteosynthesis in the treatment of
      mandibular angle fractures.

PMID- 1622971
TI  - A central venous catheter complicating head and neck surgery.

PMID- 1622973
TI  - The ethics of peer review.

PMID- 1622972
TI  - Cancrum oris-like lesions.

PMID- 1622974
TI  - Studies of method of conserving grass herbage and frequency of feeding in cattle.
      1. Voluntary feed intake, digestion and rate of passage.
AB  - The effect of method of conserving grass herbage and the frequency of feeding on
      digestion in and passage from the rumen was studied in growing cattle. A single
      sward of perennial ryegrass (Lolium perenne cv. Endura) was cut on 1 d and
      conserved as silage or hay. These forages were offered as the only feed to twelve
      rumen-cannulated Friesian steers (average initial live weight (LW) 128 kg) either
      at a restricted level of intake (20 g dry matter (DM)/kg LW; Expt 1) or ad lib.
      (Expt 2). In Expt 1 the forages were offered either once or eight times daily.
      When fed once or eight times daily, in vivo digestibility of DM was very similar
      for hay and silage (0.771 and 0.783 respectively), while the fractional rate of
      digestion measured by incubation in Dacron bags was significantly (P less than
      0.05) higher for silage (0.069) than hay (0.057). The rate of passage of
      mordanted feed out of the rumen was significantly (P less than 0.01) faster for
      silage when determined from concentrations of marker in the rumen (0.034 v.
      0.028/h). The volume of liquid in the rumen was lower (P less than 0.01) for
      animals consuming silage (27.51) compared with hay (37.11), while the fractional
      rate of passage of liquid from the rumen was higher (0.141 v. 0.098/h, P less
      than 0.05). The volume of liquid in the rumen was also lower (P less than 0.05)
      in steers offered feed eight times daily (29.5 l), compared with once daily (35.1
      l), but frequency of feeding had no significant effect either on total
      digestibility or on rate of digestion in the rumen. The ad lib. intake of silage
      was significantly (P less than 0.01) lower than that of hay (4.53 v. 5.16 kg
      DM/d) in Expt 2.

PMID- 1622975
TI  - Studies of method of conserving grass herbage and frequency of feeding in cattle.
      2. Eating behaviour, rumen motility and rumen fill.
AB  - The influence of the method of conserving grass herbage and the frequency of
      feeding on eating behaviour, rumen motility and rumen fill was studied in growing
      steers. Silage and hay were offered to twelve rumen-cannulated Friesian steers
      (average initial live weight (LW) 128 kg) at a restricted level of intake (20 g
      dry matter (DM)/kg LW) either once or eight times daily. With once daily feeding,
      the daily intake of hay was consumed in a single large meal which lasted about 2
      h, while silage was eaten in many small meals throughout the day. The proportion
      of the day spent ruminating was higher (0.39) for steers offered hay once daily
      than for those offered silage (0.28) or hay eight times per day (0.29). There was
      little effect of conservation method on frequency of rumen contraction, but
      contractile intensity (integration of frequency and amplitude) increased during
      the second half of the 24 h feeding cycle in steers offered hay either once daily
      or eight times daily, while the same effect was only observed when silage was
      offered once daily. Total daily contractile activity (the integration of the
      frequency and duration of myoelectric spike bursts) was significantly (P less
      than 0.05) higher in steers offered hay, compared with silage, once daily. The
      mean weight of organic matter in the reticulo-rumen of steers offered hay was
      significantly higher than for silage both with once (1593 v. 1326 g organic
      matter (OM)/100 kg LW, P less than 0.01) and eight (1367 v. 1160 g OM/100 kg LW,
      P less than 0.05) times daily feeding. The proportion of the particulate pool
      which was present as small (less than 1.2 mm) particles was always greater than
      0.60.

PMID- 1622976
TI  - The effect of forage and forage-concentrate diets on rumen fermentation and
      metabolism of nutrients by the mesenteric- and portal-drained viscera in growing
      steers.
AB  - Growing Friesian steers chronically catheterized in the anterior mesenteric and
      portal veins were used to study the influence of feeding with either a forage or
      forage-concentrate diet on nutrient utilization by mucosal tissue. When animals
      were consuming the forage-concentrate diet the molar proportion of propionate in
      rumen fluid was significantly increased, although production rate as measured by
      isotope dilution was not altered. Net rates of absorption of VFA into portal
      blood when compared with rumen production rates underlined the extent to which
      metabolism within mucosal tissue modifies the propionate supply to the liver. Net
      glucose utilization by splanchnic tissue was shown to be significantly lower on
      the forage-concentrate diet. There were no effects of diet on whole-body glucose
      turnover or on the proportion of glucose derived from propionate. Animals fed on
      the forage-concentrate diet had significantly lower concentrations of circulating
      essential amino acids, due mainly to a reduction in branched-chain amino acid
      levels. There was net absorption of all amino acids by animals on both diets
      except for glutamate, glutamine and taurine in forage-fed animals.

PMID- 1622977
TI  - Influence of the amount of starch on the glycaemic index to rice in non-insulin
      dependent diabetic subjects.
AB  - To test whether the glycaemic index is altered by the amount of carbohydrate,
      meals containing 25 and 50 g carbohydrate as white rice and white bread were
      taken by seven non-insulin-dependent diabetic subjects. The glycaemic indices to
      parboiled white rice corresponding to 25 and 50 g carbohydrate were similar,
      being 55 (SE 10) and 60 (SE 8) respectively. The incremental areas of blood
      glucose (above basal) to parboiled white rice were significantly lower than to
      white bread after both an amount corresponding to 25 g carbohydrate (85 (SE 24)
      mM x 180 min v. 181 (SE 55) mM x 180 min; P less than 0.01) and to 50 g
      carbohydrate 226 (SE 29) mM x 180 min v. 423 (SE 76) mM x 180 min; P less than
      0.01). Similar insulin response areas to 25 g carbohydrate given as parboiled
      white rice and white bread were found, whereas 50 g carbohydrate as white bread
      caused a significantly higher insulin response area than parboiled white rice (P
      less than 0.05). In conclusion, the glycaemic index of parboiled white rice is
      not affected by the amount of carbohydrate ingested, at least under the present
      study conditions.

PMID- 1622978
TI  - Influence of amount of dietary fat and protein on esterase-1 (ES-1) activities of
      plasma and small intestine in rats.
AB  - The objective of the present study was to characterize nutritionally esterase-1
      (ES-1). For this purpose, the effects of replacement of dietary carbohydrates by
      isoenergetic amounts of either fat or protein on ES-1 activities of plasma and
      small intestine were studied in male rats. Purified diets differing in the
      amounts of maize starch plus dextrose, casein and various types of fat were used.
      Plasma and jejunal ES-1 activities were found to be increased with increasing fat
      intakes. As to the type of fat, increasing plasma ES-1 activities were induced by
      coconut fat, olive oil, maize oil and medium-chain triacylglycerols, in this
      order. Maize oil induced higher jejunal ES-1 activities than coconut fat and
      olive oil, but had similar effects to medium-chain triacylglycerols. Maize oil
      was more powerful in increasing plasma ES-1 activity than isoenergetic amounts of
      casein, but with respect to jejunal ES-1 activity these dietary components were
      equally effective. It is concluded that the amounts of fat and protein in the
      diet are important determinants of ES-1 activities in plasma and jejunum.

PMID- 1622979
TI  - Muscle protein degradation assessed by Nt-methylhistidine excretion in mature
      White Leghorn, dwarf broiler and normal broiler males maintained on either low-
      or high-protein diets.
AB  - Protein degradation rates were assessed by the excretion of Nt-methylhistidine
      (NtMH) in four strains of mature chickens, two White Leghorns and two broilers
      (dwarf and normal), fed on diets containing two levels of dietary protein. Over
      0.9 of labelled NtMH was recovered within 7 d of injection from three White
      Leghorn, three dwarf and three normal broiler males. Protein degradation,
      measured by NtMH output, was related to adult body-weight by the power 0.71 and
      strain intercepts were significantly different. Strain differences disappeared
      when the rate of output of NtMH per unit lean was evaluated. The rate of output
      of NtMH per unit muscle was higher in birds fed on a low-protein diet of 100 g
      crude protein (nitrogen x 6.25; CP)/kg compared with males fed on 150 g CP/kg. It
      was concluded that the lower rate of protein degradation in broiler compared with
      layer strains at young ages is related to increased adult body-weight in
      agreement with well-established biological principles.

PMID- 1622980
TI  - The availability of lysine in diets for pigs: comparative methodology.
AB  - Four experiments were conducted to compare different methods for estimating the
      availability of lysine in protein feeds. The same feeds were used in all
      experiments. In the first experiment the apparent digestibility of lysine to the
      ileum of growing pigs was found to be 0.92, 0.69, 0.73, 0.85, 0.84 and 0.97 for
      soya-bean meal, cottonseed meal 1, cottonseed meal 2, meat meal, sunflower meal
      and skim milk respectively. In the second experiment the utilization of lysine
      (relative to free lysine) for weight gain, as measured in weaner pigs, was found
      to be 0.68, 0.73, 0.81, 0.86 and 1.00 for cottonseed meal 1, cottonseed meal 2,
      meat meal, sunflower meal and skim milk respectively. In Expt 3 diets were
      formulated to contain soya-bean meal, sunflower meal or cottonseed meal 2 with
      the same available lysine content from the measurements made in Expts 1 and 2.
      The feed conversion ratios of weaner pigs given these diets were similar for the
      three sources of protein when the values were adjusted for the differences in
      digestible dry matter intake. In the fourth experiment isoenergetic and
      isonitrogenous diets were formulated with increasing amounts of lysine from
      synthetic lysine or cottonseed meal 2. The diets were given to weaner pigs and
      resulted in a curvilinear response to lysine particularly for the cottonseed
      meal, so that the availability of lysine in cottonseed meal was similar to that
      of synthetic lysine at low lysine intakes and much lower than synthetic lysine at
      higher lysine intakes. Possible reasons for the curvilinear responses are
      discussed.

PMID- 1622981
TI  - Zinc absorption in adult men from a chicken sandwich made with white or wholemeal
      bread, measured by a double-label stable-isotope technique.
AB  - Eleven fasted adult men consumed a chicken meat sandwich made with white or
      wholemeal bread, extrinsically labelled with 2 mg 67Zn, on two different
      occasions. Immediately after eating the sandwich they were given an intravenous
      injection of 1.5 mg 70Zn. True Zn absorption (which was approximately 7% higher
      than apparent absorption) was determined by the faecal balance technique by
      making an allowance for endogenous excretion from measurements of faecal
      excretion of 70Zn. There was no significant difference in mean true Zn absorption
      from the white or wholemeal bread sandwich, 33.6 and 25.4% respectively. It was
      concluded that the substitution of wholemeal for white bread does not reduce Zn
      absorption from meat-based sandwiches.

PMID- 1622982
TI  - Calcium and phosphorus requirements of the very young turkey as determined by
      response surface analysis.
AB  - The first experiment was a central composite rotatable design with calculated
      calcium levels of 6.2, 7.0, 9.0, 11.0, and 11.8 g/kg diet and total phosphorus
      levels of 5.2, 6.0, 8.0, 10.0, and 10.8 g/kg diet (2.8 g phytin-P/kg by
      analysis). This design involved three replicates for each rotatable point and
      fifteen replicates of the central point. The second experiment was a 4 x 4
      factorial design with calculated Ca levels of 8.0, 10.0, 12.0, and 14.0 g/kg diet
      and calculated total P levels of 7.0, 9.0, 11.0, and 13.0 g/kg diet (2.5 g phytin
      P/kg by analysis). There were four replicates for each treatment. In both 16 d
      experiments maize-soya-bean diets were used and each replicate consisted of one
      pen containing 10-d-old broad-breasted, white tom turkeys. The Ca and total P
      requirements for optimum growth were estimated to be 12.5 and 10.0 g/kg diet
      respectively. Bone ash was adequate at these levels of Ca and total P, but
      maximum bone ash was not achieved until much higher levels of Ca and total P were
      employed. At the required levels of Ca and total P for growth the incidences of
      Ca- and P-deficiency rickets were very low. There were no treatment effects on
      feed efficiency. Increasing dietary Ca decreased the incidence of the Ca
      deficiency lesion. There was a quadratic response due to dietary total P on both
      P-deficiency rickets and plasma dialysable P; intermediate levels of dietary P
      resulted in low incidence of the P-deficiency lesion and high levels of plasma
      dialysable P. There was a strong negative correlation between the incidence of P
      deficiency rickets and plasma dialysable P. Percentage retention was very low at
      high levels of dietary P and low levels of Ca which corresponded with slightly
      higher P-deficiency rickets and low plasma dialysable P. No such obvious
      relationships existed between Ca retention, incidence of Ca-deficiency rickets,
      and plasma Ca. The incidence of tibial dyschondroplasia was very low in the
      present study. There were pronounced dietary treatment effects on phytin-P
      retention; at 14 d percentage phytin-P retention treatment means ranged from 18
      to 46 in Expt 1 and from 0 to 40 in Expt 2 with the highest retention of phytin-P
      at low levels at both Ca and total P.

PMID- 1622983
TI  - Application of selective extraction to the study of iron species present in diet
      and rat gastrointestinal tract contents.
AB  - Iron speciation in rodent diet and rat gastrointestinal tract lumen during
      dietary digestion and absorption was investigated with a novel selective
      extraction technique. Five Fe fractions were identified, namely exchangeable
      (soluble in 1 M-magnesium chloride), carbonate-bound (soluble in mild acid),
      oxide-bound (soluble in hydroxylamine-acetic acid), organic-bound (soluble after
      treatment with peroxide in nitric acid) and residual. Fe from the pelleted diet
      was mobilized by rat stomach to the exchangeable fraction, then redistributed to
      the carbonate- and oxide-bound fractions on passage through the proximal small
      intestine. In vitro incubation of diet with hydrochloric acid failed to mimic the
      in vivo effect of the stomach. In vitro neutralization of stomach contents with
      bicarbonate was found to produce a similar effect on Fe speciation to that seen
      when diet passed the proximal small intestine in vivo. Comparison of 59Fe
      speciation in extrinsically labelled diet with endogenous Fe speciation showed
      that extrinsic labelling does not uniformly label all endogenous species. The
      experiments suggest that selective extraction may provide a useful approach to
      the study of Fe species present in diets, in vitro digestions and
      gastrointestinal contents.

PMID- 1622984
TI  - Tissue alpha-tocopherol status during late fetal and early neonatal life of the
      guinea-pig.
AB  - The alpha-tocopherol content of a number of different fetal, neonatal and
      maternal guinea-pig tissues was determined and compared with plasma and
      erythrocyte alpha-tocopherol values. During late gestation, the fetal liver
      appears to act as a storage site for alpha-tocopherol, the majority of which is
      released immediately following birth. In contrast, lung and brain vitamin E
      levels are relatively constant over the final period of gestation and during
      early neonatal life. The ontogeny of alpha-tocopherol in brain and lung was
      similar to that for erythrocytes while plasma alpha-tocopherol content varied
      considerably and did not accurately reflect tissue alpha-tocopherol status.
      Surprisingly, fetal and maternal lung alpha-tocopherol concentrations were
      similar at all time-points considered, whereas fetal liver alpha-tocopherol
      status was always considerably greater than maternal liver alpha-tocopherol
      content. These results, if representative of the human fetus, suggest that
      preterm infants may not have tissue alpha-tocopherol concentrations as low as
      previously assumed and that during the perinatal period erythrocyte alpha
      tocopherol content is a more accurate indicator of tissue alpha-tocopherol
      concentration than plasma alpha-tocopherol content.

PMID- 1622985
TI  - Digestion of complex carbohydrates and large bowel fermentation in rats fed on
      raw and cooked peas (Pisum sativum).
AB  - Rats were fed on four semi-purified diets in which raw or cooked peas (Pisum
      sativum var. Sentinel) provided 250 or 500 g/kg diet. Pressure-cooking of peas
      followed by rapid freezing and freeze-drying increased the proportion of starch
      resistant to alpha-amylase (EC 3.2.1.1) without previous treatment with dimethyl
      sulphoxide. There were only minor effects of cooking on the digestibilities of
      non-starch polysaccharides and their constituent sugars. With the higher dietary
      pea concentration there were marked increases in the flow of organic matter to,
      and fermentation in, the large bowel. These increases were associated with
      significant increases in colonic tissue and contents weights, and in colonic
      transit time. Both cooking and dietary pea inclusion rate altered the pattern of
      volatile fatty acids in caecal contents and in portal blood.

PMID- 1622987
TI  - Transplant coronary artery disease.

PMID- 1622986
TI  - The effects of acute and chronic administration of n-6 and n-3 polyunsaturated
      fatty acids on ethanol-induced gastric haemorrhage in rats.
AB  - Female weanling rats in three equal groups (n 12) were given orally by intubation
      1 ml micellar solution of taurocholic acid (10 mM) and either arachidonic acid
      (20:4 n-6), linoleic acid (18:2 n-6) or eicosapentaenoic acid (20:5 n-3) at a
      concentration of 120 mM. After 1 h the rats were given intragastrically 2 ml
      absolute ethanol and were killed 1 h later. Rats given oral 20:4 n-6 showed a
      significant reduction (P less than 0.05) in the extent (%) of gastric mucosal
      haemorrhage compared with either the rats given 20:5 n-3 or 18:2 n-6 (8.3 (SD
      7.3), 23.2 (SD 10.4) and 21.4 (SD 10.4) respectively. In a second experiment,
      four equal groups (n 12) of female Wistar rats were fed for 5 weeks on either a
      control diet of standard laboratory rat food, or the same diet enriched with
      either maize oil or fish oil or butterfat at a level of 100 g/kg. Following a 24
      h fast the rats received an intragastric dose of 2 ml ethanol and were killed 1 h
      later. Examination of the extent (%) of gastric lesion showed a significant
      reduction (P less than 0.05) with the feeding of either maize oil or fish oil
      compared with the controls (12.2 (SD 8.2), 15.3 (SD 13.2) and 29.3 (SD 14.0)
      respectively). The butterfat diet was not significantly different from the
      control diet (23.8 (SD 8.1)).

PMID- 1622988
TI  - Graft atherosclerosis: effects of cellular rejection and human lymphocyte
      antigen.
AB  - Graft atherosclerosis after heart transplantation is a problem that may limit
      long-term survival. The objective of this study was to establish whether an
      association exists between graft atherosclerosis, cellular rejection, HLA
      compatibility, or antilymphocyte antibodies in recipient serum. Results of
      cineangiograms from 306 recipients were available. Life table and logistic
      regression analysis identified only a significant effect of cellular rejection on
      development of angiogram-evident graft vessel disease. A total of 146 allografts
      obtained at another transplantation or autopsy were also available. Coronary
      vessel narrowing was measured by planimetry. Linear regression with coronary
      narrowing as dependent variable established a positive association with history
      of cellular rejection. No effect was documented for panel reactive antibody level
      obtained before or after transplantation. We also did not show an impact of HLA
      mismatch on this process. The lack of HLA antigen effect prompts us to be
      cautious about linking graft atherosclerosis directly to the rejection event.

PMID- 1622989
TI  - Vascular rejection and its relationship to allograft coronary artery disease.
AB  - We have prospectively monitored 268 patients by our previously described method
      of routine immunofluorescence of endomyocardial biopsy specimens. We have
      classified these patients according to their rejection pattern: cellular,
      vascular, and mixed. The criteria for these designations have been previously
      described. In this study we retrospectively reviewed coronary angiograms of these
      patients to assess the presence and time-course of developing allograft coronary
      artery disease. All available explanted hearts and postmortem hearts were also
      assessed by light microscopic examination for acute coronary vasculitis and
      allograft coronary artery disease and by immunofluorescent microscopy for
      vascular immune complex deposition in a manner identical to immunofluorescent
      microscopic examination of endomyocardial biopsy specimens. Patients were also
      monitored for sensitization to immunoprophylactically administered murine
      monoclonal CD3 antibody (OKT3) and those demonstrated to be sensitized were
      separately analyzed. Clinical features and treatment of patients were
      retrospectively reviewed. We found that 141 patients could be classified as
      having cellular rejection, 76 as having vascular rejection, and 52 as having a
      mixed rejection pattern. The allograft survival in vascular rejection patients
      was significantly worse than in allografts of patients with cellular or mixed
      rejection, confirming our earlier results. Most importantly, we found a
      significant difference in the time to the development of allograft coronary
      artery disease based on the rejection pattern. This difference existed whether or
      not patients sensitized to OKT3 were excluded from evaluation. Patients with
      mixed rejection had an intermediate time to the development of allograft coronary
      artery disease between that of patients with cellular and vascular
      rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1622990
TI  - Relation of HLA antibodies and graft atherosclerosis in human cardiac allograft
      recipients.
AB  - Although cyclosporine has helped make heart transplantation a clinical reality,
      long-term survival remains limited by rejection and graft atherosclerosis. We
      have previously demonstrated the development of alloreactive lymphocytotoxic
      antibodies in baboon recipients of heterotopic heart transplants despite
      cyclosporine administration. The hypothesis of the present study is that
      cyclosporine-treated human heart transplant recipients are also capable of
      generating strong humoral immune responses that might adversely affect clinical
      outcome. Serial serum specimens from 240 heart transplant recipients were tested
      against a reference panel of 70 cells for anti-HLA lymphocytotoxic antibodies.
      Patients with serum panel reactive antibody levels greater than 10% were
      considered antibody producers, whereas those with serum panel reactive antibody
      levels less than 10% were considered nonproducers. To establish the time course
      of post-transplantation sensitization, we have tested anti-HLA antibodies in
      sequential sera at 3-month intervals after transplantation. The 4-year actuarial
      survival rate of those patients whose panel reactive antibody levels were greater
      than 10% during the first 6 months after transplantation was 70%, whereas the
      survival rate of patients whose levels were less than 10% during this time was
      93%. The results were significantly different (p less than 0.01). Further
      heterogeneity among the patients was demonstrated by differential analysis of
      survival in patients who showed (1) panel reactive antibody levels less than 10%
      in any of the sera obtained during the first year after transplantation, (2)
      panel reactive antibody levels greater than 10% in sera obtained during the first
      6 months but not thereafter, and (3) panel reactive antibody levels greater than
      10% throughout the first year after transplantation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1622991
TI  - Transplant coronary disease: nonimmunologic risk factors.
AB  - Since the time that coronary artery disease was first described in the
      transplanted human heart, attempts have been made to define risk factors for its
      development. Although recent reports have emphasized immunologic and infectious
      (i.e., cytomegalovirus) mechanisms in the development of transplant coronary
      disease, the influence of several nonimmunologic risk factors has also been
      studied. Some of the nonimmunologic risk factors that have been evaluated include
      recipient characteristics (age, sex, obesity, hyperlipidemia, hypertension,
      smoking, diabetes mellitus, pretransplantation heart disease), donor
      characteristics (age, sex), immunosuppressive agents/protocols, and nonimmune
      mechanisms of endothelial injury (cyclosporine, ischemic time). Studies
      evaluating the role of these risk factors have produced variable results. One or
      more studies, however, have suggested an effect of recipient age and sex, donor
      age and sex, obesity, hyperlipidemia, pretransplantation diagnosis, and ischemic
      time on the development of transplant coronary disease. The most consistently
      described relationship has been between hyperlipidemia and transplant coronary
      disease. Hyperlipidemia is common after heart transplantation, with elevations
      noted in total cholesterol, low-density lipoprotein cholesterol, and
      triglycerides. The cause of posttransplantation hyperlipidemia is not well
      defined, but obesity and the immunosuppressive agents prednisone and cyclosporine
      play a role. Treatment of posttransplantation hyperlipidemia can be difficult
      because commonly used lipid-lowering agents have side effects and interactions
      with immunosuppressive drugs that necessitate caution in their use in the
      posttransplantation population. Transplant coronary disease almost certainly has
      a multifactorial cause, with endothelial injury and nonimmunologic risk factors,
      particularly hyperlipidemia, playing contributory roles. Because hyperlipidemia
      and the obesity that commonly accompany it are modifiable risk factors, weight
      loss and treatment of hyperlipidemia are recommended.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1622992
TI  - Multicenter evaluation of percutaneous transluminal coronary angioplasty in heart
      transplant recipients. Cardiac Transplant Angioplasty Study Group.

PMID- 1622993
TI  - Predictors of survival after repeat heart transplantation. The Registry of the
      International Society for Heart and Lung Transplantation, and Contributing
      Investigators.
AB  - To examine factors potentially predictive of outcome after repeat heart
      transplantation, data were analyzed for 449 recipients of second allografts
      reported to the registry of the International Society for Heart and Lung
      Transplantation and a matched group of 421 primary transplant recipients.
      Survival was markedly decreased in repeat transplantation patients (1 year
      actuarial survival rate, 48% vs 79%; p less than 0.001). Univariate analysis
      showed no impact on survival of recipient age or gender, ischemic time, or
      transplant center experience. Accelerated coronary artery disease as the cause of
      allograft failure, longer interval between transplants, lack of preoperative
      mechanical assistance, and second transplantation after 1985 were predictive of
      increased survival after repeat transplantation. An "ideal candidate" defined by
      these predictive variables had a 1-year survival rate of 64%. In addition to the
      International Society for Heart and Lung Transplantation registry, a multicenter
      data base was developed with data for 125 repeat transplant recipients and 1325
      primary transplant recipients at 13 transplant centers in the United States. In
      this group of patients the 1-year survival rate was greater than that in the
      International Society for Heart and Lung Transplantation registry (60% vs 48%),
      and the impact of the predictive variables listed previously was decreased. The
      incidence of rejection, infection, and accelerated coronary artery disease was
      not different between secondary and primary allograft recipients. Nonskin
      malignancies occurred more frequently in repeat transplantation patients (8% vs
      4%; p less than 0.05). Recipients of second allografts were more likely to have
      major surgical complications, had a higher level of sensitization to HLA
      antigens, and were more likely to have a positive donor-specific crossmatch (17%
      vs 2%). A trend toward improved survival was noted in patients with repetition in
      the second donor of mismatched HLA antigens present in the first donor (1-year
      survival rate of 68% vs 47%; p = 0.06). We conclude that longer interval between
      transplants, accelerated coronary artery disease as cause of allograft loss, and
      lack of preoperative mechanical assistance are predictive of longer survival
      after repeat transplantation. Nonetheless, the "ideal candidate" for repeat
      transplantation has an anticipated survival rate significantly less than that
      expected for primary transplant recipients.

PMID- 1622994
TI  - Control of intimal hyperplasia by heparin.

PMID- 1622995
TI  - Preventive treatment of graft coronary vascular disease: the potential role of
      vasodilator therapy.
AB  - The prevention or treatment of graft coronary vascular disease is one of the
      major challenges facing cardiovascular medicine today. Further investigation is
      necessary to elucidate the mechanisms by which myointimal hyperplasia develops
      within the coronary vasculature of heart transplants. Studies of several models
      of the vascular disease, however, suggest that there is an interaction between
      vasoactive substances, hemodynamic stimuli, and autocrine/paracrine growth
      factors that governs the vascular remodeling response to vessel injury. In this
      review I will focus primarily on the role of vasoactive substances and
      hemodynamic stimuli as determinants of vascular structure. In addition, this
      review will provide substantiating evidence that advances the postulate that
      vasodilator therapy may have an adjunctive role in the prevention and treatment
      of graft coronary vascular disease. It is hoped that this provocative concept
      will stimulate further investigation of novel therapeutic strategies in the
      treatment of this disease.

PMID- 1622996
TI  - Allograft vascular disease: a disease not limited to hearts.

PMID- 1622997
TI  - Histopathology of graft coronary disease.

PMID- 1622998
TI  - Cardiac events after heart transplantation: incidence and predictive value of
      coronary arteriography.
AB  - Cardiac events from graft arteriopathy, including myocardial infarction, heart
      failure resulting from previous myocardial infarction, and sudden death, may
      limit long-term survival after heart transplantation. To determine the incidence
      of cardiac events and the use of coronary arteriography in predicting these
      events, the long-term results (mean follow-up, 3.5 years; standard deviation +/-
      2.0) of heart transplantation in 427 patients were reviewed. Cardiac events
      included 19 cases of myocardial infarction, 13 cases of sudden death, and 10
      cases of congestive heart failure. All these events occurred after the first year
      except for three cases of sudden death and one case of myocardial infarction.
      Cumulative incidence of cardiac events per patient year was 0.9% within the first
      year, increasing to 1.9% by 5 years. Cardiac events accounted for 3.8% of the
      deaths by the end of the first year, rising to 18% of total mortality by 7 years
      after heart transplantation. In patients dying after the first year of
      transplantation, deaths from sequelae of coronary artery disease occurred in 36%
      (20/55). The relative risk ("odds ratio") of any cardiac event was 3.44 (p less
      than 0.05) in patients with angiographic evidence of obstructive disease compared
      with those without evidence of disease, risk of cardiac death 4.6 (p less than
      0.05) and risk of sudden death, 2.4 (not significant). Of the 13 patients who
      died suddenly, five seen at autopsy were found to have had a recent myocardial
      infarction. Of all patients who died of heart disease, recent myocardial
      infarction was detected in nine who were seen at autopsy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1622999
TI  - Immunopathology of coronary arteriosclerosis in transplanted hearts.

PMID- 1623000
TI  - Serial quantitative coronary angiography in the assessment of coronary disease in
      the transplanted heart.
AB  - Quantitative angiographic studies with use of cine-videodensitometry after
      maximal coronary vasodilation with nitroglycerin in 18 "angiographically normal"
      heart transplant recipients demonstrated significant loss of lumen diameter
      between years 1 and 3. When sensitive angiographic techniques are used, graft
      arteriopathy appears to be ubiquitous in heart transplant recipients.

PMID- 1623001
TI  - Necropsy versus angiography: how accurate is angiography?

PMID- 1623002
TI  - Intracoronary ultrasound imaging in heart transplant recipients: the Stanford
      experience.

PMID- 1623003
TI  - Coronary angiography after heart transplantation: should perioperative study be
      the "gold standard"?
AB  - The fact that allograft coronary arteriopathy is frequent and has a poor
      prognosis means early diagnosis is critical. Furthermore, because of important
      distinctions between native heart coronary artery disease and allograft
      arteriopathy, standard noninvasive diagnostic tests seem less sensitive and
      specific. Assuming that coronary angiography is the optimal method for detection
      and staging of allograft arteriopathy, one must establish the point at which an
      initial study should be performed and the incidence of abnormalities in donor
      hearts. Review of perioperative coronary angiograms in 75 consecutive patients
      undergoing heart transplantation (within 8 weeks) demonstrated that only six
      hearts had coronary artery abnormalities: two had focal coronary artery disease,
      one had an anomalous circumflex coronary artery, and three had nonobstructive
      calcification of the coronary arteries. To determine if serial quantitative
      angiography was helpful in detecting progression of coronary disease during a 12
      month period, 28 patients underwent baseline and repeat quantification of mean
      luminal diameter of predetermined segments of the mid and distal portions of the
      left anterior descending artery. No patient had identifiable disease on the first
      angiogram, and 12 were studied in the first year of their transplants. During the
      interval, mean mid left anterior descending coronary diameter was 3.17 +/- 0.6 mm
      on the first study and 3.06 +/- 0.7 on the second study. Visual assessment of the
      angiograms, however, identified allograft arteriopathy when two studies were
      available for inspection in 7 of 28 patients despite no significant diameter
      reduction of identified coronary segments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623004
TI  - Endothelial dysfunction in the development and detection of transplant coronary
      artery disease.

PMID- 1623005
TI  - Growth factors and cell proliferation in human transplant arteriosclerosis.

PMID- 1623006
TI  - The relationship of soluble interleukin-2 receptor levels to allograft
      arteriopathy after heart transplantation.
AB  - Certain dynamics of rejection after heart transplantation can be characterized by
      measuring soluble interleukin-2 receptor levels. To determine whether elevated
      levels could predict development of coronary artery disease, the mean of three
      weekly determinations the first month after heart transplantation, as well as
      values obtained at 6 months, 12 months, 18 months, and 24 months after the
      procedure, were evaluated. Comparison was made between the groups in whom
      allograft arteriopathy did or did not develop. Concomitant endomyocardial biopsy
      scores also were evaluated. Fifty-five patients surviving the initial 30 days
      after heart transplantation were prospectively followed up. Eighty-five percent
      were male, and the median age was 51 years. Coronary arteriopathy developed in 15
      patients (27%) during a mean follow-up period of 26 months (range, 1 to 54
      months). For the early follow-up point, mean (+/- standard deviation) receptor
      levels for those patients without allograft arteriopathy were 880 +/- 846 U/ml
      and for those with arteriopathy, 1410 +/- 590 U/ml (p = 0.001). At each follow-up
      point thereafter, soluble interleukin-2 receptor levels were greater in the group
      with allograft arteriopathy. Indeed, at all observation points, the group in whom
      disease developed had levels greater than 1000 U/ml, and these values were, from
      a statistical standpoint, always greater than the group without detectable
      arteriopathy. In contradistinction, endomyocardial biopsy scores were no
      different at either early or late follow-up periods. Allograft arteriopathy after
      heart transplantation seems predicted by early elevation of plasma soluble
      interleukin-2 receptor levels, and patients with this difficulty generally have
      elevated levels during long-term follow-up.

PMID- 1623007
TI  - Proximal and mid-vessel coronary artery disease in the transplanted heart.

PMID- 1623008
TI  - Sympathetic reinnervation after heart transplantation in human beings.

PMID- 1623009
TI  - Cardiac allograft vasculopathy: relationship with acute cellular rejection and
      histocompatibility.
AB  - This article reviews the literature and summarizes the data obtained at Loyola
      University of Chicago about the relationship between rejection,
      histocompatibility, and cardiac allograft vasculopathy. Both the studies
      concerning the relationship between rejection and cardiac allograft vasculopathy
      and those evaluating the impact of histocompatibility on cardiac allograft
      vasculopathy have produced conflicting results. Most studies are retrospective
      and include a small number of patients followed up for short periods of time and
      treated with variable immunosuppressive regimens. In addition, the diagnosis of
      cardiac allograft vasculopathy is based on angiographic detection of coronary
      arterial abnormalities, a method that is known to underestimate the presence and
      severity of cardiac allograft vasculopathy. The ability to assess the impact of
      histocompatibility on the development of cardiac allograft vasculopathy is also
      limited by the lack of uniformity in the type and number of HLA variables
      analyzed, the extreme polymorphism of the HLA antigens and variability in
      serologic tissue typing techniques and quality. The results of our study suggest
      that complete mismatch at the HLA-B and -DR loci is associated with higher
      rejection rates and severity and with increased mortality. We also noted a trend
      toward a higher incidence of cardiac allograft vasculopathy in patients with
      complete mismatch at the HLA-DR locus. Future experimental and clinical studies
      should be done with use of molecular tissue typing techniques to further
      elucidate the impact of histocompatibility on cardiac allograft vasculopathy. The
      role of non-HLA antigens in the development of cardiac allograft vasculopathy
      requires further definition. Because in heart transplantation the short donor
      ischemic times compatible with a successful outcome limit the feasibility of
      prospective donor/recipient tissue typing, the development of immunosuppressive
      drugs that effectively reduce the detrimental effects of tissue incompatibility
      is crucially needed.

PMID- 1623010
TI  - Transport of a large neutral amino acid in a human intestinal epithelial cell
      line (Caco-2): uptake and efflux of phenylalanine.
AB  - The processes of L-phenylalanine (Phe) uptake and efflux from the apical (AP) and
      basolateral (BL) sides of an intestinal epithelial cell line (Caco-2) were
      investigated to further characterize the mechanism of transcellular transport of
      this amino acid. The results indicated that the initial uptake rates of Phe were
      saturable with a Km of 2.7 mM for AP uptake and 0.18 mM for BL uptake. Unlike the
      uptake, the initial efflux rates were shown to be proportional to the
      intracellular concentrations of Phe. Based on these kinetic studies and
      determination of other characteristics (e.g., Na+ dependency) of the uptake and
      efflux processes, it was concluded that AP uptake, BL uptake and BL efflux were
      distinctly different. This suggests that either different carriers or a different
      combination of carriers are responsible for the transmembrane transport of this
      amino acid. When the results of kinetic studies of Phe uptake and efflux were
      used to determine the rate-limiting step in the AP-to-BL transcellular transport
      of this amino acid, it was concluded that the BL efflux is the rate-limiting step
      in the transcellular transport of Phe in the Caco-2 cell monolayers.

PMID- 1623011
TI  - Effects of culture temperature on the expression of heat-shock proteins in murine
      ts85 cells.
AB  - The murine temperature-sensitive cell-cycle mutant, ts85, shows an abnormal
      induction of heat-shock proteins which is different from the wild type FM3A
      cells. This paper explores the effect of culture temperature on the expression of
      heat shock proteins in ts85 cells. When ts85 cells were maintained at 33 or 37
      degrees C, these cells synthesized heat-shock protein (hsp) 70 following
      continuous heating at 39 degrees C or subsequent incubation after heating at 42
      degrees C for 15 min. In contrast, these conditions are not conducive for hsp70
      synthesis by FM3A cells. Moreover, ts85 cells which were maintained at 37 degrees
      C synthesized hsp70 following continuous heating at 42 degrees C or subsequent
      incubation after heating at 45 degrees C for 15 min. The synthesis of hsp70 in
      these cells corresponded to an increased level of hsp70 mRNA. Furthermore, the
      constitutive hsp105 level of cells maintained at 33 degrees C was only half of
      that of cells which were maintained at 37 degrees C, and cells maintained at 33
      degrees C were more sensitive to subsequent heat treatment than those maintained
      at 37 degrees C. These results indicate that culture temperature not only affects
      the induction of hsp70 mRNA, but also cellular levels of hsp105 and the resulting
      thermal sensitivity of ts85 cells. These findings suggest that the other
      phenotypic characteristic of the mutant ts85 cells is also affected by culture
      temperature.

PMID- 1623012
TI  - Inhibition of human lymphocyte coproporphyrinogen oxidase activity by metals,
      bilirubin and haemin.
AB  - Coproporphyrinogen III oxidase activity in human lymphocytes was found to be
      inhibited by cadmium and mercury but not by lead. The organo-metal compounds
      tributyltin and methylmercury were effective inhibitors of this haem biosynthetic
      pathway enzyme. Haemin (the ultimate product of the pathway) and bilirubin (a
      product of haem catabolism) were also shown to be inhibitory. Kinetic studies
      performed under initial velocity conditions showed that bilirubin was a non
      competitive inhibitor and that one bilirubin molecule was bound to both the
      enzyme and enzyme substrate complex. The analysis also showed haemin to be a non
      competitive inhibitor in which two haemin molecules bind to the enzyme whereas
      the enzyme substrate complex accepts only one haemin molecule. The possible
      physiological significance of the inhibition of coproporphyrinogen III oxidase
      activity by haemin and bilirubin is discussed.

PMID- 1623013
TI  - Opsonophagocytosis of liposomes by peritoneal macrophages and bone marrow
      reticuloendothelial cells.
AB  - We investigated the opsonic effect of serum on the phagocytosis of cholesterol
      poor and cholesterol-rich liposomes with freshly prepared rat bone marrow and
      peritoneal phagocytes in suspension. The presence of serum in incubation
      increased the uptake of cholesterol-rich but not cholesterol-poor liposomes in
      bone marrow cells, whereas serum enhances phagocytosis of both liposome
      preparations in peritoneal phagocytes. The opsonic activity of serum on the
      uptake of liposomes by both cell types is destroyed by heat, ammonium hydroxide,
      and zymosan treatments of serum, which suggests the involvement of complement in
      phagocytosis of liposomes. However, bone marrow cells and peritoneal macrophages
      responded differently when incubated with dialysed or EGTA-chelated serum. These
      treatments result in complete loss of the opsonic effect of serum on the uptake
      of liposome in bone marrow cells. Addition of serum dialysate or divalent cations
      to dialysed serum do not reinstall its lost opsonic activity. Thus these results
      shade doubt on possibility of involvement of complements in phagocytosis of
      liposomes by bone marrow cells. Dialysed or EGTA-treated serum also failed to
      promote liposome uptake by peritoneal macrophages but unlike in the case of bone
      marrow cells replacement of divalent cations to such sera reinstalls its opsonic
      activity and enhances phagocytosis of liposomes by peritoneal macrophages. These
      observations suggest the involvement of different serum components on liposome
      uptake by bone marrow cells and peritoneal macrophages, and emphasize the
      complexities associated with RES-mediated blood clearance of the intravenously
      injected liposomes. The properties of these opsonins are compared with those of
      'liver-' and 'spleen-specific' opsonins responsible for phagocytosis of liposomes
      by Kupffer cells and spleen macrophages, respectively [4]. It is suggested that
      these tissue specific opsonins are responsible for distribution of intravenously
      injected liposomes in various organs of the reticuloendothelial system.

PMID- 1623014
TI  - Electron transfer in chromaffin-vesicle ghosts containing peroxidase.
AB  - In chromaffin vesicles, the enzyme dopamine beta-monooxygenase converts dopamine
      to norepinephrine. It is believed that reducing equivalents for this reaction are
      supplied by intravesicular ascorbic acid and that the ascorbate is regenerated by
      importing electrons from the cytosol with cytochrome b-561 functioning as the
      transmembrane electron carrier. If this is true, then the ascorbate-regenerating
      system should be capable of providing reducing equivalents to any ascorbate
      requiring enzyme, not just dopamine beta-monooxygenase. This may be tested using
      chromaffin-vesicle ghosts in which an exogenous enzyme, horseradish peroxidase,
      has been trapped. If ascorbate and peroxidase are trapped together within
      chromaffin-vesicle ghosts, cytochrome b-561 in the vesicle membrane is found in
      the reduced form. Subsequent addition of H2O2 causes the cytochrome to become
      partially oxidized. H2O2 does not cause this oxidation if either peroxidase or
      ascorbate are absent. This argues that the cytochrome is oxidized by
      semidehydroascorbate, the oxidation product of ascorbate, rather than by H2O2 or
      peroxidase directly. The semidehydroascorbate must be internal because the
      ascorbate from which it is formed is sequestered and inaccessible to external
      ascorbate oxidase. This shows that cytochrome b-561 can transfer electrons to
      semidehydroascorbate within the vesicles and that the semidehydroascorbate may be
      generated by any enzyme, not just dopamine beta-monooxygenase.

PMID- 1623015
TI  - Recent progress in structure-function and molecular analyses of the
      pituitary/placental glycoprotein hormone receptors.

PMID- 1623016
TI  - Effect of insulin-like growth factor-I on the synthesis and distribution of link
      protein and hyaluronan in explant cultures of articular cartilage.
AB  - Addition of 20% (v/v) fetal calf serum or insulin-like growth factor-I (IGF-I; 20
      ng/ml) to the medium of explant cultures of adult articular cartilage resulted in
      an increased rate of synthesis of the three components of the proteoglycan
      aggregate-namely link protein, hyaluronan and aggrecan. Fetal calf serum also
      stimulated the synthesis of other matrix proteins by articular cartilage compared
      with tissue maintained in medium alone or medium containing IGF-I. Although
      addition of fetal calf serum or IGF-I to the culture medium of cartilage explant
      cultures stimulated both hyaluronan and aggrecan synthesis, no change in the
      distribution of these two macromolecules between tissue and medium was observed.
      Approx. 50% of the newly synthesized hyaluronan was retained by the tissue
      compared to 93% of the labelled aggrecan. Culture conditions had some influence
      on the distribution of link protein, in cultures maintained in medium alone or in
      medium containing IGF-I, less than 12% of the newly synthesized link protein was
      lost to the medium of the cultures. However, in cultures maintained with fetal
      calf serum between 25% and 19% of the radiolabelled link protein was lost from
      the matrix of the explants. This work suggests that the chondrocyte synthesizes
      the macromolecules that make up the proteoglycan aggregate in a co-ordinated
      manner, thereby retaining the relative amounts of each component of this
      functionally important complex.

PMID- 1623017
TI  - Acute and long-term biphasic volume alterations in rat type-II somatotrophs
      during GH secretory stimulation.
AB  - The size and shape of growth hormone (GH)-producing rat (type II)-somatotrophs
      was studied during secretory stimulation by either human GH-releasing hormone
      (hGHRH(1-29)) or 50 nM extracellular potassium. A new type of perfusion chamber
      for light microscopy allowed the interpretation of early changes in cell
      morphology. The exposure to 10 nM hGHRH caused a significant transient decrease
      in cell volume to 94.4 +/- 2.1% within 2 s. The cell volume recovered to 99.2 +/-
      1.3% at 30 s. A second, more gradual volume decrease then followed (60 s), which
      stabilized at about 92.5 (8 min) and was still present after 20 min of continuous
      hGHRH exposure. Potassium, 50 mM, gave an immediate and persistent cell volume
      increase of about 5%. The fluctuation in rat somatotroph volume after hGHRH
      exposure correlates to a previously observed biphasic GH-secretory pattern
      involving an initial burst secretion and a second slow phase secretion. The
      transient early volume decrease may reflect ion fluxes across the membrane and/or
      the response of the cytoskeleton to calcium mobilization during the GH-secretory
      onset. The second, persistent, volume decrease closely correlates to the
      calculated volume of lost GH vesicles.

PMID- 1623018
TI  - An analysis of rising health care costs.
AB  - Why are medical costs rising so rapidly? What are the factors involved that
      influence those costs? Does inflation affect health care costs? Can anything be
      done? The solutions to these complex issues are not clearly understood. It is
      clear, however, that the resolutions to these questions must be found quickly. If
      the causes of rising medical care costs are not promptly diagnosed and treated,
      we may find our economic health to be in critical condition. This paper attempts
      to better understand the reasons for increasing health care costs. The role that
      inflation plays relative to health care costs is investigated.

PMID- 1623019
TI  - Organization of endoscopic retrograde cholangiopancreatography accessories:
      designing your own cart.
AB  - The increasing complexity of endoscopic retrograde cholangiopancreatography
      procedures has resulted in an ever-widening array of accessories to provide the
      endoscopist with the necessary equipment to diagnose and treat biliary and
      pancreatic disorders effectively. The need to organize this volume of accessories
      efficiently has become a primary concern for gastrointestinal laboratories. GI
      nurses can work together with physicians to design an organizational system to
      meet these increasing demands, while at the same time addressing quality
      assurance and supply inventory.

PMID- 1623020
TI  - Nutritional assessment in nursing.
AB  - Patients with gastrointestinal disorders are at high risk for malnutrition.
      Malnutrition results in an increased length of stay by contributing to the
      development of complications of disease or surgery. Nurses can help prevent
      complications by reporting signs and symptoms in hospitalized gastrointestinal
      patients suffering from malnutrition. Recognition of the methods of nutritional
      assessment and awareness of the shortcomings of each are needed for accurate
      assessment of the clinical status.

PMID- 1623021
TI  - The role of nursing in clinical research trials.
AB  - The role of nurses and their scope of practice in various clinical settings have
      become better defined in recent years. Research for most nurses is either new or
      unfamiliar, despite the fact that research will in some way affect every nurse in
      clinical practice. The majority of analysis in the literature of nursing research
      has focused on the relationship between research and clinical practice. What
      abilities nurses possess and how they can be put into practice for the success of
      a clinical research trial are the subjects of this article.

PMID- 1623022
TI  - NuLYTELY (PEG 3350, sodium chloride, sodium bicarbonate and potassium chloride
      for oral solution).
AB  - NuLYTELY (PEG 3350, Sodium Chloride, Sodium Bicarbonate, and Potassium Chloride
      for Oral Solution), a product from Braintree Laboratories, Inc. is a modification
      of GoLYTELY (PEG 3350 and Electrolytes for Oral Solution) that has been found to
      have the same therapeutic advantages in terms of safety, efficacy, speed and
      patient acceptance. This product was developed to improve upon the taste of
      GoLYTELY. NuLYTELY represents an effective alternative for bowel cleansing prior
      to colonoscopy that may be more acceptable to some patients.

PMID- 1623023
TI  - The role of the pediatric clinical nurse specialist in gastroenterology.
AB  - Clinical nurse specialists have been employed by hospitals for many years.
      However, very little published information exists specifically describing the
      role of the pediatric clinical nurse specialist in the field of gastroenterology.
      The pediatric GI staff nurse and/or GI assistant may be uncertain as how to best
      utilize this important nursing resource. The author discusses her own role
      implementation as a pediatric gastroenterology/nutrition clinical nurse
      specialist and highlights in particular her role as a resource to the GI nurses.

PMID- 1623024
TI  - The stomach and effects of surgical alteration.

PMID- 1623025
TI  - Continuing education for gastroenterology recertification.

PMID- 1623026
TI  - Primary sclerosing cholangitis: what are the nursing implications?
AB  - Primary sclerosing cholangitis is characterized by inflammation and fibrotic
      strictures of the intra- and extrahepatic bile ducts. The diagnosis is confirmed
      by cholangiography, either endoscopic or percutaneous. An association between
      primary sclerosing cholangitis and chronic ulcerative colitis has been recognized
      by physicians for years. To date, there is no known cure for this disease.
      Several drugs are currently being utilized for symptomatic relief. Therapeutic
      radiologic and endoscopic procedures are performed to relieve obstruction of the
      bile ducts and reduce the back pressure on the liver. Surgical procedures are
      also designed to relieve biliary obstruction and to protect hepatic function.
      Recently, liver transplantation has become an option for some patients.

PMID- 1623027
TI  - Odor control in the GI laboratory.

PMID- 1623028
TI  - Writing for GNJ.

PMID- 1623029
TI  - Preparatory information and anxiety before sigmoidoscopy: a comparative study.
AB  - This study compared selected types of information given before sigmoidoscopy to
      determine if one intervention was superior to the other in decreasing anxiety.
      The design was two-group, pre- and posttest quasi-experimental. Anxiety was
      measured by the State-Trait Anxiety Inventory (STAI) and heart rate monitoring.
      Preparatory information consisted of 3 to 5 min audiotaped messages. Subjects in
      a convenience sample of 22 men were randomly assigned to one of two information
      conditions, procedure (control) or procedure plus sensation (experimental). t
      tests and analysis of variance were used to analyze the data. Data analysis
      revealed no significant difference (p = .05) in anxiety between groups
      postintervention. There were no significant changes in heart rate between groups
      by time or within groups over time. Subjective comments on postsigmoidoscopy
      questions were strongly positive regarding the benefits of both types of
      preparatory information.

PMID- 1623030
TI  - Endoscopy nurses and research.
AB  - Six staff registered nurses completed research projects related to nursing
      responsibilities and patient responses in the endoscopy department of an urban
      hospital. The methodologies, conclusions, and nursing implications of these
      projects are summarized in this article.

PMID- 1623031
TI  - Glutaraldehyde: a potential health risk to nurses.
AB  - This article discusses the potential toxicity of glutaraldehyde, a chemical
      commonly used in endoscopy units. The literature review cites adverse health
      effects experienced by workers exposed to glutaraldehyde. The sampling
      methodology for glutaraldehyde relative to the Occupational Safety and Health
      standard for glutaraldehyde is presented. Air monitoring should be performed to
      assess employee exposure to airborne glutaraldehyde in endoscopy departments.
      Recommendations for reducing exposure to glutaraldehyde in endoscopy units are
      included.

PMID- 1623032
TI  - Infectious gastroenteritis in infants and children.
AB  - Infectious gastroenteritis is a frequent recurring illness in young children. It
      is caused by a viral agent in 70 to 80% of cases. Bacteria, parasites, and toxins
      account for the remaining 20 to 30%. A careful history and complete physical
      examination are the first steps to diagnosing acute gastroenteritis and
      establishing a treatment plan. The majority of infants and children with
      infectious gastroenteritis are successfully managed at home. The care of these
      children focuses on accurately assessing hydration status, maintaining adequate
      hydration and caloric intake to promote recovery, educating the family about the
      infection and the treatment plan, and preventing the spread of the infection.

PMID- 1623033
TI  - Omnipaque (iohexol).
AB  - The largest nationwide comparative clinical study evaluated 337,647 patients
      receiving high-osmolar ionic contrast media or low-osmolar nonionic contrast
      media and the incidence of adverse drug reactions. The overall prevalence of
      adverse drug reactions was 12.66% in the ionic contrast media group and 3.13% in
      the nonionic contrast media group. Severe adverse drug reactions occurred in
      0.22% of examinations in the ionic contrast media group and in 0.04% of
      examinations in the nonionic contrast media group. Thus, the use of nonionic
      contrast medium significantly reduces the frequency of severe and potentially
      life-threatening adverse drug reactions to contrast media.

PMID- 1623034
TI  - Listening: what are the listener's responsibilities?

PMID- 1623035
TI  - Giardiasis.

PMID- 1623036
TI  - Overtime problems: moving toward better management.

PMID- 1623037
TI  - Name of organization.

PMID- 1623038
TI  - Evaluation of teleradiology for interpretation of intravenous urograms.
AB  - The diagnostic yield of a commercial teleradiology/picture archiving and
      communication system (ATT-Philips Comm View T/PACS) was evaluated for 100
      urograms. A single image from each examination was digitized (2048 x 1684 x 12
      bit pixels) and transmitted from a satellite hospital over a T-1 line using the
      T/PACS system. The video display of each digitized image was reviewed
      independently by four radiologists. The same four radiologists reviewed the
      original film images at a different time without knowledge of their T/PACS
      interpretation. There was no statistically significant difference in the
      sensitivity for clinical findings between T/PACS (86%) and film (89%). The false
      positive rate, however, was significantly higher with T/PACS than with film (44
      versus 32 false positive findings per 100 films). We conclude that T/PACS of the
      type studied here demonstrates sufficient sensitivity for the detection of
      clinically important urographic findings in the emergency setting. A final
      reading of the original films is still necessary, however, to assure appropriate
      specificity.

PMID- 1623039
TI  - Hardware and software requirements for a picture archiving and communication
      system's diagnostic workstations.
AB  - Electronic systems (picture archiving and communications systems [PACS]) for
      image and multimedia data distribution, archiving, and transmission, represent
      the future of radiology. The workstation is the point of contact between a PACS
      and the radiologist or referring physician. Therefore, the acceptance of PACS is
      highly dependent on workstation functionality and performance. This paper, based
      on our experience in evaluating commercial workstations and on a review of recent
      literature, describes hardware and software requirements for diagnostic
      workstations that could be used for making primary diagnoses in a radiology
      department. Requirements for PACS workstations for use in referring clinics are
      also briefly described. These workstations must be able to handle the large
      volume of images to be viewed efficiently, add new functionality to improve the
      productivity of physicians, technologists, and other health care providers, and
      provide enough flexibility to allow the electronic systems to grow as medical
      imaging technology evolves.

PMID- 1623041
TI  - Automated solid models from serial section images.
AB  - A new method for creating unambiguous and complete boundary representation solid
      models with a hybrid polygonal/nonuniform rational B spline representation was
      developed and tested using computed tomography scans of the wrist. Polygon
      surface approximation was applied to a sequence of parallel planar outlines of
      individual bone elements in the wrist. An automated technique for the
      transformation of edge contours into solid models was implemented. This was
      performed using a custom batch file command sequence generator coupled to a
      commercially available mechanical computer-aided design and engineering software
      system known as I-DEAS (Structural Dynamics Research Corporation, Milford, OH).
      This transformation software allows the use of biomedical scan slice data with a
      solid modeler.

PMID- 1623040
TI  - Clinical impact of picture archiving and communication systems: evaluation of a
      prototype system.
AB  - Opinion surveys were gathered before and 6 months after installation of a
      prototype picture archiving and communication system (PACS) (PACS/1, Siemens
      Medical Systems, Iselin, NJ). Median turnaround times and the percent of delayed
      or missing reports were calculated for 1,026 baseline and 8,438 follow-up studies
      at 6 months. Neuroradiological (neuro) computed tomography (CT) used PACS, while
      neuro magnetic resonance (MR), body CT, and body MR served as controls. The
      opinion surveys showed improved service in all categories, including those not
      directly affected by PACS. PACS images favorably impressed 86% of respondents,
      but most considered the system too slow, unreliable, and the storage capacity too
      low. A majority of 81% recommended against purchase of PACS now. There was an
      overall increase in the median report turnaround time for both neuro CT and the
      controls. Neuro CT showed a 41% decrease in delayed or missing reports, but
      controls also showed similar decreases. The effects of this prototype PACS on
      turnaround time or on report delivery could not be distinguished from section
      wide changes in CT and MR services. Future improvements in PACS should vigorously
      address increased speed, reliability, and storage capacity.

PMID- 1623042
TI  - Chest imaging within the radiology department by means of photostimulable
      phosphor computed radiography: a review.
AB  - Photostimulable phosphor computed radiography has been clinically used outside of
      Japan for more than 8 years. Results of at least 35 quantitative or
      semiquantitative studies have been published so far in which the clinical utility
      of computed radiography (CR) is compared with that of conventional screen/film
      radiography (FR) for the study of the adult chest within the radiology
      department. The results can be summarized as follows: CR is superior to FR in the
      mediastinum, retrocardiac region, and subdiaphragmatic recesses, as well as in
      the evaluation of coronary artery calcifications. CR is reported to be generally
      superior or equivalent in the detection and evaluation of pulmonary nodules and
      larger pulmonary opacities. Equivocal results have been reported for pathologies
      requiring the inspection of fine details, such as interstitial infiltrates or
      pneumothorax. The studies indicate that image processing algorithms dedicated to
      the delineation of specific anatomies or pathologies improve clinical
      performance.

PMID- 1623043
TI  - Digital imaging in pediatric hospitals.
AB  - Thirty-nine of 65 children's hospitals in North America responded to a
      questionnaire regarding their use of digital fluoroscopy and computed radiography
      (CR) systems. Both digital modalities are very favorably rated by institutions
      that have them. Budget constraints limit purchases in the other institutions.
      Picture archiving and communication systems (PACS) networking is not the primary
      reason for installation of digital systems. Fourteen of 39 hospitals have digital
      fluoroscopy and another 9 plan installation within 12 months. The three most
      highly rated benefits of digital fluoroscopy were decreased radiation dose,
      immediate visualization of the acquired image on the monitor, and the ability to
      alter image contrast and density. Four of 39 hospitals have computed radiography.
      The three most highly rated benefits of computed radiography were more stable
      image quality, ability to alter contrast and density, and PACS networking.

PMID- 1623044
TI  - A strategy for the progressive introduction of picture archiving and
      communication systems for a radiology department.
AB  - An example of strategy for the progressive introduction of picture archiving
      communication systems (PACS) into a complete global image management system for a
      Department of Radiology has been developed and quantitatively examined. In
      general the strategy is based on the earliest reasonable implementation
      consistent with the evolution of the usage patterns and the state of the
      technology and its economics. The progressive implementation schedule and the
      associated numerical estimates of memory requirements in this paper are based on
      a series of qualitative and quantitative assumptions. The development of the
      projected strategy and schedule suggests that a time period of 1 1/2 to 2 decades
      would be required for an aggressive institution to achieve an operational global
      PACS system.

PMID- 1623045
TI  - Neural network synthesis of spin echo multiecho sequences.
AB  - Spin echo multiecho sequences are not frequently used in clinical practice,
      because they allow the observation of one single slice, imaged at different echo
      times, for each acquisition. To limit examination time, multislice sequences that
      include only images derived from one or two echoes are usually acquired.
      Nevertheless, the strong T2 dependence of multiecho sequences can be used
      effectively to enhance the contrast between tissues with different T2 and to
      gather useful diagnostic information. Artificial neural networks can offer new
      interesting facilities to the radiologist. In fact, the learning capabilities of
      neural networks allow them to extract the prototypical behavior of a system from
      a set of examples. After learning, artificial neural networks can emulate the
      system behavior even in the presence of new inputs, as far as these are not too
      different from those included in the training set. A conveniently trained neural
      network can synthesize a multiecho sequence for each slice of a multislice
      sequence, requiring only two images for each slice to achieve reliable results.
      When compared with a true multiecho sequence, the images generated by the network
      preserve the contrast characteristics of the original ones and have a better
      signal-to-noise (SNR) ratio. In this paper we report the results achieved by
      using a neural network to reconstruct synthetic spin echo multiecho images of the
      brain.

PMID- 1623046
TI  - Tools for medical informatics.
AB  - Informatics uses words, terms and expressions of various scientific disciplines.
      The proposed tools, hermeneutics and phenomenology, generate a basis for quality
      control by establishing the authenticity and validity of such expressions.
      Without such tools there is the danger that poorly defined expressions obscure
      true meaning and prevent progress. The method is demonstrated on "objects" as
      used in "object oriented programming" and on "open systems" as used in the
      International Standards Organization model for "open system interconnection."

PMID- 1623047
TI  - [The prevalence of malnutrition in hemodialysis].
AB  - Uremic patients undergoing hemodialysis are often catabolic and malnourished. To
      treat malnutrition effectively, a preliminary nutritional assessment is needed.
      In a group of 61 chronic uremic patients undergoing maintenance hemodialysis, the
      authors evaluated the nutritional status with the following indices: 1)
      assessment of the somatic fat and protein compartments by means of anthropometric
      measurements (body mass index: BMI, triceps skinfold thickness: TST, and arm
      muscle circumference: AMC); 2) assessment of the visceral protein compartment
      (serum albumin); 3) assessment of cell-mediated immunity by means of skin tests
      and 4) assessment of the dietary intake of nutrients with dietary diaries. BMI
      and TST were subnormal in 57 and 72% of patients, respectively. CMB and albumin
      were normal in most. The protein intake was normal, whereas the energy intake
      tended to be low. Correlations were observed among different anthropomorphic
      measurements and dietary intake of nutrients. We conclude that there is a
      tendency to caloric, and in a lower degree protein malnutrition in our patients.

PMID- 1623048
TI  - [The nutritional status and immunological situation of cancer patients].
AB  - A study was performed on the nutritional state of a sample of 138 patients with
      digestive and extradigestive neoplasias. The study protocol was based on
      anthropometric, analytical and immunological tests. The main criteria for
      malnutrition were as follows: loss of 10% or more in normal weight and/or albumen
      levels of less than 3.5 gr/dl. A global malnutrition percentage of 56.5% was
      obtained. The highest malnutrition percentages were found among patients with
      neoplasia of the oesophagus (78.9%) and the lowest in neoplasias of the breast
      (9.1%). From the nutritional standpoint, neoplasias of the rectum showed an
      extradigestive behaviour, with a low malnutrition percentage (40%) compared to
      digestive tumors. The global malnutrition level for the sample studied was 56.6%.
      The muscular compartment was the most affected in cases of malnutrition. In the
      PCHR results, no evidence of the effect of the nutritional state on the
      alteration of these was recorded (Chi 2 = 6.42, p = 0.207).

PMID- 1623049
TI  - [Parenteral nutrition: a utilization study in a general hospital].
AB  - A follow-up of 116 patients initiating parenteral nutrition was performed from
      December 1990 to March 1991 (average of 18 patients on parenteral nutrition per
      day, which accounted for a prevalence of 2% compared to total patients admitted),
      in order to determine a series of characteristics related to the use of
      parenteral nutrition in our hospital, by means of obtaining concrete, updated
      information. With regard to the patients, it was observed that 37% of these were
      suffering from chronic ailments, with more or less incapacitating pathologies.
      The nutritional state prior to parenteral nutrition was normal in 53% of cases,
      and the most common reasons for admittance to hospital were neoplasias (27%) and
      digestive pathology (18%). 42% of the patients were admitted to the ICU and 34%
      to General Surgery. Indication for parenteral nutrition was intestinal pathology
      in 23% of cases, followed by pancreatic pathology in 16% of cases and pathology
      of the oesophagus in 10%; in 45% of cases, it was commenced during the
      postoperative period. With regard to the composition of the parenteral nutrition,
      we should mention the use of polyols instead of glucose in 80% of diabetic
      patients and 75% of patients with pancreatitis, the widespread use of mixture of
      50% medium and long chain triglycerides and the use of amino acid solutions with
      20% branched chain in most patients, both in situations of stress and
      maintenance.

PMID- 1623050
TI  - [The consumption of commercial foods in childhood. The influence of a nutritional
      information program].
AB  - In order to perform an in-depth study on food standards among school children and
      evaluate the effect of a nutritional educational programme on eating habits, an
      analysis was made of the data on the intake of foods over a period of 1,890 days,
      in 187 school children from 2 schools in the Leganes-Fuenlabrada area. The
      consumption of global and stratified rations was quantified based on age,
      commercial foods (buns, fried foods and sweets) accounting for a large part of
      the children's diet, as well as dairy products, vegetables, fruit and fish,
      representing basic foodstuffs supposed to form part of their diet. The
      consumption of these was compared in two stages, before and after receiving the
      educational programme. It was observed that there was an excessive consumption of
      foodstuffs considered as lacking in nutritional value (commercial), which
      increased with age and a lack of natural foods evaluated in their food standards.
      We also observed that the applied health intervention modified the consumption of
      these foods recently incorporated into the children's diet, without achieving
      results with regard to family eating habits.

PMID- 1623051
TI  - [The development of an informational logic support for aiding diagnosis and
      treatment. The Edecan-Med program. I. The assessment of nutritional status].
AB  - We present the elaboration of an informatic program (Informatic Logic Support
      [SLI]) as a clinical help in diagnosis and treatment, for use by compatible
      computers PC. In this first part dedicated to artificial nutrition, we explain
      the scientific support, the capture of anthropometric and biochemical data, the
      processing, the results and the conclusions delivered by the computer that inform
      us about all the calculated nutritional parameters the type of malnutrition, the
      surgical risk of morbimortality (nutritional prognostic), and the caloric needs.

PMID- 1623052
TI  - [A comparative study of 5 infusion pumps: an evaluation of their suitability for
      administering parenteral nutrition].
AB  - To facilitate the control of administering parenteral nutrition (PN), the
      tendency is to replace traditional infusion equipment with infusion pumps. The
      aim of this study is to determine the characteristics that a pump should have for
      infusing PN mixtures and, based on these, to evaluate five models available on
      the market. The pumps evaluated, all with volumetric programming were: Becton
      Dickinson VIP II (Prim); Life-Care Pump Model 4 (Abbot-Shaw); Infusomat Secura
      1.000 (Braun); Flo-gard (tm) 6,200 (Baxter) and IVAC-591 (Ivac). The following
      method was used: a) Definition of 16 basic requisites and 7 secondary requisites
      considered necessary in a PN pump, in accordance with the following criteria:
      safety, practical usage, comfort and hospital circuits. b) Review and checking of
      the technical reports on each pump. c) Laboratory tests simulating PN infusion,
      evaluating the regularity and precision of the infusion speed, and d) Subjective
      evaluation survey. All the pumps under study complied with the basic requisites.
      There were differences in the subjective evaluation, although with regard to all
      concepts and models a score of over 2.5 was reached in a scale of 0 to 5. The
      highest and lowest values with regard to regularity and precision were within the
      following ranges: +/- 0.6 ml/h(-)+/- 0.0 ml/h and + 3.4%(-)-1.6% respectively,
      and no instance of values outside the established ones was detected. The pumps
      only partly complied with the secondary requisites. Finally, the criteria for
      defining the most significant requisites was reviewed, based on the services
      offered by the existing pumps, as well as techniques for determining regularity
      and precision.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623053
TI  - [The effect of the customary intake of energy and nutrients on the nutritional
      status of schoolchildren 6 to 15 years old].
AB  - An investigation was performed with regard to the effect of consuming energy and
      energetic nutrients, cholesterol and fibre in 187 children aged from 6 to 15
      years in the Leganes-Fuenlabrada Health Area (Madrid) on the build and
      nutritional state of the children. An excessive global intake of calories, total
      and saturated fats, cholesterol and proteins was observed, and a deficit of
      carbohydrates, with a corresponding loss of nutritional balance. It should be
      mentioned that 74% of the children studied could be considered normal from the
      nutritional standpoint, with 18% of overweight children and 8% of children
      suffering from malnutrition. The results also provided information on the effect
      of the consumption of energy and fats on the weight and obesity of the children,
      as well as the interesting relationship between the habitual intake of proteins
      and carbohydrates on the children's build.

PMID- 1623054
TI  - A long-term clinical trial of interferon alpha-therapy in essential
      thrombocythemia.
AB  - In a prospective clinical trial involving six patients suffering from essential
      thrombocythemia (ET), recombinant human interferon alpha 2b significantly and
      consistently lowered highly elevated peripheral platelet numbers over long time
      periods. One patient has now been on continuous treatment for 4 years. During the
      treatment phase none of the patients suffered from bleeding episodes, thrombosis
      or disturbances of the microcirculation. The interferon maintenance dose varies
      considerably from patient to patient, but it is usually much lower than the
      induction dose. One of the patients had to be withdrawn from the study due to
      interferon-specific chronic toxicity concomitant with the development of non
      neutralizing interferon antibodies. With the exception of one patient, stopping
      interferon treatment led to an increase in peripheral platelet numbers of up to
      one million cells per microliter of blood within 4 to 12 weeks. We conclude that
      interferon alpha can correct peripheral thrombocytosis in selected patients with
      essential thrombocythemia over a period of years and prevent morbidity
      attributable to this disease.

PMID- 1623055
TI  - Differences of cellular composition and adhesion molecule expression in
      "leukemic" as compared with "normal" human long-term bone marrow cultures.
AB  - Human long-term bone marrow cultures (HLTBMCs) were established with bone marrow
      samples collected from 15 patients with acute myeloid leukemia (AML) and compared
      with HLTBMCs from eight healthy volunteers. During 6 weeks of culture, the
      cellular composition of HLTBMCs was quantitatively studied. The cells of the
      HLTBMCs were divided into three main categories: fibroblasts, macrophages, and
      'other cells' (endothelial cells, hematopoietic cells and undefined cells).
      HLTBMCs derived from healthy volunteers demonstrated a very consistent
      development. The number of fibroblasts increased during culture and the number of
      macrophages decreased, resulting in a steady state after 3 weeks of culture. In
      contrast, HLTBMCs derived from patients with AML showed a strikingly different
      pattern of irregular development and a steady state was not reached under our
      conditions. The APAAP technique was used to demonstrate expression of adhesion
      molecules. VLA2, VLA5, VLA6, LFA1, Mac1, p150/95, beta 2-chain, HCAM, ICAM1,
      NCAM, and VCAM1 were more expressed on 'normal' as compared with 'leukemic' bone
      marrow stromal cells, although this reached significance only for beta 2-chain
      and NCAM. VLA1, 3, and 4 were expressed in a higher percentage on 'leukemic'
      stroma (not significant). More expression was seen on 'normal' as opposed to
      'leukemic' macrophages for the adhesion molecules tested, except for VLA5. The
      differences reached significance for the majority of molecules tested. It is
      concluded that striking differences exist in cellular composition and adhesion
      molecule expression between HLTBMCs from healthy individuals and those from
      patients with AML. This may have an impact on the pathogenesis of AML.

PMID- 1623056
TI  - Effect of cimetidine on burst-promoting activity of normal T lymphocytes.
AB  - The effect of cimetidine, an inhibitor of suppressor T lymphocytes, on the burst
      promoting activity (BPA) of normal T lymphocytes has been studied. Cimetidine has
      been shown to increase the BPA of normal T lymphocytes, both when added to the
      culture and when T lymphocytes were preincubated for 1 h with it. Cimetidine had
      no direct effect on the in vitro growth of burst-forming units (BFU-E). Our
      results show that CD8 suppressor T lymphocytes inhibit the in vitro growth of BFU
      E in normal conditions, either directly or through inhibition of BPA of CD4
      helper T lymphocytes. Cimetidine has proved to be a useful tool for investigating
      the hematological role of T-lymphocyte subsets in normal and pathological
      conditions.

PMID- 1623057
TI  - Improved microbioassay for plasma erythropoietin based on CFU-E colony formation.
AB  - We examined the conditions necessary for performing a reliable erythropoietin
      (EPO) assay based on CFU-E colony formation in fetal mouse liver cell (FMLC)
      microcultures using 96-well microtiter plates. Both linearity of colony numbers
      with the number of cells plated and comparison among the colony ratios at various
      densities of seeding cells indicated that the colonies originated from a single
      progenitor cell when 7500 or fewer cells were plated into individual microtiter
      wells. About a twofold CFU-E enrichment in 12- to 13-day FMLC was achieved by
      Ficoll-Paque centrifugation. Plasma treated with acid-boiling stimulated the
      colony formation most and contained no colony inhibitor. Dose-response curve for
      the plasma was parallel to the EPO standard curve. The "erythroid colony
      stimulating activity" in the plasma was additive to that in the standard EPO, and
      was completely neutralized by a monoclonal antibody against recombinant human
      EPO. Using the assay procedure thus established, plasma EPO titer was determined
      in normal subjects, in patients with nonuremic anemia and polycythemia vera, and
      in dialysis patients with chronic renal failure. The use of different
      preparations of standard EPO resulted in a significant difference in the titers
      because their dose-response curves differed from one another. An inverse
      relationship was found between EPO titers and hemoglobin concentrations in the
      nonuremic anemic patients, but not in the dialysis patients with about one half
      the normal EPO level.

PMID- 1623059
TI  - Chronic systemic candidiasis in acute leukemia.
AB  - In the past few years a new syndrome of invasive Candida infection, the so-called
      hepatosplenic or chronic systemic candidiasis (CSC), has been recognized with
      increasing frequency in neutropenic patients. From January 1985 to December 1990,
      ten of 305 acute leukemia (AL) patients treated at our institution were diagnosed
      as having CSC. In contrast, during the same period this type of Candida infection
      was not observed in any patient with hematological diseases other than AL treated
      in our center, including 277 patients who underwent bone marrow transplantation.
      All patients with CSC had fever and hepatomegaly, and five complained of
      abdominal pain. Seven patients had neutrophilic leukocytosis and six an increased
      serum alkaline phosphatase activity. Abdominal computed tomography and ultrasound
      study showed typical lesions in eight and seven patients, respectively. In four
      patients a laparoscopy-guided needle liver biopsy displayed yellowish nodules on
      the liver surface, and the histologic study revealed large granulomas with yeasts
      and pseudohyphae. All patients were given amphotericin B (mean: 4.6 g, range: 1
      12.5 g) and 5-fluorocytosine, and five received fluconazole. No patient died as a
      direct consequence of CSC and in six the infection resolved. Finally, once
      controlled, the infectious complication did not preclude subsequent intensive
      antileukemic therapy, including bone marrow transplantation.

PMID- 1623058
TI  - The growth capacity of hematopoietic progenitor cells in severe neutropenia
      induced by famotidine.
AB  - In four cases of severe neutropenia of unknown origin we found a strong
      inhibition of the growth of granulocyte-macrophage (GM) progenitor cells. The
      development of GM colonies in culture (GM-CFU-c) was more than 80% reduced in
      comparison to the control group. In particular, the interleukin 3-(IL-3) and
      granulocyte macrophage colony-stimulating factor-(GM-CSF) dependent growth was
      affected; a combination of growth factors (IL-3, GM-CSF, and G-CSF, the
      granulocyte colony-stimulating factor) resulted in a less reduced growth. The
      findings were primarily compatible with drug-induced bone marrow failure. Among
      the medications given to the patients, famotidine, an H2-receptor blocker, was
      discussed as an agent which possibly triggers off this process. After the
      withdrawal of famotidine, in three cases a continual increase of the growth of GM
      precursors was detected, reaching the normal level 7-17 days later. In one case,
      further investigations of the progenitor cells could not be carried out due to
      the death of the patient, but the rapid increase of neutrophils in the peripheral
      blood after withdrawal of famotidine pointed to the recovery of hematopoiesis. In
      vitro studies showed that famotidine, depending on the dose, inhibits the single
      growth factor-dependent colony growth (IL-3, GM-CSF, or G-CSF) of bone marrow
      progenitors from a concentration as low as 10 micrograms/ml. With the combination
      of all three growth factors only slight inhibitory effects were detectable (up to
      150 micrograms/ml famotidine). These results indicate that famotidine, in common
      with other H2-receptor antagonists, can affect hematopoietic progenitor cells.
      However, the plasma concentration of famotidine normally used in ulcer therapy
      does not seem to influence the hematopoiesis. Apparently, the progenitor cells of
      only a few patients possess a higher sensitivity to the blockade of H2-receptors
      at this concentration of famotidine. This was demonstrated in one case (patient
      3) 2 years after the patient had recovered from famotidine-induced neutropenia.
      The growth of peripheral myeloid, erythroid, and multilineage progenitor cells of
      this patient was remarkably reduced even at famotidine concentrations of 0.1-5.0
      micron/ml whereas in the control group no inhibition was detected at these
      famotidine concentrations. Again, the IL-3-dependent colony formation was more
      affected than in the case of the combination of IL-3, GM-CSF, and G-CSF. After
      the removal of accessory cells the inhibitory effect of famotidine persisted,
      demonstrating that accessory cells do not play a major role in this process.

PMID- 1623060
TI  - Thrombotic thrombocytopenic purpura in early pregnancy with maternal and fetal
      survival.
AB  - Thrombotic thrombocytopenic purpura (TTP) is a hematologic disorder which is
      clinically characterized by thrombocytopenia, microangiopathic hemolytic anemia,
      fever, neurologic symptoms, and cardiac and renal involvement. The pathogenic
      mechanisms of this disease are poorly understood. It is well known that TTP is
      associated with pregnancy and that prognosis for the mother and child is poor. We
      present the first case of a severe TTP diagnosed in the first trimester of
      pregnancy (13th week of gestation) with maternal survival and birth of a healthy
      child which required continuous and intensive treatment with plasma therapy until
      delivery. During a period of 24 weeks several attempts to discontinue plasma
      therapy failed because of continuous active disease, and it became evident that
      plasma infusions were not as effective as plasma exchanges. The fact that the
      patient entered into remission soon after delivery of a healthy child by cesarean
      section in the 37th gestational week shows that in this case pregnancy activated
      an unknown factor which does not cross the placenta and which can be removed by
      plasmapheresis.

PMID- 1623061
TI  - Use of a synthetic protease inhibitor for the treatment of L-asparaginase-induced
      acute pancreatitis complicated by disseminated intravascular coagulation.
AB  - In two patients receiving L-asparaginase therapy, severe acute pancreatitis
      complicated by disseminated intravascular coagulation (DIC) developed. In both
      cases it was successfully treated with continuous infusion of a synthetic
      protease inhibitor, nafamostat mesilate. In this report, we briefly discuss the
      clinical efficacy of the synthetic protease inhibitor in treating such cases.

PMID- 1623062
TI  - Career alternatives. The role of the case manager.

PMID- 1623063
TI  - Make competition your friend.

PMID- 1623064
TI  - Timeline helps put case in perspective.

PMID- 1623065
TI  - Admissibility of expert evidence in toxic tort cases.

PMID- 1623066
TI  - CPITN application in regular dental practice.
AB  - The periodontal status of 8862 dentulous and partially dentulous inhabitants of
      the Federal Republic of Germany was investigated in various dental practices,
      using the CPITN, developed by the World Health Organization. The results show
      that a total of only 4.3% of those examined have a healthy periodontal apparatus
      and thus require no periodontal treatment. At least detailed oral hygiene
      instruction needs to be given to 95.7% of all subjects. Furthermore, 80% patients
      with periodontal disease require scaling or root planing, and 10% of them require
      periodontal surgery. The treatment of shallow gingival pocketing (CPITN 3) is
      predominant in every age group, and every fifth patient aged 35 years or more is
      need of periodontal surgery. This high frequency rate of periodontal disease
      illustrates the urgent necessity in regular dental practice for each and every
      patient to undergo periodontal screening. Such screening, based on the time
      saving CPITN, is to be recommended as it ensures fast, reliable determination of
      the periodontal status of each individual patient and the treatment needs
      involved.

PMID- 1623067
TI  - [The stereognathograph PC--test results with the new version of the device].
AB  - The PC stereognathograph was investigated for measurement errors in laboratory
      experiments on an optical bench as well as on an articulator. The values obtained
      were compared with the data of the predecessor model. A substantial reduction in
      the linearity in transverse measurements has been effected, so that these are now
      within acceptable limits. A variation of linearity factors which can be avoided
      by electronic fine adjustment still arises owing to incongruence of the six
      measurement channels. The hinge axis can be localized very well on the
      articulator. By and large, the announced correction of the projection error which
      we have demanded has not been implemented up to now. In view of the clear imaging
      of condylar movement in space and time on the monitor and the adequate precision
      of the clinical measurements effected, the PC stereognathograph appears to be a
      valuable system for instrumental diagnostics.

PMID- 1623068
TI  - [The experiences of 10 years of an interdisciplinary dysgnathia consultation].
AB  - We regard the down-fracture technique in maxillary osteotomy of the Le Fort-I
      plane, the possibility of simultaneous bimaxillary procedure as well as
      adaptation osteotomy in the maxillary region, semirigid osteosynthesis technique
      with miniplates and miniscrews and consistent interdisciplinary cooperation in
      planning and therapy as the most important advances during the last ten years. A
      joint dysgnathia clinic has proved to be of great benefit. Sagittal and vertical
      recurrences are avoided in particular using the bimaxillary procedure and a
      timely and consistent orthodontic follow-up treatment. The quality of the
      definitive result crucially depends on the consistency and quality of the
      immediate postoperative orthodontic follow-up treatment.

PMID- 1623070
TI  - [The therapy and prognosis of birth-injury-related joint dislocations and
      fractures].

PMID- 1623069
TI  - [Histological study of the resorbed dental crowns of impacted wisdom teeth].
AB  - Undecalcified sections of 31 impacted third molars are examined histologically
      for signs of resorption. Resorption starts at small spots in enamel, progresses
      to dentin and may even penetrate the pulp cavity. The incidence of such
      resorption processes increases after the age fifty. A prerequisite for resorption
      is the loss of reduced ameloblastic epithelium. Histological examination reveals
      multinuclear giant cells and apposition of spongious bone to destroyed dental
      substances. The results is dental ankylosis. Because partially resorbed teeth or
      ankylosed teeth may lead to serious surgical difficulties, impacted wisdom teeth
      without any clinical symptoms and without pathologic radiological findings should
      always be extracted at a young age.

PMID- 1623071
TI  - [Individual plaque flora determination in periodontal diseases. Methods and
      standardization].
AB  - The dental plaque of 15 patients with gingivitis and of 15 patients with marginal
      periodontitis was won by means of two different methods of isolation and
      sampling. Either the plaque was sampled by a scaler with and without covering the
      crown. The estimation of plaque-microflora was done by microscopical and cultural
      bacteriological methods. Differences in the composition of plaque-microflora
      could be found in dependence of method used in isolation and sampling. Also
      differences in bacterial colonisation of different regions were found using the
      same technique of sampling. The subgingival plaque in marginal periodontitis was
      different of the plaque in gingivitis. In plaque-microflora of periodontitis the
      percentage of gram-positive cocci and rods was decreasing, the percentage of gram
      negative and mobile bacteria was increasing compared with the bacterial flora in
      gingivitis. In the subgingival plaque in gingivitis streptococci and actinomyces
      were the predominant bacteria.

PMID- 1623072
TI  - Emergence of Enterococcus as a significant pathogen.

PMID- 1623074
TI  - The disappearance of multiresistant Staphylococcus aureus in Denmark: changes in
      strains of the 83A complex between 1969 and 1989.
AB  - During the 1960s multiresistant strains of Staphylococcus aureus were problematic
      in Denmark and other countries. An analysis of the phage types and antibiotic
      resistance patterns of S. aureus strains collected from approximately 20,000
      Danish patients per year has given us a general picture of the evolution of S.
      aureus in Denmark during the last 30 years. Multiresistant S. aureus (i.e.,
      strains resistant to penicillin, streptomycin, and tetracycline and often to
      methicillin and erythromycin as well) belonged mostly to the 83A complex, a
      relatively homogeneous subset of group III strains that can be further divided
      into six subtypes. The disappearance of multiresistant strains in Denmark began
      with a decline in the frequency of isolation of the most resistant subtypes,
      which was followed by a gradual decrease in the resistance of all 83A subtypes;
      thus strains of the 83A complex ultimately became no more resistant than other
      strains. As the proportion of strains of S. aureus accounted for by the 83A
      complex declined from 24% in 1969 to 6% by the late 1980s, this complex was
      replaced by strains of type 95, the 94,96 complex, and group II, all of which
      only rarely show resistance to multiple agents.

PMID- 1623073
TI  - Management of occupational exposures to bloodborne pathogens: hepatitis B virus,
      hepatitis C virus, and human immunodeficiency virus.
AB  - Being a health care worker in today's world is not without risks. Accidental
      exposure to blood carries with it a definite risk of transmission of infection by
      various bloodborne pathogens, especially the hepatitis B, hepatitis C, and human
      immunodeficiency viruses. While infectious disease specialists, hospital
      epidemiologists, and infection control clinicians can develop many important
      strategies to reduce this risk--aggressive training, utilization of safer
      needles, identification of high-risk activities, and efficient disposal systems-
      their overriding responsibility is to design and implement a comprehensive plan
      for expeditiously and effectively dealing with accidental exposures when they
      occur. Among other things, the plan must address a number of key issues,
      including testing, administering postexposure prophylaxis, providing short- and
      long-term follow-up care, and, particularly, counseling for helping the health
      care worker deal with the tremendous anxiety associated with the injury. Drs.
      Julie L. Gerberding of the University of California, San Francisco, and San
      Francisco General Hospital and David K. Henderson of the National Institutes of
      Health and the Warren G. Magnuson Clinical Center have both made significant
      contributions in this area; in this month's AIDS Commentary they discuss the
      essential elements of such a plan.

PMID- 1623075
TI  - Varied presentations and responses to treatment of infections caused by
      Mycobacterium haemophilum in patients with AIDS.
AB  - We describe three patients with AIDS who developed clinically significant
      infection with Mycobacterium haemophilum. One patient had skin and bone
      involvement and suspected laryngeal involvement; the second had extensive
      abdominal adenopathy with partial bowel obstruction; and the third presented with
      limited skin involvement. Each patient responded transiently to antimycobacterial
      therapy, but disease recurred and progressed in all three cases. Recovery of M.
      haemophilum requires a high level of clinical suspicion and special handling of
      mycobacterial cultures by the microbiology laboratory, including cultivation on
      enriched chocolate agar or heme-supplemented media and incubation at 30 degrees C
      for up to 8 weeks. Characteristic patterns of drug susceptibility for this
      organism have been only partially defined. Reported responses to
      antimycobacterial therapy in AIDS patients with M. haemophilum infection have
      been poor, and the optimal therapeutic regimen is not yet known. The prognosis
      for recovery appears to depend heavily on host-related factors, particularly the
      degree of immunosuppression.

PMID- 1623076
TI  - Septicemia and shock syndrome due to viridans streptococci: a case-control study
      of predisposing factors.
AB  - Between 1972 and 1989, the incidence of viridans streptococcal bacteremia at the
      University of Texas M. D. Anderson Cancer Center in Houston increased from one
      case per 10,000 admissions to 47 cases per 10,000 admissions (P less than .0001).
      A shock syndrome characterized by hypotension, rash, palmar desquamation, adult
      respiratory distress syndrome, and occasionally death developed in 26% of cases
      of streptococcal septicemia but in only 4% of cases of septicemia involving other
      gram-positive bacteria (P = .0005). The risk of streptococcal infection increased
      with the prophylactic administration of trimethoprim-sulfamethoxazole or a
      fluoroquinolone (P less than .0001) and with profound neutropenia (P less than
      .0001). Treatment of chemotherapy-induced gastritis with antacids or with
      histamine type 2 (H2) antagonists was associated with a sevenfold increase in
      risk (P less than .001), while sucralfate therapy did not increase risk (P =
      .65). Streptococcal infection may result from gastric overgrowth of organisms
      resistant to trimethoprim-sulfamethoxazole in an antacid- or H2 antagonist
      induced alkaline environment, with the gastrointestinal tract ulceration caused
      by antineoplastic therapy providing a convenient portal of entry. In patients
      receiving chemotherapy, replacement of antacids or H2 antagonists by an acid
      sparing regimen should be considered to preserve the natural acidic barrier to
      infection.

PMID- 1623077
TI  - Infection caused by Mycobacterium chelonae: a diagnostic and therapeutic problem
      in the neutropenic patient.
AB  - Mycobacterium chelonae, a rapidly growing species, is a significant cause of
      fever in neutropenic patients. We describe three febrile neutropenic patients at
      the Royal Free Hospital from whom this organism was isolated on several
      occasions. The condition of the first patient improved as the neutrophil count
      recovered. The second patient developed pulmonary disease and required surgical
      resection of a pulmonary lesion. The third patient, who had rapidly progressive,
      diffuse pulmonary disease, responded to an antibiotic regimen including
      erythromycin and ciprofloxacin. Both our findings and reports in the literature
      suggest that neutropenia may be a major risk factor for disseminated infection
      due to M. chelonae and that treatment is effective only after the recovery of the
      neutrophil count.

PMID- 1623078
TI  - Gram-negative sepsis and the adult respiratory distress syndrome.
AB  - Gram-negative sepsis has dramatically increased in frequency throughout the
      twentieth century in the United States. Currently, approximately 200,000 patients
      develop gram-negative sepsis each year in this country. Of these, about one
      quarter develop the adult respiratory distress syndrome (ARDS). Among these
      critically ill patients, mortality is estimated at 60%-90%. In the complex series
      of events leading to acute lung injury in gram-negative sepsis, endotoxin is the
      proximal mediator. Although endotoxin may be capable of causing direct injury to
      the pulmonary endothelium, its primary role is as a trigger activating
      inflammatory agents, including complement, neutrophils, and platelets, and
      inducing the production of cytokines and arachidonic acid metabolites. The end
      results are impairment of the endothelial barrier, diffusely increased capillary
      permeability, and adherence of neutrophils to the endothelium with subsequent
      migration into the tissues. The consequent clinical syndrome is one of acute
      respiratory distress with pulmonary edema, poorly compliant lungs, and refractory
      hypoxemia. Endothelial injury often becomes widespread, leading to the failure of
      multiple organs, including the kidneys, brain, intestine, and liver. Conventional
      therapy consists of supplemental oxygen, positive end-expiratory pressure,
      inotropic agents, fluid management, and antibiotics aimed at the offending
      pathogen. Recent discoveries regarding the mediators of sepsis as well as the
      expansion of the biotechnological armamentarium have provided clinicians with a
      plethora of new tools with which to manipulate the host's inflammatory response.
      The challenge for the next decade will be to ensure the safety, efficacy, and
      cost-effective use of these expensive but potentially lifesaving
      immunomodulators, singly or in combination, as adjuvant therapy.

PMID- 1623079
TI  - Disseminated infection with Mycobacterium gordonae: report of a case and critical
      review of the literature.
AB  - Mycobacterium gordonae is only rarely a cause of infection despite its ubiquity
      in the environment. We describe an 11-year-old girl with disseminated infection
      due to M. gordonae whose course was complicated by renal failure requiring
      hemodialysis but who recovered after 15 months of chemotherapy. In a literature
      search we identified 23 additional cases of infection attributed to M. gordonae,
      with involvement of the lungs (eight), soft tissue (seven), the peritoneal cavity
      (three), the cornea (one), and with disseminated disease (five patients,
      including ours). Two patients were infected with human immunodeficiency virus. We
      assessed the patterns of infection characteristic of each site and the antibiotic
      sensitivities of the isolates. Adequate documentation of M. gordonae infection
      (e.g., amount of growth per culture, detection of specific biochemical
      characteristics, and confirmation of the organism's identity by a reference
      center) was lacking in many reports. M. gordonae should not automatically be
      dismissed as a contaminant when isolated from clinical material. Additional
      studies are required to establish the extent of this organism's pathogenic role.

PMID- 1623080
TI  - Infection with Borna disease virus: molecular and immunobiological
      characterization of the agent.
AB  - Borna disease virus (BDV), which seems to be distinct from all other known
      viruses, exhibits a unique mechanism of pathogenesis. This review highlights
      several aspects of the biology of infection with this virus and summarizes the
      preliminary characterization of the agent. Studies on BDV may help to illuminate
      several important areas of neurobiology, including the mechanisms regulating the
      replication of a new type of RNA virus in the nuclei of neural cells, the
      neuroinvasiveness and neurotropism of such viruses, their T cell-mediated
      immunopathology, tolerance in newborn animals to persistent viral infection of
      the central nervous system, and behavioral diseases and eating disorders induced
      by such agents.

PMID- 1623081
TI  - Antimicrobial treatment of orthopedic implant-related infections with rifampin
      combinations.
AB  - The purpose of this prospective clinical study is to evaluate the role of
      combination chemotherapy with rifampin in the treatment of orthopedic device
      related infections in which the implant could not be removed. Eleven patients
      with orthopedic implant-related infections due to staphylococci or streptococci
      were treated with the implant in situ. Each antimicrobial regimen included
      rifampin in combination with a beta-lactam antibiotic or ciprofloxacin. The
      median duration of treatment with rifampin was 86 days (range, 15-336 days) with
      a median follow-up of greater than 24 months after cessation of therapy.
      Treatment was successful for 82% of patients. Failures were associated with
      documented inappropriate treatment. These preliminary clinical data are supported
      by data from in vitro studies and animal experiments. Combination therapy with
      rifampin, in particular rifampin and a quinolone, should be considered for
      patients with orthopedic implant-related infections if the implant cannot be
      removed.

PMID- 1623082
TI  - Fever in a couple vacationing in the mountains of southern California.

PMID- 1623083
TI  - Optimal duration of therapy for catheter-related Staphylococcus aureus
      bacteremia.

PMID- 1623084
TI  - Meningitis caused by group B streptococcus in association with cerebrospinal
      rhinorrhea.

PMID- 1623085
TI  - Immunity to measles during pregnancy.

PMID- 1623086
TI  - Mixed bacterial meningitis associated with CSF leak.

PMID- 1623087
TI  - Infections due to Stomatococcus mucilaginosus: report of two new cases and
      review.

PMID- 1623088
TI  - Splenic tuberculous abscess in patients positive for human immunodeficiency
      virus: report of two cases and review.

PMID- 1623089
TI  - Pasteurella multocida infection after a Tasmanian devil bite.

PMID- 1623090
TI  - Response to treatment of infection due to Mycobacterium avium complex with
      trimethoprim-sulfamethoxazole.

PMID- 1623091
TI  - Exchange transfusion as an adjunct to the treatment of severe falciparum malaria.

PMID- 1623092
TI  - Herpes zoster-induced acute hyperparathyroid crisis.

PMID- 1623093
TI  - Acute bacterial gastroenteritis caused by Hafnia alvei.

PMID- 1623094
TI  - [Reactive thrombocytosis verses primary thrombocythemia].

PMID- 1623095
TI  - [Clinical-endoscopic-histological correlations in gastric pathology. I].
AB  - We have conducted a blind cross-selectional study with 150 consecutive patients
      undergoing fibrogastroscopy and biopsy of the antral mucosa. The endoscopic
      sensitivity for the diagnosis of the several types of gastritis, is low (63%),
      although this technique is highly sensitive for other types of pathology.
      Consequently, we conclude that, in all endoscopic explorations, at least one
      biopsy of the antral mucosa must be done, given the anatomopathological
      definition of gastritis. In addition, the clinical use of this term should be
      restricted to the histologically demonstrated cases.

PMID- 1623096
TI  - [Effectiveness of the concentrator as a supply source in home oxygen therapy].
AB  - The oxygen concentrator is an effective supply source in home oxygen-therapy
      (HO). In order to study the effectivity of the concentrator in HO, we visited at
      home 31 patients using the concentrator as the only oxygen supply source in the
      exit gas and counted the hours of concentrator usage. Only 13 concentrators
      (41.9%) supplied a percentage of oxygen higher than 87% at a flow of two liters
      per minute. In three cases (9.7%), sporadic control measures of the percentage of
      oxygen in the exit gas were being taken and only four patients (12.9%) said that
      these controls were made monthly. The concentrator did not supply the adequate
      percentage of oxygen in 12 out of the 29 patients correctly taking the HO, so the
      effectivity of the treatment can only be expected in 28.6% of studied cases. The
      concentrator operates well under ideal conditions, but potential breakdowns in
      standard conditions of use must be considered. The efficiency of the HO with
      concentrator in our environment is very low, but it can be improved with regular
      controls of the concentrators or the introduction of devices warning the patient
      when they detect a reduction of the percentage of oxygen in the exit gas.

PMID- 1623097
TI  - [What is the normal threshold of glycemia in our elderly?].
AB  - The aim of this paper is to study the evolution of basal glucemia and TTOG with
      age, as well as the prevalence of diabetes in different age groups. A cross
      sectional descriptive study was designed, with a polystratified random sampling
      method among the whole adult population of Leon. In addition to fill in a
      questionnaire, basal glucemia was measured with a capillary reflectometer and a
      TTOG with 75 g. The effect of age on the average values of basal glucemia and on
      TTOG glucemia was no demonstrated. A significant correlation between the
      prevalence of the disease and the age of subjects was also observed, being
      maximum in the age group 60-69 (14.50%). After discussing the results, we
      conclude that only prospective studies will be able to establish the threshold of
      glucose tolerance-intolerance, beyond which the risk increases.

PMID- 1623098
TI  - [Lung cancer in Internal Medicine].
AB  - In order to study the several forms of presentation of lung cancer in our
      environment, we have analyzed characteristics, age, tobacco consumption, stage of
      onset and location of initial metastasis in 20 patients in whom the diagnosis of
      this neoplasia had been established. The still low incidence of lung cancer among
      the female population is the more significant feature of our group of patients,
      compared with other series from Anglo-Saxon countries.

PMID- 1623099
TI  - [Intraparenchymal cerebral hemorrhage and cocaine].
AB  - Medical problems related to cocaine consumption are not rare in our environment;
      however, to this respect, descriptions in the spanish literature are scarce. We
      present three cases of intracerebral hemorrhage which occurred after cocaine
      consumption (intranasal route in two cases and intravenous route in one case). In
      the three cases, another associated risk factor was observed (alcohol in one
      case, hypertension in other case, arteriovenous malformation in the third case).
      We comment on the pathophysiological theories of the cause of bleeding, high
      lighting the routine search of this association.

PMID- 1623100
TI  - [Ehlers-Danlos's syndrome type II. A family study].
AB  - We describe the presence of EDS type II in a family whose diagnosis was lately
      established by medical consultation of one of its members suffering from
      hyperuricemia and gout. We stress the relevance of an early diagnosis of this
      syndrome as a means to prevent and reduce as much as possible cardiovascular,
      hemorrhagic and surgical systemic complications associated to this disease.

PMID- 1623101
TI  - [Osteoporosis as the first manifestation of minor beta-thalassemia].
AB  - We present the case of a 48-year-old premenopausal woman with right
      lumbosciatalgia secondary to osteoporosic vertebral collapses. Two of her three
      offsprings, a 31-year-old man and a 16-year-old woman, had chronic
      dorsolumbalgia, the study of which suggested the diagnosis of minor beta
      thalassemia. As opposed to thalassemic osteoarthropathy, frequently observed in
      the forms of "major" and "minor" beta-thalassemia, rheumatic manifestations have
      almost never been described in the "minor" forms. We highlight the possibility of
      symptomatic osteoporosis as the first manifestation and we review the locomotive
      disorders associated to this hemoglobinopathy.

PMID- 1623102
TI  - [Rare manifestations of diabetic neuropathy].
AB  - Up to 50% of diabetic patients develop neuropathies during their lives. Distal
      symmetric polyneuropathy is the most frequent variety, but there are other forms
      that are not exceptional and must be considered for the differential diagnosis of
      these patients. In this paper, the authors present three clinical cases of rare
      types of diabetic neuropathy: oculomotor cranial neuropathy (Case 1), diabetic
      amyotrophia (Case 2) and mixoide type with proximal asymmetrical locomotor
      neuropathy and distal polyneuropathy (Case 3). Their most relevant clinical
      characteristics are described, along with their differential diagnosis, evolution
      and therapeutical alternatives, in order to contribute to a better management of
      these patients.

PMID- 1623104
TI  - [Bronchial asthma. New ideas on pathogenicity and treatment].
AB  - New insights on the pathogenicity of asthma have derived the attention to the
      inflammatory changes observed in the airways of asthmatic patients. The cellular
      and biochemical mechanisms that take place in them are not well enough understood
      and, thus, new questions have been added to the ones that existed before the
      asthma was considered an inflammatory disease. The interactions between cells and
      inflammation mediators, and between both of them and the autonomous control of
      the bronchial tree, are still adding new questions and preventing the working-out
      of a comprehensive theory explaining all the changes observed in asthma. In
      addition, the recent insights on the relationship between asthma, athopy and
      hereditary conditionings of both, have significantly increased our body of
      knowledge on the disease and have open new perspectives that now can be only
      foreseen. The new concepts related to the pathogenicity of asthma have placed the
      anti-inflammatory therapy in the first line of the anti-asthmatic therapy. The
      development of new agonists of the platelet activation factor, leukotriens or
      tromboxanes and the therapeutical strategies based on the control of IgE
      hypersecretion, may be relevant advances for the future control of this disease.

PMID- 1623103
TI  - [Thyrotoxic hypokalemic periodic paralysis].
AB  - A case of palsy without family history associated to hyperthyroidism, is
      described. This is an rare entity in our environment (only two cases have been
      previously described) and may develop with hypo, normo or hyperkalemia. Its
      potential pathogenicity is discussed, which finally results in a disorder of the
      ionic interchange at the level of the muscle membrane. The need to identify these
      secondary forms of recurrent palsy is stressed, given that it may benefit from an
      adequate treatment. In the case presented here, the normalization of the thyroid
      function was followed by the sustained elimination of the muscle symptomatology.

PMID- 1623105
TI  - [2 new cases of male 46 XX syndrome].

PMID- 1623106
TI  - [Stoke and idiopathic hypereosinophilic syndrome].

PMID- 1623107
TI  - [De Quervain's subacute granulomatous thyroiditis: cause of fever of unknown
      origin].

PMID- 1623108
TI  - [Hypoglycemia from a pleural fibrous tumor].

PMID- 1623109
TI  - [Pure red cell aplasia associated with systemic lupus erythematosus].

PMID- 1623110
TI  - [Septic arthritis from Streptococcus pneumoniae in rheumatoid arthritis].

PMID- 1623111
TI  - Effects of the clotting process on endothelium-dependent relaxation of human
      middle cerebral artery.
AB  - Clotted blood decreased acetylcholine-induced relaxations of strips of human
      middle cerebral artery precontracted with noradrenaline, although histologically
      the endothelial layer was preserved. This effect was not prevented by catalase,
      superoxide dismutase or aspirin. Nifedipine reduced the decrease in acetylcholine
      induced relaxation.

PMID- 1623112
TI  - Annexins I to VI: quantitative determination in different human cell types and in
      plasma after myocardial infarction.
AB  - Concentrations of annexins I to VI were quantitatively determined in extracts of
      placenta and different human cell types. They were detectable in all extracts
      studied, but lymphocytes/monocytes, endothelial cells and fibroblasts had very
      high annexin contents. The results indicate cell type specific annexin
      repertoires. Annexins are intracellular proteins lacking signal sequences but
      which are detectable in trace amounts in plasma of healthy humans. The majority
      of plasma samples drawn from 14 patients suffering from myocardial infarction had
      elevated annexin III, IV and V concentrations. Shortly after infarction increased
      annexin levels were detected, reaching maximal values 24 to 48 h later. In the
      course of the following days annexin concentrations returned towards normal
      plasma levels.

PMID- 1623114
TI  - Improved lupus anticoagulant assay.

PMID- 1623113
TI  - Oral contraceptives caused thrombosis in a monoovular twin with protein C
      deficiency, while the other, without medication, remained asymptomatic.

PMID- 1623115
TI  - Thrombonostika F1.2.

PMID- 1623116
TI  - Bacterial lipopolysaccharide induces phosphatidylcholine breakdown in human
      leukaemia monocytic U937 cells.
AB  - We investigated the effect of bacterial lipopolysaccharide (LPS) on phospholipid
      (PL) turnover in human monocytic leukaemia U937 cells. Cells were pre-labelled
      with [3H]choline, [14C]ethanolamine and [3H]inositol for 24 h. By monitoring the
      radiolabel association with cellular PL, the data indicated that LPS (10
      micrograms/ml) drastically altered the catabolism of choline-containing PL; it
      induced their breakdown by 50% within 20 min. The reutilization of choline or its
      phosphates for PL synthesis was also suggested as a result of regaining
      radiolabel in the next 40 min. Choline-containing PL then underwent a second
      degradation after 60 min; 50% decline in radiolabel was detected at 120 min. In
      contrast, LPS did not induce the breakdown of phosphatidylethanolamine and
      phosphatidylinositol through phospholipase C/phospholipase D (PLC/PLD). No
      significant redistribution of the radiolabel in PL was detected in any cases
      during chasing. The data clearly indicate that LPS stimulates phosphatidylcholine
      breakdown, implying that the liberation of phosphatidic acid or diacylglycerol
      via PLC/PLD reaction may be relevant to the initiation of LPS-induced monocytic
      activation.

PMID- 1623117
TI  - Measurement of crosslinked fibrin derivatives in patients undergoing abdominal
      surgery: use in the diagnosis of postoperative venous thrombosis.
AB  - Levels of plasma crosslinked fibrin derivatives, a sensitive and direct marker of
      the lysis of intravascular crosslinked fibrin, were measured serially in 135
      patients undergoing major abdominal surgery to determine their behavior and their
      use as a screening test for postoperative venous thrombosis. Preoperative levels
      and levels on the first postoperative day were significantly higher by both
      enzyme immunoassay and latex assay in 31 patients who developed venous thrombosis
      (positive venography) than in 104 patients who did not (negative 125I fibrinogen
      leg scan). Preoperative XLFDP levels 400 ng/ml (enzyme immunoassay) had a
      sensitivity to the diagnosis of postoperative venous thrombosis of 58%,
      specificity 74%, positive predictive value 41% and negative predictive value of
      85%. The sensitivity of XLFDP levels over 1200 ng/ml on the first postoperative
      day was 65%, specificity 73%, positive predictive value 38% and negative
      predictive value 89%. These cutoff values were chosen (high negative predictive
      value) to allow identification of patients who were unlikely to have venous
      thrombosis. Measurement of plasma XLFDP, a simple inexpensive test, could be used
      as a screen to select patients for surveillance procedures (IPG or duplex
      ultrasonography). A substantial increase in XLFDP levels (greater than 500 ng/ml)
      occurred in virtually all patients, suggesting that fibrinolysis is not
      'shutdown' postoperatively and that these assays reflect lytic activity at the
      fibrin surface more accurately than do measurements of plasminogen activators and
      their inhibitors.

PMID- 1623118
TI  - The release of plasminogen activators (t-PA and u-PA) and plasminogen activator
      inhibitor (PAI-1) after venous stasis.
AB  - The aim of the present study was to compare plasma levels of urokinase-type
      plasminogen activator (u-PA), before and after 20 min of venous stasis, with
      those of tissue-type plasminogen activator (t-PA), type 1 plasminogen activator
      inhibitor (PAI-1) and t-PA/PAI-1 complexes, to determine whether both plasminogen
      activators and their inhibitor respond similarly to the same stimulus. We studied
      36 patients with recurrent venous thrombosis in whom no coagulation defects
      predisposing them to thrombosis had been detected (mean age 38.2 years, range 15
      70 years). Twenty healthy individuals (mean age 34.3 years, range 20-60 years)
      served as a control group. t-PA, PAI-1 and u-PA activity and antigen, as well as
      the t-PA/PAI-1 complex antigen, were measured before and after venous stasis.
      Post-stasis fibrinolytic parameters were corrected for the haemoconcentration
      which occurred during the venous occlusion test. Pathologically high PAI-1 levels
      (antigen and activity) were found in four out of 36 patients who were excluded
      from study. Functional and antigenic u-PA increased significantly after venous
      stasis when analysed as the absolute differences between paired samples (P less
      than 0.01). This increase in u-PA did not correlate with changes in t-PA or PAI-1
      (r = 0.28 and r = 0.36 respectively). This leads us to suggest that different
      mechanisms relating to clearance and/or release from diverse sources might be
      involved in elevations of u-PA in response to a local endothelial stimulus. We
      conclude that venous stasis might not be the elective choice when evaluating 'bad
      responders' predisposed to thrombosis.

PMID- 1623119
TI  - Exploration of rapid bedside monitoring of coagulation and fibrinolysis
      parameters during thrombolytic therapy.
AB  - Monitoring coagulation parameters during thrombolytic therapy could be useful for
      prediction and treatment of haemorrhagic episodes. Technology based on dry
      reagent chemistry has been developed that allows rapid (less than 10 min) assays
      on small samples of whole blood. The assay principle is based on the restriction
      of motion of paramagnetic particles during fibrin polymerization, and subsequent
      liberation of particle motion during fibrinolysis. This technology was used to
      monitor prothrombin time (PT), activated partial thromboplastin time (aPTT),
      fibrinogen levels and fibrinolysis profiles during thrombolytic therapy with
      tissue plasminogen activator for acute myocardial infarction. The PT and aPTT
      obtained with the COAG-1 correlated well with conventional assays (r = 0.93 and
      0.92 for PT and aPTT, respectively; p = 0.0001). Fibrinogen estimates, obtained
      by COAG-2 also correlated well with modified Clauss assays (r = 0.86, p =
      0.0001). The rapid determination of the aPTT may improve management of adjunctive
      anticoagulant therapy following thrombolysis. The fibrinolysis profile may be
      useful during thrombolytic therapy to verify that a lytic state has been
      achieved, to monitor the lytic state throughout therapy, and to verify that the
      lytic state normalizes once therapy has been completed.

PMID- 1623120
TI  - Fibrinolysis factors and lipid composition of the blood in treated and untreated
      hypertensive patients.
AB  - The correlations between the cardiovascular risk factors hypertension,
      overweight, hyperlipidemia and fibrinolysis parameters were studied in a group of
      54 otherwise healthy patients (age 19 to 70 years) with essential hypertension of
      moderate severity. Of the 54 patients 43 were treated with antihypertensive drugs
      and eleven were not. The patients included in this study who were treated with
      antihypertensive drugs were, in spite of their treatment, still hypertensive.
      Lipoprotein levels and fibrinolysis parameters did not differ between the
      untreated and treated patients. In the patient group we found significant
      incidence of hypertriglyceridemia (46%) elevated LDL-cholesterol (28%) and
      elevated lipoprotein (a) levels (43%). In comparison with a healthy control group
      the hypertensive patient group showed a decreased median tissue plasminogen
      activator activity (interquartile range): 0.23 (0.79) IU.10(3)/l vs 1.5 (0.47)
      IU.10(3)/l in the controls (p less than 0.0001), an increased tissue plasminogen
      activator antigen concentration: 8.2 (4.5) micrograms/l vs 5.1 (3.9) micrograms/l
      in the controls (p less than 0.0001), an elevated plasminogen activator inhibitor
      1 level: 2.8 (2.5) AU.10(3)/l vs 1.1 (2.0) AU.10(3)/l in the controls (p less
      than 0.01) and a slightly increased alpha 2-antiplasmin concentration: 110 (8)%
      vs 98 (16)% in the controls (p less than 0.0001). Median D-dimer concentration
      levels were substantially increased in the hypertensive patients: 315 (263)
      micrograms/l vs 199 (146) micrograms/l in the controls (p less than
      0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623121
TI  - Anticoagulants from marine algae.
AB  - Anticoagulant properties were first described in extracts from marine algae over
      50 years ago. Currently over 60 species, representing the three major divisions
      of marine algae, have been reported to have such properties. The major active
      components are a variety of sulphated polysaccharides, some of which characterize
      as proteoglycans. These sulphated polysaccharides/proteoglycans exert
      antithrombin properties, primarily mediated by heparin cofactor II (HCII).
      However antithrombin III (ATIII) mediated anticoagulant activities, as well as an
      element of direct antithrombin activity, have also been observed.

PMID- 1623122
TI  - The Porton Medal Award in conjunction with the Haemostasis Club.

PMID- 1623123
TI  - Studies on the functionality of fibrinogen during rt-PA therapy: results of three
      different methods of fibrinogen determination.
AB  - The conversion of soluble fibrinogen to insoluble fibrin is a crucial event in
      the process of haemostasis. In the present study three different methods were
      used for the determination of plasma fibrinogen levels in 12 patients with acute
      myocardial infarction during rt-PA therapy. Two methods were based on fibrin
      formation and thus measured 'functional' fibrinogen: a clotting rate assay
      according to the Clauss method and a photometric polymerization rate assay.
      Thirdly, fibrinogen antigen was measured with a new enzyme immunoassay (EIA) for
      immunologically intact fibrinogen. The levels of functional and intact fibrinogen
      were strikingly different: 4.1 g/l (Clauss) and 3.6 g/l (photometric) vs 2.6 g/l
      (EIA) at baseline, 2.2 g/l (54% of preinfusion value) and 2.1 g/l (59%) vs 2.1
      g/l (81%) at 90 min, 5.7 g/l (146%) and 4.5 g/l (130%) vs 2.7 g/l (106%) at 72 h.
      The rebound phenomenon exhibited by functional fibrinogen (130-150%) was not
      observed for levels of intact fibrinogen. A ratio was calculated of functional
      (Clauss method) to intact fibrinogen (EIA) for each individual patient and each
      time point. The mean ratio (n = 12 patients) was 1.6 at baseline, 1.0 at 90 min,
      and increased markedly between 8 and 24 h to a maximum of 2.1 (P less than 0.01).
      Our data indicate that the 'functionality', i.e. the clotting rate per unit
      concentration of circulating fibrinogen, changed during acute myocardial
      infarction and subsequent thrombolytic therapy. This is in keeping with data from
      literature that the relative amount of fast clotting high molecular weight (HMW)
      fibrinogen of total fibrinogen was increased in the initial phase of acute
      myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623124
TI  - Peptide models for the membrane destabilizing actions of viral fusion proteins.
AB  - The fusion of enveloped viruses to target membranes is promoted by certain viral
      fusion proteins. However, many other proteins and peptides stabilize bilayer
      membranes and inhibit membrane fusion. We have evaluated some characteristics of
      the interaction of peptides that are models of segments of measles and influenza
      fusion proteins with membranes. Our results indicate that these models of the
      fusogenic domains of viral fusion proteins promote conversion of model membrane
      bilayers to nonbilayer phases. This is opposite to the effects of peptides and
      proteins that inhibit viral fusion. A peptide model for the fusion segment of the
      HA protein of influenza increased membrane leakage as well as promoted the
      formation of nonbilayer phases upon acidification from pH 7-5. We analyze the
      gross conformational features of the peptides, and speculate on how these
      conformational features relate to the structures of the intact proteins and to
      their role in promoting membrane fusion.

PMID- 1623125
TI  - Normal mode refinement: crystallographic refinement of protein dynamic structure
      applied to human lysozyme.
AB  - A new method of dynamic structure refinement of protein x-ray crystallography,
      normal mode refinement, is developed. In this method the Debye-Waller factor is
      expanded in terms of the low-frequency normal modes and external normal modes,
      whose amplitudes and couplings are optimized in the process of crystallographic
      refinement. By this method, internal and external contributions to the atomic
      fluctuations can be separated. Also, anisotropic atomic fluctuations and their
      interatomic correlations can be determined experimentally even with a relatively
      small number of adjustable parameters. The method is applied to the analysis of
      experimental data of human lysozyme to reveal its dynamic structure.

PMID- 1623126
TI  - Vibrational studies of the disulfide group in proteins. Part V. Correlation of SS
      stretch frequencies with the CCSS dihedral angle in known protein disulfide
      bridges.
AB  - Normal mode calculations have been done on 92 disulfide bridges in 25 known
      protein structures in order to correlate the SS stretch frequency with the CCSS
      dihedral angle. It is possible to classify the frequencies into four major
      categories, which provide a more detailed classification scheme than previously
      proposed from dialkyl disulfide correlations.

PMID- 1623127
TI  - A general approach for determining scalar coupling constants in polypeptides and
      proteins.
AB  - A general approach is described for measuring homo- and heteronuclear spin
      coupling constants in polypeptides and small proteins. This method uses selective
      magnetization transfer to generate cross peaks similar to exclusive correlated
      spectroscopy (E.COSY) and a large direct spin coupling (1J) in one dimension to
      "pull apart" cross-peak components by frequencies much larger than the resonance
      line width. A general description of this method is presented, along with a brief
      discussion of spin topology and relaxation effects that must be considered in
      designing multidimensional nmr pulse sequences for measuring vicinal coupling
      constants. The principles are demonstrated in designs of several two-dimensional
      nmr experiments for determining coupling constants in polypeptides and proteins.
      These include experiments for measuring 3J(HN-H alpha), 3J(H alpha i-1-15Ni),
      3J(15N-H beta), and 3J(H alpha-H beta) coupling constants, which depend on the
      polypeptide dihedral angles phi, psi, and chi 1. Multidimensional nmr experiments
      developed with this approach will allow measurements of many vicinal coupling
      constants in peptides, proteins, and other molecules. Coupling constants measured
      in these spectra can be used to determine backbone and side-chain conformations,
      to obtain stereospecific resonance assignments of prochiral atoms, and to
      characterize conformational distributions of dihedral angles. Combined with
      information obtained from nuclear Overhauser effect measurements, these data will
      provide more precise determinations of protein solution structures by nmr
      spectroscopy.

PMID- 1623128
TI  - Studies on the yeast alpha-mating factor: a model for mammalian peptide hormones.
AB  - Small peptides initiate sexual conjugation in the yeast Saccharomyces cerevisiae
      and this phenomenon is an ideal paradigm for studying the mode of action of
      mammalian peptide hormones. 1H-nmr spectroscopy was used to examine the
      conformation of linear and cyclic analogues of the alpha-factor (WHWLQLKPGQPMY)
      in aqueous solution. In all cases peptides that exhibit nmr parameters expected
      for a type II beta-turn have higher biological activities than those that do not
      appear to assume this conformation. Based on a simple model for the interaction
      of the pheromone with its receptor, we prepared fragments of the alpha-factor.
      Several of these fragments either antagonize or potentiate the activity of the
      alpha-factor. The latter represent the first example of peptide fragments that
      synergize the activity of the parent pheromone.

PMID- 1623129
TI  - Conformation of uteroglobin fragments.
AB  - The conformation of three fragments of uteroglobin in aqueous solution and in the
      presence of SDS micelles is described. Two of these fragments correspond to helix
      II and helix III of uteroglobin, the crystal structure of which is made of four
      helices. The third peptide comprises helices II and III, with the connecting beta
      turn. While helix II does not interact strongly with the micelles, helix III
      adopts a rather clear alpha-helix in this system. The elongation of helix III
      with the addition of helix II at the N-terminus somewhat stabilizes the ordered
      structure. It is possible that the beta-turn found in the crystal is also present
      in solution.

PMID- 1623130
TI  - Conformational study of endothelins and sarafotoxins with the cystine-stabilized
      helical motif by means of CD spectra.
AB  - A series of CD measurements were carried out on members of peptides in the
      endothelin and sarafotoxin families. The helical structures taken by these
      peptides containing the helical motif with the sequences of Cys-X-X-X-Cys and Cys
      X-Cys [Y. Kobayashi et al. (1991) Neurochemistry International Vol. 18, pp. 525
      534] are classified into three groups: a group of structures of ET-1, ET-2 and
      vasoactive intestinal contractor (VIC), a group of sarafotoxin, and a group of ET
      3.

PMID- 1623131
TI  - Refinement of the thrombin-bound structure of a hirudin peptide by a restrained
      electrostatically driven Monte Carlo method.
AB  - Energy refinement of the structure of a linear peptide, hirudin56-65, bound to
      thrombin was carried out using a conformational search method in combination with
      restrained minimization. Five conformations originated from nmr data and distance
      geometry calculations having a similar global folding pattern but quite different
      backbone conformations were used as the starting structures. As a result of this
      approach, a series of low-energy conformations compatible with a set of upper and
      lower bounds of interproton distances determined from transferred nuclear
      Overhauser effects were found. A comparison among the lowest energy conformations
      of each run showed that the combination of energy refinement plus distance
      constraints led to a very well-defined structure for both the backbone and the
      side chains of the last 7 residues of the polypeptide. Furthermore, the low
      energy conformations generated with this technique contain a segment of 3(10)
      helix involving the last 5 residues at the COOH terminal end.

PMID- 1623132
TI  - Conformational analysis of an opioid peptide in solvent media that mimic
      cytoplasm viscosity.
AB  - Many neuropeptides exert their action between the presynaptic vesicles and
      postsynaptic transmembrane receptors, crossing different layers of specialized
      cytoplasm. Biomimetic media usually employed to study bioactive peptides do not
      reproduce the physico chemical environment of cytoplasm--in particular, the high
      viscosity of this biological fluid. Here we describe a conformational study of a
      delta-selective opioid peptide, deltorphin I, at variable temperatures in several
      biocompatible media characterized by varying values of viscosity and dielectric
      constant. It was found that only viscosity, among these parameters, induces
      ordered conformations; that is, it acts as a conformational sieve. This finding
      suggests that the high viscosity of the intersynaptic fluid contributes, in
      addition to the membrane catalysis proposed by Schwyzer, in overcoming the so
      called entropic barrier to the transition state of peptide-receptor interaction
      by selecting ordered conformations prior to receptor interaction. The folded
      conformer found in the 80:20 (v:v) DMSOd6/H2O cryoprotective mixture at 265 K has
      a shape consistent with those of rigid nonpeptidic opiates.

PMID- 1623133
TI  - Hydrophobicity-induced pK shifts in elastin protein-based polymers.
AB  - Three polypentapeptides--poly[0.8(GVGVP), 0.2(GEGVP)], poly[0.8(GVGIP),
      0.2(GEGIP)], and poly[0.75(GFGVP), 0.25(GEGVP)]--all analogues of the
      polypentapeptide of elastin--(Val1-Pro2-Gly3-Val4-Gly5)n or poly(VPGVG)--have
      been prepared to determine the effect of changing the hydrophobicity, i.e., Val1-
      --Ile1 (I) and Val4----Phe4 (F), on the pKa and the temperature dependence of pKa
      of the Glu (E) residue. Shifts in pKa as large as 1.7 units are observed and the
      temperature dependence is much steeper for the structure-dependent proximity of
      the more hydrophobic Ile1 residues to the Glu4 residue. Even though this system
      is dominated by the inverse temperature transition of hydrophobically driven
      folding on raising the temperature, the effect of adding 0.15 N NaCl is to
      suppress the hydrophobicity-induced pKa shift.

PMID- 1623134
TI  - Stoichiometry of calcium binding to a synthetic heterodimeric troponin-C domain.
AB  - In this work we describe calcium binding to two synthetic 34-residue peptides,
      determined by 1H-nmr spectroscopy. The peptides investigated, SCIII and SCIV,
      encompass the calcium-binding sites III and IV, respectively, of troponin-C. In
      the absence of calcium it has previously been shown that each of these peptides
      possesses little regular secondary structure. Further, the 1H-nmr spectra of an
      equimolar mixture of both of these apo-peptides (apo-SCIII/SCIV) shows that
      little interaction occurs between peptides. Upon calcium binding the spectral
      changes that occur to SCIII/SCIV are consistent with global conformational
      changes in both peptides. We have shown previously that these conformational
      changes are a product of calcium binding to SCIII and SCIV to form a two-site
      heterodimer Ca2-SCIII/SCIV. It is proposed that this calcium-induced folding
      proceeds via calcium binding to SCIII to form Ca-SCIII, peptide association with
      apo-SCIV to form the heterodimer Ca-SCIII/SCIV, and calcium binding to form Ca2
      SCIII/SCIV. The dissociation constants involved in this pathway, K1, Kd, and K2,
      respectively, have been determined by stoichiometric calcium titration of
      SCIII/SCIV, monitored by 1H-nmr spectroscopy. Using this procedure it has been
      determined that K1 = 3 microM, Kd = 10 microM, and K2 = 2 microM.

PMID- 1623135
TI  - Minimum energy conformations of proline-containing helices.
AB  - Proline occurs frequently in transmembrane alpha-helices of transport and
      receptor proteins even though statistical surveys demonstrate the overwhelming
      preference of this residue for a non-alpha-helical, hydrophilic environment. As a
      result, membrane-buried proline has been proposed to be functionally important,
      with function arising from structural discontinuity or destabilization of the
      helix. Destabilization may occur by Pro-mediated conformational transitions
      between discrete states, and may be manifested in membrane protein systems
      through reversible processes such as channel opening and closing or signal
      transduction. In this study, computer modeling of a model transmembrane alpha
      helix, (Ala)8-Leu-Pro-Phe-(Ala)8, in a medium of low polarity (dielectric = 2),
      is used to examine the occurrence and energetic accessibility of Pro-mediated
      conformational interconversions. Leu psi and chi 1, Pro psi, and Phe phi and chi
      1 torsion angles were assigned random values so that a data base of 200
      conformations for each of the cis and trans states was generated. The
      conformations were minimized and low-energy structures organized into families.
      This analysis demonstrated that the most populated lowest energy family is the
      Trans-I conformation, corresponding to proline in a kinked alpha-helix. Two
      additional trans structures, Trans-II and Trans-III, as well as a cis
      conformation, Cis-I, are also energetically competitive. Interconversions between
      the trans states could thus be mediated by changes at a single torsion angle,
      accompanied by minor local hydrogen-bonding rearrangements. This work
      substantiates that membrane-buried proline can provide the basis for
      conformational transitions between discrete alpha-helix-based structures in a
      nonpolar environment.

PMID- 1623137
TI  - The two-stranded alpha-helical coiled-coil is an ideal model for studying protein
      stability and subunit interactions.
AB  - We have designed de novo a two-stranded alpha-helical coiled-coil which consists
      of two identical 35-residue polypeptide chains arranged in a parallel and in
      register alignment. Their structure is stabilized by interchain hydrophobic
      interactions from hydrophobes at positions "a" and "d" of a repeating heptad
      sequence. The formation and stability of the coiled-coil is dependent on peptide
      concentration due to the monomer-dimer equilibrium. In contrast, that coiled-coil
      containing an inter-helical disulfide bond does not show any concentration
      dependence in the guanidine hydrochloride denaturation experiments as expected.
      Replacement of one large hydrophobic Leu residue in each chain with Ala
      significantly decreases coiled-coil stability in both the reduced and oxidized
      coiled-coils [decreases in transition midpoint of 1.6M (2.3-0.7) and 2.4M (5.3
      2.9), respectively]. A large pH dependence on coiled-coil stability is observed
      over the pH range 4 to 7 (transition midpoints at pH 4, 5, 5.5, 6 and 7 were 3.8,
      3.2, 2.0, 1.2 and 0.7M, respectively). The increasing stability with decreasing
      pH correlates with the protonation of the Glu acid side-chains and reduction of
      intrachain repulsions between Glu-Glu side-chains in positions i, i + 3 or i, i +
      4 along each alpha-helix of the coiled-coil. In addition, coiled-coil stability
      increases with increasing ionic strength.

PMID- 1623136
TI  - Tyrosine-derived polycarbonates: backbone-modified "pseudo"-poly (amino acids)
      designed for biomedical applications.
AB  - Starting from L-tyrosine (Tyr) and its metabolites desaminotyrosine (Dat) and
      tyramine (Tym), four structurally related model dipeptides were prepared: Dat-Tym
      (neither N- or C-terminus present), Z-Tyr-Tym (N-terminus protected by
      benzyloxycarbonyl), Dat-Tyr-Hex (C-terminus protected by a hexyl ester group),
      and Z-Tyr-Tyr-Hex (both N- and C-termini present, protected by benzyloxycarbonyl
      and hexyl ester, respectively). The model dipeptides were used as monomers in the
      synthesis of polycarbonates. The polymerization reaction in the presence of
      either phosgene or triphosgene proceeded via the phenolic hydroxyl groups.
      Polymers with molecular weights of 105,000-400,000 da (by gel permeation
      chromatography, relative to polystyrene standards) were obtained. The
      physicomechanical properties (solubility, mechanical strength, glass transition
      and decomposition temperature, processibility) of the polymers were determined,
      and an attempt was made to correlate the polymer properties with the nature of
      the N- and C-terminus protecting groups. The presence of the urethane bond at the
      N-terminus protecting group was found to reduce solubility, ductility, and
      processibility, probably due to interchain hydrogen bonding. The presence of a C
      terminus alkyl ester group increased solubility and processibility. Thus, the
      most promising candidate polymer for biomedical applications was obtained from
      Dat-Tyr-Hex, the monomer carrying a C-terminus protecting group only. Since very
      similar results had recently been obtained for a series of structurally related
      polyiminocarbonates, the structure property correlations seem to be generally
      valid.

PMID- 1623138
TI  - The structure of Ro 09-0198 in different environments.
AB  - The constitution and configuration of Ro 09-0198 (cinnamycin) have been
      determined in DMSO. Further investigations in aqueous solution, in SDS micelles
      and in a lipid bilayer have been done to study the influence of different
      environments on the conformation of the peptide. It turned out that in spite of
      the polycyclic structure of the molecule, the conformation is drastically changed
      going from water to SDS micelles. Ro 09-0198 orients itself in lipid bilayers as
      expected from its amphiphilic structure. According to a nuclear Overhauser effect
      spectroscopy experiment under magic angle spinning (MAS) conditions, the molecule
      is incorporated into the membrane with its hydrophobic part inside the bilayer.

PMID- 1623139
TI  - Determination of the phi angle in a peptide backbone by NMR spectroscopy with a
      combination of homonuclear and heteronuclear coupling constants.
AB  - The phi angle in a cyclic peptide is determined by the combined use of
      homonuclear and heteronuclear coupling constants. Two of the four coupling
      constants that define the phi angle in a peptide are determined exactly, two
      qualitatively. Via Karplus-type equations, they are transformed into dihedral
      angles and a good agreement is found, allowing for a determination of the phi
      angle with a certain range of degrees.

PMID- 1623140
TI  - The structure of a rhombohedral R6 insulin hexamer that binds phenol.
AB  - Different hexameric forms of insulin have been crystallized from a variety of
      conditions. In the presence of 1% phenol, 1.0 M sodium chloride, and at a pH of
      8.5, a rhombohedral form is produced with two monomers in the asymmetric unit,
      space group R3, a = 79.92 A and c = 40.39 A. The structure has been solved and
      refined, using data between 8.0 and 2.5 A resolution, to a residual of 0.157.
      Each of the monomers adopts an R conformation, that is residues B1-B8 are alpha
      helical. As a result of the T to R transition, an elliptical cavity is created
      between symmetry-related monomers and is occupied by a phenol molecule. A region
      of density within bonding distance to one of the zinc ions has been interpreted
      as an additional phenol molecule.

PMID- 1623141
TI  - NMR and CD studies of triple-helical peptides.
AB  - Triple-helix formation of the peptide (Pro-Hyp-Gly)10 was monitored by nmr and CD
      spectroscopy. The two-dimensional nmr spectra indicated that the Gly C alpha H
      and Pro C delta H proton resonances shift upfield in going from the nonhelical to
      helical form, while hydroxy-proline resonances are unchanged. The integrated
      areas of the helical and nonhelical resonances could be monitored in the one
      dimensional nmr spectrum, and indicate that in the (Pro-Hyp-Gly)10 about 90% of
      the residues are in a defined triple-helical conformation. The introduction of a
      glycine to alanine substitution or the deletion of a single hydroxyproline
      residue in the stable triple-helical peptide (Pro-Hyp-Gly)10 still allows trimers
      to be formed, but the trimers show a substantial loss of triple helix and
      decreased thermal stability compared with (Pro-Hyp-Gly)10. Two computer models
      were generated for the Gly----Ala peptide, one with the Ala side chains packed
      inside the helix and the other with the region containing the alanines forming a
      beta-bend that loops out from the helix. The nmr data is more consistent with the
      latter model.

PMID- 1623142
TI  - Characterization at atomic resolution of peptide helical structures.
AB  - A survey of literature for the various types of helices experimentally observed
      in high-resolution single crystal x-ray diffraction analyses of peptides has
      allowed to determine accurate conformational and helical parameters for the
      various secondary structures such as the alpha-helix, the 3(10)-helix, the fully
      extended conformation (2(5)-helix) and the beta-bend ribbon spiral. For each of
      these structures the characteristic phi, psi conformational parameters, n, the
      number of residues per turn, h, the height per residues and p, the pitch of the
      helix are described.

PMID- 1623143
TI  - Three-dimensional structure and active site of three hydrophobic molecule-binding
      proteins with significant amino acid sequence similarity.
AB  - We review our work on bovine and human retinol-binding protein (RBP), bovine beta
      lactoglobulin (BLG), and bovine odorant-binding protein (OBP). These three
      proteins share a sequence similarity high enough to justify the proposal that
      their three-dimensional structure ought to be quite similar, and they also share
      the function of similar or even identical hydrophobic ligand binding, although
      with a very different degree of specificity. Thus they constitute an ideal system
      to exhaustively explore the question of three-dimensional structure prediction
      from sequence similarity and the related question of binding site prediction for
      similar ligands. We have used x-ray diffraction techniques on single crystals of
      human and bovine RBP, bovine milk BLG, and bovine nasal mucosa OBP to investigate
      this problem. The results of these crystallographic studies indicate that to the
      level of resolution so far attained, the three-dimensional structure of these
      three proteins is reasonably predicted from the sequence similarity. The fold is
      the same and structural differences are rather subtle. Finally, we present
      experimental evidence that the binding sites of RBP, BLG, and OBP are in
      different regions of the molecules. Thus, it appears that although sequence
      alignment has correctly predicted the protein fold, it has incorrectly predicted
      the hydrophobic ligand-binding sites.

PMID- 1623144
TI  - Menopause: new indications and management strategies.
AB  - Postmenopausal women may benefit from estrogen replacement. In addition to the
      well-established treatment indications of vasomotor symptoms, genitourinary
      atrophy, and osteoporosis, studies also suggest improvement in psychologic well
      being and prevention of coronary heart disease. The potential cardioprotective
      effects of estrogen do not appear to be solely from alterations in lipid
      metabolism. Major risks of estrogen replacement including breast cancer continue
      to be a concern. Strategies of management including continuous estrogen and
      progestin regimens are reviewed. There exists an increasing body of evidence that
      successful treatment for estrogen-dependent tumors including endometrial
      carcinoma is not a contraindication to estrogen replacement therapy. The
      potential use of tamoxifen to relieve symptoms and prevent bone loss in women
      with breast cancer is suggested.

PMID- 1623145
TI  - Current status of in vitro fertilization and the new reproductive technologies.
AB  - The rapid pace of development and refinement of in vitro fertilization and
      ancillary assisted reproductive techniques warrants periodic review to keep the
      reader abreast of the growth in this clinical and scientific arena. Although not
      exhaustive, this review targets key areas of special interest and significance,
      including oocyte and embryo micromanipulation for assisted fertilization and
      genetic analysis, advances in the approach to ovarian stimulation, and
      examination of the scientific model afforded by ovum donation.

PMID- 1623146
TI  - Advances in reproductive toxicology.
AB  - Research in reproductive toxicology has relied on several animal models as well
      as on the more difficult-to-perform human studies. In animals, ovarian toxicity
      is being investigated in more detail, with investigation of characteristics of
      reversibility. Epidemiology studies using time-to-pregnancy techniques have been
      useful in identifying potential at-risk populations for further study. Male
      toxicology research has concentrated on defining normal sperm parameters in
      experimental animals and in men, particularly when those parameters are evaluated
      by computer-assisted techniques.

PMID- 1623147
TI  - New concepts in oral contraceptive pill use.
AB  - Over 30 years have elapsed since the introduction of the combination oral
      contraceptive pill. During this time, the estrogen and progestogen components of
      the pill have been reduced 80% and 90%, respectively. An improved understanding
      of the mechanisms involved in the metabolism of the oral contraceptive pill
      steroids now exists that allows us to better understand interactions of the pill
      with other drugs and medications. In an effort to reduce adverse reactions to the
      oral contraceptive pill, new progestogens have been developed for contraceptive
      pills soon to become commercially available. These issues as well as the concept
      of the pill-free interval are discussed in this review.

PMID- 1623148
TI  - Hyperandrogenism: new insights into etiology, diagnosis, and therapy.
AB  - Mutations in the genes for the insulin receptor, 21-hydroxylase, 11 beta
      hydroxylase, and 3 beta-hydroxysteroid dehydrogenase isomerase enzymes are
      associated with hyperandrogenism. These genetic causes of hyperandrogenism
      account for less than 10% of all cases. A major goal of future research will be
      to identify other genetic causes of hyperandrogenism. Evidence continues to
      accumulate that luteinizing hormone, insulin-like growth factor I, and insulin
      are major factors regulating ovarian androgen production. Optimal therapy for
      hyperandrogenism probably includes simultaneous suppression of androgen
      production and blockade of androgen action.

PMID- 1623150
TI  - Gynecologic surgery and endoscopy.

PMID- 1623149
TI  - Endometriosis: advances in understanding and management.
AB  - Endometriosis is a commonly encountered disease, yet most aspects of its
      pathogenesis, pathophysiology, and treatment remain controversial. Recent
      advances, however, have increased our understanding of this enigmatic disorder.
      While many theories persist regarding the pathogenesis of endometriosis, the
      transplantation hypothesis is by far the most widely accepted. Evidence continues
      to accumulate in support of this theory as the primary mode of generating ectopic
      endometrium. In addition, recent work has begun to uncover factors critical to
      the growth and maintenance of such implants. Advances in pathophysiology have
      strongly suggested a cause-effect relationship between endometriosis and pelvic
      pain; conversely, such a relationship between implants and infertility is
      becoming more tenuous. Treatment trials, in both animals and humans, have begun
      to clarify the role of specific interventions in combating endometriosis. In
      addition, as new pathophysiologic mechanisms have been proposed, an intriguing
      array of new modalities have been developed as treatment options.

PMID- 1623151
TI  - Infertility surgery: microsurgery.
AB  - Tubal and peritoneal factors continue to be a leading cause of infertility. In
      vitro fertilization, operative laparoscopy, and microsurgery are alternatives,
      but they are frequently complimentary therapeutic approaches. Proper
      investigation is the key to select the primary treatment modality. A well
      performed hysterosalpingography is most valuable in the initial assessment of the
      tubes and uterus. Hysterosalpingosonography, radionuclide hysterosalpingography,
      and falloposcopy are experimental investigative tools that may be useful in
      selected circumstances. Effective adjuvants to reduce postoperative adhesions
      continue to elude the surgeon and new substances are being experimented with. In
      proximal tubal obstruction, selective salpingography and tubal catheterization
      may differentiate cornual spasm from pathologic tubal occlusion and may be
      therapeutic when viscous material or endotubal synechia are the cause of
      obstruction. Microsurgery remains the effective approach for significant lesions
      such as salpingitis isthmica nodosa, endometriosis, obliterative fibrosis, and
      chronic follicular salpingitis. Distal tubal occlusion is amenable to treatment
      via either laparoscopy or microsurgery. The functional status of the oviduct
      appears to be the most important prognostic factor in subsequent pregnancy
      outcome.

PMID- 1623152
TI  - Falloposcopy.
AB  - This review discusses advances in falloposcopy over the past 10 years.
      Refinements in instrumentation, including fiberoptics, have allowed visualization
      of the endosalpinx, a portion of the reproductive tract that has evaded
      endoscopic evaluation. A coaxial system of falloposcopic placement may give way
      to a linear everting catheter that does not require hysteroscopic guidance. Tubal
      endoscopic applications are discussed, including correlating hysterosalpingogram
      findings with those findings at salpingoscopy. Endosalpingeal changes can be
      quantitated in the presence of hydrosalpinges, and possibly with endometriosis. A
      scoring system to measure changes has been described. Using this scoring system,
      endosalpingeal findings at salpingoscopy have been compared with histologic and
      electron microscopic findings.

PMID- 1623153
TI  - Gynecologic malignancy and surgery: from quantity to quality of life.
AB  - With modern anesthesia and better postoperative care, the mortality and morbidity
      of radical surgery have been markedly reduced during the last decades. With the
      maximum quantity of life achieved from radical surgery, increasing emphasis is
      now being placed on the quality of life. A better understanding of tumor biology
      and the consideration of different clinicopathologic factors that bear prognostic
      significance in therapeutic modalities will allow individualization of treatment.
      This will lead to less surgical morbidity and less functional and psychosexual
      impairments without sacrificing benefits of survival.

PMID- 1623154
TI  - Hysteroscopic surgery.
AB  - Because a wide variety of conditions can be diagnosed hysteroscopically,
      hysteroscopy has become a diagnostic gold standard. Through "operative"
      hysteroscopes, both the electrical current of the resectoscope and the energy of
      the neodymium:yttrium-aluminum-garnet laser have been effective tools in many
      cases and presented a new alternative to laparotomy and hysterectomy. The most
      frequent procedures are 1) endometrial ablation and partial endometrial ablation,
      2) myomectomy for submucous myomas, 3) two-step myomectomy for large submucosal
      and intramural myomas, 4) hysteroscopic management of mullerian defects, and 5)
      hysteroscopic management of intrauterine adhesions.

PMID- 1623155
TI  - Embryoscopy: new developments in prenatal medicine.
AB  - Embryoscopy is a new technique that allows direct visualization of the
      embryo/fetus as early as the first trimester. A rigid fiberoptic endoscope is
      passed transcervically into the extracoelomic cavity and has been utilized to
      identify developmental milestones from weeks 4 to 8 following conception. All
      major external and internal structures develop during this period. With this
      technique, it is possible to both identify anomalies and confirm those diagnosed
      by ultrasound. Fetal blood sampling has also been preformed utilizing this
      technology and has established the feasibility of access to the human embryonic
      circulation. Future applications for embryoscopy include first-trimester prenatal
      diagnosis and therapeutic interventions such as gene or cell therapy at a time
      when the embryo is immunologically tolerant.

PMID- 1623156
TI  - Surgery for female urinary incontinence.
AB  - There has been very little advance in the surgery of female urinary incontinence
      over the past 20 years. In our opinion this is due to 1) uncritical acceptance of
      the intraabdominal pressure transmission theory, 2) uncritical acceptance of the
      concept of "detrusor instability," and 3) limited and uncritical evaluation of
      results of surgery. A new theory for female urinary incontinence is presented.
      This theory explains existing phenomena in terms of anatomic defects in the
      vagina and its supporting ligaments. Based on this theory, a new classification
      of female urinary incontinence and several new minimally invasive surgical
      procedures are briefly introduced.

PMID- 1623157
TI  - Reproductive endocrinology.

PMID- 1623158
TI  - Gynecologic surgery and endoscopy.

PMID- 1623159
TI  - Abstracts for the VIIIth Biennial Scientific Meeting, Asian-Pacific Association
      for the Study of the Liver. Seoul, Korea, 6-8 April 1992.

PMID- 1623160
TI  - Effects of diazepam and D-amphetamine on rhythmic pattern of eye movements in
      goldfish.
AB  - The effects of diazepam and D-amphetamine on spontaneous, vestibular- and
      visually-induced eye movements were studied in the restrained goldfish. These
      animals showed a stereotyped pattern of spontaneous eye movements that scanned
      the visual field in the horizontal plane. Fourier analysis of these eye movements
      revealed a rhythmic pattern of about 5 cycles per minute, whose frequency
      increased to double and decreased to half following treatment with diazepam and D
      amphetamine, respectively. However, the fast and slow components of vestibulo
      ocular and optokinetic reflexes, as well as peculiar blink-like movements,
      remained unchanged at the same drug doses. These results suggest the presence of
      a central pattern generator for spontaneous eye movements in the goldfish, whose
      oscillation frequency is pharmacologically modifiable.

PMID- 1623161
TI  - Phorbol ester and lignocaine or pentobarbitone interactions at presynaptic axons.
AB  - The interaction between anaesthetics and protein kinase C activation was studied
      in unclamped field currents from unmyelinated axons which give rise to en passant
      synapses. Electrical responses could be resolved into Na, K and Ca components
      revealed by electrode polarisation pretreatment with blockers of K-conductances.
      In the presence of phorbol dibutyrate, there was an increase in the potency of
      lignocaine, pentobarbitone and tetrodotoxin: for the Na current, the potency
      increased by 2.67 +/- 0.64, 2.35 and 2.47 fold respectively. The potentiation
      does not appear to be any indirect result of changed membrane potential. It is
      suggested that protein kinase C phosphorylation of membrane channel proteins
      increases the effectiveness of these substances.

PMID- 1623162
TI  - Pre-treatment with a Ca2+ channel antagonist facilitates vestibular compensation.
AB  - A single injection of the Ca2+ channel antagonist verapamil (0.4 or 0.8 mg kg-1,
      i.m.) was given to adult guinea-pigs 1 h before a unilateral labyrinthectomy and
      the effects on the compensation of spontaneous ocular nystagmus (SN) were
      measured. At the 0.8 mg kg-1 dose, pre-treatment with verapamil significantly
      reduced SN frequency compared to saline controls; however, it also reduced the
      rate of SN compensation, resulting in no significant difference in the time
      required to reach maximal compensation. These results suggest the possibility
      that voltage-dependent Ca2+ channels may be involved in vestibular compensation.

PMID- 1623163
TI  - Modification induced in visual cortical activity of rat by neonatal monocular
      enucleation.
AB  - Monocular enucleation was performed on rats at birth. The animals were raised and
      from the age of 3 months the evoked activity was tested in the contralateral
      visual cortex both by mapping of evoked potentials and by autoradiography. It was
      found that monocular enucleation changed the distribution of the evoked activity
      characteristically. The focus of activity shifted laterally and was restricted to
      the binocular part of the primary visual cortex, while hardly any evoked activity
      or labelled neurons were found in its medial part.

PMID- 1623164
TI  - A K+ current in Xenopus muscle cells which shows inactivation.
AB  - The purpose of this study was to describe an inactivating potassium current that
      is present in Xenopus muscle cells in culture. Whole cell currents were recorded
      from muscle cells grown in culture for 16-30 h. The majority of muscle cells had
      an outward current which inactivated during a 100 ms maintained depolarization.
      The outward current was reduced by tetraethylammonium or the aminopyridines, but
      not completely eliminated by either agent. Depolarizing prepulses reduced both
      the peak current and the late component of the current. The results suggest that
      by one day in culture these skeletal muscle cells develop an inactivating outward
      potassium current.

PMID- 1623165
TI  - Function-blocking antibodies against cholinergic neuronal differentiation factor.
AB  - Cholinergic neuronal differentiation factor, CDF, causes a transition from
      noradrenergic to cholinergic phenotype in cultured sympathetic neurons. Moreover,
      its identification with leukemia inhibitory factor has shown that CDF is a
      multifunctional cytokine. To examine the physiological role of CDF and to further
      elucidate the as yet unknown effects of CDF on the nervous system, two kinds of
      function-blocking antibodies were generated. One type, raised against whole
      native CDF, completely blocks CDF activity, whereas the other type, raised
      against a synthetic peptide corresponding to the N-terminal amino acid region of
      CDF, blocks activity partially. All three anti-CDF and two antipeptide polyclonal
      antibodies tested in this study significantly inhibit CDF function.

PMID- 1623166
TI  - A rostrocaudal gradient in the synthesis of enkephalin in nucleus accumbens.
AB  - A subpopulation of projection neurons in the nucleus accumbens uses the
      neuropeptide enkephalin as a neurotransmitter. The synthesis of enkephalin in
      striatal neurons is regulated by dopaminergic inputs. In the present study
      quantitative in situ hybridization histochemistry was used to examine the effects
      of unilateral 6-hydroxydopamine lesions of the ascending dopaminergic fibres on
      levels of enkephalin mRNA in subregions of the nucleus accumbens. It was found
      that the levels of enkephalin mRNA were increased throughout the nucleus after
      the lesion. However, the increase appeared to be much higher in rostral parts of
      the nucleus than in caudal parts, indicating regional differences in the effects
      of blockade of the dopaminergic neurotransmission. Possible causative factors for
      these differences are discussed.

PMID- 1623167
TI  - A role for interleukin-2 in the regulation of striatal dopaminergic function.
AB  - The present study determined whether interleukin-2 (IL-2) is endogenous to the
      normal adult rat striatum and whether IL-2 regulates striatal dopaminergic tone.
      IL-2 mRNA (1.5 kb size), endogenous IL-2 and IL-2 receptors were found to be
      distributed throughout the rat striatum in moderate densities. Application of
      exogenous IL-2 to striatal slices in in vitro produced significant increases in
      both spontaneous and potassium (25 mM)-evoked [3H] dopamine release. The
      modulatory effect of IL-2 was dependent on the presence of external calcium and
      required axonal nerve activity, since IL-2 was unable to increase transmitter
      release under low external calcium conditions or in the presence of tetrodotoxin.
      Overall, this study indicates that IL-2 may be an endogenous neurokine that
      regulates striatal dopaminergic function in normal animals.

PMID- 1623168
TI  - Isolated p65 protein reproduces membrane binding activity of synaptic vesicles.
AB  - Purified synaptic vesicles are highly enriched with a protein which binds cell
      plasma membranes. The binding is selective for acidic phospholipids and
      sialoglycosphingolipids. In partition chromatography of vesicle proteins, the
      binding activity was co-eluted with a limited set of proteins. Among them the
      most abundant species were two vesicle-specific proteins: p65 and synaptophysin.
      In affinity chromatography of vesicle proteins, only p65 bound to a column of
      immobilized lysoganglioside. The same protein, purified by preparative
      electrophoresis, retained the binding activity and fully reproduced the
      hemagglutinating property and the selectivity for acidic lipids of whole
      vesicles. The results suggest that the (hemagglutinating) lipid binding
      properties of the vesicles are mainly if not exclusively due to p65.

PMID- 1623169
TI  - CRF increases protein phosphorylation and enhances retention performance in rats.
AB  - This study examines the roles of PKC and protein phosphorylation in the retention
      performance of a passive avoidance learning (PAL) task in rats. Results revealed
      that H7 injected into the dentate gyrus (DG) of the hippocampus impaired
      retention in a dose-dependent manner. Corticotropin-releasing factor (CRF)
      injected into the DG improved retention and this facilitation was antagonized by
      H7 pretreatment. CRF increased phosphorylation of five proteins, whereas H7
      decreased phosphorylation in three of these proteins in both the cytosol and the
      membrane fractions of hippocampus. These effects were shown not to be associated
      with stress. These results demonstrate that CRF increased protein phosphorylation
      associated with enhanced retention of PAL task in rats.

PMID- 1623170
TI  - Subcortical mechanisms in orientation sensitivity of cat visual cortical cells.
AB  - The orientation biases seen in the responses of neurones of the dorsal lateral
      geniculate nucleus (dLGN) can be reduced by the local application of the GABA
      antagonist, bicuculline methiodide. This fact was exploited to investigate
      whether these biases are important for cortical orientation selectivity by
      measuring the orientation sensitivity of cortical cells before and during
      iontophoretic administration of bicuculline in the topographically corresponding
      region of the dLGN. This procedure led to a significant reduction in the
      orientation sensitivity of the cortical cell. The results suggest that
      subcortical orientation biases are at least partly responsible for the
      orientation sensitivity seen at the level of the striate cortex.

PMID- 1623171
TI  - Slow modulation of EEG.
AB  - Time variation of the successive 2.5 s long EEG theta and alpha band powers
      during 5 min rest and 4 min hyperventilation (HV) was analyzed by modified Wigner
      distribution (WD) in 22 subjects. Two main peaks at frequency 0.02 Hz and 0.068
      Hz were detected in the WDs of both alpha and theta powers at rest. The HV
      increased the magnitude of the faster (0.068 Hz) component of both theta and
      alpha WD's while the slower (0.02 Hz) component was increased only in the theta
      WD. We hypothesize that this slow brain activity reflects spontaneous periodic
      changes of cortical excitability with control at the brain stem level.

PMID- 1623172
TI  - The hippocampo-septal projection in mice: long-term potentiation in the lateral
      septum.
AB  - In anaesthetized young mice, the fimbria was stimulated and field potentials were
      recorded ipsilaterally in the lateral septum (LS). Evoked responses were
      typically characterized by a two-component negative wave (N2 and N3) followed by
      a low amplitude positive wave. The amplitudes and latencies were highest and
      shortest respectively in the dorsal LS for the N3 component and in the ventral LS
      for the N2 component. Tetanic stimulation of the fimbria induced long-term
      potentiation (LTP) only in the case of the N3 component. The differential changes
      in N2 and N3 following tetanic fimbrial stimulation are discussed in the context
      that the dorsal LS appears to exhibit a higher density of LTP-mediating
      receptors.

PMID- 1623173
TI  - Whole-cell membrane current and membrane resistance during hypoxic spreading
      depression.
AB  - In rat hippocampal tissue slices we recorded extracellular potential (Vo) and
      whole-cell patch clamp current of CA1 pyramid cells. During hypoxic spreading
      depression (SD)-like depolarization, the holding current (Ih) increased sharply.
      Membrane 'slope' resistance (Rm) decreased to 10-67% (mean 39%) of the resting
      value. The SD-related membrane current (ISD) reversed near zero mV. With voltage
      dependent K+ and Na+ currents blocked by Cs+ and QX-314, shifts of Ih and
      decrease of Rm during SD were not suppressed. We conclude that hypoxic SD of CA1
      pyramidal cells is associated with a large non-selective inward current through
      yet to be identified membrane mechanisms, which cannot fully explain the SD
      related Vo shift.

PMID- 1623174
TI  - Alpha 1-antitrypsin and alpha 1-antichymotrypsin are in the lesions of
      Alzheimer's disease.
AB  - We performed immunocytochemistry to localize alpha 1-antichymotrypsin and alpha 1
      antitrypsin in tissue sections of Alzheimer disease patients. Our results show
      that both serine protease inhibitors are localized in neurofibrillary tangles and
      senile plaques. Using various monoclonal and polyclonal antibodies,
      immunolabeling was evident in formalin, methacarn or acetone-fixed sections.
      Brief pretreatments of sections with either formic acid or guanidine-HCl were
      also necessary to reveal clear immunostaining of the lesions with two of the
      antibodies. We suggest that both alpha 1-antitrypsin and alpha 1-antichymotrypsin
      may be functionally involved in the pathogenesis of the lesions of Alzheimer's
      disease. Like alpha 1-antichymotrypsin, the major cell producing alpha 1
      antitrypsin is likely to be astrocytes since the protein was localized there and
      astrocytes are involved in both lesions.

PMID- 1623175
TI  - Impaired acquisition of the Morris water maze following global ischemic damage in
      the gerbil.
AB  - Five minutes of global ischemia in the Mongolian gerbil impaired acquisition of a
      Morris water maze task when testing began 72 h after surgery. In spite of
      extensive damage to CA1 pyramidal cells, ischemic animals eventually learned to
      locate a submerged platform and performed normally on a subsequent retention
      test. Animals that were allowed a more protracted recovery period (21 days)
      acquired the task as readily as control gerbils. These results suggest that
      undamaged structures within and external to the hippocampal formation allow
      spatial learning to proceed at a somewhat reduced rate.

PMID- 1623176
TI  - Prolactin similar to ectopic pituitary isograft restores responsiveness in Snell
      dwarf mice.
AB  - The effects of ovine prolactin (PRL) (2 x 5 IU a day) and an ectopic pituitary
      isograft on the responsiveness were examined using locomotor and exploratory
      activities as measures in PRL-growth-hormone-thyrotropin-deficient Snell dwarf
      mice (dw/dw). After 5 weeks of treatment, both PRL and the graft restored the two
      behavioural measures to normal levels. Results clearly demonstrate the
      involvement of PRL in global behavioural responsiveness and suggest a possible
      role for PRL in the changes induced by the graft.

PMID- 1623177
TI  - The carboxy-terminal extension of the D1-precursor protein is dispensable for a
      functional photosystem II complex in Chlamydomonas reinhardtii.
AB  - The D1-precursor protein of the photosystem II reaction centre contains a carboxy
      terminal extension whose proteolytic removal is necessary for oxygen-evolving
      activity. To address the question of the role of the carboxy-terminal extension
      in the green alga Chlamydomonas reinhardtii, we truncated D1 by converting codon
      Ser345 of the psbA gene into a stop codon. Particle gun transformation of an in
      vitro modified psbA gene fragment also carrying mutations conferring herbicide
      resistance yielded a homoplasmic transformant containing the stop codon. Since
      oxygen evolution capacity is not affected in this mutant as compared with
      herbicide-resistant control cells, the carboxy-terminal extension is dispensable
      for a functional photosystem II complex under normal growth conditions.

PMID- 1623178
TI  - Functional analysis of the regulatory region of a zein gene in transiently
      transformed protoplasts.
AB  - The transcription of zein genes in maize is tissue-specific and developmentally
      regulated. The 5' regulatory region of many zein genes contains two promoters, P1
      and P2, lying approximately 1000 bases apart. The promoter/enhancer activity of
      various fragments of the two promoter regions of the zein gene E19 have been
      analysed by means of transient expression experiments. The results indicate that
      the various regions differentially affect the expression of the GUS reporter gene
      activity in protoplasts from tobacco leaves, maize immature endosperms and in
      vitro endosperm cell cultures. In tobacco protoplasts only the proximal promoter
      region, P2, activates GUS expression, while in endosperm culture cells only the
      distant promoter, P1, gives significant activity. The P1 region, both in direct
      and opposite orientation, stimulates a low level of GUS expression in protoplasts
      from immature endosperms.

PMID- 1623179
TI  - Isolation and characterization of a gene encoding a chlorophyll a/b-binding
      protein from mustard and the targeting of the encoded protein to the thylakoid
      membrane of pea chloroplasts in vitro.
AB  - Three independent clones carrying a mustard gene coding for the chlorophyll a/b
      binding protein were isolated by screening a genomic library of mustard with a
      heterologous cDNA probe from pea. All of them encode the same CAB gene, which, as
      shown by sequence analysis and comparison with published CAB sequences, belongs
      to the family of type I PSII CAB genes, encoding a precursor protein of 266 amino
      acids. Several conserved sequence motifs are observed in the 5' and 3' non-coding
      region of the gene. The putative transcription start site could be localized to
      60 bp upstream of SA-CAB1 initiator codon by S1 mapping. Plasmids were
      constructed which allow in vitro transcription and translation of the whole
      chlorophyll a/b-binding protein and of truncated species which lack increasing
      portions of the C-terminus. Whereas the in vitro import into pea chloroplasts is
      not affected by these C-terminal deletions, targeting to the thylakoid membrane
      is abolished by the removal of the C-terminal helical domain. Accordingly, the 54
      amino acids which contain the C-terminal membrane-spanning helix and flanking
      regions is an essential component of the thylakoid targeting signal.

PMID- 1623180
TI  - Construction and characterisation of a yeast artificial chromosome library
      containing three haploid maize genome equivalents.
AB  - We have constructed a yeast artificial chromosome (YAC) library using high
      molecular-weight DNA prepared from agarose-embedded leaf protoplasts of the maize
      inbred line UE95. This library contains 79,000 clones with an average insert size
      of 145 kb and should therefore represent approximately three haploid genome
      equivalents. The library is organised as an ordered array in duplicate microtitre
      plates. Forty-one pools of DNA from 1920 individual clones have been prepared for
      rapid screening of the library by the polymerase chain reaction (PCR). Using this
      approach, together with conventional colony hybridisation, we have been able to
      identify between one and eight positive clones for every probe used.

PMID- 1623181
TI  - Combination of in vitro capping and ribonuclease protection improves the
      detection of transcription start sites in chloroplasts.
AB  - A primary transcript from the chloroplast rpl32 gene was labelled at its 5' end
      using a capping enzyme and [alpha-32P]GTP followed by hybridization to a cold RNA
      probe. A RNase protection assay gave a clear protected band and its initiation
      site of transcription could thus be estimated, which had not been possible by
      using DNA probes. The combination of in vitro capping and RNase protection is an
      excellent method for mapping transcription initiation sites on the chloroplast
      genome and shows a high improvement relative to the DNA-employing strategies.

PMID- 1623182
TI  - Sequence analysis and developmental expression of an alfalfa protein disulfide
      isomerase.

PMID- 1623183
TI  - Nucleotide sequences of two cDNA clones encoding different Cu/Zn-superoxide
      dismutases expressed in developing rice seed (Oryza sativa L.).

PMID- 1623184
TI  - Sequence analysis of five new field isolates demonstrates that the chain length
      of potato spindle tuber viroid (PSTVd) is not strictly conserved but as variable
      as in other viroids.
AB  - The sequence analysis of five new field isolates of potato spindle tuber viroid
      (PSTVd) of different virulence revealed that the length of their RNA chain is not
      strictly conserved to 359 nucleotides (nts), as one could have inferred from the
      previously sequenced PSTVd strains. It was now found that the chain length is
      strain-specific like in the case of practically all other viroids, and that it
      may vary, so far, between 356 and 360 nts. Taking our previously sequenced and
      least virulent mild strain PSTVd KF6-M as standard, the new mild strains PSTVd WA
      M and PSTVd F-M differ from it by one or two nts. The new intermediate-severe
      strains PSTVd F-IS and PSTV-F 88-IS differ from the standard mild strain by eight
      and nine nts, respectively, whereas the new severe-lethal strain PSTVd F-SL
      differs in seven nts. Most of these mutations are located within the virulence
      modulating (VM) region and within the variable region (VR), and only in two
      strains a single mutation is found in the right terminal domain.

PMID- 1623185
TI  - Nucleotide sequence of the rice (Oryza sativa) Em protein gene (Emp1).

PMID- 1623186
TI  - Complete nucleotide sequence of a sorghum gene coding for the phosphoenolpyruvate
      carboxylase involved in C4 photosynthesis.

PMID- 1623187
TI  - Amino acid sequence of the N-terminal domain of yam (Dioscorea japonica) aerial
      tuber acidic chitinase. Evidence for the presence of a wheat germ agglutinin
      domain in matured acidic chitinase from unstressed tuber.
AB  - The amino acid sequence of the N-terminal domain of acidic chitinase from
      unstressed aerial tuber was determined and proved the presence of an N-terminal
      domain in acidic chitinase. The amino acid sequence was determined on a
      pyroglutamylaminopeptidase-treated N-terminal fragment of V8 protease and on
      chymotryptic peptides of this fragment. The sequence determined revealed 8
      residues deletion and 2 residues insertion as compared with the N-terminal domain
      of tobacco basic chitinase. The N-terminal domain determined showed a homology of
      40% and 52% with the N-terminal domain of tobacco basic chitinase and wheat germ
      agglutinin, respectively.

PMID- 1623188
TI  - Conserved relationship between psbH and petBD genes: presence of a shared
      upstream element in Prochlorothrix hollandica.
AB  - Prochlorophytes are an unusual group of prokaryotic oxygenic photoautotrophs that
      morphologically appear to bridge the gap between cyanobacteria and the
      chloroplasts of eukaryotic plants. Molecular data place this group evolutionarily
      within the cyanobacteria, but they have a photosynthetic apparatus that is very
      similar to that found in chloroplasts. We have sequenced from the prochlorophyte
      Prochlorothrix hollandica a set of genes (psbB, psbH, petB and petD) that has a
      conserved organization in chloroplast genomes that is different from the
      organization in cyanobacterial genomes. The four genes are linked as an operon in
      chloroplasts, but only petB and petD are closely linked and cotranscribed in
      cyanobacteria. Although the prochlorophyte gene arrangement resembles that of
      cyanobacteria, one feature suggests the coordinated regulation of the unlinked
      genes. A 93 bp region of absolute conservation occurs upstream of the psbH gene
      and the petBD operon, near the site of transcription initiation in each gene set.
      This conserved element may indicate an alternative to cotranscription for
      achieving co-regulation of the psbH and petBD genes in the prochlorophyte.

PMID- 1623189
TI  - Cloning and characterization of a gene involved in phytoene synthesis from
      tomato.

PMID- 1623191
TI  - Molecular basis for novel root phenotypes induced by Agrobacterium rhizogenes A4
      on cucumber.
AB  - We have used the wild-type Agrobacterium rhizogenes strain A4 to induce roots on
      cucumber stem explants. Cultures of transformed roots obtained that were capable
      of hormone-autonomous growth could be grouped in three phenotypic classes. Of
      particular interest were extremely thick roots of a type not previously
      described. Characterization of the transferred DNA and of the expression of the
      corresponding genes allowed us to determine that the genes rolABC of the TL
      region of the Ri plasmid are sufficient to induce thin roots similar to those
      observed in other species, while the aux genes of the TR region are sufficient to
      induce thick roots. Among clones bearing the aux genes, there was a correlation
      between level of expression of aux2 and root phenotype.

PMID- 1623190
TI  - Structure of the pine (Pinus thunbergii) chlorophyll a/b-binding protein gene
      expressed in the absence of light.
AB  - A gene for chlorophyll a/b-binding protein (cab) of pine (Pinus thumbergii) was
      isolated and sequenced. The gene (cab-6) contains an intron at a position
      equivalent to the type II cab genes of angiosperms. Transcript mapping analyses
      show that the amount of the mRNA in the dark is about half of that in the light.
      The cab-6 gene is expressed in dark-grown seedlings at a very high level,
      differing from angiosperm cab genes which are induced by light. The cab-6 gene
      typifies the coniferous plant cab genes in light-independent gene expression.

PMID- 1623192
TI  - Molecular cloning of a cDNA encoding aspartate aminotransferase-P2 from lupin
      root nodules.
AB  - Two isoenzymic forms of aspartate aminotransferase are present in the plant
      fraction of developing lupin root nodules. One of these forms, aspartate
      aminotransferase-P2 (AAT-P2), increases dramatically with the onset of biological
      nitrogen fixation and is associated with the assimilation of ammonia by the plant
      in the Rhizobium-legume symbiosis. A day 18 lupin nodule cDNA library in the
      lambda ZapII vector was immunoscreened with a monoclonal antibody specific for
      AAT-P2 and yielded two near-full-length 1700 bp clones. These clones were
      sequenced. Amino acid sequences from three peptides derived from immunopurified
      AAT-P2 were aligned, and showed 100% homology with the amino acid sequence
      deduced from the cDNA clones. The DNA sequence showed 50% homology with AAT
      sequences from a range of animal sources. Conversion of the clones to the
      phagemid form allowed their expression in Escherichia coli where both exhibited
      enzyme activity that could be immunoprecipitated with AAT-P2-specific monoclonal
      antibodies. Western blot analysis revealed protein moieties with molecular masses
      of 39, 43, 45 and 55 kDa. The 5' end of the clones coded for a hydrophobic leader
      sequence of about 50 amino acids indicative of a targeting sequence and
      consistent with the plastid localisation of nodule AAT-P2.

PMID- 1623193
TI  - Nucleotide sequence of a gene from Arabidopsis thaliana encoding a myb homologue.
AB  - A gene encoding a proto-oncogene, a myb-related gene named Atmyb1, was cloned
      from Arabidopsis thaliana, and its nucleotide sequence was determined. The Atmyb1
      gene contains an intron of 494 bp, and there are no highly homologous sequences
      present in the A. thaliana genome, but evidence was found that other myb-related
      genes exist. In the 5' flanking region, we found several typical cis-acting
      elements found in plant promoters. Sequence comparisons revealed that the ATMYB1
      protein has a putative DNA-binding domain with two repeats of tryptophan
      clusters, which is common in MYB-related proteins in plants, while animal MYB
      related proteins contain DNA-binding domains with three repeats of tryptophan
      clusters. The putative DNA-binding domain of the ATMYB1 protein has higher
      homology with that of the human c-MYB protein than with those of other plant MYB
      proteins.

PMID- 1623194
TI  - An alfalfa cDNA encodes a protein with homology to translationally controlled
      human tumor protein.

PMID- 1623195
TI  - Complete nucleotide sequence of the 22 kDa coat protein of Andean potato mottle
      virus.

PMID- 1623196
TI  - Nucleotide sequence of the mitochondrial 18S rRNA gene from lupine (Lupinus
      luteus).

PMID- 1623197
TI  - Construction of in-frame chimeric plant viral genes by simplified PCR strategies.
AB  - The use of polymerase chain reaction (PCR)-based mutagenesis to create chimeric
      genes is presently not cost-effective because of the size and number of primers
      as well as the number of PCRs required. We have developed two strategies based on
      inverse PCR that exploit limited homologies between two DNA molecules to create
      in-frame chimeric plant viral genes. This report also contains a compilation of
      information useful for determining possible restriction sites at a given common
      dipeptide coding motif between any genes of interest.

PMID- 1623198
TI  - Nucleotide sequence of a cDNA encoding an Arabidopsis cyclophilin-like protein.

PMID- 1623199
TI  - Structure and sequence of a dehydrin-like gene in Arabidopsis thaliana.

PMID- 1623200
TI  - Isolation of a gene from maize encoding a chlorophyll a/b-binding protein.

PMID- 1623201
TI  - The nucleotide sequence of the rDNA spacer region between the 25S and 18S rRNA
      genes in a species of the genus Vicia, V. hirsuta.

PMID- 1623202
TI  - Isolation and sequence analysis of a cDNA clone encoding ethylene-forming enzyme
      in Brassica juncea (L.) Czern & Coss.

PMID- 1623203
TI  - The cell-cell channel in the control of growth.
AB  - Several lines of evidence indicate that the cell-cell channels in gap junction
      are conduits for growth-regulating signals. Experimental upregulation of the
      channels by retinoids causes inhibition of cellular growth and, conversely, their
      downregulation by oncogenes, e.g. activated src, stimulates growth. In either
      direction, the extent of growth correlates tightly with the degree of
      communication. Cogent evidence of the channel's function in growth regulation is
      now on hand: incorporation of a channel-protein gene into the genome of a
      transformed communication-deficient cell line normalizes communication and
      growth. The current data conform to a model of growth control with discrete
      regulatory centers.

PMID- 1623204
TI  - Classical cadherins.
AB  - Cadherins represent a gene family of Ca(2+)-dependent cell adhesion molecules
      (CAMs) identified during development and in adult organs. They generally mediate
      cell-cell adhesion by homotypic interaction, although heterotypic binding between
      different cadherin molecules is possible. Molecular cloning and sequence
      comparison has led to the characterization of a highly homologous group of
      'classical' cadherins and more distantly related members, together composing a
      gene superfamily. The classical cadherins are transmembrane glycoproteins which
      exhibit, in addition to the structural homologies, a very similar overall protein
      topology. Protein sequence comparison has led to the identification of domains of
      common functional importance. The cytoplasmic domains of cadherins associate with
      peripheral cytoplasmic proteins termed catenin alpha, beta and gamma with
      molecular weights of 102, 88 and 80 kDa respectively. This complex formation
      seems to regulate the adhesive function of cadherins, most likely by connecting
      cadherins with actin microfilaments. Possible implications of catenins for
      cadherin function are discussed.

PMID- 1623205
TI  - Structure and interactions of desmosomal and other cadherins.
AB  - The cadherin superfamily of cell-cell adhesion molecules is now known to include
      proteins of the desmosome as well as of the adherens type of junction. The
      desmosomal cadherins consist of two families of proteins, the desmocollins and
      the desmogleins, both of which are represented by different isoforms which are
      differentially expressed in epidermis. The desmocollins are quite similar to the
      classic cadherins in overall structure, but with alternatively spliced variants;
      the desmogleins have extra cytoplasmic sequences added onto the basic cadherin
      structure. The cytoplasmic domains are specialized for binding to 'mediator'
      proteins, such as plakoglobin, which interconnect to the intermediate filament
      system rather than the actin filaments as do the classic cadherins.

PMID- 1623206
TI  - Cell adhesion in invasion and metastasis.
AB  - Metastatic cells exhibit considerable flexibility in their adhesive interactions
      with other cells or components of the extracellular matrix. This review will
      describe the involvement of specific adhesion receptors, extracellular matrix
      molecules and cell dissociating cytokines in the metastatic cascade. We will
      particularly focus on disturbance of intercellular adhesion as a prerequisite for
      the release of invasive cells from carcinomas. We suggest that cell dissociation
      in these tumours is accomplished by loss of function or expression of the
      epithelial cell adhesion molecule E-cadherin, and through the activity of cell
      motility factors such as the scatter factor.

PMID- 1623207
TI  - Immunoglobulin superfamily: structure, function and relationship to other
      receptor molecules.
AB  - The immunoglobulin superfamily includes the most diverse group of receptors
      known. They are united by the possession of a common structural feature, the
      immunoglobulin homology domain. They are found in species from insects to man.
      They are central to both the humoral and cell mediated immune reactions; they
      serve as cell surface receptors responsible for positional ques during embryonic
      development, as well as viral and growth factor receptors. They function in
      conjunction with other receptor families including the integrins and selectins.
      Thus, they are frequently parts of adhesive cascades and as such activate signal
      transducing systems required for the expression or activation of other cell
      surface receptors. They continue to be the targets of intense investigation into
      the molecular basis of adhesive interactions.

PMID- 1623208
TI  - NCAM: structural diversity, function and regulation of expression.
AB  - NCAM is a large family of structurally closely related proteins with cell-cell
      adhesive properties and a temporo-spatially regulated expression throughout
      development. This review covers recent work on NCAM with an emphasis on the still
      open questions of the full extent of structural diversity and the mechanism
      whereby it arises, the chemistry and functional consequences of the binding event
      and the intricacies of the developmental regulation of NCAM, all of which have
      ramifications in its likely role as an effector of morphogenesis.

PMID- 1623209
TI  - Selectins: cell surface lectins which mediate the binding of leukocytes to
      endothelial cells.
AB  - The selectins are the most recently identified family of cell adhesion molecules.
      The three known members of this family (L-, E- and P-selectin) mediate the
      binding of leukocytes to endothelial cells and are involved in the homing of
      lymphocytes to lymph nodes, as well as the extravasation of neutrophilic
      granulocytes into inflamed tissues. The lectin character of these cell adhesion
      molecules (CAMs) makes the selectin protein family unique among all known CAM
      families. The review will summarize present knowledge about the structural
      organization, the ligands identified (carbohydrates and glycoproteins) and the
      different regulation mechanisms of the cell surface activity of the three
      selectins.

PMID- 1623210
TI  - Local therapy of malignant pleural effusion with mitoxantrone.
AB  - Twelve patients received intrapleural instilments of the cytostatic agent
      mitoxantrone in a total dosage of 30 mg for locoregional palliative therapy of
      malignant pleural effusion. Effusion could be stopped for a mean period of 3.2
      months in 11 patients.

PMID- 1623211
TI  - Clinical pharmacokinetics of ifosfamide in combination with N-acetylcysteine.
AB  - The pharmacokinetics of ifosfamide were studied in 20 patients with soft tissue
      and bone sarcomas. Drug was administered as a 30-60 min i.v. infusion at 1.2 or
      2.0 mg/m2/day for five consecutive days. Some patients also received 1.5 g/m2 of
      N-acetylcysteine (NAC) administered 3 times per day during the course of therapy.
      NAC had no effect on ifosfamide pharmacokinetics. There were significant
      differences in plasma half-life, area under the concentration-time curve and
      plasma clearance on day 1 versus day 5 of ifosfamide administration.
      Myelosuppression and granulocytopenia correlated better with day 1 versus day 5
      ifosfamide pharmacokinetics suggesting that the alteration of ifosfamide
      pharmacology with multiple dosing has a significant effect on drug activity.

PMID- 1623212
TI  - Effects of the Ru(III) complexes [mer-RuCl3(DMSO)2Im]degrees and Na[trans
      RuCl4(DMSO)Im] on solid mouse tumors.
AB  - The effects of two new Ru(III) complexes, [mer-RuCl3(DMSO)2Im] degrees and
      Na[trans-RuCl4(DMSO)Im], were investigated on primary tumor growth and on the
      survival time using three solid metastasizing tumors of the mouse: Lewis lung
      carcinoma, B16 melanoma and MCa mammary carcinoma. Na[trans-RuCl4(DMSO)Im]
      appears to be the most promising compound, in that: (1) it is soluble in water
      and therefore easy to handle in comparison with the neutral species [mer
      RuCl3(DMSO)2Im]degrees or to the already described BBR2382; (2) similarly to
      cisplatin, though at a lower level, it reduces tumor growth in its primary site
      in each tumor model employed; (3) unlike cisplatin, it increases the life span of
      tumor-bearing hosts in all tumors used, independently of the effects on primary
      tumor growth; and (4) it is also effective in reducing spontaneous metastasis
      formation when the effects on primary tumor growth are completely absent.
      Dimethylsulfoxide (DMSO), used for solubilizing poorly water-soluble compounds
      (i.e. [mer-RuCl3(DMSO)2Im]degrees) or for stabilizing the compound in the
      solution before injection (i.e. Na[trans-RuCl4(DMSO)Im]), reduces the anti-tumor
      potency. Conversely, the antitumor effects of Na[trans-RuCl4(DMSO)Im] are more
      pronounced in mice hydrated with isotonic saline. We conclude that Na[trans
      RuCl4(DMSO)Im] is a good candidate for further investigations aimed at
      ascertaining the mechanism of the anti-metastatic activity and of the positive
      effects on survival time of mice bearing solid metastasizing tumors.

PMID- 1623213
TI  - Relationship between tumor histopathology and in vitro sensitivity to antitumor
      drugs in gastric cancer.
AB  - The in vitro drug sensitivity of gastric cancer tissues obtained from 40 patients
      with advanced cancer was compared in terms of the pathological classifications
      which were assigned according to the General Rules for the Gastric Cancer Study
      in Surgery and Pathology in Japan. Cases of poorly differentiated adenocarcinoma
      which had penetrated the serosa were evaluated using the succinate dehydrogenase
      inhibition (SDI) test for determining the in vitro chemosensitivity. The
      sensitivity of the stage III group to cisplatin was higher than that of the stage
      IV group. Although there were no statistical differences in drug sensitivities
      according to macroscopic findings (Borrmann's classification), the expanding
      growth type was more susceptible that the infiltrating type to cisplatin,
      aclacinomycin A (ACR) and carboquone (CQ) microscopically. In cases of lymph node
      metastasis [n(+)] the sensitivity to cisplatin, ACR, CQ, adriamycin and mitomycin
      C was less than in those with or without primary lymph node metastasis [n(-)];
      lymphatic invasion in the gastric wall (ly) was a significant factor linked to
      drug resistance. Our findings indicate that the evaluation of tumor pathology is
      important in predicting the chemosensitivity of poorly differentiated gastric
      cancers.

PMID- 1623214
TI  - Effects of intravesical Corynebacterium parvum on recurrences of superficial
      tumors of the urinary bladder.
AB  - We studied 96 patients with superficial tumors of the urinary bladder treated by
      transurethral resection in order to investigate the value of intravesical
      Corynebacterium parvum (CP) to prevent recurrences. In 52 cases, two vials (2 ml,
      4 mg CP) diluted in 60 ml buffer saline were intravesically administered weekly
      12 times and then monthly for a period of 2 years. All patients were studied in a
      3 year follow-up by cytology, histology and endoscopy. Recurrences were observed
      in 21.1% of cases in the CP treated group and in 54.5% of cases in the untreated
      group. CP immunostimulation is less effective in preventing recurrences in
      patients with malignant cells as indicated by urine smears in the post-operative
      period. Morphological changes of the bladder wall due to CP administration in
      patients without recurrences are described. Chronic lymphocyte infiltrate appears
      to be an essential event for the action of CP as an adjuvant therapy in urinary
      bladder cancer.

PMID- 1623215
TI  - Preclinical activity of ilmofosine against human tumor colony forming units in
      vitro.
AB  - Ilmofosine (BM 41.440, 1-hexadecylthio-2-methoxymethyl-rac-glycero-3
      phosphocholine) is a synthetic alkyl lysophospholipid analog with activity
      against a variety of tumor models in vitro and in vivo. The i.v. form is
      presently undergoing early clinical investigation in phase I trials. In order to
      help define types of tumors that might be clinically sensitive to this agent we
      have studied the anti-tumor effects of ilmofosine against a variety of freshly
      explanted human tumor specimens using an in vitro soft agar cloning system. Final
      concentrations of 1.0-30 microgram/ml were used in continuous incubations
      experiments. Of 348 specimens tested, 134 (39%) were evaluable for determination
      of tumor growth modulating activity. The most common tumor types recruited
      included non-small cell lung, breast, colorectal, ovarian, renal cell cancer and
      melanoma. A concentration-dependent increase in the frequency of inhibited tumor
      specimens was observed with 6/134 (4%) sensitive specimens at 1 microgram/ml as
      compared with 113/133 (85%) sensitive specimens at 30 micrograms/ml (p less than
      0.0000005). We conclude that ilmofosine is active against a variety of tumors in
      vitro. Clinical phase II trials with ilmofosine including the tumor types with in
      vitro sensitivity are warranted if adequate plasma concentrations of this agent
      can be reached in patients.

PMID- 1623217
TI  - The anti-neoplastic activity of 2,3-dihydrophthalazine-1,4-dione and N-butyl-2,3
      dihydrophthalazine-1,4-dione in human and murine tumor cells.
AB  - 2,3-Dihydrophthalazine-1,4-dione derivatives demonstrated potent cytotoxicity
      against the growth of murine leukemia cells and human single cell suspension,
      i.e. Tmolt3 leukemia and HeLa-S3, as well as colon adenocarcinoma and KB
      nasopharynx. However, only select compounds demonstrated activity against
      bronchogenic lung, osteosarcoma and glioma growth. 2,3-Dihydrophthalazine-1,4
      dione was active in vivo against L1210 leukemia, Lewis lung and Ehrlich ascites
      carcinoma growth. In L1210 cells the agents inhibited both DNA and RNA synthesis,
      and a few of the compounds were capable of inhibiting protein synthesis at 3
      times their ED50 values. When 2,3-dihydrophthalazine-1,4-dione and N-butyl-2,3
      dihydrophthalazine-1,4-dione were examined for their mode of action in the L1210
      lymphoid leukemia cells, the sites of inhibition by the agents appear to be the
      de novo purine pathway at the enzymes IMP dehydrogenase and PRPP amido
      transferase. IMP dehydrogenase activity was inhibited at least 45% by 45 min at
      100 microM concentration of drugs whereas the remaining enzymes that were
      affected by the drugs were not inhibited as early. Secondary sites were
      dihydrofolate reductase and thymidylate synthetase. The d(NTP) levels were also
      reduced specifically dATP and dCTP levels.

PMID- 1623216
TI  - Dose response and toxicity of doxorubicin microspheres in a rat tumor model.
AB  - The therapeutic response and toxic effects of chemotherapy using several doses of
      doxorubicin in conventional solution form or bound to an ion-exchange resin were
      compared in a rat tumor model, to assess the relationship of drug dose to
      therapeutic efficacy and associated toxicity. Single bolus injections of 3.0,
      4.5, 6.0, 7.5 and 9.0 mg/kg were administered via the abdominal aorta to rats
      bearing hindlimb tumors. Tumor size was measured serially and the growth rates of
      treated groups were compared with a control growth curve. In addition, the effect
      of empty microspheres on tumor growth rate was assessed. The levels of
      circulating white blood cells were measured and compared to control levels to
      provide an indication of the severity of bone marrow toxicity experienced by each
      form of treatment. Finally, any difference in the distribution of doxorubicin to
      tumor, hindlimb and cardiac tissue following administration of doxorubicin as
      free drug or on microspheres was ascertained. Empty ion-exchange resin exerted a
      small although significant detrimental effect on tumor growth which may be
      explained by the embolization of microspheres in the precapillary blood vessels
      of the tumor resulting in a transient delay in tumor growth rate. The lowest dose
      of doxorubicin produced a significantly better therapeutic response when
      administered in the free drug form, but higher doses elicited an equivalent delay
      in tumor growth for both drug microsphere and free drug groups in a dose
      dependent manner, with the maximum anti-tumor response occurring at the highest
      dose. Treatment with free doxorubicin at high doses resulted in significant
      reductions of circulating white blood cells suggesting the occurrence of bone
      marrow toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623218
TI  - 9-Hydroxybenfluron: effect on energy-yielding processes in Ehrlich ascites and
      P388 murine leukemia cells.
AB  - The main purpose of the present investigation was to study the effect of 9
      hydroxybenfluron (HBF) on aerobic glucose consumption, lactic acid formation,
      content of total (T-SH) and non-protein thiol groups (NP-SH), endogenous
      respiration and levels of ATP in both Ehrlich ascites and P388 murine leukemia
      cells. The lowest concentrations of HBF significantly stimulated both glucose
      consumption and lactate formation in Ehrlich ascites cells. HBF decreased the
      level of both T-SH and NP-SH in Ehrlich cells. However, the decrease in the level
      of NP-SH was significantly higher. Both respiration and ATP levels were inhibited
      more markedly in Ehrlich than in P388 cells. In P388 cells a significant decrease
      in ATP level (67%) was noted only at the highest concentration of HBF (100
      mumol/l).

PMID- 1623219
TI  - Anti-tumor properties of the organometallic complex cis
      dimethylbis[sulfinylbis[methane]-S]platinum(II).
AB  - The water-soluble organometallic complex cis-[Pt(Me)2(Me2SO)2] (Me = methyl;
      Me2SO = dimethyl sulfoxide) (cis-dimethyl platinum(II); CDMP) was evaluated for
      its toxicity on the rat and for its efficacy against two tumors of this animal:
      the Yoshida ascites sarcoma and the T8 sarcoma of Guerin. The lethal dose for 50%
      of normal animals was 46.4 mg/kg; the predominant toxic effects were loss of
      weight, decrease in leukocytes and necrosis of the kidneys after i.v. or of the
      liver after i.p. administration. Doses of drug varying from 2 to 40 mg/kg were
      administered once by i.p., i.v., i.m. and intra-tumor (i.t.) route from 1 to 7
      days after i.p. injection of 10(6) Yoshida ascites sarcoma cells and s.c.
      implantation of approximately 300 mg of T8 sarcoma of Guerin. The compound showed
      anti-tumor activity increasing both the average life span and survival of the
      rats. A comparison between the therapeutic properties of the title complex with
      those of cis-[PtCl2(NH3)2] (CDDP) reveals that cis-dimethyl platinum(II) exhibits
      the same anti-tumor activity associated with 6 times reduced toxicity.

PMID- 1623220
TI  - Lipophorin lipase from the yolk of Manduca sexta eggs: identification and partial
      characterization.
AB  - In the hawkmoth Manduca sexta high density lipophorin from adult insects (HDLp-A)
      delivers lipids to developing oocytes. During this lipid delivery HDLp-A is taken
      up by the oocyte and converted to a very high density lipophorin (VHDLp), which
      is stored in protein storage granules (yolk bodies). A membrane-free lysate of
      isolated M. sexta yolk bodies was demonstrated to contain lipoprotein lipase
      activity that hydrolyses the diacylglycerol of HDLp-A. With HDLp-A as a substrate
      yolk body lipophorin lipase (YBLpL) activity was shown to be maximal between pH 9
      and pH 9.5. NaCl concentration was optimal between 0.7 M and 1 M. YBLpL activity
      required neither bovine serum albumin nor calcium ions but appeared to be
      stimulated by 5 mM EDTA. Diisopropyl fluorophosphate effectively inhibited YBLpL
      activity, indicating the presence of a serine in the active site of the enzyme.
      The identified lipase activity co-eluted with lipophorins and vitellins from the
      yolk in the void volume of a Sephadex G-75 gel filtration column. This
      observation suggests that the lipase has a Mr of more than 80,000, or that the
      enzyme is associated with the lipoproteins. Incubation of HDLp-A with yolk body
      lysate converted HDLp-A to two classes of higher density lipophorins. The highest
      density lipophorins produced during this incubation approached the density of
      VHDLp as it is isolated from mature eggs. The possible role of YBLpL activity in
      the delivery of lipids to developing oocytes is discussed.

PMID- 1623221
TI  - Serum alanine aminotransferase levels among volunteer blood donors: effect of
      sex, alcohol intake and obesity.
AB  - Serum alanine aminotransferase (ALT) activity and antibody to hepatitis B core
      antigen (anti-HBc) were proposed as surrogate markers of non-A, non-B (NANB)
      infection. In this study we analyzed 649 consecutive repeat blood donors to
      define the possible exclusion rate if both surrogate markers were implemented in
      our Blood Service, and to assess risk factors associated with elevated ALT
      levels. One hundred and seven blood donors (16.5%) had slightly elevated ALT
      levels (higher than the upper reference value, but less than twice this level),
      but only 15 (2.3%) had a level higher than mean log + 2.25 SD. Seventy-seven
      (11.8%) resulted anti-HBc positive. Blood donors with elevated ALT levels and
      those who were anti-HBc positive belonged to different populations, being only 6
      (0.9%) positive for both surrogate markers. Only two known donors (0.3%) resulted
      anti-HCV positive, and each of them was implicated in one of the four post
      transfusion hepatitis (PTH) cases observed in 200 recipients of blood from these
      649 donors. Both were negative for anti-HBc but one had elevated ALT levels. Male
      sex, age, alcohol use and obesity resulted all independently and significantly
      associated with elevated ALT levels. For both alcohol use and body weight we
      observed a significant linear relationship with serum ALT levels. These findings
      suggest that in our Region the exclusion of blood donors with ALT levels above
      the reference value, or those anti-HBc positive, would exclude an unacceptably
      high rate of blood donors without proven evidence of post-transfusion hepatitis
      prevention.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623222
TI  - Treating chronic liver disease: lessons from a day hospital.
AB  - The relationship between the professional background of the physician requesting
      the biopsy procedure (whether non-specialist or specialist in
      hepatology/gastroenterology) and the subsequent decision of treatment of the
      patients was analyzed. Treatment was divided into two categories named
      arbitrarily "no therapy" (general supportive measures) or "therapy" (causal
      treatment based on active drugs or measures aimed at affecting the cause of the
      disease). Of the 204 cases of outpatient needle biopsies available for study, 157
      were made by specialist request and 47 were made by a non-specialist request.
      Sixty-eight (43%) of the former, but only 3 (2%) of the latter had "therapy" (p =
      0.0001). Also, patients in which histology showed chronic active liver disease
      had "therapy" more frequently (49 of 109, 44.9%) than those without chronic
      active liver disease (22 of 95, 23%) with p less than 0.01. However, patients
      with histological active chronic disease were not more frequent among specialist
      requests (56.6%) than among the non-specialist requests (42.5%). But among
      patients attended by the specialist, there were more patients (31.8%) with
      positive serum markers of Hepatitis B virus infection than among those sent by
      others (12.7%) with p less than 0.01. We conclude that at least in the premises
      in which this study was carried out, blind liver biopsies will lead to active
      treatment more often in patients treated by a specialized physician, because
      these patients are more likely to have a virus identified as the cause of their
      liver disease and consequently will receive antiviral treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1623223
TI  - Anticonvulsant-induced chronic pancreatitis. A case report.
AB  - We report the case of a young man suffering from epilepsy who developed chronic
      calcified pancreatitis after ten years of therapy with the anticonvulsant drugs
      carbamazepine and phenytoin. Long-term anticonvulsant drug therapy may have a
      contributory role in the development of chronic pancreatitis by chronic
      stimulation of cytochromes P-450.

PMID- 1623224
TI  - Endoscopy and gastroenterology.

PMID- 1623225
TI  - Italian Association for the Study of the Liver. XXV annual meeting. Rome, June 18
      19, 1992. Abstracts.

PMID- 1623226
TI  - Experimental endoscopic subcutaneous surgery.
AB  - Endoscopic techniques have found increasing applications in general surgery. In
      this article, an attempt has been made to utilize endoscopy via a subcutaneous
      approach in an experimental pig model for dissection of fat, muscle, and fascia.

PMID- 1623227
TI  - New drug interventions in Alzheimer's disease.

PMID- 1623228
TI  - Coma, intracranial pressure, intensive care, head injury and neoplasia.

PMID- 1623229
TI  - Long-term head injury problems.
AB  - Areas of current research in the nature and remediation of the long-term sequelae
      of traumatic brain injury (TBI) are reviewed. Studies identifying features that
      predict outcome still greatly outnumber those of efficacy of rehabilitation. A
      growing interest is in acute biochemical change that may exacerbate poor outcome.

PMID- 1623231
TI  - Neuropsychology, dementia and aging.

PMID- 1623230
TI  - Cerebrovascular disease.

PMID- 1623232
TI  - Disorders of cerebrospinal fluid circulation and edema.
AB  - An assessment of contemporary techniques for the diagnosis and management of
      hydrocephalus and brain edema are reviewed. Further refinements in magnetic
      resonance imaging (MRI) techniques may aid in the selection of patients with
      normal pressure hydrocephalus (NPH) who respond to shunting.

PMID- 1623233
TI  - Paediatric neurosurgery.
AB  - Surgical disorders of the central nervous system of children differ significantly
      from those of adults. The management of these disorders requires an integrated
      multidisciplinary practice of paediatric specialists in an appropriate paediatric
      environment. An increasing number of neurosurgeons are now restricting themselves
      to this field resulting in the more effective diagnosis and treatment of children
      with neurosurgical disorders.

PMID- 1623234
TI  - The early management of head injury.
AB  - Acute management involves triage, well directed investigation and timely surgical
      intervention when necessary. All are discussed in this review. Cerebral blood
      flow (CBF) and flow velocity assessment are among the other investigations
      mentioned. Other topics include paediatric head injury, cerebrospinal fluid (CSF)
      fistulae, stab wounds and post-traumatic epilepsy.

PMID- 1623235
TI  - Protection against ischaemia: the basis of acute stroke therapy.
AB  - The search for effective therapy of acute stroke, centres on the two strategies
      of restoring blood flow before ischaemia causes irreversible infarction, and
      moderation of the biochemical changes in ischaemic tissue that cause neuronal
      death. This review concentrates on the role of lactacidosis, calcium ions, free
      radicals, and excitatory neurotransmitters in the pathogenesis of neuronal death,
      and on the therapeutic possibilities in acute stroke emerging from studies in
      animal models.

PMID- 1623236
TI  - The cardiac factor in stroke.
AB  - Cardiac disorders associated with cerebral embolism including cardiac surgery,
      myocardial infarction, endocarditis and non-valvular atrial fibrillation (NVAF)
      are reviewed along with methods to detect cardioembolic sources. Warfarin and
      aspirin are effective in the primary prevention of stroke in NVAF but the
      relative efficacy remains to be determined.

PMID- 1623237
TI  - Rheology and strokes.
AB  - Further evidence is presented that rheological abnormalities antedate stroke and
      are not just a consequence of stroke. Whether these abnormalities should be
      corrected in the acute phase after stroke is still uncertain. Until more data are
      available haemodilution is not to be recommended in most cases of acute stroke.

PMID- 1623238
TI  - Imaging in cerebrovascular disease.
AB  - High-resolution structural imaging of ischemic lesions now enables the assignment
      of complex ischemic clinical symptoms to cortical and subcortical lesions.
      Functional imaging shows some new features of cerebral ischemia which can be
      directly investigated in the individual patient. Vascular imaging is rapidly
      improving with the introduction of magnetic resonance angiography (MRA). Today
      its diagnostic value is unsettled but promising, in particular if used in
      combination with other techniques like ultrasonography and positron emission
      tomography (PET).

PMID- 1623240
TI  - Neuropsychology, dementia and aging.

PMID- 1623239
TI  - Clinical trials in cerebrovascular disease.
AB  - Randomized clinical trials provide the most reliable evidence of the risks and
      benefits of a treatment or management plan. Often it is necessary to have
      information from many thousands of patients in a clinical trial to know how to
      manage the next patient in the clinic. Recent trials in stroke prevention will
      change clinical practice by the more appropriate use of carotid endarterectomy
      and the use of anticoagulation in non-rheumatic atrial fibrillation. Other
      studies have indicated that modification of risk factors, such as decreased salt
      consumption, is important. Despite many new trials there is still no proven
      treatment for acute ischaemic stroke. To provide reliable evidence on the risks
      and benefits of treatment of acute stroke we need much larger randomized
      controlled trials.

PMID- 1623241
TI  - Neuropsychology of vision.
AB  - A selection of the literature on vision published in the last 2 years from
      various neuroscience disciplines is reviewed. It is organized around the notion
      of independent processing mechanisms for sensory cues such as wavelength,
      intensity and orientation; these are subsequently integrated for the perception
      of colour, brightness and contours, for example, which then feed into higher
      order systems for visual recognition (words and objects) and visuospatial
      cognition. A strict hierarchical system is, however, not plausible. Apart from
      the physiological evidence against such a concept, the widespread observations of
      'knowledge without awareness' suggest direct links between different levels,
      which by-pass conscious experience.

PMID- 1623242
TI  - Neurology of developmental dyslexia.
AB  - Developmental dyslexia has until recently been considered to belong solely in the
      domain of educational psychology. With the advent of better theories on language
      and reading, and better methods for assessing the structure and function of
      living human brains and for determining genetic transmission, dyslexia is now
      poised to become a focal concern of cognitive neuroscience and genetic research.
      Recent findings from neuroanatomy, neurophysiology, neuropsychology, and genetics
      research are reviewed.

PMID- 1623243
TI  - Neurology of memory.
AB  - This review discusses the neurological basis of human memory focusing on brain
      behavior relations as revealed in patients with memory disorders due to brain
      lesions. A few relevant animal studies are also discussed. Recent studies are
      reviewed that provide new insights into the anatomic, chemical, and psychological
      organization of memory in health and neurological diseases.

PMID- 1623244
TI  - Amyloid, dementia and Alzheimer's disease.
AB  - Senile plaques (SP) and neurofibrillary tangles (NFT) are the major
      histopathological changes that occur in Alzheimer's disease (AD). How these two
      different types of lesions are related to each other and to the dementia of AD is
      unknown. Recent studies lead to paradoxical conclusions: NFT and neuronal
      alterations such as synapse loss are much more closely related to the symptoms of
      dementia than are SP. However, mutations in the beta-amyloid protein of SP have
      been found in some patients with familial AD, suggesting that an abnormality in
      amyloid causes the development of SP, NFT and AD dementia. Examination of
      transgenic animals that produce amyloid precursor protein (APP), or altered forms
      of APP, may lead to the development of an animal model of AD, and ultimately to
      answers that link amyloid production to neuronal alterations, and cognitive
      impairments.

PMID- 1623245
TI  - Epidemiology and genetics of multiple sclerosis.
AB  - Epidemiological data suggest an aetiological role for both genetic and
      environmental factors in multiple sclerosis (MS), but these have yet to be fully
      characterized. It is probable that MS susceptibility is determined by polygenes
      but specific loci need to be identified.

PMID- 1623246
TI  - Virus-induced demyelination in man: models for multiple sclerosis.
AB  - Epidemiologists have long worked at the limit of their powers to invoke an
      infectious agent to explain some of the epidemiological features of multiple
      sclerosis (MS). No virus has yet been definitively assigned a causal role in the
      pathogenesis of MS. Many viruses, however, have been incriminated, but it has not
      been possible to reproduce every single observation. Nevertheless, important
      lessons have been learned from the quest to identify such agents. Other kinds of
      demyelinating disease within the central nervous system (CNS) have been clearly
      linked to direct or indirect effects of viral infection. An understanding of the
      pathogenesis of these models affords possible insights into the mechanisms by
      which viruses or other agents might be operative in MS and other chronic diseases
      of the nervous system.

PMID- 1623247
TI  - Immunology of multiple sclerosis.
AB  - Recent advances in the understanding of the immunology of multiple sclerosis (MS)
      are discussed. In the central nervous system (CNS) major histocompatibility
      complex (MHC) class I and II antigens, and lymphocyte adhesion molecules are
      expressed. Furthermore, there are cells present which produce important effector
      molecules such as interferon (IFN)-gamma and tumor necrosis factor (TNF). A role
      for myelin antigen-specific autoimmunity is supported, but not proven, by the
      presence of a marked quantitative increase of T and B cells with such
      specificities, enriched to the CNS. Several myelin antigens, as well as a
      multitude of peptide parts of these, are apparently recognized. It will be of
      interest to study the functional abilities of these cells and how they are
      regulated.

PMID- 1623248
TI  - Pain and disorders of consciousness.

PMID- 1623249
TI  - Clinical epilepsy.
AB  - Advances in the understanding and treatment of human epilepsy published in the
      preceding year are discussed. The review focuses on three topical areas:
      epidemiological studies pertinent to clinical management decisions; new
      information on the pathophysiology and genetics of human epilepsy; and new
      information on vagal nerve stimulation as a potential treatment for medically
      intractable epilepsy.

PMID- 1623250
TI  - Pain mechanisms and the management of neuropathic pain.
AB  - The nociceptive system is not fixed, but changes in response to its input and
      activity. This 'plasticity' comprises dynamic developments of both pro- and
      antinociceptive processes. Recent advances in the understanding of these
      processes have important implications for the treatment of persistent neuropathic
      pain.

PMID- 1623251
TI  - Sleep disorders.
AB  - Advances in knowledge of brain regulation of sleep and wakefulness have led to
      greater understanding of the effects of such diseases as narcolepsy and sleeping
      sickness on brain function. Treatment of the two most common sleep disorders,
      insomnia and obstructive sleep apnea syndrome (OSAS), is often but not always
      effective; promising new approaches are under investigation.

PMID- 1623252
TI  - Infections and demyelinating disease.

PMID- 1623253
TI  - Pain and disorders of consciousness.

PMID- 1623254
TI  - Parkinson's disease: clinical and therapeutic aspects.
AB  - Recent developments on the clinical and therapeutic aspects of idiopathic
      Parkinson's disease (IPD) have focused on the role of monoamine oxidase B
      inhibition in IPD, strategies to manage the long-term levodopa (L-dopa) syndrome
      and attempts to replace nigral tissue by grafting. In addition, tools for
      community screening and possible identification of an 'at-risk' as well as
      presymptomatic population of sufferers have been suggested.

PMID- 1623255
TI  - Pathogenesis of Parkinson's disease.
AB  - The importance of genetic aspects, ageing, environmental factors, head trauma,
      defective mitochondrial respiration, altered iron metabolism, oxidative stress
      and glutamatergic overactivity of the basal ganglia in the pathogenesis of
      Parkinson's disease (PD) are considered in this review.

PMID- 1623256
TI  - The dystonias.
AB  - The various dystonias have been found in at least five different hereditary
      backgrounds. The gene responsible for one of the dystonias, idiopathic torsion
      dystonia (ITD), lies on chromosome 9q32-34, with flanking markers now 1-2 cM
      apart. Magnetic resonance imaging and computerized tomography (CT) abnormalities
      in the basal ganglia, especially in the putamen, are found in many secondary
      dystonias. Botulinum toxin therapy is proving very useful in the treatment of
      focal dystonias.

PMID- 1623257
TI  - Tics and myoclonus.
AB  - This article describes advances occurring over the last year in the
      pathophysiology, etiology and treatment of tics and myoclonus. Progress is being
      made in the clinical definition of Tourette syndrome (TS). The search for the TS
      gene has already excluded more than 50% of the autosomal genome. Progress in the
      understanding of myoclonus is slow but continuous. Several paper are devoted to
      clinical aspects but much recent attention has been focused on the
      pathophysiological mechanisms underlying myoclonus.

PMID- 1623258
TI  - Non-parkinsonian tremor.
AB  - Tremor may be seen not only in association with Parkinson's disease but also as
      an idiopathic disorder or in association with a variety of neurologic diseases.
      Our knowledge of these associations and of effective treatments for various types
      of tremor has increased.

PMID- 1623259
TI  - Genetic considerations in movement disorders.
AB  - Certain genetic aspects of the movement disorders, including parkinsonism,
      dystonia, ataxia, chorea, tics, and others, are reviewed. Clinical features,
      diagnostic techniques, and laboratory tests of newly recognized inherited
      syndromes are discussed. Progress in linkage analysis in several disorders is
      also presented.

PMID- 1623260
TI  - The impact of intensive neonatal care on the frequency of mental and motor
      handicap.
AB  - Recent outcome data on infants who were born extremely premature and who required
      extracorporeal membrane oxygenation (ECMO) are reviewed with particular reference
      to the design of follow-up studies. It is suggested that outcome data are an
      important medical audit measure.

PMID- 1623261
TI  - Migrational disorders of the brain.
AB  - Migrational disorders are the result of a wide range of fetal diseases that
      become manifest before midgestation. Recognition may not tell us everything about
      the etiology of these disorders, but it certainly tells us their time of origin.
      More diagnostic clues may be added to the case of an individual patient if the
      type of migrational disorder is taken into consideration.

PMID- 1623262
TI  - Epileptic encephalopathies of early childhood.
AB  - The epileptic encephalopathies of infancy and childhood include West syndrome,
      Lennox-Gastaut syndrome, severe myoclonic epilepsy of early childhood and related
      syndromes. The exact limits of these syndromes are still a subject of debate. The
      clinical features include several types of brief, frequently repeated seizures
      associated with mental retardation. The causes are multiple and brain
      malformations and dysplasias play an important role. Treatment remains
      unsatisfactory and the place of surgery seems limited.

PMID- 1623263
TI  - Neurological diseases in disorders of organic acids.
AB  - Organic acidemias remain a significant cause of mortality and morbidity,
      particularly resulting in neurological sequelae. The rapid recent expansion of
      technology has resulted in significant advances in the diagnosis of the
      disorders, but it can still be quite difficult. Recognition of specific features
      on neuroimaging can complement the biochemical and clinical assessment. Disorders
      of fatty acid oxidation have recently been recognized. It has become apparent
      that they occur more frequently and with a much wider clinical and biochemical
      spectrum than previously thought.

PMID- 1623264
TI  - New concepts in the diagnosis and treatment of lysosomal and peroxisomal
      disorders.
AB  - For the 36 known lysosomal disorders the main diagnostic advance is the
      identification of the gene defect with the demonstration of heterogeneity for
      each. Therapies that involve enzyme replacement or bone marrow transplantation
      are evolving. An increasing number of peroxisomal disorders are being identified.
      Combined liver-kidney transplantation are beneficial for hyperoxaluria type I,
      and dietary therapy and bone marrow transplantation appear to benefit patients
      with X-linked adrenoleukodystrophy.

PMID- 1623265
TI  - Multiple sclerosis in childhood.
AB  - The occurrence of multiple sclerosis (MS) in childhood is described. An
      increasing number of cases with onset before puberty have been published. The
      results of an ongoing study in Gottingen, which includes 20 patients so far are
      described and the potential value of childhood MS for research is stressed.

PMID- 1623266
TI  - Hereditary disorders including mitochondrial diseases.
AB  - Correlation between mitochondrial DNA (mtDNA) mutations and biochemical defects
      associated with several mitochondrial disorders is now possible using cybrid
      fusions. An understanding of the clinical heterogeneity of many inherited
      disorders may begin from the observation that different manifestations parallel
      different mutations in the same gene and, consequently, different activities of
      the aberrant enzyme in the body.

PMID- 1623267
TI  - Neuroendocrinology: clinical and experimental.
AB  - There have been several important publications concerning the aetiology of human
      pituitary tumours, in particular, delineating some of the gene mutations which
      may underlie this clinical problem. There have not been any major developments in
      clinical neuroendocrinology although advances have been made in the
      pharmacological development of dopaminergic drugs and the diagnosis of Cushing's
      disease.

PMID- 1623268
TI  - Alcohol and drug abuse.
AB  - Neurological complications are well recognized with alcohol abuse, and an
      increasing amount of literature is emerging describing neurological disease as a
      complication of other drugs of addiction (recreational drugs). This review covers
      recent papers related to alcohol and drug abuse.

PMID- 1623269
TI  - MPTP and other Parkinson-inducing agents.
AB  - The ability of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to produce
      parkinsonism has focused attention on potential endogenous or exogenous toxins
      that may follow similar uptake and conversion pathways to selectively target
      mitochondrial function in dopaminergic neurones. Exposure to such agents,
      together with a genetically determined susceptibility, is an attractive working
      hypothesis for the cause of Parkinson's disease. New insights into the mechanism
      of action of MPTP and its analogues are presented together with evidence
      supporting the potential role of endogenously produced toxins in the death of
      dopaminergic neurones in Parkinson's disease.

PMID- 1623271
TI  - Movement disorders.

PMID- 1623270
TI  - Neurotoxins and environmental poisons.
AB  - Recent applications of modern neurobiological techniques have provided an impetus
      to understanding mechanisms of neurotoxicity. Environmental chemicals, including
      aluminium, and the organocompounds of mercury, lead and tin, may trigger
      neurodegenerative disorders. Regional differences in toxicity may be related to
      the complexity of the amino acid excitatory systems and the ability of individual
      cell systems to handle long-term abusive stimulation.

PMID- 1623272
TI  - Pediatric and developmental neurology.

PMID- 1623273
TI  - Metabolic disorders and neurotoxicology.

PMID- 1623274
TI  - It is increasingly difficult for doctors to keep up to date with the growing
      volume of medical literature.

PMID- 1623275
TI  - The trouble with spectroscopy papers.
AB  - Writing a critique and guide for authors of clinical spectroscopy research papers
      is a likely way of ensuring that one never sees another of one's own papers
      published in this field. Nevertheless, it is disappointing, though perhaps
      predictable, that despite its historical foundations in quantitative
      spectroscopy, the field has its fair share of findings that are not so obviously
      reconciled. Here is the view of one author, one referee, and one spectroscopy
      protagonist about what might be expected of a clinical spectroscopy paper. In
      addition to novelty, the fundamental criteria for acceptance should be that the
      conclusions are supported by properly and objectively quantified results, and
      that sufficient experimental detail is provided so that one skilled in the art
      could reproduce the study and its findings.

PMID- 1623276
TI  - Dynamic study of the upper airway with ultrafast spoiled GRASS MR imaging.
AB  - Dynamic magnetic resonance (MR) imaging of the upper airway was not possible
      previously because of poor temporal resolution. Recently, a rapid technique has
      been developed that provides the means to obtain multiple images at different
      section locations with sufficient image quality and temporal resolution to allow
      a comprehensive, dynamic study of the upper airway. The authors describe an
      ultrafast spoiled GRASS (gradient-recalled acquisition in the steady state) pulse
      sequence for dynamic studies of the upper airway. The authors believe that this
      procedure has potential for identifying and characterizing upper airway
      abnormalities such as nonfixed occlusions and/or narrowings that may exist in
      patients with obstructive sleep apnea.

PMID- 1623277
TI  - Efficacy of nonionic low-osmolar gadodiamide injection in animals with
      intracranial mass lesions.
AB  - Gadodiamide injection is a nonionic, low-osmolar formulation of a paramagnetic
      metal chelate complex consisting of gadodiamide and caldiamide sodium. The
      efficacy of gadodiamide injection as a magnetic resonance (MR) imaging
      enhancement medium was evaluated by imaging intracranial 9L-glioma lesions
      induced in rats and naturally occurring lesions in dogs. T1- and T2-weighted spin
      echo images were obtained before and after administration of gadodiamide
      injection at doses of 0.1 and 0.2 mmol/kg. On the precontrast T1-weighted images,
      the intracranial lesions were not well seen, appearing isointense to normal brain
      parenchyma. Although the presence of disease was shown unequivocally on the T2
      weighted images, the margins of the masses could not be delineated. Postcontrast
      T1-weighted images were characterized by marked enhancement of the tumor, with no
      change in signal intensity in the surrounding edematous brain tissue. Gadodiamide
      injection was efficacious in identifying areas of blood-brain barrier breakdown
      associated with intracranial masses.

PMID- 1623278
TI  - OMR, a positive bowel contrast agent for abdominal and pelvic MR imaging: safety
      and imaging characteristics.
AB  - To determine the safety and imaging characteristics of OMR--an effervescent
      solution of ferric ammonium citrate--as a bowel contrast agent, magnetic
      resonance (MR) imaging at 1.5 T was performed in 29 volunteers. T1- and T2
      weighted images of the upper abdomen and pelvis were obtained before and after
      oral administration of OMR at doses of 100-400 mg of iron in 300-600 mL of water.
      Respiratory-ordered phase encoding and presaturation pulses were used routinely
      for artifact suppression. All dose levels of OMR provided marking of the bowel by
      increasing intraluminal signal intensity; however, the degree and percentage of
      small bowel opacification appeared more prominent at higher dose levels of iron.
      Semisolid or watery bowel movements were noted in 31% of subjects, but no
      clinically important laboratory abnormalities were seen. OMR improved delineation
      of the head of the pancreas on T1-weighted images in 72% of subjects but was less
      useful in defining the body and tail. OMR is a safe and effective bowel contrast
      agent for MR imaging. Because artifacts due to movement of hyperintense bowel may
      degrade the images, OMR may be most useful on short TR/TE or fast imaging pulse
      sequences or when combined with antiperistaltic agents.

PMID- 1623279
TI  - Normal and degenerating articular cartilage: in vitro correlation of MR imaging
      and histologic findings.
AB  - Histologic correlation of the different magnetic resonance (MR) appearances of
      articular cartilage has not been studied extensively. Therefore, the authors
      correlated thin (high-resolution) MR sections of articular cartilage with
      histologic sections. Human cadaver lumbar facet joints were imaged with a 1-mm
      section thickness and a 4-cm field of view, then sectioned and stained for
      histologic comparison. MR imaging patterns were identified that correlated with
      normal cartilage and three histologically different patterns of degeneration.

PMID- 1623280
TI  - Boron-11 imaging with a three-dimensional reconstruction method.
AB  - A three-dimensional projection reconstruction technique is described for imaging
      boron-11 distributions, with potential application to boron neutron capture
      therapy. The method samples a spherical volume of k space uniformly to obtain a
      32 x 32 x 32 matrix with voxel size of 0.42 cm3. A signal-to-noise ratio (S/N) of
      3 was obtained in 8.5 minutes in a phantom containing 75 micrograms/mL of boron
      in borocaptate sodium (BSH). Images were obtained in a dog after cessation of an
      intravenous infusion of BSH and again 30 minutes later, with a maximum boron S/N
      of about 12. Boron levels in the brain dropped about 6%-8% and were more
      diffusely distributed on the images obtained 30 minutes after BSH infusion.

PMID- 1623281
TI  - Reblurred deconvolution method for chemical shift removal in F-19 (PFOB) MR
      imaging.
AB  - Perfluorocarbons such as perfluoroctylbromide (PFOB) can be used as contrast
      agents in the vascular system for fluorine-19 magnetic resonance imaging or as
      synthetic oxygen carriers. F-19 imaging has been proposed for studying the
      vascular system, capillary flow, tissue perfusion, and tumor oxygenation. A major
      difficulty is that F-19 compounds often have complex multipeak spectra. These
      peaks result in chemical shift artifacts, lower signal-to-noise ratios, and
      blurred images. Each peak also excites a different section when a section-select
      gradient is applied. Direct inverse filtering is the simplest deconvolution
      method for correcting such artifacts; however, two major difficulties present
      themselves: functional singularity and noise amplification at high frequencies.
      The use of a new reblurred deconvolution (RED) method appears to overcome these
      problems. Although this method is based on iterative deconvolution in the spatial
      domain, the computational overhead is negligible. Since the point spread function
      and object data are already available in the time domain as FID data, RED appears
      to be useful for eliminating chemical shift artifacts and suppressing noise
      amplification while restoring the original image without loss of resolution.

PMID- 1623282
TI  - MR imaging appearance of intraperitoneal gelatin sponge in mice.
AB  - Intraperitoneal gelatin sponge can mimic a mass lesion on magnetic resonance (MR)
      images. To determine the MR imaging characteristics of gelatin sponge over time,
      a 15 x 10 x 4-mm piece of gelatin sponge soaked in saline was surgically
      implanted in the peritoneal cavity of 14 mice. Two mice underwent a sham
      operation. Contiguous axial spin-echo images of the abdomen were obtained with T1
      weighted, spin-density, and T2-weighted sequences preoperatively and over a 6
      week period postoperatively. Gelatin sponge initially appears as a heterogeneous
      mass of low signal intensity on T1-weighted images and increasing intensity on
      spin-density and T2-weighted images, containing multiple round foci of very low
      signal intensity, attributable to air, at all sequences. Over time, signal
      intensity further increases and becomes more homogeneous on spin-density and T2
      weighted images, although foci of air persist to 3 weeks. By 2-4 weeks, the mass
      is no longer discrete. Foci of air should help differentiate gelatin sponge from
      tumor and add gelatin sponge to the differential diagnosis of abscess.

PMID- 1623283
TI  - Effects related to temperature changes during MR imaging.
AB  - Magnetic resonance (MR) imaging has been proposed as a method of monitoring the
      interstitial laser heating of tissue for the clinical treatment of tumors (laser
      hyperthermia). The treatment causes considerable temperature changes over the
      time that image data are acquired, and therefore an analysis of the time
      dependent effects of heating is required. The problem is expressed
      mathematically, and computer-simulated images are compared with those obtained
      from experimental heating and imaging of gel phantoms. Results show that at the
      rates of heating typical for laser hyperthermia and even with the relatively slow
      standard imaging techniques used, generation of artifact is not a major concern.
      It is also shown that a spatial spin signal magnitude distribution, evolving in
      time, is effectively sampled at the time to when the low-numbered phase-encoding
      steps are collected at to. It is noted, however, that substantial temperature
      changes during image data acquisition make accurate temperature determination
      difficult and place limits on MR imaging for quantitative spatial temperature
      mapping.

PMID- 1623284
TI  - Quantitative MR signal behavior in cardiac cine loops as a function of heart
      rate.
AB  - To evaluate the heart cycle-dependent signal intensity changes in the cardiac
      chambers, the aorta, and the pulmonary artery, five healthy volunteers were
      studied with gradient-echo magnetic resonance cine loops at different heart
      rates. Quantitative evaluation of signal intensity on each side of the cardiac
      valves showed that there were changes in signal intensity due to section-entry
      and spin-phase phenomena but none due to the increase in heart rate. The authors
      conclude that there is no heart rate-dependent signal loss in healthy persons
      that simulates valvular dysfunction, thus suggesting that signal intensity change
      can be used as an indicator for this disease, independent of heart rate.

PMID- 1623285
TI  - Hepatic focal nodular hyperplasia: MR imaging at 1.0 and 1.5 T.
AB  - Ten cases of hepatic focal nodular hyperplasia (FNH) were studied with magnetic
      resonance (MR) imaging. Proof of diagnosis was by needle biopsy or follow-up of
      as long as 5 years. Both short TR/TE and long TR/TE images were obtained. The
      most common finding was isointensity of the lesion relative to liver parenchyma
      with all pulse sequences. A central scar was seen in only one patient and was
      hyperintense on long TR/TE images. Slight hyperintensity of the lesion on short
      TR/TE and long TR/TE images was seen in two cases. Textural heterogeneity was
      present in only one of these. The most common presentation in our series was a
      visually isointense lesion relative to liver on short TR/TE images and an
      isointense or slightly hyperintense lesion on long TR/TE images. A review of the
      literature and the present findings suggest that FNH has a variable appearance on
      MR images.

PMID- 1623286
TI  - Comparison of MR imaging after barium administration with CT in pelvic disease.
AB  - The use of magnetic resonance (MR) imaging for evaluating the abdomen and pelvis
      has been limited by the lack of a suitable contrast agent. The purpose of this
      study was to compare axial MR imaging after rectal barium administration with
      computed tomography (CT) for delineation of normal anatomy and lesions of the
      pelvis. MR images and CT scans of 11 patients were studied retrospectively and
      independently by four radiologists. No substantial differences in the
      visualization of normal bowel, iliac vessels, lymph nodes, bladder, prostate,
      seminal vesicles, uterus, and cervix and in detection of abnormalities were seen
      between CT scans and axial MR images obtained after barium administration. This
      preliminary study suggests that axial MR imaging with rectal barium is a useful
      alternative to CT in evaluating pelvic disease.

PMID- 1623287
TI  - High-dose gadoteridol in MR imaging of intracranial neoplasms.
AB  - Twelve patients with a high suspicion of brain metastases by previous clinical or
      radiologic examinations were studied in a phase III investigation with magnetic
      resonance (MR) imaging at 1.5 T after a bolus intravenous injection of 0.1
      mmol/kg gadoteridol followed at 30 minutes by a second bolus injection of 0.2
      mmol/kg gadoteridol. All lesions were best demonstrated (showed greatest
      enhancement) at the 0.3-mmol/kg (cumulative) dose, with image analysis confirming
      signal intensity enhancement in the majority of cases after the second
      gadoteridol injection. More lesions were detected with the 0.3-mmol/kg dose than
      with the 0.1-mmol/kg dose, and more lesions were detected with the 0.1-mmol/kg
      dose than on precontrast images. In this limited clinical trial, high-dose
      gadoteridol injection (0.3-mmol/kg cumulative dose) provided improved lesion
      detection on MR images specifically in intracranial metastatic disease.

PMID- 1623288
TI  - MR-guided aspiration cytology in the head and neck at high field strength.
AB  - Published reports of magnetic resonance (MR)-guided needle biopsy have involved
      low- and mid-field-strength systems because of the concern of needle artifact and
      risk of increased needle torque at higher field strengths. To the authors'
      knowledge, this is the first report of a high-field-strength (1.5-T) system used
      to guide aspiration cytology in the head and neck in a patient. The procedure was
      successfully accomplished without additional needle torque or substantial
      increase in image artifact relative to lower-field-strength imaging.

PMID- 1623289
TI  - Ionic versus nonionic MR imaging contrast media: operational definitions.
AB  - An experimental rationale is provided to differentiate between the terms ionic
      and nonionic for magnetic resonance (MR) imaging contrast media such as
      gadodiamide and gadopentetate dimeglumine. Four independent types of physical
      measurements (electric conductivity, osmolality, electrophoresis, and ion
      exchange) were performed on a range of test compounds, including D-glucose,
      iohexol, gadopentetate dimeglumine, and gadodiamide. Iohexol, D-glucose, and
      gadodiamide are shown to be nonionic species at physiologic pH (7.4), not
      measurably dissociating in solution. A range of gadopentetate salts behave as
      electrolytes, dissociating into constituent charged ions in aqueous media.
      Operational definitions for the terms ionic and nonionic are provided, and the
      terms neutral and net zero charge are compared with nonionic for accuracy. The
      nomenclature nonionic and ionic is deemed appropriate for differentiating MR
      imaging contrast media.

PMID- 1623290
TI  - Temperature monitoring during MR imaging: comparison of fluoroptic and standard
      thermistors.
AB  - Temperature readings from standard wire lead thermistor probes and a fluoroptic
      temperature probe were compared before, during, and after exposure to a spin-echo
      imaging sequence at 2.35 T. All the probes were placed in saline-filled vials (1
      mL capacity) surrounded by dense foam rubber to isolate and preserve local
      heating effects. There were no consistent differences in the temperatures
      recorded by the various probes. The authors conclude that wire lead thermistor
      probes do not exhibit substantial heat deposition when exposed to a standard spin
      echo imaging sequence at 2.35 T.

PMID- 1623291
TI  - Dynamic properties of cardiovascular systems.
AB  - A recently derived mathematical model of an isolated heart is extended here to a
      closed-loop cardiovascular system. Taking the end-diastolic volume as state
      variable, the authors show that the closed-loop cardiovascular system can be
      described by a one-dimensional nonlinear discrete dynamical system that depends
      on parameters describing the systolic and diastolic properties of the heart,
      heart rate, total peripheral resistance, and arterial capacitance. Studies of
      this model show that the system possesses a rich spectrum of dynamical behavior,
      from stable points through stable cycles to a "chaotic" behavior. It is shown
      that such an analysis of dynamic behavior yields those domains in the parameter
      space that correspond to a normal and abnormal beating heart, when the heart
      ejects time-invariant and time-variant (periodic or aperiodic) stable stroke
      volumes, respectively. Determination of such domains may lead to better
      understanding of the specific pathologic mechanism involved in the evolution of
      an abnormal beating heart.

PMID- 1623292
TI  - Variance components for discordances.
AB  - Tests for biotyping isolates give a result that is classified as either positive
      or negative, indicative of growth or nongrowth of bacteria. The reproducibility
      of such tests is measured by the number of discordances in replicates of the same
      measurement. In this analysis the probability distribution of the number of
      discordances is estimated for each of several tests in the presence of possible
      random between-laboratory effects as well as random laboratory-test interactions,
      which are also estimated.

PMID- 1623293
TI  - Remarks on "persistence in models of three interacting predator-prey
      populations".
AB  - For models of three interacting predator-prey populations, a result on the
      boundedness of solution orbits and a result on ultimate boundedness are
      presented. A counterexample to another result is also given for comparison.

PMID- 1623294
TI  - R0 bounds for worst-case endemic mixing models.
AB  - Upper and lower bounds are presented for the worst endemic prevalence possible in
      nonrandom mixing models. The bounds require only the value of the reproductive
      number R0 for the corresponding homogeneous epidemic model. For R0 values of 4 or
      larger, the difference between the upper and lower bounds on the worst-case
      prevalence is at most five percentage points.

PMID- 1623295
TI  - Periodic solutions of population models in a periodically fluctuating
      environment.
AB  - A periodically fluctuating environment is assumed in a population-modeling
      process that generates nonautonomous difference equations. The existence and
      uniqueness of periodic solutions are studied. A sufficient condition for
      existence and a necessary condition for uniqueness are obtained. Stability of the
      periodic solutions is investigated. Several numerical examples are given to
      illustrate the basic results, and a brief discussion is presented.

PMID- 1623296
TI  - Decomposition-based qualitative experiment design algorithms for a class of
      compartmental models.
AB  - Qualitative experiment design, to determine experimental input/output
      configurations that provide identifiability for specific parameters of interest,
      can be extremely difficult if the number of unknown parameters and the number of
      compartments are relatively large. However, the problem can be considerably
      simplified if the parameters can be divided into several groups for separate
      identification and the model can be decomposed into smaller submodels for
      separate experiment design. Model decomposition-based experiment design
      algorithms are proposed for a practical class of large-scale compartmental models
      representative of biosystems characterized by multiple input sources and
      unidirectional interconnectivity among subsystems. The model parameters are
      divided into three types, each of which is identified consecutively, in three
      stages, using simpler submodel experiment designs. Several practical examples are
      presented. Necessary and sufficient conditions for identifiability using the
      algorithm are also discussed.

PMID- 1623297
TI  - The subcritical collapse of predator populations in discrete-time predator-prey
      models.
AB  - Many discrete-time predator-prey models possess three equilibria, corresponding
      to (1) extinction of both species, (2) extinction of the predator and survival of
      the prey at its carrying capacity, or (3) coexistence of both species. For a
      variety of such models, the equilibrium corresponding to coexistence may lose
      stability via a Hopf bifurcation, in which case trajectories approach an
      invariant circle. Alternatively, the equilibrium may undergo a subcritical flip
      bifurcation with a concomitant crash in the predator's population. We review a
      technique for distinguishing between subcritical and supercritical flip
      bifurcations and provide examples of predator-prey systems with a subcritical
      flip bifurcation.

PMID- 1623298
TI  - Compensation and stability in nonlinear matrix models.
AB  - Stability, bifurcation, and dynamic behavior, investigated here in discrete,
      nonlinear, age-structured models, can be complex; however, restrictions imposed
      by compensatory mechanisms can limit the behavioral spectrum of a dynamic system.
      These limitations in transitional behavior of compensatory models are a focal
      point of this article. Although there is a tendency for compensatory models to be
      stable, we demonstrate that stability in compensatory systems does not always
      occur; for example, equilibria arising through a bifurcation can be initially
      unstable. Results concerning existence and uniqueness of equilibria, stability of
      the equilibria, and boundedness of solutions suggest that "compensatory" systems
      might not be compensatory in the literal sense.

PMID- 1623299
TI  - 2D-NMR and molecular dynamics analysis of the Torpedo californica acetylcholine
      receptor alpha 67-76 fragment and of its [Ala76]-analogue.
AB  - The alpha 67-76 fragment (Trp67-Asn68-Pro69-Ala70-Asp71-Tyr72 -Gly73-Gly74- Ile75
      Lys76) of the Torpedo californica acetylcholine receptor (AChR) is selectively
      recognized by antibodies against the main immunogenic region of the AChR. The
      antibody binding capacity of its [Ala76]-analogue is usually higher than that of
      the natural fragment. A conformational analysis of these two decapeptides has
      been carried out in Me2SO by 2D-NMR and molecular dynamics using the SYBYL and
      BIOGROMOS programs. The natural sequence presents the most numerous and strongest
      NOE connectivities and is accordingly less flexible than the [Ala76]-analogue.
      Due to the flexible orientation of the side chains in both peptides, the NOE
      backbone side chain and side chain-side chain connectivities have not been
      introduced as distance constraints in the molecular dynamics calculations. It
      appeared that the N-terminal heptapeptide in both sequences assumes two very
      similar folded conformations, whereas the Ala substitution induces conformational
      flexibility in the C-terminal tripeptide sequence. The most flexible [Ala76]
      analogue is the most tightly bound to the monoclonal mAb6 anti-AChR antibody, and
      the transferred NOEs from the bound to the free peptide in D2O reveal some
      similarity with the intrinsic NOEs for the free natural sequence in Me2SO,
      suggesting that the bound conformation of the [Ala76]-analogue could not be very
      different from that of the free natural fragment.

PMID- 1623300
TI  - Analysis of synthetic peptides using matrix-assisted laser desorption ionization
      mass spectrometry.
AB  - Matrix-assisted laser desorption ionization mass spectroscopy (LDI MS), a novel
      method for analysis of large molecules, has been used for characterization of
      synthetic peptides and their by-products. The potential of LDI MS is demonstrated
      by analyzing crude synthetic peptides representing typical members of newly
      designed peptides and proteins. In the first case, a fragment condensation
      reaction yielding a highly hydrophobic six-helic bundle template-assembled
      synthetic protein (TASP) is monitored. Then, a crude 19-mer peptide designed to
      adopt an amphiphilic alpha-helical structure and its by-products from SPPS are
      identified. Finally, analysis of crude hirulog-1, a 20-mer peptide designed as a
      thrombin inhibitor, using C18 reversed phase high performance liquid
      chromatography (RP HPLC), capillary electrophoresis (CE) and LDI MS, manifests
      the potential of the latter method.

PMID- 1623301
TI  - Reduced peptide bond pseudopeptide analogues of neurotensin.
AB  - Pseudopeptide analogues of the C-terminal hexapeptide of neurotensin (H-Arg-Arg
      Pro-Tyr-Ile-Leu-OH) were obtained by replacing each peptide bond by the reduced
      peptide bond CH2NH. The resulting analogues were then examined for their ability
      to inhibit binding of labeled neurotensin to new-born mouse brain membranes and
      for stimulation of guinea pig ileum contraction. Replacement of the Ile12-Leu13,
      Tyr11-Ile12, Pro10-Tyr11 and Lys9-Pro10 peptide bonds resulted in about 2000-,
      3400-, 200- and 3400-fold losses, respectively, in binding affinity and 400-, 750
      , 250- and 300-fold losses, respectively, in biological activity. Replacement of
      both Arg8 and Arg9 by lysine led to an analogue exhibiting the same
      pharmacological profile as the C-terminal hexapeptide of neurotensin.
      Interestingly, replacement of the Lys8-Lys9 peptide bond by the CH2NH bond
      produced an analogue exhibiting the same affinity for neurotensin receptors, but
      10 times more potent in stimulating guinea pig ileum contraction. N-terminal
      protected analogues (by the Boc group) showed decreased potency as compared with
      their amino-free corresponding compounds.

PMID- 1623302
TI  - Synthesis of neo-glycosylated L-alanyl-D-isoglutamine derivatives as potential
      immunoadjuvants.
AB  - The synthesis is described for muramyl-dipeptide-related amphiphilic analogs,
      where 1,10-diaminodecane served as a lipophilic C-terminal linker for the
      preparation of a bidentated L-alanyl-D-isoglutamine derivative and incorporation
      of aldonic and uronic acids at the N-termini as hydrophilic cores. For the N
      acylation steps via lactones, suitable conditions were elaborated to allow for
      the use of unprotected or minimally protected aldonic and uronic acid lactones,
      respectively. These procedures may represent a useful general approach for the
      synthesis of neoglycopeptides.

PMID- 1623304
TI  - Synthesis, characterization, and solution conformational analysis of C alpha
      methyl-, C alpha-benzylglycine [(alpha Me)Phe] model peptides.
AB  - We have synthesized, by solution methods, and fully characterized a variety of
      (alpha Me)Phe derivatives and model peptides (to the pentapeptide level). The
      results of the solution conformational analysis, performed by using infrared
      absorption and 1H nuclear magnetic resonance, support the view that the (alpha
      Me)Phe residue is a stronger beta-turn and helix promoter than the unmethylated
      Phe analog. A comparison is also made with the conclusions extracted from
      published work on peptides rich in other C alpha-alkylglycyl residues.

PMID- 1623303
TI  - Solution structure of deltorphin I at 265 K: a quantitative NMR study.
AB  - Deltorphin I, a delta-selective opioid peptide, has been studied in a DMSOd6/H2O
      cryoprotective mixture by two-dimensional (2D) NMR spectroscopy in the
      temperature range 260 K to 305 K. The high viscosity of the solvent at low
      temperature mimics a distinctive physico-chemical feature of cytoplasm and allows
      the measurement of a NOESY spectrum rich in intra- and inter-residue effects.
      Backbone NOEs at 265 K can be calculated with good accuracy in terms of only two
      limiting conformers: one folded, with a mole fraction of 0.30, and another
      extended with a mole fraction of 0.70. This calculation is still a rough
      approximation of the complex conformational equilibria existing in solution but,
      to the best of our knowledge, is the first one for a flexible peptide, and
      represents an encouraging starting point for a quantitative evaluation of NMR
      data of small, flexible peptides in solution. The folded conformer consistent
      with observed NOEs has a shape surprisingly similar to those of unrelated, rigid,
      delta-selective opiates.

PMID- 1623305
TI  - Convergent solid-phase peptide synthesis IX: application to the synthesis of
      peptides with repetitive sequences.
AB  - The synthesis of a 36 amino acid peptide containing six conserved repeats of Val
      His-Leu-Pro-Pro-Pro which corresponds to the glutelin-2 protein of maize has been
      carried out using a convergent approach. The protected single sequence repeat has
      been synthesized using a combination of a 9-fluorenylmethyloxycarbonyl (Fmoc)
      protection scheme and a p-alkoxybenzyl resin. The final peptide, as well as the
      different intermediate peptides, has been characterized by fast atom bombardment
      mass spectrometry (FAB-MS) and by co-elution with another sample obtained by
      stepwise continuous flow synthesis.

PMID- 1623306
TI  - [Sexually transmittable diseases and the public health service--recommendations
      for the reorganization of counseling centers for sexually transmittable
      diseases].
AB  - Sexually transmitted diseases (STD), including HIV infection, are a major and
      increasing health problem in Germany. Primary infection, complications and
      sequelae of STD are causative for an increasing economic burden. In addition a
      considerable part of the normal population suffer from persistent refractory
      virus infections and associated sequelae. The epidemic of both HIV and other STD
      and iv-drug abuse are closely related. The Public Health strategy in Germany is
      regulated by an outdated legislation to fight venereal diseases (Gesetz zur
      Bekampfung der Geschlechtskrankheiten, July 1953) and traditionally consisted in
      screening tests for bacterial STD in female prostitutes and in case-finding
      produres. Results of recent epidemiological, social and behavioural research
      urgently suggest a new approach for STD programmes on the lines of
      recommendations by the World Health Organization.

PMID- 1623307
TI  - [Prevalence of asthma in 6,000 10-year-old children in Munich and Upper Bavaria
      based on physicians' diagnoses and a symptom score].
AB  - In the Munich Survey on Asthma and Allergy the parents of 9,349 fourth-class
      schoolchildren (mean age 9.8 years) in Munich and Southern Bavaria were addressed
      by a questionnaire to which 8,204 responded (87%). In 7,192 children (76%) a skin
      prick test was performed and 7,284 (77%) had pulmonary function tests with
      maximum expiratory flow-volume loops before and after cold air challenge. Of the
      6,083 children of German nationality, 160 children (2.6%) had physician-diagnosed
      asthma, 79 (1.3%) so called asthmoid bronchitis and 373 children (6.1%) spastic
      bronchitis. Since physician-diagnosed diseases does not reflect all children with
      respiratory disease, symptoms reported in the questionnaire, results of skin
      prick and pulmonary function tests were combined to a score of probable asthma
      (VSA) with 9 items. Of the group with physician-diagnosed asthma, 79.4% of the
      children (127) have an elevated VSA, of 68.4% (54) of asthmoid bronchitis, 35.9%
      (134) of spastic bronchitis, 11.4% (192) of simple bronchitis and 3% of (114)
      never-diagnosed bronchial disease. The cumulative prevalence of asthma in ten
      year-old children is therefore estimated at 10.2%. Only half of these children
      have been diagnosed with asthmatic disease.

PMID- 1623308
TI  - [Acceptance of social security by the German population].
AB  - Against the background of persistent problems of financing and monitoring the
      system of social security as practised in the Federal Republic of Germany,
      empirical research into preferences and acceptance has gained increasing
      importance. The acceptance of social security by the population has been checked
      empirically by means of data of the Socio-Economic Panel. The following questions
      have been studied: Which degree of acceptance applies generally speaking to the
      existing system? Are there differences in respect of acceptance regarding the
      various subdivisions of social insurance and how are they to be explained? What
      are the conclusions that can be arrived on the basis of these results? Overall
      assessment of the indicators employed shows that on the whole a high degree of
      acceptance is accorded to the existing security system. It cannot be concluded
      from the results that a fundamental reorganisation of the entire system towards
      security mainly on the individual's own responsibility would be in accordance
      with the preferences of the great majority of the population. Reorganisation
      would have to reckon with a low acceptance level. However, the monthly
      contributions--especially in respect of sickness insurance--are considered to be
      too high by part of the population.

PMID- 1623309
TI  - [Recent psychiatric classification systems and their significance for forensic
      psychiatry].
AB  - The influence of operationalized diagnostic systems is growing steadily in
      general and forensic psychiatry. This article discusses the historical context
      and the advantages and problems that may occur in the application of the new
      diagnostic systems. It is of special importance that the improvement of
      communication and reliability within psychiatry does not lead to an uncritical or
      even dogmatical understanding of the new diagnostic categories.

PMID- 1623310
TI  - [Summary of important results of the Kasseler Symposium 28/29 June 1991 on the
      current status of endoscopic surgery. 34th symposium in Kassel--endoscopic
      surgery--progress or method? A critical evaluation of its status].

PMID- 1623311
TI  - [Comments on the development of a new public health regulation for the
      Mecklenburg-Vorpommern district].

PMID- 1623312
TI  - Subgroups in autism: are there behavioural phenotypes typical of underlying
      medical conditions?
AB  - Fifty-nine cases with infantile autism/autistic disorder were subclassified
      according to associated medical condition (fragile-X, tuberous sclerosis,
      neurofibromatosis, hypo-melanosis of Ito, Moebius syndrome, Rett syndrome, and a
      'new' syndrome associated with a marker chromosome). It was concluded that, even
      within a group of cases fitting currently accepted criteria for autism, there is
      considerable variation in symptom profile depending on the exact type of
      associated medical condition.

PMID- 1623313
TI  - Properties of perception of laterally moving objects in persons with profound
      retardation.
AB  - Twenty-two persons with profound retardation were assessed for their perception
      of moving objects at a velocity of 5 degrees s-1. Abnormalities were not found in
      the ocular structures and optic discs of subjects upon ophthalmological
      examination. Stimuli consisted of six habituation trials and two test trials.
      Duration of eye movement in pursuit of stimulus was estimated by calculating the
      linearity and gradients of electro-oculograms. Subjects were divided into three
      groups based on the change of estimated time of pursuit eye movement. Those
      showing habituation as well as dishabituation (group 1) had higher developmental
      communicative ages than subjects with only habituation (group 2) and subjects who
      did not exhibit habituation (group 3). The results indicated a relationship
      between the perception of moving objects and the development of communication
      level in persons with profound retardation. The present study investigated
      abnormalities in the computer tomographic scanning of the subjects' heads and
      found cerebral disturbance of the visual cognition of moving objects in persons
      with profound retardation.

PMID- 1623315
TI  - The test-retest reliability and stability of the WAIS-R in a sample of mentally
      retarded adults.
AB  - Fifty mentally retarded adults were administered the Wechsler Adult Intelligence
      Scale-Revised (WAIS-R) on two separate occasions, with the mean amount of time
      between testings being 2 years, 8 months. The data were examined in an effort to
      study the test-retest reliability and stability of the WAIS-R with the mentally
      retarded. Based on correlational, t-value and percentage of scale score change
      information, the authors concluded that the WAIS-R IQs appeared to possess good
      test-retest reliability and stability over an approximate 2.5 year period for the
      present sample of mentally retarded adults.

PMID- 1623314
TI  - Violence, death and associated factors on a mental handicap ward.
AB  - The characteristics of all the patients admitted to a high-dependency mental
      handicap ward over a 21-month period were examined. The patients that had been
      responsible for acts of violence on the ward were compared with those who had
      not. Violent patients were significantly younger and more likely to have an
      abnormal electroencephalogram. Meningoencephalitis as the aetiology of mental
      handicap was over-represented in the violent group. The level of violence was
      alarmingly high with 620 violent incidents over 21 months (30 per month). Four
      patients accounted for 74% of the violence and two of these four patients
      suffered sudden, unexpected deaths. The relationship between violence and sudden
      death is examined, and the implications of pharmacological intervention with
      anticonvulsants for violent patients with abnormal electroencephalogram results
      are discussed.

PMID- 1623316
TI  - Severe behaviour problems associated with rapid cycling bipolar disorder in two
      adults with profound mental retardation.
AB  - The authors report the clinical histories of two adults with profound mental
      retardation, features of rapid cycling bipolar disorder, and periodic maladaptive
      behaviour. In each case, primary features of mania and depression were
      identified, operationally defined and measured with an ongoing data system, which
      was used to track SIB and aggression. In the first case, data analysis across
      days showed that 1-week episodes of depressive features alternated with 2-week
      episodes of manic features and that SIB was only associated with the depressive
      features. In the second case, episodes of manic and depressive features
      alternated every few days, and aggression was only associated with the manic
      features. These cases suggest that severe behaviour problems can be a state
      dependent phenomenon of bipolar disorder. The behaviour monitoring system
      provided an objective methodology for aiding in the diagnosis of bipolar disorder
      with profoundly handicapped adults.

PMID- 1623317
TI  - [Current aspects of preoperative autologous blood donation with legal
      implications].

PMID- 1623318
TI  - [Erythropoiesis and iron metabolism in autologous blood donation].
AB  - Autologous blood donation before elective surgery has been widely endorsed as
      good transfusion practice. Although only 6 percent of patients undergoing
      elective orthopedic surgery are unable to donate 3 autologous units, 40 percent
      cannot donate 4 units because they become anemic [1,2]. According to the results
      of our study this must be due to different problems in bone marrow dynamics,
      which cannot be overcome by unselected use of human recombinant erythropoietin
      alone [3].

PMID- 1623319
TI  - Comparison of plateletpheresis using Cobe Spectra System and Fresenius AS 104.
AB  - To evaluate separation efficiency and concentrate purity, each of 50 donors
      underwent platelet (PLT) collection on both the Cobe Spectra and Fresenius AS 104
      with the constancy of processed blood volume, ACD/blood ratio 1:10 and a blood
      flow of 50 ml/min. For the Fresenius AS 104 two protocols - V 4.11 and V 4.4 -
      were evaluated. Both systems provided high quality PLT collection: PLT yield 3.91
      +/- 0.74 x 10(11) (Cobe); 4.16 +/- 1.12 x 10(11) (V 4.11); 4.66 +/- 0.89 x 10(11)
      (V 4.4). The mean cell contamination was low with all procedures, resulting in
      less WBC contamination with the Fresenius AS 104, whereby the higher efficiency
      obtained by the protocol version V 4.4 correlated with an increased of WBC
      contamination.

PMID- 1623320
TI  - [Importance of the interface position in thrombocytapheresis with the AS 104 cell
      separator].
AB  - In plateletpheresis with the Fresenius AS 104 the interface position influences
      the separation efficiency and the cell contamination of the platelet concentrate.
      The aim of the present study is to improve the purity of the platelet concentrate
      by changing the interface position. Increasing interface position results in
      rising separation efficiency and cell contamination. Alternating interface
      position gives the best result with significantly lower leukocyte contamination
      and only a slight decrease of separation efficiency. Nevertheless we prefer
      separations with variable interface position to reduce an immunisation of the
      recipient by white blood cells.

PMID- 1623321
TI  - Teflon bags for 5-day storage of platelet concentrates (PC) from cell separator.
AB  - There exist no data yet about platelet storage in teflon bags. Therefore, a
      paired study has been performed to evaluate their suitability for the 5 days
      storage of platelet concentrates (PC) from the cell separator Fresenius AS-104.
      The PC's of the AS-104 were stored in teflon as well as in polyolefin bags each
      (PL-732). In addition, PC's of the Baxter CS-3000 were stored in PL-732. PH, cell
      counts, platelet morphology, aggregation, adherence and ADP/ATP concentration,
      plasma beta TG, glucose, lactate and thrombin-antithrombin III complexes were
      investigated at day 0, 3 and 5 of storage. The results show that the teflon bags
      are quite suitable for 5 day storage of the PC's. But the functional superiority
      of fresh PC's from the AS-104 seemed to be reduced by storage in teflon bags
      compared to storage in PL-732. The unfavorable size and geometry of the teflon
      bags used could have been the cause. Therefore, size and geometry were
      consequently changed in the meantime.

PMID- 1623322
TI  - Leukocytapheresis: evaluation of a new procedure for the blood cell separator
      Fresenius AS 104.
AB  - For granulocyte separation from peripheral blood with the Fresenius blood cell
      separator AS 104 a new procedure and a new tubing set were developed and
      evaluated. Separation is done in cycles of 400 ml of whole blood processed, with
      continuous blood flow of 50-55 ml/min, speed 750 rpm. HES-450 is added for
      sedimentation acceleration together with citrate, ratio 1:10. At the end of each
      cycle granulocytes were pumped out of the separation chamber into the collection
      container. After processing 13 cycles of 400 ml whole blood/HES-citrate-volume a
      total yield of 9.20 +/- 2.80 x 10(9) white cells were collected in volumes of 125
      ml. 47 +/- 9% of the leukocytes collected were granulocytes, this corresponds to
      collection of 1.05 +/- 0.09 x 10(9) granulocytes per liter of processed blood.
      The efficacy of granulocyte collection is 22.5 +/- 5.6%, viability is more than
      95%. With this procedure it is possible to collect granulocytes with the blood
      cell separator Fresenius AS 104 in therapeutical doses.

PMID- 1623324
TI  - Virus inactivated single-donor fresh plasma preparations.
AB  - Photodynamic virus inactivation of single units of human fresh plasma in their
      plastic containers can be achieved by illuminating the plasma with visible light
      in the presence of low concentrations of one of the phenothiazine dyes methylene
      blue or toluidine blue. This procedure abrogates the infectivity of numerous
      lipid-enveloped viruses including that of human immune deficiency virus-1. In
      contrast, the functional activities and immunological properties of plasma
      proteins are only moderately influenced. Animal studies and the first clinical
      data suggest that photodynamically virus inactivated fresh plasma is as well
      tolerated as conventional fresh frozen plasma.

PMID- 1623323
TI  - [Experiences with a simple microtiter plate technique for GPT screening of blood
      donors].
AB  - A simple microtiterplate method to screen blood-donors for elevated alanine
      transaminase (ALT) was developed. The method permits a sufficiently precise
      measuring at room temperature without temperature control and has a high
      performance. The method was validated by comparison with a standardized method.

PMID- 1623325
TI  - [Initial experiences with methylene blue virus inactivated fresh frozen plasma:
      results of a clinical and in vitro study].
AB  - Methylene blue (MB) has recently been introduced to inactivate viruses in single
      donor fresh frozen plasma (FFP) units. In the first clinical study 519 units of
      MB-treated FFP were given to 103 patients. No specific clinical side effects with
      adverse reactions were recorded. However, after thawing, clots were observed in 9
      of the first 110 units, although the medical staff had thawed the MB-FFP in
      exactly the same manner as the conventional FFP in which clots are extremely
      rare. The possible effects of methylene blue were investigated by subsequent in
      vitro experiments: Methylene blue together with light led to generation of
      fibrin(ogen) derivatives which have an increased tendency for aggregation but
      cannot be normally clotted by thrombin and even seem to interfere with normal
      fibrin polymerization. Inadequate conditions during plasma preparation such as
      long illumination or temperatures above 40 degrees C enhanced the generation of
      these fibrin(ogen)-derivatives. In addition, special requirements for producers
      and users of MB-FFP and further investigations are necessary in order to prevent
      complications.

PMID- 1623326
TI  - A pasteurized therapeutic plasma.
AB  - A process to subject pooled human plasma to a viral inactivation treatment by
      heating in the liquid state for 10 hrs at 60 degrees C (pasteurization) has been
      designed and evaluated. Activity recovered from clotting factors and protease
      inhibitors exceeded 80%. Overall clotting activity remained good. No activation
      of coagulation factors was detected. The process did not generate aggregates. No
      side effects (toxicity, hypotension, variation in heart rate, thrombogenicity)
      could be detected in animal models. Virus kill studies, using 7 lipid-enveloped
      and non-enveloped viruses including HIV-1 and Sindbis virus, revealed
      inactivation levels similar to those obtained for plasma derivatives. Thus,
      pasteurisation of human plasma can be achieved in conditions that allow good
      recovery of biological properties while ensuring a high degree of inactivation of
      lipid-enveloped and non-enveloped viruses.

PMID- 1623327
TI  - Autocrine inhibition of parathyroid cell secretion requires proteolytic
      processing of chromogranin A.
AB  - Chromogranin A (CgA, Secretory Protein-I) is a protein of about 450 amino acids
      representing a major soluble component of the secretory granules of parathyroid
      and other endocrine and neuroendocrine cells. In the parathyroid, CgA is costored
      and cosecreted with parathormone (PTH). We earlier found that CgA and the derived
      peptide, pancreastatin, inhibited secretion of PTH and CgA by parathyroid cells
      in culture and that CgA antiserum stimulated secretion above the maximum achieved
      at low (0.5 mM) Ca2+. In the present study, porcine parathyroid cells were
      incubated at different cell concentrations at low Ca2+. The amount of secreted
      CgA increased over the 6-h incubation period at 1 x 10(6) to 4 x 10(6) cells/ml,
      but plateaued after 3 h at 6 x 10(6) cells/ml. Secretion did not plateau when
      antisera were added at 3 h. Conditioned medium contained a factor or factors that
      blocked secretion by fresh parathyroid cells at 0.5 mM Ca2+. Pulse-chase studies
      revealed that 40% of the secreted CgA was processed after 6 h of chase. alpha-2
      macroglobulin, an inhibitor of proteolytic processing, increased the amount of
      CgA in the medium by 30% at 1 h of chase and decreased the amount processed to
      20% by 6 h. Other protease inhibitors similarly enhanced the amount of CgA in the
      medium. These data indicate that proteolytic processing of intact CgA is
      requisite for its autocrine inhibitory activity.

PMID- 1623328
TI  - Pancreastatin and bovine parathyroid cell secretion.
AB  - Chromogranin A (CgA) is an acidic glycoprotein found in secretory granules of
      multiple peptidergic tissues and cosecreted with the resident peptide hormones.
      Pancreastatin is an amidated, biologically active peptide whose sequence is
      contained within CgA. We investigated the effect of the C-terminal fragment of
      bovine pancreastatin (bP32-47) on bovine parathyroid cell secretion. bP32-47
      amide inhibited low-calcium-stimulated PTH secretion by 44% and chromogranin A
      (CgA) secretion by 33%. We were able to identify a pancreastatin-like peptide as
      a very minor component of the endogenous breakdown peptides from CgA. However,
      using several approaches, we were unable to detect pancreastatin in secretory
      granule extracts or in incubation media. We conclude that although exogenous
      bovine pancreastatin has inhibitory effects on secretion, detectable
      pancreastatin is not secreted under normal incubation conditions. Based on our
      current data, we would question the physiologic importance of pancreastatin in
      bovine parathyroid glands.

PMID- 1623330
TI  - Bone remodelling does not decline after menopause in vertebral fracture
      osteoporosis.
AB  - There is considerable current interest in whether activators of bone remodelling,
      such as IL-1 and other cytokines, are involved in the pathogenesis of
      osteoporosis. We have therefore studied indices relating to remodelling
      activation in 50 patients with postmenopausal vertebral osteoporosis and 12 with
      hip fracture osteoporosis in comparison with 25 age- and sex-matched controls.
      Because of uncertainty regarding the accuracy of current biochemical markers of
      bone formation with respect to the estimation of whole body rates of bone
      formation, a 85Sr-based radioisotopic method was used. This method was previously
      validated by comparison with data obtained after double in vivo labelling of
      transiliac biopsies taken nearly simultaneously. Bone resorption was estimated
      from urinary hydroxyproline data. Controls selected for their continued good
      health showed a progressive and statistically highly significant decline in
      indices of bone formation with time after menopause. No such decline was seen in
      the vertebral fracture patients (P less than 0.005). There were no hip fracture
      patients within 10 years of menopause so this statistical test could not be
      applied appropriately to them. The hydroxyproline data were consistent with the
      suggestion arising from the bone formation data that remodelling declines
      progressively after menopause in the controls but not in the vertebral fracture
      patients. The data also suggested that these two fracture groups were in more
      negative calcium balance than the controls, this being particularly marked in the
      hip fracture cases. Plasma osteocalcin data correlated moderately well with the
      kinetic measurements of bone formation. It is concluded that vertebral fracture
      osteoporosis is associated with prolongation of menopausal levels of bone
      remodelling which is inappropriate by comparison with healthy controls.

PMID- 1623329
TI  - A simple method to assess osteoclast-mediated bone resorption using
      unfractionated bone cells.
AB  - To determine osteoclastic bone resorption we established a simple assay system in
      which unfractionated cells obtained from femora of 13-day-old mice were cultured
      on a dentine slice and the number of osteoclasts and their induced pit area on
      the slices were measured. When the bone cells (1 x 10(5) cells/dentine slice)
      were cultured in the presence of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] or human
      parathyroid hormone (hPTH) for 4 days, at which time newly-formed osteoclasts
      were not detected, the pit area was dose-dependently increased, being a 4.3- or
      4.1-fold respective increase over the control at a 10(-8) M concentration of
      hormones. Chick calcitonin (cCT) inhibited the osteoclastic bone resorption
      induced by either of these hormones. cCT alone also suppressed the bone
      resorption by the cells (3 x 10(5) cells/dentine slice). These findings indicate
      that 1,25(OH)2D3 or hPTH may mainly activate pre-existing osteoclasts, resulting
      in increased bone resorption, and that cCT may suppress this osteoclastic
      activity. When 1,25(OH)2D3 or hPTH was added to the cells pre-cultured in factor
      free medium for 6 days, at which time pre-existing osteoclasts had almost
      degenerated, new osteoclasts were formed, resulting in an increase in pit
      formation. Thus this system is a useful method which could more sensitively
      evaluate the effects of hormones or factors on osteoclast formation and
      activation than other previous systems.

PMID- 1623331
TI  - Biochemical assessment of bone loss in patients on long-term thyroid hormone
      treatment.
AB  - To test conditions under which thyroid hormone might be deleterious to bone, we
      studied a group of 58 patients who had undergone thyroidectomy because of thyroid
      cancer 1 to 21 years previously and were treated with steady doses of exogenous
      thyroid hormone. Vertebral bone density (BMD Z-score) was significantly reduced
      and biochemical indices of bone resorption (urinary hydroxyproline and plasma
      tartrate-resistant acid phosphatase activity) and of osteoblastic activity
      (plasma osteocalcin and bone isoenzyme of serum alkaline phosphatase) as well as
      the calculated prevalence of bone resorption relative to osteoblastic activity
      (HBP) were significantly increased in thyroid hormone-treated post-menopausal
      women but not in men and premenopausal women. The HBP as well as the biochemical
      indices of bone remodeling were significantly negatively correlated with serum
      TSH levels. In treated patients, BMD Z-score was significantly dependent on the
      HBP, menopausal state, duration of treatment and serum TSH levels. In conclusion,
      the further increase in bone resorption by thyroid hormone is predisposed by
      menopausal changes in bone turnover. The simultaneous evaluation of biochemical
      indices of bone resorption and formation improves the assessment of bone loss in
      patients treated with thyroid hormone in a suppressive dose.

PMID- 1623332
TI  - Evaluation of vitamin D-binding protein and vitamin D metabolite loss in children
      on continuous ambulatory peritoneal dialysis.
AB  - We measured the serum concentration of vitamin D-binding protein (DBP) in
      children with chronic renal failure (CRF). We also evaluated the relationships
      between the peritoneal loss of vitamin D metabolites, DBP and albumin in nine
      children on continuous ambulatory peritoneal dialysis (CAPD). The serum levels of
      DBP in children with CRF were significantly higher than in normal children. The
      mean serum DBP level in CRF children undergoing CAPD was slightly lower than in
      CRF patients who were not on dialysis. In patients on CAPD, the peritoneal loss
      of 25-hydroxyvitamin D (25OHD) showed a significant positive correlation with the
      DBP concentration in the dialysate (r = 0.855, P less than 0.005). In contrast,
      the peritoneal loss of 1,25-dihydroxyvitamin D (1,25(OH)2D) showed a significant
      correlation with the loss of albumin in the dialysate (r = 0.779, P less than
      0.01). The synthesis of 1,25(OH)2D3 is reduced in advanced renal failure, and the
      peritoneal losses of the active vitamin D sterols in patients on CAPD may
      aggravate this deficiency. We recommend that supplementation of active form of
      vitamin D, such as 1 alpha-hydroxyvitamin D3 or 1,25(OH)2D3, is important in CAPD
      patients, particularly those with elevated peritoneal loss of DBP and/or albumin.

PMID- 1623334
TI  - Dietary calcium as a statistical determinant of spinal trabecular bone density in
      amenorrhoeic and oestrogen-replete athletes.
AB  - A study investigating the relationship between spinal trabecular bone density
      (measured by QCT), dietary calcium (measured by questionnaire) and menstrual
      status in 67 elite female athletes was undertaken. Twenty-five athletes were
      amenorrhoeic, 27 eumenorrhoeic and 15 were taking an oral contraceptive. The mean
      bone density was significantly lower (P less than 0.0001) in the amenorrhoeics
      (168 mg/cm3; 95% confidence interval 154-182) than in the eumenorrhoeics (211
      mg/cm3; 197-224) and oral contraceptive takers (215 mg/cm3; 197-233). There was
      also a significant positive linear correlation between trabecular bone density.
      However, factors with which calcium intake may be linked, such as energy intake
      and expenditure, were not measured and therefore it is possible that this
      relationship is indirect. Further studies on the relationship between dietary
      calcium and bone mineral density in young women are needed.

PMID- 1623333
TI  - Bone hypertrophy and trabecular generation in Paget's disease and in fluoride
      treated osteoporosis.
AB  - The replacement of lost trabeculae characteristic of postmenopausal osteoporosis
      is problematic, since a biological pathway has not been established for
      trabecular regeneration de novo in the healthy, intact, mature skeleton. Possible
      pathways for trabecular replacement may occur under pathological conditions, in
      particular those associated with bone hypertrophy. The topography of trabecular
      hypertrophy was compared in two groups of subjects with disease- or treatment
      induced osteosclerosis following a period of atrophy. In Paget's disease and
      fluoride-treated osteoporosis a thickening of rarefied trabeculae in both was
      associated in Paget's disease only with an increase in the trabecular number and
      the transformation of a discontinuous arrangement into a more continuous network.
      The sequence seems to be a progression of intratrabecular resorption normally
      attendant upon a period of trabecular thickening. The failure of fluoride-treated
      bone in this respect, due to the unusual stability of the fluorotic skeleton, may
      provide insight to more effective anabolic regimens.

PMID- 1623335
TI  - Selected bibliography.

PMID- 1623336
TI  - Junior doctors on the warpath.

PMID- 1623337
TI  - Cognitive-behavioral approaches to panic disorder and social phobia.
AB  - In the past several years, substantial progress has been made in developing
      relatively efficient and seemingly effective brief psychosocial treatments for
      anxiety disorders. Knowledge has advanced along both biological and psychological
      fronts, although the greater effort has been put into understanding the
      neurobiological basis of anxiety disorders and developing appropriate, effective
      pharmacological treatment. Nevertheless, psychological knowledge has also
      advanced, and a more recent trend is to integrate psychological and biological
      advances at the level of psychopathology and treatment. The author highlights
      recent developments in understanding the psychological basis of two anxiety
      disorders: panic disorder and social phobia. He then describes psychosocial
      treatment protocols for these disorders that have been developed at the Center
      for Stress and Anxiety Disorders at the State University of New York at Albany,
      and reviews data on their effectiveness.

PMID- 1623339
TI  - Psychodynamics of panic disorder and social phobia.
AB  - d psychological treatments of psychiatric disorders are often wrongly polarized.
      The related anxiety disorders, panic disorder and social phobia, illustrate the
      interdependence of biology and psychology. The author describes current
      psychodynamic understanding of the factors that contribute to the etiology and
      pathogenesis of these disorders. He concludes by stressing the value of
      integrated, psychodynamic treatment.

PMID- 1623338
TI  - Psychopharmacological treatment of panic disorder.
AB  - Panic disorder is a serious, often chronic condition that warrants vigorous
      treatment. The benzodiazepines, particularly the high-potency compounds
      alprazolam and clonazepam, provide prompt relief, often with few side effects.
      Tricyclic antidepressants and monoamine oxidase inhibitors are also effective,
      although patient acceptance may be limited by a slower response and side effects
      that mimic some symptoms of panic attacks. The author suggests strategies for the
      most effective use of these agents.

PMID- 1623340
TI  - Evaluation and management of the treatment-resistant anxiety disorder patient.
AB  - Effective evaluation and management of patients with anxiety disorders require an
      integrated theoretical model that predicts risk for the disorder as a consequence
      of constitutional vulnerability shaped by developmental experience and activated
      or influenced by environmental factors. From this perspective, the author
      describes a rational therapeutic strategy with treatment-resistant patients. He
      particularly urges a careful evaluation of risk factors and associated conditions
      that may contribute to persisting distress.

PMID- 1623342
TI  - Subungual melanoma: a clinico-pathological study of 24 cases.
AB  - Twenty-four patients with subungual melanoma (13 women and 11 men) had a mean age
      of 61.6 years. Twenty-two lesions arose either on the thumb or hallux. The mean
      delay before diagnosis was 30 months. Two patients presented with stage two
      melanoma and three of the melanomas were in situ lesions (Clark level 1).
      Nineteen melanomas were Clark level 4 or 5 and the mean thickness of the invasive
      melanomas was 4.7 mm. Seven patients died of metastatic disease (mean survival 10
      months, range 6-50 months). Clark level, thickness and mitotic activity of the
      melanomas correlated with poor clinical outcome. Delay in presentation and the
      presence of advanced disease contribute to the poor prognosis of this tumour.

PMID- 1623341
TI  - Integrated treatment of panic disorder and social phobia.
AB  - The integrated treatment of disabling anxiety disorders such as panic disorder
      and social phobia draws on an understanding of psychodynamic theory, cognitive
      behavioral theory, and psychopharmacology. Regardless of the treatment employed,
      clinicians are encouraged to focus on interrelated factors affecting the course
      of the illness and its treatment, including differential diagnosis, etiology,
      patient education, symptomatic relief, underlying causes, and therapist anxiety.
      The author delineates eight key principles that foster the optimal choice or
      combination of treatment methods, and gives a case example to illustrate how
      these principles apply.

PMID- 1623343
TI  - Delay between expansion and expander/implant exchange in breast reconstruction--a
      prospective study.
AB  - It has been suggested that delay between expansion and insertion of the
      definitive prosthesis in breast reconstruction reduces the incidence of adverse
      capsular contracture. We have carried out a prospective trial to examine this
      hypothesis. 65 patients were randomly allocated into two groups; in one,
      insertion of the definitive prosthesis was 2 weeks following expansion
      ("immediate") and in the other, 6 months ("delayed"). The incidence of adverse
      capsular contracture assessed both by the Baker Scale and a linear analogue scale
      showed no difference between the two groups. A new objective method for measuring
      ptosis using a specially designed template is described. The degree of ptosis was
      not affected by the delay.

PMID- 1623344
TI  - The distally based posterior tibial arterial adipofascial flap.
AB  - A distally based posterior tibial artery adipofascial flap with skin graft was
      used for the reconstruction of soft tissue defects over the Achilles tendon in
      three cases and over the heel in three cases. Good resurfacing with protective
      sensation of these wounds was achieved. There was no breakdown of the graft or
      morbidity of donor sites, which were closed primarily. We believe there were many
      advantages to this adipofascial flap and that it is an ideal choice for the
      reconstruction of soft tissue defects in the lower third of the leg and foot,
      especially over the Achilles tendon.

PMID- 1623345
TI  - The V.L.S. classification for secondary deformities in the unilateral cleft lip.
AB  - A classification designed to be used as a simple and reproducible method to
      evaluate the residual lip deformities following unilateral cleft lip repair is
      presented. It was developed by analysing the appearance of the upper lips of 81
      patients referred to the author with repaired unilateral clefts. The assessment
      of each lip was divided into 3 separate components: the vermilion (V), the lip
      itself (L), and the scar (S), and the resulting classification was termed the
      V.L.S. classification.

PMID- 1623346
TI  - The V.L.S. classification for secondary deformities in the unilateral cleft lip:
      clinical application.
AB  - Results obtained in 70 cleft lip and palate patients who were assessed using the
      V.L.S. classification are presented. Of these 70 patients, 24 (34%) had had a
      Millard repair, 13 (19%) a straight line repair, and 33 (47%) had had a repair
      incorporating a Z-plasty. Both the Millard repair and the Z-plasty repair were
      associated with a lip of equal height in 54% of patients, whilst in the straight
      line repair group, 69% of patients had lips of equal height. A long lip was more
      often associated with the Z-plasty type repair group (27%) of patients, and short
      lips were more associated with Millard type repair (33%), and straight line
      repair (31%). Irrespective of the technique used, a notch at the site of the scar
      was the most common defect found at the vermilion. Wideness and irregularity were
      the most common unaesthetic features of the scar.

PMID- 1623347
TI  - Idiopathic muscular torticollis in children: the Cape Town experience.
AB  - 54 cases of Idiopathic Muscular Torticollis (IMT) referred for surgery over a 23
      year period and 134 cases referred for physiotherapy over a 5-year period have
      been reviewed. Long-term cosmetic and functional results for 30% of the surgical
      cases are presented, with a mean follow-up time of 10.5 years. Demographic
      features, the role of physiotherapy, the timing of surgery and serial assessment
      are discussed and results are compared with similar studies from other centres.
      Locally, of the 134 cases referred primarily for physiotherapy, 36% defaulted
      from treatment, 60% enjoyed lasting benefit and 4% required subsequent surgical
      intervention. In the surgical cases, while early surgery appears preferable,
      delayed operation, even up to the ages of 4 or 5 years did not seem to prejudice
      long-term results, providing that the advent of facial hemihypoplasia did not
      precede surgery. Delay beyond this point, or roughly 6 or 7 years of age, would
      seem to prejudice function and/or cosmesis.

PMID- 1623348
TI  - Are rhinoplasty patients potentially mad?
AB  - Rhinoplasty patients have long been considered to be psychologically unstable and
      therefore a "risky" group upon which to operate. Patients who had rhinoplastic
      operations more than 5 years ago were contacted by post and their psychological
      health assessed by the use of psychometric tests. The results show no evidence to
      support earlier suggestions that requests for rhinoplasty may be early symptoms
      of severe psychiatric disease. However, several points do emerge. Male patients
      show more symptoms of anxiety and depression than normal, and female patients who
      give no history of injury preceding their operation behave in a more extrovert
      and sociable manner than normal. Furthermore, patients of both sexes who give no
      history of injury before their operation, even though pleased with the operative
      results, are more self-conscious of their appearance than those who were injured
      prior to their rhinoplasty.

PMID- 1623350
TI  - The radial forearm--flexor carpi radialis myocutaneous flap: case report.
AB  - A patient sustained a compound fracture of the elbow resulting in a deep soft
      tissue defect with exposed bone, joint and nerve. The flexor carpi radialis (FCR)
      muscle was incorporated within the radial forearm island flap to cover the
      defect. Wrist flexion was not compromised by this procedure. The blood supply and
      applications of the radial forearm--flexor carpi radialis myocutaneous flap are
      described.

PMID- 1623349
TI  - Xeroderma pigmentosum: resurfacing versus dermabrasion.
AB  - Three patients of Xeroderma Pigmentosum (XP) have been managed for recurrent
      tumours. Improvement in pigment pattern was observed at both the donor as well as
      the recipient sites. An attempt has been made to prevent further occurrence of
      tumours over the exposed parts of the body by resurfacing and also by
      dermabrasion. A comparative study of the two procedures is being carried out and
      the preliminary results are discussed. Deep dermabrasion appears to be preferable
      as a prophylactic procedure.

PMID- 1623352
TI  - 'Angiosome theory'.

PMID- 1623351
TI  - Posterior pharyngeal tattooing: localising the implant in velopharyngeal
      incompetence.
AB  - A technique of preoperative localisation of pharyngeal wall implants for
      velopharyngeal incompetence is described. The nasal approach in the non-sedated
      patient permits precise and permanent posterior pharyngeal wall tattooing for
      accurate implant location.

PMID- 1623353
TI  - Breast implant seroma in pregnancy.

PMID- 1623354
TI  - Landing patterns in netball: analysis of an international game.
AB  - The passing and landing patterns among netball players were investigated by
      examining all the 595 passes in an international match between Australia and New
      Zealand. Intra-class correlations were used to test inter-observer reliability.
      The independence of two variables was tested using a Pearson chi 2 test and a
      contingency coefficient was used to assess the degree of association between
      variables. An inter-rater reliability in the identification of movement patterns
      was 0.99. Most of the landings observed in this match were on the forefoot and
      not the hindfoot as generally reported in controlled experiments. Only 14% of the
      players leapt to receive a pass compared with 76% reported earlier under
      controlled environments. The distribution of passing techniques unexpectedly
      showed that approximately 50% of all the players did not reach for the ball as it
      was thrown directly to them. However, over 70% of the players threw straight
      passes which were mainly received in the chest quadrant and other types of passes
      such as loop, bounce and rebound were used less frequently. Nearly 50% of all
      players used a right-handed pass to dispose of the ball, while the next most
      popular pass was to use both hands (40.2%). Landing and passing patterns differed
      between players in different positions. Footfall patterns on landing after a
      catch were associated with the trajectory of the ball.

PMID- 1623355
TI  - Making weight: a case study of two elite wrestlers.
AB  - Two mature elite Sambo wrestlers were studied during a 22-day pre-European
      Championship period, during which they were to lose weight and maintain their top
      physical performance characteristics. During this time the athletes underwent
      intensive training coupled with a hypocaloric diet. Both lost approximately 8% of
      their initial body weight, while maintaining their pre-weight loss maximum oxygen
      uptake, anaerobic threshold and maximum isometric strength. These variables
      therefore increased when expressed relative to the lower body weight. Isometric
      endurance and short-term sprinting ability, however, were compromised by the
      weight-loss regimen, decreasing by up to 7% and 13% respectively. Following a
      well-planned weight-reduction programme coupled with serious training, aerobic
      power and isometric strength were unaffected and/or improved, but prolonged
      anaerobic exercise performance was impaired.

PMID- 1623356
TI  - Effect of caffeinated coffee on running speed, respiratory factors, blood lactate
      and perceived exertion during 1500-m treadmill running.
AB  - Using a motorized treadmill the study investigated the effects of the ingestion
      of 3 g of caffeinated coffee on: the time taken to run 1500 m; the selected speed
      with which athletes completed a 1-min 'finishing burst' at the end of a high
      intensity run; and respiratory factors, perceived exertion and blood lactate
      levels during a high intensity 1500-m run. In all testing protocols decaffeinated
      coffee (3 g) was used as a placebo and a double-blind experimental design was
      used throughout. The participants in the study were middle distance athletes of
      club, county and national standard. The results showed that ingestion of
      caffeinated coffee: decreases the time taken to run 1500 m (P less than 0.005);
      increases the speed of the 'finishing burst' (P less than 0.005); and increases
      VO2 during the high-intensity 1500-m run (P less than 0.025). The study concluded
      that under these laboratory conditions, the ingestion of caffeinated coffee could
      enhance the performance of sustained high-intensity exercise.

PMID- 1623357
TI  - Accuracy of Borg's ratings of perceived exertion in the prediction of heart rates
      during pregnancy.
AB  - When using Borg's 6-20 scale during pregnancy, ratings of perceived exertion
      (RPE) did not significantly correlate with exercise heart rates (HR) (P greater
      than 0.05). The HR predicted from RPE significantly (P less than 0.05)
      underestimated the exercise HR in the second trimester during walking (Group 1:
      mean difference 16 beats min-1, n = 11), aerobics classes (Group 4: mean 15 beats
      min-1, n = 48) and circuit training (Group 3: mean 18 beats min-1, n = 24); and
      in the third trimester during cycling (Group 2: mean 16 beats min-1, n = 12) and
      aerobics classes (Group 5: mean 11 beats min-1, n = 29). Maximal individual HR
      under-estimations were large for each physical activity during pregnancy, with
      values up to 54 beats min-1. Consequently, exercise intensity should not be
      monitored solely with RPE during pregnancy.

PMID- 1623358
TI  - Does exercise reduce all-cancer death rates?
AB  - A reanalysis is made of earlier data relating to initial physical fitness and the
      likelihood of death from all forms of cancer. It is argued that the original
      analysis may have been biased by an association between initial fitness and other
      health habits, particularly cigarette smoking. The association with fitness
      status remains after reanalysis of the data on the assumption that current
      smoking leads to a uniform doubling of the risk of cancer death, but the effect
      is weaker than previously reported. There remains some potential bias, in that
      the quantity of current smoking may have been linked to fitness status. Some 55%
      of deaths were untraced, but it is argued that any socioeconomic or other bias
      from this cause is likely to account for the association between cancer risk and
      low fitness status. Any reduction of cancer risk is associated with the change
      from an extremely sedentary to a moderately sedentary lifestyle. It thus cannot
      be explained in terms of the mechanisms previously invoked to explain low risks
      of colonic and reproductive cancers in endurance athletes.

PMID- 1623359
TI  - Menarcheal age among Indian sportswomen.
AB  - The subjects of the study were 85 Indian sportswomen from Delhi and the states of
      Uttar Pradesh, Punjab and Gujarat, and included outstanding players of cricket,
      hockey, kho-kho and table-tennis, who were winners of university, state or
      national championships. A sample of 77 subjects selected at random was used as
      the control. The recall procedures suggested by Damon and Bajema (1974) were
      used. The combined mean age at menarche for sportswomen is 13.56 years and for
      the control sample is 12.7 years. Menarche was significantly delayed in those
      sportswomen who embarked on physical training activities before the onset of
      menstruation. There are also variations in the mean menarcheal age between
      participants in different sports specialities.

PMID- 1623362
TI  - Sports medicine--where are the specialists?

PMID- 1623361
TI  - Volleyball injuries: a survey of injuries of Scottish National League male
      players.
AB  - Injuries sustained in male volleyball players in the first division of the
      Scottish National League during the 1989-1990 season were investigated by means
      of a questionnaire survey. Forty-six injuries were reported, representing an
      incidence of 0.53 injuries per player. Damage to muscles, tendons and ligaments
      accounted for most of the injuries. The cause of most injuries was blocking or
      spiking. In 74% of cases the injured players were able to resume training and
      playing within 2 weeks of the injury. In 10% of cases the injured players were
      unable to train or play for 7-14 weeks.

PMID- 1623360
TI  - Efficacy of perceptual versus heart rate monitoring in the development of
      endurance.
AB  - The purpose of this investigation was to compare the effectiveness of using
      ratings of perceived exertion (RPE) with heart rate in the monitoring of exercise
      intensity during aerobic dance instruction. Thirty-eight students who enrolled in
      aerobic dance classes used heart rate to monitor exercise intensity while 38
      additional students used RPE to monitor exercise intensity during a 14-week
      course. Classes met twice a week for 50 min and all outside workouts were
      recorded. The groups did not differ with respect to the number of outside
      workouts. The dependent variable was endurance performance as measured by the
      distance run in 15 min. Data were analysed with a repeated measures analysis of
      variance (ANOVA) for multifactor experiments. There were significant trials (P
      less than 0.0001) and interaction (P less than 0.05) effects, and both groups
      improved significantly in endurance performance during 14 weeks of training.
      However, the group using RPE to monitor exercise intensity had a significantly
      greater gain in endurance. The heart rate group had a mean increase of 6% (166 m)
      whereas the RPE group increased 11% (274 m). It is concluded that during aerobic
      dance the monitoring of exercise intensity with RPE is associated with greater
      improvement in endurance than is heart rate monitoring.

PMID- 1623363
TI  - The National Sports Medicine Institute. 1. BASM's contribution to its formation.

PMID- 1623364
TI  - Parachuting injuries: a follow-up communication.

PMID- 1623365
TI  - Ocular fundus lesions in sports divers using safe diving practices.
AB  - Ocular fundus fluorescein angiography was performed on 26 divers, who had used
      safe diving practices for at least 10 years, and on seven controls. There was no
      significant difference in the incidence of macular abnormalities between these
      groups and those of a previous study. Adherence to safe diving practice confers
      some protection against the macular abnormalities known to occur in divers with a
      history of decompression sickness.

PMID- 1623367
TI  - Effect of breathing techniques on blood pressure response to resistance exercise.
AB  - Twenty novice male weight lifters performed resistance exercises using three
      different breathing techniques to determine the effects on blood pressure.
      Systolic and diastolic blood pressures were measured by an automated non-invasive
      method while subjects performed the single arm curl and double knee extension
      using the different breathing techniques. Performing the Valsalva manoeuvre
      (breath-holding) during either the single arm curl or double knee extension
      produced the highest blood pressure responses. Inhaling during the concentric
      phase of the exercise was associated with blood pressure elevations that were
      similar to the elevations observed with exhaling during the concentric phase. The
      heart rate response was slightly higher with inhalation. These results suggest
      that performing the Valsalva manoeuvre exaggerates the blood pressure response to
      resistance exercise. In addition, coupling inhalation with the concentric phase
      of the lift offers no cardiovascular advantage over coupling exhalation with the
      concentric phase of the lift.

PMID- 1623366
TI  - Ultrasonographic scan in knee pain in athletes.
AB  - Fifty-two knees were examined using real-time high-definition ultrasonography
      with a 7.5 MHz probe. The extra-articular structures were easily visualized and
      diagnosis of patellar tendon lesions and Baker's cysts formulated. While the
      meniscal cartilages were shown as a homogeneous triangular structure between the
      femoral condyle and the tibial plateau, no lesions were detected. Deeper intra
      articular structures, such as the cruciate ligaments, were not shown by the scan,
      thus their evaluation was not possible. Given its low cost, wide availability,
      non-invasiveness and patients' acceptability of the technique, ultrasonography
      may play an important role in the diagnosis of soft tissue lesions in and around
      the knee joint.

PMID- 1623368
TI  - A longitudinal study of the effects of television viewing on aggressive and
      prosocial behaviours.
AB  - A longitudinal study investigated the extent to which children's exposure to
      aggressive and prosocial television models in drama programmes influences their
      aggressive and prosocial behaviour. In The Netherlands we did not find
      significant positive correlations between prosocial behaviour and the viewing of
      prosocial behaviour on television. Positive correlations were found, however,
      between aggression and television violence viewing. This relationship disappeared
      almost completely when corrections for the starting level of aggression and
      intelligence were applied. The hypothesis, formulated on the basis of social
      learning theory, that television violence viewing leads to aggressive behaviour
      could not be supported. Our findings are further discussed and compared with the
      results found in the other countries participating in the international study.

PMID- 1623370
TI  - Personal computers and urological research.
AB  - The value of a computer in urological research depends not only upon an
      appropriate and informed choice of hardware, but also the purchase of software
      programs which will facilitate input, manipulation and transfer of relevant data.
      Acquaintance with the Data Protection Act is essential, as is registration as a
      data user in most cases.

PMID- 1623369
TI  - Transrectal ultrasound 1992.

PMID- 1623371
TI  - Psychological factors in recurrent uncomplicated urinary tract infection.
AB  - Recurrent urinary tract infection (UTI) is a very common medical complaint among
      women. A large proportion of such recurrence is attributable to a small sub-group
      of sufferers. Medical factors have proven insufficient to explain all such cases,
      and a number of psychological factors have been suggested as having a causal
      role. This study examines the evidence for the effects of behavioural and
      personality factors. Neuroticism and specific "risky" behaviours are identified
      as particularly important, being related to both the diagnosis of recurrent UTI
      and the frequency of infection. These findings suggest that treatment of
      recurrent, intractable UTI might include a psychological component.

PMID- 1623372
TI  - Extracorporeal shock wave lithotripsy with the Storz Modulith SL20: the first 500
      patients.
AB  - Our initial experience of extracorporeal shock wave lithotripsy (ESWL) with the
      Storz Modulith SL20 is reported. A total of 500 patients with 551 renal and 120
      ureteric stones, mean diameter 11.9 mm, underwent 746 treatments; 68.2% of
      patients required a single treatment. The mean treatment rate for renal calculi
      was 1.4 and for ureteric calculi it was 1.5, rising to 4.2 for staghorns; 62.2%
      of treatments were performed on an out-patient basis. Analgesia (intravenous
      fentanyl) was required in 60.9% of treatments for renal calculi but in only 38.2%
      of those for ureteric calculi. The overall stone-free rate at 3 months was 77.6%,
      with a further 14.7% of patients having fragments less than 3 mm in diameter that
      required no further treatment. The stone-free rate was dependent on the site of
      the stone, with the majority of residual fragments lying in a lower pole calix.
      There were few complications. The Modulith is an efficient and safe lithotripter
      capable of treating stones in the kidney and throughout the ureter.

PMID- 1623373
TI  - Percutaneous nephrolithotripsy for renal stones in over 1000 patients.
AB  - Over a period of 5 consecutive years, 1039 renal units were treated by
      percutaneous nephrolithotripsy for stone disease of the kidney. The success rate
      was 93.7%. Residual stones remained in 4.2% of patients and in 2.1% we failed to
      remove the stones. The complication rate was 17.8%. Complications were treated
      conservatively in most cases but nephrectomy was required on one occasion to
      control severe bleeding. The average hospital stay was 6.9 days. Follow-up of 339
      renal units (333 patients), for a minimum of 60 months, revealed minor late
      sequelae such as pelviureteric junction obstruction in 1 patient (0.3%) and post
      catheterisation strictures of the anterior urethra in 4 (1.2%). Stone recurrence
      was observed in 9.1% of patients. Percutaneous nephrolithotripsy is an effective,
      safe treatment for renal stones with minimal late sequelae and is still required
      even in the era of extracorporeal shock wave lithotripsy.

PMID- 1623374
TI  - Hydatid disease of the urinary tract: evaluation of diagnostic methods.
AB  - Eight patients with histologically proven hydatid disease of the urinary tract
      underwent eosinophil count, ultrasonography (US) and computed tomography (CT).
      The findings were compared with those in 8 age-matched controls with simple renal
      cysts. Eosinophilia was not significantly different in the 2 groups. Mixed
      echogenicity on US and multivesicular cyst with mixed density on CT were the
      diagnostic features of hydatid cysts. Using these factors, both US and CT could
      diagnose or exclude hydatid disease in a significant number of patients with
      renal cysts. However, CT was more sensitive (88 vs 50%) and accurate (94 vs 75%)
      than US in the diagnosis of urinary tract hydatid disease. Retrograde pyelography
      confirmed communicating renal hydatid cysts in 2 patients. A practical algorithm
      for the investigation of urinary tract hydatid disease is suggested.

PMID- 1623375
TI  - Prognostic value of renal venous involvement in renal carcinoma.
AB  - A series of 108 renal tumour nephrectomies carried out between 1975 and 1984 was
      studied to determine the prognostic statistical significance of the relationship
      between venous involvement and various pathological features. Tumour size,
      spread, histological grade and lymph node involvement were compared between V0
      tumours (58%), V1 (32%) and V2 tumours (10%). Actuarial 5-year survival rates
      revealed a poor prognosis with venous involvement (V0 66%, V1 27%, V2 33%).
      Tumours larger than 10 cm with perirenal spread and of higher histological grade
      were significantly related to venous involvement. Survival between renal vein
      involvement and inferior vena caval extension was statistically similar, but it
      was influenced by tumour size and higher grade. Perirenal spread and nodal
      involvement were poor indicators.

PMID- 1623376
TI  - Long-term results of surgical treatment of renal carcinoma in solitary kidneys by
      extracorporeal resection and autotransplantation.
AB  - We describe the technique and present the long-term results of extracorporeal
      partial nephrectomy and autotransplantation in 6 patients with renal carcinoma.
      During a follow-up period exceeding 5 years, dialysis was not required and the
      patients' blood pressure improved or remained within normal limits. One patient
      died post-operatively from gastrointestinal bleeding. The mean duration of follow
      up was 54 months (range 14-97). The alternatives to extracorporeal resection and
      autotransplantation (such as complete nephrectomy and in situ resection of the
      tumour) are discussed.

PMID- 1623378
TI  - Endometriosis of the ureter.
AB  - Five patients with ureteric endometriosis are described. Extensive pre-operative
      investigation failed to reveal the aetiology of the unilateral upper urinary
      tract obstruction seen in all of these patients. Due to the dense fibrosis that
      invariably accompanies ureteric endometriosis, early surgical excision of the
      ureteric stricture permits effective resolution of upper tract dilatation and
      improved renal salvage.

PMID- 1623377
TI  - Phase II clinical trial of recombinant alpha-2 interferon for biopsy-proven
      metastatic or recurrent renal carcinoma.
AB  - Twenty patients with histologically confirmed metastatic or recurrent renal
      carcinoma were treated in a phase II study with alpha-interferon (2-5 x 10(6)
      U/m2 subcutaneously, 3 times a week). Nineteen patients had multiple sites of
      disease and 18 had previously undergone nephrectomy; 9 had an ECOG performance
      status of 0.1, and 11 had a performance status of 2-3. There was one partial
      response, yielding an overall response rate of 5%. Treatment was well tolerated,
      although 7 patients developed influenza-like symptoms, and in 2 cases this was
      sufficiently severe for the patients to request cessation of treatment. As a
      single agent at this dose schedule, alpha-interferon has minimal activity in the
      treatment of renal carcinoma and cannot be recommended as standard therapy. The
      difference in outcome between this and some published series may reflect the
      stringent requirement for histological proof of the presence of metastases.

PMID- 1623379
TI  - Induction of carcinoma at ureterosigmoid anastomosis--with and without faecal
      stream.
AB  - The induction of tumours at the site of uretero-intestinal anastomosis was
      investigated in Hannover: WISTAR rats. The rats were divided into 3 groups. In
      one group (n = 70) the ureter of the left kidney was implanted into the colon,
      using microsurgical techniques developed for humans. In 13% of the rats in this
      group benign tumours developed; in 16% malignant tumours occurred. In a second
      group (n = 76) the ureter was implanted into a rectal bladder; the faeces were
      excluded from the anastomosis by a descending colon anus praeter. In this group
      benign tumours developed in 17% and malignant tumours in 8%, all of them being
      situated at the site of the anastomosis. In a control group (n = 80) no colonic
      tumour could be identified.

PMID- 1623380
TI  - Anti-reflux surgery by injection of Teflon paste.
AB  - Over a 3-year period, 55 refluxing ureters in 36 patients were treated by the
      endoscopic injection of Teflon paste. Although reflux was corrected immediately
      in 54 ureters (98%), reflux recurred 3 to 4 months later in 18 ureters.
      Reinjection was carried out once in 5 ureters and twice in 1. The success rate
      was 71% in primary reflux and 53% in secondary reflux. Significant side effects
      were encountered post-operatively in 3 patients: vesicoureteric junction
      obstruction in 2 and urethral stricture in 1. We recommend that the results of
      surgery should not be evaluated until at least 3 to 4 months after operation. A
      review of the literature shows that the overall success rate was 92% in 367
      ureters with primary reflux and 70% in 181 ureters with secondary reflux. Because
      of the uncertain outcome of surgery and the possibility of adverse side effects,
      one should be cautious when considering this form of treatment in young children.

PMID- 1623381
TI  - Abscess of urachal remnant mimicking urinary bladder neoplasm.
AB  - Three cases of urachal abscess with extensive interstitial inflammation and
      fibrosis are reported. Clinically, all patients had a lower abdominal mass and CT
      scan and ultrasonic examination revealed a large tumour located anterior or
      superior to the bladder. They all underwent laparotomy and had either a partial
      cystectomy or an en bloc resection of the bladder and adjacent organs due to
      severe adhesions. Microscopic examination of the specimens revealed no evidence
      of carcinoma and only abscess formation with extensive chronic interstitial
      inflammation and fibrosis were seen. In one case, residual columnar epithelium
      suggestive of urachal origin was identified in the abscess cavity. Urachal
      abscess should be considered when dealing with lower abdominal masses.

PMID- 1623382
TI  - Continent urinary reservoirs.
AB  - We report our experience of 30 continent urinary reservoirs (CURs) after radical
      cystectomy. The patients ranged in age from 35 to 70 years. There were 22 males
      and 8 females. Pre-operative urograms showed normal upper tracts in 22 patients,
      unilateral hydronephrosis in 4 and bilateral hydronephrosis in 4. The first 20
      patients had a standard CUR procedure and the last 10 had a modified CUR. The
      mean operative time, blood loss and post-operative stay were 6.6 h, 900 ml and 25
      days respectively for standard CURs and 5.7 h, 825 ml and 21 days respectively
      for the modified CURs. Post-operative, urinary leaks from the caecostomy site
      occurred in 2 patients (1 of which was fatal) while 3 other patients had
      prolonged ileus, burst abdomen and intestinal obstruction probably due to non
      demonstrable urinary leaks. All 5 complications occurred in the first 20
      patients. Upper tract status was evaluated in 28 patients 3 months after surgery
      and showed normal upper tracts in 19 patients, improvement in 6 (35%) and
      worsening in 3 (12.5%). Pouchograms showed no reflux in 25 patients, unilateral
      reflux in 2 and bilateral reflux in 1. Complete continence was achieved in 25
      patients--2 of them had revision surgery, giving a success rate of 89% with a
      follow-up of 6 to 48 months (median 24). The remaining 3 patients were
      incontinent.

PMID- 1623383
TI  - Cystodiathermy under local anaesthesia using the flexible cystoscope.
AB  - The use of the flexible cytoscope in the follow-up of patients with bladder
      carcinoma is becoming more widespread. In a series of 17 patients, cystodiathermy
      of small recurrent tumours using the flexible cytoscope and topical urethral
      anaesthesia proved to be a safe, effective and well tolerated procedure.

PMID- 1623384
TI  - Natural history and prognosis of prostate carcinoma in adolescents and men under
      35 years of age.
AB  - Prostate cancer is extremely rare in men under 35 years of age. The tumour is
      invariably poorly differentiated and aggressive, with rapidly growing bulky soft
      tissue metastases and negative tumour markers. Bone metastases develop late and
      are usually osteolytic. The disease responds poorly to radiation or hormonal
      therapy and is too advanced at presentation for radical surgery. Chemotherapy
      appears to be of some benefit, though in the majority of cases death occurs
      within a year. We describe a 31-year-old man with carcinoma of the prostate. A
      review of the literature is presented. This is the first patient in whom the
      epithelial origin of the prostate cancer was confirmed by immunoperoxidase
      staining with prostatic specific antigen. Plasma prostatic specific antigen was
      normal despite a large tumour burden and widespread metastases. He did not
      respond to conventional treatment. The phenotypic expression and biological
      behaviour of these tumours are distinct from those occurring in men beyond the
      fourth decade.

PMID- 1623385
TI  - Vesicoureteric reflux in sibships.
AB  - A family with 4 of 6 siblings manifesting vesicoureteric reflux is presented.
      Reflux could not be demonstrated in preceding and succeeding generations in this
      family. Genetic analysis suggests that most instances of familial vesicoureteric
      reflux arise secondary to expression of autosomal dominant single genes with
      incomplete penetrance. Screening of sibships for reflux might be most
      appropriately carried out by urine analysis, culture and ultrasound imaging.

PMID- 1623386
TI  - Multicystic renal dysplasia detected by prenatal ultrasonography. Natural history
      and results of conservative management.
AB  - In a review of 44 infants with multicystic renal dysplasia diagnosed prenatally
      by ultrasonography, contralateral anomalies, bilateral disease and other non
      urinary congenital anomalies were rare. In approximately two-thirds of infants
      the lesion was impalpable and in 2 cases involution had occurred prenatally. All
      but 5 were managed conservatively and without complications, and partial or
      complete involution of the lesion occurred in more than 50% during follow-up. It
      was concluded that the natural history of this anomaly is usually benign and that
      conservative management is advisable.

PMID- 1623387
TI  - Localised infarction of the testis.

PMID- 1623388
TI  - Perforation of bladder carcinoma presenting as acute abdomen.

PMID- 1623389
TI  - Generalised seizure after extracorporeal shock wave lithotripsy. A complication
      easy to prevent?

PMID- 1623390
TI  - Fournier's gangrene: an aetiological hypothesis.

PMID- 1623391
TI  - Paneth and argyrophil cells in prostatic carcinoma.

PMID- 1623392
TI  - Giant bladder diverticulum causing urethral obstruction in an infant.

PMID- 1623393
TI  - Abdominoscrotal hydrocele.

PMID- 1623394
TI  - Why renography can fail in the diagnosis of upper urinary tract obstruction.

PMID- 1623395
TI  - Reverse supine position on lithostar for lower ureteric stones.

PMID- 1623397
TI  - Re: A comparison of aspiration, antazoline sclerotherapy and surgery in the
      treatment of hydrocele.

PMID- 1623396
TI  - One-step dilatation of the corpus cavernosum by cardiac valve dilators.

PMID- 1623398
TI  - Different populations of cells in the suprachiasmatic nuclei express c-fos in
      association with light-induced phase delays and advances of the free-running
      activity rhythm in hamsters.
AB  - Circadian rhythmicity is controlled by a light-entrainable pacemaker located in
      the suprachiasmatic nuclei (SCN) of the mammalian hypothalamus. Brief light
      exposure during the subjective night causes phase shifts of the free-running
      activity rhythm and expression of c-fos-related proteins (Fos) among a population
      of cells in the hamster SCN. Light exposure (30 lux for 15 min) during the early
      subjective night (CT13) causes phase delays (-60 +/- 12 min), while exposure at
      mid-subjective night (CT18) causes phase advances (114 +/- 48 min) of the free
      running activity rhythm. Light exposure at mid-subjective day (CT6) does not
      cause phase alterations of the rhythm. Similarly, only light exposure at CT13 or
      CT18 induces Fos expression in the SCN. The distribution of Fos-immunoreactive
      cells in the SCN is more widespread in animals stimulated with light at CT18. In
      addition, a group of cells located dorsal and anterior to the SCN express Fos
      only after stimulation at CT18. The data are consistent with the hypothesis that
      Fos expression represents an event in the signal transduction pathway leading to
      light-induced alterations in circadian pacemaker function. Furthermore, the data
      raise the possibility that different populations of cells in the suprachiasmatic
      hypothalamus may participate in light-induced phase advances and delays of the
      circadian pacemaker.

PMID- 1623399
TI  - The functional relationship between antidromically evoked field responses of the
      dentate gyrus and mossy fiber reorganization in temporal lobe epileptic patients.
AB  - Field recordings from the dentate granule cell layer of in vitro brain slices of
      temporal lobe epileptic patients were evoked by antidromic stimulation. Tissue
      from the same specimen was stained by the Timm-sulfide method to assess the
      pattern and degree of mossy fiber reorganization into the supragranular layer. A
      wide range of physiological responses and Timm staining patterns was present
      across patients. A significant correlation was observed between the abnormality
      of antidromic responses, reflected by multiple secondary population spikes, and
      the degree of Timm staining of the supragranular layer. This relationship lends
      support to the hypothesis that mossy fiber synapses located in the supragranular
      layer may have functional implications for granule cell excitability in human
      epileptic tissue.

PMID- 1623400
TI  - Ectopic discharge in injured nerves: comparison of trigeminal and somatic
      afferents.
AB  - Using the teased fiber recording method, we have compared pathophysiological
      properties of afferent axons injured in the infraorbital nerve (ION) vs the
      sciatic nerve in rats. Both myelinated and unmyelinated axons ending in ION
      neuromas produced much less ongoing discharge than those ending in sciatic nerve
      neuromas. Similarly, mechanosensitivity and acute injury discharge in ION
      neuromas were minimal. These differences may be related to the different spectrum
      of neuropathic symptomatology associated with nerve injury in the trigeminal vs
      the segmental innervation fields.

PMID- 1623401
TI  - Interactions of fluoxetine with metabolism of dopamine and serotonin in rat brain
      regions.
AB  - Given evidence of inhibitory effects of serotonin on dopaminergic
      neurotransmission, a series of experiments sought neurochemical evidence of
      interactions between the selective serotonin transport inhibitor fluoxetine and
      the metabolism of dopamine (DA) or serotonin (5-HT) in regions of rat brain that
      might account for extrapyramidal side-effects associated with clinical use of
      fluoxetine. There were significant inhibitory effects of acute or repeated
      fluoxetine treatment on the turnover of 5-HT (accumulation of 5
      hydroxytryptophan, or ratio of [5-hydroxyindoleacetic acid]/[5-HT]) in striatum,
      nucleus accumbens and frontal cerebral cortex, but only minor effects on
      metabolism of DA (accumulation of dihydroxyphenylalanine, or [homovanillic
      acid]/[DA] ratio), even at high doses or with repeated treatment, and no
      significant inhibition of the DA metabolism-increasing actions of haloperidol.

PMID- 1623402
TI  - Effects of selective toxic lesions of cholinergic neurons of the laterodorsal
      tegmental nucleus on experimental seizures.
AB  - This study determined the effects of bilateral discrete partial lesions of
      cholinergic neurons of the laterodorsal tegmental nucleus (LDTg) of the
      pontomesencephalic tegmentum on seizures induced by intravenous pentylenetetrazol
      (PTZ). Relatively selective lesions produced by bilateral 50 nl microinjections
      of 75 pmol of the cholinergic neurotoxin ethylcholine mustard aziridinium ion
      (AF64A) resulted in a significant reduction in the threshold of myoclonic and
      facial-forelimb clonic seizures but not tonic seizures when PTZ was infused 7
      days later. This demonstrates that this cholinergic nucleus is a key site of
      subcortical seizure regulation. We propose that this control is mediated by
      ascending projections from the LDTg to the central medial intralaminar nucleus of
      the thalamus.

PMID- 1623403
TI  - Spontaneous miniature hyperpolarizations of presynaptic nerve terminals in the
      chick ciliary ganglion.
AB  - Intracellular recordings from presynaptic nerve terminals in the chick ciliary
      ganglion revealed the presence of spontaneous miniature hyperpolarizations in
      virtually all (approximately 86%) nerve terminals examined. These spontaneous
      events appeared as small, brief hyperpolarizations at resting potential and were
      observed to increase or decrease as the membrane potential was depolarized or
      hyperpolarized from rest, respectively. The hyperpolarizing potentials were
      sensitive to blockade by tetraethylammonium and Ba2+, while caffeine increased
      then abolished these events. The voltage fluctuations were unaffected by
      tetrodotoxin, low Ca2+ external solution or the synaptic blockers, picrotoxin and
      strychnine. These spontaneous, transient, miniature hyperpolarizations may be due
      to the brief and co-ordinated activation of between 15-60 Ca(2+)-dependent K+
      channels following the release of Ca2+ from internal stores.

PMID- 1623405
TI  - The effect of direct current field polarity on recovery after acute experimental
      spinal cord injury.
AB  - Recent evidence indicates that direct current (DC) fields promote recovery of
      acutely injured central and peripheral nervous system axons. The polarity of the
      applied DC field may play an important role in modulating these effects. In the
      present study, the effect of DC field polarity on recovery of injured spinal cord
      axons was examined anatomically, electrophysiologically and behaviourly in a rat
      model. After a 53 g clip compression injury of the cord at T1, 30 adult rats were
      randomly and blindly allocated to one of three groups (n = 10 each): one group
      received implantation of a DC stimulator (14 microA) with the cathode caudal to
      the injury site; the second group received implantation of a similar stimulator
      with the cathode rostral to the injury site; and the third group received a sham
      (O microA) stimulator. Clinical neurological function was assessed by the
      inclined plane technique and axonal function was assessed by motor- and
      somatosensory-evoked potentials (MEP and SSEP). A quantitative assessment of
      axonal integrity was performed by counting neurons in the brain retrogradely
      labelled by the axonal tracer horseradish peroxidase (HRP) and by counting axons
      at the injury site. The inclined plane scores (P less than 0.0001), MEP amplitude
      (P less than 0.02), counts of neurons retrogradely labelled by HRP (P less than
      0.0001), and axon counts at the injury site (P less than 0.01) were significantly
      greater in the group treated with a DC field with the cathode caudal to the
      lesion than in the other two groups. Conversely, the cathode rostral DC field
      caused a decrease in the number of neurons retrogradely labelled by HRP (P less
      than 0.05) compared to the sham and cathode caudal groups. These data confirm our
      previous finding that DC fields promote recovery of acutely injured spinal cord
      axons. Furthermore, the polarity of the applied field is of critical importance
      to this effect.

PMID- 1623404
TI  - Co-localization of hyaluronic acid and chondroitin sulfate proteoglycan in rat
      cerebral cortex.
AB  - The distribution of hyaluronate (HA) and chondroitin sulfate (CS) proteoglycan in
      the rat cerebral cortex was compared. For the localization of HA, the sections
      were incubated with human glial hyaluronate-binding protein (GHAP) and then
      reacted with monoclonal or polyclonal antibodies to GHAP. Polyclonal antibodies
      raised in rabbit were used for double-labeling experiments with monoclonal
      antibodies raised in mice and reacting with CS proteoglycans. Little reactivity
      was observed in rat cerebral cortex with polyclonal GHAP antibodies if the
      sections were not incubated with GHAP. Monoclonal antibodies to GHAP did not
      react with murine tissues. CS proteoglycans were localized in chondroitinase
      digested sections with monoclonal antibodies reacting with the 4-sulfated
      oligosaccharide stubs formed by the digestion with chondroitinase ABC of CS side
      chains. In the rat cerebral cortex, the distribution of CS proteoglycans was
      similar to that reported by Bertolotto, A., Rocca, G. and Schiffer, D., J.
      Neurol. Sci., 100 (1990) 113-123, and his collaborators using the same
      antibodies. Many neurons mainly located in the upper and deep cortical layers
      were surrounded by CS immunoreactive material. Several (but not all) CS-positive
      neurons also stained for HA with an identical distribution except that in most
      instances the staining was confined to the periphery of the perikaryon and did
      not extend to the dendritic tree. The finding suggests that cerebral cortex CS
      proteoglycan is capable of interacting with HA.

PMID- 1623406
TI  - Pharmacogenetic assessment of the effects of carbamazepine on cocaine-kindled and
      cocaine-induced seizures.
AB  - The effects of chronic carbamazepine (CBZ) on the development and expression of
      cocaine-kindled seizures and seizures produced by an acute injection of cocaine
      were evaluated in BALB/cByJ, C57Bl/6J and SJL/J mice. The repeated administration
      of a subconvulsant dose of cocaine initially resulted in the development of an
      increased sensitivity to the convulsant effects of cocaine in the three strains.
      Chronic, dietary carbamazepine attenuated this initial sensitization to cocaine
      induced seizures. While the continued administration of cocaine resulted in a
      relatively permanent sensitization to cocaine-induced seizures among SJL mice,
      tolerance to cocaine-induced seizures ultimately developed among C57 mice and to
      a lesser degree among BALB mice. Genetic factors were found to mediate the
      effects of chronic CBZ on the development of sensitization and/or tolerance to
      the convulsant effects of cocaine. Among BALB mice, chronic CBZ appears to have
      eliminated the development of tolerance to cocaine-induced seizures and allowed
      an underlying sensitization to be manifest. Among SJL mice, however, the
      sensitization observed following repeated cocaine injections was reduced, but not
      eliminated. Genetic factors were also found to be associated with the effects of
      CBZ on seizures induced by the acute administration of cocaine. BALB and C57
      mice, but not SJL mice, chronically treated with dietary CBZ were less
      susceptible to a consulvant dose of cocaine than their corresponding dietary
      controls for at least 72 h after stopping CBZ administration. In addition, there
      were genotype-specific lethal effects associated with the concurrent
      administration of CBZ and cocaine.

PMID- 1623407
TI  - Efferent microvascular responses to electrical stimulation of the area postrema
      in rats.
AB  - As part of its role to transduce blood-borne and afferent neural stimuli to the
      brain, the area postrema conducts efferent projections monosynaptically to
      individual nuclei of the medulla oblongata and pons. We hypothesized that
      electrical activation of the area postrema would mimic this transduction process
      and couple microvascular responses in efferent sites to local increases in tissue
      metabolism reported previously. We used quantitative autoradiographic techniques
      and image analysis to measure capillary transfer constants for [14C]alpha
      aminoisobutyric acid (AIB, a small, neutral amino acid) and blood flow
      (iodo[14C]antipyrine) in individual brainstem structures of anesthetized rats.
      The area postrema was stimulated electrically by means of a monopolar
      microelectrode positioned stereotaxically 100 microns deep in the dorsocentral
      aspect of the organ. There were no significant effects of stimulation on [14C]AIB
      influx or blood flow in control hindbrain structures where postremal projections
      are sparse or absent--the spinal trigeminal nucleus, reticular formation, or
      cerebellar vermis. Stimulation of the area postrema produced equivalent increases
      in transcapillary influx of [14C]AIB and capillary blood flow in the nucleus of
      the solitary tract, dorsal motor nuclei of the vagus nerves, ventrolateral
      medullary C1 region, locus coeruleus, dorsal tegmental nuclei, and lateral
      parabrachial nuclei. Formation of ratios interrelating rates of [14C]AIB influx
      and blood flow with previously assessed values of tissue glucose metabolism
      indicated that these measures increased proportionately during postremal
      stimulation. Such proportional increases in capillary [14C]AIB transfer and blood
      flow during tissue activation by area postrema stimulation are consistent with
      interpretation that the increase in blood flow resulted from recruitment of
      unused surface area in the capillary networks of individual efferent
      nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623408
TI  - Spinal projections of the locus coeruleus and the nucleus subcoeruleus in the
      Harlan and the Sasco Sprague-Dawley rat.
AB  - The descending projections of the locus coeruleus (LC) and the nucleus
      subcoeruleus (SC) to the lumbar spinal cord were examined in rats from two
      vendors using retrograde transport of fluorescent latex beads. There was a vendor
      difference observed which agrees with previous findings. The differential dorsal
      horn and ventral horn projections of the Harlan and the Sasco Sprague-Dawley
      rats, reported by Fritschy and Grzanna, and Clark and Proudfit were confirmed. In
      the Harlan rat more cells were labeled in the LC following injections in the
      dorsal horn. In contrast, in the Sasco rat, more cells were labeled in the LC
      from injections in the ventral horn. Although, in all studies, the LC in rats
      from these vendors projected to some extent to both the dorsal and the ventral
      horn. A difference in labeling was noted also for the depth of placement of the
      tracer in the dorsal horn. When the site of injection was in the nucleus
      proprius, a predominantly contralateral projection of the LC was noted. In
      contrast, when horseradish peroxidase (HRP) gel implants were placed to include
      the superficial laminae, the cells in the LC were labeled predominantly
      ipsilaterally. The SC has a major projection to the dorsal horn in the Harlan
      rats while cells in the SC were predominantly labeled following ventral horn
      injection in the Sasco rats. These cells send mostly ipsilateral projections to
      the dorsal and ventral horn of the spinal cord. Double labeled studies confirmed
      that 91% of LC and 86% of SC neurons projecting to the spinal cord were
      noradrenergic.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623410
TI  - Interactions of ibogaine and D-amphetamine: in vivo microdialysis and motor
      behavior in rats.
AB  - Ibogaine, an indolalkylamine, has been proposed for use in treating stimulant
      addiction. In the present study we sought to determine if ibogaine had any
      effects on the neurochemical and motor changes induced by D-amphetamine that
      would substantiate the anti-addictive claim. Ibogaine (40 mg/kg, i.p.) injected
      19 h prior to a D-amphetamine challenge (1.25 mg/kg, i.p.) potentiated the
      expected rise in extracellular dopamine levels in the striatum and in the nucleus
      accumbens, as measured by microdialysis in freely moving rats. Using photocell
      activity cages, the same ibogaine pretreatment enhanced the stimulatory motor
      effects induced by a wide range of D-amphetamine doses (0.625, 1.25, 2.5 or 5
      mg/kg, i.p.). These findings suggest that ibogaine might increase the reinforcing
      efficacy of D-amphetamine. However, since high doses of D-amphetamine can be
      aversive, the potentiation of D-amphetamine's effects by ibogaine might also lead
      to a decrease in the reinforcing efficacy of D-amphetamine.

PMID- 1623409
TI  - Studies on long-term potentiation of the population spike component of
      hippocampal field potential by the tetanic stimulation of the perforant path
      rats: effects of a dopamine agonist, SKF-38393.
AB  - Long-term potentiation of the field potentials recorded in the dentate gyrus of
      the hippocampus was observed in freely-moving rats by delivering a brief tetanic
      stimulation to the perforant path, and the effects of the D1 agonist, SKF-38393,
      on it was investigated. The field potential was divided into two components;
      excitatory postsynaptic potential (EPSP) and population spike. In Expt. I,
      synaptic stimulus-response (S-R) relationship, spike S-R relationship, and EPSP
      spike (E-S) relationship were plotted. The estimated slope of the regression line
      in the spike S-R relationship was enhanced after delivery of the tetanic
      stimulation (10 pulse at 400 Hz), where that in synaptic S-R relationship was not
      enhanced. The estimated slope of the regression line in the E-S relationship was
      also enhanced by the tetanic stimulation. In Expt. II, time-dependent change of
      the field potential after tetanic stimulation was investigated. The population
      spike was enhanced significantly for about 2 h following tetanic stimulation,
      while pEPSP did not change significantly. These changes following tetanic
      stimulation in Expt. I and II were significantly inhibited by previous
      administration of SKF-38393 (10 mg/kg, i.p.), and the effect of this drug was
      dose-dependently antagonized by the D1 antagonist, SCH-23390 (0.1, 0.2 and 0.5
      mg/kg, i.p.). These results suggest that a brief tetanic stimulation of the
      perforant path induces long-term potentiation of the population spike without
      potentiating the synaptic input in the perforant path-dentate synapses, and that
      potentiation of the population spike is inhibited by the dopaminergic D1
      mechanism.

PMID- 1623411
TI  - Evidence for two different afferent pathways carrying stress-related information
      (noxious and amygdala stimulation) to the bed nucleus of the stria terminalis.
AB  - The bed nucleus of the stria terminalis (BNST) is an important nucleus involved
      in mediating amygdala-regulated endocrine effects. Since the amygdala is
      important in mediating the endocrine response to noxious somatosensory stimuli
      and olfactory stimulation, this experiment studies whether noxious input (tail
      pinch, TP) and stress-related input (amygdala stimulation, AmygS) will modulate
      BNST neuronal activity. One hundred and fifty-eight BNST neurons were studied
      following AmygS, TP and cutaneous stroke. AmygS was effective in 66% of BNST
      neurons and produced one of the following five responses: oligosynaptic
      excitation (43%), polysynaptic excitation (5%), time-locked inhibition (4%),
      generalized increase in firing rate (8%), or generalized decrease in firing rate
      (6%). TP produced an increase in firing rate in 27% of BNST neurons tested.
      Analysis of a contingency table constructed to determine the degree of
      correspondence between neurons responsive to AmygS and neurons responsive to TP
      showed that the distributions of reactivity to these stimuli in BNST neurons are
      independent of each other. This suggests that although AmygS and TP are both
      capable of altering the firing rate of BNST neurons, the pathways by which they
      reach BNST differ.

PMID- 1623412
TI  - Regional quantitative permeability of blood-brain barrier lesions in rats with
      chronic renal hypertension.
AB  - Blood-brain transfer constants for a small, neutral amino acid tracer, [14C]alpha
      aminoisobutyric acid (AIB), were measured by quantitative autoradiography and
      image analysis in 15 individual brain structures of 2-kidney, 1-clip renal
      hypertensive rats (RHR) and age-matched normotensive controls (NR). Mean arterial
      pressures (MAP) for 4 month-old RHR and NR were 182 +/- 19 and 121 +/- 3 mmHg,
      respectively. Most brain structures in RHR had very low [14C]AIB transfer
      constants similar to those in NR (1-3 microliters.g-1.min-1), indicative of
      normal blood-brain barrier (BBB) function. Focal lesions, however, having
      transfer constants 2-7x normal and measuring less than 1.7 mm2 in area, appeared
      in RHR primarily in the cerebellar vermian and cerebral cortices. Chronic
      unilateral cervical sympathectomy did not influence the incidence or magnitude of
      BBB lesions in the denervated hemisphere of RHR. Acute arterial hypertension
      produced by systemic infusion of phenylephrine (elevation of MAP in RHR by 43%)
      increased the incidence and magnitude of lesions by 48% and 2-12x, respectively,
      although many brain regions in acutely hypertensive RHR retained normal
      permeability to [14C]AIB. The results demonstrate normal BBB permeability for
      much of the brain in chronic renal hypertension, with focal lesions having 7x or
      less the normal rate of blood-brain transfer for a small physiological probe.

PMID- 1623413
TI  - Individual perching behavior of laying hens and its effects in cages.
AB  - 1. ISA Brown hens were housed, from 18 to 71 weeks of age, as groups of 4 in
      cages with 675 cm2/bird. There were 7 treatments: control cages and 6 treatments
      with perches fitted across the rear of the cage. Five treatments had 450 mm wide
      cages, with perches made from hardwood, textured metal, smooth plastic, softwood
      and padded vinyl, and one treatment had a 600 mm wide cage, with a softwood
      perch. There were 4 cages in each of the first 6 treatments and 6 in the last. 2.
      Overall, birds spent about 25% of the day time on perches. Most time (28 to 41%)
      was spent perching on the 600 mm softwood perches. Among 450 mm perches, most
      time (25 to 30%) was spent on the softwood perch and least (13 to 23%) on the
      plastic; the results suggested that a slightly rough surface was preferred.
      Individual birds varied considerably in the proportion of day time they spent
      perching; this variation was relatively consistent over time. 3. Overall, the
      proportion of birds roosting on the perches at night was 85% in period 1;
      declined to 76% by period 6, probably because increased body size made it almost
      impossible for 4 birds to perch in the 450 mm cages. Birds roosting on the floor
      tended always to be the same individuals. 4. Damage to the soles of the feet was
      less in all treatments with perches than in control cages. It was least in 600 mm
      wide cages and showed a negative correlation with time spent perching, both
      within and between treatments. Long or twisted claws, in contrast, tended to be
      slightly worse in treatments where there was most perching. 5. Downgraded eggs
      tended to be slightly more frequent in cages with perches; the greatest
      proportion (cracked 1.4%, dirty 3.6%) was from the 600 mm wide cages, as a result
      of hens laying from the perch and a build-up of manure behind it. 6. Although
      problems remain the findings suggest that provision of perches is important for
      the welfare of hens; perch space should be sufficient to allow all birds to perch
      simultaneously.

PMID- 1623414
TI  - A study of heat production and heat loss in crated broiler chickens: a
      mathematical model for a single bird.
AB  - 1. A steady state model of heat production and loss in crated broiler chickens is
      presented. 2. The model is based on physiological factors and uses experimental
      data from various sources. 3. Although many of the required parameters are not
      well defined at present, the model allows a better understanding of the processes
      which lead to hyperthermic stress in crated broiler chickens, and is relevant to
      the design of ventilation systems for poultry transporters.

PMID- 1623415
TI  - Effects of photostimulation at 18, 24 and 30 weeks of age on the productivity of
      female turkeys fed ad libitum or restricted until point of lay.
AB  - 1. Turkey females were fed ad libitum or restricted from 6 weeks of age to
      achieve mean body weights of 0.6 of ad libitum fed birds on photostimulation at
      18, 24 or 30 weeks of age. Body weight, food intake, egg production and
      hatchability were recorded to 54 weeks of age. 2. Restricted turkeys were fed ad
      libitum after first egg or 36 weeks of age. Food intake after 30 weeks of age
      averaged 170 g/bird/d and was similar for all treatments. At 54 weeks of age,
      restricted turkeys photostimulated at 24 and 30 weeks were not as heavy as
      turkeys photostimulated at 18 weeks and ad libitum fed turkeys. 3. A large
      proportion of restricted turkeys photostimulated at 18 weeks of age did not
      commence lay until 30 to 40 weeks and a significant number of restricted birds
      photostimulated at 24 weeks had short laying cycles. Restricted birds
      photostimulated at 30 weeks came into lay and showed similar persistency of lay
      to ad libitum fed turkeys. 4. Ad libitum fed turkeys laid 115.0, 122.0 and 101.0
      and restricted turkeys 92.4, 99.5 and 103.4 eggs when photostimulated at 18, 24
      and 30 weeks, respectively. The number of non-settable eggs was lower in
      restricted compared with ad libitum fed turkeys and declined with age at
      photostimulation. 5. Egg size at the end of the experiment was similar for ad
      libitum fed turkeys and restricted birds photostimulated at 18 weeks but was 2.3
      g lower for restricted birds photostimulated at 24 and 30 weeks of age. 6.
      Hatchability was higher, and the proportion of second quality poults was lower
      with eggs from restricted turkeys. The mean numbers of poults hatched were 59.9,
      75.1 and 66.0 for ad libitum fed and 71.7, 65.7 and 79.4 for restricted turkeys
      photostimulated at 18, 24 and 30 weeks of age.

PMID- 1623416
TI  - Metabolic and behavioral adaptation of light-bodied chicks to meal feeding.
AB  - 1. Two-week-old male chicks of a light-bodied strain were fed one (1M) or two
      (2M) 2-h meals per day. An additional group was pair-fed (P1M) the amount
      consumed by the 1M group on the previous day. 2. After 21 days, final body weight
      of the 1M and 2M chicks attained 65% and 80%, respectively, of that of the
      control group fed ad libitum. The weight gain of the P1M chicks was equal to that
      of the 1M chicks. 3. Food consumption of chicks adapted to meals was not even
      throughout the feeding period. On day 16 of the experiment, the 1M birds consumed
      65% of the meal during the first 30 min. P1M chicks behaved similarly to the 1M
      ones. The intake of the 2M chicks during each meal was exactly half of their
      daily consumption, despite the uneven time period between meals. 4. The time
      during which food remained in the gastrointestinal tract (GIT) was longer under
      the meal feeding regimes than in the ad libitum-fed groups. 5. Although neither
      body composition nor metabolisable energy was affected by meal regime, food
      utilisation was poorer in the 1M and P1M than in the ad libitum and 2M-fed
      chicks.

PMID- 1623418
TI  - Incidence of non-laying in domestic hens.
AB  - 1. Egg production records of 31,455 individually caged hens, 27 to 34 weeks of
      age and of 4 genotypes, were examined. 2. Sixty-nine non-layers were identified
      in the 30 to 40 week age group, and examined post mortem; an incidence of 2.1 per
      1000. 3. Some of the 69 individuals had more than one abnormality. Forty-two
      percent were internal layers, 34% had some form of neoplasia, 24% had an abnormal
      or diseased oviduct, 18% were sex reversals, 16% had a diseased ovary, 8% were of
      poor condition and considered culls, and 7% were in good condition, but with
      small, immature ovaries. 4. Of 54 birds not in lay at 27 weeks, 43 (80%) had come
      into lay by 34 weeks of age. 5. Genotype influenced the incidence of neoplasia
      and, in turn, the number of non-layers.

PMID- 1623419
TI  - Enhanced induction of hepatic lipid peroxidation by ferric nitrilotriacetate in
      chickens susceptible to fatty liver rupture.
AB  - 1. Two strains of single comb White Leghorn birds, one susceptible to fatty liver
      rupture (UCD-003) and a normal commercial strain, were injected with iron
      nitrilotriacetate and the extent of hepatic lipid peroxidation that occurred was
      estimated by measuring concentrations of malondialdehyde (MDA). 2. Higher
      concentrations of MDA were found in the livers of the UCD-003 strain than in the
      normal birds after injection of iron nitrilotriacetate. No differences were found
      in the activities of glutathione peroxidase, superoxide dismutase and catalase in
      the livers of untreated birds of either strain. 3. The degree of unsaturation of
      the fats in the livers of the two strains was similar. However, the UCD-003 birds
      had a significantly higher content of liver fat than the normal birds. The
      increased concentrations of liver fat could account for the increased lipid
      peroxidation in the UCD-003 birds. 4. The increased incidence of liver
      haemorrhage that occurs in the UCD-003 birds may be caused by the increased
      susceptibility of these birds to hepatic lipid peroxidation.

PMID- 1623417
TI  - An allometric-autoregressive approach to poultry development.
AB  - 1. The relative rates of development in a commercial layer and a broiler strain
      of chicken fed 180 or 230 g crude protein/kg were investigated by the use of the
      allometric-autoregressive model. Development was divided into pre-pubertal (0 to
      8 weeks) and pubertal phases (8 to 22 weeks). 2. Significant strain effects were
      observed, at all ages, in rates of gain of live (L) body mass, carcass (C) mass,
      non-carcase (N) mass and empty-body (EB) mass as well as C, N and EB moisture,
      protein and fat content. 3. Significant dietary effects were observed in C and EB
      fat in the pre-pubertal phase and L mass, N protein and C fat in the subsequent
      pubertal period.

PMID- 1623420
TI  - Comparison between wheat, triticale, rye, soyabean oil and strain of laying bird
      on the production, and cholesterol and fatty acid contents of eggs.
AB  - 1. The effects of feeding three types of cereal grain (wheat, triticale or rye)
      and soyabean oil (0 or 20 g/kg) over a 12-week period on the production, yolk
      cholesterol and yolk fatty acid concentrations of three strains of laying pullets
      were studied. 2. Pullets fed on wheat- or triticale-based diets had higher body
      weight gains, egg productions, egg weights, egg mass and lower yolk cholesterol
      concentrations than pullets fed on rye-based diets. However, there were no
      significant differences between the cereals in yolk cholesterol content. 3. There
      were no significant differences between the three cereals in total food
      consumption of pullets nor of yolk weight nor yolk concentration of palmitic,
      stearic and oleic acids. 4. Pullets fed on triticale-based diets had higher yolk
      linoleic acid concentrations and lower yolk oleic acid: linoleic acid ratios than
      pullets fed on rye- or wheat-based diets. 5. Soyabean oil supplementation
      increased egg production, egg mass, yolk linoleic concentration and yolk
      unsaturated to saturated fatty acid ratio, but reduced yolk oleic acid: linoleic
      acid ratio. 6. There were differences between strains of pullets in weight gain,
      food consumption, rate of lay, egg weight and yolk cholesterol, but not in yolk
      fatty acid concentrations. 7. It was concluded that wheat- or triticale-based
      diets gave good production of eggs of lower cholesterol content, that soyabean
      oil supplementation gave eggs with a high unsaturated to saturated fatty acid
      ratio and that two strains of layers produced eggs with lower yolk cholesterol
      concentrations than a third strain.

PMID- 1623421
TI  - Nutritional value of naked oats (Avena nuda) in laying hen diets.
AB  - 1. Two experiments were conducted to evaluate the use of naked oats (NO) in layer
      diets. In experiment 1 the use of NO supplemented with minerals, vitamins and
      lysine was examined. In experiment 2 layers were fed equicaloric and
      isonitrogenous diets containing 0-66% NO. 2. Layers fed ground NO supplemented
      with minerals, vitamins and lysine for 6 weeks exhibited a significant depression
      in food intake, egg production, egg weight and shell strength. 3. Substitution of
      NO at 20-66% resulted in performance comparable to that of birds fed a maize
      soyabean meal diet for 12 weeks. Food intake was reduced in the first week of the
      experiment in birds fed diets with NO; thereafter, treatment effects were not
      detected. Yolk colour index progressively decreased as dietary inclusion of NO
      increased. 4. It is concluded that naked oats can be used at levels up to 66% in
      layer diets to replace all or part of the maize and part of the soyabean meal
      without any reduction in performance.

PMID- 1623422
TI  - Dietary phosphorus and food allowance of dwarf breeders affect reproductive
      performance of hens and bone development of their progeny.
AB  - 1. An experiment was conducted with 144 caged hens to study the effects of
      different dietary concentrations of phosphorus and of food restriction on the
      reproductive performance of dwarf breeder hens and on the growth and the bone
      development of their progeny. 2. Severe food restrictions at 105 g/hen day
      compared to 115 g/hen day, decreased hen body weight and hen day egg production.
      Fertility was unaffected and hatchability slightly depressed by the more severe
      restriction. 3. Egg and one-day-old chick weights were decreased by limiting the
      food intake of the breeders but the negative effect disappeared at slaughter (7
      weeks). 4. Shell quality decreased as the dietary phosphorus increased and was
      not affected by food allowance. Albumen quality was slightly impaired in severely
      restricted hens. 5. Serum inorganic phosphorus in hens and yolk phosphorus
      increased with increasing dietary phosphorus. Tibial breaking strength and tibial
      percentage ash of the progeny at hatching was markedly improved in proportion to
      maternal phosphorus and food intake. This improvement in bone quality was not
      maintained at 7 weeks. 6. The number of chicks affected by twisted legs (valgus)
      and dyschondroplasia were similar whatever the maternal diet. The frequency of
      valgus was higher in males than in females. 7. It is concluded that maternal food
      intake and phosphorus supply are of importance for the initial bone development
      of the progeny.

PMID- 1623423
TI  - Lack of effect of dietary energy-to-protein ratio and energy concentration on the
      response of broiler chickens to virginiamycin.
AB  - 1. Two factorial experiments were carried out with male broiler chicks from 6 to
      28 (experiment 1) and from 7 to 49 (experiment 2) d of age to evaluate the
      combined effect of virginiamycin (VIR), dietary energy concentration, and energy
      to-protein (E:P) ratio on performance and the utilisation of dietary nutrients.
      2. VIR had no significant effect in either experiment on food intake or weight
      gain, but significantly improved food efficiency up to 28 d of age (P less than
      0.001 and P less than 0.05 in experiments 1 and 2, respectively). 3. VIR
      consistently and significantly (P less than 0.01) decreased fat excretion,
      improved fat relative retention and increased dietary AMEn. VIR also
      significantly (P less than 0.01) increased relative retention of dry matter,
      while it did not affect nitrogen balance. 4. Neither of the variables of
      performance and utilisation of dietary nutrients was affected by the interactions
      between VIR and either dietary E:P ratio or energy concentration. It is
      concluded, therefore, that the effect of VIR in increasing the utilisation of
      dietary energy does not depend on the above factors.

PMID- 1623424
TI  - Effect of high concentrations of dietary vitamin E during various age periods on
      performance, plasma vitamin E and meat stability of broiler chicks at 7 weeks of
      age.
AB  - 1. The effect of high concentrations of vitamin E (alpha-tocopheryl acetate) fed
      during various age periods on the performance and the oxidative stability
      (thiobarbituric acid [TBA] values) of the drumstick meat of 7-week-old broiler
      chicks was determined. The basal diets (for the age periods 0 to 3, 3 to 6 and 6
      to 7 weeks) contained 60 g soyabean oil and 24 mg vitamin E/kg. The following
      five treatments were evaluated: (1) the basal diets from 0 to 7 weeks of age
      (control); (2) vitamin E, 100 mg/kg diet from 0 to 7 weeks of age; (3) vitamin E,
      150 mg/kg diet from 0 to 3 weeks of age; (4) vitamin E, 150 mg/kg diet from 0 to
      3 weeks of age and 100 mg/kg diet from 6 to 7 weeks of age; (5) vitamin E, 100
      mg/kg diet from 5 to 7 weeks of age. 2. Food intake, weight gain and food
      efficiency were not significantly (P greater than 0.05) affected by the vitamin E
      treatments. 3. Plasma alpha-tocopherol (AT) concentrations in treatments 2, 4 and
      5 were similar, and markedly higher than those in treatments 1 and 3, while those
      of treatment 3 were significantly (P less than 0.001) higher than those of
      treatment 1. Plasma retinol concentrations were not significantly (P greater than
      0.05) affected by the vitamin E treatments. 4. TBA values of the meat were very
      low and not significantly affected by the vitamin E treatments. However, after
      incubation the TBA values were highly significantly (P less than 0.01) negatively
      correlated with the amount of vitamin E consumed during the experiment. The
      stability of meat of birds fed the various combinations of vitamin E (treatments
      3, 4 and 5) was significantly (P less than 0.05) higher than that of birds which
      did not receive additional vitamin E (treatment 1), but it was significantly (P
      less than 0.001) lower than that of birds which received vitamin E continuously
      (treatment 2). 5. It is concluded that a high concentration of vitamin E fed
      during 0 to 3 weeks of age may significantly improve AT status of the broiler
      chick up to 7 weeks of age.

PMID- 1623426
TI  - The effect of increasing photoperiod and food restriction in sexed broiler-type
      birds. I. Growth and abdominal fat cellularity.
AB  - 1. Sexed broiler-type chicks were raised either under a continuous (CON) 23 h
      Light (L) and 1 h Dark (D) schedule or an increasing photoperiod (INC) consisting
      of an initial 6 h L and 18 h D which increased by 4 h L per week from 14 to 35 d
      of age after which a 23 L:1D was maintained to 49 d of age. 2. From 5 to 11 d of
      age birds were fed either: ad libitum (AL), energy intake (kJ ME) restricted to
      9.414 x gBW0.67 (R1) or energy intake (kJ ME) restricted to 6.276 x gBW0.67 (R2).
      Food intake was ad libitum at all other times. 3. Food restriction reduced growth
      to 49 d of age although some compensatory growth did occur. Food efficiency was
      not significantly affected by restriction. 4. Although abdominal fat pad weight
      was significantly reduced for R2 compared to AL, this was not significant on a
      percentage body weight basis. 5. Adipocyte number in the abdominal fat pad was
      similar for AL, R1 and R2, but concomitant with a smaller fat pad weight, R2
      showed reduced adipocyte volume compared to AL. 6. INC birds were lighter at 21 d
      of age, but body weights were equivalent to CON by 42 d of age. 7. Abdominal fat
      pad weight was some 10% larger at 49 d of age for INC birds. Adipocyte volume was
      unaffected, the increase in adipocyte being entirely caused by an increase in
      adipocyte number in INC birds.

PMID- 1623425
TI  - Follicle stimulating hormone increases serum oestradiol-17 beta concentrations,
      number of growing follicles and yolk deposition in aging hens (Gallus gallus
      domesticus) with decreased egg production.
AB  - 1. The aims of this study were to determine if the number of small yellow
      follicles (SYF) and large white follicles (LWF) in ovaries of young and old hens
      differed; and if injection of old hens with follicle stimulating hormone (FSH)
      changed growth of and yolk deposition into follicles of old hens. 2. Ovaries were
      removed and follicles were divided according to size and condition and counted.
      The number of normal SYF and LWF was decreased in old hens compared to young
      hens, whereas the number of atretic follicles was greater in old hens compared to
      young hens. 3. Old hens were injected subcutaneously with saline containing 0.1%
      bovine serum albumin (BSA, vehicle) or 12.5, 50, 200, 400 micrograms porcine (p)
      FSH or 25 or 50 IU pregnant mare's serum gonadotropin (PMSG) for 5 consecutive
      days. Blood samples were taken on days 1 and 5 before FSH and PMSG injection and
      2 h after FSH and PMSG injection on day 5. Sudan black and Sudan red dyes were
      injected intravenously on alternative days to monitor yolk deposition into
      follicles of the hierarchy removed after the fifth day of FSH treatment. 4.
      Treatment with 200 micrograms pFSH or 25 IU PMSG for 5 d increased serum
      progesterone (P4) concentrations as compared to controls. Injection of hens with
      FSH caused a linear dose dependent increase in serum oestradiol-17 beta (E2)
      concentrations, dose dependent increase in SYF and LWF, and dose related decrease
      in number of atretic SYF and LWF. The hierarchy of the ovary was disrupted with
      PMSG, but not FSH. Larger doses of FSH increased the number of small follicles
      (10 mm diameter) and yolk deposition. 5. We conclude that small follicles which
      have not entered the rapid growth phase are responsive to FSH. The increased yolk
      deposition following FSH treatment may have been a direct effect of FSH or may
      have been caused by the elevation of serum E2 concentrations in response to FSH
      treatment. It is possible that old chickens may produce inadequate amounts of FSH
      which result in decreased rate of follicular growth and ultimately decreased egg
      production.

PMID- 1623427
TI  - The effect of increasing photoperiod and food restriction in sexed, broiler-type
      birds. II. Plasma thyroxine, triiodothyronine, insulin-like growth factor-I and
      insulin.
AB  - 1. Sexed broiler-type chicks were raised either under a continuous (CON) 23 h
      light (L) and 1 h dark (D) schedule or an increasing photoperiod (INC). From 5 to
      11 d of age birds were fed either: ad libitum (AL), energy intake (kJ ME)
      restricted to 9.414 x gBW0.67 (R1) or energy intake (kJ ME) restricted to 6.276 x
      gBW0.67 (R2). 2. Blood samples were taken at 4, 7, 11, 14 d of age and weekly
      thereafter to 49 d of age. Plasma thyroxine (T4), triiodothyronine (T3), insulin
      like growth factor-I (IGF-I) and insulin were determined. 3. CON birds had
      elevated plasma T3 concentrations to 21 d of age, and greater plasma T4
      concentrations at 11 and 21 d of age concurrent with greater food intake.
      Elevated plasma T3 concentrations in INC birds at 28 d of age coincided with
      lower plasma IGF-I concentrations at a time when growth and food intake were
      greater than CON birds. 4. Food restriction elevated plasma insulin and T4 but
      depressed plasma T3 and IGF-I. Plasma T3 was greater for food-restricted birds at
      21 d of age, but subsequently, was generally lower than ad libitum-fed birds
      which may account for a lack of complete 'catch-up' in growth. 5. Plasma T3 was
      higher in females at 11 d of age when growth was equivalent for both sexes. From
      28 to 42 d, when sex differences in growth became most apparent, plasma T3 was
      greater in males.

PMID- 1623428
TI  - Genetic and environmental control of ovarian function in turkeys at sexual
      maturity.
AB  - 1. The relationships between the numbers of ovarian yellow follicles and body
      weight was investigated in four strains of turkeys photostimulated at 24 or 30
      weeks of age. The birds were fed ad libitum or control fed to reach 0.8 or 0.6 of
      the body weight of ad libitum-fed birds at 24 weeks of age. 2. There were more
      yellow follicles at 24 compared with 30 weeks of age. 3. The number of yellow
      follicles was higher in bigger strains. 4. Body weight control reduced the number
      and the proportion of similar sized yellow follicles. The effect decreased with
      increasing strain body weight. 5. There was a linear relationship of 0.633
      between log yellow follicle number and log body weight. The intercept was higher
      in turkeys photostimulated at 24 compared with 30 weeks of age.

PMID- 1623429
TI  - Preservation of quail blastoderm cells in liquid nitrogen.
AB  - 1. Quail blastoderm cells isolated from the yolk were preserved in liquid
      nitrogen. 2. Frozen-thawed blastoderm cells of the quail were viable and survived
      in vitro. By injecting the frozen-thawed cells into chick embryos, quail-chick
      chimaeras were produced.

PMID- 1623430
TI  - Bilateral testicular asymmetry and supernumerary testes in the domestic fowl
      (Gallus domesticus).
AB  - 1. The left and right testis weights from 378 males in 7 experiments were
      recorded. 2. The relationship between the right and left testis weights was
      similar in males of different ages, strains and body weights. 3. The left as a
      proportion of total testes weight was approximately normally distributed about a
      mean of 0.515. 4. The left testis was greater than the right testis weight in
      0.67 of males. 5. The linear regression of the natural logarithm of the right on
      that of the left testis weights was -0.04 + 0.99X (r2 = 0.98) and it was
      concluded that, in general, the left and right testes were of similar weight. 6.
      Three cases of triorchidism (two left testes) occurred, suggesting that this may
      not be a rare condition in the domestic fowl.

PMID- 1623431
TI  - The role of radical prostatectomy in the treatment of prostate cancer.
AB  - Recent advances in our understanding of the surgical anatomy of the prostate have
      led to an improved operative technique for radical prostatectomy. This technique
      achieves excellent results in terms of urinary continence and preservation of
      sexual function without compromising cancer control. It is therefore reasonable
      to offer radical prostatectomy for the cure of localized prostate cancer to
      patients who are otherwise well and have a life expectancy of more than 10 years.

PMID- 1623432
TI  - Prostate cancer: evaluation and radiotherapeutic management.

PMID- 1623434
TI  - The Regulated Health Professions Act. The keynote address to the Operating Room
      Nurses Association of Ontario.

PMID- 1623433
TI  - Neurofibromatoses.

PMID- 1623435
TI  - Value, venture, vision (keynote address).

PMID- 1623436
TI  - Sharing power: the Healthy Hospital project.

PMID- 1623437
TI  - Questions on sterile technique can lead to study and research.

PMID- 1623438
TI  - Principles of aseptic technique.

PMID- 1623439
TI  - Development of an operating room nursing workload measurement system.

PMID- 1623441
TI  - Life-style and dietary factors early and late in Parkinson's disease.
AB  - The study investigated features of life-style and dietary habits early and late
      in life of patients with idiopathic Parkinson's disease (IPD). Seventy-one
      patients and 103 controls were interviewed personally with a structured
      questionnaire. Living in villages during primary school time was significantly
      more frequent among patients, and in the urban environment patients had lived
      less frequently in larger-sized towns. Mushroom harvesting during childhood was
      more frequent among patients. No difference between patients and controls was
      found in childhood water supply, habits of fishing in the countryside or at the
      seaside, and eating such fish. Actual food preference in patients was greater for
      almonds and plums, while no difference was found in the actual intake of
      mushrooms, peanuts, oil-dressed salad, fish and animal offals. The study did not
      indicate a higher consumption of foods known to harbour heavy metals and
      pesticides in IPD patients either long before or during the disease. Reduced
      consumption of foodstuffs rich in vitamin E, as reported previously for premorbid
      patients, is no longer observed in patients with overt disease.

PMID- 1623440
TI  - Neuropsychological and glucose metabolic profiles in asymmetric Parkinson's
      disease.
AB  - Patients with predominantly unilateral parkinsonian signs may provide a unique
      opportunity to evaluate the cerebral representation of cognitive functions
      characteristically affected in idiopathic Parkinson's disease. Twenty
      hemiparkinsonian patients (ten left and ten right) and 10 healthy controls,
      matched for age and education, were studied with neuropsychological tests and
      positron emission tomography. Both right and left hemiparkinsonians evidenced
      impairments in visuospatial and verbal episodic memory function, but had no
      deficits in executive abilities, compared to controls. None of the
      neuropsychological test scores distinguished right from left hemiparkinsonians.
      Glucose metabolic profiles were identical for the three groups in all cortical
      areas assessed; in the subcortex however, lenticular hypermetabolism
      contralateral to the predominant side of motor involvement was evident in the
      left hemiparkinsonian group. Correlational analysis revealed that higher glucose
      metabolic rates in the basal ganglia of these hemiparkinsonians were associated
      with lower visuospatial test scores. In frontal and parietal cortex, decreasing
      glucose metabolism was positively associated with neurobehavioral function; in
      temporal cortex, measures of attention and memory decreased with increasing
      glucose metabolic rates.

PMID- 1623442
TI  - Forearm P-31 nuclear magnetic resonance spectroscopy studies in oculopharyngeal
      muscular dystrophy.
AB  - Five siblings with autosomal dominant oculopharyngeal muscular dystrophy (OPMD)
      underwent P-31 Nuclear Magnetic Resonance Spectroscopy studies of forearm flexor
      muscles. Mean values of PCr/(PCr+Pi) in the patients were reduced (p = 0.01) and
      pH elevated (p = 0.02) in resting muscle when compared to controls. During
      exercise PCr/PCr+Pi) fell quickly to values less than controls (p less than
      0.0001) despite submaximal exercise output and developed exercise-induced
      acidosis which exceeded that of controls (p = 0.05). Acidosis recovered slowly
      despite relatively normal recovery of PCr/(PCr+Pi) following exercise. Within the
      patient group, however, one member had normal resting, exercise and recovery
      values. The studies suggest that OPMD is a more widespread disorder of striated
      muscle than clinically appreciated. The pattern of findings observed in OPMD
      differs from those identified in denervation, disuse and mitochondrial myopathy.

PMID- 1623443
TI  - Diagnosis and management of spinal epidural abscess.
AB  - Twenty-five patients with spinal epidural abscess were treated at the University
      of Western Ontario hospitals between July 1980 and July 1990. There were eighteen
      males (72%) and seven females (28%), with a median age of 60 years. Concurrent
      illness resulting in immunocompromise was present in 60%. Eleven presented with
      complete myelopathy, thirteen had limb weakness, and one had no neurological
      deficit. In twenty cases the abscess consisted of frankly purulent material,
      while in five the epidural collection consisted of chronic granulation tissue.
      Staphylococcus aureus was isolated in 64% of the abscesses. Twenty-seven surgical
      procedures were performed on 21 patients. Ten cases occurred in the cervical
      spine (40%), seven in the thoracic spine (28%), three in both the cervical and
      thoracic spine (12%) and five in the lumbosacral spine (20%). Fourteen patients
      (56%) retained or recovered ambulation and there were five deaths (20%). The
      progression from back and radicular pain to weakness and eventual paralysis
      continues to be characteristic of spinal epidural infection. Morbidity and
      mortality remain unacceptably high because of delay in diagnosis and treatment.
      Magnetic resonance imaging is the radiological investigation of choice for the
      diagnosis of spinal epidural abscess. Prompt intervention, before the development
      of severe neurological deficits, can improve outcome. Immediate surgical drainage
      combined with antibiotics remains the treatment of choice.

PMID- 1623444
TI  - Intrathecal baclofen for intractable spinal spasticity--a double-blind cross-over
      comparison with placebo in 6 patients.
AB  - A group of six subjects with intractable spinal spasticity completed a double
      blind cross-over paradigm in which they received two intrathecal bolus injections
      of baclofen solution five hours apart on two different days and two intrathecal
      bolus injections of placebo saline five hours apart on two other days. Each
      subject was repeatedly tested with a battery of clinical and physiological tests.
      In contrast to the placebo injections, the group responded to the baclofen
      injections with subjective and objective, clinically significant improvement in
      parameters of spasticity in their lower limbs, including muscle tone, frequency
      of spasms, hyperreflexia and passive range of joint motion. Furthermore, this
      improvement was maintained following thirty consecutive days of intrathecal bolus
      injections of baclofen at a fixed dose.

PMID- 1623445
TI  - Fracture of temporal bone with exsanguination: pathology and mechanism.
AB  - Eight cases of basal skull fracture with transverse fracture of the petrous
      temporal bone with medial extension to the internal carotid artery and lateral
      extension of the structures of the middle ear are described. Injuries in all
      cases were due to major blunt impact to the head usually occurring in a motor
      vehicle accident. General autopsy revealed major blood loss without any obvious
      external or internal site of hemorrhage suggesting that exsanguination was a
      complication of the head injury. The internal carotid arteries at the most medial
      extension of the fractures were lacerated or transected in all cases. In selected
      cases, the cervical internal carotid arteries were perfused and perfusate escaped
      rapidly from the ear(s) with the majority of fluid bypassing the cerebral venous
      system. Magnetic resonance image reconstruction of sequential sections of the
      fractured base of the skull confirmed the laceration of the internal carotid
      arteries and disruption of the middle ear. Based on this evidence, we propose
      that some displaced fractures of the base of the skull produce carotid-middle ear
      continuities which act as arterial shunts, resulting in rapid fatal
      exsanguination through the ear.

PMID- 1623446
TI  - The anticonvulsant effects of vitamin E: a further evaluation.
AB  - Vitamin E (d-alpha-tocopherol) has proven to be a useful adjunct to
      anticonvulsant drugs in clinical studies. Improvement has occurred even in
      patients with complex partial seizures, which are often resistant to drug
      therapy. In animals, vitamin E is effective against ferrous chloride seizures,
      hyperbaric oxygen seizures and penicillin-induced seizures. It has failed,
      however, to show anticonvulsant effects in the standard animal models used for
      drug screening--the maximal electroshock and threshold pentylenetetrazol tests.
      The present experiments were designed to further explore the anti-epileptic
      actions of vitamin E in animals. Three models related to complex partial epilepsy
      were used: 1) the development of amygdala-kindled seizures; 2) the development of
      electrically-induced status in kindled animals; and 3) the development of kainic
      acid seizures. Vitamin E failed to produce significant effects in any of the
      models.

PMID- 1623447
TI  - The pharmacology of chewable versus regular carbamazepine in chronically treated
      children with epilepsy.
AB  - We report the first comparison of Chewable and Regular Carbamazepine (CBZ)
      tablets in children with epilepsy. Forty-four children receiving chronic
      monotherapy CBZ participated. In month 1 children received regular CBZ; in month
      2, the same dose of Chewable CBZ. Once per week fasting predose CBZ and CBZ
      epoxide serum levels were determined. In a subset of 15 children, at the end of
      each month serum levels were obtained every 2 hours for 12 hours beginning pre
      dose. Standards for CBZ and CBZ epoxide were tested in each centre. Overall,
      weekly levels showed no consistent differences between the month on chewable CBZ
      and regular CBZ. Seizure control and rates of reported side effects were similar.
      In five patients chewable CBZ produced higher peak CBZ levels while five had
      higher peaks with regular CBZ. In conclusion, regular and chewable CBZ often have
      unpredictable differences in peak but not trough levels of CBZ suggesting that
      peak level side effects with one form of CBZ might be alleviated by changing to
      the other.

PMID- 1623448
TI  - The insular cortex and the pathophysiology of stroke-induced cardiac changes.
AB  - Over the past fifty years considerable clinical evidence has accrued to
      demonstrate involvement of the cerebral cortex in cardiac function. Hemispheric
      stroke is often associated with electrocardiographic (ECG) evidence of cardiac
      repolarisation abnormalities. In addition strokes of all types are associated
      with specific pathological changes in the ventricular myocardium (myocytolysis).
      These effects are not attributable to concomitant cardiac ischemic disease in the
      majority of cases. The insular cortex has recently been shown to contain a site
      of cardiac representation. Prolonged stimulation of this region in the rat
      produces ECG and cardiac pathological changes similar to those observed after
      human stroke. It is suggested that middle cerebral artery stroke in certain cases
      either directly or indirectly leads to insular disinhibition, and increased
      autonomic activity represented by cardiac changes which significantly influence
      prognosis.

PMID- 1623449
TI  - Photon radiosurgery: a clinical review.
AB  - The term radiosurgery has been used to describe a variety of radiotherapy
      techniques which deliver high doses of radiation to small, stereotactically
      defined intracranial targets in such a way that the dose fall-off outside the
      targeted volume is very sharp. Proton, charged particle, gamma unit, and linear
      accelerator-based techniques appear to be equivalent from the standpoint of
      accuracy, dose distributions, and clinical results. However, capital and
      operating costs associated with the use of linear accelerators in general
      clinical use are much lower. Radiosurgery has an established role in the
      treatment of arteriovenous malformations and acoustic neurinomas. Interest in
      these techniques is increasing in neurosurgical and radiation oncological
      communities, as radiosurgery is rapidly assuming a place in the management of
      several other conditions, including craniopharyngiomas, meningiomas, and selected
      malignant lesions.

PMID- 1623450
TI  - Cerebral aneurysms and polycystic kidney disease: a critical review.
AB  - The pathogenic basis of the association between adult polycystic kidney disease
      (APKD) and cerebral aneurysms is unknown. We have compared cerebral aneurysms in
      79 patients with APKD gleaned from the literature to the sporadic aneurysm cases
      reported by the Cooperative Study to determine if there are significant
      biological differences between these two groups. Sixty-eight patients had a
      single aneurysm and 11 (14%) had multiple aneurysms. In APKD patients with
      subarachnoid hemorrhage from a single aneurysm there was a significant over
      representation of males (72%, p less than 0.01); and the APKD group had more
      aneurysms of the middle cerebral artery (37%, p less than 0.05). The peak
      decennial incidence and mean age of rupture of APKD-associated aneurysms was
      younger (mean age 39.7 years, p less than 0.01) and over 77% of APKD-associated
      aneurysms had ruptured by age 50 versus 42% for sporadic aneurysms (p less than
      0.001). Cerebral aneurysms co-existed with APKD in the absence of hypertension in
      25% of 45 cases where the presence or absence of hypertension was recorded. These
      biological differences and the occurrence of aneurysms in normotensive APKD
      patients suggests an etiology which may be independent of hypertension and that
      APKD-associated aneurysms may be genetically determined. It is hypothesized that
      cases of inherited, familial cerebral aneurysms could be linked to a genetic
      defect resembling that which occurs on chromosome 16 in APKD.

PMID- 1623451
TI  - Clinically non-functioning human pituitary adenomas.
AB  - Clinically non-functioning pituitary adenomas are morphologically classified into
      two groups, those which have hormone immunoreactivity and ultrastructural
      features of known adenohypophysial cell types but are clinically silent, and
      those composed of cells that do not resemble nontumorous adenohypophysial cell
      types. Among the former are the silent somatotroph adenomas, silent corticotroph
      adenomas and silent gonadotroph adenomas; the latter include the silent type III
      adenomas, null cell adenomas and oncocytomas. We review their histological,
      immunohistochemical and ultrastructural features, the results of in situ
      hybridization to determine hormone synthesis by these tumors and data obtained
      from tissue culture characterizing their hormone release in vitro. Non
      functioning adenomas represent a heterogeneous group. The discrepancies between
      morphology, immunoreactivity and lack of endocrine activity of silent adenomas
      are not clear. Oncocytomas are variants of null cell adenomas. We suggest that
      null cell adenomas and oncocytomas originate in uncommitted pluripotent precursor
      cells capable of undergoing multidirectional differentiation. The progenitor
      cells differentiate most frequently toward FSH/alpha-subunit producing cells; the
      mechanism of preferential differentiation is obscure.

PMID- 1623452
TI  - Tegmental pontine hemorrhages: clinical features and prognostic factors.
AB  - We report six patients with partial, predominantly paramedian, tegmental pontine
      hemorrhages. Constant clinical manifestations consisted of: ipsilateral miosis,
      horizontal gaze paresis, lower motor neuron facial paresis, contralateral
      hemisensory loss and mild and transitory hemiparesis, dysarthria and mild or no
      compromise of consciousness. Five out of six were hypertensive. All patients
      survived with mild sequelae, oculomotor disturbances being the most persistent
      deficit. We found in our patients that a transverse diameter of less than 17 mm,
      unilaterality of the injury and absence of coma were the major indicators of a
      favorable outcome.

PMID- 1623453
TI  - Chronic lymphocytic leukemia presenting as a pituitary mass lesion.
AB  - We describe a unique case of chronic lymphocytic leukemia (CLL) in a patient who
      presented with bitemporal hemianopsia, adrenal insufficiency, and gonadotrophin
      deficiency. Studies revealed an enhancing intrasellar mass with suprasellar
      extension and displacement of the optic chiasm. Peripheral blood and
      cerebrospinal fluid (CSF) studies disclosed a monoclonal IgM kappa expressing B
      cell CLL. Biopsy of the pituitary mass revealed dense infiltration of the
      pituitary gland by leukemic cells. This is, to our knowledge, the first reported
      case of CLL presenting as a pituitary mass lesion.

PMID- 1623454
TI  - Neuroblastoma and fetal exposure to phenytoin in a child without dysmorphic
      features.
AB  - Despite the fact that the teratogenic effects of phenytoin have been suggested in
      several case reports, the evidence for a possible oncogenic potential of
      phenytoin has not been widely recognized. Recently, neuroblastoma as well as
      other neuroectodermal and non-ectodermal tumors has been seen in several children
      exposed to phenytoin prenatally. Previous cases have been almost uniformly
      associated with the features of "fetal hydantoin syndrome" and none have been
      developmentally normal. We report a developmentally-normal boy of 21/2 years with
      an abdominal neuroblastoma whose mother had been on phenytoin (as well as
      carbamazepine) throughout gestation. We review the various neoplasms which have
      been reported in the offspring of mothers receiving phenytoin.

PMID- 1623455
TI  - Amantadine treatment for refractory pain and fatigue in patients with multiple
      sclerosis.

PMID- 1623457
TI  - Canadian Medicare: view from Utopia.

PMID- 1623456
TI  - Justifying the procedure.

PMID- 1623458
TI  - A survey of resuscitation training in Canadian undergraduate medical programs.

PMID- 1623459
TI  - A survey of resuscitation training in Canadian undergraduate medical programs.

PMID- 1623460
TI  - Women can abuse too.

PMID- 1623461
TI  - Reproductive hazards and the workplace.

PMID- 1623462
TI  - Quality of care: 2. Quality of care studies and their consequences. Health
      Services Research Group.

PMID- 1623463
TI  - How to diagnose and treat Lyme disease in children. Infectious Diseases and
      Immunization Committee, Canadian Paediatric Society.

PMID- 1623464
TI  - Smoking and caffeine and alcohol intake during pregnancy in a northern
      population: effect on fetal growth.
AB  - OBJECTIVES: To assess the prevalence of smoking and of caffeine and alcohol
      intake during pregnancy in a northern population and to determine the relation of
      these factors to birth weight, length and head circumference. DESIGN:
      Questionnaire survey and collection of maternal and newborn measurements.
      SETTING: Ten communities in the Inuvik Zone, NWT. PATIENTS: A total of 162 women
      (56 Inuit, 38 Indian, 37 white and 31 mixed race) who presented for prenatal care
      in their community and gave birth in Inuvik between September 1987 and January
      1990 and their newborns. RESULTS: In all, 64% (101/159) of the women smoked, 57%
      (88/154) ingested more than 300 mg of caffeine daily, and 34% (50/145) drank
      alcohol during their pregnancy. Smoking, caffeine intake and binge drinking were
      most frequent among the Inuit and Indian mothers. Smoking was significantly
      associated with decreased birth weight (p less than 0.001) and length (p less
      than 0.05). Alcohol intake, especially binge drinking, was significantly
      associated with decreased head circumference (p less than 0.05). Caffeine was
      found not to be related to any of the outcome variables after smoking was
      controlled for through stepwise multiple regression. CONCLUSIONS: The marked
      prevalence of smoking and alcohol intake during pregnancy and their effects on
      the newborn are public health concerns in the Northwest Territories and warrant
      intensive countermeasures.

PMID- 1623466
TI  - Atherosclerosis and aging of the arterial wall.

PMID- 1623465
TI  - Cardiac arrest in Ontario: circumstances, community response, role of prehospital
      defibrillation and predictors of survival.
AB  - OBJECTIVES: To describe the patient characteristics, circumstances and community
      response in cases of out-of-hospital cardiac arrest; to evaluate the effect on
      survival of the introduction of prehospital defibrillation; and to identify
      factors that predict survival. DESIGN: Population-based before-and-after clinical
      trial. SETTING: Five Ontario communities: London, Sudbury, the Greater Niagara
      region, Kingston and Ottawa. PATIENTS: A consecutive sample of 1510 primary
      cardiac arrest patients who were transported to hospital by ambulance over 2
      years. INTERVENTION: The use of defibrillators by ambulance attendants. MAIN
      OUTCOME MEASURES: Patient characteristics (sex and age), circumstances of arrest
      (place, whether arrest was witnessed and cardiac rhythm), citizen response
      (whether cardiopulmonary resuscitation [CPR] was started by a bystander, time to
      access to emergency medical services and time to initiation of CPR), emergency
      medical services response (ambulance response time, time to initiation of CPR and
      time to rhythm analysis with defibrillator) and survival rates. MAIN RESULTS: A
      total of 92.1% of the patients were 50 years of age or older, and 68.3% were men.
      Overall, 79.6% of the arrests occurred in the home. The average ambulance
      response time for witnessed cases was 7.8 minutes. The overall survival rate was
      2.5%. The survival rates before and after defibrillators were introduced were
      similar, and the general functional outcome of the survivors did not differ
      significantly between the two phases. Factors predicting survival included
      patient's age, ambulance response time and whether CPR was started before the
      ambulance arrived. CONCLUSIONS: The survival rate was lower than expected. The
      availability of prehospital defibrillation did not affect survival. To improve
      survival rates after cardiac arrest ambulance response times must be reduced and
      the frequency of bystander-initiated CPR increased. Once these changes are in
      place a beneficial effect from advanced manoeuvres such as prehospital
      defibrillation may be seen.

PMID- 1623467
TI  - Consultations then and now. 1963.

PMID- 1623468
TI  - Turning sickness into art: Robert Pope and his battle with cancer.

PMID- 1623469
TI  - Medicare turns 30.

PMID- 1623470
TI  - Ethics "inherently and inevitably" a part of every medical decision, forum told.

PMID- 1623471
TI  - Sudden death caused by work-related stress one cost of Japan's trade success.

PMID- 1623472
TI  - Adenocarcinoma of the gastric cardia. Recurrence and survival after resection.
AB  - Between January 1, 1983, and December 31, 1988, operations were performed on 112
      patients with adenocarcinoma of the gastric cardia. Resection of the primary
      tumor was performed in 93 patients. For these 93 patients, follow-up until July
      1, 1989, averaged 24 months, during which time 59 patients died. Positive
      resection margins carried a greater risk for the development of a local
      recurrence but did not correlate with survival. The cumulative overall 5-year
      actuarial recurrence rate was 69%. The cumulative 5-year recurrence rate for
      metastases was 64% and for locoregional recurrence it was 36%. The overall 5-year
      survival rate was 24%. Differences in survival were observed between patients
      with carcinomas of the various subgroups of the 1987 TNM classification system
      (T1-T2 versus T3-T4, N0 versus N1-N2, M0 versus M1, Stages I-II versus Stages III
      IV, Grades 1-2 versus Grades 3-4). In particular, lymph node status as correlated
      with histopathologic grade showed remarkable differences in survival: patients
      with no positive lymph nodes in the resection specimen and a Grade 1 or 2 tumor
      had a significantly better 5-year survival rate (53%) than the other subgroups
      (N0/Grades 3-4: 21%; N1-N2/Grades 1-2: 12%; N1-N2/Grades 3-4: 14%).

PMID- 1623473
TI  - Primary colorectal lymphoma in Taiwan.
AB  - BACKGROUND: Sixteen patients with primary lymphoma of the colon and rectum were
      studied. METHODS: The median age of these patients was 34 years, and 13 were men.
      These patients often experienced abdominal pain, diarrhea, a palpable abdominal
      mass, weight loss, bloody stools, and tumor of the cecum. Intermediate or high
      grade lymphomas occurred in 14 patients, and 5 patients had T-cell lesions. The
      diagnoses were established by using laparotomy in 14 patients and colonoscopic
      biopsy in 2 patients. Fourteen patients had surgical resections followed by
      chemotherapy: cyclophosphamide, doxorubicin, vincristine, and prednisolone in 10;
      cyclophosphamide, vincristine, and prednisolone (COP) in 2; and cyclophosphamide,
      vincristine, methotrexate, and prednisolone in 1 patient. Two patients underwent
      biopsy alone followed by chemotherapy with COP in one and chemotherapy with
      prednisolone in the other. RESULTS: The median follow-up time was 38 months
      (range, 2-82 months). Eight patients are alive with no evidence of disease
      (range, 10-82+ months). Six patients died of disease from 2 to 44 months after
      diagnosis. One patient who had no evidence of lymphoma died of esophageal
      carcinoma at 61 months. The median survival time was 59 months. CONCLUSIONS: The
      authors' experience with colorectal lymphoma in Taiwan is different from that
      reported from Japan and other countries. The patients of this study were
      significantly younger and many had T-cell lesions. Despite the frequently poor
      histologic types, surgical resection and adjuvant chemotherapy can result in long
      term, disease-free survival in many patients with primary colorectal lymphoma.

PMID- 1623474
TI  - Experience with high-dose radiation therapy and the intestinal sling procedure in
      patients with rectal carcinoma.
AB  - BACKGROUND: Surgery for Dukes' Stage B2 or C rectal carcinoma has a locoregional
      recurrence rate of 15-67%; this rate is significantly reduced when postoperative
      radiation therapy (RT) is given. However, RT contributes to radiation-associated
      small bowel injury in a dose-dependent manner. METHODS: Polyglycolic acid mesh
      used as an intestinal sling is able to keep the small bowel out of the pelvis
      during RT, thereby preventing radiation-associated small bowel injury. RESULTS:
      The authors reviewed the perioperative experiences and acute toxic effects of RT
      in 53 patients in whom the polyglycolic sling was placed from May 1985 through
      May 1990 during laparotomy for rectal malignancies (47 primary and 6 recurrent).
      There were 26 men and 27 women whose ages ranged from 34 to 88 years (mean, 64.7
      years). Mild postoperative ileus occurred in most patients, and one patient had
      an anastomotic leak with a pelvic abscess. Bowel displacement from RT portals was
      confirmed using radiologic contrast studies. Forty-three patients with primary
      tumors have completed postoperative RT, and a mean of 5174 cGy has been
      administered. CONCLUSIONS: After 1-6 years of follow-up (mean, 2.1 years), eight
      patients have died of systemic disease. There were no cases of radiation
      associated small bowel injury and only two cases of pelvic recurrence from
      primary rectal adenocarcinoma (5%).

PMID- 1623475
TI  - Giant cell carcinoma of the lung.
AB  - BACKGROUND: Giant cell carcinoma of the lung has been described as an aggressive
      tumor characterized by extensive local and distant disease and extremely short
      survival. In 1981, the World Health Organization defined giant cell carcinoma as
      a variant of large cell carcinoma. Before then giant cell lung cancer was a
      descriptive term, but it was not considered a separate entity. METHODS: The
      authors retrospectively studied 16 cases of giant cell carcinoma of the lung.
      RESULTS: These cases had a prognosis that was not appreciably different from that
      for lung cancer of other non-small cell histologic types. Of those patients with
      pathologic Stage I or II at resection, five of nine are alive and disease-free
      from 20 to 116 months and one has died without evidence of disease at 15 months.
      CONCLUSIONS: Based on this series and a review of the literature, there appears
      to be an increased incidence of both clinical and subclinical gastrointestinal
      tract involvement in patients with this histology, compared with patients with
      other non-small cell histologic types. The authors conclude that patients with
      giant cell carcinoma of the lung have a prognosis similar to that of patients
      with other non-small cell histologic types, and that clinicians should be aware
      of the increased incidence of gastrointestinal tract involvement in this disease.

PMID- 1623476
TI  - International trends in the incidence of bone cancer are not related to drinking
      water fluoridation.
AB  - BACKGROUND: Because osteosarcomas may develop in rats exposed to fluoridated
      water, water fluoridation might pose a cancer risk to humans. METHODS: A time
      trend analysis of the cumulative risk (CR) of bone cancer for the period 1958
      1987 for 40 cancer registry areas showed an increased risk for young males in
      Canada, Europe, and the United States, and a decreased lifetime risk for either
      sex in Europe. RESULTS: This was unrelated to water fluoridation and may have
      resulted from changes in coding practices. Bone cancer risk was inversely related
      to the incidence of cancers of unknown origin, suggesting that bone metastases
      were erroneously coded as primary bone cancer. In 1968-1972, most areas recorded
      more bone cancer deaths than new cases of the disease. CONCLUSIONS: The
      mortality/incidence ratio, but not the incidence rate (IR), has dropped sharply
      since then, which erodes the basis of past inferences relating cancer mortality
      to fluoridation.

PMID- 1623477
TI  - Relationship between chronic lymphocytic leukemia and small lymphocytic lymphoma.
      A comparative study of membrane phenotypes in 270 cases.
AB  - BACKGROUND: Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma
      (SLL) are considered different tissue expressions of the same disease process,
      although they are clinically separable nosologic entities. A systematic
      comparison of the membrane phenotypes in the two entities needs to be
      investigated. METHODS: Cell suspensions from peripheral blood of 184 patients
      with CLL, bone marrow from 23 patients with CLL, and lymph nodes from 86 patients
      with SLL were analyzed to compare the membrane phenotypes. RESULTS: There were no
      significant differences between the three groups in the mean percentages of cells
      expressing surface immunoglobulin (SIg), CD5, CD19, CD20, and CD2 or in the
      frequency of cases with weak SIg. Although the mean percentage of mouse rosette
      forming cells (MRFC) showed no statistical difference between bone marrow from
      CLL and lymph nodes from SLL, the mean percentage of MRFC in peripheral blood
      from CLL (48.02 +/- 18.23%) was twice as high as that in bone marrow from CLL
      (25.27 +/- 21.51%) and lymph nodes from SLL (20.87 +/- 16.72%) (P less than
      0.001). Correlation analysis assessing the association of MRFC and residual T
      cells showed a negative coefficient (r), and the r was statistically significant
      in bone marrow from CLL and lymph nodes from SLL but not in peripheral blood from
      CLL. The mean CD4/CD8 ratios in descending order were as follows: the ratio in
      lymph nodes from SLL (4.25) was greater than that in peripheral blood from CLL
      (1.70), which was greater than that in bone marrow from CLL (0.82); this followed
      the same pattern as the respective tissue controls. The mean ratios were not
      statistically different from those of their respective control groups.
      CONCLUSIONS: The similarity of membrane phenotypes between CLL and SLL provided
      evidence that the two are different tissue expressions of the same disease. The
      alterations in CD4/CD8 ratios were related to the type of tissue analyzed and not
      to the disease process. The difference in MRFC presumably results from the
      microenvironment or residual T-cells.

PMID- 1623478
TI  - Expression of disialogangliosides GD2 and GD3 on human soft tissue sarcomas.
AB  - METHODS: Fifty-six freshly frozen human sarcomas were studied for expression of
      disialogangliosides by avidin-biotin immunohistochemical staining with purified
      monoclonal antibodies (MoAb) 3F8 (antidisialoganglioside GD2) and R24
      (antidisialoganglioside GD3). RESULTS: Ninety-three percent of the tumors tested
      by the immunohistochemical staining expressed GD2 and 88% expressed GD3. The
      intensity of expression varied among sarcomas of different histologic types.
      Liposarcoma, fibrosarcoma, malignant fibrous histiocytoma, leiomyosarcoma, and
      spindle cell sarcoma reacted strongly with 3F8 and R24. Embryonal
      rhabdomyosarcoma and synovial sarcoma demonstrated substantially weaker staining
      by either MoAb. Weakly reactive or nonreactive tumors were, in general, high
      grade or metastatic sarcomas. Ganglioside extraction and thin-layer
      chromatography/immunothin-layer chromatography of two liposarcomas confirmed the
      identities of these gangliosides. CONCLUSIONS: GD2 and GD3 may indicate sites for
      MoAb-targeted imaging and therapy for sarcomas. The association of a diminished
      stainability by 3F8 and R24 with aggressive sarcomas may indicate prognostic
      significance.

PMID- 1623479
TI  - Results of surgical treatment of 1028 cervical cancers studied with volumetry.
AB  - BACKGROUND AND METHODS: The clinical staging system of cervical cancer according
      to the International Federation of Gynecology and Obstetrics (FIGO) entails a
      large measure of subjectivity. This study analyzed the results of 1028 patients
      with cervical cancer at three reference centers. All patients had radical
      surgery, and all surgical specimens were processed as histologic giant sections
      with precise volumetry of the tumor. RESULTS: The interpretation of the
      histologic findings of parametrial invasion, vascular involvement, and lymph node
      involvement was found to differ somewhat among the three centers. However, all
      these findings were associated with tumor size. Survival rates correlated more
      consistently with tumor volume than with clinical or histologic stage. Five-year
      survival rates ranged from 91% for patients with tumors smaller than 2.5 cm3 to
      70% for those with tumors 10-50 cm3. The 5-year survival rate of 24 patients with
      tumors larger than 50 cm3 (71% of whom had lymph nodes with positive findings)
      was 48%. Survival rates were identical among the three centers for patients with
      tumors smaller than 10 cm3, despite different degrees of surgical radicality. In
      contrast, more radical surgery was associated with significantly better survival
      rates in patients with larger tumors. CONCLUSIONS: The results of this study
      indicate that volumetry of the tumor permits a more accurate assessment of
      therapeutic results in patients with cervical cancer than does the FIGO
      classification. Pretherapeutic assessment of tumor volume is possible with
      magnetic resonance imaging. It seems that maximum parametrial resection is not
      necessary for patients with smaller tumors (smaller than 10 cm3), but truly
      radical surgery in patients with bulky tumors achieves better results than those
      usually expected in Stage IIb cervical cancer and at least comparable to those of
      radiation therapy.

PMID- 1623480
TI  - Disseminated intravascular coagulation and excessive fibrinolysis in a patient
      with metastatic prostate cancer. Response to epsilon-aminocaproic acid.
AB  - BACKGROUND: Disseminated intravascular coagulation (DIC) and primary fibrinolysis
      have both been reported in association with prostate carcinoma. The correct
      diagnosis of the coagulopathy can be difficult and the appropriate management
      controversial. METHODS: A case is presented of a man in whom DIC and soft tissue
      hemorrhage developed after prostatic biopsy. The results of therapy and a review
      of the literature are discussed. RESULTS: Fibrinogen levels continued to decrease
      despite high-dose estrogen therapy, but they rapidly returned to normal after
      therapy with epsilon-aminocaproic acid. Although routine coagulation tests were
      suggestive of primary fibrinolysis, the results of the D-dimer assay confirmed
      that the patient had DIC associated with excessive fibrinolysis. CONCLUSION: A
      review of the literature suggests that most cases of primary fibrinolysis are
      probably DIC with excessive secondary fibrinolysis. In cases in which bleeding is
      the primary manifestation of DIC and there is a significant reduction in alpha-2
      plasmin inhibitor activity, a trial of epsilon-aminocaproic acid and low-dose
      heparin should be considered. The failure in this case of estrogen therapy to
      correct the coagulopathy, despite a later good tumor response, is consistent with
      the delay in which anorchid testosterone levels are obtained after initiating
      treatment.

PMID- 1623481
TI  - Urethral diverticular carcinoma.
AB  - BACKGROUND: Urethral diverticular carcinoma is an unusual finding in a urologic
      lesion commonly found in female patients. METHODS: This report presents 6 new
      cases and reviews the other 53 cases in the English literature. RESULTS:
      Adenocarcinoma occurs more frequently than transitional and squamous cell cancers
      combined. CONCLUSION: The prognosis of the former is more favorable. In general,
      radical therapy is recommended. However, in some instances of localized disease,
      and with careful follow-up, a more conservative approach might be attempted.

PMID- 1623482
TI  - Cell kinetics of medulloblastomas.
AB  - BACKGROUND: Cell kinetics and clinical behavior were correlated for 22 primary
      and 10 recurrent or metastatic medulloblastomas from 30 patients. METHODS: Twenty
      six patients received bromodeoxyuridine (BUdR) intravenously during craniotomy;
      excised specimens were stained by the immunoperoxidase method. The BUdR labeling
      index (LI) was calculated. Four patients received a pulse of tritiated thymidine;
      LI was calculated autoradiographically. RESULTS: The mean LI for 32 tumors (11.7
      +/- 1.3% standard error) indicated high proliferative potential. LI appeared
      higher in tumors from younger patients and those in the cerebellar hemisphere as
      compared with those in the cerebellar vermis. LI did not correlate with survival
      time. In six BUdR-labeled tumors labeled with iododeoxyuridine, the S-phase
      duration was 6.1-11.3 hours (mean, 8.0 +/- 0.8 hours); the potential doubling
      time was 25-82 hours. The actual doubling time, estimated in three cases from
      serial imaging, was 20-24 days. A cell loss factor of approximately 0.90 was
      assumed. CONCLUSION: A high LI may reflect rapid medulloblastoma growth, but
      survival seemed more dependent on sensitivity to radiation therapy.

PMID- 1623483
TI  - Hand-rolled cigarette smoking and risk of cancer of the mouth, pharynx, and
      larynx.
AB  - A case-control study, involving 205 patients with cancer of the mouth, pharynx,
      and larynx and 273 control subjects with conditions considered not related to
      tobacco or alcohol consumption, was performed in Montevideo, Uruguay, between
      January 1988 and December 1990. Smokers of hand-rolled cigarettes showed an
      increased risk of cancer of the mouth and pharynx (odds ratio [OR] = 2.5; 95%
      confidence limit = 1.2-5.2) when compared with smokers of manufactured
      cigarettes. Also, the risk of laryngeal cancer was greater among smokers of hand
      rolled cigarettes (OR = 2.7; 95% confidence limit = 1.3-5.7) as compared with
      smokers of commercial cigarettes.

PMID- 1623484
TI  - Documentation of Burkitt lymphoma with t(8;14) (q24;q32) in X-linked
      lymphoproliferative disease.
AB  - BACKGROUND: Acquired hypogammaglobulinemia or agammaglobulinemia, aplastic
      anemia, chronic or fatal infectious mononucleosis (IM), virus-associated
      hemophagocytic syndrome, and a variety of B-cell malignant lymphomas (ML) develop
      in boys with X-linked lymphoproliferative disease (XLP) after infection by the
      Epstein-Barr virus (EBV). They have an inherited immunodeficiency to EBV.
      Approximately 80% of the patients die during childhood and 100% by the age of 40.
      The ML occurring in patients with XLP are different from those of other
      populations in that there is a maternal family history of males with phenotypes
      of XLP, particularly ML involving the ileocecal region. METHODS: This article
      describes two brothers with XLP in whom ML developed. Also, a maternally related
      male cousin had died of aplastic anemia complicating IM. RESULTS: A Burkitt
      lymphoma (BL)-specific translocation of t(8;14) (q24;q32) was observed in the BL
      cells of the younger brother. The histopathologic appearance and rapid relapse
      after complete remission in the patient also are suggestive of this aggressive
      phenotype. CONCLUSIONS: This tumor in the patient documents that the BL of
      patients with XLP probably arises from characteristic tumor-specific chromosomal
      translocations, as hypothesized in 1980.

PMID- 1623485
TI  - Pregnancy outcome in survivors of advanced Hodgkin disease.
AB  - BACKGROUND: Pregnancy outcome was reported by 139 survivors of advanced Hodgkin
      disease treated on nine protocols of Cancer and Leukemia Group B from 1966 to
      1986. METHODS: These patients provided data on 302 singleton pregnancies of a
      duration of at least 20 weeks that occurred before, during, or after treatment
      for Hodgkin disease (252, 26, and 24 pregnancies, respectively). RESULTS: There
      were 4 perinatal deaths, as compared with 5.7 expected. Cancer subsequently
      developed in 2 offspring (expected, 1.2). However, 22 newborn infants had low a
      birth weight, exceeding the expected number of 13.7 (relative risk 1.6; 95%
      confidence interval, 1.0-2.4). The excess number of low weight births occurred
      primarily during the period of Hodgkin disease diagnosis and treatment but is
      based on small numbers. CONCLUSION: No increase in adverse outcome occurred in
      pregnancies that antedated the development of Hodgkin disease.

PMID- 1623486
TI  - The role of radiation therapy in Hodgkin disease: experience and controversy. The
      54th annual Janeway Lecture: 1989.
AB  - BACKGROUND: Beginning in 1970, a series of patients with Hodgkin disease were
      treated at the University of Minnesota, after staging laparotomy, with radiation
      therapy (RT) for Stage I, II, and IIIA Hodgkin disease. This report is an
      analysis of the results of the treatment and of treatment modifications. METHODS:
      From 1970 to 1974, all patients were treated with standard RT. In 1975, an
      analysis of these patients indicated that patients with large mediastinal mass
      (LMM) and patients with Stage IIIA spleen-positive (IIIAS+) disease had a higher
      recurrence rates than patients without these factors. Subsequently, a schema of
      radical radiation therapy (RRT) was devised, which included low-dose lung RT for
      patients with LMM and low-dose liver RT for patients with IIIAS+ disease.
      RESULTS: Analysis of the results of the two treatments indicates that the use of
      low-dose lung RT in patients with LMM and low-dose liver RT in patients with
      IIIAS+ Hodgkin disease produced survival and recurrence-free survival results
      equivalent to those achieved by use of combined modality treatment (CMT) or
      chemotherapy (CT) alone. CONCLUSIONS: The use of RT with whole lung and liver
      irradiation for patients with LMM and IIIAS+ Hodgkin disease, respectively,
      produces results that are equivalent to those of CMT or CT alone with the
      advantage of a decreased incidence of second malignant neoplasms. In addition,
      patients who do not respond to initial RT have a greater chance of being saved
      with chemotherapy than do patients initially treated with CMT of being saved with
      RT. The authors suggest that radical RT is the treatment of choice for patients
      with LMM and/or IIIAS+ Hodgkin disease.

PMID- 1623487
TI  - Cytogenetic characteristics of childhood non-Hodgkin lymphoma.
AB  - Cytogenetic studies were performed successfully on 24 patients with non-Hodgkin
      lymphoma (NHL) who were younger than 15 years of age. Of these, 22 patients (92%)
      had abnormal clones. With respect to histologic findings, 3 (25%) of the 12
      patients with lymphoblastic lymphoma had 14q11 translocations and 2 (17%) had
      t(9;17) (q34;q23). Four (80%) of the five patients with small non-cleaved cell
      lymphoma had t(8;14)(q24;q32). With respect to immunologic findings, four (44%)
      of the nine patients with T-cell lymphoma had abnormalities consisting of 14q11
      and 7q36 translocations, in which the T-cell receptor genes resided. Three (33%)
      of the patients with T-cell lymphoma had t(9;17)(q34;q23). However, three (43%)
      of the seven patients with B-cell lymphoma had t(8;14) (q23;q32), and two (29%)
      of the patients with B-cell lymphoma had an extra i(11q) chromosome with a
      resultant 11q tetrasomy. Non-T-cell non-B-cell lymphomas, which occurred in 21%
      of all patients, showed various chromosomal abnormalities. This study
      demonstrated that, in childhood NHL, karyotype correlates closely with
      immunophenotype, clinical features, and histologic findings.

PMID- 1623488
TI  - Digital imaging in dermatology.

PMID- 1623489
TI  - Digital imaging in dermatology.
AB  - In this article we discuss the recent surge in activity in digital imaging in
      dermatology. The key role of digital imaging as an adjunct to detection of early
      malignant melanoma, with application in following patients with the dysplastic
      nevus syndrome, is explored. Other current and future uses of digital imaging in
      image archiving, in clinical studies such as hair growth studies, and in
      telediagnosis are reviewed. We review the varying research activities of image
      analysis laboratories participating in the dermatology image researching group.
      Research laboratories included in this group are at Oregon Health Sciences
      University, Xerox Corporation, University of Arizona, University of Cincinnati,
      University of Munich, University of Wurzburg, University of Arkansas, Harvard
      University, Southern Illinois University-Edwardsville, Johns Hopkins University,
      National Institutes of Health, and University of Missouri at Columbia and Rolla.
      The role of new imaging devices in dermatology including the "nevoscope" and the
      dermatoscope is explored. Goals and challenges for the new technology are
      discussed.

PMID- 1623490
TI  - Use of computer graphic images in teaching dermatology.
AB  - A microcomputer-based system for copying, storing, retrieving, and displaying
      color still images was assembled from commercially available components. The
      system was tested against 35-mm color photographic transparencies by measuring
      the performance of 91 medical students in a task of identifying the primary
      morphology of eight skin lesion images from the displayed images. There was no
      significant difference in the students' performance between the two display
      media.

PMID- 1623491
TI  - Three-dimensional imaging and reconstruction of skin lesions.
AB  - An optical instrument called a "nevoscope" is used to image skin lesions by
      transillumination with visible light. The lesion is transilluminated by a fiber
      optic annular ring light source that directs light into the skin area surrounding
      the lesion, forming a virtual source just beneath the lesion. Mirrors uniformly
      spaced around the lesion and tilted at various angles provide orthographic
      projections of the skin lesion. Additional views are obtained by rotating the
      mirror assembly. These multiple views are used in a direct three-dimensional (3D)
      reconstruction of the lesion using a filtered backprojection method. In this
      paper, we discuss the methodology of direct 3D reconstruction from 2D views of a
      transilluminated skin lesion as obtained using the new prototype nevoscope. We
      present the results of direct 3D reconstruction of a simulated phantom and a test
      object imaged using the nevoscope. In addition, a skin lesion was scanned in situ
      using the new prototype nevoscope. Results of the reconstruction of this lesion
      are also presented.

PMID- 1623492
TI  - Segmentation of images of skin lesions using color and texture information of
      surface pigmentation.
AB  - Image segmentation algorithms extract regions on the basis of similarity of a
      predefined image feature such as gray-level value. In many applications, images
      that exhibit a variety of structure or texture cannot be adequately segmented by
      gray-level values alone. Additional features related to the structure of the
      image are needed to segment such images. Images of skin lesions exhibit
      significant variations in color hues as well as geometrical appearance of local
      surface structure. For example, images of cutaneous malignant melanoma exhibit a
      rich combination of color and geometrical structure of pigmentation. In these
      images, the local repetition of the geometrical surface structure provides the
      basis for the appearance of a texture pattern in the neighborhood region. For
      obtaining meaningful segmentation of images of skin lesions, a multichannel
      segmentation algorithm is proposed in this paper which uses both gray-level
      intensity and texture-based features for region extraction. The intensity-based
      segmentation is obtained using the modified pyramid-based region extraction
      algorithm. The texture-based segmentation is obtained by a bilevel shifted-window
      processing algorithm that uses new generalized co-occurrence matrices. The
      results of individual segmentations obtained from different channels,
      representing the complete set of color and texture information, are analyzed
      using heuristic merging rules to obtain the final color- and texture-based
      segmentation. Simulated as well as real images of skin lesions, representing
      various color shades and textures, have been processed. We show that using
      contrast link information in the pyramid-based region extraction process, and
      using the absolute magnitude and directional information in the generalized co
      occurrence matrices (GCM) method, significant improvement in image segmentation
      can be obtained. Further, by incorporating the merging rules better results are
      obtained than those obtained using the gray-level intensity feature alone.

PMID- 1623493
TI  - Texture in skin images: comparison of three methods to determine smoothness.
AB  - Smooth texture, a critical feature in skin tumor diagnosis, is analyzed using
      three texture measurement methods. A dermatologist classified 1290 small blocks
      within 42 tumor images as smooth, partially smooth, or nonsmooth. Texture
      discriminatory power of three methods were compared: the neighboring gray-level
      dependence matrix (NGLDM) method of Sun and Wee, the circular symmetric
      autoregressive random field model of Kashyap and Khotanzad, and a new peak
      variance method. The texture analysis method that allows best prediction of
      smoothness for our tumor domain is the NGLDM method, affording 98% correct
      prediction of a smooth block with 21% false positives. We discuss applicability
      of texture analysis to dermatology.

PMID- 1623494
TI  - Automatic detection of asymmetry in skin tumors.
AB  - Asymmetry, a critical feature in the diagnosis of malignant melanoma, is analyzed
      using a new algorithm to find a major axis of asymmetry and calculate the degree
      of asymmetry of the tumor outline. The algorithm provides a new objective
      definition of asymmetry. A dermatologist classified 86 tumors as symmetric or
      asymmetric. Borders of tumors were found either manually or automatically using a
      radial search method. With either method, asymmetry determination by the
      asymmetry algorithm agreed with the dermatologist's determination of asymmetry in
      about 93% of cases.

PMID- 1623495
TI  - Automatic detection of irregular borders in melanoma and other skin tumors.
AB  - An irregularity index previously developed is applied to detect irregular borders
      automatically in skin tumor images, particularly malignant melanoma. The
      irregularity index is used to classify various tumor borders as irregular or
      regular. This procedure processes tumor images with borders automatically
      determined by a radial search algorithm previously described. Potential use of
      this algorithm in an in vivo skin cancer detection system and errors expected in
      the use of the algorithm are discussed.

PMID- 1623496
TI  - Automatic registration of multiple skin lesions by use of point pattern matching.
AB  - Computerized comparison of serial skin images is a potentially valuable tool for
      melanoma screening. In automating this process, matching or "registering" each
      lesion in a pair of images plays an important role in looking for clinically
      significant change. We have investigated three practical techniques--a point
      pattern correlation, a 2-point geometrical transformation, and a 3-point
      geometrical transformation--for their effectiveness in matching and identifying
      lesions in pairs of skin images. These techniques view the spots in each image as
      a point pattern to be matched from image to image. Each of these methods is shown
      to be quite effective as long as one or more known initial match points can be
      provided. Experiments performed by imaging actual patients under realistic
      conditions indicate that the 3-point transformation algorithm performs the best
      overall, achieving an average matching accuracy of 97%. The nature of these
      algorithms, their relative performance under a range of conditions, and possible
      methods for improving accuracies are discussed.

PMID- 1623497
TI  - Automatic derivation of initial match points for paired digital images of skin.
AB  - Computerized matching of skin images has been suggested as a means of screening
      for changes indicative of malignant melanoma. Matching or "registering" each
      lesion in a pair of images plays an important role in this process. Point-pattern
      matching algorithms based upon correlation or geometric transformations of the
      image pairs have been shown to be effective for this registration but require
      knowledge of one or more "initial match" points which are known to be the same on
      both images. A method is described for automatically finding these initial match
      points with a high degree of success. Our algorithm uses the so-called "Gabriel
      graph" representation of the paired images to select sets of probable matching
      points. Performance of the algorithm has been measured in realistic trials, using
      images of patients with large numbers of pigmented lesions. Results show that the
      single best match chosen is correct greater than 99% of the time, while over 93%
      of the first three consecutive matches will be chosen correctly. It is likely
      that these results can be improved through the use of additional nonpositional
      information or additional image processing.

PMID- 1623499
TI  - Current bibliography of cell calcium prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1623498
TI  - An automatic color segmentation algorithm with application to identification of
      skin tumor borders.
AB  - A principal components transform algorithm for automatic color segmentation of
      images is described. This color segmentation algorithm was used to find tumor
      borders in six different color spaces including the original red, green, and blue
      (RGB) color space of the digitized image, the intensity/hue/saturation (IHS)
      transform, the spherical transform, chromaticity coordinates, the CIE transform
      and the uniform color transform designated CIE-LUV. Five hundred skin tumor
      images were separated into a training set and a test set for comparison of the
      different color spaces. Automatic induction was applied to dynamically determine
      the number of colors for segmentation. Ninety-one percent of image variance was
      contained in the image component along the principal axis (also containing the
      most image information). When compared to a luminance radial search method, the
      principal components color segmentation border method performed equally well by
      one measure and 10% better by another measure, including more near border points
      outside the tumor. The spherical transform provides the highest success rate and
      the chromaticity transform the lowest error rate, although large variances in the
      data preclude definitive statistical comparisons.

PMID- 1623500
TI  - Ehrlich tumour cells: Ca(2+)-uptake modification by aluminium lactate.
AB  - Aluminium lactate provokes the same modification of 45Ca(2+)-uptake by Ehrlich
      ascites tumour cells as does ferric lactate. The increase of uptake is metal
      complex concentration-dependent, and in contrast to ferric lactate, is only
      partially inhibited by albumin. Under the same experimental conditions, chromic
      lactate provoked no modification of that uptake. A plasma membrane rigidity
      increase provoked by coordination binding of aluminium to phospholipids is likely
      to be the main cause of Ca(2+)-uptake modification by aluminium lactate.

PMID- 1623501
TI  - Spectral characterization of the effect of viscosity on Fura-2 fluorescence:
      excitation wavelength optimization abolishes the viscosity artifact.
AB  - A systematic study of the spectral characteristics of the viscosity artifact in
      Fura-2 based [Ca2+] measurements reveals that, by selecting excitation
      wavelengths approximately 10 nm longer than those routinely employed and modestly
      reducing excitation bandpasses, the magnitude of the artifact can be reduced to
      experimentally undetectable levels without greatly impairing [Ca2+] measurements.
      The feasibility of this approach was confirmed on a ratio imaging microscope; the
      magnitude of the artifact observed in dextran-conjugated Fura-2 solutions
      prepared in water or in 50% sucrose was not statistically significant using an
      excitation wavelength pair of 361/389 nm, whereas at 350/380 nm [Ca2+] was
      underestimated by 34% in the higher viscosity solution. Thus, provided potential
      pitfalls are taken into account, a simple change in imaging protocol can avoid
      the viscosity artifact without recourse to correction factors. This approach may
      be employed either routinely, or else merely to test whether apparent [Ca2+]i
      differences observed at more conventional wavelengths arise from the viscosity
      artifact.

PMID- 1623502
TI  - Ionomycin produces an improved volume recovery by an increased efflux of taurine
      from hypoosmotically stressed molluscan red blood cells.
AB  - Nucleated erythrocytes of the blood clam, Noetia ponderosa, recover cell volume
      after a hypoosmotic stress by an efflux of K+, Cl- and taurine. When the cells
      are exposed to ionomycin followed by hypoosmotic stress, swelling is less and
      volume recovery is both faster and more complete than in control cells without
      the ionophore. The improved volume recovery is caused by a large increase in the
      efflux of taurine. The taurine efflux is altered by changing Ca2+ concentrations
      in the presence of the ionophore. Potassium regulation by the osmotically
      stressed erythrocytes is also increased in the presence of ionomycin, but only by
      a small amount, perhaps accounting for the initial decrease in swelling.
      Variation of Ca2+ in the presence of ionomycin without osmotic stress produces no
      change in the regulation of either osmolyte. These results indicate that both the
      osmotic stress and an increase in [Ca2+]i are required for the permeability
      change that produces taurine efflux.

PMID- 1623503
TI  - Trigeminovascular system.

PMID- 1623504
TI  - Cluster headache.

PMID- 1623505
TI  - Personality factors in recurring and chronic pain.

PMID- 1623506
TI  - Activation of the trigeminovascular system by mechanical distension of the
      superior sagittal sinus in the cat.
AB  - Distension of dural sinuses in man produces migraine-like pain. In eight alpha
      chloralose anaesthetized cats mechanical distension of the superior sagittal
      sinus with a small intraluminal device was used to activate single units in the
      dorsolateral C2 spinal cord. Units in this region have been shown to respond to
      electrical stimulation of the superior sagittal sinus in the cat model. Linked
      responses to mechanical dilatation could only be obtained with very rapid
      stretching stimuli or high amplitudes of distension of the vessel. Lower
      thresholds for transduction of distension in the vessel wall may depend on
      transferral to the dura or biochemical or neural pre-sensitization of the
      superior sagittal sinus. These data are consistent with the view that migraine is
      not primarily a vascular disorder but requires at least humoral or neural
      facilitation.

PMID- 1623507
TI  - Subcortical cerebral blood flow and metabolic changes elicited by cortical
      spreading depression in rat.
AB  - Changes in cerebral cortical perfusion (CBFLDF), local cerebral blood flow (lCBF)
      and local cerebral glucose utilization (lCGU) elicited by unilateral cortical
      spreading depression (SD) were monitored and measured in separate groups of rats
      anesthetized with alpha-chloralose. CBFLDF was recorded with laser Doppler
      flowmetry, while lCBF and lCGU were measured by the quantitative autoradiographic
      [14C]iodoantipyrine and [14C]-2-deoxyglucose methods, respectively. SD elicited a
      wave of hyperemia after a latency of 2 to 3 min followed by an oligemic phase.
      Ninety minutes following the onset of SD cortical (frontal, parietal and
      occipital) lCBF and lCGU were essentially the same as on the contralateral side
      and in sham-treated rats. However, alteration in the lCBF and lCGU in upper and
      lower brainstem persisted. The present results demonstrate, for the first time,
      that long-lasting cerebrovascular and metabolic alterations take place within the
      subcortical regions following SD. These regions provide an attractive site to
      integrate observations in man concerning spreading depression and the aura of
      migraine with the other features of the syndrome.

PMID- 1623508
TI  - Pain sensitivity and pain reactivity of pericranial muscles in migraine and
      tension-type headache.
AB  - We investigated whether experimentally determined, suprathreshold pain
      sensitivity of pericranial musculature in patients with tension-type headache
      differs from that of migraine patients or from that of healthy subjects.
      Furthermore, we looked to see whether differences could be found in the effects
      of experimental pain induction on EMG activity of pericranial musculature and
      whether subgroups could be discovered with higher and lower pericranial pain
      sensitivity within the three diagnostic groups in terms of neurophysiological,
      psychological and clinical variables. In 20 patients with tension-type headache,
      23 patients with migraine without aura, and 29 healthy individuals experimental
      pain was induced in the temporal muscle by mechanical pressure; pain sensitivity
      in the entire metrically subdivided suprathreshold pain sensitivity range was
      measured. Surface EMG activity of pericranial muscles was determined before,
      during and after experimental pain induction. In addition, headache
      characteristics as well as personality and mood states were determined and
      recorded in a standardized fashion. There were no significant differences in pain
      sensitivity of pericranial musculature between the three groups. Patients with
      tension-type headache showed significantly higher EMG scores during
      suprathreshold pain stimulation than did migraine patients. EMG scores of healthy
      subjects fell between these two groups. With respect to pericranial tenderness
      significant differences in clinical, neurophysiological and psychological
      variables were found only between subgroups within the group of patients with
      tension-type headache. The results indicate that significant differences in the
      examined groups are found not in pain perception but in the processing or
      reaction to experimental headache stimuli. In patients with tension-type headache
      subgroups evolve based on pericranial pain sensitivity with quantitatively and/or
      qualitatively impaired reactions; for this reason diagnostic grouping according
      to the IHS classification seems to be pathophysiologically relevant. The
      intraindividual phasic comparison of pain reactions appears to be more important
      than the absolute interindividual tonic comparison.

PMID- 1623509
TI  - Tension headache and the cervical spine--plain X-ray findings.
AB  - The aim of the present study was to investigate if there is any causal connection
      between plain X-ray findings of the cervical spine and tension headache. We
      evaluated the X-rays of the cervical spine of 243 patients, in 91 of which the
      diagnosis was "tension headache", in 102 "headache not fulfilling the criteria of
      tension headache" and in 50 "spondylogenic complaints without headache". We
      compared these three groups with regard to frequency and severity of
      radiologically assessable changes of the cervical spine and found that patients
      with tension headache had normal findings significantly more often and
      significantly less often functional or organic changes or both than patients of
      the other two groups. The radiologically assessable changes of the cervical spine
      are unlikely to have an essential role in the cause or mechanism of tension
      headache.

PMID- 1623510
TI  - Cytochrome P-450-dependent hydroxylation in migraine.
AB  - The hypothesis was tested that an acute oxidation deficiency related to potential
      dietary trigger factors plays a role in the migraine attack. Migraine sufferers
      (14F and 4M), fulfilling the criteria for migraine with and without aura
      according to the classification of the International Headache Society, were
      coadministered oral mephenytoin (100 mg) and debrisoquine (10 mg) during the
      initial phase of a typical migraine attack. This was repeated during a period
      without migraine. The hydroxylation of mephenytoin and debrisoquine hydroxylation
      did not differ during and without the migraine attack. We conclude that
      hydroxylation, via cytochrome P-450 (2D6, 2C8 and 9), is not reduced during the
      migraine attack. The results do not support the hypothesis that oxidation
      deficiency is involved in the pathophysiology of migraine.

PMID- 1623511
TI  - Cytochrome-P450-dependent hydroxylation in cluster headache.
AB  - Two isozymes of the cytochrome-P450-dependent drug oxidizing system exhibit
      polymorphism. Five to 10% of a Caucasian population are deficient in debrisoquine
      hydroxylase activity and about 3% in mephenytoin-hydroxylase activity (poor
      metabolizers). We tested the hypothesis of a possible over-representation of poor
      metabolizers among patients with cluster headache. The individual metabolic
      capacity was determined in 30 cluster headache patients after administration of a
      test dose of 10 mg of debrisoquine and 100 mg of mephenytoin. Two patients (6.7%)
      were poor metabolizers of debrisoquine and one (3.3%) a poor metabolizer of
      mephenytoin. This was no different from the rate of poor metabolizers, 7.1% and
      3.3% respectively, in a reference panel of healthy Swedish volunteers.

PMID- 1623512
TI  - Accompanying symptoms of cluster attacks: their relevance to the diagnostic
      criteria.
AB  - Two-hundred-and-fifty-one consecutive cluster headache (CH) patients referred to
      the Pavia and Parma Headache Centers were evaluated in order to verify the
      presence and recurrence of one or more autonomic symptoms. Data obtained show
      that in 2.8% of patients cluster attacks were not accompanied by localized
      autonomic symptoms, thus confirming the report of Ekbom. We observed a high
      prevalence of photophobia, nausea and vomiting. The IHS diagnostic criteria for
      CH may need to be modified. The high frequency of "general" autonomic symptoms
      seems to suggest a component of "central" drive in the physiopathology of cluster
      headache.

PMID- 1623513
TI  - A double-blind study of ibuprofen versus placebo in the treatment of acute
      migraine attacks.
AB  - The efficacy of ibuprofen, a non-steroidal anti-inflammatory drug, was assessed
      in the acute treatment of migraine. Twenty-five patients completed a double-blind
      placebo-controlled multicrossover trial. The initial dose of ibuprofen was 1200
      mg. Six migraine attacks were randomly treated in each patient, three with
      ibuprofen and three with placebo. The results indicated a statistically
      significant reduction in the duration of the migraine attacks and also a
      statistically significant reduction in the severity of headache and nausea in the
      ibuprofen-treated attacks. The use of additional medication was significantly
      reduced in the ibuprofen-treated attacks (25.6% vs 57.5%). No serious side
      effects were reported. Ibuprofen is valuable in the treatment of acute migraine
      attacks.

PMID- 1623514
TI  - Cluster headache: alterations in heart rate, blood pressure and orthostatic
      responses during spontaneous attacks.
AB  - Changes in heart rate and blood pressure (BP) have been monitored beat-to-beat in
      a cluster headache patient with and without attacks using a non-invasive Doppler
      servo method. Two attacks were monitored and during one of them a tilt test was
      carried out. The variability of heart rate and BP was greater during the attack
      than during the interparoxysmal period. A marked bradycardia occurred during
      attacks. Systolic BP increased slightly. There was no heart rate increase after
      tilting during the attack, whereas this was present invariably during tests
      carried out interparoxysmally. BP changes during "attack tilt" were difficult to
      evaluate because of large variation. This may be the first observation of a
      baroreflex arc dysfunction during a cluster headache attack.

PMID- 1623515
TI  - Unilateral facial pain as the first symptom of lung cancer: are there diagnostic
      clues?
AB  - We describe three patients with unilateral facial pain due to non-metastatic lung
      cancer and review 11 published cases. Pain, most frequently located on the right
      side and around the ear, as well as digital clubbing can be clues to an early
      diagnosis. Compression of the vagus nerve by the tumour or by mediastinal
      adenopathy is most likely responsible for the facial pain and could play a role
      in pulmonary osteoarthropathy.

PMID- 1623516
TI  - Nopp140 shuttles on tracks between nucleolus and cytoplasm.
AB  - Nopp140 is a nucleolar phosphoprotein of 140 kd that we originally identified and
      purified as a nuclear localization signal (NLS)-binding protein. Molecular
      characterization revealed a 10-fold repeated motif of highly conserved acidic
      serine clusters that contain an abundance of phosphorylation consensus sites for
      casein kinase II (CK II). Indeed, Nopp140 is one of the most phosphorylated
      proteins in the cell, and NLS binding was dependent on phosphorylation. Nopp140
      was shown to shuttle between the nucleolus and the cytoplasm. Shuttling is likely
      to proceed on tracks that were revealed by immunoelectron microscopy. These
      tracks extend from the dense fibrillar component of the nucleolus across the
      nucleoplasm to some nuclear pore complexes. We suggest that Nopp140 functions as
      a chaperone for import into and/or export from the nucleolus.

PMID- 1623517
TI  - Regulation of the cdc25 protein during the cell cycle in Xenopus extracts.
AB  - The cdc25 protein is a highly specific tyrosine phosphatase that triggers mitosis
      by dephosphorylating the cdc2 protein kinase. Using Xenopus extracts, we have
      found that the cdc25 protein is active at a low level throughout interphase. Near
      the onset of mitosis, the cdc25 protein undergoes a marked elevation in
      phosphatase activity that coincides with an extensive phosphorylation of the
      protein in its N-terminal region. In vitro dephosphorylation of this
      hyperphosphorylated form of cdc25 reduces its phosphatase activity back to the
      interphase level. Moreover, treatment of interphase Xenopus extracts with okadaic
      acid, a phosphatase inhibitor that accelerates the entry into mitosis, elicits
      both the premature hyperphosphorylation of cdc25 and the stimulation of its cdc2
      specific tyrosine phosphatase activity. These experiments demonstrate the
      existence of a cdc25 regulatory system consisting of both a stimulatory kinase
      that phosphorylates a putative regulatory domain of the cdc25 protein and an
      inhibitory serine/threonine phosphatase that counteracts this kinase activity.

PMID- 1623518
TI  - Ras-induced hyperplasia occurs with mutation of p53, but activated ras and myc
      together can induce carcinoma without p53 mutation.
AB  - Using a reconstituted mouse prostate organ, the effects on endogenous p53
      expression of the ras oncogene or of the ras + myc oncogenes were investigated.
      In this system the ras gene alone causes mild hyperplasia, but the combination of
      ras and myc leads to the formation of carcinomas. Surprisingly, while p53
      mutations were found in cells derived from the reconstituted organs containing
      ras alone, no such mutations were found in the ras + myc-transformed cells. Their
      growth, unlike that of the cells containing ras alone, was not inhibited by
      transfection with plasmids encoding wild-type human p53. We suggest that
      expression of both activated ras and myc genes bypasses the need for p53 mutation
      by neutralizing the tumor suppressor activity of normal p53.

PMID- 1623519
TI  - A role for RNAase MRP in mitochondrial RNA processing.

PMID- 1623520
TI  - The pie-1 and mex-1 genes and maternal control of blastomere identity in early C.
      elegans embryos.
AB  - During C. elegans embryogenesis an 8-cell stage blastomere, called MS, undergoes
      a reproducible cleavage pattern, producing pharyngeal cells, body wall muscles,
      and cell deaths. We show here that maternal-effect mutations in the pie-1 and mex
      1 genes cause additional 8-cell stage blastomeres to adopt a fate very similar to
      that of the wild-type MS blastomere. In pie-1 mutants one additional posterior
      blastomere adopts an MS-like fate, and in mex-1 mutants four additional anterior
      blastomeres adopt an MS-like fate. We propose that maternally provided pie-1(+)
      and mex-1(+) gene products may function in the early embryo to localize or
      regulate factors that determine the fate of the MS blastomere.

PMID- 1623521
TI  - Elicitor- and wound-induced oxidative cross-linking of a proline-rich plant cell
      wall protein: a novel, rapid defense response.
AB  - Treatment of bean or soybean cells with fungal elicitor or glutathione causes a
      rapid insolubilization of preexisting (hydroxy)proline-rich structural proteins
      in the cell wall. This insolubilization, which involves H2O2-mediated oxidative
      cross-linking, is initiated within 2 min and is complete within 10 min under
      optimal conditions, and hence, precedes the expression of transcription-dependent
      defenses. Cross-linking is also under developmental control during hypocotyl
      growth and in tissues subject to mechanical stress such as the stem-petiole
      junction. Stimulus-dependent oxidative cross-linking of wall structural proteins
      is a novel site of cellular regulation with potentially important functions in
      cell maturation and toughening of cell walls in the initial stages of plant
      defense.

PMID- 1623522
TI  - Cell death and control of cell survival in the oligodendrocyte lineage.
AB  - Dead cells are observed in many developing animal tissues, but the causes of
      these normal cell deaths are mostly unknown. We show that about 50% of
      oligodendrocytes normally die in the developing rat optic nerve, apparently as a
      result of a competition for limiting amounts of survival signals. Both platelet
      derived growth factor and insulin-like growth factors are survival factors for
      newly formed oligodendrocytes and their precursors in culture. Increasing
      platelet-derived growth factor in the developing optic nerve decreases normal
      oligodendrocyte death by up to 90% and doubles the number of oligodendrocytes in
      4 days. These results suggest that a requirement for survival signals is more
      general than previously thought and that some normal cell deaths in nonneural
      tissues may also reflect competition for survival factors.

PMID- 1623523
TI  - Two distinct members of the ADP-ribosylation factor family of GTP-binding
      proteins regulate cell-free intra-Golgi transport.
AB  - We have used an intra-Golgi transport assay to identify GTP-binding proteins
      involved in regulation of protein traffic. Two soluble proteins of 20 kd were
      purified by their ability to mediate GTP gamma S-dependent inhibition of
      transport. These GTP-dependent Golgi binding factors, or GGBFs, exhibit a 3-fold
      difference in activity and are differentiated by their hydrophobicity,
      isoelectric points, and apparent size. Removal of 80% of GGBFs from cytosol
      abolishes GTP gamma S sensitivity but does not affect inhibition by aluminum
      fluoride. We demonstrate that GGBFs are members of the ADP-ribosylation factor
      (ARF) family. Recombinant ARF1 exhibits GGBF activity and myristoylation is
      required. The distinct biochemical properties of GGBFs indicate that members of
      the ARF family may have related but distinct functions in intracellular
      transport.

PMID- 1623524
TI  - An actin-binding site containing a conserved motif of charged amino acid residues
      is essential for the morphogenic effect of villin.
AB  - The actin-binding protein villin induces microvillus growth and reorganization of
      the cytoskeleton in cells that do not normally produce this protein. Transfection
      of mutagenized villin cDNAs into CV-1 cells was used to show that a conserved,
      COOH-terminally located cluster of charged amino acid residues (KKEK) is crucial
      for the morphogenic activity of villin in vivo. In vitro experiments with a 22
      amino acid synthetic peptide corresponding to this region of villin provide
      evidence that this motif is part of an F-actin-binding site that induces G-actin
      to polymerize. Chemical cross-linking of actin to this peptide, the effects of
      amino acid substitutions in peptides, and the behavior of villin variants further
      corroborate the participation of the KKEK sequence in actin contacts.

PMID- 1623525
TI  - A novel transforming protein (SHC) with an SH2 domain is implicated in mitogenic
      signal transduction.
AB  - A new SH2-containing sequence, SHC, was isolated by screening cDNA libraries with
      SH2 representative DNA probes. The SHC cDNA is predicted to encode overlapping
      proteins of 46.8 and 51.7 kd that contain a single C-terminal SH2 domain, and an
      adjacent glycine/proline-rich motif with regions of homology with the alpha 1
      chain of collagen, but no identifiable catalytic domain. Anti-SHC antibodies
      recognized three proteins of 46, 52, and 66 kd in a wide range of mammalian cell
      lines. These SHC proteins complexed with and were phosphorylated by activated
      epidermal growth factor receptor. The physical association of SHC proteins with
      activated receptors was recreated in vitro by using a bacterially expressed SHC
      SH2 domain. NIH 3T3 mouse fibroblasts that constitutively overexpressed SHC
      acquired a transformed phenotype in culture and formed tumors in nude mice. These
      results suggest that the SHC gene products couple activated growth factor
      receptors to a signaling pathway that regulates the proliferation of mammalian
      cells.

PMID- 1623526
TI  - Dentistry in paradise.

PMID- 1623528
TI  - Pro bono treatment as a marketing tool.

PMID- 1623527
TI  - The non-complying patient.

PMID- 1623529
TI  - A comprehensive approach to restorative dentistry.

PMID- 1623531
TI  - Confronting the AIDS issues.

PMID- 1623530
TI  - Sales transition for the retiring dentist.

PMID- 1623532
TI  - Tooting the profession's horn by taking dentistry to the airwaves.

PMID- 1623533
TI  - Legal aspects of the doctor-patient relationship.

PMID- 1623534
TI  - Patient retention.

PMID- 1623535
TI  - Hiring the best.

PMID- 1623536
TI  - Miracle on 87th street.

PMID- 1623537
TI  - Lasers in dentistry: soft tissue procedures.

PMID- 1623538
TI  - Lasers in dentistry: an overview.

PMID- 1623540
TI  - Periodontal regeneration.

PMID- 1623541
TI  - Seniors serving society and dentistry.

PMID- 1623539
TI  - Clinical applications of the law.

PMID- 1623542
TI  - Juliann S. Bluitt, DDS President 1992-93.

PMID- 1623543
TI  - Successful marketing on a shoestring: internal marketing.

PMID- 1623544
TI  - Treating periodontal pockets.

PMID- 1623545
TI  - The glass ceiling.

PMID- 1623546
TI  - Parents, children and dentistry.

PMID- 1623547
TI  - Productive staff meetings.

PMID- 1623548
TI  - A common sense approach to investing for income.

PMID- 1623549
TI  - Detection of Fc receptors for IgA on rat alveolar and peritoneal macrophages.
AB  - The presence of Fc receptors for IgA on alveolar macrophages was determined by
      rosette assay and immunogold labeling. IgA-mediated phagocytosis by alveolar
      macrophages was observed. Results of these assays were compared between rats
      receiving no treatment and those receiving long-term cortisone administration.
      Sheep erythrocytes coated with dextran and an IgA monoclonal antibody specific
      for the alpha 1,3 linkages of dextran bound to 16% of alveolar macrophages.
      However, peritoneal macrophages did not form rosettes with dextran-IgA-coated
      erythrocytes. Immunogold labeling by transmission electron microscopy revealed
      that most Fc receptors for IgA were found on the membrane of pseudopodia of
      activated alveolar macrophages. Long-term cortisone administration diminished the
      phagocytosis and phagocytic index of alveolar macrophages, thereby contributing
      to decreased host resistance to infection (e.g., Pneumocystis carinii pneumonia).

PMID- 1623550
TI  - Different time course patterns of local expression of delayed-type
      hypersensitivity to sheep red blood cells in mice.
AB  - The delayed-type hypersensitivity (DTH) reaction, a peripheral expression of cell
      mediated immunity is still a crucial in vivo immunological test. Nevertheless,
      the biological significance of its time course remains unclear. Thus, an
      exhaustive study of DTH was undertaken in mice immunized with increasing doses of
      sheep red blood cells (SRBC) inoculated intravenously (iv) or subcutaneously. The
      results showed that overall DTH reactions peaked at 18 hr except in mice iv
      immunized with the lowest doses (10(5) and 10(6)) and elicited at Day 4. The
      protracted DTH reaction was shown to be associated with an histological picture
      of tuberculin-type reaction. A part of the 18-hr DTH reaction is mediated by
      serum in mice inoculated with large doses of SRBC; nevertheless, numeration by
      limiting dilution analysis of circulating DTH cells showed that the frequency of
      these cells correlates with the 18-hr DTH level. The protracted DTH shown at 42
      and 48 hr, 4 days after immunization with 10(5) and 10(6) SRBC, could not be
      transferred in naive recipients with immune spleen cells; it was independent of
      the antigen life span and did not result from immunization modulation at the bone
      marrow level on recruitable cells.

PMID- 1623551
TI  - Genetic control of immune responses to the 18-kDa protein of Mycobacterium
      leprae. Different TH1 subsets may be involved in proliferative and delayed-type
      hypersensitivity responses.
AB  - In vitro and in vivo responses to the 18-kDa protein of Mycobacterium leprae have
      been analysed in different strains of mice. Lymphocytes from BALB/cJ (H-2d),
      BALB.B (H-2b), B10.BR (H-2k), and B10.M (H-2f) mice primed with 18-kDa protein
      yielded high T cell proliferative responses, while those from C57BL/10J (H-2b)
      mice yielded lower responses. Both H-2 and non-H-2 genes contributed to the
      magnitude of responsiveness. F1 mice from high and low responder strains showed
      high responsiveness to the 18-kDa protein. Supernatants from lymph node cell
      cultures prepared from 18-kDa protein-immunised BALB/cJ, B10.BR, and C57BL/10J
      mice contained IL-2 but no IL-4, indicating that activated T cells from both high
      and low responder mice were of a TH1 phenotype. Cell cultures from low responder
      C57BL/10J mice produced less IL-2 than those from high responders. The low
      responsiveness to the 18-kDa protein in proliferative assays might be due to a
      low frequency of antigen-specific T cells in the C57BL/10J mouse strain. BALB/cJ,
      C57BL/10J, and F1 (BALB/cJ x B10.BR) mouse strains were tested for in vivo DTH
      reactions to the 18-kDa protein. All strains, including C57BL/10J, were high DTH
      responders. Although DTH effector cells and 18-kDa protein-specific proliferative
      T cells belong to the TH1 subset, our data comparing high and low responder
      status indicate that distinct TH1 subpopulations are stimulated in response to
      the 18-kDa protein of M. leprae.

PMID- 1623552
TI  - The proportion of symmetric and asymmetric IgG antibody molecules synthesized by
      a cellular clone (hybridoma) can be regulated by placental culture supernatants.
AB  - The purpose of the present work was to establish whether the placenta is
      producing factors favoring an increased synthesis of asymmetric IgG antibodies
      which are known to assume a protective effect upon paternal antigens to which
      they largely are specific. In this way they can contribute to fetal survival in
      the maternal uterine environment. The hybridoma cell lines OKT8 (anti-CD8) and
      112B4 (anti-DNP) were used in this respect since they synthesized both symmetric
      and asymmetric molecules of the IgG2a and IgG1 subclasses, respectively, murine
      isotypes in which anti-paternal antibodies have been detected. The cells were
      cultured in RPMI 1640 medium supplemented with 10% BCS and different amounts (5,
      10, and 20%) of human placental supernatant. After incubation for 3 days at 37
      degrees C in a humid chamber containing 5% CO2 the cells were centrifuged and the
      antibodies were obtained from the culture medium by a purification procedure
      involving precipitation at 50% ammonium sulfate saturation followed by DEAE
      cellulose chromatography. Symmetric and asymmetric antibodies were separated by
      Con A-Sepharose affinity chromatography, the latter lectin retaining selectively
      only asymmetric IgG molecules. Both OKT8 and 112B4 hybridomas presenting a stable
      background synthesis of 15-17% of asymmetric antibodies have shown an increased
      level reaching 27-28% of these molecules in the presence of 5-10% placental
      supernatant added to the RPMI 1640 culture medium. These results clearly show
      that placental factors can up-regulate efficiently the synthesis of asymmetric
      IgG molecules of different isotypes secreted by plasma cells.

PMID- 1623553
TI  - Assembly of MHC class I molecules in ex vivo carcinoma cells induced by IFN-gamma
      or by a binding peptide.
AB  - It has been reported that the assembly of MHC class I molecules in mutagenized
      cell lines could be induced by specific binding peptides. We have now
      demonstrated that the defect in assembly between heavy and light chains of class
      I molecules naturally occurred in tumor cells of one spontaneous ovarian
      carcinoma detected by one-dimensional isoelectric focusing of immunoprecipitates
      with anti-monomorphic class I MAb (W6/32) and by immunostaining with free heavy
      chain and beta 2m-specific MAbs. In vitro treatment of the tumor cells with IFN
      gamma induced the assembly and surface expression of majority class I molecules
      (A2.1, B7, B15, Cw6, Cw7 out of A2.1, A2*, B7, B15, Cw6, Cw7). Moreover, assembly
      of A2 and Cw6 was induced by exposure of the tumor cells to a HLA A2-binding
      peptide K62 derived from influenza A matrix protein. Autologous blood T
      lymphocytes were activated in mixed lymphocyte-tumor cell culture (MLTC) by the
      IFN-gamma-treated but not by the unmanipulated tumor cells. Although activated
      lymphocytes damaged both IFN-gamma-treated and untreated tumor cells, the alpha
      class I MAb (W6/32) efficiently inhibited the lysis of IFN-gamma-treated targets,
      but not the untreated targets. These results indicate that the defect of MHC
      class I assembly may result in the escape of tumor cells from immune response.

PMID- 1623554
TI  - Transient down-regulation of PKC-zeta RNA following crosslinking of membrane IgM
      on WEHI-231 B lymphoma cells.
AB  - Regulation of protein kinase C (PKC) isoform mRNAs has been studied in the
      immature, murine B lymphoma WEHI-231 by the MAPPing protocol and by slot blot
      analysis of unamplified mRNA. This membrane IgM (mIgM)-positive cell line has
      been previously used as a model to study signal transduction by mIgM in immature
      B lymphocytes and the role of those signals in the induction of immune tolerance
      in the B cell compartment. Stimulation of the cells by anti-mu antibodies,
      phorbol ester, or Ca2+ ionophore caused growth arrest and death of the cells. IL
      4 and IL 5 slowed the growth of the cells. Of these stimuli, only anti-mu
      stimulation affected PKC mRNA levels. Anti-mu treatment caused a transient
      decrease in the amount of PKC-zeta isoform mRNA within 3 hr. Within 24 hr levels
      returned toward normal. Anti-mu had little or no effect on the expression of mRNA
      for the alpha, beta, delta, or epsilon isoforms of PKC. WEHI-231 cells do not
      express PKC-gamma. Although anti-mu treatment blocked progression of the cells
      from the G0/G1 stage into the S phase of cell cycle, viable sort selected cells
      in either the G0/G1 or the S/G2/M phases showed no clear difference in the
      expression of PKC-zeta message. Thus, there is not preferential regulation of
      expression of PKC-zeta during stages of the cell cycle. The results show that
      mIgM on WEHI-231 cells can transduce a signal that is not mediated by PKC or Ca2+
      mobilization alone. The signal causes transient, selective down-regulation of
      mRNA encoding the zeta PKC isoform.

PMID- 1623555
TI  - Persistence of lpr/lpr-derived IgG2a secreting B cells in normal----lpr/lpr adult
      radiation chimeras or lpr/lpr----normal kidney capsule chimeras.
AB  - Lethally irradiated MRL/lpr mice reconstituted with bone marrow stem cells from a
      normal mouse strain develop a state of split hematopoietic chimerism;
      erythrocytes, granulocytes, and macrophages are derived from the normal stem cell
      inoculum while the peripheral T lymphocytes are derived from radioresistant lpr
      host cells. Moreover, these mice have normal levels of serum IgM and IgG2a
      produced by radioresistant host B cells, even though they have relatively few
      sIgM+ B cells. In order to better understand the differentiation and regulation
      of B cells present in these chimeric mice, the current study was undertaken to
      localize and to assess the functional capacity of the lpr B cells producing the
      serum antibodies. Surface IgG2a+ cells could not be found in the spleen or lymph
      nodes of these mice, but large lymphocytes containing cytoplasmic IgG2 of host
      (lpr) allotype could be readily detected, even though they constituted less than
      1% of the total spleen population. The host-derived serum IgG2 and IgG2+ cells
      were even present in the spleens of "leaky" mice that had relatively normal
      numbers of donor-derived sIgM+ B cells. These lpr B cells secreted IgG2a antibody
      that bound ssDNA, but they could not respond to immunization with SRBC. These
      results indicate that the lpr-derived radioresistant B cells have a limited
      capacity for proliferation and are already committed to the memory lineage. The
      presence of similar B cells in normal mice transplanted with neonatal lpr/lpr
      spleen fragments suggests that lpr/lpr B cell development is inherently abnormal.

PMID- 1623556
TI  - Production of macrophage colony-stimulating factor (M-CSF) by human monocytes is
      differentially regulated by GM-CSF, TNF alpha, and IFN-gamma.
AB  - Macrophage colony-stimulating factor (M-CSF) stimulates the survival,
      proliferation, and differentiation of mononuclear phagocytes. In this study, the
      qualitative and relative quantitative ability of various cytokines to induce and
      to synergize in M-CSF production by monocytes was studied. GM-CSF and the
      phorbolester PMA were strong inducers of M-CSF m-RNA expression. This was
      correlated closely with the secretion of M-CSF protein as measured in the murine
      M-NFS-60 cell line bioassay. Both TNF alpha and IFN-gamma enhanced M-CSF message
      levels induced by GM-CSF, but only TNF alpha synergized with GM-CSF in the
      induction of M-CSF protein secretion. M-CSF transcripts induced by TNF alpha and
      IFN-gamma were much lower compared to those induced by GM-CSF and PMA and were
      not accompanied by the secretion of M-CSF protein. In addition, costimulation of
      cells with TNF alpha and IFN-gamma did not result in M-CSF production. Although M
      CSF did not induce its own message, it further enhanced M-CSF transcripts induced
      by GM-CSF. LPS also failed to induce M-CSF message or secretion. These results
      show that cytokines differ in their ability to induce or to synergize in the
      induction of biologically active M-CSF protein. They further demonstrate that M
      CSF message expression, induced by cytokines, does not always correlate with M
      CSF protein secretion.

PMID- 1623557
TI  - The unique killing of embryo-derived teratocarcinoma cells by nonactivated murine
      macrophages is not due to a lack of H-2 antigen expression.
AB  - It is well documented that activated macrophages, but not nonactivated ones, kill
      tumor cells in vitro without damaging normal cells. We, however, have previously
      shown that embryo-derived teratocarcinoma cells (F9, P19, PCC4) are efficiently
      killed by nonactivated macrophages as well as by activated ones. Whereas other
      tumor cells are killed extracellularly by macrophages, we found that F9
      teratocarcinoma cells are phagocytosed alive by macrophages and subsequently
      killed intracellularly by a process dependent on intact lysosomal function.
      Neither the H-2 antigens nor the mRNAs for the alpha-chain and beta 2
      microglobulin are detectable in embryo-derived teratocarcinoma cells. An obvious
      explanation for this unique killing is that the nonactivated macrophages
      recognize and kill these cells due to their lack of class I MHC antigen
      expression, assuming that class I MHC gene products on the target cells switch
      off the cytolytic machinery of nonactivated macrophages. Our present findings
      demonstrate that there is no correlation between H-2 antigen expression on tumor
      cells and their susceptibility to killing by macrophages. Retinoic acid
      differentiated F9 cells and P19 cells expressing H-2 antigen after exposure to
      MAF (IFN-gamma) were sensitive to the killing by nonactivated macrophages.
      Hybrids that arose from fusion of P19 teratocarcinoma cells with embryonal normal
      fibroblasts (C57BL/6), which displayed the morphology of embryonal carcinoma stem
      cells and expressed H-2 antigens, were also sensitive to the killing by
      nonactivated macrophages. On the other hand, the H-2-negative testicular 402AX
      teratocarcinoma cells and K1735P melanoma cells were both resistant to the
      killing by nonactivated macrophages. We concluded that the unique killing of
      embryo-derived teratocarcinoma cells by nonactivated murine macrophages is not
      related to a lack of H-2 antigen expression.

PMID- 1623558
TI  - Effect of priming with a thymus-independent antigen on susceptibility to B-cell
      tolerance.
AB  - The effects of priming on the susceptibility of B-cell subsets to tolerance
      induction have been tested in a model system in which anti-immunoglobulin (anti
      Ig) has been employed as a surrogate for tolerogen. T-cell-depleted B cells were
      primed in vitro with fluorescein or trinitrophenylated Ficoll (a thymus
      independent (TI) antigen) and then exposed overnight to anti-Ig to attempt to
      induce B-cell anergy. Primed cells were relatively resistant to this tolerance
      protocol and resistance was hapten specific. The dose response and kinetics
      suggested that this process was not due to receptor blockade or modulation, but
      was an active process. Moreover, this priming for resistance to tolerance was
      reproduced in vivo upon intraperitoneal treatment with haptenated Ficoll. Such in
      vivo priming for tolerance resistance was long-lasting and did not occur with a
      thymus-dependent priming protocol with fluoresceinated hemocyanin. These results
      are discussed in terms of TI priming to drive B cells into cycle and express
      novel functional and phenotypic properties.

PMID- 1623559
TI  - A nonspecific inhibitor of contact sensitivity elaborated by macrophages: genetic
      restriction in its production but not in its action.
AB  - It is known that macrophages armed with hapten-specific T suppressor factor (TsF)
      and then exposed to antigen (haptenized spleen cells) liberate a nonspecific
      inhibitor of the transfer of contact sensitivity (CS). This is called macrophage
      suppressor factor (MSF). This paper shows that MSF is only released when the
      source of the TsF and the haptenized spleen cells share the same I-J subregion.
      This is based on the comparison of B10.A(3R) and B10.A(5R) mice. In contrast, the
      action of MSF is antigen nonspecific and genetically unrestricted. In these
      respects it resembles the antigen-nonspecific inhibitor (nsTsF-1) made by the T
      acceptor cell when armed with TsF. However, it differs from nsTsF-1 in acting
      directly on the I-A- population which transfers contact sensitivity and not
      indirectly via I-A+ T cells. In vitro, MSF fails to inhibit the proliferative
      response of lymph node cells to specific antigen and their production of IL-3
      activity, IFN-tau, and IL-2. This indicates that MSF is not a global inhibitor of
      T cell activity. The finding that MSF inhibits systemic passive transfer of
      contact sensitivity, but has no effect on local passive transfer strongly
      supports the view that MSF affects the arrival of certain cells critical for the
      development of the reaction to the skin challenge site.

PMID- 1623560
TI  - Interferon-gamma stimulates lipid metabolism in human monocytes.
AB  - In nonactivated human monocytes, radiolabeled oleic, arachidonic, and palmitic
      acids are primarily incorporated into neutral lipids and phosphatidylcholine.
      Each of these fatty acids is also incorporated into phosphatidylethanolamine,
      phosphatidylserine, phosphatidylinositol, and sphingomyelin in characteristic
      proportions which do not differ between donors. The phospholipid head group
      precursors, choline and serine, are incorporated into phosphatidylcholine, and
      phosphatidylserine and serine is incorporated into phosphatidylethanolamine and
      sphingomyelin. The incorporation of these lipid precursors and the total lipid
      content of monocytes activated with interferon-gamma were compared to those of
      nonactivated monocytes. Fatty acid incorporation into interferon-gamma-activated
      monocytes was dramatically increased, particularly for palmitic acid. Palmitic
      acid incorporation into phosphatidylcholine, phosphatidylethanolamine,
      phosphatidylserine, phosphatidylinositol, and sphingomyelin was increased in
      activated cells by 167-387% at 2 hr and 215-274% at 4 hr compared to that of
      controls. The greatest increase in incorporation was for palmitic acid into
      sphingomyelin. Incorporation of arachidonic acid into phosphatidylinositol and
      serine into phosphatidylethanolamine was also increased in the interferon-gamma
      activated monocytes. The total lipid content of activated and nonactivated
      monocytes did not differ. These results suggest that IFN-gamma activation induces
      a short-term stimulation of phospholipid metabolism which does not alter the
      gross lipid composition. Such modifications of phospholipid metabolism may be
      important in signal transduction as well as an indication of functional changes
      in the membranes of activated macrophages.

PMID- 1623561
TI  - Interleukin 6 modulates c-sis gene expression in cultured human endothelial
      cells.
AB  - Human vascular endothelial cells secrete platelet-derived growth factor (PDGF)
      like polypeptides which may mediate some of the vascular effects in the
      inflammatory process. We have demonstrated that IL-6 caused a significant
      increase in the mRNA level of the c-sis gene (PDGF B chain) in cultured human
      endothelial cells. IL-1 alpha and IL-1 beta also increased c-sis mRNA transcripts
      after an extended incubation period and both cytokines acted synergistically with
      IL-6 in increasing c-sis expression. Tumor necrosis factor enhanced the
      accumulation of c-sis mRNA and interferon-gamma decreased its level. In the
      inflammatory process specific cytokines can modulate c-sis expression in human
      endothelial cells. Their subsequent production of PDGF-like polypeptides could
      stimulate cell migration and proliferation, and cause the release of vascular
      inflammatory mediators.

PMID- 1623562
TI  - In vivo synergistic effect of the immunomodulator AS101 and the PKC inducer
      bryostatin.
AB  - The immunomodulator AS101 has recently been found to have radioprotective
      properties when injected prior to sublethal and lethal doses of irradiation. In
      addition, this compound was found to protect mice from hemopoietic damage caused
      by sublethal doses of cyclophosphamide (CYP) and to increase the rate of survival
      of mice treated with lethal doses of CYP. AS101 was previously shown to exert a
      synergistic effect with the PKC-inducer bryostatin in cytokine secretion in
      vitro. The present studies were designed to evaluate the effects of in vivo
      combined treatment with AS101 and bryostatin on bone marrow and spleen
      cellularity and on the number of committed progenitors in the bone marrow at
      various points of time after their treatment with a sublethal dose of CYP or
      irradiation. In addition, the combined effect was tested on the survival of mice
      irradiated with a lethal dose of irradiation. Our data show the presence of
      synergism which greatly enhances the number of bone marrow and spleen cells 48 hr
      and 9 days after CYP treatment or irradiation. The combined effect was also
      demonstrated when bone marrow colony-forming units granulocyte-macrophage (CFU
      GM) progenitor cells were evaluated. Moreover, AS101 and bryostatin synergized in
      their protective effects against lethal damages of irradiation. These results
      strongly suggest that bryostatin, which lacks tumor-promoting activity, is a
      particularly good candidate in combination with AS101 for treatment in vivo in
      counteracting chemotherapy- or radiation-induced hematopoietic suppression or in
      generally improving the restoration of immune response under conditions involving
      immune or hemopoietic damage.

PMID- 1623563
TI  - Identification of functional T cell subsets and surface antigen changes during
      activation as they relate to RT6.
AB  - The functional and phenotypic heterogeneity of the rat peripheral T lymphocyte
      antigen RT6 has been examined. The in vivo popliteal graft-vs-host reaction
      (GvHR), in vitro MLR, and the generation and effector populations of cytotoxic T
      lymphocyte were used to examine the response of RT6-positive (RT6+) or -negative
      (RT6-) subsets of CD4 and CD8 T cells to alloantigen. T lymphocytes with the
      CD4+RT6+ surface phenotype are necessary and sufficient for inducing a strong
      GvHR. T lymphocytes with the CD4+RT6-, CD8+RT6+, and CD8+RT6- surface phenotypes
      do not contribute or induce a strong GvHR. Both the CD4+RT6+ and the CD4+RT6- T
      cells proliferate in the MLR assay. CTL precursors are a mixture of CD8+RT6+ and
      CD8+RT6- phenotypes, but only cells bearing the RT6- phenotype are potent CTL
      effector cells. Data presented in this paper also demonstrate that the RT6.1
      alloantigen, present on the majority of rat T cells, modulates on cortisone
      resistant thymocytes (CRT) and peripheral T cells. Although freshly isolated CRTs
      do not express the RT6.1 epitope, RT6+ cells develop when CRTs are placed into
      culture. Peripheral T cells that are RT6- will also become RT6+ in culture.
      Stimulation of T cell cultures with a mitogen causes the loss of the RT6.1
      antigen, as detected by the DS4.23 mAb. The effect is more pronounced in cultures
      of CRTs than peripheral T cells. Following a return to a nonactivated state, the
      T cells reexpress RT6. The loss and reexpression of RT6 may be related to
      activation and/or differentiation of T cells.

PMID- 1623564
TI  - Stimulation of interleukin-6 production by corticotropin-releasing factor.
AB  - Based on the immune-modulating properties of corticotropin-releasing factor
      (CRF), the effect of this peptide for interleukin-6 (IL-6) production was
      investigated. Using human peripheral blood mononuclear cells (MNC), the amount of
      bioactive IL-6 produced was significantly (P less than or equal to 0.05)
      increased by CRF (10(-10) to 10(-7) M range). However, the IL-6 production of
      lipopolysaccharide-treated MNC cultures was not modified. At concentrations of
      greater than or equal to 10 nM, CRF and two analogous peptides (Tyr-CRF and alpha
      helical CRF) elicited 16- to 21-fold stimulation of IL-6 production by MNC.
      Purified monocytes, but not purified lymphocytes, were the cells that responded
      to CRF action exhibiting nearly 19-fold stimulation at 100 nM concentration. The
      CRF-induced production of IL-6 cytokine by peripheral blood MNC may suggest a
      messenger role for this neurohormone in the feedback control of neuroendocrine
      immune circuitry.

PMID- 1623565
TI  - Role of uncultured human melanoma cells in the proliferation of autologous tumor
      specific cytotoxic T lymphocytes.
AB  - The role of uncultured melanoma cells in the proliferation of autologous tumor
      specific cytotoxic T lymphocytes (CTLs) was investigated. Uncultured autologous
      tumor cells by themselves induced modest, but significant, proliferation in 10 of
      13 (77%) CTL clones and in only two of nine non-CTL clones. Uncultured allogenic
      melanoma cells mostly failed to induce CTL proliferation. Autologous tumor
      induced CTL proliferation declined with increasing age of the culture. It did not
      correlate with IL-2 receptor-alpha expression or was not inhibited by addition of
      anti-IL-2 antibody to the culture. It was inhibited by pretreatment of tumor
      cells with anti-MHC class II, but not -MHC class I mAb. IL-2 alone was sufficient
      for the potent proliferation of five of nine CTL clones. In all these five CTL
      clones, autologous tumor cells suppressed IL-2-induced proliferation. The
      remaining four CTL clones, however, required both uncultured autologous melanoma
      cells and IL-2 for the proliferation. IL-4 or IL-6, in particular IL-6,
      facilitated IL-2-induced CTL proliferation, but not their cytotoxicity. In
      summary, uncultured melanoma cells by themselves induced modest levels of CTL
      proliferation in the context of MHC class II antigens, whereas they suppressed IL
      2-induced CTL proliferation in more than half of the clones.

PMID- 1623566
TI  - Adoptive transfer of the entire gld (generalized lymphoproliferative disease)
      syndrome in nude beige mice by a single gld thymocyte graft.
AB  - C57BL/6 nude beige mice (B6 nubq; no T cell, no NK activity) were used as
      recipients for the adoptive transfer of thymocytes from B6 gld mice (generalized
      lymphoproliferative disease) which are a model of systemic lupus erythematous.
      The [gld----nubg] chimeras showed several similarities with gld control mice
      including the T cell disorders (lymphoproliferation and Con A-response deficiency
      of splenocytes) and B cell disorders (hyperglobulinemia and elevated anti-single
      stranded DNA antibody titers). This suggests that the gld lymphoproliferative
      disorder has a thymic origin (and does not result from an abnormally extrathymic
      T cell development) and that the gld T cells have an essential role for the
      emergence of the disorders of both the T and B cells.

PMID- 1623567
TI  - Failure of signaling through a chimeric class I-immunoglobulin molecule expressed
      on the surface of transfected B lymphoma cells and cells of transgenic mice.
AB  - To test the possibility that the crosslinkage of molecules expressing a
      transmembrane region derived from the membrane form of the mu immunoglobulin
      heavy chain would be sufficient for signal transduction in B cells, a chimeric
      gene (Kk-mu) consisting of extracellular exons of the class I gene H-2Kk and the
      transmembrane and cytosolic exons of the mu constant region gene was introduced
      into WEHI-231 B lymphoma cells and into mouse blastocysts. A protein consistent
      with the predicted product of the Kk-mu gene was expressed in a transfected cell
      clone (S18) and in transgenic mice. Crosslinkage of Kk-mu protein with soluble,
      Sepharose-bound, or dextran-conjugated anti-H-2Kk antibodies failed to induce the
      accumulation of inositol phosphates or to elevate intracellular calcium
      concentrations in either S18 cells or B lymphocytes from transgenic mice.
      Furthermore, crosslinkage of Kk-mu did not inhibit growth of S18 cells or
      stimulate DNA synthesis by transgenic B cells, in the presence or absence of
      interleukin-4. The failure of crosslinkage of Kk-mu to initiate detectable
      intracellular biochemical change or to effect cellular growth suggests that
      simple crosslinkage of molecules expressing the mu transmembrane region is not
      sufficient to transduce signals in B cells.

PMID- 1623568
TI  - Joseph Discipio is Alumnus of the Year.

PMID- 1623569
TI  - Respiratory system mechanics in patients treated with isotonic or hypertonic NaCl
      solutions.
AB  - Twenty-one patients who underwent elective surgery for coronary artery bypass
      were studied right after chest wall closure. They were anesthetized, paralyzed,
      and artificially ventilated with a constant-flow ventilator. Airflow, changes in
      lung volume, and tracheal pressure were measured. Respiratory system resistance
      (Rrs,max) was partitioned into its homogeneous (Rrs,min) and uneven (Rrs,u)
      components. Respiratory system elastance (Ers) was also measured. The subjects
      were randomly divided into two groups injected with test solutions just after
      chest wall closure: eleven patients received isotonic saline (0.9% NaCl
      solution), whereas the remaining ten were injected with hypertonic saline (7.5%
      NaCl solution). In all patients, mechanical parameters were measured at six
      different times: just before infusion, at 5 and 10 min (end of infusion); and at
      15, 20, and 25 min after beginning of injection. No statistically significant
      differences were observed in respiratory system mechanical parameters between
      groups or between different times within each group. Our data suggest that
      hypertonic saline infusion does not result in significant changes in respiratory
      system mechanics in patients submitted to coronary artery bypass.

PMID- 1623570
TI  - Relationship between changes in serum estrone levels and outcome in human males
      with septic shock.
AB  - The effect of septic shock on the production of estrogens, other steroid
      hormones, and gonadotropins in men was investigated. Two groups of male patients
      in the early septic shock were studied over 3 days following their admission to
      the Intensive Care Unit. Group I (n = 9) patients recovered and group II (n = 6)
      patients died. The simplified acute physiological score was 13.5 +/- 1.5 for
      group I and 21.2 +/- 2.3 for group II (P less than .05). In group I patients,
      estrogen levels (particularly E1) were high on day 1 and decreased progressively
      (day 1: 3,515 +/- 884 pmol/L, day 2: 2,450 +/- 292 pmol/L, and day 3: 1,043 +/-
      255 pmol/L). In group II patients, estrone levels were as high as in group I on
      day 1, but increased throughout the 3 days (day 1: 3,250 +/- 1,200 pmol/L, day 2:
      4,495 +/- 930 pmol/L, and day 3: 6,123 +/- 966 pmol/L). There were few changes in
      gonadotropins and other steroid hormones, except that the testosterone levels
      were below normal in both patient groups, while cortisol was elevated in group
      II. The changes in serum E1 may provide an accurate marker of individual outcome.

PMID- 1623571
TI  - ATP-MgCl2 restores the depressed cardiac output following trauma and severe
      hemorrhage even in the absence of blood resuscitation.
AB  - A number of beneficial effects of ATP-MgCl2 administration have been demonstrated
      in preheparinized models of shock and ischemia. However, it is not known whether
      ATP-MgCl2 restores and maintains the depressed cardiac output in a nonheparinized
      model of trauma and severe hemorrhage in which resuscitation following shock was
      provided only with crystalloid. To study this, rats underwent a midline
      laparotomy (i.e., trauma induced) and were then bled to and maintained at a mean
      arterial pressure of 40 mm Hg until 40% of the maximum shed blood volume was
      returned in the form of Ringer's lactate (RL). Animals were then resuscitated
      with 4 times the volume of shed blood with RL (4 X RL) during and following which
      ATP-MgCl2 (50 mumol/kg body weight each or an equivalent volume of normal saline)
      was infused intravenously. Cardiac output was determined every 15-30 min for 4.5
      hr, using an in vivo hemoreflectometer and indocyanine green dilution technique.
      Resuscitation with 4 X RL transiently restored but did not maintain cardiac
      output; however, ATP-MgCl2 treatment restored and maintained cardiac output at
      control values. ATP-MgCl2 infusion also significantly decreased total peripheral
      resistance and attenuated tissue water content. Thus, ATP-MgCl2 appears to be a
      promising adjunct to the treatment of trauma-hemorrhage even in the absence of
      blood resuscitation.

PMID- 1623572
TI  - Differentiation of the anti-shock effect of ulinastatin from steroid hormone, by
      the continuous observation of microcirculation dynamics.
AB  - The effects of ulinastatin (UST) and methyl prednisolone (MPS) on endotoxin
      induced shock were compared by the criterion of microcirculation dynamics in rat
      mesenterium and plasma phospholipase A2 (PLA2) activity in modified Shwartzman
      reaction model. The mean arterial pressure and red cell velocity were well
      maintained when MPS was administered during endotoxin induced shock. In the case
      of UST, superior anti-shock effects, indicated by reduced vasoconstriction, were
      obtained when it was administered prior to endotoxin induced shock. The anti
      shock effect of UST, similar to MPS, was supported by the change of serum PLA2
      activity. Therefore, concerning the administration timing of anti-shock drugs,
      MPS should be administered after shock occurs, and UST is most effective as a
      prophylactic treatment. UST has an anti-shock effect like steroid hormone.

PMID- 1623573
TI  - Effects of hepatic inflow occlusion on changes in plasma potassium, histamine,
      and norepinephrine in rats.
AB  - To evaluate the effects of hepatic inflow occlusion without the shunt, the
      physiological differences were compared in three groups of rats in which the
      hepatoduodenal ligament was occluded for 15 min, 30 min, and 60 min. The survival
      rate significantly decreased in the 60 min occlusion group (53.6%) when compared
      with that of the 15 min and 30 min occlusion groups (95% and 91.6%,
      respectively). The significant differences in the changes in blood pressure (BP),
      the values of plasma potassium, histamine (HIS), norepinephrine (NE), aspartate
      aminotransferase (AST), alanine aminotransferase (ALT), and the values of
      hematocrit (HT) were also observed between the 30 min and 60 min occlusion
      groups. The results indicate that, in rats, there is a high probability of an
      irreversible state to shock after 30 min hepatic inflow occlusion when veno
      venous bypass is not applied. The values of plasma HIS and NE and the values of
      HT in portal blood were significantly greater than those in the general
      circulation. The results suggest that splanchnic congestion may have a greater
      influence than hepatic ischemia has in contributing to the deterioration of the
      physiological state.

PMID- 1623574
TI  - A nonlethal intravenous dose of endotoxin influences opsonized zymosan-stimulated
      [32P]phospholipid turnover in rat alveolar macrophages.
AB  - The opsonized zymosan-stimulated turnover of 32P-labeled phospholipids was
      examined in alveolar macrophages from rats 3 hr after intravenous administration
      of saline or a nonlethal dose of endotoxin. Stimulation resulted in increased
      incorporation of [32P]PO4 into phosphatidic acid and phosphatidylinositol. Also a
      decreased [32P]phosphatidylcholine and an increased [32P]lysophosphatidylcholine
      labeling were observed, suggesting an increased activity of phosphatidylcholine
      specific phospholipase A2. Endotoxin attenuated these changes in 32P-labeled
      phospholipids, demonstrating the ability of a nonlethal dose of endotoxin to
      perturb phospholipid-dependent signal transduction mechanisms in cells isolated
      from a compartment other than the one in which endotoxin was administered.

PMID- 1623575
TI  - Pharmacotherapy in shock syndromes: the neglected field of pharmacokinetics and
      pharmacodynamics.
AB  - Promising effects of adjuvant drugs in experimental shock models often are not
      confirmed in subsequent clinical trials, e.g., steroids, fibronectin, naloxone,
      immunotherapeutics. A key difficulty in establishing a therapeutic benefit in
      clinical studies, apart from study design shortcomings, is the lack of knowledge
      and application of principles of clinical pharmacokinetics and -dynamics. In
      shock states the relationship between an administered fixed dose regimen and the
      drug effect is strongly influenced by dynamic changes in absorption,
      distribution, metabolism, and elimination of the drug, all of which vary between
      individual patients. This article describes several neglected aspects of clinical
      pharmacology relevant to shock research under clinical conditions and discusses
      the indications, prerequisites, and limitations of "applied pharmacokinetics."
      The inclusion of therapeutic drug monitoring in clinical shock studies should be
      applied more frequently to establish experimental results in the "real world" of
      ICU settings.

PMID- 1623577
TI  - The Shock Society. Directory.

PMID- 1623576
TI  - Shock Society, 15th Annual Conference on Shock. Alabama, June 7-10, 1992.
      Abstracts.

PMID- 1623578
TI  - Semi-automated assay of erythrocyte Cu-Zn superoxide dismutase activity.
AB  - A semi-automated enzymatic colorimetric method for determining Cu-Zn superoxide
      dismutase (SOD) in erythrocytes using an FP9 parallel analyzer is described. The
      method is based on the reaction described by McCord and Fridovich
      (xanthine/xanthine oxidase, ferricytochrome C), which permits kinetic
      measurements to be determined colorimetrically for the assay of enzyme activity.
      The coefficients of variation for within- and between-run analyses were less than
      6%. The limit of linearity is 3.5-times the mean value of the normal range while
      recovery of added SOD ranged from 91 to 120%. The method, which is both reliable
      and simple, allows rapid, simultaneous measurements of multiple samples.

PMID- 1623579
TI  - Role of serum fasting gastrin in screening for hypergastrinemic syndromes in
      duodenal ulcer disease.
AB  - Basal serum gastrin levels were measured in 237 patients with endoscopically
      confirmed duodenal ulcer and were higher than normal in 16 cases. Protein meal
      gastrin stimulation was performed on this group of 16 patients and on a control
      group of 48 patients with normal basal gastrin concentrations but high rates of
      either ulcer recurrence or of complications (e.g., bleeding or perforation); 21
      patients from the two groups were also tested for serum gastrin inhibition with
      secretin. Four cases (25%) of antral G-cell hyperfunction were found in the first
      group, plus 1 case compatible with Zollinger-Ellison syndrome (6.2%). Only 1 case
      (2%) of antral G-cell hyperfunction was found among the 48 controls. These
      results suggest the clinical utility of routine basal gastrin measurement in
      screening for hypergastrinemic patients with duodenal ulcer disease.

PMID- 1623580
TI  - The biochemistry of mammalian senescence.
AB  - Senescence is a process which, until quite recently, has been the subject of
      little scientific investigation. Even the word "senescence" is difficult to
      define, and complex methodological pitfalls have impeded progress. In the past
      few years, there have been exciting advances in understanding the physiological,
      cell biological, biochemical, and molecular biological nature of senescence.
      Changes in membrane function, protein synthesis, DNA structure (including
      glycosylation, altered tertiary structure, free-radical effects, and loss of
      telomeric DNA), and changes in gene regulation with age are reviewed. Recent work
      on changes in responses to transcriptional regulatory proteins and cellular
      senescence factors, some of which have been identified, is particularly promising
      and leads to the conclusion that senescence, at least in part, is a programmed
      process. Despite these advances, the fundamental cause of senescence remains
      elusive but might, as in the case of other biological processes which are
      phylogenetically widespread, turn out to be quite simple, and perhaps, even
      modifiable.

PMID- 1623581
TI  - Antibody multispecificity in immunoassay interference.
AB  - Recent findings indicate that many endogenous antibodies exhibit
      multispecificity. These antibodies exhibit a potential for interference with
      immunoassays. Antibodies that interfere with immunoassays have been called
      heterophile or heterophilic antibodies. The purpose of this review is: (1) to
      identify the nature of heterophile antibodies; (2) to delineate the processes
      that produce them; (3) to examine the mechanisms by which these antibodies cause
      interference; and (4) to explore how this information can be used to reduce
      immunoassay interference. In addition to producing specific antibodies, the
      process of antibody production gives rise to rudimentary antibodies that are
      polyspecific; e.g., the antigen-combining site has an affinity for antigens of
      different chemical composition. This process also generates idiotypic antibodies
      containing cross-reactive idiotopes. These antibodies along with rheumatoid
      factors, which are themselves polyspecific and rich in cross-reactive idiotopes,
      are inherent parts of the process of antibody production, and exhibit
      multispecificity. Mechanisms by which these antibodies cause immunoassay
      interference are outlined. These properties of antibodies may have substantial
      consequence in directing future assays toward greater clinical predictive value.

PMID- 1623582
TI  - Clinical usefulness of high-pressure liquid chromatographic determination of
      serum pentamidine in AIDS patients.
AB  - We have developed a reproducible HPLC method to determine serum pentamidine,
      which demonstrates good chromatographic performance, and is sensitive enough to
      measure therapeutic doses. Pentamidine is first extracted from serum by passage
      through a C-18 extraction cartridge. Potential interfering substances are then
      removed by washing with 100% methanol. Pentamidine is eluted from the extraction
      cartridge with 1-heptanesulfonic acid. The extract is chromatographed on a highly
      deactivated column for basic compounds in the presence of minimal concentrations
      of 1-heptanesulfonic acid as the pairing agent. Detection is by fluorescence. The
      method can determine serum pentamidine levels in the range of 15-600 ng/mL free
      of interference from other drugs. In monitoring pentamidine levels in AIDS
      patients with Pneumocystis carinii, we found that trough serum levels over 100
      ng/mL were associated with toxicity (hypoglycemia or azotemia) in 100% of
      patients. With levels under 100 ng/mL, signs of toxicity were observed in only
      29% of the patients. We conclude that dose adjustment based on serum levels
      reduces the incidence of toxicity and enhances pentamidine therapy.

PMID- 1623583
TI  - 1992 Clinical Chemistry Forum: Government regulation: can it guarantee quality in
      the clinical laboratory? Bethesda, Maryland, November 18-19, 1991.

PMID- 1623584
TI  - The history of proficiency testing/quality control.
AB  - The history and origins of proficiency testing of clinical laboratories are
      reviewed. Since the introduction of proficiency testing in the late 1940s,
      dramatic improvement in laboratory performance has been demonstrated.
      Nonetheless, the poor performance found two decades earlier was summoned to
      support the passage of the Clinical Laboratory Improvement Act of 1967 (CLIA
      '67).

PMID- 1623585
TI  - How good are clinical laboratories? An assessment of current performance.
AB  - The Clinical Laboratory Improvement Act of 1967 and Amendments of 1988 (CLIA '67
      and CLIA '88) were enacted to ensure that clinical laboratories within the U.S.
      provide a quality of service that meets clinical needs for good patient care.
      Approved proficiency-testing programs are to judge the quality of laboratory
      testing by promulgated performance criteria. We examine the quality of analytical
      results reported in 1991 to the New York State Department of Health Proficiency
      Testing program in light of these criteria and analytical goals, based on medical
      usefulness. Analytical performance is examined for cholesterol, potassium,
      sodium, calcium, glucose, aspartate aminotransferase, digoxin, and theophylline.
      In general, proposed CLIA '88 performance standards are compatible with the
      current state of practice for the population of laboratories examined. Exceptions
      appear to be digoxin and sodium (failure rate exceeding average) and most
      therapeutic substances (low failure rate). Sources of analytical bias relative to
      an accuracy-based target value must be characterized as method-, laboratory-, or
      matrix-dependent if regulatory programs are to achieve the objective of improving
      analytical accuracy across all testing sites.

PMID- 1623586
TI  - Charts of operational process specifications ("OPSpecs charts") for assessing the
      precision, accuracy, and quality control needed to satisfy proficiency testing
      performance criteria.
AB  - "Operational process specifications" have been derived from an analytical quality
      planning model to assess the precision, accuracy, and quality control (QC) needed
      to satisfy Proficiency Testing (PT) criteria. These routine operating
      specifications are presented in the form of an "OPSpecs chart," which describes
      the operational limits for imprecision and inaccuracy when a desired level of
      quality assurance is provided by a specific QC procedure. OPSpecs charts can be
      used to compare the operational limits for different QC procedures and to select
      a QC procedure that is appropriate for the precision and accuracy of a specific
      measurement procedure. To select a QC procedure, one plots the inaccuracy and
      imprecision observed for a measurement procedure on the OPSpecs chart to define
      the current operating point, which is then compared with the operational limits
      of candidate QC procedures. Any QC procedure whose operational limits are greater
      than the measurement procedure's operating point will provide a known assurance,
      with the percent chance specified by the OPSpecs chart, that critical analytical
      errors will be detected. OPSpecs charts for a 10% PT criterion are presented to
      illustrate the selection of QC procedures for measurement procedures with
      different amounts of imprecision and inaccuracy. Normalized OPSpecs charts are
      presented to permit a more general assessment of the analytical performance
      required with commonly used QC procedures.

PMID- 1623587
TI  - Proficiency testing as a regulatory device: a CAP perspective.
AB  - The history and development of the proficiency testing programs of the College of
      American Pathologists are reviewed. Important considerations of external surveys
      include target value assignment and determination of acceptable ranges. "Blind"
      proficiency testing and on-site evaluation provide alternative methods of
      laboratory evaluation but are limited by practical logistics.

PMID- 1623588
TI  - Limitations of proficiency testing under CLIA '67.
AB  - Proficiency testing (PT), recognized as a quality-assurance (QA) and quality
      improvement tool, also has become the cornerstone of the Health Care Financing
      Administration's (HCFA) regulatory strategy under the revised Clinical Laboratory
      Improvement Act of 1967 (CLIA '67) and the proposed Clinical Laboratory
      Improvement Amendments of 1988 (CLIA '88). Use of PT as a regulatory tool
      corrupts it for things it can do better. PT as a primary regulatory strategy has
      severe limitations. We explore the nature of these limitations and their
      implications for clinical laboratories as they impact on the long-term success of
      HCFA's approved regulatory PT programs in 1991 and beyond, and CLIA '88 PT, which
      is to be implemented in 1994.

PMID- 1623589
TI  - Regulation of proficiency testing under the March 14 rule.

PMID- 1623590
TI  - Review of actual proficiency-testing performance under CLIA '67 (March 14, 1990)
      rules: perspective from the first year's data.
AB  - Under the Clinical Laboratory Improvement Act of 1967 the Health Care Financing
      Administration's proficiency-testing requirement applies to approximately 12,000
      hospital, reference, and large-clinic laboratories in the United States. The
      Wisconsin State Laboratory of Hygiene is approved by the Health Care Financing
      Administration to provide proficiency testing in all specialties and
      subspecialties. The focus of the program is to provide highly specialized service
      and support to a limited number of participants in order to assess
      intralaboratory performance correctly. We report the findings over the four
      proficiency-testing events in 1991 for the subspecialty of routine chemistry,
      which serves approximately 470 participants. Failure rates for individual
      analytes on single proficiency testing events ranged from 0% to 13%. After four
      events or one year, if the mandated evaluation criteria and failure rules were
      strictly applied, as many as 11% of the laboratories could have found themselves
      involuntarily suspended from offering all routine chemistry testing.

PMID- 1623591
TI  - Proficiency testing linked to the national reference system for the clinical
      laboratory: a proposal for achieving accuracy.
AB  - I propose using proficiency testing (PT) to achieve one of the important goals of
      CLIA: accurate and reliable clinical testing. Routine methods for the clinical
      laboratory are traceable to Definitive (DM) or Reference Methods (RM) or to
      Methodological Principles (MP) through a modification of the National Reference
      System for the Clinical Laboratory. PT is the link used to monitor consistent
      field performance. Although PT has been effective as a relative measure of
      laboratory performance, the technical limitations of PT fluids and of routine
      methods currently in use make it unlikely that PT alone can be used as a reliable
      measure of laboratory accuracy. Instead, I recommend calibration of routine
      systems through correlation to DM, RM, or MP with use of patients' specimens. The
      manufacturer is in the best position to assume this responsibility because of
      also being responsible for consistent, reliable product. Analysis of different
      manufactured batches of reagent would be compared with predetermined goals for
      precision and accuracy, as illustrated with data from product testing of Kodak
      Ektachem clinical chemistry slides. Adoption of this proposal would give
      manufacturers of PT materials, manufacturers of analytical systems, PT providers,
      and government agencies time to understand and resolve sources of error that
      limit the utility of PT for the job required by law.

PMID- 1623592
TI  - The impact of new regulations on laboratory testing in physicians' offices.
AB  - The reaction of the clinician to the specter of regulation of any part of his or
      her practice mirrors the reaction of the laboratorian to the implementation of
      Medicare and Clinical Laboratory Improvement Amendments legislation in 1965 and
      1967, respectively. Whether the regulatory burdens that will be visited upon
      these laboratories are justified or necessary is arguable; the fact of the
      upcoming regulation is not. The volume and breadth of testing in physicians'
      office laboratories (POLs) has increased exponentially since passage of the
      Diagnosis Related Group legislation by Congress in 1983, an increase made
      possible by remarkable developments in technology. State regulatory initiatives
      and private accrediting agencies have been perceived as being inadequate to
      prevent the proliferation of poorly controlled testing in the nontraditional
      laboratory environment. The testing menu of a given POL varies according to the
      scope of clinical services offered; the size of the practice group; the funding
      available for equipment and personnel acquisition; and the general availability
      of hospital, reference, and consultative laboratory services. Physicians who
      offer laboratory services as part of their practices must now prepare their
      laboratories to meet whatever requirements are mandated by regulation. This will
      include acquisition of trained personnel, improvement of instrumentation and
      methodologies, participation in proficiency testing, establishment of
      comprehensive quality-assurance programs, and adequate documentation of
      laboratory services. Organized medicine should devote its energies to assisting
      with needed educational processes to assure the survival of POLs.

PMID- 1623593
TI  - The impact of legislation on future technology development.
AB  - In this paper I examine some of the factors influencing technology development
      and attempt to explain whether CLIA '88 enhances the opportunities or exacerbates
      the problems for U.S.-based technology development. The viewpoint I express is
      concentrated on the clinical chemistry segment of the diagnostics arena.

PMID- 1623594
TI  - Dependence of free thyroxine estimates obtained with equilibrium tracer dialysis
      on the concentration of thyroxine-binding globulin.
AB  - Some equilibrium dialysis determinations of free thyroxine (T4) vary directly
      with thyroxine-binding globulin (TBG) concentration. This apparent TBG dependence
      has been limited to methods involving radiolabeled T4 added to the dialysis
      system (tracer dialysis). In this study we compared tracer dialysis with direct
      dialysis for determining free T4 and obtained the following results (mean +/- SD)
      for patients with hypothyroxinemia of nonthyroidal illness (23.8 +/- 10.7 vs 24.2
      +/- 10.9 pmol/L, P greater than 0.8), patients with congenital TBG deficiency
      (11.4 +/- 2.2 vs 16.2 +/- 7.1 pmol/L, P greater than 0.05), normal control
      subjects (32.7 +/- 6.5 vs 18.5 +/- 5.8 pmol/L, P less than 0.001), and pregnant
      women (31.2 +/- 8.7 vs 12.1 +/- 2.6 pmol/L, P less than 0.001). Direct dialysis
      determinations were independent of TBG and total T4. Tracer determinations were
      greater than direct determinations in normals, a discrepancy that increased in
      pregnancy. Tracer determinations correlated significantly with total T4 and TBG
      concentrations (P less than 0.001). TBG and total T4 dependence in the tracer
      method was attributable to small overestimations of the free fraction of T4.
      Similar overestimations multiplied by increasing total T4 concentrations resulted
      in greater errors. Relative to results for normal sera, the tracer method
      overestimated free T4 when total T4 was increased and underestimated free T4 when
      total T4 was decreased.

PMID- 1623595
TI  - Failure of common glycation assays to detect glycation by fructose.
AB  - Serum albumin was modified by in vitro glycation with either fructose or glucose,
      to see whether the common clinical assays for glycation were able to detect both
      fructose- and glucose-induced changes in protein structure in diabetes. Although
      fluorescence measurements showed that fructose causes far more protein damage
      than glucose, neither serum fructosamine (SFA) nor phenylboronate affinity (PBA)
      glycation assays reflected these changes. The SFA method implied that fructose
      causes only about 5% of the glycation induced by glucose; with PBA the proportion
      was 25%. The thiobarbituric acid- and periodate-based assays also greatly
      underestimated the true extent of fructation. We discuss these discrepancies with
      respect to the underlying chemistry, emphasizing the difference between aldehydic
      and ketonic Amadori products (exemplified by fructose and glucose derivatives,
      respectively). The implications for detecting fructose-induced secondary diabetic
      complications are also discussed.

PMID- 1623596
TI  - Homocysteine export from erythrocytes and its implication for plasma sampling.
AB  - The concentration of free and total homocysteine in plasma increases in time if
      blood is stored uncentrifuged after sampling. The increase is temperature
      dependent and the maximal increase in total plasma homocysteine at 37 degrees C
      was 3.0 mumol.L-1.h-1. Even at 4 degrees C there is a substantial increase,
      particularly of free plasma homocysteine. Plasma glutathione, cysteinylglycine,
      and gamma-glutamylcysteine also show an increase in time if whole blood is
      stored, whereas cysteine decreases. We show that the erythrocytes are responsible
      for most of the increase in plasma homocysteine and suggest that homocysteine is
      derived from adenosylmethionine-dependent protein carboxymethylations in the
      cells. We conclude that strict sampling conditions are necessary when plasma
      homocysteine and especially its free fraction are assayed.

PMID- 1623597
TI  - Dynamic relation between reduced, oxidized, and protein-bound homocysteine and
      other thiol components in plasma during methionine loading in healthy men.
AB  - We used a newly developed procedure to determine reduced, oxidized, and protein
      bound forms of homocysteine, cysteine, cysteinylglycine, and glutathione to
      measure the plasma concentrations of these species during methionine loading in
      six young healthy men with normal fasting concentrations of plasma homocysteine
      and cysteine. The methionine loading induced a transient increase in total
      homocysteine, which peaked after approximately 6-8 h. All six subjects showed a
      concurrent significant increase in reduced homocysteine and cysteine, which
      peaked 2 h after loading, and a rapid decrease in protein-bound cysteine and
      cysteinylglycine. The concentration of reduced cysteinylglycine was not altered.
      Plots of protein-bound cysteine and cysteinylglycine vs total homocysteine formed
      hysteretic loops, showing a time-dependent relation between these analytes. After
      the initial decrease, protein-bound cysteine and cysteinylglycine showed a
      slight, transient increase. From 12 to 24 h after loading, protein-bound cysteine
      approached preloading concentrations in two subjects and declined further in four
      subjects. The response pattern was similar for cysteine and cysteinylglycine in
      each subject. Simple displacement could not account for these effects, which
      suggests that plasma homocysteine may affect the disposition of other thiols
      through complex mechanisms. The presence of reduced homocysteine and the dynamic
      relation that exists between homocysteine, cysteine, and related compounds in
      plasma should be taken into account when evaluating plasma homocysteine as an
      indicator or causative agent of human disease.

PMID- 1623598
TI  - Serum adenosine deaminase: isoenzymes and diagnostic application.
AB  - Human adenosine deaminase (ADA; EC 3.5.4.4) consists of three isoenzymes: ADA1,
      ADA1+CP, and ADA2. We developed an electrophoretic technique to distinguish
      between these three isoenzymes. The isoenzyme pattern was studied in tissue and
      cell homogenates, as well as in serum from normal subjects and from patients with
      increased serum ADA who had either hepatitis, infectious mononucleosis,
      tuberculosis, pneumonia, rheumatoid arthritis, or acute lymphoblastic leukemia
      (ALL). The highest ADA activity was found in lymphocytes and monocytes. ADA2
      could be detected only in monocytes (18% of total ADA activity). It was also the
      predominant isoenzyme in the sera of controls and all disease groups, except for
      ALL--the only condition evaluated that is not of an inflammatory nature. We
      conclude that serum ADA reflects monocyte/macrophage activity or turnover in most
      diseases studied. The exception is ALL, where serum ADA most probably originates
      from lymphocyte precursors.

PMID- 1623599
TI  - Temperature effects on free-thyroxine measurements: analytical and clinical
      consequences.
AB  - We compared the analytical and clinical performance of two free-thyroxine (FT4)
      assays--a solid-phase radioimmunoassay, Spectria, and a time-resolved
      fluoroimmunoassay, Delfia, both of them two-step methods--with the performance of
      a direct radioimmunoassay, Nichols, to measure FT4 concentration in equilibrium
      dialysate of undiluted serum. The three assays showed comparable analytical
      performance. We tested clinical utility in sera from 135 healthy subjects with
      and without thyroxine-binding abnormalities and in 61 patients with and without
      thyroidal illnesses. We found significant differences for FT4 measured by
      different assays in sera from the same euthyroid patients. To explain the
      differences, we studied the influence of temperature on performance and
      calibration. Most important was the neglected fact that the association constant
      for the binding of thyroxine to thyroxine-binding globulin decreases when the
      temperature rises from 20 to 37 degrees C, causing a doubling of FT4. The two
      step assays, if performed at room temperature without a well-defined calibration,
      can give misleading FT4 concentrations. This is the case when sera from patients
      with thyroxine-binding abnormalities are measured against kit standards, made up
      in normal human sera. If an assay is to reflect the in vivo FT4 concentration at
      body temperature in all types of samples, it should be performed at body
      temperature. For practical reasons 37 degrees C is recommended, and reference
      values should be defined at 37 degrees C. The same might be valid for other free
      hormone assays.

PMID- 1623600
TI  - Design and preliminary performance characteristics of a newly proposed reference
      cell for ionized calcium in serum.
AB  - A novel flow-through design for a calcium ion-selective liquid membrane and half
      cell is proposed. The membrane is based on a neutral carrier for calcium and has
      the same quantitative chemical composition as that used in most commercial
      analyzers for ionized calcium (iCa2+). The membrane and half-cell follow the
      specifications in the Stage 1, Draft 4 document for a Reference Method for iCa2+
      of the IFCC Expert Panel on pH, Blood Gases, and Electrolytes. Measurements of
      iCa2+ in serum with this cell confirm prior observations that protein adsorption
      on the membrane surface causes a rapid but reversible shift in the cell
      calibration signal and possible systematic errors in the measurement of iCa2+ in
      serum. When the protein adsorption phenomenon is maintained at equilibrium during
      calibrations and sample measurements, the new cell can be used to reproducibly
      assign iCa2+ concentrations to serum pools. These calibrated pools may then be
      used as reference materials and to resolve the biases known to exist among
      commercial iCa2+ analyzers.

PMID- 1623601
TI  - Changes in alkaline phosphatase and 5'-nucleotidase multiple forms after surgical
      management of biliary obstruction.
AB  - Serial measurements of alkaline phosphatase and 5'-nucleotidase multiple forms in
      two patients undergoing surgical procedures to release biliary obstruction
      suggested an inverse relationship between high-M(r) isoforms and serum bile acids
      concentrations. Furthermore, the study of several groups of patients with
      cholestatic disorders confirmed this inverse correlation. Mechanisms responsible
      for these observations are discussed.

PMID- 1623602
TI  - Measuring albumin and calcium in serum in a dual test with the Hitachi 704.
AB  - We describe a method for simultaneously determining albumin, by using bromcresol
      purple, and calcium, by using Arsenazo III, in the same analytical cuvette on the
      Hitachi 704. Both assays agree well with accepted procedures. The standard curves
      for the albumin and calcium assays are linear from 0 to 60 g/L and 0 to 5.0
      mmol/L, respectively. Calibration is stable for 7 days with use of open reagent
      in the instrument. Both assays are unaffected by hemoglobin less than or equal to
      5 g/L and Intralipid less than or equal to 4 g/L; calcium is unaffected by
      bilirubin less than or equal to 600 mumol/L.

PMID- 1623603
TI  - Interassay variability of immunometric methods for thyrotropin in an external
      quality assessment survey: evidence that functional sensitivity is not always
      adequate for clinical decisions.
AB  - We investigated the ability of current immunometric methods for thyrotropin (TSH;
      thyroid-stimulating hormone) to distinguish between low-normal and subnormal
      hormone concentrations by using the data from an external quality assessment
      (EQA) survey in 1990. We computed the interassay (between-run) precision profiles
      from results from 101 laboratories, which used the five most popular kits in the
      survey; during the control period (one year) each laboratory assayed 4 EQA pools
      distributed (as hidden replicates) in five occasions. The interassay CV was
      relatively low (9-13%) for three pools in the normal TSH range (greater than 0.8
      milli-int. unit/L) but markedly higher (30-40%, except for one more precise kit)
      in the subnormal range (0.2 milli-int. unit/L). We calculated the effect of the
      between-run variability on the diagnostic accuracy (discrimination between normal
      and subnormal values) for three representative TSH concentrations: 0.2, 0.4, and
      0.5 milli-int. unit/L (0.3 milli-int. unit/L was considered the lower normal
      limit). The three concentrations were reasonably discriminated (P less than or
      equal to 5%), and only one kit showed a between-run CV less than 18% at 0.2 milli
      int. unit/L. For the other four less-precise kits, only the higher TSH value (0.5
      milli-int. unit/L) could be classified with an acceptable diagnostic reliability.
      With the most precise kit, one can distinguish two TSH concentrations in the 0.3
      0.5 milli-int. unit/L range that differ by at least 30%; with the other kits,
      differences greater than 50-60% are needed for reliable discrimination. Thus many
      laboratories fail to achieve the functional sensitivity of a second-generation
      assay, even if they use immunometric methods. TSH assays with a better interassay
      precision in the low concentration range are needed.

PMID- 1623604
TI  - Detection of hepatitis B virus DNA in serum by a nonisotopic hybridization
      technique.
AB  - We developed a nonisotopic technique, Hepagene, for measuring hepatitis B virus
      (HBV) DNA in human serum by using a sulfonated probe that is detected by a
      sandwich immunoenzymatic reaction. The detection limit, determined by serum
      dilution tests, was 2.5 ng/L. The precision of the Hepagene test was demonstrated
      by the accurate reproducibility observed for low (3 ng/L) and medium (38 ng/L)
      concentrations of HBV DNA assayed in 24 different series. Specificity was
      established by assaying HBV DNA in sera from 98 patients by the Hepagene
      technique or by a solution hybridization assay with an 125I-labeled probe.
      Results by both techniques agreed for 94 sera (96%), with 68 being concordant for
      HBV DNA negativity and 26 for positivity. HBV DNA titers assayed by both methods
      also agreed. Hepagene represents the first nonisotopic HBV DNA assay involving a
      sulfonated probe and with performance characteristics equivalent to those of
      classical radioactive hybridization techniques.

PMID- 1623605
TI  - Effects of temperature on optical absorbance spectra of oxy-, carboxy-, and
      deoxyhemoglobin.
AB  - The optical absorbance spectra of oxy-, carboxy-, and deoxyhemoglobin were
      recorded at wavelengths from 479 to 651 nm and at temperatures of 20, 30, and 40
      degrees C. As noted in earlier reports, a major effect of lowering the
      temperature was an increase in the absorptivities at or near the absorbance
      maxima. However, at other wavelengths, reducing the temperature increased,
      decreased, or caused no change in absorbance. At wavelengths where temperature
      induced shifts did occur, the absorbance change appeared to be a linear function
      of temperature. Unlike previous reports, the data presented here are quantitative
      and thus can be used to predict temperature-induced errors in spectrophotometric
      measurements of the relative concentrations of these hemoglobin species. Examples
      are given of the error that would occur in a widely used CO-Oximeter, the IL482,
      if it were not temperature controlled. Thus, the data presented here should be
      particularly useful to the operators and designers of spectrophotometric
      instruments such as oximeters, CO-Oximeters, and hemoglobinometers.

PMID- 1623606
TI  - Testing for creatine kinase and creatine kinase-2 in Ontario: reference ranges
      and assay types.
AB  - In 1991, 246 and 136 Ontario laboratories performed total creatine kinase (CK; EC
      2.7.3.2) and creatine kinase-2 (CK-2) assays, respectively. A questionnaire
      mailed to these laboratories requested information about the types of assay used,
      the origin of their reference ranges, and the source of their instruments and
      reagents. All laboratories used current test formulations for CK, although seven
      laboratories did not assay at 37 degrees C. For CK, 69% of all laboratories
      reported different upper reference limits for men and women (5th-95th
      percentiles: 160-250 and 115-215 U/L, respectively); 31% reported similar ranges
      for both sexes. Fifty-six percent derived their own ranges; the remainder used
      either kit inserts or literature references, and nearly 60% of this latter group
      claimed to have validated these suggested ranges before use. For 6% of all
      laboratories, their pediatric ranges were similar to their adult ranges. For CK
      2, only 32% used their own reference range; the remainder used kit inserts or
      literature references, but only 49% of this group validated these ranges before
      use. Reference limits (5th-95th percentiles) for CK-2 were as follows: activity 6
      24 U/L; fraction of CK, 0.022-0.06; and, for mass assays, 5-10 micrograms/L and
      relative index 0.015-0.04.

PMID- 1623607
TI  - Colorimetric determination of potassium in plasma and serum by reflectance
      photometry with a dry-chemistry reagent.
AB  - We evaluated a colorimetric assay of potassium in plasma and serum with the
      Boehringer Mannheim Reflotron reflectance photometric analyzer, which is designed
      for near-patient testing in hospitals and physicians' offices. This potassium
      method does not require calibration or instrument maintenance by the operator.
      Analysis of 30 microL of plasma or serum takes approximately 140 s. Within-day
      imprecision (CV) was 1.0-1.2%. Total CVs over a 1-month period were 1.0-1.4%.
      Patients' results from the Reflotron correlated well with those from the IL 643
      flame photometer and the Beckman Synchron CX3 ion-selective electrode methods.
      The accuracy of Reflotron values was also verified with Standard Reference
      Material 956 from the National Institute of Standards and Technology.

PMID- 1623608
TI  - Sensitive, direct procedures for simultaneous determinations of iron and copper
      in serum, with use of 2-(5-nitro-2-pyridylazo)-5-(N-propyl-N
      sulfopropylamino)phenol (nitro-PAPS) as ligand.
AB  - We developed a direct, simple, and sensitive procedure for the simultaneous
      colorimetric assay of iron and copper in serum, using sodium dodecyl sulfate
      ascorbic acid to dissociate iron and copper from transferrin and ceruloplasmin,
      respectively. We also use a new water-soluble reagent, 2-(5-nitro-2-pyridylazo)-5
      (N-propyl-N-sulfopropylamino)phenol disodium salt (nitro-PAPS) and thioglycolic
      acid to eliminate interference from copper in the measurement of iron. Within-
      and between-run precisions of the present method were 2.5-2.8% for iron and 1.8
      4.6% for copper. The proposed method is susceptible to interference by hemoglobin
      and lipemia, especially for the iron assay. Linear-regression analyses of results
      of the proposed method with those of the bathophenanthroline method for iron and
      of the atomic absorption spectroscopic method for copper correlated well (r =
      0.996, Sy/x = 0.73 and r = 0.959, Sy/x = 1.11, respectively).

PMID- 1623609
TI  - Immunoturbidimetry of apolipoprotein B in lyophilized human serum pools using
      primary standard.

PMID- 1623610
TI  - Error detection of high concentrations of endogenous free glycerol in
      determination of serum triglyceride with the TBA-80S automated discrete analyzer.

PMID- 1623611
TI  - Impact of inhibition of angiotensin-converting enzyme on urinary excretion of
      proteins in chronic heart failure.

PMID- 1623612
TI  - Multiple occurrence of macro creatine kinase in one family.
AB  - We measured creatine kinase (CK, EC 2.7.3.2), CK-MB isoenzyme activity and mass
      concentration, and distribution of CK isoenzymes (by electrophoresis) in serum
      from five members of one family. The mother and two young children showed CK-IgG
      complexes in their sera. The concentration of the CK-IgG complexes in the
      children decreased over time, suggesting that the complex involved maternal IgG
      and had been transferred across the placenta from the mother to her children.

PMID- 1623613
TI  - Actual ionized calcium (at actual pH) vs adjusted ionized calcium (at pH 7.4) in
      hemodialyzed patients.

PMID- 1623614
TI  - Atypical electrophoretic and isoelectrophoretic patterns of neutrophil alkaline
      phosphatase in a case of subacute myelomonocytic leukemia.

PMID- 1623615
TI  - Caffeine concentrations in adult patients chronically taking theophylline.

PMID- 1623616
TI  - Variability of glucose tolerance test in pregnancy diminished by use of a glucose
      polymer.

PMID- 1623617
TI  - "Half-life" is erroneously used to describe the disappearance of erythrocytes and
      hemoglobin from the circulation.

PMID- 1623618
TI  - Rapid diagnosis of mitochondrial mutation at position 11778-associated Leber
      hereditary optic neuropathy.

PMID- 1623619
TI  - Multiple serum protein abnormalities in carbohydrate-deficient glycoprotein
      syndrome: pathognomonic finding of two-dimensional electrophoresis?

PMID- 1623620
TI  - Increases in CA-125 concentrations in children.

PMID- 1623621
TI  - Familial spastic paraplegia with neuropathy and poikiloderma. A new syndrome?
AB  - We report a case study spanning three generations of familial spastic paraplegia,
      distal amyotrophy and poikiloderma. This study is the first description of an
      association between these three disorders. The gait disorder, the sensory and
      motor involvement and the skin disorder coincide in all the affected members,
      suggesting autosomal dominant inheritance with complete penetrance.

PMID- 1623622
TI  - 20 p duplication as a result of parental translocation: familial case report and
      a contribution to the clinical delineation of the syndrome.
AB  - We report two related patients, presenting duplication 20p, with a characteristic
      phenotype including normal growth pattern, mental and psychomotor retardation,
      reduced motor coordination, poor language development, round face and prominent
      cheeks, vertebral and dental anomalies, and renal malformations. Familial
      chromosome analysis showed a balanced translocation t(20;21)(p11;q22) in three
      members of the family. These cases, together with those previously reported in
      the literature, allow us to make a better delineation of the duplication 20p
      syndrome, identifying more clearly the symptoms that must be considered as
      characteristic of this clinical picture.

PMID- 1623623
TI  - Identical twins with an autosomal recessive form of spondylocostal dysostosis.
AB  - A form of spondylocostal dysostosis, marked by multiple vertebral clefts, costal
      bifurcation, and fusion was observed in identical male twins whose parents were
      first cousins. The lack of previous anomalies in the family, the high degree of
      parental inbreeding and the absence of deformities in a 3-year-old brother
      indicated an autosomal recessive mode of inheritance.

PMID- 1623624
TI  - A syndrome of progressive sensorineural deafness and cataract inherited as an
      autosomal dominant trait.
AB  - In 1982, Nadol & Burgess reported a new syndrome of cataract and progressive
      sensorineural hearing loss, inherited in an autosomal dominant fashion. Extensive
      histopathologic studies of the inner ear of the proband revealed severe
      cochleosaccular degeneration. No other sporadic or familial cases of such a
      genetic syndrome have subsequently been described. We report here a second family
      in which the syndrome of cataract and progressive sensorineural deafness is
      observed in eight members, and is inherited according to an autosomal dominant
      pattern.

PMID- 1623625
TI  - Hair-nail dysplasia--a new pure autosomal dominant ectodermal dysplasia.
AB  - An apparently hitherto undescribed pure ectodermal dysplasia of the tricho
      onychic subgroup is described. Its cause is an autosomal dominant gene with
      complete penetrance and variable expressivity. Differential diagnosis considered
      18 conditions belonging to the same subgroup, as well as Clouston syndrome. This
      report increases the number of conditions of the tricho-onychic subgroup to 19,
      and the total number of ectodermal dysplasias to 155.

PMID- 1623626
TI  - Intrachromosomal insertion of chromosome 7.
AB  - A direct intrachromosome insertion of chromosome 7 is described, and previous
      reports of intrachromosomal insertions are listed. All others were ascertained
      through a phenotypically abnormal proband. Ours is the first presenting with
      multiple pregnancy losses. Since the risk of chromosomally abnormal liveborns is
      appreciable, prenatal diagnosis should be made available to known carriers of
      chromosome insertions.

PMID- 1623627
TI  - Differentiated recurrence risk estimations in the Prader-Willi syndrome.
AB  - The Prader-Willi syndrome usually occurs sporadically. About 60% of the patients
      show a chromosomal deletion of proximal 15q. There are only a few reports on
      familial recurrence. Two previous estimates give either a low but recognizable
      recurrence risk of 1.6% or a risk of less than 0.1%. The inconsistency is
      obviously due to differences in the stringency of the diagnostic criteria used
      and to different modes of ascertainment of cases. This gave rise to a review of
      the literature, leading to the following suggestions: (1) A deletion at 15q has
      not been found in a familial case of PWS, except in those cases where del(15q) is
      due to familial structural chromosome rearrangements. Hence, with de novo
      deletion, the recurrence risk should be nearly zero. (2) In cases with familial
      translocation, risk estimates depend on the variable nature of the familial
      chromosome mutation. (3) If only one child is affected and has no deletion at
      15q, this may be a sporadic or an isolated familial case. For this situation I
      estimated an overall recurrence risk of 0.4%. (4) If two or more sibs are
      affected, I consider a risk of 50% that the next sib may also be affected. This
      estimate reflects the observed segregation ratio and is in accordance with the
      proposed genomic imprinting model in the etiology of PWS. Prenatal cytogenetic
      diagnosis in a pregnancy at risk for PWS is hampered since del(15q) is almost
      exclusively found in sporadic cases. Hence, this method is limited to those very
      rare cases where del(15q) is due to familial structural chromosome
      rearrangements.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623628
TI  - Cytogenetic and dermatoglyphic findings in a familial case of hypomelanosis of
      Ito (incontinentia pigmenti achromians).
AB  - Cytogenetic and dermatoglyphic investigations were performed in a mother (M.B.)
      and her daughter (D.B.), who were both suffering from hypomelanosis of Ito
      (incontinentia pigmenti achromians; HI). Whereas quite normal chromosomal results
      could be obtained after culture of peripheral lymphocytes, a diploid/tetraploid
      mosaicism (46,XX/92,XXXX) was found in cultured skin-fibroblasts derived from a
      hypopigmented skin area of M.B., with a slowly decreasing tetraploidy rate in the
      course of passaging: #2 23%, #5 11%, #11 and #14 6% and #18 and #21 2%. In
      cultures of normally pigmented skin, only single tetraploid cells could be
      detected. Dermatoglyphic examinations in both patients showed single transverse
      creases, a high number of secondary creases and a longitudinal alignment of the
      main line A bilaterally, and there was a tricentric fingertip pattern on the
      right digit III of M.B., i.e. a pattern which occurs very seldom in human beings.
      The results are discussed in respect to the clinical-diagnostic overlap of HI and
      incontinentia pigmenti Bloch-Sulzberger.

PMID- 1623629
TI  - Population variation and genetics of plasma homocyst(e)ine level.
AB  - A high level of plasma homocyst(e)ine (H(e)) has been reported to be an
      independent risk factor for coronary heart disease (CHD), at least in some
      populations. We have determined the H(e) concentration in the plasma of two
      series of Norwegians in order to establish a baseline for future analysis of
      people with CHD. The mean sex- and age-adjusted homocyst(e)ine level was 10.6
      (range 4.84-29.88) in one series and 10.5 (range 3.76-40.57) in the other. The
      H(e) level appeared to be independent of other proven or potential risk factors
      or protective factors with respect to CHD. The intraclass correlation coefficient
      in monozygotic (MZ) twins is a (possibly inflated) estimate of heritability. We
      have examined two series of MZ twins. The intraclass correlation coefficient was
      significant in both series. In one series, the Pearson correlation coefficient
      was 0.53 and the Kendall correlation coefficient 0.38. In the other, the values
      were 0.56 and 0.46, respectively. We conclude that in the population examined,
      H(e) levels exhibit significant heritability.

PMID- 1623630
TI  - Retinitis pigmentosa, AD type I: exclusion of linkage to D3S47 (C17) in a large
      South African family of British origin.
AB  - Linkage analysis has been performed on a large South African family of British
      origin in which 39 persons in 6 generations had early onset Type I autosomal
      dominant retinitis pigmentosa (ADRP). Tight linkage was excluded between the
      disease and the D3S47 locus on chromosome 3. This finding is further evidence for
      genetic heterogeneity in ADRP.

PMID- 1623631
TI  - Human beta-mannosidosis: a 3-year-old boy with speech impairment and emotional
      instability.
AB  - Beta-mannosidosis is a recently described inherited disorder with predominantly
      neurological signs and symptoms as the major manifestations of the disorder. The
      heterogeneous manifestations of the disease have been presented in seven previous
      patients. We describe a further case of European descent with an infantile onset
      of the disease, with the features of speech impairment as the first symptom. Beta
      mannosidase activity was completely deficient in the patient and a heterozygote
      level was found in the parents. In addition, mannosyl-N-acetylglucosamine was
      identified in the patient's urine in keeping with the diagnosis of beta
      mannosidosis.

PMID- 1623632
TI  - Chromosomal aberrations in Sotos syndrome.

PMID- 1623633
TI  - Chemical design of peripherally acting compounds.
AB  - 1. Some guanidines, related in structure to mianserin and to 2-methyl-1,2,9,13b
      tetrahydro-3H-dibenz[c,f]imadazo[1,5a] azepin-3-imine hydrobromide (WAL 801),
      have been synthesized and shown to be peripherally acting 5-HT2 antagonists.
      Structurally related compounds but not bearing a charged ionic group have been
      shown to have central activity. 2. Computer-aided molecular modelling has been
      used to establish a 5-HT2 pharmacophore. 3. The principle of exclusion from the
      CNS by incorporating a highly polar group to a biologically active molecule has
      been extended to the design and synthesis of a peripherally acting analgesic.

PMID- 1623634
TI  - The evolution of hypertensive therapy.
AB  - 1. During the past 30 years many antihypertensive agents, acting at differing
      levels on the mechanisms controlling arterial blood pressure, have been
      introduced. 2. Whereas the usefulness of early drugs was limited by side effects,
      the discovery of successive classes of agents has resulted in the gradual
      introduction of drugs causing fewer adverse effects with consequent improvements
      in patient compliance. 3. The recent appearance of angiotensin II antagonists and
      potassium channel openers, together with increased knowledge of the roles played
      by atrial natriuretic factor and endothelial cell-derived autacoids in control of
      vascular tone, hold prospects for still further improvements in therapy.

PMID- 1623635
TI  - Buprenorphine and gastrointestinal transit in rats: effect of naloxone on the
      biphasic dose-response curve.
AB  - 1. Buprenorphine (0.01-10 mg/kg, subcutaneous [s.c.]) slowed the passage of a
      charcoal meal along the gastrointestinal tract in rats. The dose-response
      relationship was U-shaped. 2. When rats were pretreated with naloxone (0.30
      mg/kg, s.c.), both the descending and ascending components of the buprenorphine
      dose-response curve were displaced to the right. 3. Buprenorphine-induced delay
      of transit was maximal at a dose of 0.10 mg/kg. In rats pretreated with naloxone,
      a 30-fold higher dose of buprenorphine was required for a comparable peak effect.
      4. Moderate-high doses of buprenorphine may be acting on a functionally related
      binding site which non-competitively inhibits the usual buprenorphine-mu opioid
      receptor interaction.

PMID- 1623636
TI  - An industrial approach to drug discovery: a pharmacologist's eyeview.
AB  - 1. The pressures on the pharmaceutical industry to produce novel, safe and
      effective therapeutic agents have provoked management to rethink the way in which
      drug discovery is undertaken. 2. Advances in drug therapy are likely to come from
      the application of new technologies and leading-edge science, perhaps in
      collaboration with academia. 3. Close collaboration between biologists and
      medicinal chemists is a proven way to discover new products. 4. The complexity of
      the modern industrial discovery process, due to the interaction of many
      disciplines, requires matrix-style management. 5. The early demonstration of
      efficacy in human subjects is considered essential for providing feedback to the
      basic scientists about the validity of hypotheses, and the relevance of the
      methods utilized, as well as whether a decision should be allowed to advance to
      full development.

PMID- 1623637
TI  - Government initiatives in the development of a pharmaceutical industry in
      Australia.
AB  - Government policy recognizes that the purchasing power of the government, through
      the Pharmaceutical Benefits Scheme, has suppressed prices and returns to the
      pharmaceutical industry in Australia, and that research, development and export
      activities have been low. The factor (f) scheme is designed to provide some
      pricing relief to those companies willing and able to undertake particular
      industry development activities. This scheme, together with the other changes
      implemented by the government, will result in the restructuring and development
      of the pharmaceutical industry in Australia.

PMID- 1623638
TI  - AMRAD: the first 4 years.
AB  - 1. AMRAD (Australian Medical Research and Development) Corporation is a Melbourne
      biomedical research and development based pharmaceutical company that has
      successfully completed the first 4 years of its activities. 2. The success of the
      company is a result of a number of factors including the association with world
      class medical research institutes, adequate seed capital and sound management
      skills.

PMID- 1623639
TI  - Symbiotic relationship between a research institute and a pharmaceutical company:
      the Baker Institute/Glaxo Australia story.
AB  - 1. The Baker Medical Research Institute is a non-profit, charitable institution
      to advance knowledge and solve problems in the area of cardiovascular medicine.
      This allows scientists to collaborate within a critical mass and be flexible in
      their approach to research. 2. The Institute has interactions with the
      pharmaceutical industry at three levels: (i) contract research on a specific
      molecule; (ii) clinical trials; and (iii) collaborative basic research
      agreements. 3. The Glaxo Australia-Baker Medical Research Institute Agreement is
      for curiosity driven research in specified areas of vascular pharmacology of
      interest to Glaxo Group Research. 4. The relationship between universities,
      research institutes and the pharmaceutical industry is discussed in terms of the
      starting point for drug development. 5. The enormous cost (US$100 million), lead
      time (10 years) and uncertainty of a successful profitable drug are compelling
      reasons why an independent pharmaceutical company is unlikely to succeed in
      Australia today.

PMID- 1623640
TI  - Cardiovascular sensitivity changes to eicosanoids in rats with experimentally
      induced diabetes mellitus.
AB  - This paper attempts to provide a short review of the evidence for: 1. Increased
      platelet production of thromboxane A2 and reduced vascular production of
      prostacyclin in the human and also animal models of diabetes. 2. Reduced
      depressor responsiveness to arachidonic acid of anaesthetized alloxan- and
      streptozotocin-induced diabetic rats. 3. Enhanced constrictor responsiveness to
      arachidonic acid in blood-perfused hindquarters of alloxan-induced diabetic rats.
      4. Potentiation by the thromboxane A2-mimetic, U46619, of constrictor responses
      to 5-hydroxytryptamine in Krebs'-perfused hindquarters and kidneys of both
      control and alloxan-induced diabetic rats. 5. Alterations during diabetes in
      production of, and responsiveness to, eicosanoids may contribute to the
      cardiovascular changes which occur in this disease.

PMID- 1623641
TI  - The atherogenic effect of lupus sera: systemic lupus erythematosus-derived immune
      complexes stimulate the accumulation of cholesterol in cultured smooth muscle
      cells from human aorta.
AB  - The influence of systemic lupus erythematosus (SLE) patients' sera on lipid
      accumulation in the cultured smooth muscle cells (SMC) from unaffected human
      aortic intima was examined. It was demonstrated that the cholesterol uptake in
      the SMC cultured in the presence of SLE sera is 1.5- to 6-fold higher than in the
      cells cultured with normal human sera (NHS) obtained from healthy donors.
      Incubation of the SMC with circulating immune complexes (CIC) isolated from lupus
      sera by precipitation with 2.5% polyethylene glycol 6000 (PEG) caused a 3- to 4
      fold rise in the intracellular cholesterol level. The atherogenic effect of lupus
      sera, as well as isolated CIC, strongly correlated (r = 0.98) with the low
      density lipoprotein (LDL) content in the PEG-precipitated CIC. The cholesterol
      level in cultured SMC also increased 2- to 3-fold when growth medium was
      supplemented with LDL, DNA, and anti-DNA autoantibodies (IgG) affinity isolated
      from lupus sera. Using immunofluorescent staining, it was shown that the addition
      of a DNA-anti-DNA IgG mixture to the growth medium, together with NHS, stimulated
      LDL incorporation in the SMC. The results of double-label staining suggest the
      formation of LDL-DNA-IgG complexes which seem to be entrapped in cells more
      actively than free LDL. The composition of PEG-precipitated CIC was studied by
      electrophoresis and immunoblotting. Significant amounts of apolipoprotein B, as
      well as low molecular weight DNA and immunoglobulins, were found in SLE-derived
      CIC. The data obtained suggest that the atherogenic effect of human lupus sera in
      vitro is generally due to the appearance of LDL-containing immune complexes.
      Different mechanisms possibly involved in the lupus atherogenesis are discussed.

PMID- 1623642
TI  - Prostaglandin E2 induces apoptosis in immature normal and malignant B
      lymphocytes.
AB  - The purpose of this research was to determine whether prostaglandin E2 (PGE2), a
      major product of macrophages which can kill certain murine B cell lymphomas,
      induces death by a necrotic mechanism or by an alternate pathway called
      apoptosis. CH31 is a phenotypically "immature" B cell lymphoma which resembles
      immature neonatal B cells in its susceptibility to killing by reagents which
      cross-link surface immunoglobulin (sIg). In the present study we first show that
      PGE2, but not the closely related prostanoid, PGF2 alpha, kills CH31 lymphoma
      cells. In contrast, CH12, a phenotypically "mature" lymphoma which is not
      negatively affected by sIg cross-linking, is not induced to die after exposure to
      PGE2. Agarose gel electrophoresis demonstrated that the DNA of PGE2-treated CH31,
      but not CH12 cells, is cleaved into characteristic 200 base pair oligonucleosomal
      fragments indicative of an apoptotic mechanism of death. However, a necrotic form
      of death, indicated by random DNA cleavage which produces a smear following
      electrophoresis, could be induced by treatment of CH12 or CH31 with anti-class II
      MHC antibodies and complement. The apoptotic mechanism of CH31 cell killing by
      PGE2 was confirmed using scanning electron microscopy which demonstrated the
      unique membrane blebbing and bubbling pathognomonic of this form of death.
      Finally, using a recently devised flow cytometric method to study apoptosis in
      heterogeneous cell populations, we compared the ability of anti-IgM, PGE2, or
      PGF2 alpha to induce apoptosis in B lymphocytes from neonatal or adult mice. Anti
      IgM, and to a lesser extent PGE2, but not PGF2 alpha, induces apoptosis in a
      fraction of neonatal B cells. None of these treatments induced cell death in B
      lymphocytes from mature mice. Overall, these observations suggest that PGE
      secreting cells such as macrophages, which inhabit the B cell microenvironments
      of lymphoid organs, may eliminate a subset of immature B lymphocytes and may be
      important in controlling the spread of PGE-sensitive malignant B lymphoma cells.

PMID- 1623643
TI  - Immune complexes and antibody levels in blisters over human leprosy skin lesions
      with or without erythema nodosum leprosum.
AB  - Erythema nodosum leprosum (ENL) is a serious complication of lepromatous leprosy,
      affecting skin and peripheral nerves in a large percentage of these patients, and
      is presumed to result from spontaneous immunologic changes. Its pathogenesis is
      poorly understood, although histopathologic features have suggested immune
      complex (IC)-mediated injury. Abundant circulating antibody is present but no
      convincing correlation has been established between circulating IC and ENL. We
      have examined cutaneous leprosy lesions in vivo using blisters induced by
      prolonged gentle suction to determine whether or not IC are demonstrable in
      lesions with or without ENL, using an IC assay based on monoclonal rheumatoid
      factor binding. We also examined whether antibodies involved in such IC are
      produced locally or reach the skin via the circulation. Surprisingly large
      quantities of IC were found in ENL lesions, and in some cases the quantities were
      significantly higher than in matching serum. Total IgG, IgA, and IgM in the skin
      were not higher than expected, however. Attempts to demonstrate increases in
      intracutaneous levels of specific anti-Mycobacterium leprae antibodies were
      unsuccessful. This is the first report of the demonstration of IC in suction
      blister fluid. The results indicate that large quantities of IC may be present in
      cutaneous leprosy lesions and are consistent with the hypothesis that they are
      formed in situ when circulating antibody combines with antigen in the skin. The
      nature of the antigen in these IC remains undefined.

PMID- 1623644
TI  - A controlled study of lymphocyte subsets in rheumatoid arthritis.
AB  - The purpose of this study was to determine if patients with rheumatoid arthritis
      (RA) exhibited unique patterns of peripheral blood lymphocyte (PBL) subsets in
      comparison to patients with osteoarthritis (OA) and, further, if such differences
      related to disease activity or nondisease factors. Data from 63 RA patients and
      47 OA patients revealed that the RA patients had lower absolute numbers of CD2+
      and CD4+ lymphocytes. Small differences also were found in selected B-cell
      subsets and subsets of lymphocytes expressing CD16 and/or CD57 antigens. Further
      analysis revealed that these differences were due primarily to the effects of
      cytotoxic medications in the RA group. However, there were also alterations in
      some subsets independent of medication groups. PBL subsets in RA patients did not
      relate to chronic low-dose prednisone or measures of disease activity. This study
      demonstrated the need to control carefully for variables such as age and
      medication in immunophenotypic investigations of RA.

PMID- 1623645
TI  - Nucleosomes and DNA bind to specific cell-surface molecules on murine cells and
      induce cytokine production.
AB  - The molecular basis for the cellular interaction of DNA and nucleosomes and the
      physiological consequences of this binding were examined. Both DNA and
      nucleosomes were demonstrated to bind specifically to the surface of human
      peripheral blood mononuclear cells and the murine T cell line S49. Western blots
      of S49 cell membranes, using probes of biotin-labeled DNA and nucleosomes, showed
      reactivity at 29 and 69 kDa. Functionally, the interaction of DNA and nucleosomes
      with murine spleen cells stimulated the release of significant amounts of IL-6
      activity. There is evidence that nucleosomes, a product of apoptosis, are the
      major component of circulating DNA found in the plasma of patients with systemic
      lupus erythematosus (SLE). The interaction of nucleosomes with cell-surface DNA
      binding molecules may have physiological relevance to some of the immune
      aberrations observed in patients with SLE.

PMID- 1623646
TI  - Antibodies to endothelial cells in primary vasculitides mediate in vitro
      endothelial cytotoxicity in the presence of normal peripheral blood mononuclear
      cells.
AB  - Twenty-eight out of 62 patients with Wegener's granulomatosis and
      micropolyarteritis display circulating antiendothelial cell antibodies (AECA)
      detectable by a cell surface radioimmunoassay. These antibodies do not induce an
      in vitro endothelial damage either alone or in the presence of fresh complement;
      however, 50% of IgG-AECA positive sera can be cytotoxic in the presence of human
      normal peripheral blood mononuclear cells (PBM) at high effector/target ratios.
      The specificity of the PBM-mediated cytotoxicity is supported by the absence of
      the phenomenon in AECA negative sera, by the disappearance of the lytic effect
      after absorption of AECA, and by the finding that cellular-mediated cytotoxicity
      can be reproduced by purified IgG-AECA positive fractions. On the contrary,
      polymorphonuclear leukocytes or adherent mononuclear cells are not involved in
      such a cytotoxic activity. AECA seem to be directed against determinants
      consitutively expressed on the endothelial surface since the activation of
      endothelial cells by interleukin-1 beta or interferon-gamma affects neither the
      antibody binding nor their ability to mediate 51Cr release in the presence of
      PBM. These findings favor the hypothesis for a possible direct pathogenetic role
      of circulating AECA in the in vivo vascular damage.

PMID- 1623647
TI  - Peripheral B cells with intracytoplasmic mu chains in HIV infection.
AB  - Besides the major alteration of T lymphocytes, B-cell anomalies have been
      reported in HIV infection, related to late stages of B-cell maturation, and
      considered to result from the dysregulation of T/B interactions. Because T cells
      are also involved in the control of lymphopoiesis and/or because of specific
      alterations of the B lineage, anomalies of B-cell maturation could occur in HIV
      infected patients. We investigated the presence of immature pre-B lymphocytes,
      characterized by cytoplasmic mu chains, in 35 peripheral blood samples from
      healthy controls, 82 from HIV-positive/non-AIDS patients, and 45 from AIDS
      patients. Significant numbers of such cells were observed in 48% of HIV
      seropositive patients and in 40% of the patients with AIDS disease. The presence
      of pre-B cells correlated with higher numbers of CD8+ and/or CD57+ cells and of
      peripheral lymphocytes. These data suggest that B-cell dysregulation in HIV
      infection may lead to the abnormal release of immature B cells in the peripheral
      blood. This observation may be interpreted as a sign of bone marrow activity.

PMID- 1623648
TI  - Tumor necrosis factor-alpha inhibitory activity in urine of Kawasaki disease.
AB  - Recently it has been reported that naturally occurring inhibitors of tumor
      necrosis factor alpha (TNF-alpha) were demonstrated in urine of some acute
      febrile patients. We investigated whether TNF-alpha inhibitory activity in urine
      increases during acute Kawasaki disease (KD). TNF-alpha inhibitory activities in
      urine were measured by a cytotoxicity assay on the TNF-susceptible cell line
      L929. KD patients had increased TNF-alpha inhibitory activities in urine during
      the acute stage and returned to a normal range during the convalescent stage. Our
      results suggest that the TNF-alpha inhibitor in urine is part of the regulatory
      system of TNF-alpha, which might be responsible for vascular injury during acute
      KD.

PMID- 1623649
TI  - Frequency of selective IgG subclass deficiency: a reappraisal.

PMID- 1623650
TI  - Heparin and myocardial infarction.

PMID- 1623651
TI  - PTCA in patients with stable angina pectoris and multivessel disease: is
      incomplete revascularization acceptable?
AB  - Of all coronary angioplasties performed nowadays, 40% of the patients have
      multivessel disease. Angioplasty in patients with multivessel disease can be
      performed with a high immediate clinical success rate and an acceptable major
      complication rate. However, complete anatomic revascularization with coronary
      angioplasty is achieved in only 32 to 59%. This raises concern about the
      immediate and long-term outcome of patients in whom incomplete revascularization
      is achieved. This report reviews the literature and provides evidence that
      incomplete revascularization with coronary angioplasty is a safe and effective
      treatment in selected patients with multivessel disease, provided that adequate
      (functional) revascularization can be achieved. Adequate revascularization
      includes dilation of all significant lesions supplying large areas of viable
      myocardium.

PMID- 1623652
TI  - The effect of treatment on survival in congestive heart failure.
AB  - Congestive heart failure (CHF) is a disorder characterized by a variety of
      clinical, biochemical, electrophysiological, and hemodynamic abnormalities.
      During the past two decades, numerous drugs have been employed in the treatment
      of this complex syndrome, and many agents have been shown to improve symptoms and
      ventricular function in patients with CHF. Because CHF is associated with a high
      risk of death, treatment should be directed not only toward the relief of
      symptoms, but also toward a reduction in mortality. Many variables have been
      shown to be related to survival; taken individually, however, each is limited in
      its utility in predicting prognosis. In recent years, large-scale studies with
      large sample sizes have directly assessed the effects of treatment on mortality
      in CHF. Results from these trials indicate that vasodilators and angiotensin
      converting enzyme (ACE) inhibitors may improve mortality in patients with
      symptoms of heart failure. Additional trials are now in progress to evaluate the
      effect of treatment on patients with asymptomatic left ventricular dysfunction.

PMID- 1623654
TI  - Multifocal atrial arrhythmia--a frequent misdiagnosis? A correlative study using
      the computerized ECG.
AB  - All computerized ECGs taken over a 17-week study period were reviewed for the
      detection of multifocal atrial arrhythmia (MAA)--tachycardia or rhythm--and
      correlated with the diagnostic statement of the ECG computer system. MAA was
      identified by the authors in 96 of 11,610 (0.8%) computerized ECGs. In all
      instances, this specific arrhythmia was misclassified by the computer system as
      atrial fibrillation. Moreover, during the over-read, only 27.1% of ECGs were
      correctly diagnosed by the assigned electrocardiographers blinded to this study.
      MAA is not an uncommon atrial arrhythmia since it was identified in 14% of
      computerized ECGs interpreted as atrial fibrillation. This study supports the
      inference that MAA is indeed frequently misdiagnosed by most physicians and the
      need for improved ECG computer analysis programs for reliable detection of MAA.

PMID- 1623653
TI  - The effects of captopril on training in patients with ischemic heart disease.
AB  - We studied a group of 30 patients to determine the effect of captopril on the
      exercise training response after a period of training in patients with ischemic
      heart disease but without cardiac failure. The study was a double-blind placebo
      controlled comparison of captopril and placebo. The patients studied were 28 men
      and 2 women, mean age 53.6 +/- 6.9 years. All were 8 to 12 weeks postmyocardial
      infarction or coronary artery bypass surgery. These patients underwent an
      organized exercise training program consisting of exercise training sessions 3
      times weekly for a period of 8 weeks. On commencement and completion of the
      program patients were assessed for exercise tolerance using submaximal exercise
      stress testing. Patients were assessed in the untreated state. Both groups showed
      a statistically significant training effect with increased exercise duration,
      decreased heart rate for equal workload, increased energy expenditure, and
      reduced functional aerobic impairment. There was no statistically significant
      change in systolic blood pressure, but the captopril group alone showed a
      significant reduction in diastolic blood pressure (p less than 0.001). The change
      in heart rate at rest over the 8-week period was not significant in both groups.
      In summary, this study shows that treatment with captopril does not affect the
      exercise training response in patients with ischemic heart disease undergoing an
      organized exercise training program.

PMID- 1623655
TI  - Clinical significance of serum colloid osmotic pressure in relation to pulmonary
      edema and coronary instability in patients with unstable angina.
AB  - Several investigators demonstrated that severe reduction of colloid osmotic
      pressure (COP) predicts a fatal outcome in patients with cardiopulmonary failure.
      To evaluate the clinical significance of COP in relation to pulmonary edema, we
      studied 117 patients with unstable angina admitted in the hospital within 24 h
      after the chest pain. The mean COP of all 117 patients was 24.8 +/- 3.7 mmHg. COP
      was significantly lower in patients with pulmonary edema, according to the chest
      x-ray findings, compared with the patients without it. Among 26 patients with
      emergency coronary arteriography, a fairly good correlation was observed between
      coronary jeopardy score and COP (r = -0.57, p less than 0.005). Furthermore, COP
      in patients who survived 26 months after the hospital discharge was significantly
      higher than that of the nonsurvivors. Thus, measurement of COP is advised for
      monitoring patients with unstable angina.

PMID- 1623656
TI  - Blood coagulability and fibrinolytic activity before and after physical training
      during the recovery phase of acute myocardial infarction.
AB  - The effects of physical training on hemostatic parameters were evaluated in 56
      postmyocardial infarction (MI) patients before and after one month of systematic
      physical training and in 30 control post-MI patients, who did not undergo such
      training. There were no significant changes in prothrombin time (PT) and alpha 1
      antitrypsin (alpha 1AT) at the beginning and end of the study in either group.
      Levels of fibrinogen, Factor VIII: C (VIII:C) and von Wildebrand antigen
      (vWf:Ag), and activities of ATIII and plasminogen (Plg) were significantly
      decreased in the group with physical training (p less than 0.05), while values
      were unchanged in the control group. Hematocrit, platelet counts, and alpha 2
      plasmin inhibitor (alpha 2PI) activities also decreased in the physical training
      group (p less than 0.05). In contrast, these variables increased in the control
      group (p less than 0.05). Activated partial thromboplastin time (aPTT) tended to
      be prolonged in the group with physical training, while it was shortened in the
      control group. In a subset of 20 patients with physical training, resting levels
      of plasmin-alpha 2PI complex (PIC), thrombin-antithrombin III complex (TAT),
      protein-C (P-C:Ag), plasminogen activator inhibitor-1 (PAI-1), VII:C, and P-C
      activities had significantly decreased after one month of physical training (p
      less than 0.05), although tissue plasminogen activator activities remained
      unchanged. Physical training appeared to suppress coagulability as indicated by
      the decrease in fibrinogen, VIII:C, vWf:Ag, VII:C, and TAT, and prolongation of
      aPTT. The decrease in plasminogen, t-PA:Ag, alpha 2PI, PAI-1, and PIC after
      physical training may result from the decreased coagulability. In conclusion,
      physical training appears to induce a suppression of the coagulation system in
      patients in the recovery phase of MI.

PMID- 1623657
TI  - 24-hour efficacy of once-daily diltiazem in essential hypertension.
AB  - The safety and effectiveness of a once daily formulation of diltiazem
      hydrochloride (diltiazem CD) in the treatment of essential hypertension was
      assessed in a total of 127 patients with supine diastolic blood pressures (DBP)
      of 95 to 110 mmHg randomized to diltiazem CD (n = 61) or placebo (n = 66).
      Patients were titrated to doses of 120, 240, or 360 mg to achieve DBP reduction
      to less than 90 mmHg. At end study diltiazem CD changed trough supine SBP and DBP
      by -8.4 +/- 1.7 (p = 0.0009) and -8.6 +/- 1.1 mmHg (p = 0.0075), respectively.
      Heart rate was not significantly changed (-1.3 +/- 1.1 beats/min, p = 0.4362).
      The average dose of diltiazem CD was 268 mg with 69% achieving a clinical
      response. A subset of 47 patients underwent ambulatory blood pressure monitoring
      to assess the consistency of the effect over the full 24-h dosing interval.
      Diltiazem CD lowered DBP and SBP throughout the dosing interval. The overall side
      effect profile was similar to placebo. This study provides evidence of 24-h
      efficacy of this new, once daily formulation of diltiazem.

PMID- 1623658
TI  - A critical appraisal of indications for the implantable cardioverter
      defibrillator (ICD).
AB  - The implantable cardioverter defibrillator (ICD) is a remarkably effective
      therapy for reducing sudden cardiac death in patients with malignant ventricular
      arrhythmias. The indications for implantation of the ICD were approved in 1985 by
      the United States Food and Drug Administration; it could be implanted in patients
      who have experienced cardiac arrest or in those with recurrent ventricular
      arrhythmias which are not suppressed by anti-arrhythmic drugs in the
      electrophysiology laboratory. These established indications have not changed in
      the last seven years. In the near future, the release of third-generation ICDs
      (with antitachycardia pacing) will likely further expand indications for the
      device. Many patients with stable ventricular tachycardia who have not had
      syncope or cardiac arrest will receive a third-generation defibrillator. Also,
      three clinical trials now in progress--CABG-PATCH, Multicenter Automatic
      Defibrillator Implantation Trial (MADIT) and Multicenter Unsustained Tachycardia
      Trial (MUSTT)--are studying "pre-event" patients with low ejection fraction and
      electrical instability; some of the patients in each trial are being
      prospectively randomized to the ICD. Within the next five years we will have a
      better understanding of the role of ICD therapy in such patients. Until these
      studies are completed, it is important that the indications for the ICD not be
      expanded.

PMID- 1623659
TI  - Acute circumferential subendocardial infarction.
AB  - A 48-year-old black man had his first attack of chest pain on exertion, radiating
      to both arms, in December 1982 (angina pectoris). It was undoubtedly preceded by
      a period of asymptomatic coronary atherosclerosis of unknown duration. The first
      anginal attack was followed by three to four similar episodes over the next four
      months. The attacks became more prolonged, frequent, and severe thereafter (so
      called "pre-infarct" angina), and six days later the patient showed signs of
      having developed actual myocardial necrosis. The patient underwent saphenous vein
      coronary artery bypass surgery but could not be weaned from the pump. He died
      late on the day of surgery. He was found at autopsy to have severe old three
      vessel coronary artery disease with the myocardial changes that would be expected
      from the severe global ischemia to which this heart was undoubtedly subjected.
      Several basic and important differences between this sort of a circumferential
      subendocardial infarct and a transmural infarct are discussed, as is the basis
      for the striking subendocardial hemorrhage.

PMID- 1623660
TI  - Black scorpion envenomation: two cases and review of the literature.
AB  - Scorpion envenomation is quite common in India, southeast Asia, the U.S.
      southwest, and Israel (in the Negev and around Jerusalem). Yellow scorpion is
      considered the most dangerous scorpion that causes cardiac toxicity. Two patients
      are described, who lived in a nonendemic area of yellow scorpions and were
      envenomated by the black scorpion. Both suffered temporary cardiac involvement
      (manifested by electrocardiographic changes) which reverted to a normal pattern
      within 24 h. These are the first two cases that have been reported (from black
      scorpion envenomation) and indicate that the toxin of the black scorpion is also
      cardiotoxic, but much less than the "yellow scorpion" toxin.

PMID- 1623661
TI  - The transesophageal echocardiographic diagnosis of left atrial myxoma simulating
      a left atrial thrombus in the setting of mitral stenosis.
AB  - We report a case of left atrial myxoma simulating a thrombus on transthoracic
      echocardiography, but correctly diagnosed using transesophageal echocardiography.
      As this tumor is usually fatal unless surgically resected, a correct diagnosis is
      essential. Myxomas which do not prolapse between the mitral valve leaflets and
      coexist with mitral stenosis may be difficult to diagnose accurately using
      transthoracic echocardiography. The advantages of transesophageal compared with
      transthoracic echocardiography in the diagnosis of nonclassical left atrial
      myxoma are discussed.

PMID- 1623662
TI  - Intermittent coronary spasm during graded exercise.
AB  - We report a patient with Prinzmetal's angina with nearly normal coronary
      angiogram who not only developed severe myocardial ischemia during exercise,
      documented both electrocardiographically (ST elevation) and scintigraphically
      (with thallium-201), but also did so intermittently as the graded exercise
      progressed. Diagnostic coronary angiography showed spontaneous focal spasm of the
      proximal left anterior descending coronary artery. This unique response to
      exercise in a patient with variant angina suggests that factors other than
      catecholamine stimulation alone are active and rapidly attenuated in some
      patients. This phenomenon could be overlooked without appropriate
      electrocardiographic monitoring.

PMID- 1623663
TI  - Spontaneous and induced vasodepressor/vasovagal syncope in hypertrophic
      cardiomyopathy.
AB  - We describe a 47-year-old man affected with hypertrophic cardiomyopathy and
      frequent episodes of syncope. During ambulatory Holter monitoring and head-up
      tilt test, a syncopal attack was associated with sinus arrest and hypotension.
      This case suggests an additional mechanism of syncope in hypertrophic
      cardiomyopathy.

PMID- 1623664
TI  - William C. Roberts.

PMID- 1623665
TI  - Epidemiology of hypertrophic osteoarthropathy.

PMID- 1623666
TI  - Hypertrophic osteoarthropathy in the paediatric age.
AB  - Hypertrophic osteoarthropathy should be considered in any child who presents with
      a non-inflammatory synovitis of the knees, ankles and wrists and particularly if
      there is finger clubbing or soft tissue hypertrophy of the fingers. It is rare to
      get the typical facial appearances until after adolescence. Alteration in
      epiphyseal growth is associated with the periosteal reaction, as is change in the
      shape of the patella; whether this leads to premature osteoarthrosis is not yet
      certain. Secondary disease is common in cyanotic congenital heart disease, but
      its frequency appears to be decreasing with early treatment of such children.
      Chest infections are also better controlled so again it is less common, but does
      still occur, particularly in cystic fibrosis in the older age group who have
      intractable chest infections. It is seen but rarely in disorders such as
      inflammatory bowel disease or pulmonary metastases, particularly from bone
      tumours.

PMID- 1623667
TI  - Cardiogenic hypertrophic osteoarthropathy.
AB  - It has been a generally held notion that the association of cyanotic congenital
      heart diseases with hypertrophic osteoarthropathy (HOA) is exceptional. However,
      recent prospective studies have demonstrated the opposite to be true. More than a
      third of patients with cyanotic heart diseases have HOA. The skeletal changes are
      more prevalent, more persistent and more severe than in any other internal
      illness. The clinical features of cardiogenic HOA are here discussed.

PMID- 1623668
TI  - Lung diseases associated with digital clubbing.
AB  - Clubbing is classified into conditions in which it is commonly, occasionally,
      rarely and never observed. Hypertrophic osteoarthropathy may be a more extreme
      form of clubbing, but is more likely to be a related but nevertheless
      qualitatively different phenomenon. Megakaryocytes or platelet clumps impacting
      in a digital stratum are plausible causes of clubbing, through the local release
      of platelet-derived growth factor (PDGF).

PMID- 1623669
TI  - Diagnostic imaging in hypertrophic osteoarthropathy.
AB  - This review discusses our experience with conventional radiography and advanced
      imaging techniques in the evaluation of diverse soft tissue, skeletal and joint
      abnormalities frequently observed in patients with both the primary and secondary
      forms of hypertrophic osteoarthropathy. The manifestations include finger
      clubbing, elephant feet, cutis verticis gyrata, synovial effusion, periostosis,
      tuftal hypertrophy and acro-osteolysis. Its coexistence with other skeletal and
      joint diseases and its imaging differential diagnosis are also reviewed.

PMID- 1623670
TI  - History of hypertrophic osteoarthropathy (HOA).
AB  - Hypertrophic osteoarthropathy (HOA) was first described in 1868 as "hyperostosis
      of the entire skeleton". It has also been mistaken for acromegaly. In 1887-1888
      the first description was given of a dermatological disorder "cutis verticis
      girata" which coexisted with the peculiar bone anomalies of HOA. In 1890 HOA was
      named "osteoarthropatie hypertrophiante pneumique". Later a distinction was made
      between the rare idiopathic (or primary) form, also called
      "pachydermoperiostosis" and the more common secondary form due to concomitant
      disorders involving the lungs and pleura. The primary form usually develops
      shortly after puberty or during adolescence and has not been found associated
      with underlying disease. Secondary HOA was initially called "hypertrophic
      pulmonary osteoarthropathy" because it is frequently associated with various
      malignancies or chronic infections of the lung and pleura. Later, since the site
      of primary disease may be elsewhere, involving the gut and the cardiovascular,
      hepatobiliary and endocrine systems, this designation fell into disuse. In some
      cases of secondary HOA, the osteoarthropatic and facial skin changes subside
      after pneumonectomy or other procedures. A disease resembling human HOA has been
      also described in dogs.

PMID- 1623671
TI  - Hypertrophic osteoarthropathy: rheumatologic manifestations.
AB  - Arthropathy can occasionally be an early clue to the diagnosis of hypertrophic
      osteoarthropathy (HOA). Joint effusions are typically relatively non
      inflammatory, while synovial membrane biopsies show a variety of vascular changes
      that suggest the consideration of several factors possibly involved in the
      pathogenesis of HOA.

PMID- 1623672
TI  - An historical approach to pachydermoperiostosis.

PMID- 1623673
TI  - The spectrum of dermatological symptoms of pachydermoperiostosis (primary
      hypertrophic osteoarthropathy): a genetic, cytogenetic and ultrastructural study.
AB  - Pachydermoperiostosis (PDP) is characterized by finger clubbing, periostosis and
      peculiar skin involvement (pachydermia, seborrhea and folliculitis). The aim of
      our work was to determine the occurrence of dermatological symptoms in patients
      with PDP and their relatives, and to study ultrastructural skin changes in the
      complete and incomplete forms of the disease. A genetic and cytogenetic study was
      performed in order to identify the mechanism of transmission, to discover
      possible links to other genetic and non-genetic diseases and to determine the
      chromosomal complement and eventual chromosomal anomalies. Pachydermia was the
      most frequent skin alteration together with seborrhea; folliculitis was present
      in five patients. In the relatives mild pachydermia was detected in 2 out of 26,
      while seborrhea was present in 6 subjects. Light microscopic observation showed
      acanthotic epidermis and endothelial hyperplasia in the dermis with partial
      occlusion of the lumen, lymphohistiocytic infiltrate, and thickening and packing
      of collagen fibers. Electron microscopy showed fibroblast activation with
      increased fibrillogenic activity as shown by hypertrophic Golgi complexes and
      rough endoplasmatic reticulum with cisternae filled with microfibrils.
      Endothelial cells partially or completely occluded the capillary lumen and
      presented an increased amount of Weibel Palade bodies. These data show that skin
      involvement in PDP is a prominent feature, that sometimes these symptoms may also
      be present in their relatives, and that endothelial and fibroblast activation is
      present in the skin. Unfortunately the cytogenetic study did not provide any
      information about possible karyotype abnormalities.

PMID- 1623674
TI  - Pathogenesis of hypertrophic osteoarthropathy.
AB  - The systematic study of patients with cyanotic heart diseases has led to a better
      understanding of the pathogenesis of hypertrophic osteoarthropathy (HOA). Current
      evidence suggests that in cases of right-to-left shunts of blood, HOA develops as
      a result of faulty pulmonary clearance of macrothrombocytes. There are
      theoretical grounds to suggest that a platelet-derived growth factor is also
      responsible for the acropachy associated with other types of internal illnesses.

PMID- 1623675
TI  - The role of vascular endothelium in fibroblast activation and tissue fibrosis,
      particularly in scleroderma (systemic sclerosis) and pachydermoperiostosis
      (primary hypertrophic osteoarthropathy).
AB  - The vascular endothelium is an organ that is distinguished by its versatility and
      ability to modulate its surroundings. Endothelial cells (EC) interact with a
      variety of cell types including fibroblasts (FB), smooth muscle cells,
      circulating mononuclear cells, platelets and other cell types. This paper will
      focus on the interaction between endothelial cells and fibroblasts in the process
      of fibrosis. Vascular changes are described in most human fibrotic models, i.e.
      radiation, bleomycin, wound healing and particularly in scleroderma. FB migration
      to the perivascular spaces and proliferation is seen in the early settings of
      tissue fibrosis. The role of EC in this process is not precisely known; however,
      the EC contribution to fibrosis is likely to be multifactorial and may involve a
      spectrum of delicate mechanisms and an array of chemical signals. The induction
      of FB chemotaxis and FB proliferation by the EC's release of chemotactic factors
      and mitogens is one possible pathway of FB activation. Another major mechanism
      involves EC mobilization, guidance and regulation of mononuclear cell
      infiltration in the perivascular spaces and the subsequent impact of that process
      on FB activation. Histologic studies of human fibrotic disorders have emphasized
      early FB proliferation. The role of EC in the induction of FB proliferation
      should be evaluated carefully in order to understand human fibrosis.

PMID- 1623676
TI  - Pachydermoperiostosis (primary hypertrophic osteoarthropathy): in vitro evidence
      for abnormal fibroblast proliferation.
AB  - Pachydermoperiostosis (PDP) is a disease characterized by the presence of
      pachydermia, periostosis and finger clubbing. Evidence that the skin and soft
      tissues are involved in the disease prompted the in vitro investigation of the
      behaviour of fibroblasts obtained from cutaneous biopsies of involved and
      apparently uninvolved PDP skin. PDP fibroblasts from affected skin demonstrated
      an abnormal proliferation, very rapid and tumultuous when compared to the growth
      of fibroblasts derived from apparently uninvolved skin and fibroblasts from the
      skin of healthy subjects. This characteristic was confirmed by the rate of
      thymidine incorporation, which was increased in PDP-affected fibroblasts (1152
      dpm) compared to apparently non-PDP involved fibroblasts (273 dpm) and controls
      (262 dpm). Ultracentrifuged and non-centrifuged conditioned medium (CM) of
      fibroblasts affected or apparently not affected with PDP were used to evaluate
      the effect on the proliferation of healthy skin fibroblasts, compared to the
      effect of CM derived from healthy fibroblasts and from healthy fibroblasts
      incubated with 10% and 1% foetal calf serum. The CM of non-centrifuged PDP
      fibroblasts resulted in a statistically significant stimulation of fibroblast
      growth when compared to that expressed by ultracentrifuged PDP CM, healthy
      fibroblast CM and 10% stimulated CM. These data show that PDP fibroblasts
      maintain in vitro the capacity to proliferate at a higher rate than healthy
      fibroblasts and that in the CM residual cells and/or their debris may be present,
      inducing the abnormal growth of healthy fibroblasts. This evidence suggests that
      fibroblasts in PDP may play a role in the development of the disease.

PMID- 1623677
TI  - The "endothelium/platelet unit" in hypertrophic osteoarthropathy.
AB  - Various pathogenetic theories of hypertrophic osteoarthropathy (HOA) have been
      proposed (neurogenic, hormonal, artero-venous shunts, genetic theory), but none
      of them is able to satisfactorily explain the genesis of HOA. The hypothesis of a
      central role of the "endothelium/platelet unit" was recently discussed. Above
      all, the release of the platelet derived growth-factor (PDGF) contained in
      platelet granules is particularly interesting. In order to assess the
      microvascular involvement in HOA we set up a research project whose aims were to
      evaluate the morphology of the capillary network at the nailfold, the dynamic
      aspects of microcirculation and in vivo platelet function. Since this study is
      still in progress, for the time being we present only a few preliminary results.

PMID- 1623678
TI  - The medical and surgical treatment of finger clubbing and hypertrophic
      osteoarthropathy. A blind study with colchicine and a surgical approach to finger
      clubbing reduction.
AB  - In fourteen patients affected with pachydermoperiostosis (PDP), or primary
      hypertrophic osteoarthropathy, the efficacy of colchicine (0.5 mg day for one
      month) versus placebo on the main clinical features of the disease (finger
      clubbing, arthritis and pachydermia) was evaluated. In addition, in one patient
      the usefulness of surgical reduction of clubbed fingertips was investigated.
      Colchicine did not demonstrate any appreciable effect on finger clubbing
      (expressed in degrees) or pachydermia, while an effect on arthralgia (as
      evaluated by the Ritchie Index and Pain Scale) was observed. The surgical
      treatment of clubbed fingertips failed to show a satisfactory and stable
      reduction of the fingertips; two months after surgery the nail matrix apparently
      produced new tissue, once again enlarging and deforming the finger. These results
      suggest that low dose colchicine cannot be considered the drug of first choice
      for the treatment of PDP, while higher dosages, although effective, are not
      tolerated because of the severe side effects. An effective medical and surgical
      treatment for PDP will be found only when the pathogenetic mechanisms of the
      disease are clarified.

PMID- 1623679
TI  - The contribution of French researchers to hypertrophic osteoarthropathy.

PMID- 1623680
TI  - French practitioners in mid 18th century London.

PMID- 1623681
TI  - Dentistry for the nation.

PMID- 1623683
TI  - Shortcuts in drug evaluation.

PMID- 1623684
TI  - Clinical use of the Medication Event Monitoring System: a new window into
      pediatric compliance.

PMID- 1623685
TI  - Statistics and clinical trials.

PMID- 1623686
TI  - Drug clearance in patients with cystic fibrosis.

PMID- 1623687
TI  - Theophylline metabolism affected by mexiletine.

PMID- 1623688
TI  - HMG-CoA reductase inhibitors and sleep.

PMID- 1623689
TI  - Adaptive control with feedback strategies for suramin dosing.
AB  - Suramin, a drug used in the treatment of parasitic diseases, is currently being
      evaluated in clinical trials as an antineoplastic agent. The use of therapeutic
      drug monitoring and adaptive control with feedback in clinical trials of suramin
      was initially motivated by an association between acute neurologic toxicity and
      plasma suramin concentrations in excess of 350 micrograms/ml. We have
      prospectively examined the performance of both two- and three-compartment
      population pharmacokinetic models in controlling plasma suramin concentrations
      and have found that a three-compartment model best describes this drug. No
      correlation was found between the clearance of suramin and creatinine clearance,
      as had been previously hypothesized. The low systemic clearance of suramin and
      the number of parameters required to describe the three-compartment model suggest
      the need for a bayesian approach to the estimation of individual
      pharmacokinetics.

PMID- 1623690
TI  - Single-dose pharmacokinetics of cefpirome in patients with renal impairment.
AB  - The pharmacokinetic parameters of cefpirome (HR 810) were examined in 22 patients
      with different degrees of renal impairment. HPLC was used to analyze samples of
      blood and urine for cefpirome; and enzymatic assay of creatinine in serum and
      urine was used to assess kidney function. Creatinine clearance correlated
      linearly with both total and renal clearance of cefpirome. The loss of kidney
      function resulted in a decreased renal clearance, whereas the volume of
      distribution remained the same. This result led to an increase in the terminal
      half-life of the drug, from 2 hours in healthy subjects to 14 1/2 hours in
      patients with uremia. This increase also resulted in a prolonged high serum
      concentration well above the minimum inhibitory concentration. The following
      dosages are thus recommended: (1) creatinine clearance greater than 50 ml/min:
      normal daily dose, (2) creatinine clearance from 20 to 50 ml/min: 50% of normal
      daily dose, and (3) creatinine clearance less than 20 ml/min: 25% of normal daily
      dose. An initial loading dose of 1 gm, independent of renal function, is advised.
      Cefpirome was safe and well tolerated.

PMID- 1623691
TI  - Failure of controlled clinical trial data to reach the literature.

PMID- 1623692
TI  - Verapamil inhibits ethanol elimination and prolongs the perception of
      intoxication.
AB  - Ten young healthy men received verapamil (80 mg every 8 hours for 6 days) or
      placebo in a blinded, randomized, crossover design. On the sixth day, ethanol was
      administered as a single oral dose (0.8 gm/kg), and blood samples were collected
      over the following 12 hours for determination of verapamil, norverapamil, and
      ethanol concentrations. Compared with placebo, verapamil increased the peak blood
      ethanol concentration (106.45 +/- 21.40 to 124.24 +/- 24.74 mg/dl, p less than
      0.05) and area under the ethanol concentration versus time curve (365.67 +/-
      93.52 to 475.07 +/- 97.24 mg.hr/dl, p less than 0.005). Verapamil areas under the
      concentration versus time curves (AUC) were positively correlated (r = 0.71, p
      less than 0.05) to increased ethanol blood AUC values. Each subject's perception
      of ethanol intoxication was measured by use of a simple visual analog scale.
      Compared with placebo, verapamil significantly increased area under the effect
      versus time curve (10.19 +/- 7.6 to 13.83 +/- 7.81 cm.hr, p less than 0.002) but
      did not change the peak effect or time to peak effect. Ethanol effect versus
      concentration plots were not significantly different between verapamil and
      placebo treatment phases when increased ethanol concentrations during verapamil
      therapy were taken into account. The findings of our study suggest that verapamil
      significantly inhibits ethanol elimination, resulting in elevated blood ethanol
      concentrations that prolong the intoxicating effects of alcohol.

PMID- 1623693
TI  - Effect of carbetocin, a long-acting oxytocin analog on the postpartum uterus.
AB  - Carbetocin, a long-acting oxytocin analog, was administered by intravenous and
      intramuscular injection to 40 women 24 to 48 hours postpartum. Intravenous
      injection of 8 to 30 micrograms produced a tetanic uterine contraction within 2
      minutes, lasting about 6 minutes, followed by rhythmic contractions for a further
      60 +/- 18 minutes. Intramuscular injection of 10 to 70 micrograms also produced
      tetanic contraction in less than 2 minutes, lasting about 11 minutes, and
      followed by rhythmic contractions for an additional 119 +/- 69 minutes. The
      prolonged duration of activity after intramuscular compared with the intravenous
      carbetocin was significant (p = 0.020). Carbetocin produced mild lower abdominal
      cramping in most patients and severe pain in three patients who received 50 or
      100 micrograms intravenously or 70 micrograms intramuscularly. Approximately half
      of the patients also experienced flushing and warmth. Although carbetocin has not
      yet been studied immediately postpartum, its prolonged uterine activity suggests
      that carbetocin may offer advantages over oxytocin in management of the third
      stage of labor.

PMID- 1623694
TI  - Differential effects of two dihydropyridine calcium antagonists in humans.
AB  - We studied the effects after single doses of niguldipine (0.3, 0.6, and 0.9 mg
      intravenously; 8 and 16 mg orally) and nifedipine (2 mg intravenously; 20 mg
      orally) in healthy male volunteers in randomized placebo-controlled experiments.
      Total peripheral resistance (TPR), heart rate-corrected electromechanical systole
      (QS2c), and preejection period (PEPc) were assessed noninvasively. Both drugs
      induced a similar pronounced decreased in TRP, indicating peripheral
      vasodilation, followed by increasing heart rate and cardiac output, a decrease in
      diastolic blood pressure, and a shortening of the PEPc. QS2c was unchanged after
      niguldipine. The prolongation of QS2c after oral nifedipine is suggestive of a
      negative inotropic effect. We conclude that the vasodilatory effects of
      dihydropyridines may (as for nifedipine) or may not (as for niguldipine) be
      associated with changes that are suggestive of negative inotropic effects, and
      that this difference is detectable by noninvasive methods in healthy subjects.

PMID- 1623695
TI  - Treatment of opioid-induced constipation with oral naloxone: a pilot study.
AB  - Opioids cause constipation by binding to specific opioid receptors in the enteric
      and central nervous systems. First-pass glucuronidation limits systemic
      bioavailability of oral naloxone. This study was designed to determine if oral
      naloxone could reverse opioid-induced constipation without precipitating
      abstinence or recrudescence of pain in opioid-dependent individuals.
      Concentrations of unmetabolized and total naloxone, including naloxone
      glucuronide, were measured by radioimmunoassay. A dose-related increase in
      symptoms of laxation resulted in all three opioid-dependent patients studied that
      paralleled the increase in active and total naloxone plasma levels. Withdrawal
      symptoms occurred with plasma naloxone area under the plasma concentration-time
      curves above 550 ng.min/ml and with dosing intervals less than 3 hours. Peak
      plasma levels did not predict withdrawal. Oral naloxone ameliorates opioid
      induced constipation in opioid-dependent persons. Titration of dose to a maximum
      of 12 mg at least 6 hours apart may be needed to avoid adverse reactions.

PMID- 1623696
TI  - AIDS debate continues.

PMID- 1623697
TI  - OSHA workplace requirements in effect: direct impact on physician offices.

PMID- 1623698
TI  - Cumulative contents of volumes 1 to 40 and cumulative author index of volumes 1
      40.

PMID- 1623699
TI  - Variation in restorative treatment decisions: application of Receiver Operating
      Characteristic curve (ROC) analysis.
AB  - It has been evident for many years that dentists, when planning treatment for
      patients, do not act in a standard manner, and previous research has shown there
      to be wide variations in treatment planning amongst groups of dentists. Signal
      detection theory and Receiver Operating Characteristic (ROC) analysis allows
      measurement of an observer's ability to detect a lesion, while at the same time
      allowing examination of how a lesion, once perceived, is judged to be in need of
      treatment. An ROC curve is constructed by plotting the sensitivity (or true
      positive rate) of decisions made, against the false positive rate (equivalent to
      1-specificity) when various decision attitudes, from interventionist to non
      interventionist, are held. Fifteen pairs of simulated bitewing radiographs were
      shown to 20 dentists, who were asked to specify, for each approximal lesion,
      whether or not they would place a conventional restoration. The 7200 decisions
      made by the dentists were validated by sectioning and microscopically examining
      the teeth. The mean sensitivity of the dentists' decisions, when the strictest
      operating thresholds were held and caries into dentine was the validating
      criterion, was 0.26 and the mean specificity was 0.96. ROC analysis shows that
      when operating at the strictest threshold, the dentists were implying that
      specificity was weighted as being 2.7 times more important than sensitivity. ROC
      analysis leads to insight into how dentists differentially weight the true and
      false, positive and negative, outcomes of their decisions and thus allows
      explanation of why two dentists would rarely make exactly the same treatment plan
      for one patient, and also why different treatments might be offered to two
      patients exhibiting the same levels of disease.

PMID- 1623700
TI  - Caries development after termination of a fluoride rinsing program.
AB  - In a municipality near Copenhagen, Denmark, where fortnightly fluoride rinses
      with 0.2% neutral sodium fluoride had been performed for more than a decade, 1306
      children from kindergarten through 6th grade were stratified by school and grade
      and randomly distributed into two groups. One group continued the fluoride
      rinses, the other group had the fluoride solution replaced with distilled water.
      Both solutions were slightly flavored. 1083 children completed the 3-yr trial.
      Caries was recorded clinically by the dentists in the municipal dental service
      using the diagnostic criteria for the Child Dental Health Services, and on
      bitewing radiographs by one of the authors applying the criteria developed by
      GRONDAHL et al. Permanent molars and premolars were included in the study.
      Clinically, caries increment in the two groups was the same with pits and
      fissures containing 94% of the DMFS. According to the radiographs, caries
      progression in the water group was higher than in the fluoride group. This
      difference was statistically significant for the surfaces erupting during the
      study (P less than 0.05).

PMID- 1623701
TI  - Extending recall intervals--effect on resource consumption and dental health.
AB  - The dental health of children has improved in recent years. This has stimulated
      more flexible planning and implementation of public dental care programs. The aim
      of the study was to compare time required for dental care and changes in dental
      health over a 2-yr period for patients examined and treated every 12 months and
      patients examined and treated every 24 months. The material comprised 185
      children aged 3, 16 and 18 yr. Children with high caries prevalence were not
      included in the material. Time used for examination and treatment and dental
      health parameters were recorded. The data were analyzed using multiple linear
      regression analysis. Mean time used for examinations and mean total time used by
      the dental health service over the 2-yr period were significantly less for
      patients examined every 24 months than for patients examined every 12 months,
      while the treatment times did not differ between the groups. The longer recall
      interval was associated with greater DMFS increment but this was not
      statistically significant. The study indicates that the dental health service in
      Norway could save resources, i.e. increase the productivity in the short term by
      extending the intervals between examinations.

PMID- 1623702
TI  - Dental health behavior in fathers of young families in Finland.
AB  - The purpose of this study was to examine dental health behavior in young fathers
      by means of a questionnaire for subjective evaluation of dental status, frequency
      of caries and visits to the dentist. Cariogenic diet was estimated by the
      consumption of sweets, confectionary and soft drinks. The participation rate 18
      months after the birth of the family's first child was 73.1%. The mean age of the
      respondents was 28.1 yr (range 17-49; SD 4.6). When background factors were
      considered, it was observed that cariogenic diet was more often mentioned by
      participants from the lower social groups. The standard of the wife's knowledge
      level was an important indicator of dental care behavior in the fathers. If the
      wife's knowledge level was high, the father assessed the future condition of his
      child's teeth as good.

PMID- 1623703
TI  - Validity of a patient self-completed health questionnaire in a primary care
      dental practice.
AB  - 1500 patient medical histories derived from self-completed health questionnaires
      alone and from a combination of questionnaire, structured interview by a dentist,
      and selective reference to family doctors were compared. In 4.25% of cases, the
      questionnaire medical history was significantly deficient. Such questionnaires
      yield an inadequate medical history when used on their own.

PMID- 1623704
TI  - Prevalence of caries in adolescents in relation to diet.
AB  - The aim of the present study was to compare dietary habits between adolescents
      with high or low dental caries prevalence. All 15-yr-old adolescents living in a
      small community in Northern Sweden were studied in 1987, 1988, and 1989. The
      median values for energy and nutrient intake exceeded or were close to the
      recommendations (SNR89) given by the Swedish National Food Administration. The
      fiber intake did not reach the recommended daily amount even for the 90th
      percentile of the studied cohort. Nineteen percent of the adolescents had caries
      free teeth and 10% had nine or more decayed or filled surfaces. There was no
      difference in daily sucrose intake or average number of meals per day between
      these two groups. The group with nine or more decayed or filled surfaces had
      worse dietary habits, expressed as a higher fat intake, lower intake of complex
      carbohydrates, and lower density of iron (mg/MJ) than the group with no dental
      caries. Dietary counseling by dentists should be a valuable addition to other
      caries prophylactic measures taken by the dentists.

PMID- 1623705
TI  - Effect of conventional dental restorative treatment on bacteria in saliva.
AB  - Dental caries results from the dissolution of mineralized dental tissues by the
      metabolic by-products of oral bacteria colonizing the surface of teeth. The
      principal modality for dealing with this infectious process is through
      restorative treatment which removes the pathologic tissue and replaces it with a
      variety of inert materials. The purpose of this study was to evaluate the effect
      of traditional restorative treatment on select oral bacterial populations. Fifty
      two females demonstrating high levels of mutans streptococci (greater than or
      equal to 2.5 x 10(4) colony forming units (cfu) per ml saliva) with no more than
      four missing posterior teeth were recruited for this study. Salivary levels of
      mutans streptococci, lactobacilli, total streptococci, and total cultivable
      bacteria were evaluated before, during, and after restorative treatment. Initial
      DMFS scores were established by two standardized examiners using bitewing
      radiographs and clinical examination, which was conducted under optimal
      conditions. All restorative treatment was completed by faculty members of the
      University of Alabama School of Dentistry using treatment plans developed by the
      DMFS examiners. The participants received a mean of 16.4 restored surfaces, which
      resulted in significant reductions of all the bacterial populations tested. All
      microbial populations monitored were predicted to return to their baseline levels
      within 151 days after restorative treatment in 50% of the participants. This
      study shows that conventional restorative treatment results in a significant
      reduction of bacterial populations including those associated with the dental
      caries process, i.e., mutans streptococci and lactobacilli.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1623706
TI  - Investigation of delay in utilization of government dental services in Malaysia.
AB  - Although delays in seeking dental care among patients are frequently observed in
      daily practice, this problem has never been investigated in other utilization
      studies. This study attempts to establish the magnitude and severity of the
      problem of delay in a delivery system where cost is not a major barrier to
      utilization. 555 users of Government dental services were interviewed. Only 37%
      of them came promptly within 6 days of perceiving a dental need. The majority
      (63%) had delayed their dental visit for more than 1 week. In fact, the highest
      frequency of delay was for more than 1 month. Prompt attendance was found to be
      associated with people who regularly came for asymptomatic check-ups. In
      contrast, more than 50% of those who thought they needed fillings and extractions
      had delayed their visit for more than a month. The main causes of delays were
      attributed to work commitments and the lack of perceived need for urgent care.
      Barriers related to transport or financial problems were ranked very low. The
      implications of these findings are discussed.

PMID- 1623707
TI  - Evaluation of appropriate use of dietary fluoride supplements in the US.
AB  - Recent epidemiologic and related evidence suggests the following trends: 1. the
      prevalence of caries continues to decline in children of the US and several other
      developed countries; 2. the prevalence of mild dental fluorosis is increasing; 3.
      the majority of the cariostatic effects of fluoride are topical; and 4. dietary
      fluoride supplements are a risk factor for dental fluorosis. These trends, and
      the scientific evidence on fluoride and fluorosis, suggest that it is time to re
      evaluate the use of dietary fluoride supplements. This paper examines the
      evidence for each of the four trends and the use of fluoride supplements in
      caries prevention today.

PMID- 1623708
TI  - Prevalence of dental caries in school children of Lahore, Pakistan.

PMID- 1623709
TI  - Periodontal conditions of 6-15-yr-olds in various fluoride areas in Greece.

PMID- 1623710
TI  - Caries, gingivitis and oral hygiene in urban and rural pre-school children in
      Indonesia.

PMID- 1623711
TI  - Periodontal status of adults in central Saudi Arabia.

PMID- 1623712
TI  - Possible explanations for decline in tooth decay in New Zealand.

PMID- 1623713
TI  - Agreement between oral contraceptive users and prescribers: implications for case
      control studies.
AB  - Case-control studies examining the effects of oral contraceptives (OC) are prone
      to misclassification bias due to errors in assessment of OC use. Concern about
      inaccurate exposure histories has increased since current studies require women
      to recall OC use over prolonged periods of time. In preparation for a case
      control study of breast cancer and OC use, an investigation was carried out to
      assess agreement between women's lifetime histories of OC use (covering a period
      of up to 20 years) and prescribers' records. OC histories were obtained during
      personal interview with 218 women who had used OC at some point in their lives
      (127 breast cancer patients, 91 controls). Recall was aided by an album with
      color photographs of all OC marketed in the Netherlands from 1962 onwards (n =
      65), and a calendar that covered the women's life span from date of birth to
      menopause. The participants were asked for the names of all physicians who
      prescribed OC for them. The rate of response from the prescribers was high (94%),
      but only half of the forms provided useful information. Patient-prescriber
      agreement on brand names (including dosage) was 70%. About half of the women
      agreed with their prescribers on starting dates to within less than a year's
      difference. Approximately the same percentage of agreement was found for stopping
      dates. Multiple linear regression indicated that agreement on brand names and
      dates of usage was lower for women of low socioeconomic status, for healthy women
      (as compared to breast cancer patients) and for periods of pill use that had to
      be recalled from the more distant past. Agreement on total duration of use was
      high enough to permit testing of a moderately strong duration-response
      relationship in a case-control study.

PMID- 1623714
TI  - Contraceptive use in Vietnam: the effect of individual and community
      characteristics.
AB  - Data from the 1988 Vietnamese Demographic and Health Survey and the 1990 Vietnam
      Study of Accessibility of Contraceptives were used in this analysis to determine
      how selective individual and community characteristics influenced the use of
      modern methods of contraception in Vietnam. Although there were no significant
      differences in the use of contraceptives between women with a primary education
      and those with a higher educational attainment, the illiterate women with no
      formal education were significantly less likely to use modern methods of
      contraception. Women living in provinces with high infant mortality rates were
      significantly less likely to use modern methods of contraception than women in
      low-infant-mortality provinces. Independent of other individual and community
      characteristics, there were no significant differences in the use of
      contraception between urban and rural women.

PMID- 1623715
TI  - Comparison of condom breakage during human use with performance in laboratory
      testing.
AB  - This paper combines results from a study of the determinants of condom quality
      and use conducted by The Population Council in two countries in the Caribbean
      with results from a condom breakage study conducted by Family Health
      International (FHI) in the United States. The studies, conducted two years apart,
      compared the breakage rates of condoms from the same lot during human use to
      their performance in laboratory test results. Breakage rates of 12.9% for
      Barbados, 10.1% for St. Lucia and 6.7% for the United States compared to passing
      ASTM laboratory tests suggest that existing laboratory tests as used with the
      current pass/fail standards are either not sufficiently sensitive or not well
      defined to reliably predict condom performance during human use. The study also
      suggests that user behaviors and practices may be a factor in condom breakage. If
      the condom is to be an effective method against unplanned pregnancy and STD/HIV
      infection, and if consumer confidence is to be retained, condom breakage during
      sexual intercourse must be reduced.

PMID- 1623716
TI  - Contraceptive efficacy of polyester-induced azoospermia in normal men.
AB  - The contraceptive effect of a polyester sling applied to the scrotum was studied
      in 14 men. The suspensor was worn for 12 months. Follow-up investigations
      comprised periodic check of semen character, testicular size, rectal-testicular
      temperature difference, serum reproductive hormones and testicular biopsy. The
      electrostatic potentials generated by friction between the polyester suspensor
      and the scrotal skin were determined. Female partners used contraceptives until
      the men became azoospermic. After 12 months, the suspensor was abandoned and the
      aforementioned investigations were performed again. In the suspensor-wearing
      period, all men became azoospermic after a mean of 139.6 +/- 20.8 sd days, with
      decrease in both testicular volume (P less than 0.05) and rectal-testicular
      temperature difference (P less than 0.001). Serum reproductive hormones showed no
      significant change (P greater than 0.05). Seminiferous tubules revealed
      degenerative changes. No pregnancy occurred during this period. The polyester
      suspensor generated electrostatic potentials (mean 366.4 +/- 30.5 sd volt/cm2 by
      day and 158.3 +/- 13.6 sd volt/cm2 by night). In the suspensor-release period,
      the sperm concentration returned to the pre-test level in a mean period of 156.6
      +/- 14.8 sd days. Likewise, the testicular volume and rectal-testicular
      temperature difference were normalized. The 5 couples, who had planned to become
      pregnant, conceived. The azoospermic effect of the polyester sling seems to be
      due to two mechanisms: 1) the creation of an electrostatic field across the
      intrascrotal structures, and 2) disordered thermoregulation. To conclude, fertile
      men can be rendered azoospermic by wearing the polyester sling. It is a safe,
      reversible, acceptable and inexpensive method of contraception in men.

PMID- 1623717
TI  - Acceptability of Norplant-2 rods as a method of family planning.
AB  - The Norplant-2 rod system consists of two silastic rods in which levonogestrel
      has been incorporated with the polymer. The continuation rate at the end of five
      year was 62%. No accidental pregnancies occurred throughout the five years of
      use. The post-removal conception rate in women desiring pregnancy was 70.8% at
      the end of two years. The majority of acceptors were happy with the rods and
      86.8% expressed the desire to have another set of implants inserted following
      removal of the first set. The study shows the Norplant-2 rod system to be a well
      accepted method of family planning.

PMID- 1623718
TI  - Effect of Norplant-2 rods on liver, lipid and carbohydrate metabolism.
AB  - The effect of Norplant-2 rods on liver, lipid and carbohydrate metabolism was
      evaluated in 100 women using Norplant-2 rods. Besides a significant increase in
      serum bilirubin, there was no other obvious evidence to suggest any possible
      hepatocellular dysfunction with the use of Norplant-2 rods. As regards lipid
      metabolism, decreases in total triglycerides, cholesterol and LDL-cholesterol and
      HDL-cholesterol were initially seen. These parameters returned to their
      preinsertion mean at the end of five years. As a result, the value of the HDL
      cholesterol/total cholesterol - HDL-cholesterol and LDL-cholesterol/HDL
      cholesterol ratios remained around their preinsertion value at the end of five
      years. All this appears to indicate that the use of Norplant-2 rods is not
      directly contributory to cardiovascular risk. The use of Norplant-2 rods was not
      associated with any significant effect on carbohydrate metabolism.

PMID- 1623719
TI  - Effects of STS-557 and 20 Aet-1 on sperm functions and serum level of
      testosterone in bonnet monkey (Macaca radiata).
AB  - Treatment of adult male bonnet monkeys with STS-557 (17 alpha-cyanomethyl 17 beta
      hydroxy estra-4, 9(10)-dien-3-one; 12 mg/monkey daily for 15 weeks; i.m.) reduced
      the sperm count from the 9th week, leading close to azoospermia on the 2nd post
      treatment week which persisted until the 10th post-treatment week and normalcy
      was restored on the 13th post-treatment week. The sperm motility was reduced from
      the 9th week of treatment to 8th post-treatment week. The fertilizing ability of
      spermatozoa (formation of swollen sperm head or pronuclei in zona-free hamster
      eggs) was abolished from the 8th week of treatment to the 7th post-treatment
      week. The serum level of testosterone was reduced from the 2nd to 12th week of
      treatment (data on subsequent weeks were not collected). When 20 Aet-1
      (testosterone-trans-4-n butyl cyclohexyl carboxylate; 40 mg/monkey, single; i.m.)
      was administered on the first day of STS-557 treatment, the sperm count was
      reduced from the 10th week, with near azoospermia ensuing on the 13th week which
      continued until the 8th post-treatment week; recovery was observed on the 12th
      post-treatment week. The motility was low from the 8th week of treatment to 6th
      week after withdrawal of treatment. The fertilizing ability of spermatozoa was
      abolished from the 8th week to the 12th week of treatment (data on last week of
      treatment were not collected). The serum level of testosterone was maintained
      within normal range except on the 2nd, 6th and 12th week of treatment. 20 Aet-1
      alone had no significant effect on these parameters.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1623720
TI  - Histopathological and biochemical effects of gossypol acetate on pituitary
      gonadal axis of male albino rats.
AB  - Histopathological and biochemical effects of gossypol acetate (GA) on pituitary
      gonadal axis were investigated. 10 and 25 mg GA/kg were administered orally to
      sexually mature adult male Wistar rats for 4 and 5 weeks, respectively. STH and
      LTH/PRL cells showed no significant changes as compared to those of controls
      while TSH cells showed hypertrophy, hyperplasia and degranulation in both
      experimental groups. Pituitary FSH, LH/ICSH cells showed progressive regression.
      Gonosomatic indices of sex accessory glands at 25 mg showed significant reduction
      in the experimental animals as compared to those of controls. The diameter of
      seminiferous tubules reduced and azoospermia developed. Sertoli and Leydig cells
      also regressed. At 10 and 25 mg GA treatment, spermatogenesis ceased at secondary
      spermatocytes and spermatogonia stages, respectively. Epididymis and prostate
      regressed. Seminal vesicle showed no significant histological variations as
      compared to that of control except reduction in secretion. Biochemical
      observations revealed increased levels of acid phosphatase, fructose and citric
      acid and significant reduction in glycerylphosphoryl choline in reproductive
      glands of both experimental groups as compared to those of controls. Possible
      mechanism of antifertility action of GA is discussed.

PMID- 1623722
TI  - Introduction of ultrasound examination.

PMID- 1623721
TI  - The effects of a combined contraceptive vaginal ring releasing ethinyloestradiol
      and 3-ketodesogestrel on vaginal flora.
AB  - Fifty nine women with documented normal ovulatory cycles and with no symptoms of
      vaginal infection were divided into four groups. Each group used a combined
      contraceptive vaginal ring (CCVR) with a mean daily release rate of 0.015 mg of
      ethinyloestradiol (EE) and 0.120 mg of 3-ketodesogestrel (3-KDG) per day, for one
      cycle of either 21, 28, 42, or 56 days. Cultures from the posterior vaginal
      fornix and from the endocervical canal were obtained immediately before insertion
      of the ring and on removal of the ring. Changes in the numbers of vaginal cells,
      aerobic and anaerobic bacteria, Chlamydia trachomatis, Gardnerella vaginalis,
      yeasts and Trichomonas vaginalis were documented at the end of each treatment.
      Intra- and inter- group changes in the vaginal flora were assessed at the end of
      each treatment. The comparison between the number and type of flora showed no
      significant change between the pre-treatment population and the post-treatment
      population. The results of this study suggest that the use of this CCVR for 21,
      28, 42 and 56 days is not associated with an increase in inflammatory cells or
      pathogenic bacteria.

PMID- 1623723
TI  - Leukocyte adhesion deficiency among Holstein cattle.

PMID- 1623724
TI  - Endocrine-immune interactions: potential role for somatotropic axis in modulating
      responses to endotoxemia in cattle.

PMID- 1623725
TI  - Thymoma in a domestic rabbit.
AB  - Thymic tumors are uncommon in small domestic animals, and thymomas are
      infrequently reported in rabbits. This report presents a 7-year-old Netherland
      dwarf rabbit with an anterior mediastinal mass which caused hyperpnea, open-mouth
      breathing, swelling of the head, and exophthalmos. The mass was composed
      predominantly of lymphocytes, but the presence of thymic epithelial cells
      established the histologic diagnosis of thymoma.

PMID- 1623726
TI  - Swine models for cardiovascular research: a low stress transport and restraint
      system for large swine.
AB  - A restraint and transport system was developed for handling large swine during
      cardiovascular research studies. The major design criteria provided for
      comfortable, low stress restraint of the swine, safety for laboratory personnel
      and ability to perform a wide variety of hemodynamic and echocardiographic
      measurements in the standing, supported standing and sedated, or in Panepinto
      sling positions. A head gate is provided for venipuncture procedures, and an
      auxiliary feeding and watering front panel can replace the head gate for use of
      the system as a post-operative "recovery room". Using this system animals
      weighing 22 to 150 kg can be easily managed.

PMID- 1623727
TI  - Rectovaginal fistula with atresia ani in three kittens.
AB  - Rectovaginal fistula with atresia ani was diagnosed in 3 kittens. Physical
      abnormalities included abdominal distension, bulging of the perineum, and lack of
      an anal opening. Vaginography was helpful in determining the type of malformation
      present in 2 cases. In each kitten attempts were made to surgically correct the
      anatomic malformations. Various post-operative complications such as fecal
      incontinence, would dehiscence, constipation, and excessive scar tissue formation
      occurred and are discussed.

PMID- 1623728
TI  - Mycoplasma felis pleuritis in two show-jumper horses.
AB  - Mycoplasma felis was identified as the cause of acute pleuritis in 2 show-jumping
      horses. The pleural exudate was proteinaceous, contained large numbers of
      neutrophils, and had a markedly increased lactate concentration. M. felis was
      isolated in pure culture from pleural fluid. Rising serum antibody titers to M.
      felis as well as a precipitous decline in titers to equine influenza virus were
      demonstrated in both horses. Pleural effusion in both horses and a pneumothorax
      detected in one of the horses resolved following a single drainage of pleural
      fluid and intravenous fluid, antibiotic, and analgesic therapy.

PMID- 1623729
TI  - Intestinal myxosarcoma in a thoroughbred mare.
AB  - A large fibrotic mass originating from the cecal base was discovered upon
      surgical exploration of the abdomen in a Thoroughbred mare with a history of
      chronic colic and weight loss. The mass protruded intraluminally resulting in
      partial obstruction. Surgical excision was not feasible due to the location of
      the mass and the inability to exteriorize it adequately from the abdominal
      cavity. The mass was fibrous with a shiny, gelatinous material present throughout
      the neoplasm. Histologically, large confluent spaces filled with
      mucopolysaccharides were identified by staining with Alcian blue. The diagnosis
      of myxosarcoma was based upon finding of atypical fibroblastic cells, mucinous
      stroma, local invasiveness, and metastasis to the regional lymph nodes.
      Myxomatous tumors have not previously been documented to occur in the equine
      intestinal tract.

PMID- 1623730
TI  - A leg restraint system for prevention of peripheral edema and limb trauma in
      swine.

PMID- 1623731
TI  - Hypoglycemia and hepatic ischemic necrosis after small intestinal incarceration
      through the epiploic foramen in a horse.
AB  - A 16-year-old stallion was presented to the Louisiana State University Veterinary
      Teaching Hospital for evaluation of acute abdominal pain. Physical examination
      and diagnostic procedures indicated a strangulating obstruction of the small
      intestine. At exploratory celiotomy, a strangulating incarceration of the jejunum
      through the epiploic foramen was found. The incarcerated small intestine was
      reduced, then resection of the nonviable bowel and anastomosis performed. After
      surgery, the horse exhibited clinical signs and laboratory findings associated
      with hypoglycemia and died in spite of emergency treatment. On post-mortem
      examination, a large thrombus was present in the portal vein at the level of the
      epiploic foramen and the liver had multiple large infarcted areas. The post
      operative signs of hypoglycemia and necropsy findings of widespread hepatic
      ischemic necrosis are complications of epiploic foramen incarceration of the
      small intestine not previously reported and may in part explain the high
      mortality rate described for this lesion.

PMID- 1623732
TI  - Intraluminal hemorrhage from small intestinal ulceration in two cows.
AB  - Two adult Holstein cows were admitted with signs of acute gastrointestinal
      hemorrhage. Abomasal ulceration was diagnosed tentatively in both cows, but was
      later ruled out in 1 cow that had an abomasotomy performed through a right
      paramedian approach. Both cows failed to respond to treatment of blood loss and
      hypovolemic shock and became recumbent; one cow died and the other was
      euthanatized. Post-mortem examination determined the source of hemorrhage in both
      cows to be ulcerated small intestine with severe intraluminal hemorrhage. The
      cause of ulceration was undetermined. Small intestinal hemorrhage should be
      considered in cattle with signs of acute gastrointestinal hemorrhage.

PMID- 1623733
TI  - The teniae of the equine intestinal tract.
AB  - At several locations along the equine cecum and colon, the outer longitudinal
      portion of the tunica muscularis is gathered into discrete bands of smooth muscle
      and connective tissue called "teniae". In this study, the disposition of the
      teniae ceci and coli was traced along the equine intestinal tract. It was
      discovered that, in several instances, arrays of teniae converge toward the
      valves and sphincters which separate the various intestinal compartments. The
      teniae may also provide support for and directionality to, peristaltic
      contraction waves. The tissue proportions of the teniae vary in different
      locations. The tenia libera lateralis of the ventral colon is rich in elastic
      connective tissue, while that of the right dorsal colon is primarily composed of
      smooth muscle. This may reflect the different responsibilities of these two
      compartments. The teniae are innervated and their smooth muscle cells are joined
      by many gap junctions. The connective tissue constituents afford intestinal
      support while yielding to intestinal distension. The smooth muscle and neural
      elements may foster active tenial participation in peristalsis. This premise must
      be tested by electrophysiological experimentation. Further experimentation is
      also necessary to ascertain whether injury to the teniae might predispose a horse
      to colic.

PMID- 1623734
TI  - Bronchoalveolar lavage in the study of asthma.

PMID- 1623735
TI  - Endoscopic management of bronchial stenosis after double lung transplantation.
AB  - Double lung transplantation with bilateral bronchial sutures is an increasingly
      popular therapeutic alternative for endstage, bilateral, septic pulmonary
      disease; however, surgical outcome has been hampered by mechanical complications
      at the level of the airway anastomoses. In our institution, therefore, the
      protocol for surveillance includes frequent flexible fiberoptic and rigid
      bronchoscopy under general anesthesia in all patients. Since 1988, there were 24
      double lung transplantations (mean age, 19 yr) performed at the University of
      Marseille Hospitals using bilateral sutures without omental wrapping. Nineteen
      patients had cystic fibrosis; of the ten individuals (53 percent) with cystic
      fibrosis who ultimately developed bronchial stenosis, six required therapeutic
      endoscopic intervention including dilatation or Nd:YAG laser resection. Five
      patients required endobronchial silicone stents. Statistically significant risk
      factors for postsurgical airway narrowing included young age (mean, 14.3 yr vs
      24.0 yr in patients without stenosis) and prolonged mechanical ventilation prior
      to transplant (all five patients ventilated before surgery developed stenosis).
      Results of interventional bronchoscopy were good, and an excellent level of
      physical activity was maintained in most patients. A team familiar with all
      aspects of therapeutic bronchoscopy is essential to ensure proper management of
      airway complications in patients after lung transplantation.

PMID- 1623736
TI  - Ventricular function in snorers and patients with obstructive sleep apnea.
AB  - We hypothesized that intermittent hypoxemia and increased ventricular afterload
      due to obstructive apnea during sleep (OSA) would cause chronic left ventricular
      dysfunction. Overnight polysomnography, M-mode and two-dimensional echo-Doppler
      studies while awake were performed on 51 consecutive snorers, 30 with OSA and 21
      without apnea. Patients with previous myocardial infarction, awake hypoxemia or
      hypercapnia, or other causes of nocturnal hypoxemia were excluded. Echo-Doppler
      measurements included end-diastolic right and left ventricular dimensions and
      wall thickness, indices of left ventricular systolic performance (fractional
      shortening, ejection fraction and ejection time and diastolic performance,
      (isovolumic relaxation time, ratio of peak early [E] to late [A] diastolic
      transmitral flow and mitral pressure half-time). Both OSA patients and nonapneic
      snorers were of similar age. Although OSA patients were heavier, had a greater
      apnea-hypopnea index, and significant nocturnal hypoxemia, their echo-Doppler
      measurements were within normal limits and were not significantly different from
      nonapneic snorers. It is concluded that isolated obstructive sleep apnea does not
      cause chronic left ventricular dysfunction.

PMID- 1623737
TI  - Glucose homeostasis. Comparison between hypothermic and normothermic
      cardiopulmonary bypass.
AB  - STUDY OBJECTIVE: Disturbance in blood glucose homeostasis during cardiac surgery
      may cause visceral and metabolic alterations. Hypothermic CPB induces glucose and
      hormonal changes. As normothermic CPB is used at some institutions, a comparison
      of blood glucose and plasma hormones between hypothermic and normothermic CPB was
      performed. DESIGN: Prospective nonrandomized study. SETTING: University cardiac
      center. PATIENTS: Twenty-two nondiabetic adults undergoing elective coronary
      bypass and/or valvular surgery. INTERVENTIONS: Group 1 (n = 12) underwent
      hypothermic CPB (25 degrees C) and group 2 (n = 10) normothermic CPB (37 degrees
      C). In both groups nonpulsatile CPB was achieved with a membrane oxygenator and
      dextrose-free crystalloid priming. Dextrose was not administered during surgery
      but was infused postoperatively (125 mg/kg/h). MEASUREMENTS AND RESULTS: Eight
      blood samples were drawn during the period of arrival in the operating room
      (control) to the third postoperative hour. During hypothermic CPB in group 1,
      blood glucose level increased to 154 +/- 20 mg/dl (mean +/- SD) associated with a
      decrease in plasma insulin and an increase in epinephrine, despite a decrease in
      cortisol and growth hormone. During rewarming, the blood glucose value continued
      to increase (to 197 +/- 35 mg/dl) associated with an increase in glucagon, growth
      hormone and catecholamines, despite a 374 percent increase in insulin. During CPB
      in group 2, insulin, glucagon, cortisol and catecholamines were significantly
      higher than during hypothermic CPB so that the blood glucose level was not
      significantly different between the two groups during CPB. Blood glucose value
      was higher in group 1 than in group 2 at closure of the chest (208 +/- 30 vs 175
      +/- 19 mg/dl, respectively, p less than 0.02) and at the third postoperative hour
      (271 +/- 30 vs 221 +/- 51 mg/dl, p less than 0.01). In both groups, however, the
      postoperative increase in blood glucose was accompanied by a similar increase in
      insulin, cortisol and catecholamines but glucagon was lower after hypothermic
      CPB. CONCLUSIONS: Hyperglycemia occurred perioperatively in cardiac surgery with
      dextrose-free priming both during hypothermic and normothermic CPB but
      normothermic CPB resulted in a slow and steady increase in both glucose and
      insulin concentrations without the major perturbations that occurred with
      hypothermic CPB. Postoperatively, higher blood glucose was observed in the
      hypothermic CPB group.

PMID- 1623738
TI  - A two-bag system for continuous measurement of oxygen uptake.
AB  - Collection of mixed expired gas in a bag has been a classic method for the
      estimation of VO2 during the steady state but has not been employed during
      unsteady state exercise in part because there is a need for suspending the
      acquisition of data during the period of gas analysis unless many bags are used.
      In this study a two-bag system is described in which one bag fills while the
      other is analyzed. Bag volume is under the control of the operator, and we
      employed volumes of 30 to 50 L. Thirty-one subjects were studied with this
      circuit in a progressive treadmill test. Although VO2 could be falsely elevated
      during periods of overbreathing, this source of error could be identified and its
      effect reduced if VO2 was plotted against both ventilation and power requirement.
      Plateau values of VO2 were identified only in six subjects and the ventilatory
      threshold in 16.

PMID- 1623739
TI  - Elevation of plasma truncated elastase alpha 1-proteinase inhibitor complexes in
      patients with inflammatory lung diseases.
AB  - Human neutrophil elastase plays an important role in the development of several
      inflammatory lung diseases; however, there have been relatively few
      investigations using plasma samples. In this report, we describe alterations in
      the plasma elastase:alpha 1-PI complex in patients with chronic obstructive
      pulmonary disease (COPD) (15 cases), COPD with infection (8), diffuse
      panbronchiolitis (DPB) (8), bronchiectasis (9), pneumonia (10), and the adult
      respiratory distress syndrome (ARDS) (14), and in 15 normal volunteers. The
      elastase:alpha 1-PI complex concentration was determined by an enzyme-linked
      immunosorbent assay. Western immunoblot analysis of the elastase:alpha 1-PI
      complex was also performed. Plasma elastase:alpha 1-PI complex was also
      performed. Plasma elastase:alpha 1-PI complex levels in patients with COPD with
      infection (504 micrograms/L +/- 93 micrograms/L) were significantly higher, as
      compared with those with COPD but without infection (118 micrograms/L +/- 9
      micrograms/L) and normal volunteers (122 micrograms/L +/- 4 micrograms/L).
      Increased complex concentrations were also found in patients with DPB and
      bronchiectasis (643 micrograms/L +/- 222 micrograms/L and 558 micrograms/L +/-
      198 micrograms/L, respectively) as compared with normal volunteers. Increased
      complex concentrations were also found in patients with pneumonia and ARDS (450
      micrograms/L +/- 101 micrograms/L and 1,400 micrograms/L +/- 438 micrograms/L,
      respectively). Western immunoblot analysis using anti-alpha 1-PI antibody and
      antineutrophil elastase antibody showed two types of elastase:alpha 1-PI
      complexes, one with a molecular weight of 60,000 daltons (60 kilodaltons [KD])
      and the other at 50,000 daltons (50 KD). Although the native 80-KD elastase:alpha
      1-PI complex was detected in bronchoalveolar lavage fluid, it was not found in
      plasma. In summary, these results demonstrated that levels of the truncated
      complex were increased in patients with various inflammatory lung diseases. This
      truncated form may play an important role in the pathophysiology of inflammatory
      processes.

PMID- 1623740
TI  - Cerebral vascular responsiveness in chronic hypercapnia.
AB  - To assess the responsiveness of the cerebral vessels to chronic hypercapnia, we
      measured middle cerebral artery flow velocity by transcranial Doppler ultrasound
      in 20 normal subjects and in 14 COLD patients before and after stimulation by
      progressive hypercapnia (rebreathing test) or by intravenous administration of an
      acetazolamide bolus. The results showed no statistically significant difference
      in baseline flow velocity between the normal subjects and the COLD patients. The
      COLD patients showed a reduced cerebral vascular responsiveness to both stimuli.
      Cerebral blood flow is normal in chronic hypercapnia and the mechanism by which
      compensation is achieved leads to a decrease in cerebral vascular responsiveness.

PMID- 1623741
TI  - Effects of body position and age on membrane diffusing capacity and pulmonary
      capillary blood volume.
AB  - The effects of body position and age on the membrane diffusing capacity (Dm),
      pulmonary capillary blood volume (Vc), and the single breath carbon monoxide
      diffusing capacity (Dco) were evaluated in the erect (sitting) and supine
      positions in 16 normal young men (under 40 years old, younger group) and in 13
      older men (over 40 years old, older group). Dm and Vc were estimated by several
      measurements of the Dco at increasing alveolar oxygen tension (PAO2). The results
      showed that Dco, Dm, Vc, and Kco (Dco corrected by alveolar volume) decreased
      with age in both positions. The differences in Dco, VC, and Kco between the two
      positions (supine minus the erect position) also decreased with age. The
      mechanisms of the increases in Dco in the supine position remain to be explained
      but may be due to a change in pulmonary capillary shape from an elliptical (erect
      position) to a circular configuration (supine position) since Vc increased more
      than Dm on assuming the supine position. The findings may be of clinical
      importance since many physicians have attempted to utilize a reduction in the
      positional change in Dco as a potential marker of disease.

PMID- 1623742
TI  - The role of bronchoscopy in the diagnosis of pulmonary tuberculosis in patients
      at risk for HIV infection.
AB  - The present study was undertaken to clarify the role of bronchoalveolar lavage
      (BAL) and transbronchial biopsy (TBB) in the diagnosis of pulmonary tuberculosis
      in patients at risk for human immunodeficiency virus (HIV) infection. We
      retrospectively identified 31 patients at risk for HIV who proved to have
      Mycobacterium tuberculosis on culture of at least one pulmonary specimen. All had
      pulmonary symptoms but initial sputum smears negative for acid-fast bacilli
      (AFB). All underwent fiberoptic bronchoscopy (FOB), including BAL and TBB;
      postbronchoscopy sputum was also collected in 19 patients. A specimen was
      considered to yield an immediate diagnosis when positive for AFB either on smear
      or histologic study; granulomas alone were considered positive when no other
      causes were identified. Overall, an immediate diagnosis was made by bronchoscopic
      specimens in 15 (48 percent) of 31 cases. TBB was the sole positive specimen in
      seven patients (23 percent). For comparison, similar specimens from 40 patients
      in whom M avium complex (MAC) grew on culture were also evaluated. An immediate
      identification of AFB was made in only four patients (10 percent). We conclude
      that the finding of AFB on staining of any pulmonary specimen is highly
      suggestive of tuberculosis, rather than MAC, and warrants institution of
      antituberculosis therapy. Of all bronchoscopic specimens, TBB provides the
      highest yield for an immediate diagnosis of tuberculosis.

PMID- 1623743
TI  - Evaluation of breath-by-breath measurement of respiratory gas exchange in
      pediatric exercise testing.
AB  - In adults, breath-by-breath analysis has been used for measuring respiratory gas
      exchange during exercise. The present study evaluates the validity and
      reproducibility of this method in children. In 21 patients with various types of
      congenital heart disease, steady state exercise testing was performed on a motor
      driven treadmill. Based on simultaneous measurements of VO2, VCO2, VE and R,
      comparisons were made between the breath-by-breath and Douglas bag methods. No
      significant differences were found between both methods for any of the variables.
      In seven other patients the reproducibility of cardiorespiratory variables during
      exercise was assessed. No significant difference was found for the
      cardiorespiratory variables during any of the tests and the coefficients of
      variation were comparable to data obtained in adults. It is concluded that the
      breath-by-breath method for measuring respiratory values can be applied in
      children with an acceptable degree of validity and reproducibility.

PMID- 1623744
TI  - Reliability of a respiratory history questionnaire and effect of mode of
      administration on classification of asthma in children.
AB  - Because there is no consensus definition of asthma for epidemiology, we have
      examined the reliability of a questionnaire and the effect of its mode of
      administration on classification of asthma in children. A symptom history
      questionnaire was parent self-administered and then readministered within three
      months by a nurse. The questions of diagnosed asthma, cumulative wheeze, and
      recent wheeze (wheeze in the previous 12 months) were more repeatable than
      questions of night cough, but 7 percent of children changed diagnosed asthma
      category, 13 percent changed cumulative wheeze category, and 9 percent changed
      recent wheeze category at second questionnaire. Because the numbers who changed
      from symptom positive to negative roughly equalled the changes from negative to
      positive, prevalence estimates were not affected. Methods of measuring asthma
      with greater precision are urgently needed. Because of reporting bias,
      epidemiologic information collected by current questionnaires should be treated
      with some caution.

PMID- 1623745
TI  - Risk factors for reduced pulmonary function in women. A possible relationship
      between Pi phenotype, number of children, and pulmonary function.
AB  - Smoking and severe deficiency of protease inhibitor (Pi Z phenotype) both
      contribute significantly to the development of chronic obstructive pulmonary
      disease (COPD). The role of moderate Pi deficiency (Pi MZ phenotype) remains
      controversial. During a community-wide study of respiratory health which included
      1,633 individuals, of whom 897 were women, we measured forced vital capacity
      (FVC), forced expired flow in 1 s (FEV1), midmaximum expired flow rate (MMFR),
      flow rate at 50 percent of FVC (Vmax50%) and flow rate at 25 percent of FVC above
      residual volume (Vmax25%). We carried out Pi phenotyping on 544 of these women,
      including 22 who were Pi MZ or FZ phenotypes. There were no statistically
      significant differences in mean pulmonary function (pf) values between the Pi MZ
      and Pi M women. Examination of residual pf values (difference between observed
      and expected) by means of multiple multivariate regression analysis revealed that
      in Pi MZ women, FEV1/FVC%, MMFR, Vmax50%, and Vmax25% had significantly greater
      values with increasing numbers of children, whereas there was no relationship in
      the Pi M women. These results suggest that some factors may interact differently
      in individuals with Pi M and MZ phenotypes. In addition, the results suggest that
      pregnancy or pregnancy-induced increased Pi levels may have significant effects
      on the pulmonary health of Pi MZ women.

PMID- 1623746
TI  - Survival of patients with severe thoracic spine deformities receiving domiciliary
      oxygen therapy.
AB  - Scoliosis can lead to respiratory failure and premature death. Alveolar
      hypoventilation is a dominant cause and artificial ventilation at home (AVH) is
      probably the treatment of choice. It has been suggested that long-term
      domiciliary oxygen therapy (LTO) is of little value because of the worsening of
      hypercapnia. We analyzed survival and predictors of death among 80 patients with
      scoliosis and other severe thoracic spine deformities receiving LTO for chronic
      hypoxia. The survival rate was higher in patients under the age of 65 (p = 0.01)
      and in patients without concomitant pulmonary or airways disease. Likewise, the
      survival rate was higher in patients with a PaCO2 of greater than 7.4 kPa than in
      patients with a lesser degree of hypoventilation and hypercapnia (p less than
      0.05). The risk of developing life-threatening hypercapnia during well-controlled
      LTO appeared to be small. In younger patients without complicating disease, long
      term survival was achieved with LTO, but with time, an increasing proportion of
      the patients changed to AVH, with or without LTO.

PMID- 1623747
TI  - Use of arm crank exercise in the detection of abnormal pulmonary gas exchange in
      patients at low altitude.
AB  - BACKGROUND: The measurement of arterial blood gases, P(A-a)O2 and VD/VT, during
      cycle ergometry is the "gold standard" for the assessment of pulmonary gas
      exchange. However, some patients are unable to perform cycle ergometry because of
      other medical problems. STUDY OBJECTIVE: To determine whether arm crank exercise
      could be used to reliably detect gas exchange abnormalities compared to cycle
      ergometry. PARTICIPANTS: Fifteen patients with a variety of pulmonary disorders,
      who were referred for exertional dyspnea. DESIGN: All patients performed maximal
      arm crank and cycle exercise. Arterial blood gases, VO2, VCO2, and VE were
      measured at rest and during exercise. RESULTS: Compared to peak cycle exercise
      (mean +/- SD), PaO2 (85 +/- 14 vs 75 +/- 13 mm Hg), SaO2 (94 +/- 2 vs 91 +/- 4
      percent), VD/VT (0.21 +/- 0.07 vs 0.19 +/- 0.08), and pH (7.37 +/- 0.04 vs 7.34
      +/- 0.03) were significantly higher during peak arm crank exercise. The P(A-a)O2
      (18 +/- 13 vs 29 +/- 12 mm Hg) was narrower, and PaCO2 (29 +/- 3 vs 29 +/- 4 mm
      Hg) and PAO2 (104 +/- 4 vs 103 +/- 4 mm Hg) were similar. Six patients had normal
      gas exchange during cycle exercise at low altitude (P[A-a]O2 less than or equal
      to 27 mm Hg, PaO2 greater than or equal to 65 mm Hg, VD/VT less than or equal to
      0.18) and nine were abnormal. Utilizing criteria specific for arm crank at low
      altitude, the same six patients had normal gas exchange (P[A-a]O2 less than or
      equal to 13 mm Hg, PaO2 greater than or equal to 85 mm Hg, VD/VT less than or
      equal to 0.26), and the remaining nine were abnormal. The P(A-a)O2 during peak
      arm crank was the most useful criterion in identifying patients with abnormal gas
      exchange. CONCLUSION: Proposed criteria for arm crank exercise testing accurately
      identified all patients with normal and abnormal pulmonary gas exchange during
      cycle exercise. The data from the present study suggest that arm crank can be an
      acceptable alternative exercise testing modality for the assessment of pulmonary
      gas exchange.

PMID- 1623748
TI  - The diagnosis of acute pulmonary embolism in patients with chronic obstructive
      pulmonary disease.
AB  - The clinical features and noninvasive tests, including ventilation perfusion
      (V/Q) lung scans, were assessed in 108 patients with chronic obstructive
      pulmonary disease (COPD) suspected of having pulmonary embolism (PE). Twenty-one
      (19 percent) of 108 patients had PE. In the majority of patients, it was
      impossible to distinguish between patients with and without PE by clinical
      assessment alone. However, when a high clinical index of suspicion was present,
      PE was confirmed by angiography in three of three patients, but the V/Q scan was
      of intermediate probability. No roentgenographic abnormalities distinguished
      between PE and no PE. There was no difference between the alveolar-arterial
      oxygen gradients in either group, nor was there evidence of a reduction in the
      PaCO2 in patients with PE who had prior hypercapnia. Among the 108 patients with
      COPD, high, intermediate, low, and normal/near normal probability scans were
      present in 5 percent, 60 percent, 30 percent, and 5 percent, respectively. The
      frequency of PE in these V/Q scan categories was five (100 percent) of five, 14
      (22 percent) of 65, two (6 percent) of 33, and zero (0 percent) of five,
      respectively. In conclusion, in the majority of patients, the V/Q scan diagnosis
      is usually intermediate and such patients require further investigational
      studies, including angiography. However, among the few patients who demonstrated
      a high probability lung scan, there was a high positive predictive value for PE
      effectively avoiding the need for further studies. In those patients with low
      probability or near normal/normal V/Q scans, the negative predictive value was
      not lower than the general hospital population.

PMID- 1623749
TI  - Changes in crackle characteristics during the clinical course of pneumonia.
AB  - Recorded crackling lung sounds of 11 patients with pneumonia were studied with
      phonopneumography, FFT spectrography and time-expanded waveform display. The
      sounds were recorded on average six days after the onset of pneumonia and the
      recording was repeated two to four days later. In the first recording the
      crackles were coarse and midinspiratory. The patients with unilateral pneumonia
      had a significant difference in the upper frequency limit of inspiratory sound of
      the FFT spectrum between the healthy and diseased lung (p less than 0.01). In the
      second recording, the beginning of crackling had shifted later (p less than 0.01)
      and the end point of crackling also became later (p less than 0.05). The largest
      deflection width of the individual crackles became shorter (p less than 0.05).
      The results indicate that the pneumonic crackles vary markedly during the
      clinical course of pneumonia. The duration of the individual crackles became
      shorter and the timing of the crackles shifted toward the end of inspiration.

PMID- 1623750
TI  - Gastric tonometry in patients with sepsis. Effects of dobutamine infusions and
      packed red blood cell transfusions.
AB  - We wanted to determine the efficacy of dobutamine infusions and Prbc transfusions
      on splanchnic tissue oxygen utilization by measuring gastric pHi. Physiologic
      parameters and pHi measurements via the use of a gastric tonometer were obtained
      in 21 septic patients before and after the administration of a dobutamine
      infusion (5 micrograms/kg/min) or the transfusion of two units of Prbc. Subsets
      of measurements with normal (greater than 7.32) and with low (less than 7.32) pHi
      were separately analyzed for each intervention. In the dobutamine low pHi group,
      pHi increased significantly from 7.16 +/- 0.03 to 7.24 +/- 0.03 (n = 9, p less
      than 0.05). In contrast, pHi failed to increase in the Prbc low pHi subgroup
      (7.16 +/- 0.05 to 7.17 +/- 0.04 [n = 10, p greater than 0.80]). We conclude that
      dobutamine rather than Prbc transfusions should be administered to reverse
      gastric intramucosal acidosis.

PMID- 1623751
TI  - Respiratory muscle strength in hypothyroidism.
AB  - To investigate respiratory muscle strength in patients with hypothyroidism,
      global respiratory muscle strength was assessed by measuring mouth pressure
      during PImax and PEmax efforts. Maximum pressures, VC, FEV1, FVC, T3, T4, and TSH
      were measured in 43 hypothyroid patients. Measurements were made before and three
      months after replacement therapy with thyroxine. The results showed that the mean
      value of PImax and PEmax increased after treatment. Significant change was found
      in the mean value of VC, FEV1, and FVC after treatment but not in the FEV1/FVC
      ratio. A highly statistically significant linear relationship was found between
      PImax and TSH and between PEmax and TSH as well as between PImax and T3 and PEmax
      and T3. We conclude that hypothyroidism affects respiratory muscle strength and
      that this weakness is linearly related to thyroid hormone levels. Respiratory
      muscle weakness is present in both inspiratory and expiratory muscles and is
      reversible with treatment.

PMID- 1623752
TI  - Lung density and lung mass in emphysema.
AB  - Mean lung density (dm) and radiologic (VLx) lung volume can be calculated using
      CT scan data. As many emphysematous patients are overdistended, the analysis of
      dm alone could be meaningless. However, lung mass (m) can be calculated as the
      product of dm and VLx. Twenty-four patients suspected of mild or severe emphysema
      as judged by roentgenographic and physiologic examinations as well as 16 healthy
      subjects were included in the protocol. They all underwent both a CT scan of the
      whole lung and functional tests from which the following were derived: airway
      resistance, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC),
      total lung capacity (TLC), CO transfer capacity, quasi-static compliance at
      functional residual capacity (FRC), and blood gases. All CT scans were performed
      at the FRC of each patient. The dm was lower in emphysema patients than in
      healthy subjects, as m was greater in patients than in healthy subjects; 1,303 +/
      398 g and 997 +/- 133 g, respectively. Although dm values were significantly
      correlated to FEV1, FEV1/FVC, and TLC, m values were not correlated to any of
      these functional indices. Unexpectedly, these results show that most patients
      (22/24) with emphysema have a normal or increased lung mass. Normal or above
      normal m values might be due to oversecretion in some patients. Nevertheless, the
      synthesis of new tissue due to chronic inflammation is the most likely
      explanation that could account for this finding.

PMID- 1623753
TI  - Long-term oxygen therapy. When to leave well enough alone.

PMID- 1623754
TI  - Clinical utility of thoracoscopy.

PMID- 1623755
TI  - Role of oxygen debt in the development of organ failure sepsis, and death in high
      risk surgical patients.
AB  - In a series of 253 high-risk surgical patients, we measured the oxygen
      consumption (VO2) at frequent intervals before, during, and immediately after
      surgical operations and calculated the rate of VO2 deficit from the measured VO2
      minus the VO2 need estimated from the patient's own resting preoperative control
      values corrected for both temperature and anesthesia. The calculated oxygen
      deficit was related to multiple organ failure, complications, and outcome. The 64
      patients who died all had organ failure; their cumulative VO2 deficit averaged
      33.2 +/- 4.0 L/m2 (+/- SEM) at its maximum, which occurred 17.8 +/- 2.2 h after
      surgery. In the 31 survivors with organ failure, the cumulative VO2 deficit
      averaged 21.6 +/- 3.7 L/m2 at its maximum, which occurred 10.1 +/- 2.7 h after
      surgery (p less than 0.05). In the 158 survivors without organ failure or major
      complications, the maximum cumulative VO2 deficit averaged 9.2 +/- 1.3 L/m2 at
      4.1 +/- 0.6 h after surgery (p less than 0.05). In a prospective randomized
      clinical trial, a protocol group maintained at supranormal hemodynamic and oxygen
      transport values had significantly reduced oxygen debt (7.6 +/- 3.4 L/m2 vs 17.3
      +/- 6.8 L/m2; p less than 0.05), fewer organ failures, and lower mortality (4
      percent vs 33 percent; p less than 0.05) compared with a control group maintained
      at normal hemodynamic values. The data demonstrate a strong relationship between
      the magnitude and duration of the VO2 deficit in the intraoperative and early
      postoperative period and the subsequent appearance of organ failure and death.
      The latter may be reduced when oxygen debts were prevented or minimized by
      augmenting naturally occurring compensations that increased oxygen delivery.

PMID- 1623756
TI  - Elevation of cardiac output and oxygen delivery improves outcome in septic shock.
AB  - Septic shock is characterized by hypoperfusion and tissue energy defects. We
      prospectively evaluated the therapeutic benefit of augmenting cardiac output and
      therefore oxygen delivery (DO2) on mortality in patients with septic shock.
      Twenty-five patients were randomized to a normal treatment (NT) group and 26
      patients were randomized to an optimal treatment (OT) group. All patients had a
      clinically evident site of infection, sepsis as defined by a systemic response to
      the infection, and shock indicated by systemic hypoperfusion. Patients were
      treated during the initial 72 h by an algorithm differing only in the end point
      of resuscitation. The cardiac index (CI) was increased to 3.0 L/min/m2 in the NT
      group and to 6 L/min/m2 in the OT group. There were no significant differences in
      cardiorespiratory parameters in the NT and OT groups on entrance into the study.
      During treatment, CI averaged 3.6 +/- 0.2 L/min/m2 and DO2 averaged 8.6 +/- 0.8
      ml/min/kg in the NT group and CI averaged 5.1 +/- 0.2 L/min/m2 and DO2 averaged
      12.2 +/- 0.7 ml/min/kg in the OT group (p less than 0.01). A significant
      correlation between DO2 and survival was observed. Seventy-two percent of the OT
      patients died vs 50 percent of the NT patients (p = 0.14). Surviving NT patients
      stayed 13.7 +/- 3 days in the ICU vs 7.4 +/- 0.6 days (p less than 0.05) for the
      OT patients. Since some of the NT patients were spontaneously hyperdynamic and
      some of the OT patients did not achieve their desired end point, patients were
      arbitrarily subsetted using a midpoint CI of 4.5 L/min/m2. The NT less than 4.5
      group had a CI of 3.1 +/- 0.2 L/min/m2 and DO2 of 10.9 +/- 1.0 ml/min/kg while
      the OT group greater than 4.5 L/min/m2 had a CI of 5.7 +/- 0.2 L/min/m2 and a DO2
      of 13.8 +/- 0.7 ml/min/kg (p less than 0.01). Mortality in the NT less than 4.5
      group was 74 percent as compared with 40 percent in the OT greater than 4.5 group
      (p less than 0.05).

PMID- 1623757
TI  - Modification of oxygen extraction ratio by change in oxygen transport in septic
      shock.
AB  - To help clarify the oxygen uptake/transport (VO2/TO2) relationship and because
      the oxygen extraction ratio (OER) and TO2 share no common variable such as
      cardiac index, we examined the changes in OER when TO2 was decreased in 12
      patients with sepsis in whom a PEEP trial was performed. From zero end-expiratory
      pressure (ZEEP) to PEEP (12 +/- 3 cm H2O), a significant increase in OER from 30
      +/- 10 percent to 38 +/- 12 percent (p less than 0.005) was observed, and
      individual percentage changes in OER were well correlated with individual
      percentage changes in TO2. The VO2 measured (VO2m) by respiratory gas analysis
      was unchanged, while VO2 calculated by the Fick equation (VO2f) decreased,
      suggesting a mathematical coupling between VO2f and TO2. Patients with
      hyperlactacidemia (n = 5) exhibited the same relationships between OER, VO2m, and
      TO2 as those without hyperlactacidemia. Our results suggest an adaptive response
      in the OER when TO2 is decreased in patients with established septic shock.

PMID- 1623758
TI  - Effects of PEEP on respiratory mechanics after open heart surgery.
AB  - Respiratory dysfunction, particularly atelectasis, is common after open heart
      surgery. Routine use of PEEP (5 to 10 cm H2O) in these patients has been
      advocated. We studied the effects of different levels of PEEP on respiratory
      mechanics in ten mechanically ventilated open heart surgery patients in the
      immediate postoperative period. PEEP was studied in increasing increments and
      decreasing decrements. This procedure was repeated three times. Flow, tidal
      volume, and airway pressure were measured. We used the rapid airway occlusion
      technique to determine static compliance of the respiratory system (Cst,rs) and
      intrinsic PEEP (PEEPi). The changes in end-expiratory lung volume (delta EELV)
      were measured with respiratory inductive plethysmography. Recruitment of lung
      units (Vrec) was estimated as the difference in lung volume between PEEP and zero
      end-expiratory (ZEEP) for the same static inflation pressure (15 cm H2O). We
      found that (1) Cst,rs at ZEEP was significantly reduced (60 +/- 2 ml/cm H2O); (2)
      while PEEP of 5 cm H2O did not cause significant recruitment, higher levels of
      PEEP (10 to 15 cm H2O) were effective; (3) Cst,rs, Vrec, and delta EELV were
      higher during stepwise PEEP decrease; (4) after the first and second stepwise
      PEEP increase-decrease run, there was a small persistent increase in EELV and
      Cst,rs at ZEEP. No further changes were found after the third run. We conclude
      that after open heart surgery, PEEP less than 10 cm H2O is not effective to
      reopen atelectatic lung units.

PMID- 1623759
TI  - P wave height during incremental exercise in patients with chronic airway
      obstruction.
AB  - We examined changes in P wave height in lead 2 of an ECG obtained during
      progressive exercise in 23 patients with COPD, and measured both P wave changes
      and pulmonary hemodynamics during exercise at a constant workload corresponding
      to approximately 50 to 60 percent of VO2 max in nine patients. The P wave
      response to exercise (delta P/delta VO2, %/ml/min), estimated by the relationship
      between percentage of change in P wave height and VO2, was significantly greater
      (p less than 0.01) in 15 patients who had a decrease in PaO2 with exercise (group
      A) than eight patients who did not have a fall in PaO2 with exercise (group B).
      There was a significant negative correlation between change in PaO2 and change in
      P wave height from rest to maximal exercise (r = -0.68, p less than 0.001).
      Oxygen therapy in nine patients in group A reduced the increase in P wave height
      during exercise. Furthermore, change in P wave height from rest to exercise
      correlated significantly with that of mean pulmonary artery pressure (r = 0.75, p
      less than 0.01). These results suggest that increase in P wave height during
      exercise in COPD patients is related partly to oxygen desaturation during
      exercise, and continuous measurement of P wave change may be useful for
      noninvasively predicting the pulmonary vascular pressure response to exercise.

PMID- 1623760
TI  - Evaluation of respiratory inductive plethysmography in the measurement of
      breathing pattern and PEEP-induced changes in lung volume.
AB  - STUDY OBJECTIVE: To assess the accuracy of the respiratory inductive
      plethysmography in the measurement of PEEP-induced changes in end-expiratory lung
      volume during mechanical ventilation and its accuracy and stability in the
      measurement of ventilation during controlled mechanical ventilation and
      spontaneous breathing. DESIGN: An open comparison between two methods using a
      criterion standard. Either a pneumotachometer (mechanically ventilated patients)
      or a spirometer (spontaneously breathing subjects) was used as the reference
      method. SETTING: Tertiary care center; a multidisciplinary intensive care unit
      and a metabolic research unit. PATIENTS: Six mechanically ventilated, paralyzed
      postoperative open heart surgery patients, six spontaneously breathing COPD
      patients, and eight healthy volunteers. INTERVENTIONS: Stepwise increases and
      reductions of PEEP from zero to 12 cm H2O during controlled mechanical
      ventilation; repeated validation of the calibration of the respiratory inductive
      plethysmography (RIP) in both mechanically ventilated and spontaneously breathing
      subjects. MEASUREMENTS AND RESULTS: The baseline drift of the RIP in vitro was 10
      ml/150 min and in a ventilated model it was 20 ml/150 min. In mechanically
      ventilated patients, the mean error of the calibration after 150 min was within
      +/- 5 percent. Change in end-expiratory lung volume (EELV) during the stepwise
      increase of PEEP up to 12 cm H2O was 849 +/- 136 ml with the RIP and 809 +/- 125
      ml with the pneumotachometer (PT), and during the stepwise reduction of PEEP it
      was 845 +/- 124 ml and 922 +/- 122, respectively (not significant [NS]. The mean
      difference between methods in the measurement of change in EELV was -6.6 +/- 3.5
      percent during increasing and 6.6 +/- 6.7 percent during decreasing PEEP (NS).
      Both in mechanically ventilated and spontaneously breathing subjects, the
      difference between methods was significant for VT and VT/TI. The difference in VT
      was -2.2 +/- 0.2 percent during mechanical ventilation, -1.1 +/- 0.5 percent in
      spontaneously breathing COPD patients, and 2.9 +/- 0.4 percent in healthy
      volunteers (NS between groups). CONCLUSIONS: The RIP is sufficiently accurate for
      the measurement of PEEP-induced changes in EELV during controlled mechanical
      ventilation. The accuracy of tidal volume measurement is similar during
      mechanical ventilation and spontaneous breathing. The calibration of the RIP is
      stable enough for bedside monitoring of changes in lung volumes.

PMID- 1623761
TI  - Drug-induced pulmonary disease. An update.

PMID- 1623762
TI  - The significance of irregular opacities on the chest roentgenogram.
AB  - Scanty irregular opacities are not uncommonly observed on the chest roentgenogram
      in the absence of interstitial fibrosis of the lungs. In such circumstances the
      irregular opacities, when present, tend to be relatively scanty and seldom, if
      ever, exceed an ILO category of 1/1. They are found in association with cigarette
      smoking, especially when emphysema is also present. The development of irregular
      opacities is also related to exposure to various mineral and other dusts, and
      although their prevalence increases with cumulative dust exposure, in general the
      type of dust, whether fibrogenic or relatively inert, seems to be of little
      moment. The presence of irregular opacities remains a troublesome confounding
      factor in epidemiologic studies of both dust-exposed and nonexposed populations.
      The morbid anatomic changes that occur in the lungs of nondust-exposed workers
      and which are responsible for the development of irregular opacities in the chest
      roentgenogram remain unknown.

PMID- 1623763
TI  - Upper lobe cystic lesions and cough in a young woman.

PMID- 1623764
TI  - Chronic, progressive, bibasilar infiltrates in a woman with constipation.

PMID- 1623765
TI  - Ethical relationships between drug companies and the medical profession.

PMID- 1623766
TI  - The effects of pharmaceutical firm enticements on physician prescribing patterns.
      There's no such thing as a free lunch.
AB  - We examined the impact on physician prescribing patterns of pharmaceutical firms
      offering all-expenses-paid trips to popular sunbelt vacation sites to attend
      symposia sponsored by a pharmaceutical company. The impact was assessed by
      tracking the pharmacy inventory usage reports for two drugs before and after the
      symposia. Both drugs were available only as intravenous preparations and could be
      used only on hospitalized patients. The usage patterns were tracked for 22 months
      preceding each symposium and for 17 months after each symposium. Ten physicians
      invited to each symposium were interviewed about the likelihood that such an
      enticement would affect their prescribing patterns. A significant increase in the
      prescribing pattern of both drugs occurred following the symposia. The usage of
      drug A increased from a mean of 81 +/- 44 units before the symposium to a mean of
      272 +/- 117 after the symposium (p less than 0.001). The usage of drug B changed
      from 34 +/- 30 units before the symposium to 87 +/- 24 units (p less than 0.001)
      after the symposium. These changed prescribing patterns were also significantly
      different from the national usage patterns of the two drugs by hospitals with
      more than 500 beds and major medical centers over the same period of time. These
      alterations in prescribing patterns occurred even though the majority of
      physicians who attended the symposia believed that such enticements would not
      alter their prescribing patterns.

PMID- 1623767
TI  - Hemodynamic effects of amrinone in a canine model of massive pulmonary embolism.
AB  - Amrinone, an inotrope with vasodilating properties, is of potential use in
      managing the right ventricular failure and pulmonary vasoconstriction induced by
      massive pulmonary embolism (PE). Therefore, to determine the hemodynamic effects
      of amrinone in a canine model of massive PE, autologous blood clot was infused
      into ten dogs (eight treated and two control animals) in an amount sufficient to
      decrease mean systemic arterial pressure (MAP) by at least 25 percent. This
      resulted in an increase in mean pulmonary artery pressure (MPAP) from 13.4 +/-
      3.7 mm Hg to 44.4 +/- 4.8 mm Hg (p less than 0.01), a decrease in MAP from 122 +/
      9.5 mm Hg to 35.6 +/- 9.8 mm Hg (p less than 0.01), and a decrease in cardiac
      output from 2.73 +/- 0.834 L/min to 1.22 +/- 0.61 L/min (p less than 0.01).
      Amrinone was administered in an initial bolus of 0.75 mg/kg followed by an
      infusion of 7.5 micrograms/kg/min, which resulted in significant hemodynamic
      improvement in all subjects, with a fall in MPAP to 35.3 +/- 5.1 mm Hg (p less
      than 0.01), an increase in MAP to 98.1 +/- 31.1 mm Hg (p less than 0.01), and an
      increase in cardiac output to 2.01 +/- 0.7 L/min (not significant) at 5 min.
      Cardiac output continued to increase to 2.56 +/- 0.16 L/min (p less than 0.01) at
      35 min. We conclude that amrinone alleviated pulmonary hypertension, systemic
      hypotension, and low cardiac output in a canine model of massive PE.

PMID- 1623768
TI  - Ciliary function, cell viability, and in vitro effect of ribavirin on nasal
      epithelial cells in acute rhinorrhea.
AB  - Nasal epithelial (NE) cells were collected from the nasopharynx of 25 individuals
      with symptomatic colds and 27 healthy volunteers (controls), and ciliary beat
      frequency (CBF) was assessed by microscopy employing video motion analysis
      techniques. Baseline CBF was statistically significantly elevated in the group
      with colds compared to the control group (14.6 +/- 1.5 Hz [mean +/- SD] vs 13.8
      +/- 0.9 Hz; p = 0.02). After four days of incubation in culture, there was a
      significant decrease in the CBF in both groups, with a change from baseline of
      1.9 Hz for the cold group, compared to 1.0 Hz for the control group (p = 0.0001).
      The in vitro addition of ribavirin at 500 micrograms/ml to NE cells from
      individuals with colds preserved the viability of the cells and maintained the
      CBF at baseline values. Twenty-four (96 percent) of 25 ribavirin-treated
      specimens from the cold group survived for four days in culture, compared with 17
      (68 percent) of 25 untreated cold specimens. In addition, the ribavirin-treated
      cells had a mean CBF of 14.2 +/- 1.3 Hz, compared with 12.7 +/- 1.9 Hz for the
      untreated cell samples (p = 0.0005). Ribavirin had no effect on NE cells from the
      control group. These results suggest that ribavirin in a concentration of 500
      micrograms/ml may have some benefit in the treatment of acute rhinorrhea.

PMID- 1623769
TI  - Polysomnography in acutely ill intensive care unit patients.

PMID- 1623770
TI  - Abdominal placement of tube thoracostomy due to lack of recognition of paralysis
      of hemidiaphragm.
AB  - Tube thoracostomy is an invasive procedure that carries a risk of complications.
      We report a patient with liver cirrhosis, ascites and large left-sided pleural
      effusion, in whom a trocar type chest tube was inserted at the seventh left
      intercostal space in the midaxillary line. Chest roentgenogram revealed that the
      drainage tube was placed into the abdominal cavity because of a misrecognized
      elevation of the left hemidiaphragm. This case demonstrates that the placement of
      a tube thoracostomy requires caution in the identification of possible
      abnormalities which can lead to dangerous complications.

PMID- 1623772
TI  - Pleural effusion as first sign of extramedullary plasmacytoma.
AB  - A patient with mediastinal EP with extension to pleural spaces and subsequent
      pleural effusion is described. The finding of many plasma cells in pleural fluid
      led to diagnosis. Similar histologic findings such as multiple myeloma and
      immunoblastic lymphoma were ruled out by clinical approach and immunochemistry,
      respectively. This pleural effusion represents the first case described caused by
      EP.

PMID- 1623771
TI  - Acute eosinophilic pneumonia due to toxocariasis with bronchoalveolar lavage
      findings.
AB  - A previously healthy young man presented with breathlessness, diffuse pulmonary
      infiltrates on the chest x-ray film, and a high degree of peripheral blood
      eosinophilia. Analysis of bronchoalveolar lavage (BAL) fluid showed 64 percent
      eosinophils. A diagnosis of toxocariasis was eventually reached on the basis of a
      positive enzyme-linked immunosorbent assay (ELISA) for Toxocara canis. The
      routine performance of the ELISA test for Toxocara in the diagnostic approach to
      pulmonary infiltration with eosinophilia could reveal an undetermined, sometimes
      unsuspected, number of cases of adult toxocariasis with pulmonary involvement. A
      high degree of eosinophilia in the differential cell count of BAL fluid may
      eventually prove to be a useful clue in favor of such a diagnosis.

PMID- 1623773
TI  - Transesophageal echocardiography to diagnose and demonstrate resolution of an
      acute massive pulmonary embolus.
AB  - A 54-yr-old man presented with acute respiratory failure and hemodynamic
      collapse. Acute massive pulmonary embolus was confirmed with visualization of the
      thrombus by transesophageal echocardiography. Successful resolution after
      thrombolysis was confirmed by a repeat study. Transesophageal echocardiography
      can be used for both diagnosis and assessment of therapy in select cases of acute
      massive pulmonary embolism.

PMID- 1623774
TI  - Heart-lung transplantation in a 16-month-old infant.
AB  - A 16-month-old boy who had a heart-lung transplantation is doing well 16 months
      postoperatively. The HLT can be a successful treatment for very young patients.
      Most of the postoperative management can be assessed with noninvasive techniques.
      Normally, the allograph grows with the recipient.

PMID- 1623775
TI  - Long-term severe pulmonary hypertension associated with right atrial myxoma.
AB  - An 18-year-old black woman presented with marginally compensated right heart
      failure, severe pulmonary hypertension, tricuspid incompetence, and right atrial
      myxoma. Catheterization suggested a substantial reactive component to her P-HTN,
      especially to nifedipine. Initial management consisted of excision of two right
      atrial myxomas and tricuspid annuloplasty, and postdischarge management with
      nifedipine, 30 mg four times daily. Emergency pulmonary thromboendarterectomy was
      required two weeks later for acute cor pulmonale. It is suggested that
      concomitant procedures are mandatory in this setting because of the otherwise
      accelerated adverse pathophysiology of obliterative pulmonary vascular
      obstructive disease.

PMID- 1623776
TI  - Amyloid heart disease manifested by systemic arterial thromboemboli.
AB  - Amyloid heart disease characteristically produces a stiff heart syndrome whereby
      diastolic filling is impaired yet systolic function is well preserved. We report
      two patients with this pattern of amyloid heart disease, both of whom developed
      cardiogenic thromboemboli. The rarity of this complication is striking given the
      pathophysiologic bases of amyloid heart disease. Investigation of contributing
      causes revealed that the phenomena appeared to represent the cumulative effects
      of disorders producing stasis, endothelial disturbance, and probable
      abnormalities in blood coagulability, the classic Virchow's triad revisited.
      Understanding of the pathophysiologic basis of this event leads to specific
      suggestions for workup and management in this patient population.

PMID- 1623777
TI  - Massive intraoperative pulmonary embolism.
AB  - Intraoperative massive pulmonary embolism is extremely rare. We describe such a
      case in a patient treated for a prolonged period preoperatively with intravenous
      heparin after an acute myocardial infarction and unsuccessful attempt at
      angioplasty, emphasizing that the problem should be borne in mind to facilitate
      expeditious and appropriate management. A clue to the diagnosis is interruption
      of venous return that is not due to a kink in the cannulae.

PMID- 1623778
TI  - High dose rate brachytherapy improves resectability in squamous cell lung cancer.
AB  - A 44-year old man with squamous cell carcinoma of the left lower lobe extending
      to the mucosa of the main carina, was treated with high dose rate brachytherapy
      prior to surgery. A significant reduction of tumor infiltration was achieved
      allowing a radical pneumonectomy instead of a sleeve pneumonectomy with resection
      of the main carina. He remains disease-free after a follow-up period of 43
      months.

PMID- 1623779
TI  - The effect of short-term nasal CPAP on Cheyne-Stokes respiration in congestive
      heart failure.
AB  - We studied male patients (BMI = 27.6 +/- 3.4, mean +/- SD), mean age 54.1 +/- 8.9
      years, with stable NYHA class 3-4 congestive heart failure (CHF) (LVEF = 24.3 +/-
      11.5 percent) and normal daytime arterial blood gas values. These patients
      underwent three consecutive nights of full polysomnography; adaptation, control,
      and treatment with nasal CPAP. Each night's study was followed during the day by
      cognitive testing and multiple sleep latency tests (MSLT). The purpose of the
      study was to document the effect of nasal CPAP on these variables. The main
      findings of the study showed no significant differences between control and
      treatment nights with respect to the amount of Cheyne-Stokes respiration (CSR)
      observed, the nocturnal oxygenation, or sleep quality. Both subjective and
      objective measures of sleep quality showed no change from night to night. In
      addition, the degree of cognitive functioning and daytime sleepiness (as measured
      by MSLT) showed no significant differences between control and treatment nights.
      We conclude that short-term treatment with nasal CPAP in patients with CHF does
      not improve either CSR, nocturnal oxygenation, or sleep quality. Furthermore,
      most of our patients did not tolerate nasal CPAP therapy.

PMID- 1623780
TI  - Bilateral proximal pulmonary artery aneurysms simulating hilar adenopathy.
AB  - Proximal pulmonary artery aneurysms (PAAs) are rare. Most are associated with
      secondary pulmonary hypertension or a variety of rare systemic disorders. An
      asymptomatic adult patient presented with bilateral hilar enlargement on a
      routine chest roentgenogram. Computed tomography of the chest revealed 5 cm
      bilateral proximal PAAs with a normal pulmonary trunk. The clinician should
      consider proximal PAA in the differential diagnosis of hilar enlargement.

PMID- 1623781
TI  - Implantation metastasis of carcinoma after percutaneous fine-needle aspiration
      biopsy.
AB  - Implantation of malignant cells along the needle tract is an extremely rare but
      potential complication following percutaneous needle aspiration biopsy of
      malignant lesions. Percutaneous fine-needle aspiration biopsy (FNAB) has recently
      received more attention for cytologic diagnosis of bronchogenic carcinoma because
      of its high diagnostic yield, simplicity, and low morbidity. On the other hand,
      dissemination of cancer cells by needle aspiration biopsy can change a
      potentially resectable localized lung cancer to an unresectable one. We report
      two cases: one patient underwent FNAB of a metastatic left adrenal mass that
      seeded a paraspinal muscle implantation of malignant cells that subsequently
      developed a tumor mass, and the second patient had tumor cell implantation in the
      chest wall after FNAB of a pleural-based adenocarcinoma of the lung. The
      theoretical and practical importance of tumor cell spread along the needle tract
      is discussed. Because of its rare incidence, however, this complication should
      not affect the use of needle aspiration biopsy in bronchogenic carcinoma,
      although care should be undertaken during the procedure.

PMID- 1623782
TI  - Erythropoietin therapy obviates the need for recurrent transfusions in a patient
      with severe hemolysis due to prosthetic valves.
AB  - Erythropoietin has been proved extremely effective in ameliorating the anemia of
      chronic renal failure and is currently under intensive investigation. We describe
      a patient with severe anemia and secondary hemochromatosis due to prosthetic
      valves, who has been successfully treated with erythropoietin. During 12 months'
      follow-up, an acceptable hemoglobin level was maintained without any need for
      blood transfusions; in addition, there was evidence indicating regression of
      hemochromatosis. This patient illustrates that erythropoietin therapy might prove
      beneficial for similar cases.

PMID- 1623783
TI  - Intramyocardial calcification in the elderly. A diagnostic and therapeutic
      puzzle.
AB  - A 70-year-old woman presented with anular and progressive intramyocardial
      calcification within a five-year period. She had become increasingly symptomatic
      with mitral regurgitation and coronary insufficiency during the same period. The
      subvalvular (mitral) calcified intramyocardial mass was found to be "grumous
      atherosclerosis." This was obliterated while the mitral valve was replaced with a
      prosthetic valve and the coronary arteries were bypassed x3. She is surviving and
      well four years postoperatively.

PMID- 1623784
TI  - Left coronary dominance due to direct continuation of the left anterior
      descending to form the posterior descending coronary artery.
AB  - Continuation of the left anterior descending to form the posterior descending
      artery is rarely observed. We describe the first patient with this variant in
      whom the coronary artery extends beyond the crux, supplying branches to the
      atrioventricular node and both atrioventricular grooves.

PMID- 1623785
TI  - Silent maladie de Roger.
AB  - A patient with no cardiac murmur was found to have a ventricular septal defect by
      Doppler echocardiography yet no evidence of pulmonary or right ventricular
      hypertension. This array of findings is distinctly unusual and appears to be at
      odds with the clinical teachings concerning small ventricular septal defects.

PMID- 1623786
TI  - Severe hypoxia due to ventilation-perfusion mismatch caused by aortic arch
      aneurysm.
AB  - We report a very rare case of hugh aortic arch aneurysm associated with aortic
      restenosis, which caused severe hypoxia due to ventilation-perfusion mismatch by
      compression of the left main bronchus and the right pulmonary artery. Aortic arch
      replacement was performed under circulatory arrest and deep hypothermia in
      addition to aortic valve replacement as a redo operation, and consequently such
      hypoxia was relieved.

PMID- 1623787
TI  - Pacemaker-induced friction rub and apical thrill.
AB  - A patient with acute myocardial infarction developed a loud systolic sound and
      apical thrill. Doppler ultrasound excluded interventricular septal rupture and
      significant mitral or tricuspid regurgitation. Auscultatory abnormalities
      disappeared after removal of a temporary pacing electrode, suggesting that the
      friction it created with intracardiac structures was responsible for these
      findings.

PMID- 1623788
TI  - Adenosine deaminase in pleural effusion.

PMID- 1623789
TI  - Reversible dilated cardiomyopathy due to growth hormone deficiency.

PMID- 1623790
TI  - Sudden apnea following attempted central line placement.

PMID- 1623791
TI  - Preventive pulmonary medical education.

PMID- 1623792
TI  - Morbidity and duration of ICU stay after cardiac surgery. A model for
      preoperative risk assessment.
AB  - Although risk factors for mortality after cardiac surgery have been identified,
      there is no widely applicable method for readily determining risk of
      postoperative morbidity based on preoperative severity of illness. The goal of
      this study was to develop a model for stratifying the risk of serious morbidity
      after adult cardiac surgery using readily available and objective clinical data.
      After univariate analysis of risk factors in 3,156 operations, 11 variables were
      identified as important predictors by logistic regression (LR) analysis and used
      to construct an additive model to calculate the probability of serious morbidity.
      Reliable correlation was found between a simplified additive model for clinical
      use and the LR model. The clinical and logistic models were then tested
      prospectively in 394 patients and demonstrated a pattern of increasing morbidity
      with ascending scores similar to that predicted by the reference group.
      Increasing clinical risk score was also associated with a greater frequency of
      individual complications as well as prolongation of ICU stay. This study
      demonstrates that it is feasible to design a simple method to stratify the risk
      of serious morbidity after adult cardiac surgery. With further prospective
      multicenter refinement and testing, such a model is likely to be useful for
      adjusting severity of illness when reporting outcome statistics as well as
      planning resource utilization.

PMID- 1623793
TI  - Don't get run over by the bandwagon.

PMID- 1623794
TI  - Recovery of pulmonary function in patients undergoing extended left ventricular
      assistance.
AB  - Heart transplantation should follow the implantation of a left ventricular assist
      device (LVAD) only after optimal postoperative recovery of pulmonary function. We
      reviewed hospital records of 12 patients who underwent extended (greater than 30
      days) left ventricular support before transplantation to determine the rate of
      return of pulmonary function. The mean cardiac index and pulmonary capillary
      wedge pressure returned to normal in all patients within three days after LVAD
      implantation. The mean pulmonary artery pressure and pulmonary vascular
      resistance decreased but did not return to normal. The mean central venous
      pressure remained elevated throughout the first month but decreased by the time
      of transplantation. Supplemental oxygen requirements and peak airway pressures
      improved, and ten of the 12 patients were extubated by the fifth postoperative
      day. Preoperative roentgenographic evidence of pulmonary edema was present in
      eight patients, and pulmonary hilar prominence was present in the remaining four
      patients. Roentgenographic resolution of the pulmonary edema occurred slowly,
      persisting for one week after surgery in seven of eight patients. Ten patients
      were able to exercise strenuously 30 days after surgery, and 11 were returned to
      excellent condition before undergoing heart transplantation. Although the
      hemodynamic status in these patients significantly improved shortly after LVAD
      implantation, optimal recovery of pulmonary function required several weeks.
      Therefore, we advocate delaying transplantation after LVAD implantation to allow
      optimal pulmonary recovery.

PMID- 1623795
TI  - Reoperation, emergency and urgent open cardiac surgery in Jehovah's Witnesses.
AB  - Progressive advances in perfusion technology and perioperative supportive
      management have made it possible for members of the Jehovah's Witnesses religious
      group to undergo open cardiac operations with remarkable safety. However,
      hospital mortality remains high in (1) patients requiring reoperation (in whom
      both technical and bleeding problems tend to be more frequent) and (2) patients
      with significantly compromised cardiac performance requiring urgent or emergency
      operation. Employing a number of perioperative measures designed to minimize
      blood loss and maintain hematocrit levels (including use of the recently
      available recombinant human erythropoietin in two patients whose cases are
      reported herein), 13 reoperations and five urgent or emergency operations were
      performed. The one death in the entire series occurred in a patient (reoperation
      group) who died of a cerebrovascular accident of presumed embolic etiology,
      having undergone combined debridement of a stenotic heavily calcified aortic
      valve and a second coronary artery revascularization procedure. None of the
      patients required surgical exploration for bleeding. We suggest that currently
      available methodology permits Jehovah's Witnesses to undergo reoperation,
      emergency surgery, or urgent open cardiac operation at a level of risk not
      dissimilar to that seen in patients who permit use of homologous blood and
      products in their treatment.

PMID- 1623796
TI  - Differential cell analysis in bronchoalveolar lavage fluid from pulmonary lesions
      of patients with tuberculosis.
AB  - To obtain information on the cellular reactions to Mycobacterium (M) tuberculosis
      in the lung, we analyzed the cells in bronchoalveolar lavage (BAL) fluid from
      pulmonary lesions in comparison with those in BAL fluid from nonaffected regions
      of the lungs, and control lungs, and in peripheral blood of patients with
      tuberculosis. Neutrophils and lymphocytes were increased in number in BAL fluid
      from affected lesions of the lungs of patients with miliary tuberculosis and
      patients with active pulmonary tuberculosis compared with those in BAL fluid from
      control patients, but the number of alveolar macrophages was decreased in BAL
      fluid from tuberculous lesions. However, the numbers of these cells were not
      changed in the BAL fluid from nonaffected regions of the lungs of patients with
      active or inactive pulmonary tuberculosis. The numbers of lymphocytes were
      decreased and the numbers of monocytes were increased in peripheral blood from
      patients with miliary tuberculosis and with active tuberculosis, indicating
      inverse changes in the numbers of lymphocytes and monocytes in the peripheral
      blood to those in the BAL fluid of patients with tuberculosis. These results
      indicate characteristic redistributions of immune or inflammatory cells in
      response to infection with M tuberculosis and suggest that these changes are
      important for understanding the pathophysiology of pulmonary tuberculosis.

PMID- 1623797
TI  - Imaged thoracoscopic lung biopsy.
AB  - Imaged thoracoscopic surgery is a technique utilized to operate on the
      intrathoracic organs without making a formal thoracotomy incision. Eleven
      patients underwent lung biopsy with this procedure and each had markedly reduced
      postoperative pain. Each patient resumed preoperative activity levels within one
      week of discharge from the hospital. Besides thoracotomy and thoracoscopy, imaged
      thoracoscopic surgery provides another option for approaching the intrathoracic
      organs.

PMID- 1623798
TI  - Correlation of bronchoalveolar lavage findings to severity of Pneumocystis
      carinii pneumonia in AIDS. Evidence for the development of high-permeability
      pulmonary edema.
AB  - We correlated bronchoalveolar lavage findings with the clinical course and
      outcome of Pneumocystis pneumonia. Forty-eight patients with AIDS and a confirmed
      diagnosis of P carinii pneumonia were studied. Patients with additional pulmonary
      infections were excluded. On the basis of BAL findings, they were divided into
      those with a low neutrophil count (less than 5 percent) and those with a high
      neutrophil count (greater than or equal to 5 percent). Sixteen patients with AIDS
      but without PCP served as a control group. All BAL fluid samples from the control
      group showed a low neutrophil count. The group with PCP and a high neutrophil
      count had more severe respiratory compromise and greater morbidity than the group
      with PCP and a low neutrophil count. Mortality rate was not different. The group
      showing a high BALF neutrophil count also showed a higher BALF protein
      concentration, a higher ratio of BALF protein concentration to plasma protein
      concentration, and the presence of alpha 2-globulins compared with other groups.
      These findings suggest that increased alveolar-capillary permeability occurs
      during severe PCP.

PMID- 1623799
TI  - Nontuberculous mycobacteria in adult patients with cystic fibrosis.
AB  - Because patients with cystic fibrosis (CF) may be predisposed to airway
      infections with unusual microorganisms, we screened the sputum of adult CF
      patients for mycobacterial organisms. Acid-fast bacilli (AFB) smears and
      mycobacterial culture were performed on 297 sputum specimens from 87 patients.
      Cultures for mycobacteria were frequently overgrown with other bacteria; 22.6
      percent of cultures were contaminated. Despite this limitation of mycobacterial
      culture, 17 patients had at least one positive culture for a Mycobacterium other
      than tuberculosis (MOTT). Eleven patients were positive for Mycobacterium avium
      intracellulare (MAI), two for MAI and M chelonei, three for M chelonei, and one
      for M fortuitum. None was positive for M tuberculosis. Patients with CF with MOTT
      were similar to patients with CF without MOTT; only a slightly different (older)
      age distribution was recognized. The clinical significance of MOTT was difficult
      to determine in any individual patient, but patients with positive AFB smears
      appeared more likely to suffer pathogenic effects. We conclude that MOTT is
      frequently recovered from adult CF patients in the southeastern United States. A
      specific risk factor for colonization and/or pathogenic infection in this patient
      group was not evident. The general prevalence and clinical pathogenesis in CF
      patients in the United States remains to be determined.

PMID- 1623800
TI  - Diagnostic value of telescoping plugged catheters in HIV-infected patients with
      pulmonary infiltrates.
AB  - To assess the diagnostic value of telescoping plugged catheters (TPC) in human
      immunodeficiency virus (HIV)-infected patients with pulmonary infiltrates (PI),
      we performed a prospective clinical study in 71 episodes of fever and PI in 66
      HIV-infected patients (five patients had two different episodes of fever and PI).
      A control group of 12 HIV-infected patients with fever and normal chest
      roentgenogram was also studied. In all patients and prior to antibiotic treatment
      (except in mechanically ventilated patients), a TPC using quantitative cultures
      (cutoff point established at 10(3) CFU/ml) and a bronchoalveolar lavage (BAL)
      sampling were performed via fiberoptic bronchoscope. The overall incidence of
      bacterial pneumonia in the study group was 21 percent. The TPC cultures resulted
      in a microbiologic diagnosis of bacterial pneumonia in eight patients (11
      percent) from the study group and in one patient (8 percent) from the control
      group. The TPC sensitivity in diagnosing bacterial infections was 53 percent and
      specificity was 76 percent. Negative predictive value was 85 percent and positive
      predictive value was 38 percent. By means of BAL, 35 episodes from the study
      group and two from the control group were diagnosed as nonbacterial or
      mycobacterial pulmonary infections. Considering TPC and BAL together, diagnosis
      was performed in 42 cases of PI (59 percent). Twenty percent (17/83) of HIV
      infected patients suffered from bacterial colonization of their lower airways (a
      TPC culture greater than or equal to 10(3) CFU/ml without clinical evidence of
      bacterial infection). We conclude that the combined use of TPC and BAL may be
      useful in HIV-infected patients with PI, since this combined use allows the
      proper diagnosis of bacterial and nonbacterial infections, thereby increasing the
      overall diagnostic accuracy. To distinguish bacterial colonization from pulmonary
      infection in HIV-infected patients with PI, the cutoff point of quantitative
      cultures of TPC may be 10(4) CFU/ml.

PMID- 1623801
TI  - Comparison of prognosis of pulmonary diseases caused by Mycobacterium avium and
      by Mycobacterium intracellulare.
AB  - A total of 55 patients with pulmonary disease caused by Mycobacterium avium and
      by Mycobacterium intracellulare were compared for their prognosis. Causative
      mycobacteria were identified by the DNA probes (Gen-Probe) method. Of the 55
      patients, 28 had pulmonary disease caused by M avium and the remaining 27, by M
      intracellulare. Of the former group, four patients had progressive disease, and
      three of them died during the observation period. In contrast, only one of the
      latter group had progressive disease. On the other hand, only one of the former
      group was cured. In contrast, six of the latter group were cured, showing the
      closure of cavity and the disappearance of mycobacteria from the sputum. The
      prognosis of pulmonary disease caused by M avium appears to be worse than that
      caused by M intracellulare.

PMID- 1623802
TI  - The effects of enalapril and spironolactone on terbutaline-induced hypokalemia.
AB  - OBJECTIVE: To investigate whether enalapril (E) 10 mg and spironolactone (S) 100
      mg attenuate the hypokalemic effect of inhaled terbutaline (T). DESIGN:
      Randomized single-blind crossover. Subjects received the following treatment
      combinations: (a) placebo (P), (b) T alone, (c) T + E, or (d) T + S. SETTING:
      University Department of Clinical Pharmacology. PARTICIPANTS: Twenty healthy
      volunteers (ten male, ten female) of mean age 22.8 +/- 3.1 years. MAIN OUTCOME
      MEASURES: Serum potassium, magnesium, ECG changes (R-R interval, T wave, and QTc
      interval) for 4 h after terbutaline inhalation. MAIN RESULTS: Baseline serum
      potassium levels were higher following prior treatment with E and S; P, 3.78
      mmol/L (3.67 to 3.88); T + E, 3.93 mmol-1 (3.82 to 4.03); and T + S, 4.03 mmol/L
      (3.93 to 4.14) (p less than 0.05). Mean potassium concentrations over 4 h were
      also higher following prior treatment with E and S; T, 3.58 mmol/L (3.54 to
      3.63); T + E, 3.68 mmol/L (3.64 to 3.72) (p less than 0.05); and T + S, 3.73
      mmol/L (3.68 to 3.78) (p less than 0.01). CONCLUSIONS: Enalapril and
      spironolactone protect against the fall in serum potassium over 4 h by elevating
      baseline potassium concentration. These potassium-sparing drugs, however, should
      not be used to prevent the hypokalemic and electrocardiographic sequelae of
      inhaled beta 2-agonists.

PMID- 1623803
TI  - Spontaneous clinical and hemodynamic improvement in patients on waiting list for
      heart transplantation.
AB  - Heart transplantation is currently the most effective therapy for patients with
      severe heart failure due to dilated cardiomyopathy, although long-term survival
      without transplantation has been described in a few patients. We have identified
      five patients with severe heart failure who experienced a significant clinical
      and hemodynamic improvement while they were waiting for heart transplantation. At
      initial assessment, all five patients were symptom-class 4; left ventricular end
      diastolic pressure was 33 +/- 4 mm Hg, left ventricular ejection fraction was
      0.20 +/- 0.01, left ventricular end-systolic volume was 130 +/- 3 ml/min/m2, and
      cardiac index was 2.1 +/- 0.1 L/min/m2. These patients showed a marked
      improvement at two to ten months after initial assessment, while they were
      waiting for a donor heart. After a follow-up of 10 to 31 months (mean follow-up,
      20 months), the five patients were still alive and their clinical and hemodynamic
      condition remained stable. On the contrary, survival was less than 15 percent at
      six months for the remaining patients with indications for heart transplantation
      but in whom transplant could not be performed because of the existence of
      contraindications or lack of donors; all these patients were dead at 18 months
      after initial assessment. The five patients who developed spontaneous favorable
      outcome showed a trend to have higher serum sodium values, shorter symptomatic
      history, lesser need for intravenous inotropic support, and better response to
      medical therapy than the other patients. Our findings suggest that some patients
      with transplants could have experienced a sustained and spontaneous clinical and
      hemodynamic recovery with medical therapy alone, although it seems currently
      difficult to identify patients with this favorable outcome.

PMID- 1623804
TI  - BOOP in Europe.

PMID- 1623805
TI  - Bronchiolitis obliterans organizing pneumonia: definition and clinical features.
AB  - There are several bronchiolar diseases with different pathologic and clinical
      findings. Idiopathic BOOP is a distinct entity consisting of a flu-like illness,
      late inspiratory crackles, patchy infiltrates roentgenographically, and
      physiologically decreased vital capacity and diffusing capacity. Response to
      corticosteroid therapy is good and relapse does not occur if sufficient therapy
      is given. Bronchiolitis obliterans organizing pneumonia is an appropriate
      description of this entity. The term is specific because it includes bronchioles
      and alveoli and excludes disorders involving only alveoli such as organizing
      pneumonitis or organizing diffuse alveolar damage. The term is general enough to
      include a sufficient number of patients with a homogenous disorder. Furthermore,
      the entity can be described to clinicians and pathologists throughout the world
      in such a fashion that patient care and research can be standardized. Researchers
      from different centers studying the cause or utilizing treatment protocols are
      able to discuss a single BOOP entity rather than comparing results of a
      heterogeneous group of many different types of interstitial lung disorders. This
      will lead to breakthroughs in discovery of etiologic causes and new effective
      therapeutic regimens.

PMID- 1623806
TI  - Clinical features of BOOP in Japan.

PMID- 1623807
TI  - High-resolution computed tomographic features of bronchiolitis obliterans
      organizing pneumonia.

PMID- 1623808
TI  - Bronchoalveolar lavage cell findings in patients with BOOP and related diseases.

PMID- 1623809
TI  - Pathologic aspects of bronchiolitis obliterans organizing pneumonia.

PMID- 1623810
TI  - Differential diagnosis of bronchiolitis obliterans organizing pneumonia.
AB  - The disease concept of idiopathic BOOP has emerged from a study of many open lung
      biopsy cases of diffuse infiltrative lung disease. The histopathologic features
      of idiopathic BOOP have several components: bronchiolitis obliterans, organizing
      pneumonia, accumulation of foamy cells in the peripheral air spaces, and
      interstitial infiltration of mononuclear cells. These pathologic findings are
      nonspecific and many conditions show such a BOOP pattern. Idiopathic BOOP has
      been discussed in the context of bronchiolitis obliterans, organizing pneumonia,
      and interstitial pneumonia. While clinically idiopathic BOOP has a relatively
      broad spectrum of manifestation, BOOP stands as a clinicopathologic disease
      entity among diffuse infiltrative lung diseases of unknown etiology.

PMID- 1623811
TI  - Bronchiolitis obliterans organizing pneumonia. A British view.

PMID- 1623812
TI  - Cryptogenic organizing pneumonitis. The North American experience.
AB  - Cryptogenic organizing pneumonitis is a clinical and pathologic syndrome
      characterized by a "pneumonia-like" illness with excessive proliferation of
      granulation tissue within small airways and alveolar ducts associated with
      chronic inflammation in the surrounding alveoli. The duration of illness prior to
      lung biopsy is short, usually less than 2 months, and it is markedly different
      from that of IPF. Interestingly, unlike in IPF where the patient has difficulty
      remembering the exact onset of symptoms, patients with COP are frequently very
      specific about the timing of their disease onset. This is because the disease
      onset is recent and is often dramatic with the development of a severe flulike
      illness, ie, cough, fever, malaise, fatigue, and weight loss. Inspiratory
      crackles are frequently present on chest examination. Pulmonary function is
      usually impaired with a restrictive defect being most common. Gas exchange
      abnormalities are extremely common with a reduction in Dco and resting hypoxemia
      being almost universal findings. The roentgenographic manifestations are quite
      distinctive with a pattern of bilateral, diffuse but inhomogeneous, ground-glass
      or alveolar opacities being present in the majority of the cases. Bronchoalveolar
      lavage findings are nonspecific but usually reveal a lymphocytosis. The response
      to corticosteroid treatment is quite favorable and death from progressive disease
      is uncommon in COP, especially if treatment is instituted early in the course of
      the disease. In our experience, the cases with the worse prognosis are those
      associated with another disease process, in particular, connective tissue
      disorders like rheumatoid arthritis. In fact, these patients are prone to develop
      a rapidly progressive form of BOOP with a clinical course similar to the "Hamman
      Rich syndrome." Recurrences are relatively frequent, consequently, withdrawal of
      treatment should be done with extreme caution. Corticosteroids have been the
      conventional initial treatment of COP, although to our knowledge, there are no
      controlled clinical trials to support it use. Antibiotics are not effective in
      treating this syndrome. Thus, based solely on our experience and that of others,
      we believe that high-dose corticosteroid therapy should be used to treat COP,
      usually initiated with 1 to 1.5 mg/kg/day (using ideal body weight) not to exceed
      100 mg/day. Prednisone is given as a single oral dose in the morning. We
      recommended maintaining this dose for 4 to 8 weeks. If the patient's condition is
      stable or improved, the prednisone dosage is gradually tapered to 0.5 to 1
      mg/kg/day (using ideal body weight) for the ensuing 4 to 6 weeks.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1623813
TI  - Risks and rewards of resin bonded bridges: a review of the literature and some
      conclusions.

PMID- 1623814
TI  - Etidronate for vertebral osteoporosis after the menopause.

PMID- 1623815
TI  - Terbinafine for dermatophytes in skin and nail.

PMID- 1623816
TI  - Management of early breast cancer.

PMID- 1623817
TI  - Postscript: starting oral contraceptives.

PMID- 1623818
TI  - [The difficult process of a woman's subjectivation. Sermon on 1. Samuel 1 to 2,
      11].

PMID- 1623819
TI  - ["Siamese twins". The connection between sterility and reproductive technics].

PMID- 1623820
TI  - [Treatment of infertility by in-vitro fertilization].

PMID- 1623821
TI  - [Laboratory methods for the treatment of women who desire children].

PMID- 1623822
TI  - [Help me to have children; if not I shall die. Report of one afflicted].

PMID- 1623823
TI  - [Nursing problems in the care of in vitro fertilized women].

PMID- 1623824
TI  - [Fertilization in vitro from the chaplain's viewpoint].

PMID- 1623825
TI  - [Artificial insemination and ethics. Thoughts on the ethical justification of a
      progressive medical technology].

PMID- 1623826
TI  - [Reproduction medicine and feministic opposition].

PMID- 1623827
TI  - [Multiple births and their problems from the view point of the neonatologist].

PMID- 1623828
TI  - [Law for the protection of embryos. Targets and methods of legal regulations for
      dealing with human life in vitro].

PMID- 1623829
TI  - [Workloads of male and female nurses in Austria].

PMID- 1623830
TI  - [Transfer of duty at the bedside. Report of experiences].

PMID- 1623831
TI  - [Primary care--an alternative?].

PMID- 1623832
TI  - [The theory of nursing--further need of clarification].

PMID- 1623833
TI  - [Pulmonary thrombendarterectomy in thromboembolic pulmonary hypertension. The
      indications and early results].
AB  - Pulmonary thrombendarterectomy was performed in 32 patients (14 men and 18 women;
      mean age 38 +/- 15 years) with thromboembolic pulmonary hypertension (New York
      Heart Association stage III: n = 22; stage IV: n = 10). The preoperative arterial
      pO2 averaged 59 +/- 11 mm Hg; pulmonary vascular resistance (PVR) and mean
      pressure (MPAP) were increased to 1,045 +/- 430 dyn.s.cm-5 and 53 +/- 12 mm Hg,
      respectively. The perioperative death rate was 22% (7 of 32). In the 25 survivors
      the pulmonary hypertension was reduced to a PVR of 194 +/- 75 dys.s.cm-5, MPAP of
      28 +/- 6 mm Hg. Subsequent re-examination in 15 patients (NYHA stage I: n = 14,
      stage II: n = 1) after a mean of 17 +/- 5 months demonstrated an arterial pO2
      averaging 92 +/- 6 mm Hg and, in 14 patients, echocardiographically normal right
      ventricular volumes and function. The primary success was confirmed in eight
      patients by haemodynamic measurements. These data indicate that
      thrombendarterectomy can effectively treat the increased PVR in most patients at
      all stages of the disease.

PMID- 1623834
TI  - [Endocrinously active parathyroid cysts. Their diagnosis by the determination of
      intact parathormone in the cyst fluid].
AB  - A 53-year-old woman with recurrent nephrolithiasis was found to have
      hypercalcaemia of 3.12 mmol/l and an intact parathormone level of 166 pg/ml,
      indicating primary hyperparathyroidism. Preoperative ultrasound examination to
      localize the parathyroid adenoma revealed a clear fluid-containing cyst in the
      right lobe of the thyroid. The aspirated fluid had an intact parathormone level
      of 306 pg/ml, twice that in serum. The cyst was removed surgically. 14 days
      postoperatively calcium and parathormone levels in serum had become normal
      without any calcium administration. Measuring the concentration of intact
      parathormone in the aspirated cyst fluid made possible not only the distinction
      from a thyroid cyst but also the precise preoperative localization of the
      parathyroid cyst.

PMID- 1623835
TI  - [Liver transplantation in erythrohepatic protoporphyria].
AB  - A 51-year-old man had for 5 years been known to have erythropoietic
      protoporphyria. GPT levels were raised up to 40 U/l, gamma-GT up to 120 U/l.
      After lengthy exposure to sun radiation an erythema with blisters, abdominal
      discomfort and jaundice developed (total bilirubin 7.3 mg/dl) and biliary liver
      cirrhosis with portal hypertension and splenomegaly were diagnosed. Because the
      acute hepatobiliary complications were not improved by conservative treatment
      (daily 750 mg ursodeoxycholic acid and 12 g colestyramine), an orthotopic liver
      transplantation was performed without complication. The excised liver showed
      small nodular parenchymal transformation and contained reddish brown
      protoporphyrin pigment in the hepatocellular cytoplasm, the Kupffer cells, the
      canaliculi and in some biliary ducts. Bilirubin and transaminase levels in blood
      became normal after the transplantation, as did the urinary excretion of
      coproporphyrin. However, isomer I was still dominant. The protoporphyrin level in
      erythrocytes and plasma remained elevated. After a symptom-free interval of one
      year biochemical and histological tests demonstrated protoporphyrin-induced
      damage in the transplanted liver.

PMID- 1623836
TI  - [Fever: the expression of a cytokine-mediated defense reaction].

PMID- 1623837
TI  - [When and how should a fever be reduced?].

PMID- 1623838
TI  - [The risk profile of low-dose methotrexate in the therapy of chronic
      polyarthritis].

PMID- 1623839
TI  - [The fee in treatment according to the rules of naturopathy. The judgement of the
      Stuttgart District Court of 1 March 1991].

PMID- 1623840
TI  - [Protein C deficiency in ulcerative colitis].

PMID- 1623841
TI  - [Acute photodermatosis (sun allergy)].

PMID- 1623842
TI  - [The vertical transmission of HIV-1].

PMID- 1623843
TI  - Impulse pattern, innervation density and two point discrimination of skin and
      mucosal afferents in humans. Considerations for a sensory reinnervation of
      urinary bladder and anal canal in spinal cord lesions. IV (IV).
AB  - 1. Single fiber action potentials (Ap's) were recorded with 2 pairs of wire
      electrodes from a coccygeal nerve root. Simultaneous impulse patterns of 3T0 +
      6T1 + 3T2 + 11T3 + 5T4 and 4P single skin afferent units were separated by their
      different Ap wave forms and conduction velocities. For a rapid touch or pin-prick
      the afferent units fired on average with 2 Ap's. 2. The touch units had most
      likely the following receptor properties. T1: rapidly adapting, medium high
      threshold, sensitive to skin traction over a distance of more than 10 cm. T2:
      rapidly adapting, high threshold. T3: slowly adapting, lowest threshold among T
      afferents for a light touch with no movement along the skin. T4: slowly adapting,
      lowest threshold among T afferents for a light touch with a movement component
      parallel to the skin surface. The T1 to T4 afferent receptors are the PC, RA, SAI
      and SAII receptors respectively. The correspondence is not safe. 3. With nerve
      fibre diameter distribution histograms (morph), myelinated fibre numbers,
      conduction velocity distribution histograms (electro) and Ap occurrence patterns,
      innervations were determined. With estimated dermatome areas, innervation
      densities i of skin dermatomes were calculated for nerve fibre diameters larger
      than 5 microns: i(electro, morph; Co) = (0.6T0 + 1.2T1 + 2.8T2 + 2.4T3 + 1.2T4 +
      1.6P)/cm2, i(morph; S4) = (0.4T0 + 1T1 + 0.8T2 + 1.1T3 + 0.5T4)/cm2, i(electro;
      S4) = 0.4T0 + 2.3T1 + 2.1T2 + 2T3 + 1.5T4)cm2, i(morph; T9) (lateral)) = (0.8 (T0
      or hair follicle) + 1.7T1 + 0.9T2 + 0.7T3 + 0.4T4)/cm2. 4. Innervation densities
      of mucosal afferent units M of urethra, trigonum vesicae and anal canal through
      S3 and S4 roots had the following lower limits: i(electro; urethra + trigonum) =
      2 M/cm2, i(electro; anal canal) = 3 M/cm2. The innervation density of skin like
      receptors of the anal canal through an S4 ventral root was with i(electro; anal
      canal) = (0.5T0 + 2.4T1 + 1.6T2 + 1.2T3 + 0.8T4)/cm2 at least as high as the
      innervation density of the S4 dermatome. The urethra possesses no skin like
      receptors in the mucosa. Mechanoreceptor afferents of the mucosa (M) of urethra
      and anal canal had thresholds similar to those of T3 and T4 afferents. 5. The two
      point discrimination of a volunteer was for a light touch 30 mm in the S3 and S4
      dermatomes and reduced to 25 mm with faster and stronger touch. In the direction
      of the anus and the os coccygeum the two point discrimination reduced to 25
      mm.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1623844
TI  - The effect of muscle fiber length change on motor units potentials propagation
      velocity.
AB  - The influence of the muscle length on the propagation velocity of the
      extraterritorial action potentials was studied. Single low--threshold motor units
      (MUs) from m. biceps brachii, both with superficially and deeply situated fibers
      were investigated. The velocity of excitation propagation decreases with the
      muscle elongation. This dependence is not so prominent for MUs having more deeply
      situated fibers. In case of superficial MUs the experimentally obtained values
      are in better agreement with the core conductor model (v = k.square root of r),
      than with the linear dependence of the propagation velocity (v) on the muscle
      fiber radius (r) (v = k.r) observed by Hakansson (1957) on frog muscles. The
      observed difference between superficial and deep MUs was discussed. At least two
      factors may be responsible for greater changes of the excitation propagation
      velocity along the fibers of the superficially situated MUs during the muscle
      elongation. One possible factor is the essential change in the external
      resistance due to the decrease of distance from the fibers to the skin surface.
      The greater change of the muscle length during a passive muscle stretching might
      be another reason.

PMID- 1623845
TI  - Peripheral nerve conduction and central motor conduction after magnetic
      stimulation of the brain in myotonic dystrophy.
AB  - Central motor conduction time was calculated after magnetic stimulation of the
      brain in 15 patients with myotonic dystrophy and in 38 healthy voluntaries of the
      same age. Conventional electromyography and motor and sensory conduction
      velocities were also performed. Central motor conduction time from vertex to C8
      was within the normal range in all patients whereas motor conduction velocity of
      the peripheral nerve and amplitude of the nerve evoked potentials were slightly
      reduced in 3 and 2 cases respectively, supporting peripheral nerve involvement in
      some subjects. Our results suggest that the reported central nervous system
      involvement in myotonic dystrophy, including the nonspecific white matter lesions
      showed by magnetic resonance imaging, would not affect the conduction of the
      corticospinal tracts. Magnetic stimulation on the motor cortex is a painless
      method to study the central nervous system and apports a satisfactory
      approximation to central motor pathways conduction.

PMID- 1623846
TI  - Electrophysiological assessment of spinal cord lesions by means of transcranial
      cortical stimulation.
AB  - Central Motor Conduction Time (CMCT) was assessed in 30 healthy volunteers and 22
      patients with spinal cord lesions due to compressive, degenerative and
      demyelinating disease. To obtain the CMCT, electrical Transcranial Stimulation
      and Percutaneous Spinal Stimulation or F wave calculations were employed.
      Pyramidal Tract (PT) conduction was always abnormal in the clinically impaired
      corticospinal tracts of all the studied patients. This results correlated with
      the degree of muscle weakness specially in those having compressive lesions.
      Subclinical evidence of pyramidal damage was also observed in two patients with
      Multiple Sclerosis. As opposed to the other groups, patients with degenerative
      spinal disease, showed essentially symmetric abnormalities. An important overlap
      of CMCT slowness was seen among the three studied groups, suggesting that this
      isolated clue is not valuable enough for aetiological suspicion. Double muscle
      responses due to single TCS were obtained, during rest, in some patients from
      each group, but never in controls. This pathological feature, not reported by
      others, could represent the excitation of indirect corticospinal connections,
      partially responsible for the residual motor function after PT damage.

PMID- 1623847
TI  - Brain-stem auditory evoked potentials in supratentorial brain tumors.
AB  - A group of 42 adult patients with supratentorial brain tumors were studied with
      computed tomography (CT or/and NMR) and brain-stem evoked potentials (BAEPs). 12
      patients had meningiomas and 30 had malignant tumors (gliomas and metastases).
      The latencies of wave V and of the interpeak latency I-III, III-V and I-V were
      evaluated both on the lesion side and the opposite side. In meningiomas mean
      latencies did not show significant differences from normal, while mean latencies
      in malignant tumors were significantly prolonged, except for the I-III interpeak
      latency. The results of this study demonstrate that BAEPs may be altered by
      supratentorial brain tumors. This examination appears to be useful in the
      monitoring of these lesions after treatment.

PMID- 1623848
TI  - High frequency vibration induced gating of subcortical and cortical median nerve
      somatosensory evoked potentials: different effects on the cervical N13 and on the
      P13 and P14 far-field SEP components.
AB  - Subcortical and cortical somatosensory evoked potentials (SEP) to median nerve
      stimulation were recorded before, during and after high frequency (270 Hz)
      vibration of the fingers 1-3 in 8 healthy subjects. A marked decrease of the
      amplitude of all potentials was observed. The attenuation of the sensory nerve
      action potential (SNAP) of the median nerve and the attenuation of SEP components
      N9, N11 and N13 showed no differences, while the attenuation of the subcortical
      P14 component was significantly higher. This is in accordance with a generator of
      the cervical N13 in the interneurons beside the lemniscal pathway. The cortical
      N20 (post-rolandic) was significantly more decreased in amplitude than P14 while
      P22 (pre-rolandic) remained reduced in amplitude like P14. An increased latency
      of the far-field subcortical P14 was observed, while P13 recorded in the same
      montage remained unchanged in latency. These findings suggest different
      generators of these peaks. A generator of P14 above the nucleus cuneatus is
      confirmed. A presynaptic generator of P13 is suspected.

PMID- 1623849
TI  - Miller Fisher syndrome: etiological significance of serial blink reflexes and MRI
      study.
AB  - We studied a patient with Miller Fisher syndrome using a serial MRI and
      electrophysiological procedures. There were peripheral nerve pathology and CNS
      dysfunction. In particular, MRI showed a lesion at the level of the 3rd nerve
      nucleus.

PMID- 1623850
TI  - Feeding problems in children with congenital heart disease: the impact on energy
      intake and growth outcome.
AB  - Cross-sectional data on growth outcome, upper-arm measurements and energy intake
      have been analysed according to the presence or absence of early feeding problems
      and poor appetite in 40 children (0.9-13 years) with congenital heart disease
      (CHD). At the time of study, refusal to eat or poor appetite was reported as a
      significant problem in 19 children and subnormal height and/or weight were
      recorded in 11 children. The children ate considerably less calories than
      recommended for healthy children. The cross-sectional analyses showed that
      children with poor appetite had significantly (P less than 0.05 and P less than
      0.01) lower outcome values of growth and upper-arm measurements than their
      disabled counterparts with no feeding problems and good appetite. Children with
      feeding problems also tended to eat less than children without feeding problems.
      For most parents (65%) feeding of infants and children with CHD involves
      difficulties, time and anxiety. This study has shown that the parents' experience
      about feeding problems may be a good predictor for low growth outcome and low
      voluntary food intake of the child. Whenever feeding problems are reported,
      nutritional intervention should be offered in order to increase the caloric
      intake of the child and to develop a sound feeding relationship in the family.

PMID- 1623851
TI  - Effect of family size and income on the biochemical indices of urban school
      children of Bangladesh.
AB  - The relationship between family size and income and the biochemical indices of
      242 children (aged from 5 to 12 years) from five schools in Dhaka City,
      Bangladesh, was investigated. Socio-economic data were collected by questionnaire
      and blood samples were drawn by visiting each school on a prefixed date. Mean
      levels of all measures, except for serum zinc, fell within the normal range.
      Older boys, but not girls (10-12 years of age) had statistically significantly
      higher haemoglobin, serum protein and serum vitamin A levels compared with those
      of the younger boys (5-9 years of age). The children were divided into three
      family size groups (small, up to 4 members; medium, 5-7 members; and large, 8 or
      more) to investigate the effect of family size on the biochemical data. The
      children from smaller families showed significantly higher levels of haemoglobin
      and serum vitamin A compared with the children from large families. For serum
      protein, copper and zinc, there was no statistically significant difference
      between the children of different family size groups. To analyse the effect of
      family income, children were divided into three income groups (low, up to taka
      2000; medium, taka 2001-4500; and high, 4501 or more). The children from the low
      family income group had significantly lower serum protein (7.5 g/100 ml) and
      haemoglobin (13.4 g/100 ml) levels compared with those of the children from the
      high family income group (for protein, 7.7 g/100 ml and haemoglobin, 14.1 g/100
      ml).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623852
TI  - Observations on the development of stunting in children of the Khon Kaen region
      of Thailand.
AB  - A cohort of children in North-East Thailand was followed from birth to 2 years of
      age in an attempt to throw light on factors determining the development of
      stunting in linear growth. By 2 years the group as a whole had an average deficit
      in height of nearly -2 standard deviations. Those index children whose sibs were
      stunted had larger deficits than those with normal sibs. Their mothers were also
      shorter and lighter. These findings suggest that it is possible to think in terms
      of stunted families. No differences were identified in socio-economic factors and
      the prevalence of infection was in general low. Dietary intakes estimated by 24
      hour recall, supplemented at 1 and 2 years by 24 h weighing, were satisfactory
      for most nutrients except iron, calcium and niacin. Intakes of Ca and P were
      lower in the more stunted children. A number of variables were measured in urine
      and blood at 1 and 2 years but few relationships could be established with the
      degree of stunting. Excretions of calcium and phosphorus showed weak negative
      correlations with height. On average the serum concentration of calcium was
      satisfactory but that of phosphorus was somewhat low. Concentrations of
      somatomedin C, thyroxin and vitamin D were within reported normal ranges, with no
      relation to the degree of stunting. From a comparison of the linear growth of
      these children with the results of other reports from Thailand it is suggested
      that environmental factors have produced stunting in the cohort as a whole, but
      the cohort is essentially homogeneous, showing within it a normal range of
      genetic variation. If that is so, major differences in intake or biochemistry
      between the taller and shorter children would not be expected. The problem
      remains of why the group as a whole is stunted. This is the first systematic
      attempt to assess biochemical factors that may be related to stunting in Third
      World children; these results are essentially negative, although there are hints
      that point at a possible deficiency of calcium.

PMID- 1623853
TI  - Weight-for-height in children aged 4-12 years. A new index compared to the
      normalized body mass index.
AB  - Data from the 1990 survey of the National Study of Health and Growth, comprising
      3357 white English boys and 3050 white English girls, were used to construct and
      evaluate a new index of weight-for-height. Prediction of triceps + subscapular
      skinfold thickness, using half of the data, led to the index (weight 
      9)/height3.7, where weight was in kilograms, height in metres. Using the second
      half of the data the index was shown to have almost as good a correlation with
      normalized (triceps + subscapular skinfold) as the body mass index (BMI) in
      children aged 4-12 years. The new weight-for-height index had stable variance
      from age 4 to 12 years after simple log transformation, unlike the BMI which
      required transformation via three age-related parameters prior to analysis or
      centile calculation. Neither index was a good proxy for skinfold measurements for
      comparison of ethnic groups. From data from inner city areas surveyed in 1989
      children of Indian subcontinent origin had substantially lower weight-for-height,
      but only Gujarati children were thinner than white children, whereas Afro
      Caribbean children were slightly heavier for their height, but thinner. Centiles
      of weight-for-height, and of BMI by age, for ages 4-12 years, were calculated for
      white English boys and white English girls.

PMID- 1623854
TI  - Energy and macronutrient intake in relation to cancer incidence among Swedish
      women.
AB  - Two dietary reporting methods were used to examine associations between
      macronutrient intake and subsequent cancer incidence in a cohort of Swedish women
      born between 1908 and 1930. 1361 subjects gave 23-h dietary recalls at their
      baseline examinations in 1968-1969, and 412 of them also provided detailed
      dietary histories. The cohort was followed up 19 years later by means of linkages
      with the National Cancer and Death Registries. Both dietary methods indicated
      that subjects who were ranked in the highest tertile of energy intake, relative
      to the lowest, were at significantly greater risk of developing cancer (all
      site). Relative risks across energy intake tertiles were 1, 1.15 and 2.04,
      respectively, using the dietary history method and 1, 1.02 and 1.55 using the 24
      h recall data. Examination of specific macronutrient energy sources indicated
      that dietary fat and carbohydrate are likely to have made the largest
      contribution to this association. However, after adjustment for total energy,
      none of the individual macronutrients was significantly associated with all-site
      cancer, by either dietary reporting method. When expressed as a percentage of
      total energy, low protein density of the diet was associated with increased
      cancer risk, by both dietary methods. However, this appeared to be a function of
      high energy intake rather than low protein intake. Simultaneous statistical
      adjustment for seven potential confounders of the association between energy
      intake and cancer was performed using both the 24-h recall and the dietary
      history data.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623855
TI  - Blunted seasonal variation in serum 25-hydroxy vitamin D and increased risk of
      osteomalacia in vegetarian London Asians.
AB  - Serum 25-hydroxy vitamin D levels were measured in 297 adult Asians and 68 white
      subjects at different times of year and seasonal variation compared between
      subjects grouped according to ethnic origin, religion and dietary habit. A sub
      group of Asians with symptoms and biochemical changes suggestive of osteomalacia
      underwent bone biopsy, and static bone histomorphometry was performed.
      Histological osteomalacia was detected in 15 Asians and borderline changes in 13.
      The majority of these cases were among vegetarian Hindus. Significant seasonal
      variation in 25-hydroxy vitamin D was observed in all groups, but with lower peak
      and trough levels among Asians, and especially the Hindus and vegetarian Asians.
      Summer rises in 25-hydroxy vitamin D levels were blunted among Hindus and
      vegetarian Asians, compared to whites, Muslims and non-vegetarian Asians.
      Vegetarian Asians had significantly lower serum calcium and higher PTH levels
      than non-vegetarians, but multivariate analysis indicated that this was an effect
      of osteomalacia, not vegetarianism. We conclude that solar exposure has a
      significant effect on vitamin D status in Asians resident in London. Non
      vegetarian Asians have similar rise and peak levels to whites, but those taking a
      vegetarian diet (in particular, Hindus) have an impaired seasonal rise in 25
      hydroxy vitamin D levels, and are at particular risk of metabolic bone disease.
      This effect did not appear to be mediated through secondary hyperparathyroidism
      consequent on a vegetarian diet.

PMID- 1623856
TI  - Nutritional profiles of chronic alcoholics.
AB  - An epidemiological study of 58 variables from 300 chronic alcoholic and normal
      subjects was carried out in the Cardiology, Gastroenterology, Neurology,
      Psychiatry and Alcohology Departments in order to research, within this chronic
      alcoholic population, a correlation between diet, alcohol intake, tobacco use and
      the various alcohol-related diseases. A standardized questionnaire (previously
      tested) was used to relate dietary intakes (proteins, fats, carbohydrates, water
      and energy) to drinking and smoking habits. Discriminant analyses were used as
      appropriate. The alcoholic population is made up of subjects with strong oral
      intake behaviour and can be classified in relation to their alcohol-related
      diseases. The alcoholics with cardiovascular and digestive diseases have the two
      (1st and 2nd) richest diets, respectively, consisting mainly of saturated fats
      and animal proteins, together with the lowest daily alcohol intake, the highest
      recorded total quantities of alcohol intake and the longest period of alcohol
      abuse before alcohol-related disease diagnosis. The 4th and 5th places can be
      reserved for the alcoholics with neurological and psychiatric diseases with
      opposite eating and drinking behaviours, i.e. with the poorest diet (less in
      terms of proteins and fats, although more than the normal population), the
      highest daily alcohol intake, the lowest quantities of total alcohol intake and
      the shortest time of alcohol abuse before disease diagnosis. The alcoholic
      population with subjects free of alcohol-related disease including mixed
      subjects, who either had not yet started or will never present any alcohol
      related disease, occupy the intermediate place (3rd) in this classification.

PMID- 1623857
TI  - Interleukin-1 in alcoholic cirrhosis of the liver: the influence of nutrition.
AB  - Interleukin-1 (IL-1) is a cytokine produced by the macrophage-monocyte system
      that has important effects on immunological responses and inflammatory reactions.
      Several clinical studies have shown that severe protein energy malnutrition
      adversely effects cell-mediated immune responses and the functional state of
      macrophages. The objective of this study was to analyse IL-1 production by
      adherent cells stimulated in vitro with lipopolysaccharide B (LPS) from patients
      with alcoholic cirrhosis of the liver and its possible relationship with
      nutritional states. Forty-five patients with alcoholic cirrhosis and 28 healthy
      donors were investigated. A combined index of nine anthropometric and biochemical
      parameters was used to evaluate nutritional status of cirrhotic patients,
      allowing a distinction to be made between those patients with acceptable
      nutrition (group I: 40%), those with slight malnutrition (group II: 37.7%), and
      those with severe malnutrition (group III: 22.3%). IL-1 activity was
      significantly lower in the cirrhosis patients than in the controls (P less than
      0.001). This activity also was significantly lower in samples obtained from
      cirrhotics with severe malnutrition than in those with acceptable nutrition (P
      less than 0.05); the combined index and the sole anthropometric index gave the
      same results, suggesting that malnutrition may play a role in the
      immunoregulatory disturbances in the pathogenesis of alcoholic liver disease.

PMID- 1623858
TI  - Cardiovascular mortality and morbidity in seven counties in Sweden in relation to
      water hardness and geological settings. The project: myocardial infarction in mid
      Sweden.
AB  - An east-west regional gradient in cardiovascular mortality was found within seven
      counties in mid-Sweden during the years 1969-1983. The mortality differences were
      of considerable magnitude for ischaemic heart disease (IHD) as well as for
      stroke. In previous reports, in which the distribution of risk factors among
      middle-aged men was presented, the moderate variation among the communities could
      not explain the mortality variation. Water hardness has previously been reported
      to be inversely related to cardiovascular mortality in several countries. In this
      paper, water samples from all 76 communities in seven counties were analysed in
      relation to mortality rates from IHD and stroke for men and women. Water hardness
      (Ca+Mg and other minor constituents), and the sulphate and bicarbonate
      concentrations of the drinking water were inversely related to IHD as well as
      stroke mortality. The water factors were also inversely related to non-fatal IHD
      even when account was taken of the age variation and the traditional risk factors
      as measured by a postal questionnaire. Variation of the water factors accounted
      for 41% of the variation in IHD mortality rate and 14% of the variation in stroke
      mortality rate over the 76 communities.

PMID- 1623859
TI  - The Tromso study: the prevalence of exercise-induced silent myocardial ischaemia
      and relation to risk factors for coronary heart disease in an apparently healthy
      population.
AB  - A random population sample of 294 men and 312 women aged 20-64 years, all
      apparently healthy, were examined following a screening to determine the
      prevalence of silent ischaemia and its relations to coronary risk factors. Based
      on exercise testing, the prevalence of silent ischaemia was 2.5% in men and 3.4%
      in women. In men, silent ischaemia was positively related to systolic blood
      pressure (P less than 0.001). The other risk factors did not show any significant
      associations with silent ischaemia. However, the men with silent ischaemia had a
      higher coronary heart disease risk score, and a tendency towards more symptoms
      and signs suggesting a poorer health status than the other men and the women. In
      the 21 men classified as 'hypertensives', silent ischaemia was more common than
      in the normotensive men (14% versus 2%, P less than 0.001). No such difference
      was observed in women. In conclusion, silent ischaemia may be a sign of
      hypertension and a generally increased risk of coronary heart disease in men, but
      probably not in the majority of women. This further supports that exercise
      electrocardiography has no role in screening asymptomatic persons for coronary
      heart disease, probably with the exception of middle-aged men with an increased
      risk.

PMID- 1623860
TI  - Left ventricular diastolic and systolic function in normotensive obese subjects:
      influence of degree and duration of obesity.
AB  - The present study was carried out to evaluate systolic and diastolic parameters
      in overweight and moderately obese, but otherwise healthy subjects, and in a lean
      control group, to determine whether degree and duration of obesity can influence
      left ventricular function. A total of 27 subjects, 17 overweight or with moderate
      obesity and 10 lean, healthy subjects were included. Patients were divided into
      three groups according to their body mass index (BMI) and to Garrow's criteria as
      follows: lean control group (BMI less than 25 kg.m-2); overweight subjects (BMI
      from 25 to 30 kg.m-2); moderately obese subjects (BMI greater than 30 less than
      40 kg.m-2). Systolic and diastolic parameters were measured using blood pool
      gated radionuclide angiography. Left ventricular (LV) ejection fraction (EF),
      peak ejection rate (PER), time to PER (tPER), peak filling rate (PFR) and time to
      PFR (tPFR) were evaluated. PER and PFR values were normalized for end-diastolic
      volume (EDV). EF and PFR were significantly lower (P less than 0.05) both in
      moderately obese and in overweight subjects and tPFR was significantly (P less
      than 0.05) prolonged in both groups in comparison to lean controls. Only in
      moderately obese subjects was PER significantly (P less than 0.05) decreased and
      tPER significantly (P less than 0.05) prolonged in comparison to lean controls.
      As compared to overweight individuals, moderately obese subjects were
      characterized by a significant decrease (P less than 0.05) in LVEF and PER and by
      a significant increase (P less than 0.05) in tPER, without relevant change in PFR
      and in tPFR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623861
TI  - Acute effects of cigarette smoking on left ventricular diastolic function.
AB  - Cigarette smoking increases coronary resistance in patients with coronary artery
      disease, causing profound disturbances in myocardial perfusion. The acute effects
      of smoking a single cigarette on left ventricular diastolic function were studied
      in 20 smokers with typical angina pectoris and angiographically documented
      coronary artery disease. Twenty healthy smokers served as a control group. We
      used simultaneous M-mode echocardiography of the mitral and aortic valves to
      measure isovolumic relaxation time, and pulsed Doppler echocardiography of
      transmitral blood flow was recorded to evaluate left ventricular filling before
      and immediately after smoking. In the patients with coronary artery disease,
      systemic blood pressure and heart rate significantly increased after smoking. The
      isovolumic relaxation time, the deceleration time as well as peak A velocity
      remained unchanged. The peak E velocity decreased by 0.06 m.s-1 (P = 0.02) and
      the peak E/A velocity ratio by 0.17 m.s-1 (P = 0.01). There were no significant
      changes in left ventricular diastolic function indexes in the controls. These
      results indicate that in patients with coronary artery disease, each cigarette
      provokes disturbances of left ventricular diastolic function.

PMID- 1623862
TI  - Abnormal diastolic filling patterns in chronic heart failure--relationship to
      exercise capacity.
AB  - Abnormal patterns of diastolic ventricular filling are well recognized in chronic
      heart failure, but their relationship to the severity of heart failure is not
      known. The present study evaluates the relationship of diastolic filling indices
      to the severity of heart failure and to exercise capacity. In 40 patients with
      chronic heart failure secondary to ischaemic left ventricular impairment,
      exercise capacity was measured as peak oxygen consumption (VO2max) by progressive
      treadmill exercise. Left ventricular function was assessed by M-mode and Doppler
      echocardiographic indices. Peak aortic velocity correlated weakly with VO2max (R
      = +0.38, P less than 0.05). VO2max did not correlate with other systolic indices,
      including mean aortic acceleration, time to peak velocity, or isovolumic
      contraction time. VO2max correlated with the mitral inflow E/A ratio (R = -0.57,
      P less than 0.005) and with the Doppler estimate of isovolumic relaxation time (R
      = -0.48, P less than 0.01). Two distinct patterns of diastolic filling were
      observed: subjects with mild-to-moderate heart failure (NYHA grade II, VO2max 15
      20 ml.kg-1.min-1) had abnormally low E/A ratios and long isovolumic relaxation
      times, whereas those with severe heart failure (NYHA grade III-IV, VO2max less
      than 12 ml.kg-1.min-1) had abnormally high E/A ratios and short isovolumic
      relaxation times. Different patterns of abnormal diastolic filling with different
      degrees of severity of heart failure may explain some of the previous controversy
      as to the prevalence of abnormal diastolic function in chronic heart failure.
      Exercise capacity in chronic heart failure appears more closely related to
      abnormalities of diastolic filling pattern than to indices of systolic function.

PMID- 1623863
TI  - Ischaemic heart disease, skeletal muscle fibres and exercise capacity.
AB  - Twenty-eight male patients with ischaemic heart disease (IHD) performed OBLA
      (onset of blood lactate accumulation) exercise stress tests and had muscle
      biopsies taken from their vastus lateralis muscle the day before coronary bypass
      grafting. All 28 patients showed the same exercise performance pattern as
      compared to healthy sedentary, age-matched, controls: a low exercise intensity
      eliciting a blood lactate concentration of 2.0 mmol x l-1 (WOBLA), WOBLA
      corresponded to a high fraction (% WOBLA) of WSL (symptom limited or 'maximal'
      capacity), and a low peak blood lactate concentration. The high % WOBLA and low
      peak blood lactate indicated a reduced glycogenolytic capacity ('anaerobic'
      performance). Muscle fibre composition disclosed a high mean value of fast twitch
      (FT), type II or 'white' muscle fibres, as compared to sedentary healthy
      controls. This indicated that this patient group constituted an extreme subgroup
      of the age-matched population. The distorted muscle fibre composition in IHD
      could reflect both heredity as well as adaptation to physical inactivity,
      degenerative cytosolic properties, etc. Muscle and blood contents of a
      mitochondrial electron translocator and nonspecific radical scavenger, ubiquinone
      or coenzyme Q10(CoQ10), were low, which coincided with an elevated frequency of
      the fibre subgroup FT(c). The presence of the FT(c) fibre type is assumed to
      reflect histological trauma.

PMID- 1623864
TI  - Electropharmacological testing by transoesophageal atrial pacing in inducible
      supraventricular tachyarrhythmias. A good approach for selection of long-term
      anti-arrhythmic therapy.
AB  - Sixty-eight patients with disabling episodes of inducible supraventricular
      tachyarrhythmia were tested electropharmacologically by transoesophageal atrial
      pacing. Using this technique we induced clinical arrhythmia in 67 (98.5%); 26
      (38.8%) had a reciprocating tachycardia due to AV node reentry and 41 (61.2%) a
      by-pass tract. In the latter we induced a reciprocating tachycardia in 12
      (29.3%), atrial fibrillation in 25 (36.5%) and both in 14 (34.2%). We then
      performed an anti-arrhythmic drug test and a transoesophageal reevaluation either
      after acute intravenous drug administration or during oral steady state.
      Altogether we tested 111 drugs or a combination of drugs before the results were
      considered positive; all patients tolerated the procedure well and were
      discharged with the drug or combination of drugs judged effective. At follow-up
      of 16.6 +/- 8.5 months, 42 patients (62.7%) were symptom-free, 17 (25.3%) had
      minor and non-disabling relapses, six (9%) stopped the drug because of inefficacy
      (1-1.5%) or side effects (5-7.5%); two (3%) dropped out. We conclude that
      electropharmacological testing with transoesophageal pacing constitutes a very
      good approach for inducible supraventricular tachyarrhythmias: it permits
      selection of optimal long-term anti-arrhythmic treatment and is well tolerated,
      only slightly invasive and without adverse effects.

PMID- 1623865
TI  - Thrombolysis and coronary occlusion: effects upon the non-infarct zone.
AB  - Regional wall motion was examined by angiography after 3 weeks in 154 patients
      taking part in the Thrombolysis in Coronary Occlusion (TICO) Trial. Coronary
      patency rate was greater after administration of recombinant tissue plasminogen
      activator, (rt-PA 62/77pts 81%) than after a placebo (P 49/77pts 64% P = 0.02),
      particularly for the left anterior descending artery compared with the right
      coronary artery (LAD 27/28 96% vs RCA 28/40 70% P = 0.006). Left ventricular
      ejection fraction (LVEF) was preserved after rt-PA (rt-PA 59 +/- 14% vs P 53 +/-
      15% P = 0.01), predominantly because of more effective non-infarct zone
      contraction (rt-PA 0.52 +/- 1.16 SD/cord vs P 1.01 +/- 1.07 SD/cord P = 0.008).
      Infarct zone scores differed little (rt-PA 2.88 +/- 0.95 SD/cord vs P 3.16 +/-
      1.11 SD/cord P = 0.09). Left ventricular ejection fraction and non-infarct zone
      function were best preserved after rt-PA compared with the placebo, particularly
      in patients with single vessel disease and in patients in whom the infarct
      related artery was the left anterior descending vessel.

PMID- 1623866
TI  - Drug-testing in patients with pulmonary hypertension of unknown cause.
AB  - The acute haemodynamic effects of seven different drugs were serially evaluated
      in eight patients suffering from pulmonary hypertension of unknown cause. The
      following drugs were tested in randomized order: nifedipine, amrinone,
      isoproterenol, captopril, prostacyclin, dihydralazine and nitroglycerin. Only a
      reduction in pulmonary vascular resistance (PVR) of more than 30% of baseline was
      considered a satisfactory response. Overall, the decrease in PVR ranged from 9 +/
      12% (nitroglycerin) to 38 +/- 23% (prostacyclin). However, marked inter- and
      intra-individual variability in the efficacy of all drugs was observed, making
      cross reactivity totally unpredictable. The number of responders for each drug
      varied between five (prostacyclin) and zero (dihydralazine, nitroglycerin).
      Conversely, a maximum of three drugs was capable of eliciting a response in an
      individual patient, with only two out of eight patients being total non
      responders. A reduction in PVR of more than 30% (n = 16) was associated with a
      significant decrease in mean pulmonary artery pressure (49.1 +/- 8.2 versus 39.4
      +/- 6.4 mmHg) and a significant increase in cardiac index (2.5 +/- 0.6 versus 3.4
      +/- 0.8l.min-1.m-2). Overall, none of the drugs tested proved to be clearly
      superior. However, because of marked inter- and intra-individual variability, the
      therapeutic approach must be based on trial and error and the evaluation of all
      drugs is indicated if one fails.

PMID- 1623867
TI  - Comparative long-term results of coronary angioplasty in single and multivessel
      disease.
AB  - The comparative long-term clinical results of coronary angioplasty in 448
      patients with single-vessel and 451 patients with multivessel disease are
      reported. Clinical status was determined at census for 898 patients (99.9%).
      Actuarial survival at 5 years was 92.7% for single-vessel and 85.6% for
      multivessel disease patients (relative risk 2.1). Patients with multivessel
      disease had higher rates of cardiac death and non-fatal myocardial infarction
      (relative risk 1.8), and coronary artery bypass surgery (relative risk 2.5) than
      patients with single-vessel disease. At follow-up 72.6% of single-vessel and
      61.3% of multivessel disease patients had no angina and 43.3% and 35.8%,
      respectively, were taking no regular anti-anginal medication. Treatment by
      coronary angioplasty is associated with a good long-term prognosis, but survival
      and event-free survival rates are lower in patients with multivessel disease than
      in patients with single-vessel disease, even after correction for differences in
      other baseline characteristics.

PMID- 1623868
TI  - Logistical problems in prehospital thrombolysis.
AB  - In this study we compared efficacy and safety of prehospital with in-hospital
      thrombolytic treatment with anistreplase in patients with acute myocardial
      infarction (AMI). Three-hundred and fifty patients with chest pain were screened
      for eligibility by the municipal ambulance staff and/or the general practitioner.
      Patients were included in the absence of contraindications and if the telephone
      transmitted ECG showed AMI. In a 6 month period 16 patients (5%) were eligible,
      but only seven (2%) were randomized. Age over 70 years, duration of chest pain
      for longer than 4 h and logistic problems were the major factors responsible for
      the low inclusion rate. The mean time spent at home with and without the ECG
      procedure was 38 +/- 14 and 14 +/- 8 min, respectively (P less than 0.001). These
      results demonstrate that in a medium sized town prehospital delivery of
      intravenous thrombolytic therapy by paramedics and/or the general practitioner is
      not feasible, leads to unnecessary time delay and may therefore yield no clinical
      benefits.

PMID- 1623869
TI  - Oxygen consumption during corridor walk testing in chronic cardiac failure.
AB  - We have examined the use of a 6-min corridor walk test in the assessment of
      functional capacity in 16 patients with chronic cardiac failure. VO2 was
      determined concurrently by a portable 'Oxylog'. Three tests were performed
      sequentially, and although there was a significant increase in distance walked
      and highest VO2 achieved between the first and second tests, good reproducibility
      was attained between the second and third tests. Both walk test variables
      correlated well with previously determined peak achieved VO2, and NYHA classes
      were separated adequately. Corridor walk testing, with or without measurement of
      VO2 should be a useful adjunct to maximal exercise testing in interventional
      studies.

PMID- 1623870
TI  - Comparison of thallium myocardial scintigraphy after exercise and
      transoesophageal atrial pacing in the diagnosis of coronary artery disease.
AB  - Forty-nine patients admitted for assessment of chest pain underwent coronary
      angiography, planar Thallium 201 myocardial scintigraphy after submaximal
      exercise (TE) and transoesophageal atrial pacing (TAP). Early hypofixation with
      redistribution after 4 h indicated ischaemia. The criterion for a myocardial
      infarction (MI) was a fixed perfusion defect. Coronary angiography was carried
      out in all patients. Sixteen patients (group 1) had no MI and over 50% narrowing
      of at least one main coronary vessel. Ischaemia was noted in 10 of the 16
      patients during exercise, and in 14 of the 16 patients during atrial pacing. The
      sensitivity for the prediction of coronary stenosis was 62% for TE and 87% for
      TAP. Nineteen patients (group 2) had had a previous MI. Reversible ischaemia was
      noted in 10 of the 19 patients during exercise, and in 11 of the 19 patients
      during TAP. Four of 14 patients with normal coronary arteries (group 3) had a
      reversible ischaemia with TE, and three of these same patients developed a
      positive scan with TAP. The respective specificities were 71% and 78%. Comparison
      of segmental hypoperfusion after TE and TAP gave identical results in 72 of the
      80 segments studied in group I (90%), and in 88 of the 95 segments studied in
      group 2 (92%). The localizing value of TAP was good in left anterior descending
      (12 out of 18) and right coronary disease (16 out of 19), but poor in left
      circumflex stenosis (3 out of 9) misclassified as right coronary disease in four
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623871
TI  - Further evidence supporting the concept of T-wave memory: observation in patients
      having undergone high-energy direct current catheter ablation of the Wolff
      Parkinson-White syndrome.
AB  - Following successful high-energy direct current catheter ablation of posterior
      septal accessory pathways, serial T-wave changes were observed in seven patients
      with Wolff-Parkinson-White syndrome, but not in two patients with a concealed
      accessory bypass pathway. Following catheter ablation in the patients with Wolff
      Parkinson-White syndrome, the previously upright T-waves in the inferior
      electrocardiographic leads became inferiorly directed. Serial electrocardiograms
      following catheter ablation revealed slow regression of these T-wave changes over
      time. In contrast, in the two patients in whom a concealed accessory pathway was
      present, the T-waves prior to and following the procedure were upright. In these
      two patients, serial electrocardiograms showed no evolution of the T-wave vector
      over the same time period. Although a small rise in myocardial CK enzymes was
      observed, ischaemic injury in the area of catheter ablation could not be
      documented by post-procedure echocardiography, tomographic thallium scintigraphy,
      technetium pyrophosphate scintigraphy or coronary angiography with left
      ventriculography. We conclude that the observed T-wave changes in the patients
      with Wolff-Parkinson-White syndrome may be a result of the change in
      depolarization sequence resulting from loss of pre-excitation, and that the time
      dependent nature of these T-wave changes is consistent with the concept of T-wave
      'memory'.

PMID- 1623872
TI  - Flecainide-related alterations in the signal-averaged electrocardiogram:
      similarity between patients with or without ventricular tachycardia.
AB  - The signal-averaged electrocardiogram (SAECG) identifies patients at risk of
      sustained ventricular tachycardia (VT), but the influence of anti-arrhythmic
      agents on the SAECG is not yet established. We have evaluated the effects of
      flecainide on the SAECG (XYZ leads, high-pass filters 25 Hz and 40 Hz, noise
      level 0.2 microV-0.4 microV, Model 1200 EPX, ART) in 25 patients: 15 (VT group)
      had documented sustained VT (nine post-MI, two dilated cardiomyopathy, four
      normal hearts) and 10 (control group) had supraventricular arrhythmias and
      structurally normal hearts. The SAECG was recorded in all patients prior to, and
      5 min following a flecainide infusion (2 mg.kg-1 over 10 min). Before flecainide
      administration an abnormal SAECG was recorded in six patients from the VT group
      and in no control patient. Following flecainide, 13 patients from the VT group
      and eight control subjects demonstrated abnormal SAECG. Flecainide produced
      similar significant percentage changes in all SAECG indices in both the VT and
      control groups: total QRS duration was prolonged by 26.0 +/- 10.4% vs 26.7 +/-
      15.7%, late potential duration under 40 microV was prolonged by 55.5 +/- 62.0% vs
      106.1 +/- 61.4%, and the root mean square voltage of the last 40 ms of the QRS
      was reduced by 42.1 +/- 34.9% vs 55.3 +/- 24.4%, respectively. We conclude that
      flecainide significantly changes the SAECG parameters in patients with and
      without a history of VT, irrespective of the underlying disease.

PMID- 1623873
TI  - Absence of pre-dose rebound phenomena with once daily 5-ISMN in a controlled
      release formulation.
AB  - To avoid the development of nitrate tolerance secondary to relatively constant
      elevated plasma nitrate concentrations, intermittent nitrate dosing has been
      advocated. However, a nitrate-free interval may induce a rebound increase in
      myocardial ischaemia, and thus increase anginal symptoms during the latter
      portion of the dosing interval. This was suggested by the results of recent
      studies in which nitroglycerin patches were administered intermittently with a 12
      h nitrate-free interval. The present investigation was carried out to determine
      whether a controlled-release formulation of 60 mg isosorbide-5-mononitrate (5
      ISMN) would produce such a rebound phenomenon. Seventy-nine patients, who had
      participated in four crossover, placebo-controlled studies in which the treatment
      arms lasted for between 1 and 2 weeks, were reviewed. These studies had assessed
      the efficacy of this nitrate preparation by exercise testing and each had
      included exercise testing at the end of each treatment phase, 24 h after the last
      medication had been administered. There were no differences noted in the time to
      onset of angina, the time to onset of 1 mm ST segment depression or the total
      exercise duration between the two treatment phases, indicating an absence of
      rebound phenomena at the end of the dosing interval. The reason for the absence
      of a detectable pre-dose rebound is unclear, but the plasma concentration profile
      of 5-ISMN produced by the presently used preparation, resulting in a nitrate-low
      instead of nitrate-free interval, may have contributed.

PMID- 1623874
TI  - Efficacy and safety of APSAC in the treatment of acute myocardial infarction.
AB  - A prospective, open, multicentre post-marketing surveillance on the efficacy and
      safety of intravenous APSAC in the treatment of acute myocardial infarction was
      performed in 2436 patients. Reperfusion suggested by non-invasive parameters was
      achieved in 77.3% of patients. In-hospital mortality was low (7.1%). After
      exclusion from analysis of patients greater than 70 years of age and those
      reported to be in cardiogenic shock, mortality rate was 2.9%. More importantly,
      non-invasive evidence for successful thrombolysis resulted in a significantly
      lower mortality (3.3%) compared with patients without evidence of successful
      reperfusion (17.2%). The incidence of serious adverse events was low (132 in 2436
      patients, 8/2436 = 0.3% fatal). The data from this post-marketing surveillance
      conducted under every-day clinical conditions confirm the efficacy and safety of
      APSAC as a thrombolytic agent in acute myocardial infarction, as demonstrated
      previously in controlled clinical trials.

PMID- 1623875
TI  - Paradoxical vasoconstriction as result of acetylcholine and serotonin in diseased
      human coronary arteries.
AB  - In experimental atherosclerosis, impairment of endothelium-dependent vasodilation
      results in an unmasking of potent vasoconstrictor responses to serotonin, a
      substance released by aggregating platelets. To determine whether similar changes
      occur in diseased human coronary arteries, the responses to selective
      intracoronary infusions of acetylcholine and serotonin (both endothelium
      dependent vasodilators) and to isosorbide dinitrate (a dilator directly acting on
      the smooth muscle) were assessed by quantitative coronary arteriography in 16
      patients with angiographically normal coronary arteries, in 10 patients with
      minimal (less than 30% narrowing) and in five patients with more advanced
      (greater than 50% narrowing) coronary atherosclerosis. Acetylcholine induced
      constriction in diseased coronary arteries, but in patients with normal coronary
      arteriograms, it caused dilatation in seven patients (smooth dilators) and
      constriction in nine patients (smooth constrictors). In the smooth dilators,
      however, serotonin evoked no significant changes (+1.4 +/- 4.1%), whereas in the
      smooth constrictors and in patients with diseased coronary arteries, serotonin
      caused dose-dependent constriction. The vasoconstrictor responses to serotonin
      were similar in patients with minimal (-26.5 +/- 4.7%) and more advanced
      atherosclerosis (-30.9 +/- 5.3%). In one patient with coronary artery disease,
      serotonin caused a temporary coronary occlusion. All other patients dilated in
      response to isosorbide dinitrate. The vasomotor responses to acetylcholine and to
      serotonin were thus shown to be completely in parallel. CONCLUSION: impairment of
      endothelium-dependent vasodilation unmasks potent vasoconstrictor responses to
      serotonin both in early and advanced coronary atherosclerosis. These changes may
      play an important role in the pathogenesis of a dynamic coronary artery stenosis.

PMID- 1623876
TI  - Fatal haemostatic complications due to thrombolytic therapy in patients falsely
      diagnosed as acute myocardial infarction.
AB  - This report describes the fate of two young men wrongly treated with thrombolysis
      for suspected myocardial infarction. Both had electrocardiographic changes upon
      admission. Correct diagnosis of aortic dissection and haemorrhagic pericarditis
      was obtained within a few hours, but due to the prolonged disturbance of
      haemostasis, appropriate therapy could not be instituted, and outcome was fatal
      for both patients. These cases underline the importance of rigid ST criteria, and
      procedures for neutralization of thrombolysis are proposed.

PMID- 1623877
TI  - Myocardial dissection following successful chemical ablation of ventricular
      tachycardia.
AB  - We describe a case of fatal myocardial rupture and tamponade following a
      successful transcoronary chemical ablation of incessant ventricular tachycardia.
      Pathological examination showed a subepicardial dissection of the heart at the
      ablation site with fibrous and fatty degeneration of the myocardium. The present
      report calls for caution, underlying a possible lethal complication of ethanol
      ablation which has not been described before.

PMID- 1623878
TI  - Emergency mitral valve replacement immediately following caesarean section.
AB  - Cardiopulmonary bypass immediately post-partum could carry the risk of severe
      uterine bleeding. We report the case of a woman who successfully underwent
      emergency replacement of a thrombosed mitral prosthesis immediately after
      Caesarean section.

PMID- 1623879
TI  - Total occlusion of the left main coronary artery and normal LV function despite
      critical narrowing of the right coronary artery.

PMID- 1623880
TI  - Development of nitrate tolerance and usefulness of pulse therapy in a patient
      with vasospastic angina.
AB  - In a 58-year-old man with vasospastic angina, we investigated the relationship
      between the antianginal effects of isosorbide dinitrate (ISDN) and plasma ISDN
      concentration. Despite adequate plasma ISDN levels, sustained therapy using ISDN
      tapes and oral ISDN (transcutaneously 160 mg and orally 100 mg ISDN day-1) failed
      to exhibit antianginal effects. However, pulse therapy using sublingual short
      acting ISDN prevented anginal episodes, although the plasma ISDN levels were less
      than those of sustained therapy. Nitrate tolerance of the antianginal effects was
      avoided by creating an abrupt plasma ISDN concentration gradient using sublingual
      ISDN.

PMID- 1623881
TI  - Fatal anaphylactoid response to protamine after percutaneous transluminal
      coronary angioplasty.
AB  - A generalized skin erythema and severe hypotension developed following
      administration of protamine for the reversal of heparin anticoagulation after an
      unsuccessful attempt at percutaneous transluminal angioplasty in a patient who
      had never been exposed to protamines before. Evidence of classical pathway
      complement activation was present indicating that this reaction could have been
      triggered by a non-immunological mechanism. The patient could not adequately be
      resuscitated because of the presence of severe coronary artery disease.

PMID- 1623882
TI  - Pleuritis-pericarditis--an unusual initial manifestation of mixed connective
      tissue disease.
AB  - Cardiac involvement has been reported in mixed connective tissue disease (MCTD).
      We describe a 16-year-old girl in whom pleuritis and pericarditis occurred as the
      initial clinical manifestations of MCTD. Although pleuritis and pericarditis form
      a common clinical entity in MCTD, it is rarely seen as an initial manifestation.
      If MCTD is suspected, the diagnosis can be made by the clinical findings and the
      occurrence of a high titre of antibody against ribonuclease-sensitive
      ribonucleoprotein (RNP). This report emphasizes the importance of screening for
      connective tissue disease in patients with pericarditis/pleuritis.

PMID- 1623883
TI  - From Harvard to Minnesota: keys to our history.

PMID- 1623884
TI  - Sport and the mass media.

PMID- 1623885
TI  - Regulation of hormonal and metabolic responses during exercise in humans.

PMID- 1623886
TI  - Human energy expenditure from Australopithecus afarensis to the 4-minute mile:
      exemplars and case studies.

PMID- 1623887
TI  - Anxiety and sport performance.
AB  - From the findings summarized in this review, it appears that there is little
      evidence in support of the inverted-U hypothesis. Available research indicates
      that there is considerable variability in the optimal precompetition anxiety
      responses among athletes, which does not conform to the inverted-U hypothesis.
      Many athletes appear to perform best when experiencing high levels of anxiety and
      interventions that act to produce quiescence may actually worsen the performance
      of this group. These findings indicate that there is a need to shift the research
      paradigm away from theories of anxiety and performance based on task
      characteristics or group effects and, instead, employ theoretical models that
      account for individual differences. Hanin's [39, 40] ZOF theory appears to be a
      good candidate for furthering our knowledge in this area. It was developed on the
      basis of research with athletes and it explicitly incorporates the concept of
      individual differences in the anxiety-performance relationship. Most important,
      because an individual's optimal range of anxiety is precisely defined, the
      validity of ZOF theory can be directly examined through hypothesis testing,
      whereas it has been argued that the inverted-U hypothesis is effectively shielded
      against falsification [84]. Although the findings of ZOF theory indicate that a
      significant percentage of athletes perform best at high levels of anxiety,
      Hanin's translated writings do not provide an explanation of why this is so.
      Further research is clearly indicated, but one explanation for this finding may
      involve how the athlete interprets or conceptualizes anxiety. For example,
      Mahoney and Avener [64] found that, although the absolute level of precompetition
      anxiety was similar between successful and unsuccessful Olympic gymnasts, there
      were differences in the way the athletes conceptualized the anxiety they were
      experiencing. The better performers viewed their anxiety as desirable, whereas
      anxiety was associated with self-doubts and catastrophizing in the unsuccessful
      gymnasts. Similar differences have been observed in the test anxiety literature
      where it has been found that poorer test takers perceive their anxiety to be more
      threatening and debilitating than do better performers [45]. Furthermore,
      temporal differences in the patterning of anxiety [64], fear responses, or
      cardiorespiratory measures [28] have been found between successful and
      unsuccessful performers; this may reflect a difference in the ability to regulate
      anxiety. It may also be the case that performance is not so much affected by the
      absolute level of precompetition anxiety as the consistency in the anxiety level
      across competitions. Athletes may also develop coping strategies that exploit
      consistent changes in attentional focus that result from elevated
      anxiety.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1623888
TI  - Genetics of aerobic and anaerobic performances.

PMID- 1623889
TI  - Oxygen transport during exercise at altitude and the lactate paradox: lessons
      from Operation Everest II and Pikes Peak.
AB  - It seems unlikely that oxygen-limited metabolism explains the increased lactate
      concentrations in blood or muscle during exercise at high altitude compared with
      sea level values because: 1. Even marked hypoxia equivalent to that at the summit
      of Mt. Everest may not be sufficiently severe to impair function or to impair
      muscle oxidative metabolism markedly during exercise; 2. At this very high
      altitude, muscle hypoxemia is probably not the limiting factor for exercise
      performance; other systems, i.e., the cerebral cortex [24, 33], probably fail
      before hypoxemia impairs muscle metabolism; 3. The traditional view of oxygen
      limited aerobic metabolism during exercise at high altitude does not explain a
      long-standing dilemma in altitude physiology, the lactate paradox (in which blood
      lactate accumulation during exercise is increased on arrival at high altitude but
      falls with acclimatization), because the lactate fall is independent of muscle
      oxygenation; 4. Net lactate release by the leg during exercise is independent of
      oxygenation; 5. Kinetic studies show that lactate appearance and disappearance
      are closely linked and both increase with acute altitude exposure and decrease
      with acclimatization; 6. Lactate appearance rate is strongly correlated with, and
      may be influenced by, the extent of beta-adrenergic stimulation; 7. The beta
      adrenergic stimulation may be, in part, determined by the degree of arterial
      oxygenation.

PMID- 1623890
TI  - Responses of the cardiac transplant patient to exercise and training.
AB  - Total denervation persists in the human heart following cardiac transplantation.
      At rest, there is some increase of heart rate and blood pressure. with a low
      normal cardiac output. The donor heart remains capable of a satisfactory acute
      response to exercise, based upon an increase of venous return (acting through the
      Frank-Starling mechanism) and slower chronotropic and inotropic responses to
      circulating catecholamines. During submaximal exercise, the stroke volume is
      greater than normal, but the cardiac output is somewhat reduced, leading to a
      widening of arteriovenous oxygen difference. Peak heart rate, peak stroke volume,
      and peak cardiac output are all less than in age-matched normals. Peak power
      output and peak oxygen intake are also subnormal immediately following cardiac
      transplantation. The poor ventricular performance reflects, in part, the
      condition of the transplanted myocardium and, in part, the increased afterloading
      associated with a loss of lean tissue mass. Although there have, as yet, been no
      controlled experiments, there is suggestive evidence that an appropriately graded
      training regimen facilitates restoration of lean tissue and, thus, functional
      recovery (including the correction of postoperative psychological disturbances).
      A suitably adapted exercise prescription is thus recommended as a useful
      component of treatment following cardiac transplantation. There is good evidence
      that a well-designed training program improves the quality of life for the
      recipient, although further study is needed to determine the impact of such
      therapy upon morbidity and mortality.

PMID- 1623891
TI  - Epidemiology, pathomechanics, and prevention of football-induced cervical spinal
      cord trauma.

PMID- 1623892
TI  - Exercise and diabetes mellitus.

PMID- 1623893
TI  - Exercise and the cutaneous circulation.
AB  - Our understanding of the control of the cutaneous circulation has increased over
      the past decade, but is still far from complete. There is a cutaneous
      vasoconstriction at the beginning of exercise that usually effectively competes
      with concurrent thermoregulatory drives for vasodilation. This cutaneous
      vasoconstrictor response, however, requires dynamic activity by a significant
      muscle mass as small muscle groups or isometric exercise are ineffective or
      nearly so. Also, exercise causes the threshold internal temperature relative to
      rest such that SKBF is lower during exercise than in resting conditions for a
      given thermal stimulus. A further influence by exercise on the cutaneous
      circulation is to limit the degree of cutaneous vasodilation when heat stress and
      exercise are combined. These three roles for exercise compete with the
      thermogenic role that promotes vasodilation. The previously described effects act
      through the adrenergic vasoconstrictor system and the separate active vasodilator
      system. The increase in SKBF with heat stress represents the combination of
      withdrawal of vasoconstrictor activity and elevation of active vasodilator
      activity. The vasoconstrictor effect of the initiation of exercise is
      accomplished strictly through enhanced vasoconstrictor activity; vasodilator
      withdrawal does not participate [72]. However, both the exercise-induced
      elevation in thermoregulatory threshold for raising SKBF and the limitation to
      cutaneous vasodilation during exercise are strictly functions of the active
      vasodilator system [69, 73, 78]. In the first case, active vasodilation is
      delayed until a higher (relative to rest) level of internal temperature is
      reached. In the second case, the plateau in SKBF during exercise in the heat is
      due to a similar plateau in active vasodilator activity. Exercise has also served
      as a tool for the study of other influences on the cutaneous circulation. The
      influences of alterations in body fluid volumes, osmolarity, acclimatization,
      hypertension, time of day, menstrual phase, and others on the control of SKBF
      have been assessed by using exercise as a calorigenic source. The question as to
      whether the nonthermoregulatory influences of exercise interact with these other
      influences to give a modification of the pattern of control different from what
      might be observed at rest is largely unanswered. Future directions for research
      are numerous, but several fundamental questions are outstanding. The mechanism of
      active cutaneous vasodilation has been elusive since its discovery and remains an
      exceptionally important question. Second, the sensory elements associated with
      exercise giving rise to the alterations in the pattern of control are unclear.
      This problem is made challenging by the fact that the efferent control by
      exercise differs between its initiation and events later in exercise.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1623894
TI  - Musculoskeletal adaptations and injuries due to overtraining.
AB  - Overtraining places a demand on the musculoskeletal system that may lead to
      damage to the musculoskeletal system, as well as to clinical, functional, and
      biomechanical adaptations that may be detrimental to sport performance. The types
      of injuries identified range from overt, which are obvious injuries that will
      usually prevent athletic performance for some period of time, to the subclinical,
      which decrease performance, but may be seldom recognized. These injuries
      apparently may be avoided or lessened in severity by a combination of several
      methods. A thorough preparticipation evaluation is important to detect subtle
      adaptations in strength and flexibility that can result from overtraining and may
      increase the athlete's chances of injury. A good sport-specific conditioning
      program is necessary to give the athlete a strong musculoskeletal base on which
      to build athletic skills and to decrease the risk of overtraining adaptation. In
      many sports, prehabilitation exercises can be performed for those musculoskeletal
      areas that are under high stress in a particular sport. Also, a maintenance
      conditioning program that extends through the season may be important to maintain
      fitness throughout the season. Following proper principles of conditioning,
      including specificity, recovery, and progression, are important. A complete and
      accurate diagnosis of the injuries that do occur is necessary so that proper
      treatment may follow. This can be facilitated by understanding the types of
      clinical presentations of injuries, and the different anatomical and functional
      alterations that may be acting to cause or to continue the clinical presentation.
      By following these general guidelines, safe participation in sporting activities
      as well as performance will be enhanced. The exact point where "training" becomes
      "overtraining" is difficult to define, especially prospectively. An exciting area
      of sports medicine research will be to define the anatomic parameters and
      exercise doses that will cause overtraining, and to devise fitness examinations
      and training programs that will allow maximal performance with minimal overload
      risk. At the present time, retrospective studies do indicate that adaptations
      occur in muscles, tendons, and bones in response to high training loads, and
      these particular adaptations are not beneficial to performance and may be
      associated with increased injury risk. Since the optimal exercise dose is not
      known, provision for evaluation of these adaptations and prehabilitation of all
      noninjured areas or proper rehabilitation of all injured areas will best prepare
      the musculoskeletal system for training.

PMID- 1623895
TI  - Clinical pharmacology and the provision of drug information.
AB  - Clinical pharmacologists have a service role in the provision of drug information
      to individuals both in hospitals and primary health care. We present here a
      systematic approach in answering questions in a drug information centre (DIC),
      and describe the working method and the documentation of the work in a question
      answer (Q/A) data base. Drugline is a full-text data base offering problem
      oriented drug evaluation comparable to a clinical consultation. The drug
      information is produced in a non-commercial drug information centre sponsored by
      the national health care sector and the National Corporation of Swedish
      Pharmacies, and run jointly by clinical pharmacologists and pharmacists. A minor
      part of Drugline is available in English for online searching, in parallel with
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      Institute Library and Information Centre, and the users represent mainly medical
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      with access to Drugline for searching and the storage of questions and answers.
      This network has the potential for expansion throughout Europe. It offers the
      unique possibility of complementing drug product information with problem
      oriented drug information emerging from cases in the real world of prescribing.

PMID- 1623896
TI  - Terodiline causes polymorphic ventricular tachycardia due to reduced heart rate
      and prolongation of QT interval.
AB  - Recent reports have suggested an association between terodiline hydrochloride and
      cardiac arrhythmias. We report 4 patients presenting over a six month period who
      developed polymorphic ventricular tachycardia (polymorphic VT) while receiving
      treatment with this agent. In each case there was prolongation of QT interval on
      electrocardiogram (ECG). Two patients had hypokalaemia associated with diuretic
      therapy. In the 3 cases in which follow-up ECG was available, QT interval
      returned to normal after discontinuation of terodiline. In order to define the
      effects of terodiline on corrected QT interval (QTc) and heart rate in the
      elderly, a prospective study was performed in 8 elderly in-patients treated with
      terodiline for urinary incontinence. After 7 days treatment with terodiline 12.5
      mg twice daily, there was a significant increase in QT by a mean of 29 ms, QTc by
      15 ms and a decrease in resting heart rate by a mean of 6.7 beats.min-1.
      Terodiline increases QTc and reduces resting heart rate in elderly patients. Both
      these effects may be associated with polymorphic VT, a potentially life
      threatening arrhythmia. This drug should be avoided in patients with other known
      risk factors for polymorphic VT, particularly hypokalaemia and cardiac disease.

PMID- 1623897
TI  - The influence of posture on the response to loop diuretics in patients with
      chronic cardiac failure is reduced by angiotensin converting enzyme inhibition.
AB  - The diuretic and natriuretic response to an intravenous dose of frusemide 40 mg
      was assessed in the erect and supine positions in 10 patients with cardiac
      failure who were being treated with enalapril 10 mg twice daily in addition to
      diuretics (Enalapril group) and in 10 patients with cardiac failure taking
      diuretics alone (Control group). Total 4 h diuresis in the erect position was 728
      ml and in the supine position was 824 ml in the patients taking enalapril
      compared to 655 ml in the erect position and 1166 ml in the supine position in
      those patients taking diuretics alone. Total 4 h natriuresis in the erect
      positions was 78 mmol and in the supine position was 85 mmol in patients taking
      enalapril 10 mg twice daily but in those patients taking diuretics alone total 4
      h natriuresis in the erect position was 67 mmol increasing to 120 mmol in the
      supine position. Measurements of plasma renin activity and plasma angiotensin II
      concentration confirmed effective converting enzyme inhibition, in the group of
      patients taking enalapril, but in those patients taking diuretics alone the erect
      position was associated with an increase in plasma renin activity, and plasma
      concentrations of angiotensin II and aldosterone. We conclude that the renin
      angiotensin system is a major factor in mediating the effect of posture on loop
      diuretic drugs.

PMID- 1623898
TI  - The effect of quinidine on the analgesic effect of codeine.
AB  - We have studied the hypoalgesic effect of codeine (100 mg) after blocking the
      hepatic O-demethylation of codeine to morphine via the sparteine oxygenase
      (CYP2D6) by quinidine (200 mg). The study was performed in 16 extensive
      metabolizers of sparteine, using a double-blind, randomized, four-way, cross-over
      design. The treatments given at 3 h intervals during the four sessions were
      placebo/placebo, quinidine/placebo, placebo/codeine, and quinidine/codeine. We
      measured pinprick pain and pain tolerance thresholds to high energy argon laser
      stimuli before and 1, 2, and 3 h after codeine or placebo. After codeine and
      placebo, the peak plasma concentration of morphine was 6-62 (median 18) nmol.l-1.
      When quinidine pre-treatment was given, no morphine could be detected (less than
      4 nmol.l-1) after codeine. The pin-prick pain thresholds were significantly
      increased after placebo/codeine, but not after quinidine/codeine compared with
      placebo/placebo. Both placebo/codeine and quinidine/codeine increased pain
      tolerance thresholds significantly. Quinidine/codeine and quinidine/placebo did
      not differ significantly for either pin-prick or tolerance pain thresholds. These
      results are compatible with local CYP2D6 mediated formation of morphine in the
      brain, not being blocked by quinidine. Alternatively, a hypoalgesic effect of
      quinidine might have confounded the results.

PMID- 1623899
TI  - Metamizole-furosemide interaction study in healthy volunteers.
AB  - The pharmacokinetic and pharmacodynamic interactions between metamizole
      (dipyrone) and furosemide were investigated in 9 of 12 healthy female subjects
      able to complete the study. They received oral metamizole 3 x 1 g for 3 days or
      placebo (cross-over) and on the last day of both study periods furosemide 20 mg
      IV. On the last two days a balanced sodium diet (120 mEq) and on Day 3 an oral
      water load (600 ml) were given. Metamizole significantly inhibited basal urine
      flow, whereas the fractional excretion of sodium and chloride and the 12 h-GFR
      remained unchanged. Metamizole significantly reduced furosemide clearance (175 vs
      141 ml.min-1), furosemide-stimulated plasma renin activity (1.42 vs 0.79 ng AI.ml
      1.h-1) and the urinary excretion of prostacyclin metabolites and of prostaglandin
      F2 alpha (by 70-81%). The renal clearance and terminal half-life of furosemide,
      peak renal chloride and volume excretion were unchanged. Thus, metamizole did not
      interact with the renal excretion and the diuretic effect of furosemide, although
      prostaglandin synthesis was significantly reduced.

PMID- 1623900
TI  - Effect of dexfenfluramine treatment on body weight, blood pressure and
      noradrenergic activity in obese hypertensive patients.
AB  - The effect of dexfenfluramine (dF) on body weight, blood pressure and
      noradrenergic activity were studied in 30 obese hypertensive patients randomly
      divided into two groups and treated for 3 months either with dF (30 mg daily; 16
      subjects) or placebo (Pl; 14 subjects). 11 patients from the dF group and 9
      patients given Pl completed the entire experimental protocol, including monthly
      visits for metabolic and hormonal measurements, as well as a bicycle exercise
      test with arterial catheterisation for haemodynamic and catecholamine
      measurements performed before and after 3 months of treatment. A progressive
      significant decrease in body weight, averaging 6.0 kg after 3 months was observed
      in the dF-treated group, whereas loss of weight in the placebo group (1.4 kg) was
      not significant. While blood pressure and noradrenergic activity, assessed as
      changes in the plasma levels and urinary excretion of norepinephrine, remained
      unaffected in the Pl group, a significant drop in the supine systolic and
      diastolic blood pressures, as well as in the resting venous norepinephrine level
      and in urinary norepinephrine excretion was found after the first month of dF
      administration. In addition, the exercise-induced rise in systolic and diastolic
      blood pressure, as well as in arterial plasma norepinephrine and epinephrine
      concentrations, was significantly reduced after 3 months of dF administration;
      there were no such changes in the Pl-treated group. The results of the present
      study indicate that, in addition to the weight-reducing effect of
      dexfenfluramine, its hypotensive effect may be mediated by a decrease in
      noradrenergic activity.

PMID- 1623901
TI  - Rectal bioavailability of 6-mercaptopurine in children with acute lymphoblastic
      leukaemia: partial avoidance of "first-pass" metabolism.
AB  - Plasma levels and the area under the plasma concentration-time curve (AUC) values
      of 6-mercaptopurine (6-MP) were determined in a balanced crossover study of oral
      (powder) and rectal (macrogol suppository) administration to 5 children with
      acute lymphoblastic leukaemia (ALL). The AUC (538.6 ng.h.ml-1) after the rectal
      dose of 30 mg/m2 was approximately 1.5-times of that (365.5 ng.h.ml-1) after the
      oral dose of 87.5 mg/m2. The coefficients of variation of interindividual
      variability of the AUCs were 21.5% and 32.3%, respectively. The relative
      bioavailability of the macrogol suppository compared to the powder was
      approximately 4.39. These findings indicate that rectal administration of 6-MP
      could avoid the first-pass effect of this drug in the alimentary canal and/or
      liver, resulting in a large AUC of 6-MP, and so could reduce interindividual
      variability in plasma 6-MP concentrations. Rectal administration of 6-MP may be
      more effective than empirical oral dosing for the treatment of children with ALL,
      especially for patients with nausea and/or vomiting.

PMID- 1623902
TI  - In vitro generation of activated natural killer cells and cytotoxic macrophages
      with lentinan.
AB  - The in vitro effect of lentinan in inducing activation of killer cells and
      cytotoxic macrophages has been examined. Human peripheral blood mononuclear cells
      were cultured with lentinan for 2, 4 and 8 days. After 4 days cytotoxicity was
      increased 4% by lentinan less than 1,000 ng/ml. After 8 days, it was increased
      12% by 25 and 1,000 ng/ml lentinan. The phenotype of the killer cells induced by
      lentinan was CD2+, CD16+ and CD56+, suggesting that they were natural killer
      cells. Macrophages separated from the spleens of 6 patients with gastric cancer
      were cultured with lentinan for 7 days, and their cytotoxicity increased 19%. The
      optimal concentration of lentinan was from 25 to 100 ng/ml. The findings suggest
      that the antitumour effect of lentinan is due to the activation of killer cells
      in vivo, because the optimal concentration of lentinan for the induction of
      killer cells in vitro was equivalent to the plasma concentration obtained after
      clinical doses of this agent.

PMID- 1623903
TI  - The inhibitory effects of a positive inotropic quinolinone derivative, 3,4
      dihydro-6-[4-(3,4-dimethoxybenzoyl)-1-piperazinyl]-2(1H)- quinolinone (OPC-8212),
      on bone-marrow progenitor cells and peripheral lymphocytes.
AB  - 3,4-dihydro-6-[4-(3,4-dimethoxybenzoyl)-1-piperazinyl]-2(1H)-quinolinone (OPC
      8212) is a quinolinone derivative with positive inotropic properties. In order to
      elucidate the effect of OPC-8212 on the haemopoietic system we studied its in
      vitro effect on bone-marrow progenitor cells (granulocyte/monocyte colony-forming
      units [CFU-GM] and erythroid burst-forming units [BFU-E]), on the proliferation
      and secretion of granulocyte/monocyte colony-stimulating factor (GM-CSF) and
      interferon-gamma (IFN-gamma) by peripheral lymphocytes, and on GM-CSF secretion
      by fibroblasts from healthy individuals. The dose-effect relations of OPC-8212 on
      CFU-GM proliferation and on lymphocytic GM-CSF secretion showed no effect at very
      low drug concentrations, with a threshold at the lower end of the therapeutic
      range and highly significant dose-dependent inhibition at concentrations above
      that threshold. BFU-E, peripheral lymphocyte proliferation and lymphocytic IFN
      gamma secretion were depressed, although to a lesser extent, in a linear dose
      dependent fashion. OPC-8212 did not affect GM-CSF secretion by one strain of
      fibroblasts but reduced it at higher concentrations in assays with another strain
      of cells. We conclude that direct toxic effects on bone-marrow progenitor cells,
      in combination with the inhibition of cytokines involved in the regulation of
      haemopoiesis in certain susceptible individuals, may be responsible for
      idiosyncratic reactions to OPC-8212.

PMID- 1623904
TI  - Rebound of plasma vancomycin levels after haemodialysis with highly permeable
      membranes.
AB  - Vancomycin is usually given only once a week to haemodialysis (HD) patients. If
      highly permeable dialysis membranes are used, however, high clearance values have
      been reported, so the aim of the study was to determine whether high clearance of
      vancomycin resulted in sufficient drug elimination to induce subtherapeutic
      plasma levels after one week. In 18 chronic HD patients, treated with polysulfone
      dialyzers (1.2 m2), the pharmacokinetics of vancomycin were studied after
      administration of 1 g. Concentrations were determined by fluorescence
      polarisation immunoassay. At a blood flow of 219 ml.min-1, HD clearance of
      vancomycin was 62.3 ml.min-1. Immediately after dialysis plasma concentrations
      were 38% lower than predialysis levels. However, marked rebound in the vancomycin
      level was observed 5 h later, resulting in plasma levels only 16% lower than
      prior to dialysis. 3 HD treatments in 1 week removed about one third of the
      initial dose. After one week 15 of 18 patients still had a therapeutic plasma
      level (greater than 4 micrograms.ml-1). In conclusion, polysulfone membranes show
      high clearance of vancomycin. However, transfer of drug from blood to dialysate
      appears to be faster than from tissues to blood. Because of a marked rebound in
      plasma level after treatment, therapeutic drug concentrations will still be
      present in most patients after one week.

PMID- 1623905
TI  - Divergent effects of different enzyme-inducing agents on endogenous and exogenous
      testosterone.
AB  - The effects of three different enzyme-inducing drugs (antipyrine 1200 mg,
      phenobarbital 100 mg, rifampicin 600 mg per day for 7 days) on plasma and urinary
      testosterone concentrations, plasma gonadotropin levels, antipyrine kinetics, and
      urinary 6 beta-hydroxycortisol excretion were studied in 18 healthy volunteers.
      Changes in plasma and urinary testosterone concentrations following exogenous
      testosterone undecanoate (TU) were also investigated. Although both antipyrine
      and rifampicin increased antipyrine clearance by about 60%, they produced
      contrary effects on testosterone: antipyrine lowered the total morning plasma
      testosterone and plasma testosterone AUC following TU, while rifampicin led to
      increases of about 20% and 78%, respectively. By contrast, phenobarbital did not
      significantly alter the endogenous and exogenous plasma testosterone
      concentrations, but it increased the urinary excretion of testosterone by more
      than 60%. The other two enzyme inducers did not alter this parameter.
      Gonadotropin levels remained unchanged. The results indicate that different
      enzyme-inducing agents exert divergent effects on endogenous and exogenous
      testosterone concentrations and suggest that the effect of enzyme induction on
      endogenous testosterone depends on the type of microsomal enzyme-inducing drug
      used rather than on the extent of the induction achieved.

PMID- 1623906
TI  - A comparison of the relative sensitivities of factor VII and prothrombin time
      measurements in detecting drug interactions with warfarin.
AB  - We have studied the comparative abilities of the prothrombin time and factor VII
      clotting activity, measured using a chromogenic assay, to detect drug
      interactions with warfarin. Pharmacokinetic and pharmacodynamic data were
      collected from studies involving the single administration of 25 mg of warfarin
      in the absence and presence of fengabin, cimetidine, ranitidine, and enoxacin.
      Fengabin caused changes in both the pharmacokinetics and pharmacodynamics of
      warfarin, whereas cimetidine and enoxacin only caused changes in its
      pharmacokinetics. Ranitidine had no effect on either the pharmacokinetics or
      pharmacodynamics of warfarin. In general, factor VII clotting activity showed
      greater sensitivity but also greater variability than the prothrombin time to
      changes in clotting activity. Consequently, factor VII clotting activity did not
      have greater discriminatory power than the prothrombin time in detecting drug
      interactions involving warfarin.

PMID- 1623907
TI  - Dipyridamole increases human red blood cell deformability.
AB  - An automated filtration technique has been used to investigate the effect of
      dipyridamole (DP) on red blood cell deformability in patients identified as
      having rigid red cells. They were patients on haemodialysis (HD) for chronic
      renal failure (n = 18), patients with peripheral vascular disease (PVD, n = 23)
      and controls (hospital outpatients, n = 33). Leucocytes and platelets were
      removed from heparinised blood by filtration through Imugard wool. Washed red
      cell suspensions in buffer at 5% haematocrit, without or with 5 microM DP, were
      filtered through Nuclepore Hemafil Membranes with 4.7 microns pores. The initial
      steady state relative filtration pressure (iRFP) was used to assess cell
      deformability. A low iRFP value reflects increased deformability and vice versa.
      The mean iRFP values were 0.33, 0.393 and 0.403 for controls, PVD and HD patients
      respectively, indicating that the red cells in the two groups of patients were
      significantly more rigid. DP reduced the iRFP to 0.266, 0.278 and 0.263 for
      controls, PVD and HD patients respectively. The results suggest that DP may be
      beneficial when red cell rigidity contributes to impaired microvascular
      perfusion.

PMID- 1623908
TI  - Pharmacokinetic-pharmacodynamic modeling of the effects of clonidine on pain
      threshold, blood pressure, and salivary flow.
AB  - Although clonidine analgesia appears to be mediated by the same central alpha 2
      adrenoceptors that mediate its hypotensive effect, it is short-lasting when
      compared to the fall in blood pressure. This has been investigated by combined
      pharmacokinetic-pharmacodynamic analysis in 10 healthy volunteers who received
      (double-blind and crossover) clonidine 200 micrograms orally + placebo i.v. and
      clonidine orally + naloxone i.v. (2.8 mg/5 h). Analgesia was assessed by
      measuring the subjective (VAS) and objective (RIII) pain thresholds after
      transcutaneous electrical stimulations of the sural nerve; the mean arterial
      blood pressure (MAP), salivary flow (SF), and plasma clonidine concentrations
      were also monitored. A combined pharmacokinetic (first order absorption - 1
      compartment) - pharmacodynamic (linear) model, including a hypothetical effect
      compartment with and without tolerance, were fitted to the data. Clonidine and
      clonidine + naloxone increased subjective and objective pain thresholds for 4 h.
      The concentration-effect plot for MAP showed distinct hysteresis. The t1/2s for
      effect compartment equilibration were 29 and 42 min for clonidine + naloxone and
      clonidine. The concentration-effect curves for RIII had the same shape as MAP but
      the starting hysteresis suddenly collapsed, suggesting acute tolerance. The best
      fit was obtained with a model where the linear relationship between concentration
      in the effect compartment and analgesia changed acutely after the third hour. The
      short-lived analgesia was probably related to an acute change in pain sensitivity
      induced by food, suggesting that it is not mediated solely by the alpha 2
      adrenoceptors responsible for hypotension.

PMID- 1623909
TI  - The postoperative pharmacokinetics of codeine.
AB  - The metabolism and systemic availability of codeine have been studied in 12
      patients after cholecystectomy. They were given 20 mg codeine as an IV bolus dose
      on the first day after surgery and 50 mg codeine as a single oral on the fourth
      day after surgery. Codeine had a medium to high extraction ratio and a total
      plasma clearance of 10.8 (4.3) ml.min-1.kg-1. The clearance varied four-fold
      between subjects. All the patients were extensive metabolizers with regard to the
      debrisoquine/sparteine polymorphism, as tested using dextromethorphan as the
      probe drug. Nevertheless, the formation of morphine from codeine was very small
      and plasma morphine concentrations were below the detection limit of 3.3 nmol.l-1
      (1 ng.ml-1). As a corollary, the morphine/codeine ratio in the the concentration
      time curves was less than 3% in all the patients. The systemic availability of
      codeine varied extensively between subjects (range 12-84%). This might partly
      explain differences in the dose of codeine required as an analgesic.

PMID- 1623910
TI  - The pharmacokinetics of fluconazole during haemodialysis in uraemic patients.
AB  - We have studied the pharmacokinetics of fluconazole in five patients on long-term
      haemodialysis. The single-pass extraction rate of the dialyzer was 59 (3.5)% (n =
      4), and the serum concentration was reduced by haemodialysis for 3 or 4 h by 26
      (3.2)% (n = 5) and 39 (2.2)% (n = 9) respectively. The estimated amount extracted
      by a dialysis of 4 h was 33 (3.2)% (n = 4) of the dose. During repeated
      administration the serum fluconazole concentration increased, reaching a plateau
      at about 4 times the peak concentration after the first dose. After discontinuing
      administration the serum fluconazole concentration fell by 25% in every 3 h
      dialysis session. We conclude that fluconazole should be given in the usual dose
      of 100 or 200 mg at the end of every haemodialysis session.

PMID- 1623911
TI  - The pharmacokinetics of nifurtimox in chronic renal failure.
AB  - The pharmacokinetics of nifurtimox, a drug used in the treatment of Trypanosoma
      cruzi infections, has been studied in seven patients with chronic renal failure
      undergoing haemodialysis, and in seven healthy subjects. Each subject took
      nifurtimox 15 mg.kg-1 orally and blood samples were obtained for 10 h after
      administration. Nifurtimox in serum was analyzed by HPLC. The patients with
      chronic renal failure had a higher Cmax than the control subjects due to a change
      in systemic availability. An alternative explanation would be that both the
      distribution volume and the clearance had changed. The mean half-life in the
      patients with chronic renal failure was similar to that in the healthy subjects.

PMID- 1623912
TI  - Effect of magnesium hydroxide on the absorption and efficacy of tolbutamide and
      chlorpropamide.
AB  - The effect of magnesium hydroxide on the absorption and efficacy of tolbutamide
      and chlorpropamide was examined in a total of 32 healthy volunteers in two
      separate, randomized parallel-group studies, with 16 subjects in each study.
      After an overnight fast, the first group of 8 volunteers ingested 500 mg
      tolbutamide or 250 mg chlorpropamide with 150 ml water, and the second group the
      same doses of the active drugs with 150 ml water containing 850 mg magnesium
      hydroxide. Magnesium hydroxide increased the area under the plasma tolbutamide
      concentration-time curve (AUC) from 0 to 1 h and from 0 to 2 h by 5-fold and 2.5
      fold, respectively. The peak plasma concentration, peak time and total AUC were
      not significantly altered. The incremental insulin area and the decremental
      glucose area from 0 to 1.5 h were significantly larger in the magnesium hydroxide
      group than in the controls. The maximum insulin response to tolbutamide was
      increased fourfold by coadministration of magnesium hydroxide, and it occurred
      about 1 h earlier than in the control group. In addition, the maximum fall in
      plasma glucose concentration was attained about 1 h earlier in the antacid group.
      A tendency to an increased rate of chlorpropamide absorption was observed after
      magnesium hydroxide, but it did not appear to affect the insulin and glucose
      responses to chlorpropamide. It is concluded that magnesium hydroxide increased
      the early bioavailability of tolbutamide, resulting in enhanced insulin and
      glucose responses. A tendency toward accelerated chlorpropamide absorption by
      magnesium hydroxide was also observed, but the efficacy of chlorpropamide was
      unaffected.

PMID- 1623913
TI  - Inhibition of cyclooxygenase attenuates baroreceptor function and increases the
      pressor response to norepinephrine in man.
AB  - The possible influence of prostaglandins on baroreceptor function in man has been
      investigated. Baroreceptor reflex was activated by intravenous infusion of
      norepinephrine and the pressor response was measured, both before and after
      administration of indomethacin. Resting blood pressure remained unchanged after
      indomethacin while resting heart rate was significantly decreased as compared to
      placebo and the norepinephrine-induced rise in mean arterial blood pressure was
      significantly more pronounced. The baroreceptor-mediated decrease in heart rate
      tended to be smaller. Baroreceptor sensitivity (delta heart rate/delta blood
      pressure) was significantly reduced by indomethacin to about half of the control
      value. In addition to attenuation of sensitivity, the findings represent
      resetting of the baroreceptor setpoint and a more pronounced pressor response to
      norepinephrine after cyclooxygenase inhibition. Thus, eicosanoids originating via
      the cyclooxygenase pathway of arachidonate metabolism may modulate the vascular
      response to adrenergic stimulation and may participate in the regulation of
      baroreceptor reflex setpoint and sensitivity.

PMID- 1623914
TI  - Endoscopic evaluation of the effect of ketoprofen, ibuprofen and aspirin on the
      gastroduodenal mucosa.
AB  - Endoscopic lesions of the gastric mucosa were evaluated in 12 healthy volunteers
      after administration of single doses of ketoprofen (25 mg), ibuprofen (200 mg)
      and aspirin (500 mg) in a randomized, double-blind, cross-over study. The grades
      of the lesions (according to Lanza's scale) were lower after the administration
      of ketoprofen than aspirin and were comparable to ibuprofen. An endoscopic score
      greater than 1 was observed in 3 cases after ibuprofen or ketoprofen, and in 8
      cases after aspirin. At a time when low, single doses of NSAIDs are widely used
      as analgesics, gastroscopy makes it possible directly to assess the local
      aggressivity of these molecules. In this way it was possible to demonstrate that
      the local toxicity of NSAIDs was lower than that of aspirin.

PMID- 1623915
TI  - Pharmacokinetics of diphemanil methylsulphate in healthy subjects.
AB  - The pharmacokinetic parameters of oral diphemanil methylsulphate have been
      evaluated in six healthy male volunteers. Absorption of the drug was slow (tmax =
      2 to 4 h), the mean half-life was 8.35 h, and the amount of the drug recovered in
      urine within 48 h ranged from 0.6 to 7.4% of the administered dose. The results
      suggest low bioavailability, assuming that the drug is poorly metabolized.

PMID- 1623916
TI  - Dose proportionality study of loperamide following oral administration of
      loperamide oxide.
AB  - The pharmacokinetics of loperamide, after oral administration of increasing doses
      (1 to 16 mg) of loperamide oxide, has been investigated in 10 healthy male
      volunteers, using a randomised cross-over design. Comparison of the maximum
      plasma loperamide concentration and AUC demonstrated that the bioavailability of
      loperamide was proportional to the dose of loperamide oxide administered.

PMID- 1623917
TI  - Secretion of the antidiarrhoeal agent loperamide oxide in breast milk.

PMID- 1623918
TI  - Anti-arthritic effects demonstrated by an interleukin-2 receptor-targeted
      cytotoxin (DAB486IL-2) in rat adjuvant arthritis.
AB  - DAB486IL-2 is an interleukin-2 receptor-specific cytotoxin which selectively
      targets and kills cells which bear the high-affinity form of the IL-2 receptor.
      Since elimination of activated T lymphocytes may be useful in the treatment of
      rheumatoid arthritis, the effect of DAB486IL-2 treatment in an animal model of
      arthritis was investigated. We demonstrated that rats treated with DAB486IL-2
      during the induction phase of disease have delayed onset of symptoms and
      significantly reduced severity of inflammation as well as a depressed
      proliferative response to mycobacterial stimulation in vitro. In addition, the
      presence of preexisting antibodies to the molecule had no impact on the anti
      arthritic effects observed in this model. These data suggest that DAB486IL-2 may
      have therapeutic potential in the treatment of rheumatoid arthritis.

PMID- 1623919
TI  - A V region-connected autoreactive subfraction of normal human serum
      immunoglobulin G.
AB  - Mouse and human natural IgM autoantibodies have been shown to be polyreactive and
      "connected" through V region-dependent interactions. In the present study, we
      have identified a connected subfraction of normal human serum IgG by using
      affinity chromatography of F(ab')2 fragments of pooled IgG (IVIg) or of IgG from
      a single donor on Sepharose-bound F(ab')2 fragments of the same source of IgG.
      The connected fraction of IgG exhibited a high content of autoantibodies directed
      against a wide panel of evolutionarily conserved self antigens and of self
      antigens that may be targets of autoantibodies in autoimmune diseases. Connected
      IgG also contained higher amounts of antibodies directed against commonly
      encountered microbial antigens than unfractionated IgG. The connected fraction
      did not, however, differ from unchromatographed IgG nor from non-connected IgG in
      its content of antibodies to vaccinal antigens and to distant foreign antigens.
      Thus, in humans as in mice, connectivity is a prominent feature of
      autoantibodies. Our observations are suggestive of a tight control by IgG of the
      expressed autoreactive repertoire in healthy individuals and strengthen the
      concept that the therapeutic infusion of pooled normal IgG (IVIg) may be
      effective in autoimmune diseases by bringing to patients normal regulatory
      components of the immunoglobulin network.

PMID- 1623920
TI  - Analysis of immunoglobulin variable region genes from human IgG anti-DNA
      hybridomas.
AB  - The molecular mechanisms leading to anti-double-stranded (ds) DNA antibody
      production in systemic lupus erythematosus (SLE) are poorly understood. We
      describe here the immunoglobulin variable region genes of six human hybridomas
      secreting IgG anti-dsDNA antibodies derived from three SLE patients. The
      monoclonal IgG anti-dsDNA antibodies have been shown to be of high affinity and
      no multireactivity was observed (Winkler et al., Clin. Exp. Immunol., 1991. 85:
      379). The comparison of the variable region genes expressed in the hybridomas
      with known germ-line genes as well as with the germ-line counterparts from one
      patient shows that the VH and VL sequences are somatically mutated. The pattern
      and extent of the observed somatic mutations are suggestive for an antigen-driven
      selection of at least four of these B cell clones. Several VH and VL genes used
      by the hybridomas were found to be expressed in the natural antibody repertoire,
      in the restricted fetal repertoire and in B cell malignancies expressing the CD5
      antigen.

PMID- 1623921
TI  - Interleukin-4-mediated tumor suppression in nude mice involves interferon-gamma.
AB  - The molecular events during the anti-tumor response induced by interleukin (IL)-4
      were investigated by quantitative polymerase chain reaction. The growth of
      Chinese hamster ovary cells transfected to produce IL-4 (CHO.T1) was strongly
      suppressed when cells were injected intraperitoneally into nude mice and this
      suppression was accompanied by the rapid accumulation of activated macrophages.
      Peritoneal cells from such mice were analyzed for mRNA induced by IL-4.
      Correlating with a high local IL-4 concentration, several transcripts were found
      to be up-regulated during the early phase of the anti-tumor response [IL-4
      receptor, IL-5, tumor necrosis factor (TNF) and interferon (IFN)-gamma]. The
      functional relevance of the elevated mRNA levels was analyzed by injection of
      CHO.T1 cells together with anti-cytokine monoclonal antibodies (mAb). In contrast
      to anti-IL-5 and anti-TNF mAb, an anti-IFN-gamma mAb interfered with the anti
      tumor response demonstrating the involvement of IFN-gamma during the IL-4-induced
      tumor suppression. Tumor growth in anti-IFN-gamma mAb-treated animals was
      significantly delayed in comparison to anti-IL-4 mAb-treated mice, suggesting
      that IFN-gamma-independent effector cells may also be involved.

PMID- 1623922
TI  - Human peripheral blood leukocytes transplanted on CB17 scid-scid mice are
      transferred to their offspring.
AB  - Severe combined immunodeficient (scid) mice are deficient in functional T cells
      and B cells. Hence, scid mice reconstituted with human peripheral blood
      leukocytes (scid-huPBL) provide an excellent model for analysis of the human
      immune response under in vivo conditions. We have investigated this model further
      by analyzing human immune responses in the progeny of scid-huPBL (termed scid
      humo). We find markedly elevated levels of human immunoglobulins (Ig) in the
      serum of scid-humo for more than 12 weeks indicating materno-fetal transfer of
      human B lymphocytes. Consistent with this finding we obtained evidence for the
      existence of human lymphocytes in scid-humo. Murine Ig levels in scid-humo were
      also elevated and surface Ig-expressing cells (probably B cells) were
      demonstrable. In this respect scid-humo resembled "leaky" scid. In contrast to
      "leaky" scid, scid-humo accepted transfer of human blood leukocytes. Not only
      leukocytes from autologous but also those from heterologous donors were accepted.
      Human Ig levels in scid-humo increased more rapidly as compared to normal scid
      mice. Thus, despite these increased B cell activities in scid-humo, transferred
      human leukocytes were not affected indicating that materno-fetal transfer of
      human cells had caused tolerization or conditioning. This is in contrast to scid
      mice in which elevated Ig levels correlate with increased failure rates of
      reconstitution with human blood leukocytes. We propose that scid-humo provide an
      improved model for studying the human immune responses in an in vivo setting.

PMID- 1623923
TI  - An anti-B cell autoantibody from Wiskott-Aldrich syndrome which recognizes i
      blood group specificity on normal human B cells.
AB  - We previously identified IgM autoantibodies in the sera of patients with Wiskott
      Aldrich syndrome (WAS) that react with a subset of normal human B lymphocytes and
      induce B cell differentiation in vitro. From splenocytes of a patient with WAS we
      generated heterohybridomas (HY18 and HY21) and a lymphoblastoid cell line (LWA10)
      that produce human IgM lambda or IgM kappa anti-B lymphocyte autoantibodies,
      respectively. Immunohistochemical and multiparameter flow cytometric analyses
      demonstrate that these autoantibodies are specific for lymphocytes of the B
      lineage and preferentially stain B cells that reside in the mantle zone of
      secondary follicles and that constitutively co-express the CD5 surface antigen
      and most major autoantibody-associated cross-reactive idiotypes; in addition,
      these antibodies stain most pre-B cells in adult bone marrow. Molecular studies
      show that these anti-B lymphocyte autoantibodies are encoded by a highly
      conserved VH4 gene, designated VH4.21. The gene encodes a number of
      autoantibodies, especially anti-i and anti-I IgM cold agglutinins.
      Hemagglutination and surface labeling studies reveal that HY18 and LWA10
      recognize the "i" carbohydrate antigenic determinant(s) which is classically
      found on human cord red blood cells and, as shown now by this study, on a
      subpopulation of human B cells which expresses it early in B cell development.
      These studies raise the possibility that the gene product encoded by this highly
      conserved germ-line VH4 gene may play a physiological role in B cell development
      and/or differentiation.

PMID- 1623924
TI  - Specificity, T cell receptor diversity and activation requirements of CD4+ and
      CD8+ clones derived from human melanoma-infiltrating lymphocytes.
AB  - To try to understand the functional significance of human melanoma-infiltrating
      lymphocytes (TIL), a clonal analysis of the specificity, T cell receptor (TcR)
      diversity and activation requirements of these lymphocytes isolated from four
      different tumors was carried out. Supporting the presence of in vivo primed tumor
      specific T lymphocytes in these four tumors, a high frequency of the Cd8+ and
      CD4+ clones, obtained from the TIL cultured for a few days with recombinant
      interleukin (rIL)-2 and autologous tumor cells, exhibited a restricted lysis or
      proliferation in response to the autologous tumor cell line. In contrast, no
      tumor-specific clone was obtained from freshly extracted TIL, suggesting that the
      frequency of tumor-specific effectors remained low in these tumors. Only the CD8+
      clones lysed the autologous tumor cells and their activity was major
      histocompatibility complex MHC class I restricted. Significant expansion of CD4+
      and CD8+ tumor-specific clones required regular restimulation by autologous
      melanoma cells but also the addition of exogenous IL-2 and of Epstein-Barr virus
      transformed B feeder cells. Five different tumor-specific clones, three CD8+ and
      two CD4+ clones were identified in a single tumor on the basis of their TcR gene
      configuration. Together, these data suggest that a spontaneous and diverse immune
      response, mediated by tumor-specific CD4+ as well as CD8+ T lymphocytes, arises
      in most MHC-bearing human melanomas but that antigen-MHC complex presentation by
      tumor cells does not, at least in vitro, allow a significant proliferation of
      these lymphocytes.

PMID- 1623925
TI  - Immunosuppression by lymphocytic choriomeningitis virus infection: competent
      effector T and B cells but impaired antigen presentation.
AB  - Lymphocytic choriomeningitis virus (LCMV) may cause a severe immunosuppression in
      mice. Its pathogenesis is apparently dependent on LCMV-specific CD8 effector T
      cells that mediate the destruction of virus-infected cells which are normally
      essentially involved in immune responses. Evaluation of various LCMV isolates in
      this study established a general correlation between their tropism for
      lymphohemopoietic cells and immunosuppression. When immune responses were
      assessed as the capacity of mice to mount an anti-vaccinia virus cytotoxic T cell
      response or an IgG response to vesicular stomatitis virus (VSV), after a primary
      LCMV infection, LCMV-Armstrong, WE, Clone 13 and Docile were increasingly
      immunosuppressive in a dose-dependent fashion with respect to both extent and
      duration. Analysis of lymphocyte subpopulations showed variable effects of the
      various LCMV isolates that did not reveal patterns readily explaining
      immunosuppression. To evaluate whether LCMV infection affected T and/or B cell
      functions directly or whether antigen presentation was impaired, adoptive
      transfer experiments were performed. Untreated or irradiated but uninfected
      normal recipient mice receiving adoptively transferred T or B cells from LCMV-WE
      or Docile-infected immunosuppressed donor mice responded within 30%-100% of
      normal ranges in both assay systems. In contrast, when T or B cells from normal
      donors were transferred to irradiated or non-irradiated LCMV-immunosuppressed
      recipients, they failed to mount a significant cytotoxic T cell response against
      vaccinia virus or an IgG response to VSV. Thus, the T and B cells from LCMV
      immunosuppressed mice were able to function within normal ranges; in contrast,
      histologically and functionally, antigen presentation was severely impaired in
      LCMV-immunosuppressed mice.

PMID- 1623926
TI  - The murine IgG1/IgE class switch program.
AB  - Immunoglobulin class switching is controlled by cytokines. Thus, interleukin-4
      (IL-4) directs class switching to both IgG1 and IgE. Consistent with this are the
      results reported here on restriction endonuclease analysis of active and inactive
      alleles of the IgH locus in IgE-producing cells. In cells that were stimulated in
      vitro by lipopolysaccharide and IL-4 the silent alleles preferentially switched
      to gamma 1, whereas in cells that were stimulated by antigen in vivo both active
      and inactive alleles switched to epsilon. Thirty percent of the recombined switch
      regions (S mu/S epsilon) contain S gamma 1 sequences, which we interpret as
      footprints of a previous switch to gamma 1. Since this percentage is a minimum
      estimate, between 30% and 100% of switching to epsilon must occur sequentially
      via gamma 1.

PMID- 1623927
TI  - Electroporation of exogenous antigen into the cytosol for antigen processing and
      class I major histocompatibility complex (MHC) presentation: weak base amines and
      hypothermia (18 degrees C) inhibit the class I MHC processing pathway.
AB  - While endogenous antigens are presented by class I major histocompatibility
      complex (MHC) molecules, exogenous antigens generally require a means for
      penetration into the cytosol for processing prior to class I MHC presentation. We
      have optimized conditions for electroporation as a means to experimentally
      introduce exogenous antigens into the cytosol, providing a system with a number
      of advantages for dissecting the class I MHC processing pathway. Presentation was
      assessed by the response of class I or class II MHC-restricted T hybridoma cells.
      Essentially instantaneous antigen delivery by electroporation facilitated kinetic
      analysis of the class I pathway and investigation of the effects of various
      inhibitors or hypothermic conditions on class I MHC antigen processing. This
      pathway was inhibited by weak base amines (e.g. chloroquine and NH4Cl),
      cycloheximide, and hypothermia (18 degrees C, which inhibits certain
      intracellular vesicular processing pathways). The electroporation technique
      provides a simple, consistent approach for rapid cytosolic antigen delivery for
      analysis of class I MHC processing.

PMID- 1623928
TI  - Regulation of interleukin-2 responses by phosphatidic acid.
AB  - Interleukin-2 (IL-2) plays a central role in the immune system by regulating the
      proliferation and differentiation of T lymphocytes. However, the molecular
      mechanism of the signal transduction through the IL-2 receptor is poorly
      understood. We have studied the role of phosphatidic acid (PA) on IL-2 signal
      transduction using cloned T lymphocytes. IL-2 stimulated a transient increase in
      the PA concentration in resting CTLL-2 cells prelabeled with [3H]palmitic acid.
      This effect was detected as early as 1 min after IL-2 addition and peaked at 5
      min. IL-2 similarly increased phospholipase D activity in intact CTLL-2 cells, as
      inferred by phosphatidylethanol production. By contrast, IL-2 did not affect
      [3H]palmitic acid-labeled diacylglycerol levels. Furthermore, exogenous addition
      of several natural or synthetic PA to T cells mimicked IL-2 activity. Thus, PA
      were able to induce DNA synthesis on CTLL-2 cells, although this effect was only
      10%-20% of that observed with IL-2. PA showed a synergistic effect with low doses
      of IL-2. In addition, PA was able to induce c-myc RNA transcription in CTLL-2
      cells as well as IL-2 receptor (CD25) expression on the cell membrane with equal
      potency as saturating doses of IL-2. It is likely that IL-2-induced PA
      accumulation is a consequence of phospholipase D activation. This hypothesis is
      further supported by the fact that the addition of exogenous phospholipase D but
      not phosphatidylinositol-specific phospholipase C also reproduced the IL-2 or PA
      effects mentioned above. In summary, our results suggest a role of phospholipase
      D activation and PA formation as second messengers of IL-2 activity.

PMID- 1623929
TI  - The use of a non-depleting anti-CD4 monoclonal antibody to re-establish tolerance
      to beta cells in NOD mice.
AB  - The use of immunosuppressive drugs in the management of autoimmunity penalizes a
      large part of the immune system for the misdemeanors of a small minority of T
      cells. An ideal form of therapy would be one in which it were possible to render
      the immune system tolerant of the inciting antigens with minimal effects on other
      responses. We here show that it is possible to re-establish self tolerance in an
      animal model of insulin-dependent diabetes mellitus without prior deletion of
      CD4+ T cells using a short course of therapy with a non-lytic monoclonal antibody
      to the CD4 adhesion receptor on T cells. This tolerance can be achieved even when
      diabetogenic cells are already in the pancreas. Primary responses to antigens
      given after therapy has ceased are normal and secondary responses to antigens
      seen prior to, but not during, the period of antibody therapy can remain
      unaffected. This suggests that intervention with selected CD4 antibodies may have
      significant advantages over and above that provided not only by conventional
      immunosuppression but also over that provided by a depleting antibody.

PMID- 1623930
TI  - Eosinophil as antigen-presenting cell: activation of T cell clones and T cell
      hybridoma by eosinophils after antigen processing.
AB  - We have studied the role of murine eosinophils as antigen-presenting cells (APC).
      Eosinophils have several characteristics that support the hypothesis of its
      function as potential APC: they have phagocytic capacity, express adhesion
      molecules and major histocompatibility complex (MHC) class II antigens and can
      produce and release interleukin-1 (IL-1). We have obtained several T cell clones
      specific for Mesocestoides corti antigens and used T cell hybridoma specific for
      ovalbumin (OVA) to test this hypothesis. Granulocyte-macrophage colony
      stimulating factor-activated pure eosinophils (99.9%), express class II antigens
      and are able to present M. corti antigens to specific T cell clones or OVA to T
      cell hybridoma 3DO 11.10, inducing the proliferation of T cell clones and IL-2
      release by the T cell hybridoma. Proliferation of T cells clones is dependent on
      the number of eosinophils used as APC. We have compared the efficiency of the
      same number of macrophages and eosinophils as APC, and have found that
      macrophages are more efficient than eosinophils. Lysosomotropic agents, such as
      chloroquine and ammonium chloride, that inhibit antigen processing, impaired
      eosinophil presentation. This presentation is restricted by MHC class II and
      inhibited by anti-I-Ad monoclonal antibody. The present study provides clear
      evidence of APC function for eosinophils. Our investigation points to a new role
      for eosinophils in the immune response.

PMID- 1623931
TI  - Low-molecular weight B cell growth factor (BCGF-12KD) as an autocrine growth
      factor in B cell chronic lymphocytic leukemia.
AB  - The role of cytokines in the growth and spreading of human hematologic
      malignancies has been underlined in recent years. Here we report evidence that a
      human 12-kDa B cell growth factor (BCGF-12KD) may function as a growth
      stimulatory factor in B cell chronic lymphocytic leukemia (B-CLL). First,
      recombinant BCGF-12KD induced dose-dependent DNA synthesis in neoplastic B cells
      of four B-CLL patients tested. Second, seven different B-CLL clones secreted a
      BCGF-12KD-like product that accounted for their proliferation. A neutralizing
      monoclonal antibody (mAb; Ac8) directed against a BCGF-12KD synthetic peptide
      inhibited the spontaneous growth of the leukemic B cells. The same mAb blocked
      DNA synthesis in normal tonsillar B lymphocytes induced by the culture
      supernatant of spontaneously proliferating B-CLL cells. Finally, BCGF-12KD mRNA
      was expressed in freshly isolated (two of three patients) as well as in vitro
      proliferating B-CLL cells (three of three patients). These findings strongly
      suggest that BCGF-12KD can modulate the growth of B-CLL cells in vivo as well as
      in vitro. They may offer significant insights into the biology of this frequent B
      lymphoproliferative disorder.

PMID- 1623933
TI  - Complexes of IgG molecules and C3a and C4a complement components in human serum.
AB  - A heterogeneous group of proteins was separated from human serum IgG using 5 M
      guanidine hydrochloride solution in 0.1 M acetic acid. The protein mixture was
      fractionated by reverse-phase high-performance liquid chromatography and two
      proteins were isolated and identified as the C3a and C4a complement components
      (anaphylatoxins) according to their molecular masses and N-terminal sequences.
      Using a chemical cross-linking technique, the capacity of C3a and C4a to
      reassociate with the heavy and the light chains of IgG was shown. On the basis of
      the molecular masses of reconstituted complexes one molecule of C3a (or C4a) was
      bound to one heavy or one light chain of IgG.

PMID- 1623932
TI  - In vivo responses of CD4+ and CD8+ cells to bacterial superantigens.
AB  - Staphylococcal enterotoxin B (SEB) is a bacterial superantigen that binds to
      major histocompatibility complex (MHC) class II molecules and specifically
      activates T cells bearing V beta 8 T cell receptor domains. We have compared
      several aspects of the response of CD4+ and CD8+ T cell subsets to SEB in vivo. V
      beta 8+ cells in both subsets proliferated to a similar extent upon SEB
      injection. Furthermore, mRNA for interferon-gamma was induced in both subsets
      with similar kinetics and SEB dose-response. Finally CD8+ (but not CD4+) T cells
      from SEB-injected mice exhibited SEB-specific lysis of MHC class II-bearing
      target cells. Collectively, these data indicate that the CD4: MHC class II
      interaction confers no detectable selective advantage to CD4+ cells in the in
      vivo response to SEB. The observed effector functions of both subsets may
      contribute to SEB-induced immunopathology.

PMID- 1623934
TI  - Synthesis of retinoic acid from retinol by cultured rabbit Muller cells.
AB  - Previous observations have shown that Muller glial cells of the vertebrate retina
      contain cellular retinoid-binding proteins, that the retina contains retinoic
      acid, and that cellular retinoic acid-binding protein is present in amacrine
      neurons (and, in some species, Muller cells) within the retina. These findings
      led to the suggestion that Muller cells may synthesize retinoic acid and release
      it for use by other retinal cells. To test this possibility, we cultured Muller
      cells from adult rabbit retinas, incubated the cultures with radioactive retinol,
      and identified and quantified the resultant radioactive retinoids by HPLC.
      Retinaldehyde was rapidly synthesized from retinol, reaching a plateau of 1-2
      pmol mg-1 cell protein by 30 min. Retinoic acid initially accumulated more
      slowly, but by 30 min constituted most of the synthesized retinoid. While the
      retinaldehyde remained within the cells, retinoic acid was rapidly released into
      the medium; extracellular retinoic acid exceeded the intracellular amount after
      30 min of incubation. Smaller amounts of retinyl esters were also synthesized and
      retained by the cells. These results are consistent with the suggestion that
      Muller glia are a source of retinoic acid in the retina. The synthesis of
      retinoic acid by these cells, and the presence of retinal neurons that contain
      cellular retinoic acid-binding protein, raise the possibility that retinoic acid
      plays a role in the retina, although this role is not presently known.
      Furthermore, these results may have implications for other parts of the adult
      nervous system. Adult brain contains retinol- and retinoic acid-binding proteins,
      and, therefore, may also be a site of retinoic acid metabolism. Because of the
      relatively simple cellular organization of the retina and its demonstrated
      capacity to synthesize retinoic acid, the retina may be a system of choice for
      further studies of the synthesis and function of retinoic acid in adult neural
      tissue.

PMID- 1623935
TI  - Calbindin D-28k and parvalbumin immunohistochemistry in developing rat retina.
AB  - The developmental profiles of two calcium-binding proteins, calbindin-D28k (CaBP)
      and parvalbumin (PV), were investigated immunohistochemically in the developing
      rat retina. CaBP-immunoreactivity appeared first on embryonic day 17 in the
      horizontal, amacrine and ganglion cells; on embryonic day 21 in the inner
      plexiform layer; and on post-natal day 6 in the outer plexiform layer. The
      reaction intensity had increased to its maximum level by post-natal day 10. PV
      immunoreactivity was first noted on embryonic day 19 in the amacrine and ganglion
      cells and reached its maximum on post-natal day 10. Two distinct subpopulations
      of amacrine cells were clearly recognized after post-natal day 6; one was
      positive for CaBP and the other for PV. Some morphological differences were noted
      between the two.

PMID- 1623936
TI  - Polypeptide profiles of normal and inflamed rabbit aqueous humor: identification
      of catabolic products of immunoglobulin G in the normal eye.
AB  - The anterior segment of the eye is isolated from the bloodstream by anatomic
      barriers. These barriers break down during inflammation elicited by muramyl
      dipeptide (MDP), a component of the cell walls of bacteria. The protein
      composition of normal aqueous humor and inflamed aqueous were characterized using
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and
      immunoblotting. The presence of transferrin, albumin, IgG and IgM were
      demonstrated in normal and inflamed aqueous. Normal aqueous additionally
      contained seven polypeptides (35, 31, 29, 25, 22, 21 and 19 kDa, respectively)
      that were not observed in inflamed aqueous. Four of these peptides (31, 29, 25
      and 19 kDa) were identified as fragments of IgG heavy chains based on their
      reactivity with anti-IgG antibodies and staphylococcal protein A. Immunoglobulin
      catabolism has been noted to occur in tissues diffusely throughout the body; this
      is the first report of it occurring in the eye. This phenomenon appears to be
      circumvented on breakdown of the blood-aqueous barrier. These observations may
      relate to the immunoprivilege of the eye and its modulation in inflammation.

PMID- 1623937
TI  - Prevention of cataract in diabetic rats by aspirin, paracetamol (acetaminophen)
      and ibuprofen.
AB  - Evidence from epidemiological, in vitro and animal studies has accumulated to
      support the idea that aspirin, ibuprofen and paracetamol protect against
      cataract. In this study rats made diabetic with streptozotocin were given these
      drugs in their drinking solution for up to 160 days. All three drugs delayed
      cataract formation assessed by slit-lamp examination for a large part of this
      time. Blood glucose levels were a little lower in diabetic rats treated with
      aspirin and ibuprofen than in untreated diabetic rats although all groups
      remained diabetic. Similarly, the increased glycation (non-enzymic glycosylation)
      of lens proteins caused by diabetes was less in the diabetic rats treated with
      aspirin and ibuprofen. The fall in glutathione induced by diabetes was also
      alleviated by aspirin and ibuprofen. Paracetamol appeared to afford similar
      protection against the biochemical changes but its effect was not statistically
      significant. The decrease in glutathione and increase in glycation were related
      to the progression of lens opacification. The greatest loss of glutathione
      occurred at an early stage, whereas glycation had its greatest change at the
      later stages--nuclear and mature cataract. These results encourage the view that
      ibuprofen, aspirin and paracetamol could protect against cataract in man: a
      hypothesis that could be tested in a properly-conducted clinical trial.

PMID- 1623938
TI  - Effect of EGF on the corneal wound healing of alloxan diabetic mice.
AB  - We identified the local treatment effect of epidermal growth factor on corneal
      wound healing of alloxan diabetic mice. The corneal wounds were induced by 0.5 M
      NaOH solution on the corneal surfaces of the diabetic and non-diabetic groups.
      The local epidermal growth factor solution (100 ng ml-1) was dropped in 5
      microliters aliquots into the eye twice a day. The corneal wounds were measured
      daily for 15 days and examined histologically at the end of 15th day of
      experimental period. The results indicated that topical epidermal growth factor
      treatment of diabetic and non-diabetic mice greatly improved the incidence of
      healing of wounded corneas.

PMID- 1623939
TI  - Does the lens serve as a 'sink' for iron during ocular inflammation?
AB  - Twenty-four hours after induction of ocular inflammation by intravitreal
      injection of endotoxin (10 ng), the intraocular fluid (IOF, aqueous and vitreous
      humors) concentration of iron (Fe) increased. This was presumably due to entry of
      the plasma Fe-binding protein, transferrin, into the IOFs through disrupted blood
      ocular barriers. After 1 day of inflammation the Fe concentration in lenses from
      the inflamed eye was 60% greater than that measured in contralateral control
      lenses. By day 15, lens Fe concentration had returned to levels of the
      contralateral control lenses. There was a distinct relationship between the dose
      of endotoxin used and the amount of Fe accumulated by the lens. The Fe
      concentration in lenses from eyes injected with 100 ng endotoxin was 0.376 +/-
      0.027 micrograms g-1 wet weight compared to 0.214 +/- 0.014 micrograms g-1 in
      lenses from eyes injected with 0.25 ng endotoxin. In a previous study, copper
      (Cu) concentration in the IOFs was elevated to the same extent as Fe in response
      to intravitreal injection of endotoxin. However, in the present study, lenticular
      Cu concentration was unaltered at the highest (100 ng) dose of endotoxin. Since
      the increase in lens uptake was selective for Fe, there may be a specific Fe
      uptake mechanism in this ocular tissue. The physiological reasons for and
      possible pathological consequences of such a process are discussed.

PMID- 1623940
TI  - Contractile cells in the human scleral spur.
AB  - The scleral spur in 37 human (age 17-87 years) and six cynomolgus monkey eyes (2
      4 years) was investigated. Serial meridional and tangential sections were studied
      with ultrastructural and immunocytochemical methods. The bundles of the ciliary
      muscle do not enter the scleral spur, but their tendons, which consist of elastic
      fibres join the elastic fibres in the scleral spur. Within the scleral spur a
      population of circularly oriented and spindle-shaped cells is found. In contrast
      to the ciliary muscle cells, the scleral spur cells form no bundles, but are
      loosely aggregated. They have long cytoplasmic processes and are connected to
      each other by adherens-type and gap junctions. They stain intensely for alpha
      smooth muscle actin, myosin and vimentin. In contrast to the ciliary muscle
      cells, they do not stain for desmin. Ultrastructurally, the scleral spur cells
      contain abundant thin (actin) filaments, but do not otherwise show the typical
      ultrastructural features of ciliary muscle cells. The scleral spur cells do not
      express a complete basal lamina. They form individual tendinous connections with
      the elastic fibres in the scleral spur, which are continuous with the elastic
      fibres of the trabecular meshwork. The scleral spur cells are in close contact
      with nerve terminals containing small agranular (30-60 nm) and large granular (65
      110 nm) vesicles but also with terminals containing small granular (30-60 nm)
      vesicles which are regarded as typical for adrenergic terminals. We conclude that
      the scleral spur cells are contractile myofibroblasts. Their contraction might
      influence the rate of the aqueous outflow.

PMID- 1623941
TI  - Temporally correlated expression of nAChR genes during development of the
      mammalian retina.
AB  - In situ hybridizations and RNase protection assays have been used to characterize
      nicotinic acetylcholine receptor (nAChR) gene expression in the developing and
      adult rat retina. At the earliest time examined (embryonic day 13) a low level of
      alpha-3 and beta-4 gene expression could be detected. During the next 48 hr there
      was a dramatic induction of the alpha-3, alpha-4, beta-2, beta-3 and beta-4 genes
      in the recently differentiated retinal ganglion cells. By post-natal day 4 we
      detected nAChR gene expression in the inner nuclear layer. In the adult retina,
      in situ hybridizations showed these genes are expressed by cells residing in the
      ganglion and inner nuclear layers. These results suggest a common regulatory
      mechanism for the induction of nAChR expression in retinal ganglion cells during
      development. In addition, the variety of nAChR genes expressed in the retina
      imply a relatively large number of different types of nAChRs can be expressed by
      these cells.

PMID- 1623942
TI  - The effect of urea on the aggregate state and elastase inhibitor activity of the
      water-insoluble fraction from bovine and human lens.
AB  - Preparations of alpha-crystallin from bovine and human lens exhibited elastase
      inhibitor activity with a specific activity of 100-250 U mg-1 protein. A washed
      water-insoluble fraction from bovine, human and cataractous lens nuclei, when
      solubilized by sonication, gave specific activities of 910, 950 and 1270 U mg-1,
      respectively. Disaggregation of these water-insoluble fractions in 8.0 M urea,
      with subsequent reaggregation by urea removal, resulted in a decrease in
      inhibitor activity. Agarose A-5m gel filtration chromatography after the urea
      treatment resolved a residual high molecular weight (HMW) fraction and a peak
      which eluted at the position of water soluble alpha-crystallin. Assays showed
      that the urea-induced 'alpha-crystallin' peaks from all three preparations had
      specific activities, equivalent to native alpha-crystallin, whereas the HMW
      fractions retained their original high specific activity. We conclude that the
      increased elastase inhibitor activity of the water-insoluble fraction is a
      property of the aggregate state of the component alpha-crystallin molecules,
      which is lost upon reaggregation to an 800-kDa alpha-crystallin. Amino acid
      analysis of the bovine water-insoluble fraction suggested a content of 85-90%
      alpha-crystallin and 10-15% beta H-crystallin, which was confirmed by SDS
      PAGE.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623943
TI  - Dexamethasone ameliorates retinal photic injury in albino rats.
AB  - The effect of dexamethasone in two regimens on retinal photic injury was studied
      in Lewis albino rats that were exposed to 24 hr of continuous green fluorescent
      light. Under regimen 1, dexamethasone was given at a daily dosage of 1 mg kg-1
      for 8 days, starting 6 days before light exposure. Under regimen 2, dexamethasone
      was given at the same daily dosage for 3 days, started 1 day before light
      exposure. Pathologic study of the light-exposed retina, morphometric evaluation
      of the photoreceptor cell loss, cell counts of the macrophages in the subretinal
      space, and measurements of rhodopsin levels were undertaken in the dexamethasone
      treated and control retinas at various times. The administration of dexamethasone
      in both regimens did not produce pathologic changes in the retina before light
      exposure, but rhodopsin levels were significantly lowered in both treated groups
      when compared to corresponding vehicle treated control animals. Under regimen 1,
      at 6 hr after light exposure, both the treated and the control groups showed
      comparable loss of photoreceptor cells, degeneration of the photoreceptor
      elements and retinal pigment epithelium, but a significantly lowered level of
      rhodopsin in the treated group was noted. At 6 days after exposure, the outer
      nuclear layer thickness, and the outer and inner segments showed significant
      preservation in the treated group. Also in the treated group, the number of
      macrophages was significantly reduced and the retinal pigment epithelial (RPE)
      vacuolation was markedly less. However, there was no difference in rhodopsin
      levels. At 14 days after exposure, the outer nuclear layer thickness and
      rhodopsin levels of the treated rats had significantly higher values than the
      controls. Under regimen 2, however, at 6 days after exposure, an ameliorative
      effect in the RPE was observed but there were no differences of rhodopsin levels,
      the outer nuclear thickness and number of macrophages between the treated and
      control groups. Regimen 1 was associated with a significantly higher retinal
      level of dexamethasone when compared with regimen 2. The ameliorative effect of
      dexamethasone on rat retinal photic injury may be through inhibition of lipid
      peroxidation, in which a high retinal level of the steroid is required.

PMID- 1623945
TI  - Flavin levels in the rat retina.
AB  - Exposure of riboflavin and its coenzymes adenine dinucleotide (FAD) and
      riboflavin-5'-phosphate (FMN) to UV and visible light results in the generation
      of radicals and photodegradative products that can damage surrounding
      macromolecules. Vertebrates and invertebrates have lost the ability to synthesize
      riboflavin and must obtain it or its coenzymes from food. The present study
      evaluated the relationship between FAD, FMN, and riboflavin concentrations in
      retina and blood of male Sprague-Dawley rats. Rations were provided in the form
      of purified diets containing 0, 3, 6, 30, and 300 mg riboflavin kg-1 diet.
      Analysis of flavins by HPLC showed that saturation levels of FAD, FMN and
      riboflavin in the retina and blood were achieved with diets containing 3 mg
      riboflavin kg-1. Retinal flavins were not significantly elevated by further
      increases in dietary riboflavin concentration, but an unidentified flavin
      appeared in the blood of rats given rations containing concentrations above 3 mg
      kg-1. The concentration of this unknown flavin varied in proportion to the level
      of dietary riboflavin.

PMID- 1623944
TI  - Modulation of macrophage colony stimulating factor in cultured human retinal
      pigment epithelial cells.
AB  - Steady-state mRNA expression and protein production of macrophage colony
      stimulating factor were measured in visually confluent monolayers of unstimulated
      cultured human retinal pigment epithelial cells and after cells were stimulated
      with recombinant cytokines. Using reverse transcription polymerase chain
      reaction, macrophage colony stimulating factor mRNA expression was detected in
      unstimulated cells obtained from each of four separate donors. In these cells,
      mRNA expression was accompanied by secretion of macrophage colony stimulating
      factor protein into cell-conditioned medium; 48 hr after cells were switched to
      fresh medium, the mean (+/- S.D.) quantity of macrophage colony stimulating
      factor, measured by enzyme-linked immunoassay, was 5.1 +/- 2.3 ng 10(-6) cells.
      There was a dose- and time-dependent induction of macrophage colony stimulating
      factor mRNA after cells were exposed to recombinant human interleukin-1 and tumor
      necrosis factor alpha. Maximal mRNA induction was observed in cells exposed for 4
      hr to interleukin-1 beta (5 U ml-1) or for 4-8 hr to tumor necrosis factor alpha;
      under these conditions, macrophage colony stimulating factor mRNA was induced up
      to 23- and 46-fold after exposure to interleukin-1 beta and tumor necrosis factor
      alpha, respectively. Similarly, macrophage colony stimulating factor protein
      production was enhanced after cells were exposed to recombinant cytokines.
      Protein secretion increased 1.3-2.5-fold (P less than 0.001) after exposure to
      interleukin-1 beta (5 U ml-1), and 1.2-1.6-fold after exposure to tumor necrosis
      factor alpha (P less than 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623946
TI  - Progressive modifications of mouse lens crystallins in cataracts induced by
      buthionine sulfoximine.
AB  - L-buthionine-S,R-sulfoximine (BSO), a specific inhibitor of GSH biosynthesis, was
      administered four times daily to mouse pups on post-natal days 7 and 8, inducing
      initiation of opacification on day 9. The initial progression of the cataract
      (less than 24 hr) was divided into four stages: (1) developing floriform; (2)
      mature floriform; (3) degenerate floriform; and (4) amorphous translucent
      cataract. Following this, dense corticonuclear opacities developed within several
      days. Two-dimensional gel electrophoresis of water-soluble whole lens extracts
      indicated that the most rapid early cataractous changes, occurring mainly during
      stage 2, were loss of the two major components of the heavy beta-crystallin
      fraction, a 31-kDa basic polypeptide and an acidic component at 27 kDa,
      concomitant with the appearance of new species at 30 and 25 kDa. This was
      followed by more extensive modification of both alpha and beta-crystallins during
      stages 3 and 4 and the appearance of abnormal species at 26, 19 and 18 kDa, which
      were slightly more acidic than the major normal alpha A-crystallin polypeptide.
      The gamma-crystallin components, relatively unaffected at stage 4, were then lost
      rapidly as dense opacities ensued. By contrast with the water-soluble fraction,
      the normal day 9 urea-soluble fraction was deficient in gamma-crystallin
      polypeptides and enriched in anodic components whose relative electrophoretic
      mobilities were similar to those reported previously for phosphorylated bovine
      alpha A-crystallin and several cytoskeletal polypeptides. At stage 4 of the
      cataract, the modifications of normal alpha and beta-crystallin components in the
      urea-soluble fraction paralleled those in the water-soluble fraction, but the
      products seen were more numerous. In addition, the cytoskeletal proteins were no
      longer detectable. Substantial increases in lens Ca2+ that precede all of the
      above changes in lens polypeptide composition suggest that Ca(2+)-activated
      proteolysis may play a major role in development of BSO cataracts.

PMID- 1623947
TI  - Lens GSH depletion and electrolyte changes preceding cataracts induced by
      buthionine sulfoximine in suckling mice.
AB  - Cataracts were induced in suckling mice by multiple injections of L-buthionine
      S,R-sulfoximine (BSO), a specific inhibitor of GSH biosynthesis, starting on post
      natal day 7. The earliest visible lens aberrations began approximately 2 days
      after t(o), following 99% depletion of lens GSH. Cataract development then
      proceeded through four stages within less than 24 hr. Elevated Na+ and Ca+ and
      decreased K+ were first detected in pre-cataractous (stage 0) lenses. During
      stage 0, lens Na+ and K+ levels displayed a significant inverse correlation; by
      contrast, Ca2+ levels were poorly correlated with those of Na+. The initial
      increase in Na+ exceeded the decrease in K+. This suggested the presence of
      osmotic stress prior to cataract stage 1 (developing floriform). Increased lens
      hydration was first apparent in stage 1, coincident with a marked elevation of
      Ca2+, further increase in Na+ and decrease in K+. These trends persisted in the
      stage 2 cataract (completed floriform). Subsequent changes in lens hydration and
      cation content during cataract stages 3 (degenerate floriform) and 4 (amorphous
      translucent) suggested substantial influx of extracellular fluid into the
      affected lenses. The BSO cataract may represent a useful in vivo model to study
      the functions of GSH in maintaining normal lens cation balance and transparency.

PMID- 1623948
TI  - Mutant zeta-crystallin from guinea-pig hereditary cataracts has altered
      structural and enzymatic properties.

PMID- 1623949
TI  - A device for quantitative measurement of the opacity of small animal lenses:
      application to Xenopus laevis.

PMID- 1623950
TI  - Retinal degeneration in the pcd/pcd mutant mouse: accumulation of spherules in
      the interphotoreceptor space.
AB  - The Purkinje cell degeneration (pcd) mutant mouse rapidly loses cerebellar
      Purkinje cells and about 50% of its retinal photoreceptor cells at between 3 and
      5 weeks of age, and thereafter slowly loses the remaining photoreceptor cells
      during the first year of life. An ultrastructural study of the developing
      photoreceptor cells of the pcd/pcd retina was undertaken using both transmission
      and scanning electron microscopy to characterize further the previously reported
      retinal vesicles associated with this mutation. Transmission electron microscopy
      (TEM) revealed an abundance of 'bead-like' vesicles or excrescences in the
      extracellular matrix surrounding the inner segment region at post-natal day (P)
      25. The vesicles are membrane bound, amorphous in appearance and vary in size
      from 125 to 370 nm. Scanning electron microscopy suggests that the vesicles seen
      with TEM are actually spherules formed from outpocketing and pinching off of the
      plasma membrane in the mitochondria-rich region of the rod inner segment. At P25,
      the spherules are concentrated in the interphotoreceptor space at the level of
      rod inner segments; at P40, however, they are displaced from their origin and
      appear mostly at the level of rod outer segments and in the subretinal space.

PMID- 1623951
TI  - Early expression and localization of rhodopsin and interphotoreceptor retinoid
      binding protein (IRBP) in the developing fetal bovine retina.
AB  - Differentiation and maturation of the photoreceptor outer segments are key steps
      in the development of the visual system. Morphological studies presented here
      show that the cow and human are nearly identical in the timing of outer segment
      appearance during fetal development, implying that the bovine retina is a good
      model system for the final stages of human photoreceptor development. To study
      photoreceptor maturation, rhodopsin and interphotoreceptor retinoid-binding
      protein (IRBP) were quantified by ELISA in a developmentally staged series of
      fetal bovine retinas. In addition, their localization within these retinas was
      determined by immunogold electron microscopy. Rhodopsin, as detected by
      antibodies directed against either the N- or C-terminal portions of the molecule,
      is first found at about 5.5 months gestation. It is first detected on the plasma
      membrane of the immature cilia and on the earliest emergent outer segment
      membrane, even before organized disk membranes are apparent. In contrast, whereas
      rhodopsin levels and outer segments are nearly undetectable before 5 months
      gestation, IRBP accumulates to a significant level (4-5% of the adult) as early
      as 3 months gestation. Immunogold electron microscopy confirmed this finding,
      with localization of IRBP predominantly in the subretinal space.

PMID- 1623952
TI  - Structural alterations in retinal tissues from rats deficient in vitamin E and
      selenium and treated with hyperbaric oxygen.
AB  - Vitamin E and selenium play key roles in preventing in vitro lipid peroxidation
      and free radical damage to retinal tissues. In this research, we studied the
      effects of hyperbaric oxygen on retinal structure in rats fed diets deficient in
      vitamin E and/or selenium. We also correlated any alterations in retinal
      structure with previously measured alterations in electroretinograms (ERGs). Age
      matched rats were fed a basal diet deficient in both vitamin E and selenium (B
      diet), a basal diet supplemented with vitamin E alone (B+E diet), or selenium
      alone (B+Se diet), or with both micronutrients (B+E+Se). Half the rats in each
      group were treated (+HBO) with hyperbaric oxygen (100% O2 at 3 ATA for 1.5 per hr
      day, 5 days per week) and half were not (-HBO). We previously found that the rats
      fed the B diet for 6 weeks and treated with HBO for 4 weeks (B+HBO group) had
      diminished a-wave ERG amplitudes. At this time point all rats in the B group and
      half of the rats in the B+E+Se group were killed for the structural studies
      reported here. Surprisingly, we found no evidence of photoreceptor cell necrosis
      [i.e. a decreased thickness of the outer nuclear layer (ONL)] in retinas from
      rats in the B+HBO group despite the diminished amplitude of the a-wave which
      arises from this retinal layer. Quantitative structural analyses of retinas from
      rats in the B+HBO, B-HBO, B+E+Se-HBO and B+E+Se+HBO groups also failed to reveal
      any significant differences in the cell height of the retinal pigmented
      epithelium (nasal, central or temporal regions) or the number of mitochondria,
      phagosomas or inclusion bodies in the central retinal pigment epithelium (RPE).
      The inner nuclear layer (INL) thickness was, however, consistently decreased in
      all retinal regions for the rats in the B+HBO group. Our previous work also
      showed that only rats fed the B+Se diet for 17 weeks and treated with HBO for 15
      weeks (B+Se+HBO group) showed diminished a-wave and b-wave ERG amplitudes. At
      this time point rats in the B+E+Se, B+E, and B+Se groups were killed for
      structural studies reported here. Only rats in the B+Se+HBO group showed a
      significantly decreased (about 20%) thickness of the central ONL. This evidence
      of photoreceptor cell necrosis correlated very well with our previous observation
      of diminished a- and b-wave amplitudes only in the B+Se+HBO group (at week
      17).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1623953
TI  - Effects of light and darkness on pH outside rod photoreceptors in the cat retina.
AB  - We recorded pH in the extracellular space surrounding rod photoreceptors in the
      dark-adapted eye of the cat and during illumination with double-barreled H(+)
      selective microelectrodes. A pH of 7.17 was recorded in the vitreous at the
      retinal surface of the dark-adapted eye and this became more alkaline during
      light adaptation. In dark adaptation, a pH close to 7.00 was recorded in a region
      of maximal acidity in the extracellular space surrounding rods in the outer
      nuclear layer (ONL). pH steeply alkalinized as the microelectrode was moved more
      distally towards the retinal pigment epithelium (RPE), and almost reached the pH
      of the arterial blood at the apical surface of the RPE. Illumination produced an
      intraretinal alkalinization that was largest (up to 0.2 pH units) in the ONL,
      maximal in amplitude at rod-saturating intensities, and that was sustained during
      steady background illumination. The light-evoked alkalinization was relatively
      slow in onset, having a time constant (1/e) of 64 sec, and took 8-12.5 min to
      return to the dark-adapted level after the offset of maintained illumination.
      These results show that acid production by cat rods is highest in the dark,
      reflecting a high rate of energy metabolism, and suggest that glycolysis is
      required to support the dark current. Illumination, by suppressing both
      glycolysis and respiration, alkalinizes the extracellular space surrounding rods.
      The substantial change in pH outside rods from dark to light could alter pH
      dependent properties of the interphotoreceptor matrix.

PMID- 1623954
TI  - Effects of systemic hypoxia on pH outside rod photoreceptors in the cat retina.
AB  - We studied the effect of systemic hypoxia on intraretinal pH in the intact cat
      eye using double-barreled H(+)-sensitive microelectrodes. Hypoxia in the dark
      further acidified the extracellular space surrounding rods in the distal retina
      and this effect was maximal in the outer nuclear layer (ONL). An acidification
      occurred in response to essentially any decrease in PaO2 below the normoxic
      level. Light-evoked alkalinizations in the ONL were larger in amplitude during
      hypoxia than in normoxia and this difference increased with the severity of
      hypoxia. Background illumination suppressed the hypoxic acidification of the ONL,
      completely inhibiting it at rod saturating intensities, at levels of hypoxia down
      to PaO2s of 40 mmHg. Systemic hyperoxia produced a small alkalinization in the
      ONL, and a reduction in the amplitude of the light-evoked alkalinizations. This
      suggests that systemic hyperoxia can partially suppress the ongoing glycolysis of
      dark-adapted rods. Changes in blood flow during hypoxia also altered intraretinal
      pH. Hypoxia led to an alkalinization in the choroid in both dark and light
      adaptation that spread into the distal retina. This alkalinization is most likely
      caused by the increase in CO2 removal that occurs as systemic blood pressure, and
      as a consequence, choriocapillaris blood flow increase during hypoxia. The
      alkalinization attenuated the acidification that was observed outside rods during
      hypoxia. There was also an alkalinization of the proximal portion of the retina,
      which spread into the vitreous. This alkalinization was attributed to the
      autoregulatory increase in blood flow that occurs in the retinal vessels during
      hypoxia. These findings provide further evidence for the hypothesis that the
      energy metabolism of dark-adapted rods is exquisitely sensitive to systemic
      hypoxia so that any small decrease in PaO2 increases rod glycolysis. Rod
      saturating illumination can completely suppress this increase in glycolysis for
      all but severe hypoxia. An increase in blood flow in the choriocapillaris during
      hypoxia appears to mitigate the effects of hypoxia on the distal retina.

PMID- 1623955
TI  - Effects of intravenous acetazolamide on retinal pH in the cat.
AB  - Double-barreled H(+)-selective microelectrodes were used to study the effect on
      intravenous acetazolamide on intraretinal pH in the cat. Acetazolamide (11.4-27.8
      mg kg-1 intravenously) caused a rapid acidification of the subretinal space. This
      change in pH originated in the most distal portion of the subretinal space and
      could not be attributed to a change in pH or PCO2 of the arterial blood. Slow
      light-evoked alkalinizations in distal retina, attributable to a decrease in rod
      photoreceptor energy metabolism, were relatively unaltered by acetazolamide. This
      result indicated that acetazolamide had not crossed the blood-retinal barrier in
      sufficient amounts to change this response. In time, following intravenous
      perfusion of acetazolamide, continuous depth profiles of intraretinal pH showed
      an acidification of the entire retina and the vitreous also became more acidic.
      These results indicate that the rapid or primary effect of acetazolamide is an
      acidification of the distal portion of the subretinal space, which is thought to
      originate in a change in the transport of H+ or HCO3- by the retinal pigment
      epithelium. This is followed by an acidification of the entire retina and
      vitreous, presumably due to diffusion of acid from the distal retina, although
      there could be additional causes.

PMID- 1623956
TI  - Spectroscopic studies on the interaction of calf lens membranes with crystallins.
AB  - The interaction of crystallins with lens membranes and liposomes was studied by
      fluorescence and circular dichroism (CD) measurements. Two extrinsic fluorescence
      probes ANS (1-anilino-naphthalene-8-sulfonic acid) and DPH (1,6-diphenyl, 1,3,5
      hexatriene) were used to detect the binding and to explore the binding site. The
      ANS fluorescence intensity is greater in membranes than in liposomes, but is
      reverse for DPH. Among alpha, beta and gamma-crystallins, only alpha c-crystallin
      decreased the ANS fluorescence intensity in membranes, indicating a binding
      between membranes and alpha c-crystallin. The binding site appears to be at the
      polar-apolar interface in membrane protein (MIP26) and alpha c-crystallin.
      Fluorescence polarization measurements show that lipid bilayer becomes less
      mobile with alpha c-crystallin binding. The change in the near UV CD due to the
      binding also indicates a decreased freedom of rotation of aromatic amino acid
      residues either in MIP26 or in alpha-crystallin.

PMID- 1623957
TI  - Fatty acid composition of phospholipids from chick neural retina during
      development.
AB  - The fatty acid composition of retina phospholipids from developing chicks was
      investigated to determine what changes, if any, occur in the relative levels of
      polyunsaturated fatty acids. Embryonic chicks were killed at 3-day intervals from
      day 6 through hatching (day 21), and at 1 week post-hatch. Fatty acids were
      prepared from retina phospholipids and were analysed by capillary gas-liquid
      chromatography. A comparison of the composition of yolk taken on day 6 with
      retinas isolated on that day revealed a much greater proportion of
      polyunsaturated fatty acids in the latter, suggesting an ability of the embryo to
      metabolize selectively unsaturated fatty acids at this early stage of
      development. Throughout the time course studied, saturated fatty acids
      constituted 50% of all fatty acids, most of which was due to palmitic acid (16:0;
      33-41%). Among other saturated fatty acids, myristic acid (14:0) increased to
      maximal levels by day 18, then declined, while stearic acid (18:0) was minimal on
      day 12 and then increased. Polyunsaturated fatty acids varied between 14 and 23%
      of total fatty acids, depending on the developmental stage. One of the most
      remarkable changes in polyunsaturated fatty acids occurred in the levels of 22:4
      (n-6). The proportion of this single fatty acid decreased from 9.4 to 2.4%
      between days 15 and 18. Relative levels of 22:5 (n-6) increased significantly
      between day 21 and 1 week post-hatch, from 1.1 to 3.2%. In this same time period,
      the proportion of 22:6 (n-3), the fatty acid known to be prominent in the outer
      segments of rod-dominant retinas, did not change.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1623958
TI  - Pressures in the anterior ciliary arteries, choroidal veins and choriocapillaris.
AB  - A micropuncture technique was used to measure the pressure in the anterior
      ciliary arteries of monkeys as well as the pressures in the choroidal veins and
      in the choriocapillaris of rabbits. Monkeys were used to measure the pressure in
      one of the anterior ciliary arteries at three different points, First at a
      scleral 'well', and then at 2 and 5 mm from the same 'well'. It was found that
      the pressures recorded increased proportionally to the distance from the scleral
      'well'. Afterwards the intraocular pressure (IOP) was increased stepwise and the
      arterial pressure was measured at each increment (from spontaneous IOP to 50
      cmH2O). When compared, it was found that an increase in IOP was not followed by a
      statistically increased anterior ciliary artery pressure. The pressure in the
      choroidal veins and the choriocapillaris was measured in rabbits through a
      scleral window positioned between the two superior veins at about 4 mm from the
      nearest. The pressure recorded in the choroidal vein was found to be 3.3 +/- 0.4
      cmH2O higher than the spontaneous IOP (20.3 +/- 1.6). However, when the IOP was
      increased stepwise it was found that this difference diminished as the value for
      the IOP neared the arterial pressure. Thus, the pressure gradient for flow from
      the intermediate-seized choroidal veins to the intraocular origin of the vortex
      veins is only a few cmH2O under normal conditions and is reduced at very high
      intraocular pressures at which the blood flow is markedly reduced or
      stopped.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623959
TI  - Phospholipid composition of myeloid bodies from chick retinal pigment epithelium.
AB  - The phospholipid composition of a myeloid body (MB) enriched subcellular fraction
      of chick retinal pigment epithelium (RPE) was determined in order to further
      characterize the origin and functional significance of these lamellar membrane
      organelles. The major MB phospholipids found were phosphatidylcholine and
      phosphatidylethanolamine which represented 43% and 34% of the total MB lipids
      respectively. Sphingomyelin and phosphatidylinositol comprised the remaining
      detectable phospholipids. The fatty acyl chain composition of all detected
      phospholipids showed that the long-chain polyunsaturated fatty acids [arachidonic
      (20:4 n-6), docosapentaenoic (22:5 n-3) and docosahexaenoic (22:6 n-3)] account
      for greater than 45% of the fatty acids in MB membranes. This high proportion of
      long-chain polyunsaturated fatty acids in MBs is particularly striking when
      compared to the long-chain fatty acid composition of the photoreceptor outer
      segments from this predominantly cone retina which contains less than 25% long
      chain polyunsaturated fatty acids. The results from this study clearly
      demonstrate that MB lipids represent a significantly enriched pool of long-chain
      polyunsaturated fatty acids.

PMID- 1623960
TI  - Improving the safety of topically applied timolol in the pigmented rabbit through
      manipulation of formulation composition.
AB  - The objective of this study was to compare the efficiency of various formulations
      in maximizing the ratio of ocular to systemic absorption of topically applied
      timolol in the pigmented rabbit. Formulations of various pHs, tonicities, and
      concentrations of benzalkonium chloride, EDTA, poly(vinyl alcohol),
      poly(vinylpyrrolidone), hydroxypropylcellulose, and Na hyaluronate were tested.
      Ocular absorption was determined by monitoring the timolol concentration in
      various anterior segment tissues 30 min after instillation of timolol solution,
      while systemic absorption was determined by monitoring the time course of timolol
      concentration over 120 min. Timolol was assayed by reversed-phase HPLC. Lowering
      the solution tonicity to 80 mosmol kg-1 and incorporating polymers into the
      formulation were the only approaches that promised to improve the safety of
      topically applied timolol, since they afforded the desired increase in ocular
      absorption and reduction in systemic absorption. Lowering the solution pH to 6.4
      and increasing the tonicity of the solution to 600 mosmol kg-1 reduced systemic
      absorption but caused either no change or a decrease in ocular absorption.
      Raising the solution pH to 8.4 and incorporating 0.025% benzalkonium chloride and
      0.5% EDTA into the formulation led to an undesirable increase in systemic
      absorption although ocular absorption was also increased. In the final analysis,
      the net effect of formulation changes on the ratio of ocular to systemic
      absorption depended on the interplay of changes in solution drainage;
      permeability of the cornea, conjunctiva, and nasal mucosa; and fraction of drug
      in the preferentially absorbed form.

PMID- 1623961
TI  - Ageing and changes in protein conformation in the human lens: a Raman
      microspectroscopic study.
AB  - Using confocal Raman microspectroscopy with laser light of 660 nm the secondary
      and tertiary conformation of crystallins was studied in human lenses of varying
      age (20-75 years). Differences in cortical and nuclear proteins in individual
      lenses and among lenses of different age and differences between small equatorial
      opacities and adjacent clear sites were analysed using a difference spectrum
      approach. Intensity calibration allows assessment of local variations in protein
      content. The main findings and conclusions are as follows. (1) Irrespective of
      the age of the lens nuclear proteins proved to contain more aromatic amino acids,
      i.e. tryptophan, tyrosine and phenylalanine. This change most probably reflects
      differences in crystallin composition between nucleus and cortex as described in
      biochemical studies. (2) Changes in the amide bands indicate a more pronounced
      beta-sheet conformation of the nuclear proteins. Taking into account available
      biochemical evidence this most probably reflects a true post-translational change
      in the secondary conformation of the crystallins. (3) Cortical proteins in 'old'
      and 'young' lenses are largely identical indicating that ageing is not
      accompanied by gross alterations in the transcription/translation of the
      crystallin genes. (4) 'Old' and 'young' nuclear proteins deviate with respect to
      the amount of aromatic amino acids, being more abundant in 'young' nuclear
      proteins. (5) Proteins in small early opacities do not exhibit alterations in
      conformation. (6) A pronounced peak in the difference spectra in the region 1425
      1435 cm-1 for nuclear proteins especially when compared with equatorial cortical
      proteins may be considered as evidence for the advanced photooxidation of
      tryptophan and/or deamidation of asparagine from superficial to deep regions of
      the lens.

PMID- 1623962
TI  - Temporal and regional production of 12(S)hydroxyeicosatetraenoic acid [12(S)
      HETE] in rat lens.
AB  - Enzymatic production of 12(S)-hydroxyeicosatetraenoic acid [12(S)-HETE] from
      exogenous arachidonic acid (AA) was studied in the 9000 g supernatant fraction of
      either whole rat lens or the capsule-epithelium and cortex-nucleus regions with
      age (4-180 days). Whole rat lens 12(S)-HETE synthetic capacity measured either by
      RIA or HPLC was significantly decreased with lens growth. 12(S)-HETE production
      was highest in the 4-day-old rat lens, the earliest time point measured, and
      declined to background levels by 6 months of age. Regional studies demonstrated
      that the capsule-epithelium possessed a higher specific activity in comparison to
      the cortex-nucleus. However, lipoxygenase activity decreased significantly faster
      in the capsule-epithelium compared to the cortex-nucleus. The bulk of the 12
      lipoxygenase activity was located in the cortex-nucleus due to the higher amount
      of tissue in the region. The elevated lipoxygenase activity in the neonate and
      its rapid decline with growth suggests that the enzyme may contribute in
      transforming the epithelial cells to fiber cells.

PMID- 1623963
TI  - Characterization and application of an in vitro detection system for studying the
      binding and phagocytosis of rod outer segments by retinal pigment epithelial
      cells.
AB  - Direct and indirect radioactivity and fluorescent assays have been developed to
      study the interaction of rod outer segments (ROS) with retinal pigment epithelial
      (RPE) cells. In the direct assays ROS labelled with 125I or fluorescein
      isothiocyanate (FITC) have been used to measure total phagocytosis, i.e. surface
      binding and ingestion. In the indirect assays RPE cells were first treated with
      unlabelled ROS or biotinylated ROS and subsequently probed with [125I]Rho 4D2
      antirhodopsin antibody or [125I]streptavidin for radioactivity measurements or
      with the Rho 4D2 antibody and FITC-goat anti-mouse Ig or FITC-streptavidin for
      fluorescent counting. In these indirect methods the number of surface bound ROS
      were distinguished from the number of ingested ROS by comparative labelling of
      non-permeabilized and permeabilized ROS-treated RPE cells. Using these assays, we
      have studied the binding and ingestion of bovine ROS with cultured bovine RPE
      cells. As in the case of newborn cultured rat RPE cells [Hall and Abrams (1987)
      Exp. Eye Res. 45, 907-22], binding and ingestion of bovine ROS by bovine RPE
      cells was saturable with respect to ROS concentration and time. At 37 degrees C
      ROS binding reached a saturating concentration at 1 x 10(7) ROS per well; the
      number of bovine ROS ingested by bovine RPE cells, however, was less than the
      number of rat ROS ingested by rat RPE cells. When 1 x 10(7) ROS per well was
      used, maximal surface binding of bovine ROS to bovine RPE cells was obtained
      after 2-3 hr, whereas after an initial delay, ingestion rapidly increased to a
      maximum at 1-2 hr.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623964
TI  - Temporal regulation of six crystallin transcripts during mouse lens development.
AB  - Using the polymerase chain reaction (PCR) and RNA blot analysis, we have examined
      the differential expression patterns of the gamma-crystallins during lens
      development. Since only four of these genes had been previously characterized,
      the cDNAs for the remaining two genes, gamma C and gamma F, were isolated and
      sequenced. The steady-state mRNA profiles were then determined by RNA blot
      analysis of samples from embryonic stages to 180 days after birth, with gene
      specific probes for gamma A, gamma B, gamma C, and gamma D, and a common probe
      for gamma E and gamma F. Due to the paucity of mismatches between the gamma E and
      gamma F-crystallin genes, the PCR technique was exploited to determine their
      relative abundance. The data showed that while all six gamma-crystallin genes
      were expressed in the embryonic lens, they were differentially regulated during
      development. At early stages, the levels of gamma B and gamma C mRNAs were found
      to be relatively low in comparison to those for gamma A, gamma D, gamma E and
      gamma F. After 30-40 days, however, the levels of gamma A, gamma E, and gamma F
      mRNAs declined rapidly, and the gamma B, gamma C and gamma D transcripts became
      the major gamma-crystallin mRNA species. The utility of the PCR technique in
      studying the relative abundance of steady-state gamma-crystallin mRNAs was also
      investigated.

PMID- 1623965
TI  - Regional variations in electrolytes related to resistivity during bovine lens
      maturation.
AB  - Little is known regarding the behavior of ions in protein-rich cytoplasm
      characteristic of lens fiber cells. Resistivity is dependent upon the electrolyte
      concentration available to conduct an applied current and the mobility of these
      electrolytes. In the present study, the relative importance of these factors in
      the increasing cortico-nuclear resistivity gradient reported for both calf and
      bovine lens homogenates was analysed. Relative ion mobility for regions of the
      lens was determined by the calculation of the ratio of resistivity of lens
      homogenates to resistivity of aqueous solutions of freely mobile KCl at the same
      molarity. The increasing resistivity ratios in the calf cortex, transition zone
      and nucleus suggest an increasingly impaired ion mobility from the outer to the
      inner lens regions.

PMID- 1623966
TI  - The second human beta B2-crystallin gene is a pseudogene.
AB  - Comparison of the partial sequences of the human beta B2-1- and beta B2-2
      crystallin genes with orthologous rat or calf sequences shows that the fourth
      exon sequence of the human beta B2-2 gene contains a one triplet deletion and a
      mutated splice acceptor site. No transcripts from the beta B2-2-crystallin gene
      could be detected in the human lens. These data suggest that the human beta B2-2
      crystallin gene is a pseudogene.

PMID- 1623967
TI  - A reassessment of protein synthesis by lens nuclear fiber cells.

PMID- 1623968
TI  - The effect of 12(R)-hydroxyeicosatetraenoic acid on aqueous humor dynamics in the
      rabbit and cynomolgus monkey.

PMID- 1623969
TI  - Phospholipid distribution among bovine rod outer segment plasma membrane and disk
      membranes.

PMID- 1623970
TI  - Rapid PCR-based construction of specifically enriched libraries from small retina
      samples.

PMID- 1623971
TI  - Frontal units of the monkey coding the associative significance of visual and
      auditory stimuli.
AB  - Two monkeys were trained on both visual and auditory association tasks. Single
      unit activity of the frontal (prefrontal and post-arcuate premotor) cortex was
      recorded in these monkeys to investigate the convergence of visual and auditory
      inputs and to examine whether the frontal units are involved in coding the
      meaning (associative significance) of the stimulus, independent of its modality.
      A total of 289 units showed changes in firing rate after the cue presentation on
      the visual and/or auditory tasks and were examined on both modalities of tasks,
      175 of them showing differential activity in relation to either the associative
      significance and/or physical properties of the visual and/or auditory cues. Of
      the 289 units, 136 (47.0%) were responsive only to the visual cue (76 of them
      showing cue-related differential activity), 13 units (4.5%) only to the auditory
      cue (6 of them showing cue-related differential activity) and the remaining 140
      units (48.5%) to both modalities of cues (18 of them showing visual, 7 of them
      showing auditory and 68 showing both modalities of cue-related differential
      activity). Fifty of the 68 bimodal differential units showed changes in firing in
      relation to the associative significance of both modalities of cues independent
      of the cue's physical properties, and are considered to be involved in the
      crossmodal coding of the associative significance of the stimulus. The proportion
      of bimodal differential units was higher in the pre- and post-arcuate areas than
      in the principalis and inferior convexity areas of the frontal cortex. The
      results indicate that some frontal units participate in the crossmodal coding of
      the associative significance of the stimulus independent of its physical
      properties, and most frontal units play different roles depending on the modality
      of the stimulus.

PMID- 1623972
TI  - Statistical analysis of long-term potentiation of large excitatory postsynaptic
      potentials recorded in guinea pig hippocampal slices: binomial model.
AB  - Excitatory postsynaptic potentials (EPSPs) were recorded in guinea pig
      hippocampal slices (area CA1) from 15 neurons after stimulation of stratum
      radiatum (str. rad.) and stratum oriens. EPSP amplitudes increased in 8 neurones
      (10 post-tetanic regions) recorded 15 to 45 min after tetanic stimulation of str.
      rad. The increase was considered to represent long-term potentiation (LTP).
      Quantal analysis was performed by two methods assuming binomial statistics: the
      histogram method using deconvolution of noise and the variance method. According
      to both methods, LTP was associated with an increase in mean quantal content (m)
      which correlated with LTP magnitude. A statistically significant increase in
      quantal size (v) was found only by the histogram method and the increase was not
      correlated with LTP magnitude. A separate analysis of EPSPs with small LTP
      magnitude demonstrated that with the histogram method only v was increased but
      not m. A smaller increase in m for the pooled data of both methods did not
      correlate with LTP magnitude for this EPSP subset. The increase in m for the
      whole EPSP set corresponds to previous results on the quantal analysis of LTP in
      in vivo preparations and favours a presynaptic location of major mechanisms
      underlying LTP maintenance. The increase in v indicates the existence of another
      mechanism responsible for the maintenance of a small part of LTP. This mechanism
      might involve either pre- or postsynaptic changes or both.

PMID- 1623973
TI  - Quantal analysis of long-term potentiation of "minimal" excitatory postsynaptic
      potentials in guinea pig hippocampal slices: binomial approach.
AB  - "Minimal" excitatory postsynaptic potentials (EPSPs) were recorded from 13
      neurones in area CA1 of guinea pig hippocampal slices after double-pulse
      stimulation of stratum radiatum (str. rad.) and stratum oriens (str. or.).
      Amplitudes of EPSPs significantly increased in 8 neurones 5 to 55 min after 9
      tetanizations in str. rad.. The increase was considered to represent long-term
      potentiation (LTP). Altogether 26 EPSPs (42 post-tetanic regions) were
      statistically analysed by four methods of the quantum hypothesis assuming the
      binomial model of transmitter release: the deconvolution (histogram), the
      variance, the failures, and the combined (variance-failures) methods. The mean
      quantal content (m) significantly increased after LTP induction according to all
      methods used. Quantal size (v) also tended to increase but according to some
      methods, the increase was not statistically significant and it did not correlate
      with LTP magnitude. However, for an EPSP subset with a LTP magnitude of less than
      1.55, the increase in v correlated with LTP magnitude, whereas the increase in m
      did not. The relative contribution of the increase in v to LTP magnitude was
      larger for cases with small LTP than for the whole EPSP set. In general, the
      increase in m corresponds to previous studies and favours the presynaptic
      location of major mechanisms of LTP maintenance, i.e. an increase in the average
      number of transmitter quanta released by each presynaptic volley. The post
      tetanic increase in v might reflect some additional mechanisms which presumably
      include an increase in the amount of transmitter in one quantum.

PMID- 1623974
TI  - Analysis of fluctuations of "minimal" excitatory postsynaptic potentials during
      long-term potentiation in guinea pig hippocampal slices.
AB  - In previous studies, quantal analysis assuming a simple binomial model has shown
      that long-term potentiation (LTP) is accompanied by an increase in both mean
      quantal content (m) and quantal size (v), whereby the increase in m predominates.
      In the present study, "compound" binomial distributions with variable
      probabilities were convolved with Gaussian distributions in computer experiments
      to simulate amplitude histograms of intracellular excitatory postsynaptic
      potentials (EPSPs). A deconvolution procedure assuming equal "quantal" separation
      (v) between discrete components, but without assuming binomial statistics, was
      applied to the simulated distributions to determine v. It was found that with a
      small ratio of standard deviation of noise to v (Sn/v less than 0.4), a reliable
      estimate of v can be obtained even for small samples (N = 100). When Sn/v was
      larger (0.4-0.6), approximate v estimates (within +/- 10-20% of the simulated v)
      could be obtained by averaging estimates from about 10 small samples (N = 100).
      "Minimal" EPSPs were recorded in area CA1 of guinea pig hippocampal slices. 37
      EPSP amplitude samples of 9 neurones were measured before and up to 55 min after
      10 tetanizations of stratum radiatum. In accordance with the previous data, the
      increase in v accounted for only about 10% of the average post-tetanic increase
      in EPSP amplitude and was not correlated with the latter. However, for an EPSP
      subset with small LTP magnitude, the increase in v accounted for an essential
      part of the LTP magnitude while the increase in m did not correlate with it. The
      results are in agreement with previous data obtained in the context of the simple
      binomial model and are interpreted as indicating primarily a presynaptic
      mechanism of LTP maintenance. The results suggest two types of synaptic mechanism
      of LTP maintenance related to the increases in m and v, respectively. The latter
      mechanism is saturated at about 10 to 30% increase in post-tetanic amplitude
      above the pre-tetanic EPSP amplitude.

PMID- 1623975
TI  - The frontal eye field provides the goal of saccadic eye movement.
AB  - Microstimulation of oculomotor regions in primate cortex normally evokes saccadic
      eye movements of stereotypic directions and amplitudes. The fixed-vector nature
      of the evoked movements is compatible with the creation of either an artificial
      retinal or motor error signal. However, when microstimulation is applied during
      an ongoing natural saccade, the starting eye position of the evoked movement
      differs from the eye position at stimulation onset (due to the latency of the
      evoked saccade). An analysis of the effect of this eye position discrepancy on
      the trajectory of the eventual evoked saccade can clarify the oculomotor role of
      the structure stimulated. The colliding saccade paradigm of microstimulation was
      used in the present study to investigate the type of signals conveyed by visual,
      visuomovement, and movement unit activities in the primate frontal eye field.
      Colliding saccades elicited from all sites were found to compensate for the
      portion of the initial movement occurring between stimulation and evoked movement
      onset, plus a portion of the initial movement occurring before stimulation. This
      finding suggests that activity in the frontal eye field encodes a retinotopic
      goal that is converted by a downstream structure into the vector of the eventual
      saccade.

PMID- 1623976
TI  - Responses of neurons in the caudal medullary raphe nuclei of the cat to
      stimulation of the vestibular nerve.
AB  - In the decerebrate cat, recordings were made from neurons in the caudal medullary
      raphe nuclei to determine if they responded to electrical stimulation of the
      vestibular nerve and thus might participate in vestibulosympathetic reflexes.
      Many of these cells projected to the upper thoracic spinal cord. The majority
      (20/28) of raphespinal neurons with conduction velocities between 1 and 4 m/s
      received vestibular inputs; 13 of the 20 were inhibited, and 7 were excited.
      Since many raphespinal neurons with similar slow conduction velocities are
      involved in the control of sympathetic outflow, as well as in other functions,
      these cells could potentially relay vestibular signals to sympathetic
      preganglionic neurons. The onset latency of the vestibular effects was long
      (median of 15 ms), indicating the inputs were polysynaptic. In addition, 34 of 42
      raphespinal neurons with more rapid conduction velocities (6-78 m/s) also
      received long-latency (median of 10 ms) labyrinthine inputs; 26 were excited and
      8 were inhibited. Although little is known about these rapidly-conducting cells,
      they do not appear to be involved in autonomic control, suggesting that the
      function of vestibular inputs to raphe neurons is not limited to production of
      vestibulosympathetic reflexes. One hypothesis is that raphe neurons are also
      involved in modulating the gain of vestibulocollic and vestibulospinal reflexes;
      this possibility remains to be tested.

PMID- 1623977
TI  - Vocalizations in the cat: behavioral methodology and spectrographic analysis.
AB  - Attempts to understand the neural mechanisms underlying mammalian vocal
      behaviors, including speech, require study of the neural activity and anatomy of
      vocalization-controlling brain structures. Such studies necessitate the
      application of invasive neurobiological techniques in animal models. In the
      current study, cats are used in the development of an animal model of vocal tract
      control. The animals are instrumentally conditioned to vocalize for food reward.
      Acquisition of this task can occur within a few minutes, although additional
      training generally is required to solidly establish the behavior and to train
      subjects to produce consistently high rates of vocalization for prolonged periods
      of time. Following training, animals can generally sustain a rate of two calls
      per minute for a period of over two hours. Optimal task performance is partly
      dependent on motivation level. Although there is considerable variation between
      animals, the vocalizations produced have an average duration of 600 ms and a
      fundamental frequency of around 500 Hz. In addition, during a typical
      vocalization, there are dynamic variations of about 150 Hz for fundamental
      frequency and 17 dB for sound intensity. These variations provide opportunities
      for relating neural and muscular activity to different aspects of the vocal
      behavior they control. Based on a number of considerations, the model and
      techniques discussed here probably are most applicable to studying the
      neurobiology of sub-cortical nuclei subserving vocal control. Similar mechanisms
      might well be present in other species, including humans. Thus, data obtained
      from study of this model may be applicable to understanding the processes
      underlying vocal tract control during human speech.

PMID- 1623978
TI  - Factors influencing neural activity in parabrachial regions during cat
      vocalizations.
AB  - The parabrachial nucleus in mammals is intimately connected with other
      vocalization controlling brainstem structures. It, along with ventromedially
      adjacent structures, also has been identified as the pneumotaxic center, and as
      such shows strong respiratory related activity in the anesthetized cat. The
      current study examines the neuronal activity in cat parabrachial regions during
      production of instrumentally conditioned vocalizations. Most of the units in our
      sample show considerable activity during periods between vocalizations. For many
      units, firing rate fluctuates during the respiratory cycle, although apparently
      not as strongly as reported in the decerebrate cat. Also, there is often strong
      phasic activity during periods where animals are licking to ingest their food
      rewards. During the peri-vocalization period, various neural activity patterns
      can be recorded. Most common is an activity increase during the vocalization
      itself. Moreover, in some units, this activity increase has an auditory
      component. A smaller number of units show other activity patterns, including a
      suppression of activity during vocalization and activity increases preceding the
      vocalization. Overall, our results suggest that the parabrachial region's
      involvement in vocal control is quite complex, involving convergence of
      respiratory, acoustic, vocalization-related, and perhaps somatosensory
      influences.

PMID- 1623979
TI  - Multiple representation in the nucleus lateralis of the cerebellum: an
      electrophysiologic study in the rat.
AB  - The motor organization of the nucleus lateralis (NL) of the rat's cerebellum was
      investigated by observing the motor effects of electrical microstimulations of
      the NL. The movements evoked by the NL mainly concerned forelimb and head
      segments. Only in a few cases were movements of hindlimb segments evoked. Motor
      effects were obtained according to a precise topographical pattern. This pattern
      delimited functional zones, or representations, within the NL, each zone being
      specifically related to a particular segment of the body. A few body segments
      were activated from single zones only (single representation) whereas some other
      body segments could be activated from different zones of the NL. Among them, the
      axio-proximal body segments were activated in a similar way from all sites
      (multiple representation) whereas the distal body segments were differently
      activated from the various representation zones (specific representation). The
      multiple and specific representations were distributed between the 3
      cytoarchitectonic subregions of the NL (NLm, DLH and slp) in such a way that the
      body segments were usually represented only once in each individual NL subregion.
      Each NL subregion included sets of representations concerning body segments
      characterized by a topographical continuity (e.g. the different segments of the
      forelimb in both DLH and slp). Thus, the individual NL subregions may bring into
      play coordinate plurisegmental muscular activities of the limbs and/or of the
      head. The NLm controls movements of all the segments of the head and those of
      axio-proximal segments of both limbs. The DLH particularly controls movements of
      the head, including both the proximal (neck) and the oral regions. To a lesser
      degree, DLH controls movements of the various segments of the forelimb, including
      synchronous flexion of all the digits. The slp is specifically involved in the
      control of motor activities of: i) the proximal segment of the head (rotation of
      the neck) as well as its distal segments (displacement of individual vibrissae,
      rotation of the ear pinna) and ii) the various segments of the forelimb including
      individual digits. Functionally, the proximal segments would be concerned in the
      spatial displacement of the limbs or of the head whereas the distal segments
      would be involved in the realization of precise and discrete movements related to
      specific functions of the distal segments concerned. The 3 subregions of the NL
      may be concerned in different motor functions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1623980
TI  - Direct retinal projections of the "non-image forming" system to the hypothalamus,
      anterodorsal thalamus and basal telencephalon of mink (Mustela vison) brain.
AB  - The retinal projections of the "non-image forming" system to the hypothalamus,
      anterodorsal thalamus and basal telencephalon were visualized in adult mink using
      the anterograde transport of cholera toxin conjugated to horseradish peroxidase
      injected intraocularly. A major and nearly symmetrical bilateral input of labeled
      retinal fibers to the suprachiasmatic nuclei was observed. A dense innervation
      was also evident in both paraventricular nuclei, and in the anterior, lateral and
      mediobasal hypothalamus on the side contralateral to the injection. Two
      projections leaving the optic tract at the level of the lateral hypothalamus or
      after crossing the geniculate body entered the anterior thalamus and ran in a
      ventro-dorsal or a caudorostral direction before terminating in the stria
      terminalis. Fibers were also observed in the horizontal limb of the diagonal band
      of Broca. These observations are compared to those in other mammalian species and
      discussed according to their possible implication in photoperiodic signal
      processing.

PMID- 1623981
TI  - Changing patterns of binocular visual connections in the intertectal system
      during development of the frog, Xenopus laevis. III. Modifications following
      early eye rotation.
AB  - In the frog, Xenopus laevis, a system of intertectal connections underlies the
      visual projection from an eye to its ipsilateral tectal lobe and is involved in
      the topographic representation of binocular visual space. Rotation of one eye in
      early life may be followed by a radical rearrangement of the connections in this
      system. The modified pattern which later emerges is that which keeps the visual
      projection through the ipsilateral eye in topographic registration with the
      direct visual projection from the contralateral eye to the same tectal lobe. This
      plasticity requires visual experience. In this paper we describe the time-course
      and sequence of events by which this plasticity is effected. Following rotation
      of one eye in larval animals or in animals undergoing metamorphic climax, the
      earliest evidence of intertectal modification was found 3-4 weeks after
      metamorphosis. With increasing intervals after metamorphosis an increasing
      proportion of animals displayed modified intertectal systems. At intermediate
      intervals many animals showed partial modifications, which were interpreted as
      transitional stages in the modification process. Analysis of these transitional
      stages indicated that the sequence of events involved in the elaboration of a
      modified intertectal system following the experimental alteration of eye
      alignment exhibits features in common with rearrangements of the system that
      occur during normal development in response to growth-related alterations in eye
      alignment.

PMID- 1623982
TI  - Characterisation of a human glioblastoma cell line (LI) expressing hypothalamic
      and pituitary hormones.
AB  - The human glioblastoma cell line LI showed morphological features typical of its
      neuroectodermal origin. Cells were positive by immunofluorescence to GFAP, MHC
      class II, and L1 determinants. Cytogenetic analysis showed the presence of a
      modal chromosome number of 63, ranging from 58 to 69 chromosomes (DNA index was
      1.6). Northern blot analysis demonstrated the presence of mRNA transcripts
      specific for transglutaminase C (type II or "tissue"), growth-hormone releasing
      hormone (GHRH), insulin-like growth factor II (IGF-II), and proopiomelanocortin
      (POMC). The GHRH mRNA was present in two different sizes, one similar to the
      normal hypothalamic species of 0.75 kb, whilst the second species was a large
      transcript of approximately 10 kb size. Treatment with 5 microM retinoic acid or
      5 mM alpha-difluoromethylornithine for 5 days sharply reduced the growth rate and
      also induced modulation of the ultrastructure and antigenic profile. This cell
      line may be useful to study glial differentiation and the relationship of GHRH,
      IGF-II and POMC expression with differentiation in neuroectodermal tumours.

PMID- 1623983
TI  - Characteristics of "anti" saccades in man.
AB  - Four subjects - all made large numbers of Express saccades in the normal gap task
      - were instructed to make saccades in the direction opposite to the side where a
      visual stimulus appeared ("anti" task). Gap and overlap trials were used.
      Saccadic reaction time (SRT), velocity and amplitude of the corresponding eye
      movements were analysed and compared to those of saccades made in the normal
      task. The velocity of "anti saccades" was found to be slightly (up to 15%) but
      significantly slower in two subjects. The distributions of SRTs in normal gap
      tasks show a small group of anticipatory saccades (with SRT below 80 ms and
      slower velocities) followed by a group of saccades with fast reaction times
      between 80 ms and 120 ms (Express saccades) followed by another large group
      ranging up to 180 ms (regular saccades). In the gap anti task there are
      anticipatory saccades and saccades with SRTs above 100 ms; Express saccades are
      missing. The distribution of SRTs obtained in the overlap anti task was unimodal
      with a mean value of 231 ms as compared to 216 ms in the normal task. The
      introduction of the gap therefore clearly decreases the reaction times of the
      anti saccades. Control experiments show that the delay of anti saccades is not
      due to an interhemispheric transfer time but must be attributed to the saccade
      generating system taking more time to program a saccade to a position where no
      visual stimulus appears. These data are discussed as providing further evidence
      for the existence of a reflex-like pathway connecting the retina to the
      oculomotor nuclei mediating the Express saccade.

PMID- 1623984
TI  - Eye position signals in human saccadic processing.
AB  - 1. We studied saccades to briefly flashed targets in 8 human subjects. The target
      flash occurred (i) during smooth pursuit ("ramp-flash"), (ii) just before a
      saccade to another target ("step-flash"), or (iii) during steady fixation ("flash
      only"). All lights were extinguished after the target flash so that smooth
      pursuit or saccadic eye movements occurred during the interval of complete
      darkness between the target flash and the saccade to it. We compared these
      saccades to those made without intervening eye movement (flash only), and
      quantified the extent to which the saccadic system compensated for the change in
      eye position that occurred during the dark interval. 2. Saccades to control
      flashes were reasonably accurate (mean gain 0.87) and consistent. Compensation
      for the intervening eye movement in the ramp-flash and step-flash paradigms was
      highly variable from trial to trial. On average, subjects compensated for 27% of
      the intervening pursuit eye movement on ramp-flash trials and for 58% of
      intervening saccadic movement on step-flash trials. 3. Multiple regression
      analysis showed that the variability did not depend on factors such as variations
      in underlying saccadic gain, response latency, timing of stimuli or size of the
      required response. We conclude that this variability is intrinsic to saccadic
      responses that require the use of an eye position signal. 4. These results show
      that an eye position signal is available to the saccadic system but that this
      signal has low fidelity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623985
TI  - Changes of cortical activity when executing learned motor sequences.
AB  - Fifteen right-handed subjects performed a learned sequence of four movements
      (flex index finger, extend hand, extend index finger, flex hand) either with
      their left or their right hand. The sequence of movements had to be continuously
      repeated for 20 s (period of execution). In the beginning of each period of
      execution large negative DC potentials were recorded in positions located above
      the mesial fronto-central cortex (Cz) and the sensorimotor hand areas of either
      hemisphere (C3 and C4). In contrast, DC potentials were absent in Cz at the end
      of the period of execution. In recordings from a position above the sensorimotor
      hand area contralateral to the performing side, negative DC potentials declined
      to some extent during task execution but were still present at the end of the
      period. Variations of both the amplitude and topography of negative cortical DC
      potentials during task-execution indicate changes of both the size and pattern of
      cortical activity. These findings were consistently found at both the beginning
      and end of the experiment. Motor performance as quantified by movement times and
      inter-onset latencies of movements showed no change, either during the periods of
      execution or when comparing the beginning of the experiment with the end.
      Conclusions are: (1) the execution of a learned motor sequence task cannot be
      associated with a particular size and pattern of cortical activity. (2) A
      pronounced decline of neural activity in the mesial, fronto-central area
      constitutes the predominant feature of the changes of cortical activity during
      the period of execution.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1623986
TI  - A frontal cortical potential associated with saccades in humans.
AB  - We describe a frontal EEG potential which begins 25-35 ms before intentional
      saccadic eye movement. It consists of a 15-20 muvolt monophasic positive waveform
      with peak during or just after movement, and returns to EEG baseline 150-200 ms
      after its onset. The waveform is largest at a midline position just anterior to
      FZ (10-20 system), is independent of visual input such as fixation guides, and is
      not related to saccade direction or amplitude. The potential is difficult to
      observe in some subjects and is independent of the "pre-saccadic spike
      potential". It may be related to the discharge of single cortical neurons that
      signal the initiation of saccadic movements, but not their exact metrics; a
      possible generator is the supplementary eye fields of the dorsomedial prefrontal
      cortex.

PMID- 1623987
TI  - Lowered cutaneous sensitivity to nonpainful electrical stimulation during
      isometric exercise in humans.
AB  - The effect of isometric exercise on cutaneous sensitivity to nonpainful electric
      stimulation was studied in human subjects. The exercises consisted of brief
      (duration: 1-10 s) palmar flexions of the hand or foot against varying loads (10
      30% of the maximal force). A visual "go" cue was used to indicate the start and
      end of the exercise. Isometric hand exercise produced a load-dependent increase
      of electrotactile thresholds of the fingers. The threshold elevation was rapidly
      attenuated with prolonged duration of the exercise. The hand exercise-induced
      threshold elevation was of equal magnitude in the glabrous and hairy skin of the
      fingers. Thresholds were not changed for the hand contralateral to the exercising
      hand. Passive static pressure of the hand did not produce threshold changes,
      whereas activation of afferent inhibition by a vibrotactile stimulus (100 Hz, 0.1
      mm) did produce a significant threshold elevation. Exercise-induced threshold
      elevation was also significant immediately prior to the EMG response of the arm
      but not at the time of the visual "go" signal, or before it. The threshold
      increase found during the EMG response was not significantly stronger than that
      found prior to the EMG response. These results suggest that isometric exercise
      load-dependently produces a phasic, rapidly attenuating increase in cutaneous
      tactile thresholds in the exercising limb but not multisegmentally. Corollary
      efferent barrage from motor to sensory structures of the brain could be
      underlying the threshold changes produced by isometric exercise, whereas afferent
      inhibitory mechanisms seem to have only a minor role.

PMID- 1623988
TI  - Miniature excitatory postsynaptic potentials in embryonic motoneurons grown in
      slice cultures of spinal cord, dorsal root ganglia and skeletal muscle.
AB  - Miniature excitatory postsynaptic potentials (mEPSPs) were recorded in
      motoneurons grown in organotypic cocultures of embryonic rat spinal cord, dorsal
      root ganglia and muscle in the presence of TTX. The motoneurons were electrically
      compact with a mean electrotonic length of 0.6. Spontaneous EPSPs were found in
      most of these motoneurons. With TTX the large EPSPs disappeared, whereas in more
      than half of the experiments mEPSPs persisted with a range in size of 1 to 4 mV
      (mean: 2.1 mV), probably originating from the spontaneous release of single
      vesicles. The net inward charge transfer at the soma ranged from 0.12 to 0.34 pC.
      The mEPSPs were heterogeneous in size even within pools of potentials that were
      homogeneous in shape. They had similar shapes and amplitudes as the smallest
      spontaneous unitary EPSPs mediated by presynaptic impulses, suggesting that for
      the smallest afferents not more than one vesicle was released per afferent
      impulse. Both the miniature and the TTX-sensitive EPSPs were readily blocked by
      the glutamate antagonist DNQX.

PMID- 1623989
TI  - In vitro study of central respiratory-like activity of the fetal rat.
AB  - A fetal rat brain stem-spinal cord in vitro preparation (15-20 days) which
      retains for several hours respiratory-like discharges on cervical and cranial
      ventral roots has been developed for analysing fetal central respiratory
      activity. Two different patterns of easily distinguishable rhythmic activity were
      recorded. The first, of spinal origin, appeared every 2-10 min as long bursts of
      potentials (3-30 s) on cervical, but not hypoglossal, roots. The second pattern
      corresponded to brief bursts (1 s) of potentials occurring on both cervical and
      hypoglossal roots at a frequency ranging from 3-4 cycles min-1. The second type
      of activity was likely to be respiratory since it originated from the medulla,
      and behaved similarly to the respiratory activity recorded in vitro from newborn
      rats. The fetal respiratory-like activity was never observed at day 15, appeared
      at day 16 in 30% of the preparations with fluctuating frequency and amplitude
      bursts, and stabilised at day 20 where it was usually present and resembled
      newborn rat respiratory activity: its frequency was stable but was reduced by
      withdrawal of CO2 and pH stimuli and modulated by a pontine noradrenergic
      influence. This fetal preparation offers many advantages for studying the
      ontogeny of the central respiratory activity because of the background knowledge
      available on the adult and newborn rat respiratory centers and the possibility of
      performing electrophysiological, morphological and pharmacological fetal studies
      directly at the central level without any feedback from the periphery.

PMID- 1623990
TI  - Myomectomy for fertility enhancement and preservation.
AB  - OBJECTIVE: To review, evaluate, and synthesize current published reports
      assessing the value of abdominal myomectomy in infertile women and those desiring
      to preserve fertility potential. DATA IDENTIFICATION: Major studies dealing with
      myomectomy were identified through Medline Searches. STUDY SELECTION: Those
      papers reporting the results of myomectomy, factors influencing them, and
      potential future innovations were obtained. RESULTS: More than half of women not
      previously pregnant and undergoing myomectomy to preserve childbearing capacity
      for treatment of recurrent pregnancy wastage or previous infertility conceive.
      The long duration of infertility before surgery, absence of other factors to
      explain their not conceiving, and short time interval subsequent to surgery in
      which conception occurs suggests myomectomy has value in treatment of patients
      with leiomyomata and otherwise unexplained infertility. The operation carries
      acceptable risk. Approximately 25% of women undergoing myomectomy have recurrent
      leiomyomata, but most recurrences are sufficiently delayed to allow adequate
      opportunity for conception. CONCLUSIONS: Abdominal myomectomy is an appropriate
      alternative to hysterectomy for most women who wish to preserve childbearing
      potential or enhance it. For the future, myomectomy by endoscopic techniques may
      hold similar potential.

PMID- 1623991
TI  - Human embryos produce transforming growth factors alpha activity and insulin-like
      growth factors II.
AB  - OBJECTIVE: To assess whether growth factors are produced by early human embryos
      in culture. DESIGN: We studied various growth factors in the culture media of
      human embryos (n = 6) cultured from days 3 to 8 after fertilization. MAIN OUTCOME
      MEASURES: Four growth factors were measured: Insulin growth factors I and II (IGF
      I and IGF-II), epidermal growth factor (EGF) and transforming growth factor alpha
      (TGF alpha) activity. RESULTS: Nonconditioned INRA Menezo B2 (Biomerieux, S.A.,
      Paris, France) culture medium contained significant levels of TGF alpha activity
      (5.2 ng/mL) and low levels of IGF-I (1.02 ng/mL) and IGF-II (2.8 ng/mL), whereas
      EGF was below detection of our assay. With human embryo, the culture media
      contained lower TGF alpha activity on days 3 and 4 after fertilization (2.5 ng/mL
      and 2.8 ng/mL, P less than 0.05). From days 5 to 8 after fertilization, a
      significant increase in TGF alpha activity and IGF-II was detected (TGF alpha
      activity: day 5: 3.7 ng/mL; day 6: 4.4 ng/mL; day 7: 6.4 ng/mL; day 8: 8.4 ng/mL)
      (IGF-II: day 5: 3.4 ng/mL; day 6: 3.1 ng/mL; day 7: 4.1 ng/mL; day 8: 4.2 ng/mL).
      Epidermal growth factor was undetectable, and IGF-I did not vary significantly.
      CONCLUSION: Transforming growth factor alpha activity and IGF-II are produced by
      human embryos in culture at a time when they could play a role in morula to
      blastocyst transformation.

PMID- 1623992
TI  - Specific binding sites for insulin in the human myometrium and leiomyomas of the
      uterus.
AB  - OBJECTIVE: To investigate whether there are increased binding sites for insulin
      in the leiomyomas of the uterus. STUDY DESIGN: Samples of myomas and myometrium
      were obtained from seven patients with myomas at the time of hysterectomy.
      Binding studies were performed with [125I] insulin. RESULTS: The percent total
      binding of [125I] insulin in the myomal tissues (mean +/- SE 20.7% +/- 2.3%/100
      micrograms protein) was significantly higher (P less than 0.01) than that in the
      myometrium (14.7% +/- 1.3%/100 micrograms protein). Scatchard analysis revealed
      that the increase in binding is because of increase in receptor affinity.
      CONCLUSIONS: There is increased binding of insulin in the myomas because of
      increase in receptor affinity. This could increase the sensitivity of the
      biological response of the myomal cells to insulin.

PMID- 1623993
TI  - Nonclassical 3 beta-hydroxysteroid dehydrogenase deficiency: a review of our
      experience with 25 female patients.
AB  - OBJECTIVE: To report 15 new menarcheal women affected with nonclassical 3 beta
      hydroxysteroid dehydrogenase deficiency (nonclassical 3 beta-HSD) and evaluation
      of glucocorticoid therapy in treated patients. DESIGN: Diagnosis of these new
      patients using a standard adrenocorticotropin test. Effects of glucocorticoid
      therapy on clinical hormonal and sonographic features of each patient are
      appreciated for periods varying between 4 months and 7 1/2 years. SETTING: All at
      The New York Hospital-Cornell Medical Center. The Pediatric Endocrinology
      Ambulatory Service; the Children's Clinical Research Center Core Laboratories;
      and the Department of Radiology. PATIENTS, PARTICIPANTS: Fifteen menarcheal women
      (14 to 30 years of age) newly diagnosed and 10 women previously diagnosed were
      evaluated for symptoms of hyperandrogenism and/or irregular menses. MAIN OUTCOME
      MEASURE(S): Positive effect of glucocorticoid therapy on signs and symptoms,
      hormonal levels, and ovarian imaging. RESULTS: Polycystic ovarian syndrome is
      noted in approximately half the cases. Glucocorticoid treatment greater than 3
      months duration results in a reversal of symptoms in most cases.

PMID- 1623994
TI  - Evaluation of a 1-year levonorgestrel-releasing contraceptive implant: side
      effects, release rates, and biodegradability.
AB  - OBJECTIVE: To determine the release rates, effects on ovulation, and side effects
      of two lengths of a biodegradable, subdermal contraceptive implant containing
      levonorgestrel in a caprolactone capsule. DESIGN: Phase II randomized clinical
      trial. SETTING: Public family planning clinic at an urban general hospital.
      PARTICIPANTS: Forty-eight healthy, parous, ovulating volunteers. INTERVENTION:
      Subjects were randomly assigned either a 2.5- or a 4.0-cm contraceptive capsule
      that was worn under the skin of the upper arm for 1 year if not removed earlier
      for other reasons. MAIN OUTCOME MEASURES: Serum concentrations of levonorgestrel,
      progesterone, estradiol, and lipoproteins were measured as were metabolic
      parameters. Vaginal bleeding and other side effects were recorded. After implant
      removal, remaining levonorgestrel, capsule viscosity, and molecular weight were
      measured. RESULTS: The 4-cm implant provided serum concentrations of
      levonorgestrel ranging from 0.65 ng/mL shortly after insertion to 0.20 ng/mL at
      12 months, but the 2.5-cm implant resulted in levels too low for contraception.
      The 4-cm implant suppressed ovulation in approximately 80% of cycles over 1 year
      of use, but the 2.5-cm implant failed to suppress ovulation. The implants were
      rapidly and easily inserted and removed. They retained structural integrity
      through 1 year of use. Of 48 subjects, 32 had abnormal bleeding patterns; the
      mean number of days of bleeding per month was 7 with 23 days between episodes.
      Women using capronor maintained normal metabolic parameters except that low
      density lipoprotein decreased slightly. CONCLUSIONS: The 4.0-cm implant is a
      promising contraceptive. There were no important metabolic effects, but there
      were bothersome minor side effects typical of progestin-only contraception.

PMID- 1623995
TI  - Psychological improvement in infertile women after behavioral treatment: a
      replication.
AB  - OBJECTIVE: To replicate previously reported psychological improvements in
      infertile women attending a group behavioral treatment program. DESIGN:
      Psychological and demographic data were collected before entering and again upon
      completion of a behavioral medicine program on a second cohort of patients.
      SETTING: The program was offered in the Division of Behavioral Medicine, an
      outpatient clinic of the Department of Medicine at New England Deaconess
      Hospital. All patients were receiving care from infertility specialists not
      affiliated with this hospital. PATIENTS: Fifty two self-referred women receiving
      medical treatment for infertility attended the program. INTERVENTION: A 10-week
      group behavioral treatment program. MAIN OUTCOME MEASURES: Three validated
      psychological instruments. RESULTS: Psychological improvement was statistically
      significant (Profile of Mood States Tension/Anxiety: P less than 0.0001;
      Depression/Dejection: P less than 0.0122; Vigor/Activity: P less than 0.0431;
      Confusion/Bewilderment: P less than 0.0057; Spielberger Anger Expression: P less
      than 0.0013; Spielberger State Anxiety: P less than 0.0037, and Trait Anxiety: P
      less than 0.0001). CONCLUSIONS: Behavioral treatment is associated with
      significant decreases in negative psychological symptoms.

PMID- 1623996
TI  - The ratio of androstenedione:11 beta-hydroxyandrostenedione is an important
      marker of adrenal androgen excess in women.
AB  - OBJECTIVE: To determine if the ratio of serum androstenedione (A):11 beta
      hydroxyandrostenedione (OHA) would be helpful in differentiating adrenal from
      ovarian hyperandrogenism. DESIGN/SETTING: Prospective study of outpatients being
      evaluated for hyperandrogenism. PATIENTS/PARTICIPANTS: Normal women (n = 27),
      those with hyperandrogenic chronic anovulation (n = 25), and 7 with adult onset
      of congenital adrenal hyperplasia (CAH) because of 21-hydroxylase deficiency.
      INTERVENTIONS: Fasting serum between 8:00 A.M. and 9:00 A.M. Patients with
      hyperandrogenic chronic anovulation and CAH received dexamethasone (DEX) 2 mg for
      7 days. MAIN OUTCOME MEASURES: Serum testosterone (T), unbound T,
      dehydroepiandrosterone sulfate (DHEAS), A, and 11 beta-OHA by radioimmunoassay.
      RESULTS: Serum 11 beta-OHA and DHEAS were elevated in 52% and 40% of patients
      with hyperandrogenic chronic anovulation and in 7 of 7 and 1 of 7 patients with
      CAH. The ratio of A:11 beta-OHA was significantly higher (P less than 0.05) in
      hyperandrogenic chronic anovulation and significantly lower (P less than 0.05) in
      CAH compared with controls. Serum A:11 beta-OHA correlated with T (r = 0.58, P
      less than 0.05). The ratios of A:11 beta-OHA were similar and significantly lower
      in CAH and hyperandrogenic chronic anovulation patients who were DEX sensitive
      compared with those who were not DEX sensitive. The ratio correlated with the
      percentage suppression of T, unbound T, and A after DEX (P less than 0.01). There
      were no differences with measurements of DHEAS and 11 beta-OHA. Using the mean
      ratio of controls (1.3) as a cutoff value, the sensitivity of the A:11 beta-OHA
      in detecting adrenal hyperandrogenism, as assessed by DEX sensitivity, was 100%,
      the specificity was 84%, and the predictive value was 67%. CONCLUSIONS: The ratio
      of A:11 beta-OHA appears to be an excellent marker for identifying patients with
      adrenal hyperandrogenism and CAH.

PMID- 1623997
TI  - Transport in vitro fertilization--a novel scheme for community-based treatment.
AB  - OBJECTIVE: To provide an inexpensive and extensive in vitro fertilization (IVF)
      service for the Mersey Region, United Kingdom. DESIGN: Twenty-four transport IVF
      patients treated in two district general hospitals using the central university
      laboratory as co-ordination point for treatment schedule and embryology. Outcomes
      were compared with 26 control patients treated in the central unit. SETTING:
      Royal Liverpool University Hospital, a central IVF unit, and two district general
      hospitals in the Mersey Region. PATIENTS: Fifty patients under 35 years of age
      with irreversible tubal damage selected and treated by IVF, half in the central
      unit and the other half in two district general hospitals. MAIN OUTCOME MEASURES:
      Pregnancy rate (PR) in the different centers. RESULTS: A PR of 42.3% per cycle in
      the peripheral hospitals compared with 30.7% per cycle in the central unit.
      CONCLUSION: Transport IVF is an inexpensive and feasible alternative to standard
      IVF in a central unit for patients without access to central units.

PMID- 1623998
TI  - Subtle rise in serum progesterone during the follicular phase as a predictor of
      the outcome of in vitro fertilization.
AB  - OBJECTIVE: To investigate the effects of subtle rises in serum progesterone (P)
      during the follicular phase on the outcome of in vitro fertilization and embryo
      transfer (IVF-ET). DESIGN, PATIENTS: One hundred one patients underwent IVF-ET
      for 170 cycles and were stimulated with a combination of clomiphene citrate and
      human menopausal gonadotropin. Based on their hormonal data, we divided the
      patients into two groups: those who had a cycle with an increase in serum P
      concentration (1.0 to 2.0 ng/mL) that was not associated with a pituitary LH
      release (subtle P rise) and those who had a cycle without any increase in serum P
      concentration (no P rise). MAIN OUTCOME MEASURES: The daily serum estradiol (E2)
      concentration and the results of IVF-ET (number of developed and collected
      oocytes, rates of mature oocytes, fertilization, and pregnancy) were compared
      between the two groups. RESULTS: Subtle P rises were observed in 31.7% (32/101)
      of the patients and 20.5% (36/170) of the cycles evaluated during the IVF-ET
      programs. A significantly higher serum E2 concentration (P less than 0.001) and a
      greater number of developed and collected oocytes (P less than 0.001 and P less
      than 0.05, respectively) also were observed in those cycles with a subtle P rise.
      The rates of mature oocyte formation and fertilization were significantly lower
      in cycles with a subtle P rise (P less than 0.001 and P less than 0.05,
      respectively). A lower pregnancy rate was observed in cycles with a subtle P
      rise, and all 12 ongoing pregnancies occurred only in cycles with a no P rise.
      CONCLUSION: These results suggest that the development of an increased number of
      follicles may not necessarily improve the outcome of IVF-ET and that the
      measurement of serum P may be a better predictor for successful pregnancy.

PMID- 1623999
TI  - Understanding the current status of oocyte donation in the United States: what's
      really going on out there?

PMID- 1624000
TI  - A prospective, randomized study of pregnancy rates after transuterotubal and
      intrauterine insemination.
AB  - OBJECTIVE: To assess the relative efficacy, in terms of clinical pregnancy rates
      (PRs), of transuterotubal insemination versus the more traditional intrauterine
      insemination (IUI) procedure. DESIGN: Prospective, randomized, cross-over.
      SETTING: University-affiliated tertiary care center. PATIENTS: One hundred sixty
      infertile patients underwent 414 inseminations with or without controlled ovarian
      hyperstimulation. INTERVENTIONS: All patients were randomized in their initial
      cycle to transuterotubal insemination or IUI then crossed-over in subsequent
      cycles (n = 191 total cycles of transuterotubal insemination and n = 223 total
      cycles of IUI). Transuterotubal insemination was performed initially with
      ultrasound guidance, and then a tactile technique was used for the last 6 months
      of the study. MAIN OUTCOME MEASURES: Clinical PRs and complications after both
      insemination methods. RESULTS: The clinical PR per treatment cycle was 7%
      (13/191) after transuterotubal insemination and 7% (16/223) after IUI. The
      overall PR per patient was 18% (29/160). The incidence of ectopic pregnancy was 1
      in 191 for transuterotubal insemination cycles and 0 in 223 for IUI cycles. Other
      complications included 3 vasovagal episodes with transuterotubal insemination and
      1 with IUI. There was no clinical evidence of tubal infection, trauma, or
      perforation in either group. CONCLUSION: Transuterotubal insemination did not
      appear to be associated with a higher PR when compared with IUI in this study.
      The potential for increased risk from complications related to the more invasive
      tubal technique does not appear to justify its use presently.

PMID- 1624001
TI  - Internal quality control of semen analysis.
AB  - OBJECTIVE: To test a scheme for quality control of semen analysis. DESIGN: The
      reproducibility of assessment of sperm concentration, motility, and morphology
      was obtained for the same sample measured by different technicians (between or
      intertechnician variation) and for different samples assessed by each technician
      with time (within or intratechnician variation). SETTING: Andrology Laboratory.
      PATIENTS: Semen samples were analyzed from all patients attending the clinic.
      INTERVENTIONS: None. MAIN OUTCOME MEASURES: Within technician and between
      technician coefficients of variation for concentration, motility, and morphology.
      RESULTS: When 100 sperm were routinely assessed, both intratechnician variation,
      as assessed from the precision of duplicate measurements, and intertechnician
      variation revealed hyperbolic curves with increasing variation at low percentages
      (less than 20) of motile or morphological forms. When these low values were
      excluded, mean intratechnician variations were 5.0%, 8.4%, and 2.8% for
      concentration, motility, and morphology, respectively, and mean intertechnician
      variations were, respectively, 6.1%, 5.6%, and 5.6%. Similar mean intertechnician
      variation for morphology was obtained for repeated assessment of prestained
      (7.3%) or presmeared (5.9%) slides. The use of cryopreserved semen to monitor
      longitudinal changes in the technicians' assessments revealed variations of 8.1%
      to 12% in concentration and 9.7% to 14% in motility. Computing the monthly means
      for sperm concentration, motility, and morphology over a 4.5-year period revealed
      a marked reduction in percentage of normal morphological forms, unrelated to the
      sperm count or mean age of the men attending the clinic. This was shown to be a
      result of a shift in the assessment by technicians. CONCLUSIONS: Quality control
      is necessary and possible in an andrology clinic.

PMID- 1624002
TI  - Spermatozoal characteristics from fresh and frozen donor semen and their
      correlation with fertility outcome after intrauterine insemination.
AB  - OBJECTIVE: To determine if conventional sperm parameters, specific
      characteristics of sperm motion determined by computer-aided semen analysis
      (CASA), sperm penetration assay (SPA), and/or spontaneous acrosome reaction assay
      could best predict fertility outcome after intrauterine insemination (IUI) from
      frozen donor sperm. DESIGN: A retrospective analysis of 2,245 cycles of
      therapeutic donor IUIs were initially studied; 1,147 cycles that met selection
      criteria were used in this report. SETTING: A university-based assisted
      reproductive technology center. PATIENTS, PARTICIPANTS: All IUIs were performed
      on women with documented patency of at least one fallopian tube, ovulatory
      cycles, and who did not receive human menopausal gonadotropins. Sperm donors had
      to be used for at least four different recipients (mean of 15) and at least 14
      different cycles of insemination (mean of 41). INTERVENTIONS: None. MAIN OUTCOME
      MEASURE: Pregnancy. RESULTS: Statistical comparisons were made between donors of
      different relative fertility by using the Mann-Whitney test, Spearman's rank
      correlation, and multiple regression analysis. These analyses demonstrated that
      the most significant predictors of the fertility of frozen-thawed donor sperm
      were curvilinear velocity, straight line velocity, and the total number of motile
      sperm inseminated. The number of sperm with spontaneous acrosome reactions
      negatively correlated with fertility outcome, and SPA provided no predictive
      value. CONCLUSIONS: Our study supports the hypothesis that the study of sperm
      motion characteristics using CASA after thawing and washing of cryopreserved
      sperm is a better predictor of fertile outcome after IUI than analysis of fresh
      semen.

PMID- 1624003
TI  - Failure to fertilize in vitro in couples with male factor infertility: what next?
AB  - OBJECTIVE: To assess the predictive value of a failure to fertilize in vitro in
      couples with sperm abnormalities on future fertility. DESIGN: Retrospective file
      review. SETTING: In vitro fertilization and embryo transfer (IVF-ET) program in
      the Sheba Medical Center during the years 1983 to 1990. PATIENTS: Seventy-six
      couples with sperm abnormalities who had at least one IVF cycle during which
      fertilization did not occur. INTERVENTIONS: None. MAIN OUTCOME MEASURES:
      Occurrence of fertilization, percentage of fertilization, and pregnancies in
      additional IVF-ET cycles. RESULTS: Of 44 couples who underwent an additional IVF
      attempt with husband's sperm, 36 (81.2%) fertilized, with a mean fertilization
      rate of 47.7% +/- 26.6%. Of 17 couples who failed twice, 11 attempted IVF again
      with husband's sperm and 7 fertilized, with a median rate of 33%. A higher sperm
      concentration was found on the cycles during which fertilization occurred. Men
      with single parameter abnormalities did not fertilize better than those with two
      or three defective parameters. CONCLUSIONS: Failure to fertilize in vitro in
      couples with male factor infertility does not seem to predict future
      fertilization in IVF. At least two cycles of IVF should be tried before reverting
      to other options such as insemination by donor sperm or gamete micromanipulation.

PMID- 1624004
TI  - Early pregnancy wastage: the role of repetitive human chorionic gonadotropin
      supplementation during the first 8 weeks of gestation.
AB  - OBJECTIVE: To determine if repetitive administration of hCG causes decreased
      pregnancy wastage rates in patients who are at a high risk of luteal inadequacy.
      DESIGN: Ovulation induction using human menopausal gonadotropin (hMG)/human
      chorionic gonadotropin (hCG) or clomiphene citrate (CC) is associated with luteal
      phase defects that may cause increased pregnancy wastage. An increased risk of
      abortion exists also in pregnancies in patients with previous repeated
      miscarriage, women older than 37 years, and various causes of infertility such as
      hyperprolactinemia. Because the presumed common denominator to the increased rate
      of pregnancy wastage in all these cases is luteal dysfunction, repetitive hCG
      administration, 2,500 U two times weekly, was carried out between the 4th and 8th
      week of gestation in 249 cases of ovulation induction and/or previous abortions,
      whereas 198 gestations served as controls (no hCG administration). RESULTS: In
      the hCG treatment group, 43 ended in miscarriage (17.3%) versus 97 abortions in
      the control group (49%, P less than 0.01). In 160 cases of hMG/hCG generated
      gestations, 94 received hCG and 66 did not. The pregnancy wastage rates were
      21.3% and 42.4%, respectively (P less than 0.05). In 144 cases of CC/hCG-induced
      pregnancies, 95 received hCG and 49 served as controls. The respective abortion
      rates were 15.8% and 44.8% (P less than 0.01). The remaining 143 spontaneous
      conceptions occurred in infertile patients with previous repeated abortions. In
      60 of these conceptions, hCG was administered during the first 4 weeks of
      gestation and 83 cases served as control. The pregnancy wastage rates were 13.3%
      versus 56.6%, respectively (P less than 0.001). CONCLUSION: Repetitive
      administration of hCG during the early gestation in cases that are at high risk
      of luteal inadequacy may significantly decrease the pregnancy wastage rate.

PMID- 1624005
TI  - Ultrastructure of human sperm in men with congenital absence of the vas deferens:
      clinical implications.
AB  - OBJECTIVE: To determine the ultrastructural features of epididymal and vasa
      efferentia sperm in men with congenital absence of the vas deferens. DESIGN:
      Prospective. SETTING: University of California Irvine Center for Reproductive
      Health. PATIENTS: Thirteen men with surgical diagnosis of congenital absence of
      the vas deferens undergoing epididymal and vasa efferentia aspiration for
      assisted reproductive technology procedures. RESULTS: The morphological quality
      and the integrity of the spermatozoa aspirated from the extratesticular segment
      of the rete testis, the vasa efferentia, and the caput epididymis were always
      markedly superior to those of sperm aspirated from the corpus and cauda
      epididymis, where the vast majority, if not all, were degenerating or frankly
      necrotic. The aspirates obtained from the distal segments of the epididymis also
      contained large numbers of sperm-laden macrophages; these were instead absent or
      exceptional in the fluids aspirated from the pre-epididymal portions of the
      excurrent pathways and from the caput of the epididymis. CONCLUSIONS: This study
      demonstrates that the ultrastructural morphology of spermatozoa obtained by
      aspiration from the rete testis, vasa efferentia, and caput epididymis of
      individuals with congenital absence of the vas deferens is indistinguishable from
      that of spermatozoa in the semen.

PMID- 1624006
TI  - Improved fertilization rate in an in vitro fertilization program by egg yolk
      treated sperm.
AB  - High fertilization and PRs have been achieved by using thawed donor sperm
      cryopreserved with medium containing EY. The aim of our study was to examine the
      possible effect of EY on the fertilizing capacity of fresh sperm in an IVF
      program. Preincubation of spermatozoa in EY for 2 hours at room temperature
      significantly improved fertilization (P less than 0.001) in couples who had low
      fertilization rates in previous cycles, whereas no effect was found concerning
      couples with high fertilization rates.

PMID- 1624007
TI  - White blood cell immunization and anticardiolipin antibody levels in women with
      recurrent miscarriages.
AB  - To determine whether WBC immunization stimulates production of anticardiolipin
      antibodies, anticardiolipin antibodies were measured before and 6 weeks after WBC
      immunization. Twenty-four non-pregnant women, who had had recurrent miscarriages
      for which a definitive cause could not be determined, were immunized with their
      partner's WBC. No significant differences in levels of anticardiolipin antibodies
      were detected between paired samples of sera obtained before and 6 weeks after
      WBC immunization. White cell immunization in nonpregnant women did not stimulate
      production of anticardiolipin antibodies.

PMID- 1624008
TI  - Concurrent hyperprolactinemia and sperm autoimmunity in a man with secondary
      infertility.
AB  - A case is presented of secondary infertility due to the concurrence of sperm
      autoimmunity and hyperprolactinemia. Treatment of his hyperprolactinemia with
      bromocriptine did not improve his fertility; however, concurrent treatment of
      both conditions resulted in improved semen quality, conception, and the birth of
      a healthy baby girl.

PMID- 1624009
TI  - Recurrence of myomas after myomectomy in women pretreated with leuprolide acetate
      depot or placebo.
AB  - The recurrence of myomas and myoma-related symptoms was evaluated in women
      participating in a randomized, double-blind, P-controlled study of the efficacy
      of LA depot before myomectomy. After 27 to 38 months of follow-up, the recurrence
      of myomas was found to be greater when at least four myomas were resected. Myoma
      recurrence was not associated with pretreatment or preoperative uterine volume,
      resected myoma mass, or preoperative medical therapy.

PMID- 1624010
TI  - The effect of varicocelectomy on testicular volume in 89 infertile adult males
      with varicoceles.
AB  - The presence of a varicocele has been associated with reduced testicular volumes
      both in the adult and pediatric patient populations. An increase in testicular
      volume after varicocelectomy, however, has been documented only in the latter
      group and then only in the ipsilateral testicle. We present our experience with
      89 infertile male patients with varicoceles who underwent operative repair. An
      increase in testicular volume was observed in 72 of the 89 patients, with the
      right side showing a greater increase, regardless of whether bilateral or
      unilateral left varicoceles were present preoperatively. No greater increase in
      testicular volume was noted among the patients who went on to achieve a pregnancy
      with their spouses. In addition, the age of the patient did not influence the
      observed change in testicular volume. No correlation between varicocele grade and
      pregnancy nor between improvement in semen parameters and improvement in
      testicular volume could be demonstrated.

PMID- 1624011
TI  - Successful clinical application of laser for micromanipulation in an in vitro
      fertilization program.
AB  - This is a report of our preliminary experience with assisted hatching by laser
      with a case of an ongoing twin pregnancy. We used an erbium laser to create a 20
      to 30-micrometer opening in the zona pellucida of human embryos to facilitate the
      embryonic hatching after the embryo transfer. Our report proves that it is
      possible to obtain a pregnancy using a simple and quick laser method instead of
      mechanical or chemical procedures within the scope of micromanipulation.

PMID- 1624012
TI  - Early diagnosis of ovarian torsion by color Doppler ultrasonography.
AB  - Ovarian torsion is often difficult to diagnose because of the nonspecific nature
      of the clinical findings. We report on the use of color Doppler ultrasonography
      in diagnosing early ovarian torsion. This technique provides a highly specific
      finding, the absence of blood flow to the ovary, that greatly facilitates the
      diagnosis of ovarian torsion.

PMID- 1624013
TI  - Ovarian failure and G-proteins--do we really need to know how they work?

PMID- 1624014
TI  - A simpler technique for reduction of uterine septum.

PMID- 1624015
TI  - Visual diagnosis of endometriosis--reliability?

PMID- 1624016
TI  - Reliability of the visual diagnosis of ovarian endometriosis?

PMID- 1624017
TI  - Value of sperm filtration?

PMID- 1624018
TI  - Defective oocytes: a new subgroup of unexplained infertility.
AB  - OBJECTIVE: To define a new category of unexplained infertility and its potential
      treatment. DESIGN: Normal infertile couples underwent prospectively, cross
      fertilization attempts in which the wife's oocytes were inseminated by the
      husband and donor semen. After recurrent failure of fertilization, cross
      insemination of donor oocytes was attempted with the husband sperm. SETTING: In
      vitro fertilization unit at a teaching hospital. PATIENTS: Three couples who were
      diagnosed as suffering of unexplained infertility and treated by in vitro
      fertilization (IVF). RESULTS: The female partner of these couples produced
      morphologically normal oocytes that were demonstrated to be functionally
      defective and failed to fertilize in vitro with both husband and donor sperm.
      Donated oocytes inseminated by the husband's sperm were fertilized in all
      patients, demonstrating the normal fertilizing ability of the husbands' semen.
      One patient conceived and delivered after an oocyte donation. CONCLUSIONS:
      Conclusive diagnosis of defective oocytes as a cause of infertility may be made
      only after IVF and oocyte donation.

PMID- 1624019
TI  - Superovulation with human menopausal gonadotropins in the treatment of
      infertility associated with minimal or mild endometriosis: a controlled
      randomized study.
AB  - OBJECTIVE: To determine the efficacy of superovulation with buserelin acetate,
      human menopausal gonadotropins (hMG), and human chorionic gonadotropin (hCG) in
      the treatment of infertility associated with minimal or mild endometriosis.
      DESIGN: Prospective, randomized, controlled study. SUBJECTS: Forty-nine infertile
      women with a laparoscopic diagnosis of endometriosis stage I (n = 29) or II (n =
      20) according to the revised American Fertility Society classification, randomly
      assigned to three superovulation cycles (n = 24) or 6 months' expectant
      management (n = 25). MAIN OUTCOME MEASURES: Cycle fecundity rates and cumulative
      pregnancy rates (CPR) in the two groups. RESULTS: Nine pregnancies were obtained
      in the superovulation-treated patients and six in the nontreated ones. The cycle
      fecundity rates and CPR were 0.15% and 37.4% after three superovulation cycles
      and 0.045% and 24% after 6 months of expectant management (P less than 0.05 and P
      = not significant, respectively). The women who did not achieve a pregnancy after
      three cycles of superovulation were followed for a total of 50 months during
      which no therapy was given. One pregnancy started in this period (cycle fecundity
      rate = 0.020). One spontaneous abortion occurred in each group. Three treated
      patients had multiple pregnancies, and four had ovarian hyperstimulation
      syndrome. CONCLUSION: Superovulation seems to be associated with a better cycle
      fecundity rate but not a better CPR than expectant management in infertile women
      with endometriosis stages I and II. The efficacy and side effects of this
      therapeutic approach should be evaluated in larger series.

PMID- 1624020
TI  - Ovarian responses to menopausal gonadotropins in groups of patients with
      differing basal growth hormone levels.
AB  - OBJECTIVE: To investigate the relationship between endogenous serum levels of
      human growth hormone (hGH) and ovarian response to human menopausal gonadotropins
      (hMG). DESIGN: Retrospective analysis of patient response to hMG. SETTING: Center
      for assisted reproductive technology. PATIENTS: Eighty women who had undergone
      controlled ovarian hyperstimulation with hMG. Basal levels of hGH in sera from 40
      of these patients were less than 5.0 microIU/mL (low hGH), values for the
      remaining 40 were greater than 5.0 microIU/mL (high hGH). Levels of hGH in day 2
      sera were analyzed against numbers of oocytes recovered in an additional 182
      patients. MAIN OUTCOME MEASURES: Serum estradiol (E2) levels and numbers of
      oocytes recovered at oocyte pick-up. RESULTS: Average (+/- SE) levels of hGH in
      sera of high-hGH and low-hGH patients were 10.2 +/- 0.6 and 2.47 +/- 0.3
      microIU/mL, respectively (P less than 0.05). Respective peripheral levels of
      insulin-like growth factor-I were 105.3 +/- 2.9 and 97.2 +/- 2.8 ng/mL. Levels of
      E2 in serum of high-hGH patients exceeded respective (P less than 0.05) low-hGH
      values throughout folliculogenesis, and more oocytes were recovered from high-hGH
      patients (8.1 +/- 0.9 versus 4.7 +/- 0.5 for low-hGH patients; P less than 0.05).
      Serum progesterone values did not differ. Higher day 2 hGH levels were associated
      with higher numbers of oocytes recovered after controlled ovarian
      hyperstimulation. CONCLUSIONS: The present findings indicate that endogenous hGH
      may augment gonadotropins during follicle recruitment and during multiple
      folliculogenesis in women. The phase of maximum ovarian sensitivity to
      hGH/gonadotropin synergism and the nature of synergism remain unclear.

PMID- 1624021
TI  - Polycystic ovaries in patients with hypogonadotropic hypogonadism: similarity of
      ovarian response to gonadotropin stimulation in patients with polycystic ovarian
      syndrome.
AB  - OBJECTIVE: To characterize the ovarian response in patients with isolated
      hypogonadotropic hypogonadism with ultrasound (US) findings of polycystic ovaries
      (PCO). DESIGN: Twenty-seven treatment cycles in patients with hypogonadotropic
      hypogonadism and US findings of normal ovaries were compared with 31 cycles in
      patients with hypogonadotropic hypogonadism and US-diagnosed PCO. Forty-one
      cycles in the hypogonadotropic hypogonadism and US-diagnosed PCO were compared
      with 59 cycles of patients with polycystic ovarian syndrome (PCOS) to examine
      pattern of response after ovulation induction. SETTING: Specialist Reproductive
      Endocrine Unit. PATIENTS, PARTICIPANTS: Twenty hypogonadotropic patients in whom
      10 had US findings of PCO and 13 patients with PCOS. MAIN OUTCOME MEASURE: Serum
      estradiol (E2) concentration, number of leading follicles on US, cancellation,
      and pregnancy rate. RESULTS: Hypogonadotropic patients with US-diagnosed PCO had
      higher baseline ovarian volume (P less than 0.02) compared with patients with
      hypogonadotropic hypogonadism with normal ovaries. After ovarian stimulation, a
      higher mean serum E2 concentration (P less than 0.001), endometrial thickness (P
      less than 0.001), and increased number of leading follicles (P less than 0.0001)
      were found in hypogonadotropic patients with US-diagnosed PCO, compared with
      hypogonadotropic patients with US findings of normal ovaries. Patients with PCOS
      had a higher serum E2 concentration (P less than 0.008), although they were
      treated for fewer days (P less than 0.0001) and with fewer ampules of
      gonadotropin (P less than 0.001) compared with patients with hypogonadotropic
      hypogonadism with US-diagnosed PCO. CONCLUSIONS: We have characterized a group of
      hypogonadotropic patients with US findings of PCO, in which the ovarian response
      to ovulation induction was similar to patients with PCOS. The results have
      practical and theoretical implications for the etiology and treatment of patients
      with PCO.

PMID- 1624022
TI  - Prediction and prevention of ovarian hyperstimulation by monitoring endogenous
      luteinizing hormone release during purified follicle-stimulating hormone therapy.
AB  - OBJECTIVE: To elucidate whether early detection of premature luteinizing hormone
      (LH) release can be useful for prediction and prevention of ovarian
      hyperstimulation during purified follicle-stimulating hormone (FSH) therapy.
      DESIGN: Retrospective and prospective study. PATIENTS: Infertile women with
      polycystic ovarian syndrome. MAIN OUTCOME MEASURES: Correlation between rate of
      endogenous LH release and incidence of excessive ovarian enlargement. In the
      prospective study, LH was measured by fluorometric enzyme immunoassay to obtain
      real-time concentration. Maximal ovarian diameter by ultrasonography. RESULTS:
      The rate of excessive ovarian enlargement (greater than or equal to 60 mm) in
      cycles that were treated by a daily administration of purified FSH and
      accompanied by premature LH release was 83.3%. This rate was significantly higher
      than that in cycles without premature LH release (24.1%, P less than 0.001).
      Interruption of FSH administration or alternate day FSH administration in cycles
      with premature LH release reduced the rate of ovarian enlargement to 45.5% (P
      less than 0.05). CONCLUSION: Early detection of premature LH release is useful
      for prediction of ovarian hyperstimulation. Ovarian hyperstimulation can be
      reduced by modulating the dose of FSH and the interval of administration in
      cycles with premature LH release.

PMID- 1624024
TI  - Distribution of follicle-stimulating hormone and luteinizing hormone isoforms in
      sera from women with primary ovarian failure compared with that of normal
      reproductive and postmenopausal women.
AB  - OBJECTIVE: To demonstrate if molecular heterogeneity of gonadotropins correlates
      with the type of primary gonadal failure. DESIGN AND METHODS: Aliquots of sera
      from women with hypogonadism were subjected to gel filtration chromatography to
      be assayed for follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by
      the use of radioimmunoassay. Molecular weight (MW) of isoforms was calculated on
      a calibration curve obtained with molecular markers. The molecular variants were
      characterized on the basis of elution volume, MW, and partition coefficient.
      RESULTS: Chromatographic profile of sera from four women with natural menopause
      exhibited two FSH peaks of immunoreactivity and a heavier LH isoform. This
      pattern was different from that obtained in sera from women of reproductive age
      who presented a single peak that eluted after the corresponding standard. In six
      cases of idiopathic premature menopause and three more with gonadotropin
      resistant ovary, the chromatographic profile showed a marked and remarkable
      molecular heterogeneity, particularly LH, and this was more apparent in women
      with resistant ovary. CONCLUSIONS: Our investigation confirms the relationship
      between the gonadotropin heterogeneity with the gonadal failure. The duration of
      the ovarian failure may influence the molecular proportion of gonadotropins and
      the predominance of heavier MW isohormones.

PMID- 1624023
TI  - Pulsatile secretion of gonadotropins and prolactin during the follicular and
      luteal phases of the menstrual cycle: analysis of instantaneous secretion rate
      and secretory concomitance.
AB  - OBJECTIVE: To characterize the pulsatile secretions of luteinizing hormone (LH),
      follicle-stimulating hormone (FSH), and prolactin (PRL) during the menstrual
      cycle and to statistically evaluate their secretory concomitance. DESIGN:
      Pulsatility study performed during the midfollicular and midluteal phases of a
      same menstrual cycle, blood samples being collected every 10 minutes for 6 hours.
      SETTING: Participants investigated in the Division of Endocrinology, University
      Hospital. PARTICIPANTS: Nine healthy women (22 to 38 years) with regular
      menstrual cycles. MAIN OUTCOME MEASURES: Plasma LH, FSH, and PRL values were
      analyzed as raw and deconvoluted data, and the specific (nonrandom) secretory
      concomitance was evaluated statistically. RESULTS: The pulsatile secretion of LH
      was confirmed, and that of FSH and PRL was clearly established during both phases
      of the cycle by characterization of peak frequency, period, and amplitude. A
      specific secretory concomitance was assessed between LH and FSH in the follicular
      but not the luteal phase, and a tight concomitance between LH and PRL was
      demonstrated during both phases. CONCLUSIONS: These results are supportive of
      significant pulsatile secretions of the three hormones during the menstrual
      cycle, and they are demonstrative of a definite copulsatility of these hormones,
      suggestive of common regulatory factors in the complex temporal patterns of
      gonadotropin and PRL secretions along the cycle.

PMID- 1624025
TI  - Efficacy of a low-dose leuprolide acetate depot in the treatment of uterine
      leiomyomata in Japanese women.
AB  - OBJECTIVE: To compare the efficacy of two different doses, 1.88 mg and 3.75 mg,
      of a monthly depot injection of a gonadotropin-releasing hormone agonist (GnRH-a)
      in the treatment of uterine leiomyomata. DESIGN: A prospective randomized study.
      SETTING: Hospital department of gynecology and obstetrics. PATIENTS: Forty-one
      premenopausal Japanese women, 25 to 53 years of age, with uterine leiomyomata.
      INTERVENTIONS: Depot type of GnRH-a, leuprolide acetate (LA) 1.88 mg or 3.75 mg
      was administered subcutaneously every 4 weeks for 24 weeks. MAIN OUTCOME
      MEASURES: Efficacy of treatment was assessed in terms of uterine volume, serum
      levels of estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone
      (FSH), and adverse symptoms during treatment. RESULTS: In both groups, a
      significant reduction in uterine volume, 52% in 1.88 mg group and 47% in 3.75 mg
      group, was obtained at week 24, with near maximal reduction (41%, 45%) apparent
      by 12 weeks. No significant difference was observed between the groups in percent
      uterine volume reduction at each treatment week. Both groups showed significant
      and equal suppression of serum levels of E2, LH, and FSH. In addition, the
      incidence of adverse symptoms was not significantly different between the two
      groups. CONCLUSIONS: Monthly injection of 1.88 mg or 3.75 mg LA depot has
      equivalent treatment efficacy in reducing uterine volume. Twelve weeks of
      treatment is enough to obtain near maximal reduction.

PMID- 1624026
TI  - Clinical history and outcome of 59 patients with idiopathic hyperprolactinemia.
AB  - OBJECTIVE: To investigate the clinical course of hyperprolactinemia without
      demonstrable cause. DESIGN: Prospective study of all patients with idiopathic
      hyperprolactinemia first seen between 1974 and 1985. SETTING: Outpatient
      Department of University Hospital. PATIENTS: Fifty-nine patients followed for 6
      to 190 months (median 78 months). Medical treatment given only in case of
      anovulatory infertility or hypogonadism. OUTCOME MEASURES: Development of
      pituitary (micro)prolactinoma, prolactin (PRL) levels, and clinical signs of
      menstrual dysfunction. RESULTS: With exception of one woman in whom it probably
      had been missed by hypocycloidal tomography, no demonstrable prolactinoma
      developed. Prolactin levels rose in two patients, one using oral contraceptives
      and the other with prolactinoma. At the end of follow-up, 15 of 16 patients using
      a dopaminergic drug had a normal cycle; 13 had normal final PRL levels. From the
      43 patients off medication, 28 (66%) had normal PRL levels and 23 (54%) had a
      normal cycle. There were no significant differences between women who had and had
      not been pregnant. Dopaminergic medication had no appreciable influence on the
      course of the disease. CONCLUSION: In idiopathic hyperprolactinemia, progression
      to pituitary prolactinoma seldom, if ever, occurs. There is a high tendency to
      spontaneous cure, and pregnancy or medication have no apparent effect. Frequent
      pituitary imaging was found to be not necessary in our patient population. It may
      best be reserved for situations in which the PRL level in symptomatic
      hyperprolactinemia is inconsistent with pituitary imaging results.

PMID- 1624027
TI  - On the nature of serum prolactin in two patients with macroprolactinemia.
AB  - OBJECTIVE: To further characterize the high molecular weight (MW) forms of
      prolactin (PRL) present in patients with macroprolactinemia. DESIGN: Case reports
      with laboratory investigations. SETTING: Academic medical centers. PATIENTS: Two
      patients with macroprolactinemia. INTERVENTIONS: Measurements of PRL
      concentrations before and after chromatographic separations. RESULTS: The
      majority of serum PRL had an estimated MW of at least 669 kd in the first patient
      and approximately 171 kd in the second. During a pregnancy, a new form of PRL (MW
      291 kd) appeared in the first patient's serum and persisted for at least 3 years.
      Immunoprecipitation and polyacrylamide gel electrophoresis under reducing and
      denaturing conditions revealed that the largest form of PRL (MW 669 kd) was
      composed mostly of 25 kd glycosylated PRL; intermediate forms (171 kd and 291 kd)
      were composed of roughly equal portions of 25 kd glycosylated PRL and 23 kd
      nonglycosylated PRL, whereas "little" PRL in these patients was composed
      primarily of 23 kd nonglycosylated PRL. Injection of the first patient's serum
      into rats demonstrated that the human PRL (hPRL) immunoreactivity was cleared
      from the serum more slowly than the PRL from sera containing predominantly little
      hPRL; after stimulation with thyrotropin-releasing hormone in the second patient,
      serum PRL concentrations decayed more slowly than observed in normal subjects.
      CONCLUSIONS: Large forms of serum PRL are at least partially glycosylated. These
      large forms are heterogeneous, both within and among patients. Delayed clearance
      may account for increased serum PRL concentrations in patients with
      macroprolactinemia.

PMID- 1624028
TI  - A comparison of the reproductive outcome between women with a unicornuate uterus
      and women with a didelphic uterus.
AB  - OBJECTIVE: To compare the reproductive performance of women with a unicornuate
      uterus with the reproductive performance of women with a didelphic uterus.
      DESIGN: Retrospective. SETTING: Reproductive endocrinology service of a tertiary
      referral hospital. MAIN OUTCOME MEASURES: The proportion of pregnancies resulting
      in spontaneous abortion, preterm delivery, term delivery, and living children was
      determined for each group. RESULTS: Twenty-nine women with a unicornuate uterus
      and 25 women with a didelphic uterus were identified. Twenty women with a
      unicornuate uterus produced a total of 40 pregnancies, whereas 13 women with a
      didelphic uterus produced a total of 28 pregnancies. The 33% spontaneous abortion
      rate in the unicornuate group was not significantly different from the 23% rate
      in the didelphic group. The proportion of pregnancies resulting in preterm
      delivery, term delivery, and living children was similar in both groups.
      CONCLUSIONS: The reproductive performance of women with a unicornuate uterus is
      similar to the performance of women with a didelphic uterus.

PMID- 1624029
TI  - Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis.
AB  - OBJECTIVE: To evaluate the diagnostic capability of transvaginal ultrasonography
      in detecting diffuse adenomyosis. DESIGN: We compared the preoperative
      transvaginal ultrasound (US) findings and the pathological findings of the
      surgical specimen in a series of women who underwent hysterectomy for
      menorrhagia. PATIENTS: Forty-three women (mean [+/- SD] age of 46 +/- 5) with
      recurrent menorrhagia and enlarged uterus, without evidence of uterine leiomyomas
      at abdominal US and of endometrial disease at vabra curettage. SETTING: Tertiary
      care center, university medical school. MAIN OUTCOME MEASURES: Sensitivity,
      specificity, predictive positive and negative values of transvaginal US in the
      diagnosis of diffuse adenomyosis. RESULTS: The sonographer diagnosed adenomyosis
      in 22 patients, whereas the pathologist found adenomyosis in 20 women, confirming
      the US findings in 16 cases and making an ex novo diagnosis in 4. The sensitivity
      of transvaginal US was 80%, the specificity 74%, the predictive value of a normal
      test 81%, and that of an abnormal test 73%. CONCLUSIONS: Transvaginal US seems to
      represent a real advance in the preoperative diagnosis of diffuse adenomyosis.

PMID- 1624030
TI  - Transvaginal intratubal methotrexate treatment of ectopic pregnancy.
AB  - OBJECTIVE: To evaluate the efficacy of transvaginal intratubal methotrexate (MTX)
      treatment of tubal ectopic pregnancy (EP). SETTING: Outpatient setting in
      University Hospital. PATIENTS: Forty women with early EP and rising serum beta
      human chorionic gonadotropin (beta-hCG) levels. INTERVENTION: Transvaginal
      intratubal administration of MTX (1 mg/kg body weight). MAIN OUTCOME MEASURES:
      Success was defined as declining serum beta-hCG to undetectable levels, no tubal
      dilatation on ultrasound examination, and no further intervention was required.
      RESULTS: Treatment was associated with a 70% success rate. No difference was
      found in the success rate between women with an embryo (76.9%) and those with no
      embryo in their fallopian tubes (66.7%). The initial serum beta-hCG levels were
      also not different between patients who were successfully treated and those who
      failed to respond to the treatment. Despite declining serum beta-hCG levels,
      tubal rupture occurred in two patients. CONCLUSIONS: Treatment of EP by
      transvaginal MTX administration is associated with a 70% success rate. This is
      independent of the presence of an embryo or the initial serum beta-hCG levels.
      Rupture of EP can still occur despite low and declining serum beta-hCG levels.

PMID- 1624031
TI  - The neonatal eye.

PMID- 1624032
TI  - Recent progress on the mechanisms of embryonic lens formation.
AB  - Formation of the lens during embryonic development depends on tissue interactions
      as shown clearly both from teratological data and from extensive experimental
      analysis. Recent work has, however, altered our view of the importance of
      particular tissue interactions for lens formation. While earlier work emphasises
      the role of the optic vesicle in lens induction, more recent studies argue that
      lens-inducing signals important for determination act before optic vesicle
      formation. Evidence is given for a four stage model in which ectoderm first
      becomes competent to respond to lens inducers. It then receives inductive
      signals, at least in part emanating from the anterior neural plate, so that it
      gains a lens-forming bias and subsequently becomes specified for lens formation.
      Complete lens differentiation does require signals from the optic vesicle, and in
      addition an inhibitory signal from head neural crest may suppress any residual
      lens-forming bias in head ectoderm adjacent to the lens.

PMID- 1624033
TI  - Cellular organisation of the optic nerve and the implications for optic neuritis.
AB  - Opportunities for studying growth, degeneration and repair in the central nervous
      system have altered over the last decade with the development of techniques for
      culturing neurones and glia and the availability of immunological or molecular
      markers that identify separate lineages and their progeny. Much pioneering work
      has been carried out in the rodent optic nerve but the principles that emerge are
      representative for other parts of the nervous system; development of neurones and
      glia may differ substantially in rats and man, so that assumptions must be made
      in extrapolating from properties of the rat optic nerve to diseases of the human
      central nervous system.

PMID- 1624034
TI  - Early visual development: differential functioning of parvocellular and
      magnocellular pathways.

PMID- 1624035
TI  - A morphological comparison of foveal development in man and monkey.
AB  - The fovea can first be identified in both monkey and human retina at 26-30%
      gestation as a region containing all adult retinal layers and only cone
      photoreceptors. A shallow foveal pit and cone outer segments appear by 63-65%
      gestation in both species. Prenatal development continues rapidly in the monkey,
      so that by birth a single layer of inner retinal neurons are present in the
      fovea, cones are three cells deep, inner segments are elongated, and outer
      segments are up to 50% of inner segment length. In contrast, human fovea does not
      reach a similar stage until several months after birth. The fovea is adult-like
      in monkey at 12 weeks and in human at 11-15 months, although human will mature
      further up to four to five years. This study shows that human fovea is less
      mature at birth than monkey but develops rapidly in infancy, suggesting that it
      may be even more susceptible to postnatal environmental influences than the
      commonly-used monkey model.

PMID- 1624036
TI  - Electrophysiological assessment of visual pathway function in infants.
AB  - The flash ERG and VEP have conspicuous immature features during the first 4
      months following birth. The most marked maturational changes occur in ERG
      amplitude and VEP latency. Concurrent recording of the skin ERG and VEP provides
      information which is very useful in helping to arrive at a diagnosis in the young
      infant with nystagmus who appears to be blind and has a fundus of normal
      appearance. ERG and VEP features associated with Leber's Amaurosis, congenital
      cone dysfunction, albinism, optic nerve hypoplasia and unilateral hemisphere
      dysfunction are described.

PMID- 1624037
TI  - Neonatal eye growth and emmetropisation--a literature review.
AB  - The refractive development of the neonatal eye has been the subject of much study
      and debate. In this paper the hypothetical mechanisms of emmetropisation and
      their relationship to the development of refractive errors will be reviewed. The
      evidence supporting visual feedback control of eye growth will be described, and
      the role of ocular accommodation will be discussed.

PMID- 1624038
TI  - The premature retina: a model for the in vivo study of molecular genetics?
AB  - Retinopathy of prematurity is a disease of developing blood vessels. Although it
      is seen predominantly in premature infants requiring life support systems to
      survive, it does occur in full-term infants, infants with hypoxia, cyanotic heart
      disease and in stillborn infants. Although oxygen has been considered to be the
      prime aetiologic agent, evidence for this, particularly in recent years, is not
      compelling. The timing of the occurrence of the disease is closely related to the
      conceptional age of the infant rather than weeks post birth, birth weight,
      gestational age at birth. In addition, the case to case similarity of the
      disease, as well as the diverse cell types produced in unfavourable outcomes
      (cicatricial ROP), point to the possibility of an in utero insult to the clone of
      cells giving rise to the vascular endothelium providing blood supply to the
      neural retina.

PMID- 1624039
TI  - Light and the immature visual system.
AB  - Preterm neonates are cared for in an environment which is continuously and
      brightly lit, and is very different to that experienced at any other time of
      life. The amount of light reaching the neonatal eye is governed by two groups of
      factors. Physical factors include intensity, spectral characteristics and
      duration of light exposure. Physiological factors are: Frequency of eyelid
      opening, transmission of light through the closed eyelid, pupil reactivity and
      area, transmission by the ocular tissues and retinal surface area. Retinal
      irradiance declines with increasing postmenstrual age. Mechanisms by which light
      may affect the neonatal eye and clinical conditions in which light have been
      implicated are considered.

PMID- 1624040
TI  - Epidemiology of childhood blindness.

PMID- 1624041
TI  - Ocular teratology. Observations, speculations, questions, principles reaffirmed.
AB  - Teratology is most simply defined as "the study of environmental agents which
      disturb development". A more comprehensive definition is "the study of causes,
      mechanisms, and manifestations of developmental deviation, structural or
      functional." Teratology has several important purposes. Obviously, the most
      important is to protect future generations by identifying environmental agents
      that cause malformations. In this sphere, ophthalmologists are generally not the
      primary detectors. One notable exception is when Gregg, in 1941, recognised that
      an increase in congenital cataracts was due to a viral agent and brought rubella
      embryopathy to the attention of the medical community. Another pertinent reason
      for teratology is that it gives us insights into normal development. As Harvey
      said with such flair, "nature is nowhere accustomed more openly to display her
      secret mysteries than in cases where she shows tracings of her workings apart
      from the beaten path".

PMID- 1624042
TI  - Congenital extraocular muscular defects.

PMID- 1624043
TI  - Neonatal cataract: aetiology, pathogenesis and management.
AB  - We review the epidemiology, aetiology, pathogenetic mechanisms and clinical
      management of neonatal cataract. Visual development and the effects of visual
      deprivation in the infant with congenital cataract are discussed and related to
      the timing of surgery. Surgical techniques and the important operative and post
      operative complications are discussed. We review post-operative management and
      compare the different techniques available for aphakic correction, and describe
      the VEP changes found in patients with monocular cataract.

PMID- 1624044
TI  - Relapse following goniotomy for congenital glaucoma due to trabecular dysgenesis.
AB  - Three hundred and thirty-five eyes of 210 patients with congenital glaucoma due
      to trabecular dysgenesis were treated by goniotomy as the primary procedure in
      infancy. In 313 eyes (93.5%) glaucoma was controlled at one year following
      surgery. Using Kaplan Meier actuarial survival analysis we found that eyes
      controlled in infancy by one or more goniotomies are at risk of relapse of
      glaucoma for at least 15 years although 93% of eyes are still controlled five
      years after the initial surgery. Patients whose symptoms of congenital glaucoma
      presented at birth were more likely to relapse than those whose symptoms
      developed in the first few months of life. Eyes requiring multiple goniotomies in
      infancy were more likely to relapse than those controlled by a single procedure.

PMID- 1624045
TI  - Do we really understand the difference between optic nerve hypoplasia and
      atrophy?

PMID- 1624046
TI  - Intrauterine infection and the eye.

PMID- 1624047
TI  - Congenital lacrimal fistula.
AB  - Congenital lacrimal fistula is a rare developmental condition. Patients may be
      asymptomatic or have tearing from the fistula, the eye or both. The clinical
      features of 60 patients are reviewed, including presenting symptoms, presence of
      other lacrimal or systemic anomalies and morphology of the fistula. A detailed
      description is given of the surgical technique utilised in patients whose
      symptoms warrant surgical intervention. The results of this technique are
      presented and alternative treatment strategies are discussed. Theories of the
      aetiology of the condition are reviewed and morphological and histological
      evidence is presented to support our belief that congenital lacrimal fistulae
      represent aberrant canaliculi.

PMID- 1624048
TI  - Cryosurgery for acute retinopathy of prematurity: factors associated with
      treatment success and failure.
AB  - Cryosurgery for stage 3 plus acute retinopathy of prematurity (ROP) increases the
      probability of disease regression, but up to 25% of eyes may progress to retinal
      detachment and blindness in spite of treatment. In a series of 37 eyes in 23
      patients treated at the Hammersmith Hospital an overall 75% of eyes reached a
      favourable outcome. We present these results in detail and analyse the apparent
      causes of treatment failure. Poor anatomical results (total retinal detachment
      and traction detachment involving the macula) were associated with inappropriate
      cryoprobe design and with zone 1 and rush-type disease. Poor functional results
      in the presence of a largely flat retina (marked macular ectopia and high myopia)
      appeared to be associated with delayed treatment during the period of evolution
      of the stage 3 lesion, and with the appearance of a more highly differentiated
      vascular shunt with early localised forward vitreous invasion. Suggestions for
      the refinement of existing gradings of acute ROP are made.

PMID- 1624049
TI  - Vitamin E therapy in retinopathy of prematurity.
AB  - Vitamin E is a fat soluble antioxidant and as a result it is able to scavenge
      free radicals derived from oxygen. The premature infant and the retina are likely
      to be particularly vulnerable to the deleterious effects of these oxygen derived
      free radicals, and as a result prophylactic vitamin E has been suggested for the
      management of retinopathy of prematurity (ROP). However, despite numerous trials,
      prophylactic supplementation with vitamin E remains controversial. This paper
      will critically review the use of vitamin E in ROP and consider the risk/benefit
      relationship of such treatment in premature infants.

PMID- 1624050
TI  - How do retinoblastoma tumours form?
AB  - The causes of retinoblastoma (RB) can now be described with considerable
      accuracy, although many details are still unclear. Understanding the genetic
      changes leading to RB has provided an awareness of general mechanisms of cancer
      development and progression, previously only suspected. From the basic
      understanding have come new diagnostic technologies that are now ready to be
      applied directly to RB patients and their families, and a rational approach,
      based on this understanding, will help us to develop new therapies that avoid the
      severe complications of conventional treatment.

PMID- 1624051
TI  - Federal support for dental education?

PMID- 1624052
TI  - Local analgesia infiltration.

PMID- 1624053
TI  - Health and safety in the laboratory.

PMID- 1624054
TI  - Laboratory technique for the construction of large scale teaching models.

PMID- 1624055
TI  - Ultrasonic vocalizations by rat pups: the primary importance of ambient
      temperature and the thermal significance of contact comfort.
AB  - We investigated the effects of isolation, huddling, and air temperature on
      ultrasound production by rat pups. Experiment 1 showed that ultrasound production
      by 8- to 9-day-olds was minimal at thermoneutrality and increased in response to
      small deviations of air temperature on either side of the thermoneutral zone.
      Experiments 2 and 3 showed that suppression of ultrasound production by contact
      with littermates is consistent with the thermal consequences of huddling.
      Experiment 4 showed that, contrary to previous conclusions, ultrasound production
      is not independent of ambient temperature in pups older than 10 days of age.
      Taken as a whole, these experiments emphasize (1) the importance of ambient
      temperature for the elicitation of ultrasound by rat pups of all ages studied,
      (2) the importance of thermal factors in the suppression of ultrasound by
      littermate contact, and (3) the manner in which different methods can change
      interpretations of the behavior and physiology of infant rats.

PMID- 1624056
TI  - The effects of early social isolation on the motivation for social play in
      juvenile rats.
AB  - Fifteen-day-old rats were subjected to one of three housing conditions: mother
      and-peer (family), peer, and isolation conditions. At 24 days of age, all
      subjects were rehoused individually. In Experiment 1, play behaviors were
      monitored in like-raised pairs. Despite their gross lack of social experience,
      isolation-reared subjects did not exhibit a deficit in frequencies of rough-and
      tumble play. It is concluded that the fundamental motivation for rough-and-tumble
      play is relatively independent of prior learning in rats. Indeed, their elevated
      dorsal contacts suggested that isolation-raised subjects may have higher
      appetitive motivation for play. In Experiment 2, the levels of social motivation
      were compared between family- and isolation-raised animals, using a T-maze. The
      isolation-raised animals made reliably more choices for social interaction reward
      over food reward than family-raised animals. Although inconclusive, the results
      from the two experiments suggest that prolonged social isolation increases the
      appetitive motivation for social play.

PMID- 1624057
TI  - Blood pressure increases in response to feeding in the term neonate.
AB  - We studied blood pressure and heart rate of 18 medically well newborn babies
      before, during, and after feeding. Seven were breast-fed and 11 bottle-fed and
      all were studied between 24 and 92 hr of age. There was an increase in heart rate
      associated with sucking on a pacifier but no additional increase with feeding. By
      30-60 min after feeding, heart rate had returned to baseline value. Blood
      pressure, however, did increase in response to feeding and showed a greater
      increase in the breast-fed group than in the bottle-fed group. Systolic blood
      pressure rose from 72 mmHg in the basal state to 85 mmHg during the first 3 min
      of feeding in the bottle-fed babies and from 73 to 99 mmHg during comparable
      periods in the breast-fed babies. The results for diastolic blood pressure were
      similar except that changes within the bottle-fed group were not statistically
      significant. Bottle-fed babies rose only from 42 to 47 mmHg while breast-fed
      babies rose from 42 to 61 mmHg from basal conditions to feeding. Blood pressure
      responses to feeding may have implications for susceptibility to necrotizing
      enterocolitis, for future blood pressure liability in adulthood and for later
      hypertensive disease.

PMID- 1624058
TI  - Faces as reinforcers: effects of pairing condition and facial expression.
AB  - The reinforcing properties of faces were investigated in two experiments in which
      tones were first paired with an adult female face and subsequently tested for
      their ability to potentiate visual fixation when compounded with a checkerboard
      pattern. In Experiment 1, infants who had been presented six pairings of a 65-dB,
      1000-Hz tone with a smiling face later fixated a checkerboard pattern
      significantly more when it was compounded with the tone than when it was tested
      alone. Infants in random and backward controls fixated the checkerboard pattern
      roughly equal amounts in the presence absence of the tone, and infants in a no
      tone control did not exhibit a novelty response when shifted from the face to the
      checkerboard pattern. In Experiment 2, facial expression was varied across groups
      and the effects on conditioning of a 65-dB tone that immediately preceded the
      face were studied. On test trials, greater fixation in the presence of the tone
      than in its absence was observed when a smiling or a surprised expression was
      presented, but not when a neutral expression was presented. Differences scores
      (fixation on tone minus no tone test trials) were significantly greater than zero
      in the smiling and surprised conditions, and significantly greater in the
      surprised condition than in the neural condition. These findings demonstrate the
      feasibility of a conditioned visual fixation paradigm for the study of the
      reinforcing properties of faces and of infant associative learning in general,
      and suggest that the expression portrayed by a face contributes to its
      effectiveness as a reinforcer.

PMID- 1624059
TI  - Analysis of the expression of a glucose-regulated protein (GRP78) promoter/CAT
      fusion gene during early Xenopus laevis development.
AB  - Developmental regulation of the expression of a glucose-regulated gene encoding a
      78 kd protein, GRP78, has been characterized by microinjection of a rat GRP78/CAT
      chimeric gene into early Xenopus embryos. Tunicamycin-induced expression of the
      chimeric gene during Xenopus development was similar to the pattern of endogenous
      GRP78 protein synthesis, with expression first being detected at gastrula and
      increasing at least until the tailbud stage. Deletion analysis of the rat GRP78
      promoter revealed that sequences between -154 and -130 were necessary for full
      tunicamycin-inducible and constitutive expression of the fusion gene. These
      results suggest that there is conservation of regulatory elements of the GRP78
      promoter between rat and Xenopus.

PMID- 1624060
TI  - In vitro regulation of the innervation pattern of quail muscle fibers by quail
      and mouse neurons.
AB  - Myoblasts from rudiments of slow and fast muscle, anterior latissimus dorsi (ALD)
      and posterior latissimus dorsi (PLD) respectively, of 9-day-old quail embryos
      were cultured in vitro for a period of up to 60 days in order to give rise to
      well-differentiated muscle fibres. These fibres were innervated by neurons from
      either quail or mouse embryo spinal cord and their innervation pattern was
      examined by the visualization of acetylcholine receptors (ACh-R) and of
      acetylcholinesterase (ACh-E) activity at the neuromuscular contacts. In the
      culture system used, quail neurons always innervated muscle fibres at several
      sites and only when a fast-type activity was imposed on these neurons did a
      reduction in the number of the previously established neuromuscular contacts take
      place. In contrast, in the muscle fibres innervated by mouse neurons, a
      spontaneous reduction in the number of the previously established neuromuscular
      contacts occurred but this spontaneous reduction depended upon the level of
      differentiation reached by the muscle fibres in vitro. In the cultures of muscle
      fibres previously innervated by mouse neurons, the addition of quail neurons did
      not provoke any modification in the initial innervation pattern, and no quail ACh
      R cluster was observed. In contrast, in the muscle fibres previously innervated
      by quail neurons, the mouse neurons contacted these fibres, resulting in a
      decrease in the number of quail ACh-R clusters. These results emphasize the part
      played by neurons in the establishment of the innervation pattern when muscle
      fibres have reached a high level of differentiation. In vitro, the slow and fast
      characteristics of the muscle fibres do not influence this pattern.

PMID- 1624061
TI  - Immunohistochemical localisation of monoclonal antibody R 24-recognized
      ganglioside Glac2 in early chick embryos.
AB  - The spatio-temporal cellular expression and biosynthesis of ganglioside Glac2 was
      investigated in early chick embryogenesis. For demonstration of embryonic Glac2
      biosynthesis, chick embryos of stage 0 and of stages 4-5 were incubated in vitro
      in the presence of radioactive sugar precursors. It was found that chick embryos
      synthesize Glac2 as early as at the blastula stage as well as at the gastrula
      stage, both within the area pellucida and the area opaca. In contrast to the
      biosynthetical findings immunohistochemical staining of the chick embryos at
      various stages by aid of the mouse monoclonal antibody (mAb) R 24, specific for
      the immunoepitope NeuAc alpha, 8NeuAc alpha, 3Gal beta less than, as present on
      the ganglioside Glac2, revealed a spatio-temporal cellular pattern of expression
      of this ganglioside in early chick embryos. Immunohistochemical staining of the
      chick embryo at stage 0 shows that all cells of the embryo, the extraembryonic
      epiblast and the yolk endoderm included, are mAb R 24-positive. At the
      intermediate streak stage (stage 3), the cranial part of the deep layer, the so
      called endophyll, is strongly mAb R 24-positive, whereas at the end of
      gastrulation (stage 5), mAb R 24-recognized epitopes appear to be restricted to a
      narrow band of deep-layer cells in the endophyllic crescent and to the yolk
      endoderm of the area opaca. At this stage, no labelling by the antibody is
      observed in cell layers of the future embryo. The beginning of neurulation (stage
      7) is characterized by the expression of the mAb R 24-recognized epitope in the
      notochord, whilst the deep layer in the cranial part of the neural fold still
      expresses this epitope. No ecto- or mesodermal structures are stained by the
      antibody at this developmental stage. During further development (stage 12 and
      13), mAb R 24-reactivity is restricted to the cranial part of the embryo with a
      preferential staining of cells of endodermal origin. At these stages, the
      notochord expresses mAb R 24 binding sites only in its cranial region. The
      spatial and temporal correlation between the presence of mAb R 24-recognized
      epitopes and the morphogenetic positioning of tissues may be indicative for a
      possible role of the ganglioside Glac2 in corresponding cellular interactions.

PMID- 1624062
TI  - [The role of the author in biomedical journals--I].

PMID- 1624063
TI  - [The enigma of mild hypertension].

PMID- 1624064
TI  - [Tossing pebbles into a pond, or ethics seen by a heretic].

PMID- 1624065
TI  - [Further comments on the classification of stenocardia syndromes].

PMID- 1624066
TI  - [Left ventricular false tendon: the most frequent cause of "innocent" murmur in
      childhood?].
AB  - BACKGROUND: The left ventricular false tendon (FT) is an anomalous fibrous or
      fibromuscular band stretching across the left ventricle. The false tendons extend
      from the septum to the left ventricular free wall or, more rarely, from the
      septum to a papillary muscle. The association between FT and innocent cardiac
      murmur has been pointed out. The aim of the present study was to assess the
      incidence of FTs in children with a murmur classified as innocent. METHODS: Two
      groups of subjects were selected. Group A consisted of 253 children with: 1)
      systolic ejection murmur; 2) normal electrocardiogram and 3) absence of clinical
      data suggesting cardiac disease. Group B consisted of 240 children clinically
      free of cardiac disease, and without any cardiac murmur. A FT was diagnosed by
      means of 2D echocardiogram whenever a linear band stretching across the left
      ventricular chamber was evident in at least two sections. RESULTS: One hundred
      and sixty-one children of group A (63.6%) reflected a left ventricular FT; only
      in 3 patients out of 161 the FT was associated with a small ventricular septal
      defect, whereas in 158 children the FT was the only abnormal finding. A normal
      echocardiogram was observed in 71 children (28.1%) of group A; whereas in 21
      patients (8.3%) a congenital heart disease was diagnosed. In group B, only 33
      subjects (13.8%) had a FT. The different incidence of FT in the two groups (63.6%
      versus 13.8%) was statistically significant (p less than 0.01). CONCLUSIONS: The
      study shows that about two thirds of children with innocent heart murmur reflect
      a left ventricular FT. Furthermore, FT is far more common in subjects with
      innocent cardiac murmur than in normal subjects. The relationship between FT and
      murmur thus appears very likely, although not definitely proven.

PMID- 1624067
TI  - [Verapamil-induced gingivitis hypertrophica: a clinical case].

PMID- 1624068
TI  - [Asymptomatic aortic dissection associated with a mitral prosthetic leak: a
      clinical case report].
AB  - A case of aortic dissection ("DeBakey type III") in an asymptomatic 78-year-old
      woman is described. The patient underwent a mitral valve replacement
      (bioprosthesis Sorin) in June 1990 for severe mitral stenosis; in October 1990
      she was admitted to our hospital for severe dyspnea and cardiac failure with good
      response to medical treatment. The routine echo color Doppler examination showed
      only a hint of paraprosthetic leak, which required further investigation by
      transesophageal echocardiography. This approach revealed the presence of a
      regurgitant jet extending from the prosthetic mitral valve toward the atrial
      septum. The examination of the thoracic aorta revealed the presence of a
      dissection flap; the color Doppler technique showed a bidirectional flow through
      the site of communication between the two lumina. The extension of the dissection
      from the aortic arch to the origin of the renal branches was confirmed by
      computerized axial tomography. We emphasize the importance of the transesophageal
      approach in elderly patients with aortic dissection, often asymptomatic.

PMID- 1624069
TI  - [The pathogenesis of dilated cardiomyopathy: current progress].
AB  - The pathogenesis of dilated cardiomyopathy (DCM) is still unknown; however, some
      factors that seem to play an important role in the development of the disease
      have recently been identified: they are enteroviral infections, immune mechanisms
      and genetic factors. Enteroviral infection (particularly due to Coxsackie virus
      B) has long been suspected to be the cause of myocarditis and subsequent DCM.
      However, only recent techniques of genetic engineering have been able to
      demonstrate the presence of enteroviral RNA in endomyocardial biopsy of patients
      with DCM. The role of the viral particles contained in the myocardium is still
      undetermined. Changes in the immune system concerning cell-mediated and humoral
      immunity have been recently detected. It has been suggested that an autoimmune
      process could be the actual cause of DCM in some patients, rather than the
      consequence. The immune system is strictly related to the major
      histocompatibility complex. As in some autoimmune diseases, a relationship
      between DCM and HLA class II phenotype has been found: particularly the DR4
      antigen seems to be associated with a high risk of disease. Besides immunogenetic
      factors, other genetic factors seem to play a role in the pathogenesis of DCM. In
      6-8% of cases a familial history of cardiomyopathy has been observed. In clinical
      studies on familial DCM different phenotypes have been shown, suggesting that
      different genetic mechanisms are involved in the pathogenesis of the disease. At
      least two main mechanisms can be hypothesized: the transmission of "predisposing"
      factors or a defect in proteins essential for the cardiac muscle cell function.
      Viral agents, autoimmune reactions, immunogenetic and genetic factors seem to
      cause myocardial damage individually or with complex interactions: the research
      should be devoted to these topics in the future.

PMID- 1624070
TI  - [Idiopathic dilated cardiomyopathy: a persistent viral infection or an organ
      specific autoimmune disease? The trial of 2 major pathogenetic hypotheses].
AB  - Aetiology and pathogenesis of idiopathic dilated cardiomyopathy (DCM) are
      uncertain. The two major pathogenetic hypotheses are: 1) autoimmunity; 2)
      persistent viral infection. Indirect evidence for virus association comes from
      the finding of raised titres of antibody to coxsackievirus in DCM, but infectious
      virus has never been isolated in myocardium from DCM patients. Bowles et al.
      using the slot-blotting technique reported that enteroviral RNA was commonly
      detectable in the myocardium of patients with myocarditis (53%) and with DCM
      (52%). Other groups using this as well as more refined hybridization techniques
      have failed to confirm such a high prevalence. Detection of enteroviral genomic
      RNA in cardiac tissue does not, however, imply active infection or pathogenicity.
      Thus the mechanisms of chronic myocardial damage in the absence of whole
      competent infectious virus remain uncertain. The other major pathogenetic
      hypothesis in DCM involves autoimmune mediated damage to myocytes. Circulating
      organ specific autoantibodies have been reported in a quarter of a group of
      patients with idiopathic DCM. This suggests that there may be autoimmune
      mechanisms operating at least in this subset of patients, but the exact relation
      of these antibodies to the pathogenesis and prognosis needs to be defined. The
      abnormal expression of major histocompatibility complex class II antigens on
      cardiac microvascular endothelium in endomyocardial biopsy tissue from DCM
      patients, and the reported association with HLA-DR4 phenotype lend further
      support to the autoimmune hypothesis. The viral and the autoimmune hypothesis in
      chronic myocarditis and in DCM are not mutually exclusive. In experimentally
      murine virus-induced myocarditis infectious virus can no longer be recovered from
      the myocardium after two weeks, although nucleic acid sequences of the viral
      genome are still detectable. The development of chronic inflammation takes place
      only in mice with a predisposing genetic background. Chronic myocyte damage is
      associated with the production of circulating heart-specific autoantibodies and
      autoreactive lymphocytes. In this animal model chronic myocarditis appears to be
      a virus-triggered or precipitated autoimmune disease, rather than a persistent
      viral infection with tissue damage due to active virus synthesis and replication.
      A similar transition from acute myocarditis into DCM may occur in man.

PMID- 1624071
TI  - [Surgical revascularization in acute myocardial infarct].
AB  - To determine the potential role of emergency surgical revascularization as
      treatment of acute myocardial infarction (AMI), results in 79 patients undergoing
      operation for myocardial revascularization during AMI from January 1986 to
      January 1991 were reviewed. Clinical characteristics for inclusion in the study
      were: 1) emergency operation; 2) persistent angina not controlled by medical
      therapy; 3) fixed ST segment elevation until surgical procedure, independently
      from magnitude of enzymatic levels. The 79 patients were divided in 2 groups: 27
      with AMI or evolving AMI (Group 1); 52 with AMI due to complications during PTCA
      (Group 2). Twenty-eight patients had extremely severe clinical conditions. Mean
      interval between the beginning of AMI and operation was 4.2 +/- 6.7 hours, with a
      statistically significant difference between Group 1 (8.7 +/- 10.0) and Group 2
      (1.9 +/- 1.0). One hundred ninety-two grafts were performed (2.4 +/- 1.1
      grafts/patient). Overall hospital mortality was 10.1% (CL 6.7-13.3) (8 deaths)
      with a difference between Group 1 [18.5% (CL 10.7-25.3)] and Group 2 [5.8% (CL
      4.7-6.6)] (p = 0.074). The incidence of perioperative myocardial infarction was
      30.4% (CL 24.9-35.1) for that one in the area of ischemic muscle and 2.6% (CL 0.8
      4.1) for infarction in remote muscle. Multivariate analysis for the entire series
      (79 patients) identified as independent predictors of increased in-hospital
      mortality: preoperative cardiogenic shock (p = 1.000E-4) and hyperlipidemia (p =
      0.008). In Group 1 multivariate analysis identified as independent predictors of
      increased in-hospital mortality: the attempt of revascularization by PTCA and
      hyperlipidemia; in Group 2: preoperative need of mechanical ventilatory
      support.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624072
TI  - [HLA polymorphism in the susceptibility or resistance to dilated cardiomyopathy].
AB  - Much of the surrounding studies on the association between HLA and diseases
      reflects a new insight into the key role of HLA molecules in the generation and
      regulation of the immune response. HLA molecules, on the surface of antigen
      presenting cells, bind foreign peptides. This HLA-antigen complex is then
      recognized by T lymphocytes and triggers the alloresponse against the peptide.
      Since many diseases associated with peculiar HLA antigens are thought to be
      autoimmune, the idea that certain Major Histocompatibility Complex (MHC)
      molecules could form complexes with self-peptides in anomalous ways, leading to
      an autoimmune reaction, is particularly attractive. Recent advances in molecular
      technology, x-ray crystallography and DNA studies have allowed the determination
      of the three-dimensional structure of some HLA class I and II molecules and also
      the amino acid sequences involved in binding of antigen fragments. This new
      information has prompted a search for differences, at the amino acid level,
      between HLA alleles previously shown to be positively or negatively associated
      with a pathology. Our own experience on the immunogenetic aspect of dilated
      cardiomyopathy (DCM) allowed us to assess some predisposing (HLA-DR4, DR5, C4A4)
      and protective (HLA-DR3) factors for DCM. Clinical heterogeneity also seems to
      imply a peculiar genetic background. The actual research is addressed to the
      study of the antigen binding site sequences and to the consideration of other new
      loci such as those entrapped within the HLA class III subregion (HSP70) and those
      lying within the class II region (PSF).

PMID- 1624073
TI  - Gm and Km allotypes in autoimmune diseases.
AB  - The associations or linkages between the polymorphisms of the Gm and Km
      immunoglobulin allotypes and the susceptibility to autoimmune diseases, including
      diseases with immuno-pathological pathogenesis are reported in this review. These
      diseases include multiple sclerosis, rheumatoid arthritis, systemic lupus
      erythematosus, insulin-dependent diabetes mellitus, Crohn's disease, coeliac
      disease, Graves' disease, atrophic thyroiditis, Hashimoto's thyroiditis,
      myasthenia gravis, chronic active hepatitis, alopecia areata, uveitis, vitiligo,
      Turner's syndrome, glomerular nephritis, Berger's disease and idiopathic dilated
      cardiomyopathy. Immunoglobulin allotypes are described as well as the statistical
      methods used to analyse the data.

PMID- 1624074
TI  - [The monitoring of plasma digoxin levels during acute digitalis poisoning treated
      with Fab anti-digoxin fragments].
AB  - Life-threatening digitalis intoxication is treated using digoxin specific
      antibody fragments (Fab) that bind and inactivate the drug. The free digoxin
      serum concentration could be useful in the management of Fab-treated patients,
      but the standard methods of measurement can be clinically misleading because Fab
      anti-digoxin interferes with digitalis immunoassay measurements. A case involving
      Fab therapy of a digoxin overdosed patient, in which two laboratory methods gave
      very different results, is reported. The radioimmunologic assay (RIA), widely
      used in laboratories, yielded high values without relation to true serum free
      digoxin concentration. On the contrary, the recently introduced fluoroenzymatic
      sequential immunoassay (FEIA), which accurately measures free glycoside
      concentration, was a valuable aid in monitoring Fab treatment. Therefore,
      cardiologists' knowledge of a possible interference of specific anti-digoxin
      fragment treatment with many immunoassays may greatly enhance the rational
      management of these patients.

PMID- 1624075
TI  - Experimental study on the effects of sclerosants for esophageal varices on blood
      coagulation, fibrinolysis and systemic hemodynamics.
AB  - The effects of five sclerosants used for treating esophageal varices on blood
      coagulation and fibrinolysis, systemic hemodynamics, and vascular endothelial
      cells were studied in mongrel dogs. With each sclerosant, hemolysis and a
      decrease in the platelet count were observed. Changes in the blood coagulation
      system occurred immediately after sclerosant administration. Prolongation of the
      PT and APTT and decreases in fibrinogen and alpha 2-PI were seen in the thrombin
      (TH), sodium tetradecyl sulfate (STS), and ethanolamine oleate (EO) groups.
      Polidocanol (PO) and absolute ethanol (ET) had less pronounced effects on these
      systems. A transient decrease in the cardiac index (CI), pulmonary artery
      pressure (PAP) and pulmonary artery resistance (PAR) was observed with the
      administration of the sclerosants, especially in the TH and STS groups. Excessive
      vascular endothelial damage was observed in the ET group, marked damage was seen
      in the EO and STS groups and slight damage was recorded in the PO and TH groups.

PMID- 1624076
TI  - Human pancreatic polypeptide, neuropeptide Y and peptide YY reduce the
      contractile motility by depressing the release of acetylcholine from the
      myenteric plexus of the guinea pig ileum.
AB  - Transmural stimulation (TS; 15 V, 0.5 msec, 1-5 Hz, for 30 sec) caused a
      contraction in a frequency-dependent manner of the longitudinal muscle with
      myenteric plexus of the guinea pig ileum. Two-min premedication with human
      pancreatic polypeptide (HPP, 10(-8) M-10(-6) M), neuropeptide Y (NPY, 10(-8) M
      10(-6) M), and peptide YY (PYY, 10(-8) M-10(-6) M) partially, by less than 35%,
      reduced TS (15 V, 0.5 msec, 10 Hz)-evoked contraction in a dose-dependent manner
      without affecting the resting tensions. Hexamethonium, phentolamine, prazocine,
      yohimbine, propranolol, naloxone and theophylline had no effects on the
      inhibitory actions of these peptides on TS-evoked contractions. TS (15 V, 0.5
      msec, 10 Hz)-evoked 3H-ACh release was significantly reduced by 2-min
      premedication of HPP (10(-6) M), NPY (10(-6) M) and PYY (10(-6) M). The order of
      potency of these depressant effects on TS-evoked contraction and 3H-ACh release
      was PYY greater than NPY greater than HPP. It is suggested that the members of PP
      family have inhibitory effects on the contractile motility by depressing ACh
      release from myenteric plexus of the guinea pig ileum.

PMID- 1624077
TI  - Prostaglandin E1 enhances hepatic portal venous flow by dilating the portal
      vascular bed in 70% hepatectomized dog.
AB  - The effects of portal, hepatic arterial and femoral venous administration of
      prostaglandin E1 (PGE) on portal venous flow (PVF) and hepatic arterial flow HAF
      were examined before and after 70% hepatectomy in anesthetized dogs. In the
      hepatectomized condition, portal venous administration of PGE (0.5
      microgram/kg/min) caused an increase in PVF without any change in systemic
      arterial pressure (SAP). HAF was unchanged following the injection. The portal
      effect of PGE on PVF was dose-dependent, and a reduction in portal venous
      resistance was seen. However, the same dose of PGE failed to change PVF under
      intact liver conditions. Hepatic arterial administration of PGE (0.5
      microgram/kg/min) brought no significant change in PVF or HAF, with or without
      hepatectomy. Femoral venous administration of PGE (0.5 micrograms/kg/min)
      produced an increase in PVF concomitant with a significant decrease in SAP. HAF
      showed no change after the injection. A decrease in PVR was seen only in the
      hepatectomized condition. It is concluded that PGE is potent in increasing PVF in
      the hepatectomized condition, and the portal vasculature is involved as the site
      of action.

PMID- 1624078
TI  - Endotoxin levels in cirrhotic rats with sterile and infected ascites.
AB  - Endotoxin levels were measured in sterile and bacterially infected ascites in a
      rat model of phenobarbital and carbon tetrachloride induced cirrhosis was used.
      An improved chromogenic substrate assay was used to measure endotoxin. All rat
      ascites specimens were positive for endotoxin. In culture-negative ascites (n =
      8), it ranged from 0.05 EU/ml to 0.14 EU/ml (0.08 +/- 0.04 EU/ml, mean +/- SD)
      (Escherichia coli 0111:B4 endotoxin was used as a reference). In culture-positive
      ascites (premortem n = 3, postmortem n = 1), it ranged from 0.78 EU/ml to 1.8
      EU/ml (1.29 +/- 0.59 EU/ml, mean +/- SD). All rats with premortem culture
      positive ascites died within two days. This model is useful to study ascites
      endotoxin levels. In this study, increasing levels of ascites endotoxin
      correlated with spontaneous bacterial peritonitis and death.

PMID- 1624079
TI  - Abnormal GH secretion in liver cirrhosis: evaluation of using GRF test and TRH
      test.
AB  - To evaluate abnormal secretion of growth hormone (GH) in cases of liver diseases,
      the authors performed a loading test of growth hormone-releasing factor (GRF) and
      approximately one week later, a loading test of thyrotropin-releasing hormone
      (TRH), and measured serum GH in 15 cases of liver cirrhosis (LC), 5 with chronic
      active hepatitis (CAH), and 5 controls. In the TRH test, 8 of 15 LC patients
      showed a peak GH value of 6 ng/ml or more and were classified as the TRH
      responder group (LC-R). Seven other LC patients showing a peak GH value of less
      than 6 ng/ml were classified as the TRH-non-responder group (LC-NR). None of the
      CAH cases or controls showed a peak GH value of 6 ng/ml or more. In GRF test, the
      response of GH was poor in all 8 in the LC-R group. The responses in the LC-NR
      group were significantly greater than those in the LC-R group from 15 to 90
      minutes after the GRF loading. In the LC-R group, greater impairment of liver
      function was indicated by total bilirubin, serum protein and cholinesterase
      values compared to the LC-NR group. Fischer's ratio was significantly lower in
      the LC-R group. In cases of liver diseases, Fischer's ratios negatively
      correlated with the peak GH values in the TRH test (r = -0.679, P less than
      0.01). These results suggest that in LC cases showing a paradoxical GH response
      to TRH, the GH response to GRF which is a GH stimulatory hormone, is
      decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624080
TI  - The relationship between biliary secretion of bilirubin and glutathione in the
      rat.
AB  - The relationship between biliary secretion of bilirubin and glutathione was
      investigated by infusing bilirubin solution (200 nmol/min/100 g body wt) into
      Sprague-Dawley rats and measuring bilirubin and glutathione in the bile. Hepatic
      glutathione level, when modified between the range of 1-10 mumols/g liver wt, did
      not affect biliary maximal secretory rate (Tm) of bilirubin (80 nmol/min/100 g
      body wt). However, when biliary secretion of bilirubin exceeded 10 mM or 30
      nmol/min/100 g body wt, biliary secretion of glutathione was markedly impaired
      while the bile flow remained relatively constant. Thus, bilirubin impaired the
      biliary secretion of glutathione selectively compared to its effect on bile
      formation. The results indicate that the mechanisms of biliary secretion of the
      two physiological substances, bilirubin and glutathione, are closely related.

PMID- 1624081
TI  - Effects of secretin on bile production in two kinds of cholestatic models by
      choledocho-caval fistula and bile duct ligation in rats.
AB  - Secretin is known to stimulate bile flow from the bile duct epithelium. To
      investigate the effects of secretin in cholestasis, we studied the response of
      the bile flow and the excretion of biliary components to secretin using two
      cholestatic models with or without damage to the bile duct epithelium. The model
      without bile duct epithelial damage was a choledocho-caval (CC) fistula over a 24
      hour period, and the model with bile duct damage was a bile duct ligation over a
      48-hour period. Secretin was administered by intravenous infusion for 30 minutes
      and bile was collected for 120 minutes. Controls were given saline similarly. The
      bile flow and biliary bicarbonate excretion rate were significantly increased
      after secretin infusion in the CC fistula rats when compared with the control
      rats, but no stimulation by secretin was observed in the ligated rats. These data
      indicate that secretin-induced bile production was enhanced under cholestatic
      conditions with no bile duct epithelial disturbance.

PMID- 1624082
TI  - A case of jejunal gastrinoma diagnosed by percutaneous transhepatic portal venous
      sampling.
AB  - A 63-year-old male was admitted to our department for further examination of
      hypergastrinemia. Secretin provocation test and calcium infusion test suggested
      Zollinger-Ellison syndrome and percutaneous transhepatic portal venous sampling
      (PTPVS) demonstrated gastrinoma in the jejunum, although CT, ultrasonography and
      angiography could not accurately detect the location of the gastrinoma.
      Laparotomy findings showed a solid tumor 1.5 cm in diameter in the jejunal
      mesentery 5 cm distal to the ligament of Treitz, and primary gastrinoma was
      confirmed in the submucosa of the jejunum immediately adjacent to this tumor. An
      immunohistochemical study using the PAP method revealed gastrin secreting cells
      in the tumor. In addition to this case of jejunal gastrinoma, a review of
      literature in Japan and other countries was presented.

PMID- 1624083
TI  - Adult descending colocolic intussusception caused by a large lipoma.
AB  - Adult intussusception is uncommon and varies considerably from the more common
      occurrence of this disorder in infants and children. Although lipoma represents
      the most common benign tumor of the colon, it is a relatively rare cause of
      gastrointestinal symptoms. A rare case of adult intussusception of the descending
      colon caused by a giant lipoma is presented and discussed.

PMID- 1624084
TI  - Sarcoidosis with tumorous hepatic and bone lesions mimicking disseminated
      malignancy: a case report.
AB  - An asymptomatic 49-year-old woman with a diffuse abnormal shadow detected on a
      routine chest rentogenogram was referred for evaluation. Ultrasonography,
      computed tomography (CT) and magnetic resonance imaging (MRI) revealed space
      occupying lesions in the liver and spleen. Lymphadenopathy was observed in the
      mediastinum and abdomen on CT, and multiple lesions of low signal intensity were
      observed in the spine on MRI. Furthermore, the presence of multiple tumorous
      nodules in the liver suggesting metastatic hepatic cancer was demonstrated on
      laparoscopy. Biopsy of the liver tumors revealed sarcoidosis; transbronchial
      biopsy specimens showed identical histological features. After administration of
      prednisolone for one month, the space-occupying lesions in the liver, spleen and
      spine improved. This case of sarcoidosis exhibited hepatic tumorous nodules and
      space-occupying lesions in the spleen and the spine which mimicked the presence
      of metastatic hepatic cancer.

PMID- 1624085
TI  - Does H2 receptor antagonist-resistant ulcer exist?--A review based on
      bioavailability in man.
AB  - Recently the term H2 receptor antagonist-resistant (H2RA-resistant) ulcer has
      been used increasingly commonly, instead of the conventional term of intractable
      ulcer, to designate an ulcer which does not respond to treatment with an H2
      receptor antagonist (H2RA). However, many authors report that an H2RA resistant
      ulcer can be cured by increasing the dosage of H2RA, or using another H2RA. In
      this study, the absorption and bioavailability of oral doses of each of three
      H2RAs, which are possible factors in these effects, were studied in healthy
      volunteers. The results showed that there was a great difference in
      bioavailability between cimetidine (80%), famotidine (39%) and ranitidine (50%).
      The lower bioavailability of famotidine and ranitidine may be partially explained
      by the following facts: 35.8% to 57.8% of orally administered famotidine is
      decomposed in gastric acid (pH 1) before absorption; and about 50% of ranitidine
      is metabolized in the liver before distribution (first-pass effect). Thus
      famotidine and ranitidine should be carefully administered to patients with slow
      gastric emptying and hepatic dysfunction, respectively. In general practice, many
      patients may not respond well to treatments because of their poor absorption, or
      extensive metabolism. In such cases, further effectiveness and safety could be
      expected if another H2RA, appropriately tailored to patients' conditions, were
      chosen. On the basis of these findings, it would seem premature to conclude that
      H2RA-resistant ulcer exists.

PMID- 1624086
TI  - Protective effect of deferoxamine for acetaminophen induced liver injury.

PMID- 1624087
TI  - Canalicular transport mechanisms of fluorescent bile acid in hepatocyte doublets.

PMID- 1624088
TI  - Somatolactin stimulates in vitro gonadal steroidogenesis in coho salmon,
      Oncorhynchus kisutch.
AB  - Somatolactin (SL), a newly discovered pituitary hormone of the teleost pars
      intermedia, is structurally similar to prolactin and growth hormone. The
      function(s) of SL are not yet established, although evidence suggests that it may
      play a role in reproduction. Possible steroidogenic activity of coho salmon SL
      was tested and compared with gonadotropin I (GTH I) in incubations of ovarian
      follicles or testicular fragments. SL stimulated production of 11
      ketotestosterone and testosterone by testicular fragments, and production of
      estradiol by ovarian follicles in a concentration-dependent manner. However, the
      steroidogenic activity of SL was considerably less than that of GTH I. These
      results suggest that SL may play a role in regulation of gonadal function in
      salmon.

PMID- 1624089
TI  - Tissue-specific sensitivity of chromatin and the vitellogenin gene to micrococcal
      nuclease after continuous exposure of salmon (Salmo salar) to 17 beta-estradiol.
AB  - Smoltified Atlantic salmon (Salmo salar), 2 years old and weighing 217 +/- 13 g,
      were treated for 2 weeks with 17 beta-estradiol containing silastic capsules
      implanted intraperitoneally. Control fish received empty capsules. Vitellogenin,
      present in the blood of both groups of fish, was enhanced by estradiol treatment.
      Nuclei were isolated from liver, blood cells, and brain and incubated with
      increasing concentrations of micrococcal nuclease (EC 3.1.31.1). In liver there
      were more mononucleosomes as a percentage of total chromatin in hormone-treated
      than in control fish. Using vitellogenin cDNA as a probe the highest
      hybridization signals were seen when 2 to 4% of the chromatin was digested to
      mononucleosomes. In blood cell and brain nuclei independent of the extent of the
      chromatin released the hybridization signals remained low. The expression of the
      vitellogenin gene in immature females was potentiated by exogenous estradiol to
      give increased micrococcal nuclease sensitivity of the chromatin without
      enhancement of the hybridization level. Micrococcal nuclease digestion and
      hybridization of the vitellogenin gene demonstrated that the hepatic specificity
      of vitellogenin synthesis is manifested as structural modulations of the
      chromatin containing the vitellogenin gene.

PMID- 1624090
TI  - Effects of melatonin implants on insulin-like growth factor 1 in male red deer
      (Cervus elaphus).
AB  - Red deer stags have a seasonal pattern of growth, alternating between periods of
      summer weight gain and winter weight loss that are influenced by photoperiod and
      by exogenous melatonin. A seasonal pattern of plasma insulin-like growth factor
      1, also influenced by photoperiod, underlies the seasonal growth pattern. The
      present studies aimed to determine the influence of exogenous melatonin,
      administered at various times of the year, on plasma IGF1 in adult red deer stags
      in New Zealand at 45 degrees S. In one study, 7-year-old stags (N = 9) were
      allocated to one of three treatment groups, either control or subcutaneous
      melatonin (3 x 18-mg coated implants (Regulin) per month) from November to
      February or from December to February. Blood was sampled, the stags were weighed,
      and antler status was recorded over 17 months. Melatonin treatment advanced the
      seasonal patterns of rise and fall of plasma IGF1 and of weight gain and loss.
      The cessation of melatonin treatment in February produced early antler casting
      and a second (out-of-season) antler and increased IGF1. In a second study, 4-year
      old stags (N = 30) were allocated to one of six treatment groups as follows:
      three melatonin implants per months for 6 consecutive months beginning on 22
      June, i.e., winter solstice, 4 August, 16 September, and 23 October; three
      melatonin implants per month for 12 months beginning on 22 June; and an untreated
      group. All animals were sampled as before for 12 months. Melatonin treatment
      beginning in July and August did not prevent the seasonal peak in IGF1, but the
      amplitude was lowered and antler casting delayed.

PMID- 1624091
TI  - Some polypeptides in the nervous system of the marine worm, Nereis diversicolor,
      are related to the sodium influx stimulating peptide of the pulmonate freshwater
      snail, Lymnaea stagnalis.
AB  - Total mRNA, extracted from brain of the marine worm, Nereis diversicolor
      (Annelida, Polychaeta), was translated either in vitro using a rabbit
      reticulocyte lysate or in ovo (Xenopus laevis oocyte). The synthesized
      polypeptides were analyzed by electrophoresis and Western blotting techniques
      using polyclonal antisera raised against three peptides: sodium influx
      stimulating peptide (SISP) sequences 10-19 and 67-76 and a monoclonal antibody
      raised against purified native SISP (1-77) of Lymnaea stagnalis. Among the
      products translated in vitro, three polypeptides of 80, 72, and 64 kDa were
      recognized by the anti-SISP (10-19) polyclonal antiserum and by the monoclonal
      antiserum, but not by anti-SISP (67-76). Some of the in ovo translated products
      showed almost identical immunoreactivity to both the anti-SISP (10-19) and the
      monoclonal antibody. These polypeptides have molecular masses of 80, 72, and 43
      kDa. No polypeptides were recognized by anti-SISP (67-76). Western blotting
      analysis of brain extracts revealed a number of proteins that reacted with the
      antiserum raised against SISP (10-19) and the monoclonal antiserum. Several
      perikarya of brain ganglionic nuclei and ventral nerve cord were immunoreactive
      to anti-SISP (10-19). The monoclonal antiserum gave similar results, although
      with a less intense immunoreaction. The infracerebral region was also stained,
      suggesting that the immunoreactive material is released as a true neurohormone
      into the hemolymph. The largest polypeptides, in particular those translated from
      brain mRNA, could be neuropeptide precursors containing a SISP-related sequence.

PMID- 1624092
TI  - Evaluation of a radioimmunoassay for the measurement of amphibian parathyroid
      hormone.
AB  - A commercial mid-region to carboxyl-region parathyroid hormone (PTH)
      radioimmunoassay (RIA) for measurement of PTH concentration in serum of humans
      was evaluated for its ability to detect amphibian PTH. The recovery of known
      amounts of human PTH added to aliquots of pooled frog serum demonstrated that
      frog serum does not interfere with the RIA system. The mean intraassay
      coefficient of variation was 0.11. During the spring and summer removal of the
      parathyroid glands from frogs resulted in significant decreases in serum calcium
      levels which the RIA revealed were associated with significant decreases in PTH
      levels. In the winter the parathyroid glands of frogs showed histological changes
      associated with inactivity. Also, parathyroidectomy of winter frogs did not
      affect serum calcium concentrations, and PTH levels of experimental and control
      animals were below or near the level of detection.

PMID- 1624093
TI  - Calcitonin gene-related peptide: an inhibitor of bullfrog (Rana catesbeiana)
      gallbladder contraction in vitro.
AB  - The presence of a calcitonin gene-related peptide (CGRP)-like material was
      demonstrated in the gallbladder of the bullfrog, Rana catesbeiana, using
      immunocytochemistry and confirmed by radioimmunoassay. An intense
      immunocytochemical reaction was observed in nerves located in the smooth muscle
      layers and associated with blood vessels. No immunoreactive nerve fibers were
      associated with ganglia, nor were immunoreactive cell bodies observed.
      Radioimmunoassay showed that 25.03 +/- 2.5 pmol/g tissue of CGRP-like material
      was present. In vitro tension studies using gallbladder strips showed that CGRP
      exerted an inhibitory effect on both acetylcholine- and cholecystokinin
      octapeptide-induced tension but had no effect on KCl-, norepinephrine-, or
      cerulein-induced tension. CGRP may act directly on the gallbladder smooth muscle
      to inhibit contraction.

PMID- 1624094
TI  - The pressor response to exogenous angiotensin I and its blockade by angiotensin
      II analogues in the American alligator.
AB  - We examined the pressor response to exogenous, nonnative angiotensin I (ANG I;
      bullfrog, turtle, and fowl) in the conscious American alligator, Alligator
      mississippiensis. In addition, the inhibitory effects of three ANG II analogues
      ([Sar1, Ala8], [Sar1, Thr8], and [Sar1, Ile8]ANG II) on the pressor responses to
      angiotensin I (fowl ANG I, [Asp1, Val5, Ser9]) were also examined. Intravenous
      administration of bullfrog, turtle, and fowl ANG I at 0.1, 0.5, and 1.0
      micrograms/kg produced dose-dependent increases in arterial blood pressure.
      [Val5]ANG II at 0.05, 0.1, and 0.5 micrograms/kg, or NE at 2 micrograms/kg also
      produced dose-dependent increases in blood pressure. [Sar1, Ile8]ANG II and
      [Sar1, Ala8]ANG II (10 micrograms/kg/min) both attenuated the pressor response to
      fowl ANG I whereas [Sar1, Thr8]ANG II (10 micrograms/kg/min) produced no
      significant blockade. These data demonstrate: (1) All three exogenous ANG I
      molecules exert potent vasopressor responses in the alligator, (2) [Sar1,
      Ile8]ANG II is the most effective ANG antagonist, and (3) the alligator appears
      to possess a renin-angiotensin system similar to that found in other vertebrates.

PMID- 1624095
TI  - Prostaglandins and teleost neurohypophyseal hormones induce premature parturition
      in the guppy, Poecilia reticulata.
AB  - Administration of PGE2, PGF2 alpha, isotocin, and vasotocin to pregnant guppies
      during late gestation induced premature parturition. Indomethacin (10
      micrograms/g body wt), the cyclooxygenase inhibitor, did not inhibit parturition
      at term, suggesting that some lipoxygenase metabolites may be involved in the
      induction of parturition. Pituitary extract, as well as LH-RH, did not induce
      premature parturition. It may be that in the guppy, in which ovulation occurs at
      the end of gestation just prior to parturition, gonadotropin is not involved in
      the induction of ovulation and parturition.

PMID- 1624096
TI  - In vitro bioactivities of various forms of GnRH in relation to their
      susceptibility to degradation at the pituitary level in the rainbow trout,
      Oncorhynchus mykiss.
AB  - In vitro potencies of native and modified forms of salmon and mammalian
      gonadotropin-releasing hormone (GnRH) were studied in relation with their
      susceptibility to degradation by intact pituitary cells maintained in culture.
      The kinetics of degradation and the origin of the proteases involved in this
      process were examined. All the molecules tested (native and modified forms) were
      equipotent at doses between 10(-6) and 10(-7) M in inducing GtH release by
      cultured pituitary cells. On the other hand, their effectiveness differed at 10(
      9) and 10(-8) M leading to the establishment of the following hierarchy of
      bioactivity: the native forms, LHRH and sGnRH, were the less potent, the fish
      analogues (DAla6Pro9Net)sGnRH and (DArg6Pro9Net)sGnRH were the more potent, and
      mammalian analogues with substitutions at position 6 and/or 10 were intermediate
      in potency. The native form sGnRH was weakly degraded while no degradation of the
      modified molecules was observed. The degradation of the native sGnRH occurred
      after 12 and 24 hr of incubation and the results indicate that the peptidases
      involved are released from the cells into the incubation medium.

PMID- 1624097
TI  - Hormonal effects on glycogen metabolism in isolated hepatocytes of a freeze
      tolerant frog.
AB  - To determine whether specific hormonal responses were involved in the production
      of cryoprotectant (glucose) by liver of the freeze tolerant wood frog, Rana
      sylvatica, metabolically active hepatocytes were isolated in reasonable yields
      (mean 20.1 +/- 1.30% SEM, n = 29) by in situ liver perfusion with collagenase.
      Freshly isolated cells from autumn-collected frogs contained large amounts of
      glycogen (650 mumol glucosyl units/g packed cells) and produced glucose from this
      endogenous reserve at a rate of 10 mumol g-1 hr-1 at 0 degrees. Glucose output
      from cells was highly responsive to the addition of hormones; rates of glucose
      release increased 2.1-, 1.7-, and 1.7-fold with the addition of 10(-7) M bovine
      glucagon, 10(-7) M epinephrine, and 5 x 10(-6) M dibutyryl-cyclic AMP,
      respectively. Norepinephrine, 5-hydroxytryptamine, and bovine insulin were
      without effect at 0.1 microM/l. Hormone stimulation of glucose release was
      correlated with an increase in both the total activity and the percentage a of
      glycogen phosphorylase in hepatocytes. However, none of the hormones tested
      affected the kinetic properties of hepatocyte pyruvate kinase, suggesting the
      absence of covalent modification control of the enzyme. The data indicate that
      the freezing-stimulated production of large quantities of glucose as a
      cryoprotectant by R. sylvatica liver does not involve qualitative differences in
      the hormonal control of liver glycogenolysis, compared with other lower
      vertebrates. However, quantitative differences were seen, such as the much
      greater phosphorylase activity, 4.38 +/- 0.33 mumol min-1 g-1 packed cells, in
      freshly isolated R. sylvatica hepatocytes compared with 0.36 +/- 0.06 mumol min-1
      g-1 in Rana pipiens hepatocytes.

PMID- 1624098
TI  - Corticotropin-releasing factor stimulates metamorphosis and increases thyroid
      hormone concentration in prometamorphic Rana perezi larvae.
AB  - Attempts to identify a hypothalamic molecule that stimulates thyrotropin (TSH)
      secretion from amphibian pituitary have been unsuccessful to date. The effects of
      mammalian (ovine and human) corticotropin-releasing factor (CRF) on the thyroid
      function of prometamorphic (Taylor & Kollros stages XI-XVII) (Taylor and Kollros,
      1946) Rana perezi larvae were studied. Chronic treatments with both ovine and
      human CRF (oCRF, hCRF) stimulated metamorphosis while delaying larval growth.
      Chronic hCRF (1 microgram) administration induced 3.2- and 5.3-fold increases in
      whole body concentration of thyroxine (T4) and triiodothyronine (T3),
      respectively. In contrast, the 0.5-microgram dose of hCRF stimulated a
      significant (3.4-fold) increase in whole body concentration of T4 but not of T3.
      Histological studies of the thyroid gland revealed a 22% increase in the number
      of follicles per section as a result of the chronic treatment with oCRF (1
      microgram). Acute oCRF (2 micrograms) treatment induced a significant increase in
      T4 concentration at 4 hr (1.3-fold) and 8 hr (2.3-fold) postinjection. T3
      concentration was not altered. These results support previous reports and lead us
      to conclude that a CRF-like peptide, and not TRH, is involved in the regulation
      of thyroid activity in anuran amphibians during metamorphosis.

PMID- 1624099
TI  - Serum gonadotropins and gonadal steroids associated with ovulation and egg
      production in sea turtles.
AB  - Changes in serum concentrations of gonadotropins and gonadal steroids during the
      periovulatory period were monitored in green, Chelonia mydas, and loggerhead,
      Caretta caretta, sea turtles. Turtles were from natural populations that nest on
      a coral island on the Great Barrier Reef. After nesting, each turtle was
      transferred to a holding tank and held for a maximum of 8 days. A time series of
      blood samples was obtained from each of five sea turtles (three C. mydas and two
      C. caretta) starting immediately after nesting and then at approximately 12-hr
      intervals until the time of release. Prior to release back into the ocean, each
      turtle was examined by laparoscopy to verify that ovulation had occurred. Serum
      concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH),
      progesterone (PRO), and testosterone (T) in both species exhibited significant
      changes during this period. Surges of FSH, LH, and PRO were evident within
      approximately 20 to 50 hr after each turtle had nested. The significant change in
      FSH concentration during the periovulatory period is the first such report for a
      reptile. Coincident with maximal concentrations of FSH, LH, and PRO was a decline
      in T concentrations in both species. Estradiol-17 beta concentrations were near
      or below assay sensitivity in the C. mydas, whereas those in the C. caretta were
      detectable but exhibited no significant changes. The dynamic changes in FSH, LH,
      PRO, and T concentrations are consistent with the hypothesis that these hormones
      facilitate specific physiological events during ovulation and egg production.

PMID- 1624100
TI  - Biosynthesis and axonal transport of multiple molluscan insulin-related peptides
      by the neuroendocrine light green cells of Lymnaea stagnalis.
AB  - The neuroendocrine light green cells (LGCs) control body growth and metabolism of
      the freshwater snail, Lymnaea stagnalis. These cells, located in the cerebral
      ganglia, use the peripheries of the median lip nerves (MLNs) as the neurohemal
      area. The LGCs express four members of a gene family encoding the precursors of
      distinct though related molluscan insulin-related peptides (MIPs). The molecular
      characterization and biosynthesis of MIPs have been investigated. MLN extracts
      were first size fractionated using gel permeation chromatography, and a major
      peak that coeluted with bovine insulin was further resolved using reverse phase
      high performance liquid chromatography. Amino acid composition analysis revealed
      that the four MIPs were present, as encoded by the MIP genes. Biosynthesis and
      axonal transport of the MIPs were studied in vitro with LGC systems in a series
      of pulse-chase incubations in combination with gel permeation chromatography
      analysis. During the pulse period of 20 min MIP precursors were formed in the LGC
      cell bodies. During the subsequent chase period these precursors were converted
      to MIPs and C peptides, which were transported to the LGC axon terminals in the
      MLNs for storage and release. The MIP precursors seem to be processed similarly
      to the insulin precursor in pancreatic islets.

PMID- 1624101
TI  - Estrogen and a calcium flux dependent factor modulate the calbindin gene
      expression in the uterus of laying hens.
AB  - The dependency of calbindin 28K synthesis on estrogen and vitamin D and its
      relationship with calcium transfer were investigated in the uterus of laying hens
      by dot blot hybridization analysis using as a probe a cDNA coding for calbindin.
      Estrogen stimulated growth of the oviduct and uterine calbindin synthesis in
      juvenile D-deficient female chicks. In laying hens, calbindin mRNA increased most
      markedly during shell deposition but calbindin concentrations did not fluctuate
      during the ovulatory cycle. Suppression of shell formation within a few hours
      reduced calbindin mRNA levels and lowered uterine calbindin concentrations when
      egg expulsions were continued for several days. The concentration of calbindin
      and its mRNA increased when shell formation resumed in hens previously laying
      shell-less eggs. These increases were maintained in hens parathyroidectomized
      just before shell resumption. Lowering dietary calcium decreased uterine calcium
      transfer and calbindin concentration but its mRNA level was unaffected. It is
      suggested that uterine calbindin synthesis is regulated in a tissue-specific
      manner through transcriptional mechanisms irrespective of change in vitamin D;
      calbindin synthesis is stimulated by estrogens as part of its effect on oviductal
      growth but its regulation predominantly involves a calcium flux dependent factor
      associated with shell calcification.

PMID- 1624102
TI  - Competitive exclusion of diarrheagenic Escherichia coli (ETEC) from human
      enterocyte-like Caco-2 cells by heat-killed Lactobacillus.
AB  - Diarrheagenic Escherichia coli (ETEC) bearing CFA/I or CFA/II adhesive factors
      specifically adhere onto the brush border of the polarized epithelial human
      intestinal Caco-2 cells in culture. Heat-killed Lactobacillus acidophilus strain
      LB, that adheres onto Caco-2 cells, inhibits diarrheagenic Escherichia coli
      adhesion in a concentration-dependent manner. Since the L. acidophilus does not
      express ETEC-CFA adhesive factors, it can be postulated that the heat-killed L.
      acidophilus LB cells inhibit diarrheagenic E. coli attachment by steric hindrance
      of the human enterocytic ETEC receptors.

PMID- 1624103
TI  - Cloning of the phospho-beta-galactosidase gene in Escherichia coli from lactose
      negative mutants of Streptococcus mutans isolated following random mutagenesis
      with plasmid pVA891 clone banks.
AB  - In order to mutagenize Streptococcus mutans a marker rescue plasmid, pVA891, was
      employed. The plasmid was ligated with Sau3AI digested chromosomal DNA fragments
      from S. mutans GS-5IS3 and the resultant plasmids were amplified in Escherichia
      coli. These plasmids were then randomly integrated into the chromosome of strain
      GS-5IS3 following transformation. Lactose-negative transformants were isolated as
      white colonies on lactose-BTR-Xgal agar plates containing erythromycin. Six
      lactose-negative mutants representing three different chromosomal sites of
      integration were isolated from about eight thousand transformants. Mutant
      chromosomal DNA fragments flanking the plasmids were recovered by a marker-rescue
      method in E. coli and exhibited phospho-beta-galactosidase activity.

PMID- 1624104
TI  - Eukaryotic cell components that bind to chlamydial elementary bodies: the
      histones.
AB  - HeLa-cell-membrane fractions isolated by sonication as used previously to
      identify chlamydial adhesins were examined by a blotting technique for binding
      chlamydial elementary bodies (EB). One HeLa cell protein with apparent molecular
      mass of 32 kDa was found to bind native EB. A monoclonal antibody (mAb) raised
      against this chlamydial binding host-cell protein reacted with eucaryotic
      histones. Histone fractions were capable of binding EB in an ELISA assay and
      histone H1 was identified as the chlamydial-binding host cell protein in the Hela
      cell membrane fraction. Probing with specific mAbs against histone H3 and DNA
      confirmed that chromatin components were present in the host-cell membrane
      extract. These data suggest that the HeLa-cell-binding chlamydial proteins were
      previously identified by their reaction with chromatin and not with membrane
      components.

PMID- 1624105
TI  - Bioluminescent Listeria monocytogenes provide a rapid assay for measuring biocide
      efficacy.

PMID- 1624106
TI  - Physical characterisation and over-expression of the Bacillus caldotenax
      superoxide dismutase gene.
AB  - The gene (sod) encoding Bacillus caldotenax (BC) Mn-superoxide dismutase (MnSOD)
      has been cloned in Escherichia coli and its entire nucleotide sequence
      determined. Within the coding region of the gene there were 21 nucleotide
      differences to the previously sequenced sod of Bacillus stearothermophilus (BS).
      The predicted amino acid sequence of BCMnSOD had two amino acid dissimilarities
      to the BSMnSOD, containing Asp and Val at positions 13 and 188, respectively,
      compared to Glu and Ile at the respective equivalent positions of BSMnSOD.
      Recombinant BCMnSOD was shown to be functionally active in E. coli, both in vitro
      and in vivo, and was produced at levels representing over 40% of the cells'
      soluble protein by coupling sod transcription to the E. coli trp promoter. The
      sequenced region of DNA was also found to encompass part of a second open-reading
      frame, of unknown function, previously noted 3' to the B. stearothermophilus
      gene.

PMID- 1624107
TI  - Inactivation of a Serpula (Treponema) hyodysenteriae hemolysin gene by homologous
      recombination: importance of this hemolysin in pathogenesis in mice.

PMID- 1624108
TI  - Selection of a Borrelia burgdorferi antigenic variant by cultivation in the
      presence of increasing amounts of homologous immune serum.
AB  - This investigation was undertaken to select antigenic variants of a Borrelia
      burgdorferi strain in vitro. The original strain BITS was cultivated in BSK
      medium supplemented with increasing concentrations of homologous hyperimmune
      serum raised in rabbits. After a few serial passages starting from a
      subinhibitory serum dilution of 1:800 in BSK up to 1:200, a variant named BITSv
      was obtained; it grew abundantly like the control culture in the presence of
      hyperimmune serum. Analysis of the antigenic pattern of the original and derived
      variants by Western blotting revealed that BITSv, compared to the original strain
      BITS, had lost the reactivity with the immune serum at the level of the
      oligosaccharide moiety. These experiments, designed to mimic the possible action
      of antibodies that arise during a Borrelia infection, suggest that
      lipopolysaccharides are surface located and that they play a role in the
      integrity of the outer membrane during the multiplication of Borrelia
      burgdorferi.

PMID- 1624109
TI  - Fine-structure mapping of cis-acting control sites in the lysC operon of Bacillus
      subtilis.
AB  - Mutations at the aecA locus of Bacillus subtilis lead to derepression of the lysC
      operon, which encodes aspartokinase II, and analysis of three independent aecA
      mutations has shown them to be nucleotide substitutions in the lysC leader region
      (Y. Lu, N.Y. Chen and H. Paulus (1991) J. Gen. Microbiol. 137, 1135-1141). DNA
      sequence analysis of the lysC control region of nine other mutants with
      derepressed levels of aspartokinase II revealed each of the mutations to be
      associated with changes in one or a few nucleotide residues. The nucleotide
      substitutions were clustered at two sites in the lysC leader: in a region of
      imperfect dyad symmetry about 40 base pairs from the transcription start site,
      and in the open reading frame for a putative leader peptide, which starts about
      40 residues further downstream. The effect of nucleotide substitutions at the two
      sites differed in that those at the upstream site gave twice the degree of
      derepression. A mutant with a small deletion in the leader peptide coding region
      potentially affecting RNA secondary structure also had a higher level of lysC
      derepression. These results suggest that the lysC leader region contains at least
      two cis-acting control sites that play important and perhaps independent roles in
      the repression of the lysC operon by lysine.

PMID- 1624110
TI  - Typing of toxic strains of Clostridium difficile using DNA fingerprints generated
      with arbitrary polymerase chain reaction primers.
AB  - Clostridium difficile is the causative agent for pseudomembranous colitis in
      humans. Toxic strains of C. difficile produce two toxins, toxin A and toxin B. A
      reliable and definitive method of typing the toxic strains of C. difficile is
      needed since nosocomial cross infection is a primary concern in hospitals and
      other health care facilities. A method for typing toxic strains of Clostridium
      difficile using arbitrary polymerase chain reaction (PCR) primers is presented in
      this study. The C. difficile strains were initially characterized for the toxin A
      genetic determinant using specific PCR primers which differentiate toxin positive
      from toxin negative strains. These toxic strains were then PCR typed using six
      arbitrary primers which generated DNA patterns that were unique for all toxic
      strains examined. The use of this typing scheme in clinical applications is
      discussed.

PMID- 1624112
TI  - Trypanosoma cruzi 5S rRNA genes: molecular cloning, structure and chromosomal
      organization.
AB  - To further study the ribosomal RNA genetic system in Trypanosoma cruzi, the 5S
      rRNA gene family was characterized. We found that this gene family is reiterated
      about 1600 times per diploid nuclei and is mostly organized as a tandem repeat of
      481 base pairs. These gene clusters were assigned to two chromosomes of about
      1500 and 1400 kilobase pairs. We found that the 5S rRNA-coding region is
      comprised of 120 nucleotides, and contains the well-known internal control
      regions of eukaryotic RNA polymerase III. The two gene-spacer regions analysed
      exhibit a putative signal for transcription termination and six sites homologous
      to the consensus sequence for the binding of transcription factor Sp1.

PMID- 1624111
TI  - The promoter element GTACAAG of the SGA and STA2 genes is a possible target site
      for repression by the STA10 gene product from Saccharomyces cerevisiae.
AB  - The SGA and STA2 genes that, respectively, encode the intra- and extracellular
      glucoamylases of Saccharomyces cerevisiae are coregulated negatively, at the
      level of transcription, by the STA10 gene. This finding was re-examined by
      determining the effects of STA10 on the expression of gene constructs containing
      different fragments from the SGA and STA2 promoter regions fused to the lacZ
      gene. Repression was observed only for promoter fragments carrying the sequence
      GTACAAG indicating that this element is responsible for the coregulation of SGA
      and STA2 by STA10.

PMID- 1624113
TI  - Combined influence of magnesium concentration and polymerase chain reaction
      specificity enhancers.

PMID- 1624115
TI  - Does high level production of SHV-type penicillinase confer resistance to
      ceftazidime in Enterobacteriaceae?
AB  - We report the isolation of a clinical isolate of Klebsiella pneumoniae that
      showed resistance to ceftazidime (MIC: 8 micrograms/ml), susceptibility to
      aztreonam (MIC: 2 micrograms/ml) and cefotaxime (MIC: 0.015 micrograms/ml). A
      synergistic effect between clavulanic acid and ceftazidime or aztreonam against
      this strain was also observed. The strain hyperproduced SHV-1 penicillinase (990
      U/g) which is encoded by a self-transferrable plasmid of at least 150 kb. That
      the ceftazidime-resistance phenotype could be due to hyperproduction of SHV-1
      penicillinase is supported by the study of a spontaneous ceftazidime-resistant
      mutant in vitro obtained from an Escherichia coli strain containing plasmid p453
      encoding the SHV-1. Indeed, this mutant hyperproducing SHV-1 (2200 U/g) was
      resistant to ceftazidime (MIC: 16 micrograms/ml) and aztreonam (MIC: 8
      micrograms/ml) but susceptible to cefotaxime (MIC: 0.03 ng/ml). Clavulanic acid
      showed a synergistic effect when associated with ceftazidime or aztreonam. In
      contrast, the hyperproduction of TEM-1 (790 U/g) did not confer a ceftazidime-
      and aztreonam-resistant phenotype while hyperproduction of both TEM-1 and SHV-1
      increased the resistance to amoxycillin/clavulanic acid and to cephalothin.

PMID- 1624114
TI  - A non-covalent NH2-terminal pro-region aids the production of active aqualysin I
      (a thermophilic protease) without the COOH-terminal pro-sequence in Escherichia
      coli.
AB  - The precursor of aqualysin I, an extracellular protease produced by Thermus
      aquaticus, consists of four domains: an N-terminal signal peptide, an N-terminal
      pro-sequence, the protease domain and a C-terminal pro-sequence. In an
      Escherichia coli expression system, mature and active aqualysin I is formed by
      treatment at 65 degrees C and the N-pro-sequence is required for its production.
      Complete deletion of the C-pro-sequence did not affect the production of active
      aqualysin I, indicating that the C-pro-sequence is not essential. A non-covalent
      N-pro-region was separately synthesized from the protease domain with or without
      the C-pro-sequence. In this system, mature and active aqualysin I was detected
      only when the C-pro-sequence was deleted.

PMID- 1624116
TI  - Mutation of serine residue 318 in the class C beta-lactamase of Enterobacter
      cloacae 908R.
AB  - The involvement of the serine residue 318 in the specificity of a class C beta
      lactamase was investigated. Multiple site-directed mutants at this position were
      generated using a polymerase chain reaction technique. These mutants were then
      probed for their activity towards various beta-lactam compounds. One mutant,
      S318G was further purified and its physico-chemical and catalytic properties
      determined. It was shown that the observed minimal inhibitory concentration
      values of this mutant could be correlated to its kinetic properties using a
      'diffusion-hydrolysis' model. However, the data showed that residue 318 has
      little influence on the specificity of class C beta-lactamases.

PMID- 1624117
TI  - Characterization of lipopolysaccharides from four Pasteurella haemolytica
      serotype strains: evidence for presence of sialic acid in serotypes 1 and 5.
AB  - Highly purified lipopolysaccharides (LPS) obtained from four strains of
      Pasteurella haemolytica representative of four different serotypes were studied
      to ascertain their overall structural elements and sugar and fatty acid
      compositions. SDS-PAGE analysis revealed that each LPS was of the smooth-type
      although they differed in migration patterns. Somewhat unusual features of these
      LPS included the presence of: (a) rhamnose in the core oligosaccharides of
      serotypes 2 and 3; and (b) sialic acid in the LPS of serotypes 1 and 5. The fatty
      acids, myristic, hydroxymyristic and palmitic occur in essentially equivalent
      amounts in each of these LPS. In addition, stearic acid was present in small
      amounts of serotypes 1 and 5.

PMID- 1624118
TI  - Virulence phenotypes of Shigella flexneri 2a avirulent mutant 24570 can be
      complemented by the plasmid-coded positive regulator virF gene.
AB  - Avirulent mutation of an opaque colony variant of Shigella flexneri 2a designated
      24570 has been believed to be linked with the glpK locus of the chromosome.
      However, avirulent phenotypes of the 24570 strain could be complemented by the
      invasion plasmid-coded virF gene, a positive regulator for invasion genes. The
      24570 strain had a DNA structural alteration upstream of the virF gene.

PMID- 1624119
TI  - Evidence for a methicillin-hydrolysing beta-lactamase in Staphylococcus aureus
      strains with borderline susceptibility to this drug.
AB  - A new beta-lactamase that hydrolyses methicillin was found in the membrane
      fraction of two clinical isolates of Staphylococcus aureus with borderline
      susceptibility to this drug. 'Methicillinase' activity was detected in renatured
      sodium dodecyl sulfate polyacrylamide gel electrophoretograms of staphylococcal
      membrane proteins. The enzyme activity appeared to be inducible and was more
      easily detected using penicillin G (or methicillin) rather than nitrocefin as
      substrate. Similar activity was not detected in the membrane fraction of a
      methicillin-susceptible strain. These results suggest that, in the two borderline
      susceptible strains, rather than a hyperproduction of the penicillinase a
      specific methicillin-hydrolysing activity is responsible for the borderline
      susceptible phenotype.

PMID- 1624120
TI  - Biosynthesis of glyantrypine by Aspergillus clavatus.
AB  - The biosynthesis of glyantrypine from radiolabelled amino acid precursors has
      been shown experimentally to involve anthranilic acid, tryptophan and glycine.
      Low values for percentage incorporation of radiolabel into glyantrypine were
      partly influenced by a complex array of other novel alkaloids shown by the
      radiolabelling experiments to be related to glyantrypine. Interpretation of
      radiolabel incorporation from [14C-carboxyl]-anthranilic acid into microbial
      metabolites seen to contain an anthranilyl moiety in various biosynthetic
      arrangements is discussed. The possibility of diversion of anthranilic acid from
      the kynurenine pathway to glyantrypine biosynthesis is recognised.

PMID- 1624121
TI  - Susceptibility of biofilm cells of Pseudomonas aeruginosa to bactericidal actions
      of whole blood and serum.
AB  - The planktonic and young biofilm cells (harvested on day 2) of mucoid Pseudomonas
      aeruginosa were susceptible to the bactericidal actions of whole blood and serum.
      Aging biofilms of this organism (harvested on day 7) were very resistant to the
      killing effect of whole blood and serum. From this study we propose that the
      establishment of aging biofilms may contribute to persistence of this organism in
      biofilm-associated infections.

PMID- 1624122
TI  - Auxotrophy of Pseudomonas aeruginosa in cystic fibrosis.
AB  - Seventy-four of 403 (18.4%) sputum isolates of Pseudomonas aeruginosa from 49 of
      136 (36.0%) adults with cystic fibrosis (CF) were auxotrophic mutants. Two of 11
      (18.2%) isolates of P. aeruginosa taken from patients with non-CF bronchiectasis
      were also auxotrophic. All 99 strains taken from non-bronchiectatic sources were
      prototrophic. Forty-six of 55 (83.6%) CF auxotrophs required one or more of 36
      growth factors tested; the requirements for the remaining 9 isolates were not
      identified. Methionine was the sole factor required by 17 of 22 (77.3%) isolated
      which depended on a single factor. We conclude that auxotrophy is a feature of P.
      aeruginosa infection in cystic fibrosis.

PMID- 1624123
TI  - Choline transport in Fusarium graminearum A 3/5.
AB  - Fusarium graminearum A 3/5 possesses a high affinity system (Km = 32 +/- 8
      microM; mean +/- SE) for uptake of choline, which was shown to be energy
      dependent and constitutive. The maximum rate of choline uptake by this system was
      repressed by ammonia and glucose, showing a three-fold increase in maximum
      activity after nitrogen (2 h) or carbon (4 h) starvation. The system was highly
      specific for choline with only dimethylethanolamine (Ki = 198 +/- 29 microM),
      betaine aldehyde (Ki = 95 +/- 14 microM) and chlorocholine (Ki = 352 +/- 40
      microM) acting as competitive inhibitors. Hemicholinium-3 acted as a mixed (non
      competitive) inhibitor (KIES = 1.9 +/- 0.6 microM; KIE = 3.6 +/- 1.9 microM).

PMID- 1624124
TI  - Isolation and properties of a low molecular mass endoglucanase from Trichoderma
      reesei.
AB  - Optimal culture conditions for obtaining low molecular mass endoglucanase (EG)
      from culture fluids of Trichoderma reesei were determined. The purification of
      this unglycosylated EG in a two-step procedure is described. In contrast to most
      cellulases, this EG did not bind to ConA-affinity columns. The unglycosylated
      fraction of the culture fluid proteins was further purified by preparative
      isoelectric focusing. Conditions relevant to an enzyme assay for this EG were
      determined (pH optimum 5.8, temperature optimum 52 degrees C).

PMID- 1624125
TI  - Aspergillus niger G proteins: subcellular localization.
AB  - Aspergillus niger postmitochondrial fraction, which contains high GTPase activity
      and high GTP binding capacity, has been subjected to subcellular fractionation on
      a sucrose gradient. A cytosolic and four membranous populations have been
      separated according to their relative density. The main difficulty has been the
      characterization of the plasma membrane of the fungus. This fraction, which does
      not contain any typical enzyme, has been identified after iodination of the outer
      proteins of protoplasts from A. niger. The immunological detection has shown the
      occurrence of cytosolic G proteins and membranous small G proteins located not
      only in the plasma membrane but also in the membranes of the endoplasmic
      reticulum.

PMID- 1624126
TI  - Gallium toxicity and adaptation in Pseudomonas fluorescens.
AB  - When cultured in a defined citrate medium supplemented with 1 mM gallium (III)
      Pseudomonas fluorescens ATCC 13525 experienced a lag phase of 40 h with no
      apparent diminution in cellular yield. Following initial uptake of the metal
      ligand complex, gallium was secreted in the spent fluid. This lag phase was
      abolished either by inoculating the medium with gallium adapted cells or by
      inclusion of iron (III) (20 microM) in the growth medium. In the culture enriched
      with both gallium and iron (III), X-ray fluorescence spectra revealed a gradual
      decrease of gallium from the spent fluid as growth progressed. In a phosphate
      deficient medium, no cellular multiplication was observed in the presence of
      gallium. The inhibitory influence mediated by the trivalent metal was reversed by
      the addition of (20 microM) iron (III). Although bacterial growth was accompanied
      by an initial decrease in exocellular gallium, a marked increment in the
      concentration of this metal was observed in the spent fluid at stationary phase
      of growth. Citrate was not detected in the exocellular fluid at cessation of
      bacterial multiplication. Electrophoretic analyses revealed numerous variations
      in the cytoplasmic protein profiles of the control and metal stressed cells.
      Gallium induced the syntheses of polypeptides with apparent molecular masses of
      89 kDa, 50 kDa, 39 kDa, 26 kDa and 12 kDa.

PMID- 1624127
TI  - Outer membrane components of Campylobacter hyointestinalis.
AB  - Outer membranes were isolated, by sodium lauryl sulphate extraction, from the
      American type strain, five Australian, and four English isolates of Campylobacter
      hyointestinalis. On SDS-PAGE examination, the protein profiles of seven strains
      (including the type strain) were similar, and were dominated by two major
      proteins of 47 and 50 kDa. Three other isolates had unique major protein
      profiles. The largest of these proteins was heat-modifiable in these isolates,
      and in the type strain. The flagellin of three isolates screened was of similar
      M(r) to that of Campylobacter jejuni/Campylobacter coli. The lipopolysaccharides
      of C. hyointestinalis isolates were heterogeneous in structure; 5/10 isolates
      synthesised material of M(r) value greater than that of the low M(r) C. jejuni/C.
      coli lipopolysaccharide. By gel excision and re-electrophoresis, it was shown
      that the higher M(r) materials of one isolate were not artifactual aggregates of
      lower M(r) species.

PMID- 1624128
TI  - Localization and distribution of hopanoids in membrane systems of the
      cyanobacterium Synechocystis PCC 6714.
AB  - Intracellular localization of triterpenic membrane stabilizers of the hopane
      series is described for the first time for a cyanobacterium. In Synechocystis PCC
      6714, a bacteriohopanetetrol derivative (main compound) and diplopterol were
      detected in cell wall (CW) and thylakoid membrane (TM). Both hopanoids were
      enriched 4.5-fold and 9.0-fold in CW and outer membrane (OM) fractions,
      respectively, compared to TMs.

PMID- 1624129
TI  - Salt tolerance and glycerol accumulation of a respiration-deficient mutant
      isolated from the petite-negative, salt-tolerant yeast Zygosaccharomyces rouxii.
AB  - A respiration-deficient (RD) mutant was isolated from the petite-negative, salt
      tolerant yeast Zygosaccharomyces rouxii. One strain among sixteen glycerol-non
      utilizing mutants exhibited vigorous liberation of CO2 but no uptake of O2.
      Furthermore, this strain lacked cytochrome aa3 and had a reduced level of
      cytochrome b. The few mitochondria found in cells of this strain contained few or
      no cristae. Salt tolerance and intracellular accumulation of glycerol by the RD
      strain were almost equal to that of the wild-type strain in media containing NaCl
      up to 2.5 M. In media with more than 3 M NaCl, the growth of the RD mutant was
      retarded and the intracellular accumulation of glycerol was depressed in spite of
      ample production.

PMID- 1624130
TI  - Mitotic and polytene chromosome analysis in Dacus oleae (Diptera: Tephritidae).
AB  - The present study constitutes the first attempt to construct a photographic map
      of the polytene chromosomes of Dacus oleae, a pest of the olive tree that causes
      serious financial damage in all olive oil producing countries. The map was
      constructed by using the larval fat body cells, the chromosomes of which are
      representative of the polytene chromosomes of other polytene tissues. In
      addition, the mitotic chromosomes of brain ganglia were examined, permitting
      tentative correlations between mitotic and polytene elements. This investigation
      shows that D. oleae is suitable for cytogenetic analysis in both mitotic and
      polytene chromosomes, a fact that may prove very useful for obtaining more
      detailed genetic information on the pest's natural populations.

PMID- 1624131
TI  - Chromosomal synapsis and the meiotic process in male mesquite lizards, Sceloporus
      grammicus complex.
AB  - Meiosis in males of the F5 cytotype of Sceloporus grammicus was examined through
      the analysis of synaptonemal complexes (SCs), diakinetic (metaphase I) nuclei,
      and secondary spermatocytes (metaphase II configurations). These data allowed the
      establishment of criteria for substaging of zygonema and pachynema, morphological
      characterization of the SC complement, and comparison of the orientation and
      segregation of the autosomes and sex chromosomes. The analysis of nuclei from all
      stages of meiotic prophase I (leptonema through diakinesis) provided a useful
      means of partitioning the temporal sequence of early meiotic events. Three
      substages of zygonema (Z1-Z3) were established, based on the extent of synapsis
      of the microchromosomal and macrochromosomal elements. Synaptic initiation of the
      autosomes and sex chromosomes was synchronous. Two patterns of macrochromosomal
      synapsis were observed. Whereas synapsis of the biarmed elements was biterminal
      (i.e., progressing from both ends of the homologs), synapsis of the acrocentric
      elements was uniterminal involving only the distal (noncentromeric) ends of the
      homologs. Unique sex-chromosomal characteristics were not observed in S.
      grammicus and, therefore, the substaging of pachynema was based on subjective
      criteria. Examination of diakinesis--metaphase I and metaphase II configurations
      indicated low levels of diakinetic irregularities with balanced segregation of
      the autosomal bivalents and the sex-chromosomal trivalent.

PMID- 1624132
TI  - New equations and a method for finding nine parameter values for two alleles at
      one locus to study gene conversion using Ascobolus immersus.
AB  - A quantitative treatment is given for meiotic gene conversion with its parameters
      and equations for their interactions to determine allele segregation class
      frequencies from heterozygotes. The possible pairing of both pairs of nonsister
      chromatids in a bivalent at exactly the same point is included. Using sets of
      data from Ascobolus immersus, it is shown that values for all nine parameters for
      hybrid DNA models of recombination can be obtained using an iterative computer
      program. The accuracy of the values is estimated and the double-strand gap repair
      model is considered. The parameter values obtained invalidate most of the
      simplifications used in previous quantitative analyses of gene conversion data.
      They showed total bias in strand preference in asymmetric hybrid DNA formation
      and some bias in which type of chromatid is the invading one. There were slight
      differences in repair frequency between the two types of mispair and very large
      differences in the direction of repair. Conversion control factors had major
      effects on hybrid DNA formation and repair of mispairs.

PMID- 1624133
TI  - The sequential appearance of components of the synaptonemal complex during
      meiosis of the female rat.
AB  - This paper describes the light microscopy (LM) and electron microscopy (EM)
      localization of synaptonemal complex (SC) antigens in oocytes of rats. For this
      purpose, we used monoclonal antibodies (Mabs) that recognize components of 30 +
      33, 125, and 190 kDa antigens of SCs of rat spermatocytes. The LM localization
      was performed by immunofluorescence and the EM localization by immunogold
      staining. The reaction of the Mabs with oocytes was similar to the reaction with
      spermatocytes, but weaker. The 30 + 33 kDa as well as the 190 kDa antigens could
      always be demonstrated if axial elements of the SC were present, irrespective of
      whether these were paired or unpaired. Thus, these antigens could be detected
      from leptotene--early zygotene until diplotene. The 190-kDa antigen appeared in a
      diffuse manner just before the appearance of the 30 + 33 kDa antigens. The 30 +
      33 kDa antigens were not only detected in the axial elements of SCs but also in
      characteristic aggregates, which appeared in zygotene and persisted until after
      the SCs had disappeared. Such aggregates had rarely been observed in
      spermatocytes. The 125 kDa antigen was only present in the tripartite segments of
      SCs, at the inner edge of the lateral elements. Thus, the reaction of the Mab
      against the 125 kDa antigen was detectable in zygotene, pachytene, and very early
      diplotene. It appeared later than 30 + 33 kDa and 190 kDa antigens and it
      disappeared earlier. We found that several steps of the immunostaining procedure
      could cause variation in the intensity of the Mab reaction.

PMID- 1624134
TI  - Two types of mouse (Mus musculus domesticus) Y chromosomes in Quebec.
AB  - A Y chromosomal repetitive sequence identified two types of Y chromosomes in mice
      (Mus musculus domesticus) caught near Ste. Anne de Bellevue, Quebec. One type is
      apparently identical to the Y chromosome found in Maryland, Delaware, and
      California, whereas the other type is similar, but not identical, to the Y
      chromosome present in M.m. poschiavinus, an Alpine race of M.m. domesticus. These
      findings suggest that the domesticus Y chromosome is highly polymorphic and thus
      useful for elucidating the relationships among American and European house mouse
      populations.

PMID- 1624135
TI  - Chromosome segregation from cell hybrids. VII. Reverse segregation from
      karyoplast hybrids suggests control by cytoplasmic factors.
AB  - Using human and Chinese hamster established lines as cell parents, we constructed
      hamster-human cell hybrids and human cell - hamster karyoplast hybrids. The cell
      hybrids retained one or two sets of hamster chromosomes and lost most of the
      human chromosomes. The karyoplast hybrids, however, retained a full set of human
      chromosomes and lost most of the Chinese hamster chromosomes. This reverse
      segregation pattern implies that cytoplasmic factors are major determinants of
      the direction of chromosome segregation.

PMID- 1624136
TI  - Partner choice in heterologous chromosome segregation of the Y chromosome in
      competitive situations in the oocyte of Drosophila melanogaster.
AB  - Heterologous segregation of the Y chromosome and secondary non-disjunction of the
      X chromosomes in female meiosis of Drosophila melanogaster was investigated in
      ten different crosses where different constellations of translocation/inversion
      or translocation/translocation systems of the large autosomes were present in the
      female parent. It appeared that the Y chromosome always segregates from the
      shortest of the possible heterologous pairing partners. This may be due to size
      dependent mechanism of so-called 'distributive disjunction' or to the possibility
      that the shorter the chromosome element is, the more easily it moves in the
      nucleus of the oocyte. Secondary non-disjunction of the X chromosomes appeared to
      be lower the more possible autosomal pairing partners the Y chromosome had,
      suggesting that the autosomes effectively compete with the X chromosomes for
      pairing with the Y chromosome. An alternative explanation is that, due to
      interchromosomal effect on recombination, crossing over in the X chromosomes was
      different in different experiments.

PMID- 1624137
TI  - A selective method for studying primary sex chromosome non-disjunction in females
      and males and X-Y exchange in males of Drosophila melanogaster including a
      demonstration of euchromatic X-Y exchange.
AB  - A selective method was developed, based on negative complementation of the
      Abruptex alleles of the Notch locus, for studying primary sex chromosome non
      disjunction in females and males of Drosophila melanogaster and X-Y exchange in
      males. The results show that the frequency of primary non-disjunction of
      structurally normal X chromosomes was lower than the frequency of X-derY non
      disjunction in males. Double exchange between the X and the derY chromosome in
      the male occurs with a frequency of at least 0.091%. Single exchanges are
      naturally expected to occur with even higher frequency. Exchanges were
      interestingly at least partly of euchromatic nature. The origin of these
      exchanges is at least partly of gonial origin.

PMID- 1624138
TI  - Gene flow by immigrants into isolated recipient populations: a laboratory model
      using flour beetles.
AB  - The effectiveness of immigrants as agents of gene flow was investigated in a
      laboratory model, using mutant marker strains of the flour beetle, Tribolium
      castaneum (Herbst). We show that immigrants had an advantage over residents. The
      proportion of hybrid offspring (PHO), resulting from immigrant mating with
      residents, was higher than expected from their frequency in the parental
      population. This advantage was observed regardless of immigrant sex and immigrant
      strain. The advantage seems to result from immigrant mating advantage (although
      not a rare-male phenomenon) and not from better survival of hybrid offspring.
      However, hybrid offspring seem to be more resistant to sporozoan infection,
      resulting in higher PHO in sporozoan-infected cultures.

PMID- 1624139
TI  - On fluctuation analysis: a new, simple and efficient method for computing the
      expected number of mutants.
AB  - Fluctuation analysis, which is often used to demonstrate random mutagenesis in
      cell lines (and to estimate mutation rates), is based on the properties of a
      probability distribution known as the Luria-Delbruck distribution (and its
      generalizations). The two main new results reported in this paper are (i) a
      simple, completely general, and computationally efficient procedure for
      calculating probability distributions arising from fluctuation analysis and (ii)
      the formula for this procedure when cells in a colony have only grown for a
      finite number of generations after initial seeding. It is also shown that the
      procedure reduces to one that was developed earlier when an infinite number of
      generations is assumed. The derivation of the generating function of the
      distribution is also clarified. The results obtained should also be useful to
      experimentalists when only a relatively short time elapses between seeding and
      harvesting cultures for fluctuation analysis.

PMID- 1624140
TI  - Effects of increasing age on vascular responses of the in vivo femoral artery of
      adult beagles.
AB  - One of the problems associated with using random-source dogs to study in vivo
      vascular responses is their unknown background. Since aging is known to influence
      vascular responses, unknown variations in age could influence experimental
      results. The vast majority of aging studies examine arteries in vitro. This study
      was undertaken to determine if increasing age of adult beagles influences in vivo
      femoral artery responses to acetylcholine, norepinephrine, and nitroglycerin.
      Experiments were performed on three groups: young (3.2 years), middle aged (6
      years), and old age (8.7 years). Femoral artery responses (change in diameter,
      mm) to topical application of increasing concentrations of vasoactive drugs were
      measured by sonomicrometry. Dose-response relationships to acetylcholine were not
      different between groups, except at the lowest concentration (-8 log M) where
      young dogs had enhanced relaxation responses. Constriction to norepinephrine and
      relaxation to nitroglycerin were not altered by age. Thus, in the in vivo canine
      femoral artery of adult beagle dogs, vascular responses are essentially
      unaffected by increasing age.

PMID- 1624141
TI  - Effect of aging on enzymatic antioxidant defenses in rat liver mitochondria.
AB  - Antioxidant defenses within liver mitochondria are pivotal in preventing liver
      damage from oxidative toxicants. In this study we determined the activities of
      glutathione peroxidase (GPO), superoxide dismutase (SOD) and glutathione
      reductase (GRD) in mitochondria from livers of variously aged Fischer 344 rats. A
      mixed pattern of age-associated alterations in mitochondrial antioxidant
      activities was observed. In male rats, GRD activity decreased in old age, whereas
      GPO and SOD activities increased. In female rats, GPO activity decreased with
      age, but SOD activity increased and GRD activity was unchanged. Age-associated
      decreases in antioxidant protection from mitochondrial enzymes appeared to be
      counterbalanced by increases in protection from other enzymes.

PMID- 1624142
TI  - Hyaluronic acid in progeria and the aged phenotype?
AB  - Hyaluronic acid (HA) is implicated in functions such as vascularity,
      morphogenesis, repair, and the general integrity of the extracellular matrix.
      Hence, it is considered possible that HA is involved in the most conspicuous
      features of the progeroid phenotype. However, it is not known whether the
      increase in HA excretion seen in progeria patients is due to a primary genetic
      defect or is a secondary effect due to some deeper problem. The phenomenon of
      'normal' aging is suggested to have a more complex etiology and phenotype than
      progeria and the role of HA levels is less well-defined.

PMID- 1624143
TI  - The fate of the quiescent surfaces of lamellar bone.
AB  - Microradiographic and histologic analysis of undemineralized bone was performed
      in 62 subjects aged 18-97 years. Ten of these samples were also submitted to
      scanning electron microscopy. Besides the usual lamellar bone remodeling, all
      types of bone surfaces, namely both haversian and vascular canals and the
      endosteal and trabecular surfaces, were involved in weathering alterations of the
      superficial lamellae, resulting in eroded outlines, less deeply notched than the
      Howship lacunae and devoid of osteoclast. Present as soon as early adult life and
      randomly distributed, these aspects were recorded in all the bone pieces
      examined. These observations were consistent with the hypothesis of a particular
      destructive process in all the quiescent lamellar bone surfaces without
      osteoclast participation, termed delitescence, which could be partly responsible
      for age-related bone loss.

PMID- 1624144
TI  - Clinical correlates of sway in elderly people living at home.
AB  - Postural sway has been noted to increase with advancing age and to correlate with
      a wide variety of clinical features. The relationships between sway and various
      clinical features were explored in a group of elderly subjects living at home and
      free from neurological illness and severe incapacity. Each subject underwent a
      thorough physical examination and sway was measured in the anteroposterior and
      lateral planes with eyes open and closed using a modified Wright's ataxiameter.
      Vibration sense was the only clinical feature to show a consistent relationship
      with all 4 measurements of sway in men. Age showed only a weak and inconsistent
      relationship to sway in both men and women. Weak but inconsistent relationships
      were noted between sway and mental function, tone, passive joint movement,
      antidepressant and tranquilliser therapy. This suggests that dorsal column
      function is of prime importance in the maintenance of balance and that the
      previously noted increase in postural sway with advancing age may have been
      exaggerated by the presence of disease processes.

PMID- 1624145
TI  - Role of obesity in development of ischemic heart disease in elderly diabetic
      patients.
AB  - The influence of obesity on the development of ischemic heart disease (IHD) was
      studied in 103 diabetic patients over 65 years of age. The patients were divided
      into three groups on the basis of their body mass index: lean, less than 20;
      normal, 20-25; obese, greater than 25. The incidence of IHD was significantly (p
      less than 0.01) higher in the obese group than in the other groups (43.2 vs. 18.8
      and 16.3%). The age, sex distribution, duration and control of diabetes mellitus,
      methods of diabetic therapy, and prevalence of hypertension, hyperuricemia and
      smoking were not significantly different in the three groups. The level of serum
      triglyceride was higher and that of high-density lipoprotein cholesterol (HDL-C)
      was lower in the obese group than in the other groups, but the prevalence of IHD
      was significantly higher in the obese patients without hypertriglyceridemia
      and/or low HDL-C than in the normal group (p less than 0.05). These results
      suggest that obesity is a risk factor for development of IHD in elderly diabetic
      patients independently of other known risk factors.

PMID- 1624146
TI  - Quantitative computer tomography in Alzheimer's disease: a re-evaluation.
AB  - This investigation addresses the question of usefulness of computer-tomographic
      (CT) scanning in discriminating patients with Alzheimer's disease (AD) from
      healthy, aged controls. Quantitative measures of brain volume loss found to be
      significant by other investigators as well as additional unique variables are
      used to discriminate 58 longitudinally studied patients meeting NINCDS-ADRDA
      criteria for the clinical diagnosis of probable AD from 59 controls. The
      sensitivity and specificity of both single CT scan parameters and multivariate
      models comprised of such CT parameters are explored. Reasons for diagnostic
      misclassification are also illuminated.

PMID- 1624148
TI  - Optimal number of biopsy specimens in the diagnosis of carcinoma of the
      oesophagus.
AB  - The study evaluated 48 patients with carcinoma of the oesophagus to assess the
      optimal number of biopsy specimens required to obtain the highest yield. Eight
      specimens were obtained from each patient and two specimens were placed serially
      in each of four vials. The first vial provided a positive diagnosis in 95.8% of
      cases. The addition of two more specimens (second vial) increased the yield to
      97.9% and the fifth and sixth specimens increased the positive yield to 100%.
      There was no statistically significant difference in the yield according to the
      site and the type of growth.

PMID- 1624147
TI  - Cigarette smoking and intestinal defences.

PMID- 1624149
TI  - Oesophageal propulsive force and its relation to manometric pressure.
AB  - A fixed volume capsule incorporating a force transducer and a side hole for
      manometric measurements was constructed and calibrated. Simultaneous measurements
      of the propulsive (aboral) force and the manometric pressure (intraluminal
      pressure) were made at 5, 10, and 15 cm above the lower oesophageal sphincter and
      in response to dry and wet (5, 10, and 15 ml) swallows. The propulsive force and
      manometric pressure waves had a simultaneous onset and were of similar duration.
      Peak values of propulsive force for wet swallows increased significantly as
      measurements were made progressively more distally within the oesophagus and were
      greatest in the distal oesophagus. The association between manometric pressure
      and propulsive force is not strong (r = 0.61) suggesting that intraluminal
      pressure is a poor predictor of propulsive force and hence an unreliable measure
      of oesophageal 'function'.

PMID- 1624150
TI  - Assessment of proliferation of squamous, Barrett's and gastric mucosa in patients
      with columnar lined Barrett's oesophagus.
AB  - There is no satisfactory biomarker yet available for predicting the likelihood of
      premalignant changes or carcinoma developing in Barrett's or columnar lined
      oesophagus. In this study we have evaluated the proliferation of squamous
      epithelium, columnar epithelium from columnar lined oesophagus and gastric
      columnar epithelium from 23 Barrett's patients using positive immunoreactivity
      with the mouse monoclonal antibody Ki67 (which recognises an antigen associated
      with proliferative cells) with a view to using this parameter as a biomarker.
      Squamous epithelium had significantly higher Ki67 immunostaining as compared with
      columnar epithelium from columnar lined oesophagus (when examining the tissue
      with greater than 15% cells staining positive for Ki67, Fisher's exact test p =
      0.004) but there was no difference found between the epithelium from the columnar
      lined oesophagus and gastric columnar epithelium. There was no correlation
      between histological inflammation and Ki67 immunoreactivity of Barrett's mucosa,
      and the Ki67 immunostaining of two patients with dysplasia was no different from
      the rest of the group. There was, however, a significant correlation between the
      Ki67 immunoreactivity of columnar epithelium from columnar lined oesophagus and
      columnar epithelium from the stomach (correlation coefficient = 0.44, p = 0.03)
      suggesting that epithelium from columnar lined oesophagus behaves in a similar
      fashion to gastric epithelium.

PMID- 1624151
TI  - Chemotactic activity of Helicobacter pylori sonicate for human polymorphonuclear
      leucocytes and monocytes.
AB  - The immunopathology of Helicobacter pylori associated active chronic gastritis,
      which is characterised by predominance of polymorphonuclear leucocyte
      infiltration, is largely unknown. To evaluate the role of bacterial components as
      inflammatory mediators ultracentrifuged sonicated preparations were made of
      clinical isolates of Helicobacter pylori. The crude sonicates were shown to
      exhibit chemotactic activity for human polymorphonuclear leucocytes and blood
      monocytes in a concentration dependent fashion. The potency was comparable with
      previously described bacterial derived cytotaxins. The cytotaxin(s) was non
      dialysable and completely destroyed by proteinase. Heat treatment did not
      decrease the chemotactic activity, but in sonicate subjected to 100 degrees C for
      15 minutes all activity disappeared after dialysis suggesting the breakdown of a
      larger protein to small fragments that are still biological active. By ammonium
      sulphate precipitation at increasing concentrations the cytotaxin(s) was
      selectively found in 10% ammonium sulphate saturation, and by further molecular
      gel separation the chemotactic activity was found in the molecular size range
      from 25 to 35 kDa. The demonstration of a polymorphonuclear leucocyte and
      monocyte cytotaxin from Helicobacter pylori sonicate may help in understanding
      the mucosal immune response in gastric inflammatory diseases.

PMID- 1624152
TI  - Chronic upper abdominal pain: site and radiation in various structural and
      functional disorders and the effect of various foods.
AB  - Pain site and radiation and the effect of various foods were studied
      prospectively in a consecutive series of patients with chronic upper abdominal
      pain. Patients followed for less than one year were excluded unless peptic ulcer
      or abdominal malignancy had been diagnosed or laparotomy had been carried out. A
      total of 632 patients were eligible for the first study and 431 for the second.
      Gastric ulcer pain was more likely to be left hypochondrial (17%) compared with
      pain from duodenal ulcer (4%) or from all other conditions (5%). It was less
      likely to be epigastric (54%) compared with duodenal ulcer pain (75%).
      Oesophageal pain was more likely to be both retrosternal and epigastric (25%)
      compared with non-oesophageal pain (2%). Radiation to the back was more common in
      peptic ulcer (31%) and biliary pain (35%) compared with functional pain (20%).
      Pain precipitation by fatty foods was commoner in biliary disease (40%) than in
      duodenal ulcer (11%), peptic ulcer (9%), or non-ulcer dyspepsia (19%). Orange,
      alcohol, and coffee precipitated pain more frequently in duodenal ulcer (41%,
      50%, and 43% respectively) than in biliary disease (17%, 0%, and 14%
      respectively). Chilli precipitated pain in one quarter to one half of subjects
      regardless of diagnosis. Approximately one tenth of all subjects avoided chilli,
      curry, coffee, and tea because of medical or other advice.

PMID- 1624153
TI  - Near infrared reflectance measurement of nitrogen faecal losses.
AB  - Chemical methods of measuring nitrogen in stools are complex, unpleasant, and
      therefore rarely performed. Recently, near infrared reflectance (NIRA) has been
      suggested for stool analysis. The aim of this study was to evaluate the possible
      application of this method in routine faecal nitrogen measurement. Nitrogen
      concentration and daily output were measured in the stools of 83 patients using
      NIRA and, for comparison, the Kjeldahl method. Nitrogen concentration and output
      ranged between 0.4-2.72 g% and 0.45-8.96 g/day respectively. Correlation
      coefficients (r), of 0.89 and 0.97 were found between the two methods for
      concentration and output respectively, and similar values were found in patients
      on enteral nutrition. Repeated measurements from the same stool collection,
      requiring only a few minutes, allowed homogenisation to be avoided. NIRA seems to
      be an easy, fast, and reliable alternative to chemical assays of nitrogen
      measurement in the management of patients with digestive disorders.

PMID- 1624155
TI  - Oral salt supplements to compensate for jejunostomy losses: comparison of sodium
      chloride capsules, glucose electrolyte solution, and glucose polymer electrolyte
      solution.
AB  - Six patients with jejunostomies and residual jejunal lengths of 105 to 250 cm
      took the same food and water each day for eight study days. In random order,
      three methods of salt replacement were tested, each over 48 hours, against a
      period without added salt. During the three test periods the patients took 120
      mmol of sodium chloride daily, as salt in gelatine capsules, as an isotonic
      glucose electrolyte (280 mOsmol/kg; 30 kcal) solution, and as a glucose polymer
      (Maxijul) solution (280 mOsmol/kg; 200 kcal). The daily stomal output remained
      constant for each patient during the four test periods but varied between
      patients from 0.60 to 2.84 kg (daily intestinal fluid balance 0.74-2.61 kg).
      Without a salt supplement, three patients lost more sodium from the stoma than
      they took in by mouth (-25, -94, and -101 mmol/day) and the mean sodium balance
      for all six subjects was -16 mmol (range -101 to 79) daily. Extra salt was
      absorbed with each form of supplement (p less than 0.05); no patient with the
      glucose electrolyte solution (mean 96, range 0 to 226 mmol), but one patient with
      the glucose-polymer solution (mean 96, range -25 to 164 mmol) and two with the
      salt capsules (mean 66, range -8 to 145 mmol) were in negative balance. Two
      patients vomited with the salt capsules. There was only a small increase in
      energy absorption (mean 115 kcal) with the glucose polymer solution compared with
      the glucose electrolyte solution. A sipped glucose electrolyte solution seems to
      be the optimal mode of sodium replacement in patients with a high output
      jejunostomy.

PMID- 1624154
TI  - Effects of acetorphan, an enkephalinase inhibitor, on experimental and acute
      diarrhoea.
AB  - Acetorphan is an orally active inhibitor of enkephalinase (EC 3.4.24.11) with
      antidiarrhoeal activity in rodents apparently through protection of endogenous
      enkephalins and a purely antisecretory mechanism. Its antidiarrhoeal activity in
      man was assessed in an experimental model of cathartic induced secretory
      diarrhoea as well as in acute diarrhoea of presumed infectious origin. In six
      healthy volunteers receiving castor oil and pretreated with acetorphan or placebo
      in a crossover controlled trial, the drug significantly decreased the number and
      weight of stools passed during 24 hours. About 200 outpatients with severe acute
      diarrhoea (more than five stools per day) were included in a randomised double
      blind study of acetorphan against placebo. The significant antidiarrhoeal
      activity of acetorphan was established using a variety of criteria: (i) the
      duration of both diarrhoea and treatment were diminished; (ii) no acetorphan
      treated patient withdrew from the study whereas five dropped out because of
      worsening in the placebo group; (iii) the frequency of symptoms associated with
      diarrhoea--for example, abdominal pain or distension, nausea and anorexia-
      remaining after two weeks was nearly halved; (iv) using visual analogue scales
      acetorphan treatment was found more effective than placebo by both investigators
      and patients. There was statistically no significant difference between
      acetorphan and placebo in respect of side effects, particularly constipation,
      which often accompanies the antidiarrhoeal activity of mu opioid receptor
      agonists this difference is attributable to the lack of antipropulsive activity
      of acetorphan in man. The efficacy and tolerance of acetorphan suggest that
      enkephalinase inhibition may represent a novel therapeutic approach for the
      symptomatic management of acute secretory diarrhoea without impairing intestinal
      transit.

PMID- 1624156
TI  - Determination of a critical level of tissue oxygenation in acute intestinal
      ischaemia.
AB  - Tissue oxygen tension (PtO2) was measured using a miniaturised polarographic
      oxygen electrode in 134 segments of rat small intestine of varying degrees of
      ischaemia. Without knowledge of the PtO2 levels, the viability of each segment
      was scored using clinical parameters and tissue damage scored by independent
      histological examination. Histologically non-viable bowel had significantly
      impaired tissue oxygenation when compared with viable bowel (t test, p less than
      0.001). Marked degrees of tissue hypoxia were frequently tolerated before major
      histological damage became apparent, a critical PtO2 level of 1.9 mmHg being
      identified. The overall accuracy rate of PtO2 measurement in the operative
      prediction of intestinal viability was 92.5%, which contrasts with a rate of only
      57.7% for clinical criteria alone.

PMID- 1624157
TI  - Occurrence of large granular lymphocytes and natural killer cells in the
      epithelium of the gut distinguishes two different coeliac diseases.
AB  - In a longterm study, we have divided coeliac disease into two distinct entities
      (abortive and permanent) based on the occurrence of large granular lymphocytes
      and natural killer cells within the epithelium of the gut. The natural killer and
      large granular lymphocytes cells were characterised by either immunohistochemical
      or phase contrast microscopical procedures on the initial biopsies from 15
      children with coeliac disease. They were compared with seven individuals with
      partial villus atrophy and eight with normal villous morphology. Although the
      histological findings were similar in the initial biopsies of all patients with
      coeliac disease, the patients with permanent coeliac disease had a significantly
      lower number (0.41(0.61)cells/mm2) of large granular lymphocytes and natural
      killer cells compared with those patients with abortive coeliac disease (11.93
      (6.23) cells/mm2). Those in the permanent group developed a significantly more
      pronounced flat mucosa after gluten challenge or provocation compared with the
      abortive group and had to remain on a strict gluten free diet in contrast with
      those in the abortive group. Thus, the occurrence of intraepithelial large
      granular lymphocytes and natural killer cells characterises two distinctly
      different coeliac diseases. Based on our results neither the histological
      evaluation of the biopsy nor the utilisation of the revised European Society for
      Paediatric Gastroenterology and Nutrition (ESPGAN) Criteria are adequate in
      diagnosing the two types of coeliac disease.

PMID- 1624158
TI  - Peripheral blood monocyte cytokine production and acute phase response in
      inflammatory bowel disease.
AB  - Cytokines released from activated mononuclear leukocytes are involved in
      triggering the acute phase response and many of the inflammatory manifestations
      of ulcerative colitis and Crohn's disease. The ability of circulating monocytes
      from patients with ulcerative colitis and Crohn's disease to generate the
      cytokines interleukin 1 beta (IL 1 beta) and tumour necrosis factor alpha (TNF
      alpha), both spontaneously and in response to stimulation by lipopolysaccharide,
      was compared. IL 1 beta generation in response to lipopolysaccharide was
      significantly higher in Crohn's disease than in ulcerative colitis and normal
      controls, with a dramatic increase in patients with active disease. There was a
      significant reduction in lipopolysaccharide stimulated TNF alpha generation in
      ulcerative colitis patients compared with Crohn's disease and normal control
      subjects. IL 1 beta and TNF alpha release correlated significantly with serum C
      reactive protein and serum alpha 1 acid glycoprotein in Crohn's disease. The
      ability of conditioned medium from monocytes in Crohn's disease to enhance
      release of alpha 1 acid glycoprotein from the liver cell line HepG2 in culture
      was assessed. There was a significant positive correlation between TNF alpha and
      IL 1 beta presence in the supernatant and alpha 1 acid glycoprotein production.
      The differences in the cytokine profile in patients with Crohn's disease compared
      with ulcerative colitis suggest an intrinsic difference in the ability to produce
      cytokines in patients with these two forms of inflammatory bowel disease, and may
      explain features such as the enhanced ability to generate a brisk C reactive
      protein response in Crohn's disease.

PMID- 1624159
TI  - Smoking in Crohn's disease: effect on localisation and clinical course.
AB  - The effects of smoking on the localisation and clinical course of Crohn's disease
      is evaluated in 231 patients. Heavy smokers (greater than 10 cigarettes/day) had
      an increased risk of operation at least once--odds ratios for heavy smokers
      compared with never smokers after five and 10 years were 1.14 and 1.24
      respectively (p = 0.03 and p = 0.017). The risk of further operations was even
      higher and after 10 years the odds ratio was 1.79 (p = 0.015). The accumulated
      number of fistulae and/or abscesses was higher for smokers than for never smokers
      (p = 0.046). Patients with a high life time tobacco exposure (greater than 150
      cigarette years) and heavy smokers (greater than 10 cigarettes/day) had small
      bowel disease more often than patients with lower life time exposure (less than
      or equal to 150 cigarette years) and patients smoking less than or equal to 10
      cigarettes/day (p = 0.002 and p = 0.045 respectively). The course of Crohn's
      disease analysed in different ways was unfavourable for smokers, especially heavy
      smokers. Patients with Crohn's disease should be dissuaded from smoking.

PMID- 1624160
TI  - Evolution of hereditary non-polyposis colorectal cancer.
AB  - The prevalence of colorectal adenoma in 23 affected patients with hereditary non
      polyposis colorectal cancer (HNPCC) was compared with that in an age matched
      forensic autopsy population. The mean ages at diagnosis of colorectal cancer in
      men (13) and women (10) were 39 and 37 years respectively. In HNPCC patients who
      presented below the age of 50 years, at least one adenoma was found in 3 of 10
      (30%) men and in 4 of 9 (44%) women. In the age matched autopsy specimens of
      large bowel, a solitary adenoma was found in 2/42 (5%) men (p = 0.015) and 1/21
      (5%) women (p = 0.0075). Of the 11 adenomas from HNPCC patients, nine were
      greater than 1 cm and six showed a pure villous architecture. Contiguous
      adenocarcinoma was observed with six adenomas. Adenomas do not occur in large
      numbers in HNPCC, but develop at a young age, attain a large size, often show a
      villous configuration, and are more prone to malignant conversion than sporadic
      adenomas.

PMID- 1624161
TI  - Families at risk of colorectal cancer: who are they?
AB  - The first degree kinships of 305 index cases have been studied to determine
      whether an early age of onset or a particular site distribution characterizes
      familial aggregations of colorectal cancer. The probands comprised 100 patients
      aged 55-74 years and 205 patients under 55 years at diagnosis and were drawn from
      a large population database. Ascertainment and verification were complete for
      2566 of 2657 first degree relatives. The history of cancer in 296 relatives was
      validated in 96% of cases from medical or other records. Among kinships
      ascertained through index cases under 55 years of age, less than 5% had three or
      more individuals affected by colorectal cancer. The comparable proportion of
      older probands' families was 3%. Probands with proximal disease were no more
      likely to have a positive family history of bowel cancer than those with disease
      distal to the splenic flexure. These findings are consistent with other
      population based studies of the epidemiology of familial colorectal cancer but
      contrast with reviews from referral centres and family cancer clinics.

PMID- 1624162
TI  - Effect of electrohydraulic and extracorporeal shock waves on gastrointestinal
      cancer cells and their response to cytotoxic agents.
AB  - Electrohydraulic and extracorporeal shock waves were used to treat the colorectal
      and gastric cancer cell lines LIM 2412 and MKN45. The effect on viability, cell
      proliferation, and the action of antitumour drugs was studied. Results showed
      that electrohydraulic and extracorporeal shock waves were cytotoxic to all cell
      lines and also caused considerable inhibition of cell proliferation. A
      significant additional reduction in cell viability was achieved by shock waves in
      cancer cells treated with methotrexate, 5-fluorouracil, and vincristine. These
      data indicate that shock waves may be worthy of further evaluation in the
      treatment of gastrointestinal cancers.

PMID- 1624163
TI  - Mucosal immune defence mechanisms in enterocolitis complicating Hirschsprung's
      disease.
AB  - Enterocolitis remains an important cause of morbidity and mortality in
      Hirschsprung's disease. The aetiology of enterocolitis is uncertain-ischaemic and
      bacterial causes and recently, rotavirus infections, have been suggested. Bowel
      tissue from 12 patients with Hirschsprung's disease who underwent Swenson's
      operation (five of whom had clinical evidence of enterocolitis) and colon from
      six controls subjects were examined to investigate possible immunopathological
      mechanisms associated with the disease. IgA, IgM, and J chain (but not IgG)
      containing plasma cells were significantly increased in the lamina propria along
      the entire length of resected bowel in enterocolitis patients, compared with non
      enterocolitis patients and controls (p less than 0.01). Luminal secretory
      component staining of the anganglionic segment of colon from enterocolitis
      patients was considerably reduced. Lamina propria CD68 positive
      monocyte/macrophages and CD45RO positive leukocytes were increased in
      enterocolitis patients compared with non-enterocolitis patients (p less than
      0.01). CD57 positive natural killer (NK) cells showed a unique distribution
      pattern compared with other cell types. Patients with enterocolitis showed a
      significant increase in CD57 positive NK cells in the lamina propria of
      ganglionic bowel only (p less than 0.05). NK cell values in ganglionic bowel of
      non-enterocolitis patients and in aganglionic bowel in all patients were similar
      to controls. The diversity of altered local immune response seen in this study
      may reflect a multifactorial microbial aetiology in enterocolitis associated with
      Hirschsprung's disease.

PMID- 1624164
TI  - Utility of a combined test of anorectal manometry, electromyography, and
      sensation in determining the mechanism of 'idiopathic' faecal incontinence.
AB  - Combined tests of anorectal manometry, sphincter electromyography and rectal
      sensation were carried out in 302 patients with faecal incontinence (235 women,
      67 men). The results obtained were compared with 65 normal subjects (35 women, 30
      men). A mechanism for incontinence was identified in all and the majority of
      patients had more than one abnormality. Two hundred and seventy eight patients
      (92%) had a weak external anal sphincter, 185 of these (67%, mostly women) also
      showed abnormal perineal descent, and 14 women showed clinical evidence of
      sphincter damage as a result of obstetric trauma. Ten per cent of patients with
      impaired external anal sphincter contraction showed associated evidence of spinal
      disease (impaired rectal sensation plus attenuated or enhanced reflex external
      anal sphincter activity). Unlike the other groups, the 'spinal' group contained
      equal numbers of men and women. Ninety seven patients (32%) had evidence of a
      weak internal anal sphincter. The external sphincter was also very weak and 92%
      of these patients also had perineal descent. Eighty two patients (27%) showed an
      unstable internal sphincter, characterised by prolonged 'spontaneous' anal
      relaxation under resting conditions and an abnormal reduction in anal pressure
      after conscious contraction of the sphincter or an increase in intraabdominal
      pressure. One hundred and forty two patients (47%) had a hypersensitive rectum
      associated with enhanced anorectal responses to rectal distension. All these
      patients had an abnormally weak external sphincter, suggesting that the
      hypersensitive or 'irritable' rectum should not be regarded as a cause of faecal
      incontinence unless accompanied by external sphincter weakness. Twenty four
      patients (8%) showed a normal basal and squeeze pressures and impaired rectal
      sensation; six showed giant rectal contractions during rectal distension. The
      results show that idiopathic faecal incontinence is not caused by a single
      abnormality, and it is suggested that combined anorectal manometry,
      electromyography, and sensory testing is a useful technique to identify the
      causes of faecal incontinence and provide a basis for appropriate treatment.

PMID- 1624165
TI  - Relation between hysterectomy and the irritable bowel: a prospective study.
AB  - Some women with irritable bowel syndrome date the onset of symptoms to previous
      hysterectomy. To assess prospectively the incidence of gastrointestinal
      symptomatology arising de novo after hysterectomy, and to study the effect of
      surgery on pre-existing symptoms, 205 women completed a symptom questionnaire
      before and six weeks and six months after surgery. Beforehand, symptoms
      suggestive of irritable bowel syndrome occurred in 22% of patients. At six months
      after operation, 60% of these had improved or were symptom free while 20% had
      increased symptomatology. New gastrointestinal symptoms were present more than
      once per week in 10% of previously asymptomatic women. Constipation predominant
      irritable bowel syndrome was the commonest symptom complex seen de novo,
      occurring more than once per week in 5% of the group. No relation was found
      between new symptomatology and the type of hysterectomy, oophorectomy, or the
      administration of perioperative antibiotics. This study suggests that many women
      with pre-existing gastrointestinal symptomatology improve after hysterectomy.
      However, symptoms suggestive of irritable bowel syndrome do arise de novo in 10%.
      As hysterectomy is common, gastroenterologists can expect to see women presenting
      with post-hysterectomy problems.

PMID- 1624166
TI  - Defecation frequency and timing, and stool form in the general population: a
      prospective study.
AB  - Because the range of bowel habits and stool types in the community is unknown we
      questioned 838 men and 1059 women, comprising 72.2% of a random stratified sample
      of the East Bristol population. Most of them kept records of three consecutive
      defecations, including stool form on a validated six point scale ranging from
      hard, round lumps to mushy. Questionnaire responses agreed moderately well with
      recorded data. Although the most common bowel habit was once daily this was a
      minority practice in both sexes; a regular 24 hour cycle was apparent in only 40%
      of men and 33% of women. Another 7% of men and 4% of women seemed to have a
      regular twice or thrice daily bowel habit. Thus most people had irregular bowels.
      A third of women defecated less often than daily and 1% once a week or less.
      Stools at the constipated end of the scale were passed more often by women than
      men. In women of child bearing age bowel habit and the spectrum of stool types
      were shifted towards constipation and irregularity compared with older women and
      three cases of severe slow transit constipation were discovered in young women.
      Otherwise age had little effect on bowel habit or stool type. Normal stool types,
      defined as those least likely to evoke symptoms, accounted for only 56% of all
      stools in women and 61% in men. Most defecations occurred in the early morning
      and earlier in men than in women. We conclude that conventionally normal bowel
      function is enjoyed by less than half the population and that, in this aspect of
      human physiology, younger women are especially disadvantaged.

PMID- 1624167
TI  - Effects of stressful life events on bowel symptoms: subjects with irritable bowel
      syndrome compared with subjects without bowel dysfunction.
AB  - A standardised inventory of stressful life events and a bowel symptom
      questionnaire were administered at three month intervals for one year to 383
      women who were unselected with respect to bowel symptoms. A NEO Personality
      Inventory was given initially to assess neuroticism. Subjects who satisfied
      restrictive diagnostic criteria for irritable bowel syndrome were compared with
      those who complained of abdominal pain plus altered bowel habits but who did not
      meet restrictive diagnostic criteria (functional bowel disorder) and with
      controls without bowel dysfunction. The irritable bowel group showed
      significantly higher levels of stress than the other two groups even when the
      confounding effects of neuroticism were statistically controlled for. Time lagged
      correlations showed that stress in one three month interval was significantly
      correlated with bowel symptoms in the subsequent three month interval for all
      groups. The slope of the regression line relating stress to bowel symptoms was
      significantly steeper for the irritable bowel group than for the other two groups
      at three and six months, suggesting that subjects with irritable bowel syndrome
      show a greater reactivity to stress. Stress scores were also significantly
      correlated with the number of disability days and the number of medical clinic
      visits for bowel symptoms.

PMID- 1624168
TI  - Effect of in vivo administration of an antibody to epidermal growth factor on the
      rapid increase in DNA synthesis induced by partial hepatectomy in the rat.
AB  - Recent reports indicate that transforming growth factor alpha (TGF-alpha) is
      produced within the liver and acts as the natural ligand of the epidermal growth
      factor (EGF) receptor causing the EGF receptor down regulation and the hepatocyte
      proliferation observed after partial hepatectomy. The reported phenomenon that an
      antibody to EGF inhibits the regenerative response to partial hepatectomy was
      therefore re-investigated. The IgG fraction of an anti-rat EGF antibody was
      injected intravenously at the time of partial hepatectomy, and its effects on
      regenerative DNA synthesis were compared with those of non-immune IgG. Injection
      of IgG reduced the DNA synthetic response to partial hepatectomy, assessed 24
      hours after resection by 3H-thymidine incorporation, but the effects of normal
      and anti-EGF IgG were not statistically different, despite the presence of excess
      anti-EGF IgG in the circulation throughout the experimental period. However, anti
      EGF IgG could completely block the proliferative response of hepatocytes in
      culture to EGF. These results support the suggestion that EGF is not the major
      mediator of hepatocyte DNA synthesis in the early stages of liver regeneration
      (less than 24 hours).

PMID- 1624169
TI  - Aminopyrine breath test in the prognostic evaluation of patients with cirrhosis.
AB  - This prospective study assessed the role of aminopyrine breath test in the
      prognosis of patients with cirrhosis, and evaluated whether the test provided
      useful information not included in the Pugh score. During a period of 36 months,
      125 patients with biopsy proven liver cirrhosis were included, and followed for
      up to 48 months (median 17 months). During follow up 43 patients died (20 of
      liver failure). Survival was univariately related to aminopyrine breath test (p
      less than 0.02), Pugh score (p less than 0.01), presence of ascites (p less than
      0.01), and sex (p less than 0.05). Using Cox's regression analysis, Pugh score,
      aminopyrine breath test, and sex, were independent significant predictors of
      survival. From the Cox's model a prognostic index was computed. According to a
      receiver operating characteristic curve analysis, the prognostic index predicting
      death showed an improvement in area under the curve when compared with a
      prognostic index calculated excluding aminopyrine breath test, but the
      improvement did not reach statistical significance (p = 0.12). A similar
      prognostic index was calculated to predict death from liver failure. Cox's
      regression analysis selected aminopyrine breath test, Pugh score, and aetiology
      as the best set of predictor covariates. According to a receiver operating
      characteristic curve analysis, a prognostic index cut off value of 2.6 had a 94%
      sensitivity and a 88% specificity. The prognostic index significantly improved
      prognostic accuracy when compared with a prognostic index calculated from Pugh
      score and aetiology, but excluding aminopyrine breath test (p = 0.05). These data
      disclose that the aminopyrine breath test offers additional prognostic
      information to the Pugh score, and the prognosis of patients with cirrhosis.

PMID- 1624170
TI  - Pancreatic surgery, not pancreatitis, is the primary cause of diabetes after
      acute fulminant pancreatitis.
AB  - Acute fulminant pancreatitis is associated with significant morbidity and
      mortality. To examine the outcome of conservative and surgical treatment of this
      disorder, 36 patients who survived an initial episode were restudied after a mean
      of six years. Fifty three per cent had developed diabetes mellitus, half of whom
      required insulin therapy. Pancreatic resection was associated with a 100%
      frequency of diabetes, while only 26% of those treated with peritoneal lavage
      developed this (p less than 0.001). Insulin secretion and sensitivity were
      assessed using the hyperglycaemic glucose clamp technique. First phase insulin
      secretion was impaired in surgically treated patients (mean (SEM) 14 (5)
      microU/ml x 10 minutes) compared with conservatively treated patients and control
      subjects (144 (66) and 87 (12) microU/ml x 10 minutes, respectively; p less than
      0.05). Second phase and 'maximal' insulin secretion were also impaired among the
      surgically treated patients compared with the conservatively treated patients and
      the controls. Insulin sensitivity was reduced among the surgically treated
      patients (2.88 (58) mg/kg.minute) when compared with conservatively treated
      patients and healthy control subjects (5.87 (1.02) and 6.45 (0.66) mg/kg.minute;
      p less than 0.05). Pancreatic resection is associated with a very high frequency
      of diabetes compared with peritoneal lavage, and these results favour
      conservative treatment of active fulminant pancreatitis whenever possible.

PMID- 1624171
TI  - Glycine nitrogen in total parenteral nutrition: two prospective clinical trials
      comparing the efficacy of high and low glycine containing amino acid solutions.
AB  - Glycine has been regarded as a poor source of nitrogen for total parenteral
      nutrition. Two prospective randomised cross over controlled clinical trials were
      undertaken to compare the efficacy of high and low glycine containing amino acid
      solutions in parenterally fed malnourished hypoalbuminaemic patients with
      gastrointestinal disease. In the first study (n = 9), amino acid solutions in
      which glycine accounted for 23% and 4% of total nitrogen were compared. No
      statistically significant difference was found in urea nitrogen/total urinary
      nitrogen excretion (mean (SEM) 83.4 (1.4) v 81.6 (1.7)%, p = 0.31), nitrogen
      balance (-1.9 (2.4) v -0.6 (2.0) g/day, p = 0.31) or plasma protein
      concentrations and blood urea nitrogen. In the second extended study (n = 5),
      there was no significant difference in net whole body protein synthesis (+1.3
      (4.7) v-0.2 (3.7) mg/kg/hour, p = 0.69) or fractional (0.403 (0.070) v 0.480
      (0.41)%/hour, p = 0.68) and absolute albumin synthesis rates (6.0 (0.9) v 7.2
      (0.06) mg/kg/hour, p = 0.22), on comparing solutions of 25% and 8% glycine
      nitrogen. In addition, a significantly higher proportion of total urinary
      nitrogen comprised urea when patients received the low glycine containing amino
      acid source (81.4 (2.5) v 83.8 (3.2)%, p = 0.04). It is concluded that there are
      no apparent short term nutritional or metabolic disadvantages to using amino acid
      solutions that contain up to 25% of nitrogen as glycine in total parenteral
      nutrition.

PMID- 1624172
TI  - Sustained hypothyroidism induced by recombinant alpha interferon in patients with
      chronic hepatitis C.
AB  - Thyroid dysfunction has been reported in patients with malignant disease treated
      with recombinant alpha interferon. Two cases of hypothyroidism in patients with
      chronic hepatitis C treated with recombinant alpha interferon are reported. In
      one patient, interferon induced hypothyroidism in the absence of pre-existing
      thyroid dysfunction and in the other it aggravated a pre-existing thyroid
      dysfunction. Both patients developed a severe, sustained hypothyroidism requiring
      thyroxine treatment for one year or more after stopping alpha interferon.
      Diagnosis of hypothyroidism during treatment can be difficult because of the
      common side effects of alpha interferon. Thyroid function should be assessed
      before and during alpha interferon therapy in patients with chronic hepatitis C.

PMID- 1624173
TI  - Thrombotic thrombocytopenic purpura mimicking acute small bowel Crohn's disease.
AB  - A 39 year old woman presented with a short history of bloody diarrhoea. She
      subsequently developed microangiopathic haemolysis, platelet consumption, and
      renal impairment. Initial investigations suggested underlying Crohn's disease of
      the terminal ileum complicated by sepsis and disseminated intravascular
      coagulation. However, after resection of a perforated caecum and terminal ileum,
      the diagnosis of thrombotic thrombocytopenic purpura was made. There was weak
      serological evidence of yersinia infection, this may have caused the early
      localisation of the lesions to the terminal ileum. This is believed to be the
      first report of thrombotic thrombocytopenic purpura affecting the small bowel
      alone at presentation.

PMID- 1624174
TI  - Oesophageal candidiasis after omeprazole therapy.
AB  - Oesophageal candidiasis was diagnosed incidentally at endoscopy in two patients
      receiving omeprazole therapy. There were no other predisposing factors for the
      development of candidiasis. The infection was resolved rapidly by anti-candidal
      therapy and by stopping omeprazole. These findings suggest that gastric acid
      secretion and physiological reflux of acid into the oesophagus may play a
      protective role in preventing candida infection.

PMID- 1624175
TI  - Adenocarcinoma and Barrett's oesophagus.

PMID- 1624177
TI  - [Proceedings of the Regional Meetings of the Italian Society of Hematology.
      Abstracts].

PMID- 1624176
TI  - Omeprazole versus ranitidine in the treatment of resistant duodenal ulcer.

PMID- 1624178
TI  - Preventing lead poisoning.

PMID- 1624179
TI  - Safety and health in the health care setting.

PMID- 1624180
TI  - Bottled water--consumers beware.

PMID- 1624181
TI  - A greener workplace at NH Hospital: a model for environmental action.

PMID- 1624182
TI  - MedCycle offers waste strategies for hospitals.

PMID- 1624183
TI  - HIV transmission in the environment: risks to public health.

PMID- 1624184
TI  - Potential hazards with protective restraint devices.

PMID- 1624185
TI  - Investigations into the fat pads of the sole of the foot: heel pressure studies.
AB  - The fat pads of the heel have a structure that is optimized for load bearing. In
      various diseases and aging, the load-carrying ability of the heel pad is
      clinically impaired. The loading pattern was examined in subjects having normal
      heel pads and those with atrophic heel pads, both with and without clinical
      symptoms. Normal heel pads showed a broad region of high pressure, which
      accounted for a high percentage of the total load transmission. In contrast, the
      atrophic heels showed a high but narrow peak pressure. However, most of the load
      was transmitted over a large area of low pressure. There was no difference
      between symptomatic and asymptomatic heels. The mechanical behavior of the fat
      pad is discussed with particular reference to the anatomic structure of the pads.
      Pad thickness and septal integrity are both important to the mechanical
      characteristics of the fat pad. The load-bearing patterns observed are discussed
      in terms of the mechanical components influencing fat pad resilience. These
      results have direct relevance to understanding the pathophysiology of heel pain
      secondary to degeneration of the fat pad.

PMID- 1624186
TI  - Investigations into the fat pads of the sole of the foot: anatomy and histology.
AB  - Anatomical, histological, and histochemical studies were performed on normal and
      abnormal fat pads of the sole of cadaver feet. The fat pads were found to contain
      a significant nerve and blood supply separate from that to the surrounding
      musculature and skin. Pacinian corpuscles and free nerve endings within the fat
      were identified. Histological analysis indicated a meshwork of fibroelastic
      septae arranged in a closed-cell configuration. The mechanical consequences of
      this organization are discussed in the context of the weightbearing role of the
      fat pads of the feet. Alterations seen in dysvascular or senescent feet are
      consistent with the hypothesis that the septal anatomy of the fat pads is central
      to their cushioning function.

PMID- 1624187
TI  - Salvage of failed first metatarsophalangeal joint implant arthroplasty by implant
      removal and synovectomy: clinical and biomechanical evaluation.
AB  - Implant removal and synovectomy were used to treat the failure of 14 first
      metatarsophalangeal joint implant arthroplasties. Revision surgery was performed
      at an average of 3.1 years after arthroplasty. Follow-up (average 4.9 years) was
      possible in 10 patients, and clinical results were excellent in seven patients,
      good in one patient, fair in one patient, and poor in one patient. No significant
      changes in alignment occurred, although a trend toward toe extension was noted.
      Dynamic force plate studies in these patients demonstrated less pressure under
      the first metatarsal head and greater loading under the lateral forefoot. The
      great toe had less contact time during gait in the involved feet than in the
      control feet.

PMID- 1624188
TI  - Talocalcaneal coalition: diagnosis and surgical management.
AB  - The authors studied 22 patients who had 32 feet with symptomatic talocalcaneal
      coalition. All feet were treated with excision of the bar and interposition of an
      autogenous free fat graft. These cases were assessed clinically and
      radiographically before and after the operation. They conclude that this
      technique is a good surgery with gratifying results. In the final outcome, 78.1%
      of feet became completely painless and 21.8% achieved relief of pain. There was
      improvement of the deformity in 68.7% and of range of motion in 75%.

PMID- 1624189
TI  - The art and science of fitting shoes.
AB  - The two primary components of achieving proper shoe fit are shoe shape and shoe
      size. Shoe shape refers to the shape of both the sole and the upper. Proper fit
      is achieved when shoe shape is matched to foot shape. Shoe size is determined by
      arch length rather than overall foot length. The proper shoe size is the one that
      accommodates the first metatarsal joint in the widest part of the shoe. A set of
      seven guidelines for achieving proper shoe fit is offered. Properly fitting shoes
      are important in avoiding foot discomfort and deformity, and are absolutely
      essential in patients with arthritis, diabetes, and other foot disorders.

PMID- 1624190
TI  - A method for measuring foot pressures using a high resolution, computerized
      insole sensor: the effect of heel wedges on plantar pressure distribution and
      center of force.
AB  - A new, high resolution, pressure-sensitive insole was tested and found to provide
      reproducible measurements of static and dynamic plantar pressures inside the shoe
      of normal test subjects under certain conditions. However, calibration between
      separate sensors was poor and the sensor pads showed significant wear with use.
      This system was also used to investigate the effect of heel wedges on plantar
      foot pressure to determine whether this system was sensitive enough to detect the
      effect of a gross shoe modification on plantar foot pressure. Medial heel wedges
      decreased plantar pressures under the first and second metatarsals as well as
      under the first toe, and shifted the center of force laterally in all portions of
      the foot. Lateral heel wedges decreased pressures under the third, fourth, and
      fifth metatarsals, increased pressures under the first and second metatarsals,
      and shifted the center of force medially in all portions of the foot. Our
      evaluations indicate that it is possible to measure static and dynamic plantar
      foot pressures within shoes and to study the possible effect of shoe
      modifications on plantar pressures in controlled gait trials.

PMID- 1624191
TI  - Transcutaneous oxygen as a predictor of wound healing in amputations of the foot
      and ankle.
AB  - Thirty-eight amputations of the foot and ankle were performed in patients with
      peripheral vascular insufficiency over a 20-month period. Amputation level
      selection was based on clinical examination, a minimum ankle-brachial index of
      0.5 as a measure of vascular supply, serum albumin of 3.0 gm/dl as a measure of
      tissue nutrition, and a total lymphocyte count of 1500 as a measure of
      immunocompetence. Transcutaneous oxygen tension was measured at the midfoot and
      ankle levels prior to surgery. Thirty-two of 38 patients (84.2%) healed their
      amputation wounds. When the transcutaneous oxygen tension was greater than 30 mm
      Hg, 24 of 26 patients (92.3%) healed. When the value was below 30 mm Hg, only
      eight of 12 patients healed. When the propensity to support wound healing is
      factored out, with patients having the metabolic capacity to heal an amputation
      wound in the foot and ankle, it appears that transcutaneous oxygen tension is an
      accurate measure of vascular inflow to support amputation wound healing.

PMID- 1624192
TI  - Silicone lymphadenopathy associated with failed prosthesis of the hallux: a case
      report and literature review.
AB  - Three years after replacement of a first metatarsophalangeal joint with a
      silicone prosthesis, a tennis player developed an enlarged ipsilateral femoral
      lymph node. The implant was also noted to have failed. Fine needle aspiration of
      the node revealed a foreign body giant cell reaction to particulates
      morphologically compatible with silicone elastomer. This finding suggests the
      potential utility of fine needle aspiration in the evaluation of patient response
      to foreign materials used in prosthetic devices. The lymphadenopathy also
      suggests that prosthetic metatarsophalangeal replacement in patients with high
      demand activities run the risk not only of failure of the prosthesis, but also of
      central migration of the particulate debris resulting from silicone elastomers.

PMID- 1624193
TI  - Excision of the fractured os peroneum: a report on five patients and review of
      the literature.
AB  - Five patients sustained fractures of the os peroneum after supination and
      plantarflexion injuries. Two of the injuries involved the knee in hyperflexion
      and the foot under the buttock. Four of the five were treated with immobilization
      for 6 weeks. All five required operative excision of the fractured sesamoid 8
      months to 8 years after the initial injury. Three fractures were bipartite and
      there were two multipartite fractures. At 12- to 28-month follow-up, all patients
      were pain-free over the lateral midfoot and four patients returned to preinjury
      activity levels.

PMID- 1624194
TI  - Regional anesthesia for foot and ankle surgery.
AB  - We present our experience with the use of regional anesthesia in 1295 of 1862
      (69.5%) surgical procedures of the foot and ankle between 1986 and 1989. Regional
      anesthesia was used for surgical procedures of the forefoot, midfoot, hindfoot,
      and ankle in the setting of elective surgery and trauma. From the viewpoint of
      the surgeon, regional anesthesia was completely successful in 95% of the
      procedures performed. Sample patient surveys confirmed that 87% of patients were
      satisfied with the use of regional anesthesia for their operative procedure.
      There were four (0.3%) minor complications, one being lidocaine toxicity. With
      increasing experience, the expanded indications and uses of regional anesthesia
      for foot and ankle surgery are proving to be simple, safe, reliable, and well
      tolerated by the patient.

PMID- 1624195
TI  - [Differential therapy with calcium antagonists].

PMID- 1624196
TI  - [Basic therapy of bronchial asthma. Evaluation of therapeutic alternatives:
      dosing aerosols, powder inhalation systems, nebulizers. Conference proceedings.
      Frankfurt-Gravenbruch, 13-14 March 1992].

PMID- 1624197
TI  - Progression of periodontal pockets in the age cohort 35-44 years.
AB  - In 1985 the Health Department of the Italian Telephone Company decided to launch
      an oral health programme for all its employees and their relatives, with the
      collaboration of the WHO Collaborating Centre of the Clinica Odontoiatrica
      Ospedale S. Paolo, Milan. The programme started with an epidemiological survey of
      dental and periodontal condition; following data analysis, the company also
      contracted with private dentists to provide oral care. Four years later, in 1989,
      several studies were set up to evaluate the programme. The WHO Collaborating
      Centre Milan was requested to evaluate the periodontal care given to a sample of
      persons living in the Milan area. Seventy-seven individuals with established
      periodontal lesions were selected out of a group of 678 aged between 35 and 44
      years examined in 1985. The same periodontal and dental indices used in 1985,
      CPITN (Community Periodontal Index of Treatment Needs) and DMFT (decayed,
      missing, filled teeth), were re-evaluated in these 77 persons and information
      about any periodontal care since 1985 was collected and checked against the
      reimbursement records of the Telephone Company. There was an increase in the
      percentage of persons with deep pockets (from 55.8 to 72.7 per cent), and of the
      mean of sextants affected (from 0.9 to 1.9). These individuals had been treated
      for dental problems, as demonstrated by an increase in the F component and a
      reduction of the D component of the DMFT, but had undergone virtually no
      treatment for periodontal problems. This may be considered as a longitudinal
      study on the natural progression of periodontal pathology in individuals with
      established periodontal lesions.

PMID- 1624199
TI  - The Swedish patient insurance scheme and guarantee insurance for prosthodontic
      treatment.
AB  - During 1975-76 a no-fault compensation system for treatment injuries in dentistry
      and failures within prosthodontics was introduced in Sweden. The guarantee
      insurance scheme for prosthetic treatment has changed somewhat during the years
      and, in 1987, became mandatory for all dentists in Sweden. All necessary
      retreatment not included in the National Dental Insurance Scheme (eg allergy to
      dental materials, all treatment following radiotherapy-related xerostomia) is
      included. For fixed prosthodontics, all replacements are covered by the scheme
      for the first 2 years. For removable prosthodontics, this is limited to the first
      year. A patient may choose any dentist in Sweden to carry out the retreatment.
      The claim system is simple and the number of cases has steadily increased,
      probably because dentists are becoming more familiar with the system and are
      willing to use it. The costs are paid for by private practitioners, the Public
      Dental Service and private dental laboratories. The insurance files are available
      for research purposes.

PMID- 1624198
TI  - The biological effects of fluoride on tooth development: possible use of cell
      culture systems.
AB  - The action of fluoride on tooth development and the observed side-effects of
      fluorosis are not yet fully understood. The authors briefly review the literature
      relating to hypotheses on dental fluorosis and describe in vitro cell culture
      techniques which could help to clarify the biological effect of fluoride on
      dental pulpal cells.

PMID- 1624200
TI  - Fear of amalgam: dentists' experiences in the Nordic countries.
AB  - The purpose of the present investigation was to study Nordic dentists'
      experiences with patients concerned about the possible adverse effects of dental
      restorations, their perceived ability to deal with this problem and their views
      as to the suitability of amalgam as a filling material. A random sample of
      practising dentists in Denmark, Finland, Norway and Sweden were sent a
      questionnaire in spring 1990. Responses were received from 1732 dentists (65 per
      cent). In 1989, virtually every dentist had seen patients concerned about
      possible adverse effects of their dental restorations. The reported mean number
      of such patients per dentist per year was 80.5 (SD = 128.1) in Denmark, 39.3 (SD
      = 68.4) in Finland, 83.3 (SD = 194.1) in Norway, and 124.4 (SD = 210.3) in
      Sweden. Ninety-two per cent of the patients' questions concerned amalgam
      fillings. About 70 per cent of the dentists believed that inexplicable symptoms
      associated with amalgam fillings had a psychosomatic background. Only about a
      fifth of the respondents felt able to examine such patients without seeking
      medical expertise. In the absence of oral or medical indications, 65 per cent of
      the respondents in Sweden and 77 per cent in the other countries considered that
      dentists should advise patients against having their amalgam fillings replaced.
      About 5 per cent of the respondents were ready to stop using amalgam in the near
      future.

PMID- 1624201
TI  - New attachment and tissue regeneration.
AB  - In periodontology, the possibility of stimulating new connective tissue
      attachment to previously diseased root surfaces, and the regeneration of the
      supporting periodontal tissues destroyed by periodontitis have been under study
      for some years. This paper reviews the different experimental methods used to
      prepare root surfaces for optimal regeneration and attachment of periodontal
      tissues. The mechanisms of blood clot formation, adhesion to the root surface and
      wound maturation are considered, as are the future needs for research in this
      subject.

PMID- 1624202
TI  - The effectiveness of the newly designed 'Concept 45 degrees' toothbrush for
      removal of dental plaque in primary schoolchildren.
AB  - A single-blind, two-period cross-over study involving 36 primary schoolchildren,
      grade 6, aged 11-12 years, was conducted to evaluate the effectiveness of the
      newly designed 'Concept 45 degrees' toothbrush. This toothbrush, with straight,
      multi-tufted bristles and a specially designed handle, was compared with a
      control toothbrush with straight, multi-tufted bristles and a conventionally
      designed handle for removing dental plaque. All subjects were instructed to brush
      their teeth using the Bass technique. The subjects were asked to refrain from
      brushing for 24 hours before the study, to provide an indication of which
      subjects had the greatest potential for plaque development. Dental plaque was
      scored before and after brushing for 2 minutes. Results indicated that the use of
      the 'Concept 45 degrees' toothbrush removed significantly more dental plaque when
      compared to a standard, conventional toothbrush.

PMID- 1624203
TI  - Prevention as a treatment of excellence--a view from Mexico City.
AB  - Using survey data from Mexico City recorded in 1982 and 1989, the results of this
      paper suggest that practice-based, disease-orientated, one-to-one technical
      dentistry is failing to solve the problems of oral health. Prevention constitutes
      a much better alternative as it can be provided for a greater number of people,
      more easily and more cheaply. Recommendations are made on how dental
      practitioners can adopt measures to change professional behaviour in order to
      institute preventive measures.

PMID- 1624204
TI  - Periodontal treatment needs, by CPITN, among employees of a Jerusalem hospital.
AB  - A survey, employing the Community Periodontal Index of Treatment Needs (CPITN),
      was conducted among 344 employees of a Jerusalem hospital. Of the population
      surveyed, 2.2 per cent demonstrated totally healthy mouths, 1.5 per cent had, at
      the worst, bleeding symptoms, 13.3 per cent had calculus, 53.4 per cent had 4-5
      mm ('shallow' according to WHO) pockets and 29.6 per cent had deep pockets (6 mm
      or more) as their worst CPITN scores. Results revealed an average of 0.55
      edentulous sextants, 0.68 healthy sextants, 0.87 sextants with bleeding symptoms,
      1.36 with calculus, 1.95 with 4-5 mm pockets and 0.61 sextants with deep pockets.
      In general, females were healthier than males, had a significantly greater number
      of healthy sextants, less sextants with calculus and less sextants with deep
      pockets. A deterioration in periodontal health with age was evident, according to
      mean number of sextants per person by CPITN scores. Associations were also
      analysed between CPITN and demographic variables. Few significant associations
      were revealed. Based on FDI and WHO estimates, the calculated periodontal
      treatment needs for the hospital employees was found to be about 2 hours per
      person. Compared with data for other countries, as reported by the WHO, this
      status demands serious efforts to be made towards periodontal health promotion.

PMID- 1624205
TI  - Disparity between medical and dental care of institutionalised elderly in
      Singapore.
AB  - Elderly persons tend to give dental care a lower priority than medical care. This
      study examined existing arrangements for and financial support of dental and
      medical care to elderly persons living in 68 long-term care facilities in
      Singapore. The chief administrators of all the homes for the aged were
      interviewed regarding the provision of physical and financial access to dental
      and medical care for their residents. Information was verified with a random
      selection of their residents. Results showed that a significantly higher number
      of homes (93 per cent) assumed responsibility for the provision of medical care
      than for dental care (70.7 per cent). A significantly greater proportion of them
      offered in-house medical care (42.6 per cent) than in-house dental care (5.9 per
      cent). Financial support for payment of providers' fees, hospitalisation and the
      transportation costs of ambulatory visits for both medical and dental care was
      found to be similar but generally inadequate. Greater commitment towards
      improving physical and financial access to dental care for the institutionalised
      elderly is necessary.

PMID- 1624206
TI  - LSA: a new liver-specific antigen in the rat. I. Purification and
      characterization.
AB  - A liver-specific antigen (LSA) was purified to homogeneity from rat liver by
      conventional methods of protein chemistry. By consecutive 100,000 g
      centrifugation, ammonium sulfate precipitation, ion-exchange chromatography on
      DEAE-cellulose, gel filtration on Sephadex G-200, ion-exchange chromatography on
      CM-cellulose and affinity chromatography on concanavalin-Sepharose, it has been
      possible to isolate a preparation that migrated as a single band on SDS-PAGE.
      This preparation gave a complete identity pattern with the original crude rat
      liver extract when tested by double immunodiffusion. This antigen has a molecular
      weight of 72.5 kD with an electrophoretic mobility in the region of alpha 2
      globulins. The LSA proved to be thermolabile since exposure to 55 degrees C
      completely destroyed the antigen. Exposure of the LSA to different pH ranging
      from 4 to 10 had no detrimental effect on its antigenic activity. The amino acid
      composition of the LSA revealed that the acidic amino acids out-number the basic
      amino acids, with glutamic acid being the most abundant of them. Failure of beta
      mercaptoethanol to split the LSA molecule suggests the absence of sulfhydryl
      groups related to its antigenic activity. Subcellular fractionation of rat liver
      revealed most of the antigenic activity in the 100,000 g supernate, i.e. the
      soluble cytoplasmic fraction of the liver (cytosol). By contrast, the LSA was
      absent from isolated Kupffer cells from rat liver. The absence of any
      carbohydrate or lipid from the purified preparation of this antigen, in
      conjunction with the destructive effects of trypsin suggest that the LSA is a
      protein or a moiety closely associated with proteins.

PMID- 1624207
TI  - Frequency analysis of allergen-reactive T-lymphocytes in individuals allergic
      against the house-dust mite Dermatophagoides pteronyssinus.
AB  - We have investigated the frequencies of Dermatophagoides pteronyssinus (Dpt)
      reactive circulating T cells in individuals allergic to this house dust mite and
      in asymptomatic controls. In allergic patients the median for frequencies of Dpt
      reactive T cells (80/10,000 T cells) was significantly higher (p = 0.0001) than
      that in the controls (19/10,000 T cells). Frequencies of spontaneously
      proliferating T cells were also determined. Here too, marked differences (p =
      0.0001) were observed between the allergics (median = 32/10,000 T cells) and the
      non-allergics (median = 7.5/10,000 T cells). The allergen-reactive T cells tended
      to occur at a higher frequency with increasing serum level of Dpt-specific IgE.
      Thus the median value for Dpt-reactive T cells in patients showing RAST class
      greater than or equal to 4 (176.5/10,000 T cells) was higher than that shown by
      patients with RAST class 3 (62/10,000 T cells). Frequency estimations of allergen
      reactive T cells before, during and after the completion of hyposensitization
      therapy might help to clarify their possible role in the allergic symptoms.

PMID- 1624208
TI  - Regulation of intestinal immunoglobulin production in response to dietary
      ovalbumin.
AB  - The effects of oral administration of ovalbumin (OVA) on intestinal
      immunoglobulin production was examined. Balb/c mice, bred and reared on an OVA
      free diet, received either one dose or 14 consecutive daily intragastric doses of
      25 mg OVA/dose. Single dose administration of OVA resulted in significant
      suppression of total immunoglobulins in the intestinal mucosa, particularly of
      the IgA isotype, although a very low titre anti-OVA IgG class antibody response
      was induced. After multiple peroral immunisations, there was more intestinal anti
      OVA antibody induction and less suppression of total immunoglobulins. However,
      all the anti-OVA antibody was of the IgG isotype. In vitro production of mucosal
      immunoglobulins was not significantly reduced over 5 days, compared with
      controls, in either single or multiple administration groups, suggestive of a
      loss of T suppressor cell function in culture. Prior adoptive transfer of splenic
      and lymph node cells from mice preimmunised with OVA was capable of abrogating
      the local suppression of immunoglobulin production in vivo. Although adoptive
      transfer of bovine serum albumin-sensitised cells could also overcome some of the
      local suppression, complete restoration of normal immunoglobulin levels was not
      achieved. These data suggest that single oral administration of a novel dietary
      antigen induces a transient, non-specific suppression of intestinal
      immunoglobulin production, which can be overcome by antigen-specific T cells.

PMID- 1624209
TI  - Bronchoconstriction in helminthic infection.
AB  - In order to determine whether infection by helminthic parasites can be associated
      with a state of bronchoconstriction, we evaluated the response to the inhalation
      of a bronchodilator before and after long-term anthelmintic treatment of children
      in a urban slum of Caracas, Venezuela. In untreated children, a direct
      association was found between the degree of helminthic infection and the increase
      in peak expiratory flow rates caused by the bronchodilator. The elimination of
      the infections was accompanied by a significant decrease in response to the
      bronchodilator. These results indicate that helminthic infection could contribute
      to the development of asthmatic conditions in areas where these parasites are
      endemic.

PMID- 1624210
TI  - Grass aeropollen of the western United States Gulf Coast.
AB  - Volumetric air sampling was performed at Corpus Christi, Tex., September 1987 to
      August 1989. Grass aeropollen during all of 1988 accounted for 15.3% of total
      pollen captured during two major peaks, one in May and another during September
      and October. The remaining grass pollen, about one-quarter of the total, was
      found throughout the year with low levels in the winter and mid-summer. This
      bimodal pollen release corresponds to the flowering of two major types of grasses
      occurring in the western Gulf Coast region, the cool temperate species which are
      predominantly spring flowering in response to long-day photoperiodicity, and the
      more common warm temperate and subtropical species flowering by and large in the
      fall as short-day plants. Supplementing the already rich grass flora and adding
      to the high proportion of total aeropollen was the long distance dispersal of
      grass pollen found perhaps in sufficiently high quantities to trigger allergic
      symptoms and to cause grass pollinosis out of season, at least in acutely
      sensitive individuals. This occurred in late March, well before the spring peak
      in May. Correlations existed between near-drought conditions and reduced pollen
      shed in 1988, and normal precipitation and much higher pollen shed during parts
      of 1987 and 1989, illustrating the importance of environmental factors such as
      moisture on annual pollen frequency and level of pollinosis which can be variable
      and annually unpredictable. What is predictable is the genetically controlled
      timing of pollen maturation and release which will be generally the same year by
      year.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624211
TI  - Complete clarification of a case of farmer's lung.
AB  - The diagnostic curriculum to clarify a case of farmer's lung in a fibrotic stage
      is presented, including clinical functional tests, X-ray, analysis of cellular
      elements recovered from bronchioalveolar lavage, determination of precipitating
      antibodies in the circulation, histological and immunohistological studies of
      transbronchial lung biopsies. The patient had precipitating antibodies against
      several species of hay molds, especially Micropolyspora faeni, and immune complex
      deposition in the lung. Elution experiments on frozen sections of the lung
      biopsies and subsequent administration of patient's serum- or mold antigen
      specific antibodies combined with appropriate serum absorption experiments
      allowed the identification of the relevant antigen, i.e. M. faeni, in the
      deposited immune complexes. The immunohistological analysis of extracellular
      matrix components revealed an interstitial increase in procollagen and collagen
      type I and an even more pronounced augmentation of procollagen type III and
      fibronectin, i.e. a constellation characteristic for a chronic, active lung
      fibrosis that developed on the basis of an immune complex disease.

PMID- 1624212
TI  - The T-lymphocyte is the primary cellular target for potentiation of the in vitro
      T-dependent IgM antibody response by the B subunit of cholera toxin.
AB  - The B (or binding) subunit of cholera toxin (CTB) was reported previously to
      potentiate the in vitro T-dependent IgM antibody response by a mechanism
      independent of the cyclic AMP-generating capacity of the intact toxin. In the
      present report, experiments were designed to determine the immune cell type
      mediating potentiation by CTB. Firstly, CTB did not potentiate T-independent
      antibody responses at concentrations that effectively enhanced T-dependent
      responses. Secondly, separation/reconstitution studies with splenocytes from CTB-
      and vehicle-treated mice demonstrated potentiation of T-dependent responses by
      CTB treatment of either the Sephadex G10 non-adherent population or the T
      lymphocyte + macrophage population of cells. Potentiation was not observed by CTB
      treatment of the plastic adherent population or the B-lymphocyte + macrophage
      population. The evidence indicates that the T-lymphocyte is the primary cellular
      target for CTB-induced effects on the T-dependent IgM antibody response.
      Monosialoganglioside GM1, the putative binding site for CTB, is most likely the
      site of action for CTB on T-lymphocytes. These studies provide new insight on the
      mechanism of immunomodulation by cholera toxin, and CTB should provide a useful
      tool for further understanding the role of gangliosides in cellular immune
      responses.

PMID- 1624213
TI  - Modulation of tumor necrosis factor release from alveolar macrophages treated
      with pentamidine isethionate.
AB  - Alveolar macrophages in AIDS patients have a marked increase in tumor necrosis
      factor release in active Pneumocystis carinii pneumonia. We have demonstrated
      that pentamidine, an aromatic diamidine currently used to treat AIDS-related P.
      carinii pneumonia, is an effective inhibitor of cellular tumor necrosis factor
      release from lipopolysaccharide-stimulated rat alveolar macrophages at
      concentrations greater than 10(-8) M. Inhibition of release is not dependent upon
      the continued presence of pentamidine in the culture medium during the release
      phase. In addition, this blockage occurs at neither the transcriptional level as
      determined by Northern blot analysis nor the translational level as determined by
      Western blot analysis. Timed addition studies suggest that pentamidine is
      targeting relatively early events following lipopolysaccharide administration.
      Pentamidine appears to alter early lipopolysaccharide-induced cellular processes
      associated with the release of tumor necrosis factor from macrophages.

PMID- 1624214
TI  - Molecular requirements of endotoxin (ET) actions: changes in the immune adjuvant,
      TNF liberating and toxic properties of endotoxin during alkaline hydrolysis.
AB  - The effect of alkaline pH and alkaline hydrolysis on the physico-chemical and
      biological properties of endotoxin (ET) isolated from Serratia marcescens ATCC
      13477 by the Biovin procedure was studied. Major emphasis was put on the ion
      exchange column chromatography and immune adjuvant activity (ADA) of the alkali
      treated samples. To measure changes in some endotoxicity parameters, Limulus
      lysate clotting (LAL), chick embryo lethality, Shwartzman skin reactivity and in
      vitro TNF release were measured. The toxic properties of ET, with the unique
      exception of the Shwartzman skin reactivity, rapidly diminished during alkaline
      treatment. As immunogen CBre3, a recombinant HIV glycoprotein which spans the C
      terminus of gp 120 and the N terminus of gp 41, was used in CD-1 mice, alkali
      treated and immediately neutralized ET samples (zero time) were inactive as
      adjuvants, in some cases immunosuppression could be clearly seen. But if the
      alkaline hydrolysis was continued for 6 h, the ADA became higher than it had been
      for the starting ET sample. Further alkaline hydrolysis eliminated the ADA of the
      samples. Both NaOH and propylamine acted similarly on the ET preparation.
      Reaction kinetic studies of the NaOH detoxification indicated the cleavage of
      ester bound acyl groups with low binding energy. Chemical analyses of the samples
      revealed that changes occurred in the fatty acid composition, characterized by a
      loss of approximately half of the 3-OH myristic acid content.

PMID- 1624215
TI  - Adjuvant activity of all-trans-retinoic acid in C57Bl/6 mice.
AB  - The effects of all-trans-retinoic acid were investigated on the immune responses
      in C57Bl/6 mice after daily oral administration for one week. In selected
      experiments the immunosuppressive chemicals, cyclophosphamide and cyclosporin A
      were used in conjunction with retinoic acid. Retinoic acid stimulated the
      production of antibodies against sheep red blood cells and DNP-Ficoll; however,
      retinoic acid did not reverse the depression caused by immunosuppressive
      chemicals. In non-immunized animals retinoic acid stimulated the production of IL
      1 but not of IL-2. The mitogenic responses of splenocytes against concanavalin A,
      phytohemagglutinin and pokeweed mitogen were depressed after the retinoic acid
      treatment; those against lipopolysaccharide were not influenced. Treatment with
      retinoic acid did not alter the mixed leukocyte responses but increased the
      activity of NK cells. Results indicate that retinoic acid may act as an adjuvant
      via activating macrophages, however, retinoic acid cannot reverse the
      immunosuppression induced by potent chemicals.

PMID- 1624216
TI  - Detection of circulating anodic antigen before and after specific chemotherapy in
      experimental murine Schistosomiasis mansoni.
AB  - In two groups of mice infected with 60 (group I) and 120 (group II) Schistosoma
      mansoni cercariae, respectively, the effects of intensity and duration of
      infection, and of praziquantel therapy (curative vs subcurative dose) on the
      levels of circulating anodic antigen (CAA), were studied. CAA was measured in
      trichloracetic acid-treated serum samples with an avidin-biotin enzyme-linked
      immunosorbent assay (AB-ELISA) using the monoclonal anti-CAA antibody. Total worm
      burdens, oogram patterns and ova counts/g liver and intestine were followed up.
      The lowest detectable level of CAA was about 1.0 ng/ml, and was positive with a
      worm load of 3-5/mouse. CAA levels became already detectable as early as 1-2
      weeks post-infection (pi) before any parasitological parameter and showed a
      significant drop from the 11th-12th week pi onwards. A positive correlation was
      demonstrated between the CAA level and worm load. Following successful
      praziquantel therapy, CAA disappeared earlier than any of the other parameters
      studied.

PMID- 1624217
TI  - Muramyl dipeptide-induced changes in murine splenocyte responses to concanavalin
      A.
AB  - The effect of muramyl dipeptide (MDP) on Con A-stimulated activation of murine
      spleen cells was studied. MDP was found to enhance or suppress the proliferative
      response of splenocytes when different concentrations of Con A were used. MDP was
      shown to change the IL-2 content in culture supernatants of stimulated cells and
      to influence IL-2-dependent proliferation of Con A-blasts. A high degree of
      correlation was found between the proliferation of Con A-blasts and the
      expression of IL-2 receptors on Con A-blasts. This correlation, however,
      disappeared in the presence of MDP. The effects of MDP were shown to depend on
      the level of initial cell activity or rather on conditions leading to a given
      initial activity of cells.

PMID- 1624218
TI  - Dose-related effects of oestradiol on rat thymic and splenic T-lymphocyte
      responsiveness to mitogens.
AB  - The dose-related effects of oestradiol on responses of thymic and splenic
      lymphocytes to mitogenic stimulation were studied in immature female Wistar rats.
      An attempt was made to relate responses not merely to dose but also to the
      circulating levels of the steroid. Lymphocytes were prepared from thymus and
      spleen and stimulated with phytohaemagglutinin (PHA) and concanavalin A (Con A)
      prior to measurement of 3H-thymidine incorporation. Oestradiol suppressed
      lymphoid tissue weight and cell number in a dose-related manner, but it was
      found, unexpectedly, that the dose of oestradiol used actually stimulated
      responsiveness of lymphocytes to mitogenic stimulation. Log dose-response curves
      indicate that the effects of oestradiol on responsiveness are complex, and the
      results suggest that the atrophic effects of oestradiol on lymphoid tissue and
      its enhancement of response to mitogens might be mediated by different
      mechanisms. Since the stimulant effects of the steroid were observed with serum
      levels of oestradiol attained both physiologically and pharmacologically, the
      results suggest a possible mechanism of action of oestradiol in abnormal cell
      proliferation, as occurs in neoplastic tissues, and might also help to explain
      certain sex-linked immune-related disorders.

PMID- 1624219
TI  - Potentiation of IL-2-induced t-cell proliferation by retinoids.
AB  - We evaluated the capacity of retinoids to potentiate proliferative responses of
      murine T-cells to recombinant human interleukin 2 (rIL-2). Concanavalin A (Con A)
      prestimulated spleen cells responded in a dose-dependent manner to added rIL-2.
      All-trans-retinoic acid (RA) at 10(-8) M potentiated the proliferative response
      by fivefold at saturating levels of IL-2. In similar experiments, two closely
      related retinamides, all-trans-(phenyl)retinamide (PR) and N-(4
      hydroxyphenyl)retinamide (4-HPR), also potentiated murine splenocyte rIL-2
      responses. Potentiation of IL-2-induced proliferation was dose-responsive to the
      concentration of added retinoid with peak potentiation occurring at 10(-10) - 10(
      8) M in the presence of 10 U/ml rIL-2. Significant potentiation was observed at
      retinoid concentrations as low as 10(-14) M. Fluorescence flow cytometry of the
      responding cells revealed that among L3T4+, Lyt-2+ or total T-cells, at 72 h
      following Con A stimulation, essentially all of the cells expressed IL-2
      receptors (IL-2R). This apparently represents near maximum IL-2R expression and
      treatment of the cells with retinoids did not increase IL-2R expression at that
      time point. The potentiation of IL-2 responses by retinoids was also observed
      with IL-2-dependent HT-2 cells, 98% of which were IL-2R positive. HT-2
      proliferative responses to rIL-2 were potentiated as much as fourfold by 10(-10)
      M RA. HT-2 proliferative responses to rIL-2 were potentiated by all three
      retinoids dose dependently. Significant potentiation was observed with as little
      as 10(-14) M retinoid. Retinoids in the absence of IL-2 induced no proliferative
      responses. These data suggest that retinoids can augment the capacity of IL-2 to
      induce T-cell proliferation using Con A-activated murine splenic T-cell blasts
      and a long-term-cultured T-cell line.

PMID- 1624220
TI  - Oral administration of a streptococcal agent OK-432 activates alveolar
      macrophages in mice.
AB  - The effect of orally administered OK-432, a streptococcal preparation, on the
      functions of alveolar macrophages in mice was examined. The oral administration
      of OK-432 (1, 2 or 4 KE, four times every 3 days) augmented phagocytic activity,
      lysosomal enzyme activity and interleukin 1 (IL-1) production of murine alveolar
      macrophages recovered 5 days after the final administration while it did not
      augment H2O2 production. The number of alveolar macrophages was not affected by
      the same treatment. These results suggested that oral administration of OK-432
      activates alveolar macrophages qualitatively to protect the lung from the
      metastasis of cancer cells and infectious diseases by pathogenic micro-organisms.

PMID- 1624221
TI  - Age-related influence of piracetam on mitotic index and number of silver-stained
      nucleolus organizer regions.
AB  - Mitotic indices and the number of silver-positive nucleolus organizer regions
      (AgNORs) were scored in phytohemagglutinin-stimulated cultures of peripheral
      lymphocytes from two age groups of females (mean = 23.1 and 84.0 yr,
      respectively) under the influence of Piracetam (2-oxo-pyrrolidine-1-acetamid;
      Nootropil, Reg. No. 17051) and in simultaneously set up control cultures without
      Piracetam addition. Piracetam concentrations of 10, 14 and 16 mg/ml culture
      medium produced a highly significant, decreasing effect on both parameters
      tested, without an age-related difference. Lower Piracetam concentrations (2 and
      4 mg/ml culture medium) showed a depressant effect on some of the cultures only;
      but, on average, there was a rather equal, significant, dose-dependent, linear
      decrease of the mitotic indices of both age groups, whereas the suppressive
      effect on the number of AgNORs was significant in cultures from the young females
      only.

PMID- 1624222
TI  - Biological activity of chemically synthesized core sugar linked lipid A analog,
      heptose-(alpha 1----5)-2-keto-3-deoxyoctonic acid-(alpha 2----6)-2,3
      diacyloxyacylglucosamine-4-phosphate.
AB  - The mitogenicity, lethal toxicity and antitumor activity against Meth A
      fibrosarcoma and the induction of tumor necrosis factor (TNF) of chemically
      synthesized compounds designated as A-103, 2,3-diacyloxyacylglucosamine-4
      phosphate (GlcN-4-P), and A-503), heptose-(alpha 1----5)-2-keto-3-deoxyoctonic
      acid (KDO)-linked GlcN-4-P (A-103), were determined. Compound A-103 induced
      significant incorporation of [3H]thymidine of C57BL/6 mice at 25-100
      micrograms/ml, and A-503 showed the highest incorporation of [3H]thymidine at 100
      micrograms/ml. The mitogenicity of A-503 exhibited a lower activity than of A
      103. Compound A-503 showed no lethality at high doses of 25 and 50
      micrograms/mouse in C57BL/6 mice loaded with D-galactosamine, whereas A-103
      caused the death of one of three mice at a dose of 50 micrograms/mouse. Although,
      the two compounds with or without muramyl dipeptide showed weak antitumor
      activity against Meth A fibrosarcoma in BALB/c mice, but there were no remarkable
      differences between the compounds on antitumor activity. Peritoneal macrophages,
      stimulated with A-103 or A-503 caused no production of TNF which induces L929
      cell lysis in vitro. These findings indicate that the addition of heptose and KDO
      to GlcN-4-P seems not to affect mitogenic activity, lethal toxicity, antitumor
      activity and TNF-production of the GlcN-4-P compound (A-103).

PMID- 1624223
TI  - Mechanism of immunosuppressive effect of alprazolam: alprazolam suppresses T-cell
      proliferation by selectively inhibiting the production of IL2 but not acquisition
      of IL2 receptor.
AB  - The purpose of this study was to elucidate the mechanism of action of alprazolam
      on concanavalin A (Con A)-induced murine T-cell proliferation. Splenic cells of
      BALB/c mice were first cultured with an optimum dose of Con A in the presence or
      absence of varying doses of alprazolam to assess effects of alprazolam on T-cell
      proliferation, interleukin 2 (IL2) production and IL2 receptor (IL2R) expression.
      Then, Con A-induced T-blast cells from BALB/c mice were cultured with an excess
      dose of human recombinant IL2 (rIL2) or crude rat IL2 supernate in the presence
      or absence of alprazolam to assess the effects of alprazolam on the interaction
      of IL2 and IL2R. The results of these studies clearly demonstrated that
      alprazolam can inhibit the T-cell proliferation in response to Con A but not to
      IL2. Alprazolam also reduced the production of IL2 by splenic T-cells, but did
      not alter the expression of IL2R on Con A-induced T-blast cells. Furthermore, the
      results also showed that (a) alprazolam did not inhibit the proliferative
      response of splenic T-cells to a combination of phorbol 12-myristate-13-acetate
      (PMA) and ionomycin, and (b) the addition of exogenous IL2 reversed the
      inhibitory effect of alprazolam on T-cell proliferation. Finally, the addition of
      alprazolam produced a time-dependent inhibiting effect on T-cell proliferation.
      However, this inhibitory effect of alprazolam was abolished when the drug was
      added to the cultures of competent cells that fully expressed IL2R. Taken
      together, these results suggest that alprazolam inhibits murine T-cell
      proliferation by affecting the mitogenic receptor-mediated events (initiation)
      rather than the IL2R-mediated events (progression) of ligand-activated T-cells
      through the cell cycle.

PMID- 1624224
TI  - The unique interaction with immunity of FCE 24517, an antitumor drug with a novel
      mode of action.
AB  - The present study was designed to characterize in mice the effects on the immune
      system of the antineoplastic agent FCE 24517, a benzoic acid mustard derivative
      of distamycin A with specificity for AT-rich base pair sequences of beta-DNA. At
      antitumorally therapeutic doses, single injections of FCE 24517 caused profound
      leukopenia and a decrease of spleen cell numbers. However, primary and secondary
      antibody production to the T-dependent antigen sheep red blood cells were
      markedly increased by FCE 24517 given before or together with antigen. Antibody
      production to the T-independent antigen type III pneumococcal polysaccharide was
      not appreciably affected by FCE 24517. The delayed type hypersensitivity response
      to sheep erythrocytes was only marginally decreased, whereas proliferation of
      spleen cells to mitogens was markedly depressed. The ability of natural killer
      cells and macrophages to mediate cytotoxicity was not affected by FCE 24517
      treatment. The ability of carrier-primed cells from drug-treated mice to
      cooperate for anti-trinitrophenyl antibody production increased twofold over that
      of vehicle-injected controls, suggesting an increase in T-helper cell activity.
      Serum cytokine levels were studied in mice injected with bacterial
      lipopolysaccharide used as a model stimulus. Peak levels of TNF and IL-6 were not
      modified by FCE 24517, but at later times higher amounts of cytokines were found
      in drug-treated mice compared with the control, suggesting a longer exposure of
      immunocompetent cells to these factors. Two compounds (FCE 24561 and CC-1065),
      also capable of binding AT-rich sequences in the minor groove of beta-DNA and
      containing an alkylating moiety, had immunomodulatory activity similar to FCE
      24517 in increasing primary anti-sheep erythrocytes response. It is concluded
      that FCE 24517 exhibits a unique interaction with the immune system, markedly
      different from that of alkylating agents and may be representative of a novel
      group of antiproliferative-immunomodulating agents.

PMID- 1624225
TI  - Testosterone inhibits the immunostimulant effect of thymosin fraction 5 on
      secondary immune response in mice.
AB  - The purpose of the present investigation was to examine the in vivo influence of
      testosterone on the immune properties of a thymic factor (thymosin fraction 5,
      TF5) a partially purified thymic preparation in male Swiss IOPS/OF1 mice (5-10
      weeks old). Testosterone administration (100 micrograms/ml) significantly
      inhibited the enhanced anti-sheep red blood cell antibody response induced by TF5
      (100 micrograms/ml); this inhibition was only observed on the secondary antibody
      response and not on the primary. These results suggest that gonadal steroids can
      affect the immune response by modulating the activity of thymic factors.

PMID- 1624226
TI  - Anti-leprosy drugs inhibit the complement-mediated solubilization of pre-formed
      immune complexes in vitro.
AB  - Incubation of pre-formed immune complexes (IC) (125I-HSA--anti-HSA) with normal
      human serum resulted in solubilization of IC. When various anti-leprosy drugs
      were added to human sera, solubilization of IC was fairly explicit with
      clofazimine, whereas this effect was marginal with dapsone. Rifampicin hardly
      displayed this effect. Aspirin, chloroquine, and prednisolone, the drugs used in
      addition to multi-drug therapy to control reactions in leprosy, were in a
      position to inhibit the solubilization of 125I HSA--anti-HSA by normal serum only
      at a very high dose. From the current data of the inhibition of solubilization of
      pre-formed IC along with our earlier observations on the modulation of complement
      mediated haemolysis by these drugs, it may be possible to postulate that
      clofazimine as well as chloroquine affect early complement components. This may
      in turn be responsible for preventing the deposition of C3 complement onto IC.

PMID- 1624227
TI  - The toxicity of chemically deglycosylated ricin A-chain in mice.
AB  - Tumor-reactive antibodies coupled to ricin or its A-chain (immunotoxins) have
      been used in rodents and humans to treat a variety of neoplastic diseases. Side
      effects of such treatment include hepatotoxicity, vascular leak syndrome, myalgia
      and low grade fever. At high doses, severe toxicities include liver damage,
      pulmonary edema, aphasia, rhabdomyolysis and kidney failure. There have been a
      limited number of toxicologic studies on uncoupled ricin or its A-chain and none
      on deglycosylated A-chain. Since the latter has been utilized in "second
      generation" immunotoxins, the current studies were carried out to evaluate the
      toxicities induced by deglycosylated ricin A-chain (dgA) in mice. The
      administration of dgA to normal BALB/c mice causes early (24 h) weight loss and
      late (10 day) accumulation of ascites. These effects could be partially altered
      by changing the route of injection of dgA from i.v. to i.p. Thus, i.p.
      administration caused weight loss but not ascites, whereas i.v. administration
      caused both. Weight loss was associated with reduced fluid intake by the treated
      mice, and was not associated with increased levels of serum TNF-alpha. SCID mice
      injected with the same dose of dgA as normal BALB/c mice developed ascites, but
      it was of lesser severity, suggesting that a functional immune system,
      differences in microbial flora, or strain differences may be involved in the
      development of ascites.

PMID- 1624228
TI  - Studies on the immunological effects of fatty alcohols--I. Effects of n
      hexacosanol on murine macrophages in culture.
AB  - n-Hexacosanol (hexa), a long chain fatty alcohol extracted from Hygrophila
      erecta, has proved to possess neurotrophic activities on cultured neurons, and to
      attenuate the degeneration of cholinergic neurons after injury. In the present
      study, we show that hexa has also interesting properties on macrophages, a cell
      type largely represented in the brain: when added to mice resident peritoneal
      macrophages, it provokes significant morphological changes, and increases their
      phagocytosis capacity. These results may indicate that some membrane properties
      involved in these different effects and in macrophage functions are affected by n
      hexacosanol, but other sites of action could also be considered.

PMID- 1624229
TI  - Prenatal exposure to alcohol enhances thymocyte mitogenic responses postnatally.
AB  - Previous studies have shown altered cell-mediated immune responses in animals
      prenatally exposed to ethanol. The present study was designed to determine the
      ontogeny of proliferative responses of thymocytes postnatally following prenatal
      exposure to ethanol. Thymocytes obtained from 44-day old Sprague-Dawley male rats
      exposed to 5% (w/v) ethanol during the last two weeks of gestation had a
      significantly greater response to mitogenic stimulation by concanavalin A (Con A,
      5.0 micrograms/ml) than controls. A similar trend was observed in rats at
      postnatal days 30 and 72, but not at day 16. Con A-conditioned thymoblasts from
      day-44 fetal alcohol-exposed animals were less responsive to further activation
      by a crude Con A supernatant than controls, but this response normalized by day
      72. These findings reveal that the effects of ethanol exposure in utero in male
      rats include alterations in the development of thymoproliferative responses to
      mitogen which persist through the peripubertal period and normalize in part by
      young adulthood.

PMID- 1624230
TI  - [Multiple codification of the causes of death: from dying "of" to dying "from"].
AB  - Multiple-cause mortality data is examined in the Valencian Region. In addition to
      coding the underlying cause of death (UCD), all causes of death which appeared
      mentioned on death certificates (MCD) were coded according to preliminary rules
      established by the Mortality Statistics Office. Specific diseases were selected
      to explore mortality patterns. The average number of conditions coded per death
      certificate was 2.7. Two or more conditions on the lowest used line appeared in
      33.8% of all medical certificates. Septicaemia, high blood pressure and
      arteriosclerosis stand out among the conditions more often coded as MCD than
      coded as UCD. Exploring for mortality patterns a statistical association between
      coronary heart disease and diabetes emerged (p less than 0.0001). Multiple-cause
      mortality coding allow to discriminate mortality patterns and show a new
      magnitude to some specific causes of death.

PMID- 1624231
TI  - [Smoking habits in nursing students: prevalence, attitudes and knowledge].
AB  - The purpose of this study has been to evaluate the prevalence of smoking habit,
      knowledge on the adverse health effects and attitudes towards it among nurses
      students in their three years of study (University School of Girona). A self
      administrated questionnaire was used. A total of 135 questionnaires were answered
      (88%) from an estimated available population of 154 students (94% females with 21
      years old of mean age). The prevalence of current smoking was 34.3%; ex smokers
      23.3% and non smokers 42.5%. The mean of tobacco consumption was 367.6
      cigarettes/month. 92% no smokers, 91% ex smokers and 76% smokers thought that
      smoking has adverse health effects (p less than 0.001). They consider the health
      protection like the first reason to give up smoking. 38% will advise their
      healthy smokers patients about the risk of their habit. We conclude: 1.-Low
      prevalence of smoking habit; 2.-Nurses should know methods aimed at lowering
      smoking rates, assuming that they have determined influence on the population
      behavior.

PMID- 1624232
TI  - [Hospital utilization and increasing old age in the user of care?].
AB  - Data are presented on hospital stay for the population 65 years-old and over,
      measured in percentage over the total for Spain, for the 1978 to 1988 period, by
      gender, for each province and autonomous region (Comunidad Autonoma). The
      country's total for the last available year was 35%. Except in Baleares and
      Murcia, the proportion of hospital stays increased in all Regions, especially in
      Navarra, where it increased from 23% to 51%. After adjusting for age, the
      increase in the proportion of hospital stays in the study population was due to
      an increase in utilization per person. The proportion, which was 13.3% in 1978,
      raised to 23.8% in 1988, with an adjusted value of 21.3%.

PMID- 1624233
TI  - [Primary-care morbidity and true morbidity due to acute respiratory infections].
AB  - The present work presents the study of morbidity due to acute respiratory
      infections (ARI) in areas of the town of Lisa in Ciudad Habana, and Isla Juventud
      (Cuba), to characterize different aspects of morbidity measured by health care
      attendance and to measure true morbidity. About 90% of consultations for ARI were
      first-time consultations, while their ratio to further consultations was 5.3.
      True morbidity rates (TMR), obtained trough active research, ranged from 110.4 to
      163.4 cases per 1000 inhabitants, considerably higher than morbidity rates
      measured by primary care consultations (MRPCC) in the same time period. The true
      morbidity index (TMI), as measured by the ratio of the two previous rates, ranged
      from 5 to 15. A high proportion (47.6%) of cases reported no medical care
      attendance. These results provide approximate estimates of true morbidity in the
      study area, and allow the establishment of a new control program, also improving
      epidemiologic surveillance within primary care activities.

PMID- 1624234
TI  - [Strategies in measuring nursing care].
AB  - When resources are limited, the balance between the supply and the demand of
      nursing care is becoming more and more necessary. This situation justifies the
      use of tools to measure work charges in nursing. This article analyses the
      relationship between work charges and time estimation in nursing care. From a
      bibliographical review on this topic it discusses possibilities and techniques of
      time estimation for the nursing care given to a patient, as well as the caring
      time he or she requires. Two different approaches and some conclusions from the
      analysis of both of them are showed: first; the direct method, i.e. that of
      measuring caring levels; and secondly, the indirect method, that is a system for
      classifying patients. The interest of the direct method is advocated because of
      its clarity, external validation possible integration in nursing care plans.

PMID- 1624235
TI  - [An analysis of survival data in the epidemiological context].
AB  - The present work reviews the methodology of survival analysis in the
      epidemiological field, especially within the framework of cancer registries. The
      main concepts used in survival analysis are presented, and the problems of
      competing mortality, as well as variable and stage adjustment are also discussed.
      Although the estimation and comparison of survival data distributions obtained
      from epidemiologic observations is technically possible nowadays thanks to a
      variety of statistical methods which take into account multiple proGnostic
      factors, it is proposed that pilot studies should be undertaken to look at the
      main problems related with potential selection biases and the standardization of
      prognostic factors to be evaluated.

PMID- 1624236
TI  - [A consensus on consensus conferences].

PMID- 1624237
TI  - An unusual complication of extracorporeal shock wave lithotripsy: urinoma due to
      rupture of the renal pelvis.
AB  - A case of a female patient with urinoma due to rupture of the renal pelvis after
      extracorporeal shock wave lithotripsy is described. Although temporary perirenal
      fluid accumulations after extracorporeal shock wave lithotripsy have been
      reported previously, possibly this is the first case presenting with an abdominal
      mass due to retroperitoneal urine collection.

PMID- 1624238
TI  - In situ extracorporeal shock wave lithotripsy for upper ureteral stones:
      experience with 65 patients.
AB  - A total of 65 patients with 67 upper ureteral stones underwent in situ
      extracorporeal shock wave lithotripsy (ESWL) between March 1990 and September
      1990. For stone disintegration the electrohydraulic shock wave lithotripter
      Tripter XI (Direx) was used. Eighty-seven per cent of stones showed satisfactory
      disintegration after the first treatment and a further 9 per cent after repeat
      treatments. The stone-free rate at 12 weeks was 85 per cent. General anaesthesia
      was needed in only 12 per cent of patients. The retreatment rate was 13 per cent.
      It was concluded that in situ ESWL is an effective procedure with negligible
      morbidity for treating upper ureteral stones.

PMID- 1624239
TI  - Ureteral incarceration in the symptomatology of hydronephrosis.
AB  - Renal colic symptoms may be caused by an aberrant vascular bundle that
      intermittently incarcerates the pyeloureteral junction. The authors describe 6
      patients who were complaint free except for the period of fits and routine
      urological examinations showed normal findings. The patients had no subjective
      complaints after open surgery.

PMID- 1624240
TI  - Ureteral fibroma: an unusual clinical symptomatology.
AB  - The authors describe a case of ureteral fibroma. The aetiology, clinical
      symptomatology and diagnosis are discussed, and differentiation between benign
      and malignant lesions is emphasized.

PMID- 1624241
TI  - Nitrofurantoin versus trimethoprim for low-dose long-term prophylaxis in patients
      with recurrent urinary tract infections. A prospective randomized study.
AB  - In a prospective randomized study 38 patients with recurrent urinary tract
      infections (rUTI) were included to take either 50 mg Nitrofurantoin (n = 19) or
      50 mg Trimethoprim (n = 19) as low-dose long-term prophylaxis for half a year.
      Compliance was checked weekly by Bacillus subtilis spore test strips sent in by
      mail. The infection rate was reduced from more than three per patient year to
      0.01. There were no significant differences between the two groups concerning the
      recurrence rate (Nitrofurantoin: one rUTI; Trimethoprim: three rUTI) or side
      effects. Under Nitrofurantoin treatment 3 symptomatic fungal infections occurred.
      Trimethoprim and Nitrofurantoin are equally suitable for low-dose long-term
      prophylaxis in rUTI. Surveillance of compliance gives important hints for failure
      of prophylaxis.

PMID- 1624242
TI  - Severe obstruction of the urinary tract due to talcum powder granuloma after
      surgery. A case report.
AB  - Talcum powder which is generally used for lubrication of surgical gloves can be
      responsible for granuloma formation with subsequent complications. This is the
      report of a case with progressive urinary tract obstruction.

PMID- 1624243
TI  - Cytologic findings of fine needle aspirates in chronic prostatitis.
AB  - Cytologic studies in patients with prostatic infection, primarily those with
      chronic prostatitis, were conducted on samples obtained by the fine needle
      aspiration method. Infiltration of inflammatory cells such as polymorphonuclear
      leukocytes and macrophages was observed to a greater extent in patients with
      chronic bacterial prostatitis as compared to those with chronic nonbacterial
      prostatitis or prostatodynia. The pathogen was isolated in only one out of 28
      patients with chronic bacterial prostatitis. We concluded that fine needle biopsy
      is useful for assessing patients with prostatic inflammation, but not for
      detecting microorganisms because of focal colonization of the organisms in the
      glands.

PMID- 1624244
TI  - Uroflow via stenotic urethra.
AB  - A DANTEC 2100 mictometer type 21C10 with uroflow transducer type 21KO2 was used
      for investigation of 50 men with urethral strictures (mean age 59 +/- 14 years).
      The patients underwent a total of 334 clinical evaluations of replicate voiding
      (minimum 4, maximum 16) before and after successful urethral dilatation on an
      outpatient basis. Using t-paired comparison test, significant increase in maximum
      urinary flow rate (P less than 0.01) after the treatment procedure was evidenced
      in each of the patients. The variability of other urinary flow parameters
      suggested a lower significance in evaluation of urine stream quality. The McNemar
      test showed a significant shift from one to another zone of classification
      suggested by Drach et al. (P less than 0.01), i.e. 64% of patients reached normal
      or overlap zone in the first spontaneous voiding after urethral dilatation.
      Furthermore, no significant difference could be established with one-way ANOVA
      between urodynamic variables of mean values of repetitive voidings in cases of
      urethral stenosis of different aetiology either before or after urethral
      dilatation (P greater than 0.05), suggesting that urethral stenoses of different
      aetiology are characterized by similar urodynamic features. A highly significant
      linear correlation was found between the maximum flow rate and the voided volume
      only after urethral dilatation (r = 0.522, P less than 0.01), while correlation
      with urethral sound sizes could not be established (r = 0.207, P greater than
      0.5). We conclude that uroflowmetry provides reliable information on the
      patient's ability to void. The use of maximum flow rate may predict the time at
      which urethral dilatation becomes necessary and provides objective evidence of
      the efficacy of treatment.

PMID- 1624245
TI  - Erectile dysfunction due to venous incompetence treated by dorsal vein ligation.
AB  - The authors describe 14 cases of erectile dysfunction. The sites of leakage were
      detected by duplex or colour flow Doppler sonography. Treatment by dorsal vein
      ligation resulted in fairly good early responses, however, at 4-month follow-up
      the great majority of patients returned to the original functional state.

PMID- 1624246
TI  - Pituitary and gonadal functions in patients with chordee without hypospadias.
AB  - Pituitary and gonadal functions in 16 prepubertal boys with chordee without
      hypospadias by stimulation of gonadotropin releasing hormone or human chorionic
      gonadotropin were compared to those of age-matched normal boys. The patients with
      chordee without hypospadias had poor follicular stimulating hormone response but
      pituitary luteinizing hormone reserve function was normal. Testosterone response
      by stimulation of human chorionic gonadotropin was not impaired in patients with
      chordee without hypospadias. The results suggested that chordee without
      hypospadias may also be categorized into hypospadias from the aspect of its
      pituitary and gonadal functions in addition to the embryogenesis of chordee.

PMID- 1624247
TI  - Two-stage surgical treatment for male transsexuals.
AB  - A plan for complex treatment of male-to-female transsexuals is presented. On the
      basis of our experience in the management of 15 patients, two-stage surgical
      treatment aiming at the change of external genitals, as well as the obtained
      cosmetic and functional results are described.

PMID- 1624249
TI  - Multiple bone fractures following an epileptic seizure in renal osteodystrophy.
AB  - Seizure induced bone fractures in patients with renal osteodystrophy are
      uncommon. A case is described where multiple bone fractures occurred following
      convulsions which appeared shortly after haemodialysis.

PMID- 1624248
TI  - Influence of antiplatelet drugs on occlusion of arteriovenous fistula in uraemic
      patients.
AB  - A long-standing arteriovenous (A-V) fistula may develop thrombotic complications.
      In 20 patients on intermittent peritoneal dialysis (IPD) arteriovenous fistula
      was made surgically. We evaluated the efficacy of three antiplatelet drugs:
      Ibustrin (Group A), sulphinpyrazone (Group B) and alpha-tocopherol (Group C) in
      preventing thrombotic occlusion of A-V fistulas. Results of the trial indicate
      that the three drugs significantly reduce spontaneous platelet aggregation and
      ADP induced aggregation. The heparin neutralizing activity was significantly
      increased during treatment. Significant prolongation of bleeding time was
      observed only in Groups B and C. In patients receiving antiplatelet drugs no
      occlusion of A-V fistulas was observed. In the control group such complications
      occurred in 3 of the 20 patients. Our results indicate that antiplatelet drugs by
      inhibiting the platelet function may prevent thrombotic occlusions of A-V
      fistulas in IPD patients.

PMID- 1624250
TI  - Deoxyribonuclease activity in T and B lymphocytes of haemodialysed patients with
      uraemia.
AB  - Deoxyribonuclease (DNase) activity and metal ion concentrations in lymphocytes of
      patients with chronic renal failure and in healthy controls were studied. The
      data suggest that T and B lymphocyte nuclei of patients with renal failure show
      increased DNase activity when compared to their healthy counterparts. It is
      suggested that the enhancement of enzyme activity is a result of increased metal
      ion concentration rather than increased enzyme copy count. The data strongly
      suggest that haemodialysis of uraemic patients is more effective for improvement
      of lymphocyte metabolism than the conservative chemical treatment.

PMID- 1624251
TI  - Endopyelotomy for ureteropelvic junction stenosis.
AB  - The authors review their experience with percutaneous endopyelotomy in the
      treatment of ureteropelvic junction (UPJ) stenosis. The method was used in 64
      patients of whom 59 had also renal stones. There was only one patient with
      secondary UPJ stenosis following pyeloplasty. The total success rate was 61%. It
      is pointed out that the results depend in a great part on the skill of the
      surgeon.

PMID- 1624252
TI  - Calculous pyelonephritis.
AB  - The authors report on 48 patients with calculous pyelonephritis. Urinary
      obstruction was caused by renal calculi in 21 patients and ureteral calculi in
      27. Urine cultures were positive in 87.5% and bacteremia was seen in 70%. The
      common organisms in urine and blood culture were E. coli, Proteus and Klebsiella.
      Septic shock occurred in 10 (20.8%) out of 48 patients. Calculous pyelonephritis
      with urinary obstruction is a very serious condition.

PMID- 1624253
TI  - Diclofenac sodium suppository in the treatment of primary nocturnal enuresis.
AB  - The prostaglandin synthesis inhibitor diclofenac sodium was given as suppository
      in the treatment of primary nocturnal enuresis in 24 patients. The statistically
      significant difference in response to diclofenac sodium and to placebo leads us
      to use diclofenac sodium in primary nocturnal enuresis.

PMID- 1624254
TI  - Urovaginal fistulas: experience with the management of 41 cases.
AB  - In a retrospective analysis the authors have evaluated their experience with the
      management of urovaginal fistulas in 41 patients. Of them 34 had vesicovaginal, 3
      ureterovaginal, 2 urethrovaginal, 1 ureterovesicovaginal and 1
      ileovasicorectovaginal fistula. Fistulas occurred most frequently after
      gynaecological operations for benign and malignant diseases and after
      radiotherapy. Reconstructive operations were performed in 37 patients, mostly
      from the vaginal approach. Primary repair of fistulas was successful in 35
      patients. In 2 patients reoperation was required. Due to good experience the
      authors recommend the transvaginal approach, which in their opinion is suitable
      for repair of the prevailing part of vesicovaginal fistulas.

PMID- 1624255
TI  - The significance of serum lipid-bound sialic acid in bladder tumours.
AB  - Tumour markers with high sensitivity and specificity for bladder cancer are still
      lacking and several markers have been investigated up to now. Serum lipid-bound
      sialic acid (LSA) was claimed to be a tumour marker by some investigators and
      this study tried to assess the value of LSA as a tumour marker in patients with
      bladder cancer. The results obtained from 27 patients and 30 controls showed that
      serum LSA levels remained within the suggested normal limits of the method used
      but they were significantly higher than in the controls. The value of serum LSA
      is questionable as an initial tumour marker for bladder cancer, but variations
      from the basal level may indeed be helpful in monitoring the efficacy of the
      therapy and in detecting relapses during follow-ups.

PMID- 1624256
TI  - Long-term BCG immune therapy of superficial bladder tumours.
AB  - Long-term local BCG treatment of superficial bladder tumours is described and the
      5-year results are reviewed. Complications of major significance in the course of
      immune therapy did not occur, loss due to death was not recorded. PPD skin test
      failed to furnish extra information regarding the biologic behaviour of the
      tumour. Annual repeats of the therapy promise better results than one single 6
      week course.

PMID- 1624257
TI  - A simple modification using the appendix as efferent limb in ileocolonic
      reservoir (Mainz pouch).
AB  - The appendix was used as an efferent limb of the ileocolonic pouch (Mainz pouch)
      in two patients who underwent radical cystectomy for invasive bladder cancer. The
      pouch has a low pressure character and sufficient capacity as well as complete
      continence. This procedure is relatively simple to perform and considered to be a
      useful modification of ileocolonic pouch.

PMID- 1624258
TI  - In vitro study of rat prostate 5 alpha-reductase activity and its inhibition.
AB  - A simple and rapid method of measuring 5 alpha-reductase (5 alpha-R) activity and
      of determining the kinetic parameters (KM and Vmax) of the enzyme is described.
      The 5 alpha-R activity in the homogenate of the prostate of Wistar rats aged 8-12
      weeks was established, and the effects of natural and synthetic steroids and of
      non-steroidal antiandrogens (IC50) upon the 5 alpha-R activity were studied. Of
      the natural steroids, 17-OH-progesterone was found to have the highest inhibitory
      effect (IC50 = 1.35 microM), followed in decreasing order by progesterone (IC50 =
      5.0 microM) and 4-androstene-3,17-dione (IC50 = 21.6 microM). Oestradiol-17 beta
      had practically no inhibitory effect. Of the synthetic steroids, 4-MA had the
      highest inhibitory effect (IC50 = 0.068 microM), followed by nortestosterone
      (IC50 = 7.4 microM) and RU-486 (Mifepristone) (IC50 = 115 microM). Even at 1000
      microM, cyproterone acetate exerted no inhibitory effect. Of the nonsteroidal
      compounds, ketoconazole proved a weak inhibitor (IC50 = 115 microM), while
      flutamide was practically ineffective.

PMID- 1624259
TI  - The cost and availability of therapeutic options in advanced prostatic carcinoma
      in Turkey.
AB  - Advanced prostatic carcinoma may be treated by a variety of methods of endocrine
      manipulation which affect the production of androgens. This can either be done by
      bilateral orchiectomy or by a number of drugs. Orchiectomy has two advantages:
      low cost and being a once-only procedure. This report outlines the costs of
      various methods of hormonal treatment and compares them with each other in
      Turkey.

PMID- 1624260
TI  - Genital infections in men associated with Chlamydia trachomatis.
AB  - The advent of new diagnostic procedures has made it possible for urologists to
      detect chlamydial presence in genital infections. Many studies have shown
      chlamydial association with urethritis. However, its presence in prostatitis and
      epididymitis has not been clearly defined yet. In this study we investigated the
      presence of Chlamydia trachomatis using enzyme linked immuno assay (ELISA)
      antigen and antibody detection method in sexually active men with different
      genital infections. We have found that in 32.1% of patients with non-gonococcal
      urethritis chlamydial antigen is detectable. We also have been able to detect
      chlamydial antigen in two patients with chronic non-bacterial prostatitis, but in
      no patients with epididymitis. We conclude that besides its presence in
      urethritis, there is an association between chlamydia and chronic prostatitis.
      Yet, further studies are needed to delineate this association more clearly.

PMID- 1624261
TI  - Long-term results of treatment of male urethral strictures using direct vision
      internal urethrotomy.
AB  - This study presents long-term results of treatment of urethral strictures in 178
      men who underwent direct vision cold urethrotomy between January 1, 1979 and
      December 31, 1984. Satisfactory urodynamic results were achieved in 69.7% of
      cases.

PMID- 1624262
TI  - Definition and treatment of chordee without hypospadias: a report of 5 cases.
AB  - The controversies in chordee without hypospadias are mostly focussed on the
      definition and treatment of type I and type IV chordee. In this respect we
      believe that surgical exploration is necessary to make a precise classification
      leading to the most appropriate therapy. We present 5 cases, 3 of which had type
      I chordee, 1 had type II and 1 had type III. In the 2 cases with type I chordee,
      type IV chordee coexisted. Although all the patients have had satisfactory
      cosmetic results, 3 of them should be reevaluated after puberty since they are
      prepubertal yet.

PMID- 1624263
TI  - Different types of median raphe cysts in the penis.
AB  - We report a case of different types of median raphe cysts in the penis. The
      literature is reviewed and the origin of these cysts is discussed.

PMID- 1624264
TI  - Squamous cell carcinoma of the penis. Analysis of 24 cases.
AB  - The authors evaluated retrospectively 24 cases of spinocellular carcinoma of the
      penis, trying to detect aetiological carcinogenic factors of the disease.
      Phimosis persisting since childhood was reported by ten men, whereby in five of
      them circumcision was performed during puberty. The duration of symptoms up to
      the time of biopsy and histological verification of differentiated spinocellular
      carcinoma of the penis varied from one month to thirteen years. Eight patients
      (33.3%) belonged to category T1, 8 (33.3%) to T2 and 8 (33.3%) to T3. Fifteen
      tumours (62.5%) were G1, 5 (20.8%) G2 and 4 (16.7%) G3. In 5 men print cytology
      was negative.

PMID- 1624265
TI  - Diagnostic value of creatine phosphokinase in testicular torsion.
AB  - In an experimental study on 36 male guinea pigs testicular torsion was induced in
      10, epididymitis in 10, surgical trauma in 6 and only ether anaesthesia was given
      to 10 animals. Serum creatine phosphokinase (CPK) levels at 0, 4, 8, 20, 28 and
      40 hours were determined in each group. Serum CPK levels were found to rise
      significantly in the torsion group. Determination of serum CPK levels may be an
      auxiliary alternative in the diagnosis of testicular torsion.

PMID- 1624266
TI  - Liposarcoma of the perineum and scrotum.
AB  - A case of liposarcoma of the perineum and scrotum, which presented as a huge
      haematoma and was left in place for three years prior to excision, is presented.
      The patient was treated by wide excision of the tumour, orchiopexy to the
      inguinal region and radiotherapy. To date, 30 months following surgery, the
      patient is completely asymptomatic and no tumour recurrence is evident either on
      physical and rectal examinations or on chest X-rays, ultrasonography and
      abdominal and pelvic computerized tomography.

PMID- 1624267
TI  - [Introductory Press Conference: Toratex--the new mono-analgesics in acute,
      intense pain. Frankfurt, 21 February 1992].

PMID- 1624268
TI  - Donaldson v. Van de Kamp.

PMID- 1624269
TI  - Ragona v. Preate.

PMID- 1624270
TI  - Beverly Hills Bar Association report to the House of Delegates.

PMID- 1624271
TI  - American Bar Association. Commission on Legal Problems of the Elderly.

PMID- 1624272
TI  - Reimbursement rates and quality of care in the dialysis industry: a policy
      discussion.

PMID- 1624273
TI  - 4th meeting of the Sardinian Group of the Italian Biochemical Society, Cagliari,
      June 13-14, 1991 and meeting on "Macromolecular Interactions" of the Lazio
      Abruzzi-Molise Group of the Italian Biochemical Society, Rome, June 14, 1991.
      Abstracts.

PMID- 1624274
TI  - Interaction of tonic labyrinth and neck reflexes in man.
AB  - Interaction of tonic labyrinth and neck reflexes was studied in 3 healthy
      volunteers by analyzing changes in Soleus H-Reflex (SHR) area in relation to both
      lateral tiltings and neck rotations. By using a Kermath chair each subject was
      tilted laterally from the vertical to the left and to the right up 15 degrees in
      steps of 5 degrees and at the same time the longitudinal body axis, keeping the
      head fixed, was rotated to the right and to the left up to 15 degrees in steps of
      5 degrees. All combinations of lateral tiltings and neck rotations were tested.
      Each test position was followed by a return to 0 degree for both rotation and
      tilting (control position). Twelve H-reflexes of right soleus muscle were
      recorded in each test and control position and the changes in RSHR area were
      expressed as percentage variations from the mean value absorbed in the pretest
      and post-test control position. Our data indicate that in man, as in animals,
      labyrinth and neck reflexes act in the opposite direction, and that in the static
      condition their contribution to postural stabilization is equal.

PMID- 1624275
TI  - The tilting cardiovascular response in orthostatic syncope.
AB  - 159 patients with a previous discharge diagnosis of recurrent vasodepressor
      syncope associated with prolonged standing or other circumstance known to trigger
      the condition were examined in order to isolate the orthostatic form. 72 patients
      with a history of at least two episodes of loss of consciousness after standing
      still for at least 10' were selected for testing by head-up tilt. Those who
      showed signs or symptoms during the test were tested a further twice, the third
      time after atropine administration. This process resulted in the diagnosis of
      orthostatic vasodepressor syncope in 28 patients who presented both 1) a positive
      test associated with hypotension and bradycardia and 2) bradycardia-free
      hypotention on repetition of the test with atropine.

PMID- 1624276
TI  - Cerebrovascular disorders and alcohol intake: preliminary results of a case
      control study.
AB  - The role of alcohol as a risk factor for cerebral infarction and hemorrhage has
      been assesed in 200 middle-aged and elderly stroke patients and 200 controls
      matched for age, sex and hospital admission date. Computed tomographic brain
      scans were done in all but 10 of the stroke patients. Alcohol intake was reckoned
      on the 12 months preceding hospitalization and expressed in grams daily according
      to a standard nomogram. The Michigan Alcoholism Screening Test was used for the
      diagnosis of alcoholism. Cerebral infarction was present in 59% of the stroke
      patients and cerebral hemorrhage in 9%. The role of alcohol as risk factor for
      stroke proved to be small (Odds Ratio 1.86) and was practically lost after
      adjustment for the most common risk factors for cerebrovascular disorders
      (previous strokes, arterial hypertension, diabetes, obesity and hyperlipidemia).
      Our findings seem to suggest that alcohol is not an independent risk factor for
      stroke in the middle-aged and elderly. The data are, however, preliminary and are
      discussed in the light of methological problems.

PMID- 1624277
TI  - Prevalence of moderate and severe Alzheimer dementia and multi-infarct dementia
      in the population of southeastern Sicily.
AB  - We have calculate the prevalence rates of moderate and severe dementia of the
      Alzheimer type (DAT) and of multi-infarct dementia (MID) in a Sicilian population
      sample aged 40 and over. For DAT the prevalence rate is 0.80% among the over 40s
      and 2.42% among the over 65s. The prevalence rates for both types, but especially
      for DAT, increase higher prevalence of primary degenerative dementia among
      females.

PMID- 1624278
TI  - Localization of the pathological process in Miller Fisher syndrome.
AB  - A 64 year old woman died at the third attack of MFS. Histological examination
      demonstrated segmental demyelination and axonal swelling of the peripheral nerves
      studied, oculomotor included. In the C.N.S. only mild chromatolytic changes and
      rare pyknosis of the nerve cells in the midbrain were found without signs of
      primary inflammation. We reviewed the findings in all the 4 anatomoclinical cases
      of MFS and in 2 cases of GBS with ophthalmoplegia or ataxia. With one exception,
      they appear to be concordant with those of our case. As the histological
      examination showed CNS involvement consequent upon peripheral nerve impairment,
      we are bound to change our opinion on the nosological position of MFS. Any small
      CT enhancements in the brain in MFS may be due, as in some cases of demyelinating
      polyneuropathy, to focal rupture of the blood-brain barrier.

PMID- 1624279
TI  - Dexamethasone suppression test, melatonin and TRH-test in cluster headache.
AB  - The origin of Cluster Headache (CH) is still unknown. The periodicty and presence
      of symptoms due to both sympathetic and parasympathetic activity suggest the
      involvement of central nervous system structures, particularly the hypothalamus.
      To investigate hypothalamic involvement in CH, we employed a
      neuroendocrinological approach. We observed a normal dexamethasone suppression
      test (DST) in all patients, increased cortisol plasma levels in remission
      patients at 8.00am before and at the end of the DST, while only in CH patients
      during cluster period did we find a reduced TSH response to TRH and a reduced
      night-time melatonin peak. The neuroendocrinological derangements found in CH may
      be consistent with hypothalamic involvement.

PMID- 1624280
TI  - A case control study of CSF copper, iron and manganese in Parkinson disease.
AB  - To elicit possible variations in the CSF concentrations of copper, iron and
      manganese due to Parkinson disease (PD) or to the stage reached, we tested 11
      patients with idiopathic PD, 6 untreated and 5 on long term L-dopa, versus 22 age
      and sex matched patients with other neurological disorders (control group-CG).
      The CSF levels of the three metals, measured by electrothermal atomization, did
      not differ significantly between the PD group and CG or between either of the PD
      subgroups and CG. Our findings therefore do not support the hypothesis that CSF
      Cu is a marker of PD.

PMID- 1624281
TI  - A case of diffuse lupus encephalopathy successfully treated with high-dose
      intravenous methylprednisolone.
AB  - We report a case of systemic lupus erythematosus (SLE) in a young woman who
      presented a serious encephalopathy with respiratory distress and coma, after
      arbitrary interruption of oral corticosteroid therapy when her first pregnancy
      ended in abortion. The patient showed rapid improvement on methylprednisolone
      pulse therapy. The case suggests the utility of such a therapy in severe, non
      focal, CNS complications of SLE.

PMID- 1624282
TI  - Calf hypertrophy due to a iatrogenic sciatic nerve lesion: case report.
AB  - We report a case of calf hypertrophy due to a iatrogenic sciatic nerve lesion.
      Nerve damage may cause hypertrophy rather than the atrophy usually seen. Ephaptic
      transmission among nerve fibers at the point of lesion may cause the hypertrophy.
      The inability of the hypertrophic muscle fibers to compensate for the atrophic
      fibers accounts for the muscle weakness.

PMID- 1624283
TI  - Alternating hemiplegia of childhood: case report.
AB  - We report the case of a 3 1/2 year old girl who had had attacks of alternating
      hemiplegia from the age of 6 months. Peculiar features from the etiopathogenetic
      angle seem to be the presence of a ring of mild stenosis of the vertebral artery
      on the right side, the influence of the upright posture on the onset of the
      attacks and perhaps also of variations in atmospheric pressure. The only drug
      that had some effect was flunarizine. Phenobartbital, haloperidol and nadolol had
      no appreciable effect.

PMID- 1624284
TI  - Giant congenital nevus and chronic progressive ascending hemiparesis (Mills
      syndrome). Report of a case.
AB  - We describe the case of a 20 year old boy with a giant congenital nevus who
      developed a chronic progressive ascending hemiparesis. The association of the
      pigmented lesion with a focal neurological deficit is pathognomonic for
      neurocutaneous melanosis complicated by a leptomeningeal melanoma. MR imaging at
      1.5 tesla ruled out such a possibility and showed a small aspecific pontine
      lesion along the route of the corticospinal tract. We discuss possible
      etiologies.

PMID- 1624285
TI  - Reflex sympathetic dystrophy in a child.
AB  - We describe a 9 1/2 year old girl who suffered from severe recurrent pain and
      functional limitation in her right leg with hyperesthesia, hyperalgesia, color
      change and edema as the presenting symptoms, during the previous two months. All
      laboratory tests were found to be normal and diagnosis of reflex sympathetic
      dystrophy was made.

PMID- 1624286
TI  - Transient abnormalities on magnetic resonance imaging after partial status
      epilepticus.
AB  - We report two patients who developed focal abnormalities on MRI after partial
      status epilepticus. Maximum radiological modification occurred in the area of
      maximal epileptic discharge. Subsequent MRI failed to demonstrate persistent
      abnormalities. These transient abnormalities on MRI could be an expression of
      cerebral edema caused by focal epileptic status.

PMID- 1624287
TI  - Neuroborreliosis: a Sardinian case with cerebellar symptoms.
AB  - We report the case of a patient long resident in Sardinia in whom the clinical
      history, neurological symptoms, serological and neuroradiological investigations
      pointed to the diagnosis of neuroborreliosis. We emphasize the rarity of
      cerebellar involvement in this disease.

PMID- 1624288
TI  - Head and neck sarcoma: report of the Head and Neck Sarcoma Registry. Society of
      Head and Neck Surgeons Committee on Research.
AB  - A Head and Neck Sarcoma Registry was established by the Society of Head and Neck
      Surgeons to review treatment results of a rare tumor by surgeons with special
      interest in this anatomic site. Two hundred fourteen patients were analyzed.
      There were 194 adult tumors and 20 pediatric tumors. The major sites included
      parotid and neck, 20%; face and forehead, 18%; maxilla and palate, 13%; scalp,
      12%; mandible, 11%; paranasal sinuses, 7%; larynx, 2%; and oral cavity, 5%.
      Eighty-four percent were resectable. The disease-free survival was 56%; overall
      survival was 70% at 5 years. Major determinants of survival were adequacy of
      resection (margins free of tumor) and tumor type. Survival differed according to
      tumor cell type (tumor grade was not available). Patients with chondrosarcoma and
      dermatofibrosarcoma had survival approaching 100%. Patients with malignant
      fibrous histiocytoma (MFH) and fibrosarcoma (FSA) had intermediate survival of
      60% to 70%. The worst survival, less than 50% at 5 years, occurred in patients
      with osteosarcoma, angiosarcoma, and rhabdomyosarcoma in decreasing order. This
      suggests a rationale for identifying high-risk patients for prospective adjuvant
      protocols. This study emphasizes the value of recording uncommon tumors to
      provide relevant information for future study and possibly therapy.

PMID- 1624289
TI  - Effect of advanced age and medical disease on the outcome of microvascular
      reconstruction for head and neck defects.
AB  - During the 5-year period from July 1984 to 1988, 72 patients over the age of 50
      underwent microvascular free tissue transfers for head and neck reconstruction.
      There were 22 patients aged 50-59 years, 31 patients aged 60-69 years, and 19
      patients aged 70-79 years. Seventy of these procedures (97%) were done at the
      time of ablative surgery utilizing a two-team approach. There was 1 total flap
      loss for a flap viability rate of 99% (73/74). There were 46 complications in 40
      patients: 21 surgical and 25 medical. Twelve of the surgical complications
      required reoperation for a major surgical complication rate of 16%. Major medical
      complications developed in 12 patients (16%). Medical complications more commonly
      were observed in patients aged 60-69 years who had significant preoperative
      comorbidity and were classified as ASA class 3 or greater. There were 5
      postoperative deaths for a mortality rate of 7%. Advanced chronologic age does
      not compromise the technical success of microsurgical free tissue transfer in the
      elderly patient with head and neck cancer. The risk of medical complications is
      significant and is directly related to concurrent illness of the individual
      patient rather than to age alone.

PMID- 1624290
TI  - Serous otitis media and paranasopharyngeal extension of nasopharyngeal carcinoma.
AB  - Two hundred thirty-two patients with nasopharyngeal carcinoma were evaluated for
      serous otitis media (SOM) at diagnosis. The diagnosis of SOM required the
      detection of effusion behind the tympanic membrane in association of air-bone gap
      of 10 dB or more in pure tone audiogram. These patients were also evaluated by
      computed tomography for the degree of tumor extension. By stepwise logistic
      regression analysis, the degree of paranasopharyngeal extension of tumor, erosion
      of petrous temporal bone, and the obliteration of pharyngeal recess were
      significantly related to the development of SOM, but sex and age were not. The
      findings of computed tomography may influence the plan of management for SOM in
      patients with nasopharyngeal carcinoma at diagnosis.

PMID- 1624291
TI  - Sensitivity of biopsy using local anesthesia in detecting nasopharyngeal
      carcinoma.
AB  - Flexible and rigid endoscopes allow good visualization of the nasopharynx using
      local anesthesia, and permit biopsies to be taken under direct vision. Little
      information is available on the accuracy of biopsies taken using local
      anesthesia, and general anesthesia is usually recommended for evaluation and
      biopsy of the nasopharynx to avoid missing small or submucosal lesions. We report
      the results from 260 patients biopsied using local anesthesia (188) and general
      anesthesia (72). All biopsies were taken using large nasal biopsy forceps under
      direct vision. The sensitivity of this technique in diagnosing nasopharyngeal
      carcinoma was 95.1% using local anesthesia and 95.6% using general anesthesia. We
      suggest that general anesthesia is rarely necessary for definitive biopsy of the
      nasopharynx. In the majority of patients, an accurate diagnosis can be obtained
      using large biopsy forceps under direct vision using local anesthesia.

PMID- 1624292
TI  - Botulinum a toxin for spasmodic torticollis: multiple vs single injection points
      per muscle.
AB  - Eighty-six injections in 49 patients with adult onset spasmodic torticollis were
      evaluated for efficacy with respect to single point per muscle versus multiple
      point per muscle injection techniques. Parameters of the syndrome assessed were
      pain, posture deformity, range of cervical motion, disfigurement, cervical muscle
      hypertrophy, activity limitation, and degree of involuntary movement. The
      multiple point per muscle injection strategy appeared superior to the single
      injection per muscle technique with respect to pain (p less than 0.002, chi
      square), posture deformity (p less than 0.001), range of motion (p less than
      0.001), and improvement in activity endurance (p less than 0.001). No significant
      differences were noted with respect to cervical muscle hypertrophy or degree of
      involuntary movements, although the injections were considered beneficial in both
      groups to these syndrome components.

PMID- 1624293
TI  - Muscle tumors in the parapharyngeal space.
AB  - Tumors arising in the parapharyngeal space are rare. Even more rare are those
      which originate from the pharyngeal and parapharyngeal musculature. Three
      examples of muscle tumors presenting as parapharyngeal masses are reported, ie, a
      rhabdomyoma, rhabdomyosarcoma, and a leiomyosarcoma, and the literature
      pertaining to these tumors is reviewed. To the best of our knowledge, this
      represents the first case of a parapharyngeal leiomyosarcoma reported in the
      literature.

PMID- 1624294
TI  - Bilateral tonsillar metastasis of gastric adenocarcinoma.
AB  - The occurrence of metastatic tumors in the tonsils, although rare, must be
      considered in the differential diagnosis of tonsillar lesions. In particular, the
      review of the literature reports only 7 cases of tonsillar metastasis of gastric
      carcinoma. The authors describe a case of adenocarcinoma involving bilaterally
      the palatine tonsils and the lingual tonsil, in a patient previously operated due
      to gastric adenocarcinoma. The clinical appearance of the lesion could be also
      consistent with lymphoproliferative or infectious diseases. The clinical and
      pathologic differential diagnosis of this peculiar case is discussed, together
      with a brief review of the literature.

PMID- 1624296
TI  - 37th Annual Meeting of the Health Physics Society. Columbus, Ohio, 21-25 June
      1992. Abstracts.

PMID- 1624295
TI  - Gene amplification and overexpression of epidermal growth factor receptor in
      squamous cell carcinoma of the head and neck.
AB  - The degree of gene amplification for epidermal growth factor receptor (EGFR) and
      its expression levels were examined in 4 cases of tumor lesions and their cell
      lines of human squamous cell carcinoma (SCC) of the oral cavity. The
      amplification was detected in 1 case (ZA), but not significantly in 3 other cases
      (HOC605, HOC815, and HOC927) in which the amplification did not occur during the
      cell line establishment. In those 3 cases, levels of EGFR synthesis and human EGF
      (hEGF) binding capacity were varied: HOC605 and HOC815 had slightly increased
      levels of hEGF binding capacity and EGFR synthesis, respectively. While HOC927
      had the lowest levels of both, the hEGF binding capacity was elevated in the
      tumor lesion when compared with the normal counterpart of the same patient. These
      results suggest that the increased capacity for EGF binding plays a more
      important role than does gene amplification on the tumorigenesis of SCC of the
      head and neck.

PMID- 1624297
TI  - Educationalists express their concerns.
AB  - The UKCC has received well over a thousand responses to their proposals for
      community education and practice (CEP). Here we reproduce an extract from the
      response of the United Kingdom Standing Conference on health visitor education
      (UKSC) by Frances Appleby and Joy Merrell, UKSC chair and honorary treasurer
      respectively.

PMID- 1624298
TI  - A route from two roots.

PMID- 1624299
TI  - Clues to the detection of fragile X syndrome.
AB  - Ioanna Giannopoulou and Jeremy Turk outline the clues to the detection of fragile
      X syndrome, the commonest cause of familial mental handicap. Health visitors have
      a crucial role in the early diagnosis of the syndrome.

PMID- 1624301
TI  - Supporting teenage mothers.

PMID- 1624300
TI  - Health visitors and child accident prevention.
AB  - Yvonne H Carter, Michael J Bannon and Peter W Jones explore the role of health
      visitors in child accident prevention in North Staffordshire, to assess their
      knowledge and awareness of local data and to facilitate more effective planning
      of educational provision for health visitors and other primary health care
      workers.

PMID- 1624302
TI  - Sickle cell disorders and the schoolchild.

PMID- 1624303
TI  - Cervical screening: default and compliance.
AB  - Health visitors could play a key role in educating at risk women about the
      benefits of cervical screening. Jane Martin and Peter J Main examine some of the
      models which outline barriers to screening uptake and consider which will help
      the health visitor to increase the knowledge and understanding of at risk
      clients.

PMID- 1624304
TI  - Cigarette butts in 'Coughee jar' and 'Packet in': a roadshow.

PMID- 1624305
TI  - The meaning of health promotion.

PMID- 1624306
TI  - Caring for the carers.

PMID- 1624307
TI  - MPs boost midwives role but warn on threat to neonatal care.
AB  - Midwives received a boost for their profession with the house of commons' second
      health committee report on maternity services. If MPs get their way midwives will
      hold their own caseloads, recommend whether pregnant women should be seen by an
      obstetrician, and play a greater part in referring women to hospital. Women
      should be seen by fewer professionals with greater continuity of care, says the
      report. A midwife known to the family should be the key worker supervising labour
      -a role eroded over the years with the shift away from home births and small
      maternity units to larger institutions and a doctor-dominated system. But MPs
      also issued a stern warning about the threat the NHS changes present to effective
      neonatal care of at risk babies.

PMID- 1624309
TI  - HIV infection: the issues for women and children.
AB  - HIV is now a worldwide pandemic, affecting some ten million adults and one
      million children--the overwhelming majority from sub-Saharan Africa. In Africa
      equal numbers of men and women are infected: in Europe just ten per cent of all
      cases of Aids are among women and two per cent among children.

PMID- 1624308
TI  - A landmark for people with AIDS.

PMID- 1624310
TI  - Women, AIDS and reproduction.
AB  - Relatively little has been written about how Aids affects women. When women are
      mentioned it is primarily as carers of people with Aids or as possible
      transmitters of the HIV virus, with the focus largely on prostitutes and pregnant
      women. The concern overwhelmingly is about how to protect the health of men and
      children, writes Diane Richardson. Here she examines the implications of Aids and
      HIV infection for women's health and reproductive rights.

PMID- 1624311
TI  - Sexuality and sexual health: an issue for community nurses.
AB  - Kate Butcher, health promotion worker in Calderdale, outlines the philosophy
      behind her work on sexual health. She argues that even in areas with a low
      incidence currently of people who are HIV positive, work on sexual health and
      sexuality by community nurses is a crucial aspect of health promotion activity.

PMID- 1624312
TI  - ME: is it a genuine disease?
AB  - Myalgic encephalomyelitis (ME) is a postviral syndrome whose dominant clinical
      features are exercise-induced muscle fatigue, disturbances in cognitive
      functioning and symptoms of overactivity of the autonomic nervous system. The
      syndrome tends to affect previously fit young adults between the ages of 20 and
      40 but no age group is excluded. One recent epidemiological survey suggested a
      prevalence rate of 1.3 per 1000 adults, with females outnumbering males by 1.8:1.
      ME is currently the subject of intense medical (and media) debate, especially
      over its pathophysiology and management. It has also become known as the
      postviral/chronic fatigue syndrome (PVFS/CFS).

PMID- 1624313
TI  - Health visiting on a playbus: a community approach.
AB  - Inappropriate and overcrowded housing, poverty and lack of social support can
      affect the health and development of young children and their mothers. Such
      factors may prevent those families who most need health resources from using
      them. Rosalind Edwards and Stephanie Ramsey describe a project that attempts to
      encourage the use of health-related information by families with young children
      through taking an inter-agency and community-based approach.

PMID- 1624314
TI  - From claimant to customer.

PMID- 1624315
TI  - Unity in action.

PMID- 1624316
TI  - Taking the early way out.
AB  - Health visitors and school nurses forced to take time off sick need to know their
      pay and leave entitlements. Some may be contemplating--or coming under pressure
      to take--early retirement on grounds of ill-health. Here we look at the issues of
      long-term sick leave and early retirement.

PMID- 1624317
TI  - Health gain versus equity.
AB  - A new organisation, the Association for Public Health, has just been formed 'to
      help deliver real health gain for the population'. Alex Scott-Samuel suggests
      that the concept of 'health gain' is counter to health equality and needs wider
      debate.

PMID- 1624318
TI  - Ehlers-Danlos syndrome support group.

PMID- 1624319
TI  - Thinking as a profession.

PMID- 1624320
TI  - Punished for caring.

PMID- 1624321
TI  - 'Jump the gun' call.

PMID- 1624322
TI  - Twins in the family.
AB  - The key role of the health visitor in supporting families with multiple births
      was highlighted in the recent OPCS study Three, four or more. JUDI LINNEY,
      president of the Twins and multiple births association (TAMBA), outlines the
      health visitor's role in these circumstances.

PMID- 1624323
TI  - Supporting parents who wish to breastfeed twins.
AB  - Parents expecting twins need special support from health visitors to prepare them
      for the changes to their lives. A sound knowledge of the mechanics of
      breastfeeding and an empathetic understanding of their hopes and fears will
      prepare them for the months ahead, writes Alison Spiro. Health visitors may also
      be able to mobilise statutory and voluntary resources in the community to provide
      extra practical or emotional help.

PMID- 1624324
TI  - Community mothers: trick or treat?
AB  - To many health visitors they are a threat. To others they are a unique and
      invaluable resource. Cath Jackson talks to the health visitors and women involved
      in two projects pioneering community mother programmes in England.

PMID- 1624325
TI  - Towards a child health audit.
AB  - Child care can be improved by using a child health summary card, writes Sheila
      Jeffries. This would highlight the common needs of all children and their
      families, the special needs of certain types of families and the evaluation of
      methods employed. Additionally this scheme would provide data to help define the
      purpose of the work of the health visitor and school nurse.

PMID- 1624326
TI  - Education for school nurses.

PMID- 1624327
TI  - A checklist of benefit options.

PMID- 1624328
TI  - Unnatural selection.

PMID- 1624329
TI  - Health promotion in the global village.

PMID- 1624330
TI  - The village that refused to die.

PMID- 1624331
TI  - It could be ME.

PMID- 1624333
TI  - Livestock Conservation Institute supports AVMA legislative initiative.

PMID- 1624332
TI  - Confronting cosmetic surgery: cropping and docking not clear-cut issues.

PMID- 1624334
TI  - Ethical considerations in clinical research.

PMID- 1624335
TI  - Smorgasbord of activities.

PMID- 1624336
TI  - Diagnosis of copper deficiency in cattle.

PMID- 1624337
TI  - Some legal implications in biotechnology.

PMID- 1624338
TI  - Urine cortisol:creatinine ratio as a screening test for hyperadrenocorticism in
      dogs.
AB  - A urine cortisol:creatinine (c:c) ratio, determined from a free-catch morning
      sample, was evaluated in each of 83 dogs as a screening test for hyper
      adrenocorticism. The dogs evaluated were allotted to 3 groups, including 20
      healthy dogs, 40 dogs with confirmed hyperadrenocorticism (HAC), and 23 dogs with
      polyuria and polydipsia not attributable to HAC (polyuria/polydipsia group;
      PU/PD). Overlap in the urine c:c ratios (mean +/- SEM), comparing results from
      the healthy dogs (5.7 x 10(-6) +/- 0.9) with those from the HAC dogs (337.7 x 10(
      6) +/- 72.0) was not found. However, 11 (64%) of the 18 values from the PU/PD
      dogs (42.6 x 10(-6) +/- 9.4) were above the lowest ratio in the HAC group and 50%
      of the HAC group had a urine c:c ratio below the highest value in the PU/PD
      group. When the mean urine c:c ratio (+/- 2 SD) for the group of healthy dogs was
      used as a reference range, 100% of the HAC dogs and 18 (77%) of 23 dogs in the
      PU/PD group had abnormal urine c:c ratios. The sensitivity of the urine c:c ratio
      to discriminate dogs with HAC was 100%. The specificity of the urine c:c ratio
      was 22% and its diagnostic accuracy was 76%. On the basis of our findings, a
      urine c:c ratio within the reference range provides strong evidence to rule out
      HAC. However, abnormal urine c:c ratios are obtained from dogs with clinical
      diseases other than HAC. Therefore, measurement of a urine c:c ratio should not
      be used as the sole screening test to confirm a diagnosis of HAC.

PMID- 1624339
TI  - Determination of the number of mast cells in lymph node, bone marrow, and buffy
      coat cytologic specimens from dogs.
AB  - Cytologic samples of popliteal lymph node, proximal femoral bone marrow, and the
      buffy coat fraction of blood were obtained from 56 dogs. The number of mast cells
      on 1 slide of each sample was determined by microscopic examination. Eleven of 46
      slides of lymph node aspirate contained mast cells (range, 1 to 16; mean, 6.4;
      median, 5 mast cells/slide). Fifty-one bone marrow aspirate slides were
      evaluated. Two of these contained a single mast cell. None of the 53 buffy coat
      smear slides examined contained any mast cells. These results indicated that in
      clinically normal dogs, a few to several mast cells may be encountered in smears
      of lymph node aspirate, mast cells are rare in smears of bone marrow aspirate,
      and mast cells are absent from smears of buffy coat.

PMID- 1624340
TI  - Evaluation of biocompatible osteoconductive polymer as an orthopedic implant in
      dogs.
AB  - The biocompatibility and osteoconductive properties of biocompatible
      osteoconductive polymer (BOP), a synthetic implant, were evaluated. Bilateral
      oval cortical defects (1 x 2 cm) were made in the lateral subtrochanteric area of
      the proximal portion of the femur in 16 dogs that later were treated with BOP
      fiber (n = 16) or autogenous cancellous bone (n = 11), or were not treated (n =
      5). The BOP block was attached extraperiosteally to the proximal portion of the
      humerus in 6 dogs. Radiographic assessment of surgery sites was performed at 4
      week intervals, and histologic evaluation was performed at 4, 8, 16, and 24 weeks
      after surgery. Radiographic signs of bone healing were not observed in defects
      treated with BOP fiber. Defects treated with cancellous bone or not treated had
      radiographic signs of progressive bone ingrowth. Radiographic evidence of
      periosteal new bone formation near control and BOP-treated defects was observed 4
      weeks after surgery; increased periosteal reaction was associated with BOP fiber.
      This new bone had resorbed by week 24, except bone adjacent to BOP fiber, where
      continued periosteal reaction was apparent. Histologic evidence of bone formation
      was observed extending to, but not incorporating, BOP fibers. The BOP fibers
      became surrounded by a fibrous capsule, and fibrovascular connective tissue
      infiltrated between and into BOP fibers, but minimal bone formation incorporated
      the BOP material during the follow-up period. During that time, active periosteal
      new bone formation was evident adjacent to the BOP fibers. Defects treated with
      cancellous bone or not treated healed by ingrowth of cancellous bone during the
      first 12 weeks after surgery and by reformation of the lateral cortical wall by
      week 24. The BOP blocks became surrounded by a fibrous capsule, but connective
      tissue or bone ingrowth into BOP blocks was not observed. Results indicate that
      BOP is not osteoconductive within a 6-month time frame when used in
      subtrochanteric femoral defects or when placed extraperiosteally on the proximal
      portion of the humerus of clinically normal dogs.

PMID- 1624341
TI  - Anesthetic management of ostriches.
AB  - We evaluated and characterized several anesthetic induction protocols used to
      facilitate intubation and anesthetic maintenance with isoflurane in 7 adult
      ostriches and 1 juvenile ostrich. Induction protocols included IV administration
      of zolazepam/tiletamine, IV administration of diazepam/ketamine with and without
      xylazine, IV administration of xylazine/ketamine, IM administration of
      carfentanil or xylazine/carfentanil, and mask induction with isoflurane. General
      anesthesia was maintained with isoflurane in 100% oxygen for various procedures,
      including proventriculotomy (6 birds), tibial (1 bird) or mandibular (1 bird)
      fracture repair, and drainage of an iatrogenic hematoma (1 bird). Heart rate and
      respiratory rate varied greatly among birds. The arterial blood pressure values
      recorded from 6 of the birds during maintenance of general anesthesia were higher
      than values recorded for most mammalian species, but were comparable to values
      reported for awake chickens and turkeys.

PMID- 1624342
TI  - Health risks of housing small psittacines in galvanized wire mesh cages.
AB  - Each week over a 6-week period, 80 adult cockatiels (Nymphicus hollandicus) of
      either gender were dosed orally with fine particles of pure zinc or galvanized
      coating removed from welded wire mesh. At dosage of 32 mg/wk, all birds became
      severely ill and either died or were euthanatized within 2 weeks. Dosage of 2
      mg/wk induced chronic illness marked by dullness, weight loss, and intermittent
      excretion of greenish droppings. Necropsy findings were unremarkable, except for
      signs suggestive of impaired gastrointestinal tract motility and histologic
      degenerative changes associated with focal mononuclear infiltration in the liver,
      kidneys, and pancreas. Tissue, especially pancreatic, contents of zinc were
      markedly high. Pure zinc was as toxic as galvanizing zinc. White rust, an
      oxidation product, also was toxic. The galvanized coating on cages and flights
      must be carefully wirebrushed and examined before housing psittacine birds.

PMID- 1624343
TI  - Mammary adenocarcinoma in four mares.
AB  - Mammary gland adenocarcinoma in 4 horses was characterized by firm swelling of
      the gland and serosanguineous discharge from the teat orifice. Two of the mares
      had ulcerative lesions of the mammary gland. Palpation of the affected gland
      typically elicited signs of pain. Diagnosis was assisted by cytologic evaluation
      of the fluid discharge, but definitive diagnosis was based on histologic
      examination. Treatment included mastectomy and lymphadenectomy.

PMID- 1624344
TI  - Immunotherapy of periocular squamous cell carcinoma with metastasis in a pony.
AB  - A 5-year-old Pony of America mare was referred for evaluation of inflamed upper
      and lower right eyelids. Squamous cell carcinoma of the eyelids and ulcerative
      keratitis secondary to self-trauma were diagnosed. Initial treatment of the
      eyelid neoplasia with 2 applications of cryotherapy failed to resolve the
      lesions, and immunotherapy with bacillus of Calmette-Guerin (BCG) was instituted.
      Multiple injections of BCG over a 17-week period resulted in progressive
      shrinkage of the tumor mass, but regional metastasis to the ipsilateral
      submandibular lymph node occurred. Six months later, ocular neoplastic lesions
      were not evident, and the lymph node had regressed in size. Eighteen months after
      the diagnosis of metastatic disease, signs of recurrence were not noticed in
      either the primary or secondary tumor sites. Squamous cell carcinoma of the
      equine eyelid historically carries a poor prognosis for resolution. Immunotherapy
      for equine ocular squamous cell carcinoma should be considered as a treatment
      alternative to cryosurgery, radiotherapy, hyperthermy, and CO2 laser ablation,
      especially in cases involving the eyelid.

PMID- 1624345
TI  - Steroid hepatopathy in a horse with glucocorticoid-induced hyperadrenocorticism.
AB  - Steroid hepatopathy was diagnosed in a horse with glucorticoid-induced
      hyperadrenocorticism on the basis of anamnesis, serum biochemical data, and
      histologic findings of hepatic biopsy. Initially, clinical signs of polyuria,
      polydypsia, and muscular degeneration were seen. The horse developed laminitis
      during hospitalization.

PMID- 1624346
TI  - Septic metritis secondary to torsion of a pedunculated uterine fibroleiomyoma in
      a filly.
AB  - A 2-year-old Arabian filly was referred for evaluation of a serosanguineous
      vaginal discharge. Palpation per rectum revealed a large, fluid-filled uterus and
      a uterine mass. The filly developed septic metritis and secondary laminitis as a
      result of torsion and necrosis of a pedunculated uterine mass. Ovariohysterectomy
      was performed. The entire cervix was removed with the uterus. Gross examination
      of the excised uterus revealed 3 intraluminal masses. Histologic evaluation
      identified the tumors as fibroleiomyoma. The filly recovered completely, and
      there was no recurrence of the tumor.

PMID- 1624347
TI  - Testicular feminization syndrome in a mare.
AB  - Testicular feminization syndrome was diagnosed in a mare with aggressive,
      stallion like behavior and a history of infertility. She was found to have a high
      baseline testosterone concentration suggesting that testicular tissue was
      present, and ovarian-like structures examined by use of transrectal
      ultrasonography had the appearance typical of testicular tissue. Although her
      external female genitalia appeared normal, her vagina ended in a blind sac, and
      no cervix or uterus were identified. Surgery was performed, and structures
      removed from the abdominal cavity were determined to be hypoplastic testicles.
      Removal of the testicular tissue resulted in complete resolution of her
      aggressive behavior. Chromosomal evaluation revealed that the mare had 64X,Y
      (normal male) karyotype. Testicular feminization syndrome is a condition
      characterized by insensitivity of reproductive tissues to androgens during
      development because of an abnormality in androgen receptors. This androgen
      insensitivity results in development of normal external female genitalia, with
      high testosterone concentrations being released from developing testicles.
      Testicular feminization syndrome has not been commonly diagnosed in horses, but
      should be considered as a differential diagnosis for overly aggressive mares with
      a history of infertility.

PMID- 1624348
TI  - Conservative management of uroperitoneum in a gelding.
AB  - Uroperitoneum as a sequela to urethral calculus in an adult gelding was
      successfully managed by use of subischial urethrotomy and abdominal drainage.
      Necrosis of bladder mucosa was seen endoscopically, but a tear or rupture was
      never identified. Peritonitis developed but was controlled with antibacterial
      treatment. Although uroperitoneum is usually a sequela to bladder rupture and the
      ideal treatment is surgical repair, conservative management may be warranted in
      selected cases.

PMID- 1624349
TI  - Arthroscopic removal of an osteochondral fragment from the caudal pouch of the
      lateral femorotibial joint in a colt.
AB  - An osteochondral fragment was removed from the caudal pouch of the lateral
      femorotibial joint in a 2-year-old Trakehner colt by use of arthroscopic surgery
      and a lateral approach. The approach to this aspect of the femorotibial joints
      was developed in another horse. The fragment was not attached and resembled an
      osteochondritis dissecans lesion. The intermittent lameness associated with the
      fragment resolved after surgical removal. A positive response to diagnostic
      anesthesia of the femorotibial joint in the absence of a confirmed diagnosis
      (following radiographic and arthroscopic evaluations of the other aspects of the
      stifle joint) is an indication for arthroscopic exploration of the caudal pouches
      of the femorotibial joints of stifles in horses.

PMID- 1624350
TI  - Tracheal obstruction from tracheal collapse associated with pneumonia in a horse.
AB  - A 20-month-old Quarter Horse stallion was admitted for evaluation of labored
      breathing, honking cough, and bilateral epistaxis that were caused by pneumonia
      and collapsed trachea. A transtracheal aspiration revealed highly cellular,
      serosanguineous fluid. Radiography revealed a patchy alveolar pattern and a
      narrowed tracheal lumen. Endoscopy confirmed narrowing of the tracheal lumen.
      Streptococcus zooepidemicus was isolated on culture of the transtracheal
      aspirate. The horse responded to penicillin treatment, and the tracheal collapse
      improved endoscopically after 4 days, with complete recovery within 1 year.
      Tracheal collapse has been reported to be a disease of older horses associated
      with degenerative cartilage. The findings in the horse of this report suggested
      that tracheal collapse may result from inflammation secondary to pneumonia and,
      therefore, may be reversible.

PMID- 1624351
TI  - Repair of a proximal diaphyseal femoral fracture in a calf, using intramedullary
      pinning, cerclage wiring, and external fixation.
AB  - Repair of a comminuted, spiral oblique, proximal diaphyseal femoral fracture in a
      7-day-old calf was achieved by use of an intramedullary pin, cerclage wires, and
      external fixator. Six stainless steel wires were used for full cerclage to secure
      a long butterfly fragment and multiple incomplete and complete nondisplaced
      fragments to the femur in order to create 2 principal fragments. Axial alignment
      and resistance to bending was provided by a round, double-pointed, end-threaded
      intramedullary pin (6.35 mm in diameter), which was inserted in a retrograde
      fashion. A type-1, double-connecting-bar external fixator, using 4 round pins
      (4.8 mm in diameter), was used to provide supplemental stabilization against
      shear and torsional forces. At 45 days after surgery, healing at the fracture
      site was seen on radiography of the limb, and the external fixator was removed.
      Eight months after surgery, the calf had a normal gait.

PMID- 1624352
TI  - Cholangiohepatitis in a dog.
AB  - Cholangiohepatitis was diagnosed in a dog with a 4-day history of anorexia,
      vomiting, fever, and icterus. Additional findings included signs of depression,
      dehydration, hepatosplenomegaly, and abdominal discomfort. Exploratory laparotomy
      was performed, and specimens of liver, spleen, and bile were obtained. Histologic
      evaluation of liver and spleen revealed acute, suppurative cholangio-hepatitis
      and splenitis, respectively. Cultures of liver and bile yielded Klebsiella sp.
      The dog responded to rehydration and intravenous administration of
      chloramphenicol. Although uncommon, cholangiohepatitis should be suspected in
      dogs with anorexia, fever, vomiting, icterus, and signs of abdominal discomfort.
      Definitive diagnosis requires bacterial cultures of liver and bile.
      Administration of an appropriate antibiotic should resolve clinical signs.

PMID- 1624353
TI  - Intermittent gastric dilatation after gastropexy in a dog.
AB  - Gastroperitoneal adhesions, which developed after tube gastrostomy in a 3-year
      old dog, caused an inverted L configuration of the pyloric antrum and duodenum,
      resulting in periodic episodes of gastric dilatation. The dog had undergone tube
      gastrostomy for treatment of gastric dilatation/volvulus, but gastropexy
      adhesions broke down 27 months later, necessitating a second pexy procedure.
      Adhesions then developed, constricting gastric outflow and trapping gas in the
      stomach and proximal duodenum. When the ventral row of adhesions was surgically
      dissected, the angle between the pyloric antrum and the duodenum was
      straightened, facilitating flow of digesta. Gastropexy rarely causes the degree
      of adhesion formation and the complications reported in this dog.

PMID- 1624354
TI  - Closure of the iliac crest ossification center in dogs: 750 cases (1980-1987).
AB  - Radiographs of 750 dogs were examined to determine whether the iliac crest
      ossification center was open or closed. The center was closed in most dogs by 2
      years of age. Eighteen percent of dogs greater than or equal to 10 years old had
      open iliac crest ossification center; 10% of dogs greater than or equal to 14
      years old had open iliac crest ossification center. Closure of the iliac crest
      ossification center is extremely variable and, in many dogs, occurs at later age
      than has been previously reported.

PMID- 1624355
TI  - Lymphocytic/plasmacytic gastroenteritis in cats: 14 cases (1985-1990).
AB  - Over a 5-year period, lymphocytic/plasmacytic gastroenteritis was diagnosed in 14
      cats. Purebred cats were affected significantly (P less than 0.025) more often
      than nonpurebred cats. Mean age at onset of clinical signs was 6.8 years (range,
      1 to 13 years); 11 cats were male. Vomiting and weight loss, each reported in 10
      of 14 cats, were the most common clinical signs. Diarrhea was reported in 7 of 14
      cats. Alopecia was found in 4 of 14 cats. High hepatic enzyme activities and low
      plasma protein concentrations were frequent biochemical findings. Hyperemia,
      hemorrhage, and a roughened or "cobblestone" mucosa were visualized by endoscopy
      in only 2 of 8 cats with duodenal disease and in 2 of 5 cats with gastric
      disease. Lymphocytic/plasmacytic inflammation was detected in biopsy specimens
      from the stomach or duodenum or both in all cats; the duodenum was affected most
      commonly. Degree of inflammation frequently varied among gastric, duodenal, and
      colonic specimens from the same cat. Glucocorticoid treatment and dietary
      management adequately controlled clinical signs in 7 cats, but treatment was
      ineffective in 6 cats, 5 of which were euthanatized because of severity of
      clinical signs.

PMID- 1624356
TI  - Actinomycetales infections in slender-horned gazelles: six cases (1987-1989).
AB  - Disseminated Actinomycetales infections were diagnosed in 6 slender-horned
      gazelles at a zoologic park over a 17-month period. Nocardia and Mycobacterium
      spp were isolated. Possible predisposing causes leading to infection were
      investigated. Environmental contamination where the gazelles were housed was not
      high, and other breeds of gazelles at the park did not become infected,
      indicating that environmental exposure was not the sole factor involved.
      Information gathered from questionnaires sent to other zoologic parks and
      personnel communications indicated that this was not an isolated incident.
      Investigation into the genetic lineage of the gazelles revealed substantial
      inbreeding in prior generations. These findings suggested inbreeding may have
      been an important predisposing factor leading to infection. Careful scrutiny to
      ensure maximal heterozygosity of future breedings is warranted.

PMID- 1624357
TI  - Blindness associated with toxoplasmosis in canaries.
AB  - Seven of 30 canaries in an aviary in New Zealand developed ophthalmic problems.
      Clinically, 5 birds had unilateral and 2 birds had bilateral lesions
      characterized by conjunctivitis, crusty exudates on eyelids, and collapse of the
      eyeball. Microscopic lesions in 12 of 14 eyes examined included inflammation of
      the choroid and retina, with osseous replacement of the globe in some. Numerous
      Toxoplasma gondii tachyzoites were seen in the detached retina and vitreous humor
      of acutely affected birds. The diagnosis of toxoplasmosis was confirmed by
      immunohistochemical staining with T gondii antiserum. Affected birds had
      encephalitis, and T gondii was localized in the brains of these by
      immunohistochemical examination and by use of bioassays in mice. Toxoplasmosis
      should be considered in differential diagnosis of ophthalmitis in canaries.

PMID- 1624358
TI  - Treatment of lead poisoning in wild geese.
AB  - Twenty-seven wild geese (Anser albifrons) suffering from lead poisoning caused by
      ingestion of lead shot were treated with disodium calcium
      ethylenediaminetetraacetate. The concentration of lead in blood ranged from 0.4
      to 23.0 micrograms/ml, with a mean concentration of 5.6 micrograms/ml. In 22 of
      the birds, 1 to 48 lead pellets (mean, 10.5 pellets/bird) were seen on
      radiographs of their gizzards. Eleven of 27 birds recovered 3 to 8 weeks after
      the initiation of treatment. In the birds that recovered, the lead pellets were
      rapidly eroded as the birds recovered their appetites in response to treatment,
      and disappeared radiographically between treatment days 17 and 52. The birds that
      did not survive died within 4 weeks, despite decreased concentrations of lead in
      blood. Of these 16 birds, 15 had radiographic evidence of impaction of the
      proventriculus at the first examination and no evidence of resolution of the
      impaction at the time of death. In contrast, only 2 of the 11 geese that
      recovered had impaction of the proventriculus at the time of admission. Thus, the
      condition of the proventriculus seems to be the first consideration to evaluate
      in the prognosis of lead poisoning in geese.

PMID- 1624359
TI  - What is your diagnosis? Osteomyelitis of the distal portion of the radius, with
      associated soft tissue swelling.

PMID- 1624360
TI  - Sporeamicin A, a new macrolide antibiotic. I. Taxonomy, fermentation, isolation
      and characterization.
AB  - Sporeamicin A, a novel antibiotic, was isolated from the culture filtrate of an
      actinomycete. The producing organism, strain L53-18, was taxonomically assigned
      as a species of the genus Saccaropolyspora. The antibiotic was extracted with
      chloroform and was then purified by crystallization. It was obtained as colorless
      prisms from ethanolic solutions. Sporeamicin A exhibited a strong UV absorption
      peak at 276 nm. The molecular formula of sporeamicin A was determined to be
      C37H63NO12.

PMID- 1624361
TI  - Sporeamicin A, a new macrolide antibiotic. II. Structure determination.
AB  - Structure of a novel antibiotic, sporeamicin A (SRM-A), was determined by a
      combination of spectroscopic and X-ray crystallographic studies. SRM-A has a
      unique structure containing a 2,3-dihydro-3-oxofuran moiety as part of a 14
      membered macrolide ring.

PMID- 1624362
TI  - Sporeamicin A, a new macrolide antibiotic. III. Biological properties.
AB  - Sporeamicin A is a new erythromycin-type antibiotic isolated from a species of
      Saccharopolyspora. It was active in vitro against a wide variety of Gram-positive
      bacteria. In vitro studies indicated that the sporeamicin A was stable in the
      presence of human serum, although it was bound to serum proteins. Sporeamicin A
      was effective in the mouse protection test against Staphylococcus aureus,
      Streptococcus pyogenes and Streptococcus pneumoniae. Sporeamicin A attained
      higher plasma and tissue levels in the rat than did erythromycin stearate.

PMID- 1624363
TI  - Deoxymulundocandin--a new echinocandin type antifungal antibiotic.
AB  - A new echinocandin type antifungal antibiotic, deoxymulundocandin, C48H77N7O15,
      was isolated from the culture filtrate and mycelia of a fungal culture,
      Aspergillus sydowii (Bainier and Sartory) Thom and Church var. nov. mulundensis
      Roy (Culture No. Y-30462). The structure was established by comparative GC-MS
      analyses of the derivatized acid hydrolysates of deoxymulundocandin and
      mulundocandin as well as by the high field NMR experiments (COSY, NOESY and
      DEPT).

PMID- 1624364
TI  - Macrolactams: a novel class of antifungal antibiotics produced by Actinomadura
      spp. SCC 1776 and SCC 1777.
AB  - Three novel antifungal antibiotics, Sch 38518, Sch 39185 and Sch 38516 were
      isolated from the fermentation broths of two actinomycetes identified by
      chemical, morphological and physiological analysis as a new species of
      Actinomadura. The compounds were isolated from broth by solvent extraction and
      purified by silica gel chromatography. Physico-chemical properties, mass spectral
      analysis, IR and UV suggested the compounds were similar. Sch 38518 and Sch 39185
      have a molecular formula of C25H48N2O5. 1H NMR, 13C NMR and hydrolysis indicated
      the aglycones were identical, however the compounds differed in containing
      isomeric sugar moieties. Sch 38518 contains mycosamine while Sch 39185 contains
      3,6-dideoxy-3-amino-L-talopyranose. Sch 38516 has a molecular formula of
      C24H46N2O5 and is a lower homolog of Sch 39185. The three compounds, Sch 38518
      (1), Sch 39185 (2), and Sch 38516 (3) exhibit similar activity against Candida
      spp. with geometric mean MICs of 1.81, 2.00 and 0.91 micrograms/ml, respectively.

PMID- 1624365
TI  - Macrolactams: two novel homologous series of compounds produced by Actinomadura
      sp. SCC 1778.
AB  - Eight antifungal compounds were identified from the fermentation of Actinomadura
      sp. SCC 1778. This culture produces four homologous compounds (C22H42N2O5
      approximately C25H48N2O5) containing the sugar, mycosamine, and four homologous
      compounds (C22H42N2O5 approximately C25H48N2O5) containing the sugar, 3,6-dideoxy
      3-amino-L-talopyranose. Five of the compounds identified were novel macrolactams.
      All these compounds exhibit antifungal activity against Candida spp. with
      geometric mean MICs ranging from approximately 1.0 micrograms/ml for the higher
      homologs to 30 micrograms/ml for the lower homologs.

PMID- 1624366
TI  - The squalestatins, novel inhibitors of squalene synthase produced by a species of
      Phoma. I. Taxonomy, fermentation, isolation, physico-chemical properties and
      biological activity.
AB  - During the screening of fungi for inhibitors of squalene synthase, Phoma sp.
      C2932 was found to produce three structurally related novel inhibitors. These
      compounds, designated the squalestatins, exhibited potent activity against both
      mammalian (rat liver) and fungal (Candida albicans) squalene synthase.
      Furthermore, they also had broad spectrum in vitro antifungal activity.

PMID- 1624367
TI  - The squalestatins, novel inhibitors of squalene synthase produced by a species of
      Phoma. II. Structure elucidation.
AB  - Three novel fungal metabolites 1-3 isolated from cultures of a Phoma sp. C2932,
      are potent and selective inhibitors of squalene synthase. Their structures have
      been determined by a combination of spectroscopic, X-ray crystallographic and
      chemical methods; these natural products incorporate the highly functionalised
      bicyclic core, [1S-(1 alpha, 3 alpha, 4 beta, 5 alpha, 6 alpha, 7 beta]-4,6,7
      trihydroxy- 2,8-dioxabicyclo-[3.2.1]octane-3,4,5-tricarboxylic acid.

PMID- 1624368
TI  - C-13 beta-acyloxymilbemycins, a new family of macrolides. Discovery, structural
      determination and biological properties.
AB  - A family of novel milbemycins possessing C-13 beta-acyloxy substitution was
      produced by Streptomyces hygroscopicus ATCC 53718. These compounds were detected
      by HPLC diode array analysis and possess anthelmintic and ectoparasiticidal
      activity. The origin of the oxygen atom at C-13 is discussed.

PMID- 1624369
TI  - L-696,474, a novel cytochalasin as an inhibitor of HIV-1 protease. I. The
      producing organism and its fermentation.
AB  - A novel cytochalasin, L-696,474, (18-dehydroxy cytochalasin H) that inhibits HIV
      1 protease was discovered in fermentations of a bark-inhabiting Ascomycete,
      Hypoxylon fragiforme. The product was first identified from extracts of an agar
      medium. Fermentation studies on a number of media indicated that the product can
      be made on several solid and liquid media. Optimum production was obtained from
      growth in a complex medium composed of glycerol, glucose, citrate, Ardamine,
      soybean meal, tomato paste, and inorganic salts. Other Hypoxylon spp., related
      species of Xylariales, and other fungi known to produce cytochalasins, were also
      surveyed for their ability to make L-696,474. Only one other Hypoxylon fragiforme
      isolate was found to make this novel cytochalasin; none of the other cultures
      surveyed made L-696,474 or any other compounds which inhibit HIV-1 protease.

PMID- 1624370
TI  - L-696,474, a novel cytochalasin as an inhibitor of HIV-1 protease. II. Isolation
      and structure.
AB  - A novel HIV-1 protease inhibitor, L-696,474 (C30H39NO4, 477), was isolated from
      the fermentations of the fungus Hypoxylon fragiforme (ATCC 20995, MF5511) and
      purified by silica gel chromatography followed by crystallization. Spectroscopic
      studies have shown the competitive inhibitor L-696,474 to be a novel
      cytochalasin. Two related novel cytochalasins were also isolated and had no
      effect on the enzyme.

PMID- 1624371
TI  - L-696,474, a novel cytochalasin as an inhibitor of HIV-1 protease. III.
      Biological activity.
AB  - L-696,474, an inhibitor of the HIV-1 protease, was discovered in extracts of the
      fungal culture Hypoxylon fragiforme (MF5511; ATCC 20995). L-696,474 is a novel
      cytochalasin with a molecular weight of 477 and an empirical formula of
      C30H39NO4. L-696,474 inhibited HIV-1 protease activity with an IC50 of 3 microM
      and the mode of inhibition was competitive with respect to substrate (apparent Ki
      = 1 microM). Furthermore, L-696,474 was not a slow-binding inhibitor. The
      inhibition due to L-696,474 was also independent of the HIV-1 protease
      concentration. L-696,474 was inactive against pepsin, another aspartyl protease;
      stromelysin, a zinc-metalloproteinase; papain, a cysteine-specific protease or
      human leucocyte elastase, a serine-specific protease. Two other novel
      cytochalasins (L-697,318 and L-696,475) isolated from the same culture were
      inactive against the HIV-1 protease. Commercially available cytochalasins B, C,
      D, E, F, H and J were inactive while cytochalasin A was as active as L-696,474
      against the HIV-1 protease.

PMID- 1624372
TI  - A new anthelmintic cyclodepsipeptide, PF1022A.
AB  - The novel anthelmintic cyclodepsipeptide PF1022A was isolated from cultured
      mycelia of Mycelia Sterilia PF1022 (FERM BP-2671). It showed strong anthelmintic
      activities against Ascaridia galli in chickens. The structure of PF1022A was
      determined to be cyclo(D-lactyl-L-N-methylleucyl-D-3-phenyllactyl-L-N-meth
      ylleucyl-D-lactyl-L-N- methylleucyl-D-3-phenyllactyl-L-N-methylleucyl) by
      spectroscopic analyses and chemical studies.

PMID- 1624373
TI  - Studies on condensed-heterocyclic azolium cephalosporins. IV. Synthesis and
      antibacterial activity of 7 beta-[2-(5-amino-1,2,4-thiadiazol-3-yl)-2(Z)-
      alkoxyiminoacetamido]-3-(condensed-heterocyclic azolium)methyl cephalosporins
      including SCE-2787.
AB  - The synthesis and in vitro antibacterial activity of 7 beta-[2-(5-amino-1,2,4
      thiadiazol-3-yl)-2(Z)-alkoxyiminoacetami do] cephalosporins bearing various
      condensed-heterocyclic azolium groups at the 3 position in the cephalosporin
      nucleus are described. The thiadiazolyl cephalosporins showed good antibacterial
      activity against both Gram-positive and Gram-negative bacteria and the MICs of
      the thiadiazolyl cephalosporins against Pseudomonas aeruginosa was more potent
      than that of the corresponding 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)
      alkoxyiminoacetamido]-3- (condensed-heterocyclic azolium)methyl cephalosporins.
      Also, the thiadiazolyl cephalosporins bearing (imidazo[1,2-b]-pyridazinium-1
      yl)methyl groups at the 3 position showed antibacterial activity against
      methicillin-resistant Staphylococcus aureus (MRSA). Among the cephalosporins
      tested, 7 beta-[2-(5- amino-1,2,4-thiadiazol-3-yl)-2(Z)-methoxyiminoacetamido]-3
      (imidaz o[1,2- b]pyridazinium-1-yl)methyl-3- cephem-4-carboxylate (4, SCE-2787)
      which exhibited the most potent antibacterial activity and the broadest
      antibacterial spectrum was selected as a parenteral cephalosporin candidate for
      further biological evaluation.

PMID- 1624374
TI  - Studies on condensed-heterocyclic azolium cephalosporins. V. Synthesis and
      antibacterial activity of 3-(condensed-triazolo-pyridinium, -pyrimidinium, and 
      pyridazinium)-methyl cephalosporins.
AB  - As a part of our studies on cephalosporins bearing condensed-heterocyclic azolium
      methyl groups at the 3 position in the cephalosporin nucleus, we describe here
      the synthesis and antibacterial activity of 7 beta-[2-(2-aminothiazol-4-yl)2(Z)
      methoxyiminoacetamido] cephalosporins (1-16, 7 beta-[2-(2-amino-5-chlorothiazol-4
      yl)-2(Z)- methoxyiminoacetamido] cephalosporins (17,18) and 7 beta-[2-(5-amino-
      1,2,4-thiadiazol-3-yl)-2(Z)-methoxyiminoacetamido) cephalosporins (19-23)
      containing a variety of condensed-heterocyclic triazolium methyl groups at the 3
      position in the cephalosporin nucleus. These cephalosporins exhibited potent
      antibacterial activity, and it appears that condensed-heterocyclic triazolium as
      well as condensed-heterocyclic imidazolium rings are effective moieties for
      improving antibacterial activity and the spectrum of activity. Among the
      cephalosporins tested, 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)
      methoxyiminoacetamido]-3-(5- methyl[1,2,3]triazolo-[1,5-alpha]pyridinium-1
      yl)methyl-3-cephem-4- carboxylate (9) and 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)
      methoxyiminoacetamido]-3-(6- methoxy[1,2,4]triazolo[1,5-alpha]pyridinium-1
      yl)methyl-3-cephem-4- carboxylate (11) showed good antibacterial activity.

PMID- 1624375
TI  - Syntheses and activities of some bactobolin derivatives.
AB  - Some derivatives of bactobolin were prepared from bactobolin by dehydration or
      substitution reactions through tris(dimethylamino)alkoxyphosphonium salt
      formation. A derivative with low toxicity, 6-deoxybactobolin, showed moderate
      activity against Gram-positive and Gram-negative bacteria including methicillin
      resistant Staphylococcus aureus.

PMID- 1624376
TI  - Polymyxin B octapeptide and polymyxin B heptapeptide are potent outer membrane
      permeability-increasing agents.
AB  - Polymyxin B octapeptide (PBOP) and polymyxin B heptapeptide (PBHP) were found to
      be effective permeabilizers of the outer membrane of Escherichia coli and
      Salmonella typhimurium. PBOP was as effective as polymyxin B nonapeptide (PMBN),
      the known very potent permeabilizer. As low a PBOP concentration as 1
      microgram/ml sensitized E. coli to rifampicin by a factor of 100. Three
      micrograms of PBOP per ml was sufficient to sensitize this target to all the
      other tested hydrophobic antibiotics (erythromycin, fusidic acid, clindamycin,
      and novobiocin) by a factor of 30. Only a slightly higher (3-fold) concentration
      of PBHP was required for a similar sensitizing effect.

PMID- 1624377
TI  - Biochemical studies on 2-deoxy-scyllo-inosose, an early intermediate in the
      biosynthesis of 2-deoxystreptamine. I. Chemical synthesis of 2-deoxy-scyllo
      inosose and [2,2-2H2]-2-deoxy-scyllo-inosose.
AB  - A practical preparative method for 2-deoxy-scyllo-inosose, the earliest key
      intermediate leading to 2-deoxystreptamine, was devised as a prerequisite to more
      detailed biochemical studies on the biosynthesis of 2-deoxystreptamine. [2,2-2H2]
      2-Deoxy-scyllo-inosose was also synthesized through a modified Ferrier reaction.

PMID- 1624378
TI  - Biochemical studies on 2-deoxy-scyllo-inosose, an early intermediate in the
      biosynthesis of 2-deoxystreptamine. II. Quantitative analysis of 2-deoxy-scyllo
      inosose.
AB  - A practical quantitative analysis of 2-deoxy-scyllo-inosose by means of GC-MS
      selected-ion monitoring (SIM) was exploited in order to assay the enzymatic 2
      deoxy-scyllo-inosose formation, the first stage of the 2-deoxystreptamine
      biosynthesis. Mass spectral fragmentations of 2-deoxy-scyllo-inosose tetra-O
      trimethylsilyl (TMS) ether was also investigated by the use of [2,2-2H2]-2-deoxy
      scyllo-inosose.

PMID- 1624379
TI  - Confirmation of in vitro synthesis of 2-deoxy-scyllo-inosose, the earliest
      intermediate in the biosynthesis of 2-deoxystreptamine, using cell free
      preparations of Streptomyces fradiae.

PMID- 1624380
TI  - Studies on the biosynthesis of bialaphos (SF-1293) 12. C-P bond formation
      mechanism of bialaphos: discovery of a P-methylation enzyme.
AB  - An enzymatic activity catalyzing P-methylation of N
      acetyldemethylphosphinothricin, a biosynthetic intermediate of the herbicide
      bialaphos, was detected in a cell extract of Streptomyces hygroscopicus SF-1293,
      a bialaphos producing organism. The gene coding for this P-methylation enzyme in
      the bialaphos biosynthetic gene cluster was also expressed in Streptomyces
      lividans. The methyl donor of the reaction was determined to be methylcobalamin.
      The P-methylation enzyme utilized both N-acetyldemethylbialaphos and N
      acetyldemethylphosphinothricin as substrates.

PMID- 1624381
TI  - WS-7338, new endothelin receptor antagonists isolated from Streptomyces sp. No.
      7338. III. Structures of WS-7338 A, B, C and D and total synthesis of WS-7338 B.

PMID- 1624382
TI  - Studies on bottromycins. I. 1H and 13C NMR assignments of bottromycin A2, the
      main component of the complex.

PMID- 1624383
TI  - Synthesis and biological properties of FCE 25199, a new oral penem.

PMID- 1624384
TI  - Microbial conversion of milbemycins: 29-hydroxylation of milbemycins by genus
      Syncephalastrum.

PMID- 1624385
TI  - Chronotoxical study of gentamicin induced nephrotoxicity in rats.

PMID- 1624386
TI  - Isolation and characterization of sporeamicin B.

PMID- 1624387
TI  - The production of semduramicin by direct fermentation.

PMID- 1624388
TI  - The Garrod Lecture. Understanding the chemotherapy of tuberculosis--current
      problems.

PMID- 1624389
TI  - BSAC, third combined British Scandinavian Hellenic Conference, May 1991:
      immunotherapy of infectious disease.

PMID- 1624390
TI  - The binding of amikacin to macromolecules from the sputum of patients suffering
      from respiratory diseases.
AB  - Antibiotics bind to whole cystic fibrosis sputum, however, the composition of
      sputum varies from one patient to another, making the interpretation of binding
      studies difficult. This problem has been examined by standardizing the
      macromolecule concentration of sputum from 13 patients suffering from cystic
      fibrosis, chronic bronchitis or bronchiectasis and adding amikacin to the sputum
      components. Also binding to fractions of sputum was studied before and after
      treatment with DNase or chondroitinase. These studies indicated that the degree
      of amikacin binding is dependent on the DNA concentration and the presence of
      acidic mucins.

PMID- 1624391
TI  - Antibacterial properties of SCE-2787, a new cephem antibiotic.
AB  - The in-vitro antibacterial properties of SCE-2787, a new semi-synthetic
      parenteral cephalosporin, were evaluated by comparing its affinities for
      penicillin-binding proteins (PBPs), its bactericidal activity and its effects on
      morphology with those of ceftazidime, cefpirome and E-1040. SCE-2787 and
      cefpirome had higher affinities for PBPs 1 and 2 of Staphylococcus aureus, and a
      more potent anti-staphylococcal activity, than ceftazidime and E-1040. All four
      antibiotics had similar activity against Escherichia coli, and showed similar
      affinities for PBP 3 of this organism. SCE-2787, ceftazidime and E-1040 were more
      potent than cefpirome against Pseudomonas aeruginosa, and showed higher
      affinities for the P. aeruginosa PBP 3. The wide-spectrum antibacterial activity
      of SCE-2787 can be explained, in general, by its high affinities for PBPs, SCE
      2787, at half its MIC level or higher, was bactericidal against all the bacterial
      strains examined, as were the other antibiotics tested. Exposure of S. aureus to
      SCE-2787 resulted in the formation of cell walls with irregular septa which
      subsequently thickened and collapsed. Elongation was the major morphological
      change of E. coli and P. aeruginosa cells treated with SCE-2787. E. coli cells
      were converted to 'ghosts', infrequent in P. aeruginosa, after prolonged
      incubation with higher concentrations of SCE-2787.

PMID- 1624392
TI  - Antimicrobial resistance in Haemophilus influenzae from England and Scotland in
      1991.
AB  - Twenty-two laboratories in England and Scotland sent 2212 clinical isolates of
      Haemophilus influenzae to The London Hospital Medical College (LHMC) between 1
      January and 31 March 1991. After confirmation of identity, the prevalence of
      resistance was determined and compared with results from previous similar
      surveys. beta-Lactamase was produced by 8.3% of non-capsulate isolates and 21% of
      52 type b isolates; both figures were higher than the 6% and 18% figures
      recorded, respectively, in 1986. There was an increase in the prevalence of non
      beta-lactamase-mediated diminished susceptibility to ampicillin (5.8%) and co
      amoxiclav (6.1%) compared with 1986 (4%). Whereas fewer H. influenzae isolates
      were resistant to tetracycline (1.4%) or chloramphenicol (0.8%), there was an
      increase in resistance to trimethoprim (6.8%) and to sulphamethoxazole (16.9%)
      compared with 1986 (4.2% and 3.5% respectively). In addition, 95 isolates (4.3%)
      were resistant to both of these anti-folate antimicrobials. Six isolates (one
      type b from CSF) were resistant to all drugs tested, except for co-amoxiclav.
      Overall, the results demonstrated that changes have occurred in the last decade
      in England and Scotland, such that H. influenzae isolates are increasingly likely
      to be resistant to ampicillin, co-amoxiclav and co-trimoxazole.

PMID- 1624393
TI  - Activity of rifapentine against Mycobacterium avium infection in beige mice.
AB  - The activity of rifapentine (MDL 473) was evaluated in the beige (C57BL/6J
      bgj/bgj) mouse model of disseminated Mycobacterium avium infection. Approximately
      10(7) cfu of M. avium, serotype 1, were given iv. Seven days later treatment was
      started with intraperitoneal rifapentine at 20 mg/kg of body weight. Treatment
      was given daily for five days followed by twice weekly for three weeks. The mice
      were killed two days after the last dose. Spleens, livers and lungs were
      homogenized and cfu/organ determined. Analysis of variance and Tukey honestly
      significant difference tests indicated that rifapentine reduced cfu in each of
      the organs compared with untreated controls. A dose-response experiment was
      performed with a daily rifapentine dose of 10, 20 or 40 mg/kg administered
      intraperitoneally. Dose-related reductions in cfu counts were observed in each of
      the organs. The activity of oral rifapentine at 20 mg/kg was demonstrated in a
      comparative experiment with rifampicin at 20, 40 or 60 mg/kg. Rifapentine
      significantly reduced cfu counts in organs compared with rifampicin. Rifapentine
      should be considered for further evaluation in the treatment of M. avium complex
      infection in humans.

PMID- 1624394
TI  - Development of resistance during ceftazidime and cefepime therapy in a murine
      peritonitis model.
AB  - Resistance emerging after ceftazidime or cefepime therapy was investigated in a
      peritonitis model. Mice were given a peritoneal challenge (10(8) cfu plus talcum)
      and treated by either antibiotic (50 mg/kg/dose, which produced similar
      antibiotic concentrations in peritoneal fluid in both cases). After one or three
      doses, resistance never developed in Serratia marcescens or Citrobacter freundii
      infections. After Enterobacter cloacae and Pseudomonas aeruginosa challenge,
      ceftazidime selected more resistance (21/36 cases) than did cefepime (1/36
      cases). In mice challenged with resistant strains selected by ceftazidime
      therapy, cefepime (six doses) successfully treated 7/18 E. cloacae infections but
      0/18 P. aeruginosa infections; ceftazidime was never effective. Neither cefepime
      nor ceftazidime cured mice infected with the resistant strain selected by
      cefepime. MICs were poor predictors of further emergence of resistance in mice
      inoculated with strains classified as susceptible, but antibiotic-containing agar
      gradients plated with a high inoculum (10(8) cfu) allowed better prediction. In
      selected clinical situations, cefepime may be preferable because it may be
      associated with less frequent emergence of resistance.

PMID- 1624395
TI  - Sampling time for serum gentamicin levels.
AB  - A survey in 53 UK hospitals showed that 44% of clinical microbiologists
      recommended post-dose serum gentamicin concentrations to be measured at less than
      40 min after an iv bolus dose. Serum gentamicin concentrations were measured in
      ten patients following bolus iv and im injections. Distribution of the drug
      occurred for up to 45 min following iv doses and maximum serum concentrations
      occurred at 45 to 60 min after im injection. The data validate current guidelines
      to sample at 60 min post bolus iv and im doses. Earlier sampling after iv bolus
      injections may result in significantly higher gentamicin concentrations, leading
      to potential interpretive errors of clinical significance.

PMID- 1624396
TI  - Penetration of pefloxacin into gynaecological tissues.
AB  - In a prospective pharmacokinetic study, the plasma and tissue concentrations of
      pefloxacin were studied. Twelve patients were premedicated with pefloxacin 400 mg
      bd orally for three days followed by 400 mg iv preoperatively. Tissue samples
      during surgery were taken from the skin, peritoneum, ovary, myometrium and
      fallopian tubes. Pefloxacin concentrations were measured by high performance
      liquid chromatography with fluorescence detection. The mean elimination half-life
      of pefloxacin was 11.3 h, the mean residence time (MRT) was 15.8 h and the
      apparent volume of distribution 1.52 +/- 0.525 L/kg. Pefloxacin concentrations in
      myometrium, ovary and fallopian tubes exceeded four- to six-fold the
      corresponding plasma concentrations 3.5 h after the last drug intake. At the
      start of surgery, about 2.5 h after the last dose, the skin/plasma concentration
      ratio and the peritoneum/plasma concentration ratio were 2.65 and 1.18,
      respectively. At the end of surgery, these ratios were 4.65 and 1.5. The tissue
      concentrations exceeded the MIC90 for most common pathogens implicated in
      gynaecological infections.

PMID- 1624397
TI  - A novel plasmid-mediated extended-spectrum beta-lactamase not derived from TEM-
      or SHV-type enzymes.

PMID- 1624398
TI  - beta-Lactamases and susceptibility phenotypes to beta-lactam antibiotics in
      Escherichia coli strains.

PMID- 1624399
TI  - In-vitro activity of LY264826, an investigational glycopeptide antibiotic,
      against gram-positive bloodstream isolates and selected gram-negative bacilli.

PMID- 1624401
TI  - Tetracycline resistance in Bacteroides ureolyticus.

PMID- 1624400
TI  - In-vitro antimicrobial activity of the penem BRL-42715, alone and in combination
      with ampicillin, against respiratory tract pathogens.

PMID- 1624402
TI  - Intraperitoneal penetration of FCE 22101.

PMID- 1624403
TI  - Communication abilities and Rett syndrome.
AB  - Investigated 6 girls with Rett syndrome (RS), ages between 2 and 13 years, to
      provide comprehensive descriptions of their communicative behaviors. Previous
      studies have not focused on communicative competence nor on the intentionality of
      the language used by children with RS. This study concluded that all members of
      the group investigated were at a preintentional level of communication.
      Intentional communication has previously been reported to develop in normally
      developing and intellectually disabled children attaining Piagetian Sensorimotor
      Stage V in Means-End behavior. The present study also investigated the cognitive
      performance of the group. We concluded that the preintentional level of
      communication noted was consistent with the subjects' profound intellectual
      disability. No Means-End (i.e., purposeful) behavior beyond Piagetian
      Sensorimotor Stage III could be elicited from the 6 girls. The relevance of this
      study for therapeutic intervention is discussed.

PMID- 1624404
TI  - Cognitive abilities of patients with Lesch-Nyhan disease.
AB  - Parents of 42 patients with Lesch-Nyhan disease completed a questionnaire
      systematizing caregiver observations of the subject's behavior during a wide
      variety of daily events. Responses were grouped in nine categories reflecting
      different aspects of cognitive skills. Only 1 boy appears to have any significant
      generalized cognitive impairment. The patients' memory for both recent and past
      events is excellent, their emotional life has a normal range of reactions and is
      appropriate; they have good concentration, are capable of abstract reasoning,
      have good self-awareness, and are highly social. However, they are behind in
      academic ability, with only 15% at grade level for math and reading. Implications
      for designing educational activities, parenting or caregiver strategies, and
      research methodology are discussed.

PMID- 1624405
TI  - Consistent stress profiles in mothers of children with autism.
AB  - The present study extends the area of research on stress in parents of autistic
      children. In this study we used the Questionnaire on Resources and Stress
      (Holroyd, 1987) to compare the stress profiles across mothers (a) who lived in
      different cultural and geographic environments; (b) who had children of different
      ages; and (c) who had children with different functioning levels. Results showed
      a characteristic profile that was highly consistent across each of these
      subgroups. Major differences from the normative data occurred on scales measuring
      stress associated with dependency and management, cognitive impairment, limits on
      family opportunity, and life-span care. Results suggest the importance of
      developing treatment programs aimed at reducing stress in specific areas in
      families with autistic children.

PMID- 1624406
TI  - Assessing resources and stress in parents of severely dysfunctional children
      through the Clarke modification of Holroyd's Questionnaire on Resources and
      Stress.
AB  - The Holroyd (1974) Questionnaire on Resources and Stress (QRS) although
      clinically useful may be too inclusive and not exclusively relevant to severely
      dysfunctional individuals. Hitherto, efforts at shortening and psychometrically
      validating the QRS have met with some success: the shorter forms however still
      target both mentally and physically handicapped children and are clinically not
      as useful as the original instrument. The 78-item Clarke modification of the QRS,
      mainly a subset of the original, was an attempt to remedy these problems. It was
      validated with mothers and fathers of autistic, mentally retarded, learning
      disabled, and asymptomatic children. Good internal consistency, split-half
      reliability, and coefficient of stability were obtained. Construct and concurrent
      validities were also acceptable. The questionnaire discriminated best between the
      two more severely affected groups and the controls. Group differences were found
      for 8 of its 9 scales and sex of parent differences were found for 3. The Clarke
      modification of the QRS is recommended for clinical use with parents of children
      with autism and mental retardation.

PMID- 1624407
TI  - Stress and family functioning in parents of girls with Rett syndrome.
AB  - Mothers and fathers of 29 girls with Rett syndrome provided data about their
      levels of parenting stress, marital adjustment, and family functioning. Their
      scores were compared to normative and clinical samples. The parents of girls with
      Rett syndrome reported more stress, lower marital satisfaction, and certain
      adaptations in family functioning compared to norms. However, most parents scored
      in the normal range on most measures and their scores were not related to SES.
      There was little relationship between specific characteristics of the daughter
      with Rett syndrome, such as her age and level of functioning, and her parents'
      scores on these measures. There were few significant differences between mothers'
      and fathers' scores. Results are discussed in terms of patterns of family
      adaptation and coping. Clinical implications are also discussed.

PMID- 1624408
TI  - Toilet training and behaviors of people with autism: parent views.
AB  - Individuals with autism often present with toileting problems, yet there is
      little information about the nature of these problems. This investigation
      surveyed 100 parents of people with autism of a mean age of 19.5 years. Results
      indicated that lower cognition and lower verbal levels were significantly
      correlated with age of accomplishment of bowel and urine training; some subjects
      were not trained at the time of the study. The average duration of urine training
      was 1.6 years, bowel training 2.1 years. On the average, training started more
      than 2 1/2 years before the average age of diagnosis of autism. Fifty-six percent
      of the sample had to be taught to self-initiate, 42% were taught to ask to use
      the toilet, and 49% were taught using a schedule. Reinforcement was used by 78%
      of the parents of males and by 100% of the parents of females. Punishment,
      primarily scolding was used by 37% of the parents. The most common problems
      reported were urinating in places other than the toilet, constipation, stuffing
      up toilets, continually flushing, or smearing feces. More fears related to
      toileting were noted for verbal subjects.

PMID- 1624409
TI  - Academic and environmental effects of small group arrangements in classrooms for
      students with autism and other developmental disabilities.
AB  - The use of small group instructional formats with children who have autism and
      developmental disabilities has received mixed results in the research literature
      (Reid & Favell, 1984). The purpose of the two studies reported herein was to
      address this controversy by comparing the performance of students in one-to-one
      instruction to those transitioned to small groups for a variety of teachers,
      students, settings, and under different training circumstances. In the first
      study, 41 students, ranging in age from 5 to 21 years old, from six classrooms,
      participated; and 25 students from six classrooms participated in the second
      study. Measures of environmental effects included academic gains via pre- and
      posttests, on-task and self-stimulatory behavior levels, correct responding, and
      frequencies of teacher behaviors during both one-to-one and small group formats.
      Results of both experiments indicated that students were able to successfully
      transition to small group formats across several curriculum areas including
      language, math, readiness, and shopping. Further, experienced teachers and
      administrators were able to train a second group of staff to use the small group
      procedures effectively. The successful application for this number of students
      and teachers within natural learning environments is unprecedented and provides
      important documentation for both the utility and practicality of small group
      instruction with students who have developmental disabilities.

PMID- 1624410
TI  - Plasma and urinary levels of biopterin, neopterin, and related pterins and plasma
      levels of folate in infantile autism.
AB  - Tetrahydrobiopterin is essential for brain cells to make monoamine
      neurotransmitters. It has been reported that the concentrations of
      tetrahydrobiopterin in plasma and urine are low in certain mental disorders and
      that oral supplements are beneficial. A group of Japanese investigators have been
      conducting clinical trials of the effect of administration of tetrahydrobiopterin
      to autistic children and reported that it is beneficial with no significant side
      effects. We, therefore, initiated a study to assess plasma and urinary levels of
      tetrahydrobiopterin in infantile autism to see if they are reduced. Besides
      tetrahydrobiopterin, we also determined plasma and urinary levels of neopterin
      and monapterin in these individuals in order to evaluate the status of
      dihydroneopterin triphosphate, a key biosynthetic precursor of
      tetrahydrobiopterin. Sixteen autistic children and 12 healthy controls were
      included in this study. Results indicated that the plasma and urinary levels of
      tetrahydrobiopterin are not statistically different between the two groups and,
      therefore, no simple explanation for the beneficial effects of administration of
      tetrahydrobiopterin on autistic children can be offered at the present time. In
      contrast, plasma and urinary levels of neopterin were depressed (.01 less than p
      less than .05) and plasma monapterin was also significantly depressed (p less
      than .01) in autistic subjects compared with controls. Levels of other pterins,
      including folate, were not statistically different between the two groups. The
      basis for this depression in neopterin and monapterin is unknown. It does not
      seem likely that this depression could be attributed to a difference in age or T
      lymphocyte/macrophage activity. However, further studies are needed to
      investigate these possibilities.

PMID- 1624411
TI  - Brief report: analysis of the internal consistency of three autism scales.

PMID- 1624412
TI  - Stress and immunological recognition in host-pathogen interactions.

PMID- 1624413
TI  - An operon of Bacillus subtilis motility genes transcribed by the sigma D form of
      RNA polymerase.
AB  - Two genes controlling motility functions in Bacillus subtilis were identified by
      DNA sequence analysis of a chromosomal fragment containing a strong promoter for
      sigma D RNA polymerase. Previous studies had shown that this sigma D-dependent
      promoter controls synthesis of a 1.6-kb transcript in vivo and in vitro. Sequence
      analysis revealed that the 1.6-kb transcript contains two open reading frames
      coding for protein sequences homologous to the Escherichia coli motA and motB
      gene products, respectively, and ends in a rho-independent termination site.
      Direct evidence linking these genes to motility functions in B. subtilis was
      obtained by precise localization by polymerase chain reaction of Tn917 transposon
      insertion mutations of Mot- strains, isolated by Zuberi et al. (A. R. Zuberi, C.
      Ying, H. M. Parker, and G. W. Ordal, J. Bacteriol. 172:6841-6848, 1990), to
      within this mot. operon. Replacement of each wild-type gene by in-frame deletion
      mutations yielded strains possessing paralyzed flagella and confirmed that both
      motA and motB are required for the motility of B. subtilis. These current
      findings support our earlier suggestions that sigma D in B. subtilis plays a
      central role in the control of gene expression for flagellar assembly,
      chemotaxis, and motility functions. Sigma F, the enteric homolog of sigma D,
      controls similar functions in E. coli and Salmonella typhimurium, and these
      factors appear to be representative of a family of factors implicated in
      flagellar synthesis in many bacterial species, which we propose to designate the
      sigma 28 family.

PMID- 1624414
TI  - The stable maintenance system pem of plasmid R100: degradation of PemI protein
      may allow PemK protein to inhibit cell growth.
AB  - We constructed plasmids carrying heat-inducible pemI and pemK genes, which were
      fused with the collagen-lacZ sequence in frame. The PemK-collagen-LacZ (PemK*)
      protein produced from the fusion gene upon heat induction inhibited the growth of
      cells and killed most of the cells in the absence of the PemI protein but did not
      do so in the presence of the PemI protein. This supports our previous assumption
      that the PemK protein inhibits cell division, leading to cell death, whereas the
      PemI protein suppresses the function of the PemK protein. We also constructed the
      plasmid carrying the heat-inducible pem operon which consists of the intact pemI
      gene and the pemK gene fused with collagen-lacZ. The simultaneously induced PemI
      and PemK* proteins did not inhibit the growth of cells. However, the temperature
      shift to 30 degrees C after induction of both proteins at 42 degrees C caused
      inhibition of cell growth and death of most cells. This suggests that the PemI
      protein is somehow inactivated upon the arrest of de novo synthesis of the PemI
      and PemK* proteins, allowing the PemK* protein to function. We observed that the
      PemI-collagen-LacZ (PemI*) protein was degraded faster than the PemK* protein,
      perhaps by the action of a protease(s). In fact, the lon mutation, which caused
      no apparent degradation of the PemI* protein, did not allow the PemK* protein to
      function, supporting the suggestion described above. Instability of the PemI
      protein would explain why the cells which have lost the pem+ plasmid are
      preferentially killed.

PMID- 1624415
TI  - Influence of attractants and repellents on methyl group turnover on methyl
      accepting chemotaxis proteins of Bacillus subtilis and role of CheW.
AB  - The ability of attractants and repellents to affect the turnover of methyl groups
      on the methyl-accepting chemotaxis proteins (MCPs) was examined for Bacillus
      subtilis. Attractants were found to cause an increase in the turnover of methyl
      groups esterified to the MCPs, while repellents caused a decrease. These
      reactions do not require CheW. However, a cheW null mutant exhibits enhanced
      turnover in unstimulated cells. Assuming that the turnover of methyl groups on
      the MCPs reflects a change in the activity of CheA, these results suggest that
      the activation of CheA via chemoeffector binding at the receptor does not require
      CheW.

PMID- 1624416
TI  - Characterization of a Bradyrhizobium japonicum ferrochelatase mutant and
      isolation of the hemH gene.
AB  - A Tn5-induced mutant of Bradyrhizobium japonicum, strain LORBF1, was isolated on
      the basis of the formation of fluorescent colonies, and stable derivatives were
      constructed in backgrounds of strains LO and I110. The stable mutant strains
      LOek4 and I110ek4 were strictly dependent upon the addition of exogenous hemin
      for growth in liquid culture and formed fluorescent colonies. The fluorescent
      compound was identified as protoporphyrin IX, the immediate precursor of
      protoheme. Cell extracts of strains LOek4 and I110ek4 were deficient in
      ferrochelatase activity, the enzyme which catalyzes the incorporation of ferrous
      iron into protoporphyrin IX to produce protoheme. Mutant strain I110ek4 could
      take up 55Fe from the growth medium, but, unlike the parent strain, no
      significant incorporation of radiolabel into heme was found. This observation
      shows that heme was not synthesized in mutant strain I110ek4 and that the heme
      found in those cells was derived from exogenous hemin in the growth medium. The
      putative protein encoded by the gene disrupted in strain LORBF1 and its
      derivatives was homologous to ferrochelatases from eukaryotic organisms. This
      homology, along with the described mutant phenotype, provides strong evidence
      that the disrupted gene is hemH, that which encodes ferrochelatase. Mutant strain
      I110ek4 incited nodules on soybean that did not fix nitrogen, contained few
      viable bacteria, and did not express leghemoglobin heme or apoprotein. The data
      show that B. japonicum ferrochelatase is essential for normal nodule development.

PMID- 1624417
TI  - Variation in antigenicity and molecular weight of Campylobacter coli VC167
      flagellin in different genetic backgrounds.
AB  - Campylobacter coli VC167 has been shown to undergo a reversible flagellar
      antigenic variation between antigenic type 1 (T1) and antigenic type 2 (T2).
      VC167 contains two flagellin genes, and the products of both genes are
      incorporated into a complex flagellar filament in both antigenic types. Although
      there are only minor amino acid changes in the flagellins expressed by T1 and T2
      cells, the two antigenic types of flagellins can be distinguished by differences
      in apparent M(r) on sodium dodecyl sulfate-polyacrylamide gels and by
      immunoreactivity with T1-specific (LAH1) or T2-specific (LAH2) antiserum. The
      isolation of stable variants of T1 and T2 has allowed for the transfer via
      natural transformation of the flagellin structural genes from the T1 background
      into the T2 background and from the T2 background into the T1 background. In
      addition, the flagellin genes from VC167 T1 and T2 have been transferred into
      strains of Campylobacter jejuni. The results indicate that the observed antigenic
      variations of VC167 flagellins are dependent on the host genetic background and
      independent of the primary amino acid sequence. These data provide evidence that
      posttranslational modifications are responsible for the antigenic variation seen
      in VC167 flagellins.

PMID- 1624419
TI  - Methylation of FrzCD, a methyl-accepting taxis protein of Myxococcus xanthus, is
      correlated with factors affecting cell behavior.
AB  - Myxococcus xanthus, a nonflagellated gliding bacterium, exhibits multicellular
      behavior during vegetative growth and fruiting body formation. The frizzy (frz)
      genes are required to control directed motility for these interactions. The frz
      genes encode proteins that are homologous to all of the major enteric chemotaxis
      proteins, with the exception of CheZ. In this study, we characterized FrzCD, a
      protein which is homologous to the methyl-accepting chemotaxis proteins from the
      enteric bacteria. FrzCD, unlike the other methyl-accepting chemotaxis proteins,
      was found to be localized primarily in the cytoplasmic fraction of cells. FrzCD
      migrates as a ladder of bands on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, reflecting heterogeneity due to methylation or demethylation and
      to deamidation. FrzCD was shown to be methylated in vivo when cells were exposed
      to yeast extract or Casitone and demethylated when starved in buffer. We used the
      methylation state of FrzCD as revealed by Western blot (immunoblot) analyses to
      search for stimuli that are recognized by the frz signal transduction system.
      Common amino acids, nucleotides, vitamins, and sugars were not recognized, but
      certain lipids and alcohols were recognized. For example, the saturated fatty
      acids capric acid and lauric acid stimulated FrzCD methylation, whereas a variety
      of other saturated fatty acids did not. Lauryl alcohol and lipoic acid also
      stimulated methylation, as did phospholipids containing lauric acid. In contrast,
      several short-chain alcohols, such as isoamyl alcohol, and some other solvents
      caused demethylation. The relatively high concentrations of the chemicals
      required for a response may indicate that these chemicals are not the relevant
      signals recognized by M. xanthus in nature. Isoamyl alcohol and isopropanol also
      had profound effects on the behavior of wild-type cells, causing them to reverse
      continuously. Cells of frzB, frzF, and frzG mutants also reversed continuously in
      the presence of isoamyl alcohol, whereas cells of frzA, frzCD, or frzE mutants
      did not. On the basis of the data presented, we propose a model for the frz
      signal transduction pathway in M. xanthus.

PMID- 1624418
TI  - Expression of recombinant proteins on the surface of the coagulase-negative
      bacterium Staphylococcus xylosus.
AB  - An expression system to allow targeting of heterologous proteins to the cell
      surface of Staphylococcus xylosus, a coagulase-negative gram-positive bacterium,
      is described. The expression of recombinant gene fragments, fused between gene
      fragments encoding the signal peptide and the cell surface-binding regions of
      staphylococcal protein A, targets the resulting fusion proteins to the outer
      bacterial cell surface via the membrane-anchoring region and the highly charged
      cell wall-spanning region of staphylococcal protein A. The expression system was
      used to secrete fusion proteins containing sequences from a malaria blood-stage
      antigen and a streptococcal albumin-binding receptor to the cell surface of S.
      xylosus. Analysis of the recombinant cells by immunogold staining and
      immunofluorescence revealed that both the receptor and the malaria peptide were
      properly processed and exposed on the surface of the host cells. However, only
      approximately 40 to 50% of the recombinant cells were strongly stained with
      antiserum reactive with the albumin-binding receptor, while approximately 10 to
      15% of the cells were stained with antiserum reactive with the malaria peptide.
      The incomplete staining of some of the cells suggests steric effects that make
      the recombinant fusion proteins inaccessible to the reactive antibodies because
      of variable cell wall structures. However, the results demonstrate for the first
      time that recombinant techniques can be used to express heterologous receptors
      and immunogens on the surface of gram-positive cells.

PMID- 1624420
TI  - Use of hupS::lacZ gene fusion to study regulation of hydrogenase expression in
      Rhodobacter capsulatus: stimulation by H2.
AB  - The Escherichia coli beta-galactosidase enzyme was used as a reporter molecule
      for genetic fusions in Rhodobacter capsulatus. DNA fragments that were from the
      upstream region of the hydrogenase structural operon hupSLM and contained 5' hupS
      sequences were fused in frame to a promoterless lacZ gene, yielding fusion
      proteins comprising the putative signal sequence and the first 22 amino acids of
      the HupS protein joined to the eight amino acid of beta-galactosidase. We
      demonstrate the usefulness of the hupS::lacZ fusion in monitoring regulation of
      hydrogenase gene expression. The activities of plasmid-determined beta
      galactosidase and chromosome-encoded hydrogenase changed in parallel in response
      to various growth conditions (light or dark, aerobiosis or anaerobiosis, and
      presence or absence of ammonia or of H2), showing that changes in hydrogenase
      activity were due to changes in enzyme synthesis. Molecular hydrogen stimulated
      hydrogenase synthesis in dark, aerobic cultures and in illuminated, anaerobic
      cultures. Analysis of hupS::lacZ expression in various mutants indicated that
      neither the hydrogenase structural genes nor NifR4 (sigma 54) was essential for
      hydrogen regulation of hydrogenase synthesis.

PMID- 1624421
TI  - Mycoplasma pneumoniae cytadherence phase-variable protein HMW3 is a component of
      the attachment organelle.
AB  - The subcellular location of the phase-variable cytadherence-accessory protein
      HMW3 in Mycoplasma pneumoniae has been examined by biochemical and immunoelectron
      microscopic techniques. Analysis by Western blot (immunoblot) with HMW3-specific
      antiserum established the presence of this protein within the M. pneumoniae
      Triton X-100-insoluble fraction or triton shell. Immunogold labeling of Triton
      extracted mycoplasmas with affinity-purified antibodies localized HMW3 to the
      terminal knob on the rodlike extensions of the triton shell, a location that
      would correspond to the adherence organelle in whole mycoplasmas. Treatment of
      triton shells with KI resulted in the selective removal of the adherence
      accessory proteins HMW1 to HMW4. Analysis of these triton shells by transmission
      electron microscopy revealed dramatic ultrastructural changes in the filamentous
      network and core structure. Immunogold labeling of KI-extracted shells reflected
      the removal of HMW3 from the disrupted tip structure. An examination of ultrathin
      sections of wild-type cells by transmission electron microscopy following
      labeling with HMW3-specific antibodies provided further evidence for the
      nonrandom distribution of HMW3 and its localization to the terminal portion of
      filamentous cell extensions. Most colloidal gold molecules were associated with
      the cell interior, but limited peripheral labeling of the terminal region was
      also observed. Postfixation antibody labeling of whole cells suggested limited
      exposure of HMW3 on the mycoplasma surface at the tip structure. However,
      prefixation antibody labeling failed to indicate surface exposure, raising some
      uncertainty regarding the relationship of HMW3 with the mycoplasma membrane.

PMID- 1624422
TI  - Temperature sensing in Yersinia pestis: regulation of yopE transcription by lcrF.
AB  - In Escherichia coli, a yopE::lacZ fusion was found to be regulated by temperature
      in the presence of the cloned BamHI G fragment of Yersinia pestis plasmid pCD1,
      which contains the lcrF locus. Increasing the copy number of lcrF relative to
      that of the yopE reporter had a negligible effect on the induction ratio (26
      versus 37 degrees C) but caused large reductions in the absolute levels of yopE
      transcription. We localized the lcrF gene by monitoring the induction phenotype
      of BamHI G deletion derivatives. Sequencing revealed an open reading frame
      capable of encoding a protein of 30.8 kDa. A protein product of this size was
      detected in a T7 expression system, and LcrF-dependent yopE-specific DNA binding
      activity was observed. As expected, LcrF exhibited 98% homology to VirF of
      Yersinia enterocolitica and significant homology to the carboxy termini of other
      members of the AraC family of transcriptional regulatory proteins. These proteins
      could be divided into two classes according to function: those regulating operons
      involved in catabolism of carbon and energy sources and those involved in
      regulating virulence genes. lcrF::lacZ transcriptional fusions were constructed
      and analyzed in Y. pestis and E. coli. The activity of the fusions was not
      affected by the native pCD1 virulence plasmid, an intact lcrF gene, or
      temperature. Thus, induction of lcrF transcription is not essential for
      temperature-dependent activation of yopE transcription. A portion of LcrF was
      found associated with the membrane fraction in E. coli; however, pulse-chase
      experiments indicated that this result is an artifact of fractionation.

PMID- 1624423
TI  - Identification of a protein-binding sequence involved in expression of an
      esterase gene from Streptomyces scabies.
AB  - Expression of an esterase gene from Streptomyces scabies is regulated by zinc in
      both Streptomyces scabies and Streptomyces lividans. A specific protein-binding
      site was identified on an esterase promoter fragment by using an S-30 extract
      from S. scabies. The location of the protein-binding site was determined by gel
      shift assays of promoter deletion fragments and by DNase I footprinting analysis.
      The protein-binding site maps from nucleotides -59 to -81 relative to the start
      of transcription. An esterase gene construct cloned and expressed in S. lividans
      was used to assess the importance of the protein-binding site. Deletion of the 23
      bp protein-binding site resulted in a 10-fold decrease in esterase production
      when cells were grown in zinc-inducing conditions. The protein-binding site may
      represent a region involved in positive regulation of the S. scabies esterase
      gene.

PMID- 1624424
TI  - Disruption of the gene for Met-tRNA(fMet) formyltransferase severely impairs
      growth of Escherichia coli.
AB  - In bacteria, as well as in chloroplasts and mitochondria, the free amino group of
      the methionylated initiator tRNA(fMet) is specifically modified by the addition
      of a formyl group. The importance of this modification remains unclear. With the
      availability of pure Escherichia coli 10-formyltetrahydrofolate:L-methionyl
      tRNA(fMet) N-formyltransferase, the enzyme catalyzing Met-tRNA(fMet) formylation,
      the corresponding fmt gene and its flanking regions were cloned and sequenced.
      The chromosomal fmt gene was disrupted, and strains modified in their formylation
      activity were constructed. A depletion of the cellular formylation activity was
      accompanied by a decrease in the growth rate of the bacteria. At 37 degrees C, in
      a rich medium, the absence of a functional fmt gene reduced the growth rate to
      0.28 doubling per h, from 2.3 for the control strain. At 42 degrees C, the
      studied fmt mutant strain did not grow further.

PMID- 1624425
TI  - TmrB protein, responsible for tunicamycin resistance of Bacillus subtilis, is a
      novel ATP-binding membrane protein.
AB  - tmrB is the gene responsible for tunicamycin resistance in Bacillus subtilis. It
      is predicted that an increase in tmrB gene expression makes B. subtilis
      tunicamycin resistant. To examine the tmrB gene product, we produced the tmrB
      gene product in Escherichia coli by using the tac promoter. TmrB protein was
      found not only in the cytoplasm fraction but also in the membrane fraction.
      Although TmrB protein is entirely hydrophilic and has no hydrophobic stretch of
      amino acids sufficient to span the membrane, its C-terminal 18 amino acids could
      form an amphiphilic alpha-helix. Breaking this potential alpha-helix by
      introducing proline residues or a stop codon into this region caused the release
      of this membrane-bound protein into the cytoplasmic fraction, indicating that the
      C-terminal 18 residues were essential for membrane binding. On the other hand,
      TmrB protein has an ATP-binding consensus sequence in the N-terminal region. We
      have tested whether this sequence actually has the ability to bind ATP by
      photoaffinity cross-linking with azido-[alpha-32P]ATP. Wild-type protein bound
      azido-ATP well, but mutants with substitutions in the consensus amino acids were
      unable to bind azido-ATP. These C-terminal or N-terminal mutant genes were unable
      to confer tunicamycin resistance on B. subtilis in a multicopy state. It is
      concluded that TmrB protein is a novel ATP-binding protein which is anchored to
      the membrane with its C-terminal amphiphilic alpha-helix.

PMID- 1624426
TI  - Effect of Salmonella typhimurium ferric uptake regulator (fur) mutations on iron-
      and pH-regulated protein synthesis.
AB  - Fur is an important regulatory protein known to function in the presence of iron
      as a repressor of iron-controlled genes. It was recently discovered that Fur is
      also essential to Salmonella typhimurium for mounting an adaptive acid tolerance
      response (J. W. Foster, J. Bacteriol 173:6896-6902, 1991). Because little is
      known about the effect of Fur on the physiology of this enteric pathogen, a
      systematic two-dimensional polyacrylamide gel electrophoresis (PAGE) analysis was
      conducted to identify proteins whose synthesis is linked to iron levels.
      Mutations in the fur locus were identified and used to classify which proteins
      are controlled by Fur. Thirty-six proteins were overtly affected by iron
      availability, most of which were clearly under the control of Fur. Although most
      of the Fur-dependent proteins were under negative control, a significant portion
      (15 of 34) appeared to be under a form of positive control. Nine of the
      positively controlled proteins required Fur and iron for expression. However, Fur
      lacking iron was also required for the induction of six gene products.
      Surprisingly, not all iron-regulated proteins were controlled by Fur and not all
      Fur-dependent proteins were obviously regulated by iron status. Because fur
      mutants fail to mount an effective acid tolerance response, we made a comparative
      two-dimensional PAGE analysis of 100 total acid- and iron-regulated gene
      products. Production of most of these proteins was regulated by only one of the
      two stresses, yet a clear subset of seven genes were influenced by both acid and
      iron and were also controlled by fur. These proteins were also members of the
      acid tolerance response modulon. Consistent with the fur effect on pH-regulated
      protein synthesis, fur mutants lacked the inducible pH homeostasis system
      associated with the acid tolerance response. The results provide further evidence
      that Fur has an extensive impact on gene expression and cellular physiology and
      suggest an explanation for the acid-sensitive nature of fur mutants.

PMID- 1624427
TI  - Klebsiella aerogenes urease gene cluster: sequence of ureD and demonstration that
      four accessory genes (ureD, ureE, ureF, and ureG) are involved in nickel
      metallocenter biosynthesis.
AB  - The region located immediately upstream from the Klebsiella aerogenes urease
      structural genes was sequenced and shown to possess an open reading frame capable
      of encoding a 29.8-kDa peptide. Deletions were generated in this gene, denoted
      ureD, and in each of the genes (ureE, ureF, and ureG) located immediately
      downstream of the three structural genes. Transformation of the mutated plasmids
      into Escherichia coli resulted in high levels of urease expression, but the
      enzyme was inactive (deletions in ureD, ureF, or ureG) or only partially active
      (deletions in ureE). Ureases were purified from the recombinant cells and shown
      to be identical to control enzyme when analyzed by gel filtration chromatography
      and sodium dodecyl sulfate-polyacrylamide gel electrophoresis; however, in every
      case the activity levels correlated to nickel contents as analyzed by atomic
      absorption analysis. UreD, UreE, UreF, and UreG peptides were tentatively
      identified by gel electrophoretic comparison of mutant and control cell extracts,
      by in vivo expression of separately cloned genes, or by in vitro transcription
      translation analyses; the assignments were confirmed for UreE and UreG by amino
      terminal sequencing. The latter peptides (apparent M(r)s, 23,900 and 28,500) were
      present at high levels comparable to those of the urease subunits, whereas the
      amounts of UreF (apparent M(r), 27,000) and UreD (apparent M(r), 29,300) were
      greatly reduced, perhaps because of the lack of good ribosome binding sites in
      the regions upstream of these open reading frames. These results demonstrate that
      all four accessory genes are necessary for the functional incorporation of the
      urease metallocenter.

PMID- 1624428
TI  - Increase of sensitivity to aminoglycoside antibiotics by polyamine-induced
      protein (oligopeptide-binding protein) in Escherichia coli.
AB  - The sensitivity of Escherichia coli to several aminoglycoside antibiotics was
      examined with E. coli DR112 transformed by the gene for polyamine-induced protein
      (oligopeptide-binding [OppA] protein) or polyamine transport proteins. The
      results clearly showed that sensitivity to aminoglycoside antibiotics
      (gentamicin, isepamicin, kanamycin, neomycin, paromomycin, and streptomycin)
      increased due to the highly expressed OppA protein. When the gene for OppA
      protein was deleted, sensitivity to aminoglycoside antibiotics was greatly
      decreased. It was also shown that isepamicin could bind to OppA protein with a
      binding affinity constant of 8.5 x 10(3) M-1 under the ionic conditions of 50 mM
      K+ and 1 mM Mg2+ at pH 7.5, and isepamicin uptake into cells was greatly
      stimulated by the OppA protein. These results, taken together, show that the OppA
      protein increases the uptake of aminoglycoside antibiotics. In addition, the OppA
      protein increased the transport of spermidine and an oligopeptide (Gly-Leu-Tyr).
      The uptake of isepamicin into cells was partially inhibited by spermidine,
      suggesting that the binding site for isepamicin overlaps that for spermidine on
      the OppA protein. Spermidine uptake activity by the OppA protein was less than 1%
      of that of the ordinary spermidine uptake system. Aminoglycoside antibiotics
      neither stimulated the synthesis of OppA protein nor increased spermidine uptake.

PMID- 1624430
TI  - Tyrosine phosphorylation of a membrane protein from Pseudomonas solanacearum.
AB  - We have investigated a tyrosine kinase activity from Pseudomonas solanacearum, an
      economically important plant pathogen. In vitro incubation of membrane fractions
      with [gamma-32P]ATP and subsequent sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis revealed an 85-kDa phosphoprotein. Phosphorylation of this
      protein on tyrosine residues was demonstrated by phosphoamino acid analysis of
      base hydrolysis products and by immunoanalysis of Western blots (immunoblots)
      with antiphosphotyrosine monoclonal antibody. In vitro incubation of membranes
      with ATP was not required for recognition by the antibody, indicating that the 85
      kDa protein is phosphorylated in vivo. These results demonstrate that membranes
      from P. solanacearum exhibit a tyrosine kinase activity toward an endogenous
      membrane protein. This bacterium provides an opportunity to study the structure
      and function of a prokaryotic tyrosine kinase.

PMID- 1624429
TI  - Molecular and functional characterization of the Salmonella invasion gene invA:
      homology of InvA to members of a new protein family.
AB  - One of the earliest steps in the pathogenic cycle of the facultative
      intracellular pathogen Salmonella spp. is the invasion of the cells of the
      intestinal epithelium. We have previously identified a genetic locus, inv, that
      allows Salmonella spp. to enter cultured epithelial cells. invA is a member of
      this locus, and it is the first gene of an operon consisting of at least two
      additional invasion genes. We have constructed strains carrying nonpolar
      mutations in invA and examined the individual contribution of this gene to the
      invasion phenotype of Salmonella typhimurium. Nonpolar S. typhimurium invA
      mutants were deficient in invasion of cultured epithelial cells although they
      were fully capable of attaching to the same cells. In addition, unlike wild-type
      S. typhimurium, invA mutants did not alter the normal architecture of the
      microvilli of polarized epithelial cells nor did they cause any alterations in
      the distribution of actin microfilaments of infected cells. The invasion
      phenotype of invA mutants was readily rescued by wild-type S. typhimurium when
      cultured epithelial cells were simultaneously infected with both strains. On the
      contrary, in a similar experiment, the adherent Escherichia coli strain RDEC-1
      was not internalized into cultured cells when coinfected with wild-type S.
      typhimurium. The invA locus was found to be located at about 59 min on the
      Salmonella chromosome, 7% linked to mutS. The nucleotide sequence of invA showed
      an open reading frame capable of encoding a polypeptide of 686 amino acids with
      eight possible membrane-spanning regions and a predicted molecular weight of
      75,974. A protein of this size was visualized when invA was expressed in a
      bacteriophage T7 RNA polymerase-based expression system. The predicted sequence
      of InvA was found to be homologous to Caulobacter crescentus FlbF, Yersinia LcrD,
      Shigella flexneri VirH, and E. coli FlhA proteins. These proteins may form part
      of a family of proteins with a common function, quite possibly the translocation
      of specific proteins across the bacterial cell membrane.

PMID- 1624431
TI  - Role of the Bacillus subtilis gsiA gene in regulation of early sporulation gene
      expression.
AB  - The Bacillus subtilis gsiA operon was induced rapidly, but transiently, as cells
      entered the stationary phase in nutrient broth medium. A mutation at the gsiC
      locus caused sporulation to be defective and expression of gsiA to be elevated
      and prolonged. The sporulation defect in this strain was apparently due to
      persistent expression of gsiA, since a gsiA null mutation restored sporulation to
      wild-type levels. Detailed mapping experiments revealed that the gsiC82 mutation
      lies within the kinA gene, which encodes the histidine protein kinase member of a
      two-component regulatory system. Since mutations in this gene caused a
      substantial blockage in expression of spoIIA, spoIIG, and spoIID genes, it seems
      that accumulation of a product of the gsiA operon interferes with sporulation by
      blocking the completion of stage II. It apparently does so by inhibiting or
      counteracting the activity of KinA.

PMID- 1624432
TI  - Physical and functional maps of the luminescence gene cluster in an autoinducer
      deficient Vibrio fischeri strain isolated from a squid light organ.
AB  - Vibrio fischeri ES114 is an isolate representing the specific bacterial light
      organ symbiont of the squid Euprymna scolopes. An interesting feature of this
      strain of V. fischeri is that it is visibly luminous within the light organ of
      the squid host but is nonluminous when grown under standard laboratory
      conditions. Luminescence can be restored in laboratory culture, however, by the
      addition of autoinducer, a species-specific inducer of the V. fischeri
      luminescence (lux) genes. Most other isolates of V. fischeri produce autoinducer
      in sufficient quantities to induce luminescence in laboratory culture. We have
      cloned an 8.8-kb DNA fragment from V. fischeri ES114 that encodes all of the
      functions necessary for luminescence in Escherichia coli in the absence of
      exogenous autoinducer. This DNA contains both of the recognized V. fischeri lux
      regulatory genes, one of which (luxI) directs E. coli to synthesize autoinducer.
      The organization of the individual lux genes within this DNA fragment appears to
      be the same as that in the other strains of V. fischeri studied; the restriction
      map of the V. fischeri ES114 lux DNA has diverged substantially, however, from
      the largely conserved maps of V. fischeri MJ1 and ATCC 7744. Although E. coli
      containing the V. fischeri ES114 lux DNA synthesizes considerable amounts of
      autoinducer, V. fischeri ES114 synthesizes autoinducer only in small amounts,
      even when transcription of the lux genes, including luxI, is activated by the
      addition of exogenous autoinducer. Nonetheless, transconjugants of V. fischeri
      ES114 that contain multicopy plasmids bearing the ES114 lux genes synthesize
      sufficient autoinducer to induce luminescence. These results suggest that V.
      fischeri ES11r does not lack a functional luxl, nor is it deficient in the
      ability to synthesize metabolic precursors for autoinducer synthesis.

PMID- 1624433
TI  - Fusion-mediated transfer of plasmids into Spiroplasma floricola cells.
AB  - We have developed and characterized a system for the transfer of plasmids
      encapsulated in large unilamellar vesicles (LUV) into Spiroplasma floricola BNR1
      cells. The approach is based on the ability of S. floricola-derived LUV to fuse
      with S. floricola cells. The fusion was continuously monitored by an assay for
      lipid mixing based on the dequenching of the fluorescent probe octadecylrhodamine
      B (R18) that was incorporated into LUV at self-quenching concentrations. The
      fusion was also evaluated by fluorescence-activated cell sorter measurements and
      by sucrose density gradient analysis. LUV-cell fusion occurred only in the
      presence of low concentrations (5%) of polyethylene glycol (polyethylene glycol
      8000) and depended on temperature, the LUV/cell ratio, and divalent cations in
      the incubation medium. Throughout the fusion process, spiroplasma cells remained
      intact and viable. Under optimal fusion conditions, the plasmid pACYC,
      encapsulated in LUV by reversed-phase evaporation, was transferred into live S.
      floricola cells and expressed chloramphenicol acetyltransferase activity. The
      expression was transient with maximal chloramphenicol acetyltransferase activity
      observed after 6 h of incubation of the transfected cells.

PMID- 1624434
TI  - Evidence for the involvement of corrinoids and factor F430 in the reductive
      dechlorination of 1,2-dichloroethane by Methanosarcina barkeri.
AB  - Cobalamin and the native and diepimeric forms of factor F430 catalyzed the
      reductive dechlorination of 1,2-dichloroethane (1,2-DCA) to ethylene or
      chloroethane (CA) in a buffer with Ti(III) citrate as the electron donor.
      Ethylene was the major product in the cobalamin-catalyzed transformation, and the
      ratio of ethylene to CA formed was 25:1. Native F430 and 12,13-di-epi-F430
      produced ethylene and CA in ratios of about 2:1 and 1:1, respectively. Cobalamin
      dechlorinated 1,2-DCA much faster than did factor F430. Dechlorination rates by
      all three catalysts showed a distinct pH dependence, correlated in a linear
      manner with the catalyst concentration and doubled with a temperature increase of
      10 degrees C. Crude and boiled cell extracts of Methanosarcina barkeri also
      dechlorinated 1,2-DCA to ethylene and CA with Ti(III) citrate as the reductant.
      The catalytic components in boiled extracts were heat and oxygen stable and had
      low molecular masses. Fractionation of boiled extracts by a hydrophobic
      interaction column revealed that part of the dechlorinating components had a
      hydrophilic and part had a hydrophobic character. These chemical properties of
      the dechlorinating components and spectral analysis of boiled extracts indicated
      that corrinoids or factor F430 was responsible for the dechlorinations. The
      ratios of 3:1 to 7:1 of ethylene and CA formed by cell extracts suggested that
      both cofactors were concomitantly active.

PMID- 1624435
TI  - Methyl-coenzyme M reductase of Methanobacterium thermoautotrophicum delta H
      catalyzes the reductive dechlorination of 1,2-dichloroethane to ethylene and
      chloroethane.
AB  - Reductive dechlorination of 1,2-dichloroethane (1,2-DCA) to ethylene and
      chloroethane (CA) by crude cell extracts of Methanobacterium thermoautotrophicum
      delta H with H2 as the electron donor was stimulated by Mg-ATP. The
      heterodisulfide of coenzyme M (CoM) and 7-mercaptoheptanoylthreonine phosphate
      together with Mg-ATP partially inhibited ethylene production but stimulated CA
      production compared Mg-ATP alone. The pH optimum for the dechlorination was 6.8
      (at 60 degrees C). Michaelis-Menten kinetics for initial product formation rates
      with different 1,2-DCA concentrations indicated the enzymatic character of the
      dechlorination. Apparent Kms for 1,2-DCA of 89 and 119 microM and Vmaxs of 34 and
      20 pmol/min/mg of protein were estimated for ethylene and CA production,
      respectively. 3-Bromopropanesulfonate, a specific inhibitor for methyl-CoM
      reductase, completely inhibited dechlorination of 1,2-DCA. Purified methyl-CoM
      reductase, together with flavin adenine dinucleotide and a crude component A
      fraction which reduced the nickel of factor F430 in methyl-CoM reductase,
      converted 1,2-DCA to ethylene and CA with H2 as the electron donor. In this
      system, methyl-CoM reductase was also able to transform its own inhibitor 2
      bromoethanesulfonate to ethylene.

PMID- 1624436
TI  - Cloning of a methanol-inducible moxF promoter and its analysis in moxB mutants of
      Methylobacterium extorquens AM1rif.
AB  - In Methylobacterium extorquens AM1, gene encoding methanol dehydrogenase
      polypeptides are transcriptionally regulated in response to C1 compounds,
      including methanol (M. E. Lidstrom and D. I. Stirling, Annu. Rev. Microbiol.
      44:27-57, 1990). In order to study this regulation, a transcriptional fusion has
      been constructed between a beta-galactosidase reporter gene and a 1.55-kb XhoI
      SalI fragment of M. extorquens AM1rif DNA encoding the N terminus of the methanol
      dehydrogenase large subunit (moxF) and 1,289 bp of upstream DNA. The fusion
      exhibited orientation-specific promoter activity in M. extorquens AM1rif but was
      expressed constitutively when the transcriptional fusion was located on the
      plasmid. However, correct regulation was restored when the construction was
      inserted in the M. extorquens AM1rif chromosome. This DNA fragment was shown to
      contain both the moxFJGI promoter and the sequences necessary in cis for its
      transcriptional regulation by methanol. Transcription from this promoter was
      studied in the M. extorquens AM1rif moxB mutant strains UV4rif and UV25rif, which
      have a pleiotropic phenotype with regard to the components of methanol oxidation.
      In these mutants, beta-galactosidase activity from the fusion was reduced to a
      level equal to that of the vector background when the fusion was present in both
      plasmid and chromosomal locations. Since both constitutive and methanol-inducible
      promoter activities were lost in the mutants, moxB appears to be required for
      transcription of the genes encoding the methanol dehydrogenase polypeptides.

PMID- 1624437
TI  - Multiple mutant of Escherichia coli synthesizing virtually thymineless DNA during
      limited growth.
AB  - The dut gene of Escherichia coli encodes deoxyuridine triphosphatase, an enzyme
      that prevents the incorporation of dUTP into DNA and that is needed in the de
      novo biosynthesis of thymidylate. We produced a conditionally lethal dut(Ts)
      mutation and isolated a phenotypic revertant that had a mutation in an unknown
      gene tentatively designated dus (for dut suppressor). The dus mutation restored
      the ability of the dut mutant to grow at 42 degrees C without restoring its
      enzymatic activity or thymidylate independence. A strain was constructed bearing,
      in addition to these mutations, ones affecting the following genes and their
      corresponding products: ung, which produces uracil-DNA N-glycosylase, a repair
      enzyme that removes uracil from DNA; deoA, which produces thymidine
      (deoxyuridine) phosphorylase, which would degrade exogenous deoxyuridine; and
      thyA, which produces thymidylate synthase. When grown at 42 degrees C in minimal
      medium containing deoxyuridine, the multiple mutant displayed a 93 to 96%
      substitution of uracil for thymine in new DNA. Growth stopped after the cellular
      DNA had increased 1.6- to 1.9-fold and the cell mass had increased 1.7- to 2.7
      fold, suggesting a general failure of macromolecular biosynthesis. DNA
      hybridization confirmed that the uracil-containing DNA was chromosomal and that
      new rounds of initiation must have occurred during its synthesis.

PMID- 1624438
TI  - Replication of prophage P1 is cell-cycle specific.
AB  - P1 prophage replication during the Escherichia coli division cycle has been
      analyzed by using the membrane-elution technique to produce cells labelled at
      different times during the division cycle and scintillation counting for
      quantitative analysis of radioactive prophage DNA. P1 prophage replicates during
      a restricted portion of the bacterial division cycle, like the minichromosome,
      but at a time during the division cycle different than the time at which the
      minichromosome replicates in the same cell. A high-copy mini-R6K plasmid present
      in the same cell replicates throughout the division cycle. Over a wide range of
      growth rates, the P1 prophage replicates approximately one-half generation after
      the minichromosome replicates. Thus, the mechanisms underlying P1 replication are
      similar to those for the F plasmid and the chromosome. Replication occurs when
      some property related to cell size or cell mass reaches a constant value per
      origin.

PMID- 1624439
TI  - Heat killing of bacterial spores analyzed by differential scanning calorimetry.
AB  - Thermograms of the exosporium-lacking dormant spores of Bacillus megaterium ATCC
      33729, obtained by differential scanning calorimetry, showed three major
      irreversible endothermic transitions with peaks at 56, 100, and 114 degrees C and
      a major irreversible exothermic transition with a peak at 119 degrees C. The 114
      degrees C transition was identified with coat proteins, and the 56 degrees C
      transition was identified with heat inactivation. Thermograms of the germinated
      spores and vegetative cells were much alike, including an endothermic transition
      attributable to DNA. The ascending part of the main endothermic 100 degrees C
      transition in the dormant-spore thermograms corresponded to a first-order
      reaction and was correlated with spore death; i.e., greater than 99.9% of the
      spores were killed when the transition peak was reached. The maximum death rate
      of the dormant spores during calorimetry, calculated from separately measured D
      and z values, occurred at temperatures above the 73 degrees C onset of thermal
      denaturation and was equivalent to the maximum inactivation rate calculated for
      the critical target. Most of the spore killing occurred before the release of
      most of the dipicolinic acid and other intraprotoplast materials. The exothermic
      119 degrees C transition was a consequence of the endothermic 100 degrees C
      transition and probably represented the aggregation of intraprotoplast spore
      components. Taken together with prior evidence, the results suggest that a
      crucial protein is the rate-limiting primary target in the heat killing of
      dormant bacterial spores.

PMID- 1624440
TI  - Leuconostoc lactis beta-galactosidase is encoded by two overlapping genes.
AB  - A 16-kb BamHI fragment of the lactose plasmid pNZ63 from Leuconostoc lactis
      NZ6009 was cloned in Escherichia coli MC1061 by using pACYC184 and was found to
      express a functional beta-galactosidase. Deletion and complementation analysis
      showed that the coding region for beta-galactosidase was located on a 5.8-kb SalI
      BamHI fragment. Nucleotide sequence analysis demonstrated that this fragment
      contained two partially overlapping genes, lacL (1,878 bp) and lacM (963 bp),
      that could encode proteins with calculated sizes of 72,113 and 35,389 Da,
      respectively. The L. lactis beta-galactosidase was overproduced in E. coli by
      using a lambda pL expression system. Two new proteins with M(r)s of 75,000 and
      36,000 appeared upon induction of PL. The N-terminal sequences of these proteins
      corresponded to those deduced from the lacL and lacM gene sequences. Mutation and
      deletion analysis showed that lacL expression is essential for LacM production
      and that both the lacL and lacM genes are required for the production of a
      functional beta-galactosidase in E. coli. The deduced amino acid sequences of the
      LacL and LacM proteins showed considerable identity with the sequences of the N-
      and C-terminal parts, respectively, of beta-galactosidases from other lactic acid
      bacteria or E. coli. DNA and protein sequence alignments suggest that the L.
      lactis lacL and lacM genes have been generated by an internal deletion in an
      ancestral beta-galactosidase gene.

PMID- 1624441
TI  - Thin aggregative fimbriae from diarrheagenic Escherichia coli.
AB  - Four strains of diarrheagenic Escherichia coli originally isolated from distinct
      geographic regions were found to produce unusual thin aggregative fimbriae
      requiring depolymerization in formic acid prior to analysis by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis. Immunoelectron microscopy of native
      fimbriae and Western blot (immunoblot) analysis of the corresponding 18-kDa
      fimbrins showed that these E. coli fimbriae were serologically cross-reactive
      with SEF 17 (Salmonella enteritidis fimbriae with a fimbrin molecular mass of 17
      kDa). The E. coli and S. enteritidis fimbrins had similar total amino acid
      compositions and highly conserved N-terminal amino acid sequences. These results
      indicate that E. coli and S. enteritidis produce biochemically related,
      aggregative fimbriae which constitute a new type of intergenerically distributed
      fimbriae for which we propose the descriptive name GVVPQ fimbriae on the basis of
      the conserved N-terminal amino acid sequence.

PMID- 1624442
TI  - Transformation of the gram-positive bacterium Clavibacter xyli subsp. cynodontis
      by electroporation with plasmids from the IncP incompatibility group.
AB  - We report the transformation of a gram-positive bacterium, Clavibacter xyli
      subsp. cynodontis, with several plasmids in the IncP incompatibility group from
      gram-negative bacteria. Our results suggest that IncP plasmids may be
      transferable to other gram-positive organisms. After optimizing electroporation
      parameters, we obtained a maximum of 2 x 10(5) transformants per microgram of
      DNA. The availability of a transformation system for this bacteria will
      facilitate its use in indirectly expressing beneficial traits in plants.

PMID- 1624443
TI  - Genetic and morphological characterization of an Escherichia coli chromosome
      segregation mutant.
AB  - The temperature-sensitive nucleoid segregation mutant of Escherichia coli, PAT32,
      formerly described as a parA mutant, has been shown to carry a mutation near 66
      min on the genetic map. Fine mapping with phages from the collection of Kohara et
      al. is consistent with its being a parC allele. Observation by fluorescence
      microscopy revealed the formation, at a nonpermissive temperature, of filaments
      containing one or two large nucleoids and of normal-size anucleate cells. There
      was also a significant loss of viability.

PMID- 1624444
TI  - Nucleotide sequences of genes encoding penicillin-binding proteins from
      Streptococcus pneumoniae and Streptococcus oralis with high homology to
      Escherichia coli penicillin-binding proteins 1a and 1b.
AB  - The nucleotide sequence of a 3,378-bp DNA fragment of Streptococcus pneumoniae
      that included the structural gene for penicillin-binding protein (PBP) 1a (ponA),
      which encodes 719 amino acids, was determined. Homologous DNA fragments from an
      S. oralis strain were amplified with ponA-specific oligonucleotides. The 2,524-bp
      S. oralis sequence contained the coding region for the first 636 amino acids of a
      PBP. The coding sequence differed by 437 nucleotides (27%) and one additional
      triplet, resulting in 87 amino acid substitutions (14%), from S. pneumoniae PBP
      1a. Both PBPs are highly homologous to bifunctional high-M(r) Escherichia coli
      PBPs 1a and 1b.

PMID- 1624445
TI  - Short, interspersed repetitive DNA sequences in prokaryotic genomes.

PMID- 1624446
TI  - Nucleotide sequences and genetic analysis of hydrogen oxidation (hox) genes in
      Azotobacter vinelandii.
AB  - Azotobacter vinelandii contains a heterodimeric, membrane-bound [NiFe]hydrogenase
      capable of catalyzing the reversible oxidation of H2. The beta and alpha subunits
      of the enzyme are encoded by the structural genes hoxK and hoxG, respectively,
      which appear to form part of an operon that contains at least one further
      potential gene (open reading frame 3 [ORF3]). In this study, determination of the
      nucleotide sequence of a region of 2,344 bp downstream of ORF3 revealed four
      additional closely spaced or overlapping ORFs. These ORFs, ORF4 through ORF7,
      potentially encode polypeptides with predicted masses of 22.8, 11.4, 16.3, and 31
      kDa, respectively. Mutagenesis of the chromosome of A. vinelandii in the area
      sequenced was carried out by introduction of antibiotic resistance gene
      cassettes. Disruption of hoxK and hoxG by a kanamycin resistance gene abolished
      whole-cell hydrogenase activity coupled to O2 and led to loss of the hydrogenase
      alpha subunit. Insertional mutagenesis of ORF3 through ORF7 with a promoterless
      lacZ-Kmr cassette established that the region is transcriptionally active and
      involved in H2 oxidation. We propose to call ORF3 through ORF7 hoxZ, hoxM, hoxL,
      hoxO, and hoxQ, respectively. The predicted hox gene products resemble those
      encoded by genes from hydrogenase-related operons in other bacteria, including
      Escherichia coli and Alcaligenes eutrophus.

PMID- 1624447
TI  - Physical mapping of repetitive extragenic palindromic sequences in Escherichia
      coli and phylogenetic distribution among Escherichia coli strains and other
      enteric bacteria.
AB  - Repetitive extragenic palindromic (REP) sequences are highly conserved inverted
      repeat sequences originally discovered in Escherichia coli and Salmonella
      typhimurium. We have physically mapped these sequences in the E. coli genome by
      using Southern hybridization of an ordered phage bank of E. coli (Y. Kohara, K.
      Akiyama, and K. Isono, Cell 50:495-508, 1987) with generic REP probes derived
      from the REP consensus sequence. The set of REP probe-hybridizing clones was
      correlated with a set of clones expected to contain REP sequences on the basis of
      computer searches. We also show that a generic REP probe can be used in Southern
      hybridization to analyze genomic DNA digested with restriction enzymes to
      determine genetic relatedness among natural isolates of E. coli. A search for
      these sequences in other members of the family Enterobacteriaceae shows a
      consistent correlation between both the number of occurrences and the
      hybridization strength and genealogical relationship.

PMID- 1624448
TI  - Cloning of the HSP70 gene from Halobacterium marismortui: relatedness of
      archaebacterial HSP70 to its eubacterial homologs and a model for the evolution
      of the HSP70 gene.
AB  - Heat shock induces the synthesis of a set of proteins in Halobacterium
      marismortui whose molecular sizes correspond to the known major heat shock
      proteins. By using the polymerase chain reaction and degenerate oligonucleotide
      primers for conserved regions of the 70-kDa heat shock protein (HSP70) family, we
      have successfully cloned and sequenced a gene fragment containing the entire
      coding sequence for HSP70 from H. marismortui. HSP70 from H. marismortui shows
      between 44 and 47% amino acid identity with various eukaryotic HSP70s and between
      51 and 58% identity with its eubacterial and archaebacterial homologs. On the
      basis of a comparison of all available HSP70 sequences, we have identified a
      number of unique sequence signatures in this protein family that provide a clear
      distinction between eukaryotic organisms and prokaryotic organisms
      (archaebacteria and eubacteria). The archaebacterial (viz., H. marismortui and
      Methanosarcina mazei) HSP70s have been found to contain all of the signature
      sequences characteristic of eubacteria (particularly the gram-positive bacteria),
      which suggests a close evolutionary relationship between these groups. In
      addition, detailed analyses of HSP70 sequences that we have carried out have
      revealed a number of additional novel features of the HSP70 protein family. These
      include (i) the presence of an insertion of about 25 to 27 amino acids in the N
      terminal quadrants of all known eukaryotic and prokaryotic HSP70s except those
      from archaebacteria and the gram-positive group of bacteria, (ii) significant
      sequence similarity in HSP70 regions comprising its first and second quadrants
      from organisms lacking the above insertion, (iii) highly significant similarity
      between a protein, MreB, of Escherichia coli and the N-terminal half of HSP70s,
      (iv) significant sequence similarity between the N-terminal quadrant of HSP70
      (from gram-positive bacteria and archaebacteria) and the m-type thioredoxin of
      plant chloroplasts. To account for these and other observations, a model for the
      evolution of HSP70 proteins involving gene duplication is proposed. The model
      proposes that HSP70 from archaebacteria (H. marismortui and M. mazei) and the
      gram-positive group of bacteria constitutes the ancestral form of the protein and
      that all other HSP70s (viz., other eubacteria as well as eukaryotes) containing
      the insert have evolved from this ancient protein.

PMID- 1624449
TI  - Genetic analysis of absB, a Streptomyces coelicolor locus involved in global
      antibiotic regulation.
AB  - The filamentous soil bacterium Streptomyces coelicolor is known to produce four
      antibiotics which are genetically and structurally distinct. An extensive search
      for antibiotic regulatory mutants led to the discovery of absB mutants, which are
      antibiotic deficient but sporulation proficient. Genetic analysis of the absB
      mutants has resulted in definition of the absB locus at 5 o'clock on the genetic
      map. Multiple cloned copies of the actII-ORF4 gene, an activator of synthesis of
      the antibiotic actinorhodin, restore actinorhodin biosynthetic capability to the
      absB mutants. These results are interpreted to mean that the failure of absB
      mutants to produce antibiotics results from decreased expression of the
      antibiotic genes. The absB gene is proposed to be involved in global regulation
      of antibiotic synthesis.

PMID- 1624450
TI  - Mutational analysis of the precursor-specific region of Bacillus subtilis sigma
      E.
AB  - sigma E is a sporulation-specific sigma factor of Bacillus subtilis that is
      formed from an inactive precursor protein (pro-sigma E) by the removal of 27 to
      29 amino acids from the pro-sigma E amino terminus. By using oligonucleotide
      directed mutagenesis, sequential deletions were constructed in the precursor
      specific region of sigE and analyzed for their effect on the gene product's
      activity, ability to accumulate, and susceptibility to conversion into mature
      sigma E. The results demonstrated that the first 17 residues of the pro sequence
      contribute to silencing the sigma-like activity of pro-sigma E and that the amino
      acids between positions 12 and 17 are also important for its conversion into
      sigma E. Deletions that remove 21 or more codons from sigE reduce sigma E
      activity in cells which carry it, presumably by affecting pro-sigma E stability.
      A 26-codon deletion results in a gene whose product is not detectable in B.
      subtilis by either reporter gene activity or Western blot (immunoblot) assay. The
      primary structure as well as the size of the pro region of sigma E contributes to
      the protein's stability. The placement of additional amino acids into the pro
      region reduces the cell's ability to accumulate pro-sigma E. Additional sigE
      mutations revealed that the amino acids normally found at the putative processing
      site(s) of pro-sigma E are not essential to the processing reaction; however, a
      Glu residue upstream of these sites (position 25) was found to be important for
      processing. These last results suggest that the pro-sigma E processing apparatus
      does not recognize the actual site within pro-sigma E at which cleavage occurs
      but rater sequence elements that are upstream of this site.

PMID- 1624451
TI  - Molecular characterization of the Entner-Doudoroff pathway in Escherichia coli:
      sequence analysis and localization of promoters for the edd-eda operon.
AB  - The nucleotide sequence of the entire Escherichia coli edd-eda region that
      encodes the enzymes of the Entner-Doudoroff pathway was determined. The edd
      structural gene begins 236 bases downstream of zwf. The eda structural gene
      begins 34 bases downstream of edd. The edd reading frame is 1,809 bases long and
      encodes the 602-amino-acid, 64,446-Da protein 6-phosphogluconate dehydratase. The
      deduced primary amino acid sequences of the E. coli and Zymomonas mobilis
      dehydratase enzymes are highly conserved. The eda reading frame is 642 bases long
      and encodes the 213-amino-acid, 22,283-Da protein 2-keto-3-deoxy-6
      phosphogluconate aldolase. This enzyme had been previously purified and sequenced
      by others on the basis of its related enzyme activity, 2-keto-4-hydroxyglutarate
      aldolase. The data presented here provide proof that the two enzymes are
      identical. The primary amino acid sequences of the E. coli, Z. mobilis, and
      Pseudomonas putida aldolase enzymes are highly conserved. When E. coli is grown
      on gluconate, the edd and eda genes are cotranscribed. Four putative promoters
      within the edd-eda region were identified by transcript mapping and computer
      analysis. P1, located upstream of edd, appears to be the primary gluconate
      responsive promoter of the edd-eda operon, responsible for induction of the
      Entner-Doudoroff pathway, as mediated by the gntR product. High basal expression
      of eda is explained by constitutive transcription from P2, P3, and/or P4 but not
      P1.

PMID- 1624452
TI  - Regulation of transcription of the cell division gene ftsA during sporulation of
      Bacillus subtilis.
AB  - Three distinct 5' ends of ftsA mRNA were identified by S1 mapping and by primer
      extension analysis. These are thought to represent three transcription start
      sites. The transcripts from the downstream and upstream sites were detected
      throughout growth. The transcript from the middle site was not detected during
      exponential growth but was detected within 30 min of the start of sporulation,
      when it was the predominant transcript. Insertion of a cat cassette in the middle
      promoter, ftsAp2 (p2), did not affect vegetative growth but prevented
      postexponential symmetrical division and spore formation. Transcription from p2
      was dependent on RNA polymerase containing sigma H, and promoter p2 resembled the
      consensus sigma H promoter. Transcription from p2 did not require expression of
      the spo0A, spo0B, spo0E, spo0F, or spo0K loci. Northern (RNA) blot analysis
      indicated that ftsA is cotranscribed with the adjacent ftsZ gene. Multiple
      promoters provide a mechanism by which essential vegetative genes can be
      subjected to sporulation control independent of control during vegetative growth.
      In the case of ftsA,Z, the promoters provide a mechanism to permit septum
      formation in conditions of nutrient depletion that might be expected to shut down
      the vegetative division machinery.

PMID- 1624453
TI  - Characterization of the genes encoding beta-ketoadipate: succinyl-coenzyme A
      transferase in Pseudomonas putida.
AB  - beta-Ketoadipate:succinyl-coenzyme A transferase (beta-ketoadipate:succinyl-CoA
      transferase) (EC 2.8.3.6) carries out the penultimate step in the conversion of
      benzoate and 4-hydroxybenzoate to tricarboxylic acid cycle intermediates in
      bacteria utilizing the beta-ketoadipate pathway. This report describes the
      characterization of a DNA fragment from Pseudomonas putida that encodes this
      enzyme. The fragment complemented mutants defective in the synthesis of the CoA
      transferase, and two proteins of sizes appropriate to encode the two nonidentical
      subunits of the enzyme were produced in Escherichia coli when the fragment was
      placed under the control of a phage T7 promoter. DNA sequence analysis revealed
      two open reading frames, designated pcaI and pcaJ, that were separated by 8 bp,
      suggesting that they may comprise an operon. A comparison of the deduced amino
      acid sequence of the P. putida CoA transferase genes with the sequences of two
      other bacterial CoA transferases and that of succinyl-CoA:3-ketoacid CoA
      transferase from pig heart suggests that the homodimeric structure of the
      mammalian enzyme may have resulted from a gene fusion of the bacterial alpha and
      beta subunit genes during evolution. Conserved functional groups important to the
      catalytic activity of CoA transferases were also identified.

PMID- 1624455
TI  - The catalytic domain of endoglucanase A from Clostridium cellulolyticum: effects
      of arginine 79 and histidine 122 mutations on catalysis.
AB  - Sequence analysis of the endoglucanase EGCCA of Clostridium cellulolyticum
      indicates the existence of two domains: a catalytic domain extending from residue
      1 to residue 376 and a reiterated domain running from residue 390 to 450. A small
      deletion in the C terminal end of the catalytic domain inactivated the protein.
      From the analysis of the sequences of 26 endoglucanases belonging to family A, we
      focused on seven amino acids which were totally conserved in all the catalytic
      domains compared. The roles of two of these, Arg-79 and His-122, were studied and
      defined on the basis of the mutants obtained by introducing various
      substitutions. Our findings suggest that Arg-79 is involved in the structural
      organization of the protein; the His-122 residue seems to be more essential for
      catalysis. The role of His-123, which is conserved only in subfamily A4, was also
      investigated.

PMID- 1624454
TI  - Acetyl-coenzyme A synthesis from methyltetrahydrofolate, CO, and coenzyme A by
      enzymes purified from Clostridium thermoaceticum: attainment of in vivo rates and
      identification of rate-limiting steps.
AB  - Many anaerobic bacteria fix CO2 via the acetyl-coenzyme A (CoA) (Wood) pathway.
      Carbon monoxide dehydrogenase (CODH), a corrinoid/iron-sulfur protein (C/Fe-SP),
      methyltransferase (MeTr), and an electron transfer protein such as ferredoxin II
      play pivotal roles in the conversion of methyltetrahydrofolate (CH3-H4folate),
      CO, and CoA to acetyl-CoA. In the study reported here, our goals were (i) to
      optimize the method for determining the activity of the synthesis of acetyl-CoA,
      (ii) to evaluate how closely the rate of synthesis of acetyl-CoA by purified
      enzymes approaches the rate at which whole cells synthesize acetate, and (iii) to
      determine which steps limit the rate of acetyl-CoA synthesis. In this study,
      CODH, MeTr, C/Fe-SP, and ferredoxin were purified from Clostridium thermoaceticum
      to apparent homogeneity. We optimized conditions for studying the synthesis of
      acetyl-CoA and found that when the reaction is dependent upon MeTr, the rate is
      5.3 mumol min-1 mg-1 of MeTr. This rate is approximately 10-fold higher than that
      reported previously and is as fast as that predicted on the basis of the rate of
      in vivo acetate synthesis. When the reaction is dependent upon CODH, the rate of
      acetyl-CoA synthesis is approximately 0.82 mumol min-1 mg-1, approximately 10
      fold higher than that observed previously; however, it is still lower than the
      rate of in vivo acetate synthesis. It appears that at least two steps in the
      overall synthesis of acetyl-CoA from CH3-H4folate, CO, and CoA can be partially
      rate limiting. At optimal conditions of low pH (approximately 5.8) and low ionic
      strength, the rate-limiting step involves methylation of CODH by the methylated
      C/Fe-SP. At higher pH values and/or higher ionic strength, transfer of the methyl
      group of CH3-H4folate to the C/Fe-SP becomes rate limiting.

PMID- 1624456
TI  - Immunochemical differences among Methanosarcina mazei S-6 morphologic forms.
AB  - Methanosarcinae are the only archaeobacteria known to undergo major morphologic
      changes during growth involving unicellular and multicellular forms, and
      Methanosarcina mazei S-6 is the only strain for which three distinct forms,
      packets, single cells, and lamina, have so far been observed. It is reported that
      two pairs of these forms, either packets and single cells or single cells and
      lamina, grew and interconverted in medium with the same composition, Ca2+ and
      Mg2+ concentrations, and growth substrate, and that the two forms in each pair
      displayed distinctive differences revealed by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and immunoblotting, the same growth medium
      substrate notwithstanding.

PMID- 1624457
TI  - A new mercury-penicillin V derivative as a probe for ultrastructural localization
      of penicillin-binding proteins in Escherichia coli.
AB  - The precise ultrastructural localization of penicillin-binding protein (PBP)
      antibiotic complexes in Escherichia coli JM101, JM101 (pBS96), and JM101(pPH116)
      was investigated by high-resolution electron microscopy. We used mercury
      penicillin V (Hg-pen V) as a heavy-metal-labeled, electron-dense probe for
      accurately localizing PBPs in situ in single bacterial cells grown to exponential
      growth phase. Biochemical data derived from susceptibility tests and
      bacteriolysis experiments revealed no significant differences between Hg-pen V
      and the parent compound, penicillin V, or between strains. Both antibiotics
      revealed differences in the binding affinities for PBPs of all strains.
      Deacylation rates for PBPs were slow despite the relatively low binding
      affinities of antibiotics. Cells bound most of the Hg-pen V added to cultures,
      and the antibiotic-PBP complex could readily be seen by electron microscopy of
      unstained whole mounts as distinct, randomly situated electron-dense particles.
      Fifty to 60% of the antibiotic was retained by cells during processing for
      conventional embedding so that thin sections could also be examined. These
      revealed similar electron-dense particles located predominantly on the plasma
      membrane and less frequently in the cytoplasm. Particles positioned on the plasma
      membranes were occasionally shown to protrude into the periplasmic space, thereby
      reflecting the high resolution of the Hg-pen V probe. Moreover, some particles
      were observed free in the periplasm, suggesting, for the first time, that a
      proportion of PBPs may not be restricted to the plasma membrane but may be
      tightly associated with the peptidoglycan for higher efficiency of peptidoglycan
      assembly. All controls were devoid of the electron-dense particles. The presence
      of electron-dense particles in cells of the wild-type JM101, demonstrated that
      our probe could identify PBPs in naturally occurring strains without inducing PBP
      overproduction.

PMID- 1624458
TI  - A positive regulatory gene, THI3, is required for thiamine metabolism in
      Saccharomyces cerevisiae.
AB  - We have isolated a thiamine auxotrophic mutant carrying a recessive mutation
      which lacks the positive regulatory gene, THI3, which differs in the regulation
      of thiamine transport from the THI2 (PHO6) gene described previously (Y.
      Kawasaki, K. Nosaka, Y. Kaneko, H. Nishimura, and A. Iwashima, J. Bacteriol.
      172:6145-6147, 1990) for expression of thiamine metabolism in Saccharomyces
      cerevisiae. The mutant (thi3) had a markedly reduced thiamine transport system as
      well as reduced activity of thiamine-repressible acid phosphatase and of several
      enzymes for thiamine synthesis from 2-methyl-4-amino-5-hydroxymethylpyrimidine
      and 4-methyl-5-beta-hydroxyethylthiazole. These results suggest that thiamine
      metabolism in S. cerevisiae is subject to two positive regulatory genes, THI2
      (PHO6) and THI3. We have also isolated a hybrid plasmid, pTTR1, containing a 6.2
      kb DNA fragment from an S. cerevisiae genomic library which complements thiamine
      auxotrophy in the thi3 mutant. This gene was localized on a 3.0-kb ClaI-BglII
      fragment in the subclone pTTR5. Complementation of the activities for thiamine
      metabolism in the thi3 mutant transformed by some plasmids with the THI3 gene was
      also examined.

PMID- 1624459
TI  - Chlorosis induced by nutrient deprivation in Synechococcus sp. strain PCC 7942:
      not all bleaching is the same.
AB  - Cell coloration changes from normal blue-green to yellow or yellow-green when the
      cyanobacterium Synechococcus sp. strain PCC 7942 is deprived of an essential
      nutrient. We found that this bleaching process (chlorosis) in cells deprived of
      sulfur (S) was similar to that in cells deprived of nitrogen (N), but that cells
      deprived of phosphorus (P) bleached differently. Cells divided once after N
      deprivation, twice after S deprivation, and four times after P deprivation.
      Chlorophyll (Chl) accumulation stopped almost immediately upon N or S deprivation
      but continued for several hours after P deprivation. There was no net Chl
      degradation during N, S, or P deprivation, although cellular Chl content
      decreased because cell division continued after Chl accumulation ceased. Levels
      of the light-harvesting phycobiliproteins declined dramatically in a rapid
      response to N or S deprivation, reflecting an ordered breakdown of the
      phycobilisomes (PBS). In contrast, P-deprived cultures continued to accumulate
      PBS for several hours. Whole PBS were not extensively degraded in P-deprived
      cells, although the PBS contents of P-deprived cells declined because of
      continued cell division after PBS accumulation ceased. Levels of mRNAs encoding
      PBS polypeptides declined by 90 to 95% in N- or S-deprived cells and by 80 to 85%
      in P-deprived cells. These changes in both the synthesis and stability of PBS
      resulted in a 90% decline in the PC/Chl ratio of N- or S-deprived cells and a 40%
      decline in the PC/Chl ratio of P-deprived cells. Therefore, although bleaching
      appears to be a general response to nutrient deprivation, it is not the same
      under all nutrient-limited conditions and is probably composed of independently
      controlled subprocesses.

PMID- 1624460
TI  - Identification of the rph (RNase PH) gene of Bacillus subtilis: evidence for
      suppression of cold-sensitive mutations in Escherichia coli.
AB  - A shotgun cloning of Bacillus subtilis DNA into pBR322 yielded a 2-kb fragment
      that suppresses the cold-sensitive defect of the nusA10(Cs) Escherichia coli
      mutant. The responsible gene encodes an open reading frame that is greater than
      50% identical at the amino acid level to the E. coli rph gene, which was formerly
      called orfE. This B. subtilis gene is located at 251 degrees adjacent to the gerM
      gene on the B. subtilis genetic map. It has been named rph because, like its E.
      coli analog, it encodes a phosphate-dependent exoribonuclease activity, RNase PH,
      that removes the 3' nucleotides from precursor tRNAs. The cloned B. subtilis rph
      gene also suppresses the cold-sensitive phenotype of other unrelated cold
      sensitive mutants of E. coli, but not the temperature-sensitive phenotype of
      three temperature-sensitive mutants, including the nusA11(Ts) mutant, that were
      tested.

PMID- 1624461
TI  - Structures of the rfaB, rfaI, rfaJ, and rfaS genes of Escherichia coli K-12 and
      their roles in assembly of the lipopolysaccharide core.
AB  - Analysis of the sequence of a 4.1-kb rfa region downstream from rfaP revealed
      four genes. The first of these encodes a basic protein of 36,730 Da and does not
      correspond to any known rfa gene. It has been designated rfaS. The second gene
      was identified as rfaB on the basis of its ability to complement a Salmonella
      typhimurium rfaB mutant and encodes a 42,060-Da protein. The third and fourth
      genes encode proteins of 39,423 and 36,046 Da which are strongly homologous to
      the RfaI and RfaJ proteins of S. typhimurium. Escherichia coli K-12 restriction
      fragments carrying these genes complement an S. typhimurium rfaI mutant and, at
      lower efficiency, an rfaJ mutant. The difference in complementation efficiency
      suggests that the rfaI and rfaJ genes of E. coli K-12 have sugar and acceptor
      specificities different from those of S. typhimurium, as predicted from the
      different lipopolysaccharide (LPS) core structures of the two organisms. Defined
      mutations affecting all four genes were constructed in vitro and crossed onto the
      chromosome. The phenotypes of these mutations suggest that extension of the core
      may require protein-protein interactions between the enzymes involved in core
      completion as well as the interaction of these enzymes with their specific
      acceptor molecules. Mutants blocked at rfaI or genes encoding earlier steps in
      core biosynthesis exhibited a single predominant LPS band on gels while mutants
      blocked at rfaJ or genes encoding later steps produced multiple strong bands,
      indicating that one of the processes generating core heterogeneity requires a
      functional rfaI gene.

PMID- 1624462
TI  - Comparison of lipopolysaccharide biosynthesis genes rfaK, rfaL, rfaY, and rfaZ of
      Escherichia coli K-12 and Salmonella typhimurium.
AB  - Analysis of the sequence of a 4.3-kb region downstream of rfaJ revealed four
      genes. The first two of these, which encode proteins of 27,441 and 32,890 Da,
      were identified as rfaY and rfaZ by homology of the derived protein sequences of
      their products to the products of similar genes of Salmonella typhimurium. The
      amino acid sequences of proteins RfaY and RfaZ showed, respectively, 70 and 72%
      identity. Genes 3 and 4 were identified as rfaK and rfaL on the basis of size and
      position, but the derived amino acid sequences of the products of these genes
      showed very little similarity (about 12% identity) between Escherichia coli K-12
      and S. typhimurium. The next gene in the cluster, rfaC, encodes a product which
      also shows strong protein sequence homology between E. coli K-12 and S.
      typhimurium, as do the rfaF and rfaD genes which lie beyond it. Thus, the rfa
      gene cluster appears to consist of two blocks of genes which are conserved
      flanking a central region of two genes which are not conserved between these
      species. Although the RfaL protein sequence is not conserved, hydropathy plots of
      the two RfaL species are nearly identical and indicate that this is a typical
      integral membrane protein with 10 or more potential transmembrane domains. We
      noted the similarity of the structure of the rfa gene cluster to that of the rfb
      gene cluster, which has now been sequenced in several Salmonella serovars. The
      rfb cluster also contains a gene which lies within a central nonconserved region
      and encodes an integral membrane protein similar to protein RfaL. We speculate
      that protein RfaL may interact in a strain- or species-specific way with one or
      more Rfb proteins in the expression of surface O antigen.

PMID- 1624463
TI  - Characterization of the periplasmic flagellum proteins of Leptospira interrogans.
AB  - The structure and composition of periplasmic flagella (PF) from Leptospira
      interrogans serovar pomona type kennewicki were characterized. Electron
      microscopic observations showed that leptospiral PF were complex structures
      composed of an 11.3-nm-diameter core surrounded by two sheath layers with 21.5-
      and 42-nm diameters. Two-dimensional gel electrophoresis of isolated PF showed
      the presence of seven different proteins ranging in mass from 31.5 to 36 kDa.
      Rabbit polyclonal and mouse monoclonal antibodies against PF proteins were
      prepared and were used to localize specific proteins to portions of the PF
      structure by immunoelectron microscopy. A 34-kDa protein was associated with the
      11.3-nm-diameter core filament, while a 36-kDa protein was associated with a PF
      sheath (21.5-nm-diameter filament). The amino termini of the 34- and 35.5-kDa
      proteins were homologous to PF core proteins of other spirochetes. The
      experimental data suggested that L. interrogans PF contains 2 proteins (34 and
      35.5 kDa) in the PF core.

PMID- 1624464
TI  - Identification of a novel promoter in the replication control region of plasmid
      R6K.
AB  - A novel source of transcription has been detected in the replication region of
      plasmid R6K by using fusions involving the galK reporter gene. The -35 and -10
      consensus RNA polymerase binding sites were identified in the region overlapping
      the binding sites for the R6K-encoded replication protein pi. Transcription from
      this promoter, designated P2, is repressed in vivo by pi-protein levels that are
      inhibitory for replication. Promoter-down mutations in P2 induced in vitro by
      bisulfite mutagenesis result in a reduced copy number of a beta-replicon but not
      of a gamma-replicon. Implications of the role of P2 in R6K replication are
      discussed.

PMID- 1624465
TI  - Ferric iron uptake in Erwinia chrysanthemi mediated by chrysobactin and related
      catechol-type compounds.
AB  - Erwinia chrysanthemi 3937 possesses a saturable, high-affinity transport system
      for the ferric complex of its native siderophore chrysobactin, [N-alpha-(2,3
      dihydroxybenzoyl)-D-lysyl-L-serine]. Uptake of 55Fe-labeled chrysobactin was
      completely inhibited by respiratory poison or low temperature and was
      significantly reduced in rich medium. The kinetics of chrysobactin-mediated iron
      transport were determined to have apparent Km and Vmax values of about 30 nM and
      of 90 pmol/mg.min, respectively. Isomers of chrysobactin and analogs with
      progressively shorter side chains mediated ferric iron transport as efficiently
      as the native siderophore, which indicates that the chrysobactin receptor
      primarily recognizes the catechol-iron center. Free ligand in excess only
      moderately reduced the accumulation of 55Fe. Chrysobactin may therefore be
      regarded as a true siderophore for E. chrysanthemi.

PMID- 1624466
TI  - Molecular modelling of the three-dimensional structure and conformational
      flexibility of bacterial lipopolysaccharide.
AB  - Molecular modelling techniques have been applied to calculate the three
      dimensional architecture and the conformational flexibility of a complete
      bacterial S-form lipopolysaccharide (LPS) consisting of a hexaacyl lipid A
      identical to Escherichia coli lipid A, a complete Salmonella typhimurium core
      oligosaccharide portion, and four repeating units of the Salmonella serogroup B O
      specific chain. X-ray powder diffraction experiments on dried samples of LPS were
      carried out to obtain information on the dimensions of the various LPS partial
      structures. Up to the Ra-LPS structure, the calculated model dimensions were in
      good agreement with experimental data and were 2.4 nm for lipid A, 2.8 nm for Re
      LPS, 3.5 nm for Rd-LPS, and 4.4 nm for Ra-LPS. The maximum length of a stretched
      S-form LPS model bearing four repeating units was evaluated to be 9.6 nm;
      however, energetically favored LPS conformations showed the O-specific chain bent
      with respect to the Ra-LPS portion and significantly smaller dimensions (about
      5.0 to 5.5 nm). According to the calculations, the Ra-LPS moiety has an
      approximately cylindrical shape and is conformationally well defined, in contrast
      to the O-specific chain, which was found to be the most flexible portion within
      the molecule.

PMID- 1624467
TI  - Candida albicans produces a cystatin-type cysteine proteinase inhibitor.
AB  - A cysteine proteinase inhibitor was found in culture media of Candida albicans.
      Purification to homogeneity of the inhibitor was performed by carboxymethyl
      papain-Sepharose affinity, DE-52 ion-exchange, and reverse-phase high performance
      liquid chromatographies. The purified inhibitor had an M(r) of 15 kDa and a pI of
      4.9. It was more stable to heat and pH than most proteins. The N-terminal
      sequence of the first 30 residues demonstrated high similarity with that of human
      cystatin A. Thus, C. albicans cysteine proteinase inhibitor seems to belong to
      the cystatin superfamily. The inhibitor activity of the yeast cellular form was
      4.0 times higher than that of the hyphal cellular form in 7-day culture media. It
      is suggested that the inhibitor has regulatory functions similar to those of its
      counterpart proteinases in the invasion of host cells.

PMID- 1624468
TI  - Elasticity of the sacculus of Escherichia coli.
AB  - Preparations of purified peptidoglycan of Escherichia coli (i.e., sacculi) were
      studied by low-angle laser light scattering. Control experiments and theoretical
      calculations based on the Rayleigh-Gans theory showed that the mean sacculus
      surface area could be accurately inferred from measurements with our apparatus by
      using computer routines developed previously. Large changes in the mean saccular
      surface area resulted from alterations in the stress caused by varying the net
      charge on the sacculi. The net charge was affected by altering the suspending
      medium pH, causing carboxyl and amino groups in the peptidoglycan to gain or lose
      protons, or by acetylation or succinylation of the amino groups. A preponderance
      of either plus or minus charges caused an expansion of the mean sacculus surface
      area. The largest increase in area probably represents the elastic limit of the
      peptidoglycan and was 300% above the area of isoionic sacculi. This degree of
      expansion is consistent with possible conformations of the intact peptidoglycan
      structure without necessitating rupture of the wall fabric. Our findings
      concerning saccular elasticity provide support for the surface stress theory. It
      provides a mechanism so that bacteria can grow and divide while maintaining
      turgor pressure, without the necessity of having and using proteins to do the
      mechanical work.

PMID- 1624469
TI  - Structure and regulation of the Yersinia pestis yscBCDEF operon.
AB  - We have investigated the physical and genetic structure and regulation of the
      Yersinia pestis yscBCDEF region, previously called lcrC. DNA sequence analysis
      showed that this region is homologous to the corresponding part of the ysc locus
      of Yersinia enterocolitica and suggested that the yscBCDEF cistrons belong to a
      single operon on the low-calcium response virulence plasmid pCD1. Promoter
      activity measurements of ysc subclones indicated that yscBCDEF constitutes a
      suboperon of the larger ysc region by revealing promoter activity in a clone
      containing the 3' end of yscD, intact yscE and yscF, and part of yscG. These
      experiments also revealed an additional weak promoter upstream of yscD. Northern
      (RNA) analysis with a yscD probe showed that operon transcription is thermally
      induced and downregulated in the presence of Ca2+. Primer extension of operon
      transcripts suggested that two promoters, a moderate-level constitutive one and a
      stronger, calcium-downregulated one, control full-length operon transcription at
      37 degrees C. Primer extension provided additional support for the proposed
      designation of a yscBCDEF suboperon by identifying a 5' end within yscF, for
      which relative abundances in the presence and absence of Ca2+ revealed regulation
      that is distinct from that for transcripts initiating farther upstream. YscB and
      YscC were expressed in Escherichia coli by using a high-level transcription
      system. Attempts to express YscD were only partially successful, but they
      revealed interesting regulation at the translational level.

PMID- 1624470
TI  - Purification and partial characterization of a penicillin-binding protein from
      Mycobacterium smegmatis.
AB  - Penicillin-binding proteins (PBPs), although characterized from several
      organisms, have so far not been studied in mycobacteria. The present study is the
      first characterization of a PBP from Mycobacterium smegmatis. The PBP was
      purified by solubilization of the membranes with Triton X-100 and successive
      chromatography of the solubilized proteins on ampicillin-linked CH Sepharose 4B
      and DE-52. The purified PBP (M(r), 49,500) catalyzed a model transpeptidase
      reaction with the tripeptide acetyl2-L-Lys-D-Ala-D-Ala as the substrate and Gly
      Gly as the acceptor. The transpeptidase activity was inhibited by 50% at a
      benzylpenicillin concentration of 1.8 x 10(-7) M, which was similar to the
      concentration (1.1 x 10(-7) M) of benzylpenicillin required to saturate to 50%
      this PBP. Of several antibiotics tested, the concentration of antibiotic required
      to inhibit [35S]penicillin binding by 90% was found to be the lowest for
      cefoxitin and Sch 34343.

PMID- 1624471
TI  - Isolation, characterization, and physiological role of the pyruvate dehydrogenase
      complex and alpha-acetolactate synthase of Lactococcus lactis subsp. lactis bv.
      diacetylactis.
AB  - The pyruvate dehydrogenase complex of Lactococcus lactis subsp. lactis bv.
      diacetylactis has a specific activity of 6.6 U/mg and a Km of 1 mM for pyruvate.
      The specific activities of E2 and E3 in the complex are 30 and 0.36 U/mg,
      respectively. The complex is very sensitive to NADH inhibition and consists of
      four subunits: E1 alpha (44 kDa), E1 beta (35 kDa), E2 (73 kDa), and E3 (60 kDa).
      The L. lactis alpha-acetolactate synthase has a specific activity of 103 U/mg and
      a Km of 50 mM for pyruvate. Thiamine pyrophosphate (Km = 3.2 microM) and divalent
      cations are essential for activity. The native enzyme measures 172 kDa and
      consists of 62-kDa monomers. The role of both enzymes in product formation is
      discussed in view of NADH inhibition and competition for pyruvate.

PMID- 1624472
TI  - The replication initiator operon of promiscuous plasmid RK2 encodes a gene that
      complements an Escherichia coli mutant defective in single-stranded DNA-binding
      protein.
AB  - The amino acid sequence of the 13-kDa polypeptide (P116) encoded by the first
      gene of the trfA operon of IncP plasmid RK2 shows significant similarity to
      several known single-stranded DNA-binding proteins. We found that unregulated
      expression of this gene from its natural promoter (trfAp) or induced expression
      from a strong heterologous promoter (trcp) was sufficient to complement the
      temperature-sensitive growth phenotype of an Escherichia coli ssb-1 mutant. The
      RK2 ssb gene is the first example of a plasmid single-stranded DNA-binding
      protein-encoding gene that is coregulated with replication functions, indicating
      a possible role in plasmid replication.

PMID- 1624473
TI  - Interallelic complementation of dnaE(Ts) mutations.
AB  - Some Escherichia coli dnaE(Ts) alleles will functionally complement in trans. The
      complementation is not due to copy number and is compatible with dimeric
      interaction.

PMID- 1624474
TI  - Transfer of conjugal elements in oral black-pigmented Bacteroides (Prevotella)
      spp. involves DNA rearrangements.
AB  - Conjugal genetic elements in isolates of oral black-pigmented Bacteroides
      denticola (Prevotella denticola) and B. intermedius (P. intermedia) transfer
      tetracycline and penicillin resistance in the absence of plasmids. Transverse
      alternating-field electrophoresis of restricted chromosomal DNAs from
      transconjugants revealed arrangements indicating that transfer and insertion can
      involve more than one 60-kb copy of the elements and occurs at strongly preferred
      sites in the recipient chromosome.

PMID- 1624475
TI  - Anaerobic toluene oxidation to benzyl alcohol and benzaldehyde in a denitrifying
      Pseudomonas strain.
AB  - The denitrifying Pseudomonas strain K172 was grown with a generation time of 6 h
      to a cell density of 0.4 g (dry weight) per liter with toluene and nitrate as
      substrates. We found that anaerobic cell suspensions oxidize [14C]toluene first
      to [14C]benzyl alcohol and subsequently to [14C]benzaldehyde. This proves that
      the methyl group of toluene is oxidized without molecular oxygen to a
      hydroxymethyl group.

PMID- 1624476
TI  - Designing a user interface and computer screens for instruction: some
      considerations.
AB  - Computer-assisted instruction and interactive videodisc are being used more often
      in allied health sciences education and medical training. Because computer
      graphics screens can enhance both legibility and readability, an effective
      computer interface for instruction is basic to the design and development of
      both. This article discusses guidelines on legibility, which includes the use of
      graphics, type and text, contrast, and color.

PMID- 1624477
TI  - Computer-aided forensic facial reconstruction.
AB  - The reconstruction of facial features on the human skull for identification
      purposes has, in the past, utilized either two-dimensional drafting or three
      dimensional sculpting techniques. We have developed two- and three-dimensional
      computer-aided routines to minimize errors introduced by limits of artistic
      ability or by inconsistencies in the application of techniques. These routines
      allow generalized facial features to be manipulated to conform to the size and
      shape of a specific skull. Subtle alterations of the surface form, texture, and
      color, based on age, sex, and race, enhance the individuality of the generated
      facial form.

PMID- 1624478
TI  - The life and work of James F. Didusch.
AB  - This retrospective look at the life and work of James F. Didusch emphasizes the
      brilliance of his talent and the great value of his contribution to the medical
      sciences. Didusch was the first student of Max Brodel in the Department of Art As
      Applied to Medicine at Johns Hopkins University from 1911 to 1913. When the
      Carnegie Institute of Embryology was established at Johns Hopkins in 1913,
      Didusch was appointed as its illustrator. He remained the Carnegie Illustrator
      until his death in 1955. His rich treasury of artwork represents a lifelong
      pursuit and is a vital contribution to the field of medical illustration.

PMID- 1624479
TI  - Informed consent.

PMID- 1624480
TI  - The prevalence of seropositivity for human immunodeficiency virus in patients who
      have severe trauma.
AB  - Patients who have severe trauma have been reported to have a substantially
      increased rate of seropositivity for human immunodeficiency virus when compared
      with the general population. We reviewed the records of 1226 consecutive Code-3
      trauma patients who were treated at our institution in San Antonio, Texas,
      between 1987 and 1989. All of the patients had serum drawn to be tested for the
      human immunodeficiency virus. In contrast with previously published studies, only
      0.8 per cent of these trauma patients were seropositive. There was no appreciable
      difference between the prevalence of seropositivity in patients who sustained
      blunt trauma and those who sustained penetrating trauma. Exposure to human
      immunodeficiency virus for medical personnel who care for trauma patients remains
      a concern, but the risk may be lower than previously reported.

PMID- 1624481
TI  - Salvage and reinfusion of postoperative sanguineous wound drainage. A preliminary
      report.
AB  - Thirty-five patients who were to have posterior spinal arthrodesis, total hip
      arthroplasty, or total knee arthroplasty were entered into one of two groups:
      Group A, to receive unwashed, filtered sanguineous drainage from the wound, or
      Group B, to receive washed, filtered drainage. The purpose of this prospective
      study was to evaluate the safety, efficacy, and difficulty of reinfusion of
      washed compared with unwashed drainage that had been salvaged from the wound
      after an orthopaedic operation. The sixteen patients in Group A received a mean
      of 475 milliliters of unwashed drainage for each total knee arthroplasty, 427
      milliliters for each total hip arthroplasty, and ten milliliters for the one
      posterior spinal arthrodesis. The complications included immediate hypotension
      (two patients), hyperthermia (one patient), and hypotension five hours after
      reinfusion (one patient). The latter patient died, four days after the operation,
      of a massive myocardial infarction. The nineteen patients in Group B received a
      mean of 193 milliliters of washed, filtered drainage for each total knee
      arthroplasty, 203 milliliters for each total hip arthroplasty, and 179
      milliliters for each posterior spinal arthrodesis. Salvage and reinfusion of
      washed drainage from the wound caused no problems in these patients.

PMID- 1624482
TI  - Autologous transfusions for orthopaedic procedures at a children's hospital.
AB  - We conducted a critical review of the use of autologous transfusions in
      orthopaedics at a tertiary-care children's hospital. The cases of 198 children
      who deposited blood before an orthopaedic operation were analyzed. There were 175
      children who were enrolled in the program of preoperative deposit of autologous
      blood who later needed transfusion of blood; 73 per cent of them received only
      autologous blood. Seventy patients also had intraoperative salvage. We were
      unable to document a proved benefit of intraoperative salvage of blood in this
      group of patients. Forty patients had some difficulty donating autologous blood
      preoperatively, but these problems were rarely serious. Major human errors
      occurred in thirteen patients and resulted in some patients receiving homologous
      transfusions while autologous blood components were still available. Fifty-five
      (40 per cent) of all of the transfusions were administered in clinical
      circumstances that failed to meet generally accepted criteria for transfusion,
      and fifty-four (38 per cent) of the postoperative transfusions also failed to
      meet these criteria. This was true of the homologous transfusions in the study as
      well. Although an autologous blood transfusion is a generally safe procedure, it
      is not without risk, and human errors can occur. In light of the potential
      complications, surgeons should adhere to the standard indications for transfusion
      when administering autologous blood.

PMID- 1624483
TI  - Anterior decompression and arthrodesis of the cervical spine: long-term motor
      improvement. Part I--Improvement in incomplete traumatic quadriparesis.
AB  - Between 1973 and 1983, fifty-eight patients who had an incomplete spinal-cord
      injury secondary to a fracture or dislocation of the cervical spine were managed
      by anterior cervical decompression and arthrodesis with iliac bone grafts. In all
      patients, myelography showed that displaced fragments of bone or disc were
      compressing the anterior aspect of the spinal cord. Anterior decompression was
      performed in an attempt to improve function in the upper and lower extremities.
      The average interval from the injury to the decompression was thirteen months
      (range, one month to nine years). Two patients died of cardiopulmonary disease
      within two months after the operation, and one patient died eighteen months after
      the operation. The remaining fifty-five patients were followed for an average of
      six years (range, two to seventeen years). Twenty-nine patients became functional
      ambulators after the operation. An additional six patients who could walk before
      the operation had improvement in the ability to walk. Noteworthy improvement in
      motor-root function in the upper extremities was seen in thirty-nine patients.
      Only nine patients had no signs of improvement of motor function. Improvement was
      less in the patients in whom operative decompression had been done more than
      twelve months after the injury. The patients who had an extension injury to a
      spondylotic spine were older, and fewer of them had improvement. No patient lost
      neurological function as a result of the operation. Anterior decompression and
      arthrodesis, even when performed late after the injury, can improve neurological
      function in both the upper and lower extremities in many patients who have
      incomplete quadriplegia due to a fracture or dislocation of the cervical spine.

PMID- 1624484
TI  - Anterior decompression and arthrodesis of the cervical spine: long-term motor
      improvement. Part II--Improvement in complete traumatic quadriplegia.
AB  - Fifty-one patients who had complete motor quadriplegia secondary to a fracture or
      dislocation of the cervical spine were managed by anterior cervical decompression
      and arthrodesis with iliac bone grafts between 1973 and 1983. In all patients,
      myelography demonstrated that displaced fragments of bone and disc were
      compressing the anterior aspect of the spinal cord. Decompression was performed
      in an attempt to gain further improvement of the motor-roots in the upper
      extremities and thereby to improve the ability of the patients to care for
      themselves. The average interval from the injury to the decompression was fifteen
      months (range, one month to eight years). Two patients died within two months
      after the operation, one had a respiratory arrest that resulted in brain damage
      one day after the operation, and two died from cardiovascular disease more than
      one year after the operation. The remaining forty-six patients were followed for
      an average of five years (range, two to thirteen years). Neurological improvement
      of at least two new functional motor-root levels was documented in seven patients
      and of one level, in eighteen. Increased motor strength by two or three grades
      was seen in six patients. Noteworthy motor improvement did not occur in the
      remaining twenty patients. The mean modified Barthel index (used to measure
      improvement in the ability to perform activities of daily living) increased from
      17 to 33 (of a possible 100) points. Functionally important improvement of the
      caudad part of the cord occurred in only one patient. In one patient, neural
      injury, with loss of one motor-root level, occurred, with only partial
      improvement. At the latest follow-up examination, the result was poor in nine of
      eleven patients who had decompression eighteen months or more after the injury.
      Only two of these patients had any improvement in the Barthel index, and then of
      only 5 points each. The result also was poor in the five patients who were more
      than fifty-three years old; two had no improvement in the Barthel index, one
      improved by 5 points, and two died.

PMID- 1624485
TI  - Long-term evaluation of adolescents treated operatively for spondylolisthesis. A
      comparison of in situ arthrodesis only with in situ arthrodesis and reduction
      followed by immobilization in a cast.
AB  - The medical records and radiographs of forty-two adolescents (twenty-three male
      and nineteen female) who had had a posterolateral spinal arthrodesis for
      spondylolisthesis between 1950 and 1986 were reviewed to assess the long-term
      outcome of this form of treatment. The average age of the patients at the time of
      the operation was fourteen years (range, seven years and nine months to seventeen
      years and eleven months). The duration of the clinical and radiographic follow-up
      ranged from two years to twenty-seven years and seven months. All patients had an
      in situ arthrodesis of the involved vertebrae. Eighteen patients had no
      additional intervention, and twenty-four patients had reduction and application
      of a cast. Use of the cast led to a decrease in sagittal translation of more than
      5 per cent in eighteen patients and a decrease in lumbosacral kyphosis (the slip
      angle) of more than 5 degrees in fourteen patients. Of the patients who did not
      have a cast, eight had an increase in sagittal translation of more than 5 per
      cent and ten had an increase in lumbosacral kyphosis of more than 5 degrees.
      There were no neurological problems at the time of the initial operation or after
      the reduction maneuver. At the most recent clinical follow-up examination, thirty
      eight patients had no complaints of low-back pain or any restriction of work
      related or recreational activities. Persistent low-back pain and pain in the
      lower extremities limited the activities of the remaining four patients, two of
      whom had another operation to alleviate these symptoms.

PMID- 1624486
TI  - Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic
      anatomy.
AB  - We investigated the structure of the myotendinous rotator cuff in thirty-two
      grossly intact cuffs from thirty fresh cadavera of subjects who had been
      seventeen to seventy-two years old at the time of death. We studied the gross
      anatomy of the capsule and ligaments of the cuff, as well as histological
      sections of the tendons of the subscapularis, supraspinatus, and infraspinatus
      muscles. The tendons were found to splay out and interdigitate to form a common,
      continuous insertion on the humerus. The biceps tendon was ensheathed by
      interwoven fibers derived from the subscapularis and supraspinatus tendons. The
      anterior margin and bursal surface of the supraspinatus tendon were enveloped by
      a thick sheet of fibrous tissue derived from the coracohumeral ligament. Fibers
      from the coracohumeral and glenohumeral ligaments were found concentrated in a
      plane between the capsule and the tendons of the cuff. Microscopically, in the
      region of the supraspinatus and infraspinatus tendons, the cuff was composed of
      five layers defined by the attachments and orientations of the fibrous elements
      in each of these layers.

PMID- 1624487
TI  - Excision of the radial head for congenital dislocation.
AB  - Eight elbows in six patients who had had excision of the radial head for
      congenital dislocation were evaluated an average of seven years postoperatively.
      The average age of the patients at the time of the excision was thirteen years
      (range, ten to 15.5 years). The dislocation was posterior in five elbows and
      posterolateral in three. The over-all increase in the arc of flexion-extension
      postoperatively compared with preoperatively was 11 degrees (p greater than 0.1):
      The over-all increase in the arc of rotation was significant at 53 degrees (p
      less than 0.002). Pain in the elbow had decreased compared with preoperatively,
      but all patients had minor pain in the wrist. The result was rated good in five
      elbows, fair in two, and poor in one. One patient had a repeat excision of the
      radial head after it re-formed, and this was the reason for the poor result. All
      patients were satisfied with the outcome of the operation. Contrary to previously
      published data, excision of the radial head for congenital dislocation resulted
      in an increased range of motion and a decrease in pain in the elbow in our
      patients.

PMID- 1624488
TI  - Release of the subscapularis for internal rotation contracture and pain after
      anterior repair for recurrent anterior dislocation of the shoulder.
AB  - Ten patients who had an internal rotation contracture and pain after an anterior
      repair for recurrent dislocation of the shoulder were treated by release of the
      subscapularis muscle. For six of the patients, radiographs demonstrated severe
      osteoarthrotic changes in the shoulder as well. The release was done an average
      of eleven years after the original procedure, which, for most patients, had been
      a Putti-Platt repair. After release of the subscapularis, each patient had less
      pain in the shoulder and an average increase of 27 degrees of external rotation.
      Release of the subscapularis can offer relief of pain and of functional
      limitations associated with the symptoms caused by an internal rotation
      contracture after an anterior repair of the shoulder.

PMID- 1624489
TI  - Frozen shoulder. A long-term follow-up.
AB  - Sixty-two patients (sixty-eight shoulders) who had been treated non-operatively
      for idiopathic frozen shoulder were evaluated subjectively and objectively at two
      years and two months to eleven years and nine months of follow-up (average, seven
      years). Thirty-one (50 per cent) of these patients still had either mild pain or
      stiffness of the shoulder, or both. The range of motion averaged 161 degrees of
      forward flexion, 157 degrees of forward elevation, 149 degrees of abduction, 65
      degrees of external rotation, and internal rotation to the level of the fifth
      thoracic spinous process. Thirty-seven (60 per cent) of the sixty-two patients
      still demonstrated some restriction of motion as compared with study-generated
      control values (calculated as the average motion, in each plane, for the thirty
      seven unaffected shoulders of the patients who had unilateral disease). Ten
      patients had restriction of forward flexion; eight, of forward elevation;
      seventeen, of abduction; twenty-nine, of external rotation; and ten, of internal
      rotation. However, when the motion of each affected shoulder of thirty-seven
      patients who had unilateral involvement was compared with that of the unaffected
      contralateral shoulder, eleven (30 per cent) demonstrated some restriction. None
      of these patients had restriction of forward flexion; two had restriction of
      forward elevation; two, of abduction; seven, of external rotation; and seven, of
      internal rotation. The patients who had substantial restriction in three planes
      or more were thirteen times more likely to be men (p greater than 0.05). Marked
      restriction, when it was present, was most commonly in external rotation. Only
      seven patients (11 per cent) reported mild functional limitation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1624490
TI  - Compressive mechanical properties of human cancellous bone after gamma
      irradiation.
AB  - The effect of gamma irradiation on the mechanical properties of human bone was
      examined. Specimens of cancellous bone were cut from the proximal epiphyseal
      region of fresh-frozen tibiae and divided into control and irradiated groups
      according to anatomical region. The irradiated groups were exposed to 10,000,
      31,000, 51,000, or 60,000 gray (1.0, 3.1, 5.1, or 6.0 megarad). The specimens
      were tested in compression to failure to determine failure stress, strain to
      failure, and elastic modulus. Failure stress and elastic modulus were found to be
      proportional to the square of the density and were normalized with respect to
      this property. Significant differences in normalized failure stress (p less than
      0.001) and normalized elastic modulus (p = 0.003), when compared with the values
      for matched control specimens, were found only for the specimens that had been
      irradiated with 60,000 gray (6.0 megarad).

PMID- 1624491
TI  - Stabilization of acetabular fractures in elderly patients.
AB  - Eighteen patients who were sixty years or older and had an acute displaced
      fracture of the acetabulum were managed with open reduction and internal
      fixation. The average age of the patients was sixty-seven years (range, sixty to
      eighty-one years). Nine fractures were a result of a motor-vehicle accident, and
      nine occurred in a fall. Nine patients had multiple associated injuries, and most
      (sixteen patients) had other complex acetabular fractures. All of the patients
      had open reduction and internal fixation with either the ilioinguinal approach
      (thirteen patients) or the Kocher-Langenbeck approach (five patients). All
      patients were managed postoperatively with early mobilization and physical
      therapy. All fractures united, and only one patient had a partial loss of
      reduction. Four patients who had a concentric reduction had a gap of as much as
      three millimeters in the articular surface due to comminution of the fracture.
      The complications included two pulmonary emboli, which resolved with
      anticoagulation, and one undetected intra-articular fragment, which led to an
      additional operation. No infections or iatrogenic nerve injuries were noted.
      Seventeen of the eighteen patients were followed for at least two years (average,
      thirty-one months). These patients had an average Harris hip-score of 90 points
      postoperatively. The treatment was regarded as having failed in only one patient.
      Open reduction and internal fixation of selected displaced acetabular fractures
      in the elderly can yield good results and may obviate the need for early and
      often difficult total hip arthroplasty.

PMID- 1624492
TI  - Shrapnel wounds in children.
AB  - Nineteen children who had open fractures and skin wounds of at least two
      centimeters due to shrapnel were followed for one to five weeks after they had
      been injured. All of the patients were managed with debridement at twenty-four to
      forty-eight-hour intervals and were given cephalosporin antibiotics. Fourteen
      patients did well. The wounds in the three patients who had the least severe soft
      tissue injury were healing well at two weeks, and ten other patients were
      progressing to soft-tissue and osseous healing at five weeks. One patient had
      progressive but slower healing, and plastic reconstructive procedures would be
      advisable. Five patients had major problems. In one of these children, a wound
      continued to drain after six weeks. Three children had an amputation, and another
      child died due to a vascular injury.

PMID- 1624493
TI  - Massive femoral osteolysis and early disintegration of a polyethylene-bearing
      surface of a total knee replacement. A case report.

PMID- 1624494
TI  - Bilateral spontaneous lateral compartment syndrome in the legs of a patient who
      received a kidney and heart transplant. A case report.

PMID- 1624495
TI  - Unstable fractures of the pelvic ring.

PMID- 1624496
TI  - Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study
      comparing decompression with decompression and inter-transverse process
      arthrodesis.

PMID- 1624497
TI  - Magnetic resonance imaging of a rupture of the medial head of the gastrocnemius
      muscle. A case report.

PMID- 1624498
TI  - Total acromionectomy. A twenty-year review.

PMID- 1624499
TI  - Concomitant fractures of the scaphoid and the distal end of the radius: treatment
      by external fixation. A report of two cases.

PMID- 1624500
TI  - Fixation is fun.

PMID- 1624501
TI  - Prognostic factors in soft-tissue sarcoma.

PMID- 1624502
TI  - Ultrasound in clinical orthopaedics.

PMID- 1624503
TI  - Staging of soft-tissue sarcomas. Prognostic analysis of clinical and pathological
      features.
AB  - In a retrospective study of all 137 patients with soft-tissue sarcoma treated by
      surgery between 1972 and 1984, the clinical course was related to several host
      and tumour features, including the Surgical Staging System of Enneking, Spanier
      and Goodman (1980). Only patients free from metastasis with untreated primary
      lesions on admission were included. According to the Surgical Staging System,
      nine tumours were IA, 18 IB, 38 IIA and 72 IIB. Only 12 patients underwent
      amputation; 125 were treated by local surgery. The mean follow-up time was ten
      years (minimum five). For the whole series the probability of seven-year survival
      was 0.65; 42 patients (31%) died from tumour disease. All these had metastases
      and 24 also had local recurrence. The local recurrence rate was 36%. Multivariate
      analysis identified large tumour size and high histological grade as significant
      risk factors for metastatic disease and tumour-related death. Sex, age, tumour
      site, surgical margin and local recurrence showed no correlation with survival.
      The prognostic contribution of compartmentality was virtually nil. Histological
      grade combined with tumour size was found to give better prognostic information
      than that obtained by the Surgical Staging System.

PMID- 1624504
TI  - Selection bias in treatment of soft-tissue sarcoma.
AB  - We analysed 256 patients with primary soft-tissue sarcoma of the extremities
      diagnosed between 1970 and 1990 to see if tumour-related and host-related
      prognostic factors influenced both the selection of operation and the margin of
      clearance obtained at surgery. Amputation was more often performed in young
      patients, in those with distal tumours, and in those with deep-seated tumours.
      Inadequate surgical margins (those with a high risk of local recurrence) were
      more common in patients with deep-seated and large tumours than in patients with
      superficial and small tumours. These features of the tumour and the host, which
      have been shown to be prognostic for survival, also influenced the choice and
      performance of surgical procedures.

PMID- 1624505
TI  - Epidemiological, clinical and radiological aspects of osteopoikilosis.
AB  - Osteopoikilosis is a rare condition showing characteristic sclerotic lesions on
      radiographic examination, which are diagnostic for the trait. We report four
      patients presenting with various complaints and 49 members of their families who
      later were found to have osteopoikilosis. The mean age of all 53 was 27.5 years
      and the male:female ratio was 33:20. Most had lesions in the small tubular bones.
      We studied the epidemiological, clinical and radiological features of these
      patients and from the pedigrees conclude that the disease is inherited as an
      autosomal dominant.

PMID- 1624506
TI  - Thigh pain despite bone ingrowth into uncemented femoral stems.
AB  - Six porous-coated, uncemented femoral components were revised at a mean of 34.5
      months for persistent thigh pain. At operation the stems were rigidly stable,
      difficult to extract, and showed good bony ingrowth. The four men and two women,
      with an average age of 59 years, all had thigh pain starting within the first
      year, progressive over time and unresponsive to conservative measures. These
      cases show that rigid fixation with good bony ingrowth does not guarantee the
      clinical success of a porous-coated uncemented femoral stem.

PMID- 1624507
TI  - Corrosion between the components of modular femoral hip prostheses.
AB  - We studied the tapered interface between the head and the neck of 139 modular
      femoral components of hip prostheses which had been removed for a variety of
      reasons. In 91 the same alloy had been used for the head and the stem; none of
      them showed evidence of corrosion. In contrast, there was definite corrosion in
      25 of the 48 prostheses in which the stem was of titanium alloy and the head of
      cobalt-chrome. This corrosion was time-dependent: no specimens were corroded
      after less than nine months in the body, but all which had been in place for more
      than 40 months were damaged. We discuss the factors which may influence the rate
      of these changes and present evidence that they were due to galvanically
      accelerated crevice corrosion, which was undetected in previous laboratory
      testing of this type of prosthesis.

PMID- 1624508
TI  - Plasma viscosity and C-reactive protein after total hip and knee arthroplasty.
AB  - We studied the changes in plasma viscosity and C-reactive protein to establish
      normal values after total hip or knee arthroplasty. Viscosity decreased from 1.68
      (+/- 0.017) to 1.57 (+/- 0.014) on the first postoperative day and thereafter
      rose to 1.60 (+/- 0.019), 1.75 (+/- 0.015), and 1.74 (+/- 0.011) on the third,
      seventh and fourteenth days respectively. Six to eight weeks after operation it
      had returned to pre-operative levels. A viscosity above the upper limit of the
      laboratory range, obtained more than two months after operation, may be
      considered as abnormal. The C-reactive protein level increased significantly on
      the first postoperative day and then decreased from a peak on the second day,
      attaining nearly normal levels at six to eight weeks after operation. It may be a
      more sensitive indicator of deep postoperative infection than plasma viscosity.

PMID- 1624509
TI  - The influence of footwear on the prevalence of flat foot. A survey of 2300
      children.
AB  - We analysed static footprints of 2300 children between the ages of four and 13
      years to establish the influence of footwear on the prevalence of flat foot. The
      incidence among children who used footwear was 8.6% compared with 2.8% in those
      who did not (p less than 0.001). Significant differences between the predominance
      in shod and unshod children were noted in all age groups, most marked in those
      with generalised ligament laxity. Flat foot was most common in children who wore
      closed-toe shoes, less common in those who wore sandals or slippers, and least in
      the unshod. Our findings suggest that shoe-wearing in early childhood is
      detrimental to the development of a normal longitudinal arch.

PMID- 1624510
TI  - The Oxford club-foot programme.
AB  - We treated 63 club feet in 44 patients by a defined programme of strapping from
      birth followed by one of two operations performed at six weeks, either a simple
      calcaneal tendon lengthening or a subtalar realignment, and reviewed them
      prospectively. The decision as to which operation to perform was taken at four
      weeks after radiographic measurement of the talocalcaneal angle. All but eight
      patients (ten feet) were followed for a mean of 8.7 years. The overall results
      after calcaneal tendon lengthening were satisfactory. The re-operation rate after
      subtalar realignment was high (39%) due to over or undercorrection of the
      deformity.

PMID- 1624511
TI  - Arthroscopic lavage and debridement for osteoarthritis of the knee.
AB  - We measured the effect of arthroscopic lavage and debridement of the
      osteoarthritic knee by comparing objective measurements of thigh muscle function
      before and after operation. There was some improvement in quadriceps isokinetic
      torque at six and 12 weeks after joint lavage but not after debridement. Neither
      method significantly relieved the patients' symptoms.

PMID- 1624512
TI  - Hip dysplasia in hereditary motor and sensory neuropathies.
AB  - Hip dysplasia complicating the hereditary motor and sensory neuropathies is not
      widely recognised. We describe four patients in whom the neuropathy affected the
      proximal muscles and we suggest that hereditary motor and sensory neuropathies
      may be responsible for the failure of the initial treatment of some neonatal
      dislocated hips.

PMID- 1624513
TI  - The changing epidemiology of osteomyelitis in children.
AB  - We reviewed 275 cases and calculated the prevalence of bacteriologically or
      radiologically confirmed acute haematogenous osteomyelitis in children under 13
      resident in Greater Glasgow during 1970 to 1990. In the 20-year period there was
      a fall of over 50%, mainly involving cases of long-bone infection, and those due
      to Staphylococcus aureus. There was a reduced incidence of complications. The
      proportion of cases involving long bones decreased from 84% to 57%, and those of
      Staphylococcus aureus infection from 55% to 31%. These changes, in what is
      becoming a rare disease, need to be known to ensure early diagnosis and adequate
      treatment, particularly of subacute non-staphylococcal infection at unusual
      sites.

PMID- 1624514
TI  - Open fractures of the tibia in children.
AB  - We describe the results of treatment of open tibial fractures in 92 children; 22
      fractures were Gustilo type I, 51 type II and 19 type III. All children received
      tetanus prophylaxis, systemic antibiotics for 48 hours and thorough debridement
      and irrigation of the wound. Fifty-one wounds with minimal soft-tissue injury
      were closed primarily. The other 41 were initially left open; of these, 18 small
      wounds were allowed to heal secondarily and 23 larger wounds required split skin
      grafts or soft-tissue local or microvascular free flaps. Stable fractures were
      reduced and immobilised in an above-knee plaster cast (71%) and external fixation
      (28%) was used for unstable fractures, extensive soft-tissue injury and multiple
      injuries. Short-term complications included compartment syndrome (4%),
      superficial infection (8%), deep infection (3%), delayed union (16%), nonunion
      (7.5%) and malunion (6.5%): these incidences are similar to those reported in
      adults. Selective primary closure of wounds did not increase the incidence of
      infection. External fixation was associated with a greater occurrence of delayed
      and nonunion than plaster immobilisation, but this technique was used most often
      for the more severe injuries. Late review, at 1.5 to 9.8 years, showed a high
      incidence of continuing morbidity including pain at the healed fracture site
      (50%), restriction of sporting activity (23%), joint stiffness (23%), cosmetic
      defects (23%) and minor leg-length discrepancies (64%). Open tibial fractures in
      children are associated with a high incidence of early and late complications,
      which are more frequent in children with Gustilo type III injuries. The Gustilo
      classification was a useful guide for predicting the outcome and planning
      treatment.

PMID- 1624515
TI  - Anterior column fractures of the acetabulum.
AB  - We retrospectively reviewed 20 patients at three to 19 years after displaced
      anterior fracture-dislocations of the hip. Eighteen of them were treated by
      traction, after ensuring that the femoral head was adequately reduced beneath the
      undisrupted part of the weight-bearing dome. Two required operation. Although
      none of the 18 conservatively treated fractures was reduced anatomically, the
      results were good in ten patients and excellent in the seven in whom the fracture
      did not involve the weight-bearing dome. We conclude that anterior column
      fractures have a favourable prognosis after conservative treatment.

PMID- 1624516
TI  - Locked nailing of humeral shaft fractures. Experience in Edinburgh over a two
      year period.
AB  - We report the results of locked Seidel nailing for 30 fractures of the humerus.
      There were frequent technical difficulties at operation especially with the
      locking mechanisms. Protrusion of the nail above the greater tuberosity occurred
      in 12 cases, usually due to inadequate locking, and resulted in shoulder pain and
      poor function. Poor shoulder function was also seen in five patients with no nail
      protrusion, presumably because of local rotator cuff damage during insertion. Our
      results suggest that considerable modifications are required to the nail, and
      possibly to its site of insertion, before its use can be advocated.

PMID- 1624517
TI  - Hyperextension-dislocation of the cervical spine. Ligament injuries demonstrated
      by magnetic resonance imaging.
AB  - We reviewed the magnetic resonance (MR) images of eight adults with acute
      hyperextension-dislocation of the cervical spine. The images were obtained to
      evaluate damage to the spinal cord. All eight patients had disruption of the
      anterior longitudinal ligament and of the annulus of the intervertebral disc, and
      separation of the posterior longitudinal ligament from the subjacent vertebra.
      Some, but not all, showed widening of the disc space, posterior bulging or
      herniation of the nucleus pulposus, and disruption of the ligamentum flavum. The
      MR demonstration of these ligament injuries, taken with the clinical and
      radiographic findings, establishes the mechanism of hyperextension-dislocation,
      confirms the diagnosis, and is relevant to management.

PMID- 1624518
TI  - Seat-belt injuries of the spine in young children.
AB  - Seat-belt fractures of the lumbar spine in adolescents and adults are well
      recognised but there are few reports of these injuries in young children. We
      reviewed all seat-belt injuries in skeletally immature patients (Risser 0), seen
      at a tertiary referral centre between 1974 and 1991. There were ten cases, eight
      girls and two boys, with an average age of 7.5 years (3 to 13). Four distinct
      patterns of injury were observed, most commonly at the L2 to L4 level.
      Paraplegia, which is thought to be uncommon, occurred in three of our ten cases.
      Four children had intra-abdominal injuries requiring laparotomy. There was a
      delay in diagnosis either of the spinal or of the intra-abdominal injury in five
      cases, although all had contusion of the abdominal wall, the 'seat-belt sign'.
      Treatment of the fractures was conservative, by bed rest and then hyperextension
      casts. The incidence of this potentially devastating injury can be reduced by the
      optimal use of restraints, but there is often a delay in diagnosis. Our
      classification system may aid in the early detection and evaluation of this
      injury.

PMID- 1624519
TI  - Neurofibromatosis of the cervical spine. A report of eight cases.
AB  - Eight patients with neurofibromatosis presented with symptoms of cervical spine
      involvement over a period of 17 years, five of them within the second decade of
      life. The symptoms included neurological deficit in five, a neck mass in four,
      and deformity in three; only two complained of pain. Osteolysis of vertebral
      bodies with kyphosis of more than 90 degrees was the most common radiological
      feature. Posterior fusion failed in the one patient in whom it was performed.
      Good results were achieved by anterior fusion, alone, or combined with posterior
      fusion. Surgical complications included one death in a patient with a malignant
      neurofibroma, and one case of transient neurological deterioration.

PMID- 1624520
TI  - Posterior fracture-dislocation of the shoulder. A superior subacromial approach
      for open reduction.
AB  - We describe 11 cases of posterior fracture-dislocation of the shoulder that
      required open reduction and fixation. Difficulties with access through anterior
      approaches led us to use the superior subacromial approach. This is an extension
      of the approach often used to expose the rotator cuff; the joint is opened by
      splitting the supraspinatus tendon 5 mm behind the cuff interval. The glenoid,
      proximal humerus and any fracture fragments can be seen from above, allowing
      reduction of the dislocation and osteosynthesis to be performed with minimal risk
      of damage to the humeral head and its blood supply. The proximity of the axillary
      nerve limits the exposure of the proximal humeral shaft. The superior subacromial
      approach is ideal for posterior dislocation with fracture of the articular
      segment, but is not suitable when there is a fracture of the proximal humeral
      shaft.

PMID- 1624521
TI  - The strength of surgical repairs of the rotator cuff. A biomechanical study on
      cadavers.
AB  - Using 26 cadaver shoulders, we produced a standard defect in the supraspinatus
      tendon and performed one of three types of repair. Their strength was found by
      testing in tension the force required to produce a gap of 3 mm, then 6 mm, and
      finally total disruption of the repair. The use of a polyethylene patch to spread
      the forces over the lateral bone surface and of extra sutures to grasp the tendon
      end raised by 2.6 times the load at which a 3 mm gap in the repair occurred and
      by 1.7 times the load to failure.

PMID- 1624522
TI  - Anatomy of the coraco-acromial arch. Relation to degeneration of the acromion.
AB  - We examined 200 scapular bones for signs of degenerative changes in the coraco
      acromial arch. The slope and length of the acromion and the height of the arch
      were found to be most closely associated with degenerative change. These
      anatomical features are not significantly altered by current techniques of
      subacromial decompression.

PMID- 1624523
TI  - Post-mortem description of slipped capital femoral epiphysis.
AB  - We found, in a museum collection of skeletons, nine adult hips with untreated
      slipped capital femoral epiphyses. All the specimens were from men, five black
      and two white. Their mean age at death was 44 years. Seven of the femora were
      retroverted beyond neutral and five had true varus deformities. Osteoarthritis
      was detected in eight of the hips and the most severe degeneration was seen in
      the most deformed hips. Radiography revealed that cysts which appeared to occupy
      the femoral head in fact lay in the metaphyseal bone of the femoral neck.

PMID- 1624524
TI  - Anterior cruciate ligament replacement with polyester fibre. A long-term study of
      tissue reactions and joint stability in sheep.
AB  - We excised the anterior cruciate ligament from the left stifle of 24 sheep and
      replaced it by a polyester fibre implant routed 'over the top' of the femoral
      condyle and fixed, using grommets and screws. All the joints were sound, and the
      animals moved normally until they were killed at six, 12 and 24 months after
      operation. We found that the implants were always covered by host tissue, which
      matured into bundles with a histological appearance similar to the natural
      ligament. The implants were joined to the bones by organised fibrous tissue and
      there was no anchorage loosening. There was no synovitis, but the operated joints
      showed progressive cartilage degeneration. The reconstructed joints became less
      stable immediately after operation, but regained normal stability as the
      neoligaments developed. The neoligaments lost strength with time, despite tissue
      ingrowth. The good functional, biomechanical, and histological results justify
      clinical trials of this type of implant.

PMID- 1624525
TI  - Magnetic resonance imaging of anterior cruciate ligament rupture. A new
      diagnostic sign.

PMID- 1624526
TI  - Fractures associated with patellar ligament grafts in cruciate ligament surgery.
AB  - We reviewed retrospectively 490 patellar ligament reconstructions for cruciate
      ligament injuries performed from 1980 to 1990. There were six cases of patellar
      splitting and three displaced patellar fractures in donor knees. The fissure
      fractures all occurred during the removal of the patellar bone block. The
      displaced fractures were sustained during early rehabilitation, and in two of the
      three patients, involved the normal contralateral knee. The major reasons for
      this complication were imprecise saw cuts, spreading osteotomies, and the use of
      a too large patellar bone block. When a trapezoidal bone block is used to self
      lock in the femoral tunnel, this should preferably be taken from the tibia.
      Special care is needed in rehabilitation when the graft has been taken from the
      contralateral knee.

PMID- 1624527
TI  - The ossific nuclei and the cartilage anlage of the talus and calcaneum.
AB  - We studied the ossific nuclei on radiographs of the feet of three stillborn
      infants, two with club feet, relating the size, position and alignment of each
      nucleus to the cartilaginous talus or calcaneum in which it lay. Anteroposterior
      projections of the nucleus of the talus show deformity of that bone as well as
      subtalar malalignment. Lateral projections of the calcaneal nucleus may
      underestimate the degree of hindfoot equinus.

PMID- 1624528
TI  - The innervation of vastus medialis obliquus.

PMID- 1624529
TI  - Cutting-out of the dynamic hip screw related to its position.

PMID- 1624530
TI  - Failure of growing endoprosthetic replacement of the humerus.

PMID- 1624531
TI  - Congenital elevation of the great toe.

PMID- 1624532
TI  - Aspiration and injection for meniscal cysts.

PMID- 1624533
TI  - Transgluteal fracture-dislocation of the hip.

PMID- 1624534
TI  - Pulsed electromagnetic fields.

PMID- 1624535
TI  - Rocking the foot.

PMID- 1624536
TI  - Porosis around prosthesis.

PMID- 1624537
TI  - Replacing the anterior cruciate ligament.

PMID- 1624538
TI  - Anterior cruciate reconstruction.

PMID- 1624540
TI  - Antiproliferative effects of free and liposome-encapsulated retinoic acid in a
      squamous carcinoma model: monolayer cells and multicellular tumor spheroids.
AB  - Antiproliferative effects of free retinoic acid (RA) and liposome-encapsulated RA
      (RAlp) were compared in a squamous carcinoma system using both monolayer cells
      and multicellular tumor spheroids (MTS), an in-vivo-like model with three
      dimensional histological structure. Initial studies examined the effect of lipid
      composition on the efficiency of RA encapsulation and on the subsequent toxicity
      of RAlp to red blood cells. In 5-day growth assays for monolayer cells, RA and
      RAlp (1 microM-0.1 nM) produced similar growth inhibition. In 6-day growth assays
      for MTS, RAlp was shown to have increased effectiveness. Liposomal uptake by the
      squamous carcinoma cells was examined by culturing monolayers and MTS with
      fluorescence-tagged liposomes and examining them under fluorescence microscopy
      between days 1 and 6. Phagocytosed liposomes were present, but their low levels
      suggested that other mechanisms of drug delivery such as adsorption, fusion or
      direct lipid transfer probably occurred for RAlp. Histological examination of MTS
      showed that RA and RAlp produced similar alterations. In this squamous carcinoma
      system, liposomes are effective in delivering retinoic acid and in producing
      biological effects in monolayer cells and within the three-dimensional structure
      of MTS.

PMID- 1624539
TI  - Fifty years of research on N-acetyl-2-aminofluorene, one of the most versatile
      compounds in experimental cancer research.
AB  - It is just about 50 years since the publication of the report on the toxicity and
      carcinogenicity of the potent carcinogen N-acetyl-2-aminofluorene (AAF). In 1940
      very few reports on the carcinogenic activity of chemical compounds in
      experimental animals were available. The discovery of pure chemicals as
      carcinogens, such as AAF, azo dyes and benzo[a]pyrene, provided cancer
      researchers with a number of tools whereby the progressive changes involved in
      the induction of cancer could be studied in experimental systems. Contrary to the
      results with other carcinogens then known, AAF induced numerous types of tumors,
      but not at the site of application. This finding stimulated a great deal of
      interest in its use as an experimental carcinogen to study its metabolic fate and
      mechanism of action. During the following years an ever increasing number of
      reports appeared on the carcinogenicity of AAF in various species, on its
      metabolic fate, on the interaction of reactive metabolites with nucleic acids and
      proteins, and on its mutagenic activity. Particularly studies on the metabolism
      of AAF and the interaction with nucleic acids have contributed appreciably to our
      understanding of the mechanism of action of aromatic amines and also of other
      chemical carcinogens. It can be expected that AAF and its derivatives will
      continue to be used for specific applications in experimental cancer research.
      One of the most recent achievements is the preparation of site-specific AAF- and
      aminofluorene-modified DNA sequences for mutagenesis studies.

PMID- 1624541
TI  - The prostacyclin analogue cicaprost inhibits metastasis of tumours of R 3327 MAT
      Lu prostate carcinoma and SMT 2A mammary carcinoma.
AB  - Investigations on mechanisms of metastatic tumour spread revealed a role for
      compounds that inhibit tumour dissemination at the time of hematogenous
      dissemination. The platelet aggregation inhibitor prostacyclin and its stable
      analogues were shown to inhibit tumour-cell-induced platelet interaction as well
      as tumour cell adhesive mechanisms. This study concentrates on the effect of the
      stable prostacyclin analogue cicaprost: 5-[(E)-(1S,5S,6S,7R)-7-hydroxy-6-[(3S,4S)
      3-hydroxy-4-methylnona-1 ,6- diinyl]-bicyclo[3,3,0]octan-3-ylidene]-3
      oxapentanoic acid (Schering AG), as cyclodextrin clathrate, on spontaneous tumour
      metastases of two different carcinomas of the rat. In Cop rats bearing
      spontaneously metastasizing R 3327 MAT Lu prostate carcinomas, cicaprost (1.0
      mg/kg p.o. daily) inhibited the number of lung metastases by about 80%, whereas
      the lower doses (0.1 and 0.5 mg/kg) exhibited borderline efficacy. In female
      Wistar-Furth rats bearing s.c. implanted SMT 2A mammary carcinomas, spontaneously
      metastasizing into regional lymph nodes and lungs, cicaprost (0.1, 0.5 and 1
      mg/kg) p.o. daily exhibited a dose-dependent inhibition of the number of lung
      metastases. Five out of ten animals treated by 1 mg/kg were free of visible lung
      metastases. The weight of the axillary lymph node was significantly reduced by
      the 1 mg/kg dose of cicaprost, whereas lower doses had no effect on the weight of
      the lymph nodes. The growth of the primary tumour was not influenced by cicaprost
      in the R 3327 MAT Lu prostate carcinoma nor in the SMT 2A mammary carcinoma in
      the dose range tested. In conclusion, the stable prostacyclin analogue cicaprost
      exhibits a strong antimetastatic action in two metastasizing tumours of the rat
      and interferes with the steps not only of haematogenous, but also of lymphogenous
      metastasis.

PMID- 1624542
TI  - A new concentrated perfluorochemical emulsion and carbogen breathing as an
      adjuvant to treatment with antitumor alkylating agents.
AB  - Many anticancer drugs require oxygen to be cytotoxic or are selectively cytotoxic
      toward cells under oxygenated conditions. The effects of the dilute
      perfluorochemical emuolsion Fluosol with a wide variety of chemotherapeutic
      agents have been explored; however, it has not been possible to determine the
      optimal level of circulating perfluorochemical emulsion with anticancer drugs
      because the volume of Fluosol that may be administered is limiting. Using a new
      concentrated perfluorochemical emulsion, a wide range of perfluorochemical doses
      has been examined in combination with melphalan, cyclophosphamide and 1,3-bis(2
      chloroethyl)-1-nitrosourea (BCNU) in the FSaIIC fibrosarcoma. When the
      perfluorochemical emulsion was administered by injection i.v. just prior to the
      injection of melphalan (10 mg/kg), cyclophosphamide (150 mg/kg) or BCNU (50
      mg/kg), the greatest tumor growth delays were obtained with dosage levels between
      4 g and 12 g of the perfluorochemical perfluorooctyl bromide/kg. With each drug
      the greatest tumor growth delays were obtained when the drug was prepared in the
      emulsion and the combination injected i.v. In each case, each dose of drug was
      followed by 6 h of breathing carbogen. The addition of the perfluorochemical
      emulsion/carbogen breathing to treatment with melphalan, BCNU or cyclophosphamide
      resulted in significant increases in the killing of tumor cells by these drugs
      without a concomitant increase in toxicity to bone marrow granulocyte/macrophage
      colony-forming units. In each case, preparing the drug in the perfluorochemical
      emulsion was most effective. These results indicate that clinical trial of this
      perfluorochemical emulsion/carbogen breathing in combination with cancer
      chemotherapy may be warranted.

PMID- 1624543
TI  - Spectrum of cell-cycle kinetics of alkylating agent adolezesin in gynecological
      cancer cell lines: correlation with drug-induced cytotoxicity.
AB  - Adolezesin is an analog of CC-1065. These compounds are among the most potent
      alkylating agents known to date. Currently Adolezesin is undergoing phase I
      clinical trials at several cancer centers in the USA. While the cytotoxic effects
      of Adolezesin have been addressed elsewhere, its effects on cell-cycle kinetics
      have not been reported. Flow cytometry was performed on five human gynecological
      cancer cell lines: AN3, AE7, BG1, HEC1A, and SKUT1B. Exposure to Adolezesin
      (U73975, Upjohn Co.) was done at near confluency at 0, 0.1, 0.2, 0.5, 1 and 5x,
      with x = 10 pg/ml as reference concentration, for 90 min. Cell samples were taken
      by trypsinization at 0, 24, 48, 72, 96, and 168 h for flow cytometry. The ATP
      chemosensitivity assays were performed on the above cell lines to establish
      dose/response curves. Flow-cytometric analyses revealed that there was a spectrum
      of cell-cycle perturbations, which included biphasic S and G2 blocks, reverse
      dose-dependent G2 blocks, and a sequential relationship of S and G2 blocks. This
      study demonstrated that the cell kinetic response to Adolezesin depended on
      several variables such as cell lines, drug sensitivity, concentrations, and
      sampling time. Because of this multivariable dependence and the lack of
      correlation with cytotoxicity, it would be difficult to use cell kinetic
      pertubations to predict chemotherapeutic response.

PMID- 1624544
TI  - Laser Doppler flux and tissue oxygenation of experimental tumours upon local
      hyperthermia and/or hyperglycaemia.
AB  - Laser Doppler fluxmetry and oxygen partial pressure (pO2) histography have been
      applied to investigate the acute effects of hyperthermia (HT) and/or
      hyperglycaemia (HG) on microcirculatory function and tissue oxygenation of
      subcutaneous rat tumours growing on the dorsum of the hind foot. The experiments
      were performed to test whether, and to what extent, the two adjunct treatment
      modalities applied alone or in combination can modify these therapeutically
      relevant parameters. Local HT was performed in a saline bath (44 degrees C) for 2
      h; HG was induced by i.v. infusion of 40% glucose solution for 2.5 h (blood
      glucose levels: 35-40 mM during heating). Laser Doppler flux (LDF) in superficial
      tumour tissue regions was recorded over the entire treatment period; tumour pO2
      distribution was evaluated immediately after termination of the treatment. HG
      alone reduced the average LDF signal to 18% of the baseline reading before
      treatment, but did not influence the tumour oxygenation status and the proportion
      of pO2 readings occurring in the radiobiologically hypoxic class (pO2 = O-2.5 mm
      Hg). This phenomenon is most probably due to the occurrence of the Crabtree
      effect (reduction of the O2 consumption rate when excess glucose is available
      within a malignant tumour). Hyperthermia alone reduced LDF to approximately the
      same extent, and led to a rise in the number of pO2 readings in the hypoxic range
      with only minor changes in the average pO2. The combined treatment (HT/HG)
      neither increased the fraction of "hypoxic" pO2 readings nor intensified the flow
      drop already present at the end of the tumour heating. It is thus concluded that
      under hyperglycaemia the oxygenation status of normothermic and heated tumours is
      maintained. It may therefore be hypothesized that hyperthermia in conjunction
      with hyperglycaemia might be a better "radiosensitizer" than hyperthermia alone.

PMID- 1624546
TI  - Central nervous system metastases in breast cancer.
AB  - Sixty-two breast cancer patients with central nervous system (CNS) metastases
      were reviewed. The CNS was the first site of metastatic involvement in 38 cases
      (61%). The median survival from the primary diagnosis was 3.0 years; from the
      diagnosis of the CNS metastasis, 6 months. The interval between primary diagnosis
      and CNS metastasis had a median value of 2.0 years; between the initial extra
      cranial metastasis and CNS metastasis this was 0.9 years. Prognostic factors for
      the appearance of CNS metastasis could not be identified. Subsequent to CNS
      metastasis appearing, the well-known prognostic factors for the survival time and
      the metastasis-free interval lose their importance. Brain metastases occur, above
      all, in patients aged between 50 and 55 years, very often in the first 2.5 years
      after the first distant metastasis and not later than 10 years from the primary
      diagnosis.

PMID- 1624545
TI  - Growth-stimulating phase of macrophage response to activation: the phenomenon and
      its implications for tumour growth and immunotherapy.
AB  - The dynamics of growth-stimulating and cytotoxic activity of mouse peritoneal
      macrophages (PMo) in response to in vivo and in vitro bacillus Calmette-Guerin
      (BCG) or bestatin treatment was studied. It was shown that BCG and bestatin
      induce cytotoxicity in PMo, and that after the cytotoxic response strong growth
      stimulating activity develops. PMo, rendered cytotoxic in vivo and afterwards
      cultivated in vitro, displayed the same switch from a cytotoxic to a growth
      stimulating phase. These results suggest that the growth-stimulating phase is the
      obligatory PMo response to biological response modifiers (BRM) at least to BCG
      and bestatin. The growth rate of tumours, transplanted into mice during the
      cytotoxic phase of the response to BCG, was suppressed, whereas tumours
      transplanted during the growth-stimulating phase were stimulated. It appears that
      the development of a growth-stimulating phase after the cytotoxic phase of
      response to activation by BRM could be one of the reasons for the limited
      effectiveness of immunotherapy based on the application of macrophage activators.

PMID- 1624547
TI  - Efficacy of cisplatin-based intraperitoneal chemotherapy as treatment of
      malignant peritoneal mesothelioma.
AB  - In an effort to examine the potential clinical utility of intraperitoneal (i.p.)
      therapy in the management of patients with malignant peritoneal mesothelioma, 19
      individuals with this disease were treated with a cisplatin-based i.p. treatment
      regimen. All but 1 patient also received i.p. mitomycin. The treatment was
      generally well tolerated, although a maximum of only four or five courses of
      cisplatin (100 mg/m2 every 28 days) and mitomycin (5-10 mg/treatment given 7 days
      after each i.p. cisplatin administration) could be administered, the treatment
      principally being stopped because of disease progression or catheter failure. Of
      15 patients with malignant ascites, 7 (47%) experienced control of fluid
      reaccumulation ranging from 2 months to 73+ months (median 8 months). While the
      median survival for the 19 patients was only 9 months, 4 (21%) patients survived
      for more than 3 years from the initiation of therapy, and 2 patients are
      currently alive and clinically disease-free more than 5 years from the start of
      the i.p. treatment program. We conclude that a subset of patients with peritoneal
      mesothelioma, principally those with small-volume residual disease following
      surgical tumor debulking, can benefit from a cisplatin-based i.p. treatment
      strategy with control of ascites and prolonged disease-free survival.

PMID- 1624548
TI  - Sarcoma of the pulmonary artery: report of two cases and a review of the
      literature.
AB  - Primary tumours of the pulmonary arteries are rare neoplasms seldom diagnosed
      during the patient's life time. We report on two cases of pulmonary artery
      sarcomas diagnosed during life time of the respective patients in intra-operative
      frozen sections by histopathological examination. Case 1 was of a 55-year-old man
      with a fibrosarcoma originating from the main pulmonary trunk. Case 2 was of a 43
      year-old woman with a malignant fibrous histiocytoma originating from the right
      pulmonary artery. In both patients a radical tumour resection under
      cardiopulmonary bypass was attempted. Both patients, however, had a local tumour
      recurrence and died 18 months (patient 1) and 6 months (patient 2) after surgery.
      A review of pulmonary artery sarcomas is given.

PMID- 1624549
TI  - Clinical neuropsychology: 1960-1990.
AB  - Clinical neuropsychology has made significant progress during the past 30 years.
      Practice and research have expanded remarkably in scope and are more incisive and
      more highly focused. There has been an explosive development of test methods but
      clinical neuropsychologists have yet to take full advantage of them. An effort
      should be made to combine the strengths of the "fixed battery" and "flexible"
      approaches to assessment. Further advances in neuropsychological assessment will
      come about only to the degree that they are linked to evolving concepts of brain
      behavior relationships. Neuropsychologists now require a deeper understanding of
      basic neuroscience and cognitive psychology than was true in the past. Steps
      should be taken to insure that training to achieve that understanding is provided
      to the upcoming generation of neuropsychologists.

PMID- 1624550
TI  - Truth in labeling: are we really an international society?

PMID- 1624551
TI  - Detection of Babesia bovis carrier cattle by using polymerase chain reaction
      amplification of parasite DNA.
AB  - Carrier cattle infected with Babesia bovis are difficult to detect because of the
      low numbers of parasites that occur in peripheral blood. However, diagnosis of
      low-level infections with the parasite is important for evaluating the efficacies
      of vaccines and in transmission and epidemiological studies. We used the
      polymerase chain reaction (PCR) to amplify a portion of the apocytochrome b gene
      from the parasite and tested the ability of this method to detect carrier cattle.
      The target sequence is associated with a 7.4-kb DNA element in undigested B.
      bovis genomic DNA (as shown previously), and the amplified product was detected
      by Southern and dot blot hybridization. The assay was specific for B. bovis,
      since no amplification was detected with Babesia bigemina, Trypanosoma brucei,
      Anaplasma marginale, or leukocyte DNA. The target sequence was amplified in DNA
      from B. bovis Mexico, Texas, and Australia S and L strains, demonstrating the
      applicability of the method to strains from different geographic regions. The
      sensitivity of the method ranged from 1 to 10 infected erythrocytes extracted
      from 0.5 ml of blood. This sensitivity was about 1,000 times greater than that
      from the use of unamplified parasite DNA. By the PCR method, six B. bovis carrier
      cattle were detected 86% of the time (range, 66 to 100%) when they were tested 11
      times, while with microscopic examination of thick blood smears, the same carrier
      cattle were detected only 36% of the time (range, 17 to 66%). The method provides
      a useful diagnostic tool for detecting B. bovis carrier cattle, and the
      sensitivity is significantly improved over that of current methods. The results
      also suggest that characteristics of the apocytchrome b gene may make this a
      valuable target DNA for PCR-based detection of other hemoparasites.

PMID- 1624553
TI  - Factors influencing the infectivity of Chlamydia pneumoniae elementary bodies on
      HL cells.
AB  - The influence of variations in the pH, NaCl concentration, temperature, and
      concentrations of calcium and magnesium ions on the survival of Chlamydia
      pneumoniae elementary bodies (EBs) outside the host cells was investigated. The
      survival was determined after various incubation periods by counting the
      inclusion-forming units after C. pneumoniae was cultured for 72 h on monolayers
      of HL cells. The normal physiological conditions were restored prior to infecting
      the HL cells with C. pneumoniae. Declines in the infectivities of C. pneumoniae
      EBs were observed at pH values of lower than 5 and higher than 8 or at NaCl
      concentrations of less than 80 mM. The viability of C. pneumoniae EBs in SPG
      medium decreased as the temperature and/or incubation period increased.
      Incubation temperatures of up to 20 degrees C and incubation periods of up to 48
      h did not affect the viability of C. pneumoniae. One hundred percent of the C.
      pneumoniae EBs were infective after 1 h of incubation at 35 degrees C, whereas
      90, 50, and 40% survived after incubations of 8, 24, and 48 h, respectively. The
      viability of C. pneumoniae was unaffected within the investigated range of Ca2+
      and Mg2+ ion concentrations in the medium. The presence of 10% fetal calf serum
      in the incubation medium had a stabilizing effect on the viability of C.
      pneumoniae. This effect became more pronounced as the incubation period
      increased.

PMID- 1624552
TI  - Detection of antibodies inhibiting the ADP-ribosyltransferase activity of
      pertussis toxin in human serum.
AB  - Bordetella pertussis produces a protein virulence factor termed pertussis toxin.
      Many candidate pertussis vaccines are based on the rationale that an immune
      response that neutralizes the virulence activities of this toxin, which are
      thought to arise from its catalytic ADP-ribosyltransferase activity, would be
      beneficial. The report describes two methods that quantify the inhibition of this
      activity by human serum. One, termed a direct assay, involves an initial
      incubation of toxin with serum, a second incubation that activates the toxin, and
      a third incubation that measures the ADP-ribosyltransferase activity of the
      mixture. The other assay, termed a plate assay, involves immobilization of the
      toxin, exposure of the immobilized toxin to serum and washing of the plate, and
      then activation and assay of the toxin's ADP-ribosyltransferase activity. The
      plate assay may be more selective than the direct assay in terms of identifying
      antibodies that neutralize the toxin in vivo. Sera from controls, selected
      patients presenting with cough, and vaccinated infants were first analyzed by the
      direct assay. In contrast to sera from controls, sera from several of the
      patients and vaccinated infants strongly inhibited activity. Dose-response curves
      of inhibition were determined for samples from three vaccinated infants by both
      the direct and plate assays. One of the samples had a dose-response curve of a
      different shape and thus differed not only in titer but also in functional
      characteristics. A comparison of inhibition of ADP-ribosyltransferase activity
      and neutralization in a CHO cell assay indicated that there was incomplete
      agreement between the two assays. Taken together, these results indicate that
      measurement of inhibition of ADP-ribosyltransferase activity by human serum is
      practical and may be useful in the evaluation of responses to pertussis vaccines.

PMID- 1624554
TI  - Characterization of Pasteurella multocida from nasal cavities of piglets from
      farms with or without atrophic rhinitis.
AB  - A total of 137 strains of Pasteurella multocida isolated from the nasal tracts of
      pigs with and without clinical atrophic rhinitis (AR) were studied for their
      biochemical, antigenic, and toxigenic characteristics. There were no major
      biochemical differences among the P. multocida isolates. Capsular antigen types A
      and D were both present in the nasal cavities of the pigs with or without
      clinical AR. However, the prevalence of type D was higher on farms with pigs with
      AR. Types A and D with different somatic antigens could both be present in the
      same pig. There was no correlation between somatic types and/or capsular types
      with the clinical AR status of the pigs on the farm. Toxigenic isolates were
      found only in pigs which had a problem of clinical AR, and a great majority of
      these isolates belonged to type D. Since there was a high level of heterogeneity
      of the strains in the P. multocida population on a farm, several strains should
      be characterized before the diagnosis of AR could be excluded on the basis of the
      absence of isolation of rhinopathogenic P. multocida strains.

PMID- 1624555
TI  - Fluorogenic substrates for differentiation of gram-negative nonfermentative and
      oxidase-positive fermentative bacteria.
AB  - A total of 803 strains of gram-negative nonfermentative and oxidase-positive
      fermentative bacteria (38 taxa) were investigated for their ability to hydrolyze
      53 different fluorogenic 4-methylumbelliferyl- and beta-naphthylamide-linked
      substrates within 6 h of incubation. The hydrolysis of 16 fluorogenic substrates
      showed high separation index values among the tested taxa, was reproducible, and
      showed good agreement with data in the literature. In combination with other
      biochemical tests (like carbon substrate utilization tests and classical
      biochemical tests), hydrolysis profiles can improve the differentiation of gram
      negative nonfermentative and oxidase-positive fermentative bacteria.

PMID- 1624557
TI  - Development and application of a new scheme of phages for typing and
      differentiating Salmonella strains from different sources.
AB  - A set of 25 phages for typing and differentiating Salmonella strains from
      different origins (food, water, and disease outbreaks) is described. All the
      strains were typeable by use of the phages, whereas by the serological method
      more than 5% of the strains could not be classified. By using the phage typing
      scheme, 75 phage types were established, and all the results were reproducible 1
      and 6 months later. Some phages were serotype and serogroup specific, which may
      be useful in additional tests for the identification of strains of some
      Salmonella serotypes. In addition, the strains responsible for an outbreak
      possessed the same phage type, which implies the potential epidemiological use of
      these phages.

PMID- 1624556
TI  - High-performance liquid chromatography of corynomycolic acids as a tool in
      identification of Corynebacterium species and related organisms.
AB  - A high-performance liquid chromatography (HPLC) study of 307 strains of
      Corynebacterium species and related taxa revealed that strains classified as
      "Corynebacterium aquaticum"; "Corynebacterium asperum"; and Centers for Disease
      Control (CDC) groups 1, 2, A-3, A-4, A-5, B-1, B-3, E, F-2, and I-2 as well as
      some unidentified coryneforms do not contain any corynomycolic acids; therefore,
      they should not be included in the genus Corynebacterium. Such an HPLC method of
      identification permitted the correct assignment to the genus Rhodococcus of two
      unpigmented strains of coryneform bacteria whose mycolic acid profiles were
      comparable to those of Rhodococcus equi. Bacteria belonging to CDC groups ANF-1,
      ANF-3, F-1, G-1, G-2, and I-1, as well as some other Corynebacterium sp. strains,
      yielded corynomycolic acid HPLC patterns related to those of Corynebacterium
      species. Either similarities or differences were observed in the corynomycolic
      acid profiles of Corynebacterium species tested after culture on sheep blood agar
      and/or sheep blood agar supplemented with Tween 80, which demonstrated that
      identification at the species or group level is possible. However,
      Corynebacterium striatum and CDC group I-1 bacteria as well as CDC group G-1 and
      group G-2 bacteria had indistinguishable HPLC patterns. Conversely, some
      variations were observed within some species as Corynebacterium xerosis, C.
      striatum, and Corynebacterium minutissimum. The evaluation procedure of this HPLC
      method by mass spectrometry analysis of isolated eluted peaks revealed that
      analytical reverse-phase HPLC alone does not provide any structural information,
      since isomers with identical polarities coeluted as a single peak. Nevertheless,
      HPLC is a rapid and reliable method for identification of corynomycolic acid
      containing bacteria in the clinical microbiological laboratory.

PMID- 1624558
TI  - Method for detection of simian immunodeficiency virus neutralizing antibodies
      using a noncommercial antigen capture enzyme-linked immunosorbent assay.
AB  - A neutralization test (NT) using a noncommercial antigen capture enzyme-linked
      immunosorbent assay (ELISA) to detect simian immunodeficiency virus (SIV) growth
      in vitro was developed. The capture antibody was a mixture of purified macaque
      anti-SIV immunoglobulin G (IgG) and a monoclonal antibody to SIV p27. Captured
      antigens were detected by using purified macaque anti-SIV IgG conjugated to
      horseradish peroxidase. The NT reliably and sensitively detected differences when
      various amounts of SIV were used with positive and negative control macaque sera.
      Dilutions of sequential sera from a macaque (Macaca nemestrina) that had been
      experimentally infected with SIV were tested for neutralizing antibody with 300
      50% tissue culture infective doses of SIV. In this macaque, neutralizing activity
      and anti-SIV IgG levels in serum (detected by ELISA) increased with time after
      SIV inoculation, and high IgG titers were required in serum before neutralization
      occurred in vitro. This simple NT, which detects the presence of SIV serum
      neutralizing antibodies at a low cost, will be useful for investigating the role
      of neutralizing antibodies in the SIV-infected macaque model for AIDS.

PMID- 1624559
TI  - Molecular epidemiology of trimethoprim-resistant Shigella boydii serotype 2
      strains from Bulgaria.
AB  - In 1990 an increased number of strains of Shigella boydii serotype 2 were
      isolated from different regions of Bulgaria. Strains were reported as sporadic,
      although they showed identical phenotypic characteristics, including resistance
      to ampicillin, carbenicillin, streptomycin, sulfonamide, tetracycline,
      ticarcillin, and trimethoprim. The objective of this study was to determine the
      genetic relatedness of the strains and the mechanism of their antimicrobial
      resistance. Plasmid fingerprinting showed an identical pattern for 23 of 25 of
      the selected strains. All 25 strains tested transferred their resistances en bloc
      to an Escherichia coli recipient. Transconjugants contained a 112-kb R plasmid
      which carried all the resistance genes, including that conferring type I
      dihydrofolate reductase-mediated trimethoprim resistance (MIC greater than 2,000
      micrograms/ml). Riboprobe analysis showed identical restriction length fragment
      polymorphisms, suggesting a highly conserved genome. All findings indicate that
      strains of S. boydii serotype 2 isolated in 1990 from different regions of
      Bulgaria were highly related genetically and can be considered representatives of
      a single bacterial clone. The presence of an R plasmid and selection pressure
      because of the usage of antimicrobial agents, particularly trimethoprim, have
      likely facilitated the spread of the clone throughout the country.

PMID- 1624560
TI  - Improved serological diagnosis of Toxoplasma gondii infection by detection of
      immunoglobulin A (IgA) and IgM antibodies against P30 by using the immunoblot
      technique.
AB  - Immunoglobulin M (IgM) and IgA antibodies against the major surface protein of
      Toxoplasma gondii were determined in a total of 195 human sera and five human
      cerebrospinal fluids by using a P30 membrane extract and the immunoblot
      technique. By using two different T. gondii strains (RH and BK) simultaneously as
      antigens, we were able to demonstrate diagnostically important strain-specific
      human antibody responses in 4.5% of the samples tested. A comparison of the
      immunoblot technique with an IgM immunocapture enzyme-linked immunosorbent assay
      demonstrated that the IgM and IgA immunoblot seems to be of advantage in the
      diagnosis of acute toxoplasmosis in certain groups of patients, especially in the
      diagnosis of cerebral toxoplasmosis in patients with AIDS. The immunoblot
      technique described is easy to perform and might be useful as an additional
      serological assay for routine diagnosis of T. gondii infections.

PMID- 1624561
TI  - Antibodies to Borrelia burgdorferi in rodents in the eastern and southern United
      States.
AB  - Serologic studies were conducted to determine whether white-footed mice
      (Peromyscus leucopus) and cotton mice (Peromyscus gossypinus) contained serum
      antibodies to Borrelia burgdorferi, the causative agent of Lyme borreliosis.
      Enzyme-linked immunosorbent assays detected antibodies to this spirochete in 35.7
      and 27.3% of 56 P. leucopus and 535 P. gossypinus serum samples, respectively,
      collected in Connecticut, North Carolina, South Carolina, Georgia, Florida,
      Alabama, and Mississippi. Antibody titers ranged from 1:160 to greater than or
      equal to 1:40,960. On the basis of adsorption tests, the antibodies detected
      appeared to be specific to Borrelia spirochetes. Seropositive rodents in the
      eastern and southern United States, areas where human cases of Lyme borreliosis
      have been reported, indicate a widespread geographic distribution of B.
      burgdorferi or a closely related spirochete.

PMID- 1624562
TI  - Optimal survival of Helicobacter pylori under various transport conditions.
AB  - The ability of clinical isolates and type strains of Helicobacter pylori to
      survive in Stuart transport medium, isotonic saline solution, and urea-containing
      isotonic saline was evaluated. The influences of temperature (4, 10, 15, 20, and
      30 degrees C) and holding time (6 to 48 h) and the effect of exposure to air on
      survival were also studied. The recovery rate of H. pylori was highest from
      Stuart transport medium in comparison with the recoveries from the other
      transport media tested. We found that at holding temperatures above 15 degrees C
      the organisms became noncultivable within 6 h or less, while they survived for 2
      days or longer at 10 degrees C. The presence of urea at a concentration of 2%
      (wt/vol) in isotonic saline resulted in the loss of viability of the organisms
      tested.

PMID- 1624563
TI  - Detection of borreliacidal antibodies in hamsters by using flow cytometry.
AB  - Flow cytometry can be used to detect antibody that kills Borrelia burgdorferi.
      Borreliacidal activity was detected within 3 h of incubating B. burgdorferi with
      immune serum and complement. Right-angle light scatter and propidium iodide
      fluorescence were the cytometric parameters which correlated best with in vitro
      killing of B. burgdorferi. Flow cytometry is a rapid method for determining the
      presence of borreliacidal activity and may lead to a better serodiagnostic test
      for the detection of Lyme disease.

PMID- 1624564
TI  - Critical assessment of blood culture techniques: analysis of recovery of obligate
      and facultative anaerobes, strict aerobic bacteria, and fungi in aerobic and
      anaerobic blood culture bottles.
AB  - Recent reports have documented a decrease in anaerobic bacteremias and have
      questioned the need for routine anaerobic blood cultures. At the same time, we
      and others have noted an increase in fungal bloodstream infections. In this two
      part study, we first compared recoveries of obligate anaerobic bacteria with
      those of fungi over a 13-year period and then examined the recoveries of all
      bacteria and fungi in aerobic and anaerobic blood culture bottles during a 12
      month period. During the 13-year period, the number of patients with anaerobic
      bacteremia remained relatively constant (average, 39 patients per year), while
      the incidence of fungemia steadily increased, from 12 patients in 1978 to 117
      patients in 1990. Of the 1,090 anaerobic isolates, 55.1 and 90.2% were recovered
      in aerobic and anaerobic bottles, respectively, compared with 98.6 and 37.0% of
      the 2,582 fungi. During the 12-month period of evaluation, 2,980 bacteria and
      fungi were recovered in cultures collected from 1,555 patients. Overall, 21.1%
      more organisms were recovered in aerobic bottles than in anaerobic bottles,
      including significantly more Staphylococcus species; gram-positive aerobic
      bacilli; Escherichia, Enterobacter, Pseudomonas, Xanthomonas, and Acinetobacter
      species; miscellaneous gram-negative bacilli; and yeasts. Only anaerobic gram
      negative bacilli and non-spore-forming gram-positive bacilli were isolated more
      commonly in anaerobic bottles. These data support the concepts that bacteremia
      caused by obligate anaerobic bacteria is decreasing relative to sepsis caused by
      other bacteria and fungi and that the routine use of unvented anaerobic blood
      culture bottles reduces the recovery of common aerobic bloodstream pathogens.

PMID- 1624565
TI  - Tracking laboratory contamination by using a Bacillus cereus pseudoepidemic as an
      example.
AB  - From 1 March to 31 May 1990, Bacillus cereus was recovered from 24 of 5,534
      (0.49%) blood cultures and 22 of 1,088 (2.02%) other body fluid cultures. The
      rarity of this organism as a pathogen and comparison with previous baseline rates
      led to the conclusion that it was a pseudoepidemic involving some form of culture
      contamination. Generalized precautions taken without specific knowledge of the
      contaminant source reduced the recovery rate of the organism. Recovery rates for
      the organism returned to normal baseline prevalence after environmental cultures
      and epidemiological analysis led to the sterilization of a contaminated water
      bath used for boiling thioglycollate media. The problems encountered in this
      investigation are examined, and a systematic approach to clinical laboratory
      epidemiology is outlined.

PMID- 1624566
TI  - Characterization of isolates of Mycobacterium avium serotypes 4 and 8 from
      patients with AIDS by multilocus enzyme electrophoresis.
AB  - Isolates of Mycobacterium avium serotypes 4 and 8 originating from patients with
      AIDS in New York City, Los Angeles, or San Francisco were further characterized
      by multilocus enzyme electrophoresis. Reference strains used to produce typing
      antisera were also examined. Thirty-one electrophoretic types (ETs) were found
      among 58 isolates of serotype 4, while 10 ETs were identified among 21 isolates
      of serotype 8. One major ET was found within each serotype, and these two ETs
      were closely related, separated by a genetic distance of only 0.05. Six ETs were
      found in more than one city. In four cases, isolates of serotypes 4 and 8 shared
      the same ET. Multilocus enzyme electrophoresis in combination with serotyping
      should be helpful in locating the specific infection sources of these commonly
      isolated opportunistic pathogens.

PMID- 1624567
TI  - Immunoglobulin G antibody avidity in patients with respiratory syncytial virus
      infection.
AB  - The titer and avidity of respiratory syncytial virus-specific antibodies were
      measured in 196 serum specimens from 93 children with an acute, laboratory
      confirmed respiratory syncytial virus infection. An enzyme immunoassay method
      based on the ability of urea to dissociate the bound antibodies with low avidity
      from the antigen was used. Three patterns of immune responses were observed.
      Children less than 6 months of age usually had low titers of antibodies with high
      avidity in their acute-phase serum samples. These antibodies were concluded to be
      of maternal origin, since their reaction pattern was similar to that of healthy
      adults. During the next few weeks, a slight increase in titers with a concurrent
      decrease in antibody avidity was observed. All children 6 to 24 months of age had
      low-avidity antibodies in their acute-phase serum samples, which matured to high
      avidity during the follow-up. On the contrary, about half of the children greater
      than 24 months of age had high-avidity antibodies already in the acute-phase
      serum samples. We conclude that the former children were experiencing primary
      infections with respiratory syncytial virus and the latter were experiencing
      reinfections. All adults with remote immunity had antibodies with high avidity.

PMID- 1624568
TI  - Enzyme immunoassay for detection of immunoglobulin G (IgG), IgM, and IgA
      antibodies against type 6B pneumococcal capsular polysaccharide and cell wall C
      polysaccharide in chinchilla serum.
AB  - Conjugation of the capsular polysaccharides of Streptococcus pneumoniae to
      protein carriers has introduced a new generation of pneumococcal vaccines which
      may be efficacious in preventing pneumococcal otitis media during infancy. The
      chinchilla model has been used extensively for studying the pathogenesis of
      pneumococcal otitis media and for testing the efficacy of early pneumococcal
      capsular polysaccharide (PCP) vaccines, but immunologic studies in the chinchilla
      have been limited by the lack of antibodies against specific immunoglobulin
      isotypes. By using affinity-purified rabbit immunoglobulin G (IgG) anti
      chinchilla IgG, IgM, and IgA, we developed a sensitive enzyme immunoassay that is
      highly specific for IgG, IgM, and IgA antibodies against type 6B PCP (anti-6B)
      and against C polysaccharide in chinchilla serum. Antibody titers increased in
      serum from five chinchillas immunized with a type 6B outer membrane protein
      complex vaccine. Increases of anti-6B IgG and IgM antibody titers were more
      striking than increases of anti-6B IgA or anti-C polysaccharide IgG, IgM, or IgA
      titers were.

PMID- 1624569
TI  - Rapid diagnosis of respiratory viral infections by using a shell vial assay and
      monoclonal antibody pool.
AB  - We compared the detection of seven respiratory viruses by using a commercially
      available monoclonal antibody pool in a 2-day shell vial assay with that by using
      standard cell culture with respiratory syncytial virus (RSV) enzyme-linked
      immunosorbent assay (ELISA)-negative nasal secretions from hospitalized children.
      We found 179 respiratory virus isolates by either method in 675 specimens.
      Overall, the shell vial assay detected 147 of 179 (79%) of the positives after 2
      days; cell culture detected 148 of 179 (80%) after a mean incubation period of
      7.6 days (range, 1 to 14 days). The sensitivity of the shell vial assay was 78%
      for RSV, 94% for influenza B virus, 83% for adenovirus, and 80% for parainfluenza
      viruses. The sensitivity of the cell culture was 70% for RSV, 79% for influenza B
      virus, 90% for adenovirus, and 89% for parainfluenza viruses. The 2-day shell
      vial assay allowed the detection of respiratory viruses in a clinically relevant
      time frame and rapidly detected RSV in specimens lacking RSV antigen by ELISA.

PMID- 1624570
TI  - Purification of sputum samples through sucrose improves detection of
      Mycobacterium tuberculosis by polymerase chain reaction.
AB  - A method is described for the routine preparation of sputum samples for detection
      of Mycobacterium tuberculosis by using polymerase chain reaction amplification.
      Liquefaction of sputum samples with NaOH and subsequent removal of inhibitors of
      the polymerase reaction with a 50% sucrose centrifugation step (5 min) in a
      desktop centrifuge allow direct amplification of a 123-bp repetitive region of
      the M. tuberculosis genome. We have evaluated the sensitivity and specificity of
      the sucrose method with 155 sputum specimens from patients suspected of having
      tuberculosis and from normal healthy volunteers. This method, in our opinion, is
      reproducible, sensitive, and reliable. Multiple samples can be handled
      simultaneously, and results can be obtained in one working day.

PMID- 1624571
TI  - Evaluation of the performance of commercial test kits for detection of
      Helicobacter pylori antibodies in serum.
AB  - We have compared the sensitivities, specificities, and predictive values of three
      commercial serological assays for the diagnosis of Helicobacter pylori infection.
      A qualitative latex method (Pyloriset; Orion Diagnostics), a semiquantitative
      enzyme-linked immunosorbent assay (ELISA) (GAP test IgG; Bio-Rad), and a
      quantiative ELISA (Helico-G; Porton Cambridge) were used in 109 untreated
      dyspeptic patients. The presence of H. pylori was established when the results of
      culture and/or histology of the gastric biopsies taken were positive. The
      prevalence of H. pylori infection was 62% (52% in 42 patients younger than 45
      years of age and 69% in 67 patients older than 45 years of age). Sensitivities
      and specificities were 68 and 76% for Pyloriset, 89 and 77% for GAP test IgG, and
      82 and 83% for Helico-G. The positive predictive values for all three tests were
      between 85 and 90%. The predictive values for the absence of disease with a
      negative result were 62, 82, and 74% for Pyloriset, the GAP test, and Helico-G,
      respectively. With Helico-G in the younger group (less than 45 years),
      sensitivity significantly lower (71 versus 87%) and a positive predictive value
      lower than those for the older group (greater than 45 years) were found. Either
      the sensitivities and specificities of commercial methods for the measurement of
      antibodies to H. pylori in serum must be improved or the relationship between the
      presence of antibodies and the presence of bacteria in the stomach at the time of
      investigation is too weak to allow the use of serological techniques instead of
      culture and histological investigation of gastric biopsy material.

PMID- 1624572
TI  - National hospital survey of anaerobic culture and susceptibility testing methods:
      results and recommendations for improvement.
AB  - The methods for performing anaerobic bacterial isolation and identification
      continue to change and improve. Anaerobic susceptibility testing has become
      controversial, and method-dependent variability has been noted. To assess the
      status of clinical anaerobic bacteriology in the United States, we surveyed, by
      means of a questionnaire, 120 hospitals, selected at random, with bed capacities
      of 200 to 1,000, and we received responses from 88 (73%). All hospitals performed
      cultures for anaerobes. The media and methods used for transport, initial
      processing, incubation, and identification varies between the different regions
      in the United States. Thirty percent of laboratories did not perform
      susceptibility studies, 16% used a reference laboratory, and 54% performed them
      in house. For half the laboratories, susceptibility testing was performed on
      isolates depending on the source; in this case, blood cultures were tested by 97%
      of the laboratories, serious infections were tested by 60%, sterile body sites
      were tested by 73%, pure cultures were tested by 47%, and tests were done by
      physician request by 39%. For laboratories doing testing, the broth disk method,
      no longer sanctioned by the National Committee for Clinical Laboratory Standards,
      was used most often (56%), followed by microdilution (33%), beta-lactamase
      testing (25%), macrotube dilution (2%), and agar dilution (2%). The antimicrobial
      agents tested were as follows: penicillin-ampicillin, 94%; clindamycin, 94%,
      metronidazole, 90%; chloramphenicol, 80%; cefoxitin, 76%; tetracyclines, 51%; and
      erythromycin, 45%. All other agents were tested by less than or equal to 25% of
      laboratories; the methods used could be improved to make the results more timely
      and consequently more clinically relevant.

PMID- 1624573
TI  - Evaluation of the autoSCAN-W/A system for rapid (2-hour) identification of
      members of the family Enterobacteriaceae.
AB  - We evaluated the ability of the Baxter autoSCAN-W/A System (MicroScan Division,
      Baxter Diagnostics, Inc., West Sacramento, Calif.) to use the rapid (2-h) gram
      negative identification panel for accurate identification of members of the
      family Enterobacteriaceae. At 2 h, 353 of 467 (75.6%) strains in a challenge set
      of biochemically typical and atypical stock cultures were correctly identified to
      genus and species. Another 76 (16.3%) strains were correctly identified to genus
      and species after the performance of recommended additional biochemical testing.
      Thus, at 24 h, 91.9% of the 467 strains were correctly identified. Twenty-two
      strains (4.7%) were identified to the correct genus but the incorrect species,
      and 16 strains (3.4%) were misidentified. Of these 16 strains, 9 were incorrect
      at 2 h, and 7 were incorrect after the additional testing. Because the system is
      based on fluorogenic substrates, no conventional tests were readily available
      with which to compare aberrant reactions. These results suggest that the autoSCAN
      W/A with its rapid gram-negative panels is acceptable for the identification of
      the Enterobacteriaceae in a clinical microbiology laboratory.

PMID- 1624574
TI  - Enzyme-linked immunoelectrotransfer blot test for diagnosis of human hydatid
      disease.
AB  - Sera from 71 patients with surgically confirmed hydatid disease (which is caused
      by Echinococcus granulosus) were studied by an enzyme-linked
      immunoelectrotransfer blot (EITB) assay. Sera from patients either with other
      cestode infections or with another illness were used as controls. Results of the
      EITB test for hydatidosis were compared with those of the double-diffusion (DD5)
      test and an enzyme-linked immunosorbent assay (ELISA). In the EITB assay with
      bovine lyophilized hydatid fluid, three antigen bands of 8, 16, and 21 kDa were
      diagnostically important. The sensitivity of the assay by using these antigen
      bands was 80% for hepatic cysts, 56% for pulmonary cysts, and 56% for cysts
      located in multiple organs. In sera from controls, the specificity of the EITB
      assay was 100%. Cross-reactions to the 8-, 16-, and 21-kDa bands occurred,
      respectively, in 12, 4, and 4% of sera from patients with cysticercosis. No cross
      reactions were noted in patients infected with Hymenolepis nana. The ELISA in
      which swine hydatid fluid was used as the antigen was as sensitive as the EITB
      test but was less specific (80%) and frequently cross-reacted with sera from
      patients with other cestode infections. The sensitivity of the DD5 test, which
      uses sheep hydatid fluid, was low (47%) , but its specificity was as high as that
      of the EITB assay. However, in patients with cysticercosis, cross-reactions were
      observed in 23% of sera tested. Despite the higher sensitivity found with the
      EITB assay, 23% (n = 5) of the serum samples that were positive by the DD5 test
      were not detected by the EITB assay. The EITB assay offers greater sensitivity
      and specificity than do the ELISA and the DD5 test. The highest proportion of
      hydatid cases is detected when the EITB and DD5 tests are run simultaneously.

PMID- 1624575
TI  - Evaluation of the Autoscan Walkaway system for rapid identification and
      susceptibility testing of gram-negative bacilli.
AB  - We evaluated the performance of the Autoscan Walkaway (W/A) system (MicroScan,
      Sacramento, Calif.) in conjunction with the fluorometric Neg Combo panels for
      rapid identification and susceptibility testing of gram-negative bacilli.
      Fermentative and nonfermentative gram-negative bacilli were tested in parallel
      with the W/A system and the Cathra Repliscan replicator (C/R) system (Cathra, St.
      Paul, Minn.). Conventional biochemical testing and agar dilution testing were
      used to resolve the identification and susceptibility testing discrepancies. Of
      495 clinical isolates tested, 445 (90%) were correctly identified by the W/A
      system and 483 (98%) were correctly identified by the C/R system. Repeat testing
      by using updated versions of the W/A system's computer identification software
      failed to demonstrate improved identification accuracy. For susceptibility
      testing, the W/A system demonstrated 5.6% total interpretative category errors,
      including only 0.9% major and very major errors. The comparative C/R system
      produced only 1% errors overall, including 0.2% major and very major errors.
      Although the W/A system is highly automated and is capable of producing results
      rapidly, our findings suggest that additional identification and susceptibility
      testing refinements are needed before the system will be suitable for routine
      use.

PMID- 1624576
TI  - Statistical analysis of the incidence of positives in the examination of
      parasitological specimens.
AB  - Results of the examination of 2,000 parasitological specimens were analyzed for
      differences between results obtained by a technologist working in parasitology
      only and those obtained by general microbiologists who were also performing other
      laboratory work. The relative share of specimens determined to be positive by the
      specialist was approximately twice as high as the relative share determined by
      the general microbiologists.

PMID- 1624577
TI  - Involvement of Gardnerella vaginalis in urinary tract infections in men.
AB  - Fifteen male patients from whose urine samples Gardnerella vaginalis was isolated
      (clinical incidence of 0.1%) were evaluated for clinical signs and symptoms of
      urinary tract infection and modality of acquisition of the organism. Ten of 15
      (67%) patients were symptomatic or had signs of inflammation as manifested by an
      increased number of urinary neutrophils. One patient had two bouts of infection
      caused by this organism which required two courses of antibiotic therapy.
      Colonies of diphtheroidlike organisms found in urine cultures should not be
      ignored as insignificant but should be further investigated to determine whether
      G. vaginalis is present.

PMID- 1624578
TI  - Fatal Legionella maceachernii pneumonia in Canada.
AB  - A case of pneumonia and acute tubular necrosis was caused by an initially unknown
      species of Legionella. The organism was later identified as Legionella
      maceachernii by a combination of cultural, biochemical, and serological methods
      along with a gas-liquid chromatographic profile.

PMID- 1624579
TI  - Graft-related endocarditis caused by Neosartorya fischeri var. spinosa.
AB  - The first case of endocarditis caused by Neosartorya fischeri var. spinosa is
      reported. The patient was a child who received a calf pericardium graft after
      removal of a previously inserted Dacron graft associated with deterioration of
      adjacent tissue. Copious vegetations removed from the heart were found to be
      composed of septate hyaline fungal filaments. The fungus was recognized in
      culture by its bivalved, winged, spiny ascospores, its Aspergillus fischerianus
      anamorph, and its thermotolerance.

PMID- 1624580
TI  - Pseudomonas mendocina, an environmental bacterium isolated from a patient with
      human infective endocarditis.
AB  - Pseudomonas mendocina has been isolated from soil and water samples. Although it
      has been recovered from some human clinical samples, its pathogenic role has not
      yet been documented. We report the first known case of endocarditis in humans due
      to P. mendocina.

PMID- 1624581
TI  - Epidemiological analysis of serologically determined rotavirus and
      enterotoxigenic Escherichia coli infections in Ecuadorian children.
AB  - The statistical association of rotavirus- and enterotoxigenic Escherichia coli
      specific serum antibody with demographic and hygienic factors was tested in
      Ecuadorian children enrolled in a cross-sectional survey. In 7- to 10-month-old
      children, enterotoxigenic E. coli-specific antibody was associated (P less than
      0.05) with poor drinking water quality, lack of a sewage system, and feeding of
      supplementary food. In 7- to 14-month-old children, rotavirus-specific antibody
      was associated only with family size but notably not with hygienic factors.

PMID- 1624582
TI  - Evaluation of a competitive enzyme immunoassay for detection of Coxiella burnetii
      antibody in animal sera.
AB  - A competitive enzyme immunoassay (CEIA) was established and compared with other
      serological techniques for detecting Coxiella burnetii antibody in camels, goats,
      and sheep. This technique was evaluated because a conjugated anti-camel
      immunoglobulin was not available to serve as a direct signal for the
      demonstration of antigen-antibody reaction. A C. burnetii antibody-positive human
      serum and a peroxidase-conjugated anti-human immunoglobulin G were used as an
      indicator system competing against antibody in animal serum or as an indicator of
      the absence of antibody. Sera were considered antibody positive when the A414 of
      the test sera plus the competing positive antibody was less than or equal to 50%
      of the A414 of the negative-control serum plus the competing antibody. Antibody
      to C. burnetii was repeatedly demonstrated in 66% of camel serum samples (n =
      200) by the CEIA. Among 48 camel serum samples, 71% were positive for antibody by
      CEIA versus 65% by EIA using peroxidase-labeled protein A. The CEIA detected C.
      burnetii antibody in 63% of sheep serum samples (n = 40) and in 50% of goat serum
      samples (n = 96), while the indirect fluorescent-antibody technique detected
      antibody in 38% of sheep and 34% of goat serum samples and the EIA detected
      antibody in 50% of sheep and 35% of goat serum samples. These data indicate that
      the CEIA is a reliable and sensitive technique for demonstrating C. burnetii
      antibody in camels, sheep, and goats.

PMID- 1624583
TI  - Isolation of vibriostatic agent O/129-resistant Vibrio cholerae non-O1 from a
      patient with gastroenteritis.
AB  - A strain of Vibrio cholerae non-O1 was isolated from a 48-year-old male in
      California who presented with a chief complaint of watery diarrhea. Laboratory
      investigations of this strain revealed the bacterium to be resistant to
      trimethoprim-sulfamethoxazole and to the vibriostatic agent O/129 (2,4-diamino
      6,7-diisopropylpteridine).

PMID- 1624584
TI  - Evaluation of microbiological processing of urine specimens: comparison of
      overnight versus two-day incubation.
AB  - In this study the value of urine culture incubation for 1 versus 2 days was
      determined. The results of the study indicate that 1 day of incubation is
      reliable if (i) all specimens are incubated for a full 24 h, (ii) all specimens
      with less than 10(4) uropathogens per ml are incubated for an additional day to
      ensure accurate quantitation, and (iii) specimens from patients with suspected
      funguria are incubated for a minimum of 2 days.

PMID- 1624585
TI  - Sensitive and specific polymerase chain reaction assays for diagnosis of human T
      cell lymphotropic virus type I (HTLV-I) and HTLV-II infections in HTLV-I/II
      seropositive individuals.
AB  - To confirm and differentiate between human T-cell lymphotropic virus type I (HTLV
      I) and HTLV-II infections, we analyzed by polymerase chain reaction (PCR) samples
      of peripheral blood lymphocytes from 98 individuals seropositive for HTLV-I/II
      using pol (SK110/111) and tax (SK43/44) consensus primer pairs. A total of 96
      samples (97.9%) were positive by the tax generic probe, while 95 were typed by
      the HTLV-I and HTLV-II pol probes. The three pol-negative samples were
      successfully amplified and typed by nested PCR with primers internal to SK110 and
      SK111. Results of PCR with a lysate of leukocyte nuclei obtained by whole blood
      lysis were comparable to those obtained with peripheral blood lymphocytes from 16
      HTLV-seropositive subjects.

PMID- 1624586
TI  - Humoral responses against the 85A and 85B antigens of Mycobacterium bovis BCG in
      patients with leprosy and tuberculosis.
AB  - Immunoglobulin G antibodies against the 85A and 85B components of the
      Mycobacterium bovis BCG antigen 85 complex separated by isoelectric focusing were
      investigated in serum samples from 129 patients representing the major forms of
      leprosy, 111 tuberculous patients, and 153 healthy subjects. For both of the
      antigens, a higher degree of staining was observed for lepromatous leprosy
      patients and patients with active tuberculosis than for the other groups. Because
      sera from some healthy subjects recognized the 85A antigen, we suggest that
      antigen 85B is the most useful component of the antigen 85 complex for the
      serodiagnosis of the multibacillary forms of leprosy or of the active forms of
      tuberculosis.

PMID- 1624587
TI  - Comparison of a modified adherence assay with existing assay methods for
      identification of enteroaggregative Escherichia coli.
AB  - Localized, diffuse, and aggregative adherence patterns of Escherichia coli
      identified with specific DNA probes were compared in cell culture adherence
      assays by using the Center for Vaccine Development, Baltimore, method, the
      University of Texas Medical School, Houston (UTH), method, and a modified UTH
      method. Increasing postwash incubation time from 2 to 4 h in the modified UTH
      method allowed identification of enteroaggregative E. coli, which was otherwise
      not identified by the original UTH method.

PMID- 1624588
TI  - Stability of the recombinant hepatitis B core antigen.
AB  - The recombinant gene for hepatitis B core antigen (HBcAg) was cloned and
      expressed, and the protein was purified from Escherichia coli cultures. Purified
      HBcAg was tested for the effects of various physical and chemical agents on its
      immunoreactivity by a paramagnetic particle-based enzyme immunoassay. Recombinant
      HBcAg retained its immunoreactivity when heated at 70 degrees C for 60 min but
      was inactivated at 85 degrees C in 10 min. It was stable between pHs 5 and 10.5
      but not at pHs 2 and 13.5. Treatment with sodium dodecyl sulfate (SDS), ethanol,
      and methanol caused a significant loss in HBcAg reactivity. The proteolytic
      enzymes papain and bacterial protease (type VIII from Bacillus licheniformis)
      degraded HBcAg significantly, but trypsin and chymotrypsin did not. The effect of
      combined SDS and 2-mercaptoethanol on recombinant HBcAg was an immediate loss in
      immunoreactivity, followed by rapid recovery to about 50% of the initial level.
      This level was maintained for 24 to 48 h and was followed by an almost total loss
      of HBcAg in about 120 h.

PMID- 1624589
TI  - Superficial temporal artery biopsies.

PMID- 1624591
TI  - Clinical applications of molecular biology to diagnostic microbiology.

PMID- 1624590
TI  - Pathogenesis of idiopathic myelofibrosis: role of growth factors.

PMID- 1624592
TI  - Methods used in the United Kingdom for the culture of micro-organisms from blood.
AB  - AIMS: To survey blood culture methods in use in the United Kingdom. METHODS: A
      questionnaire was distributed to the 415 United Kingdom laboratories
      participating in the clinical bacteriology subscheme of the UK National External
      Quality Assessment Scheme for Microbiology. RESULTS: Two hundred and eighty seven
      laboratories completed the questionnaire. The responses indicated wide variations
      in methods used including considerable differences among laboratories using the
      same basic methods. The most widely used techniques were the Bactec and
      conventional broth systems. CONCLUSIONS: Although many published comparisons have
      failed to show that any basic method is outstandingly successful in the isolation
      of all organisms, there is evidence that several factors can contribute to good
      performance. In some laboratories suboptimal conditions were in use. The
      variations in technique probably reflect differences in practical suitability of
      a system for any particular laboratory, costs, and personal preferences.

PMID- 1624593
TI  - Clinical comparison of Sentinel, a novel blood culture system, with radiometric
      Bactec 460 and Isolator 10 in the detection of streptococcal and anaerobic
      bacteraemias.
AB  - AIMS: To compare the performance of the Sentinel blood culture system with two
      other systems for the recovery of streptococci and anaerobes. METHODS: Blood
      cultures were taken from 55 patients one to two minutes after dental extraction.
      The samples were tested by the radiometric Bactec 460; the Isolator 10, which
      works by lysis centrifugation; and Sentinel, a fully automated system, which
      detects bacterial growth by changes in the voltage between two electrodes in the
      media. Positive samples were subcultured and streptococci and anaerobes were
      further identified. Terminal subcultures were performed on all negative samples.
      RESULTS: Sentinel was comparable with Bactec, with Sentinel recovering 20
      streptococci and 14 anaerobes; Bactec isolated 26 streptococci and 15 anaerobes.
      The recovery of Streptococcus sanguis was significantly better from Bactec than
      Sentinel. The Isolator 10 recovered significantly fewer streptococci and
      anaerobes than either Bactec or Sentinel. Sentinel was noticeably quicker in
      detecting anaerobes than Bactec 460. However, there was no comparable difference
      with streptococci. Contaminants were recovered from 10% of Isolator 10, 2.7% of
      Bactec, and 7.2% of Sentinel bottles. CONCLUSIONS: Sentinel and Bactec 460 were
      broadly comparable in the detection of viridans streptococci and oral anaerobes,
      and both systems were significantly better than the Isolator 10. However, the
      prototype Sentinel, was significantly poorer than Bactec for the recovery of S
      sanguis.

PMID- 1624594
TI  - Evaluation of an enzyme immunoassay kit for detecting cryptosporidium in faeces
      and environmental samples.
AB  - AIMS: To evaluate a commercially available enzyme immunoassay based on a
      monoclonal antibody to a genus specific Cryptosporidium (IDEIA Cryptosporidium;
      Dako) antigen for detecting Cryptosporidium oocysts in faecal and environmental
      samples. METHODS: 435 human faecal samples and post-filtration deposits from 10
      reservoir samples, and from six tap water samples seeded with Cryptosporidium
      oocysts, were examined by EIA according to the manufacturer's instructions, and
      by microscopic examination of phenolauramine stained smears. Samples giving
      discrepant results were examined by specific immunofluorescence, before and after
      concentration of oocysts. RESULTS: Sixteen (3.6%) faecal samples were positive by
      both microscopy and EIA; five (1.1%) were positive by microscopy of auramine
      phenol stained smears (but were not confirmed by specific immunofluorescence) and
      negative by EIA; one (0.2%) was positive by EIA alone, but confirmed by specific
      immunofluorescence; and 362 (83.2%) were negative by both microscopy and EIA.
      Compared with immunofluorescence positive faecal samples, the sensitivity of
      conventional microscopy and EIA were 94% and 100%, and specificity 76.4% and
      100%, respectively. Fifty one (11.7%) were not examined by microscopy due to
      detection of other pathogens in a previous sample from that patient, but were
      found to be negative by EIA. Ten reservoir water samples (not suspected of being
      linked to cases of cryptosporidiosis) were negative by both microscopy and EIA.
      Of six samples of tap water seeded with varying concentrations of Cryptosporidium
      oocysts, two (10(2) and 10(3) oocysts/l) were positive by both microscopy and
      EIA, two (10 and 1/l) by EIA alone, and two (0.1/l and unseeded water) were
      negative by both microscopy and EIA. CONCLUSIONS: The kit is simple and rapid to
      use and offers a less subjective method than microscopy for detecting
      Cryptosporidium in faecal samples submitted to a busy diagnostic laboratory.

PMID- 1624595
TI  - Comparison of relative uses of commercial assays for Toxoplasma gondii IgM
      antibodies.
AB  - AIMS: To compare the sensitivity and user friendliness of seven commercially
      available enzyme linked immunoabsorbent assay (ELISA) kits for toxoplasma
      specific IgM. METHODS: Five antibody capture assays supplied by Abbott, Mercia,
      Northumbria, Organon and Sorin, and two indirect ELISA assays from Biostat and
      Mast, were assessed. Using defined dilutions of Toxoplasma gondii specific IgM,
      the performance and sensitivity of each assay was established. They were further
      assessed on a panel of 27 sera with a range of dye test and IgM results (as
      determined by the Scottish Toxoplasma Reference Laboratory). All of the assays
      were performed by three experienced operators and assessed for user satisfaction.
      RESULTS: The Mast, Organon, and Abbott assays were of low sensitivity; the Mercia
      and Northumbria were of high sensitivity; and the Biostat and Sorin assays
      produced too many false positive results. The Mercia kit provided most user
      satisfaction; the Mast and Abbott assays were most difficult to use. CONCLUSIONS:
      Local laboratories investigating toxoplasma infection should have three tests:
      one IgG and two IgM (high and low sensitivity) to help in the timing of
      infection. Alternatively, one sensitive IgM assay, such as that of Mercia, could
      be used by selecting appropriate high and low thresholds.

PMID- 1624596
TI  - Comparison of immunodiffusion and enzyme linked immunosorbent assay in the
      detection of abnormal antibodies in pigeon breeder's disease.
AB  - AIMS: To compare the sensitivity of two methods for the detection of serum
      antibodies to pigeon faecal antigens in patients with pigeon breeder's disease.
      METHODS: Serum samples stored at -20 degrees C from 50 patients with pigeon
      breeder's disease, 50 control samples from patients with other respiratory
      diseases, and 50 healthy blood donors were examined for the precipitating
      antibodies and IgG antibodies to antigens present in extract of pigeon droppings
      by immunodiffusion and enzyme linked immunosorbent assay (ELISA), respectively.
      RESULTS: Both antigen preparations of pigeon dropping extract were equally
      effective. A positive immunodiffusion reaction gave one or more precipitin lines
      and these antibodies were detected only in undiluted sera from 80% of the
      patients with pigeon breeder's disease. In the ELISA the sera were tested at a
      starting dilution of 1 in 100 because positive reactions were observed with sera
      from healthy blood donors at lower dilutions. All sera which gave optical density
      readings above 3 SD of the control value were considered to have IgG antibodies.
      These antibodies were detected in sera from all the patients with pigeon
      breeder's disease. The antibody titres were much higher in those patients who had
      precipitating antibodies (range 800-51,200) than those without (range 100-800).
      The antibodies were not detected in the sera of patients with respiratory
      diseases or healthy blood donors by either method. CONCLUSIONS: Antibodies to
      pigeon dropping antigens were detected by immunodiffusion and ELISA in sera from
      patients with pigeon breeder's disease but not in control sera. ELISA was a more
      sensitive method for detecting antibodies and therefore seems to have
      considerable potential as a routine technique in the serological diagnosis of
      pigeon breeder's disease.

PMID- 1624597
TI  - Histological and electron microprobe studies of mineralisation in aluminium
      related osteomalacia.
AB  - AIMS: To determine a possible mechanism to explain the presence of aluminium
      lines within fully calcified bone in aluminium-related osteomalacia. METHODS:
      Fifty five bone cases shown by bone biopsy to be aluminium-related osteomalacia
      were studied. In 38 specimens aluminium lines were identified within calcified
      bone by means of the Aluminon stain and a characteristic form of patchy
      mineralisation was seen within thickened osteoid seams. Five representative
      examples were analysed quantitatively by histomorphometry and electronprobe X-ray
      microanalysis and compared with five cases of vitamin D deficiency-related
      osteomalacia which also had patchy mineralisation. RESULTS: The patchy
      calcification occupied 40 +/- 8% (mean +/- SEM) of the osteoid and consisted of
      small focal deposits (less than 40 microns diameter), often (52%) around osteoid
      osteocytes (probably an underestimate of the association), and larger areas that
      extended to the aluminium lines at the underlying mineralisation front. Small and
      large mineralisation nuclei were seen ultrastructurally in the patchy
      calcification. Quantitative electronprobe X-ray microanalysis showed that calcium
      concentrations and calcium:phosphorus ratios in the mineralisation nuclei and in
      the superficial layer of the fully calcified bone of the aluminium-related
      osteomalacia cases were significantly less than values measured at similar sites
      in the vitamin D deficiency-related osteomalacia cases. Furthermore, aluminium
      could not be detected by means of this technique at the mineralisation front or
      along cement lines in these specimens. CONCLUSIONS: Calcification can occur in
      thickened osteoid seams in osteomalacia. It can begin around osteoid osteocytes
      as small deposits that enlarge within the osteoid and extend to the underlying
      mineralisation front or cement line where aluminium lines may become trapped.
      Complete calcification of osteoid could account for the presence of aluminium
      lines within fully calcified bone. The Aluminon stain appears to be a more
      sensitive method for the detection of aluminium in bone than electronprobe X-ray
      microanalysis.

PMID- 1624598
TI  - Expression of HLA-DR antigen in different histological types of gastric polyp.
AB  - AIMS: To study the expression of HLA-DR antigen in the different histological
      types of gastric polyps. METHODS: Ninety five cases of gastric polyps were
      histologically classified and examined for the presence of Helicobacter pylori,
      and for degree and type of inflammation. Further sections were stained
      immunohistochemically for HLA-DR antigen expression in the epithelium using a
      monoclonal antibody that was reactive to formalin-fixed paraffin wax embedded
      tissue. RESULTS: HLA-DR antigen was expressed in all of the inflammatory polyps
      studied (20/20), and in most hyperplastic (12/16) and adenomatous (4/6) polyps.
      Only a few fundic gland polyps (8/51) stained positively for HLA-DR antigen.
      Gastric polyps seem to have a greater tendency to express HLA-DR antigens than
      non-polypoid gastric mucosa, even after considering the factors that may affect
      HLA-DR antigen expression, such as inflammation and the presence of H pylori.
      CONCLUSIONS: Growth disturbances/polyp formation may be associated with increased
      HLA-DR antigen expression.

PMID- 1624599
TI  - Simplified method of grading primary carcinomas of the breast.
AB  - AIMS: To produce a simplified prognostic index for breast cancer. METHODS: A
      retrospective study of 105 cases of primary infiltrating breast adenocarcinoma
      (not otherwise specified) was performed. Mitotic counts and semiquantitative
      assessment of tumour necrosis, fibrosis tubule formation, nuclear pleomorphism
      were made in histological sections of the primary tumour. Statistical analysis
      was performed to determine which of these parameters best predicts the observed
      survival. RESULTS: Mitotic count and necrosis correlated best with survival. This
      allowed the formation of a simple prognostic index based on these two parameters.
      CONCLUSIONS: This new prognostic index, with four tumour grades, seemed to be
      superior to Bloom's grading method, with greater separation of the prognostic
      groups. In particular, there is clear segregation of a group of patients with a
      distinctly poor prognosis.

PMID- 1624600
TI  - Implications on laboratory workload of breast cancer screening.
AB  - AIMS: To determine whether the recommended methods for the handling of breast
      excision biopsy specimens from screening patients cause more laboratory work than
      those used for non-screening patients. METHODS: All breast excision biopsy
      specimens from 1990 were identified. Ninety one came from patients identified
      during the prevalent round of breast screening. These were compared with 127 from
      non-screening patients operated on by the same surgeon. The workload in terms of
      initial blocks taken, cases which needed extra blocks or other additional work,
      and the time taken for delivery of slides to the pathologist were assessed.
      RESULTS: The screening cases required significantly more initial blocks than the
      non-screening cases (8.03 v 4.95; p = 0.000001). When looking at the malignant
      diagnoses this difference was maintained (7.74 v 6.02; p = 0.00014). CONCLUSIONS:
      Excision biopsy specimens from screening patients require more laboratory work
      per case than those from non-screening patients. The reasons for these
      differences lie in the nature of the specimens and their subsequent diagnoses,
      and in the initial indications for biopsy.

PMID- 1624601
TI  - Depletion of neuroendocrine cells in rectal biopsy specimens from HIV positive
      patients.
AB  - AIMS: To compare the density of neuroendocrine cells in rectal biopsy specimens
      from human immunodeficiency virus (HIV) infected individuals with that of a
      control group. METHODS: Neuroendocrine cells in rectal biopsies were identified
      using an immunohistochemical stain for chromogranin and subsequently quantified
      using a method of linear intercept. RESULTS: Neuroendocrine cells were found to
      be significantly decreased in the HIV positive group. CONCLUSIONS: Loss of
      neuroendocrine cells may contribute to apoptotic bodies seen in this condition.
      This could be related to infection of these cells with HIV and could contribute
      to diarrhoeal disease in HIV infection.

PMID- 1624602
TI  - Fatal case of disseminated infection with the turtle bacillus Mycobacterium
      chelonae.
AB  - An apparently immunocompetent 78 year old woman presented with confusion,
      subcutaneous abscesses, and lesions of the nasopharynx. Gram positive, acid fast
      bacilli were isolated from her blood after 10 days' incubation. She was treated
      with trimethoprim-sulphamethoxazole for presumed disseminated nocardiasis but
      deteriorated and died. A post mortem examination showed skin and pulmonary
      lesions and endomyocardial fibrous plaques. Organisms isolated from the skin and
      lung were indistinguishable from those cultured from the blood. The organism was
      subsequently identified as Mycobacterium chelonae. Primary pulmonary infection
      and disseminated disease are rarely caused by this organism and bacteraemia is
      seldom documented. The clinical presentation and bacteriological and histological
      findings are difficult to differentiate from those of disseminated nocardiasis.
      Isolation of the organism may fail without prolonged incubation of initial
      cultures and there is a danger of its being dismissed as medically unimportant.
      Diagnosis is further hampered because large pulmonary foci may be poorly revealed
      by conventional radiological examination of the chest.

PMID- 1624603
TI  - Small numbers of Chlamydia trachomatis elementary bodies on slides detected by
      the polymerase chain reaction.
AB  - A method is described in which smears on slides, which had been examined
      previously in a direct fluorescence antibody (DFA) test for Chlamydia
      trachomatis, were tested by the polymerase chain reaction (PCR). Twenty four
      (73%) of 33 smears which contained fewer than 10 elementary bodies when examined
      by the DFA test were positive by the PCR. Of the nine negative smears, seven
      contained only one or two elementary bodies. However, single elementary bodies
      were detected by the PCR in seven of the 24 positive samples. Fifteen smears were
      negative by both methods. The ability to detect small numbers of elementary
      bodies by the PCR and its specificity for negative smears indicates its potential
      for retrospective analysis of stored, archival smears on slides.

PMID- 1624604
TI  - Rapid method for differentiating strains of Branhamella catarrhalis.
AB  - The ability of Branhamella catarrhalis to cause nosocomial infections is a matter
      of some controversy. The API ZYM research kit for detecting 89 enzymes was used
      on 49 isolates of B catarrhalis to select enzymes of potential use in
      differentiating clinical isolates. Twenty nine enzymes were produced by all
      isolates (13 strongly positive) and many of these were esterases; 16 enzymes were
      not detected in any isolate (40 if a more stringent criterion was used). Twenty
      enzymes were selected to form a prototype biotyping panel which allowed 17
      different patterns of reactivity to be recognised. Of the 49, 34 isolates were
      confined to the three commonest patterns. Only one isolate was untypable using
      this panel due to lack of reactivity. A kit with these 20 substrates may be
      sufficiently discriminatory to be useful in the rapid study of outbreaks of
      infection caused by B catarrhalis.

PMID- 1624605
TI  - A viscometric method of measuring plasma fibrinogen concentrations.
AB  - A technique based on deducing the viscosity of serum from that of plasma was
      compared with the commonly used Clauss method. The two methods correlated closely
      (r = 0.914). The reproducibility of the viscometric method was slightly poorer
      than the Clauss technique at low fibrinogen concentrations, equal to that at
      medium fibrinogen concentrations, and marginally better at high concentrations.
      Fibrinogen can therefore be measured reasonably accurately with the viscometric
      method, and can be recommended as an alternative for laboratories possessing a
      viscometer.

PMID- 1624606
TI  - Occult alveolar haemorrhage in bronchopulmonary Kaposi's sarcoma.
AB  - Evidence of occult alveolar haemorrhage was sought by Perls's staining of
      bronchoalveolar lavage fluid to detect haemosiderin laden macrophages in 63 human
      immunodeficiency virus positive (HIV-1) men who underwent bronchoscopy. Twenty
      three patients had bronchopulmonary Kaposi's sarcoma; occult alveolar haemorrhage
      was present in 16 of these (including two in whom no tracheobronchial lesions
      were evident at bronchoscopy, but in whom the diagnosis was confirmed at
      necropsy). Forty patients had other diagnoses including Pneumocystis carinii
      pneumonia and bacterial pneumonia; 18 had occult haemorrhage. Occult alveolar
      haemorrhage seems to be a non-specific finding in HIV-1 positive men undergoing
      bronchoscopy.

PMID- 1624607
TI  - Clumping of lymphoma cells in peripheral blood induced by EDTA.
AB  - A peripheral blood smear from a patient with probable splenic lymphoma with
      villous lymphocytes (SLVL) showed clumping of lymphoma cells. The clumping was
      not seen in films made from unanticoagulated blood, and has not been previously
      described in lymphomas. The patient also had metastatic prostatic adenocarcinoma
      for 30 months before lymphoma was diagnosed and the clumped cells posed
      diagnostic problems.

PMID- 1624608
TI  - Parathyroid hormone related protein in hypercalcaemia of Hodgkin's disease.
AB  - The role of parathyroid hormone related protein (PTHRP) as a humoral mediator of
      hypercalcaemia was investigated in a patient with lymphocyte depleted Hodgkin's
      disease during an episode of hypercalcaemia, using an immunohistochemical
      staining technique for PTHRP on the tumour tissue and an immunoradiometric (IRMA)
      assay for PTHRP1-86 on the patient's plasma. The plasma PTHRP was less than 0.23
      pmol/l in the range found in normocalcaemic controls, and the immunohistochemical
      staining was not positive for protein. PTHRP did not have a role in the
      pathogenesis of hypercalcaemia in this patient.

PMID- 1624609
TI  - The cyanide poisoning necropsy: an appraisal of risk factors.
AB  - Blood cyanide concentrations were measured in samples obtained from a pathologist
      before and after carrying out a necropsy on the body of a victim of cyanide
      poisoning. There was no significant increase in his blood cyanide concentration
      after carrying out the procedure. It is suggested that an important factor in
      determining the risk to those carrying out necropsies of the bodies of victims of
      cyanide poisoning is the amount of cyanide remaining in the stomach. There are
      several ways in which the theoretical risk inherent in carrying out such
      necropsies could be reduced, such as the use of a full face respirator, or the
      removal, intact, of the upper gastrointestinal tract to a fume cupboard for
      examination.

PMID- 1624610
TI  - Glove puncture in the post mortem room.

PMID- 1624611
TI  - Glove puncture in the post mortem room.

PMID- 1624612
TI  - Glove puncture in the post mortem room.

PMID- 1624613
TI  - Diagnostic value of fibronectin determination in cerebrospinal fluid.

PMID- 1624614
TI  - Audit of necropsies in a British district general hospital.

PMID- 1624615
TI  - Use of computers in anticoagulant clinics.

PMID- 1624616
TI  - Tooth fracture in vivo and in vitro.
AB  - The incidence, causes and methods of investigating tooth fracture are reviewed.
      This is a problem of increasing clinical significance, with many predisposing
      factors. Large restorations and extensive carious lesions tend to be associated
      with most fractures, with fracture incidence being higher in first permanent
      molars than other tooth types, especially in the lower jaw. Tooth anatomy
      influences fracture incidence, as does the functional force applied to cusps.
      Fracture risk in restored teeth may be reduced by cuspal coverage. Traditional
      tooth fracture investigations using destructive techniques provide valuable
      information; however, replica and nondestructive techniques are also of value.

PMID- 1624617
TI  - Wear in dentistry--current terminology.
AB  - There is some confusion in the dental literature concerning the phenomenon of
      wear which is usually considered in terms of its clinical manifestations rather
      than its underlying processes. The parent discipline for the study of these
      processes is tribology. The terms attrition, abrasion and erosion are common to
      both dentistry and tribology; however their meanings are different. Even within
      the various disciplines of dentistry there are differences in the understanding
      of the same terms. This article relates the dental appreciation of wear to the
      underlying processes.

PMID- 1624618
TI  - Development of dental plaque on the incisor teeth of monkeys (Macaca
      fascicularis).
AB  - Bacterial plaque which had accumulated for 0.5, 1, 2, 4, 7, 14 and 28 days was
      cultured from the labial surface of one of the central incisor teeth in 15
      monkeys (Macaca fascicularis). Each sampling area was defined by a metal well
      contained within a custom-made removable acrylic block. The number (log10) of the
      total colony forming units (c.f.u.) increased significantly from 3.40 to 6.02
      between 0.5 and 28 days. Similarly the number of streptococci increased from 2.80
      to 4.79 during the same period, although when expressed as a percentage of the
      total c.f.u., the proportions decreased from 34.9 per cent at 1 day to 6.9 per
      cent at 7 days and then remained at that level. The number of micro-aerophilic
      actinomyces increased throughout the period of plaque accumulation and comprised
      15.3 per cent of the total c.f.u. at 28 days. Neisseriae were infrequently
      isolated from 0.5- and 1-day-old plaque and were not recovered at more than 1 per
      cent of the total c.f.u. during any period of plaque accumulation. The fastest
      doubling time (median) of the total c.f.u. was 1.9 h (range 1.3-18.5 h). The
      rapid development of dental plaque after tooth cleaning emphasizes the importance
      of regular and meticulous oral hygiene to control the accumulation of potentially
      periodontopathic and cariogenic bacteria.

PMID- 1624619
TI  - Crown behaviour during cementation.
AB  - Complete seating of restorations during cementation is hindered by the need for
      excess cement to be expressed. It has been shown that postcementation seating is
      usually worse than precementation seating. Techniques have been developed to
      minimize this problem, including venting, die spacing and limiting cement
      placement, and these techniques are reviewed. The behaviour of the crown during
      cementation is considered, and consequences of crown cementation are discussed.

PMID- 1624620
TI  - Mutans streptococci in margins of fillings and crowns.
AB  - A significant correlation was found between the number of mutans streptococci in
      saliva and the proportional distribution of these microorganisms in pooled plaque
      from the margins of all restorations. At high salivary numbers there was a
      tendency towards a higher porportion of mutans streptococci in plaque from the
      margins of separate restorations. At low and medium salivary numbers, plaque
      samples could, however, contain greater than 10 per cent mutans streptococci and
      even less than 1 per cent was found in plaque from margins of restorations at
      high salivary numbers. The reproducibility of the plaque sampling method was
      good. Plaque material collected on different occasions from the same margins did
      not vary significantly in terms of proportions of mutans streptococci. The
      numbers of mutants streptococci in plaque samples from different restorations of
      the same kind collected on the same occasion in the same mouth could, however,
      show a considerable variation. The observations made in this study, indicate that
      a low salivary number of mutans streptococci does not exclude a high proportion
      of these microorganisms in plaque from the margins of separate restorations. This
      has to be considered when efforts are made to reduce the risk of recurrent decay.

PMID- 1624621
TI  - Provision of domiciliary dental care for the older person by general dental
      practitioners in Scotland.
AB  - The databank at the Scottish Dental Practice Board (SDPB) was explored to
      determine the domiciliary care provided, for those patients over 70 years of age,
      by general dental practitioners under the National Health Service in one year.
      Three thousand nine hundred and forty-three (3943) courses of treatment were
      provided, via domiciliary visits to patients in this age category, by 38 per cent
      (1012) of dentists registered to provide dental care under the National Health
      Service. Whereas 34 per cent of dentists under 40 years of age provided
      domiciliary care, 46 per cent of those over 40 years provided such a service (P
      less than 0.001). In Scotland, approximately 1 per cent of 70-79-year-old
      patients and 2 per cent of patients over 80 years received domiciliary dental
      care over a 1-year period. For those elderly people who received such care, the
      mean percentage doubled for every 5-year increase in patient age.

PMID- 1624622
TI  - Marginal accuracy of CAD/CAM inlays made with the original and the updated
      software.
AB  - The software driving the Cerec CAD/CAM system has recently been updated. In this
      study, the marginal accuracy of computer-machined porcelain inlays was determined
      using the original and the updated software. Two types of MOD cavities in Frasaco
      resin teeth were prepared with either sharp or rounded box corners. The distance
      of the occlusal and proximal marginal interface was determined using a measuring
      microscope. The mean occlusal interfacial distance was 52 microns for both
      programs. Only the box corners showed a significantly larger space, of which the
      mean value was approximately 200 microns. The updated version improved the
      marginal accuracy at the box corners. Further reduction of the interfacial
      distance was accomplished by rounding the sharp box corners.

PMID- 1624623
TI  - Effects of polymerization contraction in composite restorations.
AB  - Post-gel polymerization contraction of resin composite induces contraction
      stresses at the composite-tooth bond and in surrounding tooth structure. Strain
      gauges have been shown to be an effective method for measuring linear post-gel
      polymerization contraction of composites. A new model was developed in which the
      composite sample was bonded to and circumscribed by an acrylic ring. The model
      simulates a composite restoration surrounded by dentine. A strain gauge measured
      the deformation of the ring while a second strain gauge simultaneously recorded
      the dimensional change of the sample. Stresses placed on the acrylic ring as a
      result of polymerization contraction of the composite were calculated, based on
      the strains on the ring and the ring's material properties. Four composites
      (Heliomolar, Vivadent, Tonawanda, NY, USA; Herculite XR, Kerr Manufacturing Co.,
      Romulus, MI, USA; P-50, 3M Co., St Paul, MN, USA; Silux Plus 3M Co.) were
      evaluated for polymerization contraction strain and stress on the surrounding
      acrylic ring during polymerization. At the end of the 60 s light application,
      Heliomolar demonstrated significantly lower post-gel contraction (0.12 per cent,
      P less than 0.05) when compared to the other materials. When the strain reached
      an equilibrium at the end of 14 min Heliomolar continued to demonstrate lower
      post-gel contraction, however this was not statistically significant at P less
      than 0.05. When the contraction stress on the surrounding acrylic ring was
      considered, P-50 rapidly developed and produced the largest stress values (1.7
      MPa) at the end of the light application while Heliomolar produced the lowest
      stress values (0.3 MPa). These values, however, were not significantly different
      when evaluated statistically.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624624
TI  - Curing light performance and polymerization of composite restorative materials.
AB  - The majority of modern composite restorative materials require light activation
      for polymerization. Variables affecting light energy absorption by the composite
      have been examined for their effect on the polymerization contraction. Since the
      polymerization contraction is closely associated in a complex way to the degree
      of cure of the restoration, this parameter served as an empirical indicator for
      the extent of polymerization. Variables included the composite shade, distance
      between the light source and composite sample, and light intensity. Three resin
      composites are evaluated. Post-gel polymerization contraction was evaluated using
      a strain gauge method. Curing light intensity diminished rapidly for distances
      greater than 2 mm between the tip of the light guide and material surface. A
      linear relationship was demonstrated between polymerization contraction and light
      intensity. The polymerization contraction of a microfilled composite and
      posterior composite, using a constant curing time and light intensity, decreased
      linearly with increasing sample thickness. Less than optimal light output of the
      curing light source can be compensated by increasing application time within
      reasonable limits.

PMID- 1624625
TI  - Effect of impression tray design upon the accuracy of stone casts produced from a
      single-phase medium-bodied polyvinyl siloxane impression material.
AB  - The study examined the accuracy of stone casts produced from impressions taken in
      stock polycarbonate trays, some of which had been strengthened with
      autopolymerizing polymethyl methacrylate resin and four designs of custom-made
      trays. Impressions of an acrylic master model of the mandibular arch on which two
      extracoronal crown preparations and one intracoronal inlay preparation had been
      carried out were taken using a medium-bodied polyvinyl siloxane material. Each
      preparation had been intended with a reference point for later measurement. Five
      impressions were taken for each type of tray and these were cast in die-stone
      after 24 h. The distances between the points were measured with a reflex
      microscope and the means determined for each design of tray. The mean difference
      between casts produced from the various tray designs and the acrylic master model
      were determined for each of the distances between the three measuring points.
      Statistical analysis showed that, with the stock trays, there were no significant
      differences between any of the modifications, or between them and the acrylic
      model, for any of the three distances (P greater than 0.1). When the results from
      the custom-made trays were analysed there were statistical differences between
      the acrylic model and the casts from the unperforated tray with no stops (P =
      0.02), and between the unperforated tray with no stops and the perforated with
      stops for the distance A-B (P less than 0.01). There were no other significant
      differences.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624626
TI  - [Teaching of geriatric dentistry; training of "mobile dental service" dentists].
AB  - Quebec presently has 650,000 people over 65 years of age and as many as 900,000
      will be alive at the beginning of the 21st century. Quebec epidemiological
      studies have shown that this group's dental condition is very poor. They feel no
      need to see a dentist, but 96% of them need treatment and the time elapsed since
      their last dental visit averages 13 years. It is forecasted that the dental needs
      of this group will rise, not only because of their increase in number but also
      because they will retain more teeth. Training in geriatric dentistry is presently
      deficient in the United States, Canada and particularly Quebec. Researchers have
      concluded, after studying the U.S. dental schools' current status of geriatric
      dentistry educational activities, that unless dental students receive training in
      geriatrics while at dental school, it is likely that they will not treat a lot of
      seniors in their practice. The teaching of geriatric dentistry is in full swing
      in the U.S. but knows a difficult birth in Quebec. There is no formal, extensive
      training program in geriatric dentistry given by the three dental schools in the
      province. Practicing geriatric dentistry requires special knowledge and skills.
      If treatment is to be successful, the practitioner must adopt a humanitarian
      approach and develop close relations and a better understanding of the feelings
      and attitudes of the elderly. The dentist must know and understand the special
      dental problems that makes them different from other groups.

PMID- 1624627
TI  - [Cholesterol demystified].
AB  - A favorite subject of newspapers, periodicals or television programs, is that
      cholesterol has invaded our lives. Although well known as being undesirable, for
      blocking the arteries and contributing to cardiovascular diseases which kill
      thousands of Canadians each year, the flood of information of diverse quality
      leaves most of us puzzled. This paper aims to answer the main questions about
      cholesterol, trying to better define its relationship to cardiovascular diseases
      and to provide useful dietary advice to help control this risk factor.

PMID- 1624628
TI  - Recurrence rates of treated basal cell carcinomas. Part 4: X-ray therapy.
AB  - This is the fourth 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 862 primary (previously untreated) BCCs irradiated by a
      "standardized" x-ray therapy schedule. The overall 5-year recurrence rate for
      these lesions, as determined by the modified life-table method, was 7.4%. This
      rate was not significantly different from that experienced with 211 recurrent
      (previously treated) BCCs with a re-recurrence rate of 9.5% (P = .552). For the
      primary BCCs, multivariate analysis showed that increasing BCC diameter was the
      only independent risk factor for high recurrence rates (P = .003). The patient's
      age or sex, the duration of the BCC, the anatomic site of the BCC, or time-span
      treated (1955-1963, 1964-1972, 1973-1982) did not significantly affect the
      recurrence rate. Additional analysis showed that BCCs on the head less than 10 mm
      in diameter had a 5-year recurrence rate of 4.4% whereas those 10 mm or greater
      in diameter had a rate of 9.5%. Lastly, the proportion of recurrence-free
      treatment sites with a good or excellent long-term cosmetic outcome after x-ray
      therapy (63%) was lower than previous reports in this series with curettage
      electrodesiccation (91%) and surgical excision (84%). Thus, if the long-term
      cosmetic outcome after treatment is not an overriding concern to the patient, x
      ray therapy is an effective modality for many primary and recurrent BCCs.

PMID- 1624629
TI  - Basal cell carcinoma treated with Mohs surgery. A comparison of 54 younger
      patients with 1050 older patients.
AB  - The average age of patients with basal cell carcinoma (BCC) is over 60 years, and
      fewer than 5% of patients with this tumor are under 30 years of age. A comparison
      of younger (15 to 30 years) and older (56 to 70 years) patients with BCC was
      conducted to identify specific tumor or host features associated with BCC
      occurring early in life. According to data collected over an 11-year period, 54
      of 2728 (2%) BCCs occurred "de novo" in younger patients. In contrast to the
      predominantly male older group, most of the younger patients were female. An
      increased use of tanning booths and hair-dyes was associated with the younger
      patients (P less than .001). More overall sunlight exposure and actinic keratoses
      were associated with the older patients (P less than .01). Defect and lesion
      sizes were smaller (P less than .01) in the younger group. Location, histology,
      and clinical morphology did not differ appreciably between the two groups. De
      novo BCCs in younger and older patients are similar, although some differences do
      exist.

PMID- 1624630
TI  - Sunscreens and the prevention of ultraviolet radiation-induced skin cancer.

PMID- 1624631
TI  - Hyperbaric oxygen and Mohs micrographic surgery in the treatment of
      osteoradionecrosis and recurrent cutaneous carcinoma.
AB  - Recurrent basal cell carcinoma (BCC) overlying bony structures which has been
      treated with radiation may be complicated by tumor invasion of bone and
      osteoradionecrosis. The authors present a case of recurrent BCC in which Mohs
      micrographic surgery and reconstructive surgery were augmented with pre- and post
      operative hyperbaric oxygen therapy.

PMID- 1624632
TI  - Immunotherapy and skin cancer.

PMID- 1624633
TI  - Consensus paper on venous leg ulcer. The Alexander House Group.
AB  - This is a condensed consensus report, summarizing the present status of various
      aspects of epidemiology, diagnosis, and treatment of venous ulcers. There are
      conflicting results regarding the prevalence of venous ulcers ranging from 0.18
      to 1.3%, depending on the types of ulcers reported. With regard to macrovascular
      changes preceding venous leg ulceration, ambulatory venous hypertension is the
      common pathway, usually related to incompetent perforating veins and the deep
      venous system. Obstruction of the deep venous system seems to be less frequently
      related to venous ulcers. Microvascular changes have been recently studied in
      more detail; morphologic as well as functional changes are summarized and
      considered from the viewpoint of various hypotheses, including fibrin cuff,
      leukocyte adhesion, etc. Various investigational approaches are summarized and
      recommendations for the most cost-effective diagnostic tests are given. Finally,
      conservative medical as well as surgical treatment avenues are evaluated.
      Emphasis is given to the normalization of ambulatory venous pressure by
      sclerotherapy, ligation, or other surgical procedures, in addition to
      compression. The consensus report is concluded by detailed recommendations for
      future clinical trials.

PMID- 1624634
TI  - Topical use of human recombinant epidermal growth factor (h-EGF) in venous
      ulcers.
AB  - A great deal of interest has been focused recently on the potential use of
      synthetic polypeptide growth factors to stimulate healing of chronic wounds. In
      this pilot double-blind randomized study conducted at a single center, we used
      human recombinant epidermal growth factor (h-EGF) to treat 44 patients with
      venous ulceration of the lower extremities. An aqueous solution (10
      micrograms/mL) of h-EGF was applied topically to the ulcers twice a day until
      healing occurred or for a maximum of 10 weeks. Patients were evaluated weekly for
      measurements of ulcer size and for the formation of granulation tissue suitable
      for grafting. Nine patients were excluded from efficacy evaluation because of
      protocol violations. Therefore, 35 patients (17 h-EGF, 18 placebo) were evaluable
      for efficacy, and 44 patients (22 h-EGF, 22 placebo) were available for safety.
      The median baseline ulcer size for all patients was 18.5 cm2, and was not
      significantly different between h-EGF and placebo group (12.9 cm2 versus 19.2
      cm2, respectively, P = .27). By study end, six (35%) of h-EGF treated patients
      and two (11%) in the placebo group had healed completely (P = .10). Another 6
      patients (2 of 17 h-EGF, 4 of 18 placebo; P = .50) developed healthy granulation
      tissue that was suitable for grafting. The median ulcer size reduction was 7% for
      h-EGF versus 3% for placebo per week (P = .29), and 73% versus 33% at study end
      (P = .32). No untoward side effects were related to the application of h-EGF. We
      conclude that topical application of h-EGF, in the dose and manner used in this
      study, was safe but failed to significantly enhance re-epithelialization of
      venous ulcers. However, a greater reduction in ulcer size and a larger number of
      healed ulcers with the use of h-EGF are encouraging results.

PMID- 1624635
TI  - The Bulletin of the North American Society of Phlebology. Insurance Advisory
      Committee Report.
AB  - The treatment of varicose veins as taught within the specialty of phlebology
      consists of the best combinations of sclerotherapy and surgery after a thorough
      evaluation by physical examination and Doppler ultrasound, as well as other
      techniques. Although patients can experience some relief of symptoms by external
      compression hosiery, only treatment that closes up leaky valves will stop the
      progression of disease. Sclerotherapy is a safe, well-accepted, non
      investigational, highly effective method to treat abnormally enlarged veins.
      Surgical procedures may be necessary to supplement sclerotherapy in certain
      anatomic sites. Varicose veins cause patients to experience pain, lose time from
      work, and can ultimately lead to permanent disability. Our healthcare system must
      provide the most high quality cost effective care for these patients. By keeping
      costs down as compared with full-scale surgical procedures, the approach of
      sclerotherapy or sclerotherapy with outpatient surgery, performed by properly
      trained physicians, provides a means to accomplish this. Medical necessity
      criteria allow exclusion of payments for patients seeking treatment purely for
      cosmetic needs.

PMID- 1624636
TI  - Recurrent varicose veins. Part 1: Evaluation utilizing duplex venous imaging.
AB  - There is the need to develop a universally accepted standard investigation for
      recurrent varicose veins. Duplex venous imaging offers a precise, non-invasive
      technique to make anatomic and hemodynamic diagnoses. A routine protocol of
      duplex imaging of recurrent varicose veins is described based on the known
      recurrent sources of reflux from deep to superficial veins. Results from this
      protocol indicate that incompetent perforating veins are the most common site of
      reflux from deep to superficial veins in patients with recurrent postsurgical
      varicose veins. Other important sites of reflux detected by this method are
      recurrent communications with the common femoral vein, the saphenopopliteal
      junction, and incompetent pelvic veins. Duplex imaging is recommended as a safe,
      non-invasive method of evaluating recurrent varicose veins.

PMID- 1624637
TI  - Total upper lip reconstruction with bilateral fan flaps.
AB  - Reconstruction of the total upper lip may be easily performed using fan flaps.
      However, two details must be taken into consideration: 1) the wide pedicle in the
      commissural angle, including the facial artery, must be designed, and 2) the
      mucosal flap must be 8 mm longer, in the inner portions, than the skin flap used
      to reconstruct the lip semimucosa.

PMID- 1624638
TI  - The vertical wedge biopsy.
AB  - A biopsy technique is described that has been used in my clinical practice
      thousands of times. This very simple, cost-effective technique employs only one
      surgical tool, the scalpel blade, and permits a biopsy to be taken with
      sufficient tissue for histologic analysis. In that there is no disruption of a
      tumor margin, it permits the physician to make a diagnosis and not limit his or
      her choice of therapeutic modalities. Again, I wish to stress that appropriate
      selection of lesions is a critical point of this technique. It is unacceptable
      for lesions suspected to be malignant melanoma or for dermatoses that may have a
      deep component.

PMID- 1624639
TI  - Office varicose vein surgery.

PMID- 1624640
TI  - Is a second dermabrasion usually necessary or not?

PMID- 1624641
TI  - Greek Society for Dermatologic Surgery.

PMID- 1624642
TI  - The Section of Dermatologic Surgery of the Polish Dermatologic Society.

PMID- 1624644
TI  - Cognitive function in major depression.
AB  - Forty patients with a major depressive episode were divided into equal endogenous
      and neurotic sub-groups using the Newcastle scale. They were all rated on the 17
      item Hamilton scale and with a variety of neuropsychological tests. They were
      compared with 20 age- and education-matched control subjects. Both endogenous and
      neurotic groups had impaired memory function on the auditory verbal learning
      test; recall and recognition were equally impaired suggesting that effort was not
      a major determinant of performance. The endogenous group was more impaired on
      digit symbol substitution and the Trail making test (A and B). Impairment was
      correlated with symptom scores on the Hamilton and Newcastle scales, even after
      allowing for the effect of age. It is concluded that the conventional distinction
      between organic and functional impairment breaks down in severe depressive
      illness. The implications of this for clinical neuropsychological testing and the
      anatomy of the brain dysfunction in depressive illness are discussed.

PMID- 1624643
TI  - Life events and relapse in bipolar affective disorder.
AB  - In a 2 year study of life events and relapse in a cohort of 62 patients with
      bipolar affective disorder, an excess of events was found during the month
      immediately preceding relapse. Of 52 relapses 19% were preceded by a severe event
      in the previous month, compared to a background rate of 5% of patients
      experiencing a severe event each month at other times. The rate of life events
      prior to relapse was not apparently different between manic and depressive
      relapse, though the number of depressive episodes was small.

PMID- 1624645
TI  - Post partum blues: depressive disease or pseudoneurasthenic syndrome.
AB  - Depressive mood disorders following childbirth can be quantified with self-rating
      and observer-rating scales. During two months, in the period from November 1989
      to March 1990, women admitted to the obstetric unit of the University of Wurzburg
      were examined on days 3 and 5 post-partum with the Hamilton Psychiatric Rating
      Scale for Depression, the Montgomery-Asberg-Depression-Rating-Scale and the
      Befindlichkeits-Scale by von Zerssen. Results reveal that during the early
      puerperium, scores on these scales rarely reach the same severity as in major
      depressive disorder. The clinical picture is no different from emotional
      hyperaesthetic hyposthenia following other kinds of physical illness such as
      endocrine disorders.

PMID- 1624646
TI  - The Galway Study of Panic Disorder. I: Clomipramine and lofepramine in DSM III-R
      panic disorder: a placebo controlled trial.
AB  - Among 79 volunteer, unpaid, family doctor-referred psychiatric out patients with
      DSM III-R panic disorder, with and without agoraphobia, 66 completed a six week
      placebo-controlled trial of lofepramine versus clomipramine and 57 survivors were
      followed up for 6 months. All subjects received one hour per week concurrent
      behavioural counselling in the acute phase. Of 13 dropouts in the first 3 weeks,
      9 (of 27) were on clomipramine, 2 (of 26) were on lofepramine and 2 (of 26) were
      on placebo. The high (30%) early dropout from the clomipramine group was largely
      due to medication intolerance. Both drugs were superior to placebo by the end of
      week 6 on several standard rating scales but not on panic attack frequency. No
      significant differences in efficacy were found between the two drugs tested to
      the end of 6 months. No tendency for relapse was noted in the three months
      following taper-off of medication from week 12 to week 24. The study provides
      evidence that both drugs, in the dosages used, are superior to placebo in the
      acute phase of panic disorder in treatment-naive subjects concurrently receiving
      appropriate psychotherapy.

PMID- 1624647
TI  - Recall and recognition memory deficits in depression.
AB  - The aim of the present study was to establish the nature of memory deficits of
      depressive subjects in word learning tests. A word learning test consisting of 1,
      3 or 5 learning trials was used. We found that patients were characterized by
      inferior memory recall compared to controls when 5 learning trials were given.
      Patients performed significantly slower than controls on a recognition test but
      both patients and controls recognized the same number of words. This suggests
      that the memory deficits that are present in many depressive subjects may be
      restricted to impaired active retrieval from memory. A second experiment revealed
      that recognition memory and delayed recall as well as immediate recall were
      impaired in depressive patients after 1 learning trial. These short-comings
      vanished after 3 trials, except for immediate recall. These data suggest that not
      only retrieval but also encoding of information into memory may be impaired in
      depression, especially in the beginning of a task when demands on cognitive
      effort are high. The results are discussed in terms of resource allocation and
      demands on effort that may change in the course of a task.

PMID- 1624648
TI  - Staffing patterns in hospital clinical dietetics and nutrition support: a survey
      conducted by the Dietitians in Nutrition Support dietetic practice group.
AB  - The Dietitians in Nutrition Support dietetic practice group of The American
      Dietetic Association administered a questionnaire to evaluate changes in
      nutrition support services provided to hospitalized patients and home patients in
      1989 and compared the results with results of a survey administered in 1986. The
      1986 survey documented an increase in tube feeding to inpatients during 1984 to
      1986 and greater dietitian staffing in tertiary care hospitals than in primary
      care hospitals and in larger hospitals in 1986. The 1989 questionnaire was mailed
      to clinical nutrition managers from a nationwide random sample of 1,000 hospitals
      from American Hospital Association members; 271 responses were received. Full
      time equivalent (FTE) registered dietitians (RDs)--including clinical RDs,
      nutrition support service RDs, and clinical nutrition managers--decreased 11%
      from 1986 to 1989. FTE dietetic technicians decreased 22%. The number of FTE
      nutrition support service RDs and clinical nutrition managers decreased
      significantly (P less than .05). The mean number of FTE clinical dietitians per
      100 beds decreased from 1.4 to 1.0 from 1986 to 1989. These decreases in
      dietetics staffing occurred despite an overall increase in total hospital FTE
      staff of 2.9%. Reported daily provision of nutrition support modalities to
      inpatients was 3.5% for parenteral nutrition, 4.9% for enteral tube feeding, and
      9.6% for oral supplements. Decreased dietetics staffing was accompanied by other
      factors that negatively affect productivity (and therefore ability to provide
      adequate patient care), including inadequate delegation of technical tasks to
      dietetic technicians, limited availability of secretarial and computer support,
      and minimal provision of pocket pagers. These trends may be evidence of
      inadequacy of dietetics staffing to meet the needs of the US population for
      nutrition care.

PMID- 1624650
TI  - Weight-related behaviors and concerns of fourth-grade children.
AB  - Behaviors and concerns related to weight were measured among 457 fourth-grade
      children attending 10 rural schools in central Iowa. A questionnaire was used to
      gather data on the children's concerns about being overweight, concerns that
      certain types or amounts of food would contribute to their being overweight,
      alterations in food intake to avoid being overweight, and perceptions that peers
      and family members were concerned about being overweight. In addition, each
      child's height and weight were measured. Weight-related behaviors and concerns
      increased with increasing weight-for-age and body mass index (BMI) and were more
      prevalent among girls than boys. The frequency of drinking diet soft drinks was
      positively correlated with weight-for-age and BMI and tended to increase with an
      increase in weight-related behaviors and concerns. Girls were more likely than
      boys to report a desire to be thinner (60.3% vs 38.4%), whereas boys were more
      likely than girls to want to be taller (67.2% vs 49.1%). The desire for less body
      fat was significantly associated with an increase in the frequency of weight
      related behaviors and concerns, the frequency of drinking diet soft drinks,
      weight-for-age, and BMI. These findings indicate a need for interventions that
      combat fear of obesity and restrictive eating among growing children.

PMID- 1624649
TI  - Effectiveness of enteric coated pancreatic enzymes given before meals in reducing
      steatorrhea in children with cystic fibrosis.
AB  - In vitro data indicate that length of enzyme incubation with food critically
      affects enzyme dissolution and presumably effectiveness. This study compared the
      effectiveness of enteric coated (EC) pancreatic enzymes given before meals with
      those given during meals (15 minutes after beginning of meal) in reducing
      steatorrhea in well-nourished children with cystic fibrosis. Eight children (6
      years 11 months old to 14 years 7 months old) were studied in the General
      Clinical Research Center at Indiana University Hospital, Indianapolis. A
      crossover study design randomly assigned enzymes before or during meals during
      two consecutive 7-day treatment periods for each child. No difference in fat
      excretion was documented for the total group when the children who took enzymes
      before meals were compared with those who took enzymes during meals. However, a
      stepwise multiple regression analysis of the difference (before minus during) in
      fat excretion on sex, age, enzyme number, and treatment order documented a
      positive correlation of age with fat excretion (r = .83). Mean fat excretion in
      younger children (less than 10 years old) decreased significantly when enzymes
      were given before meals (7.14 +/- 1.95%) rather than during meals (9.92 +/-
      1.61%) (P = .004). The difference in fat excretion (mean = 2.78 +/- 0.55%, range
      = 1.4% to 4%) translates into a half to one full year's growth potential. Younger
      children with cystic fibrosis may benefit clinically from taking EC enzymes
      before meals.

PMID- 1624652
TI  - Wasting malnutrition and inadequate nutrient intakes identified in a multiethnic
      homeless population.
AB  - The few previous studies of the nutritional status and dietary intakes of the
      homeless have been limited by small sample sizes. We collected information from a
      multiethnic sample of 277 homeless men and women in Miami, Fla. Data collected
      included a brief personal history, anthropometric variables, and a detailed 24
      hour dietary recall. An additional 24-hour dietary recall was collected from a
      subsample of 36 men. Socioeconomic characteristics of our sample were similar to
      that of other samples of the homeless. Using measurements of the upper arm muscle
      area, we identified wasting malnutrition in 20% of the men. Dietary intakes
      (percentage of the Recommended Dietary Allowances [RDAs] +/- standard error of
      the mean) for energy (82 +/- 2.88%), calcium (63 +/- 3.28%), zinc (56 +/- 2.61%),
      and vitamin B-6 (68 +/- 3.93%) were significantly below RDA guidelines for all
      ethnic groups. In addition, thiamin (75 +/- 6.34%) intakes for whites and vitamin
      A (61 +/- 12.53%) and riboflavin (74 +/- 7.72%) intakes for Hispanics were below
      RDA guidelines. Compared with men, women consumed significantly less energy,
      calcium, and zinc.

PMID- 1624651
TI  - A nutrition survey of and recommendations for individuals with Prader-Willi
      syndrome who live in group homes.
AB  - The purpose of this study was to describe anthropometric data and identify diet
      related problems of individuals with Prader-Willi syndrome (PWS) who reside in
      group homes. A group home is a licensed foster care facility that provides 24
      hour care for the developmentally disabled. Questionnaires were sent to
      dietitians (or the person responsible for nutrition care) of 25 group homes;
      responses from 18 homes were analyzed. The mean age of residents with PWS was 25
      +/- 8.4 years and the mean height was 152.4 +/- 9.7 cm. The mean weight for 19-
      to 22-year-old men was 75.5 +/- 26.8 kg and that for women of the same age was
      74.5 +/- 20 kg. The residents consumed a mean of 1,000 to 1,500 kcal/day. Most of
      the group homes (n = 16) locked their kitchens at night, and in 12 of the homes
      stealing and hoarding of food occurred. Pica behavior (eating of nonfoods) was
      reported in 7 homes. One third of all residents had success in weight loss and
      were on a maintenance diet, but a major problem was determination of a desirable
      weight goal. Our key recommendations for dietitians are weigh residents weekly;
      use the body mass index with prescribed zones for determination of weight goals;
      monitor change in circumference measurements; follow the guidelines of 7 to 8
      kcal/cm of height for weight loss and 10 to 14 kcal/cm of height for weight
      maintenance; administer 1,000 kcal/day or more and encourage daily aerobic
      exercise; respect food preferences while adhering to dietary prescriptions;
      adhere to strict food control procedures; and use nutrition education methods and
      an interdisciplinary approach for behavior modification.

PMID- 1624653
TI  - Perspectives on history: military dietetics in the Philippines during World War
      II.
AB  - The history of the profession of dietetics is a history of caring, dedicated, and
      capable individuals. This article examines the experiences of three dietitians
      during World War II in the Philippines--their pre-war status and their changing
      environments as the Japanese invaded the Philippines in overwhelming numbers. It
      recounts the extreme hardships they endured for 3 years as prisoners of war of
      the Japanese at Santo Tomas Internment Camp (formerly Santo Tomas University) in
      Manila. The article covers the time before Army dietitians had military status
      and concludes shortly after the former prisoners returned to the United States,
      when they were commissioned and promoted to the rank of first lieutenant.

PMID- 1624654
TI  - Review of L-tryptophan and eosinophilia-myalgia syndrome.
AB  - The ingestion of L-tryptophan (LT)-containing products has recently been
      associated with a newly diagnosed disorder known as eosinophilia-myalgia syndrome
      (EMS). This article reviews the pertinent research concerning the association
      between LT-containing products and EMS, including (a) the incidence and clinical
      course of EMS; (b) characteristics (eg, age and sex) of patients with EMS; (c) LT
      intakes (eg, dose, duration of intake) associated with EMS; (d) tracing of
      implicated LT-containing products to one raw material manufacturer, (e) theories
      related to the association, for example, the contamination theory; and (f)
      regulatory issues surrounding LT-containing products. The importance of this
      information to the dietitian is twofold. First, because LT is an essential amino
      acid, questions concerning LT-containing products and EMS are often directed to
      dietitians. Second, dietitians should be aware of the association to help
      facilitate the identification and care of patients with EMS.

PMID- 1624655
TI  - Prevalence of disordered eating in girls: a survey of middle-class children.

PMID- 1624656
TI  - Effect of level of lesion and quality of ambulation on growth chart measurements
      in children with myelomeningocele: a pilot study.

PMID- 1624657
TI  - Elderly veterans at risk for nutrition-related cardiovascular disease.

PMID- 1624658
TI  - Effect of a state dietetic association's weight management program on its
      members.

PMID- 1624659
TI  - Dietary status and eating out practices of college students.

PMID- 1624660
TI  - President's page: achievement...action...excellence--75 years of food and
      nutrition leadership.

PMID- 1624661
TI  - Maternity and medicine.

PMID- 1624662
TI  - Speak out for reproductive rights.

PMID- 1624663
TI  - Elizabeth Blackwell medal.

PMID- 1624664
TI  - Bertha Van Hoosen Award.

PMID- 1624665
TI  - Calcium Nutrition Education Award.

PMID- 1624666
TI  - Camille Mermod Award.

PMID- 1624667
TI  - Can children be a part of medical school?

PMID- 1624668
TI  - Pregnancy during residency: a look at the issues.

PMID- 1624669
TI  - When to have a baby: an obstetrical point of view.

PMID- 1624670
TI  - Who takes care of the caregiver's children?

PMID- 1624671
TI  - Physician pregnancy: male and female colleagues' attitudes.
AB  - A survey questionnaire was mailed to residents and faculty at a midwestern
      medical school to assess male and female attitudes toward colleagues'
      pregnancies. A total of 67% (N = 97) of the 145 faculty and 48% (N = 103) of the
      214 residents completed surveys, yielding an overall return rate of 56% (N =
      200). Among faculty, responses on only 1 of the 15 items showed a significant
      difference by gender. Residents' responses, however, showed statistically
      significant gender differences on 8 of the 15 items. More female than male
      residents felt that pregnant physicians maintain job performance and interest in
      medicine. More male than female residents believed pregnancy was disruptive to
      relationships with colleagues and viewed women of childbearing age as a risk to
      the optimum functioning of a department. The authors discuss reasons for the
      gender differences in attitude found among the residents and suggest possible
      interventions.

PMID- 1624672
TI  - Maternity leave: rights, rules and regulations.

PMID- 1624673
TI  - Physician mothers: a conceptual model for planning and coping with motherhood and
      medical practice.

PMID- 1624674
TI  - Finding HIV-infected women--the clinician's role.

PMID- 1624675
TI  - Plasma growth hormone (GH) responses to corticotropin-releasing hormone in
      patients with acromegaly--the effect of dexamethasone pretreatment and the
      comparison with GH responses to thyrotropin-releasing hormone, gonadotropin
      releasing hormone and GH-releasing hormone.
AB  - It has been reported that paradoxical GH responses to corticotropin-releasing
      hormone (CRH) occur in only few patients with acromegaly. However, we have
      observed such responses in 7 of 14 active acromegalic patients. Therefore, we
      have studied the GH responses to thyrotropin-releasing hormone (TRH) (500
      micrograms, iv), gonadotropin-releasing hormone (LHRH) (100 micrograms, iv) and
      GH-releasing hormone (GHRH) (100 micrograms, iv) in these patients to examine the
      relationships between the GH responses to CRH and the responses to these
      hypothalamic hormones. Further, these patients received human CRH (1-41) NH2 (100
      micrograms, iv) with or without dexamethasone (Dex) pretreatment (1 mg/100 ml
      saline, iv, from -30 to +30 min) to study the mechanism of CRH-induced GH
      secretion, and a perifusion experiment was performed using adenoma tissue
      obtained at surgery from one patient (10(-7) M CRH and TRH were added) to
      elucidate whether CRH acts directly at the pituitary level. Aberrant GH responses
      induced by CRH were found in 7 of 14 (50%) acromegalic patients (TRH responders:
      10/13, 77%; LHRH responders: 2/9, 22%; GHRH responders: 10/12, 83%). In these
      patients, percent GH increment induced by CRH ranged from 81 to 144% (Mean +/-
      SE, 118 +/- 8%), and the GH peak (19 +/- 3 min) appeared as early as after TRH
      (23 +/- 4 min, N = 10).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624676
TI  - Effectiveness and long-term tolerability of the slow release oral form of
      bromocriptine on tumoral and non-tumoral hyperprolactinemia.
AB  - The effectiveness and long-term tolerability of a new formulation of
      bromocriptine with slow gastrointestinal release (Parlodel SRO) has been
      evaluated on ten patients with macroprolactinoma, seven patients with
      microprolactinoma and five patients with nontumoral hyperprolactinemia during a
      period of 1-30 months. Six out of ten macroprolactinoma-bearing patients obtained
      a rapid normalization of plasma PRL levels with reduction of the tumor size
      recorded by CT scan follow-up. Four of six microprolactinomas and all the five
      nontumoral hyperprolactinemic patients became normoprolactinemic with recovery of
      gonadal functions while in two other microprolactinomas Parlodel SRO
      significantly reduced plasma PRL levels with restoration of menses. Only in two
      patients the treatment was withdrawn for the appearance of side effects. In
      conclusion, Parlodel SRO is an effective drug in the management of tumoral and
      nontumoral hyperprolactinemia. The good long-term tolerability together with the
      hypoprolactinemic activity makes this drug a very good choice therapy in
      hyperprolactinemic syndromes even in case of poor tolerability to the standard
      formulation of the drug.

PMID- 1624677
TI  - Evaluation of hypothalamic-pituitary function in patients with thalassemia major.
AB  - The increased survival of patients with thalassemia major, made possible by more
      adequate therapeutic regimens, has emphasized the importance of the endocrine
      abnormalities often associated with this disease. In twelve thalassemic patients,
      we evaluated the hypothalamic-pituitary function by measuring plasma levels of
      anterior pituitary hormones under basal conditions and in the course of
      provocative tests. An impairment of growth hormone (GH) secretion was
      demonstrated in a considerable proportion (7/12) of these patients. In some of
      them failure of GH response to insulin-hypoglycemia and normal hormone rise after
      growth hormone-releasing hormone indicate a hypothalamic defect. A defective
      prolactin secretion was observed in the female hypogonadic but not in the male
      thalassemic patients. This abnormality appears to be dependent on estrogen
      deficiency rather than on a hypothalamic-pituitary dysfunction. In our series a
      high prevalence (8/12) of hypogonadism was also noticed. In these cases, the low
      gonadotropin levels and their unresponsiveness to gonadotropin-releasing hormone
      are compatible with a hypothalamic and/or pituitary damage. Lastly, the enhanced
      ACTH responses to the stimuli associated to a reduced cortisol release suggest
      the existence, in these patients, of a diminished adrenocortical reserve. On the
      whole, this study has shown several derangements of the hypothalamic-pituitary
      function in thalassemia. This emphasizes the need for careful endocrine
      surveillance in this disease.

PMID- 1624678
TI  - Octreotide therapy of growth hormone excess in the McCune-Albright syndrome.
AB  - We report a patient with the McCune-Albright syndrome and growth hormone excess.
      Biochemical evaluation demonstrated characteristic changes typical of acromegaly,
      and an unusual pattern of delayed somatotropin response to hGHRH40, not
      previously described in this syndrome. Therapeutic trial of low-dose octreotide
      successfully reversed his growth hormone excess, whereas bromocriptine failed to
      reduce growth hormone levels. Previous reports of acromegaly and McCune-Albright
      syndrome are reviewed, and the unique features of this case discussed.

PMID- 1624679
TI  - The evolution of Graves' ophthalmopathy during treatment with antithyroid drug
      alone and combined with triiodothyronine.
AB  - We analyzed the evolution of the ophthalmopathy associated with Graves'
      hyperthyroidism in 45 patients treated with two different antithyroid drug
      regimens. Group A patients (n = 31) received either methimazole (40-100 mg daily)
      or propylthiouracil (400-900 mg daily) combined with T3 daily throughout
      treatment. Group B patients (n = 14) were treated with conventional regimen with
      lower doses of either methimazole (5-25 mg daily) or propylthiouracil (50-300 mg
      daily) and no T3 addition. Eye signs and proptosis measurement were evaluated
      just before the beginning of the treatment and compared with the results after
      antithyroid drug withdrawal. Improvement of the eye signs considered on grounds
      of the NOSPECS classification was greater in group A than group B (p less than
      0.01). Also, the decrease in proptosis measurement was greater (p less than 0.01)
      in patients treated with combined regimen (21.5 +/- 2.4 mm to 20.4 +/- 2.3 mm)
      than in patients receiving conventional therapy (20.4 +/- 1.6 mm to 20.0 +/- 1.7
      mm). Serum thyroglobulin concentrations did not correlate with either the
      severity or the evolution of the ophthalmopathy. Negative serum antithyroglobulin
      antibody (TgAb) was associated with the improvement of the ophthalmopathy that
      was noted in 24 out of 27 patients (Chi-Square = 5.84; p less than 0.001). Thus,
      serum TgAb levels might have some connection with progression of eye signs but
      serum Tg concentration does not. Our study suggests that in most patients the
      transition from hyperthyroidism to euthyroidism induced by antithyroid drug
      therapy is associated with the improvement of the Graves' ophthalmopathy.
      However, no marked difference can be drawn between the two treatment regimens.

PMID- 1624680
TI  - Corticosterone methyloxydase deficiency type II in a Croatian girl.
AB  - This is a brief case report on a four-month-old girl who was admitted for failure
      to thrive and moderate dehydration. On admission she was mildly dehydrated and
      undernourished but with otherwise normal physical findings. Laboratory
      investigation disclosed mild but constant hyponatremia and hyperkalemia, very
      high plasma renin activity (greater than 900 ng/mL per hour) and low plasma
      aldosterone concentration (2.5 ng/dL). The plasma 18-hydroxycorticosterone (18-OH
      B) was very high (1,682 ng/dL), producing thus an abnormally elevated 18-OH-B to
      aldosterone ratio of 542 (normally 6.3 +/- 3.6). The diagnosis of corticosterone
      methyloxydase deficiency type II was made, and the administration of
      fluorohydrocortisone resulted in rapid weight gain with normalization of blood
      electrolytes and gradual decrease in plasma renin activity. A very efficient
      catch-up growth resulted in normal body weight and length at the age of 2 years.
      This is the first well documented case of the disease in the population of
      Yugoslavia.

PMID- 1624681
TI  - Deceptively high thyroid hormone levels in a neonate due to autoantibodies
      against thyroid hormones transferred from a mother with Graves' disease.
AB  - At birth, a clinically euthyroid male neonate was found to have unexpectedly high
      levels of free T3 and T4 concurrent with a high TSH level. The mother was treated
      with propylthiouracil for Graves' disease during and after pregnancy. The neonate
      also had an extremely high titer of TSH receptor antibodies. He soon became
      clinically thyrotoxic as TSH levels were suppressed and thyroid hormone levels
      rose. After instituting antithyroid therapy, TSH levels became elevated again,
      while thyroid hormone levels decreased but were still above normal. Around 3
      months after birth, both TSH receptor antibodies and discordance, between the
      levels of thyroid hormones and TSH, disappeared. Because of high maternal TSH
      levels in conjunction with an elevated free T3 level at 7 months postpartum, we
      suspected the presence of autoantibodies against thyroid hormones (AAb). Maternal
      and infant blood samples were then examined retrospectively for AAb and were
      detected in all the samples except those of the infant taken more than 3 months
      after birth. The authors, therefore, suggest that physicians be aware of the
      presence of AAb in pregnant women with Graves' disease, in order to avoid
      inappropriate treatment which could lead to fetal and neonatal hypothyroidism.

PMID- 1624682
TI  - Transplacental passage of autoantibodies to triiodothyronine.
AB  - Autoantibodies to T3 (T3Ab) were detected by immunoprecipitation in a 18-year-old
      female patient affected by Graves' disease. The presence of these antibodies was
      constantly confirmed during a 7-year follow-up period, independently of therapy
      and functional thyroid status. Antithyroid microsomal antibodies (McAb) and TSH
      binding-inhibiting antibodies (TBII) were also present. The title of AbT3, McAb
      and TBII fluctuated, at times, independently of one another. The patient became
      pregnant; during pregnancy T3Ab concentration fell and went up again 4 months
      after delivery. A normal baby was born. T3Ab were present in the cord blood and
      declined during the following 2-8 months. The T3Ab of both mother and child
      belonged to the IgG class. The concentrations and the binding affinities of T3Ab
      in mother and child were identical. The presence of T3Ab in the child did not
      affect his thyroid function.

PMID- 1624683
TI  - Gonadotropin evaluation in the diagnosis of polycystic ovary syndrome using
      either a monoclonal or a polyclonal antibody radioimmunoassay.
AB  - The LH/FSH ratio values between gonadotropins dosed with a monoclonal antibody
      assay (IRMA) in the micropolycystic ovary syndrome (PCOS), are discussed and
      compared to those obtained with the classic assays using polyclonal antibodies.
      Because of the higher selectivity of this IRMA assay it is noteworthy that the
      cut-off value between normal and PCOS patients is now equal to or above one. The
      evaluation of the LH/FSH ratio between the peak values of the two gonadotropins
      after a GnRH 100 micrograms iv bolus, may be useful in the diagnosis of PCOS in
      those patients who present an LH/FSH less than 1 in basal conditions even in the
      presence of clinical and ecographic aspects of PCOS.

PMID- 1624685
TI  - An emerging hypothesis: synergistic induction of aging by free radicals and
      Maillard reactions.
AB  - Most modern theories of aging have centered around the notion that age-related
      deterioration is primarily due to structural and functional modifications of
      cellular constituents. Among them are three currently popular hypotheses--the
      Free Radical, Glycation, and Maillard Theories of Aging. The first proposes that
      age-related effects are due to free radical reactions that damage cellular
      constituents, while the latter propose damage induced by nonenzymatic glycation
      and other Maillard reactions and the consequent modification of macromolecules as
      the primary cause of aging. Although these hypotheses were formulated
      independently, recent studies suggest that free radicals, glycation, and Maillard
      reactions may in fact represent partially interactive elements of a single, more
      complex biochemical pathway. We therefore propose the Free Radical
      Glycation/Maillard Reaction Theory of Aging: that age-related deterioration is
      produced by the sum of the damage induced by free radicals, by glycation, by
      Maillard reactions, and by their interactions.

PMID- 1624684
TI  - Diagnosis and treatment of Cushing's syndrome. Cushing's syndrome: current
      clinical problems, symposium. Padova, October 19-20, 1990.

PMID- 1624686
TI  - Cellular determinants of age-related decrements in the T-cell mitogen response of
      B6CBAF1 mice.
AB  - Age-related changes in the cellular composition of the immune system that are
      associated with an impaired proliferative response to T-cell mitogens were
      identified for B6CBAF1 mice. The frequencies of precursors of Con A-induced IL-2
      secreting cells (pHTL) and of Con A-induced cytotoxic cells (pCTL), determined by
      limiting dilution analysis, were lower for splenocytes from old mice, as were the
      proliferative responses to Con A and PHA, determined in conventional high cell
      density cultures for the same mice. The pHTL frequency correlated with the
      proliferative response to Con A (r2 = .94) and to PHA (r2 = .83) among old mice,
      but not among young; there were no correlations of pCTL frequency with
      proliferative responses. The reduced pHTL frequency in old mice resulted from:
      (a) an age-related doubling of the number of splenic B cells that diluted T
      cells, and (b) a 67% decline in the absolute number of Con A-reactive pHTL cells
      in the spleen that appeared despite the maintenance of normal numbers of total
      splenic CD4+ and CD8+ cells. Thus, both a decline in absolute pHTL numbers and an
      increase in the number of non-T cells in the spleen result in a diminished pHTL
      frequency that is closely linked to the impaired mitogen response observed for
      old B6CBAF1 mice.

PMID- 1624687
TI  - Acute wound repair in an aged animal: a model for accelerated aging of the
      microvasculature?
AB  - This study of wound repair in the aged rat is based on increased carbohydrate
      content of various proteins which occurs with aging and is readily seen in the
      microvasculature (MV). We have used the periodic acid-Schiff (PAS) reaction to
      identify histochemically the carbohydrate moiety of the glycoproteins found in
      these blood vessels. In the young rat, as in other young vertebrates, elements of
      the MV are PAS negative and become increasingly PAS+ beyond the half life span.
      During acute wound repair in an old animal, the new capillaries and venules are
      PAS- 2 weeks after injury, moderately PAS+ at 4 weeks, and intensely PAS+ at 8
      weeks. Arterioles are present and PAS+ at 6 weeks, and intensively positive at 8
      weeks, comparable to vessels remote from the wound site. The MV in wound repair
      in a young animal remains PAS- throughout healing. Rapid aging of the
      microvasculature in wound repair in an old animal reproduces histochemically the
      aging which occurs progressively during the prior 24 months. These histochemical
      changes may result from successive enzymatic and nonenzymatic glycosylation of
      the various basement membrane proteins in the microvasculature in both normal
      aging and wound repair in the aged animal. The latter may serve as a model for
      study of accelerated aging.

PMID- 1624688
TI  - Accumulation of cardiac lipofuscin depends on metabolic rate of mammals.
AB  - The accumulation of lipofuscin, an important phenomenon during aging, suggests
      that the sexual maturity (puberty) of mammals is a starting point of the aging
      process. The rate of cardiac lipofuscin accumulation was not correlated linearly
      with maximum life span of mammals, but the correlation was a power function of
      the maximum life span. The rate of lipofuscin accumulation statistically
      correlated with the specific metabolic rate, and inversely correlated with the
      brain weight of mammals. The first appearance of lipofuscin showed a good
      correlation with the brain weight. However, the slope of the line was different
      between primates and domestic and laboratory animals. From these results, it is
      suggested that the accumulation of cardiac lipofuscin is dependent on the
      specific metabolic rate of mammals.

PMID- 1624689
TI  - Effects of the selective serotonin reuptake inhibitor fluoxetine on baroreceptor
      reflex sensitivity and body weight in young and old rats.
AB  - Male F344BNF1 hybrid rats (F1 crosses between female Fischer 344 and male Brown
      Norway rats) aged 3 or 24 months were treated with vehicle (1 ml water/kg, IP) or
      fluoxetine (10 mg/kg, IP) once a day for 1 day or 27 consecutive days; body
      weights were recorded daily. Baroreceptor sensitivity was assessed in conscious
      unrestrained rats implanted with vascular catheters 24 hours after the single or
      27th injection by measuring peak changes in mean arterial pressure (MAP) and
      heart rate (HR) elicited by graded doses of phenylephrine or nitroglycerin, IV.
      The results demonstrate that the effects of the serotonin uptake inhibitor
      fluoxetine, whether administered acutely or for 27 days, are similar in young and
      old rats: a relative decrease in body weight, a slight decrease in resting MAP
      without a change in HR, and no effect on baroreceptor sensitivity. In addition,
      this study in F344BNF1 hybrid rats supports previous reports in inbred rat
      strains by demonstrating that baroreceptor dysfunction, but not hypertension, is
      observed in old rats.

PMID- 1624690
TI  - A comparison of the ventilatory responses to exercise of elderly and younger
      humans.
AB  - Elderly adults are assumed to have an exaggerated ventilatory response to
      exercise. This study sought to examine this assumption by comparing the steady
      state ventilatory and gas exchange responses of a group of elderly and younger
      humans. Steady-state ventilatory responses to moderate cycle ergometer exercise
      were measured in 14 elderly (71.0 +/- 1.3, mean +/- SEM years) and 14 younger
      (21.8 +/- 0.7 years) subjects. Compared with the younger group, the elderly had a
      significantly higher VE, VCO2, and VO2 at all work rates. In addition, delta
      VE/delta VCO2 was significantly higher for the elderly than for the younger
      subjects (31.07 +/- 1.34 vs 27.16 +/- 1.01, respectively; p less than .03), but
      the intercept with the ventilation axis was significantly lower (0.81 +/- 0.97
      1.min-1 vs 4.15 +/- 0.77 1.min-1, respectively; p less than .015). Consequently,
      the VE-VCO2 relationships of the two groups crossed and the ventilatory
      equivalent for CO2 was similar for both groups. Thus, in these elderly subjects,
      the steeper delta VE/delta VCO2 was misleading because it was not associated with
      a greater ventilatory equivalent for CO2. In summary, although the ventilatory
      response of these elderly subjects to a given work rate was greater than that of
      the younger subjects, this was secondary to a greater metabolic requirement and
      cannot therefore be considered exaggerated. Furthermore, the data suggest that
      delta VE/delta VCO2 may be an inappropriate index of the ventilatory response to
      exercise in the elderly.

PMID- 1624691
TI  - The association of E. coli peritonitis with an impaired and delayed fever
      response in senescent rats.
AB  - Infection is one of the leading causes of death in elderly humans, and the
      importance of the early diagnosis of severe infection is undisputed. In the
      elderly a delay in diagnosis is often due to a reduced or absent fever. To
      understand more fully the pathogenesis of fever in senescence, we assessed the
      febrile response to E. coli peritonitis in 3-, 12-, and 24-month-old rats.
      Baseline temperatures were unchanged with age. Following infection with 1 x 10(8)
      CFU E. coli, a fever was evident in 2.8 h in the young, 3.9 h in the 12-month-old
      rats, and delayed until 5.8 h in the senescent rats. The magnitude of the fever
      was quantitatively less in the older rats compared with the two younger age
      groups throughout the time course of the fever. Because beta-adrenergic-mediated
      thermogenesis in brown adipose tissue has been implicated in the genesis of
      fever, we also assessed adenylate cyclase activity in this tissue. There was a
      progressive age-related decrease in both receptor- and postreceptor-stimulated
      adenylate cyclase activity. Our findings indicate there is both a delay in the
      onset of the fever and a reduced febrile response in the senescent rats following
      E. coli infection.

PMID- 1624692
TI  - The predictive validity of self-report and performance-based measures of function
      and health.
AB  - To learn about the value of self-report and performance-based measures of
      function in predicting mortality and institutionalization, we conducted a
      longitudinal study of 149 elderly persons at four sites (a senior citizens
      housing unit, two ambulatory-based geriatrics practices, and a board-and-care
      facility). At baseline, all subjects were administered a questionnaire containing
      Katz, Spector, and Rosow-Breslau scale items as well as the Mini-Mental State
      Exam and two performance-based measures, the Tinetti gait score and Physical
      Performance Test. At follow-up (average 22 months; range 17-29 months), 17
      subjects (11%) had died and seven (5%) had been institutionalized. Univariate
      analysis demonstrated significant associations between death and all functional
      status measures. In logistic regression models, Katz items, Tinetti gait score,
      and the seven-item Physical Performance Test were independent predictors of
      "death or nursing home placement"; Katz items and the seven-item Physical
      Performance Test were independent predictors of mortality. These findings support
      the use of performance-based as well as self-report measures for clinical and
      research purposes.

PMID- 1624693
TI  - Opioid analgesics and the risk of hip fracture in the elderly: codeine and
      propoxyphene.
AB  - We studied the risk of hip fracture in elderly persons receiving prescriptions
      for two commonly prescribed opioid analgesics--codeine and propoxyphene. Using
      automated prescription and hospitalization data, we identified 4,500 residents of
      Saskatchewan, Canada, aged 65 or older, who sustained a hip fracture between 1977
      and 1985, and 24,041 age- and sex-matched controls. Compared to nonusers, the
      relative risk (95% CI) of hip fracture in current users of codeine or
      propoxyphene was 1.6 (1.4-1.9). There was no difference between relative risks of
      fracture among current users of codeine [1.6 (1.3-1.9)] and propoxyphene [1.6
      (1.2-2.2)]. In new users of these opioids, the relative risk of fracture was 2.2
      (1.7-2.8), compared to 1.3 (1.0-1.6) in users who received at least one
      additional prescription for codeine or propoxyphene in the 90-day period prior to
      the index date. Concurrent users of these opioids and psychotropic drugs
      (sedatives, antidepressants, or antipsychotics) had a risk of fracture 2.6 (2.0
      3.4) times that of nonusers of either drug class. Review of a sample of medical
      records for 701 cases suggested this finding was not due to confounding by body
      mass, ambulatory status, functional status, or dementia. Given the essential role
      of opioids in the management of pain in geriatric practice, further study is
      needed to determine the psychomotor effects of opioid analgesics in older adults.

PMID- 1624694
TI  - A bowel symptom questionnaire for the elderly.
AB  - While functional gastrointestinal complaints are common in the elderly, valid
      instruments for their assessment are lacking. We have developed the elderly bowel
      symptom questionnaire (EBSQ) and report its feasibility, reliability, and
      validity in medical outpatients and a larger sample of the community (aged 65
      93). Reliability was measured by a test-retest procedure, while concurrent
      validity was documented by comparing physician interview and self-report data.
      Reliability (median kappa 0.65, interquartile range 0.49-0.79), and validity
      (median kappa 0.68, interquartile range 0.51-0.80) were very acceptable. A random
      sample of 424 independently living elderly persons was obtained; 77% replied to
      the mail survey. Medical record review showed that no current diagnosis of
      irritable bowel syndrome was missed by the questionnaire. Our results confirm
      that the EBSQ was easy to understand and well accepted, and was a reliable and
      valid measure of gastrointestinal symptoms in older persons; this instrument may
      have important clinical and research applications.

PMID- 1624695
TI  - The association of physical activity with mortality among older adults in the
      Longitudinal Study of Aging (1984-1988).
AB  - Self-reported physical activity/exercise and mortality among adults aged 70 and
      over were examined using data drawn from the 1984-1988 Longitudinal Study of
      Aging (LSOA). Analyses were conducted for the LSOA sample as a whole (N = 5901),
      for women (n = 3679) and men (n = 2222), and for persons with 1 + IADL
      difficulties (n = 1592). Results for the whole sample indicated that less
      activity/exercise was associated with a higher risk of mortality for each of four
      questions (activity compared to peers, have regular exercise routine, get enough
      exercise, days walking a mile per week). Analyses by gender indicated that all
      four questions were important for women, while the two questions asking for a
      judgment about activity were important for men. For persons with 1 + IADL
      impairments, walking was associated with lower mortality. This investigation
      supports literature on the importance of maintaining physical activity into older
      adulthood, and suggests that clinicians should attend to reports of activity
      level by their patients as one of the broader psychosocial domains of patient
      care.

PMID- 1624696
TI  - Salivary gland function and glucose metabolic status.
AB  - To study the relationship between glucose metabolic status and salivary gland
      function in different-aged persons, subjects with diabetes mellitus (DM = 11),
      impaired glucose tolerance (IGT = 26), and controls (n = 26), aged 24 to 93, were
      examined in the oral physiology component of the Baltimore Longitudinal Study of
      Aging. All were generally healthy (except DM) and nonmedicated. The controls and
      subjects with IGT were classified using World Health Organization criteria, and
      diabetic status was assessed using Hb1Ac levels. Unstimulated and 2% citrate
      stimulated parotid and submandibular salivary flow rates were collected, and
      subjective responses to questions about salivary hypofunction were evaluated. No
      statistically significant differences were observed between the three groups, nor
      between young and old subjects with altered glucose metabolism. These findings
      suggest that among well-controlled individuals with altered glucose metabolism,
      salivary gland function is not significantly impaired.

PMID- 1624697
TI  - Exercise training improves fat distribution patterns in 60- to 70-year-old men
      and women.
AB  - Changes in body composition and fat distribution in response to endurance
      exercise training were compared in 47 men and 46 women, aged 60 to 70 yr. Body
      composition was assessed by hydrodensitometry and fat distribution was evaluated
      with skinfold thickness and circumference measures. The 9- to 12-mo exercise
      program consisted primarily of walking and/or jogging for 46 +/- 5 min.d-1, 4.0
      +/- 0.6 d.wk-1, at 80 +/- 5% of maximal heart rate. Although men lost more weight
      during the exercise program than women (men, -3.4 +/- 4.4 kg; women, -1.6 +/- 3.8
      kg), relative changes were not significantly different, averaging -3.7 +/- 4.1%
      and -2.7 +/- 2.9% of body weight in men and women, respectively. The changes in
      body weight reflected fat loss, as fat-free mass did not change. The reductions
      in skinfold thickness and circumferences were similar in men and women, and in
      both groups the largest absolute and relative changes occurred in the truncal
      area, indicating a preferential loss of fat from the central regions of the body.
      The results of this study indicate that endurance exercise training can favorably
      modify the abdominal fat distribution profile that is typical of older men and
      women in the United States and thus, perhaps, reduce the risk of the diseases
      associated with abdominal obesity.

PMID- 1624698
TI  - Rhythmic vs homeostatic influences on mood, activation, and performance in young
      and old men.
AB  - Nine healthy old (80+ years) men were compared with nine healthy young (20-30
      years) men in a protocol that required 36 hours of continuous wakeful bedrest.
      Body temperature rhythm measurement confirmed that the old had as robust an
      endogenous circadian (approximately 24 hours) rhythm generation mechanism as the
      young. However, in measures of affect, activation, visual search speed, verbal
      reasoning speed, manual dexterity, and vigilance hit rate, the old showed a
      linear decline over the 36 hours of the vigil, with little of the superimposed 24
      hour rhythmicity that was apparent in the young. Thus, separate from the
      endogenous rhythm generation processes, there appeared to be some attenuation
      with advanced age, which led to the relative absence of rhythmic expression in
      these mood and performance variables. Such attenuation might contribute to some
      of the sleep and performance problems reported by elderly adults.

PMID- 1624699
TI  - The factorial generality of brief positive and negative affect measures.
AB  - Confirmatory factor analysis was used to test the structure of 5-item affect
      rating scales designed to measure positive affect and negative affect. A proposed
      circumplex affect structure was the source of scales constructed to represent a
      cluster of positive terms, including pleasantness and activation; the negative
      terms represented anxiety, depression, and hostility. The hypothesized simple
      structured positive and negative trait affect factors, with a moderate
      correlation between them, were found in all cases. Equivalent structure was
      confirmed for younger adults, middle-aged, and older adults of good health and
      above-average education. Although the hypothesized simple-structured positive and
      negative factors emerged for all other groups, three other tests of factor
      equivalence failed to be confirmed: trait and state factors in the older adult
      group were not identical. Factors derived from healthy and frail elders were
      structurally different. Variability among frail elders and variability over 30
      days within the same person, when factored, also showed nonequivalence. Although
      the scales are extremely useful in assessing affect, comparisons across some
      subject groups should be made with caution.

PMID- 1624700
TI  - Indicators of active and passive coping in myocardial infarction victims.
AB  - This retrospective study attempted to explore life events, personality factors,
      subjective perceptions, and coping reactions in myocardial infarction (MI)
      patients. Seventy-seven MI survivors participated in the study. The PERI Life
      Events Scale, the 16 PF personality inventory, and a questionnaire covering self
      ratings of subjective perception and coping reactions were used to assess event
      related influences. The following results were obtained: Multiple regression
      analyses yielded strong relationships between insecurity predicting perceived
      changeability, challenge, and threat. The number of prior events was a good
      predictor for problem solving and self-reflection, while self-attribution for the
      occurrence of the MI predicted self-blame and denial. A structural equation model
      indicated that anxiety and experience with stressful events were salient
      predictors for appraisal, whereas experience with prior events best predicted
      active coping, and socioeconomic status negatively predicted passive coping.

PMID- 1624701
TI  - Caregiver and environmental variables related to difficult behaviors in
      institutionalized, demented elderly persons.
AB  - This study describes the relationship between caregiver and elder behavior in
      institutionalized, cognitively impaired, elderly persons. A repeated-measures
      design was used to observe interactive behaviors between caregivers and demented
      elders within three caregiving situations (dressing, toileting, and bathing) and
      an interpersonal contact in two long-term care facilities. During observations,
      the caregiver's behaviors were rated using the Interaction Behavior Measure and
      Health Professional's-Geriatric Patient Behavior Rating scale, whereas the
      elder's behaviors were rated using a modified version of the Interaction Behavior
      Measure. The study included 116 subjects (58 elders and 58 caregivers), with each
      unique caregiver/elder pair being observed in the four situations. All elder
      behaviors varied according to situation type, with the most difficult elder
      behaviors occurring during bathing. Ten of the 12 caregiver behaviors included in
      the analysis varied by situation type. Significant relationships were
      systematically found between the caregiver's relaxed and smiling behavior and the
      elder's calm/functional behaviors, r = .42 (dressing) to r = .46 (toileting) for
      caregiver relaxed behavior and r = .34 (bathing) to r = .58 (dressing) for
      smiling. The elder's behavior did not vary by type of nursing unit (special
      dementia unit or general nursing unit), or interruptions to the interaction.

PMID- 1624702
TI  - Influence of direct computer experience on older adults' attitudes toward
      computers.
AB  - This research examined whether older adults' attitudes toward computers became
      more positive as a function of computer experience. The sample comprised 101
      community-dwelling older adults aged 57 to 87. The intervention involved a 2-week
      computer training program in which subjects learned to use a desktop publishing
      software program. A multidimensional computer attitude measure was used to assess
      differential attitude change and maintenance of change following training. The
      results indicated that older adults' computer attitudes are modifiable and that
      direct computer experience is an effective means of change. Attitude change as a
      function of training was found for the attitude dimensions targeted by the
      intervention program: computer comfort and efficacy. In addition, maintenance of
      attitude change was established for at least two weeks following training.

PMID- 1624703
TI  - Adults' reading comprehension: effects of syntactic complexity and working
      memory.
AB  - Two experiments investigated the relationship between working memory and reading
      comprehension. In the first, college students, 18 to 26 years of age, and adults,
      60 to 92 years of age, were given a battery of tests of working memory, a
      standard timed reading comprehension test, and a reading test designed to explore
      how syntactic complexity affects comprehension. In a follow-up study, the adults
      were retested on a modified version of the syntax comprehension text. Age group
      declines in working memory and reading comprehension were obtained in Experiment
      I; age group declines in reading rate but not comprehension were obtained in
      Experiment II. The results suggest that working memory limitations affect elderly
      adults' ability to process complex syntactic constructions, lowering
      comprehension in the timed test (Experiment I) and reducing reading rates in the
      untimed test (Experiment II).

PMID- 1624704
TI  - A comparison of changes in macrolinguistic and microlinguistic aspects of
      discourse production in normal aging.
AB  - Middle-aged and elderly healthy subjects were interviewed informally, and their
      discourse productions were analyzed to test for age-related changes in language
      specific, microlinguistic, and in higher order organizational, macrolinguistic
      abilities. No significant age differences were found on microlinguistic measures,
      including syntactic complexity and syntactic and lexical production errors, and
      there were also no age differences in the use of lexical cohesive ties, such as
      anaphora. Older subjects, however, obtained significantly lower ratings on a
      macrolinguistic measure of global thematic coherence. Elderly subjects failed to
      maintain coherent reference to the general topic of discourse, although they
      preserved coherent meaning relationships between contiguous utterances. These
      results are most compatible with the view that age-related performance declines
      on language tasks primarily reflect changes in macrolinguistic abilities that
      require integration of linguistic and nonlinguistic cognitive processes, rather
      than changes in language-specific cognitive processes.

PMID- 1624705
TI  - Recall of organizable words and objects in adulthood: influences of instructions,
      retention interval, and retrieval cues.
AB  - Young (mean age = 27.3 years), young-old (mean age = 66.3 years), old (mean age =
      74.8 years), and old-old adults (mean age = 84.0 years) learned organizable words
      and objects with standard instructions or organizational instructions. Immediate
      and delayed free recall and delayed cued recall were assessed. Results indicated
      equal cue benefits for all age groups for words, although cue benefits increased
      with increasing age for objects. Instructions to organize the items enhanced
      memory only for the old-old adults. Young adults forgot fewer items from
      immediate to delayed free recall than the older age groups. In addition,
      organizational instructions affected word recall, but not object recall, for all
      age groups. Although these data indicate both similarities and differences in
      patterns of performance among age groups, the overall pattern of outcome suggests
      an age-related increase in the level of cognitive support required to optimize
      episodic remembering.

PMID- 1624706
TI  - Age-related changes in the effects of target orientation on word recognition.
AB  - Twenty-four undergraduates and 24 retired faculty participated in an experiment
      involving semantic priming of lexical decisions. Age-related differences in the
      use of semantic information during visual word recognition were examined at
      varying orientations of the target word. Four main results were found: (1) larger
      rotation effects for elderly adults; (2) larger priming effects for elderly
      adults; (3) larger priming effects with increasing Target Orientation; and (4)
      larger priming effects for the elderly adults as Target Orientation increased.
      Results are interpreted within an interactive-compensatory framework.

PMID- 1624707
TI  - Age differences in short-term memory: organization or internal noise?
AB  - Older and young adults' letter search performances were examined on a short-term
      memory (STM) task where subjects compared a five-letter target sequence stored in
      short-term memory to a subsequently presented five-letter probe sequence. The
      same five letters were always presented on target and probe portions of a given
      trial, but on half of the trials, two letters were transposed in the first chunk,
      second chunk, or between the first and second chunks of the probe sequence ("No"
      trials). On the remaining half of the trials, the target and probe sequences were
      identical ("Yes" trials). Both young and older adults showed increases in
      reaction time (RT) when the chunk boundary for "yes" trials was different for the
      target and probe sequences of a given trial. This finding indicated that both age
      groups were organizing the sequences in STM in the same qualitative manner.
      However, older adults showed a relatively greater increase in RT and errors than
      young adults for second-chunk transpositions than for first-chunk or between
      chunk transpositions, and this finding suggested that an age difference in task
      complexity could not account for this effect. We propose, though, that these data
      are consistent with an internal noise model.

PMID- 1624708
TI  - Criterion validity of the cross-cultural cognitive examination in Japan.
AB  - Criterion validity of a two-stage Cross-Cultural Cognitive Examination (CCCE)
      designed for epidemiologic use was evaluated in Japanese subjects by comparison
      with a physician's DSM-III-R diagnosis of dementia and the Hasegawa Dementia
      Rating Scale (the standard Japanese instrument similar to the Mini-Mental State
      Exam). We report on 188 subjects tested in three locations in Japan: Tokyo area,
      Ise, and Osaka. Subjects ranged in age (50-93 years) and education (1-22 years)
      and included neurology outpatients, community volunteers, and inpatients. The
      CCCE was 97.4% specific for dementia, with sensitivity of 88%. The correlation
      with the Hasegawa scale was significant (r(175) = .8230, p less than .0001).
      Diagnosis using the CCCE showed good validity when compared with Japanese
      criteria for dementia. If the instrument could be shown to be reliable and more
      "culture fair" than the currently available tests, it may be useful in cross
      cultural epidemiologic studies of dementia.

PMID- 1624710
TI  - The dynamics of caregiving for a demented elder among black and white families.
AB  - Caregiving dynamics were studied in a sample of 157 Black caregivers of elders
      suffering from Alzheimer's disease and other dementias. By comparison with White
      caregivers (N = 472), there were fewer spouses and more nonspouse-nonchild
      caregivers among Blacks. With control exercised on background and socioeconomic
      variables, race differences in caregiving appraisal were found. Blacks showed
      more favorable scores on indices of traditional caregiving ideology, caregiving
      as intrusion, caregiving satisfaction, and caregiving burden. Interactions
      between race and background factors increased explained variance in caregiving
      appraisal only slightly. A cultural explanation of the more favorable appraisals
      of Blacks was sought in the caregiving ideology factor, but this dimension was
      not associated with caregiving outcomes. The overall hypothesized two-factor
      model was generally consistent with the observed covariance structures of both
      Black and White caregivers. Within both White and Black groups, caregivers who
      provided more care showed simultaneously more satisfaction and more burden.

PMID- 1624709
TI  - Memories of parental favoritism and the quality of parent-child ties in
      adulthood.
AB  - In order to better understand which factors contribute to variations in the
      quality of adult child-parent bonds, this study considered parental unfairness in
      the treatment of offspring during childhood. Using social exchange, self-esteem
      maintenance, and socialization models to predict different outcomes, memories of
      least favored status (LFS) were examined in relation to affectional
      intergenerational solidarity. A secondary analysis of a Swedish data set was
      conducted. Parent-child dyads were studied within three-generational lineages
      consisting of a grandmother (G1), her adult child (G2), and the grandchild (G3).
      Comparing parents and children, ratings of LFS were more predictive of the
      quality of the bond for children. Comparing generations of parents, LFS memories
      were more predictive for G2 than for G1. Comparing generations of children, there
      were no differences. The uniqueness of older parents in family research is
      considered, and an agenda for future research is suggested.

PMID- 1624711
TI  - Violence and violent feelings: what causes them among family caregivers?
AB  - We present a conceptual framework for understanding two distinct but related
      phenomena: violent feelings (i.e., the fear of becoming violent) and violent
      behaviors by family caregivers toward relatives with dementia. Based on both the
      literature on family caregiving and on family violence, four factors are
      hypothesized to explain these two dimensions of violence: caregiving demands,
      interactional stressors, caregiver characteristics, and caregiving context.
      Analyses of quantitative and qualitative data on 236 family caregivers to
      dementia victims revealed several characteristics that were predictive of violent
      feelings on the part of caregivers, including physical aggression by the care
      recipient, disruptive behaviors, and a shared living situation. Structural
      relationship and caregiver's age were found to be related to actual violence;
      spouses were more likely to engage in violence than other relatives, as were
      older individuals. In addition, violence by the care recipient was positively
      related to caregiver violence.

PMID- 1624712
TI  - The risk of nursing home placement and subsequent death among older adults.
AB  - This article examines the effects of the characteristics specified in the
      behavioral model of health services utilization and measured at baseline on the
      subsequent risk of nursing home placement and death within four years. Analyses
      of the 5,151 respondents in the Longitudinal Study on Aging indicate that the
      risk for nursing home placement is greater for older adults, Whites, those who
      lived alone, persons with telephones, those with fewer nonkin social supports,
      those who did not feel that they had much control over their future health, those
      with more household ADL or lower body limitations, and those who had been in the
      hospital during the year prior to baseline, or in a nursing home at any time
      before baseline. Among the 549 respondents placed in nursing homes, the risk of
      dying there was greater for older adults, men, those who had not lived in
      multigenerational households, persons who did not worry about their health,
      individuals with more upper body limitations, and respondents having a history of
      valvular heart disease or cancer. The odds of dying were 2.74 times greater among
      the 549 respondents placed in nursing homes than among the 4,602 respondents who
      remained in the community.

PMID- 1624713
TI  - Social networks, institutionalization, and mortality among elderly people in the
      United States.
AB  - This study focuses on the effect of social networks on institutionalization and
      mortality among elderly people in the United States. Data are from the
      Longitudinal Study of Aging (LSOA), which incorporates a baseline interview in
      1984 and a follow-up interview two years later. The study population consists of
      a sample of 5,151 noninstitutionalized elderly people who were 70 years of age or
      older in 1984. Multivariate analyses using logistic regression revealed that
      social networks are negatively related to the likelihood of institutionalization
      and mortality when controlling for sociodemographic characteristics and baseline
      health status. Elderly people who participated in some form of social activity
      decreased their risk of institutionalization by almost one-half, whereas living
      alone increased the likelihood of institutionalization. Participating in social
      activities and visiting or talking with friends or relatives was negatively
      related to the likelihood of mortality.

PMID- 1624714
TI  - Gender differences in exposure to life events and adaptation to retirement.
AB  - Gender differences in the experience of life events surrounding the retirement
      transition and the effects of such life event experiences on men's and women's
      adaptation to retirement were investigated. Data based on a stratified random
      sample of retirees covered by Florida's State Retirement System (n = 452 women
      and 378 men) indicate that women report more life events than men, particularly
      during the period preceding retirement. Furthermore, women's retirement
      adaptation seems more affected than men's by the experience of life events. The
      major conclusion to be drawn from these results is that better understanding of
      gender differences in the retirement experience can be achieved only if gender
      variations in the circumstances of the retirement transition are acknowledged and
      further explored.

PMID- 1624715
TI  - Take the money and sun: elderly migration as a consequence of gains in
      unaffordable housing markets.
AB  - We tested the hypothesis that elderly migration, both seasonal and permanent, to
      Sunbelt states such as Arizona is the result, in part, of economic gains made in
      unaffordable housing markets. The results of a multiple regression analysis of
      interstate migration flows to Arizona support the hypothesis. Moreover, the
      stronger relationship for seasonal migration suggests that elderly households are
      unwilling to realize housing gains in unaffordable markets but, nevertheless,
      "spend" the gains on seasonal migration. Such behavior is rational if housing is
      viewed as an investment and expectations of future returns are greater in
      unaffordable markets. Given that the study was based on housing gains of the
      1970s, the results suggest that more recent elderly migration may be even more
      influenced by such gains, inasmuch as regional differences in housing
      affordability have become more pronounced.

PMID- 1624716
TI  - Quality of self-report data: a comparison of older and younger chronically ill
      patients.
AB  - This study examined age differences in the quality of self-report data in
      patients with chronic disease conditions (hypertension, diabetes, heart disease,
      depression). Data are from 2,304 patients in three health care systems in Los
      Angeles, Chicago, and Boston. Results support the idea that self-report health
      data can be gathered from older and younger patients without significant
      decrements in data quality. Specifically, results showed: (1) small decreases in
      the reliability of multi-item measures with age, primarily occurring in balanced
      scales; (2) little evidence of differences among age groups in response set or
      the tendency to respond "don't know" or "uncertain," although older patients had
      a greater tendency to respond in a socially desirable manner; (3) higher item
      nonresponse in older patients; (4) little variation in item nonresponse by type
      of question or question placement; (5) generally high panel retention in all age
      groups, supporting the value of repeated follow-up; and (6) similar known-groups
      validity across age groups.

PMID- 1624717
TI  - [Training of the gynecologist-oncologist: the American experience].

PMID- 1624718
TI  - [Evaluation of a public health measure for the amelioration of birth safety in
      Martinique: 1977-1984].
AB  - A public health programme was instituted on the island of Martinique (in the
      Carribean archipelago) between 1977 and 1984. Its aim was to reduce the perinatal
      death rate in Martinique which was 25.7 per thousand in 1977 to the level found
      in France in the same year, namely 14 per thousand. The measures taken to improve
      the safety of deliveries included closing small maternity homes and improving the
      hospitals both public and private. The chief measure however, was to improve the
      availability of specialised antenatal care chiefly administered by midwives (free
      care consultations near the homes) for the poor and the less well educated women.
      The results showed that perinatal deaths in the island dropped to 14.9 per
      thousand in 1984. The major improvement was that women who had been attended by
      midwives had 10 per thousand perinatal deaths. This involved half the population
      of the island and the same results were found as to the wealthier and more
      educated women who were attended by private obstetricians. It was found to be
      possible to reduce the difference in the perinatal death rate between an African
      population in Martinique and an European population in European France.

PMID- 1624719
TI  - [Biological reference values in the human fetus. 106 cord blood sampling in
      utero].
AB  - The authors give biological reference figures obtained from 106 fetuses that were
      sampled in utero between the 20th and 34th week of amenorrhoea. These fetuses
      were considered to be normal because there was no clinical or ultrasound evidence
      of an abnormality. Furthermore the biological values sought in antenatal testing
      and the absence of all pathology in the first year of life, confirmed that these
      were normal fetuses. The result has been expressed as a global figure for all 106
      fetuses; then they have been divided up according to the gestational age groups
      (20-23, 24-27, and 28-34 weeks of amenorrhoea). These biological reference values
      and their changes as the age of the fetuses advanced are discussed and compared
      with the figures reported in the literature.

PMID- 1624720
TI  - [Microalbuminuria and pregnancy. Is microalbuminuria predictive of pregnancy
      toxemia?].
AB  - Several authors have suggested that estimating the levels of microalbuminuria
      will help in early screening for pre-eclampsia. The purpose of this work has been
      to look for the absence of microalbuminuria in normal pregnancies and to work out
      its predictive value for the risk of toxaemia of pregnancy when it does appear.
      The study was carried out on 257 women of whom 43 were controls and 214 women who
      were pregnant and had neither diabetes nor hypertension and had no kidney
      infections. The samples of urine were gathered in a 12 hour period of night and
      those that gave a positive reaction for albumin were rejected. RIA techniques
      were used to work out the levels of albuminuria and these were confirmed by
      immunoassay. We have compared microalbuminuria, the relationship between urine
      albumin and creatinine and the clearance of albumin in relationship to
      albuminuria (as defined by the relationship of albumin and creatinine clearance).
      We have calculated the sensitivity and the specificity and the prognostic value
      both positive and negative for these four parameters. Our results show that in a
      normal pregnancy there should not be any microalbuminuria, and on the other hand
      that if microalbuminuria does appear according to the four parameters studied,
      they are all equally sensitive for predicting pre-eclampsia. The relative
      clearance of albumin from the urine seems to be the most interesting parameter as
      far as we are concerned, and it could lead to early screening for toxaemia.

PMID- 1624721
TI  - [Contribution of magnesium gluconate in intravenous tocolysis with ritodrine].
AB  - The purpose of this randomized study was to compare the efficacy of ritodrine
      alone (51) versus ritodrine plus magnesium gluconate (56). We concluded that high
      oral doses of magnesium therapy (4 x 3 gr) potentiate the effects of intravenous
      beta-agonists, allowing a reduction of the dosage needed and a better
      "tolerance". Considering the low side effects, it seems reasonable to consider
      using magnesium in the treatment of premature labour.

PMID- 1624722
TI  - [Protocol of cervical maturation by acupuncture].
AB  - Protocol was carried out on 98 patients who were divided into three groups
      selected as (one control group, two "placebo" group, and three treated with
      acupuncture). This protocol showed that it was possible to improve cervical
      maturation if acupuncture sessions were carried out at the beginning of the 9th
      month. The Bishop scores in the three groups after 10 days interval show that
      there was a significant progression of 2.61 points in the group treated with
      acupuncture as against only 0.89 and 1.08 in the placebo and control groups.

PMID- 1624723
TI  - [Disseminated lupus erythematosus discovered during delivery: a difficult
      diagnosis].
AB  - The authors report a case of lupus showed in labour by the presence of
      generalised convulsions and coma after the crisis. This was followed by labile
      transitory hypertension, by massive proteinuria which cleared in 15 days, by
      major hyperthermia (higher than 39.5 degrees) and transitory agranulocytosis. The
      infant had a purely biological neonatal lupus. Pregnancy in a lupus patient has
      two risks: the mother's relapses of lupus, it is usual that renal failure is the
      worst of the prognostic features, but in this patient cerebral complications were
      much more serious. In the fetus there is a risk of spontaneous abortion linked to
      the anticardiolipin antibody level, and the risk of disease in the heart due to
      the anti-SSA (or anti-Ro) factor giving rise to congenital auriculo-ventricular
      blocks. The therapeutic possibilities are classically treated with
      immunosuppressants, mainly corticoids, which is added to low doses of aspirin.
      Plasmaphoresis and immunoglobulin treatments are being tried out.

PMID- 1624724
TI  - [Mycoplasmas and pregnancy. Preliminary study].
AB  - The prevalence of genital mycoplasmas was studied among 191 pregnant women
      followed up at Diaconesses Hospital, Paris. Ureaplasma urealyticum was recovered
      from 65% of patients, alone (54%) or in association with Mycoplasma hominis
      (11%). The relationship to pregnancy outcome, the effect of erythromycin
      treatment, the interest of biological markers of infection (mycoplasmal
      quantitation and serologic tests, C-reactive protein) and the role of other known
      genital pathogens were investigated. Vaginal infection with Ureaplasma
      urealyticum according to biological criteria (i.e. vaginal concentration greater
      than 10(3) CCU/ml or coisolation of Mycoplasma hominis) was significantly
      associated with an increased risk of: 1. premature rupture of the fetal
      membranes; 2. prematurity in cases of preterm labor. Erythromycin treatment was
      able to prevent only the risk of prematurity. On the other hand, we didn't show
      any influence of mycoplasmal colonization on birth weight, if expressed with
      regard to gestational age. An immune response to Ureaplasma urealyticum was
      demonstrated in 15% of patients; rare fourfold antibody rises were detected
      specially in the case of a second trimester spontaneous abortion and of an
      intrauterine death (both were untreated patients) and probably attest an
      infectious process. A randomized trial with a larger study sample must be
      undertaken to corroborate these preliminary data.

PMID- 1624725
TI  - [Bacterial infection of the newborn by maternal fetal contamination: one can
      depend on the anamnesis].
AB  - All babies born in a University maternity unit over a period of four months had
      bacteriological swabs taken in the labour ward. This was to see whether a list of
      criteria in the history for bacterial infection of the newborn could be relied
      on. The criteria were: premature rupture of the membranes (before labour had
      started at all), rupture of the membranes for more than 12 hours, stained liquor,
      prematurity, fetal tachycardia of more than 160 per minute or abnormal rhythm of
      the heartbeat, an Apgar score of less than 7 after 1 minute, maternal genital or
      urinary tract infection (not cured) in month before delivery, maternal
      temperature above 38 degrees C in labour. During the study there were: 570 live
      births of which 222 (39%) were at risk of infection according to the above list
      of criteria, 35 had bacterial colonies present and 4 were definitely infected.
      More cultures from the placenta, the gastric fluid and the skin came back
      positive when there was a recognised risk of infection. Both the clinical and
      bacteriological results show that the risk was 5.24 of colonisation when the risk
      of infection had been recognised. These prospective results when checked against
      the retrospective results already obtained in the same department, suggest that
      this kind of screening for infection is worthwhile without being too expensive,
      and one can rely on the history to screen for neonatal bacterial infection.

PMID- 1624726
TI  - [Weight and length of newborns. Differences between boys and girls].
AB  - Examination of 8,312 deliveries shows that the difference in weight between boys
      and girls at birth can be explained completely by the difference in their length.
      The sex of the child has no influence on the length of the pregnancy. This is
      influenced by the birth order, the propensity to smoke (tobacco), the mother's
      weight gain in pregnancy and her social level. The speed of intrauterine growth
      is influenced by the sex of the fetus, the number of pregnancies she has had, by
      tobacco, and by the amount of education she has had and her weight gain in
      pregnancy.

PMID- 1624727
TI  - [Esthetic results of breast reconstruction after amputation for cancer. 323
      cases].
AB  - 323 reconstructions of the breast were carried out at the Gustave-Roussy
      Institute and were analysed in order to assess the aesthetic results and the
      sequelae of these reconstruction operations. The majority of the patients were
      operated on between 1984 and 1989 with a median follow-up of 3.5 years (1 to 9
      years). Three types of reconstruction were carried out: simple prosthesis behind
      the muscle (P, 69% of this population), latissimus dorsi flap (G.D., 11%), or
      transverse rectus abdominis flap (TRAM, 20%). These reconstructions were either
      carried out immediately (RMI, 23.5%) or later (RMD, 76.5%). The unanimous
      enthusiasm of the patients for reconstruction was the greatest encouragement for
      us to continue in this way. From the aesthetic point of view the transverse
      rectus abdominis flap (TRAM) proved to be superior to the others. Scar and
      functional sequelae of the latissimus dorsi flap (GD) were by no means nil in
      this series (table 9) in contrast with other studies that have been carried out.
      All the same the majority of these sequelae were larger scars. The functional
      poor sequelae were minor. TRAM sequelae were less frequent and usually mainly in
      the abdominal wall. A more accurate technique should lower the incidence. As far
      as the timing of surgery is concerned, immediate reconstruction did not alter the
      quality of results which were better (but not significantly statistically). This
      has already been published. On the other hand patients were more satisfied with
      RMD (p less than 10(-4)). The analysis of this unexpected result show the great
      significance of psychological factors in interpreting these results.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1624728
TI  - [Chromosome X with partial long arm deletion. Three cases].
AB  - X deletions result generally in one or many features characteristic of Turner
      syndrome but each feature cannot be attribute to a well defined deletion. We
      present 3 cases of Xq partial deletion: 2 in girls with primary amenorrhea and
      normal stature, 1 in a patient with secondary amenorrhea and short stature. X
      inactivation is a complex phenomenon, the mechanism is not yet clear.
      Inactivation center(s) and active genes on inactive chromosome could explain the
      manifestation or the absence of clinical symptoms in X deletions.

PMID- 1624729
TI  - [The combined stimulation test sulpiride-TRH in the investigation of prolactin
      secretion].
AB  - We have studied the response of prolactin (PRL) secretion to the test combining
      i.m. sulpiride in the dose 1 mg/kg followed by 200 micrograms i.v. of TRH, in 12
      normal women and 37 patients with hyperprolactinaemia. The response was expressed
      as a percentage rise in plasma PRL concentration (delta %) 20 minutes after the
      administration of sulpiride or TRH. In the controls the response in PRL secretion
      to sulpiride worked out at between 639 and 2,760%. When there was a pituitary
      adenoma or supra-sellar lesion the PRL response to sulpiride was always less than
      481%. On the other hand the PRL response with TRH after sulpiride was not
      significantly different as between the controls (less than 175%) and the patients
      (less than 91%). We conclude: 1) the combined sulpiride and TRH test is useless
      for assessing hyperprolactinaemia; 2) the sulpiride test on the other hand makes
      it possible to show that hyperprolactinaemia cannot be stimulated and to suspect
      the presence in this case of a prolactin producing adenoma or a supra-sellar
      tumour.

PMID- 1624730
TI  - [Hypertrophic tuberculosis of the cervix. Three cases].
AB  - Tuberculosis of the cervix of the uterus is a rare form of genital tuberculosis.
      The epidemiology does not have any particular specific feature; but the
      macroscopic appearance gives a first impression of a cancer. Only by carrying out
      a biopsy of the cervix, followed by study of the histology can the problem be
      solved so that longterm anti-tuberculous treatment can be started. There is
      rarely any need for surgery, that only in cases resistant to medical treatment.
      The authors report three cases of tuberculosis of uterine cervix, found in the
      university clinic of obstetrics and gynaecology I (Professor Chaoui) during the
      years 1986-90. The incidence of this condition is 8.5% of genital tuberculosis.
      The outlook is good with full healing if the treatment is carried out properly.

PMID- 1624731
TI  - [Ovarian struma: 2 cases].
AB  - The authors report two cases of ovarian goiters; they insist upon their rarity
      and the difficulty of their pre-operatory diagnosis. Only histologic examination
      can affirm their goitrous origin. The treatment of ovarian goiters is surgical.
      The evolution is favorable except their exceptional malignant transformation.

PMID- 1624732
TI  - [Endometrial ablation by fiberoptic hysteroscopy and YAG laser].
AB  - The authors report the first cases of the use of operating fibre hysteroscopes
      with YAG laser to carry out endometrial ablation. Fiberoptic hysteroscopes were
      used and made it possible to carry out the procedure with much greater precision
      because of their mobility and flexibility. YAG laser rays are passed down an
      operating channel and can treat the whole of the endometrium in 20 minutes
      operating time. This treatment was suggested to 44 patients who had menorrhagia
      and did not respond to treatment with progestogens as an alternative to
      hysterectomy. There were 81.7% very good results, 11.3% good results and only 7%
      failures with a followup period of 3 to 20 months. There was no operative or post
      operative complication either in the short or the longterm. This technique is a
      new one and not much used in France, but its advantages have been confirmed by
      several authors, especially in the United States.

PMID- 1624733
TI  - [Renal toxicity of intraperitoneal cisplatin: a case report].
AB  - The new technique of treating ovarian tumours by giving cisplatin intra
      peritoneally does have its risks. This case history reports the case of a patient
      who was treated in this way and following the treatment had renal failure severe
      enough to require dialyses. The methods of administering cisplatin through this
      route have not yet been worked out completely. It is absolutely to over hydrate
      the patient beforehand.

PMID- 1624734
TI  - [Techniques too advanced (or poorly advanced) in laparoscopy or hysteroscopy?
      Reflections of an uneasy judicial expert].

PMID- 1624735
TI  - [infectious spondylodiscitis after genital prolapse cure].

PMID- 1624736
TI  - Abdominal compressions during CPR: hemodynamic effects of altering timing and
      force.
AB  - To determine the optimal method of applying abdominal compressions during
      cardiopulmonary resuscitation (CPR), 3 levels of pressure (25, 50, and 100 torr)
      were applied to the abdomen a) continuously and b) as 500 msec pulses at 10
      different phases during the CPR cycle in 8 anesthetized dogs. Thoracic aortic
      (Ao) and right atrial (RA) pressures were measured and PAo-PRA was calculated as
      the coronary perfusion gradient. A pneumatic piston device provided external
      chest compression (60/min, 120 lbs, for 50% of the cycle) and ventilation (80%
      O2, 12/min, at 20cm, H2O). Another identical device provided abdominal
      compression (AC) via an air-filled bladder. High-pressure (100 torr) AC applied
      for 500 msec commencing 200 msec prior to chest compression demonstrated the best
      overall profile, raising mean aortic pressure 26 torr (P less than 0.001) and
      peak coronary perfusion gradient pressure 17 torr (P less than 0.02) from control
      values during standard CPR of 58 and 41 torr, respectively. We conclude that
      applying high-pressure, 500-msec pulses of AC 200 msec before chest compressions
      significantly improves CPR hemodynamics.

PMID- 1624737
TI  - Clinical indicators of dehydration severity in elderly patients.
AB  - STUDY OBJECTIVE: To determine which of the signs and symptoms of dehydration
      obtainable from patient history and physical examination in the emergency
      department are most useful in assessing the severity of dehydration in elderly
      patients. DESIGN: Prospective, correlational study. SETTING: Two university
      teaching hospitals. PATIENTS: Fifty-five patients aged 60 or older presenting to
      the emergency department with suspected dehydration were studied. MEASUREMENTS
      AND MAIN RESULTS: In the emergency department, patients were evaluated by a
      standardized history and physical examination that included assessment of 38
      signs and symptoms commonly attributed to dehydration. The relationships between
      the presence and intensity of these putative dehydration indicators and an
      independent rating of dehydration severity based on a comprehensive review of the
      medical record were evaluated. Also evaluated were the relationships between
      these dehydration indicators and patient age. Indicators that correlated best
      with dehydration severity but were unrelated to patient age included: tongue
      dryness (P less than 0.001), longitudinal tongue furrows (P less than 0.001),
      dryness of the mucous membranes of the mouth (P less than 0.001), upper body
      muscle weakness (P less than 0.001), confusion (P less than 0.001), speech
      difficulty (P less than 0.01), and sunkenness of eyes (P less than 0.01). Other
      indicators had only weak associations with dehydration severity or were also
      related to age. Patient thirst was unrelated to dehydration severity.
      CONCLUSIONS: A set of signs and symptoms related to dehydration severity in
      elderly patients has been identified. These indicators may be more useful for
      evaluation of dehydration severity in the emergency department than other
      commonly used indicators.

PMID- 1624738
TI  - A comparison of diagnostic peritoneal lavage and computed tomography (CT scan) in
      evaluation of the hemodynamically stable patient with blunt abdominal trauma.
AB  - The diagnosis of intraabdominal injury in the patient who is victim of blunt
      trauma is often problematic. Currently, two procedures, diagnostic peritoneal
      lavage (DPL) and computed tomography (CT scan) are used to evaluate patients with
      possible intraabdominal injuries after blunt trauma. Controversy exists as to
      which of these modalities is more efficacious in this setting. There are
      advantages and disadvantages of both procedures, however, present evidence
      suggests that the clinician should not rely on the results of the CT scan. The
      DPL, on the other hand is a sensitive and specific modality in evaluating the
      patient with blunt abdominal trauma.

PMID- 1624739
TI  - Functional urinary outlet obstruction causing urosepsis in a male multiple
      sclerosis patient.
AB  - Detrusor-external sphincter dyssynergia (DESD) is a neuropathic disorder of
      micturition that exists when the simultaneous contractions of the detrusor muscle
      and external urethral sphincter oppose each other. When the external urethral
      sphincter contracts during a detrusor contraction, functional urinary outflow
      obstruction occurs by the increased urethral resistance. This loss of
      coordination between the bladder and its outlet is associated with a high risk
      for serious urologic complications, such as vesicoureteral reflux,
      hydronephrosis, and urosepsis. This report describes a male multiple sclerosis
      patient with DESD who developed functional outlet obstruction with urosepsis and
      discusses the diagnosis and treatment of this potentially life-threatening
      voiding dysfunction.

PMID- 1624740
TI  - Scavenging high-voltage copper wire, a hazardous petty larceny.
AB  - With the current emphasis on recycling and the establishment of markets for sale
      of used copper wire, scavenging of copper wire from old buildings and equipment
      has become common. Although scavenging without permission constitutes theft, a
      more significant risk to the perpetrator is the potential for electrical burn
      injury in attempting to remove "hot" wire. A severe high-voltage electrical burn
      injury sustained while attempting to scavenge wire from an old house is reported.
      The circumstances surrounding the injury, the clinical management of the case,
      and the long-term consequences to the patient are presented and discussed.

PMID- 1624741
TI  - The use of cough-CPR in patients with acute myocardial infarction.
AB  - A case of a patient with an acute anterior myocardial infarction (MI) and
      ventricular fibrillation is presented. The patient was resuscitated after cough
      cardiopulmonary resuscitation (C-CPR) was administered in the emergency
      department. The patient received thrombolytic therapy without complication. Cough
      CPR is a technique not in widespread use. With the advent of thrombolytic therapy
      for patients with acute myocardial infarctions, a relative contraindication to
      thrombolytic therapy is present in patients who receive "standard CPR." The use
      of cough-CPR in witnessed dysrhythmias can alleviate this problem. Cough-CPR can
      also reduce the morbidity of resuscitations.

PMID- 1624743
TI  - Dual AV nodal paths leading to AV nodal reentrant tachycardia.
AB  - A 27-year-old white female with a history of paroxysmal supraventricular
      tachycardia presented to the emergency department complaining of intermittent
      palpitations. Although no tachydysrhythmia was present, she was noted to have two
      distinct PR intervals during normal sinus rhythm while in the emergency
      department. The patient was referred for electrophysiologic study. This study
      demonstrated dual AV nodal paths, and AV nodal reentrant tachycardia was induced
      and terminated. She was placed on flecainide for outpatient management of her
      dysrhythmia. Dual AV nodal pathways leading to AV nodal reentrant tachycardia is
      discussed.

PMID- 1624742
TI  - Cinchonism: two case reports and review of acute quinine toxicity and treatment.
AB  - Two cases of acute quinine toxicity are presented, one from self-poisoning and
      the other from an unidentified source. Both patients presented with acute
      bilateral blindness. They also experienced the classic symptoms of cinchonism,
      including nausea, vomiting, and tinnitus. Prolongation of the Q-T interval
      developed in both patients. Serum quinine levels of 5.3 mg/L and 13 mg/L were
      measured. Although their visual acuity improved, both patients had some residual
      deficit at follow-up. A review of the literature, including clinical presentation
      and emergency medicine diagnosis and management, is also presented.

PMID- 1624744
TI  - Influence of emergency physician's tying technique on knot security.
AB  - The purpose of this study was to determine the influence of emergency physician's
      tying technique on knot security using 2-0 and 4-0 monofilament and multifilament
      nylon sutures. Using an Instron Tensile Tester and a portable tensiometer, knot
      security was achieved with these sutures using four-throw square knots (1 = 1 = 1
      = 1). After didactic and psychomotor skill training, medical students were taught
      to construct the four-throw square knot using either a two-hand tie or an
      instrument tie. Using the portable tensiometer, their knot tying techniques were
      judged to be superior to those used by emergency physicians. The emergency
      physician's faulty technique can easily be corrected by didactic information and
      psychomotor skill training.

PMID- 1624745
TI  - Emergency department evaluation and management of dialysis patient complications.
AB  - The number of dialysis patients in the United States has markedly increased in
      recent years to more than 100,000. An emergency physician is increasingly likely
      to be presented with the challenge of handling the emergent problems of the
      dialysis patient. This article is a review of the complications seen in the
      population of hemodialysis and peritoneal dialysis patients, with recommendations
      for emergency department evaluation and management.

PMID- 1624746
TI  - Suicide: risk factors and therapeutic considerations in the emergency department.
AB  - Emergency physicians often encounter covertly and overtly suicidal patients, and
      can thus play a key role in the prevention of suicide. The epidemiology and
      diverse presentations of suicidal behavior are reviewed. We then provide a
      detailed approach to the assessment of suicide risk, and criteria for safe
      discharge from the emergency department (ED). Finally, management considerations
      for the ED are discussed.

PMID- 1624747
TI  - The efficacy and safety of tissue plasminogen activator in acute ischemic
      strokes.
AB  - Over the past decade there has been an increasing use of thrombolytic agents in
      the treatment of coronary artery disease, pulmonary embolism, and thromboembolic
      strokes. The use of thrombolytic agents has been most successful in treating
      acute myocardial infarction. When treatment with intravenous streptokinase or
      tissue plasminogen activator (tPA) is initiated within the first 3 to 4 hours
      from the onset of symptoms, the rate of reperfusion ranges from 60% to 90%, as
      compared to a rate of 13% to 21% for placebo control. Both streptokinase and tPA
      have been extensively studied as therapies for acute myocardial infarction, and
      in general, a higher initial rate of reperfusion is achieved in tPA-treated
      patients than in streptokinase-treated patients, although the final arterial
      patency rate may not be different in the two groups due to a higher rate of
      reocclusion in the tPA-treated population. Furthermore, time dependency for
      efficacy from the onset of symptoms to the initiation of treatment is less for
      tPA than for streptokinase. However, the role of thrombolytic agents in the
      treatment of thromboembolic strokes is more experimental than clinical at the
      present time. Of all agents, tPA is the most promising and the most extensively
      studied. This paper will review the experimental data on the use of tPA in acute
      thromboembolic strokes as well as the existing clinical data on stroke
      reperfusion.

PMID- 1624749
TI  - Yet another ACLS!--(advanced "conference" life support)

PMID- 1624748
TI  - Intravenous adenosine in the treatment of junctional tachycardia.

PMID- 1624750
TI  - Objectives to direct the training of emergency medicine off-service rotations:
      anesthesiology.
AB  - This is the 15th article in a continuing series of "off-service" goals and
      objectives for resident education in emergency medicine. Knowledge and skills in
      providing anesthesia and analgesia are essential in managing patients in the
      emergency department, critical care unit, and surgery. However, Anesthesiology
      off-service rotations are often limited to a 2-week rotation. Therefore, clear
      goals and objectives in Anesthesiology are essential for the resident in
      training.

PMID- 1624751
TI  - Fast Track in the emergency department: a one-year experience with nurse
      practitioners.
AB  - The use of a Fast Track system in the emergency department is becoming
      increasingly popular in order to provide fast and efficient service to patients
      with minor emergencies. In this paper we describe the one-year results of our
      system staffed by nurse practitioners. During the first year of operation, a
      total of 4468 patients were seen in Fast Track. Approximately 28% of patients are
      triaged to Fast Track during its hours of operation. The average patient seen in
      Fast Track was ready for discharge 94.4 minutes after presentation. Fewer than 1%
      of patients required admission to the hospital. Overall, patients and medical
      staff were highly satisfied with the Fast Track system. Our experience
      demonstrates that nurse practitioners can effectively and efficiently staff a
      Fast Track in an academic emergency department.

PMID- 1624752
TI  - Intensive care.

PMID- 1624753
TI  - Sub-types of serotonin receptors: biochemical changes and pharmacological
      consequences.
AB  - Thirty-three years ago, Gaddum and Picarelli classified the serotonin receptors
      in the guinea pig ileum into D and M types based on the activity of dibenzyline
      and morphine to block contractions of intestinal smooth muscle caused by
      serotonin. The subsequent location of specific ligand binding sites for serotonin
      in the brain has led to the identification of at least eight serotonin receptor
      sub-types in rat brain. While there is some controversy over the functional
      importance of many of these receptor sub-types, there is evidence that they fall
      into two major groups according to the nature of their coupling to secondary
      messengers or ion channels. Thus the 5-HT1 and 5-HT2 receptors appear to occupy
      the G protein receptor sub-family which may be coupled either to adenylate
      cyclase (most 5-HT1 sub-types) or phosphatidyl inositol (5-HT2 sub-types). The
      central "M" receptors (now termed 5-HT3) appear to occupy a ligand gated ion
      channel super-family. The cloning of three of the serotonin receptor sub-types in
      1989 (5-HT1A, 5-HT1C and 5-HT2) has been of importance in enabling the receptor
      sub-types to be classified as specific protein molecules encoded by specific
      genes. The problem now arises with regard to the linking of the changes in the
      cellular activity of the various receptor sub-types with the plethora of
      behavioural changes that arise as a consequence of the actions of serotonin in
      the brain. The present review summarizes the evidence implicating the role of
      specific serotonin receptor sub-types in eating disorders, sleep, sexual
      activity, anxiety states, aggression, schizophrenia and depression. A summary of
      the relationship between these receptor sub-types and their possible involvement
      in the aetiology of these diseases is shown in Table 2.

PMID- 1624754
TI  - Pharmacokinetics of tetrahydroaminoacridine: relations to clinical and
      biochemical effects in Alzheimer patients.
AB  - The pharmacokinetics of tetrahydroaminoacridine (THA) was studied in patients
      suffering from Alzheimer's dementia. Single doses of the drug were administered
      by intravenous (15 mg), oral (50 mg) and rectal routes (25 mg). Pharmacokinetic
      parameters were related to clinical and biochemical effects in patients who, in a
      separate study, participated in a clinical trial of oral THA. The bioavailability
      of THA was low and varied considerably between subjects. Clinical improvement and
      occurrence of elevated liver enzymes correlated positively with drug
      bioavailability. Acetyl and butyryl cholinesterase activities in the plasma did
      not change following THA administration. Rectally administered THA had a higher
      bioavailability than orally administered THA in three subjects who were given the
      drug by both routes. These results indicate that a clinical trial of rectal THA
      would be justified as this administration route may improve resorption and
      diminish first-pass metabolism of the drug in the liver compared with oral
      administration.

PMID- 1624755
TI  - Impulsive aggression and central serotonergic system function in humans: an
      example of a dimensional brain-behavior relationship.
AB  - A dimensional relationship between central serotonergic (5-HT) system function
      and indices of suicidal and impulsive aggressive behaviors has been suggested by
      more than a decade of research in patients with psychiatric disorders. This paper
      reviews a series of studies conducted in healthy male individuals and in male
      patients with major mood and/or personality disorder involving pharmacochallenge
      and neurochemical strategies designed to explore the role of central 5-HT system
      function in the regulation of suicidal and impulsive aggressive behavior in
      humans. The results of these studies suggest that reduced overall central 5-HT
      function in the limbic-hypothalamic system is associated with suicidal and/or
      impulsive aggressive behaviors in patients with major mood and/or personality
      disorders and that diminished 5-HT post-synaptic receptor function in this brain
      region may be an important biological correlate of these behaviors.

PMID- 1624756
TI  - Buspirone induced prolactin responses in obsessive-compulsive disorder (OCD): is
      OCD a 5-HT2 receptor disorder?
AB  - Buspirone (BUSP) is a serotonergic (5-HT) agonist with activity at the 5-HT1A
      receptor. The BUSP induced prolactin (PRL) response was examined in 10 patients
      with a DSM IIIR diagnosis of obsessive-compulsive disorder (OCD). The results
      were compared with PRL responses to BUSP found in 10 age and sex matched healthy
      controls. The results suggest that the 5-HT1A receptor dysfunction may not be
      involved in the pathophysiology of OCD. The authors review the literature and
      consider the hypothesis that in OCD a complex interaction of other 5-HT receptor
      sub-types may be occurring, possibly with dysfunction primarily of the 5-HT2
      receptors.

PMID- 1624757
TI  - The effects of lithium on body weight and food intake in normal subjects--a pilot
      study.
AB  - The possibility of lithium increasing hunger and food intake was examined in an
      open, pilot study involving five healthy male volunteers each of whom took
      lithium for 1 month at a dose to give mean 12 h serum lithium level of 0.5-0.8
      mmol/l. Before starting lithium, after the first dose and again after 1 and 4
      weeks on lithium, subjects attended the unit at lunch time. They were starting
      lithium, after the first dose and again after 1 and 4 weeks on lithium, subjects
      attended the unit at lunch time. They were weighed and ate their lunch time meal
      from a food dispenser similar to those in canteens. Subjective rating scales were
      completed before and after eating. No change in weight was seen. Food intake was
      slightly increased at the end of the month on lithium compared with the start but
      had fluctuated during the intervening weeks. There was no relationship between
      food intake and weight change.

PMID- 1624758
TI  - Treatment resistant depression in the elderly: three cases.
AB  - We report three cases of severe depression in whom ECT was relatively
      contraindicated, who responded dramatically to switching lithium and fluoxetine
      to lithium and lofepramine. Possible mechanisms are discussed.

PMID- 1624759
TI  - Alcohol-free beer and the irreversible monoamine oxidase inhibitors.
AB  - Three cases of vascular crises associated with the use of MAOIs and the ingestion
      of alcohol-free beer are reported.

PMID- 1624760
TI  - Profiles in genetics: J. B. S. Haldane (1892-1964)--a centennial appreciation.

PMID- 1624761
TI  - An advantage of sexual reproduction in a rapidly changing environment.
AB  - When an environmental change imposes strong directional selection, there are two
      advantages of sexual reproduction. First, an asexual population is limited to the
      most extreme individual in the population, and progress under directional
      selection can go no farther without mutation; no such limitation applies to a
      sexual population. Second, more quantitatively, directional selection in an
      asexual population monotonically decreases the variance, whereas the variance of
      a sexual population quickly reaches a steady value; this difference remains even
      if the direction of selection occasionally changes. With realistic environmental
      changes small alterations in any particular measurement or trait are usually
      sufficient to keep up with the changes, but fitness, since it depends on a large
      number of traits, will be selected with greater intensity, which may be enough to
      confer a distinct advantage on sexual reproduction. This applies particularly to
      a large or rapid environmental change. Eventually mutation will enhance the
      variance, but by then it may be too late to prevent extinction of asexual
      strains.

PMID- 1624762
TI  - The molecular taxonomy and evolution of the guinea pig.
AB  - On the basis of 18 protein sequences totaling 2,413 aligned amino acid sites, it
      is suggested that the guinea pigs and the myomorphs (rat-like rodents) are not
      monophyletic. Rather, the evolutionary lineage leading to the guinea pig seems to
      have branched off prior to the divergence among myomorphs, lagomorphs, primates,
      chiropterans, artiodactyls, and carnivores. It is suggested therefore that the
      Caviomorpha (guinea pig-like rodents) and possibly the Hystricomorpha (porcupine
      like rodents) should be elevated in taxonomic rank and conferred an ordinal
      status distinct from the Rodentia. This suggestion calls for a reevaluation of
      the morphological evolution of guinea pigs and further molecular studies on the
      possibility of paraphyly of the order Rodentia. If the monophyly of rodents
      holds, it must be concluded that the pattern of molecular evolution in many
      guinea pig genes has been extremely unusual and that the causes for this pattern
      should be sought. It is also suggested that claims of large differences in the
      rate of molecular evolution between guinea pigs and myomorphs may have been
      exaggerated in many cases as a result of an erroneous phylogenetic position for
      the guinea pig. The average rate of amino acid replacement in the guinea pig
      seems to be comparable to that in the rat and the mouse. However, the data
      indicate that myomorph and caviomorph genes evolve, on average, about two times
      faster than their human counterparts. Finally, our analysis provides evidence
      against the hypothesis that the gundi (an African rodent) represents the most
      ancient rodent lineage.

PMID- 1624763
TI  - Characters and the systematics of Drosophilidae.

PMID- 1624764
TI  - Signal, noise, and reliability in molecular phylogenetic analyses.
AB  - DNA sequences and other molecular data compared among organisms may contain
      phylogenetic signal, or they may be randomized with respect to phylogenetic
      history. Some method is needed to distinguish phylogenetic signal from random
      noise to avoid analysis of data that have been randomized with respect to the
      historical relationships of the taxa being compared. We analyzed 8,000 random
      data matrices consisting of 10-500 binary or four-state characters and 5-25 taxa
      to study several options for detecting signal in systematic data bases. Analysis
      of random data often yields a single most-parsimonious tree, especially if the
      number of characters examined is large and the number of taxa examined is small
      (both often true in molecular studies). The most-parsimonious tree inferred from
      random data may also be considerably shorter than the second-best alternative.
      The distribution of tree lengths of all tree topologies (or a random sample
      thereof) provides a sensitive measure of phylogenetic signal: data matrices with
      phylogenetic signal produce tree-length distributions that are strongly skewed to
      the left, whereas those composed of random noise are closer to symmetrical. In
      simulations of phylogeny with varying rates of mutation (up to levels that
      produce random variation among taxa), the skewness of tree-length distributions
      is closely related to the success of parsimony in finding the true phylogeny.
      Tables of critical values of a skewness test statistic, g1, are provided for
      binary and four-state characters for 10-500 characters and 5-25 taxa. These
      tables can be used in a rapid and efficient test for significant structure in
      data matrices for phylogenetic analysis.

PMID- 1624765
TI  - Cloning and characterization of highly polymorphic porcine microsatellites.
AB  - A size-fractionated (200-400 bp) porcine genomic library was screened with the
      dinucleotide motifs (TG)n and (TC)n. The number of TG- and TC-positive clones was
      83 and four, respectively, implying that the former motif is more frequent in the
      porcine genome, as previously reported in other species. Twenty-six TG-clones
      were sequenced, and the number of repeats varied between 16 and 42 with different
      compositions of the repetitive sequences; 17 clones had a perfect stretch of TG
      repeats, four had imperfect stretches, and five had a compound structure with TG
      repeats followed by TC-repeats. Primers for DNA amplification using the
      polymerase chain reaction (PCR) were synthesized for six loci. Ten unrelated
      individuals (two wild boars and eight domestic pigs of the Swedish Yorkshire
      breed) were screened for microsatellite polymorphism. All six microsatellite loci
      were polymorphic with two to seven alleles and observed heterozygosities in the
      range of 0.42-0.84; the inheritance of the observed polymorphism was confirmed by
      family studies. The characteristics of microsatellites make them highly suitable
      as genetic markers, and these microsatellites were isolated as a part of a pig
      gene mapping project.

PMID- 1624766
TI  - Linkage analysis of five new genetic markers of the oriental fruit fly,
      Bactrocera dorsalis (Diptera: Tephritidae).
AB  - Five new autosomal recessive genes are described in the oriental fruit fly,
      Bactrocera dorsalis (Hendel). These genetic markers are associated into three
      linkage groups. The matte (mt) gene is linked to the previously described
      mandarin red (ma) gene, and the white puparium (wp) gene is linked to the white
      eye (we) and amethyst (am) loci. The third designated linkage group has the
      yellow eye (ye) marker. The we/we homozygote is epistatic to ye/ye, and each is
      epistatic to am/am and ma/ma.

PMID- 1624767
TI  - The inheritance of albinism in a freshwater snail, Physa heterostropha.
AB  - Complementation tests revealed that albinism in four laboratory strains of Physa
      (Physella) heterostropha pomilia resulted from two recessive, nonallelic genes.
      F2 dihybrid progeny displayed the 9:7 ratio classically associated with
      reciprocal recessive epistasis between unlinked loci. This offers a contrast to
      the situation in the better known planorbid snails and provides a valuable tool
      for the study of reproductive biology in these facultatively self-fertilizing
      hermaphrodites.

PMID- 1624768
TI  - Biochemical plasticity in the Arizona tiger salamander (Ambystoma tigrinum
      nebulosum).
AB  - The Arizona tiger salamander, Ambystoma tigrinum nebulosum, is a developmentally
      polymorphic species. Some individuals become sexually mature while retaining some
      larval traits (paedomorphs), while other individuals mature as metamorphosed
      salamanders. In this study, relative enzyme activities of the products of two
      duplicate loci in each of three enzyme systems (aconitase, malate dehydrogenase,
      and isocitrate dehydrogenase) were measured in paedomorphs and in paedomorphs
      forced to metamorphose by treatment with thyroxine. We found that thyroxine and
      laboratory conditions affect enzyme activities of four of the six enzymes
      examined and that activities of products of duplicate loci are altered to
      different degrees.

PMID- 1624769
TI  - Further evidence for latitudinal inversion clines in natural populations of
      Drosophila melanogaster from India.
AB  - Chromosomal analysis of eight Indian natural populations (six from north India
      and two from south India) of Drosophila melanogaster revealed the presence of 13
      paracentric inversions, including one in the X chromosome. All four types of
      inversions--common cosmopolitan (4), rare cosmopolitan (3), recurrent endemic
      (2), and unique endemic (4)--were detected. The frequency of commonly occurring
      inversions and the level of inversion heterozygosity were found to be higher in
      the two southern populations. The south Indian populations are genetically more
      differentiated than those from the north. Also, latitudinal clines in the
      frequencies of the four common cosmopolitan inversions were detected. These
      results provide further evidence for the existence of inversion clines in Indian
      populations of D. melanogaster.

PMID- 1624770
TI  - Identifying the ptilopody (feathered shank) loci of the chicken.
AB  - A series of crosses was made involving lightly-, and heavily-, and non-feather
      shanked chickens in an attempt to clear up the confusion in the literature
      concerning the inheritance of feathered shanks in chickens. The Langshan and
      Brahma breeds were both shown to possess the same single shank-feathering locus,
      but because of their differences in phenotype and penetrance in the genetic
      crosses it was suggested that they possessed different alleles at this locus.
      This locus was designated as Pti-1, with Pti-1L being the Langshan allele and Pti
      1B the Brahma allele. The Brahma allele was shown to be dominant over the
      Langshan allele. Both the Sultan and Cochin breeds were shown to possess two
      shank-feathering loci, and the data suggested that one of the loci in the Sultan
      contained the Pti-1L allele. It is hypothesized that the comparable allele in the
      Cochin breed was Pti-1B. It is proposed that the second locus in both of these
      breeds is similar, and the symbol Pti-2 is suggested.

PMID- 1624771
TI  - The hypotrophic axonopathy mutant in Japanese quail.
AB  - A new behavioral mutant showing either head or body quivering, or both, was found
      in Japanese quail. This trait was characterized by neurofilament deficiency in
      the axons of the cervical spinal cord and the optic and sciatic nerves and was
      named "hypotrophic axonopathy." This character was shown to be controlled by an
      autosomal recessive gene, for which the gene symbol hax was proposed.

PMID- 1624772
TI  - Mandible shape analysis in a testicular feminization (Tfm) strain of mice.
AB  - The role of androgens on the sexual dimorphism of mandible shape was investigated
      in mice carrying the X-linked gene for testicular feminization (Tfm), which is
      known to determine a profound insensitivity to testosterone and is associated
      with a severe reduction in androgen receptor levels in Tfm/Y males. Mandible
      shape analysis in an inbred strain of mice segregating for the Ta (tabby) and Tfm
      mutations showed that the sexual dimorphism observed between +Ta/+Ta females and
      +Ta/Y males almost disappeared between Tfm+/+Ta females and Tfm+/Y males. In
      addition, a canonical discriminant analysis showed that these two closely related
      classes, Tfm+/+Ta and Tfm+/Y, are readily differentiated from both the +Ta/+Ta
      and +Ta/Y classes. These results suggest that androgens are involved in the
      mandible shape sexual dimorphism and play a role in mandibular development in
      both males and females.

PMID- 1624773
TI  - On the displacement of single-locus polymorphisms.
AB  - And where, along the evolutionary track, some mutant gene did arise which was
      advantageous in its heterozygous degree of expression but deleterious
      homozygously, that gene, though temporarily multiplied as a make-shift
      arrangement, would usually have become replaced, after a while, by mutant genes
      of less deviant expression, occupying the same or other loci, which gave an
      equivalent advantage when they were present homozygously. For such genes would
      make possible a more uniform, and therefore (when all individuals were averaged)
      a closer approach to the adaptational optimum.

PMID- 1624774
TI  - A computer program for testing pairwise linkage disequilibria in subdivided
      populations.

PMID- 1624776
TI  - Health issues of international travelers.

PMID- 1624775
TI  - CODONS: a microcomputer program for codon usage analysis.

PMID- 1624777
TI  - General advice for the international traveler.
AB  - Medical concerns of the traveling patient may be organized into pre-travel
      medical advice and preparation, maintenance of health and behavioral modification
      during travel, and post-travel diagnosis and treatment for travelers returning
      with illness or a significant change in their general health. Pre-travel medical
      advice and preparation may be done in large part by well-informed primary-care
      providers, although patients with special health conditions or unusually
      complicated or high-risk itineraries may be best referred to a travel medicine
      specialist. Although diagnosis and treatment of exotic and tropical diseases
      usually falls within the area of expertise of the infectious diseases specialist,
      primary physicians should be familiar with the geographic distribution and
      presentation of the more common of these diseases, so that appropriate referrals
      will be made.

PMID- 1624778
TI  - Immunizations.
AB  - The protection of travelers against vaccine-preventable disease is an important
      part of pre-travel preparation. This review discusses immunizations that should
      be given as part of routine health maintenance, regardless of whether the
      individual is traveling. It also covers immunizations that may be required by a
      country as a condition for entry and those that are recommended because of a risk
      of acquiring a particular vaccine-preventable illness during travel. Prior to the
      administration of any of these vaccines, a careful health and immunization
      history and detailed travel itinerary should be obtained.

PMID- 1624779
TI  - Prevention of malaria.
AB  - Malaria is one of the most prevalent infectious diseases worldwide; it is
      transmitted in over 100 countries, and it is a major cause of serious morbidity
      and mortality in travelers. Clinicians should inform travelers of their risk,
      teach them the principles of personal protection, and offer individualized
      chemoprophylaxis regimens. The increasing prevalence of multiple drug-resistant
      Plasmodium falciparum in many parts of the world makes nonpharmacologic methods
      of malaria prevention important.

PMID- 1624781
TI  - The traveler's medical kit.
AB  - This article presents a comprehensive list of drugs and other medical supplies
      that may be of use to travelers for treating common infections and noninfectious
      travel-related illness. Recommendations are offered for using the medications to
      treat specific common medical problems while traveling. Sample medical kits, the
      contents of which vary depending on itinerary and length of stay, are presented.

PMID- 1624780
TI  - Prevention of traveler's diarrhea.
AB  - Preventing traveler's diarrhea is usually a matter of common sense, good luck,
      and the host's ability to defend against enteric pathogens, particularly
      enterotoxigenic Escherichia coli. Untreated tap water, ice cubes, unpasteurized
      milk products, salads, food from street vendors, and dining in unhygienic
      appearing restaurants should be avoided. Well-cooked food that is served hot and
      carbonated, commercially bottled beverages are usually safe. Food and water
      precautions, however, are no guarantee of success in preventing traveler's
      diarrhea. Bismuth subsalicylate used prophylactically is somewhat inconvenient
      and is only moderately effective. Although antibiotic prophylaxis is very
      effective for traveler's diarrhea, particularly the quinolones, it should be
      reserved for high-risk travelers.

PMID- 1624782
TI  - Medical considerations for the pregnant traveler.
AB  - The care of pregnant travelers requires clinical information and skills that are
      derived from many disciplines. Issues to be considered include the safety of both
      mother and fetus during commercial air travel, vigorous exercise, scuba diving,
      and even high-altitude trekking. Immunizations require a balanced approach to the
      risk of disease versus the risks of vaccine complications. Safe or treated water
      sources are of paramount importance to prevent unnecessary exposure to
      antimicrobial and antiparasitic agents during pregnancy. Malaria prophylaxis is
      made even more difficult by an increasingly widespread resistance of Plasmodium
      species to chloroquine.

PMID- 1624783
TI  - Medical considerations for international travel with infants and older children.
AB  - This article reviews preparatory guidelines for international travel with infants
      and children. Pre-travel immunizations, malaria chemoprophylaxis, and
      chemotherapy of traveler's diarrhea are reviewed. Dosages and schedules for
      special vaccines to consider for children are described. Practical advice for air
      travel and a prolonged overseas stay is offered to ensure safe and healthy
      international travel with infants and children.

PMID- 1624784
TI  - Self-help for the traveler who becomes ill.
AB  - While infections commonly occur in travelers, most can be prevented by avoiding
      fresh fruit (unless it is peeled), fresh vegetables, unpasteurized milk and
      cheeses, nonbottled water and ice; by taking antimalarial drugs; by using insect
      repellents in areas where indicated; and by using common sense. Remember also
      that travel does not prevent you from getting many of the illnesses you might get
      at home. It is essential to take any regular medications along with you. I
      recommend that you take such medications in your carry-on baggage, for airlines
      have a propensity for losing baggage that contains critical items. If you do
      become ill, you can take care of most illnesses yourself if you have planned
      ahead.

PMID- 1624785
TI  - Evaluation of diarrhea in the returning traveler.
AB  - Diarrhea in the returned traveler raises the possibility of a wide range of
      infectious, post-infectious, and idiopathic (e.g., inflammatory bowel disease)
      disorders that require a thoughtful evaluation. Specific clues in the history and
      clinical presentation are helpful in distinguishing inflammatory from
      noninflammatory processes and in suggesting persistent parasitic or other
      syndromes. The authors describe a practical approach to the diagnosis and
      management of diarrhea in the returned traveler.

PMID- 1624786
TI  - The returning traveler with fever.
AB  - The febrile returning traveler tests a clinician's knowledge of tropical medicine
      as well as skills in differential diagnosis. A thorough history with special
      emphasis placed on the patient's travel itinerary and knowledge of the geographic
      location and incubation times of certain tropical diseases will narrow the
      diagnostic possibilities. This will allow the clinician to focus the diagnostic
      work-up and make wise choices of laboratory tests and procedures.

PMID- 1624787
TI  - Evaluation of skin problems.
AB  - Travelers frequently return to North America with noninfectious skin problems.
      However, the physician who evaluates a returning traveler or immigrant with
      cutaneous abnormalities must also consider the possibility of infection.
      Attention should be paid to the nature of the skin lesions, the presence or
      absence of systemic manifestations, and the details of the travel history, e.g.,
      geographic sites visited, duration of travel, activities, and prophylactic
      medications. This article highlights the conditions most likely to be encountered
      among typical immunocompetent North American travelers.

PMID- 1624788
TI  - Evaluation of respiratory problems.
AB  - Respiratory problems are common in international travelers. Most are self-limited
      and do not result in significant morbidity. Those that are severe enough to
      result in fever and an abnormal chest roentgenogram may pose diagnostic
      difficulties. The familiar bacterial respiratory pathogens found worldwide are
      the most common causes of this syndrome, but less familiar entities also need to
      be considered. A careful evaluation, including a thorough travel history, should
      yield the diagnosis.

PMID- 1624789
TI  - Eosinophilia in the returning traveler.
AB  - Eosinophilia in a traveler returning from the developing world should first and
      foremost suggest the possible presence of a helminth parasite. Protozoal
      parasites are much less commonly associated with eosinophilia. Other entities to
      be considered include allergies, drug reactions, and numerous other miscellaneous
      causes.

PMID- 1624790
TI  - Different regulation of class I gene expression in the adult mouse and during
      development.
AB  - The expression of the class I genes encoding for histocompatibility Ag is complex
      both in adult and during development. Although ubiquitously expressed in the
      adult, the mRNA level of class I genes is variable from one organ to another.
      During development, H-2K mRNA expression has two phases: the first from
      blastocyst to day 11, where H-2K mRNA level is extremely low, and the second,
      beginning after day 11, when H-2K mRNA expression increases first dramatically
      (10x) and then progressively to birth. To localize the sequences responsible for
      the regulation of H-2K gene expression in the adult and during development, we
      have constructed a series of transgenic strains carrying 1) a 9-kb native H-2K
      gene, H-2K LF, corresponding to the entire H-2Kb gene with 2 kb of upstream
      sequences and 3 kb of downstream sequences, and 2) two hybrid constructs linking
      the same 5'-flanking region of H-2Kb gene to two reporter genes, the human growth
      hormone and the human c-myc proto-oncogene. Expression of the transgenes was
      compared with that of the endogeneous H-2K gene in adult organs and during
      development of the different transgenic strains. In the adult, the three
      constructs behave almost like the endogeneous H-2K gene, but the H-2K LF
      construct is the only one whose expression is independent of the integration site
      and related to the copy number. During development, both fusion genes are barely
      expressed in the embryo as well as in the extra-embryonic tissues, whereas the H
      2K LF transgene expression parallels that of the endogeneous class I gene.
      Therefore, our results show that H-2K developmental regulatory sequences are not
      included in the region that controls H-2K mRNA expression in the adult,
      indicating that H-2K class I gene expression in adult organs and in development
      is regulated by different mechanisms.

PMID- 1624791
TI  - Functional expression of human CD8 in fully reconstituted mice after retroviral
      mediated gene transfer of hemopoietic stem cells.
AB  - Retroviral-mediated gene transfer has been used in an attempt to efficiently and
      stably express functional cell-surface molecules in lymphoid and myeloid cells.
      The human CD8 molecule is a T cell-specific surface receptor that is intimately
      involved in class I MHC-restricted Ag recognition and subsequent T cell
      activation. After infection with a recombinant, replication-defective retrovirus
      containing the human CD8 alpha cDNA, bone marrow cells were transplanted into
      lethally irradiated recipients. The majority of lymphoid and myeloid cells of
      reconstituted animals expressed high levels of human CD8 for at least 8 months
      after transplantation. Transfer of bone marrow and spleen cells from these
      recipients 100 days after transplantation into secondary recipients also resulted
      in long term expression of CD8 in lymphoid and myeloid cells. CD8 expressed in
      splenic T cells associated with the lymphoid-specific tyrosine protein kinase
      p56lck, participated in T cell activation and conferred an increased xenogeneic
      response to human MHC class I Ag. Thus, retroviral-mediated gene transfer allows
      the long term, functional expression of cell-surface molecules in normal murine
      lymphoid and myeloid cells.

PMID- 1624792
TI  - Lectin specificity and binding characteristics of human C-reactive protein.
AB  - C-reactive protein (CRP) is thought to play an important role in
      immunomodulation. The exact biologic function of this pentraxin protein is,
      however, still unclear. Here we report experiments designed to further
      characterize the binding properties of CRP. Using purified human CRP it could be
      shown that CRP immobilized onto polystyrene surfaces or onto latex beads binds
      distinct plasma glycoproteins including IgG, asialofetuin, asialo-beta 2
      glycoprotein I and, likewise, synthetic glycoproteins as a lectin, exhibiting
      binding specificity for terminal galactosyl residues of the glycoprotein glycans.
      Binding of CRP to IgA, IgM, IgG, asialofetuin, asialo-beta 2-glycoprotein I and
      to synthetic glycoproteins requires immobilization onto surfaces of both CRP and
      the ligand. Fibronectin and fibrinogen are bound by surface-immobilized CRP also
      in soluble phase. Comparing various mono-, di-, and trisaccharides as competitive
      inhibitors of the lectin binding activity of CRP, only beta-D-Gal-(1-3)-D-GalNAc,
      beta-D-Gal-(1-4)-D-GalNAc, and beta-D-Gal-(1-4)-beta-D-Gal-(1-4)-D-GlcNAc had
      significant inhibitory power at a concentration of 8 mmol/liter. Binding activity
      of CRP was pH-dependent with an optimum at pH 5 to 6 and was reduced by 90% when
      pH was shifted from 6 to the physiologic pH value of 7.4. CRP exhibited lectin
      like properties with binding specificity for galactosyl residues also when bound
      to K-562 erythroleukemia cells. It is therefore suggested that CRP immobilized
      onto surfaces exhibits lectin activity toward galactosyl groups preferentially in
      a mildly acidic environment as present at sites of inflammation.

PMID- 1624793
TI  - Cloning and expression of recombinant Aspergillus fumigatus allergen I/a (rAsp f
      I/a) with IgE binding and type I skin test activity.
AB  - Aspergillus fumigatus secretes an 18-kDa nonglycosylated IgE-binding protein.
      This protein was previously shown to be a ribotoxin, like alpha-sarcin and
      mitogillin. A 686-bp long A. fumigatus cDNA encoding an 18-kDa ribotoxin was
      cloned and expressed in Escherichia coli as a fusion protein with six adjacent
      histidines (rAsp f I/a). rAsp f I/a was purified to homogeneity by Ni(2+)-chelate
      affinity chromatography and refolded. The recombinant protein was enzymatically
      active resulting in the cleavage of 28S rRNA within a universally conserved
      region. rAsp f I/a was cytotoxic for EBV immortalized or PHA stimulated human
      PBMC. Furthermore, rAsp f I/a was recognized by murine mAb made against an 18-kDa
      ribotoxin. IgE of individuals allergic to A. fumigatus bound to rAsp f I/a as
      shown by ELISA, dot blots, and Western blots. rAsp f I/a elicited positive
      immediate type I skin reactions in individuals allergic to A. fumigatus but not
      in healthy control individuals. The results show that rAsp f I/a has similar
      functional characteristics when compared to the native 18-kDa ribotoxin. rAsp f
      I/a expressed in E. coli can therefore be used as a standardized Ag/allergen for
      serologic and clinical diagnosis of A. fumigatus-associated diseases.

PMID- 1624794
TI  - Mhc-DQB repertoire variation in hominoid and Old World primate species.
AB  - Comparison of 87 distinct Mhc-DQB sequences, obtained from 13 primate species,
      demonstrates that five out of eight trans-species Mhc-DQB allele lineages are at
      least 30 million years old and predate divergence of hominoid and Old World
      primate species. One lineage may be much older because its members are not only
      traced back in higher primates, but also are present in a New World primate
      species. Comparing Mhc-DQB repertoire variation in distinct species, allows one
      to pinpoint when certain polymorphisms were lost or gained in primate evolution.
      Heterogeneity observed among members of trans-species Mhc-DQB allele lineages can
      be explained in major part by point mutations, whereas intraexonic crossing-over
      is a potent mechanism in generating new allele lineages. The stability of Mhc-DQB
      polymorphisms is influenced by selective forces because distinct allele lineages
      appear to have accumulated nucleotide substitutions and amino acid replacements
      at different rates.

PMID- 1624795
TI  - Rat secretory component binds poorly to rodent IgM.
AB  - Our previous studies and those of others indicated that human secretory component
      (SC), the five domain extracellular portion of the poly Ig receptor, binds avidly
      to both pIgA and IgM. In this study we report that in rodents, SC binds primarily
      to pIgA. Rat secretory component was isolated from bile and radiolabeled to known
      specific activity with 125I. Radiolabeled rat SC was incubated with rat and mouse
      monoclonal proteins for 1 h at room temperature and overnight at 4 degrees D.
      Binding of 125I-rat SC to Ig was determined in two ways: 1) immunoprecipitation
      of putative 125I-rat SC-Ig complexes with anti-L chain antibodies; 2) HPLC gel
      filtration on an analytical TSK 4000 column that separated free 125I-rat SC from
      125I-rat SC bound to Ig. Both methods of analysis yielded similar results. Rat
      and mouse polymeric (p) IgA bound rat SC with high avidity, although the binding
      activity of the IgM from either species was virtually nil. The number of SC
      binding sites on rat polymeric Ig was determined by immunoprecipitation of
      mixtures of rat pIg with saturating concentrations of 125I-rat SC and yielded
      values of 1.0 and 0.05 for rat pIgA and IgM, respectively. The significance of
      these findings with respect to the biologic function of the pIg R in rodents and
      the nature of the pIg R-binding site on pIg is discussed.

PMID- 1624796
TI  - Sequence analysis of members of the human Ig VH4 gene family derived from a
      single VH locus. Identification of novel germ-line members.
AB  - We have generated a mouse x human heterohybridoma that contains a single copy of
      chromosome 14 and, thus, a haploid set of Ig VH genes. This cell line was used to
      investigate the germ-line content and nucleotide sequences of members of the VH4
      gene family in a polymerase chain reaction-based approach. The analysis of 58
      full-length sequences revealed the presence of 12 different germ-line VH4 genes,
      each of which is potentially functional. These germ-line VH4 genes were compared
      with the nucleotide sequences of published VH4 genes. Three VH4 genes were 100%
      identical to previously published sequences and belong to a group of VH4 genes
      that are strongly conserved and highly prevalent in the human population. Three
      VH4 genes in our collection displayed greater than 99.3% sequence identity with
      reported germ-line VH4 sequences and likely represent allelic counterparts of
      these genes. Six genes displayed less than 97.2% sequence identity with published
      VH4 genes and were identified as novel members of the human VH4 gene family or
      more distantly related alleles of known VH4 genes. Collectively, these data
      suggest that, overall, the human VH4 gene family may be more diverse than
      hitherto assumed, whereas a number of individual members are nonpolymorphic and
      extremely well conserved.

PMID- 1624797
TI  - The pattern of joining (JH) gene usage in the human IgH chain is established
      predominantly at the B precursor cell stage.
AB  - Preferential utilization of JH and D genes has been demonstrated in the
      rearranged IgH chain in human peripheral B cells. We report here that the same
      hierarchy of JH gene usage is observed in leukemic cells arrested in the B
      precursor stage of differentiation. Specifically, JH4 and JH6 accounted for 42.9%
      and 35.7%, respectively, of the JH gene usage in the leukemias compared with an
      expected frequency of 16.7% assuming unbiased gene usage. Within the D gene
      families, the DN1 gene appears to be overutilized in both populations,
      representing about 15% of the total gene usage compared with an expected
      frequency of 3.2%. Because 21 of the 36 leukemias contained only nonproductive
      IgH rearrangements, the preferential gene usage could not have arisen from pre-B
      cells that have undergone clonal selection after a productive rearrangement but
      before surface Ig expression. Nonproductive rearrangements exhibited the biased
      gene usage seen for productive rearrangements. These findings suggest that a
      recombination bias favoring certain segments may be the actual mechanism
      responsible for the apparent preferential utilization of JH and D genes.

PMID- 1624798
TI  - Transforming growth factor-beta 1 inhibits murine immediate and delayed type
      hypersensitivity.
AB  - Transforming growth factor beta 1 (TGF-beta 1) is a member of a gene superfamily
      that regulates growth, differentiation, and function of cells including several
      in vitro immune functions. Our study examined the systemic effect of TGF-beta 1
      on murine delayed-type hypersensitivity (DTH), a model of T cell-mediated
      immunity that may depend on mast cells. Mice were immunized by i.v. injection of
      SRBC or by topical application of picryl chloride, and the responses were
      elicited by cutaneous challenge with the appropriate Ag. Systemic administration
      of TGF-beta 1 at the time of Ag challenge significantly reduced both the early
      and late phases of DTH. The effect of TGF-beta 1 on the release of serotonin from
      mouse peritoneal mast cells was examined. Results indicated that in vivo
      treatment with TGF-beta 1 24 h before mast cell harvest inhibited the in vitro
      release of serotonin in response to challenge with compound 48/80, or anti-IgE
      antibody. In contrast, treatment with TGF-beta 1 24 h before Ag challenge did not
      inhibit DTH indicating that mast cells may not be the direct target for TGF-beta
      1 in the DTH models. In vivo treatment with TGF-beta 1 inhibited the IgE
      mediated, mast cell-dependent, immediate hypersensitivity skin swelling response
      when injected at the time of, or 24 h before challenge. This suggests an effect
      on mast cells and a regulatory role for TGF-beta 1 in IgE-mediated responses.

PMID- 1624799
TI  - IFN-gamma and IL-2 cooperatively activate NF kappa B in murine peritoneal
      macrophages.
AB  - The combination of IFN-gamma and IL-2 has been demonstrated to induce or promote
      transcription from selected inflammatory cytokine genes in both monocytes and
      macrophages. In the present report, we have evaluated the ability of these agents
      to activate nuclear proteins, in murine peritoneal macrophages, that are capable
      of specific binding to the kappa B nucleotide consensus sequence (e.g., nuclear
      factor binding the kappa B consensus sequence (NF kappa B)), which is present in
      the region 5' of the transcription start site of many cytokine genes. Both IFN
      gamma and IL-2 treatments alone caused some activation of NF kappa B, as
      evidenced by the appearance of a characteristic DNA-protein complex in
      electrophoretic mobility shift assays; in combination, the two agents cooperated
      to increase binding activity markedly, to a level equivalent to that seen in
      macrophages stimulated with LPS, another potent stimulus of macrophage cytokine
      gene expression. The binding activity was directed toward the kappa B sequence,
      based upon competition studies with several different oligonucleotide probes
      containing the kappa B motif in different contexts. The complex formed in cells
      stimulated with either IFN-gamma/IL-2 or LPS contained two proteins, of
      approximately 50 kDa and 65 kDa, based upon UV cross-linking experiments with a
      bromodeoxyuridine-substituted oligonucleotide probe. Although the effects of LPS
      and IFN-gamma/IL-2 on NF kappa B activity were both transient, response to LPS
      was detected earlier and declined more rapidly than that seen with IFN-gamma/IL-2
      treatment. The cooperative activation of NF kappa B was dose dependent for both
      IFN-gamma and IL-2. The activation of NF kappa B by IFN-gamma/IL-2 did not depend
      upon protein synthesis. These results suggest that the induction of cytokine gene
      expression in macrophages by the combination of IFN-gamma and IL-2 may involve
      the activation of NF kappa B.

PMID- 1624800
TI  - Insulin-like growth factor-I inhibits apoptosis in IL-3-dependent hemopoietic
      cells.
AB  - The death of hemopoietic cells on withdrawal of CSF occurs by a mechanism known
      as apoptosis characterized by the early degradation of chromatin into
      oligonucleosome-length fragments. Insulin-like growth factor I plays a pivotal
      role in the regulation of somatic cell growth as a mediator of growth hormone
      action. Animals with low levels of circulating IGF-I are more vulnerable to
      infections and have diminished immune responses. To analyze the possibility of a
      regulatory role of IGF-I on hemopoiesis and determine its mechanism of action, we
      have studied the effect of this growth factor on the survival and proliferation
      of two IL-3-dependent hemopoietic cell lines and in IL-3-responsive primary
      cultures of bone marrow-derived mast cells. In IL-3-depleted cultures, IGF-I
      prevented DNA fragmentation and apoptotic cell death. Insulin at high
      concentration had a weak protective action and IGF-II was inactive in suppressing
      apoptosis in these IL-3-dependent hemopoietic cells. Cell proliferation was also
      stimulated by IGF-I in the absence of other hemopoietic growth factors although
      it was a weak mitogen when compared with IL-3. These results indicate that
      circulating or locally produced IGF-I may promote survival of both the steady
      state hemopoietic precursor population and cytokine-producing cells and could
      therefore regulate hemopoiesis acting in a concerted manner with other CSF.

PMID- 1624801
TI  - Cytokine production induced by Mycobacterium tuberculosis lipoarabinomannan.
      Relationship to chemical structure.
AB  - Lipoarabinomannan (LAM), a major cell wall component of Mycobacterium
      tuberculosis, exhibits a wide spectrum of immunoregulatory effects. To identify
      cytokines produced by human PBMC in response to LAM, we used PCR amplification to
      detect cytokine mRNA. LAM-induced transcription of mRNA for cytokines
      characteristically produced by macrophages, including TNF, granulocyte-macrophage
      CSF, IL-1 alpha, IL-1 beta, IL-6, IL-8, and IL-10. In contrast, LAM did not
      induce transcription of mRNA for cytokines produced predominantly by lymphocytes,
      such as lymphotoxin, IFN-gamma, IL-2, IL-3, or IL-4. Measurement of
      concentrations of TNF, granulocyte-macrophage-CSF, IL-6, IL-10, IFN-gamma, IL-2,
      and IL-4 in cell culture supernatants indicated that cytokine release correlated
      with mRNA patterns. Lipomannan (LM) and phosphatidylinositol mannosides (PIM) are
      simpler versions of LAM. LM lacks arabinan, whereas PIM lacks both arabinan and
      most mannan residues. LAM, LM, and PIM induced transcription of cytokine mRNA,
      elicited cytokine production, and suppressed Ag-induced T cell proliferation,
      indicating that most of the biologic activity of LAM was associated with the
      phosphatidylinositol end of the molecule. In support of this conclusion,
      deacylation of LAM abrogated its capacity to induce cytokine production and
      suppress Ag-induced proliferation. The production of macrophage-derived cytokines
      induced by LAM may mediate clinical manifestations of tuberculosis such as fever,
      weight loss, and tissue necrosis, as well as immunoregulatory effects such as
      inhibition of Ag-induced proliferation and hyperglobulinemia.

PMID- 1624802
TI  - A carboxyl-terminal fragment of Plasmodium falciparum gp195 expressed by a
      recombinant baculovirus induces antibodies that completely inhibit parasite
      growth.
AB  - The major merozoite surface Ag (gp195) of Plasmodium falciparum has been shown to
      protect monkeys against parasite infection, and gp195-based synthetic peptides
      and recombinant polypeptides have been evaluated as potential malaria vaccines. A
      major problem in developing a gp195-based recombinant vaccine has been the
      difficulty in obtaining a recombinant polypeptide that is immunologically
      equivalent to the native protein. In this study, the carboxyl-terminal processing
      fragment (p42) of gp195 was produced in yeast and in a baculovirus recombinant
      system. Immunologic analyses indicated that the secreted baculovirus p42 (BVp42)
      expressed native, disulfide-dependent conformational epitopes, whereas these
      epitopes were poorly represented in the intracellular yeast p42. BVp42, but not
      yeast p42, was also recognized by the majority of gp195-specific antibodies of
      animals immunized with purified native gp195, indicating that the anti-gp195
      response of these animals was focused on conformational determinants of the p42
      processing fragment. Sera against native gp195 of congenic mice of diverse H-2
      haplotypes recognized the BVp42 polypeptide, demonstrating that a genetically
      heterogeneous population is capable of responding to p42 epitopes. BVp42 was
      highly immunogenic and induced high titers of antibodies that were cross-reactive
      with purified native gp195 in an ELISA and also reacted with schizonts and
      merozoites by immunofluorescence. Anti-BVp42 antibodies completely inhibited the
      in vitro growth of the malaria parasite, whereas anti-yeast p42 antibodies had no
      effect. These results indicate that native, conformational epitopes of p42 are
      critical for the induction of gp195-specific, parasite growth-inhibitory
      antibodies and that the BVp42 polypeptide efficiently induces antibodies specific
      for these native determinants.

PMID- 1624803
TI  - Constitutive IL-2 mRNA expression in lymphocytes, infected with the intracellular
      parasite Theileria parva.
AB  - Theileria parva-infected lymphoblastoid cell lines of T or B cell origin were
      examined for IL-2 mRNA expression. T. parva-infected T cell lines could be of the
      CD4-CD8-, CD4+CD8-, CD4-CD8+, or CD4+CD8+ phenotype and express alpha beta or
      gamma delta TCR. By Northern blot analysis and amplification by the polymerase
      chain reaction, IL-2 mRNA could be detected in all T. parva-infected cell lines
      tested. IL-2 mRNA expression was also shown to be dependent on the continuous
      presence of the parasite in the host cell cytoplasm, because elimination of the
      parasite by treatment of T. parva-infected cell cultures with the theilericidal
      drug BW720c resulted in the disappearance of detectable IL-2 mRNA. The effect of
      anti-IL-2 antibodies on the proliferation of T. parva-infected cells was also
      tested. Inhibition experiments suggest that although IL-2 mRNA can be detected in
      all cell lines tested, not all T. parva-infected cell lines are dependent on IL-2
      for their proliferation. Our data provide the first example for the constitutive
      expression of IL-2 mRNA in T and B cells caused by infection with an
      intracellular parasite.

PMID- 1624804
TI  - Digestion of Histoplasma capsulatum yeasts by human macrophages.
AB  - The strategies used by Histoplasma capsulatum yeasts to survive and multiply
      within human macrophages (M phi) are unknown. To better understand these
      strategies we studied the intracellular fate of viable vs heat-killed (HK) yeasts
      in human monocyte-derived M phi. Initial studies demonstrated that phagolysosome
      fusion was present in M phi ingesting either viable or HK yeasts. Viable yeasts
      multiplied within M phi phagolysosomes, whereas M phi completely digested
      intracellular FITC-labeled HK yeasts within 24 h after ingestion. This
      observation was confirmed by electron microscopy. M phi that had ingested
      colloidal gold-labeled HK yeasts contained gold particles but no visible yeasts
      at 24 h. Digestion of HK yeasts was evident as early as 4 h after phagocytosis,
      and was complete by 24 h. M phi digestion of HK yeasts was blocked completely
      when M phi were cultured for 24 h in the presence of chloroquine. In M phi
      simultaneously ingesting both viable and HK yeasts, viable yeasts multiplied, but
      HK yeasts were digested within the same cell. M phi that had ingested viable
      yeasts digested them completely when M phi were cultured for 24 h in the presence
      of cycloheximide or amphotericin B. Coculture of infected M phi with nystatin or
      ketoconazole resulted in inhibition of growth, but the yeasts were not digested.
      These data indicate that: 1), HK Hc yeasts are easily digested by preformed M phi
      lysosomal hydrolases; 2), viable Hc yeasts survive and multiply within M phi
      phagolysosomes, but the yeasts do not secrete a factor(s) that affects the
      ability of other phagolysosomes within the same M phi to digest killed yeasts;
      and 3), inhibition of yeast protein synthesis or cell wall biosynthesis is
      sufficient to render viable yeasts susceptible to digestion by human M phi.

PMID- 1624805
TI  - Calcium rather than protein kinase C is the major factor to activate
      phospholipase D in FMLP-stimulated rabbit peritoneal neutrophils. Possible
      involvement of calmodulin/myosin L chain kinase pathway.
AB  - In the present study, we first investigated which of the factors, protein kinase
      C (PKC) or Ca2+, plays an important role in activation of phospholipase D (PLD)
      of rabbit peritoneal neutrophils stimulated by the chemoattractant FMLP. PLD
      activity was assessed by measuring [3H]phosphatidylethanol ([3H]PEt), the
      unambiguous marker of PLD, generated by [3H]lyso platelet-activating factor
      prelabeled neutrophils in the presence of ethanol. PKC inhibitors, staurosporine
      and 1-(5-isoquinolinesulfonyl-2-methylpiperazine dihydrochloride, augmented the
      plateau level of [3H]PEt produced in FMLP-stimulated cells, although they had no
      effect on the initial rate of the formation. Furthermore, it was found that the
      FMLP-stimulated [3H]PEt formation was inhibited by pretreatment of cells with
      PMA, a PKC activator, and exposure of cells to staurosporine before PMA
      pretreatment moderately blocked the PMA inhibition. Ca2+ ionophore ionomycin, as
      well as FMLP, stimulated [3H]PEt formation, accompanied by a decrease in
      [3H]phosphatidylcholine, in a time- and concentration-dependent manner. Both FMLP
      and ionomycin absolutely required extracellular Ca2+ to increase [3H]PEt
      formation. These results imply that elevated intercellular Ca2+ by FMLP
      stimulation is the major factor for PLD activation and that PKC rather negatively
      regulates the enzyme activity. Interestingly, a calmodulin inhibitor, N-(6
      aminohexyl)-5-chloro-1- naphthalenesulfonamide, and a myosin L chain kinase
      inhibitor, 1-(5-iodonaphthalene-1-sulfonyl)-1H-h exahydro-1,4-diazepine
      hydrochloride, both inhibited the ionomycin- and FMLP-stimulated [3H]PEt
      formation in a concentration-dependent manner. Results obtained in this study
      suggest that, in FMLP-stimulated rabbit peritoneal neutrophils, increased
      intracellular Ca2+ activates PLD through calmodulin/myosin L chain kinase pathway
      and, thereafter, the enzyme activation is turned off by simultaneously activated
      PKC.

PMID- 1624806
TI  - Release of granule proteins from eosinophils cultured with IL-5.
AB  - Eosinophils isolated from normal individuals were cultured in the presence of
      human rIL-5 (hrIL-5) for up to 14 days, and the effects of this exposure were
      determined. First, the hrIL-5-cultured eosinophils were activated and
      degranulated more readily than freshly isolated eosinophils. For example,
      eosinophils cultured for 7 days with hrIL-5 released 30 and 10% of granule
      eosinophil-derived neurotoxin (EDN) when exposed to Sepharose 4B beads coupled to
      secretory IgA and IgG, respectively, whereas freshly isolated eosinophils
      released only 19 and 4%, respectively, of their EDN in response to the same
      stimuli. Degranulation of hrIL-5-cultured eosinophils was not augmented by
      further exposure to hrIL-5, whereas degranulation of freshly isolated cells to
      secretory IgA and IgG beads was increased by exposure to hrIL-5. Second,
      eosinophils cultured with hrIL-5 had prolonged viability in vitro. For example,
      after four days of culture with 50 U/ml of hrIL-5, 86% of eosinophils were viable
      compared to 12% in medium alone. Third, hrIL-5-cultured eosinophils became
      hypodense, and electron microscopy showed that they contained granules with core
      and matrix lucency and with evidence of granule fusion. Fourth, hrIL-5-cultured
      eosinophils spontaneously lost 30 to 60% of their EDN, eosinophil cationic
      protein, and eosinophil peroxidase and about 50% of their eosinophil granule
      major basic protein content compared to freshly isolated eosinophils, and all
      four of the granule proteins were released into the culture medium. Fifth,
      detailed studies of eosinophils cultured in hrIL-5 showed that 89 +/- 10% of the
      starting quantity of EDN could be recovered at 7 days. Whereas 99 +/- 1% of the
      EDN at day 0 was cell associated, by 7 days 60 +/- 9% was in the cell
      supernatants. Thus, hrIL-5 activates eosinophils, increases their viability,
      decreases their density, and their content of granule proteins and causes release
      of the granule proteins into culture fluids. The striking loss of granule
      proteins during culture with hrIL-5 may be an important mechanism for deposition
      of these cationic toxins in various diseases where IL-5 plays a role.

PMID- 1624807
TI  - Eosinophil granule cationic proteins regulate complement. I. Activity on the
      alternative pathway.
AB  - Eosinophil granules contain several cationic proteins that mediate tissue damage
      in allergic disease. The present study examined the capacity and mechanisms by
      which these cationic proteins regulate activity of the alternative pathway of C.
      Eosinophil peroxidase and eosinophil cationic protein inhibited formation of cell
      bound alternative pathway C3 convertase, causing 50% inhibition of lysis at about
      0.19 and 0.75 microgram/10(7) cellular intermediates, respectively. Major basic
      protein inhibited alternative pathway C3 activity by only 19% at 1.5
      micrograms/10(7) cellular intermediates. Eosinophil-derived neurotoxin had no
      activity on the alternative pathway. The eosinophil granule proteins were
      examined for the mechanism by which they inhibited alternative pathway activity.
      Eosinophil peroxidase and major basic protein inhibited fluid phase factor B
      consumption in a reaction mixture that also contained factors D and C3b,
      eosinophil-derived neurotoxin had no activity on factor B consumption, and
      eosinophil cationic protein consumed factor B in the absence of C3b and factor D.
      Both eosinophil cationic protein and eosinophil peroxidase enhanced the decay of
      preformed alternative pathway convertase. Lysis of EAC4b,3b cellular
      intermediates formed to contain a low surface amount of C3b was more inhibited
      than was lysis of cells formed with a standard amount of C3b on the surface. This
      suggests that these eosinophil proteins acted predominantly on C3b to regulate
      alternative pathway activity. We also found that none of the eosinophil granule
      cationic proteins had any effect on later events after the formation of the C3
      convertase. We conclude that although eosinophil-derived neurotoxin (isoelectric
      pH value (pI) = 8.9) does not regulate alternative pathway activity, the more
      highly charged eosinophil granule cationic proteins--major basic protein (pI =
      10.9), eosinophil cationic protein (pI = 10.8), and eosinophil peroxidase (pI =
      10.8)--do share the capacity to regulate C activity and may exert this activity
      in vivo.

PMID- 1624808
TI  - Evidence for the expression of non-HLA-A,-B,-C class I genes in the human fetal
      liver.
AB  - HLA class I Ag expression was investigated in the human fetal liver. By
      immunostaining, mAb to monomorphic class I Ag showed widespread reactivity with
      both epithelial and hemopoietic cells. By contrast, mAb to polymorphic
      determinants showed more restricted reactivity that was confined to a proportion
      of hemopoietic cells: the hepatic epithelium was essentially unreactive. This
      suggested that the developing liver might express nonclassical HLA class I. Class
      I Ag were examined in membrane and cytosol fractions of mid-trimester fetal
      liver. Because of its broad reactivity with HLA-A,-B, mAb Q1/28 was selected to
      identify classical class I Ag in these studies. Immunoprecipitations were carried
      out against radiolabeled glycoprotein extracts of fetal liver membranes. W6/32
      detected a 40-kDa product characteristic of nonclassical class I proteins, as
      well as a 43-kDa product, in lysates immunodepleted with Q1/28. By
      immunoblotting, an anti-H chain antiserum (HC) identified a Q1/28- 40-kDa
      component and a 43-kDa Q1/28+ component in fetal liver membrane glycoproteins.
      The fetal liver cytosol fraction was found to contain a 42- to 43-kDa product by
      W6/32-chromatography. This component partitioned to the aqueous phase upon
      condensation in TritonX-114 detergent and by immunoblotting was reactive with
      monomorphic mAb HC10 but not with Q1/28. Total RNA and polymerase chain reaction
      amplified class I transcripts of fetal liver were probed using oligonucleotides
      specific for HLA-E, -F, and -G. HLA-F, was readily detected in total RNAs by
      Northern analysis. HLA-E, HLA-F, and HLA-G were all detected in fetal liver by
      polymerase chain reaction. Differential expression of these genes may occur
      between the first and second trimester of liver development. Overall therefore,
      the human fetal liver expresses multiple class I protein products and contains
      transcripts for non-classical class I genes; particularly HLA-F.

PMID- 1624809
TI  - Production of monocyte chemoattractant protein-1 by inflamed synovial tissue and
      cultured synoviocytes.
AB  - This study analyzes the expression of monocyte chemoattractant protein-1 (MCP-1)
      by inflamed synovial tissue and defines its regulation in cultured synoviocytes.
      Synoviocytes from patients with rheumatoid arthritis and osteoarthritis express
      the 0.7-kb MCP-1 mRNA. Stimulation of synoviocytes with IL-1, TNF-alpha, LPS,
      platelet-derived growth factor, and transforming growth factor-beta-1, but not
      with basic fibroblast growth factor causes a marked increase in MCP-1 mRNA
      levels. Expression of the MCP-1 gene is inducible by activators of the protein
      kinase A (cAMP) and C (PMA) signal transduction pathways and is differentially
      regulated by the steroids dexamethasone and retinoic acid. Cultured synoviocytes
      de novo synthesize 12-, 15-, and 15.2-kDa MCP-1 proteins, which increase after
      stimulation with IL-1. Synovial tissues from donors without joint disease and
      from patients with rheumatoid or osteoarthritis were analyzed for MCP-1 mRNA
      expression by in situ hybridization. In these samples MCP-1 mRNA expressing cells
      were predominantly found in the sublining cell layers, whereas specimens of
      normal synovial tissue contained only few positive cells. These results identify
      synoviocytes as a source of MCP-1. Its expression is controlled by peptide
      regulatory factors that are known to be present in arthritic joints. Detection of
      cells producing MCP-1 mRNA in synovial tissues from patients with arthritis shows
      that this gene is expressed in vivo and suggests that MCP-1 can play a role in
      recruiting monocytes in joint inflammation.

PMID- 1624810
TI  - Simian immunodeficiency virus-specific cytotoxic T lymphocytes are present in the
      AIDS-associated skin rash in rhesus monkeys.
AB  - An infiltration of CD8+ lymphocytes in the dermis and epidermis underlies the
      skin rash that commonly occurs as a primary manifestation of an AIDS virus
      infection. These cutaneous lymphocytes were characterized in simian
      immunodeficiency virus of macaques (SIVmac)-infected rhesus monkeys. Skin rash
      associated lymphocytes exhibited greater lysis of SIVmac-expressing target cells
      and a higher cloning efficiency for SIVmac-specific effector T cells than PBL.
      Moreover, both SIVmac envelope- and gag-specific CTL could be readily cloned from
      these skin rash-associated lymphocytes. In fact, the skin rash-associated CTL
      exhibited the same MHC restriction and epitope specificity as those CTL derived
      from PBL. These studies, therefore, demonstrate that the cutaneous infiltrating
      CD8+ lymphocytes in SIVmac-infected rhesus monkeys include SIVmac-specific CTL.
      Thus, whereas virus-specific CTL are likely to represent an important mechanism
      for controlling AIDS virus infections, they also may play a role in the
      pathogenesis of the skin lesions that occur after this infection.

PMID- 1624811
TI  - Varicella in pregnancy, the fetus, and the newborn: problems in management.
AB  - As many as 9000 pregnancies annually may be complicated by varicella, which
      creates management problems for the woman and her fetus or newborn. Estimates on
      risk to the fetus and to neonates vary widely, making counseling difficult.
      Likewise, the efficacy of passive immunization of pregnant women or their exposed
      newborns is not precisely known. In addition to these problems in clinical
      management, questions remain about the developmental immunology of varicella
      zoster virus infection. For example, why do infants exposed in utero to the virus
      get zoster at an early age and why does passive immunization of newborns appear
      to be less effective than immunization of older individuals?

PMID- 1624812
TI  - A long-term survey of morphine in cancer pain patients.
AB  - We surveyed 550 cancer patients who experienced pain and were treated with
      morphine for a total of 22,525 treatment days. Sufficient pain relief was
      achieved during more than 80% of this time using an average oral morphine dose of
      82.4 mg--significantly lower than other studies. The use of this low dose, which
      was possible due to the concomitant administration of nonopioids and specific
      coanalgesics in most patients, resulted in a low incidence of side effects.
      Constipation and nausea/vomiting were the most common of these side effects.
      Physical dependence posed no practical problem in discontinuation of morphine
      treatment. Long-term opioid intake and development of tolerance did not appear to
      be linked; an increase in morphine dosage was most often explained by progression
      of the terminal disease. Addiction was a negligible problem, with only one
      observed case.

PMID- 1624813
TI  - The assessment of pain intensity in patients with cognitive failure: a
      preliminary report.
AB  - We reviewed our experience with 14 consecutive patients with cancer pain who
      developed severe cognitive failure that reverted either spontaneously or after
      specific treatment. In 3 patients who developed a nonagitated cognitive failure
      episode (CFE), there was no difference in the pain intensity measured by the
      patient before and after the episode and that measured by the nurse during the
      episode. In 11 patients who developed an agitated CFE, pain intensity assessed by
      a nurse during the CFE was significantly higher than the patient's assessment,
      both before and after the CFE. Patients who developed agitated CFE received a
      mean of 5 +/- 2 extra doses of narcotics per day, versus a mean of 2.17 +/- 1.6
      doses in the average patient in our unit (P less than 0.01). Upon complete
      recovery, none of the 14 patients recalled having had any discomfort during the
      CFE. Problematic conflict between staff and family was detected in 4 of 11 cases
      of agitated CFE (36%), versus an expected 13 of 260 cases (5%, P less than 0.01).
      We conclude that (a) patients who recover from a severe CFE have no memory of
      pain; (b) medical and nursing staff are likely to overestimate the level of pain
      of patients with agitated CFE; and (c) agitated CFE in patients with cancer pain
      is a major source of distress for the patients' families and staff.

PMID- 1624814
TI  - Psychological techniques for controlling the adverse side effects of cancer
      chemotherapy: findings from a decade of research.
AB  - Cancer patients receiving chemotherapeutic treatments often experience unpleasant
      side effects that compromise the quality of their life and may be so severe that
      they lead to suboptimal drug dosages, missed treatments, or even discontinuation
      of treatment. In recent years it has been discovered that some of these side
      effects result from maladaptive learning. This article reviews over 10 years of
      research conducted at Vanderbilt University on the prevention and treatment of
      these psychological side effects. This research includes the assessment of the
      efficacy of a behavioral relaxation technique, the exploration of procedures that
      make this intervention clinically practical for widespread application, research
      aimed at predicting which patients will and will not benefit from the
      intervention, and the comparison of this intervention to alternative treatment
      approaches. The review of this research generates four major conclusions and
      points to several important areas for future inquiry.

PMID- 1624815
TI  - Comprehensive and multidimensional assessment and measurement of pain.
AB  - Current theories of pain and clinical experience support a multidimensional
      framework for the experience of pain that has implications for assessment and
      management in any setting. Six major dimensions have been identified:
      physiologic, sensory, affective, cognitive, behavioral, and sociocultural. Any
      clinical assessment process must address relevant dimensions of pain in the given
      setting. In acute care settings, for example, clinicians may focus on physiologic
      and sensory dimensions, whereas in chronic care settings, the affective,
      cognitive, and behavioral dimensions might assume priority. Various tools are
      available for multidimensional assessment of pain, spanning the dimensions of the
      experience from physiologic to sociocultural. The clinician in any setting must
      use appropriate tools that provide useful information. Guidelines helpful in a
      selection process include identification of relevant dimensions of pain, type of
      pain, patient population and setting, psychometric properties of the tool, and
      issues of time, clinical relevance, and feasibility. When a careful selection
      process occurs, the resulting data should simultaneously meet clinicians' needs
      for information as well as provide the foundation for initiation of
      multidisciplinary interventions.

PMID- 1624816
TI  - Postherpes simplex type 1 neuralgia simulating postherpetic neuralgia.
AB  - Patients with prodromal neuralgia associated with recurrent herpes simplex type 1
      (HST1) infection and chronic facial pain following years of relapsing HST1 have
      been described. Chronic neuralgia following a single clinical HST1 infection and
      simulating postherpetic neuralgia has not been previously reported. Such a case
      is described: A 49-yr-old woman with a 2-mo history of oral-facial dyskinesia
      developed burning pain and hypersensitivity of the left side of the tongue, lower
      gum, and inner cheek, followed 1 day later by a vesicular rash in the same
      painful distribution. Viral cultures of the lesions identified HST1 but not
      herpes zoster. Cerebrospinal fluid analyses during the vesicular lesion stage and
      1 mo later were normal with no viral growth. Oral and facial lesions resolved
      after 10 days; acyclovir was given for 3 wk. Brain and brainstem magnetic
      resonance imaging (MRI), electroencephalogram, and brainstem evoked potential
      studies were normal. Hyperesthesias, allodynia, and burning pain persisted
      despite nonsteroidal antiinflammatory agents, codeine and hydrocodone. Oral
      opioids were administered until sedation occurred, with no relief of pain. The
      burning pain and hyperesthesia resolved after the 16th day of amitriptyline use,
      75 mg/day. A trial off amitriptyline 6 mo later resulted in recurrence of pain,
      and amitriptyline was restarted with good pain control. Post-HST1 neuralgia may
      simulate postherpetic neuralgia clinically, and painful symptoms may respond to
      amitriptyline.

PMID- 1624817
TI  - [Persistent non-inflammatory carriage of group B Streptococcus in organs of
      newborn mice].
AB  - Group B Streptococcus (GBS) is an important pathogen in newborn infants and has
      shown a remarkable increase in Japan since 1970. It has been reported that the
      early-onset type of GBS infection may be caused by vertical transmission whereas
      the late-onset type may be caused by horizontal or nosocomial transmission.
      However we think that the late-onset type may be caused by continuous carriage of
      GBS after vertical transmission. Therefore, we studied the continuous carriage of
      GBS using mice. Mice were separated into two groups, and one was given 10(3)
      colony-forming units of type Ia and the other type III GBS (isolated from the
      affected human neonates) by intraperitoneal injection on the first day of life.
      Then, on the 2nd, the 5th, the 8th and the 10th day after injection, viable
      counts were obtained per 10 mg of liver, spleen, lung and brain tissues. Each
      organ was homogenized and dissolved in 1 ml physiological saline per 10 mg of
      tissue, and 0.1 ml of each was infused into brain-heart infusion agar and
      incubated for 36 hours at 37 degrees C. The type III GBS isolated from many
      organs on these days, but type Ia was isolated in only two among 72 mice. These
      results suggested the possibility that type III GBS acquired by vertical
      transmission at birth may be carried over in a non-inflammatory state for a long
      time, and that the symptoms will become manifest only when the host-parasite
      relationship is disturbed later.

PMID- 1624818
TI  - [Studies on Clostridium absonum isolates from clinical specimens].
AB  - Two strains of Clostridium absonum isolated from clinical specimens and a type
      strain were tested for heat resistance of spores, biochemical properties and
      neutralization of their lecithinase by anti-C. perfringens alpha toxin antiserum.
      In addition, the usefulness of RapID ANA (AMUCO) and ANIDENT (API) kits for the
      identification of C. absonum was examined. The results were summarized as
      follows: 1. C. absonum isolates from clinical specimens were resistant against
      heating at 70 degrees C for 10 min and a type strain against heating at 85
      degrees C for 10 min, less resistant than those of C. perfringens BP6K. 2. C.
      absonum differentiated from C. perfringens in fermentation of trehalose,
      melibiose and raffinose, and hydrosis of esculin and starch. 3. Lecithinase of C.
      absonum was not completely neutralized by anti-C. perfringens alpha toxin
      antiserum. 4. Both RapID ANA and ANIDENT kits were useful for differentiation of
      C. absonum from C. perfringens but not for the identification of C. absonum.

PMID- 1624819
TI  - [Tsutsugamushi disease found in Haruna District, Gunma Prefecture--evaluations of
      the clinical features and the outbreak pattern].
AB  - From November to December in 1990, 7 cases of tsutsugamushi disease were found
      first in the southern foot of Mt. Haruna of Gunma Pref., Japan. The present study
      was conducted to clarify the clinical features and the outbreak pattern of
      rickettsial infection in this area. All the patients consisting of 6 males and 1
      female farmers were admitted to our hospital, complaining of high fever, chills
      and skin rash on 5-12 days after working in the field. Based on laboratory
      examinations and one (or two) typical eschar, a tentative diagnosis of
      tsutsugamushi disease was made and all patients became better soon after the
      therapy with intravenous administration of minocyclin (200 mg/day). The high
      titer of serum antibody to Karp type Rickettsia (Orientia?) tsustugamushi was
      detected by an immunoperoxidase test (IP) in most of the patients, and also a
      Karp-like strain was isolated from only one patient, probably due to low
      virulence to mice. The agricultural areas along the Agatuma and Nakuta rivers in
      the northern foot of Mt. Haruna have been well known as the most endemic foci of
      the disease in Gunma Pref. Nevertheless, it was suggested that outbreaks of the
      disease might be potentially wide-spread throughout this Pref., when the
      prevalences of the disease were evaluated as incidences to a hundred thousand
      inhabitants or adjusted by the density of agricultural populations of each
      administrative divisions. As most of the patients in Gunma Pref. have been
      officially reported in autumn, a statistical trial indicates that there is a
      significant correlation between the levels of temperature and outbreaks of the
      disease in autumn.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624820
TI  - Seroepidemiology status of Nepalese against hemolytic streptococcal infection in
      Katmandu.
AB  - Immune status of apparently healthy Nepalese against hemolytic streptococci was
      studied by measuring antibodies to various streptococcal antigens such as
      streptolysin-O (SO), streptokinase (SK), deoxyribonuclease-B (DN-B) and
      streptococcal polysaccharide (SP). The normal range of anti-streptolysin-O (ASO),
      anti-streptokinase (ASK), anti-deoxyribonuclease-B (ADN-B) and anti-Streptococcus
      polysaccharide (ASP) was 60-480 (T.U.), 40-1024 (titer), 60-1280 (titer) and less
      than 2-128 (Unit), respectively. No difference was observed between the two
      sexes. ASO and ADN-B were measured by the neutralization method. Passive
      hemagglutination (PHA) was used to measure ASK and ASP. These values were 2-3
      fold higher than those obtained on the Japanese subjects.

PMID- 1624821
TI  - [Serovar distribution and drug resistance of Salmonella isolated from imported
      and domestic cases in 1980-1989 in Tokyo].
AB  - A total of 6,816 strains of nontyphoidal Salmonella isolated from oversea
      travellers (imported cases) and domestic healthy individuals and sporadic cases
      (domestic cases) in Tokyo from 1980 to 1989 were studied for their serovar
      distribution and antimicrobial sensitivity. The serological typing results showed
      that the Salmonella strains were classified into 22 O groups and 156 serovars.
      Among serovars identified, S. ser. Anatum, S. ser. Derby, S. ser. Blockley, S.
      ser. Agona and S. ser. Typhimurium were predominant in imported cases, while S.
      ser. Litchfield, S. ser. Typhimurium, S. ser. Hadar, S. ser. Infantis and S. ser.
      Thompson were predominant in domestic cases. It was also noticed that isolation
      rates of S. ser. Hadar and S. ser. Blockley have tended to increase noticeably in
      recent years in both cases. From antimicrobial sensitivity testing, 739 (28.1%)
      of 2,628 strains isolated from imported cases and 1,047 (25.0%) of 4,188 strains
      isolated from domestic cases were found to be resistant to any one of the drugs
      tested (CP, TC, SM, KM, ABPC, ST, NA, FOM and NFLX). From 1980 to 1983 the
      resistance rate was less than 20% for both cases and then the rate was increased
      year by year, and it became greater than 40% in 1989. Serovars of a high
      resistant rate during this period were S. ser. Hadar (96.3%), S. ser. Blockley
      (92.0%), S. ser. Typhimurium (75.7%), S. ser. Kentuckey (64.1%), S. ser. Krefeld
      (59.3%), and S. ser. Panama (58.3%) for the imported cases and S. ser. Hadar
      (97.5%), S. ser. Blockley (57.4%), S. ser. Litchfield (44.6%), S. ser.
      Enteritidis (44.4%), S. ser. Muenchen (42.2%) and S. ser. Typhimurium (40.9%) for
      the domestic cases. Drug resistance patterns of the resistant isolates varied up
      to as much as 50 patterns. Prevalent patterns recognized were TC.SM, CP.TC.SM.KM,
      TC, CP.TC.SM.KM.ABPC and SM for imported cases and TC.SM, TC, TC.SM.KM, SM, and
      CP.TC for the domestic cases. 21(12.4%) of 170 drug resistant strains were
      isolated from imported cases from 1988 to 1989 were found to have conjugative
      transmissible R plasmids.

PMID- 1624822
TI  - [Serological studies on Campylobacter jejuni/coli: establishment of national
      reference system for serological typing in Japan].
AB  - In order to establish a national reference system for Campylobacter serotyping in
      Japan, 7 local institutes of public health collaborated to prepare 30
      serogrouping antisera including 26 antisera of Lior's serogrouping system and 4
      antisera of TCK serogrouping system which was developed by the Tokyo Metropolitan
      Research Laboratory of Public Health. A total of 603 strains (92.2%) out of 654
      isolates from 23 outbreaks of C. jejuni throughout Japan were serogrouped by the
      30 antisera. Out of 1,198 strain isolated from sporadic cases of Camplyobacter
      gastroenteritis, 883 (73.7%) were typed and 298 strains (24.9%) were untypable.
      The remaining 17 strains belong to rough form were not used for serogrouping. A
      hundred thirteen out of 883 strains have reacted with more than one typing serum.
      Among C. jejuni isolated from 7 prefecture, Lior's serogroup 4 was most common
      followed by Lior's serogroup 4, 2, 11, 1 and TCK serogroup 1 and 12. We conclude
      from the experiment described above that this Lior's serogrouping system by
      combining with TCK serogroup for Campylobacter jejuni/coli is useful in
      epidemiological investigations in Japan.

PMID- 1624823
TI  - [Contamination of endoscopes and endoscope washers by atypical mycobacteria].
AB  - Contamination of endoscopes and endoscope washers by atypical mycobacteria was
      studied. Large amounts of atypical mycobacteria were detected with high frequency
      inside endoscopes and endoscope washers. The species of atypical mycobacteria was
      Mycobacterium chelonae subsp. abscessus. Antibacterial-effects of glutaraldehyde
      against isolated atypical mycobacteria were checked. Sufficient antibacterial
      effect was not obtained by 2% glutaraldehyde solution for endoscope
      sterilization. However, after frequent manual washing and brushing of endoscopes,
      by using 3% glutaraldehyde solution and 70% alcohol, all endoscopic instruments
      were completely decontaminated. We must pay attention to contamination of
      endoscopes and endoscope washer at least once a month.

PMID- 1624825
TI  - [An outbreak of Pseudomonas folliculitis in children--the first report on
      Pseudomonas folliculitis in Japan].
AB  - An outbreak of Pseudomonas aeruginosa folliculitis in 6 children occurred within
      5 days after playing in a tiny vinyl pool. The follicular macular or pustular
      eruptions were mainly distributed on the trunk. No associated symptoms were seen.
      The causative Pseudomonas aeruginosa strain isolated from pustules of one case
      belonged to serogroup E, corresponding to O-11 (Difco). The rash subsided
      promptly and spontaneously. Furthermore, we have encountered another case of
      Psedomonas folliculitis caused by P. aeruginosa serogroup G, corresponding to O-6
      (Difco). The maculopustular rash was distributed on the trunk and disappeared
      spontaneously as the cases mentioned above. The folliculitis of this baby were
      probably associated with the repeated use of family bath without changing water.
      In U.S. and Europe Pseudomonas folliculitis have been reported very frequently,
      but our cases were reported for the first time in Japan.

PMID- 1624824
TI  - [Long term eradication rate of mebendazole therapy for strongyloidiasis].
AB  - We treated 245 strongyloidiasis patients with 7 schedules of mebendazole (MBZ)
      and obtained the eradication rates at 8 months to 2 years after the final
      treatment as described follows; MBZ (100 mg) was given twice a day orally.
      [Square bracket shows incidence of liver disfunction.] 1) The eradication rates
      at 2 years after single course of MBZ therapy for 28 days and a combination
      therapy (thiabendazole 500 mg powder form three times daily for 5 days followed
      by MBZ in powder form for 9 days, repeated once) were 93.8% (15 of 16 patients),
      [71.4%] and 100.0% (16/16), [50.0%]. 2) The eradication rates at 8-15 months
      after using MBZ alone in varying dosages were as follows: a) MBZ powder was
      administered for 5 days and was then repeated 1, 3 and 4 weeks later: 87.1
      (27/31), [51.1%]. b) MBZ powder was given for 5 days and repeated 1 and 3 weeks
      later: 100.0% (7/7), [30.8%]. c) MBZ powder was administered for 4 days and
      repeated 1, 3 and 4 weeks later: 96.3% (26/27), [57.8%]. d) MBZ in tablet form
      was given for 4 days and repeated 1, 3 and 4 weeks later: 89.6% (43/48). [66.2%].
      e) MBZ in tablet form was administered for 4 days and repeated 1 week later:
      69.2% (9/13), [25.0%]. As described above, although the incidence of liver
      disfunction in the 4-day with 2-course therapy was lower than the other
      schedules, the eradication rate was lower. From these results, MBZ should be
      given to strongylodiasis patient for 4 days and repeated once, or for 3 days and
      repeated two or three times with 1 to 2 weeks intervals.

PMID- 1624826
TI  - [Evaluation of serological and biochemical diagnosis of candidemia].
AB  - In order to compare 4 serological and biochemical diagnostic tests, HA-test
      (Candida-HA-test), Cand-Tec, D-arabinitol detective test and Fungal Index (F.I.)
      were carried out in a total of 8 patients with candidemia, 6 were diagnosed to
      have systemic candidosis and 2 transient fungemia due to colonized catheters.
      Rabbits were given venous injections of 1.0 x 10(6) CFU (1 ml) of living Candida
      albicans type A to study the 4 diagnostic methods by sequential blood culture.
      Prior to clinical administration of antimycotics the diagnostic methods produced
      almost the same positive ratios. After administration of antimycotics, the HA
      test became positive later than Cand-Tec or D-arabinitol because it detected
      antibodies in the serum, but its conversion to negative also tended to be
      slightly slower. Accordingly, the HA-test is considered to be useful for
      retrospective diagnosis of systemic candidosis. In Cand-Tec, D-arabinitol and
      F.I., the cases where reversion to normal was not achieved soon after therapy
      were intractable. In one case, the antigen values after therapy were four times
      as high as prior to treatment. To differentiate the two cases with transient
      fungemia from those with systemic candidosis HA- and D-arabinitol tests were
      considered to be superior to Cand-Tec and F.I. In the experiments with rabbits
      Cand-Tec was, in spite of its being positive in blood culture, always negative.

PMID- 1624827
TI  - [Effect of methylrosanilinium chloride to MRSA nasal carriers].
AB  - Since the end of 1987, we have noticed an increasing incidence of Methicillin
      resistant Staphylococcus aureus (MRSA) among the inpatients of Yamanashi Medical
      College Hospital. MRSA strains were identified in 70-80 percent of the specimens
      obtained from patients with Staphylococcus aureus. From 1988 we performed yearly
      bacteriological examinations of the nares of medical personnel at Yamanashi
      Medical College Hospital. We treated nasal carriers with OFLX drop lotion or
      Povidone-iodine applied to the nares. In 1991 we treated eight nasal carriers,
      who had been unsuccessfully treated with Povidone-iodine, with 0.01%
      Methylrosanilinium Chloride ointment which was applied to the nares once a day
      for two weeks. A post-bacteriological examination again revealed that MRSA
      vanished from the nares of six nasal carriers. The minimum inhibitory
      concentration (MIC) of Methylrosanilinium Chloride was determined by the agar
      plate dilution method. The 100% MICs of MSSA were 1.0 microgram/ml and of MRSA
      were 1.0 microgram/ml by Methylrosanilinium Chloride. Moreover we examined the
      MICs of Methylrosanilinium Chloride against MRSA under the existing 5% Albumin,
      and consequently the 100% MICs were 4.0 micrograms/ml. Therefore a 0.01%
      Methylrosanilinium Chloride has sufficient efficacy against MRSA. The reaction of
      the skin and nasal mucosa to Methylrosanilinium Chloride was examined by using
      three groups of guinea pigs. 0.1% and 0.01% Methylrosanilinium Chloride ointment
      and hydrophylic poloid were applied to the nares and skin once a day for two
      weeks. Post-observation with an opticmicroscope revealed no significant findings.
      Methylrosanilinium Chloride shows good anti-Staphylococcus aureus ability.
      Further investigation is needed to determine if Methylrosanilinium Chloride has
      additional clinical application.

PMID- 1624828
TI  - [Colonization rates of Mobiluncus spp. in female lower genital tract and its
      relationship with bacterial vaginosis].
AB  - To clarify the colonization rate of Mobiluncus spp., 889 specimens were collected
      from the vagina and 688 specimens from the cervical canal in three groups of
      women, namely, non-pregnant women, pregnant women, and patients fulfilling the
      criteria of bacterial vaginosis. On screening, this organism was detected from
      the vagina in 18/576 cases (3.2%) in non-pregnant women and in 2/280 cases (0.7%)
      in pregnant women, and it was detected from the cervical canal in 12/410 cases
      (2.9%) in non-pregnant women, and 3/278 (1.1%) in pregnant women. Although the
      positive rates were slightly higher in non-pregnant women from both the vagina
      and cervical canal, they were not significant. However, in cases of bacterial
      vaginosis, the positive rate of Mobiluncus spp. was 9/33 cases (27.3%), so that
      it was significantly higher than in the other two groups. Although the role of
      Mobiluncus spp. in bacterial vaginosis has not been clarified, our results
      indicate that the presence of Mobiluncus spp. is abnormal, since its colonization
      rate in healthy women is too small to be regarded as a member of normal flora. G.
      vaqinalis and anaerobes (other than Mobiluncus spp.) are also closely connected
      to bacterial vaginosis. G. vaginalis alone was seen in 7/33 cases (21.3%),
      anaerobes alone in 7/33 (21.3%), and Mobiluncus spp. alone in 3/33 cases (9.1%).
      Multiple infections including 2 or 3 of the above organisms were seen in 13/33
      cases (39.3%), and all cases had anaerobes. On the other band, only three cases
      were infected by none of the above organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624829
TI  - [Evaluation of micro particle enzyme immunoassay (MEIA) for the demonstration of
      antibody to hepatitis B surface antigen].
AB  - A fully automated microparticle enzyme immunoassay (IMx AUSAB, Abbott) has been
      recently introduced for the detection of the presence of antibody to hepatitis B
      surface antigen (anti-HBs). The present trial was carried out to determine the
      feasibility of using the IMx AUSAB with sera and plasma, and for comparison with
      RIA (AUSAB, Abbott) and EIA (AUSAB EIA, Abbott). According to the kinds of
      vaccines used and locations of residents, the subjects were divided into six
      groups. Results obtained were as follows; In the test of 642 sera from 446
      vaccines and 196 other inhabitants of Okinawa and Miyazaki prefectures, 388
      (87.0%) were found positive for anti-HBs using IMx, 392 (87.9%) with RIA and 359
      (80.5%) with EIA. Among those vaccinated with recombinant vaccines, 96.6% were
      found positive with IMx, 96.2% with RIA and 89.4% with EIA. Among subject
      vaccinated with plasma derived vaccines, 72.9% were found positive with IMx,
      75.7% with RIA, and 68.5% EIA. Quantitative agreement between IMx and RIA among
      the six groups gave linear correlation coefficients ranging from 0.459 to 0.821.
      In the group vaccinated with the recombinant vaccine by K company (r = 0.459),
      anti-HBs was confirmed in many sera by IMx compared to that confirmed by RIA and
      EIA. In addition, anti-HBs was assayed within one hour by IMx and the procedure
      was simplified by autoanalyser equipped for this method. The results indicate
      that the sensitivity of IMx is equal to that of RIA and more than that of EIA,
      and that quantitative linear correlations were obtained between IMx and RIA, and
      IMx and EIA.

PMID- 1624830
TI  - [A clinical study of respiratory tract infection due to Staphylococcus aureus
      detected by transtracheal aspiration].
AB  - A clinical study of 24 patients with respiratory tract infection due to S. aureus
      detected by transtracheal aspiration (TTA) was conducted, and the following
      results were obtained. 1) The detection frequency of S. aureus was relatively low
      (4.6%). 2) Pneumonia was the principal clinical manifestation. 3) Approximately
      one half of the patients had previously received antimicrobials. 4) Multiple
      organisms were frequently detected, particularly in cases of hospital-acquired
      infection. H. influenzae was the most frequently simultaneously detected
      organism. 5) On sputum examination, approximately 20 ml of purulent sputum was
      found in most cases, and S. aureus was detected in sputum specimens from 20 of
      the patients. 6) The largest number of cases was found in 1987. Onset was most
      common from autumn to spring. 7) Undernutrition was the most frequently
      associated host factor. As indicated by the above findings, the clinical
      expression of S. aureus infection is variable, and it is important that it be
      diagnosed accurately.

PMID- 1624831
TI  - [The study of pathogenic mechanisms of chronic Pseudomonas aeruginosa lung
      infections by mucoid strains].
AB  - Chronic Pseudomonas aeruginosa lung infection with mucoid strains is the
      predominant cause of death in cystic fibrosis (CF) or diffuse panbronchiolitis
      (DPB). This infection is characterized by a chronic course without spread of the
      bacteria to the blood when compared with other infections due to the non-mucoid
      strains. However, the mechanism of P. aeruginosa lung infection with the mucoid
      strains remains obscure. Intra-tracheal and systemic infection in mice,
      susceptibility to the bactericidal activity of fresh human and mouse serum, and
      adherent activity to mouse fetal lung cell were examined for mucoid and non
      mucoid strains of P. aeruginosa. After intra-tracheal infection, the mucoid
      strains were distributed to other organs anormously but not the non-mucoid
      stains, and the bacterial number of the mucoid strains in the blood were
      significantly lower than that of the non-mucoid strains. On the other hand, when
      these strains were inoculated into the tail vein of mouse, the mucoid strain was
      eliminated more rapidly from blood as compared with the non-mucoid strain. The
      mucoid strains showed reduced bacteremic virulence when compared with non-mucoid
      strains with a 50% lethal dose (LD50) of 1.5 x 10(7) CFU/mouse as the mean value
      in a systemic infection. In contrast to the non-mucoid strains, the mucoid
      strains were sensitive to human fresh serum but were resistant to mouse fresh
      serum. The mucoid strains adhered to the monolayer of the mouse fetal lung cell 7
      fold better than did non-mucoid strains.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624832
TI  - Abscess formation complicated in ovarian mucinous cystadenoma: a case report.

PMID- 1624833
TI  - [Pneumonia caused by Moraxella subgenus Moraxella sp].
AB  - Moraxella subgenus Moraxella sp. was isolated in pure culture from the sputum of
      a 43-year-old male with pneumonia and congestive heart failure due to idiopathic
      dilated cardiomyopathy. In this case, we concluded that the patient's bacterial
      pneumonia was caused by M. (M.) sp. based on a Gram stain of the sputum smear and
      bacterial findings, increased WBC count, and elevated CRP. A chest X-ray revealed
      right middle, and left upper and middle lobe infiltrates. This Moraxella strain
      produced a BRO-type beta-lactamase, a carbenicillinase-type enzyme.

PMID- 1624834
TI  - [Epidemiological studies on viral hepatitis among long-term sojourners in the
      developing countries and evaluation of preventive measures].
AB  - It is known that acute viral hepatitis is very common among sojourners in
      developing countries. In order to conduct effective health control,
      epidemiological studies were made on viral hepatitis which occurred among
      Japanese staying in developing countries, and evaluations were carried out on
      preventive measures. The subjects of present study were a group of Japanese
      people staying in developing countries for two years. Mid year population of the
      group was 1732 in 1988. Period of the present study is ten years from 1979 to
      1988. The study was conducted based on the reports from offices in each country,
      survey trips and serological studies on the subjects. In 1979, frequency of
      hepatitis A (HA) was very high showing 79% of total hepatitides. However after
      starting of inoculation of human immune serum globulin (ISG), the frequency of HA
      declined remarkably. Statistical significance was recognized in the efficacy of
      ISG. Among 35 cases of hepatitis B (HB) (34 males and 1 female), 2 derived from
      HBe antigen carrier while the remaining 34 were regarded as infected during their
      stay in developing countries. No cases of HB were recognized among those who
      received injections of HB vaccine. The rate of people whose HB marker turned
      positive during their stay is showing a tendency of increase (4.2% in 1987). The
      frequency of infection with HB virus is especially high in Asian and African
      countries where the carrier rates of native people were also high. Ten cases of
      non-A non-B hepatitis were recognized. Among them 7 were infected in Asia, 1 in
      Africa and 1 in Central America.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624835
TI  - [Sero-diagnosis for human parvovirus B19 infection by IgM and IgG antibody
      capture method of enzyme-linked immunosorbent assay--study on an epidemic case of
      erythema infectiosum].
AB  - The IgM and IgG antibody capture methods of the enzyme-linked immunosorbent assay
      (ELISA) for human parvovirus B19 were performed using Horseradish peroxidase
      (HRPO)-labeled anti B19 monoclonal antibody. Serially obtained serum samples from
      one erythema infectiosum (E.I.) patient were examined at once by this methods.
      The dOD values of the IgM and IgG antibodies decreased on the typical curves
      according to the course of recovery. In the epidemic case of E.I. among students
      of one nurse school, 1) The first patients was estimated by comparing the change
      of dOD values of sera obtained at end of the epidemic and 1.5 months later. 2) In
      the pre-existing antibody positive persons, the dOD values of IgG antibody did
      not changed during the epidemic. 3) After the E.I. epidemic, and approximately
      30% of the students were remained uninfected.

PMID- 1624836
TI  - [Determination of the neutrophil chemotactic factor in bronchoalveolar lavage
      fluid in patients with diffuse panbronchiolitis].
AB  - It is well known that erythromycin (EM) therapy is effective on chronic lower
      respiratory tract disease, including diffuse panbronchiolitis (DPB). In this
      study we investigated the relationship between clinical findings and neutrophil
      chemotactic activity (NCA) in bronchoalveolar lavage fluid (BALF) in patients
      with DPB receiving orally EM therapy. The NCA in post-EM therapy BALF was
      significantly reduced (p less than 0.001) compared with that in BALF before EM
      therapy (30.17 +/- 7.84% vs 53.05 +/- 10.65%). On the respiratory function before
      and after EM therapy, DPB patients (20 cases) showed significant improvement of
      %VC, FEV1.0, RV/TLC (p less than 0.001, each) and V25 (p less than 0.05). And on
      the post-EM therapy blood gas, PaO2 and AaDO2 level were confirmed to be
      significantly improved (p less than 0.001). In addition, we examined the
      correlation between the improvement ratio of clinical finding and the reduction
      of NCA in BALF after EM therapy in 10 patients with DPB. We found the significant
      correlation between the improvement ratio of PaO2 and the reduction NCA in BALF
      of those patients (p less than 0.05). There were no significant relationships
      between the improvement ratio in other parameters as stated above and the
      reduction of NCA in BALF. These findings indicate that EM restrains the NCA in
      BALF of patients with DPB and impairs the accumulation of neutrophils in
      respiratory tract, ultimately contributes to the improvement of clinical symptoms
      such as sputum and clinical findings such as PaO2 in patients with DPB.

PMID- 1624837
TI  - [Isolation of verocytotoxin-producing Escherichia coli from cattle and pets].
AB  - During a three-year period (1987 & 1990), a comprehensive attempt was made to
      isolate verocytotoxin-producing Escherichia coli (VTEC) from 96 bovine, 89
      porcine, 67 canine and 18 feline cases suffering from gastroenteritis. VTEC were
      isolated from 11 cows and 1 cat. Bead-ELISA and oligonucteotide probes were used
      to type the verotoxins (VT) and it was found that the VTEC strains from cows
      produced not only the currently recognized VT1, VT2 and VT2vh but also produced
      two new VT's tentatively designated as VTx and VTy. The strain from the cat
      produced VTy. Serotyping of the strains revealed that some animal strains
      belonged to similar serotypes as those isolated from human patients with
      hemorrhagic colitis and hemolytic uremic syndrome. Cattle, especially cows, and
      domestic pets apparently are reservoirs of VTEC and probable sources of infection
      in our country as has been previously documented in Canada and USA.

PMID- 1624838
TI  - [Rapid differentiation method for Shigella and Escherichia coli--application of
      Indole (tryptophanase), PGUA (beta-glucuronidase) and ONPG (beta-galactosidase)
      tests].
AB  - For the differentiation of Shigella from Escherichia coli, Indole
      (tryptophanase), PGUA (beta-glucuronidase) and ONPG (beta-galactosidase) tests
      were used. A total of 377 Shigella and 124 E. coli strains was examined for each
      sero- and biosero-type by using these tests. The results were as follows. 1)
      There were no Shigella strains showing positive reactions for both Indole and
      ONPG tests. 2) No E. coli strains with Shigella-like characteristics (negative
      for lysine-decarboxylase, motility and lactose-fermentation tests) showed
      negative results for both Indole and PGUA tests. 3) The abovementioned strains
      were classified into twelve types according to the results of these tests.
      Shigella strains, thus, were differentiated from antigenically Shigella-like E.
      coli strains. Additional use of these tests together with the conventional
      methods may valuable for the identification of Shigella strains.

PMID- 1624839
TI  - [Molecular epidemiological study on Escherichia coli O114 by DNA analyses].
AB  - Four strains of Escherichia coli O114:non-motile (NM) were isolated from patients
      supposed to have endemic diarrhea in 1989. The plasmid DNA profiles and
      restriction fragment patterns of chromosomal DNA digested with Not I analysed by
      pulsed-field gel electrophoresis (PFGE) of E. coli O114:NM strains were compared
      with those of other 9 strains of E. coli O114 isolated elsewhere (O114:H2, 1
      strain; O114:H4, 2 strains; O114:H9, 2 strains; O114:H10, 1 strain; O114:H11, 1
      strain; O114:H21, 1 strain; O114:H32, 1 strain). All of E. coli O114:NM strains
      showed the same plasmid DNA profile and chromosomal DNA fragment patterns. The
      strains of E. coli O114:NM and O114:H11, and O114:H21 and O114:H32 showed the
      same plasmid DNA profiles, respectively. On the other hand, these strains could
      be differentiated by the chromosomal DNA fingerprint patterns. The chromosomal
      DNA fragment pattern of all E. coli O114:NM strains is completely different from
      those of the other 9 control strains. We suggest that chromosomal DNA
      fingerprinting is useful for the epidemiological study of E. coli O114 associated
      endemic diarrhea.

PMID- 1624840
TI  - Isolation rates and pathogenicity of enterococci in obstetric and gynecological
      operations.
AB  - Isolation of enterococci in patients undergoing obstetric and gynecological
      operations was studied as well as reviewing the postoperative infection due to
      this organism during the period from 1985 to 1990. 1) In 126 cases undergoing
      abdominal total hysterectomy, vaginal specimens were obtained before and after
      (3rd day) the operation. The isolation rates increased after the operation
      (before 16.7%, after 35.7%). They increased not only in the group using PIPC,
      CEZ, CEPR, CMZ, and LMOX by drip infusion but also in the group without
      prophylactic use of antibiotics. On the other hand in the group using CP vaginal
      suppositories, the isolation rate decreased. However no statistical proof was
      obtained as to antibiotics especially in regard to cephem drugs as the reason for
      the increase. 2) Enterococci were isolated from the surgical field during
      abdominal total hysterectomy in only 2.0% (n = 88). 3) Isolation rates of
      enterococci inside the transvaginal drain following radical hysterectomy (n = 30)
      reached 86.7%. 4) E. faecalis was isolated in 20.0% of the cases with wound
      infection (n = 25). However isolated Enterococcus strains were not regarded to be
      the causative organism. 5) There was one case of postoperative enterococcal
      septicemia in treating stage Ib adenocarcinoma of the uterine cervix.

PMID- 1624841
TI  - [Isolation of Chlamydia pneumoniae and antibodies to the agent in patients with
      acute bronchitis].
AB  - Isolation of Chlamydia pneumoniae and serologic tests were performed on 85
      children and adults patients with acute bronchitis admitted to the Kitasato
      Institute Hospital from January 1989 to May 1991. C. pneumoniae was isolated from
      sputa or tonsillar swabs in 11 of 57 (19%) patients examined. Of these, 10
      patients were tested serologically and 9 (90%) had 16 or higher titer of IgG
      antibody. A total of 68 patients were tested serologically, and 17 (25%) revealed
      positive; 14 had a fourfold rise or more in the titer of IgG antibody, or IgM
      titer of 16 or more, and 3 had IgG antibody with a titer of 512 or greater. In 34
      patients, sera were tested for evidence of acute infections not only with C.
      pneumoniae, but also with Mycoplasma pneumoniae, influenza A virus, influenza B
      virus, adenovirus, respiratory syncytial virus, coxackie A9 virus, parainfluenza
      virus type I, II, and III. Two of the 34 patients were associated with influenza
      A virus, 4 with influenza B virus, whereas 6 were associated with C. pneumoniae.
      The data available suggest that C. pneumoniae cause bronchitis much more than has
      been suspected, and also confirm earlier suggestions that the agent played an
      important role in respiratory tract infections. Chlamydia trachomatis was
      recovered from sputa and tonsillar swabs in 6 adults patients with acute
      bronchitis. Studies are needed for a better understanding of the epidemiology and
      clinical relevance of this microorganism to lower respiratory tract diseases in
      adults.

PMID- 1624842
TI  - [The ultrastructural study on the relationship between Chlamydia trachomatis and
      the host cell in adhesion and during and after invasion].
AB  - Chlamydia trachomatis (C. trachomatis) is 0.4-0.5 microns in diameter in the EB
      stage, with the nucleoid located eccentrically within it. We studied the
      relationship between the eccentric nucleoid and the host cell surface under
      electron microscope, when C. trachomatis was in adhesion to the host cell and
      during and after invasion into the host cell. When C. trachomatis adheres to and
      invades a host cell, the eccentric nucleoid is located on the side distant from
      the host cell surface (44 of 66, 66%). The 1 x 3 chi-square test indicates that
      the difference is significant at p less than 0.001. After C. trachomatis invades
      a host cell, the eccentric nucleoid is located on the side close to the host cell
      surface (61 of 138, 44%). The 1 x 3 chi-square test shows the difference to be
      significant at p less than 0.001. However, since the latter (44%) is less than
      the former (66%). C. trachomatis revolves between adhesion and the completion of
      the invasion. The 2 x 3 chi-square test shows a significant difference at p less
      than 0.001.

PMID- 1624843
TI  - [Detection of rubella virus antibody by enzyme linked immunosorbent assay with
      parallel line method].
AB  - An attempt was made to measure the antibody to rubella virus in human sera by
      ELISA by calculating the relative potency by the method of the parallel line
      assay. As a standard serum, adult serum 8 months after rubella infection was
      used. Sample sera were collected from 42 infants before MMR vaccination and 8-10
      weeks after the vaccination and 48 adults three years or more after rubella
      vaccination. In addition, three infant sera with rubella 6-19 days after onset of
      rash and three gamma immunoglobulin products were used. The dose response curve
      of the standard serum and that of the sample serum showed the lineality and the
      regression line of the sample serum was parallel to that of the standard serum.
      And the relative potency of sample sera was successfully calculated. The good
      correlation was observed between the rubella antibody titer by hemagglutination
      inhibition test and that measured by ELISA. The coefficients of variance of
      relative potency obtained from four repeated measurements for two weeks showed
      from 15% to 25% in four sera of HI high titer. The reproducibility of parallel
      line assay was also satisfactory.

PMID- 1624844
TI  - [Shigella flexneri strains having a new type antigen].
AB  - Five Shigella strains isolated from stool cultures of two domestic dysentery
      cases and three imported cases in Tokyo in 1986-1989 had an atypial serotype that
      agglutinated with only antiserum to S. flexneri group 6 factor antigen. These
      strains showed typical biochemical reactions of S. flexneri and were
      biochemically identical. Four of the strains were positive for Sereny test with
      guinea pig eye and the cell-invasion test with HeLa cells. The strains also had
      the virulence-plasmid encoding outer membrane proteins, indicating that these
      were pathogenic. These strains were serologically identical and gave significant
      cross-reactions with S. flexneri 1b and 4b that had group 6 factor antigen.
      However, results of reciprocal absorption tests showed that the O antigen of
      these strains were not identical to S. flexneri 1b and 4b, and were confirmed to
      have a new type antigen which can not be included among the known S. flexneri
      type antigen I-VI. Strain 88-893 is designated as the test strain for this new
      type antigen of S. flexneri.

PMID- 1624845
TI  - [A case of penicillin-resistant pneumococcal pneumonia and penicillin-binding
      proteins of the clinical isolates].
AB  - We experienced a case of a 68-year-old female with beta-lactam antibiotics
      including penicillin G (PCG) resistant pneumococcal pneumonia, leading to death
      during the treatment with ceftizoxime (CZX). We reported the clinical course and
      the mechanism of resistance of isolated bacteria. The present case is the first
      in Japan. Minimum inhibitory concentration (MIC) against Streptococcus pneumoniae
      88031 isolated from the present case was 1.56 micrograms/ml in PCG and 6.25
      micrograms/ml in CZX, showing PCG resistance. The isolate was no beta-lactamase
      production and serotype 23. The drug susceptibility in 34 strains of S.
      pneumoniae which were isolated as causative organism of respiratory infection in
      our department in 1988 was studied. PCG high resistant strain (PCG MIC greater
      than 1.56 micrograms/ml) was only observed in the isolated strain in the present
      case and PCG low sensitive strains (PCG MIC = 0.1-1.0 micrograms/ml) were
      observed in 3 strains (8.8%). The CZX resistance was observed only in the present
      case. The detection of penicillin-binding protein (PBP) and binding affinity of
      beta-lactam antibiotics were studied using PCG sensitive strain, S. pneumoniae
      type I (preserved strain PCG MIC = 0.05 micrograms/ml, CZX MIC = 0.1
      micrograms/ml, CMX MIC = 0.025 micrograms/ml) and PCG resistant strain, S.
      pneumoniae 88031. The result obtained showed that PBP1a, detected in sensitive
      strain type I, was not detected in resistant strain 88031 and PBP1b was
      increased. The binding of 14C-PCG of PCG resistant strain to PBP1b showed lower
      affinity for CZX and CMX than PCG sensitive strain.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1624846
TI  - [Studies on the effect of combination of amphotericin B and flucytosine on
      Candida albicans by flow cytometry].
AB  - The antifungal effects of amphotericin B (AMPH) and flucytosine (5-FC) on three
      strains of Candida albicans were studied by flow cytometry (FCM). When the
      IFM4954 and IFM4949 were treated with AMPH or 5-FC alone, cytograms of cell
      distribution changed at the concentration of 1/2 MIC, respectively. Next, the
      effect of combination of AMPH and 5-FC were examined. Cytogram of cell
      distribution of IFM4954 and IFM4949 changed under the combination of 1/4 MIC of
      AMPH and 1/4 MIC of 5-FC, namely a synergic effect was observed. In conclusion,
      FCM is a useful apparatus for analysis of the effect of antifungal agents.

PMID- 1624847
TI  - [Significance of antimicrobial activities testing of antimicrobial agents in
      human urine].
AB  - In order to clarify the in vivo effect of the new quinolones in the urinary
      tract, we investigated the antimicrobial activities against Escherichia coli in
      the human urine. Human urine was prepared from a normal volunteer. After cations
      were removed by chelating resin, human urine was supplemented with 50, 100, or
      500 micrograms of Mg2+ per ml using MgCl2 or 10, 50, or 150 micrograms of Ca2+
      per ml using CaCl2. The pH of human urine was adjusted to 5.5, 7.0, or 8.0 with
      HCl or NaOH. Four clinical isolates of E. coli and E. coli NIHJ JC-2 were used.
      And antimicrobial activities of the new quinolones (norfloxacin, enoxacin,
      ofloxacin and ciprofloxacin) against these strains were measured using various
      urines as mediums. Antimicrobial activities of the new quinolones were reduced in
      the presence of high concentration of magnesium or low pH of urine. However,
      there was no influence of calcium concentration of urine on antimicrobial
      activities of the new quinolones. From these results, the component of the urine
      should be checked in the treatment of the patients with urinary tract infection.

PMID- 1624849
TI  - [A case of Candida albicans endocarditis with impaired lung function].
AB  - A 53-year-old male was admitted to the hospital because of Candida albicans
      endocarditis. He had had a thoracoplasty due to pulmonary tuberculosis and showed
      severe restructive lung function. In 1987 and '89, trachiostomy was made because
      of respiratory failure. The patient was well until nine months earlier, when he
      consulted a physician because of fever. The investigations failed in finding the
      cause of the fever. He was administered antituberculosis agents and
      antiinflammatory drugs but had a fever every day. Two months before admission, a
      cardiac ultrasonographic study showed evident vegetations with mitral
      regurgitation. From the above course and examinations, a diagnosis of Candida
      albicans endocarditis was made. Infusions of CEZ, TOB, PIPC and miconazole for
      more than one month was ineffective. In November, 1990, he was referred to our
      medical center for the purpose of operation. A blood culture proved Candida
      albicans infection. An intravenous administration of fluconazole 400 mg/day was
      begun. However, there was pulmonary bleeding probably due to heparin used for
      prevention of atrial thrombosis and he developed fever, hypoexemia, ventricular
      tachycardia, and hyponatremia. He underwent mitral-valve replacement with a SJM
      valve. Culture of the vegetated mitral valve again proved Candida albicans. After
      operation, hypoexemia, ventricular tachycardia, hyponatremia were improved
      gradually. However he had an eosinophilia, eruption, and dyspnea. We suspected a
      drug eruption of fluconazole. Lymphocyte stimulating test of fluconazole proved
      positive. After the episode, he had no symptoms and was discharged.

PMID- 1624848
TI  - [Single-dose treatment of tosufloxacin (TFLX) for acute uncomplicated cystitis].
AB  - The effectiveness of a single 300-mg dose of tosufloxacin and of 3-day treatment
      with tosufloxacin (300 mg daily) were compared in a prospective trial in order to
      clarify the cost-effectiveness of tosufloxacin for acute uncomplicated cystitis.
      Fifty female patients (25 patients of each group) with acute uncomplicated
      cystitis received one of these treatment regimens, and the clinical data and
      follow-up culture results were analyzed. The effectiveness rates of single-dose
      treatment and 3-day treatment after 3 days were 100% and 96%, respectively. The
      recurrence rates of single-dose treatment and 3-day treatment after 14 or 28 days
      were 0% (0/13 patients) and 15% (2/13 patients), respectively. There was no
      significant difference in the effectiveness rate and the recurrence rate between
      these two groups, statistically. All isolated strains were eliminated in both
      regimens. From these results, it is suggested that single-dose treatment of
      tosufloxacin is effective enough for acute uncomplicated cystitis.

PMID- 1624850
TI  - Miliary aspergillosis in a patient with acute leukemia.

PMID- 1624851
TI  - Surgical treatment for ulnar nerve entrapment at the elbow.

PMID- 1624852
TI  - Subcutaneous or submuscular anterior transposition of the ulnar nerve?
AB  - Precise clinical and electroneurographic examinations were made of 51 patients
      before and after anterior transposition of the ulnar nerve. The mean follow-up
      period was 9.6 years. In 86%, hand function improved, while in 10% it remained
      unchanged. Subcutaneous transposition was better than submuscular transposition,
      especially with regard to sensation. This method is simple and involves low
      morbidity for patients.

PMID- 1624853
TI  - Simple decompression of the ulnar nerve: an alternative to anterior
      transposition.
AB  - Anterior transposition and/or medial epicondylectomy are often considered
      procedures of choice for ulnar neuropathy at the elbow. Much experience suggests
      simple decompression to be a comparably effective alternative which involves less
      trauma, morbidity, and rehabilitation time. The post-operative clinical and
      electrophysiological results of 52 cases of simple decompression (41 patients)
      are summarized. Excellent or good clinical results were found in 75% of the
      nerves. Mean ulnar motor conduction velocities were significantly improved post
      operatively, although nerve conduction parameters did not consistently correlate
      with clinical outcome. The average return-to-work time was 5.1 weeks. The
      advantages of simple decompression make it the procedure of choice for most cases
      of ulnar neuropathy.

PMID- 1624855
TI  - Specificity of muscle reinnervation following repair of the transected sciatic
      nerve. A comparative study of different repair techniques in the rat.
AB  - Specificity of muscle reinnervation and the recovery of muscle contractility were
      studied after repair of the transected rat sciatic nerve. Six different
      techniques were compared: epineurial suture, perineural suture, whole nerve
      graft, interfascicular grafts, skeletal muscle bridge and tubulization. Muscle
      tetanic force and specificity of reinnervation were evaluated 12 weeks after
      nerve repair. Recovery of tetanic force was superior after repair with epineurial
      sutures. There was no statistical significance between the other methods in
      respect of tetanic force. The specificity of muscle reinnervation was best after
      tubulization, repair with interfascicular grafts and perineurial suture.

PMID- 1624854
TI  - Medial epicondylectomy in cubital tunnel syndrome: an electrodiagnostic study.
AB  - Prospective analysis of 27 medial epicondylectomies in 22 patients with McGowan
      grade I ulnar neuropathy demonstrated an improvement in clinical symptoms. In all
      patients a N.C.V. study, in which compression of the ulnar nerve at the cubital
      tunnel was evident, has been a prerequisite for operation. Conduction velocity
      across the cubital tunnel averaged 48% of normal (26.4 +/- 8.7 metres per second)
      preoperatively and increased to 85% of normal (46.7 +/- 9.7 metres per second)
      postoperatively. A preoperative N.C.V. study allows the achievement of a high
      success rate, especially in the less well clinically defined group of patients
      with grade I neuropathy (subjective complaints without any objective signs of
      muscle atrophy). Medial epicondylectomy is safe and predictable in the treatment
      of cubital tunnel syndrome.

PMID- 1624856
TI  - Perineural pressures under the pneumatic tourniquet in the upper extremity.
AB  - The literature indicates that tourniquet-induced neurological injuries are
      relatively common and frequently occur at a subclinical level. In order to
      evaluate the pressure transmitted to the major peripheral nerves of the arm by an
      externally applied pneumatic tourniquet, a fully implantable biomedical pressure
      transducer was placed adjacent the radial, median and ulnar nerves in six cadaver
      upper extremities of average dimensions. This sensor allowed accurate,
      reproducible measurements of perineural pressures without requiring significant
      disruption of the normal anatomical structures of the test limb for its
      installation. At levels of tourniquet cuff inflation which are commonly used in
      clinical practice, there was little or no decrease in the pressure detected in
      the perineural regions over that applied to the surface of the limb. In addition,
      there was a steep gradient of perineural pressure between locations beneath the
      edge of the cuff and those under its midpoint. This was most marked at the
      highest levels of tourniquet inflation. At presently accepted levels of
      inflation, pneumatic tourniquet cuffs transmit high pressures to the peripheral
      nerves without any significant attenuation by the intervening soft tissues. The
      distribution of these forces is one which may subject the underlying nerves to
      deleterious shear forces, especially at higher levels of inflation.

PMID- 1624857
TI  - Anatomy of the extensor pollicis brevis muscle.
AB  - 52 hands have been dissected to check the anatomy and function of the extensor
      pollicis brevis. Various abnormalities were found: absence of the E.P.B. (two),
      insertion on the distal phalanx (four), absence of bony insertion on the base of
      the first phalanx and insertion on the extensor hood (36). In ten cases (in
      addition to the two with absence of E.P.B.), no function was elicited by pulling
      the tendon which inserted upon the extensor hood.

PMID- 1624858
TI  - Vibration-induced muscle injury. An experimental model and preliminary findings.
AB  - The hind paws of rats were subjected to vibration at a frequency of 80 Hz., an
      acceleration of 32 m./s.2 rms (i.e. ah.w approximately 6.3 m./s.2 rms) for five
      hours daily during five consecutive days. Morphological, histochemical and
      immunohistochemical analyses of the soleus, extensor digitorum longus and the
      plantar muscles in the vibrated limb and the contralateral control limb were
      performed. No changes were seen in the soleus or extensor digitorum longus
      muscles but different degrees of degeneration of the muscle fibres were seen in
      the plantar muscle sections as well as signs of regeneration. No changes were
      observed in the contralateral unexposed limb. It is concluded that it is not only
      nervous tissue but also muscle tissue that can be affected by vibration. The
      changes seem to be confined to muscles close to the vibration exciter.

PMID- 1624859
TI  - Intrinsic mitogenic potential of canine flexor tendons.
AB  - Recent studies have demonstrated an intrinsic neovascular response in
      intrasynovial healing tendons, introducing the possibility of mitogenic and/or
      angiogenic capability of intrasynovial tendon. To explore this hypothesis,
      healing canine flexor tendons were treated with early passive mobilization and
      the repair sites analysed at three, ten and 17 days. Specimens were mechanically
      digested and subjected to a standard BALB/c 3T3 mitogenic assay, which measures
      the capacity of tissue extracts to induce DNA synthesis and cell division in
      fibroblasts. Results revealed that both control and repaired flexor tendons
      possessed mitogenic activity, with the greatest activity observed in control
      specimens. Decreasing activity was noted as the time between repair and analysis
      increased. These data provide increasing evidence for the flexor tendon's active
      role in the healing process, and support the concept that mitogenic or growth
      promoting factors are associated with flexor tendons and may be released
      following injury, during the early stages of healing.

PMID- 1624860
TI  - Variation of holding strength of synthetic absorbable flexor tendon sutures with
      time.
AB  - This study examined the potential use of absorbable polytrimethylene carbonate
      (Maxon) sutures for tendon surgery. Flexor tendons of the third toe of 48
      chickens were transected and sutured, then evaluated both mechanically and
      histologically at 0, five, 15 and 45 days after operation. Mechanical testing
      showed that the suture kept its strength long enough to unite tendon ends.
      However, high tissue reactivity of polytrimethylene carbonate during its
      dissolution caused adhesions.

PMID- 1624861
TI  - Biomechanical analysis of a step-cut technique for flexor tendon repair.
AB  - We compared the strength of a new step-cut technique for flexor tendon repair
      with that of the widely used Kessler-Tajima technique, giving special attention
      to the relative contributions of the core and epitendinous sutures. 36 flexor
      digitorum profundus tendons from human cadavers were used. Corresponding digits
      from the same donor were paired, and the two tendons of each pair were placed in
      the Kessler-Tajima and step-cut groups, respectively. Each group had three
      subcategories of repair: (1) core repair alone; (2) epitendinous repair alone;
      and (3) full repair. In the Kessler-Tajima repair, the core stitch contributed
      more to ultimate tensile strength, while the epitendinous stitch contributed more
      to gap formation resistance. In the step-cut repair, however, the epitendinous
      stitch contributed more to both measures of strength. The full step-cut repair
      was 65% stronger in resisting gap formation and had 84% more ultimate tensile
      strength than the full Kessler-Tajima repair. We attribute the greater strength
      of the step-cut repair to the additional number of epitendinous loops, which lie
      perpendicular to the long axis of the tendon.

PMID- 1624862
TI  - Scapho-lunate dissociation occurring with scaphoid fracture.
AB  - In the most widely accepted model of injuries to the carpus, scaphoid fracture
      and scapho-lunate dissociation are held to be mutually exclusive. Four cases in
      which they occurred together are reported, and the likely mechanism proposed.

PMID- 1624863
TI  - Twenty questions about scaphoid fractures.

PMID- 1624864
TI  - Trans-carpal injuries associated with distal radial fractures in children: a
      series of three cases.
AB  - Isolated trans-carpal injuries in children are rare. This paper presents three
      cases of trans-carpal injury associated with an ipsilateral distal radial
      fracture. Two cases involved simultaneous fractures of the scaphoid and the
      capitate. The third case involved the scaphoid and the triquetrum. The full
      extent of these injuries was not recognized on the initial X-rays. If a child
      presents with a displaced fracture of one carpal bone it may not be an isolated
      injury.

PMID- 1624865
TI  - Normal palmar tilt: is dorsal tilting really normal?

PMID- 1624866
TI  - Features of algodystrophy ten years after Colles' fracture.
AB  - The long-term outcome of algodystrophy is unknown. Ten years after Colles'
      fracture, 26% of 55 cases showed features of the syndrome. The finding of poor
      finger function three months following the fracture correlated significantly with
      the presence of components of algodystrophy after ten years.

PMID- 1624867
TI  - The "S" Quattro in the management of fractures in the hand.
AB  - The "S" Quattro has shown its value in the management of displaced comminuted
      intra-articular phalangeal fracture dislocations. Since then the system has been
      used as a dynamic flexible external fixator in the treatment of five maluniting
      phalangeal fractures, five comminuted condylar and four severe compound
      fractures. These challenging fractures have been dealt with by easy operations,
      taking full advantage of the versatility of the "S" Quattro to achieve good
      results.

PMID- 1624868
TI  - The conservative management of proximal phalangeal fractures of the hand in an
      accident and emergency department.
AB  - 147 proximal phalangeal fractures of the hand were managed by Accident and
      Emergency doctors and hand surgeons. Most were treated conservatively with good
      results. Those treated in A. and E. were usually transverse or basal fractures of
      the shaft. Articular, oblique, comminuted and compound injuries were associated
      with greater morbidity and required specialist care.

PMID- 1624869
TI  - Irreducible distal phalangeal epiphyseal injuries.

PMID- 1624870
TI  - Conservative surgery in the management of rheumatoid disease of the hand and
      wrist.

PMID- 1624871
TI  - Rupture of the flexor carpi radialis tendon associated with scapho-trapezial
      osteoarthritis.
AB  - A case of rupture of the flexor carpi radialis tendon in association with scapho
      trapezial osteoarthritis is reported. The symptoms of pain and swelling contrast
      with the loss of function which characterizes rupture of other tendons in the
      hand and wrist.

PMID- 1624872
TI  - Pisiformectomy in young patients.
AB  - Pisotriquetral arthrosis in young patients is considered rare and the diagnosis
      may be difficult to distinguish from other ulno-carpal problems. 12 patients
      under 40 years of age (15 cases) who underwent pisiformectomy were reviewed at a
      mean of 41 months. Patients with a good history of trauma and a positive response
      to intra-articular local anaesthetic injection did well. Others with an
      indefinite history and bilateral symptoms did not do so well. Trispiral
      tomography is the radiological investigation of choice.

PMID- 1624873
TI  - Chromosomal abnormalities in Dupuytren's contracture and carpal tunnel syndrome.
AB  - The cytogenetics of cell cultures derived from Dupuytren's tissue, adjacent
      palmar fascia and palmar skin from patients undergoing fasciectomy have been
      examined and the results compared to cell cultures established from palmar
      fascia, flexor retinaculum and palmar skin of patients undergoing carpal tunnel
      decompression. Chromosomal abnormalities were detected in cell cultures from
      Dupuytren's tissue in eight of the nine patients studied. Clones of cells
      trisomic for chromosome 8 were found in five of the nine patients. Trisomy 8 was
      also present in two of five flexor retinaculum cultures from carpal tunnel
      syndrome cases. These findings in both Dupuytren's contracture and carpal tunnel
      syndrome suggest the presence of chromosomal instability in the palmar fascia.
      The significance of the chromosomal abnormalities is however unclear, but they
      indicate a possible common pathway in the onset of pathological fibrosis.

PMID- 1624874
TI  - The long-term results of enzymic fasciotomy.
AB  - We reviewed ten hands in nine patients who had enzymatic fasciotomy for
      Dupuytren's contracture, with an average follow-up of 6.5 years. While all
      patients were initially satisfied with the results, the disease recurred quite
      rapidly to pre-operative levels in seven patients over the subsequent two to
      three years.

PMID- 1624875
TI  - Reversal of digital vasospasm by glyceryl trinitrate patch.
AB  - Localized digital ischaemia following tourniquet deflation is an event producing
      considerable concern after surgical procedures on the hand, and is more common
      when severe pre-operative deformity has been radically corrected. We describe
      three such cases of digital ischaemia, occurring immediately after the release of
      severe flexion contractures of the digits. Our cases were treated successfully by
      the application of a proximal cutaneous glyceryl trinitrate patch, which produced
      prompt recovery of the circulation in the affected digits. We suggest that this
      simple technique has an important role as theraputically, and possibly also as a
      diagnostic aid, in the evaluation and management of the post-operative ischaemic
      digit prior to re-exploration being undertaken.

PMID- 1624876
TI  - A comparison of arterial and venous flaps.
AB  - The survival rate and elastic properties of the anterior abdominal skin flap in
      Sprague-Dawley rats were studied in three groups of animals. In group 1 where the
      flaps were supplied by a normal artery, arterial flaps (1A) had better survival
      rate and elastic properties than venous flaps (1B). In group 2, where the flaps
      were supplied by an artery with diminished perfusion pressure, the arterial flaps
      (2A) still had slightly better results than venous flaps (2B). However, in group
      3 where the flaps were supplied by a vein, venous flaps (3B) had better results
      than arterial flaps (3A).

PMID- 1624877
TI  - Congenital palmar nail syndrome.
AB  - Two patients are described who have a congenital ectopic nail on the little
      finger associated with absent flexion in this finger. One patient was treated by
      surgical excision of the nail.

PMID- 1624878
TI  - Isolated flexor pollicis longus palsy in twin sisters treated by brachioradialis
      transfer.
AB  - Isolated paralysis of flexor pollicis longus is an uncommon variation of the
      anterior inter-osseous nerve compression syndrome. Two cases occurring in twin
      sisters were treated by brachioradialis tendon transfer when no recovery was
      evident after six months, with good results. Brachioradialis transfer is
      technically easy to perform, but complete mobilization of the tendon and muscle
      is necessary to achieve the desired excursion of the muscle-tendon unit.

PMID- 1624879
TI  - Correlation between temporal bone pneumatization, location of lateral sinus and
      length of the mastoid process.
AB  - The relationship between temporal bone pneumatization and the location of the
      lateral sinus and length of the mastoid process was investigated in 60 fresh
      frozen adult temporal bones, by plain X-rays, computed tomography and surgical
      dissection including otomicroscopic findings. Temporal bone pneumatization was
      classified as small, moderate and large. After drilling, the shortest distances
      between the middle fossa dura and mastoid tip representing the mastoid length and
      between the sigmoid sinus and posterior border of external auditory canal were
      measured and compared to the degree of pneumatization. The distances in the
      specimens with pathological eardrum and adhesions in the middle ear were compared
      to the ones without gross pathology. The length of mastoid process was
      significantly shorter in specimens with small pneumatization than those with
      large (Mann Whitney P less than 0.001). The specimens with a pathological eardrum
      and middle ear adhesions had a significantly shorter mastoid length than those
      without gross pathology. There was no significant difference between degree of
      pneumatization and the shortest distance between sigmoid sinus and external
      auditory canal (Mann Whitney P greater than 0.05). It is demonstrated that the
      'under-developed' mastoid process can be a consequence of hampered
      pneumatization.

PMID- 1624880
TI  - Recovery of Chlamydia pneumoniae, in six patients with otitis media with
      effusion.
AB  - Six cases of otitis media with effusion associated with Chlamydia pneumoniae, a
      currently recognized respiratory tract pathogen, are presented. The organism was
      isolated from the middle ear fluids and serological evidence confirmed it as the
      infectious agent. The study population is small; however, these reports suggest
      C. pneumoniae as a causative agent of middle ear diseases.

PMID- 1624881
TI  - Endoscopic transcanal myringoplasty.
AB  - The role of the rigid endoscope has been evaluated in the management of 36 cases
      with dry central perforation of the tympanic membrane. The graft take rate was
      91.7 per cent and the air-bone gap was closed to less than 10 dB in 83.3 per
      cent. The use of the rigid endoscope in the management of dry central perforation
      of the drum represented a significant advance in middle ear surgery. It is used,
      in correlation with manometry, to evaluate the tubal function before ear surgery
      and to treat hidden causes of tubal obstruction. It replaces the operating
      microscope in observation and surgery of the tympanic membrane perforation. It
      overcomes anatomical variations that hamper access to the entire tympanic
      membrane during ear surgery. It provides an extremely sharp image with high
      resolution.

PMID- 1624882
TI  - Management of posterior mesotympanic cholesteatoma.
AB  - Contrary to previous practice, the eradication of posterior mesotympanic
      cholesteatoma can frequently be achieved using a transcanal approach and without
      the need for more major surgery. For success, certain specific steps are
      necessary. These are described and the results reported.

PMID- 1624883
TI  - Criteria for hearing preservation in acoustic schwannoma surgery: the concept of
      useful hearing.
AB  - In the quest for hearing preservation in patients with acoustic schwannomas it is
      essential that surgeons do not lose sight of the concept of 'useful' hearing.
      There is an important difference between hearing preservation which pleases the
      surgeon and that which will be appreciated by the patient. Tumour size, pure tone
      audiogram average differences between ears and speech discrimination scores have
      been recorded in a series of 114 patients with unilateral acoustic schwannomas.
      Criteria for useful hearing are presented in terms of pure tone audiogram average
      difference and speech discrimination scores. There were 11 patients (10 per cent)
      with a speech discrimination score of 50 per cent or more, a pure tone audiogram
      average difference of 30 dB or better and a tumour size of no more than 2 cm.
      Only one patient (0.9 per cent) had a speech discrimination score of 50 per cent
      or more, a pure tone audiogram average difference of 20 dB or better and a tumour
      size of no more than 1 cm. It is concluded that hearing preservation techniques
      may be applicable to between 1 and 10 per cent of patients with unilateral
      acoustic schwannomas.

PMID- 1624884
TI  - Use of protein electrophoresis in the diagnosis of cerebrospinal fluid
      rhinorrhoea.
AB  - The diagnosis of CSF rhinorrhoea on clinical grounds alone can be difficult. We
      describe how the use of non-invasive electrophoretic analysis of nasal secretions
      for tau protein (asialotransferrin) helped in the management of cases where the
      existence of a CSF leak was in doubt. Patients were thus saved unnecessary
      invasive investigations or surgery. A modification of the method of analysis,
      which improves diagnostic accuracy, is described.

PMID- 1624885
TI  - Combined internal maxillary and anterior ethmoidal arterial occlusion: the
      treatment of choice in intractable epistaxis.
AB  - Whilst it is generally accepted that the standard management for anterior or
      benign epistaxis is either cautery or anterior nasal packing, that of posterior
      or intractable epistaxis remains controversial. Various modalities of treatment,
      ranging from posterior nasal packing to arterial ligation and embolization, have
      been advocated but none have been unanimously accepted as the treatment of
      choice. The purpose of this paper was to determine the efficacy of internal
      maxillary arterial ligation versus combined internal maxillary arterial ligation
      and anterior ethmoid arterial coagulation in intractable epistaxis. Over a six
      year period, from 1985 to 1990, 454 patients were admitted and treated for
      epistaxis. Forty-seven patients were diagnosed as having intractable epistaxis on
      the basis that the epistaxis failed to settle on anterior nasal packing. They
      were moved to the next step in management, which was combined anterior and
      posterior nasal packing. There were 30 failures, one was found to have
      choriocarcinoma of the maxilla, and was treated with cytotoxics, and the other 29
      were moved to the next step, which was arterial ligation. Fifteen patients had
      internal maxillary arterial ligation, and 14 combined internal maxillary arterial
      ligation and anterior ethmoidal arterial coagulation. Large windows were created
      in both the anterior and posterior walls of the maxillary sinuses and all
      identifiable branches of the internal maxillary artery were dissected out
      carefully and two medium size ligating clips were placed over the main trunk, the
      sphenopalatine and the descending palatine branches. Single clips were placed on
      all other identifiable branches. Coagulation of the anterior ethmoidal artery was
      performed with a bipolar cautery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624886
TI  - Influence of the mode of preparation on the long-term efficacy of homologous
      costal cartilage implants.
AB  - Devitalized homologous costal cartilage is widely employed as an implant in the
      management of the saddle nose. The tissue response induced by the implant is a
      combination of enveloping fibrosis and implant resorption, which will probably,
      ultimately, be complete. We have studied the balance between resorption and
      fibrosis, following different modes of cartilage preparation, in the mouse.
      Homologous costal cartilage was devitalized by four common methods--irradiation,
      formalin, glutaraldehyde and alcohol. Segments of this cartilage were inserted at
      separate sites in the subcutaneous plain of the tail. These implants were
      harvested after one year for histology. Variations in the mode of cartilage
      devitalization, while inducing variations in the degree of the tissue response,
      did not influence the balance between fibrosis and resorption. Thus the long term
      maintenance of tissue bulk following homologous cartilage implantation is not
      influenced by the mode of preparation. Evidence suggests that the ultimate
      cosmetic results of autologous and homologous costal cartilage implantation would
      be much the same, and the use of homologous cartilage must be justified on other
      grounds.

PMID- 1624887
TI  - Leprosy of the larynx.
AB  - The result of a study conducted on 30 patients of lepromatous leprosy regarding
      laryngeal involvement is presented. The incidence of leprous laryngitis is 36.6
      per cent in this part of India in lepromatous leprosy patients. Leprosy is long
      standing disease so laryngeal lesions developed gradually and may be asymptomatic
      in some cases while others have been found to have variety of clinical
      manifestation in form of congestion, infiltration, nodulation, thickening and
      fibrosis. Anti-leprosy chemotherapy is equally effective on these lesions. A
      screening survey of laryngeal pathology in such cases should be done
      periodically.

PMID- 1624888
TI  - Characteristics of Groningen tracheo-oesophageal speaking valves prior to
      insertion and after removal for failure.
AB  - The Groningen valve was first used in Sheffield in 1986 in a patient who
      underwent laryngectomy for malignant disease. Since then it has been the main
      tracheo-oesophageal prosthesis used on our Unit for speech rehabilitation post
      laryngectomy. This biflanged device inserted primarily or as a secondary
      procedure remains in situ until failure occurs either because of leakage or
      because increased effort is required to produce satisfactory phonation. This in
      vitro study we examined the differences between new valves prior to insertion and
      those removed for failure. The mean forward opening pressures were shown to be
      similar in the two populations but the mean forward resistances were increased in
      those valves which were defective (P less than 0.001). In addition the mean
      reverse opening pressure was found to be significantly lower in the defective
      valves when compared with their new counterparts (P less than 0.05).

PMID- 1624889
TI  - Milk nasendoscopy in the assessment of dysphagia.
AB  - The bedside assessment of dysphagia may be difficult, due to the inability to
      witness the act of swallowing directly. The milk test described in this paper
      gives a good assessment of swallowing, is cheap and easily portable and allows an
      instant decision to be made without recourse to special investigations.

PMID- 1624890
TI  - Endoscopic endonasal surgery of posterior choanal atresia.
AB  - The use of the rigid endoscope in the management of posterior choanal atresia
      represents a significant advancement in choanal surgery. It provides an extremely
      sharp image with a magnified overview. It enables the surgeon to see the tips of
      his instruments, so that the bone is removed safely under direct endoscopic
      vision. It allows assessment of the size of the opening, in comparison to the
      normal choana. It ensures greater precision in flap preservation. The technique
      is short in time and safe, with early recovery and short hospitalization.

PMID- 1624891
TI  - Audiological, vestibular and radiological abnormalities in Kallman's syndrome.
AB  - Kallman's syndrome is a multifaceted congenital disorder with predominantly
      endocrine abnormalities. We have characterized the associated mixed hearing loss
      and identified consistent radiological evidence of abnormal temporal bone
      anatomy. Abnormal labyrinthine morphology is accompanied by a complete absence of
      response to vestibular stimulation with caloric or rotational chair testing. The
      endocrine abnormalities are correctable and Kallman's syndrome is a diagnosis
      worthy of consideration when assessing children with congenital hearing loss.

PMID- 1624893
TI  - Augmentation rhinoplasty in nasal sarcoidosis.
AB  - We present a case of nasal deformity due to sarcoidosis. The surgical management
      is discussed. The risk of secondary involvement of implanted autologous cartilage
      by the disease is emphasized. For this reason an inert allograft (silastic) is
      recommended for augmentation in this group of patients.

PMID- 1624892
TI  - Bilateral acute mastoiditis complicated by lateral sinus thrombosis.
AB  - A case of bilateral mastoiditis with subperiosteal abscesses complicating acute
      otitis media in a two and a half year old girl is presented. Contrast enhanced
      computerized tomography confirmed the diagnosis of right lateral sinus
      thrombosis. The aetiology, diagnosis and management of these conditions are
      discussed.

PMID- 1624894
TI  - Radiation-induced antrochoanal fibrosarcoma.
AB  - Therapeutic radiation for malignant conditions is known to cause sarcomatous
      change in an irradiated field after a latent period; equally this change may
      occur following radiotherapy to benign conditions which may result in a more
      difficult management problem later. Radiotherapy to benign conditions should be
      reserved for use after failure of conventional surgery or other interventional
      techniques.

PMID- 1624895
TI  - Chordoma of the parapharyngeal space.
AB  - An unusual case of a chordoma of the parapharyngeal space is presented with no
      direct involvement of the axial skeleton. Diagnosis was confirmed with the aid of
      immunocytochemical tests.

PMID- 1624896
TI  - Clear cell neoplasm.
AB  - We are reporting four cases of clear cell neoplasm. Local infiltration and
      destruction was observed in one case while in a second case, originating in the
      sublingual gland, metastasis to the lymph nodes occurred. The behaviour of these
      neoplasms has prompted the suggestion that these tumours be designated carcinomas
      rather that noncommittally tumours or neoplasms (Batsakis and Regezzi, 1977). The
      histopathological characteristics of our four cases conform to those that have
      been articulated and believed to be the distinctive features of these tumours
      (Batsakis and Regezzi, 1977). It is hoped that ours and similar reports will be
      helpful towards clearing the diagnostic and taxonomic confusion regarding these
      tumours.

PMID- 1624897
TI  - Oesophageal foreign body: an unusual cause of respiratory symptoms in a three
      week-old baby.
AB  - Impaction of a foreign body in the oesophagus is common in children. If the event
      is not witnessed by an adult or the object is radiolucent the diagnosis is
      difficult as respiratory symptoms may predominate. We report a three-week-old
      child with respiratory symptoms who had both a respiratory syncytial virus
      infection and a radio-lucent oesophageal foreign body. This case is the youngest
      yet reported and serves as a remainder of the difficulties in the diagnosis of
      this important condition.

PMID- 1624898
TI  - Non-occupational recurrent bilateral pneumoparotitis in an adolescent.
AB  - This is a case report of recurrent bilateral parotid swelling with intraglandular
      gaseous bubbles in a 14-year-old boy, together with a review of the literature on
      this condition, which is usually called pneumoparotitis. The disorder has been
      reported as an occupational hazard in wind instrument players and glass-blowers
      and also as a rare non-occupational disease, mainly in adolescents and often
      associated with psychological problems.

PMID- 1624899
TI  - Ballooned trachea as a consequence of intubation.
AB  - A case of iatrogenic tracheal dilatation is presented. This potentially fatal
      complication of endotracheal intubation may escape early detection. It is well
      demonstrated by CT scanning.

PMID- 1624900
TI  - Granulomatous cutaneous T-cell lymphoma of the neck.
AB  - A case of cutaneous T-cell lymphoma is presented in which the diagnosis was
      obscured by a concomitant granulomatous infiltrate. A working diagnosis of
      tuberculosis delayed appropriate treatment for several months over which time
      rapid progression of the disease was seen. Inclusion of overlying skin in the
      repeat biopsies yielded the histological information to establish the correct
      diagnosis and there was rapid regression on completion of a course of
      radiotherapy.

PMID- 1624901
TI  - Cystic lymphangioma in the adult parotid.
AB  - Cystic lymphangioma is a congenital lesion which rarely presents in adult life
      and even less commonly arises within salivary tissue. We report the sudden
      appearance of a large cystic lymphangioma within the parotid gland of a young man
      and discuss the management of this rare condition.

PMID- 1624902
TI  - Necrotizing sialometaplasia.
AB  - Necrotizing sialometaplasia is a benign self-limiting disorder which can simulate
      malignancy. We report the third such case of nasal fossa involvement in the
      literature. The pathology of this condition is discussed.

PMID- 1624903
TI  - Malignant melanoma of the middle ear.

PMID- 1624904
TI  - The impact of research on the Tufts College Dental School: from Dean Marjerison
      to Dean Marshall-Day (1933-1958).

PMID- 1624905
TI  - Differential diagnosis and treatment planning for edentulous implant candidates.

PMID- 1624906
TI  - Porcelain fracture: causes, prevention, and repair techniques.

PMID- 1624907
TI  - A clinico-pathologic presentation. Cherubism.

PMID- 1624908
TI  - A clinico-pathologic presentation. Ameloblastic fibrous odontoma.

PMID- 1624909
TI  - Evaluation of the CO2 laser for endodontic root apex welding.
AB  - A low-wattage carbon dioxide laser was tested as a means of welding (sealing) the
      apices of unfilled, endodontically prepared teeth. Thirty-five teeth were filed
      and lased using a variety of power settings. Apical seals were examined
      microscopically, radiographically, and mechanically for complete welds.
      Accurately directed laser exposures of 15 or more watts with a 0.5 second
      duration will completely seal the apical openings of anterior teeth. The ideal
      treatment for endodontically compromised teeth has always been a completely
      sealed tooth apex. Usually amalgam, gutta-percha, or resin sealers are used after
      a lengthy and tedious preparation of the exposed root area. The carbon dioxide
      laser is designed for soft tissue dental surgery but is capable of melting enamel
      and dentin which recrystallizes in a dense solid as it cools (fig. 1). The laser,
      with its potential for accurately delivering a great quantity of energy to a
      small, exposed surface, appears to be an excellent tool for quick, direct sealing
      of open apices. This paper will investigate the practicality and best methods of
      spot welding root apices.

PMID- 1624910
TI  - Wrongful birth and birth injury claims: new risks for oral surgeons.

PMID- 1624911
TI  - Synthesis and secretion of low molecular weight cuticular proteins during heat
      shock in the tobacco hornworm, Manduca sexta.
AB  - In the tobacco hornworm, Manduca sexta, heat shock normally elicits synthesis of
      the classic heat-shock proteins. A 1-hr heat shock of 42 degrees C and above can
      also increase the relative synthesis of certain 12-18 kD proteins in the
      epidermis. These 12-18 kD proteins were identified as cuticular proteins for
      several reasons. Like cuticular proteins, they appear only in the epidermis. They
      can be precipitated from epidermal homogenates with an antiserum to larval
      cuticle. The same conditions that increased labeled 12-18 kD proteins in the
      epidermis also increased labeled 12-18 kD proteins in the cuticle. Some of the
      epidermal increase may result from a partial inhibition of secretion to the
      cuticle during 46 degrees C heat shock, causing abnormal accumulation in the
      epidermis. However, slight increases also occur at lower temperatures, which do
      not inhibit secretion detectably. Preliminary results also indicate that total
      quantities of at least one cuticular protein mRNA may increase during heat shock,
      either because of increased transcription or increased mRNA stability.

PMID- 1624912
TI  - Effects of short-term 17 beta-estradiol treatment on the properties of T4-binding
      proteins in the plasma of immature rainbow trout, Oncorhynchus mykiss.
AB  - To determine the effects of 17 beta-estradiol (E2) on the properties of the
      plasma proteins that bind L-thyroxine (T4) immature rainbow trout, Oncorhynchus
      mykiss, were injected intraperitoneally on days 0 and 3 with 0.5 mg E2-3
      benzoate/100 g body weight, and plasma was sampled on days 4, 7, or 12. Control
      trout received peanut oil alone. E2 caused a small but significant decrease in
      the free T4 index. Saturation analysis on miniature G-25 Sephadex columns
      revealed at least two major T4-binding sites. Filtration on agarose Bio-gel A 1.5
      also indicated two major T4-binding protein fractions with molecular weights of
      150 and 55 kDa with a small proportion of T4 binding to a 1,500-kDa site presumed
      to be lipoprotein. Addition of unlabeled T4 displaced [125I]T4 from the 55-kDa
      site and unmasked an adjacent site of higher molecular weight. E2 increased the
      proportion of T4 bound to the low-affinity (150 kDa) site relative to that bound
      to the high-affinity (55 kDa) site, increased the level of protein associated
      with the 1,500-kDa site and its T4 binding, and also initiated the production of
      presumed vitellogenin (VTG), which bound a small amount of T4. It is concluded
      that the E2-induced depression in FT4 is caused by a shift in T4 binding between
      high-affinity and low-affinity sites, and also by binding of small amounts of T4
      to presumed lipoprotein and VTG.

PMID- 1624913
TI  - Changes in growth hormone and prolactin messenger ribonucleic acid levels during
      seawater adaptation of amago salmon (Oncorhynchus rhodurus).
AB  - To examine the changes in secretion of growth hormone (GH) and prolactin (PRL)
      with reference to their osmoregulatory roles, changes in pituitary mRNA levels
      and plasma concentrations of these hormones were examined during seawater
      adaptation in silvery juveniles (smolts) and precociously mature males (dark
      parr) of amago salmon (Oncorhynchus rhodurus). Transfer to seawater increased
      plasma sodium levels in both smolts and dark parr. Smolts adjusted their plasma
      sodium to the level associated with seawater-adaptation (165 mEq/liter) within 3
      days, whereas no adjustment was seen in dark parr; the latter failed to survive
      in seawater for more than 3 days. In smolts, plasma GH levels increased
      significantly 1 day after transfer, whereas there was no significant change in
      dark parr. An increase in GH mRNA levels was observed in smolts in association
      with increased plasma GH, whereas there was no change in dark parr. In contrast,
      a reduction in plasma PRL levels was consistently observed in both smolts and
      dark parr after transfer to seawater. However, there was no significant change in
      PRL mRNA levels in either smolts or dark parr. These results suggest that both
      gene expression and release of GH are activated by seawater transfer only in
      smolts with adequate seawater adaptability, whereas PRL gene expression is
      decreased after seawater transfer regardless of seawater adaptability.

PMID- 1624914
TI  - In vitro synthesis of oviductal secretory proteins by estrogen-treated
      ovariectomized gilts.
AB  - The objective of this study was to identify, characterize, and examine oviductal
      secretory proteins (OSP) synthesized de novo by whole oviduct (WO), ampulla (A),
      and isthmic (I) tissue from ovariectomized (OVX), corn oil (CO)-, estrogen (E)-,
      progesterone (P)-, and E + P-treated gilts. Oviducts were collected from OVX
      gilts after CO, E, P, or E + P treatment for 11 consecutive days and tissue was
      incubated with 3H-leucine (3H-leu). Rates of 3H-leu incorporation into
      nondialyzable macromolecules by WO explants were greater (P less than 0.01) with
      E- compared to CO-, P-, or E + P-treated gilts and greater (P less than 0.05) by
      A explants with E- compared to CO-, P-, or E + P-treated gilts. An effect of
      location was noted, with A having a greater (P less than 0.01) rate of
      incorporation than WO or I. Conditioned culture medium was analyzed by one (1D)-
      and two-dimensional (2D) sodium dodecyl sulfate (SDS) polyacrylamide gel
      electrophoresis (PAGE) and fluorography. Analyses by 1D-SDS-PAGE revealed three
      major E-dependent bands (335,000, 100,000, and 80,000 M(r)) in WO and A, and one
      (335,000 M(r)) in the I. A 20,000 M(r) band found in A was inhibited by E, while
      a 60,000 M(r) band found in the A was induced by P. Analyses by 2D-SDS-PAGE
      resolved major E-dependent bands 2 (100,000 M(r)) and 3 (80,000 M(r)) into basic
      and acidic 100,000 M(r) proteins and a 75,000-85,000 M(r) protein (pI less than
      4), respectively, found in WO and A, but not in I. A basic 20,000 M(r) protein
      and an acidic 45,000 M(r) complex, both found in A, were inhibited by E. Gel
      filtration of culture medium revealed a high M(r) fraction (greater than 2 x
      10(6)) that was induced by E and was 6.8-fold greater in medium from A than from
      I. This study clearly demonstrates that 1) WO and A tissue from E-treated gilts
      de novo synthesize and secrete three major proteins (basic 100,000, acidic
      100,000, and 75,000-85,000 M(r)); 2) these E-dependent proteins are not found in
      I or with other treatment; 3) several protein complexes synthesized by A are
      inhibited by E treatment; and 4) a high M(r) fraction, produced primarily in the
      A, is induced or amplified by E.

PMID- 1624916
TI  - Regenerative responses in cultured hindlimb stumps of larval Xenopus laevis.
AB  - The regenerative capacity of larval Xenopus laevis hindlimbs amputated through
      the tarsalia at different stages of development and explanted in vitro was
      tested. In the first experimental series hindlimb stumps from stage 53, 54, 55,
      and 57 larvae (according to Nieuwkoop and Faber, '56) were cultured in
      Leibovitz's L-15 medium supplemented with 10% FCS, and 0.04 U of insulin and 10(
      8) mg of L-thyroxine per ml of medium. Results showed that the distal part of the
      limb stumps from stages 53, 54, and 55 formed a regeneration blastema composed of
      proliferating mesenchymal cells beneath a typical apical cap. No blastema was
      formed in the proximal part of the stump. In limb stumps from stage 57, a
      regeneration blastema did not form either in the proximal or in the distal part
      of the stump. In a second experimental series, hindlimb stumps from stage 55
      larvae, denervated 5 days prior to amputation in order to eliminate any residual
      neurotrophic factor, were cultured in a simplified L-15 medium containing 2% FCS
      and lacking insulin and thyroxine. Results showed that also in these experimental
      conditions the stumps from stage 55 formed a conical regeneration blastema at the
      distal tip. The blastema cells duplicated their own DNA and divided. At the
      proximal extremity no regeneration blastema was formed. In the same culture
      medium, the stumps of larvae at stage 57 did not form a regeneration
      blastema.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624915
TI  - An aerodynamic valve in the avian primary bronchus.
AB  - The segmentum accelerans in geese is a constriction in the caudal end of the
      primary bronchus. Experimental evidence suggests that this part of the airway
      functions as an inspiratory aerodynamic valve, accelerating the incoming
      airstream past the ventrobronchial openings. The luminal diameter of the
      segmentum accelerans dilates in the presence of elevated CO2 levels, probably
      through relaxation of smooth muscle. Physiological control of the segmentum
      accelerans may permit inspiratory aerodynamic valving to be maintained throughout
      a wide range of ventilatory flows.

PMID- 1624917
TI  - Steroid hormone-induced male sex determination in an amniotic vertebrate.
AB  - In many reptiles, sex is determined by the temperature at which the eggs are
      incubated (i.e., temperature-dependent sex determination, or TSD). Past studies
      have shown that exogenous steroid hormones can override the effects of
      temperature and induce female sex determination. However, past attempts to induce
      male sex determination have consistently failed. In the present study, sex
      determination was studied in a turtle with TSD. By utilizing an incubation
      temperature regimen that resulted in approximately a 1:1 sex ratio in the control
      group, sex determination was shown to be sensitive to both exogenous androgen and
      estrogen treatments: androgen induced the production of male hatchlings, whereas
      estrogen induced the production of female hatchlings. This is the first report of
      an amniotic vertebrate in which an exogenous steroid hormone induces male sex
      determination.

PMID- 1624918
TI  - Immunoglobulin-containing cells in chick embryo urogenital tissues: a new site
      for early B lineage cells in endothermic vertebrates.
AB  - We have employed histological and immunofluorescent staining procedures in order
      to characterize the distribution of mu + B lineage cells in tissue sections
      prepared from developing chicken embryo urogenital tissues (UGTs) between 14 and
      21 days of incubation. B lineage cells were observed in tissue sections prepared
      from developing UGTs, especially the mesonephros and its associated tissue,
      throughout the sample period. The highest densities of mu + B lineage cells were
      observed in tissue sections prepared from 18 day embryos. The mu + UGT cells were
      distributed singly and in clusters in subcapsular regions and within the
      peritubular interstitium of the mesonephros. These observations (1) are
      consistent with those which suggest nonbursal site(s) for origin of cells in B
      lineage, (2) may help account for the varying effects of embryonic caudectomy
      performed between the second and third days of incubation and surgical bursectomy
      performed close to hatching, (3) may help provide new insights on the effects of
      sex hormones on B cell development, and (4) suggest fundamental ontogenetic and
      phylogenetic similarities between developing vertebrate immune systems.

PMID- 1624919
TI  - The role of the adrenal glands in regulating onset of winter fur growth in mink
      (Mustela vison).
AB  - The role of the adrenal glands in regulating onset of winter fur growth in mink
      was investigated in long-term adrenalectomized animals. Bilateral adrenalectomy
      of adult female standard dark mink between June 23 and July 11, 1990, initiated
      onset of winter fur growth approximately 6 weeks earlier than controls. One month
      following completion of the winter fur growth in adrenalectomized mink, molting
      and growth of a new coat was observed. The type of pelage that grew as a result
      of the second growth wave was less dense than the normal summer or winter fur.
      However, this renewed hair growth suggests that adrenal hormones not only inhibit
      the onset of winter fur growth but also influence the duration of inactivity
      following each period of hair growth. Administration of deoxycorticosterone as a
      mineralocorticoid supplement had no effect on initiation of fur growth. It would
      appear that adrenal hormones are part of the mechanism through which photoperiod
      regulates fur growth in the mink. The identity of the adrenal hormones and their
      site of action is unknown.

PMID- 1624920
TI  - Clinical correlates of cerebral ventricular enlargement in schizophrenia. Further
      evidence for frontal lobe disease.
AB  - Numerous studies have shown evidence of cerebral ventricular enlargement in
      schizophrenia and its relationship to severity of clinical symptoms and
      psychosocial dysfunction. In this large prospective study, 88
      noninstitutionalized DSM-III-R schizophrenic patients were administered a CT scan
      and rated for positive and negative symptomatology and premorbid adjustment. The
      CT scans from 14 healthy controls were used for comparison of cerebral
      ventricular measures. Patients had an enlarged ventricle to brain ratio of the
      anterior portion of the lateral ventricles, the frontal horns, compared with
      controls. Patients with larger frontal horns had more severe negative symptoms
      and poorer premorbid childhood adjustment. The area of the main body of the
      cerebral lateral ventricles, though not elevated in patients, was correlated with
      the total number of prior hospitalizations. These results support the hypothesis
      of a structural and functional "frontal" deficit in schizophrenia.

PMID- 1624921
TI  - Cerebral blood flow abnormalities in adults with infantile autism.
AB  - Structural brain abnormalities have recently been discovered using magnetic
      resonance imaging in infantile autism, a neurodevelopmental disorder of unknown
      etiology. However, functional neuroimaging studies in autism using positron
      emission tomography have had conflicting results and have not explained how the
      known structural brain abnormalities in autism act in a functioning brain to
      produce autistic behavior. Using a new technology, high-resolution brain single
      photon emission tomography, we studied and scanned four young adults with
      infantile autism and four age-matched controls using the labeled ligand 99mTc-D,L
      hexamethyl-propylene amine oxime (99mTc-HMPAO). Total brain perfusion was
      significantly decreased in autism subjects (range, 58% to 72% of controls, p less
      than or equal to .02). In addition to the globally decreased perfusion, the
      autism group also had regionally decreased flow in the right lateral temporal and
      right, left, and midfrontal lobes compared with controls (p less than or equal to
      .02, Mann-Whitney t-test).

PMID- 1624922
TI  - Neuropsychological and clinical correlates of murder and other forms of extreme
      violence in a forensic psychiatric population.
AB  - The neuropsychological and clinical correlates of extreme violence were examined
      retrospectively in young and older inpatients of a forensic psychiatric hospital.
      The young group exhibited significantly higher rates of both a learning
      disability and a history of childhood conduct disorder, whereas the older group
      had a significantly higher rate of psychosis. The older individuals charged with
      murder were also more likely to have acted alone and to have had an intimate
      relationship with the victim. These results suggest that age, specific clinical
      and neuropsychological variables, and the characteristics of the violent act may
      represent important variables for risk models of violence.

PMID- 1624923
TI  - Vulnerability-stress factors in development of posttraumatic stress disorder.
AB  - Log-linear chi 2 analyses were conducted to examine potential interactions
      between the presence of precrime axis I psychiatric diagnoses and differential
      levels of crime stress in association with posttraumatic stress disorder (PTSD)
      in a community sample of 295 female crime victims. High crime stress was defined
      as crime that included either perceived life threat, actual injury, or completed
      rape. Crime stress level was significantly associated with PTSD after the crime.
      Thirty-five percent of subjects with high crime stress exposure met criteria for
      PTSD, as opposed to 13% of those with low crime stress exposure. Precrime
      diagnosis was not associated with high crime stress exposure, indicating that
      this is not a vulnerability factor for exposure to crime characteristics
      associated with increased rates of PTSD. There were no significant independent
      associations between precrime axis I diagnoses and PTSD after the crime. However,
      a significant interaction was observed among crime stress level, precrime
      depression, and PTSD such that the rate of PTSD was substantially higher in
      association with precrime depression only in the high crime stress exposure
      group. Major findings are consistent with previous results implicating trauma
      exposure as the primary factor in development of PTSD. However, the results
      indicate that precrime depression may constitute a vulnerability factor for
      development of PTSD under conditions of high crime stress exposure.

PMID- 1624924
TI  - Negative parenting behavior, combat exposure, and PTSD symptom severity. Test of
      a person-event interaction model.
AB  - The "personal characteristics" and "extreme event" hypotheses have been proposed
      as alternative explanations for the development of posttraumatic stress disorder
      (PTSD) among combat veterans. The person-event interaction model attempts to
      integrate both perspectives by hypothesizing that premilitary individual
      vulnerability characteristics play a greater role in influencing risk of PTSD or
      PTSD symptom severity at lower than at higher levels of exposure to traumatic
      combat stressors. Focusing on a sample of 57 Vietnam veterans undergoing
      inpatient treatment for diagnosed PTSD, we assessed this model by examining
      interactions between negative parenting behaviors in childhood (e.g.,
      inconsistent love) and degree of combat exposure in predicting PTSD symptom
      severity. Hierarchical regression analyses supported the model, indicating that
      the father's negative parenting behaviors were more predictive of PTSD symptom
      severity at relatively lower levels of combat exposure. Implications of the
      findings for further research on multivariate, interactional models of PTSD
      etiology among Vietnam combat veterans are discussed.

PMID- 1624925
TI  - Avoidance and intrusion in posttraumatic stress disorder.
AB  - Longitudinal data from 290 firefighters who had completed questionnaires 4, 11,
      and 29 months after exposure to a natural disaster were used to examine the role
      of intrusive and distressing memories in the etiology of posttraumatic stress
      disorder. At 42 months, all those who were at risk of having developed a
      psychiatric disorder (N = 113) and a randomly selected comparison group (N = 34)
      who had never developed symptoms were interviewed using the Diagnostic Interview
      Schedule. The intrusion subscale score of the Impact of Events Scale accounted
      solely for the etiological link between the disaster and posttraumatic disorders.
      Avoidance had no direct relationship with the onset of symptoms and appeared to
      be a defensive strategy to contain the distress generated by the re-experiencing
      of the disaster, indicating the importance of separating these phenomena from
      disorder mood and arousal in posttraumatic stress disorder. An information
      processing model was validated using three different data sets, which suggests
      its robustness. Using cross-lagged panel correlations, a bidirectional
      relationship was demonstrated between disorder and intrusive recollections,
      suggesting that the intensity of recurring memories of a traumatic experience is
      as indicative of a disturbance of mood and arousal as the exposure to the trauma.

PMID- 1624926
TI  - Testing the validity of the neurotic depression concept.
AB  - We applied an operational definition of neurotic depression to 185 hospitalized
      patients who met Feighner and DSM-III-R criteria for unipolar depression. Based
      on a systematic chart review, 37 patients met the criteria for neurotic
      depression. As a group, these patients differed from nonneurotics in symptoms,
      clinical course, outcome, and family history. The neurotic depressives were
      younger and more likely to identify precipitating factors. They were less likely
      to meet criteria for melancholia and to have delusions. They were more likely to
      be ill 3 years later and more likely to have familial alcoholism. These
      differences help to confirm the validity of the neurotic depression concept.

PMID- 1624927
TI  - The effects of carbamazepine on stuttering.
AB  - No pharmacological treatment protocol has proven generally useful for all
      patients who stutter. Various medications, behavior therapy, relaxation,
      suggestion, and social-based therapies have been used. For this drug treatment
      study, two groups of adult stutterers were followed in an 8-week open label
      protocol. All subjects had in the past received speech therapy; none had been
      treated previously with medication for stuttering. The first group (N = 12)
      received a maximum dose of 800 mg of carbamazepine; the second group (N = 8)
      received a maximum dose of 400 mg of carbamazepine. Each patient served as his or
      her own control. A series of systematic speech tests was given weekly to
      determine the variability of fluency for each subject. A statistically
      significant change occurred for a number of "expectancy to stutter"
      characteristics. Subjects felt that they stuttered less often while taking
      carbamazepine. Subjective effects began before medication and continued after
      patients discontinued the medication. Struggle characteristics also subjectively
      decreased. However, no objective improvement was found. No change was found in
      percentage of words stuttered, reading improvement, or improvement in spontaneous
      speech rate. Interrater reliability showed a correlation of .996. Three
      carbamazepine serum level therapeutic windows were inspected with negative
      results. Interestingly, naive listener ratings did show a statistically
      significant improvement on carbamazepine versus placebo. Future anecdotal reports
      of pharmacological improvement of stuttering should be subjected to rigorous
      objective testing before general acceptance.

PMID- 1624928
TI  - The PEH. A questionnaire to assess acknowledgment of psychiatric illness.
AB  - The aim of this research project was to develop an instrument to measure
      acknowledgment and denial of illness in hospitalized psychiatric patients. The
      investigators developed a 23-item, 4-point self report scale, the Patient's
      Experience of Hospitalization (PEH), and collected validity data from a sample of
      inpatients. A total of 29 subjects completed the PEH, the Marlowe-Crowne Social
      Desirability Inventory (MCSD), the MMPI, and a Global Assessment Scale (GAS)
      report. The patients' psychotherapists also provided GAS scores. Kuder Richardson
      split-half reliability and point biserial correlations of 18 items were adequate.
      The PEH total score correlated significantly and positively with the difference
      between the GAS scores assigned to the patient by the patient and by the
      therapist, with the patient's self-report GAS score, with MCSD scores and with
      the MMPI L and K scales, considered to assess crude and subtle defensive denial.
      Correlations with MMPI clinical scales (symptom reports) were negative, further
      supporting the idea of the PEH as a measure of denial.

PMID- 1624929
TI  - Psychopathology among Jewish Ethiopian immigrants to Israel.

PMID- 1624930
TI  - Symptoms in nonpatient southeast Asian refugees.

PMID- 1624931
TI  - A positive correlation between permissiveness of mesoderm to neural crest
      migration and early DRG growth.
AB  - The microenvironment created by grafting rostral somitic halves in place of
      normal somites leads to the formation of nonsegmented peripheral ganglia
      (Kalcheim and Teillet, 1989; Goldstein and Kalcheim, 1991) and is mitogenic for
      neural crest (NC) cells that become dorsal root ganglia (DRG) (Goldstein et al.,
      1990). We have now extended these studies by using three surgical manipulations
      to determine how additional mesodermal tissues affected DRG growth in chick
      embryos. The following experimental manipulations were performed: (1) unilateral
      deletion of epithelial somites, similar deletions followed by replacing the
      somites with (2) a three-dimensional collagen matrix, or (3) fragments of quail
      lateral plate mesoderm. When somites were absent or replaced by collagen matrix,
      ganglia were unsegmented, and their volumes were decreased by 21% and 12%,
      respectively, compared to contralateral intact DRG. In contrast, when lateral
      plate mesoderm was transplanted in place of somitic mesoderm, NC cells migrated
      into the grafted mesoderm and formed unsegmented DRG whose volumes were increased
      by 62.6% compared to the contralateral ganglia. These results suggest that
      although DRG precursors do not require sclerotome to begin migration and
      condensation processes, DRG size is modulated by the properties of the mesoderm.
      Permissiveness to migration is positively correlated with an increase in DRG
      volume. This volume increase observed in grafts of lateral plate mesoderm is
      likely to result from enhanced proliferation of neural crest progenitors,
      previously demonstrated for DRG cells in rostral somitic grafts.

PMID- 1624932
TI  - Expression of a novel nuclear protein is correlated with neuronal differentiation
      in vivo.
AB  - We report the production of a monoclonal antibody (MAb 526) that recognizes a
      novel, developmentally regulated nuclear protein expressed in neurons throughout
      the rat nervous system. Analysis of whole brain and cell nuclear extracts by SDS
      PAGE and immunoblotting determined that MAb 526 recognizes a single nuclear
      protein (np) of apparent molecular weight 42 kD, designated np526, as well as a
      slightly larger (ca. 44 kD) cytoplasmic protein. Light microscopic
      immunocytochemistry showed np526 to be present in neurons of all types throughout
      the central and peripheral nervous systems. Nuclei of both fibrous and
      protoplasmic astrocytes were also immunoreactive, but oligodendrocyte nuclei were
      negative. Positive, but highly variable immunocytochemical staining of nonneural
      cell nuclei in a variety of other tissues was also observed. Electron microscopic
      (EM) immunocytochemistry using pre-embedding peroxidase methods revealed that
      np526 is associated with euchromatin or with the edges of condensed chromatin
      bundles in neurons, indicating that it is likely to be a chromosomal protein.
      Most interestingly, the expression of np526 was found to be developmentally
      regulated in brain. Immunocytochemical analysis of the developing cerebral cortex
      from embryonic day (E) 16 to postnatal day (P) 4 and cerebellum from P4 to P18
      revealed that np526 first appears in central neurons following the cessation of
      mitosis and that the intensity of nuclear staining increases during subsequent
      neuronal maturation. To our knowledge, np526 is the first presumptive chromosomal
      protein whose expression has been precisely correlated with the early postmitotic
      differentiation of mammalian neurons.

PMID- 1624933
TI  - Cholinergic differentiation in neurogenic basal forebrain cultures.
AB  - To study early events in the central nervous system (CNS) cholinergic
      development, cells from rat basal forebrain tissue were placed in culture at an
      age when neurogenesis in vivo is still active [embryonic day (E) 15]. The rapid
      mortality of these cells in defined medium, with 50% mortality after 5-10 h, was
      blocked completely by soluble proteins from the olfactory bulb (a basal forebrain
      target), extending earlier observations (Lambert, Megerian, Garden, and Klein,
      1988). Treated cultures were capable of incorporating thymidine into DNA, and
      most cells incorporating 3H-thymidine (greater than 90%) also stained positive
      for neurofilament, confirming neuronal proliferation in the supplemented
      cultures. A small percentage of 3H-thymidine labelled cells were glial fibrillary
      acidic protein (GFAP) positive, but growth factors that support astroglial
      proliferation [epidermal growth factor (EGF), basic fibroblast growth factor
      (bFGF), and insulin-like growth factor (IGF-1)] were not sufficient for neuronal
      support. After 5 culture days with supplemented medium, almost 50% of the cells
      showed choline acetyltransferase (ChAT) immunofluorescence. The cholinergic
      neurons typically formed clusters separate from noncholinergic cells. These
      mature cultures did not develop if young cultures were treated with aphidicolin
      to block DNA synthesis. The data show that cultures of very young rat basal
      forebrain cells can be neurogenic, giving rise to abundant cholinergic neurons,
      and that early cell proliferation is essential for long-term culture survival.

PMID- 1624934
TI  - Structure of the caudal neural tube in an ascidian larva: vestiges of its
      possible evolutionary origin from a ciliated band.
AB  - Ultrastructural analysis and differential immunocytochemical staining with two
      antitubulin monoclonal antibodies were used to reexamine the organization and
      development of the neural tube in the larva of an ascidian, Ciona intestinalis,
      in appraisal of a theory that the dorsal tubular nervous system of the chordates
      evolved from two halves of a ciliated band in an auricularia-like larva of the
      kind found in echinoderms and hemichordates. One of the antibodies stained cilia
      in the nervous system and elsewhere; the other reacted primarily with neuronal
      axons. The caudal neural tube consists of four rows of large ciliated ependymal
      glial cells enclosing an axial neural canal into which their single cilia extend.
      Two ventrolateral nerve tracts, containing axons, arise in the posterior brain
      region and extend along the length of the caudal tube, partially surrounded by
      the ependymal cells. The nonnervous, ciliated, ependymal neural tube of the
      ascidian larva with its two associated nerve tracts survives as a primitive early
      condition that could result from a ciliated band transformation. Tissues in the
      distal-most part of the ascidian larval tail have cell lineage origins that
      indicate an evolutionary history different from those in the proximal majority of
      the tail. The ependymal cells in this presumed later addition to the tail are not
      ciliated, although all of the others in the caudal ependymal tube appear to be.

PMID- 1624935
TI  - Neurite outgrowth on a step gradient of chondroitin sulfate proteoglycan (CS-PG).
AB  - Sulfated proteoglycans (PGs) may play a significant role in the regulation of
      neurite outgrowth. They are present in axon-free regions of the developing
      nervous system and repel elongating neurites in a concentration-dependent manner
      in vitro. The addition of growth-promoting molecules, such as laminin, can modify
      the inhibitory effect of PGs on neurite outgrowth (Snow, Steindler, and Silver,
      1990b). Substrata containing a high-PG/low-laminin ratio completely inhibit
      neurite outgrowth, while normal, unimpeded outgrowth is observed on low-PG/high
      laminin substrata. Therefore, different patterns of neurite outgrowth may result
      from regulation of the ratio of growth-promoting molecules to growth-inhibiting
      molecules. Using video microscopy, embryonic chicken dorsal root ganglia neurons
      (DRG), chicken retinal ganglia neurons (RGC), and rat forebrain neurons (FB) were
      analyzed as they extended processes from a substratum consisting of laminin alone
      onto a step gradient of increasing concentrations of chondroitin sulfate
      proteoglycan (CS-PG) bound to laminin. In contrast to neurite outgrowth
      inhibition that occurs at the border of a single stripe of high concentration of
      CS-PG (Snow et al., 1990b and this study), growth cones grew onto and up CS-PG
      presented in a step-wise graded distribution. Although the behavior of the
      different cell types was unique, a common behavior of each cell type was a
      decrease in the rate of neurite outgrowth with increasing CS-PG concentration.
      These data suggest that appropriate concentrations of growth-promoting molecules
      combined with growth-inhibiting molecules may regulate the direction and possibly
      the timing of neurite outgrowth in vivo. The different responses of different
      neuronal types suggest that the presence of sulfated PG may have varying effects
      on different aspects of neuronal development.

PMID- 1624936
TI  - Synthesis, spectroscopic, cytotoxic, and DNA binding studies of binuclear 2,2'
      bipyridine-platinum(II) and -palladium(II) complexes of meso-alpha,alpha'
      diaminoadipic and meso-alpha,alpha'-diaminosuberic acids.
AB  - Four new binuclear complexes of formula [M2(bipy)2(BAA)]Cl2 (where M is Pt(II) or
      Pd(II), bipy is 2,2'-bipyridine, and BAA is a dianion of meso-alpha-alpha'
      diaminoadipic acid (DAA) or meso-alpha,alpha'-diaminosuberic acid (DSA) have been
      synthesized. These complexes have been characterized by chemical analysis and
      ultraviolet-visible, infrared, and 1H NMR spectroscopy. The mode of binding of
      ligands in these complexes has been ascertained by infrared and detailed 1H NMR
      spectroscopy. These complexes are 1:2 electrolyte in conductivity water. They
      have also been tested against P388 lymphocytic leukemia cells and their target is
      DNA molecules. [Pt2(bipy)2(DSA)]Cl2, [Pd2(bipy)2(DSA)Cl2, and
      [Pd2(bipy)2(DAA)]Cl2 show I.D.50 values comparable or lower than cis
      diamminedichloroplatinum(II) and [Pt(bipy)(Ala)]Cl. In addition, binding studies
      of [Pt2(bipy)2(DSA)]Cl2 and [Pd2(bipy)2(DAA)]Cl2 to calf thymus DNA have been
      carried out and the mode of binding seems to be hydrogen bonding, as suggested
      earlier for analogous mononuclear amino acid-DNA complexes.

PMID- 1624937
TI  - Specific nickel(II)-transfer process between the native sequence peptide
      representing the nickel(II)-transport site of human serum albumin and L
      histidine.
AB  - The kinetics and mechanism for Ni(II)-transfer of the native sequence tripeptide,
      L-aspartyl-L-alanyl-L-histidine-N-methylamide (AAHNMA), representing the Ni(II)
      transport site of human serum albumin (HSA) and L-histidine (L-His) was studied
      in forward and reverse reactions in the pH range 6.5 to 9.0 at I = 0.2 and 25
      degrees C. For the Ni(II)-transfer from Ni(II)-(L-His)2 to native sequence
      peptide, the rate-determining step is the formation of a mixed-ligand complex of
      NiH-1AB by deprotonation of peptide nitrogen from NiAB where A and B denote the
      anionic forms of AAHNMA and L-His, respectively. For the Ni(II)-transfer from
      Ni(II)-peptide to L-His, the rate-determining step is a bond breaking between
      Ni(II) and peptide nitrogen to form NiH-1A by protonation to a peptide nitrogen
      of NiH-2A. The equilibrium constants for the metal-transfer reaction of MH-2A +
      2HB in equilibrium MB2 + A (A = Ni(II), Cu(II] were 10(3.29) and 10(0.78) for
      Ni(II) and Cu(II), respectively. NiB2 is 324 times as stable as CuB2.
      Furthermore, the ratio of Ni(II)/Cu(II) in the rate constants for the reaction of
      MB2 with A was found to be 2.8 x 10(-4). Thus, despite the similarities of Cu(II)
      and Ni(II) in the metal-binding sites of HSA and in reaction mechanism, Ni(II)-(L
      His)2 complex is so stable thermodynamically and kinetically, compared to the
      Cu(II)-(L-His)2 complex, that Ni(II) is hardly transferred from Ni(II)-(L-His)2
      to native sequence peptide. These findings may support specificities in the
      Ni(II)-transfer, its organ distribution, and its excretion through urine in vivo.

PMID- 1624938
TI  - Transgenic medicinal plants: Agrobacterium-mediated foreign gene transfer and
      production of secondary metabolites.
AB  - Agrobacterium-Ti/Ri plasmids are natural gene vectors, by which a number of
      attempts have been made in genetic engineering of secondary metabolism in
      pharmaceutically important plants in the last few years. Opines are
      biosynthesized by transformed crown galls and hairy roots integrated with T-DNAs
      of Ti/Ri plasmids. These opines are classified into five families according to
      their structures and biogenesis. The production of opines is a natural example of
      genetic engineering of the biosynthetic machinery of plant cells for the benefit
      of the bacterial pathogen. One recent advance in transgenic technology of
      potential value to pharmacognosy is an application of transgenic organ cultures
      such as hairy roots and shooty teratomas to over-production and biotransformation
      of secondary metabolites. The hairy roots induced by Ri plasmid of Agrobacterium
      rhizogenes have been proved to be an efficient means of producing secondary
      metabolites that are normally biosynthesized in roots of differentiated plants.
      So far the specific metabolites produced by hairy root cultures and/or plants
      regenerated from hairy roots of 63 species have been analyzed and reported. As an
      alternative means of producing metabolites normally produced in leaves of plants,
      the shooty teratomas incited by the tumor-forming Ti plasmid or a shooty mutant
      of Agrobacterium tumefaciens have been used for the de novo biosynthesis and
      biotransformation of some specific secondary products. A second and more direct
      way to manipulate secondary pathways is performed by transferring and expressing
      specifically modified genes into medicinal plant cells with Agrobacterium vector
      systems. The genes encoding neomycin phosphotransferase and beta-glucuronidase
      have been used as model genes under the transcriptional control of appropriate
      promoters. Recently some specific genes that can eventually modify the fluxes of
      secondary metabolism have been integrated and expressed in medicinal plant cells.
      Future prospects are also discussed.

PMID- 1624939
TI  - Chemical investigation and anti-inflammatory activity of Vitex negundo seeds.
AB  - The CHCl3 extract of the defatted seeds of Vitex negundo exhibited anti
      inflammatory activity and yielded four triterpenoids: 3 beta-acetoxyolean-12-en
      27-oic acid [1], 2 alpha, 3 alpha-dihydroxyoleana-5,12-dien-28-oic acid [2], 2
      beta,3 alpha-diacetoxyoleana-5,12-dien-28-oic acid [3], and 2 alpha,3 beta
      diacetoxy-18-hydroxyoleana-5,12-dien-28-oic acid [5]. This is the first report of
      the isolation of compounds 2, 3, and 5 from a natural source.

PMID- 1624940
TI  - Four new antibacterial sesterterpenes from a marine sponge of the genus
      Luffariella.
AB  - The structures of four new sesterterpenoid compounds 1-4 isolated from a marine
      sponge of the genus Luffariella, collected from The Great Barrier Reef,
      Australia, have been determined by analysis of their 1H-nmr, 13C-nmr, ir, uv, and
      eims spectral data. The new metabolites 1-4 were found to co-occur with the
      compounds manoalide, secomanoalide, Z-neomanolaide [5], and E-neomanoalide.

PMID- 1624941
TI  - Anti-HIV and cytotoxic alkaloids from Buchenavia capitata.
AB  - The anti-HIV activity in the organic solvent extract of leaves of Buchenavia
      capitata was traced to a series of known flavonoid alkaloids, which represent a
      new chemotype for anti-HIV activity. The 13C-nmr assignments for this series of
      compounds have been revised. O-Demethylbuchenavianine [1] was the most active
      compound of the series but produced only moderate cytoprotective effects against
      HIV in cultured human lymphoblastoid (CEM-SS) cells. Compound 1 was cytotoxic
      also in the NCI human disease-oriented in vitro tumor screening panel and
      produced a pattern of modest differential cellular sensitivity.

PMID- 1624942
TI  - Isolation and identification of xochitloldione and isoxochitlolone from
      Cnidosculus urens.
AB  - Major components of MeOH extracts from the plant roots of Cnidosculus urens
      purified by cc and tlc and crystallization were lupeol acetate and the previously
      unreported compounds isoxochitlolone [1] and xochitloldione [2], which were
      identified through mass, ir, nmr, and uv spectroscopy and X-ray crystallography.
      In preliminary testing, isoxochitlolone has been found to be active against
      Escherichia coli and Staphylococcus aureus.

PMID- 1624943
TI  - Isolation, NMR studies, and biological activities of onopordopicrin from
      Centaurea sonchifolia.
AB  - A sesquiterpene lactone, onopordopicrin [1], has been isolated from Centaurea
      sonchifolia. Its structure was established by 2D nmr (1H-1H and 13C-1H
      correlations), and the conformation in CHCl3 was examined by nOe studies.
      Cytotoxic, antibacterial, and antifungal activities are reported.

PMID- 1624944
TI  - NMR assignments of territrems A, B, and C and the structure of MB2, the major
      metabolite of territrem B by rat liver microsomal fraction.
AB  - The 1H- and 13C-nmr assignments of territrems A, B, and C [1-3] were made by
      using nOe and 2D nmr techniques. Following the same methods, the structure of MB2
      [4], the major product of territrem B incubated with rat liver microsomal
      fraction, was determined as a hydroxylation product at the pro S methyl group of
      C-4 of territrem B.

PMID- 1624945
TI  - Distribution of materials from the Natural Products Repository of the National
      Cancer Institute (NCI)

PMID- 1624946
TI  - Platelet activity and stroke severity.
AB  - Although platelets constitute the major component of a thrombus, its role in
      determining the clinical severity of thrombotic stroke is unknown. Therefore, we
      investigated the relationship between platelet ionized calcium ([Ca2+i]), a
      measure of platelet activity and presumably proneness to thrombosis, and clinical
      stroke severity in 45 consecutively studied acute ischemic stroke patients. Even
      though there was no correlation between the clinical neurological scores and the
      levels of baseline and activated platelet [Ca2+i], stroke was less severe in
      patients who had been taking aspirin at the time of stroke onset. These results
      raise several important questions: (a) is the extent of platelet activation a
      reflection of thrombus volume, (b) does the clinical severity of neurological
      deficit reflect the causative thrombus volume, and (c) whether the beneficial
      effect of aspirin in stroke prophylaxis is through its inhibition of platelets
      alone.

PMID- 1624947
TI  - Cholinergic markers in ALS spinal cord.
AB  - We analyzed binding sites for quinuclidinyl benzilate (QNB) and hemicholinium-3
      (HC-3) by quantitative slice autoradiography and the activities of choline
      acetyltransferase (ChAT) and acetylcholinesterase (AChE) in spinal cord of 5-7
      patients with amyotrophic lateral sclerosis (ALS). In the ventral horn, QNB
      binding sites were markedly reduced (38% of controls; P less than 0.001), whereas
      HC-3 binding sites were only moderately affected (76%, P less than 0.01). Losses
      in cholinergic marker enzymes were inconsistent. The loss of muscarinic binding
      sites in the ventral horn was the most reliable cholinergic disease marker in
      ALS.

PMID- 1624948
TI  - Recovery functions of somatosensory evoked potentials in parkinsonian patients.
AB  - The aim of this study was to analyze the recovery functions of median nerve
      somatosensory evoked potentials (SEPs) and to clarify changes in the
      somatosensory system of patients with Parkinson's disease (PD). The central and
      frontal SEPs and the nerve potential of the median nerve were examined. The
      latencies and amplitudes of SEPs produced by a single shock in patients with PD
      were normal. The recovery functions of central SEPs showed a low degree of
      suppression in patients with PD, although the recovery curve of the nerve
      potential in PD patients was almost normal. The change in recovery curves of SEPs
      in patients with sensory complaints were more noticeable than that in patients
      without sensory disturbance. A low degree of suppression of central SEPs might
      play a role in the sensory complaints of PD patients.

PMID- 1624949
TI  - The association of astrocytoma and pituitary adenoma in a patient with
      alcaptonuria.
AB  - A female patient with a juvenile pilocytic astrocytoma and a pituitary adenoma is
      described. The patient also has alcaptonuria, a rare inborn error of metabolism
      with autosomal recessive mode of inheritance. The association of these three
      disorders has never been reported previously. The possible existence of a common
      genetic factor in the development of both tumors and alcaptonuria is discussed.

PMID- 1624950
TI  - 1-H-localized magnetic resonance spectroscopy: preliminary observations in
      transient ischemic attacks.
AB  - Water-suppressed proton magnetic resonance spectroscopy which has recently shown
      diagnostic potential in human stroke victims was performed in two patients who
      had suffered a hemispheric transient ischemic attack. Localized spectra were
      targeted from routine MR images. In one patient lactate could be observed 8 weeks
      after a transient ischemic attack. Lactate concentration was low compared with
      that of a patient who had suffered acute stroke. The other TIA patient did not
      show evidence of lactate production. Although these observations are preliminary,
      we demonstrated that localized in vivo proton spectroscopy can detect persistent
      biochemical alterations after transient ischemic attacks. We suggest that non
      invasive in vivo proton spectroscopy will become a useful method in diagnosis and
      management of TIA in the future.

PMID- 1624951
TI  - Pathology of the cerebellar dentate and interpositus nuclei in Joseph disease: a
      morphometric investigation.
AB  - Cerebellar dentate and interpositus nuclei pathology was studied morphometrically
      in 3 patients with Joseph disease compared to 3 control subjects. Size of
      neurons, number of small neurons (cell body area: 50-199 microns 2) and large
      neurons (cell body area: 200 microns 2 or greater) at the rostral, medial and
      caudal levels, neuronal cell density, total volume of the gray bands, and total
      neuronal cell number were evaluated in the dentate, emboliform, and globose
      nuclei, using an image analyzer, after making horizontal serial 20-microns thick
      sections of a unilateral cerebellar hemisphere embedded in celloidin. The number
      of large neurons in Joseph disease was around 20% of that in the controls at each
      level in the individual nucleus (P less than 0.05 or P less than 0.01). In
      contrast, the number of small neurons was significantly reduced only at the
      caudal level of the dentate nucleus (P less than 0.05). The neuronal cell density
      was decreased within the nuclei. The total volume of the gray bands was reduced
      to about 70% within the nuclei (P less than 0.05 or P less than 0.01). The total
      number of neurons was decreased to about a third, a half, and a third within the
      dentate (P less than 0.001), emboliform (P less than 0.01), and globose nuclei (P
      less than 0.001), respectively. The principal pathologic change of the dentate
      and interpositus nuclei in Joseph disease was severe loss of neurons, with
      significant loss of the large neurons, indicating that Joseph disease is a type
      of cerebellar efferent system disorder.

PMID- 1624952
TI  - Electronmicroscopic observation of amyloid deposits in the vascular walls of the
      choroid plexus in systemic amyloidosis.
AB  - This report concerns an ultrastructural study of the vessels of the choroid
      plexus in 3 cases of systemic amyloidosis, sections of formalin-fixed brains
      being used. Small-sized arteries and arterioles were mainly affected by
      deposition of amyloid fibrils. In the arterioles, the amyloid fibrils were often
      so densely accumulated that they separated individual smooth muscle cells of the
      media and reached the subendothelial region. The basal surface of the endothelium
      of such vessels showed frequent invaginations filled with amyloid tufts; some of
      the tufts displaced the thin cytoplasm of the endothelial cells toward the lumen.
      Occasionally, tufts of amyloid fibrils were found to be exposed to and to float
      in the vascular lumen. These observations were made only in severely amyloid
      laden vessels. Among the several possibilities regarding the tuft-endothelial
      relationship, the transendothelial transport of amyloid tufts is most likely, but
      the possibility of intraendothelial processing of amyloid precursor proteins and
      their secretion to form fibrils extracellularly cannot be excluded.

PMID- 1624953
TI  - Hyperthermic injury versus crush injury in the rat sciatic nerve: a comparative
      functional, histopathological and morphometrical study.
AB  - Functional and morphological changes of the rat sciatic nerve after local
      hyperthermia (30 min, 45 degrees C) and crush treatment were compared. After
      hyperthermic injury nerve function loss developed in a time period of about 7 h.
      Nerve crush led to an immediate loss of nerve function. Nerve function loss was
      assessed by a motor and a sensory function test. Recovery from function loss took
      place in both treatment groups and was complete in 4-5 weeks. Early (within 8 h
      post-treatment) histopathological changes in the nerve after heating included
      edema, possible blood stasis and changes in the blood vessel wall, like swelling
      of the media. During this period some axonal changes were observed. Immediate
      after crushing axons were severely damaged, while many blood vessels remained
      normal. Within one week after both treatments, degeneration of axons and myelin
      was observed at the site and distal from the site of the lesion (Wallerian
      degeneration). Three weeks after treatment a major part of the axons had
      regenerated and remyelinated. Vascular changes at the site of lesion could still
      be observed in the heat-treated nerves. Twelve weeks after both treatments, blood
      vessels appeared to be normal again. Morphometrical analysis of the treated
      nerves confirmed the histological observations. Three and 12 weeks after
      treatment average axon diameters were significant smaller and average myelin
      sheaths were significant thinner compared to untreated nerves. These parameters
      did not differ significantly when the two treatment groups were compared.

PMID- 1624954
TI  - Mechanisms of oligodendrocyte interaction with normal human serum--defining the
      role of complement.
AB  - The interaction of human serum with oligodendroglia was investigated in vitro
      using purified cultured neonatal rat oligodendrocytes. Previous evidence for
      antibody independent classical pathway complement activation was confirmed; the
      results also showed a deficit in the protection of rat oligodendrocytes from
      complement attack suggesting a deficiency in the expression of terminal
      regulatory proteins of the complement cascade. Thus, rat oligodendrocytes are
      selectively sensitive to normal serum due both to complement activation and
      impaired protection from terminal complement attack.

PMID- 1624955
TI  - Computational simulations of the conformational behaviour of the adhesive
      proteins RGDS fragment.
AB  - Many adhesive proteins present in extracellular matrices and in blood contain the
      tetrapeptide sequence -Arg-Gly-Asp-Ser- (or RGDS) at their cell recognition site.
      Since this sequence, or similar ones, was found in many proteins involved in
      major biological mechanisms, conformational investigations were performed on the
      RGDS fragment. A preliminary review of available crystal structures indicates
      that the RxDy sequences exhibit 3 well-defined structural patterns: one
      corresponding to a strong interaction between the Arg and Asp ionic side chains
      which are only about 4 A apart, one with the ions separated by about 8 A, and
      another in which the side chains are further apart (about 11 A). The
      conformational behaviour of the isolated RGDS fragment was next tackled using
      sequential building, Monte Carlo and molecular dynamics computational techniques.
      Analysis of the RGDS sequence conformational possibilities, as simulated in
      vacuum and in water solution, indicates that they can be classified into several
      conformational classes, which correspond roughly to the behaviour of the RGDS
      fragment as observed in protein matrices. This suggests the possibility of
      understanding the biological role of the RGDS or parent sequences in recognition
      processes.

PMID- 1624957
TI  - Characterization of low-energy conformational domains for Met-enkephalin.
AB  - An extensive exploration of the conformational hypersurface of Met-enkephalin has
      been carried out, in order to characterize different low-energy conformational
      domains accessible to this pentapeptide. The search strategy used consisted of
      two steps. First, systematic nested rotations were performed using the ECEPP
      potential. Ninety-two low-energy structures were found and minimized using the
      CHARMm potential. High and low-temperature molecular dynamics trajectories were
      then computed for the lowest energy structures in an interative fashion until no
      lower energy conformers could be found. The same search strategy was used in
      these studies simulating three different environments, a distance-dependent
      dielectric epsilon = r, and two constant dielectrics epsilon = 10 and epsilon =
      80. The lowest energy structure found in a distance-dependent dielectric is a Gly
      Gly beta-II'-type turn. All other structures found for epsilon = r within 10
      kcal/mol of this lowest energy structure are also bends. In the more polar
      environments, the density of conformational states is significantly larger
      compared to the apolar media. Moreover, fewer hydrogen bonds are formed in the
      more polar environments, which increases the flexibility of the peptide and
      results in less structured conformers. Comparisons are made with previous
      calculations and experimental results.

PMID- 1624956
TI  - In search of new lead compounds for trypanosomiasis drug design: a protein
      structure-based linked-fragment approach.
AB  - A modular method for pursuing structure-based inhibitor design in the framework
      of a design cycle is presented. The approach entails four stages: (1) a design
      pathway is defined in the three-dimensional structure of a target protein; (2)
      this pathway is divided into subregions; (3) complementary building blocks, also
      called fragments, are designed in each subregion; complementarity is defined in
      terms of shape, hydrophobicity, hydrogen bond properties and electrostatics; and
      (4) fragments from different subregions are linked into potential lead compounds.
      Stages (3) and (4) are qualitatively guided by force-field calculations. In
      addition, the designed fragments serve as entries for retrieving existing
      compounds from chemical databases. This linked-fragment approach has been applied
      in the design of potentially selective inhibitors of triosephosphate isomerase
      from Trypanosoma brucei, the causative agent of sleeping sickness.

PMID- 1624958
TI  - Structure-activity relationships of pyrethroid insecticides. Part 2. The use of
      molecular dynamics for conformation searching and average parameter calculation.
AB  - Molecular dynamics simulations have been performed on a number of
      conformationally flexible pyrethroid insecticides. The results indicate that
      molecular dynamics is a suitable tool for conformational searching of small
      molecules given suitable simulation parameters. The structures derived from the
      simulations are compared with the static conformation used in a previous study.
      Various physicochemical parameters have been calculated for a set of
      conformations selected from the simulations using multivariate analysis. The
      averaged values of the parameters over the selected set (and the factors derived
      from them) are compared with the single conformation values used in the previous
      study.

PMID- 1624959
TI  - When is an answer the answer?

PMID- 1624960
TI  - Conformational search by potential energy annealing: algorithm and application to
      cyclosporin A.
AB  - A major problem in modelling (biological) macromolecules is the search for low
      energy conformations. The complexity of a conformational search problem increases
      exponentially with the number of degrees of freedom which means that a systematic
      search can only be performed for very small structures. Here we introduce a new
      method (PEACS) which has a far better performance than conventional search
      methods. To show the advantages of PEACS we applied it to the refinement of
      Cyclosporin A and compared the results with normal molecular dynamics (MD)
      refinement. The structures obtained with PEACS were lower in energy and agreed
      with the NMR parameters much better than those obtained with MD. From the results
      it is further clear that PEACS samples a much larger part of the available
      conformational space than MD does.

PMID- 1624961
TI  - Dubious evidence of heart and cancer deaths due to passive smoking.

PMID- 1624962
TI  - Passive smoking causes heart disease and lung cancer.

PMID- 1624963
TI  - Sleep apnea syndrome symptoms and automobile driving in a general population.
AB  - Automobile accidents are reported as being overrepresented in those suffering
      from the obstructive sleep apnea syndrome (SAS), evident by snoring, sleep
      disturbances and diurnal hypersomnia. An estimation of the prevalence of these
      symptoms amongst an adult population, predominantly automobile drivers, was
      assessed by using a one-stage questionnaire procedure. From a national random
      sample of 1214 persons a weighted reply rate of 76% was achieved. Snoring, breath
      cessations, mid-sleep awakenings, and diurnal hypersomnia were reported in 24,
      3.8, 27 and 9.1%, respectively. The maximum prevalence of SAS was estimated as
      2.8-5.5% among men, aged 30-69 years, depending on definition used. Driving
      frequency in potential sleep apneics was similar to that of the entire population
      studied. Diurnal hypersomnia, considered a consequence of SAS, was reported as an
      overall 2.2%, corresponding to 100,000 automobile drivers in Sweden.

PMID- 1624964
TI  - The differential diagnosis of primary lung cancer: inter-observer agreement and
      contribution of specific diagnostic procedures.
AB  - In order to investigate inter-observer variability in the differential diagnosis
      of primary lung cancer among women and the contribution of specific diagnostic
      procedures to this diagnosis, a group of 449 suspect cases of this disease was
      studied. Based on a standard dossier (including clinical data and the reports, if
      present, of radiology, bronchoscopy and histology) six different physicians
      independently judged, for each woman, at each diagnostic step, the presence of a
      primary lung cancer. A final consensus was organized in order to define the true
      cases. Radiology and especially histology seem to give the most important
      contribution to the diagnosis. On the other hand bronchoscopy seems to be useful
      mainly as a guide for biopsy. A predictive value of 90% was found when both
      radiology and bronchoscopy were positive; in the other cases histology seems to
      be needed to reach an adequate discrimination. Inter-rater agreement increases
      with an increasing amount of information but is not very high even when histology
      is available.

PMID- 1624965
TI  - Epidemiology of diabetes mellitus in southern Italy: a case-finding method based
      on drug prescriptions.
AB  - The study evaluates whether data concerning drug prescriptions available from the
      National Health System (NHS) can be used to provide an estimate of the prevalence
      and pattern of treatment of diabetes in a well defined health district in
      southern Italy. In Italy virtually all drug prescriptions are obtained through
      the NHS. For a period of three consecutive months all prescriptions of insulin,
      hypoglycemic agents and strips for blood and urine testing were monitored in a
      well defined area near Naples. 2958 cases were thus identified giving a
      prevalence of drug treated diabetes mellitus of 2.01%; prevalence was higher in
      females than in males (2.68 vs 1.35%) and increased with age from 0.05% in the
      age group below 9 years to 13.67 in the age group over 70 years. This case
      finding procedure was validated by cross-check with independent sources of cases.
      To evaluate the sensitivity of the method a list of 820 "known" cases of drug
      treated diabetes mellitus was obtained from a random sample of local general
      practitioners (GPs) and diabetic clinics: 73.5% of these cases were also detected
      through the analysis of drug prescriptions. To evaluate the probability of
      misclassification a random subsample of 602 cases identified through
      prescriptions was submitted to the GPs working in the study area, for 517 the
      diagnosis of diabetes was confirmed, thus yielding a positive predictive value of
      85.9%. After correction for sensitivity and probability of misclassification the
      prevalence of drug treated diabetes in our population was 2.52%. The pattern of
      prescriptions in this population is also given.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624966
TI  - Risk factors for cardiovascular disease in the developing world. A multicentre
      collaborative study in the International Clinical Epidemiology Network (INCLEN).
      INCLEN Multicentre Collaborative Group.
AB  - Twelve centres in 7 countries in the Developing World (China, Thailand, the
      Philippines, Indonesia, Chile, Colombia and Brazil) connected with the
      International Clinical Epidemiology Network (INCLEN) each measured cardiovascular
      disease (CVD) risk factors in random samples of approx. 200 men aged between 35
      and 65 years. Samples of men aimed to be representative of the population from
      which they were drawn, but the population in each centre was not designed to be
      representative of the whole country. Cigarette smoking rates varied from 16 to
      78% and mean cholesterol levels varied from 3.8 to 6.4 mmol/l. In Bogota,
      Colombia, 46% of the men had a cholesterol level greater than 6.5 mmol/l and in
      another 5 communities 19% or more of the population had these levels. A body mass
      index (BMI) of greater than 25 was seen in more than 50% of 4 communities and a
      blood pressure greater than or equal to 160 mmHg systolic and/or 95 mmHg
      diastolic was found in more than 20% of 6 countries. BMI was strongly correlated
      with blood cholesterol and blood pressure levels in almost all population groups.
      It would appear that many communities in the Developing World have high levels of
      risk factors for CVD and that steps could well start to be taken now to prevent
      the emergence of CVD epidemics in the future.

PMID- 1624967
TI  - A coronary primary prevention study of Scottish men aged 45-64 years: trial
      design. The West of Scotland Coronary Prevention Study Group.
AB  - This paper describes the design of the West of Scotland Coronary Prevention Study
      (WOSCOPS) which is a primary prevention trial involving men aged 45-64 yr with
      raised plasma cholesterol levels. The principal aim is to test the hypothesis
      that reduction of serum cholesterol by treatment with pravastatin [a competitive
      inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase--a
      regulatory enzyme in cholesterol synthesis] over an average period of 5 yr will
      lead to a reduction in fatal and non-fatal myocardial infarction. A trial
      population of approx. 6500 men have been randomized in equal numbers to treatment
      with placebo or pravastatin. At the time of randomization, these men have no
      evidence of previous myocardial infarction. All subjects are given smoking and
      dietary advice throughout the study. The principal endpoints are: (i) coronary
      heart disease death plus non-fatal myocardial infarction, (ii) coronary heart
      disease death, and (iii) non-fatal myocardial infarction.

PMID- 1624968
TI  - Health and social consequences for relatives of demented and non-demented
      elderly. A population-based study.
AB  - A population-based study was performed to investigate the subjective and
      objective burden due to caring for a demented relative. All the relatives of the
      subjects with cognitive impairment, detected in a district of Stockholm, living
      at home, were included in the study. When compared with relatives of elderly,
      mentally healthy persons living at home in the same district, they had high ORs
      for subjective burden and for use of psychotropic drugs. Spouses were the most
      stressed. However, the ORs for use of medical facilities and somatic drugs were
      close to unity, showing that caring for a demented person did not affect the
      physical health of the relative. A second comparison between relatives of
      demented persons living at home and in institutions, showed that the relatives of
      institutionalized subjects were less frequently spouses and had more problems
      with their physical health, but both groups had similar subjective feeling of
      stress.

PMID- 1624969
TI  - Acute rheumatic fever and the evolution of rheumatic heart disease: a prospective
      12 year follow-up report.
AB  - Sixty four children who presented with the initial attack of acute rheumatic
      fever and maintained continuous regular secondary prophylaxis, were followed up
      prospectively for 12.3 years (an observation period of 775 patient-years). The
      prevalence rate of rheumatic heart disease in the 29 children who had carditis in
      the initial attack and in the 35 children who had no carditis initially was 49 vs
      0%, respectively. The overall prevalence rate of rheumatic heart disease was 20%.
      Mitral incompetence developed in 11 patients (17%), aortic incompetence in 2 (3%)
      and mitral stenosis in 2 (3%). None of the patients developed aortic stenosis.
      Two recurrences developed with a recurrence rate of 0.003 per patient per year.
      One patient needed cardiac surgery and there was no mortality. These data
      strongly suggest that continuous regular secondary prophylaxis can prevent or
      significantly reduce the development of mitral and aortic valve stenosis, the
      prevalence rate of rheumatic heart disease and mortality.

PMID- 1624970
TI  - Comparison of two physical activity questionnaires, with a diary, for assessing
      physical activity in an elderly population.
AB  - Measurement of physical activity in epidemiological studies is usually achieved
      by means of a questionnaire. Little work has been done to determine which
      questionnaire format has greater validity in an elderly population. In this study
      of elderly subjects, physical activity as reported in two self-administered
      questionnaires (A and B), which differed in format and length, were compared to
      activity reported in a 4 day diary. As compared with the diary, moderate/heavy
      activity was more accurately reported in Questionnaire A (mean difference 5 min),
      the longer more detailed questionnaire, than B (mean difference 170 min). Light
      activity was under reported in Questionnaire A (mean difference 68 min) and over
      reported in B (mean difference 88 min) as compared with the diary. In contrast,
      time spent sitting was more accurately reported in Questionnaire B (mean
      difference 40 min) than in A (mean difference 230 min) as compared with the
      diary. The longer more detailed questionnaire was the more accurate instrument
      for assessing moderate/heavy activity in this elderly population. The shorter
      questionnaire was more accurate for assessing time spent sitting.

PMID- 1624971
TI  - Bias in meta-analytic research.
AB  - With the proliferation of meta-analyses in the medical literature have come
      conflicting studies. In addition, observance of guidelines for the performance of
      meta-analyses has been spotty. Bias may explain conflicting studies and
      differentiate carefully performed meta-analyses from others. Meta-analysts may
      fail to anticipate biases which threaten their study's validity. The three stages
      at which bias can be injected into a meta-analysis are finding studies, selection
      of the identified studies for the meta-analysis and extraction of data from the
      selected studies. This manuscript reviews specific types of bias which are common
      at each of these stages.

PMID- 1624972
TI  - Laboratory profile of sickle cell disease: a cross-sectional analysis. The
      Cooperative Study of Sickle Cell Disease.
AB  - We have collected steady-state laboratory data for over 2600 patients, age 2
      years and over, with sickle cell anemia (HbSS), HbSC disease, and HbS-beta(+)
      thalassemia. The packed cell volume (PCV) is lower in males than in females until
      17 or 18 years of age in HbSS and ages 13 to 15 in HbSC, but then becomes
      consistently higher in males. After age 40, the PCV falls in HbSS. The steady
      state leukocyte count in HbSS is higher than that in normals, blunting the
      utility of this measurement in the assessment of infection. In HbSC and HbS
      beta(+)-thalassemia, the leukocyte counts are more often within the range of
      normal. Platelet counts in HbSS are often found to be above normal and show a
      downward trend with age. There is a progressive rise in creatinine with age. In
      HbSS, this rise begins at age 14 and may be accounted for by the increased muscle
      mass that occurs with puberty. The further deterioration of renal function in
      patients over 20 may be a result of the known adverse effects of sickle cell
      disease upon the kidney. Our data provide a basis to compare perturbations caused
      by intercurrent complications and new therapies, as well as to contrast with
      similar information from other populations of patients with sickle cell disease.

PMID- 1624973
TI  - Soft drink consumption and urinary stone recurrence: a randomized prevention
      trial.
AB  - The object of this study was to determine if a strong association between soft
      drink (soda) consumption and recurrence of urinary stone disease, found in an
      earlier case-control study of adult males, had a causal component. The study
      sample consisted of 1009 male subjects, who completed an episode of urinary stone
      disease, who were aged 18-75 at that time, and who reported consuming at least
      160 ml per day of soft drinks. Half of the subjects were randomized to refrain
      from consuming soft drinks, while the remaining subjects served as controls. The
      intervention group had an observed 6.4% advantage in actuarial 3 yr freedom from
      recurrence (p = 0.023 one-sided) over the control group. One important secondary
      finding was that for those who reported at the time of the index stone that their
      most consumed drink was acidified by phosphoric acid but not citric acid, the
      experimental group had a 15% higher 3 yr recurrence-free rate than the controls,
      p = 0.002, while for those who reported at the time of the index stone that their
      most consumed drink was acidified by citric acid with or without phosphoric acid,
      the experimental group had a similar 3 yr recurrence-free rate to the controls, p
      = 0.55. This interaction was significant, p = 0.019.

PMID- 1624974
TI  - Prevalence of isthmic lumbar spondylolisthesis in middle-aged subjects from
      eastern and western Finland.
AB  - Isthmic spondylolisthesis of the lumbosacral spine is a common radiologic finding
      in patients with low back pain, but its prevalence in unselected populations is
      poorly known. We examined X-ray pictures of the lumbosacral region of 1147
      randomly selected 45-64-yr-old subjects living in eastern or western Finland. Of
      them, 69 subjects were found to have isthmic spondylolisthesis. The finding was
      more common in men (7.7%) than in women (4.6%; p = 0.026). The prevalence of
      spondylolisthesis was not age-related; it was higher in women with an occupation
      causing a high back load than in those with a low load occupation (p = 0.049),
      but this difference was not seen in men. The prevalence of spondylolisthesis
      tended to be higher in women with multiple pregnancies than in those with less
      than or equal to 2 pregnancies (p = 0.074). Women from eastern Finland had a
      higher prevalence of spondylolisthesis (7.2%) than those from western Finland
      (2.6%; p = 0.007), whereas no such difference was seen in men. The difference in
      women may partly be explained by factors causing loading of the low back, i.e.
      heavier work and a higher number of pregnancies.

PMID- 1624975
TI  - Colon cancer and ulcerative colitis: an epidemiologic exercise revisited.

PMID- 1624976
TI  - "Prudence" and "evidence" in disease prevention.

PMID- 1624977
TI  - Community health nursing visits for at-risk women and infants.
AB  - The purpose of this study was to utilize the Barnard Model of parent-infant
      interaction and instruments from the Barnard Newborn Nursing Models study to
      assess 30 pregnancy clients and to help determine appropriate interventions. Upon
      consent, the 30 study participants were randomly assigned to one of three groups:
      primiparous, unmarried, or otherwise socially at-risk. Thirty-three percent of
      the participants were under 19 years of age. A doctorally prepared community
      health nurse (CHN) completed all interventions, including a comprehensive
      assessment. Over 20% of participants admitted mild to moderate abuse of alcohol,
      cigarettes, and/or street drugs during early pregnancy. Counseling/supportive
      interventions established rapport and encouraged women to develop and maintain
      healthy life-styles. The control group of 10 were evaluated when their infant
      reached 6 months. A second group was followed during pregnancy, then evaluated at
      6 months. A third group of 10 women were followed through pregnancy and the first
      6 months of their babies' lives. Results indicated that substance abuse stopped
      or substantially decreased during intervention. Mothers in the intervention
      groups had fewer perinatal complications and better parent-infant interaction
      scores than the controls. This research supports previous reports that home
      visitor programs foster more healthy pregnancies and improve child developmental
      outcomes.

PMID- 1624978
TI  - Living arrangements, visit patterns, and health problems in a nurse-managed
      clinic for the homeless.
AB  - The purpose of this article is to describe living arrangements, clinic visit
      patterns, and health problems of clients by age and gender in a nurse-managed
      clinic serving the homeless. The conceptual framework for this project was
      derived from a nursing perspective of community health. The problem
      classification scheme used included four domains of community health practice:
      environmental, psychosocial, physiological, and health-related behavior. Data
      were collected during each visit to a nurse-managed health clinic for the
      homeless for 18 months. The findings indicate that living arrangements and visit
      patterns vary by age and gender. Health problems associated with integument and
      income were identified as primary and secondary problems across all age groups.
      Six other health problems were shared across all age and gender groups as either
      primary or secondary: circulation, respiration, pain, nutrition, communication,
      and prescription medication. Substance misuse was not a primary problem noted by
      clients, but was commonly a secondary problem. Genitourinary problems were noted
      primarily to be problems of younger women. Implications for planning nursing
      services for the homeless are discussed.

PMID- 1624979
TI  - Mandatory HIV testing rejected.

PMID- 1624980
TI  - Expertise in community health nursing.
AB  - This article reports on a study of expertise in community health nursing. The
      objective of the study was to develop a model of expertise derived from
      identification of the characteristics and factors influencing clinical expertise
      in community health nurses (CHNs) practicing in district nursing, school health,
      and child health. Participant observations, individual interviews, and written
      retrospective accounts of clinical episodes were analyzed from 37 nurses (10
      novices within the first year of community practice and 27 experts identified by
      peers and colleagues). The data identified the expert as someone in whom the
      following characteristics operate synchronously: knowledge; empathy; appropriate
      communication; holistic understanding; an ability to get right to the problem at
      hand; and self-confidence in her or his perceptions, judgments, and intervention
      strategies. The findings suggest that there is a combination of factors which
      influences the development of expertise. These include educational factors,
      personal factors, and experience. These factors are incorporated into the model
      of expertise. The data also suggest that, in order to educate for expert levels
      of practice, the educational process must be designed to stimulate the learner's
      perceptual as well as analytic abilities. This can best be achieved through
      clinical practice opportunities and through demonstrations and case studies which
      stimulate inferential and intuitive thinking in students.

PMID- 1624981
TI  - Health perceptions and behaviors of school-age boys and girls.
AB  - This study described and compared the health perceptions and behaviors of 83
      school-age boys and girls. An age-appropriate interview schedule was designed to
      collect data related to demographic characteristics, health perceptions, safety,
      life-style practices, nutrition, dental health, and care of minor injuries.
      Findings indicated that most boys and girls viewed themselves as healthy and
      managed their own care fairly well in the areas of seat belt use, exercise, and
      dental health. Nutrition was identified as an area of concern, with 10% of the
      children skipping breakfast, and over half eating snacks with empty calories.
      Generally, children were found to be knowledgeable in the management of simple
      injuries and how to respond in the event of an emergency. Boys and girls were
      similar in all areas of health perceptions and behaviors except for dental
      health, with boys reporting more regular visits to the dentist than did girls.
      Further research is needed to learn more about the process by which school-age
      children acquire positive health behaviors to assist nurses to design and
      implement intervention programs that appropriately address the needs of this age
      group.

PMID- 1624982
TI  - Injection sites utilized for DPT immunizations in infants.
AB  - The purpose of this investigation was to determine the site utilized by nurses
      for administering Diphtheria and Tetanus Toxoids and Pertussis (DPT) injections
      to infants under 7 months of age. Twenty-six of the 28 agencies identified in a
      metropolitan area as administering DPT injections chose to participate in the
      study. Those individuals administering DPT injections in the agencies completed a
      questionnaire with a return rate of 69% (n = 55). Forty-four participants
      indicated that they used the anterolateral thigh, the recommended site, 100% of
      the time. The participants in the study administered a total of 1,453 DPT
      injections per month. Eighty-seven percent of those injections were administered
      in the anterolateral thigh, 3.6% were given in the deltoid, 5.1% were given in
      the dorsal gluteal, and 4% were given in the ventrogluteal. The estimated
      proportion of DPT injections administered at the correct site was 84.65% which is
      much lower than the critical value 94.06% for alpha = .05 (p less than .00001).

PMID- 1624983
TI  - Enuresis: nursing diagnoses and treatment.
AB  - Living with a child with enuresis is not a major or critical problem, but it is a
      difficult and frustrating one. Wet sheets, wet pajamas, and rooms that smell of
      urine all add to the dismay felt by child and parents. Enuresis is a common
      problem which affects 22% of 5 year olds and 10% of 10 year olds (Scipien,
      Barnhart, Chard, Howe, & Phillips, 1986). Boys are affected more often than
      girls. There tends to be few answers given in the health-care system for the
      problem other than, "he'll out-grow it." Community health nurses (CHNs), working
      in the clinic, in the school setting, or in the home, may find parents and
      sometimes the child asking for help with this problem. This article presents the
      most common nursing diagnoses that apply to the family of an enuretic, and
      nursing interventions that can guide the nurse in working with the family to
      secure successful methods of treatment.

PMID- 1624984
TI  - Acute MI: a review of pathophysiology, treatment, and complications.
AB  - Few areas of clinical medicine have undergone advancements in the last decade as
      dramatic as those in the management of acute myocardial infarction (AMI). Nursing
      care of the AMI patient should be based on a comprehensive knowledge of the
      pathophysiology involved in order to intervene appropriately, understand medical
      therapies utilized, and anticipate complications. This article offers an in-depth
      review and update of the pathophysiology of AMI, current recommendations
      regarding management of the patient with acute infarction, and an overview of
      complications that still pose a threat to recovery in some patients.

PMID- 1624985
TI  - Mitral regurgitation as a complication of MI: pathophysiology and nursing
      implications.
AB  - Mitral regurgitation as a complication of myocardial infarction may be caused by
      papillary muscle dysfunction, papillary muscle rupture, or rupture of the chordae
      tendineae. Prompt diagnosis and intervention are necessary to reduce associated
      mortality and morbidity. The cardiovascular nurse is integrally involved in all
      phases of treatment for this condition. The pathophysiology, clinical course, and
      current treatment modalities utilized for postinfarction mitral regurgitation are
      described, enabling the cardiovascular nurse to develop a comprehensive plan of
      care.

PMID- 1624986
TI  - Ventricular septal and free wall rupture complicating acute MI.
AB  - This article discusses rupture of the free wall of the left ventricle and
      ventricular septal defect (VSD). Although both entities occur infrequently, they
      remain prominent causes of death from acute myocardial infarction (AMI). Rupture
      of the free wall varies from an acute tear to a slow, incomplete, or subacute
      rupture. A VSD resulting from an AMI may be simple or complex. A simple rupture
      is a direct opening in the ventricular system. A complex rupture ascribes an
      undulating course. Although VSD is potentially amendable to surgical therapy,
      free wall rupture is usually immediately fatal. Because rapid identification with
      aggressive treatment potentially influences patient outcome, cardiovascular
      nurses need to be able to rapidly identify patients experiencing these cardiac
      rupture syndromes. Nurses provide the important physiologic and psychosocial
      support that is necessary for patient survival and successful adaptation.

PMID- 1624987
TI  - Acute post-MI pericarditis.
AB  - The diagnosis of acute pericarditis may be difficult to establish in patients
      with recent transmural infarcts as the symptomatology frequently mimics the
      clinical presentation associated with recurrent ischemia. A careful assessment of
      the postmyocardial infarction patient may reveal the clinical and
      electrocardiographic features associated with developing pericarditis. Prompt and
      accurate recognition of this complication is critical in order to institute
      definitive therapy, minimize the risk of hemodynamic compromise, and provide
      psychological support.

PMID- 1624988
TI  - Psychosocial adjustment following MI: current views and nursing implications.
AB  - Psychosocial adjustment following myocardial infarction (MI) has received
      significant research attention during the past 20 years. This article highlights
      research addressing the relationship of anxiety, depression, and denial in
      influencing specific outcomes following MI. Additional research describing
      patterns of emotional response to MI is also included. Based on reported
      research, specific nursing interventions, in a care plan format, are suggested to
      foster positive psychosocial outcomes in the post-MI patient. Even though a
      significant amount of research has been completed on this subject, definitive
      conclusions regarding patient management supportive of positive outcomes are not
      possible. Suggestions for future research focus on this topic area are
      identified.

PMID- 1624989
TI  - Reduced cardiac output and exercise capacity in patients after MI.
AB  - This article summarizes the literature and suggests directions for future
      research concerning rehabilitation potential, impairment, and reduced cardiac
      output after myocardial infarction (MI). Current evidence suggests that cardiac
      output and maximal exercise capacity are reduced in some post-MI patients. The
      conceptual model of rehabilitation potential presented emphasizes the need for
      careful assessment of the state of underlying pathology present after MI when
      evaluating the response to exercise or exercise training.

PMID- 1624990
TI  - Computerized myocardial ischemia detection.
AB  - With early detection and timely intervention, the effects of ischemia are
      reversible. Without intervention, ischemia causes myocardial injury, which is
      usually evidenced by ST elevation. Computerized ST segment analysis performed by
      the bedside monitor can assist clinicians in the early recognition of ischemia,
      allowing prompt intervention and timely evaluation of treatment effectiveness.

PMID- 1624991
TI  - Depression in the post-MI patient.
AB  - Current nursing research has focused on the psychosocial complications and
      adjustment following myocardial infarction (MI). Depression can impair optimal
      recovery by the patient and family after MI. This article reviews and critiques
      two nursing studies related to depression. The first study focuses on reliably
      assessing depression in the post-MI patient. The second study explores the
      psychophysiologic link between depression and hypoxia. Implications for practice
      and further research are discussed.

PMID- 1624992
TI  - Task analysis of the ODU 11/12 explorer.

PMID- 1624993
TI  - Reasons for changing employment positions among practicing North Carolina dental
      hygienists.
AB  - This study sought to identify factors associated with dental hygienists'
      decisions to leave one dental office and commence practice in another. Although
      dental hygienists' decisions to leave the profession have been examined in some
      detail, this more common phenomenon of changing positions has not been carefully
      examined. All currently practicing dental hygienists in North Carolina were
      surveyed in 1990, as a part of a cooperative project addressing retention of
      dental office team members. The survey collected information concerning the 976
      respondents' (51% response rate) employment experience, reasons associated with
      leaving past positions, current job and career satisfaction, and personal
      characteristics. These data were analyzed to determine factors associated with
      both reported position changes and respondents' predictions of their professional
      activity status five years hence. No one reason or group of related reasons
      predominated among respondents' indicated reasons for leaving past positions.
      Approximately 25% of all changes were related to family responsibilities or
      spouse relocation. A larger proportion of changes was associated with a variety
      of job-related factors. Length of time in current position was not strongly
      related to job or career satisfaction, or to specific employment arrangements.
      The satisfaction measures were strongly associated with respondents' predictions
      of future activity status, while the employment arrangements were not. The
      results indicate that position changes occur for a variety of reasons, most, but
      not all, of which represent problems amenable to resolution through interventions
      designed to improve aspects of management within the practice.

PMID- 1624994
TI  - Dental hygiene students' and practitioners' resolution of professional issues.
AB  - The purpose of this study was to investigate the relationship among verbal
      ability, extent of education and professional experience, level of cognitive
      development, and age (separately and in combination) and dental hygiene students'
      and practitioners' ability to resolve professional issues. Forty-five dental
      hygiene students and graduates participated in this cross-sectional study (15
      associate-degree subjects with no professional experience; 15 associate-degree
      subjects with professional experience; and 15 baccalaureate-degree subjects with
      professional experience). Ability to resolve professional issues was measured
      using two professional issues cases developed by the investigator. Protocols were
      rated separately and blindly by two raters, resulting in high interrater
      reliability (r = .69) and agreement estimates (80%). Results revealed that
      subjects with higher levels of education and professional experience achieved
      higher scores on the professional issues cases. Multiple regression and part
      correlation analyses revealed that the independent variables, in combination and
      separately, were of questionable value in predicting ability to respond to
      professional issues. While no single variable was overwhelmingly predictive, the
      combination variable extent of education and professional experience appeared to
      be the best predictor.

PMID- 1624995
TI  - A national survey of outcomes assessment in dental hygiene programs.
AB  - The purpose of the study was to document methods of educational outcomes
      assessment currently utilized in U.S. dental hygiene programs. A survey was
      mailed in 1989 to 197 dental hygiene program directors. A closed- and open-ended
      questionnaire requested information on the extent of assessment and kinds of
      assessment measures in use. Responses were received from 152 directors (77%);
      frequency and percentage data were reported. Findings reveal that program
      directors are most often responsible for data collection and analysis. Assessment
      data are utilized most frequently for program improvement and future program
      planning; a majority of programs have already made changes due to outcomes
      assessment. A majority of directors perceive that their assessment measures
      demonstrate achievement of program goals and objectives. Programs are moving
      beyond use of licensure tests to assess educational outcomes. Assessment of
      knowledge and skills is commonly performed, assessment of values/beliefs is
      performed less frequently, and postgraduate surveys are generally used in the
      assessment of relationships/behaviors.

PMID- 1624996
TI  - A short-term epidemiological study of median nerve dysfunction in practicing
      dental hygienists.
AB  - The purpose of this study was to assess over time changes in median nerve
      function in a group of 20 students who entered the University of Minnesota dental
      hygiene program in 1986. This is a follow-up report on 16 of the 20 students who
      were evaluated two years postgraduation in 1990. Comparisons were made with prior
      evaluations of the subjects completed at graduation in 1988, and one year
      postgraduation in 1989. Digital vibrometry was used to evaluate median nerve
      sensibility threshold at each of the time periods studied. Analysis revealed that
      after one year of clinical practice, there was a mean sensibility threshold shift
      of 11.04% in the left median nerve and 8.42% in the right median nerve as
      measured by digital vibrometry. Results at two years postgraduation indicated
      that the threshold shift observed in an earlier study had been arrested. The
      reasons appeared to be twofold: (1) a period of work hardening with a concept of
      neuromuscular ligamentous tissue hypertrophy or adaptation to the rigors of
      dental hygiene practice, and/or (2) the practicing dental hygienist had learned
      to become more efficient in the provision of hygiene procedures. There were no
      reported symptoms of median nerve dysfunction and none of the subjects had been
      diagnosed as having CTS at any time during the two years since graduation.
      Continued evaluations will be necessary to determine whether the observations
      noted during the second year postgraduation evaluation indicated temporary or
      permanent slowing of the conditions necessary for the development of CTS.

PMID- 1624997
TI  - Factors influencing the selection of dental hygiene as a profession.
AB  - Since the mid-1970s, the dental hygiene profession has experienced a decline in
      the number of applicants. Reasons cited for this decline are fewer traditional
      college-age students, an increase in the career opportunities available to women,
      and a decrease in student financial aid. Four-year dental hygiene programs have
      experienced applicant decline faster than two-year programs. The purpose of this
      study was to determine factors that influenced university freshmen to designate
      dental hygiene as a career choice. Factors examined included reasons for choosing
      or not choosing a career in dental hygiene, and retention in the college major
      chosen. A questionnaire was mailed to three groups of students who entered the
      University of North Carolina-Chapel Hill as freshmen from 1985 through 1987: (1)
      all students who designated dental hygiene as a major on their entrance
      application; (2) a random sample who did not; and (3) all the freshman during
      that time period who subsequently matriculated into the dental hygiene program.
      The overall response rate was 78% (n = 80). Subjects began to explore career
      opportunities at a mean age of 16. Having a family member/friend in the selected
      field was found to be the most influential factor in career selection. Among
      dental hygiene students, contact with a dental hygienist was perceived to be
      influential in their career choice. Entering college freshmen exhibited a lack of
      knowledge about the dental hygiene profession, and most had not received any
      information about dental hygiene in high school. These findings can be used to
      develop recruitment strategies.

PMID- 1624998
TI  - Carpal tunnel syndrome. Risk factors and preventive strategies for the dental
      hygienist.
AB  - Carpal tunnel syndrome (CTS) is well recognized as an occupational risk for
      dental hygienists. The contributing risk factors fall primarily into two
      categories: medical and occupational. The purposes of this paper are to examine
      the factors that predispose one to CTS in order to increase awareness among
      dental hygienists, and to offer preventive strategies that can be incorporated
      into daily practice.

PMID- 1625000
TI  - Use, need and desire for pain control procedures by Iowa hygienists.
AB  - A survey of dental hygienists licensed and residing in Iowa was conducted in the
      fall of 1987. The response rate after two mailings was 596 of 705 (84.5%). Of the
      596, the responses of those who provided clinical services for adults in Iowa (n
      = 421) were analyzed for information regarding pain control. The survey was
      designed to collect demographic information and to determine hygienists' use and
      perception of the need and desire for pain control measures. Nearly 70% of the
      practitioners reported that their patients needed anesthesia but did not receive
      it. The main reason given for not asking their dentist/employer to provide pain
      control measures was that time did not permit. The estimated numbers of patients
      who received pain control measures per month was low: a mode of 1 with a median
      of 1 to 2 for local anesthesia, and a mode of 0 and median of 2 for nitrous oxide
      analgesia. Investigators examined the strength of correlations between the
      independent variables of practice and hygienist characteristics, and the
      dependent variables of use and perception of the need and desire for pain control
      measures. Hygienists who provided selected periodontal services and those who
      worked in periodontal practices were more likely to ask the dentist to provide
      pain control measures. Local anesthesia was used more frequently by those
      hygienists who saw more patients with pockets equal to or greater than 4 mm. Use
      of nitrous oxide analgesia in practice was highly correlated with preparation in
      the use of nitrous.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1624999
TI  - Effectiveness of a continuing education course in local anesthesia for dental
      hygienists.
AB  - The knowledge, skill level, and clinical practice habits of 97 dental hygienists
      were assessed after the hygienists completed a 24-hour continuing education
      course in local anesthesia. Three survey methods were used to assess changes: a
      written pretest/posttest, self-reports, and employer-reported behavior change.
      The self-report was completed prior to the course and again one month and six
      months after completion of the course. The dentists/employers completed the
      survey after six months. Data were analyzed by paired t-tests. There was a
      significant improvement in knowledge between the pretest and posttest, an
      increase in the number of dental hygienists administering local anesthesia, and
      an increased frequency of its use in the practice setting at both one and six
      months after the course. The majority of the dentists/employers stated that
      completion of the course by the dental hygienists had a positive impact on their
      practices as demonstrated by the practice running more smoothly, improved quality
      of dental hygiene services, more satisfied patients, and increased productivity
      of the dental hygienists.

PMID- 1625001
TI  - Sexual harassment within dental offices in Washington State.
AB  - Sexual harassment has been identified as a significant problem for women in the
      work force today. The purpose of this pilot study was to provide a preliminary
      assessment of the perceived problem of sexual harassment of registered dental
      hygienists (RDHs) in Washington State. The specific aim of the fall 1990 study
      was to examine the following variables: incidence of sexual harassment in the
      dental workplace; frequency and severity; perpetrators; perceptions of the
      general seriousness of harassment in the oral healthcare professions; different
      actions taken by victims following harassment; known incidents in the workplace;
      and demographic characteristics of respondents, including career age, educational
      level, type of oral healthcare practice setting, and birth year. Data were
      gathered from a 30% random sample of 2,138 registered dental hygienists in
      Washington State (n = 650) by means of a questionnaire. An initial mailing plus
      one follow-up mailing yielded a 72.6% (n = 472) response rate. Examination of the
      returned surveys disclosed that 26.3% of the respondents had personally
      experienced one or more forms of sexual harassment in their work settings. The
      most frequently reported types of sexual harassment perpetrated by both employer
      and patient were, as defined by Cooper, "aesthetic appreciation" and "active
      mental groping," followed by "social touching" and "sexual abuse," with "ultimate
      threat" reported least. Fifty-four percent of the harassed respondents (all
      women) indicated that they had been harassed by male dentists/employers, and
      37.1% reported they had been harassed by male patients, with the remaining 8%
      harassed by coworkers and others. More severe types of harassment were
      perpetrated by dentists/employers.

PMID- 1625002
TI  - Effective smokeless tobacco intervention for dental hygiene patients.
AB  - This study was designed to test the effectiveness of a smokeless tobacco (ST)
      intervention delivered in the oral healthcare office setting. A total of 518 male
      ST users were identified by questionnaire in clinic waiting rooms and then
      randomly assigned to either a usual-care control group or a special intervention
      group. Dental hygienists took the primary role in delivering the intervention,
      which consisted of a soft-tissue examination with special attention to oral
      lesions, advice to quit ST, distribution of self-help materials, a short video on
      why and how to stop using smokeless tobacco, and encouragement to set a quit
      date. Follow-up assessments conducted three months after the office visit showed
      that a significantly greater proportion of intervention group patients had
      stopped using ST (32% of the intervention group participants versus 21% of
      control group patients, kappa 2 = 8.03, p less than .01). The intervention
      protocol is described in detail so that dental hygienists may adapt it for use in
      their practice.

PMID- 1625003
TI  - Surgical repair of a craniofacial trauma patient: a case report.

PMID- 1625004
TI  - Pathophysiology and treatment of focal cerebral ischemia. Part I:
      Pathophysiology.
AB  - This article examines the pathophysiology of lesions caused by focal cerebral
      ischemia. Ischemia due to middle cerebral artery occlusion encompasses a densely
      ischemic focus and a less densely ischemic penumbral zone. Cells in the focus are
      usually doomed unless reperfusion is quickly instituted. In contrast, although
      the penumbra contains cells "at risk," these may remain viable for at least 4 to
      8 hours. Cells in the penumbra may be salvaged by reperfusion or by drugs that
      prevent an extension of the infarction into the penumbral zone. Factors
      responsible for such an extension probably include acidosis, edema, K+/Ca++
      transients, and inhibition of protein synthesis. Central to any discussion of the
      pathophysiology of ischemic lesions is energy depletion. This is because failure
      to maintain cellular adenosine triphosphate (ATP) levels leads to degradation of
      macromolecules of key importance to membrane and cytoskeletal integrity, to loss
      of ion homeostasis, involving cellular accumulation of Ca++, Na+, and Cl-, with
      osmotically obligated water, and to production of metabolic acids with a
      resulting decrease in intra- and extracellular pH. In all probability, loss of
      cellular calcium homeostasis plays an important role in the pathogenesis of
      ischemic cell damage. The resulting rise in the free cytosolic intracellular
      calcium concentration (Ca++) depends on both the loss of calcium pump function
      (due to ATP depletion), and the rise in membrane permeability to calcium. In
      ischemia, calcium influx occurs via multiple pathways. Some of the most important
      routes depend on activation of receptors by glutamate and associated excitatory
      amino acids released from depolarized presynaptic endings. However, ischemia also
      interfers with the intracellular sequestration and binding of calcium, thereby
      contributing to the rise in intracellular Ca++. A second key event in the
      ischemic tissue is activation of anaerobic glucolysis. The main reason for this
      activation is inhibition of mitochondrial metabolism by lack of oxygen; however,
      other factors probably contribute. For example, there is a complex interplay
      between loss of cellular calcium homeostasis and acidosis. On the one hand, a
      rise in intracellular Ca++ is apt to cause mitochondrial accumulation of calcium.
      This must interfere with ATP production and enhance anaerobic glucolysis. On the
      other hand, acidosis must interfere with calcium binding, thereby contributing to
      the rise in intracellular Ca++.

PMID- 1625005
TI  - Results of anterior temporal lobectomy that spares the amygdala in patients with
      complex partial seizures.
AB  - In December, 1980, the authors modified their anterior temporal lobectomies to
      exclude the amygdala from resection, a decision influenced by the dearth of
      pathology in the amygdala compared to the hippocampus. Furthermore, it had never
      been demonstrated that a good result was contingent upon including the amygdala
      per se in the lobectomy. Fifty-five (79%) of 70 patients in whom the amygdala was
      not resected were benefited by surgery. This result is similar to that achieved
      in series of anterior temporal lobectomies that include the amygdala in the
      resection. The results take on a special significance when considered together
      with those of amygdala-hippocampectomy which has been effective for controlling
      complex partial seizures of temporal mesiobasal origin (the region of the
      hippocampus, parahippocampal gyrus, and amygdala). A survey of the combined
      results strongly suggests that the anterior hippocampus and/or associated
      entorhinal cortex may be all that need be removed to control complex partial
      seizures caused by a temporal mesiobasal focus.

PMID- 1625006
TI  - Seizure outcome following standard temporal lobectomy: correlation with
      hippocampal neuron loss and extrahippocampal pathology.
AB  - The authors reviewed 149 patients who underwent standard anterior temporal
      lobectomies for intractable complex partial epilepsy with a mean follow-up period
      of 5 years. Quantitative analyses of hippocampal neuron loss showed that all
      patients had some cell loss compared to control hippocampi obtained at autopsy.
      The average hippocampal cell loss was categorized as severe (greater than 30% of
      autopsy control levels) or mild. Analysis of hippocampal and extrahippocampal
      pathologies showed that in 109 cases (73%, the hippocampal lesion group)
      hippocampal cell loss was mild in 17 cases (16%) and severe in 92 cases (84%); in
      the remaining 40 cases (27%, the extrahippocampal structural lesion group)
      hippocampal cell loss was mild in 24 cases (60%) and severe in 16 (40%). The
      first index of surgical outcome was worthwhile seizure reduction, which occurred
      in 94 cases (86%) with mild or severe hippocampal lesions and in 33 cases (82%)
      with extrahippocampal pathology. In the hippocampal lesion group, worthwhile
      seizure reduction occurred in 90% of cases with severe and in only 65% of cases
      with mild hippocampal cell loss (p = 0.015). In the extrahippocampal pathology
      group, worthwhile seizure was not statistically different, whether hippocampal
      cell loss was severe (94% of cases) or mild (75% of cases). The second index of
      surgical outcome was the occurrence of residual seizures in the patients with
      worthwhile seizure reduction, which would indicate remaining epileptogenic
      tissue. In the hippocampal lesion group, the incidence of residual seizures was
      not statistically different whether hippocampal cell loss was severe (24% of
      cases) or mild (45% of cases). However, in the extrahippocampal pathology group,
      residual seizures occurred in 53% of cases with severe cell loss (dual pathology)
      but in only 11% of cases with mild cell loss (p = 0.025). Worthwhile seizure
      reduction can be predicted by the presence of either severe hippocampal cell loss
      or an extrahippocampal structural lesion. However, residual seizures more
      frequently follow in cases with a combination of both (extrahippocampal pathology
      associated with severe hippocampal cell loss, or dual pathology), suggesting that
      epileptogenic tissue more likely extends outside the boundaries of a standard
      temporal lobectomy.

PMID- 1625007
TI  - Fentanyl-induced electrocorticographic seizures in patients with complex partial
      epilepsy.
AB  - Although electrical seizure activity in response to opioids such as fentanyl has
      been well described in animals, scalp electroencephalographic (EEG) recordings
      have failed to demonstrate epileptiform activity following narcotic
      administration in humans. The purpose of this study was to determine whether
      fentanyl is capable of evoking electrical seizure activity in patients with
      complex partial (temporal lobe) seizures. Nine patients were studied in whom
      recording electrode arrays had been placed in the bitemporal epidural space
      several days earlier to determine which temporal lobe gave rise to their
      seizures. The symptomatic temporal lobe was localized by correlating clinical and
      electrical seizure activity obtained during continuous simultaneous videotape and
      epidural EEG monitoring. In each patient, clinical seizures and electrical
      seizure activity were consistently demonstrated to arise unilaterally from one
      temporal lobe (four on the right, five on the left). During fentanyl induction of
      anesthesia in preparation for secondary craniotomy for anterior temporal
      lobectomy, eight of the nine patients exhibited electrical seizure activity at
      fentanyl doses ranging from 17.7 to 35.71 micrograms.kg-1 (mean 25.75
      micrograms.kg-1). More importantly, four of these eight seizures occurred
      initially in the "healthy" temporal lobe contralateral to the surgically resected
      lobe from which the clinical seizures had been shown to arise. These findings
      indicate that, in patients with complex partial seizures, moderate doses of
      fentanyl can evoke electrical seizure activity. The results of this study could
      have important implications for neurosurgical centers where electrocorticography
      is used during surgery for the purpose of determining the extent of the
      resection.

PMID- 1625008
TI  - Arteriovenous malformations of the brain: choosing embolic materials to enhance
      safety and ease of excision.
AB  - The authors report their experience with surgical resection of 108 previously
      embolized arteriovenous malformations (AVM's). Embolization was performed via
      only transfemoral catheterization in 70 lesions and via the surgical exposure of
      feeding vessels in 32. The remaining six patients were referred for resection
      following silicone sphere embolization elsewhere. Materials used included
      polyvinyl alcohol (PVA) foam, platinum microcoils, detachable silicone balloons,
      surgical silk, a mixture of 33% ethanol and microfibrillar collagen, and isobutyl
      cyanoacrylate (IBCA). It is believed that proximal arterial occlusion with
      balloons is an inferior choice for preresection embolization, because the
      technical difficulty of placement is high and the nidus of the AVM is unaffected.
      Vascular coagulation and section and AVM retraction are more difficult with IBCA;
      therefore, this is also considered an inferior choice. Among the materials
      studied, the combination of PVA for distal occlusion and microcoils for proximal
      occlusion appears to be the superior choice. Fewer complications (stroke or
      hemorrhage) are seen when intraarterial Amytal (amobarbital) testing is used to
      guide the embolization. Data regarding toxicity, oncogenicity, and vascular
      metabolism or recanalization associated with PVA, IBCA, and n-butyl cyanoacrylate
      are reviewed.

PMID- 1625009
TI  - Symptomatic and functional outcome of stereotactic ventralis lateralis
      thalamotomy for intention tremor.
AB  - In the past, intention tremor has responded well to selected neuroablative
      procedures; however, objective symptomatic and functional outcomes of ventralis
      lateralis (VL) thalamotomy specifically for intention tremor in the post
      computerized tomography era has rarely been reported. This series explored the
      symptomatic and functional impact of VL thalamotomy on 14 patients presenting at
      the Mayo Clinic with severe, refractory intention tremor due to multiple
      sclerosis (five patients), trauma (four patients), or stroke (five patients).
      General neurological examinations, psychometric evaluations, speech pathology
      assessments, and neuroradiological scans were performed. Pre- and postoperative
      disability were graded according to a modified form of an established rating
      scale for tremor. All patients received VL radiofrequency thalamotomies utilizing
      neurophysiological recording and stimulation control. Contralateral targeted
      upper-extremity tremor remained symptomatically absent or markedly reduced in
      81.8% of cases (mean follow-up period 23.4 months). The median disability score
      was reduced by 12 points (0.02 less than p less than 0.05). Persistent surgical
      morbidity was limited to two patients with mild, nondisabling dysarthrias. One
      elderly patient died of pulmonary complications 2 weeks postoperatively. There
      were no reported surgically induced exacerbations in multiple sclerosis; however,
      some of these patients exhibited difficulties with electrophysiological
      localization. These results compare favorably with those reported in the
      literature and confirm that stereotactic VL thalamotomy for debilitating
      intention tremor carries a low surgical risk and can be an effective treatment
      option for properly selected patients.

PMID- 1625010
TI  - Atretic cephalocele: the tip of the iceberg.
AB  - Atretic cephalocele appears as an unimportant and benign lesion. This
      malformation consists of meningeal and vestigial tissues (arachnoid, glial, or
      central nervous system rests). The authors report the findings in 16 cases (seven
      parietal and nine occipital) of rudimentary cephaloceles. Twelve patients
      presented with associated brain abnormalities detected by either computerized
      tomography (CT) or magnetic resonance imaging (MR). Nine lesions also exhibited
      an anomalous vascular component demonstrated by CT or MR imaging or at surgery.
      The existence of this tiny malformation in five cases was the main diagnostic
      clue to a severe complex of cerebral anomalies, namely cerebro-oculomuscular
      (Walker-Warburg) syndrome. An occipital location of the atretic cephalocele was
      associated with the worst prognosis, with only two children developing normally.
      However, a parietal location carried a better prognosis, which is contrary to the
      outcome reported in the current literature. The authors classify atretic
      cephaloceles into two types based on histological examination of the surgical
      specimens, and suggest that these types represent different stages in the
      development of this malformation. It is concluded that, in the evaluation of the
      atretic cephalocele, the neurosurgeon is obliged to proceed to a detailed
      neuroradiological study of the patient and that the prognosis does not depend on
      the existence of the cephalocele itself, but rather on associated "occult" brain
      anomalies.

PMID- 1625011
TI  - Intrathecal baclofen for spasticity of spinal origin: seven years of experience.
AB  - A total of 66 consecutive patients with severe spasticity of spinal cord origin
      were screened with intrathecal baclofen, and all but two responded with a two
      point decrease in their Ashworth spasticity scale and/or spasm scale score. Of
      these, 62 elected to receive chronic intrathecal baclofen administration by means
      of an implanted delivery system. These patients have been followed for an average
      of 30 months (the first three for 81 months). Intrathecal baclofen has been well
      tolerated and all serious side effects were transient and have been managed by
      dose adjustments. The pump presently available has worked safely; the only
      problem has been stalling in 7% of these devices. The catheter system has had to
      be repaired in just over one-half of the patients and is the main cause of
      interruption of drug delivery. Of the 62 patients implanted, 52 (84%) continue to
      be treated adequately for spasticity; there are three poor long-term responders,
      four deaths due to underlying disease, and three whose participation has been
      voluntarily withdrawn. It is suggested that long-term control of spinal
      spasticity by intrathecal baclofen can be achieved in most patients.

PMID- 1625013
TI  - On spinal osteochondromas.
AB  - Osteochondromas (or osteocartilaginous exostoses) make up about 30% to 40% of
      benign bone tumors. Most are solitary lesions but some are multiple, usually with
      autosomal dominant inheritance. From 1% to 4% of osteochondromas occur in the
      spine, where they can cause a variety of signs and symptoms, including those of
      spinal cord or spinal root compression. The authors present five patients with
      osteochondromas of the spine and review the findings together with those of over
      130 cases reported since 1907. The cases were divided into: 1) spinal
      osteochondromas in patients with multiple osteochondromas, and 2) solitary
      osteochondromas occurring in the spine. The age (mean +/- standard error of the
      mean) of patients in the first group was 21.6 +/- 1.8 years compared to 30.0 +/-
      2.1 years for those in the second group (p less than 0.02). There was a
      significant male predominance overall (M:F = 2.5:1; p less than 0.0005). In both
      groups, one-half of the lesions involved the cervical spine. Symptoms are caused
      by pressure on adjacent structures. Spinal cord compression was reported more
      than twice as frequently in the multiple osteochondroma group as in the single
      osteochondroma group (77% vs 33%; p less than 0.0005). Computerized tomography
      (CT) is the imaging procedure of choice. In both groups, the majority of
      surgically treated patients (90% and 88%, respectively) improve, with about three
      quarters of the improved patients having no residual disease or only minor
      deficits.

PMID- 1625012
TI  - Management of cervical spinal cord injury in ankylosing spondylitis: the
      intervertebral disc as a cause of cord compression.
AB  - Twenty-one patients with universal syndesmophytosis due to ankylosing spondylitis
      were identified in a consecutive series of 1578 patients with acute spine and
      spinal cord injuries. They were predominantly male, older than spinal cord
      injured patients in general, and most were injured by falls. Approximately one
      half were managed by halo-vest immobilization alone with good clinical and
      radiological outcomes. The remainder required surgery either for recurrent
      dislocation or for spinal cord compression associated with neurological
      deterioration. Extradural hematoma, a recognized cause of spinal cord compression
      in ankylosing spondylitis patients with spinal fractures, was encountered in two
      patients. Herniated intervertebral disc as a cause of spinal cord compression in
      ankylosing spondylitis does not appear to have been previously reported and was
      recognized three times in the present series, once in association with extradural
      hematoma. The pathology of ankylosing spondylitis is such that the nucleus
      pulposus tends to be spared, allowing disc herniation to occur in the heavily
      ossified spine. In virtually all patients, satisfactory correction of the flexion
      deformity could be safely accomplished following spinal fracture. It is concluded
      that fracture/dislocations of the cervical spine should be managed initially by
      halo-vest immobilization, without prior traction and with careful incremental
      correction of flexion deformity. Decompression is performed as required for
      extradural hematoma or intervertebral disc herniation, and internal fixation is
      carried out for recurrent dislocation.

PMID- 1625014
TI  - Loss of cerebral regulation during cardiac output variations in focal cerebral
      ischemia.
AB  - Focal cerebral ischemia was induced in anesthetized macaque monkeys by unilateral
      middle cerebral artery occlusion. The effect of blood volume expansion by a
      colloid agent and subsequent exsanguination to baseline cardiac output (CO) on
      local cerebral blood flow (CBF) was measured by the hydrogen clearance technique
      in both ischemic and nonischemic brain regions. Cardiac output was increased to
      maximum levels (159% +/- 92%, mean +/- standard error of the mean) by blood
      volume expansion with the colloid agent hetastarch, and was then reduced a
      similar amount (166% +/- 82%) by exsanguination during the ischemic period. Local
      CBF in ischemic brain regions varied directly with CO, with a correlation
      coefficient of 0.89 (% change CBF/% change CO), while CBF in nonischemic brain
      was not affected by upward or downward manipulations of CO. The difference in
      these responses between ischemic and nonischemic brain was highly significant (p
      less than 0.001). The results of this study show a profound loss of regulatory
      control in ischemic brain in response to alterations in CO, thereby suggesting
      that blood volume variations may cause significant changes in the intensity of
      ischemia. It is proposed that CO monitoring and manipulation may be vital for
      optimum care of patients with acute cerebral ischemia.

PMID- 1625015
TI  - Aneurysm recurrence following endovascular balloon occlusion.
AB  - Endovascular balloon occlusion is an alternative treatment for surgically
      unclippable cerebral aneurysms. The results of aneurysm occlusion with either a
      silicone or a latex balloon in a common carotid artery bifurcation aneurysm model
      are compared to determine which type of balloon was least likely to result in
      aneurysm recurrence. Five rabbits each underwent endovascular balloon occlusion
      with either a silicone or a latex balloon, with seven rabbits serving as
      controls. At 3 months postocclusion, nine of the 10 balloon-treated aneurysms had
      recurred. The recurrent aneurysm tended to be larger in animals treated with
      silicone than with latex balloons. A dense fibrotic response was present around
      the collar of the latex balloons, but no significant fibrotic response was found
      in the silicone balloon group. This study suggests that with currently available
      balloons, the initial complete angiographic obliteration of an aneurysm following
      balloon occlusion should not be interpreted as a cure and that periodic follow-up
      angiography should be performed.

PMID- 1625017
TI  - Oxyhemoglobin stimulation of endothelin production in cultured endothelial cells.
AB  - Oxyhemoglobin and endothelin have both been linked to the development of the
      severe and sustained cerebral vasospasm associated with subarachnoid hemorrhage.
      The effects of oxyhemoglobin on endothelin biosynthesis in cultured endothelial
      cells were evaluated. Oxyhemoglobin (0.01 to 100 microM) produced concentration
      dependent increases in immunoreactive endothelin levels in bovine pulmonary
      artery endothelial cell-conditioned medium. The median effective concentration
      for oxyhemoglobin-induced increases in immunoreactive endothelin levels was
      approximately 0.5 microM, and the maximum stimulation of immunoreactive
      endothelin levels was approximately 5.5-fold over basal conditions. In addition
      to directly stimulating basal production of immunoreactive endothelin,
      oxyhemoglobin significantly augmented immunoreactive endothelin production
      following platelet-mediated stimulation of endothelin production. An l-arginine
      analog inhibitor of nitric oxide synthase, L-NG-monomethyl arginine (L-NMMA, 200
      microM), did not significantly affect basal immunoreactive endothelin levels.
      However, L-NMMA significantly augmented platelet-induced immunoreactive
      endothelin production. Methylene blue (10 microM), an inhibitor of soluble
      guanylate cyclase, did not significantly affect basal immunoreactive endothelin
      levels, nor did it significantly affect the platelet-mediated stimulation of
      immunoreactive endothelin production in cultured endothelial cells. The present
      results reveal that oxyhemoglobin can directly stimulate endothelin biosynthesis
      in cultured endothelial cells. This newly identified property of oxyhemoglobin
      suggests a potential mechanism for the sustained and severe cerebral vasospasm
      associated with subarachnoid hemorrhage.

PMID- 1625016
TI  - Cytokines and immunoregulatory molecules in malignant glial neoplasms.
AB  - Cytokines are important regulatory proteins controlling growth and
      differentiation of normal and malignant glial cells. Astrocytes and microglial
      cells produce and respond to many of the same cytokines employed by cells of the
      immune system. The authors have analyzed 15 histologically confirmed malignant
      glial neoplasms for the presence of infiltrating lymphocytes, macrophages,
      cytokines, and other immunoregulatory molecules using a panel of specific
      monoclonal and polyclonal antibodies on frozen-tissue sections. All neoplasms
      showed focal T-cell infiltration with CD8 cells predominating. Infiltration of
      activated macrophages (positive for CD11c, class II, and interleukin-2 receptor)
      was marked in all tumors. Within the neoplasm, tumor necrosis factor-alpha (TNF
      alpha)- and interleukin (IL)-6-positive macrophages were prominent in five cases,
      while the tumor cells themselves were only weakly positive. In the other 10
      cases, the numerous infiltrating macrophages were only rarely immunoreactive for
      TNF-alpha or IL-6. Transforming growth factor-beta (TGF-beta) immunoreactivity
      was most prominent in those tumors with little TNF-alpha-positive macrophage
      infiltration, although intratumoral variability was present. This study suggests
      that, in malignant gliomas, the cytokines TNF-alpha and IL-6, although weakly
      present in neoplastic cells, are most prominent in infiltrating macrophages and
      in those regions of the tumors that show little immunoreactivity for TGF-beta.
      The important interactions among neoplastic, reactive glial, and inflammatory
      cells, which regulate tumor growth, are likely to be in part mediated through
      these molecules.

PMID- 1625018
TI  - A morphological and ultrastructural investigation of normal mouse brain tissue
      after intracerebral injection of tumor necrosis factor.
AB  - Morphological and ultrastructural changes in normal mouse brain tissue were
      investigated after intracerebral stereotactic injections of tumor necrosis factor
      (specific activity: 2.0 x 10(6) U/mg protein) into the right frontal lobe. The
      mice received either a single infusion or multiple tumor necrosis factor
      infusions in three different dose groups (10, 100, or 500 U). Compared with sham
      treated control mice that received adjusted intracerebral injections of purified
      albumin, the tumor necrosis factor-treated mice in all dose groups did not show
      any specific in vivo behavioral abnormalities during the 2 months of study
      following the infusions. Histological studies revealed hemorrhage attributable to
      the mechanics of the intracerebral infusions, a thickening of the arachnoid
      membranes, a reactive gliosis, and neutrophilic and/or mononuclear cell
      infiltration along the infusion pathway. A local neutrophilic response was
      prominent 1 day after tumor necrosis factor injection. An immunohistochemical
      analysis indicated that the mononuclear cell infiltration consisted of
      lymphocytes and macrophages. Except for the transient neutrophilic infiltration,
      these histological alterations did not differ from those seen in the sham-treated
      control groups, and most nonspecific reactive changes disappeared within 8 weeks
      after the injections. Furthermore, an ultrastructural study showed no apparent
      pathological changes in the cytoplasmic organelles of neuronal, glial, and
      endothelial cells in the tumor necrosis factor-injected mouse specimens. These
      results suggest that the tumor necrosis factor injections caused no specific
      toxicity and did not alter the parenchymal and stromal cells comprising normal
      mouse brain tissue.

PMID- 1625019
TI  - Diffuse leptomeningeal involvement by a ganglioglioma in a child. Case report.
AB  - Gangliogliomas are tumors composed of neuronal and glial elements that typically
      grow slowly by expansion only. This report describes a 20-month-old girl with a
      ganglioglioma that extensively involved the subarachnoid space; microscopic foci
      of tumor were found in the brain and spinal cord. Despite chemotherapy and
      radiation therapy, the child died 5 months after diagnosis. Molecular genetic
      analysis showed loss of chromosome 17p DNA sequences in the tumor tissue.

PMID- 1625020
TI  - Chiari malformation with compression of the medulla oblongata by the vertebral
      arteries. Case report.
AB  - A unique case is reported of Chiari malformation and compression of the medulla
      oblongata by both vertebral arteries. A 39-year-old woman complained of unsteady
      giant and motor weakness of the legs, and magnetic resonance imaging revealed the
      malformation and compression. Vascular decompression of the vertebral arteries
      was performed using synthetic (Gore-tex) vascular strips following posterior
      fossa decompression.

PMID- 1625021
TI  - Two fluid-blood density levels in chronic subdural hematoma. Case report.
AB  - The case of a chronic subdural hematoma is presented in which the computerized
      tomography scan showed two parallel fluid-blood density levels. The authors
      emphasize the importance of this finding in the management of such cases.

PMID- 1625022
TI  - Ruptured dermoid tumor of the cavernous sinus associated with the syndrome of fat
      embolism. Case report.
AB  - The syndrome of fat embolism is a well-known clinicopathological entity that may
      appear 2 to 4 days after skeletal trauma; nontraumatic causes have been
      recognized, however. This report details the fat embolism syndrome occurring in a
      patient after surgery within the cavernous sinus to remove a dermoid tumor.

PMID- 1625023
TI  - Suction control attachment for ultrasonic aspirators. Technical note.
AB  - A hand control to regulate suction has been developed and refined for use with
      ultrasonic aspirators. The instrument and its use are described.

PMID- 1625024
TI  - Barnes Hospital and the Washington University Medical Center.
AB  - The author documents the development of the Medical School at Washington
      University since 1891, when the St. Louis Medical College was first included as
      part of the University. In 1909, Robert Brookings, President of the Corporation
      of Washington University, acquired a large endowment and moved the clinical and
      hospital facilities to a new location, enabled by the estate of Robert Barnes.
      Harvey Cushing was offered the chair of surgery but eventually decided in favor
      of Harvard University in 1910. Dr. Ernest Sachs was recruited to Washington
      University by Dr. Fred Murphy, and in 1919 became the first ever Professor of
      Neurological Surgery. The history of neurosurgery and those who served it at the
      Washington University Medical Center and Barnes Hospital is recounted.

PMID- 1625025
TI  - Methylprednisolone for spinal cord injury.

PMID- 1625026
TI  - Methylprednisolone for spinal cord injury.

PMID- 1625027
TI  - Comparability of vasospasm in primates.

PMID- 1625028
TI  - Cruciate paralysis.

PMID- 1625029
TI  - Periodontoid disc herniation vs. degenerated ligaments presenting as extradural
      mass.

PMID- 1625030
TI  - Periodontoid disc herniation vs degenerated ligaments presenting as extradural
      mass.

PMID- 1625031
TI  - Facial nerve decompression following a basilar skull fracture.

PMID- 1625032
TI  - Aortic lysosomal hydrolases and pathological alterations in hypertensive and/or
      atherogenic diet fed rhesus monkeys.
AB  - Aortic lysosomal enzyme activities have been evaluated in relation to the extent
      and severity of aortic atherosclerosis in rhesus monkeys to see the biochemical
      and pathological effects of renal hypertension in experimental atherogenesis. The
      frequency and size of atherosclerotic plaques in aortas of atherogenic diet fed
      and/or hypertensive monkeys were calculated and an overall score of aortic
      atherosclerosis was computed on the basis of the gamut of pathological findings
      in relation to the biochemical alterations. This overall score of atherosclerosis
      was found to be significantly (p less than 0.01) greater in animals of all
      experimental groups as compared to the controls.

PMID- 1625033
TI  - Post-vagotomy variations of gastric mucosal mast cells in the rat.
AB  - The effects of the vagus and its action on the mucosal mast cells (MMC) of the
      secretory portion of the rat stomach are analyzed by observing the consequences
      caused by subdiaphragmatic truncal vagotomy on the MMC in terms of cell count and
      degranulation over a period of four months. Observations showed a gradual
      decrease in the number of mast cells/mm2, an increase in the percentage of MMC in
      a state of degranulation, but the same number of degranulated cells/mm2. This
      suggests that the vagus controls both numerically and functionally the MMC
      population in the secretory portion of the rat stomach.

PMID- 1625034
TI  - Tissue binding pattern of plant lectins in benign and malignant lesions of
      thyroid.
AB  - N-acetyl D-galactosamine specific lectins were isolated from the seeds of Jack
      Fruit (Artocarpus integrifolia) and Winged bean (Psophocarpus tetragonolobus) and
      D-galactose specific lectin was isolated from peanut (Arachis hypogaea). These
      lectins were conjugated to Horse Radish Peroxidase (HRP) and were used to study
      the lectin binding properties of benign and malignant lesions of the thyroid. For
      comparison of the results 10 normal fresh autopsy specimens were included in the
      study. The Peanut lectin (PNL) and Jack fruit lectin (JFL) conjugates showed
      positive binding with the cells in different lesions, while Winged Bean Lectin
      (WBL), despite its having a common inhibitory sugar, showed no binding even after
      neuraminidase treatment. These lectins revealed difference in the composition of
      glycoconjugates of benign and malignant thyroid cells. The HRP conjugated JFL and
      PNL may be of use in distinguishing carcinomatous tissues from benign tissues
      which makes them potential tools in the differential diagnosis of thyroid
      lesions.

PMID- 1625035
TI  - Regenerative capacity of minced muscle tissue in newborn and adult guinea pigs.
AB  - Our data showed that the regenerative capacity of skeletal muscle in newborn
      guinea pigs was less than in adults. In newborn guinea pigs the active
      regeneration of muscle tissue was only observed during the 1st week after mincing
      of gastrocnemius muscle. The 14-day grafts were characterized by having smaller
      muscle fibers and greater amounts of interstitial connective tissue. Furthermore,
      the active growth of connective tissue was more pronounced. The grafts did not
      recover contractility. In 60 day grafts the ectopic formation of 2-3 bone
      cartilage nodules was observed. In adult guinea pig grafts the quantity of muscle
      tissue was twice as great as in newborns. Muscle tissue was formed throughout the
      graft, but no bone-cartilage nodules were present. All 60 day grafts contracted
      when the tibial nerve was stimulated, but this contractility was very weak.
      However, the reestablishment of neuromuscular junctions had occurred. The age
      characteristics of skeletal muscle regeneration were the same both in the term
      guinea pig and in the rat.

PMID- 1625036
TI  - A light and electron microscopic histochemical study on lectin binding to cells
      with high metastatic potential in Lewis lung carcinoma.
AB  - Lectin binding to tumor cells in tissue sections of nonmetastatic and metastatic
      murine Lewis lung carcinoma (LLC) was assessed by light and electron microscopy
      using a lectin-gold technique. Ulex europaeus agglutinin-I (UEA-I) and peanut
      agglutinin (PNA) showed no binding, whereas concanavalin A (Con A), soybean
      agglutinin (SBA), Dolichos biflorus agglutinin (DBA), Maclura pomifera agglutinin
      (MPA), and Ricinus communis agglutinin-I (RCA-I) bound equally to the
      transplanted sites and metastases. However, wheat germ agglutinin (WGA) bound to
      metastases more highly than to the transplanted sites and there was a
      statistically significant difference (P less than 0.01) between the transplanted
      sites and metastases with regard to pre-embedding method. The tumor cells binding
      to WGA clearly decreased in number after sialic acid pretreatment and were rich
      in more well-differentiated organelle. In the bromodeoxyuridine (BrdUrd) labeling
      in vivo, cell proliferation was greater in the metastatic sites than in the
      transplanted sites. The above findings suggest that glycoconjugates on the tumor
      cell surface are altered in the process of metastasis and correlate with
      metastatic potential and cell proliferation.

PMID- 1625037
TI  - An antigranulomatous effect of glycyrrhizin.
AB  - In our previous study, we reported that monocyte-activation inhibitory factor was
      produced by stimulated fibroblasts. We also previously found that glycyrrhizin
      (GL) had an ability to affect fibroblasts because the proliferation of human
      fibroblasts was increased by GL. In this study, we demonstrated that culture
      supernatants from the GL-stimulated fibroblasts inhibited the activation of
      normal human peripheral monocytes in vitro. Then, studies were performed to know
      whether GL affects fibroblasts to suppress the granuloma formation. Pulmonary
      granulomas were induced in guinea pigs by Sephadex beads. The formation of
      granulomas was significantly suppressed by intraperitoneal injections of GL.
      Thus, GL was shown to have antigranulomatous effects in vivo.

PMID- 1625038
TI  - Modulation of alpha interferon levels by AZT treatment in HIV-seropositive
      patients.
AB  - The effect of AZT on serum HIV p24 antigen and endogenous serum alpha interferon
      levels was studied in AIDS and ARC patients. Following administration of AZT
      there was a rapid decline in the serum levels of both HIV p24 antigen and alpha
      interferon. When AZT treatment was interrupted, the levels of both HIV p24
      antigen and of interferon rapidly increased. These findings suggest that HIV or
      some other AZT sensitive microorganism is the inducer of interferon which is
      characteristically found in the serum of AIDS and symptomatic HIV infected
      patients. They also suggest that the rapid decline in interferon levels may
      underlie some of the symptomatic benefit that follows administration of AZT.

PMID- 1625039
TI  - Neurotoxic effects of platinum compounds in cultured dorsal root ganglion cells.
AB  - The neurotoxic cancer chemotherapeutic agent cis-diamminedichloroplatinum (II)
      (cis-platin) was tested in a model system of cultured embryonic chick dorsal root
      ganglion cells, in order to investigate cellular mechanisms of toxicity. At 7.5
      ug/ml, the drug caused mild toxicity. At doses of 75 ug/ml, cis-platin was toxic
      to cultures in 6 hours, in both neuronal and non-neuronal cell populations. After
      24 hours of incubation with 75 ug/ml cis-platin, there was extensive cell death.
      The trans isomer of the drug, trans-platin, was less toxic than cis-platin at
      similar doses, causing less severe damage to the cells as well as less cell
      death. With both drugs, abnormalities in patterns of nuclear staining were
      prominent, whereas neuronal cell membrane staining patterns were less affected.
      Both drugs seemed to affect non-neuronal cells to a greater extent than neurons.
      Ultrastructural findings with both drugs included nucleolar segregation;
      mitochondrial changes were nonspecific. In this in vitro system, both cis- and
      trans-platin are toxic. The toxicity appears to predominantly affect the nucleus,
      and to preferentially involve non-neuronal cells.

PMID- 1625040
TI  - The antagonistic effect of interferon-beta on the interferon-gamma-induced
      expression of HLA-DR antigen in a squamous cell carcinoma line.
AB  - We examined the effect of type I interferon (IFN) on IFN-gamma-induced HLA-DR
      antigen expression in A431 cells, a human squamous cell carcinoma line. A431
      cells expressed HLA-DR antigen when stimulated with IFN-gamma, but not with IFN
      beta. Simultaneous addition of IFN-gamma and IFN-beta to A431 cells resulted in
      significantly decreased HLA-DR antigen expression when compared to treatment with
      IFN-gamma alone. Kinetic studies revealed that IFN-beta was required
      concomitantly or prior to stimulation with IFN-gamma in order to down-regulate
      expression of HLA-DR antigens. IFN-alpha also inhibited IFN-gamma-induced HLA-DR
      antigen expression in A431 cells. Analysis of cytoplasmic mRNA showed that
      simultaneous treatment of A431 cells with IFN-gamma and IFN-beta resulted in a
      marked decrease of the level of DR alpha specific mRNA when compared to a level
      reached after treatment with IFN-gamma alone. These results suggest that type I
      IFN antagonize the IFN-gamma-induced HLA-DR antigen expression in human
      keratinocyte system, and that this antagonistic effect of type I IFN is confirmed
      as evidenced by a change in HLA-DR mRNA levels.

PMID- 1625041
TI  - New observations on the distribution of an old and forgotten model of enteritis
      in rats.
AB  - Human serum injected intravenously into rats caused multiple foci of acute
      enteritis. The enteritis had a predilection for the antimesenteric side of the
      intestine and for the zones between circumferential vessels. Despite their
      antimesenteric location, Peyer's patches tended to be spared. The details of
      distribution suggest that a gradient related to intestinal blood flow plays a
      role in development of the enteritis.

PMID- 1625042
TI  - Empowering your dental team.

PMID- 1625043
TI  - Creating the building blocks to running a successful practice--a success story.

PMID- 1625044
TI  - Anterior maxillary trauma resulting in tooth loss: an alternate treatment.

PMID- 1625045
TI  - Direct reimbursement vs. conventional dental insurance.

PMID- 1625046
TI  - Current computer usage in Indiana dental practices.
AB  - A survey of Indiana dentists reveals that increasing numbers of dental practices
      are computerized. Computer hardware, software, and various functions within
      dental practices are identified. Furthermore, the survey indicates future
      anticipated computer usage and the growing need for personnel to be trained in
      computers.

PMID- 1625047
TI  - Dental assistants, radiology, and the Indiana Law.
AB  - This article reviews the rules, regulations, and procedures which enable dental
      assistants to become radiology certified in Indiana. Dental assistants must
      participate in an American Dental Association (ADA)-accredited program or an
      Indiana State Department of Health (ISDH, formerly the Indiana State Board of
      Health)-approved on-the-job training program to qualify for the radiology
      certification examination.

PMID- 1625048
TI  - Sexual harassment.

PMID- 1625049
TI  - Sexual harassment. Looking at the law.

PMID- 1625050
TI  - Infectious waste disposal.

PMID- 1625051
TI  - The challenge of dental advertising: Oregon and the nation.

PMID- 1625052
TI  - Senior access program.

PMID- 1625053
TI  - A treatment rationale for periodontal prosthesis (it's simple, but not easy).

PMID- 1625054
TI  - GB (guanidinobenzoatase) cell surface protease and serum inhibitors in colorectal
      neoplasia.
AB  - Cell surface proteases and their inhibitors are functionally related to the
      invasive properties and metastatic potential of tumour cells. Epithelial cells of
      the colorectal mucosa possess a cell surface protease referred to as
      guanidinobenzoatase (GB), which is similar, if not identical, to plasminogen
      activator. GB exists in isoenzymatic forms, one of which is associated with
      epithelial cells of normal colorectal mucosa and of adenomatous polyps, whilst
      another isoenzymatic form is associated with colorectal adenocarcinoma cells.
      Normal serum contains inhibitor proteins which recognize the isoenzymatic form of
      GB found on normal and adenomatous polyp epithelial cells but this inhibitor does
      not recognize the isoenzymatic form of GB associated with adenocarcinoma cells.
      The fluorescent probe 9-amino-acridine locates cells possessing active GB in
      frozen sections of colorectal mucosa. A technique is described which enables
      colorectal carcinoma cells to be highlighted by fluorescence microscopy whilst
      normal epithelial cells are distinguished by their lack of fluorescence. This is
      of biological and possibly diagnostic significance.

PMID- 1625055
TI  - Reduction in apoptosis relative to mitosis in histologically normal epithelium
      accompanies fibrocystic change and carcinoma of the premenopausal human breast.
AB  - The aims of this study in 227 premenopausal women were (a) to determine the
      mitotic index (MI), the thymidine labelling index (LI), and the apoptotic index
      (AI) within the epithelial cells of histologically 'normal' human breast biopsy
      material removed away from the site of either a fibroadenoma or a carcinoma; and
      (b) to relate differences in the kinetic indices of the 'normal' epithelium to
      the pathology in the same breast diagnosed as fibroadenoma alone (125 patients),
      fibroadenoma with accompanying mild fibrocystic change (79 patients), or
      carcinoma (23 patients). Ratios of the average indices (AI/MI, AI/LI, MI/LI) were
      also calculated to minimize uncertainties related to the total cell population
      counted, the denominator in the LI, MI, and AI. All indices and ratios of indices
      were corrected for age, averaged over the cycle, and expressed as log-transformed
      values for analysis. Significant (P less than 0.001) reductions in AI and in
      apoptosis relative to mitosis (reduced AI/MI) were found in 'normal' epithelium
      from breasts having fibrocystic change (AI = 0.17 +/- 0.02; AI/MI = 1.01 +/-
      0.18) and carcinoma (AI = 0.19 +/- 0.04; AI/MI = 0.88 +/- 0.29), compared with
      breast with fibroadenoma alone (AI = 0.27 +/- 0.03; AI/MI = 1.29 +/- 0.39). In
      the absence of significant differences in MI and LI between the 'normal' tissue
      groups, this finding raises the possibility that reduced epithelial cell
      apoptosis might be causally associated with the development of fibrocystic change
      and with an increased risk of development of carcinoma.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1625056
TI  - Immunoelectron microscopy of cationized bovine serum albumin-induced
      glomerulonephritis in the rabbit.
AB  - Chronic immune complex glomerulonephritis was induced in a group of New Zealand
      white rabbits by daily intravenous injections of cationized bovine serum albumin
      (cBSA). The animals were serially killed and renal tissue was embedded in the
      hydrophilic resin Lowicryl K4M for immunoelectron microscopy. The results
      demonstrate the progressive deposition of rabbit IgG in the glomerular basement
      membrane in this model, with aggregation of immunoglobulins occurring only in the
      subepithelial space. Proteinuria developed concurrently with this event.
      Glomerular visceral epithelial cell (GVEC) endocytosis of immune material was
      observed at various stages of the disease process, suggesting that GVECs may be
      part of a clearance mechanism acting within the glomerulus.

PMID- 1625058
TI  - Diabetic glomerulosclerosis--immunogold ultrastructural studies on the glomerular
      distribution of type IV collagen and heparan sulphate proteoglycan.
AB  - We have undertaken an ultrastructural immunogold investigation of the
      distribution of type IV collagen and heparan sulphate proteoglycan (HSPG) in
      glomeruli from the kidneys of one normal control and three patients with diabetes
      mellitus and proteinuria. The sample included both diffuse and nodular diabetic
      glomerulosclerosis. In the control and diabetic kidneys, the type IV collagen was
      present predominantly on the endothelial aspect of the glomerular basement
      membrane (GBM), and by contrast the HSPG was found mainly on the epithelial side.
      In the mesangium in both control and diabetic glomeruli, type IV collagen was
      found predominantly in the central regions, while HSPG was mostly restricted to
      the region beneath the epithelial cells. Consequently, where there is a marked
      increase in mesangial matrix with nodule formation in diabetics there is a
      corresponding increase in the amount of type IV collagen but not of HSPG.
      Although the three diabetic patients were proteinuric, the HSPG was not decreased
      in the thickened GBMs.

PMID- 1625057
TI  - The effect of cyclosporin A on cationized bovine serum albumin-induced
      nephropathy in NZW rabbits.
AB  - The effect of cyclosporin A (CyA) was studied on the morphology and protein
      excretion of a rabbit chronic serum sickness nephritis using cationized bovine
      serum albumin (cBSA). One group of rabbits was given intravenous (i.v.)
      immunizing doses of cBSA and Escherichia coli endotoxin. One week later, these
      animals began a 6-week i.v. injection schedule of cBSA only. A second group
      followed the same injection protocol, but was given intramuscular (i.m.) CyA for
      3 days prior to the immunizing dose of cBSA/endotoxin and throughout the
      subsequent cBSA schedule. A third group was given i.m. CyA only. Regular blood
      samples for CyA levels were taken from animals given the drug. Two 24-h urine
      samples were obtained from all animals in the study. Analysis of the blood
      samples showed that immunosuppressive levels of CyA were achieved after two i.m.
      doses of CyA. These levels were maintained during the course of the schedule.
      Morphologically, all rabbits completing the cBSA only injection schedule showed
      evidence of an immune-mediated glomerulopathy with variably severe membranous and
      endocapillary proliferative change. Less than half the rabbits in the cBSA/CyA
      group showed any evidence of membranous change. The glomeruli of animals given
      CyA only were normal. No morphological evidence of CyA toxicity was seen in any
      animal given the drug. The proteinuria profiles, however, suggested that as well
      as reducing protein excretion in rabbits given cBSA, CyA may interact with the
      immunizing dose of cBSA to produce an early, reversible, nephrotoxic
      effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625059
TI  - Peripolar cells, granulated glomerular epithelial cells, and their relationship
      to the juxtaglomerular apparatus in malignant hypertension.
AB  - We have examined 12 autopsy kidneys from cases of malignant hypertension and
      compared them with normal controls. Peripolar cells and other granulated
      glomerular epithelial cells were counted in serial paraffin sections, and renin
      containing cells were quantified using an immunoperoxidase technique and a human
      renin antiserum. There were significantly more peripolar cells and other
      granulated glomerular epithelial cells in the cases of malignant hypertension.
      Most granulated glomerular epithelial cells were podocytes, situated at the
      periphery of the tuft. Peripolar cells correlated in number with other granulated
      glomerular epithelial cells and they had a similar distribution within the renal
      cortex, but there was no correlation between either of these cells and the number
      of renin-containing cells. There was hyperplasia of renin-containing cells in
      some juxtaglomerular apparatuses (JGAs), although the proportion of renin
      positive JGAs was unaltered. These results suggest that peripolar cells and other
      glomerular epithelial cells react in a similar way in malignant hypertension, but
      they do not support the hypothesis that peripolar cells are part of the JGA.

PMID- 1625060
TI  - Fabry's disease without angiokeratomas showing unusual eccrine gland vacuolation.
AB  - An unusual case of Anderson-Fabry's disease with renal damage and bilateral
      corneal deposits but without angiokeratomas is presented. Diagnosis was made by
      renal biopsy. Typical foamy transformation of endothelium, mesangium, tubular
      epithelial cells, vascular smooth muscle, and fibroblasts of kidney biopsy and
      similar changes of myoepithelial, perineural, and endothelial cells on the skin
      biopsy were observed. At electron microscopy, 'fingerprint-like' myelin figures
      were seen. The epithelial cells of eccrine sweat glands showed striking
      vacuolation but myelin figures were not seen. We suggest that electron
      microscopic study of skin biopsies is indicated in the evaluation of patients
      clinically suspected of having Fabry's disease.

PMID- 1625061
TI  - The ultrastructure of pulmonary arteries and arterioles in emphysema.
AB  - The lungs from three cases of pulmonary emphysema obtained at heart-lung
      transplantation were examined by electron microscopy to determine the origin of
      intimal longitudinal muscle and the formation of muscular tubes in small
      pulmonary arteries and arterioles. The earliest change consisted of migration of
      mature smooth muscle cells from the media of small pulmonary arteries, through
      gaps in the internal elastic lamina, into the subendothelial space. Most of these
      cells then adopted a longitudinal orientation, maintained a muscular phenotype,
      and became enmeshed in a web of elastic fibres. A small minority, immediately
      subjacent to the endothelium, were orientated circularly and, in some vessels,
      were enclosed by rudimentary internal and external elastic laminae to form early
      muscular tubes. Pulmonary arterioles, which are normally devoid of a media,
      contained several layers of circularly orientated smooth muscle cells, some of
      which also formed muscular tubes. It is postulated that the limited migration of
      mature smooth muscle cells seen in states of chronic hypoxia is mediated by a
      different stimulus from that causing the florid invasion of the intima by
      immature smooth muscle, with subsequent transformation into myofibroblasts, which
      characterize plexogenic pulmonary arteriopathy.

PMID- 1625062
TI  - Membranous expression of carcinoembryonic antigen (CEA) in the normal cervical
      squamous mucosa.
AB  - Using a panel of polyclonal and monoclonal antibodies to CEA-related antigens in
      paraffin-processed cervical biopsies, CEA and NCA expression has been
      demonstrated on the cell membrane of normal mature cervical squames.
      Cytofluorimetry of disaggregated cervical squames confirmed membranous expression
      and immunogold labelling of ultrathin cryostat sections localized CEA to the
      glycocalyx and to within cytoplasmic membrane-bound vesicles of mature squames.
      Immunoblotting of cervical tissue showed that most of the CEA reactivity was
      expressed as a glycoprotein of molecular weight around 180 k, probably CEA
      itself. Localization of the CEA to the cell membrane of mature cervical squames
      suggests a key role for these antigens in maintaining the integrity of the
      squamous mucosa, through the putative function of an adhesion molecule.

PMID- 1625063
TI  - In situ detection of oxidative stress in rat hepatocytes.
AB  - In rat hepatocytes in primary culture incubated with nitro blue tetrazolium,
      formazan content was increased by addition of t-butyl hydroperoxide, a potent
      oxidant, in a dose-related manner, but not by addition of valinomycin, which
      kills hepatocytes through mitochondrial damage. This increment after t-butyl
      hydroperoxide addition was not seen in hepatocytes preincubated with deferoxamine
      mesylate, a ferric iron chelator which inhibits radical formation. Liver
      perfusion with nitro blue tetrazolium and t-butyl hydroperoxide in rats produced
      formazan deposition faintly on the surface of hepatocytes throughout the liver
      and prominently in the cytoplasm of some hepatocytes, which was attenuated when
      performed following deferoxamine mesylate perfusion. When liver perfusion with
      nitro blue tetrazolium was performed in carbon tetrachloride-intoxicated rats,
      formazan deposition appeared diffusely in hepatocytes in the centrilobular areas.
      Similar deposition was also observed on the surface and in the cytoplasm of
      hepatocytes in the periportal and mid-zonal areas in rats undergoing post
      ischaemic reperfusion. Liver perfusion with nitro blue tetrazolium can detect in
      situ oxidative stress in hepatocytes and may be a useful tool for studying the
      role of lipid peroxidation in rat liver injury.

PMID- 1625064
TI  - Optimization of non-isotopic in situ hybridization on formalin-fixed, paraffin
      embedded material using digoxigenin-labelled probes and transgenic tissues.
AB  - The sensitivity of non-isotopic in situ hybridization (NISH), particularly on
      formalin-fixed, paraffin-embedded (FFPE) clinical tissues, has been the subject
      of controversy. Generally, NISH has been regarded as being less sensitive than
      radiolabelled procedures, although some reports have contradicted this.
      Accordingly, tissues from mice which were transgenic for variable amounts of the
      human alpha-1-antitrypsin gene were used to optimize the NISH procedure and to
      estimate the sensitivity. This approach showed that prolonged incubation of
      slides in final substrate resulted in high sensitivity--about 13 kb of target
      DNA. However, this prolonged incubation crucially depended on achieving minimal
      non-specific background staining. Many factors affected the degree of background
      staining, but five were particularly important. First, the method of mounting cut
      sections onto slides. Second, the length of the probe (ideally less than 400 bp).
      Third, the procedure for proteolytic digestion. Fourth, the denaturation
      technique, and fifth, the quality of the dextran sulphate used in the
      hybridization mix. The optimized protocol showed variable patterns of mRNA
      distribution in the transgenic mouse livers, while DNA distribution appeared
      uniform.

PMID- 1625065
TI  - Fatty acid oxidation disorders: a new class of metabolic diseases.

PMID- 1625066
TI  - Effects of neonatal polycythemia and hemodilution on capillary perfusion.
AB  - The effects of neonatal polycythemia on nutritive capillary perfusion were
      investigated by a television microscopy technique. The capillary blood flow
      velocity in skin was measured in 12 neonates with polycythemia before and after
      treatment with hemodilution, and in 13 healthy control infants. The capillary
      blood flow velocity in the patients was 0.11 (0.02 to 0.34) mm/sec and in the
      healthy control infants 0.30 (0.17 to 0.44) mm/sec (p less than 0.01, median and
      range values). In relation to the absolute hematocrit change after treatment
      range, -20% to 0%), the capillary blood flow velocity increased nonlinearly
      (range, +733% to -14%; r = -0.98; p less than 0.001). The postnatal age was found
      to contribute significantly to the variation in results--the neonates with
      polycythemia studied during the first day of life had a very slow skin capillary
      circulation and responded to treatment with a more pronounced increase in
      capillary blood flow velocity than did the older patients. This in vivo model for
      capillary perfusion indicates that an insufficient microcirculation may be
      involved in the pathophysiology responsible for the morbidity associated with
      neonatal polycythemia.

PMID- 1625067
TI  - Iron deficiency of liver, heart, and brain in newborn infants of diabetic
      mothers.
AB  - Infants of diabetic mothers frequently have polycythemia, elevated serum
      erythropoietin concentrations, and decreased serum iron and ferritin
      concentrations, likely representing a redistribution of fetal iron into
      erythrocytes to support augmented fetal hemoglobin synthesis. We hypothesized
      that fetal liver, heart, and brain iron concentrations are also reduced in these
      infants. After obtaining autopsy tissue from infants who had died before 7 days
      of age, we measured liver, heart, and brain iron concentrations using atomic
      absorption spectrophotometry. Seven infants of diabetic mothers and seven
      gestational age-matched control infants were studied. All infants of diabetic
      mothers had pancreatic islet cell hyperplasia, indicating fetal hyperglycemia and
      hyperinsulinemia. Liver iron concentrations in the infants of diabetic mothers
      were 6.6% of control values (489.0 +/- 154.4 vs 7379.7 +/- 1473.8 micrograms/gm
      dry tissue weight (mean +/- SEM); p less than 0.001), heart iron concentrations
      were 43.9% of control values (124.7 +/- 20.5 vs 284.1 +/- 34.8 micrograms/gm dry
      tissue weight; p less than 0.002), and brain iron concentrations were 60.6% of
      control values (106.1 +/- 13.7 vs 175.2 +/- 10.7 micrograms/gm dry tissue weight;
      p less than 0.003). Heart and brain iron concentrations were directly correlated
      with liver iron concentrations (r = 0.80 for both; p less than 0.001) and
      indicated that hepatic iron was greater than 75% depleted before heart and brain
      iron reduction. We conclude that severely affected infants of diabetic mothers
      have reduced liver, heart, and brain iron concentrations. The role of tissue iron
      deficiency in the genesis of the abnormal clinical findings in these infants
      deserves further consideration.

PMID- 1625068
TI  - Unsuspected congenital heart disease in neonates receiving extracorporeal life
      support: a review of ninety-five cases from the Extracorporeal Life Support
      Organization Registry.
AB  - The purpose of this study was to determine the frequency of patients with
      congenital heart disease who were given extracorporeal life support (ECLS) for
      respiratory failure. Underlying congenital heart disease "masked" by respiratory
      failure occurred in 2%. The most frequent pre-ECLS diagnosis that "masked"
      congenital heart disease was persistent fetal circulation. Of neonates with a pre
      ECLS diagnosis of persistent fetal circulation, congenital heart disease was
      found in 56 (9%) of 623 patients.

PMID- 1625069
TI  - Impairment of lung diffusion capacity in Schonlein-Henoch purpura.
AB  - Twenty-nine children with typical Schonlein-Henoch purpura (SHP) were tested at
      the initial phase of the disease for respiratory function. Of the 29 patients, 28
      had a decrease of lung transfer for carbon monoxide (TLCO) as measured by a
      steady-state method. Lung volumes and blood gas values were normal; slight
      radiologic signs of interstitial lung involvement were observed in 18 of 26
      patients. There was a decrease in TLCO to 56.8% of normal values for height and
      gender and to 58.5% when normal values were volume-adjusted to functional
      residual capacity. In 19 of 25 patients, TLCO measurements were performed at 3
      month intervals during follow-up. In all cases, normalization of TLCO values was
      observed only after complete clinical recovery from SHP. All children with
      persisting symptoms, even limited to microscopic hematuria or slight proteinuria,
      had low TLCO values. In one patient low TLCO during follow-up preceded a late
      relapse of SHP in the form of acute nephritic disease with characteristic IgA
      deposits on renal biopsy. We conclude that low TLCO in SHP is probably related to
      alteration of the alveolar-capillary membrane by circulating immune complexes.
      This noninvasive technique may be useful in diagnosis, and during the follow-up
      of the disease as an early indicator of reactivation.

PMID- 1625070
TI  - Effect of acute versus chronic intoxication on clinical features of theophylline
      poisoning in children.
AB  - OBJECTIVES: To determine whether the method of intoxication influences the
      metabolic disturbances and pattern of life-threatening events that occur after
      theophylline intoxication in children. METHODS: Five-year prospective
      observational study of consecutive pediatric patients referred to a regional
      poison control center with a theophylline concentration (theo) greater than or
      equal to 30 micrograms/ml. At the time of referral, intoxication was categorized
      as acute (single toxic exposure), chronic (long-term toxic exposure), or acute-on
      therapeutic (single toxic exposure superimposed on maintenance therapy). RESULTS:
      One-hundred twenty-five patients were monitored. Mean age was 12 years (range, 3
      days to 20 y). Seventy-four patients (59%) had acute intoxication, 31 (25%) had
      chronic intoxication, and 20 (16%) had acute-on-therapeutic intoxication. Mean
      peak serum (theo) was 55 micrograms/ml. Life-threatening events occurred in 12
      patients (10%). Patients with acute intoxication had a significantly lower serum
      potassium level (3.04 vs 3.80 mmol/L; p less than 0.001) and higher serum glucose
      level (10.8 vs 7.0 mmol/L (194 vs 127 mg/dl); p less than 0.001) than did
      children with chronic intoxication. Although life-threatening events (seizures or
      arrhythmias) occurred at a similar rate across categories, the (theo) at which
      these events occurred was significantly higher in patients with acute
      intoxication than in those with chronic intoxication (100 vs 42 micrograms/ml; p
      = 0.02). Among children with chronic intoxication, those who had life-threatening
      events had (theo) similar to those who remained well (42 vs 47 micrograms/ml) but
      were significantly younger (1.6 vs 8.0 years; p less than 0.001). CONCLUSIONS:
      These data indicate that method of intoxication has significant effects on the
      metabolic and clinical consequences of theophylline poisoning. Life-threatening
      events occur in those with acute theophylline intoxication at significantly
      higher (theo) than in those with chronic intoxication. After chronic
      intoxication, peak (theo) does not identify patients at risk for life-threatening
      events; young age appears to be the primary risk factor. These findings
      potentially complicate the management of theophylline poisoning, given the
      difficulty of extracorporeal drug removal in young infants.

PMID- 1625072
TI  - Primary and secondary amenorrhea associated with spironolactone therapy in
      chronic liver disease.
AB  - Women with severe liver disease often have amenorrhea that resolves as liver
      disease abates. We describe three patients with mild to moderate chronic liver
      disease and amenorrhea. In each case amenorrhea resolved when spironolactone
      therapy was discontinued. We suggest that spironolactone, an androgen inhibitor,
      may also cause reversible amenorrhea.

PMID- 1625071
TI  - Heparin-induced thrombocytopenia in a child.
AB  - We describe a case of thrombocytopenia and deep venous thrombosis in a boy who
      received heparin to maintain patency of a central venous catheter. Measurement of
      the release of serotonin labeled with carbon 14 confirmed the presence of heparin
      induced thrombocytopenia. Children receiving heparin therapy should be monitored
      for the possibility of heparin-induced thrombocytopenia.

PMID- 1625073
TI  - Complications of immunosuppression.

PMID- 1625074
TI  - Unforgettable patients.

PMID- 1625075
TI  - Diagnosis of Lyme disease in children.

PMID- 1625076
TI  - Laboratory studies in neonates at risk for sepsis.

PMID- 1625077
TI  - Prevalence of congenital heart disease in patients with phenylketonuria.

PMID- 1625078
TI  - Urinary calcium excretion and nonsteroidal antiinflammatory treatment.

PMID- 1625079
TI  - Screening for glucose-6-phosphate dehydrogenase deficiency.

PMID- 1625080
TI  - Diagnosis of mitochondrial encephalomyopathies.

PMID- 1625081
TI  - Testing of bronchoalveolar lavage for the laboratory diagnosis of respiratory
      syncytial virus infections.

PMID- 1625082
TI  - Testing of bronchoalveolar lavage for the laboratory diagnosis of respiratory
      syncytial virus infections.

PMID- 1625083
TI  - Maternal smoking in early childhood: a risk factor for bronchial responsiveness
      to exercise in primary-school children.
AB  - The relationship between maternal smoking and bronchial hyperresponsiveness as
      assessed by a standardized free running test was investigated in a cohort of 1812
      primary-school children in first grade. A child's exposure to maternal smoking
      during pregnancy, the first year of life, and the study year was recorded.
      Current exposure was not positively associated with bronchial
      hyperresponsiveness. The prevalence of this disorder was higher when maternal
      smoking during the child's first year of life was reported (9%) than when it was
      not (5.9%). The odds of being hyperresponsive were significantly higher in
      children exposed to maternal smoking in their first year of life (odds ratio,
      2.82; 95% confidence interval, 1.25 to 6.34; p less than 0.01), especially in
      children with asthma (odds ratio, 20.55; 95% confidence interval, 2.5 to 168.9; p
      less than 0.01). Current exposure to maternal smoking was associated with less
      hyperresponsiveness. The effect of current maternal smoking might reflect changes
      in smoking habits by mothers of children with symptoms, whereas exposure to
      tobacco smoke in early life might be causally related to bronchial
      hyperresponsiveness. Our findings support the general hypothesis that early lung
      injuries have an impact on the later respiratory health of children.

PMID- 1625084
TI  - Intrapartum asphyxia and cerebral palsy.

PMID- 1625085
TI  - Growth of breast-fed infants.

PMID- 1625086
TI  - Chiropractic manipulation in children.

PMID- 1625087
TI  - Timing of the booster dose with Haemophilus polyribosylribitol phosphate
      conjugated with Neisseria outer-membrane protein.

PMID- 1625088
TI  - Correlation between serum immunoglobulin A concentrations and allergic
      manifestations in infants.
AB  - We studied the relationship of serum levels of IgA and IgE to allergic
      manifestations and otitis media in a cohort of 179 Icelandic children, aged 18 to
      23 months. Only one of the infants had IgA deficiency (less than 50
      micrograms/ml); all the others had IgA levels that were normal for their age. The
      children were divided into three groups according to their IgA levels (lowest
      25%, intermediate 50%, highest 25%) and the clinical findings analyzed
      accordingly. The cumulative incidence of definite allergic manifestations was
      37%. Asthma and otitis media were significantly more common among the infants
      with low normal IgA levels than among those with intermediate to high IgA levels.
      There was also a significant association between the severity of allergic
      manifestations and low IgA levels (p = 0.002). Children with detectable IgE
      (greater than or equal to 0.23 kilounit/L) had a higher incidence of atopic
      manifestations than did children in whom IgE was not detectable, but only a weak
      correlation was found between the occurrence and extent of allergic symptoms and
      increasing amounts of IgE beyond the 0.23 kilounit/L level. These findings
      suggest that atopic manifestations in infants may be more dependent on delayed
      maturation of IgA production than on overproduction of IgE.

PMID- 1625089
TI  - Hematologic predictors of bone marrow recovery in neutropenic patients
      hospitalized for fever: implications for discontinuation of antibiotics and early
      discharge from the hospital.
AB  - We evaluated the timing and pattern of changes in the complete blood cell count
      that preceded marrow recovery during 107 consecutive episodes of fever and
      neutropenia in 64 children with cancer. Four measures derived from serial daily
      measurement of the complete blood cell count were evaluated: total leukocyte
      count, absolute neutrophil count, absolute phagocyte count, and platelet count.
      During 70 (65%) of these 107 episodes, patients were discharged with an absolute
      neutrophil count of fewer than 500 cells/mm3; 24 patients were discharged from
      the hospital despite an absolute neutrophil count of fewer than 100 cells/mm3.
      During all but one of these 70 episodes, however, signs of early marrow recovery
      were present before discharge; sustained increases were observed in these
      patients' leukocyte, absolute neutrophil, absolute phagocyte, and platelet counts
      2 or more days before their discharge in 41%, 49%, 50%, and 39% of cases,
      respectively. Although they were neutropenic at discharge, most patients had
      signs of multilineage marrow recovery at that time; 59 of 70 had increases in
      three of four of the measurements that we studied. None of the 69 patients who
      had evidence of marrow recovery at discharge had recurrence of fever. We conclude
      that children with cancer who were hospitalized for fever during periods of
      neutropenia have increases in the peripheral blood cell count that herald
      imminent bone marrow recovery, often several days before the absolute neutrophil
      count recovers to 500 cells/mm3. Our success in discharging such patients before
      resolution of neutropenia suggests that further controlled trials are needed to
      evaluate the safety and feasibility of cessation of antibiotic therapy and early
      discharge from the hospital.

PMID- 1625090
TI  - Relative value of diagnostic studies for von Willebrand disease.
AB  - Laboratory tests recommended to screen patients with mucosal bleeding for
      hemostatic disorders generally include determinations of prothrombin time,
      partial thromboplastin time, platelet count, and bleeding time. To determine the
      best tests to identify patients with von Willebrand disease (vWD), we reviewed
      the laboratory studies of 24 children with vWD and performed receiver operating
      characteristic analysis on the diagnostic studies. The vWD disease diagnostic
      tests included determinations of vWF activity (ristocetin cofactor activity), vWF
      factor antigen, and factor VIII procoagulant (VIII:c). The diagnosis of vWD
      required the presence of a personal and family history of bleeding symptoms and a
      documented abnormality of vWF activity or vWF antigen. vWF activity, vWF antigen,
      factor VIII:c and blood type were determined in 104 symptom-free children. There
      were no differences between patients and normal subjects for age, gender, or
      blood type. The bleeding time was abnormal in 43%, the partial thromboplastin
      time was abnormal in 25%, and either one or both were abnormal in 58% of the
      patients. The vWF activity, vWF antigen, and factor VIII:c were abnormal in 79%,
      58%, and 33%, respectively. Receiver-operated-characteristic analysis showed the
      vWF activity to be superior to either the vWF antigen or factor VIII:c in
      establishing the diagnosis of vWD. The combination of the activity, bleeding
      time, and partial thromboplastin time successfully identified 92% of the patients
      as abnormal. Determination of vWF activity should be included routinely in the
      evaluation of hemostasis in children with symptomatic disease.

PMID- 1625091
TI  - Predictors of growth response to growth hormone in otherwise normal short
      children.
AB  - Sixty prepubertal short children (39 boys) with heights less than 2 SD for age
      and gender were treated daily for 1 year with recombinant human growth hormone
      (GH), either 0.1 IU/kg (group 0.1, n = 32) or 0.05 IU/kg (group 0.05, n = 28).
      Reserve of GH was determined by at least one GH provocative stimulus and 24-hour
      continuous blood withdrawal to determine the integrated concentration of GH (IC
      GH). All participants had a GH response to provocative tests greater than 10
      micrograms/L. The height velocity (mean +/- SD) of the group as a whole increased
      from 4.46 +/- 1.02 to 7.59 +/- 1.65 cm/yr (p less than 0.001). The growth
      velocity of group 0.1 was significantly greater than that of group 0.05 (8.1 +/-
      1.5 vs 7.0 +/- 1.65 cm/yr; p less than 0.01). Bone age did not advance more than
      1 year during the treatment period. Growth velocity after 1 year of GH therapy
      was inversely correlated with the IC-GH in both groups, as was the pretreatment
      height velocity. We found no correlation of growth velocity during GH therapy
      with other measures such as parental heights, bone age/chronologic age ratio,
      maximal GH response to provocative tests, chronologic age, or pretreatment
      insulin-like growth factor I levels. We conclude that the best predictors for the
      1-year growth outcome of short children with a normal GH response to provocative
      tests are the pretreatment growth velocity and the IC-GH. The short-term benefit
      from GH therapy in children with a normal growth velocity and a normal IC-GH is
      poor, whereas marked growth acceleration is noted in children with a low growth
      velocity and a low 24-hour IC-GH.

PMID- 1625092
TI  - Six-year results of a randomized, prospective trial of human growth hormone and
      oxandrolone in Turner syndrome.
AB  - Seventy girls with Turner syndrome, verified by karyotype, were randomly assigned
      to observation or treatment with human growth hormone (hGH), oxandrolone, or a
      combination of hGH plus oxandrolone for a period of 12 to 24 months, to assess
      the effect of treatment on growth velocity and adult height. Subsequently, all
      subjects received either hGH alone or hGH plus oxandrolone. Data are presented
      for 62 subjects treated for a period of 3 to 6 years. When compared with the
      anticipated growth rate in untreated patients, the growth rate after treatment
      with hGH, both alone and in combination with oxandrolone, showed a sustained
      increase for at least 6 years. Treatment is continuing in over half of the
      subjects; at present, 14 (82%) of 17 girls receiving hGH alone and 41 (91%) of 45
      girls receiving combination therapy exceeded their expected adult heights. Thirty
      girls have completed treatment; mean height for these 30 patients is 151.9 cm,
      compared with their mean original projected adult height of 143.8 cm. We conclude
      that therapy with hGH, alone and in combination with oxandrolone, can result in a
      sustained increase in growth rate and a significant increase in adult height for
      most prepubertal girls with Turner syndrome.

PMID- 1625093
TI  - Human leukocyte antigen-DRB1*1104 in the chronic iridocyclitis of pauciarticular
      juvenile rheumatoid arthritis.
AB  - To determine whether genetic markers for chronic iridocyclitis could be
      identified, we used both serologic and oligonucleotide dot blot techniques to
      characterize immunogenetically 164 children with early-onset pauciarticular
      juvenile rheumatoid arthritis. Seventy-eight children (47.6%) had chronic
      iridocyclitis and 86 (52.4%) had not had evidence of eye disease during a mean
      follow-up period after the onset of arthritis of 15.8 years (minimum of 5.5
      years). Control subjects were 218 healthy, unrelated individuals. The analysis
      was limited to alleles known to be associated with an increased or decreased risk
      of early-onset pauciarticular juvenile rheumatoid arthritis or of chronic
      iridocyclitis in this form of juvenile rheumatoid arthritis. Only one split of
      human leukocyte antigen (HLA)-DR5, HLA-DRB1* 1104, showed a statistically
      significant association with a risk of chronic iridocyclitis (chi-square value =
      7.52; p = 0.036 adjusted; odds ratio 3.45); HLA-DQA1* 0501 and HLA-DQB1* 0301,
      both in linkage disequilibrium with HLA-DRB1* 1104, also were significantly
      associated with eye disease. Patients with both the DRB1* 1104 and DPB1* 0201
      genes had a 7.7-fold increased risk for chronic iridocyclitis compared with that
      for other patients. The presence of HLA-DRB1* 1104 was about four times as
      specific, but only about one third as sensitive, as antinuclear antibodies in
      identifying patients at risk for eye disease. Although all children with early
      onset pauciarticular juvenile rheumatoid arthritis should undergo periodic slit
      lamp examinations, those with the HLA class II gene DRB1* 1104 are at
      particularly high risk for eye disease, and we recommend that they be monitored
      carefully for its evolution.

PMID- 1625094
TI  - Acquired cystic kidney disease before and after renal transplantation.
AB  - To determine the prevalence of acquired cystic kidney disease (ACKD), as reported
      in adults receiving long-term hemodialysis treatment, we studied 48 pediatric
      patients (aged 17 +/- 5.1 years) with end-stage renal disease by high-resolution
      ultrasonography or magnetic resonance imaging or both. Forty patients (83%) had a
      functioning renal transplant, with a mean transplant survival time of 3.4 years
      (range, 0.3 to 14.8 years); four patients were treated by hemodialysis and four
      by peritoneal dialysis. The mean duration of end-stage renal disease was 5.7 +/-
      3.8 years. Ultrasonography detected ACKD in 12 (29%) of 42 patients, solitary
      cysts in 14 patients (33%), and no cysts in 16 patients (38%). In contrast, ACKD
      was diagnosed in only 3 of 37 patients studied by magnetic resonance imaging. In
      31 patients studied by both imaging techniques. ACKD was diagnosed in three
      patients by magnetic resonance imaging but in 11 by ultrasonography. In patients
      with ACKD, the duration of end-stage renal disease was significantly longer, but
      renal (transplant) function was not different from that in patients with solitary
      cysts or no cysts. One patient with a history of 12 1/2 years of hemodialysis had
      multiple renal tumors that were diagnosed as renal cell carcinomas after
      bilateral nephrectomy. These results indicate that young patients with end-stage
      renal disease should be monitored regularly for the presence of ACKD, preferably
      by ultrasonography, even after successful renal transplantation.

PMID- 1625095
TI  - Contralateral renal abnormalities in multicystic-dysplastic kidney disease.
AB  - Multicystic-dysplastic kidney (MCDK) disease has been associated with
      contralateral genitourinary tract abnormalities; however, neither the nature nor
      the prevalence of the contralateral renal lesion has been delineated. We
      retrospectively studied patients with MCDK disease to determine the prevalence of
      contralateral renal abnormalities and of other urologic anomalies. Forty-nine
      patients, ranging in age from neonates to 6 years, were examined by renal
      ultrasonography, excretory urography or nuclear medicine scanning, and voiding
      cystourethrography; 51% of the patients had an associated urologic abnormality.
      The abnormality was contralateral to the MCDK in 19 patients (39%), ipsilateral
      in 3 patients (6%), and involved the bladder wall in 3 patients (6%). The most
      common contralateral genitourinary tract abnormality was vesicoureteral reflux
      (18%) followed by ureteropelvic junction obstruction (12%). We conclude that
      urologic anomalies are common in patients with MCDK disease; contralateral
      vesicoureteral reflux is the most common abnormality identified.

PMID- 1625096
TI  - Assessing the outcome of pediatric intensive care.
AB  - To describe the short-term outcome of pediatric intensive care by quantifying
      overall functional morbidity and cognitive impairment, I developed the Pediatric
      Overall Performance Category (POPC) and the Pediatric Cerebral Performance
      Category (PCPC) scales, respectively. A total of 1469 subjects (1539 admissions)
      were admitted to the pediatric intensive care unit of Arkansas Children's
      Hospital from July 1989 through December 1990. Patients were assigned baseline
      POPC and PCPC scores derived from historical information and discharge scores at
      the time of discharge from the hospital (or from the pediatric intensive care
      unit for patients with multiple hospitalizations). Delta scores were calculated
      as the difference between the discharge scores and the baseline scores. The
      changes in POPC and PCPC scores were associated with several measures of
      morbidity (length of stay in the pediatric intensive care unit, total hospital
      charges, and discharge care needs) and with severity of illness (pediatric risk
      of mortality score) or severity of injury (pediatric trauma score) (p less than
      0.0001). Interrater reliability was excellent (r = 0.88 to 0.96; p less than
      0.001). The POPC and PCPC scales are apparently reliable and valid tools for
      assessing the outcome of pediatric intensive care.

PMID- 1625097
TI  - Vitamin A levels in children with measles in Long Beach, California.
AB  - Studies from Africa suggest that vitamin A supplementation may reduce morbidity
      and mortality rates associated with measles among poorly nourished children. We
      studied 20 children with measles in Long Beach, Calif., and found that 50% (95%
      confidence interval; 28% to 72%) were vitamin A deficient. This frequency among
      presumably well nourished American children supports evaluation of vitamin A
      status as a part of acute management of measles in the United States.

PMID- 1625098
TI  - Glutaric aciduria type I: unusual biochemical presentation.
AB  - We describe a patient with glutaryl-coenzyme A dehydrogenase deficiency,
      demonstrated by a residual enzyme activity of only 1% in cultured fibroblasts.
      Although the clinical presentation was typical of glutaric aciduria type I, the
      urine concentrations of glutaric, glutaconic, and 3-hydroxyglutaric acids
      remained normal, even during episodes of clinical decompensation. An increased
      free glutarate level was demonstrated only in cerebrospinal fluid.

PMID- 1625099
TI  - Brain dysgenesis and congenital intracerebral calcification associated with 3
      hydroxyisobutyric aciduria.
AB  - Monozygotic male twins born to nonconsanguineous parents had dysmorphic facial
      features, microcephaly, migrational brain disorder, and congenital intracerebral
      calcification. They excreted excessive amounts of 3-hydroxyisobutyric acid, a
      metabolite of valine, and had evidence of impaired oxidative metabolism and
      metabolic acidosis. The level of 3-hydroxyisobutyrate in stored samples of
      midtrimester amniotic fluid was found to be high. The association of 3
      hydroxyisobutyric aciduria with brain dysgenesis is a newly recognized mendelian
      disorder; its recurrence in a family at risk is potentially avoidable by prenatal
      diagnosis.

PMID- 1625100
TI  - Familial pulmonary nodular lymphoid hyperplasia.
AB  - We describe three persons in one family with diffuse lung infiltrates, digital
      clubbing, and chronic hypoxia. Elevated immunoglobulin levels and antinuclear
      antibodies were found in all patients; pathologic findings included hyperplastic
      lymphoid follicles infiltrating the epithelium of the small airways. These cases
      may represent a familial systemic autoimmune disorder seen primarily with
      pulmonary compromise.

PMID- 1625101
TI  - Effect of high doses of human recombinant erythropoietin on the need for blood
      transfusions in preterm infants.
AB  - To determine whether prophylactic treatment with recombinant human erythropoietin
      (rHuEPO) and iron would reduce the need for blood transfusions, we randomly
      assigned 22 premature infants with gestational ages less than or equal to 32
      weeks and birth weights less than or equal to 1.75 kg to receive rHuEPO, 400
      IU/kg three times a week, plus iron, 20 mg/wk intravenously, from the second day
      of life (11 infants), or no rHuEPO and no iron (11 infants). The two groups had
      similar birth weights and clinical variables. The treated infants required fewer
      blood transfusions (0.8 +/- 1.5 vs 3.1 +/- 2.1; p = 0.01) and less volume of
      packed erythrocytes (14.2 +/- 25.9 vs 48.4 +/- 34.0 ml/kg; p = 0.02). The amounts
      of blood sampled were not different (19.5 +/- 21.1 vs 27.8 +/- 19.1 ml/kg; p =
      0.35). Reticulocyte and hematocrit values were higher in the treated group (4.46%
      +/- 0.8% vs 1.49% +/- 1.1% (p = 0.0001) and 48.1% +/- 7.3% vs 43.8% +/- 4.7% (p =
      0.004), respectively). No side effects of either rHuEPO or intravenously
      administered iron were noted. These data indicate that rHuEPO, in combination
      with iron supplementation, is effective in reducing the need for blood
      transfusions in the premature infant. More information is needed on dosage,
      timing, and iron and vitamin supplementation.

PMID- 1625102
TI  - The influence of manufacturing parameters on the formation and growth on
      autoclaving of a 40% V/V Bis-Perfluorobutylethene emulsion.
AB  - The influence of different process variables on the number of large particles
      before and after autoclaving of a 40% V/V Bis-Perfluorobutylethene emulsion
      stabilized by egg yolk lecithin, made isotonic with blood, was examined. The
      concentration of emulsifier, emulsification and autoclaving time and temperature,
      fill volume and the cooling gradient applied to the emulsion after autoclaving
      all affect the number of large droplets and hence the stability and acceptability
      of the finished product. This work suggests that validation of equipment and
      process to very exacting specifications and strict adherence to specified
      manufacturing protocol is essential for the reproducible production of
      fluorocarbon emulsions acceptable for intravenous administration.

PMID- 1625103
TI  - Preparation and stability of intravenous solutions of sodium dichloroacetate
      (DCA).
AB  - An IV injection formulation of sodium dichloroacetate (DCA) was prepared without
      heat sterilization, and examined for stability. DCA is heat labile in aqueous
      solutions. Its decomposition involves dehalogenation and production of hydrogen
      ions. Decomposition occurs relatively rapidly at relatively low pH values, and is
      promoted by heating. Injection solutions should be prepared aseptically and
      sterilized by filtration. Solutions prepared aseptically and sterilized by
      filtration are stable stored at 4 degrees C for at least four yrs.

PMID- 1625104
TI  - The insufficiency of single point diffusive air flow integrity testing.
AB  - Filter manufacturers characterize a given filter type by a single acceptable
      maximum diffusive air flow level. A too high value is prudently rejected as
      signalling the possible presence of flaws. Values lower than the stipulated
      maximum are accepted. However, the presence of single pores, whatever their
      sizes, is not being revealed. Only their influence within the total porosity is
      measured by the diffusive air flow. Single point diffusive air flow integrity
      testing may invite misleading conclusions because it offers possibilities for
      lower air flows to mask the presence of flaws or of outsized pores. This is
      particularly so where initial (prefiltration) and final integrity are being
      compared. The filtrative accretion of retained material, viable or not, must
      inevitably come to block or diminish the size of the pores. This results in
      decreased total porosity, directly expressed in lower diffusive air flow values.
      Sufficient drop in such final air flow values may mask the presence of a flaw
      developed in the filter subsequent to its initial testing. For this reason a
      filter's entire air flow permeation curve, particularly including its bubble
      point, must be characterized. It is this measurement, and this measurement alone,
      that is capable of unambiguously revealing the existence of insufficiently
      retentive pores. The inquiry into such presence is the very purpose of filter
      integrity testing.

PMID- 1625105
TI  - Apples, oranges, and additive assurance.

PMID- 1625106
TI  - Containment: comprehensive assessment and integrated control.

PMID- 1625108
TI  - FDA: keynote address, PDA/FDA Conference.

PMID- 1625107
TI  - Role of calcium and arachidonic acid metabolites in creatine kinase release from
      isolated rat skeletal muscles damaged by organic cosolvents.
AB  - The objective of the present work is to provide additional experimental evidence
      which can help to differentiate between a direct solubilization mechanism versus
      an intracellular calcium mechanism of organic cosolvent-induced creatine kinase
      release from isolated rat skeletal muscles. An increase in cytosolic free calcium
      levels following exposure to propylene glycol was evaluated indirectly through
      the measurement of skeletal muscle glycogen levels. Skeletal muscle glycogen
      levels decreased significantly in propylene glycol-treated muscles compared to
      normal saline-treated controls; providing further evidence for the possible role
      of increased cytosolic calcium in organic cosolvent-induced muscle damage. The
      possible involvement of prostaglandins and leukotrienes which disrupt membrane
      integrity leading to propylene glycol-induced creatine kinase release was
      investigated via the use of cyclo-oxygenase and lipoxygenase inhibitors. Organic
      cosolvent-induced creatine kinase release was not significantly reduced when the
      muscles were incubated in the presence of cyclo-oxygenase inhibitors,
      lipoxygenase inhibitors, or a combination of a cyclo-oxygenase and lipoxygenase
      inhibitor. These findings suggest that in this experimental system prostaglandins
      and leukotrienes do not seem to be involved in organic cosolvent-induced
      alterations in sarcolemma integrity leading to the release of creatine kinase.

PMID- 1625109
TI  - Achieving synergy and strength: an industry perspective on the Food and Drug
      Administration.

PMID- 1625110
TI  - Empirical calibration of light blockage sensors.
AB  - The intent of this note is to describe in more detail the calibration process for
      these sensors with particular emphasis on the method of obtaining the best
      calibration curve from the raw data. A new method of assessing the accuracy of
      the calibration curve is also described.

PMID- 1625111
TI  - Two-year follow-up of a social-cognitive intervention to prevent substance use.
AB  - This study presents two-year follow-up results of the Adolescent Decision-Making
      Program initially implemented when students were in their sixth grade. The
      intervention was found to maintain a positive effect on mean tobacco use, but no
      differences were observed for mean alcohol, marijuana, or hard drug use. In a
      test of the differential effectiveness of the intervention, program students
      living with married parents reported lower mean tobacco use than control students
      living with married parents and program and control students living with single
      parents. Logistic regression analyses examining the proportion of users at follow
      up revealed a negative program effect for alcohol and no differences for the
      other substances. Subsequent attrition analyses strongly suggested that the
      positive effect for tobacco use at follow-up was most likely even stronger, and
      that the negative effect for alcohol was spurious. The importance of examining
      both program and attrition effects when evaluating the impact of longitudinal
      preventive interventions was emphasized, and the need to consider alternative
      models to guide the conceptualization and evaluation of adolescent substance use
      prevention programs was discussed.

PMID- 1625113
TI  - Substance use among women at risk for HIV infection.
AB  - This article reports results from a survey of culturally diverse women at risk
      for HIV infection in south Florida. Data concerning their substance use and its
      association with HIV risk behaviors are presented. Results indicate levels of
      consumption which exceed expectations based on general estimates of female
      substance use. Further, substance use was associated with specific behaviors and
      lifestyles which placed the women at increased risk for HIV infection.

PMID- 1625112
TI  - Race differences in antisocial behaviors and attitudes and early initiation of
      substance use.
AB  - This article examines racial differences in self-reported delinquency, school
      trouble, antisocial attitudes, and toughness and in teacher-rated aggressive and
      inattentive behaviors among fifth grade black, white, and Asian American
      subjects. Also examined are the relationships of these variables to substance
      initiation within each racial group. Controlling for socio-economic status,
      racial groups differed from one another in self-reported delinquency, school
      trouble and toughness, and in teacher-rated aggressiveness and inattention.
      Antisocial behavior and attitudes were stronger predictors of substance
      initiation for Asian American than for black and white children. For white
      children both self-reported and teacher-rated behavior were significantly related
      to substance initiation. For black children, only self-reported antisocial
      behavior, and for Asian American children only self-reported delinquent behavior
      and attitudes predicted substance initiation. Implications for prevention and
      research are discussed.

PMID- 1625114
TI  - Student perceptions of the danger of drug use: a factor analysis.
AB  - Australian secondary school students from three Year levels were asked to rate
      the danger involved in various uses of alcohol, tobacco, inhalants, marijuana and
      other illicit drugs. These ratings were then factor analyzed for each Year level.
      The results showed a more refined discrimination among the older students, with
      type of drug and frequency of use being important considerations. Familiarity was
      a major consideration for the younger students. The cognitive factors derived
      from the data are consistent with expectations based on the gateway theory of
      drug use.

PMID- 1625115
TI  - Smoking education and prevention: a developmental model.
AB  - A developmental approach to smoking education and prevention for children and
      adolescents is proposed. Literature is reviewed concerning the most appropriate
      agent, content, and presentation, of anti-smoking education for each of three age
      groups: children to age ten, pre/early adolescents eleven to fifteen, and
      adolescents fifteen to eighteen. For children to age ten, it is suggested that
      parents are the best agents of education, with teachers, peers, and the mass
      media, also playing some role. For pre/early adolescents, peers are suggested as
      the best agents of education, building onto the earlier and ongoing work of the
      agents mentioned above. For adolescents, the role of the media hero-figure is
      discussed. It is emphasized that sources of influence may function additively in
      affecting the child or adolescent's decisions about smoking, and that education
      in each stage must build on the stage before.

PMID- 1625117
TI  - Chest injuries in children: an analysis of 100 cases of blunt chest trauma from
      motor vehicle accidents.
AB  - One hundred twenty-eight cases of chest injury were seen in a Paediatric Trauma
      Unit over a 5 1/2-year period. One hundred patients sustained motor vehicle
      accident (MVA)-related blunt chest injuries, 91 of them as pedestrians. Nine
      children had blunt chest injuries from falls, 10 had stab wounds (3 assault, 7
      accidental), and 9 had gunshot injuries (6 from birdshot used by police during
      civil disturbance). MVA-related injuries were studied separately, as an
      etiologically homogeneous group. Sixty-five of these patients were under the age
      of 6. All but 3 also had serious extrathoracic injuries. The mean injury severity
      score (ISS) in MVA-related injuries was 25. Eight patients died, all with an ISS
      of 34 or more, 7 of whom had fatal head injuries. In MVA-related injuries,
      pulmonary contusion (n = 73) was the most frequent lesion seen, followed by rib
      fracture (n = 62), posttraumatic effusion (n = 58), pneumothorax (n = 38), and
      pneumatocele (n = 5). In MVA-related injuries, 18 children required ventilation.
      Thirty-nine (69%) of 56 children with radiologically evident posttraumatic
      pleural effusion had intercostal chest drainage. Analysis suggests that lung
      injury is a central event in MVA-related blunt chest trauma. Primary lung injury,
      radiologically visible as contusion, is complicated by hematoma, posttraumatic
      effusion, and pneumothorax.

PMID- 1625116
TI  - Bronchoscopy during the first month of life.
AB  - During the 6-year period from 1984 to 1989, 196 bronchoscopies were performed on
      132 neonates. The indications were grouped into four categories: (1) difficulties
      in artificial ventilation or failure to wean the baby from the ventilator (52);
      (2) other respiratory difficulties (52); (3) audible stridor (16); and (4)
      routine preoperative or postoperative examination of esophageal atresia patients
      (12). The most common finding was laryngomalacia or tracheomalacia (31). Other
      findings were: obstructing tracheal or bronchial granulation or stricture (23),
      obstructing mucous plug (22), grave tracheobronchitis (11), tracheoesophageal H
      fistula (5), laryngeal perforation (3), congenital laryngeal stenosis (2), and
      complete laryngotracheoesophageal cleft (1). Four patients had miscellaneous
      pathology. The findings were normal in 30 patients. A therapeutic procedure was
      included in 99 of the 196 bronchoscopies. Seven serious complications occurred
      during the operative bronchoscopies, two of them requiring immediate pulmonary
      surgery. All complications were successfully managed. In contrast, no
      complications occurred in the 97 purely diagnostic bronchoscopies. In experienced
      hands, bronchoscopy of the newborn is a safe and useful examination.
      Complications occur when therapeutic procedures are included. Therefore,
      operative bronchoscopy should only be performed in conditions in which immediate
      thoracotomy and pulmonary surgery can be performed.

PMID- 1625118
TI  - Continuous paravertebral block for postthoracotomy analgesia in children.
AB  - Six children with a mean age of 10.6 years (range, 7 to 16 years) underwent
      thoracotomy for pulmonary and esophageal procedures. Postoperatively, continuous
      paravertebral block using an infusion of bupivacaine via an extrapleural catheter
      was used. Excellent analgesia was attained in all patients, with no requirement
      for opiates or other analgesic drugs. There were no pulmonary complications and
      no complications related to the continuous extrapleural infusion. We conclude
      that continuous paravertebral block is an effective and safe method for ++post
      thoracotomy pain relief in children.

PMID- 1625119
TI  - CHARGE and esophageal atresia.
AB  - CHARGE association was diagnosed in 61 infants, 20 of whom died, mainly during
      the first 2 years of life. Esophageal atresia and/or tracheoesophageal fistula
      were present in 10 neonates. Axial skeletal anomalies occurred in 7 of the 10,
      but none had preaxial limb defects typical of the VATER association. All had
      major cardiac anomalies, predominantly tetralogy of Fallot. The majority of
      patients had primary repair of the esophagus. The postoperative course was stormy
      in all patients, with a high incidence of complications and 70% died. The
      recognition of features of the CHARGE association is important because it has
      major prognostic and therapeutic implications.

PMID- 1625120
TI  - Prophylactic extrapleural chest drainage following repair of esophageal atresia:
      is it necessary?
AB  - In a review of 110 cases of esophageal atresia (EA) and tracheoesophageal fistula
      (TEF), 15 patients (13.6%) developed anastomotic leakage. All patients had
      extrapleural surgical exposure and prophylactic extrapleural chest drainage
      (PEPCD). Despite this precaution, all patients with anastomotic leaks developed a
      pneumothorax with or without a pleural effusion. This required insertion of an
      additional drain in 12 (80%) cases. PEPCD following repair of EA and TEF does not
      appear to prevent pneumothorax or pleural effusion when anastomotic leakage
      occurs.

PMID- 1625121
TI  - Reassessment of the end-to-side operation for esophageal atresia with distal
      tracheoesophageal fistula: 22-year experience with 68 cases.
AB  - End-to-side anastomosis (ES) and ligation of the tracheoesophageal fistula (TEF)
      has been the procedure of choice for esophageal atresia at our institution since
      1967. This report summarizes our operative and long-term results with the ES
      operation in 68 babies, including 33 in Waterston group A (50%), 23 in group B
      (35%), and 12 in group C (15%). An additional 10 patients had a primary end-to
      end (EE) anastomosis, while 14 others required either staged EE repair or an
      esophageal replacement procedure. Overall survival rate with ES was 93% including
      two deaths attributed to major anastomotic leaks and sepsis, and three others in
      group C from cardiac anomalies. Six (9%) of those having ES anastomosis developed
      a recurrent TEF between 40 days and 21 months of age, necessitating reoperation.
      Predisposing factors to recurrent TEF were surgical inexperience (three cases;
      first operation for each surgeon), forceful vomiting secondary to
      gastroesophageal reflux (GER) in two, and drug overdose in one. Anastomotic leak
      occurred in seven (10%) following end-to-side repair and was implicated in two
      deaths. Three patients developed minor anastomotic stricture requiring less than
      three dilatations, while one with a tight stricture needed as many as five
      dilatations over the first 14 months of life. Mild dysphagia and respiratory
      symptoms were uniformly observed during the first year, but only five patients
      (7%), including the two with recurrent TEF, required fundoplication for
      persistent GER. All patients were eating table foods after 1 year of age, while
      10 (15%) have required periodic endoscopic removal of solid food lodged at the
      radiographically unobstructed anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625122
TI  - Hypogastrinemia and esophageal atresia.
AB  - To investigate extraesophageal anomalies in infants with esophageal atresia,
      preoperative plasma gastrin was measured in 12 infants. The median plasma gastrin
      was 32 ng/L (interquartile range, 24 to 44). There was significant correlation
      with birth weight (rs = .73, P less than .05) and gestational age (rs = .74, P
      less than .05). Within this group 9 infants of greater than 36 weeks' gestation
      were matched to a group of 20 control infants without esophageal atresia. Infants
      with esophageal atresia had a significantly lower median plasma gastrin (38 ng/L
      v 55 ng/L, P less than .05). This may indicate preexisting vagal abnormalities in
      esophageal atresia unrelated to surgical intervention.

PMID- 1625123
TI  - Diagnosis and management of common bile duct stones in patients with sickle
      hemoglobinopathies.
AB  - Nine of 35 patients with sickle hemoglobinopathies and cholelithiasis were found
      to have concomitant common bile duct (CBD) stones. We describe the diagnosis and
      management of these patients with CBD stones. Historical information, physical
      examination, and routine laboratory tests were unable to identify accurately the
      patients with CBD stones. Similarly, ultrasonography of the hepatobiliary system
      was an insensitive method for detecting CBD stones, as only 3 of 8 patients were
      correctly identified. In contrast, both an intraoperative cholangiogram and
      endoscopic retrograde cholangiopancreatography were sensitive procedures for
      detection of CBD stones. We conclude that CBD stones are relatively common in
      patients with sickle cell disease and cholelithiasis, and clinicians should have
      a high index of suspicion for their presence.

PMID- 1625124
TI  - Double duodenal atresia/stenosis: a report of four cases.
AB  - Four neonates with double duodenal atresia/stenosis are described. Preoperative
      plain radiographs in two patients demonstrated atypical appearances suggestive of
      complex pathology. Cystic dilatation of the second part of the duodenum was
      observed at laparotomy in two patients and in one of these the "cyst" was
      palpable preoperatively, causing diagnostic confusion. All four patients
      underwent successful surgery but one infant with Down's syndrome subsequently
      died of congenital heart disease.

PMID- 1625125
TI  - Clinical use of the absorbable spleen net in stellate rupture of spleen in
      children.
AB  - This paper reports three cases of stellate rupture of the spleen in children
      treated by wrapping with the omentum, following the use of the absorbable spleen
      net (ASN), which is made of the ordinary surgical sutures. All patients were
      cured with spleen preservation. No complications occurred.

PMID- 1625126
TI  - Intestinal injuries in childhood: analysis of 32 cases.
AB  - This is a retrospective study of 32 cases of intestinal injuries sustained among
      135 children admitted from cases of abdominal trauma in 1976 till 1989. Falls
      from height or bullock cart and bull-gore injury formed the majority of the cases
      (21/32; 65%). Clinical thermometer accounted for perforating injuries in 2
      neonates. Penetrating injury accounted for 10 cases and blunt trauma was
      responsible in 19. The site of injury was duodenum 1, jejunum 8, ileum 17, colon
      3, rectum 4, and multiple sites 1. Associated injuries included diaphragmatic
      rupture 1, liver 1, mesentery 4, retroperitoneal hematoma 4, head injury 2, and
      loss of hand due to blast 1. Diagnosis was made on history, physical examination,
      pneumoperitoneum in plain x-ray, and diagnostic four-quadrant peritoneal tap.
      Closure of perforations was done in 21 cases, wedge resection in 3, and resection
      anastomosis in 5. Protective colostomy had to be done in 5 cases. Four patients
      died of septicemia (2) and head injury (2).

PMID- 1625127
TI  - The necessity of prophylactic antibiotics in uncomplicated appendicitis during
      childhood.
AB  - A prospective, randomized, clinical study was done to evaluate the place of
      prophylactic antibiotics in uncomplicated childhood appendicitis. One hundred
      patients with uncomplicated appendicitis were randomly assigned to one of four
      groups, each consisting of 25 cases. Group 1 patients did not receive
      prophylactic antibiotic. Group 2, group 3, and group 4 patients received
      ornidazole, penicillin plus tobramycin, and piperacillin, respectively. The use
      of prophylactic antibiotics did not yield better results than the use of
      placebos. The rarity of infectious complications after uncomplicated
      appendicectomy may be unique for children. Although the need for antibiotic
      prophylaxis is well documented in adults, the rarity of infectious complications
      makes it highly questionable in the treatment of uncomplicated appendicitis in
      children.

PMID- 1625128
TI  - Perforation during hydrostatic reduction of intussusception: proposed mechanism
      and review of the literature.
AB  - Eight cases of children with intussusception in whom the bowel perforated during
      attempts at enema reduction are reviewed. Certain features in each case suggest
      that perforation may not be secondary to increased intraluminal pressure from the
      enema, but that necrotic perforated bowel is uncovered as the intussusception is
      reduced. A review of the basis for recommendations about the height of the enema
      bag during attempted reduction suggests that these guidelines are largely
      arbitrary and lack scientific support.

PMID- 1625129
TI  - Short-bowel syndrome: a collective review.
AB  - Neonates can now be expected to survive with very short lengths of bowel because
      of advances in pediatric neonatal care and in parenteral and enteral nutrition.
      Most pediatric surgeons have only a few patients with this problem under their
      care, so individual experience is limited. This collective survey, carried out by
      postal questionnaires to pediatric surgeons in the British Association of
      Paediatric Surgeons in the United Kingdom with an interest in the
      gastrointestinal tract, documents current techniques of management, the
      complications encountered, and reviews the clinical and economic consequences of
      prolonged total parenteral nutrition. We conclude that within the limitations of
      resources and our understanding of prognosis, neonates, especially if less than
      35 weeks' gestation, with remaining jejunoileal segment of greater than 20 cm
      with an intact ileocecal valve (ICV) or greater than 30 cm without an ICV, should
      be considered salvageable.

PMID- 1625130
TI  - Human amniotic membrane as an intestinal patch for neomucosal growth in the
      rabbit model.
AB  - This experiment was carried out as a preliminary study, an attempt to grow new
      intestinal mucosa on human amniotic membrane in the terminal ileum in 37 rabbits.
      After ketamin sulfate anesthesia at laparatomy, 5-cm ileal defects were patched
      with human amniotic membrane (5 x 2 cm). These patched intestines were
      investigated on the first postoperative day and the 2nd, 5th, 10th, and 20th
      weeks corresponding to 4, 5, 5, 10, and 10 rabbits, respectively. Only three
      rabbits died in the early postoperative period. There was no evidence of
      intestinal obstruction or dilatation with barium meal. Microscopically, the
      neomucosa consisted of a thin layer of columnar epithelial cells at 2 weeks with
      more maturity of the villi and less irregularity and branching by 20 weeks. All
      patches were covered with neomucosa commencing at 2 weeks and covering the whole
      patch area by 20 weeks. This technique's advantages are the large size and the
      ease of the availability of the human amniotic membrane for neonates at risk
      without jeopardizing the neonates tissues. It is hoped that this method might be
      considered when neonatal material is scarce.

PMID- 1625131
TI  - Patchy distribution of rejection changes in small intestinal transplantation.
AB  - The aim of this study is to determine the distribution of histological changes of
      rejection in small intestinal transplantation. Thirty-nine rats were randomized
      into two groups: group I (n = 15), syngeneic transplants and group II (n = 24),
      allogeneic transplants. Grafts were excised and examined on days 2, 4, and 8
      after transplantation. All grafts of the syngeneic group showed normal mucosa by
      day 4. However, by this time, all grafts of the allogeneic group demonstrated
      rejection changes with a patchy distribution in the mucosa. Therefore, with a
      biopsy from the stoma site there is a risk of missing early rejection.

PMID- 1625132
TI  - Intraanal ultrasound: a new aid in the diagnosis of pelvic processes and their
      relation to the sphincter complex.
AB  - Intraanal ultrasound provides a very accurate structural analysis of the
      continence organ. In addition it proved to give excellent pictures of solid or
      fluid intrapelvic, particularly retrorectal, structures. It is superior to
      computed tomography and magnetic resonance imaging (requiring anesthesia),
      because the scanner is very close to the structures in question. This allows high
      scanner frequencies with resolutions of 0.9 mm and better. It is a quick method,
      avoiding radiation, and can be safely repeated as often as necessary.

PMID- 1625133
TI  - Comparison of saphenous versus jugular veins for central venous access in
      children with malignancy.
AB  - A retrospective analysis was carried out to compare the performance and
      complications of central catheters inserted into either the saphenous (27) or
      jugular (52) veins. The saphenous route may be preferred in certain circumstances
      including extensive mediastinal pathology, prior neck surgery, previous
      catheter(s), and cosmetic reasons. There was no difference in complications
      (local or systemic catheter-related infections, catheter occlusions, or venous
      thrombosis). The incidence of catheter removal due to complications was also not
      different between sites. Hence, the saphenous route can provide an additional
      portal of vascular access in selected patients.

PMID- 1625134
TI  - Therapeutic significance of surgery in advanced neuroblastoma: a report from the
      study group of Japan.
AB  - The role of surgery was evaluated in 19 stage III and 102 stage IV neuroblastoma
      patients, all of whom were treated with intensive induction chemotherapy by the
      Study Group of Japan between January 1985 and March 1990. For stage III
      neuroblastoma, surgical intervention at the primary site was performed in 18 of
      the 19 patients, 9 during and 9 after the first three cycles of A1 regimen,
      consisting of high-dose cyclophosphamide, vincristine, THP-adriamycin, and cis
      platinum. Gross complete resection of primary tumor and regional lymph nodes was
      feasible in 17 of the 19 patients (89%), and the survival rate for the 17
      patients were 79%, 70%, and 70% at 2 years, 3 years, and 4 years, respectively.
      For stage IV, surgical intervention at the primary site was performed in 92 of
      the 102 patients (90%): 30 cases during the first 3 cycles of A1 chemotherapy and
      62 cases after that, with gross complete resection accomplished in 81 of the 102
      patients (79%). The 81 patients with gross complete resection achieved had a
      better prognosis than those 11 patients with partial resection (P less than .05).
      Overall survival rate was 62% at 2 years for 27 patients who underwent complete
      resection after 3 cycles of A1 when resolution of all metastases was obtained,
      whereas the survival was 52% at 2 years for 31 patients who similarly underwent
      complete resection but when evidence of persistent metastases was present.
      Patients in whom the ipsilateral kidney was preserved at surgery had an outcome
      superior to that of those with associated nephrectomy (P less than .05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1625135
TI  - Characteristics and management of patients with fetal neuroblastoma.
AB  - At 35 weeks 6 days of gestational age, ultrasound evaluation of the fetal abdomen
      showed a mixed cystic mass in the superior pole of the left kidney. The mass was
      suspected to be an adrenal hemorrhage or neuroblastoma. The diagnosis was fetal
      neuroblastoma. Differential diagnosis enabled the fetal neuroblastoma to be
      distinguished from adrenal hemorrhage. The parameters of diagnosis of fetal
      neuroblastoma include no specific ultrasonographic pattern, lack of palpability,
      and no tumor markers. However, certain features do characterize fetal
      neuroblastoma, such as little metastases, complete resection at operation, and
      excellent prognosis. In cases of suspected neuroblastoma, a laparotomy performed
      as soon as possible is generally regarded as the best course of treatment.
      Nonetheless, biological analyses of the tumor may prove in the future to be
      necessary for determining whether or not laparotomy is the best treatment.

PMID- 1625136
TI  - Rapid development of an immunoblastic lymphoma and death in children following
      cadaveric renal transplantation.
AB  - We report on three children who underwent cadaveric renal transplantation and
      subsequently developed an immunoblastic lymphoma, leading to death in two
      patients. The development of the lymphoma occurred following a multi-drug
      immunosuppression regimen ending with monoclonal antilymphocyte (OKT3) treatment
      for biopsy-proven cellular and vascular acute rejection. These patients represent
      three of 11 children who received OKT3 treatment for rejection in the last 18
      months at this institution. Following the diagnosis of lymphoma, all three
      patients were treated by transplant nephrectomy, cessation of immunosuppression,
      and administration of intravenous acyclovir. The first two patients died at 4
      days and 4 weeks, respectively, after the definitive diagnosis was made with
      widespread metastatic disease. The remaining child is a short-term survivor (13
      months), free of demonstrable malignancy. Multidrug regimens for
      immunosuppression have a profound effects on T cell function. These effects, when
      combined with a primary infection by the Epstein-Barr virus, are implicated in
      the rapid development of the lymphomas and are responsible for the death of these
      two children.

PMID- 1625137
TI  - Evaluation of factors contributing to mortality in pediatric renal transplant
      recipients.
AB  - From 1969 to 1985, 303 renal allografts (290 cadaveric) were placed in 215
      pediatric recipients. A review of actuarial recipient and allograft survival 2
      years posttransplant showed good results in patients over 6 years of age (greater
      than 90% for patients, about 70% for allografts) but less satisfactory results in
      younger patients (75% for patients, about 45% for allografts). Thirty-nine
      patients died. Loss of allograft function preceded death in 67% of cases and was
      due to rejection (61%), renal vascular thrombosis (35%), and recurrence of
      original disease (4%). On retrospective analysis, 13 deaths might have been
      preventable with current diagnostic and therapeutic modalities. Allograft
      dysfunction from thrombosis occurs at a higher frequency in the young child and
      may be confused with rejection. Treatment of rejection without biopsy,
      overagressive treatment of a chronically failing graft, and failure to withdraw
      immunosuppressive therapy in face of infection are poorly tolerated in the very
      young recipient and are prominent causes of preventable mortality. Transplant
      nephrectomy and repeated attempts at transplantation are poorly tolerated in very
      young patients. Patient survival is very dependent on the success of the initial
      allograft in children.

PMID- 1625138
TI  - Surgical management of duplex ureteroceles.
AB  - We reviewed the cases of 95 children with duplex ureteroceles treated in this
      department over an 18-year period. There were 101 ureteroceles (6 bilateral).
      Diagnosis and treatment were analyzed. Special attention was paid to newborns
      screened in utero. We always strove to preserve functional renal tissue whenever
      possible. In keeping with this goal, three surgical techniques were used: (1)
      upper pole heminephrectomy; (2) ureterocele excision, bladder neck
      reconstruction, and ureter reimplantation with or without cutaneous ureterostomy
      of the upper pole ureter; and (3) endoscopic ureterocele incision. Follow-up
      studies using x-ray and radionuclide imaging demonstrated satisfactory renal
      function in 86.6% of patients. These findings support a conservative approach to
      ureteroceles using endoscopic ureterocele incision as the primary treatment.
      Lower urinary tract reconstruction may be associated in cases involving urinary
      tract infection, obstruction or incontinence. Upper pole heminephrectomy should
      be performed only after functional evaluation following ureterocele incision or
      cutaneous ureterostomy.

PMID- 1625139
TI  - Ventriculoatrial shunt utilizing the azygos vein.
AB  - Long-term ventricular cerebrospinal fluid shunting can prove difficult in the
      neonatal population, particularly in those neonates who have had previous
      abdominal and vascular procedures. This article presents a technique of providing
      vascular access for ventriculoatrial shunting via the azygos vein for patients
      with limited vascular access and in whom ventriculoperitoneal shunting is not
      feasible.

PMID- 1625140
TI  - Esophageal tracheoplasty for congenital tracheal stenosis.
AB  - Two infants with congenital long tracheal stenosis underwent operation by means
      of an esophageal tracheoplasty. The first patient had previously undergone
      tracheal reconstruction using the pericardium. Although ventilation improved
      somewhat following this procedure, the pericardial patch suddenly ruptured 12
      days after the operation, requiring an immediate esophageal tracheoplasty. The
      esophageal portion of the reconstructed trachea epithelialized 1 month later,
      with the lumen maintaining its proper size. However, the patient died 3 months
      after the second tracheoplasty. The cause of death was thought to be due to
      complications arising from prolonged high-pressure use of mechanical ventilation.
      He had been on a respirator for 6 months before the first tracheoplasty. The
      second patient has been doing well with no recurring respiratory problems for 25
      months now. Her reconstructed trachea has adapted with her growth. This technique
      should be considered along with other forms of treatment for tracheal
      reconstruction because it is relatively simple and pliable.

PMID- 1625141
TI  - Insertion of a soft silastic nasogastric tube at operation for esophageal
      atresia: a new technical method.
AB  - A new and simple technical method for insertion of a soft silastic nasogastric
      tube into the stomach in neonates born with esophageal atresia is described. The
      technique is simple, easy to perform, and enables feeding the baby through this
      tube a day after the operation. Our method is based on the principle used in
      insertion of Broviac-Hickman catheters, namely the use of a "peel-away sheath"
      through which the silastic feeding tube is threaded. We have used this technique
      in five patients with esophageal atresia without any complication.

PMID- 1625142
TI  - The use of endotracheal tubes to assist in manipulation of esophageal strictures,
      in elongation of the esophagus in esophageal atresia, and in gastrojejunal
      feeding tube placement.
AB  - Because of the special qualities of a PVC endotracheal tube (smooth, soft,
      pliable but still with a patent lumen), it serves very well for the intubation of
      the esophagus or the duodenum through an established gastrostomy. In this article
      the use of endotracheal tubes in different manipulations of the esophagus and
      gastroduodenum is described.

PMID- 1625144
TI  - Renal infarction associated with an extraadrenal pheochromocytoma.
AB  - A patient with an abdominal extraadrenal pheochromocytoma showed computed
      tomography findings of renal infarction. Selective angiography of the affected
      kidney showed no evidence of arterial occlusion or emboli. We postulate that the
      renal infarcts were caused by reversible severe vasospasm associated with high
      systemic blood levels of norepinephrine and angiotensin II.

PMID- 1625143
TI  - Intestinal button implantation for obstipation and fecal impaction in children.
AB  - Chronic obstipation and fecal impaction in children can be difficult management
      problems for pediatricians. We describe a novel approach to the management of
      obstipation and fecal impaction: the implantation of the button gastrostomy
      device in the appendiceal stump or the terminal ileum. We report the procedure in
      two children. One child had pseudoobstruction syndrome complicated by recurrent
      obstipation; the other had cystic fibrosis complicated by recurrent obstruction
      from meconium ileus equivalent. Both children received a polyethylene
      glycol/electrolyte solution, with or without pancreatic enzymes, which was
      administered through the button. The children have remained essentially
      asymptomatic for at least 10 months. We believe that this is the first report of
      the use of a button gastrostomy device to successfully manage chronic obstipation
      and recurrent fecal impaction in children.

PMID- 1625145
TI  - Ovarian teratoma with gliomatosis peritonei.
AB  - Gliomatosis peritonei (GP) is a rare occurrence associated exclusively with
      ovarian teratoma (OT), in which numerous metastatic nodules composed mainly of
      mature glial tissue are studded on the peritoneum, omentum, and bowel wall. Two
      female patients (aged 5 years and 14 years) are reported. Various preoperative
      examinations confirmed a large abdominal teratoma with normal alpha-fetoprotein
      and beta-HCG. The OT was excised and partial omentectomy and incidental
      appendectomy were performed to remove as many metastatic nodules as possible.
      Pathological examinations including immunostains for glial fibrillary acidic
      protein showed predominantly mature glial tissue in the OT and in the metastatic
      nodules. An addition, chemotherapy was given to one of them, but both were well
      without recurrent diseases 17 months and 12 months postoperatively, respectively.
      The outcome of these two cases, in contrast to advanced malignancy in widespread
      intraperitoneal metastases of any other kind, supports the concept of benign
      nature of GP and a conservative surgical approach to this rare disorder.

PMID- 1625146
TI  - Recurrent peripheral arterial occlusion by leukemic cells sedimentation in acute
      promyelocytic leukemia.
AB  - A 10-year-old boy presenting with recurrent successive events of peripheral
      arterial occlusion in both legs, more prominent on the left side, was diagnosed
      as having acute promyelocytic leukemia. Histological examination of the occluding
      material showed that it was composed of leukemic blast cells. The boy underwent
      five operations. Each time the arterial flow was reestablished by removing
      cylindrical hollow white material obstructing the lumen. However, after the last
      operation, irreversible ischemia developed, necessitating an above-knee
      amputation. There was no evidence of disseminated intravascular coagulation.
      Three months later a right lumbar sympathectomy was performed for relief of
      causalgic-ischemic pains, with successful results. Preoperative angiography
      demonstrated irregular narrowing of the right iliac arteries and tibioperoneal
      trunk stenosis.

PMID- 1625147
TI  - Necrotizing fasciitis in two children with acute lymphoblastic leukemia.
AB  - Necrotizing fasciitis is a severe, soft tissue infection, and is an unusual
      condition in children. The cornerstone of therapy is prompt, aggressive surgical
      treatment. Despite vigorous treatment, mortality rates are high. We report the
      occurrence of necrotizing fasciitis in two children during the granulocytopenic
      phase of induction chemotherapy for acute lymphoblastic leukemia. The diagnosis
      and treatment of necrotizing fasciitis in these two children was made more
      difficult by their underlying disease and its chemotherapy. The successful
      treatment of their infections relied on a multimodality approach. Aggressive
      surgical debridement was the mainstay of therapy. Adjuvant therapy was vital to
      the successful outcomes and included meticulous wound care, intravenous
      hyperalimentation, appropriate antibiotics, and granulocyte transfusions.

PMID- 1625148
TI  - The natural history of periodontal disease in man: prevalence, severity, and
      extent of gingival recession.
AB  - This paper describes the occurrence and levels of gingival recession in 2 cohorts
      of individuals participating in parallel longitudinal studies in Norway (1969
      1988) and Sri Lanka (1970-1990), covering the age range from 15 to 50 years. In
      the Norwegian cohort gingival recession had begun early in life. It occurred in
      greater than or equal to 60% of the 20 year-olds and was confined to the buccal
      surfaces. At 30, greater than or equal to 70% had recession, which still was
      found mainly on buccal surfaces. As the group approached 50 years of age, more
      than 90% had gingival recession; greater than or equal to 25% of the buccal
      surfaces were involved, greater than or equal to 15% of lingual, and 3 to 4% of
      the interproximal surfaces. In the Sri Lankan cohort greater than or equal to 30%
      exhibited gingival recession before the age of 20 years. By 30 years, 90% had
      recession on buccal, lingual, and interproximal surfaces; and at 40 years, 100%
      of the Sri Lankans had recession. As they approached 50 years, gingival recession
      occurred in greater than or equal to 70% of the buccal, greater than or equal to
      50% of the lingual, and 40% of the interproximal surfaces. Based on the special
      features of the two cohorts, the working hypothesis is advanced that there is
      more than one type of gingival recession and probably several factors determining
      the initiation and development of these lesions.

PMID- 1625149
TI  - In vitro phagocytosis by crevicular phagocytes in various forms of periodontitis.
AB  - Phagocytes from the gingival crevice fluid (CF-cells) of 11 patients with
      localized juvenile and post-juvenile periodontitis (LJP/PJP), 14 with rapidly
      progressive periodontitis (RPP), 11 with adult periodontitis (AP), and 14
      controls without periodontal disease were examined. Phagocytic activity in vitro
      was assessed. Crevicular washings were obtained from healthy sites of controls
      and diseased sites of patients after completion of the oral hygiene phase
      (professional and home care). The cells were carefully processed to avoid
      mechanical damage. The in vitro phagocytosis by uptake of opsonized C. albicans
      was performed in a moist chamber (30 minutes, 37 degrees C) and examined by light
      microscopy. CF-cells were differentiated on the basis of their morphological
      appearance. The majority of cells in crevicular washings were PMNs, some
      macrophages, and few lymphocytes. Phagocytic activity in patients with LJP/PJP
      and RPP was significantly decreased in comparison with that from AP and the
      control group. The decreased percentage of cells phagocytosing opsonized C.
      albicans was associated with the enhanced adherence of opsonized C. albicans.
      Moreover cell viability of CF-cells from LJP/PJP sites was significantly reduced.
      The data from the present study suggest that the in vitro phagocytosis of
      crevicular phagocytes in juvenile and rapidly progressive periodontitis lesions
      is diminished.

PMID- 1625150
TI  - Analysis of site specific periodontal bacteria sampling schemes.
AB  - A great deal of controversy has existed in the periodontal literature as to
      whether the site or the subject should be the unit of analysis. Using the site as
      the unit of analysis assumes that observations of sites within the same subject
      are independent and ignores between subject variation. The purpose of this report
      is to evaluate the influence that the unit of analysis has on estimating the
      number of necessary site specific bacterial samples from each subject. The number
      of bacterial samples per subject was defined as the number of samples that would
      insure a clinician at a 95% confidence level that, if the bacteria were present
      in a subject, it would be discovered. From two data sets in which 20 to 30
      bacterial samples were taken from each subject and data generated from a
      simulation, appropriate within-subject sample size was determined. In one data
      set the presence of Actinobacillus actinomycetemcomitans, Porphyromonas
      gingivalis, Bacteroides forsythus, and Prevotella intermedia was determined by
      indirect immunofluorescence. In the other data set the presence of A.
      actinomycetemcomitans, P. gingivalis, and P. intermedia was determined using DNA
      probes. Results of this study demonstrate that there is a large between subject
      variation in site specific bacterial prevalence, as indicated by an elevated
      intraclass correlation. Simulated data in this report demonstrated that the
      number of necessary bacterial samples per subject increased with increasing
      values of intraclass correlation. The number of necessary within subject samples
      also increased with decreasing prevalence rate. For A. actinomycetemcomitans,
      which had a low prevalence rate (0.11 to 0.18), the number of necessary samples
      per subject was very high (31 to 35).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625151
TI  - Mitogenic, chemotactic, and synthetic responses of rat periodontal ligament
      fibroblastic cells to polypeptide growth factors in vitro.
AB  - The mitogenic, chemotactic, and synthetic responses of rat periodontal ligament
      (PDL) fibroblastic cells to epidermal growth factor (EGF), transforming growth
      factor-beta (TGF-beta), recombinant human platelet-derived growth factor (rhPDGF)
      AB, rhPDGF-BB, natural (n) PDGF-AB, and insulin-like growth factor-I (IGF-I) were
      examined in vitro using PDL cells obtained from the coagulum of healing tooth
      sockets. PDGFs and IGF-I have potent and comparable mitogenic effects on PDL
      fibroblastic cells. The maximum mitogenic effect of PDGFs was observed at the
      concentration of 10 ng/ml, whereas that of IGF-I was seen at concentrations
      higher than 100 ng/ml. In contrast, EGF induced moderate, and TGF-beta inhibitory
      mitogenic responses. The combination of rhPDGF-AB with either EGF or TGF-beta
      demonstrated comparable mitogenic potency, equivalent to the level of PDGF alone
      regardless of the mitogenic effect of other growth factors. The combination of
      rhPDGF-AB and IGF-I, however, showed a synergistic effect revealing the highest
      mitogenic effect among all individual growth factors as well as any combinations
      of the growth factors tested. Similarly, PDL fibroblastic cells demonstrated
      strong chemotactic responses to both IGF-I and PDGFs. The maximum effect was
      observed by IGF-I at concentrations higher than 10 ng/ml, followed by rhPDGF-BB
      at 0.1 ng/ml, rhPDGF-AB and nPDGF at concentrations ranging from 0.1 to 1 ng/ml.
      TGF-beta revealed no, and EGF slightly increased, chemotactic effects. IGF-I
      slightly enhanced the synthesis of total protein, whereas other factors had no
      significant effect. However, both rhPDGF-AB and TGF-beta stimulated collagen
      synthesis. On the other hand, IGF-I showed no effect on collagen synthesis, while
      EGF suppressed collagen synthesis. These findings suggest that rhPDGF-BB and IGF
      I stimulate proliferation and chemotaxis of PDL fibroblastic cells. In addition,
      the combination of these growth factors further increases the mitogenic effect.
      rhPDGF-AB also stimulates collagen synthesis by PDL fibroblastic cells. Thus,
      rhPDGF-BB and IGF-I may have important roles in promotion of PDL healing, and
      consequently, may be useful for clinical application in periodontal regenerative
      procedures.

PMID- 1625152
TI  - The effects of chlorhexidine digluconate on human fibroblasts in vitro.
AB  - The drug chlorhexidine has been widely utilized as a wound antiseptic and oral
      antimicrobial rinse. There have been numerous reports on its safety as an oral
      rinse, but its effects on wound healing have been contradictory. The present
      study utilized human fibroblasts derived from skin and oral tissues to test the
      effects of chlorhexidine on viability, growth, collagen gel contractions, and
      total protein synthesis. Cells were exposed for an hour to 0.005% and 0.002%
      chlorhexidine and for 30 seconds to 0.12% chlorhexidine. Our results indicate
      that a 0.002% concentration of the drug shows minimal cytotoxicity, but is able
      to suppress cell division almost completely. Collagen gel contraction, as a model
      of wound contraction, was also severely affected by all of the concentrations of
      chlorhexidine used. Total protein synthesis was suppressed by chlorhexidine in
      collagen gel culture. The data support the hypothesis that chlorhexidine is
      highly cytotoxic to cells in vitro, but various cell functions such as
      proliferation, collagen gel contraction, and protein synthesis are affected to
      different degrees by the drug.

PMID- 1625153
TI  - Clinical and light microscopic observations of gingivitis and early ligature
      induced periodontitis in the cynomolgus monkey.
AB  - Clinical and histological observations were made on gingivitis and ligature
      induced periodontitis in 4 adult female cynomolgus monkeys (Macaca fascicularis)
      to define the changes occurring in the early periodontitis lesion. Silk ligatures
      were tied around selected posterior teeth and replaced weekly for 4 weeks. The
      changes from gingivitis to periodontitis induced by ligation, and back to a state
      of clinical health after ligature removal, scaling and polishing, were
      characterized by Plaque Index, Gingival Index, probing pocket depth, attachment
      loss, and histologic evaluation. A mild, chronic marginal gingivitis was the
      normal finding in the gingiva of posterior teeth. The inflammatory infiltrate in
      the connective tissue contained primarily lymphocytes. Hygienic measures once a
      week reduced the amount of infiltrate and the epithelial proliferation, but did
      not eliminate it. Placement of silk ligatures rapidly changed the clinical
      picture to a moderate or severe gingivitis, which presented an almost bizarre
      response of sulcular and oral epithelium, with an increase in polymorphonuclear
      neutrophil infiltration. Within 2 weeks there was significant probing attachment
      loss. The clinical response on removal of ligatures and plaque was almost as
      rapid as the onset. The animal model is useful for manipulating variables in ways
      not possible in the study of human periodontitis.

PMID- 1625154
TI  - Early effects of periodontal therapy on the detection frequency of four putative
      periodontal pathogens in adults.
AB  - This study aimed to examine early posttreatment changes in the periodontal
      microflora. Paper point sampling and conventional bacterial cultivation were used
      to monitor the effects of surgical and non-surgical periodontal therapy on the
      detection frequency of Porphyromonas gingivalis, Prevotella intermedia,
      Actinobacillus actinomycetemcomitans, and Capnocytophaga species in deep
      periodontal pockets. Ten patients, 5 men and 5 women (mean age 44 years), with
      advanced periodontal disease were selected from the dental school patient
      population for the study. A total of 245 teeth in 10 defined areas of the
      dentition were treated by oral hygiene instruction followed by scaling and root
      planing alone (121 sites) or with surgical interventions (124 sites). Ninety
      sites, 47 surgical and 43 non-surgical, with initial pocket depth greater than or
      equal to 6 mm were sampled at baseline and 3 months after completion of therapy.
      Treatment by both procedures resulted in significant clinical improvements as
      assessed by all clinical parameters used. Baseline results may indicate that the
      level of P. gingivalis was reduced in the presence of P. intermedia, while A.
      actinomycetemcomitans seemed to be reduced in the presence of P. gingivalis
      and/or P. intermedia. Three months after therapy, the detection frequency of P.
      gingivalis was significantly reduced (P less than 0.05) in surgical and non
      surgical sites while the reduction for P. intermedia was significant only for
      surgical sites (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625155
TI  - Gingival overgrowth among renal transplant recipients related to
      immunosuppressive medication and possible local background factors.
AB  - The aim of this study was to determine the occurrence of gingival overgrowth (GO)
      among renal transplant recipients and to analyze possible background factors
      causing GO among cyclosporine-treated (CsA) patients as compared with others
      receiving azathioprine (Aza). A total of 32 recipients, 22 treated with CsA and
      10 with Aza (ages 22 to 68 years) participated. The examination included
      determination of renal function, whole blood CsA concentration, and periodontal
      status. The tooth surface data were analyzed in terms of the given background
      variables for GO in the whole patient sample by logistic regression analysis. The
      occurrence of GO was significantly higher in the CsA group as compared with the
      Aza group (P less than 0.03). The CsA responders had significantly more gingival
      units overgrown as compared with the Aza responders (P less than 0.005). There
      were no differences in age, sex, whole blood concentration of CsA, or duration of
      CsA medication between the responders and non-responders. Expressed as individual
      means, the gingival inflammation scores were significantly higher among the CsA
      responders than among the CsA non-responders (P less than 0.005). Analysis of the
      surface data showed that CsA had an independent major effect on GO. Furthermore,
      simultaneous gingival bleeding increased the risk of overgrowth (odds ratio = 2).
      The results show that CsA medication is a significant factor for GO and the risk
      of the occurrence of GO is further increased by simultaneous gingival
      inflammation.

PMID- 1625156
TI  - Guided tissue regeneration in the treatment of human facial recession. A 12-case
      report.
AB  - A guided tissue regeneration procedure was used to treat human buccal recessions,
      3 to 7 mm deep, in 12 patients. No procedure for increasing the width of
      keratinized tissue was performed prior to treatment. A thick bipedicled flap was
      raised with a semilunar incision in the alveolar mucosa and a marginal incision
      was extended to the adjacent papilla. The root surface was made concave by curets
      and burs to create space for regeneration. The membrane was fixed to the cemento
      enamel junction and covered by the flap which consisted of the residual gingiva
      and of alveolar mucosa. The membranes were removed 4 weeks after placement. The
      patients were recalled 6 months after the reentry procedure. The average
      reduction in recession was 2.50 mm (P less than 0.01) and the average attachment
      gain was 2.84 (P less than 0.01). Pocket depth was slightly reduced (0.33 mm),
      although the degree of reduction was not of statistical significance. The width
      of keratinized tissue increased slightly (0.83 mm). These results demonstrate the
      possibility of treating human buccal recessions by means of a guided tissue
      regeneration procedure, with predictable recession reduction and attachment gain.
      A minimal amount of keratinized tissue was needed.

PMID- 1625157
TI  - Gingival lesions in lipoid proteinosis.
AB  - Lipoid proteinosis is a rare heritable disease of the skin and mucous membranes
      characterized by subepithelial deposits of hyaline material. The morbid factors
      include disfiguring papulo-nodular lesions particularly of exposed skin,
      hoarseness of voice due to vocal cord infiltration, nodular deformation of the
      eyelids, and board-like rigidity of the tongue. Infiltration of the gingiva is
      usually unreported, and when mentioned has been equivocally related to the
      overall disease process. This patient demonstrates striking ulceration and
      hypertrophy with histologic evidence of heavy deposition of amorphous material
      confirming a gingival component to the lipoid proteinosis entity.

PMID- 1625158
TI  - [Specific nutrition for the pregnant woman].

PMID- 1625159
TI  - [Drug therapy for treatment of obstetrical pathology].

PMID- 1625160
TI  - [Treatment of benign symptoms during pregnancy: advice for the community
      pharmacist].

PMID- 1625161
TI  - [Infant sudden death].

PMID- 1625162
TI  - [Maternal milk].

PMID- 1625163
TI  - [The dietetic basis of infant nutrition].

PMID- 1625165
TI  - [Milk substitution and diversification of nutrition].

PMID- 1625164
TI  - [Infant digestive intolerance].

PMID- 1625166
TI  - [Special milk substitutes].

PMID- 1625167
TI  - [Trace elements and vitamins for pregnant women].

PMID- 1625168
TI  - Protective effects of benidipine hydrochloride (KW-3049), a calcium antagonist,
      against experimental arterial calcinosis and endothelial dysfunction in rats.
AB  - Protective effects of benidipine hydrochloride (KW-3049) against arterial
      calcinosis and its possible mechanisms of action have been investigated. Arterial
      calcinosis was induced in rats by combined administration of vitamin D2 (1050000
      IU/kg, s.c.) and nicotine (12.5 mg/kg, p.o., b.i.d.) for 6 successive days.
      Calcium antagonists, benidipine or nifedipine, were given orally twice a day
      during the same period. The aortic calcium content in vitamin D2 and nicotine
      treated (control) rats increased to about 25 times that in normal rats,
      accompanying an increase of serum calcium level. Benidipine (10 mg/kg, p.o.,
      b.i.d.) reduced the aortic calcium content to about 18% of control rats without
      reducing the serum calcium level. Although the presence of aortic endothelial
      cells was observed under light microscopy in control rats, their surfaces were
      degenerated under scanning electron microscopy. Benidipine exerted a protective
      effect against these degenerative changes. Acetylcholine-induced endothelial
      dependent relaxation was attenuated in control rats, compared with that in normal
      rats. Benidipine significantly improved this attenuation of the relaxation. These
      results suggest that the anticalcinotic effect of benidipine is accompanied by
      its protective effect on endothelial cells.

PMID- 1625169
TI  - Selective analysis of mutual displacement effects at the primary binding sites of
      phenoxymethylpenicillin and cephalothin bindings to human serum albumin.
AB  - In order to analyze the mutual displacement effects on the protein binding of
      beta-lactam antibiotics, binding experiments with the human serum albumin (HSA)
      were performed for cephalothin (CET) and phenoxymethylpenicillin (PCV) by using
      the centrifugal ultrafiltration method. The numbers of primary and secondary
      binding sites, n1 and n2, and the affinity constants for the primary and
      secondary binding sites, K1 and K2 were determined for CET to be 1.00 +/- 0.06
      (mean +/- S.D.) and 4.54 +/- 0.12 and 2.59 x 10(3) +/- 0.10 x 10(3) (M-1) and
      2.59 x 10(2) +/- 0.16 x 10(2) (M-1), respectively, and for PCV to be 0.94 +/-
      0.10 and 5.41 +/- 0.40 and 3.52 x 10(3) +/- 0.25 x 10(3) (M-1) and 4.07 x 10(2)
      +/- 0.54 x 10(2) (M-1), respectively. Using the predicted optimum unbound
      concentration of PCV, i.e., 4.6 x 10(-4) M, the displacement effect of PCV to the
      binding of CET at the primary site has been demonstrated, while no significant
      effect was observed at the secondary binding site. Moreover, a competitive
      displacement effect of CET was also demonstrated for the binding of PCV to HSA at
      the primary binding site, suggesting that CET and PCV bound to HSA at the same
      primary binding site.

PMID- 1625170
TI  - Relationship between lipophilicity and binding affinity with human serum albumin
      for penicillin and cephem antibiotics.
AB  - Relationship between structure and binding affinity to human serum albumin (HSA)
      has been studied for penicillin and cephem antibiotics. For penicillin analogs, a
      good correlation between the apparent affinity constants, Kapp, for HSA binding
      and the partition coefficient, Papp, determined in isobutyl alcohol-pH 7.4
      phosphate buffer system was observed, indicating that the hydrophobic interaction
      of 6-substituent of penicillins with amino acid of HSA would play an important
      role for the binding. However, no correlation between the Kapp and Papp values
      was observed for cephem antibiotics. Mutual competitive displacement effects were
      demonstrated for the primary binding sites of cephalothin, cefazolin, cefotetan
      and cefatrizine, suggesting the presence of a common binding region in HSA among
      these cephem antibiotics examined. Significant differences were observed for the
      Kapp value among cephems having the same 3-substitute of N-methylthiotetrazole in
      the molecule, i.e., cefpiramide, cefotetan, cefoperazone, cefamandole,
      cefmenoxime, cefmetazole and cefbuperazone, suggesting that 7-substitute of
      cephem would play an important role for the binding with HSA. Moreover, comparing
      the binding affinity and the structure of 3-substitute for cephems, all of the
      analogs having a heterocycle bind strongly with HSA in spite of their low
      lipophilicity. These observations suggest that an interaction between heterocycle
      at the position 3 and HSA would contribute to an additional binding force for the
      binding of cephem antibiotics to HSA.

PMID- 1625171
TI  - A time for action.

PMID- 1625172
TI  - Children's participation in research: their right to consent.
AB  - This article discusses the ethical and legal considerations related to the
      inclusion of children in the research process. Specific attention is paid to
      situations in which customary guidelines are inappropriate. In addition, the
      results of a survey to determine the manner in which Institutional Review Boards
      are addressing these issues is presented with suggestions to assist nurse
      researchers in acquiring review board approvals.

PMID- 1625173
TI  - School-aged children's interpretation of their experience with acute surgical
      pain.
AB  - This study examined the intensity of pain children experience following surgical
      procedures, the relationship between analgesic administration patterns and
      perceived level of pain, and children's affective, cognitive, and sensory
      interpretation of their experiences with pain. The sample included 24 children
      between 7 and 11 years of age who were hospitalized after abdominal, orthopedic,
      or urologic surgery. Children rated the intensity of their pain on a visual
      analog scale three times on the day after surgery. A chart review examined
      analgesic administration. On the third day after surgery, children were
      interviewed about their experiences with pain. The findings provide insight into
      the content of children's fears and concerns when they have postoperative pain,
      and how they interpret their responses and the responses of others in the
      management of their pain experience.

PMID- 1625175
TI  - The short bowel syndrome: an update and a case study.
AB  - Infants with the short-bowel syndrome are living longer and are increasing in
      number due to new medical treatments and a larger number of survivals with very
      low birth weights. This article reviews the medical and nursing management of
      these infants. A case study of an infant with the short-bowel syndrome is
      presented with a detailed nursing care plan emphasizing the physical, emotional,
      and social care of these infants.

PMID- 1625174
TI  - Social competence of school-aged children with chronic illnesses.
AB  - This study examines social competence among 67 chronically ill children, aged 7
      to 14 years, whose families participated in a grounded theory study of how
      families define and manage a child's chronic illness. Child Behavior Check List
      ratings (Achenbach & Edelbrock, 1983) by both fathers and mothers indicated a
      significantly greater risk for social competence difficulties among the
      chronically ill children as compared with the normative sample. Case vignettes,
      drawn from extensive interviews with family members, are used to show contrasting
      styles of family management and child coping and to suggest nursing interventions
      aimed at fostering social competence.

PMID- 1625176
TI  - Disease patterns in homeless children: a comparison with national data.
AB  - Although homeless children have increased in numbers as poverty has become
      feminized, minorities have become poorer, and low-income housing has become less
      accessible, little is known of their health problems. This study compared the
      health problems of a group of uninsured and homeless children visiting a free,
      nurse-managed, primary care clinic on Los Angeles' Skid Row with data from
      children's primary care visits to pediatricians and general and family physicians
      sampled in the National Ambulatory Medical Care Survey. Diagnoses were classified
      into the following health service categories: (a) acute, (b) communicable, and
      (c) chronic disease; (d) preventive and (e) injury care. Comparisons indicated
      that services to homeless children differed significantly from reimbursed
      services in the national sample in all categories except chronic disease.
      Demographic analysis indicated that homeless children were predominantly Hispanic
      Americans. When data from Hispanic children were examined, the pattern of
      differences between the homeless and National Ambulatory Medical Care Survey
      diagnostic categories persisted. This study shows the variations in nursing care
      which a group of high-risk, severely impoverished, uninsured children require.

PMID- 1625177
TI  - The family and chronic sorrow: role theory approach.
AB  - This article explores the presence of chronic sorrow in families of chronically
      ill children and applies role theory concepts in the understanding of this
      phenomenon. Research findings in the area of chronic sorrow, family adaptation,
      and role theory are used to formulate propositions specific to the application of
      role theory in the study of chronic sorrow. The clinical and research
      applicability for nurses working with families of chronically disabled children
      are discussed to assist in providing quality family-nursing care.

PMID- 1625178
TI  - Nursing services for children of families living in university housing.
AB  - A university-based ambulatory pediatric nursing clinic was developed for two
      purposes: (a) to provide clinical experiences for senior nursing students in
      pediatric ambulatory care, and (b) to deliver nursing services to families with
      children for whom no organized health service existed on campus. Topics covered
      in this article include a literature review, historical background, and
      description of services delivered. A brief case study depicts use of the nursing
      clinic by one family.

PMID- 1625179
TI  - Family foster care: a service under siege.

PMID- 1625180
TI  - Microcomputers in nursing practice: point of care clinical series software, Part
      II.

PMID- 1625181
TI  - Establishing an education program for non-English-speaking families.

PMID- 1625182
TI  - Effects of L-carnitine on carbon tetrachloride-induced changes in serum and liver
      lipids and acylcarnitines.
AB  - Effects of 0.5% L-carnitine-supplemented diet on carbon tetrachloride-induced
      alterations of hepatic and serum lipids were examined in male rats. Treatment
      with carbon tetrachloride significantly increased hepatic total lipids,
      triglycerides, and total carnitine, but these were not significantly altered by
      0.5% L-carnitine supplementation. However, in plasma, supplementary carnitine
      significantly decreased nonesterified fatty acids and increased acylcarnitines.
      These suggest that carnitine may soften hepatic lipid load by releasing
      acylcarnitines in blood.

PMID- 1625183
TI  - Changes of 8-hydroxydeoxyguanosine levels in rat organ DNA during the aging
      process.
AB  - We investigated the accumulation of oxidative DNA damage during the aging process
      by using 8-hydroxydeoxyguanosine (8-OH-dG) as a marker. The 8-OH-dG is one of the
      oxidative DNA damage products and is supposed to be a critical factor in
      carcinogenesis involving oxygen radicals. The 8-OH-dG levels in the DNA of liver,
      kidney, brain, lung, and spleen were measured in male and female F344 rats 6- to
      30-month-old. The 8-OH-dG levels in the liver and kidney DNA of male rats
      increased significantly with age, but did not change in brain, lung, and spleen.
      Similarly, the 8-OH-dG levels in the liver and kidney DNA of female rats
      significantly increased with age, while changes in the brain, lung, and spleen
      DNA were much smaller. These results indicate that the accumulation of oxidative
      DNA damage during the aging process varies among organs, with slight sex
      difference.

PMID- 1625184
TI  - Hepatomegaly is an early biomarker for hepatocarcinogenesis induced by peroxisome
      proliferators.
AB  - The relationship between hepatomegaly and the hepatocarcinogenesis associated
      with by peroxisome proliferators was examined. (1) Male F-344 rats were
      maintained on diets containing clofibrate, ciprofibrate, nafenopin, gemfibrozil,
      Wy-14, 643, di(2-ethylhexyl)phthalate (DEHP), or di(2-ethylhexyl)adipate (DEHA)
      at carcinogenic doses for 1 week. A close correlation between relative liver
      weights and hepatocarcinogenicity was observed (r = 0.910). (2) Administration of
      perfluorooctanoic acid (PFOA), perfluorodecanoic acid (PFDA), simfibrate, or DL
      040, for which hepatocarcinogenicity is not known, resulted in hepatomegaly in
      all treated groups, this being especially marked in the PFOA case. Therefore,
      PFOA may have strong hepatocarcinogenic potential. (3) Administration of the
      antioxidants butylated hydroxyanisole (BHA) or vitamin E (VE) did not affect the
      hepatomegaly induced by DEHP. These results suggest that the hepatomegaly may be
      an early biomarker for prediction of the potential hepatocarcinogenicity of
      peroxisome proliferators. However, this requires further clarification in terms
      of its relation to the oxidative stress thought to be involved in peroxisome
      proliferator-induced hepatocarcinogenesis.

PMID- 1625185
TI  - Malignancy of proliferative pulmonary lesions in the Syrian hamster following
      inhalation of 239PuO2.
AB  - The malignancy of pulmonary lesions induced by inhaled 239PuO2 in the Syrian
      hamster was tested by transplantation in the hamster cheek pouch. Serving as
      negative and positive controls, 42 female hamsters were given either 0.9% sodium
      chloride (NaCl), ferric oxide suspended in NaCl (Fe2O3), or benzo(a)pyrene +
      Fe2O3 suspended in NaCl (BP), by intratracheal instillation. One hundred female
      hamsters were given a single, nose-only inhalation exposure to high-fired 239PuO2
      (initial lung burden, 2.4 kBq). At intervals from 160 to 425 days after Pu
      inhalation or instillation, ten 1-mm3 tissue cubes were removed from the lung of
      each hamster and transplanted into the cheek pouch of male hamsters, for a total
      of 1320 transplantations. None of the lung transplants from hamsters receiving
      239PuO2, NaCl, or Fe2O3 grew in recipient cheek pouches, but 14% of transplants
      from BP hamsters grew rapidly in the cheek pouch. Lung carcinomas were
      histologically identified only in BP hamsters and BP transplants. It was
      concluded that proliferative pulmonary lesions induced by a-irradiation of the
      lung of hamsters were not malignant, and that the malignancy of lung lesions in
      the hamster induced by ionizing radiation should be evaluated by transplantation.

PMID- 1625186
TI  - Breast cancer and diet in Spain.
AB  - Breast cancer is the foremost cause of cancer death in women. A possible
      relationship has been suggested between breast cancer and cholesterol-rich diets,
      although no clear link has been established till now. This is an epidemiological
      study of the evolution of breast cancer mortality in Spain during the period 1977
      to 1985, and it was made in relation to the principal dietary components of this
      country. The study period involved has made it necessary to take into account the
      corresponding changes in demographic structure; thus, standardization or specific
      fitting permitted comparisons. Global energy consumption in Spain is under 150
      kcal per person per day for 50% of the population, and less than 180 kcal per
      person per day for 98% (range: 140 to 162) during the study period involved. Low
      correlation values were observed in relating mean breast cancer mortality rates
      for the 50 Spanish provinces to the dietary components studied. However, the most
      significant correlations relate mean mortality rate to total lipids, fiber,
      cereals, and Vitamin C intake.

PMID- 1625187
TI  - Digestive cancer in relation to diet in Spain.
AB  - Dietary factors are widely considered to be largely responsible for the different
      cancer incidences observed in different populations. In the present study we
      investigated the possible influence of dietary habits on the incidence of
      digestive cancer in the provinces of Spain. Data on specific mortality due to
      digestive cancer corresponding to the period 1975 to 1985 were obtained from the
      Instituto Nacional de Estadistica. Nutritional data on the different provinces
      were in turn gathered from the Instituto de Nutricion del Consejo Superior de
      Investigaciones Cientificas. The information was processed by the SPSS
      statistical software package. Lifestyle and socio-cultural factors are found to
      influence dietary risk factors in digestive cancer, particularly among women. The
      most significant correlations with the different cancers studied corresponded to
      total energy intake (responsible for 27.4% of variance), animal fats, and smoked
      fish and coffee. The latter is related to oral and esophageal cancer in
      particular (responsible for 15.4% of variance). Consumption of carrots and frozen
      vegetables is responsible for 6.5% of variance, vs. 4.4% of variance for
      alcoholic beverages, sugar, and Vitamin D. Differences are noted between both the
      sexes and their relationship to the different cancers studied.

PMID- 1625188
TI  - Caffeine, theophylline, theobromine, and developmental growth of the mouse
      mammary gland.
AB  - The purpose of this study was to determine the comparative activities of three
      methylxanthines, i.e., 1,3,7-trimethylxanthine (caffeine), 1,3-dimethylxanthine
      (theophylline), and 3,7-dimethylxanthine (theobromine) on developmental growth of
      the mammary gland in ovarian-hormone treated, mature nulliparous female Balb/c
      mice. When caffeine or theophylline was administered daily (via drinking water,
      500 mg/L) for 30 days to 17 beta-estradiol/progesterone-treated intact or
      ovariectomized mice, a significant (p less than 0.05) enhancement of hormone
      induced mammary gland lobulo-alveolar differentiation was observed. Caffeine or
      theophylline thus accelerated and/or intensified mammae lobulo-alveolar
      differentiation induced by the ovarian steroids. In contrast, theobromine (500
      mg/L drinking water) did not significantly modify this developmental process. The
      stimulatory effect of caffeine and theophylline on mammae development was
      comparable quantitatively. In an effort to determine whether or not the
      stimulatory effect of caffeine or theophylline was directly on the mammary gland,
      small slow-release Elvax-40P pellets containing these methylxanthines were
      implanted directly into the mammary gland of mice concurrently treated with
      estrogen and progesterone. No significant stimulatory effect of caffeine or
      theophylline (or theobromine) was observed. Furthermore, the addition of
      methylxanthines (caffeine, 100 microM) to the culture media of whole mouse
      mammary glands (organ cultures) did not enhance lobulo-alveolar differentiation
      induced by mammotrophic hormones. Thus, while a consistent significant
      stimulatory effect of caffeine and theophylline on mammary lobulo/alveolar
      differentiation was observed when the methylxanthines were consumed orally
      (drinking water), no direct effect of these methylxanthines, when placed directly
      into the mammary gland or in culture media, on mammae development was observed.
      These data demonstrate that certain methylxanthines (e.g., caffeine and
      theophylline) but not others (e.g., theobromine) can significantly enhance
      mammotrophic hormone-induced mammary lobulo-alveolar differentiation in female
      Balb/c mice, an effect that appears not to be manifested via a direct action of
      the methylxanthines on the mammary gland.

PMID- 1625189
TI  - Development of tolerance to the analgesic activity of mu agonists after
      continuous infusion of morphine, meperidine or fentanyl in rats.
AB  - We investigated the role of intrinsic activity in the ability of mu-opioid
      agonists to produce tolerance to the analgesic effects of other mu agonists. Dose
      response curves were generated for each test drug before and 24 hr after 1 week
      s.c. agonist infusions, using a tail-flick procedure in male rats. Morphine
      tolerance was dose-dependent over a range of doses, 0.3 to 1.4 mg/kg/hr, infused
      for 7 days by osmotic pump; 0.8 mg/kg/hr (1/4 acute ED50/hr) shifted the morphine
      dose-response curve roughly 2-fold to the right. Morphine, fentanyl or meperidine
      were then infused for 1 week to induce tolerance; doses were based on equipotent
      acute s.c. doses (1/4 ED50/hr). Drugs tested for analgesic activity, using a
      cumulative dosing procedure, included morphine, fentanyl, meperidine, methadone,
      buprenorphine, etorphine and levorphanol. The relative potency (RP) was
      calculated for each animal by dividing the preinfusion analgesic ED50 by the
      postinfusion ED50. The potency of morphine, fentanyl, meperidine and levorphanol
      decreased after a 7-day infusion of 0.8 mg/kg/hr morphine (RP = 0.44-0.70), but
      the potency of etorphine (RP = 0.85) and methadone (RP = 0.78) were not
      significantly changed. Chronic infusions of 6.25 mg/kg/hr meperidine produced
      more tolerance than did morphine (RP = 0.11-0.51). No significant change in
      analgesic potency was seen in six of the seven test drugs after infusions of 0.01
      mg/kg/hr fentanyl (RP = 0.81-1.27). Buprenorphine did not produce an analgesic
      response in rats that received infusions of any of the three mu agonists. The RP
      of drugs with low intrinsic activity was lower than the RP of high efficacy
      drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625190
TI  - M2 muscarinic receptors inhibit isoproterenol-induced relaxation of canine airway
      smooth muscle.
AB  - Classification of muscarinic receptors in the central airways has revealed the
      coexistence of M2 and M3 muscarinic receptors in this tissue, with the M2 subtype
      being predominant. Although M3 muscarinic receptors have been linked to airway
      smooth muscle contraction, a functional role for the M2 subtype in this tissue
      has been unclear. In nonairway smooth muscle, stimulation of the M2 muscarinic
      receptor has been shown to be associated with inhibition of adenylyl cyclase. In
      the present study, characterization of muscarinic receptors in canine tracheal
      smooth muscle confirmed that the majority of these muscarinic receptors were of
      the M2 subtype (89 +/- 3%), with a minor population of M3 receptors (11 +/- 3%).
      In functional studies, both isoproterenol and forskolin cause a dose-dependent
      relaxation of precontracted airway smooth muscle. In tissues precontracted with
      methacholine, 11-([[2-(diethylamino)methyl]-1-piperidinyl]acetyl)5,11- dihydro-6H
      pyrido[2,3-6][1,4]benzodiazepine-6-one (AF-DX 116), a selective M2 antagonist,
      shifted dose-response curves to both isoproterenol and forskolin significantly to
      the left. In contrast, AF-DX 116 did not alter relaxation induced by the K+
      channel opener BRL 38227. Furthermore, the ability of AF-DX 116 to enhance
      isoproterenol-induced relaxation appears to be limited to smooth muscle
      precontracted with muscarinic agonists because AF-DX 116 had no effect on
      isoproterenol dose-response curves in muscle strips precontracted with histamine.
      Hexahydrosiladifenidol (HHSiD), a selective antagonist for M3 receptors, did not
      shift the isoproterenol dose-response curve in muscle precontracted with
      methacholine. This study demonstrates that stimulation of M2 muscarinic receptors
      in canine airway smooth muscle plays an important role in functional antagonism
      by reducing the relaxation caused by agents such as isoproterenol and forskolin.

PMID- 1625191
TI  - Attenuation of amiodarone-induced lung fibrosis and phospholipidosis in hamsters
      by taurine and/or niacin treatment.
AB  - Therapeutic use of amiodarone (AD), an effective antiarrhythmic drug, is
      associated with serious pulmonary toxicity (e.g., fibrosis and phospholipidosis).
      In the present study, we tested if taurine and/or niacin, which prevent bleomycin
      induced lung toxicity, could prevent AD-induced lung toxicity in hamsters. AD
      alone significantly increased lung hydroxyproline (an index of fibrosis) and lung
      phospholipid (an index of phospholipidosis) levels to 154 and 133% of their
      control counterparts at 21 days, respectively. However, treatment of hamsters
      with taurine, niacin or taurine + niacin for 6 days before AD, and daily
      thereafter, significantly decreased subsequent AD-induced collagen accumulation.
      Similarly, phospholipid levels in niacin + AD and taurine + niacin + AD groups
      were decreased significantly compared to AD alone. We conclude that taurine and
      niacin administered p.o. either singly or in combination can significantly
      decrease AD-induced increases in lung collagen deposition and phospholipidosis
      and may, therefore, be potentially useful in reducing AD-induced pulmonary
      toxicity.

PMID- 1625192
TI  - In vitro pharmacology of L-158,809, a new highly potent and selective angiotensin
      II receptor antagonist.
AB  - L-158,809 interacted in a competitive manner with rabbit aortic angiotensin II
      (AII) receptors as determined by Scatchard analysis of the specific binding of
      [125I]Sar1Ile8-AII. The affinity of L-158,809 (IC50 = 0.3 nM) for AII receptors
      in this tissue was appreciably greater than that of other reported nonpeptide AII
      antagonists such as DuP-753 (IC50 = 54 nM) and EXP3174 (IC50 = 6 nM) and similar
      to the natural ligand, AII. L-158,809 also exhibited a high potency at AII
      receptors in several other tissues from different animal species (IC50 = 0.2-0.8
      nM). In vitro functional assays utilizing AII-induced aldosterone release in rat
      adrenal cortical cells demonstrated further that L-158,809 acts as a competitive,
      high affinity antagonist of AII (pA2 = 10.5) and lacks agonist activity. L
      158,809 also potently inhibited AII-induced inositol phosphate accumulation in
      vascular smooth muscle cells and contractile responses to AII in isolated blood
      vessels. The specificity of L-158,809 for AII receptors was demonstrated by its
      lack of activity (IC50 greater than 1 microM) in several other receptor binding
      assays and its inability to affect in vitro functional responses produced by
      other agonists. L-158,809 demonstrated a very high selectivity for the AT1
      compared to the AT2 receptor subtype (AT2 IC50 greater than or equal to 10
      microM). The high affinity and selectivity makes L-158,809 a valuable new tool
      for investigating the physiological and pharmacological actions of AII.

PMID- 1625193
TI  - In vivo pharmacology of L-158,809, a new highly potent and selective nonpeptide
      angiotensin II receptor antagonist.
AB  - L-158,809 (5,7-dimethyl-2-ethyl-3-[[2'-(1H-tetrazol-5yl)[1,1']-bi- phenyl-4-yl]
      methyl]-3H-imidazo[4,5-b]pyridine) is a potent, competitive and specific
      antagonist of AT1 subtype of angiotensin II (AII) receptors in in vitro
      radioligand binding and functional isolated tissue assays. The present study was
      carried out to characterize the in vivo pharmacology of this potent AII receptor
      antagonist. In conscious, normotensive and anesthetized pithed rats, L-158,809
      inhibits AII (0.1 microgram/kg i.v.) elevations in blood pressure without
      altering pressor responses to methoxamine or arginine vasopressin. In conscious
      rats, the relative potencies (ED50) were 29 micrograms/kg i.v. and 23
      micrograms/kg p.o. Duration of action with single i.v. or p.o. doses exceeded 6
      hr in rats. In similar experiments using rhesus monkeys, the potencies of L
      158,809 were 10 micrograms/kg i.v. and approximately 100 micrograms/kg p.o. In
      these rats and monkeys, L-158,809 was 10 to 100 times more potent than DuP-753
      (losartan) and approximately 3 times more potent than the metabolite, EXP3174.
      AII-induced elevation of plasma aldosterone in rats was also inhibited by L
      158,809. Unlike angiotensin converting enzyme inhibitors, L-158,809 did not
      potentiate the hypotensive responses to i.v. bradykinin. L-158,809 was
      antihypertensive in high renin hypertensive rats (aortic coarction) and volume
      depleted rhesus monkeys. The maximum hypotensive responses with acute doses of L
      158,809 were equal to those with an angiotensin converting enzyme inhibitor in
      these renin-dependent animal models. From these in vivo data, L-158,809 is a
      selective AII receptor antagonist with high potency, good p.o. absorption, long
      duration and antihypertensive efficacy equal to angiotensin converting enzyme
      inhibition after single doses.

PMID- 1625195
TI  - Aminoglycoside-mediated calciuresis.
AB  - Gentamicin and calcium compete for binding to various tissues including renal
      tubular brush border. Moreover, gentamicin has calcium channel blocking
      properties in cardiac and vascular tissue. Calcium channel blockade in vitro by
      nifedipine or verapamil decreases calcium uptake by renal tubular epithelial
      cells. To determine the acute in vivo effects of gentamicin on renal calcium
      handling, we administered gentamicin 10 mg/kg as an i.v. bolus to F344 rats.
      Within 30 min of administration fractional excretion of calcium increased from a
      mean of 11 +/- 2% (S.E.M.) to 128 +/- 37%. There was no change in glomerular
      filtration rate, or urinary sodium, potassium or phosphate excretion. Maximum
      calciuria occurred immediately after administration, was dose-related and was
      correlated to preadministration urinary calcium. Urine calcium concentration was
      also correlated to urinary gentamicin concentration. Urinary calcium returned to
      base-line values within 90 min of bolus gentamicin administration, but remained
      elevated if a gentamicin infusion was continued. Parathyroidectomy and dietary
      calcium content did not affect gentamicin calciuria. Tobramycin, a less
      nephrotoxic aminoglycoside in the F344 rat, had calciuric effects similar to
      gentamicin. Verapamil, a calcium channel blocker which is largely excluded from
      the urine, and potassium dichromate, a nonaminoglycoside proximal tubular
      nephrotoxin, had no effect on urinary calcium. The mechanism of aminoglycoside
      calciuria is unclear, but may be related to competition between aminoglycosides
      and calcium for brush border binding, intraluminal calcium channel blockade by
      aminoglycosides or aminoglycoside inhibition of basolateral calcium ATPase or Na
      K ATPase.

PMID- 1625194
TI  - Protective effects of (2E)-3-[5-(2,3-dimethoxy-6-methyl-1,4- benzoquinoyl)]-2
      nonyl-2-propenoic acid on endotoxin-mediated hepatitis in mice.
AB  - E3330 [(2E)-3-[5-(2,3-dimethoxy-6-methyl-1,4-benzoquinoyl)]-2-nonyl-2- propenoic
      acid] is a newly synthesized hepatoprotective quinone derivative. We examined the
      protective effects and possible mechanism of action of E3330 in three different
      endotoxin (lipopolysaccharide)-induced murine hepatitis models, in which tumor
      necrosis factor is suggested to play a critical role in the pathogenesis. One of
      these models was induced by i.v. injection of lipopolysaccharide in combination
      with D-galactosamine to mice. Oral pretreatment with E3330 improved the survival
      rate and attenuated the increase in plasma aminotransferase activities of the
      survivors. The other two models were induced by i.v. injection of
      lipopolysaccharide or a mixture of D-galactosamine and lipopolysaccharide in
      Propionibacterium acnes-primed mice. In both of these models, tumor necrosis
      factor was detected in the plasma within 3 hr of the injection. Oral pretreatment
      with E3330 attenuated the elevation of plasma tumor necrosis factor activity and
      protected mice from liver injury. Furthermore, E3330 inhibited the production of
      tumor necrosis factor from cultured Propionibacterium acnes-elicited murine
      peritoneal macrophages on stimulation with lipopolysaccharide in vitro. These
      findings suggest that the inhibition by E3330 of tumor necrosis factor production
      is the major mechanism of the protective effect of E3330 in these endotoxin
      mediated hepatitis models in mice.

PMID- 1625196
TI  - Role of aortic baroreceptors in ethanol-induced impairment of baroreflex control
      of heart rate in conscious rats.
AB  - This study investigated the relative contribution of aortic baroreceptors to the
      depressant effect of ethanol on arterial baroreceptor function. The acute
      hemodynamic effects of ethanol were studied in conscious freely moving aortic
      baroreceptor denervated (ABD) and sham-operated (SO) rats. ABD but not the sham
      operation caused immediate and significant (P less than .05) increases in mean
      arterial pressure and heart rate (HR) and an impairment of the baroreflex
      mediated control of HR (baroreflex sensitivity, BRS). Two to three days after
      ABD, these parameters, except the BRS, subsided to near-control levels. Both
      operations (ABD and sham) significantly reduced the daily water intake but the
      reduction was significantly greater in ABD rats. Intravenous administration of
      ethanol (0.1, 0.5 or 1.0 g/kg) to either SO or ABD rats produced short-lived dose
      related pressor and bradycardiac responses which correlated well with blood
      ethanol concentration. In SO rats, ethanol caused dose-related decreases in the
      slopes of the curves relating increments in mean arterial pressure induced by
      phenylephrine to corresponding bradycardiac responses; the higher dose
      significantly (P less than .05) reduced the slope from -2.03 +/- 0.14 to -1.28 +/
      0.18 beats/min/mm Hg, indicating an impairment of BRS. Conversely, in ABD rats,
      ethanol failed to influence the BRS; the slopes before and after ethanol (1 g/kg)
      were similar (-1.1 +/- 0.07 vs. -1.0 +/- 0.23 beats/min/mm Hg). The lack of
      ethanol effect in ABD rats cannot be accounted for by the assumption that aortic
      barodenervation depressed the baroreceptor reflex to its nadir or by a difference
      in concentration of blood ethanol.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625197
TI  - Influence of the adenosine receptor antagonist, CGS 15943A, on renal function
      after reconstruction of chronic renal artery stenosis in the dog.
AB  - Surgical reconstruction of chronic renal artery stenosis may correct the
      anatomical defect but not result in an initial improvement in function of the
      revascularized kidney. The functional and hemodynamic changes associated with
      surgical correction of the one-clip, two-kidney, canine model of renovascular
      hypertension were studied. In 14 dogs, a surgical clip was placed across the
      proximal renal artery and tightened to decrease perfusion pressure (RPP) and
      blood flow (RBF). One month later, measurements were obtained distal to the
      constriction, before and 30 min after vascular reconstruction. Surgical
      reconstruction was associated with a rise in RPP (86%, P less than .001), renal
      vascular resistance (47%, P less than .001) and RBF (22%, P less than .05).
      Creatinine clearance (CCr) remained unchanged, but a significant negative
      association existed between initial CCr and change in CCr. The role of adenosine
      in mediating these changes was examined using the selective receptor antagonist,
      CGS 15943A (CGS), or its vehicle. After vascular reconstruction, vehicle dogs
      sustained a marked increase in renal vascular resistance, with a 60 +/- 8 mm Hg
      rise in RPP, but only an 18% rise in RBF. In contrast, renal vascular resistance
      was unchanged in the CGS group, with a 56 +/- 7 mm Hg increase in RPP and a 69%
      increase in RBF (P less than .0001). CCr was not changed by either vascular
      reconstruction or CGS 15943A. Vascular reconstruction was associated with
      increases in urinary flow rate and sodium excretion in both groups, but this
      change was significantly greater in the CGS group.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1625198
TI  - Chimeric M1/M2 muscarinic receptors: correlation of ligand selectivity and
      functional coupling with structural modifications.
AB  - Chimeric M1/M2 receptors were expressed in murine fibroblasts (B82) transfected
      with recombinant m1/m2 receptor genes. The binding affinities of a number of
      muscarinic antagonists and the agonist carbachol for these chimeric receptors
      were compared with the ligands' affinities for the M1 and M2 receptors expressed
      in the B82 cells. The tricyclic compounds, namely pirenzepine (PZ), 11-([2
      [(diethylamino)methyl]-1-piperidinyl]acetyl)-5,11- dihydro-6H-pyrido-[2,3
      6][1,4]benzodiazepine-6-one (AF-DX 116) and himbacine, shared a binding site
      between transmembrane domains VI and VII. However, the selective interaction of
      pirenzepine with M1 and AF-DX 116 and himbacine with M2 involved different
      structural regions. The high-affinity binding for 4-diphenylacetoxy-N-
      methylpiperidine and hexahydrosiladifenidol was confined to within loop o2 and
      transmembrane domains V and VI, which were clearly distinguishable from those of
      the tricyclic compounds. These results support the hypothesis that the ligands'
      stereochemical features are critical in their optimal alignment within the ligand
      binding pocket. The cytoplasmic i3 loop modulated the binding of carbachol such
      that receptors which contained the i3 domain from the M2 receptor exhibited a
      single high-affinity state, whereas those with the i3 domain from the M1 receptor
      had an additional low-affinity state for the agonist. The i3 regions are
      essential for the differential functional coupling of the M1 and M2 receptors to
      second messenger systems; however, additional upstream regions seem to be
      essential for a potent and efficacious activation of phospholipase C by the M1
      receptor. This study provides new insight into the molecular basis of ligand
      selectivity.

PMID- 1625200
TI  - Norepinephrine amplifies angiotensin II-induced vasoconstriction in rabbit
      femoral artery.
AB  - Several reports have focused on the ability of angiotensin II to amplify vascular
      contractile responses to norepinephrine, but none have determined whether
      norepinephrine enhances angiotensin II-induced vasoconstriction. Measuring
      isometric contraction in isolated rabbit femoral artery rings, we have found that
      the angiotensin II-induced contractile response was amplified in the presence of
      a threshold contraction to norepinephrine, as manifested by a 2.9-fold leftward
      shift of the midpoint of the concentration-response curve with no change in the
      maximal response. This amplification was attenuated markedly by nifedipine (0.1
      microM), a calcium channel antagonist, implicating calcium channel activation in
      the amplification phenomenon. Precontracting the smooth muscle with a threshold
      concentration of angiotensin II had no enhancing effect on further angiotensin
      responses, indicating that the norepinephrine-induced amplification was due to a
      specific action of norepinephrine, rather than to a precontraction itself. In
      experiments in which the angiotensin II response was diminished by the presence
      of the noncompetitive angiotensin II antagonist [Sar1 Ala8]angiotensin II (0.3
      microM), norepinephrine affected the angiotensin II response primarily by
      increasing the maximal response attainable. Prazosin (0.1 microM) both blocked
      the norepinephrine threshold contraction and abolished completely the
      amplification. However, when the norepinephrine concentration was increased until
      a threshold contraction was elicited in the presence of a fixed concentration of
      prazosin, amplification of the angiotensin II response was restored. These
      results indicate that norepinephrine exerts its amplifying effect on angiotensin
      II via activation of alpha-1 adrenoceptors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625199
TI  - Morphine potentiates transforming growth factor-beta release from human
      peripheral blood mononuclear cell cultures.
AB  - Opiates modulate a variety of immune responses by peripheral blood mononuclear
      cells (PBMC). In the present study, we investigated the effect of morphine on the
      release of several cytokines upon stimulation with mitogens. An interleukin (IL)
      4-dependent HT-2 cell proliferation assay was used to quantify transforming
      growth factor-beta (TGF-beta). IL-6 and tumor necrosis factor-alpha (TNF-alpha)
      were measured by enzyme-linked immunosorbent assays. Morphine (1 pM and 10 nM)
      alone did not significantly modulate the release of TGF-beta, IL-6 or TNF-alpha.
      Upon stimulation with lipopolysaccharide and phytohemagglutinin, PBMC released
      more (P less than .01) TGF-beta, IL-6 and TNF-alpha than unstimulated PBMC.
      Exposure of PBMC to morphine (1 pM) for 24 hr substantially amplified (P less
      than .05) the release of TGF-beta in the following 24 hr incubation period.
      Morphine did not alter the release of immunodetectable IL-6 or TNF-alpha from
      stimulated cells. The amplifying effect of morphine on the release of TGF-beta
      was mediated through a naloxone-sensitive mechanism. Given the fact that TGF-beta
      has a potent immunosuppressive effect, morphine-potentiated release of TGF-beta
      from PBMC may be involved in the immunomodulatory activity ascribed to morphine.

PMID- 1625201
TI  - Toxicity of the 1-methyl-4-phenyl-2,3-dihydropyridinium and 1-methyl-4
      phenylpyridinium species in primary cultures of mouse astrocytes.
AB  - The biochemical and toxic effects of the two monoamine oxidase-generated
      metabolites of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine were investigated
      using primary cultures of mouse astrocytes. After the addition of equimolar
      concentrations (25 microM) of these metabolites, namely 1-methyl-4-phenyl-2,3
      dihydropyridinium (MPDP+) ion or 1-methyl-4-phenylpyridinium (MPP+) ion, similar
      levels of MPP+ accumulated within the astrocytes. Both MPDP+ and MPP+ caused
      cytotoxicity which was preceded by increased glucose utilization and lactate
      accumulation. The metabolites were equipotent in producing a rapid decrease in
      cellular ATP which correlated well with the intracellular accumulation of MPP+
      and the loss of cell viability. When astrocytes were incubated in glucose-free
      medium, both ATP depletion and loss of viability occurred more rapidly. Formation
      of MPP+ from MPDP+ was not affected by the presence of astrocytes, because MPP+
      concentrations increased over time at the same rate regardless of the presence or
      absence of cells. In contrast to pretreatment of cells with monoamine oxidase
      inhibitors before addition of MPTP, pretreatment of astrocytes with deprenyl and
      clorgyline had no effect on intracellular levels of MPP+ after exposure to MPDP+
      or MPP+ and did not protect against ATP depletion or cytotoxicity. These results
      indicate that 1) MPP+ and MPDP+ cause similar metabolic changes leading to cell
      death probably via ATP depletion; (2) intracellular levels of MPP+ are directly
      correlated to cytotoxicity; and (3) MPDP+ toxicity is also correlated to
      intracellular MPP+ accumulation, further confirming that MPP+ rather than MPDP+
      is responsible for cell damage.

PMID- 1625202
TI  - Effects of xylamine on vascular neuroeffector transmission.
AB  - The effect of xylamine on sympathetic neuroeffector transmission in rabbit
      isolated blood vessels was examined. Xylamine (10(-8) to 10(-6) M) caused a
      slowly progressing inhibition of the contractions of pulmonary artery evoked by
      electrical field stimulation. The inhibition was irreversible. Cocaine (3 x 10(
      5) M) prevented the inhibitory action of xylamine (10(-7) M), but it did not
      reverse the inhibition caused by xylamine (10(-6) M). Xylamine (10(-7) to 3 x 10(
      5) M) reduced the accumulation of [3H]norepinephrine (NE) (10(-8) M). In the
      presence of desipramine (10(-6) M), xylamine (10(-7) to 3 x 10(-5) M) and
      corticosterone (10(-6) to 10(-4)) reduced the 3H-accumulation. Xylamine (10(-7)
      to 10(-5) M) reduced the tissue NE content by up to 50%. Xylamine (10(-7) to 10(
      6) M) antagonized in a noncompetitive manner the contractions of aorta evoked by
      NE (10(-9) to 3 x 10(-5) M), histamine (10(-6) to 3 x 10(-4) M) and 5
      hydroxytryptamine (10(-8) to 3 x 10(-4) M). In the case of NE, the antagonism was
      more marked in the presence of either cocaine (3 x 10(-5) M) plus corticosterone
      (4 x 10(-5) M) or corticosterone (4 x 10(-5) M). In the presence of xylamine (10(
      7) to 10(-6) M), cumulative addition of near maximally effective concentrations
      of NE, 5-hydroxytryptamine and histamine caused a progressive and complete
      relaxation of aorta. Xylamine (10(-7) to 10(-5) M) did not alter the contractions
      of aorta evoked by potassium (17-55 mM). The results support the contention that
      xylamine is an inhibitor of neuronal and extraneuronal uptake, an adrenergic
      neurone blocking agent and a noncompetitive antagonist of alpha-1 adrenoceptors,
      histamine and 5-hydroxytryptamine2 receptors. Xylamine is not a direct acting
      vasodilator on smooth muscle.

PMID- 1625203
TI  - Endothelin-3 effects on renal function and prostanoid release in the rat isolated
      kidney.
AB  - The direct effects of rat endothelin (ET-3) on renal function and prostanoid
      levels were examined in the isolated, oncotically perfused kidney of the rat. ET
      3 at 0.75 and 2.0 ng/ml produced sustained increases in perfusion pressure of 46
      and 83 mm Hg, respectively, as compared with control kidneys. Glomerular
      filtration rate was significantly higher than control after additions of ET-3 as
      was the absolute and fractional excretion of water and electrolytes. ET-3
      increased perfusate 6-keto-prostaglandin (PG)F1 alpha (breakdown product of PGI2)
      levels and stimulated greater urinary excretion of PGE2 and PGF2 alpha than 6
      keto-PGF1 alpha. ET-3 did not affect urinary excretion or perfusate levels of
      thromboxane B2. Time-dependent increases in renin release were suppressed by ET
      3. Indomethacin (10 microM) prevented ET-3-induced increases in urinary and
      perfusate prostanoids; however, renal vasoconstrictor and excretory responses
      were the same in the presence or absence of indomethacin. These results indicate
      that ET-3 acts directly on the perfused rat kidney to increase the release of
      prostanoids from the vascular and urinary compartments. A modulatory influence of
      prostaglandins on the acute renal hemodynamic and excretory effects of ET-3 was
      not observed under these conditions.

PMID- 1625204
TI  - Effects of cocaine alone and in combination with bromocriptine in human cocaine
      abusers.
AB  - This study was conducted to determine whether the acute administration of
      bromocriptine, a dopamine agonist, modulates the acute pharmacologic effects of
      i.v. cocaine in humans. Eight current users of i.v. cocaine who were not seeking
      treatment for their cocaine abuse completed the study while they were inpatients
      on a research unit. Twelve drug conditions were tested in all subjects in
      randomized order under double-blind, double-dummy conditions and included cocaine
      (0, 12.5, 25 and 50 mg, i.v.) in combination with bromocriptine (0, 1.2 and 2.5
      mg given orally 2 hr before the cocaine injection). Physiologic and subject- and
      observer-rated responses were measured. Cocaine alone significantly increased
      pupil diameter, heart rate and blood pressure, and ratings of drug effect, good
      effects, liking and rush. Bromocriptine alone significantly increased pupil
      diameter and heart rate, decreased blood pressure and had only minor effects on
      subjective measures. There were significant cocaine/bromocriptine interactions on
      diastolic and mean arterial blood pressure, with combinations producing
      significantly smaller increases compared to cocaine alone, and on heart rate,
      with combinations producing significantly larger increases compared to cocaine
      alone. The physiologic and subjective effects of cocaine were not modified by
      pretreatment with bromocriptine in any other way that might indicate either a
      therapeutic benefit or a safety concern. However, bromocriptine alone produced
      undesirable effects (fainting) that should be considered before administration to
      outpatient cocaine abusers. Any possible therapeutic benefits of acute
      administration of bromocriptine in cocaine abuse are not likely to be due
      directly to modulation of the acute effects of cocaine.

PMID- 1625205
TI  - Modulation by certain conserved aspartate residues of the allosteric interaction
      of gallamine at the m1 muscarinic receptor.
AB  - Muscarinic acetylcholine receptors belong to a superfamily of G-protein coupled
      receptors and contain within their structure several conserved aspartate
      residues. These residues have been implicated to play important roles in the
      interaction of agonists and their competitive antagonists with the receptor. In
      the present work, we investigated whether the same residues might also serve as
      important contact points for allosteric antagonists of muscarinic receptors,
      because the majority of these compounds are cationic in nature, or if such
      residues are involved in modification of receptor conformation by these
      antagonists. Gallamine was used as a prototype for these antagonists. Site
      directed mutagenesis of the m1 muscarinic receptor subtype was utilized to define
      some of the molecular determinants involved in cooperative allosteric
      interactions. We report that substitution of the aspartate residue at position
      71, but not at positions 99 and 122 with asparagine, affected the affinity of
      gallamine for the unliganded m1 receptor. A similar substitution at positions 71
      and 99 decreased the magnitude of its cooperative effects on the binding of [3H]N
      methylscopolamine. Our data suggest that these residues are implicated in
      cooperative interactions. At present, however, we cannot discount a more pivotal
      role of other residues on the receptor sequence in allosteric interactions. The
      data also support the notion that different molecular entities are required for
      the binding of allosteric antagonists as compared to the interaction of agonists
      and competitive antagonists at the receptor.

PMID- 1625206
TI  - Selective effects of cocaine on regional cerebral blood flow in the rat.
AB  - Cocaine is a potent central nervous system (CNS) stimulant whose primary
      mechanism of action is reuptake inhibition of the monoamines at presynaptic
      transporter sites. Drug-induced stereotypic motor effects may be due to actions
      within the dorsal striatum and associated structures while reinforcing properties
      have been attributed to action in the ventral striatal terminal fields of the
      mesolimbic system. Recent metabolic mapping studies have revealed activation of a
      limited number of CNS structures. However, because of the pharmacokinetic
      properties of cocaine, brief duration of action and complex behavioral actions,
      regional cerebral blood flow (rCBF), a rapid marker of neuronal activity, was
      used to identify structures involved in different temporal aspects of its
      pharmacologic profile. Conscious rats were injected i.v. with either 0, 0.1, 0.5,
      0.75, 1.0 or 5.0 mg/kg cocaine, 1 min before administration of
      [14C]iodoantipyrene. A dose-related increase in rCBF was seen in specific
      terminal fields of the mesolimbic system such as the basolateral and
      corticomedial nuclei of the amygdala, ventral pallidum, olfactory tubercle and
      medial prefrontal cortex. Additional structures became activated at successively
      higher doses, including the nucleus accumbens and ventral pallidum. Biphasic
      responses were seen in several structures manifest as increased blood flow at 0.1
      mg/kg and a decrease or no effect at the mid doses only to increase again after
      the two highest doses. Thus, rCBF appears to be a sensitive measure of the
      neuronal effects of cocaine and, as a brief temporal marker of neuronal activity,
      has identified activation of several novel CNS structures.

PMID- 1625207
TI  - Common mechanisms underlying the proconflict effects of corticotropin-releasing
      factor, a benzodiazepine inverse agonist and electric foot-shock.
AB  - The effects of corticotropin-releasing factor (CRF), a benzodiazepine inverse
      agonist (methyl-6,7-dimethoxy-4-ethyl-beta-carboline-3-carboxylate; DMCM) and
      electric foot-shock on rat conflict behavior were characterized and compared.
      Rats were trained to lever press under a multiple fixed-ratio schedule (FR 20) of
      food reinforcement in which responses during the first component were not
      punished, and the first response of each FR during the second component produced
      electric shock of an intensity sufficient to suppress responding by 10% to 15%.
      Intracerebroventricular injection of CRF (0.1-5.6 micrograms) caused a dose
      dependent decrease in the rate of responding in both components of the schedule.
      However, CRF was more potent in decreasing rates of punished responding
      (proconflict effect). DMCM (10-100 micrograms; i.c.v.) also decreased rates of
      punished and nonpunished responding and was more potent during the punishment
      component. The suppression of punished and nonpunished responding by CRF and DMCM
      was mimicked by increasing the shock intensity (delta = 0.1 to 0.6 mA) during the
      punishment component. To determine whether CRF, DMCM and electric shock shared
      common mechanisms for these effects, rats were pretreated with i.c.v. injections
      of either a CRF antagonist (alpha helical CRF9-41, 50 micrograms), a
      benzodiazepine agonist (chlordiazepoxide, 10 micrograms) or a benzodiazepine
      antagonist (flumazenil, 10 micrograms) before the administration of equieffective
      doses of CRF or DMCM or an increase in shock intensity. Chlordiazepoxide
      attenuated the effects of all three stimuli. Flumazenil antagonized DMCM and CRF,
      but not shock, implicating a pharmacologic interaction between CRF and
      benzodiazepine systems.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625209
TI  - Electrophysiologic actions of clofilium and lidocaine in ischemically injured
      canine epicardium.
AB  - The electrophysiologic actions of the Class III antiarrhythmic drug, clofilium,
      and the Class IB antiarrhythmic drug, lidocaine, were examined in ischemically
      injured canine epicardium, 4 days after coronary artery occlusion. Experiments
      were performed utilizing 1) composite electrode recordings from the intact heart
      in the anesthetized dog and 2) intracellular and extracellular recordings from
      superfused canine epicardium. In intact hearts, both clofilium (2 mg/kg i.v.) and
      lidocaine (6 mg/kg i.v.) increased refractoriness (188 +/- 16 to 331 +/- 39 and
      288 +/- 18 msec, respectively, P less than .01), and produced tachycardia
      dependent conduction disorders in ischemically injured epicardium. For both
      drugs, slowing the sinus heart rate with vagus nerve stimulation (32 +/- 6/min)
      returned activation delays to predrug values. Unlike lidocaine, clofilium failed
      to increase maximal activation delays in ischemically injured epicardium
      preceding conduction block (116 +/- 14 msec vs. 71 +/- 7 msec and 147 +/- 16 msec
      for clofilium and lidocaine, respectively, P less than .01 for both drugs). In
      superfused epicardium, both clofilium (3 x 10(-7) M) and lidocaine (4 mg/l)
      prolonged refractoriness in ischemically injured epicardium (175 +/- 16 predrug
      vs. 273 +/- 33 msec, P less than .01) and (181 +/- 3 predrug vs. 216 +/- 10 msec,
      P less than .01), respectively, whereas only lidocaine reduced Vmax and prolonged
      local conduction times in the same tissue. The results demonstrate that 1)
      lidocaine increases refractoriness in ischemically injured tissue via a decrease
      in Vmax and conduction velocity and 2) clofilium increases refractoriness in
      ischemically injured tissue without altering action potential duration, Vmax or
      conduction velocity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625208
TI  - Further studies on the modulation of regional brain neurotensin concentrations by
      antipsychotic drugs: focus on haloperidol and BMY 14802.
AB  - Acute and chronic treatment with the antipsychotic drug haloperidol or the
      potential antipsychotic BMY 14802 produce increases in regional neurotensin
      concentrations which are similar with respect to regional specificity (nucleus
      accumbens and caudate), time course, magnitude of increase and precedence by an
      increase in proneurotensin mRNA. The present study characterizes further the
      effects of haloperidol and BMY 14802 on regional brain neurotensin concentrations
      and compares certain of their effects to those of sulpiride. Neurotensin
      concentrations in discrete brain regions of adult, male, Sprague-Dawley rats were
      determined by radioimmunoassay. Both acute and chronic treatment with BMY 14802
      produced significant decreases in the concentration of neurotensin in the frontal
      cortex. When administered concomitantly, low doses of haloperidol and BMY 14802
      produced additive increases in neurotensin content in the nucleus accumbens and
      caudate. Increases in neurotensin content resulting from concomitant treatment,
      or with doses which produce maximal effects individually, were not greater than
      those produced by either drug alone. Concomitant administration of SCH 23390 and
      sulpiride attenuated the neurotensin increases observed after treatment with
      sulpiride. Increases in neurotensin concentrations produced by haloperidol and
      BMY 14802 were not antagonized by SCH 23390. These findings support the
      hypothesis that haloperidol and BMY 14802 modulate regional neurotensin
      concentrations through a common or similar mechanism which is distinct from that
      of sulpiride.

PMID- 1625210
TI  - Endothelin-1 stimulates contraction and ion transport in the rat colon: different
      mechanisms of action.
AB  - Endothelin-like immunoreactivity has been detected in all regions of the rat
      gastrointestinal tract. In the present study, we studied the effect of endothelin
      1 (ET-1) on muscle contraction and ion transport in the rat colon. Isometric
      tension was recorded in colonic muscle strips oriented along their longitudinal
      axis. The effect of ET-1 on ion transport was investigated by assessing changes
      in short-circuit current in segments of muscle-stripped rat colon in Ussing
      chambers. ET-1 induced concentration-dependent contraction of the colon (EC50, 3
      nM). The concentration-response curve to ET-1 was not modified by the neuronal
      blocker tetrodotoxin (0.1 microM) or by atropine (1 microM). Pretreatment of
      colon muscle strips with the calcium channel blockers diltiazem (0.1 microM) or
      nicardipine (1 microM) had no effect on the contractile response to ET-1.
      Furthermore, the response was not affected by removal of extracellular calcium.
      In the ion transport studies, serosal addition of ET-1 produced a transient,
      bumetanide (chloride secretion inhibitor) -sensitive, increase in transepithelial
      short-circuit current. The maximal increase was 107 +/- 13 microA/sq. cm, with an
      EC50 of 2.5 nM. The increase in short-circuit current evoked by ET-1 was not
      significantly affected by 1 microM atropine, but was reduced by 50% (P less than
      .05) by 1 microM tetrodotoxin, or removal of extracellular calcium. We conclude
      that ET-1 stimulates smooth muscle directly, whereas its effect on epithelial
      chloride secretion is mediated in part via the enteric nerves. Moreover, the
      effect of ET-1 in these two systems can be differentiated on the basis of
      sensitivity to extracellular calcium.

PMID- 1625211
TI  - P-450-dependent arachidonic acid metabolism in rabbit olfactory microsomes.
AB  - Microsomes isolated from rabbit olfactory epithelium catalyzed the conversion of
      arachidonic acid to several metabolites at a rate of 692 +/- 106 pmol/min/nmol P
      450. The major metabolite was the omega-hydroxylated metabolite, 20
      hydroxyeicosatetraenoic acid, accounting for 57% of the total metabolite
      produced. A putative omega-1 hydroxylated metabolite was also formed to a lesser
      extent. Epoxyeicosatrienoic acids were not detected with microsomal incubations,
      although metabolites corresponding to the dihydroxyeicosatrienoic acids were
      observed and represented about 20% of the total metabolite produced. The
      metabolism of arachidonic acid was also studied in a reconstituted system with
      six purified P-450 isoforms that are known to be expressed in rabbit olfactory
      mucosa. These included P-450NMa, P-450 2G1 (NMb), P-450 1A2, P-450 2B4, P-450
      2E1, P-450 3A6 and a partially purified preparation of P-450 4A isoforms. The P
      450 4A forms were the only enzymes to produce significant amounts of the omega
      hydroxylated metabolite of arachidonic acid. The other isoforms were either
      inactive (P-450NMa and P-450 3A6) or produced metabolites other than the 20
      hydroxyeicosatetraenoic acid and, thus, cannot account for the majority of the
      miscrosomal metabolism of arachidonic acid. Immunoblot analysis with goat anti
      rat P-450 4A1 identified one major and a second minor protein of the P-450 4A
      gene family in olfactory microsomes. The same antibody identified two proteins in
      rabbit renal tissue that were significantly induced by pretreatment with
      clofibric acid and were present in a partially purified preparation of P-450 4A
      from rabbit renal cortex.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625212
TI  - Pharmacokinetic and pharmacodynamic comparisons between human granulocyte colony
      stimulating factor purified from human bladder carcinoma cell line 5637 culture
      medium and recombinant human granulocyte colony-stimulating factor produced in
      Escherichia coli.
AB  - The pharmacokinetics and biological activities of recombinant human granulocyte
      colony-stimulating factor (hG-CSF) produced in Escherichia coli were compared
      with those of hG-CSF purified from human bladder carcinoma cell line 5637 culture
      medium (5637-hG-CSF). Recombinant hG-CSF was biologically active in a bone marrow
      cell proliferation assay in vitro, with a dose-response curve similar to that of
      5637-hG-CSF. The effects of 5637- and recombinant hG-CSF administered via i.v.
      injection to rats showed similar response patterns of neutrophil counts in
      peripheral blood. From these results, it is concluded that the O-linked sugar
      chain of hG-CSF does not contribute to the in vitro and in vivo biological
      activities. The pharmacokinetics of both forms of hG-CSF in rats were
      investigated using a sandwich enzyme-linked immunosorbent assay. After i.v.
      administration, the serum concentration-time curves of 5637- and recombinant hG
      CSF declined biexponentially. Total body clearance and steady-state volume of
      distribution of 5637-hG-CSF were smaller than those for the recombinant form.
      After s.c. administration, a lower peak serum level, smaller AUC, and lower
      bioavailability of 5637-hG-CSF were observed compared to recombinant hG-CSF.

PMID- 1625213
TI  - Metabolic effects of ritodrine in the fetal lamb.
AB  - Ritodrine infusion to fetal lambs causes numerous metabolic perturbations
      including hypoxemia. To investigate these changes further and to elucidate a
      mechanism for the development of hypoxemia, ritodrine was infused at rate of 2.6
      micrograms/min into nine chronically catheterized fetal lambs for 8, 12 or 24 hr.
      Plasma levels of ritodrine (20.0 +/- 2.7 ng/ml) were within the range of those
      reported in human fetuses exposed to ritodrine tocolysis. Fetal arterial glucose
      levels nearly doubled (0.72 +/- 0.07 to 1.29 +/- 0.18 mM), whereas lactate levels
      rose more than 5-fold (1.54 +/- 0.11 to 8.67 +/- 1.12 mM), with the latter change
      leading to a decline in fetal arterial pH from 7.370 +/- 0.004 to 7.273 +/-
      0.033. Fetal oxygen consumption (VO2) rose from 342 +/- 35 to 407 +/- 30
      mumol/min.kg via an increase in fetal fractional O2 extraction (32.0 +/- 1.1 to
      49.0 +/- 1.7%). The rise in fetal O2 extraction contributed to concurrent
      declines in fetal arterial PO2 (21.9 +/- 0.6 to 17.0 +/- 0.5 mm Hg) and O2
      content (3.7 +/- 0.2 to 2.1 +/- 0.1 mM). Umbilical venous PO2 and O2 content also
      fell resulting in a decline in fetal O2 delivery (DO2) from 1115 +/- 97 to 838 +/
      68 mumol/min.kg. The rise in fetal VO2 was reflected by a similar rise uterine
      VO2 (not significant), with the latter being accompanied by a significant
      increase in uterine O2 extraction and decrease in uterine venous PO2 and O2
      content, perhaps contributing to the fall in fetal DO2. In conclusion, fetal
      hypoxemia during the infusion of ritodrine results from an increase in fetal VO2
      that is not compensated for by a similar increase in umbilical or uterine DO2.
      These metabolic effects may put the fetus at risk, particularly in situations in
      which fetal DO2 is already reduced, as may occur in compromised pregnancies.

PMID- 1625214
TI  - Effects of pH upon the inhibition by sulphonylurea drugs of ATP-sensitive K+
      channels in cardiac muscle.
AB  - The effect of pH was tested upon the inhibition of ATP-sensitive K+ (KATP)
      channels caused by the sulphonylurea drugs tolbutamide and glibenclamide. KATP
      channels and currents (I-KATP) were activated with SR 44866 in ventricular
      myocytes isolated from guinea pig hearts. Modification of either external or
      internal pH had little effect upon the background K+ current (IK1). External pH
      had no consistent effects upon I-KATP. The application of NH4Cl inhibited I-KATP
      and its withdrawal caused a slight rebound activation. Compared with the results
      obtained at pHo 7.4, inhibition of I-KATP by the sulphonylurea drugs was enhanced
      at pHo 6.5 and reduced at pHo 8.4. The kinetics of the recovery of I-KATP was
      independent of pHo. Neither internal pH 6.5 nor NH4Cl had any effect upon
      sulphonylurea-induced inhibition of I-KATP. The dose-response curves for
      inhibition of I-KATP at different pHo's were found to coincide when plotted for
      the unionized concentrations of the drugs. It is concluded that it is the
      unionized forms of the sulphonylurea drugs which are responsible for closure of
      KATP channels in cardiac muscle. In consequence, extracellular acidification
      during ischemia will increase the effective concentration of glibenclamide and
      may be responsible for the cardiovascular disorders associated with this
      treatment in noninsulin-dependent diabetics.

PMID- 1625215
TI  - The effect of pulse repetition rate on the delay sensitivity of neurons in the
      auditory cortex of the FM bat, Myotis lucifugus.
AB  - 1. Echo delay is the primary cue used by echolocating bats to determine target
      range. During target-directed flight, the repetition rate of pulse emission
      increases systematically as range decreases. Thus, we examined the delay tuning
      of 120 neurons in the auditory cortex of the bat, Myotis lucifugus, as repetition
      rate was varied. 2. Delay sensitivity was exhibited in 77% of the neurons over
      different ranges of pulse repetition rates (PRRs). Delay tuning typically
      narrowed and eventually disappeared at higher PRRs. 3. Two major types of delay
      sensitive neurons were found: i) delay-tuned neurons (59%) had a single fixed
      best delay, while ii) tracking neurons (22%) changed their best delay with PRR.
      4. PRRs from 1-100/s were represented by the population of delay-sensitive
      neurons, with the majority of neurons delay-sensitive at PRRs of at least 10
      20/s. Thus, delay-dependent neurons in Myotis are most active during the search
      phase of echolocation. 5. Delay-sensitive neurons that also responded to single
      sounds were common. At PRRs where delay sensitivity was found, the responses to
      single sounds were reduced and the responses to pulse-echo pairs at particular
      delays were greater than the single-sound responses. In facilitated neurons
      (53%), the maximal delay-dependent response was always larger than the best
      single-sound responses, whereas in enhanced neurons (47%), these responses were
      comparable. The presence of neurons that respond maximally to single sounds at
      one PRR and to pulse-echo pairs with particular echo delays at other PRRs
      suggests that these neurons perform echo-ranging in conjunction with other
      biosonar functions during target pursuit.

PMID- 1625216
TI  - Circadian entrainment by feeding cycles in house sparrows, Passer domesticus.
AB  - We studied the potential zeitgeber qualities of periodic food availability on the
      circadian rhythms of locomotor and feeding activity of house sparrows. The birds
      were initially held in a LD-cycle of 12:12 h, with food restricted to the light
      phase. After transfer to constant dim light, the birds remained entrained by the
      restricted feeding schedule. Following an exposure to food ad libitum conditions,
      the rhythms could be resynchronized by the feeding cycle. Shortening of the
      zeitgeber period to 23.5 h resulted in the loss of entrainment in most birds,
      whereas a longer zeitgeber period of 25 h re-entrained the rhythms of most birds.
      Although these results prove that periodic food availability can act as a
      zeitgeber for the circadian rhythms of house sparrows, several features of our
      data indicate that restricted feeding is only a weak zeitgeber. The pattern of
      feeding activity prior to the daily time of food access shown under some
      experimental conditions suggests that anticipation is due to a positive phase
      angle difference of the birds' normal circadian system rather than being caused
      by a separate pacemaker.

PMID- 1625217
TI  - Appearance and maturation of voltage-dependent conductances in solitary spiking
      cells during retinal regeneration in the adult newt.
AB  - Electrical membrane properties of solitary spiking cells during newt (Cynops
      pyrrhogaster) retinal regeneration were studied with whole-cell patch-clamp
      methods in comparison with those in the normal retina. The membrane currents of
      normal spiking cells consisted of 5 components: inward Na+ and Ca++ currents and
      3 outward K+ currents of tetraethylammonium (TEA)-sensitive, 4-aminopyridine (4
      AP)-sensitive, and Ca(++)-activated varieties. The resting potential was about 
      40 mV. The activation voltage for Na+ and Ca++ currents was about -30 and -17 mV,
      respectively. The maximum Na+ and Ca++ currents were about 1057 and 179 pA,
      respectively. In regenerating retinae after 19-20 days of surgery, solitary cells
      with depigmented cytoplasm showed slow-rising action potentials of long duration.
      The ionic dependence of this activity displayed two voltage-dependent components:
      slow inward Na+ and TEA-sensitive outward K+ currents. The maximum inward current
      (about 156 pA) was much smaller than that of the control. There was no indication
      of an inward Ca++ current. During subsequent regeneration, the inward Ca++
      current appeared in most spiking cells, and the magnitude of the inward Na+,
      Ca++, and outward K+ currents all increased. By 30 days of regeneration, the
      electrical activities of spiking cells became identical to those in the normal
      retina. No significant difference in the resting potential and the activation
      voltage for Na+ and Ca++ currents was found during the regenerating period
      examined.

PMID- 1625218
TI  - Calcium is necessary for light excitation in barnacle photoreceptors.
AB  - Illumination of barnacle (Balanus amphitrite) photoreceptors is known to increase
      the membrane permeability to sodium and Ca2+ ions resulting in a depolarizing
      receptor potential. In this report, we show that lanthanum (La3+), a known
      inhibitor of Ca-binding proteins, reversibly eliminates the receptor potential of
      barnacle photoreceptors when applied to the extracellular space. Similar
      reversible elimination of the light response was obtained by removing
      extracellular Ca2+ by application of the calcium chelating agent EGTA.
      Iontophoretic injection of Ca2+, but not K+ into the cells protected both the
      transient and the steady-state phases of the receptor potential from elimination
      by EGTA while only the transient phase was protected in the presence of La3+. The
      EGTA experiments suggest that internal Ca2+ is necessary for light excitation of
      barnacle photoreceptors while the La3+ experiments suggest that La(3+)-sensitive
      inward current is necessary to maintain excitation during prolonged light.

PMID- 1625219
TI  - Multiple gate control of the descending statocyst-motor pathway in the crayfish
      Procambarus clarkii Girard.
AB  - 1. Synaptic responses of uropod motoneurons and interneurons to magnetic field
      stimulation of the statocyst were studied in a whole animal preparation using
      intracellular recording and staining techniques to characterize the descending
      statocyst pathways controlling uropod steering behavior. 2. When the animal was
      engaged in abdominal postural movement, all uropod motoneurons received sustained
      excitatory input. Motoneurons which were to be activated during steering behavior
      showed excitatory responses to the stimulus superimposed on the sustained
      excitation. In the resting state, they showed weaker responses or no visible
      responses to the same stimulation. 3. Motoneurons to be suppressed during
      steering showed inhibitory responses to the stimulus only during abdominal
      movement. These included both active inhibition as well as disfacilitatory
      suppression of excitatory input to the motoneurons. 4. Premotor nonspiking
      interneurons, like motoneurons, showed greater responses to the stimulus during
      abdominal movement than at rest. Unlike motoneurons, however, they did not always
      receive sustained input during abdominal movement. 5. Descending axons which
      responded to statocyst stimulation independent of abdominal movement were found
      in the 4th and 5th abdominal ganglia. Other axons showed greater responses during
      abdominal movement than at rest. 6. A number of intersegmental descending
      interneurons with cell bodies and dendrites in the 4th or 5th ganglion were found
      to receive excitatory inputs from both the statocyst and the motor system
      controlling abdominal posture. These responses were found to summate with each
      other to generate spikes. 7. Statocyst signals are thus transmitted to uropod
      motoneurons by two types of descending pathways: one whose operation is affected
      by the abdominal system and the other which operates independently. The former
      pathway functions by recruiting intersegmental abdominal interneurons and makes
      stronger connections with motoneurons than the latter.

PMID- 1625220
TI  - Regulation of melatonin production by light, darkness, and temperature in the
      trout pineal.
AB  - The pineal gland of the rainbow trout, Salmo gairdneri, when kept under in vitro
      perifusion culture conditions, displays a consistently elevated level of
      melatonin production in darkness (Gern and Greenhouse 1988). Upon light exposure
      melatonin production falls and stabilizes at a new lower level that is dependent
      upon the irradiance of the stimulus. To achieve the maximal response for each
      irradiance, the duration of the stimulus must exceed 30 min. The response
      amplitude is maximally sensitive to photons presented over durations of 30-45
      min; is very insensitive to shorter light exposures; and is maintained with no
      evidence of adaptation over longer exposures. Temperature plays a role in
      regulation of melatonin production both in darkness and during light exposure;
      increased temperature increases melatonin production in darkness and also
      increases the sensitivity of the response to light. The action spectrum for the
      response is best fit by the Dartnall nomogram for a vitamin A1 based rhodopsin
      with peak sensitivity near 500 nm. The possible adaptive significance of control
      of melatonin synthesis by light and temperature is considered.

PMID- 1625221
TI  - Mechanosensory afferents innervating the swimmerets of the lobster. I. Afferents
      activated by cuticular deformation.
AB  - The mechanosensory innervation of the lobster (Homarus americanus) swimmeret was
      examined by electrophysiologically recording afferent spike responses initiated
      by localized mechanical stimulation of the caudal surface of the swimmeret. Two
      functional groups of subcuticular hypodermal mechanoreceptors innervate the
      swimmeret. Afferents of one group innervate the small discrete "ridges" of
      calcified cuticle lining the margins of both swimmeret rami. Putative ridge
      receptors are bipolar sensory neurons responding phasically to deformation of the
      ridge cuticle with the number and frequency of impulses produced dependent on
      stimulus strength and velocity. Afferents of the second group, which innervate
      substantial areas of hypodermis underlying the soft, flexible cuticular regions
      of the swimmeret, were designated "wide-field" hypodermal mechanoreceptors. These
      neurons have multiterminal receptive fields and respond phaso-tonically to
      cuticular distortion. The response properties of both types of hypodermal
      mechanoreceptors imply that they are activated during the characteristic beating
      movements of the swimmerets.

PMID- 1625222
TI  - Mechanosensory afferents innervating the swimmerets of the lobster. II. Afferents
      activated by hair deflection.
AB  - Feathered hair sensilla fringe both rami of the lobster (Homarus americanus)
      swimmeret. The sensory response to hair displacement was characterized by
      recording afferent impulses extracellularly from the swimmeret sensory nerve
      while deflecting sensilla with a rigidly-coupled probe or controlled water
      movements. Two populations of hairs were observed: "distal" hairs localized to
      the distal 1/3 of each ramus and "proximal" hairs near its base. Distal hairs are
      not innervated by a mechanosensory neuron but instead act as levers producing
      strain within adjacent cuticle capable of activating a nearby hypodermal
      mechanoreceptor. Hair deflections of 25 degrees or more are required to evoke an
      afferent response and this response is dependent on hair deflection direction.
      The frequency and duration of the afferent discharge evoked are determined by the
      velocity of hair displacement. Each proximal hair is innervated by a single
      mechanosensory neuron responding phasically to hair deflections as small as 0.2
      degrees in amplitude. Deflection at frequencies up to 5 Hz elicits a single
      action potential for each hair movement; at higher frequencies many deflections
      fail to evoke an afferent response. These sensilla, which are mechanically
      coupled, may be activated by the turbulent flow of water produced by the
      swimmerets during their characteristic beating movements.

PMID- 1625223
TI  - The neuroanatomical basis of feeding behavior in the pteropod mollusc, Clione
      limacina (Phipps).
AB  - 1. In order to investigate neural mechanisms underlying the switching from
      hovering-swimming to hunting behavior in the carnivorous mollusc Clione limacina,
      the innervation of the major muscle bands was studied. The destination of a
      majority of nerves was traced. 2. Nervous cells sending their processes in the
      sensory motor nerves were mapped using the retrograde transport of cobalt ions.
      3. The combination of morphological investigation, with local extracellular
      stimulation of groups of cells in semi-intact preparations, provided a detailed
      description of the functional involvement of the majority of the neural elements
      in either type of behavior. As a result, detailed diagrams for intracellular
      investigation of participation of individual cells and functional groups were
      obtained.

PMID- 1625224
TI  - Effects of thioridazine on mechanical responses of human vas deferens induced by
      noradrenaline or potassium.
AB  - Thioridazine (0.1-10 mumol l-1) inhibited shortening of specimens of human vasa
      deferentia induced by noradrenaline (100 mumol l-1) or high extracellular
      potassium (136 mmol l-1). Thioridazine did not inhibit the lengthening response.
      In Ca(2+)-free media with EGTA (0.5 mmol l-1) similar results were obtained with
      responses to noradrenaline, but exposure to potassium elicited small contractions
      that were potentiated by thioridazine. Both shortening and lengthening responses
      to noradrenaline were antagonized by the alpha-adrenoceptor blockers prazosin (1
      10 mumol l-1) and phentolamine (1-10 mumol l-1) and by the Ca2+ antagonists
      verapamil (10 mumol l-1) and diltiazem (10 mumol l-1). Responses to potassium
      were virtually abolished by the Ca2+ antagonists. These results show that
      thioridazine specifically inhibits longitudinal muscle of the human vas deferens
      and that its action cannot be entirely accounted for by a blockade of voltage
      gated Ca2+ channels.

PMID- 1625225
TI  - Effects of ethanol on the decidual cell reaction in rats.
AB  - The effects of ethanol on uterine sensitivity to induction of decidualization and
      deciduoma growth were determined. Rats were ovariectomized, given an oestrogen
      progesterone regimen to optimize induction and growth of deciduoma and randomly
      assigned to one of three ethanol treatment groups: (i) days 1-4 (pre
      induction/period of sensitivity), (ii) days 5-9 (post-induction/period of
      growth), (iii) days 1-9 (periods of sensitivity and growth); or to a control
      group not treated with ethanol (pair-fed to treated groups). Ethanol (0, 1, 2, or
      4 g kg-1) diluted in water was administered by stomach tube on the days
      prescribed. Decidualization was induced in one uterine horn by intraluminal
      injection of sodium phosphate buffer. Uterine sensitivity and decidual growth
      were assessed as cornu weight. Blood alcohol concentrations were measured by gas
      chromatography. Alcohol treatment reduced uterine sensitivity, but increased
      deciduoma growth. Blood alcohol concentrations rose to 133 mg% at 30 min,
      remained high for 90 min and declined to 82 mg% at 120 min. Thus, blood alcohol
      concentrations sufficient to induce mild intoxication in humans suppressed
      uterine sensitivity to decidualization and enhanced deciduoma growth in rats. As
      all ovarian steroid hormone support was exogenous, the effects of ethanol on
      deciduoma induction and growth were not due to alterations in the hypothalamic
      pituitary-ovarian axis.

PMID- 1625226
TI  - Effects of expression of human or bovine growth hormone genes on sperm production
      and male reproductive performance in four lines of transgenic mice.
AB  - Reproductive performance was studied in transgenic males from lines expressing
      and transmitting four hybrid genes: mouse metallothionein-I/human growth hormone
      (GH) (MT/hGH), MT/hGH placental variant (MT/hGH.V), MT/bovine GH (MT/bGH) and
      phosphoenolpyruvate carboxykinase/bGH (PEPCK/bGH). Each male was exposed to three
      normal females for 1 week and to three different normal females for another week.
      Females were examined for vaginal plugs and necropsied on day 14 of pregnancy.
      Males were killed for analysis of organ weights, numbers of testicular
      spermatids, numbers of epididymal sperm and measurements of plasma glucose
      concentration. Fertility of MT/hGH and MT/hGH.V transgenic males was
      significantly lower than in normal males, primarily because most males failed to
      impregnate any females. In females that became pregnant, the numbers of corpora
      lutea, total fetuses and live fetuses did not differ from those in females mated
      to normal (nontransgenic) males. Fetal crown-rump length on day 14 of pregnancy
      did not differ between litters sired by normal or by transgenic males. Weights of
      testes and seminal vesicles were significantly greater in all four types of
      transgenic male, but daily sperm production per unit weight (g-1) of testis was
      not affected and epididymal sperm reserves were either normal or slightly higher
      than normal. Plasma glucose concentrations were significantly higher in PEPCK/bGH
      mice than in other mice. Average or individual reproductive performance of
      transgenic males from the various lines did not correlate with any of the
      parameters examined except for significantly heavier seminal vesicles in MT/hGH
      and MT/hGH.V males than in normal males; these transgenic males exhibited a high
      incidence of infertility. Since hGH and hGH.V, but not bGH, are lactogenic in
      rodents, it was concluded that chronic stimulation of GH and prolactin receptors
      by ectopically produced human GHs in transgenic mice compromises male fertility
      by an unknown mechanism. Reduced fertility of transgenic males with MT/hGH or
      MT/hGH.V hybrid genes is due to failure to inseminate or impregnate females
      rather than to reduced numbers of spermatozoa or gross changes in the male
      reproductive system.

PMID- 1625227
TI  - Developmental capacity of mouse oocytes matured in vitro: effects of
      gonadotrophic stimulation, follicular origin and oocyte size.
AB  - Development of mammalian oocytes is usually correlated with ovarian follicular
      development. This correlation was tested by determining whether gonadotrophic
      stimulation of follicular development in immature mice resulted in a coordinated
      increase in the embryonic developmental capacity of the oocytes. Oocyte cumulus
      cell complexes were isolated at the germinal vesicle stage from small, medium and
      large antral follicles of 26-day-old mice and matured and fertilized in vitro.
      The frequency with which embryos from oocytes from small follicles completed the
      two-cell to blastocyst transition was lower than for embryos from oocytes from
      large follicles (33% and 79%, respectively). Germinal-vesicle stage oocyte
      cumulus cell complexes were isolated from 22-26-day-old mice that were unprimed
      or primed by injection of equine chorionic gonadotrophin 48 h before isolation.
      Oocytes were matured in control medium, or in medium containing 1 microgram
      follicle-stimulating hormone (FSH) ml-1, and then fertilized in vitro. Priming
      did not increase the number of embryos completing the two-cell stage to
      blastocyst transition in the 22-day-old group nor did FSH treatment of maturing
      oocytes when the oocytes were isolated from unprimed 22-day-old mice. In
      contrast, priming increased the percentage of embryos completing the two-cell
      stage to blastocyst transition in the 26-day-old group by 20%. FSH treatment of
      maturing oocytes from the unprimed, 26-day-old group increased the number of
      embryos completing the transition to the same level as those in the primed 26-day
      old group, but FSH did not increase the frequency of transition in the primed 26
      day-old group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625228
TI  - Development from birth to sexual maturity in a semi-free-ranging colony of
      mandrills (Mandrillus sphinx) in Gabon.
AB  - This report presents information collected over 7 years (1983-1990) in Gabon, on
      a breeding group of 14, increasing to 45, mandrills maintained in a rainforest
      enclosure. Under these conditions, a seasonal cycle of mating (June-October) and
      birth (January-May) occurred. Females began to exhibit sexual skin swellings at
      age 2.75-4.5 years (3.6 +/- 0.6 years, mean +/- SD; n = 10) and first delivered
      offspring when 3.25-5.5 years old (4.4 +/- 0.8 years; n = 9). Gestation periods
      ranged from 152 to 176 days (167 +/- 9 days; n = 6 accurately dated pregnancies)
      and interbirth intervals from 11 to 15 months (12.4 +/- 1.3 months; n = 15).
      Females could reproduce 2 years before attaining adult body weight (10-15 kg) and
      complete dental eruption by 5.0-5.5 years. Males, by contrast, developed more
      slowly, reaching adult body weight (30-35 kg) and testicular volume (volume of
      left testis: 25-30 ml) at 8 years. Consistently high circulating testosterone
      concentrations (8.17 +/- 2.0 ng ml-1) could be measured by 9 years of age. Fully
      developed males exhibited fatting of the rump and flanks, as well as striking
      sexual skin coloration and an active sternal cutaneous gland; little expression
      of these features was evident during pubertal development. Marked individual age
      differences occurred with regard to the onset and complete development of these
      features, suggesting possible interactions between social environment and
      physical maturation.

PMID- 1625229
TI  - Ability of nifedipine to prolong parturition in rats.
AB  - Rats were randomly assigned to treatments: (i) no surgery control; (ii) saline
      control; (iii) 0.25, 0.5, 1.0 or 2.0 micrograms nifedipine kg-1 min-1; or (iv)
      5.0 micrograms ritodrine kg-1 min-1. All drug treatments increased the interval
      between pup deliveries compared with the no surgery and saline controls. Apparent
      complete tocolysis was observed in 20, 60, 80 and 80% of the animals receiving
      0.5, 1.0 or 2.0 micrograms nifedipine kg-1 min-1 or 5.0 micrograms ritodrine kg-1
      min-1, respectively. A positive pharmacodynamic relationship was observed for the
      nifedipine doses. Analysis of pup viability showed no statistically significant
      difference among treatments. Treatment with 2.0 micrograms nifedipine kg-1 min-1
      gave a delay in pup delivery comparable to that with ritodrine.

PMID- 1625230
TI  - Androgens in relation to prenatal development and postnatal inversion of the
      gubernacula in rats.
AB  - Exposure of male rats to the anti-androgen flutamide during fetal life, from day
      10 after conception to the day of birth, allowed quantitatively unaltered
      development of the gubernacula. Apparently, androgens play no important role or
      no role at all in their growth. Castration of newborn male rats did not interfere
      with the inversion during further postnatal life of the gubernacula to create the
      muscular parts of the scrotum (cremaster muscles). Prenatal exposure to
      flutamide, followed by castration immediately after birth, also allowed
      gubernacular inversion and cremaster muscle growth. Neonatal administration of
      testosterone, after castration at birth, did not enhance gubernacular inversion
      or promote cremaster muscle growth in infancy or during adulthood. Apparently,
      postnatal gubernacular inversion and cremaster muscle growth are independent not
      only of androgens, but also of all testis hormones. Neonatal administration of
      the potent androgen 5 alpha-dihydrotestosterone propionate suppressed
      gonadotrophin secretion and, in intact males, inhibited testicular growth.
      Administration from the day of birth to day 33 delayed testicular descent and
      enhanced growth of the genital apparatus, but did not affect the size of the
      cremaster muscles. These experiments indicate that androgens are not involved in
      the processes that create the cavities into which testes descend to acquire their
      full reproductive potential.

PMID- 1625231
TI  - Circadian rhythm of photosensitivity and the adaptation of reproductive function
      to the environment in two populations of Arvicanthis niloticus from Mali and
      Burkina Faso.
AB  - Previous studies have shown that there is a circadian rhythm of photosensitivity
      in different rodent species of the Sahel (Burkina Faso) and that, despite the low
      amplitude of seasonal variations in daylength, the photoperiod may control
      reproductive function. The present investigation of Arvicanthis niloticus
      provides additional support for this hypothesis. Populations of Arvicanthis
      niloticus from two regions at the same latitude 1000 km apart but with different
      climates were studied. Oursi, Burkina Faso, has an arid climate (annual rainfall
      315 mm) and Kamale, Mali has a wetter climate (annual rainfall 1114 mm). The
      circadian rhythm of photosensitivity had the same features in both populations,
      involving inhibition of testicular activity, but the photosensitive phase began
      11 h 30 min after dawn in the population from Burkina Faso and 45 min later in
      that from Mali. Comparison of these results with the annual variation of
      daylength showed that the photoperiod inhibits the reproductive activity of A.
      niloticus from April to December in Burkina Faso and only from mid-May to mid
      August in Mali. The population of Arvicanthis niloticus living in an environment
      with a large and seasonally stable food supply (Mali) thus has a longer
      reproductive period. This corroborates results from field studies on annual
      variations of population density.

PMID- 1625232
TI  - Production of prostaglandin by late-gestation porcine placental cells in vitro.
AB  - Fifteen sows were assigned to three groups of five each, according to gestational
      age (109 days, 114 days or labour). Two fetuses per sow were chosen at random,
      and amnion, allantochorion, amniochorion, amniotic fluid and fetal urine were
      collected. Tissues were enzymatically dispersed and incubated for 1, 2, 3 or 4 h
      and the prostaglandin (PG) content of the supernatant medium was measured by
      radioimmunoassay. In general, all placental cell types produced at least three
      times more prostaglandin E (PGE) and 6-keto-PGF1 alpha than PGF. Production did
      not vary across gestational age, except that production of 6-keto-PGF1 alpha was
      lower in cells collected during labour, resulting in a relative increase in PGF
      and PGE. Aminochorion cells had a lower de novo capacity to synthesize PG than
      did allantochorion or amniochorion, whereas treatment of allantochorion with
      preterm amniotic fluid, preterm or term fetal urine resulted in increased PG
      output. These results demonstrate that porcine placental cells can synthesize and
      metabolize prostaglandin in late gestation but suggest that their capacity to
      produce PGI2 (as measured by 6-keto-PGF1 alpha) is lower than for other
      prostaglandins during labour.

PMID- 1625233
TI  - Effects of active immunization against a synthetic peptide sequence of the
      inhibin alpha-subunit on plasma gonadotrophin concentrations, ovulation rate and
      lambing rate in ewes.
AB  - Thirty adult Mule (Blue-faced Leicester x Swaledale) ewes were actively immunized
      against a synthetically produced peptide corresponding to the N-terminus of the
      alpha-subunit of bovine inhibin conjugated to tuberculin purified protein
      derivative (PPD). Primary immunization in the late anoestrous period was followed
      by two booster injections at 5 week intervals. Control groups were either not
      immunized (n = 15) or received PPD only (n = 15). Ten days after the second
      booster, oestrus was synchronized using progestagen sponges and ovulation rate
      was assessed by laparoscopy on days 9-10 of the cycle. Blood samples were taken
      at the time of each immunization and immediately before laparoscopy. Ewes were
      mated with fertile rams in mid-November and the resulting conception, pregnancy
      and lambing rates monitored. All inhibin-immunized ewes generated antibodies that
      bound 125I-labelled native bovine inhibin (M(r) 32,000), and their plasma
      follicle-stimulating hormone (FSH) concentrations after the second booster were
      significantly higher than the preimmunization values (30%; P less than 0.001) and
      the corresponding value in the controls (25%; P less than 0.025). Inhibin
      immunization was associated with a 90% increase in ovulation rate (P less than
      0.005) and had no adverse effect on conception rate (100%), pregnancy rate (100%)
      or length of gestation (146 days). However, only a 37% increase (P less than
      0.05) in lambing rate was recorded for inhibin-immunized ewes, indicating a
      higher incidence of wastage of ova, or embryos, or both, in these ewes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1625234
TI  - Effects of season and testosterone treatment on gonadotrophin secretion and
      pituitary responsiveness to gonadotrophin-releasing hormone in castrated Romney
      and Poll Dorset rams.
AB  - In castrated rams (Romney and Poll Dorset, n = 8 for each breed), inhibition by
      testosterone treatment (administered via Silastic capsules) of luteinizing
      hormone (LH) pulse frequency, basal and mean LH concentrations, mean follicle
      stimulating hormone (FSH) concentration, and the peak and total LH responses to
      exogenous gonadotrophin-releasing hormone (GnRH) were significantly (P less than
      0.01) greater during the nonbreeding than during the breeding season. Poll Dorset
      rams were less sensitive to testosterone treatment than Romney rams. In rams not
      receiving testosterone treatment, LH pulse frequency was significantly (P less
      than 0.05) lower during the nonbreeding season than during the breeding season in
      the Romneys (15.8 +/- 0.9 versus 12.0 +/- 0.4 pulses in 8 h), but not in the Poll
      Dorsets (13.6 +/- 1.2 versus 12.8 +/- 0.8 pulses in 8 h). It is concluded that,
      in rams, season influences gonadotrophin secretion through a steroid-independent
      effect (directly on hypothalamic GnRH secretion) and a steroid-dependent effect
      (indirectly on the sensitivity of the hypothalamo-pituitary axis to the negative
      feedback of testosterone). The magnitude of these effects appears to be related
      to the seasonality of the breed.

PMID- 1625236
TI  - Changes related to the oestrous cycle in the expression of endometrial and
      oviductal proteins of mice.
AB  - Soluble proteins extracted from the endometria and oviducts of normal sexually
      mature cycling Swiss Webster mice were analysed by two-dimensional high
      resolution sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE).
      Thirty endometrial and 25 oviductal proteins showed differential expression
      related to the oestrous cycle. In the endometrium, 19 proteins were maximally
      expressed in the oestrous phase, and significantly decreased or could not be
      detected in dioestrus. Eleven additional proteins were more prominent in
      dioestrus. Most of these endometrial cyclic proteins were acidic. In the oviduct,
      almost two-thirds of cycle-related, differentially expressed proteins were more
      strongly expressed in dioestrus and were significantly less prominent or could
      not be detected in the oestrous phase. In contrast to the endometrial proteins,
      most of the oviductal cyclic proteins were basic. Fourteen proteins appeared to
      be identical in both organs, and five of these showed the same cyclic pattern of
      expression. The remaining cyclic proteins were organ specific and showed uterus-
      or oviduct-specific changes during the oestrous cycle. Among the cyclic proteins,
      four endometrial and two oviductal proteins were restricted to oestrus, whereas
      two endometrial and seven oviductal proteins were restricted to dioestrus. These
      proteins could serve as markers for specific phases of the oestrous cycle. Our
      data show that the mouse oestrous cycle is associated with consistent and
      predictable changes in protein expression in both the endometrium and oviduct.

PMID- 1625235
TI  - Effects of ovine conceptus secretory proteins and progesterone on oxytocin
      stimulated endometrial production of prostaglandin and turnover of inositol
      phosphate in ovariectomized ewes.
AB  - This study examined the effects of progesterone and intrauterine injection of
      ovine conceptus secretory proteins (oCSP) on endometrial responsiveness to
      oxytocin. Twelve ewes were ovariectomized on day 4 of the cycle (oestrus = day 0)
      and assigned in a 2 x 2 factorial arrangement, to receive either 1.5 mg ovine
      serum proteins (SP) or oCSP containing 25 micrograms ovine trophoblast protein 1
      (oTP-1) (by radioimmunoassay) in 1.5 mg total protein into each uterine horn, via
      catheters, twice a day on days 11, 12, 13 and 14. Ewes received 200 mg
      progesterone per day (i.m.) from day 4 to day 10 or 15. Oxytocin-induced
      prostaglandin F2 alpha was measured as 13,14-dihydro-15-keto-prostaglandin F2
      alpha (PGFM) on days 11, 12, 13 and 14 in plasma from three integrated, 10 min
      (10 ml) blood samples (0-10, 10-20, 20-30 min) obtained after intravenous
      injection of 20 iu oxytocin, and in a pre-oxytocin (-10 to 0 min) sample
      collected via an indwelling jugular catheter. The pre-oxytocin samples were also
      assayed for progesterone. Oxytocin-induced turnover of inositol phosphate was
      determined in endometrium on day 15 after hysterectomy. In ewes receiving
      progesterone to day 10, plasma progesterone decreased from about 12 to 2 ng ml-1
      (SEM +/- 2.6) during the treatment period (days 11-14), but remained high (12-20
      +/- 2.6 ng ml-1) in ewes that received progesterone to day 15. Intrauterine
      injection of oCSP resulted in high basal concentrations of PGFM on days 12 and 13
      compared with SP-treated ewes (P less than 0.01). Treatments with progesterone
      did not affect basal PGFM concentrations. Treatment with oCSP abolished oxytocin
      induced endometrial secretion of prostaglandin only if progesterone was
      maintained to day 15 (P less than 0.01); in ewes receiving such treatment, oCSP
      inhibited (P less than 0.01), but SP did not inhibit, oxytocin-induced
      endometrial turnover of inositol phosphate (P less than 0.06), which was greater
      in ewes treated with progesterone to day 10 than in those treated to day 15 (P
      less than 0.05). Ewes that responded to oxytocin with increased PGFM exhibited
      increased oxytocin-stimulated turnover of inositol phosphate on day 15. These
      results indicate that the antiluteolytic action oTP-1 exerts on the endometrium
      requires progesterone and that this mechanism involves inhibition of oxytocin
      stimulated turnover of inositol phosphate.

PMID- 1625238
TI  - The fate of DNA injected into mammalian oocytes and zygotes at different stages
      of the cell cycle.
AB  - The stability of exogenous DNA microinjected into the cytoplasm at different
      stages of the meiotic cycle and after pronuclear formation was examined in
      ungulate species. Metabolism of the injected 1201 base pair (bp) DNA was examined
      by Southern blotting. Similar levels of metabolism of the injected DNA were
      detected in pig, sheep and bovine oocytes before germinal vesicle breakdown, in
      which about 30-40% of detected DNA was ligated into higher-molecular-weight
      forms. Porcine metaphase oocytes and pronuclear zygotes showed a reduced ability
      to ligate the exogenous DNA. In contrast, sheep and bovine metaphase oocytes and
      zygotes showed increased levels of ligation and, at the pronuclear stage,
      generated significant amounts of extremely large (greater than 15 kbp) ligation
      products. These results are discussed in the context of maternal precursors and
      metabolic activities in the egg.

PMID- 1625237
TI  - A new technique for the precise location of lactate and malate dehydrogenases in
      goat, boar and water buffalo spermatozoa using gel incubation film.
AB  - Gel incubation film, which contained gelatin to prevent the diffusion of enzyme
      during chemical reaction and phenazine methosulfate to operate as a hydrogen
      acceptor between NADH and tetrazolium, was used and light microscopy revealed
      that lactate dehydrogenase was located in the head and tail of the spermatozoa as
      well as in the midpiece, whereas malate dehydrogenase was confined to the
      midpiece in spermatozoa of the animals examined. In goat spermatozoa, lactate
      dehydrogenase was associated mainly with the inner acrosomal membrane in the
      head, the mitochondrial matrix in the midpiece and with flagellar fibrils in the
      tail, whereas malate dehydrogenase was present only in the mitochondrial matrix.

PMID- 1625239
TI  - Characterization of glutamine uptake in mouse two-cell embryos and blastocysts.
AB  - Mouse two-cell embryos and blastocysts take up [3H]glutamine in vitro at a
      constant rate for at least 15 min, depending on the concentration of glutamine
      and developmental stage of the embryo. Uptake by two-cell embryos can be resolved
      into two saturable components. The major contributing system is Na+ independent,
      inhibited by alanine, methionine, 2-amino-2-norbornanecarboxylic acid (BCH) or
      leucine and has a Km of 3856 +/- 672 mumols l-1 and Vmax of 436 +/- 58 fmol per
      embryo per 10 min. These features are characteristics of the ubiquitous system L
      transporter. The second component is Na+ dependent with Km of 1064 +/- 914 mumols
      l-1 and Vmax 107 +/- 47 fmol per embryo per 10 min. Similar Vmax and inhibition
      of this component by glycine suggest a low reactivity with the gly-system.
      Blastocyst uptake of glutamine is mainly by a Na(+)-dependent saturable mechanism
      with Km of 524 +/- 75 mumols l-1 and Vmax of 1264 +/- 101 fmol per embryo per 10
      min which is inhibited by alanine, isoleucine, leucine and BCH, features
      characteristic of the system B0,+. The increase in uptake capacity as a
      consequence of the appearance of the system B0,+ may be related to increased
      metabolic requirements for glutamine, in the rapidly expanding blastocyst.

PMID- 1625240
TI  - Menstruation in short-tailed fruit bats (Carollia spp.).
AB  - Uterine function was assessed histologically in Carollia spp. removed from a
      laboratory breeding colony. The uteri of periovulatory bats examined on days 1-3
      post coitum varied considerably depending upon whether regressing corpora lutea
      were present. In females lacking such corpora lutea, the endometrium was shallow
      and proliferative. In most of the bats having regressing corpora lutea, the
      endometrium was thicker and necrotic portions of the superficial lamina
      functionalis were being sloughed off with associated bleeding (i.e. in the form
      of a true menstrual process). The presence of regressing corpora lutea and well
      developed endometria in these animals indicated that short-tailed fruit bats are
      spontaneous ovulators with a functional luteal phase to their cycles.
      Menstruation was also observed in some females that were not periovulatory, or
      that lacked regressing corpora lutea. The endometrium was not vascularized by
      spiral arterioles, but it did contain distinctive granulocytes similar to those
      observed in catarrhine primates and other menstruating bats. Most endometrial
      growth occurred after ovulation and, in pregnant animals, was associated with
      retention of the embryos in the oviducts for approximately 13-16 days. Carollia
      perspicillata normally produces one young at a time, after a gestation period of
      about 4 months, and is a seasonal breeder in the wild. Menstruation probably
      provides this bat with an efficient mechanism for eliminating a well-developed
      endometrium from its simplex uterus in the event of fertilization failure or
      early embryonic loss. This may give the female another chance to establish a
      pregnancy and produce an infant at a reasonably opportune time during the same
      breeding season.

PMID- 1625241
TI  - Effect of different fractions of seminal plasma on the fertilizing ability of
      fowl spermatozoa stored in vitro.
AB  - This paper describes the effects of whole seminal plasma and of dialysed seminal
      plasma on the fertilizing ability of fowl spermatozoa stored for 24 h at 4
      degrees C. The fertilizing ability of fowl semen diluted 1:1 with Beltsville
      Poultry Semen Extender and stored for 24 h at 4 degrees C was enhanced after
      replacement of the homologous seminal plasma by the diluent (89 versus 77%
      fertilization rate). Better results were obtained with seminal plasma dialysed
      against water before sperm storage to discard the less than 1 kDa or the less
      than 50 kDa fractions. It was concluded that low molecular weight seminal plasma
      fractions could damage the fertilizing ability of spermatozoa during storage at 4
      degrees C, whereas high molecular weight fractions appeared to enhance
      fertilizing ability.

PMID- 1625242
TI  - Isolation and culture of glandular epithelial and stromal cells from the
      endometrium of mares.
AB  - Glandular epithelial and stromal cells were isolated from the endometrium of
      mares by collagenase digestion and were incubated on plastic for 7-9 days until
      the cells formed confluent monolayers. The cells differed in morphology:
      epithelial cells appeared polyhedral and stromal cells were spindle like. The
      monolayers were incubated in the presence and absence of oxytocin. Medium was
      removed from wells after 2, 8 and 24 h of incubation. Concentrations of
      prostaglandin F (PGF) in the medium increased significantly during this time.
      Glandular epithelial cells produced significantly more PGF than did stromal
      cells. Both types of cell responded significantly to oxytocin stimulation by
      increased secretion of PGF; the response of glandular epithelial cells tended to
      be greater than that of stromal cells. Secretion of PGF by cultured cells was not
      affected by cycle stage or pregnancy.

PMID- 1625243
TI  - Differential binding of (+) and (-) gossypol to plasma protein and their entry
      into rat testis.
AB  - Concentrations of (+) and (-) gossypol were measured by high performance liquid
      chromatography after they were incubated with plasma proteins in vitro. The
      concentration of (-) gossypol decreased more than the concentration of (+)
      gossypol. A similar decrease in free gossypol concentrations in the blood plasma
      of rats was observed after intravenous infusion of gossypol enantiomers. The
      concentration of (-) gossypol was also found to be lower than the concentration
      of (+) gossypol at the blood-testis barrier. The biological effect of (-)
      gossypol probably results from its stereospecific binding to extra- and
      intracellular proteins in vivo and inhibition of the biological activity of some
      proteins.

PMID- 1625244
TI  - Evidence from the oestrous cycle for male-induced ovulation in Bettongia
      penicillata (Marsupialia).
AB  - Female brush-tailed bettongs (Bettongia penicillata) housed in a breeding group
      of one male and one to three females had an average gestation period of 21.2 days
      (n = 58) and parturition was followed within 24 h by oestrus and mating. If a
      young was not born as a result of the mating, oestrus recurred after about 21.7
      days (n = 12). From removal of pouch young to birth was 17.5 days, on average (n
      = 85), in females that had mated post partum, but most females that were isolated
      from a male before parturition returned to oestrus about 6.6 days after
      simultaneous removal of pouch young and return to the male (n = 9). Females
      housed in female-only groups appeared not to come into oestrus or to do so
      irregularly. These females, when returned to the male, usually came into oestrus
      within 10 days. These data provide evidence that, in most females of B.
      penicillata, ovulation does not occur in the absence of a male and that
      previously isolated females return to oestrus within 10 days of return to the
      male.

PMID- 1625245
TI  - Evidence from plasma progesterone concentrations for male-induced ovulation in
      the brush-tailed bettong, Bettongia penicillata.
AB  - Female brush-tailed bettongs, Bettongia penicillata, were housed with either an
      intact or vasectomized male or isolated from males in the peripartum period.
      Development of the quiescent corpus luteum formed at the post partum oestrus was
      initiated by removing the pouch young. Blood samples for analysis of plasma
      progesterone were collected from the females 2 days before removal of pouch
      young, daily for 5 or 6 days and then 2-3 times each week until 19 days after
      removal of pouch young. Plasma progesterone profiles were similar in pregnant and
      nonpregnant cycles. There was an early progesterone peak (1206 +/- 121 pg ml-1,
      mean +/- SEM; n = 16) between days 2 and 5 after removal of pouch young, and a
      second period of high concentrations (greater than 800 pg ml-1) before birth on
      day 17.4 +/- 0.2 (n = 16). The interval between the early peak and birth was 14
      or 15 days. On five of 34 occasions, no increases in plasma progesterone
      concentrations occurred after removal of pouch young. On 12 of 15 occasions for
      13 females that had been isolated from males post partum, plasma progesterone
      concentrations also remained low (less than 100 pg ml-1) and did not change after
      removal of pouch young. Females that showed no increases in plasma progesterone
      concentration after removal of pouch young had significantly lower (P less than
      0.001) plasma progesterone concentrations while lactating than those females that
      did undergo a cycle after removal of pouch young (60 +/- 4 pg ml-1, n = 17 and
      225 +/- 23 pg ml-1, n = 30, respectively). Females isolated from males post
      partum, and monitored until day 12 after removal of the pouch young, and that
      showed no increases in progesterone in this period, had ovaries that contained no
      corpus luteum, only corpora albicantia and numerous atretic or developing
      follicles. We conclude that brush-tailed bettongs are induced ovulators, a
      characteristic described for only one other marsupial, Monodelphis domestica,
      from South America.

PMID- 1625246
TI  - Hormonal evidence for induced ovulation in Monodelphis domestica.
AB  - Breeding activity in the South American grey opossum, Monodelphis domestica, is
      stimulated by the presence of males. This study presents the first analysis of
      changes in concentrations of plasma progesterone during pregnant and nonpregnant
      cycles. In Expt 1, females were paired with either intact or vasectomized males
      to stimulate a reproductive cycle, or were isolated from males. Within 4-8 days
      of pairing, females showed marked changes in the size of the urogenital opening
      (vulva), which were paralleled by similar changes in body weight (11.4 +/- 2%;
      mean +/- SEM; n = 13). There was a second increase and decrease in body weight
      (21.7 +/- 3.3%; n = 13) in pregnant and nonpregnant cycles during the luteal
      phase of the cycle. Changes in concentrations of plasma progesterone, determined
      from samples collected three times a week, were similar in pregnant and
      nonpregnant cycles. Plasma progesterone concentration, which was increased for 15
      18 days, showed two distinct peaks. The first peak, 3-4.5 ng ml-1, occurred
      immediately after the decrease in vulval swelling, and the second peak (1-2 ng ml
      1) occurred 8-12 days later. Concentrations of plasma progesterone were low
      before parturition occurred. Females isolated from males for 35 days showed no
      changes in body weight or vulval swelling and concentrations of plasma
      progesterone remained undetectable. In Expt 2, concentrations of luteinizing
      hormone (LH) in plasma were determined twice a day for the first few days after
      pairing. In three of five females an LH peak was detected coincident with the
      maximal swelling of the vulva.

PMID- 1625247
TI  - Genetic susceptibility to chlamydial salpingitis and subsequent infertility in
      mice.
AB  - Groups of mice from genetically defined inbred strains were infected genitally
      with a pathogenic human strain of Chlamydia trachomatis and their subsequent
      fertility was compared. The CBA, C3H (H-2o) and C3H/He-mg (H-2k) mice were less
      fertile than control mice, at least up to 6 months after infection. In contrast,
      fertility was not impaired in BALB/c mice or in congenic BALB/K mice, which had
      the H-2k haplotype. Reduced fertility was paralleled by the extent of
      histological oviductal inflammation in mice of each strain. No salpingitis was
      seen 21 days after infection in the BALB strains, but lesions were apparent in
      CBA and C3H strains up to about 70 days after inoculation and these sometimes
      developed into hydrosalpinges. These results indicate that susceptibility to
      chlamydial salpingitis and subsequent infertility is under genetic control. This
      control was not simply associated with the major H-2 gene complex, as mouse
      strains of the same haplotype (H-2k) differed in susceptibility. The fertility of
      BALB/c (H-2d) and BALB/K (H-2k) strains was no different from that of controls,
      and congenic C3H mice of differing H-2 haplotypes (H-2k and H-2o) showed reduced
      fertility. Although all the infected F1 (BALB/K x C3H/He-mg) mice produced
      litters at the same rate as untreated controls, the litters were considerably
      smaller. This was due to the occurrence of unilateral pregnancies in the mice
      inoculated under the ovarian bursae and possibly also to early fetal death in
      mice inoculated directly in the uterus. These findings emphasize the importance
      of early diagnosis and treatment of infection of the lower genital tract of
      women.

PMID- 1625248
TI  - Synchronous division of mouse two-cell embryos with nocodazole in vitro.
AB  - Mouse two-cell embryos were cultured in a medium supplemented with nocodazole or
      colcemid for 12.5-14.5 h in vitro, and development after elimination of these
      drugs was examined. All embryos cultured with nocodazole stopped at the metaphase
      of the second cell cycle. When nocodazole was removed, almost all embryos divided
      to the normal four-cell stage within 1 h and then developed into blastocysts
      (98%). The proportion of embryos that developed into young after transfer to
      recipients was not significantly different from the control (35 versus 36%), but
      the developmental ability of the embryos treated with colcemid was reduced,
      especially after transfer to recipients.

PMID- 1625249
TI  - A comparison of rate and uniformity of embryo development in Meishan and European
      white pigs.
AB  - A comparison was made of the rate and uniformity of development of embryos
      recovered from Meishan and European white sows. The time of ovulation was
      estimated to be 34.3 and 49.0 h after the onset of oestrus in large white and
      Meishan sows, respectively. Embryos were recovered from a total of 38 Meishan and
      37 European pigs between 18 and 219 h after the estimated time of ovulation.
      Embryos recovered after 18-59 or 44-82 h were classified into one of 11 stages
      (from early fertilization to early blastocyst), and the maximum blastocyst
      diameter was measured for embryos recovered 140-219 h after ovulation. There was
      no evidence of a difference between the genotypes in the stage or size of embryos
      at these times or of large differences between the genotypes in the extent of
      variation in embryo stage within females, although a minority of European white
      females had very variable embryos. As the differences between the embryos of the
      Meishan and the European white were small, it seems unlikely that greater
      uniformity of Meishan embryo development is a major cause of the higher prenatal
      survival in that breed.

PMID- 1625251
TI  - Effects of treatment with butylated hydroxytoluene on the susceptibility of boar
      spermatozoa to cold stress and dilution.
AB  - Boar spermatozoa acquired resistance to cold shock immediately after exposure to
      2.0 mmol butylated hydroxytoluene (BHT) l-1 when Beltsville thawing solution was
      used as a basic diluent, as judged by motility (the proportion of motile
      spermatozoa) and acrosomal integrity. The concentration of BHT could be reduced
      to 0.2 mmol l-1 without decreasing the protective action. However, motility was
      altered in the presence of greater than 0.15 mmol BHT l-1. Beltsville freezing 5
      (BF5) diluent was more effective than Beltsville thawing solution in protecting
      spermatozoa from cold shock, but addition of BHT to BF5 diluent did not affect
      the motility and acrosomal morphology of spermatozoa before or after cold shock.
      Dilution of BHT-treated spermatozoa with BF5 diluent did not restore motility and
      did not afford further protection against cold shock; it was detrimental to
      spermatozoa treated with 2 mmol BHT l-1 for greater than 15 min. Egg yolk or
      lecithin had a detrimental effect. When spermatozoa were treated with 0.05-0.10
      mmol BHT l-1 before slow cooling to 5 degrees C, the progressive motility and
      acrosomal integrity were maintained better after storage for 6 days than in
      untreated spermatozoa.

PMID- 1625250
TI  - A pseudoseasonal reproductive strategy in a tropical rodent, Peromyscus nudipes.
AB  - A population of cloud forest mice (Peromyscus nudipes) at latitude 10 degrees N
      near Monteverde, Costa Rica, was sampled four times by live-trapping twice during
      the 7-8 month wet season and twice during the 4-5 month dry season in 1989 and
      1990. Body weights were lower during the early part of the dry season in males
      and throughout the dry season in females than at other times. Testes and seminal
      vesicles were somewhat lighter early in the dry season, but epididymal
      spermatozoa were abundant in most males throughout the year. Adult females
      ovulated, mated and became pregnant in the wet and dry seasons, but young were
      produced only during the wet season. Most embryos failed to implant during the
      dry season, and the few that did complete implantation were reabsorbed before
      midpregnancy. Apparently, every year, the females in this population spend
      several months actively engaged in a behavioural and metabolically costly process
      that is doomed to be unsuccessful. This reproductive strategy is termed
      pseudoseasonal, because reproductive success is highly seasonal, but attempts to
      reproduce are nonseasonal. Implantation failures similar to those seen in the
      wild were induced in the laboratory using mild restriction of food or water.
      Field evidence points to food restriction as the more important cause of
      pregnancy losses in the wild. Exposure to the gradually changing daylengths
      typical of Costa Rica had no effect on the production of young by adults, and
      maintenance on light cycles of 8 h light: 16 h dark, 11 h light: 13 h dark, 13 h
      light: 11 h dark and 16 h light: 8 h dark had no effect on the reproductive
      development of young animals of either sex.

PMID- 1625252
TI  - Induction of immunity to spermatozoa in male domestic fowl and effects on
      fertility.
AB  - Male fowl were immunized intravenously (i.v.) or intramuscularly (i.m.) with
      spermatozoa to assess the effects of immunity to spermatozoa on fertility.
      Histological and immunofluorescence evaluations of testis and ductus deferens
      tissues after 24 weeks of immunizations revealed immune cell infiltration and
      immunoglobulin associated with spermatozoa. The long-term immunization regimen
      resulted in significant antisperm antibody titres in the immunized groups. When
      semen from i.v.-immunized males was used to inseminate females, fertility over 7
      days was reduced (P less than 0.05). A subsequent experiment using a 10-week i.v.
      immunization scheme also led to high antisperm titres. Spermatozoa from these
      males were characterized by lower fertility and duration of fertility than those
      of controls (P less than 0.05). As in mammals, a reduction in fertility may
      result from exposure of avian males to sperm antigens.

PMID- 1625253
TI  - Effects of age, photoperiod and follicle-stimulating hormone on lactate
      production by cultured Sertoli cells from prepubertal Siberian hamsters (Phodopus
      sungorus).
AB  - To define a functional difference in Sertoli cells of animals exposed to
      different photoperiodic conditions, we isolated Sertoli cells from the testes of
      juvenile Siberian hamsters and cultured them in serum-free medium. In all age
      groups studied, Sertoli cells isolated from hamsters with delayed and normal
      puberty responded to follicle-stimulating hormone (FSH) with an increase in
      lactate production. The increase in lactate production induced by 1000 ng FSH ml
      1 was significantly greater in Sertoli cells isolated from hamsters with delayed
      puberty than in those with normal puberty. These results suggest that Sertoli
      cells of Siberian hamsters exposed to short photoperiod in vivo may respond to
      increases in plasma FSH concentrations associated with photostimulation or
      spontaneous sexual maturation by an increase in secretory activity that may be
      critical for the initiation of spermatogenesis.

PMID- 1625254
TI  - Frequent semen collection and sperm reserves of the male Angora goat (Capra
      hircus).
AB  - Semen was collected from six mature and sexually rested Angora bucks at one-hour
      intervals five times a day on each of 5 consecutive days in the breeding season.
      There was a marked decline in semen volume (P less than 0.001), sperm
      concentration (P less than 0.05) and number of spermatozoa (P less than 0.001) on
      consecutive days. Successive ejaculates within days differed only in number of
      spermatozoa (P less than 0.001). The following year at the beginning of the
      breeding season, the weights of testes and epididymides and the reserves of
      spermatozoa in these parts were examined after slaughter of the six bucks. The
      mean number of spermatozoa in the paired testes, capita, corpora and caudae of
      the epididymides were (22.8 +/- 1.24) x 10(9), (9.4 +/- 1.19) x 10(9), (3.4 +/-
      0.22) x 10(9) and (35.0 +/- 2.21) x 10(9), respectively. Epididymal reserves of
      spermatozoa were correlated with testicular weight (r = 0.50, P = 0.01) and
      number of spermatozoa in the testes (r = 0.42, P = 0.07), but not with epididymal
      weight. The daily production of spermatozoa per animal in the breeding season was
      estimated to be 4.0-6.4 x 10(9).

PMID- 1625255
TI  - Society for the Study of Fertility. Annual conference. Glasgow, 15-17 July 1992.
      Abstracts.

PMID- 1625256
TI  - Excessive fear of dilute radiation.

PMID- 1625258
TI  - The portrayal of the physician in non-medical literature--the physician and his
      family.

PMID- 1625257
TI  - Graft-versus-host disease following liver transplantation.

PMID- 1625259
TI  - Acute urinary retention secondary to carcinoma of the prostate. Is initial
      channel TURP beneficial?
AB  - Over a 2-year period patients presenting with acute urinary retention secondary
      to locally advanced prostate carcinoma (stage T3/T4) were randomized to one of
      two treatments. Ten patients underwent channel transurethral resection of
      prostate (TURP) and bilateral orchidectomy, 12 patients underwent bilateral
      orchidectomy alone. Treatment by channel TURP and bilateral orchidectomy was
      complicated by difficulties in voiding in four patients, one requiring a further
      TURP. Ten of the 12 patients were voiding well one month following bilateral
      orchidectomy alone. Only two patients in this group required TURP. In patients
      with acute urinary retention secondary to prostate carcinoma, in whom hormonal
      manipulation is thought appropriate due to bulk of local tumour or metastatic
      disease, channel TURP may confer extra morbidity and therefore be held in reserve
      for those patients unable to void after hormonal manipulation.

PMID- 1625260
TI  - Percutaneous endoscopic gastrostomy in 41 patients: indications and clinical
      outcome.
AB  - Percutaneous endoscopic gastrostomy, under local anaesthetic, was successfully
      used in 40 out of 41 patients referred for nutritional support. The indications
      were neurological disorders of swallowing in 32 patients, head and neck cancer in
      four patients and supplemental feeding in a miscellaneous group of five patients.
      The main complications of this procedure were one failed insertion and one
      peritubal infection. At prospective follow-up, the tube continued to function in
      16 patients (seven at home) a mean of 184 days post-insertion (range 6-610 days).
      In 11 patients resumption of swallowing at a mean of 122 (20-390) days allowed
      tube removal. Thirteen patients died from their disease, a mean of 96 (12-320)
      days post-insertion. Patient tolerance and patient and carer satisfaction have
      been excellent and early results suggest that recovery of speech and swallowing
      in acute neurological disorders may be enhanced. Percutaneous endoscopic
      gastrostomy should be performed in all patients referred for a gastrostomy and
      should be considered in all patients requiring long-term tube feeding.

PMID- 1625261
TI  - Use of a bandage contact lens in perforating injuries of the cornea.
AB  - Four cases of perforating corneal injuries as a result of work-related injuries
      are presented. All were managed with a bandage contact lens and surgical
      intervention was avoided. Topical pilocarpine was used to free incarcerated iris
      in two cases. All patients received a course of broad-spectrum systemic
      antibiotics, and also used topical preservative-free chloramphenicol for the
      duration of contact lens wear. No lens related complications occurred. Final
      unaided visual acuities were the same or better than at presentation.

PMID- 1625262
TI  - Inappropriate circumcision referrals by GPs.
AB  - One hundred and twenty boys were referred by GPs over a 12-month period to a
      paediatric urologist for circumcision. The reasons for referral were: ballooning
      in 36, non-retraction in 28, balanoposthitis in 36 or a combination in 15. On
      examination 53% had a retractile, 21% a partially retractile and 21% a non
      retractile foreskin. Six patients had obvious balanitis xerotica obliterans. Only
      one quarter of the patients required a circumcision. The penis was not examined
      by the referring doctor in 15 patients. The implications of this survey are that
      a large proportion of general practitioners have difficulty in discriminating
      between a true phimosis and a developmentally non-retractile foreskin. This
      diagnostic inaccuracy was greatest when the referring doctor did not examine the
      patient.

PMID- 1625263
TI  - Benefits of training junior physicians to detect diabetic retinopathy--the
      Glasgow experience.
AB  - The accuracy and appropriateness of 115 consecutive referrals by non-consultant
      physicians to a specialist Diabetic Retinopathy Clinic were assessed in a
      retrospective study. The source of the referrals was masked throughout the study.
      Referrals were classed as 'appropriate' or 'inappropriate' for patient
      management, and the referral diagnosis (where specified) was compared with the
      ophthalmologist's initial assessment. It was graded as 'correct', 'partly
      correct' and 'incorrect'. Referrals from physicians who had received 40-50 hours
      of outpatient training in the Diabetic Retinopathy Clinic (group A, n = 49) were
      compared with referrals from doctors without this special instruction (group B, n
      = 66). Referral was deemed 'appropriate' in 32 (65%) of group A referrals, but in
      only 22 (33%) of group B (chi 2 = 11.54, df = 1, P less than 0.001). Referral
      diagnosis (when expressed) was graded as 'correct' in 28 (67%) of group A
      referrals compared with only 12 (30%) of group B, being 'incorrect' in 10 (25%)
      of group B referrals and just two (4.5%) of group A (chi 2 = 12.9, df = 2, P less
      than 0.005). Regular fundoscopy with accurate assessment and appropriate action
      is vital to prevent loss of vision in diabetic patients. Short-term outpatient
      training in a Diabetic Eye Clinic leads junior physicians to more appropriate
      referral and more accurate referral diagnosis.

PMID- 1625264
TI  - Health of a team competing in the 1990 World Solar Car Challenge.
AB  - The health of a team participating in the 1990 World Solar Car Challenge was
      recorded for 10 of the 11 race days. Morbidity was collected during daily
      consultations with the team doctor and the diagnoses were later converted to the
      ICPC code. Team members' self-perceived health status was also recorded daily,
      using the Nottingham Health Profile. Team drivers consulted the doctor more often
      than the support staff and the three full-time drivers had significantly more
      diagnoses than the support staff. The Nottingham Health Profile scores on sleep,
      energy and emotional reactions showed correlations between higher minimum
      temperatures and sleep for all team members and for the three full-time drivers,
      there were significant correlations between increasing maximum temperatures and
      emotional reaction scores. The morbidity records and perceived health scores
      reflect the conditions of the race. Twenty-five per cent of full-time driver
      consultations dealt with skin, eyelid or finger infections probably caused by the
      lack of washing water. The scores on sleep and emotional reactions were affected
      by temperature and previous research reports degradation in concentration and
      dual tasks with increasing temperature. This may account for the difficulty some
      drivers had in continuing their shifts. Close supervision of the drivers and the
      recording of their perceived health status helped reduce the health problems of
      the team.

PMID- 1625265
TI  - Final year medical students' knowledge of practical nutrition.
AB  - An entire final-class of medical students was set a 6-part question on dietary
      advice to patients as commonly seen in general practice. The marks were scored by
      a formal, agreed system. Eighty-two per cent failed though only 2% failed the
      whole exam. The teaching of practical nutrition needs to be improved.

PMID- 1625266
TI  - Familial colorectal cancer: discussion paper.

PMID- 1625267
TI  - The Sherlock Holmes paradigm--detectives and diagnosis: discussion paper.

PMID- 1625268
TI  - Cerumen: its fascination and clinical importance: a review.

PMID- 1625269
TI  - 'Value in love poetry?'--an appraisal of Ovid's 'Amores'.

PMID- 1625270
TI  - Imaginary conversations from the history of medicine: Robert Koch and Wilhelm
      Conrad Rontgen.

PMID- 1625271
TI  - Necrobiotic xanthogranuloma with orbital involvement.

PMID- 1625272
TI  - Idiopathic megarectum treated by Duhamel's operation.

PMID- 1625273
TI  - Gaucher's disease.

PMID- 1625274
TI  - Psittacosis and acute thrombocytopenic purpura.

PMID- 1625275
TI  - Implantation metastasis from adenocarcinoma of sigmoid colon into fistula in ano.

PMID- 1625276
TI  - Co-existing Listeria and pneumococcal infection in a chronic alcoholic.

PMID- 1625277
TI  - Ophthalmic manifestations of metastatic carcinoma of the breast.

PMID- 1625278
TI  - 7th European Conference on Clinical Haemorheology.

PMID- 1625279
TI  - Haemorheological treatment of ischaemia--facts or fancy?

PMID- 1625280
TI  - The COMA report: sugars and dental caries.

PMID- 1625281
TI  - Warts and all.

PMID- 1625282
TI  - Inhalation therapy in asthma.

PMID- 1625283
TI  - Inhalation therapy and asthma.

PMID- 1625284
TI  - Doctors' dress.

PMID- 1625285
TI  - Neonatal cleft lip repair.

PMID- 1625286
TI  - Unilateral choanal atresia.

PMID- 1625287
TI  - Female body size, parity, and malaria infection of Anopheles maculatus (Diptera:
      Culicidae) in peninsular Malaysia.
AB  - The relationship among body size (as indicated by wing length), age (as indicated
      by parity dissections), and malaria infection were observed in host-seeking
      Anopheles maculatus Theobald females collected in aboriginal villages of
      peninsular Malaysia. Both ELISA and salivary gland dissections were used to
      determine malaria infection. The wings of parous females were significantly
      longer than those of nulliparous females, suggesting that larger females live
      longer than smaller ones, and thus have a higher vectorial capacity. Body size
      differences were not detected between infected parous and uninfected parous
      females. Females infected with only oocysts were significantly larger than
      females infected with sporozoites. No correlation was found between the number of
      oocysts or sporozoites and body size in this small sample.

PMID- 1625288
TI  - Gonotrophic cycle and survivorship of Anopheles albimanus (Diptera: Culicidae) in
      southern Mexico.
AB  - The length of the gonotrophic cycle of Anopheles albimanus was estimated by 12
      mark-release-recapture studies conducted in corrals in southern Mexico from 1987
      to 1990. The initial set of three mark-release studies indicated that the
      gonotrophic cycle takes at least 4 d based on the day when gravid mosquitoes were
      first recaptured. However, in later experiments, mosquitoes recaptured seeking
      hosts at 48 h after release were in Sella's and Christophers' stages I and II,
      but parity rates had nearly doubled, indicating that eggs may have developed in
      less than 48 h and that mosquitoes returned to refeed immediately following
      oviposition. Two gonotrophic cycles probably exist, one of 48 h dominated by
      parous mosquitoes and one of 4 d comprised of nulliparous, pregravid mosquitoes.
      Daily survivorship was estimated by regression from the decrease in the daily
      recapture rate (0.46-0.68) was less than that estimated by the parity rates (0.67
      0.69), with no important differences found between wet and dry seasons. Estimates
      of the probability of a mosquito living long enough to transmit malaria were 2%
      (range, 1.8-2.5%).

PMID- 1625289
TI  - Scanning electron microscopic observations of Anopheles albimanus (Diptera:
      Culicidae) eggs.
AB  - To investigate the existence of subspecies of Anopheles albimanus Wiedeman in
      southern Mexico, the egg morphology of specimens obtained from several field
      populations and from insectary-adapted colonies of uniform pupal phenotype was
      examined. Scanning electron microscopic observations have shown that the eggs of
      An. albimanus are polymorphic in respect to the size and shape of their floats,
      but not in their ornamentation. Four types of eggs were found. Differences in the
      proportion of the various morphological types were statistically significant,
      although proportions of egg types were variable among individuals within the same
      population. These observations are suggestive of distinctive populations and
      warrant further studies using more sensitive methods to investigate sibling
      species in An. albimanus sensu lato.

PMID- 1625290
TI  - Cellular responses of laboratory mice to feedings of Ornithodoros talaje (Acari:
      Argasidae) larvae.
AB  - Studies were carried out in which laboratory mice were subjected to sequential
      feedings by slow feeding Ornithodoros talaje (Guerin-Meneville) larvae to detect
      and characterize the host cellular response. After the first exposure,
      histological evidence showed a strong neutrophil infiltration at the site of
      attachment and feeding. By the third exposure, a marked shift to lymphocytes was
      noted in the mouse tissues using histological preparations of the feeding ticks.
      Lymphocyte proliferation tests also provided indirect evidence of a host
      lymphocyte response as a result of the three tick exposures and feedings.

PMID- 1625291
TI  - Dormancy, embryogenesis, and hatching of eggs of Prosimulium kiotoense (Diptera:
      Simuliidae) under natural and experimental conditions.
AB  - The egg dormancy and embryogenesis of the univoltine black fly, Prosimulium
      kiotoense Shiraki, in southwestern Japan were examined under natural and
      laboratory conditions. Eggs laid in April remained dormant until August
      (approximately 14 wk after oviposition). Hatching commenced in early October
      (after 23 wk), when air and water temperatures decreased to 20 and 15 degrees C,
      respectively, and continued until mid-December (32 wk) in the field. Laboratory
      experiments showed that lower temperatures (10 and 14 degrees C) supported
      embryogenesis similar to that observed in the field. In contrast, higher
      temperatures (18 and 22 degrees C) retarded or completely suppressed
      embryogenesis after the termination of dormancy. However, completion of dormancy
      was accelerated when eggs were exposed experimentally to these higher
      temperatures for 3-12 wk, then returned to a constant low temperature (14 degrees
      C). Daylength did not affect the maintenance and termination of dormancy.
      Therefore, temperature played an important role differentially affecting
      completion of dormancy and postdormancy development. Variable lengths of
      developmental periods among egg batches under the same conditions indicated
      possible genetic control of dormancy intensity.

PMID- 1625292
TI  - Aedes aegypti (Diptera: Culicidae) vision: response to stimuli from the optical
      environment.
AB  - Although Aedes aegypti (L.) are capable of some wavelength discrimination,
      behavioral experiments demonstrated that color was not a stimulus to which they
      responded. Optical stimuli that did affect Ae. aegypti behavior were luminous
      reflectance, vertical contrast, and movement. Stationary objects of low
      reflectance and solid color were the most attractive to males and females.

PMID- 1625293
TI  - Quantitative evaluation of sampling methods for Ixodes dammini and Amblyomma
      americanum (Acari: Ixodidae).
AB  - Three tick-sampling methods (dry ice-baited tick traps, cloth drags, and
      ambulatory human host) were evaluated to determine which technique yielded the
      greatest capture of host-seeking stages of Ixodes dammini Spielman, Clifford,
      Piesman & Corwin and Amblyomma americanum (L.). The most reliable method,
      catching more stages and significantly more numbers of I. dammini and A.
      americanum; was dry ice-baited tick traps. There were no significant differences
      between the drag and human-host methods for any stage of ticks (I. dammini and A.
      americanum) collected. The numbers of ticks caught during the study were 5,052 by
      dry ice-baited tick traps, 199 by cloth drags, and 89 by ambulatory human host.

PMID- 1625294
TI  - Morphological and functional classification of the hemocytes of adult female
      Simulium vittatum (Diptera: Simuliidae).
AB  - Morphology and function of the hemocytes of 1-d-old, female Simulium vittatum
      Zetterstedt were studied using light and scanning electron microscopy. Four types
      of hemocytes, comparable with those of other medically important Diptera, were
      identified: prohemocytes, plasmatocytes, granulocytes, and spherulocytes.
      Plasmatocytes and granulocytes contained neutral red granules, but only
      granulocytes exhibited significant acid phosphatase activity. Plasmatocytes and
      granulocytes were identified as the primary phagocytes: plasmatocytes and
      granulocytes of bacteria in vitro and granulocytes of human red blood cells in
      vivo. Granulocytes also were observed attached to and degranulating into fat body
      and hemopoieticlike tissue fragments, perhaps assisting in the mobilization of
      nutrients for egg development and in the release of immature hemocytes into
      circulation.

PMID- 1625295
TI  - Reproductive and metabolic differences between Aedes aegypti and Ae. albopictus
      (Diptera: Culicidae).
AB  - Aedes albopictus (Skuse) females were more likely to develop eggs after they
      ingested small blood meals than were Aedes aegypti (L.) when both species were
      maintained under the same suboptimal adult nutritional regimen. The longevity of
      adult female Ae. albopictus under conditions of starvation was also significantly
      greater than that of Ae. aegypti. Analyses of total body proteins, lipids, and
      glycogen indicated that the increased reproductive efficiency of Ae. albopictus
      may be a result of its greater reserves accumulated during a longer larval
      period.

PMID- 1625296
TI  - Ecological observations on the 1989 outbreak of St. Louis encephalitis virus in
      the southern San Joaquin Valley of California.
AB  - Temporal and spatial patterns of St. Louis encephalitis (SLE) virus transmission
      were compared at permanent study areas in the southern San Joaquin Valley during
      years with low (1988 and 1990) and elevated (1989) viral activity. During 1989
      and 1990, virus appeared first at sentinel chicken flocks exhibiting low to
      moderate seroconversion rates at the end of the previous season. This finding,
      and the early season seroconversion of sentinel chickens at a marsh habitat on 5
      March and 2 April 1990, circumstantially indicated that SLE virus may have
      overwintered on the valley during the winters of 1988-1989 and 1989-1990. The
      mechanism of overwintering was not elucidated further, because virus could not be
      isolated from overwintering adult mosquitoes or from immatures collected during
      the spring. An outbreak of 26 confirmed SLE cases occurred in 1989 during a
      drought year (rainfall 50% of normal) and followed a spring with elevated
      temperatures (1.7-3.4 degrees C above normal) and Culex tarsalis Coquillett
      abundance. Cx. tarsalis was the primary vector, being most abundant during the
      virus amplification period in early summer and most frequently infected (70 SLE
      virus positive pools/329 tested). SLE virus also was detected in Culex
      quinquefasciatus Say (14/65) and Cx. stigmatosoma Dyar (1/4); however, both
      species were distributed focally and increased in abundance only after widespread
      seroconversions had occurred in sentinel chickens. Increased virus activity
      during 1989 was not accompanied by marked changes in vector susceptibility or in
      SLE virus infectivity for mosquitoes. Decreased virus activity in the Bakersfield
      area during 1990 could not be attributed to immunity in passeriform birds,
      because a small seroprevalence survey indicated that few adult birds had
      antibodies to SLE virus.

PMID- 1625297
TI  - Vector competence of Aedes hendersoni (Diptera: Culicidae) for La Crosse virus:
      lack of impaired function in virus-infected salivary glands and enhanced virus
      transmission by sporozoite-infected mosquitoes.
AB  - Previous research has shown Aedes hendersoni Cockerell to be an incompetent
      vector of La Crosse (LAC) virus because of a salivary gland escape (SGE) barrier;
      that is, the salivary glands are infected but the mosquito fails to transmit the
      virus orally. Intradermal probing behavior and ability to locate blood were
      studied in infected mosquitoes as indicators of salivary gland impairment to
      determine if the SGE barrier was due to virus-induced pathology of the salivary
      glands. No evidence of salivary gland impairment as a result of virus infection
      was detected in infected Ae. hendersoni. This was also true for Aedes triseriatus
      (Say), a competent vector of LAC virus, which was used as a control. However,
      coinfection of Ae. hendersoni with Plasmodium gallinaceum and LAC virus
      dramatically increased virus transmission (72 versus 8%), whereas transmission by
      coinfected Ae. triseriatus was not significantly affected. Possible causes for
      the SGE barrier in Ae. hendersoni are discussed.

PMID- 1625298
TI  - Biosynthesis of trypsinlike and chymotrypsinlike enzymes in immature Lutzomyia
      anthophora (Diptera: Psychodidae).
AB  - The biosynthesis of trypsinlike and chymotrypsinlike enzymes was followed in the
      four instars and pupa of Lutzomyia anthophora Addis. A 32-fold increase in the
      biosynthesis of trypsinlike enzymes was observed from the first to the fourth
      instar. Trypsinlike and chymotrypsinlike isozymes were also synthesized by pupae
      1-8 d old. Similarly, a 29-fold increase in the biosynthesis of chymotrypsinlike
      isozymes also was observed from first to fourth instars. Several different [1,3
      3H]DIP trypsinlike and chymotrypsinlike derivatives of first to fourth instars
      and pupae (1 and 8 d old) were studied using polyacrylamide gel electrophoresis
      and fluorography.

PMID- 1625299
TI  - First isolation of Borrelia burgdorferi in southern California.
AB  - The Lyme disease spirochete, Borrelia burgdorferi Johnson, Schmid, Hyde,
      Steigerwalt & Brenner, was isolated from the blood of a dusky-footed wood rat,
      Neotoma fuscipes Baird, in the San Bernardino Mountains of southern California.
      Antigenic, protein, and molecular analyses demonstrated that the isolate varied
      slightly from most isolates of B. burgdorferi from northern California and was
      clearly distinct from other species of Borrelia that are endemic to the state.
      This is the first reported isolate of B. burgdorferi from southern California and
      demonstrates that the Lyme disease spirochete is enzootic in mountains near the
      major human population center of the state.

PMID- 1625300
TI  - Ecological studies of adult Ixodes scapularis in central Mississippi: questing
      activity in relation to time of year, vegetation type, and meteorologic
      conditions.
AB  - Adult Ixodes scapularis Say were collected weekly during two fall-winter-spring
      seasons from 1989 to 1991 to assess their temporal and spatial distribution as
      well as the effects of several meteorologic parameters on questing activity.
      Collections were made in three 0.4-ha sites in central Mississippi by flagging
      vegetation with a white flannel cloth. Adult I. scapularis were collected from 25
      October through 11 April during the 1989-1990 season and 24 October-1 April in
      the 1990-1991 season. Peak I. scapularis questing activity occurred on 5 February
      and 4 February during the two seasons, respectively. Ticks were collected most
      often at approximately 20 degrees C but seven were collected on a day when the
      temperature was 6.9 degrees C. Ticks were clustered within the study sites and
      not evenly distributed. Most I. scapularis were collected from Ligustrum sinense
      and Chasmanthium sessiliflorum at a height of 31-40 cm. Statistical analyses of
      the meteorologic factors that affect questing activity are presented and
      discussed.

PMID- 1625301
TI  - Ectoparasitic mites (Acari) of sympatric Brazilian free-tailed bats and big brown
      bats in Alabama.
AB  - Seven species of mites were recovered from 133 Brazilian free-tailed bats,
      Tadarida brasiliensis, and 94 big brown bats, Eptesicus fuscus, from February
      through November 1990 in colonies that shared roosting space in east-central
      Alabama. The macronyssid Chiroptonyssus robustipes (Ewing) was the most common
      mite on T. brasiliensis (964 mites, 87% of bats infested) and on E. fuscus (109
      mites, 29% of bats infested). However, C. rubustipes normally is a specific
      parasite of T. brasiliensis. The macronyssids Steatonyssus ceratognathus (Ewing)
      and S. occidentalis (Ewing) were recovered from both species of bats in low
      numbers. S. ceratognathus is not a typical parasite of either species of bat, but
      S. occidentalis normally is specific to E. fuscus. Predictably, S. occidentalis
      was most frequently collected from E. fuscus (16 mites, 9% of bats infested), but
      two specimens were recovered from T. brasiliensis. Five specimens of the laelapid
      Androlaelaps casalis (Berlese) (a mite that is frequently associated with
      rodents) and one specimen of the myobiid mite Ewingana (Doreyana) longa (Ewing)
      (a specific ectoparasite of T. brasiliensis) were also recovered from T.
      brasiliensis. Singletons of the rosensteiniids Mydopholeus sp. and
      Nycteriglyphites pennsylvanicus Fain, Lukoschus & Whitaker were the only
      additional mites collected from E. fuscus; both of these mites have previously
      been collected from bats or their guano but are recorded here from Alabama for
      the first time. With respect to ectoparasite cross-infestations, E. fuscus
      appears to be at greater risk from sharing roots with T. brasiliensis. This is
      highlighted by the comparatively large numbers of C. robustipes that occurred on
      E. fuscus and the low numbers of S. occidentalis on T. brasiliensis. Although
      mites were the only arthropods recovered from bats in this study, a separate
      survey in 1991 revealed that the bat bug Cimex adjunctus Barber infested some
      other colonies of T. brasiliensis and E. fuscus in Alabama.

PMID- 1625302
TI  - Inability of Ixodes cookei and Amblyomma americanum nymphs (Acari: Ixodidae) to
      transmit Borrelia burgdorferi.
AB  - The vector competency of Ixodes cookei Packard and Amblyomma americanum (L.) for
      Borrelia burgdorferi was studied using Syrian hamsters. Ixodes dammini Spielman,
      Clifford, Piesman & Corwin were used as controls. Darkfield and immunofluorescent
      examinations of midgut diverticula revealed B. burgdorferi spirochetes in 32 of
      36 (88.9%) I. dammini larvae, 5 of 36 (13.9%) I. cookei larvae, and 7 of 36
      (19.4%) A. americanum larvae within 48 h after feeding on infected Syrian
      hamsters. B. burgdorferi were also observed in the midguts of 94 of 107 (87.8%)
      I. dammini nymphs that developed from the fed larvae. However, none of 30 I.
      cookei nymphs was positive for spirochetes and only 1 of 60 (1.7%) A. americanum
      nymphs was found positive for B. burgdorferi. Nymphs of each tick species, reared
      from larvae that had fed on infected hamsters, were allowed to feed on uninfected
      hamsters to determine their ability to transmit B. burgdorferi. Transmission was
      demonstrated only by I. dammini nymphs.

PMID- 1625303
TI  - Population dynamics of adult Culex mosquitoes (Diptera: Culicidae) along the Kern
      River, Kern County, California, in 1990.
AB  - The temporal and spatial abundance, dispersal, survivorship, and density of Culex
      tarsalis Coquillett and Cx. quinquefasciatus Say populations were studied in
      riparian, agricultural, and residential habitats along the Kern River bed during
      the drought year of 1990. The temporal abundance of both species was related to
      cotton agricultural practices and peaked during intensive irrigation after
      cultivation was terminated in July. Cx. tarsalis peaked in abundance 2 wk earlier
      than Cx. quinquefasciatus, perhaps because of the advantage of autogenous
      oviposition, which shortened generation time. Although host-seeking females of
      both species were most abundant in the riparian habitat, more Cx.
      quinquefasciatus than Cx. tarsalis were collected in the residential habitat.
      Marked females released within the riparian habitat were recaptured most
      frequently within 1 km of the release point; however, flights as far as 12.6 km
      were documented within the 180-km2 study area. On average, marked Cx.
      quinquefasciatus dispersed farther and more rapidly than Cx. tarsalis and were
      recaptured more frequently within the residential habitat. Survivorship,
      estimated horizontally from the female recapture rate, ranged from 0.60 in May to
      0.79 in July for Cx. tarsalis and from 0.74 in September to 0.84 in July for Cx.
      quinquefasciatus. The estimation of survivorship vertically from the parity rate
      was complicated by elevated autogeny rates in Cx. tarsalis and by the low parity
      rate in Cx. quinquefasciatus. Cx. tarsalis population density ranged from 125
      females per km2 in May to 65,500 per km2 in August, and was well correlated with
      relative abundance. Collectively, these ecological data indicated that Cx.
      tarsalis may be important in disseminating arboviruses within the riparian
      habitat, but that Cx. quinquefasciatus may be important secondarily by
      disseminating virus from the riparian habitat to the adjacent residential
      habitat.

PMID- 1625304
TI  - Effectiveness of an aerial application of carbaryl in controlling Ixodes dammini
      (Acari: Ixodidae) adults in a high-use recreational area in New Jersey.
AB  - Lyme disease risk reduction through the control of the principal tick vector,
      Ixodes dammini Spielman, Clifford, Piesman & Corwin, has become a major issue
      facing public health agencies in many endemic states. Where large tracts of land
      are involved, established methods of I. dammini control are impractical. An
      aerial application of carbaryl directed against fall populations of I. dammini
      adults resulted in 93.8% control after 96 h. Control persisted through the
      following spring. The usefulness of aerial applications may be limited to areas
      where logistic constraints obviate the use of conventional ground applications.

PMID- 1625305
TI  - Biosynthesis and metabolism of juvenile hormone III from methyl farnesoate by
      exposed corpora allata of Lutzomyia anthophora.
AB  - The in-vitro biosynthesis of [12-3H] juvenile hormone (JH) III by exposed corpora
      allata (CA) of teneral, sugar-fed, and blood-fed female Lutzomyia anthophora
      (Addis) was followed by incubating the CA for 4 h with [12-3H]methyl farnesoate.
      Synthesis of [12-3H]H III was determined by C18 reversed-phase high-pressure
      liquid chromatography (HPLC) and preparative gas chromatography. The rate of
      synthesis of JH III by teneral females was 5.6 fmol/h per CA. The CA of 1-d-old
      females synthesized 17 fmol/h per CA, whereas 3-d-old females synthesized 5.4
      fmol/h per CA. The rate of synthesis of JH III 4 h after the blood meal increased
      to 17.3 fmol/h per CA and then declined to reach a minimum of 1.6 fmol/h per CA
      at 30 h before increasing again to reach 21.6 fmol/h per CA at 96 h. The
      concentration of methyl farnesoate in the tissue culture medium during incubation
      of CA from sugar- and blood-fed females was compared with the rate of synthesis
      of JH III and its metabolites diol-acid, diol, acid, and bisepoxide. The rate of
      synthesis of JH III and its metabolites from methyl farnesoate indicated a steady
      state equilibrium of synthesis and metabolism of JH III by the exposed CA. The
      rapid increase in JH III synthesis immediately after the blood meal confirmed
      that in sand flies, like mosquitoes, there is an increase in the rate of
      synthesis of JH III immediately after the female takes blood. The role of the
      hormone in vitellogenin biosynthesis is also discussed.

PMID- 1625306
TI  - New species of the genus Parichoronyssus (Acari: Macronyssidae) on Tonatia evotis
      (Chiroptera: Phyllostomidae) in southeastern Mexico.
AB  - The new species Parichoronyssus radovskyi was found on the bat Tonatia evotis in
      Quintana Roo and Chiapas, Mexico. The female, male, and protonymph are described
      and illustrated.

PMID- 1625307
TI  - Facultative myiasis by Megaselia sp. (Diptera: Phoridae) in Texas: a case report.
AB  - Facultative myiasis caused by larval Megaselia sp. is reported in a human in
      Texas. On two occasions during 24 h, the youth experienced a "crawling sensation
      deep in [his] throat" which caused him to cough, expelling a living Megaselia sp.
      larva. The site of the infestation was presumed to be the sinuses or upper
      respiratory tract. The symptoms resolved upon expulsion of the larvae, and no
      additional complications were observed in the patient.

PMID- 1625308
TI  - Efficient laboratory maintenance of blood-feeding mesostigmatid mites (Acari).
AB  - A technique is described for colonizing hematophagous mesostigmatid (= gamasid)
      mites under laboratory conditions. The apparatus consisted of a 473-ml (1 pint)
      Mason jar with sterilized surgical gauze and corrugated card placed inside on the
      bottom; these functioned as absorbent and mite bedding materials, respectively. A
      suckling mouse was placed onto the surgical gauze for 2-24 h to provide a food
      source for the mites. Stickem adhesive was smeared along the inside neck of the
      jar, which had a tight-fitting but ventilated screw-cap lid. The apparatus rested
      in a petri dish filled with water. This system provided excellent containment of
      the mites.

PMID- 1625309
TI  - Indoor and outdoor host-seeking rhythms of Anopheles albitarsis (Diptera:
      Culicidae) in Trinidad, West Indies.
AB  - The diel host-seeking periodicity of Anopheles (Nyssorhynchus) albitarsis Lynch
      Arribalzaga (sensu latu) was monitored on humans during a period of 6 mo in
      Frederick Settlement, County Caroni, Trinidad, West Indies. Similar abundances
      and periodicities were recorded at indoor and outdoor sites, with peak host
      seeking occurring at 1900 hours. Only 78 An. albitarsis females were collected
      resting indoors, indicating that most females rest outdoors and, therefore, may
      escape contact with residual insecticides applied on wall surfaces.

PMID- 1625310
TI  - New perspectives in giardiasis.

PMID- 1625311
TI  - Production of enterotoxin and cytotoxin in Campylobacter jejuni strains isolated
      in Costa Rica.
AB  - The production of toxins by 79 strains of Campylobacter jejuni isolated in Costa
      Rica from children with campylobacter-induced diarrhoea (44 strains) and from
      chickens (35 strains) was studied. An enterotoxic effect giving a rounding of
      mouse adrenocortical tumour (Y1) cells, which could be neutralised with antitoxin
      against Escherichia coli heat-labile enterotoxin, was detected in supernates from
      16 (62%) of 26 strains from children with watery diarrhoea, in 5 (28%) of 18
      strains from children with bloody or inflammatory diarrhoea, and in 12 (34%) of
      the 35 strains from chickens. Cytotoxic effects in human lung fibroblasts (MRC
      5), African Green monkey kidney (Vero) cells and human cervical carcinoma (HeLa)
      cells were observed in none of the 26 strains from children with watery
      diarrhoea, in 2 (11%) of the 18 strains from children with bloody or inflammatory
      diarrhoea, and in 6 (17%) of the 35 strains from chickens. The simultaneous
      production of enterotoxin and cytotoxin was detected in four strains. The
      cytotoxic effect, which was most prominent in cells freshly seeded at a low
      density, appeared as a lethal rounding of the cells. Fibroblasts were more
      sensitive than epithelial cells. The effects of the supernates were inactivated
      by heating at 100 degrees C for 10 min and decreased after 1 week at 4 degrees C.
      The production of toxins was lost after storage of the strains for one year at 
      70 degrees C.

PMID- 1625312
TI  - Killing of alpha-haemolytic and non-haemolytic Escherichia coli strains in human
      serum and polymorphonuclear leucocytes.
AB  - The role of alpha-haemolysin (AH) in the resistance of Escherichia coli strains,
      isolated from patients with extra-intestinal diseases or diarrhoea, to the
      bactericidal activity of human serum and intracellular killing in
      polymorphonuclear leucocytes (PMNL) was investigated in vitro. Sets of alpha
      haemolytic and non-haemolytic E. coli strains and sets of isogenic E. coli
      strains, which included wild-type alpha-haemolytic strains and derived strains
      with a reduced production of AH, were used. Compared with non-haemolytic strains,
      alpha-haemolytic strains were significantly more resistant to the bactericidal
      activity of 10% and 100% human serum and to intracellular killing in PMNL. Higher
      resistance to serum killing and to intracellular killing in PMNL was also found
      in wild-type alpha-haemolytic E. coli than in isogenic bacteria with reduced
      production of AH. These results provide evidence that production of AH in E. coli
      strains counteracts both the bactericidal activity of serum and intracellular
      killing in PMNL.

PMID- 1625313
TI  - Factors that influence the interaction of Campylobacter jejuni with cultured
      mammalian cells.
AB  - Although Campylobacter jejuni is now recognised as a common enteric pathogen, the
      mechanisms by which this organism produces enteritis remain ill-defined. It has
      been proposed that its abilities to adhere to and enter epithelial cells
      represent properties essential to virulence. However, the characteristics of
      these interactions and factors that may influence the association of C. jejuni
      with epithelial cells are incompletely described. We have determined that the
      ability of C. jejuni to bind to epithelial cell lines in vitro is significantly
      affected by the growth temperature and growth stage of the bacteria, but not by
      growth-medium composition. Binding of C. jejuni to cultured cells is not affected
      by temperature or phylogenetic origin of the target cell, and exhibits a non
      uniform or patchy distribution. In contrast, internalisation is markedly
      diminished at low temperature, appears to involve active invagination of the
      target cell membrane via pseudopod formation, and is maximal when cells of human
      origin are employed.

PMID- 1625314
TI  - Fibronectin binding of Lactobacillus species isolated from women with and without
      bacterial vaginosis.
AB  - Lactobacilli isolated from the vaginas of healthy women (39 strains) and from the
      vaginal discharge of women with bacterial vaginosis (15 strains) were
      investigated for their binding to 125I-fibronectin. Nine of the 54 strains bound
      fibronectin at pH 7.2. The binding capacity of these nine strains was about the
      same as that observed with Staphylococcus aureas Cowan 1. The binding was
      specific; an excess of unlabelled fibronectin or its amino-terminal 29-kDa
      fragment effectively competed for binding, whereas bovine serum albumin, human
      IgG and orosomucoid did not. Incubation of lactobacilli with fibronectin for
      different periods revealed a time-dependent increase in binding. Lowering the pH
      to 4.0 increased the binding capacity of all of the lactobacilli tested; binding
      occurred with strains that had previously failed to bind at pH 7.2. The increased
      binding of lactobacilli to fibronectin at a low pH may play a role in the
      maintenance of the ecological balance of the vagina.

PMID- 1625315
TI  - Cytopathic effect of Haemophilus ducreyi for human foreskin cell culture.
AB  - An explant adult foreskin cell culture (FS2-3) was compared with human lung
      carcinoma cell culture (A549) with regard to the ability of Haemophilus ducreyi
      to produce a cytopathic effect. The survival of H. ducreyi for up to 26 days in
      FS2-3 cells was far greater than in any previously described in-vitro culture
      system. H. ducreyi survived for up to 7 days in A549 cells. The H. ducreyi cells
      grew and formed "fungal-like" microcolonies on the eukaryotic monolayer. Portions
      of the microcolonies remained attached despite extensive washing. Transmission
      electronmicroscopy indicated that, at 48 h after infection, the H. ducreyi cells
      did not penetrate the FS2-3 cells but they were closely associated with them;
      there was only a 2-5 nm gap between the H. ducreyi cell wall and the FS2-3
      membrane. The virulent H. ducreyi strains RO18 and 35,000 produced a cytopathic
      effect on FS2-3 cells that did not appear to be due to a soluble toxin. These
      strains did not produce any CPE on A549 cells. H. influenzae and the avirulent H.
      ducreyi strain CIP542, inoculated in the same concentration and incubated for the
      same length of time, did not produce CPE on FS2-3 cells. This study demonstrated
      that the use of FS2-3 foreskin cell culture provided an in-vitro approach for
      evaluating the cytopathic effect of virulent H. ducreyi whereby, unlike in other
      in-vitro systems, viability of the micro-organism could be readily maintained.

PMID- 1625316
TI  - An analysis of lectin agglutination as a means of sub-dividing gonococcal
      serovars.
AB  - Sixteen lectins were examined for their ability to agglutinate 298 strains of
      Neisseria gonorrhoeae. Seven lectins failed to agglutinate any of the strains;
      the remaining nine lectins gave 22 different agglutination patterns. The 298
      strains were divided into 14 serovars with a single panel of monoclonal antibody
      typing reagents; lectin agglutination subdivided these into 57 serovar/lectin
      patterns. A combination of two monoclonal antibody serotyping panels divided the
      strains into 32 serovar combinations; lectin agglutination further subdivided
      these into 79 serovar/lectin patterns. There was no correlation between lectin
      pattern and serovar. Lectin agglutination is a simple supplementary typing method
      and could be particularly useful in micro-epidemiological studies.

PMID- 1625317
TI  - Classification of oral pigmented anaerobic bacilli by pyrolysis mass spectrometry
      and biochemical tests.
AB  - Clinical (66) and reference (5) strains of pigmented gram-negative anaerobic
      bacilli, identified as Prevotella intermedia (47), Pr. melaninogenica (1), Pr.
      corpora (8), Porphyromonas asaccharolyticus (12), P. endodontalis (1) and P.
      gingivalis (2), were examined by pyrolysis mass spectrometry (PMS) and in
      conventional tests. Numerical classification based on conventional test reaction
      patterns (CTRPs) resolved five clusters, four comprising strains identified as
      Pr. intermedia, Pr. corpora, Pr. melaninogenica, and P. gingivalis respectively,
      and one comprising strains identified as P. asaccharolyticus and P. endodontalis.
      Numerical classification based on PMS showed a similar division, with decreasing
      homogeneity of chemical composition in the order Pr. intermedia, Pr. corpora, P.
      asaccharolyticus, which agreed with the order of homogeneity in CTRPs. PMS
      clusters corresponding to the genus Porphyromonas were clearly distinct from
      those of the genus Prevotella. PMS and CTRP classification disagreed on cluster
      membership for six strains. PMS identification from blind challenge sets was in
      agreement with conventional identification for 64 of 67 strains.

PMID- 1625318
TI  - Radiochemical assay to measure the biofilm produced by coagulase-negative
      staphylococci on solid surfaces and its use to quantitate the effects of various
      antibacterial compounds on the formation of the biofilm.
AB  - A firmly adherent mass of slime plus organisms (biofilm) accumulates on the sides
      of culture tubes when some strains of coagulase-negative staphylococci are grown
      in a chemically-defined medium containing [14C]glucose. This mass was washed (to
      remove labelled medium) and then counted after adding scintillation fluid.
      Organisms from the liquid culture were also washed and counted to check that
      [14C]glucose had been utilised to label the bacteria. Nine strains were examined
      in this way, and the results were compared with those obtained with four older
      techniques for recognising slime production or adherent bacteria. The new method
      is quick, and has advantages of reproducibility and good discrimination between
      strains; there was a 15-fold difference in counts in the biofilm between slime
      producing and non-producing strains respectively. With the new radiolabel assay,
      the effects of several antibacterial compounds on the build-up of the biofilm
      were investigated with four slime-producing strains. Tunicamycin, chloramphenicol
      and 5-fluorouracil, at levels below their minimum growth-inhibitory
      concentrations, each greatly diminished biofilm formation; several other drugs
      had less effect.

PMID- 1625319
TI  - Characterisation of hospital isolates of Moraxella (Branhamella) catarrhalis by
      SDS-PAGE of whole-cell proteins, immunoblotting and restriction-endonuclease
      analysis.
AB  - Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of whole
      cell proteins (WCP), immunoblot analysis and DNA restriction-endonuclease
      analysis (REA) were applied as potential typing methods to 31 clinically
      significant strains of Moraxella (Branhamella) catarrhalis, five of which came
      from a suspected outbreak of nosocomial infection in a respiratory-diseases ward.
      Twelve of 31 isolates were placed in four groups, each of which contained strains
      indistinguishable by the three typing techniques used. Each of a further two
      groups contained two strains, and they were similar by at least one technique;
      the remaining 15 strains were unique by all three methods. Four of five strains
      from the suspected outbreak were indistinguishable by SDS-PAGE of WCP,
      immunoblotting and REA. Results show that SDS-PAGE of WCP, immunoblotting and REA
      are suitable techniques for characterising M. catarrhalis and that there is a
      considerable degree of strain heterogeneity. Nosocomial infection with M.
      catarrhalis may be relatively common and further epidemiological studies with a
      combination of typing techniques are indicated.

PMID- 1625320
TI  - Cytotoxicity of Bacillus piliformis.
AB  - Seven isolates of B. piliformis, the agent of Tyzzer's disease, obtained from
      various host species, were examined for cytotoxic activity by incubating culture
      filtrates on BRL 3A rat-hepatocyte and 3T3 mouse-fibroblast cell lines. One
      isolate exhibited cytopathic effects on BRL 3A cells, but not on 3T3 cells. Three
      other isolates were strongly cytotoxic for 3T3 cells but only slightly so for BRL
      3A cells. The remaining three isolates showed no cytotoxicity for either cell
      line. The cytotoxic products were greater than 100 kDa in mol. wt, thermolabile,
      and partly destroyed by trypsin treatment. The data show that some B. piliformis
      isolates produce cytotoxic proteins, which may contribute to the pathogenesis of
      Tyzzer's disease.

PMID- 1625321
TI  - Plasmid profiles of "Campylobacter upsaliensis" isolated from blood cultures and
      stools of paediatric patients.
AB  - Seventy-three clinical isolates of "Campylobacter upsaliensis" were screened for
      the presence of plasmids. Plasmid bands were found in 68 (93%) isolates, from
      which 14 plasmid types were identified. Type 5 was found only in blood-culture
      isolates, whereas types 7-14 were found only in faecal isolates. Plasmid-free
      isolates and the other plasmid profiles were present in both faecal and blood
      isolates. The reproducibility of these profiles was largely dependent on the
      method of plasmid isolation. The chloroform-phenol lysis method was the most
      efficient and reliable method of preparing plasmid DNA for plasmid profile
      analysis. The success of this method may be largely attributable to two factors:
      (1) the efficacy of cell lysis was independent of either an alkaline agent or of
      heat; (2) the inactivation of nucleases by the utilisation of chloroform-phenol
      to lyse the cells. Furthermore, this method of plasmid DNA preparation is ideally
      suited for use on clinical isolates, especially when rapid plasmid profile
      analysis may be required.

PMID- 1625322
TI  - Phospholipid dependence of rat liver microsomal acyl:CoA synthetase and acyl
      CoA:1-acyl-sn-glycero-3-phosphocholine O-acyltransferase.
AB  - Investigations were performed on the influence of the phospholipid composition
      and physicochemical properties of the rat liver microsomal membranes on acyl-CoA
      synthetase and acyl-CoA:1-acyl-sn-glycero-3-phosphocholine O-acyltransferase
      activities. The phospholipid composition of the membranes was modified by
      incubation with different phospholipids in the presence of lipid transfer
      proteins or by partial delipidation with exogenous phospholipase C and subsequent
      enrichment with phospholipids. The results indicated that the incorporation of
      phosphatidylglycerol, phosphatidylserine and phosphatidylethanolamine induced a
      marked activation of acyl-CoA synthetase for both substrates used--palmitic and
      oleic acids. Sphingomyelin occurred as specific inhibitor for this activity
      especially for palmitic acid. Palmitoyl-CoA: and oleoyl-CoA: 1-acyl-sn-glycero-3
      phosphocholine acyltransferase activities were found to depend on the physical
      state of the membrane lipids. The alterations in the membrane physical state were
      estimated using two different fluorescent probes--1,6-diphenyl-1,3,5-hexatriene
      and pyrene. In all cases of membrane fluidization this activity was elevated. On
      the contrary, in more rigid membranes obtained by incorporation of sphingomyelin
      and dipalmitoylphosphatidylcholine, acyltransferase activity was reduced for both
      palmitoyl-CoA and oleoyl-CoA. We suggest a certain similarity in the way of
      regulation of membrane-bound acyltransferase and phospholipase A2 which both
      participate in the deacylation-reacylation cycle.

PMID- 1625323
TI  - Purification and characterization of the apical plasma membrane of the rat
      pancreatic acinar cell.
AB  - A method is described for the rapid purification of the apical plasma membrane
      from the rat pancreatic acinar cell. It makes use of wheat germ agglutinin
      affinity chromatography to selectively bind vesicles with N-acetyl glucosamine
      present at their surface. Particular conditions (150 mM NaCl) had then to be used
      to keep membrane vesicles in the coveted orientation, i.e. as right-side-out
      vesicles. Due to its specific apical location in many epithelial cells, gamma
      glutamyltranspeptidase was chosen to monitor the purification procedure. The
      final fraction was enriched in gamma-glutamyltranspeptidase by a factor of 75
      relative to the homogenate. Na,K-ATPase, a strict basolateral membrane marker,
      was not detectable in the fraction. No membranes originating from other
      compartments, more particularly expected from zymogen granules, or from other
      cell types, did contaminate the preparation. As expected for an epithelial cell
      apical plasmalemma, lipid composition showed a very high ratio of glycolipids
      (37.5%). The absence of membrane-bound GP-2, and the exceptionally high specific
      activity of gamma-glutamyltranspeptidase suggest that the apical membrane would
      not be made up by the exocytosis of secretory granule, but instead by the fusion
      of specialized secretory vesicles very likely originating from the constitutive
      secretory pathway. In conclusion, this report describes a method of obtaining a
      fraction highly enriched in the secretory apex of the pancreatic exocrine cell
      that would be directly involved in exocytosis with zymogen granules and also in
      local anion transport.

PMID- 1625326
TI  - Michigan's black dental heritage.

PMID- 1625324
TI  - Role of Lys 558 and Lys 869 in substrate and inhibitor binding to the murine band
      3 protein: a study of the effects of site-directed mutagenesis of the band 3
      protein expressed in the oocytes of Xenopus laevis.
AB  - The effect of mutation of either Lys 558 or Lys 869 or both on mouse erythroid
      band 3 protein (AE1)-mediated 36Cl- efflux and its inhibition by pyridoxal 5
      phosphate (P5-P), DNDS and H2DIDS were studied. Regardless of the mutation, band
      3 was always capable of executing Cl- self-exchange. P5-P (5 mM, pH 7.6) produced
      irreversible inhibition in the wild type (KK) and in the mutant in which Lys 558
      (NK) or Lys 869 (KM) had been replaced by asparagine (N) or methionine (M),
      respectively. However, when both residues were replaced, mutant (NM),
      irreversible inhibition could no longer be achieved. This shows that P5-P is
      capable of producing inhibition with either one of the lysine residues, 558 or
      869. Inhibition by DNDS changed dramatically upon mutation. The Ki app increased
      from 6.0 microM in the wild type (KK) to 23 microM in the mutant NK, to 73 microM
      in the mutant KM and to 474 microM in the double mutant NM. The Km value for
      activation of the transport system by varying the substrate concentration by
      isosmotic substitution of Cl- with SO4(2-) decreased from 42 mM in the wild type
      (KK) to 11.3 mM in the mutant NM. The results show that both Lys 558 and Lys 869
      are involved in the maintenance of the structure of the overlapping binding sites
      for stilbene disulfonates and the substrate Cl-. In the double mutant NM, H2DIDS
      is no longer able to produce irreversible inhibition at pH 7.6. This is evidently
      related to the replacement of Lys 558 (pK 8.2) by Asn 558 in this mutant (see
      Bartel, D., Lepke, S., Layh-Schmitt, G., Legrum, B., Passow, H., 1989. EMBO J.
      8:3601-3609). However, at pH 9.5, some irreversible inhibition could still be
      observed. This suggests that the other lysine residue (pK 10.8) that is known to
      be involved in covalent binding with the second isothiocyanate group of H2DIDS is
      still present, and hence, not identical to Lys 869, which had been substituted by
      a methionine residue. However, this result remains inconclusive since after
      mutagenesis, the H2DIDS may produce inhibition at a site that is not normally
      involved in H2DIDS binding.

PMID- 1625325
TI  - Block of the sheep cardiac sarcoplasmic reticulum Ca(2+)-release channel by tetra
      alkyl ammonium cations.
AB  - The purified ryanodine receptor channel of the sheep cardiac muscle sarcoplasmic
      reticulum (SR) membrane functions as a calcium-activated cation-selective channel
      under voltage-clamp conditions following reconstitution into planar phospholipid
      bilayers. We have investigated the effects of the tetra-alkyl ammonium (TAA)
      cations, (CnH2n+1)4N+ and the trimethyl ammonium cations, ethyltrimethyl ammonium
      and propyltrimethyl ammonium, on potassium conductance through the receptor
      channel. Small TAA cations (n = 1-3) and the trimethyl ammonium derivatives act
      as asymmetric, voltage-dependent blockers of potassium current. Quantitative
      analysis of the voltage dependence of block indicates that the conduction pathway
      of the sheep cardiac SR ryanodine receptor channel contains two distinct sites
      for the interaction of these small organic cations. Sites are located at
      approximately 50% for tetramethyl ammonium (TMA+) and 90% for tetraethyl ammonium
      (TEA+) and tetrapropyl ammonium (TPrA+) of the voltage drop across the channel
      from the cytosolic face of the protein. The chemical substitution of an ethyl or
      propyl group for one of the methyl groups in TMA+ increases the voltage
      dependence of block to a level similar to that of TEA+ and TPrA+. The zero
      voltage dissociation constant (Kb(0)) falls with the increasing number of methyl
      and methylene groups for those blockers acting 90% of the way across the voltage
      drop. This is interpreted as suggesting a hydrophobic binding site at this point
      in the conduction pathway. The degree of block increases as the concentration of
      small TAA cations is raised. The concentration dependence of tetraethyl ammonium
      block indicates that the cation interacts with a single site within the
      conduction pathway with a Km of 9.8 +/- 1.7 mM (mean +/- SD) at 40 mV. Larger TAA
      cations (n = 4-5) do not induce voltage-dependent block of potassium current of
      the form seen with the smaller TAA cations. These data support the contention
      that the sheep cardiac SR ryanodine receptor channel may be occupied by at most
      one ion at a time and suggest that a large proportion of the voltage drop falls
      over a relatively wide region of the conduction pathway.

PMID- 1625327
TI  - Automated endodontics: current concepts.

PMID- 1625328
TI  - Preventing transmission of hepatitis B.

PMID- 1625329
TI  - Clinically versus laboratory photocured facings.
AB  - Acrylic and composite resin facings may fracture or become detached from the
      metal framework. Insufficient retention, abrasion and trauma are among the causes
      of these phenomena. Clinical and laboratory techniques have been developed to
      fabricate facings by means of light-curing composite systems such as the
      Dentacolor (Kulzer, Inc.) system. The effect of different polishing methods,
      obtained in both techniques using the same material, was studied with SEM on
      samples. Finishing and polishing procedures were accomplished using fine
      finishing diamonds, diamond burs and sof-lex discs. Smooth and lustrous surfaces
      were obtained with finishing discs, in contrast to techniques using other
      finishing instruments. Little or no difference in surface texture was observed
      between samples finished by clinical and those finished by laboratory techniques.

PMID- 1625330
TI  - Internal management of the implant practice.

PMID- 1625331
TI  - What is peri-implantitis and how do we prevent and treat it?

PMID- 1625332
TI  - The technical procedure for the edentulous mandibular overdenture. Simplified
      procedure for fabrication of an implant overdenture.

PMID- 1625333
TI  - The key to compliance: MIOSHA requirements for employee training.

PMID- 1625334
TI  - Guided tissue bone generation.

PMID- 1625335
TI  - X-ray stereomicroscopy: high resolution 3-D imaging of human spermatozoa in
      aqueous suspension with natural contrast.

PMID- 1625336
TI  - An improved cryo-jet freezing method.
AB  - A new cryo-jet freezing apparatus is described that is easy to use and gives good
      results using a propane-butene mixture (3:1). Our use of the freezer in the study
      of mouse spinal cord explant cultures is discussed. At the tissue surface, the
      quality of tissue preservation from freezing, followed by freeze substitution,
      rivals that of conventional electron microscopic methods. Certain intracellular
      structures are better visualized using our methods. There is no evidence of the
      tissue being distorted by the cryogen jet when the freezer is operated correctly.
      A new freeze substitution device is also discussed.

PMID- 1625337
TI  - Coping processes as mediators of the relationship between hardiness and health.
AB  - Hardiness has been hypothesized to moderate the impact of stress on health by
      influencing coping responses, but little attention has been focused upon these
      associations. This study examined the relationship among hardiness, coping, and
      illness while attending to recent criticisms of the hardiness literature
      including the potential overlap with neuroticism, whether hardiness is a unitary
      construct, and the predominant use of male samples. Hardiness was found to be
      positively related to adaptive coping variables and negatively related to
      maladaptive coping variables. Problem-focused, support-seeking, and avoidant
      coping were found to mediate the hardiness-illness relationship. Although these
      hardiness-coping relationships were partially independent of the influence of
      neuroticism, the relationship of both coping and hardiness with self-reported
      illness appeared to result from the common influence of neuroticism. Consistent
      with previous research, the commitment and control components correlated most
      consistently with coping variables, and predicted hardiness effects were most
      consistently demonstrated for males.

PMID- 1625338
TI  - Dimensions of anger-hostility and cardiovascular reactivity in provoked and
      angered men.
AB  - This study investigated the relationship between two dimensions of anger
      hostility--the expression of anger-hostility and the experience of anger
      hostility--and cardiovascular reactivity in provoked and angered men. A serial
      subtraction task was administered to 41 male undergraduates who were provoked and
      angered. A measure of the expression of anger-hostility correlated positively and
      significantly with systolic and diastolic blood pressure (BP) reactivity. There
      were no significant correlations between a measure of the experience of anger
      hostility and cardiovascular reactivity. The two types of anger-hostility were
      also found to relate differentially to life-style variables that have been
      identified as risk factors for coronary heart disease (CHD), with only the
      expression of anger-hostility showing positive relationships with these life
      style CHD risk factors. These findings are discussed within the context of a
      similar differential relationship between the two dimensions of anger-hostility
      and CAD and CHD. Finally, significant negative relationships were obtained
      between the experience of anger-hostility and resting BP and heart rate levels.
      These findings are discussed within the context of other data suggesting that
      trait anxiety-neuroticism may have protective properties.

PMID- 1625339
TI  - Anger and impatience/irritability in patients of low socioeconomic status with
      acute coronary heart disease.
AB  - This case-control study examines the relationship between anger and
      impatience/irritability and acute coronary heart disease (CHD) in middle-aged men
      of low socioeconomic status (SES). Subjects included patients with myocardial
      infarction (MI) (N = 31) or unstable angina (AP) (N = 26), who were compared with
      hospital controls (N = 26). In separate multivariate analyses for each anger
      scale, MI was associated with Anger-Out and Impatience/Irritability, particularly
      in the subgroup of patients who did not have a previous MI. The same factors were
      associated with AP, but only when this acute ischemic event was not preceded by a
      MI. No relationship was found between Trait-Anger and Anger-In and either acute
      ischemic outcome. The results indicate that particularly overt behavioral
      expression of anger is related to CHD in lower SES patients and that there is
      similarity in the behavioral factors associated with acute CHD between low- and
      high-SES men.

PMID- 1625341
TI  - A psychophysiological evaluation of female urethral syndrome: evidence for a
      muscular abnormality.
AB  - This is a preliminary investigation into a recently defined urological disorder
      occurring in a subgroup of women with "urethral syndrome" suggestive of pelvic
      floor muscular (PFM) dysfunction. Symptoms include straining to void, urgency,
      frequency, hesitation, incontinence and/or retention, and subpubic pain. Finding
      neither bladder nor urological abnormalities, urologists may consider these women
      emotionally unstable without organic cause for their symptoms. However, their
      distress may be a consequence rather than a cause of their voiding problems.
      Sixteen female urological patients were matched with 16 asymptomatic controls to
      investigate PFM functioning, psychological status, and symptomatology. Results
      showed heterogeneity of symptomatology and little elevation of depression or
      anxiety when comparing patients with controls. Hypotheses of muscular abnormality
      were confirmed. Patients evidence poor control over testing and relaxing PFM,
      elevations of PFM activity under various conditions, and chronic pain as a
      prominent symptom. Treatment approaches specifically designed to address PFM
      dysfunction are discussed.

PMID- 1625342
TI  - Primary care physicians in Mississippi: implications for rural health care.
AB  - Despite a 24% increase in Mississippi primary care physicians during the 1980s,
      rural areas of the state continue to be underserved with 39 of 82 counties
      classified as health manpower shortage areas for primary medical care. Utilizing
      1980 and 1990 census data and reports from the Mississippi State Department of
      Health, primary care physician manpower was analyzed to determine where growth
      and trends occurred. Most of the primary care physician growth occurred in ten
      populous counties, with family physicians and general practitioners continuing to
      provide most of the care in the lesser populated counties. Public and private
      entities are exploring new and innovative methods of delivering health care to
      rural areas which recognize the changing professional and lifestyle expectations
      of today's physicians. Multispecialty primary care group practices need to be
      promoted and innovative financial arrangements provided. Educational systems need
      to recruit students from rural areas and provide more training experiences in
      rural areas.

PMID- 1625340
TI  - Psychological and physiological predictors of lipids in black males.
AB  - The association between lipids and both psychological and physiological measures
      were examined in this study of healthy black males. The results revealed that
      certain psychological measures, namely, State and Trait Curiosity and Trait
      Anger, explained a significant proportion of the variance in high-density
      lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides. Although
      psychological factors accounted for a significant proportion of the variance in
      lipids (29% for HDL, 25% for LDL, 64% for LDL/HDL, 29% for triglyceride), the
      amount of explained variance was significantly increased by the inclusion of both
      psychological and physiological variables in the regression equation. However,
      neither of the psychological variables explained any of the variance for total
      cholesterol when physiological variables were included in the regression
      analysis. The overall pattern of the findings suggests that black males who are
      at increased risk for elevated lipid levels may be identified by their level of
      mental vigilance, the frequency at which their anger is experienced, and the
      presence of other traditional risk factors.

PMID- 1625343
TI  - Graduate follow-up in the University of Mississippi family practice residency
      program.
AB  - Practice profiles in 120 University Medical Center Department of Family Medicine
      residency graduates were assessed by questionnaire and follow-up telephone calls.
      Physician credentials, career satisfaction, and evaluation of residency training
      were also addressed. Findings include some preferences for partnership or group
      practice settings and practices in communities of less than 25,000. Eighty
      percent of graduates remain in Mississippi, and most are satisfied with their
      careers and the residency training they received. Changing patterns in areas such
      as obstetrical care provided and Medicare/Medicaid acceptance suggest new surveys
      may be needed to provide the department with information that will assist in
      meeting its goals.

PMID- 1625344
TI  - Report of the AMA Council on Ethical and Judicial Affairs: reporting impaired,
      incompetent, or unethical colleagues.

PMID- 1625345
TI  - Feeling like a 'real doctor' again.

PMID- 1625346
TI  - Bioluminescent measurement in single cardiomyocytes of sudden cytosolic ATP
      depletion coincident with rigor.
AB  - The sequence of events that leads to irreversible injury of the ischaemic
      myocardium is poorly understood but it is axiomatic that lack of oxygen will
      impair regeneration of ATP. In the globally-ischaemic heart a contracture
      develops which is independent of raised cytoplasmic free Ca2+ and which has been
      attributed to activation of actomyosin by nucleotide-free actomyosin cross
      bridges ('rigor complexes') which form at low ATP concentrations. Single,
      metabolically-poisoned or anoxic cardiomyocytes show comparable behaviour,
      shortening before a significant rise in cytoplasmic free Ca2+ occurs. To explain
      the close temporal relationship that exists between cell shortening and the onset
      of the free Ca2+ rise we have predicted that, during myocyte shortening, a
      precipitous fall in cytosolic ATP concentration occurs, the result of rigor
      complexes activating myosin ATPase, which then perturbs ionic homeostasis. Here
      we show, by means of continuous measurements of cytosolic ATP using firefly
      luciferase microinjected into single, isolated cardiomyocytes, that cell
      shortening coincides with an abrupt fall in cytosolic ATP.

PMID- 1625347
TI  - Prolonged propionyl-L-carnitine pre-treatment of rabbit: biochemical, hemodynamic
      and electrophysiological effects on myocardium.
AB  - Recently it has been reported that prolonged treatment with propionyl-L
      carnitine, a carnitine derivative, results in a positive inotropic effect. To
      gain further insight into its mode of action, we pre-treated 253 rabbits for up
      to 10 days with daily doses of 1 mmol/kg propionyl-L-carnitine or L-carnitine
      intraperitoneally, using saline-treated animals as control. Twenty-four hours
      after the last injection, we isolated papillary muscles for electrophysiological
      investigations. Whole hearts were used in perfusion experiments for biochemical
      and hemodynamic measurements. In addition, mitochondria were harvested from these
      hearts for the analysis of their function. Plasma and cardiac levels of free
      carnitine, along with plasma short-chain acylcarnitines, increased at least two
      fold after treatment with carnitine or its propionyl-ester, with concomitant
      rises in tissue long-chain acylcarnitine and long-chain acyl-CoA. At the time of
      animal sacrifice, treatment did not increase plasma or tissue propionyl-L
      carnitine content. The studies carried out with perfused hearts and isolated
      mitochondria failed to show an effect of propionyl-L-carnitine pre-treatment on
      high-energy phosphate metabolism or respiration. Papillary muscles from animals,
      treated for 10 days, showed a lengthening of the action potential duration from
      63 +/- 4 to 102 +/- 6 ms (P less than 0.001) at -10 mV. Perfused hearts from
      these rabbits displayed positive inotropy, as indicated by an improved pressure
      development at higher ventricular filling volumes, e.g., from 39 +/- 4 to 60 +/-
      3 mmHg (P less than 0.05) at 3.6 ml. Pre-treatment with L-carnitine or saline
      failed to affect the electrophysiological and hemodynamic variables. Thus,
      prolonged treatment of rabbits with propionyl-L-carnitine, but not with L
      carnitine, improved contractility and lengthened action potential duration in
      isolated muscle preparations.

PMID- 1625348
TI  - Evidence for malonyl-CoA-sensitive carnitine acyl-CoA transferase activity in
      sarcoplasmic reticulum of canine heart.
AB  - The formation of palmitoylcarnitine is catalyzed by carnitine palmitoyl
      transferase (CPT-I) and this catalysis is the first committed step in beta
      oxidation. The malonyl-CoA-inhibited isoform appears to be distinct from latent
      (CPT-II) activity, which is localized to the matrix side of the mitochondrial
      inner membrane. Sarcoplasmic reticulum from canine cardiac muscle was
      fractionated on a discontinuous sucrose density gradient into three major bands,
      all of which contained Ca(2+)-ATPase activity. Only the fraction that banded at a
      concentration of 38% surcrose was slightly contaminated by mitochondria.
      Peroxisomal uricase was low or absent in fractionated SR. All sarcoplasmic
      reticulum fractions contained malonyl-CoA-sensitive medium- (COT) and long-chain
      (CPT) carnitine acyltransferase activities. CPT activity decreased in
      sarcoplasmic reticulum when Triton X-100 was present. Carnitine acyltransferase
      activities were inactivated by preincubating the sarcoplasmic reticulum with the
      sulfhydryl reagent, 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB). In contrast,
      mitochondrial CPT-II activity was stable in the presence of DTNB and activated by
      Triton X-100. Western blots of mitochondria and sarcoplasmic reticulum fractions
      showed that the mitochondrial fractions reacted with antibody to mitochondrial
      CPT-II but not with SR protein when both were added at comparable specific
      activities. The data suggest that cardiac SR contains a unique malonyl-CoA
      sensitive isoform of CPT, and that synthesis of acylcarnitine may occur in the
      microenvironment of Ca2+ transport, where the extent of production of
      acylcarnitine is controlled by cardiac acetyl-CoA carboxylase activity.

PMID- 1625349
TI  - Increase in myofilament separation in the "stunned" myocardium.
AB  - This study explores the effects of ischemic reperfusion injury on the radial
      separation distance between thick and thin myofilaments. The left anterior
      descending coronary artery was occluded for 5 mins and reperfused for 10 mins
      twelve times repetitively in 6 dogs. At the end of a final 90 min reperfusion
      period, the hearts were fixed by perfusion with glutaraldehyde, and subepicardial
      and subendocardial tissue from both normal and ischemic areas were prepared for
      transmission electron microscopy. Quantitative analysis of inter-filament
      distance (IFD) was performed on micrographs of transverse sections. The center-to
      center IFD was calculated from the numerical density of thick filaments at the A
      band level using a hexagonal array conversion formula. Sarcomere length was
      measured on micrographs of longitudinal sections. The results showed that center
      to-center thick IFD in the stunned subendocardium was 43.9 +/- 0.8 nm which was
      significantly greater than the control distance of 40.6 +/- 0.4 nm (P less than
      0.001) from normal zone tissue. Thick IFD in the subepicardium was also
      significantly different: 43.4 +/- 0.6 nm in the stunned tissue as compared with
      39.0 +/- 0.7 nm in the non-ischemic tissue (P less than 0.001). Sarcomere length
      in the normally perfused subendocardium was 2.01 +/- 0.07 micron and was
      increased to 2.20 +/- 0.08 micron in the stunned subendocardium (P less than
      0.005). Sarcomere length in the normal and the stunned subepicardium was also
      different: 2.02 +/- 0.04 vs. 2.10 +/- 0.09 micron (P less than 0.005). The
      significant increase in spatial separation between the contractile filaments may
      affect optimal cross-bridge force generation at the molecular level.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1625350
TI  - Myocardial adenosine formation during hypoxia: effects of ecto-5'-nucleotidase
      inhibition.
AB  - Release of adenosine and AMP into epicardial fluid and coronary venous effluent
      of isovolumic guinea-pig hearts was examined during normoxic (95% O2) and hypoxic
      (30% O2) perfusion with and without the ecto-5'-nucleotidase inhibitor alpha,beta
      methylene adenosine diphosphate (AOPCP)*. Normoxic epicardial and venous
      adenosine levels were 221 +/- 27 and 67 +/- 11 nM, respectively, in untreated
      hearts. During 15 min of hypoxia, epicardial and venous adenosine levels
      increased in a phasic manner, reaching maximal values of 498 +/- 32 and 441 +/-
      43 nM, respectively, during the initial 5 min of hypoxia. Epicardial and venous
      adenosine levels then declined slightly during the subsequent 10 min to 332 +/-
      33 and 224 +/- 34 nM, respectively. Infusion of 50 microM AOPCP significantly
      reduced venous adenosine levels during normoxia (less than 50% of control), but
      was without effect on normoxic epicardial adenosine. Epicardial and venous
      adenosine levels increased during hypoxia with AOPCP but the increases were lower
      than those for untreated hypoxic hearts. Epicardial and venous adenosine levels
      recovered to baseline levels following 30 min of reoxygenation in both groups.
      Epicardial and venous AMP levels were elevated by AOPCP treatment during normoxia
      and hypoxia. Coronary vascular resistance decreased during hypoxia but the
      decline in resistance was less in AOPCP treated hearts. It is concluded that
      whereas basal interstitial adenosine levels appear to be independent of ecto-5'
      nucleotidase activity, the hypoxic increase in interstitial adenosine is
      partially derived from an AOPCP sensitive ecto-5'-nucleotidase. Venous adenosine
      appears to be significantly dependent on ecto-5'-nucleotidase activity during
      normoxia and hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625351
TI  - The effects of aspartate and 2-oxoglutarate upon glycolytic energy metabolites
      and mechanical recovery following global ischaemia in isolated rat hearts.
AB  - The hypothesis that aspartate and 2-oxoglutarate might help to relieve the
      inhibition of glycolysis during global myocardial ischaemia and improve post
      ischaemic mechanical recovery was tested in isolated rat hearts. The hearts were
      attached to a lumped parameter model of the rat vascular impedance and initially
      perfused in the working mode with buffered Krebs-Henseleit solution containing
      10.1 mmol/l glucose, with or without 3.3 mmol/l of aspartate and 3.3 mmol/l of 2
      oxoglutarate, prior to imposing global ischaemia for 5, 10 or 15 mins. The
      addition of aspartate and 2-oxoglutarate improved the preservation of tissue CP
      after 5 mins of ischaemia and of ATP after 10 mins of ischaemia. The total
      adenine nucleotide pool was higher in the supplemented hearts after all three
      periods of ischaemia. Dihydroxyacetone phosphate, alanine, succinate and lactate
      accumulated during ischaemia, but the dihydroxyacetone phosphate accumulation was
      reduced while the alanine and succinate concentrations were increased by the
      addition of aspartate and 2-oxoglutarate to the perfusate. These observations
      lend support to the hypothesis that ischaemia arrests glycolysis at the
      glyceraldehyde phosphate dehydrogenase step due to a lack of oxidised
      nicotinamide adenine dinucleotide. Increasing the substrate concentrations of
      aspartate and 2-oxoglutarate may permit glycolysis to proceed for longer into the
      period of ischaemia by stimulating an additional pathway for nicotinamide adenine
      dinucleotide reoxidation. Small improvements in mechanical recovery were
      associated with the metabolic changes.

PMID- 1625352
TI  - Heterogeneous distribution of fatty acid-binding protein in the hearts of Wistar
      Kyoto and spontaneously hypertensive rats.
AB  - In the present study we investigated the concentrations of cardiac cytoplasmic
      fatty acid-binding protein (H-FABPc) in various regions of the left and right
      ventricles of both Wistar Kyoto rats (WKY) and spontaneously hypertensive rats
      (SHR). To this end, the ventricles of six WKY and six SHR hearts were cut in
      three slices, which were further dissected in one right ventricular piece and ten
      left ventricular pieces (five inner layer and five outer layer pieces). After
      homogenisation. H-FABPc was assessed using an Enzyme Linked Immuno Sorbent Assay
      (ELISA) of the sandwich type. It was found that, when expressed per gram wet
      tissue, the overall concentration of H-FABPc tended to be lower in SHR than in
      WKY hearts (874 +/- 53 micrograms/g and 955 +/- 51 micrograms/g, respectively;
      0.1 less than P less than 0.2, means +/- S.E.M. for n = 6 animals in each group).
      However, due to a 30-35% higher ventricular heart mass in SHR than in WKY, the
      total H-FABPc content per heart turned out to be about 20% higher in SHR than in
      WKY rats. No concentration differences could be detected between right and left
      ventricles in WKY and SHR but a marked difference between the outer layer and the
      inner layer of the left ventricular wall was monitored in both groups. In
      general, the concentration in the outer layer was 5-15% higher than in the
      corresponding inner layer. These differences reached the level of significance (P
      less than 0.05) in regions close to the basis of the heart.

PMID- 1625353
TI  - Why do ischemic and hypoxic myocardium lose potassium?

PMID- 1625354
TI  - Response of the cardiovascular system to stress. Annual meeting of the
      International Society for Heart Research (American Section). Burlington, Vermont,
      17-20 June 1992. Abstracts.

PMID- 1625355
TI  - Congestive heart failure in the elderly--echocardiographic insights.
AB  - One hundred and seventy-two patients (110 were greater than or equal to 65 years
      and 62 were less than 65 years) with congestive heart failure (CHF) were
      prospectively evaluated to determine various pathophysiologic mechanisms of CHF.
      The incidence of CHF with normal left ventricular (LV) systolic function was
      higher in elderly (30% vs 12%, p less than 0.05). Of the 110 elderly patients, LV
      systolic function was impaired in 77. Fifty-five patients had LV dilatation
      without increased wall thickness, and the clinical diagnosis was "dilated
      cardiomyopathy in the elderly". Twenty-two patients had hypertrophied LV and a
      high incidence of hypertension, and they were diagnosed as "hypertensive heart
      failure" due to contractile dysfunction. On the contrary, the remaining 33
      patients did not have impaired LV contractile function. Thirteen patients lacking
      LV hypertrophy had enlarged atria. CHF was induced by reduced chamber compliance
      called "the stiff heart syndrome". Twenty patients had hypertrophied LV and a
      high incidence of hypertension. They were diagnosed as having "hypertensive
      hypertrophic cardiomyopathy of the elderly" and abnormalities of diastolic
      function accounted for the CHF. Since echocardiography can easily and accurately
      diagnose the pathophysiologic mechanism of CHF, an increased awareness of its
      occurrence in the elderly and use of echocardiography would reduce diagnostic and
      therapeutic errors.

PMID- 1625356
TI  - Intermediate-term results of balloon valvuloplasty for isolated and complicated
      pulmonary valve stenosis.
AB  - The purpose of this study is to report our experience regarding the acute and
      intermediate-term results of balloon pulmonary valvuloplasty (BPV) in various
      types of congenital pulmonary valve stenosis. METHODS AND RESULTS: Twenty-four
      consecutive patients with a median age of 6.6 years (ranging from 1 month to 24
      years old) underwent BPV between January 1988 and September 1991. These patients
      were divided into 2 groups; Group 1 consisting of 13 patients with isolated
      pulmonary valve stenosis, and Group 2 consisting of 11 patients with complicated
      pulmonary valve stenosis (supravalvular, subvalvular, valved conduit and post
      right ventricular outflow reconstruction). Mean peak systolic pressure gradients
      from the right ventricle to the pulmonary artery were as follows: In group 1, 48
      +/- 21 (mean +/- SD) mmHg before BPV, 18 +/- 8 mmHg immediately after BPV and 13
      +/- 5 mmHg at the longest follow-up based on catheterization or Doppler
      echocardiographic studies. The gradients in group 2 were 65 +/- 28 mmHg before
      BPV, 46 +/- 25 mmHg immediately after BPV and 47 +/- 21 mmHg at the longest
      follow-up. CONCLUSIONS: BPV provides both acute and intermediate-term gradient
      relief in patients with isolated pulmonary valve stenosis. In complicated
      pulmonary valve stenosis, on the other hand, the effect of BPV was unsatisfactory
      and appears to depend on the mechanism of associated obstruction. Therefore
      accurate evaluation of the anatomy of associated obstruction in the pulmonary
      valve region is needed to determine that BPV is indicated.

PMID- 1625357
TI  - Pulmonary arterial flow-pressure characteristics in dogs--effects of hypoxia and
      nitroglycerin.
AB  - To investigate the effects of hypoxia and nitroglycerin on pulmonary vascular
      tone, multipoint mean pulmonary arterial flow-pressure (Q-P relationship) plots
      were constructed by producing stepwise increments of pulmonary flow with a roller
      pump installed in a right ventricle-pulmonary artery shunt in 12 mongrel dogs
      under pentobarbital sodium anesthesia. The normal Q-P relationship was convex to
      the pressure axis when pulmonary flow was 0-0.2 L/min, but it became linear when
      pulmonary flow was over 0.2 L/min. The slopes and pressure intercepts
      extrapolated (RAPI) from linear regression fits to the linear parts of the Q-P
      relationship were determined to compare the effects of hypoxia and nitroglycerin
      on pulmonary vascular tone. Hypoxic ventilation (FIO2: 0.1) increased the slope
      from 8.3 +/- 3.3 to 12.5 +/- 3.6 mmHg/L (p less than 0.01), with no significant
      effect on PAPI. Nitroglycerin (1 microgram/min/kg as a continuous infusion)
      decreased the slope from 8.9 +/- 4.4 to 5.8 +/- 2.6 mmHg/L (p less than 0.05),
      again with no significant effect on PAPI. The results suggest that hypoxia and
      nitroglycerin, respectively, increased and decreased incremental pulmonary
      vascular resistance upstream to the site of pulmonary vascular closure.

PMID- 1625358
TI  - Torsades de pointes in patients with electrical alternans of T-U wave without
      change in QRS complex.

PMID- 1625359
TI  - 55th Annual Scientific Session of the Japanese Circulation Society. Kyoto, March
      31, 1991.

PMID- 1625360
TI  - Evaluation of arterial wall histological and physical characteristics using
      intravascular echography.
AB  - Using a high-frequency ultrasound intravascular imaging system we evaluated the
      intravascular echo image by comparing it with histological findings in 57
      arterial segments of 17 autopsy cases. Moreover, in 8 dogs we estimated the
      arterial elastic property by observing the change of the arterial section
      accompanying a reduction of arterial pressure due to hemorrhage (H) or nifedipine
      infusion (N). The characteristics of the intravascular echograms were as follows:
      1) In a normal artery the arterial wall consisted of the inner high echoic, the
      medial low echoic and the outer high echoic layers. 2) In an aged artery the
      fibrous thickened intima was seen as the low echo layer giving an echo about the
      same as that of the normal media, and the intensity of the echo from the
      degenerated media was lower than that of the normal media. 3) In atheroma the
      echo intensity of the elastic fiber-rich region was higher than that of the
      surrounding region, while the calcified region showed as a brighter echo with
      outer echo free space due to shadowing. We measured the arterial radius, area and
      circumferential length on the intravascular echo image and calculated the
      arterial wall tension-circumferential length and the pressure-arterial area
      relationships. By analysing each relation, we obtained the stiffness and
      compliance parameters, respectively. The stiffness parameter with N was lower
      than that with H [(1.5 +/- 0.5) x 10(-2) vs (2.8 +/- 0.9) x 10(-2)] and the
      compliance parameter with N was higher than that with H (0.92 +/- 0.28 vs. 0.46
      +/- 0.12).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625361
TI  - Intravascular ultrasound imaging--in vitro and vivo validation.
AB  - Intravascular ultrasound imaging is a new technique for visualizing arterial
      structures. The purpose of this study was twofold; first, to assess the ability
      of this intravascular ultrasound catheter to generate cross-sectional images of
      human artery segments in vitro and second, to determine the reliability of
      intravascular ultrasound technique in the evaluation of human arteries in vivo.
      For the vitro study, ultrasound images of the arteries were presented as a two
      dimensional, 360 degrees display of vessel cross-section perpendicular to the
      long-axis of the probe. The ultrasound scanning provided an accurate description
      with high resolution of lumen structure and lumen-intima interface in all vessel
      specimens. There was a good correlation between the planimetric luminal area on
      the ultrasound images and the area obtained from histologic images (r = 0.92).
      There was also a good correlation in the plaque thickness between ultrasound and
      histological examination (r = 0.88). In the in vivo study, the ultrasound
      catheter was easily introduced, readily manipulated, and images were successfully
      obtained in all patients. No untoward effects were noted during manipulation of
      the catheter. There was a good correlation in the arterial dimension between
      ultrasound and angiographic measurements (r = 0.93). Thus, intravascular
      ultrasound imaging appears to be useful for characterizing and quantitating
      arterial lesions.

PMID- 1625362
TI  - Intravascular ultrasound imaging in human peripheral and coronary arteries in
      vivo.
AB  - To determine the feasibility of intravascular ultrasound imaging in vivo, a
      miniaturized high frequency transducer catheter was introduced into human
      peripheral (n = 10) and coronary (n = 4) arteries. Cross-sectional ultrasound
      images were obtained from iliofemoral arteries in 10 patients using a 20 MHz
      transducer catheter (1.2 mm in diameter) and from coronary arteries in 4 patients
      using a 30 MHz transducer catheter 5 French size (Fr) following successful
      coronary angioplasty. Ultrasound images obtained from peripheral arteries showed
      a three-layered appearance (echo-reflective intima, echo-lucent media and echo
      reflective adventitia) in the normal arteries. In diseased arteries, the
      location, amount and extent of atheromatous plaque were clearly documented. The
      arterial diameters measured by ultrasound closely correlated with the
      measurements by angiography (r = 0.91) in the peripheral arteries. Coronary
      angiograms obtained following balloon angioplasty revealed smooth edges at the
      dilatation sites without significant narrowing in all patients. However, a
      significant amount of residual atheromatous plaque was clearly observed on the
      ultrasound images at the previously dilated sites. Coronary dissection, which was
      identified as an echo-lucent area behind the plaque, was noted in 2 patients.
      Ultrasound images also revealed the presence of calcium in the plaque which was
      unrecognized on the angiograms in 3 patients. In addition, direct measurement of
      the lumen cross-sectional area was possible on the ultrasound images.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1625363
TI  - The effectiveness of coronary angioscopy in detecting intraluminal pathologic
      changes.
AB  - We have evaluated the feasibility of percutaneous transluminal coronary
      angioscopy for detecting intraluminal pathological changes as a diagnostic tool,
      and investigated the pathogenesis of two acute coronary disorders, acute
      myocardial infarction and unstable angina. Twelve patients with an acute coronary
      disorder and 20 patients who underwent percutaneous transluminal coronary
      angioplasty were selected for this comparison between the diagnostic accuracy of
      angioscopy and arteriography. One hundred and thirty patients were investigated
      by angioscopy as follows in order to investigate the pathogenesis of their acute
      coronary disorders: 22 within 8 h of onset acute myocardial infarction; 28 from
      one day to 2 months since onset recent myocardial infarction; 37 with an old
      myocardial infarction; 26 with unstable angina; and 23 with stable angina. Our
      results have indicated thrombi were detected more frequently by angioscopy than
      by arteriography (p less than 0.01). Also, thrombi, intimal irregularities, and
      xanthomatous atheromas were observed more frequently in patients with acute
      myocardial infarction, recent myocardial infarction, and unstable angina. It is
      concluded that coronary angioscopy is a much more sensitive method for detecting
      intraluminal changes, and that a thrombus overlying a rupture in the lining of
      plaque plays a major role in an acute coronary disorders, and that the fragile,
      lipid-rich gruel atheroma may precede its rupture.

PMID- 1625364
TI  - Advances in transesophageal echocardiography for the evaluation of
      atherosclerotic lesions in thoracic aorta--the effects of hypertension,
      hypercholesterolemia, and aging on atherosclerotic lesions.
AB  - We assessed atherosclerotic lesions in the thoracic aorta in 166 consecutive
      patients (aged 56 +/- 13 years) by transesophageal echocardiography, and
      investigated the influences of hypertension, hypercholesterolemia and age on the
      prevalence of such lesions. Satisfactory images were obtained of all the thoracic
      aorta, except for a small part of the ascending aorta, by use of a biplane
      transesophageal probe. We defined atherosclerotic lesions as increased
      echogenicity of the intima (intimal thickening), raised plaque, calcification,
      ulceration, or aneurysms. Lesions were observed in 97 patients (58%). The
      incidence of lesions in patients with hypertension (81%) or hypercholesterolemia
      (80%) was significantly greater than in those without both conditions (37%, p
      less than 0.005). The incidence of lesions was significantly increased among
      patients over 60 years old compared with that in patients under 60 (76% vs 42%, p
      less than 0.005). Patients without either hypertension or hypercholesterolemia
      showed a marked increase in the incidence of lesions with age (16% at less than
      60 yrs vs. 67% at greater than 60 yrs), and no significant influence of these
      conditions on the incidence of lesions was found in patients over 60. We conclude
      that hypertension and hypercholesterolemia might be important risk factors for
      the development of atherosclerotic lesions in the thoracic aorta in relatively
      younger patients. Age appears to become a more important determinant of such
      lesions in Japanese patients over 60 years old irrespective of blood pressure and
      serum cholesterol levels.

PMID- 1625365
TI  - Assessment of myocardial viability by using newly developed myocardial SPECT
      imaging.
AB  - Thallium myocardial imaging has been widely available for the detection of
      myocardial ischemia and assessment of myocardial viability in coronary artery
      diseases. However, myocardial imaging using SPECT and gamma-emitting
      radiopharmaceuticals has been developed for accurate evaluation of myocardial
      infarction and ischemia. The present study was undertaken to clinically evaluate
      myocardial necrosis, metabolism and sympathetic nerve activity. In this study,
      myocardial fatty acid metabolism was assessed using 123I-BMIPP, myocardial
      sympathetic neural activity was assessed using 123I-MIBG and myocardial necrosis
      was assessed using 111-In-antimyosin Fab. Dual energy SPECT using these new
      agents and thallium gives precise characterization of myocardial viability in
      coronary artery disease.

PMID- 1625366
TI  - Positron emission tomography--usefulness in assessing myocardial viability.
AB  - Positron emission tomography (PET) using N-13 ammonia and F-18 fluorodeoxyglucose
      (FDG) has been used to evaluate myocardial viability in comparison with thallium
      201 single photon emission computed tomography (SPECT), and left ventricular wall
      motion in comparison with contrast ventriculography. Forty patients with anterior
      myocardial infarction underwent stress and delayed resting perfusion imaging
      using Tl-201 SPECT and ammonia PET, a glucose metabolism study using FDG PET, and
      wall motion assessment with left ventriculography. Out of a total of 600 segments
      of left ventricular imaging, SPECT demonstrated 197 fixed perfusion defects, 99
      with redistribution on delayed imaging and 304 normal segments. Of 197 segments
      with fixed defects, 24 (12%) were normal and 71 (36%) ischemic according to PET
      criteria. Nineteen of 28 with infarction and all of 12 with non-Q wave infarction
      showed a viable myocardium. Left ventricular wall motion was significantly better
      in patients with normal PET findings compared with those with ischemia or scar on
      PET. Post-PTCA PET revealed improved ammonia PET in 6 of 11 patients but reduced
      FDG uptake was noted only in 3. These data suggests that Tl-201 SPECT
      significantly underestimates myocardial viability and that PET imaging is a
      promising tool for assessing the presence of salvaged myocardium.

PMID- 1625367
TI  - In vivo 31P nuclear magnetic resonance spectroscopy in patients with old
      myocardial infarction.
AB  - To assess the usefulness of in vivo 31P nuclear magnetic resonance (NMR)
      spectroscopy, we investigated spectra from the myocardium in 6 patients with old
      Q-wave infarction (QMI), 6 with old non-Q-wave infarction (NQMI) and 9 controls
      by ECG-gated depth-resolved surface-coil spectroscopy. External
      hexamethylphosphoric triamide (HMPT) was used to quantify the signal intensities.
      Left ventricular weight in the region of interest (LVW) was estimated from 1H
      magnetic resonance images. The extent score by 201Tl scintigraphy was determined
      in 3 QMI and 4 NQMI patients. No significant differences were found among the 3
      groups in peak area ratios of 31P NMR spectra to phosphocreatine (PCr) or
      adenosine triphosphate (ATP). Compared with controls, significant reductions were
      observed in values for the peak areas of PCr normalized by the standard HMPT
      (PCr/HMPT) or by both HMPT and LVW (PCr/HMPT/LVW) for QMI patients (p less than
      0.05), and in ATP/HMPT and ATP/HMPT/LVW for QMI and NQMI patients (p less than
      0.01). There was a significant negative correlation between ATP/HMPT and the
      201Tl scintigraphy extent score (p less than 0.05). These findings suggest that
      in vivo 31P NMR spectroscopy can detect high-energy phosphate reduction in the
      infarcted myocardium and may be useful in evaluating myocardial viability.

PMID- 1625368
TI  - High-energy phosphate metabolism of the myocardium in normal subjects and
      patients with various cardiomyopathies--the study using ECG gated MR spectroscopy
      with a localization technique.
AB  - Nuclear magnetic resonance spectroscopy (MRS) is a new technique for the
      evaluation of myocardial metabolism. Recently, localized MRS has been clinically
      available to measure by a non-invasive method the relative concentrations of the
      high-energy phosphate metabolites in the myocardium. We performed ECG gated P-31
      MRS using ISIS (image-selected in vivo spectroscopy) in 15 normal volunteers, 12
      patients with hypertrophic cardiomyopathy, 12 with left ventricular hypertrophy,
      6 with dilated cardiomyopathy and 11 with specific heart muscle disease.
      Myocardial peak height ratios of PCr/gamma-ATP, Pi/gamma-ATP and PCr/Pi were
      measured. Myocardial P-31 MRS demonstrated a significant decrease in the ratio
      PCr/ATP in patients with hypertrophic cardiomyopathy and specific heart muscle
      disease as compared with normal subjects, indicating myocardial metabolic
      disturbance in these patients. The ratio of PCr/ATP in patients with dilated
      cardiomyopathy did not differ significantly from that of normal subjects.
      However, exercise MRS revealed a marked decrease of PCr peak in an asymptomatic
      patient with dilated cardiomyopathy, which may indicate a latent metabolic
      disturbance in the myocardium of dilated cardiomyopathy.

PMID- 1625369
TI  - Evaluation of myocardium in ischemic heart disease by ultrafast computed
      tomography.
AB  - In this study we evaluated quantitatively the contrast enhancement of the
      myocardium of 27 patients with infarction and ischemia by ultrafast CT (Imatron C
      100) with a scan time of 100 msec. We defined three parameters from the CT
      numbers of the myocardium and the ventricle in both the early and the late phase
      (about 4 min) after the injection of non-ionic contrast material; the difference
      of the CT numbers of myocardium between the early and the late phase (delta CT#),
      and the ratios of the CT numbers of the myocardium and the ventricular lumen
      (M/L) in both the early phase and the late phase. The delta CT# for myocardial
      infarction and severe ischemia were -20 +/- 10HU and -8 +/- 10HU, respectively.
      These values were significantly lower than the mild ischemic myocardium and
      normal myocardium (p less than 0.001). The average M/L values for myocardial
      infarction and ischemia in the early phase were 19 +/- 8% and 16 +/- 6%,
      respectively. These values were significantly lower than those in normal
      myocardium (p less than 0.001). The average M/L values for infarction and severe
      ischemia in the late phase were 90 +/- 18% and 63 +/- 20%, respectively. These
      M/L were significantly dissociated (p less than 0.001). Our results indicate that
      with contrast UFCT it is feasible to detect quantitatively the myocardial
      characteristics of ischemia and infarction.

PMID- 1625370
TI  - Evaluation of cardiac motion and function by cine magnetic resonance imaging.
AB  - Cardiac cine magnetic resonance imaging (MRI) was studied to evaluated the
      cardiac motion and function, and a water-stream phantom study was performed to
      clarify whether it was possible to quantitatively assess the valvular
      regurgitation flow by the size of the flow void. In normal subjects, the left
      ventricular (LV) epicardial apex swung up to the base only a few millimeters, and
      the mitral annulus ring moved about 14 mm as mean value toward the apex during
      systole. Those motions of mitral annulus ring may contribute to the left atrial
      filling. The LV longitudinal shortening and torsions were shown by the tagging
      method. This tagging method was the best method for estimating cardiac motions.
      Cardiac cine MRI using software including a modified Simpson's method program and
      a wall motion analysis program was useful for routine LV volumetry and wall
      motion analysis because it was a simple and reliable method. Our water-stream
      phantom studies demonstrated that it might be difficult to perform quantitative
      evaluation of valvular regurgitation flow by using only the size of the flow void
      without acquiring information relating to the orifice area.

PMID- 1625371
TI  - Correlation of alpha activity between the frontal and occipital cortex.
AB  - A method of modified coherence analysis was applied to the interpretation of EEG
      differences between the frontal and occipital cortex. This paper discusses a
      bidirectional communication model for the frontal and occipital cortex. Directed
      coherence method was used to analyze alpha activities over the scalp. The results
      show that both in the left and right hemisphere, slow waves in the alpha
      frequency band had high correlation in the frontal-occipital direction, and fast
      waves had high correlation in the occipital-frontal direction. It may suggest
      that the structure of information transmission is different for fast and slow
      waves of alpha rhythm.

PMID- 1625372
TI  - Characteristics of TNF alpha- and TNF beta-induced fever in the rabbit.
AB  - Febrile responses of rabbits to recombinant human tumor necrosis factors alpha
      (TNF alpha) and beta (TNF beta) were compared. Intravenous (0.1-30 micrograms/kg,
      I.V.) and intracerebroventricular (0.01-2.5 micrograms/kg, I.C.V.) injection of
      TNF alpha and TNF beta both caused monophasic and biphasic fevers depending on
      the dose. The magnitude of fever induced by I.V. and I.C.V. injection of TNF beta
      was significantly greater than that induced by TNF alpha. Moreover, the second
      peak of TNF beta-induced biphasic fever was attained more quickly than that of
      TNF alpha-induced fever. Indomethacin given subcutaneously inhibited the fevers
      produced by I.V. and I.C.V. injection of TNF alpha and TNF beta. Fever induced
      either by intravenously injected TNF beta or by intracerebroventricularly
      injected TNF beta was significantly inhibited by I.C.V. pre-injection of
      indomethacin. On the other hand, indomethacin given intracerebroventricularly did
      not affect the fever induced by I.V. injection of TNF alpha or that induced by
      I.C.V. injection of TNF alpha. These results suggest that TNF alpha and TNF beta
      act on the brain sites responsible for the activation of prostaglandin synthesis
      in somewhat different ways.

PMID- 1625373
TI  - Effects of increased ureteropelvic pressure on fluid and NaCl absorption across
      the jejunum.
AB  - The aim of the present study was to elucidate the effects of an increased
      ureteropelvic pressure (UPP) on the net jejunal fluid, Na+, and Cl- absorption in
      anesthetized dogs. UPP was changed under hydrostatic pressure with warmed
      Ringer's solution. At a UPP of 0 mmHg, the net jejunal fluid, Na+, and Cl-
      absorption were 10.1 +/- 0.5 ml, 2.4 +/- 0.1, and 2.0 +/- 0.1 mEq, and were
      significantly reduced to 5.9 +/- 0.4 ml, 2.0 +/- 0.1, and 1.6 +/- 0.1 mEq,
      respectively, by an increase in UPP to 60 mmHg. After lowering the UPP to 0 mmHg,
      the net absorption recovered to the control values. The same experiments were
      performed after ipsilateral renal denervation. Ipsilateral renal denervation
      completely abolished this response. This result suggests that the afferent
      pathway of this response is the renal nerves. We also assessed the validity of
      the method using a jejunal loop by examining the effects of repetition of the
      absorption experiment on the net absorption. The net absorption was not altered
      by 6 times repetition of the absorption experiment. To determine the collection
      ratio, phenol red was used in the first and sixth absorption experiments. The
      collection ratios were 92.2 +/- 1.1 and 90.3 +/- 0.9%, respectively. There was no
      significant difference in collection ratio between the first and sixth values.
      This is the first report in which an increased UPP was found to inhibit the net
      jejunal fluid, Na+, and Cl- absorption.

PMID- 1625374
TI  - Decreases in catecholamine concentrations of cisternal cerebrospinal fluid and
      plasma in rats caused by pentobarbital anesthesia.
AB  - Pentobarbital anesthesia led to a decrease of noradrenaline concentrations of
      both cisternal cerebrospinal fluid and plasma and adrenaline concentration of
      plasma with a concomitant decrease in blood pressure in rats. These data suggest
      that pentobarbital suppresses both central and peripheral noradrenergic nervous
      activity.

PMID- 1625375
TI  - Effect of splanchnic nerve stimulation on epinephrine and norepinephrine release
      from gastrointestinal sympathetic postganglionic endings in the frog.
AB  - Gastrointestinal vascular perfusates in bullfrogs before and after splanchnic
      nerve stimulation were collected and analyzed for epinephrine and norepinephrine.
      Catecholamine in the perfusate before stimulation was predominantly epinephrine.
      Upon stimulation a marked increase in epinephrine release without any significant
      change in norepinephrine release was observed in experiments at 8-10 degrees C as
      well as 16-21 degrees C, showing that in frogs epinephrine is the sympathetic
      neurotransmitter and that the release of epinephrine is not affected by low
      temperatures.

PMID- 1625376
TI  - Systems analysis of the carotid sinus baroreflex system using a sum-of-sinusoidal
      input.
AB  - The purpose of the present study was to determine the dynamic characteristics of
      the carotid sinus baroreflex system (CS) employing systems analysis. In 28
      anesthetized and mechanically ventilated dogs with vagotomy, intracarotid sinus
      pressure (ICSP) was changed artificially. In protocol 1 (n = 7), we estimated the
      transfer function of the CS by means of a single sinusoidal input (SIN), the
      Gaussian white-noise input (GWN), and a sum-of-sinusoidal input (SUM). The
      transfer function of ICSP to systemic arterial pressure (SAP) was second-order
      delay with an identical corner frequency of 0.025 Hz and damping ratio of 0.7.
      The steady-state gain estimated using GWN (1.12 +/- 0.13) or SUM (1.13 +/- 0.08)
      was significantly smaller than SIN (1.69 +/- 0.25). In protocol 2, to find the
      reason why there was a difference among the estimated steady-state gains, we
      investigated the effect of ICSP pulsation on the open-loop gain of the CS. The
      maximum gain of the gain curve was decreased and the operating range was
      increased significantly with the 2-Hz pulsation. We could simulate the above
      phenomena by using a model with a nonlinear sigmoidal relationship between ICSP
      and SAP. The dynamic characteristics of the CS appeared to be changed by
      pulsation, but this phenomenon was attributable to the sigmoidal nature of the
      relationship between ICSP and SAP. Pulsation decreases the maximum gain and
      increases the operating range, which may contribute to stability of the CS and
      homeostasis of SAP.

PMID- 1625377
TI  - Response field of cat trigeminal sensory complex neurons responsive to mechanical
      stimulation of the canine tooth.
AB  - Response fields of periodontal mechanoreceptive (PM) neurons in the cat's
      trigeminal sensory complex were examined while mechanical stimulation was applied
      to the canine tooth in 12 directions on the horizontal plane. Almost all the
      slowly adapting PM neurons were directionally selective to stimulation, and their
      response fields had response angles greater than 180 degrees, i.e. broad type.

PMID- 1625378
TI  - Effects of chronic administration of noradrenaline and glucagon on in vitro brown
      adipose tissue thermogenesis.
AB  - The in vitro brown adipose tissue (BAT) oxygen consumption stimulated by
      noradrenaline (NA) or glucagon (G) was significantly lower in chronically NA
      treated rats and that of G-treated rats did not differ as compared with that of
      vehicle-treated control animals. In vitro thermogenic response of BAT in NA
      treated rats was consistent with that induced by cold acclimation.

PMID- 1625379
TI  - Evidence of direct activation of adenosine A1 receptor by 5'-adenosine
      monophosphate in isolated guinea pig atrial myocytes.
AB  - The electrophysiological effect of 5'-adenosine monophosphate (AMP) was examined
      in isolated atrial myocytes of guinea pig. Membrane potential and ionic currents
      were measured by the tight-seal, whole-cell patch-clamp technique. AMP caused the
      shortening of atrial action potential in a dose-dependent manner. In voltage
      clamp experiments, AMP (3-10 microM) caused the activation of IKACh as well as
      the decrease in basal ICa. Prolongation of action potential duration caused by
      isoproterenol (20 nM) was antagonized by AMP (10 microM). Isoproterenol (20 nM)
      occasionally caused the sustained rhythmic activity and the subsequent
      application of AMP (10 microM) terminated it. AOPCP (10 microM), which inhibits
      5'-nucleotidase and hence prevents breakdown of AMP, did not significantly
      attenuate the effect of AMP on shortening action potential. However, the
      application of adenosine deaminase (1 U/ml), which deaminates adenosine to
      inosine, partially reversed the shortening of action potential caused by AMP (10
      microM). These results indicate that (1) AMP could activate IKACh and decrease
      basal ICa simultaneously, and antagonize the isoproterenol-stimulated action
      potential prolongation; and (2) the observed electrophysiological effect of AMP
      in whole-cell preparation is attributed to AMP per se as well as its degradative
      product, adenosine.

PMID- 1625380
TI  - Biphasic change in plasma potassium concentration by mannitol infusion in rats.
AB  - Changes in plasma Na+([Na+]pl) and K+([K+]pl) concentrations were continuously
      measured in nephrectomized rats consequent to intravenous infusion of isosmotic
      mannitol (M group) or sucrose (S group) at 1.6 ml/100 g body wt. for 10 min, and
      for the following 30 min. The effect of a Ca2+ channel blocker (diltiazem, 0.1
      mg/100 g body wt.) was also evaluated. In the S group, [K+]pl decreased during
      the infusion and rose above the control level after the discontinuance of
      infusion. In the M group, [K+]pl gradually increased even during the infusion and
      reached the same level as the S group at the end of the experiment. In both the S
      and M groups, [Na+]pl decreased, while PaCO2, pH, and HCO3- did not change. The
      increase in [K+]pl in the M group had two components. The first was a transient
      component as presented by the difference of [K+]pl between the M and S group. It
      might be attributable to K+ release from the intracellular space during a
      regulatory volume decrease consequent to cell swelling induced by isosmotic
      mannitol infusion. The second component of the increase in [K+]pl after the
      infusion was observed in both groups, and this increase might be related to the
      dilution of ions induced by the large amount of infused nonelectrolyte solution.
      Diltiazem suppressed both of these changes in [K+]pl, suggesting that they are
      related to Ca2+ channels. The results suggest that increase in [K]pl by isosmotic
      mannitol infusion is related to the effects of regulatory volume decrease and
      dilutional effect.

PMID- 1625381
TI  - Effects of cold acclimation on cold-induced changes in lipid metabolism of rat
      brown adipose tissue.
AB  - Effects of acute cold exposure (0 degree C, 12 h) on lipid metabolism of the
      interscapular brown adipose tissue (BAT) were studied in warm controls (25
      degrees C) (WC) and cold-acclimated rats (5 degrees C, 4 weeks) (CA). 1) We
      confirmed that cold acclimation brought about decreased BAT triglyceride (TG)
      level and increased BAT phospholipid (PL) level. The indexes of unsaturation,
      such as unsaturation index and polyunsaturated fatty acids/saturated fatty acids
      ratio, of bulky fatty acids (FA) (palmitic, stearic, oleic, and linoleic acids)
      decreased in TG, while those increased in PL. Rare FA (eicosadienoic acid, homo
      gamma-linoleinic acid, lignoceric acid) level, which were about five times higher
      in PL than TG in WC, decreased in both TG and PL in CA. 2) Effect of acute cold
      exposure in WC: The level as well as the amount of TG in BAT was greatly reduced
      and the indexes of unsaturation in TG-FA increased. The most part of reduced TG
      (85%) was explained by the bulky FA. Rare FA explained only 1.1% of reduced TG.
      PL level in BAT did not change, but its amount decreased. The indexes of
      unsaturation increased in PL-FA. 3) Effect of acute cold exposure in CA: CA was
      placed in warm temperature of 25 degrees C before cold exposure. In contrast with
      the cold-reduced TG in WC, either the level or the total amount of TG in BAT did
      not change, but the indexes of unsaturation in TG-FA decreased. The level as well
      as the total amount of PL in BAT increased. The arachidonic index and
      arachidonate in PL-FA decreased, but the indexes of unsaturation did not change.
      These results indicate as a whole that acute cold exposure as well as cold
      acclimation influences BAT lipid metabolism in FA compositions as well as amount
      of TG and PL, suggesting that such changes are related to thermogenic activity of
      this tissue.

PMID- 1625383
TI  - [A case of psittacosis with migratory infiltrates].
AB  - A 56-year-old man with fever, headache, cough and sputum was admitted to another
      clinic. Chest X-ray examination revealed infiltrates in the upper lobe of the
      right lung. Cefem and aminoglycoside therapy was not effective, and the
      infiltrates migrated from the right upper lobe to the right middle and lower
      lobes and then to the left lung. He was transferred to our clinic, and laboratory
      data showed that CRP was 6+; ESR, 119 mm/1 h; WBC, 3000/mm3; and CAR, 512. The
      tentative diagnosis of atypical pneumonia was based on the positive agglutination
      test for Legionella pneumophila, and treatment with erythromycin, minocycline and
      rifampicin resulted in alleviation of symptoms and resolution of the infiltrates
      in the lungs. Complement fixation titer for Chlamydia was 128 at admission and
      was elevated to 512 after 2 weeks. Indirect fluorescent antibody for Legionella
      was negative. Transient liver dysfunction was also observed.

PMID- 1625382
TI  - Measurements of CO2 diffusivity and buffering capacity in myoglobin solutions.
AB  - Diffusion processes of CO2 into or out of a thin layer of myoglobin (Mb) solution
      were followed by pH-sensitive fluorescence of 4-methylumbelliferone. Mb solutions
      were prepared by dissolving horse heart Mb at 0.1 to 4 mM in a modified Krebs
      solution containing NaHCO3 of 30 mM. Carbonic anhydrase was added to observe the
      diffusion-limited pH changes. The PCO2 in the layer were calculated as the
      numerical solution of a diffusion equation. For the simulation of the observed pH
      time curves, the PCO2 changes were converted to the pH changes using a linear
      relation between logPCO2 and pH. The diffusion coefficients of CO2 and HCO3-
      (DCO2 and DHCO3) were determined as the optimum parameters to fit the calculated
      pH-time curves to the observed ones. Both the DCO2 and DHCO3 decreased
      exponentially as the Mb concentration was increased. At a physiological
      concentration of Mb in cardiomyocytes (0.2 mM) and at 37 degrees C, the DCO2 and
      DHCO3 values were 9.8 x 10(-5) and 16 x 10(-5) cm2.s-1, respectively. The buffer
      value (beta) was calculated as the slope of a pH-bicarbonate diagram by measuring
      the CO2 content and pH of the Mb solutions equilibrated with known PCO2 gases.
      The beta was found to increase with increasing Mb concentration with a value of
      6.2 mEq.l-1.pH-1 at 0.2 mM.

PMID- 1625384
TI  - [A case of primary antiphospholipid syndrome with fever, pulmonary
      thromboembolism and endocardial lesion].
AB  - A previously healthy 16-year-old girl complaining of fever, hemosputum, chest
      pain and dyspnea was hospitalized. On admission, physical examination revealed
      mental confusion, holosystolic heart murmur, and swelling of the left foot.
      Laboratory investigations showed anemia, leukocytosis, thrombocytopenia,
      activation of inflammatory reactions, prolongation of PT and APTT, and hypoxia.
      Antinuclear antibody test was negative. There were no other findings suggestive
      of collagen diseases such as SLE. Chest X-ray showed consolidation in the left
      lower lung field and pleural effusion. Echocardiography disclosed a mass lesion
      in the left atrium in contact with the mitral valve, and mitral regurgitation. No
      findings indicative of an infectious etiology were present. The patient rapidly
      improved with high dose corticosteroid and anticoagulant therapy. A venogram of
      the lower extremity disclosed deep venous thrombosis. A lung ventilation
      perfusion scan revealed multiple pulmonary thromboemboli. Elevation of
      anticardiolipin antibody was noted. Based on these findings, the diagnosis of
      primary antiphospholipid syndrome was made. Further administration of steroid and
      anticoagulant resulted in decrease of the titer of anticardiolipin antibody. This
      is the second report of primary antiphospholipid syndrome in Japan. The clinical
      significance of this disease is also discussed.

PMID- 1625385
TI  - [A case of bronchocentric granulomatosis presenting as a tumorous shadow on chest
      X-ray film].
AB  - A 57-year-old woman was admitted to our hospital with cough, sputum and abnormal
      chest X-ray. In summer, 1989, she developed cough which gradually worsened in
      autumn. In November, the chest X-ray revealed a tumorous shadow in the left
      suprahilar region. On admission, there were no symptoms of bronchial asthma.
      Chest X-ray revealed a subpleural tumorous shadow in the left upper lung field. X
      ray findings suggested that the tumorous shadow in the suprahilar region moved to
      the left peripheral upper lung field. Left B1+2 orifice obstruction with necrotic
      tissue was seen on fiberoptic bronchoscopy. Transbronchial biopsies failed to
      yield specific diagnostic findings, except for bronchitis with exudate containing
      eosinophils. In February, 1990, she developed hemosputum and left chest pain.
      Chest X-ray showed consolidation in the left apical lung field. Left upper
      lobectomy was performed. Histological examination disclosed many granulomas with
      central necrosis around the bronchi, and aspergillus hyphae were seen. These
      findings are compatible with bronchocentric granulomatosis without asthma.

PMID- 1625386
TI  - [Prophylactic effect of ulinastatin on cisplatin-induced renal disorders in lung
      cancer patients].
AB  - In order to determine whether ulinastatin (US) can prevent renal dysfunction due
      to cisplatin (CDDP) or not, we comparatively studied serum BUN, serum creatinine
      (Cr), creatinine clearance (Ccr), urine gamma-glutamyl transpeptidase (gamma-GTP)
      excretion, urine N-acetyl-beta-D-glucosaminidase (NAG) excretion, fractional
      excretion of Na (FENa) and urine beta 2-microglobulin excretion between one group
      of 10 patients receiving single treatment with CDDP and another group of 10
      patients receiving combination treatment with CDDP+US, in 20 subjects with
      primary lung cancer. In the US combination treatment group, urine gamma-GTP
      excretion, urine NAG excretion, and FENa elevation were significantly inhibited.
      Urine beta 2-microglobulin excretion was inhibited. In summary, US was considered
      to have a preventive effect against renal toxicity due to CDDP.

PMID- 1625387
TI  - [A case of intractable hemoptysis due to malignant hemangioendothelioma].
AB  - A 65-year-old man who died of respiratory failure due to malignant
      hemangioendothelioma is reported. He was admitted to our hospital because of
      intractable hemoptysis. Chest roentgenogram revealed multiple patchy shadows in
      both lungs, but we could not make a diagnosis by usual clinical examinations
      including transbronchial lung biopsy. Since the patient's condition became
      critical, oxygen therapy, anticoagulants and antibiotics were started. In
      addition, corticosteroid therapy and double filtration plasmapheresis were
      performed since immunological disorder was suspected because of positive
      immunological examinations such as antinuclear antibodies and an increase in
      circulatory immune complexes. There was little response to the treatments and the
      patient finally died of respiratory failure. At autopsy, multiple tumor nodules
      were found throughout the lungs and the liver. Metastasis to mediastinal lymph
      nodes was also discovered. These findings made it impossible to confirm the
      primary lesion. Microscopy showed proliferation of anastomosing capillaries
      encasing tumor cells of unknown origin. Silver staining demonstrated capillaries
      encompassing the atypical cells, suggesting a vascular origin of the tumor.
      Furthermore, factor VIII related-antigen in the tumor cells was confirmed by the
      peroxidase-antiperoxidase (PAP) method. The final diagnosis of malignant
      hemangioendothelioma was made from these histological findings. Malignant
      hemangioendothelioma is rare, but is an important cause of intractable
      hemoptysis.

PMID- 1625388
TI  - [A case of gold-induced pneumonitis showing a positive reaction in the drug
      lymphocyte stimulation test (DLST) for gold].
AB  - A case of acute interstitial pneumonia developing during gold therapy is
      reported. A 67-year-old female with rheumatoid arthritis for about twenty years
      who received a total dose of 80 mg of gold thiomalate (Shiosol) for about two
      months, developed high fever and dry cough. Exertional dyspnea developed and
      chest roentgenogram showed diffuse small nodular and reticular shadows. RA and
      RAPA tests were positive. Drug lymphocyte stimulation test (DLST) for Shiosol was
      positive. The dyspnea resolved on administration of methylprednisolone. Chest
      roentgenogram and CT-scan showed improvement. A total dose of 80 mg of gold
      thiomalate, as administered in this case, is the minimum dose previously reported
      in Japan. It has been recently reported that allergic reaction is the mechanism
      of gold lung. In the present case, positive DLST indicated the existence of many
      activated lymphocytes, and was very useful in the diagnosis of gold lung.

PMID- 1625389
TI  - [A case of plasmacytoma of the ribs with intrathoracic tumors].
AB  - A 75-year-old male was admitted because of two tumors, one in the left middle
      lung field and one in the right upper lung field. Chest CT revealed intrathoracic
      tumors extending from destroyed ribs. Biopsy specimens of both tumors showed well
      differentiated plasmacytoma. Retrospective investigation suggested that solitary
      plasmacytoma of bone (SPB) originating in the left fourth rib had developed into
      multiple myeloma (MM). Both tumors were treated with doses of 50 Gy irradiation
      and responded very well. Intrathoracic plasmacytomas have rarely been observed,
      so we have no established classification or therapy. According to reported cases,
      we classified intrathoracic plasmacytomas into 5 groups, and consider that
      treatment with doses of over 40 Gy irradiation was adequate for local control.

PMID- 1625390
TI  - [A case of diffuse endobronchial infiltration in a patient with non-Hodgkin's
      lymphoma].
AB  - A 38-year-old man with diffuse endobronchial infiltration with non-Hodgkin's
      lymphoma (NHL) is reported. He was admitted to our hospital on November 1990
      because of lymph node swelling. Physical examination on admission revealed left
      axillary, bilateral cervical and inguinal lymph node swelling. Chest and
      abdominal CT scan showed para-aorta lymph node swelling, mild splenomegaly and
      heterogeneous density of the liver, although hilar and mediastinal
      lymphadenopathy were not found. Microscopic examination of the biopsy specimen
      obtained from the right inguinal lymph node and liver revealed NHL (B cell
      lymphoma, diffuse, mixed type). After two courses of chemotherapy, a chest
      roentgenogram showed bilateral hilar lymphadenopathy and reticular shadows. CT
      scan demonstrated a thickening of the left main bronchus. Bronchoscopic
      examination revealed a small submucosal nodule in the left main bronchus on
      February 1991, from which the biopsy specimen revealed NHL infiltration similar
      to that of the lymph node. At follow-up bronchoscopic examination, in spite of
      chemotherapy, scattered NHL infiltration was found in the submucosal space of the
      left vocal cord, carina and the bifurcation between left upper and lower bronchi.
      In patients with NHL, endobronchial involvement is rare. In this case, diffuse
      endobronchial infiltration was not thought to be direct invasion from the lymph
      node but hematogenous or lymphatic spread to the bronchi.

PMID- 1625391
TI  - [A case of carcinosarcoma of the lung].
AB  - A 78-year-old man was admitted to our hospital with cough and left anterior chest
      pain. Chest X-ray examination on admission revealed a tumor shadow in the left
      upper lobe. Malignant tumor cells were observed on histopathological examination
      of a specimen obtained by bronchoscopic biopsy. Radiotherapy was performed but
      was not effective, and the patient died of respiratory failure 4 months after
      admission. Autopsy revealed a 15 cm diameter tumor with marked local invasion
      tendency without distant metastasis. Microscopically, the tumor consisted partly
      of squamous cell carcinomas, and partly of fibrosarcomas, composed of spindle
      cells and osteo-chondrosarcoma. The tumor was therefore diagnosed as
      carcinosarcoma. Immunohistochemical examination showed positive keratin and EMA
      staining only in the squamous cell carcinoma component of the tumor.

PMID- 1625392
TI  - [A case of localized pleural mesothelioma containing a wedge-shaped area of
      aeration].
AB  - A 32-year-old man was admitted to our hospital because of an abnormal shadow on
      the chest X-ray film, which was detected on mass survey. The chest X-ray film on
      admission revealed an irregular mass shadow in the pleural layer between the left
      upper lobe and the lower lobe, and this shadow had a wedge-shaped area of
      aeration inside it. Needle biopsy under ultrasonography suggested a localized
      pleural mesothelioma. Surgery to resect the tumor revealed that it was
      pedunculated and had developed from the pleura of the left S5 segment. The
      resected specimen showed lung tissue invaginating into the tumor through a
      concave area of the tumor. The chest X-ray findings of this case are very
      unusual, and we were unable to find a similar case of localized pleural
      mesothelioma in the literature.

PMID- 1625393
TI  - [Clinical aspects of precapillary pulmonary hypertension].
AB  - Cor pulmonale is present in 54-64% of patients with respiratory failure (mean
      PaO2: 52-54 Torr) receiving home oxygen therapy in Japan. This may imply that the
      development of clinical symptoms of cor pulmonale in the course of the disease
      more strongly reflects far advanced stage than the presence of respiratory
      failure. In this paper, clinical data from subjects with various forms of
      precapillary pulmonary hypertension were analysed with respect to correlation
      between the prognosis and the pulmonary vascular response to various therapeutic
      modalities such as acute administration of oxygen, vasodilator drugs, and
      surgery. The results were as follows: 1) In subjects with COPD, there was a
      significant correlation between mean pulmonary arterial pressure (PPA) and
      prognosis. Patients who showed decreased pulmonary vascular resistance (% delta
      PVR less than -10) after 100% oxygen inhalation had a good prognosis. 2) In
      subjects with sequelae of pulmonary tuberculosis, there was no apparent
      correlation between the prognosis and % delta PVR after 100% oxygen inhalation.
      3) In subjects with both COPD and sequelae of pulmonary tuberculosis, the lowest
      value of desaturation during sleep was significantly correlated to the PPA during
      wake. 4) Analysis of 232 cases with primary pulmonary hypertension revealed the
      following prognostic factors: PPA, cardiac output, stroke volume index, pulmonary
      vascular resistance, mixed venous oxygen tension, right atrial pressure, total
      bilirubin, and total protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625394
TI  - [Experimental study on development and lung injury in pneumonia under neutropenic
      condition].
AB  - This study was performed to demonstrate the characteristic findings in pneumonia
      under neutropenic condition. The results were as follows. 1) After nebulizing
      Klebsiella pneumonia DT-S strains, the survival rate in the neutropenic mouse
      group rapidly decreased compared with that of the control group. 2) In the
      neutropenic state, a rapid decline of survival rate was demonstrated during the
      initial stage of infection. Bacteremia and endotoxemia developed earlier than in
      the healthy control group. 3) In neutropenic pneumonia, the neutrophil cell count
      in BALF was significantly lower than that in usual pneumonia. Consequently, a
      large number of bacteria grew in the alveolar spaces during the early period
      after inhalation. Neither inflammatory cell infiltration nor thickening of the
      alveolar wall was present; however, structural destruction of alveolar and
      vascular walls was found. 4) These pathological changes were also seen following
      intratracheal inoculation of some extracellular enzymes of Klebsiella pneumoniae
      DT-S into rabbit lung. However, no destruction of alveolar walls was observed
      after nebulizing the killed Klebsiella pneumoniae DT-S. It was suggested that the
      significant amount of enzymes produced by the bacteria growing in the alveoli
      caused tissue damage, especially in the neutropenic state. 5) Thus the typical
      inflammatory changes that occurred in the usual state, were not seen in
      neutropenic pneumonia, and a large number of bacteria grew in the alveoli. Marked
      tissue damage was caused by extracellular enzymes produced by bacteria.
      Consequently, bacteria entered the blood stream and bacteremia and endotoxemia
      developed. These processes observed in neutropenic pneumonia readily progressed
      to bacteremia of endotoxemia, which are more severe in this state.

PMID- 1625395
TI  - [Assessment of alveolar epithelial permeability in progressive systemic sclerosis
      (PSS) using 99mTc-DTPA (diethylene triamine penta acetate) aerosol inhalation].
AB  - To evaluate alveolar epithelial damage in PSS, we studied pulmonary epithelial
      permeability by measuring the clearance of inhaled 99mTc-DTPA aerosol and
      performing thin slice CT scan, pulmonary function tests and right heart
      catheterization in 28 patients with PSS. The 99mTc-DTPA clearance rate (kep
      value) in PSS was greater than in 11 non-smoking normal subjects (18.2 +/- 7.63 x
      10(-3)/min vs. 9.12 +/- 0.77 x 10(-3)/min, p less than 0.01). In PSS, the kep
      value did not correlate with age, sex, duration of illness, dermal lesions, %
      vital capacity, or PaO2. In contrast, the kep value showed significant
      correlations with %DLco (diffusing capacity for carbon monoxide), extent of
      interstitial lesions evaluated by CT scan (CT score), and mean pulmonary artery
      pressure. On the other hand, the kep value was high in some patients with normal
      CT scan and normal %DLco. These findings indicate that pulmonary interstitial
      lesions in PSS are accompanied by alveolar epithelial damage, and that the
      clearance of 99mTc-DTPA may be an early predictor of interstitial change.

PMID- 1625396
TI  - [Analysis of bronchoalveolar lavage fluid in patients before and after bone
      marrow transplantation].
AB  - We analysed BALF cell findings in 9 patients (group A: 5 patients without lung
      disease after bone marrow transplantation (BMT), group B: 4 patients with lung
      disease after BMT) before and after BMT. Before BMT, BALF cell findings in group
      A were almost normal, whereas a relative increase of lymphocytes was seen in
      group B. Although total cell counts and cell composition in group A changed
      little after BMT, CD4/CD8 ratios in BALF lymphocytes decreased. In contrast, a
      relative increase of lymphocytes and neutrophils was seen in group B and there
      was variation of CD4/CD8 ratios in BALF lymphocytes after BMT. We there studied
      the BALF lymphocytes of 3 patients in group A and 4 patients in group B after BMT
      by means of 2-color analysis. Among CD4+ cell populations, CDw 29+ cells were
      decreased in both groups after BMT. A relative increase of BALF-CD4+ HLA-DR+
      cells and CD8+ HLA-DR+ cells was seen in group A, but was not seen in group B.
      These findings suggest that there is abnormality of local immunity in the lung
      after BMT.

PMID- 1625397
TI  - [Ventricular performance during exercise in patients with chronic obstructive
      pulmonary disease (COPD)].
AB  - We assessed ventricular performance during exercise in 16 COPD patients and 8
      normal control subjects by means of radionuclide equilibrium angiography using
      technetium-99m as a tracer. Supine exercise on a bicycle ergometer was performed
      until symptom-limited exhaustion. Data were accumulated for 300 heart beats at
      rest and 150 heart beats during exercise. We used the standard voxel count method
      to calculate the ventricular volumes. Age, FEV1.0%, %VC, PaO2 and PaCO2 of the
      COPD patients were 63 +/- 8 yr, 46 +/- 11%, 69 +/- 18%, 68 +/- 11 Torr and 44 +/-
      7 Torr (mean +/- SD), respectively. Systolic dysfunction of both the left and
      right ventricles was well confirmed in the present study. In 12 patients who also
      underwent hemodynamic studies, resting total pulmonary vascular resistance index
      (TPVRI) and mean pulmonary artery pressure (Ppa) significantly correlated with
      right ventricular end-systolic volume index (RVESVI) obtained by RI angiography;
      gamma = 0.769 (p less than 0.01) and gamma = 0.631 (p less than 0.05),
      respectively. A significant relationship was also observed between left
      ventricular dysfunction and the degree of hypercapnia. In response to exercise
      testing, 10 of 16 patients exhibited insufficient augmentation of stroke volume,
      and both left and right end-diastolic volumes decreased in half of 10 patients.
      It is suggested that cardiac function may be disturbed by mechanical factors such
      as pulmonary hyperinflation in COPD patients.

PMID- 1625398
TI  - [Eosinophil colony stimulating factor production by lymphocytes from patients
      with bronchial asthma].
AB  - To investigate the eosinophilia in patients with bronchial asthma (BA), we
      examined the release of eosinophil colony stimulating factor (Eo-CSF) from blood
      mononuclear cells (MNC) and lymphocytes from BA. We also investigated the effect
      of specific antigens on the release of Eo-CSF to determine its relation to other
      known Eo-CSFs. 1) Phytohaemagglutinin (PHA) and interleukin (IL)-2 at optimal
      concentrations stimulated mononuclear cells from BA, and induced Eo-CSF release.
      In contrast, MNC from normal volunteers released Eo-CSF with only PHA, but did
      not release Eo-CSF with IL-2. 2) Lymphocytes from BA who were sensitive to house
      dust mite and Dermatophagoides farinae (D. farinae) antigens responded to
      specific antigens with Eo-CSF production, but those from normal volunteers did
      not. 3) The anti-IL-3, anti-IL-5, and anti-granulocyte-macrophage (GM)-CSF
      antibody inhibited Eo-CSF activity in culture media of lymphocytes from BA. These
      results indicate that the increase in responsiveness of lymphocytes from BA to
      specific antigens and cytokines produced by T cells play an important role in the
      induction of eosinophilia in BA.

PMID- 1625399
TI  - [Leukocyte migration inhibition test in drug-induced pneumonitis].
AB  - The leukocyte migration inhibition test (LMIT) was performed in 8 cases of
      presumed drug-induced pneumonitis. The drugs involved were amiodarone in 3 cases,
      methotrexate in 2 cases, and fenofibrate, nadolol, and gold salt, each in one
      case. The agarose microdroplet technique for photoelectric readings of leukocyte
      migration inhibition was applied in the presence of a wide range of drug
      concentrations. LMIT was found to be positive in 6 of the 8 cases (75%). The
      presence of a positive LMIT indicates the elaboration of leukocyte migration
      inhibitory factor. These results suggest that cell-mediated immunity may play a
      role in the pathogenesis of drug-induced pneumonitis and that LMIT may be useful
      for the detection of causative drugs in patients with this condition.

PMID- 1625400
TI  - [Content and localization of leukotriene C4 in lung tissue during biphasic
      allergic bronchoconstriction in the guinea pig].
AB  - Leukotriene C4 (LTC4) is a very potent bronchoconstrictor, and is believed to be
      an important mediator during immediate (IAR) and late asthmatic response (LAR).
      No direct measurement of LTC4 in lung tissue during IAR and LAR has been
      reported, however, and its localized site in the lung remains unclear. In an
      effort to clarify these issues, the content of LTC4 in lung tissue was evaluated
      at the onset of antigen-induced IAR and LAR, and the distribution of LTC4 was
      examined by immunohistochemistry. IAR and LAR were induced by inhalation of
      aerosolized ovalbumin (OA) in conscious guinea pigs. The development of IAR and
      LAR following inhaled OA exposure was determined in sensitized guinea pigs by
      measurement of respiratory resistance using the oscillation method. LTC4 in lung
      tissue was measured by radioimmunoassay at six different stages (S1: non-treated
      group; S2: group before OA-challenge following sensitization; S3: IAR group; S4:
      group two hours after IAR; S5: LAR-positive group; S6: LAR-negative group). For
      immunohistochemistry, non-treated guinea pigs and the sensitized animals at the
      onset of LAR were used. Lung sections were stained with anti-LTC4 antibody by
      avidin biotin peroxidase complex method (ABC method). About 70% of the guinea
      pigs displayed IAR, followed by LAR that peaked at 6-20 hours after OA challenge.
      The LTC4 content in lung tissue was significantly increased (p less than 0.01) at
      the onset of IAR, but was significantly decreased (p less than 0.01) after two
      hours, and significantly increased (p less than 0.01) at the onset of
      LAR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625401
TI  - [Mediastinitis with bilateral empyemas following neck phlegmon].
AB  - A 46-year-old male complaining of fever and neck swelling was transferred to our
      department because of bilateral empyemas in the pleural spaces following neck
      phlegmon. A culture of the right pleural effusion obtained at his local hospital
      revealed Gram-positive anaerobic cocci. Chest roentgenogram showed bilateral
      effusions and widening of the upper mediastinum. Neck roentgenogram confirmed
      widening of the retropharyngeal space. CT clearly demonstrated a continuous
      lesion from the neck to the mediastinum and occupying the pleural spaces
      bilaterally. The patient responded to intravenous antibiotics and tube drainage
      of the pleural cavities, and was discharged after 10 weeks of hospitalization.
      Because no mediastinal abscess requiring drainage was recognized on CT, surgical
      drainage of the mediastinal space was not performed. Sequential CT was used to
      follow the lesion in the retropharyngeal space, mediastinum and pleural spaces,
      to check and reposition the tubes for drainage of pleural exudate.

PMID- 1625402
TI  - [Pulmonary tuberculosis in youth].
AB  - The study of the group younger than 29 years of age with pulmonary tuberculosis
      was carried out. Thirty seven out of 287 tuberculosis patients who were
      discharged from National Chiba-Higashi Hospital in 1989 were enrolled. Only 5
      patients (13.5%) were associated with complication. The smear and culture of
      sputum for acid-fast bacilli were positive in 30 cases (81.1%) and chest X-ray
      films revealed cavitary lesion in 31 cases (83.3%). Many of them were moderately
      advanced cases. Twenty four of them were found symptomatically, 10 by mass survey
      and 3 under treatment of other diseases. The total delay of symptomatic patients
      was 8.5 weeks until 80% of them were definitely diagnosed. The days of hospital
      stay were 122 until half patients were discharged. Five of them (13.5%) were non
      Japanese and all stayed in Japan illegally. Their condition was rather severe.

PMID- 1625403
TI  - [Study on familial attacks of pulmonary tuberculosis in Sapporo City].
AB  - We studied familial attacks of pulmonary tuberculosis in Sapporo City from 1987
      to 1990. There were 146 sources of infection. Two hundred twenty three were
      infected secondly. Chemotherapy was given to the 75 out of 223 patients.
      Chemoprophylaxis was given to the total of 148 children. The average ages of the
      sources, those who were infected secondly and those who had given
      chemoprophylaxis were 44.8, 32.2 and 7.7 years of age respectively. The ratio of
      male vs female was 1:0.4 among the sources. The main routes of transmission of
      this disease were from husbands to wives, from fathers to children, and from
      grandfathers to grandchildren. The patients who did not have health examination
      in the preceding one year of their present diagnoses had more severe state of
      disease as well as higher Gaffky degrees and were treated for more than one year.
      The infectious patients accounted for more than 50% of the active pulmonary
      tuberculosis in Sapporo City in 1990. Tuberculin skin test has been performed in
      almost cases of family examination and the period of chemoprophylaxis has been
      standardized along the guideline for the chemoprophylaxis by Japan Tuberculosis
      Association and the Ministry of Health and Welfare. Family and relatives of the
      patient who expectorates tuberculosis bacilli should take at least one
      examination annually. Younger people should take it more frequently and
      chemoprophylaxis should be given to the child whose reaction of Tuberculin skin
      test is strongly positive.

PMID- 1625404
TI  - [Detection of mycobacteria by polymerase chain reaction].
AB  - The polymerase chain reaction (PCR) was used to detect mycobacterial DNA
      sequences in the cultured or the clinical specimens. Four oligonucleotide primers
      derived from the sequence of a gene coding 65-kilodalton antigen of Mycobacterium
      tuberculosis amplified DNA samples of all the 11 species of mycobacteria tested.
      Serial dilution of M. bovis BCG showed that DNA extracted from only 12 bacilli
      was enough for the detection by PCR method. However, mycobacteria in sputum were
      detected by PCR when more than 10(3) bacilli were present. The PCR method may
      become a useful tool for the rapid diagnosis of mycobacterial infections.

PMID- 1625405
TI  - [A radiographic progression during and after initial chemotherapy for pulmonary
      tuberculosis].
AB  - Transient radiographic progressions during or after antituberculous chemotherapy
      were observed in 60 (4.5%) out of 1,321 cases with active pulmonary tuberculosis
      who received an initial combination chemotherapy including INH and RFP. The
      radiographic patterns of these progressions were classified into a singular and a
      gregarious pattern. A correlation between the two radiographic patterns and a
      positive or negative culture in sputum at the time of the radiographic
      progressions was studied, revealing significantly more frequent singular patterns
      in culture negative cases while more frequent gregarious patterns in culture
      positive cases. In a majority of the cases, radiographic progressions developed
      within 3 months after an initiation of chemotherapy. Either of the increased
      shadows during chemotherapy or after completion of chemotherapy showed an
      improvement in a moderate degree or over and a good prognosis thereafter by
      continuous administration of the same drugs or under observation without
      retreatment respectively. It is concluded that radiographic progressions appeared
      during an intensive chemotherapy or after its completion do not always require
      changing the antituberculous drugs or resumption of chemotherapy.

PMID- 1625406
TI  - [A case of adenosquamous carcinoma with unknown origin and with superior vena
      cava syndrome as the first symptom].
AB  - This report is concerning a case of adenosquamous carcinoma having unknown origin
      and showing SVC syndrome as the first symptom. A 44 year-old man was admitted to
      our hospital because of facial edema at the beginning of April 1990. He was
      diagnosed as having a mediastinal tumor of the SVC syndrome type. Resection of
      the SVC tumor and part of the pericardium was performed on June 20, 1990. The
      operation had extraordinary findings. Lymph nodes adhering to tumor invaded the
      adjacent right side of the trachea and were situated in a rosette-like form.
      Furthermore, a part of the tumor stemmed into the lumen of the superior vena cava
      causing complete obstruction. The pathological diagnosis of the SVC tumor was
      adenosquamous carcinoma, however, no clinical examinations could identify its
      original matrix. Mediastinal tumors of unknown origin are reported as about 1% of
      all mediastinal tumors, and are responsible for 0.68% of all carcinomas in the
      mediastinum. This was one experience of a rare case of mediastinal tumor having
      unknown origin and showing SVC syndrome as the first symptom.

PMID- 1625408
TI  - [PTCA and left ventricular systolic function (evaluation by exercise two
      dimensional echocardiography)].
AB  - Successful transluminal coronary angioplasty (PTCA) should improve left
      ventricular systolic function. To assess the effect of this procedure 25 patients
      with coronary heart disease were examined before and 3-to 5 days after successful
      PTCA with electrocardiographic treadmill exercise test, and exercise two
      dimensional echocardiography (modified Bruce protocol). Echocardiographic
      examination was obtained prior to and immediately following exercise. Left
      ventricular ejection fraction and segmental wall motion at the baseline and
      immediately after exercise were assessed. Electrocardiographic evidence of
      ischemia was found in 16 of 25 patients prior to PTCA and in 9 patients after
      PTCA. Following angioplasty, exercise duration was increased and the exercise
      induced angina rate was significantly decreased. Ejection fraction did not change
      significantly in patients prior and after PTCA (52 +/- 10% versus 55 +/- 16%, p =
      NS). Following angioplasty, ejection fraction increased from 55 +/- 10% (rest) to
      64 +/- 11% (exercise) (p less than 0.001). New exercise-induced echocardiographic
      segmental wall motion abnormalities were found in 16 of 25 patients prior to PTCA
      and in only one patient following PTCA. Significant improvement of ejection
      fraction and segmental wall motion were also observed in 11 patients with old
      myocardial infarction subjected to successful angioplasty of infarct-related
      coronary artery. Opposite to post-exercise results, the resting mean values of
      these echocardiographic parameters did not differ significantly between pre and
      post-PTCA examinations. These data demonstrate an improvement in systolic left
      ventricular function and better exercise tolerance following successful PTCA.
      This occurs also in patients with old myocardial infarction after angioplasty of
      infarct-related coronary artery. Two-dimensional exercise echocardiography may be
      helpful in assessing the early results of successful angioplasty.

PMID- 1625407
TI  - [Primary arterial hypertension. Treatment with captopril and function of the left
      heart ventricle, concentration of catecholamine in blood and activity of renin].
AB  - We evaluated the effect of captopril treatment on left ventricular mass (LVM) and
      function in sustained mild-to-moderate primary hypertension. In 16 men aged 34.5
      +/- 6.4 yrs. M-mode echo and pulsed wave Doppler recordings were obtained prior
      to and after 2 months captopril treatment (50-150 mg daily). No significant
      changes in heart rate, systolic blood pressure, ejection fraction, fractional
      shortening, cardiac output, LVM and Doppler-derived indices of mitral inflow were
      observed. Diastolic blood pressure measured during examination fell from 102.2 +/
      13.3 to 90.3 +/- 9 mmHg (p less than 0.026). No consistent correlations between
      catecholamines and indexes of left ventricular function were found. Two-month
      captopril therapy in mild-to-moderate hypertension results in diastolic blood
      pressure lowering with no effect on LVM or left ventricular function.

PMID- 1625409
TI  - [Does the appearance of pro-arrhythmic response to anti-arrhythmic drugs have
      prognostic significance?].
AB  - Study was undertaken to assess whether proarrhythmic response to antiarrhythmic
      drug is a risk factor for cardiac death in patients (pts) with ischaemic heart
      disease (IHD). In 782 pts with IHD and frequent and/or complex ventricular
      ectopic beats (VEB) 1041 drug tests guided by 24 hour Holter monitoring were
      conducted. The following drugs were assessed: propranolol, disopyramide,
      mexiletine, amiodarone. Pro-arrhythmia was defined according to Velebit:
      1/greater than or equal to 4-fold increase in VEBs, 2/greater than or equal to 10
      fold increase in repetitive forms of 3/new occurrence of ventricular tachycardia
      or ventricular fibrillation (VT/VF). Proarrhythmic effect was observed in 8.4% of
      pts and in 7.9% of drug tests. The frequency with individual drugs ranged from
      5.7% to 9%. No drug was completely free of this type of reaction. Antiarrhythmic
      drugs inducing arrhythmogenic response were eliminated. Pts were followed-up for
      a mean of 22 months (range 1-49). Chronic antiarrhythmic treatment was conducted.
      Pts were discharged taking the agent deemed most effective for suppression of
      arrhythmia. Follow-up visits were made every 6-12 months. All cases of death were
      verified. In long-term observation cardiac death and sudden death occurred in 53
      and 32 pts. With actuarial analysis (Kaplan-Meler method, log rank test) there
      was significant difference in cardiac death (p less than 0.05) of pro-arrhythmia
      (+) compared with ++pro-arrhythmia (-) pts at yr (11% v 4%, 7% v 3%) and 3 yr
      (24% x 11%, 16% v 7%). The relative importance of baseline clinical variables in
      predicting survival was assessed with a stepwise Cox regression.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1625410
TI  - [Role of collagen in myocardium].

PMID- 1625411
TI  - [Renin-angiotensin systems--pathophysiologic, diagnostic and therapeutic
      aspects].

PMID- 1625412
TI  - [Circulatory insufficiency, ischemic disease, arrhythmia and the renin
      angiotensin-aldosterone system and angiotensin converting enzyme inhibitors].

PMID- 1625413
TI  - [Healing with heart].

PMID- 1625414
TI  - [Stress and heart disease; it's source and possible defeat].

PMID- 1625415
TI  - [Type A behavior and ischemic heart disease].

PMID- 1625416
TI  - [How to treat ventricular arrhythmia (comparison of Polish and international
      inquiry with commentary)].

PMID- 1625417
TI  - [In what diseases do the patients have to be provided with a stoma by operative
      medicine?].

PMID- 1625418
TI  - [Children as stoma patients].

PMID- 1625419
TI  - [The preoperative tasks of the stoma therapist].

PMID- 1625421
TI  - [What are the patient's requirements from modern stoma care materials].

PMID- 1625422
TI  - [On the track of the enigma of aging. The personal "un-folding"].

PMID- 1625420
TI  - [Innovations for a better quality of life].

PMID- 1625423
TI  - [The stoma patient's skin--skin protective materials in conflict with the stoma
      patient's skin].

PMID- 1625424
TI  - [Treatment of skin irritations in stoma patients from a nursing viewpoint].

PMID- 1625425
TI  - [Complications and therapy in colostomies and ileostomies].

PMID- 1625426
TI  - [Coloplast assura].

PMID- 1625427
TI  - [Problems in the selection of stoma care products in fixed payment groups].

PMID- 1625428
TI  - [Modern ambulatory care of stoma patients].

PMID- 1625429
TI  - [Infections in the area of the stoma and their treatment].

PMID- 1625430
TI  - [Information and counseling for stoma patients by the health products industry].

PMID- 1625431
TI  - [Care for stoma patients in the new Federal Territories yesterday and today--new
      concepts in patient care].

PMID- 1625432
TI  - [Nutrition for stoma patients].

PMID- 1625433
TI  - [Cost containment?].

PMID- 1625434
TI  - [Psychological factors in the acceptance of disease in patients with stomas].

PMID- 1625435
TI  - [Disclosure by the physician about mortal illness].

PMID- 1625436
TI  - [Professional situation and professional perspectives for stoma therapists].

PMID- 1625437
TI  - [Experiences with the use of Coloplast Assura].

PMID- 1625439
TI  - [Am I what I create out of myself?].

PMID- 1625438
TI  - [Brain surgery using endoscopy. Thin and flexible instruments, many functions,
      fewer tissue injuries].

PMID- 1625440
TI  - Intracellular signal transduction and the control of endothelial permeability.

PMID- 1625441
TI  - Spinal cord microglia in experimental allergic neuritis. Evidence for fast and
      remote activation.
AB  - We have studied the response and the spatial distribution pattern of microglial
      cells during experimental allergic neuritis induced in the Lewis rat by the
      transfer of varying doses of activated T cells specific either for the P2 or P0
      protein. The microglial reaction was studied immunocytochemically at the light
      and electron microscopic level using a panel of monoclonal antibodies which
      included two recently produced antibodies against rat microglial cells, Murine
      Clone 101 and 102. Activation of microglial cells became apparent through changes
      in their immunophenotype and morphology within 48 hours of T cell transfer and
      therefore preceded the onset of clinical disease. Activated microglial cells
      showed an increased expression of the complement type three receptor, the murine
      clone 101 and 102 determinants and major histocompatibility complex antigens. The
      microglial reaction in experimental allergic neuritis occurs at a site remote
      from the inflammatory changes in the peripheral nerve, the microglial reaction
      being most prominent in the dorsal and ventral grey matter of the lumbar and the
      thoracic spinal cord. Similar changes were also observed at this time in the
      terminal projection fields of the primary, afferent, sensory fibers, such as the
      nucleus gracilis. Subsequently, after 7 days, motoneurons, particularly in the
      ventral grey matter of the lumbar spinal cord, were ensheathed by perineuronal
      microglial cells. These perineuronal microglial cells were in close contact with
      the neuronal plasma membrane and occasionally appeared to detach afferent
      synaptic terminals from the surface. Microglial responses were not detected in
      animals injected with nonpathogenic T cells specific either for the purified
      protein derivative or ovalbumin. This early activation of microglial cells
      observed in experimental allergic neuritis suggests that a rapid and remote
      signaling might be operating in the microglial responses during T cell-mediated
      autoimmune diseases.

PMID- 1625442
TI  - Mercuric chloride-treated brown Norway rats develop widespread tissue injury
      including necrotizing vasculitis.
AB  - BACKGROUND: Mercuric chloride (HgCl2) induces a T cell-dependent autoimmune
      syndrome in Brown Norway (BN) rats, characterized by polyclonal B cell activation
      and circulating autoreactive T cells. A number of autoantibodies are produced,
      including antibodies to glomerular basement membrane, and there are circulating
      immune complexes. However, histologic evidence of tissue injury in this model has
      previously been reported to be rare. EXPERIMENTAL DESIGN: Six BN rats were given
      five injections of HgCl2, each of 1 mg/kg, over 10 days. Controls were four BN
      rats given equal volumes of saline and 10 Lewis rats given the same amount of
      HgCl2. Blood samples were taken thrice weekly. Animals were killed at various
      stages, necropsies performed, and organs histologically examined. The effect of
      pretreatment with broad spectrum antimicrobial drugs was examined by comparing
      two further groups of six BN rats: one group was pretreated with tylosin,
      ivermectin, and metronidazole before HgCl2 was given, and the other group
      received no pre-treatment. RESULTS: HgCl2-treated BN rats developed inflammation
      and ulceration of the skin which was most marked at mucocutaneous junctions.
      Macroscopic examination of internal organs showed hepatomegaly and gross
      haemorrhagic lesions in the wall of the gut, most marked in the duodenum and
      caecum. Microscopically, the skin lesions were characterized by a subepidermal
      mononuclear cell infiltrate with occasional hair shaft necrosis. In the liver
      there was a periportal mononuclear cell infiltrate, and in the gut there was
      intense submucosal inflammation and a leucocytoclastic vasculitis accompanied in
      places by mucosal ulceration. Lewis rats (which are not prone to mercury-induced
      autoimmunity) showed no such changes after receiving HgCl2, nor did control BN
      rats given saline. BN rats pretreated with broad spectrum antimicrobial agents
      and then given HgCl2 showed milder histologic abnormalities, although
      antimicrobial treatment did not affect the antiglomerular basement membrane
      autoantibody response. CONCLUSIONS: We have identified a syndrome induced by
      mercuric chloride in BN rats in which there is evidence of tissue injury in many
      organs, with some features in common with graft-versus-host disease. There is
      also necrotizing leucocytoclastic vasculitis affecting the gut, and the
      importance of this is enhanced by the description in the accompanying paper of
      autoantibodies similar to those found in human systemic vasculitis. Our
      observations strengthen the analogies between this model and human autoimmune
      disease.

PMID- 1625443
TI  - Growth and dissemination of human malignant melanoma cells in mice with severe
      combined immune deficiency.
AB  - BACKGROUND: The severe combined immune deficiency (SCID) mouse is lacking mature
      B and T lymphocytes and may be permissive for human tumor growth and metastasis.
      EXPERIMENTAL DESIGN: SCID mice received human melanoma cells of diverse origins
      including: 2 established cell lines, 4 early passage cell lines, and fresh or
      cryopreserved cells obtained directly from 9 patient biopsies. They were
      introduced into SCID mice via intraperitoneal, subcutaneous and intravenous
      injections. RESULTS: Tumor growth occurred with each of the 15 melanoma specimens
      for a take rate of 100% considering cell source. In addition, 60% of the 102
      total mice injected displayed tumor growth in at least one site. The most
      consistent tumor growth (77%) occurred after intraperitoneal injection. Tumors
      developed in 41 and 48% of mice injected subcutaneously and intravenously,
      respectively. The mice developed both local tumor growth with palpable tumor
      nodules at injection sites and hematogenous and/or lymphatic dissemination to
      multiple sites in the abdominal and thoracic cavities. The number of metastases
      per animal averaged 16.3 and the number per organ ranged from 1 to 38. Melanotic
      and amelanotic tumor nodules obtained from a single patient retained their
      original characteristics with regard to melanin production after passage in the
      SCID mouse. The appearance of the human melanoma cells in SCID mouse tissues
      ranged from implants on the organ capsule to frank parenchymal organ involvement
      and vascular invasion. Some small foci of tumor were only detected using
      immunohistochemistry with monoclonal antibodies against the S-100 and HMB-45 to
      melanoma-related antigens. CONCLUSIONS: We conclude that the SCID mouse
      consistently supports growth, invasion, and metastatic spread of human melanoma
      cells, including specimens obtained from fresh patient biopsies. The SCID mouse
      will serve as a relevant in vivo model for studying the biology of human
      malignant melanoma and screening new therapeutic agents.

PMID- 1625444
TI  - An immune model of beryllium-induced pulmonary granulomata in mice.
      Histopathology, immune reactivity, and flow-cytometric analysis of
      bronchoalveolar lavage-derived cells.
AB  - BACKGROUND: Beryllium compounds can cause acute and chronic lung injury in
      humans. Although models of chronic granulomatous lung disease have been
      established in various animal species, a murine model of beryllium-induced
      chronic lung disease has not been established. EXPERIMENTAL DESIGN: Beryllium was
      introduced intratracheally either as a soluble salt (BeSO4) or in particulate
      form (BeO). Various preimmunization protocols were used to enhance immune
      mediated pulmonary changes. Cells obtained by bronchoalveolar lavage (BAL) were
      analyzed using flow cytometry, and the observations correlated with in vitro
      immune responses and with lung histopathology. RESULTS: Histologic changes were
      consistently found in mice preimmunized with BeSO4.4H2O plus syngeneic serum.
      Addition of complete or incomplete Freund's adjuvant to the preimmunization
      protocol was not necessary to induce granulomatous changes. BAL showed a
      significant increase in lymphocytes at 2, 4, and 8 weeks after intratracheal
      BeSO4. Approximately one-third of BAL lymphocytes expressed the gamma/delta T
      lymphocyte receptor at 2 weeks; at 4 weeks the lymphocytes were predominantly
      Thy1+, L3T4+ (CD4+) and expressed only the alpha/beta T lymphocyte receptor. Only
      BAL lymphocytes from mice preimmunized with BeSO4/serum and challenged with
      BeSO4/serum showed significant in vitro proliferation in response to BeSO4.
      Macrophage activation antigens (Mac-2, Mac-3) were expressed only during the
      acute inflammatory phase (2 weeks) whereas increased expression of a
      monocyte/macrophage antigen (Mac-1) remained elevated beyond the inflammatory
      period in some instances. Attempts to induce similar lesions in BALB/c and
      C57BL6/J mice were unsuccessful. Genetic differences at the H-2 major
      histocompatibility complex gene complex may account for the differential
      responses to BeSO4 among various mouse strains. A single exposure to BeO also
      induced histopathologic changes in the lung which correlated with BAL
      cellularity, but these changes were only observed 8 months after exposure and did
      not proceed to frank granulomas. CONCLUSIONS: A murine model of granulomatous
      lung disease may prove useful in understanding the genetic and immunologic
      factors that determine the response to beryllium. The animal model may also have
      implications for pulmonary sarcoidosis, a disease of unknown cause(s), whose
      disease manifestations and BAL profiles are difficult to distinguish clinically
      and pathologically from chronic beryllium disease.

PMID- 1625445
TI  - Sequential assay of human milk immunoglobulins shows a predominance of lambda
      chains.
AB  - BACKGROUND: Little is known of the light chains associated to heavy chains in
      secretions immunoglobulins. We investigated the partition of light chains in a
      mucosal fluid of easy access and major physiologic importance: human milk.
      EXPERIMENTAL DESIGN: This study provides a sequential analysis of IgA, lambda and
      kappa chains levels in human milk during the first days of lactation. The levels
      of IgA alpha-chain and of lambda and kappa light chains of immunoglobulins were
      assayed in 162 samples of normal human milk collected during the first night of
      lactation, using a classical immunonephelometric assay. A specific enzyme-linked
      immunosorbent assay was developed to specifically measure the levels of IgA
      linked light chains, yielding similar values. Ten samples of normal human serum
      obtained from healthy adults were tested in parallel. RESULTS: The highest levels
      were observed during the first 3 days of lactation, and a plateau appeared for
      the three proteins after day 4. Mean lambda chains levels were consistently
      higher than these of kappa chains, resulting in a reversed kappa/lambda ratio,
      significantly different from the classical 2:1 serum ratio confirmed with this
      method on control samples. CONCLUSIONS: This study indicates that milk
      immunoglobulins use an unusual partition of light chains, especially in IgA.

PMID- 1625446
TI  - Embryology and morphology of microphthalmia in transgenic mice expressing a gamma
      F-crystallin/diphtheria toxin A hybrid gene.
AB  - BACKGROUND: Transgenic mice in which elongating lens fiber cells were ablated
      resulting in microphthalmia have been reported, however, their embryology and
      detailed morphology have not. EXPERIMENTAL DESIGN: The morphology of homozygous
      and hemizygous CDI, transgenic mice carrying the gamma FDT-A gene was studied by
      light microscopy on different days of gestation as well as postpartum. The
      findings were compared with normal CD-1 wild type controls. RESULTS: The earliest
      changes in mouse embryos transgenic for the gamma F-crystallin/diphtheria toxin A
      transgene are seen on day 12, when apoptotic cells appear in the area of
      elongation. In hemizygous embryos, ocular development is relatively normal until
      day 17 when the lens and eye are slightly smaller than normal and the lens
      vesicle is filled with abnormal lens material. At this time, the posterior
      capsule of the lens may rupture, releasing abnormal lens material which disperses
      throughout the eye, perturbing growth and other ocular structures. Additional
      breaks may subsequently occur and the ultimate morphology of the hemizygotes
      correlates with when the posterior capsule ruptures, how much lens material is
      released, and where it disperses. In homozygous embryos, due to extensive
      ablation of lens fiber cells, the "lens" becomes a diminutive mass of abnormal
      lens material, posteriorly located within the eye, and otherwise unable to
      fulfill its mechanical or inductive role in the development of the cornea,
      anterior chamber, iris, ciliary epithelium, and zonules with the result that all
      of these structures are markedly abnormal or absent. In addition, the lens is
      necessary for the accumulation of vitreous which in turn is required for the
      growth of the eye as a whole. In homozygous animals, vitreous does not accumulate
      and severe microphthalmia results. CONCLUSIONS: This study confirms and extends
      previous observations and conclusions on the central, orchestrating role of the
      lens in the development of the eye and illustrates the power of transgenic
      technology to elucidate the finer points of mammalian ocular development.

PMID- 1625447
TI  - Ultrastructural pathology of experimental autoimmune uveitis. Quantitative
      evidence of activation and possible high endothelial venule-like changes in
      retinal vascular endothelium.
AB  - BACKGROUND: Experimental autoimmune uveitis (EAU) is a highly organ-specific
      autoimmune disease in which the target is the retinal photoreceptors. It is well
      recognized as a model of uveoretinitis in humans. The mechanisms that control the
      homing of sensitized lymphocytes and other leukocytes to the retina is unknown.
      The aim of this study was to investigate changes in the retinal vasculature that
      may be involved with aiding leukocyte-endothelial cell interactions and
      subsequent extravasation of leukocytes into the retina. EXPERIMENTAL DESIGN:
      Lewis rats immunized with S-antigen were used to produce EAU. The retinal
      vasculature was assessed by morphologic (light and electron microscopy) and
      morphometric techniques at various stages in the generation and course of the
      disease (days 3, 7, 11, 14, 21, 28 and 49 postimmunization) for evidence of
      endothelial cell (EC) activation and leukocyte-EC interaction. Image analysis of
      the retinal vessels at the electron microscopic level was performed to detect
      alterations in the thickness and irregularity of the EC surface, both considered
      to be important in lymphocyte homing in the high endothelial venules (HEVs) of
      lymphoid tissues. Control values were obtained from normal eyes, pertussis-only
      treated animals, and normal lymph node HEVs. RESULTS: The clinical and
      histopathologic changes in the eyes were consistent with previous descriptions of
      EAU and included perivasculitis, focal mononuclear infiltrate in the outer
      retina, and choroid with destruction of the photoreceptor outer segments and
      eventually loss of large portions of the outer retina. During the course of EAU,
      a significant proportion of retinal venules underwent both qualitative and
      quantitative morphologic changes including EC activation evident as increased
      cytoplasmic organelles, a 230% average increase in mean EC thickness, and a
      concomitant 4-fold increase in irregularity of the EC, that produced plump
      irregular EC with deep intercellular clefts. These alterations were maximal at
      day 21, however from day 11 onward, large numbers of lymphocytes and monocytes
      were observed adhering to or lodged in the clefts of plump EC, migrating through
      the EC cytoplasm, or lying beneath the EC. CONCLUSIONS: The characteristics
      acquired by the retinal venules during EAU are reminiscent of HEVs. This study
      suggests that tissue-specific changes in the endothelial cells of retinal venules
      may be responsible for the homing of S-antigen specific autoreactive lymphocytes
      to the target organ in this model of retinal autoimmunity.

PMID- 1625449
TI  - Expression of type I and III collagens and fibronectin after transection of rat
      sciatic nerve. Reinnervation compared with denervation.
AB  - BACKGROUND: The regeneration of transected peripheral nerve is thought to happen
      with the help of cell-cell and cell-extracellular matrix interactions. We studied
      the role of axon in controlling the expression of extracellular matrix genes in
      transected peripheral nerve. EXPERIMENTAL DESIGN: Left sciatic nerves were
      transected in a total of 132 rats. In half of the animals, regeneration was
      allowed to occur, while in the other half regeneration was prevented. The
      expression of type I and III collagen and fibronectin genes was studied
      proximally and distally to the site of transection up to 8 weeks after the injury
      both with and without axonal reinnervation. For Northern blotting, the
      endoneuriums of 10 animals from both groups were used at each time point. For in
      situ hybridization, transverse sections of the nerves were used to observe
      cellular source of the mRNA. In addition, immunohistochemistry was performed in
      sequential sections in order to identify the cells expressing the studied
      extracellular matrix genes. RESULTS: Northern hybridization showed the highest
      expression of type I and III collagens in the distal stumps of transected nerves
      7 to 14 days after nerve transection both with and without axonal reinnervation.
      The proximal site of the injury showed strong expression of the extracellular
      matrix genes which lasted markedly longer than in the distal site. In situ
      hybridizations showed that epi-, peri-, and endoneurium are active for producing
      type I collagen. S-100 immunohistochemistry suggested that the cell type
      responsible for the production of type I collagen in the endoneurium during the
      peripheral nerve regeneration is endoneurial fibroblast. CONCLUSIONS: During
      peripheral nerve regeneration the expression of the extracellular matrix genes
      does not seem to be simply related to the presence of axons. Endoneurial
      fibroblasts contribute to the production of collagen type I and apparently to
      that of fibronectin, which thus is not totally derived from plasma.

PMID- 1625448
TI  - Nasopharyngeal carcinoma and retinoblastoma gene expression.
AB  - BACKGROUND: The pathogenesis of nasopharyngeal carcinoma (NPC) is not well
      defined yet. To evaluate oncosuppressor genes in NPC, two NPC cell lines were
      investigated for expression of the retinoblastoma (RB) gene. EXPERIMENTAL DESIGN:
      We used Western blotting to identify RB protein species, and checked the RB gene
      conformation by Southern blotting. We also used immunohistochemistry, in situ
      nucleic acid hybridization, and in situ extraction of RB protein to observe RB
      protein in NPC culture cells. RESULTS: Both cell lines as well as sublines could
      synthesize normal RB proteins of 110, 113 and 114 kilodaltons. These cells showed
      no RB DNA rearrangement. Most interphase cells showed variable amounts of anti-RB
      reaction product in their nuclei when immunostained by 13 monoclonal antibodies.
      However, all mitotic cells contained RB protein either in the cytosol or the
      chromosomes, depending upon the mitotic phase. The level of RB mRNA increased
      slightly in mitotic cells as compared with interphase cells. Double localization
      of bromodeoxyuridine and RB protein in NPC cells and localization of RB protein
      in synchronized NPC cells in different phases of the cell cycle revealed random
      RB protein expression in each individual tumor cell. Co-localization of RB mRNA
      and RB protein in interphase cells showed a different degree of RB message
      expression in each cell. Low-salt hypotonic buffer could remove a fraction of RB
      protein from stained interphase nuclei. A similar finding with slight variations
      was observed in 16 other cancer cell lines. CONCLUSIONS: These data indicate that
      our NPC cell lines contain no obvious RB gene rearrangement, but each cancer cell
      may have an abnormal expression of RB mRNA and protein. This phenomenon may also
      be true in other cancer cell lines with a normal RB gene.

PMID- 1625450
TI  - Multiple sclerosis. Interactions between oligodendrocytes and hypertrophic
      astrocytes and their occurrence in other, nondemyelinating conditions.
AB  - BACKGROUND: The proliferation of oligodendrocytes and their association with
      hypertrophic astrocytes has been previously described in resolving multiple
      sclerosis (MS) lesions. EXPERIMENTAL DESIGN: Central nervous system lesions of
      different ages were examined from 9 cases of MS with clinical histories ranging
      from 8 weeks to 13 years and in a variety of non-MS conditions. RESULTS: In MS,
      these associations were found to occur most frequently in acute, actively
      demyelinating (as opposed to resolving) lesions. They also occurred, albeit
      rarely, in chronic active and chronic silent MS plaques and in areas showing
      remyelination or normal myelination adjacent to lesions. Immunocytochemistry
      revealed that the oligodendrocytes occurred in increased numbers and displayed
      enhanced reactivity for HNK-1, similar to previous studies that claimed such
      cells to be of recent origin. Ultrastructurally, hypertrophic astrocytes in the
      lesion center usually possessed no formed bundles of intermediate filaments, but
      rather displayed a finely granular cytoplasm. Towards the perimeter, they
      contained bundles of filaments and showed increased staining with anti-glial
      fibrillary acidic protein antibody. The interactions involved the close
      apposition to, and internalization of oligodendrocytes by astrocytes, between
      which membrane specializations occurred, suggestive of an adhesion event.
      Identical glial associations were also seen in various non-MS conditions. In most
      of the latter cases, there was evidence of central nervous system inflammation
      and/or destruction. CONCLUSIONS: These observations underscore the increased
      frequency of the glial cell phenomenon in active MS lesions, its ubiquity in
      diseases of different etiologies and the need for careful scrutiny of control
      central nervous system tissue in assessing the specificity of phenomena
      attributed to MS. It is suggested that these glial associations may represent a
      transient protective mechanism and may be related to local cytokine production.

PMID- 1625451
TI  - Hyponatremia: manifestations and treatment.
AB  - All hyponatremic states have in common elevation of vasopressin. Without this the
      loss of salt would be followed by appropriate diuresis and normonatremia. If
      hyponatremia is triggered by a volume change as in heart failure or portal
      cirrhosis not only is ADH released but the mechanisms that control salt retention
      create an essentially sodium free urine, always less than 20 mEq/L. If the
      initial event is inappropriate ADH secretion whether it be cerebral disease,
      neoplasm, a pulmonary lesion or a growing list of drugs; there is no related
      signal for salt retention and urine sodium and tonicity are high, the latter
      usually higher than that of plasma. If salt loss is due to intrinsic renal
      disease, diuretics, osmotic or otherwise, or adrenal failure urinary sodium is
      variable depending upon the magnitude of the response to volume of salt retaining
      factors. Because hyponatremia is often present with major illness and because
      more than one factor may be involved in its genesis, the establishment of its
      origin and appropriate treatment remain a diagnostic and therapeutic challenge.

PMID- 1625452
TI  - Medicine, illness, and creativity.

PMID- 1625453
TI  - Medical burnout.

PMID- 1625454
TI  - E-Speed dental film, time to take a new look?
AB  - Although various studies have indicated that there is no statistical difference
      in the diagnostic value between D- and E-speed films, and resolution and contrast
      were reported as being identical, the general acceptance of E-speed film has been
      slow. The dental profession is faced with a decision: Do we use the slower D
      speed film that might be more "cosmetic" in appearance or use E-speed that can
      reduce radiation by as much as 50 percent? Recent research has indicated that 85
      percent of parotid gland exposure is the result of dental radiography and carries
      an increased risk for meningiomas and tumors. It is the opinion of some that risk
      factors now dictate that only the fastest speed (E-speed) film should be
      used.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625455
TI  - Nifedipine-induced gingival hyperplasia.
AB  - Gingial hyperplasia is a complication which may be seen in a significant number
      of patients taking nifedipine (Procardia, Pfizer) a commonly used medication for
      cardiac vessel dilitation. This is a report of gingival changes in a 43-year-old
      hypertensive male who began using the calcium channel blocking agent during his
      active dental treatment. Gingival hyperplasia developed which was severe enough
      to alter the course of his dental treatment and prompt his changing to other
      medications to control his blood pressure. The recognition that the drug was
      responsible for the hyperplasia led to prompt and effective methods to resolve
      this problem.

PMID- 1625456
TI  - Management of penetrating injuries to the carotid artery.

PMID- 1625457
TI  - A woman with superior vena cava syndrome.

PMID- 1625458
TI  - The sympathy factor.

PMID- 1625459
TI  - Norplant.

PMID- 1625460
TI  - Patients/physicians disagree on definition of quality. TMA Communications and
      Public Service Committee.

PMID- 1625461
TI  - Hippocrates lives!

PMID- 1625462
TI  - Too grievous to bear.

PMID- 1625463
TI  - Ethics Committee shares ANA's statement on ethics and human rights.

PMID- 1625464
TI  - Hospice nursing care--comfort--sharing.

PMID- 1625465
TI  - Kentucky nurse testifies in Washington, D.C. Testimony on nursing education and
      research funding before the Labor, Health and Human Services, Education and
      Related Agencies Subcommittee of the House Appropriations Committee, April 28,
      1992.

PMID- 1625466
TI  - Chemical dependency: in the curriculum.

PMID- 1625467
TI  - In vitro culture of hematopoietic progenitors in the diagnosis of blood
      disorders.

PMID- 1625468
TI  - Phenotypic diversity and prognosis of adult T-cell leukemia.
AB  - We examined phenotypically 107 patients with adult T-cell leukemia (ATL), using a
      panel of monoclonal antibodies, in order to clarify the occurrence of aberrant
      phenotypes, and to determine the correlation between phenotypic diversity and
      prognosis. The incidence of the typical (CD4+.CD8-) phenotype, the double
      negative (CD4-.CD8-), the double-positive (CD4+.CD8+), and the CD8-positive (CD4
      .CD8+) phenotypes was 81%, 7%, 7%, and 4%, respectively. The median survival time
      (MST) for all patients was 10.0 months with 17% survival at 2 years. The patients
      with typical phenotypes had a 10.2 month MST with 20% survival at 2 years,
      significantly better than the patients with the unusual phenotypes whose MST were
      4.9, 7.8, and 2.6 months, respectively, for the double-negative, double-positive,
      and CD8-positive phenotypes. Lack of antigens reactive with CD2, CD3, CD5, and
      WT31 monoclonal antibody panels was one factor in bad prognosis, but the presence
      of CD4 and CD8 antigen abnormalities was much more significant.

PMID- 1625469
TI  - Monocytic differentiation induction of HL-60 cells by MC 903, a novel vitamin D
      analogue.
AB  - 1.25 (OH)2D3 is a potent inducer of differentiation of leukaemic cells into a
      monocytic direction. However, therapeutic application is difficult because of the
      development of hypercalcaemia. We examined a novel vitamin D analogue, MC 903,
      which is at least 100 times less effective on calcium metabolism in rats than
      1.25 (OH)2D3. Using the HL-60 cell line, differentiation was measured with a
      comprehensive panel of qualitative and quantitative parameters. Development of
      monocytic cells was shown morphologically, immunophenotypically and functionally
      by increased capability of reducing NBT (vs cultures without MC 903, p less than
      0.0001) and by qualitatively and quantitatively increased non-specific esterase
      activity. Furthermore, a concomitant decreased activity of myeloperoxidase and
      lactate dehydrogenase was noticed. In conclusion, MC 903 is a potent inducer of
      monocytic differentiation, comparable with 1.25 (OH)2D3 and will therefore be an
      interesting and potential therapeutic agent for studies in human acute leukaemia.

PMID- 1625470
TI  - Pyrene butanol--an efficient, selective and non-metabolized photosensitizing
      agent for human myeloid leukemia cells.
AB  - Methods for ex vivo purging of neoplastic cells from harvested marrow are being
      developed to increase the efficacy of autologous transplantation. One approach is
      selective photosensitization, using sensitizing compounds and light radiation.
      Pyrene-containing fatty acids and lipids are potent photosensitizers, e.g. 12-(1
      pyrene)dodecanoic acid (P12), is taken up preferentially by leukemic cells and
      undergo photoexcitation when exposed to long wave ultra-violet light, resulting
      in selective killing of leukemic cells. These compounds are incorporated into the
      neutral- and phospho-lipids of the cells. The presence of intracellular pyrene
      linked lipids might present a potential hazard in applying these agents for
      clinical use. We have, therefore, studied a series of other pyrene-linked
      compounds with the objective of finding a non-metabolizable photosensitizing
      agent that can be easily removed from the cells. In the present paper we report
      the results with pyrene butanol (P4-OH), a pyrene linked short-chain alcohol.
      When compared to P12, P4-OH was found to be taken up by cells most rapidly and
      reached saturation within minutes. It did not undergo any metabolism and washing
      the cells with serum-containing salt solutions removed practically all the P4-OH.
      This compound was found to be an efficient photosensitizer (in terms of
      concentrations and time of incubation with the cells) and selective to leukemic
      cells--it caused a 99% reduction in leukemic clonogenic cells under conditions
      that normal hemopoietic progenitors remained almost intact. These properties make
      P4-OH a potential photosensitizer for clinical application.

PMID- 1625471
TI  - Heterogeneity of acquired idiopathic sideroblastic anaemia (AISA).
AB  - Clinical, haematological and outcome data were studied in 84 patients with
      acquired idiopathic sideroblastic anaemia (AISA) from a registry of 613
      consecutive myelodysplastic syndromes (MDS) recorded by five institutions in
      western France. Two groups could be identified and compared: 'pure'
      erythroblastic AISA (AISA-E: 59 pts), and AISA with myelodysplastic features,
      i.e. dysgranulo and/or dysmegakaryopoiesis (AISA-M: 25 pts). Results were also
      compared to those of a series of 71 cases of refractory anaemia without
      sideroblastosis (RA) carried out from the same registry. Dyserythropoiesis was
      present in 90% of all AISA subtypes, dysgranulopoiesis in 88% of the AISA-M
      cases; dysmegakaryopoiesis was observed in 44% of AISA-M. Ten patients with both
      forms of AISA showed high platelet counts. These cases appeared particular in
      that four of them were associated with a splenomegaly and/or a hyperleucocytosis.
      They had to be distinguished from myeloproliferative syndromes. Outcome
      comparison of AISA-E with AISA-M showed a significant discrepancy of survival
      duration (60 vs 38 months respectively). Progression towards refractory anaemia
      with excess of blasts or acute leukaemia, was significantly higher for AISA-M
      than for AISA-E. The risk of transformation increased to 24% for the AISA-M group
      similarly to those of RA patients (17%). We conclude that AISA must be divided
      into two categories, 'pure' AISA and AISA-M, because survival duration and risk
      of transformation are different.

PMID- 1625472
TI  - VLA molecule expression may be involved in the release of acute myeloid leukaemic
      cells from the bone marrow.
AB  - Acute myeloid leukaemia (AML) cells have a variable capacity to egress from bone
      marrow into peripheral blood. This may be due to a variable lack of adhesion
      molecules on leukaemic cells. The expression of VLA1, 3, 4, 5, 6, beta 1-chain,
      LFA1, beta 2-chain, ICAM1 and NCAM appeared to be higher in bone marrow as
      compared to peripheral blood leukaemic cells, although this only reached
      significance for beta 1-chain (p less than 0.01). The number of cases with more
      than 20% positive cells in bone marrow leukaemic cells was lower in immature FAB
      subtypes (M1, M5a) as opposed to more mature subtypes (M2, M3, M4, M5b) for the
      adhesion molecules tested. This reached significance for VLA5 (p less than 0.05)
      and beta 1-chain (p less than 0.007), while there was trend for VLA4. It is
      discussed that VLA4 and 5 may play a role in the release of leukaemic cells from
      the bone marrow.

PMID- 1625473
TI  - Argininosuccinate synthetase gene expression in leukemias: potential diagnostic
      marker for blastic crisis of chronic myelocytic leukemia.
AB  - Argininosuccinate synthetase (ASS) activity is hardly detected in human
      lymphocytes. In this study, we examined the ASS gene expression of various
      leukemia cells by a polymerase-chain-reaction method. We demonstrate here that
      (a) acute lymphocytic and acute myelocytic leukemia cells exhibit the highly
      elevated expression of the ASS gene and (b) chronic myelocytic leukemia (CML) in
      blastic crisis also exhibits the increase of ASS gene expression while CML in
      chronic phase, chronic lymphocytic leukemia and adult T leukemia cells show the
      similar level to that of normal lymphocytes. These results suggest that the ASS
      gene expression is of value as a diagnostic marker of acute type leukemia,
      particularly for blastic crisis of CML.

PMID- 1625474
TI  - Analysis of mutations in the Gs protein alpha subunit gene in human leukaemia.
AB  - Mutations at codons 201 and 227 that cause oncogenic activation of the gene
      encoding the Gs alpha subunit protein occur in a subset of human solid tumours.
      To determine whether such oncogenic mutations occur in leukaemia we have analysed
      DNA from leukaemic cells from 59 patients representing a spectrum of acute and
      chronic leukaemia types by direct nucleotide sequence analysis of polymerase
      chain reaction (PCR) amplified DNA. No mutations were detected at oncogenic hot
      spots represented by codons 201 or 227, nor in any other codons extending from
      nucleotide position 196-230 in the Gs alpha subunit gene. This strongly suggests
      that this region of the Gs alpha gene is highly nonpolymorphic and that oncogenic
      mutations in this gene are unlikely to play a significant role in the
      pathogenesis of leukaemia.

PMID- 1625475
TI  - The linking of anticancer drugs, cell cycle blocks, and differentiation:
      implications in the search for antineoplastic drugs.
AB  - The quest for anticancer drugs has been primarily directed at agents that
      interfere with cell replication, yet the basis for drug-induced cytotoxicity
      remains unsolved. In our previous studies we noted a relationship between a
      mitotic block and commitment to terminal differentiation in the murine (Friend)
      erythroleukemia (FEL) cell. Since anticancer drugs are known to often block cell
      cycle transit typically in G2/mitosis, we tested a number of anticancer drugs
      with various modes of action and found that they all committed FEL cells to
      differentiate. Furthermore, other G2/mitosis-blocking drugs were also effective
      in inducing commitment. These results suggest (1) a causal relationship involving
      anticancer drugs, cell cycle block and differentiation, (2) that the search for
      new anticancer drugs utilize a differentiation assay and include G2/mitosis
      blocking agents.

PMID- 1625476
TI  - The combination of quercetin and cytosine arabinoside synergistically inhibits
      leukemic cell growth.
AB  - It has been demonstrated that quercetin (3,3',4',5,7-pentahydroxyflavone)
      inhibits the growth of several cancer cell lines and that the antiproliferative
      activity of this substance is probably mediated through a binding interaction
      with type II estrogen binding sites (type II EBS). The effect of quercetin and
      cytosine arabinoside (Ara-C) alone or in combination, was tested on HL-60 cell
      growth. Quercetin significantly synergized the inhibitory activity of Ara-C on HL
      60 cell growth while rutin, the 3-rhamnosylglucoside of quercetin, neither
      competed with [3H]estradiol for type II EBS nor was effective alone or in
      combination with Ara-C. Based on these results, we studied by a clonogenic assay
      the effect of quercetin and Ara-C alone and in combination on colony formation by
      human leukemic cells (CFU-L). In all cases both drugs exhibited a dose-related
      inhibition of CFU-L in a range of concentrations between 10 nM and 10 microM and
      0.01 nM and 10 microM for quercetin and Ara-C, respectively. The combination of
      the two drugs resulted in a synergistic inhibitory activity on CFU-L. Considering
      that plasma concentrations of quercetin effective in vitro were obtained in vivo
      without any apparent side effects, we conclude that this report represents
      further experimental evidence that quercetin could be used in the treatment of
      acute leukemias.

PMID- 1625477
TI  - Predicting remission outcome in acute non-lymphocytic leukemia: general
      principles and their application to residual marrow leukemia.
AB  - The objective of this paper is to demonstrate the importance of a rigorous and
      comprehensive evaluation of predictive tests in acute leukemia, especially when
      these may influence therapeutic decisions. To illustrate these issues, we have
      chosen an emerging test, early residual bone marrow leukemia, as the example and
      we have presented actual data from Leukemia Intergroup Studies of adults with
      first relapse acute non-lymphocytic leukemia induced with high-dose cytosine
      arabinoside. We show how the choice of a suitable cut-off value to discriminate
      between patients predicted to have different remission rates is influenced by
      several variables including the reasons for remission failure, the estimated
      efficacy and toxicity of the intervention to be employed, and considerations of
      resource utilization. We suggest that before applying a new predictive test in
      practice, clinicians should carefully evaluate its performance, and the
      consequences of its use in their own clinical settings.

PMID- 1625478
TI  - Emergence of myeloid stem cell line from T-lymphoid blastic phase of chronic
      myeloid leukemia in culture.
AB  - A new cell line designated JA-CML was derived from the peripheral blood of a
      patient with blastic phase CML. Sequential evolution of phenotypic and genetic
      markers was demonstrated during adaptation from primary to continuous culture in
      vitro. In the primary sample the majority of blast cells displayed the early T
      cell markers, CD7, HLA-DR, and TdT, but were negative for the common ALL antigen
      (CALLA), CD4 and CD8. Simultaneously, unstimulated metaphase cells showed great
      karyotypic variation with a range of 43-46 chromosomes per cell. Clonal changes
      included the Ph chromosome t(9;22), loss of the Y and gain of several altered
      chromosomes. The cells grew slowly in suspension during the first 10 weeks of
      culture. During that time, cells still expressed the CD7 and HLA-DR antigens.
      Karyotypic analysis at ten weeks showed a pattern of 46,X,-Y,t(9;22),+8 in more
      than 90% of metaphases with disappearance of all other abnormal chromosomes noted
      in the original sample. A tetraploid subline exhibiting duplication of most
      chromosomes, including the Ph, comprised the remaining metaphases. Upon further
      cultivation in vitro, the cells transformed spontaneously over a period of
      several weeks, from T-lymphoid into myeloid cells. Expression of CD7 was lost,
      but reactivities with monoclonal antibodies to CD34, CD33 and CD13 were newly
      acquired. The karyotype was hypertriploid and all cells carried two copies of
      t(9;22) and lacked normal copies of No. 9 or Y. The cells have since maintained
      stable cytogenetic and phenotypic profiles. Molecular rearrangement of the
      breakpoint cluster region was identified in the primary blasts and the
      established line and T-cell receptor gene rearrangements were not found. These
      observations suggest that the leukemic blast arose from primitive stem cells, not
      irreversibly committed T cells, and that these stem cells retained the capacity
      to differentiate along the myeloid pathway.

PMID- 1625479
TI  - In vitro suspension culture reactions to 1,25 dihydroxyvitamin D3 in relation to
      bone marrow morphology and prognosis in patients with myelodysplastic syndromes.
AB  - Thirty-four patients with MDS or AML following MDS were studied with regard to
      survival, peripheral blood values and bone marrow morphology. The effects of 1,25
      dihydroxyvitamin D3 (D3) on differentiation (NBT positivity) and proliferation
      (3H-thymidine incorporation) were studied in suspension cultures of bone marrow
      cells. Twelve bone marrow donors served as controls. Normal cells showed
      spontaneous differentiation in vitro, but only 2/12 were induced to
      differentiation by D3. Myelodysplastic cells did not differentiate spontaneously,
      but cells from 18/34 patients differentiated after incubation with D3. Normal
      cells showed increased proliferation, myelodysplastic cells showed a
      heterogeneous response and leukemic cells reacted with decreased proliferation
      after D3 incubation. Poor survival was associated with low platelet counts, high
      percentage of bone marrow blasts (BM blast %), low spontaneous in vitro
      proliferation and absence of hypogranulation of myeloid cells. Platelet counts
      and hypogranulation retained their predictive value in a multi-variate analysis.
      Progression to AML was predicted by a high BM blast % and low scores for
      erythroid and total dysplasia. In conclusion, the pattern of in vitro
      proliferation showed prognostic value while the pattern of vitamin D3-induced
      differentiation failed to correlate to other parameters. An estimation of bone
      marrow dysplasia can be used to predict the development of AML. Our results add
      to the information about the biology of MDS and may be important for the
      evaluation of therapeutic trials.

PMID- 1625480
TI  - Four additional cases of trisomy 14 as the sole anomaly in various haematological
      malignancies.
AB  - We report on four cases of trisomy 14 as the sole anomaly. Three cases were
      myelodysplastic syndromes and one was a non-Hodgkin's lymphoma. This anomaly is
      mainly in myeloid disorders and still remains to be well documented. On the other
      hand, we show this anomaly to be also a non-random anomaly in lymphoproliferative
      disorders.

PMID- 1625481
TI  - Inversion of chromosome 3 (q21; q26) in a case of secondary acute leukaemia with
      thrombocythaemia.

PMID- 1625482
TI  - Sensitivity of flow cytometry.

PMID- 1625483
TI  - Bone marrow transplants for chronic lymphocytic leukaemia.

PMID- 1625484
TI  - SCL gene in human tumors.
AB  - The SCL gene encodes a member of the helix-loop-helix (HLH) family of
      transcription factors and is reportedly involved in up to 25% of T-cell acute
      lymphoblastic leukemia (T-ALL). We have surveyed over 120 primary human tumors
      including melanomas, myeloid, and lymphoid leukemias, and other solid tumors
      without evidence of rearrangements involving SCL. These results are further
      supported by low level expression of SCL in these tumors (as assessed by a
      polymerase chain-reaction-based method). We conclude that
      rearrangement/translocation with subsequent activation of SCL occurs infrequently
      in myeloid leukemias and melanomas.

PMID- 1625485
TI  - Comparison of the effects of all-trans and cis-retinoic acid on the blast stem
      cells of acute myeloblastic leukemia in culture.
AB  - Recent work has shown that acute promyelocytic leukemia (APL) cells have a
      characteristic translocation involving the retinoic acid receptor on chromosome
      17 and the myl protein on chromosome 15. Patients with APL respond to the
      administration of all-trans-retinoic acid. A cell line with t15;17 (NB4) has
      recently been reported; this line responds to all-trans-retinoic acid with
      differentiation. There is also a recent report showing that all-trans-retinoic
      acid is more active than cis-retinoic acid in inducing differentiation in freshly
      obtained APL cells. All-trans-retinoic and cis-retinoic acid are compared for
      their effects on growth in culture of freshly obtained AML cells, cell lines
      without t15;17, and NB4 cells. While all of these AML populations responded to
      both forms of retinoic acid, NB4 cells only were much more sensitive to all-trans
      retinoic acid compared to cis-retinoic acid. The difference was seen when the NB4
      cells were exposed in suspension and not when colony-formation in methylcellulose
      was used as an end point. Both forms of retinoic acid increased the sensitivity
      of blast cells to cytosine arabinoside; for NB4 cells, the sensitization was much
      greater when all-trans-retinoic acid was used rather than cis-retinoic acid. We
      conclude that the increased effects of all-trans-retinoic acid are specific for
      APL cells, and that a major effect of retinoic acid is on blast stem cell self
      renewal.

PMID- 1625486
TI  - B-chronic lymphocytic leukemia cells contain both endogenous kappa immunoglobulin
      mRNA and critical immunoglobulin gene activation transcription factors.
AB  - B-cell chronic lymphocytic leukemia (B-CLL) is a hematologic malignancy
      characterized by the proliferation and accumulation of mature-looking B
      lymphocytes. Patients with B-CLL exhibit a number of immune defects including:
      auto-antibodies, depressed cell-mediated immunity and hypogammaglobulinemia (HG).
      We investigated the control of Ig production in the malignant CLL B-cell at a
      transcriptional and translation level. We isolated fresh leukemic B-cells from
      CLL patients and analyzed for the presence of nuclear factors OCT-1, OCT-2, and
      NF-KB. Malignant B-cells were purified to greater than 90% B-cells, and total
      cellular RNA and nuclear proteins were isolated from these cells. Mobility shift
      assays were probed with 32P-labeled oligonucleotides specific to the
      immunoglobulin (Ig) enhancer and promotor regions. We detected endogenous OCT-1,
      OCT-2, and NF-KB in all patients tested (n = 5). We then evaluated whether
      activation of CLL B cells could augment kappa-mRNA levels. CLL cells (n = 3)
      exposed to phorbol ester and A23187 were harvested at 0, 2, 4, 8, and 48 min and
      examined for kappa-mRNA by Northern blot. All CLL patients (n = 3) had easily
      detectable levels of endogenous kappa-mRNA. However, only one patient had an
      obvious increase in kappa-mRNA post-induction with TPA/A23187. There was no
      concomitant increase in this patient's OCT-1, OCT-2, or NF-KB level. This finding
      prompted us to survey other B-CLL patients (n = 6) for Ig nuclear transcriptional
      factors pre- and post-induction. In summary, CLL B cells express Ig
      transcriptional factor OCT-1, OCT-2, and NF-KB constitutively. The endogenous
      level of NF-KB may account for the basal kappa-mRNA detected in B-CLL cells.
      However, the inability to augment NF-KB levels may, in part, explain the low
      levels of Ig synthesis in CLL B-cells.

PMID- 1625488
TI  - Partial characterization of a familial B lymphosarcoma with a thymic localization
      in cattle.
AB  - We recently described an original epidemiological form of bovine leukosis in
      cattle. In the young female offspring of one bull, more than 3% of animals
      developed a thymic lymphoblastic lymphosarcoma. Of these, 31 cases, together with
      a lymphoid cell line established from one of the tumours, were phenotypically
      characterized. Characterization was done using a large combination of well
      clustered monoclonal antibodies, and monoclonal antibodies prepared in our
      laboratory by immunizing mice either with bovine normal lymphocytes or with
      tumour thymic cells. The thymic tumours and the cell line did not express any T
      lymphoid antigens but they did express some B lymphoid markers. The phenotype of
      the tumour cells was CD45+/-, CD44+/- TdT+, class II-DR+/-, CD19+/-, CD21-, Ig-
      and HBM 57+ (recognizing the mb-1 chains of the B-cell receptor). The cell line
      expressed a more mature phenotype: TdT-, CD45-, CD44+, class II-DR+, CD19+,
      CD21+/- and sIgG+. These results allow us to consider these tumours as B-cell
      derived. These B lymphosarcomas with a thymic localization are reminiscent of a
      human mediastinal non-lymphoblastic lymphoma reported as a primary mediastinal
      clear cell lymphoma. The possibility of a thymic or extrathymic origin for this B
      lymphosarcoma is discussed.

PMID- 1625487
TI  - Initiation and promotion in radiation-induced myeloid leukemia.
AB  - Acute myelomonocytic leukemia develops in 10-30% of irradiated (300 rad) SJL/J
      mice, after a lag period of around one year. Additional treatment with
      dexamethasone shortly after irradiation increased leukemia incidence up to 50%.
      Experiments were conducted in order to demonstrate the existence of preleukemic
      cells in irradiated mice and to explore the possible role of dexamethasone,
      cyclophosphamide, and different hemopoietic growth factors on their promotion to
      overt leukemia. Transplantation of bone marrow cells from mice exposed to 300 rad
      plus dexamethasone into appropriate recipients, performed 4-5 months after
      leukemogenic treatment, resulted in acute myeloid leukemia (AML) development of
      donor origin in 70% of the recipients. Transfer of fractionated preleukemic bone
      marrow showed that the highest AML incidence developed in the recipients of
      fractions enriched in early hemopoietic precursors. The promoting effect of
      dexamethasone on preleukemic cells was confirmed by demonstrating its similar
      coleukemogenic effect whether administered within several hours or 130 days after
      radiation. Treatment with cyclophosphamide shortly after radiation could not
      replace the dexamethasone effect but was found to be complementary to the
      coleukemogenic effect of dexamethasone. Early administration of hemopoietic
      growth factors (starting 14 days after radiation and dexamethasone) showed that
      colony-stimulating factor (CSF) 1 increased the AML incidence (75%) and reduced
      its latency. Treatment with recombinant granulocyte-CSF (rG-CSF) had a reduced
      effect and recombinant granulocyte-macrophage CSF (rGM-CSF) had no promoting
      effect. However, administration of different factors several months after the
      leukemogenic treatment revealed that rGM-CSF increased AML incidence (75%) and
      shortened its latency, whereas rG-CSF and CSF-1 had no effect. In contrast, the
      late administration of recombinant interleukin 6 reduced AML incidence
      significantly (23%). The present results indicate that murine radiation induced
      AML is a multiphase process involving radiation induced preleukemia that can be
      promoted by different treatments.

PMID- 1625489
TI  - The non-random dic(9;12) translocation in acute lymphoblastic leukemia is
      associated with B-progenitor phenotype and an excellent prognosis.
AB  - A dicentric translocation involving the short arms (p) of chromosomes 9 and 12
      was identified in 15 of 2303 successfully banded cases of acute lymphoblastic
      leukemia (ALL) in children, consecutively entered on protocols of the Pediatric
      Oncology Group (1986-1990) or St Jude Children's Research Hospital (1984 and
      1990). The dic(9;12)(p1?1;p1?2) was seen only in patients with a B progenitor
      cell immunophenotype: the frequency was 0.8% among pre-B cases (4/508) and 0.9%
      (11/1177) among early pre-B cases. Laboratory and clinical characteristics were
      similar to those of the general population of children with ALL, with the
      exception of a marked male preponderance (12/15 cases). Flow cytometric studies
      revealed a leukemic cell DNA index of 1.0 in all cases. All fifteen patients are
      in continuous complete remission at a median follow-up duration of 57+ months
      (range 9-93+ months). These findings suggest that the dic(9;12) is a recurrent
      chromosomal translocation in pediatric ALL, occurs exclusively in B-progenitor
      ALL, and unlike other non-random translocations, is associated with an excellent
      prognosis.

PMID- 1625490
TI  - Late intensification with POMP chemotherapy prolongs survival in acute
      myelogenous leukemia--results of a Southwest Oncology Group study of rubidazone
      versus adriamycin for remission induction, prophylactic intrathecal therapy, late
      intensification, and levamisole maintenance.
AB  - Between August 1978 and September 1982, 642 patients with newly diagnosed acute
      myelogenous leukemia (AML) were entered onto a Southwest Oncology Group Study
      which addressed four questions. (i) What is the comparative utility of rubidazone
      versus adriamycin in remission induction? (ii) What is the role of prophylactic
      intrathecal therapy in AML? (iii) Does late intensification affect treatment
      outcome? (iv) Does maintenance with levamisole affect disease-free survival or
      overall survival? Among 611 evaluable patients, 329 (54%) achieved complete
      remission. There was no difference in the remission rate between those patients
      receiving rubidazone (54%) and those receiving adriamycin (54%) as part of the
      induction regimen. Prophylactic intrathecal therapy with cytosine arabinoside had
      no effect on the incidence of central nervous system disease or survival. After
      nine months of complete remission, patients were randomized between late
      intensification with POMP (mercaptopurine + vincristine + methotrexate +
      prednisone) or continued maintenance with OAP (vincristine + cytosine arabinoside
      + prednisone). T patients randomized to late intensification had better survival
      and disease-free survival, compared to those randomized to receive no late
      intensification (p = 0.027 and 0.030, respectively). At twelve months of
      remission, surviving patients were randomized to receive levamisole or no further
      treatment. There was no evidence that levamisole affected survival or disease
      free survival.

PMID- 1625491
TI  - Cytogenetic analysis of hemopoietic peripheral blood cells collected by
      leukapheresis after intensive chemotherapy in advanced phase Philadelphia
      positive chronic myelogenous leukemia.
AB  - Peripheral hemopoietic blood cells previously collected by leukapheresis were
      reinfused in advanced phase Philadelphia (Ph)-positive chronic myelogenous
      leukemic patients to promote the recovery of bone marrow function after intensive
      radiochemotherapy. Cytogenetic analysis was performed on these cells, induced to
      proliferate and to be mobilized by a first administration of marrow toxic drugs
      and collected when the white blood cell count was very low. In five patients only
      Ph-negative apparently normal cells were found. In five cases different
      proportions of Ph+/Ph- cells were observed and in the remaining five cases only
      Ph+ cells were present. Chromosomal abnormalities other than Ph, not detected in
      the cytogenetic analysis performed on bone marrow cells before chemotherapy
      treatment, were found in five cases. These findings confirm that Ph- cells can
      persist in the marrow of Ph+ patients in the advanced phase of disease and
      indicate that a high percentage of leukemic cells retain karyotype evolution not
      detectable using standard drawing and culture techniques.

PMID- 1625492
TI  - Cost of complete remission induction in acute myeloblastic leukemia: evaluation
      of the cost-effectiveness of a new drug.
AB  - The use of new drugs in the treatment of AML could dramatically increase the cost
      of induction chemotherapy. To evaluate the cost-effectiveness of such new drugs,
      the overall cost to achieve complete remission (CR) with treatments including
      these drugs has to be compared to the cost of the daunorubicin-cytosine
      arabinoside (DNR-AraC) association, considered as the reference treatment. A
      retrospective analysis of charts from 15 patients treated with DNR-AraC was used
      to identify 228 items of cost, including general cost, diagnostic, supportive
      care, and chemotherapy. Eleven patients underwent CR after one course of
      chemotherapy for a cost of US$16,701 +/- 4451, and four patients achieved CR
      after two courses for a cost of US$37,130 +/- 4923. The chemotherapy represented
      only 1.4% of the total cost, supportive care 25% and general cost 56%. According
      to these data, the projective cost of a treatment with mitoxantrone instead of
      DNR was simulated in 40 untreated patients with AML. The better rate of CR
      obtained after one course of chemotherapy leads to a saving of 9% (US$1261) per
      patient, despite the higher cost of chemotherapy. Cost-effectiveness evaluation
      should be included in the clinical study of trials with new drugs.

PMID- 1625493
TI  - Molecular analysis of Philadelphia-positive childhood chronic myeloid leukemia.
AB  - The breakpoints in chromosome 22 were determined in five children with
      Philadelphia-positive chronic myeloid leukemia. All had rearrangements within the
      major breakpoint cluster region (M-bcr). Four patients had breakpoints in the 5'
      region of M-bcr (zones 1-3), whereas one had a rearrangement in the 3' region
      (zone 4). The patient with the 3' rearrangement was the only one to develop a
      lymphoid blast crisis; he also had a substantially longer survival (102 months)
      than the others (11-54 months).

PMID- 1625494
TI  - Selective toxicity of ethacrynic acid towards lymphocytes of chronic lymphocytic
      leukemia in vitro.
AB  - We have used the MTT colorimetric assay to determine the sensitivity to
      ethacrynic acid of lymphocytes from normal donors and of peripheral blood cells
      from leukaemia patients. Whereas normal lymphocytes and cells from acute or
      chronic myeloid leukaemia showed similar sensitivities (median inhibitory dose,
      ID50 = 20-22 microM), lymphocytes from chronic lymphocytic leukaemia patients
      were much more sensitive (ID50 = 6 microM). This result was found irrespective of
      the assay duration.

PMID- 1625495
TI  - Haematopoietic stem cell lines activate novel enhancer-dependent expression of
      reporter DNA immediately after transfection by mechanisms involving interleukin 3
      and protein kinase C.
AB  - Approaches to analysing gene regulation in haematopoietic stem cells are limited
      by their low concentration and rapid cell death outside of a trophic marrow
      environment. We have used interleukin 3 (IL3)-dependent cell lines as stem-cell
      models to investigate gene regulation during signal transduction by growth
      factors. We report that expression of the bacterial chloramphenicol acetyl
      transferase reporter gene linked via the weak thymidine kinase promoter to known
      upstream enhancer regions required for expression of the proliferation-dependent
      proto-oncogene c-fos occurs almost immediately (within 2 h) after transfection.
      Expression is stimulated by IL3 or activation of protein kinase C. Our findings
      indicate that IL3-dependent cell lines possess an extremely rapid transcription
      mechanism for introduced DNA, which if also present in normal cells may be
      usefully used to analyse gene regulation during signal transduction leading to
      growth and differentiation by haematopoietic growth factors.

PMID- 1625496
TI  - Serum monocyte colony-stimulating factor, erythropoietin and interleukin-6 in
      relation to pancytopenia in hairy cell leukemia.
AB  - In patients with hairy cell leukemia (HCL), we measured serum levels of monocyte
      colony-stimulating factor (M-CSF), interleukin-6 (IL-6), and erythropoietin
      during various degrees of pancytopenia characteristic for this disease. Serial
      sera from 12 HCL patients during various stages of the disease were analyzed. No
      correlation was found between the levels of M-CSF or IL-6 and the numbers of
      circulating monocytes or platelets, normal values of M-CSF (4 to 10 mg/l), and IL
      6 (3-50 U/ml) being detected during all stages of the disease. In contrast,
      erythropoietin levels were inversely related with the hemoglobin concentration (r
      = -0.79), indicating the presence of a normal feedback mechanism for this factor
      in patients with HCL.

PMID- 1625497
TI  - Transient cytogenetic relapse in a Ph1-positive chronic myelogenous leukemia
      patient previously treated with alpha-interferon.
AB  - Therapy with alpha-interferon (IFN alpha) can suppress the Ph1-positive
      hemopoiesis in a percentage of patients with chronic myelogenous leukemia (CML).
      We used IFN alpha to treat a 30-year-old CML patient, characterized by favourable
      prognostic signs (such as low leukocytosis, absence of splenomegaly and no
      increase in bone marrow blasts) at diagnosis, and obtained a complete remission,
      as evaluated by Southern blot and cytogenetic analysis, after one year of
      treatment. However, the polymerase chain reaction (PCR) revealed the persistence
      of a minimal residual disease. The IFN alpha therapy was stopped and the
      hematological status remained stable until eighteen months later, when a
      cytogenetic analysis revealed the appearance of a clone characterized by t(9;22)
      and trisomy 8, accounting for 30% of bone marrow metaphases. This cell population
      spontaneously regressed in the following months, before any cytotoxic treatment.
      However, as leukemic cells, detected by PCR, were still present, the patient
      received a high dose chemotherapy, which induced the complete eradication of the
      Ph1-positive clone, as demonstrated by the absence of bcr-abl transcript at the
      PCR reaction. Molecular and cytogenetic remission persist one year later, without
      any further therapy.

PMID- 1625499
TI  - Early afterdepolarization in myocardium and its clinical implications.

PMID- 1625498
TI  - Monosomy 7 and unbalanced t(1;7) in an adolescent boy with myelodysplastic
      syndrome.
AB  - Monosomy 7 occurs in approximately 5% of cases of myelodysplastic syndrome (MDS)
      in children and is associated with a poor prognosis. The unbalanced translocation
      t(1;7) is common in therapy-related MDS in adults but is extremely rare in
      children, with only three cases reported to date. We describe a pediatric case of
      MDS with the unusual combination of monosomy 7 and unbalanced t(1;7) in two
      distinct clones. Both clones were detected at diagnosis and have persisted
      throughout the course of MDS in this patient, a 16-year-old boy without prior
      exposure to known mutagens. Because of recurrent severe infections associated
      with neutropenia, he was treated with recombinant human granulocyte-macrophage
      colony-stimulating factor. This therapy improved the neutrophil count but did not
      alter the karyotype or the progression of disease.

PMID- 1625500
TI  - Time-dependence of inducible ventricular tachycardia in a chronic canine model.
AB  - The natural history of inducible ventricular tachycardia in post-infarction dogs
      was followed with serial programmed electrical stimulation (PES: 1-3
      extrastimuli, 4 msec duration, 2 x diastolic threshold). Arrhythmia inducibility
      was defined as a minimum of four unstimulated ventricular ectopic beats. Of 119
      dogs prepared for chronic electrophysiological study, 87 (73.1%) were ambulant 24
      hours after surgery. Mean infarct size was 11.1 +/- 1.5% of left ventricular (LV)
      mass for animals dying in the first week, before stimulation. 92.4% of 66 animals
      were inducible when stimulated at one week, 66.7% at two weeks and 64.3% and
      55.6% at the third and fourth weeks respectively (p less than 0.01, Chi-square
      analysis). Infarct sizes fell from 7.0 +/- 0.5% LV mass at first stimulation to
      4.6 +/- 0.8% at third stimulation and could not be visualized thereafter (p less
      than 0.01,ANOVA). There was no statistical difference between infarct sizes for
      inducible and non-inducible animals, but in both cases infarcts were smaller (p
      less than 0.01) than for those animals which died suddenly during the first week.
      This time-dependent decrease in arrhythmia inducibility, which may be related to
      infarct size, should be considered when similar models are employed for chronic
      electrophysiological studies.

PMID- 1625501
TI  - Effect of a new antiarrhythmic BK 129 on canine vascular smooth muscle in vitro.
AB  - The effect of a new carbanilate derivative BK 129, 1-methoxymethyl-2(1
      perhydroazepinyl)ethyl ester 2-(n)-pentyloxycarbanilic acid hydrochloride, was
      tested on preparations of canine dorsal pedal and coronary artery in vitro. The
      drug produced relaxation of arterial rings both under resting conditions and
      under precontraction with KCl. BK 129, at a concentration of 10(-5) mol/l,
      produced a shift to the right of the concentration-response curve of
      phenylephrine, with a decrease in the slope and a depression of the maximal
      response. BK 129 inhibited the response to norepinephrine and blocked histamine-
      and norepinephrine-induced contractions in Ca(2+)-free physiological salt
      solution. The electrical stimulation-induced contractions of arterial preparation
      were also inhibited. BK 129 shifted the concentration-response curve of CaCl2 in
      Ca(2+)-free depolarizing solution to the right in a non-competitive manner. It
      may be concluded that BK 129 is a local anesthetic which possesses relaxant
      properties. It appears to inhibit Ca2+ entry into the smooth muscle cell and Ca2+
      release from sarcoplasmic reticulum.

PMID- 1625502
TI  - Selectivity of a CaCl2 continuous infusion screening method in rats.
AB  - In albino rats the combined use of two methods based on a continuous perfusion of
      aconitine nitrate (0.15 mg/ml) or calcium chloride (0.4 M) demonstrated the
      selectivity of the calcium chloride-induced dysrhythmias model. This rapid
      screening was carried out with antidysrhythmic agents according to the Vaughan
      Williams's classification (1): quinidine (class I) 5 mg/kg; atenolol (class II) 2
      mg/kg; amiodarone (class III) 10 mg/kg and verapamil (class IV) 2 mg/kg. A
      compound synthesized in our laboratory was used to verify model selectivity.

PMID- 1625503
TI  - Effects of amiodarone on the pharmacokinetics and toxicity of digoxin in
      laboratory animals.
AB  - Some pharmacokinetic interactions between digoxin and amiodarone were studied in
      experiments on rabbits. An increase of digoxin serum levels was established in
      amiodarone-treated rabbits (amiodarone 30 mg/kg s.c. for five days alone or
      together with digoxin). The calculated elimination half-life (t 1/2) and the area
      under the curve (AUC) of digoxin were increased and the digoxin clearance was
      decreased, being most pronounced in animals receiving amiodarone-digoxin
      combination for five days. There were no changes either in digoxin toxicity in
      amiodarone-treated guinea pigs or in serum levels of T4, T3 and TTH. The possible
      mechanisms of digoxin-amiodarone interactions are discussed.

PMID- 1625504
TI  - Omeprazole-induced changes in gastric mucus secretion.
AB  - The influence of omeprazole treatment on gastric mucus secretion in man was
      examined in two separate studies. 24 outpatients with endoscopic duodenitis but
      normal gastric mucosa were treated under double-blind conditions with either
      omeprazole 20 mg o.m. or placebo for four weeks. Omeprazole was found to induce a
      significant reduction (p less than 0.001) in the amount of neutral and total
      mucoproteins into the gastric juice and in the viscous and protective properties
      of mucus as assessed by a Mucoprotective Index. In a subsequent study 12
      omeprazole-treated patients were re-examined either 10 days (6 patients) or 15
      days (6 patients) after the drug withdrawal. A trend towards normalization of
      mucus secretion was detectable already after 10 days, but only at 15 days did
      gastric mucus fully revert to normal. The results suggest that the decrease in
      the quantity and quality of mucus secretion observed with omeprazole is a
      transient phenomenon, secondary to the sustained acid suppression induced by the
      drug and clinically irrelevant.

PMID- 1625505
TI  - Dialysability of dimethindene maleate (Fenistil) from blood after intravenous
      injection.
AB  - Dimethindene, an antihistaminic drug, is the treatment of choice in dialysis
      patients suffering from skin itching. During hemodialysis procedures not only
      toxic metabolites, but also drugs are extracted from plasma. To answer the
      question if dimethindene is dialyzable from plasma, three healthy male volunteers
      received 4 mg of dimethindene solution intravenously. Ten minutes later 100 ml
      cubital vein blood was taken and 25,000 I.E. Liquemine was added. Plasma was
      separated and pumped through a cuprophan hollow fiber dialyzing module with an
      effective surface of 35 cm2. In periods of ten minutes samples of plasma and
      dialysate were taken to analyze their dimetindene concentrations. A mean
      clearance of 38 ml/min*m2, SD 10.2 and coefficient of variation [%] 26.8 was
      found. This is comparable to the well known clearance of theophylline, so it can
      be considered that dimethindene is eliminated from plasma during hemodialysis
      procedures.

PMID- 1625506
TI  - Intracerebroventricular endothelin-1 (ET-1) produces Ca(2+)-mediated
      antinociception in mice.
AB  - Intracerebroventricular (i.c.v.) administration of endothelin-1 (ET-1) at doses
      of 0.313, 0.625, 1.25, 2.5 and 5 pmol/mouse produced a strong antinociceptive
      effect as evaluated by hot plate method in mice. The effect was dose-dependent
      and lasted for more than 120 min. The opioid receptor antagonist naloxone did not
      antagonize, and the cyclooxygenase inhibitors indomethacin and diclofenac
      slightly inhibited the ET-1 effect. The calcium overload blocker cinnarizine
      antagonized the antinociceptive effect of ET-1, suggesting that the ET-1 effect
      might be Ca(2+)-mediated.

PMID- 1625507
TI  - [Comparative studies of preventive antibiotic administration in ERCP].
AB  - In a nonblind nonrandomized clinical trial two groups of patients who were
      undergoing ERCP - A (n = 182) with antibiotic prophylaxis and B (n = 220) without
      an antibiotic--were compared on a prospective basis. The efficacy of properly
      timed prophylaxis with a therapeutically effective antibiotic had previously been
      established by a pilot study and a definitive trial based on HPLC assays of
      endoscopic biopsy specimens taken from the duodenal papilla. In Group A (n = 182)
      there was hyperamylasaemia without a leucocytic reaction in only 18 (14.75%) of
      the ERP patients and two (3.33%) of the ERC patients, but in Group B (no
      antibiotic - n = 220) this change was detected in 48 (35.29%) of the ERP patients
      and 12 (14.28%) of the ERC patients (P = 0.00018 and 0.043 respectively).
      Hyperamylasaemia with a leucocytic reaction occurred in only one patient with ERP
      from Group A (0.82%) as compared with 15 patients (11.02%) from the untreated
      group (P = 0.00047). These results were highly significant. There were three
      cases of subclinical pancreatitis and two of acute pancreatitis--all of them in
      the control group. Although these results were not statistically significant
      (because the number of cases was too small), they are clearly consistent with the
      growing tendency towards using antibiotic cover. On the basis of these results we
      regard antibiotic prophylaxis during ERCP as a sensible precaution, and in
      patients with any concurrent disease which heightens the risk it is essential.

PMID- 1625508
TI  - [Preoperative hemodilution before elective resections of colorectal cancers for
      sparing homologous blood transfusion].
AB  - The records of 389 patients following elective resection of colorectal carcinoma
      were analysed in order to examine perioperative transfusion. Preoperative
      hemoglobin levels of 12.8 g/dl in women and 14.2 g/dl in men were found (p less
      than 0.01). Only 11% of the patients had an anemia. Increasing age and sex had
      both a significant relation to decreasing preoperative hemoglobin level and
      higher frequency of transfusion (p less than 0.01). Women got perioperative more
      often blood transfusion (84.4%). On an average 2.1 units of blood were
      transfused. There were no relation to tumor stage or tumor location be found (p
      greater than 0.01). 48.8% of the patients had attendant diseases. Cardiac
      insufficiency and pulmonary diseases became more frequent. Excluding all patients
      with contraindication to preoperative hemodilution it was possible to do
      preoperative hemodilution by 61.2% of the patients. In conclusion preoperative
      hemodilution should be done before elective resection of colorectal cancer if
      there was no contraindications to reduce the number of autologous blood
      transfusion.

PMID- 1625509
TI  - [Improved treatment results in advanced gallbladder and bile duct cancer by
      postoperative combined radiotherapy].
AB  - From 1984 to 1990 38 patients had an operation for carcinoma of the gallbladder
      and bile ducts. The unfavorable prognosis of this type of cancer was improved by
      a combined treatment, consisting of surgical tumor reduction and implantation of
      a transhepatic drainage, followed by external radiation and intracatheter
      brachytherapy. Nine patients were treated in this manner, seven died 6-67 months
      after operation, two are still alive 7 and 13 months postoperatively.

PMID- 1625510
TI  - [Chronic reflux esophagitis with endobrachyesophagus and multifocal
      adenocarcinoma].
AB  - In approximately 10% of all cases of endobrachesophagus a malignant degeneration
      occurs. A frequent endoscopic and bioptic control of the endobrachesophagus is
      the prognostic decision in order for a developing adenocarcinom to be identified
      in the early stages. Our casuistry demonstrates the problematic nature of the
      diagnostic and therapy of a multifocal adenocarcinom in an endobrachesophagus.

PMID- 1625511
TI  - [Endometriosis of the terminal ileum--differential diagnosis of Crohn disease].
AB  - Ileocecal resection was performed in two female patients with stenosis of the
      terminal ileum. Histological findings confirmed the clinical diagnosis of Crohn's
      disease in the first case, although focal intestinal endometriosis was detected.
      The resection specimens of the other patient exclusively showed lesions of
      endometriosis extending from the subserosa to the mucosal tissue. Typical lesions
      of Crohn's disease were totally absent in this case. Although not very frequent,
      endometriosis is an important differential diagnosis of Crohn's disease in young
      females.

PMID- 1625512
TI  - [Helicobacter pylori spectrum: from gastritis to malignancy].

PMID- 1625513
TI  - [Risk of cancer in chronic inflammatory bowel diseases].
AB  - This article summarizes the data concerning cancer risk in chronic inflammatory
      bowel disease. Cancer risk of ulcerative colitis and Crohn's disease is highly
      dependent on the duration of the disease, extent of bowel inflammation, and
      probably also of the age at onset of the disease. Cancer development follows the
      dysplasia-carcinoma-sequence. Diagnosis of premalignant changes is the basis for
      follow-up studies in ulcerative colitis as suggested here.

PMID- 1625514
TI  - Pro- and anti-inflammatory properties of human recombinant IL-1 beta during
      experimental arthritis in rats: 1. Dependence on dose and severity threshold.
AB  - The effects of human recombinant interleukin-1 beta (HrIL-1 beta) were
      investigated in arthritic rats sensitized with type II collagen (CII) and muramyl
      dipeptide (MDP). When administered subcutaneously (sc) daily during established
      arthritis, low (0.02 micrograms) and medium (0.2 micrograms) HrIL-1 beta doses
      exerted paradoxical beneficial properties on paws with moderate and severe
      inflammation, respectively. In contrast, the highest dose (2 micrograms) had a
      pejorative effect on developing arthritis. In addition, HrIL-1 beta attenuated
      paw volume and deterioration of the joints as assessed radiologically. Hence, paw
      inflammation response to IL-1 exposure depended on the dosage and the severity of
      previous arthritis prior to the IL-1 challenge. Some of these paradoxical
      activities may be due to the capacity of IL-1 to induce its own inhibitors or
      feedback loops thus counterbalancing its phlogistic properties.

PMID- 1625515
TI  - Failure of the gamma-aminobutyric acid (GABA) derivative, baclofen, to stimulate
      growth hormone secretion in heroin addicts.
AB  - In order to establish possible alterations in the gamma aminobutyric acid
      (GABA)ergic control of growth hormone (GH) secretion in heroin addicts, ten
      patients (age, 25.8 +/- 1.07 yr (mean +/- SE); duration of heroin addiction,
      range 3-8 yr; weight, 67.3 +/- 0.87 kg body weight), and ten age (29.1 +/- 0.84
      yr)- and weight (69.7 +/- 0.87 kg)-matched normal controls were tested with the
      GABAergic B-receptor agonist baclofen (10 mg p.o. at 09.00 h) (experimental test)
      or a placebo (control test). Blood samples for GH assay were taken every 15 min
      for the next 150 min. Normal controls underwent one control and one experimental
      test. Heroin addicts were submitted to both baclofen and placebo test twice, once
      around the time of their admission to a recovery community for drug abusers, when
      they were still assuming heroin, and again after two months of permanence in the
      community. From the time of their admission to the community, the patients were
      forbidden to use heroin. For two weeks after admission they were treated with
      clonidine and acetylsalicilic acid to attenuate withdrawal symptoms. Thereafter,
      the patients underwent a period of wash-out of pharmacological treatments for at
      least 6 weeks before being retested. Basal GH levels were similar in normal
      controls and heroin addicts in all tests and remained unmodified during control
      tests in all subjects. The administration of baclofen increased four times the
      serum GH levels within 120 minutes in the normal controls, whereas it did not
      modify serum GH concentrations in heroin addicts either during the period of drug
      abuse or after two months of abstinence. These data show that the control of GH
      secretion mediated by GABAergic B-receptors is impaired in heroin addicts. It is
      hypothesized that this neuroendocrine alteration might represent a trait marker
      of heroin addiction, or more likely, that it was a consequence of a long
      addiction to heroin persisting after two months of abstinence.

PMID- 1625516
TI  - Recombinant human superoxide dismutase can attenuate ischemic neuronal damage in
      gerbils.
AB  - The effects of recombinant human superoxide dismutase (r-hSOD) on ischemic
      neuronal injury were examined. Cerebral ischemia was produced in Mongolian
      gerbils by occluding bilateral common carotid arteries for 5 min. Preischemic
      treatment with r-hSOD clearly reduced hippocampal neuronal damages while
      postischemic treatment did not. This result suggests that oxygen free radicals
      play an important role in selective vulnerability to ischemia and r-hSOD has a
      potential clinical usefulness against cerebral ischemia.

PMID- 1625517
TI  - One brief exposure to a psychological stressor induces long-lasting, time
      dependent sensitization of both the cataleptic and neurochemical responses to
      haloperidol.
AB  - Rats were exposed for 10 minutes to one of several enclosures graded in novelty.
      In one experiment they were then simply sacrificed and plasma corticosterone
      determinations made in order to obtain an index of the relative stressfulness of
      these enclosures. In a second experiment the animals received haloperidol and
      were tested for catalepsy, 2 hours or two weeks following the novel experience.
      The most novel experience, exposure to a black box, resulted in the highest
      corticosterone levels and was the only one of our pre-treatments to induce
      significant enhancement of catalepsy as well as alteration of nucleus accumbens
      dopamine levels, 2 weeks--but not 2 hours--later. These findings indicate that
      brief exposure of adult animals to a psychological stressor can induce a long
      term alteration in both behavioral and neurochemical responses to a drug and that
      this effect requires a minimum level of stress to get started and once triggered
      gets stronger with the passage of time.

PMID- 1625518
TI  - Effects of vinconate on spatial learning impairments induced by medial septal
      lesion in rats.
AB  - We investigated the effects of vinconate, a novel vinca alkaloid, on spatial
      learning deficits induced by medial septal (MS) lesion in rats. MS lesion was
      produced by passing an anodal DC current. In vehicle-treated MS-lesioned rats
      impairment of spatial learning was observed, shown by a decrease in correct
      choices and an increase in total errors during training in a radial arm maze
      task. Vinconate (10 mg/kg) treatment alleviated the decrease in correct choices
      and the increase in total errors induced by MS lesion. Vinconate (5 and 10 mg/kg)
      treatment showed a tendency to reverse the decrease in choline acetyltransferase
      activity in the hippocampus caused by MS lesion. The present study suggests that
      vinconate has an anti-amnesic effect on MS lesion-induced amnesia by ameliorating
      the dysfunction in cholinergic (ACh) neurons.

PMID- 1625519
TI  - The effect of opiate agonists and antagonists on Na(+)-Ca2+ exchange in cardiac
      sarcolemma vesicles.
AB  - Opiate agonists and antagonists inhibit Na(+)-Ca2+ exchange in the isolated
      cardiac sarcolemma vesicles. Non-opioid stereoisomers (dextrorphan, Mr 1542MS,
      WIN 44,441-3) display effects similar to their opioid isomers (levorphanol, Mr
      1543MS, WIN 44,441-2) suggesting that inhibition is not mediated by opiate
      receptors. Naloxone (permeable) and methylnaloxone (impermeable) inhibit the
      Na(+)-Ca2+ exchange similarly, suggesting an extravesicular location of
      inhibitory site. The inhibitory potency of naloxone is pH-independent in the
      range of 7.4-9.1, suggesting that the charge-carrying properties of drug-protein
      interactions are not altered under the tested conditions. Opiates display similar
      dose-response relationships for Na(+)-Ca2+ exchange and its partial reaction, the
      Ca(2+)-Ca2+ exchange. The opiate-induced inhibition is complete and
      noncompetitive in regard to extravesicular calcium. These data suggest that
      opiates do not bind to the Ca(2+)-binding domain (A-site), but they may interest
      either with the Na(+)-binding site (B-site) or with a putative opiate-binding
      site, presumably located outside of the ion-binding vicinity. Further studies on
      structure-activity relationship might lead to the discovery of potent and more
      specific inhibitors of cardiac Na(+)-Ca2+ exchanger. A possible relevance of
      these findings to some non-opioid pharmacological effects of naloxone on the
      cardiac muscle is suggested.

PMID- 1625520
TI  - Arginine-vasopressin fragment 4-9 stimulates the acetylcholine release in
      hippocampus of freely-moving rats.
AB  - We examined the effects of arginine-vasopressin (AVP) C-terminal fragment 4-9,
      which facilitates learning and memory, on the extracellular acetylcholine (ACh)
      release in hippocampus of freely-moving rats using the microdialysis technique.
      Following administration of AVP4-9, p-Glu-Asn-Cys[Cys]-Pro-Arg-Gly-NH2, through
      the dialysis probe into the hippocampus, ACh levels in dialysates from the
      hippocampus increased markedly in dose and time dependent manner at 2-2.5 and 2.5
      3 hr. AVP1-9, the parent peptide, has a similar enhancing effect on ACh release
      as AVP4-9. Stimulated ACh release by AVP4-9 was significantly inhibited by V1
      selective receptor antagonist ([1-(beta-mercapto-beta,beta
      cyclopentamethylenepropionic acid), 2-(O-methyl)-tyrosine]AVP), but not by V2
      selective antagonist ([1-(beta-mercapto-beta,beta-cyclopentamethylenepropionic
      acid), 2-D-Ile, 4-Ile]AVP). From these observations, it is demonstrated that AVP4
      9 stimulates the ACh release in rat hippocampus via mediating V1-like vasopressin
      receptors.

PMID- 1625521
TI  - Effects of haloperidol and prolactin secreting tumors on cerebrospinal fluid
      concentrations of prolactin in the female rat.
AB  - Studies were conducted to determine the effects of acute and chronic elevations
      in prolactin (PRL) secretion on serum and cerebrospinal fluid (CSF) PRL
      concentrations in the female rat. Young female rats showed a dose-dependent
      increase in serum and CSF PRL in response to haloperidol. A time-course
      evaluation of serum and CSF PRL levels after haloperidol indicated that serum PRL
      concentrations increased markedly by 30 min and declined thereafter; while CSF
      PRL increased more slowly, peaking at 2 to 8 h. In young rats with basal serum
      PRL levels, CSF PRL was maintained at 0.8 to 2.1% of serum PRL levels. During
      acute hyperprolactinemia, the CSF to serum PRL ratio increased to about 4%.
      During chronic severe hyperprolactinemia, induced by the growth of a MtT.W15
      tumor, CSF PRL concentrations increased to 75 ng/ml, but this represented only
      1.5% of serum PRL concentrations. Collectively, these data indicate that the
      blood-brain barrier effectively limits access to the brain of circulating PRL.

PMID- 1625522
TI  - Quantitative analysis of platelet-activating factor in rat brain.
AB  - Age-related decrease of the platelet-activating factor (PAF) content in rat brain
      was shown by a convenient method consisting of solid extraction of lipids with a
      Sep-Pak C-18 cartridge, lipid separation by HPLC and bioassay on rabbit
      platelets. This method was sufficiently sensitive to allow measurement of PAF in
      a single brain, and the recovery of PAF was quite high throughout the procedure.

PMID- 1625523
TI  - Effect of contraceptive treatment on thymic glucocorticoid receptors and hepatic
      microsomal enzyme system of adult rats.
AB  - Contraceptive steroid treatment accounted for about a 30 per cent decrease in the
      number of thymic glucocorticoid receptors of adult rats. Neonatal allylestrenol
      treatment had no influence on that treatment. The activity of the hepatic
      microsomal (PSMO) enzyme system was not changed by the contraceptive treatment.
      It appears that contraceptive treatment may account for overlaps on receptors in
      adulthood.

PMID- 1625524
TI  - The 5,7-DHT-induced anticonflict effect is dependent on intact adrenocortical
      function.
AB  - We have recently reported that the anxiolytic-like effect observed in rats
      severely depleted of brain serotonin (5-HT) by means of 5,7-DHT is indirect and
      probably involves the GABA(A)/benzodiazepine chloride ionophore receptor complex
      (GABAA/BDZ-RC). One tentative explanation for this effect considered the
      involvement of corticosteroids. In the present series of experiments we have
      therefore investigated the effect of adrenalectomy (ADX) on the 5,7-DHT-induced
      anxiolytic-like effect displayed by rats in Vogel's conflict test. ADX totally
      abolished the anticonflict effect of the 5,7-DHT lesion. Replacement treatment
      with corticosterone, but not with dexamethasone, reinstated the anticonflict
      effect. These results indicate that an intact adrenocortical function, possibly
      via brain steroid type I receptors, is required for the expression of the 5,7-DHT
      induced anxiolytic-like effect. It is postulated that ADX lowers the
      concentration of endogenous positive modulators at the GABAA/BDZ-RC to a level no
      longer sufficient to produce anxiolytic-like effects in 5,7-DHT-lesioned animals.
      The finding that 5,7-DHT-lesioned animals were more sensitive than sham-lesioned
      controls to the anticonflict effect of the barbiturate-like corticosteroid THDOC
      provides further support for the contention that an increased endogenous activity
      at the GABAA/BDZ-RCes is involved in the anxiolytic-like effect observed in rats
      with a severe depletion of brain 5-HT.

PMID- 1625525
TI  - High affinity acylating antagonists for muscarinic receptors.
AB  - The muscarinic antagonists pirenzepine and telenzepine were derivatized as
      alkylamino derivatives at a site on the molecules corresponding to a region of
      bulk tolerance in receptor binding. The distal primary amino groups were coupled
      to the cross-linking reagent meta-phenylene diisothiocyanate, resulting in two
      isothiocyanate derivatives that were found to inhibit muscarinic receptors
      irreversibly and in a dose-dependent fashion. Preincubation of rat forebrain
      membranes with an isothiocyanate derivative followed by radioligand binding using
      [3H]N-methylscopolamine diminished the Bmax value, but did not affect the Kd
      value. The receptor binding site was not restored upon repeated washing,
      indicating that irreversible inhibition had occurred. IC50 values for the
      irreversible inhibition at rat forebrain muscarinic receptors were 0.15 nM and
      0.19 nM, for derivatives of pirenzepine and telenzepine, respectively. The
      isothiocyanate derivative of pirenzepine was non-selective as an irreversible
      muscarinic inhibitor, and the corresponding derivative prepared from telenzepine
      was 5-fold selective for forebrain (mainly m1) vs. heart (m2) muscarinic
      receptors.

PMID- 1625526
TI  - Influence of amygdala catecholamines on ovarian and adrenal medullary secretion.
AB  - The amygdaloid complex participates in the modulation of endocrine functions, and
      contains measurable amounts of noradrenaline (NA) and dopamine (DA). This study
      examined the contribution of the amygdaloid catecholaminergic systems to the
      regulation of the adrenal medulla and the ovary. To accomplish this the
      neurotoxin 6-hydroxydopamine (6-OHDA) was bilaterally injected into the
      basolateral nucleus of the amygdala (ABL) in cycling rats. The contents of NA and
      DA in right and left amygdala decreased significantly in lesioned animals with
      respect to sham lesioned animals, but hypothalamic levels were not different
      between groups. Administration of 6-OHDA to rats increased the NA, DA and
      adrenaline (A) contents of the adrenals compared to vehicle treated rats. In
      addition, lesioned animals showed a significant increase of NA and DA contents in
      the ovary, although A levels did not differ between groups. Serum oestradiol (O)
      concentrations were significantly lower in lesioned animals than in controls.
      These data suggest that the amygdaloid catecholaminergic systems exert an
      inhibitory effect on catecholamine content of the adrenals and the ovary, and
      influence the ovarian oestradiol secretion mechanism.

PMID- 1625527
TI  - Whole blood serotonin levels in chronic renal failure.
AB  - Whole blood serotonin levels were investigated in a control group (n = 35) and in
      a group of chronic renal failure patients (n = 127) on various treatment regimen
      i.e. conservative treatment (n = 39), maintenance haemodialysis (n = 35) and
      after renal transplantation (n = 53). The whole blood serotonin levels, as
      determined by high performance liquid chromatography, were significantly lower in
      the chronic renal failure patients than in the control group (p = 0.0001). Whole
      blood serotonin levels were significantly lower in the white subjects than in the
      black subjects of the study (p = 0.0001).

PMID- 1625528
TI  - Association of radiolabeled urogastrone binding with regenerating intestinal
      mucosa and epidermal growth factor/urogastrone producing organs in rat.
AB  - In the present study, we have tested the hypothesis that the regeneration of
      intestinal epithelium is regulated by changes in the uptake of radiolabeled
      recombinant human urogastrone (125I rhUG) in the regenerating mucosa and
      epidermal growth factor/urogastrone (EGF/URO) producing organs in the rats.
      Operations were performed on rats to approximate the ileal mucosa to the serosal
      surface of the cecum. This procedure allows the regeneration of ileal mucosa onto
      the serosal surface of the cecum. Groups of 5 rats were killed on the 2nd, 4th,
      8th and 12th post-operative days. Two hours before autopsy, rats were given 0.5
      ml (50 microCi with 30 micrograms protein) of 125I rhUG intravenously and the
      following tissues were removed: regenerating mucosa, salivary gland, duodenum,
      liver and kidney. Results indicated that the uptake of 125I rhUG was
      significantly greater in the salivary gland and duodenum on the 2nd post
      operative day which gradually tapered with increasing time after surgery. A
      similar pattern in the uptake of 125I rhUG was also evident in the regenerating
      mucosa. Further analysis revealed a significant correlation between the uptake of
      125I rhUG in the salivary gland and duodenum vs rate of epithelialization and
      uptake of 125I rhUG in the regenerative mucosa. These results suggested that the
      endogenous EGF/URO produced in the salivary gland and duodenum may be a factor in
      the regulation of intestinal regeneration; however, the mechanism responsible for
      reflex stimulation of EGF/URO production in these organs is not known.

PMID- 1625530
TI  - Professional courtesy: a bygone era.

PMID- 1625529
TI  - Trace dosages of the neurotoxins MPTP and MPP+ may affect brain dopamine in vivo.
AB  - The present study has examined the effects of systemically administered MPTP and
      MPP+ upon striatal DA and Dopac of C57 mice, also treated concurrently with
      either saline or reserpine. MPTP followed by saline did not affect DA level but
      decreased that of Dopac only at 5.0 mg/kg and higher dosages. The potency of MPTP
      affecting DA increased greatly when the neurotoxicant was followed by either 5.0
      or 10.0 mg/kg reserpine; MPTP at 0.10 mg/kg and higher dosages significantly
      reversed the DA depleting effects of reserpine. MPP+ (1.0 or 10.0 mg/kg) with
      saline did not affect either DA or Dopac. In contrast, MPP+ at 0.10 mg/kg and
      higher dosages, when followed by 10.0 mg/kg reserpine, dose-dependently enhanced
      the DA depleting effects of reserpine. In agreement with the earlier results
      obtained in vitro, the present study indicates that MPTP administration at trace
      level dosages may lead to an inhibition of MAO in vivo. The effect of
      systemically given MPP+ on DA, however, appears to be more complex in nature,
      conceivably comprised of actions at the striatal neurones including the
      intraneuronal vesicles and, possibly, at the substantia nigra which may affect
      striatum in turn. That MPP+ may have reached brain areas in these experiments is
      also indicated by the observation of a significant striatal level of 3H-MPP+
      after its systemic administration. In conclusion, irrespective of MPTP and MPP+
      action mechanisms, trace levels of these neurotoxicants appear to affect brain
      dopamine neurons.

PMID- 1625531
TI  - Lyme disease in Maryland: 1987-1990.
AB  - We describe the epidemiology of Lyme disease in Maryland for 1987 to 1990 when
      the number of cases reported grew from 23 to 448 and the number of cases meeting
      the CDC case definition grew from 23 to 238, as well as discuss the implications
      of increased reporting and diagnosis of Lyme disease.

PMID- 1625532
TI  - The clinical use of histamine-2 receptor antagonists.
AB  - Histamine-2 receptor antagonists have been available for fifteen years for the
      treatment of peptic ulcer disease and related disorders. While very safe,
      clinicians need to know correct dosing guidelines, drug interactions, and side
      effect profiles. Long-term therapy should be reserved for patients at high risk
      of recurrence.

PMID- 1625533
TI  - Normal sexual development of children: physician roles in bridging gaps in parent
      child communication.
AB  - Physicians have opportunities to help a child have pride about his or her body,
      support the child's sexual self, and encourage shame-free limit setting. By
      supporting a parental coalition that is resilient and indivisible, physicians
      help children value their gender role, and may influence the outcome of sexual
      orientation.

PMID- 1625534
TI  - Journey of the Maryland International Health Task Force to post-war Kuwait: May
      19-27, 1991.
AB  - Thirty-eight physicians, nurses, hospital administrators, and support personnel-
      members of the Maryland Medical Task Force--journeyed to Kuwait in May 1991. The
      experience sensitized members of the Maryland delegation to the specific needs of
      post-war Kuwait in rebuilding its health care system.

PMID- 1625535
TI  - James McHenry, M.D. of Fort McHenry in Baltimore Towne.
AB  - James McHenry, M.D., whose name is best known for the fort immortalized in the
      Star Spangled Banner, was one of the early members of Med Chi. In addition, he
      was secretary to George Washington; aide to Lafayette; member of the Maryland
      Senate, the General Assembly of Maryland, and the US Congress; and signer of the
      Constitution.

PMID- 1625536
TI  - Ethical dilemma: a patient refuses a life-saving cesarean.

PMID- 1625537
TI  - The illiterate client: strategies in patient teaching.

PMID- 1625538
TI  - Indications, management, and patient education: anticoagulation therapy during
      pregnancy.
AB  - Anticoagulation is necessary in a variety of cardiovascular diseases to prevent
      thromboembolic complications. On a chronic basis, this type of therapy carries
      with it frustrations and challenges to both the woman and the health care
      provider related to monitoring, safety, and compliance. These problems are
      compounded during pregnancy by specific pharmacological considerations that often
      require substitution of a parenteral agent. Although at first this may seem an
      additional burden, the clinician can recruit the mother's naturally heightened
      awareness of health issues, as these extend beyond herself to the well-being of
      her child, to achieve therapeutic success.

PMID- 1625539
TI  - Reaching out to mothers with mental retardation.

PMID- 1625540
TI  - The unheard voices of women: spiritual interventions in maternal-child health.

PMID- 1625542
TI  - Reviews of research literature: meta-analysis for synthesizing.

PMID- 1625541
TI  - Issue update: parental notification.

PMID- 1625543
TI  - Aspirin for prevention of pregnancy-induced hypertension.

PMID- 1625544
TI  - Physical activity and cardiovascular health. 1st National Meeting of the National
      Heart, Lung, and Blood Institute. Chevy Chase, Maryland, August 28-28, 1991.

PMID- 1625545
TI  - Overview of the National Heart, Lung, and Blood Institute Workshop on physical
      activity and cardiovascular health.

PMID- 1625546
TI  - The public health burden of a sedentary lifestyle.

PMID- 1625547
TI  - Cardiovascular benefits and assessment of physical activity and physical fitness
      in adults.

PMID- 1625548
TI  - Determinants of physical activity and interventions in adults.

PMID- 1625549
TI  - Assessment, prevalence, and cardiovascular benefits of physical activity and
      fitness in youth.

PMID- 1625550
TI  - Determinants of physical activity and interventions in youth.

PMID- 1625551
TI  - Acute response and chronic adaptation to exercise in women.

PMID- 1625552
TI  - Exercise and atherosclerotic heart disease in women.

PMID- 1625553
TI  - The reproductive system and exercise in women.

PMID- 1625554
TI  - Exercise in pregnancy.

PMID- 1625555
TI  - Osteoporosis and exercise in women.

PMID- 1625556
TI  - Comparison of in vivo and in vitro Hahn T2 measurements in rat lung.
AB  - We compared in vivo and in vitro Hahn echo T2 measurements in rat lungs in both
      imaging and nonimaging modes. All measurements could be characterized by
      multiexponential functions consisting of either two or three exponentials.
      Essentially the same values of the time constants were observed for spontaneously
      breathing rats and for excised lungs.

PMID- 1625557
TI  - 31P magnetization transfer studies in the monkey brain.
AB  - The forward and reverse rates through the creatine-kinase (CK) catalyzed
      reaction, phosphocreatine + ADP+ H+ kf in equilibrium with kr creatine + ATP in
      the in vivo monkey brain were measured using the techniques of saturation
      transfer (ST) and inversion transfer (IT) 31P nuclear magnetic resonance (NMR)
      spectroscopy. Independent checks on the ST apparent longitudinal relaxation (tau)
      data could be obtained from the parameters determined from the IT analyses. At
      near-equilibrium it is assumed that the forward-to-reverse flux ratio lies close
      to 1.0. In the monkey brain the value for the forward-to-reverse flux ratio
      obtained is 1.37 +/- 0.26 calculated from ST with average tau values from IT
      initial slopes, a value which is not significantly different from unity. The
      present NMR data point to the CK reaction in the living monkey brain being
      maintained at or near equilibrium.

PMID- 1625558
TI  - Modification of the Carr-Purcell sequence for single-shot echo-planar imaging.
AB  - An artifact caused by the RF field inhomogeneity in echo-planar imaging (EPI)
      with the CPMG sequence is analyzed. A modified sequence is presented, using 90
      degrees phase alternation of the pi pulses, which suppresses the spurious
      components of the signal. Thus the phase cycling procedure can be avoided and the
      pi-pulsed EPI experiment can be reduced to a single shot.

PMID- 1625559
TI  - Magnetization transfer contrast in fat-suppressed steady-state three-dimensional
      MR images.
AB  - We demonstrate that magnetization transfer contrast can be used to improve the
      diagnostic utility of fat-suppressed steady-state three-dimensional gradient
      recalled images. Fat suppression is achieved using a "jump-return" pair of
      contiguous shaped pulses. No time interval exists between the pulses, and no RF
      echo is generated. The sequence normally produces images with "density"
      weighting. Preparation of the spin magnetization with off-resonance frequency
      selective excitation creates magnetization transfer contrast which attenuates
      signal intensity in proportion to the exchange rate of magnetization from free
      water with magnetization from water bound to macromolecules or protons that have
      restricted mobility. The resulting images have excellent fat suppression with low
      sensitivity to motion since no subtraction is used. In addition, the mechanism of
      signal attenuation is independent of paramagnetic effects, and addition of Gd
      DTPA produces signal enhancement from vascularized regions of tissue. Examples
      are presented for the knee and breast, where the observation of pathology with
      signal enhancement from Gd-DTPA is improved over conventional 3D fat-suppressed
      images.

PMID- 1625560
TI  - Factors influencing the accuracy and precision of velocity-encoded phase imaging.
AB  - Velocity-encoded phase contrast imaging is being used increasingly in clinical
      imaging for quantization of blood flow. In this study, the accuracy and precision
      of ascending aorta flow measurements were found to depend on several subtle
      aspects of the scan prescription and image analysis. While the usual scan
      parameters such as TR, TE, and flip angle gave incremental changes in the flow
      measurements, four additional factors that had a much greater effect on the
      measurements were identified. These factors were (1) the zero velocity
      (background) pixel value, (2) the size and shape of the vessel region of
      interest, (3) the maximum velocity encoded in diastole, and (4) the temporal
      resolution. Statistical analysis was done on a total of 48 scans on nine normal
      subjects to confirm the significance of the measured differences using the
      various choices for each of these factors. These factors must be considered if
      accurate and precise measurements of blood flow are desired. Estimates of
      accuracy and precision suggest that quantitative flow measurements from velocity
      encoded MR imaging can be clinically useful.

PMID- 1625561
TI  - Analysis of hybrid imaging techniques.
AB  - Hybrid imaging techniques have been proposed as a means of decreasing imaging
      time without the cost and technical constraints of echo planar imaging. With this
      technique phase encoding measurements acquired at different echo times in more
      than one multiecho experiment are used to form a single image. This study
      analyzes the trade-offs which occur in the selection of this technique over more
      conventional imaging in terms of signal/noise, contrast, resolution, imaging
      time, and efficiency. Hybrid imaging is shown to be advantageous when raw speed
      is essential such as in abdominal or pediatric imaging. When coverage rather than
      time becomes the important factor, hybrid imaging does not offer a significant
      advantage over conventional methods. T2 decay will also serve as a roll-off
      filter which will reduce the spatial resolution, but not the noise, for short TE
      hybrid imaging.

PMID- 1625562
TI  - Theory of contrast agents in magnetic resonance imaging: coupling of spin
      relaxation and transport.
AB  - The role of diffusive transport on the enhancement of nuclear spin relaxation
      through NMR contrast agents is described by means of diffusion-Bloch equations.
      These equations are solved in the mean relaxation time approximation [W. Nadler
      and K. Schulten, J. Chem. Phys. 82, 151-160 (1985)]. A model presented considers
      relaxation enhancement in tissue in which contrast agents confined to
      intravascular spaces affect nuclear spin in the extravascular volume. We show how
      the mean relaxation time depends on capillary density, on permeability, and on
      diffusion. A second model describes enhanced phase relaxation of liver tissue in
      the presence of magnetic particles in Kupffer cells. The relationship between
      relaxation rate and density of Kupffer cells is investigated. The diagnostic
      value of enhanced nuclear relaxation in the presence of contrast agents is
      discussed on the basis of the systematic mathematical results obtained.

PMID- 1625563
TI  - MR imaging of anisotropic and restricted diffusion by simultaneous use of spin
      and stimulated echoes.
AB  - A new magnetic resonance imaging technique for evaluating anisotropic and
      restricted diffusion effects in a single experiment is described. The method is
      based on a pulse sequence that simultaneously excites a spin echo (SE) and a
      stimulated echo (STE) and contains two pairs of diffusion-sensitive gradient
      pulses. The diffusion attenuation of the SE and STE can be controlled
      independently by separate adjustment of the parameters associated with each pair
      of the diffusion-sensitive gradient pulses. This method can be more time
      efficient than acquiring separate SE and STE images for the same study.
      Furthermore, the pulse sequence minimizes the effect of motion and instrumental
      and physiological variations that occur between separate image acquisitions which
      can give rise to artifactual results when difference imaging is employed. In
      addition to applications to anisotropic and restricted diffusion, this technique
      can be used for: (1) simultaneous acquisition of T2-weighted and diffusion
      weighted images during cerebral ischemia studies; (2) calculation of diffusion
      coefficients from a pair of diffusion-weighted images; (3) separating fast and
      slow diffusion components in a single imaging experiment; and (4) two-dimensional
      velocity-encoded imaging.

PMID- 1625564
TI  - A fast gradient-recalled MRI technique with increased sensitivity to dynamic
      susceptibility effects.
AB  - A fast imaging method that is based on gradient-recalled echoes of spins whose
      excitation and echo formation are separated by more than one TR period is
      presented. This method does not incorporate chemical-shift refocusing and thus
      results in drastically increased sensitivity to dynamic susceptibility effects,
      while maintaining a short total imaging time. The efficiency of the new technique
      is demonstrated in dynamic contrast-enhanced experiments (bolus tracking) in the
      cat brain using a duration of 600 ms for each image. Blood volume maps are
      derived with expected contrast between white and gray matter.

PMID- 1625565
TI  - Effects of the interaction between ferric iron and L-dopa melanin on T1 and T2
      relaxation times determined by magnetic resonance imaging.
AB  - T1 and T2 relaxation times of agar phantoms containing L-dopa melanin and Fe3+
      were measured under MRI conditions. Fe3+ shortened T1 and T2 relaxation times.
      Melanin influenced relaxation times only in the presence of Fe3+; thus, contrast
      in MR images of the basal ganglia may depend upon levels of both paramagnetic
      iron and neuromelanin.

PMID- 1625566
TI  - Analysis of phospholipids in brain tissue by 31P NMR at different compositions of
      the solvent system chloroform-methanol-water.
AB  - Brain phospholipids can be quantitated by high-resolution 31P NMR of crude brain
      tissue extracts in the solvent system chloroform-methanol-water (+EDTA) which was
      introduced recently (P. Meneses and T. Glonek, J. Lipid Res. 29, 679 (1988)).
      Phospholipid resonance positions depend on the type of tissue extract and on
      solvent composition. The effects of systematic variation of the solvent system on
      phospholipid NMR profiles are presented. Resolution can be optimized by
      adjustment of the solvent composition. Virtually all phospholipid classes can be
      resolved, and the major phospholipids in brain: sphingomyelin and phosphatidyl
      choline, -serine, -inositol, -ethanolamine, and -ethanolamine plasmalogen can be
      quantitated easily. Additional resonances have been assigned to
      phosphatidylcholine plasmalogen, alkylacyl-phosphatidylcholine and
      phosphatidylinositolbisphosphate. NMR offers a rapid method for quantitative
      analysis of the phospholipid composition in brain tissue which requires minimum
      sample handling.

PMID- 1625567
TI  - 31P NMR of electrically stimulated rectus femoris muscle: an in vivo graded
      exercise model.
AB  - This study reports on the development of a model for studying skeletal muscle
      metabolism in humans using NMR spectroscopy. Graded exercise was simulated using
      electrical stimulation in 10 healthy, fit subjects (mean VO2max = 53 +/- 4 ml.kg
      1.min-1). The effects of varying the stimulation parameters, namely, the
      stimulation frequency, the stimulation intensity, and the duty cycle, as well as
      the spectral interrogation volume, were compared using data acquired from the
      rectus femoris muscle. With stimulation, the inorganic phosphate to
      phosphocreatine concentration ratio ([P(i)]/[PCr]) and the intracellular pH both
      follow curvilinear relationships over the stimulation frequencies from 3 to 30
      Hz, with the magnitude of the observed change related closely to stimulation
      intensity and duty cycle. Oxidative phosphorylation predominates at stimulation
      frequencies below 12 Hz, while anaerobic metabolism increases sharply above 12
      Hz. Our findings show clearly the interdependence of the effects of the various
      stimulation parameters and emphasize the care that must be exercised in
      interpreting the physiological significance of the biochemical data obtained from
      electrical stimulation models used to study skeletal muscle metabolism.

PMID- 1625568
TI  - Single-input double-tuned Foster-type probe circuit.
AB  - Synthesizing two different values of inductance from a given sample coil for use
      in a single-input double-tuned circuit is possible by means of three extra LC
      elements. A detailed analysis with derived equations shows how to calculate the
      circuit component values and what to expect from this kind of probe. It also
      derives the upper limit of the trap coil/sample coil inductance ratio beyond
      which no solution exists to double-tune the 31P-1H probe. The general expression
      for the channel efficiency shows that the latter is a function not only of the
      inductance of the coils, but also of their quality factor and of the operating
      frequencies. A numerical example is given illustrating good agreement between
      experiment and theory provided high quality rf capacitors are used.

PMID- 1625569
TI  - Quantitative MR in the diagnosis of multiple sclerosis.
AB  - In patients with multiple sclerosis (MS), the apparently uninvolved cerebral
      white matter between demyelinated plaques may have biochemical abnormalities. To
      what degree the changes in the white matter contribute to symptomatology in MS is
      unknown. In 39 patients with multiple sclerosis, and in 39 age-matched
      nondiseased volunteers, T1 and T2 were calculated from spin-echo images in four
      regions of apparently uninvolved white matter. In three of four white matter
      areas, the average T1 and T2 were significantly longer in the patients than in
      the controls. The T1 correlated with the disability, measured by the Kurtzke
      Extended Disability Status Scale, although the correlation was marginally
      significant. The results suggest that in patients with MS, white matter disease
      that is not visualized in MR as distinct foci of abnormal signal intensity may
      contribute to disease burden and disability.

PMID- 1625570
TI  - Fast and accurate measurements of T1 using a multi-readout single inversion
      recovery sequence.
AB  - TOMROP is a multiple readout single inversion-recovery sequence which may
      potentially allow the measurement of multi-exponential T1 recoveries in vivo by
      NMR imaging. It is shown that several important modifications must be made to
      this sequence to permit T1 to be measured accurately and reliably. With these
      modifications it is possible to measure T1 with a mean systematic error of -1.5%
      (-0.3% for samples with T1 greater than 300 ms), a mean accuracy of 3.1% (2.1%
      for samples with T1 greater than 300 ms) and a mean repeatability of 1.4% (1.4%
      for samples with T1 greater than 300 ms), using data collected in 6.4 min from
      sixteen 128 x 128 matrix images.

PMID- 1625571
TI  - Proton nuclear magnetic resonance lineshape studies on human blood plasma lipids
      from newborn infants, healthy adults, and adults with tumors.
AB  - The usefulness of proton NMR spectroscopy of human blood plasma for cancer
      research has been extensively studied in recent years. Two main starting points
      have been offered by Fossel et al. (N. Engl. J. Med. 315, 1369 (1986)) and
      Mountford et al. (FEBS Lett. 203, 164 (1986)). In this work the experimental
      proton NMR spectra of blood plasma were analyzed with the aid of the multivariate
      lineshape fitting method. An appropriate model structure, in terms of the various
      lipoprotein (VLDL, LDL, and HDL) signals, for the methylene region was used.
      Neonates, healthy adults, and adults with nonmalignant and malignant tumors were
      studied. The linewidth of the methylene region was found to be linearly dependent
      on the relative concentrations of the lipoproteins. The correlation coefficient
      was -0.89 (P less than 0.001) for VLDL and 0.88 (P less than 0.001) for HDL. A
      correlation between VLDL concentration and age, 0.76 (P less than 0.001), was
      also established. VLDL was modeled using two components. The half-linewidth of
      the lower field component was slightly elevated for the adults with large
      metastases. This might be in association with the fucose-containing proteolipid
      complex detected earlier in cancer cells or in sera of cancer patients. Some
      signals of this complex may fall in the same region of the spectra. The spectra
      for the neonates were indicated to be totally different from the adults. This and
      other related questions were explained by means of the model parameters and the
      relative concentrations of the lipoproteins VLDL, LDL, and HDL. The presented
      technique can be used as a rapid research tool for figuring out the relative
      concentrations of the lipoproteins in blood plasma and explaining the reasons
      behind the changes in the spectra.

PMID- 1625572
TI  - Control of translation initiation in Saccharomyces cerevisiae.
AB  - The first observations regarding the control of translation initiation in the
      yeast Saccharomyces cerevisiae were made by Fred Sherman and his colleagues in
      1971. Elegant genetic studies of the CYC1 gene resulted in the formulation of
      'Sherman's Rules' for translation initiation as follows: (i) AUG is the only
      initiator codon. (ii) the most proximal AUG from the 5' end of a message will
      serve as the start site of translation; and (iii) if the upstream AUG codon is
      mutated then initiation begins at the next available AUG in the message. Hidden
      within these rules is the mechanism of eukaryotic translation initiation, as
      these very same rules were later shown to apply to higher eukaryotic organisms
      and were formulated into the scanning model. However, only in the past five years
      has yeast been taken seriously as an organism for studying the mechanism of
      eukaryotic translation initiation. The basis for this is that the yeast genes for
      at least four mammalian translation initiation factor homologues have been
      identified and the number is growing. Similar factors suggest similar mechanisms
      for translation initiation between yeast and mammals. For some translation
      initiation factors, the genetics of yeast has provided new insights into their
      function. A mechanism for regulating translation initiation in mammalian cells is
      now evident in yeast. It seems clear that the molecular genetics of yeast coupled
      with the available in vitro translation system will provide a wealth of
      information in the future regarding translational control and regulatory
      mechanisms. The purpose of this review is to summarize what is known about
      translational control in S. cerevisiae.

PMID- 1625573
TI  - Genomic diversity and organization of virulence genes in the pathogenic anaerobe
      Clostridium perfringens.
AB  - Pulsed-field gel electrophoresis has been used to assess genomic diversity and to
      identify virulence regions in 10 strains, representing all five serotypes, of the
      anaerobic pathogen Clostridium perfringens. Detailed physical and gene maps of
      the approximately 3.6 Mb circular chromosomes have been established in eight
      cases and used to deduce a consensus map. With one exception the chromosomal
      arrangement was relatively constant and map comparison allowed three
      hypervariable regions to be identified. One of these was associated with the
      enterotoxin gene, cpe, which is an important cause of human diarrhoea following
      the ingestion of food contaminated with C. perfringens. Another variable region
      spanning the major virulence gene plc, which encodes the cytolytic toxin, alpha,
      was located near oriC in all cases whereas the gene for another lethal typing
      toxin, epsilon, was borne by an episome. It now seems likely that the serological
      variations, and the changes in the pathogenic spectrum which constitute the C.
      perfringens typing system, may be due entirely to the loss, or acquisition, of
      extrachromosomal genetic elements.

PMID- 1625574
TI  - IRE1 encodes a putative protein kinase containing a membrane-spanning domain and
      is required for inositol phototrophy in Saccharomyces cerevisiae.
AB  - A novel gene, IRE1, of Saccharomyces cerevisiae was cloned through genetic
      complementation of a myoinositol auxotrophic mutant. The predicted amino acid
      sequence indicated that IRE1 encodes a protein of 126983 Da with two highly
      hydrophobic regions, probably a signal sequence and a membrane-spanning region.
      The carboxy-terminal region of IRE1 showed close sequence similarity to the
      catalytic domains of protein kinases. Disruption of the IRE1 locus caused myo
      inositol auxotrophy. The IRE1 product is very likely a protein kinase required
      for myo-inositol synthesis.

PMID- 1625575
TI  - Molecular genetic analysis of the Rhizobium meliloti fixK promoter:
      identification of sequences involved in positive and negative regulation.
AB  - Transcription of the Rhizobium meliloti fixK gene is induced in symbiotic and
      microaerobic growth conditions by the FixL/FixJ modulator/effector pair.
      Transcription of fixK is also negatively autoregulated. By 5' deletion analysis,
      the involvement in negative regulation of a DNA region between -514 and -450 with
      respect to the transcription start was demonstrated. Site-directed mutagenesis
      allowed us to show that a sequence homologous to the binding site of the
      Escherichia coli Fnr protein, centred at position -487, participates in this
      effect. However, deletion or mutagenesis of this Fnr-like sequence does not
      completely eliminate FixK-dependent repression, which suggests that either an
      additional DNA region is involved in negative regulation or that it is mediated
      at the level of fixLJ transcription. Deletion analysis also allowed the
      definition of a DNA region involved in FixJ-mediated activation of the fixK
      promoter, between -79 and -42. Different point mutations in the -60, -45 and -35
      regions were shown to affect promoter activity. In some cases, the activity of
      mutant promoters could be partly or fully restored by increasing the expression
      of the fixLJ regulatory genes, in an E. coli strain harbouring a plasmid with
      fixLJ under the control of an inducible (p-tac) promoter.

PMID- 1625576
TI  - Carbon catabolite repression can account for the temporal pattern of expression
      of a penicillin biosynthetic gene in Aspergillus nidulans.
AB  - Aspergillus nidulans synthesizes penicillins as secondary metabolites when grown
      under certain culture conditions. Broths containing carbon (C) sources that give
      rise to carbon catabolite repression (CCR) support a much lower antibiotic yield
      than broths with non-repressing C sources. Steady-state levels of the
      isopenicillin N synthetase (IPNS) gene transcript are considerably reduced in
      mycelia grown with repressing C sources and are depressed in mycelia grown with
      sugars which do not cause CCR, indicating that penicillin biosynthesis is
      regulated by CCR through transcriptional control of structural genes. CCR is
      sufficient to explain the temporal window of expression of the IPNS gene during
      the growth cycle since (i) the transcript becomes derepressed as soon as the
      concentration of a repressing C source drops to non-repressing levels and (ii)
      derepressing C sources sustain derepressed IPNS transcription at all tested
      moments of the growth cycle. Several tested hypofunctional mutations in creA (the
      negatively acting regulatory gene which mediates CCR in A. nidulans) do not cause
      full derepression of IPNS transcript in the presence of a repressing C source.
      The slight degree of IPNS derepression caused by some creAd (derepressed) alleles
      parallels the strength of the mutation (as determined by the morphological effect
      they elicit).

PMID- 1625577
TI  - Identification of individual amino acids required for secretion within the
      haemolysin (HlyA) C-terminal targeting region.
AB  - The release of haemolysin from Escherichia coli involves direct secretion across
      both the inner and outer membranes. Secretion of HlyA is dependent upon a
      specific membrane export complex composed of HlyB, -D and possibly TolC. HlyA is
      targeted to the medium via the membrane translocation complex, by a novel C
      terminal secretion signal. Previous studies involving deletion and fusion
      analyses have given contradictory results for the minimal length (20-60 residues)
      of this HlyA signal region and little is known of the nature of the specific
      residues and structural features required for function. In this study we have
      analysed, quantitatively, the effect upon secretion of many point mutations
      introduced into the HlyA C-terminus. The results indicate the presence of a
      minimal secretion signal domain whose proximal boundary extends to at least
      residue -46 and which contains at least four individual residues essential for
      maximal secretion levels. We propose that such residues act co-operatively,
      forming multiple contact points with the translocator proteins, with the 'best
      fit' promoting maximal levels of secretion.

PMID- 1625578
TI  - Involvement of the Arc system in redox regulation of the Cob operon in Salmonella
      typhimurium.
AB  - Transcription of the cobalamin biosynthetic (cob) genes in Salmonella typhimurium
      is induced during anaerobic growth. Two mutants defective in induction of the Cob
      operon were isolated. The mutants showed decreased anaerobic induction, both
      during conditions of fermentation and anaerobic respiration, relative to the wild
      type. The mutant genes were localized by Hfr and transduction mapping to 100
      minutes and 69 minutes on the chromosome. The mutants were sensitive to the dye
      toluidine blue. The mapping and the dye sensitivity suggest that these mutants
      are defective in the arcA and arcB genes, not previously identified in Salmonella
      typhimurium. Thus the regulatory function of the Arc system is expanded to
      include anaerobic activation of the Cob operon.

PMID- 1625579
TI  - The spo0A gene is implicated in the maintenance of non-complementing diploids in
      Bacillus subtilis.
AB  - Bacillus subtilis can exist in a diploid state in which two genetically distinct
      chromosomes co-exist in the same cell and yet only one of them is expressed,
      thereby determining the phenotype. Such cells are called non-complementing
      diploids (Ncds). In this study, two types of experiments are reported which
      indicate that a previously known pleiotropic gene, spo0A, plays a role in the
      maintaining the diploid state, as follows. (i) When protoplasts of two Spo0A
      mutant strains were fused, the resulting products continued to segregate cells of
      both parental phenotypes for many more divisions than had been reported
      previously. (ii) When a stable Ncd (an Ncd in which the unexpressed markers are
      not spontaneously activated at a detectable level) harbouring a chloramphenicol
      acetyltransferase gene on the silent chromosome was transformed with spo0A null
      alleles the transformants often expressed chloramphenicol acetyltransferase
      activity. Together these results indicate that the spo0A gene is involved in
      maintenance of the diploid state in both unstable and stable Ncds.

PMID- 1625580
TI  - Cloning of genes affecting capsule expression in Staphylococcus aureus strain M.
AB  - Staphylococcus aureus strain M produces large amounts of capsular polysaccharide.
      It produces a non-encapsulated variant at a frequency of 0.01% at 37 degrees C.
      At high temperature (43 degrees C), the frequency of capsule loss was shown to be
      1-38%. A 19 kb plasmid and a prophage were found to be carried by the M strain,
      but curing of these elements did not affect capsular production. To clone the
      capsular (cap) genes, a plasmid library of S. aureus M was constructed directly
      in S. aureus RN4200. The library was then infected with phage 80 alpha. After
      transduction of the phage lysates to a Cap- mutant derived from M strain, a
      recombinant plasmid was obtained which complemented the mutant to a Cap+
      phenotype. Chromosomal walking experiments were used to clone additional nearby
      cap genes. Complementation tests using a collection of Cap- mutants showed that
      most of the mutants were complemented by a 19.4 kb DNA fragment, suggesting that
      the majority of the cap genes affecting capsule production are clustered
      together.

PMID- 1625581
TI  - Mutational analysis of the operon (hyc) determining hydrogenase 3 formation in
      Escherichia coli.
AB  - In-frame deletions were introduced into each of the eight genes of the hyc operon
      coding for products required for the formation of the formate hydrogenlyase (FHL)
      system. The deletions were transferred to the chromosome and the resulting
      mutants were analysed for development of formate dehydrogenase H and hydrogenase
      1, 2 and 3 activity. It was found that hycA, the promoter-proximal gene, is a
      regulatory gene and that it codes for a product counteracting transcriptional
      activation by FhlA. Deletions within the hycB to hycH genes specifically affected
      formate dehydrogenase H activity or hydrogenase 3 activity, or both. None of the
      mutations affected hydrogenase 1 or 2 activity. A model is proposed for the
      functional interaction of the different hyc operon gene products in the formate
      hydrogenlyase complex, which is based on the results of the mutational analysis,
      on the determination of the subcellular localization of the FdhF, HycE, HycF and
      HycG polypeptides and on the similarity of hyc gene product sequences with those
      from other hydrogenase systems. HycH, the product of the most promoter-distal
      gene, does not seem to form part of the functional FHL complex but rather is
      required for the conversion of a precursor form of the large subunit of
      hydrogenase 3 into the mature form.

PMID- 1625582
TI  - AIDA-I, the adhesin involved in diffuse adherence of the diarrhoeagenic
      Escherichia coli strain 2787 (O126:H27), is synthesized via a precursor molecule.
AB  - The adherence mechanisms of enteropathogenic Escherichia coli (EPEC) to
      epithelial cells are still not understood. To study the molecular basis of the
      diffuse adherence (DA) phenotype exhibited by diarrhoeagenic E. coli expressing
      classical EPEC serotypes we investigated strain 2787 (O126:H27) isolated from a
      case of infantile diarrhoea. A 6.0 kb plasmid-derived DNA fragment mediates the
      DA phenotype and encodes the 100 kDa adhesin protein AIDA-I (adhesin involved in
      diffuse adherence). Sequencing of the entire fragment revealed two open reading
      frames which encoded proteins of 45 kDa and 132 kDa, respectively. The 132 kDa
      protein has been identified as an AIDA-I precursor protein. After cleavage of the
      signal sequence further processing at the C-terminus of the 132 kDa precursor
      leads to the mature approximately 100 kDa AIDA-I. While the exact function of the
      cytoplasmic 45 kDa protein is not known, preliminary evidence indicates that it
      is necessary for the correct maturation of AIDA-I. The AIDA-I precursor exhibits
      significant homology with the virG(icsA) protein of Shigella flexneri which seems
      to be involved in the intercellular spread of invasive Shigella organisms.

PMID- 1625583
TI  - nov: a new genetic locus that affects the response of Escherichia coli K-12 to
      novobiocin.
AB  - We have identified a new gene locus (nov) affecting the resistance of Escherichia
      coli K-12 to novobiocin. The gene also affects, although to a lesser extent,
      tolerance to another gyrase inhibitor coumermycin. Transductional and
      complementation analysis show that nov is located between att phi 80 and the osmZ
      (hns) genes at minute 27 of the E. coli K-12 genetic map. In standard laboratory
      strains of E. coli K-12 nov exists at least in two allelic forms.

PMID- 1625584
TI  - Insertional mutagenesis in the extreme thermophilic eubacteria Thermus
      thermophilus HB8.
AB  - The transcription and translation signals of the S-layer gene (slpA) from Thermus
      thermophilus HB8 have been used to express a thermostable kanamycin adenyl
      transferase gene in this organism. The chimaeric resistance gene was inserted in
      vitro into slpA to produce different inactive forms of the gene, which were used
      to transform T. thermophilus HB8. After 48 hours of incubation at 70 degrees C,
      only two constructions that contained the kat gene flanked by Thermus sequences
      from both sides of slpA were able to produce protein layer (P100)-defective
      mutants. The mutants obtained with both constructions showed identical protein
      patterns, in which a major 50 kDa protein and two other minor proteins were
      tentatively identified as P100 fragments, expressed from the extreme 5' end of
      slpA. They also exhibited important phenotypic defects, such as slow growth in
      liquid broth, a tendency to aggregate as 'rotund bodies', a twisted filamentous
      shape, and an extreme sensitivity to lysozyme, suggesting protective and shaping
      roles for the S-layer in T. thermophilus HB8. These results also demonstrate for
      the first time the feasibility of using selective antibiotic-resistance markers
      in extreme thermophiles.

PMID- 1625585
TI  - The VirF protein from Shigella flexneri is a member of the AraC transcription
      factor superfamily and is highly homologous to Rns, a positive regulator of
      virulence genes in enterotoxigenic Escherichia coli.

PMID- 1625586
TI  - The provision of the maternity services in the UK.

PMID- 1625587
TI  - An evaluation of the importance of formal, maternal fetal movement counting as a
      measure of fetal well-being.
AB  - Maternal perception of fetal movements has, over the years, become recognised as
      a valuable tool for early detection of fetal compromise. Several studies
      published in the mid-1970s have demonstrated that a reduction or cessation in
      maternally perceived fetal movements may precede antepartum late fetal death by a
      day or longer. From these findings formal fetal movement counting emerged as a
      valuable, non-invasive method of assessing fetal well-being; the belief being
      that clinical actions taken on the basis of reduced fetal movement counting may
      prevent antepartum death or morbidity. Conversely, more recent studies have
      failed to demonstrate that there is a beneficial effect of a formal, fetal
      movement counting policy on antepartum death. It is not disputed that fetal
      movements are of clinical importance but it seems that routine daily counting of
      fetal movements by women followed by appropriate action when movements are
      reduced offers no advantages over formal inquiry about fetal movements during
      standard antenatal care. Thus, the application of formal, maternal fetal movement
      counting as a method of fetal surveillance to reduce late antepartum death must
      be questioned.

PMID- 1625588
TI  - The role of the midwife and consumer groups as advocates for the rights of the
      consumer.
AB  - There has been an increasing number of consumer advocacy groups actively lobbying
      for the right of women to have an informed choice about care and facilities for
      their childbearing. Mothers and Midwives Action (MAMA) South Australia Inc was
      formed in 1989 to campaign for improved childbirth services for the women of
      South Australia. Although the group has been involved in a number of issues this
      article will concentrate on two, the group's participation in the planning of a
      Birthing Unit at the new Adelaide Medical Centre for Women and Children and the
      setting up of a Childbirth Information Centre. The difficulties and complexities
      of successful lobbying will be discussed within the context of the Ottawa
      Charter. Midwives in their advocacy role need to be more aware of consumer
      issues. They must be prepared to participate actively, supporting the consumer
      when appropriate, both on a personal level and collectively as a professional
      group. The MAMA group in Adelaide SA has been both supportive and helpful in the
      production of this article.

PMID- 1625589
TI  - An evaluation of pre-registration midwifery education in England. Research
      design: a case study approach.
AB  - In this paper some aspects of research design are described and discussed. A
      national study to evaluate pre-registration midwifery education in England is
      currently in progress. As part of that study six case study sites have been
      selected. How those sites were selected and the theory and method of the case
      study approach are discussed in this paper. The value of the case study approach
      is discussed as are methodological issues of the case study method. What is a
      case? Are case studies representative? How can you generalise from case studies?
      What is theoretical sampling? What is the difference between statistical and
      logical inference? These are some of the questions raised and examined. It is
      suggested that an understanding of these theoretical issues and the research
      process is important to understand the research findings. By making the research
      design explicit and describing the research process the study also adopts a
      reflexive approach.

PMID- 1625590
TI  - A reconsideration of the factors affecting birth outcome in Pakistani Muslim
      families in Britain.
AB  - Over recent years, Bradford has had a consistently high perinatal mortality rate
      (PNMR), especially amongst its Asian population, 66% of whom originate from
      Pakistan. There is a high incidence of consanguineous marriages reported among
      Pakistani and Muslim couples. Often, this observation is used to explain their
      higher PNMR and congenital malformation rates. The factors affecting birth
      outcome in Pakistani women are complex and interrelated. Socioeconomic, genetic,
      biological and environmental factors all contribute to adverse birth outcome. In
      addition, these are complicated by discrimination, communication barriers and
      culture blaming. The aim of this paper is to challenge midwives and other health
      professionals to reconsider the overwhelming emphasis placed on consanguinity as
      a factor affecting birth outcome, and to recognise the impact and interplay of
      other confounding variables.

PMID- 1625591
TI  - Temperature changes during the first day of life in the North Staffordshire
      Maternity Hospital.
AB  - A prospective study of post-delivery temperature changes from birth to 24 h,
      carried out in a busy District General Hospital is reported. The temperature fall
      after delivery was less than expected and reflected a high level of awareness of
      the dangers of hypothermia. On the basis of the findings of the survey,
      hypothermia in the first 24 h can be defined as a rectal temperature of less than
      36.4 degrees C. Those babies who did become hypothermic were significantly more
      likely to be of low birth weight or preterm gestation.

PMID- 1625593
TI  - Case in point: contract protects employee from capricious discipline.

PMID- 1625592
TI  - Aging population requires increased education in gerontological nursing.

PMID- 1625594
TI  - The origin and the progression of varicose veins.
AB  - It is proposed that pathological varicosities begin as acute dilator responses of
      normal veins to noradrenaline released from the vasa vasorum of the vein; the
      noradrenaline is part of a circulating pool formed by overflow following
      adrenergic nerve activity. In health, a minimal quantity of noradrenaline
      routinely flows by reflux to the vasa where it has a negative feedback,
      venodilator effect. However, when the volume of reflux becomes excessive, the
      noradrenaline in it abolishes venoconstrictor tone, thereby creating a
      varicosity. Excessive venous reflux over a short period causes no significant
      hypoxic damage to the vein wall or any other tissues and any damage associated
      with it regresses when the excess reflux ceases. However, if excessive reflux is
      persistent then a time comes when irreversible hypoxic structural changes occur
      in the vein wall and in other tissues affected by the reflux. The structural
      pathology associated with varicose veins reflects the effect of the long-term
      tissue hypoxia associated with that condition.

PMID- 1625595
TI  - Manifestations of pediatric AIDS: proposed mechanisms of transmission.
AB  - Pediatric Acquired Immunodeficiency Syndrome (AIDS) is expected to increase by
      greater than 75% by 1993. Most of these infants will become infected with the
      Human Immunodeficiency Virus (HIV) through the mother. It is unclear exactly how
      the virus is passed from mother to child. The nature of HIV infection is
      described in this paper, and several mechanisms relevant to its transfer are
      proposed.

PMID- 1625596
TI  - Purinergic stimulation of cell division and differentiation: mechanisms and
      pharmacological implications.
AB  - Extracellular purine nucleosides and nucleotides in micromolar concentrations
      stimulate proliferation of a variety of cell types in vitro and in vivo. As well
      they act synergistically with NGF to stimulate neurite outgrowth from PC12 cells.
      A variety of purine nucleosides and deoxyribonucleosides promote cell
      proliferation and increase intracellular cAMP. Their activities are inhibited by
      adenosine A2 receptor antagonists. Only adenosine interacts with the A2 receptor.
      We propose that the other nucleosides and deoxyribonucleosides inhibit
      extracellular adenosine deaminase, thereby increasing the extracellular
      concentration of adenosine. The nucleotides apparently act by stimulating P2y
      receptors coupled to inositol phosphate metabolism. We propose that the
      nucleosides and nucleotides act synergistically with other growth factors because
      each has distinct but complementary second messenger systems. If our hypotheses
      are correct, it should prove possible to modulate the growth and morphogenesis in
      several cell types using drugs that inhibit or stimulate adenosine A2 or purine
      P2y receptor agonists or the second messenger systems coupled to these receptors.

PMID- 1625597
TI  - Membrane fluidity, reactive oxygen species, and cell-mediated immunity:
      implications in nutrition and disease.
AB  - Membrane-associated functions are profoundly influenced by the fluidity and
      physical state of the membrane. These two features are in turn determined by the
      membrane lipid acyl chain profile. Reactive oxygen species (ROS) modify the acyl
      chains by lipid peroxidation of the unsaturated chains, thus affecting the
      fluidity and physical state of the membrane. By enhancing endogenous ROS levels,
      therefore, aging, and disease affect integral membrane function, such as the cell
      mediated immune (CMI) reaction involving phagocyte membrane NADPH oxidase. This
      enzyme relies on triggering by membrane-inserted protein kinase C (PKC), for its
      superoxide (O2-) producing function. The molecular mechanism of the depressed
      immunocompetence in the aged, and in disease and malnutrition, may reside in the
      down-regulation of these two enzymes by excess ROS. These excess ROS arise from
      activated phagocytes in disease states, and from enhanced ROS from other sources
      in the aged, as well as from the decrease in antioxidants in the aged. Research
      should be intensified on PKC and NADPH oxidase function with the aim of
      unravelling the molecular mechanism of the depressed immunocompetence, and
      thence, of formulating appropriate intervention strategies against it.

PMID- 1625598
TI  - Some thoughts about the importance of X-ray exposure histories for patients.
AB  - The controversy regarding the importance of the definition and standardization of
      a radiation exposure history is identified. Cancer incidence is increasing partly
      due to increased diagnostic accuracy but some over utilization of diagnostic X
      ray exposure has been linked with increased breast, brain, thyroid and skin
      cancer, leukemia and multiple myeloma incidence. Since there is a lack of
      standardization of radiation histories and lack of knowledge by some physicians
      of radiation exposure dosages, this practitioner has compiled a suggested
      practical reference list of common radiation exposure dosages and indications for
      a detailed radiation history with current references.

PMID- 1625599
TI  - Extracellular purine nucleosides stimulate cell division and morphogenesis:
      pathological and physiological implications.
AB  - Extracellular purine nucleosides and nucleotides are ubiquitous, phylogenetically
      ancient, intercellular signals. Purines are released from hypoxic, damaged or
      dying cells. Purine nucleosides and nucleotides are potent mitogens for several
      types of cells such as fibroblasts, endothelial cells and neuroglia. They also
      induce other cell types to differentiate. For example, they act synergistically
      with nerve growth factor to stimulate neurite outgrowth from a pheochromocytoma
      cell line (PC12). We propose that after injury to tissues, including the central
      nervous system, purine nucleosides and nucleotides interact synergistically with
      other growth factors. They stimulate proliferation and morphological changes in
      the various cell types involved in the wound healing response. In the central
      nervous system this response includes glial proliferation, capillary endothelial
      cell proliferation, and sprouting of nerve axons. Since many actions of
      extracellular purines are mediated through specific cell surface receptors, this
      hypothesis has broad pharmacological implications.

PMID- 1625600
TI  - Margarines and coronary artery disease.
AB  - In a previous paper we predicted that health effects of dietary fats in humans
      would require half a century or more to be understood, instead of the decade or
      so predicted during 1956 by an Editorial in The Lancet. It would seem that our
      prediction may have been optimistic since it has now been reported that trans
      unsaturated fatty acids present in high concentrations in margarines promote
      hypercholesterolemia in humans. Consequently, there has been a call for the
      reclassification of dietary fats upon the basis of their hypercholesterolemic
      properties. Using the latter criterion, therefore, many margarine brands would be
      classified as coronary artery disease risk foods. The primary adverse metabolic
      action of trans unsaturated fatty acids is the competitive inhibition of delta-6
      desaturase, the hepatic enzyme responsible for the initial metabolic desaturation
      of the essential fatty acids cis linoleic and cis alpha-linolenic acid. In
      addition to margarines, many other common foods such as deep-fried foods, many
      convenience foods and bakery products contain relatively high levels of trans
      fatty acids. Therefore, since it has become virtually impossible to avoid a
      consistent, daily dietary intake of trans fatty acids, it would appear that a
      precautionary, preventative supplementation of the diet with supplements
      containing the direct metabolic products of delta-6-desaturation of the essential
      fatty acids, would be prudent. Such supplements are readily available.

PMID- 1625601
TI  - Generalizing the control process for embryonic genes.
AB  - Embryonic genes are considered as a separate subset of genes with unique
      chromatin properties. There is a problem of defining the duration of
      perturbations of embryonic gene activity that has been chemically induced and the
      normal relatively longer lasting changes that occur during differentiation. This
      problem may be related to unique properties of the chromatin of embryonic genes.
      Methylation of DNA is thought to be only one level of control and the
      superstructure of chromatin involving heterochromatin is of equal importance to
      embryonic gene expression. Proto-oncogenes are considered to be embryonic type
      genes whose activities are regulated under the same mechanisms by which other
      embryonic genes are regulated. Control aspects are discussed in the light of i)
      repressor-derepressor and blocking-deblocking mechanisms, ii) activator genes,
      pseudogenes, LINES, SINES, v-type position effects, iii) effects of ethionine,
      and iv) steroid hormone effects especially with respect to a subset of repeated
      rRNA genes which are considered to be structured in embryonic type chromatin.

PMID- 1625602
TI  - Maintenance of embryonic gene activity into the adult state.
AB  - It is now apparent that certain embryonic gene activities may be maintained
      before the transition from embryonic to the adult state takes place. The
      consequence of such a condition could have far reaching results and create a
      totally new approach to biotechnology by dealing with epigenetic methods and not
      gene-splicing methods. For example, if a group of c-oncogenes, believed to be of
      the embryonic type (1) that are responsible for growth factors which regulate
      embryonic rates of growth, then large increases in growth rates during the adult
      stage should occur. Two major alterations seem to be required. One is the
      interference of DNA methylation patterns using such agents as ethionine
      (interfering with S-adenoysl-1-methionine synthesis) or azacytidine (interfering
      with DNA methylase activity). Secondly, a change in chromatin configuration
      (deheterochromatization?) with agents such as n-butyrate or
      hexamethylenebisacetamide (HMBA). Maintenance methylases would make the altered
      (hypomethylated) pattern of the perturbed chromatin invariant after the initial
      perturbation. Enhancer-promoter mechanics are probably pertinent to this process.

PMID- 1625603
TI  - The role of catecholamines in gram-negative sepsis.
AB  - Recently obtained in vitro evidence has demonstrated that neurochemicals such as
      the catecholamines can dramatically increase the growth of Gram-negative
      bacteria. Depending on the catecholamine, an up to 100,000-fold increase in the
      in vitro growth rate of pathogenic Gram-negative bacteria such as Escherichia
      coli and Yersinia enterocolitica can be observed. Dramatic elevations in the
      levels of plasma catecholamines have been amply demonstrated to occur as part of
      the neurophysiological response to infection. It is proposed that the ability of
      pathogenic bacteria to utilize the host's neurophysiological response to
      infection to modulate its own growth may govern the eventual clinical outcome of
      the infection.

PMID- 1625604
TI  - The properties of the nervous system and the two-growth-types (egg-sperm) concept
      of carcinogenesis.
AB  - Some common morphological and functional features of the sperm and of the
      neuroblast (above all the resistance of the egg once fertilized to penetration of
      further sperms and of the embryonic cell once innervated to additional
      innervation) point to their developmental relationship, viz. to continued
      existence of the sperm, following temporary disappearance and genetic interaction
      within the egg, in the form of a neuroblast. The egg and the sperm would thus
      give origin to the two basic growth types of the vertebrate body, viz. the
      cellular-divisional (of the non-nervous tissues) related to the egg and the
      neural-extensive originating in the sperm and characterized by sprouting of
      processes even several decimeters long from a single nerve cell body. The nervous
      system, in addition to its intricate functions, represents an extremely dense
      feltwork of nervous trunks, branches and fibres, the 'nervous skeleton' (6), the
      product of the extensive neural growth which is 'stuffed' with the products of
      the cellular divisional proliferation of the other, non-nervous tissues. The
      absence of nerves (or of normal nerves) within the malignant tumours points to
      cellular 'escape' from the limiting confines of the nervous skeleton as the
      biological cause of malignancy: the 'escaped' cells pursue the one-growth type
      way of life instead of the normal two-growth-types way, viz. they revert back
      towards the egg-condition and acquire embryonic features. Introduction of
      neuroblasts into the malignant tumour aimed at re-establishment of its nervous
      skeleton should convert the malignant lesion into a benign one.

PMID- 1625606
TI  - Cancer epidemiology in Australia: priorities for the 1990s and beyond.

PMID- 1625605
TI  - The DDT method: an alternative to the use of radiolabelled microspheres for the
      determination of regional blood flows in the rat.
AB  - Intravenous administration of the 14C-radiolabelled insecticide DDT--1,1,1
      trichloro-2,2-bis-(p-chlorophenyl)ethane--can be used for the estimation of
      regional blood flows in small rodents. A mathematical model is presented which
      enables the conversion of relative into absolute blood flows.

PMID- 1625608
TI  - Health expenditure in Australia. The current dilemma.

PMID- 1625607
TI  - Caring for carers--a national problem.

PMID- 1625609
TI  - Genetics and the risk of coronary heart disease.

PMID- 1625610
TI  - Rabies case in New South Wales, 1990: public health aspects.
AB  - OBJECTIVES: To identify the source of rabies in the recent case in New South
      Wales, and to determine the need for post-exposure rabies prophylaxis among
      contacts of the patient. DESIGN: Information was obtained by face-to-face
      interview of the dead girl's family and face-to-face and telephone interviews
      using a questionnaire of health care workers. Other information was gathered from
      overseas and local sources through telephone and facsimile contact. RESULTS: The
      girl had migrated from Vietnam in 1984 to Hong Kong, and from there in 1986 to
      Australia. No evidence of contact with a rabid animal in Australia or Hong Kong
      was found. There had also been no organ donations from the girl. Four health care
      workers were given post-exposure rabies prophylaxis. CONCLUSIONS: Because of the
      lack of evidence of animal contact in Australia and the fact that extremely long
      incubation periods for rabies have been documented, it was considered that the
      most likely source of the rabies virus was North Vietnam. Genetic studies of the
      virus also supported a South-East Asian source. Nevertheless the presumed
      incubation period--at least six years and four months--is one of the longest
      recorded.

PMID- 1625611
TI  - Detection of reversible platelet aggregates in the blood of smokers and ex
      smokers with peripheral vascular disease.
AB  - OBJECTIVE: To demonstrate that smoking increases platelet aggregation in vivo,
      that smoking cessation reverses platelet aggregation and that this explains, in
      part, why smoking perpetuates the development of peripheral vascular disease.
      DESIGN: Prospective case-control study involving three groups of patients:
      smokers with peripheral vascular disease, ex-smokers with peripheral vascular
      disease and smokers with peripheral vascular disease who quit smoking during the
      study. SETTING/PARTICIPANTS: Fourteen smokers and seven ex-smokers, new patients
      with confirmed peripheral vascular disease, attending the vascular clinic at
      Fremantle Hospital between February and November, 1988. INTERVENTIONS: Blood
      samples taken weekly from all subjects for five weeks. Week 1 was taken as the
      baseline before smoking cessation in the six smokers who were assigned to stop
      smoking during the study. MAIN OUTCOME CRITERIA: Platelet aggregate ratio, an
      indicator of in-vivo platelet aggregability where an increase in platelet
      aggregate ratio suggests a decrease in platelet function. RESULTS: Only three of
      six smokers stopped smoking for the duration of the study. Median platelet
      aggregate ratios were: smokers = 0.85 (range, 0.79-0.92) v. non-smokers = 0.93
      (range, 0.91-1.00). The difference was statistically significant P less than
      0.0002. The difference in platelet aggregate ratios between smokers and quitters
      was not statistically significant. CONCLUSIONS: This study demonstrated an
      increase in platelet aggregability in smokers compared to ex-smokers but there
      was no clear evidence that platelet function was fully reversed after only four
      weeks cessation of smoking. The data suggested that platelet function of the ex
      smokers had fully reversed to normal over a longer period. This could explain the
      decreased incidence of complications of peripheral vascular disease in ex
      smokers. The small number of patients able to quit smoking impeded this study.

PMID- 1625612
TI  - Aluminium beverage cans as a dietary source of aluminium.
AB  - OBJECTIVE: To examine the possibility that aluminium beverage cans contribute to
      the dietary level of aluminium. METHOD: The aluminium content of a variety of
      beverages from aluminium cans and glass containers was measured. RESULTS: The
      contents of 106 aluminium cans and bottles representing 52 different beverages
      all had a higher aluminium content than Newcastle tap water at 1.4 mumol/L,
      ranging as high as 385 mumol/L. Non-cola soft drinks averaged 33.4 mumol/L from
      cans and 5.6 mumol/L from bottles. Cola drinks averaged 24.4 mumol/L from cans
      and 8.9 mumol/L from bottles, whereas beer in cans or bottles averaged about 6
      mumol/L. CONCLUSIONS: In general, the aluminium content of beverages from
      aluminium cans was higher than that from glass containers, and it rose with
      decreasing pH. Within a given category there was a wide variation in aluminium
      content. If the speculative link between aluminium intake and Alzheimer's disease
      is established then beverages from aluminium cans, particularly soft drinks, may
      be a risk factor.

PMID- 1625613
TI  - Sexual activity and condom use in high school students.
AB  - OBJECTIVE: To determine the level of sexual experience and condom use among Year
      9 high school students. DESIGN: Self-administered questionnaire to all Year 9
      students attending a personal development workshop. SETTING: The study was
      carried out in two regional high schools in New South Wales, one in an urban area
      and the other in a rural area. PARTICIPANTS: A total of 253 students in Year 9 at
      the two high schools; only two students declined to participate. RESULTS: Seventy
      one students (28.1%) had had intercourse at least once. There was no
      statistically significant difference between the percentage of male and female
      students or rural and urban students who had had intercourse. Thirty students
      (42.3%) always used condoms, 35.2% used them sometimes and the other sexually
      active students had never used them. The commonest reasons for non-use were
      unplanned sex, unavailability or no time. CONCLUSIONS: The unpredictability of
      teenage sexual activity may mean that condoms are not available at the crucial
      time. Girls appear to have more difficulty in asking for condoms to be used, but
      the numbers are two small in this survey to draw definite conclusions. If both
      pregnancy and sexually transmissible diseases are to be prevented among
      adolescents, sex education must encourage condom use as the first method of
      contraception for this group and emphasise the need for consistent availability
      and use.

PMID- 1625614
TI  - Mild bleeding disorders. A clinical and laboratory study.
AB  - OBJECTIVE: To investigate in-vitro haemostasis in subjects with symptoms
      suggesting a mild bleeding disorder. DESIGN: A prospective study in which an
      extensive range of in-vitro tests were applied unselectively. SETTING: Patients
      were referred from community-based practices and hospital outpatient services.
      PATIENTS: Ninety-three consecutive patients were examined. Hospital patients with
      severe illness were excluded. CLINICAL FEATURES: Patients presented with easy
      bruising (68%), epistaxis (12%), excessive operative bleeding (7%), menorrhagia
      (4%), haematuria (3%), dental bleeding (1%) and bleeding from other sites (5%).
      In no instance was the bleeding life threatening. OUTCOME MEASURES: Results of
      laboratory tests for patients presenting with the symptoms of a mild bleeding
      disorder were compared with the results for a healthy reference group. RESULTS:
      Abnormal results of in-vitro tests were found in 53% of the subjects. Thirteen
      per cent had a prolonged bleeding time, of whom the majority had abnormal results
      of other in-vitro tests. Von Willebrand's disease was diagnosed in 7% of
      patients, although only half of these had a prolonged bleeding time. CONCLUSIONS:
      Abnormal results of in-vitro tests were prevalent among subjects with symptoms of
      mild bleeding disorder. Easy bruising was as powerful a clue as any other
      bleeding manifestation to the presence of an abnormal in-vitro test result.

PMID- 1625615
TI  - A memory clinic at a geriatric hospital: rationale, routine and results from the
      first 100 patients.
AB  - OBJECTIVE: To describe the operation of a memory clinic with reference to the
      referral pattern, patient characteristics and psychiatric diagnoses, frequency of
      reversible dementias and utility of brief cognitive screening tools in the
      detection of dementia. DESIGN: All patients underwent cognitive screening tests
      (Mini Mental Status Examination, Abbreviated Mental Test Score, Organic Brain
      Syndrome Scale of the Brief Assessment Scale) and two activities of daily living
      instruments. Psychiatric diagnoses were made according to criteria of the
      Diagnostic and statistical manual, third edition revised, of the American
      Psychiatric Association (DSM-III-R). SETTING: A large geriatric hospital.
      SUBJECTS: First 100 patients referred. RESULTS: The mean age of the patients was
      75.5 years and 75 were women. Seventy-four met DSM-III-R criteria for dementia
      and a further 13 had other organic brain syndromes. No case of reversible
      dementia which recovered was encountered. The cognitive screening tools had a
      high correlation (r = 0.85-0.89) with one another but a much lower correlation
      with the activities of daily living instruments (r = 0.27-0.37). CONCLUSION:
      Reversible dementias are unlikely to be detected in a memory clinic at a
      geriatric hospital, but the assessment process may have other benefits which will
      need to be assessed in prospective research. The clinic population represents a
      unique resource for further research on dementia.

PMID- 1625616
TI  - Plant hair dermatitis.
AB  - OBJECTIVE: To survey the ill effects of plant hairs on humans in Australia,
      incorporating new records. DESIGN: Retrospective analysis of new records, in some
      cases confirmed and supplemented by experimental skin contacts, along with a
      general survey of relevant literature. METHODS: Reports of accidental injuries
      submitted to the authors, through either medical or other sources, and to the
      Botanic Gardens of Adelaide and State Herbarium of South Australia, were studied
      and compared with existing literature; in some cases the effects were confirmed
      experimentally. RESULTS: A general survey of plant hair dermatitis in Australia
      is offered. Most species included have been referred to in the scattered earlier
      literature, but a few plants not previously recorded as irritating are included,
      notably Apalochlamys spectabilis, Wisteria sinensis and Grevillea species.
      Attention is also called to the penetrating and irritating pod spines of
      Brachychiton spp. (kurrajongs and relatives) and Lagunaria patersonii (Norfolk
      Island hibiscus or pyramid tree), which are often planted as ornamental street
      trees. Generally those most likely to receive these injuries are gardeners and
      children.

PMID- 1625617
TI  - Hepatitis B virus markers in children and staff in Northern Territory schools.
AB  - OBJECTIVE: To measure the prevalence of hepatitis B virus (HBV) infection in
      children and staff at Northern Territory schools. DESIGN: Children in Years 5-7
      in 24 selected primary schools were invited, with parental consent, to provide
      demographic and ethnic details, and a capillary blood sample for tests for
      hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen
      (anti-HBs). School staff participated on a similar basis. PARTICIPANTS: 1104
      children, comprising 556 from ethnic groups (originating from the United Kingdom,
      Ireland and northern Europe) previously reported as "low HBV prevalence", 439
      Aboriginal Australians, and 109 from "other" ethnic groups (originating from
      Asia, the Pacific, the Middle East and southern Europe); and 209 school staff,
      comprising 180 from "low HBV prevalence" ethnic groups, and 29 from Aboriginal
      and other ethnic groups. RESULTS: Prior HBV infection (i.e. serum positive for
      HBsAg or anti-HBs) was detected in 28.7% of children (46.9% of 439 Aborigines;
      13.7% of the 556 children from the "low prevalence" groups and 32.1% of the 109
      from the "other" groups). HBsAg was detected in 8.2% of Aboriginal children, in
      0.36% of those from "low prevalence" groups, and in 1.8% of those from the
      "other" groups. Aboriginal children in rural schools had the highest prevalence
      of HBV: 5.4% were positive for both HBsAg and anti-HBs, and an additional 9.8%
      were positive for HBsAg alone. In urban schools, the prevalence was highest in
      the "other" ethnic groups. For school staff, the prevalence of HBV infection was
      12.8% for those from "low prevalence" ethnic groups, and 37.9% for those from all
      remaining groups (including Aborigines). CONCLUSION: In the Northern Territory
      the prevalence of past HBV infection is high in children and school staff from
      ethnic groups previously known to be at higher risk of HBV infection. For
      students and staff from ethnic backgrounds expected to be at low risk, HBV
      prevalence is greater than in individuals from similar backgrounds in other parts
      of Australia. HBV vaccination is now offered to all infants in the Northern
      Territory. These results also provide a rationale for the more widespread use of
      HBV vaccine in other situations where significant HBV transmission might occur.

PMID- 1625619
TI  - Managing sore throat: a literature review. II. Do antibiotics confer benefit?
AB  - OBJECTIVE: To assess the justification for the use of antibiotics in the
      management of sore throat in general practice. DATA SOURCES: The literature from
      1945 to 1990 was systematically screened to identify studies that addressed the
      question whether antibiotics reduce non-suppurative and suppurative complications
      and symptoms of sore throat. The key-words, "pharyngitis" and "tonsillitis" were
      used to identify trials of antibiotics for the treatment of sore throat. STUDY
      SELECTION: Studies were included in comparison tables if they involved the trial
      of one or more antibiotics against a control and there was an outcome in terms of
      reduction in the incidence of acute rheumatic fever, acute glomerulonephritis,
      acute otitis media, acute sinusitis, quinsy or any symptoms related to the acute
      illness. RESULTS: The published literature suggests that antibiotic treatment
      protects patients with sore throat against acute rheumatic fever and some
      suppurative complications, but not against acute glomerulonephritis. It does not
      reduce the symptoms. CONCLUSIONS: In Australia, with the exception of
      socioeconomically deprived Aboriginal communities, the incidence of acute
      rheumatic fever is probably not high enough to justify the use of antibiotics for
      sore throat. Protection against suppurative infection seems to be slight and it
      is difficult to establish the benefit of antibiotic treatment for reducing the
      symptoms of sore throat. Until more benefits for antibiotic management of sore
      throat can be demonstrated, it is recommended that infrequent use be adopted.

PMID- 1625618
TI  - South Australian hypertension survey. General practitioner experiences with drug
      treatment.
AB  - OBJECTIVE: To investigate prescribing habits, educational approaches and
      perceived needs of general practitioners in the drug treatment of hypertension.
      DESIGN, SETTING AND PARTICIPANTS: Of 156 randomly selected South Australian
      general practitioners 132 responded to a questionnaire survey. MAIN FINDINGS:
      Diuretics are the most commonly chosen drug for the initial management of
      uncomplicated moderate hypertension. Equivalent patients aged 45, 60 and 75 years
      would be prescribed a diuretic as drug of first choice in 41%, 55% and 68% of
      cases respectively. Despite this, there are wide differences in the choice of
      initial therapy between individual practitioners. These differences can have a
      substantial cost impact, given that in Australia the cost of diuretic therapy for
      one month can be as low as $1.97 compared with $34.08 for standard angiotensin
      converting enzyme inhibitor therapy for one month. There was also a perceived
      need, and demand, for patient education materials to assist practitioners in the
      drug treatment of hypertension.

PMID- 1625620
TI  - A case of murine typhus in Queensland.
AB  - OBJECTIVE: To present a case of murine (endemic) typhus, the first to be reported
      within the last 30 years in Australia. CLINICAL FEATURES: A 17-year-old pregnant
      woman presented with a viral-like illness and later developed a spotted rash,
      fever and headache. INVESTIGATION AND OUTCOME: Sera taken on Day 7 and Day 30 of
      the illness showed seroconversion to Proteus OX19 (Weil-Felix) and to Rickettsia
      typhi (by immunofluorescence), indicating recent infection with Rickettsia of the
      typhus group. Her illness was clinically compatible with murine typhus. She
      responded well to erythromycin and delivered a normal infant at term. CONCLUSION:
      Infection with Rickettsia typhi (murine typhus) still occurs in Australia. It can
      be diagnosed by means of specific serological tests for rickettsial disease,
      which are superior to the non-specific Weil-Felix test.

PMID- 1625621
TI  - Rabies. A second Australian case, with a long incubation period.
AB  - OBJECTIVE: The description of a second case of rabies in Australia, stressing the
      clinical features and that long incubation periods are possible. CLINICAL
      FEATURES: A 10-year-old Vietnamese girl presented with fever, shoulder pain,
      subcutaneous emphysema, swallowing difficulty and agitation. After a period of
      maniacal behaviour all peripheral and central nervous system function was lost.
      INTERVENTION AND OUTCOME: Despite maximal intensive care, the patient died. The
      diagnosis of rabies was made at autopsy. CONCLUSIONS: Rabies occurs in Australia
      and needs to be considered in the differential diagnosis of acute encephalitis
      and/or the Guillain-Barre syndrome. Incubation periods of more than six years can
      occur.

PMID- 1625622
TI  - Subdural haematoma presenting with transient neurological deficits.
AB  - OBJECTIVE: To stress that transient neurological deficits do not always imply
      transient cerebral ischaemia, and may be produced by subdural haematoma. CLINICAL
      FEATURES: An 80-year-old man was seen for intermittent gait disturbance, with
      normal findings on initial examination. He was then admitted after the onset of a
      fixed neurological deficit which worsened. Subdural haematoma was diagnosed by
      computed tomography (CT). An 80-year-old woman was seen after she had experienced
      left hemisphere transient neurological deficits. A CT scan showed a left-sided
      subdural haematoma. INTERVENTION AND OUTCOME: Both patients underwent successful
      surgery with complete resolution of their symptoms and signs. CONCLUSION:
      Subdural haematoma is relatively common and must be considered in those with
      unexplained transient neurological deficits. Magnetic resonance imaging or CT are
      the diagnostic procedures of choice. Antiplatelet or anticoagulant therapy must
      not be instituted until subdural haematoma is excluded.

PMID- 1625623
TI  - Doctor versus laboratory notification of gonorrhoea in Western Australia.

PMID- 1625624
TI  - Native valve endocarditis and vertebral osteomyelitis caused by Staphylococcus
      epidermidis.

PMID- 1625625
TI  - Resistance to ciprofloxacin of respiratory pathogens in patients with cystic
      fibrosis.

PMID- 1625626
TI  - Pap smear reminder systems.

PMID- 1625628
TI  - Ciprofloxacin in cat-scratch disease.

PMID- 1625627
TI  - "Holistic" health workers.

PMID- 1625629
TI  - Tuberculosis in Australia--a forgotten disease.

PMID- 1625630
TI  - Tuberculosis in Australia--a forgotten disease.

PMID- 1625631
TI  - Tuberculosis in Australia--a forgotten disease.

PMID- 1625632
TI  - Tuberculosis in Australia--a forgotten disease.

PMID- 1625633
TI  - Does the doctor listen?

PMID- 1625634
TI  - The battle of the couches and the rats.

PMID- 1625635
TI  - In search of the pathogenesis of refractory cervicobrachial pain syndrome.

PMID- 1625636
TI  - In search of the pathogenesis of refractory cervicobrachial pain syndrome.

PMID- 1625637
TI  - Sodium cromoglycate for ACE inhibitor cough.

PMID- 1625638
TI  - The "Ulysses syndrome" in pathology.

PMID- 1625639
TI  - Basal cell naevus syndrome.

PMID- 1625640
TI  - Enuresis and body worn alarms.

PMID- 1625641
TI  - Stevens-Johnson syndrome induced by verapamil.

PMID- 1625642
TI  - Oxygenation and carbon dioxide elimination during cardiopulmonary bypass.

PMID- 1625643
TI  - Inotropic support of the failing heart.

PMID- 1625644
TI  - Incidence of postoperative hypoxemia as detected by pulse oximetry.

PMID- 1625645
TI  - Differential diagnosis of delayed return to consciousness.

PMID- 1625646
TI  - The effect of propofol and thiopentone on pentylenetetrazol seizure threshold in
      the rat.
AB  - The protective effects of subanesthetic and anesthetic doses of propofol and
      thiopentone against pentylenetetrazol (PTZ)- induced seizures were studied in the
      rat. Intraperitoneal administration of propofol and thiopentone at doses
      producing comparable levels of sedation prior to intravenous infusion of PTZ,
      resulted in a marker and significant increase in PTZ seizure threshold. However,
      at all doses, the effects of propofol on PTZ convulsive threshold were more
      profound. These data suggest that propofol is an effective anticonvulsant and
      affords a greater degree of protection than thiopentone against PTZ-induced
      seizures in the rat.

PMID- 1625647
TI  - Nosocomial infections in ventilated patients.

PMID- 1625649
TI  - Neurobiological disorders in children and adolescents.

PMID- 1625648
TI  - Anesthetic management for cesarean section in a patient with Wilson's disease.
AB  - We describe the successful management of a 28-year-old female with Wilson's
      disease who developed gestational pre-eclamptic hypertension (GPH) during
      pregnancy and who required an urgent cesarean delivery. We discuss the rationale
      of using magnesium sulphate prior to induction and the importance of adequate
      monitoring is selecting an anesthetic technique based on the pathophysiology of
      the disease.

PMID- 1625650
TI  - Reforming insurance law to provide equitable coverage for persons with
      neurobiological disorders.

PMID- 1625651
TI  - Obtaining insurance coverage for bipolar disorder and other neurobiological
      disorders on a par with other physical illnesses.

PMID- 1625652
TI  - Parents forced to surrender custody of children with neurobiological disorders.

PMID- 1625653
TI  - A free, appropriate public education for children with neurobiological disorders-
      sometimes available only through due process litigation.

PMID- 1625654
TI  - Professional supportive caring for children and adolescents with chronic
      neurobiological disorders.

PMID- 1625655
TI  - Autism.

PMID- 1625656
TI  - Obsessive-compulsive disorder.

PMID- 1625657
TI  - Bipolar disorder.

PMID- 1625658
TI  - Attention deficit hyperactivity disorder.

PMID- 1625659
TI  - Pharmacological treatment of conduct disorder.

PMID- 1625660
TI  - Anxiety disorders.

PMID- 1625661
TI  - Neuroimaging in neuropsychiatry.

PMID- 1625662
TI  - Brain development: pervasive developmental disorders and infantile autism.

PMID- 1625663
TI  - Integrating the neurobiological revolution into child and adolescent psychiatry
      and into society.

PMID- 1625665
TI  - The development of nursing research--a paradigm shift in nursing.

PMID- 1625664
TI  - Individualized services for children.
AB  - In Alaska, the development of a model of individualized services has been
      beneficial to children with neurobiological disorders. The AYI program has
      successfully demonstrated that even the most disabled children can be served in
      communities. This finding promotes a new level of less restrictive and more
      therapeutic alternatives tailored to the needs of children and their caring
      families.

PMID- 1625666
TI  - Student nurses' perceptions of experiential learning.
AB  - Experiential learning has been widely discussed and recommended in the nursing
      literature--particularly in the fields of psychiatric nursing and interpersonal
      skills training. This report offers some of the findings from a research study
      which is aimed at identifying the perceptions of student nurses towards
      experiential learning. 12 nursing students were interviewed and the interview
      transcripts were analysed using a modified grounded theory approach. Findings
      indicated that these students tended to see experiential learning in terms of
      clinical learning and learning through working in the wards and community
      settings.

PMID- 1625667
TI  - Reflective practice and nursing.
AB  - Reflective practice is a frequently used but in-frequently defined concept in
      nursing at the present time. Part of the reason for the lack of definition lies
      in the fact that there is no theory of practice. This paper lays the foundations
      for a theory of practice and paves the way for one useful way in which the
      relationship between theory and practice can be understood. It is suggested that
      thoughtful practice is often mistaken for reflective practice, but that the
      latter can only exist where practice is not taken for granted and so the outcome
      of practice is more learning from experience. The paper also maintains that for
      reflective practice to be practised within the profession it is necessary both to
      have the structures within which it can be encouraged and the theoretical
      foundation whereby efficient practice need not only be judged in terms of 'value
      for money'.

PMID- 1625668
TI  - Reflections of a distance education facilitator.
AB  - After nearly a year of preparation, 'Therapeutic Communication', the first
      nursing unit in our new Bachelor of Nursing degree was taught for the first time
      in 1988. The unit has developed and grown since this time, with both educational
      and financial factors determining such things as design of student materials and
      assessment mode. The geographically scattered--and often isolated--students are
      formally recognised for their individuality and their personal and professional
      life experiences, and given choices within the unit of what they want to learn
      and how they will present this material, through introduction of a learning
      contract as part of the unit assessment. Difficulties encountered by these
      students in maintaining their self-esteem when moving from the demanding and
      complex world of clinical nursing to the arena of tertiary study are discussed.
      The provision of speedy, comprehensive feedback with general as well as specific
      guidance with essay writing and referencing, focuses on the process skills many
      nurses lack as they enter this unit. The applicability of therapeutic
      communication to clinical practice and the diversity of projects undertaken by
      students within the limits of the unit demonstrate its appeal to a wide range of
      registered nurses. Some of the often ignored or minimised factors that
      differentiate external study from on-campus work are highlighted for both
      students and unit facilitator, and the creation of an in-house booklet to assist
      students in developing their skills in external study is outlined.

PMID- 1625669
TI  - Nursing students' learning styles: a comparison of degree and non-degree student
      approaches to studying.
AB  - This research utilised the Lancaster inventory to investigate the approaches to
      studying of a group of nurse learners (n = 32) from a college of nursing and
      midwifery and a group of nursing undergraduates (n = 23) from an institution of
      higher education. It was hoped that the research would cast some light on whether
      the two groups approach their studying in similar or different ways, since these
      approaches may dictate success in educational ventures. The results indicated no
      statistically significant differences between the two learner groups' approaches
      to studying.

PMID- 1625670
TI  - Interaction in the classroom: district nurse students and their teachers.
AB  - This research project aimed to investigate interaction in the classroom between
      district nurse students and their teachers and to identify some characteristics
      of effective teaching and learning. The research explored events in the classroom
      and relationships between students and teachers, and students and their peers.
      Symbolic Interactionism was used as the theoretical framework. Ethnographic
      methods within qualitative research focused on the ways in which teachers and
      students organise themselves and their environment through roles, rules and
      procedures.

PMID- 1625671
TI  - Knowledge about, and attitudes to, HIV/AIDS among students in a Sydney nursing
      college.
AB  - The purpose of this study was to assess nursing students' knowledge about HIV
      infection and AIDS. 231 nursing students at a nursing college in Sydney were
      invited, and agreed, to participate. They were surveyed on knowledge about
      transmission, precautions to take when providing nursing care and epidemiology,
      general attitudes to HIV/AIDS, attitudes to patient-care, risk of infection at
      work and homosexuality. Two knowledge and four attitude scales were constructed.
      The students showed a fairly high level of knowledge: a mean percentage score of
      78 on the transmission scale and 80 on the precaution scale. They also had some
      misconceptions about transmission routes. A majority (72%) had favourable
      attitudes to AIDS patient care; a minority (22%) had a clear fear of contagion
      through occupational exposure; 26% had negative attitudes to homosexuality.
      Nursing students with AIDS-care experience had significantly more positive
      attitudes than those who had no such experience. Knowledge and attitudes were
      positively correlated (correlation range 0.24-0.46). It is suggested that
      training programmes include experiential learning to address fear, discomfort and
      anxieties about HIV/AIDS.

PMID- 1625672
TI  - AIDS counselling and nurse education.
AB  - The number of people with AIDS and HIV related disorders is increasing. Nurses
      are going to be called, increasingly, to act as AIDS counsellors. This paper
      explores some of the issues involved in counselling people with AIDS and some of
      the related literature. It suggests that any course for helping nurses to develop
      such skills will involve at least the following elements: information, values
      clarification and basic counselling skills.

PMID- 1625673
TI  - APL: a corporate strategy.
AB  - This paper is based on, and summarises, papers read at the second annual
      international conference of Nurse Education Tomorrow held at the University of
      Durham (UK) September 1991. To this end this paper will offer: Some Accreditation
      of Prior Learning (APL) definition and process as reflected in the literature
      available. A distinction will be made between APL and Accreditation of Prior
      Experiential Learning (APEL) although the procedures and processes for assessing
      them will be shown to be the same. A brief outline of corporate strategy, as it
      applies to APL, will be given to form the basis for logical demonstration of how
      Derbyshire Institute of Health and Community Studies has employed such a
      corporate strategy. Insights developed and gained from APL research currently
      being undertaken through the college of nursing and midwifery will be used to
      inform the development and nature of corporate strategy. A flowchart of the
      operationalisation of the corporate strategy is offered as an integrative summary
      of how all the APL ideas have had a positive cumulative effect. The paper
      finishes by highlighting the possible strengths and limitations of APL corporate
      strategy.

PMID- 1625674
TI  - The nurse teacher's role in the practice setting.
AB  - In the light of the education reforms brought about by the implementation of
      Project 2000 it is essential that nurse teachers critically appraise their role
      and function. In particular, they need to give careful consideration to their
      role in relation to the practice setting. Whilst the English National Board
      (1989) indicate that nurse teachers should retain their clinical competence and
      be able to teach in both classroom and practice settings, little has been written
      in respect of the implications of this directive. This paper considers the issue
      of clinical competence and explore some of the different dimensions of the nurse
      teacher's role in the practice setting, in respect of teaching, providing
      educational support and facilitating good practice. Finally, some of the issues
      relating to the successful fulfilment of this role are identified for
      consideration.

PMID- 1625675
TI  - Getting there by degree . . . a personal view of undertaking a part-time degree
      course.
AB  - Nine months ago the author became a student on a part-time Bachelor of Nursing
      Sciences Course. The author shares her experience in order to encourage nurses to
      consider undertaking this type of study and at the same time persuade course
      selector that part-time workers with domestic commitments can cope.

PMID- 1625677
TI  - Effects of phorbol esters on insulin receptor function and insulin action in
      hepatocytes: evidence for heterogeneity.
AB  - We investigated the effect of phorbol 12-myristate 13-acetate (PMA), a protein
      kinase C (PKC) activator on insulin receptors and insulin action in freshly
      isolated and primary cultures of rat hepatocytes. PMA (1 x 10(-7) M) did not
      alter insulin receptor numbers or affinity either acutely or chronically but
      within 60 minute inactivated insulin stimulated tyrosine kinase of the insulin
      receptor. PKC activation inhibited insulin (1 x 10(-7) M) stimulation of glycogen
      and lipid synthesis with a decrease or no change in basal glycogenesis and
      lipogenesis respectively. However, PKC activation did not alter insulin
      stimulated or basal amino acid transport even though PKC activation inhibited
      insulin stimulation of the insulin receptor tyrosine kinase. Thus, within one
      tissue, PKC activation has differential effect on insulin action depending on
      which pathway is examined. Furthermore, insulin stimulation of the insulin
      receptor tyrosine kinase may not be a necessary step for all insulin signaling
      pathways.

PMID- 1625676
TI  - Approaches to the molecular cloning of protein-tyrosine phosphatases in insulin
      sensitive tissues.
AB  - The intrinsic tyrosyl kinase activity of the insulin receptor is regulated by a
      balance between insulin-induced receptor autophosphorylation, which stimulates
      the receptor kinase, and enzymatic dephosphorylation of the receptor, which
      deactivates its kinase activity. The cellular protein-tyrosine phosphatase
      (PTPase) enzymes responsible for reversing the activated state of the insulin
      receptor have not been characterized. Our laboratory is interested in identifying
      and cloning the specific PTPase(s) that regulate the phosphorylation state of the
      insulin receptor. This chapter will summarize the design and results of our
      initial molecular cloning studies to identify specific PTPases in insulin
      sensitive tissues that may have a potential physiological role in insulin action
      and clinical insulin resistance.

PMID- 1625678
TI  - Insulin resistance and hypertension.

PMID- 1625679
TI  - Comparative effects of 6 week fructose, dextrose and starch feeding on fat-cell
      lipolysis in normal rats: effects of isoproterenol, theophylline and insulin.
AB  - The precise effects of fructose feeding on adipose tissue is not clearly known.
      Consequently, we studied the effects of fructose feeding on stimulated and
      inhibited in vitro lipolysis. Twenty seven male Sprague Dawley rats, 5 weeks of
      age, were fed for 6 weeks on one of three diets containing 57% CHO as fructose
      (F), dextrose (D) or starch (S). At week 6 the epididymal fat pad weights showed
      no difference between groups. Stimulation of lipolysis by isoproterenol or
      theophylline showed: decreased sensitivity of adipocytes to isoproterenol, but
      not to theophylline, in F (p less than 0.05); the maximal responses were
      decreased, but NS, after stimulation by either isoproterenol or theophylline. The
      maximal antilipolytic responses to insulin were increased in F (27%) and D (29%)
      when compared to S (16%), (p less than 0.05). Only, in F there was an increase
      (NS) in ED50 (0.63 +/- 0.23 ng/ml) compared to D (0.45 +/- 0.18) and S (0.29 +/-
      0.18), indicating decreased sensitivity. Nonfasting plasma insulin and
      triglycerides were increased at the 6th week in F (p less than 0.01), without any
      change in plasma glucose levels. However, there was no difference in 12 h fasting
      plasma glucose, insulin or triglycerides. In conclusion, a 6 week 57% fructose
      containing diet in normal rats led to: 1) decreased lipid mobilization in the
      epididymal adipose tissue; and 2) increased nonfasting plasma insulin and
      triglycerides. Thus fructose, under these experimental conditions, seems to have
      adverse metabolic effects in normal rats.

PMID- 1625680
TI  - Vanadate induces the recruitment of GLUT-4 glucose transporter to the plasma
      membrane of rat adipocytes.
AB  - In rat adipocytes, the insulin stimulation of the rate of glucose uptake is due,
      at least partially, to the recruitment of glucose transporter proteins from an
      intracellular compartment to the plasma membrane. Vanadate is a known insulin
      mimetic agent and causes an increase in the rate of glucose transport in rat
      adipocytes similar to that seen with insulin. The objective of the present study
      was to determine whether vanadate exerts its effect through the recruitment of
      glucose transporters to the plasma membrane. We report that under conditions
      where vanadate stimulates the rate of 2-deoxyglucose uptake to the same extent as
      insulin, the concentration of GLUT-4 in the plasma membrane was increased
      similarly by both insulin and vanadate, and its concentration was decreased in
      the low density microsomal fraction. These results suggest that vanadate induces
      the recruitment of GLUT-4 to the plasma membrane. The effects of vanadate and
      insulin on the stimulation of 2-deoxyglucose uptake and recruitment of GLUT-4
      were not additive. This is the first report of an effect of vanadate on the
      intracellular distribution of the glucose transporter.

PMID- 1625681
TI  - The effects of orthovanadate, vanadyl and peroxides of vanadate on glucose
      metabolism in skeletal muscle preparations in vitro.
AB  - The insulin-like effects of various vanadium compounds (orthovanadate, vanadyl
      and peroxides of vanadate) on rates of glucose oxidation, lactate formation and
      glycogen synthesis were measured in isolated incubated epitrochlearis (mainly
      type II fibres) and soleus (mainly type I fibres) muscle preparations. There was
      a small stimulation of the rate of glucose utilisation in soleus muscle
      preparations in vitro by orthovanadate (1 mM). Orthovanadate or vanadyl, at 1 mM,
      had little effect on the rates of lactate formation or glycogen synthesis in
      isolated incubated epitrochlearis muscle preparations. In contrast, peroxides of
      vanadate (peroxovanadates, at 1 mM) significantly stimulated glucose utilisation
      in both soleus and epitrochlearis muscle preparations in vitro. The stimulation
      of the rate of glycogen synthesis was associated with an increase in the
      percentage of glycogen synthase in the I (or a) form. Peroxovanadates were
      administered in the drinking water to rats made insulin deficient by
      streptozotocin treatment. There was no decrease in the elevated level of blood
      glucose over an 8 day administration period.

PMID- 1625683
TI  - Impairment of contractility associated with muscarinic supersensitivity in
      trachea isolated from diabetic rats: lack of correlation with ultrastructural
      changes or quinuclidinyl benzylate binding to lung membranes.
AB  - Evolution of cholinergic response of rat isolated trachea was determined after
      various durations of diabetes (17, 40, 90, 150 and 210 days). Long-term diabetes
      was associated with both impairment of contractility and supersensitivity to
      cholinergic stimulation. However, the mechanism of these alterations remains to
      be determined, as response to field stimulation was not specifically altered
      while electron microscopy studies could not detect any significant change in the
      aspect of nerves, smooth muscle or epithelium. As well, binding studies of lung
      cholinergic receptors using the antagonist ligand [3H]-quinuclidinyl benzylate
      and the agonist carbachol did not detect any change in diabetic animals.

PMID- 1625682
TI  - Effects of vanadyl derivatives on animal models of diabetes.

PMID- 1625684
TI  - Serum lipids and urinary albumin excretion in non insulin-dependent diabetics.
AB  - The increase of urinary albumin excretion has a predictive value for
      cardiovascular disease in insulin-dependent and non insulin-dependent diabetics.
      To study the relationship between urinary albumin excretion and serum lipids, 380
      non insulin-dependent diabetics, 40 to 75 yr old, with urinary albumin excretion
      from 0 to 200 mg/l, and normal serum creatinine (less than 150 mumol/l), were
      surveyed. Urinary albumin excretion, was related positively to age (r2 = 0.014; p
      = 0.02), to systolic blood pressure (r2 = 0.073, p = 0.0001) and diastolic blood
      pressure (r2 = 0.052, p = 0.0001); a negative correlation existed with HDL
      cholesterol (r2 = 0.043, p = 0.0001) and Apoprotein A1 (r2 = 0.044, p = 0.0001).
      A stepwise regression analysis was performed and resulted in three independently
      contributing variables related to urinary albumin excretion: First systolic blood
      pressure (F = 36), second Apoprotein A1 (F 24), third hemoglobin A1C (F = 6). The
      presence of hypertension or insulin therapy did not modify these findings. In
      conclusion, serum lipid seems an important determinant of urinary albumin
      excretion in non insulin-dependent diabetics.

PMID- 1625685
TI  - Models of insulin action on metabolic and growth response genes.
AB  - In ongoing studies aimed at elucidating the mechanism of insulin action on the
      expression of genes that modulate glucose utilization and cell growth, we have
      focused on the inductive effect of insulin on transcription of glyceraldehyde-3
      phosphate dehydrogenase (GAPDH) and the early growth response gene, Egr-1.
      Insulin acutely stimulates the expression of both genes in 3T3 adipocytes;
      however, in primary adipocytes, chronic insulin exposure has opposing effects on
      the expression of these genes. GAPDH mRNA is decreased in the epididymal fat
      cells of diabetic animals and is increased over control levels when insulin is
      replaced, while Egr-1 mRNA levels are increased in diabetic animals. These
      observations, coupled with the finding that insulin-stimulated Egr-1 gene
      transcription is impaired in a Chinese hamster ovarian (CHO) cell line that
      displays normal metabolic responses but impaired ability to regulate DNA
      synthesis, support the conclusion that insulin regulation of Egr-1, a growth
      response gene, and GAPDH, a metabolic response gene, are mediated by distinct
      pathways. We present evidence that supports the role of protein phosphorylation
      in mediating the effect of insulin on activation of Egr-1 and GAPDH gene
      transcription.

PMID- 1625686
TI  - Link studied between maternal behaviors, pregnancy outcome.

PMID- 1625687
TI  - FDA panel recommends restricted use of breast implants.

PMID- 1625688
TI  - New organization targets carnitine deficiency.

PMID- 1625689
TI  - What is the difference between diagnostic mammography and screening mammography?

PMID- 1625690
TI  - NAACOG position statement. Issue: the HIV-infected health-care worker.

PMID- 1625691
TI  - Nursing intervention with battered women. Abuse often increases with pregnancy.

PMID- 1625693
TI  - Clinical issues studies neonates with low birth weights.

PMID- 1625692
TI  - What drugs are used to prevent and treat chlamydial eye infections in newborns?

PMID- 1625694
TI  - As breast cancer rates rise, nurses' role increases.

PMID- 1625695
TI  - What is the role of pelvic muscle exercise (PME) in the prevention and treatment
      of stress urinary incontinence (SUI)?

PMID- 1625696
TI  - FDA limits access to breast implants.

PMID- 1625697
TI  - Mechanistic studies in the transcuticular delivery of antiparasitic drugs. II: Ex
      vivo/in vitro correlation of solute transport by Ascaris suum.
AB  - Using live, intact Ascaris suum and a closed perfusion system, the absorption
      kinetics and tissue distribution of selected radiolabeled permeants were measured
      to determine the importance of the transcuticular pathway for drug absorption.
      The data support the conclusions established by previous in vitro transport
      studies which utilized excised cuticle-hypocuticle tissue preparations. The
      external surface of A. suum can be breached by drugs and the rate-determining
      barrier is the lipoidal hypocuticle tissue, provided the permeant is sufficiently
      small to traverse the aqueous-filled, negatively charged collagen matrix of the
      cuticle. The ex vivo permeability coefficients of the model permeants for the
      cuticle-hypocuticle barrier were in good quantitative agreement with the in vitro
      permeability coefficients. The lipophilic permeants hydrocortisone and p
      nitrophenol were preferentially distributed in the gut tissue, whereas the
      hydrophilic permeant urea was distributed evenly throughout the organism and was
      extensively metabolized. Ligated and nonligated A. suum showed no significant
      differences in either uptake kinetics or tissue distribution of the permeants.
      This indicates that the transcuticular pathway is the major route of drug
      absorption as compared to oral ingestion.

PMID- 1625698
TI  - A potential hexose transporter gene expressed predominantly in the bloodstream
      form of Trypanosoma brucei.
AB  - A cDNA cloned from Trypanosoma brucei brucei codes for a putative membrane
      protein which is homologous to the erythrocyte glucose transporter and several
      other sugar transporters from Escherichia coli, yeast, algae and Leishmania. This
      cDNA hybridizes to a 2.3-kb mRNA that accumulates to a much higher degree in the
      bloodstream mammalian form than in the procyclic insect form of the parasite. The
      correlation between the expression of this gene and the hexose metabolism of
      Leishmania enriettii and T. brucei suggest that these 2 related genes probably
      encode hexose transporters. The gene encoding this mRNA is a member of a
      multigene family. The putative hexose transporter gene is highly conserved among
      Kinetoplastidae, indicating an important role for this protein in the parasite
      life cycle.

PMID- 1625699
TI  - Chromosomes of Babesia bovis and Babesia bigemina.

PMID- 1625700
TI  - Molecular cloning and sequencing of glutathione peroxidase from Schistosoma
      mansoni.

PMID- 1625701
TI  - Cloning and characterization of the Wuchereria bancrofti S15 ribosomal protein.

PMID- 1625702
TI  - Cloning and sequence analysis of a calcium-binding protein gene from a pathogenic
      strain of Entamoeba histolytica.

PMID- 1625703
TI  - The protein sequence predicted from a Leishmania guyanensis gp63 major surface
      glycoprotein gene is divergent as compared with other Leishmania species.

PMID- 1625704
TI  - Stage-specific expression of aldolase isoenzymes in the rodent malaria parasite
      Plasmodium berghei.
AB  - We have cloned two gene (aldo-1 and aldo-2) encoding the glycolytic enzyme
      aldolase of the rodent malaria parasite Plasmodium berghei. The amino acid
      sequence of one gene product, ALDO-1, is virtually identical to P. falciparum
      aldolase whereas ALDO-2, the second gene product, is different and has 13%
      sequence diversity to ALDO-1. We expressed ALDO-2 as an active enzyme in
      Escherichia coli and compared the biochemical and kinetic properties to that of
      P. falciparum recombinant aldolase (ALDO-1 type). Based on the Km and Vmax
      constants for FMP and FBP, neither ALDO-1 nor ALDO-2 can be clearly assigned to
      any of the known mammalian isoenzyme classes. We demonstrate that expression of
      the two isoenzymes is developmentally regulated: specific antibody probes detect
      ALDO-1 in sporozoite stages of P. berghei and ALDO-2 is found in blood stage
      parasites.

PMID- 1625705
TI  - Active site thiol(s) in Leishmania donovani adenosine kinase: comparison with
      hamster enzyme and evidence for the absence of regulatory adenosine binding site.
AB  - Adenosine kinase (ATP, adenosine 5'-phosphotransferase, E.C. 2.7.1.20) from
      Leishmania donovani, unlike adenosine kinase from other known eukaryotic sources,
      does not elicit an inhibitory response at high concentrations of adenosine. The
      mechanistic basis for this unique catalytic behavior of the parasite enzyme has
      been probed with the help of chemical modification and enzyme inhibition kinetics
      experiments. The use of cysteine-directed reagents has shown that chemical
      integrity of cysteinyl residues is essential for the expression of functional
      activity of the enzyme. Thiol group titration revealed that the enzyme contains 3
      cysteine residues. However, in contrast to adenosine kinase from other sources,
      inactivation of the parasite enzyme could be correlated with alkylation of 2
      cysteinyl residues. Adenosine, but not ATP, protected 2 thiols against -SH
      blocker-mediated inactivation of the enzyme. The thiol groups were shown to map
      at positions corresponding to approximately 16, 22, and 36 kDa sites from the
      protein's N-terminal end. The functions of 2 thiols at the catalytic site were
      functional thiol groups yielded a 'protection constant' (KpAd) of 3.4 microM,
      while the dissociation constant (KsAD) of the enzyme-substrate complex was 2.7
      microM, hence supporting involvement of the same in both processes, namely
      catalysis and protection. The overall results were therefore interpreted as
      showing that (a) the leishmanial enzyme, in contrast to adenosine kinase from
      other sources, contains 2 functional thiol groups at the catalytic site; and (b)
      the enzyme binds adenosine exclusively through the catalytic site and as a
      consequence is not amenable to inhibition at high adenosine
      concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1625706
TI  - Schistosoma mansoni p48 eggshell protein gene: characterization, developmentally
      regulated expression and comparison to the p14 eggshell protein gene.
AB  - Egg production by worm pairs is a major cause of pathogenesis in schistosomiasis.
      To further the understanding of female reproductive development, we have isolated
      and characterized a complete copy of an eggshell protein precursor gene, p48.
      Sequence analysis reveals that the gene has 3 open reading frames and does not
      contain an intron. One of the open reading frames, ORF1, encodes a polypeptide of
      50 kDa which shows strong homology to insect chorion proteins. Determination of
      the position of the mRNA cap-site facilitated identification of putative
      regulatory elements in the 5' upstream region of the gene. Some of these elements
      (e.g., TCACGT) have been shown to play a role in the regulation of chorion gene
      expression in insects. p48 mRNA is detectable only in mature female worms and the
      ability to detect the mRNA coincides temporally with worm pairing. Quantitative
      comparisons, during female reproductive development, of p48 transcripts to those
      from another eggshell protein precursor gene, p14, show that the p48 mRNA is
      significantly less abundant than p14 mRNA. In mature female worms, p48 mRNA can
      only be detected in vitelline cells. Antibodies made against the polypeptide
      sequence deduced from ORF1 of the p48 gene recognize a 50-kDa molecule in
      extracts from mature female worms, but not in extracts from immature females or
      males.

PMID- 1625707
TI  - Chitinase activity in encysting Entamoeba invadens and its inhibition by
      allosamidin.
AB  - Chitinase activity was measured in extracts of Entamoeba invadens cells as a
      function of time of encystation in axenic conditions using 4-MU(Ch)3 as
      substrate. Encystment was paralleled by chitinase activity which showed a peak
      after about 72 h of cultivation where cysts accounted for 63% of cell population.
      Thereafter, activity fell off rapidly, whereas encystment continued, reaching 80%
      at the end of the experiment (96 h). Comparison of activity between cysts and the
      total cell population in 48- and 72-h-old encysting cultures suggested that
      chitinase may start to accumulate in the pre-cyst forms. About 70% of the enzyme
      was recovered in the supernatant following low-speed centrifugation of whole
      extracts. Most of this activity represented soluble chitinase since it was not
      sedimented by further centrifugation at 105,000 x g. A minor proportion of enzyme
      activity remained associated to the buffer-washed, high-speed sediment. In
      addition to 4-MU(Ch)3, chitinase activity was also measured following the
      hydrolysis of other substrates such as nascent, preformed or colloidal chitin.
      Like other chitinases, the cyst enzyme preferred nascent over preformed chitin as
      substrate. Digestion of the former yielded GlcNAc and minor amounts of (GlcNAc)2
      as products. Allosamidin strongly inhibited hydrolysis of the fluorogenic
      substrate by the amebic chitinase in vitro with a Ki of 0.065 microM. IC50 values
      were 0.085 microM and 0.16 microM at 5 microM and 10 microM 4-MU(Ch)3,
      respectively. When added to the axenic medium, the drug markedly retarded
      encystment though it was partially recovered after longer periods of incubation.

PMID- 1625708
TI  - Changes in the surface composition after transmission of Acanthocheilonema viteae
      third stage larvae into the jird.
AB  - This study describes the dynamics and the biochemical nature of changes in the
      surface of the filarial nematode Acanthocheilonema viteae after its transmission
      into the vertebrate host. Vector-derived third-stage larvae (mL3) were inoculated
      into naive Meriones unguiculatus and recovered from the tissues at different
      times post-infection until their moult to fourth-stage larvae (L4). Surface
      specific labelling with fluoresceinated lectins revealed that the larvae are
      covered by a carbohydrate envelope. Although the mL3 envelope was strongly
      reduced one day after transmission, new surface carbohydrates appeared until the
      onset of moulting, some of which could also be identified on the surface of L4.
      In general, surface carbohydrates were partially shed by moving larvae,
      suggesting a loose association of these components in the epicuticle. The fate of
      cuticular lipids and proteins of L3 and L4 was monitored by external 125I
      labelling and differential extraction of the components. Thin-layer
      chromatography of surface-labelled lipids revealed only minor changes 1 day after
      parasite transmission. Afterwards the number of lipids accessible to label
      decreased further until moulting was complete. Two-dimensional sodium dodecyl
      sulphate-polyacrylamide gel electrophoresis of surface-labelled proteins showed a
      consistent surface exposure of mL3 specific proteins until 1 day post-infection.
      Thereafter, the composition of surface-labelled proteins changed rapidly,
      resembling that of the L4 as early as several days before moulting. During this
      period individual differences in the composition of surface proteins were
      evident.

PMID- 1625709
TI  - Characterization of the rDNA unit and sequence analysis of the small subunit rRNA
      and 5.8S rRNA genes from Tritrichomonas foetus.
AB  - The ribosomal RNA gene unit of the protozoan parasite Tritrichomonas foetus has
      been cloned and analyzed. Southern blot analysis of the genomic DNA showed that
      the ribosomal RNA gene unit is organized as a tandem head to tail repeat with a
      unit length of 6 kb. By Northern analysis a primary transcript of 5.8 kb was
      detected. Copy number analysis showed the presence of 12 copies of the ribosomal
      RNA gene unit. The lengths of the small subunit ribosomal RNA and 5.8S ribosomal
      RNA are 1571 bp and 159 bp, respectively, as determined by sequence analysis. The
      T. foetus small subunit ribosomal RNA sequence is one of the shortest eukaryotic
      small subunit rRNA sequences, similar in length to those from 2 other
      amitochondrial protists. Although shorter than the majority of the eukaryotic
      small subunit ribosomal RNAs, this sequence maintains the primary and secondary
      structure common to all eukaryotic small subunit ribosomal RNA structures, while
      truncating sequences found within the eukaryotic variable regions. The length of
      the large subunit ribosomal RNA was measured at 2.5 kb.

PMID- 1625710
TI  - Surface-associated antigens of Brugia malayi L2 and L3 parasites during vector
      stage development.
AB  - Surface and metabolic labeling procedures were used to characterize the
      composition and the time of expression of Brugia malayi L2 and L3 surface
      associated molecules as the larvae develop within the mosquito vector. Larvae
      were harvested from mosquito tissues at 5 (early L2), 8 (late L2) and 11 (L3)
      days post-infection and labeled with 125I-Iodo-Gen. The results of one
      dimensional analysis showed that there is a progressive increase in the
      complexity of peptides associated with the surface of developing larvae,
      culminating in the expression of 7 major labeled components on L3s. Both L2 and
      L3 parasites have surface-associated components of 42, 35, 33, 19 and 17 kDa.
      Between days 8 and 11 of development in the insect vector, Brugia malayi
      undergoes the L2 to L3 molt and acquires additional major immunogenic peptides of
      40 and 22 kDa. Two-dimensional analyses of extracts from 125I-labeled L2s and L3s
      revealed that the major 35-, 33-, 19- and 17-kDa molecules are part of a peptide
      complex that forms a 'ladder' between 17 and 150 kDa. To gain information on the
      times during which the major surface-associated molecules are produced by the
      parasite, larvae were labeled with [35S]methionine either in situ as they
      developed within the mosquito or during culture after exiting the vector. For in
      situ labeling, [35S]methionine was introduced into the hemolymph of infected
      mosquitoes by micro-injection at days 2, 5 and 8 post-infection and the larvae
      were allowed to develop for an additional 3 days. The results of 1- and 2
      dimensional analyses of [35S]methionine-labeled extracts from vector-stage or
      post-vector-stage larvae indicate that the molecules associated with the surface
      of B. malayi L3s are synthesized between day 5 and day 11 of development in the
      insect host. Immediately after the larvae exit the vector, the synthesis of the
      40 and 22-kDa peptides is drastically reduced or terminated.

PMID- 1625711
TI  - Mitral annular calcification and the risk of stroke in an elderly cohort.
AB  - BACKGROUND: Previous clinical studies have suggested that there is an association
      between mitral annular calcification and the risk of stroke, but it is unclear
      whether this association is independent of the traditional risk factors for
      stroke. We examined the relation between mitral annular calcification and the
      incidence of stroke in a population-based study. METHODS: Subjects in the
      Framingham Study receiving a routine examination underwent M-mode
      echocardiography to determine the presence and severity (thickness in
      millimeters) of mitral annular calcification. The incidence of stroke during
      eight years of follow-up was analyzed with a proportional-hazards model adjusting
      for the calcification, age, sex, systolic blood pressure, diabetes mellitus,
      cigarette smoking, atrial fibrillation, and coronary heart disease or congestive
      heart failure. RESULTS: Among 1159 subjects whose echocardiograms could be
      assessed for mitral annular calcification and who had no history or current
      evidence of stroke at the index examination (51 percent of all subjects), the
      prevalence of mitral annular calcification was 10.3 percent in the men and 15.8
      percent in the women. Multivariate analysis demonstrated that the presence of
      mitral annular calcification was associated with a relative risk of stroke of
      2.10 (95 percent confidence interval, 1.24 to 3.57; P = 0.006). There was a
      continuous relation between the incidence of stroke and the severity of mitral
      annular calcification; each millimeter of thickening as shown on the
      echocardiogram represented a relative risk of stroke of 1.24 (95 percent
      confidence interval, 1.12 to 1.37; P less than 0.001). Furthermore, even when
      subjects with coronary heart disease or congestive heart failure were excluded
      from the analysis, subjects with mitral annular calcification still had twice the
      risk of stroke. CONCLUSIONS: In an elderly, longitudinally followed population
      based cohort, mitral annular calcification was associated with a doubled risk of
      stroke, independently of traditional risk factors for stroke. Whether such
      calcification contributes causally to the risk of stroke or is merely a marker of
      increased risk because of its association with other precursors of stroke remains
      unknown.

PMID- 1625712
TI  - Brief report: severe symptoms of hyperhistaminemia after the treatment of acute
      promyelocytic leukemia with tretinoin (all-trans-retinoic acid)

PMID- 1625713
TI  - Brief report: kidney-related Munchausen's syndrome.

PMID- 1625714
TI  - Effect of cocaine use on the fetus.

PMID- 1625715
TI  - The Red Baron.

PMID- 1625716
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 32-1992. A 72-year-old man with a mass in the posterior thigh.

PMID- 1625717
TI  - The risk of transfusion-transmitted infection.

PMID- 1625718
TI  - Lethal food allergy in children.

PMID- 1625719
TI  - The maturation of differentiation therapy.

PMID- 1625720
TI  - Gatekeeping revisited--protecting patients from overtreatment.

PMID- 1625721
TI  - Cancer in the contralateral breast after radiotherapy for breast cancer.

PMID- 1625722
TI  - Cancer in the contralateral breast after radiotherapy for breast cancer.

PMID- 1625723
TI  - Cancer in the contralateral breast after radiotherapy for breast cancer.

PMID- 1625724
TI  - Cancer in the contralateral breast after radiotherapy for breast cancer.

PMID- 1625725
TI  - Monoclonality of multiple bladder cancers.

PMID- 1625726
TI  - Monoclonality of multiple bladder cancers.

PMID- 1625727
TI  - Screening sigmoidoscopy and colorectal cancer.

PMID- 1625728
TI  - Partner notification in cases of HIV infection.

PMID- 1625729
TI  - Partner notification in cases of HIV infection.

PMID- 1625730
TI  - Pneumococcal vaccine for Olympic athletes and visitors to Spain. Barcelona
      Olympic Organizing Committee.

PMID- 1625731
TI  - Functional asplenia and vasculitis associated with antineutrophil cytoplasmic
      antibodies.

PMID- 1625732
TI  - The American health care system--introduction.

PMID- 1625733
TI  - Factitious Munchausen's syndrome--a confession.

PMID- 1625734
TI  - HIV infection among patients in U.S. acute care hospitals. Strategies for the
      counseling and testing of the hospital patients. The Hospital HIV Surveillance
      Group.
AB  - BACKGROUND: Routine, voluntary testing of hospital patients for the human
      immunodeficiency virus (HIV) has been proposed in order to identify those with
      early HIV infection in a setting where there is ready access to counseling,
      appropriate clinical referral, evaluation, and therapy. We studied the pattern of
      HIV infection among patients in 20 U.S. hospitals, in order to evaluate possible
      national strategies for the routine, voluntary HIV counseling and testing of
      hospital patients. METHODS: Blood specimens remaining after clinical use from a
      systematically selected sample of patients at 20 hospitals in 15 U.S. cities were
      tested anonymously for antibody to HIV type 1 (HIV-1). Multivariate regression
      was used to determine which variables best predicted HIV seroprevalence in
      individual hospitals. Using these data, we estimated the number of HIV-positive
      patients in all U.S. hospitals and considered the efficiency of routine
      counseling and testing in different subgroups of patients and hospitals. RESULTS:
      From September 1989 through October 1991, 9286 of 195,829 specimens (4.7 percent)
      were positive for HIV-1 in the 20 hospitals. The seroprevalence of HIV at these
      institutions ranged from 0.2 percent to 14.2 percent. Among HIV-positive
      patients, 32 percent had symptomatic HIV infection or the acquired
      immunodeficiency syndrome (AIDS) at the time of admission or evaluation. In the
      20 hospitals, HIV seroprevalence was 10.4 times (95 percent confidence interval,
      8.8 to 12.0) the AIDS-diagnosis rate (the annual number of patients with new
      diagnoses of AIDS per 1000 discharges in 1990). In a multivariate model that
      included 13 hospital-specific variables, only the AIDS-diagnosis rate was
      associated with the hospital-specific HIV-seroprevalence rate (P less than
      0.001). Using these data and the AIDS-diagnosis rates for all U.S. acute care
      hospitals, we estimated that 225,000 HIV-positive persons were hospitalized (95
      percent confidence interval, 190,000 to 260,000) in all 5558 such hospitals in
      1990, including 163,000 persons presenting with conditions other than HIV or AIDS
      (95 percent confidence interval, 130,000 to 196,000). In 1990, in 593 U.S.
      hospitals with AIDS-diagnosis rates of 1.0 or more per 1000 discharges, HIV
      testing of patients 15 to 54 years old (3 million patients, or 12.0 percent of
      all patients in U.S. acute care hospitals) would have identified an estimated 68
      percent of all HIV-positive patients (110,000 patients) who were admitted with
      conditions other than symptomatic HIV infection or AIDS. CONCLUSIONS: We estimate
      that about 225,000 HIV-positive persons were hospitalized in 1990, of whom only
      one third were admitted for symptomatic HIV infection or AIDS. Routine, voluntary
      HIV testing of patients 15 to 54 years old in hospitals with 1 or more patients
      with newly diagnosed AIDS per 1000 discharges per year could potentially have
      identified as many as 110,000 patients with HIV infection that was previously
      unrecognized.

PMID- 1625735
TI  - Implications of third heart sounds in patients with valvular heart disease. The
      Veterans Affairs Cooperative Study on Valvular Heart Disease.
AB  - BACKGROUND: The presence of third heart sounds in patients with valvular heart
      disease is often regarded as a sign of heart failure, but it may also depend on
      the type of valvular disease. METHODS: We assessed the prevalence of third heart
      sounds and the relation between third heart sounds and cardiac function in 1281
      patients with six types of valvular heart disease. RESULTS: The prevalence of
      third heart sounds was higher in patients with mitral regurgitation (46 percent)
      or aortic regurgitation (28 percent) than in those with aortic stenosis (11
      percent) or mitral stenosis (8 percent). The left ventricular ejection fraction
      was significantly lower (P less than 0.001) when a third heart sound was detected
      in patients with aortic stenosis (0.38, vs. 0.56 in those without third heart
      sounds) or mixed aortic valve disease (0.40 vs. 0.55). However, the ejection
      fraction was only slightly lower in patients with mitral regurgitation and third
      heart sounds (0.51 vs. 0.57, P = 0.03). The pulmonary-capillary wedge pressure
      was higher (P less than 0.001) when a third heart sound was detected in patients
      with aortic stenosis (18.6 mm Hg, vs. 12.1 mm Hg in those without third heart
      sounds). There was no association between the wedge pressure and third heart
      sounds in patients with mitral regurgitation. The prevalence of third heart
      sounds increased with the severity of mitral regurgitation. CONCLUSIONS: In
      patients with mitral regurgitation, third heart sounds are common but do not
      necessarily reflect left ventricular systolic dysfunction or increased filling
      pressure. In patients with aortic stenosis, third heart sounds are uncommon but
      usually indicate the presence of systolic dysfunction and elevated filling
      pressure.

PMID- 1625736
TI  - Elevated arterial blood pressure in cardiac tamponade.
AB  - BACKGROUND: In cardiac tamponade cardiac output falls, but peripheral vascular
      resistance increases, so that systemic blood pressure may be maintained at normal
      or near-normal levels. We recently observed a patient with cardiac tamponade
      whose blood pressure was markedly elevated. METHODS: To determine the frequency
      of elevated blood pressure in patients with cardiac tamponade and their
      hemodynamic characteristics, we studied 18 consecutive patients with cardiac
      tamponade from a variety of causes using right heart catheterization. RESULTS:
      Six of the 18 patients had systolic arterial blood pressures ranging from 150 to
      210 mm Hg (mean [+/- SD], 176 +/- 26) and diastolic pressures ranging from 100 to
      130 mm Hg (mean, 113 +/- 14). All six had previously been hypertensive. After
      pericardiocentesis there was a significant decrease in blood pressure (to 139 +/-
      13 mm Hg systolic, P less than 0.05; and 83 +/- 6 mm Hg diastolic, P less than
      0.01) and peripheral vascular resistance (from 2150 +/- 588 to 1207 +/- 345
      dyn.sec.cm-5, P less than 0.01). Cardiac output increased in all six. The other
      12 patients, 3 of whom had a history of hypertension, had significant increases
      in cardiac output and systolic blood pressure (from 119 +/- 13 to 127 +/- 7 mm
      Hg, P less than 0.05) after pericardiocentesis, whereas peripheral vascular
      resistance decreased. Both groups had similar degrees of cardiac tamponade, as
      indicated by measurements of cardiac output and intrapericardial, right atrial,
      and pulmonary-artery wedge pressures. CONCLUSIONS: Elevated blood pressure may
      occur in some patients with cardiac tamponade who have preexisting hypertension.
      Moreover, blood pressure may fall after pericardiocentesis in patients who have
      elevated blood pressure associated with tamponade.

PMID- 1625737
TI  - Breast cancer (3).

PMID- 1625738
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 33-1992. A 34-year-old woman with endometriosis and bilateral
      hydronephrosis.

PMID- 1625739
TI  - Screening for HIV infection--benefits and costs.

PMID- 1625740
TI  - AIDS and absolutism--the demand for perfection in prevention.

PMID- 1625741
TI  - Transmission of hepatitis B by a finger-stick device.

PMID- 1625742
TI  - Transmission of hepatitis B by a finger-stick device.

PMID- 1625743
TI  - Transmission of hepatitis B by a finger-stick device.

PMID- 1625744
TI  - Pneumocystis carinii pneumonia during cyclosporine therapy for ulcerative
      colitis.

PMID- 1625745
TI  - Allopurinol in the treatment of American cutaneous leishmaniasis.

PMID- 1625746
TI  - Hodgkin's disease.

PMID- 1625747
TI  - Hodgkin's disease.

PMID- 1625748
TI  - Successful thrombolysis of an aortic-arch thrombus in a patient after mesenteric
      embolism.

PMID- 1625749
TI  - The Guillain-Barre syndrome.

PMID- 1625750
TI  - AIDS and activists.

PMID- 1625751
TI  - AIDS and activists.

PMID- 1625752
TI  - Newspaper reports and suicide.

PMID- 1625753
TI  - The bite of the spider woman. Loxosceles reclusa (the brown recluse).

PMID- 1625754
TI  - Does a demented patient lose the right to refuse surgical intervention?

PMID- 1625755
TI  - Pott's disease revisited. Paravertebral abscess extending into the right lower
      extremity.

PMID- 1625756
TI  - Epilepsy--diagnosis and treatment.
AB  - In summary, a better understanding of seizures, seizure disorders and epilepsy
      syndromes, as well as the advent of effective medications with generally low
      toxicity and side effects, now enables most epileptics to lead relatively normal
      lives. Careful analysis of seizure type, accurate prescription of appropriate
      medication and precise monitoring of medication are essential. The prognosis of,
      and lifestyle enjoyed by, individuals with epilepsy is far less grim than the
      image conjured up in the mind of the average, uninformed person on the street.
      Prejudice and misunderstanding still exist, however, and further public education
      and awareness are appropriate goals for the future.

PMID- 1625757
TI  - Health care of the homeless in the British National Health Service.

PMID- 1625758
TI  - Diabetes education. An idea whose time has come.

PMID- 1625759
TI  - Auditing the clinical learning environment in West Glamorgan: evaluating the
      process.
AB  - The responsibility for auditing clinical learner areas was developed from the
      Welsh National Board to individual educational establishments in Wales in 1988.
      The West Glamorgan College of Nursing and Midwifery designed on audit tool, based
      on the National Board's guidelines, and have used it in clinical areas since
      1990. This paper reports on an evaluation survey carried out after the tool had
      been in use for one year. The results suggest that the ward/area managers
      involved have been able to identify a range of benefits for their units with the
      introduction of the tool, and demonstrate an acceptance of the need to maintain
      standards of practice and education.

PMID- 1625760
TI  - A trial of the use of psychodrama for women with alcohol problems.
AB  - Psychodrama is a method of group psychotherapy in which the subject can be helped
      to explore the psychological dimensions of his or her problems through the
      enactment of conflict situations. This study aimed to investigate the perceived
      effectiveness of psychodrama in the treatment of women with alcohol problems. A
      group of six women undertaking psychodrama in a centre in Northern Ireland were
      surveyed by questionnaire and participant observation. It was found that
      psychodrama was perceived as being useful by the four subjects who had a better
      education and were demonstrably more verbally expressive and extroverted. Alcohol
      problems need to be understood and treated in the social context in which they
      develop and thrive; psychodrama enpowers problem drinkers to explore their unique
      social context.

PMID- 1625761
TI  - The efficacy of primary nursing as a foundation for patient advocacy.
AB  - Modern nursing practice aims at addressing the needs of the client in a way which
      is consistent with his or her individual views, rights and wishes. Salvage (1)
      describes these changes in nursing as the advent of 'new nursing.' This has
      encouraged an interest in the concept of patient advocacy. This article examines
      the areas of practice which, it is suggested, affect the way in which nurses can
      take on the role of patients' advocate, the different types of relationship which
      may be formed between nurses and patients, and the effect of individual nurse's
      personal values in influencing planning and implementation of care. It is
      suggested that the organisational mode of primary nursing offers nurses a means
      to fulfil the role of patients' advocate through its emphasis on the crucial
      importance of the nurse's responsibilities and relationships with patients.

PMID- 1625763
TI  - The integration of a database and a statistical program in the analysis of a
      large scale survey in nursing.
AB  - Large scale surveys have conventionally been analysed using a statistical
      package. This saves considerable time and permits many more analyses to be
      undertaken than with more traditional methods. It does, however, have certain
      drawbacks. First, it does not help with the problem of data management. SPSS and
      Epfino, for example, have some facilities for data entry restrictions and cross
      checking. They are excellent for the static purpose for which they are designed,
      but rather crude in comparison with those provided by a dedicated database tool.
      Second, it requires considerable experience to achieve maximum benefit. Third, it
      does not help at all in the major undertaking of data exploration. The authors
      have analysed a large scale survey using a statistical package and a database in
      collaboration. Their experience is reported here.

PMID- 1625762
TI  - Private patients' perceptions of nursing practice in the National Health Service.
AB  - A study of private patients (n = 649) was carried out in Wessex Region in January
      1991 to discover why patients decide to go private rather than use the NHS for in
      patient treatment. Relatively few patients complained of the attitudes of nurses
      in the NHS, but just over one third mentioned nursing as a significant problem in
      the NHS and, of this group, over half were critical of nurses' attitudes. Further
      analysis revealed that these perceptions were not based on direct experience (of
      those who said that nursing was a problem, only 5 per cent had been NHS in
      patients since 1985), but alarm about the public image of nursing remains.

PMID- 1625764
TI  - Visually impaired patients' perceptions of their needs in hospital.
AB  - This article reports on a study of visually impaired patients' perceptions of
      their social and psychological needs in hospital. A qualitative approach was
      taken to explore and describe these perceptions, and 18 in-patients from one
      ophthalmic hospital took part in semi-structured interviews lasting approximately
      half an hour. Patients did not agree on their most important need. Many stresses
      and methods of coping were specific to individual patients. Patients reported on
      three areas in which most of them had problems: behavior of some staff, anxiety,
      and communication, but most felt their physical needs were met by nurses.
      Implications and recommendations for nursing practice are discussed. In
      particular, the results indicate a need for individualised care. It is also
      apparent that further research is needed to explore nurses' beliefs and feelings
      towards visual impairment.

PMID- 1625765
TI  - Deterioration of spatial and nonspatial reference and working memory in aged
      rats: protective effect of life-long calorie restriction.
AB  - Two different aspects of learning (spatial and nonspatial) and two different
      types of memory (reference and working) were simultaneously measured in
      populations of 3- (young), 11- (adult), and 25-month-old (aged) rats fed ad
      libitum either a standard (ST) or a hypocaloric (HY) diet. All groups, regardless
      of age or diet, showed ability in learning all four versions of the task.
      However, old ST rats were significantly slower and less efficient at learning
      than the young and adult ST rats. In contrast, senescent HY rats' cognitive
      abilities did not differ from those of their young and adult counterparts. The
      decline in reference and working memory in the aged ST rats was more pronounced
      in the spatial than the nonspatial version of the task. This study confirms and
      extends to more specific aspects of memory our earlier finding that age-related
      cognitive deterioration in rats was antagonized by life-long calorie restriction.

PMID- 1625766
TI  - Regional synaptic pathology in Alzheimer's disease.
AB  - Synaptic pathology in Alzheimer's disease (AD) may occur diffusely or may have
      regional predilections. A new antibody called EP10 which detects synaptophysin
      like immunoreactivity was used to study synapses in postmortem brain tissue. Four
      brain regions from cases of AD and controls were studied. Controls with a wide
      range of ages were used to investigate the possibility of age-related changes in
      synaptophysin-like immunoreactivity. A significant reduction in the EP10 antigen
      was observed to occur with age in the control caudate but not in the hippocampus
      or temporal or occipital cortices. Antigen levels were significantly reduced in
      the hippocampus (77%) and the temporal cortex (54%) in AD. The expected abnormal
      pallor of the outer two-thirds of the dentate gyrus molecular layer was observed
      with immunocytochemistry. In the temporal cortex, the reduction in synaptophysin
      like immunoreactivity was inversely correlated with the neurofibrillary tangle
      count. No such relationship existed in the hippocampus. These results suggest
      that at least certain components of the synaptic loss in AD occur regionally and
      are disproportionately large in the hippocampus.

PMID- 1625767
TI  - Preservation of the density of the dopamine uptake complex in aging Fischer 344
      rat brain.
AB  - This study was performed to determine if there are selective regional or global
      changes in the density or pharmacology of the dopamine uptake complex (DAUC) in
      aged rodent. Fifteen regions of the Fischer 344 rat (aged 4, 12, and 24 months)
      central nervous system were analyzed for the density of the DAUC employing
      [3H]GBR 12935 and in vitro quantitative autoradiography. Additionally, cocaine
      competitions were performed in the striatum of all of the animals. A 26-fold
      variation in the DAUC density was found in the regions sampled. However, no
      significant age-related changes were identified. Intrastriatal analysis of the
      DAUC density revealed binding heterogeneities; decreasing lateral to medial and
      decreasing dorsal to ventral gradients. No significant effect of aging on
      striatal gradients was observed. The proportion of high and low affinity sites
      for cocaine was unchanged in the three age groups. Taken together, these findings
      suggest a stability of this dopamine presynaptic marker in aging rat central
      nervous system.

PMID- 1625768
TI  - Convergent cholinergic activities in aging and Alzheimer's disease.
AB  - Choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) activities have
      been examined postmortem in a series of 66 individuals with no evidence of CNS
      disease, ranging in age from 24 gestational weeks to 95 years and in 33 cases of
      Alzheimer's disease (AD) aged 57-89 years. In the normal human hippocampus a
      striking and highly significant age-related decline in ChAT occurred from middle
      to old age (between 40 and 100 years); a trend apparent at a later stage and to a
      lesser extent in the hippocampal gyrus. In both areas enzyme activity in AD was
      inversely related to age at death; reductions compared with the normal were on
      average 70-80% in the 60-70 year old groups compared with 30-40% in the 80-90
      year old group. A similar trend was apparent with respect to acetylcholinesterase
      (AchE) histochemical activity associated with fibers and terminals (predominantly
      cholinergic and concentrated in CA3 and 4 of the hippocampus) but not with
      reactive perikarya (considered to be noncholinergic) present in both hippocampus
      and cortex. These data indicate that the normal aging human hippocampus may
      constitute a useful model for investigating the dysfunction or degeneration of
      basal forebrain cholinergic neurons in AD.

PMID- 1625769
TI  - Glucose enhancement of memory in elderly humans: an inverted-U dose-response
      curve.
AB  - In animals, enhancement of memory with glucose and many other treatments is
      characterized by an inverted-U dose-response curve. The present experiment
      examined the dose-response curve for glucose enhancement of memory in elderly
      humans. Using a repeated measures, counterbalanced, crossover design, the
      subjects (60-82 year olds) were tested on four sessions, separated by 1 week or
      more, for performance on the Wechsler Logical Memory Test after ingestion of a
      fruit drink sweetened with glucose (0, 10, 25, and 50 g) and saccharin matched to
      comparable taste. The findings indicate that glucose enhanced performance on this
      test in an inverted-U dose-response manner, with optimal enhancement obtained at
      the 25 g glucose dose. These findings provide further demonstration of glucose
      enhancement of memory in elderly humans and also describe an additional analogy
      between the characteristics of glucose enhancement of memory in animals and
      humans.

PMID- 1625770
TI  - Alzheimer's disease and aging: effects on perforant pathway perikarya and
      synapses.
AB  - The hippocampal perforant pathway originates in the entorhinal cortex (ERC) and
      terminates in the outer molecular layer of the dentate gyrus (DG). To compare the
      effects of normal aging and Alzheimer's disease (AD) on the elements of the
      perforant pathway, we compared relative perikaryal numbers (determined by
      counting cell bodies and estimating volumes) in layer II of the ERC with synaptic
      quantities (estimated from immunoreactivity for the synaptic terminal protein
      synapsin I and DG volume) in the molecular layer of the DG. The brains of 5 young
      and 9 elderly cognitively normal individuals, and of 9 AD patients were studied.
      In normal aging we found a significant age-related decline in perikaryal numbers
      in the ERC without demonstrable synaptic loss in the DG. In AD there was marked
      and equivalent, (or proportional) reduction in both ERC perikaryal numbers and DG
      synapses. These data suggest that in normal aging remaining neurons may continue
      to support a full array of synapses, perhaps due to mechanisms such as axonal
      sprouting, synaptic enlargement, or synaptic ingrowth. In AD, however, the
      accelerated neuronal loss may overwhelm such compensatory mechanisms or
      alternatively, independent synaptic and perikaryal losses may occur.

PMID- 1625771
TI  - Evidence for changes in the Alzheimer's disease brain cortical membrane structure
      mediated by cholesterol.
AB  - Small angle X-ray diffraction analysis of Alzheimer's disease (AD) lipid
      membranes extracted from cortical gray matter showed significant, reproducible
      structure changes relative to age-matched control samples. Specifically, there
      was an average 4 A reduction in the lipid bilayer width and significant changes
      in the membrane electron density profiles of AD cortical samples. There were no
      significant structure differences in the membrane bilayers isolated from an
      unaffected region (cerebellum) of the AD brain. Lipid and protein analysis of 6
      AD and 6 age-matched controls showed that the phospholipid:protein mass ratio was
      unchanged but that the unesterified cholesterol:phospholipid (C:PL) mole ratio
      decreased by 30% in the AD temporal gyrus relative to age-matched controls. By
      contrast, the C:PL mole ratio in the cerebellum did not change significantly. X
      ray diffraction analysis of a cholesterol enriched AD sample demonstrated a
      virtual restoration of the normal membrane bilayer width and electron density
      profile, suggesting that the cholesterol deficit played a major role in the AD
      lipid membrane structure perturbation. Alterations in the composition and
      structure of the membrane bilayer may play an important role in the
      pathophysiology of AD by altering the activity and catabolism of membrane-bound
      proteins, including the beta-amyloid precursor protein.

PMID- 1625772
TI  - Detection of distinct isoform patterns of the beta-amyloid precursor protein in
      human platelets and lymphocytes.
AB  - Cerebral deposition of the amyloid beta-protein (A beta P), approximately 40
      residue fragment of the integral membrane protein, beta-amyloid precursor protein
      (beta APP), has been implicated as the probable cause of some cases of familial
      Alzheimer's disease (AD). The parallels between A beta P deposition in AD and the
      deposition of certain plasma proteins in systemic amyloid diseases has heightened
      interest in the analysis of beta APP in circulating cells and plasma. Here, we
      describe distinct isoform patterns of beta APP in peripheral platelets and
      lymphocytes. PCR-mediated amplification of mRNA from purified platelets
      demonstrated the expression of all three major beta APP transcripts (beta
      APP770,751,695). The full-length, approximately 140 kDa form of beta APP751,770
      was detected in membranes of resting and activated platelets but very little
      immature, approximately 122 kDa beta APP751,770 was found, suggesting a different
      processing of beta APP in platelets than that described in a variety of cultured
      cells and tissues. Platelets stimulated with thrombin, calcium ionophore, or
      collagen released the soluble, carboxyl-truncated form of beta APP (protease
      nexin-II), but no evidence for the shedding of full-length beta APP associated
      with platelet microparticles was found, in contrast to previous reports. As a
      positive control marker for microparticles, the fibrinogen receptor subunit,
      GPIIIa, was readily detected in platelet releasates. Resting and activated
      platelets contained similar amounts of the approximately 10 kDa carboxyl terminal
      beta APP fragment that is retained in platelet membranes following the
      constitutive cleavage of protease nexin-II. Nonstimulated peripheral B and T
      lymphocytes contained small amounts of membrane-associated mature and immature
      beta APP751,770. The potentially amyloidogenic full-length beta APP molecules
      present in circulating platelets and lymphocytes but not in microparticles could
      serve as a source of the microvascular A beta P deposited during aging and
      particularly in AD.

PMID- 1625773
TI  - In vitro and in vivo ethanolamine metabolism in rat brain: effect of time and
      aging.
AB  - The effect of the time in culture of foetal rat neurons and age on the
      incorporation of radioactive ethanolamine into methylated derivatives was
      investigated. Decreased incorporation of [3H]ethanolamine into its various
      methylated water-soluble and lipidic derivatives was observed in rat neurons
      cultures at 12 day in vitro (DIV) as compared to the 3rd and the 7th DIV. In vivo
      studies showed that there was a diminished labeling of methylated products in the
      older animals as compared to the younger ones. These in vitro and in vivo
      observations suggest a generalized decrease of N-methyltransferase activities
      during maturation and aging.

PMID- 1625774
TI  - Cholinergic fiber aberrations in nucleus basalis lesioned rat and Alzheimer's
      disease.
AB  - Innervation density and morphological aberrations of cholinergic fibers were
      studied with choline acetyltransferase (ChAT) immunocytochemistry and
      acetylcholinesterase (AChE) histochemistry in 30-35 month-old aged rats and rats
      with long-term bilateral lesions of the magnocellular basal nucleus (MBN). In
      addition, AChE histochemistry was performed on human cortical sections derived
      from autopsy brains of normal aged and Alzheimer's disease (AD) patients. A
      limited but variable number of morphological alterations were observed in ChAT
      immunoreactive fibers in the cortex and the hippocampus of the aged control rats.
      The aged MBN-lesioned rats displayed a severely reduced number of cholinergic
      fibers in the denervated areas of the neocortex, whereas the surviving fibers
      showed a strongly increased number of aberrations. Fiber anomalies were also
      observed in the cortex of the aged human subjects and Alzheimer patients, the
      latter showing a higher incidence of such aberrations. Only a part of these
      distended profiles were seen in close association with senile plaques as detected
      in the AChE-stained material. These findings suggest that experimental MBN
      lesions combined with aging share with AD the induction of large quantities of
      fiber malformations. Implications of possible mechanisms in both conditions are
      discussed.

PMID- 1625775
TI  - Familial Alzheimer's mutation: mRNA secondary structure revisited.
AB  - It has been suggested that the mutation at position 717 of the amyloid precursor
      protein (APP), found in several cases of familial Alzheimer's disease, affects
      the secondary structure of the corresponding messenger RNA and the rate of its
      translation (10). Phylogenetic analysis based on comparison with other mammalian
      APP sequences does not support this possibility.

PMID- 1625776
TI  - Quantitative electroencephalography in Parkinson's disease, dementia, depression
      and normal aging.
AB  - The relationship between depression and dementia in Parkinson's disease (PD) has
      rarely been explored. Using a quantitative EEG (qEEG) parameter, we studied four
      groups of subjects: PD, demented Alzheimer's type and major depressed patients
      and normal controls. The qEEG data were compared with those of the Mini-Mental
      State and the Hamilton Depression Scale. The qEEG pattern was different in the
      four groups of subjects. Moreover, there was a significant correlation between
      the qEEG data and the other variables, and, particularly, with the cognitive
      performances. Our findings demonstrate that the qEEG method of assessment may
      give valuable data for a better classification of dementia syndromes and for a
      distinction between dementia and pseudodementia.

PMID- 1625777
TI  - Neuroendocrine responses to a glucose challenge in substance users with high and
      low levels of aggression, impulsivity, and antisocial personality.
AB  - Plasma glucose concentrations, and plasma prolactin and cortisol responses to a 5
      hour oral glucose tolerance test (OGTT) in 37 substance abusers, were examined to
      assess the relationship between varying degrees of antisocial personality,
      impulsivity, and aggressiveness and measures of endocrine function. Childhood and
      presenting aggression, impulsivity and antisocial personality features were
      evaluated by several self-report questionnaires. Those with high scores for
      psychopathic deviance (MMPI) differed in glucose levels following OGTT from those
      with low scores. Lower cortisol nadir levels were associated with higher scores
      on measures of antisocial personality and aggressiveness. Also, prolactin
      response to glucose was attenuated relative to baseline levels in the more
      antisocial and aggressive subjects. The results indicate that substance abusers
      with high levels of self-reported antisocial personality and aggressive behavior
      have altered neuroendocrine responses to glucose challenge, although there was no
      evidence of hypoglycemia. No one personality or behavioral trait, as measured by
      our test battery, more strongly predicted neuroendocrine responses to glucose
      administration. Thus, our data partially support other reports of altered
      neuroendocrine responses to stressful challenges in aggressive/antisocial
      individuals.

PMID- 1625778
TI  - Saliva cortisol responses to unpleasant film stimuli differ between high and low
      trait anxious subjects.
AB  - The present study, which aims to investigate effects of low and high trait
      anxiety on saliva cortisol secretion, was performed on 64 healthy male
      volunteers. They were assigned either to an unpleasant or a control film.
      Furthermore, subjects were divided within each film group by median split of
      their anxiety ratings into high and low trait anxious groups, resulting in four
      equal-sized groups. Saliva cortisol and mood ratings were the dependent
      variables. In contrast to the low anxious, the high anxious subjects responded
      with a diminished saliva cortisol response.

PMID- 1625779
TI  - Attenuated late positivity in the visual evoked potential in aphasia induced by
      lesions in anterior speech area.
AB  - Seven anterior aphasics, 7 nonbrain-damaged subjects and 7 normal controls were
      tested for their visual evoked potentials. Aphasics showed an attenuation of the
      long latency positivity related to interest in the stimulus. The attenuation may
      indicate the subject's failure to signal communicative intention. Thus the
      attenuated positivity may be a physiological correlate of a behavioral state
      (aphasia) induced by brain lesions.

PMID- 1625780
TI  - Serotonergic inhibition of limbic and thalamic seizures in cats.
AB  - To clarify the role of the serotonergic system in limbic and thalamic epileptic
      activity, we examined the effects of 5-hydroxytryptophan (5-HTP, 20 and 40 mg/kg)
      on fully kindled seizures from the hippocampus and lateral geniculate nucleus.
      The intraperitoneal administration of 20 mg/kg 5-HTP exerted no anticonvulsant
      effect on hippocampal kindled seizures, and a higher dose (40 mg/kg) produced a
      significant reduction in the behavioral seizure stage. 5-HTP at 20 mg/kg
      displayed no suppressive effect on lateral geniculate seizures, and 5-HTP at 40
      mg/kg significantly reduced both the seizure stage and afterdischarge duration.
      Our data suggest that serotonergic mechanisms play an inhibitory role in seizures
      kindled from these brain regions.

PMID- 1625781
TI  - Leftward shift of R-axis on electrocardiogram in patients with panic disorder and
      depression.
AB  - In a prospective study, we have compared R-axis on routine electrocardiograms of
      panic disorder patients (n = 52) with that of depressed patients (n = 41) and
      normal controls (n = 65). All subjects were physically healthy and were
      normotensive. There was a significant leftward shift of R-axis in both depressed
      and panic disorder patients compared to normal controls. The implications of
      these findings are discussed.

PMID- 1625782
TI  - Lymphocyte subsets in major depressive patients. Influence of anxiety and
      corticoadrenal overdrive.
AB  - We studied 26 inpatients (17 females; mean age +/- SD: 41.2 +/- 14.3 years) who
      met the DSM III criteria for a major depressive episode and had a mean (+/- SD)
      Hamilton Depression Score of 19.3 +/- 8.0. All patients were drug free and
      medically healthy at the time of experimentation. We found a significant
      correlation between the CD4/CD8 ratio and the Hamilton Anxiety Score (r = 0.57, p
      less than 0.005). When splitting our sample in dexamethasone suppression test
      suppressors (DST-S) and nonsuppressors (DST-NS), this relationship appeared only
      in DST-NS (DST-NS: r = 0.81, p less than 0.005; DST-S: r = 0.20, p = NS). These
      results are discussed in terms of heterogeneity among major depressive disorders
      and possible relationships between catecholaminergic activity and the immune
      system.

PMID- 1625784
TI  - Brain Research Association, 9th National Meeting. Nottingham, U.K., 6-8 April
      1992. Abstracts.

PMID- 1625783
TI  - Abnormal electroretinography in schizophrenic patients with a history of sun
      gazing.
AB  - Electroretinographic (ERG) measurements were performed in 9 schizophrenic
      patients and in 13 control subjects. The measurements of schizophrenic patients
      as a group did not differ from those of normals. However, 6 schizophrenic
      patients who had a past history of sun gazing showed a decrease in retinal
      responsiveness under conditions of light adaptation. These results suggest that a
      subgroup of schizophrenic patients, who show deviant light-related behavior, have
      abnormal ERG. We postulate that an abnormality in retinal dopaminergic neurons,
      which are known to reduce light responsiveness of horizontal and ganglion cells,
      is the underlying pathophysiology of this clinical finding.

PMID- 1625785
TI  - Evidence that 3 alpha-hydroxy-5 alpha-pregnan-20-one is the metabolite
      responsible for anesthesia induced by 5 alpha-pregnanedione in the mouse.
AB  - Mice were anesthetized with [3H]5 alpha-pregnanedione (5 alpha). Brain levels for
      5 alpha and its metabolites were quantitated and compared at time points
      following injection and at two behavioral endpoints that are characteristic of
      the anesthetized state. The results support the hypothesis that 3 alpha-hydroxy-5
      alpha-pregnan-20-one (3 alpha), a metabolite of 5 alpha, mediates this anesthetic
      response, and they weigh against the hypothesis that 5 alpha itself is solely
      responsible for activity. Anesthesia occurred at 3-8 min following injection.
      During this period, levels of 3 alpha derived from 5 alpha were comparable to
      those seen when 3 alpha was administered alone. It is estimated that 5 alpha, if
      active at all, is at least 3-5 times less potent than 3 alpha.

PMID- 1625786
TI  - Platelet secretory products have a damaging effect on neurons.
AB  - We studied the direct effect of platelet secretory products on rat spinal cord
      explants. Morphological changes in the ventral horn neurons were assessed after
      staining for acetylcholinesterase (AChE). Compared to control, exposure to
      platelet secretory products was associated with a significant decrease in the
      number of AChE-positive neurons per ventral horn. Aspirin appeared to partially
      prevent this neurotoxicity. These results suggest that platelet secretory
      products may contribute to neuronal injury.

PMID- 1625787
TI  - Apparent disappearance of postseizure inhibitions and intensity of seizures
      during the development of rapid kindling in rabbits.
AB  - The evolution of seizures and postseizure inhibitions in the course of 'rapid
      kindling' and after the termination of stimulation were studied in rabbits with
      chronically implanted electrodes (neocortex, dorsal hippocampus, amygdala,
      caudate nucleus). The amygdala (n = 4) or hippocampus (n = 7) was electrically
      stimulated every 5 min. Generalized convulsions and wide-spread electrographic
      epileptic changes together with a striking shortening of postictal refractory
      periods were produced by this procedure within 2-6 h. In most cases, these
      epileptogenic effects continued their progression after the termination of
      stimulation for more than 2-4 weeks. The degree of reduction of postseizure
      inhibition durations was significantly greater than the degree of increase of
      generalized motor seizure durations. These may be mediated by mechanisms which
      facilitate the onset of seizure but do not significantly influence seizure
      expression.

PMID- 1625788
TI  - Prolonged postischemic hyperventilation reduces acute neuronal damage after 15
      min of cardiac arrest in the dog.
AB  - Hyperventilation is commonly used as a constituent of antiedematous therapy after
      global cerebral ischemia. The effect of hyperventilation on brain functions,
      however, is complex, and a number of mechanisms involved remains unclear. In this
      study, we attempted to determine whether postischemic hyperventilation influences
      acute neuronal changes developing during recirculation. Two groups of dogs
      underwent 15 min of cardiac arrest and cardiopulmonary resuscitation with an 8 h
      survival. After resuscitation, in group A the internal environment was maintained
      in the physiological ranges. In group B the animals were artificially
      hyperventilated maintaining a high level of respiratory alkalosis during
      recirculation. Histopathological examination of the vulnerable structures was
      performed using the Nauta degenerating method and the argyrophilic neurons were
      counted. Statistically significant amelioration in group B suggests that
      postischemic hyperventilation may act as a neuroprotective factor.

PMID- 1625789
TI  - Subcellular localization of insulin-like growth factor I (IGF-I) in Purkinje
      cells of the adult rat: an immunocytochemical study.
AB  - Insulin-like growth factor I (IFG-I) was localized by light and electron
      microscopic immunocytochemistry in the adult rat cerebellum. Neurons showing the
      same cytological characteristics and pattern of synaptic input as Purkinje cells
      were IGF-I immunoreactive. In these neurons, intense electron-dense reaction
      product was consistently located in the rough endoplasmic reticulum and,
      occasionally, in multivesicular bodies and associated with the nuclear envelope.
      Thus, the results of this study suggest synthesis IGF-I in Purkinje cells and
      furthermore provide anatomical support for IGF-I participation in paracrine or
      autocrine regulatory systems in the brain.

PMID- 1625790
TI  - The changes in the activity of pudendal motoneurons in relation to reflex
      micturition evoked in decerebrate cats.
AB  - Reflex micturition was evoked in both non-immobilized (n = 5) and immobilized (n
      = 5) decerebrate cats by filling the bladder with physiological saline.
      Intracellular recordings were made from pudendal motoneurons (PU-MNs; n = 14)
      throughout the periods of before, during and after reflex micturition. The
      changes in the activity of PU-MNs were correlated with those in the intravesical
      pressure. Our results support the proposition that coordination of the sphincters
      and the detrusors is established by a gating mechanism, which is activated by the
      supraspinal source such as the pontine micturition center.

PMID- 1625791
TI  - Direct projections from the globus pallidus to the midbrain and pons in the cat.
AB  - Employing the anterograde and retrograde axonal tracing techniques with Phaseolus
      vulgaris leucoagglutinin and cholera toxin B subunit, we demonstrated direct
      projections from the globus pallidus (GP) to the midbrain and pons in the cat.
      Cells of origin of these projections were localized in the caudal 2/3 of the GP,
      and their major target sites included the peripeduncular region, nucleus of the
      brachium of the inferior colliculus, para-lateral lemniscal zone, nucleus
      sagulum, external and pericentral nuclei of the inferior colliculus, and
      cuneiform nucleus. A combination of retrograde axonal tracing and
      immunohistochemistry for choline acetyltransferase revealed that GP neurons
      giving rise to such descending projections were primarily non-cholinergic.

PMID- 1625792
TI  - Changes in extracellular concentration of amino acids in the hippocampus during
      cerebral ischemia in stroke-prone SHR, stroke-resistant SHR and normotensive
      rats.
AB  - To investigate the role of glutamate release in cerebral ischemia, the amounts of
      amino acids (glutamate, taurine, alanine, glycine and glutamine) released in the
      hippocampal CA1 region of stroke-prone SHR (SHRSP), stroke-resistant SHR (SHRSR)
      and normotensive rats (WKY) were determined during and after cerebral ischemia by
      the microdialysis method under halothane anesthesia. Cerebral ischemia was
      produced by the occlusion of both common carotid arteries for 20 min. The basal
      amino acids release did not differ among the three strains of rats, but ischemic
      glutamate and taurine releases were more marked in SHRSP than in other strains.
      These results suggest that the massive glutamate release during cerebral ischemia
      of SHRSP might be related with severe neuronal cell injury.

PMID- 1625793
TI  - Brain amines in glucocorticoid-induced hypertension in the rat.
AB  - A two week administration of the glucocorticoid betametasone to male Wistar rats
      produced a mild hypertensive state. The brain of these rats showed some
      significant changes in amine and metabolite content with respect to normotensive
      controls. Epinephrine and metanephrine were increased in the rostral
      ventrolateral medulla and in the preoptic area. Epinephrine also increased in the
      septal area. Normetanephrine decreased in the rostral ventrolateral medulla.
      Dopamine and homovanillic acid increased in septal and preoptic areas. Dopamine
      alone increased in rostral ventrolateral medulla. Serotonin and 5-hydroxyindole-3
      acetic acid increased in the septal area and dorsal medulla. These changes
      suggest significant alterations in the aminergic activity of the brain circuitry
      known to regulate cardiovascular functions; the changes may play a basic role in
      the development and maintenance of glucocorticoid-induced hypertension.

PMID- 1625794
TI  - The cholinergic system participates in thyrotropin-releasing hormone (TRH)
      regulation.
AB  - The effect of chronic atropine treatment was studied on thyrotropin releasing
      hormone (TRH) content of several brain areas in Wistar rats. Atropine produced
      TRH increases in the septal area, preoptic area and the hypophysis; this was
      observed when rats were killed immediately after the last dose, while a decrease
      was observed only in the hypophysis 48 h after the last atropine dose. TRH
      concentration in cerebrospinal fluid rose significantly after atropine withdrawal
      with respect to controls. Treatment with eserine, an acetylcholinesterase
      inhibitor, produced the same effect. These results indicate cholinergic
      participation in central TRH regulation.

PMID- 1625795
TI  - Variations in cerebellar morphology of the Atlantic stingray, Dasyatis sabina.
AB  - The cerebellar corpus of the Atlantic stingray consists of an anterior lobe which
      is divided into rostral and caudal lobules, and a posterior lobe. The long axis
      of the posterior lobe and rostral lobule of the anterior lobe both lie along the
      midline, whereas the orientation of the caudal lobule varies. We examined this
      variation in 127 animals. In 52% the long axis of the caudal lobule lay on the
      right of the midline, in 21% it was on the left, and in 27% across the midline.
      While this distribution is not random, it is not related to size or sex. It is
      proposed that the observed variation is the reflection of variation in the
      cerebellar developmental program.

PMID- 1625796
TI  - Luteinizing hormone-releasing hormone in the pigeon terminal nerve and olfactory
      bulb.
AB  - The presence of a terminal nerve in the avian brain has recently been reported.
      As the terminal nerve in other classes of vertebrates contains luteinizing
      hormone-releasing hormone (LHRH), we used immunocytochemistry to determine
      whether the pigeon terminal nerve also contained LHRH. We found LHRH
      immunoreactivity in the olfactory nerve and in the olfactory bulb. The
      distribution of LHRH neurons was similar to the LHRH neuronal migration pathway
      during development.

PMID- 1625797
TI  - Early effects of unilateral lesions of substantia nigra on immune reactivity.
AB  - It has recently been demonstrated that central dopaminergic pathways are
      asymmetrically involved in the modulation of the immune response. Mitogen-induced
      proliferation of T lymphocytes was shown to be enhanced 4-6 weeks after right
      lesion of the substantia nigra (SN) in mice, when compared to left lesioned and
      control animals. In order to study the involvement of post lesion neuronal
      reorganization in these results, the same immunological parameters were
      determined as early as 2 weeks after right or left lesion of the SN. We showed
      that the lymphoproliferation induced by alpha CD3 and concanavalin A was
      decreased in both lesioned groups, but phytohemagglutinin-induced mitogenesis was
      more impaired in the right than in the left lesioned animals. Hence, the time
      course effects of the right lesions of SN shifted from depression to enhancement
      of the T lymphocyte responsiveness. This shift appeared to occur around the two
      weeks period following the lesion. These immunomodulatory effects of unilateral
      SN lesioning, which depended on time and side of lesion, were similar to those
      observed after hemidecortication. Based on these findings, it is reasonable to
      suggest that asymmetry in brain immunomodulation involves functionally related
      dopaminergic and cortical networks.

PMID- 1625798
TI  - Nerve growth factor induces proliferation and enhances fiber regeneration in
      oligodendrocytes isolated from adult pig brain.
AB  - Mature oligodendrocytes (OL) isolated from adult pig brains start to regenerate
      their fibers after 4-5 days in vitro (DIV); after 14 DIV a network of OL fibers
      is formed. Growth factors, of which it was known that they play an important part
      during proliferation and differentiation of OL progenitor cells, were used to
      study their influence on the regeneration of mature OL. For this purpose, OL were
      treated at 6 DIV with different concentrations of various growth factors. At 24 h
      intervals the [3H]thymidine incorporation was measured and at 8 DIV the OL fiber
      production evaluated. None of these factors did influence the regenerative
      process to any significant extent except nerve growth factor (NGF). For the first
      time it could be shown that NGF enhanced the OL fiber regeneration considerably
      and induced the proliferation of a subset of OL. These results may have important
      implications for the remyelinating process in demyelinating diseases such as
      multiple sclerosis.

PMID- 1625799
TI  - Nitric oxide inhibitors attenuate N-methyl-D-aspartate excitotoxicity in rat
      hippocampal slices.
AB  - To investigate whether nitric oxide (NO) plays a role in the neurotoxicity
      produced by N-methyl-D-aspartate (NMDA) we have examined the effects of NO
      inhibitors on NMDA-mediated neurodegeneration in the CA1 region of rat
      hippocampal slices. L-NG-Monomethylarginine, L-NG-nitroarginine and hemoglobin
      markedly diminished the toxicity produced by activation of NMDA receptors without
      interfering with NMDA receptor-mediated ion currents or synaptic responses. The
      neuroprotective effects are reversed by coapplication of L-arginine with the NO
      synthase inhibitors. These results suggest that activation of the NO system is an
      important component of the biochemical cascade leading to neurodegeneration
      produced by NMDA receptors.

PMID- 1625800
TI  - Apolipoprotein E: a pathological chaperone protein in patients with cerebral and
      systemic amyloid.
AB  - Many biochemically diverse proteins can give rise to amyloid fibrils; however,
      they are all accompanied by P component and glucosaminoglycans. With antibodies
      specific to apolipoprotein E (apo E) we used immunohistochemical techniques to
      test for the presence of this protein in both cerebral and systemic amyloid. We
      found apo E immunoreactivity in all tested types of cerebral and systemic
      amyloid. In amyloid deposits apo E P, component and glucosaminoglycans may be
      acting as 'pathological molecular chaperones'. The latter we define as a group of
      unrelated proteins that induce beta-pleated conformation in amyloidogenic
      polypeptides.

PMID- 1625801
TI  - Immunocytochemical localization of beta thyroid receptor in the rat cerebellum.
AB  - Using a specific antibody, we report here the immunocytochemical localization of
      the beta thyroid receptor (TR beta) in the adult rat cerebellum. We show that the
      immunoreactivity is specifically located in the Purkinje cells while the internal
      granular layer and the molecular layer are devoid of staining. In Purkinje cells,
      the immunoreactivity is either limited in the nuclei, or predominantly located in
      the perinuclear region and the cytoplasm. The presence of thyroid receptor is
      correlated with the presence of TR beta mRNAs as determined by Northern analysis.

PMID- 1625802
TI  - Mechanism of rapid K(+)-induced swelling of mouse astrocytes.
AB  - Cultured astrocytes from newborn mouse cortex were impaled with double-barrelled
      ion-sensitive microelectrodes to investigate their response following a 5 min
      exposure period to saline containing 60 mM K+. The membrane potential decreased
      from -74 to -11 mV, the intracellular K+ concentration increased from 102 to 145
      mM and the intracellular pH increased from 7.05 to 7.60 indicating an increase in
      the HCO3- concentration from 9 to 31 mM. All changes were reversible. In
      additional series of experiments the cells were loaded with choline and the
      application of a bias current to electrodes containing the Corning 477317 resin
      made them more sensitive to choline than to K+. This resulted in a decrease of
      the ion potential during K+ exposure, which stabilized within 2 min. It is
      assumed that this is due to a dilution of intracellular choline by water intake.
      Thus, the early K(+)-evoked swelling response can be explained by a fast (approx.
      2 min) swelling induced by K+ and HCO3- (and Cl-) influx.

PMID- 1625803
TI  - Role of Ia muscle spindle afferents in post-contraction and post-vibration motor
      effect genesis.
AB  - Experiments carried out on 14 human subjects showed that long-lasting involuntary
      tonic motor responses occurred after the offset of muscle vibration (70 Hz, 0.5
      mm, duration 30 s). These post-vibratory biceps and triceps brachii motor
      responses were compared with the motor responses observed in the same subjects
      after performing an isometric contraction of the same duration, i.e., post
      contraction responses, or the so-called 'Kohnstamm phenomenon'. The results show
      the existence of close similarities between these two types of motor after
      effect, particularly as regards the muscle sites where they develop, their
      amplitudes and their temporal patterns (latencies and offset times). Neither type
      of excitatory post-effect can be elicited by co-contracting or co-stimulating two
      antagonist muscles at the same frequency. Lastly, visual stimulation can cause
      both types of motor response to switch from one muscle to its antagonist.
      Comparative analysis of the spindle proprioceptive activities recorded in
      response to either vibration or isometric contractions suggests that these motor
      after-effects may both result from the fact that the spindle afferents from
      agonist and antagonist muscles are asymmetrically activated in these two
      particular situations.

PMID- 1625804
TI  - Chronic infusion of nerve growth factor does not rescue pyramidal cells after
      transient forebrain ischemia in the rat.
AB  - Male Wistar rats received chronic intracerebroventricular infusions of nerve
      growth factor (NGF) starting immediately before induction of a transient
      forebrain ischemia and continuing until 7 days after the infarct. Ischemia was
      induced by carotid occlusion and simultaneous hypotension. Seven days after the
      infarct the brains were examined histologically and the number of necrotic cells
      in the hippocampus were counted. The results did not reveal any difference in
      treated vs. untreated animals. The data suggest that application of exogenous NGF
      does not prevent ischemic cell death in the hippocampus.

PMID- 1625805
TI  - Block of synapse formation between cerebral cortical neurons by a protein kinase
      inhibitor.
AB  - Synchronized Ca2+ transients in cultured hippocampal neurons reflect the pattern
      of underlying electrical activity. Here we demonstrate a similar synchronization
      of cerebral cortical neurons in culture, and show that this functional coupling
      is correlated to the appearance of morphologically identified synapses using
      electron microscopy. During screening of a series of drugs for inhibition of in
      vitro synaptogenesis, the continuous presence of a protein kinase inhibitor (K
      252b) in the culture medium was found to block the synchronous firing and to
      decrease significantly the number of morphologically identifiable synapses. Since
      K-252b does not permeate the cell membrane, the results strongly suggest that
      phosphorylation of cell surface protein(s) by a K-252b sensitive-protein kinase
      is an essential process in synapse formation.

PMID- 1625806
TI  - Ethanol inhibits excitotoxicity in cerebral cortical cultures.
AB  - Excitatory amino acid neurotransmitters have been implicated in the pathogenesis
      of cerebral ischemia and related forms of acute neuronal injury. Because ethanol
      inhibits cellular signaling mechanisms activated by excitatory amino acids, we
      examined its effect on excitatory amino acid-induced toxicity in neuron-enriched
      cultures prepared from rat cerebral cortex. Both glutamate and N-methyl-D
      aspartate (NMDA) were toxic to cultured cortical cells, as demonstrated by a
      reduction in their ability to exclude trypan blue dye, and this toxicity was
      reversed by the NMDA antagonist MK-801. Ethanol (100 mM) provided partial
      protection from the excitotoxic effect of NMDA. Thus ethanol, like conventional
      excitatory amino acid antagonists, can attenuate excitotoxic neuronal injury in
      vitro.

PMID- 1625807
TI  - Widespread neuronal degeneration after ibotenic acid lesioning of cholinergic
      neurons in the nucleus basalis revealed by in situ hybridization.
AB  - In efforts to test the cholinergic hypothesis for Alzheimer's disease and to
      create an animal model for this disease, ibotenic acid has been used to lesion
      cholinergic neurons in the basal forebrain. In this study we have used in situ
      hybridization with oligonucleotide probes specific for mRNAs encoding choline
      acetyltransferase and glutamic acid decarboxylase, respectively, to study the
      effects of such a lesion. Our results show that lesion paradigms normally used to
      induce neuronal degeneration in nucleus basalis by ibotenic acid not only lesion
      the cholinergic neurons within this nucleus, but in addition, a major fraction of
      gamma-aminobutyric acid (GABA) neurons in nucleus basalis, substantia innominata,
      globus pallidus and ventral pallidum.

PMID- 1625808
TI  - Enhancement of NMDA-evoked neuronal activity by glycine in the rat spinal cord in
      vivo.
AB  - The effects of iontophoretically administered N-methyl-D-aspartate (NMDA),
      glycine and strychnine on nociceptive dorsal horn neurons of the rat spinal cord
      were studied to test the hypothesis that their responses to NMDA are influenced
      in vivo by glycine acting at a strychnine-insensitive site. Experiments were
      carried out on 44 dorsal horn neurons responsive to microiontophoretic
      application of NMDA and peripheral stimulation. Glycine alone either enhanced or
      inhibited NMDA responses depending upon its dose (151% and 68% of control,
      respectively). Strychnine alone increased the NMDA-induced neural firing (129%),
      suggesting the presence of endogenous glycine. When glycine was co-ejected with
      strychnine, NMDA responses were further elevated (171%) revealing the activation
      of strychnine-insensitive binding sites. These data provide evidence that glycine
      can potentiate NMDA responses of nociceptive dorsal horn neurons in vivo and thus
      that glycine sites on NMDA receptors on these neurons are not saturated.

PMID- 1625809
TI  - Reduced urinary bladder afferent conduction velocities in streptozocin diabetic
      rats.
AB  - Previous experiments in our laboratory have described the method used to measure
      the conduction velocity distribution of a selected group of fibers (Brain Res.,
      520 (1990) 83-89). We have applied this technique to the 2 month streptozotocin
      diabetic rat. Glycosylated hemoglobin values measured at the time of death were
      17.19 +/- 4.74% (diabetic, n = 8) and 4.07 +/- 0.74% (controls, n = 6). Diabetic
      bladders were thicker and heavier. The wet weights were 0.50 +/- 0.11 g
      (diabetic, n = 7) and 0.16 +/- 0.01 g (controls, n = 6). The conduction
      velocities of a total of 151 and 86 single afferent fibers were measured in the
      diabetic and control animals respectively. The conduction velocity distribution
      of the diabetics showed a shift towards slower speeds when compared to controls.
      The mean conduction velocities were 1.70 m/s for diabetics and 2.84 m/s for
      controls. The percent of units with conduction velocities greater than 2.5 m/s
      was 17.2 for diabetics and 36.0 for controls. This experiment demonstrates, for
      the first time, that diabetes causes a significant reduction of afferent
      conduction velocities in a functionally well-defined system.

PMID- 1625810
TI  - Localization of dystrophin in the Purkinje cells of normal mice.
AB  - A monoclonal antibody that reacts with a mid rod fragment of dystrophin was used
      to localize this protein in the central nervous system (CNS). Due to a low
      abundance of dystrophin in the CNS, an immunoperoxidase reaction amplified with a
      biotin-avidin system was used. All Purkinje cells in normal mice were dystrophin
      positive while the mdx mouse cerebellum was completely devoid of reaction.
      Dystrophin staining was present in the soma and dendrites of Purkinje cells but
      not in their axons. This uniform dystrophin labelling in the normal mouse
      Purkinje cells indicates that this protein is not only localized in synaptic
      contact regions of the CNS.

PMID- 1625811
TI  - Preprogastrin-releasing peptide messenger ribonucleic acid: neuroanatomical
      localization in rat brain by in situ hybridization with synthetic
      oligodeoxynucleotide probes.
AB  - Gastrin-releasing peptide (GRP) is a 27 amino acid peptide that is present in
      both the central and peripheral nervous systems and that shares immunological and
      functional properties with the amphibian peptide, bombesin. GRP has multiple
      putative biological functions including effects on feeding behaviour and
      carbohydrate metabolism, body temperature, and effects on hormone release, but
      little is known about the regulation of GRP gene expression in the brain. This
      study examined the distribution of neurones expressing preproGRP mRNA in rat
      brain by in situ hybridization of [35S]-labelled DNA oligonucleotides. PreproGRP
      mRNA was detected in several regions of brain, with highest concentrations in the
      parvocellular paraventricular and suprachiasmatic nuclei of the hypothalamus, the
      lateral and basolateral nuclei of the amygdala, the amygdaloid-hippocampal area
      and the ventral part of the granule cell layer of the dentate gyrus. Moderate
      levels were seen in layers II and III of the cingulate and retrosplenial cortex,
      the medial and mediobasal nuclei of the amygdala, the anteroventral thalamic
      nucleus; medial geniculate nucleus and the parabrachial nucleus. These findings
      are largely consistent with the cellular localization of GRP-like
      immunoreactivity in rat brain and recent studies of preproGRP mRNA localization
      using cRNA probes. The distribution of preproGRP mRNA observed further suggests
      the involvement of GRP in the central regulation of several functions including
      regulation of hypothalamic/pituitary hormone release.

PMID- 1625812
TI  - Locomotor rhythms induced by methylphenidate in suprachiasmatic nuclei-lesioned
      rats.
AB  - A robust locomotor activity rhythm with a circadian period appeared by chronic
      treatment with methylphenidate or methamphetamine in the suprachiasmatic nuclei
      (SCN)-lesioned rats whose circadian rhythms had been abolished. The appearance of
      the rhythmicity was accompanied by an increase in the activity level. However,
      significant circadian periods were detected only in rats whose locomotor activity
      increased more than 200% of the pretreatment levels. An increase in the activity
      level is necessary to generate and/or express the circadian locomotor rhythm in
      SCN-lesioned rats and there seems to be a threshold.

PMID- 1625813
TI  - Central respiratory neurons of the adult rat regrow axons preferentially into
      peripheral nerve autografts implanted within ventral rather than within dorsal
      parts of the medulla oblongata.
AB  - A great number of severed central nervous system (CNS) neurons of the adult rat
      have the capillary to regrow axons into peripheral nerve autografts. In the
      present experiment, autologous segments of the peroneal nerve were inserted
      perpendicularly to the dorsal surface of the medulla oblongata more or less
      laterally within either the ventral respiratory group or the so-called dorsal
      respiratory group (ventrolateral grafts, n = 5; dorsolateral grafts, n = 5). From
      2 to 4.5 months after the graft implantation, spontaneous unitary activities (n =
      197) were recorded within all the grafted nerves: they were found to arise from
      both central respiratory (R, n = 60) and non-respiratory (NR, n = 137) neurons
      which were giving off regenerated axons along the nerve grafts. The graft
      reinnervation by respiratory axons was found to be significantly more abundant
      within the medullary ventrolateral grafts than within the dorsolateral ones. The
      low rate of axonal regeneration from respiratory neurons observed within the
      dorsolateral grafts provides further evidence that the number of the respiratory
      neurons in the dorsal respiratory group, if present at all, is much smaller than
      that of the ventral respiratory group in the rat.

PMID- 1625814
TI  - Altered basal firing pattern and postactivation inhibition of locus coeruleus
      neurons in spontaneously hypertensive rats.
AB  - We compared the spontaneous unit activity and inhibition of impulse activity
      following antidromic activation (postactivation inhibition, PAI) of locus
      coeruleus (LC) neurons in spontaneously hypertensive rats (SHR) with those of LC
      neurons in Wistar-Kyoto rats (WKY). Spontaneous spikes of the LC were analyzed by
      interspike time histograms. The basal unit activity and variation coefficient of
      the interspike interval were decreased in SHR. The duration of the PAI which was
      yielded by antidromic activation from the dorsal noradrenergic bundle was
      shortened in SHR. These findings suggest that SHR LC neurons possess an altered
      basal firing pattern and inhibitory mechanism.

PMID- 1625815
TI  - Adenosine modulation of potassium currents in preganglionic nerve terminals of
      avian ciliary ganglia.
AB  - Potassium currents in calyciform nerve terminals of the avian ciliary ganglion
      were analyzed using a single microelectrode voltage clamp. The modulatory affects
      of adenosine on these currents was also determined. Intracellular CsCl (1 M)
      blocked the steady-state outward current, indicating that it is mostly carried by
      K+. Tetraethylammonium (TEA, 10 mM) blocked over 40% of the outward current at a
      command potential of -30 mV. If Ca2+ influx was blocked by CoCl2 (5 mM), the
      steady-state outward current was reduced by over 16% in the nerve terminals
      suggesting that about one fifth of the outward current passes through calcium
      activated potassium channels IK(Ca). Adenosine (50 mM) decreased the outward
      steady-state current over a wide range of command potentials in most terminals
      studied but failed to decrease this current in the presence of CoCl2 (5 mM). It
      is concluded that adenosine blocks IK(Ca) in nerve terminals.

PMID- 1625816
TI  - Controlled ultraviolet irradiation generates endothelial damage without affecting
      the nerve terminals of the cerebral artery in cats.
AB  - The vesicles of adventitial autonomic nerve terminals were examined
      quantitatively under an electron microscope in controlled ultraviolet ray (UV)
      irradiated cerebral vessels. Five cats whose basilar arteries were irradiated
      with UV (UV group) and 5 cats whose basilar arteries were irradiated with visible
      rays (control group) were compared. Endothelial vacuolation was observed only in
      the UV group. There was no statistically significant difference in the diameters
      of the dense-cored vesicles, related to noradrenaline, and clear vesicles,
      related to acetylcholine, between the two groups. It is concluded that controlled
      UV irradiation which generates endothelial damage does not affect the vascular
      adventitia ultrastructurally.

PMID- 1625818
TI  - Basic fibroblast growth factor (bFGF) acts centrally in the brain to inhibit
      gastric emptying in rats.
AB  - In the present study, we evaluated the central nervous system action of basic
      fibroblast growth factor (bFGF) on gastric emptying of a liquid meal in conscious
      rats using a Phenol red method. Intracisternal injection of bFGF dose-dependently
      inhibited gastric emptying, while intraperitoneal injection of bFGF at the same
      doses failed to alter gastric emptying. These results suggest for the first time
      that bFGF acts in the central nervous system to delay gastric emptying.

PMID- 1625817
TI  - Slowing of the dominant occipital rhythm in electroencephalogram is associated
      with low concentration of noradrenaline in the thalamus in patients with
      Alzheimer's disease.
AB  - The thalamus is involved in the regulation of the neocortical rhythmicity
      reflected in EEG as the alpha rhythm. Recent evidence suggests that the thalamus
      is affected in Alzheimer's disease (AD). We studied the relationship between the
      dominant occipital rhythm of the lifetime EEG and the choline acetyltransferase
      activity (ChAT) and monoamine concentrations in the postmortem thalamus of 20
      histologically verified AD patients. The AD patients were divided into 3 groups
      (5-6 Hz, 7 Hz and 8-9 Hz) according to the frequency of the dominant occipital
      rhythm (FOC). Noradrenaline (NA) concentrations were significantly lower for the
      5-6 Hz and 7 Hz subgroups as compared to the 8-9 Hz subgroup. The NA content of
      the thalamus correlated significantly with the FOC (r = 0.46, P = 0.04). The ChAT
      activity or concentrations of dopamine or serotonin did not correlate with the
      FOC or differ across the AD subgroups. The results suggests that the
      noradrenergic deficit of the thalamus may contribute to slowing of the dominant
      occipital rhythm in AD.

PMID- 1625819
TI  - Degeneration of motor nerve fibers enhances the expression of calcitonin gene
      related peptide in rat sensory neurons.
AB  - Calcitonin gene-related peptide (CGRP) in skeletal muscle is of neural origin.
      After degeneration of sensory fibers induced by removal of the lumbar dorsal root
      ganglia (DRG), the CGRP content in the rat soleus muscle was reduced to about 5%
      of the normal level. In contrast, degeneration of motor fibers induced by
      sectioning of the lumbar ventral roots markedly increased the CGRP content in the
      soleus muscle and CGRP levels in the lumbar DRG. It is suggested that the
      expression of CGRP in sensory neurons is up-regulated by some humoral factor
      induced by degeneration of motor nerve fibers.

PMID- 1625820
TI  - Nerve growth factor (NGF) in rat brain following long-term barbital treatment:
      relation to convulsions and cognitive function.
AB  - Nerve growth factor (NGF) protein has been implicated in alterations of cognitive
      function either following brain damage, selective lesions or aging. Groups of
      rats were given long-term (48 weeks) oral barbital treatment or tap water and
      following an extended period of abstinence (14 weeks) were tested for spatial
      learning ability in the Morris swim maze. Following the maze test, they were
      sacrificed and the NGF content of hippocampal and cortical brain regions were
      analyzed. Barbital treated rats were divided into convulsing and non-convulsing
      groups. It was found that there was a slight, significant increase (12%) in NGF
      content of the hippocampus in convulsing rats. Correlations between maze learning
      performance, brain weight and NGF in the cortex indicated a significant negative
      relationship between (a) performance and brain weight on day 1 of testing and (b)
      NGF content and performance on day 2. These data indicate some involvement of NGF
      in functions derived from a considerably different animal model to those applied
      previously.

PMID- 1625822
TI  - Possible functional consequences of synaptic reorganization in the dentate gyrus
      of kainate-treated rats.
AB  - The hypothesis that lesion-induced hippocampal granule cell axon sprouting causes
      granule cell hyperexcitability was tested in the rat. Kainic acid damaged dentate
      hilar neurons, decreased granule cell inhibition, and increased granule cell
      excitability to afferent stimulation, all before synaptic reorganization
      occurred. Granule cell recurrent inhibition and relatively normal excitability
      were unexpectedly restored as granule cell axon sprouting occurred. Anatomical
      analysis revealed that a dense innervation of inhibitory neurons by aberrant
      granule cell axons was a consistent feature in each animal. These results
      indicate that granule cell hyperexcitability precedes dentate synaptic
      reorganization and is associated with the selective interneuron loss that is the
      presumed stimulus for axon sprouting. Thus, if granule cell axon sprouting has
      functional significance, it may be primarily inhibitory, rather than
      epileptogenic, in nature.

PMID- 1625821
TI  - Effect of dietary n-3 fatty acid deficiency on blood-to-brain transfer of
      sucrose, alpha-aminoisobutyric acid and phenylalanine in the rat.
AB  - Possible alterations in blood-to-brain unidirectional transport of sucrose (mol.
      wt., 342), alpha-aminoisobutyric acid (mol. wt., 104), and L-phenylalanine (mol.
      wt., 165) induced by a diet deficient in n-3 polyunsaturated fatty acids were
      studied with respect to blood-brain barrier function. Two groups of rats were for
      to two generations with a semisynthetic diet. One group of rats was fed a peanut
      oil+rapeseed oil diet which contained both essential fatty acids: linoleic acid
      (18:2 n-6) and alpha-linolenic acid, (18:3 n-3). Another group was fed a diet of
      peanut oil, this diet (containing 18:2 n-6) was deficient in alpha-linolenic
      acid. The experiments were performed at 6 months of age. Unidirectional transfer
      rate constants (Ki) of sucrose, alpha-aminoisobutyric acid and L-phenylalanine
      were measured. The diet based on peanut oil (deficient in n-3) caused a greater
      blood-to-brain transport of sucrose but not of alpha-aminoisobutyric acid or L
      phenylalanine. These observations indicate that regardless of the mechanisms
      involved, alterations in essential fatty acids induced by diet can modulate to
      some extent the blood-brain transport of hydrophilic molecules without a carrier.

PMID- 1625823
TI  - A study of New Zealand wood workers: exposure to wood dust, respiratory symptoms,
      and suspected cases of occupational asthma.
AB  - A randomly selected group of 50 New Zealand wood workers was studied. The level
      of airborne wood dust to which they were exposed ranged from 1.0-24.5 mg/m3. The
      wood workers reported experiencing higher rates of both lower and upper
      respiratory tract symptoms than a control group of office workers. Inhaled wood
      dust, in particular from rimu (Dacrydium cupressinum), was frequently cited by
      workers as being associated with respiratory tract symptoms. The wood workers'
      responses to the respiratory symptom questionnaire, and serial recordings of peak
      expiratory flow rate were used to screen the group for suspected cases of
      occupational asthma. Five cases fulfilled the study's criteria for suspected
      occupational asthma. In four of these, further evidence was found to support this
      diagnosis. We conclude that exposure to wood dust may cause occupational asthma
      in the woodworking industry in New Zealand.

PMID- 1625824
TI  - The effect of employment status and household composition on health care
      utilisation in a general practice.
AB  - OBJECTIVE: to investigate the effect of employment status and family composition
      on general practice and secondary health care utilisation rates of a New Zealand
      general practice population. METHODS: the study practice's health care records
      were electronically interrogated and pooled data on utilisation rates was
      obtained for a 12 month period. Individual records were grouped according to the
      number of people in the family and families were further categorised according to
      the employment status of the adults in the family. Comparisons were made between
      family groups in rates of general practice and secondary care activities. Costs
      were attributed to each activity and a cost analysis undertaken. RESULTS:
      families of four or more people depending on government benefits had a lower
      primary care cost per person than equivalent families where an adult was in paid
      employment, but higher costs in secondary care resulted in a higher total health
      care cost. Overall, for the year reviewed, the mean cost per person for public
      health care was $365 for people in families where at least one person was in the
      paid workforce, $568 for those in families depending on government support, and
      $1438 for people over 60 years of age. CONCLUSION: in this practice the increased
      use of secondary care facilities by those who have lower rates of general
      practice activity resulted in a higher overall cost of health care to those
      patients. This study indicates the need for further analyses of activities by
      differing patient groupings to facilitate rational and equitable health care
      planning.

PMID- 1625826
TI  - Does methionine alter the outcome in halothane hepatitis?

PMID- 1625825
TI  - Chronic pain and the use of health services.
AB  - The range and extent of health consulting by people who have chronic pain
      attending a specialist clinic was assessed. Forty-two subjects attending Auckland
      Hospital pain clinic completed a questionnaire about their use of conventional
      and complementary health services for their pain in the previous 12 months. The
      general practitioner was the most frequently consulted health professional,
      visited, on average, 12.9 times per annum; compared with the expected rate of 4.2
      consultations per annum. Medical specialists and health professionals had been
      consulted more frequently than complementary specialists. Twenty-five percent of
      the sample had been admitted to hospital for investigations relating to their
      pain in the previous year. On average, these patients spent $1333.63 per annum of
      their personal funds on health care. The cost of health care for chronic pain is
      significant both for the individual and the state and highlights the need for
      intensive pain management programmes.

PMID- 1625827
TI  - You can't ask if you don't know what to ask: a survey of the information needs
      and resources of hospital outpatients.
AB  - OBJECTIVES: to test public demand for health and sickness information and
      identify sources of information used by the public. METHODS: using a
      questionnaire as the basis of a highly structured interview, 274 outpatients or
      their caregivers from nine clinics in Wellington Hospital, attending for the
      second or subsequent time, were asked whether they felt they knew enough about
      their illness and treatment, and where they had obtained their information.
      RESULTS: almost half expressed a wish for more illness information and two-fifths
      wanted to know more about their treatment. Respondents were significantly more
      satisfied with treatment than illness information. Outpatient comments further
      indicated dissatisfaction with information. Sixteen sources of information were
      each used by four or more people, almost 20% of the sample using more than six
      sources. Health professionals, the hospital doctor in particular, were the most
      important source of information; informal personal contacts were also widely
      used. CONCLUSIONS: the results highlight the difficulties of communication
      between health professionals and clients. The possibility of cooperation between
      health and information professionals in providing patients with more information
      is raised.

PMID- 1625828
TI  - Down-sizing of hospitals with effective community care.

PMID- 1625829
TI  - Baseline risk for asthma deaths.

PMID- 1625830
TI  - Illegal vacancy advertisement?

PMID- 1625831
TI  - Iron deficiency.

PMID- 1625832
TI  - Outpatients appointments.

PMID- 1625833
TI  - Waiting lists.

PMID- 1625834
TI  - The new health changes: views from top nurses.

PMID- 1625835
TI  - Breathing easier.

PMID- 1625836
TI  - Getting ahead.

PMID- 1625837
TI  - Converting technology resistors and hesitators into users.

PMID- 1625838
TI  - Protecting the rights of computer artisans.

PMID- 1625839
TI  - Maximizing the probability that purchased software will be used.

PMID- 1625840
TI  - Getting funded by the Helene Fuld Health Trust.

PMID- 1625841
TI  - Practice nurses and OH.

PMID- 1625842
TI  - Corporate manslaughter--what next?
AB  - Corporate manslaughter is a relatively new concept, but with the catalogue of
      tragic disasters in recent years it is an idea that is gathering increasing
      support. Gillian Howard examines the legal basis for such an action.

PMID- 1625844
TI  - Working with display screen equipment.

PMID- 1625843
TI  - Building a healthier workforce.
AB  - The European Year of Health has put the construction industry at the top of its
      agenda. Sarah Evans examines the challenge presented to OH practitioners in this
      field and looks at the ground-breaking work of OHN, Mike King.

PMID- 1625845
TI  - Debriefing victims of violence.
AB  - Public sector unions have been warning for some time about the effects of violent
      incidents on their members. OH clinical psychologist, Martin Bamber (right),
      believes that psychological debriefing can help victims of workplace violence and
      prevent long term problems.

PMID- 1625847
TI  - AIDS update. New infections.

PMID- 1625846
TI  - Osteopathy: the 'orthodox' alternative.
AB  - Janice Kaye believes that osteopathy can significantly reduce employee
      absenteeism. Here she explains its unique system of treatment and argues for its
      use in OH departments.

PMID- 1625848
TI  - Impairment in health professionals: misunderstood and mistreated.

PMID- 1625849
TI  - [PHysiological function of veins and their intrinsic regulation].
AB  - Physiological functions of the veins include: 1. Blood collectors with flow
      rectifying valves; 2. Selective barrier function, venular reabsorption of fluid;
      3. Capacity function and redistribution of the blood volume, pressure-damping; 4.
      Maintaining the filling pressure of the heart by adequate venous return at
      varying cardiac output; 5. Increasing orthostatic tolerance of the body; 6.
      Postcapillary resistance; 7. Angiogenesis (in venous side of the
      microcirculation); 8. Secretion of bioactive substances by the endothelial and
      smooth muscle cells; 9. Lymphocyte homing (high-endothelial venules); 10.
      Cooperation between venular endothelium and the polymorphonuclear leukocytes
      (margination and rolling); 11. Enhanced inhibition of platelet aggregation and
      thromboembolic reactions; 12. Other special functions (e.g. facial vein:
      contribution to cranial thermoregulation; internal jugular vein: antisiphonage
      "device", etc.). Recent results suggest: 1. that intrinsic biomechanical
      adaptation of the systemic vein wall may occur in response a) to fast pressure
      changes within the physiological range by myogenic capacity autoregulation of the
      lumen; b) to long-term physiological haemodynamic loading by increase in total
      capacity and in short-term myogenic autoregulation range without marked changes
      of the wall thickness; c) to chronic arterialization with compensatory increase
      in wall-thickness reducing the extreme mechanical stresses induced by arterial
      pressure (such changes also imply fibrotic transformation of the wall-structure);
      2. EDRF physiologically released by venous endothelium seems to be an important
      factor protecting the veins against non-desirable increases of smooth muscle tone
      (e.g. at low Mg-ion level of extracellular fluid, or in case of axial overstretch
      of the vein, etc.).

PMID- 1625850
TI  - [Study of the virulence of coagulase-negative staphylococci in experimental
      infections].
AB  - The pathogenicity and virulence of 3 strains of Staphylococcus epidermidis,
      Staphylococcus haemolyticus and Staphylococcus saprophyticus, respectively were
      studied in BALB/c mice by intraperitoneal (ip) challenge using 4 bacterial
      suspensions of different colony forming units (CFU) of each strain. Strains were
      isolated from wound, blood, and urine of inpatients. On the base of the lethality
      rates, S. saprophyticus proved to be the most virulent (LD50 = 2.7-2.9 x 10(7)
      CFU/g body wt), while the S. epidermidis species was the least virulent (LD50 = 6
      8 x 10(7) CFU/g body wt). The lethality rate of male mice was higher than that of
      the female ones at the same challenge bacterium concentration. Mice of higher
      body weight were generally more sensitive to a quality of bacteria calculated to
      1 g of mice than the lighter mice. The 245 mice surviving the challenge were
      dissected at the 10th day of infection. Splenomegaly was found to be the most
      frequent macroscopic pathological alteration. There appeared kidney abscesses,
      liver abscesses, and rarely peritoneal abscess. The frequency of pathological
      findings were directly proportional to the amount of bacteria injected. The
      results indicate that clinical strains of coagulase-negative staphylococci (CNS)
      examined were pathogenic and virulent for BALB/c mice they are invasive after ip
      injection and can cause macroscopic pathological changes in parenchymal organs.
      Thus, ip CNS challenge in mice may be a model to imitate and study infections
      caused by CNS in human.

PMID- 1625851
TI  - [Epidemiologic aspects of osteoporosis and fractures in advanced age].
AB  - The most important word-wide and home trends of osteoporosis and age-related
      fractures are reviewed. The author summarizes the relationship between fractures
      and bone mass, the bone mass determinants and the risk factors for osteoporosis.
      He describes the secular trends, age- and sex specific incidence as well as
      geographic distribution of fractures of the proximal femur, vertebrae and distal
      forearm. Finally the social and financial impact of this major public health
      problem are discussed.

PMID- 1625852
TI  - [Hand fractures and epiphyseal injuries in childhood].
AB  - Anatomic features of the hand in childhood are presented that are responsible for
      the types of certain injuries. On the basis of the data in the literature and of
      the authors' own experience of 92 cases the main points of the diagnosis and
      therapy of metacarpal and phalanx fractures are summarized. The possibility of
      finger-replantation is also mentioned. Their statements are illustrated by their
      own cases. In order to recognize late growth disturbances, the necessity of the
      follow up is emphasized.

PMID- 1625853
TI  - [Basal cell carcinoma of the leg with metastases to the surrounding skin and
      inguinal lymph nodes].
AB  - A case of metastasizing basal cell carcinoma in a 57-year-old male is described.
      The primary tumor localised on the left lower leg metastasized to near skin and
      inguinal lymph nodes. The primary and metastatic skin tumors were excised and the
      defects covered by free skin grafts. Besides, the inguinal lymph nodes were block
      dissected and a part 10 cm long of the left calf bone was resected.

PMID- 1625855
TI  - [Medical ethics? Oh!].

PMID- 1625854
TI  - [Lymphomatoid granulomatosis].

PMID- 1625856
TI  - [Pathology--on a molecular level (determination of nucleic acids from fixed
      embedded samples)].
AB  - Molecular biological techniques may open new avenues to pathological archives.
      Fixed and paraffin embedded blocks are a suitable source of nucleic acids,
      especially of DNA, for retrospective analysis. The quality of DNA depends mainly
      on the fixation procedure. High molecular weight DNA allows Southern
      hybridization, but fragmented DNA also became a target with the appearance of
      polymerase chain reaction (PCR). PCR has rising applicability and enables
      amplification of required sequence even from one section. Using these techniques
      on archieved materials a wide variety of informations, e.g. correlation between
      morphology, phenotypic expression and gene alteration, will be available.

PMID- 1625858
TI  - [Can gastroesophageal reflux be prevented by inducing a scar tissue ring around
      the cardia?].
AB  - Severe gastroesophageal reflux was accomplished in 18 dogs by circular
      cardiomyectomy. After this intervention a Vicryl scarf was placed around the
      cardia in 12 dogs. The Vicryl scarf was absorbed within 6 months and in its place
      remained a scarred tissue. In the follow up gastroesophageal reflux could not be
      detected by manometry, pH-metry, radiology and endoscopy. In the control group
      all 6 dogs died within 3 weeks due to complications of gastroesophageal reflux.
      On the basis of these data the Vicryl scarf implantation is an effective, simple,
      new antireflux operation which can be initiated into the human surgical practice.

PMID- 1625857
TI  - [Gonadotropin releasing hormone loading test with bromocryptin therapy: a new
      possibility in the differential diagnosis of normo-prolactinaemic anovulation].
AB  - An anovulation group with normal basal prolactin level (less than 600 mU/l) was
      found during GnRH loading tests. After GnRH administration there was a definite
      increase in prolactin value together with an insufficient hypophyseal response.
      Bromocriptine treatment was commenced on the 10th day (daily 2.5 mg) before
      carrying out the GnRH loading tests again. During the repeated tests prolactin
      levels remained normal, basal FSH and LH values increased and reactive
      hypophyseal responses occurred. On the basis of the examination a group ("latens
      hyperprolactinemia") responding with increased prolactin production during GnRH
      administration was found. This higher prolactin level inhibits gonadotropin
      release from hypophysis. In these cases ovulation induction with bromocriptine is
      adviseable in spite of basal prolactin level is normal.

PMID- 1625859
TI  - [Polythelia and renal malformation].
AB  - The authors found 241 polythelia (5.86) among 4113 schoolchildren (aged 6-14
      years). They investigated 236 of the 241 with ultrasound and found 10 renal
      malformations (4.24%). Among 280 controls with respiratory infection, accident or
      tonsillectomy they found 9 renal malformations (3.21%). With screening of 1635
      neonates they found 66 with accessory nipples (4.05%). Two of the 66 had renal
      malformations (3.03%), while among the 1957 control neonates 37 had renal
      malformations (1.89%). In the hospital and ambulancy the authors found 106
      polythelia, five of them had renal abnormalities (4.72%). The authors did not
      found association of polythelia and renal malformation with ultrasound
      investigation of 408 children with polythelia.

PMID- 1625860
TI  - [A case of numerous foreign bodies found in the esophagus and the right main
      bronchus].
AB  - The authors report about the elimination of foreign bodies fixed in the
      oesophagus and aspirated into the right main bronchus. They discuss the
      diagnostic work and the ways of its elimination. They emphasize the importance of
      cooperation between the endoscopist and the surgeon.

PMID- 1625861
TI  - [Istvan Hollos].

PMID- 1625862
TI  - [Cardiovascular diseases in the Bible].

PMID- 1625863
TI  - Epidemiology, pathogenesis, and genetics of acoustic tumors.
AB  - This article reviews the epidemiology of both unilateral and bilateral (NF-2)
      acoustic tumors. The growth rate of acoustic tumors is examined from a clinical,
      radiographic, and laboratory perspective. The anatomic, histologic, and
      biochemical considerations as well as the influences of sex hormones on acoustic
      tumor formation are reviewed. Also presented are an update on the laboratory
      search for the NF-2 gene on chromosome 22 and recently identified DNA markers.
      Predictions are made concerning the potential future applications of genetic
      testing for prenatal or presymptomatic diagnosis of the disease that causes
      bilateral acoustic tumors.

PMID- 1625864
TI  - Clinical manifestations and audiologic diagnosis of acoustic neuromas.
AB  - If an AN is suspected, a detailed patient history and a thorough otologic and
      neurotologic physical examination should be carried out. The first echelon of
      diagnostic testing begins with a pure tone audiogram, speech reception threshold,
      speech discrimination testing, and acoustic reflex testing. If the clinician is
      even moderately suspicious of the presence of an AN, the patient should undergo a
      Gd-MRI scan. If suspicion is low, an ABR should be performed, and if negative,
      the patient should be reevaluated periodically.

PMID- 1625865
TI  - Imaging of acoustic neuromas.
AB  - A negative high-quality, high-resolution, contrast-enhanced MRI scan is excellent
      evidence that a patient does not have an AN. Most nerve sheath tumors have a
      characteristic appearance, and when a tumor is detected there is seldom any doubt
      as to the identity of the lesion. There are other causes of enhancement, however,
      or of high signal that can be mistaken for an AN, and these must be kept in mind
      when a case is considered positive. In some cases, it may be appropriate to defer
      surgery to clarify a questionable finding by obtaining a follow-up scan. CT is
      still a reliable examination. In addition to evaluating the IAC, valuable
      information about the architecture of the petrous bone and labyrinth is provided.
      Improvements in imaging technology are occurring at a rapid rate. Thinner slices
      and more rapid scan techniques will make MRI even more useful in evaluation of
      the IAC.

PMID- 1625866
TI  - Hearing preservation in acoustic tumor surgery.
AB  - Preservation of hearing is a realistic goal, possible through the retrosigmoid or
      middle fossa surgical approaches. The best candidates have small tumors and good
      preoperative hearing. Preoperative ABR, ENG, and imaging characteristics may help
      prognosticate chances for hearing preservation. Hearing rarely improves after
      surgery, and some have noted a decline in the preserved hearing over time. With
      the introduction of gadolinium-enhanced magnetic resonance imaging, a larger
      number of small acoustic tumors are being diagnosed before hearing has been
      significantly affected. These patients benefit from this early diagnosis and are
      the best candidates for hearing preservation surgery.

PMID- 1625867
TI  - Facial nerve outcome in acoustic neuroma surgery.
AB  - Patients consider facial paralysis the most concerning sequelae following
      acoustic tumor resection. Surgical and anesthetic refinements have lowered
      operative mortality to allow the surgeon to focus on preserving facial nerve
      function. Tumor size, microsurgical technique, and intraoperative monitoring are
      the most important factors that define the risk of postoperative facial
      paralysis. A protocol for uniform surgical reporting is proposed.

PMID- 1625869
TI  - Management of ophthalmic complications of facial nerve palsy.
AB  - Six stages--supportive care (with or without tarsorrhaphy), planning for facial
      reanimation, lower eyelid and lateral canthal resuspension, passive upper eyelid
      reanimation, dynamic eyelid reanimation, and soft tissue repositioning--should be
      considered in the management of the ophthalmic complications of facial nerve
      palsies. Each stage should be considered in order, although action in each stage
      may not be appropriate for all patients. In addition, after appropriate
      consideration, two or more staged procedures may be performed at the same time.
      Treatment may be held at any stage in which the cornea is compensated and the
      patient is comfortable and happy. By employing this staged approach, the surgeon
      has a method of organizing therapy in a logical fashion, and the patient is
      offered a set of reassuring goals, which combine to make the treatment plan more
      effective.

PMID- 1625868
TI  - Reanimation of the paralyzed face.
AB  - The challenge of reconstruction in the paralyzed face is to provide symmetry both
      at rest and in active expression. Although functional considerations must take
      precedence, the patient with unilateral facial palsy faces social stigmata that
      are exceptionally difficult. The best reconstructions in late paralyses fall far
      short of natural facial expression. Conley, one of the pioneers in facial nerve
      rehabilitation, reflected the frustration of dealing with limited techniques: It
      has been assumed by many surgeons that involuntary emotional communication is
      through the facial nerve, but this has never been substantiated. Indeed,
      emotional expression may be beyond our concept of a mere physical tract. It
      certainly has never been totally restored by any surgical technique that attempts
      to rehabilitate the face. When injury to the facial nerve is established, early
      nerve grafting on the ipsilateral side is the best treatment. In acoustic neuroma
      and other intracranial operations, the only real opportunity for grafting or
      repair is at the time of the procedure. If the nature of the injury is uncertain,
      a period of 12 months is allowed to elapse before consideration of intervention,
      which should be started if there is no return of function at that point.
      Electromyography may be of assistance in assessing minimal early return; if any
      early return is noted, further waiting is indicated. If there is no return at 1
      year, cranial nerve XII to VII crossover will preserve facial muscle tone and
      permit a more measured decision-making approach. Patients with multiple cranial
      nerves involved may be candidates for a partial hypoglossal transfer using a
      nerve graft, to attempt to preserve swallowing. In selected cases, cross-facial
      nerve grafting to the preserved facial muscles will give excellent results and
      obviate the need for local or distant muscle transfers. When treating established
      paralysis of long duration, cross-facial nerve grafting with microneurovascular
      muscle transfer is the best option for symmetrical movement of the face.
      Temporalis and masseter muscle transfers should be reserved for the patient with
      intercurrent medical disease or the patient who refuses additional operations or
      operative sites. Static slings and other related procedures should be considered
      adjunctive but not primary treatment in the vast majority of cases. Although
      there are limitations in each of the procedures described, close cooperation
      between the otolaryngologist, the neurosurgeon, and the plastic surgeon can
      provide many patients with satisfactory rehabilitation from facial paralysis.

PMID- 1625870
TI  - Conservative management of acoustic neuromas.
AB  - The results of this study and others document the biologic behavior of acoustic
      neuromas. In view of the evidence presented, which describes both variable rates
      of individual tumor growth and spontaneous regression in size, it would seem
      prudent that before selecting a nonsurgical treatment modality, the growth rate
      for the particular tumor in question should be established. To date, none of the
      literature that addresses the use of focused irradiation has attempted to do so.
      Our study as well as those of others suggests that the growth rate of acoustic
      neuromas becomes predictable over time. Based on this observation, a conservative
      (nontumor excision) management strategy is proposed for selected individuals.
      Patients to whom this management philosophy has been recommended or who
      themselves have chosen this option are seen twice yearly. Each visit consists of
      a thorough neurotologic examination as well as high-definition CT or MRI. Careful
      comparison of the clinical course as well as calculation of the tumor size is
      carried out in each instance. If the clinical course and rate of tumor growth
      remain unchanged over a 3-year follow-up, annual assessments are recommended. In
      the event of tumor enlargement, surgery may or may not be recommended, depending
      on the rate of growth and the age of the patient. Our experience suggests that a
      rate of growth equal to or exceeding 0.2 cm per year constitutes an indication
      for tumor removal.

PMID- 1625871
TI  - Meningiomas, epidermoids, and other nonacoustic tumors of the cerebellopontine
      angle.
AB  - Nonacoustic tumors of the CPA include meningioma, epidermoid, arachnoid cyst,
      lipoma, facial nerve schwannoma, and metastatic tumor, among others. Like AN,
      these lesions present with audiovestibular symptoms, facial nerve dysfunction,
      and other cranial nerve neuropathies. Preoperative differentiation among these
      lesions based on clinical history, physical examination, and audiovestibular
      testing is difficult. CT and gadolinium-enhanced MRI reveal the characteristic
      appearance of these tumors and make accurate diagnosis possible.

PMID- 1625872
TI  - Health care reform--a nursing perspective.

PMID- 1625874
TI  - Researcher develops computer networks for AIDS and Alzheimer patients.

PMID- 1625873
TI  - AIDS in Pennsylvania.

PMID- 1625875
TI  - Making it the right time to be a nurse. Interview by Susan FitzGerald.

PMID- 1625876
TI  - Impaired professional program available to health care professionals.

PMID- 1625877
TI  - PNA position statement issued: unlicensed assistive personnel.

PMID- 1625878
TI  - A decision making model for determining RN/LPN scope of practice.

PMID- 1625879
TI  - Pennsylvania legislators' opinions about nurses and nursing.

PMID- 1625880
TI  - The effect of leadership style of emergency department nurse managers on job
      satisfaction of their nursing staff.

PMID- 1625881
TI  - OSHA regulations: do you know what protection is required?

PMID- 1625882
TI  - Author and hospice founder to address AIDS conference.

PMID- 1625883
TI  - Ferguson to keynote AIDS conference.

PMID- 1625884
TI  - ANA asks Congress for increased funding for nursing education & research.

PMID- 1625885
TI  - Educating nurses in political process: a growing need.

PMID- 1625886
TI  - Political action--an investment in the future.

PMID- 1625887
TI  - Pennsylvania Safe Kids Coalition features infant car safety.

PMID- 1625888
TI  - Role strain in patients and family experiencing cancer.

PMID- 1625889
TI  - Pre-employment mandatory testing for HIV.

PMID- 1625890
TI  - Laufband locomotion with body weight support improved walking in persons with
      severe spinal cord injuries.
AB  - After low transection of the spinal cord mammalian quadrupeds can be trained to
      walk on a driven surface indicating that coordinating neuronal circuits persist
      in the spinal cord segments caudal to the lesion. We trained 8 persons with
      incomplete spinal cord lesion on a Laufband (driven treadmill) for 1 1/2 to 7
      months (5 days a week, 30-60 minutes daily) starting 5 to 20 months after injury
      and found significant improvement in the utilisation of the paralysed limbs
      during locomotion. Locomotion is described in one additional patient who had
      trained independently on parallel bars for several years. Five patients had
      complete functional paralysis in one lower limb when tested in a resting
      position. In EMG recordings voluntary activity (ie activity induced upon command)
      was absent or residual in the main flexor and extensor muscles of this limb. In
      contrast, during locomotion flexion and extension movements were performed and
      phasic EMG activity was present. In these 5 patients, and in all others reported
      here, skin sensibility and proprioception are preserved to different degrees in
      all limbs. In the course of locomotive training of 4 severely paralysed patients
      the initially habituating flexion reflexes could be entrained in the paralysed
      limbs as was the case for knee extension during stance. Subsequently, initial
      body weight support (BWS) of 40% could be reduced to 0%. The distance covered on
      the Laufband (0-104 m in the first week) increased significantly (200-410 m) in
      the last week of training as did speed (0-10 to 14-23 m/min). More importantly,
      this training subsequently allowed patients to walk on a static surface for 100
      to 200 meters while voluntary activity remained absent in the paralysed limb when
      tested at rest. Similar progress was achieved in the 4 less severely paralysed
      patients. The one patient who had trained independently on parallel bars for
      several years is described walking on a static surface for 40 meters with the
      help of a walker, though he had one completely and one near completely paralysed
      lower limb. It appears that bipedal stepping with consequent knee extension and
      stabilisation can be taught after unilateral complete or near complete loss of
      voluntary activity, suggesting the manifestation of complex reflex motor patterns
      at the spinal level.

PMID- 1625891
TI  - Ambulation using the reciprocating gait orthosis and functional electrical
      stimulation.
AB  - Until recently, rehabilitation engineering offered 2 different methods to improve
      daily living independence for spinal cord paralyzed subjects. One, the use of
      various orthotics and the other, the application of functional electrical
      stimulation. In the present work we chose to combine reciprocating gait orthosis
      (RGO) with functional electrical stimulation (FES) into one hybrid system. A
      detailed biomechanical and clinical instruction for the use of this system is
      given. Results obtained from application of the hybrid system on a complete T4
      paraplegic patient demonstrate that the most significant contribution was the
      reduced invested energy cost required for stand-up and for ambulation.

PMID- 1625892
TI  - Physiological cost index of paraplegic locomotion using the ORLAU ParaWalker.
AB  - Energy expenditure is an important parameter in the assessment of gait and
      orthotic treatment of locomotor disabilities. Up until now oxygen uptake
      measurement has been the most common method used to assess this. In able bodied
      subjects heart rate monitoring is also increasingly used. In high thoracic level
      lesion paraplegics monitoring heart rate was considered to be unreliable because
      of suspicion of injury to the sympathetic contribution to the cardiac plexus. Bar
      On & Nene found that in paraplegics below the lesion level T3 heart rate still
      shows linear relation to oxygen uptake. MacGregor combined the heart rate and
      speed of locomotion to produce a single index called physiological cost index.
      This study consists of monitoring heart rate and speed of 16 adult thoracic level
      paraplegics walking with the ORLAU ParaWalker, calculation of their physiological
      cost index, and establishing a range of physiological cost index of paraplegic
      locomotion using the ORLAU ParaWalker.

PMID- 1625893
TI  - Voiding by increased abdominal pressure in male spinal cord injury patients--long
      term follow up.
AB  - We reviewed the long term follow up of five spinal cord injury patients with
      detrusor areflexia who emptied their bladder using high abdominal pressure. Ages
      ranged from 29 to 58 years, and the mean time elapsed from injury was 18.9 years.
      The bladder pressure during voiding ranged from 95 to 160 cm of water. One
      patient developed vesicoureteral reflux and hydronephrosis. Long term monitoring
      is suggested in patients who use high abdominal pressure for bladder emptying.

PMID- 1625894
TI  - Bladder outlet resistance decreasing operations in spinal cord damaged patients
      with vesicoureteral reflux.
AB  - Bladder outlet resistance decreasing operations were carried out on 68 spinal
      cord damaged patients with 87 vesicoureteral refluxes in the Paraplegic Centre,
      Hamburg, from 1982 to 1988. These patients were studied regularly with infusion
      urography and voiding cystourethrograms combined with urodynamic procedure.
      Although the primary aim of the operative treatment was to achieve balanced
      voiding, 62 (71%) refluxes disappeared, 10 (12%) changed for the better, 13 (15%)
      stood unchanged and 2 (2%) worsened. It was observed that the results of
      operative treatment of secondary vesicoureteral reflux depend only on the
      recuperative capacity of ureterovesical junction after reducing the
      pathologically increased bladder outlet resistance. Successful treatment of
      secondary vesicoureteral reflux does not influence renal parenchymal scarring. In
      all of the patients with unchanged or worsened reflux balanced voiding has still
      not been achieved, the bladder outlet resistance being not sufficiently
      decreased.

PMID- 1625895
TI  - Exertional hypotension in thoracic spinal cord injury: case report.
AB  - Exertional hypotension is well described in quadraplegics, but there are few
      descriptions of this hemodynamic response in paraplegics or of treatment
      modalities to correct this condition. We describe a patient with a complete T3-4
      spinal cord lesion who repeatedly demonstrated symptomatic hypotension with
      wheelchair sports and arm ergometry. We used gas exchange analysis and exercise
      echocardiography to delineate the mechanism for hypotension. These results
      enabled us to develop a simple treatment plan consisting of abdominal binding and
      elastic stockings to avoid recurrent symptoms.

PMID- 1625896
TI  - The effectiveness of a pressure clinic in preventing pressure sores.
AB  - The role of a pressure clinic in reducing the incidence of pressure sores is
      described. Interface pressures are routinely measured to ensure that appropriate
      cushioning is provided. In patients most at risk, thermography is also valuable
      to ensure that the blood flow to the skin is not compromised. The implementation
      of such a clinic has proved successful and has resulted in a reduction of over
      50% both in the incidence of sores and in the admission rate due to sores, when
      compared with studies from other spinal units.

PMID- 1625897
TI  - The role of intracavernosal vasoactive agents to overcome impotence due to spinal
      cord injury.
AB  - Twenty-two spinal cord injured men (mean age 35.2 years) referred because of
      impotence were treated with intracavernosal vasoactive agents. Papaverine 2-20
      mg, papaverine 40 mg plus phentolamine 0.5 mg or prostaglandin E1 (1-20
      micrograms) were used. Nineteen responded and were taught to self administer the
      medication with varying degrees of assistance from their partners. Fourteen men
      participated in a postal survey; 12 (86%) continued to use the drugs every 1 to 4
      weeks and reported satisfaction with the method. Partner responses were positive
      in half of the group and when not so it influenced the patients to abandon or
      reduce the frequency of treatment. Counselling was essential to allay anxiety.
      Clinical management was not compromised and side effects were minimal. Overall we
      found this treatment effective, safe and worthwhile.

PMID- 1625898
TI  - Ossification of the posterior longitudinal ligament in the thoracic spine causing
      intermittent paraplegia in an Englishman: case report.
AB  - Compression of the spinal cord due to ossification of the posterior longitudinal
      ligament (OPLL) often leads to quadriplegia or paraplegia in Japanese patients.
      This disease is uncommon in other races. We report the case of a middle-aged
      Englishman who presented with complaints of intermittent paraparesis due to OPLL
      at the T5-T6 level in his thoracic spine.

PMID- 1625899
TI  - Health and psychosocial issues of individuals with incomplete and resolving
      spinal cord injuries.
AB  - Longitudinal data and clinical experience indicate that a greater proportion of
      spinal cord injuries result in incomplete or resolving neurological lesions.
      Although it has been reported that persons with incomplete injuries enjoy better
      functional outcomes, routine contacts with these individuals indicate that many
      experience problems and complications strikingly similar to those with complete
      spinal cord injuries. Thus, to document the issues and needs of these
      individuals, data from Colorado's population-based spinal cord injury
      surveillance program were analyzed. Of 330 persons registered since January 1,
      1986, 121 (37%) were found to be minimally disabled (Frankel class D or E).
      Review of medical records and follow up documentation for these individuals
      indicated that although over 75% were ambulatory and virtually all were
      physically independent, more than 80% did report problems in one or more areas:
      21% had orthopedic issues and 17% faced additional spinal surgery; 16% reported
      neurological deterioration or increased spasticity; 25% had pain problems; and
      16% had bladder difficulties. Other issues included bowel problems, blood
      pressure abnormalities, skin breakdown, sexual difficulties, depression, and
      unemployability. Implications for rehabilitation are discussed in the light of
      these and other findings.

PMID- 1625900
TI  - A second traumatic spinal cord injury: associated risk factors. Case report and
      review.
AB  - Despite advances in acute care and long term management, traumatic spinal cord
      injury remains a devastating and disabling event. This report describes the case
      of a second traumatic spinal cord injury in a previously rehabilitated and
      functionally independent paraplegic. Factors potentially associated with the
      second spinal cord injury in this patient include wheelchair use, previous spinal
      fusion, alcohol use and sensation-seeking behavior. These factors, which are
      common to many spinal cord injured patients, could potentially be risk factors
      for a second traumatic spinal injury.

PMID- 1625901
TI  - Preoperative embolisation, transpedicular decompression and posterior
      stabilisation for metastatic disease of the thoracic spine causing paraplegia.
AB  - During a brief period from March 1988 to January 1990 we were faced with 13
      patients with malignant vertebral neoplasms (metastasis) of the thoracic spine.
      Nine of these had progressive extradural spinal cord compression with motor,
      sensory and sphincter involvement of varying degrees and duration. After proper
      evaluation these 9 cases were aggressively managed by preoperative embolisation
      of the tumour, transpedicular decompression and a same stage posterior metallic
      fixation. The immediate results were encouraging, with 2 patients showing total
      recovery and 3 showing partial recovery. All of the 9 operated cases were pain
      free postoperatively and could sit up unaided and be easily transferred to the
      Cancer Institute for back up chemotherapy and radiotherapy. They also improved
      psychologically, and cooperated well in their subsequent rehabilitation
      programme.

PMID- 1625902
TI  - The role of motor evoked potentials in the management of hysterical paraplegia:
      case report.
AB  - The role of motor evoked potentials in the management of a case of presumed
      hysterical paraplegia precipitated by spinal injury in a man with a previous
      history of surgery for scoliosis is presented. Motor evoked potentials were
      elicited with magnetic stimulation 12 days after injury and were within normal
      limits. The presence of normal motor electrophysiology and observation by the
      patient of involuntary movement of the lower limbs during stimulation greatly
      facilitated the patient's management. These findings are discussed with reference
      to current diagnostic investigations in the presence of a suspected diagnosis of
      hysterical paraplegia.

PMID- 1625903
TI  - Examination of murine antibody response to secondary hydatidosis using ELISA and
      immunoelectrophoresis.
AB  - Antibody responses in mice with up to 64 weeks of secondary Echinococcus
      granulosus hydatidosis were examined by ELISA using hydatid protoscolex antigen
      (Px), Antigen 5 (Ag5) and Antigen B (AgB), and by immunoelectrophoresis (IEP)
      using sheep hydatid cyst fluid (SHCF). Anti-Px IgG antibodies, evident from 3-5
      days post infection (p.i.), increased steadily until 16 weeks and maintained a
      high level afterwards. Anti-Ag5 IgG antibodies were negligible up to two weeks,
      but they showed a small increase around 2-3 weeks which was followed by a big
      increase around 16 weeks p.i. The high level of anti-Ag5 IgG antibodies persisted
      to the end of experiment. The level of anti-AgB IgG antibodies remained
      relatively low throughout infection. Anti-Px IgM antibodies appeared in the early
      period of infection, but became insignificant as the infection proceeded.
      Specific IgM antibodies to Ag5 and AgB showed two waves of increase, one between
      3 days to 4 weeks p.i. and the other between 16 weeks to 46 weeks p.i. The level
      of IgA antibodies to Ag5 and AgB was low and only a moderate amount of anti-Px
      IgA antibodies was detected. Generally, a higher level of serum antibodies are
      associated with a larger number of mature cysts. Serum samples from 5 of 8 mice
      harbouring hydatid cysts formed 1-3 bands with SHCF in IEP, including Arc 5, but
      a precipitation are with AgB was not observed. Analysis of hydatid cyst fluid
      from the infected mice (MHCF) in IEP also failed to demonstrate AgB. Despite the
      high levels of antihydatid antibodies generated in the infected mice,
      protoscoleces appeared to be unhindered in their growth to mature cysts.

PMID- 1625904
TI  - Immune responses of sheep to surface antigens of infective larvae of Ostertagia
      circumcincta.
AB  - Immune responses to surface antigens of infective larvae of Ostertagia
      circumcincta were studied in 5-month old Finn-Dorset male lambs. The sheep were
      vaccinated subcutaneously with 2 doses of 25 micrograms/kg body weight of
      infective larvae surface or somatic extracts and Freund's or beryllium hydroxide
      adjuvants. It was found that only in lambs vaccinated with L3 surface extracts
      and beryllium hydroxide as an adjuvant did worm burdens differ significantly (P
      less than 0.01) from those of challenge controls (71.7% protection). Sheep
      vaccinated with the same antigenic preparation but administered with Freund's
      adjuvant or with beryllium adjuvant and somatic extracts demonstrated rather poor
      protection (32.4 and 30.5% respectively). All the vaccinated sheep showed a high
      IgG response to L3 surface antigens while significant levels of serum and bile
      IgA reacting with the surface extracts were only detected in those lambs
      vaccinated with L3 surface extracts and beryllium hydroxide. In
      immunofluorescence tests serum IgA of this group reacted with the whole surface
      of exsheathed larvae or with the site of opening of excretory pore while IgG
      antibodies reacted strongly with the anterior and posterior parts of the
      infective larvae. Both IgA and IgG responses to surface antigens were stage
      specific.

PMID- 1625905
TI  - Alternative patterns of MHC-restricted antibody responsiveness following
      intraperitoneal immunization of inbred mice with different preparations of an 86
      kilodalton antigen of Schistosoma mansoni.
AB  - The investigation of MHC restricted antibody responses to an 86 kDa antigen (p86)
      during chronic Schistosoma mansoni infection has been extended to immunization
      with this antigen. In the absence of adjuvant, a similar pattern of
      responsiveness by mice expressing H-2k and H-2d but not H-2b was observed
      following immunization with unpurified adult worm homogenate. Adjuvant
      selectively abrogated the capacity of H-2d mice to respond and this was also the
      case when purified p86 with adjuvant was injected. Immunization with purified
      subfragments of p86 again demonstrated MHC restriction in the capacity to
      immunoprecipitate p86 in vitro translation product, the pattern varying according
      to the fragment used. Western blot analysis showed that in some, but not all
      instances of apparent 'non-responsiveness' characterized by immunoprecipitation,
      antibody specificities capable of recognizing p86 epitopes on the nitrocellulose
      bound p86 were, indeed, present. Thus the fine specificity as well as the
      absolute capacity to respond is influenced by both the MHC haplotype of the host
      and the nature of the immunizing antigen.

PMID- 1625906
TI  - Vaccination of dogs against Babesia canis infection using parasite antigens from
      in vitro culture.
AB  - Groups of five dogs were vaccinated with different Babesia canis vaccine
      formulations. It appeared that partial protection against challenge infection was
      obtained when using parasite antigens from in vitro culture in combination with
      saponin. Protection was evident as a decrease in parasitaemia after challenge and
      was associated with the presence of serum antibodies against Babesia parasites.
      In addition, parasite antigen derived from in vitro culture supernatant exhibited
      more protective activity than somatic parasite antigen, in that a less marked
      fall of haematocrit values was found after challenge infection. The fall of
      haematocrit value observed in the animals immunized with somatic parasite antigen
      was not different from that observed in the adjuvant control group.

PMID- 1625907
TI  - Testosterone-unresponsiveness of existing immunity against Plasmodium chabaudi
      malaria.
AB  - Testosterone (Te) is known to suppress immunity and to increase host
      susceptibility to many parasites. This study investigates the action of Te on
      immunity acquired against blood-stages of the malaria parasite Plasmodium
      chabaudi in female mice of the inbred strain C57BL/10. Our data show: (i) About
      90% of mice infected with 10(6) P. chabaudi-infected erythrocytes are able to
      develop protective immune mechanisms which become evident in self-healing the
      infection. The capability of self-healing is lost when mice are pretreated with
      Te for 3 weeks. (ii) Mice which have self-healed infections acquire immunity to
      homologous rechallenge. Concomitantly, mice become Te-unresponsive in that their
      acquired immunity is not suppressible by Te-treatment. (iii) Flow cytometry
      reveals that Te-pretreatment entails an increase of CD8+ cells and a decrease of
      Ig+ cells by about 4% in spleens of non-immune mice. In immune mice, however,
      there is a Te-unresponsiveness of the percental distribution of splenic cell
      populations. (iv) Adoptive transfer experiments indicate that immunity is
      conferred by spleen cells, presumably non-T-cells. These cells are Te
      unresponsive, since they exert their effect in Te-pretreated mice in the presence
      of Te. (v) Te-unresponsive immunity can be also transferred by serum, especially
      the IgG-fraction, obtained from immune mice. Our data demonstrate that Te
      prevents the development of protective immunity against P. chabaudi infections.
      However, when once established, protective immunity becomes unresponsive to Te.
      Our data suggest that the effector mechanisms of protective immunity involve Te
      unresponsive B cells secreting protective IgG-antibodies.

PMID- 1625908
TI  - Naturally acquired cellular and humoral immune responses to the major merozoite
      surface antigen (PfMSP1) of Plasmodium falciparum are associated with reduced
      malaria morbidity.
AB  - We have investigated the pattern of acquired immune responses to the major
      surface protein of Plasmodium falciparum merozoites (gp 190, PfMSP1) in a malaria
      endemic population in West Africa. A prospective longitudinal study in 3- to 8
      year-old children was conducted to examine the relationship between naturally
      acquired immune responses to PfMSP1 and subsequent susceptibility to malaria
      infection and clinical disease. A population cross-sectional survey was performed
      to investigate changes in immune response with age. The prevalence and
      concentration of antibodies to all regions of the molecule increased with age
      with the highest prevalence of antibodies being detected against regions of the
      molecule which are highly conserved between parasite isolates. In vitro lympho
      proliferation and interferon-gamma production in response to recombinant proteins
      representing polymorphic regions of the molecule also increased with age.
      Interestingly, proliferative responses to some regions of the molecule, including
      some highly conserved sequences, were highest in young children and decreased
      markedly with increasing age. Significant associations were observed between
      antibody and lymphoproliferative responses to proteins from the C terminus of the
      molecule and resistance to episodes of fever associated with high parasitaemia in
      partially immune children. In addition, high concentrations of antibodies to a
      conserved region close to the N terminus of PfMSP1 were also significantly
      associated with protection.

PMID- 1625909
TI  - Cats with single Brugia pahangi infections: relationship between parasitological
      status and humoral responses to somatic and surface parasite antigens.
AB  - Cats given a single inoculation of Brugia pahangi infective larvae (L3) were
      retrospectively allocated into three groups according to parasitological outcome
      of infection. Recognition of somatic and surface antigens of B. pahangi by sera
      from each group was compared by ELISA, immunoelectroblotting, and
      immunoprecipitation techniques. In cats that never became microfilaraemic mean
      serum IgG antibody levels against somatic extracts from adult male worms, L3, and
      microfilariae (mf) were higher than levels in cats that initially became
      microfilaraemic (mf + ve) then spontaneously became nonmicrofilaraemic (mf - ve).
      The lowest levels of antibody against each stage were found in cats that remained
      persistently mf + ve. Antigenic components of 18 kD and 22 kD in somatic extracts
      of adult worms and L3 were recognized by sera from cats that never became mf + ve
      and by spontaneously mf - ve cats, but not by sera of persistently mf + ve cats.
      When radioiodinated surface antigens of mixed adult worms and microfilariae were
      immunoprecipitated by sera from cats in the three groups, no correlation was
      observed between recognition of individual antigen components and parasitological
      outcome of infection.

PMID- 1625910
TI  - The ultimate balance: caring for yourself--caring for others.
AB  - We all know that caring is both a traditional as well as a contemporary value in
      nursing, and yet how many of us are as good at caring for ourselves as we are at
      meeting the needs of others? It's time the ethic of caring was expanded to
      include caring for the caregiver, as well as the more traditional emphasis on the
      patient's needs. Before you can care for others well, you must first know how to
      care for yourself. This article is an invitation to interact with the material.
      If you merely read the words you will miss the opportunity to reflect more
      closely on the balance between caring for others and caring for yourself. So take
      out a pen and some paper and spend some introspective time. Use this article as a
      mirror for personal reflection and a springboard for professional action.

PMID- 1625911
TI  - A brighter future for adults who have myelomeningocele--one form of spina bifida.
AB  - Recently a new population of adults with myelomeningocele, the most severe form
      of spina bifida, has emerged. Because of the complex issues challenging these
      adults, specialized health care services provided by a multispecialty team are
      recommended. With the hope that similar services will be developed, the
      establishment of one specific teen/adult spina bifida multispecialty team is
      discussed in this article. An overview of myelomeningocele is presented, which
      includes adult focused physical/cognitive/social-emotional challenges and goals,
      potential medical problems, and opportunities for nurse leadership.

PMID- 1625912
TI  - Postoperative orthopaedic blood salvage and reinfusion.
AB  - Minimal use of homologous blood is a desirable goal for both patients and health
      care providers. This article discusses one adjunctive technique that is used for
      the orthopaedic patient, postoperative blood salvage and reinfusion, and the
      implications for nurses.

PMID- 1625913
TI  - The physiologic changes of aging.
AB  - It is estimated that by the year 2030, 21.2% of the United States population will
      be 65 years of age or older. The elderly are the fastest growing segment of the
      population and use health care services extensively. Today 30% of all
      hospitalized individuals are elderly. The professional nurse must therefore be
      able to assess and assist elderly persons during the course of hospitalization.
      An important component of assessment is the ability to differentiate the normal
      physiologic changes of aging from the pathologic changes. To effectively
      intervene in a therapeutic plan of care the nursing professional must be aware of
      the limitations brought on by aging.

PMID- 1625914
TI  - Live and learn: patient education for the elderly orthopaedic client.
AB  - Patient education is a critical component of nursing interventions for health
      maintenance and illness prevention in assisting older persons with orthopaedic
      problems to maintain optimum independence and quality of life. This article
      focuses on the needs of the adult learner with emphasis on the elderly.
      Theoretical considerations of learning and characteristics of the adult learner
      are briefly introduced. Changes attributed to aging and factors that affect
      learning for elders are discussed. The article closes with strategies for
      planning effective patient education.

PMID- 1625915
TI  - Assessment of organizational culture: a tool for professional success.
AB  - Assessing the culture, or shared norms, of an institution to learn about its
      values, beliefs, and practices can be very useful in determining one's "fit"
      within an organization. It can also be helpful to those engineering change and to
      those interested in shaping an institutional image that attracts and retains
      qualified staff. This article discusses the concept of organizational culture,
      provides suggestions for assessment, and explicates this information through some
      familiar examples. Implications of organizational culture assessment are also
      discussed as they apply to the roles of staff nurse, nurse manager, clinical
      nurse specialist, faculty member, and nurse executive. Consideration is also
      given to nursing as a profession.

PMID- 1625916
TI  - Caring enough to bring about change.

PMID- 1625917
TI  - Enhancing orthopaedic nurses' clinical decision making.
AB  - Clinical decision making ability is necessary for safe and effective orthopaedic
      nursing practice. By clinical decision making, we mean the rendering of a
      judgment about patient care using analytical and intuitive processes and
      incorporating professional knowledge. Although recent research findings indicate
      that there is no single approach that clinicians use to make all decisions, there
      are several general aspects of decision making processes. Among these are the
      development of mental representations, decision-making procedures, and pattern
      recognition. Five selected strategies for enhancing these general processes are
      described and illustrated with patient situations relevant to orthopaedic
      nursing.

PMID- 1625918
TI  - Consumer advisory helps nurses talk to patients about AIDS.

PMID- 1625919
TI  - Nurses to be protected against AIDS, hepatitis B under new federal regulations.

PMID- 1625920
TI  - [Kinetics of myoglobin, creatine kinase and aspartate aminotransferase in
      uncomplicated and complicated forms of healing of experimental myocardial
      infarction].
AB  - It was demonstrated in experiments on 60 dogs that in hyporeactive myocardial
      infarction (MI) myoglobin (MG) concentration and the activity of creatine kinase
      (CK) and aspartate aminotransferase (ASAT) increase at a slower rate and reach
      maximum values later. In hyperreactive MI the rate of their increase and the time
      of attainment of maximum values are, respectively, greater and earlier than in
      normoreactive MI. The connection of MG, CK, and ASAT changes with reactivity
      allows them to be used in prognosticating MI healing.

PMID- 1625921
TI  - [Effect of the antioxidant ionol on myocardial energy metabolism and the course
      of traumatic shock].
AB  - Energy metabolism was studied in experiments on rats with due regard for the
      individual features of the organism's reaction to trauma. The animals were
      divided into 2 subgroups according to the survival period during the experiment.
      Disorders of mitochondrial function were revealed in both subgroups, but they
      differed in degree according to the severity of the process. Preliminary
      injection of the antioxidant ionol prolonged the animals' survival and prevented
      disorders of mitochondrial function. The article discusses the possibility of
      preventing activation of free-radical oxidation of the membrane lipids and
      removal of their damaging effect on the mitochondria with ionol.

PMID- 1625922
TI  - [Role of changes in insulin-binding activity and energy metabolism in the
      pathogenesis of experimental crush syndrome].
AB  - Study of the effect of the crush syndrome on cell metabolism and insulin-binding
      activity revealed a new aspect of the pathogenesis of the syndrome, namely, a
      marked reaction of the mononuclear receptor apparatus. Accumulation of lactate in
      the tissues and the development of acidosis probably play an important role in
      disturbance of the insulin-binding activity of the plasma membrane. Reduction of
      the level of tree adenine nucleotides and ATP in particular may be of essential
      importance in the late stages of compression. Of importance in the pathogenesis
      of the crush syndrome was the binding of insulin with its receptors and the
      subsequent intensification of metabolic disorders and reduction of
      phosphorylation, which in turn may be the cause of reduced transmission of the
      signal to the receptors, i. e. disorder of the postreceptor action of insulin.

PMID- 1625923
TI  - [Effect of staphylococcal toxin on the microcirculatory system].
AB  - Study of microcirculation in the mesentery of narcotized rats showed that the
      staphylococcal toxin causes increased migration of leukocytes, aggregation of
      formed elements, and disturbance of the blood flow in the small venules and
      arterioles. The toxin stimulates rhythmic contractile activity of the lymphatic
      microvessels and induces their constriction and even complete obliteration. The
      lymphoconstrictive effect of the toxin is weakened by verapamil and completely
      removed by dimethyl sulfoxide.

PMID- 1625924
TI  - [Protective effect of unithiol and its combination with magnesium sulfate in
      endotoxin poisoning and in infection by gram-negative bacteria].
AB  - It is shown that unithiol protects mice from death in intoxication by S.
      typhimurium and S. Sonnei lysates and in infection caused by S. typhimurium.
      Magnesium sulfate strengthens the protective effect of unithiol. It is suggested
      that the protective effect of unithiol is due to its antioxidant action.

PMID- 1625925
TI  - [Use of enterosorption for reducing the biogenic amine content of blood and
      exudate in peritonitis].
AB  - The administration of an enterosorbent prevents increase of the level of
      biologically active substances in blood and exudate of rats in fecal peritonitis.
      The results of biochemical and radionuclide methods of examination allow 2
      mechanisms of reduction of the histamine and serotonin level in blood and exudate
      to be distinguished--direct and mediated.

PMID- 1625926
TI  - [Use of superoxide dismutase in infusion therapy of experimental hemorrhagic
      shock].
AB  - The work deals with study of the possibility of increasing the efficacy of
      infusion therapy in massive blood loss by preliminary administration of
      superoxide dismutase (SOD). The data obtained bear evidence that in preliminary
      administration of SOD infusion of a blood substitute produces a more marked and
      stable improvement of central hemodynamics and microcirculation, oxygen regimen,
      and acid-base equilibrium in rats. A significant increase of the circulation
      volume and stroke volume of the heart following SOD injection may be linked with
      lesser intensity of lipid peroxidation in the cardiocyte membranes during
      reoxygenation.

PMID- 1625927
TI  - [Modulating action of intermediate molecular weight peptides on the course of
      experimental burn injury].
AB  - Preliminary injection of middle mass peptides (MMP) obtained from blood of intact
      dogs and dogs with burn injury aggravated the response of mice and rats to
      thermal injury. The mortality among mice with burns grew and the reaction of the
      lymphoid organs (thymus and spleen) of rats to the thermal burn was intensified.
      The aggravating action of MMP in mice correlated well with their damaging effect
      in experiments on human blood neutrophils. A MMP fraction possessing a protecting
      effect in burns in rats was isolated from the blood of intact dogs. The data
      obtained are discussed from the standpoint of the pathogenetic importance of MMP
      in burn disease.

PMID- 1625928
TI  - [Effect of alpha1-acid glycoprotein on rheologic blood parameters in experimental
      thermal burns].
AB  - Experiments were conducted on albino noninbred mice and rats to study the effect
      of alpha 1-acid glycoprotein (alpha 1-AG) on burn healing. Injection of alpha 1
      AG in the first 24 hours after the burn causes rapid epithelialization and
      increases contracture of the burn wounds. At the same time it increases the
      deformity of the red cells, reduces their hemolysis due to a mechanical effect,
      and reduces spontaneous aggregation of blood platelets. No authentic effect of
      alpha 1-AG on the aggregation of red cells was revealed. It is suggested that
      alpha 1-AG is a natural defence factor of the organism which prevents the
      development of microvascular thrombosis and limits in this way the size of the
      inflammatory and necrotic processes.

PMID- 1625929
TI  - [Immunotropic activity of human alpha1-glucoprotein].
AB  - Experiments were conducted to study the effect of alpha-acid glycoprotein on a
      fatal infection caused by Pseudomonas pyocyanea, growth of melanoma B-16, and
      transplantation of a skin graft from C57BL/6 mice to CBA mice. Injection of the
      agent significantly increased the anti-infection resistance in mice, suppressed
      growth of melanoma-16, and prolonged the survival of the skin grafts, which was
      evidence of marked glycoprotein immunomodulating activity.

PMID- 1625930
TI  - [Functional state of immunocompetent cells in rabbits partially tolerant to
      lipopolysaccharide].
AB  - The author studied the regular features of interleukin-1 (IL-1) formation and
      proliferative activity of cells of the lymphoid organs in rabbits tolerant to
      lipopolysaccharide (LPS). A weak temperature response of LPS tolerant rabbits to
      LPS administration was linked with decrease of IL-1 secretion by blood and
      splenic cells and the formation in the spleen of a cell population which had a
      suppressive effect on IL-1 production. In administration of large LPS doses, the
      changes of the processes of IL-1 proliferation and production in the various
      lymphoid organs of the rabbits differed. The proliferative response of the
      splenic cells to T- and B-cell mitogens reduced, a tendency to intensification of
      the proliferative processes was noted in the thymus. The secretion and
      accumulation of IL-1 by blood and splenic cells was reduced, the secretion and
      intracellular content of this mediator in the thymus and lymph nodes was
      increased.

PMID- 1625931
TI  - [Blood cyclic nucleotide content in acute regional ischemia of the extremities].
AB  - Fifty healthy males aged from 19 to 34 years were examined. Experiments were
      conducted on 30 male mice weighing 200-250 g. After 10- and 20-minute ischemia of
      the upper limb the concentration of cAMP and cGMP in its venous blood increases
      in direct proportion to the duration of ischemia. Increase of the level of cyclic
      nucleotides (CN) in the blood does not depend on hypersecretion of
      catecholamines. Increase of the CN level coincides in time with increase of blood
      CPK. The mechanisms of changes in the blood CN level in ischemia are discussed.

PMID- 1625932
TI  - [Study of contractile properties of muscles of curarized animals by the method of
      stimulation impedancography].
AB  - The effect of relaxation doses of tubocurarine on the stimulation and contractile
      properties of muscles in complete synaptic block was studied in experiments on
      laboratory rats by means of a previously developed method of stimulation
      impedancography. During intramuscular electrostimulation the stimulus threshold
      for short 0.01 mc test impulses increased, while the steepness of the
      characteristic "force of action--contractile effect" curve, registered at 1 mc
      impulses, reduced. The reduction was caused by loss of the function of synaptic
      nerve structures which take part in recruiting the contractile elements.
      Nonsynaptic mechanisms of recruiting through direct stimulation of the muscle
      fibres ensure 45% of recruitment. Changes of the duration of the contraction were
      not detected in the first 20 minutes of the effect. After 60-80 minutes of
      relaxation there was a tendency to prolongation of the time of the contraction
      act, which may be caused by prolonged immobilization of the animals.

PMID- 1625933
TI  - [Effect of blood coagulation on adenylate nucleotide metabolism of erythrocytes
      in healthy people].

PMID- 1625934
TI  - [Mechanism of changes in renal functions in osmotic irritation of the right
      atrium].
AB  - Chronic experiments conducted on 17 dogs whose ureters were brought out on the
      skin of the abdomen showed that administration of solutions of saccharose (1150
      mmol/l) and NaCl (515 mmol/l) into the right atrium reduces diuresis and
      increases natriuresis. The concentration of atrial natriuretic factor in the
      blood does not change, vasopressin and cortisol secretion increases while that of
      aldosterone decreases. It is concluded that, in addition to the cardiopeptide
      mechanism regulating the blood volume, the right atrium possesses a reflex
      osmoregulatory mechanism.

PMID- 1625935
TI  - [Effect of cultured Polyscias cells on the activity of components of the protein
      synthesizing system of rabbit liver].
AB  - The authors studied teh effect of cultured Polyscias filcifolia Bailey cells on
      protein biosynthesis in an acellular system obtained from the liver of rabbits in
      experimental myocardial ischemia. It was found that the preparation normalizes
      the values of protein biosynthesis, the duration of the average polypeptide chain
      synthesis, and the activity of aminoacyl-tRNA synthetases.

PMID- 1625936
TI  - [Disease as pathology of the information process].

PMID- 1625937
TI  - [Construction of histograms of time intervals without conducting linear
      measurements].

PMID- 1625938
TI  - [Glucocorticoid dependence as a consequence of inadequate conditions in
      engagement of one adaptational mechanism of the immune system].

PMID- 1625939
TI  - [Glucose consumption by the rat brain in ethanol intoxication and the abstinence
      syndrome].
AB  - The effect of acute and chronic alcohol intoxication and of the syndrome of
      ethanol withdrawal on the consumption of glucose by the brain of rats was studied
      by means of intravascular ethanol infusion. Infusion of ethanol into the internal
      carotid artery had no effect on glucose consumption by the brain, while its
      infusion into the femoral vein reduced consumption twofold. The effect was
      completely removed by the inhibitor of alcohol dehydrogenase pyrazole. Chronic
      intoxication also caused a twofold decrease of glucose utilization by the brain
      of rats. Infusion of ethanol into the internal carotid artery of rats who were in
      a state of alcoholic intoxication led to increase of glucose consumption by the
      brain to the control level. Infusion of ethanol into the femoral vein in this
      case had no effect on glucose consumption by the rat brain. Utilization of
      glucose by the brain diminished to an equal degree in rats suffering from the
      syndrome of ethanol withdrawal and in animals who were in a state of alcoholic
      intoxication. Infusion of ethanol, both intraarterial and intravenous, had no
      effect on glucose consumption by the brain. Activation and inhibition of the
      function of external respiration were encountered in equal concentrations of
      ethanol in blood flowing from the brain, whatever the method of its infusion.

PMID- 1625941
TI  - Editorial ethics.

PMID- 1625940
TI  - Antibiotic treatment failures in acute otitis media.

PMID- 1625942
TI  - Introduction and overview: why another polemic on ethics?

PMID- 1625943
TI  - The ethical practice of pediatrics in a world of potential conflicts: an
      interview. Interview by John M. Freeman.

PMID- 1625944
TI  - On paternalism.

PMID- 1625945
TI  - Advocating for the abused child: can ethics and the law be in conflict?.
      Interview by John M. Freeman.

PMID- 1625946
TI  - When too much is not enough.

PMID- 1625947
TI  - Federal efforts through an office of adolescent health.

PMID- 1625948
TI  - Neonatal petechiae: strategies for nursing interventions.
AB  - Planning appropriate nursing care for the neonate with petechiae requires
      knowledge of its etiology, accurate assessment, and ongoing monitoring. The nurse
      can use this information to provide interventions that facilitate healing,
      prevent further sequela, and enhance parental involvement and interaction in the
      care of their newborn.

PMID- 1625950
TI  - Chronic granulomatous diseases of childhood.
AB  - Nursing care for the child with chronic granulomatous disease (CGD) is complex
      and challenging. Understanding the mechanism behind the disease increases the
      effectiveness of nursing care.

PMID- 1625949
TI  - Special children, special needs: the ectodermal dysplasias.
AB  - Ectodermal dysplasias are a group of genetic disorders that arise from
      abnormalities of the ectoderm. Children with the disorder exhibit a wide range of
      clinical features that frequently affect the skin, teeth, hair, and sweat glands.
      With early detection and careful management, these children can lead normal,
      productive lives.

PMID- 1625951
TI  - Care of the infant in a Pavlik harness.
AB  - Congenital hip dysplasias, a common orthopaedic problem in children, can be
      treated effectively if diagnosed early. One such valuable tool in treating this
      disorder is the Pavlik Harness. These authors describe their child's experience
      with the Pavlik Harness along with the personal needs of the child and family.

PMID- 1625952
TI  - Childhood injuries: an epidemiologic approach.
AB  - Injuries are the leading cause of childhood death and disability in the United
      States today. However, injuries can be studied, their magnitude described, and
      risk factors identified. Furthermore, many injuries can be prevented and
      controlled with available knowledge and technology.

PMID- 1625953
TI  - Munchausen syndrome by proxy: recognizing the victim.
AB  - Munchausen syndrome by proxy is a serious and potentially lethal form of child
      abuse in which a parent deliberately induces or reports physical symptoms in a
      child. The child not only suffers from parent's action, but he or she is
      subjected to an extensive battery of invasive medical and radiological testing
      that are unnecessary and painful. All health care professionals must work
      together to ensure that the syndrome is discovered in time and the child is
      protected. The child's psychological and physiological welfare are in danger.

PMID- 1625954
TI  - Practices surrounding ribavirin administration.
AB  - Fifty major pediatric medical centers were queried regarding their practice
      surrounding Ribavirin administration. The survey addressed safety precautions and
      prescriptive practices. The object of the survey was to assist community
      hospitals in policy development for Ribavirin use.

PMID- 1625955
TI  - Pediatric management problems. Tummy ache.

PMID- 1625956
TI  - Role of carnitine supplementation in pediatric patients receiving valproic acid
      therapy.

PMID- 1625957
TI  - Extubation and reintubation in the NICU: identifying opportunities to improve
      care.
AB  - An investigation was conducted to determine the overall incidence and reasons for
      extubation and reintubation in a NICU population in order to establish a baseline
      for ongoing quality assessment and evaluation monitoring. The investigators
      sought to identify factors associated with accidental extubation for which action
      plans to improve care could be developed.

PMID- 1625958
TI  - Terminal care costs in childhood cancer.
AB  - PURPOSE: To present a conceptualization of health care costs and to describe
      costs of health care in the terminal phase of childhood cancer. To present an
      exploratory comparison of the costs of terminal care in the hospital versus home
      care services, and to discuss the use of cost research in nursing practice.
      METHOD: Telephone interviews were done approximately 16 months after the death of
      a child to retrospectively ascertain services used, costs to the family, and
      insurance information. Provider billing and insurance data were subsequently
      collected. The families were divided into two groups based upon the use of home
      care or traditional hospital care during the terminal phase. FINDINGS: Home care
      was less expensive for total costs than hospital care. Home care was more
      expensive for nonhealth care and indirect costs than hospital care. CONCLUSIONS:
      Nurses should consider direct health care costs, nondirect health care costs, and
      indirect costs when assisting family decisions about care. Nurses and families
      should be aware of potential cost shifting.

PMID- 1625959
TI  - Adolescent health: the need for stronger governmental policies.

PMID- 1625960
TI  - Health promotion, health protection, and disease prevention in childhood.
AB  - Approximately one-half of America's youth are at risk for developing
      cardiovascular disease as adults. Because the etiology of adult cardiovascular
      disease is multifactorial, a number of interventions have been designed to lessen
      this health risk. Health promotion strategies to reduce cardiovascular disease
      focus on teaching children and adolescents healthy lifestyle habits (regular
      exercise, prudent eating, abstinence from tobacco). Health protection strategies
      include requiring food labels that contain information about fat and sodium
      content and publishing warnings about the hazards of tobacco use. Disease
      prevention strategies encompass clinical counseling regarding control of blood
      pressure and weight. This article highlights some of the existing pediatric
      health promotion/health protection/disease prevention programs aimed at reducing
      adult cardiovascular disease.

PMID- 1625961
TI  - Private practice: the time is now.
AB  - Nurses are creative professionals who have their own expertise in delivering
      personalized health care. Until we establish our own autonomy within the health
      care system, we will continue to be misjudged and undervalued. The development of
      an independent nursing practice is one method of demonstrating autonomy. What is
      needed is proper information, positive thinking and the courage to move forward.
      We need to support nurses in the pursuit of autonomy for the sake of ourselves,
      our clients, and the health care system.

PMID- 1625962
TI  - Developmental assessment of the technology-dependent infant and young child.
AB  - Appropriate developmental intervention for the technology-dependent infant or
      young child has its basis in a carefully designed and thorough assessment. The
      role of the nurse is central in this process. This article guides the nurse
      through an analysis of developmentally relevant medical considerations, an
      examination of tolerance and endurance, the determination of developmental level,
      an approach to working with families, and the process of translating assessment
      data into intervention plans.

PMID- 1625964
TI  - Professional development module. P9: Advocacy. Part (ii): The 'how' of advocacy.

PMID- 1625963
TI  - Primary prevention of childhood lead poisoning: a goal for the 1990s.
AB  - Childhood lead poisoning remains a common problem in America today. The U.S.
      Department of Health and Human Resources has recently released a strategic plan
      on eliminating childhood lead poisoning, and health care professionals should
      become familiar with the basic elements of the plan.

PMID- 1625965
TI  - Better training and resources needed for resuscitation.

PMID- 1625967
TI  - Swingeing London.

PMID- 1625966
TI  - Outreaching.

PMID- 1625968
TI  - Changing behaviour.

PMID- 1625969
TI  - Springboard to success.

PMID- 1625970
TI  - Impractical project.

PMID- 1625971
TI  - Let's tell it as it is.

PMID- 1625972
TI  - Teenage traumas.

PMID- 1625973
TI  - Lump it or like it.

PMID- 1625974
TI  - Education--super confusion.

PMID- 1625975
TI  - Living with loss.

PMID- 1625976
TI  - Making sense of the principles of genetics.

PMID- 1625977
TI  - Show some emotion.

PMID- 1625978
TI  - Learning to fail.

PMID- 1625979
TI  - Can you hear me?

PMID- 1625980
TI  - Island of strength.

PMID- 1625982
TI  - Minister will not change law on HIV.

PMID- 1625981
TI  - Trusting to technology.

PMID- 1625983
TI  - Improving lines of communication.

PMID- 1625984
TI  - Choosing garments to aid incontinence.

PMID- 1625985
TI  - A matter of life and death.

PMID- 1625986
TI  - An approach to minor trauma.

PMID- 1625987
TI  - Preparing to heal.

PMID- 1625988
TI  - High HIV toll on children.

PMID- 1625990
TI  - S-100 positive undifferentiated neuroblastomas with a special reference to the
      tumor stroma related to favorable prognosis.
AB  - Fifty-four cases of undifferentiated neuroblastoma (stroma-poor neuroblastoma
      with undifferentiated histology) were studied immunohistochemically for the
      presence of S-100 protein-positive cells and extracellular matrix proteins
      (laminin, type IV collagen and fibronectin). In 30 of the 54 patients, the tumor
      had S-100 protein-positive cells in the peculiar stroma observed as thick
      fibrocellular septa (trabecular pattern) or delicate fibrovascular meshwork
      surrounding small nests of tumor cells (reticular pattern). The tumors were
      divided into four subgroups according to the stromal patterns: type A showing a
      predominant "reticular" pattern (14 cases); type B showing a predominant
      "trabecular" pattern (6 cases); type C showing both "reticular" and "trabecular"
      patterns (14 cases), and type D lacking either pattern but rich in vascular
      channels (20 cases). Clinicopathologically, the patients with S-100 protein
      positive cells had a more favorable outcome (86.7% 2-year survival rate) than
      patients without these cells (12.0% 2-year survival rate). It is concluded that
      the existence of peculiar fibrovascular stroma containing S-100 protein-positive
      cells and extracellular matrix proteins is correlated with a favorable prognosis
      in undifferentiated neuroblastomas.

PMID- 1625989
TI  - Immunohistochemical analysis of ras oncogene p21 product in human gastric
      carcinomas and their adjacent mucosas.
AB  - In an attempt to clarify the relationship between ras oncogene expression and the
      clinico-pathological features of malignant and pre-malignant lesions of the
      stomach we undertook the immunohistochemical study of the expression of ras gene
      p21 product in a series of eighty gastric carcinomas and their respective
      adjacent mucosas. In two cases the mRNA of Ha-ras was also studied by in situ
      hybridization. The majority of gastric carcinomas as well as their adjacent non
      neoplastic mucosas expressed ras gene product. There was a significant
      relationship between the expression of ras gene p21 product and the morphologic
      pattern of the tumours. An enhanced ras expression was found in several
      conditions regarded as precursor lesions of intestinal and/or diffuse types of
      gastric carcinoma (dysplasia, foveolar hyperplasia and even the neck zone of
      normal-appearing gastric glands, namely in the mucosa adjacent to diffuse
      carcinomas). Ras expression was actually more prominent in most of these
      conditions than in their respective adjacent carcinomas. No significant
      relationship was found between ras expression and invasiveness of the wall, nodal
      metastases and venous invasion.

PMID- 1625991
TI  - Helix pomatia lectin binding pattern of brain metastases originating from breast
      cancers.
AB  - The glycosylation pattern of brain metastases originating from primary breast
      carcinomas was investigated using Helix pomatia agglutinin (HPA), a lectin which
      recognises N-acetyl-galactosamine (GalNac) residues of glycoconjugates. In a
      previous retrospective study this lectin was shown to label only those primary
      breast cancers that metastasised. To explore this as a clinical marker of
      metastatic breast cancer behaviour it is necessary to analyse the HPA binding
      pattern of metastases to see if this differs from primary cancers. To test the
      question if brain metastases commitently retain this trait of metastatic primary
      tumors, we studied Helix pomatia binding pattern of brain metastases removed by
      surgical excision and immediately fixed and processed. Brain metastases from 16
      patients with breast cancer were obtained, 13/16 metastases showed binding to the
      cytoplasm in the majority of cancer cells, 3/16 did not show binding to cancer
      cells. Normal adjacent brain showed binding to red blood cells, to capillary
      endothelium of several biopsies and to rare neurones; this binding did not relate
      to cancer cell binding. Therefore we conclude that HPA is a relatively stable
      marker for metastasizing breast cancer cells.

PMID- 1625992
TI  - Cushing syndrome-associated pheochromocytoma and adrenal carcinoma. An
      immunohistological investigation.
AB  - Seven adrenal carcinomas and seventeen pheochromocytomas (PHs), two of which were
      clinically associated with a Cushing's syndrome and one associated with multiple
      endocrine neoplasia Type II (MEN-II), were investigated immunohistologically with
      a panel of antibodies against intermediate filament proteins, a proliferation
      associated nuclear antigen (Ki-67), neuroendocrine tumor markers, and different
      hormones on paraffin-embedded tissue sections and, from 19 cases, also on frozen
      tissue sections. Synaptophysin proved to be the most reliable tumor cell marker
      on both snap-frozen and paraffin-embedded tissue but, like antibodies against
      NSE, yielded unspecific stainings in the carcinomas. The two Cushing-associated
      pheochromocytomas (CaPH) showed the same immunohistological profile as the other
      PHs, except one chromogranin-negative tumor. Five PHs showed weak reactivity for
      calcitonin, one for serotonin, and two for a-HCG in small amounts. All PHs lacked
      other hormone expression, including ACTH. The average growth fraction was small
      (2.2%) in 13 cases, but 80% of the tumor cells were proliferating in one case of
      CaPH. Adrenal carcinomas showed only weak or no expression of keratin in one
      case, a homogenous or droplet, non-filamentous cytoplasmic staining with
      antibodies against neurofilament in frozen tissue section, and they were
      completely chromogranin-negative. The average growth fraction was 7.6% in 5
      cases.

PMID- 1625993
TI  - Prolactin-containing pituitary adenomas. Their characteristics and comparative
      study with non-prolactin adenomas.
AB  - Immunohistochemical study of 130 pituitary adenomas shows that 31% are prolactin
      containing adenomas, two-thirds of which are monohormonal adenomas, i.e.
      prolactin cell adenoma, and one-third are multihormonal adenomas, i.e. mixed
      growth hormone cell-prolactin cell adenoma and plurihormonal adenoma with
      prolactin. Clinical symptoms including amenorrhea and galactorrhea are not useful
      in distinguishing prolactin from non-prolactin adenomas. Serum prolactin
      concentration of 80 ng/ml is a good cut-off point to distinguish prolactin cell
      adenoma from non-prolactin adenoma but can not separate many of the multihormonal
      adenomas from non-prolactin adenomas. Calcification is not only more commonly
      seen but also more prominent in prolactin-containing adenomas. Spheroid amyloid
      is present in one prolactin cell adenoma. Immunohistochemistry is specific and
      reliable in identifying prolactin-containing adenomas. All prolactin cell
      adenomas and 2/13 multihormonal adenomas show paranuclear staining of prolactin
      in almost every adenoma cell. The remaining (11/13) multihormonal adenomas show
      less prolactin cells and diffuse cytoplasmic staining of prolactin. The prolactin
      staining pattern in the latter group is unique and appears to be indicative of
      the presence of other hormone(s).

PMID- 1625994
TI  - Immunohistochemical study of the inflammatory infiltrate in villitis of unknown
      etiology. A qualitative and quantitative analysis.
AB  - Villitis is characterized by an inflammatory infiltrate within the substance of
      the chorionic villi. Quantitative and qualitative analyses of the mononuclear
      infiltrate in areas of villitis were performed in placentas with villitis of
      unknown etiology (VUE). We used a panel of monoclonal antibodies and
      immunoperoxidase technique in paraffin sections from 17 placentas with VUE and 8
      without VUE. Macrophages followed by T lymphocytes were the predominant
      inflammatory cells in areas of villitis in virtually all cases. B lymphocytes
      were not observed and monocytes were present usually in small number in 58 per
      cent of the cases. Mononuclear cells which expressed HLA-DR antigens were found
      in 75 per cent of the cases. In areas of villitis with trophoblastic necrosis, we
      found monocytes and some T lymphocytes adhered to them. These cells apparently
      had migrated from the maternal circulation. We suggest that in areas of villitis
      with destruction of the trophoblast and its basal membrane the inflammatory
      infiltrate might have a mixture of fetal and maternal cells. The maternal
      monocytes and T lymphocytes might be attracted to these sites of trophoblastic
      necrosis and activated due to exposure to fetal MHC antigens of the villous
      stroma.

PMID- 1625995
TI  - Ultrastructure of Warthin-Starry stain-positive bacteria in abscess-forming
      reticular lymphadenitis.
AB  - This study describes the ultrastructure of Warthin-Starry (WS) stain-positive
      bacteria in abscess-forming reticular lymphadenitis (ARL) compatible with cat
      scratch disease (CSD). Sections containing WS-positive bacteria were re-embedded
      in Epon, and semithin sections were examined by electron microscopy. Silver
      particles were aggregated on the outer surfaces of the bacteria. Stereoscopic
      observations clearly showed that the bacteria were pleomorphic, rod-shaped,
      arranged in a row or at an angle, and frequently showed septal formation.
      Electron microscopy of ultrathin sections revealed that the cell wall possessed
      an outer membrane characteristic of gram-negative bacteria. The results indicate
      that rod-shaped bacteria with the WS-positive, gram-negative staining cause ARL
      histopathologically consistent with CSD.

PMID- 1625996
TI  - Cylindrical cell papilloma of the nasal cavity and paranasal sinuses. A
      histochemical and cytochemical study.
AB  - A cylindrical cell papilloma occurring in the sino-nasal mucosa of a 61-year-old
      woman was studied histochemically at both light and electron microscopic levels.
      The cylindrical cells demonstrated distended intracytoplasmic microcysts with
      numerous microvillous projections on the apical cell membrane. The retained
      mucosubstance in the cystic spaces stained intensely with HID-TCH-SP sequence and
      showed no apparent communication with the extracellular space. These findings
      indicate that the cylindrical cells may be of mucous-secreting cell derivation,
      being derived from cells possessing abnormal and/or failed secretory function.
      The property of sulfated mucin in the 'cylindric' intracytoplasmic cysts is
      suggested to be the result of endodermal displacement or metaplasia of the
      Schneiderian epithelium.

PMID- 1625997
TI  - Cell kinetics of melanocytes in common and dysplastic nevi and in primary and
      metastatic cutaneous melanoma.
AB  - The 3H-thymidine labelling (LI) and mitotic (MI) indexes were calculated in 29
      cutaneous melanocytic lesions: 6 common nevi (CN), 11 dysplastic nevi,
      subclassified as nevi with architectural atypia (NAA = 4) and nevi with cyto
      architectural atypia (NCAA = 7), 2 melanomas in situ (MIS), 4 invasive
      superficial spreading melanomas (IM) and 6 metastatic melanomas (MM). The LI mean
      values resulted to be: CN = 0.23%, NAA = 0.98%, NCAA = 1.79%, MIS = 5.75%, IM =
      5.16%, MM = 3.80%. In CN, NAA, NCAA and MIS, these values were calculated at
      epidermal level; in IM and MM at dermal level. At dermal level, the LI mean
      values of CN, NAA and NCAA were: 0.20%, 0.20%, 0.23% respectively. The MI mean
      value was close to 0 in CN, NAA, NCAA, MIS; 0.18% in IM, 0.16% in MM. Confirming
      a low proliferative activity in CN and a high activity in melanomas (MIS, IM,
      MM), the results showed that dysplastic nevi (NAA, NCAA) had a proliferative
      activity intermediate between common nevi and melanomas. The lesions with
      melanocytic atypia (NCAA) resulted to have a higher proliferative activity than
      those without this histological feature (NAA).

PMID- 1625998
TI  - Statistical evaluation of the predictive power of fine needle aspiration (FNA) of
      salivary glands. Results and cytohistological correlation.
AB  - Fine needle aspiration (FNA) of the salivary glands was carried out on 97
      patients. Diagnosis was confirmed by histological findings in 93 patients. There
      were 75 benign lesions (including 52 benign tumours) and 18 malignant lesions. In
      our series "positive predictive value" of FNA was 0.900 and the negative
      predictive value was 0.963. Thus, the probability of a false positive is 0.100
      and of a false negative 0.037.

PMID- 1625999
TI  - Subsequently occurring leiomyosarcoma and desmoid tumor of the right thigh.
AB  - We present the case of a 44-year-old patient with a primary leiomyosarcoma of the
      right upper thigh, who developed a second mesenchymal lesion at the same thigh,
      diagnosed as an extra-abdominal desmoid tumor, some months after surgical
      treatment of his leiomyosarcoma. Clinically, histomorphologically, DNA
      cytometrically, immunohistochemically and radiologically the different
      histogenetic origin of the two lesions could be proven. The patient died 17
      months after his first tumor diagnosis of lung metastases of his leiomyosarcoma.

PMID- 1626000
TI  - Diffuse bilateral glomerulocystic disease of the kidneys and multiple cardiac
      rhabdomyomas in a newborn. Relationship with tuberous sclerosis and review of the
      literature.
AB  - A case of glomerulocystic disease of the kidneys in a newborn is described. The
      kidneys were very large and diffusely cystic. Histologically, all portions of the
      nephron were involved and some of the cysts were lined by a prominent
      hyperplastic eosinophilic epithelium. This, together with the presence of
      numerous cardiac rhabdomyomas, a nodular haemangiomatous harmartoma and
      histiocytoid cell nests in the spleen were strongly suggestive of tuberous
      sclerosis. The relation between glomerulocystic kidney disease and tuberous
      sclerosis is discussed.

PMID- 1626001
TI  - Primary pure choriocarcinoma of the liver.
AB  - We report a pure choriocarcinoma of the liver studied at necropsy. The tumour was
      diagnosed ante-mortem and treated by chemotherapy with no satisfactory response.
      Previous cases of hepatic choriocarcinoma are reviewed and criteria to diagnose
      this extragonadal neoplasm are recommended.

PMID- 1626003
TI  - A rare and special privilege.

PMID- 1626002
TI  - Peliosis lienis: uncommon cause of rupture of the spleen.
AB  - Rare anomaly: peliosis lienis, which was found in the spleen of a woman
      splenectomised for rupture, is presented. Speculations on the etio-pathogenesis
      of this peculiar disorder are discussed based on literary data. The awareness of
      this pathological curiosity may be of practical importance because of the hazard
      of life-threatening haemorrhagic consequences following rupture of the lesions.

PMID- 1626004
TI  - On consulting and being consulted.

PMID- 1626005
TI  - The pediatric hospital consultant.

PMID- 1626006
TI  - Eye injury.

PMID- 1626007
TI  - Henoch-Schoenlein purpura.

PMID- 1626008
TI  - Prenatal diagnosis and carrier detection by DNA analysis.

PMID- 1626009
TI  - Children, adolescents, and television.

PMID- 1626010
TI  - Cutaneous fungus infections in children.

PMID- 1626011
TI  - Let the change come from within. The process of change in nursing.
AB  - Current developments in nurse management and education have resulted in
      significant changes to nursing practice. By planning ahead and acting as change
      agents, nurses can seize the initiative to apply change in a positive way.

PMID- 1626012
TI  - Assessment allows action on risk factors. Infection control and surgical wounds.
AB  - Surgical wound infection is costly to the NHS and debilitating to the patient.
      Thorough assessment of patients' risk of developing infection allows nurses to
      act to reduce that risk.

PMID- 1626013
TI  - On course for an enhanced career? An assessment of the diploma in nursing.
AB  - The Diploma in Nursing is designed to improve nursing practice and enhance job
      promotion, but is this true in practice? A research project asked nurses who had
      completed the diploma whether they and their practice had benefited from the
      course.

PMID- 1626014
TI  - An unfinished story. Helping people to come to terms with miscarriage.
AB  - The pain and distress caused by miscarriage is often underestimated. By offering
      information, counselling and advice, nurses and midwives can help couples come to
      terms with their loss and face the future with greater confidence.

PMID- 1626015
TI  - When self-help begins at home. Pain control in cancer care.
AB  - Ineffective pain control prevents many people with advanced cancer from being
      cared for at home as they would wish. Teaching patients about their analgesia and
      encouraging the use of complementary techniques can help prevent unnecessary
      suffering.

PMID- 1626016
TI  - Thalassaemia: a preventable disease?

PMID- 1626017
TI  - Searching for signs of revival. Uses and abuses of the Glasgow coma scale.
AB  - The Glasgow coma scale is widely used to measure patients' levels of
      consciousness. Attention to detail and an understanding of the scale's assessment
      criteria are essential to avoid misuse.

PMID- 1626018
TI  - Malignant melanoma: mole watching and the adolescent.

PMID- 1626019
TI  - A valuable contribution to care. The role of leg ulcer resource groups.
AB  - The survey on which this series has been based suggests district nurses are
      becoming more competent and confident in treating most leg ulcers. This final
      article discusses possible future research and the role of leg ulcer resource
      groups.

PMID- 1626020
TI  - On a donor run.

PMID- 1626021
TI  - Determination of optical properties of turbid media using pulsed photothermal
      radiometry.
AB  - Pulsed photothermal radiometry (PPTR) measures blackbody radiation emitted by a
      sample after absorption of an optical pulse. Three techniques for obtaining the
      absorption coefficient of absorbing-only, semi-infinite samples are examined and
      shown to give comparable results. An analytic theory for the time dependence of
      the PPTR signal in semi-infinite scattering and absorbing media has been derived
      and tested in a series of controlled gel phantoms. This theory, based on the
      diffusion approximation of the radiative transport equation, is shown to model
      the time course of the detected signal accurately. Furthermore, when the incident
      fluence is known, the theory can be used in a non-linear, two-parameter fitting
      algorithm to determine the absorption and reduced scattering coefficients of a
      turbid sample with an accuracy of 10-15% for transport albedos ranging from 0.42
      0.88.

PMID- 1626022
TI  - Analysis of tissue optical coefficients using an approximate equation valid for
      comparable absorption and scattering.
AB  - New photosensitizers activated by longer wavelengths than 630 nm light used with
      Photofrin II are under evaluation by various groups for the treatment of
      malignancies. Any increase in tumour volume destroyed by these agents as compared
      to Photofrin II will be partly determined by tissue penetrance at the longer
      wavelengths. Attenuation coefficients were measured for various tissues at 630 nm
      and the more penetrative near infrared wavelength of 789 nm. A new model of light
      propagation in tissue is shown to be accurate for arbitrary ratios of absorption
      and scattering, by comparison with a rigorous solution to the transport equation.
      Absorption and transport scattering coefficients of tissues at 630 and 789 nm
      were obtained by fitting this model to optical attenuation measurements. In vitro
      tissues included bovine heart, kidney and tongue, pig liver and fat, and chicken
      muscle; in vivo tissues included Dunning R3327-AT and R3327-H tumours. The
      penetration depth was found to be 1.35-2.25 times greater at 789 than 630 nm,
      depending on tissue type. The greatest differences in penetration between the two
      wavelengths were in the highly pigmented tissues. These substantial increases in
      penetration in the infrared may be important in future applications of
      photodynamic therapy.

PMID- 1626023
TI  - Mathematical modelling of objectives in radiation therapy treatment planning.
AB  - We view radiation therapy treatment planning (RTTP) as a problem of constrained
      optimization. In this context, the 'optimal' treatment is one that maximizes some
      objective function subject to the inherent constraints of the problem. We discuss
      two objective functions which are motivated by biological considerations rather
      than mathematical expedience. One of these measures the 'goodness' of a treatment
      in terms of its probability of success. The other measures the degree to which a
      treatment succeeds in satisfying a system of constraints that are mutually
      contradictory. We describe how to actually perform the optimization of these
      objective functions in practice and show some numerical results which demonstrate
      advantages of these objective functions over their more conventional
      counterparts.

PMID- 1626024
TI  - Analogous filters for beam shaping in diagnostic radiology.
AB  - A computer simulation based on photon transport calculation was used to evaluate
      the properties of a wide variety of materials that could be used for the
      filtration of x-ray beams. A single filter was added to the inherent filtration.
      For comparison, the concept of analogous filters was introduced: two filters were
      considered analogous if both produced the same ratio of entrance exposure at the
      patient to the energy absorbed in the detector consisting of a pair of
      intensifying screens positioned immediately behind the water phantom. The
      efficiency, contrast and integral dose were calculated for filters of odd atomic
      numbers from 1 to 91 with a large number of different parameters (48,600
      different combinations). They include essentially all major diagnostic radiology
      procedures, except mammography. Only extreme cases are presented here. No magic
      filter was found which would produce increased contrasts or a decreased integral
      dose, while maintaining efficiency close to that of aluminium. Filters of some
      atomic numbers produced increased contrast, but had negligible efficiency.
      Analogous filters of atomic numbers between 7 and 37 and also between 71 and 91,
      had almost identical properties but varied efficiencies. Unpredictable behaviour
      was obtained with filters of atomic numbers 38 to 70, where small changes in
      atomic number may produce large changes in all the properties due to the presence
      of K-edge discontinuities.

PMID- 1626025
TI  - Temperature uniformity during hyperthermia: the impact of large vessels.
AB  - During hyperthermia the presence of a large vessel entering the heated volume and
      carrying blood at the systemic temperature can be an important source of
      temperature non-uniformity and possible underdosage. The minimal tumour
      temperature near a large vessel is determined by the vessel wall temperature: a
      number of factors influencing the vessel wall temperature are considered-
      effective tissue conductivity, flow type, vessel size, entrance effects and
      counter-current flow. In some specific cases, especially when tissue perfusion is
      high, the vessel wall temperature may reach therapeutic levels when the mean
      blood temperature is still low. In general, well perfused tumours have a better
      chance of being heated uniformly. Regional heating improves temperature
      uniformity by reducing entrance and equilibration effects as blood is heated
      before entering the tumour. Raising the core temperature also reduces temperature
      inhomogeneity. Spatial SAR resolution should preferably be of the order of
      magnitude of a centimetre or better.

PMID- 1626026
TI  - Bone composition measured by x-ray scattering.
AB  - Ten composite samples consisting of cortical bone and adipose tissue, in known
      proportions, were made. The intensity of monochromatic x-rays (energy 8 keV)
      scattered by these samples was determined as a function of the modulus of the
      scattering vector, K. The ratio of the heights of peaks at K values of around 134
      and 22 nm-1 provided a measure of the ratio of adipose tissue to bone mineral in
      these samples. This method was then used to determine the ratio of adipose tissue
      to mineral in samples of trabecular bone from 16 vertebral bodies. The results
      were correlated with measurements of the bone composition determined by ashing (r
      = 0.66) and histomorphometry (r = 0.66). Furthermore, the ashing and
      histomorphometry results were correlated with each other (r = 0.68). The
      feasibility of using higher energy x-rays (35-80 keV) for obtaining the same
      information from bone within the body is briefly discussed.

PMID- 1626027
TI  - Measurement of iron bioavailability by means of stable 54Fe and mass
      spectrometry.
AB  - Stable isotopes represent a useful tool for the assessment of biokinetic
      parameters in in vivo studies on humans. A procedure is described to evaluate the
      bioavailability of iron in pharmaceutical preparations by means of 54Fe as a
      tracer and mass spectrometry for the determination of time dependent changes in
      the isotope ratio of 54Fe/56Fe in red blood cells. Iron tablets with an increased
      portion of 54Fe were administered to iron deficient subjects and red cell iron
      utilization was used as a measure of iron bioavailability. Iron utilization was
      derived from changes in the 54Fe/56Fe ratio as evaluated by means of fast atom
      bombardment-mass spectrometry (FAB-MS) on processed blood samples. A good
      intraindividual reproducibility was observed for blood samples drawn at various
      times after application of the trial drug. Figures for bioavailability and its
      interindividual variations were in the range expected from comparable studies on
      similar iron preparations using radioiron as tracers. The results obtained show
      that quantitative data of bioavailability from pharmaceutical iron preparations
      may be obtained without radiation exposure of the subjects investigated.

PMID- 1626028
TI  - The automatic computer detection of subtle calcifications in radiographically
      dense breasts.

PMID- 1626029
TI  - The use of a radiation sensitive CCD camera system to measure bone mineral
      content in the neonatal forearm: a feasibility study.

PMID- 1626030
TI  - Two compartments of slowly exchangeable sodium in bone.

PMID- 1626031
TI  - The Institute of Physical Sciences in Medicine 1991 Award. Founders' Prize 1991.

PMID- 1626032
TI  - Renal effects of head-out water immersion in humans: a 15-year update.

PMID- 1626033
TI  - Golgi tendon organs in mammalian skeletal muscle: functional properties and
      central actions.

PMID- 1626034
TI  - Nonsteroidal signals originating in the gonads.
AB  - The discovery of the various peptide factors in the gonads followed different
      paths. A number of factors were specifically searched for because of
      physiological experiments that predicted that an activity from the gonads was
      necessary to explain phenomena. Such was the case for gonadal steroids and for
      such peptide factors as inhibin, MIS, OMI, FRP, seminal plasma inhibin, relaxin,
      PA factor and other proteases, and ABP. In the process other factors such as
      activin and follistatin were serendipitously discovered. A second group of
      factors was discovered because in vitro experiments of various combinations of
      gonadal cell types failed to replicate in vivo findings, suggesting missing
      signals. Such substances are the panoply of growth factors aiding in
      differentiation and growth promotion and inhibition: LS and LI, P-Mod-S,
      clusterin, and various components of the ECM. Finally, and most recently, another
      set of peptides has been identified because immunological or molecular probes
      have been used to search gonadal tissue for factors originally discovered
      elsewhere; these include POMC, GnRH-like peptide, oxytocin, AVP, angiotensin,
      ANF, CRF, neural peptides, and c-mos. Our understanding of the relationship of
      most of these peptides to the local signals necessary for gonadal function is
      still very elementary. Clearly some like relaxin and inhibin function as
      important hormones, and ABP, for example, probably functions importantly in
      transporting testosterone down the tubule. Most local paracrine or autocrine
      peptide signals appear to act in relationship to gonadotropin levels probably in
      local differentiation in the process of gamete maturation, but this is only
      conjecture at this point. No experimental verification that any of these factors
      is involved in follicle selection for recruitment or for atresia is yet
      available. For many of the factors local receptors have not yet been identified.
      The richness of the variety of peptides in the gonads suggests that microanalysis
      of cell-cell signaling would be rewarding, but at the time of this writing such
      investigations are not yet possible.

PMID- 1626035
TI  - Selective attention in auditory processing as reflected by event-related brain
      potentials.
AB  - Measures of event-related brain potentials (ERPs) have revealed two kinds of
      selective-attention mechanisms that operate on attended and unattended auditory
      stimuli. The processing negativity of the ERP reveals a mechanism of intramodal
      selective attention in the auditory cortex controlled by the frontal cortex. This
      mechanism selects attended auditory stimuli for further processing when they
      differ from unattended stimuli in location or tonal frequency. Studies of
      intermodal selective attention have compared auditory ERPs during auditory and
      visual attention. At least in part different brain mechanisms may be involved in
      the selection of auditory stimuli among other auditory stimuli (intramodal
      selective attention) and in the selection of auditory stimuli among visual
      stimuli (intermodal selective attention). This is suggested by the results
      showing that the earlier component of the processing negativity, which is
      generated in the auditory cortex during intramodal selective attention, differs
      in scalp distribution from the early attention-related negativity elicited during
      intermodal selective attention. With respect to the unattended auditory stimuli,
      ERP studies of selective attention suggest that physical features of these
      stimuli are extensively processed. This is shown by the mismatch negativity
      component of the ERP, which is usually elicited by infrequent physical deviations
      in an auditory stimulus sequence both when this sequence is attended and when it
      is ignored. This would be impossible if the physical stimulus features were not
      extensively processed, even in the absence of attention.

PMID- 1626036
TI  - Cardiovascular reactivity in Type A and B males to mental arithmetic and aerobic
      exercise at an equivalent oxygen uptake.
AB  - Cardiovascular hyperreactivity (i.e., response in excess of metabolic
      requirements) to psychological stress has been implicated in the development of
      coronary heart disease. The purpose of this study was to evaluate cardiovascular
      hyperreactivity to psychological stress in Type A and B subjects. Fifteen Type A
      and 15 Type B young men performed mental arithmetic and cycle ergometry tasks.
      Linear regressions were calculated for each dependent variable during exercise
      with oxygen uptake serving as the independent variable. All cardiovascular
      variables were significantly correlated (p less than .0001) with oxygen uptake
      during exercise. The regression equations obtained during exercise were then used
      to predict the value of each cardiovascular variable at the oxygen uptake level
      obtained during mental arithmetic for each person. Repeated measures ANOVA
      compared responses observed during arithmetic with responses predicted from
      exercise at an equivalent oxygen uptake in Type A and B subjects. Heart rate,
      total peripheral resistance, and mean arterial pressure were significantly
      greater (p less than .0001) and stroke volume was significantly lower (p less
      than .0002) during arithmetic than during exercise, while Heather index, cardiac
      output, and arteriovenous oxygen difference did not differ significantly. No
      significant differences were found between Type A and B males. Results
      demonstrated that cardiovascular hyperreactivity was equally robust across Type A
      and B subjects.

PMID- 1626037
TI  - Cardiovascular responses to the combination of caffeine and mental arithmetic,
      cold pressor, and static exercise stressors.
AB  - The present study examined cardiovascular responses to the combination of
      caffeine (250mg) and mental arithmetic, cold pressor, and static exercise
      stressors in 48 healthy males. Subjects were tested in a within-subject, placebo
      controlled, double-blind design. Repeated measurements of heart rate, finger
      temperature, respiratory sinus arrhythmia, forearm blood flow, and blood pressure
      were obtained during a pre-drug resting baseline, a post-drug resting baseline,
      the three stressor tasks, and a recovery baseline. The primary analyses were
      2(Drug) x 5(Period) x 6(Stress Order) MANCOVAs using pre-drug baseline values as
      covariates. Significant period main effects were observed for all measures.
      Significant drug main effects were observed for blood pressure, finger
      temperature, respiratory sinus arrhythmia, and forearm blood flow. The
      significant changes in blood pressure and finger temperature produced by caffeine
      combined in an additive fashion with the effects produced by the stressors.
      Significantly greater increases in forearm blood flow and heart rate during
      mental arithmetic on the caffeine day suggested a potentiation of sympathetic,
      beta-adrenergic activity. Questionnaires administered during baseline periods to
      assess psychological responses to stress and caffeine revealed a potentiation of
      anxiety and anger responses to stress on the caffeine day.

PMID- 1626038
TI  - Developmental changes in the duration of attention to unfamiliar stimuli in the
      rat.
AB  - The purpose of the present study was to examine developmental changes in the
      duration of attention to novel auditory stimuli in rats from infancy to
      adulthood. In all experiments, the cardiac component of the orienting response
      was used as the index of attention. In the first experiment 16-, 23-, 30-, and 75
      day-old rats were exposed to a novel auditory stimulus for 60 s. Animals of all
      four ages exhibited a marked decrease in heart rate in response to this stimulus.
      Although there were no significant effects of age on the magnitude of the cardiac
      response, there were dramatic developmental differences in the persistence of the
      response. The 16-day-olds maintained a decrease in heart rate for the entire
      stimulus period, whereas heart rate returned to baseline in the 75-day-olds after
      only 40 s. The duration of the cardiac response of the 23- and 30-day-olds was
      between these extremes. In Experiments 2A and 2B the effect of stimulus
      complexity on duration of the cardiac response was examined. Increasing stimulus
      complexity prolonged the deceleratory response in the 30-day-olds (Experiment
      2A), and decreasing stimulus complexity decreased the duration of the cardiac
      response in the 16-day-olds (Experiment 2B). The results of these experiments
      were discussed in the context of Cohen's and Porges's two-phase theories of
      attention. The findings demonstrate that the initial attention-getting or
      reactive phase of attention did not change with age, but that the duration of the
      attention-holding or sustained phase decreased substantially during development.

PMID- 1626039
TI  - Third ventricle enlargement and lower heart rate levels in a high-risk sample.
AB  - Heart rate activity and computed tomographic measures of structural brain
      abnormalities were evaluated in 32 individuals with a genetic risk for
      schizophrenia (offspring of schizophrenic mothers). Heart rate activity was
      assessed in 1962 when the subjects were a mean age of 15.1 years. Diagnostic and
      computed tomography assessments were conducted in 1980. Compared to individuals
      with normal third ventricles, individuals with enlarged third ventricles
      evidenced significantly lower heart rate levels overall and significantly lower
      heart rate during rest and during the periods preceding conditioning and test for
      conditioning stimulus trials. These effects were independent of age, psychiatric
      diagnosis, and abnormalities in other brain regions. Difficulties in
      interpretation posed by the index of brain abnormality employed and by the 18
      year time interval between the heart rate and computed tomography assessments are
      discussed. Together with prior evidence of a relationship between third ventricle
      enlargement and reduced electrodermal responsiveness in the same subjects, these
      findings provide a preliminary indication that enlargement of the third ventricle
      may involve damage to diencephalic structures involved in autonomic nervous
      system activity.

PMID- 1626040
TI  - Increased salivary cortisol in severe dental anxiety.
AB  - The aim of the present study was to investigate the feasibility of saliva
      collection from highly anxious dental patients and to evaluate whether salivary
      cortisol concentrations could discriminate between 13 highly anxious dental
      patients and 13 non-anxious subjects. Whole mixed saliva was sampled by suction
      after stimulation with citric acid crystals. Salivary free cortisol levels were
      measured in duplicate by radioimmunoassay. Collection of saliva took 2-5 min and
      was not experienced as unpleasant. Salivary free cortisol concentrations were
      significantly elevated if the patients manifested anxiety according to the scores
      on the Dental Anxiety Scale. The measurement of salivary cortisol may be a
      convenient method for the assessment of dental anxiety.

PMID- 1626041
TI  - The effect of common versus distinctive stimulus features on electrodermal
      orientation to significant stimuli.
AB  - The relationship between electrodermal responsivity and stimulus similarity was
      previously demonstrated in a series of studies. These studies were guided by a
      feature-matching model according to which similarity is an additive function of
      the common and distinctive features of the stimuli. In these experiments common
      and distinctive features were simultaneously manipulated, thus confounding the
      effects of the two sets of features. In the present experiment, we examined the
      separate effects of these two sets of features by an independent manipulation of
      common and distinctive components of the stimuli. A modified version of the
      guilty knowledge technique was employed, with compound pictorial and verbal
      stimuli (schematic faces and verbal descriptions of people) as the relevant items
      memorized by the subjects. Skin conductance responses were measured during the
      subsequent presentation of a stimulus sequence comprised of a test stimulus,
      which shared some common components with the relevant stimulus, and several
      neutral control stimuli. As hypothesized, a larger number of distinctive
      components resulted in decreased responsivity. Yet, contrary to our expectation,
      the number of common components of the relevant and test stimuli had no effect on
      responsivity. Several hypotheses are suggested to account for this unexpected
      result.

PMID- 1626042
TI  - Scopolamine effects on visual information processing, attention, and event
      related potential map latencies.
AB  - We measured performance and event-related brain potential (ERP) map latencies in
      12 subjects during four visual discrimination tasks to compare the timing of
      scopolamine effects on information processing and attention. "Topographic
      component recognition" found ERP map latencies at times of best fit with a
      component model map. This "common topography" criterion minimized topographic
      differences among conditions to facilitate latency interpretations. Scopolamine
      slowed N1 latency in all tasks, and P3 and reaction time in some tasks. The drug
      delayed responses to easy targets more than to hard targets. It also induced a
      disproportionate N1 delay for unilateral high spatial frequency gratings. Both
      effects reflect a scopolamine-induced impairment when processing targets that
      usually capture attention. Scopolamine also impaired accuracy for unilateral high
      spatial frequency gratings, and for gratings presented at probable locations,
      confirming and extending previous findings. Scopolamine-induced P1 and N1 delays
      showed that visual processing was affected. Several results were inconsistent
      with a serial stage model. We suggest that scopolamine both delays selected
      processes and impairs a processing mode based on automatic capture of attention,
      inducing more serial processing.

PMID- 1626043
TI  - Can echoic memory store two traces simultaneously? A study of event-related brain
      potentials.
AB  - The mismatch negativity, a component of the event-related brain potential
      elicited by infrequent deviants in sequences of auditory stimuli, is presumably
      generated by an automatic mismatch process in a mechanism that compares the
      current stimulus to the trace of the previous one. The present study addressed
      the possible simultaneous existence of two such traces. Two equiprobable (45%
      each) frequent stimuli ("standards"), one of 600 Hz and the other of 700 Hz, were
      presented together with an infrequent (10%), "deviant" stimulus which was of
      different frequency in different blocks. These deviants elicited a mismatch
      negativity, though a smaller one than that obtained in corresponding blocks with
      only one standard stimulus. Two aspects of the present results from the blocks
      with two standard stimuli implicate two parallel stimulus traces in these blocks:
      1) deviants elicited a mismatch negativity (MMN) of approximately the same
      amplitude when preceded by sequences of four identical standards as when preceded
      by sequences of four stimuli containing both standards; 2) in contrast to the one
      standard condition, the magnitude of stimulus deviance did not affect the MMN
      component elicited by the different deviants.

PMID- 1626044
TI  - Digital filtering: background and tutorial for psychophysiologists.
AB  - Digital filtering offers more to psychophysiologists than is commonly
      appreciated. An introduction is offered here to foster the explicit design and
      use of digital filters. Because of considerable confusion in the literature about
      terminology important to both analog and digital filtering, basic concepts are
      reviewed and clarified. Because some time series concepts are fundamental to
      digital filtering, these are also presented. Examples of filters commonly used in
      psychophysiology are given, and procedures are presented for the design and use
      of one type of digital filter. Properties of some types of digital filters are
      described, and the relative advantages of simple analog and digital filters are
      discussed.

PMID- 1626045
TI  - Local distribution and dosimetry of 226Ra in the trabecular skeleton of the
      beagle.
AB  - Young adult beagle dogs received a single injection of 38.1 kBq/kg body wt 226Ra
      and were serially sacrificed at 4 to 2955 days postinjection. Samples of sites of
      trabecular bone in the lumbar vertebral body, proximal ulna, and distal femoral
      metaphysis and epiphysis were analyzed autoradiographically. The time-dependent
      changes in the average 226Ra concentrations in the four regions were analyzed in
      terms of a compartmental model. The clearance rate from the lumbar vertebral body
      was about four times more rapid than for the proximal ulna and distal femoral
      epiphysis. Ratios of hotspot to diffuse label concentrations varied from about 10
      to 23. The dose rate to the endosteum ranged between 8.7 and 39.5 mGy/day
      initially and 4 and 10.5 mGy/day toward the end of the observation period. Mean
      marrow dose rates were lower by a factor of 3 to 9.5. During their residence time
      the nuclei of bone lining cells receive a maximum dose of 8 Gy in the proximal
      ulna (2955 days after injection) and a minimum dose of 0.63 Gy in the lumbar
      vertebra (2955 days after injection). This corresponds on the average to 17 and
      1.4 alpha-particle hits to the cell nuclei, respectively.

PMID- 1626046
TI  - Early changes in mouse urinary bladder function following fractionated X
      irradiation.
AB  - Functional changes in the mouse urinary bladder following single-dose or
      fractionated irradiation were assessed by cystometry, i.e., by measuring the
      intravesical volume-pressure relationship during transurethral filling. The early
      response presented as a dose-dependent and transitory decrease in the reservoir
      function of the organ as defined by the intravesical volume at a filling pressure
      of 10 or 20 mm Hg, V10 or V20. The quantal dose response used in the present
      study was a reduction in the individual bladder volume (V10 and V20) by at least
      50%. After single doses greater than or equal to 10 Gy, the reaction occurred
      between Days 7 and 25 with maximum prevalence between Days 7 and 14. The
      individual duration of the response was 3-9 days. Treatment with single doses and
      2, 3, 5, and 10 fractions demonstrated a significant sparing effect with ED50
      values of 18.3, 24.9, 26.8, 29.8, and 38.0 Gy, respectively. The linear-quadratic
      model fitted the data reasonably well when tested according to Tucker (Int. J.
      Radiat. Oncol. Biol. Phys. 10, 1933-1939, 1984). The alpha/beta ratios estimated
      with different two-step techniques ranged from 11.1 to 12.4 Gy. Analysis of the
      data as proposed by Thames et al. (Int. J. Radiat. Biol. 49, 999-1009, 1986)
      yielded an alpha/beta value of 13.9 Gy (95% confidence limits 8.4 and 24.6 Gy),
      illustrating a fractionation effect typical for acutely responding tissues,
      although no clear cell depletion occurred in the urothelium.

PMID- 1626047
TI  - Effect of prostaglandins, inositol 1,4,5-trisphosphate, and phorbol esters on
      radiation-induced decreases in calcium influx in rat brain synaptosomes.
AB  - Gamma irradiation (60Co) reduced KCl-stimulated voltage-dependent uptake of
      45Ca2+ in rat whole-brain synaptosomes. Prostaglandins, inositol 1,4,5
      trisphosphate, and phorbol esters were tested for their ability to inhibit
      radiation-induced decreases in calcium influx. None of the compounds tested alone
      completely prevented radiation-induced decreases in calcium uptake, but some drug
      combinations did inhibit decreases. Results suggest that radiation-induced
      decreases in calcium uptake are due to impairment of protein kinase C activity
      and mobilization of calcium by these drugs.

PMID- 1626048
TI  - Effect of fluoride on inhibition of plasma membrane functions in Chinese hamster
      ovary cells photosensitized by aluminum phthalocyanine.
AB  - Fluoride inhibits photohemolysis induced by chloroaluminum phthalocyanine
      tetrasulfonate (AlPcS4) when it is added to dye-loaded human erythrocytes prior
      to light exposure (E. Ben-Hur, A. Freud, A. Canfi, and A. Livne, Int. J. Radiat.
      Biol. 59, 797-806, 1991). This is due to formation of a complex of F- with Al3+,
      leading to selective release and/or modified dye binding with some proteins so
      that the effective photochemical reaction is prevented. In this work we used F-
      as a probe to evaluate the involvement of the plasma membrane functions of
      Chinese hamster ovary cells in photocytotoxicity induced by chloroaluminum
      phthalocyanine (AlPc). Fluoride was found to protect against killing of cells
      photosensitized by AlPc but not AlPcS4. Plasma membrane damage induced by AlPc
      photosensitization was manifested by K+ leakage, membrane depolarization,
      inhibition of glucose and amino acid uptake, and Na+/K(+)-ATPase inactivation.
      The latter enzyme system was found to be the one most sensitive to inhibition by
      the combination of AlPc and PDT among the membrane functions studied, and was
      completely protected by F- in the dose range at which up to 95% of the cells are
      killed. Of the other membrane functions only glucose transport was slightly
      protected by F-. It is concluded that damage to the plasma membrane is involved
      in cell killing induced by AlPc photosensitization and that the plasma membrane
      enzyme Na+/K(+)-ATPase is a probable candidate as a critical target.

PMID- 1626049
TI  - Evidence that DNA double-strand breaks initiate the phenotype of delayed
      reproductive death in Chinese hamster ovary cells.
AB  - A persistently reduced cloning efficiency occurs in many of the cloned progeny of
      Chinese hamster ovary (CHO) cells surviving X irradiation, a stable phenotype we
      have previously termed delayed reproductive death (Int. J. Radiat. Biol. 60, 483
      496, 1991). We now report that this phenotype is also induced by the alkylating
      agent ethyl methanesulfonate (EMS), but not by irradiation with ultraviolet
      light. The restriction endonuclease HinfI, which binds at G [symbol: see text]
      ANTC DNA sequences and generates cohesive-end double-strand breaks, was also
      efficient in inducing delayed reproductive death. On the other hand, an X-ray
      sensitive CHO mutant, xrs-5, which is defective in the repair of DNA double
      strand breaks, did not show this phenotype following X irradiation. These results
      suggest that DNA double-strand breaks, as well as the endogenous repair processes
      for these breaks, are associated with the induction of the delayed reproductive
      death phenotype in CHO cells. The possible mechanism for the induction of delayed
      reproductive death by EMS is discussed.

PMID- 1626050
TI  - Transformation of C3H 10T1/2 cells with 4.3 MeV alpha particles at low doses:
      effects of single and fractionated doses.
AB  - Oncogenic transformation of C3H 10T1/2 cells was determined after exposure to
      graded doses of 4.3-MeV alpha particles LET = 101 keV/microns. The source of
      alpha particles was 244Cm and the irradiation was done in an irradiation chamber
      built for the purpose. Graded doses in the range of 0.2 to 300 cGy were studied
      with special emphasis on the low-dose region, with as many as seven points in the
      interval up to 10 cGy. The dose-effect relationship was a complex function.
      Transformation frequency increased with dose up to 2 cGy; it seemed to flatten at
      doses between 2 and 20 cGy but increased again at higher doses. A total of 21 cGy
      was delivered in a single dose or in 3 or 10 equal fractions at an interval of
      1.5 h. An inverse dose-protraction effect of 1.4 was found with both
      fractionation schemes. Measurements of the mitotic index of the population
      immediately before the various fractions revealed a strong effect on the rate of
      cell division even after very low doses of radiation. Mitotic yield decreased
      markedly with the total dose delivered, and it was as low as 50% of the control
      value after 4.2 cGy and 20% after 14 cGy with both fractionation schemes.

PMID- 1626051
TI  - Inactivation action spectra of Bacillus subtilis spores with monochromatic soft X
      rays (0.1-0.6 nm) of synchrotron radiation.
AB  - Five types of Bacillus subtilis spores differing in DNA repair and
      recombinational capacities were exposed in vacuum to monochromatic soft X rays
      from synchrotron radiation. The inactivation rate constants were obtained from
      exposure-survival curves upon irradiations at 12 wavelengths in the range of
      0.1000 nm (12.40 keV) to 0.6000 nm (2.066 keV). Spores of two repair-deficient
      strains, UVS (uvrA ssp) and UVP (uvrA ssp polA), exhibited almost equal
      sensitivities to those of wild-type UVR+, while those of two recombination
      deficient strains, RCE (recE) and RCF (recF), exhibited higher sensitivities in
      the whole wavelength range. This suggested that the repair of DNA damage produced
      by soft X rays was dependent on the recombinational capabilities. Inactivation
      action spectra based on photon fluence showed that the effectiveness of the
      radiation increased as the wavelengths became longer. Abrupt changes in the
      effectiveness occurred around the wavelengths corresponding to the absorption
      edges of K-shell electrons of phosphorus and calcium. In both cases, the
      sensitivity was the highest at the wavelengths of the resonance absorption peak,
      the next highest at those of the higher energy, and the lowest at the lower
      energy. Mass energy absorption coefficients of spores were obtained from the
      transmission of a flake made of spores. They were used to derive inactivation
      action spectra based on absorbed doses. In these spectra, basal levels of the
      sensitivity seemed constant, and enhancements of the sensitivity were observed
      consistent with the absorption by calcium and phosphorus. Thus calcium and
      phosphorus atoms were the predominant targets for the absorption events leading
      to the inactivation of spores in the wavelength range examined.

PMID- 1626052
TI  - Linear-quadratic analysis of radiosensitization by halogenated pyrimidines. I.
      Radiosensitization of human colon cancer cells by iododeoxyuridine.
AB  - Radiosensitization by iododeoxyuridine (IdU) is a method of enhancing cell
      killing in the radiotherapy of human cancers, especially for tumors that
      proliferate faster than the surrounding normal tissues, such as might appear in
      brain or liver. We have investigated in vitro the relationship between the amount
      of thymidine replacement by IdU and the resulting radiosensitization in two human
      colon cancer cell lines, HCT 116 and HT 29, with differing inherent sensitivities
      to X rays. The results show that an increase in the initial slope of the cell
      survival curve was the predominant mode of radiosensitization. In this situation,
      the emphasis on changes in the initial slope suggest the use of a survival curve
      model that contains the initial slope as a defined variable, which the
      traditional single-hit, multitarget model does not. We present our analyses
      mainly in terms of alpha (initial slope) and changes in surviving fraction at 2
      Gy and also as a modified form of sensitizer enhancement ratio that describes the
      dose-modifying factor of IdU at a single radiation dose of 2 Gy (SER 2 Gy).
      Iododeoxyuridine is an effective radiosensitizer in both cell lines, but IdU
      appears especially effective in increasing the initial slope of the more
      radioresistant line, the HT 29 cells.

PMID- 1626053
TI  - Linear-quadratic analysis of radiosensitization by halogenated pyrimidines. II.
      Radiosensitization of human colon cancer cells by bromodeoxyuridine.
AB  - As a continuation of the studies in Part I (Miller, Fowler, and Kinsella, Radiat.
      Res. 131, 000-000, 1992), which examined the radiosensitizing effects of
      iododeoxyuridine (IdU), similar experiments with bromodeoxyuridine (BrdU) were
      conducted concurrently to characterize its effects on the shape of the radiation
      survival curves of cells of two human colon cancer cell lines, HT 29 and HCT 116.
      The efficiency of radiosensitization by BrdU, expressed as a function of
      percentage thymidine replacement, was lower when compared to IdU in both cell
      lines. However, the major radiosensitizing effect of BrdU was manifest as an
      increase in the initial slope (alpha), just as observed for IdU. However, with
      BrdU, in contrast to IdU, an increase in curvature (repairable damage) was also
      evident. Cells of the more radiosensitive line, HCT 116, showed less
      sensitization by either BrdU or IdU than cells of the more radioresistant line,
      HT 29. These results were consistent with the proposed mechanism of
      radiosensitization being an increase in the single-hit character of low-LET
      radiation. It follows that the radiosensitizing effects of both analogs were
      largest in the low-dose region of the survival curve.

PMID- 1626054
TI  - Nurse denied pay differential for unscheduled work.

PMID- 1626055
TI  - Are nurses held to same standards of care as physicians? Case in point: Alef v.
      Alta Bates Hospital (6 Cal Rptr. 2d 900-CA [1992]).

PMID- 1626056
TI  - A new method for monitoring the cerebrovascular response to acetazolamide using
      99mTc-DTPA-HSA.
AB  - We developed a new method for monitoring the cerebrovascular response to
      acetazolamide using technetium-99m diethylenetriaminepentaacetic acid human serum
      albumin (99mTc-DTPA-HSA). We infused 740 M Bq (20 mCi) of 99mTc-DTPA-HSA
      intravenously and carried out dynamic scanning of the anterior view of the head
      for 50 minutes. Ten minutes after the start of scanning, 1,000 mg of
      acetazolamide was injected intravenously. In three normal volunteers, the
      radioactivity in brain increased for an average of 8 minutes after the injection
      of acetazolamide and then remained relatively stable. The average of dilatation
      index [(peak count/the count just before acetazolamide injection-1)x 100] was
      16.1. Our method enabled us to observe vasodilation caused by acetazolamide
      straight, and may be of value in assessing cerebral perfusion reserve easily and
      quantitatively.

PMID- 1626057
TI  - Pancreatic angiography using balloon catheter occlusion and a vasoconstrictor.
AB  - When a vasoconstrictor (noradrenaline) was injected during occlusion of the
      common hepatic artery with a balloon catheter, the vasoconstrictor flowed only
      into the proper hepatic artery and constricted it. The balloon was immediately
      deflated and contrast medium injected into the common hepatic artery. The flow of
      the contrast medium into the gastroduodenal artery was then increased, clearly
      visualizing the entire pancreatic-duodenal arcade.

PMID- 1626058
TI  - Clinical evaluation of assistant diagnostic system for mammograms using the auto
      analyzing method.
AB  - Clinical usefulness of a newly developed auto-analyzing system of mammograms to
      search the abnormal dense areas such as cancer lesions was studied. 345 breasts
      including 86 cancers, 52 mastopathies, 18 fibroadenomas, 13 cysts, 4 lipomas and
      172 normals were analyzed and compared with final diagnosis. 84 of 86 cancer
      lesions were correctly pointed out (sensitivity: 97.9%). Based on the gradient of
      the density, the ranking of the cancer or calcified lesions among suspected
      regions in a mammogram was decided. 55 lesions of them (64.0%) were ordered at
      the first rank and 83 (96.5%) were in the upper three ranks. 68 of 74 breasts
      with calcifications were correctly diagnosed and 48 of them were ranked in the
      upper three ranks. Although further improvement of the system is needed, this
      system will be a useful assistance for screening the breast cancer in the
      analyses of mammograms.

PMID- 1626059
TI  - A case of abdominal cystic lymphangioma: cobweb appearance on ultrasonography.
AB  - A case of abdominal cystic lymphangioma is described. Our sonographic examination
      showed a large multilocular cyst with a cluster of honeycomb cysts revealing a
      cobweb appearance, which correlated with the pathologic specimen, and revealed
      characteristics of the disease. Sonographic appearance may be helpful in
      differentiating abdominal cystic lymphangioma from other multilocular cystic
      tumors.

PMID- 1626060
TI  - Case report of malignant splenic tumor.
AB  - Primary angiosarcoma and malignant lymphoma of the spleen are uncommon. We report
      such tumors in a 44-year-old-woman and a 51-year-old-man. The value of diagnostic
      imaging by US and CT is emphasized. These techniques can establish the solid
      nature of the mass and may be the first methods to suggest malignancy.

PMID- 1626061
TI  - Extrahepatic portal obstruction with intestinal malrotation: a case report.
AB  - We report the case of a 20-year-old woman with extrahepatic portal obstruction,
      anomalous branching of the celiac artery, and intestinal malrotation with
      duodenal dysgenesis. The patient had no history of neonatal event and had normal
      liver function. The combination of these abnormalities, rarely reported in the
      literature, suggests that the extrahepatic portal obstruction in this case might
      be congenital in origin.

PMID- 1626062
TI  - CT and MR findings in diastematomyelia, with embryogenetic consideration.
AB  - Diastemstomyelia is an extremely rare disorder that is seldom found among the
      Japanese. This paper presents two Japanese patients, a newborn male and a newborn
      female, with diastematomyelia. CT demonstrated bony spurs more clearly than plain
      film, and magnetic resonance images indicated split cords and associated
      anomalies. Although the embryogenesis of diastematomyelia has not been clearly
      elucidated, the coincidence of levels of associated anomalies and
      diastematomyelia in our cases and in the literature supports Bremer's
      embryogenetic explanation of persistent accessory neurenteric canal.

PMID- 1626063
TI  - Assessing the health risks of priority substances under the Canadian
      environmental protection act.
AB  - The Canadian Environmental Protection Act (CEPA) came into force in June 1988.
      This legislation provides the federal government with broad powers to deal with
      health and environmental problems posed by chemicals and the products of
      biotechnology throughout their life cycle. Responsibility for administering CEPA
      is shared between the Department of the Environment and the Department of
      National Health and Welfare. Part II of the Act, the "toxic substances"
      provisions, enables the federal government to impose controls on substances new
      to Canadian commerce and to address the health and environmental risks posed by
      existing substances. Part II of CEPA also delineates the manner in which existing
      substances are to be selected for assessment (priority substances) and
      controlled. The first Priority Substances List was published in February 1989.
      The 44 entries on this list include discrete chemicals, classes of chemicals, and
      complex mixtures of chemicals; the Department of the Environment and the
      Department of National Health and Welfare must ascertain whether these substances
      pose a risk (are "toxic" as defined in CEPA) to the environment or to human
      health by February 1994. This paper outlines the administrative arrangements for
      conducting risk assessments and the requirements for ascertaining whether a
      substance is "toxic" with respect to human health under CEPA. The rationale for
      deeming dioxins and furans, the first two priority substances to be assessed, as
      "toxic" with respect to human health is also described.

PMID- 1626064
TI  - An analysis of exposure rate effects for benzene using a physiologically based
      pharmacokinetic model.
AB  - A new physiological pharmacokinetic model was used to explore the effect of
      exposure rate on the rate of formation of several crucial metabolites of benzene.
      Metabolite formation was compared following exposure to benzene over the course
      of an 8-hr workday and following a single exposure for 15 min. These exposures
      were based on the permissible exposure limit and short-term exposure limit of the
      benzene standard set by the Occupational Safety and Health Administration. The
      model was parametrized using in vitro and in vivo experimental data on benzene
      toxicokinetics and metabolism. Ranges, rather than fixed values, were assigned to
      the parameters. Model predictions show that the amounts of hydroquinone,
      catechol, and muconaldehyde formed in the body following a peak exposure to 32
      ppm of benzene over 15 min are on average 20% higher than those formed following
      an equivalent dose of 1 ppm over an 8-hr period. The health consequences of these
      findings and the implications for policy concerning short-term exposure limits
      are discussed.

PMID- 1626065
TI  - Pesticide tolerances and their relevance as safety standards.
AB  - Following an investigation of the relationship between pesticide tolerances and
      safety, it is concluded that pesticide tolerances are not relevant as safety
      standards. This conclusion is based upon the findings that theoretical exposures
      to legal levels of pesticides in the diet may pose greater than negligible risks,
      while exposures to most illegal residues are of no apparent toxicological
      significance. Thus, the common and logical views that "legal" residues are "safe"
      while "illegal" residues are "unsafe" are not supported by scientific evidence.
      Pesticide tolerances do serve important roles as enforcement tools, and tolerance
      enforcement programs are useful in the regulation of international trade and
      provide economic disincentives that may discourage pesticide misuse and emphasize
      compliance with regulations. Since tolerances are not appropriate as safety
      standards, however, legislative food safety proposals focusing upon revocation or
      reduction of tolerances and upon increasing enforcement capabilities may result
      in little benefit to public health.

PMID- 1626066
TI  - Incidence of developmental defects at the no observed adverse effect level
      (NOAEL).
AB  - Bioassay data from Teratology, Vol. 1 (1968) through Vol. 40 (1990), were
      utilized which were sufficient to establish no observed adverse effect levels
      (NOAEL's) for 120 experiments on 93 developmental toxicants in animals. The
      observed incidence (risk) at the NOAEL was calculated as the proportion of
      affected fetuses minus the proportion affected in the control animals. This
      calculation did not require any dose-response modeling. Data were primarily from
      experiments on rats and mice with a few studies on rabbits and hamsters. There
      did not appear to be differences in risks at the NOAEL among these four species.
      For each experiment, the risk at the NOAEL was tabulated for all of the adverse
      effects which shared the same NOAEL. Since the observed risk at the NOAEL for
      either dead/resorbed or abnormal fetuses exceeded 1% in about one-fourth of the
      cases, this suggests that a benchmark dose with a risk on this order would
      eliminate the higher risks and serve as a basis for establishing reference doses.
      If the lower confidence limit on a benchmark dose is used in place of the NOAEL,
      better experimental designs with more animals would result in tighter confidence
      limits, giving larger (less stringent) reference doses than poorer experiments.

PMID- 1626067
TI  - Statistical properties of the NOAEL.
AB  - The use of the no observed adverse effect level (NOAEL) in setting allowable
      exposure levels for noncancer endpoints is a source of controversy. Based on
      computer simulations and empirical studies, several authors have criticized the
      use of the NOAEL in terms of its sensitivity to sample size and its high sampling
      variability from experiment to experiment. The purpose of this paper is to derive
      the statistical distribution of the NOAEL. Using Weibull models, we investigate
      the impact of the shape of the underlying dose-response curve on the distribution
      of the NOAEL. The results confirm previous criticisms of the NOAEL and show that
      average risk levels associated with the NOAEL may be substantial. These results
      provide additional motivation for developing alternative approaches to risk
      assessment.

PMID- 1626068
TI  - Does the animal-to-human uncertainty factor incorporate interspecies differences
      in surface area?
AB  - Risk assessment practices for noncarcinogens typically employ an uncertainty
      factor (UF) for animal-to-human extrapolation when defining acceptable levels for
      humans based on animal studies. EPA has interpreted the use of this factor as
      addressing interspecies differences due to dose normalization via surface area
      (exposure-dose relationships) and to innate differences in species susceptibility
      (dose-response relationships). Thus EPA has concluded that dose normalization via
      surface area is not necessary when using animal studies to define acceptable
      levels for noncarcinogens for humans. In this report we challenge this position
      on both theoretical and practical grounds. It is recommended that the UF for
      animal-to-human extrapolation for noncarcinogens in the risk assessment process
      and the technique for dose normalization be considered distinctly.

PMID- 1626069
TI  - Use of human data in quantitative risk assessment of carcinogens: impact on
      epidemiologic practice and the regulatory process.
AB  - Epidemiologic data are increasingly being used to assess cancer risk from
      chemicals as their value is recognized and as more and better studies become
      available. Weight-of-evidence approaches are now available for classifying the
      experimental and epidemiological evidence regarding human carcinogenicity. When
      the human data are extensive and of good quality, they should be given
      substantial weight in assessing risk. Both the positive and the negative
      epidemiologic data should be used in a quantitative risk assessment (QRA),
      because only then can an unbiased risk assessment be derived. Good-quality
      epidemiological studies are those with sound methodology, lack of bias, long
      enough follow-up times to observe a carcinogenic response, adequate exposure
      information, and dose-response information. Before a lack of carcinogenicity can
      be inferred, it is essential that the exposures be of substantial duration and
      intensity, and that the number of exposed persons be reasonably large.
      Epidemiologists need to give more attention to exposure assessment, because lack
      of quantitative exposure information is often the limiting factor that prevents
      the use of epidemiologic data in QRA. Development of methods to estimate
      historical workplace exposure intensities from surrogate industrial hygiene
      variables should receive high research priority, since they have the potential to
      increase the usefulness in QRA of many epidemiologic studies that have limited
      exposure information. Several frequently used surrogates for exposure
      measurements have limitations or pitfalls in their use. In particular, the use of
      "ever/never" exposed has a large potential to produce falsely negative results by
      means of a "dilution" effect, especially in the common case where the exposure
      distribution is skewed. Duration of exposure (rather than duration x intensity)
      may also give misleading results. There is little information to suggest that
      synergistic exposures to multiple toxicants in an industrial environment are
      likely to invalidate QRAs, probably because few studies have identified a group
      of workers with major workplace exposures to multiple carcinogens that cause the
      same type of cancer. Most of the interactive effects which have been identified
      to date are between smoking and some occupational carcinogen, so this possibility
      needs careful evaluation for smoking-related diseases. It is important to
      evaluate dose-response gradients in a QRA to obtain maximum precision and
      accuracy in the resulting risk coefficient. The analysis should take into account
      an appropriate cancer induction period. Various methods to account for cancer
      induction times are compared; those that incorporate a lag period or model the
      induction-time distribution are superior to other methods.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1626071
TI  - Antinuclear antibodies.

PMID- 1626070
TI  - Molecular biology of nuclear autoantigens.
AB  - This article provides a historical overview of the application of molecular and
      immunologic techniques to the analysis of autoantigenic structure and function,
      as well as to autoantibody recognition of protein and nucleic acid autoantigens.
      Examples presented here illustrate the role of autoantibodies as tools in the
      elucidation of the autoimmune components of cellular ribonucleoproteins. In turn,
      the subsequent molecular dissection of autoantigenic ribonucleoproteins has
      advanced understanding of autoantibody specificities. The nature of
      autoantibodies reactive with various proteins and nucleic acids will be the
      subject of the following articles in this issue. Taken together, these studies of
      antibody-antigen interactions that arise during the autoimmune response have
      revealed novel mechanisms of molecular recognition within the RNP autoantigens.
      These findings are of general importance for understanding basic cellular
      processes and have contributed to our knowledge of the underlying mechanisms of
      immunoregulatory abnormalities that arise in autoimmune diseases.

PMID- 1626072
TI  - Antibodies to snRNPs in systemic lupus erythematosus.
AB  - Antibodies to the Sm and RNP antigens are diagnostic hallmarks in patients with
      systemic lupus erythematosus. Both antigens are located on the U1 snRNP (small
      nuclear ribonucleoprotein particle), a complex of a small RNA and associated
      proteins that carry the antigenic determinants. This particle also plays an
      essential role in messenger RNA processing within the cell nucleus. Newer
      diagnostic techniques are available for detection of anti-Sm and antiRNP
      antibodies (the latter are now more appropriately called anti-U1 RNP antibodies)
      and a great deal of information on the molecular biology of snRNPs is currently
      available.

PMID- 1626073
TI  - Anti-Ro in Sjogren's syndrome and systemic lupus erythematosus.
AB  - Anti-Ro autoantibodies are frequently found in the sera of patients with
      Sjogren's syndrome, systemic lupus erythematosus, and subacute cutaneous lupus
      erythematosus as well as in the sera of mothers of infants with the neonatal
      lupus syndrome. Close associations have been found between anti-Ro and a number
      of clinical manifestations, particularly including hematologic cytopenias, heart
      block, and photosensitive skin rashes. Serologic and genetic associations have
      been found between anti-Ro and anti-La, rheumatoid factor,
      hypergammaglobulinemia, the histocompatibility alleles DQ1 and DQ2, and alleles
      of the T-cell receptor beta chain gene. The origin of anti-Ro and other
      autoantigens is thought to relate to the etiology of Sjogren's syndrome and
      systemic lupus erythematosus and remains the most fundamental unanswered question
      preventing a comprehensive understanding of these diseases.

PMID- 1626074
TI  - Anti-La antibodies.
AB  - Anti-La antibodies usually occur in sera with anti-Ro antibodies and represent
      important serologic markers of Sjogren's syndrome and neonatal lupus
      erythematosus. In addition to their diagnostic and prognostic significance, anti
      La antibodies have proved valuable reagents for molecularly characterizing its
      antigenic target, which is a 47 kD ribonucleoprotein located in the nucleus and
      cytoplasm of mammalian cells. The isotype distribution and fine specificity of
      the anti-La response as well as its associations with HLA-DR and DQ loci suggest
      that these autoantibodies arise by a T cell-dependent, antigen-driven mechanism.
      Further insights into the mechanisms of anti-La production in humans may be
      gained by studying experimental animal models that develop these antibodies
      spontaneously or through induction by various immunization protocols.

PMID- 1626075
TI  - Antibodies to the p70/p80 (Ku) antigens in systemic lupus erythematosus.
AB  - The Ku (p70/p80) autoantigen, a heterodimer consisting of 70 kDa (p70) and 80 kDa
      (p80) protein subunits, is one of a group of DNA-associated autoantigens
      identified as targets of autoantibodies produced by patients with SLE and related
      disorders. Many of these DNA-protein antigens are involved in organizing the
      genome into transcriptionally active (euchromatin) and inactive (heterochromatin)
      domains. The bulk of available evidence indicates that the Ku antigen is also
      involved in organizing the genome, although its precise role remains unclear.
      Molecular cloning of the protein subunits of Ku has revealed that the structure
      of p70 resembles that of certain transcriptional activator proteins, and there is
      some evidence in vitro that Ku may increase transcriptional activity from at
      least two promoters. Moreover, examination of the distribution of Ku in the
      polytene chromosomes of insects suggests an association with transcriptionally
      active chromatin. The DNA-binding domain of Ku has been localized to the C
      terminus of p70, whereas p80 does not appear to bind DNA, and may be involved in
      interactions with other proteins. Epitope mapping and mutagenesis experiments
      have shown that the immunodominant epitope of p70 lies within the DNA-binding
      domain. Surprisingly, this autoepitope is not conserved between humans and mice,
      raising the possibility that the interaction of Ku with DNA might exhibit species
      specific functional differences. At least seven additional autoepitopes have been
      identified on the Ku particle, located on p70, p80, or both subunits.
      Autoantibodies to p70, p80, and DNA are produced tandemly by patients with SLE,
      providing evidence for an antigen-driven immune response targeting the entire Ku
      particle. The multiple specificities of anti-Ku autoantibodies and the tandem
      production of antibodies to the various constituents of the Ku particle are
      consistent with a role of either "molecular mimicry" or "intermolecular help" in
      the generation of autoimmunity to this antigen.

PMID- 1626076
TI  - Antibodies to histones in systemic lupus erythematosus and drug-induced lupus
      syndromes.
AB  - Antihistone antibodies are some of the most frequent autoantibodies in rheumatic
      diseases and can represent useful diagnostic markers in some autoimmune
      syndromes. Histone epitopes are often located in accessible regions of chromatin
      or are conformational determinants resulting from the association of several
      components. These observations and studies with murine models of lupus strongly
      support the view that histones play a direct stimulatory role in triggering
      autoantibody production.

PMID- 1626077
TI  - Anti-DNA antibodies in systemic lupus erythematosus.
AB  - Anti-DNA antibodies are the serologic hallmark of systemic lupus erythematosus
      and important markers for diagnosis and prognosis. Although a number of
      mechanisms for anti-DNA production have been proposed, recent evidence from human
      as well as murine lupus indicate a prominent role of DNA antigen drive. To
      identify further the basis of this response, current research is focusing on the
      structural features of DNA associated with immunogenicity in both the normal and
      autoimmune settings. Elucidating these mechanisms should thus provide insights
      into the pathogenesis of systemic lupus erythematosus as well as the immunologic
      activity of nucleic acids.

PMID- 1626078
TI  - Autoantibodies in scleroderma.
AB  - The antinuclear and antinucleolar antibodies found in patients with scleroderma
      are discussed. Many of the autoantigens have been characterized, the cDNA cloned
      and the epitopes defined. Many of the more common autoantigens are DNA-binding
      proteins, which are very important in transcription and in cell division. The
      clinical significance of the autoantibodies is discussed: their prevalence and
      their relation to disease manifestations and prognosis is examined. The unique
      exclusiveness of the major autoantibodies is discussed. The data on the
      immunoglobulin and IgG subclass is reviewed in relation to the overall concept
      that most autoantibodies in scleroderma patients represent the result of an
      antigen-driven response.

PMID- 1626079
TI  - Acquisition, generalization, and spontaneous use of color adjectives: a
      comparison of incidental teaching and traditional discrete-trial procedures for
      children with autism.
AB  - Incidental teaching and traditional discrete-trial procedures were used to teach
      two children with autism the expressive use of two color adjectives to describe
      preferred toys and food items. The two teaching procedures were performed in a
      classroom setting, and generalization and spontaneous usage were assessed at home
      with parents. The results demonstrated that traditional discrete-trial teaching
      was more efficient and produced faster acquisition and, initially, greater
      generalization. However, by follow-up, the incidental teaching methods resulted
      in equal retention, greater generalization, and equal or greater spontaneous
      usage. The findings indicate that although it takes a longer time for children
      with autism to learn with incidental teaching procedures, once they have acquired
      an ability, it may be more permanent. It is recommended that incidental teaching
      procedures be included in future language development programs for children with
      autism.

PMID- 1626080
TI  - The use of self-management procedures by people with developmental disabilities:
      a brief review.
AB  - Self-management procedures, such as self-monitoring, self-administering
      consequences, and self-instructing, are frequently taught to people with
      developmental disabilities. In this paper, research examining the use of self
      management procedures is reviewed and critiqued. Areas for future investigation
      are discussed.

PMID- 1626081
TI  - Treatment acceptability ratings for sexual offenders: effect of diagnosis and
      offense.
AB  - Case description methodology was used to obtain treatment acceptability ratings
      for mentally retarded and nondisabled (normal) sex offenders across three
      different offenses (masturbation, rape, and child fondling) and eight
      interventions. For both diagnostic groups, social-sexual skills training (SST)
      was the most acceptable treatment except in cases of rape, fondling of a minor,
      and public masturbation. For these offenses, SST was as acceptable as aversive
      treatments and incarceration. The addition of a positive treatment component to a
      preexisting aversive intervention did not result in significantly different
      acceptability ratings relative to ratings of aversive interventions alone.
      Respondent's history as a victim of sexual abuse did not affect treatment
      acceptability ratings for prison, medication, or use of noxious odors.

PMID- 1626083
TI  - Effects of picture referencing on PVC chair, love seat, and settee assemblies by
      students with mental retardation.
AB  - This study examined the effects of two indirect corrective feedback procedures on
      the assembly skills of five secondary students with moderate mental retardation.
      Picture and video referencing conditions, during which the experimenters pointed
      to a picture or video screen following a performance error and requested the
      student do the step again, were more effective than assembly photographs,
      sequenced pictures, sequenced pictures and modeling, and video modeling
      conditions. Picture referencing enabled each participant to independently
      assemble a 13-step, 31-piece chair that required assembly of 45 loose, assembled,
      or loose and assembled parts. Following the introduction of picture referencing
      across two more complex tasks, four students independently completed more complex
      love seat and settee assemblies in fewer trials than required during their
      initial chair assembly. This article discusses the self-correction and self
      management implications.

PMID- 1626082
TI  - Constant time delay with discrete responses: a review of effectiveness and
      demographic, procedural, and methodological parameters.
AB  - Constant time delay, a variation of progressive time delay, is a response
      prompting strategy designed to provide and remove prompts in a systematic manner
      on a time dimension. Constant time delay has two defining characteristics: (a)
      initial trials involve presentation of the target stimulus followed immediately
      by delivery of a controlling prompt; and (b) on all subsequent trials, the target
      stimulus is presented, a response interval of a fixed duration is delivered, the
      controlling prompt is provided, and a second response interval is delivered as
      needed. Reports of 36 studies using the constant time delay procedure with
      discrete behaviors were identified and analyzed. The results are described in
      terms of demographic variables (i.e., the types of subjects, settings, behaviors,
      instructors, and instructional arrangements), and the procedural parameters of
      the strategy. The effectiveness of the strategy and the outcome measures are
      summarized. Finally, the methodological adequacy of the constant time delay
      research is examined. Implications for practice and for further research are
      presented.

PMID- 1626084
TI  - Reduction of multiple aberrant behaviors and concurrent development of self-care
      skills with differential reinforcement.
AB  - A modified functional analysis was used to assess the behavioral function of a
      profoundly retarded man's self-injurious behavior (SIB). Results of that analysis
      showed that the behavior was most likely to occur in a demand context (self-care
      instructions) but was maintained by positive reinforcement in the form of
      attention and physical contact. The results of the functional analysis also
      prescribed a treatment involving differential reinforcement of alternative
      behavior (DRA). Further investigation showed that other aberrant behaviors, such
      as aggression and disruption, were members of the same functional response class
      as SIB. The differential reinforcement of alternative behavior (DRA) procedure
      effectively reduced those behaviors while compliance to a self-care acquisition
      task increased markedly. The results are discussed in terms of the importance of
      determining behavioral function prior to treatment.

PMID- 1626085
TI  - Review of Behavior on a Disk from CMS Academic Software: instructional programs
      for teaching teachers.
AB  - The programs on BOAD represent a set of useful simulations and demonstrations of
      learning phenomena that successfully convey important practical and theoretical
      information to students. The most successful modules deal with shaping and the
      selective effect of positive reinforcement on behavior. The range of examples is
      sufficiently broad to convey the generality of these learning phenomena, but the
      graphics and particular examples are better suited to the college classroom (for
      which they were developed and in which they have received extensive field
      testing) than to the general public, where some users might be distracted by
      working with simulated animal "subjects" or bored by the simple graphics. There
      is a separate application on the disk that drills students on behavioral
      vocabulary, a useful resource for helping to assure that behavioral issues are
      discussed using consistent terminology. Although a single disk is initialized for
      a single user so that individual progress can be tracked accurately in printed
      reports, the cost of a disk is so low that no student who needs to learn about
      teaching would be discouraged from purchasing it. In truth, this is the best deal
      in instructional software I have seen yet.

PMID- 1626086
TI  - [The April Report and its medical implications].

PMID- 1626087
TI  - [The early prognostic assessment of heat stroke].
AB  - We study the clinical characteristics of 21 heat strokes at admittance, to
      analyze the clinical features in relationship with prognosis. 15 patients (71%)
      suffered a classical heat stroke and 6 (29%) an active heat stroke. Global
      mortality was 33%. Sun exposition was more frequent in patients who survived (p
      less than 0.05), fact that we relate with earlier withdrawal from noxa. Patients
      with worse prognosis were showing more frequently coma (p less than 0.05);
      photomotor (p less than 0.01), oculocephalic (p less than 0.01) and corneal (p
      less than 0.01) reflexes abolition; together with disorders in spontaneous and
      induced motility of members (p less than 0.05); areflexia (p less than 0.01) and
      plantar extensor response (p less than 0.05). However the most discriminatory
      parameter between the two groups was the response to cooling, because the outcome
      was always fatal when cooling did not take place (p less than 0.01). From the
      analytical standpoint, serum bicarbonate was lower in the patients who died (p
      less than 0.05). We insist in the need to start prevention and treatment programs
      in those communities with high incidence of this syndrome.

PMID- 1626088
TI  - [A Staphylococcus haemolyticus study in urinary infections. An analysis of 8
      cases].
AB  - Urinary infections caused by Staphylococcus are attributed usually to
      Staphylococcus epidermidis or Staphylococcus saprophyticus. 8 cases of urinary
      infection due to S. haemolyticus are discussed: 5 adults all of them over 66
      years, diagnosed respectively of diabetes, cancer and stroke. Three children
      diagnosed of febrile syndrome, encephalopathy and enterocolitis associated with
      urinary infection. S. haemolyticus was identified through the determination of 19
      biochemical parameters. The antibiograms performed showed that all S.
      haemolyticus isolated were sensible to vancomycin, nitrofurantoin and
      trimethoprim/sulfamethoxazole. It is concluded that S. haemolyticus is an
      opportunistic pathogen that is present on immunodepressed hosts, that is why is
      advisable to perform a more in-depth characterization of the S. epidermidis
      isolated in urine, especially in persistent pathologic processes.

PMID- 1626089
TI  - [Humoral immunity following splenectomy in adults].
AB  - Humoral immunity was examined in a population of one hundred adult patients
      splenectomized after abdominal trauma without associated disease, and the results
      were compared with those observed in healthy individuals. We found, in addition
      to the disorders, a large increase in the seric concentration of total IgE, and
      increased presence of autoantibodies and circulating immunocomplexes. These
      alterations were not correlated with the asplenia period.

PMID- 1626091
TI  - [Acute suppurative thyroiditis and Klebsiella pneumoniae sepsis. A case report
      and review of the literature].
AB  - The acute suppurative thyroiditis is a rare infection. It affects specially
      patients with preexisting thyroid gland pathology and its frequency is higher in
      women. In childhood it's linked to local anatomic defects. The infection used to
      be located in left thyroid lobe and it's much less usual in right lobe, in both
      or in isthmus. The most important causal microorganisms are staphylococci
      (Staphylococcus aureus overcoat) and streptococci (usually Streptococcus pyogenes
      and Streptococcus pneumoniae), with frequent isolation of mixed flora and
      anaerobes in the last reported cases. We present the case of a male patient,
      without previous thyroid disease, who suffered an acute suppurative thyroiditis
      and Sepsis due to Klebsiella pneumoniae, with right lobe abscess and secondary
      septic focus formation (kidneys, spleen, lungs), with fatal course despite of
      medical treatment, favoured or precipitated by the development of serious
      alcoholic abstinence.

PMID- 1626090
TI  - [Cryptococcosis in AIDS patients: a study of 19 cases].
AB  - We discuss 19 cases of infection due to Cryptococcus neoformans diagnosed in 438
      AIDS patients admitted to our center (4%). Fourteen of them showed meningitis
      confirmed by culture of C. neoformans in CSF. Clinical features were rather
      unspecific and disorders in CSF parameters were non striking. The diagnostic
      techniques performed with best results were culture of C. neoformans and antigen
      determination, especially in serum. Survival probability at one year was 75%.
      Treatment response was good. Treatment with fluocytosine did not seem to provide
      additional benefits versus amphotericin alone, neither in respect to clinical
      evolution nor regarding survival probability at one year. Fluconazole has shown
      effectiveness in maintenance therapy, being not be possible to evaluate it as an
      acute phase therapy because the low number of cases in which it was studied. It
      is advisable to follow a suppressive treatment, having found a 10% relapse rate
      in patients following therapy and a 50% in those who interrupted it.

PMID- 1626092
TI  - [A 78-year-old man with pain and tumefaction in the right ankle].

PMID- 1626093
TI  - [Clinical management].

PMID- 1626094
TI  - [Paraneoplastic arthritis as the first manifestation of a hypernephroma].

PMID- 1626095
TI  - [An adverse reaction to proglumetacin].

PMID- 1626096
TI  - [The tuberculin test].

PMID- 1626097
TI  - [Rectal melanoma and von Recklinghausen's disease].

PMID- 1626098
TI  - [Acute ascites as an isolated manifestation of an episode of systemic lupus
      erythematosus].

PMID- 1626099
TI  - [Tussigenic crisis, bronchial hyperreactivity and enalapril].

PMID- 1626100
TI  - [Pyogenic liver abscess. Its exclusive treatment with antibiotics].

PMID- 1626102
TI  - [Visceral leishmaniasis in immunosuppressed patients].

PMID- 1626101
TI  - [The cytosolic concentrations of CAM26 and CAM29 in breast tumors classified
      according to the clinical stage].

PMID- 1626103
TI  - Epidemiology of occupational reproductive hazards: methodological aspects.
AB  - Both male and female workers may be exposed to occupational agents which affect
      their reproductive processes. Reproductive outcomes are important in their own
      right, for example teratogenic effects and impaired neurological development. In
      addition, reproductive impairment may indicate germ cell mutation, which has far
      reaching implications. Research into reproductive effects is beset with pitfalls.
      Applying the results of toxicological research may be suggestive, but such
      extrapolation is very unreliable owing to profound differences in reproductive
      and/or toxicological mechanisms. Epidemiological data are therefore
      indispensable. Optimal methods of data collection and study design, comparable
      with similar studies of other populations, are essential. Otherwise reliable
      conclusions cannot be drawn, and this is a waste of resources and of the work and
      cooperation of everyone who participates in the research. In considering study
      design, the key question is the measurement (or minimally, the accurate
      description) of exposures, which is more problematic than the ascertainment of
      reproductive outcome variables. From the viewpoint of exposures, case control
      studies have the same disadvantage as studies of the general population, that
      exposures are heterogeneous, and most specific exposures are therefore rare, even
      in a large study; in addition, measurement is particularly difficult in this
      situation. Occupationally defined populations have the corresponding advantages
      of relative homogeneity and availability of data, although even here numerous
      problems exist, which are well known. Outcomes can be assessed by means of
      biological or questionnaire-based methods. They are best regarded as
      complementary, as each has its strengths and weaknesses.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1626104
TI  - Epidemiology of respiratory hazards: recent advances.
AB  - A bibliographical review of epidemiological studies published over the last five
      years has led us to individualize the themes that have been the subject of most
      recent publications (Table I). These research themes are not new, which shows a
      certain continuity in epidemiological research on the respiratory risks of
      occupational origin. Few studies are devoted to the identification of
      unrecognized respiratory risks; nevertheless, the methodology used, the
      indicators of effects studies contribute to a better knowledge of the respiratory
      effects of known occupational exposure factors. Among these effects, exposure to
      asbestos, silica, isocyanates and organic dusts is frequently referred to in most
      publications. Smoking habits are more and more taken into consideration in these
      studies. The themes retained and the publications cited here are not exhaustive,
      and this bibliographical review does not pretend to represent a complete
      appraisal of recent developments of the epidemiological respiratory risks of
      occupational origin.

PMID- 1626105
TI  - Methodological problems of time-related variables in occupational cohort studies.
AB  - In studies of long-term health effects of occupational exposures it is important
      that the time patterns of the study exposure and of the relevant confounders
      should be taken into account in the analysis. The time-related confounders that
      have been most frequently considered include age at risk, calendar period,
      duration of employment, length of follow-up, and employment status (active or
      retired). These factors are related to the healthy worker effect which is more
      pronounced among active workers, and declines with length of follow-up. Thus,
      these time-related factors are potential confounders in occupational cohort
      studies (and in nested case-control studies). It is therefore advisable to
      routinely control for length of follow-up and employment status, in addition to
      the usual confounding factors of age at risk and calendar period. However, it
      should be stressed that this approach will minimise, but not eliminate,
      confounding due to the healthy worker effect. In particular, direct control for
      employment status is inadvisable if this constitutes an intermediate variable in
      the pathway between exposure and disease, and more complex analytical procedures
      are necessary in such situations. It is also important that the principle
      exposure under study should also be analyzed in a time-related manner, taking
      account of the likely induction and latency periods, and the relative etiological
      importance of exposure intensity, exposure duration and cumulative exposure. The
      simplest approach is to analyse the cumulative exposure in a time-related manner,
      and this may suffice when the aim is merely to consider whether or not there is
      an effect of exposure. However, once it has been provisionally assumed that an
      effect exists, attention then shifts to understanding the nature of the effect.
      In this context, the temporal pattern of exposure and outcome can be considered
      by examining the effects of exposures in specific time windows while controlling
      for time-related confounders, and for the effects of exposures in other time
      windows. A more sophisticated approach is direct fitting of a theoretical model
      of carcinogenesis, such as the Armitage-Doll or Moolgavkar models. However, it
      should be emphasized that occupational cohort studies only rarely have sufficient
      numbers, and data of sufficient quality, to permit meaningful conclusions to be
      drawn from more sophisticated analyses of this type.

PMID- 1626106
TI  - Electromagnetic fields and cancer risks.
AB  - Cancer was first associated with exposure to electromagnetic fields (EMF) in 1979
      when Wertheimer and Leeper reported that children dying from cancer resided more
      often in homes believed to be exposed to higher EMF than did healthy control
      children. The risks were as high as 2.23 (1.56-3.18) 3.09 (1.68-5.71) for all
      cancers, 2.98 (1.72-5.15) for leukemia and 2.40 (1.08-5.36) for brain cancers.
      Wire configuration around houses was used as a surrogate for direct EMF exposure
      measurements. Wertheimer's finding of an association between cancer and wire
      configuration around houses has been replicated in two recent studies. However,
      direct measurement of EMF fields in houses of cancer children have not yielded
      the same results as the wire configuration around houses, thereby jeopardizing
      the hypothesis of an association between EMF and cancer. To comprehend the
      putative association between residential exposure to EMF and childhood cancer,
      one would have to understand what is hidden behind the notion of 'wire
      configuration' around the house. In parallel with residential studies, scores of
      studies were conducted among workers occupationally exposed to EMF. What have we
      learned from these occupational studies? Hypotheses generating and case control
      studies have revealed the existence of an excess risk of leukemia among
      electrical workers. Pooled results have estimated the risk for all leukemia to be
      1.18 (1.09-1.29) and for acute myeloid leukemia 1.46 (1.27-1.64). An increased
      risk of leukemia among electrical workers does not necessarily mean that EMF is a
      causal agent, other chemicals such as benzene, creosote, solvent, could possibly
      account for it but this has yet to be confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626107
TI  - Uses of biochemical and biological markers in occupational epidemiology.
AB  - The use of biochemical or biological markers is increasing in cancer
      epidemiology, but the rationale for their introduction is not always clear, i.e.
      it has not been established when and how their use is scientifically justifiable,
      ethically correct and cost-effective. There is an entire range of indications for
      biomarkers, from the use of very specific measurements aimed at single molecules,
      to measurements indicating cumulative exposure to agents with the same mechanism
      of action. The following are some potential uses of markers in occupational
      epidemiology: 1) exposure assessment in cases in which traditional epidemiologic
      tools are insufficient (particularly for low doses and low risks; 2) multiple
      exposures or mixtures, in which the aim is to disentangle the etiologic role of
      single agents; 3) estimation of the total burden of exposure to chemicals having
      the same mechanistic target; 4) investigation of pathogenetic mechanisms; 5)
      study of individual susceptibility (e.g. metabolic polymorphism, DNA repair).
      Examples are discussed together with methodological limitations.

PMID- 1626108
TI  - Epidemiology of occupational neurobehavioural hazards. Methodological experiences
      from organic solvent research.
AB  - Neurobehavioral hazards have been identified since long in occupational health,
      e.g. lead, mercury, certain solvents, and many others agents. There are reviews
      and books on "Occupational neurology" or "Prevention of neurotoxic illness in
      working populations". Many methods have been applied for studies of the central
      and peripheral nervous systems in humans: registered diagnoses, questionnaire
      ratings, clinical evaluation, psychometric tests, neurophysiological and
      neuroradiological methods, cerebrospinal fluid components etc. Some neurological
      disorders are well defined, while neuropsychiatric syndromes often are less
      precisely diagnosed. Decreased subclinical test results in exposed groups might
      predict an increased risk for later, more serious disorders but the longitudinal
      information on clinical importance is often lacking. Some historical lessons from
      the epidemiology of occupational neurology will be repeated and a few reflections
      on the suitability of different diagnostic entities for epidemiological research
      shall be made. Since the beginning of the 1970s' a number of studies from the
      Scandinavian countries have demonstrated long-term neurobehavioral effects from
      working conditions with relatively moderate exposure to organic solvents. Similar
      findings have been verified in studies from some countries outside Scandinavia
      while other studies have been inconclusive. Those results have caused
      considerable controversy and have been discussed at international conferences and
      in scientific journals. Very different outcomes have been investigated in those
      solvent studies, however, and most studies have had a cross-sectional design with
      inherent problems. The exposure has been assessed in different ways, e.g. by
      years of occupation, hygienic measurements of the present working conditions,
      biological monitoring, retrospective assessments on qualitative or semi
      quantitative scales. Sometimes single solvent exposures have been studied but
      most of the studies concern mixtures of solvents from aromatic and aliphatic
      hydrocarbons. As the designs have varied the exposure assessment has been crude
      and many different outcomes have been studied, it is hardly surprising that the
      results and the interpretations have differed. The first results from a
      comprehensive investigation on 135 solvent exposed painters and 71 carpenters as
      referents, selected from active members of the respective trade union 1965-70 and
      investigated in the late 80s, will be presented. Clinical, including psychiatric,
      diagnostic work up and neuropsychological as well as neurophysiological tests
      have been performed. Psychological test results from military conscripts at age
      19 were available for all. The individual exposure history has been carefully
      assessed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1626109
TI  - [An autopsy study of patients who died at the Medical Clinic of the University of
      Siena from 1986 to 1989].
AB  - In the past twenty years autopsies are performed much less frequently in the
      elderly than in younger patients. The clinical diagnostic error rate documented
      by autopsy studies ranges from 6% to 68%. We analyzed the clinical and autopsy
      records of 214 patients who died from 1 January 1986 to 31 December 1989 at our
      Institute to determine the accuracy of clinical cause of death with respect to
      the pathologic cause of death. The most common cause of death were
      bronchopneumonia (25.2%) followed by gastroenteric and lung cancer (20%),
      cerebrovascular accident (15.8%), myocardial infarction (8%) and pulmonary
      embolism (7.4%). Pulmonary embolism was correctly classified only in 25% of
      patients. The most accurately diagnosed condition were neoplastic diseases (88%)
      and cerebrovascular accident (84.8%) while bronchopneumonia were correctly
      diagnosed antemortem in 72.2% of the patients studied. Our data suggest that
      advances in diagnostic technology have not reduced the value of the autopsy and
      that a goal-directed autopsy remains a vital component in the assurance of good
      medical care.

PMID- 1626110
TI  - [The relationships between the lipoprotein profile and rheological-coagulation
      parameters in patients with hyperlipoproteinemia type II].
AB  - The aim of the study was to evaluate the direct influence of lipid parameters
      (total and HDL-cholesterol, triglycerides and total lipids) on the rheologic
      coagulative pattern. We studied blood rheological properties--blood (BV),
      plasmatic (PV), and seric (SV) viscosity, whole blood (WBF) and red cell (RCF)
      filterability--and some coagulative factors--fibrinogen (Fib), levels of clotting
      factor VII (fVIIc) and VIII (fVIIIc) activity--in 156 men aged 40-54 years; 87
      patients had type II hyperlipoproteinemia (46 type IIa and 41 type IIb) and 69
      were normolipemic controls. Smokers, patients with arterial hypertension,
      diabetes mellitus or cardiovascular clinical manifestations were excluded. Type
      IIb hyperlipoproteinemic patients had increased blood viscosity (shear rate 225
      sec-1, p. less than 0.01), which was positively correlated with triglycerides and
      fibrinogen concentration. Levels of fibrinogen, fVIIc and fVIIIc activity did not
      differ significantly in hyperlipemic patients and controls, although fVIIc
      activity and fibrinogen were both positively related with lipid parameters. These
      data suggest that, in absence of other major risk factors, the alterations of the
      rheologic-coagulative pattern are mainly dependent on the severity of the lipid
      disorder.

PMID- 1626111
TI  - Hyperosmolar hyperglycemic nonketotic coma in Waldenstrom's macroglobulinemia
      associated with type II diabetes and complicated by pulmonary tuberculosis.
AB  - In this paper we describe a successfully treated case of hyperosmolar
      hyperglycemic non ketotic coma (HHNC). The HHNC was observed in a patient
      affected by Waldenstrom's macroglobulinemia, associated with type II diabetes and
      complicated by pulmonary tuberculosis. Hyperosmolar hyperglycemic nonketotic coma
      is a clinical condition with a high mortality rate associated with a severe
      increase in blood viscosity. This increase in blood viscosity justifies several
      clinical manifestations of the HHNC. We believe that an increase in the blood
      viscosity produced by the simultaneous presence of the single diseases mentioned
      above may have encouraged the development of hyperosmolar coma in the case
      reported.

PMID- 1626112
TI  - [Jaccoud's postrheumatic arthritis. A clinical case report].
AB  - The authors describe a case of Jaccoud's arthropathy, a very rare disease of
      unknown pathogenesis, that can develop in patients after repeated attacks of
      rheumatic fever. Clinical pictures with analogous features can be found
      associated with many other pathological processes, such as connective tissue
      diseases or cancers. The case presented here is interesting for the diagnostic
      and therapeutic mistakes made, probably because it is an illness very little
      known and with ambiguous clinical features.

PMID- 1626113
TI  - [Polymyalgia rheumatica and malignant neoplasms. A report of 3 cases].
AB  - Polymyalgia rheumatica (PMR) is an inflammatory disease which mainly affects
      elderly patients and is highly responsive to steroid therapy. PMR can be
      associated with giant cell arteritis and, less frequently, with malignancy. The
      authors describe three cases of paraneoplastic PMR. In one patient PMR has been
      the initial manifestation of a B-cell non-Hodgkin lymphoma, in two of a malignant
      neoplasm of the gastrointestinal system. In two patients the response to steroid
      therapy was documented. A careful clinical evaluation and a long term follow-up
      is needed before considering PMR an idiopathic disease.

PMID- 1626114
TI  - [The nonspecific bronchial stimulation test with methacholine and an ultrasonic
      mist of distilled water: which is to be preferred in the military sphere?].
AB  - The authors compare the methacholine (Mch) and the nebulized ultrasonic distilled
      water (NUDW) bronchial challenge as regard sensitivity and time required to
      perform them. For military service fitness, were studied 24 asthmatic patients.
      Each subject performed random a bronchial challenge by Mch (Yan method) and by
      NUDW (Allegra method) in two different days; for each bronchial challenge has
      been measured the time required to perform it. The atopic status has been
      evaluated by skin-prick test. All the subjects have shown a positive response to
      Mch test (PD 20 FEV1 mean: 352 mcg, range 80-850) whereas 13 subjects (54%) have
      shown a positive response to NUDW. The time required to evaluate all the subjects
      by Mch test has been 199.5 minutes whereas the total time required to evaluate
      all the subjects by NUDW test (127 minutes) and to evaluate by Mch test the non
      responders to NUDW (100 minutes) has been 227 minutes. The most of subjects were
      skin reactors. No difference was found as regard onset of disease, basal lung
      function and atopic status between responders and non responders to NUDW test. We
      conclude that NUDW test has shown a lack of sensitivity in this sample (50% of
      asthmatic patients could be misdiagnosed) and that the Mch test is preferable to
      determine a rapid method for measurement of bronchial responsiveness.

PMID- 1626115
TI  - [The role of clinical, biochemical and echographic data in identifying the
      biliary pathogenesis of acute pancreatitis].
AB  - The role of clinical (biliary pain and/or jaundice), laboratory (discriminant
      function (DF) calculated using AST, ALT, AlkPh and GGT serum values) and
      ultrasonographic (US)(dilation and/or stone of common bile duct (CBD)) findings
      in identification of the biliary etiology of acute pancreatitis (AP) was studied
      in 60 patients. AP biliary etiology was defined by ERCP executed in the early
      phase of the disease (lithiasis and/or stenosis of CBD; endoscopic features of
      forced papilla in patients with gallstone). US showed the best values of
      sensitivity (84.6%) and diagnostic efficacy (76.7%); DF showed the best results
      of specificity (62.5%) and of test positive predictive value (92.8%). The
      statistical evaluation (McNemar test) showed a significant increase of
      sensitivity for US vs clinical findings and of specificity for DS vs clinical
      findings (p less than 0.05). The sensitivity, specificity, accuracy, test
      negative and positive predictive value were improved to 96.1, 87.5, 96.6, 77.1
      and 92% by the combination of US and DF. Therefore the association of US and DF
      can provide the best non invasive method in rapidly detecting CBD pathology as an
      etiological factor in AP and then the enough accurate indication to early
      operative ERCP.

PMID- 1626116
TI  - [The clinical implications of the use of an amino acid mixture without tryptophan
      in liver cirrhosis].
AB  - The ingestion of an amino acid mixture lacking tryptophan causes a rapid fall of
      plasma tryptophan in healthy subjects. This is because amino acids elicit protein
      synthesis and endogenous tryptophan is incorporated into new proteins. If protein
      synthesis is the mechanism through which tryptophan-free solution decrease blood
      tryptophan, it may be interesting to study tryptophan levels after a tryptophan
      free mixture in subjects with impaired protein synthesis. In the present paper we
      show that in 27 cirrhotics the administration of a tryptophan-free solution
      caused a fall of total plasma tryptophan that began significantly later than in
      14 control subjects, the delay being significantly proportional to the severity
      of the disease. The difference between control and cirrhotic subjects was due to
      the bound fraction of plasma tryptophan. The diagnostic and clinical usefulness
      of our findings are discussed.

PMID- 1626117
TI  - [The dietary protein contribution and hepatic encephalopathy in cirrhosis].
AB  - Hepatic encephalopathy is a neuropsychiatric syndrome, which can occur in the
      clinical course of acute (fulminant) or chronic hepatic failure of various
      aetiology; reversible metabolic abnormalities without neuronal structural changes
      are frequently found in this condition. High blood ammonia levels, an imbalance
      between plasma concentrations of branched-chain and aromatic amino acids, false
      neurotransmitters and neurotransmitters receptor changes in CNS are the commonly
      recognized pathogenetic mechanism of this syndrome. Protein malnutrition is a
      frequent occurrence in liver cirrhosis, especially of alcoholic aetiology. High
      protein diets may precipitate hepatic encephalopathy; protein restriction leads
      to malnutrition and enhances a negative nitrogen balance. Several clinical
      studies have shown that vegetable proteins are tolerated better than animal in
      patients with liver cirrhosis and chronic portal-systemic encephalopathy:
      encephalopathy index is usually lower after vegetable-protein than animal-protein
      diet. The favourable therapeutic effect of vegetable diets on nitrogen metabolism
      can be mainly accounted for by the increased intake of dietary fibers and
      increased incorporation and elimination of nitrogen in fecal bacteria. Mixture of
      amino acids enriched with branched-chain amino-acids may contribute to maintain a
      positive nitrogen balance and minimize muscle wasting in cirrhotics.

PMID- 1626118
TI  - Prenatal diagnosis of inherited hemoglobinopathies.
AB  - This paper reviews the techniques presently available for the prenatal diagnosis
      of inherited hemoglobinopathies. At the present time, mutations of the globin
      genes are detected directly in trophoblast DNA, enzymatically amplified by
      polymerase chain reaction. Known mutations may be defined by restriction
      endonuclease digestion, non denaturing gradient gel electrophoresis, allele
      specific oligonucleotide probes or allele specific oligonucleotide primers.
      Unknown mutations are detected by denaturing gradient gel electrophoresis
      followed by direct sequencing. Other potentially useful methods for unknown
      mutations are single strand conformation polymorphism analysis and chemical
      mismatch cleavage analysis. A potential pitfall for all procedures based on
      analysis of amplified DNA is the coamplification of maternal sequences. This may
      be avoided by a careful dissection of maternal decidua from fetal trophoblast, by
      using an amount of chorionic villi not inferior to 5-10 mg and by reducing the
      number of amplifying cycles to approximately 20. Monitoring the presence of co
      amplified maternal sequences by the analysis of polymorphic sequences is strongly
      recommended. Future perspectives consist of preimplantation diagnosis by biopsy
      of the morula or blastula or ova genotyping by analysis of the second polar body.

PMID- 1626119
TI  - [Current views of thalassemia intermedia].
AB  - Recently the molecular bases of thalassemia intermedia have been elucidated in
      several populations. In general this attenuated, non-transfusion dependent form
      of homozygous beta-thalassemia is mainly determined by a) the co-inheritance of
      deletion alpha-thalassemia; b) the presence of the so-called mild beta
      thalassemia mutations; and more rarely, c) the inheritance of genetic conditions
      able to enhance the gamma-globin chain expression in adult life. Although there
      are several complex genetic and acquired interactions involved in the wide
      clinical heterogeneity of thalassemia intermedia, data in Italians indicate a
      definite genotype-phenotype relationship in conditions such as the co-inheritance
      of at least two alpha-thalassemia genes in severe and mild homozygous beta
      thalassemia; the molecular homozygosity or double heterozygosity for the -87, 
      101 and IVS1(nt6) beta(+)-thalassemia mutations; and the coexistence of
      structural gamma-globin gene defects, i.e. Sicilian and Sardinian delta beta
      thalassemias, deletional and non-deletional hereditary persistence of fetal
      hemoglobin and the polymorphism for the -158 XmnI G gamma restriction site.
      Thalassemia intermedia resulting from the inheritance in heterozygous beta
      thalassemia of triple alpha-globin gene complex or the presence of dominant beta
      thalassemia is also described and the role of these new informations in genetic
      counselling is discussed.

PMID- 1626120
TI  - Transient monocular blindness in a patient with giant-cell arteritis.
      Pathogenetic and therapeutic considerations.

PMID- 1626121
TI  - Postoperative elevations of serum interleukin 6 and group II phospholipase A2:
      group II phospholipase A2 in serum is an acute phase reactant.
AB  - Elevations of serum immunoreactive interleukin 6 (IL-6) and Group II
      phospholipase A2 (M-PLA2) were observed without exception after elective
      surgeries for various sites. Serum IL-6 rose steeply after surgery, and reached
      the maximum level on the 1st postoperative day. Serum M-PLA2 increased from the
      1st postoperative day and reached the maximum level on the 2nd postoperative day
      in 10 patients (76.9%), on the first day after surgery in 2 patients and on the
      3rd day in one patient. The peak serum M-PLA2 after surgery was significantly
      correlated with the peak IL-6 and blood loss volume during surgery. These results
      suggested that serum M-PLA2 is an acute phase reactant.

PMID- 1626122
TI  - Enhanced mobilization of hepatic cadmium in mice upon coadministration of an N, N
      disubstituted dithiocarbamate and an alkyl monoester of dimercaptosuccinate.
AB  - Oral (po) administration of mono-iso-amyl (2,3-dimercapto) succinate (Mi-ADMS),
      0.5 mmol/kg for three consecutive days, to mice previously injected with cadmium
      (Cd) chloride reduced the whole body Cd burden 34%. Intraperitoneal (ip)
      administration of N-iso-amyl-N-glucaminedithiocarbamate (i-AmGDTC) by the same
      regimen reduced total body Cd 41%. Coadministration of the two compounds reduced
      the whole body Cd burden 60% (p less than 0.05). The liver Cd concentration was
      reduced 56% and 50%, respectively, by Mi-ADMS given po and i-AmGDTC given ip,
      each at 0.5 mmol/kg for three consecutive days. Coadministration of the two
      chelators reduced the liver Cd concentration 90% (p less than 0.05). The kidney
      Cd concentration was reduced 10% by Mi-ADMS alone, and 60% by i-AmGDTC alone, but
      there was only a 47% reduction when the two chelators were coadministered,
      probably as a result of redistribution of mobilized hepatic Cd to the kidneys. As
      50-55% of the administered Cd is sequestered in the liver in this mouse model, it
      is concluded that coadministration of the two chemical classes of Cd complexing
      agents may offer a therapeutic advantage over administration of either agent
      alone.

PMID- 1626123
TI  - Enantiomeric interaction in the sulfate conjugation of the beta 2-agonist drug
      albuterol by the human liver.
AB  - Sulfate conjugation of the pure enantiomers of albuterol was compared to that of
      racemic drug using the 100,000g cytosol of four human livers as the catalyst.
      Whereas a trend towards a lower Kmapp was seen for sulfation of (-)-compared to
      (+)-albuterol, there was no enantiomeric difference in Vmaxapp. However, when the
      sulfation of racemic albuterol was compared to that of its pure enantiomers,
      there was a marked suppression of the reaction. This was due to a reduction in
      Vmaxapp by about 75% (p less than 0.01) with no difference in Kmapp. Thus, an
      enantiomeric interaction occurs in the sulfoconjugation of albuterol, which must
      be taken into account when evaluating the pharmacokinetics of the individual
      enantiomers following racemic drug administration.

PMID- 1626124
TI  - Nephrotoxicity of thiazoles structurally related to thiabendazole in mice
      depleted of glutathione by treatment with buthionine sulfoximine.
AB  - In mice depleted of glutathione (GSH) by treatment with DL-buthionine sulfoximine
      (BSO), thiabendazole [2-(4'-thiazolyl)benzimidazole, TBZ] produces renal damage
      characterized by increases in relative kidney weight and serum urea nitrogen
      (SUN) concentration. Several thiazole and benzimidazole compounds related to TBZ
      were examined for the ability to cause nephrotoxicity in mice pretreated with
      BSO. 4-Methyl- and 4-phenylthiazoles were highly effective compounds. In the
      absence of BSO, 4-methylthiazole resulted in no nephrotoxicity; inhibitors of
      hepatic and renal cytochrome P-450 enzymes such as methoxsalen and piperonyl
      butoxide prevented the nephrotoxicity of 4-methylthiazole given in combination
      with BSO. In addition, there was a sex difference in the nephrotoxicity of 4
      methylthiazole in combination with BSO; the nephrotoxicity was observed only in
      males. These features of nephrotoxicity of 4-methylthiazole are well in accord
      with those of TBZ previously reported. This suggests that TBZ and 4
      methylthiazole share a common mechanism of nephrotoxicity.

PMID- 1626125
TI  - Influence of a combination of ritodrine and nifedipine on the isolated rat
      uterus.
AB  - Studies were undertaken to evaluate the efficacy of the beta 2-adrenergic agonist
      ritodrine and the calcium channel blocker nifedipine, alone and in combination,
      for inhibition of contraction in isolated rat uterine strips. Both compounds
      produced a dose-dependent reduction of area under the curve. When contractions
      were produced by oxytocin, a 26% reduction was observed with 0.144mcg of
      ritodrine and a significant 68.1% decrease was produced with 1.44mcg of
      ritodrine. Contraction frequency (contractions per ten minutes) was not
      significantly affected. Prostaglandin F2 alpha-induced contractions were
      significantly inhibited 27.1% and 62.2% by 1.44mcg and 14.4mcg of ritodrine,
      respectively. Also, contraction frequency was significantly affected by both
      concentrations. Inhibition of area under the curve of oxytocin-induced
      contractions produced by nifedipine was 39.3% for 0.05mcg and 78.4% (P less than
      0.05) for 0.50mcg. Contraction frequency was unaffected. Prostaglandin F2 alpha
      induced contractions were significantly attenuated by 60% and 86% with nifedipine
      (0.50mcg and 5.02mcg, respectively); contraction frequency was significantly
      reduced from 15 to 2 contractions per ten minutes by 5.02mcg. Oxytocin-induced
      contraction was attenuated 39.8% by a combination of ritodrine 0.144mcg and
      nifedipine 0.05mcg; contraction frequency was unaffected. Area under the curve
      and contraction frequency of oxytocin-induced contractions were significantly
      decreased by a combination of ritodrine 0.144mcg and nifedipine 0.50mcg (89.8%
      reduction; decrease in frequency from 12 contractions in control to 4
      contractions post-inhibitory agent). Significant attenuation of prostaglandin F2
      alpha-induced contractions was produced by ritodrine 1.44mcg and nifedipine
      0.50mcg. Area under the curve decreased by 73.2% and frequency was reduced from
      13 to 8 contractions. A combination of ritodrine 1.44mcg and nifedipine 5.02mcg
      also produced significant decreases in area under the curve (85.3%) and frequency
      (13 contractions in control to 1 contraction after compounds were added). Because
      the mechanisms of action of these two agents are different, it is reasonable to
      suggest that they be used in combination to control premature labor. The results
      of this study suggest they may provide inhibition of contraction superior to
      either agent alone, and could therefore provide more effective inhibition and
      possibly reduce untoward side effects common to ritodrine therapy.

PMID- 1626126
TI  - Effect of fenofibrate on the tail artery contraction of rats fed with an
      atherogenic diet.
AB  - The feeding of rats by an atherogenic diet for 4 weeks modified the postsynaptic
      effect of noradrenaline in the perfused rat tail artery. When fenofibrate (100
      mg/kg p.o.) was administered simultaneously, with an atherogenic diet, at the
      first onset of the experiment this effect was completely inhibited, while when it
      was administered from the 15th day of the experiment it had no effect on
      vasoconstrictor responses to noradrenaline. The atherogenic diet decreased the
      contraction of the rat tail artery at the lower concentrations (3 x 10(-8) - 3 x
      10(-7) M) and increased vasoconstrictor response to a maximal concentration (10(
      5) M) of noradrenaline. These results suggest that fenofibrate can prevent the
      changes in the contractile profile of an isolated atherogenic rat tail artery.

PMID- 1626127
TI  - Modulation of hepatic and pulmonary drug-metabolizing enzyme activities of
      rabbits by dietary cholesterol.
AB  - Modulation of the activities of drug-metabolizing enzymes by dietary cholesterol
      was studied in rabbits. In male rabbits fed a 1.5% cholesterol-diet, an elevated
      levels of serum cholesterols and triglycerides were observed from the early phase
      of cholesterol-feeding. At 12 weeks after the onset of cholesterol feeding, a
      marked increase was observed in the wet weights of livers but not of lungs, while
      total contents of lipids and cholesterols were elevated in both tissues in
      cholesterol-fed animals. The content of collagen was increased significantly in
      livers, but not in lungs and the phase I drug-metabolizing enzyme activities were
      significantly reduced in livers but remained unchanged in lungs by cholesterol
      feeding. On the other hand, the phase II drug-metabolizing enzyme activities
      varied depending on the enzymes in both tissues. The results demonstrate that
      dietary cholesterol induces different effects on rabbit liver and lung and that
      the modulation of the hepatic enzymes by dietary cholesterol in rabbits differs
      from that in rats, mice and guinea pigs in which the activity of the enzymes are
      elevated by dietary cholesterol.

PMID- 1626128
TI  - Effects of 2,5-dimethylpyrazine on reproductive and accessory reproductive organs
      in female rats.
AB  - The effects of 2,5-dimethylpyrazine on reproductive and accessory reproductive
      organs in female rats were studied. Following the administration of 2,5
      dimethylpyrazine, uterus weight was significantly decreased while ovary weight
      was not affected, nor was there any influence on serum level of estradiol. The
      increase of uterine weight observed following estradiol injection after
      ovariectomy was inhibited by 2,5-dimethylpyrazine pretreatment. The uptake of 3H
      estradiol into the uterus was also significantly decreased by 2,5
      dimethylpyrazine. On the other hand, chlorpromazine administration resulted in
      significant decrease in ovary and uterus weight as well as serum estradiol level.
      These results suggest that 2,5-dimethylpyrazine may have direct inhibitory action
      on the uterus of rats.

PMID- 1626129
TI  - CO uptake kinetics of red cells and CO diffusing capacity.
AB  - The rate at which CO displaces oxygen from combination with hemoglobin in intact
      red cells was measured spectrophotometrically in whole blood thin films that
      minimize unstirred layer extra-cellular diffusion barriers. A step-change was
      made in CO tension from zero to one of four values (2, 7, 21 and 70 Torr) during
      a constant background of one of eight O2 tensions (0, 40, 70, 100, 153, 214, 285
      and 428 Torr). For PO2 greater than 100 Torr measured red cell initial CO uptake
      rates were compared with calculated rates at the same PCO-PO2 based on the Gibson
      Roughton rate equation (Gibson and Roughton, Proc. R. Soc. B 143: 310-334, 1955)
      for a well mixed Hb solution. Measured CO uptake rates expressed as initial rate
      of saturation change (delta S/delta t) quantitatively followed the theoretical
      rate equation (time in seconds) [sequence: see text] These measurements provide
      new values for theta CO, the specific conductance of whole blood (ml.min-1.Torr
      1; PCO, PO2 in Torr): [sequence: see text] These results signify that in vivo, in
      normoxia and hyperoxia, red cell CO uptake rate is wholly reaction rate limited
      and that pulmonary capillary red cell CO diffusion equilibrium is rapidly
      achieved. The Bohr-Krogh assumption that red cell PCO = 0 during CO uptake is
      untrue.

PMID- 1626130
TI  - Ventilation and gas exchange during sustained exercise at normal and raised CO2
      in man.
AB  - Five subjects underwent each of three protocols for 43 min: (A) at rest; end
      tidal PCO2 was held constant at 2-5 Torr above resting values; (B) during 70 Watt
      bicycle exercise; PETCO2 was uncontrolled; (C) during 70 Watt exercise; PETCO2
      was held 2-5 Torr above exercising values. During all protocols, end-tidal PO2
      (PETO2) was held at 100 Torr. The first 5 min of each protocol were excluded from
      data analysis to approach a steady state, and the remaining 38 min analysed to
      determine whether any trends were present. At rest, ventilation did not change
      over the 38 min period. However, during hypercapnic exercise (protocol C),
      ventilation rose significantly by a mean +/- SE of 4.9 +/- 0.8 L/min (P less than
      0.01) over the 38 min period. In protocol B, ventilation was lower than in
      protocol C, but did not change over the 38 min period. However, PETCO2 fell
      significantly by a mean of 0.65 +/- 0.05 Torr (P less than 0.01). This change in
      PETCO2 was due to a significant fall in the respiratory quotient (mean = -0.05 +/
      0.01, P less than 0.01) and metabolic CO2 production (mean = -0.06 +/- 0.01
      L/min, P less than 0.01). The fall in respiratory quotient implies a change in
      metabolic substrate during exercise. Furthermore, the results suggest that
      ventilation is not always matched closely to metabolic CO2 production during
      exercise.

PMID- 1626131
TI  - Functional characteristics of arterial chemoreceptors in an amphibian (Bufo
      marinus).
AB  - In order to further describe the functional characteristics of arterial
      chemoreceptors of anuran amphibians, multi-unit chemoreceptor discharge frequency
      (MCDF) was recorded from the carotid (N = 23) or aortic nerve (N = 2) of pithed,
      unidirectionally ventilated toads (Bufo marinus). MCDF increased with decreasing
      PaO2: typically, the threshold PaO2 lay between 40 and 60 mmHg. The MCDF-PaO2
      relationship was right-shifted along the PaO2 axis by increasing PaCO2 (N = 5).
      In three toads, the MCDF-PaO2 relationship was unaffected when CaO2 was reduced
      35-89% by hemorrhage. MCDF was also unaffected by occlusion of the outflow from
      the heart, though it increased upon release of the occlusion. MCDF was stimulated
      by epinephrine, and inhibited by dopamine. Our results demonstrate that the MCDF
      responds to the range of PaO2 and PaCO2 values encountered in vivo, suggesting
      that arterial chemoreceptors may participate in ventilatory control in toads. The
      receptors do not respond to the rate of oxygen delivery per se, and may be
      influenced by catecholamines known to exist in the carotid labyrinth.

PMID- 1626132
TI  - Effects of endothelin, platelet activating factor and thromboxane A2 in ferret
      lungs.
AB  - We have compared the effects of three vasoactive agents, endothelin, platelet
      activating factor and thromboxane A2 analogue, U 46,619, in the pulmonary
      circulation of ferrets. Lungs of nine adult ferrets, body weight 1.06 +/- 0.27
      kg, were isolated and perfused with sheep red blood cells suspended in Kreb's
      solution with 2 g% Dextran 70 (hematocrit 33 +/- 6%), under conditions of
      constant flow in zone 3. Endothelin-1 (ET: 0.1-1.35 micrograms/kg), platelet
      activating factor (PAF: 0.5-5.5 micrograms/kg) or thromboxane A2 analogue (U
      46,619: 1 microgram/kg), was infused into the pulmonary artery and the pressure
      response determined. To locate the site of action of the agents, the pulmonary
      circulation was partitioned into arteries, microvessels and veins by measuring
      pressures in 20-50 microns diameter subpleural arterioles and venules by
      micropuncture, both during baseline and after the peak response to each
      vasoactive drug. We found that the ferret pulmonary circulation constricted in
      response to ET, PAF and U 46,619, but the magnitude of constriction varied.
      Ferret lungs were most sensitive to U 46,619 and least sensitive to PAF. The
      major site of action also differed among the agents; U 46,619 and ET
      predominantly constricted veins whereas PAF predominantly constricted arteries.
      We conclude that the ferret pulmonary circulation demonstrates differential
      responsiveness to vasoactive agents, that venous constriction is a common feature
      and that the predominant site of action varies with the specific agent.

PMID- 1626133
TI  - Strength of the pulmonary blood-gas barrier.
AB  - The mammalian pulmonary blood-gas barrier is well known to be extremely thin. For
      example, in the human lung, half of the area of the barrier (the 'bulging' part)
      has a thickness of only 0.2-0.4 micron. We show here that the barrier is also
      immensely strong. This is an essential requirement because the capillary wall
      stresses during heavy exercise become very large (about 7 x 10(4) N/m2 = 70 kPa)
      when capillary pressure increases to 30 mmHg. Stress failure of the pulmonary
      capillary wall consistently occurs in experimental rabbit preparations at
      abnormally high pressures exceeding 40 mmHg and may be the cause of bleeding into
      the lung in galloping racehorses. The great strength of the thin side of the
      blood-gas barrier can be attributed to the extracellular matrix, especially the
      type IV collagen which is predominantly located in the very thin lamina densa.
      The alveolar wall is therefore particularly vulnerable to injurious agents which
      attack type IV collagen such as autoantibodies in Goodpasture's Syndrome and
      perhaps neutrophil elastase in emphysema. The combination of extreme thinness and
      great strength of the blood-gas barrier poses a unique design requirement.

PMID- 1626134
TI  - P-V characteristics in heart-pulsation affected and non-affected lung units: a
      model.
AB  - Elastic recoil pressure, pleural pressure and pressure pulsation of the heart
      (PHRT) control the expired flow from a small lung unit. Variability in each trait
      may affect the expirate. The same (SDPV) or different (DDPV) regional
      distribution of P-V characteristics, regional effects of PHRT-affected (O) and
      non-affected units (N) and regional differences in pleural pressure, were
      incorporated into a computer model. Output acceptability was judged by the
      alveolar slope of the N2 washout, cardiogenic oscillations (CO) and the phase
      shift between PHRT and CO. Can SDPV be in both O and N units? What causes CO and
      phase shift? With SDPV in O and N units, CO were negligibly small. The
      incorporation of the pleural pressure difference did not fulfill the three
      criteria, which were met when there was DDPV in the N and O units. We conclude
      that the distribution of P-V characteristics changes with the distance from a
      pulsating artery, and only DDPV, and not different time constants or pleural
      pressure difference, can explain CO.

PMID- 1626135
TI  - Estimating alveolar surface area during life.
AB  - Alveolar surface area (Sa) may be derived from measurements of total lung
      capacity (TLC) and mean linear intercept (Lm), an estimate of average airspace
      size. Because the index of pulmonary distensibility, K, is a function of Lm, we
      were able to derive Lm from ln K using their respective age regressions and
      estimated Sa in 147 healthy subjects. K was obtained from exponential analysis of
      static pressure-volume data. TLC was measured in a body plethysmograph. As an
      estimate of airspace size, the value used for Lm was shown to be appropriate for
      the air-inflated lung at TLC. In 95 men (mean age 40 +/- 16 SD years), Sa was 118
      (SD 22) m2 and in 52 women (mean age 38 +/- 17 SD years) it was 91 (SD 18) m2 and
      Sa decreased with age (P less than 0.001). In a morphometric study, Thurlbeck
      (Am. Rev. Respir. Dis. 95: 765-773, 1967) obtained smaller values for Sa (owing
      to the use of a smaller lung volume) and a similar decrease in Sa with age as
      that found here. Providing a standardised methodology is used for measurement of
      K, the present method allows a reasonable estimate of Sa to be obtained during
      life.

PMID- 1626136
TI  - Influence of exercise training on the oxidative capacity of rat abdominal
      muscles.
AB  - Our purpose was to determine if endurance exercise training would increase the
      oxidative capacity of the abdominal expiratory muscles of the rat. Accordingly, 9
      male rats were subjected to an endurance training protocol (1 h/day, 6 days/week,
      9 weeks) and 9 litter-mates served as controls. Citrate synthase (CS) activity
      was used as an index of oxidative capacity, and was determined in the following
      muscles: soleus, plantaris, costal diaphragm, crural diaphragm, and in all four
      abdominal muscles: rectus abdominis, transversus abdominis, external oblique, and
      internal oblique. Compared to their non-trained litter-mates, the trained rats
      had higher peak whole body oxygen consumption rates (+ 16%) and CS activities in
      plantaris (+34%) and soleus (+36%) muscles. Thus, the training program caused
      substantial systemic and locomotor muscle adaptations. The CS activity of costal
      diaphragm was 20% greater in the trained animals, but no difference was observed
      in crural diaphragm. The CS activity in the abdominal muscles was less than one
      half of that in locomotor and diaphragm muscles, and there were no significant
      changes with training except in the rectus abdominis where a 26% increase was
      observed. The increase in rectus abdominis CS activity may reflect its role in
      postural support and/or locomotion, as none of the primary expiratory pumping
      muscles adapted to the training protocol. The relatively low levels of CS
      activity in the abdominal muscles suggests that they are not recruited frequently
      at rest, and the lack of an increase with training indicates that these muscles
      do not contribute significantly to the increased ventilatory activity
      accompanying exercise in the rat.

PMID- 1626137
TI  - Effect of a single breath of cigarette smoke on slowly adapting receptors in
      canine lungs.
AB  - Inhalation of cigarette smoke has been shown to induce bronchoconstriction which
      should stimulate slowly adapting pulmonary stretch receptors (PSRs). To test this
      possibility, the activity of PSRs was recorded from fine afferent filaments of
      the vagus nerve before and after 120 ml of smoke generated from high-nicotine
      cigarettes was delivered into the lungs in a single breath in anesthetized, open
      chest and artificially ventilated dogs. The base-line activity of PSRs did not
      change during the first two breaths following smoke delivery. However, PSR
      activity started to increase by the third breath (post-smoke), concomitant with
      an increase in tracheal (transpulmonary) pressure. Both the smoke-induced
      increase in tracheal pressure and the delayed effect on PSRs were prevented by a
      pretreatment with aerosolized isoproterenol, a bronchodilator, suggesting that
      the delayed response of PSRs to smoke was elicited by the change in bronchomotor
      tone. Although smoke evoked a delayed stimulation in the majority (61%) of the
      PSRs studied, it caused a mild delayed inhibition (24%) or had no effect (15%) in
      some of the receptors. The variable responses to smoke among PSRs are probably
      related to the smoke-induced heterogeneous changes of mechanical properties in
      the lungs and their different anatomic locations.

PMID- 1626138
TI  - Oxygen consumption and acid-base balance during shallow hypothermia in the
      pigeon.
AB  - In pigeons, during shallow nocturnal hypothermia induced by food deprivation,
      body temperature falls to values between 35 degrees C and 38 degrees C. Body
      temperature, oxygen consumption, and arterial blood pH and PCO2 were recorded
      during the entrance into such nocturnal hypothermic periods. In vivo pH was kept
      constant, while in vivo PCO2 increased slightly during hypothermia. This caused
      the temperature-corrected value of pH (pH*, measured at 40 degrees C) to fall by 
      0.014 units/degrees C, and the total CO2-content to rise by 3.2 mM, an increase
      of 16%. These changes in the acid-base balance represent, in effect, a
      respiratory acidosis that closely parallels the normal buffer line for pigeons.
      Q10 values, relating oxygen uptake to body temperature, were higher than 4.0 at
      the very beginning of the entrance into hypothermia, indicating that the
      metabolic rate was actively inhibited. However, the present results do not
      indicate any relationship between the acidosis and the inhibition of the
      metabolic rate.

PMID- 1626139
TI  - Acid-base state and intermittent breathing in the torpid bat, Eptesicus fuscus.
AB  - The effects of intermittent breathing on acid-base state and blood gases were
      characterized in the torpid bat, Eptesicus fuscus, during steady-state torpor
      between body temperatures (Tb) of 5 and 37 degrees C. Arterial blood samples were
      taken from indwelling catheters without disturbing the torpid state. Arterial pH
      (pHa) of samples taken without knowledge of ventilatory state rose by 0.15 units
      from 37 to 5 degrees C with a delta pHa/delta Tb slope over this range of -0.0055
      U/degrees C. However, at and below Tb = 20 degrees C, Eptesicus fuscus breathes
      intermittently with typical apneic periods of 40-150 min and 4-12 min at 10 and
      20 degrees C, respectively. Samples taken at the end of a ventilatory bout and
      near the end of an apneic period at Tb = 20 degrees C revealed cyclic changes in
      pH (from 7.49 +/- 0.02 to 7.34 +/- 0.01), PO2 (from 96.6 +/- 3.4 to 30.8 +/- 3.9
      Torr), and PCO2 (28.2 +/- 1.4 to 45.9 +/- 1.5 Torr). Between 10 and 37 degrees C,
      end-ventilatory pHa varied inversely with temperature with a delta pHa/delta T
      slope of -0.011 U/degrees C. Because intermittent breathing is common to many
      animals during hibernation, these results demonstrate the importance of
      coordinating blood sampling with ventilatory state for a reliable interpretation
      of acid-base regulation under these conditions.

PMID- 1626140
TI  - Ventilatory response to hypoxia and hypercapnia in the torpid bat, Eptesicus
      fuscus.
AB  - Ventilatory pattern and ventilatory responses to hypercapnia and hypoxia were
      investigated in torpid big brown bats at body temperatures of 5, 10, 20, 30 and
      37 degrees C. The pattern of breathing at temperatures below 30 degrees C was
      intermittent, consisting of rhythmic breathing bouts separated by apneic periods
      with occasional sporadic, non-rhythmic breathing episodes. Overall ventilation
      (Ve) was matched consistently to overall oxygen consumption (MO2) over the entire
      range of temperatures with a mean air convection requirement (Ve/MO2) of 1.28
      L/mmol. However, calculating the air convection requirement using only oxygen
      uptake acquired during ventilation yielded an ectotherm-like temperature
      relationship. Ventilation was stimulated at all temperatures by either increased
      inspired CO2 or decreased inspired O2. At 20 degrees C, graded hypercapnic
      stimulation increased the duration of the rhythmic bouts and decreased the
      duration of apneas until at high CO2 (greater than 3%) breathing was continuous.
      Hypoxic stimulation below about 7% O2 increased ventilation by selectively
      increasing the non-rhythmic ventilations and decreasing rhythmic bouts.

PMID- 1626141
TI  - Pulmonary gas exchange during intermittent ventilation in the American alligator.
AB  - The present study characterized pulmonary gas exchange in the American alligator,
      Alligator mississipiensis during ventilation and apnea at a body temperature (Tb)
      of 25 degrees C. Pulmonary gas exchange parameters were measured on a breath-by
      breath basis utilizing a computer-assisted data acquisition system. In addition,
      paired blood samples were analyzed from left and right atrium during ventilation
      and voluntary apneas (1, 2, 5 and 10 min). Measurements of lung PO2 and PCO2
      indicated that as apnea progressed, CO2 flux into the lung decreased rapidly
      while O2 was continuously removed at a constant and steady rate. The reduction in
      VCO2 resulted in a decrease in R (less than 0.4). Blood gas measurements
      indicated that the pulmonary arterial-pulmonary venous PCO2 difference, (Ppa
      Ppv)CO2 was 4.9 +/- 0.9 mmHg during ventilation, decreased and became negative
      within 2 min of apnea, reaching -3.9 +/- 0.6 mmHg after 10 min. It is postulated
      that during apnea the Haldane effect accounts for both the blood gas behavior
      across the lung and insures a continued CO2 flux into the lung during apnea.

PMID- 1626142
TI  - Effect of amiloride and surfactant on lung liquid clearance in newborn rabbits.
AB  - Immature and nearly mature fetal rabbits (gestational age 27.5 and 29.5 days,
      respectively) were obtained by hysterotomy and tracheotomized at birth. Immature
      rabbits received, via the tracheal cannula, 2.5 ml/kg of either normal saline,
      porcine surfactant (60 mg/ml), 1 mM amiloride in normal saline, or a mixture of
      surfactant and amiloride; nearly mature rabbits received either normal saline, or
      1 mM amiloride in saline. The neonates were ventilated with a tidal volume of
      approximately 10 ml/kg for 0-60 min (immature animals) or 0-120 min (nearly
      mature animals). The lungs were then excised for determination of wet lung
      weight/body weight ratio (LW/BW). The right lung was further processed for
      quantification of extravascular lung water (EVLW) per unit dry lung weight, and
      the left lung fixed for measuring the size of perivascular 'cuffs' (adventitial
      tissue including lymphatics) in histological sections, using vascular lumen as
      reference volume. Immature animals receiving surfactant had improved compliance
      and smaller perivascular cuffs in comparison with the other groups. In immature
      animals amiloride had no effect on compliance, LW/BW, and EVLW, but reduced
      perivascular cuff size at 15 min. Nearly mature animals receiving amiloride had
      higher values for LW/BW and EVLW at 120 min, and lower perivascular cuff size at
      15, 60, and 120 min, in comparison with saline-treated litter-mates. We conclude
      that surfactant improves lung-thorax compliance and reduces perivascular fluid
      accumulation in immature newborn animals without influencing total lung water
      content, and that amiloride retards fetal lung liquid resorption in nearly mature
      newborn animals without affecting lung-thorax compliance during artificial
      ventilation.

PMID- 1626143
TI  - When are resting water-breathers lacking O2? Arterial PO2 at the anaerobic
      threshold in crab.
AB  - The minimum arterial O2 partial pressure (PaO2) at which, in resting conditions,
      O2 consumption (MO2) can be maintained and below which anaerobic metabolism is
      initiated was studied in the crabs Eriocheir sinensis and Carcinus maenas at 15
      degrees C. Arterial PO2, MO2 (in E. sinensis), blood lactate concentration
      ([lact]b) and blood copper concentration ([Cu]b, an index of the blood O2
      carrying capacity) were determined after 24 h exposure to inspired PO2 (PIO2)
      ranging from 2.7-2.1 kPa. They were compared to normoxic controls. In normoxia,
      the most frequently measured PaO2 ranged between 1 and 3 kPa in both species. In
      hypoxia, the threshold for blood lactate appearance was PaO2 = 2.1 kPa in E.
      sinensis and 1.3 kPa in C. maenas, but in many individuals anaerobic metabolism
      was initiated at lower PaO2's. The lowest PaO2 with [lact]b approx. 0 was 0.7 kPa
      in both species. MO2 was maintained in 4 E. sinensis out of 6 with PaO2 ranging
      from 0.7-1.2 kPa (PIO2 = 2.1 kPa). The arterial PO2 at which anaerobic metabolism
      occurred was not related to blood O2 carrying capacity.

PMID- 1626144
TI  - Metabolic responses of chicken embryos and hatchlings to altered O2 environments.
AB  - The oxygen consumption (MO2) response over a 4 h period of exposure to altered
      ambient O2 (air, 10, 15, 40, 60, 80 and 100%), helium (He) and sulfur
      hexafluoride (SF6) environments was determined for young (12 days old) and late
      (16 and 18 days old) embryos, externally pipped (EP) eggs and just hatched chicks
      (hatchlings) of the domestic fowl. The young embryos were insensitive to
      hyperoxic gas mixtures and to He exposure, while the late embryos increase their
      MO2 in hyperoxic environments, independently of O2 concentration, and also in a
      He atmosphere. Both the young and late embryos responded to SF6 exposure with
      decreasing MO2, as SF6 reduces O2 diffusivity through the eggshell. The MO2 of EP
      eggs and hatchlings in He and SF6 varied very widely, the effects of altered
      diffusivity being insignificant. In hypoxic environments in which the MO2
      decreased, the fall of MO2 became smaller as embryos developed and particularly
      after they pipped the shell and hatched. In an atmosphere of 10% O2, the MO2 of
      all embryos in the egg before hatching decreased to below 10% of the control
      after 4 h, while in hatchlings the MO2 remained above 80% of the control. As all
      embryos in situ in the egg depend entirely or partly on diffusion in order to
      obtain O2, this emphasizes the limitation of the diffusive process. A 4 h
      exposure to 10% O2 was lethal for embryos in the egg even if they had pipped the
      shell and were breathing air with the lungs.

PMID- 1626145
TI  - Effect of pulsatile flow on gas exchange in the fish gill: theory and
      experimental data.
AB  - A model for gas exchange in the fish gill allowing for time-varying water and
      blood flow is presented. An analysis based on this mathematical model shows that
      pulsatile water and blood flow potentially may reduce the efficiency of gas
      exchange significantly. The degree of inefficiency imposed on gas exchange is,
      however, determined by the physical dimensions of the gill and the gas
      capacitance coefficients of water and blood. Using anatomical and physiological
      data it is shown to be likely that for a large group of fishes, including the
      salmonids, pulsatility of water and blood flow affects gas exchange efficiency
      only marginally. A close coupling between cardiac and respiratory rhythms is
      therefore only of marginal advantage to gas exchange efficiency. Due to their
      exceptional gill dimensions tunas, and to a lesser extent mackerels, are
      susceptible to the negative effect of pulsatility on gas exchange, which may be
      one of the factors favouring ram ventilation in these species.

PMID- 1626146
TI  - Ventilatory effects of the interaction between phrenic and limb muscle afferents.
AB  - We studied the effects on ventilation and ventilatory muscle activation of
      stimulation of the central ends of the left phrenic and gastrocnemius nerves
      separately and concurrently in 10 spontaneously breathing, alpha-chloralose
      anaesthetized dogs. The nerves were stimulated for 1 min, at a frequency of 40 Hz
      and pulse duration of 1 ms. The phrenic nerve was stimulated at 20 and 40 times
      twitch threshold (TT). During these stimulation periods ventilation increased by
      39% and 79% of control values, respectively. The gastrocnemius nerve was
      stimulated at 20 times TT. This produced a 90% increase in ventilation.
      Stimulation of either nerve resulted in increases in the activity of the right
      diaphragm, parasternal intercostal and alae nasi muscles comparable in magnitude
      to the increase in tidal volume. The activities of the genioglossus and
      transversus abdominis muscle increased to a much greater extent than did the
      other muscles under all conditions. In contrast, triangularis sterni activity
      remained unchanged during stimulation of either nerve. The phrenic nerve was then
      stimulated at 40 times TT for 1 min with superimposed gastrocnemius nerve
      stimulation (20 times TT) during the last 30 s. Ventilation had risen by 66%
      after 30 s of phrenic nerve stimulation. With the addition of gastrocnemius nerve
      stimulation, ventilation rose by a further 84% for a total increase of 150% of
      the control value. Mathematical summation of the responses to individual nerve
      stimulation at these intensities predicted a 156% increase in ventilation.
      Similar degrees of summation were found with respect to respiratory muscle
      activation. We conclude that the interaction between phrenic and limb muscle
      (gastrocnemius) afferent is additive with respect to their effects on
      ventilation.

PMID- 1626147
TI  - Thromboxane A2 mimetic, U46,619, and slowly adapting stretch receptor activity in
      the rabbit.
AB  - The effect of infusing the thromboxane A2 mimetic U46,619 on afferent activity
      from slowly adapting airway stretch receptors (SARs) in the anesthetized rabbit
      was examined in these experiments. SAR vagal afferent fibers (n = 29) were
      identified by their slow adaptation to a sustained (10-15 s duration) lung
      inflation in the closed-chest, mechanically ventilated animal (n = 16).
      Intravenous infusion of U46,619 increased the discharge frequency of the SAR,
      measured at the end of inspiration, in a dose-dependent manner: by 6.6% and 8.0%
      at doses of 0.1 and 0.5 microgram of U46,619/kg, respectively. This increase in
      SAR activity was correlated with increases in end-inspiratory tracheal airway
      pressure (6.4% at 0.1 micrograms/kg and 9.1% at 0.5 micrograms/kg). Higher doses
      of U46,619 could not be administered due to decreases in systemic arterial blood
      pressure. The increase in SAR activity and tracheal airway pressure was
      qualitatively comparable to the response to histamine (25 micrograms/kg), a known
      bronchoconstrictor. We conclude that intravenous infusion of U46,619 in the
      anesthetized rabbit at doses that elicit significant hemodynamic effects causes
      modest bronchoconstriction and comparable increases (less than 10%) in SAR
      afferent nerve activity. From these data, it appears that U46,619 has no direct
      effect on SARs, but rather increases SAR activity due to bronchoconstriction.

PMID- 1626149
TI  - Normal immune function of the gastrointestinal tract.

PMID- 1626148
TI  - An assessment of central-peripheral ventilatory chemoreflex interaction in
      humans.
AB  - The independence of the central and peripheral chemoreflexes has been tested in
      humans. Acute metabolic acidosis generated by a prior bout of brief, hard
      exercise was used to stimulate primarily the peripheral chemoreceptors, and
      respiratory acidosis generated by inhaled CO2 was used to stimulate both central
      and peripheral chemoreceptors. Seven healthy young men were studied. Ventilation
      and arterial pH, PCO2 and PO2 were recorded. Peripheral chemoreflex sensitivity
      to hypoxia during acute metabolic acidosis was repeatedly determined by measuring
      ventilation in euoxia (PETO2 = 100 Torr) and hypoxia (PETO2 = 50 Torr) as the
      subject recovered from exercise-induced acidosis. Peripheral chemoreflex
      sensitivity to hypoxia during CO2 inhalation was repeatedly determined by
      measuring ventilation in euoxia and hypoxia at two levels of hypercapnia (PETCO2
      = 45 Torr and PETCO2 = 50 Torr). The ventilatory sensitivity to hypoxia at
      matched arterial pH values was not significantly different between conditions of
      high (CO2 inhalation) and low (metabolic acidosis) central chemoreceptor
      activity. We therefore conclude that interaction between central and peripheral
      chemoreflexes was non-significant in all subjects.

PMID- 1626150
TI  - Pathophysiology of inflammatory bowel disease.

PMID- 1626151
TI  - Overview of inflammatory bowel disease in humans.

PMID- 1626152
TI  - Feline lymphocytic-plasmacytic enterocolitis.

PMID- 1626153
TI  - Lymphocytic-plasmacytic enterocolitis in dogs.

PMID- 1626154
TI  - Canine eosinophilic gastroenterocolitis.

PMID- 1626155
TI  - Immunoproliferative enteropathy of basenjis.

PMID- 1626156
TI  - Endoscopic biopsy interpretation in canine or feline enterocolitis.

PMID- 1626157
TI  - [What is your diagnosis? Bilateral motor and sensory deficiency in the area of
      the musculocutaneus nerve].

PMID- 1626158
TI  - [Colorectal carcinoma--current pathogenetic concepts. Significance of cell-matrix
      interaction for invasive growth and metastasis].
AB  - Altered expression of certain cell-matrix receptors has been found to be specific
      for malignant, transformed epithelial cells in the large intestine. An attractive
      hypothesis, therefore, is that invasion and metastasis result from characteristic
      changes of these cell adhesion molecules. In animal models, it was possible to
      reduce the frequency of tumor invasion and metastasis and to achieve longer
      survival by modifications of cell membrane binding components on malignant cells.
      An increasing understanding of the role of receptor-mediated epithelium-matrix
      interactions in malignancy facilitates the development of new therapeutic
      concepts.

PMID- 1626159
TI  - [Adjuvant therapeutic possibilities in carcinoma of colon and rectum].
AB  - Recently published results of large randomized trials have changed the
      recommendations for adjuvant treatment in patients with colorectal cancer.
      Patients with Dukes C cancer of the large bowel should be treated with a
      combination of Levamisole and 5-FU. For patients with rectal carcinoma Dukes B
      and C, a combined chemo-/radiotherapy is recommended.

PMID- 1626160
TI  - [Clinical aspects of acute diverticulitis and its complications].
AB  - The diagnosis of acute diverticulitis is obvious if the patient presents with the
      typical symptoms of acute pain in the left lower abdominal quadrant and fever. A
      high index of suspicion, however, is required to diagnose diverticulitis with
      atypical presentation, which may be present in the elderly or immunocompromised
      patient. The detection of complications, most commonly diverticular abscess and
      colovesical fistulas, requires a careful and repeated examination and diagnostic
      skill.

PMID- 1626161
TI  - [Acute diverticulitis--radiological and endoscopic studies].
AB  - In patients with suspected acute diverticulitis, plain abdominal radiographs may
      demonstrate free gas in the abdomen. Ultrasound can indicate the nature of
      disease but is not sufficient to assess the extent of the inflammation. If
      perforation is suspected, a water-soluble contrast agent should be used to
      demonstrate diverticulitis and peridiverticular abscess. Computed tomography is
      ideally suited for the evaluation of the disease. it permits the radiologist to
      tell the clinician the exact extent of the extramucosal inflammation and the
      involvement of adjacent organs and structures.

PMID- 1626162
TI  - [Current insights on the pathogenesis of chronic inflammatory bowel diseases].
AB  - The pathogenesis and etiology of inflammatory bowel disease (IBD) is poorly
      understood. As a matter of fact, it is not even certain whether either one is a
      single entity with different forms of clinical manifestations, or whether each
      one represents a single clearly separable entity. Common features of both
      diseases are chronic persistence, recurrent exacerbation and remission, the
      production of autoantibodies, as well as the expression of aberrant HLA-class II
      molecules on the surface of epithelial cells on the site of inflammation gut. It
      is likely that these events involve a disturbed immunoregulatory function or
      autoimmune process. Since the beginning of investigation the cause of IBD,
      infectious agents (bacteria, virus, mycobacterium paratuberculosis and others) or
      bacterial products (endotoxin, peptidoglycans from the bacterial cell wall) have
      been considered as primary causes. Epidemiological studies showed a marked
      increase of the incidence rates of IBD in industrial countries leading to the
      hypothesis, that environmental factors could play a role in the pathogenesis of
      the disease. So far it is clear that the major identified risk factor for IBD is
      a genetic susceptibility confirmed by studies showing a positive family history.

PMID- 1626163
TI  - [Internistic therapy possibilities in therapy-resistant Crohn disease].
AB  - About 20% of patients with active Crohn's disease do not respond to acute-phase
      therapy with glucocorticoids at an initial dose of 60 mg prednisolone-equivalent
      and stepwise dose reduction every week. In case of primary failure of this
      therapeutic scheme the dose of glucocorticoids has to be enhanced. If necessary a
      combination with total parenteral nutrition or tube feeding should be used. In
      case of early recurrence of inflammation during dose reduction or chronic steroid
      dependent disease activity a combination of glucocorticoids with Azathioprine
      will be successful in about 75% of patients. In addition a combination of
      glucocorticoids with tube feeding (elemental or polymeric diet) will lead to
      remission of inflammatory activity in about 60 to 70% of these patients. In
      patients, who are still refractory to these therapeutic procedures, operation
      should be discussed.

PMID- 1626164
TI  - [Cinitapride in the treatment of gastroesophageal reflux. Comparative study with
      metoclopramide and placebo].

PMID- 1626165
TI  - [Clinical usefulness of the glucagon test in the study of pancreatic islet cell
      function].
AB  - In an attempt to assess the utility of glucagon test as an index of beta cell
      function, we have studied the C-Peptide response to intravenous injection of 1 mg
      of glucagon in 77 patients with type I diabetes, 27 type II diabetics and 14
      normal subjects. A significant difference between basal and glucagon-stimulated C
      Peptide levels as well as a good relationship between both values were observed
      in all groups (r values 0.91, 0.80 and 0.89 respectively). Both basal and
      stimulated C-Peptide concentrations showed significant relationship with the body
      mass index and total cholesterol levels, whereas both parameters were negatively
      related to insulin requirements in type I diabetic group. Absolute C-Peptide
      increment was different in all groups, despite it was not related to basal C
      Peptide levels. These findings confirm the usefulness of glucagon test as an
      investigative tool to assess the secretory capacity of beta-cell, suggesting that
      estimation of C-Peptide increment represents the best parameter to evaluate beta
      cell reserve.

PMID- 1626166
TI  - [Care of the terminally ill patient].

PMID- 1626167
TI  - [73-year-old female with intermittent fever, splenomegaly and 15 kg weight loss].

PMID- 1626168
TI  - [Comparative bioavailability and pharmacokinetics of Dolotren retard and
      Dolotren].
AB  - A randomized crossover study was designed in order to evaluate the bioequivalence
      of a sustained-release preparation (DR) of diclofenac sodium (Dolotren RETARD)
      with respect to an enteric coated (D) tablet (Dolotren). For this purpose the
      bioavailability of both formulations, orally administered in single and multiple
      doses, was determined. Nine healthy volunteers were included in this study,
      receiving 100 mg of D and 100 mg of DR, firstly in single dose and then for 15
      days b.i.d. for D group and once a day for DR group. For the analytical
      determination of diclofenac, blood samples at established time intervals, the day
      of the single dose and the 3rd, 7th and 15th day of multiple dose administration,
      were taken. The following kinetic parameters were determined: Cmac, tmax, alpha
      and beta, clearance, ka, area under the curve and absolute and relative
      bioavailability. When administered both endovenous and orally, the great
      interindividual variability in the kinetic characteristics of diclofenac sodium
      is evidenced. The lag time (tlag) for DR is 0.4 h, shorter than for D (2.2 h),
      which indicates a faster absorption in the upper sections of the gastrointestinal
      tract. Also tmax was shorter for Dr (1.9 h) than for D (4.3 h). Cmax obtained
      with D was higher tan with DR. The diclofenac sodium elimination process from
      plasma is significantly slower with DR than with D (t1/2 beta = 18.1 h and 2.5 h,
      respectively). In consequence, quantifiable plasmatic levels are maintained for
      at least 24 hours after administration of DR, but not of D. Absolute
      bioavailability of both preparations is about 80%, with great interindividual
      variations. Significant differences between the two preparations could not be
      demonstrated. Relative bioavailability between DR and D was 91.5%. None of the
      preparations when administered in repeated doses, D every 12 hours and DR every
      24 hours, produced accumulation, neither their pharmacokinetic characteristics
      changed. Clinical and biological tolerance of both preparations were excellent,
      at doses used and for the period of time studied. Dolotren Retard is absorbed
      orally faster than Dolotren and maintains plasmatic levels longer, which allows
      it to be administered once a day, with a lesser incidence of undesirable effects
      related to Cmax.

PMID- 1626169
TI  - [Indications for operative hysteroscopy. A series of 418 interventions].
AB  - Over a period of 38 months, from October 1, 1987 to December 31, 1990, 418
      surgical hysteroscopies were carried out following systematic pre-operative
      hysteroscopy. Two-hundred and eighty-two patients presenting with a benign
      intercavitary lesion were treated by transcervical endo-uterine resection (EUR).
      The efficacy of the surgical method was assessed from the control of hemorrhagic
      phenomena, the most frequent sign. 89.7 percent of the patients who presented
      with menometrorrhagia, had become asymptomatic from the first cycle after EUR and
      83.5 percent remained asymptomatic after a mean follow-up period of 28 months, 71
      endometrectomies were carried out by EUR during this period, after careful
      hysteroscopic and histological evaluation of the endometrium. The results after
      one year of cycles were satisfactory in 82 percent of patients. Twenty-two
      patients presenting with a uterine septum were treated by endoscopic
      hysteroplasty. In most cases, the authors used the tip of the Charriere 21
      resector. The follow-up period exceeds 1 year in 15 patients, 11 of whom became
      pregnant, giving birth to 9 live infants, 43 cases of synechia were treated by
      hysteroscopy in the context of Ashermann's syndrome. The functional results were
      good in 90 percent of patients, with the restoration of normal cycles. Only
      limited results were obtained in fertility in cases of muscular or fibrous
      synechia. The risks linked to surgical hysteroscopy are analysed. They appear to
      be acceptable, on condition that rigorous methods are used. The quality of
      sequelae and the short hospitalization make operative hysteroscopy preferable in
      the selected indications.

PMID- 1626170
TI  - [Conservative treatment of cancer of the ovary].
AB  - The authors assess the potential of conservative treatment in a series of cases
      of ovarian cancer. Surgical evaluation is essential, in order to confirm that the
      conditions required for conservative treatment are present. The tumor must be a
      stage IA tumor, with a low histoprognostic score and small in size. Conservative
      treatment must be proposed in cases of tumors of potential malignancy and tumors
      of the sexual cords. It is debateable in epithelial tumors. The question of the
      necessity of further surgery to remove the genital tract after the desired
      pregnancies may be debateable in cases of epithelial tumors.

PMID- 1626171
TI  - [Hysteroscopic endometrial reduction. Analysis of 85 cases].
AB  - The authors report the results of their experience of hysteroscopic endometrial
      reduction through a retrospective series of 85 patients who underwent surgery
      between October 1988 and February 1991. The indication consisted of hemorrhage
      (menorrhagia and metrorrhagia) of endometrial origin in women with a group mean
      age of 46 years who had no intention of becoming pregnant in the future. The pre
      treatment assessment was based on diagnostic hysteroscopy and was intended to
      eliminate neoplasm of the endometrium or its precursors. The endometrial
      reduction procedure always preserved an isthmic ring of endometrial tissue. No
      peroperative complication was reported. The mean duration of surgery was about 39
      minutes. With a follow-up period of more than one year, bleeding had disappeared
      in 78% of cases. The authors conclude that the technic of endometrial resection
      in the treatment of benign lesions of the endometrium, on condition that the
      possibility of any disorder calling for laparotomy is ruled out and that there is
      regular postoperative follow-up.

PMID- 1626172
TI  - [Triplet pregnancies in France. Results of a retrospective, multicenter study of
      two years (1987-1988). Proposals for optimal management].
AB  - The explosion of procedures for medically assisted parenthood (MAP) has resulted
      in a previously little known type of pregnancy: triple pregnancies. In order to
      assess the current obstetrical and pediatric situation, the authors have carried
      out a major retrospective, multicenter survey in France concerning the triple
      pregnancies from 1987 to 1988: 156 case histories have been collected. The finds
      are compared with those reported in the French and international literature,
      showing that in France, three-quarters of such pregnancies result from MAP,
      mainly due to ovulation-inducing agents. Hospitalization is prolonged (averaging
      27 days), early (24 WA) and imposed by complications (in 8 out of 10 cases),
      prophylactic hospitalization being rarely prescribed. The main complications
      encountered are late miscarriages (1.9%), in-utero death (6.41%), dysgravidia
      (16.6%), hydramnios (5.12%) and serious cardio-pulmonary complications related to
      the use of beta-mimetics. A Cesarian is performed in only 87 percent of cases.
      The mean birth weight was 1,776 g. Neonatal mortality is on the decline, but
      still equivalent to 80.3 per thousand. Hypotrophy is common (27%). Birth is
      nearly always premature (99.3%), but very early prematurity (28-32 WA) was
      reduced. The approach suggested for optimum management is based on the personal
      experience of the authors, the findings of their survey and of the international
      literature. It is based on the prevention of prematurity and a fundamentally
      multidisciplinary approach.

PMID- 1626173
TI  - [Effects of preinduction by mifepristone on therapeutic abortions of the second
      and third trimesters induced by intravenous sulprostone].
AB  - The authors investigate the effects of preinduction by administering 600 mg of
      mifepristone (RU486) per os before medical termination of pregnancy during the
      third to ninth months of pregnancy by intravenous sulprostone (Nalador). The
      study included a population of 35 patients treated with RU486 and then Nalador
      versus a population of 38 patients treated with Nalador only. The characteristics
      of the two groups did not show any statistically significant differences
      (medical, surgical and obstetric difference, indication for termination). The
      gestational age was lower in the RU486-Nalador group (group mean age : 20.9 weeks
      of amenorrhea versus 23.3, p less than 0.01). The group receiving RU486
      significantly demonstrated the following : reduced time for induction of labour
      to modifications of the cervix (7.2 h versus 10.9 h, p less than 0.05), a higher
      number of rapid expulsions (within 10 h in 37.1% versus 15.7%, p less than 0.05)
      and a reduction of side effects (45.7% versus 71.05%, p less than 0.05). The
      other parameters analysed (duration of termination, total dose of prostaglandin)
      appeared to be better with RU486, but the values were not significantly
      different.

PMID- 1626174
TI  - [Neonatal consequences of premature rupture of membranes (more than five days)
      before the 34th week of gestation].
AB  - Twenty-six cases of premature braking of the membranes which occurred before week
      34 of amenorrhea and lasted for more than 5 days are assessed retrospectively.
      The mean age when the membranes broke was 26.6 weeks of amenorrhea. Delivery
      occurred on average at 31.5 +/- 2 WA, with an interval of between 6 and 91 days
      (mean 35 +/- 23 days). In 4 cases, chorioamniotitis complicated the premature
      breaking of the membranes. The perinatal mortality rate was 5 out of 27,
      including 2 still births. Nine of the neonates showed respiratory distress which
      required artificial ventilation. Four cases of pulmonary hypoplasia were
      confirmed by pathological examination. In all cases, this was associated with a
      reduction in the volume of the amniotic fluid, reduced fetal mobility and delayed
      intrauterine growth. In contrast, when these three factors were absent the
      prognosis was always good, regardless of the date at which the membranes broke.
      In the long term, the surviving children showed no neurological sequelae.

PMID- 1626175
TI  - [Umbilical Doppler velocimetry in prolonged pregnancies].
AB  - One-hundred and eighty-seven single pregnancies, at full term determined
      accurately and confirmed by ultrasound before 17 weeks of amenorrhea and which
      were proceeding normally were monitored every 2 days after the expected end of
      term. This was done by conventional methods and in 132 cases by determining a
      placental resistance index (R = D/S). All the deliveries were carried out under
      monitoring and the infants examined by a pediatrician. The umbilical index at 280
      to 300 days of gestation was found to be constant and equal to R = 0.52 +/- 0.041
      (n +/- D) and the signs of fetal distress and post-maturity increased beyond
      term. In the first 80 pregnancies studies in this way, the determination of the
      value of the index R was not included in the decision-making process. Twelve of
      the 14 cases of fetal heart rate arrhythmia during delivery and all recorded
      cases of post-mature clinical signs and neonatal acidosis occurred when the index
      was above RI = 0.54. The next 107 pregnancies were randomly divided into two
      groups. In the 52 pregnancies in which the Doppler revealed an index at two
      consecutive determinations in excess of 0.54, this was taken to be a criterion
      for the induction of childbirth. In this group, some of the women gave birth
      earlier, without any increase in the number of Caesareans and this resulted in
      fewer post-mature infants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626176
TI  - [Problems posed by the delivery of twin pregnancies].
AB  - The authors present a retrospective study of 249 deliveries of twin pregnancies
      collected between 1987 and 1990. The incidence of twin pregnancies is 1.6%.
      Delivery is premature in 28.1% of cases and that of low birth weight is 51.7%. In
      13.2% of cases, delivery was Cesarean and the Apgar score was significantly
      higher for the first twin than for second. Perinatal mortality was 7.2 percent.
      The authors compare these findings with those reported elsewhere in the
      literature.

PMID- 1626177
TI  - [Intra-fascial (or intra-cervical) hysterectomy with the help of a cervicotome.
      33 cases].
AB  - The authors report 33 hysterectomies carried out by abdominal route (isolated or
      combined with other surgical procedures) using a Cervicotome. This instrument
      carries out ablation of the endocervix and the junction zone without preliminary
      dissection of the paracervix. The operating procedure is explained: subtotal
      hysterectomy which is then completed using the Cervicotome. Hemostasis and
      closing of the section. The analysis of the outcome assesses preoperative
      complications and the quality of postoperative sequelae. The patient follow-up
      made it possible to analyse the anatomical and functional results (notably
      sexual). The advantages of this procedure over extra- and intra-fascicular
      hysterectomies are listed. This instrument was initially designed to eliminate
      the risks of lesions of surrounding organs during difficult hysterectomies (when
      dissection of the paracervix could be dangerous), but the operative convenience
      and quality of the outcome have led the authors to use it for all abdominal route
      hysterectomies.

PMID- 1626178
TI  - The utility of lipid-associated sialic acid (LASA or LSA) as a serum marker for
      malignancy. A review of the literature.
AB  - The utility of the lipid-associated sialic acid (LASA or LSA) test as a serum
      marker for malignancy is reviewed. The name LASA or LSA test is confusing because
      it suggests that only or mainly lipid-bound sialic acid is measured. In reality,
      glycoprotein-bound sialic acid is determined predominantly. The assay appears to
      have a particularly high positivity rate in leukemia, Hodgkin's disease,
      melanoma, sarcoma, advanced ovarian carcinoma and oropharyngeal tumors,
      suggesting that LASA may serve as a valuable marker in these malignancies. As a
      consequence of the rise of sialic acid-rich acute-phase proteins, such as alpha 1
      acid glycoprotein, in inflammatory diseases the specificity of LASA and therefore
      its diagnostic accuracy is low. LASA can be useful for monitoring cancer patients
      during treatment, especially in combination with other tumor markers.

PMID- 1626179
TI  - Intracellular fluid of waybread (Plantago major) as a prophylactic for mammary
      cancer in mice.
AB  - The investigations were performed on female mice of the strain C3H Strong. Only
      the breeders were used in the experiments. A number of mice were given
      intracellular fluid of way-bread in subcutaneous injections. The controls
      received no treatment. The age at which mammary cancer appeared was noted and
      also how often the tumors occurred. The frequency of tumor formation was 93.3% in
      the controls and 18.2% in the treated mice. The difference is significant.

PMID- 1626180
TI  - Breast cancer mucin: an automated assay to detect mucus glycoproteins.
AB  - Episialin, a mucus glycoprotein, is a well-known tumor-associated antigen used in
      a variety of tests to detect the presence of adenocarcinoma. With the
      introduction of the microparticle-captured enzyme immunoassay (MEIA), a new
      technique was introduced. We compared this assay with our standard method to
      detect adenocarcinomas, the measurement of carcinoembryonic antigen (CEA). In
      breast cancer, the breast cancer mucin (BCM) assay was more often positive in
      metastatic disease but was not better than CEA in stages I-III. In lung
      carcinomas, BCM and CEA gave similar results while in colorectal carcinoma, CEA
      was superior. BCM gave similar results to CA 15.3 in a group of breast cancer
      patients.

PMID- 1626181
TI  - CA125 and placental alkaline phosphatase as serum tumor markers in epithelial
      ovarian carcinoma.
AB  - Placental alkaline phosphatase (PLAP) was measured by an immunoradiometric assay
      using the monoclonal antibody C2 (PLAP-C2). Serum samples of 135 patients with
      epithelial ovarian cancer were analyzed, and the results were compared with CA125
      levels. CA125 and PLAP-C2 were elevated in 85 and 43% of the patients,
      respectively. Only 1 patient with normal CA125 and evidence of disease at the
      time of sampling had an elevated PLAP-C2. Fifty-three patients with measurable
      tumor were followed longitudinally during chemotherapy. Correct correlation with
      disease evolution was observed in 95% of the patients for CA125 and in 59% for
      PLAP-C2. The PLAP-C2 assay did not add significantly to the predictive value of
      CA125 in the diagnosis and follow-up of epithelial ovarian cancer.

PMID- 1626182
TI  - Serous ovarian cyst fluids contain high levels of endometrial placental protein
      14.
AB  - This paper reports the detection and characterization of endometrial placental
      protein 14 (PP14) in human ovarian cyst fluids. PP14 from ovarian cyst fluid has
      the same molecular size as PP14 purified from human amniotic fluid. No clear
      difference was found in the PP14 concentrations between benign, borderline and
      malignant cyst fluids, but serous ovarian cyst fluids had significantly higher
      PP14 concentrations (median 253.3 micrograms/l) than mucinous cyst fluids (median
      17.5 micrograms/l).

PMID- 1626183
TI  - cDNA cloning of new protein tyrosine phosphatases in the human colon.
AB  - Oligonucleotide probes corresponding to three invariant amino acid sequence
      motifs within the protein tyrosine phosphatase (PTPase) catalytic domain were
      synthesized and employed in the polymerase chain reaction (PCR). PCR products
      amplified from human colonic tissues were analyzed. Among 41 cDNA clones
      sequenced, two putative novel PTPases designated as CL-6 and CL-2B were isolated.
      cDNA cloning of CL-6 was performed, and three overlapped cDNA clones encoding
      part of the coding region, which was 2.1 kb long, were obtained. Expression of
      mRNAs of these clones was then investigated by Northern blot analysis or reverse
      transcriptase-PCR, suggesting that CL-6 mRNA may be expressed in a cell-type
      specific manner, whereas the expression of CL-2B mRNA could be ubiquitous.

PMID- 1626184
TI  - [Allografts of cryo-preserved and radio-sterilized spongy bone tissue. Their use
      in orthognathic surgery].
AB  - In some circumstances, the orthognathic surgery creates inter-fragmentary spaces
      which have to be filled to ensure that the osteotomized segments are wedged and
      consolidated, and to avoid the appearance of unsightly subcutaneous contours. The
      authors report the results obtained through the use of cryo-preserved radio
      sterilized cancellous bone allografts, coming from femoral heads, used as
      fillers, in diverse types of osteotomy. Thus, 19 centers of osteotomy have been
      filled. Follow-up periods ranged from 5 to 20 months. In 8 cases, evidence was
      made through radiology of the blending of the grafts. The stability of the
      correction was constantly noticed as well as the perfectly harmonious facial
      contours, which testifies the osteogenic qualities of this material. No sepsis
      was observed. It is a quantitatively available material, of easy shaping, the use
      of which does not lead to a lengthening of the operation, nor to the creation of
      cutaneous scars. The risk of viral transmission through allografts, specially
      H.I.V. and hepatitis non A - non B - non C virus is nil due to the
      radiosterilization.

PMID- 1626186
TI  - [Stafne's cyst simulating a periapical cyst. Apropos 2 cases].
AB  - We report about two cases of accidental radiological discovery of a radiolucent
      area that seemed to be related to the apex of the teeth. The diagnosis of a cyst
      is contested by performing a sialographic study of the submaxillary salivary
      gland, which demonstrates a benign abnormality known as Stafne's lacuna.

PMID- 1626185
TI  - [The first- and second-arch syndrome. A treatment analysis and plan].
AB  - There is a very great lesion staging in these syndromes, and a great number of
      procedures have been described, according to the age and severity of the lesions.
      The initial assessment is therefore important, since it allows classifying these
      malformations according to their severity in key sectors. Scheduling the
      treatment in time must take account of: growth, the necessity to perform
      successive operations in one region, since no operation must hinder a subsequent
      one. It is essential to determine the optimum time for bone reconstruction. An
      early treatment with a conventional bone graft, without any intrinsic growth
      potential, condemns the reconstructed region to immobility, therefore to a
      progressive degradation of the result in time and to successive corrections.
      Early reconstruction is justified only if the available reconstruction means
      allow the reconstructed area to grow, either naturally or with the aid of
      orthopaedic stimulation. Some means seem to be available to date. A choice must
      therefore be made between: delayed morphological surgery, early functional
      surgery. Considering the extent of the means implemented, this is reserved for
      severe cases. The other great problem is the reconstruction of the auricle, which
      most often requires a series of operations scheduled over 2 years. The middle ear
      may not be operated if the lesions are unilateral. The other malformations,
      including macrostomia, muscular and neural abnormalities, involvement of the
      eyelids, sometimes require correction, which must fit in a repair schedule that
      must be established as soon as possible and must take account of the predictable
      procedures in order to prevent them from hindering each other.

PMID- 1626187
TI  - [The incidence of Actinomyces israeli colonization in tonsillar tissue. A
      histopathological study].
AB  - The presence of the Actinomyces usually is not determined by the common
      histologic examination of preparations of tonsillar tissue which has been removed
      surgically. The Actinomyces are common saprophytic microorganisms which are found
      inter alia in the oral cavity and palatine tonsils. In this study, the authors
      examined histologically 238 surgical preparations of tonsillar tissue. In 84 of
      these, that is 35.21%, it has been noted, except the others, the presence of
      Actinomyces israeli. At the same time, the authors state their views concerning
      the contribution of the Actinomyces of tonsillar crypts to the pathogenesis of
      chronic tonsillitis.

PMID- 1626188
TI  - [The advantages and limits of the use of desmopressin (Minirin) in stomatology.
      Apropos 2 young female patients presenting with von Willebrand's disease].
AB  - The authors describe two cases of wisdom tooth germ removal in female adolescents
      presenting with von Willebrand's disease. The effect of the Minirin injection was
      studied during a preoperative test and allowed carrying out the operation with
      normalized hemostasis, without using substitution factors and with no
      postoperative complications. The authors specify the indications and limitations
      of the use of desmopressin before surgery.

PMID- 1626189
TI  - [Respiratory pathology of sleep and the upper airways].
AB  - Respiratory disorders in the upper respiratory tract during sleep are most often
      part of a continuous pathological process of long standing. Schematically, three
      clinical syndromes with increasing severity are described: breathing with the
      mouth open, snoring and the sleep apnea syndrome. These conditions always include
      a functional maxillofacial perturbation, which may be associated to a
      constitutional or acquired morphological disorder. Besides the medical approach
      itself, the treatment sometimes is surgical, always orthopedic. The earlier it is
      initiated, the more effective, simple and unconstraining it is.

PMID- 1626190
TI  - [Fractures of the condylar region].
AB  - Condylar fracture are responsible for: homolateral TMJ disorders following discal
      apparatus lesions such as: disc displacement, discal lesion, osteoarthrosis of
      articular surfaces (condylar and temporal), contralateral TMJ disorders, more
      frequent, with destabilisation of the masticatory apparatus and decrease of ramus
      height or compensatory hypermobility. Functional treatment can prevent articular
      and muscular ankylosis. It is often indicated: non-displaced low undercondylar
      fractures or after surgery. Surgical reduction is indicated in two cases:
      displaced-low undercondylar fracture. The discal apparatus is intact and function
      usually excellent, displaced-high undercondylar fractures with 90 degrees head
      luxation. The bone reduction and contention must be associated to discal
      apparatus control. If dislocated or displaced, the apparatus should be replaced
      and sutured. Four factors are implicated in articular function: the fracture
      position, bone displacement (condylar head in or out of the glenoid fossa),
      discal apparatus integrity (the lower layer of the retrodiscal tissue is involved
      in bone regeneration especially in infants), and the quality of occlusion.

PMID- 1626191
TI  - [A comparative study of 2 series of mandibular osteosynthesis using screwed
      plates].
AB  - In a retrospective study, we compared monocortical internal fixation versus
      bicortical screwing in the treatment of the mandibular fractures. Between 1983
      and 1985, 40 patients underwent bicortical screw plate osteosynthesis and 46 were
      treated with the monocortical screw plate technique. The results are favorable to
      bicortical screwing, as regards both infection and pseudarthrosis. Monocortical
      screwing caused fewer occlusal disorders than bicortical screwing. Best on the
      increased amount of complications we decided to abandon the using of monocortical
      in favour with bicortical plates.

PMID- 1626192
TI  - [The sequelae of fractures of the orbital floor. An evaluation of the physical
      damage].
AB  - The authors describe their experience with a homogeneous series of 88 fractures
      of the floor of the orbit. After a clinicopathological and therapeutic summary,
      the authors describe the sequellae encountered in their series. Sensory disorders
      are the most frequent sequellae, being noted in 30% of all cases. The
      maxillofacial surgeon and the ophthalmologist must cooperate to accurately
      evaluate the physical injury. The various items of damage are analyzed and
      evaluated.

PMID- 1626193
TI  - [A malignant salivary lymphoepithelial lesion with a poorly differentiated
      epidermoid carcinoma. Apropos a case].
AB  - A case of malignant lymphoepithelial lesion of the submandibular gland is
      reported in a 71-years-old woman. The carcinoma showed a poorly differentiated
      pattern and its epidermoid nature was obvious after immunohistochemistry and
      electron microscopy. The epithelial nests were lying in an abundant lymphoid
      stroma consisting of small lymphocytes. A recurrence occurred ten months after
      surgical treatment. This observation is compared with those already related in
      the literature.

PMID- 1626194
TI  - [Osteosarcomas of the mandible].
AB  - On the base of 3 cases of mandibular osteosarcoma, the current role of surgery is
      specified. The most often used procedure is Rosen's protocol, which includes:
      preoperative chemotherapy, radical surgery with reconstruction, and postoperative
      chemotherapy. The key element is the pathological study of the surgical specimen.
      This will determine the response of the tumor to preoperative chemotherapy and,
      by comparing the histology of the initial biopsy specimen to that of the surgical
      specimen, will be used as a basis to select the postoperative chemotherapy. For
      this type of tumor, chemotherapy has completely substituted for radiation
      therapy, which is no longer used in the initial treatment. Prophylactic lung
      radiation therapy has also been given up due to the risks of pulmonary fibrosis
      entailed by the effective doses. Surgery still has a role of choice in the
      therapeutic schedule, even if it cannot be contemplated as the sole treatment.
      Considering the usually young age of the patients, we currently think that
      reconstruction must be immediate and must resort to all the techniques likely to
      produce the best possible functional and morphological result.

PMID- 1626195
TI  - [The technic and advantages of using the tongue flap in the reconstructive
      surgery of cancer of the oral cavity. Our experience apropos 16 cases].
AB  - In this study, primary we present briefly the main anatomic elements that concern
      the tongue as also the clinical and other structures of the cancer of the oral
      cavity. Simultaneously, we notice our experience from the use of the tongue flap
      in 16 patients with cancer of the floor of the oral cavity. This procedure is
      simple, easy, brief and it does not cause aesthetic problems to patients. It is
      also emphasized that this method does not create functional disabilities to the
      rest part of the tongue, with result the patients not have disturbances in
      speech, in chewing or in swallowing.

PMID- 1626196
TI  - [Mandibular reconstruction by a free peroneal transfer].
AB  - After an anatomical study of the osteo-septo-cutaneous fibular flap, we reported
      4 reconstructions of segmental mandible defects by this procedure, published in
      1989 by D. Hidalgo. 2 patients presented mandibular defects associated with
      intraoral soft- tissue loss, following resection for epidermoid carcinoma with
      pre or post-operative radiation. The third patient had a multirecurrent
      ameloblastoma associated with extraoral soft-tissue extension. The fourth patient
      presented a complex loss of soft tissue and mandible following a war injury. The
      flaps survived in all patients. The osteo-septo-cutaneous fibular flap for
      mandible reconstruction has presented several advantages. The flap has been
      elevated under a tourniquet, the distant donor site has allowed a two-team
      approach. The osteo-septo-cutaneous blood supply has been adequate to support a
      skin island for intra or extraoral soft-tissue replacement. Biomechanical
      properties of the fibula have allowed fixation with miniplates and no
      postoperative intermaxillary fixation. Osteointegrated implants (Branemark) for
      dental rehabilitation were done for one patient. There was no long-term donor
      site morbidity.

PMID- 1626198
TI  - Non-Hodgkin lymphoma of the female urethra.
AB  - The third case of a malignant non-Hodgkin lymphoma of the female urethra is
      reported. The urethra was the primary localisation of the malignancy. In the two
      other cases which could be found in a literature review urethral involvement by
      this disease was secondary to other organs. In all cases the tumor first was
      described as a caruncle. Non-Hodgkin lymphoma should be considered in the
      differential diagnosis of urethral tumors.

PMID- 1626197
TI  - "Triple incision plasty". A convenient procedure for preputial relief.
AB  - Circumcision is the accepted operation to treat phimosis. However, when the
      purpose is to achieve retractility of a narrow foreskin to avoid further scarring
      and phimotic development after recurrent balanitis, a preputial plasty might be
      sufficient. Several methods with single or multiple incisions have been
      introduced throughout the years. None of them seems to have gained general
      acceptance. Single plasties tend to give cosmetically unsatisfactory results with
      an apparent cleft or deformity, while the multiple ones, where the deformity is
      more or less spread around the circumference, are not always easily done, at
      least not in children. Still, circumcision seems to remain the standard procedure
      for preputial relief. A simple technique, where three longitudinal incisions are
      transversely sutured, is described. It has been used in a series of 63
      consecutive patients with good results, and seems to offer a good compromise
      between simplicity and cosmetical demands.

PMID- 1626199
TI  - The treatment of female bladder neck dysfunction.
AB  - During the period 1981-88, 38 women who eventually had the diagnosis of bladder
      neck obstruction established, were treated by bladder neck incision. Their age
      range was 28-85 years. The preoperative investigations included a full urodynamic
      examination and urethro-cystoscopy. The gynecologic examination was normal. The
      most constant finding was an elevated, rigid bladder neck seen by endoscopy. The
      treatment included a bladder neck incision either at 4 or at 8 o'clock. The
      results four weeks postoperatively were good, the symptoms had disappeared or the
      patients were improved in most cases, and the flow curves were normalized. Mean
      observation time was 55 months. After a longer period of time the symptoms in
      some cases returned, and then the incision was repeated. After the final control,
      we found 76% of the patients symptomatically improved.

PMID- 1626200
TI  - The expression of estramustine-binding protein in the human prostatic cancer cell
      line DU 145 is not androgen dependent.
AB  - Estramustine-binding protein (EMBP) constitutes one of the major proteins in the
      prostatic gland, it binds estramustine and estromustine, the active metabolites
      of estramustine phosphate (Estracyt). Previous studies in rats have indicated
      that the expression of EMBP is androgen dependent, with diminishing quantities
      following castration and estrogen treatment as well as restored pre-castration
      production upon administration of androgens. In this study, we have used the
      human prostatic cancer cell line DU 145 transplanted in female and male nude
      mice. This cell line, which is sex hormone independent, gave rise to subcutaneous
      tumors in the rats with no difference in growth characteristics between the males
      and females. The expression of EMBP was analysed by radioimmunoassay,
      immunohistochemical and Western blot techniques. No difference was seen between
      the two sexes with respect to EMBP content, demonstrating that the expression of
      EMBP, in contrast to that reported for the normal prostate, is neither androgen-
      nor estrogen-dependent in tumor tissues.

PMID- 1626201
TI  - Sexual function in men after radical cystectomy with or without urethrectomy.
AB  - Sexual function was evaluated in 21 patients with bladder carcinoma who had
      undergone radical cystectomy either with (n = 9) or without (n = 12) excision of
      the urethra. All patients received preoperative radiotherapy, and the cystectomy
      was done by a nerve-sparing surgical technique. At follow-up all patients
      reported normal sexual desire and tactile sexual activity. Eight of the 12
      patients in whom the urethra was preserved could achieve penile erection and
      orgasm to tactile stimulation, and five of them had sufficient strength and
      duration of erection for sexual intercourse. Two of the nine patients in whom the
      urethra was removed-had weak erections insufficient for intercourse; three could
      experience orgasm. These results show that when cystectomy is done by a nerve
      sparing technique and without urethrectomy there is more chance of preserving
      sexual function than when simultaneous urethrectomy is done.

PMID- 1626202
TI  - Patterns of primary care and survival in 336 consecutive unselected Norwegian
      patients with bladder cancer.
AB  - The outcome of 336 unselected patients diagnosed as having bladder cancer in 1985
      in a southern health region of Norway was studied. Two hundred and forty patients
      had superficial bladder cancer (Tis, Ta and T1). Seventy-four had T2-3 and 17 had
      T4 bladder tumours at the time of diagnosis (the T-category was unknown in five
      cases). In 46 of 248 evaluable cases (19%) 12 or more months had elapsed between
      the onset of symptoms and the histological confirmation of the diagnosis. The
      information received from the initial routine histology report was inadequate in
      51 of 240 (21%) of the patients with superficial bladder cancer. Among the 91
      patients with muscle-infiltrating tumours the primary treatment varied
      considerably, and only 15 patients underwent total cystectomy as the initial
      treatment. Only 46 in whom muscle-infiltrating tumours were diagnosed initially
      were referred to the regional uro-oncological unit during the course of the
      disease. The cancer-corrected, four-year survival was 86% and 42% for superficial
      and muscle infiltrating bladder cancer, respectively. The comparable figures for
      crude survival were 64% and 34%, respectively. The lack of optimal standard
      treatment of muscle-infiltrating bladder cancer warrants the introduction of
      clinical trials to assess both curative and palliative regimens as well as to
      study prognostic factors such as proliferation and immunohistochemical parameters
      by uro-oncological units. Scandinavian Cancer Registries should consider the
      optional recording of the T category on the case record forms for newly diagnosed
      cases of bladder cancer.

PMID- 1626203
TI  - Psychosocial adjustment and general state of health in patients with ileal
      conduit urinary diversion.
AB  - The psychosocial adjustment and general state of health were investigated in 66
      patients (40 males, 26 females) who had been subjected to an ileal conduit
      urinary diversion on account of bladder cancer (44 patients) or incontinence or
      bladder dysfunction (22 patients). Seventy per cent of the patients reported
      unchanged, overall, social activity (OSA) after the operation. Twenty per cent
      reported less and 10% more activity. Bladder-cancer patients were more likely to
      curtail their social activities compared with the patients with incontinence or
      bladder dysfunction. Appliance-related problems were mentioned by half of the
      patients who reported decreased OSA. One-third of the patients considered
      accidental leakage or fear of such leakage as the most negative aspect of
      surgery. Factors related to an altered body image were the most common negative
      aspect reported by females. Despite psychosocial problems, the majority of the
      patients (80%) considered their health to be good. Males, individuals working
      full-time and patients with unchanged OSA scored higher on a Health Index, i.e.
      considered themselves healthier than the rest of the patients.

PMID- 1626204
TI  - Living donor nephrectomy. Complication rates in 490 consecutive cases.
AB  - 490 living donor nephrectomies were performed during a 25-year period, all
      through a retroperitoneal approach. In this report, short-term complications and
      donor renal function are analysed. There was no mortality. The major complication
      rate was 1.4%. There were 5 cases of postoperative haemorrhage requiring
      reoperation, one of which developed non-A-non-B hepatitis. There was one case
      each of septicemia and pulmonary embolism. All these patients recovered. Minor
      complications were noted in 13.6% of the cases, mostly bacteriuria or minor
      pulmonary infiltrates. There were 5 cases of reversible heart disorders and 6
      cases of mental disorders. After 6-12 months, all donors had satisfactory
      function of the remaining kidney, which had increased its GFR by 32-38%. We
      conclude that the short-term consequences of donor nephrectomy are acceptable.
      From previous reports, from this unit and from others, it is evident that the
      procedure does not carry any definite long-term health risks. With a permanent
      shortage of cadaveric organs and with continued superiority in the outcome of
      living donor transplantations, this important resource should not be disregarded.

PMID- 1626205
TI  - Radiological examinations of the urinary tract. Changes during the last 24 years.
AB  - Procedures for imaging the urinary tract have been recorded in six Norwegian
      hospitals for the last 24 years. For three of the hospitals, data were collected
      from 1965 to 1989, and for the other three from 1966, 1971 and 1975,
      respectively. There was a significant reduction in the number of intravenous
      pyelograms, voiding cystograms, and renal angiograms, but the number of
      retrograde pyelograms and plain radiographs of the urinary tract remained
      constant. Computed tomography of the urinary tract increased during the first
      years, but after the introduction of ultrasonography, the number of computed
      tomograms decreased. Ultrasonographic examinations of the urinary tract are still
      rapidly increasing, and seem to have replaced some of the other imaging
      techniques. The present results should be taken into consideration when planning
      the health care for the future.

PMID- 1626206
TI  - Renal parenchymal function evaluated by scintillation camera renography before
      and after pyeloplasty for hydronephrosis.
AB  - Scintillation camera renography with Tc-DTPA was performed before and after
      pyeloplasty on 16 kidneys with urographic signs of pelviureteric obstruction
      causing hydronephrosis. Regional parenchymal renograms were generated, and the
      passage of Tc-DTPA through the parenchyma was measured and correlated to the
      change in separate glomerular filtration rate. Preoperative parenchymal passage
      of DTPA was significantly slower (p = 0.02) in kidneys with improved glomerular
      filtration rate after pyeloplasty than in those without such improvement.
      Postoperative passage of DTPA in parenchyma was almost identical with that in a
      reference series. This method seems to be clinically useful for evaluating cases
      of hydronephrosis and for predicting the outcome of pyeloplasty.

PMID- 1626207
TI  - Prophylactic antibiotics in the insertion of Tenckhoff catheters.
AB  - We assessed the efficacy of preoperative antibiotic prophylaxis in a prospective
      trial for patients undergoing insertion of Tenckhoff catheters for continuous
      ambulatory peritoneal dialysis (CAPD). The prophylactic regimen was a single dose
      of cefazolin (500 mg) and gentamicin (80 mg) given intravenously half an hour
      before surgery. There was no significant difference in the number of exit site
      infections (8 in the antibiotic group vs. 8 in the controls) and the number of
      episodes of peritonitis (5 in the antibiotic group vs. 2 in the controls). Our
      study showed that prophylactic preoperative antibiotics did not reduce the number
      of exit site infections and peritonitis after the insertion of Tenckhoff
      catheters.

PMID- 1626208
TI  - Effect of erythropoietin on sexual potency in chronic haemodialysis patients. A
      preliminary study.
AB  - Six male dialysis patients were submitted to a Doppler study of the deep penile
      arteries and intracavernosal injection of 30 mg papaverine under basal conditions
      before and after erythropoietin therapy. Penile tumescence was recorded after 15
      min by measuring the length and the circumference of the penis as well as the
      erectile angle between the penis and the legs with the patient in standing
      position. Haematocrit was raised by erythropoietin therapy from 19.3 +/- 4.5 to
      31.2 +/- 5.5 within 3 months. Five patients completed the study. We encountered a
      significant improvement in the frequency of sexual intercourse per month from 1.3
      +/- 0.5 to 2.3 +/- 0.8 (p = 0.014). Furthermore, an increase was observed in the
      penile brachial index (from 0.87 +/- 0.1 to 0.91 +/- 0.1) and in the papaverin
      induced increase in penile length (4.6 +/- 1.4 cm versus 5.2 +/- 1.1 cm), penile
      circumference (2.7 +/- 0.14 cm versus 2.7 +/- 0.27 cm) as well as in the erectile
      angle (61.7 +/- 37.1 versus 80 +/- 23.5 degrees). These changes were not
      statistically significant. There was a significant correlation between the
      increase in the erectile angle and the increase in frequency of intercourse (p =
      0.04). In conclusion, erythropoietin treatment could improve the sexual potency
      in uraemic patients under chronic haemodialysis therapy.

PMID- 1626209
TI  - Leiomyoma of the bladder. Case report.
AB  - A 33-year-old woman was incidentally noted to have a benign bladder leiomyoma on
      pelvic ultrasonography during pregnancy. This was resected and she made an
      uneventful recovery. Leiomyomas of the bladder are rare and usually asymptomatic;
      the treatment is excision.

PMID- 1626210
TI  - Successful pregnancy after ileocystoplasty. Case report.
AB  - A 32-year-old woman with multiple sclerosis had an uncomplicated pregnancy and
      labour two years after successful "clam" ileocystoplasty for urge incontinence
      and frequency of micturition. She remained well after three years following.

PMID- 1626211
TI  - Spontaneous bladder rupture after colocystoplasty. Case report.
AB  - An 18-year-old girl had bladder extrophy managed by sigmoid cystoplasty with
      clean intermittent catheterization. Spontaneous bladder rupture occurred 12
      months after reconstructive surgery. The diagnosis was made by ultrasound with
      abdominal tapping and cystography under fluoroscopy. Management included
      intravenous antibiotics, laparotomy and closure of the perforation. The diagnosis
      was delayed and postoperative intraperitoneal abscess formation occurred.

PMID- 1626212
TI  - Fatal outcome of bilateral nephrectomy in a patient with polycystic kidney
      disease. Case report.
AB  - A 49-year-old woman had polycystic kidneys and liver cysts first diagnosed in
      1968. She presented with hepatic and renal failure in 1980 and by 1988 was
      undergoing regular haemodialysis. In February 1989 she had bilateral nephrectomy
      (before renal transplantation) but developed septic shock and died. The reported
      mortality of bilateral nephrectomy before kidney transplantation is about 5%, and
      patients should be carefully selected and assessed before operation.

PMID- 1626213
TI  - Primary malignant melanoma of the urinary bladder. Case report.

PMID- 1626214
TI  - Light chain nephropathy. Case report.
AB  - Two patients with light chain nephropathy are described. The diagnosis and
      management of this rare condition is discussed.

PMID- 1626215
TI  - Treatment of primary chronic glomerulonephritis with immunosuppressive and anti
      inflammatory agents. Review.

PMID- 1626216
TI  - Seventh report on the standardisation of terminology of lower urinary tract
      function: lower urinary tract rehabilitation techniques. International Continence
      Society Committee on Standardisation of Terminology.

PMID- 1626217
TI  - Foreign body reaction after modified silicone rubber arthroplasty of the first
      carpometacarpal joint.
AB  - Twenty patients who had been treated with a silicone rubber trapezial implant for
      degenerative changes in the first carpometacarpal joint were evaluated
      radiologically and clinically. After a mean follow up of 4.5 years, 11 of the 20
      required reoperation and removal of the prosthesis for persisting pain and
      weakness. In all hands in which the prosthesis remained radiographs showed bone
      resorption or carpal bone cysts typical of silicone particle synovitis. In the
      light of these results we now do not recommend this procedure for the treatment
      of arthritis of the first carpometacarpal joint.

PMID- 1626219
TI  - Multiple symmetric lipomatosis: combined surgical treatment and liposuction. Case
      report.
AB  - A 47 year old man with a history of alcoholism presented with symmetrical lipomas
      on the shoulders, neck, and chest. He also had lipomatous areas on the trunk and
      thighs. He was treated with a combination of surgery and liposuction, and made an
      uneventful recovery. Histological examination confirmed the diagnosis of multiple
      symmetric lipomatosis, a rare disorder only about 200 cases of which have been
      reported. The aetiology is unknown, but is often seen in patients with a history
      of alcoholism.

PMID- 1626218
TI  - Transfer of the second toe for reconstruction of the hand after trauma.
AB  - Twenty-six transfers of second toe to hand have been carried out in 25 cases. On
      25 occasions the toe was anastomosed to the stump of the thumb, and in one to a
      metacarpal hand. Revascularization failed in five cases, but the remaining 21
      healed with bony union occurring within six weeks in all cases. The mean follow
      up period was 52 months, range 14-81, and the results in 19 thumb cases were
      classified as excellent and in one as good by the Tamai score. We conclude that
      the microsurgical technique of transferring the second toe to the hand is
      challenging, but if revascularization is successful the functional results are
      good. Morbidity at the donor site is minimal.

PMID- 1626221
TI  - Calcifying aponeurotic fibroma. A case of multiple primary tumours. Case report.
AB  - A 20 year old man had had three subcutaneous tumours on his left forefinger for
      15 years. After operation they were found to be infiltrating into the surrounding
      tissue, and histological examination showed them to be calcifying aponeurotic
      fibromas. To the knowledge of the author this is the first reported case of
      multiple primary tumours of this kind.

PMID- 1626220
TI  - Traumatic false aneurysm of finger tip. Case report.
AB  - A 13 year old girl presented with a false aneurysm of the tip of the left middle
      finger. This was treated by ligation of the branch of the digital artery and sac
      excision. The patient made an uneventful recovery. To our knowledge, only 10 such
      cases have been reported, and these were all proximal to the distal
      interphalangeal joint.

PMID- 1626222
TI  - Prepared neurovascular forehead island flap for reconstruction of minor full
      thickness nasal defects. Case report.
AB  - A forehead neurovascular island flap has twice been used for reconstruction of
      minor full thickness nasal defects caused by surgical removal of malignant
      tumours. The flap was raised one month before transposition, and a split
      thickness skin graft was applied to the inner surface of the galea of the flap.
      The periosteum of the forehead was also grafted, thus repairing the donor site
      before the flap was removed. The flap is based on the supraorbital artery, which
      was dissected to its origin at the incisura or supraorbital foramen. The
      advantages are those of a small flap with external as well as internal lining and
      with preserved sensibility.

PMID- 1626223
TI  - Diagnosis of induced cleft palate in rats from defective patterns of
      differentiation of isoenzymes.
AB  - Cleft palate was induced in 420 embryos of Sprague-Dawley rats with a single oral
      dose of 600 mg/kg beta-aminoproprionitrile (BAPN) on embryonal day 15, 7 hours.
      The cleft palate was accompanied by a pathological differentiation pattern of
      various isoenzymes in palatal shelves. These isoenzymes could be detected in
      amniotic fluid from the 16th to the 20th days of pregnancy when they also had a
      pathological differentiation pattern. We conclude that teratogenically induced
      cleft palate in rats is accompanied by a pathological differentiation pattern
      that can be traced by determination of isoenzymes in the palatal shelves as well
      as in amniotic fluid.

PMID- 1626224
TI  - Ischemia in wound healing. I: Design of a flap model--changes in blood flow.
AB  - A standardized ischemic, H-shaped, double flap model in rats was developed for
      investigating the influence of different factors that could potentially increase
      flap survival. The blood flow was measured in the flaps as well as in normal
      healing incisional wounds on day -1 (intact skin) and on days 1, 4, 8, and 16 by
      the xenon-133 (133Xe) clearance technique. The flow in normal healing incisional
      wounds remained the same as the flow in intact skin. The flow in the flaps,
      however, initially decreased to ischemic levels, but afterwards gradually
      increased to that of normal healing incisional wounds and intact skin. Further,
      the cutaneous blood flow in both the cranially and the caudally based ischemic
      dorsal flap was independent of the width of the flap.

PMID- 1626225
TI  - Temperature load test to increase the accuracy of laser Doppler monitoring of
      flaps.
AB  - A heat and cold provocation test was evaluated in 10 porcine island flaps to
      improve the quality of monitoring flap circulation by the laser Doppler
      technique. When the pedicle blood flow was undisturbed there were significant
      increases in flow after a heat stimulus (p = 0.01), whereas no significant flow
      changes were noted during arterial or venous occlusion. This method can increase
      the accuracy of the laser Doppler technique in monitoring the circulation in skin
      flaps.

PMID- 1626226
TI  - Laser technology in plastic surgery.

PMID- 1626227
TI  - The effect of preoperative needle abrasion of the recipient site on survival of
      autologous free fat grafts in rats.
AB  - Pads of fat ranging from 670-1758 mg in weight were taken from the right groins
      of 20 rats and implanted subcutaneously over their right pectoral muscles. One
      week previously the recipient site on the thorax had been abraded with a needle
      in 10 of the rats. After three months the transplanted fat was taken out,
      weighed, and examined histologically by light microscopy. Regional tissue blood
      flow in the transplanted fat and in the fat from the left groin was measured by
      the microsphere technique. The amount of surviving fat and blood flow in the fat
      transplanted to an abraded recipient site was significantly higher than in the
      control group after three months. We conclude that preoperative needle abrasion
      of the recipient site may increase the chance of revascularisation and survival
      of the transplanted fat in rats.

PMID- 1626228
TI  - Conditioning effect induced by chronic nerve compression. An experimental study
      of the sciatic and tibial nerves of rats.
AB  - To find out if chronic nerve compression could affect the peripheral nerve by
      acting as a "conditioning lesion", silicone tubes (internal diameter 0.8-1.6 mm)
      were placed round the sciatic or tibial nerves of adult rats for different time
      periods. After the period of compression the tubes were removed and a test crush
      lesion was made on the sciatic nerve in the thigh. Regeneration distances of the
      sensory nerve fibres were analysed by the pinch reflex test after a further three
      or six days. Compression of sciatic or tibial nerves induced a significant
      increase in outgrowth length compared with nerves subjected to mobilisation and
      crush lesion alone. All the tubes tested had a conditioning effect, but only
      tubes with a small internal diameter seemed to induce nerve fibre degeneration as
      assessed by immunocytochemistry. The results showed that chronic compression
      induced a regenerative response in the peripheral nerve. The mechanism by which
      this was accomplished remains obscure but it may involve both the neurons and the
      non-neuronal cells.

PMID- 1626229
TI  - Reconstruction of ligaments with expanded polytetrafluoroethylene. An
      experimental study in rabbits.
AB  - The medial collateral ligaments in the knee joints of 15 rabbits were replaced
      with expanded polytetrafluoroethylene (E-PTFE). The joints were not immobilised
      postoperatively, and their structure and function were evaluated after 12 months.
      Range of motion was equal in all groups. Stability of the knee joints and
      breaking strength of the ligaments were similar in the group in which the
      ligament had been reconstructed and in the sham operated control group (n = 8).
      The group in which the ligament had been severed and left to heal by formation of
      scar tissue (n = 7) had significantly reduced joint stability and the breaking
      strength of the medial collateral ligament was significantly less. The E-PTFE
      ligaments were well incorporated into the surrounding tissues. There were no
      adverse tissue reactions and the articular cartilage looked normal both
      macroscopically and microscopically. These results indicate that E-PTFE might be
      a useful substitute for damaged ligaments, at least in smaller joints like
      metacarpophalangeal and interphalangeal joints.

PMID- 1626230
TI  - Birth weight and placental weight in cleft probands.
AB  - The mean birth weight of the 1,568 probands with clefts who were born in Finland
      between 1975 and 1985 was 3,346 g, which is lower than the mean of all live born
      babies in 1980 (3,541 g). The 345 who had an associated anomaly or syndrome had a
      mean birth weight of 3,027 g and placental weight of 538 g, compared with 3,435 g
      and 609 g, respectively, for those with solitary clefts. The more severe the
      cleft the lower the birth weight, but not the placental weight. The percentage of
      low birthweight (less than or equal to 2,500 g) infants was higher than in the
      general population (8.5% compared with 3.8%). The highest percentage of low
      birthweight infants was in the subgroup with bilateral cleft lip and palate
      (16.8%).

PMID- 1626231
TI  - Craniofacial development in children with unilateral clefts of the lip, alveolus,
      and palate treated according to four different regimes. II. Mandibular and
      vertical development.
AB  - Lateral skull radiographs of 85 patients with unilateral clefts of the lip,
      alveolus and palate treated according to four different regimes were compared
      longitudinally, at three different ages, regarding mandibular and vertical facial
      development. It was found that there were no lasting differences in mandibular
      morphology resulting from regimes including primary or early secondary bone
      grafting. The non grafted group, however, showed increased mandibular length and
      anterior height. The jaw angle was increased and there was a more favourable
      sagittal jaw relationship. Regimes that included primary bone grafting were
      associated with reduced upper anterior facial height, which resulted in less
      harmonious facial proportions compared with treatment regimes including early
      secondary bone grafting done during the mixed dentition, or no bone grafting at
      all. Vertical development was greatest where bone grafting was excluded.

PMID- 1626232
TI  - The early gingivoalveoloplasty. Preliminary results.
AB  - To try and achieve good alveolar structure without the need for later bone
      grafting, we have carried out secondary gingivoalveoloplasties in 19 consecutive
      patients with cleft lip and palate at a mean age of 36 months (range 19-68). The
      lip and soft palate had been repaired at a mean age of 6 months. Preliminary
      results suggest that simultaneous closure of the hard palate and reconstruction
      of the alveolomaxillary cleft results in good formation of new bone and good or
      reasonable alveolar structure, so obviating the necessity for bone grafting at
      the age of 9-10 years. Long term follow up is needed to confirm these results.

PMID- 1626233
TI  - Correlation between the age at repair and speech outcome in patients with
      isolated cleft palate.
AB  - The effect of the age at primary palatal repair on the speech of 3-year old
      children with isolated cleft palate was assessed. The group comprised 108
      consecutive children whose palates were repaired at the mean ages of 12.9 (n =
      45), 18.5 (n = 18) and 22.1 months (n = 45). Signs of cleft palate speech and the
      degree of speech impairment were recorded. The signs sought were: hypernasality,
      audible nasal air emission, and misarticulations associated with velopharyngeal
      insufficiency. The speech impairments were subdivided into three categories by
      combining the signs of cleft palate speech. The results showed that children who
      were operated on at the age of about 12-18 months were significantly better
      speakers than those operated on later. Of these 46 were rated as normal or
      practically normal speakers (73%), compared with 10 of the children who had their
      repairs delayed until about 22 months (22%). As a result of the speech
      evaluations, it was predicted that 5 (11%), 0 and 21 (47%) children in the early,
      middle, and late closure groups, respectively, required secondary surgery to
      eliminate signs of cleft palate speech associated with velopharyngeal inadequacy.
      The numbers who had secondary surgery were 4, 0 and 18 in the three groups.

PMID- 1626235
TI  - Breast reconstruction using tissue expansion.
AB  - To assess the advantages of tissue expansion as a method of breast
      reconstruction, a prospective, consecutive study was carried out in 41 women who
      had undergone mastectomy. The expander was positioned in the submuscular plane
      and expanded weekly to double the volume of the calculated permanent implant. A
      permanent gel implant was inserted after 10 weeks. Two examiners judged the rate
      of capsular contracture after 15 and 32 months according to the Breast
      Augmentation Classification. The rate of capsular contracture was 28% at the
      second follow-up. Major complications were rare--7%. The patients were pleased
      with the overall result in 82% of cases. We conclude that tissue expansion is
      safe, produces a good result and causes few complications with only minor
      discomfort to the patient.

PMID- 1626234
TI  - The retroauricular coronal incision.
AB  - The coronal incision has been modified so that if it needs to be extended to
      improve exposure, the extension will be behind the ear and therefore less
      noticeable. The incision has been used in 25 adults and 30 children with no
      complications. Its cosmetic appearance is superior to the preauricular coronal
      incision, and it is preferred especially by young people in whom the scar tends
      to widen with time.

PMID- 1626236
TI  - Microvascular reconstruction of soft tissue and bone loss in war wounds.
AB  - Seventy-seven skin and bone defects caused by high velocity missiles have been
      repaired with various combinations of microvascular free transfer of skin flaps
      and vascularised bone grafts. We concluded that the free osteoseptocutaneous
      fibula transfer (1,4) is the best method of reconstruction if a long bone defect
      is associated with skin loss.

PMID- 1626237
TI  - Total wrist arthroplasty. Experience with Swanson flexible silicone implants,
      1982-1988.
AB  - In a study of the results of silicone rubber arthroplasty of the wrist 18
      patients (19 operated wrists) were re-examined after a mean follow up of five
      years. Experience with the ulnar head implant was discouraging, and it was not
      used in the last eight wrists. This did not affect the outcome, patients having
      good supination and pronation without pain. The range of motion with the
      radiocarpal prostheses was 0-70 degrees, mean 39 degrees. Radiological results
      showed severe subsidence in all patients followed up for more than two years, and
      prosthetic fracture in five (26%), which was disappointing. Nevertheless the
      patients had a useful range of motion and all but two were relieved of pain. By
      the patients' own assessments 16 wrists were considered good, one fair, and two
      poor. Predictors of failure (prosthetic fracture) were poor alignment before
      operation, postoperative range of motion of more than 50 degrees, and rupture of
      the carpal extensor tendon. With these reservations we recommend the silicone
      spacer as the best solution for most patients with severe problems of the wrist
      as a result of rheumatoid arthritis.

PMID- 1626238
TI  - Microbeam studies of the sensitivity of structures within living cells.
AB  - Determining the biological effects of low doses of radiation with high linear
      energy transfer (LET) is complicated by the stochastic nature of charged-particle
      interactions. Populations of cells exposed to very low radiation doses contain a
      few cells which have been hit by a charged particle, while the majority of the
      cells receive no radiation damage. At somewhat higher doses, a few cells receive
      two or more events. Because the effects of damage produced by separate events can
      interact in the cell, we have had to make assumptions about the nature of these
      interactions in order to interpret the results of the experiments. Many of those
      assumptions can be tested if we can be sure of the number of charged-particle
      events which occur in individual cells, and correlate this number with the
      biological effect. We have developed a special irradiation facility at Pacific
      Northwest Laboratory (PNL) to control the actual number of charged particle
      tracks that pass through cell nuclei. The beam from a 2 MeV tandem accelerator is
      collimated to approximately 5 microns. Cells, grown in special dishes with 1.5
      microns thick plastic bottoms, are positioned so that the desired portion of the
      cell aligns with the collimator. A shutter in the beam line is opened and closed
      after the desired number of particle tracks has been counted. This approach can
      be used to investigate the effects of the interaction between irradiated and
      unirradiated cells in an organized system, as well as to study the effects of
      spatial and temporal distribution of radiation damage within single
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626239
TI  - The effect of colcemid on the heat survival of mitotic V79 Chinese hamster cells.
AB  - V79 Chinese hamster cells were collected by colcemid addition to study the effect
      of heat on mitosis. When they were heated at 42 degrees C and 45 degrees C in the
      presence of 0.06 micrograms/mL colcemid, cell survival increased over the control
      samples, which were heated in ordinary medium. Scanning electron microscopy
      showed that cells heated to 45 degrees C in the presence or absence of colcemid
      had fewer microvilli on the surface, but they did not have increased bleb
      formation. Transmission electron microscopy showed that the chromatin was diffuse
      in the heated cells and the kinetochores were indistinct. The mitochondria in the
      heated cells were also swollen and contained visible particles.

PMID- 1626240
TI  - A light, transmission and scanning electron microscope study of snuff-treated
      hamster cheek pouch epithelium.
AB  - The effects of smokeless tobacco (snuff) on hamster cheek mucosa were studied by
      light microscopy, transmission (TEM) and scanning electron microscopy (SEM). Two
      grams of commercially available smokeless tobacco were placed into the blind end
      of the right cheek pouch of each experimental animal, once a day and five days a
      week for 24 months. The control animals did not receive smokeless tobacco. After
      24 months treatment with smokeless tobacco, hamster cheek mucosal epithelium lost
      its translucency and had become whitish in color. By light microscopy
      hyperorthokeratosis, prominent granular cell layers with increased keratohyalin
      granules and hyperplasia were seen. At the ultrastructural level, wider
      intercellular spaces filled with microvilli, numerous shorter desmosomes, many
      thin tonofilament bundles, increased number of mitochondria, membrane coating
      granules and keratohyalin granules were seen in snuff-treated epithelium. The
      changes in the surface of the epithelium as seen by SEM were the development of
      an irregular arrangement of the microridges and the disappearance of the normal
      honeycomb pattern. The microridges were irregular, widened and surrounded the
      irregular elongated pits. Some smooth areas without microridges and pits were
      also seen. The long-term histological, TEM and SEM changes induced by smokeless
      tobacco treatment of the epithelium are well correlated with each other and were
      similar to those reported in human leukoplakia without dyskeratosis. They imply
      changes of pathological response resulting from topically applied snuff.

PMID- 1626241
TI  - Levels of complexity in the microstructure of mammalian enamel and their
      application in studies of systematics.
AB  - Description and analysis of the complex structure of enamel can be facilitated
      through the application of a system of hierarchical levels of structural
      complexity. Five interdependent levels are distinguished. These are the levels
      of: 1) crystallites, 2) prisms, 3) enamel types, 4) schmelzmuster, and 5)
      dentition. This system provides a basis for analysis of both variation of
      particular structures and variation of structural types throughout a mammal's
      dentition. Optimally, in wide ranging systematic and biomechanical studies, all
      levels of structural complexity should be considered, but lack of information
      about one level does not prevent significant analyses at other levels.

PMID- 1626242
TI  - Architecture of mixed calcium oxalate dihydrate and monohydrate stones.
AB  - Calcium oxalate dihydrate (COD) and monohydrate (COM) are the most frequent
      constituents of urinary stones, and there still exist some questions about the
      interrelation between the two hydrates. Architecture of mixed COD and COM stones
      was observed by electron microscopy to solve the questions. The fractured surface
      of a stone is composed of the fractured face of the crystals. In this situation a
      morphological criterion of typical dipyramid shape is useless to identify COD.
      But we could identify COD using the partial dissolution method, which etched
      square pits on COD crystals. COD and COM formed distinctly separate layers. COD
      was always found in the stone surface and COM in the center. The stone surface
      was covered by a thick layer of organic matrix, and the intercrystalline space
      was filled with matrix. The crystals were grown thrusting the matrix aside to
      minimize the space. Although COD is more soluble than COM, the urine contains
      specific substances that favor the formation of COD. Supposing the stone matrix
      excludes these substances selectively, the gel-state matrix provides a preferable
      condition for COM formation. This hypothesis is suitable to explain the high
      incidence of COM stones. An abrupt change of the crystalline constituent can be
      explained by COD crystal deposition on COM stones. Frequent COD crystalluria can
      explain why COD is always found in the stone surface. Once the stone surface is
      covered with COD crystals, they continue to grow in the gel-state matrix or
      deposit further to form the bulk of the stone.

PMID- 1626244
TI  - Idiopathic calcium oxalate nephrolithiasis: a cellular disease.
AB  - Physico-chemical, metabolic and hormonal theories regarding the pathogenesis of
      calcium oxalate nephrolithiasis do not sufficiently explain many features of this
      disease. The recent findings of an abnormally faster oxalate self-exchange and
      higher phosphorylation of band 3 in erythrocytes of idiopathic calcium oxalate
      stone formers suggest the hypothesis that nephrolithiasis may be a cellular
      disease, characterized by a defect in the function of the anion-exchange. The
      cellular anomaly seems genetically controlled. Band 3 anion exchanger function
      seems to be biochemically regulated through modulation of band 3 phosphorylation,
      which depends on cyclic AMP- and phospholipid-sensitive Ca2+ independent protein
      kinases. In this light, a reduced glycosaminoglycan concentration in the
      erythrocyte membranes of stone formers might play a role, as these molecules
      exert a strong inhibitory effects on band 3 phosphorylation and anion transport
      in vitro and in vivo. An in vivo trial was performed in which stone formers were
      administered glycosaminoglycans orally. A reduction in oxalate excretion, and
      oxalate renal clearance, and a simultaneous correction of the abnormal RBC
      oxalate flux and band 3 phosphorylation were observed. These data suggest the
      existence of a link between the erythrocyte abnormality and oxalate transport by
      the kidney and gut.

PMID- 1626243
TI  - Factors affecting fasting urinary calcium excretion in stone former patients on
      different dietary calcium intake.
AB  - The effects of variable calcium content on daily and fasting urinary calcium and
      other lithogenic solutes excretion, on the bone turnover index (fasting
      hydroxyproline urinary excretion) and on the calciotropic hormones were studied
      in 312 stone former patients with an outpatient protocol and 15 stone former
      patients in an inpatient study. Furthermore in 60 of these patients, 30 while on
      a low calcium diet (LCD) and 30 on a free calcium home diet (FCD), the effects of
      an oral calcium load (OCL) on bone turnover index, calciotropic hormones and
      calcium excretion were evaluated. The results demonstrate that an LCD is
      effective in reducing daily calcium excretion. Fasting calcium excretion is
      apparently not affected by changes in dietary calcium content. On the other hand,
      LCD induces a marked increase in bone resorption, without apparent signs of
      increased parathyroid activity. This may explain the failure to reduce fasting
      urinary calcium excretion by the LCD. The OCL greatly reduced bone resorption
      rate, without any change in calciotropic hormones, especially in patients on LCD.
      In conclusion, the LCD induces a reduction in the lithogenic factors in the urine
      of stone formers, but induces a marked increase in bone resorption. The lack of
      any change in fasting urinary calcium excretion in conditions of different
      dietary calcium intake may be due to an opposite change in the intestinal and
      osseous components that affect this parameter, and is therefore of little value.

PMID- 1626245
TI  - The microvasculature of human oral mucosa using vascular corrosion casts and
      India ink injection. I. Tongue papillae.
AB  - The microvasculature of human tongue papillae originating from 9 males and 6
      females, aged 0.5 to 2 years was studied by scanning electron microscopy (SEM) of
      vascular corrosion casts and by light microscopy (LM) of India ink injected
      specimens. All papillae showed a microvasculature characterized by primary,
      secondary and tertiary capillary loops. In the filiform papillae the loops were
      generally arranged in a corolla-like pattern with the tertiary loops
      demonstrating a hair-pin shape. The fungiform papillae showed basically a similar
      architectural pattern although the loops were somewhat more compact and complex
      in structure. A small, shallow depression of the tertiary loops at the top of
      these papillae was found to be occupied by a prominent rete ridge of the surface
      epithelium. There was a gradual transition from filiform to foliate papillae, the
      latter appearing as rows of coalesced filiform papillae. The circumvallate
      papillae easily identified by the surrounding furrow showed a rather complex and
      compact pattern of capillary loops of which typical hair-pin shaped tertiary
      loops dominated the periphery of the papilla. Small grooves or depressions in the
      vascular network were found to be occupied by rete ridges of the overlying
      mucosal epithelium.

PMID- 1626246
TI  - Correlative transmission electron microscopy and high resolution scanning
      electron microscopy studies on the fine structural organization of the chicken
      pituitary gland.
AB  - The present study employs transmission (TEM) and high-resolution scanning
      electron microscopy (HR-SEM) to examine the inter- and intra-cellular
      organization of the pars distalis of the chicken anterior pituitary gland. The
      overall view of the cryofractured surface of the par distalis illustrates the
      arrangement of different pituitary cells and tissues in the follicles. Fine
      structural examination by HR-SEM shows that the membrane of the mitochondria has
      a similar configuration to that of the rough endoplasmic reticulum. Granule-like
      structures, on the surface of the mitochondrial membrane, are similar in size to
      ribosomes. Standard imaging and three-dimensional imaging demonstrated the
      formation of developing granules inside the Golgi sacs and the release of mature
      granules from the end of Golgi stacks. The occurrence of granule-granule
      connections suggests that granules may be released by exocytosis in groups or
      individually.

PMID- 1626247
TI  - Structural artifacts and advantages of cytocentrifugation of cells as viewed by
      scanning electron microscopy.
AB  - Cytocentrifugation of cell suspensions onto glass slides is a widely used
      procedure in contemporary cytology. We employed here scanning electron microscopy
      (SEM) to investigate putative morphological changes induced in cells submitted to
      cytocentrifugation. The fine structure of murine pleural exudate cells
      (macrophages mainly) processed by spinning was compared with that of similar
      cells treated without centrifugation (poly-L-lysine attachment of the cells to
      glass slides at 1 g). Cells of cytocentrifuged preparations showed a significant
      increase in diameter and smoothening of the cell surface as compared with the
      morphology of non-centrifuged cells. Cytocentrifugation also induced the
      formation of thin elongations coming out of the cellular outlines. The
      centrifugation-induced flattening of the pleural macrophages improved the
      detection of large intracellular inclusions (containing tungsten particles):
      these bodies were readily identified by secondary-electron imaging mode of SEM in
      cytospinned cells whereas their detection in non-centrifuged spherical cells
      required the use of the backscattered-electron imaging mode of SEM. We conclude
      that the cytocentrifugation methodology, on one hand, requires caution on the
      interpretation of the microanatomy of the cells and, on the other hand, the
      procedure may be an adequate method to improve the identification of large
      intracellular inclusions by routine (secondary-electron imaging mode) SEM.

PMID- 1626248
TI  - [Significance of bronchial alveolar lavage in the diagnosis of eosinophilic
      pneumonia].
AB  - We describe 3 cases of eosinophilic pneumonia of unknown etiology with atypical
      clinical findings diagnosed by bronchoalveolar lavage (BAL). In 2 patients with
      subacute symptoms and restrictive ventilatory dysfunction there was no
      eosinophilia in peripheral blood, and chest X-ray showed a bilateral acinar and
      mixed interstitial-acinar pattern respectively. Transbronchial lung biopsies
      revealed only nonspecific changes. The third patient had acute respiratory
      failure and the eosinophils in peripheral blood were 1500/microliters. Chest X
      ray demonstrated only minimal interstitial changes. In all instances the
      eosinophilic pneumonia was diagnosed by a marked BAL-eosinophilia of 25 to 45%.
      No specific etiology could be detected for the eosinophilic lung disease. The
      response to treatment with corticosteroids was prompt.

PMID- 1626249
TI  - [Perioperative morbidity and mortality of colon resection in colonic carcinoma].
AB  - An analysis of the local and systemic perioperative complications is conducted to
      explore the risk of resection of colon cancer. In a retrospective study we
      analyzed 231 consecutive patients operated on between 1984 and 1988. The mean age
      was 70 (37-91) years. The operations consisted in 3 ileocecal resections, 144
      right hemicolectomies, 10 resections of the transverse colon, 22 left
      hemicolectomies, 77 resections of the sigmoid colon and 5 subtotal colonic
      resections. 2 patients (0.9%) had a clinical leakage of the anastomosis. 3
      patients were reoperated: one because of anastomotic leakage and two because of
      ileus due to small bowel adhesions. 2 patients with uncomplicated local healing
      died within 30 days after the operation from systemic complications (mortality
      0.9%). It is concluded that with standardized preoperative bowel preparation,
      prophylactic perioperative antibiotics and modern anesthesia, the resection of
      colon cancer is today possible with minimal perioperative risk.

PMID- 1626250
TI  - [Helicobacter pylori colonization of the gastric remnant following partial
      resection].
AB  - Colonization by Helicobacter pylori (HP) in 53 patients after remote gastric
      surgery and Roux-en-Y anastomosis was investigated using a rapid urease test (CU
      Test) and histology (H&E and Giemsa stain). The pH-value of gastric juice was
      measured. HP infection of the gastric remnant was found in 56% of 43 patients
      after partial resection and in no case after total gastric resection. HP-positive
      and HP-negative patients were comparable in age, sex distribution, indication and
      technique of gastric operation (except for total gastrectomy with jejunal gastric
      replacement), intake of acid inhibiting drugs and antibiotics was well as in the
      presence or absence of a macroscopically visible pathology of the gastric mucosa.
      On the other hand, the two groups differed in their histological findings, pH
      value of gastric juice and time interval since surgery. HP infection of gastric
      remnants is associated with significant glandular atrophy and an additional rise
      in gastric intraluminal pH compared with HP-negative patients. Both changes may
      involve an increased risk for gastric cancer. In this report on patients with Y
      en-Roux operation there is no decrease in gastric HP-colonization with an
      increasing interval since the time of operation, but rather an increase. This
      phenomenon seems to depend on the absence of enterogastric reflux.

PMID- 1626251
TI  - [Livedo reticularis and multiple vascular occlusions in a patient with HLA-B27
      negative spondyloarthrosis and antiphospholipid antibodies].
AB  - We report the case of a 74-year-old patient with HLA-B27 negative
      spondylarthropathy presenting with acute disseminated vascular occlusions. The
      presence of livedo reticularis prompted a search for antiphospholipid antibodies
      which were found to be markedly elevated. Histopathological examination revealed
      noninflammatory vascular obstruction. The clinical evolution was rapidly fatal in
      spite of corticosteroid treatment. Livedo reticularis can be an important
      diagnostic clue to various types of underlying disease. Increased levels of
      antiphospholipid antibodies have been associated with thrombosis and
      thromboembolism, especially in the context of autoimmune diseases such as
      systemic lupus erythematosus. This paper reports antiphospholipid antibody
      associated noninflammatory vascular occlusions in a patient with HLA-B27 negative
      spondylarthropathy. The pathogenetic mechanism of antiphospholipid antibody
      mediated vascular occlusions is not completely understood and optimal therapy
      remains to be defined.

PMID- 1626253
TI  - [Dentistry Europe--the future has begun].

PMID- 1626252
TI  - [HIV infection: survey among practicing physicians in Bern].
AB  - With increasing numbers of HIV-infected patients, practitioners will play a
      crucial role in the prevention of HIV infection and in the care of infected
      persons. To assess the need for accurate education programs we investigated by
      questionnaire the current practice, attitudes and knowledge of 1057 practitioners
      (general, internists, surgeons, dermatologists, gynecologists), on care,
      prevention and treatment of HIV infection and HIV-related problems in the Canton
      of Berne (population 1 million), Switzerland. 65% of the practitioners provided
      completely evaluable responses. More than 90% had already prescribed HIV tests by
      the end of 1989. A majority rejected routinely performed tests (e.g. for all
      pregnant women, for all patients before surgery). Only about 50% considered a
      patient's informed consent mandatory before each test. Primary prevention by
      sexual history-taking was only rarely done in current practice. All
      recommendations from the Swiss "Stop Aids" campaign were supported, and even
      experimental measures such as allowing i.v. drug use in street corner agencies or
      controlled distribution of heroin were supported by the majority. Mandatory
      testing of risk groups was favored by about 50% but almost nobody wanted to
      establish name records of persons with risk behaviour. By the end of 1989 about
      one third of practitioners regularly cared for HIV-infected persons. Most
      practitioners would prefer to care independently for asymptomatic HIV-infected
      persons, but would favor a specialist support when caring for symptomatic
      patients. Lack of medical skills and knowledge was the main reason for their
      reluctance in caring for patients. Skilled and experienced practitioners were
      more prone to care for additional patients and were more active in prevention.
      Knowledge about HIV transmission, HIV-related complications and treatment was
      good among general practitioners and internists. However, there was some
      confusion about the indications for active vaccination in Aids patients. The
      readiness of Bern practitioners to care for HIV-infected persons is already large
      and could be increased by improving their medical knowledge. However, it is
      unlikely that more medical information alone will improve their prevention
      activities. It appears that education programs aimed at improving the prevention
      activities of practitioners are best designed and performed by their skilled and
      experienced colleagues.

PMID- 1626254
TI  - [Dental surveillance and prophylaxis among schoolchildren in the Canton of Geneva
      between 1980 and 1990].
AB  - As in previous years, the dental status of schoolchildren from Geneva has been
      examined on a yearly basis between 1980 and 1990. A global assessment is
      presented here, showing a gradual increase in the percentage of caries-free
      children, especially in kindergarten classes. Moreover, a single evaluation of
      first permanent molars is presented.

PMID- 1626255
TI  - [The release of mercury and copper from in vivo aged amalgam fillings].
AB  - Release of mercury and copper in water over time from in vivo annealed amalgams
      in an unpolished and polished state was measured. Mercury and copper loss from
      unpolished amalgams was on the average 1,00 micrograms/cm2.d and 0.06
      micrograms/cm2.d, respectively. Polishing the amalgams reduced these values
      significantly to 0.19 micrograms/cm2.d for mercury (p = 0.004) and to 0.03
      micrograms/cm2.d for copper (p = 0.009). It was concluded that polishing amalgam
      surfaces (under water cooling) reduces release of mercury and copper
      significantly.

PMID- 1626256
TI  - [The factors affecting the risk for the loss of resin-bonded bridges].
AB  - 1310 three-unit resin-bonded bridges were examined for their failure rates. After
      five years 86% (+/- 4%) were still in situ. 64% (+/- 5%) didn't need rebonding.
      Significant prognostic factors were: preparation of abutments, surface treatment
      (net retention, silicoating), type of luting agent (Bis GMA) and mobility of the
      abutments.

PMID- 1626257
TI  - [The status of the prosthodontic care of poor adults in Zurich].
AB  - This study wants to give an overview of the prothetical state of treatment of low
      income, above-50-year-old patients, who called for examination and treatment at
      the Cantonal Public Dental Clinic of Zurich. An average of 11.5 own teeth,
      excluding wisdom teeth, were found among the 151 test persons, whose mean age was
      71 years. 30 persons (19.9%) were edentulous. Removable dentures were found
      significantly more often than fixed reconstructions: 72.5% of the test persons
      were equipped with removable dentures and 17.2% with fixed bridges. More than 50%
      of the examined dentures showed hard and/or soft accumulation of plaque and
      calculus. 43% of the anchor teeth of all partial dentures and 16.3% of all bridge
      pillars showed carious lesions. About two-thirds of the "denture patients" were
      not satisfied with their removable denture and wished an adjustment or a new one.
      These results point out a big need for prothetical treatment among the examined
      patient group.

PMID- 1626258
TI  - [Stomatology. Amalgam-associated lichenoid lesions of the oral mucosa].

PMID- 1626259
TI  - [Salivary gland and mesenchymal tumors (II). Orofacial neoplasms: their
      epidemiology, risk factors, prognosis].

PMID- 1626260
TI  - [The routine HIV test before surgical interventions].

PMID- 1626261
TI  - [The Jura Societe d'Odontostomatologie. Interview by Kurt Venner].

PMID- 1626262
TI  - [AIDS].

PMID- 1626263
TI  - [3 implant systems are presented].

PMID- 1626264
TI  - [A microscopic evaluation of the marginal adaptation of onlays in gold].
AB  - The aim of this in vitro trial was to evaluate the marginal seal and adaptation
      of gold onlays according to the instrumentation used to prepare the bevels, the
      quality of margins (as cast vs. polished in the laboratory) and two different
      finishing procedures (burnishing during or after setting of the cement). For that
      purpose, 25 freshly extracted human molars were restored with onlays using
      standardized preparation and fabrication methods. The marginal adaptation of the
      cemented onlays was evaluated using replicas and scanning electron microscopy.
      The marginal seal was evaluated on sample sections after a dye infiltration test.
      In order to improve the marginal fit of gold onlay restorations, it can be
      recommended to: use diamond burs (Intensiv no. 32 and 37) to prepare the bevels
      finish and polish restorations in the laboratory except for areas with access to
      clinically burnish, and polish the margins after setting of the cement.

PMID- 1626265
TI  - [Silicone molding compounds and latex gloves. The effect of latex gloves on
      addition and condensation silicones].
AB  - Inhibited setting of addition silicones has been observed using latex gloves in
      the dental office. Therefore four addition silicones as well as four condensation
      silicones were mixed with seven latex gloves with different properties
      (sterility, powder, accelerator, inner layer). The masses were mixed with bare
      hands as a control and--additionally--with powdered hands. Condensation silicones
      stayed unaffected when put together in exact amounts, while some addition
      silicones showed nearly complete inhibition. Mixing the condensation silicones
      under the conditions of daily practice--one spoon of body plus a distinct amount
      of catalyst-resulted in hardness differences compared to using the exact dose.
      Nevertheless the resulting impressions were of satisfying quality. The powder
      component (Bio-sorb, Surgikos) leads to an accelerated setting. The general
      dental practitioner/dental hygienist have to consider these aspects while
      choosing gloves and silicone putties for taking impressions.

PMID- 1626266
TI  - [Substance ablation with a superpulsed CO2 laser].
AB  - In this study a new, superpulsed CO2-laser was evaluated to remove enamel, dentin
      and several dental restorative materials. In the first part of the experiment,
      superpulsed mode was compared with pulsed and continuous wave using
      semiquantitative test methods. It was found that only superpulse was suitable for
      the purpose. In the following second part of the experiment, temperature rise,
      crater depth and crater diameter were quantitated for the superpulsed mode in a
      range of parameters defined in the first experimental part. It is concluded that
      superpulsed CO2-laser basically has the potential for a mechanical drill
      substitute, provided that the output power is limited to about 1 W and short
      pulses of 0.2-0.3 s duration are applied. In the present form the system is not
      adapted to clinical use. Cooling of the substrate and flexible beam delivery must
      be developed.

PMID- 1626267
TI  - [Tooth root resection and transdental fixation. The flaws and complications].

PMID- 1626268
TI  - [Odontogenic tumors. Primary and secondary neoplasms in the jaw area: their
      epidemiology, prevention and screening].

PMID- 1626269
TI  - [Oral-dental care in Africa: utopia or reality?].

PMID- 1626270
TI  - [An interview with the representatives of the 3 systems...Branemark, Ha-Ti and
      Bonefit (ITI)].

PMID- 1626271
TI  - [Comments on the paper "Anterior tooth trauma"].

PMID- 1626272
TI  - Demand vs. capacity in the healthy pulmonary system.
AB  - This review examines the lung and chest wall adaptation to exercise in health in
      persons of widely varying degrees of fitness. First we examine the regulation of
      breathing and gas exchange in the sedentary young adult who shows a near perfect
      regulation of alveolar gases, ventilation to perfusion distribution, diffusion
      equilibrium in the lung during all levels of exercise. This individual's
      respiratory muscles are also ideally recruited both tonically and phasically so
      as to meet multi-faceted postural, locomotory and respiratory demands. The topic
      of plasticity in the pulmonary system is discussed with specific reference to the
      effects of physical training and athleticism. The key point made here is that
      both homeostasis of gas transport and mechanical efficiency, with which the
      pulmonary system meets the demands of muscular exercise will depend upon the
      ability to maintain a significant margin between demand vs. structural capacity.
      Pulmonary diffusion capacity and at least some aspects of respiratory muscle
      function seem to be "overbuilt" in the young untrained adult. This margin of
      safety no longer prevails as the athlete becomes fitter. The cause is to be found
      in the relative lack of adaptability of the lung and chest wall to the training
      stimulus. Examples of demand coming very close or exceeding the capacity of the
      pulmonary system include the highly trained young endurance athlete and the aged
      athlete. Examples of "failure" or near failure in the pulmonary system's response
      to exercise include: a) exercise induced arterial hypoxemia via diffusion
      limitation; b) diaphragmatic fatigue in endurance exercise; c) expiratory flow
      limitation at VO2max.; d) achieving the capacity of inspiratory muscles for
      pressure generation at VO2max. and e) oxygen cost of breathing which is in excess
      of 15% of VO2max. in those athletes who experience the most mechanical
      limitation.

PMID- 1626273
TI  - [Sudden death during performance of sport: forensic medicine elucidation].
AB  - Our study deals with cases of sudden death (non-traumatic death) while playing
      sport which were examined at the Institute of Forensic Medicine at the University
      of Geneva, and covers the last ten years: 1980-1989. We discovered 19 cases, all
      men between the ages of 17 to 67. In the case of the younger sportsmen (under the
      age of 45-50) or when the causes of mortality were unclear, the police requested
      an autopsy, which totalled 8 cases. In the other 11 cases, we were asked to make
      an external examination of the bodies, in order to exclude any signs of violence.
      Seven sportsmen, aged 36-49, who used to play high-risk sports such as football,
      tennis, basketball and running were autopsied and presented a myocardial infarct.
      Its interesting that 2 of these cases had also an old scar of a myocardial
      infarct. The eighth case was a 17 year old boy who had an already known
      obstructive cardiomyopathy.

PMID- 1626275
TI  - Publishing is an obligation.

PMID- 1626274
TI  - [Lactate measurements in sports medicine: comparison of analytic methods].
AB  - The measurement of lactate is a major aid for controlling the capacity of an
      athlete and for establishing individual training schedules. The results are
      affected by different factors like the site of blood sampling or the distribution
      of lactate in the blood. The aim of the study was to investigate under constant
      conditions the results of four different commercially available methods for
      measuring lactate in blood. All methods were first tested with pure standards of
      lactate and with different reference sera. Both the accuracy and the
      reproducibility of the results were good. One method (Lange) showed good accuracy
      at room temperature but the values were too low at higher temperatures. The
      enzymatic method was then chosen as reference method for investigations with
      blood samples. The first method (ESAT) showed excellent correspondence, the
      results of the second (Lange) were 5-10% too low, and the third method (YSI)
      showed results too low and were also susceptible to trouble.

PMID- 1626276
TI  - Improving continuity of care by evaluation of post-discharge outcomes.
AB  - Evaluation of nursing care is being expanded to identify and assure attainment of
      patient outcomes. Ideally, evaluation of care will occur throughout all phases of
      treatment and include perceptions of the patient and/or significant others. A
      framework for patient outcomes as proposed by Marek (1989) was useful in defining
      outcomes for newly injured and chronically skin-compromised patients with spinal
      cord injury. Guidelines established by the Joint Commission for Accreditation of
      Health Organizations also influenced development of the nursing quality assurance
      approach. A pilot program demonstrated attainment of expected patient outcomes
      for high-risk and problem-prone aspects of nursing care.

PMID- 1626277
TI  - Deafferentation pain after spinal cord injury. Part I. theoretical aspects.
AB  - Pain which persists long after spinal cord injury can become the most disabling
      sequela for the survivor. In extreme cases, it may lead to chemical dependency,
      severe depression and even suicide. Following definition and description of
      deafferentation pain, the risks and benefits of current pharmacologic, surgical
      and other therapies are presented. Part I (in this issue) presents theoretical
      aspects and Part II (in Vol. 9 No. 3) will present management aspects of
      deafferentation pain. This two-part review is intended to facilitate informed
      decision-making by both consumers and caregivers.

PMID- 1626278
TI  - ANA position statements. The role of the registered nurse in the management of
      analgesia by catheter techniques (epidural, intrathecal, intrapleural, or
      peripheral nerve catheters).

PMID- 1626279
TI  - ANA position statements. The role of the registered nurse in the management of
      patients receiving IV conscious sedation for short-term therapeutic, diagnostic,
      or surgical procedures.

PMID- 1626280
TI  - Seronegative inflammatory arthritis in the myelodysplastic syndromes.
AB  - The myelodysplastic syndromes (MDS) are a group of therapeutically refractory
      anemias resulting from a clonal stem cell disorder often associated with
      cytogenetic abnormalities. Immunologic abnormalities and occasionally vasculitis
      have been reported although no series has characterized an associated arthritis.
      All cases of MDS diagnosed in 1990 by bone marrow biopsy and followed up at the
      authors' institution were reviewed. Of the 28 consecutive patients, 8 had acute
      seronegative inflammatory arthritis temporally related to the initial discovery
      of cytopenia. Five patients had a symmetric polyarthritis resolving only with use
      of steroids or upon evolution to leukemia, and 3 had episodes of oligoarthritis
      with systemic features including fever, pleuritis, pericarditis, and hemolytic
      anemia. Arthrocenteses in 2 cases did not show crystals or infection. Serological
      studies were nondiagnostic. The arthritis and systemic features responded to
      steroids in all 5 treated patients. Inflammatory arthritis appears to be common
      in MDS. Most compelling is the apparent bone marrow response to steroids in 2
      cases, possibly identifying a treatable subgroup.

PMID- 1626281
TI  - Treatment of psoriatic arthropathy.
AB  - Psoriatic arthritis develops in 5% of patients with cutaneous psoriasis.
      Management is similar to that of other chronic inflammatory joint diseases, and
      the characteristic features of psoriatic arthritis should be considered: the
      disease is usually mild, with unpredictable flares and remissions, and skin
      disease is a concomitant feature. Nonsteroidal antiinflammatory agents are the
      mainstay of therapy and usually provide adequate control. Among long-term
      treatments, parenteral gold salts, methotrexate, and azathioprine have been shown
      to be effective. Retinoids are often used in patients with extensive skin
      lesions. Other treatments are currently being evaluated (auranofin, colchicine, D
      penicillamine, sulfasalazine, cyclosporine, and gamma-interferon). Antimalarials
      are difficult to handle and may cause progression of skin lesions. Topical
      treatments are indicated in every case. Indications depend on the specific
      features of psoriatic arthritis, the clinical pattern, and the severity of the
      condition.

PMID- 1626282
TI  - Dietary fish oil and rheumatic diseases.
AB  - Dietary fish oil supplementation can induce several metabolic changes relevant to
      rheumatic diseases. Both experimental and clinical evidence show that dietary
      fish oil supplementation modulates inflammatory and immune responses. Many
      studies have shown beneficial, albeit modest, effects in the treatment of
      rheumatoid arthritis. Studies in murine models of systemic lupus erythematosus
      have been encouraging, but few studies have been performed to assess the effects
      of dietary fish oil in the human disease or in other systemic rheumatic diseases.
      Further study on the efficacy of dietary fish oil supplementation in the
      treatment of specific rheumatic diseases is warranted.

PMID- 1626283
TI  - A debate: should patients with rheumatoid arthritis on methotrexate undergo liver
      biopsies?
AB  - The question of whether it is appropriate to perform liver biopsies in rheumatoid
      arthritis patients receiving long-term weekly methotrexate therapy is debated.
      This debate includes a detailed discussion of the literature to support the
      debaters' respective views. Points made in favor of biopsy include (1) the
      significant prevalence of hepatic abnormalities in psoriatic patients; (2) the
      need to continue administration of the drug to sustain a clinical response; (3)
      the high incidence of elevations in aspartate amino-transferase, which correlate
      significantly with hepatic histological outcome; and (4) the fact that the
      rheumatology community has had relatively short experience with the widespread
      use of the drug. Arguments against biopsy include (1) the poorly defined specific
      role of methotrexate in the development of hepatic histological abnormalities;
      (2) the nonquantitative histological grading system, which makes precise
      assessment of progression in hepatic disease difficult; (3) the poorly defined
      role of other factors in the progression of hepatic changes in patients taking
      methotrexate; and (4) the cost and potential morbidity of the procedure itself.
      The role of the hepatic Ito cell in the development of fibrosis is also
      discussed. The protagonists agree on the need to continue studies of liver biopsy
      tissue from rheumatoid arthritis patients receiving methotrexate to better define
      this key issue.

PMID- 1626284
TI  - Fibronectin mediates anchorage-dependent focus formation in cultured human
      synoviocytes.
AB  - To determine the effect of extracellular matrix proteins on synoviocyte
      phenotype, a serum-free, defined-medium culture system was established.
      Rheumatoid synoviocytes maintained on type I collagen appeared monolayered,
      whereas cells maintained on fibronectin showed focus formation. Focus formation
      was abrogated by maintaining cells in the presence of antifibronectin. Focus
      formation was associated with a fibronectin-rich extracellular matrix, whereas
      monolayer morphology was associated with matrices containing a greater proportion
      of collagen. The abundant amount of fibronectin present in the synovial
      microenvironment may be partially responsible for the transformationlike
      phenotype displayed by rheumatoid synoviocytes.

PMID- 1626285
TI  - Analysis of cell populations in rheumatoid arthritis synovial tissues.
AB  - Knee synovium, taken from patients with rheumatoid arthritis at the time of
      arthroplasty, was studied immunohistologically. Focal perivascular lymphoid
      infiltrates of different sizes were examined in detail to evaluate changes in
      cell populations as the infiltrate size increased. T cells formed the largest
      component of mononuclear cells of all aggregates. The large grade 3 aggregates
      contained substantial numbers of B cells arranged around a central venule and
      cells bearing the CD45RA+ phenotype. In contrast, the small grade 1 aggregates
      contained few B cells and the T-cell population contained relatively greater
      numbers of CD8+ cells. Cells bearing the CD45RO+ phenotype exceeded CD45RA+ cells
      in grade 1 aggregates. Detailed analysis of mononuclear cell aggregates of
      different sizes in the rheumatoid synovium suggests that the composition of each
      aggregate depends on the total number of mononuclear cells it contains.

PMID- 1626286
TI  - Aging of the human synovium: an in vivo and ex vivo morphological study.
AB  - Age-associated changes of the human synovium have been investigated by
      microarthroscopy, optical and electron microscopy, immunohistochemistry, and
      cytochemistry. The knee joints of nineteen 15- to 56-year-old subjects,
      classified as normal by inspection, were carefully examined by microarthroscopy;
      small synovial tissue biopsy specimens from both the suprapatellar pouch and the
      medial tibiofemoral gutter were taken. Microarthroscopy showed that the villi
      were more numerous and the vascular network and cell distribution and profiles
      less regular in aged individuals. These data were confirmed by scanning electron
      microscopy, which also showed large areas of the synovial surface devoid of cells
      and collagen bundles in contact with the joint cavity in aged subjects. Light and
      transmission electron microscopy confirmed these data and allowed evaluation of
      the number, distribution, shape, and internal organization of cells as well as
      the distribution of vessels and the organization of the extracellular matrix in
      the full thickness of the synovium (down to 2 mm). Particular attention was paid
      to synovial lining cells, among which three main phenotypes could be recognized:
      synthetic type (present at all ages and hypertrophied in aged subjects),
      macrophagelike (increasing with age), and fibroblastlike. Collagen increased with
      age. Further studies are needed for comprehensive understanding of age-associated
      changes in the human synovium.

PMID- 1626287
TI  - The use of intravenous gadopentetate dimeglumine in magnetic resonance imaging of
      synovial lesions.
AB  - Spin echo T1- and T2-weighted images and intravenously administered gadopentetate
      dimeglumine-enhanced T1-weighted images were obtained in 4 normal volunteers and
      11 patients (11 joints) with painful, intermittent, or persistent joint swelling
      of unknown etiology. These studies were retrospectively reviewed to assess the
      benefits of contrast-enhanced magnetic resonance imaging (MRI) in evaluating the
      synovium. Normal synovium and joint fluid showed no visually apparent enhancement
      on images obtained immediately after intravenous injection of gadopentetate
      dimeglumine. Abnormal synovium enhanced significantly, allowing the precise
      identification of equivocal or unsuspected synovial disease processes. These
      results suggest that, in selected cases, enhanced MRI can be a useful adjunct in
      the evaluation of suspected synovial disease processes.

PMID- 1626288
TI  - The geography of coracoclavicular joints.
AB  - On the basis of published anatomical and skeletal anthropological surveys
      supplemented by published and unpublished commissioned radiologic surveys, the
      distribution of coracoclavicular joints in the world is described. The findings
      are in keeping with a focus having developed in central Asia in Pleistocene
      times. Thus, this anatomical variant can serve, by regression, as a marker for
      population migration from prehistoric times to the present.

PMID- 1626289
TI  - Pathology of osteonecrosis of the femoral head. A review of experience at the
      Hospital for Joint Diseases, New York.
AB  - Pathological examination of the resected femoral heads from approximately 2000
      total hip replacement operations carried out at the Hospital for Joint Diseases
      from 1984 to 1989 identified the presence of osteonecrosis in 345 patients (377
      femoral heads). In 232 patients the osteonecrosis, referred to as "idiopathic,"
      had occurred in the absence of a subcapital fracture. The present paper describes
      the pathology of the necrotic lesions in these 232 patients. The use of
      undecalcified sections and microradiography provides evidence of bone marrow
      calcification which, at the margin of the lesion, is sufficient to influence the
      radiographic features of the lesion significantly. Although a subchondral
      fracture is an almost constant feature of osteonecrosis when it occurs in a
      femoral head with a normal articular cartilage, no such fracture was found in
      cases in which osteonecrosis had occurred in an osteoarthritic joint.

PMID- 1626290
TI  - The lateral approach for hip arthrography.
AB  - Despite advances in imaging techniques, hip arthrography is still a useful
      diagnostic tool. We have found that the lateral approach to the hip joint, with
      the needle inserted superior to the greater trochanter and parallel to the table
      top under fluoroscopic control, allows easy advancement of the needle into the
      lateral hip joint space.

PMID- 1626291
TI  - Quantitative early phase scintigraphy in the prediction of healing of tibial
      fractures.
AB  - Imaging with technetium-99m methylene diphosphonate (99mTc-MDP) is established in
      the diagnosis of infection, neoplasia and ischaemic necrosis in orthopaedic
      practice, but its role in fracture healing is less well-defined. Previous studies
      have shown a relationship between fracture site activity (region A), activity in
      adjacent normal bone (region C) and time to union. The predictive value of the
      A/C ratio of the image obtained 300-800 s after injection was assessed in a
      prospective study of 50 patients with closed tibial fractures managed with
      plaster casts, external fixators and intramedullary nails. There were significant
      differences in absolute uptake and A/C ratio between the three groups (P less
      than 0.05), but this was not related to time to union. Reamed nailing alters the
      distribution of 99m-Tc-MDP uptake so as to reduce the A/C ratio (1.10 +/- 0.20),
      but there is a promising role for early phase bone scanning in non-operative (A/C
      = 1.40 +/- 0.21) or externally fixed (A/C = 1.26 +/- 0.22) fractures in
      conjunction with other non-invasive methods of monitoring the biomechanical
      environment.

PMID- 1626292
TI  - Degenerative disc disease in the lumbar spine: another cause for focally reduced
      activity on marrow scintigraphy.
AB  - A patient is presented in whom a focal reduction in marrow activity in the lumbar
      spine on both leucocyte and nanocolloid marrow scintigraphy was subsequently
      shown to be due to fatty infiltration of marrow in association with disc
      degeneration. Degenerative disease in the lumbar spine has not been previously
      described as a cause of abnormal bone marrow distribution by such means and needs
      to distinguished from a more serious pathology, such as malignant infiltration
      and vertebral infection, which it may mimic. In a retrospective review of 33
      nanocolloid bone marrow and 117 leucocyte scintigrams, 8 showed a degree of
      reduced marrow activity in the lumbar spine consistent with that caused by
      degenerative changes.

PMID- 1626293
TI  - Case report 713. Chondromyxoid fibroma of the third metatarsal.
AB  - In the case presented, the imaging features are those of an aggressive benign or
      less aggressive malignant lesion. The differential diagnosis radiographically
      included aneurysmal bone cyst with or without an accompanying lesion, giant cell
      tumor synovial sarcoma, and other mesenchymal sarcomas. Indeed, at times it is
      difficult to be certain whether the process originated in the bone or soft
      tissue. Pathological examination of the resected specimen showed the typical
      features of chondromyxoid fibroma. Grossly, the tumor was well demarcated and
      firm and composed of tan, translucent tissue that destroyed cortex but was
      confirmed by periosteum. Histologically, the tumor consisted of myxoid,
      chondroid, and fibrous elements. The tumor lobules were composed of predominately
      myxoid matrix containing stellate cells. Variable chondroid elements were present
      with immature appearing chondrocytes, containing eosinophilic cytoplasm and
      irregularly shaped nuclei.

PMID- 1626294
TI  - Case report 729. Myositis ossificans and aneurysmal bone cyst.
AB  - This is the first reported case of ABC in a reactive lesion of soft tissue. The
      ABC may be regarded as an unusual type of organization of hematoma encountered in
      a bone-producing milieu. This would support the current concept that ABC
      occurring in association with another condition represents a secondary change in
      a pre-existing lesion.

PMID- 1626295
TI  - Case report 730. Malignant large cell lymphoma of tibial epiphysis.
AB  - We present a case of primary lymphoma of bone arising in the proximal tibial
      epiphysis of a 16-year-old boy. To the best of our knowledge, primary lymphoma of
      bone has not been described previously as a mimicker of chondroblastoma. This
      case report is intended to increase awareness among clinicians and radiologists
      that primary lymphoma of bone can present with a long clinical prodrome and
      initially benign radiographic appearance. Early recognition of this unusual
      presentation will (hopefully) increase the likelihood of cure. However, it is
      recognized that in children, primary lymphoma of bone is a rare diagnosis and
      associated with a poor prognosis unless aggressive treatment is utilized [8].

PMID- 1626296
TI  - Case report 731. Complicated Baker's cyst.
AB  - The atypical appearance of a gas-containing, noninfected, popliteal synovial cyst
      has been presented. The case again demonstrates the value of plain radiographs,
      in this instance in distinguishing gas bubbles and calcification, which may not
      be apparent by MRI and ultrasound. The uniqueness of this case is stressed. The
      cause of the gas bubbles was not ascertained.

PMID- 1626297
TI  - Case report 732. Gout presenting as a large pseudo tumor (tophus) in the proximal
      end of the tibia.
AB  - A case of a large, lytic, tophaceous defect in the upper end of the tibia has
      been reported in a 44-year-old man as a solitary lesion. The term "gouty tophus"
      should not be confused with the geode or subchondral bone cyst.

PMID- 1626298
TI  - Case report 733. Calcific tendinitis of the origin of the medial and lateral
      heads of the rectus femoris muscle and the anterior iliac spin (AIIS).
AB  - Calcific tendinitis at the site of origin of the rectus femoris muscle is a rare
      lesion. Presumed to be formed by deposition of hydroxyapatite crystals, this
      entity may be confused with other lesions such as os acetabuli or posttraumatic
      abnormalities. The characteristic location and appearance of the calcifications
      in a symptomatic patient with no history of trauma should allow diagnosis and
      subsequent symptomatic therapy.

PMID- 1626299
TI  - Case report 734. Fibroma of tendon sheath eroding 3rd metatarsal bone.
AB  - A case is presented of a 37-year-old man with an extrinsic lesion originating in
      the soft tissue adjacent to the 3rd metatarsal and smoothly eroding the adjacent
      bone. The operatively confirmed diagnosis of fibroma of tendon sheath was
      surprising, giant cell tumour of tendon sheath eroding bone being considerably
      more common; these two lesions are normally impossible to distinguish
      radiologically.

PMID- 1626300
TI  - Case report 735. Vertebral osteosarcoma.
AB  - A case of OS of the T6 vertebra in a 58-year-old man is presented. Diagnosis was
      obtained by an open biopsy. The clinical and radiographic findings were
      described. The topic of vertebral OS was discussed at length. We emphasize the
      fact that OS of the spine is rare and that those cases not associated with
      Paget's disease or previous radiation therapy are even rarer.

PMID- 1626301
TI  - Effect of lumbar orthosis on intervertebral mobility. A roentgen
      stereophotogrammetric analysis.
AB  - To determine the stabilizing effect of external lumbar supports on the
      intervertebral mobility in the lower lumbar spine, seven patients with a
      posterolateral lumbosacral fusion without internal fixation were examined by
      roentgen stereophotogrammetric analysis in supine and erect positions 1 month
      after surgery, that is, after soft tissue healing but before fusion
      consolidation. Each patient was examined without lumbar support, with a molded,
      rigid orthosis and with a canvas corset with molded, plastic posterior support.
      Neither of the two types of lumbar support had any stabilizing effect on the
      sagittal, vertical, or transverse intervertebral translations. This study using
      roentgen stereophotogrammetric analysis confirms that lumbosacral orthosis has
      effect by restricting gross motions of the trunk rather than intervertebral
      mobility in the lumbar spine.

PMID- 1626302
TI  - An improved method of stature measurement for quantitative determination of
      spinal loading. Application to sitting postures and whole body vibration.
AB  - A refined procedure for measuring stature is described; this provides a
      reproducibility error of 0.4 mm. The procedure accommodates the natural diurnal
      change in stature and permits estimation of the net stature change caused by a
      change in spinal loading. A series of measurements done with a cohort of 20 young
      and middle-aged persons showed that stature decrease was related linearly to the
      quasi-static load on the spine. The coefficient of proportionality between load
      and height loss was inversely proportional to the cross-sectional area of the
      lumbar discs. This method was used to investigate sitting postures and whole-body
      vibration to demonstrate the applicability of the procedure to quantify spinal
      strain (and, therefore, estimate comparative loading) in applied ergonomics.
      Sitting invariably led to an increase in stature, regardless of the type of chair
      used or the posture maintained. Whole-body vibration did not induce any loss of
      stature. Thus, this novel approach was able to enhance understanding of spinal
      behavior under different loading conditions.

PMID- 1626303
TI  - Human facet cartilage: swelling and some physico-chemical characteristics as a
      function of age. Part 1: Swelling of human facet joint cartilage.
AB  - The hydration of cartilage from human facet joints was measured after the joints
      had been subjected to different treatments. One group of facets was opened and
      directly exposed to physiologic saline solution before extraction of cartilage
      plugs. The plugs were weighed, re-equilibrated in fluid, and weighed again. The
      swelling results obtained under these conditions were compared with those when
      similar plugs of cartilage were excised from joints that had not been exposed to
      solution or had been exposed to solution while still closed. It was found that
      swelling was least (and similar in value to hip cartilage) for joints that had
      been exposed open to saline solution, highest for joints that had not been
      exposed to solution, and intermediate for joints that had been exposed to
      solution while still closed. The same trends were observed whether the cartilage
      on the joint was intact or fibrillated, although in each group the swelling and
      the final hydration were higher for fibrillated than for intact tissue. It was
      concluded that facet cartilage, unlike human hip or knee cartilage, is
      underhydrated when excised from the joint. This underhydration is thought to
      reflect the permanent presence of stresses in vivo on some part of the facet
      joints, the position of the loaded site changing with time. The authors attempted
      to distinguish between the swelling caused by this underhydration and that from
      disruption of the collagen network in the case of fibrillated specimens.

PMID- 1626304
TI  - Implants of heterologous demineralized bone matrix for induction of posterior
      spinal fusion in rats.
AB  - The authors tested the osteoinductive capacity of powdered heterologous (bovine)
      demineralized bone matrix in rats. The first part of the study concerned a
      monolateral posterior spinal implant after decortication of three vertebrae,
      using as a control area the animal's contralateral side, in which neither bone
      graft nor any other material were placed. In another group of rats, a comparative
      evaluation was made of powdered heterologous demineralized bone matrix and fresh
      autologous bone. In the same animal, autologous bone was implanted to realize a
      thoracic posterior fusion and demineralized bone matrix, to induce a posterior
      fusion in the lumbar area. All data obtained suggested a good osteoinductive
      activity of heterologous powdered demineralized bone matrix. The two posterior
      spinal fusions done in the same animal with heterologous demineralized bone
      matrix or autologous bone, respectively, had similar callus development and
      required the same time for formation.

PMID- 1626305
TI  - Pulmonary function after spinal surgery for idiopathic scoliosis.
AB  - Respiratory function was assessed in 20 patients with idiopathic scoliosis
      undergoing spinal surgery (median age, 15 years; range, 11-34 years; median
      preoperative vital capacity, 67%; range, 28-109% predicted). Ten patients
      underwent anterior spinal surgery through a thoracotomy incision, seven of whom
      had posterior spinal surgery as a second-stage procedure. The other ten had
      posterior spinal surgery as their initial operation. Postoperatively, three
      patients had clinical evidence of respiratory complications. Daytime oxygen
      saturation was reduced throughout the first postoperative week, with no
      significant difference between anterior and posterior spinal surgery. Hypercapnia
      was unusual and generally mild. Vital capacity was reduced significantly 1 week
      after both anterior and posterior spinal surgery (P less than 0.05). The median
      vital capacity 1 week after anterior spinal surgery was 45% of preoperative
      values compared with 78% after posterior surgery (P less than 0.05). Inspiratory
      muscle strength, as assessed by sniff mouth pressure, was 56% of preoperative
      values 1 week after anterior spinal surgery (P less than 0.05) and 85% after
      posterior spinal surgery (not significant). Vital capacity, but not sniff mouth
      pressure, remained significantly reduced 6 weeks after surgery. Oxygen saturation
      should be monitored noninvasively during the first week after both anterior and
      posterior spinal surgery even in patients at low risk of developing respiratory
      complications.

PMID- 1626306
TI  - Respiratory failure in scoliosis and other thoracic deformities. A survey of
      patients with home oxygen or ventilator therapy in Sweden.
AB  - Registers covering Swedish patients with home ventilator or long-term oxygen
      therapy were used to study respiratory failure caused by thoracic deformities. In
      all, 107 patients were studied. Postpolio scoliosis was found in 47 patients. The
      age of starting therapy varied between 28 and 80 years. Fourteen patients had
      thoracic deformities other than scoliosis. The mean scoliotic angle was 135
      degrees among the patients with scoliosis, and the mean vital capacity was 26%
      (range, 13-54%) of predicted normal. The yearly demand for home ventilator or
      oxygen therapy is calculated to three per million inhabitants. No operated
      patients had respiratory failure, and no patients were found with idiopathic
      scoliosis and respiratory failure younger than 30 years of age, which may
      indicate a preventive effect of corrective surgery on the development of
      respiratory failure.

PMID- 1626307
TI  - Spinal extradural angiolipoma. Case report and review of the literature.

PMID- 1626308
TI  - Hemolysis after laminectomy. A case report.

PMID- 1626309
TI  - Radiologic interpretation of lumbar vertebral rotation.

PMID- 1626310
TI  - Possible functions of a new genetic marker in central nervous system: the
      sulfated glycoprotein-2 (SGP-2).
AB  - This brief review discusses the recent characterization in the brain of a gene
      coding for a protein that may be involved in programmed cell death and/or brain
      plasticity. We will term it sulfated glycoprotein-2 (SGP-2), the name
      corresponding to the first cDNA characterized. Recent studies have demonstrated
      the overexpression of this sulfated glycoprotein in various CNS disorders, such
      as certain gliomas, Alzheimer's disease and epilepsy, as well as after
      experimental brain injury in animals where different cell types were undergoing
      tissue remodelling or cell death. In peripheral tissues, SGP-2 gene expression
      has been found to be strikingly increased following experimental manipulations in
      which cells of injured tissues were undergoing programmed cell death or
      apoptosis. The results reported thus far are intriguing and suggest the possible
      involvement of SGP-2 in apoptotic mechanisms as well as its interaction with
      components of the immune system possibly associated with cell death in
      neurodegenerative disorders.

PMID- 1626311
TI  - Effects of nigrostriatal lesions on the levels of messenger RNAs encoding two
      isoforms of glutamate decarboxylase in the globus pallidus and entopeduncular
      nucleus of the rat.
AB  - The neurotransmitter gamma-aminobutyric acid (GABA) is present in efferent
      neurons of the striatum and of the pallidum, one of the main striatal target
      areas. Dopaminergic nigrostriatal neurons play a critical role in the regulation
      of GABAergic neurotransmission in the striatum. In the present study, we
      investigated their role in the regulation of glutamate-decarboxylase (GAD) mRNA
      expression in two divisions of the pallidum in rats: the globus pallidus and
      entopeduncular nucleus, equivalent to the external and internal pallidum,
      respectively, of primates. Dopaminergic neurons were lesioned by unilateral
      injections of 6-hydroxydopamine (6-OHDA) in the substantia nigra of adult rats.
      Two or 3 weeks after the lesion, frontal cryostat-cut sections of the brain were
      processed for in situ hybridization histochemistry with 35S-labeled RNA probes
      synthesized from cDNAs encoding two distinct isoforms of GAD of respective
      molecular weight 67,000 (GAD67) and 65,000 (GAD65). The number of labeled cells
      was determined, and intensity of labeling in individual cells was analyzed by
      computerized image analysis on emulsion radioautographs. In the globus pallidus,
      the number of labeled neurons and intensity of labeling per cell were increased
      on the side ipsilateral to the lesion as compared with control rats in sections
      hybridized with the GAD67 RNA probe. No changes were detected on the side
      contralateral to the lesion or in the levels of labeling for GAD65 mRNA.
      Confirming previous data, the level of labeling for GAD65 mRNA was much higher
      than for GAD67 mRNA in the entopeduncular nucleus of control rats. In rats with a
      6-OHDA lesion, labeling for both GAD67 and GAD65 mRNAs was decreased on the side
      contralateral, but not ipsilateral, to the lesion, as compared with control rats.
      The results show that lesions of the nigrostriatal pathway in rats affect the
      levels of mRNAs encoding two distinct isoforms of GAD in neurons of the globus
      pallidus and entopeduncular nucleus differently. In addition, results in the
      entopeduncular nucleus further support a bilateral effect of unilateral
      dopaminergic lesions.

PMID- 1626312
TI  - Calcium-, calcium/calmodulin-, and calcium/phospholipid-stimulated protein
      phosphorylation in the rat anterior pituitary.
AB  - Calcium-dependent protein phosphorylation may be a critical step in the
      stimulated secretion of anterior pituitary hormones. We have noted the existence
      of a number of calcium-calcium/calmodulin-, and calcium/phospholipid-dependent
      phosphoproteins in the normal rat anterior pituitary. Cell extracts were prepared
      from anterior pituitary glands of male rats and phosphorylated with [gamma
      32P]ATP in the presence or absence of calcium, calmodulin, and
      phosphatidylserine. The samples were electrophoresed on SDS-PAGE gels,
      autoradiographs prepared, and phosphate incorporation into specific proteins
      quantitated with microdensitometry. Calcium alone significantly stimulated the
      phosphorylation of proteins with molecular weights of 80.0-, 62.0-, 51.0-, 30.5-,
      and 25.0-kDa. The phosphorylation of 21.5-, 51.0-, and 80.0-kDa MW
      phosphoproteins was found to be phospholipid dependent. The phosphorylation of
      62.0-, 51.0-, 33.0-, 30.5-, and 25.0-kDa MW phosphoproteins was found to be
      calcium/calmodulin kinase dependent. Calcium/calmodulin also inhibited
      phosphorylation of the 80.0-kDa phosphoprotein.

PMID- 1626313
TI  - MK-801 protection against methamphetamine-induced striatal dopamine terminal
      injury is associated with attenuated dopamine overflow.
AB  - Repeated administrations of methamphetamine (m-AMPH) produce high extracellular
      levels of dopamine (DA) and subsequent striatal DA terminal damage.
      Pharmacological blockade of N-methyl-D-aspartate (NMDA) receptors has been shown
      previously to prevent m-AMPH-induced striatal DA terminal injury, but the
      mechanism for this protection is unclear. In the present study, in vivo
      microdialysis was used to determine the effects of blockade of NMDA receptors
      with the noncompetitive antagonist MK-801 on m-AMPH-induced striatal DA overflow.
      Four injections of MK-801 (0.5 mg/kg, ip) alone did not significantly change
      extracellular striatal DA concentrations from pretreatment values. Four
      treatments with m-AMPH (4.0 mg/kg, sc at 2-hr intervals) increased striatal DA
      overflow, and the overflow was particularly extensive following the fourth
      injection. This m-AMPH regimen produced a 40% reduction in striatal DA tissue
      content 1 week later. Treatment with MK-801 15 min before each of the four m-AMPH
      injections or prior to only the last two m-AMPH administrations attenuated the m
      AMPH-induced increase in striatal DA overflow and protected completely against
      striatal DA depletions. Other MK-801 treatment regimens less effectively reduced
      the m-AMPH-induced striatal DA efflux and were ineffective in protecting against
      striatal DA depletions. Linear regression analysis indicated that cumulative DA
      overflow was strongly predictive (r = -.68) of striatal DA tissue levels measured
      one week later. These findings suggest that the extensive DA overflow seen during
      a neurotoxic regimen of m-AMPH is a crucial component of the subsequent
      neurotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626314
TI  - Regional norepinephrine response to amphetamine using dialysis: comparison with
      caudate dopamine.
AB  - The response of extracellular norepinephrine to the acute administration of
      amphetamine was assessed, using dialysis, in prefrontal cortex and hippocampus in
      awake, behaving rats. Norepinephrine exhibited a pronounced and rapid dose- and
      time-dependent increase in response to 0.5 and 2.5 mg/kg amphetamine, which
      corresponded closely to the time course of the behavioral profile. These results
      are consistent in with a possible role for norepinephrine in the behavioral
      response to amphetamine.

PMID- 1626315
TI  - Distribution of enkephalin and its relation to serotonin in cat and monkey spinal
      cord and brain stem.
AB  - The distribution of enkephalin (ENK)-like immunoreactivity (LI) in spinal cord
      and medulla oblongata of cat and gray monkey (Macaca fascicularis) was studied by
      use of immunofluorescence and peroxidase antiperoxidase (PAP) techniques.
      Possible coexistence between ENK- and 5-hydroxytryptamine (5-HT)-LI was also
      analyzed with double labeling immunofluorescence. Furthermore, in situ
      hybridization was used to demonstrate cell bodies in the brain stem expressing
      mRNA encoding for ENK. ENK-immunoreactive (IR) axonal varicosities and fibers
      were demonstrated throughout the spinal cord gray matter, with the highest
      density in the superficial dorsal horn, the area around the central canal, the
      intermediolateral cell column, the sacral parasympathetic nucleus, and in Onuf's
      nucleus. In the monkey ventral horn, ENK-IR varicose fibers could in some cases
      be demonstrated in very close apposition to cell bodies. A low degree of co
      localization between ENK- and 5-HT-LI was seen in the spinal cord of both
      species. Still, fibers containing both compounds could as a rule be demonstrated
      in every section studied. The highest degree of coexistence was encountered in
      the motor nucleus of the ventral horn. Six weeks after a low thoracic spinal cord
      transection a decreased staining for ENK-LI was demonstrated in the ventral horn
      motor nucleus, whereas other parts of the spinal cord appeared unaffected. In the
      brain stem of cats after colchicine treatment, ENK-LI was found in a majority of
      the 5-HT-IR cell bodies in the raphe nuclei (nucleus raphe magnus, pallidus and
      obscurus) and in the lateral reticular nucleus (rostroventrolateral reticular
      nucleus). In cat not pretreated with colchicine, a few weakly stained ENK-IR cell
      bodies could be found in the midline raphe nuclei and in the lateral reticular
      nucleus with the PAP technique. In the monkey brain stem without colchicine
      treatment, using the PAP technique, heavily stained ENK-IR cell bodies could be
      seen in the lateral reticular nucleus whereas, as in the cat, only a few, weakly
      stained ENK-IR cell bodies could be seen in the midline raphe nuclei. Using in
      situ hybridization technique, ENK mRNA expressing cells were demonstrated in the
      lateral reticular nucleus while no convincing mRNA signal could be found over
      cell bodies in the raphe nuclei. It is concluded that part of the ENKergic
      innervation of the cord in both species derives from supraspinal or
      suprasegmental levels.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1626316
TI  - [Results of studies with aborted cattle fetuses].
AB  - The laboratory of the Animal Health Service of South Holland investigated 2410
      cases of spontaneous abortion (twins (112) were considered one case). Seventy
      eight afterbirths without foetuses were also examined. The aim of the study was
      not only to find the cause of abortion but also to see whether there was a
      relation between the results of the different bacteriological, virological and
      histological tests used. The presence of IgG in the blood of foetuses older than
      5 months was also determined. A micro-organism was isolated from 25% of the
      foetuses. On the basis of results of other tests, it is probable that microbial
      infection played a role in a further 21% of the abortions. BHV was isolated in
      2.5% of the cases. Actinomyces pyogenes was found in 6% of the foetuses and fungi
      in 3.5%. More infections with Actinomyces pyogenes, Listeria monocytogenes and
      fungi were observed when the cattle were kept indoors. It is emphasised that both
      foetuses as well as placental membranes should be examined, and both foetuses of
      twins. In stable enzooties in the Netherlands, the following infections should be
      taken into consideration: Brucella abortus, BHV, BVD, Chlamydia psittaci and
      Leptospira hardjo. The authors stress the need for a more standardised approach
      to research, the more so because the results could have consequences not only for
      monitoring activities (checks for Br. abortus) but also for liability.

PMID- 1626317
TI  - [A horse with osteochondrosis. Now what?].
AB  - Based on three clinical cases, the history and the clinical and radiological
      aspects of osteochondrosis in horses are discussed. The prognosis, therapy and
      consequences with regard to athletic soundness and use for breeding are
      described.

PMID- 1626318
TI  - [Spirit and animal].

PMID- 1626319
TI  - [Complementary testing criteria for veterinary drugs applied in animals for
      choice meat production. Recommendations by the Drug Advisory Commission of the
      Royal Dutch Society for Veterinary Medicine].

PMID- 1626320
TI  - Gene expression in Echis carinatus (carpet viper) venom glands following milking.
AB  - RNA was extracted from the venom glands of Echis carinatus at different times
      after milking, and the temporal pattern and nature of mRNA transcribed during
      venom regeneration was examined by in vitro translation. Venom products were
      immunoprecipitated with E. carinatus venom polyclonal antiserum. Maximum
      transcriptional activity occurred 3 days after milking. Electrophoretic analysis
      of the translation products showed minimal differences in the banding patterns at
      each time interval. Analysis of the translation products from Kenyan, Nigerian
      and Saudi Arabian carpet vipers, however, revealed differences which suggest that
      the observed heterogeneity in E. carinatus venom occurs at the level of the
      genome.

PMID- 1626321
TI  - Effects of myotoxin alpha on fusion and contractile activity in myoblast-myotube
      cell cultures.
AB  - Cultured myoblasts and moytubes were used to study the effects of purified
      myotoxins from rattlesnake venoms. Standard cell culture techniques were used to
      establish and maintain primary cultures derived from neonatal rat tissue and two
      clonal cell lines, rat RMo cells and mouse C2 cells. Toxin concentrations,
      ranging from 0.04 to 1.0 microM, were added to the cultures at various times
      under distinct, well-defined conditions. Addition of myotoxin alpha to primary
      myoblast cultures did not appear to affect the fusion process, whereas similar
      experiments with two clonal cell lines produced larger myotubes when contrasted
      with untreated control cultures, particularly with RMo cells. The myotubes
      derived from primary cell cultures twitched spontaneously but the twitching
      ceased when the medium was replaced with a serum-free chemically defined
      incubation medium. Addition of myotoxin alpha to the primary myotubes incubated
      with serum-free defined medium caused the myotubes to twitch again. Derivatives
      of myotoxin alpha were prepared by reactions with tetranitromethane and with
      iodoacetic acid, the latter under reducing and non-reducing conditions. The
      resulting products, purified but not chemically characterized, were nearly devoid
      of activity when primary cultures were used to test activity.

PMID- 1626322
TI  - Antibodies to brevetoxin B: serologic differentiation of brevetoxin B and
      brevetoxin A.
AB  - A brevetoxin B immunogen was prepared by reacting brevetoxin B with the amino
      groups of bovine albumin followed by treatment with sodium borohydride. Immunized
      rabbits produced antibodies that bound [3H]brevetoxin B-alcohol. This binding
      increased with repeated immunization (KD for one rabbit after three courses of
      immunization was about 10 pM). Brevetoxin B inhibited greater than 500 times more
      effectively than brevetoxin A. When tested in a competitive binding assay with
      [3H]brevetoxin B-alcohol-brevetoxin B antibody, the alcohol was six times more
      effective as an inhibitor than brevetoxin B. Despite some similarities in
      structure with brevetoxin A, the antibodies to brevetoxin B did not recognize the
      backbone of brevetoxin A.

PMID- 1626323
TI  - Sensitivity in culture of epithelial cells from rhesus monkey kidney and human
      colon carcinoma to toxins A and B from Clostridium difficile.
AB  - The effect of toxins A and B from Clostridium difficile on human colon carcinoma
      cells (HT-29, epithelial), rhesus monkey kidney cells (MA-104, epithelial) and
      green monkey kidney cells (VERO, fibroblast) was studied. Both toxins caused
      rounding of HT-29 cells and rounding with projections remaining attached to the
      substrate in MA-104 and VERO cells; however, the sensitivity to each toxin varies
      considerably. Toxin A was detected in ng by VERO, pg by HT-29 and fractions of pg
      by MA-104 cells; for toxin B, pg were detected by VERO, ng by MA-104 and
      micrograms by HT-29 cells. HT-29 cells were grown with galactose to allow their
      differentiation to enterocytes, and their sensitivity to the toxins during the
      process was studied. At early stages, the sensitivity to both toxins was similar,
      and as the differentiation proceeded, the response to both toxins decreased
      continuously, and after 16 days no evident morphological effect was observed,
      even with micrograms amounts of either toxin. In contrast to all cell lines
      reported to date, HT-29 and MA-104 epithelial cells are exquisitely sensitive to
      toxin A and less responsive to toxin B. The rounding of HT-29 by these toxins
      depends on the degree of differentiation of the cell.

PMID- 1626324
TI  - Hemorrhagic, fibrinogenolytic and edema-forming activities of the venom of the
      colubrid snake Philodryas olfersii (green snake).
AB  - The venom of P. olfersii has high hemorrhagic, edema-inducing and
      fibrin(ogen)olytic activities. It is devoid of thrombin-like, procoagulant,
      phospholipase A2 and platelet aggregating enzymes. The main activities are
      metalloproteinases inhibited by metal chelators (EDTA and 1,10-phenanthroline)
      and sulfhydryl compounds (DTT and cysteine). The hemorrhagic and fibrinogenolytic
      enzymes were partially purified by gel filtration on HPLC. The hemorrhagic
      activity of the venom was neutralized by commercial horse antivenoms to Bothrops
      species, as well as by rabbit antisera specific for hemorrhagic factors isolated
      from these Bothrops venoms. No immunoprecipitin reactions were obtained,
      indicating that the few epitopes of the P. olfersii hemorrhagin are involved in
      these neutralization reactions. The fibrinogenolytic enzyme cleaves A alpha-chain
      more quickly than the B beta-chain of human fibrinogen. The venom also
      solubilizes fibrin. This solubilization appears to occur from the hydrolysis of
      unpolymerized alpha-chain and cross-linked gamma-gamma dimer. The fibrin peptide
      products are distinct from those produced by plasmin.

PMID- 1626325
TI  - Activity of sarafotoxin/endothelin peptides in the heart and brain of lower
      vertebrates.
AB  - The effects of sarafotoxin-b (SRTX-b) and endothelin-1 (ET-1) were tested in the
      fish tilapia (Ore niloticus x O. aureus hybrids) and torpedo (Torpedo ocellata),
      the toad (Bufo viridis), the agama lizard (Agama stellio) and water snake (Natrix
      tessellata). In isolated heart preparations of the fish and agama, peptide doses
      of 0.05-0.5 micrograms/ml induced positive inotropic effects, reduction of the
      contraction rate and arrhythmia, leading to cardiac arrest. In the toad, a
      negative inotropic effect and a reduction of the contraction rate were observed,
      whereas the water snake was hardly affected by either SRTX-b or ET-1. In the
      agama, an i.v. injection of 15 micrograms of SRTX-b caused changes in the ECG,
      culminating in A-V block that led to cardiac arrest, while in the toad an
      injection of 45 micrograms induced only transient disturbances in the ECG.
      Binding studies with 125I-SRTX-b revealed specific binding sites for SRTX-b and
      ET-1 in the heart and brain preparations of fish (tilapia and torpedo) and agama,
      whereas no specific binding could be demonstrated in the toad or in the snake.
      These results suggest that most vertebrates tested are sensitive to SRTX/ET,
      while the snake may possess receptors that are of a different structure.

PMID- 1626326
TI  - Factors associated with the mass of venom expended by prairie rattlesnakes
      (Crotalus v. viridis) feeding on mice.
AB  - The purpose of this study was to assess through correlation analyses the various
      factors and consequences associated with the mass of venom injected by prairie
      rattlesnakes (Crotalus v. viridis) into their natural prey, deer mice (Peromyscus
      maniculatus). Fifty-seven predator-prey interactions were studied via slow motion
      videotape review. The mass of venom expended by snakes during biting was
      quantified by enzyme-linked immunosorbent assay (ELISA) of whole-animal
      homogenates. The quantity of venom expended was not related to size of prey;
      however, the range of mouse sizes (13-31 g) was quite narrow. Multiple bites of
      the same mouse were not associated with incremental increases in venom
      expenditure; only about 40% more venom was expended by striking prey a second
      time. The duration of fang contact and site of fang penetration had no
      discernible effects on venom expenditure. The site of fang penetration of prey
      appeared to be random, due to evasive actions of the mice. The components of
      striking (duration of launch, fang contact, and recoil, respectively) and
      distance of the strike were correlated and appeared to be influenced by the
      prey's reaction. After striking and releasing mice, the snakes did not attempt to
      relocate more quickly those prey which succumbed to venom relatively quickly.
      Both natural (snakebite) and artificial (syringe) injections indicated that the
      site of venom injection (e.g. anterior, posterior, muscle, vital organ) has a
      greater influence on subsequent mobility and survival of mice than the quantity
      of venom injected. It appears that some behavioral aspects of predation
      (especially the sequential components of striking) are flexible and responsive to
      prey reactions, while others (venom expenditure and poststrike immobility) are
      less subject to modification.

PMID- 1626327
TI  - Citrate is a major component of snake venoms.
AB  - Citrate has been identified as a major component of snake venoms by gas liquid
      chromatography and mass spectrometry. The venoms of Bothrops asper, Crotalus
      atrox, Crotalus viridis viridis, Crotalus adamanteus, Sistrurus miliarius
      barbouri, Crotalus horridus horridus, Agkistrodon contortrix mokasen, Agkistrodon
      contortrix contortrix and Agkistrodon piscivorus piscivorus contain citrate at
      concentration levels which can serve as effective buffers. Calcium, magnesium,
      zinc, iron, sodium and potassium salts of citrate would be constituents of venom.

PMID- 1626329
TI  - Bibliography of toxinology.

PMID- 1626328
TI  - A new bioassay reveals mollusc-specific toxicity in molluscivorous Conus venoms.
AB  - Contraction of the foot pedal of a limpet snail is described as a new and
      quantifiable bioassay for mollusc paralysis. This bioassay was used for screening
      the venoms of seven different species of Conus snails. Comparison of the results
      of the limpet assay with those obtained from fish and blowflies shows a
      correlation between the feeding specificities and venom toxicities of these
      Conidae. The limpet bioassay should be useful for identification and monitoring
      of the purification of new toxins active on molluscan systems.

PMID- 1626330
TI  - Creativity, depression and suicide.
AB  - The relationship between suicide and creativity has long been a subject of
      considerable concern. The author presents evidence indicating that in fact
      depression, suicide, and creativity are related. Several hypotheses for the
      relationship are posited. It is suggested that the same changes in the
      serotonergic system that are associated with depression in general and with
      impulsive suicides and homicides in the extreme may also be responsible for an
      element of risk taking that characterizes creativity and innovation in a person
      psychodynamically predisposed to being creative.

PMID- 1626331
TI  - Identification of coping ideation and strategies preventing suicidality in a
      college-age sample.
AB  - This study attempts to identify coping mechanisms relevant to the prevention of
      progressive lethality in suicidal behavior among youth. College students (N =
      296) aged 18 to 24, self-identified as having no past suicidal ideation, mild
      ideation, severe ideation, or having attempted suicide, completed the Reasons for
      Living Inventory (Linehan, Goodstein, Nielson, & Chiles, 1983), a similarly
      derived instrument for age-specific coping cognitions, and a scale of coping
      strategies for diminishing suicidality. Discriminant functions analyses of the
      mean factor scores for each scale were used to assess the pertinence of various
      coping mechanisms among the 4 groups. Patterns of similarities and differences in
      mechanisms were identified.

PMID- 1626332
TI  - Inferred characteristics of successful suicides as function of gender and
      context.
AB  - This paper examines college students' attributions about suicide as a function of
      gender and context (athletic vs. relationship failure). Results indicated that
      male athletes who suicided were considered more emotionally well-adjusted
      compared to males who suicided because of a relationship failure and all females.
      Male and female athletes who suicided were seen as more competent and less
      distressed compared to those who suffered a failed relationship. Females were
      also seen as more distressed compared to males. These results are discussed in
      terms of a positive bias toward athletes in our society as well as gender
      stereotypes. Implications of these findings as well as methodological limitations
      are discussed.

PMID- 1626333
TI  - Sex-role change, anomie and female suicide: a test of alternative Durkheimian
      explanations.
AB  - Durkheim's influential book, Suicide, provides general (economic) anomie,
      conjugal anomie, and sex-role convergence explanations of changes in suicide
      rates under conditions of social change. We used trend analyses of American
      suicide rates and female/male suicide ratios from 1950 to 1984 and the regression
      of the ratios on female educational attainment, white female labor force
      participation, white fertility rates, and divorce rates to examine these
      explanations. The general anomie explanation of female suicide trends is
      supported for the middle-aged (30 to 54 years) but not for the young (10 to 30
      years) or the elderly (55 to 74 years). The conjugal anomie proposition is at
      best supported for age groups between 15 and 44 when general anomie is not
      pronounced. The role convergence explanation is rejected for all 13 5-year-age
      groups. General anomie may not be a viable explanation of suicide trends for
      groups actively supporting relevant social changes or not yet tradition-bound or
      for groups whose retirement status reduces the importance of some social changes.

PMID- 1626334
TI  - Suicidal adolescents' perceptions of their family environment.
AB  - This study examined the extent to which adolescents' perceptions of their family
      environments were associated with suicidal behavior. Fifteen suicidal
      adolescents, 14 psychiatric controls, and 14 normal controls rated their families
      on cohesiveness, adaptability, parent-adolescent communication, parental caring,
      and parental over-protectiveness. Suicidal adolescents rated their families as
      the least cohesive and most rigid of the 3 groups, suggesting that adolescent
      suicidal behavior may occur when isolation is experienced within an inflexible
      family system. Suicidal and psychiatric control adolescents rated their families
      as similarly dysfunctional along the remaining variables, and as more
      dysfunctional than families of normal control adolescents. The implications of
      these findings are discussed, and it is suggested that several characteristics
      commonly attributed to families of suicidal adolescents may actually be general
      risk factors for adolescent psychopathology, rather than for suicidal behavior
      specifically.

PMID- 1626335
TI  - The impact of epidemic, war, prohibition and media on suicide: United States,
      1910-1920.
AB  - The paper utilizes a natural experiment approach to estimate the impact of
      exogenous social and political events on suicide behavior in the United States
      between 1910 and 1920. The study is concerned with determining the impact of
      World War I, the great Influenza Epidemic, and the prohibition experiment on
      suicide. Estimating the monthly population in the United States registration area
      from 1910 to 1920, monthly suicide and mortality rates are computed. A time
      series model is postulated, and second-order autoregressive estimates are used to
      determine the impact of the independent variables in the model. It is concluded
      that World War I did not influence suicide; the Great Influenza Epidemic caused
      it to increase; and the continuing decline in alcohol consumption between 1910
      and 1920 depressed national suicide rates. Further individual-level aggregate
      studies are needed to confirm the findings of the study.

PMID- 1626336
TI  - The effect of the media on suicide: the Great Depression.
AB  - Previous work on the media and suicide has neglected the mood of the audience in
      its models. The present study tests the thesis from symbolic interaction theory
      that the degree of media influence is contingent on audience receptivity.
      Audience receptivity to suicide stories is assumed to be high in the Great
      Depression given widespread unemployment, a condition thought to promote
      suicidogenic mood such as anomie. A taxonomy of stories is developed using
      classic imitation, social learning, and differential identification theories.
      Analysis of monthly data on suicide and publicized stories finds, however, little
      supporting evidence. Only stories concerning political leaders were associated
      with suicide. Stories concerning other categories of victims, such as villains,
      entertainers, and foreigners, were not associated with suicide. Possibly the
      potential impact was offset by other factors such as the absence of television to
      echo for the messages carried by the newspapers and radio and heightened
      political integration.

PMID- 1626337
TI  - Suicidal behavior and marital interaction.

PMID- 1626338
TI  - Characterization of thymic weight and thymic peptide thymosin-beta 4: effects of
      hypophysectomy, sex, and neonatal sexual differentiation.
AB  - An initial experiment was conducted to analyze the effects of hypophysectomy
      (Days 5-30 post hypophysectomy) on thymic weight and thymosin-beta 4
      concentrations. After hypophysectomy, thymic weight and thymosin-beta 4
      concentrations decreased with time (5, 10, 15, and 30 days post hypophysectomy)
      and by 30 days post hypophysectomy were reduced by 50%. Exp. II investigated the
      effects of early sexual differentiation on thymic weight and thymosin-beta 4
      concentrations in pituitary intact and hypophysectomized male, female,
      nonmasculinized rats (via castration of males at Day 2 or 11 of age and
      androgenized female (at Day 3 of age) rats. Rats were hypophysectomized at 30
      days of age and, at 17 days post hypophysectomy, the thymus gland was dissected
      and weighed. Serum was collected for thymosin-beta 4 analysis. At 47 days of age,
      males have a greater thymic weight when compared to females (p less than 0.01)
      but hypophysectomy eliminated any sex differences and significantly reduced
      thymic weights (p less than 0.05). Hypophysectomy did produce increased thymosin
      beta 4 concentrations across all treatments (p less than 0.01) and is considered
      to be a combination response of decreased gonadal function via lack of pituitary
      hormonal stimulation (luteinizing hormone and follicle stimulating hormone) and
      lack of gonadotrophic effects on the thymus gland and its secretory capacity.
      Hypophysectomized males and Day-2 castrate males had increased thymosin-beta 4
      concentrations when compared to hypophysectomized females and neonatally
      androgenized females (p less than 0.05). Differences of thymic weights between
      male and female rats during prepubertal development are probably related more to
      presence or absence of gonads, gonadal steroids, and response of the thymus to
      pituitary secretagogues rather than to neonatal sexual differentiation of thymic
      function and secretion of thymosin-beta 4.

PMID- 1626339
TI  - Expression of a histone H1 gene (H1.1) in human testis and Hassall's corpuscles
      of the thymus. Expression of a histone H1 gene (H1.1).
AB  - The expression of a H1 gene (H1.1) was studied in several human tissues. Northern
      blot analysis revealed that this gene is expressed in testis and thymus, but not
      in other human tissues like liver, spleen, lung, brain, thyroid gland and skin
      fibroblasts. Furthermore in situ hybridization on tissue sections revealed a cell
      type specific expression of histone H1.1 gene in the Hassall's corpuscles of the
      thymus.

PMID- 1626340
TI  - How are the American Association of Blood Banks standards developed?

PMID- 1626341
TI  - Is it homologous or is it allogeneic?

PMID- 1626342
TI  - Detection of antibodies to human immunodeficiency virus type 2 (HIV-2) in blood
      donor sera using United States assay methods for anti-HIV type 1.
AB  - Twelve serum samples from French blood donors that were uniformly reactive in
      tests for antibody to human immunodeficiency virus type 2 (anti-HIV-2) also were
      reactive in 92 to 100 percent of tests with three anti-HIV type 1 (anti-HIV-1)
      enzyme-linked immunoassays currently in widespread use for donor screening in the
      United States. Supplemental tests for anti-HIV-1 on these anti-HIV-2-reactive
      samples differed in their responses. All samples reacted in a licensed anti-HIV-1
      Western blot, but there was an atypical band near the p41 position, which could
      be a clue to the fact that this result was a cross-reaction with anti-HIV-2. A
      recombinant immunoblot gave an indeterminate result for anti-HIV-1 in all 12
      samples. A local immunofluorescence assay for anti-HIV-1 reacted with 92 percent
      of the samples, but a commercial one detected only 58 percent.

PMID- 1626343
TI  - Ultraviolet-B irradiation of platelets: a preliminary trial of efficacy.
AB  - Prior studies established that ultraviolet-B light (UVB) irradiation of platelet
      concentrates (PCs) at appropriate doses can eliminate the mixed lymphocyte
      culture-stimulating and -responding capacity of lymphocytes in the PCs without
      adversely affecting in vitro platelet function. The in vivo recovery and survival
      and in vitro characteristics of UVB-irradiated platelets were investigated in
      paired studies. PCs were stored for 1 day and then exposed to UVB. Platelet
      recovery, survival, and function were comparable to those of nonirradiated
      platelets. Recovery and survival of platelets stored for 5 days before UVB
      exposure were decreased relative to controls, although they were considered
      clinically acceptable. Paired transfusion studies were also performed in seven
      thrombocytopenic patients by using platelets obtained by apheresis. Comparable
      posttransfusion platelet increments and bleeding time corrections were obtained
      with both irradiated and control (nonirradiated) platelets. It can be concluded
      that platelets survive and function relatively normally in vivo after UVB
      irradiation sufficient to abolish lymphocyte reactivity in mixed lymphocyte
      culture. Long-term studies of UVB-irradiated PCs are needed to assess their
      potential in reducing recipient alloimmunization.

PMID- 1626344
TI  - A comparison of two supplemental procedures for confirmation of antibody to
      hepatitis C virus c100-3 antigen in Louisiana blood donors.
AB  - In a pilot study designed to evaluate the performance of supplemental hepatitis C
      virus (HCV) tests, 146 consecutive HCV enzyme immunoassay (EIA)-reactive samples
      (0.98% of 14,949 donors) were comparatively evaluated with two sets of
      supplemental tests: HCV antibody neutralization/c100-3 peptide EIA and the first
      generation HCV recombinant immunoblot assay (RIBA). Of these samples, 68.5
      percent were positive and 17.8 percent were negative on both supplemental assays.
      Nineteen samples were discordant. Eleven samples were positive on one assay (9 on
      neutralization/peptide, 2 on RIBA) and negative or indeterminate on the alternate
      supplemental test, but reacted with two additional HCV antigens outside the c100
      3 region in a second-generation dot immunoblot assay. The dot immunoblot assay
      was used as a reference and reactive samples were considered confirmed. The
      remaining eight discordant samples were indeterminate or negative on either assay
      and did not react on the dot immunoblot assay. These data indicate a 0.74-percent
      prevalence of HCV exposure detected by reactivity with the c100-3 antigen in
      blood donors in southern Louisiana.

PMID- 1626345
TI  - Quantitation of red cell-bound IgG by an enzyme-linked antiglobulin test in human
      immunodeficiency virus-infected persons.
AB  - Anemia, thrombocytopenia, and neutropenia have been observed in patients with
      acquired immune deficiency syndrome (AIDS) and AIDS-related complex. To
      investigate whether red cells (RBCs) of patients with human immunodeficiency
      virus infection were coated with IgG and/or complement (C3), blood samples of 239
      patients were tested. The prevalence of a positive direct antiglobulin test on
      RBCs was 16.7 percent. By use of an enzyme-linked antiglobulin test (ELAT) to
      measure more accurately the number of IgG molecules per RBC in a group of 67
      patients, 30 of the 67 individuals were observed to have increased numbers (mean,
      155) compared to normal controls and to patients with hypergammaglobulinemia due
      to multiple myeloma or chronic liver disease. Hemoglobin level was correlated
      with the number of IgG molecules per RBC (p = 0.008), but no correlation could be
      demonstrated between those numbers and serum immunoglobulin (p = 0.10) or
      circulating immune complexes (p = 0.38). Our results with ELAT suggest that some
      AIDS patients may have specific binding of IgG on the surface of their RBCs,
      rather than nonspecific uptake; further clinical correlations are necessary to
      confirm these findings.

PMID- 1626346
TI  - Storage of platelets in additive solutions: a new method for storage using sodium
      chloride solution.
AB  - The in vitro effect of 6-day storage of platelets prepared from 6 pooled buffy
      coat (BC) units and stored in a platelet storage medium containing approximately
      40 percent CPD-plasma and 60 percent platelet additive solution (PAS) was
      evaluated. PAS is composed of sodium and potassium chloride, citrate, phosphate,
      and mannitol. The total count of platelets per pooled unit included in the in
      vitro studies (n = 25) was 376 +/- 59 x 10(9) (mean +/- SD). The present study
      included three steps. 1. Evaluation of platelet storage in one (n = 7) and two (n
      = 6) 1000-mL polyolefin containers using PAS. During storage in one container,
      significantly lower values were found for pH, pO2, glucose, ATP, and the ratio of
      ATP to AMP+ADP+ATP. The values for mean platelet volume, pCO2, lactate, and
      extracellular adenylate kinase activity were significantly higher. These results
      indicate that storage in only one polyolefin container is not appropriate for
      maintaining satisfactory platelet quality. During storage in two polyolefin
      containers, a remarkably decreased lactate production (0.07 +/- 0.02
      mmol/day/10(11) platelets) was noted. 2. PAS was substituted for saline during 6
      day storage in two 1000-mL polyolefin containers (n = 12). The composition of the
      platelet preparations was the same in all other respects. Similar in vitro
      results were noted with PAS and saline, which indicated that PAS has no specific
      effect on the storage of platelets different from that of saline.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1626347
TI  - Preoperative red cell production in patients undergoing aggressive autologous
      blood phlebotomy with and without erythropoietin therapy.
AB  - Previous studies have demonstrated that autologous blood donors have a suboptimal
      endogenous erythropoietin response to the mild anemia induced by blood donation.
      Recent studies in baboons subjected to aggressive phlebotomy have shown an
      acceleration of erythropoiesis that may be beneficial perioperatively. To address
      the issue of accelerated erythropoiesis in autologous blood donors, red cell
      production during an aggressive preoperative autologous blood donation program
      was analyzed. The volume of red cells increased 568 mL (27% over baseline) and
      911 mL (47% over baseline) for 23 placebo and 21 erythropoietin-treated patients,
      respectively, by hospital admission (9 days after last drug administration and 26
      days after beginning therapy). The mean rate of additional red cell production
      was 22 mL per day in the placebo group and 34 mL per day in the erythropoietin
      group (p less than 0.001), which represents a twofold and a 2.5-fold increase
      over basal erythropoiesis, respectively. The major difference in red cell
      production in the placebo and erythropoietin groups occurred early in the
      collection period. It can be concluded that an aggressive autologous blood
      phlebotomy program results in clinically important increased erythropoiesis at
      the time of surgery. In patients unsuited for aggressive autologous phlebotomy, a
      more modest autologous blood procurement program, coupled with the administration
      of recombinant erythropoietin, may be a preferable approach.

PMID- 1626348
TI  - Effects of oral donor questioning about high-risk behaviors for human
      immunodeficiency virus infection.
AB  - The purposes of this study were 1) to compare blood donor deferrals resulting
      from additional, oral questions about human immunodeficiency virus risk behaviors
      with deferrals resulting from currently used, written screening questions; 2) to
      examine differences in donor deferral resulting from use of an indirect (IQ)
      versus direct (DQ) additional oral question format; and 3) to evaluate written
      survey responses of donors and staff members to the additional questions. The IQ
      group (n = 3050) were asked if they understood the seven ineligible-donor risk
      behaviors, and the DQ group (n = 4753) were asked if they had engaged in any of
      these behaviors. Owing to positive answers or refusal to answer the additional
      questions, there was an increase in donor deferrals, over the level seen with
      customary screening. Only 1 percent of donors indicated they would not return if
      the questions were asked in the future. Embarrassment was indicated by 3 percent
      of the IQ group and 7 percent of the DQ group; 14 to 15 percent preferred to
      write their answers rather than give them orally. The staff members generally
      felt training was adequate (IQ = 92%, DQ = 83%) and were comfortable asking the
      questions (IQ = 82%, DQ = 78%). Mean screening times were 5.7 minutes before the
      addition of the oral questions, 7.5 minutes with IQ, and 7.6 minutes with DQ.
      This study confirms the value of IQ and DQ formats in identifying potentially
      infectious donors and suggests that the DQ format may be slightly more effective.

PMID- 1626349
TI  - Electronmicroscopic examination of white cell reduction by four white cell
      reduction filters.
AB  - The mechanisms of white cell (WBC) reduction in 16-hour-old CPDA-1 red cell (RBC)
      concentrates by filtration on a column filter and on three different flatbed
      filters were studied by electron microscopy, with special emphasis on cell-to
      cell interaction, cell damage, and interaction of blood cells with the material.
      Generally, lymphocytes were removed by mechanical sieving and monocytes by
      adherence and mechanical sieving. Granulocyte depletion occurred by mechanical
      sieving, direct adhesion to the fibers, and indirect adhesion to activated and
      spread platelets. In the column filter, most granulocytes were captured by
      adhesion. In the coarse layers of two of the flatbed filters, indirect adhesion
      was most prominent, whereas direct adhesion was most prominent in the other
      flatbed filter. For the most part, granulocytes were captured by direct adhesion
      in the fine layers, but in one flatbed filter, capture apparently occurred by
      mechanical sieving. The results of this study suggest that the efficiency and the
      mechanism of WBC reduction depend on the physicochemical characteristics of the
      non-woven materials in the filters as well as the cellular composition of the RBC
      concentrates.

PMID- 1626350
TI  - Red cell transfusions in coronary artery bypass surgery (DRGs 106 and 107)
AB  - To study red cell transfusion practice in 3216 coronary artery bypass graft
      (CABG) cases in 11 hospitals in 1988, abstracted patient records were stratified
      by diagnosis related group (DRG) (that is, DRG 106, coronary artery bypass
      without catheterization, or DRG 107, coronary artery bypass with catheterization)
      and International Classification of Diseases, 9th revision, Clinical Modification
      (ICD-9-CM) surgical procedure code. Means of units per transfused patient, age
      and length of stay, and in-hospital mortality rates were significantly greater
      for patients in DRG 106 than DRG 107. Gender was a significant factor for
      transfusion outcomes; female patients were more likely to undergo transfusion,
      and, when transfused, they received more units of red cells than male patients.
      For a given DRG/ICD-9-CM surgical procedure class, significant differences were
      found between hospitals in the percentage of patients transfused, but not in mean
      units of red cells per transfused patient. However, within individual hospitals,
      the proportion of patients transfused and the number of units per transfused
      patient did not vary significantly across DRG/ICD-9-CM procedure classes. These
      results suggest that circumstances operating within a hospital, still to be
      identified, had more influence on transfusion decisions than the nature of the
      surgical intervention.

PMID- 1626351
TI  - Duties to donors.

PMID- 1626352
TI  - Molecular biology of red cell blood group genes.
AB  - The explosion of new information and technology for probing the fine architecture
      of gene structure has already brought new insights into the varied phenotypic
      expression of red cell blood group antigens. Molecular biologic techniques will
      be increasingly applied to red cell antigens as well as blood group antigens on
      other blood cells. Not since the introduction of the Coombs reagent has such a
      powerful method been available with which to increase our understanding of the
      nature of blood cell antigens.

PMID- 1626353
TI  - What is a blood group antigen?

PMID- 1626354
TI  - Is it homologous or allogeneic?

PMID- 1626355
TI  - A review of the usefulness of myelography in 50 dogs.
AB  - Fifty dogs showing clinical signs of spinal disease were investigated by
      myelography, using iopamidol. In 27 cases the technique was considered
      worthwhile. Of the 19 dogs not subjected to surgery or euthanasia as a result of
      the findings, three suffered seizures during recovery from anaesthesia, eight
      deteriorated in neurological condition and one suffered permanent respiratory
      arrest as a result of extensive subarachnoid haemorrhage.

PMID- 1626356
TI  - Staphylococci on the skin of pigs: isolates from two farms with different
      antibiotic policies.
AB  - Staphylococci isolated from pigs on two farms were identified and their
      antibiotic resistance and plasmid profiles were examined. A highly resistant
      Staphylococcus hyicus was epidemic on one of the farms which was also that at
      which antibiotic-containing feedstuffs were used most often. Staphylococci from
      this farm were more often resistant to two or more antibiotics than were the
      strains from the other farm. The many plasmids present in these staphylococci
      prevented the determination of the genetic nature of the antibiotic resistance.

PMID- 1626357
TI  - Abomasal dilatation and impaction in two Hampshire rams.
AB  - Two adult Hampshire rams, unrelated and from separate farms, were examined for
      the cause of intermittent bloat and, or anorexia which lasted for three to six
      weeks and caused depression and cachexia. The rumen of each ram was hypermotile
      and ballottement of the ventral abdomen of each animal revealed an enlarged
      doughy viscus. Mild prerenal azotaemia, hypokalaemia with metabolic alkalosis,
      and high rumen chloride concentrations were evident. One ram died during the
      induction of anaesthesia for an abomasotomy and the other was euthanased after
      unsuccessful medical therapy. The abomasum of each ram was four to six times
      larger than that of a normal adult ram and filled with coarse, semi-moist,
      impacted ingesta. This abnormality was clinically identical to the abomasal
      emptying syndrome which has been described only in the Suffolk breed.

PMID- 1626358
TI  - Successful use of a QT-sensing rate-adaptive pacemaker in a dog.

PMID- 1626359
TI  - Availability of medicines.

PMID- 1626360
TI  - Transmission of blue-eared pig disease.

PMID- 1626361
TI  - Acral lick dermatitis in a dairy cow.

PMID- 1626362
TI  - Dangerous dogs.

PMID- 1626363
TI  - Disease hazards for UK livestock.

PMID- 1626364
TI  - Oxalate urolithiasis in Dandie Dinmont terriers.

PMID- 1626365
TI  - A competitive ELISA using anti-N monoclonal antibodies for specific detection of
      rinderpest antibodies in cattle and small ruminants.
AB  - A competitive ELISA (C-ELISA) using monoclonal antibodies (mAbs) which bind to
      the nucleo-protein (NP) of rinderpest virus (RPV) for detection of RPV antibodies
      in cattle and small ruminant sera is described. Unlike virus neutralisation test
      (VNT), this test using mAb IVB2-4, can detect specific RPV antibodies without
      showing a cross-reaction with antibodies to peste-des-petits ruminants-virus
      (PPRV); by contrast, when mAb VE4-1 is used the test detects both RPV and PPRV
      antibodies, including low levels of antibodies that can be found in sera
      containing maternal antibodies. Although antibodies to the PPRV 75-1 strain are
      also detected with mAb 51-5-6, the test is suitable for assessing the immune
      status of cattle against the Rinderpest Old Kabete (RBOK) strain. The results
      from a panel of sera with a known status of vaccination provide evidence for a
      highly significant correlation between C-ELISA and VNT. This test may be a useful
      tool for a standardized and accurate determination of the immunity status of both
      cattle and small ruminants.

PMID- 1626366
TI  - Characterisation and biological activity of monoclonal antibodies specific for
      Pasteurella haemolytica A1 capsule and lipopolysaccharide.
AB  - Monoclonal antibodies (mAb) against both Pasteurella haemolytica A1 capsule and
      lipopolysaccharide (LPS) were produced. Anti-capsule mAb reacted with the
      homologous A1 serotype only, whereas mAb against LPS reacted with P. haemolytica
      serotypes A2, A5, A8, A12, A14 and A16 but not with 33 bacterial species or rough
      LPS mutant strains tested. Both capsule and LPS antigens were visualised on the
      surface of bacteria by immunogold electron microscopy. Neither of the mAbs
      demonstrated antibody-dependent complement-mediated killing in vitro but both
      facilitated phagocytosis in vitro.

PMID- 1626367
TI  - Serological assay for swine erysipelas using nitrocellulose particles impregnated
      with an immunodominant 65 kDa antigen from Erysipelothrix rhusiopathiae.
AB  - Pigs (n = 10) that were experimentally challenged with an arthritogenic isolate
      of Erysipelothrix rhusiopathiae (strain VRS 229; serotype 1a) developed arthritis
      in at least one of twelve major limb joints. Immunoblots using sera obtained from
      these pigs at necropsy revealed a major band of immunoreactivity against a
      subunit polypeptide of apparent molecular mass 65 kDa. The usefulness of the 65
      kDa immunodominant subunit as an assay reagent in an ELISA test was examined by
      presentation of antigen impregnated onto nitrocellulose particles (AINP). This
      was prepared by electro-transfer of bacterial polypeptides from SDS-PAGE gels to
      nitrocellulose. Protein bands were visualized by staining with amido black and a
      strip of nitrocellulose bearing the 65 kDa band was excised and extracted with
      formic acid. Nitrocellulose particles impregnated with the 65 kDa antigen (65
      AINP) were precipitated from solution by neutralization with ammonium hydroxide.
      65-AINP was suspended in water and the optimum dilution for ELISA assay was
      determined by titration to be 0.1 A650 units. Sera from all pigs challenged with
      VRS 229 reacted against the 65-AINP antigen in the ELISA assay while sera from
      control, and experimental pigs prior to challenge, failed to do so. The 65-AINP
      antigen could also be used efficaciously to quantify serological reactivity of
      pigs experimentally infected with other strains of E. rhusiopathiae representing
      the three major serotypes (1a, 1b and 2) that are most commonly associated with
      swine erysipelas infections. Mouse immunizations with 65-AINP also confirmed that
      nitrocellulose particles bearing the immunodominant subunit antigen will elicit
      murine antibodies that are monospecific against this determinant.

PMID- 1626368
TI  - Species identification and some characteristics of coagulase-negative
      staphylococci isolated from bovine udders.
AB  - The species of 203 strains of coagulase-negative staphylococci (CNS), isolated
      from bovine udder quarters was determined; all were tested for hydrophobicity and
      encapsulation, attributes that may relate to virulence. Twelve species were
      identified, of which Staphylococcus simulans, (34.5%), S. chromogenes (16.7%), S.
      epidermidis (13.8%) and S. xylosus (8.9%) were the most frequent. The majority of
      strains possessed a hydrophilic cell surface. However, strains from two species
      (S. chromogenes and S. epidermidis) were more hydrophobic than the others. Only
      five strains were encapsulated (S. xylosus, 3; S. saprophyticus, 1; and S.
      sciuri, 1). Judging from the low frequencies of hydrophobic and encapsulated
      strains, and comparing with strains isolated from clinical cases, it is suggested
      that these properties are not major virulence determinants of CNS.

PMID- 1626369
TI  - Cross protection studies on Bordetella bronchiseptica in mice using an
      intracerebral challenge model.
AB  - Protective activities of heat-inactivated (60 degrees C for 30 min) merthiolate
      preserved Bordetella bronchiseptica and B. pertussis bacterins were compared in
      intraperitoneally immunized mice challenged intracerebrally (i.p./i.c.) or
      intraperitoneally (i.p./i.p.). In the i.p./i.c. assay (Kendrick test), a B.
      pertussis bacterin protected mice against challenge with B. pertussis 18-323, as
      well as against phase I cytotoxic and non-cytotoxic strains of B. bronchiseptica.
      A B. bronchiseptica bacterin, prepared from a phase I cytotoxic strain, gave
      protection against two phase I B. bronchiseptica strains, irrespective of their
      cytotoxin-production. A non-cytotoxic phase I strain of B. bronchiseptica
      elicited protection against the homologous strain only. Neither cytotoxic nor non
      cytotoxic B. bronchiseptica strains protected mice challenged with B. pertussis
      18-323. Vaccines prepared from phase III strains of B. bronchiseptica were not
      protective at all against any of the challenge strains. No such differences in
      the protective activities of the bacterins could be detected by the i.p./i.p.
      method. They seem to cross-protect equally well. The results indicate that the
      Kendrick test may be useful in testing potency of different B. bronchiseptica
      bacterins.

PMID- 1626370
TI  - The effect of exposure to a delta cya/delta crp mutant of Salmonella typhimurium
      on the subsequent colonization of swine by the wild-type parent strain.
AB  - This study characterizes the clinical response and colonization pattern of
      caesarean-derived, colostrum-deprived swine exposed to a delta cya/delta crp
      mutant (chi 4233) of S. typhimurium and challenged with the wild-type parent
      strain. chi 4233 was mildly virulent in swine and induced transient fever and
      soft stools. Chi 4233 colonized the ileum, cecum, liver, spleen, tonsils, and
      mandibular and ileocolic lymph nodes of swine in a manner similar to the parental
      wild-type, but the numbers of S. typhimurium (chi 4233) in the ileum were 100- to
      1000-fold less than those of pigs exposed to the parental wild-type. Pigs exposed
      to chi 4233 21 days before parental wild-type challenge demonstrated a milder
      clinical response to challenge than did pigs that did not receive chi 4233. The
      wild-type populations in the ilea of chi 4233-exposed pigs after challenge were
      100- to 10,000-fold less than those in pigs not receiving chi 4233. The liver,
      spleen, and ileocolic lymph nodes were cleared of wild-type S. typhimurium more
      quickly after challenge in chi 4233-exposed pigs. The populations of chi 4233 in
      the ilea of exposed pigs after wild-type challenge were also less than would have
      been expected in unchallenged pigs. Thus, exposure of swine to a delta cya/delta
      crp mutant of S. typhimurium modulated the subsequent response to parental wild
      type challenge and reduced carrier populations of wild-type S. typhimurium in
      infected swine.

PMID- 1626371
TI  - The pathogenesis of edema disease in pigs. A review.
AB  - Edema disease is known to cause important losses in the period shortly after
      weaning. Although the disease is known for many decades, intensive studies with
      bacterial lysates of pathogenic E. coli, followed by biotechnological research
      the last ten years, has led to a better understanding of its pathogenesis.
      Especially the impact of the toxin is clearly established. Evidence also exists
      that adhesion factors play a crucial role in the pathogenesis of edema disease.

PMID- 1626372
TI  - Tissues and exudates contain sufficient thymidine for growth of anaerobic
      bacteria in the presence of inhibitory levels of trimethoprim-sulfamethoxazole.
AB  - Obligate anaerobes are susceptible in vitro to trimethoprim-sulfonamides.
      Clinical efficacy of this drug combination for treatment of infectious processes
      in which anaerobes are involved is uncertain. We hypothesize that this
      uncertainty is a result of thymidine in tissues and exudates which abrogates the
      inhibitory effect of trimethoprim-sulfonamides. We shown herein that species of
      anaerobic bacteria commonly encountered in infectious processes grew on thymidine
      containing medium despite the presence of levels of trimethoprim-sulfamethoxazole
      (S x T) previously shown to be inhibitory. Biologic fluids and tissues, where
      anaerobic bacteria are commonly encountered in diseased states, were shown to
      contain thymidine levels that were sufficient to reverse the inhibitory effect of
      S x T upon these species of bacteria. These observations suggest that the use of
      trimethoprim-sulfonamides is not a rational choice for treatment of infectious
      processes in which an obligate anaerobe is a component.

PMID- 1626373
TI  - ELISA tests for antibodies in experimental bovine tuberculosis.
AB  - It was shown that 10(4) cfu of a field isolate of Mycobacterium bovis caused
      illness in five experimentally infected calves; one of these died. One of three
      contact calves also became clinically infected. Considerable variation in the
      humoral response of the affected animals was demonstrated by ELISAs using
      purified protein derivative (PPD) and phosphatide antigens. The inoculation of
      antigens used in the comparative tuberculin skin test significantly enhanced the
      level of PPD antibodies in the affected animals whereas that of the apparently
      non-infected contact animals remained unchanged.

PMID- 1626375
TI  - Restriction endonuclease analysis of DNA from ruminant Chlamydia psittaci and its
      relation to mouse virulence.
AB  - DNA from 20 pathogenic or non-pathogenic ruminant strains of Chlamydia psittaci
      was compared by restriction endonuclease analysis. The strains could be easily
      differentiated according to their invasiveness for mouse, whatever their
      pathological origin. DNA patterns of invasive strains were similar, whereas those
      of non-invasive strains were distributed in two groups.

PMID- 1626374
TI  - Detection of entero- and verocyto-toxin genes in Escherichia coli from diarrhoeal
      disease in animals using the polymerase chain reaction.
AB  - Oligonucleotide primers were designed for the specific polymerase chain reaction
      (PCR) amplification of the enterotoxins STIa and LTI and of the verocytotoxins
      VT1 and VT2. All of 184 E. coli isolates from cases of diarrhoea from pigs,
      cattle and sheep gave identical toxin profiles by PCR and gene probe.
      Differentiation between VT2 and VT2v was achieved using two oligonucleotide
      primers pairs in PCR and showed that all of 34 VT2+ porcine isolates, of which 23
      were 0138:K1, harboured VT2v whereas 20 VT2+ bovine and ovine isolates harboured
      VT2. No isolate harboured both VT2 polymorphs. Simplified methods for sample
      preparation for PCR were examined and showed that PCR was not inhibited by direct
      addition of broth culture to the reaction mixture.

PMID- 1626376
TI  - Typing of Australian isolates of Treponema hyodysenteriae by serology and by DNA
      restriction endonuclease analysis.
AB  - A total of 91 isolates of Treponema hyodysenteriae which were obtained from 62
      piggeries located around Australia were typed by serology and by DNA restriction
      endonuclease analysis (REA). The isolates fell into eight serogroups, of which
      groups B and D were the most common. Isolates with different REA patterns were
      recognised within serogroups, whilst a few isolates with the same REA pattern
      were placed into different serogroups. Some of the latter isolates were either
      from the same piggery or from farms with epidemiological links, thus indicating
      the bacteria may have altered their antigenic properties. A total of 31 different
      REA patterns were recognised amongst the Australian isolates. These comprised
      eight major patterns, with four of these being subdivided on the basis of minor
      differences in banding. Where a number of isolates were obtained from individual
      piggeries these all had the same REA pattern, and in one piggery isolates with
      the same pattern were recovered over a five year period. Plasmid bands were
      observed in 70 of the Australian isolates (77%), and in six of the seven overseas
      isolates included in the study for comparison. These plasmids did not affect the
      REA pattern. Of the States from which substantial numbers of isolates were
      examined, the greatest number of different strains (12 amongst 19 piggeries) were
      found from Victoria, and there were 10 REA patterns in strains from 24 piggeries
      in Queensland. Despite the large total number of different strains of T.
      hyodysenteriae in Australia, only three were found in more than one State.

PMID- 1626377
TI  - Chromosomal DNA probes for the identification of asaccharolytic anaerobic
      pigmented bacterial rods from the oral cavity of cats.
AB  - A dot-blot hybridisation assay using isolated high molecular weight DNA as whole
      chromosomal probes of the cat pigmented asaccharolytic Bacteroides/Porphyromonas
      species was used against both purified high molecular weight DNA and DNA released
      on membranes from whole cells for the identification of B. salivosus and for its
      differentiation from the other anaerobic species isolated from normal and
      diseased mouths of cats and horses. 32P-labelled probes were compared with
      digoxigenin (DIG)-labelled probes (Boehringer-Mannheim). The whole chromosomal
      probes were specific--differentiating B. salivosus from a variety of species
      (including members of the genera Bacteroides, Fusobacterium, Eubacterium, and
      Prevotella) found in normal and abnormal mouths of cats and horses. Likewise,
      asaccharolytic black pigmented Group 2 strains were distinguishable from all
      strains tested. However, cat strains of P. gingivalis which show 68-76% DNA-DNA
      homology with human strain P. gingivalis ATCC 33277T, were not distinguishable
      from each other using either 32P-labelled or DIG-labelled probes. The minimum
      amount of pure Bacteroides DNA which could be detected by the 32P-labelled probe
      was 100-300 pg, while the amount of pure DNA detected by the DIG system was 1-3
      mg after room temperature colour development for 1 h and 100-300 pg after 6 h
      colour development.

PMID- 1626378
TI  - Different stabilities to bile among feline calicivirus strains of respiratory and
      enteric origin.
AB  - Feline calicivirus (FCV) strains isolated from feces (E-FCV) were compared with
      FCV strains of respiratory origin (R-FCV). All strains were shown to be labile at
      pH 3.0. All strains except one strain of E-FCV were found to be sensitive to the
      action of trypsin. When exposed to bile salt (deoxycholic acid sodium salt), all
      R-FCV strains were markedly inactivated, but none of the E-FCV strains was
      inactivated. It was possible to select bile-resistant substrains from a bile
      sensitive strain.

PMID- 1626379
TI  - Effects of four preparations of 0.05% chlorhexidine diacetate on wound healing in
      dogs.
AB  - Four chlorhexidine diacetate (CHD) antiseptic wound lavage preparations were
      evaluated in vivo to determine their effects on second intention wound healing in
      the dog in vitro to determine their relative antibacterial activity against
      Staphylococcus intermedius. Chlorhexidine was diluted to 0.05% in sterile water,
      0.9% sodium chloride, lactated Ringers solution (LRS), and LRS that was allowed
      to form a precipitate with CHD. Control solutions included sterile water and LRS.
      There were no significant differences in wound contraction or epithelialization.
      All 0.05% CHD preparations provided 100% bacterial kill.

PMID- 1626380
TI  - Effects of flunixin meglumine on dogs with experimental gastric dilatation
      volvulus.
AB  - Gastric dilatation-volvulus (GDV) was created experimentally and maintained for
      90 minutes in 16 anesthetized, mixed-breed dogs. After the GDV was corrected,
      normal saline solution (0.044 mL/kg intravenously [IV]) was administered to eight
      dogs (controls), and flunixin meglumine (2.2 mg/kg IV) was administered to eight
      dogs. Microspheres labeled with radioactive cobalt, scandium, tin, or niobium
      were injected intravenously at baseline (before GDV) and minutes 90, 100, and
      270, respectively, to determine tissue blood flows. Plasma endotoxin and
      prostacyclin were measured at the same intervals. Electrocardiogram, mean
      arterial pressure, portal pressure, and cardiac output were recorded
      continuously. Dogs were euthanatized at minute 270 and necropsied. There was no
      significant difference between treatment groups for any measured variable at any
      time. Endotoxin levels increased significantly during GDV. Prostacyclin levels
      were lower in dogs treated with flunixin meglumine than in controls at minutes
      210 and 270. Histopathologic findings were similar for all dogs and consistent
      with those associated with endotoxemia. Flunixin meglumine treatment did not
      alter cardiac indices or tissue blood flows significantly. However, elevation of
      prostacyclin was inhibited by flunixin meglumine, which suggested that continued
      effects of endotoxic damage might be attenuated or inhibited.

PMID- 1626381
TI  - Suspensory apparatus prosthesis in the horse. Part 1: In vitro mechanical
      properties.
AB  - Mechanical properties of equine suspensory apparatus preparations and three
      braided synthetic prostheses were evaluated in vitro. Force versus displacement
      plots and failure modes were recorded from single load-to-failure testing in 18
      cadaver limbs before and after replacement of each suspensory apparatus with a
      prosthesis. Mean load at failure, energy to failure, and stiffness values of
      polytetrafluoroethylene (PTFE) prostheses were lower than those of the suspensory
      apparatus and aramid prosthesis. The PTFE prosthesis failed by elongation or
      rupture of the prosthesis. Mechanical properties of the aramid prosthesis with
      collar augmentation were not significantly different from the suspensory
      apparatus. The main site of failure in both aramid prostheses was at the screw
      fixation to bone.

PMID- 1626382
TI  - Suspensory apparatus prosthesis in the horse. Part 2: In vivo evaluation in a
      suspensory apparatus disruption model.
AB  - The suspensory apparatus of one forelimb was surgically disrupted in six adult
      horses by transecting the distal sesamoidean ligaments. A double-braided
      prosthetic ligament made of aramid yarn was installed to support the flexor
      surface of the metacarpophalangeal joint. The prosthesis was routed through
      tunnels in the third metacarpal bone and proximal phalanx, and secured to bone
      with screws. Evaluation by radiography, synovial fluid analysis, cinematography,
      and dynamography was performed before surgery and at weeks 16 and 30.
      Supracondylar cortical lysis and periosteal proliferation were observed on
      postoperative radiographs. Synovitis and fragmentation of the prosthesis were
      apparent from synovial fluid evaluation. Weight bearing and metacarpophalangeal
      joint motion were decreased and loading was transferred in part to the opposite
      forelimb. Clinical lameness improved and weight bearing increased during the
      second half of the 30-week period. At necropsy, there was abrasion of the
      prosthesis and the articular surfaces in contact with the prosthesis. Diffuse
      granulomatous synovitis developed in response to aramid fiber fragments within
      the synovium.

PMID- 1626383
TI  - Corticocancellous bone biopsy from the 12th rib of standing horses.
AB  - Unicortical corticocancellous bone biopsy specimens 4.5 mm and 6.5 mm in diameter
      were obtained without long-term complications from the 12th rib in eight standing
      horses. However, the bone specimens were unsuitable for histologic or
      histomorphometric evaluation. In in vitro comparisons of biopsy specimens 6.5 mm
      and 12 mm in diameter, and of unicortical and transcortical biopsy specimens, 12
      mm transcortical specimens yielded the most cancellous bone. Transcortical bone
      biopsy specimens 12 mm in diameter were obtained from eight horses by using power
      assisted trephination. The surgical procedure was well tolerated, but some degree
      of pneumothorax in all horses was treated by aspiration of air from the thorax.
      Long-term complications were not observed.

PMID- 1626384
TI  - Arthrographic analysis of communication between the tarsometatarsal and distal
      intertarsal joints of the horse.
AB  - The intra-articular anatomy of 103 equine tarsi was studied by contrast
      radiography with image intensification and computerized tomography. There was
      communication between the tarsometatarsal and distal intertarsal joints in 21 of
      55 (38%) interpretable tarsometatarsal arthrograms, and in 11 of 48 (23%)
      interpretable distal intertarsal arthrograms. The difference was not significant.
      The volume of contrast agent and the pressure of injection did not correlate with
      communication. Forced injection caused subcutaneous leakage of contrast medium
      but not communication. Communication occurred via the tarsal canal and the space
      between the third and the combined first and second tarsal bones. Injection of
      the distal intertarsal joint from the dorsomedial aspect of the limb, distal to
      the palpable distal border of the medial branch of the tendon of the tibialis
      cranialis muscle and between the central, third, and combined first and second
      tarsal bones, provided reliable access except in the presence of severe
      periosteal proliferations.

PMID- 1626385
TI  - Long-term outcome of tooth repulsion in horses. A retrospective study of 61
      cases.
AB  - The records of 61 horses undergoing tooth repulsion for treatment of alveolar
      periostitis were reviewed. Seventeen of 36 horses (47%) in which maxillary teeth
      were removed had serious postoperative complications, such as infection of a
      second tooth, bone sequestration, chronic sinusitis, draining tracts, retained
      dental packing, feed impaction of the alveolus or sinus, suture-line dehiscence,
      or skin-flap sloughs. Eight horses required at least one additional surgical
      procedure. Eight of 25 horses (32%) in which mandibular teeth were removed had
      serious postoperative complications, and four horses required an additional
      surgical procedure. Hospitalization lasted 2 to 61 days (median, 22 days) for
      maxillary teeth and 3 to 35 days (median, 8 days) for mandibular teeth. Long-term
      follow-up (at least 5 months) was possible in 47 horses. Twenty-four of 30 horses
      (80%) with maxillary tooth repulsion healed without further problems; six horses
      had persistent nasal discharge. Fourteen of 17 horses (82%) with mandibular tooth
      repulsion healed with no further problems or with only minor complications; three
      horses had a chronic draining tract.

PMID- 1626386
TI  - Levator nasolabialis muscle transposition to prevent an orosinus fistula after
      tooth extraction in horses.
AB  - The ventral part of the levator nasolabialis muscle was transposed to the
      alveolar defect after sinusotomy and tooth extraction in five normal horses and
      six horses with a tooth root abscess and sinusitis. In the normal horses at weeks
      6, 10, 14 and 18, the transposed muscles remained viable and were incorporated
      into the recipient sites, and orosinus fistulae did not form. Histologically,
      there was a progressive transition from muscle to fibrous tissue. There was no
      facial deformity or loss of nasal function at the donor site. A localized abscess
      was associated with incomplete removal of tooth root fragments in one horse.
      After 1 year or more, five horses treated for dental disease had complete
      resolution of clinical signs. One horse continued to have intermittent mild nasal
      discharge.

PMID- 1626387
TI  - Trigger points in 48 dogs with myofascial pain syndromes.

PMID- 1626388
TI  - Radiographic criteria for evaluation of uncemented total hip replacement in dogs.
AB  - A zonal analysis system and corresponding nomenclature were developed to describe
      the location and nature of radiographic changes in canine uncemented total hip
      arthroplasties. Criteria to assess prosthetic component alignment, percentage of
      femoral canal fill, resorptive and formative bony changes, and alterations in the
      bone at the implant-bone interface were derived by studying serial radiographs of
      100 consecutive canine uncemented total hip arthroplasties for up to 30 months
      after surgery.

PMID- 1626389
TI  - Mechanical evaluation of three methods of plating distal radial osteotomies.
AB  - Eighteen intact canine cadaver radii underwent nondestructive axial testing, and
      were osteotomized, plated, and retested. Each bone was tested with and without
      mediolateral or craniocaudal restriction of motion. Fixation of the osteotomies
      was performed under static compression with a cranially applied 5-hole 3.5 mm
      dynamic compression plate, a cranially applied 7-hole 3.5 mm T-plate, or a
      medially applied 7-hole 2.7 mm dynamic compression plate. There was no loss of
      axial stiffness after osteotomy and fixation, and there were no differences in
      axial stiffness between the methods of fixation. Mediolateral stiffness (bending
      around the craniocaudal axis) was consistently greater than craniocaudal
      stiffness (bending around the mediolateral axis) before and after osteotomy and
      plate fixation. There was no difference in the axial stiffness of otherwise
      intact radii when craniocaudal or mediolateral screw holes were drilled; however,
      all radii with craniocaudal screw holes and one radius with mediolateral screw
      holes fractured at a screw hole at high axial loads.

PMID- 1626390
TI  - Implantation of an uncemented total hip prosthesis. Technique and initial results
      of 100 arthroplasties.
AB  - A porous-coated modular total hip system was developed for uncemented
      implantation in dogs. The operative technique was developed in cadaver bones and
      live animals. One hundred uncemented total hip arthroplasties were performed in
      92 dogs. Results were successful in 98% of the joints during follow-ups of 3
      months or more. Complications included three luxations of the prosthetic joint,
      two fissure fractures of the femoral cortex, and one complete displacement of the
      acetabular component from its bony bed. Four complications were resolved
      successfully.

PMID- 1626391
TI  - Mechanical evaluation of half-pin (type 1) external skeletal fixation in
      combination with a single intramedullary pin.
AB  - Half-pin (type 1) external skeletal fixators with four, three, and two fixation
      pins and an intramedullary pin, and four-pin external skeletal fixators without
      an intramedullary pin were applied to prepared canine femurs. Load to failure,
      load to yield, safe load, and stiffness under compressive and torsional loads
      were calculated. When tested in compression, all measurements for the four-pin
      fixators with an intramedullary pin were significantly higher than for the two
      pin fixators with an intramedullary pin. The values for all parameters except
      load to yield were significantly higher for the four-pin fixators with an
      intramedullary pin than for the four-pin fixators without an intramedullary pin.
      When tested in torsion, all measurements for the four-pin fixators with an
      intramedullary pin were significantly higher than for the two or three-pin
      fixators with an intramedullary pin.

PMID- 1626392
TI  - Partial or total hemipelvectomy in the management of sarcomas in nine dogs and
      two cats.
AB  - The functional results of partial or total hemipelvectomy in seven dogs and two
      cats with sarcomas involving the pelvis were excellent, and the cosmetic outcome
      was acceptable to all owners. Tumors in two dogs were inoperable. Locally
      recurrent cancer occurred in two animals and metastases occurred in three
      animals. Three dogs survived longer than 2.5 years and the overall and disease
      free survival at 12 months was 62%. It appears that osteosarcoma of the pelvis is
      at least as aggressive as osteosarcoma of limbs and, unless effective adjuvant
      therapy is used, poorer survival results are likely in dogs with osteosarcoma
      than with other sarcomas of the pelvis. Hemipelvectomy is an aggressive surgical
      procedure that can be used successfully in selected dogs and cats with cancer
      involving the pelvis.

PMID- 1626393
TI  - Effects of arytenoid abduction and modified castellated laryngofissure on the
      rima glottidis in canine cadavers.
AB  - The percentages of change in cross-sectional area and dorsoventral height of the
      rima glottidis were measured after seven types of laryngoplasty in 30 postmortem
      canine specimens. The mean increases in area after each procedure were, in
      decreasing order, bilateral cricoarytenoid disarticulation with interarytenoid
      sesamoid band transection before placement of arytenoid abduction sutures 350% +/
      42%, bilateral placement of arytenoid abduction sutures 318% +/- 40%, bilateral
      cricothyroid disarticulation before placement of arytenoid abduction sutures 255%
      +/- 51%, modified castellated laryngofissure 244% +/- 30%, unilateral
      cricoarytenoid disarticulation with interarytenoid sesamoid band transection
      before placement of an arytenoid abduction suture 161% +/- 25%, unilateral
      placement of an arytenoid abduction suture 151% +/- 24% and unilateral
      cricothyroid disarticulation before placement of an arytenoid abduction suture
      108% +/- 25%. Bilateral cricoarytenoid disarticulation with interarytenoid
      sesamoid band transection before placement of arytenoid abduction sutures
      resulted in a significantly greater increase in rima glottidis area than modified
      castellated laryngofissure and all unilateral arytenoid abduction techniques.
      Modified castellated laryngofissure resulted in a significantly greater increase
      than unilateral placement of an arytenoid abduction suture and cricothyroid
      disarticulation before placement of an arytenoid abduction suture. Bilateral
      disarticulation of the cricothyroid joint before placement of arytenoid abduction
      sutures resulted in significant collapse of the dorsoventral height of the rima
      glottidis.

PMID- 1626394
TI  - En bloc resection of primary rib tumors in 40 dogs.
AB  - Single or multiple rib resection was performed in 40 dogs for the treatment of
      primary osteosarcoma or chondrosarcoma. The resulting thoracic wall defect was
      closed with polypropylene (12 dogs), primary muscle flap (16 dogs), diaphragmatic
      advancement (10 dogs), or a combination (2 dogs). Few immediate (less than 2
      weeks) postoperative complications were observed. Twenty dogs with osteosarcoma
      had a median survival time of 3.3 months (range, 0.5 to 23 months), with a 20% 6
      month survival time. Metastases occurred in all the dogs. Fourteen dogs with
      chondrosarcoma followed up longer than 2 weeks had a median survival time of 10.7
      months (range, 0.5 to 36 months) with a 64% 6-month survival time. Eight dogs
      developed metastases, five died from concurrent disease, and one dog is alive.
      Dogs with chondrosarcoma survived significantly longer than dogs with
      osteosarcoma. Survival time was not related to tumor size or number of ribs
      resected.

PMID- 1626395
TI  - Pleural compartmentalization in a dog with a pleuroperitoneal shunt.
AB  - Four years after successful implantation of a pleuroperitoneal shunt in a dog
      with persistent pleural effusion, signs of lethargy and dyspnea reappeared.
      Although the shunt was still functional, compartmentalization of the right
      pleural space eventually isolated a pocket of fluid, causing dyspnea. Symptomatic
      relief was achieved for at least 11 months by contralateral implantation of a
      second shunt.

PMID- 1626396
TI  - Continent jejunal reservoir (Kock pouch) for urinary diversion in dogs.
AB  - Urinary diversion by transplantation of both ureters into a reservoir constructed
      from 60 cm of jejunum was performed in six clinically normal dogs. The reservoir
      was connected to a stoma on the abdominal wall through a valve constructed from a
      short segment of intussuscepted bowel to provide continence. The reservoir was
      emptied three times daily by catheterization. One dog did not survive the
      surgical procedure and two dogs died within 1 week of surgical complications. The
      postoperative capacity of the reservoir in surviving dogs was 100 to 200 mL; it
      increased during the first month to 600 to 750 mL. Continence was excellent in
      two dogs. One dog was continent until month 2, when partial slippage of the
      intussusception occurred. A reversible hyponatremic, hypochloremic, hypokalemic
      metabolic acidosis developed. Bacteriuria was not responsive to systemic or local
      instillation of antibiotics. Ascending pyelonephritis, hydroureter, and
      hydronephrosis occurred in two dogs. Struvite urinary calculi formed in one dog.
      The procedure as described would be unsuitable for clinical use in dogs.

PMID- 1626397
TI  - Short-bowel syndrome in four dogs.
AB  - Short bowel syndrome occurred in four dogs after extensive (74% to 88%) small
      intestinal resection. Weight loss and diarrhea were the principal clinical signs.
      Treatment was based on the severity of clinical signs. One dog is alive after 27
      months. Three dogs died within 3 months. The prognosis depends on the extent and
      site of resection, degree of intestinal adaptation, preoperative condition, and
      postoperative care.

PMID- 1626398
TI  - The effect of tension on perfusion of axial and random pattern flaps in foals.
AB  - Caudally based axial pattern and random pattern skin flaps, 5 cm x 10 cm, were
      raised on the abdomens of seven foals. Blood flow was measured 7.5 cm from the
      flap bases during incremental increases in applied tension. At tensions less than
      1400 g, cutaneous blood flow was more than four times higher in axial pattern
      flaps than in random pattern flaps. Blood flow in axial pattern flaps at tensions
      up to 1500 g was greater than baseline flow in random pattern flaps. After
      removal of applied tension, perfusion in axial pattern flaps gradually increased
      but remained below baseline values. A short period of hyperperfusion after
      removal of tension in random pattern flaps may have been indicative of
      accumulation of waste products and localized acidosis. All flaps healed in their
      donor beds without complications.

PMID- 1626399
TI  - Arthrodesis for congenital flexural deformity of the metacarpophalangeal and
      metatarsophalangeal joints.
AB  - A llama, a miniature horse, and a miniature donkey with severe bilateral
      congenital flexural deformities of the metacarpophalangeal and
      metatarsophalangeal joints were treated successfully by arthrodesis with dynamic
      compression plating or external skeletal fixation. The flexor tendons were more
      taut than the suspensory ligaments and were transected. In the llama, the
      suspensory ligament was transected, and overcorrection caused ischemic necrosis
      of one distal limb and subluxation of the other fetlock joint. In the horse and
      donkey, the suspensory ligament was preserved and wedge osteotomy was performed
      to correct the deformity.

PMID- 1626400
TI  - A comparison of nylon, polybutester, and polyglyconate suture materials for long
      digital flexor tenorrhaphy in chickens.
AB  - Digital flexor tenorrhaphies were performed in 32 8-week-old chickens with
      polyglyconate, polybutester, or nylon. There was no difference in maximum loads
      to failure at weeks 4 or 8. Polyglyconate and polybutester tenorrhaphies were
      significantly stronger at week 8 than all tenorrhaphies at week 4. Nylon
      tenorrhaphies at week 8 were not significantly stronger than any tenorrhaphy at
      week 4. The tenorrhaphies consistently had immature scars at week 4 and more
      mature scars at week 8. Scar maturity was not appreciably different between any
      of the suture materials at week 4 or week 8. There was no apparent difference in
      tissue reactivity to any of the suture materials at weeks 4 or 8.

PMID- 1626402
TI  - Covariances for estimated totals when comparing between years.

PMID- 1626401
TI  - Hemodynamic function during neurectomy in halothane-anesthetized horses with or
      without constant dose detomidine infusion.
AB  - Nine horses were premediated with acepromazine, and anesthesia was induced with
      guaifenesin and thiamylal. Anesthesia was maintained in four horses with
      halothane in oxygen, and in five horses with halothane in oxygen plus a constant
      dose infusion of detomidine. Both maintenance regimens produced a MAC equivalent
      of 1.4 at the ambient barometric pressure. Hemodynamic and respiratory
      measurements were made after the horses were anesthetized, during surgical
      manipulations involving skin or tissues other than nerves, during manipulation
      and transection of digital nerves, and after surgery while the limbs were being
      bandaged. Heart rate was significantly higher in horses anesthetized with
      halothane only than in horses that also received detomidine; there were no other
      differences in hemodynamic function or recovery characteristics. Respiratory rate
      was significantly higher than baseline during soft tissue and nerve
      manipulations; arterial blood pressure was significantly higher after surgery
      began and highest during neurectomy; cardiac output and cardiac index were
      significantly decreased during surgery; systemic vascular resistance was
      significantly increased during neurectomy and bandaging and highest during
      neurectomy. The data suggest that the increase in blood pressure often associated
      with surgical stimulation is caused by increased vascular resistance and may be
      accompanied by a decrease in cardiac output.

PMID- 1626403
TI  - [Organizational principles of medical and public health measures during a large
      scale accident at an atomic power station based on the Chernobyl experience].
AB  - The whole complex of organizational medical measures on the elimination of
      aftereffect of the large-scale radiation accident at the NPP may consist of the
      three basic groups: 1) preventive, aimed at maximally lowering the population and
      its critical subpopulations exposure levels; 2) curative and diagnostic, which,
      in addition to the rendering of medical assistance, provide for implementation of
      the programs of long-term population health studies, and 3) sanitation and
      educational, aimed at preventing negative social and psychological processes that
      accompany radiation accidents.

PMID- 1626404
TI  - [The medico-social significance and forms of introducing the results of program
      C.27 into public health and national economy practice].

PMID- 1626405
TI  - [Chronic radiation sickness in man caused by long-term gamma rays].
AB  - A retrospective analysis was made of the leading syndromes of chronic radiation
      sickness (CRS) induced by external gamma-radiation in a dose of 1.0-9.33 Gy
      during the disease formation and in the long-term period (30-35 years after
      diagnosis). The frequency of the hematological and neurological syndromes,
      secretory alterations in the stomach, efficacy of rehabilitation measures,
      morbidity in specialists with a history of the clinical manifestations of CRS,
      who continue working are estimated. The incidence of the main somatic diseases is
      presented.

PMID- 1626406
TI  - [The levels of irradiation of superficial tissues in personnel engaged in the
      clean-up of the consequences of the accident at the Chernobyl Atomic Electric
      Power Station].

PMID- 1626407
TI  - [Means of improving and characteristics of the use of beta spectrometry of 90Sr
      after the Chernobyl accident].
AB  - The paper is concerned with a theoretical possibility of the use of 90Sr beta
      spectrometry in a mixture of radionuclides including 137Cs, 134Cs, 144Ce and
      106Ru after the Chernobyl accident. Special attention is paid to the choosing of
      a detector and spectrum treatment techniques as factors determining the minimum
      detectable activity of the method. A brief description of the spectrometric
      system as well as of the software used is given. The comparison of the method
      with traditional radiochemical and gamma-spectrometric methods has shown that it
      is applicable to a wide range of activities and to different objects including
      those of biological origin. The sources of errors are considered in detail.
      Approaches to the development of the method are given.

PMID- 1626408
TI  - [The significance of modifying factors in evaluating the effect of
      radionuclides].
AB  - The authors provide the data obtained in experimental animals, pertaining to the
      influence of certain modifying factors on metabolism and biological effects
      induced by radioactive isotopes of iodine, by transuranium elements and
      beryllium. Out of all the modifying factors investigated, the form of the
      introduced compound and age turned out the most significant ones.

PMID- 1626409
TI  - [The relation of non-stochastic effects to the radiation dose of the human
      thyroid gland].
AB  - The paper is concerned with the reported data characterizing the dose-effect
      relationship for the main non-stochastic effects, namely for acute radiation and
      chronic thyroiditis and hypothyroidism that occur as a result of external and
      internal radiation of the thyroid. The threshold doses for acute thyroiditis,
      hypothyroidism, temporary thyroid hypofunction in adults and children exposed to
      131I are estimated. The influence of modifying factors on the intensity and the
      times of thyroid lesion manifestations such as hyperactive thyroid is under
      consideration.

PMID- 1626410
TI  - [Experimental optimization of iodine prophylaxis in an accidental accumulation of
      radioiodine].

PMID- 1626411
TI  - [Dynamics of the radiation conditions and evaluation of the radiation dosage of
      the inhabitants of Kiev following the accident at the Chernobyl Atomic Electric
      Power Station].
AB  - The estimation of the effective dose equivalents of exposure to accidental and
      non-accidental sources was made on the basis of the studying of radiation
      situation variations in Kiev after the Chernobyl accident in 1986-1989. The total
      annual effective dose equivalents to the Kiev population from all sources of
      exposure for 1986-1989 were 9.19, 7.29, 5.34 and 5.03 mSv, respectively. The
      necessity of radiation health measures aimed at limiting the intake of long
      acting radionuclides of Chernobyl nature and reducing the exposure doses by
      optimizing the x-ray procedure and by regulating the natural radioactivity of
      building materials are under discussion.

PMID- 1626412
TI  - [We must speak up].

PMID- 1626413
TI  - [Priority tasks of the common program for the clean-up of the consequences of the
      accident at the Chernobyl Atomic Electric Power Station].
AB  - The paper is concerned with the problems pertaining to the implementation of the
      State Union-Republic program of urgent measures for 1990-1992 and Republican
      programs of the elimination of Chernobyl accident consequences. Among the basic
      priorities covered by the program, the author regards the problems of the living
      of the population at the polluted areas, criteria for accepting decisions as to
      the possibility of further living or settling out together with favourable and
      unfavourable consequences of such a measure as settling out. Emphasis is laid on
      some priorities of the optimal use of means alloted for implementing the programs
      of the elimination of Chernobyl accident consequences.

PMID- 1626414
TI  - [Radiologic consequences and medico-biological problems 4 years after the
      accident at the Chernobyl Atomic Electric Power Station].
AB  - The data on the assessment of the radiobiological situation and the results of
      clinical and epidemiological studies into the population health status, exposed
      to radiation because of the Chernobyl NPP accident are summarized. Appropriate
      regularities in soil contamination with 137Cs are ascertained. It has been shown
      that the disease incidence among the children's and adult population of the
      controlled areas is associated not only with improvement of the disease revealing
      but with the influence of the accident consequences.

PMID- 1626415
TI  - Biochemical and immunological evidence that the 11 kDa zinc-binding protein of
      lymphocytic choriomeningitis virus is a structural component of the virus.
AB  - The completed sequence of the arenavirus, lymphocytic choriomeningitis virus,
      revealed a new gene encoding a small protein with a single zinc-binding domain.
      The cDNA for this gene has been expressed in E. coli to produce fusion protein
      that has been used to raise antisera. The antisera facilitated the positive
      identification of the p11 'Z' gene product as a structural component of the
      virion. A related arenavirus, Tacaribe, has a comparable p11 gene product. The
      abundance of the p11 Z protein relative to other virion components has been
      determined by metabolic labeling. Triton X-114 extraction and dimethyl
      suberimidate-HCl crosslinking indicate that the p11 Z protein is a hydrophobic
      protein associated with the nucleocapsid of the virion core.

PMID- 1626416
TI  - Rapid treatment of whole cells and RNA viruses for analysis of RNA by slot blot
      hybridization.
AB  - To avoid extensive manipulation for the purification of RNA from cells, several
      methods were evaluated for the direct release of RNA from influenza virus
      infected cells and supernatants using slot blot hybridization and non-radioactive
      probes. Treatment with an equal volume of 10 M aqueous guanidine hydrochloride
      produced the best hybridization signal. Less, but significant amounts of RNA were
      also released using the following treatments: dilute alkali (final concentration
      of 0.16 M NaOH) or 100 degrees C/5 min or RNA sample buffer containing
      formamide/formaldehyde, then heating at 65 degrees C/10 min. Despite the presence
      of large amounts of cell debris, RNA from guanidine hydrochloride treated whole
      cell extracts bound quantitatively to the positively charged nylon membranes. The
      sensitivity of RNA detection when whole cell extracts treated with guanidine
      hydrochloride were probed with a digoxigenin labelled cDNA probe was similar to
      the detection of RNA in highly purified, protein free samples. Three positively
      charged membranes were tested (from Amersham, ICN and Boehringer Mannheim) using
      two alkaline phosphatase substrates, NBT-X phos, and a chemiluminescent
      substrate, 3-(2'-spiroadamantane)-4-methoxy-4-(3'-phosphoyloxy)-phenyl- 1-1,2
      dioextane (AMPPD) and a peroxidase substrate, tetramethylbenzidine (TMB). The
      Boehringer Mannheim membrane had the highest sensitivity for the alkaline
      phosphatase substrates, but the peroxidase reaction with the TMB substrate was
      the most consistently sensitive, irrespective of which membrane was used. The
      ability to quantitatively detect RNA from whole cells without any purification
      will allow the rapid screening of large numbers of samples for specific RNA
      species in research or diagnostic laboratories.

PMID- 1626417
TI  - Host dependence of naturally occurring temperature-sensitive influenza A viruses
      and location of their genetic lesions.
AB  - Naturally occurring temperature-sensitive (ts) strains have been found in large
      number in human influenza A viruses of all subtypes (J. Virol. 41 (1982) 353).
      Further studies have demonstrated that the ts phenotype of these viruses is host
      dependent in that they are highly ts in chick embryos and chick embryonic cells,
      but are ts+ in MDCK cells. Previous studies have located by complementation tests
      the ts lesion of two H3N2 viruses (HK/8/68 and Ningxia/01/72, also known as Xia
      ts) on the NP gene and that of two H1N1 viruses (Tianjin/78/77 and Beijing/1/79)
      on the M protein gene. By recombination and polyacrylamide electrophoresis
      migration of the RNA segments of its ts+ recombinant with PR8, the ts lesion of a
      later H3N2 virus A/Qi/39/79 has now been located on the M protein gene. The
      possibility for Qi/39/79 of acquiring the M gene lesion by reassortment with
      concurrently circulating Tianjin/78/77-like (H1N1) virus which also has ts lesion
      on the M gene was investigated. In contrast to Tianjin/78/77 (H1N1), however,
      Qi/39/79 complemented well with ts 51, a WSN ts strain with a single M gene
      lesion. Qi/39/79 and Tianjin/78/77 also complemented each other. Thus, there are
      two intra-segmental complementation groups of the M gene: Qi/39/79 belongs to one
      complementation group, while WSN ts 51 and Tianjin/78/77 belong to another. At
      present, there is no evidence of reassortment involving the genes concerned in
      the ts lesions of H3N2 and H1N1 viruses under natural conditions.

PMID- 1626419
TI  - Reconstitution of influenza virus RNA polymerase from three subunits expressed
      using recombinant baculovirus system.
AB  - Influenza virus RNA polymerase catalyzes multiple step reactions in transcription
      and replication of the genome RNA. The core enzyme is composed of each one of the
      three P proteins, PB1, PB2 and PA (Honda et al. (1990) J. Biochem. 107, 624-628).
      For detailed analysis of the role of each P protein and of the functional domains
      on each P polypeptide, we expressed individual P proteins in cultured insect
      cells after infection with recombinant baculoviruses. PB1 and PB2 accumulated in
      cell nuclei whereas PA stayed in cytoplasm. Both the PB1 and PB2 proteins were
      purified from aggregates in the respective nuclear extract, and the PA was
      partially purified from the cytoplasm. RNA polymerase was reconstituted by mixing
      the three P proteins in a urea solution and then dialyzing against a
      reconstitution buffer. The reconstituted enzyme was able to transcribe model RNA
      templates. Minus-sense RNA was a better template than plus-sense RNA.

PMID- 1626418
TI  - Enzymatic properties of the mouse Mx1 protein-associated GTPase.
AB  - Murine Mx1 protein, an interferon-inducible nuclear protein present in inbred
      mouse Mx+ strains, confers resistance to influenza virus infection. The purified
      Mx1 protein was found to carry the activities of both GTPase and GTP-binding.
      Enzymatic properties of the Mx1-associated GTPase were examined using the Mx1
      protein purified from Escherichia coli expressing Mx1 cDNA. The Mx1 protein
      exhibited a substrate preference for GTP. The Vmax of ATP hydrolysis was about
      7.6% the rate of GTP hydrolysis. The hydrolysis of CTP and UTP was virtually
      negligible. The Km for GTP hydrolysis was 667 microM and the rate was 13.8 mol
      GTP hydrolysis per min per mol Mx1 protein. The enzymatic properties of Mx1
      protein-associated GTPase were compared with those of the GTPase super-gene
      family and the Mx-related family.

PMID- 1626420
TI  - Regulation of pH by the M2 protein of influenza A viruses.
AB  - Inhibition of the function of the M2 protein by amantadine can cause a
      conformational change in the haemagglutinin (HA) of H7 influenza A viruses and
      the consequent expression of the low pH form of the glycoprotein on the surface
      of virus-infected cells. Immunofluorescence studies showed that this conversion
      occurs shortly after HA exists from the Golgi complex apparently during its
      transport through the trans Golgi network and using the pH probe, DAMP/anti-DNP,
      that it is the direct result of reduced vesicular pH. The lowest pHs encountered
      were estimated using mutant HAs differing in pH stability to be approximately 5.2
      and 5.6 in virus-infected CEF or MDCK cells, respectively, in the absence of
      functional M2. Depending on the particular M2, this protein was responsible for
      increases in vesicular pH of up to 0.8 units. The influence of mutations in both
      HA and M2 on the maturation of native HA illustrates the important relationship
      between the structural and functional properties of these two proteins. Using the
      fluorescent probe SNARF-1 the M2 protein was also shown to be largely responsible
      for the 0.3-0.4 unit reduction in intracellular pH of virus-infected cells. The
      data thus provide further evidence for the pH regulatory function of M2 and its
      importance for the maturation of the HA glycoprotein.

PMID- 1626421
TI  - Host range determination and functional mapping of the nucleoprotein and matrix
      genes of influenza viruses using monoclonal antibodies.
AB  - Construction and comparison of phylogenetic trees, the standard approach to
      determining the host-specific lineage of influenza A virus genes is tedious and
      expensive. In this study, panels of monoclonal antibodies (Mabs) produced against
      the matrix proteins (M1) of A/WSN and A/PR/8/34 and the nucleoprotein (NP) of
      A/WSN were assessed for their value in identifying the hosts of origin of the M1
      and NP genes in influenza virus isolates and in mapping the proteins' functional
      domains. Using ELISA against a broad spectrum of reference viruses, we found two
      Mabs against the NP (150/4 and 469/6) to be useful in determining host-specific
      lineage. Comparative sequence analysis placed five amino acids within the
      antigenic domains recognized by Mab 150/4 and two amino acids within the domains
      recognized by 469/6. One Mab against the NP (5/1) recognized a conserved epitope
      that is present on each of the 36 influenza A viruses tested. This epitope may be
      a type-specific determinant for influenza A viruses and an RNA binding site.
      Monoclonal antibodies to M1 did not discriminate among species, but they did
      contribute information to the construction of a functional map of M1. These
      results demonstrate that Mabs to defined protein epitopes can provide useful
      information on the molecular epidemiology of influenza viruses.

PMID- 1626422
TI  - Marburg virus, a filovirus: messenger RNAs, gene order, and regulatory elements
      of the replication cycle.
AB  - The genome of Marburg virus (MBG), a filovirus, is 19.1 kb in length and thus the
      largest one found with negative-strand RNA viruses. The gene order - 3'
      untranslated region-NP-VP35-VP40-GP-VP30-VP24-L-5' untranslated region-resembles
      that of other non-segmented negative-strand (NNS) RNA viruses. Six species of
      polyadenylated subgenomic RNAs, isolated from MBG-infected cells, are
      complementary to the negative-strand RNA genome. They can be translated in vitro
      into the known structural proteins NP, GP (non-glycosylated form), VP40, VP35,
      VP30 and VP24. At the gene boundaries conserved transcriptional start (3'
      NNCUNCNUNUAAUU-5') and stop signals (3'-UAAUUCUUUUU-5') are located containing
      the highly conserved pentamer 3'-UAAUU-5'. Comparison with other NNS RNA viruses
      shows conservation primarily in the termination signals, whereas the start
      signals are more variable. The intergenic regions vary in length and nucleotide
      composition. All genes have relatively long 3' and 5' end non-coding regions. The
      putative 3' and 5' leader RNA sequences of the MBG genome resemble those of other
      NNS RNA viruses in length, conservation at the 3' and 5' ends, and in being
      complementary at their extremities. The data support the concept of a common
      taxonomic order Mononegavirales comprising the Filoviridae, Paramyxoviridae, and
      Rhabdoviridae families.

PMID- 1626423
TI  - Gene junction sequences of bovine respiratory syncytial virus.
AB  - The nucleotide sequences of seven gene junctions (N-P, P-M, M-SH, SH-G, G-F, F-M2
      and M2-L) of bovine respiratory syncytial virus (BRSV) strain A51908 were
      determined by dideoxynucleotide sequencing of cDNAs from polytranscript mRNAs and
      from genomic RNA. By comparison with the consensus sequences derived from human
      respiratory syncytial virus (HRSV) mRNAs, gene-start and gene-end sequences were
      found in all BRSV mRNAs. There was a perfect match between the BRSV and HRSV in
      all gene-start sequences, except for the sequence of the SH gene which contained
      one nucleotide difference compared to HRSV A2; and the gene-start sequence of the
      L gene, which was one nucleotide shorter than the corresponding sequence of HRSV.
      Analysis of the intergenic regions showed a high degree of divergence in the
      nucleotide sequence between BRSV and HRSV. However, the length of the nucleotides
      in the intergenic sequences was similar for a given gene junction. As in the case
      of HRSV, the M2 and L genes of BRSV overlap by 68 nucleotides, suggesting a
      similar transcription attenuation mechanism. The sequences of the overlap,
      corresponding to the 3' end of the L gene, were almost identical between BRSV and
      HRSV.

PMID- 1626424
TI  - Comparison of the deduced gene products of the L, M and S genome segments of
      hantaviruses.
AB  - The amino acid sequences deduced from all currently available nucleotide
      sequences of hantaviruses are compared. Comparisons of three large (L), eight
      medium (M) and five small (S) genome segments are included. A consensus sequence
      is provided, allowing easy identification of conserved and unique gene regions.
      The viruses included in this report represent four serologically distinct
      hantaviruses which are capable of causing severe, moderate, mild or no human
      disease.

PMID- 1626425
TI  - Nucleocapsid specific T and B cell responses in humans after rabies vaccination.
AB  - The importance of the immune response directed to the internal component of the
      rabies virus, the nucleocapsid (NC), was evaluated in humans after rabies
      vaccination. T cell activation was measured with a bulk proliferative assay and
      relative frequencies of circulating NC-specific PBL were calculated with the
      limiting dilution technique. Vaccinees were classified into two groups: NC
      responders and NC non-responders. In NC responders, the frequency of NC-specific
      circulating lymphocytes was up to 6 times higher than the frequency of virus
      specific lymphocytes. In non-responders, NC-specific lymphocytes were up to 25
      times less common than virus-specific ones. The NC capacity to induce a secondary
      antibody response was tested in vitro. After a stimulation with complete virus,
      lymphocytes originating from donors vaccinated with tissue culture vaccine
      produced a secondary antibody-response composed mainly of glycoprotein-specific
      neutralizing antibodies, whereas lymphocytes from suckling mouse brain vaccines
      produced essentially NC-specific antibodies. This result confirmed the
      serological status of suckling mouse brain vaccinees, who usually developed high
      titres of NC-specific antibodies. After an in vitro NC stimulation, lymphocytes
      collected from NC responders produced not only NC-specific antibodies, provided
      they have NC-specific B cells at the time of blood sampling, but most
      surprisingly, they also produce glycoprotein-specific neutralizing antibodies.
      This finding indicates that NC free of glycoprotein is capable, in some
      individuals, of boosting an heterologous glycoprotein response.

PMID- 1626426
TI  - Influenza A virus NP protein expressed in insect cells by a recombinant
      baculovirus is associated with a protein kinase activity and possesses single
      stranded RNA binding activity.
AB  - Influenza A virus NP protein, the phosphoprotein associated with viral RNA in
      ribonucleoprotein (RNP) complexes, has been expressed at high levels
      (approximately 100 mg/liter cells) in insect (Sf9) cells by a baculovirus
      recombinant, and was localized almost entirely in the nuclei of these cells. NP
      was purified by immuno-affinity chromatography, and purified NP was shown to
      autophosphorylate and to phosphorylate casein in a cAMP-independent reaction.
      Furthermore, purified NP was able to bind to ssRNA as demonstrated by a mobility
      shift of ssRNA in non-denaturing gels. The binding of NP to ssRNA caused a
      diminution of its kinase activity in proportion to binding.

PMID- 1626427
TI  - Isolation and sequence analysis of the gene encoding translation elongation
      factor 3 from Candida albicans.
AB  - The structural gene encoding translation elongation factor 3 (EF-3) has been
      cloned from a Candida albicans genomic library by hybridization to a
      Saccharomyces cerevisiae probe containing the Saccharomyces gene, YEF3 (Sandbaken
      et al., 1990b). The sequences were shown to be functionally homologous to the
      Saccharomyces gene by three criteria: (1) a Saccharomyces strain transformed with
      a high copy plasmid containing CaEF3 sequences overproduces the EF-3 peptide two
      fold; (2) extracts from this strain exhibit a two-fold increase in the EF-3
      catalysed, ribosome-dependent ATPase activity (Kamath and Chakraburtty, 1988);
      and (3) the Candida gene complements a Saccharomyces null mutant. The coding
      region, identified by DNA sequencing, indicates that CaEF3 encodes a 1050 amino
      acid polypeptide having a potential molecular weight of 116,865 Da. This protein
      shows 77% overall identity to the Saccharomyces YEF3 gene, with a significantly
      greater identity (94%) concentrated in the region of the protein thought to
      contain the catalytic domain of EF-3 (Sandbaken et al., 1990a). The upstream non
      coding region contains T-rich regions typical of many yeast genes and several
      potential RAP1/GRF1 elements shown to regulate expression of a number of
      translational genes (Mager, 1988). The data confirm a high degree of conservation
      for EF-3 among the two organisms.

PMID- 1626428
TI  - N-linked glycosylation of proteinase B precursors of the yeast Saccharomyces
      cerevisiae is not required for proper targeting or processing of the enzyme.
AB  - Proteinase B precursors are modified by an N-linked carbohydrate side chain at
      Asn 314. Glycosylation at this position is not required for proper localization,
      processing, or activation of the enzyme.

PMID- 1626429
TI  - Genetic analysis of maintenance and expression of L and M double-stranded RNAs
      from yeast killer virus K28.
AB  - The killer phenotype expressed by Saccharomyces cerevisiae strain 28 differs from
      that of the more extensively studied K1 and K2 killers with respect to immunity,
      mode of toxin action and cell wall primary toxin receptor. We previously
      demonstrated that the M28 and L28 dsRNAs found in strain 28 are present in virus
      like particles (VLPs) and that transfection with these VLPs is sufficient to
      confer the complete K28 phenotype on a dsRNA-free recipient cell. We also
      demonstrated that L28, like the L-A-H species in K1 killers, has [HOK] activity
      required for maintenance of M1-dsRNA, and predicted that M28 would share with M1
      dependence on L-A for replication. We now confirm this prediction by genetic and
      biochemical analysis of the effects of representative mak, ski and mkt mutations
      on M28 maintenance, demonstrating that M28 replication resembles M1 in all
      respects. We also show that L28 is an L-A-H species lacking [B] activity, and
      that M28 excludes both M1 and M2 from the same cytoplasm. Stable coexpression of
      K28 phenotype from M28 and of K1 phenotype from an M1-cDNA clone was
      demonstrated. Exclusion, therefore, acts at the level of dsRNA replication,
      presumably reflecting competition for the L-A-H encoded capsid and cap-pol fusion
      protein, rather than reflecting incompatibility of toxin or immunity expression.
      Finally, we show that expression of active K28 toxin, but not of K28 immunity,
      requires the Kex2 endoprotease.

PMID- 1626430
TI  - Identification of RAD16, a yeast excision repair gene homologous to the
      recombinational repair gene RAD54 and to the SNF2 gene involved in
      transcriptional activation.
AB  - The RAD54 gene of Saccharomyces cerevisiae is involved in the recombinational
      repair of DNA damage. The predicted amino acid sequence of the RAD54 protein
      shows significant homologies with the yeast SNF2 protein, which is required for
      the transcriptional activation of a number of diversely regulated genes. These
      proteins are 31% identical in a 492-amino acid region that includes presumed
      nucleotide and Mg2+ binding sites. We noted previously that the SNF2 protein also
      shares homology with a partial open reading frame (ORF) that was reported with
      the sequence of an adjacent gene. This ORF also shares homology with the RAD54
      protein. To test whether this ORF is involved in transcriptional activation or
      DNA repair, yeast strains deleted for part of it have been isolated. These
      strains do not show a Snf-like phenotype, but they are UV sensitive. This gene
      has been identified as RAD16, a gene involved in the excision repair of DNA
      damage. Analysis of the rad16 deletion mutations indicates that RAD16 encodes a
      non-essential function and is not absolutely required for excision repair.
      Outside the region of homology to RAD54 and SNF2, the predicted RAD16 protein
      contains a novel cysteine-rich motif that may bind zinc and that has been found
      recently in eleven other proteins, including the yeast RAD18 protein. The
      homologies between RAD16, RAD54 and SNF2 are also shared by several additional,
      recently isolated yeast and Drosophila genes.

PMID- 1626431
TI  - Molecular analysis of yeast chromosome II between CMD1 and LYS2: the excision
      repair gene RAD16 located in this region belongs to a novel group of double
      finger proteins.
AB  - We have analysed a region some 30 kb centromere distal from PHO5 on the right arm
      of yeast chromosome II and determined the nucleotide sequence of a 8.95 kb DNA
      segment from this region. By this analysis we were able to derive the precise
      location and the transcriptional orientation of CMD1, ALG1, SSN6 and LYS2. An
      open reading frame of 2370 bp was localized between SSN6 and LYS2, which has
      recently been identified (Schild et al., 1991) to be the RAD16 gene. The putative
      gene product, 790 amino acids in length, reveals several interesting features. It
      contains a nuclear target signature and shares several blocks of similarity with
      the yeast recombinational repair protein RAD54 and the nuclear factor SNF2
      (SWI2), which is required for the transcriptional activation of a number of yeast
      genes. The similarity blocks in these three proteins are reminiscent of those
      found in the helicase superfamily. Furthermore, RAD16 contains a novel 'double
      finger' motif, which has been encountered in a variety of proteins from different
      organisms that are suggested to interact with DNA and are involved in diverse
      functions including site-specific recombination, DNA repair, and transcriptional
      regulation. The putative gene product of RAD16 then is the first example of a
      protein in which the novel double-finger motif is found to be combined with a
      potential DNA helicase framework.

PMID- 1626432
TI  - The complete sequence of a 10.8 kb segment distal of SUF2 on the right arm of
      chromosome III from Saccharomyces cerevisiae reveals seven open reading frames
      including the RVS161, ADP1 and PGK genes.
AB  - We have entirely sequenced a 10,835 bp segment of the right arm from chromosome
      III contained in the J11D and J11D-K3B GF clones. The segment contains seven open
      reading frames longer then 100 amino acids. Three of them, RVS161 (Urdaci et al.,
      1990; Crouzet et al., 1991), ADP1 (Purnelle et al., 1991) and PGK1 (Hitzeman et
      al., 1982) have been described previously. YCR10C encodes a putative membrane
      protein. YCR8W (encoding a putative protein kinase) and YCR14C extend inside the
      D10H (Skala et al., 1991) and 62B5-2D clones respectively. Four ARS elements
      previously reported by Palzkill et al. (1986) are located between RVS161 and
      YCR10C.

PMID- 1626433
TI  - Sequence of the novel essential gene YJU2 and two flanking reading frames located
      within a 3.2 kb EcoRI fragment from chromosome X of Saccharomyces cerevisiae.

PMID- 1626434
TI  - [Fetomaternal signal transduction by growth factors].
AB  - An attempt was made to review the current knowledge on the role of growth factors
      in the field of fetomaternal interaction. Of special interest was the relation
      between maternal T-lymphocytes and fetal growth. Stimulation of cytotrophoblast
      growth is effected by: IGF I/II (insulin-like growth factor), CSF-1 (colony
      stimulating factor), EGF (epidermal growth factor), FGF (fibroblast growth
      factor), IL-1, IL-3 (Interleukin), PDGF (platelet derived growth factor). TNF
      (tumor necrosis factor) inhibits trophoblast cell growth. TNF is synthesized in
      both decidual and chronic cells. CSF-1 considered the most potent stimulator of
      the induction of trophoblast cell growth. Cytotrophoblast itself produces IGF
      I/II, EGF, PDGF, TGF (transforming growth factor). Furthermore, it is known that
      HCG-secretion is mainly stimulated by IL-1. Whereas intra- and paracrine
      mechanisms in the placenta will remain in the field of basic research for the
      next future, animal experiments proving the positive impact of IL-3 and GM-CSF
      (granulocyte/macrophage-colony stimulating factor) on trophoblast growth should
      give reason for clinical investigations. It is assumed, that maternal T
      lymphocytes realize paternally inherited alloantigenic structures resulting in
      local response of IL-3 and GM-CSF production.

PMID- 1626435
TI  - [Immunologic aspects of endometriosis].
AB  - In development of endometriosis immunological phenomenons are discussed. In women
      with endometriosis specific antibodies are demonstrated and it is worth to
      speculate that there takes place de novo-expression of specific antigens. It is
      also possible, that changes in humoral immunity in endometriosis are secondary to
      deficient cellular mechanisms.

PMID- 1626436
TI  - [Evaluation of the efforts in prenatal care for the prevention of prematurity].
AB  - A retrospective analysis was done in 341 singleton premature deliveries to assess
      the practised activities in antenatal care for the prevention of premature
      delivery. This analysis, expressed in terms of adequacy revealed that 56% were
      adequate whereas 23% were conditionally adequate and 21% were inadequate.
      Clinically these activities were reflected in suppression of uterine contractions
      (80%/57%/40%-effective tocolysis), achieved prolongation of pregnancy (25d/8d/2d)
      and a lowered rate of premature delivery before the 32nd week of gestation
      (17%/31%/33%), respectively. A prospective study depending on these results (n =
      450) done in 4 centers for antenatal care (under constant supervision to keep the
      respective recommended activities) showed a significant reduction in the rate of
      premature delivery compared to a similar control group (n = 458) in the year
      1988. Simultaneously, we could demonstrate the influence of patient explanation
      and the growing patient satisfaction which resulted in reduction of premature
      delivery.

PMID- 1626437
TI  - [Ultrasound diagnosis of fetal lung maturity--a new method].
AB  - First results are presented to determine the maturity of fetal lung by
      sonography. Using the fetal liver as a reference-organ we are avoiding the known
      pitfalls which made it impossible in the past to standardize the fetal lung
      changes depending on the age of gestation. We examined 104 patients between week
      27 and week 41. In one ultrasound section cut we depicted as well lung and liver.
      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). Afterwards the frequencies of the lung were divided
      by those of the liver. Of all weeks of gestation the mean value and standard
      deviation were calculated. We found the liver as an adequate reference-organ,
      since there is no change of the reflection pattern between the different weeks of
      gestation, while there are significant changes to be registered in the fetal
      lung, a cutting line being week 35. A quotient of f(mean) lower than 1.1 hints to
      lung maturity while values over 1.1 point to immaturity. This was confirmed by
      several cases of analysis of amniotic fluid (L/S-ratio). Further comparisons with
      amniotic fluid results will have to validate these findings.

PMID- 1626438
TI  - [Doppler ultrasound study of breast tumors using color Doppler ultrasound, duplex
      ultrasound and the CW Doppler ultrasound].
AB  - The preoperative examinations by doppler-sonography of 83 patients with tumors of
      the breast are presented. The examinations are done with newest technique: duplex
      sonography in slow-flow-technique (AI 3200, Dornier); colour-sonography in MEM
      technique (AI 5200, Dornier) and synchronical colour-doppler++ (Quantum 2000,
      Siemens) and CW-doppler-sonography (Vasocope 3, Kranzbuhler). There is a markable
      difference between the side of carcinoma and the normal side as well as pre- and
      postmenopausal patients. No difference is shown in cases of benign tumors and the
      normal side. The increasing blood flow of a malignant tumor is showed in changing
      the doppler parameters (A/B-ratio and resistance-index) and in the doppler wave
      form. The number of vessels found in or around a tumor is not a good criteria to
      find malignant diseases, the best criteria is the difference between sides of the
      mamma.

PMID- 1626439
TI  - [Therapy of primary fallopian tube cancer--a retrospective study of 30 cases].
AB  - Between the years 1968-1988 30 patients with primary carcinoma of the fallopian
      tube were treated in the Department of Obstetrics and Gynecology of the
      University of Kiel. In 27 cases the initial treatment consisted of total
      abdominal hysterectomy and bilateral salpingo-oophorectomy. In 3 cases where the
      patients had undergone surgical treatment in another hospital a second operation
      for completion was performed. 2 patients received no further treatment after
      surgery. Postoperative radiotherapy was given to 20 patients and a combined
      treatment with radiation and polychemotherapy was implemented in 5 cases.
      Postoperative treatment in 3 patients was poly-chemotherapy alone. The 5-year
      survival rate taking all tumor stages and modes of therapy employed into
      consideration was 36.7%. In analysing the survival rate for small numbers as
      directly related to postoperative treatment a 5-year-survival rate for
      radiotherapy of 35% (7/20) and for radiation therapy plus poly-chemotherapy of
      40% (2/5) was found. After operative treatment followed by poly-chemotherapy
      alone one of three patients survived after 5 years.

PMID- 1626440
TI  - [Virucidal disinfection in gynecology].
AB  - The different structure and stability of viruses requires the application of
      virucidal disinfection procedures in gynaecology. For this purpose disinfectants
      should be used which are tested according to the guidelines of the German
      Association for the Control of Virus Diseases (DVV; Deutsche Vereinigung zur
      Bekampfung der Viruskrankheiten) in a virus suspension test and in nearly all
      cases only a slight increase of application conditions is necessary to get equal
      efficacy for the disinfection or surfaces of instruments. But the application
      solutions of instrument disinfectants should not be used longer than one day.
      Experiments testing the virucidal effectivity of such solutions showed an
      insufficient decontamination of infectious materials already after 3 days usage.

PMID- 1626441
TI  - [Congenital cervico-vaginal atresia and pelvic endometriosis. Clinical case and
      review of the literature].
AB  - Congenital cervico-vaginal atresia is a rare malformation; the presence of a
      functioning endometrium combined with this anomaly causes a retrograde
      menstruation and then a greater likelihood of endometriosis. Up to the present
      literature relates only thirteen cases in which congenital cervico-vaginal
      atresia was combined with a functioning endometrium. Primary amenorrhea and
      cyclic, cramping lower abdominal pain was the common symptoms of all the
      patients. In this work we report a new case of such pathology in a 23 old woman
      affected also by harmonic nanism. After the review of the literature the
      embryologic mechanisms involved in lower Mullerian tract malformations, the
      surgical treatment and the mechanism of formation of endometriosis in association
      with an outflow tract obstruction are discussed.

PMID- 1626442
TI  - Behaviour and the concept of "heritability" axioms of an ethological refutation.
AB  - This paper discusses the widespread use of heritability calculations in recent
      behaviour research including behaviour genetics. In the sequel, a radical
      criticism concerning the basic axioms of the underlying, more general concept
      itself is presented. The starting point for testing the proclaimed universal
      validity of this concept stems from a fictitious yet realistic example taken from
      learning research. The theoretical result, based on the application of the
      conventional reasoning in this field, states that developmental processes--and
      learning is only one specific case out of an immense number of similar
      behavioural mechanisms--can neither be adequately described nor causally
      explained with sufficient reliability within the context of the heredity
      paradigm. On the contrary, an inherent inconsistency of the concept itself when
      applied to behaviour processes is demonstrated. Finally, a conceptual alternative
      involving a systems-theoretical approach to the problem is presented: In such a
      perspective it is the concept of "cognition" which represents the adequate
      explanatory theorem--a theorem in which quantitative processing of "information"
      from the environment is clearly revealed to belong to a subordinate level of
      living organization.

PMID- 1626444
TI  - Evolutionary epidemiology.

PMID- 1626443
TI  - Cancer as a mechanism of hypermutation.
AB  - The highly structured mechanisms of cancers, their tendency to occur as a
      response to environmental stress, and the existence of oncogenes, suggest that
      neoplasticity may represent more than a biological disfunction. It is proposed
      that cancer exists as a phylogenetic mechanism serving to promote
      "hyperevolution", albeit at the expense of the ontogeny, that is similar to a
      process recently discovered in bacterial mutations. Cell-surface-associated
      nucleic acid in tumorigenic cells and sperm cell vectorization of foreign DNA
      indicate the existence of essential mechanisms necessary to the occurrence of
      cancer mediated hyperevolution. An analysis of the proposed mechanism indicates
      that for mutagenesis of chemical cytology, stress induced neoplasticity confers
      an evolutionary advantage of more than two orders of magnitude.

PMID- 1626445
TI  - The concept of structuregenesis.

PMID- 1626446
TI  - In vivo and in vitro productions of interleukin-2, interleukin-2 receptor and
      gamma-interferon in multitransfused thalassemic patients.
AB  - In vivo and in vitro productions of interleukin-2 (IL-2), IL-2 receptor (IL-2R)
      and gamma-interferon (gamma-IFN) in 64 multi-transfused thalassemic patients and
      20 healthy children were studied. The results were: 1) Increased serum
      concentrations of IL-2 and IL-2R, and decreased serum concentration of gamma-IFN
      were found in thalassemic patients when compared to controls. 2) In in vitro
      study, productions of IL-2, IL-2R and gamma-IFN were much lower in thalassemic
      patients than in controls. The possible mechanisms for the altered lymphokine
      productions are discussed.

PMID- 1626447
TI  - Recombinant human growth hormone (Genotropin) in treatment of children with
      growth hormone deficiency: the first year observation.
AB  - Five prepubertal children with previously untreated growth hormone deficiency
      were enrolled in this trial and treated with authentic recombinant human growth
      hormone hGH, 0.1 IU/Kg/day, subcutaneously, for one year. All of the children
      markedly increased their growth rate; the height velocity increased from 3.4 +/-
      0.7 cm/yr to 11.3 +/- 2.0 cm/yr during one year's treatment. The height-standard
      deviation score for chronological age increased from -4.03 +/- 0.52 to -2.70 +/-
      0.68. The bone age increased from 5.6 +/- 1.5 year before treatment to 6.4 +/-
      1.6 years after one-year treatment. Only one child acquired low titer anti-hGH
      antibodies during the course of treatment (1:2 to 1:6). No untoward symptoms were
      complained of by these children and no biochemical abnormalities occurred except
      transient subclinical hypothyroidism in one child during the treatment course.

PMID- 1626448
TI  - Factors affecting the severity of neonatal jaundice of unknown etiology: the role
      of enterohepatic circulation.
AB  - Jaundice is the most common condition of otherwise healthy, full-term newborns
      during the first week of life, and Chinese newborns are known to have a higher
      incidence and severity of neonatal jaundice than Caucasian newborns. This
      prospective study was designed to examine factors affecting the severity of
      neonatal jaundice of unknown etiology in the first week of life with special
      emphasis on the role of enterohepatic circulation. One hundred and thirty-six
      healthy, full-term newborns were enrolled in this study. Serum bilirubin levels
      were monitored daily in the morning for the first five days after delivery. Cord
      blood, postpartal maternal blood, breast milk and infants' stools were analyzed
      for beta-glucuronidase activity. Infants with serum peak bilirubin level less
      than or equal to 7 mg/dl had older gestational age, less maximal weight loss and
      the bilirubin levels peaked at an earlier age than those infants with peak serum
      bilirubin level more than 7 mg/dl. They also had lower fecal beta-glucuronidase
      activity in the stool collected at a mean age of 4.5 (+/- 0.6) days. Among the
      136 study cases, 92 infants received some maternal breast milk. There was
      considerable amount of beta-glucuronidase activity in the human breast milk. Yet
      its presence did not affect the fecal enzyme activity. Mixed breast feeding also
      did not influence the serum bilirubin level in the first four days of life.
      However, infants fed dominantly with breast milk had a higher incidence of serum
      bilirubin level more than 10 mg/dl at five days old than infants fed solely by
      infant formula.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626450
TI  - Influence of maturation on diastolic events of left ventricle in children.
AB  - To delineate the influence of maturation process on diastolic events of cardiac
      cycle, we had performed M-mode and Doppler echocardiography in 120 normal
      subjects aged from 1 hour to 16 years. The isovolumic relaxation period (IVRP,
      msec), defined as the time interval between the aortic valve closure to the
      mitral valve opening, was not statistically different in various age groups.
      Different equations based on individual ranges of cycle length (CL) were
      disclosed for each of three different age groups, demonstrating a positive linear
      correlation between IVRP and CL. On the contrary, an equation showing a linear
      correlation between diastolic total period (DTP, msec) and CL could be applied to
      all age groups: DTP = 0.58 x CL-75.2 (r = 0.89, p less than 0.001). Similarly
      applicable to all age groups, the duration of early diastolic filling (D-F, msec)
      changed with DTP in all age groups by an equation: D-F = 0.57 x DTP + 0.11 (r =
      0.93, p less than 0.001). Ratios between the maximal velocity of early (E) and
      atrial (A) diastolic filling increased gradually with age. This was largely due
      to an increase in E with maturation, suggesting a depressed early diastolic
      filling in the young hearts. We conclude that the patterns of diastolic
      relaxation and filling are heterogeneously affected by the degree of maturation
      and represent the net results of complex interactions between changing
      inactivation properties and loading status at various stages.

PMID- 1626449
TI  - The management of anorectal malformations.
AB  - From 1982 to 1990, 120 cases of anorectal malformation (84 males and 36 females)
      were admitted to Mackay Memorial Hospital; 101 cases were corrected surgically.
      Among these, 40 cases were high (H) or intermediate (I) type, and 61 cases were
      low (L) type. In the 40 cases of the H and I type, 13 (Group 1) received
      Stephens' procedure (SPR) and the remaining 27 (Group 2) received Pena's
      procedure (PSARP). For the L type, translocation anoplasty, cut-back anoplasty
      and limited PSARP were employed in 10, 45 and 6 cases, respectively. Anorectal
      continence results were evaluated by Kiesewetter's criteria. In Group 1, the
      results were good in 25%, fair in 17% and poor in 58%. In Group 2, the results
      were good in 70% and fair in 30%. In addition to better anorectal continence, the
      PSARP resulted in a lower rate of major complications. In the L type, the results
      were excellent without significant difference among the types of surgery
      employed.

PMID- 1626451
TI  - A study of genetic leukodystrophies in Chinese children.
AB  - During 1986 and 1991, we had diagnosed 12 cases with genetic leukodystrophy
      including 9 cases with metachromatic leukodystrophy (MLD), 1 case with globoid
      cell leukodystrophy (GLD, Krabbe's disease), 1 case with neonatal
      adrenoleukodystrophy (NALD), and the other with probable Pelizaeus-Merzbacher
      disease (P-M disease). The clinical, biochemical, neurophysiological and
      neuroradiological features were reported. The diagnosis of MLD, GLD, NALD was
      confirmed by means of the measurement of serum arylsulfatase A activity,
      leukocyte galactocerebrosidase activity and serum very long chain fatty acids,
      respectively. The P-M disease was highly suspected according to clinical picture
      and evoked potential findings. All the brainstem auditary evoked potentials
      (BAEPs) and the scalp somatosensory evoked potentials (scalp SEPs) studies in 6
      patients with MLD, 1 patient with GLD and 1 patient with NALD were abnormal. In
      patients with MLD or GLD, the nerve conduction velocity (NCV) studies showed
      moderate to severe slowing suggesting peripheral demyelinating neuropathy. Brain
      CT in patients with MLD or NALD demonstrated marked lucency in the white matter.
      Brain CTs in the patient with GLD showed progressive brain atrophy. In
      conclusion, though final diagnosis of genetic leukodystrophy should be
      established throughout biochemical studies, the neurophysiological and
      neuroimaging studies are of value as an aid to early diagnosis, prediction of
      clinical course and evaluation of prognosis for genetic leukodystrophy.

PMID- 1626452
TI  - Urinary N-acetyl-beta-glucosaminidase in children with acute renal failure.
AB  - Urinary excretion of N-acetyl-beta-glucosaminidase (NAG) was measured in random
      urine as the ratio of NAG to grams of urinary creatinine. Sixteen children with
      acute renal failure as well as 8 patients without serum creatinine changes after
      ischemic insults or nephrotoxic hazards were evaluated for their urinary NAG
      excretion. For children without renal failure, there was a significant increase
      (p less than 0.001) in urinary NAG after insults. The urinary NAG returned to
      normal within 2 weeks. In children with acute renal failure, the mean peak serum
      creatinine was 3.6 +/- 2.0 mg/dl, and the mean duration between onset and the
      time serum creatinine returning to normal was 8.8 +/- 4.1 days. Urinary NAG was
      markedly elevated during acute azotemic stage, remained at high level (p greater
      than 0.05) after serum creatinine returning to normal, and even continued to be
      abnormal several weeks after clinical recovery. Corrected with age, the mean
      urinary NAG level was elevated 6 times above normal after insults in patients
      without renal failure, and 34 times greater than normal in children with acute
      renal failure (p less than 0.01). We suggest that the extent of elevation of
      urinary NAG may be used to monitor the development of acute renal failure in
      patients exposed to potentially nephrotoxic hazards.

PMID- 1626453
TI  - Intraspinal enterogenous cyst: report of one case.
AB  - A 13-year-old boy with an intradural extramedullary enterogenous cyst is
      presented. He presented with progressive weakness of lower limbs. The myelography
      and computed tomography scan of spinal cord demonstrated an intradural,
      extramedullary lesion at the spinal level of T 7-9. A cystic lesion was
      discovered during operation. The cyst caused the spinal cord compression and was
      related to neurological deficit. Histologically, it was confirmed by Periodic
      Acid-Schiff and Alcian Blue stain to contain mucin. He recovered very well after
      surgical removal of the cyst.

PMID- 1626454
TI  - Kawasaki disease with Reye syndrome: report of one case.
AB  - A seven-month-old girl was admitted to the Pediatrics Department of Mackay
      Memorial Hospital with the following symptoms and signs: (1) high fever for more
      than five days; (2) injection of bilateral conjunctiva; (3) bright red lips with
      strawberry tongue; (4) edematous change of palms and soles, followed by digit
      desquamation; (5) an ill-defined, erythematous plaque on the scar of the BCG.
      Kawasaki disease was diagnosed, and high dose aspirin (100 mg/kg/day) and
      intravenous gamma-globulin (IVIG) (400 mg/kg/day) were given for four days. The
      patient was afebrile on the second day after IVIG infusion, and was discharged
      six days after admission. A small single daily dose of aspirin (10 mg/kg/day) was
      given after the afebrile days. Unfortunately, vomiting and consciousness
      disturbance were noted one day after discharge. Laboratory data showed elevated
      aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ammonia.
      Hypoglycemia and prolonged PT and PTT were also noted. Reye syndrome was
      suspected, and the patient was admitted to the intensive care unit for further
      management. A liver biopsy gave findings consistent with Reye syndrome. In spite
      of intensive treatment, the infant expired on the second day after admission. In
      a review of the literature, no correlation between these two syndromes was found.
      This rare case is presented to warn that Reye syndrome may follow Kawasaki
      disease when aspirin has been prescribed at a high dose.

PMID- 1626455
TI  - Primary psoas abscess: report of one case.
AB  - A 6-year-old girl was admitted to our hospital with the problems of persistent
      fever, limping gait, and right hip pain. On physical examination, flexion of the
      right hip with limitation of the range of motion was noted. Tenderness over the
      right inguinal area was also elicited. Pyogenic arthritis of the right hip was
      suspected. Aspiration of the right hip joint was negative. Two days later, a
      careful examination revealed that the Patrick's test was negative and a local
      tenderness on the right lower abdomen was found. Laparotomy was performed under
      the impression of retroperitoneal abscess. The postoperative diagnosis was psoas
      abscess. After surgical drainage and antibiotics therapy, she was discharged 2
      weeks later with good condition.

PMID- 1626456
TI  - Alloplastic facial contouring: surgery of the fourth plane.
AB  - Plastic surgeons are now better prepared to fulfill the primary goal of facial
      aesthetic surgery. By manipulating and combining the various new techniques, they
      can restore, rejuvenate, or enhance facial form and affect aging changes.
      Infinite variations in facial contour can now be achieved with alloplastic facial
      implants. By using techniques based on the concepts of zonal anatomy, the facial
      skeleton can be augmented with a minimum of complications. Alloplastic onlay
      techniques significantly improve facial contour to correct both hereditary
      deficiencies in youth as well as aging changes. The use of implants in the
      "fourth" skeletal plane, as defined by the author, represents the newest
      favorable manipulation of volume.

PMID- 1626457
TI  - Art in medical education: especially plastic surgery.
AB  - The importance of art studies in the training of plastic surgeons has not been
      well recognized. Presently, very few medical schools offer courses on art or
      include it in the humanities. Because the study of art is a great experience that
      helps to develop the trained eye, the inclusion of art in medical education is
      recommended. For plastic and aesthetic surgeons, art knowledge can greatly add to
      the development of surgical skill. Courses in drawing, modeling, and casting are
      recommended along with lectures or seminars on art appreciation.

PMID- 1626458
TI  - Dermal and facial autografts in facial aesthetic surgery.
AB  - Results are presented of dermis grafts used in conjunction with surgery for aging
      changes in the face. During a two-year period grafts were used to correct crease
      lines in the glabella and nasolabial creases, as well as angles of the mouth and
      vermilion. Volume of the grafts was well maintained and very few complications
      occurred. This technique offers better long-term results than can be obtained by
      collagen or fat injections. The results and techniques are presented in detail.

PMID- 1626459
TI  - Response to subdermal implantation of textured microimplants in humans.
AB  - In lieu of the problems involved with the use of foreign substances such as
      ivory, paraffin, liquid silicone, and collagen, a new subcutaneous injectable
      device has been developed. This material--Bioplastique--has been developed in an
      attempt to overcome the shortcomings of previous augmentation materials, most
      notably absorption, migration, and immunologic rejection. This article presents a
      longitudinal study of the use of this new microimplant.

PMID- 1626460
TI  - The sensuous lip.
AB  - The author uses Zyplast to help increase the volume of the upper or lower lip. It
      is emphasized that there is a clear bilobulation of the lower lip which creates
      the appearance of a beautiful mouth. His injection of Zyplast demonstrates a
      technique that helps to emphasize this bilobulation.

PMID- 1626461
TI  - A new safe and aesthetic approach to suction abdominoplasty.
AB  - Suction abdominoplasties are associated with a number of surgical complications,
      mainly in obese people and diabetic patients. The aesthetic result is often
      spoiled by poor balance caused by improper distance between the "guide points" of
      an harmonious abdomen (e.g., minimum of 10 cm between the pubic scar and the
      umbilicus). Almost all surgical complications are caused by extensive undermining
      and can be avoided by an en bloc resection without any undermining (the suction
      lipectomy of the upper flat creates a "mesh undermining" which is almost as
      efficient). A new neo-umbilicoplasty, described here, can be situated in the
      "right position" with good aesthetic results.

PMID- 1626462
TI  - Correction of deep gluteal depression by autologous fat grafting.
AB  - In the past, the traditional method of contouring the iliac crest and lateral
      femoral areas has been liposuction or the surgical removal of the bulges.
      Unfortunately, this method fails to correct the deep gluteal depression
      juxtaposed at these two sites. Since we use autologous fat grafts to correct
      contouring deficiencies elsewhere, it seems logical to investigate whether this
      technique is applicable to correcting this deformity. We have performed
      autologous fat grafting to the gluteal depression on 12 patients who underwent
      lipoplasty of the iliac crest and lateral femoral sites. The longest followup was
      one year. We have found that this method corrects the deep gluteal depression and
      yields an improved aesthetic contour. This article describes the technique,
      addresses the problems encountered, and shows postoperative results.

PMID- 1626463
TI  - External lipoplasty suction device.
AB  - Most mobile suction devices specially designed for blunt suction lipectomy are to
      some degree noisy and several of them could be considered expensive. Their
      exhaust goes out in the operating room (OR). The potential contamination by
      aerosoles and fumes favor the use of special outlet filters. The author describes
      the suction equipment he made in 1984. An industrial high-power vacuum pump is
      placed outside the OR. The suction tubing goes out of the ceiling in the OR. The
      machine has double remote pedal control. The exhaust vents out at a hidden place
      in the clinic's garden, where eventually any AIDS or hepatitis virus will die
      promptly. This equipment has been used in more than 4200 suction lipoplasty
      procedures with no technical or surgical complications related to the device.

PMID- 1626464
TI  - An alternative approach to reduction mammoplasty.
AB  - The female breast can be reduced by a number of operative techniques. Their goal
      is to transform different deformities into a so-called ideal form. The ideal form
      is obtained by small changes such as fixing the nipple's position in relation to
      predetermined anatomical marks. Under certain conditions we have to deviate from
      the ideal form. In these cases the operative method used is not determined by the
      deformity but by the desired form. Reduction mammoplasty techniques are just
      variations of a single method whose principles still need to be defined.

PMID- 1626465
TI  - Capsular contracture and silicone gel: experimental study.
AB  - Wistar rats were used to study the effects, if any, of membrane thickness and
      implant volume of a silicone gel prosthesis on the development of fibrous capsule
      contraction. A total of 30 miniprosthesis with three different membrane
      thicknesses and two different volumes were implanted in the subcutaneous space of
      five animals. One hundred eighty days later the fibrous capsule was resected and
      histologically analyzed. Different grades of thickness were observed. The
      statistical analysis of the data indicates that the thickness of the prosthesis'
      membrane and the implant's volume did not impact significantly on the grade of
      fibrosis.

PMID- 1626466
TI  - Quick and simple technique for the anatomical reconstruction of the concha
      auriculae.
AB  - Rhinoplasty cases require use of a cartilaginous graft from the concha auriculae.
      The perfect anatomical reconstruction of the donor area is possible through a
      quick and simple technique based on the partial reuse of the graft itself. This
      article describes use of the technique and the excellent results obtained.

PMID- 1626467
TI  - Minimal suture blepharoplasty: closure of incisions with autologous fibrin glue.
AB  - Blepharoplasty incisions can be cloned safely with autologous fibrin glue. The
      fibrinogen, prepared either from a whole-blood or plasmapheresis source, is mixed
      with commercially available thrombin to form a seal that is both hemostatic and
      adhesive. The complication rate is low and primarily due to technical factors in
      the initial cases. When compared with standard suture techniques, the incidence
      of minor problems such as milia formation was much lower. In select cases, the
      technique of using fibrin glue and a minimal number of sutures may be useful as
      an alternative method of wound closure in blepharoplasty patients.

PMID- 1626468
TI  - [Application of dye enhanced laser photocoagulation in ophthalmology].

PMID- 1626469
TI  - [In vitro formation of endothelial cells into capillary-like cords is promoted by
      keratocytes].
AB  - When isolated bovine capillary endothelial cells were co-cultivated with rabbit
      corneal keratocytes, capillary-like cords extended actively from the capillary
      endothelial cells in multilayers of keratocytes. The developing cords continued
      to elongate, branch out and anastomose with each other, forming a capillary-like
      network by the 12th day of co-culturing. Electron microscopic observation
      revealed that the cords had tubular structures, which were composed of 3-8
      endothelial cells in the multilayers of keratocytes, and that a basal-like matrix
      was situated on the outer surface of the endothelial cells. The roles of
      keratocytes in the cord formation by capillary endothelial cells were discussed.
      This simple in vitro experimental system is proposed as a useful tool in the
      study of corneal neovascularization.

PMID- 1626470
TI  - [Human corneal epithelial, stromal and endothelial cells produce interleukin-6].
AB  - We have been investigating the production of cytokines in ocular tissues. In this
      paper, we demonstrated the in vitro production of interleukin-6 (IL-6) by human
      corneal epithelial, stromal and endothelial cells using enzyme-linked
      immunosorbent assay (ELISA). In culture supernatant of the stromal cells, the
      production of immunoreactive IL-6 was induced, depending upon the doses of
      lipopolysaccharide (LPS) or IL-1 alpha added into the culture. Detectable IL-6
      activity in the supernatant of the stromal cells was found 2 hours after addition
      of IL-1 alpha and the activity increased to a peak level at 48 hours. On the
      other hand, in the supernatant of the endothelial cells, IL-6 activity was found
      even in unstimulated-culture, and induced further by LPS stimulation. The
      molecular weights (MWs) of the IL-6 produced by the epithelial, stromal and
      endothelial cells were calculated by gel filtration as about 30 kDa. From Western
      blotting analysis, the MW of IL-6 produced by the stromal cells was also
      determined to be 30 kDa.

PMID- 1626471
TI  - [Effect of trigeminal denervation on rabbit corneal epithelium].
AB  - To investigate the effects of trigeminal denervation on the corneal epithelium,
      left postganglionic trigeminal neurotomy via intracranial approach was performed
      in 22 rabbits. Among 16 rabbits survived successfully, 13 denervated eyes (81%)
      showed corneal epithelial abnormalities that included 4 epithelial defects and 9
      epithelial opacities. The remaining 3 eyes were normal. Histological examination
      showed many atrophic epithelial cells and the thinning of the corneal epithelial
      layer in the denervated eyes with corneal opacities. There was no abnormality in
      corneal stroma or endothelium. The ratio of epithelial to total corneal thickness
      calculated by a computer-assisted image analyzer was 6.5 +/- 2.1 (%) in control
      eyes and 3.8 +/- 1.9 (%) in the denervated eyes, the two values being
      significantly statistically different (p less than 0.001).

PMID- 1626472
TI  - [The synthesis of cytokines by human lens epithelial cells--interleukin 1 (IL-1),
      tumor necrosis factor (TNF) interleukin 6 (IL-6), and epidermal growth factor
      (EGF)].
AB  - We proposed the hypothesis that pseudophakic inflammation, including the fibrin
      reaction, may be caused by cytokines and/or prostaglandins, synthesized by
      residual lens epithelial cells (LEC). To test our hypothesis, we measured IL-1
      alpha, TNF-alpha, IL-6 and EGF in the culture media of human LEC, obtained by
      capsulotomy during cataract surgery, by ELISA. IL-1 alpha was detected in one of
      the two pools of 2-week cultures (20.7 pg/10(5) cells), in two of the three pools
      of 3-week cultures (12.0 pg/10(5) cells and 13.9 pg/10(5) cells), and in one pool
      of 4-week cultures (11.1 pg/10(5) cells). IL-6 was detected in 1-week culture
      (195 pg/10(5) cells) and in 7-week culture (81.6 pg/10(5) cells). TNF-alpha and
      EGF were not detected. During culture, the cells proliferated and underwent
      fibroblast-like changes on exposure to the plastic wells. IL-1 and IL-6 may be
      also produced in vivo by residual LEC contacting with posterior chamber lens
      after cataract surgery, and these mediators may play a role in postoperative
      inflammation including fibrin reaction.

PMID- 1626473
TI  - [The tension of zonule and aging changes of ciliary bodies].
AB  - The zonular tension was studied in thirty fixed autopsy eyes (7 eyes under 30
      years old, 15 eyes seventh decade and 8 eyes over 85 years old) by pulling the
      lens backward, and the surface structure of the ciliary body was studied
      histopathologically following the removal of zonular fibers. The tension for
      breaking zonules was 49.1 +/- 8.0 gm in younger age group, and 35.3 +/- 8.2 gm in
      older age group. The zonules in the younger age group was statistically stronger
      than those in the older age group (p less than 0.01). This breaking occurred at
      the region adjacent to the ciliary body in the younger age group, but at the
      region adjacent to the lens in the older age group. The internal surface of the
      pars plicata and the anterior pars plana was characterized by regular meridional
      ridges and grooves in the younger age group but was irregular in older age group.
      In the older age group, grooves among the ridges were wide. In the posterior pars
      plana, spine-like structure was observed learning parallel toward the lens along
      the course of zonular fibers. These ageing changes of zonules and ciliary body
      may depend on the load for the accommodation.

PMID- 1626474
TI  - [Photodynamically induced vitreous liquefaction in vivo].
AB  - Photodynamically induced vitreous liquefaction in rabbit eye was investigated.
      Photosensitizer, riboflavine phosphate, was injected into the vitreous cavity of
      the rabbit before white-light irradiation. After the irradiation (0, 1, 3, 6 hr)
      the rabbit vitreous body was separated into gel and liquid portions. The liquid
      vitreous body was weighed, and the vitreous liquefaction percentage was
      calculated. One hour irradiation caused 38% of liquefaction of the eye; 3 hr, 50%
      liquefaction; 6 hr, 59% liquefaction. Although irradiated control eye (without
      photosensitizer) and the dark adapted control eye (non-irradiated) showed 10-15%
      liquefaction throughout the experimental period, the liquefaction percentage of
      the experimental vitreous bodies was significantly larger than that of the
      control vitreous. Inhibition experiment showed that the radical scavengers (Cu,
      Zn-superoxide dismutase, catalase, and mannitol) could suppress the
      photodynamically induced vitreous liquefaction. Results indicated that free
      radicals, including hydroxyl radical and superoxide anion, which are generated by
      photosensitizer and visible light irradiation, may contribute to the age-related
      vitreous liquefaction of humans.

PMID- 1626475
TI  - [Effects of cadmium on the gene expression of retinoblastoma (Y79) cells in
      culture].
AB  - We examined the effects of cadmium on the mRNA levels of several genes in
      cultured retinoblastoma (Y79) cells. After Y79 cells were treated with 15 microM
      CdCl2, RNA was extracted at a given time. The levels of retinoblastoma gene (Rb)
      mRNA decreased after cadmium treatment, although it was unlikely that the Rb gene
      product is functional in this cell line. The N-myc gene (oncogene) is
      constitutively expressed in untreated Y79 cells but its mRNA levels also
      decreased following cadmium treatment. On the other hand, the mRNA levels of both
      heat-shock protein (hsp 70) and metallothionein gene, both having physiological
      protective effects, increased under these conditions. These results indicate that
      Y79 cells have physiological protective responses to such a heavy metal as
      cadmium and that both Rb and N-myc gene expressions are down-modulated in the
      presence of cadmium.

PMID- 1626476
TI  - [Indocyanine green enhanced photocoagulation in the pigmented rabbit].
AB  - We performed histological studies of rabbit eyes after intravenous administration
      of indocyanine green (ICG) and fundus endophotocoagulation with diode laser at
      the wavelength of 810 nm. As continuation of our previous experiments in albino
      rabbits, we used 10 eyes of 5 pigmented rabbits which more simulate human eyes.
      We created weak photocoagulation spots 5 to 30 seconds after intravenous ICG, 4
      mg/kg. Each photocoagulation lasted 0.2 sec and its irradiation power was
      averaged 170 mW. One hour after photocoagulation, there were no changes in the
      inner retinal layers. In the choroid, we observed occlusion of the
      choriocapillaris, destruction or loss of endothelial cells of large choroidal
      vessels, and stromal edema. One month after photocoagulation, large choroidal
      vessels had disappeared. Whole choroidal layers were replaced by fibrous scar
      tissue. The findings seemed to indicate that ICG enhanced photocoagulation effect
      can be observed in eyes with pigmented retinal pigment epithelium and that
      irreversible choroidal damages can be induced throughout the whole thickness of
      the choroid. The observed choroidal damages were less in intensity than those in
      albino rabbits.

PMID- 1626477
TI  - [Indocyanine green videoangiography of the choroidal circulation in the
      experimental retinal opacity induced by blunt trauma].
AB  - Retinal opacity was experimentally induced by blunt trauma to the rabbit eye and
      the damage to the choroidal circulation was investigated immediately thereafter
      by using indocyanine green (ICG) videoangiography. Ten pigmented rabbit eyes were
      used. In the early phase, the defect of choroidal inflow (10 eyes), the twitch of
      the choroidal artery (2 eyes) and the reflux of the vortex vein (5 eyes) could be
      observed dynamically. The defect of choroidal inflow showed its peak around the
      point where the choroidal arteries branched off from ciliary arteries and
      disappeared within a few second to over ten seconds. The reflux from the vortex
      vein seemed to be important as collateral pathway. In the middle phase, several
      points of ICG leakage were observed around the apex of the delayed area of
      choroidal circulation (9 eyes). This ICG leakage was intra-choroidal and seemed
      to be caused by the breakdown of the great vessels at the outer layer of the
      choroid. This study indicates that ICG videoangiography could observe various
      choroidal circulatory disturbances following blunt trauma and may be useful in
      delineating the pathogenesis of retinal opacity.

PMID- 1626478
TI  - [Ultrastructural studies of the lamina suprachoroidea in the human eye].
AB  - The lamina suprachoroidea of the human choroid was examined by electron
      microscopy using both thin sections and freeze fracture replicas. The lamina
      suprachoroidea was composed of 5-10 layers of pigmented cells interspersed with
      multiple layers of flattened fibroblastic cells. Tight junctions, gap junctions
      and intermediate junctions were seen between the fibroblastic cells. Tight
      junctions did not reveal zonula occludens but predominantly isolated types were
      revealed, as well as several pore-like fenestrations in the attenuated cell
      processes of the fibroblasts. The characteristic morphological appearance of the
      lamina suprachoroidea might suggest that the aqueous humour may be able to leak
      into the extraocular tissues through it. However, the numerous cellular layers
      and also the junctional complexes between the fibroblasts of the lamina
      suprachoroidea are likely to produce more resistance to uveoscleral drainage. As
      the multi-layered arrangement of fibroblastic cells and pigmented cells in the
      lamina suprachoroidea did not show the cellular barrier, it may be possible that
      the extraocular substances are able to flow into the eye through it.

PMID- 1626479
TI  - [The recovery of the local ERG recorded from reattached retina after retinal
      detachment].
AB  - The functional recovery of the reattached retina after retinal detachment was
      investigated electrophysiologically. Experimental retinal detachment
      approximately 4 mm in diameter was made in the rabbit eye by injecting Hanks'
      solution (HS) or sodium hyaluronate (HNa) into the subretinal space. Local ERG
      (LERG) was recorded from the spontaneously reattached retina by a double-barreled
      microelectrode. The retinal detachments caused by HA reattached at an average of
      321 +/- 56 minutes after making the detachment, while the detachments by HNa at
      20.8 +/- 1.8 days. The recovery of the amplitudes of b-wave and slow P III of the
      LERG was slower and worse in HNa group than in HS group. In both groups, the
      amplitudes of the b-waves recovered earlier than the slow P IIIs. Result
      indicated that earlier reattachment is related to favorable recovery of the
      retinal function, and that the inner retina generating the b-wave restores its
      function earlier than the distal retina generating the slow P III.

PMID- 1626480
TI  - [Color sensation of pseudophakic eye from a viewpoint of electrophysiological
      study].
AB  - Monochromatic ERG b-waves were recorded in normal eyes, cataractous eyes and
      pseudophakic eyes implanted with non-UV or UV IOLs. ERG b-waves were elicited by
      fourteen monochromatic stimulus lights ranging from 400 to 660 nm under white
      light adaptation, and spectral response curves were obtained from b-wave
      amplitudes. Compared with normal eyes or cataractous eyes, the relative b-wave
      amplitude of pseudophakic eyes was significantly larger in the short wavelength
      range from blue to green. Except for 400 nm, the spectral response curve of the
      eyes implanted with UV IOLs was similar to that of eyes implanted with non-UV
      IOLs. These results suggested that dyschromatopsia might not only occur in eyes
      implanted with non-UV IOLs but in eyes with UV IOLs.

PMID- 1626481
TI  - [Confusion lines in dichromatism using various surface colors].
AB  - Confusion lines, convergence points, and neutral points in dichromatism were
      examined using various surface colors. Confusion lines were obtained from 8 cases
      of protanopia and 24 cases of deuteranopia by color matching with the surface
      colors of the Farnsworth-Munsell 100 hue test, then regression analysis was
      carried out on the cross-points of all confusion lines obtained. Convergence
      points were obtained and neutral points were also calculated. The convergence
      point obtained from protanopia using surface colors converged to x = 0.811 and y
      = 0.189, which is a point near Pitt and Judd's convergence point. The confusion
      line gradient obtained from deuteranopia was steeper than that of Pitt and Judd's
      line. The convergence point of deuteranopia was x = 1.959 and y = -0.959.
      Compared with previous reports, it was in the lower right region. The neutral
      point of protanopia was in the vicinity of 495 nm and that of deuteranopia in the
      vicinity of 500 nm. These two values were almost the same as the values in Judd's
      report. Considering the results mentioned above, the neutral point obtained with
      surface colors was almost the same as that obtained with spectrum color. From the
      above results, the convergence point was thought to be different from that
      obtained using spectrum color. In particular, the difference was significant in
      deuteranopia.

PMID- 1626482
TI  - [A case of orbital hematic cyst].
AB  - A case of orbital hematic cyst is reported. The patient was a 3-year-old boy in
      whom swelling of the left upper lid and left exophthalmos appeared after blunt
      trauma in the region of the left eye. A hematoma was thought to be present from
      upper lid to the orbit. The hematoma was absorbed but the swelling of the eyelid
      and exophthalmos increased though more than seven days elapsed after the trauma.
      The existence of the cyst located from the upper lid to the orbital deep portion
      and collection of blood were confirmed during operation. Histopathologically the
      cyst consisted of thickened fibrogranulomatous tissue and the inner wall lacked
      endothelial or epithelial lining. The blood collected in the cyst hardly
      coagulated and was examined hematologically. Extreme delay of activated partial
      thromboplastin-time and prothrombin time, extreme decrease of fibrinogen and
      abnormal increase of fibrin degradation products were recognized. This indicated
      that the blood in the cyst had been in a localized accelerated fibrinolytic
      state. The results support the hypothesis of the mechanism leading to the
      enlargement of hematic cyst proposed by Pearson et al.

PMID- 1626483
TI  - [A juvenile case of mesenchymal chondrosarcoma originating from soft tissue in
      the orbit].
AB  - Mesenchymal chondrosarcoma is a very rare occurrence in the orbit. A 10-year-old
      girl presented with right exophthalmos. Computed tomography revealed a round
      tumor inside the muscular cone of the right orbit. There was a sign of slight
      calcification inside the tumor. The tumor was surgically removed by the Kronlein
      Berke procedure. Histopathological examination showed undifferentiated
      mesenchymal cells and cartilage tissue. A recurrent tumor was found in the same
      location 34 months after the surgery, which was removed by frontal approach
      saving the globe with normal function. Histopathology of the recurrent tumor
      revealed a slight difference from the primary tumor, showing hemangiopericytoma
      pattern without cartilage components. Immunohistochemical studies of the primary
      and recurrent tumors showed their cells to be positive for antifactor VIII and S
      100, and negative for myoglobin and monoclonal antibody to muscle actin. Electron
      microscopically these undifferentiated cells had large nucleus and very scanty
      cytoplasm, mostly containing glycogen granules. This is probably the first
      description of a juvenile case of mesenchymal chondrosarcoma originating from
      soft tissue in the orbit.

PMID- 1626484
TI  - Baroreceptor reflex function in congestive heart failure.
AB  - Congestive heart failure is characterized by decreased parasympathetic and
      increased sympathetic nervous system activity. Impairment of baroreceptor reflex
      function may be relevant to this altered neural profile. The effect of
      cardiopulmonary and arterial baroreceptor stimulation on corresponding afferent
      neural activity is reduced in experimental models of heart failure. In addition,
      the heart rate and blood pressure responses to perturbations in arterial and
      carotid sinus pressure are less in animals with heart failure than in control
      animals. Comparable observations have been made in humans. Unloading
      cardiopulmonary baroreceptors with lower-body negative pressure causes less
      forearm vasoconstriction in patients with heart failure than in healthy subjects.
      The chronotropic response to changes in arterial and carotid sinus pressure
      induced by drug infusions or by use of a neck chamber is attenuated in heart
      failure. These data suggest that abnormalities in cardiopulmonary and arterial
      baroreceptor reflex function contribute importantly to altered autonomic nervous
      system activity in heart failure.

PMID- 1626485
TI  - Recognition and management of digitalis toxicity.
AB  - The most important step in the management of toxicity due to any of the cardiac
      glycosides is its recognition. Despite the development of an accurate clinical
      assay for serum levels of digoxin greater than 20 years ago, digitalis toxicity
      remains common and difficult to confirm, even if suspected, due primarily to 2
      factors. First, the signs and symptoms of digitalis toxicity, most commonly an
      abnormal electrocardiogram showing ventricular or atrial arrhythmias, with or
      without some degree of concurrent atrioventricular block, often also occur in
      patients with congestive heart failure (CHF) and underlying coronary
      atherosclerosis who are not receiving a cardiac glycoside. Second, due to
      digoxin's narrow therapeutic ratio, the marked degree of variability in the
      sensitivity of individual patients to its toxic effects, and the common problem
      of obtaining blood samples inappropriately during the early distribution phase
      following dosing, a serum digoxin concentration often does not serve as a
      reliable indicator of toxicity. Despite these difficulties in diagnosis, the
      management of digoxin toxicity has been made much more effective with the
      widespread availability of F(ab) fragments of anti-digoxin antibodies. This drug
      provides the clinician with a rapidly acting, safe antidote for all commonly used
      digitalis preparations. Conventional therapy for digoxin toxicity remains the
      maintenance of serum potassium levels greater than or equal to 4 mEq/liter,
      reversal of decompensated CHF or overt myocardial ischemia, attention to serum
      magnesium levels and the patient's acid-base status, appropriate antiarrhythmics
      in the event of ventricular arrhythmias, and a temporary pacemaker for high-grade
      atrioventricular block. Nevertheless, the high specificity and documented safety
      of the antibody preparation provides a needed safety net for the continuing use
      of cardiac glycosides as first-line inotropic agents in the modern therapy of
      chronic CHF.

PMID- 1626486
TI  - Recognition and management of asymptomatic patients with left ventricular
      dysfunction.
AB  - In recent years there have been encouraging developments in the therapy for
      congestive heart failure. Vasodilator therapy, as an adjunct to digitalis and
      diuretics, has made a major impact. Vasodilator therapy results in improved left
      ventricular (LV) ejection fraction, improved functional capacity, and enhanced
      quality of life. When an angiotensin-converting enzyme (ACE) inhibitor is used,
      several studies published since 1988 show that these improvements are accompanied
      by improved survival. Yet many questions remain. Principal among these is how to
      approach the patient who has significantly depressed LV function, but is
      asymptomatic or has only minimal symptoms. In these patients the prognosis cannot
      be based on New York Heart Association (NYHA) functional class, but must reflect
      objective measurements of ventricular function. Any intervention should be
      specifically designed to improve survival, since functional capacity and quality
      of life are apparently unimpaired. On the other hand, there are no data at
      present to suggest that intervention in these patients will improve survival.
      This article considers the evaluation of such asymptomatic patients and potential
      therapeutic approaches. These are the use of cardiac glycosides, the use of ACE
      inhibitors, or their combination. Circumstantial evidence supporting their use in
      this select patient population is considered. It is stressed that any decision to
      intervene therapeutically in the asymptomatic patient must be made by the
      physician on an individual basis.

PMID- 1626487
TI  - Management of refractory congestive heart failure.
AB  - Despite recent advances in the treatment of congestive heart failure (CHF), many
      patients continue to present with symptoms refractory to digoxin, diuretic, and
      vasodilatory therapy. Since it is unlikely that this population will decrease in
      the near future, practical approaches to management of refractory CHF are
      reviewed. Refractory CHF here is defined as New York Heart Association (NYHA)
      functional class III-IV heart failure, despite maximal drug therapy. Before such
      a diagnosis is made, the patient should be treated with digoxin, diuretics, and a
      vasodilator. Approach to therapy requires assessment of changing clinical status
      and pathophysiology, optimizing oral drug treatment, and providing temporary
      parenteral support when indicated. Specific attention should be given to factors
      that influence the optimal response to each of these 3 treatment classes. A
      theoretical, but unproven, concept suggests that combined vasodilatory therapy
      may be appropriate as long as excessive hypotension is avoided. In the course of
      management, a decision is required as to whether further optimization of therapy
      can be achieved on an outpatient basis. Hospital-based intravenous inotropic
      support given for 2-4 days will often provide the opportunity to restructure
      patient therapy.

PMID- 1626488
TI  - Long-term strategies in the management of heart failure: looking beyond
      ventricular function and symptoms.
AB  - Therapeutic approaches to the management of heart failure have traditionally
      focused on shortterm hemodynamic and symptomatic goals, but present evidence
      suggests that most therapeutic decisions have long-term consequences. Treatment
      may change the rate of disease progression, modify the need for additional
      therapy, influence the number of hospitalizations, and alter the risk of death.
      However, there may be little relation between a drug's short-term effect on
      cardiac function or cardiovascular symptoms and its long-term effect on survival.
      Some therapeutic interventions favorably influence the outcome of patients with
      heart failure, even though they exert negative inotropic effects; others
      adversely affect the outcome of patients, even though they markedly improve
      cardiac performance. This discordance might be explained if the most important
      predictor of response to a therapeutic intervention in heart failure were the
      effect of the pharmacologic agent on neurohormonal systems rather than on
      hemodynamic variables. In general, drugs that decrease the effects of the
      sympathetic nervous system (digitalis glycosides) and the renin-angiotensin
      system (angiotensin-converting enzyme [ACE] inhibitors) reduce the risk of
      worsening heart failure. Conversely, drugs that potentiate the effects, or
      increase the activity, of the sympathetic nervous system (phosphodiesterase
      inhibitors) or the renin-angiotensin system (calcium antagonists) increase
      cardiovascular morbidity and mortality. These observations suggest that
      physicians should no longer focus on short-term hemodynamic or symptomatic goals
      in the treatment of heart failure but, instead, should manage patients to improve
      both the quality and quantity of life.

PMID- 1626489
TI  - Reflex cardiovascular control in congestive heart failure.
AB  - This article reviews evidence that the reflex control of the cardiovascular
      system provided by negative feedback mechanisms is impaired in congestive heart
      failure (CHF). The impairment involves vagal and sympathetic modulation of the
      heart exerted by arterial baroreceptors. It also affects baroreceptor control of
      blood pressure and peripheral vascular resistance, as well as the cardiopulmonary
      receptor's ability to modulate sympathetic activity. The degree of such
      impairment is most marked in severe CHF but is also apparent, to a minor degree,
      in mild heart failure. Reflex impairment is due to a reduction in the receptor
      signal, but other factor under investigation are probably also involved. Digoxin
      and other pharmacologic treatments of CHF improve reflex function, thereby
      facilitating a reduction in the elevated sympathetic activity and a stepping up
      of the reduced vagal activity typical of CHF. This may be relevant to a patient's
      prognosis.

PMID- 1626490
TI  - Digitalis and neurohormonal abnormalities in heart failure and implications for
      therapy.
AB  - A pathophysiologic hallmark of heart failure is neurohormonal excitation, a
      prominent feature of which is activation of the sympathetic nervous system.
      Studies from our laboratories demonstrate that clinical heart failure is
      characterized by marked increases in efferent sympathetic neural outflow to
      muscle; the magnitude of this sympatho-excitation parallels the degree of cardiac
      dysfunction. Impairments of cardiopulmonary and arterial baroreflex sensory
      mechanisms appear to be responsible to a significant degree for this sympatho
      excitation, consistent with findings in animal models of heart failure. Digitalis
      glycosides exert modest inotropic actions when administered to patients with
      heart failure. Digitalis also has potent autonomic effects that can potentiate
      impaired arterial and cardiopulmonary baroreflex mechanisms in experimental
      models of cardiac dysfunction. Acute digitalis administration to patients with
      moderate-to-severe heart failure produces profound and sustained sympatho
      inhibition, which precedes any observed hemodynamic action of the agent. Further,
      acute digitalization of such patients rapidly normalizes impaired baroreflex
      mediated mechanisms. Data now suggest that the mechanism of action of digitalis
      in humans is an acute potentiation of baroreceptor-mediated afferent regulation
      of sympathetic neural mechanisms. Prospective, randomized and controlled studies
      now are required to test the hypothesis that the acute effects of digitalis on
      autonomic mechanisms also are observed during chronic administration. In theory,
      the chronic sympatho-inhibitory action of digitalis, combined with its chronic
      potentiation of impaired baroreflex mechanisms, may offer beneficial effects
      independent of its inotropic actions in patients with heart failure.

PMID- 1626491
TI  - Acute hemodynamic effects of digoxin alone or in combination with other
      vasoactive agents in patients with congestive heart failure.
AB  - Although digitalis preparations have been in use for greater than 200 years, it
      is only within the last 2 decades that the central hemodynamic and neurohumoral
      effects occurring over several hours following intravenous administration of
      digoxin have been investigated in patients with congestive heart failure (CHF).
      Although digoxin has been shown to stimulate myocardial contractility in tissue
      preparations, its positive inotropic activity does not consistently translate
      into improvements in hemodynamic measurements in humans. Digoxin given
      intravenously results in increased cardiac index and decreased heart rate, left
      ventricular filling pressure, and right atrial pressure, as well as in acute
      attenuation of neurohumoral abnormalities, in patients with chronic CHF who have
      abnormal baseline hemodynamic measurements. Unlike other drugs with positive
      inotropic activity, however, digoxin does not influence hemodynamics in normal
      volunteers or in CHF patients in whom hemodynamics have been normalized with
      other therapies. These differing effects may be related to the drug's diverse
      peripheral vascular effects in CHF patients in whom vasodilation may occur in
      comparison with those that occur in normal subjects in whom the peripheral
      vasoconstrictor effects may prevent the inotropic effects of the drug from being
      translated into an increase in cardiac output. The hemodynamic effects of digoxin
      in patients with chronic CHF due primarily to diastolic dysfunction have not been
      fully investigated. Intravenous digoxin produces hemodynamic effects in patients
      with CHF associated with acute myocardial infarction, but these changes are small
      compared with those resulting from the administration of dobutamine. Digoxin does
      not appear to influence hemodynamic measurements in patients with right
      ventricular dysfunction unless concomitant left ventricular failure is present.
      In patients with chronic left ventricular dysfunction, the hemodynamic effects of
      intravenous digoxin and vasodilators are enhanced when these agents are given in
      combination.

PMID- 1626492
TI  - Review of randomized trials of digoxin therapy in patients with chronic heart
      failure.
AB  - Although digitalis glycosides were introduced in the treatment of cardiac
      maladies greater than 200 years ago, controversy persists regarding the precise
      role of digoxin in any multidrug approach to the treatment of congestive heart
      failure (CHF). Despite its widespread use for more than 2 centuries, only
      recently have double-blind, randomized, placebo-controlled trials of digoxin
      therapy been conducted in patients with moderate CHF and sinus rhythm. These
      trials demonstrate that digoxin is superior to placebo in improving left
      ventricular (LV) ejection fraction, increasing exercise capacity, and preventing
      CHF worsening. Digoxin produces benefits similar to those seen with angiotensin
      converting enzyme (ACE) inhibitors with regard to clinical compensation and
      improvement in LV function. However, improved survival is demonstrated only in
      response to ACE inhibitors. The recently completed RADIANCE study addresses the
      value of combining digoxin with ACE inhibitor therapy in patients with mild-to
      moderate CHF. Because increased mortality has been reported with the newer oral
      inotropic agents, it currently appears that digoxin is the only oral inotropic
      agent useful in clinical practice in the treatment of CHF. However, the effects
      of digoxin on mortality in patients with CHF remain unknown. In the large, double
      blind, randomized trial conducted by the National Heart, Lung, and Blood
      Institute, the effects of digoxin on mortality in patients with CHF and already
      being treated with ACE inhibitors are currently being evaluated. Presently, based
      on the results of placebo-controlled studies, it appears that digoxin, alone or
      in combination with ACE inhibitors, is beneficial in patients with any signs or
      symptoms of CHF due to systolic LV dysfunction.

PMID- 1626493
TI  - Need for a large randomized trial to evaluate the effects of digitalis on
      morbidity and mortality in congestive heart failure.
AB  - Despite major advances in the prevention and treatment of cardiovascular
      diseases, the incidence and prevalence of congestive heart failure (CHF) have
      been increasing in recent years. As the average age of the population increases,
      the prevalence of CHF is expected to continue to increase. The number of deaths
      in which CHF was considered the underlying or contributing cause increased from
      51,000 in 1955 to 274,000 by 1988 in the United States. Even accounting for
      population growth and an increase in the number of elderly, this represents a 2
      fold increase. Additionally, CHF was responsible for about 643,000
      hospitalizations in 1988. Digitalis is one of the drugs most commonly prescribed
      for CHF and has been used for greater than 200 years. In 1990, digoxin was one of
      the most commonly prescribed drugs in the United States, accounting for greater
      than 21 million prescriptions. There has been little decline in the drug's use
      over the last 5 years, indicating that newer treatments for CHF have not replaced
      the widespread use of digitalis. Despite these findings, considerable controversy
      surrounds the appropriateness of its role and value in treating CHF patients who
      are in sinus rhythm. A number of recent, uncontrolled studies have arrived at
      apparently contradictory conclusions concerning the effects of digitalis on
      mortality in postmyocardial infarction and heart failure patients. A large,
      double-blind, randomized, controlled clinical trial to evaluate the effects of
      digitalis on mortality, morbidity and quality of life is being sponsored by the
      National Heart, Lung, and Blood Institute in conjunction with the Department of
      Veterans Affairs Cooperative Studies Program.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626494
TI  - Ventricular arrhythmia in congestive heart failure.
AB  - The importance of ventricular arrhythmia is based on its association with sudden
      death. In certain groups of patients, ventricular arrhythmia--primarily runs of
      nonsustained ventricular tachycardia (NSVT)--is associated with an increased risk
      for sudden death. Although this relationship has been most often reported in
      patients with recent myocardial infarction, it has also been recognized in
      patients with dilated cardiomyopathy, regardless of etiology. Therefore,
      ventricular arrhythmia is common in patients with CHF due to cardiomyopathy. A
      number of studies have reported that 70-95% of patients with cardiomyopathy and
      congestive heart failure (CHF) have frequent ventricular premature beats, and 40
      80% will manifest runs of NSVT. Many factors are responsible for ventricular
      arrhythmia in such patients, including structural abnormalities, electrolyte
      imbalance, hemodynamic impairment, activation of neurohormonal mechanisms, and
      pharmacologic therapy. Many studies have reported a high yearly mortality in
      patients with cardiomyopathy and CHF; greater than 40% of deaths are sudden, most
      often the result of sustained ventricular tachyarrhythmia. Most studies have
      noted an association between presence (and frequency) of NSVT and risk of sudden
      cardiac death in these patients. Unfortunately, other techniques--such as the
      signal-averaged electrocardiogram and electrophysiologic testing--are not helpful
      in identifying the individual at risk. Although several drug interventions will
      reduce mortality from progressive CHF, these drugs have not been shown to reduce
      sudden death and, indeed, have a variable effect on ventricular arrhythmia.
      Although NSVT is a marker for increased risk for sudden death, it is uncertain if
      antiarrhythmic drugs will prevent this outcome. Antiarrhythmic drugs have not
      been shown to be effective for preventing sudden death, although there are as yet
      no well-controlled randomized trials. Several studies suggest that amiodarone and
      beta blockers are beneficial, but this requires confirmation. For patients who
      have been resuscitated following an episode of sudden death due to a sustained
      ventricular tachyarrhythmia, antiarrhythmic therapy guided by invasive and
      noninvasive techniques appears to reduce risk of recurrent arrhythmia. However,
      the response rate to antiarrhythmic agents is low and side effects are common in
      patients with CHF. Especially important is the increased risk of precipitating
      CHF and aggravating the arrhythmia being treated. For many such patients who have
      had serious ventricular tachyarrhythmia, the automatic implantable cardioverter
      defibrillator may prove a better option. Other drugs used for management of CHF
      reduce overall mortality, but not risk of sudden death.

PMID- 1626495
TI  - Clinical use of serum digoxin concentrations.
AB  - The development of the radioimmunoassay for digoxin by Smith and coworkers in
      1969 was a landmark in digitalis therapy. Since then, the complex
      pharmacokinetics of digoxin have been defined. As a result, the incidence of
      digitalis toxicity has markedly decreased. To use the digoxin assay properly,
      however, the relation of this pharmacokinetic parameter to digoxin
      pharmacodynamics must be known and the limitations of the assay itself
      understood. Systolic time intervals (STI) are uniquely useful to quantitate the
      inotropic effect of digitalis preparations. This technique can demonstrate the
      onset and magnitude of the inotropic effect for both oral and intravenous
      digitalis administration. By defining the mathematical relation between STI and
      simultaneous serum digoxin concentrations following intravenous administration of
      1 mg digoxin, computer simulations can be made of the effect of dosing changes on
      blood and tissue concentrations. The serum digoxin assay has technical problems
      relating to quality control, interference by metabolites, and cross-reactions
      with endogenous digitalis-like substances. Further, a standard time for
      measurement following dosing has not been established. Physical activity can
      significantly after the serum digoxin concentrations by increasing skeletal
      muscle binding. Numerous drugs can interfere with digoxin absorption or
      elimination. Using the serum digoxin assay is the only way to assess these
      interactions. Computer surveillance (ideally with physician or pharmacist
      interaction) has been used to monitor digitalis but has not yet gained widespread
      acceptance. This is clearly a method in need of further testing.

PMID- 1626496
TI  - Effectiveness of low-dose colestipol therapy in patients with moderate
      hypercholesterolemia.
AB  - Recommended doses of bile-acid binding resins have an established
      hypocholesterolemic effect, but data on responses to low doses, especially in
      women and subjects with moderate hypercholesterolemia, are sparse. A double
      blind, placebo-controlled, randomized trial of 3 low doses of colestipol
      hydrochloride was conducted in women and men with moderate hypercholesterolemia.
      Men and women with plasma low-density lipoprotein (LDL) cholesterol
      concentrations greater than 4 mmol/liter (155 mg/dl) and triglyceride
      concentrations less than 2.82 mmol/liter (250 mg/dl) were recruited for the
      study. Eligible patients (54 women and 98 men) were placed on the American Heart
      Association step I diet 6 weeks before randomization. Participants were
      subsequently assigned to 1 of 4 drug treatment groups (placebo, and 5, 10 and 15
      g/day of colestipol in 2 divided doses) for an additional 12 weeks. Of the 152
      patients randomized, 141 completed all aspects of the study. For the treatment
      groups--placebo, and 5, 10 and 15 g of colestipol--LDL cholesterol reductions
      (mmol/liter) were observed respectively (n = 141): 0.10 +/- 0.49 (2.7%), 0.65 +/-
      0.41 (16.3%), 0.98 +/- 0.36 (22.8%) and 1.17 +/- 0.47 (27.2%) (p less than
      0.001). Similar changes were observed in total cholesterol and apolipoprotein B
      concentrations. The apolipoprotein B/LDL cholesterol ratio increased
      significantly with increasing colestipol dosage. Modest but insignificant changes
      in plasma triglyceride levels occurred, and high-density lipoprotein cholesterol
      levels remained unchanged. A dose of 5 g/day of colestipol achieved 51% of the
      LDL cholesterol reduction noted with 15 g/day. Low-dose colestipol therapy is
      effective in the treatment of patients with moderate
      hypercholesterolemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626497
TI  - Greater diagnostic sensitivity of treadmill versus cycle exercise testing of
      asymptomatic men with coronary artery disease.
AB  - Maximal hemodynamic and ventilatory responses using cycle and treadmill ergometer
      were compared in 52 asymptomatic patients with angiographically proved coronary
      artery disease. Moreover, test sensitivity with respect to ST-segment depression
      and typical angina pectoris were compared between exercise modes used. Exercise
      tests were performed on different days in randomized order. In 42 patients,
      exercise-induced myocardial ischemia, expressed as a fraction of left ventricular
      circumference, was assessed by thallium-201 scintigraphy. The main finding of
      this study was a significantly higher maximal oxygen uptake (1.87 +/- 0.4 vs 2.2
      +/- 0.5 liters/min; p less than 0.001), heart rate (148 +/- 19 vs 158 +/- 18
      beats/min; p less than 0.001) and rate-pressure product (28.3 +/- 5 x 10(3) vs
      30.7 +/- 5 x 10(3); p less than 0.001) during treadmill walking than during
      cycling. Therefore, stress-induced myocardial ischemia was significantly more
      extensive after treadmill walking (31 +/- 37 degrees vs 45 +/- 40 degrees; p less
      than 0.001). Moreover, there were significantly more patients with signs of
      myocardial ischemia (ST-segment depression or typical angina pectoris, or both)
      during treadmill than during cycle ergometry (35 vs 25 patients; p less than
      0.05). However, lactate levels measured at peak exercise (4.07 +/- 2.0 vs 4.38 +/
      1.9 mmol/liter) and 3 minutes into the recovery period (5.60 +/- 2.2 vs 5.80 +/-
      2.2 mmol/liter) were comparable between both methods, indicating no significant
      difference in anaerobic energy production. These findings suggest that walking on
      a treadmill represents an exercise method with a greater ability than cycling to
      detect coronary artery disease.

PMID- 1626498
TI  - Prognosis in rupture of the ventricular septum after acute myocardial infarction
      and role of early surgical intervention.
AB  - Since 1944, 91 patients (50 men and 41 women, mean age 68 years [range 39 to 86])
      with ventricular septal rupture after acute myocardial infarction were seen at
      the Mayo Clinic. Patients were divided into 4 groups according to therapy and
      timing of surgical intervention. Fourteen patients seen before 1965, when surgery
      was not performed for such a complication or not readily available, were excluded
      from the analysis. Group 1 (n = 22) had surgery within 48 hours of septal
      rupture, group 2 (n = 6) underwent operation between 2 and 14 days, group 3 (n =
      24) had surgery after 14 days, and group 4 (n = 25) only received medical
      treatment. Short-term (30 days) survivors (45%, 35 of 77 patients) were compared
      with nonsurvivors. Using logistic regression, by univariate analysis, 3 variables
      were significantly associated with outcome: age (p less than 0.01), cardiogenic
      shock (p less than 0.00001), and long delay between ventricular septal rupture
      and surgical intervention (p less than 0.004). By multivariate analysis, however,
      only cardiogenic shock (p less than 0.00001) and age (p less than 0.007)
      correlated with an adverse outcome. In patients with cardiogenic shock after
      septal rupture, the prognosis was uniformly fatal unless patients undergo early
      surgery. None of the 23 patients in groups 2, 3 or 4 survived, whereas 5 of 13
      patients (38%) who had surgery within 48 hours of septal rupture
      survived.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626499
TI  - Prognostic value of changes in R-wave amplitude during exercise testing after a
      first acute myocardial infarction.
AB  - To investigate the prognostic value of exercise-induced changes in R-wave
      amplitude and their relation to other exercise and angiographic variables, 303
      consecutive patients who underwent maximal exercise testing and coronary
      angiography within 2 months of a first acute myocardial infarction were studied.
      R-wave amplitude at peak exercise increased or was unchanged in 159 patients
      (57.4%) and decreased in 118 (42.6%). Increased R-wave amplitude was
      significantly related to underlying 3-vessel disease (p = 0.0001), the extent of
      ST-segment depression on exercise (p = 0.0001), and the time to 1 mm ST
      depression (p less than 0.05). Follow-up information was available in 285
      patients (86.4%) at a mean of 4 +/- 1.8 years. Death from cardiac causes occurred
      in 25 patients (9%); 18 (6.5%) developed recurrent myocardial infarction, and 32
      (11.6%) developed angina. Variables with a predictive value for cardiac death
      were maximal exercise heart rate (p = 0.0005), occurrence of exercise-related
      supraventricular arrythmia (p = 0.02), and number of diseased vessels (p = 0.02).
      R-wave changes had no predictive value. No variable had a predictive value for
      recurrent infarction. Maximal exercise heart rate (p = 0.02) and increased R-wave
      amplitude (p = 0.0001) were significantly related to the occurrence of angina at
      follow up. Exercise-related R-wave increases were associated with the presence of
      angina at follow-up, but had no predictive value for cardiac death or recurrent
      infarction; their association with subsequent angina appears to reflect an
      association with more severe underlying coronary disease.

PMID- 1626500
TI  - Effects of captopril on left ventricular systolic and diastolic function after
      acute myocardial infarction.
AB  - The left ventricle progressively dilates in some patients after acute myocardial
      infarction (AMI). Both systolic and diastolic left ventricular (LV) dysfunction
      can be of significance in the development of heart failure. Captopril has been
      shown to prevent dilatation, but the effect on LV diastolic function is unknown.
      In a placebo-controlled double-blind parallel study, 58 AMI patients with heart
      failure or low ejection fraction, or both, were consecutively randomized at day 7
      to either placebo or captopril (25 mg twice daily). No differences were present
      between the groups at baseline. Fifty-three patients completed the 6-month study
      period. Both LV diastolic and systolic volume indexes increased significantly in
      the placebo group (17 and 14%, respectively); in the captopril group there was no
      change in LV diastolic volume index, but a 13% reduction in LV systolic volume
      index. Ejection fraction increased significantly in the captopril group. The peak
      flow velocities of the early and atrial filling phases were measured, and the
      ratio between the velocities was calculated. A significant reduction was observed
      during the study period in early peak flow velocity (65 to 52 cm/s) and in the
      ratio between early and atrial peak flow velocity (1.3 to 0.8) in the placebo
      group (p less than 0.05), but no significant changes occurred in the captopril
      group. No correlation was found between dilatation of the left ventricle and
      reduction in early peak flow velocity or the ratio between early and atrial peak
      flow velocity. In conclusion, captopril prevented LV dilatation, improved
      ejection fraction and prevented LV diastolic dysfunction in AMI patients with
      early signs of LV systolic dysfunction.

PMID- 1626501
TI  - Acute and long-term outcome of narrowed saphenous venous grafts treated by
      endoluminal stenting and directional atherectomy.
AB  - Angioplasty of the narrowed saphenous vein bypass grafts remains a difficult
      challenge. Over a 37-month period at this institution, 119 of 176 interventions
      (68%) on saphenous vein grafts (average age 8.3 years from bypass surgery to
      graft intervention) were performed using either directional coronary atherectomy
      (n = 35) or Palmaz-Schatz intracoronary stents (n = 84), representing 37% of all
      stents and 15% of all atherectomies during the study period, respectively. Of the
      57 saphenous vein graft lesions treated with conventional balloon angioplasty
      during this period, 49 (86%) had 1 or more contraindications to stenting or
      directional atherectomy (thrombus, total occlusion, reference vessel less than 3
      mm in diameter). The acute success rate was 99% for stents (1 failure to dilate)
      and 94% for directional atherectomy (2 failures to cross the lesion with the
      atherectomy device). Lumen diameter increased from 0.9 to 3.6 mm (reference
      vessel 3.6) for stents, and from 0.9 to 3.5 mm (reference 3.8) for atherectomy
      (for all comparisons, p = not significant), with no major complications (abrupt
      or subabrupt closure, emergent coronary bypass surgery, death, or Q-wave
      myocardial infarctions). During the same time period 50 of 57 vein grafts (88%)
      rejected for stenting or atherectomy were dilated successfully by conventional
      balloon angioplasty, with 3 patients (5%) requiring emergent coronary bypass
      surgery. Angiographic follow-up was available for 50 of 64 eligible patients
      (78%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626502
TI  - Comparison of accuracy for detecting coronary artery disease and side-effect
      profile of dipyridamole thallium-201 myocardial perfusion imaging in women versus
      men.
AB  - Intravenous dipyridamole planar thallium-201 imaging is a safe and effective test
      for detection and prognosis of coronary artery disease (CAD) in the general
      population. The relative diagnostic accuracy and side-effect profile of
      dipyridamole thallium-201 stress imaging in women is not defined. Forty-three
      consecutive female and 71 male patients who underwent dipyridamole thallium-201
      imaging (0.56 mg/kg) within 3 months of cardiac catheterization were studied.
      Scans were considered abnormal if fixed or reversible perfusion defects were
      detected. Stenosis severity of greater than or equal to 50% luminal diameter
      reduction of any artery defined CAD. Overall sensitivity for detection of CAD was
      0.87 in women and 0.94 in men; specificity was 0.58 in women and 0.63 in men (p =
      not significant). Sensitivity for detection of 1-vessel CAD was 0.60 in women and
      0.94 in men (p = 0.001). The sensitivity for detection of multivessel CAD (with
      or without surgical revascularization) was 1.0 and 0.94 in women and men,
      respectively. Adverse effects were reported in 62% of women and in 38% of men (p
      = 0.01). There was no significant difference in the incidences of chest pain,
      headache, nausea, flushing or electrocardiographic changes. The incidences of
      severe ischemia and dizziness were higher in women. Possible explanations for
      this difference in adverse effects include gender differences in the volume of
      distribution of dipyridamole due to varied fat-to-muscle ratios and different
      subjective nocioceptive sensitivities to the effects of dipyridamole. Overall
      sensitivity and specificity are comparable between the sexes.

PMID- 1626503
TI  - Strategy of complete revascularization in patients with multivessel coronary
      artery disease (a report from the 1985-1986 NHLBI PTCA Registry).
AB  - Percutaneous transluminal coronary angioplasty (PTCA) is increasingly performed
      in patients with multivessel coronary artery disease (CAD) despite reports
      showing relatively low rates of complete revascularization and poorer long-term
      prognosis for patients with significant residual narrowings. Reasons for
      incomplete revascularization were assessed in 618 patients with multivessel CAD
      in the 1985-1986 National Heart, Lung, and Blood Institute (NHLBI) PTCA Registry.
      The PTCA operator was asked to describe the treatment plan and outcome for each
      of the 1,942 significant lesions (greater than or equal to 50% luminal diameter
      stenosis) in the Registry patients. Although all significant narrowings were
      considered amenable to balloon angioplasty in 77% of patients, complete
      correction was intended only for 34% of them. It was attempted in 28% and
      successful in 19%. Only 63% of total occlusions were considered amenable to PTCA
      and only 54% of those attempted were successfully dilated. PTCA was intended for
      38% with 50 to 69% stenoses versus 80% with 70 to 89% stenoses and for greater
      than 85% with narrowings greater than or equal to 90%. Dilatation in narrowings
      of the left circumflex and left anterior descending artery systems was intended
      less frequently than in lesions of the right coronary artery. Finally, there was
      wide variability in operator strategy among the different Registry
      sites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626504
TI  - Mortality after coronary angioplasty and coronary artery bypass surgery (the
      national Medicare experience).
AB  - Mortality rates for Medicare patients who underwent coronary artery bypass
      surgery were compared with those who had angioplasty or angioplasty and bypass
      surgery. Two data sets were used for this study: The first contained information
      on demographic factors, co-morbidities and subsequent mortality on all 96,666
      Medicare patients who had bypass surgery or angioplasty in 1985; the second
      contained additional detailed clinical data collected using the MedisGroups
      method on a random sample of 2,931 revascularization patients from 6 states. From
      the national data set 30-day and 1-year mortality rates were 3.8 and 8.2% for
      25,423 angioplasty patients and 6.4 and 11.8% for 71,243 bypass surgery patients
      (p less than 0.001 for both time periods). Mortality rates for the MedisGroups
      data were 4.4 and 8.5% for the angioplasty patients and 6.5 and 11.9% for the
      bypass surgery patients. After eliminating patients admitted with a myocardial
      infarction, mortality rates were 1.9 and 6.0% for 632 angioplasty patients and
      5.1 and 10.8% for 1,730 bypass surgery patients. The risk-adjusted relative risk
      of mortality for bypass surgery versus angioplasty was 1.72 (p = 0.001) for all
      patients, 2.15 (p less than 0.001) for low-risk patients and 0.90 (p = not
      significant) for high-risk patients. Results suggest that low-risk patients have
      better survival with angioplasty because of lower short-term mortality.

PMID- 1626505
TI  - Cardiac response to combined moderate heat and exercise in men with coronary
      artery disease.
AB  - The effect of moderate heat stress on cardiac performance during sustained
      moderate physical work was evaluated in men greater than or equal to 6 weeks
      after a cardiac event. Subjects (n = 10) performed upright leg cycle ergometer
      exercise at approximately 50% of peak oxygen uptake for up to 60 minutes in warm
      (30.0 +/- 0.9 degrees C) and thermoneutral (21.5 +/- 0.3 degrees C) environments.
      Cardiac output (carbon dioxide rebreathing method), left ventricular ejection
      fraction and relative left ventricular end-diastolic volume (portable nuclear
      VEST monitor) were periodically determined. In both environments, heart rate
      increased (p less than 0.05), stroke volume decreased (p less than 0.05), and
      cardiac output remained unchanged with exercise time. In the warmer environment,
      heart rate was increased (p less than 0.05) and stroke volume tended to be
      decreased (p less than 0.08), with no difference in cardiac output. In both
      environments, left ventricular ejection fraction did not change from minute 6 to
      60 of exercise, whereas relative left ventricular end-diastolic volume decreased
      (p less than 0.05) with exercise time. Arterial blood pressure was unchanged from
      minute 6 to 60 in the warm environment. Arrhythmias were not altered by exercise
      time or environment, and no subjects had evidence of myocardial ischemia. The
      data indicate that although heart rate increased and stroke volume and relative
      left ventricular end-diastolic volume decreased with exercise time, cardiac
      output and left ventricular ejection fraction remained unchanged in both
      thermoneutral and warm environments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626506
TI  - Mechanisms and dynamics of episodes of progression of 2:1 atrioventricular block
      in patients with documented two-level conduction disturbances.
AB  - Twenty episodes of progression of 2:1 atrioventricular (AV) block were identified
      during incremental atrial stimulation in 7 patients with documented (2-level)
      block in the AV node and His-Purkinje system. All occurred at cycle lengths
      shorter than those at which stable 2:1 HV block had been detected. Thirteen
      episodes were typical since 2:1 increased to 3:1 AV block when an atrio-His (AH)
      Wenckebach period was completed with an atrial impulse that otherwise would have
      been conducted. These episodes occurred with dynamic A(M): V(N) ratios similar to
      those seen at the AV node. Seven atypical episodes were identified (while AH
      Wenckebach periods were occurring): (1) 2:1 increasing to 3:1 AV block and then
      to 4:1 AV block resulting from prolonged refractoriness in the His-Purkinje
      system subsequently followed by concealed conduction in the latter structure; (2)
      conversion of 3:2 directly into 3:1 AV block due to block of the next-to-last
      atrial impulse in the His-Purkinje system with completion of AH Wenckebach period
      with the following atrial impulse; and (3) 4:2 AV block presumably due to
      supernormal conduction in a transversely dissociated His-Purkinje system. These
      episodes occurred with A(M): V(N) ratios, which in other structures would have
      been indicative of different degrees of AV block. In conclusion, progression of
      2:1 AV block during documented 2 level conduction disturbances (1) can be
      explained by mechanisms different than those currently known, and (2) has rich,
      but different dynamics from those observed exclusively in the AV node and
      exclusively in the His-Purkinje system.

PMID- 1626507
TI  - Electrocardiographic abnormalities after radiofrequency catheter ablation of
      accessory bypass tracts in the Wolff-Parkinson-White syndrome.
AB  - Repolarization abnormalities on surface electrocardiograms have been described
      after loss of ventricular preexcitation in some patients with the Wolff-Parkinson
      White syndrome. Radiofrequency catheter ablation of overt accessory pathways
      provides a unique opportunity to study this phenomenon. In this study, serial
      electrocardiograms were obtained before and after radiofrequency ablation of
      manifest accessory pathways in 19 patients, of concealed accessory pathways in 6
      and after radiofrequency atrioventricular nodal modification in 12. Seven
      patients undergoing manifest right-sided accessory pathway ablation had left
      superior frontal plane T-wave axis deviations after ablation (-42 +/- 13
      degrees). No patient with a manifest left-sided or concealed accessory pathway,
      or atrioventricular nodal modification had T-wave abnormalities after ablation;
      however, left anterior fascicular block and incomplete right bundle branch block
      each occurred in 1 patient with left accessory pathway ablation. Repolarization
      abnormalities observed after ablation were similar to T-wave abnormalities during
      the absence of preexcitation before ablation and persisted up to 5 weeks after
      the procedure. Patients with repolarization abnormalities after ablation had
      significantly longer preexcited QRS durations than those without such changes,
      suggesting that the initial contribution of the pathway to ventricular activation
      is an important determinant of T-wave changes after ablation. The proposed
      mechanism for repolarization abnormalities after ablation is the phenomenon of T
      wave "memory."

PMID- 1626508
TI  - Improved detection of accessory pathways that bridge posterior septal and left
      posterior regions in the Wolff-Parkinson-White syndrome.
AB  - To improve the detection of accessory pathways that bridge the posterior septum
      and left posterior free wall, catheter maps of the coronary sinus from 21
      patients (group I) who needed dissection of both these anatomic regions were
      compared with data from 23 (group II) with pathways confined to the posterior
      septum and from 9 (group III) with left posterior pathways. A decapolar catheter
      was used to map the coronary sinus in 0.5 to 1 cm steps. Intraoperative mapping
      was performed with a 16-electrode band. Catheter maps during atrial pacing and
      orthodromic supraventricular tachycardia were analyzed for the site of earliest
      activation and for differences in a new directional measure of conduction time
      between adjacent mapping sites. The site of earliest activation alone did not
      distinguish accessory pathways that bridged both anatomic regions, because 14 of
      21 patients (66%) in group I would have been misclassified to either group II or
      III. In contrast, anterograde and retrograde directional conduction times
      distinguished patients in group I from those in groups II (p less than 0.01 to
      less than 0.0003) and III (p less than 0.04 to less than 0.0001). A multivariate
      model that incorporated the observed differences in directional interelectrode
      conduction times improved the identification of group I patients, with a
      sensitivity of 87% and a specificity of 90%. The results define new features in
      activation patterns measurable during catheter mapping that identify accessory
      pathways that bridge the posterior septum and left posterior free wall.

PMID- 1626509
TI  - Recordings from the slow zone of reentry during burst pacing versus programmed
      premature stimulation for initiation of reentrant ventricular tachycardia in
      patients with coronary artery disease.
AB  - Programmed premature stimulation and burst pacing were compared for initiation of
      ventricular tachycardia (VT) in 16 patients with inducible sustained monomorphic
      VT. In all patients VT could be induced by programmed stimulation with 2 or 3
      extrastimuli. On the other hand, initiation of VT by burst pacing was dependent
      on the length of the train; only 2 to 4 of the 11 trains tested could induce VT
      in any single patient. Recordings obtained from the slow zone of reentry showed
      that programmed premature stimulation that induced VT resulted in a critical
      degree of conduction delay as revealed by lengthening of local fractionated
      electrograms spanning 70 to 100% of the diastolic interval. Similarly, the last
      beat of a burst pacing train that induced VT was always followed by a similar
      degree of local conduction delay, whereas trains that failed to induce VT were
      followed by a lesser delay. It is concluded that although programmed stimulation
      with up to 3 extrastimuli was consistently successful in inducing VT, burst
      pacing succeeded in only 26% of the trials and was dependent on the length of the
      train, which varied from one patient to the other. Similar to what was shown
      previously in the experimental model of reentrant VT, burst pacing could
      initiate, conceal, terminate, and reinitiate reentry depending on the length of
      the train.

PMID- 1626510
TI  - Radiation exposure to patients and medical personnel during radiofrequency
      catheter ablation for supraventricular tachycardia.
AB  - Radiofrequency catheter ablation is an effective alternative to medical therapy
      for patients with supraventricular arrhythmias. The purpose of this study was to
      determine the risks to the patient and to medical personnel due to radiation
      exposure from fluoroscopy during radiofrequency ablation of supraventricular
      tachycardia. One hundred eight consecutive patients with Wolff-Parkinson-White
      syndrome or atrioventricular nodal reentry who underwent the ablation procedure
      were studied. The ablation procedure was successful in 95% of the patients
      studied. Preexcitation or supraventricular tachycardia recurred in 5% of the
      patients during a mean follow-up of 9 +/- 4 months. The mean fluoroscopy time was
      50 +/- 31 minutes. An anthropomorphic radiologic phantom was used to determine
      organ exposure and the effective dose equivalents for the patient and medical
      personnel. The patient's effective dose equivalent during a representative
      ablation procedure was 1.7 rems, which is comparable to other invasive
      cardiovascular procedures. The risk of inducing a fatal cancer from this exposure
      is 1 chance in 745, which is 1% of the spontaneous risk. The risk of a serious
      birth defect is 1 chance in 80,000, which is 0.1% of the current incidence of
      serious birth defects in the United States. The cardiologist who receives the
      highest exposure among medical personnel, would incur 1.8 mrems per case or 450
      mrems per year if 250 procedures were performed. This exposure is 9% of the
      recommended annual limit. These results demonstrate the efficacy of
      radiofrequency energy ablation of supraventricular tachycardia and confirm that
      radiation exposure to patients and medical personnel is within established
      guidelines.

PMID- 1626511
TI  - Baroreceptor-mediated release of vasopressin in patients with chronic congestive
      heart failure and defective sympathetic responsiveness.
AB  - In patients with congestive heart failure (CHF), overactivity of the sympathetic
      nervous system may be accompanied by an impairment of the baroreflex control
      mechanism. To evaluate the reflex responses of the sympathetic nervous system,
      the renin-angiotensin system and vasopressin release to baroreceptor unloading,
      38 patients with left ventricular dysfunction were studied. Hemodynamic data, and
      plasma norepinephrine, renin activity and vasopressin concentrations were
      measured before and 60 minutes after administration of high-dose hydralazine (0.4
      mg/kg intravenously). On the basis of blood pressure response to vasodilator
      administration, patients were divided arbitrarily into those with a decrease in
      mean arterial blood pressure greater than or equal to 15 mm Hg (group A; n = 12)
      and those with a decrease less than 15 mm Hg (group B; n = 26) compared with
      control values. In response to hydralazine, heart rate decreased in group A from
      100 to 92 beats/min (p less than 0.001) and increased in group B from 90 to 96
      beats/min (p less than 0.05). In group A, hemodynamic changes induced by
      hydralazine were accompanied by a decrease in plasma norepinephrine from 822 to
      518 pg/ml (p less than 0.01) and an increase in plasma vasopressin from 8.4 to
      45.2 pg/ml (p less than 0.001). In group B, plasma norepinephrine and vasopressin
      did not change significantly (407 vs 447, and 8.4 vs 8.3 pg/ml, respectively).
      Plasma renin activity remained unchanged in group A and increased in group B (p
      less than 0.001). The data show that baroreceptor-mediated release of vasopressin
      is not impaired in patients with CHF and a defective sympathetic reflex control
      mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626512
TI  - Rate of progression of valvular aortic stenosis in adults.
AB  - Until recently the hemodynamic severity of valvular aortic stenosis (AS) was
      evaluated only by cardiac catheterization. Now, Doppler echocardiography allows a
      noninvasive and accurate assessment of AS severity and can be used to study its
      progression with time. The progression of AS was assessed during a follow-up
      period of 6 to 45 months (mean 18) by serial Doppler examinations in 45 adult
      patients (21 men and 24 women, mean age 72 +/- 10 years) with isolated AS. The
      following parameters were serially measured: left ventricular outflow tract
      diameter and velocity by pulsed Doppler, peak velocity of aortic flow by
      continuous-wave Doppler, to calculate peak gradient by the modified Bernoulli
      equation, and aortic valvular area by the continuity equation. At the initial
      observation, 13 of 45 patients (29%) were symptomatic (1 angina, 1 syncope and 11
      dyspnea); during follow-up, 25 (55%) developed new symptoms or worsening of the
      previous ones (5 angina, 3 syncope and 17 dyspnea); 11 underwent aortic valve
      replacement and 3 died from cardiac events. Baseline peak velocity and gradient
      ranged between 2.5 and 6.6 m/s, and 25 and 174 mm Hg, respectively; aortic area
      ranged between 0.35 and 1.6 cm2. With time, mean peak velocity and gradient
      increased significantly from 4 +/- 0.7 to 4.7 +/- 0.8 m/s (p less than 0.01), and
      64 +/- 30 to 88 +/- 30 mm Hg (p less than 0.01), respectively. A concomitant
      reduction in mean aortic area occurred (0.75 +/- 0.3 to 0.6 +/- 0.15 cm2; p less
      than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626513
TI  - Comparison of cardiac findings in patients with mitral valve prolapse who die
      suddenly to those who have congestive heart failure from mitral regurgitation and
      to those with fatal noncardiac conditions.
AB  - Sudden death occurs in a small but important subset of patients with mitral valve
      prolapse (MVP). Clinical criteria for identifying patients at risk for sudden
      death have been elusive. To determine if certain morphologic characteristics were
      present in hearts from patients with sudden cardiac death and MVP, autopsy hearts
      from persons with sudden death and isolated MVP who were previously asymptomatic
      or had a history of cardiac arrhythmias (n = 27) were compared with (1) hearts
      from patients with congestive heart failure (CHF) and mitral regurgitation (MR)
      secondary to MVP (n = 14), and (2) hearts from persons dying from non-cardiac
      causes in which MVP was an incidental finding (n = 19). Patients who died
      suddenly were younger than both patients with MR/CHF and incidental cases (37 +/-
      10 vs 65 +/- 16 and 58 +/- 21 years, respectively, p less than 0.001). Mitral
      valve annular circumference, anterior and posterior mitral valve leaflet lengths,
      posterior mitral valve thickness, and presence and extent of endocardial plaque
      were greater in hearts from patients with sudden death than hearts from those
      with incidental MVP. Hearts from patients with MR/CHF weighed significantly more,
      had greater left and right atrial cavity sizes and left ventricular cavity
      diameter than hearts from both sudden death and incidental cases.

PMID- 1626514
TI  - Hemodynamic evaluation by Doppler echocardiography of small (less than or equal
      to 21 mm) prostheses and bioprostheses in the aortic valve position.
AB  - To assess resting hemodynamics of an unselected group of patients with prostheses
      or bioprostheses sized less than or equal to 21 mm implanted into the aortic
      valve position during a 7-year period, 46 of 50 eligible patients were examined
      by Doppler echocardiography. The valves were Carpentier-Edwards (CE) supraannular
      21 mm (n = 8), Medtronic-Hall (MH) 20 mm (n = 8) and 21 mm (n = 21), and the rest
      (n = 9) were other valves with only 1 to 3 patients in each group. Gradients,
      valve areas and dimensionless obstruction indexes (ratio of subvalvular/valvular
      velocities and velocity time integrals) were compared. By analysis of variance,
      gradients did not differ significantly between the CE supraannular 21 mm, the MH
      20 and 21 mm prostheses (peak/mean 25 +/- 8/14 +/- 5, 31 +/- 13/16 +/- 6 and 25
      +/- 10/13 +/- 5 mm Hg; p = not significant). Only 2 patients had a mean gradient
      greater than 25 mm Hg. The valve area was slightly larger for the MH 21 mm group
      compared with the CE supraannular 21 mm group (1.34 +/- 0.15 vs 1.16 +/- 0.14
      cm2, p less than 0.05). The dimensionless obstruction indexes did not differ (CE
      supraannular 21 mm 0.36 +/- 0.07/0.40 +/- 0.07 (velocities/velocity time
      integrals), MH 20 mm 0.40 +/- 0.12/0.47 +/- 0.12, MH 21 mm 0.38 +/- 0.05/0.44 +/-
      0.06; p = not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626515
TI  - Usefulness of transesophageal echocardiography in evaluation of paracardiac
      neoplastic masses.
AB  - Mediastinal paracardiac tumors may cause both cardiovascular complications and
      problems in differential diagnosis of cardiac diseases. Transesophageal
      echocardiography (TEE) may give an additional new window to mediastinal
      neoplasms, but only a few studies have been reported. TEE was performed in 70
      patients with paracardiac neoplastic masses. The procedure was indicated to solve
      particular clinical problems in 20 patients, and as a prospective study on 50
      unselected patients with mediastinal neoplasms. Twenty-three patients underwent
      follow-up studies; a total of 101 echocardiograms were recorded. The procedure
      was tolerated well or very well by most patients, and provided additional
      anatomic or hemodynamic data in every patient in group a and in 45 of 50 in group
      b. The additional data were relevant for clinical management in 14 of 20 patients
      in group a, and in 3 of 45 in group b. Based on the results of this study, TEE is
      useful in association with other radiologic techniques in patients with
      paracardiac neoplasms. As an imaging technique, it may represent a reliable
      alternative to computed tomography whenever the latter is not feasible.

PMID- 1626516
TI  - Safety of intravenous high-dose dipyridamole echocardiography. The Echo
      Persantine International Cooperative Study Group.
AB  - Clinical data on 10,451 high-dose (up to 0.84 mg/kg over 10 minutes) dipyridamole
      echocardiography tests (DET) performed in 9,122 patients were prospectively
      collected from 33 echocardiographic laboratories, each contributing greater than
      100 tests. All patients were studied for documented or suspected coronary artery
      disease (1,117 early [less than 18 days] after acute myocardial infarction and
      293 had unstable angina). Significant side effects including major adverse
      reactions and minor but limiting side effects occurred in 113 patients (1.2%).
      Major adverse reactions occurred in 7 cases (0.07%). In 6 of these cases, adverse
      reactions were associated with echocardiographically assessed ischemia and
      included 1 prolonged cardiac asystole (complicated by acute myocardial infarction
      and coma, with death after 23 days), 1 short-lasting cardiac asystole, 2
      myocardial infarctions, 1 pulmonary edema and 1 sustained ventricular
      tachycardia. In all 6 cases, the cardiologist-echocardiographer performing the
      study had a limited experience (less than 100 tests) with DET, and at off-line
      reading in 5 cases, the obvious echo-positivity preceded the onset of
      complications by 1 to 5 minutes. The only ischemia-independent major side effect
      was a short-lasting cardiac asystole that was reversed by aminophylline and
      atropine. Significant side effects associated with echocardiographically assessed
      ischemia occurred in 89 additional cases (21 with and 68 without concomitant
      echocardiographically assessed myocardial ischemia). The most frequent of these
      side effects was hypotension or bradycardia, or both, which occurred in 40
      patients with negative and 6 with positive DET. In all cases, side effects
      promptly subsided after aminophylline. In 1,857 cases, the high dose was not
      given for echo-positivity before the eighth minute.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1626517
TI  - Left ventricular mass quantitation using single-phase cardiac magnetic resonance
      imaging.
AB  - Magnetic resonance imaging (MRI) has been used to measure left ventricular (LV)
      mass in animals with superior accuracy. However, its use in cardiac patients has
      been limited by the long total scan times necessitated by imaging the heart at
      end-diastole at each of 8 to 10 slice locations. Recent canine studies showed
      that LV mass may be determined accurately, with considerable timesavings, by use
      of sequential images throughout the cardiac cycle (single-phase MRI). Twenty
      normal subjects underwent spin-echo MRI to determine the relationship between LV
      mass computed from single-phase MRI and results obtained from the more time
      consuming end-diastolic MRI (which was used as the reference standard for this
      study). The left ventricle was spanned with 2 interleaved series of 5 short-axis
      1 cm thick slices. 5 images, evenly spaced throughout the cardiac cycle, were
      obtained at each slice location in all subjects. LV mass ranged from 86 to 198 g.
      Although end-diastolic LV mass exceeded single-phase results by an average of 5 g
      (p less than 0.002), there was a close correlation between the 2 (slope = 0.99; r
      = 0.96). Although LV mass derived from end-diastolic images exceeded single-phase
      results, this difference is unlikely to be clinically significant and is small
      compared with the standard error of echocardiographic methods. Furthermore, when
      the order in which single-phase images were selected was reversed, there was
      improved agreement with end-diastolic MRI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626518
TI  - Morphologic findings in explanted Mitroflow pericardial bioprosthetic valves.

PMID- 1626519
TI  - Electrocardiographic abnormalities in mitral valve prolapse.

PMID- 1626520
TI  - Balloon cutting.

PMID- 1626522
TI  - More on fast foods and quick plaques.

PMID- 1626521
TI  - Does enflurane effect ventricular tachycardia?

PMID- 1626523
TI  - A long-term comparison of nonextraction and premolar extraction edgewise therapy
      in "borderline" Class II patients.
AB  - The long-term effects of extraction and nonextraction edgewise treatments were
      compared in 63 patients with Class II, Division 1 malocclusions who were
      identified by discriminant analysis as being equally susceptible to the two
      strategies. A lateral cephalogram, study models, and a self-evaluation of the
      esthetic impact of treatment were obtained from each of the 33 extraction and 30
      nonextraction subjects. The average posttreatment interval was 14.5 years.
      Although the two strategies produced significant, long-lived differences in the
      convexity of the profile and the protrusion of the dentition (the nonextraction
      patients were about 2 mm "fuller"), half of the nonextraction patients and three
      fourths of the extraction patients ultimately presented with less than 3.5 mm of
      lower incisor irregularity. The two groups showed an essentially identical
      pattern of posttreatment relapse/settling that was related more to the
      differential growth of the jaws than to the posttreatment position and
      orientation of the denture. Because in the end the various tooth movements tended
      to cancel one another, excess mandibular growth was also the most important net
      contributor to the molar and overjet corrections. In the process, both groups
      showed a marked forward displacement of the mandible, both at the chin and at the
      condyle. Finally, although it is probable that most of the present sample would
      today be treated by expansion, the 30 patients who actually received this
      presumably correct treatment rated their appearance no more highly than did the
      extraction subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626524
TI  - Superelastic wires.

PMID- 1626525
TI  - Prediction of cooperation in orthodontic treatment.
AB  - A prospective study of patient cooperation with orthodontic treatment was
      conducted on 100 adolescent patients. Patient, parent, and orthodontist
      questionnaires were used at three stages of orthodontic treatment. The first was
      used at the initiation of treatment and the latter two at 6-month intervals.
      Psychosocial measures from investigators reported in orthodontic patient
      cooperation literature were screened for use in the present study. These measures
      included attitudes toward treatment, social desirability, need for approval, and
      need for achievement. None of the variables selected for this investigation
      adequately predicted cooperation of a patient in orthodontic treatment. The
      stepwise regression procedures indicated that inclusion of all variables
      accounted for 40% of the variability. Variables assessing the orthodontist's
      perception of orthodontist-patient relationship had the strongest association
      with patient compliance.

PMID- 1626526
TI  - Comment on mandibular growth.

PMID- 1626527
TI  - Special TMJ issue comment.

PMID- 1626528
TI  - More comments on the special TMJ issue.

PMID- 1626529
TI  - Occlusal contact changes after the active phase of orthodontic treatment.
AB  - Occlusal contacts in maximum intercuspidation were recorded at the end of active
      orthodontic treatment and 3 months into the retention period. Hawley retainer,
      tooth positioner, and nontreated normal occlusion groups of 10 subjects were
      examined for change in the number and location of occlusal contacts. Soft
      silicone-base impression materials were used to make interocclusal registrations.
      The contacts were then transferred onto the study models, and standard
      photographs of each model were taken. To determine any locational changes,
      superimposition of the first registration photograph on the second one was done.
      Significant difference in the number of total contacts between the treated groups
      and the control sample was recorded at both time periods. Use of a tooth
      positioner as a retainer did not show any additional gain of contacts in the
      positioner group when compared with the Hawley retainer group. No significant
      change in the location of contacts occurred during the period of observation.

PMID- 1626530
TI  - The duration of orthodontic treatment.
AB  - Characteristics of the patient, the treatment plan, and the practitioner's office
      were examined to evaluate causes for variation in the duration of orthodontic
      treatment. From six offices 118 patients were evaluated. All patients were
      treated in a single phase with fixed appliances. Appliances were worn for an
      average of 23.1 months. The mean duration for offices ranged from 19.4 to 27.9
      months. Thirty-eight percent of the patients had extractions, and 32% wore
      headgear. Fifty percent of the variation in treatment duration among patients was
      explained by a five-step multiple regression equation. The variables entering
      this equation were (1) number of extracted premolars, (2) number of broken
      appointments, (3) pretreatment mandibular plane angle, (4) pretreatment ANB
      angle, and (5) pretreatment Salzmann Index. Observations within each office
      suggested that the time spent by individual clinicians in detailed finishing,
      which would not be detected by measures such as the Salzmann Index, was an
      important source of unexplained variation in treatment duration.

PMID- 1626531
TI  - A multivariate analysis of the relations between craniofacial structure and
      occlusion with DiPaolo's quadrilateral measures.
AB  - This study examined the relations between craniofacial structure and occlusion
      with clinically oriented skeletal measures consistent with Enlow's counterpart
      principle and a combination of univariate and multivariate statistics. The
      pretreatment lateral cephalograms and dental casts of 59 white adolescents with
      natural skeletal and occlusal development were selected to provide a random
      sampling of various malocclusions. Craniofacial structure was described with
      DiPaolo's quadrilateral measures. The relations between craniofacial structure
      and occlusion were analyzed with simple correlation analysis, stepwise multiple
      regression, and stepwise discriminant analysis. Intratester and intertester
      reliability were established, and a lack of sexual dimorphism was demonstrated.
      Three types of relations were identified: anteroposterior relations, vertical
      relations, and coordinations. A strong association was found between the
      variation in the anteroposterior measures and the variation in sagittal
      occlusion. A more modest association was found between the variation in the
      vertical measures and the variation in vertical occlusion. A combined skeletal
      measure composed of the variable pair mandibular plane angle and the ratio of
      anterior lower facial height to anterior upper facial height was found to explain
      the greatest percent of the variance in vertical occlusion. Several coordinations
      were found which, when taken together, described an overall pattern of
      associations.

PMID- 1626532
TI  - Variations in bracket placement in the preadjusted orthodontic appliance.
AB  - This study was conducted to determine the accuracy of bracket placement with the
      direct bonded technique. Ten orthodontic faculty members bonded a preadjusted
      orthodontic appliance on models of five cases of malocclusion in a simulated
      clinical situation (mannequin). A total of 50 sets of models served as the
      population of the study. Photographs of the models were measured to determine
      vertical and angular discrepancies in position between adjacent bracket pairs
      from a constructed reference line. Variations are evaluated with respect to the
      classification of malocclusion, specific tooth type, and intra/inter operator
      differences. A mean of 0.34 mm for the vertical discrepancies and a mean of 5.54
      degrees for the angular discrepancies are found in placement of the orthodontic
      brackets.

PMID- 1626533
TI  - Compliance with infection control procedures among California orthodontists.
AB  - We conducted a survey of a random sample of California orthodontists and of
      general dentists to compare their infection control procedures. Questionnaires
      were returned by 124 orthodontists (56% response rate) and 126 general dentists
      (61% response rate). Eighteen questions were asked covering practice profile,
      perception of risk from hepatitis B virus (HBV) and human immunodeficiency virus
      (HIV), exposure to blood, barrier protection used, and sterilization and
      disinfection procedures. Gloves always were worn by 80% of the orthodontists
      sampled, 63% always wore glasses, and 59% changed gloves between patients.
      Orthodontists sterilized their instruments 66% of the time and pliers 49% of the
      time. Compared with general dentists, orthodontists' perception of risk, use of
      barrier protection, and sterilization and disinfection procedures were lower in
      all areas. Our data suggest that poorer performance may be because orthodontists:
      (1) perceive their younger population of patients at less risk for HBV and HIV;
      (2) treat 2.5 times as many patients, which increases the costs of infection
      control; (3) do not use invasive procedures; and (4) perceive that glove use
      decreases dexterity. Orthodontists should follow the American Dental
      Association/Council on Dental Therapeutics infection control guidelines for
      universal precautions. To meet these guidelines, orthodontists still need
      improvement in all aspects of their infection control procedures.

PMID- 1626534
TI  - Improving the facial profile of a girl born with a right unilateral cleft lip and
      palate.

PMID- 1626535
TI  - Alveolar bone: the production of eruption.

PMID- 1626536
TI  - Exposure control plan.

PMID- 1626537
TI  - The changing pattern of human immunodeficiency virus type 1 infection in
      intravenous drug users. Results of a six-year seroprevalence study in Palermo,
      Italy.
AB  - A cross-sectional seroepidemiologic study was carried out between 1985 and 1990
      in 1,567 heterosexual intravenous drug users who had been seen at the AIDS
      Regional Reference Center in Palermo, Italy, to evaluate the rate of human
      immunodeficiency virus type 1 (HIV-1) seroprevalence in this group and its long
      term trend. Sixty serum samples collected from drug users in 1980 and 1983,
      before the founding of the Center (1985), were tested as well. Some demographic
      and behavioral risk factors were studied in a subgroup of intravenous drug users
      enrolled in 1985, 1987, and 1990 for their possible association with HIV-1. These
      factors were also studied in relation to hepatitis B virus infection, since both
      viruses share the same modes of spread. These drug users had a higher prevalence
      of markers for hepatitis B virus than of HIV-1 antibodies, and the prevalence
      rates in sera collected declined over time for both infections. The presence of
      both antibodies to HIV-1 and markers for hepatitis B virus was independently
      associated with the age of the drug user, the duration of drug use, and the year
      of serum collection. Antibodies to HIV-1 were observed more frequently in females
      than in males. No relation was found between education or employment status and
      the presence of HIV-1 antibodies or hepatitis B virus markers. Although new HIV-1
      infections still occur, the decline in seroprevalence observed at the end of the
      1980s might be related to modifications in social behavior among newer drug
      users, partial exhaustion of the susceptible population, and increasing risk
      awareness in more experienced users.

PMID- 1626538
TI  - Risk of congenital malformations associated with proximity to hazardous waste
      sites.
AB  - Concern about environmental pollutants has increased; however, it remains unclear
      whether chronic exposures to toxic chemicals in the environment occur at doses
      sufficient to produce adverse health effects in humans. To date, community
      studies have not adequately addressed this question. In this study, the authors
      linked two existing data bases of the New York State Department of Health to
      evaluate the relation between congenital malformations and residential proximity
      to hazardous waste sites in New York State. A total of 9,313 newborns with
      congenital malformations and 17,802 healthy controls living in proximity to 590
      hazardous waste sites in 1983 and 1984 were evaluated. After the authors
      controlled for several possible confounding factors, results indicated that
      maternal proximity to hazardous waste sites may carry a small additional risk of
      bearing children with congenital malformations (odds ratio (OR) = 1.12, 95%
      confidence interval (Cl) 1.06-1.18). Higher malformation rates were associated
      with both a higher exposure risk (no exposure risk: OR = 1.00; low exposure risk:
      OR = 1.09, 95% Cl 1.04-1.15; high exposure risk: OR = 1.63, 95% Cl 1.34-1.99) and
      documentation of off-site chemical leaks (not exposed: OR = 1.00; exposed, but no
      leaks at site: OR = 1.08, 95% Cl 1.02-1.15; exposed, and leaks found at site: OR
      = 1.17, 95% Cl 1.08-1.27). The increased rates detected may be important in terms
      of their public health implications. Further research is necessary to strengthen
      causal inferences regarding the teratogenicity, of waste site exposure.

PMID- 1626539
TI  - Fertility of male workers exposed to cadmium, lead, or manganese.
AB  - The effect of exposure to cadmium, lead, or manganese on male reproductive
      function was examined in 1988-1989 in Belgian blue-collar workers. The workers
      were exposed to cadmium in two smelters (n = 83; geometric mean urinary cadmium
      level = 6.94 micrograms/g of creatinine; mean duration of exposure = 24 years),
      to lead in a battery factory (n = 74; mean blood lead level = 46.3 micrograms/dl;
      mean duration of exposure = 10.7 years), or to manganese (manganese dioxide) in a
      dry alkaline battery plant (n = 70; median atmospheric concentration of total
      manganese dust = 0.71 mg/m3; mean duration of exposure = 6.2 years). Fertility in
      these workers and in an unexposed population (n = 138) was assessed by examining
      the birth experiences of their wives through a logistic regression model. The
      probability of a live birth was not different between the unexposed workers and
      the cadmium- or manganese-exposed workers before or after the onset of exposure.
      While the fertility of the lead-exposed workers was somewhat greater than that of
      the unexposed before the onset of exposure, a significant decrease in fertility
      was observed during the period of exposure to the metal (odds ratio = 0.65, 95%
      confidence interval 0.43-0.98).

PMID- 1626541
TI  - Short- and long-term association of serum cholesterol with mortality. The 25-year
      follow-up of the Finnish cohorts of the seven countries study.
AB  - The association of serum cholesterol with cause-specific and all-cause mortality
      was assessed in a cohort of 1,426 men aged 40-59 years who were free of
      clinically evident heart disease at baseline (1959). A total of 748 deaths (53
      percent of the participants) occurred during the 25-year follow-up period. Men
      with high serum cholesterol levels at baseline had high mortality due to coronary
      heart disease during both the early and later parts of the follow-up period. In
      contrast, the association of serum cholesterol with mortality due to causes other
      than coronary heart disease changed during follow-up (interaction of cholesterol
      with follow-up period: p = 0.004). During the first 10 years of follow-up,
      despite their high coronary mortality, men with high cholesterol levels had lower
      all-cause mortality (age-adjusted relative risk = 0.71 for serum cholesterol
      above 5.79 mmol/liter vs. below 5.80 mmol/liter; p = 0.03) because of their low
      cancer mortality (relative risk = 0.55, p = 0.03) and residual mortality
      (relative risk = 0.49, p less than 0.01). During the last 15 years of follow-up,
      cholesterol at baseline was no longer associated with mortality due to causes
      other than coronary heart disease, and consequently, because of their high
      coronary mortality, men with high cholesterol levels also had higher all-cause
      mortality (relative risk = 1.22, p = 0.05). The results suggest that to fully
      analyze the association of serum cholesterol with all-cause mortality, the follow
      up period should be sufficiently long--possibly more than 10 years--and the
      possibility of a change in the direction of the association studied should always
      be considered.

PMID- 1626540
TI  - Sex hormones and postmenopausal breast cancer: a prospective study in an adult
      community.
AB  - Few studies have examined the role of endogenous sex hormones in breast cancer,
      and to the authors' knowledge, only two have done so prospectively. The authors
      report here the results of a prospective study based on an available bank of
      previously analyzed plasma collected in 1972-1974 from 442 women aged 50-79 years
      in Rancho Bernardo, California. These women were followed for 12-15 years, during
      which time 42 cases of breast cancer were identified: 15 incident cases diagnosed
      1 year or more after baseline, 18 prevalent cases diagnosed earlier than 1 year
      after baseline, and 9 cases with unknown dates of onset. No apparent trends in
      plasma levels of sex hormones or sex hormone-binding globulin and incidence or
      prevalence of breast cancer were observed. Mean crude and age-adjusted plasma
      hormone levels at baseline (in pg/ml) for incident cases, total cases, and
      noncases, respectively, were: androstenedione: 647, 638 +/- 328 (standard
      deviation); 626, 620 +/- 245; and 664, 664 +/- 291; testosterone: 254, 258 +/-
      120; 238, 241 +/- 153; and 262, 261 +/- 143; estrone: 37, 38 +/- 18; 35, 35 +/-
      15; and 37, 37 +/- 17, and estradiol: 13, 13 +/- 7; 15, 15 +/- 8; and 15, 15 +/-
      9. For sex hormone-binding globulin, mean crude and age-adjusted levels at
      baseline (nM) were 35 and 36 +/- 33 for incident cases; 31 and 31 +/- 25 for
      total cases; and 29 and 29 +/- 21 for noncases. Cox proportional hazards multiple
      regression showed no associations with breast cancer after simultaneous
      adjustment for age, body mass index, and cigarette smoking.

PMID- 1626542
TI  - The FINMONICA Stroke Register. Community-based stroke registration and analysis
      of stroke incidence in Finland, 1983-1985.
AB  - In the early 1980s, a standardized community-based stroke register was started in
      three geographic areas in Finland: North Karelia and Kuopio in eastern Finland
      and Turku/Loimaa in southwestern Finland. The results from the first 3 years,
      1983-1985, confirmed the high incidence of stroke in Finland. The incidence of
      stroke was higher in eastern Finland than in the southwestern part of the
      country. The age-standardized annual incidence among men aged 25-74 years varied
      from 206 per 100,000 population in southwestern Finland to 322 per 100,000
      population in the province of Kuopio in eastern Finland. Among women aged 25-74,
      incidence was 119 and 187 per 100,000 population in these two areas,
      respectively. The age-standardized male:female ratio in incidence was 1.7,
      slightly higher than that previously reported in Finland. Out of 3,574 stroke
      events registered, 78% were first events without a history of previous stroke.
      People aged 65-74 years accounted for 45% of all events among men and 62% of all
      events among women. The authors' experience shows that the geographic variation
      in stroke incidence and attack rates is difficult to assess even within a country
      with a relatively uniform health care system. Rigorous standardization and
      quality control is needed for the assessment of long-term trends; this is the
      primary goal of the FINMONICA Stroke Register. The findings of this study suggest
      that the incidence of stroke is still high in Finland, although mortality from
      stroke has steeply declined during the past 15-20 years. The number of stroke
      survivors in Finland may actually be increasing. Since the occurrence of stroke
      is high in Finland as compared with other countries, intensified primary and
      secondary prevention measures are needed to reduce it.

PMID- 1626544
TI  - Alcohol consumption regression models for distinguishing between beverage type
      effects and beverage preference effects.
AB  - In relating health outcomes to alcohol consumption, several investigators have
      evaluated differences among beverage types, but there is no consistency with
      respect to models used for this purpose. Furthermore, beverage type effects and
      beverage preference effects have not been evaluated simultaneously. In this
      report, the authors propose regression models which permit the simultaneous
      evaluation of beverage type (congener dose response) effects and beverage
      preference (sociobehavioral) effects. The presence of sociobehavioral effects can
      be established even if the variables responsible for them have not been measured
      or identified. The models are applied to a data set from 589 women who
      participated in an oral contraceptive study at the Johns Hopkins University
      (Baltimore, Maryland) in 1988-1989.

PMID- 1626543
TI  - Influence of body fat and its regional localization on risk factors for
      atherosclerosis in young men.
AB  - A study was carried out in 1988 in Verona, Italy, to examine the relation of body
      fat and its localization to several risk factors for atherosclerosis in young
      men. Total body fat (bioelectrical impedance), waist and hip circumferences, and
      waist/hip circumference ratio were measured in 1,293 18-year-old men. Fasting
      serum levels of total cholesterol, low density lipoprotein cholesterol, high
      density lipoprotein cholesterol, triglycerides, and insulin, as well as systolic
      and diastolic blood pressure, were also measured. Significant differences were
      found in all metabolic and hemodynamic variables among quartiles of total body
      fat. Most of these differences remained significant after the authors controlled
      for the independent effect of fat localization and behavioral factors such as
      smoking, alcohol intake, and physical activity. Triglycerides, insulin, and blood
      pressure were significantly different among quartiles of waist/hip ratio, but
      these differences disappeared after the authors controlled for the independent
      effect of total body fat. These results indicate that in young men, irrespective
      of its regional localization, an excess of body fat is associated with a poor
      profile of risk for atherosclerosis. On the other hand, the prevalent
      localization of fat in the central part of the body is not independently
      associated with any risk factor.

PMID- 1626545
TI  - Nonlinear modeling of alcohol consumption for analysis of beverage type effects
      and beverage preference effects.
AB  - In a previous report (Kimball and Friedman, Am J Epidemiol, 1992;135:1279-86),
      linear models for relating health outcomes to alcohol consumption were proposed
      for differentiating between beverage type effects and beverage preference
      effects. The models were applied to data relating serum high density lipoprotein
      cholesterol to alcohol consumption. In this report, those models are extended to
      the nonlinear case and are applied to data from the 1982 Maryland Hypertension
      Survey relating systolic blood pressure to alcohol consumption.

PMID- 1626546
TI  - Epidemiologic mapping using the "kriging" method: application to an influenza
      like illness epidemic in France.
AB  - This paper presents the application of a technique from the earth sciences, the
      "kriging" method, to the field of geographic epidemiology. Both the principles of
      the method and the basic equations are given. A key advantage of the method is
      that it relies on an analysis of the spatial variability of the data and allows
      the representation of the variable under study as a continuous process throughout
      a country. Application of the kriging method to the geographic distribution of an
      epidemic of influenza-like illness in France is discussed.

PMID- 1626547
TI  - Methods for trend estimation from summarized dose-response data, with
      applications to meta-analysis.
AB  - Meta-analysis often requires pooling of correlated estimates to compute
      regression slopes (trends) across different exposure or treatment levels. The
      authors propose two methods that account for the correlations but require only
      the summary estimates and marginal data from the studies. These methods provide
      more efficient estimates of regression slope, more accurate variance estimates,
      and more valid heterogeneity tests than those previously available. One method
      also allows estimation of nonlinear trend components, such as quadratic effects.
      The authors illustrate these methods in a meta-analysis of alcohol use and breast
      cancer.

PMID- 1626548
TI  - Re: "A statistical method for evaluating suicide clusters and implementing
      cluster surveillance".

PMID- 1626549
TI  - Re: "Case-control studies of environmental influences in diseases with genetic
      determinants, with an application to Alzheimer's disease".

PMID- 1626550
TI  - Re: "Birth defects among offspring of firemen".

PMID- 1626551
TI  - The future of the end-stage renal disease program.
AB  - The rapidly changing health care environment in the United States will affect the
      future of nephrology in several areas. Reductions in Medicare spending will
      affect graduate medical education, physician payments, and, eventually, payments
      for medical supplies and therapeutic agents. The resource-based relative value
      system (RBRVS) developed by the Health Care Financing Administration (HCFA) will
      be implemented over the next 4 years, and it is likely that similar plans will be
      adopted by other insurance carriers. Under this system, payments for the
      procedure of dialysis will be substantially reduced--decreases in Medicare
      reimbursement will range from approximately 30% to 60% depending on geographic
      location and current charges. However, the current economic pressures may have a
      beneficial effect on the practice of nephrology by providing an incentive to
      develop standardized practice guidelines that will eliminate wide variations in
      practices and minimize unfounded litigation. In the near future, attention must
      also focus on the training of nephrology fellows; ideas for future directions are
      presented.

PMID- 1626552
TI  - Quality of life and hematocrit level.
AB  - As the anemia that accompanies chronic renal failure (CRF) is successfully
      treated with recombinant human erythropoietin (epoetin), striking improvements in
      overall quality of life have been noted in several clinical studies of patients
      receiving chronic hemodialysis. A review of available clinical data has shown
      that, following epoetin therapy, peak oxygen consumption, a principal indicator
      of exercise ability, increased by approximately 50% as the hematocrit level
      increased. Following epoetin therapy in pediatric patients with end-stage renal
      disease (ESRD), the ventilatory anaerobic threshold (VAT) increased significantly
      and correlated well with increases in hemoglobin concentrations. Increased
      exercise capacity associated with the reversal of anemia appeared to positively
      effect many quality-of-life parameters. Analysis of questionnaires incorporating
      both subjective and objective quality-of-life indicators showed significant
      improvements between baseline and follow-up periods. Many patients experienced
      relief from some of the debilitating symptoms of anemia and many had
      significantly improved functional ability. Higher activity and energy levels were
      reflected in enhanced emotional and social well-being, with improvements noted in
      appetite, sleeping behavior, and sexual function. There was no change in the
      employment status of most patients. The extent of improvement in overall quality
      of life may be a function of the baseline level of impairment and the potential
      for reversal. However, baseline capabilities at rest may not be appropriate for
      physiologic studies.

PMID- 1626553
TI  - Epoetin and cognitive function.
AB  - The uremia of chronic renal failure (CRF) can alter brain electrophysiology and
      cognitive function, even in the well-dialyzed patient. The effect of uremia on
      brain function can be assessed by electrophysiologic techniques such as
      electroencephalogram (EEG), sensory-evoked potentials (EPs), and cognitive event
      related potentials (ERPs), and through a series of neuropsychologic tests. Five
      tests have been used clinically to measure the speed and efficiency of cognitive
      functioning and include the following: Number Cancellation, Trailmaking Test,
      Symbol Digit Modalities Test, Rey Auditory Verbal Learning Test, and Controlled
      Oral Word Association Test. Test performance by patients with CRF is often below
      that of healthy controls. Auditory ERPs, a sensitive indicator of subtle changes
      in central nervous system (CNS) function in uremia, result in the generation of a
      P300 component wave that varies in amplitude and latency with patient variables
      such as attention and effort. Although dialysis tends to normalize P300
      latencies, the waves remain somewhat prolonged in most patients. The anemia often
      observed in patients receiving chronic dialysis appears to aggravate uremic
      encephalopathy. This effect can be reversed when anemia is corrected following
      administration of recombinant human erythropoietin (epoetin). Improvement in P300
      amplitudes, and, in some cases, decreases in P300 latencies correlated well with
      epoetin-induced increases in hematocrit levels. With the correction of anemia,
      that component of brain dysfunction not attributable to retention of uremic
      toxins can largely be reversed.

PMID- 1626554
TI  - The end-stage renal disease program: trends over the past 18 years.
AB  - Data from the Michigan Kidney Registry and the US Renal Data System (USRDS) show
      that the number of patients receiving treatment for end-stage renal disease
      (ESRD) increased sevenfold following the introduction of Medicare coverage for
      ESRD in 1973. The number of new patients added per year has also increased
      dramatically--approximately fourfold. Initial selection criteria for acceptance
      into the ESRD Program included age less than 65 years and absence of systemic
      diseases such as diabetes. During the past 18 years, the gradual acceptance of
      older patients and of diabetic patients has led to an increase in the median age
      of new patients from 46 to 61 years and a 12-fold increase in the incidence of
      treatment in patients with ESRD due to diabetes. Given the broad acceptance of
      sicker and older patients, withdrawal from dialysis has become a consideration
      when dialysis no longer benefits the patient. Treatment modalities have also
      changed, and increasing numbers of patients undergo successful renal
      transplantation or receive continuous ambulatory peritoneal dialysis (CAPD).
      During the 1980s, hemodialysis treatment times and dialysis staffs decreased;
      however, several improvements in the care of patients on dialysis occurred during
      this period.

PMID- 1626555
TI  - Impact of reimbursement regulations on patient management.
AB  - The Medicare End-Stage Renal Disease (ESRD) Program has saved the lives of
      thousands of patients with chronic renal failure; however, the absolute cost of
      the program has steadily increased since its inception in 1972 and quickly
      exceeded all budget estimates, although the actual cost per patient has increased
      only 69%, which is less than half the inflation rate. Cost-containment efforts
      have resulted in progressive reductions in reimbursement provided by Medicare to
      both physicians and dialysis centers. The reimbursement amount per dialysis
      treatment--the largest component of ESRD expenditures--has actually decreased
      from $138 in 1974 to approximately $54 in 1991 when measured in constant dollars.
      It is likely that these reimbursement restrictions have negatively impacted the
      level of patient care; both mortality and morbidity rates in patients receiving
      chronic dialysis are increasing in the United States. This is a significant cause
      for concern, particularly as the mortality rates in other industrialized
      countries began much lower than the US rate and have continued to decline despite
      adding older and presumably sicker patients. Although the mortality rate may be
      affected by factors such as broader patient acceptance criteria, particularly the
      inclusion of older patients and those with serious comorbid conditions, and by an
      increase in transplantation rates, there is concern that a trend toward shorter
      dialysis times may, perhaps, result in inadequate dialysis treatment.

PMID- 1626556
TI  - Hereditary amyloidosis and cardiomyopathy.

PMID- 1626557
TI  - Hepatotoxicity associated with sustained-release niacin.
AB  - Niacin (nicotinic acid) is a widely used agent in the treatment of
      hyperlipidemias characterized by elevated low-density lipoprotein and very-low
      density lipoprotein. The tendency of the conventional crystalline niacin to cause
      flushing has limited its use in many patients. Sustained-release (SR) niacin
      preparations are increasingly utilized due to a lower incidence of flushing and
      convenient dosing frequency. Although gastrointestinal and hepatotoxic side
      effects are common to both formulations, they are more frequent and occasionally
      more severe with the SR preparations. We describe a patient who developed an
      acute illness characterized by hypothermia, hypotension, metabolic acidosis, and
      severe hepatic dysfunction 2 days after substitution of an SR preparation for a
      previously well-tolerated crystalline niacin.

PMID- 1626558
TI  - Purulent tuberculous pericarditis with cardiac tamponade.

PMID- 1626559
TI  - Gas-forming soft tissue abscess caused by Streptococcus pneumoniae.

PMID- 1626560
TI  - Effective treatment of cerebral toxoplasmosis with doxycycline.

PMID- 1626561
TI  - Angiotensin-converting enzyme inhibitors and lithium toxicity.

PMID- 1626562
TI  - Direct fine needle aspiration cytology.

PMID- 1626563
TI  - Clinical characteristics and pathophysiology of erythromelalgia and
      erythermalgia.

PMID- 1626564
TI  - Autoimmune diseases, IgA deficiency, and intravenous immunoglobulin treatment.

PMID- 1626565
TI  - Interferon for mixed cryoglobulinemia associated with hepatitis C.

PMID- 1626566
TI  - Use of ice-water bag to obtain dive reflex.

PMID- 1626567
TI  - Parity and incidence of non-insulin-dependent diabetes mellitus.
AB  - PURPOSE: To examine prospectively the association between parity and subsequent
      incidence of non-insulin-dependent diabetes mellitus (NIDDM). Most previous
      studies have not controlled for potential confounding by age and obesity.
      PATIENTS AND METHODS: In a prospective cohort study, 113,606 United States
      registered nurses aged 30 to 55 years and free of diagnosed diabetes, coronary
      heart disease, stroke, and cancer at baseline were followed for 12 years.
      Endpoint was incidence of confirmed NIDDM. RESULTS: During 1,278,188 person-years
      of follow-up, we confirmed 2,310 incident cases of NIDDM. An apparent association
      between parity and diabetes was observed in unadjusted analyses (relative risk =
      1.56 [95% confidence interval (CI), 1.27 to 1.91] among women with six or more
      births compared with that in nulliparous women) (p, trend less than 0.00001).
      This association was attenuated after adjustment for age (relative risk = 1.19
      [CI 0.97 to 1.48], p, trend = 0.06) and was completely abolished after adjustment
      for both age and body mass index (relative risk = 0.95 [CI 0.75 to 1.19], p,
      trend = 0.19). Multivariate adjustment for family history of diabetes, age at
      first birth, hormone use, and other variables did not materially alter these
      findings. There was no important modifying effect of family history of diabetes
      on these associations. CONCLUSIONS: Despite a temporary diabetogenic effect of
      pregnancy, parity is not associated with an increased risk of subsequent clinical
      NIDDM. These data underscore the importance of control for confounding by age and
      obesity in evaluating these associations.

PMID- 1626568
TI  - Preoperative evaluation for diabetic renal transplantation: impact of clinical,
      laboratory, and echocardiographic parameters on patient and allograft survival.
AB  - OBJECTIVE: To assess the impact on renal transplant patients and graft survival
      of clinical, laboratory, and echocardiographic parameters commonly measured prior
      to surgery. PATIENTS: Forty-seven consecutive diabetics with preoperative
      echocardiograms at the time of transplantation. METHODS: Clinical history,
      standard chest roentgenogram, electrocardiogram, blood tests, echocardiograms,
      and HLA testing at baseline; follow-up from 2 to 7 years with periodic
      reassessment of graft function. RESULTS: Patient survival did not appear to be
      influenced by age, sex, or type of allograft. A history of either myocardial
      infarction, congestive heart failure, or angina was present in 15 patients with 3
      year survival of 50% (72% if not present, p less than 0.05). Histocompatibility
      testing did not impact on survival. Serum sodium, potassium, calcium, phosphate,
      and calcium-phosphate product did not discern different survival groups. A
      hematocrit greater than 30% was present in 15 patients with 3-year survival of
      43% (73% if not present, p less than 0.05). Greater than 10% antibody
      sensitization of the recipient resulted in a 3-year survival of 38% in eight
      patients (68% if not present, p less than 0.05). Radiologic evidence of
      cardiomegaly or congestive heart failure and standard electrocardiographic
      evidence for left ventricular hypertrophy or strain did not impact on survival.
      Echocardiographic measurements of left ventricular end-diastolic diameter,
      posterior wall thickness, or ejection fraction were also not predictive.
      Increased end-systolic diameter (10 patients, 30% 3-year survival versus 69%, p
      less than 0.05) and decreased velocity of circumferential fiber shortening (11
      patients, 45% 3-year survival versus 71%, p less than 0.05) both appeared to be
      related to survival. Increased accuracy of prediction could be obtained by adding
      risk factors so that a history of coronary artery disease and increased end
      systolic diameter predicted 3-year survival of 42% versus 82% if neither was
      present. In terms of graft survival, no clinical, radiographic, or
      electrocardiographic result yielded predictive information. Among the laboratory
      tests, only highly antibody-sensitized patients (eight patients, 0% 3-year
      survival versus 66% 3-year survival, p less than 0.001) showed different survival
      patterns. Echocardiographic elevated end-systolic diameter predicted a
      significantly (p less than 0.001) decreased graft survival (3-year survival 33%
      versus 63%). CONCLUSION: Preoperative prediction of patient and graft survival in
      diabetic renal transplantation may be enhanced by echocardiographic assessment of
      systolic load and function. For patients with normal systolic function, whose
      hematocrit is below 30%, with preformed antibodies less than 10%, renal
      transplantation has an excellent prognosis; invasive cardiac procedures are not
      likely required. Since these risk factors are likely additive, a high-risk group
      may be identified. These latter patients should undergo coronary angiography.

PMID- 1626569
TI  - Nonresolving pneumonia in steroid-treated patients with obstructive lung disease.
AB  - PURPOSE: To review autopsy-proven cases of opportunistic pneumonia and determine
      how many of these patients had received corticosteroid therapy for obstructive
      lung disease in order to define whether this therapy was the major risk factor
      predisposing to infection. PATIENTS AND METHODS: All autopsies performed at
      Winthrop-University Hospital over a 5-year period were reviewed, and 30 cases of
      opportunistic pneumonia were identified. In eight of 30 cases, corticosteroid
      therapy for chronic obstructive pulmonary disease (COPD) was the only
      identifiable risk factor for opportunistic infection. The other 22 patients had
      other well-defined risk factors for infection. Chart review of the eight patients
      with COPD was undertaken to define the clinical features of their infections.
      RESULTS: All eight patients had a progressive multilobar pneumonia that failed to
      resolve, either clinically or radiographically, despite the use of multiple broad
      spectrum antibiotics. In four cases, the infection was community-acquired, while
      in the other four cases, it was nosocomial in origin. Despite the presence of a
      nonresolving pneumonia, opportunistic infection was generally not considered as a
      diagnostic possibility, with only one case being correctly diagnosed antemortem.
      Autopsy examination documented Aspergillus species as being responsible for six
      episodes of pneumonia, Candida albicans accounting for one episode, and
      cytomegalovirus accounting for one episode. CONCLUSION: Based on this experience,
      it is clear that corticosteroid therapy of COPD can lead to opportunistic
      pulmonary infection, in or out of the hospital. This diagnosis should be
      considered when patients receiving this therapy develop a pneumonia that fails to
      respond to broad-spectrum antibiotics.

PMID- 1626571
TI  - Peritoneal dialysis in end-stage renal disease patients with preexisting chronic
      liver disease and ascites.
AB  - PURPOSE: Hemodialysis in patients with chronic liver disease and ascites may be
      complicated by intradialytic hypotension, limiting the amount of ultrafiltration
      and resulting in massive ascites. Successful maintenance peritoneal dialysis (PD)
      has not been previously reported as an alternative to hemodialysis in this
      population. PATIENTS AND METHODS: Nine patients with chronic renal failure,
      chronic liver disease, and tense ascites prior to beginning PD are described. All
      chronic PD catheters were placed percutaneously by the nephrology staff. Seven
      patients were maintained primarily on continuous ambulatory peritoneal dialysis,
      whereas two were on intermittent peritoneal dialysis. RESULTS: PD catheters were
      placed without serious hemorrhage or bowel injury. PD provided adequate clearance
      and volume maintenance for each patient. Fifteen episodes of peritonitis occurred
      in 18 patient-years of PD. All episodes of peritonitis were successfully treated
      with intraperitoneal antibiotics without catheter removal. Only one patient had a
      decline in the serum albumin level of 0.5 g/dL or more during the course of
      chronic PD. Three of the nine patients are still alive and on PD for durations of
      18 to 24 months. One patient insidiously developed sclerosing peritonitis after 8
      years on PD and is now on hemodialysis, and another patient switched to
      hemodialysis because she was no longer able to care for herself or to manage her
      PD. Four patients died while maintained on PD; three deaths were due to
      complications of liver failure within the first 4 months of PD and the fourth was
      due to empyema after 4 years of PD. CONCLUSION: PD can be used successfully to
      treat chronic renal failure in patients with chronic liver disease and ascites
      when the liver disease itself is not rapidly fatal. PD may be better tolerated
      than hemodialysis and perhaps should be the renal replacement treatment of choice
      in these patients.

PMID- 1626570
TI  - A Danish kindred with familial amyloid cardiomyopathy revisited: identification
      of a mutant transthyretin-methionine111 variant in serum from patients and
      carriers.
AB  - PURPOSE: In familial amyloid cardiomyopathy of Danish origin, the amyloid
      microfibrils contain a mutant transthyretin (TTR) with a methionine-for-leucine
      substitution at the molecular position 111. We studied the possible occurrence of
      this variant TTR-Met111 in serum from afflicted as well as nonafflicted family
      members and their offspring, in order to define its possible role as predictor of
      the disease and to describe its mode of inheritance. PATIENTS AND METHODS:
      Stored, frozen serum samples obtained from 1959 through 1960 from 36 of 40 living
      members of the kindred were analyzed. The method employed to detect the abnormal
      TTR was based on the electrophoretic separation of fragments produced by cyanogen
      bromide cleavage at the two methionine sites. RESULTS: All sera from family
      members with amyloid cardiomyopathy contained the variant transthyretin TTR
      Met111 as did sera from half of their offspring. In contrast, nonafflicted family
      members and their offspring were seronegative for TTR-Met111. Three cousins from
      the second generation died between 1980 and 1986 of amyloid cardiomyopathy. The
      presence of variant TTR-Met111 preceded their deaths by 20 to 26 years.
      CONCLUSIONS: The occurrence in serum of the mutant transthyretin TTR-Met111 is
      linked to the occurrence of amyloid cardiomyopathy in patients and their
      offspring, while unafflicted branches of the family are negative for the variant
      protein. That the occurrence in serum of TTR-Met111 precedes the onset of
      clinical amyloid cardiomyopathy by several decades makes the variant TTR a marker
      for the disease. The distribution of afflicted family members and seropositivity
      for the variant TTR shows an autosomal dominant mode of inheritance. CLINICAL
      SIGNIFICANCE: The results make possible early detection of potential patients and
      provide tools for genetic counseling. Cardiac transplantation may provide a new
      therapeutic option.

PMID- 1626572
TI  - Very low doses of GM-CSF administered alone or with erythropoietin in aplastic
      anemia.
AB  - PURPOSE AND RATIONALE: There has been no previously published experience with
      granulocyte-macrophage colony-stimulating factor (GM-CSF) at doses less than 15
      micrograms/m2/d in patients with aplastic anemia, and most observations have been
      made at doses of 100 to 500 micrograms/m2/d (2.5 to 12.5 micrograms/kg/d). The
      benefits of using considerably lower doses, if effective, should include a
      decrease in cost and in side effects. We have therefore used very low doses of GM
      CSF to treat a group of patients with aplastic anemia. Additionally, since severe
      anemia is often a problem in these patients, we recently started administering
      erythropoietin along with the GM-CSF. Herein we report the results of very-low
      dose GM-CSF therapy in patients with aplastic anemia and our preliminary findings
      in those individuals who received combination therapy. PATIENTS AND METHODS: We
      administered recombinant human GM-CSF subcutaneously at doses of 5 to 20
      micrograms/m2/d ("very-low-dose GM-CSF") to 12 patients with aplastic anemia. In
      addition, a 13th patient received erythropoietin together with the GM-CSF
      regimen, and three of the 12 individuals who initially received 1 or more months
      of GM-CSF alone were later also given erythropoietin (4,000 U/d subcutaneously).
      RESULTS: In five of 12 patients (42%) treated with very-low-dose GM-CSF, an
      increase in neutrophil counts (2.0- to 6.7-fold) was noted, and one of these
      subjects attained a bilineage response (neutrophil counts, 0.3 to 1.75 x 10(9)/L;
      platelet counts, 8 to 169 x 10(9)/L). Moreover, a sixth patient showed a rise in
      platelet counts (19 to 80 x 10(9)/L) without a concomitant increase in
      neutrophils. Constitutional side effects were minimal. Combining erythropoietin
      and very-low-dose GM-CSF produced a bilineage response (neutrophils, 1.0 to 3.0 x
      10(9)/L; hemoglobin, 7.4 to 9.4 g/dL) in the one patient who received
      erythropoietin together with the GM-CSF from the time that GM-CSF was initiated.
      In one of the other patients who were given combination therapy, the addition of
      erythropoietin appeared to enhance the response; this patient demonstrated a
      neutrophil response to GM-CSF alone and a trilineage response (neutrophils, 0.8
      to 3.75 x 10(9)/L; hemoglobin, 7.0 to 13.1 g/dL; and platelets, 10 to 34 x
      10(9)/L) to the combination. No toxicity was associated with the addition of
      erythropoietin. CONCLUSIONS: Our observations suggest that (1) very low doses of
      GM-CSF (5 to 20 micrograms/m2/d subcutaneously) may be used initially in
      neutropenic patients with aplastic anemia, and the dose subsequently increased
      only in patients who do not respond; and (2) the administration of erythropoietin
      together with GM-CSF is well tolerated, can augment responsiveness in some
      patients, and deserves further study.

PMID- 1626573
TI  - Diagnosis and treatment of outpatient insomnia by psychiatric and nonpsychiatric
      physicians.
AB  - Insomnia is commonly encountered in general medical practice, but little is known
      about how primary care physicians manage this problem. We reviewed medical
      records describing 536 patient encounters in which either triazolam (Halcion) or
      flurazepam (Dalmane) was prescribed for outpatient use. Only 12% of the progress
      notes written by internists or surgeons contained even a remote reference to
      sleep, whereas 74% of psychiatrist's notes contained at least some sleep symptom
      documentation. In a multivariate analysis including the number of medical and
      psychiatric diagnoses, patient age, and physician gender, only the prescriber
      department was independently associated with the presence of symptom
      documentation. We also found that 30% of the prescriptions written by internists
      or surgeons were for inappropriately large quantities of these drugs (180 or more
      doses) compared with 6% of the prescriptions written by psychiatrists. We
      conclude that the evaluation of insomnia by nonpsychiatrists is often incomplete
      and that hypnotic drugs may be inappropriately prescribed by these physicians.
      Further efforts are needed to improve the management of insomnia by primary care
      physicians in the outpatient setting.

PMID- 1626574
TI  - Tapping the child's perspective.

PMID- 1626575
TI  - Cirrhosis in a 66-year-old woman.

PMID- 1626576
TI  - Prevalence of neurosyphilis in human immunodeficiency virus-infected patients
      with latent syphilis.
AB  - PURPOSE: A prospective study was done to determine the prevalence of confirmed
      neurosyphilis (cerebrospinal fluid [CSF] Venereal Disease Research Laboratory
      [VDRL]-reactive) in human immunodeficiency virus (HIV)-infected patients with
      latent syphilis (reactive serum rapid plasma reagin [RPR] and
      microhemagglutination-Treponema pallidum [MHA-TP]). PATIENTS AND METHODS: All HIV
      infected patients seen for their first visit at the Los Angeles County/University
      of Southern California Medical Center AIDS Clinic from June through December 1990
      were screened for latent syphilis. Those with reactive serum RPRs and MHA-TPs who
      had not received recent (within 6 months) therapy for syphilis were offered
      diagnostic CSF sampling. RESULTS: A total of 312 patients were screened, of whom
      71 (22.8%) had reactive serum RPRs and MHA-TPs. Thirty-three of these patients
      (47%) had diagnostic CSF sampling (26 refused lumbar puncture or were lost to
      follow-up; 12 had had recent therapy for syphilis and thus did not have CSF
      sampling). Among the 33 patients who had CSF sampling, 20 (60.6%) had normal CSF
      profiles (white blood cell count less than 8/mm3; protein less than 0.60 g/L;
      glucose greater than 2.8 mmol/L) and nonreactive CSF VDRLs. Ten of the 33
      patients (30.3%) had abnormal CSF profiles and nonreactive CSF VDRLs, and three
      of 33 (9.1%) had reactive CSF VDRLs. CONCLUSIONS: Asymptomatic neurosyphilis was
      found in 9.1% of our patient population undergoing CSF sampling, giving a 1.0%
      prevalence of CSF VDRL-reactive neurosyphilis in the population we screened. The
      abnormal CSF findings may have been due to either nonreactive CSF VDRL
      neurosyphilis, central nervous system infection with HIV, or infection with some
      unrecognized agent.

PMID- 1626577
TI  - Subacute bacterial endocarditis secondary to Streptococcus pneumoniae.
AB  - Pneumococcal endocarditis characteristically presents as an acute illness, often
      accompanied by purulent meningitis, rapid destruction of the heart valves,
      congestive heart failure, and high mortality. We describe two patients with
      subacute pneumococcal endocarditis without a known primary source of pneumococcal
      bacteremia, fever, meningitis, or congestive heart failure. Both patients were
      cured with medical therapy. Pneumococcal endocarditis can present as an indolent
      illness resembling viridans streptococcal endocarditis.

PMID- 1626578
TI  - Severe hepatotoxicity in a patient receiving both acetaminophen and zidovudine.
AB  - We report the development of severe hepatotoxicity in a patient on zidovudine
      therapy who received 3.3 g of acetaminophen in less than 36 hours. Three days
      later, the patient's serum aspartate aminotransferase level was 5,724 U/L,
      alanine aminotransferase was 3,124 U/L, lactate dehydrogenase was 12,675 U/L,
      alkaline phosphatase was 84 U/L, and total bilirubin was 20 mumol/L. These values
      substantially improved over the ensuing 4 days. Serologic results for hepatitis
      B, hepatitis A, and cytomegalovirus were all negative. The pattern and time
      sequence of transaminase elevation in this patient are consistent with acute
      acetaminophen hepatotoxicity, especially since zidovudine-induced hepatotoxicity
      is described as producing cholestasis rather than acute hepatitis. We hypothesize
      that our patient's susceptibility to acetaminophen-dependent hepatotoxicity may
      have been augmented by competitive utilization of glucuronidation by other drugs
      such as zidovudine and/or trimethoprim-sulfamethoxazole with subsequent increased
      cytochrome P450-dependent metabolism of acetaminophen. Additionally, due to
      malnutrition and/or to human immunodeficiency virus infection per se, our patient
      may have had decreased hepatic reserves of glutathione with which to conjugate
      the toxic acetaminophen product of the P450 system. Although severe acetaminophen
      associated hepatotoxicity has not previously been reported in patients receiving
      zidovudine, we suggest that clinicians be aware of this potential interaction and
      counsel malnourished patients, especially those with concomitant hepatic disease,
      to exercise caution when taking both these medications.

PMID- 1626579
TI  - Diagnosis and treatment of granulomatous mastitis.
AB  - Granulomatous mastitis is a benign inflammatory breast disease of unknown
      etiology. Although it is rare, it frequently presents in a manner similar to that
      of breast carcinoma. Surgical resection of the affected tissue has often been the
      method of treatment, but many patients have experienced recurrences.
      Corticosteroids have also been used, but the initiation of this therapy is often
      limited by concerns related to the presence of an infectious etiology. Presented
      here are two cases that demonstrate the efficacy of corticosteroids in this
      condition after appropriate evaluation is performed.

PMID- 1626580
TI  - Summer frustrations.

PMID- 1626581
TI  - One bias at a time.

PMID- 1626582
TI  - Do they really understand us?

PMID- 1626583
TI  - The muddy waters of clinical teaching.

PMID- 1626584
TI  - Rescue operations for snakebite.

PMID- 1626586
TI  - Slimefighters!

PMID- 1626585
TI  - Corralling atrial fibrillation with 'maze' surgery.

PMID- 1626587
TI  - What do you say when you delegate work to others?

PMID- 1626588
TI  - How to predict and prevent pressure ulcers.

PMID- 1626589
TI  - Making a critical difference.

PMID- 1626590
TI  - Backlash signs and symptoms.

PMID- 1626591
TI  - The fifth sound.

PMID- 1626592
TI  - An HIV-infected pharmacist.

PMID- 1626593
TI  - The psychoanalysis of an adult survivor of incest: a case study.

PMID- 1626594
TI  - A case report: Part II.

PMID- 1626595
TI  - Updike: fiction and the writer's access to contradictory ego states.

PMID- 1626596
TI  - Don Pasquale, Fidelio, and psychiatry.
AB  - Donizetti's Don Pasquale and Beethoven's Fidelio are discussed in order to
      illustrate how two very different operas can illustrate the human quest for
      authenticity. Through their music and dramatic presentation they are able to
      convey experiential insights into profound philosophic and psychologic truths.
      Along with other experiential communications, such as myths, folklore, poetry,
      humor, and art, they can be especially helpful--not only but also--in
      psychotherapy, in providing access to potentials that ordinarily are sealed off,
      in enhancing the awareness of inauthentic attitudes, in facilitating the
      acceptance of seemingly paradoxical aspects of human existence, and in providing
      a deeper sense for life's meaningfulness. Music is invaluable in opening our soul
      to the story's thoughts, feelings, and commitments.

PMID- 1626597
TI  - On Freud's admiration for Beethoven and his "splendid creations".

PMID- 1626598
TI  - Direct interpretation of dreams: some basic principles and technical rules.

PMID- 1626599
TI  - Different perspectives of inventory management among physicians and hospital
      administrators.

PMID- 1626600
TI  - Colorectal carcinoma associated with ulcerative colitis: a study of prognostic
      indicators.
AB  - Fifty-two patients with ulcerative colitis and colorectal cancer undergoing
      colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied
      retrospectively to determine the correlation of age, sex, duration of colitis,
      tumor location, number of cancers, tumor differentiation, colloid content,
      presence of signet ring cells, Dukes' classification, and DNA ploidy with
      survival. The mean age was 45 years, with a mean duration of colitis of 21 years.
      Five patients (10%) had Dukes' A lesions, 17 (33%) had Dukes' B lesions, 17 (33%)
      had Dukes' C lesions, and 13 (25%) had distant metastases. Thirty patients (58%)
      had well- or moderately differentiated tumors, whereas tumors were poorly
      differentiated in 22 (42%). Twenty-eight patients (54%) had colloid tumors, and,
      in 14 (27%), signet ring cells were present. Thirty-one patients (60%) had
      nondiploid tumors. Actuarial analysis revealed that the 5-year survival rate was
      significantly worse for patients with nondiploid tumors (76% versus 32%). When
      stratified by stage, only patients with Dukes' C lesions showed a significant
      difference in survival for diploid versus nondiploid tumors. Multivariate
      analysis showed that the Dukes' classification was the best prognostic indicator,
      followed by tumor differentiation and DNA ploidy. Tumor location, colloid
      content, number of cancers, duration of disease, age, and sex did not correlate
      with the prognosis.

PMID- 1626601
TI  - Surgery for recurrent rectal adenocarcinoma in the presence of hydronephrosis.
AB  - From January 1974 to December 1989, 16 patients with locally recurrent rectal
      adenocarcinoma and hydronephrosis underwent exploratory celiotomy with curative
      intent. There were eight males and eight females. The median age was 61 years.
      Primary rectal adenocarcinomas were treated with abdominoperineal resection in 12
      patients and low anterior resection in 4 patients. Four patients underwent
      adjuvant radiotherapy, one patient adjuvant chemotherapy, and one patient
      combination therapy. The median disease-free interval between resection of the
      primary tumor and recurrence was 18 months. Hydronephrosis was unilateral in
      seven patients (44%), and bilateral in nine patients (56%). Preoperative
      evaluation indicated that all 16 patients had local pelvic-perineal recurrence or
      pelvic recurrence alone. Resection was not possible in any of these 16 patients
      for the following reasons: 5 patients (31%) had pelvic sidewall involvement and
      carcinomatosis; 3 patients (19%) pelvic sidewall involvement alone; 2 patients
      (13%) pelvic sidewall involvement and sacral fixation; and 2 patients (13%) had
      sacral fixation alone. In the remaining four patients, there was pelvic sidewall
      involvement by tumor and/or synchronous hepatic metastases, carcinomatosis, or
      sacral fixation. The median survival after exploratory celiotomy was 8 months in
      the 16 patients who died of their disease. Unilateral and bilateral
      hydronephrosis appears to be a contraindication for potentially curative surgical
      resection in recurrent rectal adenocarcinoma.

PMID- 1626602
TI  - Reevaluation of current transfusion practices in patients in surgical intensive
      care units.
AB  - Widespread interest in the complications associated with packed red blood cell
      (PRBC) transfusions has led to the scrutiny of traditional transfusion practices.
      Recently, attempts have been made to define more clearly the indications for PRBC
      transfusions in patients, particularly those who are critically ill. At present,
      however, transfusions continue to be ordered based on a hemoglobin level less
      than 10 g/dL. We report herein the impact on oxygen consumption of PRBC
      transfusions administered for a hemoglobin concentration less than 10 g/dL in 30
      surgical intensive care unit patients who were euvolemic and hemodynamically
      stable. For the group as a whole, transfusion had a negligible effect on oxygen
      consumption. Fifty-eight percent of all such transfusions failed to change oxygen
      consumption by greater than 10% and could therefore be considered of questionable
      benefit.

PMID- 1626603
TI  - Predictability of clinicobiochemical scoring systems for early identification of
      severe gallstone-associated pancreatitis.
AB  - Early identification of severe gallstone-associated acute pancreatitis (GAAP) is
      a prerequisite for treatment with urgent endoscopic sphincterotomy. This study
      assesses the value of two clinicobiochemical scoring systems to this end. Over
      the 7-year period from 1983 to 1989, 100 consecutive patients with acute
      pancreatitis (45 related to gallstones, 36 to alcohol, and 19 of undetermined
      etiologies) had clinicobiochemical analysis within 48 hours of admission. The
      final diagnosis and outcome were retrospectively compared with the prediction
      achieved by the scoring systems. With regard to Blamey's criteria for early
      identification of gallstones, significant differences were found between the
      biliary and nonbiliary groups with respect to female sex, serum amylase
      concentration greater than or equal to 4,000 IU/L, alkaline phosphatase level
      greater than or equal to 300 IU/L, and alanine aminotransferase level greater
      than or equal to 100 IU/L (all p values less than 0.001). Age greater than or
      equal to 50 years was found to be significant (p less than 0.02) only in
      differentiating gallstone- versus alcohol-associated acute pancreatitis. When
      three or more positive factors were present, the sensitivity and specificity for
      predicting gallstones were 60% and 87%, respectively; the predictive value of a
      positive result was 79%, of a negative result 74%, and the overall accuracy was
      75%. At a cutoff level of five, rather than three or more prognostic factors, the
      modified Ranson's criteria for patients known as having GAAP allowed a suitable
      discrimination of patients with an expected high risk of complications and
      mortality. When the two scoring systems (Blamey greater than or equal to 3 and
      Ranson greater than or equal to 3) were combined, 17 patients were predicted as
      having severe GAAP: 6 of these 17 patients were misdiagnosed as having biliary
      pancreatitis, whereas 9 patients with definite severe GAAP were not selected
      because of a Blamey score less than 3. More specific diagnostic tools are needed,
      and higher cutoff levels for prognostic scores are required for the prediction of
      severe GAAP, particularly in view of selecting patients for potentially dangerous
      approaches such as urgent endoscopic sphincterotomy.

PMID- 1626604
TI  - Diagnosis and management of 17 consecutive patients with inflammatory abdominal
      aortic aneurysm.
AB  - This report reviews the authors' experience in diagnosing and managing 17
      consecutive patients with inflammatory abdominal aortic aneurysm (AAA). Among 491
      patients undergoing repair for AAA during a 10-year period, 17 (3%) had evidence
      of associated periaortic fibrosis, which was confirmed histologically. No patient
      had acute rupture, and two patients (12%) had chronic contained rupture. Ureteral
      obstruction was evident in seven patients. In 41% of the patients, available
      surgical correlation demonstrated that computed tomographic (CT) scan accurately
      delineated the extent of the disease. Sixteen patients underwent aneurysm
      resection. Ureteral obstruction was relieved by ureterolysis in three patients
      treated early in this series. In the last period of the study, well-documented
      hydronephrosis spontaneously subsided in two patients without special treatment.
      Of these 17 patients, 15 (88%) were early (30-day) survivors. There were two late
      deaths at 2 months and 5 years; 12 (71%) patients are still alive and free of
      symptoms up to 10 years after operation. On the basis of our study, we conclude
      the following: (1) precise preoperative diagnosis and detailed anatomic
      information are widely available with CT; (2) aneurysm resection is the treatment
      of choice because the risk of rupture still exists, and this procedure seems to
      reverse the inflammatory process; (3) good early and late results can be expected
      with proper surgical technique; and (4) routine follow-up with CT is recommended
      to document resolution or progression of the fibrotic process after aneurysm
      resection.

PMID- 1626605
TI  - Twelve-year follow-up of a prospective, randomized trial of selective vagotomy
      with pyloroplasty and selective proximal vagotomy with and without pyloroplasty
      for the treatment of duodenal, pyloric, and prepyloric ulcers.
AB  - Between 1973 and 1981, 161 patients with prepyloric, pyloric, or duodenal ulcers
      were randomly allocated to selective vagotomy with pyloroplasty, selective
      proximal vagotomy with pyloroplasty, or selective proximal vagotomy alone. No
      significant differences in clinical results were found 3 years after surgery by
      Emas and Fernstrom (Am J Surg 1985; 149: 236-42). There was one postoperative
      death, and one patient lost to follow-up. Of 159 patients, 52 underwent selective
      vagotomy with pyloroplasty, 55 selective proximal vagotomy with pyloroplasty, and
      52 selective proximal vagotomy alone. Fifteen patients did not undergo endoscopy,
      but they had no epigastric complaints. From 1 to 16 years after surgery,
      recurrent ulcer was detected in 13%, 18%, and 23%, respectively, after selective
      vagotomy with pyloroplasty, selective proximal vagotomy with pyloroplasty, or
      selective proximal vagotomy without pyloroplasty. Twenty-eight percent of the
      patients with recurrent ulcer had no symptoms and received no treatment. Sixteen
      patients died within 8 years after surgery of causes unrelated to the ulcer
      disease. At their final examination, 14 of the 16 patients had Visick I or II
      (modified Visick scale) results, and the disease that caused their deaths
      obscured evaluation in 2 patients. The remaining 143 patients were followed up
      for 8 to 16 years (average: 12 years). Epigastric pain with or without ulcer was
      recorded more often (significant) after selective proximal vagotomy alone (40%)
      than after selective vagotomy with pyloroplasty (17%) or selective proximal
      vagotomy with pyloroplasty (14%). Bowel habits were unchanged in 96% of patients
      who underwent selective vagotomy with pyloroplasty or selective proximal vagotomy
      with pyloroplasty and 100% of patients who had selective proximal vagotomy alone.
      Mild dumping tended to be more common after vagotomy with pyloroplasty but was a
      minor nuisance in only a few patients. Very good or good results (Visick I or II)
      were recorded in 75% of the patients after selective vagotomy with pyloroplasty
      or selective proximal vagotomy with pyloroplasty or selective proximal vagotomy
      with pyloroplasty and in 54% after selective proximal vagotomy alone (significant
      difference). Seventeen patients underwent reoperation with antrectomy and
      gastrojejunostomy Roux-en-Y (13 patients) or gastroduodenostomy (4 patients) with
      no mortality. The results of the reoperations were graded as Visick I or II
      results in all but one patient. The final grading, including the reoperations,
      were Visick I or II in 85% of patients after selective vagotomy with pyloroplasty
      and selective proximal vagotomy with pyloroplasty and in 55% after selective
      proximal vagotomy alone (significant difference).(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1626606
TI  - Absorption of Intralipid and interferences from nutrients infused into the
      peritoneal cavity of the rat.
AB  - We studied the peritoneal absorption and elimination of Intralipid after its
      intraperitoneal and intravenous infusion into rats, by means of a two-compartment
      model. Follow-up measurements of the plasma triglyceride rate were made. The
      peritoneal absorption of Intralipid gives the following absorption and
      elimination constants: Ka (absorption constant from the peritoneal cavity) is
      0.106 +/- 0.08 h-1; Ke (elimination constant from the blood stream) is 0.0440 +/-
      08 h-1; and BAa (absolute bioavailability) is 84.5 +/- 0.08% 8 hours after
      infusion. These results show that the intraperitoneal absorption of Intralipid is
      high and progressive during the first 8 hours, thus supplying the daily caloric
      needs of the animal through the administration of a single bolus administration,
      and the plasma triglyceride clearance is faster than the intraperitoneal
      absorption after the first 6 hours, thus avoiding dangerous overloads. We also
      studied the behavior of different combinations of glucose, amino acids, and fats
      infused into the peritoneal cavity of rats in order to observe possible
      interferences with the absorption of these nutrients. Two microcuries of
      radioactive L-glucose-1-C14 with 5 mL of 5% D-glucose, with 5 mL of 3.5% amino
      acid solution, or with 5 mL of 20% fat emulsion were infused intraperitoneally
      into three different groups of animals. Slight differences of plasma
      radioactivity were registered among these three groups 1 hour after infusion.
      Likewise, small differences of plasma radioactivity were observed between the
      animals receiving an infusion of 1 microCi of five L-amino-acids-U-C14 diluted
      with 5 mL of 3.5% amino-acid solution, with 5 mL of 5% glucose solution, or with
      5 mL of 20% fat emulsion 4 and 6 hours after infusion. No differences in the
      plasma triglyceride rates were observed between those groups of animals infused
      with 5 mL of 20% Intralipid plus 5 mL of glucose solution or with 20% Intralipid
      plus 3.5% amino-acid solution compared with the group receiving only 5 mL of 20%
      Intralipid. The infusion of fats does not seem to interfere with that of other
      substrates, possibly because of the different absorption route (lymphatic for
      fats and capillary vessels for amino acids and glucose solutions), but further
      research is needed to reach conclusive results. Perhaps the prolonged
      administration of fat, together with other substrates, produces precipitates and
      other galenic problems that hinder absorptive mechanisms of the preparations.

PMID- 1626607
TI  - Use of color Doppler imaging in the distinction between thyroid and parathyroid
      lesions.
AB  - To determine whether the use of color Doppler imaging in conjunction with
      standard high-resolution 10-MHz ultrasound could increase the screening
      sensitivity in distinguishing between thyroid and parathyroid lesions in the
      detection of parathyroid disease, we studied 32 patients with hyperparathyroidism
      with both modalities who were subsequently treated surgically. Among these 32
      patients, parathyroid lesions were predominantly avascular (n = 21, average size
      0.9 x 0.6 cm) but with increased size demonstrated some vascularity (n = 9,
      average size 2.1 x 1 cm, 32%). Of these 32 patients, 46.6% had thyroid lesions as
      well. Thyroid lesions were avascular when small (n = 26 lesions, average size 0.5
      x 0.5 cm) but tended to demonstrate vascularity (n = 14, 35%) at about 1 cm in
      size or greater. Although the addition of color Doppler imaging enabled the
      differentiation of vessel from soft-tissue abnormalities and some distinction
      between parathyroid and thyroid lesions, it had no effect on overall sensitivity
      (65%) in the detection of parathyroid disease.

PMID- 1626608
TI  - Claviculectomy for the exposure and en bloc resection of adjacent tumors.
AB  - Claviculectomy has been described for primary or metastatic tumors of the
      clavicle. In 11 patients, claviculectomy was used as a technical expedient for
      the exposure and en bloc resection of large, underlying nodal metastases from
      melanoma (7 patients) and soft tissue tumors (4 patients). There were no wound
      complications. Three patients developed moderate edema of the arm. There was
      little limitation at the shoulder, and the use of the upper extremity has been
      essentially normal. Claviculectomy is well tolerated, provides good exposure of
      the underlying neurovascular structures, and, in some patients, provides a method
      of limb salvage for underlying tumors in preference to forequarter amputation.

PMID- 1626609
TI  - A technique for converting a needle-catheter jejunostomy into a standard
      jejunostomy.
AB  - The benefits of enteral nutrition for surgical patients have been well documented
      in the literature, and needle catheter jejunostomy is frequently used at initial
      surgical exploration. Occasionally, the need arises for prolonged use of the
      catheter, and problems occur with occlusion of the catheter. A simple technique
      is described for converting the needle-catheter jejunostomy into a standard
      feeding jejunostomy.

PMID- 1626610
TI  - Novel antibody drug products.
AB  - Recent developments in protein and genetic engineering methods have allowed the
      production of antibody-derived molecules that have important potential as
      therapeutic agents. Although monoclonal antibodies of murine origin have been
      used for therapeutic purposes, limitations due to anti-antibody responses and
      suboptimal effectiveness for some indications, such as tumor cell killing, have
      led to the development of human monoclonal antibodies, chimeric and
      complementarity determining-region grafted antibodies, immunotoxins, and other
      engineered products. These novel antibodies are being tested for the treatment
      and prevention of infectious diseases and for the diagnosis and treatment of
      cancers, as well as for indications considered nontraditional for antibodies
      (e.g., as antithrombotics or inhibitors of neutrophil adherence). The
      availability of antibody drug products raises a number of issues for clinicians.
      Among these are new patterns of adverse effects, immunogenicity (development of
      anti-antibody response), important questions regarding administration and dosage,
      and substantial cost implications.

PMID- 1626611
TI  - Drug therapy for inflammatory bowel disease: Part I.
AB  - In a two-part series, recent improvements in drug therapy for inflammatory bowel
      disease are reviewed. Part I summarizes aminosalicylates and corticosteroids. The
      active moiety of sulfasalazine, which is 5-aminosalicylic acid (mesalamine), in
      topical or oral form is as effective as sulfasalazine for treatment and
      prophylaxis of ulcerative colitis and is tolerated by 80% of sulfasalazine
      intolerant patients. Coated forms of mesalamine have a potential advantage in the
      treatment of Crohn's ileitis in that these forms do not require bacterial
      cleavage for activity. New rapidly metabolized corticosteroids (budesonide,
      tixocortol pivalate, beclomethasone dipropionate) in topical and oral forms are
      emerging as equivalent therapy to standard corticosteroids but are associated
      with less adrenal suppression.

PMID- 1626612
TI  - Management of mandibular fractures.

PMID- 1626613
TI  - A clinical approach to dysphagia.

PMID- 1626614
TI  - Prevention and management of intubation injury of the larynx and trachea.

PMID- 1626615
TI  - Infections of the external ear.

PMID- 1626616
TI  - Reconstructive alternatives following segmental mandibulectomy.

PMID- 1626617
TI  - c-myc oncogene copy number in squamous carcinoma of the head and neck.
AB  - PURPOSE: Altered resident cellular genetic sequences (oncogenes) may result in
      malignant transformation, maintenance of tumor growth, and metastatic propensity.
      In this pilot study, we have elected to probe c-myc oncogene in evaluating
      specimens from human squamous cell carcinoma. MATERIALS AND METHODS: Samples were
      obtained from 24 patients with squamous cell carcinoma of the head and neck. The
      ratio of tumor DNA values to that of control DNA was used to estimate the c-myc
      copy number. RESULTS: Data from material obtained from eight patients was
      analyzed to the point of c-myc copy number. Tumors varied from stage II through
      IV. Five originated in the oral cavity and three in the larynx. Analysis of
      primary tumors demonstrated that two of eight had increased c-myc copy numbers.
      Histologically positive neck specimens were encountered in five of the study
      patients. Three demonstrated elevated c-myc copy numbers, two of which had had
      increased copy number at the primary site. CONCLUSION: This study confirms that c
      myc amplification can be present in squamous cell carcinoma of the head and neck.
      c-myc Amplification may also be present in neck metastasis. Oncogene
      amplification in neck metastasis may indicate an increased metastatic propensity
      for individual tumor cells demonstrating c-myc amplification.

PMID- 1626618
TI  - The total reconstruction of the tympanic membrane by the "crowncork" technique.
AB  - PURPOSE: The "crowncork tympanoplasty" is a technique for the total
      reconstruction of the tympanic membrane. It is recommended in cases of ear
      malformation, blunting phenomena, and total deficiency of the membrane caused by
      chronic otitis media. PATIENTS AND METHODS: The records of 12 patients undergoing
      "crowncork tympanoplasty" were reviewed. This includes 5 patients who were
      operated on because of middle ear malformation, 6 cases with a blunting phenomena
      following prior tympanoplasty, and 1 patient with chronic otitis media. RESULTS:
      In each case an intact tympanic membrane was achieved. The air bone was reduced
      to 17, 19, 16, and 11 dB in the frequency 500, 1,000, 2,000, and 4,000 Hz.
      CONCLUSION: The use of cartilage for tympanoplasty has been useful despite the
      comparatively worse vibration characteristics of the rigid material. Total
      reconstruction of selected problem cases using this "crowncork technique" has
      resulted in good healing with favorable hearing results and should be
      incorporated into the routine of the skilled otosurgeon.

PMID- 1626619
TI  - alpha-Fluoromethylhistidine but not diphenhydramine prevents motion-induced
      emesis in the cat.
AB  - PURPOSE: This study seeks to evaluate the comparative role of alpha
      fluoromethylhistidine and diphenhydramine in the prevention of motion sickness.
      METHOD: The role of histaminergic mechanisms in motion sickness were evaluated in
      a feline model. Twenty-six female cats were studied. A variety of doses of
      fluoromethylhistidine and diphenhydramine were administered before motion
      testing. RESULTS: Fluoromethylhistidine was effective in preventing motion
      sickness. The efficacy was dose dependent. In contrast, diphenhydramine failed to
      prevent motion sickness in any of the tested doses. CONCLUSIONS: The failure of
      diphenhydramine to prevent motion sickness was unexpected. This may reflect the
      route of administration or the animal model studied. Depletion of histamine with
      fluoromethylhistidine prevented motion sickness in cats. Our results suggest that
      this drug may provide a very long duration of protection in cats.

PMID- 1626621
TI  - Genetics of the Rett syndrome.
AB  - The current knowledge concerning the inheritance of the Rett syndrome is
      reviewed. So far the main interest has been focused on the short arm of the X
      chromosome as the possible location for the gene for the Rett syndrome. There is,
      however, no conclusive evidence for such a location. The authors suggests that
      other possible gene locations also should be investigated.

PMID- 1626620
TI  - Chronic respiratory distress caused by radiolucent esophageal foreign body.

PMID- 1626622
TI  - The Rett Syndrome: the recent advances in genetic studies in the USA.
AB  - The present status of efforts in the USA to understand the genetic basis of the
      Rett syndrome (RS) is reviewed. Analysis of monozygotic and dizygotic twin data
      provide compelling support for a genetic mechanism. Similarly, support can be
      derived from familial cases following maternal lines. Special attention is
      directed to the X chromosome. Nonrandom X inactivation in the mother of half
      sisters and the identification of RS girls with translocations involving the X
      chromosome and separate autosomes have sharpened the focus molecular studies.

PMID- 1626623
TI  - Neuronal constituents of postural and locomotor control systems and their
      interactions in cats.
AB  - Studies in both decerebrate, and intact cats have already established the
      presence of specific areas in the brainstem that subserve control of posture and
      locomotion. They are the subthalamic locomotor region (SLR) in the lateral
      hypothalamic area (LHA), the mesencephalic locomotor region (MLR) in the
      posterior midbrain, the dorsal tegmental field (DTF) and the ventral tegmental
      field (VTF) of caudal pons along its midline. These areas can be stimulates
      either electrically or chemically to induce site-specific changes in posture and
      locomotor synergies. Our observations indicate that the postural and locomotor
      synergies are structured in a hierarchy within rostro-caudal axis of the
      brainstem, and that the command routing through the brainstem relies on
      interactions with the SLR, the MLR, the DTF area and the VTF area. These results
      and our concepts for postural and locomotor control and their interactions are
      discussed with the concepts of command hierarchies for motor control.

PMID- 1626624
TI  - Electrocortical arousal and spindles on physiological cortico-subcortical
      interactions.
AB  - The neuronal mechanisms of electrocortical arousal and sleep spindles were
      reviewed on the basis of intracellular analyses on the motor cortex in
      atraumatically maintained encephale isole cat preparations. When arousal is
      initiated by subcortical afferents from the brainstem, the cortical neurons
      respond with either excitation (E), inhibition (I), disfacilitation (DF), or
      disinhibition (DI), in a cascade pattern proceeding from the superficial to deep
      layers. These neuronal activities on arousal involve DF of the output neurons
      that may set the subcortical sensorimotor functions in a readiness state for a
      possible adaptive behavior of animals. This initial transient arousal termed
      phasic develops soon to the next, more sustained phase termed tonic by the action
      of other subcortical afferents. The cascade transmissions then occur again,
      producing E, I, DF, and DI in the cortical neurons but with a reverse laminar
      pattern proceeding from the deep to superficial layers. These neuronal activities
      on tonic and arousal deliver the cortical outputs to the subcortical systems that
      may trigger an orienting or searching behavior of animals in their environment.
      Sleep spindles also accompany the cascade transmissions that are partly common to
      those in arousal. Various modes of the cascade transmissions were further
      examined by applying electric shock stimuli to the cortical surface, the
      ventrolateral nucleus of the thalamus, and the cerebral peduncle to activate the
      subcortical afferents converging onto different cortical layers. The combined
      results from these experiments may imply that the cortico-subcortical
      interactions in which all the cortical neurons participate with dynamic harmony
      are instrumental to set a physiological sequence of animal behavior. If these
      interactions be impaired on the way of normal growth of the brain, as in the case
      of disorders with the Rett syndrome, many forms of ill adaptation may be brought
      about by dedifferentiation of sensorimotor functions.

PMID- 1626626
TI  - The mystery of the Rett syndrome.

PMID- 1626625
TI  - Early monoaminergic dysfunction.
AB  - The chemical anatomy of the Rett syndrome and experimental studies concerning
      early monoaminergic lesions were overviewed. An early monoaminergic dysfunction
      is a likely occurrence for the mechanism underlying the Rett syndrome. For
      assessing the alteration of monoamine neuron system, 1) regional vulnerability,
      2) age-dependent vulnerability and 3) interaction between the monoamine neuron
      systems should be considered.

PMID- 1626628
TI  - Possible lesions of the Rett syndrome: opinions of contributors.

PMID- 1626627
TI  - Discussion for the Rett Syndrome symposium--the importance of rigorously defining
      one's level of investigation.

PMID- 1626629
TI  - Tokyo symposium on the Rett syndrome: neurobiological approach--concluding
      remarks and epilogue.
AB  - Based on data presented at the Tokyo Rett Syndrome Symposium, November 1990,
      actual neurobiological knowledge and interpretations are compiled. The underlying
      biological concepts, as well as the potential origin of the condition are
      particularly discussed.

PMID- 1626630
TI  - Motor symptoms of the Rett syndrome: abnormal muscle tone, posture, locomotion
      and stereotyped movement.
AB  - Amongst the motor, mental, cognitive and emotional symptoms of the Rett syndrome
      (RS) the motor symptoms stand out as the hallmark in analyzing the essential
      pathophysiology. Summarizing the motor symptoms and searching into the knowledge
      of relevant basic sciences, this report aims at stressing the pathophysiological
      basis of RS which we have reported in previous studies. The core motor symptoms
      of RS consist of two aspects; firstly the unique developmental abnormalities of
      the discrepancy of crawling and walking and secondly the pathognomonic symptoms
      which include the abnormal muscle tone, posture, locomotion and stereotyped
      movement. The deranged crawling reflects the abnormal locomotive function. The
      primary responsible neuronal structures of the abnormal muscle tone, posture and
      locomotion are probably in the brainstem. Aberrantly formed neuronal structures
      responsible for voluntary movements and modulatory factors from the basal ganglia
      are the pathophysiological basis of the stereotyped movement of RS. Thus the
      neuronal structures that underlie the clinical characteristics of RS extend
      broadly from the motor neurons to the higher cortex, but involve the specific
      neuronal systems. The most important and primary of these specific neuronal
      systems are thought to be the monoaminergic systems, originating from the
      brainstem and midbrain. Abnormally deficient noradrenergic, serotonergic and
      dopaminergic systems result in the abnormal modulation of ontogeny and function
      of the higher and lower nervous systems. As we have already stressed, this unique
      putative pathophysiological basis could explain the very striking set of clinical
      symptoms of RS and their age dependent appearance despite the lack of major
      specific findings in neuropathology.

PMID- 1626631
TI  - Electroencephalographical study of the Rett syndrome with special reference to
      the monorhythmic theta activities in adult patients.
AB  - The long-term course of the EEG in the Rett syndrome is documented with reference
      to past studies. The monorhythmic theta activities in the waking state which were
      characteristically seen in adults with the Rett syndrome were investigated in
      patients aged between 27 and 28, using auto power spectra. They were often
      suppressed when the patients were excited or strained. Then the suppression was
      thought to elevate their conscious levels. The theta activities were often
      suppressed by calling, but not easily suppressed by other stimuli, especially the
      somatosensory stimuli of pain and touch. There were also abnormal findings in the
      ABR and blink reflexes. In the Rett syndrome we, therefore, suspect there are
      disturbances in the brain stem functions especially in the ascending reticular
      activating system which is related to elevation of the conscious level.

PMID- 1626632
TI  - Middle and short latency somatosensory evoked potentials (SEPm, SEPs) in the Rett
      syndrome: chronological changes of cortical and subcortical involvements.
AB  - Middle and short latency somatosensory evoked potentials (SEPm, SEPs) were
      studied in 11 cases of the Rett syndrome (RS) to detect the chronological changes
      of cortical and subcortical involvements. The cortical N1 (18) latency was
      significantly delayed in cases above the age of 5 years. Subcortical components
      up to N16 which are considered to be derived from the thalamus or the upper
      brainstem were mostly normal in cases under 9 years of age. However, in those
      over 9 years, the brainstem component P14 and the cervical cord component N13
      revealed a delay in latency. The clavicular component N9 and component N11, which
      is considered to be from the spinal cord entry, were still normal in our cases.
      These findings suggested that before the age of 9 years, the revealed lesion in
      SEP is mainly rostral to the thalamus or upper brainstem. With increasing age and
      disease process, the involvement of the lower brainstem and the spinal cord
      becomes apparent. Thus, a degenerative process might be suspected. However, the
      chronological changes of N1 (18) and N13 parallel to normal development seen in
      RS indicated that the maturational changes were found up to around the age of 5-6
      years in the former and 9 years in the latter, though the mean values of these
      two peak latencies were slightly higher than those in controls as early as the
      age of 3-4 years. These observations also indicated developmental, probably
      metabolic, abnormality underlies the pathogenesis of RS and the degenerative
      process might overlay in the later period of the disease.

PMID- 1626633
TI  - A review of the respiratory disorder in the Rett syndrome.
AB  - The characteristics and physiological accompaniments of the respiratory disorder
      in the Rett syndrome are reviewed and placed in the context of other clinical
      studies. Events are indicated which may play a part in the occurrence of vacant
      spells. A scheme is proposed to explain the various manifestations of the Rett
      syndrome disorder throughout life. The Rett syndrome is viewed as a developmental
      disorder in which the evolving clinical signs are due to the effects of
      maturation and aging on an abnormal brain rather than to primary degenerative
      disease. Thus development elicits preexisting defects which subsequently become
      clinically manifest. The clinical evidence is suggestive of a genetically
      determined early defect in central receptive processing which leads to failure of
      central motor planning with release of extrapyramidal rhythms.

PMID- 1626634
TI  - Polysomnography in the Rett syndrome.
AB  - The features of sleep parameters in the Rett syndrome were compared with those in
      early infantile autism (EIA) and hereditary progressive dystonia with marked
      diurnal fluctuation (HPD). The sleep-wakefulness cycle and the tonic and phasic
      components of sleep were evaluated in each disorder, the former was estimated by
      the day-by-day plot method and the latter two by polysomnography (PSG) following
      our method. Abnormalities of the sleep-wakefulness cycle were observed in the
      Rett syndrome and EIA, but in the latter these abnormalities became inapparent
      with age and improved markedly by correcting the environmental condition and
      completely by 5-hydroxytriptophan. The latter, if treated early, was followed by
      improvement of behavior. In the Rett syndrome, however, the abnormalities
      continued into late childhood to adolescence. In HPD, PSG abnormalities were
      restricted to the phasic component, which improved completely after levodopa in
      accordance with the clinical improvement. On the other hand, in the Rett syndrome
      as well as in EIA both the phasic and tonic components were involved and also the
      leakage of the components of REM stage into NREM stage was observed. In the Rett
      syndrome, these abnormalities aggravated with age, with disturbances in % sleep
      stage, nocturnal variation of tonic and phasic components of sleep and REM-NREM
      cycles, while in EIA the results of PSGs revealed no such progressions but showed
      an increase in twitch movement and a lack of normal increase in the number of
      REMs occurring in short intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626635
TI  - The Rett syndrome: an introductory overview 1990.
AB  - The position at the end of 1990 of clinical experiences and research in the Rett
      syndrome (RS) is summarized. Aspects on clinical and pathogenetic heterogeneity
      are given. Supports for RS as a developmental neuronal disconnection condition,
      with early infantile brain growth arrest, are emphasized. In trying to explain
      origin a two step process is hypothetically suggested: 1) an age dependent
      genetic deficiency, or transient dysfunction, as a basic predisposing factor; 2)
      a superimposed trigger factor which might differ in type and between groups of
      cases.

PMID- 1626636
TI  - Neurochemistry of the Rett syndrome.
AB  - The current status of neurochemistry research with respect to the Rett syndrome
      (RS) is reviewed and correlations developed with the previously described
      neuropathologic changes. Despite reports of abnormalities in intermediary
      metabolism and the biogenic amine neurotransmitters, follow-up studies have
      failed to support any consistent abnormality in either area. In general, the
      levels of membrane lipid constituents in various brain regions have been similar
      to control values. New information suggests a disturbance in the ganglioside
      pattern leading to a reduction in GD1a and GT1b gangliosides in cerebrum and
      cerebellum. The corresponding reduction of these gangliosides in cerebrospinal
      fluid, if shown to be specific for RS, could represent an important clue in
      confirming the clinical diagnosis. Evidence of pervasive growth failure is
      presented and the current status of the role of beta-endorphins in RS is
      described. Considerations regarding future directions for research in RS are
      presented. These strategies include an approach to the fundamental question,
      namely, the identification of the primary molecular defect.

PMID- 1626637
TI  - Cerebral blood flow and oxygen metabolism in the Rett syndrome.
AB  - Positron emission tomography (PET) was performed on six patients with the Rett
      syndrome and the results were compared with the concurrent clinical status of the
      patients. The cerebral metabolic rate of oxygen (CMRO2) was low in five patients,
      and oxygen extraction fraction (OEF) was low in four patients; both had a
      tendency to decline with advancing age. Although the cause is unknown, it is
      suggested that impaired oxidative metabolism exists in the Rett syndrome. An
      analysis of the distribution among brain regions showed that the ratios of values
      for the frontal cortex to those for the temporal cortex for both the cerebral
      blood flow (CBF) and CMRO2 were lower than those for the controls, which may
      indicate the loss of hyperfrontality in the Rett syndrome. Distribution of brain
      metabolism may be immature in the Rett syndrome.

PMID- 1626638
TI  - Quantitative magnetic resonance imaging and studies of degenerative diseases of
      the developing human brain.
AB  - The Rett syndrome is a progressive disorder which is associated with regression
      of psychomotor development and precipitous deceleration of brain growth during
      the first year of life. General histopathological surveys in postmortem specimens
      have identified degeneration of subpopulations of neurons of the nigrostriatal
      system but no other evidence of degenerative process. Magnetic resonance imaging
      based morphometry may usefully guide application of rigorous but demanding
      quantitative histologic search for evidence of neuronal degeneration. The volumes
      of the principal set of cortical and nuclear structures of principal interest in
      the disorder may be measured by currently available MRI-based methods. Optimized
      levels of precision now allow detection of volumetric changes over time in the
      same brain of approximately 10% at the 95% confidence level.

PMID- 1626639
TI  - The neuropathology of the Rett syndrome.
AB  - The neuropathology of the Rett syndrome is summarized utilizing a format of
      clinical pathological correlations, describing the pathology at specific anatomic
      sites which could correlate with the well defined clinical signs and symptoms in
      the Rett syndrome; decreased head and body size, autism, gait dysfunction,
      spasticity, movement and breathing disorder. Published reports of altered
      morphology in the cerebral cortex, basal ganglia, substantia nigra, cerebellum,
      spinal cord, muscle, nerve, pituitary gland and somatic organs are supplemented
      by the author's observations. These include studies of dendritic morphology
      employing Scholl analysis of Golgi preparation, and quantitation of cerebellar
      Purkinje cells. The possible pathoetiology of the Rett syndrome is considered,
      particularly, in relation to the ultrastructural demonstration of altered
      mitochondria and accumulations of lipidic bodies in several tissues.

PMID- 1626640
TI  - Corticosterone induces rat liver alcohol dehydrogenase mRNA but not enzyme
      protein or activity.
AB  - Glucocorticoids induced ADH activity and mRNA 2- to 4-fold in rat hepatoma cells
      (H4IIE and H4IIEC3), but were reported not to alter ADH activity in rat liver.
      The failure of corticosteroids to induce ADH may have been due to the short-term
      treatment of the rats or the dose of steroid used. To reevaluate the effect of
      glucocorticoids in vivo, we studied animals 4.5 weeks after adrenalectomy so that
      ADH activity and mRNA should have reached a new steady-state level; the dose of
      glucocorticoid used was estimated to provide physiological replacement. Male
      Wistar rats were injected with a single daily dose (10 mg/kg/day) of
      corticosterone-21-acetate or vehicle subcutaneously for 10 days. Liver extracts
      were assayed for ADH activity, ADH protein, and ADH mRNA. Nuclei were isolated
      for nuclear run-on assays. Adrenalectomy did not reduce the activity of ADH in
      liver. Subsequent corticosterone treatment did not alter ADH enzyme activity, nor
      did it affect ADH protein levels as analyzed on Western blots. However, Northern
      blot analysis of ADH mRNA indicated a 2-fold increase in ADH mRNA in the treated
      animals when the data were normalized to the level of the 28S ribosomal RNA or
      CHO-B mRNA. The rate of transcription of the ADH gene in nuclei isolated at the
      end of 10 days of treatment from corticosterone-treated adrenalectomized rats was
      not statistically different from that in the oil-treated adrenalectomized ones.
      The disparity between ADH activity and protein levels and the mRNA level may have
      resulted from other effects of corticosterone, e.g., stimulation of protein
      degradation or effects on translation.

PMID- 1626641
TI  - In utero ethanol exposure decreases the biosynthesis of phosphatidylserine in rat
      pup cerebrum.
AB  - Phosphatidylserine is enriched in the brain and has been implicated to play a
      role in regulating neuronal membrane functions. In this study, three experimental
      protocols were used to examine the effects of in utero ethanol exposure on
      phosphatidylserine biosynthesis in rat pup brain, namely, (1) assay of the serine
      base-exchange enzyme activity in brain microsomes, (2) incubation of brain slices
      with [3H] serine, and (3) incorporation in vivo of [3H]serine into
      phosphatidylserine as well as serine-related phospholipids in brain. Results from
      all three protocols point to a decrease in phosphatidylserine biosynthesis in
      newborn rat pup cerebrum on exposure to ethanol in utero compared with the pair
      fed controls. When in utero ethanol-exposed pups were nursed by mothers given a
      chow diet, the differences gradually returned to control levels by 17 days of
      age. The decrease in phosphatidylserine biosynthesis may be important in
      explaining some of the neuronal deficits associated with in utero ethanol
      exposure.

PMID- 1626642
TI  - Alterations in brain polyribosomal RNA translation and lymphocyte proliferation
      in prenatal ethanol-exposed rats.
AB  - The long-term effects of prenatal ethanol exposure on the properties of brain
      polysomes and the proliferative responses of lymphocytes to mitogenic stimulation
      in adult offspring were assessed. Female Sprague-Dawley rats either ingested the
      control or 6.6% ethanol-containing Lieber-DeCarli liquid diet during the 3rd
      trimester of pregnancy. Controls were age-matched and pair-fed. At 42 to 72 days
      of age, ethanol effects were evaluated on the (1) polysomal properties in the
      cerebral hemispheres, cerebellum, and hippocampal regions of the brain after
      translation in a messenger RNA (mRNA)-dependent rabbit reticulocyte lysate system
      and (2) immunologic functions of lymphocytes cultured from spleen cells by
      measuring their responses to mitogenic stimulation. Results showed long-term
      adverse effects of in utero ethanol exposure on the polysomal RNA translation in
      each of the three brain regions tested with free polysomal mRNAs affected more
      than the bound polysomal mRNAs. Of these, the hippocampal region appeared to
      sustain the most injurious effects. In addition, a suppression of the mitogen
      induced lymphocyte proliferative responses were present under these conditions.
      The degree of suppression varied with the specific mitogen used. Data suggest
      that the ethanol effects on the CNS and lymphocyte proliferation are most
      possibly irreversible, and in the case of the CNS, a post-translational
      modification by ethanol is indicated. The reduced lymphocyte responses are
      suggestive of a possible interference by ethanol of the synthesis of interleukin
      2 (IL-2) and/or a reduced binding of IL-2 with its receptor (IL-2 receptors).

PMID- 1626643
TI  - Effect of ethanol on the release of prostaglandins from ovine fetal brain stem
      during gestation.
AB  - Prostaglandins (PGs) have been implicated as mediators of the ethanol-induced
      suppression of ovine fetal breathing movements (FBM). The objectives of the
      present study were to determine the ontogeny of the in vitro efflux of PGE2 and 6
      keto PGF1 alpha in ovine fetal brain stem during the second half of gestation and
      to determine the effect of in vitro ethanol exposure on the efflux of these PGs.
      Ovine fetal brain stem tissue was obtained at mean gestational ages of 80 days (n
      = 6), 105 days (n = 10), and 135 days (n = 16) by rapid excision following
      maternal euthanization. Tissue slices (400 microM thickness) were prepared from
      the lower pons-medulla region of the brain stem. After a 1-hr equilibration
      period in artificial cerebrospinal fluid, efflux of PGE2 and 6-keto PGF1 alpha in
      the brain stem was determined using the brain slice-superfusion method, and the
      PGE2 and 6-keto PGF1 alpha concentrations in the superfusate were determined by
      specific radioimmunoassay. The mean spontaneous efflux of PGE2 and 6-keto PGF1
      alpha expressed as pmol PG/gram wet weight of tissue/5-min collection period was,
      respectively, 31.9 +/- 4.2 and 26.6 +/- 2.4 at 80 days, 38.3 +/- 5.2 and 29.6 +/-
      2.2 at 105 days, and 57.4 +/- 3.1 and 27.1 +/- 1.1 at 135 days of gestation. In
      vitro exposure to 20, 40, and 80 mM ethanol did not affect PG efflux in the brain
      stem at 80 and 105 days of gestation. In vitro ethanol exposure decreased PGE2
      and 6-keto PGF1 alpha efflux at 135 days of gestation to 36.8 +/- 5.3% and 41.6
      +/- 4.3% of spontaneous efflux within 15 min, respectively; this effect of
      ethanol was not dose-dependent. The data do not support the hypothesis that
      ethanol increases PG efflux in the ovine fetal brain stem. In view of these
      findings and the data implicating PGs in the mechanism of ethanol-induced
      suppression of FBM, it is possible that ethanol acts at either central sites
      rostral to the brain stem (i.e., upstream CSF) or peripheral sites to increase
      the synthesis of PGs and their efflux into the systemic circulation, with
      subsequent transfer to the respiratory control region(s) of the brain stem.

PMID- 1626644
TI  - Differences in the brain and pituitary beta-endorphin system between the alcohol
      preferring AA and alcohol-avoiding ANA rats.
AB  - The content of pro-opiomelanocortin (POMC) mRNA was determined in the
      hypothalamus, as well as in the anterior and intermediate lobes of the pituitary
      gland of the alcohol-preferring AA and alcohol-avoiding ANA rats under basal
      conditions. In addition the content of beta-endorphin-like immunoreactivity (beta
      EPLIR) was measured in nine brain regions, the anterior and intermediate lobes of
      the pituitary gland and the serum. The content of beta-EPLIR was significantly
      higher in the septum and significantly lower in the amygdala, and periaqueductal
      gray matter of the AA rats, while there was no significant difference between the
      AA and ANA rats in the arcuate nucleus plus median eminence, nucleus accumbens,
      caudate, hippocampus, and cortex. HPLC analysis indicated no significant
      differences in the relative proportions of non-acetyl and acetyl forms of beta
      endorphin peptides in the hypothalamus, distinct brain regions, and anterior and
      neurointermediate lobes of the pituitary gland, between the AA and ANA rats. The
      content of POMC mRNA but not of beta-EPLIR was significantly higher in the
      hypothalamus and neurointermediate lobe of the AA rats, while the content of both
      beta-EPLIR and POMC mRNA were significantly higher in the anterior pituitary of
      the AA than of the ANA rats. Thus, there are genetically determined differences
      in the pituitary and brain beta-endorphin system between the AA and ANA rats,
      which may be important in controlling the differences in the voluntary ethanol
      consumption exhibited by these animals.

PMID- 1626645
TI  - The rate of ethanol absorption is influenced by corticosterone in long-sleep and
      short-sleep mice.
AB  - Ethanol was administered by intragastric (IG) injection and absorption was
      measured in long-sleep (LS) and short-sleep (SS) mice under various conditions
      that alter levels of adrenal steroids. In naive mice, LS mice absorbed ethanol
      more quickly than SS mice. Ethanol absorption was slower in both lines of mice
      after adrenalectomy (ADX). Short-term inhibition of corticosterone synthesis had
      no effect on ethanol absorption in either line of mice. The effect of ADX was
      most pronounced in SS mice at 24 hr after surgery and at 168 hr after surgery in
      LS mice. Therefore, the effects of various steroid replacements were examined at
      these times. At 24 hr after ADX, ethanol absorption was replaced to SHAM-operated
      values in SS mice receiving corticosterone treatments. Likewise, in LS mice at
      168 hr after ADX, corticosterone implants reversed the effects of ADX while
      dexamethasome was ineffective. These results support a role for corticosterone in
      regulation of gastric ethanol absorption and suggest that the lack of
      repeatability for pharmacokinetic measures of ethanol absorption and metabolism
      in previous human and animal studies may relate to environmental impact on stress
      responses.

PMID- 1626646
TI  - Effects of ethanol on glucose utilization by cultured mammalian embryos.
AB  - We have previously observed correlations between placental glucose transfer and
      growth of fetuses of ethanol (EtOH)-fed and control rats. In the present study,
      whole mammalian embryos were used to define the interaction of glucose supply and
      the effects of EtOH on growth and differentiation. Rat embryos were cultured in
      75% normal rat serum from day 9.5 to day 11.5 of gestation. EtOH produced dose
      dependent reductions of embryo protein content (mean +/- SEM = 212 +/- 5, 171 +/-
      11, 141 +/- 16, and 113 +/- 9 micrograms/embryo in the presence of 0, 25, 50, and
      100 mM EtoH, respectively). Somite number was 25.7 +/- 0.3, 23.4 +/- 0.7, 21.8 +/
      0.7, and 21.1 +/- 0.4 under the same conditions. Exposure to ethanol during the
      first 24 hr in culture decreased embryo protein content to the same extent as
      exposure for the entire 48-hr culture period. After 46 hr in culture, control and
      ethanol-exposed embryos were incubated with 14C-glucose for 2 hr. Ethanol
      produced dose-dependent reductions of CO2 production, anabolic utilization,
      lactate release, and total glucose utilization. Glucose supplementation (300
      mg/dl) significantly increased embryo protein content and each of these glucose
      utilization parameters. When glucose utilization was expressed relative to embryo
      protein content, incorporation of the label into embryonic tissues was
      significantly reduced by ethanol and increased by glucose supplementation. Embryo
      protein content correlated closely (r = 0.871, p less than 0.0001) with anabolic
      glucose utilization. Thus, ethanol directly affects embryo glucose utilization,
      both as an energy source and as a synthetic substrate, in addition to its effects
      on placental glucose transfer.

PMID- 1626647
TI  - Time dependency of IgA nephropathy induction in alcohol ingestion.
AB  - We investigated the influence of the alcohol ingestion period on the incidence of
      IgA nephropathy in an animal model. A group of 41 rats received a continuous
      infusion of liquid diet and alcohol: "alcoholics." A further group of 41 control
      rats received an isocaloric diet in which the alcohol was replaced by glucose.
      IgA nephropathy was diagnosed by the presence of intense IgA deposition in the
      mesangium. At 6 weeks, 60% of the alcoholic rats had IgA nephropathy. The
      incidence increased until 100% of the alcoholic rats presented the renal disease
      at 16 weeks. IgA nephropathy was not found in any of the control animals. We
      conclude that, in this animal model, the incidence of IgA nephropathy is
      dependent on the time frame of the alcohol ingestion.

PMID- 1626648
TI  - Ethanol induces marked changes in lymphocyte populations and natural killer cell
      activity in mice.
AB  - Treatment of mice in vivo with 5% w/v ethanol given in a liquid diet causes
      marked changes in spleen, peripheral blood, and thymus lymphocytes. In both the
      thymus and spleen, there is an acute cellular depletion resulting in a
      significant decrease in gross tissue size and cell number. In spleen and
      peripheral blood, the percentage of T lymphocytes is increased relative to B
      lymphocytes, but the ratio of CD4+/CD8+ T cell sub-populations remains unchanged.
      Splenic natural killer (NK) cell activity is increased in ethanol-consuming mice,
      although the percentage of NK1.1+ cells is relatively unchanged.

PMID- 1626649
TI  - Audiogenic seizure susceptibility and auditory brainstem responses in rats
      prenatally exposed to alcohol.
AB  - Rats prenatally exposed to alcohol (0%, 17.5%, or 35% ethanol-derived calories)
      were tested for audiogenic seizure susceptibility on one of postnatal days 18 to
      23, then retested 5 days later. Prenatal alcohol exposure did not influence
      audiogenic seizure susceptibility or severity. There was, however, a significant
      increase in seizure incidence on the retest day for all groups, suggesting a
      priming effect. Auditory brainstem response (ABR) data suggested that prenatal
      alcohol exposure and acoustic trauma (i.e., exposure to an alarm bell used for
      eliciting audiogenic seizures) induced measurable sensorineural hearing loss, and
      that the combined exposure to alcohol and acoustic trauma interacted additively
      to produce greater hearing loss than either alone.

PMID- 1626650
TI  - Activation of glycolysis with isoproterenol but not digoxin reverses chronic
      alcohol depression in hamster hearts.
AB  - The purpose of this study was to confirm that an agent, which increases diastolic
      [Ca2+]i, namely digoxin, depresses cardiac performance, mitochondrial activity,
      and glycolysis in chronic alcohol-treated and myopathic hearts, and that an
      agent, which lowers diastolic [Ca2+]i, namely isoproterenol, activates cardiac
      performance, mitochondrial activity, and glycolysis in these animals. Energy
      levels, glycolysis, mitochondrial activity, hemodynamics, and cAMP were studied
      in isolated hearts from three groups of animals, i.e., 9-month control hamsters,
      hamsters given 50% alcohol until 9 months of age, and 6-month-old cardiomyopathic
      hamsters in heart failure. Isolated hearts were perfused with either a control
      medium, a medium containing isoproterenol, digoxin, or digoxin + isoproterenol.
      Measurement of phosphomonoester sugars, and glucose-6-phosphate, were used to
      assess glycolytic activity. Oxygen consumption was used to analyze mitochondrial
      activity. All hearts perfused with either isoproterenol or isoproterenol +
      digoxin showed an increase in developed pressure, rate-pressure-product, and a
      decrease in end-diastolic pressure. Isoproterenol activated mitochondrial
      activity and glycolysis in hearts from myopathic and chronic alcohol hamsters.
      Based on 31P-NMR studies, isoproterenol or isoproterenol + digoxin improved the
      over-all energy state of hearts from cardiomyopathic hamsters, but not hearts
      from control and chronic alcohol hamsters. Digoxin alone augmented the rate
      pressure-product and oxygen consumption in control hearts but not hearts from
      myopathic and chronic alcohol hamsters. Digoxin caused an increase in end
      diastolic pressure in myopathic and chronic alcohol hearts but not control
      hearts. Digoxin depressed glycolysis and worsened the energy state in hearts from
      cardiomyopathic and chronic alcohol hamsters, but not hearts from control
      hamsters. In conclusion digoxin, but not isoproterenol nor isoproterenol +
      digoxin, depressed cardiac performance and glycolysis as well as high energy
      phosphates in cardiomyopathic and chronic alcohol hearts. Isoproterenol added to
      digoxin negated the adverse effects of digoxin in cardiomyopathic and chronic
      alcohol hearts.

PMID- 1626651
TI  - A recombinant inbred strain analysis of sleep-time responses to several sedative
      hypnotics.
AB  - The results of previous studies suggested that the sleep-time differential
      between long-sleep (LS) and short-sleep (SS) mice decreases for a series of
      sedative-hypnotic drugs as lipid solubility increases. Using the LS x SS
      recombinant inbred (RI) strains, we have tested whether this relationship arises
      because of common genetic influences on the sleep-time responses or was simply a
      fortuitous difference between LS and SS mice. Mice were sleep-time tested after
      intraperitoneal injections of a variety of sedative-hypnotic drugs that vary in
      lipid solubility including alcohols, barbiturates, chloral hydrate, and urethane.
      Sleep-time values from each of these drugs were compared with ethanol-induced
      sleep times in the LS x SS RI strains. Significant genetic correlations were
      observed between ethanol-induced sleep time and those responses elicited by
      butanol, propanol, and chloral hydrate, but not by pentobarbital or secobarbital.
      When the partition coefficient (log P) values were compared with the genetic
      correlations, a significant relationship (r = -0.85) was observed. These data
      suggest that common genes mediate sedative-hypnotic reactions to ethanol and some
      drugs resembling it in log P value, and that anesthetic agents with low lipid
      solubility may be working through different mechanisms than drugs with greater
      lipid solubilities.

PMID- 1626652
TI  - Alcohol withdrawal in rats is associated with a marked fall in extraneuronal
      dopamine.
AB  - Withdrawal of rats from chronic ethanol (2-5 g/kg, every 6 hr for 6 days)
      resulted in withdrawal symptomatology and dramatic fall in extracellular dopamine
      (DA) in the ventral striatum as measured by microdialysis. The changes in DA
      output paralleled the withdrawal symptomatology and both phenomena were reversed
      by a challenge ethanol dose (5 g/kg orally). The results suggest that the
      decrease in DA output may be responsible for the aversive symptoms of withdrawal.

PMID- 1626653
TI  - Predictors of alcohol abusers' inconsistent self-reports of their drinking and
      life events.
AB  - Although considerable research supports the veridicality of alcohol abusers' self
      reports, all studies find that some proportion of self-reports are inaccurate.
      Recently, a few studies have examined variables predictive of inaccurate self
      reports and found considerable intersubject variability. The present study
      examined predictors of alcohol abusers' inconsistent reports of life events and
      drinking using test-retest reliability data from two questionnaires. Results
      indicated that inconsistent self-reports were associated with the type (i.e.,
      objective versus subjective) and amount (i.e., more drinking involvement at the
      first interview was associated with greater discrepant reports at the second
      interview) of information to be recalled. It appears that the nature of the
      questions asked may be as much or more of a contributing factor to inaccurate
      self-reports as subject or setting factors, especially for individuals who report
      high levels of alcohol use, for whom special efforts may be necessary to gather
      valid self-report data.

PMID- 1626654
TI  - Alterations in EEG amplitude, personality factors, and brain electrical mapping
      after alpha-theta brainwave training: a controlled case study of an alcoholic in
      recovery.
AB  - A controlled case study was conducted of effects of EEG alpha and theta brainwave
      training with a recovering alcoholic patient who experienced craving and fear of
      relapse after 18 months of abstinence. Training consisted of six sessions of
      thermal biofeedback to increase central nervous system (CNS) relaxation. Effects
      were documented with pretreatment and post-treatment personality testing, 20
      channel digitized EEG evaluations both under relaxed conditions and under stress,
      minute-by-minute physiologic recordings of autonomic and EEG data during each
      training session, blood pressure, and heart rate indications taken both during
      relaxation and under stress, and by clinical observation. Results replicated
      those of a previous controlled study with chronic alcoholic patients not
      abstinent prior to treatment. New findings include post-treatment indications of
      more relaxed CNS functioning under stress, and of reduced autonomic activation
      both during relaxation and under stress. Brain-mapping indications of anxiety
      associated with painful cold-pressor stimulation were seen only in the pretest
      readings; at post-test the brain map indicated pain-associated EEG activity in
      the contralateral somatosensory area, but no apparent anxiety-associated EEG
      activity. At 4 months post-treatment the patient's wife and colleagues report the
      patient appears to function in a more relaxed way under the impact of stress, and
      he reports no longer experiencing craving for alcohol. Overall, support is
      provided for the possibility that alpha and theta brainwave training may be a
      useful intervention for the abstinent alcoholic experiencing stress-related
      craving and fear of relapse.

PMID- 1626655
TI  - Sedating effects of ethanol and time of drinking.
AB  - Ethanol (0.5 g/kg) was administered to 12 healthy, normal-sleeping men, aged 21
      to 45, at two different times of the day (0900 and 1700 hr). The Multiple Sleep
      Latency Test (MSLT) was conducted at 1000, 1200, 1400, and 1600 hr in the day
      drinking condition and at 1800, 2000, 2200, and 2400 hr in the evening drinking
      condition. On placebo, sleepiness was greater in the daytime testing hours than
      in the evening, replicating findings on the circadian rhythm of
      sleepiness/alertness. There was a time of drinking (day versus evening) by
      ethanol interaction. An ethanol effect on sleep latency was found in the daytime
      hours, when alertness was relatively low. Ethanol failed to have a significant
      effect on sleep latency during the evening hours when alertness levels were
      increasing. Performance on a divided attention task, administered 1 hr
      postconsumption, was impaired by ethanol consumption, but did not vary as a
      function of time of drinking (day versus evening). However, at 5 hr
      postconsumption, mean reaction time on the first 20 min of a 40-min auditory
      vigilance task was slowed by ethanol to a greater extent after day drinking then
      after evening drinking.

PMID- 1626656
TI  - Autism in fetal alcohol syndrome: a report of six cases.
AB  - This paper reports on six children who all fulfill the criteria for fetal alcohol
      syndrome and have a history of maternal alcohol abuse during pregnancy, and who
      also fulfill the criteria for diagnosis of autism. Their behavior and natural
      history is compared with eight contrast FAS children, of similar ages and
      functional levels, who were free of autistic behaviors. The autistic FAS children
      were all moderately or severely retarded. Autistic behavior has not been commonly
      associated with prenatal alcohol exposure. Clinicians need to be aware of this
      potential dual diagnosis so that appropriate educational and treatment resources
      can be employed.

PMID- 1626657
TI  - Activation, attention, and visuospatial learning in adults with and without a
      family history of alcoholism.
AB  - While recent evidence shows visuospatial information processing deficits to be
      present in chronic alcoholics, it remains unclear whether such deficits are
      present prior to alcohol abuse in persons at risk for developing alcoholism. If
      present, it is also unclear whether the information processing mechanisms
      underlying these deficits are the same in alcoholics and persons at risk for
      alcoholism. This study investigated visuospatial information processing
      psychophysiological activation in adults with and without a family history of
      alcoholism. Thirty matched nonalcoholics served as participants. Fifteen persons
      were from families in which at least one biologic parent and one other relative
      had a history of alcoholism. Another group of 15 persons had no family history of
      alcoholism. In addition to displaying atypical patterns of learning-contingent
      physiological activation, participants with a family history of alcoholism
      displayed visuospatial learning that was significantly poorer than persons with
      no family history of alcoholism. The learning and physiological activation
      displayed by the participants with a family history of alcoholism were similar to
      those displayed by previously studied alcoholics using a similar learning task.
      The data suggest that visuospatial learning deficits may reflect an antecedent
      to, rather than a consequence of, chronic alcohol abuse.

PMID- 1626658
TI  - Family history as a predictor of alcohol dependence.
AB  - The effects of various levels of positive family history of alcoholism on the
      probability of past year alcohol dependence were investigated using a general
      population sample of 23,152 drinkers 18 years of age and older. Forty percent
      reported a positive family history. After adjustment for age, race, gender, and
      poverty and compared with persons with a negative family history, the odds of
      alcohol dependence were increased by 45% among persons with alcoholism in second
      or third degree relatives only, by 86% among those with alcoholism in first
      degree relatives only, and by 167% among those with alcoholism in first and
      second or third degree relatives. The effects of family history did not vary
      among population subgroups as defined by age, race, gender, and poverty.

PMID- 1626659
TI  - Using adapted short MASTs for assessing parental alcoholism: reliability and
      validity.
AB  - In previous research adapted versions of the Short Michigan Alcoholism Screening
      Test (SMAST) have been employed to assess an individual's father's (F-SMAST) and
      mother's alcohol abuse (M-SMAST). However, to date psychometric information on
      these forms has been limited. In order to more broadly assess the psychometric
      properties of these forms, several critical issues in five related studies were
      addressed. The samples for the five studies were drawn from a college population
      at a large midwestern university. Overall, the reliability and validity of the
      adapted SMASTs appears to be quite good. The F-SMAST demonstrated high
      reliability (from the standpoint of internal consistency, temporal stability, and
      reliability across siblings) as well as validity (both in respect to convergence
      with an interview measure and with father's own report on a parallel instrument).
      Furthermore, shortening both of these instruments to nine-item versions appears
      to improve their reliability and validity. For researchers and clinicians
      interested in assessing parental history of alcoholism, the F-SMAST and M-SMAST
      would appear to be a reliable and valid paper-and-pencil measure.

PMID- 1626660
TI  - Sensation seeking, stress reactivity, and alcohol dampening discriminate the
      density of a family history of alcoholism.
AB  - Data collected from 95 nonalcoholic men who had either a multigenerational (MFH),
      unigenerational (UFH), or negative family history (FHN) of alcoholism were
      subjected to a discriminant function analysis to determine how well a set of
      variables differentiated between the family history groups. The data-set
      comprised personality measures (sensation seeking scales, neuroticism, and
      extroversion), measures of cardiovascular reactivity to unavoidable shock, and
      measures of the cardiovascular reactivity-dampening effects of alcohol. The
      discriminant analyses correctly classified 62% of all subjects, 75% of MFH
      subjects, 47% of UFH subjects, and 63% of FHN subjects. A canonical discriminant
      function analysis revealed one significant dimension (canonical variable) that
      differentiated between family history groups. The high density (MFH) family group
      scored positively on this dimension, while the UFH and FHN groups had negative
      mean scores on this variable. A MFH of alcoholism was characterized by a pattern
      of increased sensitivity to the cardiovascular reactivity-dampening effect of
      alcohol, cardiovascular hyperreactivity to unavoidable shock when sober, and the
      personality characteristic of experience seeking, which is associated with a
      desire for novel and unconventional experiences.

PMID- 1626661
TI  - Alcohol availability and the formal power and resources of state alcohol beverage
      control agencies.
AB  - The formal powers and resources of state alcohol beverage control agencies place
      them in a position to regulate access to alcoholic beverages through restrictions
      on retail distribution and sales. For example, monopoly states restrict access to
      spirits, and sometimes wine, by allowing retail sales only through state stores.
      On the other hand, license and monopoly states share in restricting sales through
      the use of price posting and fixing provisions. The degree to which these powers
      are realized in restrictions on alcohol outlets (e.g., licenses) and subsequent
      alcohol consumption (e.g., sales) was investigated in the current study. In a
      cross-sectional analysis of data available from 44 alcohol beverage control (ABC)
      jurisdictions in the United States, it was shown that states with greater
      restrictions on retail sales had greater resources for the conduct of ABC
      activities and lower densities of spirit outlets. These states, however, had
      greater densities of wine and beer outlets. States with greater marketplace
      restrictions had more resources for ABC enforcement activities and lower outlet
      densities across all beverage types. Further, supporting the suggestion that
      availability and demand may be simultaneously related, greater outlet densities
      were related to greater alcohol consumption (for beer) and greater levels of
      consumption were related to greater outlet densities (for wine).

PMID- 1626662
TI  - Resource management.

PMID- 1626663
TI  - Induction of anaesthesia with propofol using a target-controlled infusion system.
AB  - Sixty patients premedicated with temazepam were allocated randomly to receive an
      infusion of propofol designed to achieve and maintain a target blood
      concentration of 3, 4 or 5 micrograms.ml-1. Induction time was measured from the
      start of infusion to loss of verbal contact. The success rate of inducing
      anaesthesia within 3 min of achieving the target concentration was 40% when the
      predicted target concentration was 3 micrograms.ml-1, 75% when the predicted
      target was 4 micrograms.ml-1 and 90% when the target was 5 micrograms.ml-1. There
      were no significant differences between the three groups for time to loss of
      verbal contact in patients who were induced successfully within 3 min. There were
      significant reductions in arterial pressure 3 min after achieving the target
      concentrations within the groups but not between them. The frequency of apnoea
      and pain on injection was small in all groups. Selecting a target concentration
      of 5 microgram.ml-1 would successfully induce anaesthesia in the majority of
      patients premedicated with temazepam without major haemodynamic or respiratory
      side effects.

PMID- 1626664
TI  - Ventilatory effects of subarachnoid fentanyl in the elderly.
AB  - Twenty-eight elderly patients scheduled for urological surgery were randomly
      assigned to receive, in a double-blind study, subarachnoid hyperbaric bupivacaine
      15 mg with 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), or
      12.5 micrograms (group C, n = 7) of fentanyl or 1 ml of saline (group D, n = 7)
      in a total volume of 4 ml. The pattern of breathing and the ventilatory response
      to CO2 were studied before and 90, 150 and 480 min after the subarachnoid
      injection. In group A, mild pruritus and sedation occurred in five patients,
      while nausea, vomiting and periodic breathing occurred in two. In group B, mild
      pruritus and sedation were observed in four patients, while nausea and vomiting
      occurred in two. No significant differences in minute ventilation, respiratory
      drive and respiratory timing were observed between the groups. Patients receiving
      fentanyl 50 micrograms showed a percentual change from baseline values as
      function of time (slope VE/PE'CO2) significantly below baseline at 90 and 150 min
      (p less than 0.05). However, the baseline values in this group reverted after 480
      min. No side effects were observed in groups C or D. It is concluded that
      subarachnoid fentanyl 50 micrograms can cause an early respiratory depression and
      its use as a postoperative analgesic should be avoided in the elderly.

PMID- 1626665
TI  - Clinical use of a small soda lime canister in a low-flow to-and-fro system.
AB  - It may be possible to overcome the classical disadvantages of a to-and-fro system
      by the use of a small soda lime canister. We report our experience of such a
      system in a series of 13 adult patients requiring mechanical ventilation of the
      lungs during surgery. The system was found to be convenient to use and the charge
      of soda lime had sufficient absorptive capacity to last throughout the great
      majority of surgical cases. Using a fresh gas flow of 1 l.min-1, the ratio of
      inspired isoflurane concentration to isoflurane vaporizer setting was found to be
      approximately one half after 10 min of anaesthesia. This ratio was maintained
      throughout the procedure, except for a few minutes following each change in
      vaporizer setting. A to-and-fro system using a small soda lime canister is a
      convenient alternative to the circle system for low-flow anaesthesia.

PMID- 1626666
TI  - Changes in arterial blood pressure during traction of extra-ocular muscles. A
      study in rabbits.
AB  - A significant reflex fall in mean arterial blood pressure from baseline values
      was observed during extra-ocular muscle traction in rabbits. This effect could be
      abolished only by retrobulbar block (afferent pathway block) and not by vagotomy,
      intravenous atropine or glycopyrronium, suggesting that it is distinct from, and
      independent of, the oculocardiac reflex. We suggest that these reflex changes in
      blood pressure be known as the 'oculodepressor reflex'.

PMID- 1626667
TI  - Hyperkalaemic periodic paralysis and anaesthesia.
AB  - Hyperkalaemic periodic paralysis is the rarer of the two forms of potassium
      associated familial paralysis. We report a family with hyperkalaemic periodic
      paralysis with paramyotonia and the anaesthetic management of four affected
      members. In three of these, paralytic episodes had been precipitated by previous
      anaesthesia, but this was avoided in the anaesthetics described. We conclude from
      our experiences that with depletion of potassium before surgery, prevention of
      carbohydrate depletion, avoidance of potassium-releasing anaesthetic drugs and
      maintenance of normothermia, patients with hyperkalaemic periodic paralysis can
      be anaesthetised without complications. We have no evidence that they exhibit
      abnormal sensitivity to nondepolarising neuromuscular relaxants.

PMID- 1626668
TI  - Delayed profound respiratory depression after premedication with trimeprazine.
AB  - Delayed, profound respiratory depression occurred in a 4-year-old boy, who had
      been premedicated with trimeprazine 4 h after tonsillectomy. This is a rare, but
      potentially fatal idiosyncratic reaction.

PMID- 1626669
TI  - Instrumental bronchial tears.
AB  - Two case reports of bronchial tears following airway instrumentation are
      presented, one of which resulted in death. Both patients developed pneumothoraces
      and other complications after attempts had been made under general anaesthesia to
      insert bronchial stents. It appeared that bronchial tears were made during
      instrumentation with the stent introducer and these cases demonstrate that great
      care should be taken when rigid materials, such as plastic guides and bougies,
      are used blindly in the airway.

PMID- 1626670
TI  - An evaluation of oxygen delivery using nasal prongs.
AB  - Oxygen delivery using nasal prongs was assessed using a lung model for
      spontaneous ventilation. The analogue lung was attached to a manikin, which
      provided a model of the 'face and pharynx' to which the nasal prongs were
      applied. Oxygen concentrations were measured in the model trachea at varying
      fresh gas inflow and peak inspiratory flows. The study demonstrated enormous
      variability in the both the peak-inspired (26.3-90.0%) and end-expired
      concentrations (25.2-78.6%) of oxygen delivered to the trachea. There was a
      regular relationship between the ratio of peak inspiratory flows, expressed over
      fresh gas inflow and the end-expired oxygen concentrations which could allow
      estimation of inspired oxygen concentration.

PMID- 1626671
TI  - A pressure regulator for the cuff of a tracheal tube.
AB  - A regulator is described for the maintenance of a constant pressure difference
      above airway pressure during positive pressure ventilation in a cuffed tracheal
      tube. It comprises a tubular threshold valve which is powered by the anaesthetic
      gas supply source to a breathing system. The valve is interposed between the
      anaesthetic gas supply machine and the breathing system creating a pressure
      differential. The upstream pressure is transmitted to the pilot tube supplying
      the cuff of a tracheal tube via an upstream connection. The valve is suitable
      only for breathing systems that require a constant gas supply. The regulator was
      evaluated during anaesthesia, using a modified Mallinkrodt Hi-Lo jet ventilation
      tube to obtain simultaneous pressure measurements within the cuff and the lumen
      of the tracheal tube. A greater pressure was demonstrated in the cuff than in the
      airway and the two traces were approximately parallel throughout the respiratory
      cycle. The device should prevent excessive cuff inflation pressure and solves the
      problem of forgetting to let the cuff down before extubation.

PMID- 1626672
TI  - An evaluation of the Rapid Infusion System.
AB  - The performance of the Rapid Infusion System was evaluated in the laboratory.
      Using a conventional mixture of two units of packed red cells, two units of fresh
      frozen plasma and 500 ml crystalloid, a single line and a driving pressure of 300
      mmHg, the highest flow in our study was 970 ml.min-1 (2.8 mm catheter, no
      stopcock). With a 1.6 mm venous cannula the measured flow was 640 ml.min-1.
      Additional diluting of the standard 'blood cocktail' did not add much to the
      performance of the system. When primed with tap water 21 degrees C (12 degrees C
      respectively), the fluid at the outlet of the system reached a maximum
      temperature of 37.8 degrees C (37.4 degrees C) after 6 min at a flow of 400
      ml.min-1. At flows higher than 1150 ml.min-1 (priming with 12 degrees C tap
      water: 800 ml.min-1), the system slowed down to flows of 700 to 1000 ml.min-1 in
      order to maintain an adequate temperature. We conclude, that the Rapid Infusion
      System is a valuable tool for situations where a rapid but controlled replacement
      with warmed blood at rates up to at least 1100 ml.min-1 is needed. The use of
      large bore intravenous catheters and avoiding additional resistors such as
      standard 3-way stopcocks is highly recommended.

PMID- 1626673
TI  - Forces applied during laryngoscopy and their relationship with patient
      characteristics. Influence of height, weight, age, sex and presence of maxillary
      incisors.
AB  - The relationships between patients' height, weight, age, body mass index, gender
      and presence of maxillary incisors and a series of laryngoscopic factors have
      been studied. These included the duration of laryngoscopy, maximally applied
      force, mean applied force and the integral of force over time. There was a
      positive correlation between height and weight and laryngoscopic factors. Sex and
      age also showed a positive correlation but these could be explained by
      differences in height, weight and the presence of maxillary incisors. This latter
      factor was the dominant patient characteristic influencing the measured
      laryngoscopic factors. Use of these laryngoscopic factors as a measure of
      difficulty of laryngoscopy is discussed.

PMID- 1626674
TI  - The minimum effective dose of lignocaine to prevent injection pain due to
      propofol in children.
AB  - In a single-blind study of 100 children aged 1 to 10 years, the minimum effective
      dose of lignocaine required to prevent injection pain due to propofol was 0.2
      mg.kg-1 when veins on the dorsum of the hand were used. This is more than twice
      the adult value. We concluded that injection pain should not limit the use of
      propofol in children if an adequate amount of lignocaine is mixed immediately
      prior to injection.

PMID- 1626675
TI  - Continuous paravertebral block in children. Initial experience.
AB  - Continuous paravertebral block has not previously been described for use in
      children. This study reports the use of this technique in five patients (aged 7
      months to 8 years) scheduled for renal surgery or cholecystectomy. The block was
      not difficult to perform and provided good intra- and postoperative analgesia.
      Continuous paravertebral block appears to be a promising technique for pain
      management in children and might prove a valuable addition in the field of
      paediatric regional anaesthesia.

PMID- 1626676
TI  - Factors influencing epidural catheter migration.
AB  - The incidence and amount of migration of epidural catheters was investigated in a
      prospective randomised study of 153 women who required analgesia in labour.
      Inward or outward migration occurred in 36% of patients. Inward migration by 1-3
      cm occurred in 21 (13.7%) patients and outward migration by 1 cm or more occurred
      in 34 (22.2%); three (2%) catheters migrated out through the skin. There were
      significant positive correlations between outward migration and weight, body mass
      index, and depth of the epidural space. There was no relationship between
      migration and height, age, intervertebral space used or duration of
      catheterisation. Problems with epidural block were no more likely in patients in
      whom migration of 1 cm or more occurred compared with those in whom migration was
      limited to a maximum of +/- 0.5 cm. However, the pattern of problems was
      different. All cases of failed epidural block occurred in patients whose epidural
      catheter migrated outward by 2.5 cm or more. Unilateral blockade was not more
      likely if migration of 1 cm or more occurred.

PMID- 1626677
TI  - Perineuronal morphine in intercostal block.
AB  - In a double-blind, randomised study the potential benefits of combining low-dose
      morphine with bupivacaine for intercostal nerve blocks for analgesia after
      biliary surgery were investigated. There was no significant improvement in pain
      scores or consumption of supplementary analgesics when morphine was added to
      bupivacaine. This investigation supports the findings of other workers who showed
      that perineural morphine was ineffective for postoperative pain relief.

PMID- 1626678
TI  - Haemodynamic stability during general anaesthesia for intra-ocular surgery: the
      effect of topical oxybuprocaine.
AB  - Local anaesthesia is frequently used in combination with light general
      anaesthesia to reduce the reflex responses to surgical stimulation. This
      combination has not previously been evaluated for intra-ocular surgery. During
      cataract extraction under general anaesthesia, the effect of topical anaesthesia
      with oxybuprocaine 0.4% on the pressor response was compared with normal saline
      in a control group. The simple technique of instilling local anaesthetic drops
      into the conjunctival sac blocked the pain pathway sufficiently to prevent the
      pressor response to surgical stimulation (p less than 0.001). Higher inspired
      concentrations of enflurane were required in the control group to achieve and
      maintain haemodynamic stability (p less than 0.001).

PMID- 1626679
TI  - Intravenous regional anaesthesia with 0.5% prilocaine or 0.5% chloroprocaine. A
      double-blind comparison in volunteers.
AB  - Ten healthy male volunteers received intravenous regional anaesthesia of the
      upper limb on two separate occasions using 40 ml of 0.5% prilocaine or 40 ml
      plain 0.5% chloroprocaine by random allocation. Using a double-blind method, the
      onset and recovery of sensory block was tested (pinprick) in the four main nerve
      areas. The onset and recovery of motor block was measured by squeezing a rubber
      balloon connected to a manometer. The symptoms after deflation of the tourniquet
      were recorded. Seven volunteers in both groups developed total anaesthesia in 20
      min. Complete motor block occurred in 12.3 min with prilocaine and 11.3 min with
      chloroprocaine. Sensation recovered in all areas in 7.6 min with prilocaine and
      10.0 min with chloroprocaine (ns). Motor function recovered in 8.4 and 12.0 min
      respectively (p less than 0.01). Six volunteers in the chloroprocaine group
      showed signs of venous irritation and/or antecubital urticaria in the test arm
      for 30-45 min after the deflation. Four volunteers in the chloroprocaine group
      had increased in heart rate (greater than 20%) and one of them short periods of
      junctional rhythm during the first 2 min after tourniquet deflation. Mild, short
      lived CNS side effects occurred in both groups.

PMID- 1626680
TI  - The effect of pre-induction glycopyrronium on the haemodynamic response of
      elderly patients to anaesthesia with propofol.
AB  - This study investigated whether pretreatment with glycopyrronium can attenuate
      the hypotension caused by anaesthesia of the elderly with propofol. Twenty
      elderly patients (77.1 +/- 2.44 years, mean +/- SEM) of ASA physical status 2 or
      3 scheduled for elective urological procedures were given glycopyrronium 0 (n =
      10) or 5 micrograms.kg-1 (n = 10) in a randomised, double-blind manner, 5 min
      before induction of anaesthesia with propofol infused at 600 ml.h-1 (average
      induction dose 1.7 +/- 0.06 mg.kg-1, mean +/- SEM) followed by maintenance with a
      propofol infusion at 10 mg.kg-1.h-1. Although glycopyrronium significantly
      increased heart rate (p less than 0.01, ANOVA), the decrease in blood pressure 2
      and 5 min after induction was similar in both groups. The study had a power of
      80% to detect a 20 mmHg difference in systolic arterial pressure between
      treatment groups with p less than 0.05.

PMID- 1626681
TI  - Predicting difficult intubation. What factors influence the thyromental distance?

PMID- 1626682
TI  - The variable deadspace is not necessary.

PMID- 1626683
TI  - Anaesthetic death of a child with a cold.

PMID- 1626684
TI  - Manual ventilation and the Humphrey ADE breathing systems.

PMID- 1626685
TI  - Suprascapular nerve block. New indications and a safer technique.

PMID- 1626686
TI  - Intra-articular morphine for the management of frozen shoulder.

PMID- 1626687
TI  - Potential hazard with the M&IE Carden Ventmasta ventilator.

PMID- 1626688
TI  - A badly fitting tray.

PMID- 1626689
TI  - Blood reflux, central venous cannulation and right-sided haemothorax.

PMID- 1626690
TI  - Reversal of prolonged suxamethonium apnoea.

PMID- 1626691
TI  - Epidural infusion of bupivacaine and diamorphine for postoperative analgesia on
      surgical wards.

PMID- 1626692
TI  - Fibreoptic laryngoscopy as a method of assessing the risk of airway obstruction
      following laryngeal mask airway insertion.

PMID- 1626693
TI  - Decorative hairbands--an unusual cause of difficult intubation.

PMID- 1626695
TI  - Change to the TVX transducer cartridge.

PMID- 1626694
TI  - Patient misunderstanding.

PMID- 1626696
TI  - Can calcium channel blockers prior to tracheal intubation prevent myocardial
      ischaemia.

PMID- 1626697
TI  - Blease Manley 4 ventilator and PEEP.

PMID- 1626698
TI  - Maximal respiratory pressure measurement.

PMID- 1626699
TI  - Determination of protamine dose.

PMID- 1626700
TI  - More on automatic cardioverter-defibrillators.

PMID- 1626701
TI  - Problem with a laryngeal mask airway.

PMID- 1626702
TI  - Use of 15 mm tubing with the Humphrey ADE breathing system.

PMID- 1626703
TI  - Eliminating pollution in paediatric and dental anaesthesia.

PMID- 1626704
TI  - Planar chromatography.

PMID- 1626705
TI  - Liquid chromatography: theory and methodology.

PMID- 1626706
TI  - Size exclusion chromatography.

PMID- 1626708
TI  - Dynamic electrochemistry: methodology and application.

PMID- 1626707
TI  - Mass spectrometry.

PMID- 1626709
TI  - Cytochemical localization of dipeptidyl peptidase II activity in rat incisor
      tooth ameloblasts.
AB  - Dipeptidyl peptidase II (DPP II), E.C. 3.4.14.2, a serine class endopeptidase, is
      widely used as a lysosomal marker in cytochemical studies. To date most
      ultrastructural studies of ameloblasts use the presence of acid phosphatase
      activity to identify cellular organelles to be lysosomal. Using decalcified rat
      mandibles, with kidney tissue as a positive control, DPP II activity, was
      assessed with specific substrate Lysyl-alanine-4-methoxy-2-naphthylamide in
      ameloblasts at an ultrastructural level. Reaction product (RP) indicative of DPP
      II activity was observed only within lysosome-like organelles. These RP-labelled
      organelles were only localized in the supra- or para-nuclear regions of the
      ameloblasts, which corresponds with previous studies using acid phosphatase
      cytochemistry. However, in contrast with these studies, RP was not detected in
      the distal region of the ameloblasts, viz., in the Tomes' processes of the
      secretory ameloblasts or near the ruffled border in the maturation ameloblasts.
      The transitional ameloblasts were notable for the intensity of staining of their
      RP-labelled organelles. We propose that DPP II may have a role in programmed cell
      death which is thought to occur in this transition zone. Biochemical analysis of
      rat incisor enamel organ homogenates, indicated tissue fixation resulted in an
      82% reduction in DPP II activity, although the specific activity of DPP II was
      not affected.

PMID- 1626710
TI  - Chondroclasts and endothelial cells collaborate in the process of cartilage
      resorption.
AB  - The condylar cartilage of the young rat is a major growth center of the
      craniofacial complex. Differences between the mechanism that results in bone
      formation from growth centers in the epiphyseal plates of long bones are dictated
      primarily by the different character of the mineralization of the cartilage. In
      this ultrastructural study we demonstrate that the terminal hypertrophic
      chondrocytes undergo apoptosis and disintegration while simultaneously
      chondroclasts dissolve gaps in the calcified cartilage that engulfs them. The
      latter are also phagocytizing debris of the chondrocytes. The chondroclasts are
      intimately followed by tube-forming endothelial cells that most probably coalesce
      to create extensions of the invading capillaries into the evacuated lacunae. The
      chondroclasts have ultrastructural features similar to osteoclasts. They are
      multinucleate, are rich in mitochondria and vacuoles, form clear zones that
      adhere to the spicules of the calcified cartilage, and also form a sort of
      ruffled border. The latter is not as elaborate and orderly arranged as is known
      from osteoclasts. The capillaries that follow orient the stroma cells to the
      evacuated lacunae and, together with the calcified cartilaginous scaffold, supply
      the adequate environmental conditions for the stroma cells to differentiate into
      osteoblasts and to build up trabecular bone.

PMID- 1626711
TI  - Changes in the apical microfilaments of rat uterine epithelial cells in response
      to estradiol and progesterone.
AB  - This study investigates the interaction of hormones and the cytoskeleton within
      the apical cytoplasm of uterine epithelial cells of the rat. The effects of the
      hormones estradiol-17 beta and progesterone on the microfilament configuration
      were studied using myosin subfragment 1 (S1) decoration of actin microfilaments
      (MF) and transmission electron microscopy. In control ovariectomized animals, a
      sparse MF distribution was found in the apical cytoplasm underlying short
      microvilli with S1-decorated core MF. Hormone treatment experiments consisted of
      injecting ovariectomized rats with either progesterone or estradiol-17 beta. For
      the study of the MF configuration accompanying an apical surface primed for
      blastocyst receptivity, progesterone treatment was immediately followed by a
      single dose of estradiol-17 beta. The long, regular microvilli associated with
      estradiol only treatment contained bundled, decorated MF with tightly bundled
      rootlets. Progesterone alone produced numerous short microvilli with decorated
      core bundle MF and pronounced rootlets that frequently appeared splayed. The
      irregular microvilli and luminal surface of the uterine epithelial cells
      associated with the receptivity hormone sequence contained variable MF
      configurations, including MF bundles, networks, and areas with a "felted"
      appearance. The results show that the various hormone regimes produce
      characteristically different MF configurations and that this component of the
      cytoskeleton appears to be under the control of a delicate hormone balance within
      these uterine cells. The responses of uterine MF to specific regimes of steroid
      hormones used in this study are not only important for the understanding of the
      mechanisms at work during early pregnancy, but also contribute to the body of
      knowledge concerning the ways in which hormones in general effect the
      cytoskeleton of target cells.

PMID- 1626712
TI  - Reinitiation of gonocyte mitosis and movement of gonocytes to the basement
      membrane in testes of newborn rats in vivo and in vitro.
AB  - Movement of postnatal gonocytes to the periphery of the seminiferous cord, where
      they contact the basement membrane, and resumption of mitosis by these previously
      quiescent cells are likely to be critically important in establishing
      spermatogenesis in neonatal rats. We used several approaches both in vivo and in
      vitro to determine precisely when each of these two events begins, to study their
      temporal relationship to each other, to determine whether gonocyte division is a
      prerequisite for relocation or vice versa, and to probe the source of factors
      initiating and/or regulating these events. Both light and electron microscopy
      were used to determine that the first gonocytes make contact with the basement
      membrane on postnatal day 4, while quantitative autoradiography following 3H
      thymidine administration in vivo indicated that the first gonocytes to re
      initiate cell division do so one day earlier, on day 3, and that the percentage
      of gonocytes dividing remains at a stable level through day 5. Moreover, we organ
      cultured neonatal testes from birth onwards in the presence of defined, serum-
      and hormone-free medium and determined that both proliferation and relocation of
      gonocytes begin and continue in vitro as in vivo. This observation argues against
      involvement of extratesticular factors in stimulating gonocyte relocation and
      division, and points to the testis itself as the most likely source of agent(s)
      regulating postnatal maturation of these cells. In other, similar incubations we
      included 3H-thymidine for varying periods of time to label either those gonocytes
      that are the first to divide or all gonocytes that divide during the first 48 hr
      of culture. From these studies, we confirmed that the first gonocytes to divide
      do so while separated from the basement membrane and found that, although some
      cells divide before moving peripherally, others do not.

PMID- 1626713
TI  - Evidence that hepatocytes can phagocytize exogenous substances.
AB  - Although the phagocytic action of Kupffer cells is well known, such a phenomenon
      has not been well documented for hepatocytes. Following the injection of a
      suspension of egg lecithin-coated silicon particles (0.5-1.5 microns in diameter)
      into the portal vein of rats, Kupffer cells showed minimal phagocytotic action,
      which was in contrast to the hepatocytes which displayed numerous phagocytized
      silicon particles. By comparison, when noncoated silicon particles of the same
      diameter as those that were coated were injected into the portal vein, the
      opposite observation was made. There was no uniformity in the ability of the
      hepatocytes to phagocytize either coated or noncoated particles from one lobule
      to another. Some showed active phagocytosis, while in others no evidence of such
      a process was observed. These data provide strong evidence for the selective
      phagocytic action of liver hepatocytes.

PMID- 1626714
TI  - Forms of lung lymphatics: a scanning electron microscopic study of casts.
AB  - In a recent study, rats given monocrotaline underwent angiogenesis on their
      pleural surfaces. The rats also had novel structures in their bronchovascular
      bundles that were detected by scanning electron microscopy of vascular casts.
      These vessels could have been either new blood capillaries or dilated lymphatic
      capillaries. To determine if these structures were lymphatics or new blood
      vessels, specimens from animals that were undergoing angiogenesis were compared
      to those that were not. Finding similar structures in normal animals would imply
      that they were lymphatic. The second purpose of this work was to describe the
      three-dimensional anatomy of the lymphatics of the lung. Cast lymphatics were
      found in most lungs with edema or angiogenesis, but were rare in other
      conditions. The vascular structures in question were found in animals not
      undergoing angiogenesis and were, therefore, lymphatic. Additionally, scanning
      electron microscopy of casts showed several distinct forms of lymphatics in the
      lung. Prelymphatics are tissues planes beneath the pleura and around
      bronchovascular structures. They join reservoir, conduit or tubulo-saccular
      lymphatics. Reservoir lymphatics are broad ribbon-like structures with textured
      surfaces and small laterally branching pouches. They occur on the pleural
      surface, are closely linked with prelymphatics, and join conduit lymphatics.
      Conduit lymphatics are tubular structures that may contain valves, twist and go
      great distances without accepting tributaries. On the pleural surface, they may
      wind around blood vessels and vary greatly in diameter. Sacculo-tubular
      lymphatics surround arteries, veins and bronchioles. They have thin walls with
      wide saccular segments. They may be so dense that they form cylinders around the
      vessels or airways. Different forms of lung lymphatics suggest different function
      and potential.

PMID- 1626715
TI  - Scanning and transmission electron microscopy of venous sphincters in the rat
      lung.
AB  - The rat pulmonary microvasculature was studied using scanning and transmission
      electron microscopy of vascular corrosion casts and tissue sections. Special
      emphasis was placed on small pulmonary venous vessels. The shape of vascular
      casts was analyzed and interpreted concerning the wall composition of
      corresponding vessels studied in tissue sections. On the casts of pulmonary
      venules and small pulmonary veins, narrow or wider annular constrictions were
      regularly observed. Within these constrictions, marks of circularly running
      grooves were seen as an additional structural detail, which obviously mimic
      impressions of single or grouped smooth muscle cells. The depth of the
      constrictions varies; it may be more or less pronounced, occasionally narrowing
      down the luminal diameter to approximately 50%. These constrictions are caused by
      muscular sphincters. In tissue sections of small pulmonary veins, sphincter
      regions were identified as abruptly appearing single or grouped true smooth
      muscle cells. Smooth muscle cells may be arranged side by side in a group or
      bundle or even staked in two or three layers. Between the sphincter regions, the
      venous wall consists merely of endothelium and an accompanying connective tissue
      layer. The smooth muscle cells of a sphincter are regularly positioned between
      endothelial layer and elastic lamina. The smooth muscle cells next to the
      endothelium form myoendothelial junctions. Autonomic nerves near the sphincters
      were never seen. The venous sphincters described are suggested to be effective
      devices involved in blood flow regulation. Blood-borne substances or local tissue
      hormones might govern sphincter function.

PMID- 1626716
TI  - Immunohistological characterization of proximal colonic lymphoid tissue in the
      rat.
AB  - Proximal colonic lymphoid tissue (PCLT) is a lymphoid structure located in the
      proximal colon of the mouse and the rat. In the present investigation we studied
      the immunomorphology and cytology of PCLT in the rat. We also studied sites of
      lymphocyte proliferation using the BrdU-anti BrdU technique. Results demonstrated
      no evident phenotypical differences between the lymphocyte populations of PCLT
      and either jejunal or ileal Peyer's patches (PP). The majority of the lymphocytes
      within PCLT were B cells localized in follicles, which were separated from each
      other by interfollicular T cell areas. Germinal centers (GC), containing ED5+
      follicular dendritic cells, are found within PCLT follicles. The T cell areas
      contained both MHC Class II+ interdigitating cells and high endothelial venules.
      Studies using BrdU-anti BrdU indicated that lymphocyte proliferation within PCLT
      takes place mainly in germinal centers. Together the data show that the
      organization, lymphoid constituents, and sites of lymphocyte production are very
      similar in PCLT and PP. We therefore conclude that PCLT in the rat is not a Bursa
      equivalent, but more likely a PP with some special characteristics.

PMID- 1626717
TI  - Follicle-associated epithelium and medullary epithelial tissue of the bursa of
      fabricius are two different compartments.
AB  - The bursae of Fabricius from the chicken and turkey were studied by light and
      electron microscopy and immunohistochemical methods. The study focused on the
      relationship of follicle-associated epithelium to the medulla. The follicle
      associated epithelium was supported by 3 to 5 layers of stratified epithelial
      cells which were a continuation of the corticomedullary epithelial cells. The
      follicle-associated epithelium consisted of M cells and scattered secretory
      dendritic cells. The network of the reticular epithelial cells of the medulla was
      filled with secretory dendritic cells, B cells, and a few T cells and
      macrophages. The cellular content of the follicle-associated epithelium and the
      medulla suggested that they were different cellular compartments. Communication
      between the follicle associated epithelium and medullary epithelial compartment
      occurred through the supporting cells of the follicle-associated epithelium. When
      the supporting layers of the follicle-associated epithelium infolded into the
      medulla, they formed lamellated epithelial bodies similar to the thymic Hassall
      bodies. The lamellated bodies enclosed secretory dendritic cells but not
      lymphocytes. The infolding of supporting cells varied from follicle to follicle.
      The asynchronization of infolding contributed to heterogeneity of follicle
      composition. Follicle heterogeneity was demonstrated by differences in reactivity
      with a battery of monoclonal antibodies.

PMID- 1626718
TI  - Demonstration of amelogenin in the enamel-free cusps of rat molar tooth germs:
      immunofluorescent and immunoelectron microscopic studies.
AB  - The enamel-free cusps of 1-4 day-old rat mandibular first molars were
      investigated using the monoclonal antibody En3 against rat amelogenin at light
      and electron microscopic levels in order to clarify whether the enamel-free cusp
      is virtually devoid of enamel. At 1 day after birth, there were presecretory
      ameloblast-like cells (PALCs), which were short and were not polarized, at the
      cusp tips. They were close to the outer enamel epithelium. Hematoxylin positive
      enamel matrix was not distinctly observed in the enamel-free cusp by light
      microscopy, but almost continuous immunofluorescence for amelogenin was detected
      at the interface between PALCs and dentin. The penetration of immunopositive
      material toward the dental pulp was also observed in the enamel-free cusp. At 4
      day after birth, both in the frontal section and in the horizontal section,
      almost continuous immunofluorescence was recognized at the interface between
      PALCs and dentin in the enamel-free cusp. The penetration of amelogenin toward
      the dental pulp was not seen in the enamel-free cusp. By immunoelectron
      microscopy, immunolabelling was recognized in the Golgi apparatus of PALCs, in a
      layer of amorphous material at the interface between PALCs and dentin, and in
      stippled material-like substance in the intercellular space between PALCs.
      Although no basement membrane was observed beneath PALCs, they did not have
      Tomes' processes. These investigations suggest that PALCs in the enamel-free cusp
      differentiate into the secretory cells and that they can synthesize and secrete
      the amorphous material containing amelogenin at the interface between PALCs and
      dentin. The penetration of amelogenin toward the dental pulp might play a role in
      the interaction between PALCs and odontoblasts in the enamel-free cusp and/or the
      initiation of mineralization of predentin.

PMID- 1626719
TI  - Postnatal development of the harderian gland in the Syrian golden hamster
      (Mesocricetus auratus): a light and electron microscopic study.
AB  - The main objective of the present investigation was to study the morphological
      and chronological aspects of the development of the Harderian gland in the Syrian
      golden hamster. Tissues were obtained from male and female hamsters at days
      1,3,5,7,10,12,15,17,20,27,37,46, and 90 after birth and processed for light and
      transmission electron microscopy. The present observations indicate that a well
      defined temporal sequence in microscopic and ultrastructural modification is
      recognizable in the development of the hamster Harderian gland. Four stages of
      development were proposed. Between days 1-5 (first stage), the gland shows
      characteristics of an immature structure. The glandular cells contain many free
      ribosomes, few and small organelles, and large irregular-shape nuclei. Between
      days 7-17 (second stage), there is a marked increase of organelles involved in
      synthesis and secretion. The gland begins the secretion of lipids and porphyrins,
      but no morphological differences between male and female glands are observed.
      Between days 20-36 (third stage), the morphological differences between the two
      sexes appear and progressively develop. In 45-day-old hamsters, the Harderian
      gland possesses the structural characteristics of adult glands, and further
      developmental changes are essentially quantitative in nature (fourth stage). At
      all stages of development, the population of secretory cells has a uniform
      appearance. The morphological results are discussed as well as the possible
      relationship of this temporal sequence with hormonal changes.

PMID- 1626720
TI  - Inhibition of epibranchial placode-derived ganglia in the developing rat by
      bisdiamine.
AB  - Although bisdiamine has been shown to affect the development of mammals, its
      effect on the nervous system has gone largely unrecognized. In the present study,
      rats were given bisdiamine by gavage on days 9 and 10 of pregnancy. They were
      sacrificed at intervals and the fetuses were prepared for study of serial
      sections stained with hematoxylin and eosin, or by immunohistochemical reaction
      with HNK-1 monoclonal antibody. HNK-1 reacted strongly with the nervous system,
      allowing precise analysis of the components and their relationships. Controls
      receiving no bisdiamine were prepared and studied in parallel with the
      experimental fetuses. Administration of bisdiamine inhibited development of the
      petrosal and nodose ganglia, altered associations of the glossopharyngeal, vagus,
      and hypoglossal nerves, and inhibited contributions of vagal nerve fibers to the
      developing enteric system. The proximal ganglia of the glossopharyngeal and vagus
      nerves developed normally. It is concluded that bisdiamine affects, directly or
      indirectly, the differentiation of nervous components derived from the
      epibranchial placodes. It seems likely that these placode-derived components
      serve as pioneer neurons in establishing the pathway for the posteriorly
      extending trunks of the glossopharyngeal and vagus nerves. The early changes in
      congenital conditions such as the DiGeorge syndrome may not be limited to
      alterations in neural crest derivatives. It may be worthwhile to investigate more
      closely whether there are alterations in the nervous system associated with these
      syndromes.

PMID- 1626721
TI  - Selective lectin-binding sites of primordial germ cells in chick and quail
      embryos.
AB  - To ascertain the histochemical characteristics of surface carbohydrates on avian
      primordial germ cells (PGC), we examined the distribution of binding sites for
      several biotinylated lectins in chick and quail embryos. Some binding sites were
      detected almost selectively with PGC but not with other embryonic sites. Of
      these, lectin from Sojanum tuberosum (STA) reacted with PGC in both avian
      species, whereas lectin from Wistaria floribunda (WFA) and Griffonia
      simplicifolia II (GS-II) reacted in the quail and the chick, respectively. The
      binding site for STA was found at the cell surface and cytoplasm of the PGC from
      their initial appearance in the germinal crescent through migration to sexually
      indifferent gonads, whereas the WFA reaction was seen at stages before and during
      migration. These reactivities showed most intensely on the surface of PGC at the
      peak of their migration. In contrast, GS-II binding site was restricted to the
      cytoplasm, and its distribution was similar to that of the periodic acid-Schiff
      (PAS)-positive glycogen granules in chick PGC. These results suggest that some
      selective binding sites on the PGC surface play a significant role in their
      migration and show that lectins STA, WFA, and GS-II can be used as probes for
      identification of the avian PGC.

PMID- 1626722
TI  - Stratificational relationship among the main nerves from the dorsal division of
      the sacral plexus and the innervation of the piriformis.
AB  - In order to comprehend more completely the morphology of the nerves to the
      piriformis, it is necessary to obtain a detailed understanding of the
      relationship of the origin and the course of these nerves from the dorsal
      division of the sacral plexus, with reference to the superior and inferior
      gluteal nerves. Twelve of seven human pelvic halves were carefully dissected in
      order to examine the origins of the nerves from the dorsal division of the sacral
      plexus. Six of these pelvic halves were further dissected under a
      stereomicroscope to examine the nerves to the piriformis. 1. The origin of the
      superior gluteal nerve was more proximal and dorsal in the sacral plexus than
      that of the inferior gluteal nerve. 2. The superior gluteal nerve consisted of a
      thick cranial part and a thin caudal part; the former continued as the inferior
      branch of the nerve, and the latter, the superior branch. The cranial and caudal
      parts crossed before reaching the glutei medius and minimus. 3. The nerves to the
      piriformis arose from three main nerves from the dorsal division of the sacral
      plexus: 1) the caudalmost root of the superior gluteal nerve, 2) the caudal roots
      of the inferior gluteal nerve and 3) the common peroneal nerve. Considering the
      stratificational relationship among the main nerves from the dorsal division of
      the sacral plexus, the piriformis appears to be composed of parts from different
      muscle layers.

PMID- 1626723
TI  - Arteriographic study of the rabbit lower limb.
AB  - The rabbit hind limb has been used extensively as an orthopaedic model in the
      investigation of fracture pathology and healing and the effects of vascular
      abnormalities. However, a detailed description of the normal arterial supply
      appears to be absent from the literature. A study of the entire arterial
      vasculature has been undertaken using a lead oxide injection technique developed
      for this and other orthopaedic studies. This technique has proved reliable and
      inexpensive, giving high-quality arteriography, which is easily interpreted.
      Accurate description of the arterial anatomy is possible without the need for
      repeated dissection. The rabbit lower limb shows some interesting variations in
      blood supply, particularly below the knee. The foot has three distinct patterns
      of blood supply, depending on the presence or absence of the peroneal artery and
      the degree of dominance of the dorsalis pedis artery. This arrangement has not
      previously been described and differs from the situation in other mammals. The
      arteriographic technique and the anatomical description have allowed the
      interpretation of changes occurring in the vasculature after injury in a fracture
      model.

PMID- 1626724
TI  - Plastic embedding procedure for 15 microns sections of large undecalcified tissue
      blocks.
AB  - A method is described that produces sections (15 microns) of large specimens
      (with dimensions up to 140 x 100 x 200 mm). They are suitable for comparison to
      CT images of that specimen and can be used as a basis for three-dimensional
      reconstructions. Frozen unfixed parts of the human body are embedded in
      polyurethane and scanned with CT. Undecalcified slices, 6 mm thick, of these
      specimens are cut with a bandsaw. These slices are successfully embedded in
      polyester resin by means of fixation, dehydration, and subsequent impregnation
      with this resin. Sections of 15 microns are obtained by cutting the trimmed and
      sandpapered polyester blocks with an LKB multirange microtome. They are collected
      on adhesive tape and stained according to Weigert-Azan, sealed between adhesive
      acetate sheets and photographed on colour slide film. As an example photographs
      of sections of the human elbow and lumbar spine region are presented.

PMID- 1626725
TI  - [Arteriovenous fistulae of posttraumatic origin: apropos 7 cases].
AB  - We present our experience with arterio-venous traumatic fistulas. Seven cases,
      between 6 patients are reviewed. Respective etiologies were: 4 cases after an
      accidental traumatism, 2 cases produced by iatrogenicity and 1 case of idiopathic
      etiology. Respective localizations were: 6 cases at lower limbs (85.7%) and one
      case at cervical column (14.2%). All patients underwent surgical treatment. There
      was any case of mortality and treatment results were satisfactory in all cases.
      Patients were followed and, up to now, no recidives have been registered. follow
      time ranged from 1.5 to more than 6 years.

PMID- 1626726
TI  - [Cholesterol embolism: an infrequent cause of ischemic ulcers of the lower
      extremities].
AB  - A case of cholesterol embolism with digital ulcerations is reported. Pathologic
      anatomy, Radiologic images, symptomatology and treatment of such pathology are
      discussed.

PMID- 1626727
TI  - [Simultaneous coronary and carotid surgeries].
AB  - Two patients with severe coronary artery disease and significant stenosis of the
      left internal carotid artery were operated upon. A combined or simultaneous
      operation was performed in both, carotid endarterectomy plus coronary artery
      bypass surgery was performed. The patients are symptoms-free after the operation
      and with evidence of satisfactory reconstruction in the carotid and coronary
      arteries. A review of the topic simultaneous revascularization of the carotids
      and coronary arteries in presented.

PMID- 1626728
TI  - [Acute arterial thrombosis of the extremity in pseudoxanthoma elasticum].
AB  - We report a case of a patient with an elastic pseudoxanthoma (PXE) who presented
      an acute ischaemia at the left lower limb. The cause of such ischaemia was a
      thrombosis into the iliac and femoropopliteal arteries. Patient underwent a
      surgical procedure. The arteriopathy associated with a PXE rarely cause an
      arterial major occlusion. We did not found a case of acute arterial thrombotic
      ischaemia and PXE, treated with direct arterial revascularization in the reviewed
      literature.

PMID- 1626729
TI  - [Postural physiotherapy: a possible conservative treatment of the thoracic outlet
      syndrome].
AB  - A physiotherapy treatment protocol of "thoracic outlet syndrome" is presented.
      This treatment is based on the correction positional and not on the reinforcement
      and developing of determinate muscular groups. Treatment includes 10 exercises,
      which have to be progressively practiced during each seance. Twenty patients were
      included into the assay, and they have no signs of their Syndrome by the end of
      the study. Authors conclude that positional physiotherapy treatment is effective
      on cases of "thoracic outlet syndrome" without neurovascular complications.

PMID- 1626730
TI  - [The study of arteriogenic erectile impotence by noninvasive methods].
AB  - With the development of noninvasive haemodynamic methods, recognition of arterial
      insufficiency signs is possible also in cases in which, in old times, we just
      could suspect a psychogenic cause. Although this advance, discrimination
      permitted by this method can be improved. Eighty-eight supposed healty patients
      and eighty-four patients with arteriogenic erectile impotency (tested by
      arteriography) were included into an study, which results are presented in here.
      Analysis made, avoided the effect of envelleiment on haemodynamic parameters
      interpretation. For identification of patients which obstructive arterial defect
      can be cause of sexual disfunction, combination of systolic pressure
      determination and arterial flow velocity curves (by Doppler ultrasonography) is
      proposed. We recommend this method as a part of the multifactorial examen
      required by such type of patients.

PMID- 1626731
TI  - The Simon nitinol filter: evaluation by MR and ultrasound.
AB  - In this prospective blinded study of inferior vena caval (IVC) patency, 18
      patients underwent 25 duplex ultrasound (US) and magnetic resonance (MR)
      angiography examinations over an eight-month period following Simon nitinol
      filter placement. Clinical examination for lower extremity venous stasis and
      plain abdominal radiography were also performed. Twenty-three of 24 MR
      examinations and 11 of 24 US examinations were judged technically adequate by the
      blinded observers. One technically adequate US exam was false positive for
      intraluminal caval thrombus. Thirteen technically inadequate US examinations
      missed 3 complete caval occlusions and 2 partial occlusions. MR identified all
      patients with complete or partial caval occlusion. The authors conclude that
      duplex US reliably confirms IVC patency only when strict criteria for technical
      adequacy and interpretation are met (good visualization of filter and IVC above
      and below filter). MR, although expensive, more reliably identifies nonoccluding
      intraluminal thrombus and caval occlusion. It should be the noninvasive study of
      choice in symptomatic patients with venous stasis and patients with recurrent
      pulmonary emboli.

PMID- 1626732
TI  - Effect of pentoxifylline on treatment of lower limb ulcers in patients with
      thalassemia major.
AB  - The possible healing effect of deferoxamine and pentoxifylline on persisting
      lower limb ulcers was studied in 51 patients with thalassemia major. The results
      indicated that the regular use of deferoxamine at an intravenous dose of 20 mg/kg
      did not affect the healing progress and the recurrence rate of these ulcers
      significantly. On the contrary, the oral administration of pentoxifylline at a
      dose of 1,200 mg daily during the ulcer's healing time and at a low long-term
      maintenance dose of 400 mg daily during the ulcer-free intervals improved their
      healing ability impressively and diminished their recurrence rate significantly.

PMID- 1626733
TI  - Measuring ankle systolic blood pressure: validation of the Dinamap 1846 SX.
AB  - Clinical and epidemiologic situations requiring repeated measurements of blood
      pressure in the lower extremity are increasingly incorporating automated
      measurement devices; however, no device has been validated adequately for ankle
      blood pressure. This study evaluates the Dinamap 1846 SX against Doppler
      ultrasound in determining ankle systolic blood pressure (SBP) and compares a
      parallel with contour wrapping technique for applying the blood pressure cuff.
      Ankle SBP was measured on 71 adult volunteers by both devices simultaneously, for
      each cuff wrap. Averages of three readings were compared to evaluate Dinamap
      versus Doppler SBP estimates and to assess any cuff wrap effect. Multiple linear
      regression was used to assess potential effect modifiers. Instrument differences
      (Dinamap minus Doppler) for the parallel wrap (95% confidence intervals in
      parenthesis) were -1.5 mmHg (-3.1, 0.0) and -3.9 mmHg (-5.6, -2.2) for the
      contour wrap. Wrap effect differences (contour minus parallel) for the Doppler
      were -4.9 mmHg (-6.3, -3.5) and -7.2 mmHg (-8.7, -5.8) for the Dinamap. Degree of
      ankle taper was a strong modifier of cuff effect for the Dinamap but not for the
      Doppler: adjusted cuff effect with the Dinamap ranged from -3 to -10 mmHg.
      Measurement precision (within-person reproducibility, measured by within-person
      standard deviation [sigma 2] and reliability coefficient [R]) was higher for the
      Dinamap than the Doppler technique, lowest for the parallel wrap and Doppler
      configuration (sigma 2 = 5.4 mmHg, R = 0.88) and greatest for the contour wrap
      and Dinamap (sigma 2 = 4.0 mmHg, R = 0.94). In conclusion, cuff-wrapping
      technique can generate SBP differences of greater magnitude than instrument
      differences. Conditional on the use of the contour wrap, and by virtue of its
      high repeatability and ease of operation, the Dinamap is a useful tool for
      epidemiologic study and the clinical assessment of peripheral arterial disease.

PMID- 1626734
TI  - Measurement of lymphatic flow variation by noninvasive method cases of
      lymphedema.
AB  - The purpose of this study was to measure the variations of lymphatic flow. A
      noninvasive isotopic method was used to achieve a functional exploration of
      lymphatic circulation. Fifteen subjects were used in the study: 10 healthy
      subjects and 5 patients with lower extremity lymphedema. A first subcutaneous
      injection of technetium 99m rhenium sulfate (99mTc) was performed in the first
      interdigital space of both feet. The radioactivity was recorded in two places:
      the first one on the inguinal site by a gamma camera; the second, below the
      first, on the precordial site by a multichannel analyzer. With the two types of
      recording procedures, it was possible to obtain a curve that showed the amount of
      radioactivity in relation to time. In order to obtain a muscular activity fifty
      five minutes after the injection, each subject or patient spent ten minutes on an
      ergometric bike. A second subcutaneous injection was performed one week later,
      but prior to the injection, the subject or patient took orally 1800 mg of
      heptaminol adenosine phosphate (HAP) per day for three days. The radioactivity
      recording was made under the same conditions as with the muscular activity. The
      statistical results of the experiment without treatment on the two types of
      recording show that in the healthy subjects the amount of radioactivity increased
      during muscular activity. Moreover, the treatment indicated higher radioactivity
      values, which remained at a higher level. However, the muscular activity
      performed by a patient was unable to increase the radioactivity. On the other
      hand, the drug gave radioactivity values that were higher than the previous
      values of the first curve.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626735
TI  - Short- and long-term comparative study of anistreplase versus streptokinase in
      acute myocardial infarction.
AB  - Streptokinase is well established as an effective thrombolytic. Anistreplase, a
      new thrombolytic drug, is a complex of streptokinase and acylated human
      plasminogen that can be administered by intravenous bolus and activates
      plasminogen at the clot site. Although both streptokinase and anistreplase are
      effected in treating myocardial infarction (MI), they have different
      pharmacologic properties. This study was designed to identify short- and long
      term differences in their clinical effectiveness, safety in use, and survival
      rates in patients with acute MI. One hundred ten successive patients under
      seventy years of age admitted within three hours after onset of sustained chest
      pain suggestive of acute MI were randomized to receive either 30 units of
      anistreplase intravenously over five minutes or intravenous injection of 750,000
      units of streptokinase over thirty to sixty minutes. Reperfusion was achieved in
      34 of the 52 (65%) patients treated with anistreplase and in 41 of the 58 (71%)
      patients treated with streptokinase (p = NS). The two drugs were equally
      effective in preserving left ventricular ejection fraction, which was found to be
      significantly better in patients with anterior wall MI who had achieved
      reperfusion than it was in those who did not (p less than 0.02). One-month,
      twelve-month, and thirty-six-month survival rates were high (96% to 88%) with no
      significant difference between the two treatment groups. The authors conclude
      that the two drugs are equally effective thrombolytic agents but that
      anistreplase has the advantage that it can be administered as a bolus injection.

PMID- 1626736
TI  - Ventricular arrhythmias induced by programmed ventricular stimulation after
      uncomplicated myocardial infarction.
AB  - The aim of this study was to correlate the occurrence of ventricular dysrhythmias
      induced by programmed ventricular stimulation and sudden cardiac death (SCD)
      after a first episode of acute myocardial infarction (AMI). Twenty-seven
      consecutive male patients aged fifty-four +/- six (forty-seven to seventy) years
      were studied prospectively. Thirty days after AMI, patients were submitted to
      coronary arteriography and programmed ventricular stimulation with the S2-S3-S4
      protocol. Noninvasive assessments, including Holter monitoring, ECG stress test,
      and radionuclide ejection fraction, were also repeated six and twelve months
      after AMI. Ventricular dysrhythmias were induced in all patients. According to
      such response, patients were divided into three groups: (1) repetitive
      ventricular response (n = 9); (2) nonsustained ventricular tachycardia (n = 8);
      and (3) sustained ventricular tachycardia (n = 10). All patients consistently
      developed complex ventricular dysrhythmias at Holter monitoring and ECG stress
      test. One patient from group 2 suffered SCD and another presented a syncope.
      Similarly, in group 3, 2 patients suffered SCD, 1 during a documented episode of
      recurrent AMI. Except for 1 patient, radionuclide ejection fraction remained
      unchanged throughout the study in all cases. SCD was also unrelated to the
      presence and type of dysrhythmias at noninvasive evaluation. Therefore, the type
      of ventricular dysrhythmia induced by the S2-S3-S4 protocol has no correlation
      with late SCD in patients with a first AMI and preserved ejection fraction.

PMID- 1626737
TI  - Efficacy of antihypertensive medication in orthotopic heart transplant recipients
      and its effect on renal function.
AB  - The authors looked at 77 patients following orthotopic heart transplant who
      received a triple immunosuppressive regimen including cyclosporine to see the
      effect of various antihypertensive medications on mean arterial blood pressure
      and renal function. There were 62 men and 15 women retrospectively classified
      into three groups according to the antihypertensive medications they received.
      Group 1 included 26 patients followed up for 10.7 +/- 2.7 months who received
      hydralazine therapy. Group 2 included 32 patients followed up for 9.0 +/- 3.4
      months who received angiotensin-converting enzyme inhibition therapy. Group 3
      included 19 patients followed up for 10.1 +/- 3.3 months who received beta
      adrenergic blocking agents. Mean arterial pressure (MAP), serum blood urea
      nitrogen (BUN), and serum creatinine (CR) were determined for each group at the
      start and end of the follow-up period. The MAP at the start of the study was 107
      +/- 14 in group 1, 110 +/- 13 in group 2, and 100 +/- 11 in group 3. It was not
      statistically significantly different in any of the groups. At the end of the
      follow-up period, MAP was 112 +/- 10, 111 +/- 10, and 106 +/- 12 for the three
      groups respectively, and it was not significantly different in any group. The
      serum BUN in group 3 was 25 +/- 8 mg/dL at the start of the study, and it was not
      significantly lower than that in group 1, 28 +/- 6, but it was significantly
      different from that in group 2, 34 +/- 9, P less than 0.05. At the end of the
      follow-up period, the difference was still maintained.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1626739
TI  - Heterogeneity of rabbit aortic endothelial cells, with special reference to
      phagocytosis.
AB  - Heterogeneity of aortic endothelial cells with regard to phagocytotic ability was
      examined by injecting India ink into normal rabbits. Light and electron
      microscopic analyses revealed that particles of India ink were phagocytosed in
      the endothelial cells, which in turn were localized at the distal side of the
      orifice of aortic branches, especially those of brachiocephalic, left clavicular,
      and dorsal intercostal arteries. No remarkable differences were found
      ultrastructurally between phagocytosing and nonphagocytosing endothelial cells.
      Ingested India ink particles were present within phagosomes of the endothelial
      cells for several hours after injection; the particles eventually accumulated in
      the subendothelial space twenty-four hours after injection. These results
      indicate that an active transport system of large molecules via the phagocytotic
      processes is present in endothelial cells located at the distal sides of the
      orifice of aortic branches. These regions are known to develop initial
      atherosclerotic lesions in hypercholesterolemic animals. Thus, a possible
      correlation between phagocytotic ability of endothelial cells and development of
      atherosclerosis is suggested.

PMID- 1626738
TI  - A four year clinical and echographic follow-up of asymptomatic carotid plaque.
AB  - Eighty-five patients with asymptomatic carotid plaque--a diagnosis revealed by B
      mode high-resolution echotomography--were followed up for four years; the
      echoplaque changes were compared with the clinical history. Eight patients died
      (2 from stroke, 4 from myocardial infarction, and 2 from lung tumor) and were
      excluded from the follow-up. Three patients underwent carotid
      thromboendarterectomy (TEA) (1 bilateral), and these 4 carotids were not
      considered in the total series. At the first echo Doppler evaluation of 150
      carotids, plaques were observed in 112; 38 vessels were free of lesions. Of the
      150 carotids, 8 revealed a new plaques. In regard to the echogenic pattern, 95 of
      the 112 plaques (84.8%) remained unchanged, 16 (14.3%) progressed, and regression
      of a small homogeneous plaque was observed in 1 patient (0.9%). An increase of
      the degree of vascular stenosis, was observed in 23 of the 150 carotids (15.3%).
      Cerebral ischemic symptoms occurred in 5 patients. In 1 patient who suffered from
      stroke, a new, soft, dyshomogeneous plaque in the carotid of the side of the
      lesion was observed. In 3 patients (2 with strokes, 1 with transient ischemic
      attack) the occlusion of a previous severe stenosis was observed. The fifth
      patient had a stroke on the side of an unchanged, ulcerated hemodynamic lesion. A
      valid criterion for identifying a risky plaque should be the joint evaluation of
      the echostructural characteristics and the degree of stenosis.

PMID- 1626740
TI  - Blood rheology after LDL apheresis using dextran sulfate cellulose absorption--a
      case report.
AB  - The authors describe a thirty-eight-year-old woman with familial
      hypercholesterolemia treated by dextran sulfate cellulose adsorption apheresis.
      This technique and the selective extracorporeal LDL cholesterol elimination by
      immunoabsorption or heparin-induced precipitation not only dramatically decrease
      blood lipids but also result in a marked improvement in the rheologic profile. It
      is suggested that the amelioration of blood rheology by LDL apheresis may
      represent the cause for the early clinical improvement felt by most patients with
      severe coronary heart disease and hypercholesterolemia.

PMID- 1626741
TI  - Intralobar sequestration of the lung presenting as a continuous murmur--a case
      report.
AB  - An eighteen-year-old asymptomatic woman with a continuous murmur, normal two
      dimensional echocardiogram, and mild haziness of the left lower segment of the
      lung on chest x-ray was diagnosed to have sequestration based on the presence of
      a large anomalous systemic artery arising from the descending thoracic aorta
      supplying the lower lobe of the left lung. Normal bronchial connections with the
      rest of the lung on bronchoscopy and delayed dye clearance from the left lower
      lobe bronchioles on bronchogram indicated its intralobar nature. The cause of the
      continuous murmur was thought to be the large flow through the anomalous systemic
      artery.

PMID- 1626742
TI  - Congenital antithrombin III deficiency causing mesenteric venous infarction: a
      lesson to remember--a case history.
AB  - Congenital antithrombin III deficiency is an uncommon but important cause of
      venous thrombosis, usually presenting with recurrent or atypical venous
      thromboembolism. Its importance lies in the fact that early recognition can lead
      to treatment in the acute stage, which can prevent propagation of the disease,
      and further prophylactic treatment may reduce the incidence of further episodes.
      The authors present a case of mesenteric venous infarction associated with
      congenital antithrombin III deficiency and briefly discuss the diagnosis,
      surgical implications, and treatment of this disorder.

PMID- 1626743
TI  - TIAs in a spontaneously dissecting aneurysm of the internal carotid artery--a
      case report.
AB  - A spontaneous internal carotid artery dissection of an aneurysmal form is
      reported. The patient, a fifty-eight-year-old man, had manifested recurrent
      transient left hemiparesis, dysesthesia of the left upper limb, and dysarthria
      for three months. After administration of ticlopidine, the transient ischemic
      attacks completely disappeared. Three months later, the follow-up angiographic
      study revealed the same form of dissection in the same portion as compared with
      the initial study. Conservative therapy was successful.

PMID- 1626744
TI  - Mandibular incisor extraction--postretention evaluation of stability and relapse.
AB  - Pretreatment, posttreatment and 10-year postretention dental cast and lateral
      cephalogram records of 42 patients were evaluated. Each patient had undergone
      edgewise orthodontic treatment following removal of one or two mandibular
      incisors and various maxillary teeth. Seven of 24 patients (29%) in the single
      incisor extraction group and 10 of 18 (56%) patients in the two-incisor
      extraction group demonstrated unacceptable mandibular incisor alignment at the
      postretention stage. This result was considerably more favorable than the results
      of previously reported premolar extraction cases (70% unacceptable alignment at
      postretention). Intercanine width decreased during treatment and continued to
      decrease postretention in most cases. Overbite and overjet remained acceptable.
      No associations could be found to predict the amount of relapse.

PMID- 1626745
TI  - Periodontal considerations in the use of bonds or bands on molars in adolescents
      and adults.
AB  - This longitudinal study compared the periodontal status of bonded and banded
      molars in 20 adult and 40 adolescent patients before, during and after treatment
      with fixed orthodontic appliances. Plaque accumulation (measured by the Plaque
      Index), gingival inflammation (measured by the Gingival Index and the bleeding
      tendency), and pocket depth were assessed by one examiner at sites along the
      mesio-buccal line angle of the maxillary right first molar and the mandibular
      left first molar. Assessments were made immediately prior to the placement of
      fixed appliances (pretreatment), at 1, 3, 6, 9, 12 and 18 months after appliances
      were placed; and 3 months after appliances were removed (posttreatment). Loss of
      attachment between the pretreatment and posttreatment visits also was determined.
      At pretreatment, no significant differences were found in gingival inflammation
      between maxillary and mandibular banded and bonded molars. During treatment, both
      maxillary and mandibular banded molars showed significantly (p less than 0.05)
      greater gingival inflammation and plaque accumulation than did bonded molars.
      Three months after appliance removal, the maxillary molars that had been banded
      continued to show significantly more gingival inflammation and loss of attachment
      than did the maxillary molars that had been bonded. When all banded and bonded
      teeth were grouped by patient age, mean values for plaque accumulation and
      gingival inflammation in the maxillary molar regions were significantly greater
      for adolescents than for adults.

PMID- 1626746
TI  - A proportional analysis of the soft tissue facial profile in young adults with
      normal occlusion.
AB  - A proportional soft tissue profile analysis is presented, based on natural head
      position (NHP) and an extracranial vertical reference line through Porion. Twelve
      linear soft tissue variables and norms for 11 indices expressing vertical and
      horizontal soft tissue proportions of the face were obtained from lateral skull
      radiographs of 40 Swedish adults (20 males, and 20 females) with good occlusion.
      Sexual dimorphism, with larger dimensions in men than in women, was most
      pronounced in the vertical plane. With regard to facial soft tissue proportions,
      significant differences between men and women were found only for those indices
      which involved measurements of lower jaw prominence and facial height. The means
      and standard deviations for six indices in the female group were compared with
      corresponding data obtained from the Peck and Peck sample, which had been
      selected on esthetic grounds. The results showed a close match between the
      groups. The proportional soft tissue analysis is recommended for the treatment
      planning of patients scheduled for orthognathic surgery.

PMID- 1626747
TI  - A comparison of the effects of first premolar extractions on third molar
      angulation.
AB  - The effect of third molars on the stability of orthodontic treatment has been
      studied extensively. Yet the effect of orthodontic treatment, particularly
      premolar extractions, on third molars has not been substantially studied. The
      purpose of this investigation was to compare the changes in third molar
      angulation in patients treated with and without extractions. Records of 45 Class
      I, nonextraction and 33 Class I, first premolar extraction patients were
      examined. The pretreatment and posttreatment pantographs were digitized, and the
      angles between the third molar long axes and the occlusal plane were measured.
      Changes in third molar angulation from pretreatment to posttreatment for the two
      groups were compared for statistical differences using a Student's t-test.
      Statistical analysis revealed there were no significant differences in the change
      in third molar angulation in either group. On average, the maxillary and
      mandibular third molars showed an improvement in angulation relative to the
      occlusal plane. The results suggest that factors other than first premolar
      extractions may influence third molar angulation.

PMID- 1626748
TI  - Craniofacial pattern of Class III deciduous dentition.
AB  - The purpose of this study was to investigate the morphological characteristics of
      the cranio-dento-facial complex of children with deciduous dentition and Class
      III malocclusion. Forty Chinese children in Taiwan with normal occlusion and 40
      with Class III malocclusion in deciduous dentition were selected for
      cephalometric analysis. Mandibular length was significantly greater and the
      mandible was situated farther forward in the Class III group. The maxilla was
      also slightly backward in this group, perhaps in association with the shorter
      maxillary length. The mandibular incisors were tipped lingually to compensate for
      the intermaxillary skeletal dysplasia and the maxillary incisors were tipped
      lingually by the retroinclined mandibular incisors.

PMID- 1626749
TI  - Problems associated with ceramic brackets suggest limiting use to selected teeth.
AB  - Ceramic brackets became popular as esthetic appliances which could withstand
      orthodontic forces and resist staining better than plastic brackets. Several
      clinical complications may arise from the use of ceramic brackets. They include
      the effects debonding can have on underlying enamel, attrition of teeth occluding
      with ceramic brackets and increased friction in the orthodontic appliance.
      Solutions to these problems are discussed which indicate the need for careful
      selection of teeth to be bonded with ceramic brackets.

PMID- 1626750
TI  - Case report HL.

PMID- 1626751
TI  - The orthodontist's role in managing traumatic dental injuries.

PMID- 1626752
TI  - Vertical malocclusion article raises questions.

PMID- 1626753
TI  - Vertical malocclusion article raises questions.

PMID- 1626754
TI  - The gingival smile line.
AB  - A comparative study was performed to examine the nature of the gingival smile
      line (GSL), a specific dentolabial configuration characterized by the exposure of
      maxillary anterior gingiva during a full smile. Five soft-tissue, three dental
      and three skeletal variables were selected, measured and reported for a GSL
      sample (n = 27) and a reference sample (n = 88), both consisting of North
      American white orthodontic patients with a median age of 14.4 years. The results
      indicated that the capacity to project a gingival smile was related to: anterior
      vertical maxillary excess and the muscular ability to raise the upper lip
      significantly higher than average when smiling. Other variables significantly
      associated with GSL were greater overjet, greater interlabial gap at rest, and
      greater overbite. Factors that did not appear associated with the GSL phenomenon
      were upper-lip length, incisor clinical crown height, mandibular plane angle, and
      palatal plane angle. Clinical aspects of GSL were discussed.

PMID- 1626755
TI  - Intranasal administration of a beta adrenergic amine: an alternative to metered
      dose inhalers.
AB  - In anesthetized, artificially ventilated guinea pigs, intranasal and intravenous
      administration of albuterol produced the same maximum degree of protection
      against bronchoconstriction induced by bilateral electrical stimulation of the
      cervical vagal nerves. Intranasal albuterol showed a slower onset of action than
      intravenous albuterol and exhibited equivalent cardiovascular side effects for
      the same level of bronchoprotection. Accordingly, intranasal albuterol may
      represent an alternative to metered-dose inhalation for prophylaxis and treatment
      of bronchoconstriction in humans.

PMID- 1626756
TI  - Delayed hypersensitivity to diltiazem in two patients.
AB  - We report two cases of cutaneous adverse reactions during treatment with
      diltiazem. Both patients developed wide-spread, pruriginous, erythematous,
      maculopapular eruptions with fever and facial angioedema, 48 to 72 hours after
      starting diltiazem. Delayed hypersensitivity to diltiazem was suspected and the
      diagnosis was confirmed by skin patch tests followed by cutaneous biopsy.

PMID- 1626757
TI  - Comparison of terbutaline Turbuhaler and albuterol chlorofluorocarbon (CFC)
      inhaler in middle-aged and elderly patients with obstructive lung disease.
AB  - The aim of the present study was to compare the effect of terbutaline Turbuhaler
      (0.5 mg qid) with that of albuterol chlorofluorocarbon (CFC) inhaler (0.2 mg qid)
      in middle-aged and elderly patients with obstructive lung disease. The study was
      performed as an open cross-over (2 x 2 weeks) and randomized study in 85
      patients. A significant increase in PEF was seen after inhalation from both
      devices (P less than .001). Baseline PEF values before inhalation were higher
      with Turbuhaler than with the CFC inhaler both in the mornings and in the
      evenings. Fifty-six percent of the patients preferred terbutaline Turbuhaler and
      26% albuterol CFC inhaler (P = .004).

PMID- 1626758
TI  - Malignant idiopathic anaphylaxis: three additional cases and extended evaluation.
AB  - Northwestern University's Division of Allergy and Immunology (NUAI) has evaluated
      and treated 225 patients with idiopathic anaphylaxis (IA) over a period of 16
      years. Four patients have been identified with malignant IA. The term "malignant"
      is used to identify those patients with the most severe form of IA that is
      resistant to standard therapy. The diagnosis of malignant IA is made in patients
      with IA whose controlling oral corticosteroid dose was not able to be reduced
      below 60 mg of prednisone (or its equivalent) every other day or 20 mg of
      prednisone (or its equivalent) every day without an exacerbation of IA. Presented
      here is the long-term evaluation of one patient as well as three additional
      patients with malignant IA managed by our service. At the time of this report we
      have had no deaths due to IA in patients treated with pharmacologic regimen.

PMID- 1626759
TI  - Isolated early response after nasal allergen challenge is sufficient to induce
      nasal hyperreactivity.
AB  - Ten rhinitic patients allergic to grass pollen were challenged with histamine
      intranasally 24 hours before and 24 hours after nasal provocation with grass
      pollen. Up to ten hours after allergen provocation nasal lavage fluid was
      obtained to characterize early and late phase reactions by measuring the levels
      of histamine and leukotrienes as indicators of mediator release, and albumin as a
      marker of increased vasopermeability. Ten minutes after allergen challenge with
      10,000 BU grass pollen extract LTC4,D4, and albumin significantly increased from
      62 to 576 pg/mL (P = .008) and from 15 to 81 micrograms/mL (P = .008),
      respectively, without significant changes after placebo challenge a week earlier.
      Although the patients showed increased responsiveness to histamine after allergen
      challenge compared with a placebo-challenged control group (P = .02), one patient
      only demonstrated a late phase nasal allergic reaction characterized by
      recurrence of clinical symptoms eight to ten hours after allergen challenge and
      recurrence of mediators in lavage fluid. It is concluded that an isolated early
      response after allergen challenge is sufficient to induce nasal hyperreactivity.
      A biochemically or clinically defined late phase allergic reaction does not
      necessarily accompany allergen-induced hyperreactivity.

PMID- 1626760
TI  - Immunoassay of specific IgE: use of a single point calibration curve in the
      modified radioallergosorbent test.
AB  - Interest in immunoassay standardization has prompted development of specific IgE
      assays reporting results related to the international IgE reference. To examine
      the single point calibration curve employed in the modified RAST assay (MRT) to
      convert MRT counts to IgE units, independent dilutions of a 25 kU/L total IgE
      reference and nine allergic sera (three each for short ragweed, cat, and timothy)
      were made in horse serum and assayed. In a log-log plot, the single point curve
      was, by definition, linear over its entire range; the dilution curve was
      curvilinear because of reagent system saturation, which was at 7 kU/L. Curves
      were not parallel (P less than .001). Allergen-specific dilution curves showed
      saturation points at values similar to or less than the total IgE system. The
      linear portions of these curves paralleled the total IgE dilution curve but not
      the single point curve. This lack of parallelism would have resulted in varying
      magnitudes of error in estimation of IgE antibody levels in the upper and lower
      assay ranges, and would imply a lower detection limit for IgE than that which the
      assay actually has. Modified RAST assay is not appropriate in research or a
      clinical situation in which accurate quantitative results are needed. Modified
      RAST assay would furthermore be an inappropriate means of assigning units to
      proposed reference preparations for standardization.

PMID- 1626761
TI  - Etiologic factors in childhood chronic urticaria.
AB  - In order to identify the etiologic factors in childhood chronic urticaria, we
      studied 226 children, 122 boys and 104 girls, aged 1 to 14 (mean = 8.14) years
      with chronic urticaria and/or angioedema. The initial evaluation consisted of a
      thorough history, physical examination, and basic laboratory tests. Specific in
      vivo and in vitro tests were done according to the findings of the initial
      evaluation. Urticaria alone was present in 78.4% of the patients, angioedema
      alone in 6.6%, and both urticaria and angioedema in 15% of the patients. Chronic
      urticaria was attributed to physical factors in 6.2% of the patients, infections
      in 4.4%, aeroallergens in 2.2%, foods in 4%, food additives in 2.6%, and drugs in
      1.8% of the patients. Overall, causal factors of chronic urticaria were found in
      21.2% of the patients.

PMID- 1626762
TI  - High prevalence of celiac disease in healthy adults revealed by antigliadin
      antibodies.
AB  - Sera from 1866 healthy blood donors and from 40 untreated adults with celiac
      disease were analyzed using a micro-ELISA assay. Blood donors with IgA
      antigliadin activity greater than 40 units corresponding to the 96.8th percentile
      and IgG antigliadin activity greater than 20 units corresponding to the 91.3rd
      percentile were selected for further investigation and jejunal biopsy. Seven of
      49 blood donors with high IgA antigliadin activity showed mucosal lesions typical
      for celiac disease. None of the donors with high IgG antigliadin activity (35
      subjects) but without high IgA activity had such mucosal lesions. A prevalence of
      celiac disease of at least 1/256 was observed in the donor group. There were
      significant age-group differences in IgA antigliadin activity. In the present
      study, a high IgA antigliadin activity had a positive predictive value between
      18% and 25% in individuals without symptoms indicative of celiac disease
      depending on the way the cut-off points were chosen. In contrast, the positive
      predictive value of high IgG antigliadin activity alone was estimated to be 0%.

PMID- 1626764
TI  - Improving compliance.

PMID- 1626763
TI  - Continuous nebulization for status asthmaticus.
AB  - Continuous nebulization of beta 2 agonists is now recognized as a useful
      treatment for severe exacerbations of asthma. This mode of administration has
      been described both for adults and children in the emergency room and in the
      intensive care unit. It has been suggested that early use of continuous
      inhalation therapy may reduce or prevent the need for intensive care unit
      admissions and potentially toxic treatments such as intravenous beta agonists and
      mechanical ventilation. A number of methods have been proposed for continuous
      administration of beta agonists, however, there is no concensus as to the best
      one. The lack of controlled studies clearly demonstrating superior outcomes in
      patients who receive this treatment leaves many questions unanswered. In
      addition, differences in efficacy and safety between frequent and continuous
      nebulization, if any, are unclear. Adverse effects primarily consist of muscle
      cramps, hypokalemia, and hyperglycemia. It is suggested that use of this
      treatment should be considered for the asthmatic patient who demonstrates
      progression towards significant obstruction before institution of the more toxic
      treatments listed above. While continuous nebulization has not been proven to
      prevent the need for them, it is clearly safer. Should population studies
      eventually fail to demonstrate its superior efficacy, continuously nebulized beta
      2 agonist therapy may still be beneficial for individual patients.

PMID- 1626765
TI  - Pharmacist substitution of slow-release products.

PMID- 1626766
TI  - Monitoring for airborne allergens.
AB  - Monitoring for allergens can provide some information on the kinds and levels of
      exposure experienced by local patient populations, providing volumetric methods
      are used for sample collection and analysis is accurate and consistent. Such data
      can also be used to develop standards for the specific environment and to begin
      to develop predictive models. Comparing outdoor allergen aerosols between
      different monitoring sites requires identical collection and analysis methods and
      some kind of rational standard, whether arbitrary, or based on recognized health
      effects.

PMID- 1626767
TI  - Microvascular circulation of the descending colon in horses.
AB  - The microvascular circulation of the descending colon was studied in 5 adult
      horses, using microangiography and light microscopy combined with gross studies
      and scanning electron microscopy of vascular replicas. After heparinization,
      horses were euthanatized, and 3 segments of the descending colon and its
      mesentery containing 1 vascular arcade were removed from each horse. The fecal
      balls were gently massaged from the lumen, and the blood was flushed free of the
      circulation with isotonic NaCl. In 5 segments, the vascular system was injected
      with a modified radiopaque medium and evaluated radiographically. Specimens
      examined radiographically also were prepared for histologic examination, using
      standard methods. Ten segments were injected with 1 of 2 types of plastics and
      studied grossly or by scanning electron microscopy. Arcuate arteries gave rise to
      a descending colonic rete that surrounded the vein and supplied numerous
      descending colonic lymph nodes. The rete also supplied the mesocolon and the
      descending colonic tissue. Short filamentous vessels arising from the rete
      directly penetrated the mesenteric tenia to supply an intermuscular plexus
      between the longitudinal and circular muscle layers of the muscularis externa.
      Larger vessels arising from either side of the rete divided into the long- and
      short-terminal arteries that supplied an extensive submucosal plexus, which was
      continuous around the circumference. The submucosal plexus supplied the mucosa,
      the tunica muscularis, and the serosa. Vessels running centrifugally from the
      submucosal plexus formed an intermuscular plexus between the longitudinal and
      circular muscle layers of the muscularis externa. The intermuscular plexus at the
      mesenteric angle also was supplied by vessels branching from the short-terminal
      arteries as they penetrated the muscularis externa.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1626768
TI  - Anatomic and radiographic study of the lacrimal apparatus of llamas.
AB  - The anatomy of the nasolacrimal duct of llamas was examined grossly and
      radiographically in 2 llamas. Dacryocystorhinography was performed on cadaver
      heads, using a radiographic aqueous contrast agent. Anatomic casts of the
      nasolacrimal apparatus were obtained by cannulation of the duct and use of
      polyurethane cast material. Dacryocystorhinography accurately revealed the
      nasolacrimal apparatus and compared favorably with gross dissections and
      polyurethane casts.

PMID- 1626769
TI  - Effects of two adenoviruses (type 1 and type 8) on functional properties of
      bovine alveolar macrophages in vitro.
AB  - Cultures of bovine alveolar macrophages were inoculated with type-1 and type-8
      adenoviruses, initially isolated from calves with respiratory tract disease, and
      functional properties of the cells were observed over a period of 10 to 11 days.
      Both viruses replicated in macrophages; viral titers were low (less than 3.75
      log10 TCID50/0.1 ml), and intranuclear inclusions were detected by indirect
      immunofluorescence in 5 to 10% of the cells from 3 days after inoculation.
      Highest titers were induced by type-1 adenovirus, which also induced the greatest
      functional changes. Expression of Fc and complement receptors was reduced by both
      viruses, although the greatest effects were seen with type 1. Phagocytosis of
      Candida krusei cells was reduced following type 1 infection, whereas phagocytosis
      in type-8-infected cells was not different from that of noninfected macrophages.
      Ability to kill ingested Candida cells also was reduced following type-1
      infection, whereas type-8-infected macrophages had lower killing ability only at
      2 to 4 days after inoculation. Neither virus had substantial effects on the
      production of neutrophil chemotactic factors by the macrophages.

PMID- 1626770
TI  - Investigation of antibodies to extractable nuclear antigens in dogs.
AB  - Determination of antibodies to specific nuclear antigens, termed extractable
      nuclear antigen (ENA), was investigated in healthy dogs and in dogs with
      autoimmune, inflammatory, and neoplastic diseases. Using a
      counterimmunoelectrophoresis method, the dogs' sera were tested for antibodies
      against the nuclear antigens single-stranded DNA, Sm, Ro, La, ribonucleoprotein,
      Scl, and proliferating cell nuclear antigen. Antibodies to the Ro antigen were
      found in 1 dog with discoid lupus erythematosus, in 1 dog with pemphigus
      erythematosus, and in 1 dog with facial pyoderma and chronic superficial
      keratitis. In 15 dogs, antibodies were detected to ENA, but the precipitin lines
      were too weak to identify the specific ENA. These antibodies were found in some
      dogs with systemic lupus erythematosus, discoid lupus erythematosus, pemphigus
      erythematosus, dermatomyositis, vitiligo, lymphoma; in the dog with facial
      pyoderma and chronic superficial keratitis; and in 1 healthy dog. The highest
      percentage of dogs with antibodies to ENA in a large series (greater than 8) of
      this study was in dogs with systemic lupus erythematosus (4 of 13; 31%).

PMID- 1626771
TI  - Cardiopulmonary, anesthetic, and postanesthetic effects of intravenous infusions
      of propofol in greyhounds and non-greyhounds.
AB  - The cardiopulmonary, anesthetic, and postanesthetic effects of an IV infusion of
      the hypnotic agent propofol were assessed in 6 Greyhounds and 7 non-Greyhounds.
      After IM injection of acetylpromazine and atropine, a bolus injection of propofol
      sufficient to allow endotracheal intubation (mean +/- SEM = 4.0 +/- 0.3 mg/kg of
      body weight in Greyhounds; 3.2 +/- 0.1 mg/kg in non-Greyhounds) was administered,
      followed by continuous infusion at a rate of 0.4 mg/kg/min for 60 minutes, during
      which time dogs breathed 100% oxygen. In 23% of all dogs (3 of 13), apnea
      developed after initial bolus administration of propofol. Arterial blood pressure
      was well maintained in all dogs, but heart and respiratory rates were decreased
      significantly (P less than 0.05) during the infusion in Greyhounds. In
      Greyhounds, mild respiratory acidosis developed after 45 minutes, whereas
      arterial carbon dioxide tension was increased at all times after propofol
      administration in non-Greyhounds. In all dogs, PCV and total plasma proteins were
      unaffected by propofol. Rectal temperature decreased during treatment. Muscle
      tremors were observed in approximately 50% of dogs (in 3 of 6 Greyhounds and 3 of
      7 non-Greyhounds) during and after infusion of propofol. Non-Greyhounds lifted
      their heads, assumed sternal recumbency, and stood 10 +/- 1, 15 +/- 3, and 28 +/-
      5 minutes, respectively, after the end of the infusion; in Greyhounds, the
      corresponding times were 36 +/- 4, 43 +/- 6, and 63 +/- 7 minutes.

PMID- 1626772
TI  - Hematologic and serum biochemical effects of long-term administration of anti
      inflammatory doses of prednisone in dogs.
AB  - Results of routine hematologic and serum biochemical analyses from 12 healthy
      adult male dogs that were given prednisone (0.55 mg/kg of body weight, PO, q 12
      h) for 35 days were compared with those of a control group of 6 dogs that were
      given gelatin capsules. Analyses were performed at 2-week intervals during and
      after prednisone administration. Lymphocyte and eosinophil counts were
      significantly (P less than 0.005) decreased after 2 and 4 weeks of prednisone
      treatment, compared with controls. Two weeks after treatment, eosinophil counts
      in prednisone-treated dogs were similar to those of control dogs, whereas
      lymphocyte counts remained low 4 weeks after treatment in treated dogs (1,869 +/-
      145 cells/microliters), compared with that in control dogs (3,662 +/- 548
      cells/microliters). Neutrophil and monocyte counts did not significantly change
      during glucocorticoid administration. Mean platelet volume significantly (P less
      than 0.001) decreased after 4 weeks of prednisone treatment, but returned to
      pretreatment values by 2 weeks after treatment. Four weeks of prednisone
      treatment did not cause significant increased activity in serum alanine
      transaminase, total alkaline phosphatase or the steroid-induced isoenzyme of
      alkaline phosphatase. Significant increases in serum albumin (P less than 0.001)
      and total protein (P less than 0.05) concentrations were detected after 4 weeks
      of treatment, but mean values were not significantly different from those of
      controls 2 weeks after treatment ended. Results of our study indicate that
      eosinophil and lymphocyte counts are the most sensitive indicators of long-term
      glucocorticoid administration at anti-inflammatory dosages of 1.1 mg/kg daily.

PMID- 1626773
TI  - Morphologic and biochemical study of sternal cartilage autografts for resurfacing
      induced osteochondral defects in horses.
AB  - Using biodegradable pins, sternal cartilage autografts were fixed into
      osteochondral defects of the distal radial carpal bone in ten 2 to 3-year-old
      horses. The defects measured 1 cm2 at the surface and were 4 mm deep. Control
      osteochondral defects of contralateral carpi were not grafted. After confinement
      for 7 weeks, horses were walked 1 hour daily on a walker for an additional 9
      weeks. Horses were euthanatized at 16 weeks. Half of the repair tissue was
      processed for histologic and histochemical (H&E and safranin-O fast green)
      examinations. The other half was used for the following biochemical analyses:
      type-I and type-II collagen contents, total glycosaminoglycan content, and
      galactosamine-to-glucosamine ratio. On histologic examination, the repair tissue
      in the grafted defects consisted of hyaline-like cartilage. Repair tissue in the
      nongrafted defects consisted of fibrocartilaginous tissue, with fibrous tissue in
      surface layers. On biochemical analysis, repair tissue of grafted defects was
      composed predominantly of type-II collagen; repair tissue of non-grafted defects
      was composed of type-I collagen. Total glycosaminoglycan content of repair tissue
      of grafted defects was similar to that of normal articular cartilage. Total
      glycosaminoglycan content of nongrafted defects was 62% of that of normal
      articular cartilage (P less than 0.05). Repair tissue of all defects was
      characterized by galactosamine-to-glucosamine ratio significantly (P less than
      0.05) higher than that of normal articular cartilage. These results at 16 weeks
      after grafting indicate that sternal cartilage may potentially constitute a
      suitable substitute for articular cartilage in large osteochondral defects of
      horses.

PMID- 1626774
TI  - Lymphoscintigraphy in healthy dogs and dogs with experimentally created thoracic
      duct abnormalities.
AB  - Lymphoscintigraphic evaluation of the thoracic duct (TD) was performed in 10
      healthy and 12 dogs with experimentally created TD abnormalities (6 dogs with TD
      lacerations and 6 dogs with cranial vena ligations). Complete imaging took 4
      hours and caused no adverse effects or complications. Lymphoscintigraphy of
      healthy dogs failed to image the TD; however, background activity in the abdomen
      and thorax, and radioactivity in the kidneys, bladder, liver, and heart were
      noticed. Lacerations and transections of the TD were experimentally created in 6
      dogs to ascertain whether TD rupture could be detected with lymphoscintigraphy.
      Lymphoscintigraphy was performed within 48 hours of creating the TD defect. There
      was no significant difference in the scintigraphic pattern of healthy dogs and
      those with experimentally created TD defects. Ligation of the cranial vena cava
      was performed in 6 dogs; 3 dogs developed chylothorax. In those 3 dogs, diffuse
      radioactivity was imaged in the thorax and was compatible with thoracic
      lymphangiectasia. In one of these dogs, linear activity consistent with the TD
      and localized regions of radioactivity cranial to the heart (compatible with the
      mediastinal lymph nodes) were noticed. Lymphoscintigraphic findings in these dogs
      correlated with lymphangiographic findings.

PMID- 1626775
TI  - Evaluation of sulbactam plus ampicillin for treatment of experimentally induced
      Klebsiella pneumoniae lung infection in foals.
AB  - Efficacy of sulbactam, a beta-lactamase inhibitor, in combination with
      ampicillin, was evaluated for treatment of experimentally induced pneumonia
      caused by beta-lactam-resistant Klebsiella pneumoniae. Infection was
      experimentally induced in 18 healthy weanling foals that were randomly allocated
      to 3 treatment groups: sulbactam plus ampicillin (S/A, 3.3 and 6.6 mg/kg of body
      weight, respectively), ampicillin (6.6 mg/kg), or vehicle only. Foals were
      treated daily for 7 days; the observer was unaware of treatment status. Compared
      with ampicillin and vehicle, treatment with S/A resulted in a statistically
      significant (P less than 0.05) decrease in severity of pneumonia, with regard to
      bronchoalveolar lavage cytologic findings (decreased total cell and neutrophil
      numbers, and increased lymphocyte numbers) and extent of macroscopic lesions in
      lung tissue of the noninoculated regions. Marked trends toward improvement of S/A
      treated foals were observed for quantitative results of bacteriologic culture of
      bronchoalveolar lavage fluid samples (P less than 0.07), macroscopic pathologic
      features of the whole lung (P less than 0.1), and histopathologic variables (P
      less than 0.07), compared with ampicillin- and vehicle-treated foals. Treatment
      effects were not observed for radiographic, hematologic, and blood gas
      abnormalities that resulted from infection. In conclusion, the combination of
      sulbactam plus ampicillin was found to have synergistic effects in vivo, to
      reduce the extent and severity of experimentally induced gram-negative lung
      infection in foals.

PMID- 1626776
TI  - In vitro comparison of equine granulocytes labeled with 99mTc
      hexamethylpropyleneamine oxime or 111In-oxine.
AB  - Isolated equine granulocytes (WBC), radiolabeled with 99mTc
      hexamethylpropyleneamine oxime (99mTc-HMPAO) or 111In-oxine, were evaluated in
      vitro for their labeling characteristics, viability, and phagocytic function over
      a 6-hour postlabeling period. Mean +/- SD labeling efficiency for 111In-oxine-WBC
      was 62.2 +/- 15.3%, which was significantly (P less than 0.001) higher than that
      for 99mTc-HMPAO-WBC (32.0 +/- 17.0%). In vitro elution of radiolabel from cells
      was significantly (P less than 0.02) greater for 99mTc-HMPAO-WBC at 0.5, 2, and 4
      hours, but was not significantly different from elution of radiolabel for 111In
      oxine-WBC at 6 hours. Viability, assessed by trypan blue dye exclusion, for 99mTc
      HMPAO-WBC, 111In-oxine-WBC, and nonlabeled control WBC ranged from 97 to 100%,
      and was not significantly different among groups. Cell function was assessed by
      use of a phagocytosis assay and was reported as phagocytic index. The phagocytic
      index ranged from 0.86 to 0.96 for 99mTc-HMPAO-WBC, and from 0.76 to 0.97 for
      111In-oxine-WBC. The phagocytic index was not significantly different at 0.5, 2,
      or 4 hours, but was significantly (P = 0.038) greater at 6 hours for 99mTc-HMPAO
      WBC. Because of the superior imaging characteristics of 99mTc-HMPAO-WBC and equal
      or better labeling characteristics than those for 111In-oxine at 6 hours, 99mTc
      HMPAO-WBC appear to be a good alternative to 111In-oxine-WBC.

PMID- 1626777
TI  - Evaluation of an enzyme-linked immunosorbent assay for diagnosis of
      trichinellosis in swine.
AB  - Experimental and field trials were conducted to evaluate an ELISA for its ability
      to detect Trichinella-infected domestic swine and to compare ELISA results with
      muscle-digestion test results. The ELISA used was a commercial double-antibody
      kit, containing an excretory-secretory antigen, and was evaluated principally for
      epidemiologic use. Experimentally induced infection in swine (4 groups of 3 pigs
      each; inoculated with 0, 50, 500 or 5,000 larvae) was detected as early as
      postinoculation week 4, with seroconversion of all inoculated swine by
      postinoculation week 8. The rate of seroconversion appeared to be affected by
      initial larval dose, time after inoculation, and immunocompetence of the
      individual host. Determination of antibody kinetics generally revealed rapidly
      increasing antibody titer, followed by its steady decrease in most pigs. Once
      seropositive, however, all pigs remained seropositive for the duration of the 10
      week study. Presence of muscle larvae was confirmed in all infected pigs at
      termination of the study. We recognize that the experimental conditions may not
      be truly representative of those under which natural infection develops in pigs;
      however, the ELISA detected an infected pig with muscle larval density of 0.87
      larvae/g of tissue. Results of a field trial (n = 310) indicated no muscle
      digestion test-positive pigs (35 g of diaphragm muscle digested/pig), but 3
      samples tested positive by ELISA for specificity of 99.0%.

PMID- 1626778
TI  - Effects of intracameral injection of tissue plasminogen activator on corneal
      endothelium and intraocular pressure in dogs.
AB  - Contact wide-field specular microscopy was performed on eyes of 16 healthy dogs
      after tissue plasminogen activator at a concentration of 25 micrograms/100
      microliters (group 1, n = 8) or 50 micrograms/100 microliters (group 2, n = 8)
      was injected into 1 anterior chamber of each dog. The contralateral eye served as
      a nontreated control. Applanation tonometry was used to measure intraocular
      pressure in both eyes for up to 168 hours. By use of computerized morphometric
      analysis and pachymetry, changes from baseline values in endothelial cell
      density, cell morphologic features, and corneal thickness were evaluated at
      postinjection hours 24, 48, and 168. Significant mean differences in intraocular
      pressure were not detected between treated eyes of group-1 dogs and those in
      group 2 at designated times, or between treated and nontreated eyes of dogs in
      either group. Mean corneal thickness of treated and nontreated eyes was similar
      in both groups through postinjection hour 168. Changes in mean percentage of
      endothelial cell sides were observed only in treated eyes of group-2 dogs, with
      the mean percentage of hexagons at postinjection hour 168 decreasing by 18%, a
      decrease that was significantly (P less than 0.05) greater than the decrease in
      nontreated eyes. The mean percentage of 6-sided cells in treated eyes of group-2
      dogs was significantly (P less than 0.05) less than that in treated eyes of group
      1 dogs at postinjection hour 168.

PMID- 1626779
TI  - Use of tissue plasminogen activator for intraocular fibrinolysis in dogs.
AB  - Fibrin clots were induced in eyes of dogs by injection of autogenous citrated
      plasma into the anterior chamber. Twenty-four hours after clot formation, 0.01 ml
      of tissue plasminogen activator at a concentration of 1 microgram/100 microliters
      (group 1, n = 5) or 25 micrograms/100 microliters (group 2, n = 5) was injected
      into 1 anterior chamber of each dog. The contralateral eye served as a nontreated
      control. Serial photographs were taken of the fibrin clots after intracameral
      injection of tissue plasminogen activator. Computerized morphometric analysis was
      then used to evaluate changes in cross-sectional surface area of the fibrin clot.
      Significant (P less than 0.001) fibrin-clot lysis was detected in treated eyes of
      group-2 dogs, but was not found in treated eyes of group-1 dogs. A mean decrease
      of greater than 90% in clot surface area was detected by 120 minutes after
      injection in treated eyes of group-2 dogs.

PMID- 1626780
TI  - Detection of hemorrhagic septicemia virus of salmonid fishes by use of an enzyme
      linked immunosorbent assay containing high sodium chloride concentration and two
      noncompetitive monoclonal antibodies against early viral nucleoproteins.
AB  - Inclusion of high-ionic strength buffers helped us to develop a sandwich ELISA to
      detect hemorrhagic septicemia virus (HSV) in cell culture and infected trout
      tissue extracts. For maximal sensitivity of 0.1 to 0.2 ng/well/100 microliters or
      about 10 to 50 TCID50/well/100 microliters, trout extracts were diluted 1:1 and
      assayed for the earliest synthesized nucleoprotein N. Simultaneous binding of the
      N protein from HSV in the sample to the wells coated with monoclonal antibody
      (2D5 against the N protein) and to the peroxidase-labeled monoclonal antibody
      (2C9 against the N protein) proceeded during a 2-hour incubation at 20 to 22 C
      (room temperature). The response was linear between 6 to 60 ng/well of purified
      virus. Monoclonal antibodies used were noncompetitive with each other and reacted
      with F1, F2, 23.75, and 5 Spanish isolates of HSV, but not with infectious
      hematopoietic necrosis or infectious pancreatic necrosis viruses. Tissue
      specimens with low content of HSV virus may now be assayed directly without use
      of cell culture, rapidly, and with high precision, during the acute phase of the
      disease in salmonid fishes.

PMID- 1626781
TI  - Effects of xylazine on ventilation in horses.
AB  - The effects of 3 commonly used dosages (0.3, 0.5, and 1.1 mg/kg of body weight,
      IV) of xylazine on ventilatory function were evaluated in 6 Thoroughbred
      geldings. Altered respiratory patterns developed with all doses of xylazine, and
      horses had apneic periods lasting 7 to 70 seconds at the 1.1 mg/kg dosage.
      Respiratory rate, minute volume, and partial pressure of oxygen in arterial blood
      (PaO2) decreased significantly (P less than 0.001) with time after administration
      of xylazine, but significant differences were not detected among dosages. After
      an initial insignificant decrease at 1 minute after injection, tidal volume
      progressively increased and at 5 minutes after injection, tidal volume was
      significantly (P less than 0.01) greater than values obtained before injection.
      Partial pressure of carbon dioxide in arterial blood (PaCO2) was insignificantly
      increased. After administration of xylazine at a dosage of 1.1 mg/kg, the mean
      maximal decrease in PaO2 was 28.2 +/- 8.7 mm of Hg and 22.2 +/- 4.9 mm of Hg,
      measured with and without a respiratory mask, respectively. Similarly, the mean
      maximal increase in PaCO2 was 4.5 +/- 2.3 mm of Hg and 4.2 +/- 2.4 mm of Hg,
      measured with and without the respiratory mask, respectively. Significant
      interaction between use of mask and time was not detected, although the changes
      in PaO2 were slightly attenuated when horses were not masked. The temporal
      effects of xylazine on ventilatory function in horses should be considered in
      selecting a sedative when ventilation is inadequate or when pulmonary function
      testing is to be performed.

PMID- 1626782
TI  - Bronchial circulation during prolonged exercise in ponies.
AB  - Tracheal, bronchial, and renal flow were studied in 8 healthy ponies at rest and
      during exercise performed on a treadmill at a speed setting of 20.8 km/h and 7%
      grade (incline) for 30 minutes. Blood flow was determined with 15-microns
      diameter radionuclide-labeled microspheres that were injected into the left
      ventricle when the ponies were at rest, and at 5, 15, and 26 minutes of exertion.
      Heart rate and mean aortic pressure increased from resting values (40 +/- 2
      beats/min and 124 +/- 3 mm of Hg, respectively) to 152 +/- 8 beats/min and 133 +/
      4 mm of Hg at 5 minutes of exercise, to 169 +/- 6 beats/min and 143 +/- 5 mm of
      Hg at 15 minutes of exercise, and to 186 +/- 8 beats/min, and 150 +/- 5 mm of Hg
      at 26 minutes of exercise. Tracheal blood flow at rest and during exercise
      remained significantly (P less than 0.05) less than bronchial blood flow.
      Tracheal blood flow increased only slightly with exercise. Vasodilation caused
      bronchial blood flow to increase throughout exercise. Pulmonary arterial blood
      temperature of ponies also increased significantly (P less than 0.05) with
      exercise and a significant (P less than 0.005) correlation was found between
      bronchial blood flow and pulmonary arterial blood temperature during exertion. At
      5 minutes of exercise, renal blood flow was unchanged from the resting value;
      however, renal vasoconstriction was observed at 15 and 26 minutes of exercise. We
      concluded that bronchial circulation of ponies increased with exercise in close
      association with a rise in pulmonary arterial blood temperature.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1626783
TI  - Synchronization of estrus in dairy goats treated with prostaglandin F at various
      stages of the estrous cycle.
AB  - Dairy goats were given IM injections of 125 micrograms of cloprostenol sodium on
      day 6 of the estrous cycle (prostaglandin F [PGF] 6, n = 22) or day 12 of the
      estrous cycle (PGF 12, n = 26). Mean +/- SE hours from injection to onset of
      behavioral estrus and proportion of goats responding were 46 +/- 4.2 (range, 12
      to 88 hours) and 95% and 48 +/- 2.9 (range, 34 to 68 hours) and 100% for groups
      PGF 6 and PGF 12, respectively. There was no significant difference between the
      groups in mean time to onset of estrus, but variances about the means were
      different. Of the does in groups PGF 6 and PGF 12, 67 and 85%, respectively, had
      signs of onset of estrus between 36 and 60 hours after administration of PGF.
      Mean (+/- SE) hours from injection to time of peak concentrations of luteinizing
      hormone (LH) were 62 +/- 3.1 and 64 +/- 2.1 for groups PGF 6 and PGF 12,
      respectively. Of the does in groups PGF 6 and PGF 12, 86 and 100%, respectively,
      had LH peaks. Of the does in groups PGF 6 and PGF 12, 68 and 77%, respectively,
      had peak concentrations of LH between 48 and 72 hours after administration of
      PGF. All does in groups PGF 6 and PGF 12 had concentrations of progesterone
      greater than or equal to 1.0 ng/ml on the day of administration of PGF.
      Concentrations decreased to less than 1.0 ng/ml by 48 hours after injection in
      all does except 1 in group PGF 6.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626784
TI  - Cardiopulmonary responses to experimentally induced gastric dilatation in
      isoflurane-anesthetized dogs.
AB  - Gastric dilatation was experimentally induced in 6 anesthetized dogs maintained
      with constant-dose isoflurane in oxygen. An intragastric balloon was used to
      distend the stomach with a constant 30 mm of Hg pressure for 3.5 hours. The PaCO2
      was maintained between 35 and 45 mm of Hg, using intermittent positive-pressure
      ventilation. Cardiopulmonary measurements prior to stomach distension (baseline)
      were compared with measurements taken during 0.1, 0.5, 1.0, 1.5, 2.5, and 3.5
      hours of stomach distension by analyzing the change from baseline in a randomized
      block analysis with each dog as a block. After distending the stomach, cardiac
      index increased (P less than 0.01) from 1.5 to 3.5 hours. Stroke volume did not
      change, thus the increase in the cardiac index was attributable to an increase in
      heart rate. During inflation, increases were observed in systemic arterial,
      pulmonary arterial, and right atrial pressure. Respiratory frequency was
      unchanged; however, to maintain PaCO2 constant, it was necessary to progressively
      increase peak airway pressure. Although PaO2 tended to decrease during gastric
      dilation, the dogs were never hypoxemic. These results indicate that when our
      methods are used to maintain a constant anesthetic dose of isoflurane in oxygen,
      an observed increase in cardiovascular performance is expected. This differs from
      other studies in anesthetized dogs that have shown reduction in cardiovascular
      performance following gastric dilatation.

PMID- 1626786
TI  - Purification of a protein from serum of cattle with hepatic lipidosis, and
      identification of the protein as haptoglobin.
AB  - A protein that has 2 subunits with molecular weight of 35,000 and 23,000 was
      detected in serum of cattle with hepatic lipidosis (fatty liver). The protein was
      purified from serum obtained from a cow with fatty liver, and was identified as
      haptoglobin, which is known to have hemoglobin-binding capacity and to be an
      acute-phase protein. To assess the relevance of haptoglobin in fatty liver,
      cattle were classified in 3 groups (healthy control, haptoglobin-positive, and
      haptoglobin-negative); liver triglyceride content and several serum biochemical
      variables were evaluated for the 3 groups. Compared with the control and
      haptoglobin-negative cattle, haptoglobin-positive cattle had significantly (P
      less than 0.01) higher liver triglyceride content, serum bilirubin concentration,
      and aspartate transaminase activity. Serum haptoglobin concentration was high in
      slaughter cattle (27 of 40 cattle tested), particularly in cows (20/28).

PMID- 1626785
TI  - Hematologic values in newborn beef calves.
AB  - Hematologic values were determined in 35 beef calves at birth, at 24 and 48
      hours, and in 22 of these calves at 3 weeks after birth. Thirty calves did not
      have clinical signs of disease throughout the 3-week period. Variables that
      changed significantly over time in these healthy calves included hematocrit, RBC
      count, hemoglobin concentration, mean cell volume, mean cell hemoglobin
      concentration, WBC count, neutrophil-to-lymphocyte ratio, and plasma total
      protein and serum immunoglobulin concentrations. Of the 35 calves, 5 had clinical
      signs of disease at 3 weeks. Comparison of hematologic values from these calves
      with values for healthy calves revealed significant differences at each sample
      collection time, although disease was not evident at the 3 early sample times.
      The band neutrophil count and the neutrophil-to-lymphocyte ratio differed between
      the 2 groups at birth. At 24 hours, the monocyte count was higher in the 5 ill
      calves. At 48 hours, total leukocyte, mature neutrophil, and monocyte counts, and
      neutrophil-to-lymphocyte ratio also were higher in the 5 calves. At 3 weeks when
      clinical signs of disease were detectable in the 5 calves, the total leukocyte,
      band neutrophil, and mature neutrophil counts, neutrophil-to-lymphocyte ratio,
      and plasma total protein and fibrinogen concentrations were higher.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1626787
TI  - Measurement of serum myoglobin concentrations in horses by immunodiffusion.
AB  - Quantitative immunodiffusion in one dimension was performed in 6-mm Duran tubes
      containing a 1% Nobel agar solution and various dilutions of antisera. A series
      of dilutions of pure myoglobin in equine sera as well as plasma from horses with
      rhabdomyolysis were tested. Standard curves were prepared of the migration
      distance of the formed precipitate from the meniscus of the gel after 3, 6, 12,
      and 24 hours. The clearest line of precipitate was formed with a 1:20 dilution of
      antisera in agar. Standard curves were nonlinear and plasma myoglobin could be
      detected at 2 micrograms of myoglobin/ml or greater. The test was optimal, with
      an error of 5.6%, when read at 24 hours at approximately 25 C. Tubes with agar
      could be stored for 6 months at 4 C without affecting the accuracy of the test.
      The specificity of myoglobin for skeletal or cardiac muscle, and its rapid
      clearance from serum after muscle necrosis, make it ideally suited for evaluating
      acute muscle damage and for testing the susceptibility of horses for
      rhabdomyolysis following an exercise test.

PMID- 1626788
TI  - Isolation and characterization of alpha 1-acid glycoprotein from horses, and its
      evaluation as an acute-phase reactive protein in horses.
AB  - Equine alpha 1-acid glycoprotein (alpha 1AG) was isolated from equine serum by
      successive ammonium precipitation, anion- and cation-exchange chromatographies,
      and gel filtration. Purified equine alpha 1AG had a molecular weight of 46,000 +/
      1,000, and contained 31.4% carbohydrate. Gel isoelectric focusing revealed an
      isoelectric point range of 2.8 to 3.7. With immunoelectrophoresis, it was found
      that alpha 1AG migrated to the alpha 1-globulin region. Single radial
      immunodiffusion was used for quantitative measurement of alpha 1AG in equine
      serum. In clinically normal foals, serum alpha 1AG was undetectable (less than or
      equal to 20 micrograms/ml) in less than or equal to 7-day-old foals, but was
      detected by 14 days. The alpha 1AG concentration (mean +/- SD) increased to reach
      mean adult values of 99.23 +/- 26.90 micrograms/ml by 1 year of age. The alpha
      1AG concentration in pregnant mares decreased at 2 to 3 months before
      parturition, then gradually increased until 1 day after parturition, when a brief
      decrease was observed. The concentration increased again at 2 weeks after
      foaling, then a decrease was observed, after which the alpha 1AG concentration
      increased again by 2 to 4 months after parturition. The concentration of serum
      alpha 1AG quickly rose to peak values 2 to 3 days after castration and
      jejunojejunostomy in adult horses, returning to baseline values by 14 to 28 days
      after surgery. The alpha 1AG was concluded to be an acute-phase reactive protein
      in horses.

PMID- 1626789
TI  - Viscosity and rheologic properties of blood from clinically normal horses.
AB  - Blood viscosity (BV) was measured in 32 healthy horses at 6 spindle speeds (60,
      30, 12, 6, 3, and 1.5 rpm) and for PCV of 40%, using a digital rotational cone
      and plate microviscometer. Also, in 7 of 32 horses, BV was measured 3 times each,
      for 3 PCV values (20, 40, and 60%), and at each spindle speed to determine effect
      of PCV on BV and machine and among-horse variations. Total plasma protein and
      fibrinogen concentrations were measured in all horses, using a standard
      refractometer and heat precipitation, respectively. In 7 of 32 horses,
      quantitative fibrinogen concentration was measured, using a quantitative
      fibrinogen assay. Plasma protein and fibrinogen concentrations were measured to
      determine their effect on BV. Plasma total protein (6.0 to 7.5 g/dl) and
      fibrinogen (100 to 400 mg/dl) concentrations were within normal reference range
      for our laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626790
TI  - Comparative virulence of Haemophilus parasuis serovars 1 to 7 in guinea pigs.
AB  - Reference strains for Haemophilus parasuis serovars 1 to 7 were examined for
      virulence by inoculation of guinea pigs. Guinea pig response to intraperitoneal
      inoculation was similar for the 7 reference strains. However, apparent
      differences in virulence were detected after intratracheal inoculation. Cells of
      the references strains for serovars 1 and 5 were most invasive, causing
      moribundity or death at higher doses and a persistent septicemia at lower doses.
      Haemophilus parasuis could be isolated from respiratory and systemic sites;
      purulent bronchopneumonia, pericarditis, and pleuritis were apparent in infected
      guinea pigs. Inoculation of cells of the reference strains for serovars 2 and 6
      also resulted in bronchopneumonia and moribundity or death in some guinea pigs;
      however, reisolation of H parasuis and microscopic lesions at necropsy were less
      pronounced than those observed with serovars 1 and 5. Inoculation of cells of
      serovars 3, 4 and 7 induced only transient clinical signs and minimal evidence of
      H parasuis infection at necropsy. The data from intratracheal inoculation of
      guinea pigs are similar to data from other investigations in swine, indicating
      differences in the pathogenic potential of H parasuis strains. Thus, guinea pigs
      may be useful as a laboratory animal model for examining cellular factors
      associated with virulence and immunogenicity of H parasuis.

PMID- 1626791
TI  - Microvascular circulation of the small intestine in horses.
AB  - The microvascular anatomic features of the small intestine was described by
      correlating results of microangiography, light microscopy, gross studies, and
      scanning electron microscopy of vascular replicas in 14 horses. After
      heparinization, the horses were euthanatized, a length of jejunum was transected,
      and blood was flushed free of the circulation, using isotonic NaCl solution. In
      six horses, the circulatory system was perfused with a modified radiopaque medium
      and evaluated radiographically. These sections were then evaluated by standard
      histologic methods. Sections from 8 horses were perfused with 1 of 2 types of
      plastics and studied grossly or by scanning electron microscopy. The marginal
      arterial arcade gives rise to vessels that enter the jejunum at the mesenteric
      angle. These vessels penetrated either directly, by branching and entering on
      both sides of the mesenteric angle, or supplying only 1 side of the mesenteric
      angle. All these vessels continued in the submucosa branching extensively,
      forming a submucosal plexus. This submucosal plexus supplied the tunica
      muscularis, tunica serosa, and the mucosa. Vessels within the 2 muscle layers ran
      parallel to the muscle fibers and, consequently, perpendicular to each other. The
      arterial supply to the mucosa penetrated the muscularis mucosae and branched to
      supply 2 mucosal capillary networks. An eccentrically placed arteriole penetrated
      the base of the villus and spiralled to the tip where it "fountained" into a mesh
      like capillary network, which descended peripherally in the villus to drain via 1
      to 3, but most commonly 2 venules. Venules from adjacent villi united and drained
      via the submucosal veins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626792
TI  - Allergic and nonallergic asthmatics have distinct patterns of T-cell activation
      and cytokine production in peripheral blood and bronchoalveolar lavage.
AB  - Activation of lymphocyte subpopulations was determined in conjunction with levels
      of cytokines in peripheral blood and bronchoalveolar lavage (BAL) of asthmatics.
      Allergic asthmatics had increased numbers of CD4+ IL-2R+ T cells in peripheral
      blood and BAL, and T-cell activation closely correlated with numbers of low
      affinity IgE receptor (CD23) bearing B cells. In contrast, in nonallergic
      asthmatics both CD4+ and CD8+ T cells from blood and BAL had increased expression
      of IL-2R, HLA-DR, and VLA-1. Furthermore, in the nonallergic asthmatics CD8+ T
      cells were decreased in blood but increased in BAL. Cytokine levels were
      determined in BAL fluid and supernatants from purified peripheral blood T cells
      and enriched BAL lymphocyte preparations. Allergic asthmatics were characterized
      by increased levels of IL-4 and IL-5, and this elevated IL-4 contributed to the
      elevated IgE levels found in these allergic subjects. In contrast, nonallergic
      asthmatics had elevated levels of IL-2 and IL-5, with IL-2 contributing to T-cell
      activation. In both types of asthma, the close correlation of IL-5 levels with
      eosinophilia suggests that IL-5 is responsible for the characteristic
      eosinophilia of asthma. Thus, we provide evidence of distinct T-cell activation
      resulting in different spectra of cytokines in allergic and nonallergic asthma.

PMID- 1626793
TI  - Ventilatory and metabolic responses to acute hyperoxia in newborns.
AB  - Hyperoxia has previously been found to increase metabolic rate (oxygen
      consumption [VO2] and CO2 production [VCO2]) in newborn mammals. We asked whether
      the same occurs in the newborn infant. Breathing pattern was measured in 25 full
      term infants, 1 to 2 days of age, from the spirometric record obtained with a
      pneumotachograph attached to a face mask. Concentrations of O2 and CO2 were
      continuously measured at the mouth; VO2 and VCO2 were computed as the product of
      VE and the difference between inspired and expired concentration of the
      respective gases, 5 min of air (FIO2 = 0.21) and 5 min of O2 (FIO2 = 1). A bias
      flow through the mask and pneumotachograph delivered the inspired gas and
      eliminated the effects of the instrumental dead space. In neither case did
      measurements at 1 min significantly differ from those taken at 5 min. In
      hyperoxia VE increased in 22 of the 25 infants, in average +18% (p less than
      0.001, paired two-tailed t test). Because of a rise in tidal volume (+35%, p less
      than 0.001) and a decrease in breathing rate (-11%, p less than 0.005) alveolar
      ventilation (VA) increased by about 58% (p less than 0.001). VO2 and VCO2
      increased by 25% and 17%, respectively (p less than 0.001). The rise in VO2 was
      too large to be explained by the greater respiratory work of the
      hyperventilation, whereas that of VCO2 was not large enough to fully explain the
      increase in VA. We conclude that in newborn humans, as in other newborn species,
      the normoxic metabolic rate seems to be limited by the availability of
      O2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626794
TI  - Safety of bronchoalveolar lavage and bronchial biopsies in patients with asthma
      of variable severity.
AB  - The safety of fiberoptic bronchoscopy, bronchoalveolar lavage (BAL), and
      bronchial biopsies has been questioned in asthma, and current recommendations
      indicate that bronchoscopies should only be performed in mild to moderate asthma.
      Moreover, in most studies patients receive premedication with nebulized
      bronchodilators that may enhance the safety of the procedures. The purpose of
      this study was to determine (1) whether the overall safety of fiberoptic
      bronchoscopy, BAL, and bronchial biopsies in mild to moderate asthma could be
      extended to patients with more severe asthma and (2) whether these procedures are
      safe without premedication with nebulized bronchodilators. A group of 50 patients
      with asthma of variable severity (FEV1 ranging from 37 to 107% of predicted
      values) and 25 healthy volunteers were studied. Bronchoscopy, BAL (250 ml), and
      four bronchial biopsies were performed in a standardized manner, without
      premedication with a nebulized bronchodilator, by the same investigator. Safety
      was assessed by clinical follow-up, continuous recording of arterial oxygen
      saturation during the procedure with a digital oximeter, and measuring FEV1,
      FEF25-75, and FVC just before and 5 min after bronchoscopy. Arterial oxygen
      saturation decreased in asthmatic patients from 97% (range 91 to 99%) (T1) to 92%
      (range 79 to 98%) (T8) (ANOVA, Fisher's PLSD) and in control subjects from 97%
      (range 94 to 99%) (T1) to 93% (range 88 to 98%) (T8) (ANOVA, Fisher's PLSD). The
      fall in arterial oxygen saturation was not significantly different between
      asthmatic and normal subjects, and there was no correlation between arterial
      oxygen desaturation and the severity of asthma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626796
TI  - Increase in airway responsiveness and effect of deep inhalation on airway caliber
      in allergen-induced asthma. Relationship to the late-phase response.
AB  - The airway responsiveness to methacholine (MCh) and the effect of deep inhalation
      (DI) on airway caliber were determined in 18 asthmatic patients at baseline and 3
      and 24 h after an allergen inhalation challenge. The dose of MCh causing a 20%
      fall of FEV1 (PD20) was used as an index of airway responsiveness; the ratio of
      forced expiratory flow at 40% of FVC from maximal and partial flow/volume curves
      (MEF40M/P) was used to assess the effect of DI on airway caliber. Thirteen
      patients showed a dual asthmatic response (DAR) to allergen, 5 patients an
      isolated early-phase asthmatic response (EAR). In the DAR patients, 3 h after
      allergen challenge, when the early-phase response had resolved and the late-phase
      response had yet to develop, MChPD20 (geometric mean) was reduced from 202 to 71
      micrograms (P less than 0.001) whereas MEF40M/P at the MCh end point was
      unchanged (p greater than 0.4). Twenty-four hours after allergen challenge, when
      late-phase response had developed, MChPD20 was further reduced to 51 micrograms
      (p less than 0.02), and this reduction was accompanied by a decrease of MEF40M/P
      at the MCh end point (p less than 0.01). In the EAR patients, neither MChPD20 nor
      MEF40M/P was significantly changed at any time during the study. We conclude that
      most of the increase in airway responsiveness that follows acute exposure to
      allergen precedes the late-phase response and is not determined by the same
      mechanisms that impair the ability of the lung to dilate airways with a
      DI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626795
TI  - Different effects of nasal and bronchial glucocorticosteroid administration on
      bronchial hyperresponsiveness in patients with allergic rhinitis.
AB  - Disorders of the upper respiratory tract, particularly allergic rhinitis, are
      commonly associated with bronchial hyperresponsiveness. The latter may be due to
      postnasal drip or to mediator or chemotactic factors into the lower airways that
      either directly alter airway reactivity or cause airway inflammation. The aim of
      this study was to compare the effect of an identical dose of nasal or bronchial
      corticosteroid administration on bronchial hyperresponsiveness in patients with
      allergic rhinitis. Eleven patients were studied. All of them were judged atopic
      on the basis of positive skin tests to common allergens. During control,
      spirometry, flow-volume curves, and specific airway conductance (SGaw) were
      measured. Bronchial challenges were then performed with increasing concentrations
      of carbachol, and dose-response curves were constructed. The concentration of
      carbachol that decreased SGaw by 35% from baseline (PD35) was determined by
      interpolating from the dose-response curve. Control measurements were repeated at
      1-wk intervals to ensure that PD35 was stable in all the patients. Then the
      patients received for 2 wk, in a double-blind randomized crossover fashion, a
      topical administration of either an aerosol of 400 micrograms of beclamethasone
      dipropionate (B) into the nose (100 micrograms four times per day) or into the
      bronchi. During each trial period, identical sprays of placebo were used, the
      latter being administered into the nose when B was administered into the bronchi
      and vice versa. Measurements were then performed after 2 wk of intranasal
      administration and after 2 wk of intrabronchial administration.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1626797
TI  - Histamine tachyphylaxis in human airway smooth muscle. The role of H2-receptors
      and the bronchial epithelium.
AB  - The role of airway epithelium and H2-receptors in the development of histamine
      tachyphylaxis was studied using human isolated bronchial smooth muscle strips
      obtained from 18 patients undergoing thoracotomy. In epithelium-intact strips, a
      38% reduction in the maximal contractile response (Emax) (p less than 0.002) and
      a 2.14-fold increase in the EC50 (p less than 0.02; n = 18) was observed after
      three separate histamine cumulative concentration effect curves (CCEC). In
      contrast, significant differences were not seen for either Emax (p greater than
      0.4; n = 10) or EC50 (p greater than 0.26; n = 10) in epithelium-denuded strips.
      In separate experiments, both intact and denuded muscle strips were treated with
      the H2-receptor antagonist ranitidine (60 microM), either 30 min prior to the
      first or 30 min prior to the second histamine CCEC. In epithelium-intact strips,
      pretreatment with ranitidine caused a 1.8-fold increase in Emax in the initial
      CCEC (p less than 0.02), and both ranitidine schedules prevented tachyphylaxis (n
      = 8). In epithelium-denuded preparations, ranitidine did not enhance the
      responsiveness to histamine beyond that seen in untreated epithelium-denuded
      strips (n = 6). These data suggest that histamine-induced tachyphylaxis occurs in
      human airway smooth muscle and is mediated, at least in part, via H2-receptors
      resident on airway epithelium. In vivo, this may function as a protective
      mechanism, but damage to the epithelium and loss of H2-receptors may be
      significant in the development of histamine bronchial hyperreactivity as seen in
      asthma.

PMID- 1626798
TI  - Effect of interleukin-2 on the airway response to antigen in the rat.
AB  - To evaluate the hypothesis that lymphocyte stimulation can modify the
      bronchoconstrictive response to inhalational challenge with an allergen, we
      administered interleukin-2 (IL-2), an important lymphokine in lymphocyte
      activation and proliferation, to actively sensitized rats. Brown Norway rats
      received either human recombinant IL-2 (n = 8) or its vehicle (n = 7) twice a day
      from the ninth to the fourteenth day after active sensitization to ovalbumin (OA)
      and were challenged with an aerosol of OA. Lung resistance (RL) during the early
      response increased to a maximum of 698 +/- 230% and 180 +/- 26% of baseline
      values in the animals receiving IL-2 and vehicle, respectively (p less than
      0.025). The late response was threefold greater in IL-2-treated than in vehicle
      treated animals (p = 0.01). IL-2 increased OA-specific IgG levels in the serum,
      but it did not significantly affect total or specific IgE levels. IL-2 caused an
      inflammatory infiltrate around the airways with significant increases in
      eosinophils, lymphocytes, and mast cells prior to antigen challenge. Our results
      indicate that stimulation of cell-mediated immunity can affect airway
      responsiveness to antigen.

PMID- 1626799
TI  - Immunohistology of the nasal mucosa following allergen-induced rhinitis.
      Identification of activated T lymphocytes, eosinophils, and neutrophils.
AB  - We have studied the immunohistology of the nasal mucosa in allergen-induced
      rhinitis. Sixteen grass pollen-sensitive patients were challenged twice by
      randomly allocated allergen or control solutions applied on filter paper disks to
      the inferior turbinate. All had immediate nasal responses, but late-phase
      responses were equivocal and only evident as nostril blockage. When cell counts
      in the nasal submucosa were compared with control values 24 h after allergen,
      there were no changes in CD45+ (total leukocytes), CD3+, or CD8+ cells.
      Significant increases were found in the numbers of CD4+ T-helper cells (p less
      than 0.05) and CD25+ [interleukin-2 receptor (IL-2R+)] cells (p less than 0.02).
      Increases in eosinophils (anti-major basic protein, p less than 0.01) and
      neutrophils (antineutrophil elastase, p less than 0.01) were also observed. There
      were increases in tissue macrophages and HLA-DR-positive immunostaining and a
      reduction in mast cells (tryptase positive), but none of these changes was
      statistically significant. No significant changes in epithelial thickness, cross
      sectional area, or integrity were observed. There was a significant correlation
      between CD4+ and CD25+ cells (r = 0.61, p less than 0.01) but not between
      macrophages and CD25+ cells (r = 0.18). The changes in the nasal submucosa were
      not merely a reflection of alterations in circulating cell populations since it
      was shown that a significant increase in the lymphocyte CD4/CD8 ratio (p less
      than 0.05) was observed in nasal biopsies but not in peripheral blood after
      allergen challenge.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626800
TI  - Latent adenoviral infection in the pathogenesis of chronic airways obstruction.
AB  - Childhood infection of the respiratory tract has been proposed as an independent
      risk factor in the pathogenesis of the chronic obstructive pulmonary disease
      (COPD) that develops in cigarette smokers. The present study examines adult lung
      tissue for latent adenoviral DNA because many of its 41 serotypes cause childhood
      respiratory disease and the virus is known to persist in other tissues in a
      latent form. Lung tissue resected for solitary nodules from 20 patients with
      airways obstruction and 20 patients without airways obstruction, matched for age,
      sex, and smoking history, were compared to determine whether adenoviral DNA is
      more commonly found in patients with COPD. The polymerase chain reaction (PCR)
      was used to examine two widely separated segments of the adenoviral genome. In
      situ hybridization (ISH) was performed using a probe covering the entire viral
      genome to determine the types of cell infected by the virus. The PCR analysis
      showed that a 675 base pair target sequence of the E1A region of the adenovirus
      was present in most of the lungs studied with greater copy numbers in the smokers
      with airways obstruction in both paraffin-embedded (p less than 0.002) and frozen
      lung tissue (p less than 0.016), whereas the E3/19K region showed no difference
      between the groups. When sufficient copy numbers were present to localize the DNA
      by ISH it was found in epithelial cells of the smokers who had airways
      obstruction. These data are consistent with a current model of adenoviral
      integration into host DNA and suggest that the E1A region of the adenovirus may
      contribute to the pathogenesis of COPD.

PMID- 1626801
TI  - Hydatid disease of the lungs. Study of 386 cases.
AB  - During a 10-yr period, 386 patients with hydatid disease of the lung were treated
      at our hospital. There were 165 male and 221 female patients with a mean age of
      30.15 + 16.9 yr. There were 286 solitary, 20 multiple, and 21 bilateral cysts. In
      59 patients, the cysts included the lung and other organs; in 54, the lung and
      the liver; in four, the lung and the kidney; in one, the lung and the peritoneum.
      Diagnosis was made using clinical criteria, serologic findings, and imaging
      techniques; 373 patients were treated surgically. Surgical procedures consisted
      of cystectomy in 93 patients, pericystectomy in 166 patients, and lung resection
      in 114 patients. Mebendazole and flubendazole were used in three patients.
      Postoperative complications occurred in 44 patients (15.8%). There were two
      operative deaths (mortality rate, 0.53%). Patients have been followed yearly,
      with a median follow-up of 6 yr. Active hydatid disease has been found in two
      patients.

PMID- 1626802
TI  - Late effects of endotoxin on the accumulation and function of monocytes in rabbit
      lungs.
AB  - Recent studies from our laboratory show that the lung contains a marginated pool
      of monocytes. The present study was designed to investigate monocyte accumulation
      in this pool 4 to 28 h after a single dose of endotoxin when the endotoxin had
      disappeared from the circulation. This was accomplished by administering a single
      intravenous dose of endotoxin (Escherichia coli, 50 micrograms/rabbit) to
      unanesthetized animals (n = 6) and saline to controls (n = 5) at time 0. Four
      hours after this dose of endotoxin, 111In-monocytes (93.5% pure) isolated from
      donors were injected intravenously, and, at 27 h, the rabbits were anesthetized
      and colloidal carbon (CC, 1 ml/kg body weight) was injected intraarterially to
      provide a phagocytic stimulus. The animals were sacrificed at 28 h, and the lungs
      were fixed in situ with glutaraldehyde. The data show that lungs from the
      endotoxin-treated rabbits contained 4.8 times more 111In-monocytes than controls,
      that 92% of these radiolabeled monocytes were in the alveolar capillaries, and
      that 72% of these labeled cells had phagocytosed CC. The histologic studies of
      unlabeled cells confirmed that this endotoxin treatment caused a 3-5-fold
      increase in unlabeled mononuclear cells and neutrophils (PMN) in the
      microvasculature and that many of the unlabeled monocytes in the endotoxin
      treated group had also phagocytosed colloidal carbon. The behavior of the donor
      monocytes injected after the endotoxin had time to disappear from the circulation
      suggests that they accumulate in the lung in response to the indirect effects of
      endotoxin on endothelial cells.

PMID- 1626803
TI  - Erythromycin reduces neutrophils and neutrophil-derived elastolytic-like activity
      in the lower respiratory tract of bronchiolitis patients.
AB  - Diffuse panbronchiolitis (DPB) is a disease of adults characterized by chronic
      inflammation of the respiratory bronchioles and the infiltration of chronic
      inflammatory cells. The clinical efficacy of erythromycin therapy has been
      demonstrated in DPB patients, but the mechanism of action of this drug is
      unknown. We investigated the localization of neutrophils in lung biopsy
      specimens, as well as the cell population and elastolytic-like and chemotactic
      activity of bronchoalveolar lavage (BAL) fluid, before and after treatment with
      erythromycin or ampicillin in 11 DPB patients (six biopsy-proven and five
      clinically diagnosed) and one follicular bronchiolitis patient. These
      bronchiolitis patients had a high percentage of neutrophil and a high neutrophil
      derived elastolytic-like activity in BAL fluid compared with chronic bronchitis
      patients and normal control subjects. The number of neutrophils and the
      neutrophil-derived elastolytic-like activity in BAL fluid decreased significantly
      after treatment with erythromycin along with a significant improvement in
      pulmonary function studies, although there was no significant change in the
      chemotactic activity of BAL fluid. No significant reduction in BAL fluid
      neutrophilia was found in the ampicillin-treated patients. These results suggest
      an important role for the neutrophil in the pathogenesis or development of
      bronchiolitis, and also suggest that erythromycin may be useful for the treatment
      of bronchiolitis through its direct action upon host phagocytic cells.

PMID- 1626804
TI  - Re-targeting ventilatory objectives in adult respiratory distress syndrome. New
      treatment prospects--persistent questions.

PMID- 1626805
TI  - Risk factors for the degradation of lung elastic fibers in the ventilated
      neonate. Implications for impaired lung development in bronchopulmonary
      dysplasia.
AB  - In order to evaluate the risk for proteolytic destruction of lung parenchymal
      elastic fibers in ventilated premature infants, the concentrations of elastase
      were determined in tracheal aspirates of 65 infants from whom we obtained a total
      of 327 sequential samples. Elastase was detected at least once in 39 of the 65
      infants studied. Eleven of these infants were ventilated with greater than 60%
      oxygen for greater than 5 days. In 19 infants, the presence of elastase was
      associated with positive bacterial and/or viral cultures and/or elevated ratios
      (greater than 0.22) of immature neutrophils to total neutrophils. Elastase was
      not detected in the lung secretions of 26 infants ventilated with greater than
      60% oxygen for less than 3 days, suggesting minimal risk for elastic fiber
      destruction in the intubated infant who neither has pneumonia nor requires
      prolonged hyperoxic ventilation. The risk for elastic fiber destruction was
      further evaluated by analyzing sequential urine and tracheal aspirate samples for
      the presence of an elastolytic degradation product of elastin (desmosine). The
      biochemical data indicated a potential risk for proteolytic destruction of
      elastic fibers in association with infection and/or prolonged hyperoxic exposure.
      In addition, autopsy specimens obtained from three of the infants revealed
      structurally abnormal lung parenchymal elastic fibers. Because elastic fibers are
      believed to provide the structural support for alveolar septal development,
      proteolytic degradation of these fibers may be a significant factor in the
      impaired lung development that occurs in infants with bronchopulmonary dysplasia.

PMID- 1626807
TI  - Pulmonary vasculitis in Behcet's disease.
AB  - Clinical findings of 12 patients with Behcet's disease and lung involvement are
      presented. Male to female ratio was 11/1, mean age was 35.3 +/- 8.8 yr. All
      patients had at least four other organ manifestations of vasculitis, either in
      their history or during the period of lung involvement. The main complaint was
      hemoptysis of varying degree in 11 of the 12 patients. The chest X-ray films
      showed unilateral hilar enlargements in six patients, diaphragm elevation in
      four, horizontally or obliquely oriented linear opacities in three, diffuse, ill
      defined infiltrates in upper and lower zones in three, wedge-shaped peripheral
      opacities in one, and bilateral pleural effusion in one patient. Computed
      tomography of the chest performed in nine patients revealed aneurysms,
      narrowings, and cutoffs of the main, lobar, segmental, or peripheral branches of
      the pulmonary artery and irregular configuration of other pulmonary vessels.
      Perfusion scans demonstrated defects of various sizes in all patients. Pulmonary
      angiography performed in only two patients showed amputation of branches of the
      pulmonary artery and aneurysmal dilatations. The patients were treated with a
      combination therapy consisting of corticosteroid, cyclophosphamide, colchicine,
      and antiaggregants, with very good results in the short term.

PMID- 1626806
TI  - Increased pulmonary artery elastolytic activity in adult rats with monocrotaline
      induced progressive hypertensive pulmonary vascular disease compared with infant
      rats with nonprogressive disease.
AB  - In a rat model of pulmonary hypertension induced by monocrotaline, medial
      hypertrophy of the pulmonary arteries is associated with enhanced production
      (synthesis) of insoluble elastin relative to accumulation and an increased number
      of elastin fragments, features suggestive of an elastolytic process. In the
      present study, we measured and characterized pulmonary artery (PA) elastolytic
      activity at time points before as well as coincident with the progression of
      medial hypertrophy in monocrotaline-injected adult male Sprague-Dawley rats. We
      also determined whether medial hypertrophy is preceded by ultrastructural changes
      in elastin. Since medial hypertrophy develops but fails to progress in rats
      injected with monocrotaline at 8 days of age, we assessed whether, compared with
      adult rats, there were also structural and biochemical differences in elastin and
      elastolytic activity. A twofold increase in elastolytic activity per milligram
      tissue was observed 2 days after monocrotaline injection in adult rats (p less
      than 0.01), and there was an increased number of breaks in the internal elastic
      lamina (IEL) at 4 days (p less than 0.05) (i.e., before the development of medial
      hypertrophy). Associated with the progression of medial hypertrophy between 16
      and 28 days after monocrotaline injection, there was a further threefold increase
      in elastolytic activity per milligram tissue by 28 days (p less than 0.01).
      Susceptibility of the elastolytic activity to specific inhibitors suggested that
      one or more serine elastases is involved. In infant rats in which medial and
      right ventricular hypertrophy fail to progress in severity between 16 and 28 days
      after monocrotaline injection, we did not measure an increase in elastolytic
      activity, nor was there evidence of an increase in the number of breaks in the
      IEL at 4 days, suggesting a lack of increased elastolytic activity at an earlier
      time point. The total content of PA elastin in infant rats, although increased
      compared with control rats (p less than 0.01), was not associated with heightened
      production and appeared ultrastructurally as thicker laminae (p less than 0.05)
      rather than as fragments previously reported in adult rats.

PMID- 1626808
TI  - Diseases of the small airways.

PMID- 1626809
TI  - Effect of steroids on diaphragm of newborn, weanling adolescent, and adult rats.
AB  - The purpose of this study was to compare the effects of dexamethasone on the rat
      diaphragm during the postnatal period and into adulthood. Groups of 48 newborn,
      60 weanling adolescent, and 60 adult rats were either (1) treated with DXM (ST,
      steroid-treated animals) or (2) untreated and pair-fed (C, control animals).
      After birth, 24 newborn rats were kept with their mother, which received a daily
      intramuscular injection of 0.5 mg/kg body weight of dexamethasone for 2 wk.
      Groups of thirty weanling adolescent and 30 adult rats were treated with 1
      mg/kg/day of dexamethasone given intramuscularly for 2 wk. Diaphragm performance
      was compared between ST animals and age-matched C animals. Weights of the body,
      the diaphragm, the extensor digitorum longus (EDL), and the soleus were obtained.
      Diaphragm strips were studied in an in vitro preparation to assess contractile
      and endurance properties. In all the ST animals, body and total diaphragm weights
      were reduced compared with age-matched C animals (p less than 0.001). In newborn
      and weanling adolescent ST animals, loss in diaphragm weight was slightly less
      than in limb muscles, in contrast to adult animals (p less than 0.05). However,
      diaphragms from adult and weanling adolescent ST animals showed unaffected twitch
      characteristics, normalized force-frequency curves, and endurance capacity. In
      the meantime, in newborn ST animals, diaphragm atrophy was associated with
      significantly decreased force normalized for fiber cross-sectional area and
      muscle weight (p less than 0.01) and decreased endurance capacity (p less than
      0.05). We conclude that the effects of DXM on the diaphragm depend on the
      developmental status of the muscle at the time of drug administration.

PMID- 1626810
TI  - Interleukin-5 modulates eosinophil accumulation in allergic guinea pig lung.
AB  - Based on its involvement in eosinophil biology, interleukin 5 (IL-5) may play a
      role in the pulmonary eosinophilia associated with allergic reactions. We have
      examined that hypothesis using a neutralizing antibody to IL-5 in ovalbumin
      sensitized guinea pigs challenged with aerosolized antigen. The extent of
      eosinophilia has been quantitated in bronchoalveolar lavage (BAL) and by
      histologic evaluation of lung tissue sections. Acute intraperitoneal
      administration of a rat IgG, monoclonal antibody to murine IL-5 derived from TRFK
      5 cells prevented lung and BAL eosinophilia in a dose-dependent fashion at and
      above 10 micrograms per guinea pig. Treatment with either an experimentally
      irrelevant, isotype-matched antibody from GL113 cells or with heat-denatured IL-5
      antibody was without effect. These studies demonstrate the importance of IL-5 to
      pulmonary eosinophilia in challenged, allergic guinea pigs.

PMID- 1626811
TI  - Extracutaneous manifestations of Sweet's syndrome: steroid-responsive culture
      negative pulmonary lesions.

PMID- 1626812
TI  - Effects of positive end-expiratory pressure on the canine venous return curve.
AB  - To study the mechanism whereby positive end-expiratory pressure (PEEP) decreases
      venous return, we used a closed-chest canine venous bypass preparation to study
      the effects of 10 mm Hg PEEP on the systemic venous pressure-flow curves from the
      superior and inferior vena cava (SVC and IVC). These curves were characterized by
      three variables: the critical downstream pressure below which venous return was
      maximal (PCRIT), the conductance to venous return (GVR), and the effective
      upstream pressure driving venous return. PEEP reduced venous return by decreasing
      the maximal venous return even when the pressures at the outflow of the IVC and
      SVC were maintained below zero. PEEP increased PCRIT in the SVC and IVC (SVC: 
      0.31 +/- 0.53 to 3.21 +/- 0.84; IVC: -0.41 +/- 0.64 to 5.23 +/- 1.02 (SE) mm Hg;
      p less than 0.005). GVR in the SVC was reduced (52.5 +/- 26 to 37.8 +/- 5.3 (SE)
      ml/min/mm Hg; p less than 0.005), but changes in the IVC did not reach
      statistical significance. These changes were partially offset by increases in the
      upstream pressure driving venous return (SVC: 9.44 +/- 0.54 to 12.25 +/- 0.71;
      IVC: 9.42 +/- 0.69 to 12.51 +/- 1.02 (SE) mm Hg; p less than 0.01). Analysis of
      these findings suggests that PEEP may alter venous return through effects on the
      peripheral circulation, independent of its effects on the heart.

PMID- 1626813
TI  - Lung inflammation in coal miners assessed by uptake of 67Ga-citrate and clearance
      of inhaled 99mTc-labeled diethylenetriamine pentaacetate aerosol.
AB  - We compared the diffuse lung uptake of 67Ga-citrate, an index of inflammatory
      lung activity, with the lung clearance of inhaled 99mTc-labeled
      diethylenetriamine pentaacetate (DTPA) aerosol, an index of pulmonary epithelial
      permeability, in a group of 19 West Virginia coal miners whose pulmonary status
      was compatible with coal worker's pneumoconiosis. 99mTc-DTPA clearance alone and
      67Ga-citrate uptake alone were measured in nine and five additional subjects,
      respectively. The objective of this study was to determine if increased 99mTc
      DTPA lung clearance was caused by inflammation at the lung epithelial surfaces.
      Subjects inhaled approximately 150 microCi (approximately 5.6 MBq) of 99mTc-DTPA
      aerosol, and quantitative gamma camera images of the lungs were acquired at 1-min
      increments for 25 min. Regions of interest (ROI) were selected to include (1)
      both lungs; (2) each individual lung; and (3) the upper, middle, and lower thirds
      of each lung. 99mTc-DTPA clearance was determined from the slopes of the
      respective time-activity plots for the different ROI. Each subject was
      intravenously administered 50 miCroCk (1.9 MBq)/kg 67Ga-citrate 48 to 72 h before
      imaging the body between neck and pelvis. The extent of 67Ga-citrate lung uptake
      was expressed as the gallium index (GI). Mean radioaerosol clearance half-time
      (T1/2) for the six nonsmoking coal miners (60.6 +/- 16.0 min) was significantly
      shorter (p less than 0.001) than for the nonsmoking control group (123.8 +/- 28.7
      min). T1/2 for the 12 smoking miners (18.4 +/- 10.2 min) was shorter than for the
      smoking control group (33.1 +/- 17.8 min), but the difference did not attain
      statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626814
TI  - Pulmonary tuberculosis in Kigali, Rwanda. Impact of human immunodeficiency virus
      infection on clinical and radiographic presentation.
AB  - The aim of the present study was to compare the clinical and radiographic
      presentation as well as the therapeutic outcome of pulmonary tuberculosis (PT) in
      adult patients with and without human immunodeficiency virus type 1 (HIV-1)
      infection in Kigali, Rwanda. Over a 17-month period 59 consecutive patients with
      bacteriologically and/or histopathologically documented PT were enrolled. Of
      these, 48 (81%) patients were HIV seropositive. Among these, 35 fit the WHO
      clinical criteria for AIDS (WHOCCA) at the time of admission. Significant
      differences were found between the HIV-seropositive and HIV-seronegative groups
      of patients: fever (85 versus 36%; p less than 0.001), tuberculin skin test
      anergy (69 versus 0%; p less than 0.01), mediastinal and/or hilar adenopathies
      (31 versus 0%; p = 0.05), and pleural effusion (43 versus 9%; p less than 0.05)
      were more frequently encountered in the HIV-seropositive group, and upper lobe
      infiltrates (55 versus 16%; p less than 0.02) and cavitation (91 versus 39%; p
      less than 0.003) were more often seen in the HIV-seronegative group. However, HIV
      seropositive patients not meeting WHOCCA were less frequently anergic (0 versus
      100%; p less than 0.001) and feverish (53 versus 97%; p less than 0.01) and more
      often had cavitation (69 versus 28%; p less than 0.02) and less often mediastinal
      and/or hilar adenopathies (7 versus 40%; p less than 0.04) compared with HIV
      seropositive patients meeting WHOCCA. Under antituberculosis treatment, clearance
      of fever was slower in HIV-seropositive compared with HIV-seronegative patients,
      and among the HIV-seropositive group it was slower in those fitting
      WHOCCA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626815
TI  - Results of a directly observed intermittent isoniazid preventive therapy program
      in a shelter for homeless men.
AB  - We offered directly supervised isoniazid preventive therapy to middle-aged and
      elderly men who were exposed to tuberculosis during an outbreak of cases at a
      homeless shelter. Isoniazid, 900 mg, was administered twice weekly to men at the
      shelter and at the downtown Public Health Clinic. We report on compliance and
      adverse reactions associated with this preventive regimen. Isoniazid preventive
      therapy was offered to 64 men. Forty-seven men (73%) began therapy, and 23 of
      them (49%) completed the 6- to 12-month regimen. Men who failed to complete
      isoniazid therapy received a median of 11 biweekly doses (range, 1 to 41 doses)
      over a median of 9 wk (range, 3 to 37 wk). The most common reason for incomplete
      treatment was that the men no longer frequented the shelter. One hepatotoxic
      reaction occurred, for a 2.1% cumulative incidence among all men who started
      therapy and a 3.7% cumulative incidence among the 27 known alcoholic men who
      began therapy. In addition, we sought to identify personal characteristics of the
      men that might be associated with noncompliance. Out-of-state location of
      personal contacts in case of emergency was strongly associated with poor
      compliance. These data provide some assurance that directly supervised isoniazid
      preventive therapy may be offered safely to sheltered elderly men with a high
      prevalence of alcoholism. Further improvements in compliance with isoniazid
      preventive therapy in homeless populations may depend on the development of a
      therapeutic regimen of only 2 to 3 months duration.

PMID- 1626816
TI  - Nonfibrous mineral particles in bronchoalveolar lavage fluid and lung parenchyma
      from the general population.
AB  - It is recognized that bronchoalveolar lavage (BAL) gives access to particulate
      matter present at the surface of the peripheral airspace. The objective of the
      present study was to evaluate the ability of BAL fluid analysis to predict the
      lung parenchymal particulate content. A BAL fluid sample, the parenchyma sample
      having undergone BAL, and an adjacent parenchyma sample that had not undergone
      BAL were obtained at autopsy on 10 individuals without any known recent
      occupational exposure to mineral particles. The particles (larger than 0.1
      micron) were analyzed using a transmission electron microscope equipped with a
      microanalysis system. Nineteen types of particles were distinguished. The
      distribution of particle types in the three samples was compared. No significant
      difference between the relative concentrations was found, except for two particle
      types: fly ash (excess in BAL fluid compared with lavaged lung) and kaolinite
      (excess in lavaged lung compared with adjacent area). Such differences may be due
      to limitations in methodology. Although no correlation could be found between the
      absolute concentrations of particles in BAL fluid and in lung tissue, analysis of
      particles in BAL fluid may provide information on the types of particles present
      in the lung parenchyma.

PMID- 1626817
TI  - Relationship between urinary cotinine level and diagnosis in children admitted to
      hospital.
AB  - The reported association between passive smoking and respiratory illness in
      children has been based on the parents' assessment of their own level of smoking.
      To more critically evaluate a causal relationship between passive smoking and
      childhood ill health, we used urinary cotinine, which is the major metabolite of
      nicotine and has a long half-life, to objectively quantitate the level of passive
      smoking in children. Urine was collected from 609 children (median age 3.8 yr,
      range 1 month to 17 yr) on admission to hospital; cotinine levels were obtained
      in 491 of these samples, and a comprehensive respiratory questionnaire was
      completed for 468 children. Statistical analysis was carried out on transformed
      data using both parametric and nonparametric statistics. Cotinine levels in the
      children correlated with the parents' current smoking (p less than 0.001).
      Elevated levels were found in the 41 children admitted with bronchiolitis
      compared with a group of a similarly aged children with nonrespiratory illnesses
      (p less than 0.02). Elevated levels were not found for any other diagnosis. We
      conclude that the urinary cotinine approach has provided objective evidence
      linking passive smoking to hospital admission for bronchiolitis in infants.

PMID- 1626818
TI  - Peak expiratory flow variability and bronchial responsiveness to methacholine. An
      epidemiologic study in 117 workers.
AB  - We studied the relationships between peak expiratory flow (PEF) variability and
      bronchial responsiveness to methacholine in 117 workers attending the annual
      compulsory examination (mean age, 38.7 yr +/- 9.5; men, 86.3%). Subjects recorded
      their highest PEF out of three, every 3 waking hours (i.e., five times a day) for
      7 days, each using a newly purchased Vitalograph peak flow meter, and underwent
      methacholine challenge tests with a maximal cumulative dose of 1,200 micrograms.
      Those with a FEV1 fall of 15% or more were considered as reactors. The
      variability of PEF was expressed as the amplitude percent mean, calculated from
      daily amplitude (highest-lowest reading/mean reading of the day x 100), averaged
      over 6 days, from the second to the seventh. This index had a continuous
      distribution, skewed towards the greatest amplitudes, and correlated negatively
      with FEV1 (r = -0.25, p = 0.01). Subjects with asthma (n = 8) had greater
      variations. In the 109 nonasthmatics, greater variability was observed in
      subjects with wheeze apart from colds, breathlessness, or hay fever; the average
      amplitude was greater in reactors than in nonreactors to methacholine (16.9%
      versus 9.3%, p less than 0.001). The subjects with excessive PEF variability were
      all methacholine reactors, but they were only a subgroup of the reactors. These
      results provide evidence that excessive PEF variability is an indicator of
      bronchial hyperresponsiveness to methacholine in a population sample.

PMID- 1626819
TI  - Long-term prognosis of near-fatal asthma. A 6-year follow-up study of 145
      asthmatic patients who underwent mechanical ventilation for a near-fatal attack
      of asthma.
AB  - The objective of the present study was to investigate the long-term prognosis of
      near-fatal asthma. A retrospective cohort study design was used. Cases were
      defined as any asthmatic individual requiring mechanical ventilation for the
      first time for an asthma exacerbation between January 1, 1983 and December 31,
      1988. The consecutive sample of patients was drawn from four study sites,
      specifically four intensive care units (ICU), based in a large urban area (1
      million inhabitants). These four ICU total approximately 5,000 admissions per
      year and are the referral centers for more than 95% of patients requiring
      respiratory intensive care in the area. Data collection was obtained by
      questionnaires addressed to the patients and to their attending physicians and
      was completed by telephone calls if necessary. A total of 147 patients entered
      the study. The long-term outcome could be evaluated in all but two patients. The
      follow-up period ranged from 1 to 75 months. In-hospital mortality was 16.5%.
      Among the 121 patients discharged from the ICU, 18 subsequently died, 17 of whom
      died from a new attack of asthma. Post-hospitalization mortality was 10.1% (95%
      CI, 5.9 to 16.8%) after 1 yr, 14.4% (CI, 9 to 22.3%) after 3 yr, and 22.6% (CI,
      12.7 to 36.8%) after 6 yr. Nearly two-thirds (61.5%) of these secondary deaths
      occurred within the year following discharge from the ICU. Smoking was associated
      with a higher in-hospital mortality, as well as with a higher posthospitalization
      mortality. Age was also independently associated with a higher
      posthospitalization mortality. It is noteworthy that the secondary deaths were
      mostly observed in patients over 40 yr of age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626820
TI  - Reproducibility of visual analog scale measurements of dyspnea in patients with
      chronic obstructive pulmonary disease.
AB  - The purpose of this study was to evaluate the reproducibility of visual analog
      scale ratings of the effort to breathe (VASe) and the degree of discomfort evoked
      by breathing (VASd) in patients with chronic obstructive pulmonary disease (COPD)
      during exercise. Six subjects with moderately severe COPD (FEV1 = 1.12 +/- 0.29
      L, FEV1/FVC = 44 +/- 4%) underwent progressive incremental exercise testing to a
      symptom-limited maximum every week for 8 wk. VASe and VASd were highly correlated
      in each subject (r = 0.99 +/- 0.01). The slope of the VASd/VASe relationship for
      all trials in all subjects was not significantly different from 1, indicating
      that our subjects were rating a common sensation with the two scales. VASe at
      maximal exercise was reproducible in every subject; the within-subject
      coefficient of variation (CV) was 6% (range, 2 to 10%) and compared favorably
      with physiologic indices: 7% (range, 3 to 12%) for oxygen consumption and 10%
      (range, 5 to 16%) for minute ventilation (VI). In contrast, submaximal VAS
      ratings were highly variable. At 66% of the maximal work load, the within-subject
      CV for VASe was 21% (range, 11 to 28%) compared with 6% (range, 4 to 7%) for VO2
      (p less than 0.003) and 10% (range, 5 to 16%) for VI (p less than 0.01). VASe
      correlated linearly with VI and VO2 in all subjects in all trials. However,
      within an individual subject the slope and position of these relationships varied
      widely between trials.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626821
TI  - Effective site of bronchodilation by beta-adrenergic and anticholinergic agents
      in patients with chronic obstructive pulmonary disease: direct measurement of
      intrabronchial pressure with a new catheter.
AB  - To study the effective site of bronchodilators in patients with chronic
      obstructive pulmonary disease (COPD), a catheter tip micromanometer sensing
      lateral pressure of the airway was wedged into the right lower lobe of a
      bronchus, 3 mm inner diameter, in 14 patients with COPD. We simultaneously
      measured mouth flow, transpulmonary pressure (PL) and intra-airway lateral
      pressure during quiet tidal breathing. Total pulmonary resistance (RL) was
      calculated from PL and mouth flow, and central airway resistance (RC) was
      calculated from intra-airway lateral pressure and mouth flow. Peripheral airway
      resistance (RP) was obtained by the subtraction of RC from RL. This technique
      permitted identification of the site of changes in airway resistance. Atropine
      sulfate (5 mg/ml) was continuously inhaled during tidal breathing for 1 min by
      seven patients (Group A), and the other seven patients (Group B) inhaled
      fenoterol (1 mg/ml) for 1 min. The doses that were actually delivered were 0.75
      mg for atropine sulfate and 0.15 mg for fenoterol. The baseline resistances of RC
      and RP were 3.9 +/- 0.8 and 3.7 +/- 0.6 cm H2O/L/s in Group A, and 4.3 +/- 0.5
      and 3.5 +/- 0.4 cm H2O/L/s in Group B, respectively. Both atropine sulfate and
      fenoterol significantly decreased RL by an average of 2.4 and 2.6 cm H2O/L/s, and
      there was no significant difference between them (p greater than 0.20). The
      percentage decrease in resistance from the baseline values by fenoterol did not
      differ significantly between RC and RP (p greater than 0.20). However, atropine
      sulfate significantly decreased RC more than RP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1626822
TI  - Peripheral airways resistance in smokers.
AB  - To determine peripheral airways resistance (Rp) in asymptomatic smokers, we used
      a wedged bronchoscope technique to study 19 volunteers (18 to 44 yr of age) who
      actively smoked for 2 to 28 pack-years. A fiberoptic bronchoscope was wedged in a
      subsegmental bronchus of the right upper lobe. Using a double lumen catheter
      inserted through the working channel of the bronchoscope, we infused 5% CO2 in
      air through one lumen and measured pressure through the second lumen. Rp was
      determined as the average of the peripheral resistance measured at three or more
      flow rates. This resistance ranged from 0.003 to 0.075 cm H2O/ml/min in the 19
      subjects. We have previously shown normal subjects to have an average Rp of 0.009
      +/- 0.002 cm H2O/ml/min (mean +/- SE) and asthmatic subjects an average of 0.069
      +/- 0.017 cm H2O/ml/min. Thus, despite normal pulmonary function as assessed by
      spirometry, these asymptomatic smokers demonstrated a wide range of Rp values
      from normal to that observed in asthmatic subjects. These findings are consistent
      with a mechanism that considers the high resistance to result from inflammatory
      changes in the small airways.

PMID- 1626823
TI  - Regulation of oxytocin gene expression and forms of oxytocin in the brain.

PMID- 1626824
TI  - Control of synthesis and release of oxytocin in the sheep brain.

PMID- 1626825
TI  - Oxytocin and vasopressin. From genes to peptides.

PMID- 1626826
TI  - Increases in dendritic bundling and dye coupling of supraoptic neurons after the
      induction of maternal behavior.

PMID- 1626827
TI  - Evolutionary precedents for behavioral actions of oxytocin and vasopressin.
AB  - It is clear that the behavioral actions of oxytocin and vasopressin in mammals
      are not newly acquired, but have evolutionary antecedents. Injection studies with
      fish, amphibians, reptiles, and birds indicate that AVT can activate certain
      reproductive behaviors. The strongest evidence that AVT acts centrally to control
      reproductive behaviors comes from research on T. granulosa. In this amphibian,
      injections of AVT agonists activate courtship behaviors (amplectic clasping) in
      males and egg-laying behaviors in females, whereas injections of AVT antagonists
      inhibit the behaviors. Also, in Taricha males, AVT concentrations in specific
      brain areas are associated with the expression of courtship behaviors. Several
      conclusions about steroid-peptide interactions can be drawn, based on research
      with this amphibian. First, gonadal steroid hormones act to maintain the
      behavioral actions of AVT in both males and females. In Taricha, gonadectomy
      abolishes and steroid implants restore AVT-induced courtship in males and egg
      laying in females. Second, gonadal steroids maintain the behavioral actions of
      AVT, in part, by modulating AVT receptor numbers on target neurons. In Taricha
      males and females, gonadectomy reduces AVT receptor concentrations (but not
      binding affinity) in certain brain areas (amygdala pars lateralis) and not
      others. Third, the type of gonadal steroid determines whether AVT elicits male
      like or female-like reproductive behaviors. Ovariectomized Taricha females
      respond to AVT injections with egg-laying behaviors when implanted with estradiol
      and with male-like amplectic clasping when implanted with dihydrotestosterone.
      Fourth, the masculinization of AVT-induced behaviors in females most likely
      reflects site-specific actions of androgens on AVT-synthesizing neurons. In
      Taricha, AVTir concentrations in the optic tectum are sexually dimorphic (higher
      in males than females) and reach peak levels in males during the breeding season.
      Fifth, AVT content in specific brain areas increase as a function of performing
      the behaviors. In Taricha, AVTir concentrations in DPOA, CSF, and ventral
      infundibulum are higher in males that exhibit courtship behaviors than in males
      that do not. These conclusions illustrate how steroid-peptide interactions in the
      control of behaviors entail multiple neuroanatomical sites and neurochemical
      actions.

PMID- 1626828
TI  - Oxytocin involvement in male and female sexual behavior.

PMID- 1626829
TI  - Oxytocin and social bonding.
AB  - The prairie vole is an excellent model for examining the neurobiology of social
      attachment, and in particular of pair-bond formation. In female prairie voles
      either sexual interactions or oxytocin infusions can hasten the formation of a
      partner preference. These results implicate oxytocin in the formation of adult
      heterosexual social bonds. In conjunction with work on other social systems
      described in this volume, these findings also support the suggestions of Klopfer
      and Newton that oxytocin may be important in coordinating mammalian social
      interactions with other critical reproductive events such as birth, lactation,
      and sexual behavior.

PMID- 1626830
TI  - Role of vasopressin in aggressive and dominant/subordinate behaviors.

PMID- 1626831
TI  - Vasopressin and the regulation of hamster social behavior.

PMID- 1626832
TI  - Oxytocin effects on emotional processes: separation distress, social bonding, and
      relationships to psychiatric disorders.

PMID- 1626833
TI  - Oxytocinergic neuronal systems during mating, pregnancy, parturition, and
      lactation.

PMID- 1626834
TI  - The regulation of oxytocin mRNA levels in the medial preoptic area. Relationship
      to maternal behavior in the rat.

PMID- 1626835
TI  - Neurotransmitter and neurohormonal regulation of oxytocin secretion in lactation.

PMID- 1626836
TI  - Push-pull perfusion and microdialysis studies of central oxytocin and vasopressin
      release in freely moving rats during pregnancy, parturition, and lactation.

PMID- 1626837
TI  - In situ hybridization for showing hormone effects on oxytocin mRNA in specific
      populations of hypothalamic neurons and their possible participation in
      multiplicative hormonal responses.

PMID- 1626838
TI  - Gonadal steroid modulation of vasopressin pathways.

PMID- 1626840
TI  - Ricin-cytotoxin conjugate administration reveals a physiologically relevant role
      for oxytocin in the control of gonadotropin secretion.

PMID- 1626839
TI  - Pituitary portal plasma levels of oxytocin during the estrous cycle, lactation,
      and hyperprolactinemia.
AB  - The median eminence receives fibers from both parvocellular and magnocellular OT
      neurons in the hypothalamus. The OT neuronal terminal in the median eminence is
      secretory and is the major source of the neuropeptide in the blood of pituitary
      portal vessels. The OT secretion into pituitary portal plasma increases by
      ovarian steroids, PRL, and the suckling stimulus. The OT secretion into the blood
      of pituitary portal vessels changes in parallel with the altered secretion of PRL
      from the pituitary. Because of correlative association between pituitary portal
      plasma OT and systemic plasma PRL and much abundant evidence for a direct
      stimulatory action of OT on PRL release, we propose that the pituitary portal
      vascular system serves as the window for the central OT neurotransmission to the
      pituitary lactotropes.

PMID- 1626841
TI  - Preventing suckling-induced release of oxytocin does not inhibit maternal
      aggression in lactating rats.

PMID- 1626842
TI  - Oxytocin messenger RNA levels in hypothalamic, paraventricular, and supraoptic
      nuclei during pregnancy and lactation in rats. Evidence for regulation by
      afferent stimuli from the offspring.

PMID- 1626843
TI  - Analysis of oxytocin release by microdialysis and interactions with progesterone.

PMID- 1626844
TI  - Physiological significance and interactions between oxytocin and central
      neuropeptide and monoamine neurotransmitters in the regulation of the
      preovulatory secretion of luteinizing hormone.

PMID- 1626845
TI  - The effects of hypogastric and pelvic neurectomy on oxytocin-induced facilitation
      of receptivity.

PMID- 1626846
TI  - Social and environmental determinants of centrally administered oxytocin effects
      on male squirrel monkey behavior.

PMID- 1626847
TI  - Oxytocin in the amygdala facilitates maternal aggression.

PMID- 1626848
TI  - Vasopressin and the individual differentiation in aggression in male house mice.

PMID- 1626849
TI  - Opposite effects of central amygdaloid vasopressin and oxytocin on the regulation
      of conditioned stress responses in male rats.

PMID- 1626850
TI  - Expression of exogenous vasopressin mRNA by magno-cellular neurons of the
      supraoptic and paraventricular nuclei in Brattleboro rats.

PMID- 1626851
TI  - Afferent projections of the hamster periaqueductal gray. A neural site where
      vasopressin can stimulate flank marking.

PMID- 1626852
TI  - Existence of a sexual dimorphism in vasopressin binding in the area of the
      ventromedial nucleus of the hypothalamus in hamsters.

PMID- 1626853
TI  - Oxytocin and related peptides elicit contractions of prostate and seminal
      vesicle.

PMID- 1626854
TI  - The oxytocin secretory response to dopamine receptor agonists in male and female
      monkeys.

PMID- 1626855
TI  - The quantitative effect of oxytocin (Pitocin) on human milk yield.

PMID- 1626856
TI  - The relation of the milk-ejection reflex to the ability to breast feed.

PMID- 1626857
TI  - Partner preference development in female prairie voles is facilitated by mating
      or the central infusion of oxytocin.
AB  - Results of these experiments indicate that females given at least 24 hours of
      cohabitation with a male develop a social preference for the familiar partner
      versus a stranger. Mating is not essential for the development of partner
      preferences, but clearly facilitates the onset of preferences. Females given six
      hours of cohabitation showed partner preferences only if they mated with the
      partner during cohabitation (Experiment 2) or if they received oxytocin
      (Experiment 3). Females that continued to mate during preference tests
      (Experiment 2, n = 4) mated exclusively with the partner. Oxytocin infusions,
      even in the absence of mating or estrogen priming, facilitated the development of
      partner preferences.

PMID- 1626859
TI  - Speculations concerning the physiological significance of central oxytocin in
      maternal behavior.

PMID- 1626858
TI  - Oxytocin activation of maternal behavior in the rat.

PMID- 1626860
TI  - The role of biotechnology in tropical diseases.

PMID- 1626861
TI  - Immunization of cattle with an inactivated polyvalent vaccine against
      anaplasmosis and babesiosis.

PMID- 1626862
TI  - Evaluation of a DNA-based probe for the detection of cattle experimentally
      infected with Babesia bigemina.
AB  - A digoxigenin-labeled probe was used for hybridization to various preparations of
      Babesia bigemina-infected erythrocyte extracts. Dot blot hybridization and
      immunological detection of DNA hybrids revealed that the probe was specific for
      B. bigemina DNA because it did not hybridize to the DNA of B. bovis, a closely
      related species. Studies of sensitivity showed that the probe would bind to as
      little as 1 ng of B. bigemina DNA, but not to 1 microgram of the B. bovis DNA.
      The probe reacted with equal intensity against seven B. bigemina isolates from
      different geographic areas. The lowest percentage of B. bigemina-infected
      erythrocytes detected was 0.001%, a level of parasitemia not usually detected
      with the light microscope. Six intact, mixed-breed steers, approximately 3 years
      old, were inoculated with a blood stabilate containing B. bigemina-infected
      erythrocytes. Blood samples collected from day -1 to day 86 postinoculation (PI)
      and prepared for DNA extraction were analyzed in a dot blot hybridization assay
      using a nonradioactive DNA probe. Hybridization reaction (HR) signals were
      compared to results obtained by light microscopy (LM) examination of Giemsa
      stained blood smears and to antibody titers of serum samples assayed with the
      complement fixation test (CFT) and indirect fluorescent antibody test (IFAT).
      Four of six inoculated steers became infected with B. bigemina as assessed by LM.
      The parasitemias were low (less than 0.01-0.05) at day 10 PI. Only three steers
      were serologically positive by CFT (titer 1:40-1:160) and IFAT (1:1280). All four
      infected steers had positive HR signals in the dot blot assay. The HR signals
      were observed from day 10 to day 77 PI and were usually correlated with the
      presence of parasites in blood as observed by LM. The HR signals varied in
      intensity for different blood samples from the experimental animals and with day
      of blood sample collection. Although the signal intensity did not correlate with
      the parasitemia level estimated by LM, the nucleic acid hybridization assay was
      more sensitive than LM, CFT, or IFAT for the detection of B. bigemina-infected
      cattle.

PMID- 1626863
TI  - Immunophenotypic characterization of owl monkey peripheral blood mononuclear
      cells.
AB  - A two-phase study was initiated to delineate the peripheral blood lymphocyte
      populations present in owl monkeys and to correlate those populations with immune
      response and parasitism during malaria infection. The goal of phase I of the
      study was to elucidate a monoclonal antibody panel that could be used to
      characterize peripheral blood mononuclear cell (PBMC) populations with flow
      cytometric techniques. Forty-two monoclonal antibodies (reported to be reactive
      with human and macaque lymphocyte antigens) were screened for activity to owl
      monkey PBMC. Eleven monoclonals were found to react: anti-H42A (MHC Class II DP
      like); anti-TH14B (MHC Class II DR-like); and anti-TH81A5 (MHC Class II DQ-like);
      anti-H58A (MHC Class I); anti-DH59B (granulocyte and monocyte); anti-B1 (B cell);
      anti-T4 (CD4); anti-Leu3a (CD4); anti-Leu11a (CD16); anti-60.3 (CD18); and anti
      OKM1 (NK and monocyte). In a preliminary retrospective study correlating antibody
      titers, parasitemia values, and MHC Class I and Class II marker profiles on PBMC
      to test antigens used in malaria vaccine trials, a significant negative
      association was observed between cells bearing MHC Class II molecules and the
      other elements of the comparison. In summary, an appropriate panel of monoclonal
      antibodies has been identified for characterizing PBMC in owl monkeys, and
      preliminary studies indicate a possible association between clinical outcome and
      expressed phenotypic PBMC markers.

PMID- 1626864
TI  - Leishmaniasis in the Caribbean Islands. A review.
AB  - A review is presented of the current knowledge relating to leishmaniasis in the
      West Indies. The only country where an autochthonous focus of cutaneous
      leishmaniasis has been discovered within the last 20 years is the Dominican
      Republic. Most of the cases are of the diffuse clinical type, which tend to be
      anergic to the Montenegro skin test, but subclinical or mild cases are apparently
      common. The responsible agent is a new species of Leishmania and the suspected
      vector is Lutzomyia cristophei, the only anthropophilic sandfly on the island;
      the black rat could be a wild reservoir for the parasite. Sporadic indigenous
      cases have also been reported in Martinique and in Trinidad. On the latter
      island, no new cases have been found in the last 60 years, and only an enzootic
      cycle between rodents and marsupials and Lu. flaviscutellata exists there at
      present; the responsible parasite in this cycle is L. amazonensis or a closely
      related species. An apparently indigenous case of visceral leishmaniasis has been
      reported in Guadeloupe but new studies are needed to confirm if this form of the
      disease is endemic on the island. The sandfly fauna in some of the larger islands
      is discussed in relation to the existence of possible vectors and the
      establishment of the disease. In the case of Haiti, there is no reason for human
      leishmaniasis not to be present as it is in the neighboring Dominican Republic.
      In Trinidad, the conditions are present for leishmaniasis to become a true
      zoonosis at any time, produced by L. amazonensis. In Cuba, conditions seem to be
      favorable for the introduction of cutaneous leishmaniasis in the near future. No
      predictions can be made at this time for other islands because of lack of
      information about the existence of the factors required.

PMID- 1626865
TI  - A redescription of schizogony of Cytauxzoon felis in the domestic cat.
AB  - Cytauxzoon felis is a protozoan parasite that is transmitted by Dermacentor
      variabilis ticks and causes a uniformly fatal disease in domestic cats. In order
      to study schizogony and merozoite formation, D. variabilis nymphs were allowed to
      feed on domestic cats experimentally infected with C. felis, after which the
      molted adult ticks were fed on susceptible cats. Lung and liver tissues were
      collected from the cats during clinical cytauxzoonosis and were fixed for light
      and transmission electron microscopy. Some stages of parasite development were
      evident with light microscopy, but specific events associated with merogony could
      be documented only with electron microscopy. Schizogony was observed in
      endothelial macrophages of all tissues examined. The parasite appeared first as a
      multinucleated syncytium in which nuclear proliferation was evident. As the
      parasite syncytium developed, it became an increasingly elaborate labyrinth with
      extensive branches that were interconnected by thin processes of parasite
      cytoplasm. Organelles, including mitochondria and rhoptries, became apparent.
      Merozoite formation seemed to occur by rapid sequential fission along the margins
      of the multinucleated sporont in the cytoplasm of the host cell. As the sporont
      became smaller, merozoites were produced in a rosette-like configuration from the
      remaining parasite mass. Merozoites entered erythrocytes directly by endocytosis,
      without apparent injury to these cells. The sequence of events associated with
      merozoite formation in Cytauxzoon felis described herein differs from the
      previous description for this species and appears to be analogous to that
      described for the genus Theileria.

PMID- 1626866
TI  - Leptospira serology in small ruminants on St. Croix, U.S. Virgin Islands.
AB  - A serological survey of 16 serovars of Leptospira interrogans, previously
      reported in tropical small ruminants, was undertaken to determine the serovars
      involved and the prevalence of these antibodies in sheep and goats on St. Croix,
      U. S. Virgin Islands (USVI). Seven of eight goat herds (108 animals) had at least
      two seropositive animals in each herd with an individual animal seroprevalence of
      26%. The 53 sheep tested (one flock only) showed a 32% seroprevalence. Antibodies
      against seven serovars were detected in goats (autumnalis, ballum, bataviae,
      bratislava, canicola, icterohemorrhagiae, and pyrogenes). In addition, hardjo
      antibodies were detected in sheep. Serovar autumnalis accounted for about 30% of
      seropositive animals in each species. Many animals showed titers against more
      than one serovar. The number of seropositive animals suggests Leptospira may be a
      factor in the health of small ruminants on St. Croix.

PMID- 1626867
TI  - Serological survey for Lyme disease in domestic dogs and white-tailed deer from
      Oklahoma.
AB  - Sera from 223 randomly selected dogs and 489 white-tailed deer (Odocoileus
      virginianus) were tested for antibodies to Borrelia burgdorferi using an indirect
      kinetic ELISA. Dog samples were obtained in 1989 whereas deer samples were
      obtained between 1975 and 1990. Ten known negatives and two known positives from
      each group were run on each plate as controls. Samples showing mean mOD values
      above the mean of negatives + 3 SD were considered positive. Twenty-six dog
      (11.7%) and 22 deer (4.5%) samples were positive. Deer reactors were first
      detected among 1978 samples. Reactive deer were from central and eastern Oklahoma
      whereas reactive dogs were mostly from central Oklahoma. Confirmed human cases
      between 1986 and 1989 were distributed throughout the state, thus showing no
      correlation with either deer or dog results.

PMID- 1626868
TI  - Production of anti-idiotypic antibodies as potential immunoreagents for the
      serological diagnosis of bovine cysticercosis.
AB  - Although serological assays have been developed for cysticercosis, difficulties
      remain in isolating antigens from cross-reacting components and in obtaining
      reliable sources of parasite material for purification. The object of this study
      was to demonstrate the feasibility of using anti-idiotypic antibodies as
      alternative immunoreagents for the serological diagnosis of bovine cysticercosis.
      A fraction of Taenia hydatigena cyst fluid (ThFAS) had previously been used as a
      diagnostic antigen for Taenia saginata cysticercosis. Rabbits and mice were
      inoculated with ThFAS to produce either polyclonal or monoclonal antibodies
      (idiotypes), respectively. Idiotypes were purified by preparative protein A
      column, then inoculated into other rabbits to produce anti-idiotypes. The
      presence of anti-idiotypes in hyperimmune serum was demonstrated by competitive
      inhibition ELISA. Then anti-idiotypes were purified and used as coating antigen
      in a plate ELISA; results were compared to those using ThFAS as coating antigen.
      Anti-idiotypes yielded results comparable to those obtained with the native
      antigen and thus can be used as synthetic antigens for diagnostic purposes.

PMID- 1626869
TI  - Amyloidosis, hemochromatosis, and atherosclerosis in a roseate flamingo
      (Phoenicopterus ruber).
AB  - An aged male roseate flamingo, in a private collection in the British Virgin
      Islands, was found acutely "down." After four days of supportive therapy, the
      flamingo succumbed. At necropsy gross lesions included emaciation; collapsed and
      thickened, yellow abdominal air sac; dark red liver, partially covered by friable
      yellow material; and a raised, intimal plaque in the aorta near the iliac
      trifurcation. Histologic examination revealed severe, diffuse, pyogranulomatous
      air sacculitis with associated locally extensive pleuroperitonitis/perihepatitis.
      Pansystemic, predominantly periarteriolar distribution of amyloid deposition was
      evident, as was massive intrahepatocellular accumulation of iron pigment
      (hemachromatosis/hemosiderosis). A locally extensive, nonobstructive,
      fibroatheromatous plaque was present in the distal aorta. Amyloidosis,
      hemochromatosis/hemosiderosis, and atherosclerosis have been recognized in
      Phoenicopteriformes and other marine or aquatic birds. Their pathogenesis and
      pathogenicity remain a matter of debate.

PMID- 1626870
TI  - Hematological study of water buffalo (Bubalus bubalis) during theileriosis
      (Theileria annulata).

PMID- 1626871
TI  - Wasting disease associated with cutaneous and renal nematodes, in commercially
      obtained Xenopus laevis.
AB  - Xenopus laevis, the South African clawed frog or toad, is a member of the family
      Pipidae. Now in high demand for research purposes, they are available
      commercially. Its reported lifespan is up to fifteen years. Investigators and
      caretakers are frustrated when commercially obtained, young frogs (four years or
      younger), not subjected to any studies, "waste" and die. The wasting syndrome is
      characterized by anorexia, color change, and "flaky skin." Often the first sign
      of this syndrome is the presence of large fragments of "flakes" of desquamated
      epithelium in the water. At necropsy, these frogs are thin and have rough skin
      instead of smooth slimy skin. Histologic examination reveals tortuous
      intraepithelial cavities or tunnels that contain nematodes, and associated mild
      to moderate granulomatous inflammation. Nematodes are also found in the kidneys
      of some of these frogs, usually in Bowman's space, wrapped around the glomerulus.
      The cutaneous capillarid nematode is identified as Pseudocapillaroides xenopi.
      Successful treatment with ivermectin and thiabendizole has been reported. The
      renal glomerular nematode has not been identified.

PMID- 1626872
TI  - An epizootic of Tanaisia bragai in a captive population of Puerto Rican plain
      pigeon (Columba inornata wetmorei).

PMID- 1626873
TI  - Hemodynamics of heartworm infection.
AB  - To determine the hemodynamic responsiveness of dogs testing positive for
      heartworms (direct blood smear), we compared the response of control and
      heartworm-infected animals to stellate stimulation (SS). Using the anesthetized,
      open-chest model, twenty dogs (10 control and 10 heartworm-positive) were
      instrumented to measure left ventricular pressure (LVP), arterial pressure (AP),
      and coronary flow velocity (CFV) of the left circumflex coronary artery. CFV was
      converted to flow per gram tissue (CBFG) by weighing the perfusion area of the
      circumflex artery. The average wet weight of the worm mass infecting the dogs was
      1.0 +/- 0.1 g, which represented an average of 5% of the right ventricular free
      wall weight. Overall heart size and right ventricular weights were greater in the
      heartworm-positive animals, as well as heart weight to body weight ratios. Prior
      to SS, LVP was the same for both groups. However, dP/dt and CBFG were 21% and 19%
      lower, respectively, in the heartworm-positive animals. Stellate stimulation
      sufficient to produce a 30-mmHg rise in AP led to 25%, 13%, and 40% increases in
      LVP, dP/dt, and CBFG, respectively, in the control animals. Increases of 22%,
      10%, and 52% in the same parameters were observed in the heartworm-positive
      animals. Although control dP/dt and CBFG in the heartworm-positive animals were
      lower than in the heartworm-negative animals, heartworm infection at this level
      did not hinder myocardial responsiveness to SS.

PMID- 1626874
TI  - A method for the recovery of infective larvae from Toxocara canis eggs for
      collection of larval secretory/excretory products.

PMID- 1626875
TI  - Venezuelan equine encephalomyelitis and African horse sickness. Current status
      and review.
AB  - The arthropod-borne virus (arbovirus) diseases of livestock have worldwide
      impact. The prevention of an introduction of an exotic disease and the control of
      one subsequent to an introduction will require the attention, cooperation, and
      support of the livestock industry, regulatory agencies, and researchers. The most
      effective protection of our livestock industries is to prevent the introduction
      of an exotic disease agent. This implies complete restriction of animal imports
      and exports. However, "zero risk" is an unacceptable option in today's world of
      internationally integrated and interdependent agriculture. Scientifically sound
      and factually based regulatory decisions must be combined with continued
      vigilance and preparedness, as well as appropriately directed surveillance and
      research, to protect the world agricultural marketplace. Two exotic arbovirus
      diseases that are of current concern to the livestock industries and regulatory
      officials of the North American and Caribbean Basin countries are VEE and AHS.
      Devastating epizootics of VEE in equines have occurred frequently in the Western
      Hemisphere, but no recent epizootic activity has been documented. Naturally
      occurring foci of sylvatic, equine nonpathogenic VEE virus subtypes, however, do
      exist in the tropical countries of the hemisphere. The relationship of these
      sylvatic virus foci to the origin of equine virulent epizootic VEE virus subtypes
      is unknown. AHS epizootics had been confined to Africa, the Middle East, and the
      Indian subcontinent until recent outbreaks in 1966 and 1987-1990 in Spain. With
      the recurrence of AHS in Spain for the past four years, concern about the
      possible introduction into potential vector species and equines in the Western
      Hemisphere has increased. This review addresses the current VEE and AHS virus
      activity and the potential for outbreaks in the Western Hemisphere.

PMID- 1626876
TI  - A review of African horse sickness with emphasis on selected vaccines.

PMID- 1626877
TI  - Rift Valley fever: present status and risk to the Western Hemisphere.

PMID- 1626878
TI  - Experiences with African swine fever in Haiti.

PMID- 1626880
TI  - Recent advances in the biology of Anaplasma spp. in Dermacentor andersoni ticks.

PMID- 1626879
TI  - Macroepidemiology of the HIVs-AIDS (HAIDS) pandemic. Insufficiently considered
      zoological and geopolitical aspects.
AB  - The human immunodeficiency viruses (HIVs)-acquired immunodeficiency syndrome
      (AIDS) or HAIDS pandemic originated from lentiviruses of nonhuman primates (thus
      qualifying as a zoonosis) that moved into humans in Africa. The HAIDS patients
      eventually die of opportunistic infections, all potentially zoonotic. The HAIDS
      infection remained parochial, first endemically and then epidemically, until the
      African urbanization that occurred in each of the countries postindependence. The
      latter included wars and the massive movement of soldiers (virologically naive)
      from the American continent to Africa and back. The HAIDS viral ecology coincided
      with African swine fever (ASF) in the Americas. Haiti became the focal point for
      both infections. Some infected Haitians also became, together with some infected
      drug addicts in the United States, a source of contaminated human blood for
      transfusions and production of plasma derivatives.

PMID- 1626881
TI  - Treatment strategies for human arboviral infections applicable to veterinary
      medicine.

PMID- 1626882
TI  - The role of Amblyomma variegatum in the transmission of heartwater with special
      reference to Guadeloupe.
AB  - Heartwater has been diagnosed in Guadeloupe, Marie-Galante, and Antigua; it
      induces important losses among goats and European or cross-bred cattle when local
      zebu creole are highly resistant to infection. Amblyomma variegatum is the vector
      of the disease in the Caribbean. The tick strain of Martinique, occurring in that
      island that has apparently been disease-free since 1948, has not lost its ability
      to experimentally transmit the disease. In Guadeloupe 97% of nymphs and nearly
      100% of adults feed on cattle and goats. Some immature ticks (4.5%) feed on
      wildlife, including birds that may be involved in the spread of infected ticks.
      Only 1 to 4% of adult ticks are infected and only a proportion of infected ticks
      are really infective: 53%, 9%, and 50% of nymphs, males, and females,
      respectively. Nymphs play the major role in the transmission: they are more
      numerous than adults and engorge faster. Infected ticks have the same maximum
      longevity as noninfected ticks, that is, 18 months for nymphs and nearly 23
      months for adults. Cowdria is not transmitted immediately after tick fixation but
      after a delay of 2-3 days for nymphs and 4 days for adults. The disease is more
      often fatal when transmitted by tick biting rather than by needle transmission.
      The daily infection rate that summarizes all the parameters is very low (0.14%
      and 0.20% for goats and cattle, respectively), resulting in an unstable
      epidemiological situation. The transmission of Cowdria by A. variegatum in
      Guadeloupe shows significant differences compared with the transmission by A.
      hebraeum in Africa.

PMID- 1626883
TI  - Chemotherapeutic prevention of complications caused by vaccinia virus-vectored
      immunogen.
AB  - Vaccinia virus strains and constructs differ greatly in the number of PFUs
      required to produce tail lesions in the vaccinia virus mouse model. The
      pathogenesis of lesion formation appeared to involve virus spread from an initial
      focus in specific cells surrounding hair follicles to other concentrated areas of
      the dermis and finally, at the time of lesion development, to the epidermis.
      Antivirals that suppressed tail lesions, to a greater or lesser degree, included
      ara A, ribavirin, rifampicin, adenosine N'-oxide, and selected analogues.
      Immunomodulators, including ampligen and recombinant interferon, suppressed
      lesions at very low doses. Spread of virus infection from the dermis to the
      epidermis was inhibited as determined by immunofluorescence. These studies in the
      tail lesion model have suggested drugs that could be tested further in primate
      models of vaccinia virus infection. In addition, these studies provide additional
      data on a model that may be a useful adjunct in safety testing of recombinant
      vaccinia virus vaccines.

PMID- 1626884
TI  - Mongoose rabies in the Caribbean.
AB  - Mongooses (Herpestes auropunctatus) have been introduced into most of the larger
      Caribbean islands, some notable exceptions being Dominica, Tobago, and
      Montserrat. Rabies in Caribbean mongooses is present in Puerto Rico, Cuba, the
      Dominican Republic (and presumably Haiti), and Grenada. Bat rabies is known on
      Cuba, Grenada, and Trinidad, although mongooses found on Trinidad are free of the
      disease. None of the other islands is known to have rabies, although it could be
      present in sequestered bat populations. All reported case numbers of mongoose
      rabies in the Caribbean are underestimates, and available information is at best
      incomplete and at times fragmentary. Nevertheless, data are presented from the
      four affected islands. Mongoose reduction campaigns have been undertaken on Cuba
      and Grenada. In Cuba strychnine sulfate inoculated into labeled eggs is used,
      whereas in Grenada sodium fluoroacetate (1080) has been used in boiled cowhide
      baits. Mongoose poisoning is unsatisfactory and ineffective in the long-term.
      Because many mongooses naturally exposed to rabies virus develop serum
      neutralizing antibodies and are considered to be immunized, possibly for life,
      vaccination in the wild has been under consideration since the mid-1970s. Early
      attempts to produce a pill coated with ERA vaccine for enteric absorption in
      mongooses were not very successful, but new modified vaccines and recombinant
      techniques hold considerable promise.

PMID- 1626885
TI  - The role of the veterinarian in hurricanes and other natural disasters.
AB  - Hurricanes create a multiplicity of complicated problems and hazards ranging from
      outbreaks of infectious disease to animal control problems precipitated by
      destruction of property. A multidisciplinary response is required to solve such
      problems. The pool of knowledge derived from various professionals interacting
      with multiple levels of government agencies (federal, state, and local) will
      provide the expertise needed. Because the veterinarian is trained to deal with
      disease involving populations of animals (e.g., herds or flocks) as well as
      individuals, and because of his/her intensive clinical training, the veterinarian
      is uniquely qualified to deal with the disaster situation. The veterinarian
      possesses extensive knowledge in disease and disease processes and has the
      capability of disease and injury management in affected populations, which
      qualifies him/her for an essential role, with unlimited potential as a member of
      any disaster relief team. There is considerable potential for veterinarians to
      play a role in responding to natural disasters. The areas of disease control,
      animal care, animal control, protection of the food supply,
      disinfection/sterilization, and planning are all areas where veterinarians can
      take an active part. Inclusion of the veterinarian in the process of planning for
      and responding to natural disasters will yield significant public health
      benefits.

PMID- 1626886
TI  - A new food safety strategy for tropical America.

PMID- 1626887
TI  - The Caribbean Animal and Plant Information Network.
AB  - The Inter-American Institute for Cooperation on Agriculture (IICA) is presently
      implementing a four-year project in the Caribbean region to establish a regional
      information network on animal and plant health--the Caribbean Animal and Plant
      Health Information Network (CARAPHIN). CARAPHIN's immediate goal is to give the
      participating countries the technical capability to process and analyze the phyto
      and zoo-sanitary information that they generate, share this information within
      the region, and use it as an effective instrument for decision making for
      agricultural development and trade. Sharing of information is further facilitated
      through the periodic regional and hemispheric meetings organized by IICA, by the
      Inter-American Animal Health Commission, and by the Technical Advisory Committee
      on Plant Protection. The Veterinary and Plant Protection Services of the region
      have expressed interest in the continuation of CARAPHIN as a permanent mechanism
      for agricultural health information management in the Caribbean. This motivated
      IICA to seek financing for a second phase of CARAPHIN, which will be executed
      from 1992 through 1996. Phase II of the project will seek to ensure the
      continuing application of the techniques and methodologies acquired by the
      agricultural health services of the different countries, and the functioning of
      the disease/pest information systems at the regional level. This will be achieved
      through technical assistance, continuing education, publications, provision of
      useful databases, and transfer of the project to a regional institution.

PMID- 1626888
TI  - Problems of developing a self-financing veterinary diagnostic laboratory service
      in southern Peru.

PMID- 1626889
TI  - Use of LANDSAT MSS imagery and soil type in a geographic information system to
      assess site-specific risk of fascioliasis on Red River Basin farms in Louisiana.
AB  - A geographic information system (GIS) was constructed in an ERDAS environment
      using maps of soil types from the USDA Soil Conservation Service, LANDSAT
      satellite multispectral scanner data (MSS), boundaries for 25 study farms, and
      slope and hydrologic features shown in a two-quadrangle (USGS, 7.5') area in the
      Red River Basin near Alexandria, Louisiana. Fecal sedimentation examinations were
      done in the fall of 1989, spring of 1990, and fall and winter of 1990-1991 on 10
      16 random samples per herd. Fecal egg shedding rates for F. hepatica ranged from
      10-100% prevalence and 0.3-21.7 eggs per two grams of feces (EP2G). For
      Paramphistomum spp., a rumen fluke also transmitted by F. bulimoides but not
      affected by flukicides, egg shedding rates ranged from 10-91% prevalence and 0.1
      42.8 EP2G. Soil types present ranged from sandy loams to hydric, occasionally
      flooded clays. Herd Paramphistomum spp. egg shedding rates increased with the
      proportion of hydric clays present, adjusted for slope and major hydrologic
      features. F. hepatica infection intensity followed a similar trend, but were
      complicated by differing treatment practices. Results suggest that earth
      observation satellite data and soil maps can be used, with an existing climate
      forecast based on the Thornthwaite water budget, to develop a second generation
      model that accounts for both regional climate variation and site-specific
      differences in fascioliasis risk based on soils prone to snail habitat.

PMID- 1626890
TI  - Economic benefits of controlling internal and external parasites in South
      American camelids.
AB  - A trial was carried out in alpacas (Lama pacos) and llamas (Lama glama) to
      determine the economic benefits of controlling both external and internal
      parasites by the use of ivermectin ("Ivomec," Merck Sharp & Dohme). After four
      months the treated male alpacas gained on average 3.1 kg more than the untreated
      males, and their fleece weighed 0.36 kg more. The treated female alpacas gained
      1.9 kg more than the controls, but their fleece weighed 0.03 kg less. This
      treatment gave a net financial benefit to the farmer of U.S. $3.54 for each of
      his male alpacas and U.S. $1.36 for each of his female alpacas. The results for
      the llamas were not significant because there was great variation in the weight
      gains (and losses). Because the value of llama fleece is less, the economic
      benefits were also less.

PMID- 1626891
TI  - Biology and transmission of Babesia bigemina in Boophilus microplus.

PMID- 1626892
TI  - Epizootiology of Lyme disease and methods of cultivating Borrelia burgdorferi.
AB  - Lyme disease is prevalent over vast areas of land in the northern hemisphere. The
      etiologic agent is a spirochete, Borrelia burgdorferi, that is transmitted by
      Ixodes ticks. At least five species of anthropophilic ticks are competent
      vectors, and the causative agent or closely related species have been detected in
      20 wild or domestic mammals and eight birds. The ability to isolate and culture
      B. burgdorferi from humans, ticks, and wildlife has significantly contributed to
      our understanding of the epizootiology of Lyme disease. Specific procedures for
      isolating borreliae from ticks and rodents in Barbour-Stoenner-Kelly medium are
      described. The authors have preserved in liquid nitrogen more than 500 isolates
      from ticks, wildlife, and a human.

PMID- 1626893
TI  - Impact of zoonoses in tropical America.

PMID- 1626894
TI  - Eradication of Boophilus microplus (Acari: Ixodidae) in Puerto Rico.
AB  - The ongoing cooperative effort between the United States Department of
      Agriculture, Animal and Plant Health Inspection Service and the Puerto Rico
      Department of Agriculture to eradicate the southern cattle tick, Boophilus
      microplus (Canestrini), is reviewed. Epidemiological and biological aspects of
      the tick that influence efficient control and/or eradication in Puerto Rico are
      discussed. The differences between the current eradication methodology and that
      initially utilized by the program are emphasized. The status and possible future
      adaptations of the program, as well as its applicability to other areas in the
      Caribbean, are also addressed.

PMID- 1626895
TI  - Preliminary attempts to infect bovine erythrocytes in vitro with a tick-derived
      stage of Anaplasma marginale.

PMID- 1626896
TI  - Studies on the biology of Ixodes dammini in the upper midwest of the United
      States.
AB  - The seasonal activity pattern of Ixodes dammini was monitored in south-central
      Wisconsin in 1989 and 1990. Immature tick activity and abundance were assessed by
      small mammal trapping (732 Peromyscus leucopus examined) and supplemented with
      flagging. Tick survival and molting times were evaluated by maintaining ticks in
      environmental chambers at field sites. Results indicate the biology of I. dammini
      in the upper midwest is similar to that previously reported from the eastern
      United States. One notable difference was that seasonal larval activity appeared
      broader (late April through October) and peaked earlier (on 9 July 1989 mean was
      7.7 larvae/mouse; on 9 June 1990 mean was 7.3 larvae/mouse). Nymphal activity on
      P. leucopus peaked in May of both years (mean = 2.5 in 1989; mean = 1.8 in 1990).
      Bloodfed females placed in the field in early May 1990 oviposited in early June,
      and larvae emerged by early August. All bloodfed stages successfully overwintered
      at field sites.

PMID- 1626897
TI  - Vaccines against coxiellosis and Q fever. Development of a chloroform:methanol
      residue subunit of phase I Coxiella burnetti for the immunization of animals.
AB  - We have demonstrated the safety, immunogenicity, and efficacy of the WC and CMR
      vaccines in guinea pigs. Vaccination of guinea pigs with either WC or CMR
      protects animals against challenge with virulent C. burnetii. A total of 2
      micrograms of either WC or CMR vaccine was a significant priming dose. A total of
      20 micrograms gave complete protection against lethal challenge. Detection of
      antibodies to phase II cells by microaglutination, after vaccination with either
      WC or CMR and before lethal challenge, correlated with the ability of guinea pigs
      to mount a protective immune response. The PD50 values for WC and CMR vaccines,
      administered as a single dose, were 0.3 and 1.4 micrograms per animal,
      respectively. In contrast, the PD50 values for the WC and CMR vaccines,
      administered as two doses, were 0.83 and 0.72 micrograms per animal,
      respectively. Although the PD50 values for the two vaccines are similar, the CMR
      vaccine is preferred over the WC vaccine because it induces significantly fewer
      adverse reactions, and repeat injections can be given. Unvaccinated guinea pigs
      do not clear infectious microorganisms after challenge infection. Vaccination
      before challenge infection reduces the infectious load of C. burnetti in the
      blood and in various organs of the animals. When vaccinated animals were
      challenge infected and treated with rifampicin, the microorganisms were not
      eliminated from various organs. However, the combination of vaccination,
      challenge, and rifampicin treatment is effective in reducing the number of
      infectious microorganisms in some of these sites. We have demonstrated the safety
      and immunogenicity of the CMR vaccine in sheep and goats. Animals that were
      seropositive for one or more antigens developed significant levels of antibodies
      to alternate antigens, but no adverse reactions were observed at the site of s.c.
      injection of the CMR vaccine. This demonstrates that seropositive animals can be
      successfully immunized with this vaccine. These results also indicate that a long
      term vaccination program using the CMR vaccine has the potential for producing
      animals with significant antibody titers to C. burnetii and perhaps lifelong
      immunity. The goal of a Q fever vaccination program is to produce immunized
      animals that are able to clear completely the infectious microorganisms. The
      appropriate vaccination schedule to render adult animals and their offspring "Q
      fever-free" should now be thoroughly investigated.

PMID- 1626898
TI  - Serge Alexander Korff (1906-1989).

PMID- 1626899
TI  - Are we ready for the year 2001?

PMID- 1626900
TI  - The surgery of otosclerosis. 1937.

PMID- 1626901
TI  - Tracheal agenesis.
AB  - Tracheal agenesis is a catastrophic congenital anomaly that invariably results in
      death. Forty-seven cases have been previously reported in the literature. We add
      five additional cases, including two type 1 cases, two type 2 cases, and one type
      3 cases, based on Floyd's classification scheme. We describe the features of this
      unusual anomaly at the time of diagnosis. We discuss a rational approach to the
      management of this difficult problem on an emergent basis that allows for the
      maintenance of the infant's life until all of the implications of this fatal
      condition can be assessed. While we do not advocate reconstructive surgery for
      this anomaly, which has been universally fatal, we discuss the potential
      rearrangement of the anatomy, which may offer some hope in future cases. The
      concomitant congenital anomalies associated with these cases are reviewed, and
      autopsy specimens are presented for their anatomic interest.

PMID- 1626902
TI  - Videostroboscopy of human vocal fold paralysis.
AB  - Previous stroboscopic studies of human vocal cord paralysis have been infrequent
      and have lacked documentation of the site of lesion. In order to study human
      laryngeal paralysis, the recurrent and superior laryngeal nerves were infiltrated
      unilaterally with lidocaine hydrochloride in three human volunteers. Vagal
      paralysis was simulated by combined (superior and recurrent) infiltration in one
      volunteer. Additionally, 20 patients with untreated laryngeal paralysis were
      studied from the voice laboratory at UCLA. In addition to videostroboscopic
      analysis, photoglottography and electroglottography were performed and
      synchronized with the stroboscopic images. The most significant finding in
      stroboscopy of the paralyzed larynx was the asymmetry of traveling wave motion.
      The traveling wave on the normal vocal fold had a faster wave velocity that
      created a phase difference in the vibration of the two folds. The wave also
      traversed a greater distance along the vocal fold mucosa on the normal side. No
      patient or volunteer with untreated laryngeal paralysis had a symmetric traveling
      wave, either in superior or recurrent laryngeal nerve paralysis. Synchronization
      with glottography indicated that the differentiated electroglottographic waveform
      provides useful information about the timing of glottic opening and closure in
      states of asymmetric laryngeal vibration. Implications for future studies and for
      the diagnosis of laryngeal paralysis are discussed.

PMID- 1626903
TI  - Noninvasive technique for estimating subglottic pressure and laryngeal
      efficiency.
AB  - The clinical assessment of aerodynamic parameters is important in the physiology
      and pathophysiology of laryngeal function. Vocal efficiency is among these
      objective measurements and can be calculated from simultaneous recordings of
      subglottic pressure, airflow, and sound intensity. Modern techniques allow us to
      accurately determine sound intensity and airflow. However, methods to determine
      subglottic pressure are either invasive or laborious. We have evaluated a
      noninvasive, indirect method to determine subglottic pressure by using a
      technique based on the interruption of transglottic airflow during phonation. The
      correlation between the indirectly acquired subglottic pressure measured in the
      oral cavity by using this technique and the subglottic pressure obtained directly
      by translaryngeal puncture in human volunteers was highly significant in 35
      trials (r = .92, p less than .01). This study describes a reliable technique for
      the noninvasive measurement of subglottic pressure, sound intensity, and airflow.

PMID- 1626904
TI  - Lidocaine effects on the laryngeal chemoreflex, mechanoreflex, and afferent
      electrical stimulation reflex.
AB  - The use of lidocaine hydrochloride as either a topical or intravenous agent has
      become a common practice for minimizing laryngospasm and the reflex
      cardiovascular effects resulting from upper airway manipulation. The efficacy and
      mechanism of action of lidocaine for this purpose remain unclear. We evaluated
      the effect of lidocaine on the laryngeal chemoreflex (LCR), mechanoreflex (LMR),
      and superior laryngeal nerve electrical stimulation adductor reflex (SLN-ESAR) in
      piglets. Cardiopulmonary responses were used to assess LCR and LMR. Latency
      following SLN stimulation was used to assess SLN-ESAR. Intravenous lidocaine
      hydrochloride at 3 mg/kg produced no suppression of the LCR, LMR, or latency (SLN
      ESAR onset latency before lidocaine 11.7 +/- 0.7 milliseconds, after lidocaine
      12.2 +/- 0.5 milliseconds; peak latency before lidocaine 13.2 +/- 0.2
      milliseconds, after lidocaine 13.4 +/- 0.4 milliseconds). Topically applied
      lidocaine at the same dose eliminated both LCR and LMR responses in all animals,
      with return of reflex responses 15 minutes after application. No effect on the
      SLN-ESAR was seen with application of topical lidocaine. This study supports
      topical lidocaine as a suppressant of laryngeal mucosal neuroreceptors without
      central neural reflex effects. Intravenous lidocaine did not affect peripheral
      neuroreceptors, nor did it significantly affect the latency of the SLN-ESAR
      neural reflex arc. Intravenous and topical lidocaine differ in mechanism of
      action and efficacy with regard to modulation of reflex effects induced by
      laryngeal stimulation.

PMID- 1626905
TI  - Meniere's syndrome inherited as an autosomal dominant trait.
AB  - Brown in 1941 reported on five families having two members with Meniere's
      syndrome. In 1949 she reported on three siblings (children of first cousins) and
      two identical twins bearing the syndrome. Bernstein in 1965 reported on seven
      families having two or more members afflicted by the symptoms. All these reports
      showed association between Meniere's syndrome and migraine headaches. None
      provided detailed pedigree studies in order to clarify the mode of genetic
      transmission. We report on a father, three daughters, and one son with typical
      Meniere's syndrome and paroxysmal headaches. The pedigree strongly suggests
      autosomal dominant transmission. After studying this family we have been paying
      close attention to family histories of Meniere's syndrome patients. It is not at
      all uncommon to hear about other members of the family with the syndrome, but it
      is difficult to document all of the cases for logistical reasons.

PMID- 1626906
TI  - Pediatric airway reconstruction at Great Ormond Street: a ten-year review. II.
      Revisional airway reconstruction.
AB  - One hundred eight consecutive patients with pediatric laryngotracheal stenosis
      requiring airway reconstruction over a 10-year period were reviewed. Thirty-two
      patients required revisional airway reconstruction in an attempt to achieve
      decannulation. Patients underwent from one to four revisional airway
      reconstructions, most often laryngotracheal reconstruction with costal cartilage
      grafting. In the Cotton grading scheme of preoperative stenosis, those patients
      requiring revisional airway surgery tended to come from the more severely
      affected categories. Twenty-two patients of 32 (69%) achieved decannulation with
      revisional airway reconstruction. Thus, revisional airway reconstruction is
      indicated if the first attempt fails.

PMID- 1626907
TI  - Orbital complications of acute sinusitis: comparison of computed tomography scan
      and surgical findings.
AB  - The accuracy of computed tomography (CT) in distinguishing an abscess from
      cellulitis in children who present with orbital manifestations of paranasal sinus
      infection remains in question. In this 10-year retrospective study, CT results
      are compared with surgical findings in 19 patients with orbital complications who
      underwent surgical exploration within 24 hours of their CT scans. Fifteen of the
      19 CT scan interpretations indicated abscesses that were verified
      intraoperatively. Two patients had negative surgical explorations despite CT
      interpretations predicting abscesses. An abscess was also surgically documented
      in 1 of 2 patients whose preoperative scans indicated cellulitis alone. We
      conclude that the correlation between radiologic and operative findings in 16 of
      these 19 cases, although not absolute, does substantiate the use of CT scanning
      as a therapeutic guide in children presenting with orbital disease secondary to
      paranasal sinusitis.

PMID- 1626908
TI  - Planum semilunatum of the rat: new light and electron microscopy observations.
AB  - Planum semilunatum (PSL) cells of the rat ampullae were studied by light,
      transmission, and scanning electron microscopy. The observed ultrastructure of
      rat PSL cells was similar to that described in other species, but is in
      disagreement with earlier reports of rat PSL cells, most probably because of
      previous divergent definitions of the PSL. Regions of PSL cells were easily
      distinguished from other nonsensory epithelia at the lateral ends of the crista
      ampullaris. The PSL region consisted of irregular-shaped columnar to cuboidal
      pentagonal or hexagonal cells that interdigitated with one another by lateral
      membrane infoldings. In the PSL region the subepithelial reticular layer appeared
      thickened and formed wartlike impressions in the basal surface of the PSL cells.
      These morphological characteristics of the subepithelial reticular layer were
      unique to the PSL region in the ampulla and may reflect special adaptations of
      the PSL region to mechanical stress. Furthermore, the thick subepithelial
      reticular layer may have implications for transport across the PSL region.

PMID- 1626909
TI  - Effect of endotoxin on cultured chinchilla middle ear epithelium.
AB  - The effect of endotoxin on the growth and morphology of cultured chinchilla
      middle ear epithelium was examined. Within 24 hours of culture, cells maintained
      in medium containing endotoxin exhibited dose-dependent morphological changes.
      The highest concentration of endotoxin (100 mg) resulted in cell death. The
      growth curve of the cells in culture demonstrated a dose-dependent, significant
      increase in cell number when endotoxin was added to the medium.

PMID- 1626910
TI  - Vestibular pathophysiologic changes in experimental perilymphatic fistula.
AB  - An animal model of experimental perilymphatic fistula (EPLF) was developed in the
      guinea pig in order to study vestibular pathophysiology. In experimental animals,
      4 microL of perilymph was suctioned from one cochlea via the round window
      membrane. Changes in vestibular function were as follows. 1) During the acute
      stage (5 hours postoperatively), spontaneous nystagmus directed toward the normal
      side was noted in 57.4% of the EPLF animals. This lasted less than 24 hours. 2)
      One week postoperatively, direction-fixed positional nystagmus toward the
      lesioned ear was present in 22.7% of the EPLF animals, especially when the
      lesioned ear was positioned inferiorly. 3) With the ice water caloric test, no
      response was present in 58.1% of the EPLF animals and an irregular response was
      found in 22.6% of them, 1 week postoperatively. These results tend to indicate
      that tests of vestibular function may differentiate between patients with
      Meniere's disease and those with perilymphatic fistula. Histologic findings
      indicate that a floating labyrinth is the cause of positional nystagmus and
      caloric irregularity. The absence of caloric responses was associated with
      collapse of the vestibular labyrinth.

PMID- 1626911
TI  - Cartilaginous tumor of the larynx.

PMID- 1626912
TI  - Calcification of internal auditory canal tumors.

PMID- 1626913
TI  - Choanal and angiomatous polyps of the sinonasal tract.
AB  - Choanal and angiomatous polyps can be distinguished from ordinary sinonasal
      polyps by either a distinctive clinical presentation (choanal) or the
      histopathologic appearance (angiomatous). Nearly all choanal polyps arise within
      paranasal sinuses, with the antrochoanal polyp the most common. The angiomatous
      polyp is most often a secondary change in a choanal polyp and can be mistaken for
      vascular neoplasms, eg, angiofibroma.

PMID- 1626914
TI  - Drug receptor assays: quo vadis?

PMID- 1626915
TI  - Insulin-like growth factor 1: a valid nutritional indicator during parenteral
      feeding of patients suffering an acute phase response.
AB  - Insulin-like growth factor 1 (IGF-1) is regulated by nutritional intake
      independently of growth hormone and may be a better nutritional indicator than
      the plasma proteins. This possibility was investigated in six malnourished
      inpatients, who suffered sepsis, surgical trauma, or both and who received total
      parenteral nutrition (TPN) for 10-35 days. Both plasma IGF-1 and pre-albumin
      showed (P less than 0.05) increases during TPN from baseline values of 0.042-0.42
      U/mL (median, 0.11) and 59-156 mg/L (median, 108), respectively, to maxima of
      0.19-1.12 U/mL (median, 0.63) and 140-363 mg/L (median, 203). Statistically
      significant (P less than 0.05) positive correlation occurred between nitrogen
      balance (range, -7.5 to +11.0 g/day) and IGF-1 or pre-albumin. Correlation
      between nitrogen balance and IGF-1 is preserved during the acute phase response
      to tissue injury when C-reactive protein (CRP) varies in the range 40-248 mg/L.
      Under these circumstances, the correlation between nitrogen balance and pre
      albumin is, in contrast, abolished. These results suggest that IGF-1 behaves as a
      valid index of nutritional adequacy during parenteral feeding whereas pre-albumin
      reflects mainly the acute phase response.

PMID- 1626916
TI  - Variation of sweat sodium and chloride with age in cystic fibrosis and normal
      populations: further investigations in equivocal cases.
AB  - Patients attending cystic fibrosis clinics had sweat sodium and chloride
      concentrations measured, were reassessed clinically and had DNA studies
      performed. Sweat test results were compared with a matched control population. In
      both populations sweat sodium increased with age up to 12 years, and did not
      change significantly thereafter. The age-related increase was significantly less
      in the cystic fibrosis group. Sweat chloride increased with age in normal, but
      not in cystic fibrosis children. After age 12 years there was no age-related
      change in the normal group, and a fall with age in the cystic fibrosis group.
      Sweat chloride provided the best discrimination between normal and cystic
      fibrosis populations and this was particularly important in older subjects.
      Combining sweat sodium and chloride results did not improve discrimination. Nine
      patients were identified with equivocal sweat chloride results. DNA studies
      showed six of these subjects were heterozygous for the delta F508 mutation in the
      cystic fibrosis gene. Clinical assessment did not always resolve cases with
      borderline sweat chloride results.

PMID- 1626917
TI  - Incomplete testicular feminization syndrome: studies of 17 beta-oestradiol
      binding activity and aromatase activity in cultured genital fibroblasts showing
      impaired dihydrotestosterone-binding.
AB  - Dihydrotestosterone (DHT) and 17 beta-oestradiol binding, and aromatase activity
      were measured in cultured genital skin fibroblasts from two siblings with the
      incomplete testicular feminization syndrome. Whole-cell and nuclear DHT binding
      in the cells from both patients were reduced to 80% and 60%, respectively of
      those in a normal male subject. The nuclear oestradiol binding was not impaired
      in the fibroblasts from the patients whose plasma oestradiol was normal or a
      little elevated. Although gonadectomy led to a decrease in plasma testosterone
      concentration, the concentration of testosterone-binding globulin showed no
      change suggesting no apparent effect on testosterone-binding globulin synthesis
      by testicular steroids. There was no significant difference in aromatase activity
      of the fibroblasts between the patients and the normal male subjects. The
      relatively increased oestrogen concentration in the syndrome might result from
      oestrogen production in testes, but is unlikely to be from peripheral tissues
      such as fibroblasts. This is the first report to examine oestradiol binding and
      aromatase activity in the cells from the incomplete testicular feminization
      associated with impaired DHT binding. These findings may give new insight into
      the pathogenesis of abnormal male sexual differentiation in the patients with
      testicular feminization syndrome.

PMID- 1626918
TI  - Serum urate, serum glucose and diabetes.
AB  - We have studied the relationship between serum glucose and urate in 260,699 men
      and 214,118 women from Sweden, and 140,084 men and 30,653 women from the UK. We
      found an increase in mean serum urate with increasing glucose concentrations up
      to 7.0 mmol/L in men and 9.0 mmol/L in women. Thereafter increasing glucose
      values were accompanied by a statistically significant decrease in urate
      concentrations. This fall was particularly marked in younger subjects. We believe
      this may have important implications for the free radical status of diabetics.

PMID- 1626919
TI  - Measurement of dopamine, HVA and HMMA in untimed urine samples: establishment of
      age-related reference data in children.
AB  - We describe assays for homovanillic acid, hydroxymethylmandelic acid and dopamine
      that have proven practical and reliable during 3 years of routine use.
      Homovanillic and hydroxymethylmandelic acids were measured as trimethyl silyl
      derivatives by capillary gas chromatography. Dilution of samples prior to
      extraction was found to be necessary to achieve consistent recoveries of these
      acidic metabolites. Dopamine was assayed by high pressure liquid chromatography
      with electrochemical detection using an optimized method of catecholamine
      isolation that involved both ion exchange and alumina extraction. Untimed urine
      samples were collected from 140 hospitalized children. Age related reference data
      for the excretion of all three metabolites are reported. We suggest certain
      precautions that should be observed when using untimed samples and relating the
      results to creatinine excretion.

PMID- 1626920
TI  - A method for the determination of sex hormone binding globulin using Concanavalin
      A-sepharose.
AB  - A binding assay for sex hormone binding globulin (SHBG) has been developed in
      which SHBG is saturated with tritiated dihydrotestosterone (DHT). Separation of
      bound and free DHT is achieved by using Concanavalin A-Sepharose as a solid phase
      matrix. The method is described and its performance, including linearity,
      imprecision and comparison with other methods, is assessed. The assay is simple
      and robust and is suitable for analysis of samples of plasma or serum for
      clinical or research use.

PMID- 1626921
TI  - Circulating levels of tartrate-resistant acid phosphatase in macrophage-activated
      lung disease.
AB  - Tartrate-resistant acid phosphatase (TrACP) is abundant in alveolar macrophages,
      suggesting that these cells might contribute to the activity of this isoenzyme in
      sera of patients with conditions characterized by activation of alveolar
      macrophages. TrACP was therefore measured in patients with pulmonary sarcoidosis
      and cryptogenic fibrosing alveolitis and compared with values in controls. Since
      osteoclasts are known to be the main source of TrACP in serum several indices of
      bone-turnover were also measured: serum bone-specific alkaline phosphatase and
      urine hydroxyproline:creatinine ratios. Patients with Paget's disease of bone
      constituted a reference group presenting increased bone turnover. TrACP was not
      significantly higher in the lung-disease groups than in controls, although there
      was a strong positive correlation with angiotensin-converting enzyme in pulmonary
      sarcoidosis. As expected, TrACP activity was elevated together with the other
      indices of bone turnover in Paget's disease. It is unlikely that TrACP from
      alveolar macrophages contributes significantly to serum acid phosphatase activity
      in lung disease.

PMID- 1626922
TI  - A reference preparation of human prostatic acid phosphatase: purification,
      characterization and field trials.
AB  - Acid phosphatase has been prepared in an apparently pure state by affinity
      chromatography from human prostatic tissue. When dissolved in an acidic albumin
      solution, lyophilized and stored at -20 degrees C for up to 2 years, no time
      dependent loss of catalytic activity was detectable in the reconstituted
      material. Accelerated degradation tests also predicted complete stability. A
      preliminary distribution of the lyophilized preparation to 143 laboratories
      confirmed its robustness and demonstrated its potential usefulness as a calibrant
      to unify the results of different methods of measuring acid phosphatase activity.

PMID- 1626923
TI  - Human serum and urine glycosaminoglycans in health and in patients with chronic
      renal failure.
AB  - Quantitation of uronic acid precipitable by cetylpyridinium chloride (CPC) and
      electrophoretic separation of glycosaminoglycans were performed on sera from
      patients with chronic renal failure and compared to normal controls. Serum CPC
      precipitable uronic acid (CpUA) levels in patients with renal failure were
      significantly higher (mean 13.7 mg/L, range 7.1-23.6 mg/L) than normal controls
      (mean 9.6 mg/L, range 5.1-13.9 mg/L) due to increased concentrations of low
      sulphated chondroitin sulphate. A positive correlation between serum CpUA and
      creatinine was found in renal failure patients. Urine CpUA excretion was raised
      in renal failure patients compared to normal controls with an increased excretion
      of chondroitin sulphate (Ch-S) of reduced electrophoretic mobility. Heparan
      sulphate (HS), a major glycosaminoglycan in normal urine, was absent from the
      urine of these patients. The possible origin of urine glycosaminoglycans and the
      role of the kidney in glycosaminoglycan metabolism are discussed.

PMID- 1626924
TI  - A method for quantitative measurement of mitochondrial creatine kinase in human
      skeletal muscle.
AB  - Defects in the mitochondrial energy generating system in patients with a
      mitochondrial myopathy are known to be localized in various enzyme complexes
      involved in energy production. Such a defect may exist at the level of
      mitochondrial creatine kinase (Mi-CK). On that account we have developed a method
      for measurement of the enzyme activity in human skeletal muscle biopsy material
      (greater than 10 mg). Interfering creatine kinase isoenzymes are removed by anion
      exchange and affinity chromatography. The activity of Mi-CK in reference skeletal
      muscle homogenates amounts to 240 +/- 88 mU/mg protein (30 +/- 8.0 mU/mg wet
      weight).

PMID- 1626925
TI  - Creatine kinase isoforms: investigation of inhibitors of in vitro degradation and
      establishment of a reference range.
AB  - The in vitro stability of creatine kinase isoforms was examined by separation
      with high voltage electrophoresis. The effect of inhibitors of carboxypeptidase
      was evaluated. Preservation of samples is essential to inhibit in vitro changes
      in isoform pattern. EDTA at a final concentration of 15 mmol/L is recommended.
      Using appropriately preserved samples, normal reference intervals for the MM
      isoforms have been established.

PMID- 1626926
TI  - Carbamylated haemoglobin in normal, diabetic and uraemic patients.
AB  - Carbamylated haemoglobin arises from the non-enzymic modification of haemoglobin
      monomers by isocyanate derived from the spontaneous dissociation of urea. We
      measured carbamylated haemoglobin by high performance liquid chromatography in
      healthy subjects, non-uraemic hospital patients, diabetics, and different groups
      of uraemic patients. Carbamylated haemoglobin levels were found to be raised in
      uraemic subjects, but were independent of age, sex, glycaemic state and
      haemodialysis procedure. There was no significant difference in carbamylated
      haemoglobin levels between two groups of patients having different modes of
      dialysis treatment, probably indicating a similar degree of uraemic exposure in
      these patients.

PMID- 1626927
TI  - Immunoblotting of transferrin in the identification of cerebrospinal fluid
      otorrhoea and rhinorrhoea.
AB  - Cerebrospinal rhinorrhoea is potentially serious due to the risk from infection.
      In patients presenting with a nasal discharge of clear fluid it is important to
      identify the nature of the fluid. Cerebrospinal fluid is readily identified by
      the presence of asialo-transferrin (tau protein). A method is presented for the
      identification of tau protein based upon agarose electrophoresis, followed by
      transfer onto cellulose nitrate membrane and immunochemical detection of
      transferrin. The method is reliable, sensitive and simple, and requires only
      basic electrophoresis apparatus.

PMID- 1626928
TI  - Achieving consensus on out-of-hours laboratory tests.
AB  - Many reports on guidelines for investigation describe either the guidelines
      themselves or their implementation. Implicitly these assume that there has been
      general agreement about the guidelines, whereas there may be uncertainty about
      the appropriateness of a particular investigation in a given situation. We report
      the use of a technique for developing guidelines which explicitly seeks to
      identify areas of agreement and disagreement, and focuses on the reasons that
      particular decisions were made and the causes of disagreement.

PMID- 1626929
TI  - Lead haem saturation method: a method for measuring red cell lead binding
      protein.

PMID- 1626930
TI  - Sample storage conditions for the assay of glyoxalase activities in whole blood
      samples.

PMID- 1626931
TI  - Effect of educational feedback on clinicians' requesting of cardiac enzymes.

PMID- 1626932
TI  - Effect of racial variation in serum creatine kinase on interpretation: a case
      report.

PMID- 1626933
TI  - Clinical and metabolic findings in a patient with phytosterolaemia.

PMID- 1626934
TI  - Pseudohyperphosphataemia in multiple myeloma.

PMID- 1626935
TI  - The incidence of asymptomatic hypothyroidism in new referrals to a hospital lipid
      clinic.

PMID- 1626936
TI  - [Complications and their management in intraarterial infusion chemotherapy].
AB  - Complications and its management were evaluated in intraarterial infusion
      chemotherapy for 188 patients with advanced carcinoma of the digestive organs
      from 1975 to Sept. 1991. Subjects were divided into four groups: Group I was 62
      patients in whom the tip of the catheter without knots was established in the
      abdominal aorta via celiac axis, Group II consisted of 72 patients with the tip
      of the catheter without knots in the common hepatic artery. Group III had 35
      patients with the tip of the catheter with knots (Anthron catheter) in the common
      hepatic artery. Group IV was 19 patients with the tip of the anthron catheter
      connected to the Infuse A-Port in the common hepatic artery. The most frequent
      complications seen among Group I, II and III were caused by catheter thrombosis
      (11.3%) in Group I, spontaneous dislodgement of catheter (26.4%) in Group II and
      extravasation (20%) in Group III. By using 16 gauge Toray Anthron catheter with
      Heparin coating on its inner and outer surfaces, the number of complications in
      Group I and II was kept smaller. Extravasation, on the other hand, has been less
      frequently seen in Group III by establishing the tip of the catheter at the
      branching site of the gastroduodenal artery from the common hepatic artery.
      Complications in Group IV (19 patients) were noted only in 3 patients, i.e.,
      extravasation, subcutaneous necrosis and subcutaneous abscess, respectively.
      Therefore, we concluded that Group IV showed the most favorable intraarterial
      infusion chemotherapy with the most infrequent complications.

PMID- 1626937
TI  - [The study on intravesical instillation of THP in the treatment of in-situ and
      superficial bladder cancers].
AB  - The efficacy and safety of Pirarubicin (THP), administered by intravesical
      instillation, have been studied in recurrent multiple superficial bladder cancer
      patients and patients who tested positive by urine cytology but lacked
      protuberant legions (CIS). The average age and range of the 19 patients (M 15,
      F4) studied were 63.3 (37-84). Twelve patients had protuberant, multiple cancer
      and 7 patients had CIS. Sixteen of the cases were recurrent disease. Twenty mg
      THP, delufed in 40 ml of 5% glucose solution were instilled for 2 hours once or
      twice a week. Each patients received 8 treatments. One week after the last
      treatment, the therapeutic result was evaluated on the bases of cystoscopy and
      urine cytology. Before and after administration, CBC and biochemical blood tests
      were run. Nine of the 12 patients (75%) with multiple recurrent tumor and all the
      7 patients with CIS showed complete response. The total outcome for CR was 84.2%
      in this study. Intravesical instillation with THP did not cause any serious side
      effects.

PMID- 1626938
TI  - [A phase I study on a weekly schedule of DWA2114R].
AB  - A phase I study on a weekly schedule of DWA 2114R, a new platinum analogue, was
      conducted in 21 patients with various tumor types by clinical groups at 10
      institutions. Nineteen of the 21 patients entered in this study were evaluable.
      The starting dose was 200 mg/m2 (1 n) administered intravenously for 1 hr and
      gradually escalated stepwise to 700 mg/m2 (3.5 n). The dose limiting factor (DLF)
      was leukocytopenia, especially neutropenia and maximum tolerated dose (MTD) was
      700 mg/m2. The major clinical toxicity was gastrointestinal. Nephrotoxicity and
      hepatotoxicity were mild. Ototoxicity and cardiac failure did not emerge.
      Following administration of the drug, total platinum (Pt) showed a biphasic decay
      and AUC of total Pt was dependent on the dose. Excretion into urine 24 hr was
      between 42.6 and 100% of the administered platinum. The recommended dose of phase
      II study on a weekly schedule was 600 mg/m2, repeated every 2 or 3 weeks and
      administered via intravenous within drip infusion.

PMID- 1626939
TI  - [A phase II study of DWA2114R, a new platinum complex for breast cancer].
AB  - A multi-institutional phase II study of DWA2114R was conducted in breast cancer.
      DWA2114R at doses of 800-1,000 mg/m2 was administered by 1-hour intravenous
      infusion every 3-4 weeks on minimal two cycles. Fifty-two patients entered the
      study; 34 were eligible, 7 ineligible. Eleven patients were dropped from
      evaluation due to incomplete observations. There were 1CR, 6PR, 1MR, 12 NC, and
      14 PD with an overall response rate of 20.6%. A median duration of responses was
      11 weeks. Leukopenia and nausea/vomiting were frequently observed but well
      tolerated and recovery was quick. It is concluded that DWA2114R is a useful drug
      in the treatment of breast cancer.

PMID- 1626940
TI  - [A phase II clinical study of cis-diammine glycolato platinum, 254-S, for
      advanced breast cancer].
AB  - A phase II clinical study of 254-S, a new anticancer platinum complex for
      advanced breast cancer, was conducted by the 254-S Breast Cancer Study Group
      consisting of 6 institutions nation-wide. Considering the results of the phase I
      clinical study, 254-S was administered at 100 mg/m2 by intravenous drip infusion
      and this administration was repeated at least 2 times at 4-week intervals. Of 19
      patients registered, 16 were evaluable for tumor response (complete cases).
      Partial response (PR) was obtained in 2 patients, for a 12.5% response rate.
      Major toxic effects observed were hematotoxicity thrombocytopenia and leukopenia,
      and gastrointestinal toxicity (nausea and vomiting, and anorexia), though there
      was no case in which the treatment with 254-S had to be discontinued due to the
      toxic effect.

PMID- 1626941
TI  - [Chromosome and DNA analyses of peripheral blood lymphocyte from the quadruple
      cancer patient].
AB  - The patient with quadruple cancer was a 32 year-old female who had osteosarcoma,
      bilateral breast cancer and adenocarcinoma of the lung. When chromosomal analysis
      of peripheral blood lymphocyte was performed, two abnormal cells were detected
      among 42 cells examined. The first cell showed a translocation involving
      chromosome 1 and 20 and trisomic for chromosome 19. The second cell was trisomic
      for chromosome x. Southern blot analysis of DNA from peripheral blood lymphocyte
      revealed that there was no difference in the expression of Rb gene between the
      patient and healthy adult.

PMID- 1626942
TI  - [The clinical effect of cisplatin and 5-FU infusion in oral cancer].
AB  - The combination chemotherapy of cisplatin and 5-fluorouracil (5-FU) is more
      effective than monotherapy of either drug in the head and neck cancer. In 1982,
      Kish reported that CF-therapy, the combination of cisplatin and 5-FU, had a high
      curative rate (about 82%). CF-therapy was utilized in 9 patients with carcinoma
      of the oral region from March, 1987 to September, 1990 in our hospital. The
      patients' ages ranged from 23 to 74 years old with an average of 55. All tumor
      were squamous cell carcinoma. There were 2 cases in stage II, 4 cases in stage
      III and 3 cases in stage IV. Two patients treated with only CF-therapy and the
      other patients treated with radiotherapy and operation in addition to CF-therapy.
      Our regimen is cisplatin 80-100 mg i.v. or i.a. in day 1 and 5-FU 250 mg i.a. or
      5-FU 750 mg i.v. in day 2-6. The therapeutic results showed a 78% response rate
      to the therapy with 4 cases of CR (complete response), 3 cases of PR (partial
      response), 1 case of MR (minor response) and 1 case of PD (progressive disease).
      Side effects of cisplatin plus 5-FU (eg. nausea and vomiting) were so severe that
      the treatment had to the stopped in many patients. The method we have reported
      here was evaluated, and it is concluded that this CF-therapy is very effective as
      a first treatment of oral cancer.

PMID- 1626943
TI  - [A resected case of advanced gastric cancer with complete remission of liver
      metastasis by chronic daily administration of oral etoposide and UFT].
AB  - An advanced gastric cancer with liver metastasis was treated with the combination
      MMC, Etoposide and UFT. Etoposide was administered orally at 25-50 mg/day to the
      gastric cancer patient with liver metastasis. In operative findings, there was no
      liver and lymphoid node metastasis. The gastric tumor diminished in size and
      changed its characteristics due to the chemotherapy. In 19 months, no liver nor
      LN metastasis was observed by CT scan. Presently, the patient feels well and
      receives outpatient treatment.

PMID- 1626944
TI  - [Short-term intensive consolidation chemotherapy in the treatment of acute non
      lymphocytic leukemia].

PMID- 1626945
TI  - [Potentiation of thymidylate synthetase (TS) inhibition by combined
      administration of HCFU and dipyridamole: preliminary report. Kinki Cooperative
      Study Group of Chemotherapy for Colorectal Carcinoma].

PMID- 1626946
TI  - [Cell culture and its application proliferative life span and immortalization of
      cultured human cells].
AB  - It known that human diploid cells in culture have a limited proliferative life
      span (cellular senescence). Recently, evidence has accumulated that known and
      unknown anti-oncogenes participate in this phenomenon. Deletion or inactivation
      of these genes resulted in unlimited proliferation (immortalization).

PMID- 1626947
TI  - ["Workshop on Data Monitoring Committee in NIH"--data monitoring in cancer
      clinical trial].

PMID- 1626948
TI  - [Trends of cancer occurrence and survival in Japan, and in Osaka].
AB  - Recent improvements in cancer medical care in Osaka have resulted in the
      elevation of survival rates of cancer patients, except for the so-called
      "refractory" cancers. Five-year relative survival rates for reported patients
      diagnosed in 1981-1983 were higher than 60% for cancers of the breast, uterus and
      bladder, and around 40% for rectum, colon and stomach cancers. However, cancers
      of the liver, gallbladder, pancreas, and lung continued to show very low survival
      rates of less than 10%. In higher age-groups, advanced cases occupied a larger
      proportion while cases which received curative resection occupied a smaller
      proportion. Reflecting this, survival rates were lower in age-groups higher than
      75, and the reduction of age-differences between younger and older groups was not
      observed during the decade. Cancer incidence for all sites in Japan was estimated
      by the Research Group for Population-based Cancer Registries to be 320,000 in
      1985. The stomach, colorectal, lung, liver, and breast were the five leading
      cancer sites. According to the authors' studies, cancer incidence is projected to
      be 740,000 in Japan in 2015, of which 40% would be patients of "refractory"
      cancers and 62% would be aged patients in their upper than 70, though these were
      19% and 32% in 1985. In order to combat this difficult situation in the near
      future, the following activities are urgently required: (1) Promotion of primary
      preventive measures for incurable cancers. (2) Development of specific therapy
      programs taking into account of QOL for aged patients as well as advanced
      patients. (3) Promotion of secondary preventive measures for aged people as well
      as younger people.

PMID- 1626949
TI  - [Biochemical modulation--the historical background].
AB  - Biochemical modulation is a word to mean biochemical or pharmacological
      modulation of the efficacy or side effects of a anticancer drug. Historically,
      combination therapy of methotrexate (MTX) and 5-fluorouracil (5-FU) developed by
      Bertino et al. in 1970s has been proved to be effective to advanced gastric
      cancer. Many combination therapies from 1960s seem to be based on this concept of
      biochemical modulation. Beside MTX and 5-FU combination, currently combined use
      of 5-FU or other fluoropyrimidines with cisplatin (CDDP) has been studied for the
      treatment of cancer of the digestive organs. The therapeutic efficacies in these
      combination of drugs were also found to be based on biochemical or
      pharmacological modulation of anticancer drugs.

PMID- 1626950
TI  - [Mechanism of synergism and clinical results of sequential methotrexate and 5
      fluorouracil in the treatment of gastric cancer].
AB  - Mechanism of synergism and clinical results of methotrexate and 5-fluorouracil
      (MTX/5-FU) combination therapy for gastric cancer were studied. The response rate
      against poorly differentiated gastric cancers was 35% in this treatment. This
      treatment also showed a remarkable effect against cases with pleural and
      abdominal effusion caused by cancerous disseminations. A promising result was
      obtained by this treatment as neoadjuvant and postoperative chemotherapy against
      Borrmann type 4 gastric cancer. A greater dependence on the de novo pathway of
      pyrimidine synthesis against poorly differentiated gastric carcinoma, which was
      estimated by the fact that the thymidylate synthetase/thymidine kinase ratio was
      significantly higher in poorly differentiated gastric cancer than in well
      differentiated cancer, may potentiate therapeutic results of this treatment.

PMID- 1626951
TI  - [High-dose leucovorin and 5-FU].
AB  - Leucovorin (LV), given intravenously the orally becomes 5, 10-methylene
      tetrahydrofolate in both cancer and normal cells. FdUMP which is an active
      metabolite of 5-FU binds tightly to thymidylate synthase in the presence of the
      cofactor 5, 10-methylene tetrahydrofolate. This interaction leads to potentiate
      the cytotoxic effect of 5-FU by prolonged inhibition of thymidylate synthase.
      Clinically, the combination of LV and 5-FU is given parenterally by two
      schedules; 5 consecutive days schedule and weekly schedule. Five 5 consecutive
      days-schedule is divided into 2 methods. One is a 200 mg/m2/day of LV by
      Machover, and the other is 20 mg/m2/day of LV by O'Connell. The weekly schedule
      is a 2-hour infusion of dl-LV (500 mg/m2) and iv bolus of 5-FU (600 mg/m2), given
      1 hour after the beginning of LV infusion by Petrelli. A multicenter cooperative
      study in Japan was conducted to evaluate the clinical efficacy of LV and 5-FU
      using the weekly schedule by Petrelli. Response rates were 31.5% and 41.2%
      against advanced gastric and colorectal cancer respectively. Then, we carried out
      a randomized early phase II study using 250 mg/m2 of l-LV weekly (similar to the
      schedule of Petrelli's, armA) and 100 mg/m2 (similar to the schedule of
      Machover's, arm B) or 10 mg/m2 (similar to the schedule of O'Connell's, arm C) of
      l-LV for 5 consecutive days against gastric cancer. The response rate was 33.3%
      in arm A, 24.1% in arm B and no response in arm C. Toxicity was within acceptable
      limits, Toxic effects included diarrhea, stomatitis, anorexia and
      myelohypoplasia. Our data suggests that high-dose LV and 5-FU seems to be a very
      promising combination but, there was no responder using low dose (10 mg/m2) of l
      LV schedule against gastric cancer patients.

PMID- 1626952
TI  - [Biochemical modulation of 5-FU with interferon].
AB  - A phase II clinical trials of the combination of 5-FU and interferon (IFN) were
      reviewed. The treatment regimen was based on the method reported by Scott Wadler,
      et al: 5-FU was administrated as continuous infusion at 750 mg/m2/day for 5
      consecutive days and as intravenous bolus at 750 mg/m2 weekly for 7 weeks
      beginning on day 12. IFN was administrated subcutaneously at 9 x 10(6) I.U three
      times a week during weeks 1 to 8. Although the mechanism of action remains to be
      elucidated, some studies in immunological, pharmacokinetics, or biochemical
      viewpoint were reported. In this paper, the mechanisms of action related to TS
      and TK were introduced in biochemical viewpoint. Furthermore, side effects of
      IFN/5-FU combination and dual modulation of 5-FU with IFN and LV were referred.

PMID- 1626953
TI  - [Combined therapy with 5-FU and levamisole].
AB  - Levamisole, which had been used as an insecticide for more than 20 years, was
      reported to have anticancer effects as an immunopotentiator. Among many clinical
      trials with this agent, Moertel and his colleagues reported excellent results in
      Dukes-C colon cancer patients treated with 5-FU and levamisole in 1990. In this
      paper, results of our animal experiments would be reported in conjunction with
      the review of the recent clinical trials.

PMID- 1626954
TI  - [Clinical significance of serum CA 125 values in patients with gastric cancers-
      especially correlation with peritonitis carcinomatosa].
AB  - A study of 387 patients with gastric cancers revealed elevation of CA 125 in sera
      of 7.2% of the patients. Patients with Borrmann 1 and 2 in gross type, poorly
      differentiated adenocarcinoma in histological type and stage 4 in stage grouping
      of gastric cancer, showed a higher positive rate than patients with the others.
      In patients with peritonitis carcinomatosa, positive rate of serum CA 125 was
      42.9% of patients with synclonus metastasis, 72.2% with metaclonus metastasis.
      Elevation of serum CA 125 was observed earlier than detection by image diagnosis
      in almost all cases. These results indicate that CA 125 is an useful tumor marker
      for detection and follow up of patients with peritonitis carcinomatosa from
      gastric cancers.

PMID- 1626955
TI  - [Combination chemotherapy of solid tumor--effects of hyaluronidase on doxorubicin
      (DXR) penetration into multicellular tumor spheroids (MTS)].
AB  - We have studied the effects of hyaluronidase (HYD) on the penetration and cell
      kill effect of doxorubicin (DXR) using multicellular tumor spheroids (MTS). MTS
      of approximately 500 microns in diameter were prepared by liquid over lay culture
      technique from PC-10 lung and HEp-2 laryngeal squamous carcinoma cell lines.
      Cells in MTS and monolayer were exposed for various durations to HYD, followed by
      1 hr, rest interval, and by 1 hr. exposure to DXR. MTS and monolayer cells were
      then trypsinized to a single cell suspension and subjected to clonogenic assay.
      For PC-10 MTS, pretreatment with HYD for 24 hr. resulted in approximately 10-fold
      increases in DXR cell kill effects as compared to DXR alone. HEp-2 MTS were more
      sensitive to HYD pretreatment. Thus, 1 hr. exposure to HYD produced approximately
      4-fold increases in DXR-induced cell lethality. Fluorescent microscopic study
      revealed that 1hr. exposure of MTS to DXR produced DXR fluorescence only 1-2
      outer layer of MTS. When MTS were pretreated with HYD, there was an enhanced
      penetration of DXR fluorescence into the MTS core. HYD-induced enhancement of DXR
      penetration and its cell kill effect was dependent on the exposure time and tumor
      cell origin.

PMID- 1626956
TI  - [Analysis of cell proliferation kinetics and the effects of cisplatin on the cell
      cycle of human gastric cancer cells by autostage cytofluorometry].
AB  - Analysis of both cell proliferation kinetics and effects of cis
      diamminedichloroplatinum (CDDP) on cell cycle in human gastric cancer cell line
      (HGC-Y2) by measuring the contents of nuclear DNA, RNA and the Ki-67 antigen
      using autostage cytofluorometry system was described. In HGC-Y2 cells, RNA
      content increased during the cell cycle and reached to the maximum at G2/M phase.
      The results of pulse treatment with CDDP on these cells demonstrated a
      prolongation of S phase and G2 arrest with increasing of RNA content of these
      cells. We classified the cells by intranuclear distribution pattern of Ki-67
      antigen and thus could identified the cells at G0 and M phases from these
      classification. The content of Ki-67 antigen was moderate grade at G1 phase and
      it decreased in the early S phase, then increased gradually during S phase and at
      the late S phase. It increased rapidly, reaching to the maximum at G2/M phase.
      After CDDP treatment, the content of Ki-67 antigen increased in the cells in
      prolonged S phase and in the cells arrested at G2 phase. It was also found that
      the syntheses of both Ki-67 antigen and RNA were not inhibited by CDDP. These
      results suggest that the method using autostage cytofluorometry system was useful
      for the research, on the mechanism of cancer therapy because of making possible
      to analyze precisely the cell cycle and the influence of anticancer drugs.

PMID- 1626957
TI  - [Comparison of surgical therapy and combined irradiation in rectal cancer--second
      report. Effect of irradiation and ACNU on the tumor].
AB  - As part of a joint study on preoperative radiotherapy for developing an optimal
      mode of rectal cancer therapy, ACNU sensitization was studied in a total of 120
      cases, with the cooperation of 48 facilities participating nationwide. The
      following results were obtained. Improvement in depth of invasion was more
      distinct in the combination preoperative therapy-ACNU group than in the
      preoperative radiotherapy group, with no other significant differences between
      the two. This finding suggests that dose and administration method could be
      improved. White blood cells and platelets were reduced in some cases of the ACNU
      combination group, but these reductions were not serious enough to impede
      surgical procedures. In addition, no significant difference in complications was
      noted between the two.

PMID- 1626958
TI  - Skeletal hyperostosis in patients receiving chronic, very-low-dose isotretinoin.
AB  - BACKGROUND AND DESIGN: We conducted a prospective roentgenographic survey of
      patients participating in a randomized, placebo-controlled, multicenter clinical
      trial that evaluated the effectiveness of chronic, very-low-dose (approximately
      0.14 mg/kg per day for 3 years) isotretinoin in preventing the subsequent
      occurrences of new basal cell carcinoma in patients with previous basal cell
      carcinoma. To assess potential skeletal changes, a sample of 269 patients from
      among a total of 981 enrollees were randomly selected for comparative
      roentgenographic review. Baseline and 36-month roentgenograms of the cervical and
      thoracic spine of each patient were read side by side by a radiologist, masked to
      treatment group, who noted both the presence and extent of abnormalities at each
      vertebral level at baseline and the progression of existing or occurrence of new
      abnormalities at previously unaffected levels at 36 months. RESULTS: In
      comparison with the placebo group, significantly more patients in the
      isotretinoin group exhibited progression of existing hyperostotic abnormalities
      (40% vs 18%; P less than .001) and new hyperostotic involvement at previously
      unaffected vertebral levels (8% vs 1%; P = .015). CONCLUSION: Our findings
      indicate that chronic, very-low-dose isotretinoin can induce hyperostotic axial
      skeletal changes similar to those reported in patients taking higher doses.

PMID- 1626959
TI  - Ultraviolet-B phototherapy for early-stage cutaneous T-cell lymphoma.
AB  - BACKGROUND AND DESIGN--Cutaneous T-cell lymphoma (CTCL) is a slowly advancing
      disease that initially presents in the skin and may later progress to involve the
      lymph nodes and viscera. Since CTCL most often presents on non-sunlight-exposed
      regions of the body, a possible protective role for UVB irradiation has been
      suggested. Recent observations have also found that UVB irradiation serves an
      immunoregulatory role. Given that limited data are available regarding the use of
      UVB phototherapy in treating CTCL, a retrospective nonrandomized study of 37
      nonconsecutive patients with early CTCL was performed to assess the efficacy of
      UVB phototherapy in the treatment of CTCL. RESULTS--Twenty-five (71%) of the 35
      patients treated with UVB phototherapy (two were unavailable for follow-up)
      achieved a total clinical remission. Median time to remission was 5 months, and
      median duration of the remission was 22 months. Twenty-five (83%) of 30 patients
      with disease limited to patches achieved remission, whereas none of the patients
      with plaque-level disease achieved a remission. Of the 25 patients who achieved
      complete remission, five (20%) had a recurrence of CTCL. CONCLUSIONS-
      Phototherapy with UVB appears to be effective in patients with early patch-stage
      CTCL.

PMID- 1626960
TI  - Reticulated black solar lentigo ('ink spot' lentigo).
AB  - BACKGROUND AND DESIGN: Pigmented lesions that are black and have an irregular
      outline are often considered suspicious for melanoma; however, these features may
      be seen in benign lesions. The reticulated black solar lentigo is such a lesion
      and is described in a clinicopathologic study of nine lesions in eight patients.
      RESULTS: The "ink spot" lentigo is distinguished clinically by its color and wiry
      or beaded, markedly irregular outline. It has a reticulated pattern and most
      resembles a spot of ink on the skin. In this series of patients, the lesions were
      limited to sun-exposed areas of the body and had a distribution pattern similar
      to that of solar lentigines. Although all the patients were of Celtic ancestry
      and had numerous solar lentigines, they usually had only one black lentigo
      (range, one to four; mean, 1.6; median, one). Histologic evaluation, including
      electron microscopy and dopa-incubated vertical sections, demonstrated
      lentiginous hyperplasia of the epidermis, marked hyperpigmentation of the basal
      layer with "skip" areas that involved the rete ridges, and a minimal increase in
      the number of melanocytes. CONCLUSIONS: Because of their dark color, irregular
      border, and limited number, reticulated black solar lentigines were of concern to
      patients and primary care physicians. However, the characteristic features of
      these lesions allow one to make the clinical diagnosis of a benign lentigo.

PMID- 1626961
TI  - Prevalence and significance of acanthosis nigricans in an adult obese population.
AB  - BACKGROUND AND DESIGN: Acanthosis nigricans develops commonly in obese
      individuals, yet its prevalence and significance in an unselected adult obese
      population has not been determined. To address these issues, 34 patients enrolled
      in the Adult Obesity Clinic at Parkland Memorial Hospital (Dallas, Tex) were
      chosen at random and examined. RESULTS: Acanthosis nigricans was observed in
      fully 74% of patients; its prevalence correlated positively with severity of
      obesity. Black obese patients demonstrated a greater propensity for manifesting
      the cutaneous disorder than did white obese individuals. Patients with acanthosis
      nigricans exhibited fasting plasma insulin levels that were markedly higher than
      those of nonacanthotic cohorts. CONCLUSIONS: Obesity is a significant risk factor
      for the development of acanthosis nigricans. Conversely, acanthosis nigricans is
      a reliable cutaneous marker of hyperinsulinemia in obese individuals.

PMID- 1626962
TI  - Controlled localized heat therapy in cutaneous warts.
AB  - BACKGROUND: Controlled localized heating as a method of superficial tissue
      destruction has been used in veterinary medicine for the treatment of benign and
      malignant tumors. The rationale for its use is that the diseased tissue being
      treated is more sensitive to the effects of heating than is normal tissue. This
      technology was applied to the treatment of common hand warts in a placebo
      controlled study. OBSERVATIONS: Twenty-nine warts were treated one to four times
      (median, two times) at 50 degrees C for 30 to 60 seconds. Twenty-five (86%) of 29
      treated verrucae regressed completely while seven (41%) of 17 control warts
      resolved during the course of the study. No wart that regressed regrew during the
      follow-up period (mean, 15.6 weeks). CONCLUSIONS: Controlled localized heating
      can cause the regression of hand warts. The 86% regression rate compares
      favorably with other wart treatment modalities. The mechanism of action and the
      effect of heat on these virally induced tumors is not known but may involve
      direct antiviral effects, physical destruction of the tumor, or the promotion of
      an inflammatory response that ultimately eradicates the lesion.

PMID- 1626963
TI  - Dermatologic features of the superior vena cava syndrome.
AB  - BACKGROUND: The superior vena cava syndrome occurs when extrinsic compression or
      intraluminal occlusion impedes blood flow through this vessel. The most common
      underlying cause is a malignant neoplasm, especially a bronchogenic carcinoma.
      This article describes the cutaneous findings of this disorder. OBSERVATIONS:
      Among the earliest and most prominent features are numerous, dilated, vertically
      oriented, and tortuous cutaneous venules or veins above the rib cage margin.
      Recognition of this cutaneous sign allowed us to make a diagnosis of lung cancer
      in several patients. Other features include upper body edema and ruddiness or
      cyanosis, distended neck veins, proptosis, and conjunctival suffusion.
      CONCLUSIONS: Detecting the characteristic cutaneous features can lead to an early
      diagnosis of the superior vena cava syndrome. These skin changes usually
      represent indirect dermatologic signs of an underlying malignant neoplasm; for
      most patients, this syndrome is the initial manifestation of their cancer. The
      most common cause is a bronchogenic carcinoma, especially the small-cell variety,
      but others include lymphomas, primary mediastinal tumors, and metastases to the
      mediastinal lymph nodes from extrathoracic primary tumors, especially breast
      cancer. Treatment of the underlying malignant neoplasm and relief of the
      obstruction produce prompt improvement in the dermatologic findings.

PMID- 1626964
TI  - Cutaneous nerves in cafe au lait spots with white halos in infants with
      neurofibromatosis. An electron microscopic study.
AB  - BACKGROUND AND DESIGN: Although two cardinal skin manifestations of
      neurofibromatosis are cutaneous neurofibromas and cafe au lait spots, the
      pathogenesis of cafe au lait spots are very poorly known compared with that of
      cutaneous neurofibromas. Thus, the cafe au lait spots in two Japanese infants
      were clinically, histologically, and electron-microscopically investigated.
      OBSERVATIONS: Some of the cafe au lait spots in the mongolian spots were
      surrounded by white halos. Histologically, in the cafe au lait spots, the
      epidermal basal cells had abundant melanin pigment, but macromelanosomes were not
      seen throughout the epidermis. In the white halo, the epidermal basal cells had a
      small amount of melanin pigment. Electron microscopically, the cafe au lait spots
      and their white halos had many subepidermal and intraepidermal nerves that
      belonged to free nerve endings. All the cutaneous nerves were mature. Some of the
      intraepidermal nerves had partially or completely naked axons that contacted
      tightly with the cytomembranes of the basal keratinocytes. Some of the axons in
      the subepidermal nerves showed degenerative changes only in the white halos. No
      ultrastructural pathologic changes were observed in the melanocytes, the
      epidermal keratinocytes, or melanosomes in those cells in the cafe au lait spots
      and their white halos; also, dermal melanocytes were absent in the both areas.
      CONCLUSIONS: The increase of the cutaneous nerves and the absence of dermal
      melanocytes in the cafe au lait spots and their white halos may be considered as
      characteristic histologic cutaneous findings in infants with neurofibromatosis.
      However, no evidence indicates that the cutaneous nerves may participate closely
      in the pathogenesis of the white halos.

PMID- 1626965
TI  - Multiple primary cutaneous plasmacytomas.
AB  - BACKGROUND: Cutaneous plasmacytoma is an uncommon tumor and is mostly seen in the
      context of end-stage multiple myeloma. Only 20 cases of primary cutaneous
      plasmacytoma have been documented. A significant proportion of these patients
      went on to develop systemic disease with a poor prognosis. In a number of
      patients, however, the abnormal clone of plasma cells may arise in the skin and
      never progress to multiple myeloma involving the bone marrow. OBSERVATIONS: We
      describe a patient who developed multiple primary cutaneous plasmacytomas after a
      possible insect bite reaction. The monoclonality of the tumor cells is
      demonstrated using immunohistochemical techniques. He has been treated vigorously
      with chemotherapy and local radiotherapy and remains well 3 years after
      diagnosis. Bone marrow has been harvested for use as an autologous bone marrow
      transplant in the event of systemic relapse. CONCLUSIONS: Unlike previous reports
      of this rare entity, this case documents the monoclonality of tissue plasma cells
      with immunohistochemical techniques. As cutaneous plasmacytomas have been
      reported with an early significant mortality, unlike extramedullary plasmacytomas
      elsewhere, we have advocated combination chemotherapy and cryopreservation of
      uninvolved bone marrow for future autologous bone marrow transplantation should
      systemic myelomatosis develop in the patient.

PMID- 1626966
TI  - Amyloidosis cutis dyschromica. DNA repair reduction in the cellular response to
      UV light.
AB  - BACKGROUND: Amyloidosis cutis dyschromica, a special type of primary cutaneous
      amyloidosis, is assumed to be a congenital disorder and sun exposure is thought
      to be the major causal factor. Herein we report a case of this rare disease and
      DNA repair characteristics of UV damages in the fibroblasts derived from the
      patient. OBSERVATIONS: A 24-year-old Japanese woman showed hyperpigmented and
      hypopigmented xerotic lesions in sun-exposed skin since she was 10 years old;
      deposits of amyloid material were detected in the papillary dermis. The
      fibroblasts were hypersensitive to UV-B, but not so sensitive to UV-C.
      Unscheduled DNA synthesis of the patient's cells after UV-C exposure was lower
      than that of normal cells at 3 hours and both reached the same level at 6 hours.
      After UV-B exposure, unscheduled DNA synthesis of the patient's cells was lower
      than that of normal cells at least until 6 hours after UV exposure. CONCLUSION:
      Although the origin of amyloidosis cutis dyschromica is unknown, hypersensitivity
      to UV-B with possible DNA repair defects is suggested to be the cause of this
      disease.

PMID- 1626967
TI  - Isotretinoin does not prevent basal cell carcinoma.

PMID- 1626968
TI  - Vesicular lesions in a woman with progressive systemic sclerosis. Penicillamine
      induced intradermal vesicles: an example of human lathyrism.

PMID- 1626969
TI  - An intensive care unit nurse with a recurring annular lesion. Erythema annulare
      centrifugum (EAC).

PMID- 1626970
TI  - An erythematous nodular eruption. Secondary syphilis.

PMID- 1626971
TI  - Giant inflammatory targetoid plaques. Granuloma annulare (GA).

PMID- 1626972
TI  - Anti-liver-kidney microsome type 1 antibodies in lichen planus.

PMID- 1626973
TI  - Becker's nevus and ipsilateral breast hypoplasia--androgen-receptor study in two
      patients.

PMID- 1626974
TI  - Treatment of hyperkeratotic skin diseases with R 68151, a topical 5-lipoxygenase
      inhibitor: four case reports.

PMID- 1626975
TI  - Efficacy of ivermectin in the therapy of cutaneous larva migrans.

PMID- 1626976
TI  - Papular mucinosis and human immunodeficiency virus infection.

PMID- 1626977
TI  - Successful treatment of an antimony-resistant American mucocutaneous
      leishmaniasis: a case report.

PMID- 1626978
TI  - Cutaneous necrosis induced by injection of hydrocarbons.

PMID- 1626980
TI  - Metaphysical urticaria.

PMID- 1626979
TI  - Repigmentation of leukotrichia by epidermal grafting and systemic psoralen plus
      UV-A.

PMID- 1626981
TI  - Paediatric cochlear implantation.
AB  - Cochlear implantation may now be considered as a method of managing children with
      profound sensory hearing loss who do not benefit from conventional amplification.
      It involves a team approach with integration of many skilled individuals, as well
      as the child and his or her parents and family. As William House has said, in
      1991, 'The future is not in the adult programme, but in the continued expansion
      of the children's programme'.

PMID- 1626983
TI  - Stressful life events and childhood illness.

PMID- 1626982
TI  - Detection of minimal residual disease in leukaemia.

PMID- 1626984
TI  - The Scottish low birthweight study: II. Language attainment, cognitive status,
      and behavioural problems.
AB  - Of the 636 survivors of a total geographically based population born in Scotland
      in 1984, who weighed less than 1750 g at birth, 611 (96%) were assessed at 4.5
      years to determine the prevalence of language, cognitive, and behavioural
      problems. Language development was significantly related to birth weight,
      gestational age, and social class for comprehension, less so for expressive
      language. Mean (SD) intelligence quotient (IQ) on the British ability scales was
      92.9 (14.7). Within this population there were no significant differences between
      birthweight groups. Overall they performed poorly on visual recognition, verbal
      comprehension and number skills subscales--in the latter those with birth weights
      less than 1000 g were significantly worse than the heavier children. Only 5% had
      IQs less than 70, but a further 3% could not be tested because of other physical
      disability. Among those with normal IQs were groups of children who exhibited
      patterns of skill deficits in different subscales raising the possibility of
      specific learning difficulties. Poor attention span was reported in 47%, and
      parents said the study children had more behavioural problems than their
      siblings.

PMID- 1626985
TI  - Impaired motor function (clumsiness) in 5 year old children: correlation with
      neonatal ultrasound scans.
AB  - All 155 surviving children from a cohort of 200 very low birthweight infants
      originally studied in 1984-5 were traced. These infants had careful sequential
      ultrasound examinations in the neonatal period. The children were examined again
      at entry into school at 5 years of age. The test of motor impairment (TOMI) and
      the vocabulary subscale of the Wechsler preschool and primary scale of
      intelligence (WPPSI) were administered to 152 of the index cohort and 144 control
      children of the same age in the same class at school. Twelve of the cohort had
      cerebral palsy, but eight of these were in mainstream schools. The index group
      scored significantly higher on both the TOMI and the WPPSI subscale compared with
      the controls. The index cases were subdivided on the basis of their neonatal
      ultrasound scans into four groups: group 1, consistently normal; group 2,
      'prolonged flare'; group 3, germinal matrix haemorrhage-intraventricular
      haemorrhage (GMH-IVH), without parenchymal haemorrhage, but no evidence of
      prolonged flare; and group 4, both GMH-IVH and prolonged flare. The group of
      index children with consistently normal ultrasound scans had a higher TOMI and
      lower WPPSI compared with their controls. There was a statistically significant
      increase in the TOMI subscore 1 (manual dexterity) in group 4 infants compared
      with group 1, but not differences between the other groups. Regression analysis
      suggests that neither prolonged flare nor GMH-IVH has an important individual
      contribution to the variation, but the low birth weight does have a significant
      relationship with motor impairment. It appears that relatively minor ultrasound
      appearances such as prolonged flare and GMH-IVH are associated with motor
      impairment (clumsiness) at 5 years, but this has a small effect compared with low
      birth weight.

PMID- 1626986
TI  - Postdischarge formula consumption in infants born preterm.
AB  - In 31 infants born preterm and formula fed ad libitum, all milk intake was
      weighed from hospital discharge to nine months post-term. Mean daily milk intake
      was high, reaching 230 g/kg before four weeks post-term and was still over 150
      g/kg beyond six months. Five of the 31 infants (16%) consumed 300-350 g/kg; 50%
      'voluntarily' consumed more than upper recommended limits for energy intake and
      35% did so for protein intake.

PMID- 1626987
TI  - Computed tomography findings in partial seizures.
AB  - The computed tomography findings in 82 children with partial seizures of unknown
      aetiology were reviewed. All had seizures with predominantly focal motor
      phenomena and none had abnormality on neurological examination. Findings on
      computed tomography were normal in 64 children (78%) and abnormal in 18 children
      (22%). Fourteen children had changes representing static pathology (mainly
      cerebral atrophy) which did not influence patient management but four had
      potentially correctable lesions (two tumours and two arteriovenous
      malformations). There were no correlations between seizure control, seizure
      duration, intellectual handicap, postictal weakness, electroencephalographic
      findings, and abnormality on the computed tomogram. In particular, none of these
      features were useful in predicting the presence of a tumour or arteriovenous
      malformation. It is concluded that a computed tomogram is indicated in every
      child with partial seizures.

PMID- 1626988
TI  - Difficult and unlikeable parents.
AB  - Children of parents who are perceived as difficult or unlikeable are at risk of
      receiving less good medical care. Therefore a postal questionnaire was sent to
      100 hospital doctors dealing with children asking which features made them
      consider a parent to be difficult or unlikeable. Seventy eight responded. Most
      problems arose from parents who displayed aggression, disparagement of their
      child, unacknowledged anxiety, or fixed ideas about the medical condition and its
      management. Other unpopular parental features were poor compliance, failure to
      listen, and the attendance of more than one accompanying adult. Respondents
      graded 16 features in order of their detrimental effect on the child's care. A
      major factor was if the child had a condition for which the doctor could offer no
      treatment; less important was the fact that the child might have a condition not
      understood by the doctor. Parents originating from the Indian subcontinent posed
      additional problems, in particular the common unavailability of interpreters.
      Doctors of all grades understood why parents behaved in awkward ways, but lacked
      strategies for dealing with them. A similar survey of nurses and therapists
      produced a poor response (51% returns). Only the most senior acknowledged that
      some parents were difficult or unlikeable and that, as a consequence, the child's
      care might be affected. Nurses acknowledged difficulty with parents who were
      violent or who abused their children physically.

PMID- 1626989
TI  - Asthma, inhaled corticosteroid treatment, and growth.
AB  - To evaluate the effects on growth of inhaled corticosteroid treatment (ICT) and
      of the quality of control of asthma, height velocity was studied in 58
      prepubertal children attending a specialist asthma clinic because of chronic
      asthma that was difficult to control. The height velocity standard deviation (SD)
      score was maximal when the asthma was well controlled both before (0.01) and
      after (-0.07) starting ICT. It was least when the asthma was poorly controlled
      both before (-1.50) and after (-1.55) starting ICT. The effectiveness of control
      correlated significantly with the height velocity SD score, both before and after
      ICT was started. No evidence was found that the administration of ICT has an
      adverse effect on growth.

PMID- 1626990
TI  - Tartrazine in atopic eczema.
AB  - Multiple double blind placebo controlled challenges with tartrazine 50 mg (three
      challenges) and glucose placebo (three challenges) were performed in 12 children
      with atopic eczema aged 1 to 6 years. The children were selected on the basis of
      severity (regular clinic attenders) and a parental history that tartrazine
      provoked worsening of the eczema. In only one patient did the three tartrazine
      challenge periods correspond with the highest symptom scores or the highest
      physician observer scores, and the probability of this occurring by chance in one
      or more patients out of 12 was 0.46. In this sample we were unable to confirm
      intolerance to tartrazine in 11 out of 12 patients.

PMID- 1626991
TI  - Frontoethmoidal meningoencephalocele: a common and severe congenital abnormality
      in South East Asia.
AB  - The clinical features of 23 cases of fronto-ethmoidal meningoencephalocele are
      described in two South East Asian populations. The clinical, embryological, and
      epidemiological evidence may support an early teratogenic insult in the aetiology
      of this congenital defect.

PMID- 1626992
TI  - Early diagnosis and management of 5 alpha-reductase deficiency.
AB  - Two siblings of Pakistani origin, karyotype 46 XY, were born with predominantly
      female external genitalia with minute phallus, bifid scrotum, urogenital sinus,
      and palpable gonads. The older sibling at the age of 8 days showed an adequate
      testosterone response to human chorionic gonadotrophin (hCG) stimulation. The
      diagnosis of 5 alpha-reductase deficiency was made at age 6 years when no 5 alpha
      reduced glucocorticoid metabolites were detectable in urine even after
      tetracosactrin (Synacthen) stimulation. In the younger sibling the diagnosis of 5
      alpha-reductase deficiency was provisionally made at the early age of 3 days on
      the basis of high urinary tetrahydrocortisol (THF)/allotetrahydrocortisol (5
      alpha-THF) ratio and this ratio increased with age confirming the diagnosis.
      Plasma testosterone: dihydrotestosterone (DHT) ratio before and after hCG
      stimulation was within normal limits at age 3 days but was raised at age 9
      months. Topical DHT cream application to the external genitalia promoted
      significant phallic growth in both siblings and in the older sibling corrective
      surgery was facilitated. In prepubertal male pseudohermaphrodites with normal or
      raised testosterone concentrations, phallic growth in response to DHT cream
      treatment could be an indirect confirmation of 5 alpha-reductase deficiency.

PMID- 1626993
TI  - Salivary IgA antigliadin antibody as a marker for coeliac disease.
AB  - In recent years, serum antibodies to gliadin (AGA) have been reported to be
      useful markers of coeliac disease. IgA AGA have also been found in intestinal
      secretions and saliva in coeliac disease and may offer a convenient, non-invasive
      screening test. In order to test this hypothesis, salivary and serum AGA were
      measured in children with coeliac disease proved by biopsy and compared with
      several control groups. Measurement of salivary IgA AGA provided excellent
      discrimination between those children with coeliac disease and the control
      groups, and our study suggests that it may provide a rapid, non-invasive method
      of screening for this disease before intestinal biopsy.

PMID- 1626994
TI  - Family characteristics and insulin dependent diabetes.
AB  - During the calendar year of 1988 a survey of new cases of insulin dependent
      diabetes mellitus (IDDM) in children under the age of 15 years in the British
      Isles was conducted. After cases had been confirmed and permission obtained to
      contact the families, postal questionnaires were sent to the parents of children
      diagnosed in England, Wales, Northern Ireland, and the Republic of Ireland.
      Children who developed diabetes were significantly more likely to be heavier at
      birth in comparison with national reference data. The diabetic children were less
      likely to have been breast fed, and there were more children than expected whose
      fathers were in nonmanual occupations. Where there was a first degree relative
      with IDDM there were positive correlations between the age at diagnosis of the
      index cases and that of their diabetic fathers and their diabetic siblings, but
      not their diabetic mothers. A higher proportion of children than expected who
      were diagnosed under the age of 5 years had fathers with IDDM. Characteristics of
      family members associated with IDDM in children that might provide pointers to
      the aetiology of the disease include heavier birth weight, method of infant
      feeding, the age at onset of IDDM in affected fathers and affected siblings, and
      the family lifestyle as defined by social class of the father.

PMID- 1626995
TI  - IgG antibodies in early Pseudomonas aeruginosa infection in cystic fibrosis.
AB  - The relationship between IgG antibodies to Pseudomonas aeruginosa and its
      isolation from sputum was determined in 100 patients with cystic fibrosis
      observed at intervals of two months for a median period of one year. Only one
      patient had a raised antibody titre (greater than 22.9 ELISA units) before
      isolation of P aeruginosa. Initially 65 patients were antibody negative, of whom
      48 were also culture negative. Of 24 patients with positive sputum culture and
      negative antibodies, seven became antibody positive at a median (range) 15 (6-25)
      months later. The remaining 17 patients continued antibody negative until the end
      of the study at a median range 15 (1-123) months after becoming culture positive.
      This latter group were younger and had more intermittently positive sputum
      cultures. In general positive IgG antibody titres do not predate isolation of P
      aeruginosa, but in some patients are present soon after acquisition of infection.
      A positive titre indicates significant exposure to P aeruginosa and could be used
      to detect infection in patients unable to produce sputum and possibly indicate
      the effect of early antipseudomonal treatment.

PMID- 1626996
TI  - The value of proximal small intestinal biopsy in the differential diagnosis of
      chronic diarrhoea.
AB  - The value of proximal intestinal mucosal biopsy was reviewed in 381 children
      presenting with chronic diarrhoea over an eight year period. An enteropathy was
      detected in 44% of cases and was more frequently seen in those aged less than 6
      months. A diagnosis was established in 91% of cases. The most common diagnosis
      was the postenteritis syndrome where the presence of an enteropathy indicated
      those requiring treatment with a cows' milk free diet. Other conditions where a
      biopsy facilitated diagnosis or treatment included giardiasis, enteropathogenic
      Escheriichia coli, crytosporidiosis, autoimmune enteropathy, and microvillous
      atrophy. Coeliac disease was considered in 55% of children and established in 8%,
      clearly identifying those requiring a gluten free diet. This also emphasises the
      important role of the biopsy procedure in the exclusion of specific diseases.
      Proximal small intestinal mucosal biopsy is an essential investigation in
      children with chronic diarrhoea in whom an enteropathy is suspected.

PMID- 1626997
TI  - Dealing with the courts and parenting breakdown.

PMID- 1626998
TI  - Child health and paediatric care in Spain: where are we going?

PMID- 1626999
TI  - Statistics from the inside. 6. Data structures (continued).

PMID- 1627000
TI  - Asthma: a follow up statement from an international paediatric asthma consensus
      group.

PMID- 1627001
TI  - Beta glucuronidase and hyperbilirubinaemia in breast fed infants of diabetic
      mothers.

PMID- 1627002
TI  - The value of the Medicare cost report.

PMID- 1627003
TI  - Regarding one-inch needles for peritoneal dialysis medications.

PMID- 1627004
TI  - Response on NSAIDs article.

PMID- 1627005
TI  - Renal physiology series: Part 2 of 8. Glomerular filtration and renal
      hemodynamics.
AB  - The formation of urine is a process that begins with glomerular filtration and is
      greatly influenced by changes in renal hemodynamics. Selective filtration of the
      blood is possible because of the unique characteristics of the glomerulus and
      renal circulation. Many factors interact to maintain a consistent blood flow,
      allowing filtration and urine formation to continue despite systemic changes in
      blood pressure. Factors that impact on renal hemodynamics include the
      autoregulatory mechanism, the renin-angiotensin mechanism, eicosanoids, kinins,
      the sympathetic nervous system, catecholamines, antidiuretic hormone, dopamine,
      histamine, endothelin, endothelium-derived relaxing factor, and atrial
      natriuretic peptide. Knowledge of the effects of these factors will allow the
      nephrology nurse to predict, identify, and assist in the treatment of clinical
      conditions that can alter renal hemodynamics and glomerular filtration.

PMID- 1627006
TI  - Tidal peritoneal dialysis vs. continuous cyclic peritoneal dialysis: children's
      preference.
AB  - The purpose of this survey was to determine if the shorter dialysis time of tidal
      peritoneal dialysis (TPD) was valuable enough to warrant additional training time
      and machine assembly. The subjects included 6 children ranging in age from 5-16
      years and their parents. Children and parents were taught to use an automated
      cycler system to provide TPD. Dialysis was limited to 8 hours and overday volumes
      minimized. Prescriptions were altered to prevent uremia and maintain clearances
      of urea and creatinine at prior continuous cyclic peritoneal dialysis (CCPD)
      levels. At 6 months, subjects were surveyed. Subjects felt comfortable with TPD
      within 6 weeks of training. They preferred the shorter dialysis time. All asked
      to remain on TPD, which has improved the quality of life for these children and
      their families by decreasing the amount of time required for dialysis.

PMID- 1627007
TI  - A case illustration of family management style in childhood end stage renal
      disease.
AB  - Families of children with end stage renal disease (ESRD) experience their
      situation based on how they define the illness, manage it, and view the
      consequences of the illness on the family and individual family members. The
      purpose of this study was to describe how a family with a child with ESRD defined
      and managed their situation. Interviews with individual family members from two
      separate interview sessions were analyzed. The family's management style changed
      from struggling to adaptive over a 1-year period following the child's kidney
      transplant.

PMID- 1627008
TI  - A peer support group for adolescent dialysis patients.
AB  - Adolescents with chronic renal failure face unique problems often best understood
      by peers with the same condition. An adolescent peer support group can be a
      valuable tool to foster peer relationships and enhance self-esteem. Moreover,
      nurses can learn to be effective group leaders.

PMID- 1627009
TI  - Machine cleaning and disinfecting.

PMID- 1627010
TI  - Peritoneal dialysis patient completes successful pregnancy.
AB  - This patient was able to meet seven of the expected outcomes. Her weight and
      nutritional status improved after initiating CAPD, which she performed safely and
      effectively. She closely monitored her vital signs and appropriately notified the
      obstetrician when her blood pressure became elevated. She maintained proper fluid
      balance. The patient was successfully treated for exit site infection with
      antibiotics. She self-administered intraperitoneal antibiotics for peritonitis
      successfully. In spite of the infections, hypertension, and poor nutrition, the
      patient was able to complete her pregnancy to the 35th week and delivered a
      small, but healthy infant. Frequent monitoring and a team approach to S.B.'s well
      being contributed greatly to her delivery of a viable infant. The education and
      training provided by the nephrology nurses was a key element in the successful
      management of the patient.

PMID- 1627011
TI  - Oral iron therapy with ferrous fumarate and polysaccharide iron complex.
AB  - Oral iron replacement therapy with Chromagen, containing ferrous fumarate, and
      Niferex, containing polysaccharide iron complex, can successfully maintain
      hematologic and iron indices in dialysis clients and demonstrated fewer adverse
      effects in selected clients. Their multiple ingredient dose forms, which further
      support erythropoiesis, and their possible decrease in distressing side effects
      should enhance client compliance, making these two drugs excellent alternatives
      to traditional iron therapies.

PMID- 1627012
TI  - Case management of the anemic patient. Epoetin alfa: focus on inflammation and
      infection.
AB  - Response to Epoetin alfa can be influenced by several factors, including the
      presence of inflammation or infection. It is important that nurses monitor
      patients so that possible undesirable effects of inflammation or infection can be
      avoided or minimized.

PMID- 1627013
TI  - ANNA. Directory of nephrology nurse researchers.

PMID- 1627014
TI  - Qualitative research: beyond open-ended questions.

PMID- 1627016
TI  - Declining interest in internal medicine. Preliminary vs categorical residents as
      role models.

PMID- 1627015
TI  - Primary prevention of coronary heart disease with drug therapy. Safety and total
      mortality issues.

PMID- 1627017
TI  - A critical appraisal of ticlopidine, a new antiplatelet agent. Effectiveness and
      clinical indications for prophylaxis of atherosclerotic events.
AB  - BACKGROUND: Recommendations are broadening for the prophylaxis of atherosclerotic
      disorders, but aspirin is the only widely used agent. Ticlopidine hydrochloride,
      a new antiplatelet medication, has recently been approved for prescription in
      North America. We reviewed the major clinical trials of ticlopidine and derived
      guidelines for its use. METHODS: Studies of ticlopidine were sought through
      MEDLINE for 1980 to 1990 and through bibliographies of retrieved articles. All
      published, randomized trials of ticlopidine were appraised if they reported major
      morbidity and mortality as primary end points. All eligible studies were formally
      reviewed by an expert panel according to published principles for critical
      appraisal of the medical literature. Both benefits and risks were quantified.
      RESULTS: Four randomized trials reported major clinical end points. In these,
      ticlopidine was more effective than placebo for preventing recurrences after
      completed stroke; was more effective than aspirin for patients with transient
      ischemic attacks and partial strokes; and reduced vascular death and nonfatal
      myocardial infarction in an open trial among patients with unstable angina. For
      patients with intermittent claudication ticlopidine, was not significantly better
      than placebo for preventing myocardial infarction or stroke. Side effects were
      more common with ticlopidine than with aspirin or placebo. CONCLUSIONS:
      Ticlopidine should be prescribed in place of aspirin for stroke prophylaxis or
      unstable angina if the patient is unable to tolerate aspirin. Ticlopidine may
      also benefit patients who experience new ischemic events while taking aspirin or,
      probably, patients with peripheral vascular disease. A complete blood cell count
      should be performed every 2 weeks during the first 3 months of therapy to check
      for leukopenia.

PMID- 1627018
TI  - Modulators of coagulation. A critical appraisal of their role in sepsis.
AB  - Widespread intravascular coagulation is common in patients with sepsis.
      Coagulation abnormalities may result from exposure to endotoxin, from tumor
      necrosis factor alpha or interleukin 1 release, or from the actions of a more
      specific mediator, such as vascular permeability factor. The result is marked
      activation of the contact and coagulation systems; simultaneously, there is
      decreased fibrinolysis and depressed levels of the inhibitors of the contact and
      coagulation systems. Multiple agents are being studied to correct these
      abnormalities. Antithrombin III holds promise because it inhibits a number of
      factors important in contact and coagulation activation, not just thrombin.
      Plasminogen activators may prove helpful in increasing fibrinolysis during
      sepsis; because they have been associated with rebound thrombin generation,
      however, plasminogen activators may be most effective if used in conjunction with
      hirudin or a synthetic hirudin analogue. Bradykinin may offset hypotension in
      sepsis. Protein C may inhibit thrombin formation and also complex with
      plasminogen activator inhibitor 1, thereby promoting fibrinolysis. Other agents
      that may prove effective include alpha 1-antitrypsin Pittsburgh, C1-esterase
      inhibitor, monoclonal antibodies to contact factors, soybean trypsin inhibitors,
      thrombomodulin, prostaglandin I2, and aprotinin. There are no data to support the
      use of heparin or fibronectin, except in limited circumstances.

PMID- 1627019
TI  - Atypical roentgenographic manifestations of Pneumocystis carinii pneumonia.
AB  - Although Pneumocystis carinii pneumonia (PCP) usually presents with bilateral
      interstitial pulmonary infiltrates, many other roentgenographic presentations
      occur in human immunodeficiency virus-infected patients. To clarify the
      determinants of atypical presentations of PCP, we evaluated 65 English-language
      reports that related the roentgenographic manifestations of consecutive cases of
      PCP. The incidence of PCP-associated upper lobe disease, cysts, and spontaneous
      pneumothoraxes was increased in human immunodeficiency virus-infected patients
      receiving aerosolized pentamidine prophylaxis. Normal chest roentgenograms were
      more common and nodular lesions were less common in human immunodeficiency virus
      infected patients than in uninfected patients. However, the roentgenographic
      manifestations of PCP could not be specifically predicted by a patient's
      underlying disease. Neither zidovudine therapy nor intravenous drug use
      apparently affected the roentgenographic presentation of PCP. Unusual pathologic
      responses to PCP, including granuloma formation, vascular invasion, and
      microscopic foci of calcification, were present in all patient groups.

PMID- 1627020
TI  - The Lipid Research Clinics Coronary Primary Prevention Trial. Results of 6 years
      of post-trial follow-up. The Lipid Research Clinics Investigators.
AB  - BACKGROUND: Participants in the Lipid Research Clinics Coronary Primary
      Prevention Trial, a randomized, cholesterol-lowering trial comparing
      cholestyramine (N = 1907) vs placebo (N = 1899) treatment in 35- and 59-year-old
      asymptomatic hypercholesterolemic men, conducted between 1973 and 1983, were
      followed up annually from 1985 until 1989. Post-trial treatment was not provided.
      METHODS: Eleven predefined hypotheses pertaining to possible benefits and adverse
      effects of in-trial cholestyramine treatment were tested by standard statistical
      comparisons of the two original Coronary Primary Prevention Trial treatment
      groups (cholestyramine and placebo). RESULTS: Similar increasing proportions of
      cholestyramine and placebo used cholesterol-lowering drugs post-trial. After 13.4
      years of in-trial plus post-trial follow-up, there were 13 (143 vs 156) fewer
      deaths in the cholestyramine group than in the placebo group. Although not
      statistically significant, the mortality hazard ratio (0.89) was similar to that
      in other cholesterol-lowering trials. This trend, a result of reduced coronary
      heart disease mortality, occurred despite a post-trial narrowing of the in-trial
      cholestyramine-placebo difference in coronary heart disease incidence from 32
      (155 vs 187) to 16 (268 vs 284). The cholestyramine and placebo groups had
      similar 13.4-year mortality rates from cancer, other medical causes, and trauma
      and similar cancer incidence rates. However, 13.4-year incidences of benign
      colorectal tumors (50 vs 34), cancer of the buccal cavity and pharynx (eight vs
      two), gallbladder disease (68 vs 53), and gallbladder surgery (58 vs 40) were
      nonsignificantly increased in the cholestyramine group. CONCLUSION: Overall, 6
      years of post-Coronary Primary Prevention Trial follow-up have not provided
      conclusive evidence of benefit or long-term toxicity of cholestyramine treatment
      beyond that evident at the cessation of the trial.

PMID- 1627021
TI  - A possible protective effect of nut consumption on risk of coronary heart
      disease. The Adventist Health Study.
AB  - BACKGROUND: Although dietary factors are suspected to be important determinants
      of coronary heart disease (CHD) risk, the direct evidence is relatively sparse.
      METHODS: The Adventist Health Study is a prospective cohort investigation of
      31,208 non-Hispanic white California Seventh-Day Adventists. Extensive dietary
      information was obtained at baseline, along with the values of traditional
      coronary risk factors. These were related to risk of definite fatal CHD or
      definite nonfatal myocardial infarction. RESULTS: Subjects who consumed nuts
      frequently (more than four times per week) experienced substantially fewer
      definite fatal CHD events (relative risk, 0.52; 95% confidence interval [CI],
      0.36 to 0.76) and definite nonfatal myocardial infarctions (relative risk, 0.49;
      95% CI, 0.28 to 0.85), when compared with those who consumed nuts less than once
      per week. These findings persisted on covariate adjustment and were seen in
      almost all of 16 different subgroups of the population. Subjects who usually
      consumed whole wheat bread also experienced lower rates of definite nonfatal
      myocardial infarction (relative risk, 0.56; 95% CI, 0.35 to 0.89) and definite
      fatal CHD (relative risk, 0.89; 95% CI, 0.60 to 1.33) when compared with those
      who usually ate white bread. Men who ate beef at least three times each week had
      a higher risk of definite fatal CHD (relative risk, 2.31; 95% CI, 1.11 to 4.78),
      but this effect was not seen in women or for the nonfatal myocardial infarction
      end point. CONCLUSION: Our data strongly suggest that the frequent consumption of
      nuts may protect against risk of CHD events. The favorable fatty acid profile of
      many nuts is one possible explanation for such an effect.

PMID- 1627022
TI  - Does computed tomographic brain imaging have a place in the diagnosis of
      dementia?
AB  - BACKGROUND: Computed tomographic (CT) scanning of the head is an accepted routine
      in the evaluation of dementia. This study attempted to identify a patient group
      in which brain imaging adds meaningful data to the clinical picture. METHODS: One
      hundred patients who met criteria for dementia as defined in the Diagnostic and
      Statistical Manual of Mental Disorders, Revised Third Edition, underwent computed
      tomographic imaging. From clinical data alone, 56 of these patients also met the
      following strict criteria for the diagnosis of probable Alzheimer's disease
      (PAD): the McKhann criteria for PAD, Diagnostic and Statistical Manual of Mental
      Disorders, Revised Third Edition, criteria for primary degenerative dementia, a
      score of less than 4 on the modified Hachinski Ischemia Scale, a normal
      neurologic examination and symptoms for at least 1 year. RESULTS: In the PAD
      group, eight scans (14%) had abnormalities other than atrophy; only three (two
      showing lacunae and one showing infarct) were of possible clinical significance.
      In the 44 patients not meeting PAD criteria, 23 scans (52%) were abnormal,
      including 15 with infarcts, two with periventricular lucencies, three showing
      tumors, and one showing hydrocephalus. CONCLUSIONS: These results support the
      diagnostic value of computed tomographic scanning in atypical dementia and its
      limited utility in PAD. The data indicate that clinical guidelines can be
      developed for the application of CT in the diagnosis of dementia.

PMID- 1627023
TI  - Neurologic syndrome in 25 workers from an aluminum smelting plant.
AB  - BACKGROUND: This article expands on an earlier series of three patients with a
      neurologic syndrome, who had all worked in an aluminum smelting plant. METHODS:
      Twenty-five symptomatic workers from the same plant were referred for a
      standardized evaluation, including completion of a health questionnaire,
      neurologic examination, and neuropsychologic evaluation. An exposure index was
      calculated for each worker based on level and duration of exposure in the
      potroom, where exposures were the greatest. This index was correlated with
      symptoms, signs, and neuropsychologic test scores. RESULTS: Twenty-two (88%) of
      the patients reported frequent loss of balance, and 21 (84%) reported memory
      loss. Neurologic examination revealed signs of incoordination in 21 (84%) of the
      patients. Neuropsychologic test results showed preservation in certain spheres of
      functioning, such as verbal IQ, with substantial impairment in others,
      particularly memory functioning. On memory tests, 70% to 75% showed mild or
      greater impairment. The majority (17 of 19 tested, or 89%) showed depression on
      the Minnesota Multiphasic Personality Inventory. The exposure index was
      significantly correlated with signs and symptoms of incoordination. CONCLUSIONS:
      This study and others in humans and animals support the existence of a syndrome
      characterized by incoordination, poor memory, impairment in abstract reasoning,
      and depression. Aluminum exposure in the potroom seems the most likely cause.

PMID- 1627024
TI  - Risk of needlesticks and occupational exposures among residents and medical
      students.
AB  - PROBLEM: Occupational exposure to human immunodeficiency virus (HIV) disease is a
      problem of concern to all health care workers, especially those in large urban
      teaching hospitals with large numbers of HIV-positive patients. METHOD: The self
      reported incidence of needlesticks and other exposures to patients' blood and
      body fluids in 550 medical students and residents at the Los Angeles County
      University of Southern California Medical Center during the 1989 through 1990
      training year was studied by means of an anonymous survey. RESULTS: Seventy-one
      percent of respondents reported one or more needlesticks or other exposures
      during the training year. Surgical residents had a sixfold greater rate of
      occupational exposure compared with medicine residents and were significantly
      more likely to experience suture needlesticks, cuts, open wound contamination,
      and mucous membrane exposure. Medical students generally were at somewhat lower
      risk compared with residents, but had greater rates of hollow-needle puncture
      accidents. No trend was found for accidental exposure by level of residency
      training. The known HIV-positive exposure rate for students and residents was
      9.5% per person per year. Only 9% of exposures were actually reported to the
      health center. CONCLUSIONS: Based on the rate of exposures reported, numbers of
      known and estimated HIV-positive patients, and previously published HIV
      seroconversion rates, we would expect an annual rate of HIV seroconversion rates,
      we would expect an annual rate of HIV seroconversion as a result of occupational
      exposures of between 27 and 46 per 100,000. This rate is similar to the leading
      cause of death in this age group--motor vehicle accidents--and is equivalent to
      one student or resident in this medical center seroconverting every 2 to 3 years.
      Although only a portion of accidental exposures are regarded as preventable,
      these data emphasize the importance of increased efforts toward improved
      education, prevention, and accessibility of protective equipment.

PMID- 1627025
TI  - Nosocomial acquisition of beta-lactamase--negative, ampicillin-resistant
      enterococcus.
AB  - BACKGROUND: A recent prospective study at the Department of Veterans Affairs
      Medical Center, Martinez, Calif, revealed that 9% of enterococcal clinical
      isolates were ampicillin resistant. We prospectively studied 100 patients
      hospitalized in one general medicine ward and in the medical intensive care unit
      to study determinants of acquisition of ampicillin-resistant enterococcus.
      METHODS: Rectal swabs and urine cultures were obtained from patients within 72
      hours of admission to the study ward and twice weekly until discharge from the
      ward or the intensive care unit. Cultures were obtained from the hands of
      personnel and from environmental surfaces in the general medical ward and the
      intensive care unit. Ampicillin-resistant enterococcal isolates were examined for
      molecular relatedness by plasmid DNA analysis. RESULTS: The cultures from 23
      patients yielded ampicillin-resistant enterococci. The rectal swabs yielded
      ampicillin-resistant enterococci before the urine cultures did except in one
      patient whose urine and rectal cultures were both positive on the same day.
      Acquisition of ampicillin-resistant enterococci was significantly associated with
      previous antimicrobial agents, Foley catheterization, and being bedridden.
      Resistant enterococci were not isolated from hospital personnel or environmental
      surfaces. Plasmid analysis by gel electrophoresis demonstrated nine strains, two
      of which predominated. Rectal and urine isolates from the same patient had
      identical plasmid electrophoresis patterns. CONCLUSIONS: We conclude that
      ampicillin-resistant enterococci are common in the rectal flora, can spread to
      the urinary system, are associated with patient characteristics that predipose to
      nosocomial infection, and may become an emerging clinical problem.

PMID- 1627026
TI  - Cost and quality effects of alternative treatments for persistent
      gastroesophageal reflux disease.
AB  - BACKGROUND: Gastroesophageal reflux disease is commonly encountered by general
      internists and gastroenterologists. METHODS: We used decision analysis to assess
      the clinical and economic effects of three treatments--phase 1 therapy alone or
      combined with omeprazole or ranitidine hydrochloride therapy--for patients with
      persistent, symptomatic grade 2 or higher gastroesophageal reflux disease. To the
      maximum extent possible, data were obtained from the published literature. We
      convened an expert consensus panel to estimate specific data points when they
      were unavailable or contradictory in the literature, including estimates of
      optimal and actual clinical practice patterns. A 7-month model was used to
      correspond to the time frame of available clinical trial data. The perspective of
      the analysis was that of the payer. The costs of medical care for various
      clinical outcomes were based on actual mean payments made by Independence Blue
      Cross of Philadelphia and Pennsylvania Blue Shield. RESULTS: Although the retail
      payments for daily omeprazole therapy are the highest among the three
      interventions tested, it produced both the lowest expected overall payments for
      medical care and the most effective strategy for treating symptoms during the 7
      month model. Omeprazole therapy was consistently approximately $1800 less costly
      than ranitidine therapy and $2700 less costly than phase 1 therapy alone during
      the period examined, regardless of whether empiric or nonempiric treatment
      strategies were used. Even when payments for major complications (the most
      important cost variable) were reduced by 80%, omeprazole therapy resulted in
      payments 17% and 22% lower than those associated with ranitidine therapy and
      phase 1 therapy alone, respectively. Omeprazole also produced the most symptom
      free months during the 7-month follow-up period. The clinical and economic
      outcomes of performing an initial diagnostic workup, compared with treating
      patients empirically, were equal. CONCLUSIONS: We conclude that omeprazole
      therapy is the preferred initial therapeutic approach for patients with
      persistent, symptomatic gastroesophageal reflux disease in whom phase 1 therapy
      fails. Assessment of long-term approaches must await the results of extended
      clinical studies.

PMID- 1627027
TI  - Descriptive epidemiology of agranulocytosis.
AB  - BACKGROUND: To determine the incidence of agranulocytosis, a descriptive
      epidemiologic study was performed. METHODS: With the use of computerized Medicaid
      billing data from 1980 through 1985 from Minnesota, Michigan, and Florida, the
      ratio of persons hospitalized with a discharge diagnosis of neutropenia to
      persons with any claim for medical service was first used as an estimate of the
      incidence rate of the condition. Patients with cancer and patients receiving
      cytotoxic and immunosuppressive drugs were excluded. The information provided by
      a review of medical records for a subset of neutropenia cases was used to
      determine the proportion with neutropenia after excluding cases with recurrent or
      chronic neutropenia, and to determine the proportion with agranulocytosis.
      RESULTS: The incidence rates (95% confidence intervals) of agranulocytosis,
      excluding recurrent or chronic disease, were 2.3 (1.4 to 3.7), 7.7 (6.6 to 8.9),
      and 15.4 (11.3 to 20.4) per million per year in each state, respectively. The
      overall incidence was 7.2 (6.3 to 8.1) per million per year. CONCLUSIONS:
      Agranulocytosis is an extremely uncommon condition. The excess risk of
      agranulocytosis due to any drug other than cytotoxic drugs must, therefore, be
      very low.

PMID- 1627028
TI  - Prevalence of measles susceptibility in hospital staff. Evidence to support
      expanding the recommendations of the Immunization Practices Advisory Committee.
AB  - BACKGROUND: In 1989 and 1990, measles reached epidemic proportions in the United
      States, including several areas of California. Children's Hospital Oakland
      (Calif), a major health care provider for children in a measles epidemic area of
      California, reported 131 cases between 1989 and 1991, the largest number ever
      reported by that institution. In February 1990, four cases of measles were
      reported among hospital staff. Continued risk of nosocomial infection prompted
      the development of a program to ensure that all hospital staff were adequately
      protected against measles. METHODS: All hospital employees who were unable to
      document proof of measles immunity were required to be serologically screened for
      measles antibody and to be vaccinated against measles if they were determined to
      be nonimmune. Serologic screening was performed in-house with a commercially
      available enzyme-linked immunosorbent assay measles antibody test. Dates of birth
      were recorded for all employees screened. Individuals with negative or repeatedly
      equivocal results were considered to be nonimmune and were vaccinated with
      trivalent measles-mumps-rubella vaccine. RESULTS: Between March and June 1990,
      1694 staff were serologically tested for measles antibody. Eighty-nine (5.3%) of
      the employees were considered to have inadequate immunity. Forty (45%) of these
      susceptible individuals were born before 1957. CONCLUSIONS: We conclude that the
      recommendations of the Immunization Practices Advisory Committee should be
      expanded to include serologic screening or vaccination of hospital personnel who
      were born before 1957. Serologic screening of hospital staff may be a reasonable
      alternative to vaccination under certain circumstances.

PMID- 1627029
TI  - Ethical considerations in living organ donation and a new approach. An Advance
      Directive Organ Registry.
AB  - Living organ donation should be recognized as an ethical compromise to the
      principle of nonmaleficence (doing no harm), given the risks healthy donors are
      allowed to assume. Living organ donation should be reserved for situations in
      which there is no acceptable alternative. Increasing the availability of
      cadaveric organs is most desirable, since it would decrease (although probably
      not eliminate) the need for living organ transplantation and would provide organs
      (ie, hearts) that could not otherwise be obtained. We propose the development of
      an incentive-based Advance-Directive Organ Registry, in which all adults are
      encouraged to register their advance directive regarding organ donations. Those
      individuals agreeing to permit usable organs to be taken at the time of death
      would receive priority for organs generated by the program, should a transplant
      become necessary when there is a shortage of organs. The proposed Advance
      Directive Organ Registry is firmly founded on the principles of autonomy,
      beneficence, and justice.

PMID- 1627030
TI  - Serum cholesterol level and mortality findings for men screened in the Multiple
      Risk Factor Intervention Trial. Multiple Risk Factor Intervention Trial Research
      Group.
AB  - BACKGROUND: With increased efforts to lower serum cholesterol levels, it is
      important to quantify associations between serum cholesterol level and causes of
      death other than coronary heart disease, for which an etiologic relationship has
      been established. METHODS: For an average of 12 years, 350,977 men aged 35 to 57
      years who had been screened for the Multiple Risk Factor Intervention Trial were
      followed up following a single standardized measurement of serum cholesterol
      level and other coronary heart disease risk factors; 21,499 deaths were
      identified. RESULTS: A strong, positive, graded relationship was evident between
      serum cholesterol level measured at initial screening and death from coronary
      heart disease. This relationship persisted over the 12-year follow-up period. No
      association was noted between serum cholesterol level and stroke. The absence of
      an association overall was due to different relationships of serum cholesterol
      level with intracranial hemorrhage and nonhemorrhagic stroke. For the latter, a
      positive, graded association with serum cholesterol level was evident. For
      intracranial hemorrhage, cholesterol levels less than 4.14 mmol/L (less than 160
      mg/dL) were associated with a twofold increase in risk. A serum cholesterol level
      less than 4.14 mmol/L (less than 160 mg/dL) was also associated with a
      significantly increased risk of death from cancer of the liver and pancreas;
      digestive diseases, particularly hepatic cirrhosis; suicide; and alcohol
      dependence syndrome. In addition, significant inverse graded associations were
      found between serum cholesterol level and cancers of the lung, lymphatic, and
      hematopoietic systems, and chronic obstructive pulmonary disease. No significant
      associations were found of serum cholesterol level with death from colon cancer,
      with accidental deaths, or with homicides. Overall, the inverse association
      between serum cholesterol level and most cancers weakened with increasing follow
      up but did not disappear. The association between cholesterol level and death due
      to cancer of the lung and liver, chronic obstructive pulmonary disease,
      cirrhosis, and suicide weakened little over follow-up. CONCLUSIONS: The
      association of serum cholesterol with specific causes of death varies in
      direction, strength, gradation, and persistence. Further research on the
      determinants of low serum cholesterol level in populations and long-term follow
      up of participants in clinical trials are necessary to assess whether inverse
      associations with noncardiovascular disease causes of death are consequences of
      noncardiovascular disease, whether serum cholesterol level and noncardiovascular
      disease are both consequences of other factors, or whether these associations are
      causal.

PMID- 1627031
TI  - Herpes simplex virus associated with recurrent Stevens-Johnson syndrome. A
      management strategy.
AB  - We describe a 36-year-old man with recurrent Stevens-Johnson syndrome, which
      became progressively more severe over a 13-year period. His episodes were
      apparently preceded by herpes simplex virus oral mucosal infections. A management
      protocol, including immediate therapy with acyclovir and prednisone at the onset
      of herpes simplex virus oropharyngitis, is outlined. This management strategy has
      successfully prevented four subsequent episodes of progression to Stevens-Johnson
      syndrome. Thus, Stevens-Johnson syndrome associated with herpes simplex virus may
      be prevented by early use of acyclovir and prednisone.

PMID- 1627032
TI  - Cutaneous oxalosis after long-term hemodialysis.
AB  - A 27-year-old woman undergoing long-term hemodialysis developed cutaneous
      calcifications on her fingers. A skin biopsy specimen showed that the deposits
      were calcium oxalate. To our knowledge, only one previous article has reported
      pathologic and crystallographic studies on calcifications of the skin resulting
      from dialysis oxalosis. We speculate that vitamin C supplements, liberal tea
      consumption, an increased serum ionized calcium concentration, and the long
      duration of hemodialysis contributed to the production of these deposits.

PMID- 1627033
TI  - Nonsteroidal anti-inflammatory drug-associated pulmonary infiltrates with
      eosinophilia. Review of the literature and Food and Drug Administration Adverse
      Drug Reaction reports.
AB  - OBJECTIVE: The purpose of this study was to detail the clinical and pathologic
      presentation of pulmonary infiltrates with eosinophilia (PIE) associated with
      nonsteroidal anti-inflammatory drug use. METHODS: We reviewed case reports and
      Food and Drug Administration Adverse Drug Reaction Spontaneous Reporting Program
      reports. RESULTS: A case of pulmonary infiltrates with eosinophilia related to
      naproxen use was studied. Six similar cases from the medical literature and 22
      reports from the Food and Drug Administration were reviewed. Four cases of PIE
      associated with ibuprofen, obtained from the Food and Drug Administration, and
      single literature reports of PIE associated with fenoprofen and sulindac detailed
      similar clinical presentations. The clinical presentation of PIE syndrome
      associated with nonsteroidal anti-inflammatory drugs included fever, cough,
      dyspnea, infiltrates on chest roentgenogram, and an absolute peripheral
      eosinophilia. Pathologic examination revealed poorly defined granulomas with
      infiltrating eosinophils. CONCLUSIONS: Naproxen and other nonsteroidal anti
      inflammatory drugs can elicit the PIE syndrome. The prevalence of this side
      effect is likely underestimated, given the extensive use of these drugs and the
      relatively benign course of PIE syndrome.

PMID- 1627034
TI  - Use of spontaneous reporting system data.

PMID- 1627035
TI  - Futile cardiopulmonary resuscitation.

PMID- 1627037
TI  - Goals of medicine.

PMID- 1627036
TI  - Cardiopulmonary resuscitation and the dying patient with cancer: a resuscitator's
      response.

PMID- 1627038
TI  - Goals of medicine.

PMID- 1627039
TI  - Patient-induced pulmonary embolism.

PMID- 1627040
TI  - Pericardial drainage vs pericardial 'window'.

PMID- 1627041
TI  - Autosplenectomy complicating pneumococcal meningitis in adults.

PMID- 1627042
TI  - Do fluoroquinolones alter the effects of warfarin therapy?

PMID- 1627043
TI  - Limbic system abnormalities identified in schizophrenia using positron emission
      tomography with fluorodeoxyglucose and neocortical alterations with deficit
      syndrome.
AB  - A hypothesis of psychosis localization in schizophrenia was derived from studying
      metabolic alterations in rat brain in response to phencyclidine hydrochloride
      administration. Since phencyclidine and its selective agonist dizocilpine maleate
      (MK801) induced overlapping and long-lasting metabolic alterations predominantly
      in limbic areas, the hypothesis developed that schizophrenic patients with
      psychosis would evidence functional abnormalities in limbic circuits compared
      with normal controls. Accordingly, 12 actively psychotic, drug-free patients with
      schizophrenia and matched normal controls underwent functional brain scans using
      positron emission tomography and fluorodeoxyglucose. Regions of interest were
      identified on five matched axial slices in each patient and control subject, and
      average metabolic rates were calculated. Patients with schizophrenia showed a
      significantly lower regional cerebral metabolic rate of glucose in the
      hippocampus and the anterior cingulate cortex than did normal controls, but not
      in neocortical areas or in the extrapyramidal system. When the group of
      schizophrenic patients was divided into deficit and nondeficit types, a
      preliminary exploratory analysis suggested thalamic, frontal, and parietal
      cortical hypometabolism in the deficit subgroup, with normal metabolism in the
      nondeficit patient group in those areas; in contrast, hippocampal and anterior
      cingulate cortical metabolism was reduced in both deficit and nondeficit
      subtypes. These results suggest that the limbic system, especially the
      hippocampus, is functionally involved in schizophrenic psychosis and that
      different manifestations of schizophrenia may involve different neuronal
      circuits.

PMID- 1627044
TI  - Volumes of ventricular system subdivisions measured from magnetic resonance
      images in first-episode schizophrenic patients.
AB  - In vivo brain imaging and postmortem investigations have demonstrated structural
      anomalies in the brains of schizophrenic patients. However, previous studies have
      not established clear relationships between the characteristic symptoms of the
      disorder and neuropathologic changes in specific brain regions. We have obtained
      high-resolution magnetic resonance brain images of first-episode schizophrenic
      and normal control subjects and, with a computerized mensuration system,
      determined the volumes of the different components of the entire ventricular
      system. Volumes of ventricular segments were significantly larger in patients
      than controls (differences ranged from 17% to 40%). Temporal horn enlargement
      consistently demonstrated significant correlations with a broad range of
      schizophrenic symptoms. Our data indicate that anomalies of limbic structures in
      the medial temporal lobe surrounding the temporal horn play a crucial
      pathophysiologic role in schizophrenia.

PMID- 1627045
TI  - Preliminary data on the metabolic brain pattern of patients with winter seasonal
      affective disorder.
AB  - The brain metabolic pattern of patients with winter seasonal affective disorder
      with and without light treatment was determined by positron emission tomography.
      Compared with controls, patients with seasonal affective disorder with and
      without light treatment had globally lower metabolic rates, relatively lower
      superior medial frontal cortex rates, and somewhat higher basal ganglia rates.
      Patients receiving light treatment had a relatively higher rate in an occipital
      region of interest containing the primary visual cortex. Patients without light
      treatment had relatively higher metabolic rates in right parietal and medial
      orbitofrontal cortex and lower rates in the left parietal cortex. Patients not
      receiving light treatment had a hemispheric metabolic asymmetry (left greater
      than right) for the midprefrontal cortex located 67 mm above the canthomeatal
      line. The right side of this region, previously found reduced in manic-depressive
      illness and schizophrenia, was decreased primarily in patients with seasonal
      affective disorder with fewer atypical depressive symptoms. These "abnormal"
      prefrontal and parietal cortex regions appeared highly "coupled" in the patients
      with seasonal affective disorder.

PMID- 1627046
TI  - Magnetic resonance imaging of the caudate nuclei in depression. Preliminary
      observations.
AB  - A role of the caudate nucleus in depression has been suggested from relevant
      clinical conditions, such as patients with Huntington's disease or caudate
      infarcts, as well as animal studies. Correlations of caudate nucleus disease with
      depressive symptoms have been limited to autopsy studies and cases of gross
      pathological disorder, such as large infarcts. We used serial axial high-field
      magnetic resonance images and an unbiased stereological technique to estimate the
      volumes of the caudate nuclei in 50 patients who met DSM-III criteria for major
      depression (23 men, 48.3 +/- 17 years old) in comparison with 50 age- and gender
      matched normal controls free of major neurological and psychiatric disorders.
      Depressed patients had smaller caudate nucleus volumes (5.2 +/- 1.6 cm3) compared
      with controls (6.2 +/- 1.7 cm3). Right and left caudate nucleus volumes were
      smaller in depressed patients compared with controls. Age was negatively
      correlated with caudate nucleus volumes in depressed patients as well as in
      controls. Caudate nucleus volumes in depressed patients were inversely correlated
      with the bicaudate and bifrontal indices. These results may be the first
      demonstration of diminished caudate nucleus volumes in depression and suggest a
      role for the caudate nucleus in the pathogenesis of major depression.

PMID- 1627047
TI  - Neuroendocrine aspects of primary endogenous depression. XI. Serum melatonin
      measures in patients and matched control subjects.
AB  - To ascertain the extent of dysregulation of melatonin secretion in endogenous
      depression, we measured nocturnal and diurnal serum melatonin concentrations in
      38 depressed patients (23 women and 15 men) who had primary, definite endogenous
      depression according to the Research Diagnostic Criteria and in 38 individually
      matched normal control subjects. Previous reports have suggested that such
      patients may have reduced nocturnal melatonin secretion, often in conjunction
      with increased hypothalamic-pituitary-adrenal cortical axis activity. This has
      been considered as a possible reflection of reduced noradrenergic activity in
      depression. Compared with their matched controls, the depressed patients showed a
      trend toward a significantly elevated average nocturnal melatonin concentration
      that was accounted for primarily by the 14 premenopausal women--the
      postmenopausal female and male depressive patients did not differ significantly
      from their respective controls. The average diurnal melatonin concentration also
      showed a trend toward being higher in both the female and male depressed
      patients. The melatonin measures were not consistently related to any of the
      previously reported hypothalamic-pituitary-adrenal cortical axis measures in
      these subjects. Our findings thus failed to confirm a "low melatonin syndrome" or
      an inverse relationship between nocturnal melatonin and nocturnal cortisol
      concentrations in depression. This discrepancy may be related to methodologic
      differences among studies; our data are in accord with those findings of the one
      other reported study in which normal controls were individually matched to
      patients on variables that were known to influence melatonin secretion. Most of
      the studies, including ours, have been cross-sectional.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1627048
TI  - Urinary excretion of catecholamines and their metabolites in relation to
      circulating catecholamines. Six-hour infusion of epinephrine and norepinephrine
      in healthy volunteers.
AB  - Some depressed patients have been shown to excrete abnormal amounts of
      catecholamines and their metabolites in urine. Some studies suggest that
      hypersecretion of epinephrine by the adrenals and of norepinephrine by the
      peripheral sympathetic system cause increased excretion of urinary catecholamines
      and their metabolites in a subgroup of patients. To evaluate the effect of
      increased catecholamine levels in the peripheral circulation on urinary
      catecholamine and metabolite levels, we infused healthy volunteers during 6 hours
      with epinephrine, norepinephrine, or placebo, respectively, in a three-period,
      double-blind, crossover design. The results indicate that (1) urinary epinephrine
      and norepinephrine levels were the most sensitive indicators of increased
      circulating epinephrine and norepinephrine levels, respectively; (2) changes in
      circulating epinephrine or norepinephrine levels were not readily reflected in
      changes in urinary vanillylmandelic acid or 3-methoxy-4-hydroxyphenylglycol
      levels; and (3) increased normetanephrine excretion was not only induced by
      infusion of norepinephrine but also by epinephrine. This last finding may be due
      to activation of the sympathetic nervous system by circulating epinephrine. These
      results may help to explain the mechanism of adrenal epinephrine and sympathetic
      nervous system norepinephrine hypersecretion observed in subgroups of depressed
      patients.

PMID- 1627049
TI  - The 'anatomy' of research funding of mental illness and addictive disorders.
AB  - To assess the level and sources of research funding for mental illness and
      substance abuse fields, we undertook a systematic survey of public and private
      funding entities. Applying standard definitions, we found that research support
      in these fields totaled approximately $859 million in fiscal 1988. This level of
      research support for mental illness and substance abuse is extremely limited and
      disproportionate to the overall costs to society by these disorders. Mental
      disorders and substance abuse accounted for $66.8 billion in health care costs in
      1988; in the same year, research on these disorders represented only 4.7% of all
      health research support nationwide. The three institutes of the Alcohol, Drug
      Abuse, and Mental Health Administration (ADAMHA) (namely, the National Institute
      of Mental Health [NIMH], the National Institute of Drug Abuse [NIDA], and the
      National Institute on Alcoholism and Alcohol Abuse [NIAAA]) support 64% of all
      mental illness and substance abuse research; other federal agencies add little
      more than 7.5%, with the Department of Veterans Affairs the largest at 2%. The
      pharmaceutical and hospital industries account for another 17% of all support;
      state funding is 8%, which is particularly surprising in light of the states
      responsibility for the chronically mentally ill. While there has been recent
      significant growth in the research budgets of the NIMH, the NIDA, and the NIAAA,
      other sectors have not grown commensurately, leaving the field vulnerable to the
      funding vicissitudes of these institutes. Greater coalition building and advocacy
      are necessary to expand the breadth and depth of research resources for the
      field.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627050
TI  - Fluoxetine, akathisia, and suicidality: is there a causal connection?

PMID- 1627051
TI  - Thyroid function and partial sleep deprivation response.

PMID- 1627052
TI  - Psychosurgical treatment of obsessive-compulsive disorder.

PMID- 1627053
TI  - Methodological issues in the assessment of human immunodeficiency virus-related
      cognitive impairment.

PMID- 1627054
TI  - Thought disorder ratings distinguish between diagnostic groups.

PMID- 1627055
TI  - Role of antenatal care in reducing maternal mortality.
AB  - Maternal mortality in the developed nations has been considerably reduced, but it
      still is very high in developing nations. I carried out an indepth study of
      maternal mortality at N. Wadia Maternity Hospital, Bombay. India, from 1929 to
      1988, which revealed that the MMR which was 1920 per 100,000 live births during
      1929-1939 period has declined to 82 per 100,000 live births during 1980-1988
      period. This achievement in reduction of maternal mortality over the decades was
      due to multiple factors like increased and effective antenatal, intranatal, and
      postnatal care. This study shows the apathy of pregnant women to come forward to
      avail of antenatal care though available even free of charge nearby. To give
      maximum benefits to pregnant women specially in the developing nations, we have
      to carry the antenatal care at the door-steps of the community.

PMID- 1627056
TI  - Meconium aspiration syndrome: the role of resuscitation and tracheal suction in
      prevention.
AB  - We reviewed our experience of meconium staining of liquor and meconium aspiration
      syndrome over a 33 month period. The clinical and radiological severity of
      disease was assessed in comparison with tracheal suction and resuscitation. Sixty
      (27%) of newborns with meconium stained liquor subsequently developed MAS. No
      association was found between the thickness of meconium or its presence on
      tracheal aspiration with subsequent severity of respiratory disease. However, the
      presence of meconium in the trachea was strongly associated with radiological
      abnormality. The severity of meconium aspiration syndrome and mortality were also
      related to the clinical stability of the infants at presentation. Our results
      indicate that intrauterine aspiration and pulmonary maladaptation may play a
      significant role in meconium aspiration syndrome rather than resuscitative events
      at delivery.

PMID- 1627057
TI  - Bilateral ovarian cysts in a newborn: a case report.
AB  - Large ovarian cysts in the fetus are uncommon. Ultrasonography has helped in the
      detection of these cysts antenatally and in the newborn female infant. A case of
      bilateral ovarian cysts in a newborn is presented. The choice of management
      between conservative measures and surgical approaches remains controversial.

PMID- 1627058
TI  - Chorionic villus sampling: evaluation of obstetric performance.
AB  - Chorionic villus sampling is frequently utilised in the Nottingham region as a
      means of early prenatal diagnosis of genetic problems. Its relative safety in the
      early antenatal period is well established but there has been some concern that
      perinatal mortality may be greater in the chorionic villus sampling group as
      compared to amniocentesis. We have in response studied our own data and report
      the obstetric outcome in 144 cases where the pregnancy has progressed beyond 28
      weeks gestation. We have selected a procedure free control group matched for
      parity. We have found no significant difference in the perinatal outcome and
      obstetric performance and conclude that at this juncture we should continue to
      offer our services as chorionic villus sampling offers significant advantages in
      the first trimester over amniocentesis.

PMID- 1627059
TI  - Perinatal mortality in high risk pregnancy: a prospective study of preventable
      factors.
AB  - The present study was undertaken to identify the preventable factors operative in
      high fetal and neonatal losses. Over a period of one year, of total of 1,600
      consecutive deliveries, 1,107 were considered to be at-risk: there were 33 fetal
      and 31 early neonatal deaths with an overall perinatal mortality rate of 40/1,000
      births. Perinatal mortality was higher in mothers who had received inadequate
      antenatal care and/or with bad obstetric history. Major maternal and obstetric
      factors associated with a high PMR were: advancing maternal age and parity,
      antepartum hemorrhage, diabetes, anemia, instrument and vaginal breech delivery.
      Overall cesarean section rate was 16.9%. Infants with a gestational age of less
      than 37 weeks and/or of birth weight of less than 2,500 g contributed for 56.2%
      and 68.7% of the total perinatal losses respectively. PMR was three fold higher
      among twins compared with singleton births. Identifiable causes of perinatal
      deaths observed were: asphyxia (31%), congenital anomalies (18.7%), sepsis
      (18.7%) and low birth weight (25%). It would appear that preventable factors are
      operative in over two third of the cases of perinatal loss and better maternal
      health, obstetric and neonatal care can improve the perinatal outcome in majority
      of the cases.

PMID- 1627060
TI  - A study on the placental transport mechanism of vitamin K2 (MK-4).
AB  - The present study was primarily concerned with in vitro investigation of vitamin
      K2 (MK-4) transport using human placental villous tissues, with the objective of
      elucidating the placental transport mechanism of vitamin K2. 1. When vitamin K2
      (MK-4) was not administered to gravidae, the observed concentrations of vitamin
      K2 were 0.32 +/- 0.07 ng/ml in the maternal venous blood, undetectable in
      umbilical venous blood, and 1.01 +/- 0.37 ng/g wet tissue in the placental
      villous tissue. 2. When vitamin K2 was administered to gravidae, (20 mg/day x 7
      days per os), the corresponding concentrations were 0.89 +/- 0.21 ng/ml in the
      maternal venous blood, 0.18 +/- 0.06 ng/ml in umbilical venous blood, and 5.38 +/
      1.05 ng/g wet tissue in the placental villous tissue. 3. In vitro studies using
      placental villous tissue indicated that vitamin K2 transport into villous tissue
      is not active, but suggested the existence of a highly vitamin K2 specific
      transport system in the human placenta. On the other hand, the results of
      comparison studies of transport of vitamin K2 and vitamin K1 into villous tissue
      indicated that transport activity with respect to the former vitamin was higher.
      Moreover, comparison of vitamin K2 transport into villous tissue at the end of
      the first trimester and at full term revealed that transport was somewhat higher
      during the final stage. In summary, the above results indicated that whereas
      transport of vitamin K1 into the fetus is not especially pronounced, transport
      into the placental villous tissue is comparatively good.

PMID- 1627061
TI  - Ectopic ovary in the omentum.
AB  - At caesarean section the right ovary of a patient was found to be absent. There
      was an omental cyst that was excised and this was found to be an ectopic ovary.
      This case is reported because of its rarity. The nomenclature and embryological
      aspects of the condition are discussed.

PMID- 1627062
TI  - Government-funding program on reversal of tubal sterilization.
AB  - Three hundred and sixty-one women were provided government-funded sterilization
      reversal services with the technique of microsurgery. A large majority of reasons
      (89.8%) for requesting reversal surgery was a loss of children, and the mean
      interval between sterilization and reversal was 28.7 months. Two hundred and
      seven (69.7%) of 297 follow-up cases have experienced term delivery or intra
      uterine pregnancy and 5 cases were ectopic pregnancy. The largest number of
      reversal clients (63.3%) were sterilized by the laparoscopic unipolar coagulation
      technique and the next largest group (24.2%) was sterilized by the laparoscopic
      banding technique. The highest pregnancy rate (77.8%) was shown in clients who
      had undergone laparoscopic banding technique while the lowest (65.9%) was the
      group of laparoscopic unipolar coagulation. A more than 60% of the clients became
      pregnant within 6 months of their reversal surgery, with the shortest interval
      being 1 month, the longest 39 months, and the mean 7.6 months. A large majority
      of the successful cases, 81.6%, were pregnant within 1 year of their reversal
      surgery.

PMID- 1627063
TI  - Immunohistochemical assessment of the growth fraction in cervical cancers using
      the monoclonal antibody Ki-67; relationship to the clinical stage, histologic
      type and DNA content.
AB  - To assess the growth potential of cervical cancer, cell populations in
      proliferating cycle (%PC) were examined by an immunohistochemical technique using
      the monoclonal antibody Ki-67. The %PC was 31.63 +/- 16.61% in 36 cervical
      cancers and was significantly higher when compared to the 7.8 +/- 3.81% found in
      24 samples of normal ectocervical tissues. In cervical cancer tissues, the %PC
      increased in accordance with progression of the clinical stage of the disease,
      however, the %PC was not different among the various histologic types of invasive
      cervical cancers. The DNA index also increased in accordance with progression of
      the clinical stage of cervical cancer, however, there was no correlation between
      the %PC and the DNA index. These results suggest that the value of %PC obtained
      using the monoclonal antibody Ki-67 can be used as a parameter for evaluating the
      growth activity of cervical cancer and for predicting biological heterogeneity in
      a tumor.

PMID- 1627064
TI  - Changes in bone mineral density and fracture prevalence in Japanese women after
      oophorectomy.
AB  - The bone changes after gynecological surgery during the early phase of recovery
      were examined. The subjects were randomly selected from women who had undergone
      bilateral oopho-hysterectomies (OOX, n = 98, 46.0 +/- 5.0 year-old) or
      hysterectomies (HX, n = 75, 43.6 +/- 4.6 year-old) within 4 years prior to
      entering the study. The ovarian functions in the HX group were presumed to be
      intact following the hysterectomies, judging from the cytological evaluation of
      the vaginal pap smears. The bone morphological changes in both groups were
      examined to measure the cortical thickness of the metacarpal bone (MCI) on hands
      X-ray film using microdensitometry, and the posterior/anterior height ratios (P/A
      ratio) of the entire vertebral bodies, on vertebral X-ray films using a
      digitizer. The changes in bone mineral densities in both groups were measured by
      dual energy X-ray absorptiometry at lumbar vertebrae (L2-4 BMD) and by
      microdensitometry at the metacarpal cortical bone; the bone densities of
      metacarpal bone were referenced by the density of aluminum step wedge on the same
      X-ray films. The prevalence of vertebral body fractures (P/A ratio greater than
      1.4) in the OOX group (5.1%) was 3.9 times higher than that in the HX group
      (1.3%). There was a significant decrease in MCI in the OOX group compared with
      the HX group (p less than 0.01). L2-4 BMD in the OOX and HX group were 1.07 +/-
      0.15 and 1.16 +/- 0.13 g/cm2, respectively (p less than 0.001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1627065
TI  - Direct posterior composite resin restorations: a review. 2. Clinical technique.
AB  - Despite the increased use of composite resin to restore posterior teeth, there is
      evidence that clinicians should be selective in their use of these restorations.
      This paper describes the clinical technique--preparatory procedures, preparation
      of the cavity, preparation for placement of composite resin, placement of
      composite resin and finishing of the restoration--for the relatively conservative
      use of composite resin in posterior teeth and reviews the literature to discuss
      briefly many of the controversial aspects of the technique.

PMID- 1627066
TI  - Massive bleeding following maxillofacial trauma. Case report.
AB  - A case is reported of massive haemorrhage following severe maxillofacial trauma.
      The various procedures that were used to control the bleeding are discussed with
      particular reference to therapeutic arterial embolization.

PMID- 1627067
TI  - Anterior maxillary supernumerary teeth: a clinical and radiographic study.
AB  - Clinical records and radiographs of 90 patients with 113 anterior maxillary
      supernumerary teeth (mesiodens) have been evaluated. Although uncommon,
      mesiodentes are the most frequent supernumerary teeth and may disturb the
      eruption and/or position of the adjacent permanent incisors. Clinical and
      radiographic examination may disclose the number, direction and location of
      mesiodentes and their effects on neighbouring teeth. In the present study the
      majority of the supernumerary teeth lay palatal to the central incisors. Complete
      or partial eruption of a mesiodens was rare, hence the importance of radiographs
      to locate supernumerary teeth in the premaxilla. Pathological findings included
      the formation of dentigerous cysts in three patients and complete ossification of
      the pericoronal space with resorption of the crown of the mesiodentes in eight
      cases. Retention and malposition of the adjacent permanent incisors occurred in
      39 and 24 cases, respectively.

PMID- 1627068
TI  - Restoration longevity in an Australian Defence Force population.
AB  - Replacement of restorations comprises a considerable portion of the work of most
      dentists. Consequently, factors that affect restoration longevity can influence
      the pattern of dental practice in a given community. Based on the results of
      research into treatment provision in the General Dental Service in Scotland, it
      was considered possible that factors such as the frequency with which patients
      were examined, and the frequency with which they changed dentists, might
      influence restoration longevity in other populations. Therefore, the present
      study was initiated to investigate the effects of these two factors in a
      population of 100 long-term members of the Royal Australian Air Force. No
      statistically significant relationship could be found between examination
      frequency, or frequent changes in dental practitioner, and restoration longevity.
      It is proposed that the large differences found in restoration longevity between
      this study and the Scottish study upon which it was based, may be due in part to
      the differing modes of remuneration of the dentists in the two studies.

PMID- 1627069
TI  - Dental caries amongst Royal Australian Navy recruits, 1988.
AB  - A sample of 1100 Royal Australian recruits were examined for dental caries in
      1988. Socio-demographic data were also collected. The mean DMFT scores were 4.33,
      6.85, and 8.87 teeth for the 15-19 year-olds, 20-24 year-olds, and 25-29 year
      olds, respectively. Caries experience varied between the state of origin of
      recruitment with Victorian and Queensland subjects having the highest DMFT
      scores, and Tasmanian subjects, the lowest. Comparison with previous military
      studies indicated not only a decreased dental caries experience, but also that
      restoration of teeth rather than extraction is a more likely treatment outcome of
      dental caries in recent recruits.

PMID- 1627070
TI  - Dental treatment and dental health. Part 2. An alternative philosophy and some
      new treatment modalities in operative dentistry.
AB  - In this, the second of two papers on the relationships between dental treatment
      and dental health, the philosophical basis of Minimum Intervention Dentistry is
      presented. This approach to patient care has several distinct treatment
      modalities. These range from preventive measures and fissure sealants, through
      monitoring carious lesions for active progression or arrest, to minimal cavity
      designs such as tunnel preparations and preventive resin restorations which
      employ adhesive dental restorative materials. This paper discusses these
      techniques and the implications of this change in philosophy for dental teaching,
      research and manpower considerations.

PMID- 1627071
TI  - Emigration tendencies among Hong Kong Chinese dentists--1990.
AB  - A postal questionnaire survey was conducted in April-May 1990 among 1223 Hong
      Kong Chinese dentists resident in Hong Kong to ascertain their plans for
      emigration from the Territory, as there were no data on emigration trends among
      dentists. A response rate of 47 per cent was obtained. Only 7 per cent of
      respondents definitely did not plan to emigrate and 47 per cent planned
      definitely or hopefully to emigrate, mostly in the years prior to 1997. Canada,
      Australia and the United States of America were the destinations most commonly
      cited by those planning to emigrate, and only one-quarter of these have any plans
      to return to Hong Kong. It was concluded that the emigration and return of Hong
      Kong dentists would influence workforce planning in the territory, and thus
      should be monitored.

PMID- 1627072
TI  - Survey of dental practice/dental education in Victoria. Part V. One-year follow
      up survey of 1988 graduating class.
AB  - A follow-up survey of the 1988 graduating class was carried out in order to
      compare views of the same cohort after 12 months of dental practice. The most
      significant finding was that there were few changes in opinion in respect to
      those subjects where 60 per cent or more respondents in the 1988 survey had
      judged the practical and/or theoretical components to have too little emphasis.
      These included fixed prosthodontics, occlusion, orthodontics, endodontics,
      aesthetic dentistry, oral surgery, conservative dentistry and care of the special
      patient. Recent changes to the undergraduate curriculum were high-lighted and the
      need for further development in continuing education courses was re-emphasized.

PMID- 1627074
TI  - Oral herpes remission and fluoride pulsing.

PMID- 1627073
TI  - Present and future patterns of practice and workforce needs in oral and
      maxillofacial surgery.
AB  - Oral and maxillofacial surgeons have shown curiosity and concern for their
      present and future patterns of practice and workforce needs. Few oral and
      maxillofacial surgeons would not have an understanding of how they came to be, or
      opinions on where the specialty is and appears to be going. Such opinions,
      however, need to be rigorously tested against the best available information.
      Quantitative information is the substantive input to decisions on whether oral
      and maxillofacial surgeons wish to go where they appear to be going, and if so
      why, and if not, why not? The Oral and Maxillofacial Surgeons 1990 Workforce
      Study* aimed to provide information relevant to these questions. Oral and
      maxillofacial surgeons are surprising in both their heterogeneity in patterns of
      practice and homogeneity in most of the content of services provided. Projections
      of the workforce indicate that a status quo in recruitment is actually a steady
      decline in capacity to serve the community, a picture in contrast to the
      international comparative data and opinion that supports a broadening in the
      service role of oral and maxillofacial surgeons. The Oral and Maxillofacial
      Surgeons 1990 Workforce Study offers insights into present and future patterns of
      practice and workforce needs. Ultimately, however, decision-making in the
      specialty will reflect additional social, economic and dento-political factors to
      which the Australian and New Zealand Association of Oral and Maxillo-Facial
      Surgeons must be the major contributor.

PMID- 1627075
TI  - Soft tissue sports injuries. First of a continuing series on sports medicine.

PMID- 1627076
TI  - Acute chest pain.
AB  - Of the many causes of acute chest pain, it is important to delineate the life
      threatening causes, such as myocardial infarction, dissecting aneurysm and
      pulmonary embolism. It is important to consider the cause as 'myocardial
      infarction until proved otherwise'. Common causes in general practice are
      musculoskeletal disorders and functional problems. A diagnostic strategy is
      outlined.

PMID- 1627077
TI  - Influenza surveillance in general practice.
AB  - This paper describes a survey of influenza conducted in general practice from
      July to October 1990. The study demonstrates how interested general practitioners
      can be involved in community based surveillance for the early detection of
      influenza outbreaks.

PMID- 1627078
TI  - Intra-articular injection of a finger.

PMID- 1627079
TI  - Patient education. Schizophrenia.

PMID- 1627080
TI  - Tuberculoid leprosy in country Victoria. Pitfalls in clinical diagnosis.

PMID- 1627081
TI  - The 'crown' excision for facial skin lesions.

PMID- 1627082
TI  - Half days of our lives.

PMID- 1627083
TI  - Radiotherapy and skin cancer.

PMID- 1627084
TI  - The management of common respiratory infections.

PMID- 1627085
TI  - Vaccine efficacy for reducing turbinate atrophy and improving growth rate in
      piggeries with endemic atrophic rhinitis.
AB  - Two vaccines, based on formalin-killed whole cells of toxigenic Pasteurella
      multocida type D and Bordetella bronchiseptica combined with a partially toxoided
      cell extract of P multocida, were prepared with Freund's incomplete adjuvant
      (vaccine 1) or by alum precipitation (vaccine 2). Each was tested for safety and
      efficacy in reducing the severity of nasal turbinate atrophy and improving the
      growth rate of pigs in three Western Australian commercial piggeries with endemic
      atrophic rhinitis. In safety experiments with vaccine 1, no adverse clinical
      effects were observed in vaccinated sows or their progeny. Piglets receiving
      vaccine 2 showed no injection site abnormalities, pyrexia or turbinate atrophy.
      In field trials, vaccine 1 significantly reduced the prevalence of moderate to
      severe nasal turbinate atrophy (Done score 3 to 5) when used in two piggeries (A
      and B). Progeny from vaccinated sows in piggery B also grew significantly faster
      than controls. When vaccine 2 was used in piggery A at a later date and in
      another piggery (C), growth rate was not improved in either piggery and the
      prevalence of moderate to severe turbinate atrophy was reduced only in piggery C.

PMID- 1627086
TI  - Cadmium concentrations in the kidneys of Western Australian pigs.

PMID- 1627087
TI  - Suspected Sarcocystis encephalitis in a stillborn kid.

PMID- 1627088
TI  - Lymphocystis in cultured snapper (Pagrus auratus) and wild kingfish (Seriola
      lalandi) in Australia.

PMID- 1627089
TI  - Suspected jute seed (Corchorus olitorius) poisoning of cattle.

PMID- 1627090
TI  - Serological evidence for the presence of Leptospira interrogans serovar
      bratislava in Australian pigs.

PMID- 1627091
TI  - High level resistance to cypermethrin in the sheep body louse.

PMID- 1627092
TI  - A comparison of the interferon gamma assay with the absorbed ELISA for the
      diagnosis of Johne's disease in cattle.

PMID- 1627093
TI  - Changes in hematological, blood gas, and serum biochemical variables in broilers
      during exposure to simulated high altitude.
AB  - One-day-old broilers were reared until 35 days of age at both natural low (100 m)
      and simulated high altitude (2133 m) to assess the incidence and development of
      ascites syndrome. Clinical measurements were conducted at 7, 14, 21, 28, and 35
      days of age. Birds reared at 2133 meters exhibited significantly (P less than or
      equal to 0.05) reduced body weights at 7 through 28 days of age. Total serum
      calcium and biochemical enzyme activities were found to be altered at 35 days of
      age. In addition, the high-altitude group had significantly (P less than or equal
      to 0.05) higher erythrocyte counts, hematocrits, and hemoglobin at 14, 21, 28,
      and 35 days of age and higher serum inorganic phosphorus at each weekly sample
      time than birds at the low altitude. Total mortality was 20.3% at 2133 meters and
      4.6% at 100 meters. The incidence of ascites syndrome in the high-altitude group
      ranged from 16.6% to 61.1% during the 5-week experimental period.

PMID- 1627094
TI  - Colonization of Escherichia coli in young turkeys and chickens.
AB  - In order to investigate the possibility of pathogenic Escherichia coli
      penetrating the bloodstream via the intestinal mucosa in normal and stressed
      turkeys and chickens, birds were inoculated orally with the bacteria or exposed
      environmentally to it. Immediately after hatch, intestines contained a
      substantial number of coliform bacteria that increased with time. In orally
      infected turkeys, the pathogenic bacteria (nalidixic-acid-resistant O78) replaced
      10%-50% of the native coliform flora but could not be isolated from the trachea
      or blood. Environmentally exposed groups exhibited pathogenic bacteria in
      intestines but not in blood. Stressing of exposed turkeys resulted in isolation
      of the pathogenic bacteria from blood and even spleen. In orally infected broiler
      chickens, stress resulted in bacteremia and mortality. Chickens that were exposed
      to pathogenic bacteria at a young age and showed no mortality or morbidity
      demonstrated no detrimental effects due to challenge with the same pathogenic
      bacteria later in life. Stress seems to cause penetration of the pathogenic
      bacteria into the bloodstream, which in turn can cause severe disease and
      mortality.

PMID- 1627095
TI  - Comparison of a vaccine strain and field isolates of avian reovirus by T1
      oligonucleotide mapping.
AB  - Total RNA of eight avian reovirus isolates and the S1133 strain were compared by
      RNase T1-oligonucleotide mapping. The viruses were propagated in Vero cell
      cultures, and viral genomes were extracted from purified virions for comparison.
      Pairwise comparisons of the oligonucleotide maps showed genetic variation among
      reovirus isolates ranging from 78% to 99%. The T1 fingerprints of the RNA of
      isolates 1103, 724, 615, and 684 differed slightly from the standard S1133
      strain, suggesting that the vaccine strain might have changed and became part of
      the circulating reoviruses. In contrast, when compared with the vaccine strain,
      isolates 902, 644, and 6207 showed greater differences in the fingerprint
      pattern. This genomic diversity may be due to the differences in immunological
      status of the affected avian population and/or due to simultaneous coinfection
      with different reovirus strains.

PMID- 1627096
TI  - Frequency of Salmonella enteritidis and other salmonellae in the ceca of spent
      hens at time of slaughter.
AB  - A study was conducted to determine the frequency of Salmonella enteritidis (SE)
      and other Salmonella serovars in the cecal contents of spent laying hens at a hen
      processing plant in the southeastern United States over a 4 1/2-month period,
      from October 1990 through February 1991. A total of 1920 pooled cecal samples
      (three ceca per sample) from 38 flocks representing 23 producers were obtained
      and tested for the presence of SE and other Salmonella serovars. A total of 359
      samples (18.7%) from 37 of the 38 flocks (97.4%) showed characteristic reactions
      for salmonellae on triple sugar iron agar (TSIA) slants. Twenty-nine of the 359
      Salmonella-positive samples (8.1%) were Group D-positive, all of which were found
      to be SE on further serotyping. The SE-positive samples were from seven of the 38
      flocks (18.4%); four flocks originated from the USDA/APHIS-designated Northern
      Region of the United States, and three were from the Southeastern Region.
      Serotyping of the 330 TSIA-positive Group-D negative Salmonella revealed 37
      different serovars. S. heidelberg, the predominant serovar, was identified in
      49.1% of these isolates.

PMID- 1627097
TI  - Prevalence of Salmonella enteritidis in spent hens.
AB  - As part of a USDA/APHIS study on the prevalence of Salmonella enteritidis in
      spent laying hens, 3700 pooled cecal samples were cultured for Salmonella.
      Samples were received from a single processing plant and represented 81
      commercial egg-type layer flocks from nine southern states. Salmonella were
      isolated from 2418 of the 3700 (65.4%) cecal pools, but only six isolates were
      serotype enteritidis. S. enteritidis was isolated from three flocks from two
      states but was detected in only six of 140 samples from those flocks. Various
      Salmonella isolation media and procedures were compared. Xylose-lysine-tergitol-4
      plates detected 64% of the total Salmonella-positive cecal samples. Brilliant
      green agar with novobiocin detected 72% of the total Salmonella-positive samples.
      When used in combination, 82% of the positive samples were detected with these
      two plates. The remaining 425 Salmonella-positive samples were detected after
      delayed secondary enrichment.

PMID- 1627098
TI  - Transmission of Pasteurella multocida on California turkey premises in 1988-89.
AB  - Restriction endonuclease analysis (REA) of whole-cell DNA was used to determine
      possible sources of Pasteurella multocida for each outbreak of fowl cholera
      occurring in turkey flocks in eight commercial poultry companies in California
      from October 1988 to September 1989. Over this period, 179 isolates of P.
      multocida were obtained from dead turkeys in 80 meat and breeder flocks on 43
      premises. P. multocida was isolated from wildlife on five premises. Isolates were
      characterized by subspecies, serotype, presence of plasmid DNA, and REA type. In
      52 (65%) flocks, all isolates of P. multocida had the same REA pattern as the M9
      live vaccine strain following digestion of DNA with the restriction enzyme SmaI.
      Field strains of P. multocida were obtained from 27 (34%) flocks, and one flock
      (1%) yielded both M9 and a field strain of the organism. REA of field strains of
      P. multocida revealed 17 different SmaI REA types. Based on matching SmaI REA
      types, potential sources of P. multocida were identified for 15 of the 28 flocks
      infected with field strains of the organism, and transmission between turkey
      premises was a possibility in only seven flocks.

PMID- 1627099
TI  - Restriction endonuclease analysis of Pasteurella multocida isolates from three
      California turkey premises.
AB  - Three California turkey premises that had repeated outbreaks of fowl cholera were
      studied for periods of 2 to 4 years. Using biochemical, serologic, plasmid DNA,
      and restriction endonuclease analyses of isolates of Pasteurella multocida from
      turkeys and wildlife on the premises, strains of the organism were found to be
      enzootic on two of the premises. On the third, a variety of strains of P.
      multocida were isolated from fowl cholera outbreak flocks.

PMID- 1627100
TI  - Necrotizing typhlocolitis associated with a spirochete in rheas (Rhea americana).
AB  - Necrotizing typhlocolitis was diagnosed in 13 juvenile common rheas (Rhea
      americana) from three separate of geographically isolated Ohio flocks, with
      mortality ranging from 25% to 80%. At postmortem examination, a diphtheritic
      membrane covered ulcerated cecal mucosa. Histologically, cecal sections showed
      necrosis and granulomatous-to-suppurative inflammation that extended into the
      submucosa and often surrounded large eosinophilic colonies of bacteria. Warthin
      Starry staining showed these colonies to be composed of entangled spirochetes
      that invaded the submucosa and frequently were present transmurally. Similar
      organisms were identified by Warthin-Starry staining in the cecum of a juvenile
      rhea from a fourth flock that histologically had mild lymphocytic typhlitis.
      Scanning and transmission electron microscopy demonstrated the presence of a
      spirochete in the ceca. Anaerobic culture yielded a gram-negative, beta-hemolytic
      spirochete. Coccidia, histomonads, and Salmonella spp. were consistently absent.

PMID- 1627101
TI  - Spondylitis in turkeys associated with experimental Pasteurella anatipestifer
      infection.
AB  - Nine previously vaccinated turkeys were inoculated intravenously with Pasteurella
      anatipestifer, and blood samples were taken periodically to evaluate the
      potential of chronically infected turkeys to serve as reservoirs of infection for
      blood-feeding arthropod vectors. Vertebral osteomyelitis (spondylitis), as yet
      unreported in the literature in association with infection with the organism, was
      found in the thoracic vertebrae of five out of nine inoculated turkeys, and P.
      anatipestifer was isolated from the thoracic vertebrae of three of the five. The
      organism was isolated from the peripheral blood of six turkeys 24 hours
      postinoculation and from the peripheral blood of one turkey 7 days
      postinoculation. The organism was also isolated from the heart blood of two birds
      at necropsy--from one at 21 days and, following an intramuscular injection of
      dexamethasone, from the other turkey at 38 days postinoculation.

PMID- 1627103
TI  - Pathogenicity of Salmonella pullorum in northern bobwhite quail and mallard
      ducks.
AB  - Ten-day-old northern bobwhite quail and mallard ducks were inoculated orally and
      intravenously with Salmonella pullorum at selected concentrations (10(3) to
      10(10) colony-forming units). Mortality in bobwhites ranged from 65% to 100%,
      whereas no mallards died or exhibited any signs of morbidity. Significantly (P
      less than 0.05) increased values for serum calcium, uric acid, and lactate
      dehydrogenase were observed in mallards inoculated with live S. pullorum, and
      antibody titers were detected as early as 1 week postinoculation. Viable bacteria
      were cultured from feces, liver, lungs, heart, kidneys, pancreas, and spleen of
      bobwhites and from livers of four mallards. Bacterial colonies were frequently
      found in the capillaries of various organs of the quail, particularly in the
      heart and kidneys, with slight-to-moderate diffuse or multifocal necrotizing
      inflammation present in all organs examined. Bobwhites are susceptible to
      infection from S. pullorum, with morbidity and mortality rates similar to those
      of chicks and poults, whereas mallards undergo a short, subclinical infection
      that is resolved without lasting tissue damage.

PMID- 1627102
TI  - Binding of Salmonella strains to immobilized intestinal mucosal preparations from
      broiler chickens.
AB  - The binding kinetics of radiolabeled Salmonella california 1989/O (mannose
      sensitive hemagglutinin-positive [MSHA+]) to immobilized mucus or enterocytes
      isolated from broiler ceca and inhibition of binding by D-mannose and sodium
      metaperiodate were characteristic of adherence of mannose-sensitive type 1
      fimbriae of bacteria to eukaryotic mannose-containing receptors. Binding by
      radiolabeled strains 1989/O (in the presence of D-mannose) and S. typhimurium S
      7471 N (MSHA-, non-fimbriated) indicated non-specific binding that was
      characterized by less binding to enterocytes and mucus and lack of inhibition by
      carbohydrates or prior treatment with sodium metaperiodate. Inhibition of non
      specific binding to enterocytes by pretreatment with various enzymes or by the
      presence of tetramethylurea or p-nitrophenol (known to disrupt hydrophobic
      interactions) indicate involvement of multiple sites and hydrophobic bonding.
      Strain-specific outer-membrane preparations inhibited non-specific binding to a
      greater extent than did lipopolysaccharide, Escherichia coli outer-membrane
      preparations, or bovine serum albumin.

PMID- 1627104
TI  - Pathological study of lead poisoning in whooper swans (Cygnus cygnus) in Japan.
AB  - During spring 1989, thirty-three whooper swans (Cygnus cygnus) died at Lake
      Miyajima in Hokkaido, Japan; 15 were examined. The birds were diagnosed as having
      subacute lead poisoning due to ingestion of spent lead shot. The main gross
      findings were bile-stained liver, edematous or gelatinous bone marrow, bile
      stained lining with hyperkeratosis and lead pellets in the gizzard, and
      proventricular impaction. Histopathologically, there was lead-hemolytic jaundice
      of the liver, hemosiderosis in the liver and spleen, and hypoplasia of the bone
      marrow with increased numbers of polychromatic erythroblasts. Acid-fast
      intranuclear inclusion bodies were seen in kidneys of seven swans. Under electron
      microscopy, inclusion bodies had frayed contours and consisted of high-electron
      dense fine granules. The lead concentration of the liver ranged from 5.5 to 44.3
      mg/kg wet weight. It was suggested that these changes resulted from excess
      breakdown of erythrocytes, inhibition of heme synthesis, and impaired
      erythropoiesis caused by lead shot.

PMID- 1627105
TI  - Molecular characterization of Salmonella enteritidis isolates from Maine poultry
      and poultry farm environments.
AB  - Eighty-six Salmonella enteritidis isolates obtained during a surveillance program
      of poultry farms in Maine were subjected to phage-typing, plasmid profiling and
      fingerprinting, outer-membrane polypeptide analysis, and antimicrobial
      sensitivity testing. Isolates were obtained from a variety of sources, including
      poultry-farm environmental samples, chicken organ samples, human stool samples,
      cat feces, and live-trapped rats and mice. These isolates were compared with 21
      S. enteritidis isolates originating outside of Maine. Phage types isolated in
      Maine included 13a (60%); 14b (29%); 23 (5%); 8 (2%); and 2 (2%). All S.
      enteritidis isolates from Maine carried plasmid DNA, and 97% of these isolates
      carried a 40.3-megadalton plasmid alone (6%) or in conjunction with several
      smaller plasmids (91%). All 52 phage-type 13a isolates harbored 40.3- and 3.0
      megadalton plasmids. All 25 phage-type 14b isolates carried 3.3- and 1.3
      megadalton plasmids, and 22 isolates also carried the 40.3-megadalton plasmid.
      All isolates displayed highly similar outer-membrane polypeptide profiles and
      were sensitive to a variety of antimicrobials commonly used against gram-negative
      organisms. The above data suggest that phage type and plasmid content may be
      related in the cases of phage-type 13a and 14b isolates, and that traditional
      plasmid-borne antimicrobial resistance determinants were not present in Maine
      isolates. Results also indicate that phage-typing can be a valuable
      epizootiological tool for monitoring the potential spread of these strains
      throughout the Northeast.

PMID- 1627106
TI  - Effect of nitrofurazone or novobiocin on Salmonella enteritidis cecal
      colonization and organ invasion in Leghorn hens.
AB  - Nitrofurazone (433 mg/liter drinking water) administration to leghorn laying hens
      for 72 hours with a 48-hour withdrawal period before nitrofurazone-sensitive
      Salmonella enteritidis challenge resulted in a S. enteritidis culture-positive
      rate significantly (P less than 0.05) higher than that of unmedicated controls
      when hens were cultured 6 days following challenge. In a similar experiment,
      simultaneous nitrofurazone administration and S. enteritidis challenge resulted
      in no significant differences in S. enteritidis isolation frequency. However,
      unchallenged nitrofurazone-medicated contact control hens showed a significantly
      higher S. enteritidis culture-positive rate than the unchallenged unmedicated
      controls. This increase in apparent S. enteritidis susceptibility was associated
      with significantly lower cecal propionic acid and fewer anaerobic colony-forming
      units (CFU). In a third experiment, nitrofurazone treatment had no effect when
      the antibiotic was withdrawn 72 hours before S. enteritidis challenge. In a
      subsequent experiment, novobiocin (385 mg/kg) or nitrofurazone (300 mg/kg) was
      administered to adult hens for 7 days before challenge with nitrofurazone and
      novobiocin-resistant S. enteritidis. Both nitrofurazone and novobiocin
      administration resulted in a significantly higher S. enteritidis culture-positive
      rate than unmedicated controls at end of the experiment 7 days post-challenge.
      Results indicate that administration of some antibiotics may enhance
      susceptibility to S. enteritidis in leghorn hens.

PMID- 1627107
TI  - Characteristics of conjugative R-plasmids from pathogenic avian Escherichia coli.
AB  - Three of four virulent avian Escherichia coli isolates transferred a single large
      molecular-weight R-plasmid to two recipient E. coli strains. Antibiotic
      resistances transferred included streptomycin (two isolates) and streptomycin
      tetracycline-sulfa (one isolate). Production of colicin and siderophores,
      complement resistance, and embryo lethality present in the virulent isolates were
      not transferred to recipient organisms. From the results, it appears that the R
      plasmids of these virulent avian E. coli are not associated with virulence.

PMID- 1627108
TI  - Inability of so-called chicken anemia agent (CAA) infections to be diagnosed by
      anemia and hematopoietic organ atrophy alone.
AB  - In the recent past, anatomic and clinical pathologic diagnoses of so-called
      chicken anemia agent (CAA) infections have been based on lesions such as anemia
      and hematopietic organ atrophy (HOA). In the present study, significant (P less
      than or equal to 0.05) positive and negative correlations were seen in a lesion
      matrix constructed from 89 cases of anemia and HOA in Georgia broilers during
      1988 and 1989. Only splenic atrophy and bursal atrophy were not significantly
      associated. We concluded that information regarding only HOA and anemia is not
      sufficient to allow pathologists to diagnose CAA in broiler chickens submitted to
      diagnostic laboratories such as ours.

PMID- 1627109
TI  - Pathogenicity of Campylobacter jejuni for turkeys and chickens.
AB  - A Campylobacter jejuni isolate obtained from a turkey liver, designated C101, and
      a C. jejuni isolate obtained from the feces of a chicken, designated C111, were
      used to inoculate their respective hosts. Isolate C101 depressed weight gain by
      20% when inoculated into newly hatched poults or 4-day-old poults. It also caused
      death, hepatic necrosis, and generalized hemorrhages in turkey embryos. The
      chicken-derived isolate, C111, did not reduce weight gain in newly hatched
      chicks, but it did induce mortality in chicken embryos. The supernatant of the
      cultures of both C. jejuni isolates also caused mortality in embryos.

PMID- 1627110
TI  - Optimum conditions for the turkey lymphocyte transformation test.
AB  - Optimum conditions for turkey lymphocyte transformation tests were determined.
      Thrice-washed turkey buffy-coat cells obtained after slow centrifugation (40 x g,
      10 minutes) responded well to mitogenic stimulation. Turkey lymphocytes isolated
      on Ficoll-containing separation media largely lost their ability to respond to
      mitogens. Maximum responses were obtained with 2 x 10(7) lymphoid cells/ml.
      Responses to the mitogens were greatest when bovine fetal serum was used at a
      2.5% concentration or pooled turkey serum and autologous plasma were used at a
      1.25% concentration. Higher concentrations of turkey serum or plasma decreased
      the responses when sub-optimum doses of concanavalin-A (Con A) or
      phytohemagglutinin-P (PHA-P) were used. Serum-free cultures gave higher
      stimulation indices than cultures with serum only when sub-optimum doses of Con A
      or PHA-P were used. Optimum mitogen concentrations varied with individual birds,
      timing of the culture, temperature of incubation, and serum concentration in the
      cultures. Responses were usually greatest with final concentrations of 5
      micrograms Con A/ml, 10 micrograms PHA-P/ml, and 20 micrograms pokeweed mitogen
      (PWM)/ml and when the cultures were incubated in 96-well microplates at 40 C in
      humidified air with 5% CO2 for 40-42 hours with pulsing with 3H-thymidine during
      the final 16 hours of incubation.

PMID- 1627111
TI  - Comparison of a complement resistance test, a chicken embryo lethality test, and
      the chicken lethality test for determining virulence of avian Escherichia coli.
AB  - Results with four pathogenic avian Escherichia coli isolates and one avirulent
      isolate in a complement resistance test, a chicken lethality test, and a chicken
      embryo lethality test were compared. Results of the complement resistance test
      with these isolates were highly correlated to results of the chicken lethality
      test of virulence. The chicken embryo test yielded results that were of a medium
      positive correlation with the chicken lethality results. The results of the
      complement resistance and chicken embryo lethality tests were highly correlated.

PMID- 1627112
TI  - Vaccination of turkeys with cell-free culture filtrate of Pasteurella multocida:
      effects of ultrafiltration and endotoxin removal.
AB  - Cell-free culture filtrate (CCF) of Pasteurella multocida strain R44/6 (serotype
      3/4/9/12) was fractionated by ultrafiltration into fractions of less than 10,000,
      greater than 10,000, greater than 30,000, and 10,000 to 30,000 molecular weight
      (MW). The less-than-10,000-MW fraction contained little endotoxin comparable to
      bacteriologic medium; the 10,000-to-30,000-MW fraction had a moderate amount of
      endotoxin, whereas the greater-than-10,000- and greater-than-30,000-MW fractions
      contained high levels of endotoxin. Following ultrafiltration, each fraction,
      except the less-than-10,000-MW fraction, was divided into two equal parts, and
      endotoxin was removed from one part. Turkeys were vaccinated with the various MW
      fractions of CCF, with and without endotoxin, via the air sacs at 6 and 9 weeks
      of age and compared with negative controls given bacteriologic medium and
      positive controls vaccinated with a commercial bacterin. Before oral challenge
      with strain P-1059 (serotype 3) at 12 weeks of age, antibody titers were detected
      only in positive control turkeys. Protection against challenge, as measured by
      post-challenge mortality and body-weight gain, was provided by the greater-than
      10,000-, greater-than-30,000-, and 10,000-to-30,000-MW fractions containing
      endotoxin and the commercial bacterin. Turkeys that had been vaccinated with
      bacteriologic medium and the four different fractions without endotoxin were not
      protected. Results indicated that endotoxin in CCF of P. multocida is critical in
      protecting turkeys from pasteurellosis.

PMID- 1627113
TI  - Packed cell volume reference intervals to aid in the diagnosis of anemia and
      polycythemia in young broiler chickens.
AB  - Packed cell volume (PCV) reference intervals were established for use in
      diagnosing anemia and polycythemia in young broiler chickens. Blood samples were
      collected from one hundred twenty 3-to-49-day-old clinically healthy
      conventionally reared broiler chickens. PCVs were determined and analyzed. PCVs
      regressed significantly (P less than 0.025) on age, which shows that neonatal
      physiologic anemia occurs in broiler chickens, as well as in mammals and specific
      pathogen-free (SPF) chickens. The definition for anemia in broiler chicks varies
      with age. We defined anemia as a PCV less than or equal to 26%, 29%, 33%, 32%,
      33%, 33%, 31%, and 28% for broiler chickens, 3, 7, 14, 21, 28, 35, 42, and 49
      days old, respectively. We define polycythemia as a PCV greater than or equal to
      42%, 43%, 41%, 40%, 42%, 42%, 41%, and 40% for broiler chickens 3, 7, 14, 21, 28,
      35, 42, and 49 days old, respectively. Otherwise, broiler chickens have PCVs
      within established reference intervals. Results provide guidelines for detecting
      anemia and polycythemia in young broiler chickens of various ages.

PMID- 1627114
TI  - Toxicological pathology of cockleburs (Xanthium spp.) for broiler chickens.
AB  - Spiking mortality syndrome (SMS) in chickens resembles cocklebur toxicity in
      cattle, sheep, pigs, and rats. In order to determine if cockleburs are toxic to
      broiler chicks, crushed burs were fed (25% wt:wt) to broilers for 21 days.
      Ingestion of cockleburs resulted in significant failure to properly gain body
      weight. Otherwise, chicks did not develop clinical signs of illness or gross or
      microscopic lesions. Although there were some significant differences in serum
      chemistry values among chick groups, there were no consistent patterns. Severe
      hypoglycemia is said to be a characteristic finding in chicks that die with SMS.
      Because glucose levels were not low in chicks that were fed cockleburs, we feel
      certain that cockleburs do not cause SMS.

PMID- 1627116
TI  - Fumonisin mycotoxicosis in broilers: performance and pathology.
AB  - Fusarium moniliforme culture material containing fumonisin B1 at 300 mg/kg was
      incorporated into a broiler starter ration and fed ad libitum to 1-day-old
      broiler chicks for 2 weeks in two experiments. Clinical features of the disease
      produced included diarrhea, a 19% reduction in body weight, a 30% increase in
      relative liver weight, and a worsening of feed conversion by 20 points at 2 weeks
      of age. Histologically, chicks fed fumonisin had multifocal hepatic necrosis,
      biliary hyperplasia, muscle necrosis, intestinal goblet-cell hyperplasia, and
      rickets. Simultaneous feeding of 0.5% aluminosilicate had no effect on the
      clinical disease or lesions. The clinical disease and lesions induced mimicked
      those of a viral enteritis.

PMID- 1627115
TI  - Use of the fluorochromes xylenol orange, calcein green, and tetracycline to
      document bone deposition and remodeling in healing fractures in chickens.
AB  - The fluorescent calcium binding dyes xylenol orange, calcein green, and
      tetracycline were used successfully to sequentially label new bone deposition and
      bone remodeling during the healing of rigidly fixed humeral fractures in the
      chicken. Xylenol orange and calcein green, administered subcutaneously at 90
      mg/kg and 10 mg/kg, respectively, provided easily identified and differentiated
      bands in newly deposited bone within periosteal and endosteal calluses,
      intercortical gaps, and screw holes. Tetracycline, administered at 50 mg/kg per
      os by crop tube, labeled bone faintly in a non-specific manner. Parenteral
      administration of the same compound might have yielded better results.

PMID- 1627117
TI  - Cloacal flora isolated from wild black-bellied whistling ducks (Dendrocygna
      autumnalis) in Laguna La Nacha, Mexico.
AB  - Cloacal swabs from 110 adult black-bellied whistling ducks trapped at Laguna La
      Nacha, Tamaulipas, Mexico, were cultured to determine the prevalence of normal
      and potentially pathogenic bacteria. Twenty-five gram-negative enterobacteria and
      four gram-positive cocci were isolated. The most common isolates included
      Escherichia coli (54%), Staphylococcus spp. (29%), Streptococcus spp. (22%),
      Aeromonas hydrophila (15%) Enterobacter cloacae (14%), and Micrococcus sp. (14%).
      The implications of whistling ducks as possible reservoirs of pathogenic bacteria
      are discussed.

PMID- 1627118
TI  - High mortality of domestic turkeys associated with Ascaridia dissimilis.
AB  - Third- and fourth-stage Ascaridia dissimilis larvae were isolated from commercial
      white turkey intestinal scrapings from two farms that were experiencing high
      mortality. Lesions consisted of a necrotic-like enteritis that was most severe in
      the jejunum. Subsequent bacteriological isolation yielded heavy growth of
      Escherichia coli and Clostridium perfringens. The rate of mortality declined
      rapidly when the turkeys were administered 18 ppm fenbendazole for 7 days.

PMID- 1627119
TI  - Squamous-cell carcinoma on the legs of an Aracauna chicken.
AB  - Squamous-cell carcinoma was diagnosed on both legs of a 6-year-old pet Aracauna
      chicken. Grossly, the tumors were raised and horny with superficial ulceration.
      Histologically, the tumors were highly invasive, extending deep into the dermis,
      tendon sheaths, and periosteal tissues. There was no evidence of vascular
      invasion or metastasis to other organs.

PMID- 1627120
TI  - Doxycycline plasma concentrations in macaws fed a medicate corn diet.
AB  - A trial was conducted to determine the doxycycline plasma concentrations attained
      by feeding a medicated corn diet to large psittacine birds. Doxycycline is the
      preferred drug for the treatment of chlamydiosis in psittacine birds. Healthy
      macaws were fed a 0.1% doxycycline-medicated corn diet for 45 days, and plasma
      doxycycline concentrations were determined by microbiological assay on treatment
      days 3, 15, 30, and 45. Plasma doxycycline concentrations exceeded 1 microgram/ml
      in 87% of the samples assayed. As blood concentrations of 1 microgram/ml are
      considered therapeutic, a doxycycline-medicated corn diet may be efficacious in
      the treatment of chlamydiosis in large psittacine birds.

PMID- 1627121
TI  - Description of a microfilaria from an umbrella cockatoo (Cacatua alba) and an
      unsuccessful attempt to infect mosquitoes (Culex pipiens pipiens).
AB  - Unidentified microfilariae circulating in the blood of an umbrella cockatoo
      (Cacatua alba) are described. They are ensheathed, measure 102-152 microns long
      and 2-3 microns in diameter, and have four distinct and consistent gaps in the
      nuclear column. Attempts to infect mosquitoes (Culex pipiens pipiens) with the
      microfilariae were unsuccessful.

PMID- 1627122
TI  - Thermal biofeedback treatment of mild hypertension. A comparison of effects on
      conventional and ambulatory blood pressure measures.
AB  - Several studies have produced results suggesting that thermal biofeedback
      treatment is effective in lowering the blood pressure (BP) of individuals with
      both mild and moderate essential hypertension. This study used thermal
      biofeedback to treat 9 unmedicated individuals with mild hypertension. Subjects
      underwent 24-hour ambulatory BP monitoring both prior to and following the
      thermal biofeedback treatment regimen. Four of the subjects were considered
      treatment successes using standard office blood pressure assessments as the
      success-fail criteria. However, 24-hour ambulatory BP measures showed a markedly
      different pattern of results, with several subjects who were considered successes
      under conventional assessment techniques showing an increase in 24-hour
      ambulatory BP from pre- to posttreatment. There was a significant decrease in
      diastolic blood pressure for all subjects as measured by the ambulatory method.
      There was also a significant decrease in systolic and diastolic standing home
      blood pressure. The implications of these results are discussed.

PMID- 1627123
TI  - Development of the feminine gender role stress scale. A cognitive-behavioral
      measure of stress, appraisal, and coping for women.
AB  - The cognitive appraisal of threats and challenges to sterotypical feminine gender
      role coping behavior was defined as feminine gender role stress (FGRS). This
      article describes the development of a self-report measure of FGRS. Situations
      perceived as more stressful for women than for men wer categorized by factor
      analysis, yielding the following constellation of maladaptive stress responses
      particularly salient for women: (a) fear of unemotional relationships, (b) fear
      of being unattractive, (c) fear of victimization, (d) fear of behaving
      assertively, and (e) fear of not being nurturant. Women demonstrated
      significantly higher FGRS appraisal scores than men, and scores among women
      showed good 2-week test-retest reliability. The tendency to appraise situations
      on the FGRS scale as stressful was associated with the tendency to consider daily
      hassles stressful but was not related to self-perceived femininity in women. It
      was predicted that women who tend to exhibit the FGRS appraisal style would have
      more difficulty in coping with stressors related to depression. Supporting this
      hypothesis, women with higher FGRS scores reported greater depression than those
      with lower scores. The assessment of FGRS appraisal and coping style in women
      provides useful information for devising treatment strategies to improve women's
      health through promotion of adaptive coping.

PMID- 1627124
TI  - Proteolytic processing of amyloid beta protein precursor (APP) by thrombin.
AB  - Search for proteases responsible for an altered processing of APP which generates
      intermediates containing beta/A4 peptide is preceding to understand the formation
      of beta amyloid deposits characteristic of Alzheimer's disease, since many
      studies reveal that APP is ordinarily processed so as not to generate beta
      amyloid. Here, we have examined the action of thrombin, a serine protease in the
      blood clotting, in APP processing. Thrombin cleaved the mouse recombinant APP695
      in vitro, resulting in the accumulation of 28 kDa fragment. The immunoblot
      analysis showed that the fragment is derived from the carboxy-terminal side of
      the recombinant APP695. Further, amino acid sequencing exhibited that the
      fragment is generated by the cleavage at Arg 510-Ile 511 and therefore includes
      entire beta/A4 peptide. We consider that the 28 kDa fragment is a possible
      intermediate for beta/A4 peptide. Thus thrombin may be involved in the altered
      processing of APP.

PMID- 1627125
TI  - Variable tRNA content in HIV-1IIIB.
AB  - Low molecular weight RNA in HIV-1 is found in three size classes resembling 7S
      RNA, 5S RNA, and tRNA. The 2-dimensional polyacrylamide gel electrophoresis (2D
      PAGE) patterns of tRNA found in HIV-1 have been determined in virus produced in
      five different cell types: H9, UHC1 (a U937-derived clone), UHC8 (an RT(-)
      derivative of U937), HeLa, and COS. The presence of the putative primer tRNA for
      reverse transcriptase, tRNA(Lys,3), has also been determined either by
      hybridization with a tRNA(Lys,3)-specific DNA probe or by a comparison of the
      electrophoretic mobility of viral tRNA species with purified human tRNA(Lys,3).
      Our results indicate the following: 1) The number of tRNA species found in
      infectious HIV-1IIIB produced in different cell types varies, according to cell
      type, from greater than 20 to 4, indicating that only 4 or less tRNA species are
      required for the viral infectious life cycle. 2) There are 1-3 tRNA species
      tightly associated to the viral genomic RNA, depending upon the cell type
      producing the virus. 3) The putative primer tRNA, tRNA(Lys,3), is detected with
      the tRNA(Lys,3)-specific hybridization probe in the tRNA of HIV-1 produced in H9
      cells, and the tightly associated tRNA species in this virus has the same
      electrophoretic mobility in 1-D PAGE as purified tRNA(Lys,3). On the other hand,
      we cannot detect tRNA(Lys,3) in the tRNA of HIV-1 produced in HeLa cells, and the
      tightly associated tRNA found in this virus does not migrate with the same
      electrophoretic mobility as tRNA(Lys,3).

PMID- 1627127
TI  - Association of the carboxy-terminus of beta-amyloid protein precursor with
      Alzheimer paired helical filaments.
AB  - We investigated whether a peptide fragment from the C-terminus of beta-amyloid
      protein precursor is associated with Alzheimer paired helical filaments (PHFs).
      Antiserum BR188, to the last 20 amino acids of the precursor, did not cross-react
      with tau protein, known to be in PHFs. It did react with all five pronase-treated
      PHF preparations assayed by ELISA and immunogold-labelled the same PHF fibrils
      that a PHF-specific tau antibody labelled. Neither antibody labelled beta/A4
      fibrils. These results suggest that a fragment from the C-terminus of beta
      amyloid precursor protein copurifies with pronase-treated PHFs and may play a
      role in their molecular pathogenesis.

PMID- 1627126
TI  - Inhibition of Ca(2+)-dependent catecholamine release by myosin light chain kinase
      inhibitor, wortmannin, in adrenal chromaffin cells.
AB  - To elucidate the possible involvement of myosin light chain kinase (MLCK) in the
      mechanism of exocytosis, we studied effects of MLCK inhibitor, wortmannin, on the
      secretory function of bovine adrenal chromaffin cells. Preincubation of
      chromaffin cells with wortmannin inhibited both acetylcholine- and high K(+)
      evoked catecholamine (CA) release. The IC50 for high K(+)-evoked CA release was 1
      microM. When the cells were permeabilized with digitonin after wortmannin
      preincubation, Ca(2+)-dependent exocytosis was inhibited in a dose-dependent
      manner (IC50, 1 microM). These findings suggest the implication of MLCK in the
      Ca(2+)-triggered process in the machinery of exocytosis.

PMID- 1627128
TI  - Gene expression of metalloproteinase and its inhibitor in mesangial cells exposed
      to high glucose.
AB  - To clarify the roles of metalloproteinases and their inhibitor (TIMP) in diabetic
      glomerulopathy, we studied the effect of a high glucose concentration on the gene
      expression of metalloproteinase transin and TIMP as well as collagen type IV and
      laminin in cultured rat mesangial cells (MCs). In the high glucose group,
      collagen type IV, laminin, and TIMP mRNA levels were all elevated in a
      concentration-dependent manner, whereas transin expression was suppressed.
      Osmotic control of high glucose with mannitol selectively stimulated TIMP
      expression. We hypothesize that high glucose decreases matrix-degrading activity
      as well as increases matrix productivity in MCs.

PMID- 1627129
TI  - Nonspecific primer and PCR generated hybridization probes for physical ordering
      large restriction fragments in complex genome of S. aureus.
AB  - Pulsed field gel electrophoresis (PFGE) allows separation of large restriction
      fragments from bacterial genome. Restriction fragments obtained by digestion of
      Staphylococcus aureus DNA with rare cutting enzymes (Sma I, and Csp I) were
      separated by PFGE. To arrange the physical order of the fragments generated by
      digestion with one enzyme, probes were prepared by nonspecific priming and
      polymerase chain reaction (PCR), using individual fragments of the other
      enzymatic digest as a template. Probes were then used for Southern hybridization
      to the PFGE separated fragment distribution of the two infrequent cleaving
      enzymes (Sma I and Csp I). Using probes generated from four Sma I fragments and
      five Csp I fragments as individual templates, a partial physical order of Csp I
      fragments of the genome of S. aureus ISP8 has been determined in relation to a
      previously published Sma I map of S. aureus genome.

PMID- 1627130
TI  - Evidence for the involvement of tryptophan 38 in the active site of glutathione S
      transferase P.
AB  - Glutathione S-transferase P (GST-P) exists as a homodimeric form and has two
      tryptophan residues, Trp28 and Trp38, in each subunit. In order to elucidate the
      role of the two tryptophan residues in catalytic function, we examined intrinsic
      fluorescence of tryptophan residues and effect of chemical modification by N
      bromosuccinimide (NBS). The quenching of intrinsic fluorescence was observed by
      the addition of S-hexylglutathione, a substrate analogue, and the enzymatic
      activity was totally lost when single tryptophan residue was oxidized by NBS. To
      identify which tryptophan residue is involved in the catalytic function, each
      tryptophan was changed to histidine by site-directed mutagenesis. Trp28His GST-P
      mutant enzyme showed a comparable enzymatic activity with that of the wild type
      one. Trp38His mutant neither was bound to S-hexylglutathione-linked Sepharose nor
      exhibited any GST activity. These findings indicate that Trp38 is important for
      the catalytic function and substrate binding of GST-P.

PMID- 1627131
TI  - The phosphate groups of the high mobility group like protein P1 strengthens its
      affinity for DNA.
AB  - PCA soluble proteins isolated from rat liver and proliferating HeLa interphase
      cells were subjected to chromatography on columns containing immobilized s.s and
      d.s. DNA. P1 from rat liver was eluted from s.s. and d.s. DNA between 0.20 and
      0.45 M NaCl, while dephosphorylated P1 was not retained by s.s. and d.s. DNA
      columns at 0.25 M, suggesting that phosphate groups enhance the affinity of P1
      for DNA. P1 from proliferating HeLa interphase cells exhibit increased affinity
      for d.s. as well as s.s. DNA when compared to rat liver P1. The higher extent of
      phosphorylation in proliferating cells supports the finding that phosphate
      enhances rather than reduces the affinity of P1 for DNA.

PMID- 1627133
TI  - Procalpain I in cytoplasm is translocated onto plasma and granule membranes
      during platelet stimulation with thrombin and then activated on the membranes.
AB  - Thrombin stimulation of platelets resulted in changes in the subcellular
      localization of calpain I, with a concomitant alteration of its molecular weight
      as measured by immunoblotting. Calpain I in resting platelets was distributed as
      procalpain I, an 80 kDa form which does not exhibit the enzyme activity, and 83%
      of the total antigen was localized in the cytosol fraction. When platelets were
      stimulated with thrombin, the total content of calpain I antigen was not
      significantly changed as compared with that of the resting platelets, though a
      decrease in the cytosolic distribution of 80 kDa form (from 83% to 47% of the
      total antigen) was observed with concomitant appearance of the active 76 kDa and
      intermediate 78 kDa forms of calpain I and increase in the 80 kDa form in the
      granule and membrane fractions. These results indicated that calpain I was
      translocated from the cytosol to both the plasma and granule membranes as
      procalpain I and then activated on the membranes during platelet stimulation with
      thrombin.

PMID- 1627132
TI  - Metal-inducible activities of metallothionein promoters in fish cells and fry.
AB  - Activities of trout metallothionein-A promoter and mouse metallothionein-I
      promoter in fish cells and fry were examined using the chloramphenicol
      acetyltransferase (CAT) gene as a reporter. Transfection and transient CAT assays
      on a trout liver cell line indicated that both promoters were inducible by
      metals, including zinc. In vivo activities of both promoters were examined using
      microinjection system into medaka eggs. Some of the hatched fry were exposed to
      zinc and their CAT activities were assayed. Both promoters revealed considerable
      activities after exposure to zinc while only weak activities were detected in
      unexposed fry.

PMID- 1627134
TI  - Protein-tyrosine kinase p72syk is activated by wheat germ agglutinin in
      platelets.
AB  - We previously reported a molecular cloning of porcine gene syk encoding a non
      receptor type 72-kDa protein-tyrosine kinase (Taniguchi et al. (1991) J. Biol.
      Chem. 266, 15790-15796). In this study, we have demonstrated that p72syk is
      expressed in porcine platelets at 0.1-0.2% of total protein and that the lectin
      wheat germ agglutinin induces an activation of p72syk against both auto- and
      exogenous-substrate-phosphorylation in porcine platelets. The activation of
      p72syk was abrogated by the coexistence of N-acetyl-D-glucosamine with wheat germ
      agglutinin. These data suggest that p72syk is a candidate of responsible protein
      tyrosine kinase for platelet activation and that cell surface glycoprotein is
      involved in the activation of p72syk in platelets.

PMID- 1627136
TI  - A putative new juvenile peptide hormone in lepidopteran insects.
AB  - A growth-blocking peptide (GBP) with repressive activity against juvenile hormone
      (JH) esterase has been isolated from the last (6th) instar larval plasma of the
      armyworm Pseudaletia separata (Lepidoptera: Noctuidae) parasitized by the
      parasitoid wasp Apanteles kariyai (Hymenoptera: Braconidae) (1,2). This study
      demonstrates that GBP not only exists in the plasma of parasitized last instar
      larvae, but also in the plasma of unparasitized penultimate (5th) instar larvae,
      while the plasma of last instar larvae does not contain any detectable amount of
      GBP. The detection of GBP in unparasitized penultimate instar larvae, before the
      final larval molt, demonstrates that this factor is naturally occurring in the
      insect larva before the last larval instar and is seemingly coordinating, along
      with JH, the regulation of juvenile characteristics. This finding suggests the
      existence of a new type of juvenile peptide hormone in lepidopteran insects.

PMID- 1627135
TI  - Inhibition of DNA polymerases by tripeptide derivative protease inhibitors.
AB  - Benzyloxycarbonyl(Z)-Leu-Leu-Leu-al and dansyl(Dns)-Leu-Leu-Leu-CH2Cl, well known
      as protease inhibitors, effectively inhibit the activities of DNA polymerases
      alpha, beta and gamma from rat liver and pol I from Escherichia coli, but the
      ability of these inhibitors to inhibit terminal deoxynucleotidyl transferase
      (TdT) is weak. The mode of inhibition by these tripeptide analogues is non
      competitive with dNTP. The Ki values for Z-Leu-Leu-Leu-al and Dns-Leu-Leu-Leu
      CH2Cl are 6.25 x 10(-5) M and 6.56 x 10(-5) M, respectively.

PMID- 1627137
TI  - Competitive protein binding assay for activin A/EDF using follistatin
      determination of activin levels in human plasma.
AB  - A sensitive and specific protein binding assay for activin A/EDF (activin) was
      developed using follistatin as a binding protein and [125I] labelled activin as a
      tracer. As 50% acetonitrile (CH3CN) separated free and follistatin-bound activin,
      plasma pretreated with an equal volume of CH3CN was used as the assay sample and
      B/F separation was also done with 50% CH3CN. The recovery of the assay was 85.0%
      and its sensitivity was 0.5 ng/ml. Crossreactivity with inhibin A was 1.8%. The
      mean plasma level of follistatin-free activin in normal subjects was 1.3 +/-
      0.7%. (M +/- SD) ng/ml. Plasma free activin levels were generally elevated in
      patients with chronic renal failure or hematological diseases associated with
      anemia.

PMID- 1627138
TI  - Post-translational modifications in the collagen of human osteoporotic femoral
      head.
AB  - No detailed biochemical analysis has been made of the possible compositional
      changes in the collagen relating to the fragility of osteoporotic bone. We report
      for the first time significant changes in the compositional properties of the
      collagen. The major differences were observed in the post-translational
      modifications, namely, in the hydroxylation of lysine residues and the nature of
      the stabilizing cross-links of the collagen fibre. The increase in hydroxylation
      was greater in the head region compared to the neck region of the femoral head,
      whilst the decrease in the intermediate cross-links was greater in the neck
      region. Clearly, the collagen is altered in osteoporosis and it is important that
      these changes are recognised in studies of bone metabolism in osteoporosis since
      they may play a role in the pathogenesis of the disease.

PMID- 1627139
TI  - Increase in cytoplasmic Ca2+ and stimulation of calcitonin secretion from human
      medullary thyroid carcinoma cells by the gastrin-releasing peptide.
AB  - Examination was made of the effects of gastrin-releasing peptide (GRP) on human
      medullary thyroid carcinoma cells (TT cells). GRP stimulated calcitonin(CT)
      release in a concentration-dependent manner at 0.1-1000 nmol/l. On adding
      forskolin along with GRP, CT release was greater than by GRP alone. The
      stimulatory effect of A23187 was not additive. Intracellular free calcium
      concentration ([Ca2+]i) was measured for individual TT cells loaded with fura-2.
      The addition of GRP caused a rapid and transient rise in [Ca2+]i in a
      concentration-dependent manner followed by a sustained increase in [Ca2+]i. In
      the medium without Ca2+, this sustained increase did not occur and the
      concentration of CT release from TT cells by GRP was reduced by approximately a
      half. GRP would thus appear to be importantly involved in the regulation of
      thyroid C cell function through modulation of [Ca2+]i.

PMID- 1627140
TI  - N-and O-acetylation of aromatic and heterocyclic amine carcinogens by human
      monomorphic and polymorphic acetyltransferases expressed in COS-1 cells.
AB  - Human monomorphic and polymorphic arylamine acetyltransferases (EC 2.3.1.5) were
      expressed in monkey kidney COS-1 cells and used to study the N- and O-acetylation
      of a number of carcinogenic amines and their N-hydroxy metabolites. The
      monomorphic enzyme N-acetylated the aromatic amines, 2-aminofluorene and 4
      aminobiphenyl, and also O-acetylated their N-hydroxy derivatives. None of the
      food-derived heterocyclic amines (Glu-P-1, PhIP, IQ, MeIQx) were substrates and
      their N-hydroxy metabolites were poorly O-acetylated by this isozyme. By
      contrast, the polymorphic acetyltransferase catalyzed the N-acetylation of both
      aromatic amines, and to a lesser extent, Glu-P-1 and PhIP. However, all six N
      hydroxy amine substrates were readily O-acetylated to form DNA-bound adducts by
      the polymorphic isozyme. These data suggest that, for the heterocyclic amine
      carcinogens, rapid acetylator individuals will be predisposed to their
      genotoxicity.

PMID- 1627141
TI  - Molecular cloning of rabbit cytochrome b5 genes: evidence for the occurrence of
      two separate genes encoding the soluble and microsomal forms.
AB  - The rabbit genomic segments for the soluble cytochrome b5 (b5) and microsomal b5
      were amplified and isolated, respectively, by means of the polymerase chain
      reaction using primers corresponding to various portions of the open reading
      frame of microsomal b5 cDNA. The DNA sequence analysis revealed that the soluble
      b5 gene has an extra 24 nucleotide long insert which encodes a C-terminal amino
      acid and a termination codon which are specific to the soluble b5. Except for the
      insert, the sequences of the soluble and microsomal b5 genes are identical with
      each other from the 5' end to the 3' end of the open reading frame of the
      microsomal b5 cDNA. Comparison of the genomic sequences with the cDNA sequences
      suggested that the soluble and microsomal genes are intronless within their open
      reading frames. These data indicate that rabbit soluble and microsomal b5 mRNAs
      are encoded by two highly conserved but separate genes.

PMID- 1627142
TI  - The N-terminal region of HIV-1 integrase is required for integration activity,
      but not for DNA-binding.
AB  - HIV-1 integrase binds to both double- and single-stranded DNA with Kd-values of
      around 20 nM, irrespective of sequence similarities with the termini of the viral
      LTR. For integration activity, however, the correct LTR sequence of the substrate
      is required. The putative zinc-binding site present at the N-terminus of the
      protein is not essential for DNA binding, since deletion mutants of the protein
      lacking this sequence show similar affinity towards DNA as the wild-type;
      however, these mutants are not capable of performing the LTR-cleavage and
      integration reactions. Thus, it appears that the N-terminal part of the integrase
      is essential for catalytic activity.

PMID- 1627143
TI  - Ubiquitous nuclear factors bind specifically to a 5'-region conserved in
      carcinoembryonic antigen-related genes.
AB  - We recently cloned members of the murine carcinoembryonic antigen (CEA) gene
      family, some of which are differentially expressed during placental development.
      By intra- and interspecies sequence comparisons, we identified an element in the
      putative promoter and/or 5'-nontranslated region which is conserved within all
      human and rodent CEA-related genes analyzed so far. Using gel retardation
      analysis and DNaseI hypersensitive site mapping, we now show that ubiquitously
      expressed nuclear factors specifically bind to the conserved region derived from
      the mouse gene Cea-2 in vitro and probably also in vivo. Another DNaseI
      hypersensitive site lies within or close to a simple sequence motif [(GGA)n]
      located in the first intron of Cea-2. Such sequences have been reported to play a
      role in the regulation of certain genes. Therefore, this analysis has identified
      putative regulatory regions for Cea-2 and possibly CEA-related genes in general.

PMID- 1627144
TI  - Growth inhibition of N1E-115 mouse neuroblastoma cells by c-myc or N-myc
      antisense oligodeoxynucleotides causes limited differentiation but is not coupled
      to neurite formation.
AB  - Antisense oligodeoxynucleotides were found to be stable in the culture medium
      containing fetal calf serum (heat-inactivated 30 minutes at 65 degrees C) and in
      cells. Antisense oligomer treatment causes cessation of mitoses, but does not
      lead to morphological differentiation. Under antisense conditions, we have
      observed an increase in the amount of two neurospecific protein, namely
      peripherin and gamma-enolase. Comparison of the results obtained with chemical
      inducers and antisense oligodeoxynucleotides allows us to postulate three phases
      in N1E-115 differentiation: the first correspond to the arrest of mitosis, the
      second to the expression of a limited neuronal program, and the third to the
      morphological and electrophysiological differentiation.

PMID- 1627145
TI  - Nonoxidative ethanol metabolism: expression of fatty acid ethyl ester synthase
      III in cultured neural cells.
AB  - Alcohol metabolism in the human brain has been characterized as essentially
      nonoxidative in nature, with the esterification of ethanol with fatty acids via
      fatty acid ethyl ester synthase. This pathway of ethanol metabolism is related to
      end organ damage in the brain but the neural cell type expressing FAEES has not
      been identified. In this study human and rodent neuroblastoma and glioma cell
      lines are assayed for fatty acid ethyl ester synthase activity. Cells with
      neuronal properties demonstrated higher activity than glioma cell lines. We
      confirmed the presence of the mRNA for one type of synthase, fatty acid ethyl
      ester synthase-III in three neuronal cell lines--N1E115 cells, PC12 cells, and SK
      N-MC cells. These results support the hypothesis that FAEES activity is expressed
      chiefly in cells with neuronal properties and suggest that non-oxidative ethanol
      metabolism is potentially related to the toxic effect of ethanol on the human
      brain.

PMID- 1627147
TI  - Synthesis and structure-activity relationships of elafin, an elastase-specific
      inhibitor.
AB  - Elafin, an elastase-specific inhibitor isolated from human skin, and its related
      peptides were synthesized by the solution procedure, and their inhibitory
      activities were measured against various enzymes. During the oxidative folding
      reactions of the reduced peptides, the ratio of the active product to the
      inactive product was varied by changing the concentration of guanidine HCl and
      the amount of redox reagents. The disulfide structures of fully active synthetic
      elafin and the inactive product were determined by amino acid analysis, gas-phase
      sequencing and mass spectrometry of their proteolytic fragments. The relationship
      between structure and inhibitory activities and/or the folding reaction was
      examined and the amino terminal part of the elafin molecule was found to have a
      great influence on the folding reactions, but not on the inhibitory activities.

PMID- 1627146
TI  - Estrogen receptor-induced bending of the Xenopus vitellogenin A2 gene hormone
      response element.
AB  - DNA bending is increasingly proposed as an essential step for the establishment
      of the multiprotein complexes required for transcription initiation. Polyamines
      and metallic cations, known to promote DNA-bending, enhance the binding of
      purified estrogen receptor (ER) to the estrogen response element (ERE) of the
      Xenopus vitellogenin A2 gene. Using both circular permutation electrophoretic
      mobility and cyclization assays, we provide evidence that ER bends the DNA at the
      estrogen response element. The same bending occurs as a result of estrogen
      receptor protein binding independently of its conformational changes induced by
      hormone or anti-hormone. We suggest a role of the observed DNA bending in
      estrogen-regulated transcription.

PMID- 1627148
TI  - Activin A increases cytosolic free calcium concentration in rat pituitary
      somatotropes.
AB  - The effect of activin A on the cytosolic free calcium concentration ([Ca2+]i) in
      normal rat pituitary cells was examined using a calcium sensitive fluorescent
      dye, indo 1 AM, and a digital imaging fluorescent microscope system. The cells
      showing an increase in [Ca2+]i in response to activin A were then characterized
      by comparison with cells responding to growth hormone releasing hormone (GRH),
      thyrotropin releasing hormone (TRH), corticotropin releasing hormone (CRH), and
      gonadotropin releasing hormone (GnRH) in monolayer cultures of normal rat
      pituitary cells. Activin A increased [Ca2+]i in some cells in a mixed population
      of normal rat pituitary cells. The cells that responded to activin A also
      responded to GRH. Most of these cells were not affected by other tropic hormones
      (CRH, TRH, and GnRH), but a few cells responded to both GRH and TRH. None of the
      activin A-responding cells responded to CRH or GnRH, and none of the CRH- or GnRH
      responding cells responded to activin A. In a preparation of somatotropes
      purified 80-90% by fluorescence-activated cell sorting, activin A increased
      [Ca2+]i in 30% of the cells that shows a [Ca2+]i-response to GRH. These findings
      suggest direct involvement of somatotropes in activin A-induced biological events
      in the rat pituitary gland.

PMID- 1627149
TI  - Prostacyclin administration suppresses the increase in hepatic levels of COL1A(I)
      and glyceraldehyde-3-phosphate dehydrogenase mRNAs in the rat treated with carbon
      tetrachloride.
AB  - Northern analysis using total RNAs from the component cells of normal rat liver
      indicated that COL1A(I) mRNA is present in fat-storing cells (Ito cells) and
      sinusoidal endothelial cells. A fraction for Kupffer cells also contained this
      mRNA. When CCl4 was given, COL1A(I) mRNA was increased in a factor of 1.5 in the
      fractions of these component cells. After 48 h of the drug administration,
      hepatocytes appeared to possess over 60% of liver COL1A(I) mRNA, although in
      normal hepatocytes its level was below the range detectable by our procedures.
      Under this injured condition of liver, glyceraldehyde-3-phosphate dehydrogenase
      (GAPDH) mRNA level was elevated, while activity of this enzyme was lowered by 50%
      of the control value. All the changes were obviously suppressed by the
      simultaneous administration of prostacyclin.

PMID- 1627150
TI  - Identification of two types of homologous DNA pairing activity in mouse cells.
AB  - We have identified two types of homologous DNA pairing activity in mouse cell
      extracts by a strand-transfer assay. Both activities are separated from each
      other by anion-exchange chromatography; neither of them needs ATP. One requires
      magnesium ion and is stimulated by Escherichia coli single-stranded DNA binding
      protein, whereas the other does not require the ion and shows a higher affinity
      for a left-handed Z-DNA.

PMID- 1627151
TI  - Identification of a gene encoding for the human formyl peptide receptor.
AB  - The neutrophil FMLP receptor is involved in activation and subsequent response to
      certain chemotactic stimuli. The normal receptor has been reported to consist of
      several components, ranging in size from 43-94 kDa, and to contain both high and
      low affinity states. However, limited information is available on the gene/s
      which encode for the receptor. In this study, we have generated oligonucleotide
      probes derived from a published cDNA sequence encoding for one of the components
      of the FMLP receptor, and used these probes to amplify genomic DNA from HL-60
      cells as well as normal human neutrophils, using the polymerase chain reaction.
      Such procedure resulted in the amplification of a single, approximately 1 kb
      fragment of genomic DNA identical in sequence to the cDNA described in the
      literature for one of the isoforms of the receptor. This finding supports the
      notion that the human FMLP receptor is encoded by at least one, intronless gene.

PMID- 1627152
TI  - Importance of iron in lipid peroxidation in the tyrosinase/4-hydroxyanisole
      system: possible mechanism of killing of malignant melanoma cells by 4
      hydroxyanisole.
AB  - Phospholipid peroxidation of unsaturated phospholipid liposomes in the
      tyrosinase(mushroom)-4-hydroxyanisole system was studied in both the presence and
      absence of Fe3+, as a model of melanocyte damage by this agent. Ferric ion is
      required for the lipid peroxidation, and maximal lipid peroxidation was achieved
      with a molar ratio of [Fe3+]/[4-hydroxyanisole] of about 1. The lipid
      peroxidation was significantly inhibited by ceruloplasmin (a ferroxidase),
      indicating that Fe3+, which would be coordinated with metabolites, catechols,
      should be reduced to express its oxidant property. Judging from the results
      obtained with inhibitors or scavengers of active oxygen species, O2-, H2O2, and
      .OH would not mainly involve in the lipid peroxidation.

PMID- 1627153
TI  - Characterization of a trypsin inhibitor from equine urine.
AB  - A trypsin inhibitor was isolated from pregnant mares' urine by adsorption on
      bentonite and elution with aqueous pyridine followed by batch DEAE-cellulose
      treatment and column chromatography. Final purification to an electrophoretically
      homogenous glycoprotein was achieved by gel permeation chromatography. This
      equine urinary trypsin inhibitor (E-UTI) is acid- and heat-stable, has a
      molecular weight of 22 to 23 kDa, an isoelectric point of 4.55, forms a 1:1 molar
      complex with trypsin and has serine as its N-terminal amino acid. The N-terminal
      amino acid sequence of this protein is almost identical with that of EI-14, the
      inhibitor obtained from horse serum by tryptic treatment, except for two extra
      amino acid residues, Ser-Lys- on the N-terminal end of E-UTI. In its isoelectric
      point E-UTI differs from EI-14 and the inhibitor from human urine.

PMID- 1627155
TI  - Morphological differences in crystals of multiple forms of yeast transketolase.
AB  - Monocrystals of three individual multiple forms of yeast transketolase (A, B and
      C) differing in their thermostability have been obtained. Ammonium sulfate was
      used as a precipitating agent. Crystals of the mentioned forms were found to
      possess different morphology and stability during storage. Single crystals
      growing from the enzyme form C within 4-7 days were subsequently destroyed.
      Simultaneously, in the preparation, microcrystals started to grow in a great
      number. They were found to correspond morphologically to crystals obtained from
      transketolase A. A possibility of interconversions of the enzyme forms in
      sequence C----A----B is discussed.

PMID- 1627154
TI  - Trypsin inhibitors of buffalo seminal plasma.
AB  - Two trypsin inhibitors from acid-treated buffalo seminal plasma were purified by
      gel filtration and affinity chromatography. These acid-stable trypsin inhibitors
      having charge heterogeneity were homogeneous with respect to size as revealed by
      gel filtration and SDS-PAGE. Gel filtration data suggest molecular weight value
      of 9,900 Da for inhibitor I and 10,900 Da for inhibitor II. Molecular weight
      estimated by SDS-PAGE was found to be 10,600 Da and 11,200 Da for inhibitors I
      and II, respectively. The hydrodynamic properties such as Stokes radii (1.58 nm
      and 1.62 nm); intrinsic viscosity (2.5725 ml/g and 2.5025 ml/g) and diffusion
      coefficient (13.499 x 10(-11) m2/sec. and 13.166X10(-11) m2/sec) respectively for
      inhibitor I and II were determined by analytical gel filtration. These inhibitors
      were fairly thermostable and could not be stained by PAS reagent. Both the
      inhibitors were found to inhibit buffalo acrosin but not bovine chymotrypsin.

PMID- 1627156
TI  - Age-dependent 6kb deletion in human liver mitochondrial DNA.
AB  - Using PCR technique, restriction mapping and DNA sequencing, we analyzed liver
      mitochondrial DNA (mtDNA) of 2 stillborn babies and 62 Chinese subjects with non
      liver disease from 27 to 86 years old. The results showed an age-dependent 6,063
      bp deletion in the liver mtDNA of older subjects. We found a TAACAGAC sequence
      flanking the 5'-end breakpoint at 7,842 nucleotide position and an imperfect
      repeat sequence CAACATAC flanking the 3'-end breakpoint at 13,905 nucleotide
      position. The incidence of the deleted mtDNA was found to increase with age. The
      deleted mtDNA was not detected in the liver of the stillbirth or blood cells of
      all the subjects. This is the first account that an age-related 6,063 bp deletion
      occurs in the liver mtDNA of old humans. The occurrence of this and previously
      reported 4,977 bp deletions is consistent with our recent finding that liver
      mitochondrial respiratory functions decline with age and support the hypothesis
      that continuous accumulation of mtDNA mutations is an important contributor to
      ageing process in the human.

PMID- 1627157
TI  - Reduction of immunoreactivity of bovine serum albumin conjugated with
      polyethylene glycol(PEG) in relation to its esterase activity.
AB  - Bovine serum albumin was modified with activated PEG2, 2,4-bis[O
      methoxypoly(ethylene glycol)]-6-chloro-s-triazine. The PEG-modified albumin, in
      which 15 out of the total 60 amino groups in the albumin molecule were coupled
      with activated PEG2, lost immunoreactivity towards anti-albumin serum and
      retained 63% of the esterase activity of native albumin.

PMID- 1627158
TI  - Phosphatidic acid with medium-length fatty acyl chains synergistically stimulates
      phospholipase C with Ca2+ in rabbit platelets.
AB  - The mode of phospholipase C activation in platelet cells induced by didecanoyl
      (C10)-phosphatidic acid (PA) was investigated with washed rabbit platelets. The
      C10-PA dose-dependently induced aggregation and serotonin secretion, as well as
      increases in cytoplasmic free Ca2+ concentration and 1,2-diacylglycerol
      formation. None of these responses was evoked unless Ca2+ had been added to the
      platelet suspension. Furthermore, under the conditions of various intracellular
      Ca2+ concentrations which were set by treatment of the cells with ionomycin and
      Ca2+, C10-PA promoted 1,2-diacylglycerol formation only at the Ca2+ concentration
      of 300 nM or higher, whereas thrombin induced the formation even at 100 nM Ca2+.
      These results suggest that PA activates platelet phospholipase C in cooperation
      with Ca2+ and contributes to platelet activation through such an effect.

PMID- 1627159
TI  - Interaction of membrane phospholipids with some DNA substructures studied by
      means of differential scanning calorimetry.
AB  - The interaction of dipalmitoylphosphatidylcholine, dipalmitoylphosphatidic acid
      and dipalmitoylphosphatidylethanolamine with some DNA substructures such as
      cytidine, uridine, adenosine 5'di- and triphosphate, guanosine 5'mono- and
      diphosphate, cytidine 5'mono- and triphosphate, uridine 5'mono- and triphosphate
      and inosine 5'monophosphate was studied with differential scanning calorimetry.
      The dependence of pretransition and main transition temperatures and the enthalpy
      of main transition on the molecular characteristics of the interacting molecular
      species was calculated by stepwise regression analysis. Nucleosides and
      nucleotides increased the main transition temperature and peak half width of
      phospholipids and they decreased the enthalpy of main transition proving the
      existence of interaction between phospholipids and DNA substructures. Calculation
      proved that the interaction is mainly of hydrophilic character but the
      involvement of hydrophobic forces or steric conditions cannot be ruled out.

PMID- 1627160
TI  - Structure of a Micrococcus lysodeikticus cell wall fragment containing
      phosphorylated sugars.
AB  - A polysaccharide-peptidoglycan complex containing different phosphorylated sugars
      from Micrococcus lysodeikticus cell wall has been isolated and purified. The
      peptidoglycan contained muramic acid 6-phosphate and N-acetylglucosamine 6
      phosphate as phosphorylated sugars in addition to other sugar residues. Mild acid
      hydrolysis of the peptidoglycan and subsequent reduction of the released
      polysaccharide showed therein the presence of glucose and N-acetyl-glucosamine in
      the linkage of the external polysaccharide residues to the peptidoglycan through
      phosphodiester linkage. These data suggest the presence of polysaccharide chains
      linked to a peptidoglycan core through two phosphorylated sugars via two
      different terminal carbohydrate residues of the external polysaccharide chains in
      a same polymer.

PMID- 1627161
TI  - Trehalase activity and its regulation during growth of Saccharomyces cerevisiae.
AB  - Trehalase activity decreased in 95% at the onset of the transition phase of
      growth of S. cerevisiae. The question which we raised was whether this phenomenon
      was due to proteolysis or to conversion of the enzyme to a less active form
      (dephosphorylation). Immunological methods allowed to identify the presence of
      the trehalase protein during cell growth. At the same stage of growth, an
      increase in the non-phosphorylated enzyme was detected "in vitro". Results
      utilizing mutant strains also indicated that regulation occurred by
      interconversion of forms. The same mechanism also seems to control trehalase
      activity in non proliferating conditions.

PMID- 1627162
TI  - Nuclear S1 proteins from the starfish Asterina pectinifera.
AB  - Nuclear S1 proteins are a group of proteins apparently ubiquitous in vertebrate
      cell nuclei. They were originally isolated at pH 4.9 from the supernatant of rat
      liver nuclei mildly digested with DNase I. In the present study, under the
      conditions identical to those employed for vertebrate cells, we identified two S1
      proteins in the starfish Asterina Pectinifera. Their molecular weights are 47,200
      and 39,000. This finding suggests widespread occurrence of S1 proteins in
      eukaryotes and their basic function in the cell nucleus.

PMID- 1627163
TI  - E. coli gpt gene expression effects on K562 human leukemia cell proliferation and
      erythroid differentiation altered by mycophenolic acid.
AB  - Inosine monophosphate dehydrogenase (IMPDH, EC 1.1.1.205) inhibitors including
      mycophenolic acid (MPA) were reported to induce K562 human leukemia cells to
      differentiate into erythroid cells. A shuttle vector plasmid pMSG containing E.
      coli xanthine-guanine phosphoribosyl transferase (Eco gpt) gene was transfected
      into K562 cells (K562-pMSG cells) to investigate the role of IMPDH in both K562
      cell proliferation and erythroid differentiation. Eco gpt provides K562 cells
      with an additional salvage pathway for GMP production from xanthine. In the
      presence of xanthine, K562-pMSG cells continued to proliferate and did not
      differentiate to erythroid cells regardless of the presence of MPA, but they
      discontinued proliferating and differentiated into the erythroid lineage in the
      absence of xanthine. Proliferation and differentiation of control K562 cells into
      erythroid cells were suppressed by MPA regardless of the presence or absence of
      xanthine. Addition of guanosine maintained the proliferation and blocked the
      erythroid differentiation of K562 and K562-pMSG cells induced by MPA even in the
      absence of xanthine. These data indicate that a decrease in the activity of IMPDH
      and a subsequent decline in the concentration of guanine nucleotides caused by
      MPA resulted in the induction of the erythroid differentiation and
      discontinuation of the proliferation of K562 cells.

PMID- 1627164
TI  - A method for determination of transketolase activity based on the use of a pH
      indicator.
AB  - A new method for assaying transketolase activity is proposed. The method consists
      in recording the pH changes in the course of the enzymatic reaction and is based
      on the use of the pH-indicator p-nitrophenol. When p-nitrophenol is added to a
      reaction mixture containing hydroxypyruvate and glycolaldehyde as substrates the
      absorbance increases. The rate of the change of absorbance is proportional to the
      enzyme concentration.

PMID- 1627165
TI  - Effect of chronic insecticide, phosalone, toxicity on haem synthesis and blood
      gas composition in the rat.
AB  - The influence of multiple sublethal concentrations of phosalone on whole animal
      and kidney oxygen consumption, haem synthesis and blood gases of rat, were
      carried out over a 90 day dosed period. The results indicate the existence of
      hypoventilation and a hypoxic condition in the animals which lead to the
      disruption of neuromuscular transmission in respiratory muscles and increase of
      erythropoiesis and haemoglobin synthesis. The changes were most pronounced when
      animals were exposed for the 90 day dosed period.

PMID- 1627166
TI  - Binding of anti-human-interleukin-6 monoclonal antibodies to synthetic peptides
      of human interleukin-6 studied using surface plasmon resonance.
AB  - Biosensor technology employing surface plasmon resonance (SPR) detection provides
      a highly-sensitive (sub ng), non-extrinsic labelling approach for monitoring
      protein interactions in real-time. We have used this approach to map the binding
      sites on human interleukin-6 (hIL-6) for a series of anti-hIL-6 monoclonal
      antibodies (mAbs). Epitopes were localised by monitoring the ability of ten
      synthetic peptides, spanning the sequence of hIL-6, to inhibit the binding of
      anti-hIL-6 mAbs to immobilised hIL-6. Peptide P8 (Pro139-Gln153) inhibited
      binding of anti-IL-6-mAbs 1, 2 and 7. To increase the sensitivity of detection of
      antibody-synthetic peptide interactions, a procedure was developed for
      immobilising the synthetic peptides directly to the sensor surface of the SPR
      instrument. From this study, association equilibrium constants of 2.1 x 10(6)M-1
      and 3.6 x 10(4)M-1 were calculated for the mAb7-immobilised P8 and mAb7-free P8
      interactions, respectively.

PMID- 1627167
TI  - The generation of big-endothelin (1-22) (endothelin-valine) from big-endothelin
      in the soluble fraction of porcine lung.
AB  - The degradation of big-endothelin (big-ET) in the soluble fraction of porcine
      lung was investigated. The degradation in the presence of p-chloromercuribenzoate
      (PCMB), pepstatin A, and EDTA resulted in the accumulation of two newly-formed
      fragments, big-ET (23-39) and big-ET (1-22), the latter called endothelin-valine
      (ET-Val). The generation of the two fragments was inhibited by
      diisopropylfluorophosphate (DFP). The enzyme responsible, called ET-Val
      generating endopeptidase, was isolated from porcine lung by a procedure including
      chromatographies on columns of DEAE-cellulose, hydroxylapatite, Mono Q, p
      mercuribenzoate-Sepharose, and Superose 6. The molecular weight of the enzyme was
      140,000 and the pH optimum of the activity was 7.0. The activity was strongly
      inhibited by DFP, but scarcely inhibited by PCMB, EDTA, and pepstatin A. Thus,
      the isolated enzyme was classified as a serine protease cleaving big-ET at the
      Val22-Asn23 bond.

PMID- 1627168
TI  - Sensitivity in vitro of mature and immature mouse thymocytes to dexamethasone
      cytotoxicity and its correlation to poly ADP-ribosylation.
AB  - Mouse thymocytes were fractionated into heavy (subtype I, 79% of total cell
      number), medium (subtype II, 18%) and light (subtype III, 3%) ones by Percoll
      density centrifugation and they were identified as immature (subtype I and II)
      and mature (subtype III) thymocytes based on their proliferative response to
      mitogens. Whereas the nuclear activity of poly (ADP-ribose) polymerase (EC
      2.4.2.30) in the subtype III was only one half that of denser subtypes, it
      increased two-fold upon mitogen stimulation. The sensitivity of three thymocyte
      subtypes to the dexamethasone cytotoxicity, as judged by the extent of the DNA
      cleavage, depletion of NAD and cell viability, was highest in the subtype I and
      lowest in the subtype III. The possible involvement of poly ADP-ribosylation in
      the apoptotic (programmed) cell death during intrathymic development of immature
      to mature thymocytes is discussed.

PMID- 1627169
TI  - mRNA containing an extended Shine-Dalgarno sequence is translated independently
      of ribosomal protein S1.
AB  - The role of ribosomal protein S1 in the translation of mRNA containing an
      extended Shine-Dalgarno sequence was investigated. Using the toeprinting
      technique, formation of the ternary initiation complex between 30S subunits, both
      S1-depleted or treated with anti-S1 antibodies, and mini-mRNA containing the 9
      nucleotide-long Shine-Dalgarno sequence was studied. It was concluded that the
      initiation of translation on mRNA with an extended Shine-Dalgarno sequence is S1
      independent. It was demonstrated that S1-depleted ribosomes effectively translate
      the cro-mini-mRNA in a cell-free system. In contrast to cro-mini-mRNA, 30S
      subunits without protein S1 are inactive in ternary initiation complex formation
      with, and cell-free translation of, MS2 or fr phage RNAs and RNA protein III of
      phage fd.

PMID- 1627170
TI  - Lectin extracts of champedak seeds demonstrate selective stimulation of T
      lymphocyte proliferation.
AB  - The effect of extracts of champedak (Artocarpus integer) seed lectin on the
      proliferation of normal human lymphocyte was investigated. The IgA1 binding
      lectin was demonstrated to stimulate the proliferation of human peripheral blood
      mononuclear cells. Action of the lectin on enriched T and B cell populations
      demonstrated T lymphocyte specificity. The lectin was not mitogenic to B
      lymphocytes. Optimal stimulation of proliferative response was achieved when
      cells were subjected to 5 days exposure to the crude lectin at 20 micrograms/ml.

PMID- 1627171
TI  - Analysis of Vipera russelli venom using polyclonal antibodies prepared against
      its purified toxic phospholipase A2 VRV PL-V.
AB  - Vipera russelli venom induces predominantly neurotoxic, myotoxic necrotic and
      hemorrhagic symptoms in experimental animals and has several hydrolytic enzyme
      activities. In this study, V. russelli venom is characterized both as a PLA2 and
      as a toxin. Anti PL-V Ig (antibodies to a toxic phospholipase A2 VRV PL-V of V.
      russelli venom) nullifies the toxicity of whole V. russelli venom to a great
      extent. The neurotoxic symptoms vanish completely in the presence of anti PL-V
      Ig. The cross reacting components of whole V. russelli venom were removed by
      precipitating them from whole venom by the addition of anti PL-V Ig. The non
      cross reacting components present in the supernatant were checked for toxicity.
      There was a significant reduction in toxicity. The LD50 value of the supernatant
      had increased from 4.1 mg/kg body weight to 11.7 mg/kg body weight and it showed
      about 34% of the total venom phospholipase A2 activity. It had edema forming,
      hemorrhagic and hemolytic activity but failed to induce neurotoxic, anticoagulant
      and myotoxic effects.

PMID- 1627172
TI  - A small proteoglycan isolated from human cartilage containing a nonfunctional
      hyaluronic acid binding region.
AB  - A low buoyant density fraction (A4) was isolated from human cartilage by CsCl
      density gradient ultracentrifugation. This fraction contained a hydrodynamically
      small proteoglycan (Kav, 0.74 on Sepharose CL-2B) that reacted with monoclonal
      antibody 12/20/1C6 specific for the hyaluronic acid binding region (G1 globe) of
      the large aggregating high-density proteoglycan isolated from many animal
      cartilages. Despite the presence of the hyaluronic acid binding region, this
      small proteoglycan did not form proteoglycan aggregates with hyaluronan, not even
      in the presence of link protein.

PMID- 1627173
TI  - RNA unwinding by eukaryotic initiation factor 4A and nucleotide modification.
AB  - Unwinding of double-stranded RNA by nuclear helicases can lead to modification of
      adenosine-residues, resulting in inosine. During initiation of protein synthesis
      the 5' untranslated region of an mRNA is unwound by eukaryotic initiation factors
      (eIF) -4A and -4B. In this work we investigated the possible nucleotide
      modification after unwinding by eIF-4A and eIF-4B of in vitro synthesized,
      labeled RNA. The products of unwinding were analyzed by gel-electrophoresis and,
      after nuclease digestion, by thin layer chromatography of the mononucleotides.
      Crude protein fractions unwound the duplex RNA and converted part of the AMP
      residues into IMP-residues. However, unwinding by purified factors was not linked
      to this conversion, the deamination of AMP residues. Concluding, unwinding of RNA
      during initiation of protein synthesis does not lead to conversion of adenosine
      into inosine.

PMID- 1627174
TI  - Facile cloning and sequencing of S-crystallin genes from octopus lenses based on
      polymerase chain reaction.
AB  - S-crystallin is a major lens protein present in the octopus and squid of
      Cephalopods. To facilitate the cloning of the protein, cDNA was constructed from
      the poly(A)+RNA of octopus lenses, and amplification by polymerase chain reaction
      (PCR) was carried out with two primers designed according to the 5'- and 3'
      coding regions of S-crystallin gene. Sequencing two of 15 positive clones
      obtained shows 37-44% similarity in nucleotide and 23-30% similarity in amino
      acid sequences as compared with mammalian glutathione S-transferases (GST),
      revealing that S-crystallins exist as a multigene family and probably derived
      from GST by gene duplication and subsequent mutational base replacements.

PMID- 1627175
TI  - Enzymatic reduction of shogaol: a novel biotransformation pathway for the
      alpha,beta-unsaturated ketone system.
AB  - A novel reductive metabolism of 1-(4-hydroxy-3-methoxyphenyl)-deca-4-ene-3-one
      (shogaol), a pungent principle of ginger, was investigated in rat liver in vitro.
      Ethyl acetate-extractable metabolites of shogaol formed by incubation of this
      alpha,beta-unsaturated ketone with rat liver cytosolic fraction fortified with
      NADPH or NADPH-generating system were isolated, and two major metabolites were
      identified as 1-(4-hydroxy-3-methoxyphenyl)-decan-3-one (paradol) and 1-(4
      hydroxy-3-methoxy)-decan-3-ol (reduced paradol). 1-(4-hydroxy-3-methoxyphenyl)
      deca-1-ene-3-one (dehydroparadol), a non-pungent analog of shogaol, formed the
      same metabolites as did shogaol under similar incubation conditions. Paradol
      appears to be an intermediate in the reductive metabolism of the alpha,beta
      unsaturated ketone moiety of shogaol to the corresponding saturated alcohol.

PMID- 1627176
TI  - Preparation of monoclonal antibodies against a poly(U), poly(C) specific
      ribonuclease prepared from the insect Ceratitis capitata.
AB  - A poly(U), poly(C) specific RNase of apparent MW 34 kDa has recently been
      purified from 6 day old larvae of the insect Ceratitis capitata. Two monoclonal
      antibodies were obtained by immunizing mice with this protein. Immunoblot
      analysis of the RNase revealed that both antibodies recognize the 34 kDa protein.
      Furthermore, immunoprecipitation experiments show that both antibodies were
      capable of precipitating the ribonuclease without affecting its catalytic
      activity.

PMID- 1627177
TI  - Serine base-exchange in rat liver microsomes: effect of phospholipids.
AB  - We enriched liver microsomes in lipid classes and molecular species disrupting
      membranes with octyl glucoside and reassembling them by detergent removal.
      Phosphatidylethanolamine incorporated into membranes better than
      phosphatidylserine or phosphatidylcholine. In addition, the degree of
      incorporation depended on the unsaturation of fatty acyl-chains. The enrichment
      of the membranes with phosphatidylserine or phosphatidylcholine inhibited serine
      base-exchange, whereas the addition of phosphatidylethanolamine usually
      stimulated it. The effect of exogenous lipids also depended on molecular species;
      egg yolk phosphatidylcholine and dipalmitoyl phosphatidylcholine inhibited base
      exchange whereas the effect of palmitoyl-oleoyl phosphatidylcholine depended on
      the incorporated amount. The degree of unsaturation also modulated the effect of
      phosphatidylethanolamine.

PMID- 1627178
TI  - Simplified construction and characterization of yeast artificial chromosome
      libraries.
AB  - Three yeast artificial chromosome (YAC) libraries were constructed using two
      human cell lines and the pYAC-RC vector. The main differences from the previously
      described methods were: i) genomic DNA was digested in low melting point (LMP)
      agarose blocks with the rare cutting enzyme ClaI; ii) DNA was ligated in melted
      LMP agarose after agarase treatment; iii) spheroplast regeneration plating was
      done in calcium alginate thin layer. In addition, a panel of PCR primers was used
      to identify quickly the presence in the libraries of repetitive and single copy
      human DNA sequences.

PMID- 1627179
TI  - Plasmodium falciparum synthesizes O-glycosylated glycoproteins containing O
      linked N-acetylglucosamine.
AB  - Asexual blood forms of the human malaria parasite, Plasmodium falciparum,
      synthesize a major glycosylated 195 kDa protein that has been considered for the
      development of a vaccine. beta-Elimination-borohydride reduction of the 195 kDa
      glycoprotein and its 16 kDa processed product after metabolic labeling of their
      carbohydrates, showed the presence of derived, labeled glucosaminitol and
      alanine. This suggests that the 195 and 16 kDa glycoproteins contain distinct O
      glycosyl linkages and that N-acetylglucosamine and serine residues are involved
      in the attachment of carbohydrate moieties to the protein core. Endo-O-glycanase
      treatment of total glycoproteins shows that O-glycosidycally-linked sugars
      represent a major carbohydrate moiety in P. falciparum glycoproteins.

PMID- 1627180
TI  - ATP synthesis in plasma membrane enriched particles by the action of insulin and
      related growth factors.
AB  - Early biosynthesis of short-life ATP was observed in plasma membranes of target
      cells stimulated by insulin or other polypeptide growth factors in the presence
      of all components of aerobic phosphorylation and cytochrome c. The effect is
      always mediated by the binding of insulin or growth factors to specific
      receptors. Erythrocyte plasma membranes are a convenient model to study the
      phenomenon. Insulin-stimulated synthesis of the plasma membrane "signal" ATP in
      an amount of 1-10 nM is potentized by ionophores carbonyl cyanide p
      trifluorometoxyphenylhydrazone and monensin and inhibited by amiloride and
      ouabain. It is supposed that the plasma membrane "signal" ATP readily generated
      in response to a growth or mitogenic factor is an "amplifier" or "coupling agent"
      in the transduction of a signal to growth, proliferation, and mitogenesis.
      Biosynthesis of the plasma membrane "signal" ATP seems to be associated with
      partial reversion of Na+, K+ -ATPase with the participation of the plasma
      membrane redox chain as a proton generator.

PMID- 1627182
TI  - Sertaconazole (FI-7045). A new antifungal agent.

PMID- 1627181
TI  - Metabolic and functional changes in macrophages of rats fed polyunsaturated or
      saturated fatty acid rich-diets during ageing.
AB  - Previous reports from our laboratory showed that rats fed a polyunsaturated fatty
      acid-rich diet (UC), during an acute intervals, present important changes in
      macrophage metabolism and function, while a saturated fatty acid diet (SC) did
      not induce significant changes (10). In this study, two important questions were
      addressed: 1. the persistence of the changes induced by the UC and 2. the effect
      of a SC offered during ageing. The maximal activities of hexokinase, glucose-6
      phosphate dehydrogenase, glutaminase, citrate synthase and glutathione peroxidase
      and the total content of lipid peroxides were measured in resident and
      inflammatory macrophages of rats fed control chow (CC), UC or SC during 14
      months. Intraperitoneal cell migration by thioglycollate injection and the
      phagocytosis capacity were also evaluated. The results indicate that: 1) the
      changes caused by UC are exacerbated during ageing, and 2) the SC, given during a
      prolonged period of time, also caused important alterations of macrophage
      metabolism and function.

PMID- 1627183
TI  - Sertaconazole (FI-7045). A new antifungal agent. Introduction.

PMID- 1627184
TI  - Synthesis and antimycotic activity of (benzo[b]thienyl)methyl ethers of 1-(2,4
      dichlorophenyl)-2-(1H-imidazol-1-yl)-ethanol and of (Z)-1-(2,4-dichlorophenyl)-2
      (1H-imidazol-1-yl)ethanone oxime.
AB  - A new series of (benzo[b]thienyl)methyl ethers of 1-(2,4-dichlorophenyl)-2-(1H
      imidazol-1-yl)ethanol and of (Z)-1-(2,4-dichlorophenyl)-2-(1H-imidazol-1
      yl)ethanone oxime were synthesis and tested for antifungal activity. Series
      design, synthesis, preliminary antimycotic data and structure-activity
      relationships are reported. 7-Chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-
      yl)ethoxymethyl]benzo[b] (8i, Sertaconazole, FI-7045, CAS 99592-32-2) and its
      nitrate were selected for further research.

PMID- 1627185
TI  - Physico-chemical properties, analytical determinations and stability of
      sertaconazole nitrate.
AB  - Sertaconazole nitrate, the nitrate salt of 7-chloro-3-[1-(2,4-dichlorophenyl)-2
      (1H-imidazol-1-yl)ethoxy-methyl] benzo[b]thiophene (sertaconazole, FI-7045, CAS
      99592-32-2), is a new azole antifungal, which has proved to have a wide spectrum
      and high activity. This paper describes its physico-chemical properties,
      structural identification including polymorphism, detection of impurities,
      determination of related compounds, separation, quantification and purity assays
      using high-performance liquid chromatography (HPLC) and quantitative assays
      specially elemental and functional analysis. Stability of sertaconazole nitrate
      in solid form under accelerated (light, humidity and temperature) and real time
      conditions and in suspension form at different pH values (acid and basic) was
      also studied. The results show that sertaconazole nitrate is extremely stable
      under all the conditions tested, both in solid and in suspension form.
      Sertaconazole nitrate in solid form packaged in tight sealed amber glass bottles
      was stable for over 5 years under normal storage conditions.

PMID- 1627186
TI  - In vitro activity of sertaconazole.
AB  - The activity of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl) ethoxy
      methyl]benzo[b]thiophene (sertaconazole, FI 7045, CAS 99592-32-2), a new topical
      antifungal, was studied in vitro against several infecting organisms. The results
      obtained show that sertaconazole is a broad-spectrum antifungal against yeasts
      (C. albicans, C. tropicalis, C. pseudotropicalis, C. krusei, Trichosporon and
      Cryptococcus), dermatophytes (Microsporum, Trichophyton and Epidermophyton),
      opportunistic filamentous fungi (Aspergillus) and Gram-positive bacteria. The MIC
      (minimum inhibitory concentration) values for the fungistatic activity were
      between 0.35 and 5.04 micrograms/ml for yeasts and between 0.24 and 2
      micrograms/ml for dermatophytes; even partial activities (IC25) against these
      organisms were obtained at concentrations 10 times lower than those mentioned. At
      concentrations superior to MIC (MFC between 0.5 and 16 micrograms/ml),
      sertaconazole exhibited fungicidal activity.

PMID- 1627187
TI  - In vitro antifungal activity of sertaconazole.
AB  - The antifungal activity of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H- imidazol-1
      yl)ethoxy-methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2)
      versus miconazole has been studied in vitro against yeast-like fungi,
      dermatophytes and other filamentous fungi. Candida albicans was very sensitive to
      sertaconazole both in serotype A and serotype B strains (MIC = 0.21
      micrograms/ml). Sensitivity of Candida non albicans species (MIC = 0.17
      microgram/ml), Torulopsis (MIC = 0.09 microgram/ml) and Trichosporon (MIC = 0.09
      microgram/ml) was also remarkable. For dermatophytes, partial inhibitions were
      observed at concentrations of 0.04 and 0.09 microgram/ml, the 50% inhibition
      ranging between 0.36 and 12.56 micrograms/ml for most strains. Filamentous
      opportunistic fungi were less sensitive to azoles, although sertaconazole MICs
      were lower than those of miconazole. Sertaconazole also proved to possess a
      remarkable fungicidal activity on all strains of Candida albicans under study.

PMID- 1627188
TI  - In vitro comparative study of the fungistatic and fungicidal activity of
      sertaconazole and other antifungals against Candida albicans.
AB  - The fungistatic and fungicidal activity of 7-chloro-3-[1-(2, 4-dichlorophenyl)-2
      (1H-imidazol-1-yl)ethoxy-methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS
      99592-32-2) against Candida albicans was determined and compared with that
      obtained for other antifungals. The fungistatic activity of sertaconazole,
      evaluated through the MIC obtained in Sabouraud and YNB media, gave results
      comparable to those obtained with miconazole and clotrimazole, and superior to
      those presented by bifonazole and ketoconazole. The fungicidal activity,
      evaluated by means of the 90% reduction in viable cells, took place at a
      concentration of 8 micrograms/ml for sertaconazole and at higher concentrations
      for the other drugs studied.

PMID- 1627189
TI  - In vivo activity of sertaconazole in experimental dermatophytosis in guinea pigs.
AB  - The comparative curative effect of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-
      imidazol-1-yl)ethoxy-methyl]benzo [b]thiophene (sertaconazole, FI-7045, CAS 99592
      32-2) (SZ) and miconazole (MZ) 2% creams in a model of dermatomycosis caused by
      Trichophyton mentagrophytes in guinea pigs was studied. Two treatments of
      different duration (12 and 3 days) were applied, and their efficacy versus
      infected and untreated animals (control group) was evaluated according to
      clinical parameters (degree of alopecia and lesion) and microbiological healing
      (recovery of T. mentagrophytes from hair pulled from the infected site). The
      therapeutic effect resulting from the application of the creams for 12 days was
      excellent and similar for both test creams; however, the application of SZ cream
      for 3 days had greater therapeutic effect than MZ cream according to the
      improvement of clinical symptoms and microbiological healing.

PMID- 1627190
TI  - Inhibition of ergosterol synthesis by sertaconazole in Candida albicans.
AB  - 7-Chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl) ethoxy-methyl] benzo [b]
      thiophene (sertaconazole, FI-7045, CAS 99592-32-2), a new topical antifungal
      agent, has shown activity against a broad range of clinically relevant yeasts and
      fungi. In the present study, the molecular basis of the pharmacological action of
      sertaconazole was examined by investigating the inhibition of ergosterol
      synthesis in cultures of Candida albicans, ATCC E-10.231, at 6 x 10(5) cells/ml
      grown aerobically at 37 degrees C, using various concentrations of sertaconazole.
      Sertaconazole inhibited the ergosterol synthesis with IC50 = 115 nmol/l. The
      results show that one of the mechanisms of action of sertaconazole consists in
      the inhibition of ergosterol synthesis.

PMID- 1627191
TI  - Direct membrane-damaging effect of sertaconazole on Candida albicans as a
      mechanism of its fungicidal activity.
AB  - The direct action of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1
      yl)ethoxy- methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) on
      the membrane integrity of C. albicans is studied by quantifying the leakage of
      intracellular adenosine triphosphate (ATP) into the medium as an index of the
      changes in membrane permeability and integrity and cell viability of the culture
      used. Sertaconazole caused a dose-dependent decrease in intracellular ATP after
      only 10-min exposure and a concomitant significant increase in extracellular ATP.
      This behaviour is characteristic of antifungals which are fungicidal as a result
      of a direct membrane damage. Thus sertaconazole, in addition to the mechanism of
      action responsible for its fungistatic activity (inhibition of ergosterol
      synthesis), has a second mechanism of action providing a significant fungicidal
      activity due to direct cell membrane damage.

PMID- 1627192
TI  - Acute toxicity studies of sertaconazole.
AB  - The acute toxicity of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1
      yl)ethoxy- methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) was
      evaluated in mice and rats after single administration by oral, subcutaneous and
      intraperitoneal routes. The latter intended to ensure maximum blood levels, since
      intravenous route was unfeasible due to drug insolubility in water. LD50 was
      indeterminable (greater than 8000 mg/kg) in all routes of dosing. According to
      these results, and having furthermore proved the absorption of the test substance
      after oral administration, sertaconazole was concluded to be very safe in the
      event of overdose or accidental ingestion.

PMID- 1627193
TI  - Subacute toxicity and maximum tolerable dose of sertaconazole in repeated
      administration studies.
AB  - 28-Day oral and dermal subacute toxicity studies of 7-chloro-3-[1-(2,4
      dichlorophenyl)-2-(1H-imidazol-1-yl) ethoxy-methyl] benzo [b] thiophene
      (sertaconazole, FI-7045, CAS 99592-32-2), were carried out. The oral studies
      included the evaluation of subacute toxicity in rat (dose levels of 50, 150 and
      300 mg/kg) and maximum tolerable dose in repeated administration in ferrets
      (consecutive dose levels in accordance with a geometric progression of 50, 75,
      112.5, 168 and 250 mg/kg), which were the animal species intended for chronic
      toxicity studies. The dermal studies included the evaluation of subacute toxicity
      in rats and rabbits (1 ml/kg of a 2% cream). The results, in general, have shown
      low toxic effects, which can be summarized as a slight non-significant
      hepatomegalia in the rat with increased gamma-GTP and alkaline phosphatase values
      and a high urinary pH value; no histopathological changes were observed. These
      effects are characteristic of azole derivatives and are therefore common to other
      antifungals with this chemical group.

PMID- 1627194
TI  - Chronic toxicity studies of sertaconazole after oral administration to rats and
      ferrets.
AB  - Six-month chronic oral toxicity studies of 7-chloro-3-[1-(2, 4-dichlorophenyl)-2
      (1H-imidazol-1-yl)ethoxy-methyl] benzo[b]thiophene (sertaconazole, FI-7045, CAS
      99592-32-2) were carried out in rats and ferrets. The dose levels used were 50,
      150 and 300 mg/kg in rats and 50, 150 and 250 mg/kg in ferrets. There was no
      mortality associated with the drug in either of the two species. The results
      obtained show that the toxic effects may be summarized as a smaller body weight
      increase in rats at 150 and 300 mg/kg and in male ferrets at 250 mg/kg. Food
      consumption decreased significantly in rats at 300 mg/kg, and was not
      proportional to the doses of 150 and 50 mg/kg. In serum biochemistry, increases
      in alkaline phosphatase in rats, ALT in male ferrets at 150 and 250 mg/kg and AST
      only at 250 mg/kg were observed. BUN increased at 150 and 250 mg/kg in ferrets.

PMID- 1627195
TI  - Reproduction toxicity of sertaconazole. Segment II (teratology) and Segment III
      (peri-postnatal toxicity).
AB  - The reproduction toxicity of 7-chloro-3-[1-(2,4-dichlorophenyl)-2- (1H-imidazol-1
      yl)ethoxy-methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) (50,
      100 and 150 mg/kg by oral route) has been investigated by performing two studies:
      the embryotoxicity or teratology study in rats and rabbits, and the peri
      postnatal toxicity study in rats. According to the results obtained from the
      embryotoxicity studies, there was no maternal toxicity in either of the two
      species studied. The only embryofoetal abnormalities with statistical and
      toxicological significance were observed at the dose of 150 mg/kg in the
      teratology study on rabbits: hepatomegalia, pericardial oedema and peritoneal and
      hepatic haemorrhages. The results of the peri-postnatal study showed that the
      only maternal effect relating to the drug was an increase, proportional to the
      dose, in the weight of the ovaries, which was significant at the dose of 150
      mg/kg. With reference to the offspring, only a reduction in the viability index
      at 150 mg/kg was observed. The non observed effects level (NOEL) for all three
      studies can be estimated at 100 mg/kg.

PMID- 1627196
TI  - Genotoxicity studies on sertaconazole.
AB  - A series of 6 studies has been performed to evaluate the potential genotoxic
      effect of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H- imidazol-1-yl)ethoxy
      methyl]benzo[b]thiophene (sertaconazole, FI 7045, CAS 99592-32-2). From these
      studies, the reverse mutation assay on Salmonella typhimurium, sex-linked
      recessive lethal mutations on Drosophila and genetic mutations in cultured mammal
      cells allowed to study the genetic mutations in prokaryotes and eukaryotes. In
      vitro and in vivo chromosomal aberrations were studied using human lymphocytes
      cytogenetic test, micronucleus test and sister chromatid exchange test. The
      results obtained in these studies, which are complemented one another,
      demonstrated that sertaconazole did not induce any signs of promutagenic,
      mutagenic or clastogenic activity or interference with the chromosomal
      segregation process.

PMID- 1627197
TI  - Dermal tolerance and phototoxicity studies of sertaconazole.
AB  - The local dermal tolerance of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H- imidazol
      1-yl)ethoxy-methyl]benzo[b] thiophene (sertaconazole, FI 7045, CAS 99592-32-2)
      was evaluated in hairless rats and albino rabbits. Test substance was applied in
      2% powder (0.5 g), gel (0.5 ml) and solution (0.5 ml) formulations to rats (this
      is the concentration intended for the pharmaceutical preparation) and in 6% cream
      (0.5 ml) to rabbits (this concentration was used to estimate an overdose maximal
      effect). After 3- and 24-h exposure of the test substance to animals, they were
      observed for erythema and oedema. Sertaconazole may be considered as non
      irritant, since its primary irritation index was less than 0.5 in all the tests.
      A phototoxicity study was also carried out on guinea pigs with 1 ml 2% cream per
      animal, compared with psoralene as a positive control. Sertaconazole did not
      present any risk, since the phototoxicity level reached was null, with 2 being
      the minimum value considered as having toxic significance.

PMID- 1627198
TI  - Pharmacokinetic evaluation of labelled sertaconazole after dermal application.
AB  - 14C-labelled 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl)ethoxy
      methyl] benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) was
      administered systemically (i.v. route) and topically (dermal route) in different
      formulations at doses of 10 mg/kg to hairless Sprague-Dawley rats. Determination
      of plasma and liver levels of radioactivity demonstrated that the dermal
      application of sertaconazole induced very low systemic absorption with all the
      formulations used: 1.47% for sertaconazole cream, 1.97% for sertaconazole
      solution, 0.665% for sertaconazole powder and 0.885% for sertaconazole gel.
      Calculations were made from the areas under plasma levels curves of each topical
      administration in comparison with intravenous administration. Significant
      radioactivity levels were found in the liver, which was consistent with a high
      hepatic metabolization and faecal excretion of the substance. However, the liver
      levels after topical application were virtually insignificant in comparison with
      the levels in the same organ obtained after intravenous administration.

PMID- 1627199
TI  - Pharmacokinetics and tolerance of sertaconazole in man after repeated
      percutaneous administration.
AB  - The local and systemic tolerance of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-
      imidazol-1-yl)ethoxy-methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592
      32-2) 2% cream was studied in healthy volunteers after cutaneous application in
      an increasing-dose schedule during 13 days. Blood and urine samples were
      collected after the application of 16 g of cream. Percentage of absorption was
      determined in eight 3 x 3 cm areas of the volar arm skin after 2 mg cream topical
      application. No changes on vital signs (blood pressure, heart rate and body
      temperature) or in the ECG were found during the trial. Sertaconazole did not
      produce skin irritation nor systemic side effects. Sertaconazole was not detected
      in either the serum and urine samples obtained. The percentage of cutaneous
      absorption at 24 h after administration reached 72% of the applied dose.

PMID- 1627200
TI  - Study on the sensitizing capacity of the new antimycotic sertaconazole in the
      treatment of cutaneous mycoses.
AB  - The sensitizing capacity of 7-chloro-3-[1-(2,4-dichlorophenyl)-2- (1H-imidazol-1
      yl)ethoxy-methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) was
      studied in a randomized double-blind clinical trial in 78 atopical volunteers of
      both sexes. Sertaconazole in 2% dermatological cream form was compared with 5
      other commercially available antimycotics (econazole, ketoconazole, bifonazole,
      clotrimazole and miconazole), using the excipient of the cream without
      sertaconazole and 2% sertaconazole in vaseline as controls. At the end of the
      trial, only miconazole showed a positive allergy (vesiculation) in two of the 78
      individuals studied. The other substances did not demonstrate any sensitizing
      capacity, including sertaconazole and its excipient. This trial showed that
      sertaconazole in 2% dermatological cream form does not possess a sensitizing
      capacity for causing contact dermatitis which confirmed its excellent safety in
      topical use.

PMID- 1627201
TI  - Phase II study of the therapeutic efficacy and safety of the new antimycotic
      sertaconazole in the treatment of superficial mycoses caused by Candida albicans.
AB  - The activity of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl)ethoxy
      methyl] benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) was studied in
      a randomized parallel double-blind clinical trial on 20 patients suffering from
      superficial mycosis caused by Candida albicans (confirmed microscopically and
      microbiologically). The patients were divided into two groups; one received
      sertaconazole 1% cream (10 patients) and the other received sertaconazole 2%
      cream (10 patients), over a period of 28 days. Clinical, microscopic and
      microbiological parameters were evaluated. Analytical parameters such as the
      appearance of possible undesirable effects (both local and general) were also
      monitored. The cure was total for 19 out of the 20 patients, demonstrating high
      efficacy. There were no relapses of infection in any of the cured patients. No
      local or general effects were recorded during the trial. The analytical
      parameters remained within normal limits. The clinical and microbiological cure,
      absence of relapses and the non-existence of local and general undesirable
      effects indicate that sertaconazole may represent an important advance in the
      therapy of superficial mycosis caused by Candida albicans.

PMID- 1627202
TI  - Therapeutic efficacy and safety of the new antimycotic sertaconazole in the
      treatment of cutaneous dermatophytosis.
AB  - 7-Chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl)ethoxy-methyl]
      benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) is a new antimycotic
      which, in experimental infection studies, proved to possess potent antifungal
      activity. In a randomized, parallel, double-blind trial, the activity of
      sertaconazole cream was studied in 20 patients suffering from superficial mycoses
      caused by dermatophytes, confirmed by microscopic examination (KOH) and culture
      test. The patients, who were included in accordance with microbiological,
      microscopic and clinical criteria, were divided into two groups of 10 and were
      treated with sertaconazole 1% or sertaconazole 2% (cream) twice a day for 28
      days. Both treatments achieved a total cure of the disease, with a cure being
      reached in a shorter time in the group of patients treated with sertaconazole 2%.
      No undesirable effects or statistically significant changes in the blood tests
      conducted at the end of the trial were observed. The results of the trial show
      that sertaconazole 2% cream is more effective. In view of the advantages offered
      by topical therapy over systemic therapy and of the good results obtained in
      patients with dermatophytosis, sertaconazole may represent an important advance
      in the therapy of superficial dermatophytoses.

PMID- 1627203
TI  - Therapeutic efficacy and safety of the new antimycotic sertaconazole in the
      treatment of Pityriasis versicolor.
AB  - The activity of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl) ethoxy
      methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32,2) was studied in
      a randomized parallel double-blind clinical trial on 21 patients suffering from
      Pityriasis versicolor (confirmed by KOH microscopic examination and exploration
      with Wood's light). The patients were divided into two treatment groups: one with
      11 patients receiving sertaconazole 1% cream and the other with 10 patients
      receiving sertaconazole 2% cream. The cream was applied twice a day during 4
      weeks. The data were assessed clinically and microscopically (optical and
      fluorescence). All the patients were cured (100% cure), showing excellent
      efficacy. A check-up performed after the end of the treatment showed no relapses
      of infection. The drug safety was optimum, since no local or general undesirable
      effects were recorded, nor were there any changes in the analytical parameters
      studied in the 21 patients. Because of its high antifungal activity and excellent
      safety, sertaconazole represents an important advance in the topical therapy of
      this disease.

PMID- 1627204
TI  - Multi-centre double-blind trial on the efficacy and safety of sertaconazole 2%
      cream in comparison with miconazole 2% cream on patients suffering from cutaneous
      mycoses.
AB  - The efficacy and tolerance of 7-chloro-3-[1-(2,4-dichlorophenyl)-2- (1H-imidazol
      1-yl)ethoxy-methyl]benzo[b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) 2%
      dermatological cream in two daily applications compared with miconazole 2% cream
      in two daily applications were studied on 631 patients suffering from superficial
      cutaneous mycosis (sertaconazole n = 317, miconazole n = 314), in a double-blind,
      controlled multicentre trial with parallel groups. The therapeutic efficacy was
      evaluated by clinical assessment of the improvement of the lesion and symptoms, a
      microscopic test on the presence of hyphae or mycelia in the affected area and a
      culture test on the presence of active infection. Tolerance and safety were
      evaluated by a general blood analysis and interrogation of the patient on adverse
      effects. The rate of clinical cures for both treatments at the end of the follow
      up was 95.6% for sertaconazole and 88.1% for miconazole, with the difference
      being statistically significant. In the comparative analysis of the actuarial
      curve, it was observed that the patients treated with sertaconazole were cured
      earlier and in a higher proportion than those treated with miconazole, with the
      difference being significant. The negative result of the microscope examination
      and culture test confirmed the superiority of sertaconazole over miconazole,
      already after 14 days of treatment. At the end of the follow-up, 98.6% of the
      patients in the sertaconazole group obtained a negative culture test result, as
      opposed to 91.7% in the miconazole group, with the difference being highly
      significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627206
TI  - Nutrition and inflammatory events: highly unsaturated fatty acids (omega-3 vs
      omega-6) in surgical injury.
AB  - Given the poor prognosis and high cost of care for patients with acute
      inflammatory responses (often leading to organ failure and/or allograft
      rejection), immunomodulation of this hyperresponse represents an important
      priority for research in nutritional medicine. The primary goal of nutritional
      support in inflammatory disease is to provide adequate energy, particularly
      through use of novel lipids (to alter eicosanoid pathway toward a more regulated
      inflammatory state), and protein to meet endogenous requirements for tissue
      repair IL-1 production, and restored cellular function, thus preventing secondary
      infection (52). Manipulation of macrophage eicosanoid production by use of omega
      3 PUFA may reduce the cellular immune response (by competing with arachidonic
      acid, which produces inflammatory eicosanoids of the 2- and 4-series), whereas
      inclusion of MCT found in coconut oil may lower the arachidonic acid content of
      membrane phospholipids. As more data are obtained on the use of such tailored
      therapies in critically ill patients, a new generation of parenteral and enteral
      diets will be developed to reduce inflammation and immune dysfunction.

PMID- 1627205
TI  - Roles of a 106-bp origin enhancer and Escherichia coli DnaA protein in
      replication of plasmid R6K.
AB  - A dnaA 'null' strain could not support replication of intact plasmid R6K or
      derivatives containing combinations of its three replication origins (alpha,
      gamma, beta). DnaA binds in vitro to sites in two functionally distinct segments
      of the central gamma origin. The 277-bp core segment is common to all three
      origins and contains DnaA box 2, which cannot be deleted without preventing
      replication. Immediately to the left of the core lies the 106-bp origin enhancer,
      which contains DnaA box 1. When the origin enhancer is deleted, the core alone
      can still initiate replication if levels of wt pi protein are decreased or if
      copy-up pi mutant proteins are provided in trans. DnaA does not effect expression
      of R6K replication initiator protein pi, although several DnaA boxes were
      identified in the coding segment of the pir gene, which encodes pi. Together
      these data suggest that a single DnaA box, 2, is sufficient for initiation from
      the gamma origin and might be sufficient for initiation from the gamma origin and
      might be sufficient and required for the activity of the alpha and beta origins
      as well. Implications of the DnaA protein binding to two domains of the gamma
      origin and the role of the 106-bp origin enhancer in replication are discussed.

PMID- 1627207
TI  - Diminution in size of a fetal intrathoracic mass: caution against aggressive in
      utero management.
AB  - Space-occupying lesions within the fetal thorax are associated with poor
      perinatal outcome. Therefore some investigators have suggested in utero
      treatment. We describe a case of a fetus with a large intrathoracic mass that was
      noted to decrease markedly in size as gestation advanced. This case cautions
      against aggressive antenatal treatment.

PMID- 1627208
TI  - Effect of daily immersion on the edema of pregnancy.
AB  - To evaluate whether pregnant women become refractory to the effects of immersion,
      we studied 11 healthy women from 26 to 38 weeks' gestation, immersed in 34
      degrees C shoulder-deep water for 4 or 5 consecutive days. The daily immersion
      diuresis showed no change throughout the study (p = 0.98: mean, 145 ml, 159 ml,
      159 ml, 173 ml, 184 ml, day 1 through day 5, respectively). The range of urine
      volumes was broad, 35 to 675 ml, depending on the subject's degree of edema.
      Immersion produced a significantly larger diuresis compared with preimmersion
      values, 162 ml versus 110 ml. Maternal blood pressure and heart rate consistently
      fell during immersion, and this effect was maintained for each day studied. The
      subjects' hematocrit, hemoglobin, and total protein were unchanged from a
      preimmersion sample on day 1 to a postimmersion sample on the last day of the
      study. The results of this study indicate that pregnant women do not become
      refractory to the hemodynamic and diuretic effects of immersion.

PMID- 1627209
TI  - Response of fetal heart rate to scalp stimulation related to fetal acid-base
      status.
AB  - The correlation of the response of the fetal heart rate (FHR) to scalp
      stimulation and the acid-base status of the fetal scalp blood (FSB pH) was
      studied in 104 term fetuses during labor. The mean FHR was determined for the 5
      minute period before the preparation for fetal scalp blood pH determination and 1
      minute following FSB pH. The analysis was performed for three pH groups: (a)
      Normal (pH more than 7.25, = 73); (2) preacidotic (pH 7.20 to 7.25, = 16); and
      (3) acidotic (pH less than 7.20, = 15). The pH was confirmed at delivery by
      determination of umbilical cord blood acid-base status. Regression analysis of
      the number of fetuses responding by changing their heart rate against time was
      significant only for the nonacidotic fetuses. There was no significant difference
      in the number of subjects whose mean FHR increased, decreased, or remained
      unchanged between the three pH groups. Furthermore, there was no difference
      between the three pH groups in the number of fetuses who demonstrated significant
      mean heart rate changes (p less than 0.05) following the stimulation compared to
      those who did not. Further analysis between fetuses in the three pH groups who
      increased FHR 15 beats/min or more following stimulation did not discriminate
      between groups. We conclude that scalp stimulation results in a FHR response in
      all three pH categories. However, the net change in the mean heart rate following
      the stimulation may be negative or positive. The magnitude and the direction of
      this change in FHR is not significantly related to FSB pH.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1627210
TI  - Serum erythropoietin quantitation in pregnancy using an enzyme-linked
      immunoassay.
AB  - During normal pregnancy there is a decrease in the hematocrit due to a
      disproportionate increase in the blood volume compared with the red cell mass.
      Using a new enzyme-linked immunoassay (Amgen Diagnostics), serum erythropoietin
      was quantified in normal nonanemic pregnancies throughout gestation and in third
      trimester anemic patients. We found that the mean hematocrit in normal pregnancy
      reached a nadir late in the second trimester and the serum erythropoietin
      plateaued at a 50% increase. Those pregnancies complicated by anemia defined by a
      hematocrit less than 30 vol% demonstrated a statistically significant increase in
      serum erythropoietin above those not anemic.

PMID- 1627211
TI  - Assessment of thermal conditions in neonatal care: use of a manikin of premature
      baby size.
AB  - A thermal manikin of the size of a 1 kg premature baby has been constructed. The
      nonevaporative heat loss from eight different regions and the total heat loss
      were measured. The measurements of heat loss have high repeatability and the
      values are in good agreement with measurements of dry heat loss for premature
      babies, using indirect calorimetry. The heat losses from the manikin in a single
      walled, air-heated incubator and on a recently described heated, water-filled
      mattress have been compared. The total heat loss was found to be 20 to 30 W/m2
      with both methods at ambient temperatures between 15 degrees and 25 degrees C.
      Treatment on a heated, water-filled mattress provides a means of direct
      conductive heat input to the baby, with a conductive heat transfer coefficient of
      0.4 W/degrees C or 21 W/m2 degrees C. The thermal manikin appears to provide an
      accurate method for assessment of the thermal conditions in neonatal care.

PMID- 1627213
TI  - Umbilical artery and uteroplacental velocimetry in pregnancies complicated by
      idiopathic low birthweight centile.
AB  - Umbilical artery and uteroplacental Doppler flow velocity waveforms were studied
      in 35 pregnancies complicated by idiopathic low birthweight centile. Thirty
      fetuses (86%) were below the 5th centile birthweight for gestation. Fifteen (43%)
      had an abnormal umbilical artery systolic to diastolic ratio. Uteroplacental
      waveforms were recorded in 29 of the 35 pregnancies and five (17%) showed an
      abnormal systolic to diastolic ratio. Abnormal uteroplacental systolic to
      diastolic ratios were associated with a significantly earlier gestational age at
      delivery and significantly more cesarean sections for fetal distress compared
      with normal uteroplacental systolic to diastolic ratios (p less than or equal to
      0.01). The absence of umbilical artery end-diastolic frequencies was associated
      with a significantly earlier gestational age at delivery compared with the
      presence of umbilical artery end-diastolic frequencies (p less than 0.005). No
      differences in pregnancy outcome were observed comparing normal with abnormal
      amniotic fluid volume assessment. These findings suggest that Doppler studies may
      be useful in estimating the risk of adverse perinatal outcome for small for
      gestational age fetuses with no identifiable cause.

PMID- 1627212
TI  - Zidovudine pharmacokinetics during pregnancy.
AB  - As the indications for zidovudine (ZDV) treatment in human immunodeficiency virus
      infected individuals expand, we anticipate an increased use of this drug during
      pregnancy. We report pharmacokinetics data from a patient studied both in the
      third trimester and intrapartum. ZDV peak-plasma levels and serum half-lives were
      comparable to nonpregnant adults. High concentrations of ZDV and its glucuronide
      metabolite were found in umbilical cord blood and in amniotic fluid.

PMID- 1627214
TI  - Treatment of neonatal renovascular hypertension with intravenous enalapril.
AB  - Hypertension in the neonate is commonly related to renal disease. More
      specifically, renovascular hypertension in neonates is often associated with the
      placement of a umbilical artery catheter. Many medications, including angiotensin
      converting enzyme (ACE) inhibitors, have been used in the treatment of neonatal
      hypertension. Captopril, an ACE inhibitor, is an oral agent that is effective in
      renovascular hypertension. We describe the use of intravenous enalapril, another
      ACE inhibitor, in successfully treating severe renovascular hypertension
      refractory to standard medical therapy in two term neonates.

PMID- 1627215
TI  - Perinatal outcome of twin pregnancies complicated with preeclampsia.
AB  - Twenty-five mild and 19 severe preeclampsia cases in twin pregnancies (12.5%)
      were compared to 44 matched for gestational age controls. All three groups were
      similar with respect to maternal age, intertwin birthweight differences, and
      rates of abdominal deliveries and low (less than 7) 5-minute Apgar scores. The
      frequency of primiparas in the severe preeclampsia group was significantly higher
      compared with controls (p less than 0.03). Severe preeclampsia patients delivered
      at a significantly earlier gestational age (p less than 0.005) and had a
      significantly lower mean twin birthweight (p less than 0.003) compared with the
      mild preeclamptic group. The mean twin birthweight of the severe preeclamptic
      cases was also significantly lower compared with that of controls. All three
      neonatal deaths occurred in severely discordant second twins born to severe
      preeclamptic patients. It is concluded that adverse perinatal outcome is
      associated with severe but not with mild preeclampsia in twin gestations.

PMID- 1627216
TI  - Use of percutaneous silastic central venous catheters in neonates and the
      management of infectious complications.
AB  - A prospective study of 35 patients in the neonatal intensive care unit was
      conducted to examine the safety and feasibility of percutaneous Silastic central
      venous catheters for the provision of prolonged parenteral alimentation.
      Particular attention was directed to the possibility of maintaining these lines
      through intercurrent episodes of infection. Catheters were placed in 34 infants
      (97%). At the time of insertion, 21 patients (62%) weighed less than 1000 gm and
      13 patients (38%) weighed less than 750 gm. The average duration of
      catheterization was 32.0 +/- 18.2 (SD) days; 19 patients (56%) had lines in place
      for more than 30 days. Mechanical difficulties complicated the course of five
      patients (15%). Four cases of bacteremia were identified; this represents 3.7
      infections/1000 days of catheter use. All infections were caused by methicillin
      resistant staphylococci. Two patients required catheter removal to clear their
      infection, but in two of the four bacteremic patients, the infection was cleared
      and the line was sterilized by the administration of antibiotic therapy through
      the central catheter. We conclude that Silastic central venous catheters can be
      used safely to deliver intravenous nutrition to extremely small preterm infants
      over a prolonged period of time, and in carefully selected patients, successful
      treatment of complicating infections may be achieved without catheter removal.

PMID- 1627217
TI  - Sucking patterns of neonates during bottle feeding: comparison of different
      nipple units.
AB  - The present study was designed to compare the sucking pattern of term and preterm
      infants during bottle feeding with different types of nipple units (Enfamil
      single-hole nipple units for term and preterm infants and SMA Nuk nipple units).
      In addition, the sucking pattern of term neonates during a feeding regimen
      commonly used in many feeding studies was evaluated (reservoir nipple system). In
      this system milk flows from a reservoir through a tube and depends on the sucking
      pressure generated by the infant. Only the Enfamil single-hole nipple units for
      term and preterm infants were compared in preterm infants. No significant
      difference in sucking frequency was observed in term neonates with different
      types of nipple units. Although the mean sucking pressures generated tended to be
      less among nipple units with higher flow, these differences were not
      statistically significant. Similarly, no significant difference in total sucking
      or feeding time was observed among the three nipple units tested. Sucking
      pressures generated by term infants were significantly less when milk flow was
      increased markedly utilizing the reservoir system. In preterm infants no
      differences in sucking frequency, sucking pressure, mean flow, or total feeding
      time were observed when sucking patterns with term and preterm nipple units were
      compared. Implications of these findings in feeding neonates are discussed.

PMID- 1627218
TI  - Nicotine-induced changes in the cerebral circulation in ovine fetuses.
AB  - Pulsed Doppler ultrasound was used to investigate fetal and maternal ovine
      circulation in 16 ewes. Resistance index (R) was measured at the following sites:
      umbilical, fetal cerebral, and uterine arteries. Measurements were performed at
      days 80, 100, and 130 of gestation, day 0 being the day of mating. Normal ranges
      of the Doppler indices were delimited on the six control ewes. Five ewes were
      treated by intramuscular injection of 10 mg of nicotine 5 days per week and five
      others received placebo injections. No difference was found on the Doppler
      indices between the control group and the placebo group. The cerebral indices did
      not differ in the three groups at days 80 and 100 but were significantly higher
      at day 130 in the nicotine group in comparison to the two others (p less than
      0.01). The umbilical indices were slightly elevated at days 80 and 130 in the
      nicotine group. No significant difference was found on the uterine indices at any
      of the three stages of gestation whatever the treatment. In the control and
      placebo groups the ewes delivered in the normal ranges of gestation length. In
      these groups 2 of 20 lambs (10%) died at birth. In the nicotine group 2 ewes
      delivered prematurely and 8 of the 13 lambs (62%) were stillborn. In conclusion,
      repeated nicotine injections induce vasoconstriction on the umbilical and
      cerebral arteries of the fetus at the end of the gestation and are associated
      with poor perinatal outcome.

PMID- 1627219
TI  - Periosteal reaction induced by prostaglandins.
AB  - Prostaglandin administration is the main therapy for ductal-dependent congenital
      heart disease prior to definitive therapy. We report a case in which tetralogy of
      Fallot and Noonan syndrome were diagnosed, complicated by small pulmonary
      arteries, which occasioned a delay in surgery. Treatment was started with
      prostaglandins, which were given for a total of 2 months, and a diffuse
      periosteal reaction occurred secondary to the administration of intravenous
      prostaglandin E1.

PMID- 1627220
TI  - Does prenatal care decrease the incidence and cost of neonatal intensive care
      admissions?
AB  - This study was conducted to examine the potential effects of expanded Medicaid
      coverage for low income women. Statewide birth data for 1983 to 1985 were
      examined to determine the relationship between prenatal care and admissions to
      neonatal intensive care units (NICUs) and the costs of this care. An NICU sample
      was constituted from infants who were discharged live following more than 7 NICU
      days, were referred to an out of state tertiary center, or died following NICU
      admission. Inadequate care (no prenatal care, only last trimester care, or less
      than five visits) was received by 11% of the total birth cohort and by 18% of the
      infants in the NICU sample (p less than 0.001). Infants with inadequate care had
      a NICU admission rate of 5.10% versus 2.86% for those with adequate prenatal care
      (p less than 0.001). The hospital billings for infants in the NICU sample with
      inadequate care were significantly higher than were those for infants with
      adequate care (p less than 0.05). Assuming that economic resources limit access
      to prenatal care, the projection can be made that had all women with inadequate
      prenatal care received Medicaid-covered adequate prenatal care, expenditure for
      this care would yield more than a two to one return in savings in NICU costs.

PMID- 1627221
TI  - Effect of labor and delivery on neonatal polymorphonuclear leukocyte number and
      function.
AB  - The ability of the neonate to mount an adequate polymorphonuclear leukocyte (PMN)
      response, either quantitatively or functionally, is impaired. To assess whether
      neonatal PMN number and function are altered by labor and delivery, three groups
      of infants were studied: cesarean section without labor (10), cesarean section
      after labor (10), and vaginal delivery (11). PMN counts were higher in the groups
      undergoing labor (p less than 0.01) compared with the cesarean section without
      labor group. Similarly, the labor groups had evidence of complement activation
      (increased C3a desarg) compared with the cesarean section without labor group. No
      differences were noted between the groups in measures of PMN motility
      (chemokinesis or chemotaxis) or PMN degranulation (plasma lysozyme), suggesting
      that normal labor and delivery does not contribute to the general PMN dysfunction
      of the neonate.

PMID- 1627222
TI  - Seroprevalence of human immunodeficiency virus type 1 among pregnant women.
AB  - Five (0.74%) of 678 women delivering in 1985 at a tertiary referral hospital for
      high-risk pregnancies and 16 (1.34%) of 1198 women visiting an urban prenatal
      obstetrics clinic in 1986-1987 had serologic evidence of human immunodeficiency
      virus type 1 (HIV-1) infection. Unlinked testing (removal of personal identifiers
      from the blood specimen and the epidemiologic data sheet) of residual serum from
      hepatitis B virus serologic testing was used. Neither age, marital status, payor
      status, nor serologic markers of hepatitis B virus infection was useful in
      identifying women at risk for HIV-1 infection. As a result of these data, we have
      initiated a program in which counseling is offered to all women and testing for
      those who consent. Unlinked testing of women who refuse consent is performed for
      epidemiologic purposes. This will allow us to continue to plan for health care
      resource needs and to track the course of the epidemic in various subgroups of
      pregnant women.

PMID- 1627223
TI  - Respiratory complications associated with cryotherapy in premature infants.
AB  - We reviewed the frequency of respiratory complications associated with
      cryotherapy in 14 premature infants who underwent 17 cryotherapy procedures. Five
      of the procedures were performed on infants already being mechanically
      ventilated. Two of these infants required increased ventilatory support during
      and following the procedure for decreased spontaneous respirations. For the 12
      procedures performed on 11 infants who were not being mechanically ventilated at
      the time of cryotherapy, four infants had no complications, three infants had
      minor respiratory deteriorations, and five infants required positive pressure
      ventilation for severe apnea and bradycardia episodes (one just after narcotic
      administration, four during the procedure). Excluding the three infants (five
      procedures) who were already receiving mechanical ventilation at the time of
      cryotherapy, the infants who had severe apnea requiring the initiation of
      positive pressure ventilation weighed less and were younger than those infants
      not having a serious respiratory complication (p less than 0.05).

PMID- 1627224
TI  - A case of deletion of the short arm of chromosome 10 with severe hearing loss and
      brainstem dysfunction.
AB  - A male newborn infant with a deletion of the short arm of chromosome 10p 14 was
      described. In addition to the typical clinical features, electrophysiologic
      studies showed brainstem dysfunction and severe hearing loss when examined with
      auditory brainstem response and photopalpebral reflex. These electrophysiologic
      studies may be of benefit for early evaluation of brainstem functions and hearing
      ability of the patients of such chromosomal aberration and may also be useful
      predictors of psychomotor development.

PMID- 1627225
TI  - In utero conversion of supraventricular tachycardia with digoxin and procainamide
      at 17 weeks' gestation.
AB  - The earliest reported case of fetal supraventricular tachycardia at 17 weeks'
      gestation causing hydrops fetalis is presented. Maternal treatment with digoxin
      and procainamide successfully cardioverted the fetus with resolution of the
      hydrops. Using this combination, sinus rhythm was maintained until term.

PMID- 1627226
TI  - Comparison of rapid tests for detection of group B streptococcal colonization.
AB  - Accurate rapid detection of maternal lower genital tract colonization with group
      B streptococci (GBS) in high-risk patients is essential for selective institution
      of intrapartum antibiotic treatment to reduce neonatal GBS infection. In this
      study, pure GBS isolates were used to evaluate five commercially available rapid
      tests in terms of speed, ease of use, and sensitivity. The products tested were
      Directigen, Equate, Bactigen, PathoDx, and Phadebact. Although each test could be
      performed relatively quickly, the ease of performance and level of sensitivity
      (10(5) to 10(8) CFU/ml) varied markedly. Quantitative cultures obtained from 17
      known GBS carriers showed concentrations ranging from less than 10(2) to greater
      than 10(8) CFU/gm of vaginal material. Since only 40% of the women had greater
      than or equal to 10(5) CFU/gm of vaginal material, it appears that many colonized
      women would not be identified by these rapid tests.

PMID- 1627227
TI  - Prenatal care revisited: does it make a difference?

PMID- 1627228
TI  - Magnetic resonance imaging and computed tomography scan for the diagnosis of
      acute fatty liver in pregnancy.

PMID- 1627229
TI  - Low-dose-aspirin: treatment of the imbalance of increased thromboxane and
      decreased prostacyclin in preeclampsia.

PMID- 1627230
TI  - Woman with AIDS presented for elective termination of pregnancy.

PMID- 1627231
TI  - Detection of cell-mediated immunity in type I diabetes mellitus.
AB  - Type I insulin dependent diabetes mellitus (IDDM) is thought to result from
      chronic, cell-mediated, 'autoimmune' islet damage. Antibody testing is
      extensively used to define and follow the pre-diabetic population. However, the
      assay for cell mediated immunity (CMI) should be more predictive of impending
      disease. This report shows that it is possible to detect human islet reactive CMI
      in the IDDM patient. Groups of athymic CD-1 nu/nu mice were injected
      intraperitoneally with either mononuclear blood cells (MBCs) or plasma from 10
      newly diagnosed Type I diabetic patients and 10 normal control subjects. Both
      glycemic control and histopathology were used to assay islet specific CMI in
      diabetic individuals. None of the injected mice showed any impairment of glycemic
      control. However, MBCs from six of 10 diabetic patients, but from none of the 10
      normal subjects, induced significant mononuclear cell infiltrate in the pancreas
      of the recipient mice (P = 0.005). The infiltrate was focused on the islet tissue
      and no damage was seen in control tissues. No histological abnormalities were
      observed when plasma was transferred. We conclude that cellular reactivity seen
      in this model is tissue specific and disease associated. Our findings provide
      evidence that CMI to human islet tissue can be detected in IDDM patients.

PMID- 1627232
TI  - Production of a human monoclonal anti-epithelial cell surface antibody derived
      from a patient with pemphigus vulgaris.
AB  - The production of monoclonal autoantibodies derived from individuals with
      autoimmune diseases constitutes a powerful tool to analyse an autoimmune process
      at both the antigen and antibody levels. We established a human anti-epithelial
      cell surface monoclonal antibody by applying hybridoma technology using
      peripheral blood lymphocytes from a patient with pemphigus vulgaris using a
      heteromyeloma as the fusion partner. The F12 monoclonal antibody displays four
      major characteristics: (1) it belongs to the IgM, kappa class; (2) it binds to
      the cell surface of stratified squamous and simple epithelia; (3) it recognizes
      an antigenic determinant associated with the desmosomal complex as demonstrated
      by indirect immunoelectron microscopy; (4) by immunoblotting analysis, it reacts
      with a 185 kDa polypeptide which was also recognized by a few pemphigus vulgaris
      sera. Although the F12 monoclonal antibody does not have the immunochemical
      properties of classical pemphigus vulgaris autoantibodies, several arguments
      suggest its relevance to the pemphigus vulgaris autoimmune response and,
      therefore, the heterogeneity of the antigen/antibody systems involved in this
      autoimmune disorder.

PMID- 1627233
TI  - SRI 62-834, a cyclic ether analogue of the phospholipid ET-18-OCH3, displays long
      lasting beneficial effect in chronic relapsing experimental allergic
      encephalomyelitis in the Lewis rat. Comparison with cyclosporin and (Val2)
      dihydrocyclosporin effects in clinical, functional and histological studies.
AB  - The therapeutic effect of the ether phospholipid SRI 62-834, which lacks the
      characteristics of an immunosuppressive agent, was compared with those of two
      immunosuppressive drugs, cyclosporin and valine2-dihydrocyclosporin, in a rat
      model of chronic relapsing experimental allergic encephalomyelitis (CR-EAE). Drug
      treatment was initiated at the beginning of the first spontaneous remission on
      day 15 and was discontinued on day 31. Whereas the untreated rats experienced two
      paralytic relapses around days 21 and 31, the progression of CR-EAE was prevented
      during the period of drug administration. Protection with both cyclosporin and
      its derivative was complete, but SRI 62-834 only attenuated the clinical disease.
      The absence of paralytic symptoms was reflected by a distinct reduction in
      mononuclear cell infiltration in the central nervous system at days 21 and 31 in
      treated animals. The main difference between the two drug classes became apparent
      after withdrawal of therapy. Discontinuation of SRI 62-834 resulted in a long
      lasting beneficial effect, with the rats remaining clinically normal and showing
      no histopathological changes. However, cyclosporin only delayed the clinical
      symptoms which reappeared after cessation of treatment. The exacerbated paralytic
      relapse, which followed about 1 week later and was associated with severe
      perivascular cell infiltrates and tissue destruction, subsequently became chronic
      in several animals. By contrast, withdrawal of valine2-dihydrocyclosporin
      partially prevented disease relapse and markedly reduced severity of symptoms
      without progression of a chronic disease. These results demonstrate the clear
      differences in the mode of action of these compounds in CR-EAE and suggest that
      SRI 62-834 could be an interesting candidate for the treatment of multiple
      sclerosis.

PMID- 1627234
TI  - Implications of modifying cardiolipin acyl composition by diet. 1. Cardiolipin
      acyl chain is an important determinant in the binding to antiphospholipid
      antibodies in SLE sera.
AB  - Antiphospholipid antibodies (aPL), prevalent in sera of patients with systemic
      lupus erythematosus (SLE), have been linked to thrombosis, thrombocytopenia,
      recurrent miscarriages, neurological disorders and ischemic heart disease. Most
      evidence suggests that phosphodiester-linked phosphate groups are the reactive
      epitope of cardiolipin (CL) in binding to aPL. Little attention has been given to
      the acyl moiety. To address this problem we have evaluated the ELISA binding of
      12 highly positive IgG anticardiolipin antibody-positive SLE sera to: bovine CL
      (86.1% 18:2n-6), monolyso CL (MLCL; bovine CL minus 1 fatty acid), dilyso CL
      (DLCL; minus 2 fatty acids), tetraoleoyl CL (TOCL), myristoyl CL (MCL) and E.
      coli CL. The reductions in binding of the IgG aPL antibodies relative to bovine
      CL were as follows: DLCL 83%; MLCL 70.7%; MCL 58%; and TOCL 14% (P less than
      0.05). These data suggest that the number of acyl chains and the unsaturation of
      the acyl chain of CL may be important determinants in the binding to aPL present
      in SLE sera. To investigate the nutritional relevance of this finding, we
      examined the incorporation of several dietary fatty acid classes into the CL pool
      of mice. Mice were fed diets containing n-6 (safflower oil), n-9 (olive oil) or n
      3 fatty acids as either 18:3n-3 (linseed oil) or 20:5n-3/22:6n-3 (fish oil) for a
      5 month period. The feeding of fish oil and olive oil resulted in replacement of
      a substantial portion of 18:2n-6 with 22:6n-3 or 18:1n-9, respectively. These
      results suggest that there may be therapeutic value in modifying the CL acyl
      composition by nutritional means with respect to binding to pathogenic aPL.

PMID- 1627235
TI  - Soluble interleukin-2 receptor and disease activity in Crohn's disease.
AB  - An ELISA was used to measure concentrations of soluble interleukin-2 receptor
      (sIL-2R) alpha chain in the sera of patients with Crohn's disease. In a group of
      56 patients, serum concentrations of sIL-2R were significantly raised in patients
      with active disease compared with patients with inactive disease and age-matched
      control populations. There was a significant correlation between serum sIL-2R
      concentration and disease activity as assessed by the Harvey-Bradshaw index (r =
      +0.60; P less than 0.001) and laboratory measurements of disease activity
      including C-reactive protein (r = +0.79; P less than 0.001), ESR (r = +0.64; P
      less than 0.001) and platelet count (r = +0.533; P less than 0.001). We also
      found a negative correlation between sIL-2R levels and serum albumin (r = -0.66;
      P less than 0.001). In longitudinal studies, changes in the concentration of
      serum sIL-2R reflected the changes in disease activity. Soluble IL-2R, therefore,
      offers a new measure of disease activity in Crohn's disease with a potential
      advantage over other laboratory parameters currently available in that it may
      reflect more accurately the underlying immunopathogenic process.

PMID- 1627236
TI  - Warm Carolina rinse solution prevents graft failure from storage injury after
      orthotopic rat liver transplantation with arterialization.
AB  - An injury to nonparenchymal cells, characterized by loss of viability of
      sinusoidal endothelial cells and activation of Kupffer cells, occurs after
      reperfusion of livers stored for transplantation. Recently, a new solution,
      Carolina rinse solution, was shown to prevent reperfusion injury to endothelial
      cells in vitro almost completely and to improve graft survival after orthotopic
      rat liver transplantation (ORLT) without arterialization. ORLT with
      arterialization permits longer cold storage of donor livers and more closely
      models human surgery. Therefore, we evaluated the effects of Carolina rinse
      solution on graft survival after ORLT with arterialization in syngeneic Lewis
      rats. Just prior to implantation, donor livers stored in University of Wisconsin
      (UW) solution were rinsed with 30 ml of Ringer's solution, saline, or Carolina
      rinse solution at 1 degree-4 degrees C. In livers stored for 15 h and rinsed with
      Ringer's or saline solution, long-term graft survival was only 8%. Using Carolina
      rinse solution containing 1 mmol and 200 mumol adenosine per liter, graft
      survival improved to 40% and 80%, respectively. Graft survival did not improve
      when using Carolina rinse solution with adenosine omitted or Ringer's solution
      containing 200 mumol adenosine per liter. Livers were also rinsed with Carolina
      rinse solution containing 200 mumol adenosine per liter at 28 degrees-30 degrees
      C rather than at 1 degree-4 degrees C. With warm Carolina rinse solution,
      survival improved further to 100%, 80%, and 50% after 15, 18, and 21 h of
      storage. After 18 h of storage, light and electron microscopy demonstrated marked
      denudation of the sinusoidal lining and activation of Kupffer cells in grafts
      rinsed with Ringer's solution.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627237
TI  - Postprandial increase in serum creatinine in renal transplant recipients.
AB  - Daily variation in serum creatinine and the effect of a protein load was studied
      in 18 patients with renal transplants and in 10 healthy controls. Serum
      creatinine was analyzed both with a standard Jaffe method and with a specific
      HPLC technique. Following a protein meal, a 30% increase in serum creatinine
      levels was noted in both groups, but the rise in absolute terms was more
      prominent among the transplanted patients. Urinary excretion of creatinine did
      not increase in the transplanted group, indicating a reduced ability to deal with
      the surplus creatinine in the protein meal. It is concluded that serum creatinine
      levels are diet-dependent and that this variation is more pronounced when renal
      function is reduced. Standardized blood sampling is important when following
      serum creatinine in renal transplant recipients from one day to the next.

PMID- 1627238
TI  - Histologic resolution of documented hemosiderosis in a renal transplant
      recipient. A case report.
AB  - A 33-year-old cadaveric renal transplant recipient showed complete histologic
      resolution of hemosiderosis by liver biopsies obtained pre- and post
      transplantation. Although there have been reports in the past of progression of
      hemosiderosis to hemochromatosis to severe liver failure in the renal transplant
      population, the correlation has never been clear. This is the first case report
      of complete resolution of hemosiderosis as documented histologically by liver
      biopsies in a cadaveric renal transplant recipient.

PMID- 1627239
TI  - A simplified technique for hepatic revascularization of the liver graft with
      inadequate recipient hepatic artery.

PMID- 1627240
TI  - "Arterialization", "revascularization", "rearterialization"--what's in a name?

PMID- 1627241
TI  - Liver transplantation for arteriohepatic dysplasia (Alagille's syndrome).
AB  - Thirteen out of 268 children (less than 18 years old) underwent hepatic
      transplantation (OLT) for end-stage liver disease (ESLD) associated with
      arteriohepatic dysplasia (AHD). Seven children are alive and well with normal
      liver function. Six children died, four within 11 days of the operation and the
      other two at 4 and 10 months after the OLT. Vascular complications with
      associated septicemia were responsible for the deaths of three children. Two died
      of heart failure and circulatory collapse, secondary to pulmonary hypertension
      and congenital heart disease. The remaining patient died of overwhelming sepsis
      not associated with technical complications. Seven patients had a
      portoenterostomy or portocholecystostomy early in life; five of these died after
      the OLT. Severe cardiovascular abnormalities in some of our patients suggest that
      complete hemodynamic monitoring with invasive studies should be performed in all
      patients with AHD, especially in cases of documented hypertrophy of the right
      ventricle. The improved quality of life in our surviving patients confirms the
      validity of OLT as a treatment of choice in cases of ESLD due to AHD.

PMID- 1627242
TI  - Effect of reduced cyclosporin dosage on long-term renal allograft histology.
AB  - The effect of different doses of cyclosporin (CyA) on the occurrence of
      histological lesions in renal allograft biopsies was investigated 2 years after
      transplantation. Biopsy findings were compared in three different groups of
      patients. In group 1, patients were immunosuppressed with CyA and prednisolone
      according to an early, high-dosage schedule (initial CyA dose 15-17.5 g/kg body
      weight); in group 2, they were treated with a medium CyA dose (initial dose 12
      mg/kg), together with prednisolone; and in group 3, patients were given triple
      drug therapy consisting of low doses of CyA (initial dose 8 mg/kg), together with
      both azathioprine and prednisolone. Interstitial fibrosis and tubular atrophy
      were common findings in all groups, and on the basis of all biopsies, no
      difference could be found between the groups with respect to the relative volume
      of the renal cortical interstitium, which was used as a quantitative parameter
      for interstitial fibrosis. Likewise, no difference was found with respect to
      serum creatinine levels. When grafts that showed signs of rejection (usually
      vascular rejection) in the biopsy were excluded (two in group 1, six in group 2,
      and ten in group 3), the mean interstitial volume was significantly lower in
      group 3 (triple drug therapy) than in the other groups. The serum creatinine
      levels were also significantly lower in group 3 than in group 1. Thus, chronic
      renal lesions could be ameliorated when CyA doses were lowered, but this appeared
      to entail an increased risk of acute or chronic vascular rejection.

PMID- 1627243
TI  - The use of the University of Wisconsin (UW) and Euro-Collins (EC) solutions
      either alone or in a combined method.
AB  - From June 1988 to October 1990, a total of 100 orthotopic liver transplantations
      (OLTs) in 91 patients were performed at the Hospital Clinic of Barcelona. Euro
      Collins (EC) solution was used as the flush and storage solution in 29 livers,
      and the University of Wisconsin (UW) solution was used in 24. A combined method,
      consisting of flushing and harvesting the liver with UW solution through the
      portal vein and with EC solution through the aorta, was used in the remaining 47
      livers. Livers harvested using such a combined method showed substantially better
      postoperative function in terms of AST, ALT, and prothrombin activity than those
      harvested in EC solution alone. Although AST and ALT values were lower in
      patients whose livers were harvested using the combined method than with UW
      alone, differences were not significant. On the other hand, prothrombin activity
      was consistently better in the UW group. Bilirubin levels, platelet count, and
      bile output showed no difference among the three groups. We conclude that the
      combined use of UW and EC solutions for flushing and harvesting is not hazardous
      to human liver preservation and, in fact, may considerably reduce the amount of
      UW solution needed and, consequently, the costs.

PMID- 1627244
TI  - Effectiveness of low-dose cotrimoxazole prophylaxis against Pneumocystis carinii
      pneumonia after renal and/or pancreas transplantation.
AB  - We retrospectively examined the effectiveness of prophylaxis with cotrimoxazole
      in preventing Pneumocystis carinii pneumonia in recipients of kidney and combined
      kidney-pancreas transplants between 1985 and 1989. Cotrimoxazole prophylaxis (480
      mg daily or 300 mg/m2), when used, was started within 2 months after
      transplantation and usually continued until 6 months after surgery. Eight (3.7%)
      of the 214 patients who were not given prophylaxis were infected with
      Pneumocystis carinii, and there were 4 fatalities (50% mortality). There were no
      cases among the 161 patients given prophylaxis (P less than or equal to 0.03). No
      serious adverse effects were noted in the prophylaxis group. It is concluded that
      prophylaxis against Pneumocystis carinii infection is well tolerated and should
      be given as soon as possible to all organ transplant recipients for at least 6
      months.

PMID- 1627245
TI  - Chronic rejection of rat renal allograft. I. Histological differentiation between
      chronic rejection and cyclosporin nephrotoxicity.
AB  - Chronic allograft rejection is both a clinical and a histopathological diagnosis.
      Until recently, the histological definition of chronic renal allograft rejection
      was based on clinical diagnostic biopsies, where the evidence was partially
      obscured by recurrence of the original renal disease, and/or by administration of
      immunosuppressive drugs. In this communication, we present an experimental rat
      model for chronic renal allograft rejection, devoid of recurrence of the original
      disease. By comparing allografts to similarly immunosuppressed syngeneic
      transplants, we define which histological features should be attributed to
      chronic rejection and which to cyclosporin nephrotoxicity. Rat renal transplants
      were performed from DA (Ag-B4, RT1av1) to WF strain (Ag-B2, RT1u) or, for
      control, to DA strain, and immunosuppressed for 2 or 3 weeks with cyclosporin
      using a variety of different dosages. The animals were monitored weekly for serum
      creatinine levels and for blood cyclosporin concentrations, and core needle
      biopsies were performed on the grafts at regular intervals. At 3 months post
      transplantation the animals were sacrificed and a complete histopathological
      evaluation was performed. Thirty-one histological variables were scored blindly
      by two investigators and separately for the graft interstitium, glomeruli,
      tubuli, and the graft vasculature. The following histological alterations were
      significantly more prominent in allografts than in similarly immunosuppressed
      syngeneic transplants: the intensity of interstitial inflammation, particularly
      the degree of pyroninophilia within the inflammatory cell population; the extent
      of glomerular mesangial matrix increase, basement membrane thickening, and
      glomerular sclerosis; the increase in the vascular intimal thickness affecting in
      particular the first and second order branches of the renal artery; and the
      obliteration of the graft vasculature. These alterations were considered as being
      primarily due to chronic rejection. In contrast, the extent of interstitial
      fibrosis and the extent of tubular changes, including tubular epithelial
      vacuolation, epithelial atrophy, and tubular basement membrane changes, were not
      significantly different in the allografts as compared to the syngeneic controls.
      These alterations were attributed primarily to cyclosporin nephrotoxicity. Serial
      monitoring of the grafts by needle biopsies clarified the sequence of events in
      the development of the chronic alterations in the transplant. The first event, as
      expected, was tubulointerstitial pyroninophilic inflammation, resembling that of
      acute episodes of rejection. This was significantly stronger and appeared earlier
      in allografts immunosuppressed for 2 rather than for 3 weeks. Vascular
      alterations developed next. The last to develop were the glomerular lesions.

PMID- 1627246
TI  - Regulation of major histocompatibility complex (MHC) products in fresh and
      cultured human fetal pancreata aged 9-16 gestational weeks by gamma-interferon.
AB  - Immunological data on the human fetal pancreas (HFP) are mainly confined to its
      constitutive expression of the MHC antigens. However, cytokines, such as gamma
      interferon (g-IFN), released by lymphocytes during immune reactions, can induce
      or upregulate the expression of MHC products in allografts and alter their
      immunological behaviour. We investigated the effects of g-IFN on fresh and
      cultured HFPs aged 9-16 gestational weeks (gw). Following g-IFN stimulation of
      fresh HFPs, there was class I hyperexpression by the ductal cells, and some of
      the ductal, endothelial and islet cells also became class II+. Conventional
      tissue culture (5% CO2 in air at 37 degrees C) reduced the number of interstitial
      class II+ cells within the HFP after 1 week but was associated with de novo class
      I expression by some of the ductal cells. Remarkably, the changes in major
      histocompatibility complex (MHC) antigen expression by the ductal cells occurred
      earlier and were markedly enhanced when the HFPs were cultured beforehand. The
      number of interstitial class II+ cells in fresh and cultured HFPs was not
      influenced by g-IFN. The significance of these observations with regard to
      clinical HFP transplantation is discussed.

PMID- 1627247
TI  - HIV interactions with CD4: a continuum of conformations and consequences.
AB  - Here, Lee Eiden and Jeffrey Lifson present a model for HIV envelope glycoprotein
      CD4 interactions that attempts to reconcile recent, seemingly conflicting,
      structural, biochemical and biological observations. Central to this model is the
      involvement of both the CDR2-like and CDR3-like domains of CD4 in the interaction
      with gp120, leading to a conformational change and dissociation of gp120 from the
      gp120-gp41 complex.

PMID- 1627248
TI  - Does the HIV envelope induce a chronic graft-versus-host-like disease?
AB  - Evidence is accumulating that susceptibility to disease following HIV infection
      is genetically restricted. In addition, activation of the immune response appears
      to play an important role in disease progression. Here, John Habeshaw and
      colleagues propose that HIV envelope glycoproteins mimic foreign MHC molecules
      and, in doing so, stimulate alloreactive lymphocytes. This activation may explain
      the marked clinical and immunological similarities between chronic GVHD and AIDS.

PMID- 1627249
TI  - Developmental and maturational changes in human blood lymphocyte subpopulations.

PMID- 1627250
TI  - The role of nasopharyngeal lymphoid tissue.
AB  - Nasal-associated lymphoid tissue (NALT), which comprises paired lymphoid organs
      in the nasopharynx of rodents, is the principal mucosal lymphoid tissue of the
      respiratory tract. As described in this review, NALT bears certain similarities
      to the Peyer's patches of the intestine but the two differ remarkably in
      morphology, lymphoid migration patterns and the binding properties of their high
      endothelial venules (HEV).

PMID- 1627251
TI  - Uterine granular lymphocytes are activated natural killer cells expressing VLA-1.

PMID- 1627252
TI  - Cytokines and Alzheimer's disease.

PMID- 1627253
TI  - Localization of MPP+ binding sites in the brain of various mammalian species.
AB  - The distribution and density of 3H-MPP+ binding sites were studied by in vitro
      quantitative autoradiography in the brain of the mouse, rat and monkey. The
      highest levels of 3H-MPP+ specific binding were observed in rat brain. The
      substantia nigra in rat and monkey, and the anterior caudate-putamen formation in
      mouse and monkey showed the lowest density of autoradiographic grains. The
      presence of a relatively high density of MPP+ sites in the hippocampus of all
      species studied could be of interest to explain some effects of MPTP
      administration on convulsions caused by chemoconvulsants. The finding of a 60-70%
      reduction of 3H-MPP+ binding sites in the rat caudate-putamen, on the side of
      quinolinic acid infusion and no changes after 6-hydroxydopamine lesion of
      dopaminergic nigrostriatal neurons suggests the presence of these sites mainly on
      striatal cells. The results suggest that the distribution of MPP+ binding sites
      in brain would not seem to be related to MPTP toxicity.

PMID- 1627254
TI  - Release signs in Parkinson's disease with and without dementia.
AB  - Release signs have been described in both age-associated diseases and in the
      healthy elderly. We investigated the palmomental, snout, grasp, corneomandibular
      and glabellar reflexes in demented and non-demented Parkinson-patients compared
      to Alzheimer's disease and age-matched controls. The palmomental reflex and a
      persisting glabellar reflex were linked to parkinsonism irrespective of dementia
      and were found also in Alzheimer's disease. A corneomandibular reflex was
      observed more frequently in demented than non-demented Parkinson-patients and in
      Alzheimer's disease. The snout-reflex was present in nearly all individuals
      irrespective of diagnosis. Thus, various release signs react quite differentially
      to degenerative brain disease and dementia.

PMID- 1627255
TI  - Age influences abnormalities in striatal dopamine metabolism during and after
      transient forebrain ischemia.
AB  - Age has been found to be a significant risk factor for brain ischemia and its
      mortality. After cerebral ischemia, the nigrostriatal dopaminergic system
      undergoes selective vulnerability with necrosis of striatal neurons. To study the
      effect of age and transient forebrain ischemia on striatal dopamine metabolism,
      investigations were performed in 1-year-old (adult) and 2-year-old (aged) male
      Wistar rats. A 15 min period of bilateral transient incomplete ischemia (ICI) was
      induced, and the concentrations of dopamine (DA), 3,4-dihydroxyphenylacetic acid
      (DOPAC), 3-methoxytyramine (3-MT), and homovanillic acid (HVA) were measured in
      the striatum by means of HPLC and electrochemical detection at the end of
      ischemia without reperfusion, and after 1 h, 24 h, 72 h, 144 h, and 288 h of
      postischemic cerebral reperfusion. In normal conditions, no 3-MT was detectable
      in either age group studied, and no other age-related changes could be found in
      DA or its metabolites. During ICI, an age-related difference became obvious in
      the 3-MT concentration, which was higher in aged animals. In this group, DOPAC
      dropped and DA turnover increased. After 1 h of postischemic reperfusion, the
      concentrations of DOPAC and HVA, as well as the turnover rate, had increased in
      both age groups, whereas an increase in the DA concentration became apparent in
      the adult animals only. The enhancement of the concentration of both DOPAC and
      HVA was more marked in adult animals than in aged ones. At 24 h of postischemic
      cerebral reperfusion, DA concentration was still elevated in both age groups, and
      HVA in the 1-year-old animals only. At 72 h of postischemic cerebral reperfusion,
      no differences were obvious between adult experimental animals and controls,
      whereas the elevated DA concentration persisted in aged animals, being higher
      than in the control group and in the 1-year-old rats. DA turnover was reduced.
      Longer periods of postischemic cerebral reperfusion were not found to be followed
      by any abnormalities compared with controls except for the DA concentration at
      288 h (1-year-old group); nor were there any differences between the two age
      groups studied. The data obtained in this investigation clearly indicate age
      related differences in the striatal dopaminergic neurotransmission after
      transient cerebral ischemia, in that in the aged brain reactions are markedly
      delayed after an injurious event such as ischemia.

PMID- 1627256
TI  - Brain gamma-aminobutyrate aminotransferase (GABA-T) and monoamine oxidase (MAO)
      in patients with Alzheimer's disease.
AB  - Activities of Gamma-aminobutyrate aminotransferase (GABA-T) and Monoamine oxidase
      (MAO)-A and -B were estimated in postmortem brains from 6 control subjects
      without psychiatric or neurologic disorders and 8 histopathologically verified
      cases of patients with Alzheimer's disease and senile dementia of Alzheimer type
      (AD/SDAT). The enzyme activities were examined in four cortical brain regions,
      three nuclei in the basal ganglia, thalamus and white matter. GABA-T activities
      in the cortical regions (frontal, parietal, occipital and temporal cortices) and
      nucleus caudatus were significantly lowered in the AD/SDAT patients. The MAO-A
      activities were significantly increased in the occipital cortex, caudate nucleus,
      thalamus and white matter in the AD/SDAT patients. No significant differences
      were found in the other regions (frontal cortex, parietal cortex, temporal
      cortex, putamen and globus pallidus). The MAO-B activities in three cortical
      regions (frontal, parietal and occipital cortices), thalamus and white matter
      were significantly increased in the AD/SDAT patients, whereas no difference was
      apparent in the other regions. The changed activities could not be correlated
      with age or postmortem time. The present results are the first describing
      decreased GABA-T activities as well as increased MAO-A activities in brain from
      patients with AD/SDAT, while the results with MAO-B support previous findings. A
      possible connection was found between the order of magnitude of the changes in
      enzyme activities and the severity of the disease.

PMID- 1627257
TI  - Cognitive profile of Alzheimer patients with extrapyramidal signs: a longitudinal
      study.
AB  - The cognitive profile of Alzheimer patients without (ADE-, n = 17) and with (AD,
      E+, n = 15) extrapyramidal signs (rigidity or bradykinesia), at the time of
      diagnosis, was examined in a 3-year follow-up study and compared to cognitive
      performance of demented (PD D+, n = 18) and nondemented (PD D-, n = 17) patients
      with Parkinson's disease and normal elderly controls (n = 19). Although the AD E+
      and AD E- groups did not differ significantly at the initial testing, the AD E+
      patients showed greater deterioration on visual, praxic and expressive speech
      functions as well as in category memory. The cognitive profile of the AD E+
      patients was similar to that of the PD D+ patients except that the AD E+ patients
      recognized more false positive targets on list-learning task. The AD E- patients
      had better preserved praxic functions and WAIS Performance IQ but they, like AD
      E+ patients, recognized more false positive targets on list-learning than the PD
      D+ patients did. The results suggest that AD patients with extrapyramidal signs,
      even if mild, at the time of diagnosis may have greater progression of cognitive
      impairment, especially on cortical functions, which may explain earlier need for
      institutional care observed in previous studies as compared to patients without
      these signs.

PMID- 1627258
TI  - Monoclonal antibody H3/5-47 recognizes an inducible cell surface antigen
      expressed differently in endothelium of normal and diseased tissues and in vitro.
AB  - Monoclonal antibody H3/5-47 was raised against a human melanoma metastasis and
      recognizes an antigen expressed in the endothelial cells of all normal human
      organs as assessed by immunohistochemistry. Antigen expression is higher in
      venous than in capillary or arterial endothelia; capillary endothelia of
      different microvascular beds, such as skin, lung, gut or liver, may express
      varying amounts of this antigen. H3/5-47 antigen expression in the endothelia of
      diseased tissues (inflammatory diseases, neoplasias) largely reflects its
      expression pattern in normal tissues. As might be anticipated, the highest
      expression of H3/5-47 antigen is found in resting adult cutaneous and hepatic
      cavernous venous hemangiomas. In contrast, psoriatic vessels, characterized by
      hypertrophy and fenestrations, tend to express H3/5-47 antigen at a much lower
      density. In human umbilical vein endothelial cells, half the single donor cases
      show no expression of H3/5-47 antigen, while the rest express the antigen at
      relatively low densities in about half the cells. Treatment with interferon-gamma
      or thrombin, but not interleukin-1, lipopolysaccharide, endothelial cell growth
      factor or phorbolester, either enhances or induces de novo expression in cultured
      human umbilical vein endothelial cells within 24h; maximum expression of H3/5-47
      antigen is induced by interferon-gamma within 72 h. H3/5-47 antigen is not
      similar to other antigens inducible in human umbilical vein endothelial cells
      such as HLA-DR, ICAM-1, HECA-452, Leu13, MCP-1 or gamma-IP-10. It is not
      specifically expressed in the endothelium as it may also recognize certain
      epithelia, peripheral nervous tissue and bone marrow-derived cell
      populations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627259
TI  - Effects of recombinant cytokines on murine megakaryocyte colony formation in a
      serum-free fibrin clot culture system.
AB  - A convenient serum-free fibrin clot culture system for murine megakaryocyte
      progenitor cells was developed. The culture and counting of colonies is much
      easier in this system, when compared with previously reported serum-free culture
      methods. Recombinant murine interleukin-3 (rmIL-3) stimulated megakaryocyte
      colony formation in a dose-dependent manner in this system. While recombinant
      human granulocyte colony-stimulating factor (rhG-CSF) had no effect on
      megakaryocytopoiesis, recombinant human erythropoietin (rhEpo) and recombinant
      human interleukin-6 (rhIL-6) augmented megakaryocyte colony formation stimulated
      by rmIL-3. The depletion of adherent cells and T cells from the cultured bone
      marrow did not eliminate the synergistic effect of rhEpo and rhIL-6.

PMID- 1627260
TI  - Immunohistochemical localisation of transforming growth factor-beta in first and
      third trimester human placenta.
AB  - Recently it has been demonstrated that human placental tissue is a source of
      transforming growth factor-beta (TGF-beta) and that it expresses high TGF-beta
      mRNA activity. For a better understanding of its in vivo function, it was
      necessary to determine the site of TGF-beta synthesis in placenta. We have
      demonstrated that TGF-beta immunoreactivity is present in the cytoplasm of
      syncytiotrophoblast cells in both early and term placenta. The most intense
      staining was, however, observed in the first trimester trophoblast syncytial
      sprouts known to be an early stage in the development of placental villi. These
      results suggest the involvement of TGF-beta in the paracrine regulation of
      trophoblast-endometrial interaction.

PMID- 1627261
TI  - Cellular functions related to metastasis differing between low- and high
      malignancy variants of AKR lymphoma.
AB  - Two AKR lymphoma variants of low (LM) and high (HM) malignancy were characterized
      for cell properties important for metastatic capacity. Previous data suggested
      that these murine lymphoma variants differed in the late phase of metastasis. In
      the present study we attempted to determine more accurately the stage in which
      they differ. The HM cells attached less efficiently than the LM ones to both
      endothelial cells (5 times) and extracellular matrix (twice), possibly indicating
      a more efficient extravasation capacity of the HM cells. The level of heparinase
      was low in the two variant cells. Attachment to liver sections was, however, more
      efficient with the HM than with the LM cells.

PMID- 1627262
TI  - Detection of Borrelia burgdorferi in human blood and urine using the polymerase
      chain reaction.
AB  - We investigated the use of the polymerase chain reaction (PCR) to detect Borrelia
      burgdorferi strain B-31 in human blood and urine experimentally inoculated with 5
      and 1 borreliae/cm3, respectively, and to biotinylate a DNA probe specific for B.
      burgdorferi in the dot blot and Southern blot assays. When the blood and urine
      samples were subjected to PCR, a 370-bp amplified product was consistently
      visible on agarose gel electrophoresis after 30 and 45 cycles, respectively. The
      total human genomic DNA extracted from a 1-cm3 sample of inoculated blood was
      approximately 6.25 micrograms, and the total amount of B. burgdorferi DNA was
      estimated to be 0.01 pg/6.25 micrograms of the human DNA. For PCR, 2.5 micrograms
      of human DNA which contained the equivalent of 0.004 pg of borrelia DNA
      (approximately two borreliae) were used for enzymatic amplification. When 1/20 or
      1/10 of the PCR-amplified products were used either for dot blot or Southern blot
      hybridization, the accessible copies of amplified B. burgdorferi DNA were
      sufficient for detectable hybridization to occur. PCR amplification of B.
      burgdorferi DNA in clinical specimens followed by dot blot hybridization may be a
      valuable adjunct or alternative to current but inadequate laboratory methods for
      the diagnosis of Lyme disease.

PMID- 1627263
TI  - Microbial metabolism of quinoline and related compounds. XIII. Purification and
      properties of 1H-4-oxoquinoline monooxygenase from Pseudomonas putida strain
      33/1.
AB  - 1H-4-Oxoquinoline monooxygenase was purified to homogeneity from Pseudomonas
      putida strain 33/1 which can use 1H-4-oxoquinoline as sole source of carbon and
      energy. The apparent M(r) of the native enzyme was determined to be 126,000 by
      gel chromatography. SDS polyacrylamide gel electrophoresis of the enzyme revealed
      one protein band corresponding to M(r) 42,000. The enzyme consists of three
      probably identical subunits with a relative molecular mass of about 42,000. The
      enzyme requires oxygen and NADH for the reaction and is significantly inhibited
      by metal ions like Cu2+, Zn2+, Hg2+. The enzyme is specific only for 1H-4
      oxoquinoline and the Km values of the enzyme for NADH and 1H-4-oxoquinoline were
      determined to be 87 microM and 25 microM, respectively.

PMID- 1627264
TI  - Stimulation of human polymorphonuclear leukocytes by recombinant human
      interleukin-1 beta.
AB  - Leukocyte activation is a property of systemic infection. Animal experiments
      indicate interleukin-1 (IL-1) as a possible modulator, while contradictory
      results have been reported from in-vitro stimulation of isolated leukocytes. The
      purpose of the present study was to investigate the activation of isolated
      polymorphonuclear (PMN) leukocytes in vitro by preparations of recombinant human
      IL-1 beta and IL-1 receptor antagonist, which in earlier studies could elicit and
      abrogate, respectively, a sepsis-like syndrome in rabbits. They have also been
      shown to influence acute phase protein synthesis in mice and rats, and release of
      leukocyte cathepsin G in vivo. It was found that recombinant human IL-1 beta
      elicited a dose-dependent luminol-enhanced chemiluminescence response in isolated
      human PMN leukocytes in the dose range 8.8 x 10(-11)-8.8 x 10(-8) M. The effect
      could be blocked by prior treatment with the IL-1 receptor antagonist, indicating
      a direct effect on the specific IL-1 receptor. Preincubation by IL-1 beta
      enhanced the effect of a secondary challenge with phorbol 12-myristate 13-acetate
      or formyl-Met-Leu-Phe by 30-40%. The priming effect of rhIL-1 beta could also be
      blocked by the specific receptor antagonist. In this study, incubation of PMN
      leukocytes with rhIL-1 beta failed to induce degranulation of both azurophil
      (neutrophil proteinase 4/proteinase 3) and specific (lactoferrin) granules. rhIL
      1 beta has been shown to induce degranulation in vivo, which is thus indicated as
      an indirect effect. We conclude that IL-1 beta is a direct and specific, but
      probably weak stimulator of the PMN leukocyte.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627265
TI  - Characterization of four genes encoding basic proteins of the porcine spermatid
      nucleus and close linkage of three of them.
AB  - Protamines and transition proteins (TNP) play a major role during spermatogenesis
      and spermatid differentiation. By screening a porcine genomic library with the
      corresponding cDNAs, we isolated the genomic clones for porcine protamines 1 and
      2 as well as for transition proteins 1 and 2. Analysis and comparison of exon
      intron structure, 5' and 3' untranslated regions and transcription start points
      revealed features common to their counterparts in other mammals. In contrast to
      TNP2 the gene for TNP1 is well conserved among species, indicating a non species
      specific function in the chromatin condensation of the spermatid nucleus.
      Furthermore, Southern blot hybridization of digested phage DNA demonstrated close
      linkage between both protamine genes and the gene for transition protein 2 in a
      13-kb stretch of DNA. Our observations support the hypothesis that these genes
      may have evolved by gene duplication.

PMID- 1627266
TI  - Rat tumor necrosis factor-alpha. Transcription in rat Kupffer cells and in vitro
      posttranslational processing based on a PCR-derived cDNA.
AB  - A DNA fragment with a reading frame of 708 basepairs coding for TNF-alpha from
      rat liver was cloned by the polymerase chain reaction. Using this species
      specific cDNA a biotin-labelled antisense (-)RNA was transcribed. This probe was
      used for Northern blot analysis of TNF-alpha gene activation. Exposure of rat
      Kupffer cells to LPS led to a time-dependent change of TNF-alpha-mRNA expression
      with a maximum between one and two hours after stimulation. In vitro translation
      was carried out with sense (+)RNA in the presence of microsomes. SDS gel
      electrophoresis of the immunoprecipitated proteins revealed the formation of
      polypeptides with estimated molar masses of 26 and 17 kDa. They correspond to the
      estimated molar masses of a precursor of TNF-alpha encoded by the entire reading
      frame and of the mature form of TNF-alpha, respectively. A sequence of the cDNA
      assumed to code for the leader peptide was deleted and the remainder used for the
      construction of an expression plasmid. Using this construct, biologically active
      mature TNF-alpha was expressed in E. coli (10(6) units TNF-alpha per liter of
      culture medium). The propeptide as well as the biologically active TNF-alpha
      possess a homology of 92 and 76% to mouse and human TNF-alpha, respectively.

PMID- 1627267
TI  - Gangliosides in bovine milk. Changes in content and distribution of individual
      ganglioside levels during lactation.
AB  - Bovine milk undergoes changes in its ganglioside contents during the different
      stages of lactation. These contents are higher in colostrum (7.5 mg of lipid
      bound NeuAc/kg) than in transitional (2.3 mg) or mature (1.4 mg) milk. The sialic
      acid content of milk follows a similar profile to that of gangliosides with the
      highest content during the first few days post partum followed by a gradual
      decrease towards the end of the period studied. When the individual distribution
      of gangliosides was examined throughout the course of lactation, several changes
      were also found. GD3 is the major ganglioside (about 60-70%) found; its content
      decreases from the first to the fifth day, increasing towards the end of the
      period considered. GM3, GD3 and GT3, sialyllactosylceramide-containing
      gangliosides account for 80-90% of the total lipid-bound NeuAc content. The most
      striking change in the ganglioside pattern was the gradual increase in G3.

PMID- 1627268
TI  - Distinct distributions of D-erythro-neopterin in arteries and veins and its
      recovery by an enterohepatic circulation.
AB  - Large amounts of D-erythro-neopterin, a pteridine derivative, are formed from
      guanosine triphosphate (GTP) by human macrophages upon stimulation with
      interferon-gamma. In addition, in humans a basal neopterin level in all body
      fluids is evident also in absence of immunological stimuli. Extremely high
      concentrations of D-erythro-neopterin were detected in biliary fluid. We
      therefore investigated, if an enterohepatic circulation might exist for this
      substance. We quantified concentrations of pteridines in serum obtained from
      various vessels and in biliary fluid. Samples were collected during surgery of
      five patients with duodenal ulcer or adenocarcinoma of the stomach. Our data
      clearly demonstrate the existence of an enterohepatic circulation for the
      recovery of neopterin which seems to be specific for this substance. The relative
      distributions of neopterin concentrations in the gastrointestinal tract and
      vessels were seen invariably in all patients and were consistent with findings in
      five corpses examined post mortem. In addition, significantly higher neopterin
      concentrations, were found in arteries than in veins. The data indicate that
      neopterin derivatives are consumed in the peripheral capillary system and an
      enterohepatic circulation is established to maintain constant blood levels of
      neopterin derivatives. Furthermore, we suppose that the liver is the source of
      constitutive neopterin concentrations.

PMID- 1627269
TI  - Peer review.

PMID- 1627270
TI  - Activity of liposomal interleukin-2 in vitro.
AB  - Preclinical in vitro assessment of highly purified natural human interleukin-2
      (IL-2) packed in egg lecithin liposomes was performed in short- and long-term T
      cell cloning and propagation systems, and in experiments testing induction of
      lymphokine-activated killer (LAK) cells. Liposomal IL-2 (lip-IL-2) was
      essentially as active as free natural or recombinant IL-2 for cloning and culture
      of both helper and cytotoxic alloreactive T cells. However, lip-IL-2 was found to
      be markedly inferior to free natural or recombinant IL-2 for the induction of LAK
      cells from normal donors. Nevertheless, lip-IL-2 was able to maintain LAK
      cytotoxicity of populations preactivated with free IL-2. These results suggest
      that lip-IL-2 can interact with activated T cells and LAK cells in the same way
      as free IL-2, but that it is much less efficient at activating LAK-cell
      precursors.

PMID- 1627271
TI  - Antitumor activity of recombinant human tumor necrosis factor in combination with
      hyperthermia against heterotransplanted human prostatic carcinoma and its lymph
      node metastasis in nude mice.
AB  - The antitumor activity of recombinant human tumor necrosis factor (rhTNF) against
      heterotransplanted human prostatic carcinoma (PC-3) and spontaneous lymphatic
      tumor metastasis was studied in vivo. The spontaneous lymphatic metastasis of PC
      3 tumor was found in approximately 50% of cases. Significant antitumor activity
      was observed with repeated intratumoral administration of a large dose of rhTNF,
      not only on the subcutaneous tumor xenografts but also on the lymph node
      metastases. Strong antitumor activity could be achieved even with the
      intratumoral administration of a small dose of rhTNF in combination with mild
      hyperthermia on either the transplanted tumors or on the metastatic tumors.

PMID- 1627272
TI  - Combination biotherapy utilizing interleukin-2 and alpha interferon in patients
      with advanced cancer: a National Biotherapy Study Group Trial.
AB  - The National Biotherapy Study Group (NBSG) conducted a broad phase II trial using
      interleukin-2 (IL-2) by continuous infusion and alpha interferon (IFN)
      subcutaneously in 267 patients with a variety of advanced cancers, including 29
      with breast cancer, 89 with renal cancer, and 69 with melanoma. IL-2 [18 million
      international units (MIU)/m2] was given by continuous infusion for 108 hours with
      3 mu/m2 subcutaneous IFN every other day during the IL-2 infusion. The patients
      were treated for 1 week followed by a 2-week rest. After two cycles of treatment,
      patients were evaluated for response. Of the 237 patients evaluable for response,
      20 (8%) had a complete or partial response and 128 (54%) were stable. Therefore,
      62% of the evaluable patients were nonprogressive during the first 90 days of IL
      2/IFN therapy. The objective response rate was 11% in melanoma, 7% in renal
      cancer, 14% in breast cancer, and 3% in patients with a variety of malignancies
      for an overall response rate of 7% in these patients with advanced cancer. The
      patients were treated on a general medical ward and tolerated treatment well with
      fatigue and fever being nearly universal. Dyspnea, pruritus, chills, and elevated
      creatinines were frequent but less common. This combination biotherapy regimen
      has minimal activity in a variety of advanced cancers and must be compared with
      the best existing chemotherapy for each cancer type in randomized, prospective
      trials.

PMID- 1627273
TI  - Mimicking of superoxide dismutase activity by protein-bound polysaccharide of
      Coriolus versicolor QUEL, and oxidative stress relief for cancer patients.
AB  - The protein-bound polysaccharide of Coriolus versicolor QUEL (PS-K) has been
      found to express antioxidant activity as an "ion-radical scavenger" in diamine
      oxidation reactions. The mode of this expression was examined to determine
      whether the drug functioned as a simple radical scavenger or mimicked the action
      of superoxide dismutase (SOD). The latter was confirmed in both enzymatic and
      nonenzymatic superoxide anion radical (O2-.) producing systems in vitro. The SOD
      mimetic activity of PS-K was demonstrated by quantitative analysis of hydrogen
      peroxide as the end product of O2-., its formation being assisted catalytically
      by SOD or PS-K. Analysis by electron spin resonance also confirmed the SOD
      mimetic activity of PS-K in a xanthine-xanthine oxidase reaction. Relative SOD
      activity with PS-K was approximately 1/8,000 in a KO2-O2-.-producing system. The
      SOD mimetic activity of PS-K resisted treatment by 0.7N HCl, 0.7N NaOH, boiling
      for 30 minutes in a double water bath, and digestion by pronase. Fractionation
      according to differences in molecular mass caused no significant increase in
      relative SOD activity within a certain range of molecular mass, indicating that
      there is no definite molecule expressing SOD mimetic activity. Tumor-bearing rats
      and human patients with digestive tract cancer who suffered from oxidative stress
      were relieved by a single intraperitoneal administration of PS-K or a 1-day
      peroral prescription.

PMID- 1627274
TI  - Enhanced cell-mediated cytotoxicity by interferon-gamma and interleukin-2 against
      syngeneic murine mammary adenocarcinoma.
AB  - The effect of murine recombinant interferon-gamma (IFN-gamma) on cell-mediated
      cytotoxicity against tumor cells in vitro and in vivo was investigated using a
      spontaneously developed, weakly immunogenic, syngeneic murine mammary
      adenocarcinoma, designated JC, as the target. Preincubation of JC tumor cells
      with IFN-gamma increased the susceptibility of lysis by both cytotoxic T
      lymphocytes and interleukin-2 (IL-2)-induced lymphokine-activated killer cells in
      an IFN-gamma dose-dependent manner. A direct injection of IFN-gamma (10,0000 U/d)
      daily for 5 consecutive days into the JC tumor nodule on the backs of BALB/c mice
      reduced the tumor growth in comparison with that of the control group. This
      antitumor activity was further enhanced by combination with a simultaneous
      intraperitoneal injection of IL-2 (300,000 IU/d) daily for 5 consecutive days.
      Phenotypic examination of tumor-infiltrating lymphocytes after injection of IFN
      gamma plus IL-1 revealed an increased percentage of the cells expressing asialo
      GM1, L3T4, and IL-2 receptors. Additionally, an enhanced expression of major
      histocompatibility complex class I molecules on the JC tumor cells was detected.
      These results indicated that a direct injection of IFN-gamma into the tumor
      accompanied with the administration of IL-2, by enhancing cell-mediated immunity
      of the hosts and expression of major histocompatibility complex class I antigens
      on target cells, will be of potential clinical value.

PMID- 1627275
TI  - Structure of N,N-[bis(2-pyridylmethyl)-gamma-aminobutyrato]copper(II) bromide
      methanol solvate.
AB  - [Cu(C16H18N3O2)]Br.CH4O, Mr = 459.83, orthorhombic, P2(1)2(1)2(1), a = 10.452
      (4), b = 12.197 (7), c = 14.984 (6) A, V = 1910 (3) A3, Z = 4, Dm = 1.61 (1), Dx
      = 1.599 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 32.37 cm-1, F(000) = 932, T
      = 174 K, R = 0.0396, wR = 0.0419, 1146 observed reflections [I greater than 3
      sigma(I)]. The title compound is a polymeric species in the solid state, with a
      unit cell consisting of two segments of one-dimensional chains. The ligand, a
      derivative of gamma-aminobutyric acid in which the amino group is substituted
      with two 2-pyridylmethyl moieties, coordinates to one copper atom through the
      three nitrogen atoms and to another copper atom through the two carboxylate
      oxygen atoms. The copper(II) atom has a pseudo square-pyramidal geometry,
      distorted by a distant sixth interaction to a carboxylate oxygen atom [Cu-O(2),
      2.770 (7) A].

PMID- 1627276
TI  - Structure of the anti-malarial drug primaquine diphosphate.
AB  - 8-(4-Amino-1-methylbutylamino)-6-methoxyquinoline bis(dihydrogenphosphate),
      C15H23N3O2+.2(H2PO4)-, Mr = 455.35, triclinic, P1, Z = 2, a = 7.389 (6), b =
      8.862 (4), c = 16.055 (10) A, alpha = 97.57 (2), beta = 100.21 (3), gamma = 77.01
      (2) degrees, V = 1003.6 (5) A3, Dm = 1.495 (by flotation), Dx = 1.507 g cm-3,
      lambda (Cu K alpha) = 1.5418 A, mu(Cu K alpha) = 24.48 cm-1, F(000) = 480, room
      temperature, R = 0.068 for 3448 observed reflections. The above working cell is
      related to the reduced cell with angles alpha = 82.43, beta = 79.79 and gamma =
      77.01 degrees by the transformation (-100/0 -10/001). Primaquine diphosphate was
      crystallized in the dicationic form with protonation on the quinoline ring
      nitrogen atom and on the terminal amino group. One dihydrogenphosphate anion is
      chelated by the quinoline ring and the butylamino side chain. The other
      dihydrogenphosphate anion is hydrogen bonded to the terminal amino group. The
      C(14) atom is nearly in the plane of the quinoline ring with a C(9)-C(8)-N(13)
      C(14) torsion angle of 169 degrees. The butyl-diamino side chain is kinked by
      rotation about the C(14)-C(16) bond with a N(13)-C(14)-C(16)-C(17) torsion angle
      of -59 degrees. The C(15) methyl substituent is in line with the rest of the
      butyl chain. The terminal amino group N(19) is hydrogen bonded to three symmetry
      related phosphate groups while N(1) and N(13) are 'chelated' to a fourth
      phosphate group.

PMID- 1627277
TI  - Reflections on joining the circus of life.

PMID- 1627278
TI  - The family's role in stroke rehabilitation. A review of the literature.
AB  - Clinical and research attention in stroke care has been on managing the acute
      stage of stroke recovery and on evaluating the effectiveness of relatively short
      term rehabilitation programs. However, studies suggest that stroke can diminish
      quality of life and the well-being of patients' families. This article reviews
      the literature pertaining to the effects of stroke on family functioning and
      discusses stroke in terms of clinical problems that make rehabilitation a family
      dilemma. Issues identified in the literature include the need for family
      assessment, education, advocacy and counseling to foster treatment compliance and
      social support after stroke.

PMID- 1627279
TI  - Beaumont Lifestyle Inventory of Social Support. Can it predict disposition prior
      to an inpatient rehabilitation admission?
AB  - Predicting which rehabilitation patients will ultimately be discharged to a
      nursing home is a difficult task because methods used to evaluate preexisting
      home environment and quantify social support have been inadequate. To address
      this problem, the Beaumont Lifestyle Inventory of Social Support (BLISS) was
      developed. This questionnaire examines the family's willingness to care for,
      supervise and provide financial assistance to the patient. Organized into 10
      weighted questions, BLISS results in a maximum score of 12. A prospective study
      was conducted to determine the correlation of the BLISS score with discharge
      disposition. Prior to rehabilitation admission, continuing care coordinators
      administered the BLISS to an involved family member of each patient. After 6
      months, all BLISS forms were scored and compared with discharge disposition.
      Seventy-nine patients were included in this study and six (7.6%) were discharged
      to nursing homes. Comparison of BLISS scores obtained in patients discharged home
      versus nursing home revealed averages of 9.3 and 4.0, respectively (P less than
      0.0006). These findings indicate that BLISS can quantify a patient's social
      situation and provide a predetermination of the social factors that lead to
      nursing home discharge. Consequently, BLISS will be a useful screening tool
      during the rehabilitation selection process.

PMID- 1627280
TI  - Neuroendocrine changes during functional electrical stimulation.
AB  - This study examined the effects of a computerized functional electrical
      stimulation exercise program on plasma beta-endorphin-like immunoreactivity (BEP
      ir), cortisol levels and depression parameters in spinal cord-injured
      individuals. Nine subjects from 1.2 to 33.5 yr postinjury with both motor and
      sensory complete lesions between C5 and T12 participated. It was determined that
      patients who sustained spinal cord-injuries less than 5 yr before this study had
      lower than normal baseline levels of BEP-ir and flattened circadian rhythms.
      Patients who sustained their injury greater than 5 yr before this study had
      higher baseline levels of BEP-ir with some return to normal circadian
      rhythmicity. Baseline cortisol levels, regardless of time since injury, appeared
      to be dysregulated. Regular exercise with computerized functional electrical
      stimulation caused significantly (P less than 0.05) sustained increases in BEP-ir
      in all patients and improved the regulation of cortisol. Furthermore, the more
      strenuous the exercise training, greater increases in BEP-ir levels were seen.
      Last, depression scores improved, which suggests a possible association between
      subjective mood and BEP-ir levels.

PMID- 1627281
TI  - The effect of different needle recording electrodes on somatosensory-evoked
      potentials and intertrial waveform variation.
AB  - This investigation examined the cortical somatosensory-evoked potentials (SEP)
      waveforms obtained from four sets of commercially available subdermal needle
      electrodes in 19 normal subjects. The composite materials of the four electrodes
      were stainless steel and a platinum/iridium alloy. Tibial nerve SEP peak
      latencies for P37 and N45 as well as P37/N45 amplitudes were recorded from each
      electrode pair in a random fashion. Using nonparametric analysis, no significant
      differences of waveform parameters were found between electrode pairs (P greater
      than 0.01). Correlation evaluation demonstrated values in excess of 0.92.
      Additionally, intertrial waveform analysis for each of the electrode pairs was
      performed. Again, nonparametric evaluation demonstrated no statistically
      significant waveform differences. Correlation coefficients were also highly
      correlative. Variable temperature response to prolonged tibial nerve stimulation
      was recorded that did not significantly effect the latencies or amplitudes of the
      cortical SEP responses. We conclude that within temperature ranges typically
      encountered in clinical practice, there is no statistically significant waveform
      differences recorded with commonly available subdermal needle electrodes.
      Additionally, although intertrial waveform variation may exist during SEP
      recordings, these differences do not reach statistically significant levels.

PMID- 1627282
TI  - Contralateral v ipsilateral cane use. Effects on muscles crossing the knee joint.
AB  - Although using a cane contralaterally has been shown to reduce muscular activity
      across the hip joint, little is known about effects on the knee. We measured
      muscular activity around the knee in 10 able-bodied subjects. We simultaneously
      recorded integrated rectified surface electromyographic activity from the right
      quadriceps, medial and lateral hamstrings, gastrocnemius and hip abductors during
      various standing maneuvers: two-legged stance, unsupported one-legged stance and
      one-legged stance putting maximal, moderate (20% body weight) or minimal (10%
      body weight) force through an ipsilateral or contralateral cane.
      Electromyographic activity was expressed as the percentage of that recorded
      during unsupported one-legged stance in each muscle. Hip abductor activity was
      lowest when maximal weight was placed through a contralateral cane (66%) and
      highest with maximal weight ipsilaterally (424%). Medial hamstrings activity
      increased by 404% and 200%, respectively, when maximal and moderate force was
      applied to a contralateral cane, although there was no change with ipsilateral
      cane. Lateral hamstrings were also most active during contralateral cane use.
      Quadriceps activity decreased using a cane in either hand with moderate or
      minimal force (range 57 to 84%). Gastrocnemius activity decreased during
      contralateral (60 to 66%) and ipsilateral (75 to 96%) cane use. This data
      suggests that forces generated by muscular activity around the knee are not
      uniformly diminished by holding a cane in the contralateral hand and may even be
      increased.

PMID- 1627283
TI  - Driving evaluation after traumatic brain injury.
AB  - Traumatic closed head injury results in a variety of cognitive and behavioral
      deficits that may be difficult to assess fully. Adequately evaluating driving
      safety is a common and important problem for health care professionals. The
      purpose of this study was to examine the relationship between standardized
      measures of cognitive function and measures of driving performance in patients
      with closed head injuries and in their age-matched relative or friend cohorts.
      Thirteen patients were evaluated. They had each sustained a closed head injury
      (followed by more than 1 h of coma) 3 to 6 months before testing. Their scores
      were analyzed along with those of seven cohorts. Assessments of cognitive
      function and behind-the-wheel driving performance were conducted by examiners
      blinded to subjects' group membership and medical condition. There was a
      significant relationship (r = 0.44) between the sum of rated scores of the
      Tactual Performance Test and Trail Making Test and the global pass/fail ratings
      of the behind-the-wheel driving test, but it was not related to the driving
      performance score. The difference between the verbal and performance IQs, and the
      difference between the block design and other performance tests of the Wechsler
      Adult Intelligence Scale-Revised were also not significantly related to driving
      performance. These results suggest that tests of cognitive function alone are not
      adequate to predict driving performance, and should be used along with
      standardized driving performance evaluations before recommendations are made.

PMID- 1627284
TI  - Rheumatology rehabilitation: the role of a physical medicine and rehabilitation
      liaison consultation service. A commentary.

PMID- 1627285
TI  - Chin augmentation. An important adjunctive procedure to rhinoplasty.
AB  - Augmentation mentoplasty is a cosmetic procedure designed specifically to
      supplement deficient fullness of the mental area. Patients seeking care from
      rhinoplastic surgeons for nasal corrective procedures may not be aware of a
      deficiency, which is the most common abnormality in this area. Complete
      evaluation of the full facial profile, which should be performed in all potential
      rhinoplasty patients, identifies such abnormalities. The general concepts of
      preoperative evaluation, corrective options available, including make of implant
      materials, and complications are discussed. Patients with mild to moderate
      microgenia can be simply corrected by augmentation mentoplasty to balance the
      facial profile. The most common method of adding fullness in the chin area is use
      of an implantable material. This article discusses the advantages and
      disadvantages of the available materials.

PMID- 1627286
TI  - Perilymph fistulas. Clinical criteria.
AB  - A perilymph fistula may be defined as an abnormal opening between the inner ear
      and the external surface of the labyrinth capsule, which allows the escape of
      perilymph and causes specific disorders of hearing, balance, or both. Its
      diagnosis remains somewhat controversial. This communication presents a defined
      set of clinical diagnostic criteria, the historic context by which those criteria
      have been developed, the histopathologic and clinical studies by which they have
      been challenged or substantiated, and the deficiencies that remain in our
      understanding of the pathogenic mechanisms that allow for abnormal cochlear or
      vestibular function.

PMID- 1627287
TI  - Perilymph fistula.

PMID- 1627288
TI  - Revision rhinoplasty. An analysis of aesthetic deformities.
AB  - Revision rhinoplasty can present difficult and challenging problems, which
      maximally test the skill and judgment of the facial plastic surgeon. We conducted
      a retrospective study of 1221 consecutive rhinoplasties, of which 170 were
      revision procedures. The rate of revision of our own procedures is 5.3%.
      Postrhinoplastic deformities are divided anatomically into the upper, middle, and
      lower thirds of the nose. The largest category of deformities occur in the lower
      thirds of the nose, in which bossa are the most common problem. Overall,
      pollybeak is the most common deformity in 33% of the procedures performed,
      followed by bossa in 26%, and excessive dorsal removal in 24%. We analyzed the
      causes and selected management of these cases.

PMID- 1627289
TI  - The superior trapezius myocutaneous flap in head and neck reconstruction.
AB  - The superior trapezius myocutaneous flap, based on the paraspinous perforating
      branches of the intercostal vessels, is generally not a first-line choice for
      reconstruction of head and neck defects. However, after wound breakdown following
      radical neck dissection and radiation therapy, the superior trapezius flap is
      extremely reliable for coverage of exposed major neck vessels. The flap was used
      in 30 patients undergoing lateral neck reconstruction. All 30 patients had
      undergone prior neck dissection and all but two had undergone prior radiation
      therapy. There were no flap failures. The superior trapezius flap is unique among
      other regional myocutaneous flaps presently in use in that it has a superiorly
      based pedicle, which reduces the problem of gravitational pull on the suture
      lines of severely unfavorable recipient beds. Another advantage of using the
      denervated muscle of this flap is that it imposes no additional functional loss.
      The deficiencies of this flap are primarily related to its limited arc of
      rotation, thereby precluding its use when resurfacing defects that extend beyond
      the midline of the neck. The reliability of the superior trapezius flap after
      neck dissection can be explained by the angiosome concept. Based on that concept,
      previous ligation of the transverse cervical vessels during a neck dissection
      serves to simultaneously stage this flap, thereby improving its reliability and
      potential surface area available.

PMID- 1627290
TI  - The pectoralis major myofascial flap for intraoral and pharyngeal reconstruction.
AB  - The pectoralis myocutaneous flap has been widely used for reconstruction of oral
      cavity and pharyngeal defects. However, it has several disadvantages, such as
      chest distortion, hair growth at the reconstructed site, and excessive bulk, all
      of which can be avoided by the use of the pectoralis myofascial flap. Oral
      cavities and pharyngeal defects, ranging in size from 4 to 9 cm in largest'
      dimension, in 26 patients were reconstructed with the pectoralis myofascial flap.
      All but three defects were successfully reconstructed. The surface of the flap
      was covered by squamous epithelium in 1 month. The flap remained healthy during
      and after radiotherapy. The pectoralis myofascial flap is ideal for soft-tissue
      coverage of small- to medium-size oral cavity and pharyngeal defects. Its major
      advantages over the pectoralis myocutaneous flap are decreased bulk and improved
      cosmesis.

PMID- 1627291
TI  - Fluorescein and acidosis. Implications for flap perfusion studies.
AB  - The visual fluorescein technique underpredicts survival of a skin flap during the
      first 24 hours after raising the flap. This problem limits its use as a research
      and clinical tool. There is no compelling explanation for this observation, but
      two facts are known: fluorescein is a derivative of phthalein, a pH indicator,
      and ischemic tissues become acidotic, with the pH falling below 7.0. These
      observations lead to the hypothesis that acidosis quenches fluorescence in distal
      skin flaps. No data could be found regarding this effect. Therefore, the effect
      of acidosis on sodium fluorescein was studied in vitro. A spectrophotometer was
      used to measure the intensity of the fluorescence of sodium fluorescein in
      buffered solutions of different hydrogen ion concentrations. Two studies were
      performed at different concentrations of fluorescein. At a concentration of 10(
      5) g/mL, there is a drop of 26% in fluorescence intensity from pH 7.5 to 7.0, and
      51% between pH 7.5 and 6.5. At 10(-7) g/mL, there is a 43% decrease in
      fluorescence between pH 7.5 and 6.5. This study supports our hypothesis that
      acidosis quenches the fluorescence of fluorescein. This effect must be considered
      when interpretating basic studies of skin flap microcirculation.

PMID- 1627292
TI  - Clinical determinants for the management of thyroid nodules by fine-needle
      aspiration cytology.
AB  - To evaluate the utility of clinical features for the selection of patients with
      thyroid lesions suitable for diagnosis by fine-needle aspiration cytologic study,
      we reviewed 149 cases with complete clinical histories, laboratory evaluations,
      fine-needle aspirates, and histologic study of the index lesion. Review of these
      data demonstrated that only the presence of lymphadenopathy was of statistical
      value in the distinction of benign from malignant nodules. Moreover, once an
      aspiration diagnosis of "follicular neoplasm" had been made, no clinical,
      radiologic, or laboratory test aided in the distinction of follicular adenoma
      from follicular carcinoma.

PMID- 1627293
TI  - Effect of extraluminal oxygen on carbon dioxide laser ignition of endotracheal
      tubes.
AB  - Ignition times of endotracheal tubes used in laser surgery have been determined
      in room air with oxygen flowing through the tube. Using uncuffed endotracheal
      tubes in children, we measured the oxygen level around the endotracheal tube at
      the vocal cords and found that it closely approximates the inspired oxygen
      concentration. We then tested Rusch red rubber and polyvinyl chloride
      endotracheal tubes while varying the external oxygen concentration. Little
      difference in ignition time was found for the polyvinyl chloride tube. The red
      rubber tube ignited significantly faster as the ambient oxygen levels were
      increased to as little as 30%. Our tests indicate that uncuffed red rubber tubes
      are not safer than polyvinyl chloride tubes when used with the carbon dioxide
      laser. All endotracheal tubes used with the laser should be tested for ignition
      at various extraluminal oxygen concentrations.

PMID- 1627294
TI  - Is nasotracheal intubation safe in surgery for mandibular cancer?
AB  - A retrospective study of problems of postoperative airway maintenance after
      surgery for mandibular cancers was conducted. Twenty-seven patients treated in an
      intensive care unit after mandibular resection and primary reconstruction were
      included. The mean duration of nasotracheal intubation in 22 patients was 33.7
      hours. Reintubation because of breathing difficulties was required in four cases.
      In one of these cases, failed intubation led to an emergency cricothyroidostomy.
      Failure to perform reintubation resulted in the death of one patient. One patient
      was tracheostomized after 5 days of nasotracheal intubation. Prolonged
      nasotracheal intubation after major surgery for oral malignant neoplasms may be
      an alternative to tracheostomy, provided that adequate monitoring is available
      after extubation. The safe duration of endotracheal intubation is difficult to
      determine. Primary reconstruction does not eliminate the need for an artificial
      airway after tumor surgery.

PMID- 1627295
TI  - Human olfactory biopsy. The influence of age and receptor distribution.
AB  - Thirty-six mucosal specimens were obtained with a biopsy instrument from the
      upper nasal septum of 12 human autopsy cases before the en bloc removal of the
      entire olfactory area. Examination of these 36 specimens with transmission
      electron microscopy demonstrated olfactory epithelium in only 17. A significant
      negative correlation (r = -.728) was noted between the age of the subject and the
      probability of obtaining olfactory epithelium, supporting the idea that the
      olfactory mucosa is gradually replaced by respiratory epithelium with aging.
      Using the en bloc specimens, the distribution of olfactory epithelium was
      reconstructed from light microscopic examination of silver-stained sections.
      Multiple patches of respiratory epithelium were observed over the upper portion
      of the nasal septum and superior turbinates, ie, the presumptive olfactory area.
      On transmission electron microscopic examination, frequent respiratory metaplasia
      was also suggested. Within the area of respiratory metaplasia, supporting cell
      like and microvillar cell-like structures often were found; these structures may
      be remnants of olfactory epithelium. The sampling of olfactory tissue with a
      biopsy procedure is hampered by the irregular and patchy distribution of
      olfactory epithelium. The invasion of respiratory epithelial patches into the
      olfactory mucosa seems to be characteristic of the human olfactory epithelium and
      may increase as a function of age. Thus, conclusions about the structure of the
      olfactory mucosa in an individual patient must be based on several tissue
      samples.

PMID- 1627296
TI  - Polysomnographic and clinical findings in children with obstructive sleep apnea.
AB  - A retrospective study was conducted to determine which types of children might
      have polysomnographic findings that are most compatible with obstructive sleep
      apnea (OSA). The charts of 93 patients who were aged 18 months to 12 years were
      examined. All 93 patients had symptoms that were initially suggestive of OSA, and
      they underwent polysomnography. The types of presenting symptoms and associated
      illnesses were noted. Physical findings, including height, weight, and tonsil
      size, were examined. Of 93 patients with symptoms that were suggestive of OSA, 34
      met sleep study criteria for OSA. In 44 patients, OSA was not demonstrated, and
      15 patients had other results. On the basis of age, sex, and symptoms, no
      significant differences could be found between the group with OSA and the group
      with normal polysomnographic findings. Cor pulmonale, tonsil hypertrophy, and
      failure to thrive were associated with OSA. Surprisingly, obesity was not
      significantly associated with OSA.

PMID- 1627297
TI  - Demonstration of interleukin 6 in middle ear effusions.
AB  - In response to infection in the middle ear, inflammatory cells produce cytokines-
      potent regulators and mediators of the immune response. In an earlier study, we
      demonstrated that levels of the cytokine interleukin 1 were higher in middle-ear
      effusions from younger children, while levels of the cytokine tumor necrosis
      factor were higher in middle-ear effusions from older children and in those
      requiring tympanostomy on multiple occasions. In this study, we evaluated middle
      ear effusions for levels of the cytokine interleukin 6. Activities of interleukin
      6 include stimulation of bone erosion and production of antibodies and fever.
      Using an enzyme-linked immunosorbent assay system, significant levels of
      interleukin 6 (greater than 0.2 pg/mL) were found in 14 (36%) of 39 middle-ear
      effusions from 25 children with otitis media with effusion. The mean (+/- SE)
      level of interleukin 6 in middle-ear effusions was 173.9 +/- 74.7 pg/mg of total
      protein. Like interleukin 1, levels of interleukin 6 were higher in younger
      children. Tumor necrosis factor may be an important regulator of the local immune
      response in the middle-ear cleft during persistence of otitis media with
      effusion, while interleukin 1 and interleukin 6 may be important regulators
      during the early stages of otitis media with effusion.

PMID- 1627298
TI  - Inhibition of lymphoproliferation by middle ear effusion in experimental otitis
      media.
AB  - In this study, experimental otitis media was created in the chinchilla by direct
      middle ear challenge with Escherichia coli endotoxin, Streptococcus pneumoniae,
      Haemophilus influenzae, or Pseudomonas aeruginosa. The effusions recovered from
      the chinchillas in all four challenge groups were shown to inhibit the
      lymphoproliferative response of chinchilla peripheral blood lymphocytes to
      stimulation with phytohemagglutinin. The effect was dose dependent, and for
      effusions of infectious origin, the degree of inhibition was directly related to
      the duration of infection. Presence of the inhibitor in plasma was undocumented,
      suggesting a local production within the middle ear. Lymphocytes from middle ears
      infected with bacteria but not middle ears challenged with endotoxin were
      hyporesponsive or nonresponsive to stimulation with phytohemagglutinin. These
      results confirm the presence of an inhibitor of the lymphoproliferative response
      in experimental otitis media of different etiologies.

PMID- 1627299
TI  - Luetic cervical adenitis in patients with human immunodeficiency virus type 1
      infection.
AB  - The clinical course of syphilis may be altered in some patients with human
      immunodeficiency virus type 1 infection. We report two cases of syphilis in
      patients with human immunodeficiency virus type 1 infection who presented with
      marked unilateral anterior cervical adenopathy after engaging in oral-genital
      sex. Neither of the patients had evidence of oropharyngeal chancres. One patient
      developed a cutaneous rash of secondary syphilis soon after the cervical
      adenopathy developed. Both patients responded well to antibiotic therapy.

PMID- 1627300
TI  - Curettage of nontuberculous mycobacterial cervical lymphadenitis.
AB  - Cervicofacial nontuberculous mycobacterial infections of the head and neck are
      difficult to treat surgically because of their common location near the branches
      of the facial nerve. Curettage of these lesions through a small skin incision
      makes treatment simple without injury to the facial nerve fibers and leaves the
      patient with an excellent cosmetic result. Most discussions on the topic,
      however, favor complete surgical excision even though curettage has been reported
      as a safe and excellent means of treatment. For the past 2 years, the department
      of otolaryngology-head and neck surgery at the Geisinger Medical Center,
      Danville, Pa, has used curettage in seven patients as the primary treatment
      modality for these facial and cervical infections. A review of these cases is
      presented.

PMID- 1627301
TI  - Allergy is not a significant cause of nasal polyps.

PMID- 1627302
TI  - Casual surgical techniques in January 1992 photograph.

PMID- 1627303
TI  - Pathologic quiz case 2. Plexiform neurofibroma.

PMID- 1627304
TI  - Pathologic quiz case 1. Cervical thymic cyst.

PMID- 1627306
TI  - Is high technology medicine a threat to health care?

PMID- 1627307
TI  - Prevention and treatment of osteoporosis: summary of the statement prepared by
      the consensus development conference of the Finnish Academy of Science and the
      Finnish Medical Society Duodecim.

PMID- 1627305
TI  - Beta-carotene, vitamin A and prostatic cancer.

PMID- 1627308
TI  - Peroxisomal diseases.
AB  - The peroxisomal diseases, which are rare inborn metabolic errors, often have
      serious effects on the well being of the individual and many of them are fatal at
      an early age. The Zellweger cerebro-hepato-renal syndrome represents a group
      consisting of diseases with a generalized loss of peroxisomal functions and is
      considered as a prototype for peroxisomal dysfunction. The largest group includes
      those diseases where only a single peroxisomal function is impaired. The most
      common peroxisomal disease, x-linked adrenoleukodystrophy (ADL), belongs to this
      group, and neurological symptoms dominate among the patients. The primary
      diagnosis is usually based on clinical findings and measurement of accumulated or
      depleted metabolites in the body (e.g. very long chain fatty acids, bile acid
      intermediates or plasmalogens). Some progress has been made in treating of the
      peroxisomal diseases. Many patients with x-linked ALD have benefitted from the
      supplementation of the diet with long chain monounsaturated fatty acids like
      erucic acid or oleic acid with the simultaneous restriction of very long chain
      fatty acids. Docosahexenoate (C22:1) has also shown promising results in some
      studies.

PMID- 1627309
TI  - Interventional uroradiology today.

PMID- 1627311
TI  - Polymerase chain reaction (PCR)--a new tool in clinical medicine.

PMID- 1627310
TI  - Advances and retreats in the molecular genetics of major mental illness.
AB  - With the last two decades, the importance of genetic factors in the aetiology of
      major mental illness has been firmly re-established and psychiatric research has
      now firmly embraced the era of molecular genetics. Despite a number of false
      starts in the study of schizophrenia and affective disorder, there have been
      successes in unmasking some of the aetiological secrets of Alzheimer's disease.
      We will give an overview of the rationale behind these studies and the major
      findings to date.

PMID- 1627312
TI  - From one to millions--the polymerase chain reaction in diagnosis.

PMID- 1627313
TI  - PCR-based mutation analysis in cystic fibrosis.

PMID- 1627314
TI  - PCR in the diagnosis of phenylketonuria.

PMID- 1627315
TI  - Applications of PCR in the diseases of genetic isolates.

PMID- 1627316
TI  - The use of PCR in diagnosing lipoprotein disorders.

PMID- 1627317
TI  - PCR in the analysis of mutations in mitochondrial DNA.

PMID- 1627318
TI  - PCR in the diagnosis of viral hepatitis.

PMID- 1627319
TI  - When government regulations go too far.

PMID- 1627320
TI  - The total greenhouse warming potential of technical systems: analysis for
      decision making.
AB  - Mitigation of greenhouse gas (GHG) warming of the atmosphere concerns many
      industrial and government sectors. Since no quantitative measures existed to
      compare the complete effects of processes and their GHG emissions, past decisions
      were based primarily on qualitative or partial analyses. Three developments
      extending existing methods are proposed. First, a systems perspective should be
      used to facilitate identification of all GHGs associated with industrial or
      agricultural operations and reduce chances of unanticipated side effects
      following any decision. Second, the entire life-cycle plus aftereffects should be
      used to portray system time effects. Third, a Warming Forcing Factor and Index
      are suggested for use to completely describe the effect of each GHG emitted by a
      system and relate it to useful output, as well as to composite the effects of all
      emissions. As an illustration of its suitability for individual technology
      assessments, results are presented for a biomass-to-methanol vehicle fuel system.

PMID- 1627321
TI  - Flow rates and compositions of incinerated waste streams in the United States.
AB  - The quantity and composition of RCRA hazardous wastes incinerated during 1986
      were examined using the National Hazardous Waste Survey. This Survey, collected
      for U.S. EPA by the Research Triangle Institute, is the most extensive
      examination of hazardous waste generation and management available. The survey
      data show that although a wide variety of hazardous wastes were treated by
      incineration, more than 75 percent of incinerated waste streams were from
      chemical manufacturing. The survey data also show that more than 90 percent of
      the incinerated wastes were treated by incinerators located at the facility
      generating the waste. Despite the predominance of a single industrial sector in
      generating incinerated hazardous wastes, the compositional profile of the wastes
      is far from uniform. To illustrate this variability, the metals and chlorine
      content of the wastes are reported along with the sources of the metal and
      chlorine loadings.

PMID- 1627322
TI  - Synthesis of environmental evidence: nitrogen dioxide epidemiology studies.
AB  - The use of meta-analysis is becoming more common in the medical literature, but
      it is not common in the environmental literature. Although meta-analysis cannot
      combine a group of poorly executed, conflicting studies to get an unequivocal
      answer, there are certain situations where it can be helpful. The inability of
      studies to produce similar results may be a function of the power of the studies
      rather than a reflection of their quality. The literature on the effects of
      nitrogen dioxide on the odds of respiratory illness in children is such an
      example. Three quantitative methods for the synthesis of this evidence are
      presented. Although the methods produce slightly different results, the
      conclusion from all three methods is that the increase in the odds of respiratory
      illness in children exposed to a long-term increase of 30 micrograms/m3
      (comparable to the increase resulting from exposure to a gas stove) is about 20
      percent. This estimated increase is not sensitive to the method of analysis.

PMID- 1627323
TI  - Atmospheric concentrations of PCDDs/PCDFs in southern California.
AB  - A comprehensive air toxics measurements program designed to establish baseline
      concentrations of atmospheric polychlorinated dioxins and dibenzofurans
      (PCDDs/PCDFs) in the South Coast Air Basin has been completed. The program
      utilized state-of-the-art air sampling and laboratory analysis techniques
      (HRGC/HRMS) to quantify the fifteen 2,3,7,8-substituted PCDDs/PCDFs congeners of
      primary toxicological significance. This study, which included nine discrete
      sampling sessions between December 1987 and March 1989, provides the first
      systematic assessment of ambient PCDDs/PCDFs concentrations in the state of
      California. The highest PCDDs/PCDFs concentrations noted during this study
      occurred in December 1987. This period was dominated by off-shore air flows,
      suggesting a regional air mass and transport phenomena. Concentrations of the
      PCDDs/PCDFs were diminished markedly in subsequent sampling sessions where air
      flow patterns were primarily of on-shore or of coastal origin. Ambient
      PCDDs/PCDFs concentrations, expressed as toxic equivalents, were highest during
      the December 1987 sampling period. The El Toro monitoring site, located
      approximately 40 miles southeast of Los Angeles, consistently showed the lowest
      measured ambient PCDDs/PCDFs concentrations and toxic equivalents values. In the
      majority of the sessions and samples examined the PCDDs/PCDFs congener profiles
      strongly suggest combustion source influences. Typical of combustion source
      profiles, 1,2,3,4,6,7,8-HpCDD was the predominant 2,3,7,8-substituted species and
      most prevalent PCDD after OCDD. The congener of highest toxicological
      significance, 2,3,7,8-TCDD, was reported below the 10-20 fg/m3 detection limit
      for most of the ambient air samples selected for analysis.

PMID- 1627324
TI  - Effects of operating variables on PAH emissions and mutagenicity of emissions
      from woodstoves.
AB  - As part of the Integrated Air Cancer Project, the U.S. Environmental Protection
      Agency (EPA) has conducted field emission measurement programs in Raleigh, North
      Carolina, and Boise, Idaho, to identify the potential mutagenic impact of
      residential wood burning and motor vehicles on ambient and indoor air. These
      studies included the collection of emission samples from chimneys serving wood
      burning appliances. Parallel projects were undertaken in instrumented woodstove
      test laboratories to quantify woodstove emissions during operations typical of in
      house usage but under more controlled conditions. Three woodstoves were operated
      in test laboratories over a range of burnrates, burning eastern oak, southern
      yellow pine, or western white pine. Two conventional stoves were tested at an
      altitude of 90 m. One of the conventional stoves and a catalytic stove were
      tested at an altitude of 825 m. Decreasing burnrate increased total particulate
      emissions from the conventional stoves while the catalytic stove's total
      particulate emissions were unaffected. There was no correlation of total
      particulate emissions with altitude whereas total polynuclear aromatic
      hydrocarbon (PAH) emissions were higher at the lower altitude. Mutagenicity of
      the catalytic stove emissions was higher than emissions from the conventional
      stove. Emissions from burning pine were more mutagenic than emissions from oak.

PMID- 1627325
TI  - Endomyocardial biopsy of normal donor hearts before cardiac transplantation. A
      morphological and morphometrical study in 97 cases.
AB  - Endomyocardial biopsies from 97 normal donor hearts were examined. Morphometric
      analysis showed: mean myocyte diameter 22.21 +/- 6.93 mu, mean nuclear dimension
      7.32 +/- 2.33 mu, mean nuclear/sarcoplasmic ratio 0.33 +/- 0.02. 31 biopsies
      showed enlarged myocytes (mean diameter 31.65 +/- 3.98 mu) with increased nuclear
      size (mean 10.45 +/- 1.39 mu), but preserved nuclear/sarcoplasmic ratio (mean
      0.33 +/- 0.01). The mean age of these latter subjects was significantly higher.
      Endocardial thickness mean value was 17.73 +/- 4.58 mu, but in 28 cases the value
      exceeded the considered upper normal limit of 20 mu. Interstitial mononuclear
      cells were rare and randomly present. Interstitial fibrosis was observed in 15%
      and focal fibrosis in 27% of cases. Our results show that histology of biopsies
      from clinically normal hearts can widely vary, sometime overriding the pathologic
      boundaries. These apparently "benign" abnormalities should be kept in mind when
      specific pathologic substrates of cardiac diseases have to be defined.

PMID- 1627326
TI  - Marfan syndrome with aortic dissection and triple-barrel aorta.
AB  - A case of Marfan syndrome with spontaneously and subsequently developed
      dissections of the aorta, one in the form of triple-barrel aorta, three times
      corrected by grafts is described. The autopsy revealed "healed" and acute
      dissections in almost the entire aorta outside the grafts. "Healed"
      thoracoabdominal dissection had true lumen (with entry and re-entry intimal
      tears), and old false lumen and in addition in its distal portion of a triple
      barrel aorta was formed (dissection of healed aortic dissection). Lethal
      adventitial rupture occurred in the portion with an old false lumen. Dissection
      of the left subclavian artery, the right common carotid artery, resulting in
      saccular aneurysm, and avulsion of the right renal artery were also found.

PMID- 1627327
TI  - AIDS and the heart in the Caribbean: a silent entity.

PMID- 1627328
TI  - Aortic aneurysm at autopsy: a five year survey in Hong Kong.
AB  - The authors reviewed 3133 consecutive autopsies performed in the 5 year period
      from 1986 to 1990 in Queen Mary Hospital (Hong Kong), and 96 cases of aortic
      aneurysms were found. The incidence was 1 in 33 autopsies. The ratio of male to
      female was 1.8 to 1, and the disease was most common in the eighth decade of
      life. The majority of death was due to rupture (70%) or related atherosclerotic
      diseases (14%), and the majority of aneurysms were not suspected before autopsies
      (62%). Most of the non-dissecting aneurysms were found in the abdominal aorta,
      the infra-renal portion. For dissecting aneurysms, Daily's type A was much more
      common. Hypertension was recognized in a high proportion of cases. Accompanying
      diseases like syphilis, Takayasu's disease, ischemic heart disease,
      cerebrovascular accident, diabetes mellitus, peripheral vascular disease, and
      chronic obstructive airway disease were also noted.

PMID- 1627329
TI  - Vasculopathic and cardiomyopathic changes induced by low-protein high
      carbohydrate tapioca based diet in bonnet monkey. Vasculopathic and
      cardiomyopathic changes in induced malnutrition.
AB  - Mucoid vasculopathy is an entity characterized by a generalized
      mucopolysaccharidosis of blood vessels. It has been observed in patients from our
      Institute. Bonnet monkeys (Macaca radiata) were given low-protein normal
      carbohydrate and low-protein high-carbohydrate tapioca based diets for
      experimental periods of 3 or 5 months. The latter diet is similar to that
      consumed by people from this part of India (Kerala) where mucoid vasculopathy is
      observed. Vascular lesions were seen in all test animals as a generalized
      mucopolysaccharidosis and as hyperplastic changes in intimal and medial smooth
      muscle cells. In 6/31 animals gross cardiac lesions were found. They consisted of
      biventricular hypertrophy and atrophy owning to myopathic changes and endocardial
      thickening. The cardiovascular lesions were enhanced in animals that received low
      protein high-carbohydrate diet for a longer period. Our experiments established
      an etiologic role for diet, especially protein deficiency, in the induction of
      both vascular and cardiac changes.

PMID- 1627330
TI  - Recurrent cervical squamous cell carcinoma presenting with cardiac tamponade.
      Recurrent cervical carcinoma-tamponade.
AB  - Cervical squamous cell carcinoma rarely metastasizes to the heart, and cardiac
      tamponade secondary to pericardial involvement has been only rarely reported. We
      describe a case of recurrent cervical squamous cells carcinoma presenting with
      cardiac tamponade secondary to extensive pericardial metastases. The patient, a
      38-year old woman, initially presented with Stage IIIB cervical squamous cell
      carcinoma. She responded well to radiation and chemotherapy, there was no
      clinical or radiographic evidence of persistent disease after the initial
      therapy. Sixteen months after presentation, she developed shortness of breath and
      chest pain. The patient received additional chemotherapy; however, she died 17
      months after her initial presentation. At autopsy, metastatic keratinizing
      squamous cell carcinoma extensively involved the pericardium and superficial
      myocardium. This case illustrates the unusual occurrence of recurrent cervical
      squamous carcinoma presenting with cardiac dysfunction secondary to pericardial
      metastases.

PMID- 1627331
TI  - Post-ischemic rupture of the anterior papillary muscle of the right ventricle
      associated with persistent pulmonary hypertension of the newborn: a case report.
AB  - We report the case of a six-day-old male infant exposed in utero to a
      prostaglandin synthetase inhibitor, who presented pulmonary arterial
      hypertension, tricuspid insufficiency, and electrocardiographic signs of diffuse
      myocardial ischemia. The necropsy showed organizing infarction of the anterior
      and posterior right papillary muscles (probably occurred in utero) with complete
      rupture of the former, besides abnormal muscularization of the intraacinar
      pulmonary arterioles (persistent fetal circulation of the newborn). The authors
      suggest a possible relation between the myocardial ischemic and pulmonary
      hypertensive lesions since the prostaglandin synthetase inhibitor can induce
      precocious pulmonary arteriolar muscularization and constriction of the arterial
      duct, leading to right ventricular overload, thus facilitating the occurrence of
      papillary and subendocardial ischemia.

PMID- 1627332
TI  - Fatal lipoma of the heart.
AB  - The clinical and postmortem findings of the largest cardiac lipoma reported to
      this date are described. Emphasis is made on the symptoms of respiratory
      embarrassment that were prominent in this fatal case.

PMID- 1627333
TI  - An unusual expression of a squamous cell marker, small proline-rich protein gene,
      in tracheobronchial epithelium: differential regulation and gene mapping.
AB  - An unusual expression of a putative squamous cell marker, small proline-rich
      protein (spr1), in mucociliary epithelial cells of conducting airways was
      demonstrated in a serum-free culture system. A cDNA clone was isolated from the
      cDNA library of monkey tracheobronchial epithelial (TBE) cells by differential
      hybridization. This cDNA clone, MT5, exhibited 98% homology to a DNA sequence
      obtained from human keratinocytes treated with either UV light or phorbol esters
      (T. Kartasova et al., 1988, Mol. Cell. Biol. 8:2195-2230). The predicted peptide
      of MT5 is unusual for its high content of proline (29%), glutamine (18%), and
      cysteine (9%) and its repeated PKVPEPC units. The level of spr1 mRNA in cultured
      cells was inhibited more than 90% by vitamin A. In contrast, phorbol 12-myristate
      13-acetate (PMA) stimulated the level of spr1 mRNA by 3- to 8-fold. This
      differential regulation coincided with the effects of these chemicals on the
      cornification of cultured TBE cells. Using MT5 as a probe, we have localized the
      tracheal spr1 gene on the human chromosome 1 by a Southern blot analysis using a
      panel of human-rodent somatic cell hybrid DNAs. The gene was further sublocalized
      to bands q22-23 by in situ hybridization.

PMID- 1627334
TI  - Modulation of neutrophil and mononuclear cell adherence to bronchial epithelial
      cells.
AB  - Neutrophils and mononuclear cells have been associated with the lower respiratory
      tract inflammation observed in both acute and chronic bronchitis. In order to
      transit into and remain within the airways, neutrophils and mononuclear cells
      would likely need to adhere to bronchial epithelium. To test this hypothesis,
      bovine bronchial epithelial cells (BBECs) were isolated and cultured on a round
      coverslip. After 7 to 10 days, 51Cr-labeled neutrophils and mononuclear cells
      were evaluated for their capacity to adhere to the BBEC monolayer. Both
      neutrophils and mononuclear cells readily bound to the BBEC monolayer (10.8 +/-
      1.2% bound neutrophils; 40.5 +/- 2.8% bound mononuclear cells). Stimulation of
      the neutrophils and mononuclear cells with phorbol 12-myristate 13-acetate (PMA)
      increased the adherence (45.8 +/- 10.6% bound neutrophils, P less than 0.01
      compared with unstimulated cells; 58.7 +/- 6.2% bound mononuclear cells, P less
      than 0.01 compared with unstimulated cells). Importantly, stimulating the BBEC
      monolayer with PMA, bacterial lipopolysaccharide, or a cigarette smoke extract
      for 4 to 72 h also increased the adherence of both cell types (P less than 0.01,
      all comparisons at 24 h). The adherence was not decreased by exposure of either
      the BBEC monolayer, the neutrophils, or the mononuclear cells to cycloheximide or
      to the anti-CD11/CD18 monoclonal antibody 60.3 (P greater than 0.05). However,
      exposure of the BBEC monolayer to trypsin before addition of the neutrophils
      significantly decreased adherence (P less than 0.05). Because neutrophils and
      mononuclear cells are thought to mediate cell cytotoxicity by adhering to the
      target cells, BBECs were labeled with 51Cr, and 51Cr release was measured as an
      index of cytotoxicity. There was a modest increase in 51Cr release by the
      addition of unstimulated neutrophils and mononuclear cells, and culturing the
      BBEC monolayer with PMA before the addition of the neutrophils or mononuclear
      cells resulted in a further modest enhancement of 51Cr release (P less than
      0.05). Similar results were obtained using lactate dehydrogenase release as a
      measure of cytotoxicity. These results demonstrate that inflammatory cells can
      adhere to BBECs and may be capable of mediating cytotoxicity and adherence and
      cytotoxicity can be increased by stimulating BBECs.

PMID- 1627335
TI  - Homeobox 1.3 expression: induction by retinoic acid in human bronchial
      fibroblasts.
AB  - Homeobox (Hox) genes code for transcriptional factors and are expressed during
      many developmental and differentiative processes. In this study, we describe the
      induction of Hox 1.3 expression by retinoic acid (RA) in human bronchial
      fibroblasts (HBF) derived from explants of bronchial tissue. Using Northern blot
      analysis, we show that RA induces Hox 1.3 mRNA 3- to 10-fold over steady-state
      levels within 2 h after addition of RA to HBF culture medium. The induction was
      dose dependent, reaching a half-maximal level at approximately 10(-8) M RA. This
      induction was not seen in human dermal fibroblasts. Immunofluorescent staining of
      HBF showed a corresponding increase in Hox 1.3 protein levels in the nuclei. The
      increase in Hox 1.3 transcript levels in HBF was not abolished by cycloheximide
      treatment, suggesting that synthesis of a protein intermediate is not required
      for the induction. RA did not significantly alter the rate of degradation of the
      Hox 1.3 mRNA as determined by actinomycin D treatment, suggesting that the
      increase in Hox 1.3 mRNA may be due to an increase in the rate of transcription.
      This study provides further evidence that bronchial fibroblasts are targets for
      RA. Although downstream target genes for Hox 1.3 have not yet been identified, it
      is likely that the induction of Hox 1.3 by RA is an early step in a cascade of RA
      induced changes in gene expression in bronchial fibroblasts.

PMID- 1627336
TI  - Transient ultrastructural injury and repair of pulmonary capillaries in
      transplanted rat lung: effect of preservation and reperfusion.
AB  - A donor lung is injured during preservation and is generally thought to be
      further injured by reperfusion on transplantation. Donor lungs from 15 adult male
      Lewis rats preserved by flush perfusion with cold Marshall's solution at 4
      degrees C were examined by scanning and by quantitative transmission electron
      microscopy after 2, 4, or 7 h of storage at 4 degrees C and after transplantation
      (syngeneic) at 4 or 12 h (six animals per time interval). During preservation of
      the donor lung, capillary morphology changed rapidly. Both endothelial cells and
      type I pneumonocytes thinned (surface/volume ratio increased by 2 h in both; P
      less than 0.001). Pericapillary edema developed involving the blood-gas barrier.
      Basement membrane thickness increased significantly (P less than 0.001).
      Occasional breakage of the endothelial cell sheet occurred after 4 h of
      preservation, but even after 7 h of preservation there was no evidence of
      irreversible cell damage. The lamellar bodies of type II pneumocytes aggregated.
      Changes increased in severity with increase in preservation time. After
      transplantation, type I and type II pneumonocytes recovered after 12 h, but it
      took longer for the endothelial cell morphology to recover. Edema decreased
      rapidly during the first 4 h, despite the number of adherent neutrophils
      increasing 3-fold. The pulmonary capillaries of the transplanted lung showed no
      structural evidence of additional reperfusion injury, indicating a satisfactory
      method of preservation.

PMID- 1627337
TI  - Interleukin-2 directly increases albumin permeability of bovine and human
      vascular endothelium in vitro.
AB  - The direct effects of interleukin-2 (IL-2) on albumin permeability of cultured
      bovine pulmonary artery endothelial cell (BPAEC) and human arterial endothelial
      cell (HAEC) monolayers were studied. BPAEC were exposed to IL-2 (500 to 25,000
      U/ml) for 4 h. The steady-state transfer rate of [125I]albumin across the BPAEC
      monolayer was 3.3 +/- 0.4%/h (n = 10) in control BPAEC (diluent alone), was
      significantly increased in BPAEC exposed to 500 U/ml of IL-2 (72 +/- 3% above
      control values, n = 6, P less than 0.02), and further increased in BPAEC exposed
      to 5,000 U/ml (60 +/- 2% increase above 500 U/ml values, n = 5, P less than
      0.02). No further increase was noted after exposure to 25,000 U/ml of IL-2.
      Additionally, no further increase in [125I]albumin transfer rates was noted in
      BPAEC exposed to 5,000 U/ml of IL-2 for 24 versus 4 h. Similar changes were found
      using HAEC. Preincubation of HAEC with an anti-IL-2 low-affinity receptor
      antibody (anti-IL-2R alpha) inhibited the IL-2-induced permeability increase.
      Expression of IL-2R alpha receptors in HAEC incubated with 5,000 U/ml of IL-2 for
      4 h was also found. Thus, IL-2 appears to have a direct effect on cultural
      arterial endothelial monolayers not requiring the presence of other cell types or
      serum proteins. IL-2-induced increases in endothelial macromolecular permeability
      may play an important role in the pathogenesis of the IL-2-induced vascular leak
      syndrome seen in vivo.

PMID- 1627339
TI  - [Statistical aspects of the methodology of investigation: a critical situation].

PMID- 1627338
TI  - Antioxidant defense mechanisms in cultured pleural mesothelial cells.
AB  - The role of different antioxidant pathways in cultured rat pleural mesothelial
      cells was studied by exposing the cells to various hydrogen peroxide (H2O2)
      concentrations and by measuring H2O2 cell cytotoxicity and the capacity of the
      cells to scavenge H2O2. The antioxidant enzymes, glutathione peroxidase,
      glutathione reductase, glucose-6-phosphate dehydrogenase, and catalase were
      analyzed biochemically. Catalase and CuZn superoxide dismutase were localized by
      immunocytochemistry. To enable investigation of the glutathione redox cycle and
      catalase pathways, glutathione reductase was inactivated with 1,3-bis(2
      chloroethyl)-1-nitrosourea (BCNU) and catalase was inactivated with
      aminotriazole. When the cells were exposed to a low, sublethal (0.030 mM) H2O2
      concentration, glutathione reductase but not catalase inactivation resulted in a
      decreased capacity to remove H2O2 from the extracellular medium. When the cells
      were exposed to a high (0.25 mM) H2O2 concentration, H2O2-scavenging capacity
      decreased remarkably when catalase was inactivated. When the cells were exposed
      to 0.1 to 0.5 mM H2O2, cell cytotoxicity (lactate dehydrogenase release)
      increased significantly if glutathione reductase was inactivated; catalase
      inactivation resulted in a significant cytotoxicity only at high (greater than or
      equal to 0.25 mM) H2O2 concentrations. Immunocytochemical studies showed that the
      cells, both in situ and in vitro, contained low amounts of catalase. This
      suggests that the results of the catalase-inhibition studies are probably not due
      to a change in the characteristics of the cells in culture. 3-Aminobenzamide is a
      compound that is known to prevent NAD depletion through inhibition of poly(ADP
      ribose) polymerase during oxidant stress. When intact cells were treated with
      different antioxidants and exposed to 0.5 mM H2O2, both catalase and 3
      aminobenzamide protected the cells completely.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627340
TI  - [Epidemiologic study of post-traumatic epilepsy on the Island of Majorca].
AB  - The epidemiological study of post-traumatic epilepsy after 10 years of follow-up
      on the island of Mallorca is reported. The double prospective and retrospective
      method was used for patient selection. Prospectively, 23,082 isolated head
      injuries were studied in the Hospital of Son Dureta in Palma de Mallorca between
      the years 1980 to 1988. Retrospectively, 663 epileptics proceeding from different
      data bases of different centers were studied. Two hundred and twelve post
      traumatic epilepsies of certain etiology were identified. Results are discussed
      with regard to age, sex and latency time found. Special emphasis is made in that
      benign cerebral concussion is not causing seizures. A prevalence of 4% of post
      traumatic epilepsy is found in the population of risk head injuries, and post
      traumatic epilepsy represents 7% of the total of the casuist of epileptic
      patients.

PMID- 1627341
TI  - [Morphologic and morphometric study of the superficial peroneal nerve. Use of
      material from autopsies and amputations].
AB  - A series of 100 human peroneal nerves proceeding from autopsies and amputations
      were studied by histologic and morphometric techniques with a qualitative and
      quantitative analysis of each being performed following the morphological
      criteria of Dick et al (1985). After evaluating the results the authors consider
      that the peripheral nerve proceeding from autopsies and amputations is useful for
      basic morphologic study providing it is adequately processed within the first 29
      hours post-mortem and post-amputation. Previous studies demonstrating the
      existence of minimum morphological alterations in normal nerves is corroborated.
      In order to perform a correct morphological evaluation of the peripheral nerve a
      mere qualitative analysis is not sufficient but rather statistically evaluated
      quantitative parameters must be employed.

PMID- 1627342
TI  - [Prenatal diagnosis of Lesch-Nyhan syndrome].

PMID- 1627343
TI  - [Natural history of a bilateral carotid dissection].
AB  - The coexistence of arterial dissection in several cervical vessels is exceptional
      and is usually an accidental finding detected upon performance of an extensive
      angiographic examination in patients with unilateral manifestations. The absence
      of previous clinical manifestations related with asymptomatic vessel dissection
      impedes the knowledge of the time between the different dissections. The case of
      a bilateral carotid dissection (CD) is presented in which the clinical course
      permitted the authors to know the interval between both dissections. The patients
      initially presented manifestations of right CD and, at 15 days, an ictus due to
      left CD in which the presence of right unilateral asterixis was of note. The time
      span between both dissections was established as 12-15 days.

PMID- 1627344
TI  - [Dystonia sensitive to levodopa].
AB  - A Spanish family with the DTI variant sensitive to L-Dopa is presented with three
      patients, 2 first cousins and an aunt being described. The dystonic beginning of
      the disease during infancy is of note in the former two patients as is the later
      initiation of parkinsonism in the third patient. Marked improvement was observed
      in all of the patients with L-Dopa treatment. Some peculiarities of the cases are
      commented upon and the discussion includes analysis of the nosological aspects,
      relation with juvenile parkinsonism and Parkinson's disease. Finally, reference
      is made to the different hypersensitivity for presenting choreic dyskinesia which
      the patients had.

PMID- 1627345
TI  - [Ischemic ictus in a young woman with fibromuscular dysplasia of the basilar
      artery].
AB  - Fibromuscular dysplasia (FMD) is a vasculopathy of unknown etiology generally
      presented in young women and preferentially found in the renal arteries. The
      second site of frequency of appearance corresponds to the cervical-cephalic
      arteries with cases of the intracranial vessels being exceptional. We recently
      had the opportunity to study a female patient of 29 years of age admitted
      following an acute progressive cerebrovascular event. Cranial computerized
      tomography (CT) demonstrated multiple ischemic lesions bilaterally affecting the
      basilar-vertebral territory. Angiographic study established the diagnosis of FMD
      upon observing "pearl-like" lesions located in the distal part of the basilar
      artery. Anticoagulant treatment was initiated and the patient evolved
      satisfactorily although some neurologic deficits persisted. The authors insist on
      the need to consider FMD as a cause of ictus in young, specially female,
      patients.

PMID- 1627346
TI  - [Trigeminal neuralgia secondary to an intraventricular tumor].

PMID- 1627347
TI  - [Acute hemichorea-hemiballism in active pulmonary tuberculosis].

PMID- 1627348
TI  - [Ischemic cranial polyneuritis secondary to arteritis of the temporal artery].

PMID- 1627349
TI  - Effect of diazepam on the fatty acid composition of plasma and liver
      phospholipids in rat.
AB  - Male Wistar rats (2 months old) were maintained on a nutritionally adequate diet,
      and diazepam was administered at a dose of 10 mg/kg/day. After 24 weeks the
      effects on the fatty acid composition of plasma and liver phospholipids were
      studied. Increased levels of palmitic (16:0), palmitoleic (16:1n-7), stearic
      (18:0), and oleic (18:1n-9) acids were found in plasma phospholipids. In
      contrast, the levels of docosapentanoic (22:5n-3) and docosahexanoic (22:6n-3;
      DHA) acids were drastically decreased by diazepam. A significant decrease
      produced by diazepam was also found in levels of DHA in liver phospholipids.

PMID- 1627350
TI  - In vitro effects of glycosylated insulin in perfused liver and hindquarter in
      rats.
AB  - Using the perfused liver and hindquarter of the rat, the uptake of glycosylated
      insulin and its effect on glucose output were investigated. Insulin was
      glycosylated in ambient high glucose concentration, and glycosylated insulin GI80
      (insulin incubated with 0.08% glucose), GI350 (incubated with 0.35% glucose), and
      GI1000 (incubated with 1% glucose) were prepared. The liver and hindquarter were
      perfused with nonglycosylated insulin (N-GI) or glycosylated insulin at a
      concentration of 100 or 1000 microU/ml. There were no significant differences in
      the fractional uptake of insulin by perfused liver and hindquarter despite
      glycosylation. Insulin-induced decrement in glucose output was significantly
      lower in the liver perfused with GI1000 than that in the liver perfused with N
      GI, GI80, and GI350 at an insulin concentration of 100 microU/ml. There were no
      significant differences in insulin-induced decrement in glucose output between
      the hindquarter perfused with N-GI, GI80, GI350, and GI1000. These results
      suggest that when insulin (100 microU/ml) is incubated with a markedly elevated
      concentration of glucose (1000 mg/dl) its biological activity is reduced in the
      liver, but not in the hindquarter.

PMID- 1627351
TI  - Hurler syndrome: a patient with abnormally high levels of alpha-L-iduronidase
      protein.
AB  - Mucopolysaccharidosis type I (MPS I: McKusick 25280) is a clinically heterogenous
      lysosomal storage disorder which is caused by a variable deficiency in alpha-L
      iduronidase activity (alpha-L-iduronide iduronohydrolase, EC 3.2.1.76). Cultured
      fibroblasts from an MPS I patient (cell line 2827) with a severe clinical
      phenotype (Hurler syndrome) have been characterized using immunochemical and
      biochemical techniques. Using a specific immunoquantification assay, we have
      demonstrated that cell line 2827 had an alpha-L-iduronidase protein content (189
      ng/mg of extracted cell protein) at least six times greater than the mean level
      found in normal control fibroblasts (30 ng/mg of extracted cell protein). This
      was the only MPS I cell line, from a group of 23 MPS I patients, that contained
      greater than 7% of the mean level of alpha-L-iduronidase protein detected in
      normal controls. Cell line 2827 had very low alpha-L-iduronidase activity toward
      the fluorogenic substrate 4-methylumbelliferyl-alpha-L-iduronide, and a
      radiolabeled disaccharide substrate derived from heparin. Maturation studies of
      alpha-L-iduronidase in cell line 2827 showed apparently normal levels of alpha-L
      iduronidase synthesis with delayed processing to the mature form. Subcellular
      fractionation experiments demonstrated alpha-L-iduronidase protein in lysosomal
      enriched fractions isolated from cell line 2827, suggesting a normal cell
      distribution and supporting the proposed delayed processing. It is proposed that
      the MPS I patient described has an alpha-L-iduronidase gene mutation which
      affects both the active site and post-translational processing of the enzyme.
      This mutation must be structurally conservative because it does not result in
      instability either during maturation or in the lysosome.

PMID- 1627352
TI  - Methylenetetrahydrofolate reductase (MR) deficiency: thermolability of residual
      MR activity, methionine synthase activity, and methylcobalamin levels in cultured
      fibroblasts.
AB  - Methylenetetrahydrofolate reductase (MR) deficiency is the most common inborn
      error of folate metabolism with more than two dozen patients described. The
      phenotypic spectrum ranges from severe neurological deterioration and early death
      to asymptomatic adults. Some patients with a severe deficiency of MR have been
      shown to have thermolabile reductase at 55 degrees C. Since
      methyltetrahydrofolate, the product of MR, is a methyl donor for methylcobalamin
      (MeCbl), the cofactor for methionine synthase (MS), we have looked at MeCbl
      accumulation and MS activity in fibroblasts from 15 patients with MR deficiency.
      Thermolabile MR was most often but not always seen in later onset disease. MeCbl
      levels were often lowest in the patients with early onset disease. All but two
      patients had levels of methionine synthase within the control range.

PMID- 1627353
TI  - Influence of calcium antagonists on thrombin-induced calcium mobilization and
      platelet-vessel wall interactions.
AB  - Elevation of cytosolic ionized calcium plays a critical role in human platelet
      activation. We have evaluated three well-characterized calcium antagonists for
      their ability to prevent thrombin-induced calcium mobilization in Fura 2 AM
      loaded platelets and also their ability to inhibit platelet-vessel wall
      interactions. Thrombin (0.2 U/ml) caused significant elevation of cytosolic
      calcium (basal 84 +/- 18, activated 546 +/- 76 nM; n = 3). Verapamil, diltiazem,
      and nifedipine (100 microM) did not exert any inhibitory effect on thrombin
      mediated calcium elevation. Untreated platelets perfused through a Baumgartner
      chamber containing a rabbit aorta preparation reacted with exposed and denuded
      subendothelium. The percentage of the total area covered by control platelet
      thrombi was 39.6 +/- 3.4. Diltiazem and Nifedipine significantly reduced the
      percentage of area covered by platelet thrombi, but the drugs were not as
      effective as aspirin (8.2 +/- 1.4). Calcium antagonists studied did not inhibit
      thrombin-stimulated elevation of cytosolic calcium in blood platelets. Although
      these drugs have been shown to prevent in vitro platelet aggregation and offer
      some protection against risks for atherosclerosis and thrombosis, they failed to
      significantly inhibit platelet-vessel wall interactions leading to formation of
      spread platelets and aggregates.

PMID- 1627354
TI  - Purification and properties of AMP-deaminase from human kidney.
AB  - AMP-deaminase from human kidney (cortex and medulla) was purified and the
      physicochemical properties were characterized. The enzyme from both portions of
      the kidney exhibited identical kinetics and regulatory properties. At optimal pH
      (6.6), the AMP-deaminase studied exhibited a distinctly sigmoidal substrate
      saturation kinetics, with the half-saturation parameter (S0.5) as high as 10 mM.
      ATP at 1 mM strongly activated the enzyme, decreasing S0.5 nearly 10-fold. The
      activating effect of ADP was less strong. Orthophosphate inhibited the enzyme,
      but the inhibition observed was weak (Ki approximately 16 mM) and had a pure
      competitive character. At pH 7.2, physiological for the kidney cortex,
      orthophosphate inhibition became even weaker and became partially competitive.
      Variations in the adenylate energy charge had potent effects on the activity of
      AMP-deaminase, depending on the size of the total adenine nucleotide pool
      examined. The results of gel filtration and SDS-PAGE indicated that human kidney
      AMP-deaminase is an oligomeric enzyme composed of four, probably identical,
      subunits weighing about 37 kDa each.

PMID- 1627355
TI  - Heterogeneity in cblG: differential retention of cobalamin on methionine
      synthase.
AB  - Cultured fibroblasts from patients with functional methionine synthase deficiency
      have been shown to belong to two complementation classes, cblE and cblG. Both are
      associated with decreased intracellular levels of methylcobalamin (MeCbl) and
      decreased incorporation of label from 5-methyltetrahydrofolate into
      macromolecules. Methionine synthase specific activity is normal or near normal in
      cell extracts from cblE patients under standard reducing conditions, whereas
      specific activity is low in cblG extracts. Seven of 10 cblG cell lines
      accumulated [57Co]CN-Cbl equivalent to control cells and showed similar
      proportions of label associated with the two intracellular cobalamin binders,
      methionine synthase and methylmalonyl-CoA mutase. The remaining three cblG lines
      showed reduced accumulation of labeled Cbl and virtually none associated with
      methionine synthase. The specific activity of methionine synthase was decreased
      in cell extracts from both cblG subgroups, being almost undetectable in extracts
      from the latter three lines. Incorporation of label from [14C]MeTHF into either
      macromolecules or into methionine was decreased in both cblG groups, but was
      paradoxically higher in the three lines with very low in vitro methionine
      synthase activity. These results demonstrate further heterogeneity within cblG
      and suggest that the defect in the three variant lines affects the ability of
      methionine synthase to retain Cbl.

PMID- 1627356
TI  - Screening for gene deletions and known mutations in 13 patients with ornithine
      transcarbamylase deficiency.
AB  - We analyzed DNA from 13 males with ornithine transcarbamylase (OTC) deficiency
      for gene deletions and known point mutations using the polymerase chain reaction
      (PCR), allelle-specific oligonucleotide (ASO) hybridization, and Southern
      blotting with full-length OTC cDNA and exon-specific probes. Three patients were
      found to have deletions: one was missing the whole OTC gene; a second patient had
      a deletion of both exon 7 and 8; and the third had a deletion of exon 9. Only one
      of the remaining 10 patients had a known point mutation consisting of a G-to-A
      change in nucleotide 422 of the sense strand resulting in a glutamine
      substitution for arginine at amino acid 109 of the mature OTC protein. This study
      describes the integration of various molecular methods to screen OTC-deficient
      patients for deletions and points mutations. Two new deletions within the OTC
      gene are described.

PMID- 1627357
TI  - Sulfate transport in normal and cystic fibrosis fibroblasts.
AB  - The glycoconjugate component of cystic fibrosis (CF) epithelial secretions is
      abnormally sulfated. Previous studies have suggested that some but not all CF
      fibroblasts express this secondary defect. We tested the hypothesis that the
      major CF mutation (delta F508/delta F508) is correlated with elevated sulfate
      transport, by measuring the rates of saturable and nonsaturable [35S]SO4(2-)
      uptake in skin fibroblasts isolated from CF patients of known genotype. No
      significant differences were apparent between normal and CF fibroblasts.

PMID- 1627358
TI  - Characterization of human genomic yeast artificial chromosome inserts containing
      hexokinase 1 coding information on chromosome 10.
AB  - Hexokinase 1 (HK1) is one of four mammalian HK isoenzymes and maps to human
      chromosome 10. Two yeast artificial chromosomes (YACs) were identified in the
      Washington University human YAC library using polymerase chain reaction (PCR)
      primers designed with knowledge of the human HK1 cDNA sequence. YAC B129B12 is
      120 kb in length and maps entirely to chromosome 10. YAC A159D5 is 400 kb in
      length and appears to have resulted from a recombination of chromosome 10 with
      non-chromosome 10 material. We report these YACs as potential resources for those
      interested in HK1 gene organization and mapping, as well as those desiring
      additional genomic information and markers on chromosome 10.

PMID- 1627359
TI  - Inhibitory effect of demoxepam on tryptophan binding to rat hepatic nuclei.
AB  - Since some patients with eosinophilia-myalgia syndrome ingested tryptophan along
      with benzodiazepines, we investigated whether demoxepam, the N-desalkylated
      compound of chlordiazepoxide, would influence the binding of tryptophan to
      hepatic nuclei. L-Tryptophan has been shown to bind (saturable, stereospecific,
      and of high affinity) to rat hepatic nuclei and nuclear envelopes. We report that
      demoxepam has an inhibitory effect on in vitro [3H]tryptophan binding to rat
      hepatic nuclei and has an apparent KD approximately 22 microM.

PMID- 1627360
TI  - Abnormal hepatic nucleotide pools in sparse fur (spf) mutant mice deficient in
      ornithine transcarbamylase.
AB  - Sparse fur hemizygous male mice are over 90% deficient in ornithine
      transcarbamylase and exhibit increased synthesis of orotic acid. Because our
      earlier studies have demonstrated that orotic acid is a liver tumor promoter in
      the rat, it was of interest to determine whether this genetic disorder also
      increases the risk of tumor promotion. The results revealed that the livers of
      mutant mice showed a fourfold increase in uridine nucleotides and a 50% decrease
      in adenosine nucleotides compared to corresponding controls, a pattern of
      nucleotide pool imbalance similar to that seen in the livers of rats exposed to
      orotic acid under promoting conditions. Creation of such an imbalance appears to
      be important for orotic acid to exert its promotional effects. Sparse fur mutant
      mouse may, therefore, be an ideal animal model to study the tumor-promoting
      effects of orotate.

PMID- 1627361
TI  - Moniliformin: the result of storing a citric acid cycle intermediate.

PMID- 1627362
TI  - Double-minute chromosomes as megabase cloning vehicles.
AB  - Radiation-reduced chromosomes provide valuable reagents for cloning and mapping
      genes, but they require multiple rounds of x-ray deletion mutagenesis to excise
      unwanted chromosomal DNA while maintaining physical attachment of the desired DNA
      to functional host centromere and telomere sequences. This requirement for
      chromosomal rearrangements can result in undesirable x-ray induced chromosome
      chimeras where multiple non-contiguous chromosomal fragments are fused. We have
      developed a cloning system for maintaining large donor subchromosomal fragments
      of mammalian DNA in the megabase size range as acentric chromosome fragments
      (double-minutes) in cultured mouse cells. This strategy relies on randomly
      inserted selectable markers for donor fragment maintenance. As a test case, we
      have cloned random segments of Chinese hamster ovary (CHO) chromosomal DNA in
      mouse EMT-6 cells. This was done by cotransfecting plasmids pZIPNeo and pSV2dhfr
      into DHFR-CHO cells followed by isolation of a Neo + DHFR + CHO donor colony and
      radiation-fusion-hybridization (RFH) to EMT-6 cells. We then selected for initial
      resistance to G418 and then to increasing levels of methotrexate (MTX). Southern
      analysis of pulsed-field gel electrophoresis of rare-cutting restriction
      endonuclease digestions of DNA from five RFH isolates indicated that all five
      contain at least 600 kb of unrearranged CHO DNA. In situ hybridization with the
      plasmids pZIPNeo and pSV2dhfr to metaphase chromosomes of MTX-resistant hybrid
      EMT-6 lines indicated that these markers reside on double-minute chromosomes.

PMID- 1627363
TI  - Quantitative analysis of DNA-sequencing electrophoresis.
AB  - At the heart of the DNA-sequencing process is a remarkably selective
      electrophoretic separation of up to 1000 oligonucleotide fragments, each
      differing in size by only a single nucleotide unit. A quantitative analysis of
      this separation is performed in terms of both selectivity and efficiency. It is
      shown that both the Ogston sieving and reptation migration mechanisms are
      operative. It is demonstrated that, under the conditions used in traditional
      sequencing electrophoresis, Joule heating does not significantly contribute to
      band broadening, and that diffusion is the primary contributor to plate height.
      An analytic expression is derived relating the peak width for each fragment to
      its molecular size. Calculations are presented showing that, when longer
      sequences are required, the maximum electrical field strength will be limited by
      the influence of biased reptation on the separation selectivity. Finally, it is
      shown that, when short sequences are required, the electrical field strength is
      limited by the ability to dissipate Joule heat, and that in these cases a tube
      format will be approximately 50% faster than a slab having a thickness equivalent
      to the tube diameter.

PMID- 1627364
TI  - Sequential cisplatin--doxorubicin, early debulking in advanced ovarian cancer.

PMID- 1627365
TI  - Low-dose radiation carcinogenesis.

PMID- 1627366
TI  - EC proposal for directive can destroy the possibilities of cancer research.

PMID- 1627367
TI  - Axillary surgery in breast cancer--is there still a debate?

PMID- 1627368
TI  - Doxorubicin in advanced breast cancer: influence of schedule on response,
      survival and quality of life.
AB  - The influence of scheduling of doxorubicin on response, survival and quality of
      life was assessed in a randomised trial in patients with advanced breast cancer,
      none of whom had previously received cytotoxic chemotherapy for advanced disease.
      28 patients received 75 mg/m2 doxorubicin every 3 weeks for four courses (arm 1)
      and 31 patients received 25 mg/m2 weekly for 12 courses (arm 2). Response rates
      and median time to progression were similar in the two arms and median survival
      was 8 months in both arms. However, amongst patients receiving treatment every 3
      weeks, psychological distress measured using the Rotterdam symptom checklist fell
      significantly over the course; no such change was observed in those treated
      weekly. Physical symptoms related to cancer improved during treatment similarly
      for both groups.

PMID- 1627369
TI  - Continuous infusion of recombinant interleukin-2 with or without autologous
      lymphokine activated killer cells for the treatment of advanced renal cell
      carcinoma.
AB  - Data have been analysed for 327 patients with advanced renal cell carcinoma
      receiving a continuous infusion of recombinant interleukin 2 (rIL-2) alone (225
      patients) or rIL-2 plus lymphokine activated killer (LAK) cells (102) on a normal
      oncology ward. Eligibility criteria were uniform across protocols, all patients
      having advanced progressive disease, but with an ambulatory performance status.
      The baseline characteristics of patients receiving rIL-2 alone did not differ
      significantly from those receiving LAK, with the exception that the LAK treated
      patients had a better performance status. Despite similar treatment intensity,
      toxicity was more severe in the patients receiving LAK. The addition of LAK did
      not lead to higher response rates or to prolonged response duration, progression
      free survival or survival. This review confirms the activity of rIL-2 for the
      treatment of advanced renal cell carcinoma and demonstrates that the addition of
      LAK cells does not lead to increased efficacy.

PMID- 1627370
TI  - Phase II study of continuous subcutaneous interferon-alfa combined with cisplatin
      in advanced malignant melanoma.
AB  - Interferon-alfa (IFN-alpha) and cisplatin have shown synergism in vitro against
      tumour cell lines and optimal effects were observed with continuous and high IFN
      concentration. 20 patients with advanced malignant melanoma were treated with 10
      MU IFN subcutaneously continuously, daily, plus cisplatin 50 mg/m2 intravenously
      on days 8 and 9. Cisplatin was repeated every 4 weeks. The main toxic effects
      were myelosuppression, fatigue and weight loss. Toxicities always resolved
      completely after reduction/interruption of IFN and no life-threatening infection
      was observed. There were 1 complete and 6 partial responses. 6 patients had
      stable disease. Median time to progression was 7 months with a range of 16 to 2
      months. The combined regimen of IFN-alpha and cisplatin is active in patients
      with multiple visceral and skeletal sites.

PMID- 1627371
TI  - Sequential interleukin-2 and alpha interferon for renal cell carcinoma and
      melanoma.
AB  - There is a theoretical basis for the synergy of interleukin-2 (IL-2) with other
      cytokines. We have investigated sequential treatment with IL-2 and alpha
      interferon. 1 of 22 patients with metastatic renal cell carcinoma had a partial
      response and one a minimal response to continuous infusion IL-2 but none of the 9
      patients with melanoma responded. 16 of 17 patients with renal cell cancer, and 8
      with melanoma, were then treated with alpha interferon. 2 patients with renal
      cell cancer responded to alpha interferon with sustained remissions of 30 and 40
      months; both had responded to IL-2. The investigation of combination therapy with
      other cytokines is suggested, by these unusually long responses to alpha
      interferon.

PMID- 1627372
TI  - Phase I study comparing continuous infusion of recombinant interleukin-2 by
      subcutaneous or intravenous administration.
AB  - 22 cancer patients entered a randomised phase Ib trial comparing the effects of
      low-dose recombinant interleukin-2 (300 micrograms/m2, approximately equivalent
      to 6.4 x 10(6) cetus units or 38 x 10(6) U per day) given continuously by
      intravenous or subcutaneous infusion. At 48 h after two 5-day courses, median
      lymphocyte levels (x 10(9)/l) were 6.0 (387% increase) in the subcutaneous arm (n
      = 9) and 5.9 (369% increase) in the intravenous arm (n = 8). Liver and renal
      toxicity were similar in the two groups. One minor response lasting 4 months
      occurred in 12 renal cancer/melanoma patients receiving subcutaneous treatment
      and one durable complete remission continuing at 30 months and one minor response
      lasting 10 months occurred in 6 renal cancer/melanoma patients receiving
      intravenous treatment.

PMID- 1627373
TI  - Prognostic value of epidermal growth factor receptor in a series of 303 breast
      cancers.
AB  - 125I-EGF (epidermal growth factor) binding assay was used in tumoral specimens
      concerning 303 clinical T1-T2, N0-N1 breast carcinoma diagnosed between May 1987
      and October 1989. Binding assay for epidermal growth factor receptor (EGFR) was
      performed using single saturating concentration of 125I-EGF incubated with
      membrane preparations in the presence or absence of unlabelled EGF. A median
      value of 3 fmol EGF binding capacity per mg of membrane was obtained and then
      selected as the threshold value to define positive and negative EGFR tumour
      samples. According to this definition, 50.8% of the samples were EGFR positive.
      We noted an inverse relationship between the expression of EGFR and that of
      oestrogen receptor, and a decreased EGFR expression with tumour differentiation.
      With a rather short median follow-up (16 months), the multivariate analysis shows
      that progesterone receptor appears as the only powerful predictor of disease-free
      survival (P = 0.002), taking into account that 70% of the patients received an
      adjuvant medical treatment.

PMID- 1627374
TI  - Inter-observer and intra-observer variability of mammogram interpretation: a
      field study.
AB  - To evaluate the performance of radiologists in mammographic mass screening, seven
      radiologists read blindly the mammograms of 45 women (two views for each breast).
      The films included 12 normal, 24 benign disease and 9 cancers. The readings were
      repeated after 2 years. As expected, variability was higher among radiologists
      than between the two readings of the same radiologist, but general
      reproducibility was moderate. Kappa values for a positive/negative classification
      were 0.45 at the first and 0.44 at the second reading (inter-observer
      comparisons). For the intra-observer comparisons, Kappa values ranged from 0.35
      to 0.67 (mean 0.56). Generally, accuracy was low partly due to the difficulty of
      the cases. A slight increase in sensitivity was observed at the second reading.
      The level of agreement is a good indicator of accuracy. Proper training and
      standardization of criteria are essential before mass breast screening is
      implemented.

PMID- 1627375
TI  - Surgical treatment for chest wall recurrence of breast cancer.
AB  - From 1977 to 1987, 23 patients with isolated chest wall recurrence, excluding
      sternal metastasis, from breast cancer underwent full thickness chest wall
      resection. The 5-year survival rate after chest wall resection was 48% but the 5
      year relapse-free survival rate was 26%. Mediastinal metastasis was proved
      histologically at the time of chest wall resection in 7 patients, and survival
      period with mediastinal involvement was significantly (P less than 0.01) shorter
      than that with no mediastinal involvement (n = 16). In 17 patients with a long
      disease-free interval (DFI greater than or equal to 24 months), survival was
      longer than in 6 patients with a short DFI (less than 24 months). For the
      selected patients without mediastinal involvement and long DFI, surgical
      treatment for chest wall recurrence of breast cancer should play a significant
      role in improving the quality of life, and even in prolonging the survival rate.

PMID- 1627376
TI  - Determinants of the psycho-social outcome after operation for breast cancer.
      Results of a prospective comparative interview study following mastectomy and
      breast conservation.
AB  - In a prospective interview study, designed to compare the psycho-social outcome
      after a breast-conserving vs. a mastectomy operation, we analysed possible
      predictors of the psycho-social adjustment. 99 women with breast cancer
      histopathological TNM stages I and II were consecutively admitted to the study.
      Half-structured interviews, based on the Social Adjustment Scale and a scale by
      P. Maguire, were performed 4 and 13 months after the operation. Living together
      with the spouse seems to protect women from developing psycho-social problems
      postoperatively. Women who were gainfully employed or who were given radiotherapy
      had a higher risk of poor adjustment after 4 months. At 13 months, the scorings
      indicate that radiotherapy has a reassuring effect. Type of surgery was
      controlled for in the analysis and showed that, of the risk factors studied, the
      most consistent trend for an overall better outcome was in the breast-conserved
      group except for sexual disturbances.

PMID- 1627377
TI  - Breast carcinoma and skeletal formation.
AB  - We have studied skeletal structure in 67 women with breast carcinoma and in 59
      women without breast carcinoma, looking for differences of development that might
      be correlated with hormonal, metabolic or genetic abnormalities. We have measured
      the lengths of the limbs and of their segments (upper arm, forearm, thigh, leg),
      of the bisacromial and bitrochanteric transverse diameters and total height and
      height divided into the parts from vertex to pubis and from pubis to the ground.
      The analysis showed statistically significant coefficients of regression with
      presence of mammary carcinoma for height (0.0904262, S.D. 0.0461), length of
      thigh (0.12989, S.D. 0.03981) and length of lower leg (-0.68475, S.D. 0.1390).
      This skeletal type might be the expression of a genetic condition that is
      associated with the existence of mechanisms that permit development of mammary
      cancer.

PMID- 1627378
TI  - A phase I study of local treatment of liver metastases with recombinant tumour
      necrosis factor.
AB  - 15 patients with therapy-resistant liver metastases were treated in a phase I
      study with recombinant tumour necrosis factor (rTNF). rTNF was injected into a
      liver metastasis by ultrasound guidance, using a 50 micrograms escalating dose
      schedule (3 patients/dosage) ranging from 100 to 350 micrograms per injection.
      Influenza-like symptoms such as fever, chills, nausea and vomiting were the main
      clinical side-effects. 2 patients experienced transient hypotension, probably due
      to concomitant use of morphine. Other toxicities, as reported after systemic use
      of rTNF, such as decrease in leucocytes and platelet counts, renal or liver
      toxicity were not observed. No difference was seen in subpopulations of
      lymphocytes (CD3+, CD4+, CD8+, CD16+ and CD19+) prior to and after rTNF
      injection. In 8 patients stable disease occurred in rTNF-treated metastases. The
      maximal dose used by this route of administration is 350 micrograms per
      injection. Based on these observations we conclude that the toxicity of rTNF
      injected into liver metastases by sonographic control is transient and mild. The
      results suggest that intratumoral administration of rTNF might play a role in
      local tumour control.

PMID- 1627379
TI  - Prediction of survival by thymidine labelling index in patients with resistant
      ovarian carcinoma.
AB  - The relationship between tumour proliferative activity, evaluated by thymidine
      labelling index (TLI), clinicopathological variables and clinical outcome, was
      analysed in a series of 64 chemotherapy-resistant, ovarian cancer patients. The
      median TLI of 4.6% (range 0.01-45.7) was used as the cut-off to discriminate
      rapidly from slowly proliferating tumours. Univariate analyses showed a
      significant advantage in survival for patients with TLI less than or equal to 4.6
      (P = 0.0004), ECOG performance status less than or equal to 1 (P = 0.0001) and
      residual disease after primary surgery less than or equal to 2 cm (P = 0.019).
      Multivariate analysis demonstrated that performance status was the only
      independent prognostic variable, although TLI was the last covariate removed from
      the Cox's regression model.

PMID- 1627380
TI  - Effect of the dosing interval on myelotoxicity and survival in mice treated by
      cytarabine.
AB  - Many antineoplastic drugs are cell-cycle-phase-specific. These drugs are often
      highly toxic to the host, as they have the potential to impair replication, not
      only in the cancer cells, but also in the normal tissues. Using mathematical
      models it has been shown how selectivity of these drugs can be increased by
      exploiting the relatively large variability in cell-cycle parameters of the
      neoplasia. These models predict that toxicity to the host of cell-cycle-phase
      specific drugs can be minimised if the dosing interval is an integer multiple of
      the average intermitotic interval of the susceptible host cells. Experimental
      evidence supporting this prediction is presented in this work. Our results show
      that a constant duration of the dosing interval yields higher survival rates in
      mice treated by cytarabine, as compared with random dosing intervals. Minimal
      myelotoxicity is exerted when the dosing interval is an exact multiple of the
      inter-mitotic time of bone marrow stem cells and erythroid progenitors (i.e. 7
      h). Survival is significantly lower in mice treated every 8 h, or its multiple,
      as compared with that of mice treated at a 7 h or 10 h dosing interval.

PMID- 1627381
TI  - Stability of K-ras mutations throughout the natural history of human colorectal
      cancer.
AB  - We have used a rapid, non-radioactive and sensitive method based on allele
      specific amplification using the polymerase chain reaction for the identification
      of K-ras mutations in archival tissues of colorectal carcinomas. Our purpose was
      to determine whether or not K-ras mutation provides, when present, a tumour
      marker throughout the natural history of the disease. We have studied 35 patients
      who developed recurrent cancer. In 71% of these patients a ras mutation in codons
      12 or 13 was observed in the primary tumour. For each of these cases an identical
      ras mutation was found in the DNA from the local or distant recurrence. In the
      29% of cases where no ras mutation was observed in the primary tumour, no newly
      acquired ras mutation appeared in the recurrent tumour. The time interval between
      primary tumours and recurrences varied from 3 to 60 months. Our results indicate
      that K-ras mutation provides a stable tumour marker throughout the natural
      history of colorectal cancer.

PMID- 1627382
TI  - beta-Carotene-mediated inhibition of a DNA adduct induced by 7,12
      dimethylbenz(a)anthracene and 7-hydroxymethyl-12-methylbenz(a)anthracene in mouse
      mammary gland in vitro.
AB  - The influence of beta-carotene on the formation of DNA-adducts induced by 7,12
      dimethylbenz(a)anthracene (DMBA) and 7-hydroxymethyl-12-methylbenz(a)anthracene
      (7-OHM-12-MBA) during transformation of mouse mammary cells in organ culture was
      analysed. Treatment with beta-carotene (10(-8)-10(-5) mol/l) caused inhibition
      (48.8-94.4%) of an adduct (VI), which was detectable in DNA samples from DMBA
      treated mammary glands. Out of six adducts, derived from further analysis of DNA
      samples from 7-OHM-12-MBA-treated glands, adduct f eluted in the same fraction as
      adduct (VI), indicating these adducts were analogous. Likewise, adduct f was also
      inhibited by beta-carotene. Boronate chromatographic analysis revealed this
      particular adduct was a syn-dihydrodiol epoxide product. Adduct inhibition was
      detectable both at the start and after DMBA treatment. alpha-Tocopherol and
      canthaxanthin were ineffective in inhibiting adducts. It is reasonable to
      conclude that beta-carotene-mediated modification of adducts is associated with
      the inhibition of a syn-adduct, which is derived from further metabolism of a 7
      OHM-12-MBA intermediate.

PMID- 1627383
TI  - Altered platelet stearic to oleic acid ratio in malignancy.
AB  - Alteration of lipid metabolism associated with malignant disease is well
      documented and some studies have suggested a reduced stearic to oleic acid ratio
      occurs in erythrocytes in cancer patients. In this study, the fatty acid
      composition was measured in platelets, which are capable of lipid synthesis and
      have a much shorter lifespan. While demonstrating any malignancy related change
      in the platelet stearic to oleic acid ratio the study aimed to assess whether it
      could be of value as a tumour marker. Patients with active malignancy (n = 46)
      had a lower ratio of stearic to oleic acid than those with malignant disease in
      clinical remission [mean (S.D.) 1.08 (0.22) vs. 1.26 (0.30), P less than 0.01],
      and 22 healthy controls [1.29 (0.24), P less than 0.001]. However in a group of
      17 patients with chronic, non-malignant diseases the ratio was also lower than in
      normal controls and similar to that seen in the active malignancy group [0.97
      (0.29)]. Thus while a reduction in platelet stearic to oleic acid ratio was found
      in active malignancy, it is not specific to neoplastic disease.

PMID- 1627384
TI  - Levamisole plus 5-fluorouracil inhibits the growth of human colorectal xenografts
      in nude mice.
AB  - Fragments of human colorectal adenocarcinomas were inserted under the renal
      capsule of nude mice. The growth of these tumour grafts was significantly
      inhibited by the combination of 5-fluorouracil (5-FU) and levamisole. An
      alternating regimen of levamisole 2.5 mg/kg and 5-FU 20 mg/kg decreased the size
      of tumour implants by 33-59% and/or increased the number of macroscopically
      disappeared fragments in the combined group compared with ineffective monotherapy
      with saline, levamisole or 5-FU. This model could be valuable for investigating
      the mechanism of action of levamisole and to evaluate the effects of this
      adjuvant therapy in other oncological settings.

PMID- 1627385
TI  - The influence of hyperthermia on the uptake of cisplatin in the rat cervical
      spinal cord.
AB  - The influence of local hyperthermia on the uptake of cisplatin in the rat
      cervical spinal cord was investigated. After single intraperitoneal or
      intravenous injection of cisplatin (5 mg/kg body weight), the spinal cord region
      cervical 5-thoracic 2 was heated for 60 min at mean (S.D.) 41.2 (0.4) degrees C
      or 40 min 42.4 (0.3) degrees C using a 434 MHz microwave heating device. One day
      after treatment with either hyperthermia alone, cisplatin alone or the
      combination, none of the animals expressed neurological symptoms. The spinal cord
      was dissected and platinum levels were measured by flameless atomic absorption
      spectroscopy. No difference was found in uptake of platinum in the spinal cord
      between control- and heat treated animals. In a second series of experiments, the
      spinal cord was heated for 30-60 min. during a 2 h infusion of cisplatin. One day
      after treatment at 42.3 degrees C for 60 min, neither motor nor sensory functions
      were affected and platinum levels did not differ significantly between control
      and treated animals. Also, platinum levels measured in the spinal cord
      immediately after cisplatin infusion were not influenced by heat treatment at
      42.1 or 43.0 degrees C for 30 min. However, after a heat dose of 60 min 43
      degrees C, cisplatin uptake was significantly increased (P less than 0.001) by a
      factor of 2.8 (1.3). The data demonstrate that mild hyperthermia has no effect on
      the uptake of cisplatin in the spinal cord, while an injurious heat dose leads to
      a significant increase in cisplatin uptake. The present findings indicate that,
      in case of treatment of tumours of the central nervous system with hyperthermia
      and cisplatin, a treatment which might be toxic for the tumour is well tolerated
      by the normal nervous tissue.

PMID- 1627386
TI  - Pregnancy-related factors and risk of breast cancer in a prospective study of
      29,981 Norwegian women.
AB  - It has been suggested that pregnancy is associated with a short-term increased
      risk of breast cancer followed by a life-long protection. We studied 340 incident
      cases of breast cancer in relation to parity, age at first full term birth, and
      time since last child birth during 14 years follow-up in a prospective cohort of
      29,981 Norwegian women. We found no evidence for a transient increase in risk of
      breast cancer subsequent to pregnancy followed by a reduction in risk of long
      lasting duration. However, our results indicate that up to an approximate age of
      45 years, the nulliparous have a lower breast cancer risk than everparous women.
      Among parous women, there was an increasingly protective effect on breast cancer
      risk at a young age (less than 50 years) with increasing number of child births,
      independent of age at first birth, whereas the protection associated with an
      early age at first full term pregnancy may increase in importance with increasing
      age. This finding may reconcile conflicting reports related to these two factors.
      This study confirms the results of previous investigations suggesting that a
      "cross-over" in breast cancer incidence between nulliparous and ever-parous women
      appears to take place some time during the fifth decade of life.

PMID- 1627387
TI  - Host factors and breast cancer growth characteristics.
AB  - The rate of growth and spread of breast cancer varies considerably from patient
      to patient. An observational study was undertaken to identify possible
      associations between breast cancer growth characteristics and a wide variety of
      host factors, including demographic, anthropometric, hormonal and dietary
      variables in 91 patients with breast cancer. Increasing age was associated with
      favourable growth characteristics, while previous tonsillectomy was associated
      with adverse growth characteristics. There were no significant associations in
      anthropometric variables. For postmenopausal women, increasing bioavailability of
      oestradiol was associated with favourable growth characteristics, while
      increasing prolactin concentration was associated with adverse growth
      characteristics. Increasing consumption of sugar, fibre, fruit and vegetables and
      vitamins was associated with favourable growth characteristics. Consumption of
      fat (monounsaturated and saturated) was associated with adverse characteristics
      when adjustment was made for total energy intake. The host environment may play a
      role in the control of breast cancer growth. In particular, the associations with
      oestrogen and progesterone receptor status indicate that nutrients may be of
      value as biological response modifiers in patients having hormonal therapy. This
      requires further investigation to assess therapeutic potential.

PMID- 1627388
TI  - A comparison of menstrual cycle profiles of salivary progesterone in British and
      Thai adolescent girls.
AB  - Menstrual-cycle profiles of salivary progesterone concentration, obtained by
      radioimmunoassay of daily samples collected throughout the cycle, were obtained
      from Thai (n = 232) and British (n = 130) adolescent girls up to 4 years
      postmenarche. These profiles were graded from 1 to 5 ranging, respectively from
      concentrations at the detection limit of the assay to profiles generally observed
      for the mature premenopausal woman. Contingency table analysis of the grade
      frequencies for Thai-British pairs of girls matched for chronological age and age
      at menarche (n = 2 x 90) demonstrated that British girls had more mature cycles
      (22/90) than Thais (11/90) (P less than 0.05) particularly in the first 2 years
      postmenarche (P less than 0.01). For these matched pairs of girls there was no
      evidence to support the view that girls with an early age of menarche develop
      their profiles more quickly following menarche than those with a late age of
      menarche, as previously reported and which was thought to be important in the
      development of breast cancer. The findings of this study also suggest that
      adolescent girls in Britain develop their menstrual cycle profiles of salivary
      progesterone more quickly than their Thai counterparts and this may be of value
      in formulating hypotheses regarding any role that ovarian progesterone secretion
      may have on subsequent breast cancer risk.

PMID- 1627390
TI  - Cutaneous melanoma and sunburns in childhood in a southern European population.
AB  - A population-based case-control study of 260 patients (74 males and 186 females,
      mean age = 56) with cutaneous malignant melanoma and 416 controls (211 males and
      205 females, mean age = 55) was conducted in Turin, north-west Italy, to examine
      the relation between timing of sunburns and sun exposure and melanoma risk within
      a southern European population, which is still relatively little investigated.
      Particularly elevated risk was associated with history of sunburns in childhood
      [odds ratio 5.9; 95% confidence interval (CI) 3.6-9.5], and such risk elevation
      persisted after allowance for other major melanoma risk covariates. Conversely,
      risk increase from history of severe sunburns lifelong was lower (odds ratio =
      1.7; 95% CI: 1.1-2.4) and was eliminated by allowance for type of skin reaction
      to sun exposure and history of sunburns in childhood. A significant increase in
      the risk of cutaneous malignant melanoma was also associated with number of weeks
      spent on holiday at the beach not only as an adult, but also as a child.

PMID- 1627389
TI  - Attributable risks for oesophageal cancer in northern Italy.
AB  - The population attributable risk for oesophageal cancer in relation to cigarette
      smoking, elevated alcohol use and low beta-carotene intake has been estimated
      with 300 cases and 1203 controls in Greater Milan. In males 71% of oesophageal
      cancers were attributable to smoking, 45% to elevated alcohol use and 40% to low
      beta-carotene consumption. The corresponding figures were 32%, 10% and 29% in
      females and 61%, 39% and 38% in total. The overall estimate, including the joint
      effect of the three factors, was 90% in males, 58% in females and 83% in total.
      The discrepancies between the sums are due to the assumption of a multiplicative
      model and to the great percentage of oesophageal cancers attributable to each
      single factor. Cigarette smoking is the major known cause of oesophageal cancer
      and the three factors account for practically all the difference between male and
      female mortality rates. Elimination of smoking, reduction of alcohol consumption
      and enrichment of diet with fruit and vegetables would make oesophageal cancer a
      rare disease in Italians of both sexes.

PMID- 1627391
TI  - Oral contraceptives and breast cancer risk in Denmark.
AB  - To evaluate the influence of oral contraceptives (OCs) on breast cancer risk, a
      population-based case-control study was conducted in Denmark. The study
      population included women aged less than 40 years (203 cases, diagnosed between 1
      March 1983 and 31 August 1984, and 212 controls) and women aged 40-59 years (856
      cases, diagnosed between 1 March 1983 and 29 February 1984, and 779 controls).
      Cases were identified from the nationwide clinical trial of the Danish Breast Co
      operative Group and the Danish Cancer Registry. The control groups were age
      stratified random samples of the general female population. Data on OC use and
      breast cancer risk factors were collected by self-administered questionnaires. In
      both age groups, no significant association was detected between breast cancer
      risk and duration, age at start, latency or recency of OC use. However, the data
      provided some limited support that OCs containing 50 micrograms or more oestrogen
      may be more harmful than pills with a lower oestrogen dose.

PMID- 1627392
TI  - Diethylstilboestrol: I, Pharmacology, Toxicology and carcinogenicity in humans.
AB  - Diethylstilboestrol is still used as an adjunct palliative treatment in certain
      patients with breast and prostate cancer. Its pharmacological, toxicological and
      carcinogenic properties are reviewed. In addition to the usual untoward effects
      following subacute or chronic administration of oestrogens, treatment with
      diethylstilboestrol has been associated with serious cardiovascular sequelae.
      Most characteristic are, however, the carcinogenic properties of this drug. Many
      epidemiological data provide evidence that prenatal exposure to
      diethylstilboestrol is causally associated with vaginal and cervical clear-cell
      adenocarcinomas, a very rare type of cancer in the unexposed female population.
      The intrauterine exposure of males leads to an increased risk of testicular
      cancer, although the data are less conclusive in this respect. There is some
      evidence that administration of diethylstilboestrol in large doses to adult women
      during pregnancy increases the risk of subsequent breast cancer and it probably
      increases the incidence of endometrial carcinoma, as has been shown with other
      similar oestrogens given chronically for menopausal symptoms.

PMID- 1627393
TI  - New approaches in cancer pharmacology: drug design and development. Report of a
      European School of Oncology Task Force.

PMID- 1627394
TI  - Cell kinetic alterations during epidermal carcinogenesis. EACR--Muhlbock Memorial
      Lecture, 1991.

PMID- 1627396
TI  - Minimal guidelines for the monitoring of early clinical trials (phase I-II) in
      Europe under CRC/EORTC/NCI joint agreement.

PMID- 1627395
TI  - Trends of cancer mortality in Europe, 1955-1989: IV, Urinary tract, eye, brain
      and nerves, and thyroid.

PMID- 1627397
TI  - Problems associated with the study of cytokines in patients with leukaemia.

PMID- 1627398
TI  - Cisplatin-induced sodium and magnesium wastage.

PMID- 1627399
TI  - Suramin and prostate cancer: the role of hydrocortisone.

PMID- 1627400
TI  - Comparison of growth fraction with tumour stage and grade in renal cell
      carcinoma.

PMID- 1627401
TI  - Early ovarian cancer and the icon trials.

PMID- 1627402
TI  - Sociocultural habits and urological malignancies in Ibadan, Nigeria.

PMID- 1627403
TI  - MMAF for advanced gastric cancer.

PMID- 1627404
TI  - Prolonged thrombocytopenia after procarbazine "overdose".

PMID- 1627405
TI  - Rare occurrence of amplification of HER-2 (erbB-2/neu) oncogene in ovarian cancer
      patients.

PMID- 1627406
TI  - The impact of cytotoxic chemotherapy--perspectives from patients, specialists and
      nurses.
AB  - This study, carried out in three European countries, elicited the views and
      impact of three medical groups involved in patient care. Their views were
      compared with patients' perspectives of their condition. The main stage of the
      study was carried out by self-completion questionnaires by 300 patients across
      Italy, France and the U.K. The views of the medical profession were quantified
      via 150 hospital specialists, 75 cancer care nurses and 30 general practitioner
      interviews. Patients' symptoms most frequently seen by the medical profession
      were nausea, tiredness, loss of hair, vomiting, worrying and lack of appetite. On
      a scale of 1-4 (1 = not at all; 4 = very much) the frequency of these side
      effects were rated at 2.8 or over. Intensity of concern was highest for nausea
      and vomiting. These two symptoms was most frequently highlighted as one of the
      three highest concerns respectively for 74% and 54% of specialists, 64% and 60%
      of nurses and 50% of general practitioners. Patients on average reported a lower
      frequency of major symptoms. Most frequent were loss of hair, tiredness, lack of
      energy, nausea and decreased sexual interest. In terms of the impact of these
      problems, tiredness, nausea and loss of hair were the most frequently mentioned.
      Vomiting bothered them more than the frequency would suggest. 1 in 10 patients
      claim to have delayed their treatment because of previous experiences of side
      effects. The main impact on patient's quality of life related to the aspects of
      worrying and the effects on the family. In terms of communication, both the
      medical profession and the patients felt that patients were well informed about
      the disease and treatment. However, differences emerged between what patients
      claim to have been told about the disease and its treatment and what nurses and
      doctors claim to have said.

PMID- 1627407
TI  - Behavioural interventions and psychological aspects of care during chemotherapy.
AB  - Numerous studies have reported the deleterious impact that the side effects of
      cytotoxic chemotherapy can exert on the quality of life in patients with cancer.
      Nausea and vomiting consistently feature as the most distressing aspects of
      cancer therapy. Uncontrolled emesis can cause patients to abandon treatment and
      the poor public image of chemotherapy may lead others to refuse treatment
      altogether. Anticipatory nausea and vomiting can also develop in patients and
      this may persist for many years after successful completion of treatment. There
      are several behavioural interventions that are effective in ameliorating or
      preventing these unpleasant side effects. Consequently, psychological support
      should be provided as an integral part of good patient management, alongside
      appropriate antiemetic and anxiolytic drugs. As we can identify the
      characteristics of those patients more at risk from severe emesis and the
      development of anticipatory problems, there are good arguments for the most
      effective drug therapy (rather than the cheapest) being given to them
      prophylactically, together with relaxation techniques.

PMID- 1627408
TI  - Medical costs of osteoporosis.
AB  - Global healthcare expenditure has risen at an alarming rate over the past thirty
      years and the situation is most pronounced in the USA, which now spends 12% of
      its gross domestic product on healthcare. The greatest component of this
      expenditure is accounted for by the costs of hospitalisation, and is also
      particularly centred on the elderly sector of the population - a group that,
      relative to other sections of the population, will expand over the next thirty
      years. Osteoporosis, a chronic, disabling disorder, predominantly affects the
      elderly. Growth in the recognition and level of intervention in osteoporosis,
      when viewed alongside the increase in the elderly population, emphasises the need
      to examine the costs of osteoporosis against the already burgeoning healthcare
      bill. A detailed study in the USA in 1986 assessed the direct medical costs of
      osteoporosis in women over the age of 45; analysis included the costs of
      hospitalisation, nursing home care and outpatient services. The results of this
      survey revealed a figure for total direct costs of $5.15 billion, with hospital
      and nursing home care being the greatest contributors. A subsequent analysis of
      data for 1989 has shown expenditure to have risen to over $6 billion. This form
      of economic assessment of direct medical costs, based on discharge surveys and
      audit data, is likely to be reasonably accurate for osteoporosis-related hip and
      wrist fractures, which will generally present to hospitals, but less so for
      vertebral fractures, which have a varied clinical presentation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1627409
TI  - The success and failure of the adaptive response to functional load-bearing in
      averting bone fracture.
AB  - The skeleton's ability to sustain loads without fracture requires bone mass and
      architecture to be appropriate for the loading involved. Load-bearing is the only
      functional influence which requires any particular bone architecture, and
      functionally-engendered strains provide the only feedback relevant to both the
      bone's loading and its structural suitability. The specific strain-related
      objectives of the mechanically-related modelling/remodelling response responsible
      for matching structure to load-bearing have not been adequately defined but they
      appear to be different for cortical and cancellous bone. Static loads have no
      effect on modelling/remodelling activity whereas the effects of dynamic loading
      can be profound. The osteogenic effect of loading appears to be greatest when the
      strains and strain rates are high and the strain distributions unusual. This
      raises the possibility of continued load-bearing which only involves restricted
      activity patterns being interpreted by the bones' cell population as relative
      disuse. The osteogenic stimulus of each loading configuration appears to saturate
      after a few daily loading cycles. Since loading produces a local effect on
      modelling/remodelling, exercise regimens whose objective is to preserve or
      increase bone mass must be designed in relation to load-bearing at each skeletal
      location. Through their independent effects on bone cells nutritional and
      hormonal factors can enable, enhance, limit, or frustrate full expression of the
      adaptive response to loading. However, such systemic factors cannot engender, or
      successfully imitate, the cumulative local osteo-regulatory effects which loading
      engenders. This explains the absence of any natural systemic substances capable
      of engendering a sustained, structurally appropriate increase in bone
      mass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627410
TI  - The natural history of vertebral osteoporosis. Is low bone mass an epiphenomenon?
AB  - Osteoporotic bone fragility is due not only to decreased bone mass but to
      inadequate repair of fatigue damage and to trabecular disconnection. The precise
      roles and relative contributions of these three factors are not known for
      osteoporosis in general, and certainly not in any individual case. However, it is
      known that reduced physical activity causes bone loss. It is a virtual certainty,
      therefore, that, to the extent that the fracture produces disability,
      osteoporotics lose bone after they first experience a fracture, whatever its
      antecedent causes. In that sense, some of the bone loss we find in our patients
      is indeed an epiphenomenon. However, this is not to suggest that reduced bone
      mass is unimportant. Quite the contrary: prospective studies have clearly
      established that reduction in bone mass does increase risk of fracture, and
      hence, when it is consequent upon a fracture, it aggravates the patient's
      condition. In this way a vicious circle may develop: the pain and fear that
      follow fracture lead to decreased activity, which leads to bone loss, which can
      only increase the fragility, and hence predispose to further fracturing, even in
      cases in which the initial fragility may not have been due to low bone mass. But
      low bone mass, with its proper fragility, may not be inevitable. That is why pain
      control and a comprehensive programme of rehabilitation are critically important
      in the early management of patients with symptomatic vertebral fractures.

PMID- 1627411
TI  - The clinical consequences of vertebral compression fracture.
AB  - Vertebral compression fractures (VCFs) may be defined radiographically or as a
      clinical event. The prevalence of these fractures in women aged 50 and over has
      been estimated at 26% when defined as a reduction in vertebral height greater
      than 15%. Retrospective reviews of case records have shown a clinical detection
      rate of VCF in white women of 153/100,000 person years. Of these clinically
      detected VCFs, 84% were associated with pain. VCF may be defined as a clinical
      event characterised by loss of height and acute pain. The pain of acute fracture
      usually lasts 4 to 6 weeks with intense pain at the site of fracture. Chronic
      pain may also occur in patients with multiple compression fractures, height loss
      and low bone density but is probably due to structural changes or osteoarthritis.
      Radiographic VCF may not be symptomatic. The greater the deformity, the greater
      the likelihood of pain and disability. As height is lost, patients experience
      discomfort from the rib cage pressing downward on the pelvis. Patients develop a
      thoracic kyphosis, a lumbar lordosis, and a protuberant abdomen with prominent
      horizontal skinfold creases. The reduced thoracic space may result in decreased
      exercise tolerance and reduced abdominal space may give rise to early satiety and
      weight loss. Sleep disorders may also occur. Patients lose self esteem. Self care
      may become difficult. They are often depressed. They become fearful of further
      fracture. They have distorted body image and poor health perception. Patients
      with one vertebral fracture are at increased risk of peripheral fracture and
      further vertebral fracture. The aims of acute management are to reduce symptoms
      and mobilise the patient as quickly as possible.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627412
TI  - The radiological assessment of vertebral osteoporosis.
AB  - The traditional skeletal X-ray is of little help in quantifying osteopenia in the
      spine, and indirect criteria, such as increased lucency, loss of horizontal
      trabeculae and reduction in end-plate thickness with relatively increased
      opaqueness, can be misleading. However, the clinical expression of osteoporosis
      is fracture, which can be identified by radiography. Any reduction in the
      anterior, middle, or total height of the vertebral body should be classified as
      vertebral fracture. In mild cases, such fractures are not easily detectable,
      particularly when previous radiographs are not available for comparison. Thus
      several objective methods for fracture identification have been developed. Most
      of these methods are based on the ratio between posterior and anterior or middle
      height (wedge or biconcave deformity, respectively) and on the ratio between
      posterior height of adjacent vertebrae or with a single vertebral reference (T4).
      Some of these indices are referred to normal ranges in order to take into account
      intervertebral and interindividual variability. In 36 women with postmenopausal
      osteoporosis we have compared the lateral radiographs of lumbar and thoracic
      spine to similar X-ray pictures taken by chance at least five years before
      menopause. By defining a fracture as any decrease in vertical height above 1 mm,
      we found 77 deforming events in 29 out of 36 patients. We then applied some of
      the methods to identify objectively fractures in our postmenopausal radiographs:
      the sensitivity of the various systems ranged from 50 to 100%; however there was
      a large overlap between false positives and false negatives and the methods with
      the highest sensitivity lack specificity and vice versa.

PMID- 1627413
TI  - Management of high turnover osteoporosis with calcitonin.
AB  - Osteoporosis, associated with a high turnover of bone and acute bone loss, occurs
      in a number of clinical models, such as following prolonged steroid therapy,
      extremity and spinal immobilisation, and often is associated with fracture.
      Confinement to bed and subsequent hypodynamism relating to the pain following a
      vertebral fracture may activate the process of high bone turnover and acute bone
      loss. In postmenopausal women, the acute bone loss resulting from such clinical
      pictures may be superimposed on to the natural course of bone loss occurring in
      many postmenopausal women. Salmon calcitonin, a potent inhibitor of osteoclast
      activity, has been shown to prevent bone loss in all clinical models of acute
      bone loss due to increased bone turnover and osteoclastic resorption. In
      addition, salmon calcitonin has a potent analgesic effect, thereby causing a
      reduction in bone pain and improvement in functional capacity. For these reasons,
      calcitonin remains a first-line therapy in bone loss related to a hyper
      resorptive state.

PMID- 1627415
TI  - NIH Consensus Development Conference on the Treatment of Early-Stage Breast
      Cancer. Bethesda, Maryland, June 18-21, 1990.

PMID- 1627414
TI  - Implications of architecture for the pathogenesis and prevention of vertebral
      fracture.
AB  - Rapid loss of cancellous bone after menopause occurs by a mechanism that removes
      some structural elements completely, leaving those that remain more widely
      separated and less well connected. Slow loss of cancellous bone continues by a
      mechanism that reduces the thickness of the structural elements that survive the
      initial phase of rapid loss. Both processes have advanced further in patients
      with vertebral compression fracture due to osteoporosis, than in healthy subjects
      of similar age; whether this is because they began sooner, proceeded more rapidly
      or continued for longer is unknown. This overall concept, first developed about
      ten years ago, has now been confirmed by a variety of different methods including
      node-strut analysis, star volume and the change in curvature with profile
      dilation. Because part of the architectural contribution to compressive strength
      is captured by non-invasive densitometric methods, and the contribution of
      cortical bone to compressive strength is significant, it has been difficult to
      demonstrate an independent architectural component of bone fragility by in vitro
      comparison of structural measurements with biomechanical testing. Nevertheless,
      three independent clinical studies, comparing subjects with and without vertebral
      fracture, have each strongly suggested an independent architectural contribution
      to fracture risk. Complete removal of structural elements is initiated by focal
      perforation of trabecular plates, but the mechanism of perforation remains
      controversial.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627416
TI  - Consensus statement: treatment of early-stage breast cancer. National Institutes
      of Health Consensus Development Panel.

PMID- 1627417
TI  - Systemic therapy in node-negative patients: updated findings from NSABP clinical
      trials. National Surgical Adjuvant Breast and Bowel Project.
AB  - This report updates findings from two National Surgical Adjuvant Breast and Bowel
      Project (NSABP) clinical trials conducted to evaluate the worth of systemic
      therapy for the treatment of node-negative breast cancer patients. In trial B-13,
      737 women with estrogen receptor (ER)-negative tumors treated by sequential
      methotrexate and fluorouracil (MTX----5-FU) followed by leucovorin were compared
      with a control group treated by surgery alone. Findings for all patients through
      5 years of follow-up indicate a 27% reduction in treatment failure as a result of
      MTX----5-FU (76% vs 67%). While patients 49 years old or less and 50 years old or
      more benefited significantly from MTX----5-FU, the effect on disease-free
      survival (DFS) was greatest in those 50 years or older, where a 50% reduction in
      treatment failure occurred (86% vs 72%). A 69% reduction in mortality resulting
      from MTX----5-FU was observed in the older group (95% vs 84%). Trial B-14
      compared placebo with tamoxifen (TMX) in 2844 patients with ER-positive tumors.
      As originally reported, findings through 5 years of follow-up indicate a
      significant reduction (36%) in treatment failure as a result of the TMX (82% vs
      72%). Improvement in DFS was highly significant in both age groups. In patients
      49 years old or younger, there was a 44% reduction in DFS (81% vs 66%) and, in
      those 50 years old or more, a 31% reduction (82% vs 74%). A Cox proportional
      hazards model failed to indicate a benefit from MTX----5-FU and TMX in all
      patient subgroups. Both therapies reduced local-regional and distant recurrence,
      as well as breast tumor recurrence following lumpectomy. Updated findings from
      trials B-13 and B-14 continue to support our conclusions that (a) no subgroups of
      node-negative patients that we examined have such a good outcome as to preclude
      the use of effective systemic therapy in their treatment and (b) despite the
      benefits observed from MTX----5-FU and TMX, no subgroup of patients was so
      affected as to preclude use of a particular subgroup in assessing other therapy
      regimens in additional clinical trials. The identification and evaluation of
      markers to determine which patients should receive systemic therapy are of the
      highest priority. At present, however, the use of markers for therapeutic
      decision making regarding individual patients is tenuous.

PMID- 1627418
TI  - The Christie Hospital adjuvant tamoxifen trial.
AB  - A clinical trial was carried out at The Christie Hospital, Manchester, England,
      between November 1976 and June 1982. Following surgery, patients with clinical
      stage T1-T3a, N1-N2b, M0 tumors were randomly allocated in the following way:
      premenopausal women to either tamoxifen 20 mg/day for 1 year or to an irradiation
      induced menopause; postmenopausal women to either tamoxifen for 1 year or no
      further treatment (controls). In the node-negative subgroup, an analysis at a
      median follow-up of 10 years shows no statistically significant difference in
      overall or disease-free survival between tamoxifen-treated patients and
      irradiation-induced menopause and control patients. Side effects were few, and
      compliance was excellent. There was no significant increase of second primary
      tumors in target endocrine organs in the tamoxifen-treated patients. For the
      whole series of 961 patients, a log-rank analysis of events, allowing for node
      status, still shows a statistically significant benefit for tamoxifen-treated
      patients (P = .04).

PMID- 1627419
TI  - Use of a physician-directed questionnaire to define a consensus about management
      of breast cancer: implications for assessing costs and benefits of treatment.
AB  - The present study was designed to assess the preferred methods of treatment of
      early breast cancer by United States oncologists, to define the impact of
      published clinical trials on their practice, and to define questions related to
      clinical decision making that should be subjected to further research. A
      questionnaire was mailed to 405 oncologists of all three disciplines (medical,
      radiation, and surgical oncology) and to 60 oncology nurses who practice in the
      United States. The questionnaire included clinical scenarios of: (a) a patient
      with primary breast cancer; (b) a premenopausal woman with node-negative breast
      cancer; and (c) a postmenopausal woman with estrogen receptor (ER)-negative, node
      positive breast cancer. Respondents were asked to describe their preferred
      management for each scenario. Our study demonstrates a consensus that modified
      radical mastectomy, or partial mastectomy plus radiation therapy, should be
      offered as equal options to selected patients with primary breast cancer; this
      consensus is supported by results of clinical trials. We also found agreement
      that adjuvant chemotherapy should be offered to premenopausal women with node
      negative, ER-negative breast cancer. There was a similar consensus in favor of
      adjuvant chemotherapy for postmenopausal patients with ER-negative, node-positive
      breast cancer, despite the absence of improvement in overall survival in large,
      mature, controlled randomized trials (and in a meta-analysis). We suggest that
      further research be undertaken into factors that influence decision making by
      oncologists when they consider the administration of adjuvant
      chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627420
TI  - A model of chemotherapy in node-negative breast cancer.
AB  - Should all women with node-negative breast cancer receive chemotherapy?
      Acceptance of such a broad recommendation has been controversial due to the
      relatively good prognosis of these women and the lack of evidence of an
      improvement from chemotherapy in overall survival. We studied the question with a
      decision analytic model, which simulates a clinical trial of a large number of
      women over several decades, to calculate quality-adjusted life expectancy and the
      cost-effectiveness of chemotherapy in 45-year-old and 60-year-old women. The
      model considered a variety of scenarios about the long-term benefits of
      chemotherapy. The initial analysis found a lifetime benefit of 4 to 5 quality
      months (range, 2 to 14 months) at a cost of $15,400 to $18,800 per quality year
      (range, $5,100 to $56,800). If a risk-stratification protocol could identify a
      low-risk group, then benefit drops to about 1 quality month at a cost of $65,000
      to $90,000 per year. For the average woman, chemotherapy increases the quality
      adjusted life expectancy by a substantial amount at a generally acceptable cost.
      However, given the uncertainty of the duration of benefit and current potential
      for risk-stratification, a broad recommendation for chemotherapy is
      inappropriate.

PMID- 1627421
TI  - Randomized clinical trial to assess the value of breast-conserving therapy in
      stage I and II breast cancer, EORTC 10801 trial.
AB  - In a prospective randomized clinical trial conducted by the European Organization
      for Research and Treatment of Cancer (EORTC), mastectomy was compared with breast
      conserving therapy in 903 stage I and stage II breast cancer patients entering
      the study between 1980 and 1986. The main participating centers were: Guy's
      Hospital, London; The Netherlands Cancer Institute, Amsterdam; University
      Hospital, Leuven; Radiotherapy Institute, Rotterdam; Breast Unit, Tijgerberg,
      S.A. The data were collected in the EORTC Data Center, Brussels. Treatment in the
      study arm consisted of lumpectomy, axillary clearance, and radiotherapy to the
      breast (50 Gy external irradiation in 5 weeks followed by boost with iridium
      implant of 25 Gy). Important in this study is the large number of TNM stage II
      patients (755). Most patients were stage II because of the size of the tumor (2-5
      cm). The patient and tumor characteristics in the study and control groups were
      well balanced. So far the survival curves and local recurrence rates are not
      statistically different for the two study arms. Tumor size was found in
      univariate analysis to be a significant risk factor for local recurrence in the
      breast-conserving therapy group but not in the mastectomy group. Results of
      salvage treatment for local recurrence were not better for the breast-conserving
      therapy group compared with the mastectomy group. Measurements of quality of life
      and cosmesis show a clear benefit for the breast-conserving therapy group.

PMID- 1627422
TI  - Survival and prognostic factors in node-negative breast cancer: results of long
      term follow-up studies.
AB  - Seven hundred sixty-seven patients treated at the Memorial Sloan-Kettering Cancer
      Center from 1964 through 1970 by mastectomy and axillary dissection have now been
      followed for a median of 18 years. This unusual database consists of a
      consecutive series of women cared for by physicians specialized in the treatment
      of breast cancer in one institution. The data suggest that patients with T1, N0,
      M0 tumors of 1 cm or less may be "cured" by mastectomy and axillary dissection,
      the estimated proportion of "cured" patients being 89%. The data also suggest
      that node-negative patients can be placed in categories of risk for recurrence on
      the basis of primary tumor size.

PMID- 1627423
TI  - Classical prognostic factors in node-negative breast cancer: the DBCG experience.
AB  - Classical prognostic factors were analyzed in patients with low-risk primary
      breast cancer, defined as absence of tumor-positive axillary lymph nodes, tumor
      size less than or equal to 5 cm in diameter, and no invasion into skin or deep
      fascia. The primary surgical treatment was total mastectomy and lower axillary
      dissection. None of the patients received adjuvant therapy. Between 1977 and
      1990, 7315 patients entered the study, and at the time of this analysis (January
      1, 1990), the median follow-up time is 5 years. In univariate analyses, the
      following variables were significantly related to recurrence-free survival: age
      in premenopausal patients; tumor size; number of negative nodes removed;
      histological grade; and in premenopausal patients, estrogen receptor and
      progesterone (PgR) status. In multivariate analyses, age in premenopausal
      patients was the most important factor, followed by tumor size and histological
      grade, whereas PgR status in premenopausal patients was just of borderline
      significance. These variables should be included in multivariate analyses testing
      the value of more recently introduced prognostic factors.

PMID- 1627424
TI  - Prognostic potential of DNA flow cytometry measurements in node-negative breast
      cancer patients: preliminary analysis of an intergroup study (INT 0076).
AB  - An ancillary study (INT 0076) to the Intergroup clinical trial of node-negative
      breast cancer patients (INT 0011) was performed to retrospectively evaluate DNA
      flow cytometry measurements of ploidy (DNA content) and proliferative capacity (S
      phase fraction) for their ability to predict time to recurrence. Of the 915
      patients eligible for the clinical trial, 788 were registered for the ancillary
      flow cytometry study (INT 0076). Four hundred and three of these patients
      [estrogen receptor (ER)-positive, tumor size less than 3 cm] had been registered
      to the observation arm of the clinical trial and 385 (ER-negative and/or tumor
      size greater than or equal to 3 cm) had been randomly assigned to adjuvant
      chemotherapy (cyclophosphamide, methotrexate, fluorouracil, and prednisone for
      six cycles) or to observation. Paraffin blocks from 95% (748 of 788) of these
      patients were obtained, 712 of which had sufficient cancer tissue to be evaluable
      for the flow cytometric assay. DNA ploidy status (DNA diploid vs DNA aneuploid)
      was evaluable for 565 (79%) specimens, 64% of which were aneuploid. Proliferative
      capacity was estimated by the percentage of cells having an S-phase DNA content,
      using a trapezoidal modeling algorithm(s) as previously described. The median S
      phase value for the entire group (both registered and randomly assigned patients)
      was 6.97%, which defined the cutoff for interpretation of high or low S-phase
      values. With a median follow-up time of 4.55 years, S-phase fraction, but not
      ploidy status, is a significant predictor for time to recurrence in both the
      randomly assigned and the untreated population (observed registered group and
      observed randomly assigned group).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627425
TI  - Treatment decisions in axillary node-negative breast cancer patients.
AB  - Treatment decisions must be made on 9000 axillary node-negative breast cancer
      patients each month in the United States. Which of these patients will benefit
      from adjuvant therapy is a major question. Valid methods are needed to
      distinguish those patients who are "cured" from those who will suffer a cancer
      recurrence. A complex network of prognostic variables enters into the treatment
      decision, together with a risk-versus-benefit assessment. We are using a neural
      network-based form of artificial intelligence that, once "trained" with data
      representing an event and its outcome, can identify subsets of patients with low
      recurrence risks. Larger data sets are being evaluated with the hope of
      introducing the neural-network technique to routine clinical practice.

PMID- 1627426
TI  - Epidermal growth factor receptor and other oncogenes as prognostic markers.
AB  - Analysis of epidermal growth factor receptor (EGFr) and estrogen receptor (ER)
      was performed on tumor samples from 231 patients with operable breast cancer
      followed for up to 6 years after surgery. The median duration of follow-up in
      patients still alive at the time of analysis was 45 months. Thirty-five percent
      of patients (82) had tumors greater than 10 fmol/mg of 125I-EGF binding (EGFr+)
      and 47% (109) had cystolic ER concentration greater than 5 fmol/mg (ER+), with a
      marked inverse relationship between EGFr and ER (P less than .00001). EGFr was
      second only to axillary-node status as a prognostic marker for all patients in
      terms of both relapse-free and overall survival in univariate analysis (P less
      than .001, log-rank EGFr + v EGFr-). For patients with histologically negative
      axillary nodes, EGFr was superior to ER in predicting relapse and survival (P
      less than .01 and P less than .005, respectively, compared to P less than .1 and
      P less than .1, log-rank). In a multivariate (Cox model) analysis, only EGFr--out
      of EGFr, ER, size, and grade--was predictive for either relapse-free or overall
      survival for patients with node-negative disease (P = .052 and P = .026,
      respectively). One hundred eighty-seven case patients in the series were assessed
      for neu expression immunochemically, and 31 were positive. There was a highly
      significant increased risk of relapse and death in the positive group. In
      patients with otherwise good prognostic markers (ER+, node-negative, well
      differentiated tumors), neu expression predicted for significantly worsened
      overall survival.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627427
TI  - Danish randomized trial comparing breast conservation therapy with mastectomy:
      six years of life-table analysis. Danish Breast Cancer Cooperative Group.
AB  - The Danish Breast Cancer Cooperative Group (DBCG) conducted a randomized trial
      comparing breast conservation with mastectomy in patients with invasive mammary
      carcinoma. From January 1983 to March 1989, the trial accrued a total of 1153
      women. Of this number, 905 patients (79%) were randomly assigned to one of the
      two treatment options, whereas 248 patients (21%) did not accept randomization.
      Of the randomly assigned patients, 90% received the surgical option to which they
      had been originally assigned. In the breast conservation arm the tumor was
      excised with the intention of obtaining free margins determined at gross
      examination, and radiotherapy was subsequently administered to residual breast
      tissue. The axilla was dissected in all instances. Patient and tumor
      characteristics were similar in the two randomization arms. The median follow-up
      time was 40 months. At 6 years of life-table analysis the probability of
      recurrence-free survival was 70% in the breast conservation arm against 66% in
      the mastectomy arm. Survival figures were 79% against 82%, respectively.

PMID- 1627428
TI  - Results of the National Cancer Institute early breast cancer trial.
AB  - In 1979, a prospective, randomized trial was begun at the National Cancer
      Institute comparing lumpectomy, axillary dissection, and radiation therapy (XRT)
      to modified radical mastectomy for the treatment of invasive breast cancer,
      clinical stage T1-2, N0-1, M0. Treatment in the radiation arm consisted of full
      axillary dissection and gross removal of the tumor, followed by 4500 to 5000 cGy
      to the whole breast and a boost to the tumor bed of 1500 to 2000 cGy. Patients
      with positive axillary dissections received radiation to the supraclavicular
      nodes, in addition to cyclophosphamide and doxorubicin. Two hundred thirty-seven
      patients entered in the trial between 1979 and 1987 are available for analysis,
      116 in the mastectomy arm and 121 in the radiation arm. With a median follow-up
      of 67.7 months, there are no significant differences in 5-year overall survival
      (85% vs 89%, mastectomy vs radiation) or 5-year disease-free survival (82% vs
      72%, mastectomy vs radiation). Patients in the radiation arm had an actuarial in
      breast recurrence rate of 12% at 5 years and 20% at 8 years. There were no major
      differences between complication rates in the treatment arms. The results of the
      study indicate that patients with invasive breast cancer, stage I and II, can be
      treated with lumpectomy, axillary dissection, and radiation therapy with results
      comparable to those with modified radical mastectomy.

PMID- 1627429
TI  - Recurrence in the breast following conservative surgery and radiation therapy for
      early-stage breast cancer.
AB  - This report summarizes the experience of the Joint Center for Radiation Therapy
      (JCRT) in treating patients with clinical stage I and II breast cancer with
      conservative surgery and radiation therapy. The study population consisted of
      1396 patients treated between 1968 and 1985. All patients underwent a gross
      excision of the tumor and received breast irradiation (with or without nodal
      irradiation) including a "boost" to bring the primary tumor site to a total dose
      of at least 60 Gy. The method of treatment evolved over the study-time period.
      During the interval from 1968 to 1982, patients typically underwent a limited
      gross excision of the tumor without regard to the microscopic margins of
      resection. During the period 1983 to 1985, film-screen mammography, inking of
      specimen margins, and reexcisions for inevaluable or involved margins were more
      commonly performed. With a median follow-up of 80 months, the 5-year crude rate
      of failure in the breast (as the first site of failure) was 8% (106/1396) and the
      crude rate of regional nodal/distant failure (as the first site of failure) was
      16% (228/1396). The time-course of failures in the breast was protracted,
      occurring at a fairly constant rate over the first 7 years after treatment, but
      still seen beyond that point. Most recurrences in the breast (75%) developed at
      or near the original tumor site. The most important risk factor for developing a
      breast recurrence was the presence of an extensive intraductal component in the
      tumor. The cosmetic results following treatment were excellent or good in the
      majority of patients (87%) and were most adversely affected by extensive
      surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627430
TI  - Surgical considerations in selecting local therapy.
AB  - Clinical trials have demonstrated that patients treated with lumpectomy and
      radiation therapy have long-term survival rates equivalent to those treated with
      classical forms of mastectomy. Perhaps questions remain about appropriate
      treatment of the very smallest and the largest of operable breast tumors, but the
      majority of patients with primary breast cancer can be successfully treated with
      conservative surgery and radiation. Factors involved in surgical decision making,
      technical features of lumpectomy, and postoperative treatment are discussed.

PMID- 1627431
TI  - Radiotherapeutic considerations in the treatment of primary breast cancer.
AB  - Patients who are candidates for conservative surgery and radiation include those
      with a primary tumor size of less than 4-5 cm, without evidence of gross
      multicentricity or diffuse microcalcifications. Patients with an extensive
      intraductal component may be appropriate candidates, provided that margins of
      resection are negative. Focally positive margins of resection in patients without
      an extensive intraductal component are not a contraindication, provided that a
      boost dose of radiation is employed; young age is also not a contraindication to
      conservative treatment. The optimal radiotherapy technique includes a total dose
      to the breast of 4500-5000 cGy with a daily fraction size of less than 250 cGy
      and a weekly dose of more than 800 cGy. The role of boost treatment in patients
      with negative margins of resection is currently under investigation. Boost
      treatment is essential in patients with positive margins. A direct photon-beam
      field to treat the internal mammary nodes should be avoided, especially in
      patients receiving chemotherapy. The subset of patients for whom the addition of
      radiation following an excisional biopsy does not result in a decreased risk of
      breast cancer recurrence remains to be defined and is currently being evaluated
      in several prospective randomized trials. The optimal sequencing of adjuvant
      chemotherapy and primary radiotherapy has not been determined.

PMID- 1627432
TI  - Lumpectomy for breast cancer: an update of the NSABP experience. National
      Surgical Adjuvant Breast and Bowel Project.
AB  - The data in this report continue to indicate, as first noted in 1985, that
      lumpectomy followed by breast irradiation in all patients, and adjuvant
      chemotherapy in women with positive nodes, is appropriate therapy for negative-
      or positive-node patients with tumors 4 cm or less in size, provided that the
      margins of the resected specimens are free of tumor. The value of irradiation in
      reducing the incidence of tumor in the ipsilateral breast after lumpectomy
      continues to be significant in all patients regardless of nodal status, age, or
      tumor size. A multivariate analysis indicates that, in all patients, three
      covariates, ie, treatment, tumors with poor histologic type, and tumors with a
      maximum pathologic size greater than or equal to 2 cm, are significant predictors
      of breast tumor recurrence following lumpectomy. Of particular significance is
      the continuing observation that the distant disease-free survival (DDFS) and
      survival (S) of patients in the three treatment groups (total mastectomy,
      lumpectomy alone, and lumpectomy followed by breast irradiation) demonstrate no
      significant difference through 9 years of follow-up, despite the fact that the
      total mastectomy group (by virtue of breast removal) had no breast tumor
      recurrence, that lumpectomy patients treated with breast irradiation had a 10%
      ipsilateral tumor recurrence, and that patients treated by lumpectomy alone
      demonstrated a 40% recurrence of tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627433
TI  - Swiss adjuvant trials in women with node-negative breast cancer. OSAKO.
AB  - Women with node-negative breast cancer have a 30% chance of relapse 5 years after
      mastectomy. If it is possible to prevent or defer recurrent disease with adjuvant
      systemic therapy, node-negative patients, with their low tumor burden, should
      theoretically benefit most from such treatment. In 1974 we started a randomized
      adjuvant trial in eastern Switzerland, using a subjectively less toxic regimen
      [chlorambucil, methotrexate, and fluorouracil (LMF)]. Two hundred fifty-four
      patients were randomly assigned after standardized modified radical mastectomy to
      observation only or to treatment with oral LMF for 6 months followed by BCG skin
      scarifications monthly for up to 2 years. While we find no significant
      statistical difference between the control group and the treated group in terms
      of relapse-free survival, there is a strong and consistent trend toward
      prolongation of overall survival within the treated group.

PMID- 1627434
TI  - Adjuvant CMF for node-negative and estrogen receptor-negative breast cancer
      patients.
AB  - From December 1980 to September 1985, a total of 90 eligible patients with stage
      T1-3a, node-negative, and estrogen receptor-negative (less than or equal to 10
      fmol/mg of cytosol protein) tumors were entered into a randomized study to assess
      the effectiveness of adjuvant intravenous (IV) cyclophosphamide, methotrexate,
      and fluorouracil (CMF) in a subset of patients at high risk of early disease
      relapse. High values of [3H]thymidine labeling index were documented in two
      thirds of 62 assessed specimens from the patient population, and one half of the
      patients had histologically undifferentiated tumors. Patients were allocated to
      either local-regional modality alone (control group, 45 women) or to CMF (45
      patients) after surgery. A full dose of CMF (600 mg/m2 each of cyclophosphamide
      and fluorouracil, and 40 mg/m2 of methotrexate) was administered IV on day 1, and
      then repeated every 3 weeks for a total of 12 treatments. After a median follow
      up of 80 months, the 7-year results confirmed the superiority of adjuvant CMF
      compared to local-regional modality alone (relapse-free survival 85% vs 42%, P =
      .0001; total survival 86% vs 58%, P = .006). A benefit from adjuvant CMF was
      observed in all subgroups, and the rates of both local-regional and distant
      failure were decreased. Treatment was fairly well tolerated and devoid of life
      threatening toxicity. Present results confirm our previous observation concerning
      the dismal prognosis of node-negative and estrogen receptor-negative breast
      cancer patients as well as the beneficial effect of adjuvant chemotherapy in this
      selected subset.

PMID- 1627436
TI  - A single perioperative adjuvant chemotherapy course for node-negative breast
      cancer: five-year results of trial V. International Breast Cancer Study Group
      (formerly Ludwig Group).
AB  - Twelve hundred seventy-five patients who were defined as having node-negative
      breast cancer were evaluated in a randomized trial that compared a single cycle
      of combination chemotherapy started within 36 hours of surgery (848 patients)
      with no adjuvant treatment (427 patients). The chemotherapy consisted of
      intravenous cyclophosphamide, methotrexate, and fluorouracil given on days 1 and
      8. Leucovorin (given on days 2 and 9) was added to the regimen to decrease severe
      toxic effects attributed to drug interaction between nitrous oxide used in
      anesthesia and methotrexate given in the immediate postoperative period. At a
      median follow-up of 60 months, the 5 year disease-free survival (DFS) percentages
      (+/- SE) were 74% +/- 2% for the treated group, and 68% +/- 2% for the no
      adjuvant therapy group. The estimated hazard ratio [95% confidence interval (CI)]
      was 0.78 (0.63 to 0.96); P = .02, representing a 22% +/- 9% relative reduction in
      the risk of relapse. The overall survival (OS) difference was not statistically
      significant with 5-year OS percentages of 88% +/- 1% for the treated group, and
      85% +/- 2% for the control group [estimated hazard ratio (95% CI) = 0.85 (0.62 to
      1.16); P = .31]. A subgroup analysis by menopausal status and by estrogen
      receptor (ER) status revealed that the treatment effect was largest among the
      postmenopausal women with ER-negative tumors. The 5-year DFS percentages were 79%
      +/- 4% and 56% +/- 7%, and the OS percentages were 91% +/- 3% and 70% +/- 6%, for
      the treated and control groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627435
TI  - West Midlands Oncology Association trial of adjuvant chemotherapy in node
      negative breast cancer.
AB  - Between 1976 and 1984, 574 patients with operable breast cancer and
      histologically negative axillary lymph nodes were randomly assigned after
      mastectomy to receive either no further treatment or chemotherapy with oral LMF
      (fluorouracil, 500 mg, methotrexate, 25 mg, and chlorambucil, 10 mg, on day 1;
      fluorouracil, 500 mg, and chlorambucil, 10 mg, on day 2). There is no overall
      survival or relapse-free survival benefit at a median follow-up of 10 years and 8
      years, respectively. There are significantly more local relapses in the control
      group (P less than .01), but an excess of distant relapses in the treated group
      is not statistically significant (P = .24). A positive treatment effect in small
      tumors (relapse-free survival, odds ratio = 0.55, P = .01) and a negative effect
      in progesterone receptor-positive tumors (survival, odds ratios = 2.04, P = .04)
      is probably ascribable to chance. Analysis of various prognostic factors shows
      that tumor size and histological grade have a clear effect on both relapse-free
      interval and survival.

PMID- 1627437
TI  - Chemotherapy versus observation in high-risk node-negative breast cancer
      patients.
AB  - Postoperative women with breast cancer but without histopathological evidence of
      metastases to the axillary lymph nodes or clinical evidence of metastases were
      studied. Six hundred fifty-five "good-risk" patients who were estrogen receptor
      positive (ER+) with primary tumors less than 3 cm were registered for
      observation. Twenty-four of these patients were treated with chemotherapy. Five
      hundred thirty-six "poor-risk" patients who were either ER+ with primary tumors
      greater than or equal to 3 cm or estrogen receptor negative (ER-) with any
      primary tumor size were randomly assigned between chemotherapy and observation.
      Randomization was stratified by type of surgical procedure, number of lymph nodes
      examined, menopausal status, tumor size, and ER status. The chemotherapy (CMFP)
      consisted of six 4-week cycles of cyclophosphamide, 100 mg/m2 orally days 1-14;
      methotrexate, 40 mg/m2 intravenously (IV) days 1 and 8; fluorouracil, 600 mg/m2
      IV days 1 and 8; and prednisone, 40 mg/m2 orally days 1-14. Treatment arms in the
      randomly assigned patients were balanced with respect to pretreatment
      characteristics. This analysis includes 445 eligible patients entered in the
      registration arm and 425 eligible patients entered into the randomized
      treatments. The median follow-up is 4.5 years in the randomly assigned cohort and
      4.8 years in the registered cohort. The overall 5-year disease-free survival
      (DFS) among the randomly assigned patients was 83% with CMFP and 61% with
      observation (P less than .0001). A DFS treatment benefit was observed in
      premenopausal and postmenopausal patients as well as in patients with ER+ or ER-
      tumors. There were fewer local-regional and distant relapses among the CMFP
      treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627438
TI  - Epilepsy, cerebral blood flow, and cerebral metabolic rate.
AB  - Penfield's observations in the 1930s provided the first systematic evidence of
      changes in regional cerebral blood flow (rCBF) associated with focal seizures.
      Further studies in humans and animals confirmed increases in cerebral blood flow
      and metabolism during generalised seizures, but the interictal, ictal, and
      postictal changes in focal epilepsy have begun to be elucidated in the last
      decade with the advent of in vivo imaging techniques such as positron emission
      tomography (PET) and single photon emission computed tomography (SPECT) and, in
      the case of animal studies, of autoradiography. Most studies have been of
      temporal lobe epilepsy. Interictally, the characteristic finding has been reduced
      blood flow and/or metabolism in the affected temporal lobe, or more extensively
      in the ipsilateral hemisphere. The few studies to date of ictal or postictal
      changes have been of rCBF using SPECT. They show hyperperfusion of the whole
      temporal lobe ictally, hyperperfusion of the hippocampus, combined with
      hypoperfusion of lateral structures in the immediate postictal period. Later in
      the postictal period, hypoperfusion alone is seen. Studies of focal seizures in
      animals have shown hyperperfusion and hypermetabolism at the site of the focus
      often with widespread depression of both parameters in the ipsilateral neocortex.
      Limited studies of coupling between blood flow and metabolism in humans have
      suggested that flow during seizures is adequate for metabolic demand, although
      some animal studies have suggested localised areas of uncoupling. The results of
      modern in vivo imaging of ictal and postictal changes in blood flow and
      metabolism have correlated well with Penfield's observations, and these changes
      are now being used to help localise epileptic foci, allowing wider use of the
      surgical treatment he pioneered.

PMID- 1627439
TI  - Transcranial Doppler: clinical and experimental uses.
AB  - Blood flow velocity in the basal intracranial arteries can be reliably recorded
      using transcranial Doppler (TCD) ultrasonography. The utility of Doppler
      ultrasound in detecting stenosis of arteries has therefore been extended to
      include the intracranial basal arteries. This has been useful in detecting
      intracranial stenosis from a variety of causes including atherosclerosis and
      vasospasm induced by subarachnoid hemorrhage. Changes in cerebral hemodynamics
      during significantly increased intracranial pressure have also been detected, and
      have been useful in warning of compromise of the cerebral circulation in head
      injury. The assessment of the final hemodynamic effects of occlusive disease on
      the middle cerebral artery can be studied using the CO2 reactivity test. This
      offers additional diagnostic information in these patients. The direct detection
      of intracranial microemboli using TCD is also now possible and this has
      implications in the management of patients with stroke and transient ischemic
      attacks. Continuous monitoring of the middle cerebral artery velocity has been
      useful in indicating relative blood flow changes through this artery under
      certain specific circumstances. By providing continuous information on relative
      blood flow changes, the dynamics of the cerebral circulation can be studied in
      more detail. This has allowed the assessment of cerebral autoregulation, as well
      as blood flow changes, due to changes in cortical activity induced by visual
      stimulation. Further research on the dynamics of the human cerebral circulation
      will be possible using this technology.

PMID- 1627440
TI  - In vivo and in vitro studies of the dopaminergic system in movement disorders.
AB  - Over the past 20 years, tritiated radioligand receptor binding has been used to
      study the relationship between dopamine receptor binding and various movement
      disorders, in particular Parkinson disease. More recently, in vivo imaging
      techniques like positron emission tomography and single photon emission computed
      tomography have been used to study the dopaminergic system in these disorders.
      This review describes the data that have been obtained using in vivo and in vitro
      measurements of the dopaminergic system in movement disorders, and examines the
      relationship between them. The contribution of these techniques to clinical
      management is described.

PMID- 1627441
TI  - Radiographic contrast media.

PMID- 1627442
TI  - Magnetic resonance angiography.
AB  - Literature of the past year contains several worthwhile papers describing the
      application of MR angiography techniques to imaging of the vascular system. MR
      angiography has been performed with two-dimensional time-of-flight, two
      dimensional phase-contrast, and three-dimensional time-of-flight techniques. With
      current methodology it appears that a variety of MR angiography techniques are
      necessary to image the various vascular beds of the vascular system, with the
      appropriate MR angiography technique determined by the velocity and flow
      characteristics of the vascular bed of interest. Knowledge of the change in
      velocity patterns in disease states appears necessary for appropriate pulse
      sequence selection. Signal loss due to higher motion disorders remains
      problematic; however, the steady progress in MR angiography techniques suggests
      that these limitations will be overcome. Efforts are also underway to measure the
      velocity of blood flow. The potential combination of imaging and functional
      capabilities makes it likely that MR angiography will be an important technique
      for assessing the vascular system.

PMID- 1627443
TI  - Radiologic treatment of abdominal abscesses with fistulous communications.
AB  - Although percutaneous radiologic drainage of abdominal abscesses is now a well
      established, standard procedure, several factors may limit its success. These
      limitations include the absence of a safe anatomic access route, presence of
      fistulous communications, and association with severe inflammation of organs such
      as the bowel or the pancreas. This review addresses advances and persisting
      limitations in the percutaneous management of complex abdominal abscesses.

PMID- 1627444
TI  - Gallbladder and biliary interventional radiology.
AB  - The past ten years have seen the introduction of a number of new techniques for
      the treatment of biliary diseases. In this report, we discuss the roles of both
      extracorporeal shock-wave lithotripsy and percutaneous treatment of gallstones,
      and we emphasize the changing role of these techniques since the advent of
      laparoscopic cholecystectomy. The literature on chemical cholecystectomy is
      reviewed with particular reference to experience in humans. Biliary
      endoprosthesis using expandable metallic stents is discussed in patients with
      benign and malignant biliary obstruction. Finally, we review the role of
      interventional radiologic procedures on liver transplant patients.

PMID- 1627445
TI  - Cardiovascular radiology.

PMID- 1627446
TI  - Doppler echocardiography.
AB  - In the past year, Doppler echocardiography has continued to transform the "echo
      laboratory" into a "cardiac imaging and hemodynamics laboratory." Evaluation of
      blood flow through the cardiac chambers and great vessels is moving from
      semiquantitative to quantitative. The potential for measuring mitral regurgitant
      flow more precisely has been demonstrated by evaluating the zone of flow
      acceleration that occurs on the left ventricular side of the mitral valve. Direct
      imaging of pulmonary venous return to the left atrium using transesophageal
      Doppler echocardiography has also allowed more precise quantification of mitral
      regurgitation. Left ventricular systolic function may be better quantified in
      patients with mitral regurgitation by calculating the ratio of the change in
      pressure to the change in time from the continuous wave spectrum of regurgitant
      flow. The practical application of transmitral flow.in evaluating diastolic
      function has been applied to cardiac amyloidosis.

PMID- 1627447
TI  - Interventional radiology.

PMID- 1627449
TI  - Ultrafast computed tomography of the heart.
AB  - Recent cardiovascular morphologic studies focus on direct innovative ultrafast CT
      applications in detecting coronary calcifications and assessing pericardial
      diseases. In functional studies, quantitation of regional and global indicators
      of myocardial function and structure, such as wall thickness or thickening,
      volume, and mass, can be performed using ultrafast CT and MR imaging with similar
      approaches. Recent ultrafast CT developments illustrate the fact that cardiac
      tomographic imaging is evolving rapidly. The production of three-dimensional
      images from tomography, which is still uncommon, has enhanced resolution and wall
      motion analysis. Applications will have a major impact on the knowledge of
      cardiac physiology and the understanding of cardiovascular diseases, if not in
      daily patient care. Further developments in computer-automated analysis from
      cardiac ultrafast CT or MR images must be carried out to gain clinical acceptance
      and to facilitate the routine and consistent measurements of the parameters of
      cardiac function.

PMID- 1627448
TI  - Myocardial perfusion imaging in the diagnosis of coronary artery disease.
AB  - The role of myocardial perfusion imaging has been extended from diagnosis to
      management and prognosis in patients with coronary artery disease. Great emphasis
      has been placed on improving the accuracy of the test to better define perfusion,
      viability, and the extent of damage of the myocardium. To achieve this goal,
      investigators have focused on several areas including imaging technique, in which
      the accuracy of single-photon emission CT has been compared with that of positron
      emission tomography; radiopharmaceuticals, in which 201Tl has been compared with
      99mTc-sestamibi and 99mTc-teboroxime; stress modalities, in which dipyridamole
      and adenosine stress have been compared with exercise; myocardial viability, as
      determined by delayed and reinjection 201Tl imaging or by measurement of cellular
      integrity using 82Rb compared with 18fluorodeoxyglucose metabolic PET imaging;
      and assessment of myocardial salvage and prognosis by exercise or dipyridamole
      201Tl imaging in acute myocardial infarction.

PMID- 1627450
TI  - Magnetic resonance imaging of the heart and the great vessels: morphology,
      function, and perfusion.
AB  - The capability of MR imaging to evaluate cardiovascular disease is developing
      faster than ever, as is well documented by the numerous contributions that have
      been made to the literature during the past year. As the field progresses, MR
      imaging will probably become one of the preferred investigational methods for the
      evaluation of cardiac function. The first stage of MR imaging development
      emphasized replication of commonly used methods for studying morphology and
      analyzing global ventricular performance. Thus, validated MR imaging methods
      exist for the assessment of ventricular' volume, ejection fraction, and mean wall
      stress. More recently, emphasis has been directed toward the evaluation of
      regional function and perfusion, using novel methods and attracting increasing
      interest from the cardiovascular research community. Studies reviewed here focus
      on both clinical results obtained using well-established MR imaging techniques
      and new results using innovative methods, further extending the usefulness of MR
      imaging. Topics discussed include congenital and ischemic heart disease and
      disease of the great vessels. Technical advances in flow and velocity mapping and
      in the evaluation of ventricular performance are also discussed.

PMID- 1627451
TI  - Cardiac magnetic resonance spectroscopy.
AB  - Magnetic resonance spectroscopy provides information about metabolic processes in
      living tissues. The resulting information may be more sensitive and specific than
      that obtained using techniques that rely on functional or structural
      measurements. Although the preponderance of applications to date have been in
      physiologic investigations in animals, clinical applications are emerging.
      Reports in the past two years have appeared evaluating the clinical use of
      phosphorus spectroscopy to detect ischemic heart disease, cardiomyopathy, and
      cardiac transplant rejection. Active research using nuclei other than phosphorus
      for spectroscopy will expand the potential clinical applications. Technical
      developments, including improved surface coil design, wider use of high-field
      magnets and new pulse sequences, will allow improved sensitivity and spatial
      localization in the future.

PMID- 1627452
TI  - Coronary angiography and interventional cardiology.
AB  - Percutaneous transluminal coronary angioplasty has become the most commonly
      applied coronary revascularization procedure. Its growth is due to expanding
      indications and new patient populations including patients with multivessel
      coronary artery disease, acute myocardial infarction or cardiogenic shock, and
      elderly patients. Success rates and complications for percutaneous transluminal
      coronary angioplasty have remained the same or improved despite the expanding
      indications and the persistent problem of restenosis. Several recent studies have
      examined new biologic approaches to restenosis. However, the most exciting area
      of interventional cardiology continues to be the use and development of new
      mechanical devices including stents, lasers, and atherectomy for unfavorable
      anatomic lesions, acute occlusion after angioplasty, and to prevent restenosis.
      The gold standard in the assessment of coronary disease is still angiography, but
      newer imaging techniques including intravascular ultrasound and angioscopy have
      added to our understanding of angioplasty, unstable angina, and the use of new
      devices.

PMID- 1627453
TI  - Pediatric cardiovascular diagnosis.
AB  - Significant progress is being made in the field of pediatric cardiovascular
      imaging. The application of color Doppler transesophageal echocardiography has
      proven to be extremely useful in both intra- and perioperative examinations. The
      introduction of the long-axis pediatric probe has expanded the abilities of
      transesophageal imaging in clinical pediatric practice. MR imaging is continuing
      to evolve as a noninvasive imaging technique. The development of cine-MR imaging
      now permits simultaneous evaluation of cardiac anatomy and function and is
      forecasting a larger role for this technology. In the field of interventional
      cardiovascular radiology, there have been further reports describing percutaneous
      balloon valvoplasty both at valve and vascular levels, as well as the application
      of balloon expandable intravascular stents for a variety of obstructive lesions.

PMID- 1627454
TI  - Current status and extended applications of intravascular stents.
AB  - The introduction of several novel techniques and mechanical devices to
      interventional radiology has expanded the range of therapies for a variety of
      medical disorders. Intravascular metallic stents have received widespread acclaim
      and may possess the most potential of all the newest devices available to the
      interventionist. The addition of metallic stents to the percutaneous therapeutic
      arsenal provides the interventionist with a device that can resist the elastic
      recoil of a stenotic vessel or support a newly created vascular tract. Peripheral
      artery metallic stent placement holds great promise for the treatment of selected
      patients; other applications of stents, including transjugular intrahepatic
      portosystemic stent shunts are likely to have a great impact in patient
      management. We review the techniques, appropriate indications, and recent
      clinical results of vascular stents for percutaneous intervention and therapy.

PMID- 1627455
TI  - Peripheral angiography and angioplasty.
AB  - This paper reviews recent developments in diagnostic and therapeutic
      interventional procedures for the peripheral arteries reported from February 1991
      to January 1992. Topics discussed include endovascular metallic stents,
      atherectomy catheters, and intravascular ultrasound.

PMID- 1627456
TI  - Venous imaging and inferior vena cava filters.
AB  - Thromboembolic disease is a major complication in many hospitalized patients.
      Imaging of deep venous thrombosis is important for making the diagnosis. After
      establishing the diagnosis, a decision must be made regarding anticoagulation. If
      the patient can not be anticoagulated, placement of an inferior vena cava filter
      is indicated. This paper discusses some of the latest information available on a
      variety of filters. However, a long-term multicenter study is needed to determine
      the effectiveness and safety of the available filters. A new approach to
      percutaneous insertion of central venous catheters is also discussed.

PMID- 1627457
TI  - Visceral angiography and embolization.
AB  - New aspects of both diagnostic and therapeutic angiography are reviewed in the
      context of tumor therapy, trauma, and portal hypertension. The use of intra
      arterial administration of calcium gluconate as a diagnostic challenge for
      insulinomas, tumor embolization, and chemoembolization are reviewed. The use of
      angiography for proximity injuries and the therapeutic aspects of embolization in
      blunt hepatic, pelvic, and splenic trauma are also noted. Angiography in portal
      hypertension is emphasized as an adjunct to surgery. The use of the transjugular
      intrahepatic portosystemic shunt is reviewed and is noted to be of great promise.

PMID- 1627459
TI  - Variants of human L1 cell adhesion molecule arise through alternate splicing of
      RNA.
AB  - The L1 cell adhesion molecule was initially identified and characterized in mouse
      as a cell-surface glycoprotein that mediates neuron-neuron and neuron-Schwann
      cell adhesion. We have characterized L1 in humans using cDNA structural and mRNA
      expression analyses. We present the entire coding sequence for human L1, which
      predicts a 1253-amino acid protein displaying a signal sequence, transmembrane
      segment, RGD sequence, and potential glycosylation and phosphorylation sites.
      Nucleotide and deduced amino acid sequence identities between human and mouse L1
      are 85% and 87%, respectively. In contrast, the amino acid identity between human
      L1 and the L1-related molecule chicken Ng-CAM is only 45%. Using Northern blot
      analyses, a single L1 transcript of 5.5 kb is detected in human fetal brain and
      in neuroblastoma (IMR-32) and retinoblastoma (Y-79) cell lines. L1 is also
      expressed in the rhabdomyosarcoma cell lines RD and A-204, which display several
      muscle characteristics. Two forms of L1, which differ by the presence or absence
      of a 12-bp cytoplasmic segment, are expressed in both human and mouse. This
      segment is encoded by a single exon that can be alternately spliced to give rise
      to the two forms, which appear to be expressed in tissue-specific patterns.

PMID- 1627461
TI  - The reeler gene: a clue to brain development and evolution.
AB  - Reeler mutant mice are characterized by profuse anomalies of cell positioning in
      the telencephalic and cerebellar cortices as well as by distinct malformations in
      non-cortical structures such as the inferior olive, the facial nerve nucleus and
      other brainstem nuclei. Studies of the embryonic development of these structures
      reveal that the early cell patterns formed by reeler neurons is consistently
      affected, so that the reeler gene plays an important role in the development of
      nerve cell patterns. Comparative studies of cortical development in reptiles
      suggest further that the mammalian type of cortical architectonics has been
      acquired progressively during brain evolution, and reveal some similarities in
      early cortical organization between reeler and reptilian, particularly chelonian,
      embryos, most notably the presence of an inverted gradient of cortical
      histogenesis. These observations point to a possible role of the reeler gene in
      cortical evolution. Although the factors responsible for the formation of neural
      cell patterns are largely unknown, most data point to the importance of cell-cell
      interactions. Cell-interaction molecules have probably been acquired during brain
      evolution and the reeler gene could act by perturbing, directly or indirectly,
      such cell interactions. The characterization and thus the cloning of the reeler
      gene is therefore important for our understanding of brain development. Recent
      data on the fine chromosomal mapping of the mutation prior to its positional
      cloning are reported.

PMID- 1627462
TI  - Autonomous mesoderm formation in blastocoelic roof explants from inverted Xenopus
      embryos.
AB  - Xenopus eggs, artificially fertilized, were prevented from undergoing equilibrium
      rotation by incubation in medium containing ficoll. Three orientations were
      selected: normal, with animal pole uppermost; inverted, with vegetal pole away
      from gravity; and an off-axis orientation, with embryos tilted approximately 90
      degrees from the animal-vegetal axis. At blastula stage 8, cells forming the
      blastocoelic roof were cultured in isolation as explants. These cells are
      normally fated to from epidermis ventrally and neural derivatives dorsally.
      Unexpectedly, in the fragments originating from inverted or 90 degrees-off-axis
      embryos, axial structures were found: notochord, somites, neural cells, cement
      glands, and sometimes sensory organs. Inverted eggs could be exploited in studies
      of mesodermal specification.

PMID- 1627460
TI  - Expression of thymosin beta-4 and related genes in developing human brain.
AB  - The retinoic acid-responsive thymosin beta-10 gene is known to be developmentally
      regulated in the human brain. We now report the novel finding that thymosin beta
      4, a structurally related 5-kDa actin-sequestering protein, is also subject to a
      similar but not identical pattern of expression during normal human
      neuroembryogenesis. However, while thymosin beta-10 mRNA was undetectable (by
      northern blot analysis) in adult human brain, levels of thymosin beta-4 mRNA,
      although greatly reduced, were still present. Moreover, a novel thymosin beta-10
      like gene was also found to exhibit a unique stage-specific expression during
      early human neural development. These experiments, together with previous
      findings, indicate that the products of the two thymosin genes, possibly in
      association with cytoskeletal elements, may play different roles during early
      neuroembryogenesis and neural maturation.

PMID- 1627458
TI  - Molecular and cellular biology of Alzheimer amyloid.
AB  - Alzheimer's Disease (AD), a disorder of unknown etiology, is the most common form
      of adult-onset dementia and is characterized by severe intellectual
      deterioration. The definitive diagnosis of AD is made by postmortem examination
      of the brain, which reveals large quantities of neurofibrillary tangles (NFT) and
      senile plaques within the parenchyma. The NFT are composed of paired helical
      filaments associated with several cytoskeletal proteins. The primary protein
      component of senile plaques is beta/A4 amyloid, a 42-43 amino acid peptide
      derived from a much larger molecule, the amyloid precursor protein (APP).
      Vascular beta/A4 amyloidosis is also prevalent in the disease. The mechanism by
      which beta/A4 amyloid accumulates in the AD brain is unknown. Recent research has
      demonstrated that the precursor molecule, APP, is a transmembrane protein with a
      large extracytoplasmic domain, a membrane spanning region that includes the
      portion that gives rise to beta/A4 amyloid, and a short intracytoplasmic domain.
      The precursor has multiple forms among which are those that differ by a variable
      length insert within the extracytoplasmic domain. The insert has sequence
      homology to the family of Kunitz protease inhibitor proteins. Cellular and animal
      models have been developed to study the nature of APP processing and the
      biological and behavioral consequences of beta/A4 amyloidosis. The results of
      such studies indicate that the normal processing of APP involves enzymatic
      cleavage of the molecule within the beta/A4 amyloid region, thus preventing the
      accumulation of beta/A4 in the normal brain. The factors leading to abnormal
      processing of APP, and consequent beta/A4 amyloid accumulation within the AD
      brain, have yet to be identified. In cell culture, the biological effects
      associated with beta/A4 amyloid include neurotrophic and neurotoxic activities,
      while the peptide has also been shown to have dramatic behavioral effects in
      animal models.

PMID- 1627463
TI  - The arrest of cell migration in the chicken blastoderm: experimental evidence for
      the involvement of a band of extracellular fibrils associated with the basal
      lamina.
AB  - This article overviews our current knowledge of the occurrence and distribution
      of oriented extracellular fibrils associated with the basal lamina, and their
      presumptive role in contact guidance of cells in early embryos. To investigate
      the role of the band of extracellular fibrils situated at the basal side of the
      epiblast at the cranial edge of the area pellucida of the chicken blastoderm, we
      determined the precise location and morphology of the fibrils using TEM and SEM,
      described the relationship between migrating mesoblast cells and the fibrillar
      band, and, finally, tested experimentally the behavior of homologous and
      heterologous tissues in the vicinity of the fibrillar band. The descriptive
      analysis demonstrated that a horseshoe-shaped, 170 microns-wide band of fibrils
      occurs at the cranial and lateral edges of the area pellucida and area opaca, the
      highest density being found in the area pellucida. Migrating mesoblast cells
      presented a surface morphology that was different from the morphology of cells
      reaching the fibrils at the lateral edge of the area pellucida. Mesoblast cells
      never crossed the fibrils, an observation that may explain why during
      gastrulation, mesoblast cells invade the area opaca only in the caudal region,
      where no fibrillar band is present. The experimental analysis, which involved
      transplantation and healing experiments, demonstrated that the arrest of cell
      migration, that occurred in all cases in the vicinity of the fibrillar band, was
      correlated with changes in surface morphology suggesting a decreased cell
      adhesion to the fibrils. From these observations emerged the view that the
      horseshoe-shaped fibrillar band functions as a barrier inhibiting migration of
      individual mesoblast cells and expansion of tissue sheets, rather than as an
      extracellular substrate mediating the oriented guidance of cells. In addition to
      its inhibitory role in cell migration, the extracellular band may also be
      regarded as a factor that stabilizes the polarity of the early embryo by
      determining the cranial and lateral limits between embryonic and extraembryonic
      tissues.

PMID- 1627464
TI  - Location of DNA within the nucleolus of rat oocytes during the early stages of
      follicular growth.
AB  - We have investigated the DNA distribution within the rat oocyte nucleolus during
      the early stages of follicular growth by means of the in situ terminal
      deoxynucleotidyl transferase method. In the fibrillogranular nucleolus, label is
      visualized on small clumps of peri- and intranucleolar chromatin. Such labeled
      clumps are frequently observed inside the interstices surrounding the fibrillar
      centers. Label is also consistently found in the fibrillar centers whereas the
      dense fibrillar component and the granular component are devoid of gold
      particles. These results contradict earlier data but conform with other recent
      immunocytochemical observations, obtained in nucleoli of a variety of somatic
      cell types, concerning the correlation between structure and function in the
      nucleolus.

PMID- 1627465
TI  - Biochemical characterization of subcellular particles in fetal and neonatal rats.
AB  - By a variety of methods, such as ultracentrifugation in different media,
      hypoosmotic activation and hydrostatic compression, subcellular particles were
      characterized at different perinatal ages and compared to the adult rats. Fetal
      mitochondria elicited a higher density, an increased osmotic space and a greater
      resistance to compression. The size of these particles was larger than in the
      adults. Mitochondria in the 1-day-old animals were freely permeable to sucrose
      and their external membrane was more resistant to hypoosmotic activation.
      Lysosomes were shown to decrease their sucrose permeability and their resistance
      to hypoosmotic activation with development. Moreover, the size of the lysosomes
      increased with development.

PMID- 1627466
TI  - Evolution of the developmental scores of sixteen morphological features in mouse
      embryos displaying 0 to 30 somites.
AB  - A precise framework of morphological developmental events observed
      macroscopically in early postimplantation mouse embryos aged 8-10 days (0-30
      somites) is established. The quantitative evolution of the developmental score of
      16 features as a function of the developmental stage of the embryos (expressed in
      number of somites) is presented. Thirty-one groups of ten embryos, each with 0 to
      30 somites, were scored for each feature according to the previous description of
      the authors. In addition, the variation of individual structures as a function of
      embryonic developmental stages is evaluated. It is suggested that the framework
      of differentiating individual structures at given developmental stages will help
      to plan experiments in developmental biology of rodents and will facilitate the
      interpretation of results in developmental toxicity.

PMID- 1627467
TI  - A new interpretation of the necrotic changes occurring in the developing limb bud
      paddle of mouse embryos based upon recent observations in four different
      phenotypes.
AB  - Degenerative changes occurring in the apical ectodermal ridge (a.e.r.) and
      undifferentiated distal mesoderm of developing limb buds were studied macro- and
      microscopically in day-11 to day-13 mouse embryos displaying the normal (+/+),
      oligosyndactylous (Os/+), polydactylous (Xpl/+) and hybrid (Os/+/Xpl/+)
      phenotypes. Isolated limb buds were submitted either to supravital staining with
      Nile blue sulfate or to lectin binding staining in serial paraffin sections,
      taking advantage of strong binding affinites of macrophage cells for peanut
      agglutinin after neuraminidase treatment and for ricinus communis agglutinin.
      Necrotic changes detected in three definite areas of the distal mesoderm of
      normal limb buds exhibit characteristic spatial temporal relationships with
      earlier cytolytic changes affecting the pre- and postaxial parts of the a.e.r.
      Two of them, known as the primary preaxial site (fpp) and the anterior marginal
      necrotic zone (AMNZ) appeared deeply modified in mutant embryos as compared to
      the posterior marginal necrotic zone (PMNZ) which remained unaffected. Macrophage
      cells loaded with cell debris appear in advance and in excessive number in the
      fpp of Os/+ limb buds. Conversely, they were found absent or locally reduced in
      number in the fpp and AMNZ of Xpl/+ limb buds which otherwise develop in the same
      area a preaxial protrusion covered with a healthy portion of the a.e.r. Hybrid
      Os/+/Xpl/+ limb buds expressing both mutant genes develop a smaller and
      macrophage-free preaxial protrusion which coexists with residual and locally
      excessive necrotic changes in its immediate surrounding and is covered with a
      normally necrotic portion of the a.e.r. Microscopic observations collected in the
      limb buds of all phenotypes, though more frequently in Os/+ limb buds, strongly
      suggest that in all three necrotic sites examined, macrophage cells of vascular
      origin somehow contribute to the clearance of ectodermal necrotic debris and
      eventually return in the blood stream through the marginal vein and its
      affluents.

PMID- 1627468
TI  - The Brussels School of Embryology.

PMID- 1627470
TI  - Review of scientific contributions by the Belgian medical centers concerned with
      human in vitro fertilization and embryo transfer (IVF).
AB  - In vitro fertilization and embryo transfer (IVF) may be considered as a
      particular application of modern medical therapeutics linked to human
      reproduction. The treatment of human sterility therefore involves some
      fundamental human values such as life, love and death. The quality of this highly
      technological treatment with fast knowledge of outcome at the end of the
      patient's menstrual cycle has been evaluated since the early 80s. It is a
      typically multidisciplinary team effort involving medical doctors, biologists,
      laboratory technicians, nurses and clerks that is representative of modern
      medical practice. IVF covers much more than just embryology, as this review will
      explain. IVF developed in close relation with clinical and experimental research
      protocols, which are the major topics of this paper. The newness of the
      techniques used led to the necessary interactions between clinicians and
      biologists working on animal experimental embryology.

PMID- 1627469
TI  - In vitro production of cattle embryos: review and Belgian results.
AB  - This paper reviews the overall process of in vitro production and
      cryopreservation of bovine embryos in Belgium. Three laboratories are involved in
      this field, one at the University of Liege, one at the University of Ghent and
      ours at the University of Louvain-La-Neuve. Each one uses this technology as a
      tool to reach different goals. This paper refers mainly to the work done in
      Louvain-La-Neuve. Oocytes are obtained by punction of 2-4 mm follicles on
      slaughtered cow ovaries. They are matured in hormone-supplemented TCM199
      containing 10% heat-treated fetal calf serum. In vitro fertilization by Percoll
      selected spermatozoa is followed by in vitro culture in oviduct-conditioned
      medium for 7-9 days. Six calves have been born from in vitro produced
      blastocysts. Recently, full development was obtained in conditioned medium
      without protein supplementation. This finding will allow further investigations
      on oviduct/embryo molecular communication and research of oviduct-secreted
      embryotrophic proteins which were impaired in previous culture systems using
      serum-supplemented media. In vitro produced blastocysts were frozen-thawed and
      non-surgically transferred: 7/19 recipients remained pregnant beyond 2 months.
      Embryo loss was high between day 21 and 35 (31%).

PMID- 1627471
TI  - A pioneer of experimental mammalian embryology: Jacques Mulnard.

PMID- 1627472
TI  - Jean Brachet and his school.

PMID- 1627473
TI  - Lucien Vakaet, an avian embryologist.

PMID- 1627475
TI  - Research and the teaching of developmental biology in Belgium.

PMID- 1627474
TI  - The developmental biology of neural connectivity.
AB  - How can the development of an ordered array of neuronal connections be encoded in
      the genome? Results on the establishment of sensory connections in insects
      indicate that this programming is a multi-stepped process which begins as soon as
      the first axons develop. Because each step relies on the previous level of
      organization, the first steps of the process are subject to intense structural
      constraints, and therefore have been largely conserved through evolution. What is
      known of the molecular biology of some essential steps, like the differentiation
      of excitable cells, their aggregation in nerve cords, and the diversification of
      a periodic structure, supports the idea that the basic organization of the CNS
      evolved before the divergence between the chordate and the arthropod/annelid
      lineage.

PMID- 1627476
TI  - Molecular genetic approaches to plant development.
AB  - Higher plant morphogenesis has received renewed interest over the past few years.
      The improvement of molecular genetic approaches to generate tagged developmental
      mutants, for instance by T-DNA insertion, facilitated the isolation and
      characterization of the altered genes. Here we present recent progress on flower
      and root morphogenesis in the small crucifer Arabidopsis thaliana. The current
      model of Arabidopsis flower development is presented. We report on FLOWER1 (Fl1),
      which is a T-DNA-tagged ap2 allele. Our observations indicate that this Fl1
      mutant has, besides the homeotic Ap2 phenotype, an aberrant seed coat, suggesting
      that this gene has also a function late in flower development. Furthermore, we
      present a brief summary about root development and focus on the super root (Sur)
      mutant, which is an ethyl methanesulfonate-induced mutant that produces excess
      lateral roots. Root explants of the Sur mutant, that do not develop further than
      the 4-leaf stage, can be induced to produce normal-looking shoots and flowers by
      addition of only cytokinin to the medium. The phenotype of Sur and its relation
      to the action of phytohormones is discussed.

PMID- 1627477
TI  - Controlling cellular development in a single cell system of Nicotiana.
AB  - Cells regenerated from freshly isolated leaf mesophyll protoplasts can be induced
      to develop along very different pathways. Depending on the hormone content and
      the mechanical characteristics of the environment, cells choose between division
      and expansion. In the former case they form microcolonies of isodiametric cells,
      while in the latter they exhibit a typical tubular growth or increase their
      volume considerably by bulging and budding. A culture method was developed which
      allows a careful control of the experimental environment and non-destructive high
      resolution monitoring of development of individual cells.

PMID- 1627478
TI  - Plant protoplasts as genetic tool: selectable markers for developmental studies.
AB  - Protoplasts have usually been presented as a methodological tool. Even as such,
      they make possible an impressive array of applications in plant biology. Here we
      report on the use of protoplast-derived selectable markers in the study of
      several disturbed genetic systems with obvious effects on plant development: (1)
      auxotrophic mutants and the control of amino acid biosynthesis and transport in
      vegetative and reproductive tissues; (2) introgression of alien genetic
      information across phylogenetic boundaries by protoplast fusion, a consequence of
      controlled dedifferentiation-redifferentiation processes and attenuated
      incompatibility reactions in cultured cells; (3) expression (in)stability of
      foreign genes in transgenic plants during successive meiotic generations and in
      crosses between independent transformants.

PMID- 1627479
TI  - The determination of sense organs in Drosophila: a search for interacting genes.
AB  - The determination of sense organs in Drosophila requires the concerted action of
      a battery of genes, several of which have been identified. Previous experiments
      revealed that flies doubly heterozygous for mutations in two of these genes have
      a reduced number of sense organs, suggesting the existence of a direct
      interaction between the corresponding genes and/or their products. We have now
      used this observation to search for mutations in additional genes that would show
      similar interactions. We have detected 10 recessive mutations that show a
      dominant reduction in the number of bristles when simultaneously heterozygous for
      either Df(2)J27 or Df(4)M62f. Among these mutations, 3 are homozygous viable and
      show striking defects in their bristle patterns, confirming that the genes thus
      identified play a role in the patterning of sense organs. We conclude that the
      "gene dose titration" method (Botas et al., 1982) is an efficient method for
      identifying interacting genes involved in a common process, provided one can
      identify a well-defined phenotype to look at, and at least one mutation that
      alters the process. Our experience suggests that its efficiency should be
      substantially improved by the use of insertional mutagenesis.

PMID- 1627480
TI  - The discovery of meiosis by E. Van Beneden, a breakthrough in the morphological
      phase of heredity.

PMID- 1627481
TI  - 17th annual scientific meeting of the British Oncological Association, in
      association with the Nordic Cancer Societies. Canterbury, 5-7 July 1992.
      Abstracts.

PMID- 1627482
TI  - [Epilepsy in children].

PMID- 1627483
TI  - [Inhalation devices for fixed dosage aerosols with disodium cromoglycate].

PMID- 1627484
TI  - [The 3 year basic training in pediatric nursing has to be retained].

PMID- 1627485
TI  - [Parents at the intensive care unit].

PMID- 1627486
TI  - [Multiple lentigines syndrome (LEOPARD syndrome)].

PMID- 1627487
TI  - [Poisonous and less poisonous plants. I].

PMID- 1627488
TI  - [Heinz Hungerland (1905-1987)].

PMID- 1627489
TI  - [Admission to nursing in foreign countries].

PMID- 1627490
TI  - [Medical terminology and nursing documentation].

PMID- 1627491
TI  - [Preparation of baby bottles and nipples].

PMID- 1627492
TI  - Selection against N-region diversity in immunoglobulin heavy chain variable
      regions during the development of pre-immune B cell repertoires.
AB  - The generation of Ig heavy chain chain diversity is dependent on the ordered
      rearrangement of three different, i.e. variable (VH), diversity (DH), and joining
      (JH), germline gene segments, exonuclease nibbling of the terminals of these gene
      segments, and the addition of template-independent nucleotide (N-sequences) in
      the junctions of these segments. The latter process has recently been reported to
      be limited within B cells formed during early ontogeny. In this study, we have
      analysed a large number of VHDJH rearrangements isolated from genomic DNA of
      adult and neonatal C57BI/6 mice using the polymerase chain reaction (PCR)
      technique. A comparison of functional versus non-functional VHDJH rearrangements
      derived from these PCR libraries, or from a set of previously published clones of
      BALB/c origin, revealed a selection against N-region diversity both in neonatal
      and adult B cell repertoires. This selection process is most pronounced in the
      early development of the immune system but can still be observed in the adult.
      Furthermore, selection against N-sequence additions was evident amongst neonatal
      VHDJH rearrangements utilizing both VH 7183 and VH J558 genes, but only in VH
      7183 utilizing clones of adult origin. These results imply that in addition to a
      developmentally controlled onset of N-sequence additions, cellular selection
      against N-region diversity exist both in the neonatal and adult immune system.

PMID- 1627493
TI  - Limited repertoire of utilized VH gene segments in a VHa3-allotype-suppressed
      rabbit.
AB  - Between 70 and 90% of serum Ig molecules of normal laboratory rabbits bear one of
      the serologically defined VHa allotypic specificities, a1, a2, or a3, and are
      termed VHa+ (a-positive) molecules; the remaining 10-30% of Ig molecules that do
      not have VHa allotypic specificities are designated VHa- (a-negative). The
      repertoire of utilized VHa(+)-encoding gene segments has been examined
      extensively, but only limited studies of the repertoire of utilized VHa(-)
      encoding gene segments in normal rabbits have been done. To examine the
      repertoire of utilized VHa- gene segments, we analyzed VH-encoding cDNA clones
      from mRNA of a VHa-allotype-suppressed rabbit whose serum Ig was primarily VHa-.
      For VHa suppression a newborn a3/a3 rabbit was injected periodically with anti
      VHa3 antiserum; when it was 2 months of age and its serum Ig was greater than 94%
      VHa-, cDNA clones were generated from splenic RNA. The nucleotide sequences of
      eight putative VHa(-)-encoding cDNA clones were compared to those of eight cDNA
      clones generated from RNA of non-suppressed a3/a3 rabbits. The presumed VHa3
      encoding cDNA clones from the non-suppressed rabbits appeared to derive from VH1
      a3, the 3'-most germline VH gene segment. In contrast, the VHa(-)-encoding cDNA
      clones from the suppressed rabbit were distinctly different from VH1 and were
      most probably derived from germline VH segments other than VH1. Because the
      expressed VHa- gene repertoire was highly restricted, we propose that VHa-
      molecules in a3/a3 rabbits may be derived from as few as three germline VH gene
      segments.

PMID- 1627494
TI  - Differential effects of IL-4 and IL-10 on IL-2-induced IFN-gamma synthesis and
      lymphokine-activated killer activity.
AB  - Culture of human peripheral blood mononuclear cells (PBMC) with IL-2 stimulates
      synthesis of cytokines and generation of lymphokine-activated killer (LAK)
      activity. Both IL-4 and IL-10 [cytokine synthesis inhibitory factor (CSIF)]
      inhibit IL-2-induced synthesis of IFN-gamma and tumor necrosis factor (TNF)-alpha
      by human PBMC. However, unlike IL-4, IL-10 inhibits neither IL-2-induced
      proliferation of PBMC and fresh natural killer (NK) cells, nor IL-2-induced LAK
      activity. Moreover, IL-4 inhibits IL-2-induced IFN-gamma synthesis by purified
      fresh NK cells, while in contrast the inhibitory effect of IL-10 is mediated by
      CD14+ cells (monocytes/macrophages). IL-10 inhibits TNF-alpha synthesis by
      monocytes or monocytes plus NK cells, but not by NK cells alone. These results
      suggest that IL-4 and IL-10 act on NK cells via distinct pathways, and that IL-2
      induced cytokine synthesis and LAK activity are regulated via different
      mechanisms.

PMID- 1627495
TI  - Distinct mechanisms of extrathymic T cell tolerance due to differential
      expression of self antigen.
AB  - Self-reactive T lymphocytes escaping thymic tolerance induction can be rendered
      non-responsive by contact with antigens in the periphery. In order to determine
      the parameters controlling peripheral tolerance induction we followed the fate of
      one well-defined self-reactive T cell population in three different mice
      expressing the self antigen in various nonlymphoid tissues outside the thymus.
      This was achieved by crossing anti-Kb T cell receptor (TCR) transgenic mice with
      transgenic animals expressing the Kb antigen exclusively on hepatocytes or
      keratinocytes or neuroectodermal cells. Due to this differential expression
      clonotype+, anti-Kb reactive T cells were found to exist at three different
      levels of tolerance. These levels were distinct with regard to downregulation of
      TCR and CD8 molecules, and the requirements for reexpression of TCR in vitro.
      This differential induction of peripheral tolerance suggest that some tissues are
      more likely to be affected in autoimmune diseases than others.

PMID- 1627496
TI  - Transfer of both protection and delayed-type hypersensitivity against live
      Listeria is mediated by the CD8+ T cell subset: a study with Listeria-specific T
      lymphocytes recovered from murine infected liver.
AB  - The recruitment of specific T lymphocytes in murine liver is thought to be a key
      event in the ultimate control of Listeria monocytogenes growth during primary
      infection. However, there has been little functional characterization of the cell
      populations recruited in this non-lymphoid organ. Therefore in this study, the
      recruited lymphomyeloid cells were isolated from the liver of C57BL/6 mice at the
      peak of the immune response (day 7) triggered by a non-lethal L.monocytogenes
      infection. The anti-Listeria T lymphocytes were detected in vivo by their ability
      to transfer protection and delayed-type hypersensitivity (DTH) to live
      L.monocytogenes in naive recipients: protection was measured not only by the
      effect on reduction of the bacterial load in liver and spleen, but also on
      survival after the lethal challenge, and DTH was detected using as eliciting
      antigen, either live L.monocytogenes or heat-killed L.monocytogenes. When live
      pathogens were used, both functions were found to be mediated by T lymphocytes
      belonging to the CD8+ subset. However, when heat-killed L.monocytogenes were used
      as eliciting antigen in the DTH assay, Listeria-specific CD8+ T lymphocytes could
      not be restimulated in immune lymphoid cell populations recovered either from
      liver or spleen of Listeria-infected mice. Both populations were thus found to
      share the same qualitative properties in the DTH assay. The importance of the use
      of live pathogens versus heat-killed pathogens for detection of DTH and
      protection functions is discussed in the light of current concepts on processing
      and presentation pathways of Listeria-derived peptides.

PMID- 1627497
TI  - Does CD4 help to maintain the fidelity of T cell receptor specificity?
AB  - During antigen presentation, a close association between CD4 and the T cell
      receptor (TCR) occurs as a result of interacting with the same major
      histocompatibility complex class II molecule. The potential consequences of such
      an intimate interaction on TCR specificity was addressed using CD4 loss variants
      of four different murine T cell hybridomas specific for the immunodominant hen
      egg lysozyme (HEL) peptide 46-61. While all the CD4+ and CD4- variants tested
      possessed comparable surface expression of TCR, CD3, CD2 and LFA-1, and responded
      similarly to immobilized anti-TCR and anti-CD3 monoclonal antibodies, they
      differed dramatically in their responses to either the naturally processed HEL
      antigen, synthetic peptide 46-61 or staphylococcal enterotoxin superantigens.
      While one hybridoma was comparatively unaffected by the loss of CD4, another lost
      its responsiveness to antigen and peptide completely while retaining reactivity
      to SE. In contrast, two other hybridomas still responded to antigen but lost
      reactivity to synthetic peptide and SE. These data could not be readily explained
      on the basis of affinity or signal transduction requirements alone, and thus
      suggest that the intimate association of CD4 with the TCR may result in a subtle
      modulation of its fine specificity for some but not all T cells.

PMID- 1627498
TI  - [Natural killer cell activity in mice infected with Acanthamoeba culbertsoni].
AB  - The natural killer cell activity of splenocytes and TBC, active NK cells,
      recycling capacity of natural killer cells were observed by means of both the
      51Cr-release cytotoxicity assay and single cell cytotoxicity assay against YAC-1.
      C3H/HeJ mice were infected intranasally with 1 x 10(4) or 1 x 10(5) trophozoites
      of pathogenic Acanthamoeba culbertsoni. The infected mice showed mortality rate
      of 34% in 1 x 10(4) group and 65% in 1 x 10(5) group, and mean survival time was
      16.40 +/- 3.50 and 13.20 +/- 4.09 days respectively. The cytotoxic activity of
      natural killer cells of the 2 groups was significantly higher than that of non
      infected mice from the 12th hour to the 2nd day after infection, showing the
      highest on the first day. On the 10th day after infection, the cytotoxic activity
      of natural killer cells was significantly suppressed as compared with that of the
      control. There was no significant difference in NK cell cytotoxicity between two
      infected groups. The target-binding capacity and active NK cells of natural
      killer cells in 1 x 10(5) trophozoite infected mice was significantly increased
      on the 12th hour and the first day after infection as compared with the control
      group. Maximal recycling capacity (MRC) was not changed during the observation
      period. The present results indicated that the elevation of natural killer cell
      activity in the mice infected with A. culbertsoni was due to elevation of target
      binding capacity and increased active NK cells of natural killer cells, and not
      due to the maximal recycling capacity of the individual NK cell, and there was no
      difference between two experimental dose groups.

PMID- 1627499
TI  - [The protective effects of monoclonal antibodies in mice from Naegleria fowleri
      infection].
AB  - Protective effects of monoclonal antibodies against N. fowleri were comparatively
      studied. BALB/c mice were treated with two types of monoclonal antibodies, Nf 2
      and Nf 154, before and after the infection with N. fowleri. The mortality and
      mean survival times were then compared. Also, direct effect of the monoclonal
      antibodies on the N. fowleri trophozoites in vitro were observed. In vitro
      protective effects of the monoclonal antibodies were also studied in cells
      infected with N. fowleri. The observed results are summarized as follows: 1.
      Among mice pretreated twice before the infection with monoclonal antibody Nf
      2(McAb Nf 2), only 15.8% were killed, and the mean survival time was 17.7 days.
      This was not much different from the mice pretreated once, as the mortality and
      mean survival time were 16.7% and 17 days. Those effects were compatible with
      monoclonal antibody Nf 154(McAb Nf 154). The above findings contrast with the
      mortality and mean survival time of the control mice, which were 22.7% and 14.6
      days respectively. 2. Mice which received twice the McAb Nf 2 following N.
      fowleri infection incurred a 19.4% mortality rate with 13.6 days survival time;
      17.9% and 15.8 days with on time administration, in contrast to the 25% and 14.6
      days in the control group. 3. Marked agglutination effect of McAb Nf 2 or McAb Nf
      154 were observed on N. fowleri trophozoites. 4. When N. fowleri trophozoites
      were treated with McAb Nf 2 or McAb Nf 154 combined with comments, the
      proliferation rate was more significantly suppressed than in that the control. 5.
      N. fowleri trophozoites treated with McAb Nf 2 or McAb Nf 154 showed an increased
      number of swollen mitochondria, disfigured cisternae, lipid droplets, and
      osmiophilic granules in the cytoplasm. 6. A remarkable protective effect of
      monoclonal antibodies was noticed in CHO cells infected with N. fowleri. More
      than 90.6% of the infected CHO cells survived, contrasted with 27% of untreated
      cells. The overall results in this study suggest that N. fowleri treated with
      monoclonal antibodies against N. fowleri reduce the mortality and prolong the
      survival time of the mice when the antibodies are administered before the
      infection. The protective effect of the monoclonal antibodies is surmised being
      caused by agglutination of the trophozoites.

PMID- 1627500
TI  - [Changes in blastogenic responses and antibody titers of mice infected with
      Toxoplasma gondii].
AB  - This study was performed to observe the cell-mediated and humoral immune
      responses in mice which were infected with Beverley, Fukaya and ME49 strain of
      Toxoplasma gondii, respectively. The blastogenic responses of splenocytes using
      [3H]-thymidine and serum antibody titers were measured weekly up to 10 weeks
      after infection. The blastogenic responses of splenocytes treated with
      concanavalin A and Toxoplasma lysate were significantly declined in the 3 strain
      groups as compared with the non-infected group (p less than 0.05), however
      lipopolysaccharide-treated blastogenic responses were not significantly different
      between infected and non-infected groups. The serum IgG antibody titers in the
      three infected groups increased from 2 weeks after infection, and the serum IgM
      antibody titers increased until 4 weeks after infection. No significant
      differences were revealed in blastogenic responses and serum antibody titers
      among the 3 groups. The present study suggested that cell-mediated immune
      responses were involved in T. gondii infected mice and blastogenic responses of T
      lymphocytes were inhibited in acute T. gondii infection.

PMID- 1627502
TI  - [Comparative study on the effectiveness of modified Kato's cellophane thick smear
      and Stoll's dilution egg counting technique for quantitative fecal examination of
      helminth eggs].
AB  - A total of 197 fecal specimens was prepared for quantitative examination of
      helminth eggs by modified Kato's cellophane thick smear (M.C.T.S.) and Stoll's
      dilution egg counting technique (D.E.C.T.). The comparative effectiveness of two
      techniques was evaluated and conversion function was deduced. The average time
      required for the microscopic examination on one slide by M.C.T.S. was 12.6
      minutes and that of D.E.C.T. was 14.6 minutes. M.C.T.S. showed lower false
      negative rate than D.E.C.T. in light worm burden cases. Functions to convert the
      counts obtained by M.C.T.S. to E.P.G. by Stoll's dilution egg counting technique
      were 47.86 x 10(0.87) logM.C.T.S. in A. lumbricoides, 41.69 x 10(0.82)
      logM.C.T.S. in T. trichiura and 63.10 x 10(0.85) logM.C.T.S. in C. sinensis. It
      was suggested M.C.T.S. be better than D.E.C.T. for the quantitative examination
      of intestinal helminthiases such as A. lumbricoides, T. trichiura, and C.
      sinensis infections even in the cases with low worm burden.

PMID- 1627501
TI  - Immunogenicity and protective efficacy of solubilized merozoite-enriched
      Theileria sergenti immunogens. I: Protection against homologous stabilate
      challenge.
AB  - Theileria sergenti were isolated from infected erythrocytes by hypotonic lysis,
      and soluble merozoite antigens were purified by sonication and differential
      centrifugation. The preparation contained 29, 34, 35 and 105 kD immuno-dominant
      poly-peptides. The soluble antigens (0.5 mg/ml) were prepared and fortified with
      Freund's adjuvant. Five month old naive Korean calves were subcutaneously
      inoculated with the preparation and a booster dose was administered 4 weeks
      later. Nine weeks after the booster dose, vaccinates and controls were challenged
      with a homologous stabilate (5.6 x 10(6) RBC/dose, 40% Parasitemia). All animals
      were monitored for hematocrit, total erythrocyte count, parasitemia and for the
      specific antibody by Western immunoblot (WB) and indirect immuno-fluorescent
      antibody (IFA) test. By 18 weeks after vaccination (6 weeks after the challenge),
      vaccinated cattle had an average IFA titer of 1:10,240 compared with 1:1,280 of
      the controls. The vaccinates showed negligible change in hematocrit and total RBC
      count whereas control animals showed significant (p less than 0.05) hematological
      changes and associated anemia. After vaccination and challenge, the antibody
      responses demonstrated that vaccination had induced significant production of
      antibody to the 29 and 35 kD polypeptides. The latter polypeptide was much more
      strongly recognized by the vaccinated animals, and thus it may be a potential
      candidate for the vaccine.

PMID- 1627503
TI  - Second case of human infection with Mesocestoides lineatus in Korea.
AB  - The second case of human infection with Mesocestoides lineatus in Korea was
      reported. The patient, a farm worker, complained of abdominal pain and massive
      discharge of sesame-like proglottids in his stool for several months. Worms,
      recovered by chemotherapy with niclosamide, consisted of 32 strobilae. This may
      be the heaviest worm burden in human infection ever reported. The infected man
      habitually ate the raw viscera of chickens.

PMID- 1627505
TI  - [Tegumental ultrastructure of juvenile and adult Echinostoma cinetorchis].
AB  - The tegumental ultrastructure of juvenile and adult Echinostoma cinetorchis
      (Trematoda: Echinostomatidae) was observed by scanning electron microscopy. Three
      day (juvenile) and 16-day (adult) worms were harvested from rats (Sprague-Dawley)
      experimentally fed the metacercariae from the laboratory-infected fresh water
      snail, Hippeutis cantori. The worms were fixed with 2.5% glutaraldehyde,
      processed routinely, and observed by an ISI Korea DS-130 scanning electron
      microscope. The 3-day old juvenile worms were elongated and ventrally curved,
      with their ventral sucker near the anterior two-fifths of the body. The head
      crown was bearing 37-38 collar spines arranged in a zigzag pattern. The lips of
      the oral and ventral suckers had 8 and 5 type II sensory papillae respectively,
      and between the spines, a few type III papillae were observed. Tongue or spade
      shape spines were distributed anteriorly to the ventral sucker, whereas peg-like
      spines were distributed posteriorly and became sparse toward the posterior body.
      The spines of the dorsal surface were similar to those of the ventral surface.
      The 16-day old adults were leaf-like, and their oral and ventral suckers were
      located very closely. Aspinous head crown, oral and ventral suckers had type II
      and type III sensory papillae, and numerous type I papillae were distributed on
      the tegument anterior to the ventral sucker. Scale-like spines, with broad base
      and round tip, were distributed densely on the tegument anterior to the ventral
      sucker but they became sparse posteriorly. At the dorsal surface, spines were
      observed at times only at the anterior body. The results showed that the tegument
      of E. cinetorchis is similar to that of other echinostomes, but differs in the
      number and arrangement of collar spines, shape and distribution of tegumenal
      spines, and type and distribution of sensory papillae.

PMID- 1627504
TI  - The maintenance of free-living amoebae by cryopreservation.
AB  - We have successfully cryopreserved free-living amoebae in order to maintain them
      feasibly under the conditions in our laboratory. The viability of trophozoites
      was higher when frozen by slow cooling (overall 0.7 degree C/min) than by fast
      cooling (overall 1.3 degrees C/min). Glycerol and dimethylsulfoxide at the final
      concentration of 7.5% each was used for cryopreservation of free-living amoebae
      trophozoites. The survival rate was 2-39% after storage in the liquid nitrogen
      for 60 days. Gross cultural or morphological changes were not noted in
      trophozoites thawed from frozen suspensions.

PMID- 1627506
TI  - Surface ultrastructure of Heterophyes nocens (Trematoda: Heterophyidae).
AB  - The surface ultrastructure of Heterophyes nocens (Trematoda: Heterophyidae) was
      studied by scanning electron microscopy(SEM). The adult worms were recovered from
      experimentally infected cats and from a naturally infected patient. They were
      leaf-like, ventrally concave, and ovoid or pyriform in shape. Ciliated knob-like
      sensory papillae (type I) were observed in single or grouped forms on and around
      the oral sucker, whereas non-ciliated round swellings (type II papillae) were
      seen on the lip of the ventral sucker. The tegumental spines around the oral
      sucker were 5-9 pointed, whereas those between the two suckers were 12-17
      pointed. Ventrolaterally, three groups of 5-6 type I papillae were located
      between the oral and ventral suckers, with single ones alternating between them.
      The genital sucker was protruded or depressed, depending on the contraction state
      of the flukes, and the gonotyl spine number ranged 50-60. The number of tip
      points of tegumental spines was decreased posteriorly; finally they became 1-3
      pointed. On the dorsal surface, 4 groups of 4-5 type I papillae were
      symmetrically located on both lateral sides, and the shape and distribution of
      tegumental spines were similar to those of the ventral surface. Although the
      tegumental ultrastructure of H. nocens was generally similar to those of other
      heterophyids, the genital sucker morphology including the number of gonotyl
      spines and/or the distribution pattern of tegumental spines and sensory papillae
      were suggested to be the characteristic features of H. nocens.

PMID- 1627507
TI  - Detection of antibodies in serum and cerebrospinal fluid to Toxoplasma gondii by
      indirect latex agglutination test and enzyme-linked immunosorbent assay.
AB  - Sensitivity of anti-Toxoplasma antibody (IgG) test by enzyme-linked immunosorbent
      assay (ELISA) was evaluated in comparison with indirect latex agglutination (ILA)
      using 2,016 paired human samples of serum and cerebrospinal fluid (CSF). The
      samples were collected from neurologic patients in Korea with mass lesions in
      central nervous system (CNS) as revealed by imaging diagnosis (CT/MRI). When the
      sera were screened for anti-Toxoplasma antibody by ILA, 76 cases(3.8%) were
      positive (1:32 or higher titers). In the paired samples of CSF, no positive
      reactions were observed. When ELISA was performed using PBS extract of Percoll
      purified tachyzoites as antigen, cut-off absorbance was determined as 0.40 for
      serum and 0.27 for CSF tests. The antibody positive rates by ELISA were 7.0% in
      serum and 5.6% in CSF. Of them, 40 cases (2.0%) showed positive reactions in both
      serum and CSF. The antibody positive rates were higher in groups older than 40
      years. The rates were higher in male (4.7% by ILA, 8.3% by ELISA) than in female
      (2.2% by ILA, 5.0% by ELISA). The rates in CSF showed no such sex difference.
      ELISA showed twice higher positive rates when serum was tested, and was sensitive
      enough to detect specific antibodies in CSF. Etiologic relations between positive
      antibody tests and CNS lesions remained unknown.

PMID- 1627508
TI  - Tissue origin of soluble component proteins in saline extract of adult
      Paragonimus westermani.
AB  - Tissue origin of individual component proteins in crude extract of adult
      Paragonimus westermani was investigated. Major soluble component proteins were
      separated by disc-PAGE in 8% slab gel. By predefined Rf values, strips of gel
      containing each band protein was cut out. Each band protein was eluted by
      electrophoresis. Monospecific antibodies were prepared by immunizing rabbits with
      each band protein. When peroxidase-antiperoxidase (PAP) staining was done,
      antiserum to Band 1 reacted to content of eggs both in the worm and in the
      infected lung tissue. Antiserum to Band 2 reacted to parenchymal tissue of the
      worm. Antiserum to Band 4 showed the positive reaction at intestinal content
      while that to Band 5 reacted to the intestinal epithelial border. Antiserum to
      combined proteins of Bands 6/7 and that to Band 8 reacted to parenchymal tissue
      of the worm respectively. From the results, the origin of individual proteins in
      crude extract of adult P. westermani could be differentiated.

PMID- 1627509
TI  - Lacrimal lesions and orbital surgeons.

PMID- 1627510
TI  - The pattern electroretinogram in glaucoma and ocular hypertension.
AB  - Thirty one eyes with established glaucoma, 61 high risk ocular hypertensive
      (OHTs) eyes, 66 medium risk OHT eyes, 58 low risk OHT eyes, and 47 control eyes
      have been followed for up to 2 years by clinical examination and pattern
      electroretinography (PERG). The study was 'masked' so electrophysiological and
      clinical data were kept separate. Criteria have been devised which enable PERG
      measurements to distinguish all established glaucomatous eyes from all normal
      controls; these criteria demonstrate abnormalities in some OHT eyes, particularly
      those at high risk. The PERG abnormality is greatest in eyes with established
      glaucoma in which the intraocular pressure has been lowered by treatment. The
      PERG becomes smaller as the degree of clinical abnormality increases. Test-retest
      variability of the PERG is sufficiently low to ensure that most of those first
      described as abnormal continue to be so.

PMID- 1627511
TI  - Dermofat grafts to the extraconal orbital space.
AB  - Dermofat grafts were placed in the upper or lower lid sulci in 35 subjects, aged
      from 11 to 59 years, to improve the cosmesis of volume deficient sockets or
      prevent tissue adhesion. Volume enhancement and cosmetic improvement were
      achieved in 31 patients, in whom useful vision was present in 13/22 after
      previous trauma, in 4/4 with facial clefting, and in 3/3 with orbital or facial
      fat atrophy. Grafts were used successfully in nine patients to prevent scar
      formation after division of adhesions between the eyelids or levator muscle and
      the orbital margins. A reduction of the bulk of upper-lid grafts was required in
      three cases; histopathology of the excised fat showed relatively minor degrees of
      inflammation, atrophy, and fibrosis.

PMID- 1627512
TI  - Endophthalmitis following extracapsular cataract surgery: a review of 32 cases.
AB  - Thirty two cases of endophthalmitis following extracapsular cataract surgery that
      had occurred within our department and had undergone intraocular diagnostic tap
      between May 1982 and May 1991 were reviewed. An infectious agent was identified
      in 20 cases (62.5%). The commonest organism was Staphylococcus epidermidis (11
      cases) (55%). Proteus was the only gram negative organism identified (four cases)
      (20%). Both of these organisms were associated with a favourable visual outcome.
      In the culture positive subgroup 15 eyes (75%) achieved a final acuity of 6/60 or
      better with 10 eyes (50%) gaining 6/12 or better. Thirteen (65%) of the culture
      positive cases were managed without vitreal intervention. Of these 11 (85%)
      achieved 6/60 or better with eight (62%) gaining 6/12 or better. It appears that
      when an endophthalmitis follows uncomplicated extracapsular cataract surgery
      delivery of antibiotic by the 'conventional' routes (topical, subconjunctival and
      systemic) is consistent with a favourable visual result in many cases. A modified
      anterior chamber diagnostic tap technique is described.

PMID- 1627513
TI  - Possible environmental sources of Acanthamoeba spp in contact lens wearers.
AB  - The water supply and dust samples from the home environment (bathrooms and
      kitchens) of 50 wearers of contact lenses (CLs) were cultured for the presence of
      free-living amoebae. CL cases, solutions, and water taps were cultured for
      bacteria, which amoebae require for growth. Acanthamoeba spp were isolated from
      water drawn from six bathroom cold water taps (tank supplied), five in the
      presence of limescale, and from one kitchen cold water tap (mains supplied).
      There was an association between the presence of limescale in water and direct
      culture for free-living amoebae, suggesting that scale provides a favourable
      microenvironment for amoebae. Acanthamoebae were also found in dust from around
      one washbasin. Nineteen of 50 CL cases, 12/122 CL care rinsing solutions, and
      59/100 cold water taps yielded Gram negative bacteria which could be ingested by
      amoebae. It is concluded from this study that CLs should not be washed in first
      drawn tank-fed cold water, especially if limescale is present, and that soft CLs
      should be rinsed in manufactured single-use, sterile solutions. Rigid CL and CL
      cases should only be washed with boiled tap water (preferably hot), or single-use
      sterile solutions, and stored dry to prevent multiplication of amoebae and Gram
      negative bacteria.

PMID- 1627514
TI  - Biometry of the crystalline lens in late onset diabetes: the importance of
      diabetic type.
AB  - Lenticular and anterior chamber biometry were studied in non-cataractous eyes by
      means of Scheimpflug photography and digital image analysis. The study population
      consisted of 91 late onset diabetic subjects and 115 non-diabetic controls.
      Anteroposterior axial lens thickness, cortical thickness, nuclear thickness,
      anterior clear zone thickness, anterior chamber depth, and anterior and posterior
      lenticular curvatures were assessed. Age played an important role in determining
      lens biometry in all subjects, and small but significant differences were found
      between late onset diabetics and non-diabetics. In the late onset diabetic
      subgroup, apart from age, diabetic retinopathy was the only significant parameter
      found which determined lens biometry. These biometric findings in late onset
      diabetes are in marked contrast to the large overall effect of diabetes and the
      powerful effect of diabetic duration which we previously reported in early onset
      diabetes. Further analysis of the data from our previous study has been provided,
      which clearly demonstrates differences between the impact of early and late onset
      diabetes on the biometry of the anterior ocular segment.

PMID- 1627515
TI  - Nystagmus in infancy.

PMID- 1627516
TI  - Primary malignant ectomesenchymoma of the orbit.
AB  - Malignant ectomesenchymoma (MEM) is a rare soft tissue tumour believed to arise
      from a pluripotential migratory neural crest cell and composed of both a
      mesenchymal element (most often rhabdomyosarcoma) and a neuroectodermal element
      (often neuroblastoma). Reported sites of origin are the abdomen, perineum or
      scrotum, the extremities, the middle ear, nasopharynx, face, and neck. We report
      the first case of an orbital MEM, with a review of the 17 cases previously
      reported from other sites.

PMID- 1627517
TI  - Disc edge veins of Kraupa: rare exit anomalies of the retinal vein.
AB  - Disc edge veins of Kraupa are anomalies of the retinal venous system in which
      blood flows from the retina through a single venous trunk at or near the edge of
      the disc instead of at its centre. We report two examples of patients with these
      anomalies and illustrate the appearance of the anomalies with fundus photographs
      and a fluorescein angiogram. In one patient the retinal vein exited the eye
      through the sclera at the margin of the optic disc; in the other it disappeared
      into the disc tissue near the disc margin.

PMID- 1627518
TI  - Recurrent malignant melanoma of the corneal stroma: a case of 'black cornea'.
AB  - A 39-year-old Caucasian woman with a history of recurrent conjunctival melanoma
      of her right eye developed an intrastromal heavily pigmented malignant melanoma,
      which involved the whole corneal diameter. The patient was treated by
      corneoscleral lamellar keratoplasty and there has been no evidence of recurrent
      neoplasm during 4 years of follow-up. This apparently unique presentation of
      malignant melanoma of the cornea is illustrated and the differential diagnosis of
      corneal pigmentation is discussed.

PMID- 1627519
TI  - Ocular leprosy.

PMID- 1627520
TI  - Use of a blue filter in visual field analysis.

PMID- 1627521
TI  - A comparison between the old Transcend and the new Transcend series 2000 bracket.
AB  - The shear/peel and tensile/peel bond strengths of the original Transcend and the
      new Transcend series 2000 bracket were determined using two different light-cured
      composites, Prismafil (high filler) and Heliosit (low filler). Predominant sites
      of failure were recorded for each bracket with each cement in each mode of
      testing. Transcend series 2000 produced higher bond strengths than Transcend in
      shear/peel, but were significantly weaker in tensile/peel testing. Heliosit
      generally produced higher bond strengths than Prismafil. Enamel fractures were
      observed with Transcend in both modes of testing when bonded with Heliosit, but
      not with Transcend series 2000 when bonded with Heliosit. The new Transcend
      series 2000 brackets should only be removed in tensile/peel mode as suggested by
      the manufacturers, due to their very high bond strengths in shear.

PMID- 1627522
TI  - Functional appliances and arch width.
AB  - A retrospective study was undertaken using treated functional appliance cases.
      The groups involved 27 Andresen, 19 Bionator, and 23 Frankel cases. The reflex
      metrograph was used to measure arch width from study models at the start of
      treatment, end of treatment including retention, and at least 1 year post
      treatment. The effects of each appliance on arch width are compared during and
      after treatment.

PMID- 1627523
TI  - A modification to the incisor classification of malocclusion.
AB  - During the study of two-hundred orthodontic cases under treatment in the General
      Dental Service, four clinicians showed only moderate agreement using the British
      Standard Classification of Incisor Malocclusion. Cohen's Kappa statistic was used
      to measure the inter-examiner agreement. The 35 cases in which there was high
      disagreement between the examiners were scrutinized to determine the source of
      this disagreement. Following discussion, revised definitions were produced which
      included the introduction of a Class II-intermediate group. After an interval of
      2 months these 35 cases were reclassified using the new definitions. Increased
      inter-examiner agreement was found. Four examiners (three of whom were common to
      the original study) then used the modified classification to describe the incisal
      relationship of 100 cases referred for treatment at Bristol Dental Hospital. The
      inter-examiner and the intra-examiner agreement were both found to be good. It is
      recommended that the Incisor Classification of Malocclusion be extended to
      include a Class II-intermediate group.

PMID- 1627524
TI  - Different techniques of residual composite removal following debonding--time
      taken and surface enamel appearance.
AB  - Four different methods of in vitro residual composite removal following debonding
      performed by two different operators (an orthodontist and a hygienist) were
      assessed for enamel surface damage (using scanning electron microscopy) and the
      time involved. There was no difference in the quality of enamel surface
      appearance between the two operators, regardless of the method used for composite
      removal. There was a statistically significant difference (P less than 0.05) for
      the time taken for composite removal between the two operators using a tungsten
      carbide bur method only. It is suggested that an expanded duties auxiliary with
      the practical skills of the hygienist would be able to remove residual composite
      debris and produce a satisfactory polished enamel surface using tungsten carbide
      burs and aluminium oxide polishing discs, thus becoming a safe and cost-effective
      member of the orthodontic team.

PMID- 1627525
TI  - Indelible bond location marks: an avoidable aesthetic hazard.
AB  - An increasingly popular method of aiding the precise placement of bonded brackets
      is to identify the long axis and centre of the crown with small pencil marks. A
      case is reported where marks placed with a soft pencil in the centre of the
      etched enamel have led to the inclusion of pigment deep in the enamel surface
      which has proved impossible to remove.

PMID- 1627526
TI  - The orthodontic/restorative interface. Restorative procedures to aid orthodontic
      treatment.
AB  - Restorative procedures which complement orthodontic treatment and which may be
      carried out by the orthodontist are summarized. The importance of planning, with
      the restorative requirements in mind and the maintenance of prepared space
      (individual tooth or abutment positions) in all three planes of space during the
      period of retention, is described. The importance of liaison regarding the timing
      of the placement of the definitive restoration, if it is to be carried out by
      another dental surgeon, is stressed.

PMID- 1627527
TI  - Part-time teachers in orthodontics. An Association of University Teachers of
      Orthodontics (AUTO) report.

PMID- 1627528
TI  - Recycling bands and brackets.
AB  - Orthodontists have a wide choice of companies offering a comprehensive recycling
      service at competitive prices. Careful debonding procedures should be used before
      sending bands and brackets for recycling. None of the companies make a charge for
      recycling damaged brackets, and some companies have established advanced systems
      of quality control.

PMID- 1627529
TI  - GDC's proposals on specialist registration.

PMID- 1627530
TI  - Research in the field of enamel demineralization and the implications that this
      has for orthodontic practice.

PMID- 1627531
TI  - The Barry Project--a cephalometric assessment of treatment change in a
      consecutive sample of malocclusion.
AB  - This is the last of a three-part series examining the results of orthodontic
      treatment in a consecutive sample of malocclusion from a Welsh town. The
      cephalometric changes are compared for the different treatment regimes which were
      employed. Where the variables being examined were common to both radiographs and
      study cast records the treatment changes observed for the regimes were similar.
      Only limited 'skeletal' change, interpreted as a change in a few cephalometric
      measurements, was found to occur during treatment. Perhaps of most interest was
      the consistent reduction of 'A' point in the full fixed appliance group.

PMID- 1627532
TI  - The prevalence and severity of malocclusion and the need for orthodontic
      treatment in 9-, 12-, and 15-year-old Glasgow schoolchildren.
AB  - An epidemiological investigation involving 765 Glasgow schoolchildren aged nine,
      twelve, and fifteen years was undertaken to assess the severity of malocclusion,
      the need for orthodontic treatment, and the proportion of children in each age
      group who had previously received treatment. An index termed the Malocclusion
      Severity Index (MSI) was developed to establish objectively the severity of
      malocclusion in each individual. Fifty sets of orthodontic study models and six
      orthodontists assessed the reproducibility and validity of the index. Although
      there was a significant reduction in the proportion of children in need of
      orthodontic treatment between 9 and 15 years of age, a considerable number were
      still in need of treatment; crowding of their dentitions being responsible for
      the majority of the treatment requirement. The MSI was found to be as precise and
      valid as previously developed occlusal indices, for estimating the treatment
      needs of sample populations.

PMID- 1627533
TI  - Three-dimensional evaluation of dentoskeletal changes after posterior cross-bite
      correction by quad-helix or removable appliances.
AB  - The aim of the study was to evaluate in a three-dimensional manner the
      dentoskeletal changes after slow maxillary expansion. The sample consisted of 34
      children with a unilateral, symmetrical posterior cross-bite. Half of the
      children were treated with a quad-helix and the rest with a removable appliance.
      Assessment of the changes was made with study casts, and frontal and lateral
      cephalograms, before treatment, at the end of the expansion, after a retention
      period of 3 months, and after a post-retention period of 3 months. The results
      showed that sufficient expansion of the dental arches took place in both groups.
      The expansion expressed in the molar region in the quad-helix group was mostly
      due to buccal translation of the teeth and in the removable appliance group due
      to buccal tipping. The quad-helix group showed somewhat greater basal expansion
      than the removable appliance group, though the basal expansion in both groups was
      rather small. A tendency towards an increase of the NL/ML angle characterized the
      removable appliance group, but the opposite pattern was present in the quad-helix
      group.

PMID- 1627534
TI  - Immunoglobulin and HLA-DP genes contribute to the susceptibility to juvenile
      dermatitis herpetiformis.
AB  - HLA-DQ genes and gluten diet are the main factors involved in the pathogenesis of
      Dermatitis Herpetiformis (DH), as well as Coeliac Disease (CD). However other
      genetic factors are probably relevant, since about 10% of the patients with DH
      and CD lack the DQA1*0501/B1*0201 heterodimer while the majority of individuals
      presenting this genotype and also being exposed to gluten diets did not suffer
      from these diseases. To evaluate the role of other genes, 36 Northern Italian
      children with DH were analysed for DNA polymorphisms at HLA-DP and immunoglobulin
      (Ig) heavy chain loci. DPA1*0201 and DPB1*1301 frequencies were higher in
      patients than in controls (Pc = 0.0357 and Pc = 0.0273). With respect to
      immunoglobulin heavy chain restriction fragment length polymorphisms (RFLP), the
      4.6 kb SacI RFLP at the switch alpha 2 gene was more frequent in patients (0.13)
      than in controls (0.019; Pc = 0.036). Moreover, rare alleles or duplications in
      the switch regions occurred more frequently in the patients than in the controls.
      These results support the hypothesis of a multifactorial inheritance of DH, the
      HLA and Ig constant heavy chain genes being some of the loci contributing to the
      susceptibility. In accordance with previous CD studies, these data also confirm
      that DP subregion is probably involved in the pathogenesis of DH.

PMID- 1627535
TI  - Damage in B2m genes and DNA methylation of H-2 genes are involved in loss of
      expression of class I MHC products on the membrane of LR.4, a cell line
      derivative of the T-cell lymphoma L5178Y.
AB  - We have isolated an H-2 deficient cell line (LR.4) from the T-cell lymphoma
      L5178Y which grew without restrictions in the peritoneal cavity of different
      inbred strains of mice. The use of polyclonal anti-H-2 antiserum and complement
      indicated that LR.4 cells did not express class I determinants on the cell
      membrane. Southern blots of genomic DNA of LR.4 cells showed that B2m genes were
      severely damaged and that class I H-2 genes were extensively methylated.
      Consequently, LR.4 cells failed to transcribe mRNAs for both B2m and class I H-2
      genes. On the other hand, specific immunity to LR.4 was demonstrated in C57BL/6J
      mice since, in subsequent challenges with either LR.4 or EL4.4, LR.4 did not
      grow, whereas EL4.4 grew and killed the mice. In C57BL/6J mice, rejection of LR.4
      was accompanied by the production of cytotoxic antibodies. The immune response
      induced in C57BL/6J mice was determined by non-H-2 antigenic determinants in LR.4
      cells.

PMID- 1627536
TI  - Detailed mapping of the Rfv-1 gene that influences spontaneous recovery from
      Friend retrovirus-induced leukaemia.
AB  - Using H-2 recombinant and mutant mice, the Rfv-1 gene influencing spontaneous
      recovery from Friend retrovirus (FV)-induced leukaemia was mapped in the D locus.
      Two Db alleles were required for full recovery, and a single Dd transgene did not
      convey increased susceptibility to FV in the presence of homozygous Db/b
      genotype. The results suggest that an increase in the expression of Db may lead
      to more effective stimulation of FV-specific CTL.

PMID- 1627537
TI  - Nomenclature for factors of the HLA system, 1991.

PMID- 1627538
TI  - Detection of structural changes upon S1-to-S2 transition in the oxygen-evolving
      manganese cluster in photosystem II by light-induced Fourier transform infrared
      difference spectroscopy.
AB  - The light-induced Fourier transform infrared (FT-IR) difference spectrum between
      the S1 and S2 states of the O2-evolving photosystem II (PSII) was obtained for
      the first time. Detection of an S2/S1 difference spectrum virtually free from
      contributions by the acceptor-side signals was achieved by employing an exogenous
      electron acceptor, potassium ferricyanide, to trypsin-treated PSII membranes and
      using one-flash excitation at 250 K. A synthetic difference spectrum obtained by
      adding this S2/S1 spectrum to the QA-/QA spectrum measured with Mn-depleted PSII
      was almost identical with the difference spectrum of the S2QA-/S1QA charge
      separation measured with untreated PSII. This successful simulation verifies the
      correctness of the S2/S1 spectrum thus obtained. The observed S2/S1 spectrum
      reflects the structural changes within the water-oxidizing Mn cluster upon the S1
      to-S2 transition, most probably changes in vibrational modes of ligands
      coordinating to the Mn ion(s) that is (are) oxidized upon the S2 formation and/or
      changes in protein conformation. The present results demonstrate that FT-IR
      difference spectroscopy is a promising method to investigate the structure of the
      intermediates of the Mn cluster involved in photosynthetic water oxidation.

PMID- 1627539
TI  - Purine nucleoside phosphorylase. Inosine hydrolysis, tight binding of the
      hypoxanthine intermediate, and third-the-sites reactivity.
AB  - Purine nucleoside phosphorylase from calf spleen is a trimer which catalyzes the
      hydrolysis of inosine to hypoxanthine and ribose in the absence of inorganic
      phosphate. The reaction occurs with a turnover number of 1.3 x 10(-4) s-1 per
      catalytic site. Hydrolysis of enzyme-bound inosine occurs at a rate of 2.0 x 10(
      3) s-1 to form a stable enzyme-hypoxanthine complex and free ribose. The enzyme
      hydrolyzes guanosine; however, a tightly-bound guanine complex could not be
      isolated. The complex with hypoxanthine is stable to gel filtration but can be
      dissociated by acid, base, or mild denaturing agents. Following gel filtration,
      the E.hypoxanthine complex dissociates at a rate of 1.9 x 10(-6) s-1 at 4 degrees
      C and 1.3 x 10(-4) s-1 at 30 degrees C. The dissociation constant for the tightly
      bound complex of enzyme-hypoxanthine is estimated to be 1.3 x 10(-12) M at 30
      degrees C on the basis of the dissociation rate. The stoichiometry of the
      reaction is 1 mol of hypoxanthine bound per trimer. The reaction is reversible
      since the same complex can be formed from enzyme and hypoxanthine. Addition of
      ribose 1-phosphate to the complex results in the formation of inosine without
      release of hypoxanthine. Thus, the complex is catalytically competent. Inorganic
      phosphate or arsenate prevents formation of the tightly-bound E.hypoxanthine
      complex from inosine or hypoxanthine. Direct binding studies with hypoxanthine in
      the presence of phosphate result in 3 mol of hypoxanthine bound per trimer with a
      dissociation constant of 1.6 microM. In the absence of phosphate, three
      hypoxanthines are bound, but higher hypoxanthine concentrations cause the release
      of two of the hypoxanthines with an apparent inhibition constant of 130 microM.
      The results establish that enzymatic contacts with the nucleoside alone are
      sufficient to destabilize the N-glycosidic bond. In the absence of phosphate,
      water attacks slowly, causing net hydrolysis. The hydrolytic reaction leaves
      hypoxanthine stranded at the catalytic site, tightly bound to the enzyme with a
      conformation related to the transition state. In the phosphorolysis reaction,
      ribose 1-phosphate causes relaxation of this conformation and rapid release of
      hypoxanthine.

PMID- 1627540
TI  - Three-dimensional structure of the apo form of the N-terminal EGF-like module of
      blood coagulation factor X as determined by NMR spectroscopy and simulated
      folding.
AB  - The three-dimensional structure of a 42-residue fragment containing the N
      terminal EGF-like module of blood coagulation factor X was determined by means of
      2D NMR spectroscopy and computer simulation. The spectroscopic data consisted of
      370 NOE distances and 27 dihedral angle constraints. These were used to generate
      peptide conformations by molecular dynamics simulation. The simulations used a
      novel functional form for the constraint potentials and were performed with two
      time steps to ensure rapid execution. Apart from preliminary runs to aid
      assignment of NOEs, 60 runs resulted in 13 accepted structures, which have two
      antiparallel beta sheets, no alpha helices, and five tight turns. There is no
      hydrophobic cluster. The root mean square deviation for the backbone of the 13
      conformations is 0.65 +/- 0.11 A against their mean conformation. About half of
      the side chains have well-defined structure. The overall conformation is similar
      to that of murine EGF.

PMID- 1627541
TI  - Surface binding kinetics of prothrombin fragment 1 on planar membranes measured
      by total internal reflection fluorescence microscopy.
AB  - Total internal reflection fluorescence microscopy (TIRFM) has been employed to
      investigate the Ca(2+)-dependent membrane-binding characteristics of fluorescein
      labeled bovine prothrombin-fragment 1 (F-BF1). Light scattering measurements
      demonstrated that F-BF1 bound to small unilamellar
      phosphatidylserine/phosphatidylcholine (25/75, mol/mol) vesicles with an apparent
      dissociation constant (1.5 +/- 0.2 microM) similar to that of unlabeled protein
      (1.1 +/- 0.1 microM). Negatively charged supported planar membranes were
      constructed by fusing small unilamellar vesicles at quartz surfaces. TIRFM
      measurements under equilibrium conditions showed that F-BF1 bound to planar
      membranes with an apparent dissociation constant (0.9 +/- 0.2 microM)
      approximately equal to that on vesicles. Total internal reflection/fluorescence
      photobleaching recovery (TIR/FPR) curves for F-BF1 on 25 mol% PS planar surfaces
      were diffusion-influenced at F-BF1 solution concentrations less than or equal to
      5 microM. Fluorescence recovery rates from samples of high F-BF1 concentrations
      were slowed by increasing the solution viscosity with glycerol, thus providing
      further support for a diffusion-limited effect at low F-BF1 concentrations.
      Analysis of the reaction-limited fluorescence recovery curves at F-BF1 solution
      concentrations greater than or equal to 10 microM gave average association and
      dissociation kinetic rates of approximately 10(5) M-1 s-1 and approximately 0.1 s
      1, respectively. Kinetic association rates increased significantly with
      increasing PS, whereas kinetic dissociation rates increased only slightly.
      Fluorescence recovery curves were nonmonoexponential; possible mechanisms for
      this behavior are described.

PMID- 1627542
TI  - Heparin binding to human plasma low-density lipoproteins: dependence on heparin
      sulfation degree and chain length.
AB  - Binding between low-density lipoproteins (LDL) and fluorescein-labeled heparin
      was studied quantitatively with a modified form of a published procedure [Cardin,
      A. D., Randall, C. I., Hirose, N., & Jackson, R. L. (1987) Biochemistry 26, 5513
      5518], using fluorescence anisotropy titrations. Assumption of binding site
      equivalence satisfactorily interpreted experimental data. Accordingly, the
      apparent total capacity, n, and the average dissociation constant, Kd, were
      estimated as n approximately 24 disaccharides per LDL particle and Kd
      approximately 4 microM in 0.05 M HEPES/0.1 M NaCl, pH 7.4, 22 degrees C.
      Competition experiments with unlabeled heparins were exploited for the
      quantitative study of Kd as a function of heparin chain length and sulfation
      degree (ns = sulfate groups per disaccharide). The former parameter was
      investigated with a series of bovine lung heparin fractions with Mw ranging from
      1,800 to 21,000 and constant sulfation degree (ns = 2.8 +/- 0.1). A series of
      physically fractionated or chemically modified heparins having 1.2 less than ns
      less than 3.5 were used to explore the dependence on sulfation degree. LDL
      affinity was found to increase with increasing both ns and Mw: an empirical Mw
      1.6 dependence represented very well the chain length data set; a linear
      dependence was observed for log Kd as a function of ns, after appropriate
      allowance was made for chain length differences among samples. This regularity
      confirmed that LDL-heparin binding is mainly driven by electrostatic
      forces.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627543
TI  - Extensive comparison of the substrate preferences of two subtilisins as
      determined with peptide substrates which are based on the principle of
      intramolecular quenching.
AB  - Subtilisins are serine endopeptidases with an extended binding cleft comprising
      at least eight binding subsites. Interestingly, subsites distant from the
      scissile bond play a dominant role in determining the specificity of the enzymes.
      The development of internally quenched fluorogenic substrates, which allow
      polypeptides of more than 11 amino acids to be inserted between the donor and the
      acceptor, has rendered it possible to perform a highly systematic mapping of the
      individual subsites of the active sites of subtilisin BPN' from Bacillus
      amyloliquefaciens and Savinase from Bacillus lentus. For each enzyme, the eight
      positions S5-S'3 were characterized by determination of kcat/KM values for the
      hydrolysis of substrates in which the amino acids were systematically varied. The
      results emphasize that in both subtilisin BPN' and Savinase interactions between
      substrate and S4 and S1 are very important. However, it is apparent that
      interactions between other subsites and the substrate exert a significant
      influence on the substrate preference. The results are rationalized on the basis
      of the structural data available for the two enzymes.

PMID- 1627544
TI  - Inactivation of dimeric D-amino acid transaminase by a normal substrate through
      formation of an unproductive coenzyme adduct in one subunit.
AB  - D-amino acid transaminase, which contains pyridoxal 5'-phosphate (vitamin B6) as
      coenzyme, catalyzes the formation of D-alanine and D-glutamate from their
      corresponding alpha-keto acids; these D-amino acids are required for bacterial
      cell wall biosynthesis. Under conditions usually used for kinetic assay of enzyme
      activity, i.e., short incubation times with dilute enzyme concentrations, D
      alanine behaves as one of the best substrates. However, the enzyme slowly loses
      activity over a period of hours when exposed to substrates, intermediates, and
      products at equilibrium. The rate of inactivation is dependent on enzyme
      concentration but independent of substrate concentration greater than Km values.
      Continuous removal of the product pyruvate by enzymic reduction precludes the
      establishment of equilibrium and prevents inactivation. The formation of small
      but detectable amounts of a quinonoid intermediate absorbing at 493 nm is
      proportional to inactivation. Studies with [14C]-D-alanine labeled on different
      carbon atoms indicate that the alpha-carboxyl group of the substrate is absent in
      the inactive enzyme; such decarboxylation is not a usual function of this enzyme.
      The inactive transaminase contains 1.1 mol of [14C]-D-alanine-derived adduct per
      mole of dimeric enzyme; this finding is consistent with the 50% reduction in the
      fluorescence intensity at 390 nm (due to the PMP form of the coenzyme) for the
      inactive enzyme. Thus, inactivation of one subunit of the dimeric enzyme renders
      the entire molecule inactive. Inactivation may occur when a coenzyme
      intermediate, perhaps the ketimine, is slowly decarboxylated and then undergoes a
      conformational change from its catalytically competent location.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1627545
TI  - Complete replacement set of amino acids at the C-terminus of thymidylate
      synthase: quantitative structure-activity relationship of mutants of an enzyme.
AB  - The C-terminal residue of thymidylate synthase (TS) is highly conserved and has
      been implicated in cofactor binding, catalysis, and a conformational change. The
      codon for the C-terminal valine of Lactobacillus casei TS has been replaced with
      those for 19 other amino acids and the amber stop codon. Fourteen of the
      resulting mutant proteins were active by genetic complementation using a Thy-
      strain of Escherichia coli, and 18 mutants were active by in vitro assay. Only
      the aspartate and amber mutations had undetectable activity. All of the mutants
      were expressed at high levels (5-30% of soluble protein) and were purified by
      phosphocellulose chromatography. In general, the alterations at position 316 led
      to little effect on the Km for dUMP, an increase in Km for the folate cofactor,
      and a decrease in kcat. The observations show that TS can tolerate the
      substitution of most amino acids for valine at the C-terminus without a complete
      loss of activity, that hydrophobic substitutions are preferred, and that the C
      terminal side chain is involved in both cofactor binding and catalysis. There was
      an excellent correlation between log kcat and hydrophobicity of the side chain at
      position 316 and an inverse correlation between log Km and the hydrophobicity of
      this residue. Kinetic parameters of the cofactor-independent TS-catalyzed
      dehalogenation of BrdUMP showed no variation with the side chain at position 316.
      In context of the structure of TS, it is proposed that binding of the cofactor
      triggers a conformational change in which the C-terminal side chain undergoes
      hydrophobic interactions that stabilize a rate-limiting transition state of the
      TS reaction.

PMID- 1627546
TI  - Thymidylate synthase with a C-terminal deletion catalyzes partial reactions but
      is unable to catalyze thymidylate formation.
AB  - The V316Am mutant of Lactobacillus casei thymidylate synthase has a single amino
      acid deletion at the C-terminus which abolishes catalysis of dTMP formation.
      However, V316Am catalyzes two partial reactions which require covalent catalysis:
      a CH2H4folate-dependent exchange of the 5-hydrogen of dUMP for protons in water
      and a thiol-dependent dehalogenation of 5-bromo- and 5-iodo-dUMP. These reactions
      proceed with kcat and Km values similar to those of the wild-type TS-catalyzed
      reactions. dUMP, dTMP, and FdUMP are competitive inhibitors of the debromination
      reaction with Ki values similar to those obtained with wild-type enzyme. These
      results show that removal of the terminal valine does not alter the ability of
      the enzyme to bind to or form covalent bonds with nucleotide ligands. V316Am also
      forms a covalent ternary complex with FdUMP and CH2H4folate. However, the
      affinity of the TS-FdUMP complex for the cofactor is reduced, and the rate of
      covalent ternary complex formation and its stability are significantly lower than
      with wild-type TS. These results allow us to place the major defects of the
      mutation on steps that occur subsequent to initial CH2H4folate binding.

PMID- 1627547
TI  - Basis for the anomalous effect of competitive inhibitors on the kinetics of
      hydrolysis of short-chain phosphatidylcholines by phospholipase A2.
AB  - The effect of four specific competitive inhibitors on the kinetics of hydrolysis
      of short-chain diacyl-sn-glycero-3-phosphocholines below their critical micelle
      concentrations was examined. The kinetics of hydrolysis of short-chain substrates
      dispersed as solitary monomers were generally consistent with the classical
      Michaelis-Menten formalism; i.e., hydrolysis began without any latency period,
      the steady-state rate was observed at higher substrate concentrations, the steady
      state initial rate showed a linear dependence on the enzyme concentration, and
      the hyperbolic dependence of the initial rate on the substrate concentration
      could be described in terms of KM and Vmax parameters. The competitive nature of
      the inhibitors used in this study has been established by a variety of
      techniques, and the equilibrium dissociation constants for the inhibitors bound
      to the enzyme were measured by the protection method [Jain et al. (1991)
      Biochemistry 30, 7306-7317]. The kinetics of hydrolysis in the presence of
      competitive inhibitors could be described by a single dissociation constant.
      However, the value of the dissociation constant obtained under the kinetic
      conditions was comparable to that obtained by the protection method for the
      inhibitor-enzyme complex bound to a neutral diluent, rather than to the value of
      the dissociation constant obtained with solitary monomeric inhibitors and the
      enzyme in the aqueous phase. Spectroscopic methods showed that the effectively
      lower dissociation constant of an inhibitor bound to PLA2 at the interface is due
      to the stabilization of the enzyme-inhibitor complex by interaction with other
      amphiphiles present in the reaction mixture.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627549
TI  - Isomerization of (R)- and (S)-glutathiolactaldehydes by glyoxalase I: the case
      for dichotomous stereochemical behavior in a single active site.
AB  - The ability of glyoxalase I to isomerize both diastereomeric thiohemiacetals
      formed between glutathione and alpha-ketoaldehydes has been probed with
      stereochemically "locked" substrate analogues. Both (R)- and (S)
      glutathiolactaldehyde (5 and 5') were unambiguously synthesized by employing the
      Sharpless epoxidation procedure as a key step. In the presence of human
      erythrocyte glyoxalase I, high-field 1H NMR analysis reveals that the R and S
      isomers (approximately 20 mM) are both converted to glutathiohydroxyacetone at
      rates of 0.8 and 0.4 s-1, respectively. This reaction is characterized by a
      nonstereospecific proton abstraction followed by a partially shielded proton
      transfer to the si face of the cis-enediol intermediate. Glyoxalase I catalyzes
      the exchange of the pro-S proton of glutathiohydroxyacetone with solvent
      deuterium. Glutathiohydroxyacetone was found to be a good competitive inhibitor
      of the normal glyoxalase I reaction (KI = 1.46 mM), suggesting that the slow
      processing rate of these compounds with respect to the normal thiohemiacetals is
      not due to poor binding. The results are consistent with a nonstereospecific
      proton abstraction and a stereospecific reprotonation at contiguous substrate
      carbons.

PMID- 1627548
TI  - Role of phospholipids in reconstituted cytochrome P450 3A form and mechanism of
      their activation of catalytic activity.
AB  - Cytochrome P-450 coded for by the 3A gene family requires specific conditions in
      a reconstituted system, if its catalytic activity is to be efficient. We
      investigated the mechanism of activation of the catalytic activity of cytochrome
      P450 3A by phospholipids. Rat P450 PB-1 (3A2), human P450NF (3A4), and rabbit
      P450 3c (3A6) were used. They had low activity in a reconstituted system (system
      I) with dilauroylphosphatidylcholine (DLPC) but had high activity with a mixture
      of phospholipids (DLPC, dioleoylphosphatidylcholine, and phosphatidylserine) and
      sodium cholate (system II). P450 3A forms are cationic (having a high content of
      lysine residues) and needed the anionic phospholipid phosphatidylserine to have
      sufficient activity. Double-reciprocal plots of the metabolic rate of cytochrome
      P-450 versus the concentration of NADPH-cytochrome P-450 reductase showed that
      cytochrome P-450 and the reductase interacted more in system II than in system I.
      P450 PB-1 did not absorb at 450 nm in the presence of reductase, CO, DLPC, and
      NADPH, although other cytochrome P-450s absorbed at around 450 nm in such a
      mixture. However, P450 PB-1 was reduced in the presence of the phospholipid
      mixture and sodium cholate instead of DLPC. These results suggested that the
      stimulation of catalytic activity by phospholipids involved increased interaction
      between cytochrome P-450 and the reductase. Studies of proteolytic digestion and
      chemical cross-linking in systems I and II showed that a P450 3A form needed
      disaggregation of cytochrome P-450 and/or the reductase, not the formation of an
      aggregated complex necessary for the catalytic activity of other cytochrome P
      450s.

PMID- 1627550
TI  - Structure of the human pancreatic cholesterol esterase gene.
AB  - The gene for human pancreatic cholesterol esterase consists of 11 exons and 10
      introns and is 9.2 kb in length. The last and longest exon (841 nucleotides) is
      unique to the human gene. Functional amino acids are encoded on separate exons.
      The leader sequence is encoded by a single exon which carries two additional N
      terminal amino acids of the mature functional protein. A positive TATA element is
      identified 43 nucleotides from the start codon. Pulse-field gel electrophoresis
      and hybridization with various cDNA probes and direct sequence data revealed the
      existence of a CEase-like gene. Partial sequence analysis of this gene from a
      human cosmid library and human genomic DNA showed a premature stop signal in exon
      10, shortly after the codon for the active-site histidine. Both the functional
      gene and the CEase-like gene have a polyadenylation signal in the 3'-untranslated
      region. Thus, the complex gene structure for this intestinally active enzyme may
      provide in part a potential molecular explanation for the well-known
      heterogeneity of the intestinal absorption of cholesterol.

PMID- 1627551
TI  - EcoRV restriction endonuclease: communication between catalytic metal ions and
      DNA recognition.
AB  - In the absence of magnesium ions, the EcoRV restriction endonuclease binds all
      DNA sequences with equal affinity but cannot cleave DNA. In the presence of Mg2+,
      the EcoRV endonuclease cleaves DNA at one particular sequence, GATATC, at least a
      million times more readily than any other sequence. To elucidate the role of the
      metal ion, the reactions of the EcoRV restriction enzyme were studied in the
      presence of MnCl2 instead of MgCl2. The reaction at the EcoRV recognition site
      was slower with Mn2+. This was caused partly by reduced rates for phosphodiester
      hydrolysis but also by the translocation of the enzyme along the DNA after
      cleaving it in one strand. In contrast, alternative sites that differ from the
      recognition site by one base pair were cleaved faster in the presence of Mn2+
      relative to Mg2+. When located at an alternative site on the DNA, the EcoRV
      enzyme bound Mn2+ ions readily but had a very low affinity for Mg2+. The EcoRV
      nuclease is thus restrained from cleaving DNA at alternate sites in the presence
      of Mg2+, but the restraint fails to operate with Mn2+. A discrimination factor,
      which measures the ratio of the activity of the EcoRV nuclease at its recognition
      site over that at an alternative site, had values of 3 x 10(5) in MgCl2 and 6 in
      MnCl2.

PMID- 1627552
TI  - EcoRV restriction endonuclease: communication between DNA recognition and
      catalysis.
AB  - A genetic system was constructed for the mutagenesis of the EcoRV restriction
      endonuclease and for the overproduction of mutant proteins. The system was used
      to make two mutants of EcoRV, with Ala in place of either Asn185 or Asn188. In
      the crystal structure of the EcoRV-DNA complex, both Asn185 and Asn188 contact
      the DNA within the EcoRV recognition sequence. But neither mutation affected the
      ability of the protein to bind to DNA. In the absence of metal ion cofactors, the
      mutants bound DNA with almost the same affinity as that of the wild-type enzyme.
      In the presence of Mg2+, both mutants retained the ability to cleave DNA
      specifically at the EcoRV recognition sequence, but their activities were
      severely depressed relative to that of the wild-type. In contrast, with Mn2+ as
      the cofactor, the mutant enzymes cleaved the EcoRV recognition site with
      activities that were close to that of the wild-type. When bound to DNA at the
      EcoRV recognition site, the mutant proteins bound Mn2+ ions readily, but they had
      much lower affinities for Mg2+ ions than the wild-type enzyme. This was the
      reason for their low activities with Mg2+ as the cofactor. The arrangement of the
      DNA recognition functions, at one location in the EcoRV restriction enzyme, are
      therefore responsible for organizing the catalytic functions at a separate
      location in the protein.

PMID- 1627553
TI  - Characterization of the alpha and beta subunits of casein kinase 2 by far-UV CD
      spectroscopy.
AB  - Although Chou-Fasman calculations of the secondary structure of recombinant
      casein kinase 2 subunits alpha and beta suggest they have a similar overall
      conformation, circular dichroism (CD) studies show that substantial differences
      in the conformation of the two subunits exist. In addition, comparison of the far
      UV CD spectrum of reconstituted CK-2 with the spectra of the subunits indicates
      that conformational changes occur in the backbone region upon association. Such
      changes may explain the increased enzyme activity of the holoenzyme relative to
      that of the alpha subunit itself. In contrast, no changes in the far-UV CD
      spectrum of the alpha subunit are observed in the presence of casein or the
      synthetic decapeptide substrate RRRDDDSDDD. Furthermore, the alpha-helical
      structure of the alpha subunit (but not the beta subunit) can be increased in the
      presence of stoichiometric amounts of heparin, presumably by its binding to the
      polylysine stretch at amino acid positions 74-77. Heat denaturation experiments
      (25-90 degrees C) support the notion that heparin may provide a local protective
      function. A similar but much larger effect was also observed in the presence of
      the beta subunit only, which supports previous suggestions of a protective
      function for this subunit. These results indicate that the protection provided by
      the beta subunit and the increased enzyme activity of the holoenzyme may arise,
      in part, from a stabilization of the conformation of the enzyme complex and an
      increase in alpha-helical content.

PMID- 1627554
TI  - Fusion of phospholipid vesicles induced by an amphiphilic model peptide: close
      correlation between fusogenicity and hydrophobicity of the peptide in an alpha
      helix.
AB  - A model peptide with 51 amino acid residues consisting of tandem repeats of a Lys
      Lys-Leu-Leu sequence and a turn sequence of Asn-Pro-Gly at the center of the
      molecule has a random conformation at neutral pH but adopts an amphiphilic alpha
      helical form in the presence of various salts or nucleotides [Goto, Y., & Aimoto,
      S. (1991) J. Mol. Biol. 218, 387-396; Goto, Y., Okamura, N., & Aimoto, S. (1991)
      J. Biochem. (Tokyo) 109, 746-750]. The interaction of this model peptide with
      liposome membranes and the resulting alpha-helical conformational transition and
      membrane fusion as well as the effect of the nucleotide ATP on these events were
      examined at neutral pH. The peptide associated stoichiometrically with liposome
      membranes composed of phosphatidylserine (PS) and phosphatidylcholine (PC) in a
      molar ratio of 2:1, resulting in formation of an amphiphilic alpha-helix and
      induction of fusion of the liposomes. However, the final fusion level was not
      correlated with the amount of binding or the helix content and was found to
      increase on an increase in hydrophobicity of the peptide in the alpha-helical
      form by neutralization of its positive charges by the negative charges of PS. In
      contrast, in the presence of ATP, the peptide bound completely to the PS/PC
      membranes at a lower concentration of liposome and concomitantly induced membrane
      fusion, indicating that ATP cooperates with PS to neutralize the charges of the
      peptide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627555
TI  - Autophosphorylation of skeletal muscle myosin light chain kinase.
AB  - Ca2+/calmodulin-dependent myosin light chain kinase phosphorylates the regulatory
      light chain of myosin. Rabbit skeletal muscle myosin light chain kinase also
      catalyzes a Ca2+/calmodulin-dependent autophosphorylation with a rapid rate of
      incorporation of 1 mol of 32P/mol of kinase and a slower rate of incorporation up
      to 1.52 mol of 32P/mol. Autophosphorylation was inhibited by a peptide substrate
      that has a low Km value for myosin light chain kinase. Autophosphorylation at
      both rates was concentration-independent, indicating an intramolecular mechanism.
      There were no significant changes in catalytic properties toward light chain and
      MgATP substrates or in calmodulin activation properties upon autophosphorylation.
      After digestion with V8 protease, phosphopeptides were purified and sequenced.
      Two phosphorylation sites were identified, Ser 160 and Ser 234, with the former
      associated with the rapid rate of phosphorylation. Both sites are located amino
      terminal of the catalytic domain. These results indicate that the extended "tail"
      region of the enzyme can fold into the active site of the kinase.

PMID- 1627556
TI  - Identification of the Ca(2+)-dependent calmodulin-binding region of chromogranin
      A.
AB  - Chromogranin A (CGA), the most abundant protein in bovine adrenal chromaffin
      granules, is a high-capacity, low-affinity Ca(2+)-binding protein found in most
      neuroendocrine cells, and binds calmodulin (CaM) in a Ca(2+)-dependent manner.
      The binding of chromogranin A to calmodulin was determined by measuring the
      intrinsic tryptophan fluorescence of chromogranin A in the presence and absence
      of Ca2+. Binding was specifically Ca(2+)-dependent; neither Mg2+ nor Mn2+ could
      substitute for Ca2+. Chelation of Ca2+ by EGTA completely eliminated the
      chromogranin A-calmodulin interaction. CaM binding was demonstrated by a
      synthetic CGA peptide representing residues 40-65. When the CGA peptide and CaM
      were mixed in the presence of 15 mM CaCl2, the intrinsic tryptophan fluorescence
      emission underwent a substantial blue-shift, shifting from 350 to 330 nm. Like
      the intact CGA, the peptide-CaM binding was specifically Ca(2+)-dependent, and
      neither Mg2+ nor Mn2+ could induce the binding. Calmodulin bound both to CGA and
      to the synthetic CGA peptide with a stoichiometry of one to one. The dissociation
      constants (Kd) determined by fluorometric titration were 13 nM for the peptide
      CaM binding and 17 nM for intact CGA-CaM binding. The Kd values are comparable to
      those (approximately 10(-9) M) of other CaM-binding proteins and peptides,
      demonstrating a tight binding of CaM by CGA. The CaM-binding CGA residues 40-65
      are 100% conserved among all the sequenced CGAs in contrast to 50-60%
      conservation found in the entire sequence, implying essential roles of this
      region.

PMID- 1627557
TI  - Phosphatidylinositol inhibits microtubule assembly by binding to microtubule
      associated protein 2 at a single, specific, high-affinity site.
AB  - The effects of various anionic phospholipids on the in vitro assembly of
      MAP2/tubulin microtubules has been examined. We show that the potency to inhibit
      is related to the polarity of the phospholipids and that this is consistent with
      a mode of action involving the sequencing of microtubule-associated proteins
      (MAPs) by nonspecific electrostatic interactions. The inhibitory potency of
      phosphatidylinositol (PI) is, however, considerably larger than predicted by this
      model. The effects of PI on MAP2/tubulin microtubule assembly have therefore been
      examined in greater detail by preparing phosphatidylcholine (PC) liposomes doped
      with increasing amounts of PI. We show that when the PI is sufficiently dispersed
      by dilution with PC, it inhibits microtubule assembly by binding to MAP2 with an
      apparent stoichiometry, after correction for the bilamellar nature of the
      liposomes, of 1:1 mol.mol-1 PI:MAP2. Furthermore, we show that the Kd of this
      interaction is in the submicromolar range.

PMID- 1627558
TI  - Bacteriorhodopsin can be refolded from two independently stable transmembrane
      helices and the complementary five-helix fragment.
AB  - This paper describes experimental tests of the hypothesis that bacteriorhodopsin
      (BR) can fold by the association of independently stable transmembrane helices.
      Peptides containing the first and second helical segments of BR were chemically
      synthesized. These two peptides and the complementary five-helix fragment of BR
      were reconstituted in three separate populations of native-lipid vesicles which
      were then mixed and fused to allow the fragments to interact. After addition of
      retinal, absorption spectroscopy of the reconstituted BR and X-ray diffraction of
      two-dimensional crystals of this material showed that the native structure of BR
      was regenerated. The first two helices of BR can therefore be considered as
      independent folding domains, and covalent connections in the loops connecting the
      helices to each other and to the rest of the molecule are not essential for the
      appropriate association of the helices.

PMID- 1627559
TI  - The broad diversity of neutral and sialylated oligosaccharides derived from human
      salivary mucins.
AB  - Mucin glycopeptides were prepared from the salivary mucins of 20 healthy donors
      with blood group O. The carbohydrate chains of the high-molecular-weight mucins
      were released by alkaline borohydride treatment. Neutral and monosialylated
      oligosaccharide-alditols were purified by ion-exchange chromatography, gel
      filtration, and HPLC. The structures of the oligosaccharide-alditols were
      determined by high-resolution 1H-NMR spectroscopy in combination with fast atom
      bombardment mass spectrometry and methylation analysis. Thirty-seven
      oligosaccharide-alditols were characterized and illustrate the extreme diversity
      of the salivary mucins carbohydrate chains. This diversity might represent a
      mosaic of bacterial adhesion sites and be involved in the early events of the
      nonimmune defense of the oral cavity. Among these 37 oligosaccharide-alditols, 31
      have not been previously described in human saliva and five of these are novel
      structures: [formula: see text]

PMID- 1627560
TI  - Cooperative binding of polyamines induces the Escherichia coli single-strand
      binding protein-DNA binding mode transitions.
AB  - The Escherichia coli single-strand binding (SSB) protein is an essential protein
      involved in DNA replication, recombination, and repair processes. The tetrameric
      protein binds to ss nucleic acids in a number of different binding modes in
      vitro. These modes differ in the number of nucleotides occluded per SSB tetramer
      and in the type and degree of cooperative complexes that are formed with ss DNA.
      Although it is not yet known whether only one or all of these modes function in
      vivo, based on the dramatically different properties of the SSB tetramer in these
      different ss DNA binding modes, it has been suggested that the different modes
      may function selectively in replication, recombination, and/or repair. The
      transitions between these different modes are very sensitive to solution
      conditions, including salt (concentration, as well as cation and anion type), pH,
      and temperature. We have examined the effects of multivalent cations, principally
      the polyamine spermine, on the SSB-ss poly(dT) binding mode transitions and find
      that the transition from the (SSB)35 to the (SSB)56 binding mode can be induced
      by micromolar concentrations of polyamines as well as the inorganic cation
      Co(NH3)6(3+). Furthermore, these multivalent cations, as well as Mg2+, induce the
      binding mode transition by binding cooperatively to the SSB-poly(dT) complexes.
      These observations are interesting in light of the fact that polyamines, such as
      spermidine, are part of the ionic environment in E. coli and hence these cations
      are likely to affect the distribution of SSB-ss DNA binding modes in
      vivo.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627561
TI  - Interaction of thymosin beta 4 with muscle and platelet actin: implications for
      actin sequestration in resting platelets.
AB  - Quantitative measurements of the interactions of T beta 4 with muscle actin
      suggest that its only physiological role is monomer sequestration. T beta 4 forms
      a 1:1 complex with monomeric actin under physiological salt conditions. Its Kd
      for actin is not affected by calcium. T beta 4 binds only to actin monomers and
      not to filament ends or alongside the filament. T beta 4-actin complexes do not
      elongate actin filaments at either the barbed or the pointed end, and, unlike
      actobindin, T beta 4 does not specifically suppress the nucleation of
      polymerization. We assessed the fraction of monomeric actin that can be
      sequestered by T beta 4 in resting platelets. This was done on the basis of (a)
      its Kd of 0.4-0.7 microM for platelet actin, which had been prepared by a newly
      devised simpler method, and (b) the values for the concentrations of monomeric
      actin and of T beta 4 which we measured as 280 and 560 microM, respectively.
      Using the higher Kd value of 0.7 microM, the T beta 4-complexed actin is
      calculated to be between 70 and 240 microM, depending on the steady-state free G
      actin concentration. This may vary from 0.1 to 0.5 microM, the critical
      concentrations for uncapped and for fully barbed-end-capped actin filaments. If
      the Kd in the platelet is the same as in vitro, most of the sequestered actin
      would be bound to T beta 4 if more than 95% of the actin filaments are capped at
      their barbed ends in resting platelets.

PMID- 1627562
TI  - Identification of five sites of acetylation in alfalfa histone H4.
AB  - Radioactive acetylation in vivo of plant histone H4 of alfalfa, Arabidopsis,
      tobacco, and carrot revealed five distinct forms of radioactive, acetylated
      histone. In histone H4 of eukaryotes ranging from fungi to man, acetylation is
      restricted to four lysines (residues 5, 8, 12, and 16) possibly caused by a
      quantitative methylation of lysine-20. Chemical and proteolytic fragmentation of
      the amino terminally blocked alfalfa H4 protein, dynamically acetylated by
      radioactive acetate in vivo, allowed protein sequencing and identification of
      selected peptides. Peptide identification was facilitated by analyzing fully
      characterized calf histone H4 in parallel. Acetylation in vivo of alfalfa histone
      H4 was restricted to the lysines in the amino-terminal domain of the protein,
      residues 1-23. Lysine-20 was shown to be free of methylation, as in pea histone
      H4. This apparently makes lysine-20 accessible as a novel target for histone
      acetylation. The in vivo pattern of lysine acetylation (16 greater than 12
      greater than 8 greater than or equal to 5 = 20) revealed a preference for lysines
      -16 and -12 without an apparent strict sequential specificity of acetylation.

PMID- 1627563
TI  - Isolation and sequence of a cDNA encoding porcine mitochondrial NADP-specific
      isocitrate dehydrogenase.
AB  - The cDNA for porcine mitochondrial NADP-specific isocitrate dehydrogenase was
      isolated from a lambda gt11 library using polymerase chain reaction. Translation
      of the DNA sequence gave a 413-residue amino acid sequence and a calculated
      molecular weight of 46,600 for the mature polypeptide. Previously determined
      peptide sequences for the amino terminus and for internal tryptic peptides were
      all contained within the translated sequence. The porcine protein was found to
      share 63% residue identity with yeast mitochondrial NADP-specific isocitrate
      dehydrogenase and to be immunoreactive with an antiserum against the yeast
      protein. Highly conserved regions include residues which have been implicated in
      substrate and cofactor binding in previous studies of the porcine enzyme. The two
      eucaryotic enzymes exhibit only minimal homology with the NADP-dependent
      isocitrate dehydrogenase from Escherichia coli, with the exception of a striking
      conservation of residues implicated in formation of the metal-isocitrate site of
      the procaryotic enzyme.

PMID- 1627564
TI  - Binding specificities of actinomycin D to non-self-complementary -XGCY
      tetranucleotide sequences.
AB  - Studies on the binding specificity of actinomycin D (ACTD) to tetranucleotide
      sequences of the form -XGCY- have been extended to include the non-self
      complementary sequences. ACTD binding characteristics are investigated by
      equilibrium, kinetic, and thermal denaturation for decameric duplexes d(ATA-XGCY
      ATA)-d(TAT-Y'GCX'-TAT), where X and Y are complementary to X' and Y',
      respectively, but not to each other. The results indicate that when X = G or Y =
      C, the oligomers exhibit significantly weaker ACTD binding affinities, smaller
      melting temperature increases upon drug binding, and faster SDS-induced ACTD
      dissociation rates than the other sequences. Estimated binding constants at 18.5
      degrees C for decameric duplexes containing -AGCA-/-TGCT-, -AGCG-/-CGCT-, or 
      CGCA-/-TGCG- are in the range of 4-9 microM-1, whereas for the ones containing 
      GGCT-/-AGCC-, -GGCA-/-TGCC-, or -GGCG-/-CGCC- they range from 0.6 to 2 microM-1.
      In contrast to the characteristic SDS-induced ACTD dissociation times of 600-1000
      s for the stronger binding sites, the sequences containing X = G or Y = C exhibit
      at least an order of magnitude faster dissociation kinetics. These observations
      are further supported by the induced CD results and fluorescence measurements
      with 7-amino-ACTD. The findings from these non-self-complementary -XGCY-
      tetranucleotide sequences are consistent with those found earlier for the self
      complementary counterparts, and they together clearly demonstrate that a base
      sequence alteration adjacent to the GC site can have a profound effect on the
      ACTD binding as well as dissociation characteristics, likely a consequence of
      subtle conformational alterations near the binding site.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1627565
TI  - Hairpin and duplex forms of a self-complementary dodecamer, d-AGATCTAGATCT, and
      interaction of the duplex form with the peptide KGWGK: can a pentapeptide
      destabilize DNA?
AB  - Ordered forms of a synthetic dodecamer, d-AGATCTAGATCT, a direct repeat of the
      BglII recognition sequence, have been investigated using UV, CD, and fluorescence
      spectroscopy. Complex hairpin-duplex equilibria are manifest in UV thermal
      transitions, which are monophasic in the presence of very low or high NaCl
      concentrations but distinctly biphasic at intermediate ionic strengths. In 100 mM
      NaCl, the 1/Tm vs 1n C curve has a reasonable positive slope, which yields delta
      H and delta S for duplex formation as -66.2 kcal/mol and -190 cal/mol,
      respectively. Interaction of the dodecamer in duplex form with a tryptophan
      containing peptide, KGWGK, has also been investigated to test the "bookmark"
      hypothesis (Gabbay et al., 1976) under the uniform structural constraint of the
      oligonucleotide of defined sequence. CD spectra of the peptide (P), the
      oligonucleotide (N), and their mixtures at different P/N ratios show a dramatic
      change in peptide spectrum but little change in nucleic acid dichroism with
      peptide binding. The Tm of P-N complexes decreases with an increase in peptide
      binding and levels off at saturation binding of P/N = 2.0. The data are
      interpreted in terms of a groove-cum-intercalation mode of binding, where
      intercalation to the tryptophan side chain destabilizes the double helix. A
      Scatchard plot of the binding data is nonlinear, with best-fit values for an
      overall association constant K = 4.33 x 10(5) M-1, and the number of binding
      sites n = 3.23 when fitted to the site-exclusion model of binding.

PMID- 1627566
TI  - Co2+ as a shift reagent for 35Cl NMR of chloride with vesicles and cells.
AB  - Applications of high-resolution 35Cl NMR to the study of chloride in vivo and in
      vesicles have hitherto been limited by problems of NMR detectability and of
      resolving internal from external signals. We have characterized the effects of
      Co2+ on the 35Cl resonance of Cl- in solution and have shown that when added to
      suspensions of lipid vesicles, Co2+ shifts the 35Cl signal of the extravesicular
      Cl-, allowing clear resolution and quantitation of two peaks. We have assigned
      these signals to chloride inside and outside the vesicles. The spectra do not
      change over a 90-min period, demonstrating the stability of the vesicles in the
      presence of Co2+. This technique is shown to be applicable to red blood cell
      ghosts, where intravesicular and extravesicular chloride signals were separated
      and measured and chloride/sulfate exchange through the band 3 anion transport
      protein A was followed. In two plant species (an alga and a higher plant), an
      intracellular Cl- signal can be observed and resolved from the extracellular
      signal. The intracellular transportable chloride was found to be fully NMR
      visible (+/- 5%) in the algal cells. The high steady-state levels of Cl- seen in
      the alga were consistent with previous work using 36Cl- labeling on a related
      species [Doblinger, R., & Tromballa, H.W. (1982) Planta 156, 10-15]. Successive
      spectra acquired after adding Co2+ to Chlorella cells under deenergizing
      conditions allow us to follow the time course of movement of Cl- out of the
      cells.

PMID- 1627567
TI  - Use of a potential of mean force to analyze free energy contributions in protein
      folding.
AB  - A method for calculation of the free energy of residues as a function of residue
      burial is proposed. The method is based on the potential of mean force, with a
      reaction coordinate expressed by residue burial. Residue burials are calculated
      from high-resolution protein structures. The largest individual contributions to
      the free energy of a residue are found to be due to the hydrophobic interactions
      of the nonpolar atoms, interactions of the main chain polar atoms, and
      interactions of the charged groups of residues Arg and Lys. The contribution to
      the free energy of folding due to the uncharged side chain polar atoms is small.
      The contribution to the free energy of folding due to the main chain polar atoms
      is favorable for partially buried residues and less favorable or unfavorable for
      fully buried residues. Comparison of the accessible surface areas of proteins and
      model spheres shows that proteins deviate considerably from a spherical shape and
      that the deviations increase with the size of a protein. The implications of
      these results for protein folding are also discussed.

PMID- 1627568
TI  - Determination of kinetic constants for the interaction between a monoclonal
      antibody and peptides using surface plasmon resonance.
AB  - Differences in the affinity of a monoclonal antibody raised against the protein
      of tobacco mosaic virus for 15 related peptides (residues 134-146) carrying
      single-residue modifications were investigated using a novel biosensor technology
      (Pharmacia BIAcore). Analysis of the peptide-antibody interaction in real time
      allowed fast and reproducible measurements of both association and dissociation
      rate constants. Out of 15 mutant peptides analyzed, five were not recognized by
      the antibody at all, and seven were recognized as well as the wild-type peptide.
      For three of the peptides, the rate constants were different for the mutant and
      wild-type peptides. The pattern of residue recognition suggests that the epitope
      is formed by three residues (140, 143, and 144) in a helical conformation that
      mimics the structure in the protein. Even a minor modification of these residues
      totally abolishes recognition by the antibody. Modifications of adjacent residues
      result in small but significant differences in association and/or dissociation
      rate constants. One of the recognized residues is totally buried in the three
      dimensional structure of TMV protein, suggesting that a structural rearrangement
      next to the helix occurs during protein-antibody interaction.

PMID- 1627569
TI  - Light product of photoreactive 6-azido-FAD bound to deflavo-milk xanthine
      oxidase.
AB  - Xanthine oxidase from milk was reconstituted with the photoreactive flavin, 6
      azido-FAD. While irradiation of the reconstituted enzyme under anaerobic
      conditions yielded 6-amino-FAD as a light product, aerobic irradiation resulted
      in formation of an unknown product, which gave the enzyme almost the same
      activity as that of the native enzyme. The light product could be extracted from
      the enzyme without breakdown and was found to be highly fluorescent. Upon
      treatment with phosphodiesterase, this light product was converted to the FMN
      form. The absorption spectrum of the FMN form has a peak at 464 nm, a shoulder at
      450 nm in the visible region, and two peaks at 260 and 298 nm in the UV.
      Irradiation of free 6-azido-3-methyllumiflavin in the presence of a saturating
      concentration of oxygen yielded a light product whose absorbance and fluorescence
      spectra were very similar to those of the light product extracted from the
      enzyme, suggesting that the two had undergone some common photochemical change at
      the same place in the isoalloxazine ring. Analysis of the light product of 6
      azido-3-methyllumiflavin with 1H NMR and FAB mass spectrometry suggested its
      possible structure with a new five-membered ring, C(6) = N-O-CH = C(7), adjacent
      to the benzene ring of the flavin.

PMID- 1627570
TI  - Mechanism of adenylate kinase. Structural and functional roles of the conserved
      arginine-97 and arginine-132.
AB  - The structural and functional roles of two conserved active site residues, Arg-97
      and Arg-132, in chicken muscle adenylate kinase (AK) were evaluated by site
      directed mutagenesis in conjunction with one- and two-dimensional proton nuclear
      magnetic resonance (NMR), kinetics, and guanidine hydrochloride-induced
      denaturation. In addition, 31P NMR analysis was used to evaluate the contribution
      of Arg-97 to the phosphorus stereospecificity of AK. The results and conclusions
      are summarized as follows: (i) Kinetic analysis of R97M reveals 6- and 28-fold
      increases in the dissociation constant Ki and Michaelis constant K of AMP,
      respectively, and a moderate 30-fold decrease in kcat. The Ki and K values of
      MgATP are relatively unperturbed. The localized effect of AMP stabilization was
      independently confirmed by proton NMR titration, which showed a ca. 20-fold
      increase in the dissociation constant of AMP but not of MgATP. (ii) R132M affords
      a dramatic decrease in kcat by a factor of 8.0 x 10(3), with unchanged
      dissociation and Michaelis constants for either substrate. The lack of
      perturbation in the affinities toward substrates was confirmed by proton NMR
      titration. (iii) Although small chemical shift changes were observed for the free
      mutants and their complexes with substrates, further analyses by nuclear
      Overhauser enhanced spectroscopy with the bisubstrate analogue inhibitor, P1,P5
      bis(5'-adenosyl)pentaphosphate (AP5A), indicated little perturbation in the
      global conformation. (iv) Contributions to conformational stability by Arg-97 and
      Arg-132 are negligible on the basis of the free energy of unfolding, delta GdH2O.
      (v) R97M was predicted and demonstrated to exhibit enhanced stereospecificity at
      the AMP site by at least 10-fold relative to WT in the conversion of adenosine 5'
      monothiophosphate to adenosine 5'-(1-thiodiphosphate). This result for R97M was
      predicted on the basis of the orientation of Arg-97 relative to Arg-44 and AMP in
      the active site as observed in available crystal structures and the
      stereospecificity results of R44M [Jiang, R.-T., Dahnke, T., & Tsai, M.-D. (1991)
      J. Am. Chem. Soc. 113, 5485-5486]. (vi) The above structural and functional
      analyses led us to conclude that Arg-97 interacts with the phosphoryl group of
      AMP, beginning at the binary complex (1-2 kcal/mol), continuing through the
      transition state (3.5 kcal/mol), and that Arg-132 stabilizes the transition state
      by greater than 5 kcal/mol. (vii) The functional importance of Arg-97 appears to
      be similar to that of Arg-44 [Yan, H., Dahnke, T., Zhou, B., Nakazawa, A., &
      Tsai, M.-D. (1990) Biochemistry 29, 10956-10964].(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1627571
TI  - ATP/ADP binding sites are present in the sulfonylurea binding protein associated
      with brain ATP-sensitive K+ channels.
AB  - Covalent labeling of nucleotide binding sites of the purified sulfonylurea
      receptor has been carried out with alpha-32P-labeled oxidized ATP. The main part
      of 32P incorporation is in the 145-kDa glycoprotein that has been previously
      shown to be the sulfonylurea binding protein (Bernardi et al., 1988). ATP and ADP
      protect against this covalent labeling with K0.5 values of 100 microM and 500
      microM, respectively. Non-hydrolyzable analogs of ATP also inhibit 32P
      incorporation. Interactions between nucleotide binding sites and sulfonylurea
      binding sites have then been observed. AMP-PNP, a nonhydrolyzable analog of ATP,
      produces a small inhibition of [3H]glibenclamide binding (20-25%) which was not
      influenced by Mg2+. Conversely, ADP, which also produced a small inhibition (20%)
      in the absence of Mg2+, produced a large inhibition (approximately 80%) in the
      presence of Mg2+. This inhibitory effect of the ADP-Mg2+ complex was observed
      with a K0.5 value of 100 +/- 40 microM. All the results taken together indicate
      that ATP and ADP-Mg2+ binding sites that control the activity of KATP channels
      are both present on the same subunit that bears the receptors for antidiabetic
      sulfonylureas.

PMID- 1627572
TI  - Apolipoprotein(a) and plasminogen interactions with fibrin: a study with
      recombinant apolipoprotein(a) and isolated plasminogen fragments.
AB  - Lipoprotein(a) [Lp(a)], but not low-density lipoprotein (LDL), was previously
      shown to impair the generation of fibrin-bound plasmin [Rouy et al. (1991)
      Arterioscler. Thromb. 11, 629-638] by a mechanism involving binding of Lp(a) to
      fibrin. It was therefore suggested that the binding was mediated by
      apolipoprotein(a) [apo(a)], a glycoprotein absent from LDL which has a high
      degree of homology with plasminogen, the precursor of the fibrinolytic enzyme
      plasmin. Here we have evaluated this hypothesis by performing comparative fibrin
      binding studies using a recombinant form of apo(a) containing 17 copies of the
      apo(a) domain resembling kringle 4 of plasminogen, native Lp(a), and Glu
      plasminogen (Glu1-Asn791). Attempts were also made to identify the kringle
      domains involved in such interactions using isolated elastase-derived plasminogen
      fragments. The binding experiments were performed using a well-characterized
      model of an intact and of a plasmin-digested fibrin surface as described by
      Fleury and Angles-Cano [(1991) Biochemistry 30, 7630-7638]. Binding of r-apo(a)
      to the fibrin surfaces was of high affinity (Kd = 26 +/- 8.4 nM for intact fibrin
      and 7.7 +/- 4.6 nM for plasmin-degraded fibrin) and obeyed the Langmuir equation
      for adsorption at interfaces. The binding to both surfaces was inhibited by the
      lysine analogue AMCHA and was completely abolished upon treatment of the degraded
      surface with carboxypeptidase B, indicating that r-apo(a) binds to both the
      intrachain lysines of intact fibrin and the carboxy-terminal lysines of degraded
      fibrin. As expected from these results, both r-apo(a) and native Lp(a) inhibited
      the binding of Glu-plasminogen to the fibrin surfaces.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1627573
TI  - The type II isoform of bovine brain protein L-isoaspartyl methyltransferase has
      an endoplasmic reticulum retention signal (...RDEL) at its C-terminus.
AB  - Bovine brain is known to contain two major isoforms of protein L-isoaspartyl
      methyltransferase (PIMT), an enzyme that facilitates repair of atypical L
      isoaspartyl peptide bonds in proteins. Although the two isoforms can be separated
      by anion-exchange chromatography, they appear to have similar, if not identical,
      substrate specificities in vitro. The more basic type I isoform has been
      extensively characterized, and its complete sequence has been reported. The
      present study was undertaken in an attempt to understand the structural and
      functional uniqueness of the more acidic type II isoform. Electrospray mass
      spectrometry of the intact enzymes revealed that the type II isoform is
      approximately 43 amu heavier than the type I isoform. Cyanogen bromide cleavage
      followed by HPLC with on-line mass analysis revealed that the type II isoform
      contains a unique C-terminal fragment which is 43 amu heavier than the
      corresponding fragment from the type I isoform. Amino acid composition analysis
      and direct sequencing of this fragment indicate that the type II isoform ends in
      the sequence ...RDEL, while the type I is known to end in ...RWK. Since ...RDEL,
      like ...KDEL, serves as an effective endoplasmic reticulum retention signal, we
      propose that the type II isoform serves to repair damaged proteins within the
      endoplasmic reticulum or, perhaps, within some other specialized compartment of
      the cell. Comparison of the protein sequences of the two bovine brain isoforms to
      DNA sequences for rodent PIMT reported by others suggests that the type II
      isoform may be produced by splicing within the codon for Arg224.

PMID- 1627574
TI  - Ca2+ induces transbilayer redistribution of all major phospholipids in human
      erythrocytes.
AB  - Elevating cytoplasmic Ca2+ levels in erythrocytes activates a pathway for
      transbilayer diffusion of plasma membrane phospholipids. The use of spin-labeled
      and fluorescent phospholipid analogues revealed that the pathway permits
      diffusion of all the major classes of phospholipids and does not distinguish
      between the two types of probes. Diffusion was bidirectional, began immediately
      upon elevation of cytoplasmic [Ca2+] above 50-100 microM, persisted as long as
      the [Ca2+] remained elevated, and disappeared promptly when Ca2+ levels fell.
      Diffusion was unaffected by conditions which suppress shedding of vesicles,
      discounting this event as a requisite for phospholipid reorientation induced by
      Ca2+.

PMID- 1627575
TI  - Calcium channel blockers and dysmenorrhea.
AB  - Dysmenorrhea is a significant problem in adolescents. Routine medical management
      has included analgesics and prostaglandin inhibitors. We describe the use of a
      calcium channel blocker, nicardipine, in the management of an adolescent who was
      refractory in routine treatment for severe dysmenorrhea. The patient had
      excellent resolution of menstrual cramping without serious side effects. The role
      of calcium channel blockers in the management of refractory dysmenorrhea should
      be further studied to examine a future role.

PMID- 1627576
TI  - Validity of self-report of pubertal maturation in early adolescents.
AB  - Self-report measures of sexual maturation continue to be used to classify
      pubertal development even though their reliability remains in question. This
      study examined the accuracy of self-report measures by early adolescents in two
      settings. Standardized figured drawings depicting Tanner's sexual maturation
      scale (SMS) were shown to early adolescents at school (S1) and again in a
      clinical sitting (S2), and subjects were asked to rate their own pubertal
      development. Physical examination by a physician at S2 was used to corroborate
      sexual maturation. Participating in the study were 46 males, age 11-14 years
      (mean, 12.4, SD, 1.9), and 37 females, age 11-14 years (mean, 12.7, SD, 0.7).
      Concordance rate between physical examination and self-report of pubic hair
      development (males) at S1 was 58% (kappa = 0.35, p less than 0.0001) and 78%
      (kappa = .66, p less than 0.0001) at S2. Concordance rate of self-report of
      genital development at S1 and S2 was 27% (kappa = -0.06, p less than 0.49) and
      44% (kappa = 0.18, p less than 0.04), respectively. Self-report of breast
      development demonstrated a concordance rate of 59% (kappa = 0.43, p less than
      0.0001) at S1 and 72% (kappa = 0.59, p less than 0.0001) at S2. Concordance rate
      for self-report of pubic hair development in females was 58% at S1 (kappa = 0.42,
      p less than 0.0001) and 75% at S2 (kappa = 0.64, p less than 0.0001). There was a
      tendency for subjects to overestimate their development at early stages of
      maturation and underestimate development at later stages.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1627577
TI  - Reliability of adolescents' reports of height and weight.
AB  - The purpose of our study was to compare adolescents' self-reports of height and
      weight with measured height and weight to assess possible bias in self-report.
      The study was designed to be a cross-sectional, clinical study in a primary care
      Adolescent Medicine Clinic in an urban teaching hospital. The subjects were 725
      consecutive patients aged 14-20 years (564 females, 161 males) with initial
      visits during a 2-month period. Our results showed that height was overreported
      by 0.5 cm and 0.6 cm by females and males, respectively. Weight was underreported
      by 1.5 and 1.2 kg by females and males, respectively. Differences in height or
      weight reports were not due to subjects' age. Females and males in the heaviest
      quartiles of measured weight underreported weight by significantly more than
      those in lighter quartiles. There were no differences in the accuracy of height
      or weight reports when subjects were grouped by height quartile. In conclusion,
      adolescents' self-reports of weight are particularly likely to differ from
      measured values, and these differences are largest for heavier individuals. This
      bias in self-report could affect results of clinical and survey research using
      self-report. The magnitude of such an effect would likely be small.

PMID- 1627578
TI  - Validity of self-reported weight and stature of American Indian youth.
AB  - Stature, weight, and body mass index (BMI) were obtained by self-reports and by
      measurements for 69 American Indian youth, 12-19 years of age, to determine the
      validity of self-reported values for research and clinical use. Self-reported
      weight was significantly less than measured weight by 2.64 kg and 2.76 kg for
      boys and girls, respectively. There was no systematic bias in self-reported
      stature in either sex. BMI based on self-reported values was significantly less
      than measured BMI by about 1 kg/m2 in each sex. Reporting errors for weight and
      BMI were related to measured size, with the greatest underestimates at the
      highest values of measured weight and BMI. If the patterns observed in this
      sample exist more widely, self-reported measures may not be acceptable proxies
      for measured values.

PMID- 1627579
TI  - Child abuse and mental health among adolescents in dependent care.
AB  - Do adolescents in dependent care who have been abused or neglected demonstrate
      more mental health problems than their nonabused peers? This study examined
      relationships of child abuse, depression, and self-esteem among 82 adolescents
      (mean age 14.5 years, 52% male, 82.9% white) living in a dependent care facility.
      Of these, 32 adolescents were victims of child abuse or neglect. Upon admission,
      54 adolescents were identified as depressed on the Beck Depression Inventory.
      Initial scores on the depression and self-esteem instruments did not differ by
      age, race, or history of maltreatment, though trends among subtypes of abuse were
      identified. Females had significantly lower self-esteem and tended toward more
      depression. Repeat evaluation 6 months after admission revealed significant
      improvement in both depression and self-esteem scores for the entire sample. As a
      group, however, the maltreated adolescents did not demonstrate significant
      improvement in depression, and a history of neglect was associated with less
      improvement. Depression in this dependent care sample was common, however, we did
      not identify the maltreated adolescents as having significantly more problems
      with self-esteem or depression. For some adolescents, dependent care may be an
      appropriate and helpful alternative.

PMID- 1627580
TI  - Physical and sexual abuse as predictors of substance use and suicide among
      pregnant teenagers.
AB  - In order to better define risk factors for perinatal substance abuse, data from
      352 pregnant teenagers enrolled in a comprehensive prenatal clinic were analyzed.
      Fifteen years was the average age, 82% were of minority descent, and all were
      receiving public assistance. At their first visit, a social worker obtained
      information on their home environment, family history, education, peer
      relationships, physical and mental health, and history of substance use.
      Following the interview, all teens were given a complete prenatal examination,
      including drug toxicology screening. The results indicate relatively low rates of
      substance use based on toxicology at the time of enrollment (3.6%). Self-reported
      rates of substance use prior to awareness of conception varied from 23% for
      tobacco to 17% for alcohol and marijuana; 7% of the subjects reported use of
      illicit substances after conception was confirmed. In addition, 80 of the 352
      subjects acknowledged having been physically or sexually abused and 40 admitted
      to having suicidal ideation or actions. A comparison of those teenagers who had
      been physically or sexually abused with the remaining cohort revealed significant
      differences on marijuana (p less than 0.01) and cocaine (p less than 0.05) use
      prior to awareness of conception and on prior suicidality (p less than 0.0001). A
      positive history of physical or sexual abuse delineated a subset of pregnant
      teenagers who were at high risk for self-destructive behaviors. Teenagers in
      prenatal clinics should be screened, not only for current and past substance use,
      but also for sexual and physical abuse, domestic violence, and suicidal thoughts
      and actions.

PMID- 1627581
TI  - Attitudinal and behavioral correlates of condom use in urban adolescent males.
AB  - To determine correlates of condom use in adolescent males, we administered a
      sexual behavior questionnaire to 105 urban males attending a general adolescent
      clinic. The mean age was 16.5 +/- 1.6 years, and all reported heterosexual
      activity during the prior 3 months. Condom use was significantly (p less than
      0.05) associated with perceived hassle of use (Spearman's rho = -0.40),
      perception of girlfriend's attitude toward condoms (rho = -0.36), self-confidence
      in correct use (rho = 0.26), younger age (rho = 0.25), reported degree of
      exposure to sexually transmitted disease (STD) education (rho = 0.23), perceived
      condom safety (rho = 0.23), and perceived risk of STD if not wearing a condom
      (rho = 0.21). Using stepwise multiple regression, four variables explained a
      significant amount of variation in condom use: perceived hassle of use, perceived
      girlfriend's attitude toward condom use, age, and self-confidence in correct use
      (adjusted R2 = 0.28, p less than 0.001). Intention to use free condoms was
      significantly (p less than 0.05) associated with past use (rho = 0.63),
      girlfriend's attitude toward use (rho = -0.46), self-confidence in correct use
      (rho = 0.36), perceived hassle (rho = -0.31), and degree of exposure to STD
      education (rho = 0.25). Three variables in a regression model explained a
      significant amount of variation in intent to use free condoms: self-reported past
      use, girlfriend's attitude, and self-confidence in correct use (adjusted R2 =
      0.51, p less than 0.001).

PMID- 1627582
TI  - Comparison of human immunodeficiency virus related knowledge, attitudes,
      intentions, and behaviors among sexually active and abstinent young adolescents.
AB  - Although young sexually active adolescents are at greater risk for human
      immunodeficiency virus (HIV) acquisition than their abstinent peers, little is
      known about their respective HIV-related knowledge, attitudes, and general risk
      behaviors. This study of middle school adolescents (n = 1379; mean age, 13.2
      years) found that the sexually active boys, compared with their peers, were less
      knowledgeable about HIV, less fearful of HIV, less tolerant of people with
      acquired immunodeficiency syndrome (AIDS), riskier in non-HIV-related attitudes
      and had a greater history of other risk behavior. A similar, but less marked
      pattern, was found for girls. It is suggested that physicians counsel all
      adolescents about HIV and sexuality during office visits and that early
      adolescent sexuality should prompt special efforts in HIV education/counseling.

PMID- 1627583
TI  - Barriers to adolescent prenatal care.
AB  - It is estimated that over one-half of all adolescent mothers receive inadequate
      prenatal care. Our objectives were to explore the barriers to care as perceived
      by adolescents and to develop a model to identify adolescents at risk for
      inadequate care. Structured interviews were conducted with 101 adolescents less
      than 17 years of age who delivered infants at an urban university hospital
      between September 1988 and January 1989. All the interviews were conducted within
      48 hr of delivery by a single investigator. The Maternal Health Services Index
      was used to divide subjects into those who received inadequate care (Group 1, n =
      37) and those who received intermediate or adequate care (Group 2, n = 64). Both
      groups were predominantly black (99%), poor (mean Hollingshead score = 2), and
      unmarried (99%). Groups 1 and 2 differed (p less than 0.05) in 12 variables
      pertaining to beliefs about prenatal care and course during the pregnancy. Of the
      12 variables, 7 comprised a stepwise logistic regression model designed to
      maximally differentiate Groups 1 and 2--negative attitudes towards physicians
      (20% vs 6%), perceived importance of first trimester care (78% vs 94%), confusion
      about available prenatal services (24% vs 5%), lack of health insurance (41% vs
      16%), exposure to pregnant friends (76% vs 95%), mean gestational age at
      recognition of pregnancy (15 wks vs 11 wks), and desire for an adolescent-only
      prenatal clinic (78% vs 58%). The adjusted odds ratios of the variables ranged in
      declining order from 15.4 to 4.7. The attributable risks, or etiologic fractions,
      of the variables ranged in increasing order from 0.19 to 0.49. Receiver-operating
      characteristic curve analysis of the model demonstrated a curve area of 0.89 +/-
      0.04, significantly better than chance. We conclude that the model clarifies the
      barriers to care and helps identify pregnant adolescents who are likely to
      receive inadequate prenatal care.

PMID- 1627584
TI  - Access to health care for adolescents. A position paper of the Society for
      Adolescent Medicine.

PMID- 1627586
TI  - Glutathione S-transferase of mouse liver: sex-related differences in the
      expression of various isozymes.

PMID- 1627585
TI  - Quantitative separation of uric acid and allantoin from rat liver tissue.
AB  - A simple procedure is described for the assay of liver uric acid and allantoin
      and their specific radioactivity after administration of a radioactive precursor.
      Uric acid was quantified by the uricase reaction in liver trichloroacetic acid
      (TCA) extracts. The 'true' allantoin content of the liver could be estimated only
      after precipitation with Hg-acetate, a step by which the standard allantoin was
      also quantitatively recovered. Crude extracts lead to the evaluation of
      'apparent' allantoin. For the determination of specific radioactivity, the Hg
      acetate precipitate was further purified by ion-exchange chromatography. The
      purity of the two metabolites was confirmed by ultraviolet absorbance spectra,
      HPLC, constancy of specific radioactivity and the absence of amino acids. The
      incorporation of [14C]formate into uric acid and allantoin in the liver was
      studied by this procedure. The radioactivity in allantoin was several-fold higher
      than that in uric acid up to 60 min after administration of the precursor. This
      quite unexpected result is not easily explained on the basis of current
      knowledge.

PMID- 1627587
TI  - Time course characterization of the induction of cytochrome P-450 2E1 by pyrazole
      and 4-methylpyrazole.
AB  - Cytochrome P-450 (P-450) 2E1 is under transcriptional and post-transcriptional
      control. Well-defined time courses were carried out to compare the effect of
      pyrazole and 4-methylpyrazole on catalytic activities, apo-P-450 2E1 levels and
      mRNA levels to evaluate whether induction of P-450 2E1 is preceded by altered
      mRNA levels. Two days of treatment with pyrazole or three days of treatment with
      4-methylpyrazole resulted in significant induction of P-450 2E1, as assessed by
      Western blots and by oxidation of dimethylnitrosamine or p-nitrophenol. No
      changes in mRNA levels were detected with either inducer. Within 2 h of the
      second treatment with pyrazole, maximal induction of P-450 2E1 was observed,
      however, a 8-12 h time-dependent period was required after the third treatment
      with 4-methylpyrazole for maximal induction. Irrespective of the time period,
      increased catalytic activity and P-450 2E1 appears to reflect a post
      transcriptional mechanism. A single treatment with 4-methylpyrazole increased P
      450 2B1/B2 levels and oxidation of pentoxyresorufin about 2- to 3-fold. No change
      in mRNA levels for 2B1/B2 was observed. Although significant, the induction of
      2B1/B2 by 4-methylpyrazole is more than an order of magnitude less than that by
      phenobarbital. Pyrazole did not induce 2B1/B2. It appears that, similar to
      acetone and ethanol, 4-methylpyrazole may increase several P-450 isozymes,
      whereas pyrazole is more specific for induction of P-450 2E1.

PMID- 1627588
TI  - Purification and partial characterization of xanthine oxidase from human milk.
AB  - Xanthine oxidase was purified from human milk in yields comparable with those
      obtained from bovine milk. The freshly purified enzyme appeared homogeneous in
      gel permeation FPLC and SDS-PAGE, consistent with its being a homodimer with
      total M(r) 290,000 +/- 6000. The ultraviolet/visible absorption spectrum differed
      only slightly from that of bovine milk enzyme and showed an A280/A450 ratio of
      5.13 +/- 0.29, indicating a high degree of purity. Xanthine oxidase activities of
      purified enzyme varied with batches of milk, ranging between 3 and 46 mU/mg
      protein; values that are some two to three orders of magnitude smaller than those
      shown by the most highly purified samples of bovine milk enzyme. Direct
      comparison with commercially-available bovine milk enzyme showed that activities
      involving xanthine as reducing substrate were 1-6% that of the bovine enzyme,
      whereas those involving NADH, in contrast, were of the same order for the two
      enzymes. Anaerobic bleaching experiments indicated that less than 2% of the human
      enzyme was present as a form active with xanthine. These findings, together with
      the activity data, are consistent with a very high content, possibly greater than
      98%, of demolybdo- and/or desulpho-forms of human enzyme, both of which occur, to
      a lesser extent, in bovine xanthine oxidase. Molybdenum assay indicated that
      demolybdo-enzyme could only account for some 26% of this inactive component,
      suggesting that desulpho-enzyme may account for the remainder.

PMID- 1627589
TI  - Interaction of carnitine with mitochondrial cardiolipin.
AB  - The physiological role of L-carnitine is to determine the transport of acyl-CoA
      through the mitochondrial membrane. However, some observations may also suggest a
      direct effect of the molecule per se on the physical properties of the membrane,
      most probably at the level of the binding site. This possibility has been
      investigated by studying the influence of adriamycin, a drug that binds to
      cardiolipin, on the effect of carnitine on isolated rat liver mitochondria. It
      has been found that adriamycin almost abolishes the activating effect of
      carnitine on state 2 respiration. The effect and its inhibition is seen by using
      either the L-form of carnitine or the D-form or both. Cardiolipin removes the
      effect of adriamycin and restores the activation by carnitine. It is proposed
      that some effects of carnitine on mitochondrial properties may be the result of
      interaction of carnitine with cardiolipin at the membrane level.

PMID- 1627590
TI  - Insulin binding to liver nuclei from lean and obese mice is altered by dietary
      fat.
AB  - Insulin binding to the plasma membrane is known to be altered by modifying the
      membrane composition through dietary treatment. As insulin binding receptors are
      also present on nuclear membrane, this study was undertaken to investigate if
      specific binding of insulin to the liver nuclei is altered by diet. 8-wk-old
      female C57 B 6J lean and ob/ob mice were fed semipurified diets containing 20%
      (w/w) fat of either high or low polyunsaturated-to-saturated (P/S) fatty acid
      ratio for 4 wk. Liver nuclei were prepared, insulin binding was measured and
      nuclear phospholipids were isolated for lipid analysis. Insulin binding was
      highest in nuclei prepared from lean mice fed a high P/S diet. Specific binding
      of insulin to nuclei prepared from obese mice was also increased by the high P/S
      diet, but to a lesser extent compared to lean mice. Feeding a high P/S diet
      increased polyunsaturated fatty acid content of membrane phospholipids from both
      lean and ob/ob mice. Obese mice were characterized by higher levels of
      arachidonic acid and lower levels of linoleic acid in phosphatidylcholine. The
      present study establishes that insulin binding to liver nuclei is increased by
      feeding a high P/S diet, and that insulin binding to liver nuclei from obese mice
      is lower than from lean mice.

PMID- 1627591
TI  - The structural elucidation of the two positional isomers of a mono-glucopyranosyl
      mono-acyl glycerol derivative from Cystobacter fuscus (Myxobacterales).
AB  - The structures of two glycolipids produced by Cystobacter fuscus Cb 685 have been
      determined by 1H-NMR spectroscopy including 2D-techniques, as the positional
      isomers 1- and 2-isopentadecanoyl-3-beta-D-glucopyranosyl-X-glycerol. The chain
      length of the fatty acid residue determined by 13C-NMR spectroscopy has been
      confirmed by negative ion FAB-mass spectrometry.

PMID- 1627592
TI  - An anti-probasin monoclonal antibody recognizes a novel 40-kDa protein localized
      in rat liver and a specific region of kidney urinary tubule.
AB  - Immunoblotting with a monoclonal antibody against probasin (rat prostatic
      secretory protein) showed that a 40-kDa protein antigenically related to probasin
      was localized in rat liver and kidney. The contents of probasin in these organs
      were negligible. Immunostaining revealed that the 40-kDa protein (probasin
      related antigen: PRB-RA) was expressed in the liver parenchymal cells and the
      kidney urinary tubular epithelial cells in outer stripe. The content of PRB-RA in
      the kidney was low during 0 to 2 weeks of age, then rapidly increased about 10
      fold from 2 to 8 weeks of age. The content in the liver increased about 2-fold
      during the period, reaching a value of 10-12 ng/micrograms protein, which was ten
      times higher than that in the kidney. PRB-RA was purified from rat liver by ion
      exchange chromatography, gel filtration and fast protein liquid chromatography on
      a hydroxyapatite column. The purified protein formed insoluble aggregates in the
      absence of a detergent, and it had a blocked amino terminal. The amino acid
      sequence of a peptide generated by tryptic digestion of alkylated PRB-RA was
      determined. Computer analysis showed that there was no protein having a
      significant homology with the peptide. These results indicate that a novel 40-kDa
      protein with a structural similarity to probasin is localized in rat liver and
      kidney, and might bear a function specific to these organs.

PMID- 1627593
TI  - Identification of a rhodopsin photoreceptor in Euglena gracilis.
AB  - Visual pigments are a class of receptor proteins that absorb light and trigger
      sensory signals. Retinal-containing proteins are used in nature as photoreceptors
      mainly in animals vision. Mammalian rhodopsin is the best studied example of a
      light sensor which couples photon absorption to a cascade of biochemical
      reactions amplifying the input signal. A surprising discovery was to find
      rhodopsin also in Archaebacteria and in unicellular eukaryotes. On the basis of
      absorption microspectroscopic measurements and of inhibition experiments on
      pigment biosynthetic pathways, we have recently suggested that a rhodopsin could
      be the functional receptor of the visual process in Euglena gracilis, a
      flagellate which can use light directly to promote photosynthetic reactions, or
      as an incident flux of information to adjust its swimming orientation. We here
      report purification and identification of all-trans-retinal by column
      chromatography, HPLC and GC-MS in E. gracilis; these findings indicate with
      absolute certainty that rhodopsin is the photoreceptor molecule of this
      microorganism.

PMID- 1627594
TI  - Isolation and characterization of type IX collagen-proteoglycan from the Swarm
      rat chondrosarcoma.
AB  - Type IX collagen was partially purified from the Swarm rat chondrosarcoma by a
      series of a conventional salting-out procedures. The preparation was further
      separated by anion exchange chromatography into an unbound and a bound fraction
      in an A230 ratio of about 5:1. On sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, the bound fraction appeared as a broad band, whose molecular
      mass ranged from 250 to 270 kDa. Digestion with chondroitinase ABC reduced the
      apparent molecular mass of the bound fraction to about 250 kDa, a value
      comparable to the molecular mass of the unbound fraction. Tryptic peptide maps of
      the protein moieties of unbound and bound forms showed that their molecular
      structures were basically identical. A monoclonal antibody specific for LMW, one
      of the pepsin-resistant fragments of the rat sarcoma type IX, reacted with both
      the unbound and bound fractions. Together the results indicate that the unbound
      and bound fractions represent a type IX collagen devoid of the chondroitin
      sulfate chain and its proteoglycan form with covalently bound chondroitin
      sulfate, respectively. The extent of glycosaminoglycan attachment to type IX
      collagen molecules in rat chondrosarcoma (about 16%) is quite different from the
      extents described in chick embryo cartilage (about 80%), chick vitreous humour
      (100%) and bovine cartilage (less than 5%). Further studies on the neoplastic
      tissue will offer additional information regarding the biological basis and
      biological consequences of the glycosaminoglycan attachment to type IX collagen
      molecules.

PMID- 1627595
TI  - Formation, separation and characterization of three beta-1,3-glucanases from
      Sclerotium glucanicum.
AB  - The appearance of beta-1,3-glucanases in supernatants of Sclerotium glucanicum
      cultures was followed by SDS-PAGE and shown to be dependent on cultivation time.
      Three beta-1,3-glucanases were isolated and purified. Glucanase I and III
      appeared homogeneous on SDS-PAGE with molecular masses of 85 and 33.5 kDa,
      respectively. Enzyme I was an endo-splitting beta-1,3-glucanase. In hydrolyzing
      laminarin it released glucose, laminaritriose and laminaribiose as major
      endproducts and smaller amounts of higher oligosaccharides. Enzyme III was an exo
      beta-1,3-glucanase removing glucose from laminarin and gentiobiose and glucose
      from scleroglucan. For laminarin as substrate the Km of enzyme I and III was 2.5
      and 3.33 mg/ml, respectively. Enzyme II was only partially purified and found to
      be also an exo-beta-1,3-glucanase, releasing glucose as the only hydrolysis
      product from laminarin. It did not attack scleroglucan. Its molecular weight was
      determined to be 78 kDa. Optimum pH and temperature of the three enzymes were
      determined. The three activities were significantly inhibited by 1 mM Hg2+.

PMID- 1627596
TI  - Evaluation of the amount of acyl-CoA elongases in leek (Allium porrum L) leaves.
AB  - Polyclonal antibodies have been raised against the acyl-CoA elongase purified
      from leek epidermal cells. The antibodies recognize the fractions containing the
      elongating activity after DEAE or Ultrogel chromatography and their response with
      the other fractions is very low. The immune complex is immunoprecipitable with
      Protein A-Sepharose. 1% of the solubilized proteins from leek epidermis
      microsomes are immunoprecipitated. The immunoprecipitate contains an elongating
      activity which is 86 +/- 20-times that of the unbound fraction.

PMID- 1627597
TI  - Further mechanistic study on intestinal absorption enhanced by unsaturated fatty
      acids: reversible effect by sulfhydryl modification.
AB  - In order to study the relationship between the sulfhydryl (SH) modification of
      membrane-associated proteins and the oleic acid-induced permeability enhancement
      of the colonic mucosa, in vitro and in situ absorption studies were performed
      using rat colon and carboxyfluorescein as an impermeable dye. The pretreatment of
      the mucosa with diamide, a bifunctional sulfhydryl modifier, in in vitro
      experiments with the everted colonic loops reduced the absorption enhancing
      effect of oleic acid in a concentration-dependent manner, less inhibitory effect,
      though just a little, was observed as compared to N-ethylmaleimide. The
      inhibition caused by the addition of diamide was absolutely restored by exposure
      of the mucosa to dithiothreitol. On the other hand, these SH modifiers showed no
      pronounced effect on the in vivo permeability of quinine which is well-known to
      be absorbed by a passive transport system mainly via the membrane lipid bilayer.
      These results obtained in the present study have identified an important role of
      the functional SH groups of membrane proteins on modulating the permeability
      alteration of the mucosal epithelium provoked by oleic acid. Furthermore, the SH
      proteins have been revealed as being unimportant in the intestinal absorption of
      lipoid-soluble compounds.

PMID- 1627598
TI  - Identification and purification of a novel serine/threonine messenger-independent
      growth-related protein kinase from lactating goat mammary gland.
AB  - A second messenger-independent serine/threonine protein kinase from lactating
      goat mammary gland is purified and characterized. The purification steps include:
      homogenization, ultracentrifugation, ammonium sulphate precipitation, DEAE
      Sepharose, phosphocellulose, hydrophobic and Mono Q columns. On the final step of
      purification the enzyme is revealed as a single band of mol wt 45,000 on silver
      stained SDS-PAGE. Mg2+ and K+ are necessary for its optimum activity. Phosvitin
      and casein are substrates for the enzyme but kemptide, RRREEETEEE, protamine and
      histone mixture are all poorly phosphorylated. The kinase is inhibited by
      quercetin, heparin, random tyrosine- and glutamic acid-containing polymers, Ca2+,
      NaF, 2,3-bis-phosphoglycerate. 1 mM Mn2+ affects positively the basal level of
      the kinase activity but 5 mM Mn2+ completely suppress the effect of 10 mM Mg2+.
      Km of this enzyme for ATP is 1.57 microM and pH optimum is from 6 to 7. Isolation
      of this kinase is facilitated by its unusually high affinity for
      phosphocellulose.

PMID- 1627599
TI  - Generation of one set of monoclonal antibodies specific for a-pathway ganglio
      series gangliosides.
AB  - We established five murine monoclonal antibodies (MAbs) specific for a-pathway
      ganglio-series gangliosides by immunizing C3H/HeN mice with these purified
      gangliosides adsorbed to Salmonella minnesota, followed by fusion with mouse
      myeloma cells. The binding specificities of these MAbs were determined by enzyme
      linked immunosorbent assay and immunostaining on thin-layer chromatogram. These
      five MAbs, designated GMR6, GMB28, GMB16, GMR17, and GMR11 reacted strongly with
      the gangliosides GM3, GM2, GM1, GD1a, and GT1a, respectively, that were used as
      immunogens. Three MAbs, GMB28 (anti-GM2), GMB16 (anti-GM1), and GMR11 (anti-GT1a)
      showed highly restricted binding specificities, reacting only with the immunizing
      ganglioside. None of the other various authentic gangliosides or neutral
      glycolipids was recognized. On the other hand, the other two MAbs, GMR6 (anti
      GM3) and GMR17 (anti-GD1a) exhibited broader specificities. MAb GMR6 cross
      reacted with GM4, GM1b, GD1a, GT1b, and IV3NeuAc alpha-nLc4Cer. MAb GMR17 also
      reacted with GM1b and GT1b. Neither GMR6 nor GMR17 reacted with other
      gangliosides or neutral glycolipids tested. Using these MAbs, we determined the
      expression of these gangliosides, especially GM1, GD1a, and GT1a on mouse, rat
      and human leukemia cells. GM1 and GD1a were expressed on some leukemia cells,
      whereas GT1a was not detected in these cells.

PMID- 1627600
TI  - Molecular expression of the negative growth factor murine beta-galactoside
      binding protein (mGBP).
AB  - Characterisation of the negative growth factor mGBP at molecular and biological
      levels indicates that the protein has no lectin nature and suggests instead a
      participation in the cytokine network. The protein is shown to be expressed as a
      monomer in two forms, one of which is non-covalently linked to a glycan complex.
      This confers greater efficiency to the inhibitor and may favour a paracrine role.
      The two monomeric forms may oxidise into tetramers which retain biological
      activity, but lack ability to link to specific saccharide residues.

PMID- 1627601
TI  - Molecular aging of lens crystallins and the life expectancy of the animal. Age
      related protein structural changes studied in situ by Raman spectroscopy.
AB  - In order to investigate the relationship of molecular aging of lens crystallins
      to an animal's life expectancy or to the type of the lens, Raman spectra have
      been measured in situ for rabbit and guinea-pig lens nuclei at various stages of
      aging; these spectra have been compared with those of rat and mouse lens nuclei
      previously reported. Lens aging results in pronounced differences among the Raman
      spectra of the lens nuclei of the four species. It is shown that the rates of
      dehydration, inter- and intramolecular disulfide bond formation, and
      microenvironmental changes in the tryptophan residues of lens crystallins are
      different among the four species. Much faster changes occur for rat and mouse,
      which have a shorter life expectancy (2 years) and give rise to hard lens nuclei
      while slower changes occur for rabbit and guinea-pig, which have a longer life
      expectancy (5-7 years), and give soft lens nuclei. In addition, the Raman data
      reveal, for all the species investigated, that there are correlations among the
      rates of the dehydration, the inter- and intramolecular disulfide bond formation,
      and the microenvironmental changes in the tryptophan residues. Therefore, there
      seems to be a common mechanism for molecular aging of lens crystallins among the
      four species, although the rate of the molecular aging strongly depends upon the
      life expectancy of the animal and the type of the lens. The most important factor
      determining the rate of the molecular aging is probably the dehydration which
      decreases free water in the lens nucleus.

PMID- 1627602
TI  - Mapping of the active site of T7 RNA polymerase with 8-azidoATP.
AB  - The photoaffinity analog of ATP, 8-azidoATP, labels T7 RNA polymerase.
      Photoincorporation exhibits saturation behavior and is protected against by the
      substrate ATP. 8-AzidoATP is a competitive inhibitor of ATP incorporation with Ki
      approximately 40 microM. The photolabeled T7 RNA polymerase, following cyanogen
      bromide digestion, was analyzed by phenylboronate agarose column chromatography
      followed by reverse-phase high pressure liquid chromatography. Sequencing of the
      peptides labeled with radioactive photoprobe allowed the identification of three
      peptides, P314-M362 (I), L550-M666 (II), and F751-M861 (III). These peptides are
      in the proximity of the photoprobe 8-azidoATP and, therefore, expected to contain
      functionally significant residues and define an active site domain. These
      peptides (I and II) contain residues previously implicated in T7 RNA polymerase
      activity or show homology to active site regions of the Klenow fragment of DNA
      polymerase I (II and III).

PMID- 1627604
TI  - Temperature-jump studies and polarized absorption spectroscopy of methemoglobin
      thiocyanate single crystals.
AB  - Association equilibria and association kinetics of the thiocyanate binding
      reaction to methemoglobin in single crystals and solution are studied using
      temperature-jump technique and polarized absorption spectroscopy. Different
      kinetic constants are found for the reaction in solution and crystal phase for
      the alpha- and beta-subunits of the methemoglobin tetramer. The reduction of the
      reactivity of the alpha- and beta-subunits in crystalline phase is 6-fold and 2.4
      fold, respectively, compared to the values found in solution. The intramolecular
      binding reaction of the N epsilon of the distal histidine E7 which is observed in
      methemoglobin in solution cannot be detected in single crystals. Our results
      suggest that crystallization of hemoglobin has little influence on small-scale
      structural fluctuations which are necessary for ligands to get to the binding
      sites and large-scale structural motions are suppressed.

PMID- 1627603
TI  - Human red cell acid phosphatase (ACP1): the primary structure of the two pairs of
      isozymes encoded by the ACP1*A and ACP1*C alleles.
AB  - The Af, As, Cf and Cs isozymes encoded by the human red cell acid phosphatase
      ACP1*A and ACP1*C alleles, respectively, have been sequenced. All four isozymes
      consist of a single non-glycosylated peptide chain (157 residues), acetylated at
      the amino-terminal alanine residue. Each f isozyme differs from the corresponding
      s isozyme over the sequence segment 40-73, while the remaining four-fifth of the
      molecules are identical. These findings are consistent with results for the Bf
      and Bs isozymes encoded by the common ACP1*B allele and confirm that the presence
      of a specific f or s segment is a common property to ACP1 isozymes. This supports
      our hypothesis that f and s isozymes are generated by alternative splicing of
      exons in the primary RNA transcript. Cf and Cs are identical in sequence with Bf
      and Bs, respectively. Thus, the ACP1*B and ACP1*C alleles encode exactly the same
      pair of isozymes, the only difference at the protein level being the ratio of f
      and s isozyme. Af and As differ from the Bf and Bs isozymes by a single
      substitution at residue 105; Arg and Gln, respectively. These observations
      explain the electrophoretic identity of the B and C isozyme pairs and the higher
      P(i) of the A isozyme pair.

PMID- 1627605
TI  - Secondary structure of synthetic peptides derived from the repeating unit of a
      giant secretory protein from Chironomus tentans.
AB  - The secretory proteins of Chironomus tentans larvae, which are used to construct
      underwater feeding and pupation tubes, assemble into complexes in vitro. Members
      of a family of 1000 kDa proteins, the spIs, appear to form the fibrous backbone
      of the assembled complexes. The spIs consist of a core of tandemly repeating
      units of 60 to 90 amino acids that can be subdivided into two regions: the
      subrepeat region, made up of short internal repeats, and the constant region,
      which lacks simple subrepeats. We have synthesized peptides representative of the
      constant and subrepeat regions of one of the spIs, and have examined their
      secondary structure using Fourier transform IR and CD spectroscopy. The IR
      spectrum of the constant peptide indicates that this peptide has alpha-helical
      regions and beta-turns. The CD spectrum confirms this. The IR spectrum of the
      subrepeat peptide is similar to that of the poly(Gly)II helix, and also may
      indicate the presence of beta-turns. The CD spectrum is consistent with this
      helical structure. Extrapolation of these results to intact spIs is in agreement
      with secondary structure prediction and modeling studies. Our results indicate
      that the alpha-helices and poly(Gly)II-like helices are not arranged as coiled
      coils, which are often found in fibrous proteins. We suggest that these
      structural elements may be in an unusual arrangement in the spIs, organized as
      alternating alpha-helices and poly(Gly)II or collagen-like helices, interspersed
      with beta-turns.

PMID- 1627606
TI  - Recombinant bovine rhodanese: purification and comparison with bovine liver
      rhodanese.
AB  - Recombinant bovine rhodanese (thiosulfate: cyanide sulfurtransferase, EC 2.8.1.1)
      has been purified to homogeneity from Escherichia coli BL21(DE3) by cation
      exchange chromatography. Recombinant and bovine liver rhodanese coelectrophorese
      under denaturing conditions, with an apparent subunit molecular weight of 33,000.
      The amino terminal seven residues of the recombinant protein are identical to
      those of the bovine enzyme, indicating that E. coli also removes the N-terminal
      methionine. The Km for thiosulfate is the same for the two proteins. The specific
      activity of the recombinant enzyme is 12% higher (816 IU/mg) than that of the
      bovine enzyme (730 IU/mg). The two proteins are indistinguishable as to their
      ultraviolet absorbance and their intrinsic fluorescence. The ability of the two
      proteins to refold from 8 M urea to enzymatically active species was similar both
      for unassisted refolding, and when folding was assisted either by the detergent,
      lauryl maltoside or by the E. coli chaperonin system composed of cpn60 and cpn10.
      Bovine rhodanese is known to have multiple electrophoretic forms under native
      conditions. In contrast, the recombinant protein has only one form, which
      comigrates with the least negatively charged of the bovine liver isoforms. This
      is consistent with the retention of the carboxy terminal residues in the
      recombinant protein that are frequently removed from the bovine liver protein.

PMID- 1627608
TI  - Glycosylation of membrane cofactor protein (CD46) in human trophoblast, kidney
      and platelets.
AB  - Many cell surface glycoconjugates are differentiation markers and are involved in
      cell-cell and intermolecular interactions in development, immunity and cancer.
      Membrane cofactor protein (MCP) comprises structurally related 65 and 55 kDa
      glycoproteins that bear O- and N-linked glycans. MCP prevents amplification of
      autologous complement action on human cells. We used immunoblotting with MCP
      specific monoclonal antibody TRA-2-10 to determine lectin-binding properties and
      glycosidase sensitivities of MCP in a study of cell-specific variation in
      glycosylation of this protein. The results showed that N-linked glycans on
      placental syncytiotrophoblast and cytotrophoblast, kidney and platelet MCP are
      similar in binding to concanavalin A and Lens culinaris lectins, but are not
      bound by leucophytohemagglutinin. Lectin binding prior to and after neuraminidase
      digestion indicates that MCP from these sources is highly sialylated. 65 kDa MCP
      was confirmed to contain more O-linked glycans than 55 kDa MCP. A fraction of
      platelet 65 kDa MCP is distinct, however, in bearing peripheral fucose residues.
      Syncytiotrophoblast is unique in containing a 110 kDa form of MCP in non-reducing
      SDS-PAGE that resembles 65 kDa MCP in glycosylation. Chorion laeve MCP in 4 of 8
      preparations was unusually heterogeneous and differed from syncytiotrophoblast
      MCP after neuraminidase digestion in the forms bound to peanut agglutinin and
      WGA. The results indicated for the first time, differences in O-linked
      glycosylation of MCP in chorion laeve cytotrophoblast relative to
      syncytiotrophoblast, platelet and kidney MCP. We conclude that structures of MCP
      glycans can differ between trophoblasts and other cell types.

PMID- 1627607
TI  - Inhibition of Clostridium perfringens phospholipase C by ammonium and sulfonium
      dications.
AB  - Polyamines, alkyldiammonium and alkyldisulfonium salts, inhibit the Clostridium
      perfringens phospholipase C-catalyzed hydrolysis of 1-S-phosphocholine-2-O
      hexadecanoyl-1-mercapto-2-ethanol (1) at pH 7.5, 37 degrees C, mu = 1.0 with KCl.
      Simple saturation kinetics are observed as both 1 and [Ca2+] are varied and
      simple linear inhibition is observed. The data are consistent with a non
      competitive mechanism that involves binding of the inhibitors to free enzyme,
      E.[Ca2+] and E.[Ca2+].[S]; the inhibition constants for
      decamethylenebis(trimethylammonium) and decamethylenebis(dimethylsulfonium)
      bromides are 90 and 0.28 mM, respectively. It is suggested that the enhanced
      inhibition by the alkyldisulfonium salts results from more favorable equilibrium
      constants for contact ion-pair formation or from the formation of tetracoordinate
      sulfuranes.

PMID- 1627609
TI  - Rearrangements of the nucleosome structure in chromatin by poly(ADP-ribose).
AB  - In order to approach and clarify the effect of poly(ADP-ribose) on the
      nucleosomal structure, polynucleosomes from calf thymus were incubated with long
      poly(ADP-ribose) chains prepared in vitro and examined by ELISA with antibodies
      directed against the five individual histones H1, H2A, H2B, H3 and H4 as well as
      against two synthetic peptides in residues 1-25 of H2B and 130-135 of H3. The
      results showed that: (i) free ADP-ribose polymers did indeed interact with the
      nucleosomes; (ii) the accessibility of epitopes recognized by any of the
      different antibodies was altered, the binding of antibodies being increased or
      decreased depending on the quantity of poly(ADP-ribose) added thereby suggesting
      a modulation in nucleosome structure; (iii) for any ADP-ribose polymer
      concentration, core histones as well as histone H1 were always recognized by
      their respective antibodies, thus suggesting that poly(ADP-ribose) does not seem
      to cause complete stripping of histones from nucleosomal DNA.

PMID- 1627610
TI  - Methionine oxidation and inactivation of alpha 1-proteinase inhibitor by Cu2+ and
      glucose.
AB  - The effect of glucose/Cu2+ incubation on (a) pure methionine oxidation, (b) the
      oxidation of active-site methionine in alpha 1-proteinase inhibitor (alpha 1PI)
      and (c) the resulting activity and structural changes of this inhibitor was
      investigated. While no methionine was oxidized during a 24 day, 37 degrees C
      incubation with 0.01 M EDTA and 100 mM glucose, 64.2% oxidation occurred in 6
      days when 0.01 mM Cu2+ was added to the 100 mM glucose. The first-order rate
      constant for oxidation in 10 mM glucose, 0.01 mM Cu2+ was 0.0218 day-1. Oxidation
      was inhibited by catalase, but accelerated by ascorbate ion. The active-site
      methionyl residue of alpha 1PI was oxidized 71.3% after a 4 day incubation in 100
      mM glucose, 0.01 mM Cu2+ (pH 7.45), 0.1 M phosphate buffer. The elastase and
      trypsin inhibiting activities were lowered to 3.1 and 1.5% of control samples
      during this incubation. The inclusion of 1 mM DETAPAC, a transition metal
      chelator, resulted in a 98 + % retention of activity. Intrinsic fluorescence (350
      nm excitation, 415 nm emission) of alpha 1PI increased 576% over control for the
      sample incubated in 100 mM glucose, 0.01 mM Cu2+ and SDS-PAGE revealed protein
      fragment molecular weights of 44.4 and 39.8 kDa. These studies suggest that both
      methionine oxidation and free radical induced fragmentation contribute to loss of
      alpha 1PI activity during glucose/Cu2+ incubations.

PMID- 1627611
TI  - Specific identification of human ribonucleases by antibodies produced against two
      synthetic peptides corresponding to the N- and C-terminal amino-acid sequences of
      human urinary secretory-type ribonuclease.
AB  - Antibodies were raised in rabbits by immunizing two synthetic peptides, which
      corresponded to the N- and C-terminal 15 residues, respectively, of human urinary
      secretory ribonuclease (RNase). These antibodies did not block the RNase
      activity, but reacted well with enzymes blotted onto a transfer membrane
      following electrophoresis, and discriminated strictly between secretory- and
      nonsecretory-type RNases. Therefore, these antibodies should to be valuable tools
      for the immunological identification of human RNases.

PMID- 1627612
TI  - Expression and purification of human angiotensinogen in Chinese hamster ovary
      cells.
AB  - We have produced human angiotensinogen in Chinese hamster ovary (CHO) cells. The
      expression products were purified to homogeneity by a single column
      chromatography and its 17 amino-terminal sequences were identical to those of the
      native protein. We demonstrated the recombinant human angiotensinogen to be a
      substrate for human renin.

PMID- 1627613
TI  - Unsaturated and branched chain-fatty acids in temperature adaptation of Bacillus
      subtilis and Bacillus megaterium.
AB  - The effect of growth temperature on the cellular fatty acid profiles of Bacillus
      subtilis and Bacillus megaterium was studied over a temperature range from 40 to
      10 degrees C. As the growth temperature of B. subtilis was reduced, the lower
      melting point anteiso-acids increased, while the higher-melting point iso-acids
      decreased. Consequently the ratio of branched- to straight-chain acids was
      unaffected by temperature, although changes in the position of fatty acid
      branching and the degree of unsaturated branched-chain fatty acids occurred. In
      B. megaterium a more complicated, biphasic behaviour was observed. Saturated,
      straight-chain and iso-branched acids decreased only from 40 degrees C down to 20
      26 degrees C, and anteiso-acids decreased only from 20-26 degrees C to 10 degrees
      C, while unsaturated acids increased over the whole temperature range studied.
      Thus, in B. megaterium total branched-chain acids decreased and straight-chain
      acids increased as temperature decreased. However, the overall cellular content
      of lower-melting point fatty acids increased with decreasing temperature in both
      bacilli, and unsaturated fatty acids appeared to be essential components in the
      adaptation of the microbes to changes in temperatures. Since changes in the
      relative amounts of branched- and straight-chain fatty acid biosynthesis are
      known to reflect differences in fatty acid primers, temperature seems to affect
      not only the activity of the fatty acid desaturases but also the formation or
      availability of these primers. The results indicate, however, that notable
      species-specific regulatory features exist in this genus of bacteria.

PMID- 1627614
TI  - Polyunsaturated fatty acid incorporation into plasmalogens in plasma membrane of
      glioma cells is preceded temporally by acylation in microsomes.
AB  - Plasmalogens (1-O-alk-1'-enyl-2-acyl-sn-glycero-3-phosphoethanolamine) are major
      phospholipids in many tissues and cells, particularly of neural origin. Using
      cultured C6 glioma cells and subcellular fractions isolated on Percoll gradients
      we investigated selectivity for esterification of several polyunsaturated fatty
      acids (PUFA) in the sn-2 position of plasmalogens compared to [1-14C]hexadecanol,
      representative of de novo synthesis of the ether-linked sn-1 position. In whole
      cells at a final concentration of 105 microM PUFA, 2-4 nmol plasmalogen/mg
      protein was labeled in 4 h and 10-14 nmol in 24 h, representing 8-15% and 35-50%,
      respectively, of initial plasmalogen mass. Incorporation of label from
      hexadecanol was lower than PUFA incorporation (20:5(n-3) greater than 20:4(n-6)
      greater than 18:3(n-3) much greater than 18:2(n-6)) suggesting deacylation
      reacylation at the sn-2 position. Plasmalogens accounted for 50% of total cell
      ethanolamine phospholipids and 75% in plasma membrane. Using a novel, improved
      method for extraction of subcellular fractions containing Percoll, plasma
      membrane also was enriched in plasmalogen relative to microsomes (107.4 +/- 5.2
      vs. 40.0 +/- 2.9 nmol/mg protein). Selectivity for esterification at the sn-2
      position of plasmalogens with respect to chain length and unsaturation of the
      fatty acyl chain was similar in both subcellular fractions and reflected that of
      whole cells. Labeling of plasma membrane with PUFA and fatty alcohol lagged
      behind that of microsomes. Chase experiments in cells prelabeled with [1
      14C]18:3(n-3) for 2 h showed no significant reduction of label in plasmalogen of
      any subcellular fraction although accumulation of label in the microsomal
      fraction was slowed initially. Reduction of plasmalogen label (40-50%) did occur
      in microsomes and plasma membrane when cells prelabeled for 24 h were switched to
      chase medium with or without chase fatty acid. Our data suggest that
      esterification of PUFA to plasmalogen may occur at the endoplasmic reticulum with
      subsequent translocation to plasma membrane resulting in accumulation of
      relatively stable pools of plasmalogen that are not readily accessible for
      deacylation-reacylation exchange with newly appearing PUFA. Alternatively,
      deacylation-reacylation may occur in a more stable phospholipid pool within the
      plasma membrane but would involve a slower process than at the endoplasmic
      reticulum.

PMID- 1627615
TI  - Solubility of long-chain fatty acids in phosphate buffer at pH 7.4.
AB  - The solubility of the saturated fatty acids lauric, myristic, palmitic, and
      stearic acid and the unsaturated oleic acid at 37 degrees C in phosphate buffer
      (pH 7.4) was estimated by using two independent methods. The one was a
      conventional solubility technique measuring the concentration of dissolved fatty
      acid in buffer by using radioactive compounds. The other was a dialysis exchange
      technique monitoring possible aggregation of solvated fatty acid anions by
      measuring the rate of diffusion of labelled compound across a dialysis membrane
      under conditions of chemical equilibrium. It was found that the results were
      strongly dependent on the radiochemical purity of the fatty acids. Using highly
      purified samples of radioactively labelled fatty acids, the solubility of
      monomeric laurate was shown to be greater than 500 microM, whereas the solubility
      of monomeric myristate was found to be 20-30 microM. Palmitate, stearate, and
      oleate solutions, on the other hand, showed a tendency to aggregation even at
      concentrations below 1 microM. Special attention was given to palmitate, as a
      reference compound for long-chain fatty acids, and the solubility of monomeric
      palmitate was estimated to be lower than 10(-10) M.

PMID- 1627616
TI  - Effect of the human cholesteryl ester transfer protein on the particle size
      redistribution of specific subpopulations of high density lipoproteins-3.
AB  - The effect of the cholesteryl ester transfer protein (CETP) on the size
      redistribution of high density lipoprotein-3 (HDL3) particles containing either
      apolipoprotein A-I without apolipoprotein A-II, designated HDL3 (A-I w/o A-II),
      or apolipoprotein A-I with apolipoprotein A-II, designated HDL3 (A-I w A-II), was
      investigated by incubating HDL3 at 37 degrees C in the presence of a purified
      preparation of CETP. At the end of the incubation, the distribution of total HDL3
      as well as HDL3 (A-I w/o A-II) particles, recovered after immunoprecipitation of
      HDL3 (A-I w A-II) particles with anti-apo A-II antibodies, was determined by non
      denaturing polyacrylamide gradient gel electrophoresis. Total HDL3
      ultracentrifugally isolated from plasma consisted of two distinct subpopulations
      of particles with apparent diameters of 8.5 and 7.8 nm. The distribution profile
      of HDL3 (A-I w/o A-II) particles, revealed that the HDL3 subpopulation with a
      mean diameter of 8.5 nm comprised two typs of particles, containing either only
      apo A-I or apo A-I with apo A-II, while the lipoprotein subpopulation with a mean
      diameter of 7.8 nm consisted exclusively of particles containing both
      apolipoproteins. During incubation at 37 degrees C, CETP induced the
      redistribution of HDL3 with a mean apparent diameter of 8.5 nm towards particle
      subpopulations of larger (9.4 nm diameter) and smaller (7.8 and 7.4 nm diameter)
      size. It was demonstrated that the CETP-mediated conversion of HDL3 concerned
      both type of particles. CETP preferentially induced the transformation of HDL3 (A
      I w A-II) particles with a mean diameter of 8.5 nm into larger (9.4 nm diameter)
      and smaller (7.8 nm diameter) particles containing apo A-I and apo A-II.
      Secondly, CETP induced a shift of HDL3 (A-I w/o A-II) particles with a mean
      diameter of 8.5 nm towards particles of smaller size (7.4 nm diameter) containing
      only apo A-I, while HDL3 (A-I w A-II) particles with mean diameters of 7.8 and
      9.4 nm remained stable. In addition, this study demonstrated that the
      redistribution of HDL3 particles was accompanied by a dissociation of
      apolipoprotein A-I from the lipoprotein surfaces. The effect of myristic acid on
      CETP-induced HDL3 redistribution was mainly due to a redistribution of HDL3 (AI
      w/o AII) particles.

PMID- 1627617
TI  - Characterization of a bile salt-dependent cholesteryl ester hydrolase activity
      secreted from HepG2 cells.
AB  - HepG2 cells and medium were assayed for cholesteryl ester hydrolase (CEH)
      activity in the presence and absence of sodium cholate. Although bile salt
      dependent CEH activity was measured in the medium at 6 to 96 h (up to 4500 pmol/h
      per mg cell protein), there was very little activity detected in the
      corresponding cell homogenates (less than 70 pmol/h per mg cell protein).
      Activity in the medium was expressed only in the presence of trihydroxy bile
      salts and was maximal at 40 mM cholate and pH 7.5. Incubation of HepG2 cells with
      brefeldin A resulted in an 80 to 90% inhibition of secretion of the bile salt
      dependent CEH activity, while only inhibiting total protein secretion by 42%.
      Bile salt-dependent CEH activity could also be detected in rat liver perfusates.
      Although there was measurable activity in all of 14 livers analyzed (47 +/- 10
      and 53 +/- 17 nmol/h per g liver per h perfusion during two 5-min collections
      after 15 and 30 min of perfusion, respectively), it did not correlate with the
      activity found in corresponding liver homogenates, as only four livers had
      detectable bile salt-dependent CEH activity. These results provide evidence for
      the secretion of a bile salt-dependent CEH activity, from both a hepatic cell
      line and the intact liver, that has similar properties to the enzyme previously
      isolated from rat liver homogenates and rat pancreas.

PMID- 1627619
TI  - The intracellular storage and turnover of apolipoprotein B of oxidized LDL in
      macrophages.
AB  - We have studied the effect of several chemical modifications to low-density
      lipoprotein (LDL) on its intracellular fate in macrophages. Native, acetylated
      and oxidized 125I-LDL were supplied to cultured peritoneal macrophages and the
      accumulation and distribution of labelled protein was measured both during uptake
      and a subsequent chase period. The intracellular accumulation of macromolecular
      oxidized LDL protein greatly exceeded that of acetylated LDL, despite similar
      rates of uptake and common endocytic receptors. The accumulation of intracellular
      apoprotein was proportional to the extent to which the LDL was first oxidized.
      ApoB of oxidized LDL was more resistant to proteolysis by lysosomal enzymes than
      native apoB. Interestingly, acetylated apoB is more rapidly hydrolysed than the
      native protein. 125I-LDL modified with 4-hydroxynonenal (HNE) and myricetin, but
      not with malondialdehyde (MDA), was also accumulated within macrophages in a high
      molecular weight fraction, and was resistant to cell-free lysosomal proteolysis.
      These forms of LDL also contained crosslinked apoB molecules. It is suggested
      that the accumulation of oxidized LDL within macrophages may he due, at least in
      part, to the formation of inter- or intra-molecular crosslinks in apoB which
      render it less accessible to proteolysis.

PMID- 1627618
TI  - Dramatic differences in lipoprotein composition among gray short-tailed opossums
      (Monodelphis domestica) fed a high cholesterol/saturated fat diet.
AB  - Lipoproteins of gray short-tailed opossums (Monodelphis domestica) were
      characterized to determine the basis of differences among individuals in response
      to a challenge diet enriched in saturated fat and cholesterol. Animals were
      selected from two phenotypic groups (high and low plasma cholesterol response to
      the challenge diet). Half of the animals in each group were fed basal diet (8.1%
      fat and 0.04% cholesterol by weight), and the remainder were fed challenge diet
      (17.7% fat and 0.61% cholesterol). The plasma cholesterol values of both groups
      fed the basal diet and of low responders fed the challenge diet were similar. In
      addition, both very-low-density and low-density lipoproteins (VLDL+LDLs) and high
      density lipoproteins (HDLs) were similar among these groups in density and in
      lipid and apolipoprotein compositions. In contrast, the high responders fed the
      challenge diet showed a 7-fold increase in total plasma cholesterol, which was
      primarily a consequence of increases in the VLDL+LDL cholesterol component
      defined by heparin-Mn precipitation. Moreover, the VLDL+LDLs were more
      heterogeneous and were characterized by decreased densities. The VLDL+LDLs of the
      high-responding group had higher levels of apolipoprotein (apo) B and apoE than
      the other groups. Plasma apoB concentrations estimated by dot blotting techniques
      increased by 3-fold, and apoE by 44-fold in the high responding group.
      Understanding the factor(s) mediating responder phenotype in this new model
      species will expand our knowledge of the regulation of lipemic response to diet.

PMID- 1627620
TI  - Antioxidant activity of xanthophylls on peroxyl radical-mediated phospholipid
      peroxidation.
AB  - The ability of xanthophylls (canthaxanthin, zeaxanthin, and astaxanthin) as chain
      breaking antioxidants was investigated in peroxyl radical-mediated peroxidation
      of phosphatidylcholine (PC) liposomes under atmospheric conditions using lipid
      soluble and water-soluble radical generators. These xanthophylls retarded the
      chain propagation reaction of phosphatidylcholine hydroperoxides (PC-OOH)
      formation, although their activities to trap chain-carrying peroxyl radical were
      much less than that of alpha-tocopherol. In chick plasma studies, it was observed
      that endogenious xanthophylls participated in the antioxidant defenses against
      the attack of aqueous peroxyl radical. It was concluded that xanthophylls possess
      the ability to act as chain-breaking antioxidants in the peroxidation of
      membraneous phospholipids. Dietary xanthophylls may, therefore, be helpful in
      resisting membraneous phospholipids against oxidative damage in vivo.

PMID- 1627621
TI  - Effect of high levels of selected dietary essential amino acids on
      hypercholesterolemia and down-regulation of hepatic LDL receptors in rabbits.
AB  - Earlier studies showed that the elevation of serum total and low density
      lipoprotein (LDL) cholesterol levels produced in rabbits by feeding high levels
      of a casein amino acid mixture in a cholesterol-free, semipurified diet was due
      primarily to the essential amino acids (EAA) in the mixture. Replacing all of the
      non-essential amino acids in the mixture by glutamic acid (45% EAA+Glu) had
      little effect on the hypercholesterolemia produced by the EAA. Experiments
      designed to identify the hypercholesterolemic EAA showed that (i) feeding high
      levels of ketogenic EAA only (45% EketoAA) gave a substantial but variable
      elevation of serum total and LDL cholesterol and (ii) feeding high levels of all
      EAA except arginine (45% EAA-Arg) gave a particularly strong hypercholesterolemic
      response. In rabbits fed the 45% EAA-Arg diet and to a lesser extent, in those
      fed the 45% EAA+Glu diet, EDTA-sensitive binding of 125I-LDL to hepatic membranes
      in vitro was reduced compared to a control, low-cholesterolemic group fed all
      essential and non-essential amino acids at a level corresponding to 14.7% casein,
      indicating that the hypercholesterolemia was associated with down-regulation of
      hepatic LDL receptors.

PMID- 1627622
TI  - Synthesis of platelet activating factor and metabolism of related lipids in
      embryonic cells.
AB  - Primary cultures of mouse embryo palate mesenchyme (MEPM) cells incubated with 1
      O-[3H]alkyl-2-lyso-sn-glycero-3-phosphocholine ([3H])lyso-PAF) incorporated
      radiolabel into 1-radyl-2-acyl-sn-glycero-3-phosphocholine (PC) and 
      phosphoethanolamine (PE). The radiolabeled PC was insensitive to hydrolysis with
      HCl fumes, whereas at least 82% of the 3H found in the PE was hydrolyzed to 3H
      aldehydes by such treatment. Treatment of the PC with Vitride produced
      [3H]alkylglycerol; similar treatment of the PE produced [3H]alk-1-enylglycerol.
      None of the radiolabeled products yielded fatty alcohol upon reduction with
      Vitride. These findings indicate the radiolabeled PC was 1-O-alkyl-linked whereas
      the PE contained predominantly 1-O-alk-1'-enyl species with smaller amounts of 1
      O-alkyl species. Homogenates of MEPM cells which had been prelabeled with
      [3H]lyso-PAF and [14C]arachidonic acid produced 14C-fatty acid, [3H]lyso-PC, and
      [3H]alkylglycerol when incubated at selected values of pH and concentrations of
      calcium. There was no accumulation of [3H]lyso-PE in the various incubation
      mixtures. Stimulation of MEPM cells with the ionophore A23187 in the presence of
      calcium and [3H]acetate resulted in the production of 3H-platelet-activating
      factor (PAF), identified by its migration with authentic PAF and its conversion
      to 1-O-[3H]alkyl-2,3-diacetylglycerol upon treatment with phospholipase C and
      acetic anhydride. These studies demonstrate that: (i) MEPM cells are able to
      incorporate [3H]lyso-PAF into 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine, the
      storage form of PAF, and into 1-O-alk-1'-enyl-2-acyl-sn-glycero-3
      phosphoethanolamine (PE plasmalogen); (ii) endogenous 1-O-[3H]alkyl-2-acyl-sn
      glycero-3-phosphocholine can serve as a substrate for phospholipase A2 in
      homogenates; and (iii) MEPM cells have the ability to synthesize PAF, thus
      raising the possibility that this compound may play a role in modulating the
      physiology of these embryonic cells.

PMID- 1627624
TI  - Inhibition of phospholipase A2 by cis-unsaturated fatty acids: evidence for the
      binding of fatty acid to enzyme.
AB  - Calcium-dependent phospholipases A2 are markedly inhibited in vitro by cis
      unsaturated fatty acids (CUFAs) and to a much lesser extent by trans-unsaturated
      or saturated fatty acids. Thus, CUFAs may function as endogenous suppressors of
      lipolysis. To better understand the mechanism of inhibition, kinetic analysis,
      fluorescence spectroscopy and gel permeation chromatography were employed to
      demonstrate that CUFAs interact with a highly purified Ca(2+)-dependent
      phospholipase A2 from Naja mossambica mossambica venom. Arachidonate inhibited
      hydrolysis of both [1-14C]oleate-labelled, autoclaved Escherichia coli and [1
      14C]linoleate-labelled phosphatidylethanolamine in an apparent competitive
      manner. When subjected to gel permeation chromatography, [3H]arachidonate, but
      not [3H]palmitate, comigrated with the enzyme. Arachidonic and other CUFAs
      increased the fluorescence intensity of the enzyme almost 2-fold in a dose
      dependent fashion (50 microM = 180% of control); methyl arachidonate was without
      effect. Saturated fatty acids had only a modest effect on enzyme fluorescence (50
      microM = 122% of control). Concentrations of arachidonate that inhibited in vitro
      enzymatic activity by almost 80% did not alter binding of phospholipase A2 to the
      E. coli substrate. Collectively, these data demonstrate that, while CUFAs
      selectively bind to the enzyme, they do not influence phospholipase A2-substrate
      interaction. Inhibition of in vitro phospholipase A2 activity by CUFAs may be
      mediated by the formation of an enzymatically inactive enzyme-substrate-inhibitor
      complex.

PMID- 1627623
TI  - Evidence for mechanisms of the hypotriglyceridemic effect of n-3 polyunsaturated
      fatty acids.
AB  - Ingestion of modest amounts of n-3 polyunsaturated fatty acids (PUFA) (2.8% w/w)
      decreased plasma triglyceride levels in Syrian hamsters by 49%. This was
      associated with a 45% increase in hepatic carnitine palmitoyl transferase
      activity. Significantly, at this low level of n-3 PUFA intake, hepatic
      peroxisomal oxidation measured as CN- insensitive palmitoyl-CoA dependent NAD
      reduction was unaffected. Consumption of increasing amounts of dietary n-3 PUFA
      up to 2% (w/w) in hamster diets containing 15% fat, gradually decreased plasma
      triglycerides to 56% of the control levels. The diet induced changes in plasma
      triglyceride levels were highly correlated (r = -0.97, P less than 0.01) with
      changes in hepatic carnitine palmitoyl transferase activity. A gradual decrease
      up to 59% in hepatic phosphatidate phosphohydrolase activity with n-3 fatty acid
      consumption was also observed. The hypotriglyceridemic effects of moderate
      intakes of n-3 fatty acids are, therefore, associated with changes in key enzymes
      in hepatic triglyceride synthesis and mitochondrial oxidation, but not
      peroxisomal oxidation.

PMID- 1627625
TI  - Metabolism in vivo of [14C]oleic acid and [3H]retinol of lipid-poor and lipid
      rich chyle.
AB  - [3H]Retinol and [14C]oleic acid labelled fresh chyle was obtained from thoracic
      duct cannulated rats. The labelled compounds were fed dispersed in either a small
      amount of egg phosphatidylcholine to produce a lipid-poor chyle, or in a soy bean
      lipid emulsion to produce a lipid-rich chyle. Small amounts (100 microliters, 24
      and 172 micrograms triacylglycerol, respectively) of fresh labelled chyle
      preparations were injected i.v. into fed recipient animals, which were killed
      after 10, 20 or 30 min. At 20 min, more [3H]retinyl ester remained in plasma in
      the rats injected with lipid-rich than in those injected with lipid-poor chyle.
      The difference was, however, smaller than the difference in the hepatic uptake of
      3H. Both the uptake of 3H by the liver and the hydrolysis of [3H]retinyl ester
      after the uptake, was faster in the group that had been injected with the lipid
      poor chyle. The 3H/14C ratios of the serum and liver lipids in relation to that
      of the injected material did not differ between the two groups, indicating that
      the proportion of the [14C]triacylglycerol that underwent hydrolysis before
      clearance of remnants by the liver did not differ. Particularly in the heart, but
      also in adipose tissue, lungs and kidneys the 3H radioactivity after injecting
      lipid-rich chyle was highest at 10 min and then decreased with time, being
      similar in the two groups at 30 min. The results suggest that the formation of
      remnants from lipoproteins formed after a fat meal requires a longer time for the
      interaction with endothelial-bound lipoprotein lipase. The uptake by the spleen
      was also 6-9-fold higher than in the group receiving lipid-poor chyle, indicating
      that the reticuloendothelial system participates in the metabolism of chyle
      lipoproteins after a fat meal.

PMID- 1627627
TI  - Identification of 7 alpha-hydroxy-3-oxo-4-cholestenoic acid in chronic subdural
      hematoma.
AB  - We detected a novel kind of bile acid in the content of chronic subdural
      hematoma. This substance was specifically found in chronic subdural hematoma, and
      not in subdural hygroma, which is pathologically similar except for the lack of
      capsular membrane. The compound was identified as 7 alpha-hydroxy-3-oxo-4
      cholestenoic acid by high performance liquid chromatography, gas chromatography
      mass spectrometry, and nuclear magnetic resonance spectrometry. The structure was
      confirmed by the comparison with the chemically synthesized compound. The average
      contents in chronic subdural hematoma were 658.09 +/- 137.53 ng/ml, while those
      in normal human plasma were 126.27 +/- 17.73 ng/ml. It was not detected in normal
      cerebrospinal fluid. The higher level in chronic subdural hematoma than human
      plasma strongly suggests the local, extrahepatic production of this type of C27
      bile acids.

PMID- 1627626
TI  - Biosynthesis and chemical synthesis of carboxyl-linked glucuronide of lithocholic
      acid.
AB  - The glucuronidation of lithocholic acid (LA) by phenobarbital-induced male
      Fischer 344 rat liver microsomes supplemented with UDP-glucuronic acid was
      studied. A single radioactive metabolite was formed and its structure was
      determined by high pressure liquid chromatography/particle beam/mass spectrometry
      (HPLC/PB/MS), both with and without prior methylation and acetylation of the
      sample. The reaction product was rigorously identified as the 1-O-acyl-beta-D
      glucuronide of LA by comparison with a chemically synthesized standard. The
      chemical synthesis of the acyl glucuronide of LA was accomplished via a
      condensation reaction using benzyl 2,3,4-tri-O-benzyl-D-glucopyranuronate. The
      latter compound was prepared in two steps from benzyl 2,3,4-tri-O-benzyl-1-O
      methyl-alpha-D-glucopyranuronate via the 1-O-acetyl derivative. The
      stereoselective beta coupling of LA with 2,3,4-tri-O-benzyl-D-glucopyranuronate
      was achieved by the Mitsunobu reaction, in the presence of the free hydroxyl
      function of LA, using triphenylphosphine and diisopropyl azodicarboxylate in THF
      followed by preparative TLC. The benzylic ester and ether groups were cleaved by
      hydrogenation with Pd on charcoal as the catalyst. Positive identification of the
      glucuronide was established by HPLC/PB/MS and 1H-NMR spectra. No side products
      formed by acyl migration were detected, but the free acyl glucuronide underwent
      rapid transesterification in methanol.

PMID- 1627628
TI  - Reversibility of the effects of dietary fish oil on the fatty acid composition of
      the brain and retina of growing chicks.
AB  - Dietary fish oil increases levels of (n-3) fatty acids in the brain and retina of
      younger animals but has less effect in adults. The duration of the effects of
      fish oil in young animals, as well as the extent of reversibility of the effects,
      are unknown. Laying hens were fed either a fish oil diet or a soybean oil-based
      control diet. Resulting chicks were assigned to three diet groups: chicks from
      fish oil and soybean oil hens were continued on fish oil and soybean oil diets,
      respectively, for 0, 3, 6, or 9 weeks, and additional chicks from the fish oil
      hens were fed the fish oil diet for 0, 3, or 6 weeks and then reversed to the
      soybean oil diet for a period of 3 weeks. The fatty acid composition of the
      brain, retina, liver, and serum of the reversal chicks was compared with chicks
      fed the fish oil diet only or the soybean oil diet only. Brain levels of
      docosahexaenoic acid (22:6(n-3)) decreased substantially when reversal from the
      fish oil diet to the control diet was begun at hatching, but did not decrease
      when reversal was begun at later times. Other (n-3) fatty acids in the brain,
      docosapentaenoic acid (22:5(n-3)) and eicosapentaenoic acid (20:5(n-3)),
      decreased substantially at all ages, and to a greater extent than 22:6(n-3).
      Brain arachidonic acid (20:4(n-6)), which was low in fish oil chicks, rose to
      control after reversal at hatching, but recovered only partially when reversal
      was begun at later times. A similar patterns was observed in the retina. Serum
      and liver (n-3) fatty acids fell to control in all reversal chicks, and (n-6)
      fatty acids increased to control, except in chicks reversed at 6 weeks. This
      study demonstrates that by 3 weeks of age the chick brain strongly resists diet
      induced lowering of high levels of 22:6(n-3).

PMID- 1627629
TI  - Emerging role of lipids of Candida albicans, a pathogenic dimorphic yeast.
AB  - It is clear that C. albicans lipids have gained tremendous importance in recent
      years. In addition to being a barrier for entrance of various metabolites, it
      also provides the site of action for the synthesis of enzyme(s) involved in cell
      wall morphogenesis and antifungal action. While alterations in lipid composition
      during a yeast to mycelia transition have been observed, in most of the studies,
      lipid fluctuations reported could have been due to various environmental factors
      involved in the induction of morphogenesis [4,5]. A clear understanding of lipid
      biosynthesis and metabolic blocks due to antifungal action is likely to shed
      further light on selective interactions of antifungals. Despite the multifacet
      role of lipids in various functions of this pathogenic yeast, their exact
      involvement is poorly understood. The situation is little better with regard to
      ergosterol and its metabolism. Ergosterol is, indeed, important for anti-candidal
      activity and appears to be involved in the morphogenesis of C. albicans. The
      fluctuation in phospholipid composition have led to altered properties of plasma
      membrane namely, membrane fluidity, transport activities and drug sensitivity,
      which suggest that-a critical level of individual phospholipid is important for
      proper functioning of the plasma membrane. What the exact role is of individual
      phospholipid is far from clear. Many unanswered questions relating to the role of
      PI and sphingomyelin in signal transduction, involvement of phospholipases in the
      maintenance of phospholipid composition, and role of lipid transfer proteins in
      assembly and asymmetry of lipids are some aspects which merit further work.

PMID- 1627630
TI  - Tetrahydropyran ring-containing fatty acid-combined taurine
      (tetrathermoyltaurine) in the taurolipid fraction of Tetrahymena thermophila.
AB  - A tetrahydropyran ring-containing fatty acid-combined taurine
      (tetrathermoyltaurine) was found in the taurolipid fraction of Tetrahymena
      thermophila. Tetrathermoyltaurine accounted for about 0.6% of the total
      taurolipid of the cells. The compound was subjected to methanolic hydrochloric
      acid hydrolysis, and the structures of the hydrolysis products were identified by
      nuclear magnetic resonance and mass spectrometries, as taurine and 2,3-dihydroxy
      9,13-oxy-7-trans-octadecenoic acid (tetrathermic acid). The chemical structure of
      tetrathermoyltaurine was identified as 2-(2,3-dihydroxy-9,13-oxy-7-trans
      octadecenoylamino) ethanesulfonic acid. This structure suggests that
      tetrathermoyltaurine may be derived from taurolipid B as the major taurolipid of
      the cells. When cells of HL 60, as a human lymphoma, were cultured with
      tetrathermoyltaurine, 88% of the cell growth was inhibited at the concentration
      of 100 micrograms/ml.

PMID- 1627631
TI  - Human peripheral lymph lipoproteins are enriched in sphingomyelin.
AB  - The concentrations of total choline-containing phospholipids and of sphingomyelin
      have been determined in peripheral lymph from six volunteers. The concentration
      in lymph of total phospholipids was 14.6 +/- 6.0 mg/dl and of sphingomyelin 6.1
      +/- 2.7 mg/dl; the estimated concentration of phosphatidylcholine (by subtracting
      the concentration of sphingomyelin from that of total choline-containing
      lipoproteins) was 8.5 +/- 5.1 mg/dl. The concentration of free choline in lymph
      was less than 1 mg/dl. The ratio of the concentration in lymph to that in the
      subject's own plasma of sphingomyelin was 0.18 +/- 0.07 and that of (estimated)
      phosphatidylcholine 0.05 + 0.04; the difference between these two ratios was
      significant at P less than 0.002. The present data are compatible with the
      hypothesis that some of lipoprotein phosphatidylcholine is lost while crossing
      from plasma to lymph.

PMID- 1627632
TI  - Differences in the interconversion between 20- and 22-carbon (n - 3) and (n - 6)
      polyunsaturated fatty acids in rat liver.
AB  - When male weanling rats were fed diets containing either 5% corn oil or a diet in
      which half of the corn oil was replaced by fish oil, the 20:5(n - 3) in liver
      choline and ethanolamine phosphoglycerides, not only partially replaced
      arachidonate but also paired with palmitic and stearic acids in the same molar
      ratio as did arachidonate. The 22:5(n - 3)/22:6(n - 3) ratio in the liver
      phospholipids of corn oil fed rats was similar to that found when the esterified
      levels of these two acids were increased 5-fold by feeding fish oil. Moreover,
      the pairing of both 22:5(n - 3) and 22:6(n - 3) with palmitic and stearic acids,
      on a molar ratio basis, was relatively independent of the total amount of
      esterified 22:5(n - 3) and 22:6(n - 3). When (3-14C)-labeled 22:4(n - 6) was
      injected into rats raised on a chow diet or incubated with hepatocytes from these
      animals, its primary metabolic fate was retroconversion to arachidonate followed
      by esterification. Conversely, [3-14C]22:5(n - 3) was a poorer substrate for
      retroconversion with a larger amount being esterified directly into phospholipids
      and, in addition, this acid served as a precursor for 22:6(n - 3). The enhanced
      metabolism of both [3-14C]22:4(n - 6) to 22:5(n - 6) and of [3-14C]22:5(n - 3) to
      22:6(n - 3) in animals raised on a diet devoid of fat or in their hepatocytes may
      possibly be due to elevated 6-desaturase activity and/or the level of this enzyme
      or enzymes. This hypothesis is based on studies showing that the synthesis of
      22:6(n - 3) proceeds via a pathway independent of a 4-desaturase but requires the
      use of a 6-desaturase at two steps (Voss, A., Reinhart, M., Sankarappa, S. and
      Sprecher, H. (1991) J. Biol. Chem. 266, 19995-20000).

PMID- 1627633
TI  - Incorporation of new amphiphilic perfluoroalkylated bipyridine platinum and
      palladium complexes into liposomes: stability and structure-incorporation
      relationships.
AB  - New perfluoroalkylated side-chain (formed by a perfluoroalkyl tail grafted onto a
      hydrocarbon spacer) bipyridine complexes of platinum, palladium and their
      hydrocarbon analogs, when dispersed in aqueous solutions in the presence of egg
      yolk phospholipids (EYP), are incorporated into EYP vesicles. Most complexes
      retain their chemical and structural integrity when entrapped into liposomes,
      thermally sterilized under the FDA norms and stored for 3 months at 25 degrees C.
      All complex/liposome preparations consist mainly of small unilamellar vesicles
      (size less than 100 nm) together with a population of larger uni- or
      multilamellar vesicles (100 to 230 nm). These preparations are remarkably stable
      with respect to particle size and size distribution evolution and complex
      leakage: no precipitate of drug was detected even after 7 months of storage at 25
      degrees C. The impact of the perfluoroalkyl tail and of the other structural
      features of the complexes on their incorporation efficiency into EYP liposomes is
      assessed. A high fluorophilic character (long perfluoroalkyl tail), when tempered
      by an equally lipophilic one (long hydrocarbon spacer) is not detrimental to the
      incorporation efficiency of a perfluoroalkylated drug into hydrocarbon vesicles.
      This incorporation efficiency is considerably improved by the introduction of a
      double bond between the perfluoroalkyl tail and the hydrocarbon spacer, forming
      the bipyridine side-chains.

PMID- 1627634
TI  - Regulation of HMG-CoA reductase, apoprotein-B and LDL receptor gene expression by
      the hypocholesterolemic drugs simvastatin and ciprofibrate in Hep G2, human and
      rat hepatocytes.
AB  - The comparative effects of simvastatin (a competitive inhibitor of HMG-CoA
      reductase) and ciprofibrate (another inhibitor of cholesterogenesis) on the
      incorporation of [14C]acetate and [3H]mevalonate into cholesterol HMG-CoA
      reductase activity, apo-B synthesis, LDL receptor, and their corresponding mRNAs,
      have been studied in the human hepatoma cell line Hep G2 and in human and rat
      hepatocytes in primary culture. Incubation of Hep G2 with simvastatin (0.01-1.5
      microM) or ciprofibrate (25-100 microM) produced not only a marked inhibition of
      cholesterogenesis from [14C]acetate but also from [3H]mevalonate, an intermediate
      downstream of the HMG-CoA reductase reaction. However, in human and rat
      hepatocytes, cultured in similar conditions, simvastatin inhibited only the
      cholesterol synthesis from [14C]acetate, as expected. HMG-CoA reductase activity
      was greatly induced in Hep G2 and rat hepatocytes after incubation with
      simvastatin (up to 400% of controls), but not with ciprofibrate. Increased enzyme
      activity was accompanied by a higher cell content of reductase mRNA. Apo-B
      concentration in the medium of Hep G2 cells was 31% lower after 31 h incubation
      with simvastatin than in controls. However, neither simvastatin nor ciprofibrate
      modified the synthesis rate of apo-B or its mRNA level. Both LDL-receptor and its
      mRNA levels were raised by simvastatin at concentrations inhibiting cholesterol
      synthesis. Our data show that, in this human hepatoma cell line, HMG-CoA
      reductase competitive inhibition by simvastatin triggers a coordinate regulation
      of the expression of genes coding for reductase and LDL receptor but not for apo
      B. Ciprofibrate, though efficient in inhibiting cholesterogenesis, did not induce
      the same regulatory reactions. The reason for this discrepancy is unknown.

PMID- 1627635
TI  - Plasma clearance of model lipoproteins containing saturated and polyunsaturated
      monoacylglycerols injected intravenously in the rat.
AB  - Triacylglycerols, with a saturated long-chain fatty acid at the glycerol-2
      position, slow the clearance from plasma of remnants derived from injected
      chylomicrons and chylomicron-like emulsions. Slowing of remnant clearance also
      occurs when about 1% of monostearoylglycerol is added to a triolein chylomicron
      like emulsion. We have now found that addition of monoacylglycerols, containing a
      saturated acyl chain from 12 to 20 carbons, slowed the plasma clearance and
      decreased the liver uptake of the remnants. In contrast, monoacylglycerols with
      unsaturated acyl chains were inconsistent in their effects on the remnant
      clearance. Monoarachidonin (M20:4) slowed remnant clearance comparable to that of
      saturated monoacylglycerols, monolinolenin (M18:3) and monolinolein (M18:2) were
      less effective, while monoolein had the least effect on remnant clearance. We
      have confirmed the defective remnant clearance in rats of injected emulsions
      containing saturated acyl chain by the using the diester-2-ether analogues of
      triolein and 1,3-dioleoyl-2-stearoylglycerol (OSO). Chylomicron-like lipid
      emulsions made with the ether analogues had clearance rates similar to their
      triester counterparts. Preformed remnants derived from emulsions of OSO, its
      ether analogue, and triolein emulsions or emulsions of triolein with
      approximately 1% saturated monoacylglycerols were prepared in hepatectomized
      rats. After intravenous injection into conscious recipient rats, these remnants
      were cleared from plasma similar to remnants traced in situ by lipolysis of
      injected chylomicron-like emulsions.

PMID- 1627636
TI  - Inhibition of cellular transport systems by alkyl phospholipid analogs in HL-60
      human leukemia cells.
AB  - Specific non-metabolizable alkyl-phospholipids selectively kill neoplastic cells,
      yet normal and more differentiated cells are relatively resistant. Although these
      highly selective anticancer lipids appear to target the cell membrane, their
      mechanism of cytotoxic action remains to be defined. We report here that
      treatment of 'sensitive' HL-60 leukemia cells with one of the most potent lipid
      agents, 1-alkyl-2-methoxy-glycero-3-phosphocholine, inhibits the cellular
      transport of multiple essential nutrients including choline, amino acids, fatty
      acids, and the non-metabolizable carbohydrate, 2-deoxy-D-glucose. Minimal
      inhibitory responses of the varied transport systems were noted in HL-60 cells
      treated with the less potent, 2-lyso analog, and in 'resistant' K562 leukemia
      cells, treated with the 2-methoxy lipid. Although both the 2-methoxy lipid and 12
      tetradacanoylphorbol 13-acetate induce differentiation in HL-60 cells,
      significant differences in the interactions of these lipids on cellular choline
      transport were found. Based on these results, we conclude that multiple nutrient
      deprivation induced by the detergent-like action of the methoxy-containing alkyl
      phospholipid results in the selective destruction of neoplastic cells that are
      sensitive to this membrane-targeted antitumor agent.

PMID- 1627637
TI  - Tissue lipid accumulation by L-aminocarnitine, an inhibitor of carnitine
      palmitoyltransferase-2. Studies in intact rats and isolated mitochondria.
AB  - Tissues of fasted animals treated with L-aminocarnitine (L-3-amino-4
      trimethylaminobutyrate) showed an accumulation of long-chain acylcarnitines and
      triacylglycerols. Blood levels of free fatty acids, long-chain acylcarnitines and
      triacylglycerol-rich lipoproteins were found to be increased, whereas glucose was
      reduced. The liver mitochondria isolated from rats treated with L-aminocarnitine
      utilized both pyruvate and succinate normally, but were not able to oxidize
      palmitoylcarnitine. In vitro oxidation of palmitoylcarnitine by liver
      mitochondria was inhibited by L-aminocarnitine in a concentration-dependent
      fashion in contrast to succinate and pyruvate oxidation which was not modified. L
      aminocarnitine proved to be a potent and selective inhibitor (IC50 = 805 nM) of
      the carnitine palmitoyltransferase isoenzyme, located on the inner side of the
      mitochondrial inner membrane (CPT2). The activity of the carnitine
      palmitoyltransferase isoenzyme located on the mitochondrial outer membrane
      inhibitable by malonyl-CoA (IC50 = 19 microM), was not inhibited by 0.8 microM L
      aminocarnitine. Both in vitro and in vivo effects of L-aminocarnitine suggest
      that the substance has a specific and potent inhibitory action on CPT2. Its in
      vivo inhibition results in a dramatic increase of long-chain acylcarnitines in
      various organs, that it is why this increase can be considered a very good marker
      of CPT2 inhibition. A markedly altered lipid metabolism was observed.

PMID- 1627638
TI  - Physical evidence for the presence of two forms of phosphatidate phosphohydrolase
      in rat liver.
AB  - Phosphatidate phosphohydrolase (PAP)-catalysed dephosphorylation of phosphatidic
      acid to diacylglycerol is an important step in glycerolipid metabolism and cell
      signalling. Gel filtration chromatography on Superose 6 and anion-exchange
      chromatography on Mono Q of rat liver subcellular fractions has provided physical
      evidence for the presence of two distinct forms of PAP activity. One form was
      sensitive to inhibition by N-ethylmaleimide (NEM), had an apparent M(r) of
      540,000 and was eluted from the anion-exchange column by 0.35 M NaCl, while the
      other was insensitive to inhibition by NEM, had an apparent M(r) of 240,000 and
      was eluted from the anion-exchange column by 0.15 M NaCl. Studies on the
      subcellular distribution of these two enzymes, using 5'-nucleotidase as a plasma
      membrane marker, demonstrated that the NEM-sensitive form was predominantly
      cytosolic but translocated to the microsomal membranes in response to oleate. The
      NEM-insensitive form was predominantly located in the plasma membrane but a small
      proportion (approx. 10%) of total cell activity was present on the endoplasmic
      reticulum. The implications of these results for the likely roles of the two
      different forms of PAP in fatty acid esterification and cell-signalling are
      discussed.

PMID- 1627639
TI  - Endothelial EA.hy 926 cells can be loaded with cationized LDL, but not with
      acetylated LDL.
AB  - EA.hy 926 cells, a human endothelial cell line, show characteristics of
      differentiated endothelial cells. Endothelial cells normally express membrane
      scavenger receptors. Therefore modified LDL, eg., acetylated LDL, can be taken
      up, causing accumulation of mass amounts of cholesterol. We have shown that EA.hy
      926 cells cannot be loaded with cholesterol using acetylated LDL, but can be
      efficiently enriched with cholesterol by incubation with cationized LDL. The
      loaded cells may serve as models for studies on reverse cholesterol transport.

PMID- 1627640
TI  - Base-exchange and cell growth in 3T6 mouse fibroblasts.
AB  - Synthesis of phosphatidyl serine by base-exchange and DNA synthesis both declined
      rapidly in mouse fibroblast cultures upon withdrawal of serum from nutrient
      medium. Base-exchange returned to control levels within 3 h after the addition of
      serum, while DNA synthesis lagged by 10 h. Phosphatidyl serine synthesis is thus
      an early response of 3T6 cells to mitogenic signals.

PMID- 1627641
TI  - Subcellular distribution and activity of glucose transporter isoforms GLUT1 and
      GLUT4 transiently expressed in COS-7 cells.
AB  - In adipose and muscle cells, the glucose transporter isoform GLUT4 is mainly
      located in an intracellular, vesicular compartment from which it is translocated
      to the plasma membrane in response to insulin. In order to test the hypothesis
      that this preferential targeting of a glucose transporter to an intracellular
      storage site is conferred only by its primary sequence, we compared the
      subcellular distribution of the fat/muscle glucose transporter GLUT4 with that of
      the erythrocyte/brain-type glucose transporter GLUT1 after transient expression
      in COS-7 cells. Full-length cDNA was ligated into the expression vector pCMV that
      is driven by the cytomegalovirus promoter, and introduced into COS cells by the
      DEAE-dextran method. Cells were homogenized and fractionated by differential
      centrifugation to yield plasma membranes and a Golgi-enriched fraction of
      intracellular membranes (low-density microsomes). In these membrane fractions,
      the abundance of glucose transporters was assessed by immunoblotting with
      specific antibodies against GLUT1 and GLUT4, and their transport activity was
      assayed after solubilization and reconstitution into lecithin liposomes. Uptake
      rates of 2-deoxyglucose assayed in parallel samples were higher in cells
      expressing GLUT1 or GLUT4 as compared with control cells (transfection of pCMV
      without transporter cDNA). Reconstituted glucose transport activity in plasma
      membranes was about 5-fold higher after expression of GLUT1 and GLUT4 as compared
      with control cells. The relative amount of GLUT4 in the low-density microsomes as
      detected by reconstitution and immunoblotting exceeded that of the GLUT1, but was
      much lower than that observed in typical insulin-sensitive cells, e.g., rat fat
      cells or 3T3-L1 adipocytes. These data indicate that COS-7 cells transfected with
      glucose transporter cDNA express the active transport proteins and can be used
      for functional studies.

PMID- 1627642
TI  - The strain-dependent constitutive expression of murine serum amyloid-P component
      is regulated at the transcriptional level.
AB  - The strain-dependent expression of murine serum amyloid P-component (SAP) has
      been known to be linked to the Sap locus. We have quantified the SAP mRNA in
      several inbred strains including DBA/2 and C57BL/6 mice which represent high and
      low producers of SAP at resting state, respectively, and found that the mRNA
      levels correlated well with the amount of SAP protein. Interestingly, the SAP
      mRNA level of F1 mouse between DBA/2 and C57BL/6 was low and similar to that of
      C57BL/6. Primer extension and ribonuclease (RNAase) protection analyses
      demonstrated that a single type of transcript was generated from the SAP gene and
      that the cap sites were identical regardless mouse strains tested under
      unstimulated and stimulated (by lipopolysaccharide (LPS) or interleukin-6 (IL-6))
      conditions. To investigate possible structural difference of the SAP gene
      including 5' flanking region, we have cloned, sequenced and compared the SAP
      genes from DBA/2 and C57BL/6 mice. Sequence analyses revealed that the 5'
      flanking regulatory regions, as well as the coding regions, were well-conserved
      between the two strains. These results demonstrate that the strain-dependent SAP
      expression occurs at the transcriptional level but seems to be affected by
      neither different type of the transcripts nor structural difference of the 5'
      flanking and coding regions of the SAP gene. It was suggested that a possible
      transcription factor with suppressive activity, which is encoded by a gene linked
      to Sap, may be involved.

PMID- 1627643
TI  - Neonatal extinction of liver lipoprotein lipase expression.
AB  - In contrast to the complete absence of lipoprotein lipase (LPL) mRNA in adult rat
      liver, fetal and neonatal rat liver contain substantial amounts of LPL mRNA,
      which is translated in active LPL protein as can be deduced from the presence of
      LPL activity in this organ. At this neonatal stage, both the relative abundance
      of LPL mRNA and LPL activity increased with starvation. During the suckling
      period, LPL mRNA and LPL activity gradually decreased until both parameters were
      undetectable. While the administration of L-thyroxine or hydrocortisone enhanced
      the disappearance of LPL mRNA, induced hypothyroidism delayed its disappearance.
      In adult animals induced hypothyroidism could not reactivate LPL mRNA production
      in the liver. The data presented suggest that liver LPL production responds to
      changes in the nutritional state and becomes extinguished during development, in
      a fashion reminiscent to the extinction of alpha-fetoprotein. This extinction of
      LPL gene expression is influenced by hormonal factors.

PMID- 1627644
TI  - cDNA cloning, sequencing, expression and possible domain structure of human APEX
      nuclease homologous to Escherichia coli exonuclease III.
AB  - cDNA encoding the human homologue of mouse APEX nuclease was isolated from a
      human bone-marrow cDNA library by screening with cDNA for mouse APEX nuclease.
      The mouse enzyme has been shown to possess four enzymatic activities, i.e.,
      apurinic/apyrimidinic endonuclease, 3'-5' exonuclease, DNA 3'-phosphatase and DNA
      3' repair diesterase activities. The cDNA for human APEX nuclease was 1420
      nucleotides long, consisting of a 5' terminal untranslated region of 205
      nucleotide long, a coding region of 954 nucleotide long encoding 318 amino acid
      residues, a 3' terminal untranslated region of 261 nucleotide long, and a poly(A)
      tail. Determination of the N-terminal amino acid sequence of APEX nuclease
      purified from HeLa cells showed that the mature enzyme lacks the N-terminal
      methionine. The amino acid sequence of human APEX nuclease has 94% sequence
      identity with that of mouse APEX nuclease, and shows significant homologies to
      those of Escherichia coli exonuclease III and Streptococcus pneumoniae ExoA
      protein. The coding sequence of human APEX nuclease was cloned into the pUC18
      SmaI site in the control frame of the lacZ promoter. The construct was introduced
      into BW2001 (xth-11, nfo-2) strain and BW9109 (delta xth) strain cells of E.
      coli. The transformed cells expressed a 36.4 kDa polypeptide (the 317 amino acid
      sequence of APEX nuclease headed by the N-terminal decapeptide derived from the
      part of pUC18 sequence), and were less sensitive to methylmethanesulfonate and
      tert-butyl-hydroperoxide than the parent cells. The N-terminal regions of the
      constructed protein and APEX nuclease were cleaved frequently during the
      extraction and purification processes of protein to produce the 31, 33 and 35 kDa
      C-terminal fragments showing priming activities for DNA polymerase on acid
      depurinated DNA and bleomycin-damaged DNA. Formation of such enzymatically active
      fragments of APEX nuclease may be a cause of heterogeneity of purified
      preparations of mammalian AP endonucleases. Based on analyses of the deduced
      amino acid sequence and the active fragments of APEX nuclease, it is suggested
      that the enzyme is organized into two domains, a 6 kDa N-terminal domain having
      nuclear location signals and 29 kDa C-terminal, catalytic domain.

PMID- 1627645
TI  - Secondary (non-GpC) binding sites for actinomycin on DNA.
AB  - Actinomycin D has long been known to bind selectively to the dinucleotide step
      GpC. We have investigated its ability to bind to other non-canonical sequences
      using a series of synthetic DNA fragments. DNase I footprinting experiments
      reveal that actinomycin can also bind well to GG (CC). Binding to this sequence
      and the canonical GC site is potentiated by flanking regions of (GT)n.(AC)n.
      Weaker but specific binding to GT and AC is also evident and appears to be
      cooperative.

PMID- 1627646
TI  - A rapid procedure for production of human basic fibroblast growth factor in
      Escherichia coli cells.
AB  - Human basic fibroblast growth factor has been expressed in Escherichia coli cells
      at a level of 2-3 mg/l culture, using a rapid procedure which requires only
      simple DNA manipulative work. The recombinant material has the same potency as
      natural basic fibroblast growth factor from bovine pituitary glands.

PMID- 1627647
TI  - Cationic liposomes enhance targeted delivery and expression of exogenous DNA
      mediated by N-terminal modified poly(L-lysine)-antibody conjugate in mouse lung
      endothelial cells.
AB  - A new and improved system for targeted gene delivery and expression is described.
      Transfection efficiency of N-terminal modified poly(L-lysine) (NPLL) conjugated
      with anti-thrombomodulin antibody 34A can be improved by adding to the system a
      lipophilic component, cationic liposomes. DNA, antibody conjugate and cationic
      liposomes form a ternary electrostatic complex which preserves the ability to
      bind specifically to the target cells. At the same time the addition of liposomes
      enhance the specific transfection efficiency of antibody-polylysine/DNA binary
      complex by 10 to 20-fold in mouse lung endothelial cells in culture.

PMID- 1627648
TI  - PCR cloning and nucleotide sequence determination of the 18S rRNA genes and
      internal transcribed spacer 1 of the protozoan parasites Cryptosporidium parvum
      and Cryptosporidium muris.
AB  - The genes encoding 18S rRNA and internal transcribed spacer 1 (1TS1) of
      Cryptosporidium parvum and Cryptosporidium muris were amplified from oocysts by
      PCR utilizing primers complementary to conserved regions of the 5' end of 18S and
      5.8S rRNA. PCR products were cloned and the complete nucleotide sequences of two
      clones of each Cryptosporidium species were determined. The 18S rRNA genes of C.
      parvum and C. muris showed more than 99% sequence identity.

PMID- 1627649
TI  - The primary structures of the flavodoxins from two strains of Desulfovibrio
      gigas. Cloning and nucleotide sequence of the structural genes.
AB  - The structural genes coding for the flavodoxin proteins from two different
      strains of the sulfate-reducing bacteria Desulfovibrio gigas (ATCC 19364/NCIB
      9332 and ATCC 29494/DSM 496) have been identified, cloned and the nucleotide
      sequence established. The protein sequences derived from the gene from each
      strain share a sequence identity of 66% with regions directly involved in binding
      the flavin mononucleotide cofactor being the most homologous. Both aromatic
      residues that flank the flavin isoalloxazine ring in the crystal structure of the
      flavodoxin from D. vulgaris, i.e., Trp-60 and Tyr-98, are also present in these
      flavodoxin proteins. These observations stand in contrast to reports that the
      flavodoxin from Desulfovibrio gigas contains a single tryptophan residue which is
      located distant from the flavin binding site. Therefore, the FMN binding site of
      this flavodoxin is not distinct from the other Desulfovibrio flavodoxins in this
      regard.

PMID- 1627650
TI  - The cDNA cloning and mRNA expression of rat protein C.
AB  - We cloned a cDNA coding for rat protein C, which provides hybridization probes
      for the detection of protein C mRNA in several tissues. The cloned cDNA was 1543
      bp long and contained a single open reading frame of 1383 nucleotides. The
      proposed rat protein C precursor contained 461 amino acid residues: a 41 amino
      acid preproleader sequence, and light (155 amino acids) and heavy (263 amino
      acids) chains joined by a Lys-Arg dipeptide. Northern blot analysis showed that
      the rat protein C mRNA was expressed not only in the liver, but also in the
      kidney.

PMID- 1627651
TI  - Cloning and nucleotide sequence of the Vibrio proteolyticus aminopeptidase gene.
AB  - The gene encoding the Vibrio proteolyticus aminopeptidase was cloned and
      sequenced and its amino acid sequence was deduced. The gene encodes a 54 kDa
      protein, larger than the previously reported size of 30 kDa for the purified
      aminopeptidase. Sequence alignments revealed a 43-45% homology with two other
      Vibrio sp. extracellular proteinases.

PMID- 1627652
TI  - The isolation and characterization of rabbit motilin precursor cDNA.
AB  - The cDNA sequence of rabbit motilin precursor has been determined. The predicted
      amino acid sequence indicates that the precursor consists of 133 amino acids and
      includes a 25 amino acid signal peptide followed by the 22 amino acid motilin
      sequence and an 86 amino acid motilin associated peptide (MAP). As in the human
      and porcine precursors, two lysine residues follow motilin in the rabbit
      sequence. Rabbit motilin shares 64% amino acid sequence identity with human and
      porcine motilin, and all amino acid substitutions represent conservative changes.
      Amino acid sequence alignments of the rabbit, human and porcine MAP sequences
      suggest three functional/structural motifs corresponding to a putative
      endoproteinase recognition site, a putative PEST site and a potential
      posttranslational processing recognition element.

PMID- 1627653
TI  - Gene for 17 alpha-hydroxylase/C (17-20) lyase P-450: complete nucleotide sequence
      of the porcine gene and 5' upstream sequence of the rat gene.
AB  - We describe the isolation and characterization of a full-length clone for the
      porcine 17 alpha-hydroxylase/C(17-20) lyase (CYP17) gene. The complete exon and
      partial intron sequences are presented including approx. 1000 bp of the 5'
      upstream sequence. In addition we describe the isolation and characterization of
      the 5' upstream region of the rat CYP17 gene. The sequences of the first exon,
      part of the first intron, and approx. 3.5 kb of the 5' upstream region are
      presented.

PMID- 1627654
TI  - Primary sequence of -1436 to +53 bp of the rat preproenkephalin gene putative Z
      DNA and regulatory motifs.
AB  - We report novel sequence data extending -1436 bases 5' of the rat proenkephalin
      gene start site known as E4. We noted an interesting stretch of 58 bases of
      alternating pyrimidines that lies immediately adjacent to 71 bases of an
      alternating purine-pyrimidine Z-DNA-like sequence that lies between -694 bp and 
      566 bp. Multiple sequence homologies to putative cis-acting regulatory factor
      binding sites were identified by a computer aided sequence search.

PMID- 1627655
TI  - Molecular basis of 3-ketothiolase deficiency: identification of an AG to AC
      substitution at the splice acceptor site of intron 10 causing exon 11 skipping.
AB  - 3-Ketothiolase deficiency (3KTD) is the result of a deficiency in mitochondrial
      acetoacetyl-CoA thiolase (T2). The molecular basis of 3KTD was analyzed in a
      patient (GK10) and his family at the protein, cDNA and gene levels. Protein
      analyses showed that GK10's T2 protein was undetectable in fibroblasts even with
      the pulse-protein labeling method and that his parents were carriers of 3KTD.
      Complementary DNA analyses with PCR showed that T2 cDNA in the patient lacked the
      normal exon 11 sequence and that his parents were obligatory carriers of the DNA
      sequence which canceled exon 11. When the PCR-amplified genomic fragments around
      exon 11 were sequenced, an AG to AC mutation at the 3' splice site of intron 10
      was detected. This mutation is presumed to be responsible for exon 11 skipping.

PMID- 1627656
TI  - Assay for L-pipecolate oxidase activity in human liver: detection of enzyme
      deficiency in hyperpipecolic acidaemia.
AB  - A direct assay method is described for L-pipecolate oxidase. The assay uses
      NaHSO3 to trap the L-alpha-amino [3H]adipate delta-semialdehyde (AAS) formed as a
      direct reaction product of L-pipecolate oxidase from L-[3H]pipecolic acid. The
      adduct so formed was separated from the substrate on Dowex 50 (H+) column. The
      product was identified as [3H]AAS by amino acid analysis after breaking down the
      adduct by boiling under acidic conditions. The assay is simpler and more specific
      than fluorometric methods; it is also more sensitive, requiring at most 16
      micrograms of liver peroxisome-enriched protein per assay. We have used this
      assay procedure to detect L-pipecolate oxidase in skin fibroblasts obtained from
      a control subject and from patients of hyperpipecolic acidaemia and Zellweger
      syndrome and found that this enzyme activity is present in the control, but
      absent or decreased in the patients with the peroxisomal disorders.

PMID- 1627657
TI  - Restoration of mitochondrial energy-linked reactions following dexamethasone
      treatment of rats infected with the liver fluke Fasciola hepatica.
AB  - Mitochondria isolated from male Wistar rats experimentally infected with the
      common liver fluke, Fasciola hepatica, exhibit loss of respiratory control from 2
      weeks post-infection (Rule, et al. (1989) Biochem. J. 260, 517-523). We now
      report that subcutaneous injections of the anti-inflammatory drug, dexamethasone,
      during the final week of infection prevented the mitochondrial uncoupling and
      restored respiratory control almost to the levels of uninfected controls. Further
      investigations have shown that mitochondria from infected rat livers are unable
      to synthesize ATP and that abnormal respiration is also evident in hepatocytes
      isolated from infected rats. These abnormalities were absent when infected rats
      were treated with dexamethasone. In addition, liver mitochondrial function in
      infected, congenitally athymic, nude rats (CBH/R nu/nu) was not significantly
      different from that in uninfected nude or Wistar controls. These results provide
      evidence that the mitochondrial dysfunction in fascioliasis is host-mediated and
      that T lymphocytes in particular may be involved.

PMID- 1627658
TI  - Tissue-selective action of pravastatin due to hepatocellular uptake via a sodium
      independent bile acid transporter.
AB  - Pravastatin is a foreign substrate of a sodium-independent transport system for
      bile acids. The tissue selectivity of pravastatin in inhibiting 3-hydroxy-3
      methyl-glutaryl-coenzyme A reductase is due to the uptake via a transport system
      which exists predominantly in liver cells. Pravastatin competitively inhibits the
      sodium-independent hepatocellular uptake of cholate, taurocholate and ouabain,
      whereas the total uptake of cholate is non-competitively blocked. The affinity of
      pravastatin to the sodium-dependent taurocholate transporter is, however, low.
      Millimolar concentrations of pravastatin are needed to inhibit the sodium
      taurocholate cotransporter. Pravastatin has no affinity to other transport
      systems in liver cells such as those for long-chain fatty acids, amino acids,
      rifampicin and bivalent organic cations.

PMID- 1627659
TI  - Calpain II induced insolubilization of lens beta-crystallin polypeptides may
      induce cataract.
AB  - Addition of calpain II (EC 3.4.22.17) to soluble proteins from 10-day-old rat
      lens caused an increase in turbidity and production of water-insoluble protein.
      The insolubilization increased with higher concentrations of both lens protein
      and calpain II, it could be prevented by the cysteine protease inhibitor E-64; it
      required at least 0.5 mM Ca2+, it was limited to 6% of the soluble protein
      present and resulted from precipitation of proteolyzed beta-crystallin
      polypeptides. When compared by two-dimensional electrophoresis, the insoluble
      beta-crystallin polypeptides produced by calpain II were similar to insoluble
      beta-crystallin polypeptides found in cataractous lenses. Trypsin also caused
      insolubilization of beta-crystallin polypeptides, but these polypeptides were
      unlike polypeptides produced during cataract formation. These data suggested that
      the loss of solubility was due to a specific removal of N/or C-terminal
      extensions from beta-crystallin polypeptides by calpain II, and that a similar
      process may occur in vivo during cataract formation. It is hypothesized that the
      insoluble protein produced by calpain II causes cataract by increasing light
      scatter in the lens.

PMID- 1627660
TI  - Induction of hepatic and pulmonary caeruloplasmin gene expression in developing
      guinea pigs following premature delivery.
AB  - We have previously shown that mRNA for caeruloplasmin, the serum copper-binding
      protein, is not expressed in guinea-pig liver prior to birth and expression
      increases rapidly following parturition. To further study the regulation of
      caeruloplasmin in neonatal animals we have used 3-day preterm guinea pigs,
      delivered by caesarean section, to investigate mRNA expression in liver and lung.
      Within 12 h of premature birth, hepatic caeruloplasmin mRNA levels are
      significantly increased and remain elevated by 72 h. This induction of expression
      is accompanied by an increase in circulating levels of holoprotein. Even greater
      induction of caeruloplasmin mRNA was observed in premature animals maintained in
      95% oxygen for 72 h, confirming an acute-phase response in prematurity. Studies
      of lung RNA showed that caeruloplasmin mRNA is expressed throughout development,
      with highest levels observed in adult lung. In the premature animals levels were
      significantly elevated 12 h after delivery, but then fell by 72 h to below those
      seen in normal term lung. Hyperoxia did not influence the pulmonary mRNA levels.

PMID- 1627661
TI  - The human glutathione S-transferases: comparison of isoenzyme expression in
      normal and astrocytoma brain.
AB  - We describe expression of alpha, mu and pi class glutathione S-transferases (GST)
      in brain tissue from 21 controls and uninfiltrated and tumour tissue from 17
      glioma patients. GST were sequentially resolved by chromatofocusing into the
      GST2, GST1, GST5, GST2 (5.5), GST3, GST6 sets and the contribution of each to
      total activity determined. The immunological identity of these isoforms was
      studied using immunoblotting. The pi class GST3 isoform was the major contributor
      to activity in control tissue (70.9%) and, uninfiltrated (75.1%) and tumour
      samples (82.4%). Expression was significantly greater in the tumours (P less than
      0.05). Expression of alpha isoforms GST2 and GST2 (5.5) was variable with most
      subjects demonstrating no detectable GST2 (B1 and B2 chromatofocused monomers).
      An isoform termed GST2 (5.5) chromatofocussed at pH 5.5 and cross-reacted with
      antisera to B1. It was detected in most control and glioma patients and comprised
      about 5% of total activity. The contribution of GST2 and GST2 (5.5) to activity
      was similar in control, uninfiltrated and tumour tissue. Two mu class enzymes,
      GST1 and GST5, were identified. GST1 isoforms were detected in 9 of 21 control
      samples, the phenotype of these and matched liver samples were identical. GST1
      isoforms were detected in 4 of 16 tumour samples, a significantly lower incidence
      than in a previously established control group. GST5 was expressed in most
      samples, the contribution of this locus to activity was significantly reduced in
      the tumours (5.2%) compared with control samples (14.5%).

PMID- 1627662
TI  - Use of cytosolic metabolite patterns to estimate free magnesium in normoxic
      myocardium.
AB  - Cytosolic free magnesium (Mgf) is considered relatively constant. To test this
      concept, Mgf was estimated during hyperkalemic ventricular akinesis, normal and
      maximum adrenergic stimulation, and sulfate loading of the normoxic perfused
      guinea-pig heart. The Mgf estimates utilized a new sliding scale derived from the
      Mg(2+)-dependence of glyceraldehyde-3-phosphate dehydrogenase/phosphoglycerate
      kinase (GAPDH/PGK). The pseudo constant K'GAPDH.K'PGK was measured as ([creatine
      phosphate][3-phosphoglycerate][lactate]KLDH)/([creatine][Pi] [glyceraldehyde 3
      phosphate][pyruvate]KCK), which varied with magnesium due to KCK (CK, LDH =
      creatine kinase, lactate dehydrogenase). However, the correct magnesium
      dependencies of the true constants KGAPDH.KPGK and KCK were taken from the
      literature. The [Mg2+] at which pseudo K'GAPDH.K'PGK equalled true KGAPDH.KPGK
      was the best estimate of Mgf.Mgf fell to approximately 0.13 mM in hyperkalemic
      arrest from a control of approximately 0.6 mM, rising to approximately 0.85 mM
      only during maximum adrenergic stress. Mgf increased further to approximately 1.3
      mM during sulfate loading which induced ATP catabolism. Mgf and ATP were
      reciprocally related. Thus; (1) myocardial free [Mg2+] judged from GADPH/PGK mass
      action relations changed appreciably only under extreme physiological states; (2)
      ATP was a major chelator of Mg2+ in perfused myocardium, i.e., acute ATP pool
      size reduction may be associated with increments in Mgf.

PMID- 1627663
TI  - Substance abuse prevention.

PMID- 1627664
TI  - Public policy statement on prevention.

PMID- 1627665
TI  - Substance abuse prevention: competence enhancement and the development of
      positive life options.
AB  - Recent advances in the field of substance abuse prevention have derived from a
      consideration of the etiology of substance use and have also been solidly
      grounded in psychological theory. Evaluation studies of psychosocial prevention
      interventions have become increasingly rigorous, and clearly demonstrate that
      there are effective approaches to prevention. The Life Skills Training Program is
      an example of a competence enhancement approach to substance abuse prevention.
      While research with this approach demonstrates its effectiveness at reducing
      substance use behavior, experience working with disadvantaged youth suggests the
      need to broaden the concept of competence enhancement. Specifically,
      recommendations are made for formalizing the concept of positive life options as
      a potentially important component of substance abuse prevention.

PMID- 1627666
TI  - Etiologies and consequences of adolescent drug use: implications for prevention.
AB  - This paper reviews recent results and work in progress from a longitudinal study
      of drug use etiologies and consequences. Early- and mid-adolescent drug use
      patterns, personality, and behavioral correlates were studied in a large sample
      of normal youth beginning in the mid-1970's. To determine the correlates and
      consequences of adolescent drug use, controlling for related tendencies such as
      lack of social conformity and deviant friendship networks, 654 youngsters were
      followed into young adulthood and their behaviors and lifestyles evaluated.
      Teenage drug use was found to disrupt many critical developmental tasks of
      adolescence and young adulthood. Tendencies to use many different drugs as an
      adolescent led in young adulthood to increased drug crime involvement, decreased
      college involvement, increased job instability, income, psychoticism, and
      stealing episodes. Intervention efforts should be directed not only towards
      decreasing drug use, but also towards improving personal maturity, social skills,
      and economic opportunities.

PMID- 1627667
TI  - An integrated model for prevention and treatment of drug abuse among American
      Indian youth.
AB  - American Indian youth have been shown to be at high risk for drug abuse.
      Epidemiological studies of Indian school students over the past two decades have
      revealed rates of use consistently higher than those found for other youth.
      Socioeconomic and historical factors have led to conditions that put a great deal
      of stress on the family and other support systems which in part account for the
      seriousness of the problem. A model is presented which can guide both prevention
      and treatment efforts addressing drug abuse in Indian communities. Five variable
      domains, social structure, socialization factors, psychological variables, peer
      associations and drug use, are related in an integrated structure. By following
      the progression of the etiological variables, a stepwise plan can be developed to
      organize interventions. Although the model has immediate utility, a number of
      further research questions are outlined that will enhance its application.

PMID- 1627668
TI  - Job satisfaction among substance abuse prevention personnel.
AB  - This study of military substance abuse prevention personnel examined the
      relationship of job satisfaction with perceived importance to unit mission and
      frequency of performance vis-a-vis five prevention duties. Findings indicated a
      positive association between job satisfaction and perceived importance for all
      five duties. Results suggest a conditional positive relationship between
      performance frequency and job satisfaction only for duties involving one-to-one
      interaction. Findings applicable to non-military settings and implications for
      further research are discussed.

PMID- 1627670
TI  - When to target elderly patients. Sooner is better.

PMID- 1627669
TI  - William James' legacy to Alcoholics Anonymous: an analysis and a critique.
AB  - When evolving a philosophy and a "modus operandi" the pioneers of Alcoholics
      Anonymous made significant use of William James' Varieties of Religious
      Experience. Indeed, although AA carefully picked and chose various of James'
      ideas which seemed particularly relevant, James' imprint is clearly stamped upon
      AA philosophy and methodology. Here, I will review James' work and explore what
      specific ideas were particularly relevant to AA's evolution as a self-help
      movement. The implications of this heritage will be explored.

PMID- 1627671
TI  - Platelets, eicosanoids and aging.

PMID- 1627672
TI  - Nutritional status of the very old: anthropometric and biochemical findings in
      apparently healthy women in old people's homes.
AB  - To obtain reference values for comparison with malnourished geriatric patients,
      the nutritional status of 50 apparently healthy women aged 75 or older living
      independently in two old people's homes in Heidelberg was examined. All women
      were able to walk, and were free from overt disease and signs of mental
      deterioration. Anthropometric measurements (body height and weight, triceps
      skinfold thickness, midarm circumference) and biochemical determinations of
      protein and vitamin status were performed. Anthropometric parameters were similar
      to those obtained in "younger" samples of healthy elderly, lower than those
      reported in younger adults, and markedly greater than those reported in geriatric
      patients. The majority of biochemical findings were within normal reference
      ranges established for healthy young adults. Only plasma retinol concentrations
      were below the reference limit in 8 women (16%). These findings show clearly that
      even in the very old, major alterations in biochemical indicators of nutritional
      status are rare. Neither advanced age nor institutionalization are associated
      with malnutrition. This obviously suggests that malnutrition in old age is mainly
      related to physical and mental disabilities.

PMID- 1627673
TI  - Intracranial meningiomas in patients over 70 years old. Follow-up in operated and
      unoperated cases.
AB  - Forty-six cases of intracranial meningioma in patients above 70 years of age form
      the basis of this study; 34 underwent surgery while 12 did not. The decision to
      operate was based on the general condition of the patient, evaluated according to
      the Karnofsky index, neurological conditions, the site and dimensions of the
      tumor, and the presence of peritumoral edema. The post-surgical mortality rate
      was 11.5% at 30 days, and 20% at 3 months. Long-term follow-up in both patient
      groups ranged from 1 to 5 years, and quality of life was evaluated by the
      Karnofsky index. Five operated patients died during follow-up (only 1 from
      intracranial pathology); the 22 survivors showed further improvement in their
      grading level compared to scores immediately following surgery. Among the
      unoperated patients, 6 died within two years of diagnosis, all from causes
      related to intracranial pathology; among the survivors, the Karnofsky index was
      unchanged in 2, and diminished in the other 4 cases.

PMID- 1627674
TI  - Aging: a challenge for psychology and psychologists. We are living in a graying
      world.

PMID- 1627675
TI  - Dementia patients with low serum cobalamin concentration: relationship to
      atrophic gastritis.
AB  - Serum concentrations of group I pepsinogens (pepsinogen-I) and gastrin were
      determined in patients with dementia disorders in order to assess the
      relationship, if any, between these indices of gastric mucosal function and serum
      cobalamin (vitamin B12) levels. A significant positive correlation between
      pepsinogen-I and B12 and, as expected, an inverse relationship between gastrin
      and pepsinogen-I concentrations was found, indicating that vitamin B12 deficiency
      was mainly determined by gastric mucosal atrophy (atrophic gastritis) in this
      West-Swedish sample of patients with dementia disorders. Patients with low B12
      but normal gastrin and pepsinogen-I concentrations should, therefore, be further
      evaluated for possible nutritional deficiency, as well as nongastric causes of
      poor B12 assimilation from the diet.

PMID- 1627676
TI  - Response stability and reliability in longitudinal health evaluations.
AB  - Two approaches were used to study the stability over time and intravisit
      reliability of health questions and clinical medical examination items in the
      Baltimore Longitudinal Study of Aging (BLSA). The stability of responses was
      determined by evaluating the medical history and physical examination completed
      at each visit to identify items that once answered in a positive manner, should
      continue to be answered positively over time. Stability for each question and
      subject was calculated by the number of positive responses following the first
      positive response divided by the total number of visits following the first
      positive response. For 35 questions answered by the subject, the stability was
      58% by a simple average or 64% when weighted for the percentage of subjects who
      had a positive response to the question; for 10 physician-asked questions, the
      corresponding figures were 29% or 36%. Eighteen items from the physical
      examination had a stability of 34% or 37%. Intravisit reliability was estimated
      by comparing responses from the general health questionnaire to responses on the
      Cornell Medical Index completed at the same visit. Subject-completed questions
      had substantial agreement (Kappa = 0.74, for questions worded the same), while
      physician-asked questions had moderate agreement (Kappa = 0.44).

PMID- 1627677
TI  - Assessing hip fracture risk in a population-based health survey: the NHANES III
      osteoporosis component.
AB  - A unique study of osteoporotic hip fracture risk, currently being conducted as
      part of a national health survey of the United States population, is described.
      The osteoporosis component of the third National Health and Nutrition Examination
      Survey (NHANES III) will provide data on multiple risk factors for hip fracture,
      including bone density of the proximal femur, from a nationally representative
      sample of adults that includes the very old. The minimum age for inclusion in the
      component is 20 years, so risk factors can be examined across the adult age
      range. The component includes men as well as women, and blacks and Mexican
      Americans as well as non-Hispanic whites. Finally, a longitudinal follow-up of
      the cohort will allow risk factor data to be related to subsequent hip fracture
      occurrence.

PMID- 1627678
TI  - Readmissions to a geriatric medical unit: is prevention possible?
AB  - Of the 622 patients admitted to a geriatric medical unit during the period
      November 1985 to October 1986, 211 (33.9%) had been discharged from hospital
      within the previous year. Of these, 117 (55.5%) had previously been admitted to
      the geriatric medical unit (18.8% of all admissions). The reasons for readmission
      were deterioration of existing disease (47.4%), new medical events (33.2%), poor
      management of previous discharge (9.5%), and social problems (5.7%). Age was not
      a significant factor influencing readmission. Readmission was judged preventable
      by better management of the previous admission and discharge in only 33 cases
      (15.6% of readmissions). A prospective study of the patients discharged in the
      same year revealed that 19.3% were readmitted in the following year, and of these
      readmissions 2.3% were considered to be preventable. There was no difference in
      medical causes for readmission in the two years. A significant number of the
      patients readmitted in both years studied was categorized as "high dependency".
      The figures suggest that although unplanned readmission is common, it is
      generally not preventable by better management of the previous admission, and
      often reflects a highly dependent and medically frail group of patients, in whom
      early intervention with readmission is appropriate.

PMID- 1627679
TI  - Survival prognosis in geriatric patients admitted to permanent institutional
      care.
AB  - The influence of clinical and laboratory findings on the two-year survival
      prognosis was investigated in 558 geriatric patients admitted to permanent
      institutional care. The patients surviving for two years (52%) were somewhat
      younger (79 vs 82 years, p less than 0.01), and on admission had significantly
      higher diastolic blood pressure (p less than 0.001), serum thyroxin (p less than
      0.05), serum albumin (p less than 0.01) and blood haemoglobin (p less than 0.05),
      but lower treatment score (p less than 0.001), serum creatinine (p less than
      0.001), and fasting plasma glucose (p less than 0.05). Decreased survival
      prognosis was also found in patients with abnormal serum sodium, chloride, and
      potassium (p less than 0.05 or less). However, an excess mortality of patients
      with abnormal laboratory data occurred within the first month after admission.
      Stepwise logistic regression analysis disclosed that the three-month survival
      prognosis was significantly impaired by low blood pressure (less than 110/70
      mmHg), high treatment score (greater than 22), elevated serum creatinine (greater
      than 150 mumol/L), use of digitalis and atrial fibrillation. Poor two-year
      survival was further associated with the use of diuretics, and diabetes mellitus.
      The risk for death was lowest in patients with elevated blood pressure (greater
      than 160/95 mmHg). These data verify the significance of the clinically common
      diseases and indicators of homeostasis in the assessment of geriatric hospital
      patients, and demonstrate the nature of "terminal decline" in geriatric practice.

PMID- 1627680
TI  - Twenty-four hour blood pressure monitoring in the Syst-Eur trial.
AB  - This article describes the objectives and protocol of a study on ambulatory blood
      pressure in elderly patients with isolated systolic hypertension. This study
      constitutes an optional side-project to the Syst-Eur trial. The multicentre Syst
      Eur trial investigates whether antihypertensive treatment of elderly patients
      with isolated systolic hypertension will influence the incidence of stroke.
      Secondary endpoints include cardiovascular events, such as myocardial infarction.
      The main objective of the side-project is to investigate whether ambulatory blood
      pressure monitoring will improve the prediction of cardiovascular complications
      based on blood pressure measurement in the clinic. The side-project also provides
      the opportunity to evaluate the diurnal profile of blood pressure in elderly
      patients with isolated systolic hypertension randomized to placebo or active
      antihypertensive treatment.

PMID- 1627681
TI  - Simulation of adaptive mechanisms in the vestibulo-ocular reflex.
AB  - The vestibulo-ocular reflex (VOR), which stabilizes the eyes in space during head
      movements, can undergo adaptive modification to maintain retinal stability in
      response to natural or experimental challenges. A number of models and neural
      sites have been proposed to account for this adaptation but these do not fully
      explain how the nervous system can detect and correct errors in both gain and
      phase of the VOR. This paper presents a general error correction algorithm based
      on the multiplicative combination of three signals (retinal slip velocity, head
      position, head velocity) directly relevant to processing of the VOR. The
      algorithm is highly specific, requiring the combination of particular sets of
      signals to achieve compensation. It is robust, with essentially perfect
      compensation observed for all gain (0.25X - 4.0X) and phase (-180 degrees - +180
      degrees) errors tested. Output of the model closely resembles behavioral data
      from both gain and phase adaptation experiments in a variety of species. Imposing
      physiological constraints (no negative activation levels or changes in the sign
      of unit weights) does not alter the effectiveness of the algorithm. These results
      suggest that the mechanisms implemented in our model correspond to those
      implemented in the brain of the behaving organism. Predictions concerning the
      nature of the adaptive process are specific enough to permit experimental
      verification using electrophysiological techniques. In addition, the model
      provides a strategy for adaptive control of any first order mechanical system.

PMID- 1627682
TI  - Vestibuloocular reflex arc analysis using an experimentally constrained neural
      network.
AB  - The primary function of the vestibuloocular reflex (VOR) is to maintain the
      stability of retinal images during head movements. This function is expressed
      through a complex array of dynamic and adaptive characteristics whose essential
      physiological basis is a disynaptic arc. We present a model of normal VOR
      function using a simple neural network architecture constrained by the
      physiological and anatomical characteristics of this disynaptic reflex arc. When
      tuned using a method of global optimization, this network is capable of
      exhibiting the broadband response characteristics observed in behavioral tests of
      VOR function. Examination of the internal units in the network show that this
      performance is achieved by rediscovering the solution to VOR processing first
      proposed by Skavenski and Robinson (1973). Type I units at the intermediate level
      of the network possess activation characteristics associated with either pure
      position or pure velocity. When the network is made more complex either through
      adding more pairs of internal units or an additional level of units, the
      characteristic division of unit activation properties into position and velocity
      types remains unchanged. Although simple in nature, the results of our
      simulations reinforce the validity of bottom-up approaches to modeling of neutral
      function. In addition, the architecture of the network is consistent with current
      ideas on the characteristics and site of adaptation of the reflex and should be
      compatible with current theories regarding learning rules for synaptic
      modification during VOR adaptation.

PMID- 1627683
TI  - Synaptic potentials and transfer functions of lamprey spinal neurons.
AB  - 1. Electrotonic and chemical synaptic potentials were measured as a function of
      frequency of presynaptic action potentials. Over the frequency range from 0.02 to
      10 Hz, the electrotonic synaptic potential was constant, while the chemical
      synaptic potential decreased in magnitude. Above 10 Hz, both synaptic events
      decreased in magnitude consistent with filtering by the dendritic structures. 2.
      Electrotonic synaptic transfer functions from 0.5 to 100 Hz were measured for the
      I1 reticulospinal Muller axon to spinal neuron electrotonic synaptic junction of
      the lamprey spinal cord using paired recordings from the pre-synaptic terminals
      and the post-synaptic neurons. In addition to this two-point synaptic transfer
      function, individual single point impedance functions of both the post-synaptic
      soma and the pre-synaptic axon terminal were measured. 3. The measured functions
      were interpreted with a computational model based on a three dimensional
      reconstruction of a Lucifer yellow filled motoneuron. Simulations of the model
      for a synaptic location of the I1 synapse were consistent with the measured
      synaptic transfer functions. 4. Synaptic potentials were simulated for inputs on
      dendrites near the I1 axon as well as distal dendritic regions. The high
      frequency filtering increased as the synaptic location was moved from the soma to
      the periphery, but the potential response on distal dendrites was larger than
      would have been predicted from the end of the equivalent cylinder of a Rall model
      that was used to fit soma impedance functions. 5. Electrotonic post-synaptic
      potentials were enhanced by the activation of a TTX-sensitive negative
      conductance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627685
TI  - Purposive behavior and cognitive mapping: a neural network model.
AB  - This study presents a real-time, biologically plausible neural network approach
      to purposive behavior and cognitive mapping. The system is composed of (a) an
      action system, consisting of a goal-seeking neural mechanism controlled by a
      motivational system; and (b) a cognitive system, involving a neural cognitive
      map. The goal-seeking mechanism displays exploratory behavior until either (a)
      the goal is found or (b) an adequate prediction of the goal is generated. The
      cognitive map built by the network is a topological map, i.e., it represents only
      the adjacency, but not distances or directions, between places. The network has
      recurrent and non-recurrent properties that allow the reading of the cognitive
      map without modifying it. Two types of predictions are introduced: fast-time and
      real-time predictions. Fast-time predictions are produced in advance of what
      occurs in real time, when the information stored in the cognitive map is used to
      predict the remote future. Real-time predictions are generated simultaneously
      with the occurrence of environmental events, when the information stored in the
      cognitive map is being updated. Computer simulations show that the network
      successfully describes latent learning and detour behavior in rats. In addition,
      simulations demonstrate that the network can be applied to problem-solving
      paradigms such as the Tower of Hanoi puzzle.

PMID- 1627684
TI  - Detection of motor unit action potentials with surface electrodes: influence of
      electrode size and spacing.
AB  - A model of the motor unit action potential was developed to investigate the
      amplitude and frequency spectrum contributions of motor units, located at various
      depths within muscle, to the surface detected electromyographic (EMG) signal. A
      dipole representation of the transmembrane current in a three-dimensional muscle
      volume was used to estimate detected individual muscle fiber action potentials.
      The effects of anisotropic muscle conductance, innervation zone location,
      propagation velocity, fiber length, electrode area, and electrode configuration
      were included in the fiber action potential model. A motor unit action potential
      was assumed to be the sum of the individual muscle fiber action potentials. A
      computational procedure, based on the notion of isopotential layers, was
      developed which substantially reduced the calculation time required to estimate
      motor unit action potentials. The simulations indicated that: 1) only those motor
      units with muscle fibers located within 10-12 mm of the electrodes would
      contribute significant signal energy to the surface EMG, 2) variation in surface
      area of electrodes has little effect on the detection depth of motor unit action
      potentials, 3) increased interelectrode spacing moderately increases detection
      depth, and 4) the frequency content of action potentials decreases steeply with
      increased electrode-motor unit territory distance.

PMID- 1627686
TI  - Single evoked potential reconstruction by means of wavelet transform.
AB  - We would like to propose a method of single evoked potential (EP) extraction free
      from assumptions and based on a novel approach--the wavelet representation of the
      signal. Wavelets were introduced by Grossman and Morlet in 1984. The method is
      based on the multiresolution signal decomposition. Wavelets are already used for
      speech recognition, geophysics investigations and fractal analysis. This method
      seems to be a useful improvement upon Fourier Transform analysis, since it
      provides simultaneous information on frequency and time localization of the
      signal. We would like to introduce wavelet formalism for the first time to brain
      signal analysis. One of the most important problems in this field is the analysis
      of evoked potentials. This signal has an amplitude several times smaller than
      EEG, therefore stimulus-synchronized averaging is commonly used. This method is
      based on several assumptions. Namely it is postulated that: 1) EP are
      characterized by a deterministic repeatable pattern, 2) EEG has purely stochastic
      character, 3) EEG and EP are independent. These assumptions have been challenged
      e.g. the variability of the EP pattern was demonstrated by John (1973) by means
      of factor analysis. In view of the works of Sayers et al. (1974) and Basar (1988)
      EP reflects the reorganization of the spontaneous activity under the influence of
      a stimulus and it is connected with the redistribution of EEG phases. Several
      attempts to overcome the limitation of the averaging method have been made.
      Heintze and Kunkel (1984) used an autoregressive moving average (ARMA) model to
      extract evoked potentials from 2 segments. This was possible under two
      conditions: high signal to noise ratio and clear separation of the EEG and EP
      spectra.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627687
TI  - Information in channel-coded systems: correlated receivers.
AB  - Noise correlation can easily occur in the densely connected systems observed in
      biological information processing. We study the consequences of noise correlation
      for a statistically optimal processing of noise-perturbed receptor array outputs.
      We find a critical importance of the noise correlation length as compared to the
      receptors' tuning width for both the structure and the performance of the ideal
      observer. We show the general consistency of our scheme with psychophysical
      discrimination thresholds obtained in human spatial vision.

PMID- 1627688
TI  - Heart-lung transplantation: indications and technique.

PMID- 1627689
TI  - Results of lung transplantation.

PMID- 1627690
TI  - Pediatric lung transplantation.

PMID- 1627691
TI  - Retransplantation following isolated lung transplantation.
AB  - The results of retransplantation for early allograft failure are discouraging.
      Fortunately, with recent technical advances and improved postoperative
      immunosuppression, airway complications have been significantly reduced. It is
      now unusual to see patients with airway complications following lung
      transplantation. This group of patients is not likely to represent a large
      population in need of retransplantation in the future. However, rejection
      mediated OB remains a persistent problem seen in all transplant centers. The
      group of patients who deteriorate despite augmented immunosuppression will put
      increasing pressure on transplant programs to provide the only known solution for
      survival: retransplantation. In the Toronto experience, only 1 patient survived
      early retransplantation. Three of the 5 recipients retransplanted late in their
      course have survived and 2 are presently alive and well. Yet this is in sharp
      contrast to the current 80% 1-year survival for initial transplant recipients. As
      the demand for donor lungs increases with the growing need for first-time
      procedures, the use of donor lungs for retransplantation becomes a significant
      problem. The decision whether to allocate a donor lung (and commit significant
      hospital resources) to a retransplant recipient or to a first-time recipient is
      difficult. A patient with early graft failure has a dismal prognosis and a
      decision not to retransplant may be straightforward. However, the decision to
      retransplant a patient who has developed OB late following their initial
      transplant is much more difficult. It is still our responsibility to manage this
      limited resource and provide donor lungs to those who have the optimal chance of
      survival.

PMID- 1627692
TI  - Diagnosis and management of acute and chronic lung rejection.

PMID- 1627694
TI  - Airway complications after lung transplantation.

PMID- 1627693
TI  - Complications following lung transplantation.

PMID- 1627695
TI  - Lung transplantation.

PMID- 1627696
TI  - Lung transplantation: recipient selection.

PMID- 1627697
TI  - Lung transplantation: donor selection.

PMID- 1627698
TI  - Lung preservation.
AB  - Pulmonary transplantation is now a clinical reality that offers hope to large
      numbers of patients with end-stage lung disease. Current methods of preserving
      pulmonary function allow for transplantation, but operation must be expeditious,
      and transportation time and operating time become critical factors in determining
      outcome. The ability to preserve lungs for longer time intervals could
      potentially allow for more widespread distribution of donor organs of unusual
      size or blood type, and could set the stage for more appropriate HLA matching
      between donor and recipient. Furthermore, a more thorough understanding of the
      pathophysiology of preservation injury will likely lead to a better understanding
      of the pathophysiology of other types of lung injury. In turn, this could
      increase the size of the pulmonary donor pool by allowing transplantation of
      lungs with suboptimal gas exchange function at the time of donor brain death.
      Finally, a more thorough understanding of lung metabolism and determinants of
      cellular viability in the lung would be useful for the potential application of
      the use of lungs from circulation-arrested cadavers for transplantation.

PMID- 1627699
TI  - Single lung transplant: indications and technique.

PMID- 1627700
TI  - Bilateral lung transplant: indications and technique.

PMID- 1627702
TI  - Ethics of health research.

PMID- 1627701
TI  - Medical care for institutionalised elderly people in Singapore.
AB  - This study examined physical and financial arrangements for medical care of
      institutionalised elderly people in Singapore. Chief administrators of all long
      term care facilities were interviewed on the existing arrangements for medical
      care of their residents. Results showed that 66 out of a total of 68 (97%) homes
      arranged medical care for residents. Of those, 29 homes offered on-site medical
      care with alternative arrangements when the in-house facilities were not
      operating. While government-owned homes would pay for all medical costs incurred
      by their residents, over 48% of voluntary homes and 87% of commercial homes
      required residents to be financially responsible for their care. The availability
      of financial support given to residents for payment of medical care was found to
      be associated with the type of sponsorship of the homes. While there was adequate
      physical access to medical care, the lack of financial support would pose a
      potential barrier to use of medical care for institutionalised elderly people.

PMID- 1627703
TI  - Alcohol advertising.

PMID- 1627704
TI  - Low birthweight and socioeconomic status, Victoria 1982 to 1986.
AB  - The aim of this study was to evaluate the association between the incidence of
      low birthweight and socioeconomic status, in particular whether the relationship
      was different for very low birthweight (less than 1500 g) and moderately low
      birthweight (1500 to 2499 g). The study population was births from 1982 to 1986
      to women resident in Victoria (300,704). Data on socioeconomic status were
      derived from an indicator developed by the Australian Bureau of Statistics from
      the 1981 census and applied to postcodes. Using the rates of very low birthweight
      and moderately low birthweight in the highest socioeconomic status decile as the
      reference value we found that the relative risk for very low birthweight was
      significantly raised in only the lowest socioeconomic status decile (relative
      risk = 1.29, 95% confidence interval (CI) 1.17 to 1.42). The relative risk for
      moderately low birthweight was increased in the two lowest deciles: 1.19 (CI 1.12
      to 1.26) and 1.09 (CI 1.01 to 1.17) respectively. Women not married at the time
      of the birth had a higher rate of low birthweight and were more likely to live in
      the lower socioeconomic status postcode areas. The relationships between very low
      birthweight, moderately low birthweight and socioeconomic status were attenuated
      but still significant when this factor was taken into account. Differences in low
      birthweight by socioeconomic status decile were not apparent for nonsmoking
      women. The relationship between smoking and low birthweight was different in the
      two lowest socioeconomic status deciles: the relative risk of low birthweight in
      smokers was 2.60 (CI 1.73 to 3.91) compared with a relative risk of 1.64 (CI 1.33
      to 2.03) in deciles 3 to 10.

PMID- 1627705
TI  - A family study of coronary risk factors in Geelong.
AB  - A study of coronary risk factor relationships was carried out in 213 families
      with adolescents in Geelong, Victoria, Australia, in 1987. Weight, height,
      skinfold thicknesses, body circumferences, blood pressure and serum cholesterol
      were measured in both parents and children and other relevant information was
      obtained by questionnaire. The study group did not differ significantly from the
      Geelong population with respect to the proportion of Australian-born parents but
      contained a significantly higher proportion than expected of fathers who had a
      university degree or diploma. Twenty-five per cent of adolescents, 30% of mothers
      and 38% of fathers were positive for at least one of the three major established
      coronary risk factors. Significant correlations between parents and children, but
      not between parents, were found for total cholesterol and systolic blood
      pressure, while significant correlations were observed both between parents and
      children and between parents for measures of body size, body fatness and body fat
      distribution. The strongest predictors of risk factor status in adolescence were
      both parents with total cholesterol at or above 5.5 mmol/l, one or more parents
      who smoked and one or more grandparents with a history of coronary heart disease.
      Body mass index in adolescence was unrelated to heart disease risk factor status
      in adolescence or to a family history of heart disease. During early childhood
      and adolescence, parental risk factor status, rather than anthropometric or risk
      factor screening of the children themselves, is likely to provide the best guide
      to those at risk for an adverse coronary risk factor profile.

PMID- 1627707
TI  - Ecological disruption and human health: the next great challenge to public
      health.

PMID- 1627706
TI  - Ear health of aboriginal primary school children in the Eastern Goldfields Region
      of Western Australia.
AB  - The ear health and state of hearing of 642 Aboriginal children living in the
      Eastern Goldfields of Western Australia in 1989 was assessed by audiometry,
      otoscopy and tympanometry in order to establish the efficacy of the existing ear
      health program. A heavy burden of ear disease and hearing loss is reported and
      the findings are compared with previous surveys. A conclusion is drawn that the
      ear health of this population has not improved in the last decade.

PMID- 1627708
TI  - Measles immunisation compliance: poor impact of bicentennial measles control
      campaigns on children under five.
AB  - A measles immunisation survey was conducted among children who enrolled in school
      kindergarten classes in the Eastern Sydney Area in 1989. Its aims were to
      determine baseline compliance rates, to identify subpopulations at risk of poor
      compliance and to evaluate the impact of the bicentennial measles control
      campaigns on compliance among children under five years. All 73 schools
      participated, questionnaires were returned by 2230 (81.4%) children, and
      compliance with immunisation was 91.3%. 89.1% of children attending public
      schools were immunised, compared to 91.9% of Catholic school pupils and 95.8% of
      independent school pupils (chi 2 = 21.4, P less than 0.001). Among public school
      children, 91.6% of pupils from English-speaking families were immunised in
      comparison to 81.4% of pupils from non-English-speaking backgrounds (chi 2 =
      20.5, P less than or equal to 0.001). The fraction of previously unimmunised
      children who were known to have been immunised during each year of the measles
      control campaigns was 16% in 1986-87, 10% in 1987-88 and 9% in 1988-89. These
      small increments in immunisation uptake suggest that under-five-year-olds were
      not effectively targeted by the measles control campaigns. However, no control
      group was evaluated. Immunisation delivery systems must be designed which ensure
      that all children receive measles-mumps-rubella vaccine as soon as possible after
      the first birthday. Immunisation promotions and service providers will need to
      target specific language and socioeconomic groups.

PMID- 1627709
TI  - Aspirin use in children: heeding the warning?
AB  - In 1986, the Australian Government issued warnings about the use of aspirin for
      children and adolescents after the link had been established between aspirin use
      and Reye's syndrome in America. This study questioned a representative community
      sample of parents in Newcastle, New South Wales, about their awareness of this
      caution, and their recent aspirin use for children under 18 years. While 65% of
      women and 47% of men reported that they were aware of the Government
      recommendations, only 8% of women and 9% of men reported obtaining this
      information from the printed warning on the medicine container or packet. Despite
      awareness of the warnings, almost one third of parents reported administering
      aspirin to their children. When it is necessary to caution patients about the use
      of over-the-counter medications, it is not sufficient to use package labelling as
      the main site of information.

PMID- 1627710
TI  - The public perception of the risks and benefits of alcohol consumption.
AB  - A survey of the community was undertaken in August 1989 to assess the public's
      perception of the risks and benefits of alcohol use, and their understanding of
      recommended levels of safe alcohol consumption. A household sample of 500 men and
      women (18 to 65 years) in metropolitan and rural New South Wales were asked their
      opinions about the risks and benefits of alcohol use, the health and social
      consequences of 'drinking too much', and the number of standard drinks that would
      produce a low, medium and high risk to the health of an adult man and woman. The
      major perceived benefits of alcohol use were relaxation and medication; the major
      health and social problems attributed to alcohol abuse were brain and liver
      damage, and domestic violence and family problems. The quantities of alcohol
      which respondents thought could be consumed with a 'low' risk to health were
      close to National Health and Medical Research Council recommended levels of safe
      consumption.

PMID- 1627711
TI  - Prevalences and perceptions of licit and illicit drugs among New South Wales
      secondary school students, 1989.
AB  - This paper presents findings on drug prevalences for licit and illicit drugs
      among New South Wales secondary school students (n = 3753) in late 1989. It also
      considers the accuracy of students' perceptions of the drug causing the most and
      fewest drug-related deaths. Data were analysed by age and gender, using logistic
      regression for the prevalence data. Findings indicate that licit drugs (tobacco,
      alcohol and analgesics) were the most frequently and widely used. Rates for
      illicit drugs were low, although there was some degree of experimental use of
      cannabis which increased amongst older males. Perceptions were found to be
      inaccurate in emphasising the dangers of the illicit drug heroin over those of
      the licit drugs tobacco and alcohol. Reasons for these findings are discussed,
      and more in-depth research recommended into the relationship between drug
      prevalences and perceptions for different age groups, and its relevance for
      planning drug prevention initiatives.

PMID- 1627712
TI  - Changes in reported drug prevalence among New South Wales secondary school
      students, 1983 to 1989.
AB  - Three drug use surveys employing a standardised questionnaire format and sampling
      procedure were conducted on samples of New South Wales school students in 1983,
      1986 and 1989. Alcohol and tobacco were the most frequently used substances
      across the surveys, with rates of use of illicit substances being considerably
      lower. Declines in the prevalence of alcohol, tobacco and stimulant use were
      found between 1983 and 1986 and between 1986 and 1989 for both males and females.
      Rates of use of inhalants, sedatives, hallucinogens and narcotics declined
      between 1983 and 1986, but remained unchanged between the 1986 and 1989 samples.
      Cannabis use declined significantly among females between 1983 and 1989, but not
      among males. Possible reasons for the general decline in drug use over the six
      year period are discussed.

PMID- 1627713
TI  - The impact of a screening mammography program on Sydney general practitioners.
AB  - The aim of this study was to determine changes in Sydney general practitioners'
      (GPs) knowledge about, attitude towards and intention to recommend screening
      mammography over the two years since a screening mammography program was first
      implemented in the Central Sydney Health Service (CSHS) area. 123 GPs from the
      CSHS area were selected from a list maintained by the Breast X-ray Programme,
      while 127 GPs from the rest of Sydney were selected from the Yellow Pages
      telephone directory. The overall response rate was 84 per cent. Outcomes were
      assessed by a self-administered questionnaire covering knowledge, attitudes and
      beliefs, self-report of recent referral practice, intention to recommend, and
      sources of information about mammography screening. Demographic data were also
      collected. Results showed that overall knowledge has increased both inside and
      outside the CSHS area, but important deficiencies in knowledge remain in both
      areas. Attitudes to screening mammography have improved in the CSHS area,
      especially regarding the efficacy of screening mammography and patient
      compliance. Importantly, positive views of screening mammography have declined
      outside the CSHS area, especially about whether screening mammography can save
      women's lives. GPs in both areas remain concerned about costs. The presence and
      strategies of the Breast X-ray Programme have had some positive effect on the
      attitudes of GPs towards, but not knowledge of, screening mammography.

PMID- 1627714
TI  - Valuable health: what do we want, and how do we get it?

PMID- 1627715
TI  - Evaluating the impact of a promotional campaign for screening mammography: who
      attends?
AB  - The Breast X-ray Programme of the Central Sydney Health Service is one of 11
      pilot programs in Australia assessing the best methods of delivering population
      based mammographic screening. The aim of this study was to determine the
      attendance rate and to describe sociodemographic predictors of attendance in an
      area serviced by the program. A well-defined population of approximately 4500
      women aged 45 to 70 was identified within the Central Sydney area for intensive
      testing of recruitment strategies. After four visits (spanning two years) to the
      area by a mobile screening van, 48% of the women were screened. Women from non
      English-speaking backgrounds were just as likely to attend as women from English
      speaking backgrounds, probably because special attention was given to recruiting
      these women. Older women from English-speaking backgrounds were less likely to
      attend, whereas no age trend existed for women of non-English-speaking
      backgrounds. Sampled attendance data of women from English-speaking backgrounds
      showed that women with more education were more likely to attend screening. Women
      who were employed were just as likely to attend as those who were not. In order
      to screen 70% of the targeted population as set forth for a national mammography
      screening program, it appears that community recruitment efforts alone will not
      be sufficient. With special attention to recruitment coverage, older women and
      women from non-English-speaking backgrounds can be successfully recruited.
      Special attention will also need to be focused on encouraging attendance in women
      who have less formal education.

PMID- 1627716
TI  - Evaluating the impact of a promotional campaign for screening mammography:
      women's knowledge and sources of awareness.
AB  - The Breast X-Ray Programme of the Central Sydney Health Service was advertised by
      generalised strategies aimed at the total community, including poster and
      pamphlet distribution, and strategies aimed at general practitioners,
      supplemented by written invitations and recommendation from the general
      practitioner, invitations for friends, and invitations from the service using the
      electoral listing. In order to evaluate the reach or impact of the promotional
      campaign in the Drummoyne local government area, telephone interviews were
      conducted with women aged 45 to 70 randomly selected from the community. Women's
      knowledge about breast cancer, screening and the Breast X-Ray Programme, plus
      sociodemographic characteristics, were obtained before screening (n = 628), 10
      months (n = 93) and 2 years after screening started (n = 206). While knowledge
      about risk did not change, significant increases were found in the proportion of
      women who had heard of mammography, screening mammography specifically and the
      screening van. In addition there were significant increases in the proportion of
      women exposed to information about screening mammograms. The campaign generally
      had an equal effect on different sociodemographic but managed to achieve greater
      effects in women of non-English-speaking backgrounds and lower occupational
      status. A random sample of program attenders aged 45 to 70 (n = 763) were asked
      how they found out about the van. 'Seeing the van' was the most consistently
      reported source of awareness. Others included 'GPs' 'newspapers', 'other print
      media' and 'personal networks'. Women with additional qualifications since
      leaving school were more likely to state 'newspaper' and 'other print media' as a
      source.

PMID- 1627717
TI  - Ineffective recruitment strategies for screening mammography: letterbox drops and
      invitations for friends.
AB  - To test the effectiveness of two interventions to encourage women to attend for
      mammographic screening, four randomised trials of letterbox drops were conducted.
      Leaflets about the screening service (n = 3984) were distributed to households
      within defined areas. Attendance from the 79 streets where a drop was made was
      compared with attendance from 78 control streets before and after the drop. No
      major effects were found either within each trial or across trials. In the second
      intervention, 69 women who attended the service were offered invitations for two
      friends. An additional 21 attenders were approached with the offer of an
      incentive to recruit friends. Invitations included an explanatory letter with an
      appointment time, a pamphlet and a contact phone number. The final response rate
      was only 7% and an incentive of an instant scratch lottery ticket for the
      original attender did not improve the response. Thus we identified two
      interventions with no major effect in recruiting women to mammographic screening.

PMID- 1627718
TI  - Preferences of rural Victorian women for screening mammography services.
AB  - The aim of this study was to examine rural women's access to regional fixed-site
      screening mammography services and their preferences for either a mobile service
      or a fixed-site centre. One hundred and thirty-seven women aged 49 to 69 from
      rural Victoria were interviewed in June 1991. Eighty-five per cent of women
      normally go to major towns which are possible screening sites at least once every
      six months, spending an average of five hours each visit. Around 77% of women
      said they would be likely to go to a fixed site while 86% said they would be
      likely to go to a mobile service. If the fixed-site centre was at a major town
      not usually frequented, this would be a deterrent to 58% of women. A decision to
      widely implement mobile screening in rural areas of Victoria is not justified at
      this time, but pilot mobile services should be considered.

PMID- 1627719
TI  - Trends in general practitioner distribution from 1984 to 1989.
AB  - An analysis of the distribution of general practitioners by electorates during
      the six years 1984 to 1989 showed that the maldistribution of practitioners in
      Australia has worsened despite significant increases (26%) in total general
      practitioner numbers. One in five rural electorates had worse population-to
      general-practitioner ratios in 1989 than in 1984. The changes in distribution of
      general practitioners ran counter to the changes in distribution of the
      population over the period studied. In 1984, the 38.7% of the population living
      in rural Australia was served by 33% of the nation's general practitioners. By
      1989, more of the population (39.8%) lived in rural areas but they were served by
      a smaller proportion (32%) of the general practitioner workforce. It is clear
      that many urban electorates have fewer people per general practitioner than the
      most generous ideal ratios, while most rural electorates have more people per
      general practitioner than the least generous.

PMID- 1627720
TI  - Progress in assessing the quality of Australian nursing home care.
AB  - This paper critically examines the clarity, practicality, desirability and
      validity of the 31 outcome standards that the Commonwealth Government introduced
      to assess quality of care in Australian nursing homes. Key features of the
      Australian system in an international context are its focus on outcomes, the
      limited number of standards used, and the comparatively subjective nature of some
      standards. Directors of nursing from 410 nursing homes in the Brisbane, Sydney,
      Melbourne and Adelaide metropolitan areas were interviewed as part of the Nursing
      Home Regulation in Action Project. The overwhelming majority reported the
      standards as clear and desirable. In the minority of cases where problems were
      raised, practicability was the basis for concern. A factor analysis of the
      ratings given by standards monitoring teams to these 410 homes failed to
      demonstrate redundancy across standards or grouping of standards by objectives.
      Nevertheless, the standards were sufficiently highly interrelated to justify
      summing to produce an overall compliance score. This study shows that the 31
      standards hold up well under scrutiny, both from the perspectives of key actors
      in the monitoring process, and from a psychometric point of view.

PMID- 1627721
TI  - A five-year study of residents of a special hostel for people with dementia.
AB  - In order to consider whether admission to a special hostel was a desirable policy
      in view of the likelihood of subsequent transfer to a nursing home, this study
      compared the time spent by residents in a special hostel with the period in a
      nursing home after they were transferred out of the hostel. We also estimated the
      number of nursing home places necessary for residents who were transferred and
      studied the reasons for transfer. The setting was a special hostel in Perth,
      Western Australia, for 36 people with moderate or severe dementia. The periods
      spent in the hostel or a nursing home were calculated for all residents admitted
      between 1985 and 1990. Forty-two of the 84 residents admitted during the study
      period were transferred to nursing homes. About two thirds of the total time in
      the two institutions was spent in the hostel. The two principal reasons
      necessitating transfer to a nursing home were advancing dementia and the addition
      of a physical impairment. Because a major proportion of the care of selected
      people with dementia (who can no longer remain at home) can be undertaken in a
      special hostel, this facility should be included with standard hostel and nursing
      home in arrangements for institutional care. Between 20 and 25 nursing home
      places are necessary for residents transferred from a hostel of this size.

PMID- 1627722
TI  - Characterization of two phospholipases A2 in serum of patients with sepsis and
      acute pancreatitis.
AB  - Pancreatic phospholipase A2 and non-pancreatic ascitic phospholipases A2 were
      studied in sera of healthy individuals and of patients suffering from sepsis or
      acute pancreatitis. In gel filtration experiments, immunoreactive ascitic
      phospholipase A2, as determined in serum by a time-resolved fluoroimmunoassay,
      eluted either unassociated with an apparent M(r) of 10,000-14,000 or associated
      with proteins of high molecular mass. Catalytically active ascitic phospholipase
      A2 was associated with high molecular weight proteins. In acute pancreatitis the
      catalytically active and immunoreactive pancreatic phospholipase A2 eluted mainly
      as a protein of M(r) of 14,000. The results of the gel filtration experiments
      indicate that pancreatic phospholipase A2 is not associated with other proteins
      in human serum, whereas ascitic phospholipase A2 is associated with protein(s) of
      relative high molecular weight, or exists in different polymeric forms. We also
      purified phospholipase A2 from sera of healthy individuals by ion exchange
      chromatography and HPLC. The enzyme was homogenous, displayed an M(r) of
      approximately 13,500 as judged by SDS-polyacrylamide gel electrophoresis, and
      reacted with an antibody raised against ascitic phospholipase A2.

PMID- 1627723
TI  - Age-related changes in cerebrospinal fluid gamma-aminobutyric acid concentration.
AB  - The purpose of this study was to clarify the effect of aging on brain gamma
      aminobutyric acid metabolism. We measured the cerebrospinal fluid gamma
      aminobutyric acid concentration in subjects of various ages, including healthy
      volunteers and patients without neurological or psychiatric disease. The
      cerebrospinal fluid gamma-aminobutyric acid concentration was determined by
      radiolabelled receptor assay using [3H]gamma-aminobutyric acid. Cerebrospinal
      fluid gamma-aminobutyric acid was significantly higher in the control group (20s
      and 30s) than in the groups of subjects in their 50s, 60s, 70s and 80s. There was
      a significant negative correlation between cerebrospinal gamma-aminobutyric acid
      concentration and age (p less than 0.01). These data suggest that dysfunction of
      brain gamma-aminobutyric acid metabolism increases with age, and that the various
      symptoms caused by abnormal gamma-aminobutyric acid metabolism in the brain are
      therefore more likely to appear in elderly people.

PMID- 1627724
TI  - The extent of diffuse intravascular coagulation and fibrinolysis in patients with
      liver cirrhosis.
AB  - Twenty-five patients with different stages of liver cirrhosis were evaluated with
      regard to the degree of liver synthesis reduction, the extent of the decrease of
      blood coagulation factors and/or alterations of the fibrinolytic system. For the
      assessment of the residual level of liver synthesis we used pseudo-cholinesterase
      and serum albumin as references. We did not find a correlation between these
      quantities and antithrombin III or fibrinogen, but highly significant inverse
      correlations with tissue plasminogen activator activity and D-dimer
      concentration. We found considerable alterations in the concentrations of the
      coagulation and fibrinolysis factors, with the exception of fibrinogen and
      plasminogen activator inhibitor. Significant increases were seen for thrombin
      antithrombin III complex, tissue plasminogen activator activity and D-dimer,
      while significant decreases were seen for antithrombin III and alpha 2
      antiplasmin, compared with a group of healthy volunteers. In the group of
      patients with liver cirrhosis and reduced liver synthesis, as documented by
      lowered pseudo-cholinesterase and serum albumin, the reduction of both
      antithrombin III and alpha 2-antiplasmin was most prominent. Intravascular
      coagulation was negligibly small. For the fibrinolytic system, the increase of
      tissue plasminogen activator, the decrease of the fibrinolysis inhibitor (alpha 2
      antiplasmin) and the elevated D-dimer concentration seem to be important. These
      results suggest an acceleration of fibrinolysis and the prolonged presence of
      cross-linked fibrin degradation products.

PMID- 1627725
TI  - Comparison of four procedures for measuring elastase production by Pseudomonas
      aeruginosa strains from cystic fibrosis patients.
AB  - Forty-five Pseudomonas aeruginosa strains were isolated from the sputa of cystic
      fibrosis patients. The elastase production of each strain was assayed in the
      culture supernatant using four different procedures, i.e. two immunological
      assays (RIA and ELISA), and two enzymatic assays, the latter employing either
      elastin or tetraalanine as substrate, with conductometric measurement of
      substrate hydrolysis. Elastase concentrations were determined from standard
      curves prepared with the same purified elastase, and expressed in mg of elastase
      per litre of supernatant. The resulting values were in the range reported in the
      literature, and differed greatly from one strain to another (0-230 mg/l). Linear
      relationships were found when assays were compared in pairs. Significant
      correlation coefficients were obtained (r greater than 0.76, p less than 0.001)
      but the values were quite different for different assays. Thus, ELISA
      measurements were always from three to five times higher, and RIA results were
      from two to five times lower, than those from the other assays. Enzymatic assays
      with elastin gave higher values than those using tetraalanine. Most P. aeruginosa
      strains produce two other proteinases, alkaline proteinase and Las A protein.
      Both enzymes have limited elastolytic and peptidasic activities. The presence of
      alkaline proteinase does not result in falsely elevated elastase values, but an
      increase of elastase activity was observed when Las A was preincubated with
      elastin. Since this increase was not observed when tetraalanine was used as the
      substrate, the presence of Las A in the supernatants could explain the
      differences observed between the enzymatic assays. The assay with the synthetic
      substrate is therefore preferred.

PMID- 1627726
TI  - Evaluation of interlaboratory proficiency surveys of bilirubin determinations in
      sera of newborns.
AB  - We evaluated the results of two surveys of neonatal bilirubin determinations in
      66 Slovakian clinical chemistry laboratories. Identical control samples prepared
      as described by Vink (Clin. Chem. 33 (1987) 1817-1821) and commercially available
      control serum were used for both surveys. These control samples were analysed in
      the participating laboratories using various modifications of diazo techniques
      based on the Grof-Jendrassik principle, and direct two-wavelength
      spectrophotometry according to Vink (Clin. Chem. 34 (1988) 67-70). The
      interlaboratory precision and accuracy of these two different analytical
      principles were compared. For diazo techniques the CVs varied from +/- 6.8% to +/
      10.3%, while the CVs for direct spectrophotometry were between +/- 5.3% and +/-
      6.4%. Better results were obtained by recalculating the raw data of the analyses
      from all laboratories, using the reported results for the analysis of an
      identical calibrant. Accuracy was evaluated as the percentage of acceptable
      results (within +/- 7% of the reference values). About 60% of the results
      obtained with diazo methods were considered acceptable, compared with about 22%
      of those obtained by direct spectrophotometry. However, results recalculated on
      the basis of the identical calibrant showed greater accuracy; acceptable results
      then varied between 74% and 82% of the total for the diazo techniques and from
      83% to 91% for direct spectrophotometry.

PMID- 1627727
TI  - An indirect ELISA for urinary gonadotropins using immobilized human menopausal
      gonadotropin.
AB  - An indirect ELISA for the estimation of urinary gonadotropins is described. Human
      menopausal gonadotropin is adsorbed on a microtitre plate, where it serves as an
      immunosorbent. The residual antigonadotropin antibody is captured by the
      immunosorbent after reaction with the sample or standard and detected with enzyme
      labelled antispecies antibody (antirabbit gamma-globulin-horse radish
      peroxidase). The assay developed here is rapid and satisfies usual validatory
      criteria expected from an immunoassay. Moreover, it obviates the need for
      extraction of samples with acetone, as shown by the close agreement between the
      respective lutropin or follitropin concentrations in extracted and unextracted
      urine samples.

PMID- 1627728
TI  - A time-resolved fluoroimmuno assay of the IgM-rheumatoid factor.
AB  - A time-resolved fluoroimmuno assay of the IgM-rheumatoid factor is described.
      Aggregated rabbit IgG was coated to microtitre plates to serve as the target
      protein. F(ab')2-fragments from antibodies, raised in rabbits against human IgM,
      were labelled with Eu3+ and used in the assay to mark the bound IgM-rheumatoid
      factor. The labelling procedure is easy to perform, and there is no need for
      special equipment. The shelf life of the label at -20 degrees C is at least one
      year. The lower detection limit of the assay is 1.3 x 10(3) IU/l. The range over
      which the IgM-rheumatoid factor can be measured at a within-run precision of less
      than 5% without varying the dilution (working range) is 5-1200 x 10(3) IU/l.
      Linearity in serum dilutions is good. There is good correlation with existing
      methods for the assay of IgM-rheumatoid factor. This correlation is better with
      an assay using rabbit IgG as the target than with one using human IgG. Comparison
      of methods shows that standardization, despite the use of the WHO Reference
      Preparation as the first calibrator, remains problematic. The 95th percentile in
      normal bloodbank donors is 8 x 10(3) IU/l. The costs for the reagents were about
      0.5 Dutch florin (ca 0.30 US-$) per well. In conclusion, the method described
      here is analytically at least comparable with other methods, in precision,
      linearity, working range etc. Finally, it is easy to perform.

PMID- 1627729
TI  - Automated latex nephelometric immunoassay of theophylline in human serum.
AB  - A latex test was adapted for the nephelometric quantitation of theophylline in
      human serum. The assay is fully automated on the Behring Nephelometer Analyser
      with a sampling rate of 150 samples per hour. There is no interference from
      bilirubin (up to 340 mumol/l), haemoglobin (up to 7000 mg/l), Intralipid (up to 5
      g/l), or rheumatoid factor (up to 1100 x 10(3) IU/l). The theophylline standard
      curve extends from 1.25 to 40 mg/l. The coefficient of variation ranged from 2.4
      to 7.4%. The correlation coefficient between the latex immunoassay and the TDx
      theophylline procedure was 0.988, calculated from the assay of 74 samples.

PMID- 1627730
TI  - Proposed quality specifications for the imprecision and inaccuracy of analytical
      systems for clinical chemistry.
AB  - A Working Group of the European Group for the Evaluation of Reagents and
      Analytical Systems in Laboratory Medicine proposes, after detailed study of the
      advantages and disadvantages of available strategies, the following quality
      specifications for analytical systems for clinical chemistry. Total imprecision
      should be: (a) less than one-half of the average within-subject biological
      variation, or (b) less than the state of the art achieved by the best 0.20
      fractile of laboratories, whichever is the less stringent. The second approach
      may be used when data on biological variation do not exist. Inaccuracy should be:
      (a) less than one-quarter of the group (within- plus between-subject) biological
      variation, or (b) less than one-sixteenth of the reference interval, when data on
      group biological variation do not exist, or (c) less than twice the ideal
      imprecision, if the above specifications are too demanding.

PMID- 1627731
TI  - Symbiotic interactions in the EVOLVE III ecosystem model.
AB  - Parasitic feeding mechanisms were introduced into the EVOLVE III ecosystem model.
      The modified system exhibited a number of interesting behaviors, including
      obligative and facultative parasitism, transient facultative mutualism and
      nonsymbiotic feeding. Speciation and massive die-offs were also observed. The
      introduction of a symbiotic capability altered the co-evolutionary development of
      traits that exhibited an arms race when the symbiotic capability was not present.
      Stable mutualisms were not possible in the present version of the model due to
      the restriction that organisms were not allowed to feed both on other organisms
      and from the environment at the same time. The ecosystem biomass increased with
      increased symbiotic activity. Biomass was influenced by the balance of virulence
      and resistance traits in the population and decreased as these traits became more
      disparate.

PMID- 1627732
TI  - Formation of a regular dissipative structure: a bifurcation and non-linear
      analysis.
AB  - A non-linear reaction diffusion model of a negative feedback epigenetic control
      system is presented. The model involves synthesis of the mitotic inducing and
      inhibiting proteins, simultaneously with intercellular self-diffusion and cross
      diffusion of the latter only. The importance of negative cross-diffusion for
      creating a regular dissipative structure is shown. A bifurcation analysis of the
      non-linear diffusive system has been performed and it is concluded that
      bifurcation is supercritical. Lastly, using Liapunov's direct method, it is shown
      that the pattern evolved by the system is globally asymptotically stable.

PMID- 1627733
TI  - Propagation of force and the induced bending displacement along eukaryotic
      flagellar axoneme.
AB  - The mechanical forces responsible for inducing the bending movement of eukaryotic
      flagellar axonemes have components that propagate at velocities different from
      those for the displacement of the medium. These forces are subject to the Third
      Law of Mechanics which states the null-conservation of acting and reacting
      forces. Experimental demonstration of the propagating internal tensile force
      along the axoneme, when not accompanied by simultaneous bending displacement,
      demonstrates that the active force for the bending of the flagellar axoneme is
      part of the process of counterbalancing the corresponding reactive force to the
      ATP hydrolysis underlying the force generation.

PMID- 1627734
TI  - Bone marrow regeneration under cytotoxic drug regimens: behaviour ranging from
      homeostasis to unpredictability in a model for hemopoietic differentiation.
AB  - In the process of hemopoiesis, bone marrow stem cells differentiate into the
      various types of mature blood cells. We present a model for bone marrow dynamics,
      which retrieves its ability to continuously modulate the balance between self
      renewal and differentiation, even under periodic cytodestructive perturbations.
      Yet, a temporally stochastic perturbation results in chaotic-like behaviour which
      has no deterministic source.

PMID- 1627735
TI  - Somatic kinetics or paroral membrane: which came first in ciliate evolution?
AB  - The ciliate species which lack a distinctive oral ciliature are considered to
      represent an ancestral state in ciliate evolution. Consequently, the somatic
      kineties composed of kinetids (kinetosomes plus cilia and associated fibrillar
      systems) are thought to be the ancestral ciliature. Results on stomatogenesis in
      'gymnostomial ciliates' have shown that these ciliates probably have evolved from
      ancestors already equipped with an oral ciliature. Thus instead of the somatic,
      the oral ciliature may be regarded an ancestral. Based on these ideas a
      hypothesis on the evolution of the ciliate kinetome (assembly of all kinetids
      covering the body of a given ciliate) is presented. The first step in the
      evolution of the kinetome was the formation of a paroral membrane, a compound
      ciliary organelle lying along the right side of the oral area which historically
      but falsely is termed membrane. It was composed of kinetosomal dyads
      (dikinetids), derived from the kinetid of a dinoflagellate-like ancestor. From
      the beginning the paroral membrane was responsible for locomotion, ingestion and
      for the formation of a cytopharyngeal tube which the first ciliate probably had
      inherited from its flagellate ancestor. In the second step a first somatic kinety
      was formed from the right row of kinetosomes of the paroral membrane as a result
      of a longitudinal splitting of the paroral membrane and a subsequent migration of
      the forming kinety to the right into the somatic cortex. To increase the number
      of somatic kineties this process was repeated until the kinety produced first
      reached the left border of the oral area. By this step the locomotive and the
      nutritional functions were differentiated between somatic and oral structures. In
      a third step the adoral organelles were formed from somatic kinetids left of the
      oral area. The primitive type of stomatogenesis was a buccokinetal one derived
      from the mode the flagellate ancestor used to distribute its replicated
      kinetosomes to the offspring cells (buccokinetal means that at least parts of the
      oral anlage for the posterior offspring cell has its origin in the parental oral
      apparatus). This hypothesis, based on comparative studies on ciliate
      morphogenesis, is corroborated by molecular data from other laboratories.

PMID- 1627736
TI  - Effects of stress on adrenal steroidogenesis blockade by aminoglutethimide.
AB  - After one week of AG-treatment, the adrenal cortex reveals a marked storage of
      lipids and cholesterol, as well as a decrease in haematic corticosterone and
      progesterone levels. On the contrary, when AG-treatment is associated with
      stress, an increase in plasma corticosterone and progesterone levels occurs,
      together with a less evident lipidic storage in the adrenal cortex. These results
      seem to indicate the possibility that, during stress, hypothalamo-hypophysis axis
      activation is able to remove, at least partially, the adrenal biosynthesis
      blockade operated by AG-administration.

PMID- 1627737
TI  - Measurement of carbon clearance in mice as toxicity parameter for liposomal
      preparations.
AB  - The measurement of carbon clearance in female BDF1 mice was used for the
      characterization of affinity of empty multilamellar (MLV) or small unilamellar
      vesicles (SUV) made from HEPC:CH:DCP 1:1:0,25 to the reticuloendothelial system
      (RES). Five mice each were treated i.v. with the corresponding liposomes or
      physiologic saline. At different times after treatment india ink was administered
      i.v. and its elimination over 15 minutes was determined by measuring the
      extinction in blood at 650 nm. MLV had a significant influence on the phagocytic
      function of RES, leading to a three-fold prolongation of elimination half time
      after 8h. At 48 hours the normal function of RES was restored. This effect was
      already seen with a dose of 0.05 ml MLV/mouse corresponding to 1.06 mg lipid. On
      the contrary, SUV caused no change of carbon clearance up to a dose of 0.8
      ml/mouse. From these results we conclude that liposomes, especially MLV, can lead
      to a measurable but reversible impairment of RES function, while SUV are better
      suited for a by-pass of this tissue and a probable reaching of other targets, as,
      for example tumors.

PMID- 1627738
TI  - Effect of pine seed shell extract on microbial and viral infection.
AB  - Pretreatment of mice with ammonia extract of seed shell of Pinus Koraicenis, via
      the intraperitoneal or intravenous route, effectively protected them from lethal
      infection of Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus.
      The pine seed shell extract also moderately inhibited syncytium formation and
      cytopathogenic effect induced by human immunodeficiency virus (HIV) infection in
      cultured human lymphotropic virus type I (HTLV-1) positive MT-4 cells. These data
      suggest a medicinal potential of pine seed shell extract against opportunistic
      infection in HIV patients.

PMID- 1627739
TI  - Modulation by the insecticides heptachlor and chlordane of the cell-mediated
      immune proliferative responses of rhesus monkeys.
AB  - Peripheral blood mononuclear cells (PBMC) were isolated from heparinized blood
      samples from twelve young, healthy male rhesus monkeys. Triplicate cultures were
      made in RPMI 1640 with 10% heat-inactivated homologous plasma with or without the
      test mitogens (phytohemagglutinin, concanavalin A and pokeweed mitogen). Under a
      defined assay condition, although a different monkey responded to a different
      degree (3 to 4-fold difference in stimulation index) to a specific mitogen, the
      proliferative responses of all monkeys were affected significantly by the
      addition of the chlorinated hydrocarbon heptachlor or chlordane to the test
      cultures. The insecticides, at 10-40 microM, may also act as mitogens for the
      unstimulated monkey PBMC or stimulate the release of IL-2 from a mitogen
      stimulated culture. At 80 microM, both heptachlor and chlordane completely
      suppressed the proliferation and IL-2 release of the monkey lymphocytes. These
      studies suggest immunomodulatory effects of the insecticides heptachlor and
      chlordane.

PMID- 1627740
TI  - Ascorbic acid with cupric ions as a chemotherapy for human lung tumor xenografts
      implanted beneath the renal capsule of immunocompetent mice.
AB  - The growth of human lung carcinoma xenografts implanted beneath the renal capsule
      of immunocompetent mice was investigated (the six-day subrenal capsule assay) by
      using combinations of ascorbic acid and cupric ions. A maximum suppression of
      growth of this human lung tumor, LX-1, was observed at an estimated consumption
      level by the mice of 6 to 8 g ascorbic acid and 2 to 5 mg cupric ions per day per
      kg body weight. The data suggest that more than one oxidative or degradative
      product of ascorbic acid or of some copper compounds may be responsible for the
      observed antitumor activities, and that the chemotherapeutic effect is being
      produced at some stoichiometric ratios of ascorbic acid to cupric ions. When such
      a combination of the two substances was consumed by the mice, optimal therapeutic
      effect was exerted on the implanted xenografts.

PMID- 1627741
TI  - Effect of atrazine on hemopoietic system.
AB  - For a long time some pesticides (chlordane, lindane, DDT) have been associated
      with bone marrow aplasia. Little is known on the toxic activity of the herbicides
      s-triazines on hemopoiesis. We studied the effect of one of these compounds
      (atrazine) on mouse hemopoietic progenitors (CFU-S and GM-CFC) and on peripheral
      blood (leukocytes and reticulocytes) after a single i.p. injection of 58.65
      mg/kg. The peripheral blood leukocyte level was not modified; on the contrary,
      reticulocytes dropped severely but recovered promptly. Hemopoietic progenitors
      were severely hit but they recovered and reached normal levels in a few days. Our
      results demonstrate a hemotoxic effect of atrazine. However, more data are
      needed, especially in experiments with chronic exposure.

PMID- 1627742
TI  - Acute inflammation effects on in vivo granulopoiesis: comparative studies in
      healthy and leukaemic mice.
AB  - Mice undergoing an inflammatory reaction, induced by subcutaneous implantation of
      copper rods, elaborate two kinds of humoral stimulatory factors: the diffusible
      granulopoietic stimulator (DGS) that enhances diffusion chamber (DC)
      granulopoiesis, and the serum colony stimulating factor (CSF) that stimulates in
      vitro granulocyte-monocyte colony growth. We demonstrate here that mice suffering
      from acute myeloid leukaemia (AML) are unable to augment the production of these
      humoral stimulatory factors when acute inflammation is induced. Moreover, our
      results show that increased levels of normal humoral stimulatory factors (DGS and
      CSF) do not influence the proliferation and/or the differentiation of leukaemic
      cells implanted in DC.

PMID- 1627743
TI  - Carcinogenicity of lifelong administration of capsaicin of hot pepper in mice.
AB  - Capsaicin was administered in a semisynthetic powdered diet at 0.03125% level for
      the lifespan of Swiss mice starting from 6 weeks of age. As a result of C
      treatment, tumors of the cecum were induced in 22% of females and 14% of males,
      whereas the corresponding tumor incidences in untreated female and male controls
      were both 8%. Histopathologically, the tumors were classified as benign polypoid
      adenomas. Capsaicin is the main pungent principle of hot pepper, which is
      consumed in high quantities by humans worldwide. The capsaicin content of some
      chili varieties ranges up to 0.53%.

PMID- 1627744
TI  - Some physiological characteristics of (SLN X C3H/He)F1 obese mice.
AB  - (SLN x C3H/He)F1 mice of both sexes showed significantly heavier body weights
      than the parental strains associated with the higher food intake and an
      accumulation of adipose tissue in the subcutaneous and the abdominal regions.
      Furthermore, serum levels of free fatty acid and growth hormone of F1 mice were
      higher and lower, respectively, than those of the parental strains. The results
      indicate that the obesity of these F1 mice is ascribed to excess food intake and
      metabolic disorders and they are promising as an animal model for the study of
      several diseases related to obesity.

PMID- 1627745
TI  - Relationship between pup growth, mother weight, food or water intake in four
      strains of mice.
AB  - The partial correlation coefficients were computed between pup growth rate on day
      12 of lactation and mother weight on day 11 or daily food or water intake by
      mother between days 4 and 11 in the 1st to 3rd lactations of four strains of
      mice, SHN, SLN, C3H/He and GR/A, in order to estimate the influence of food
      and/or water intake on lactational performance (pup growth) and mother weight. In
      SHN mice, pup growth rate had negative and positive correlations with food intake
      and mother weight, respectively, in the 1st lactation. This indicates that food
      ingested is used for mother weight increase rather than for lactation. On the
      contrary, there was a positive correlation between pup growth rate and food
      intake in the 3rd lactation of SHN mice and in the 2nd lactation of GR/A mice,
      suggesting the preferential contribution of food to lactation. In neither SLN nor
      C3H/He mice apparent relations between variables were seen. These results suggest
      the careful choice of mouse strains for studies on nutrition and lactation.

PMID- 1627746
TI  - Transplantation of canine malignant lymphomas in the nude and SCID mouse.
AB  - Canine lymphoid tumours, which share a number of features with human non
      Hodgkin's lymphomas, were grafted in nude or SCID mice. Two (DL.24,DL.31) out of
      eight lymphomas and two (DL.31,DL.35) out of three lymphomas produced a sub
      cutaneous (s.c.) tumour in nude and SCID mice respectively. In all animals, the
      s.c. tumours that developed at the inoculation site were regularly associated
      with metastasis to the regional lymph nodes, and also to the spleen, liver and
      bone marrow in SCID mice. The four transplanted tumours, with a pseudo-diploid
      canine karyotype, were diffuse large cell lymphomas as the initial dog tumours,
      and could be immunophenotypically characterized by surface immunoglobulins, MHC
      class 2 and Thy-1 antigens. Serially transplanted lymphomas in nude and SCID mice
      may hence be used for further studies of these tumours.

PMID- 1627747
TI  - Quantification of the sulphomucin-producing cell population of the colonic mucosa
      during protracted stress in rats.
AB  - The sulphomucins contained in goblet cells of the descending colon of 55 Sprague
      Dawley rats were histochemically labelled by High Iron Diamine (HID) and
      quantified in an image analyzer (Cortex controller). After transportation to the
      stress laboratory, 25 rats were compelled to swim for two consecutive hours/day
      either only once (5 rats), for one week (5 rats), two weeks (5 rats), four weeks
      (5 rats) or eight weeks (5 rats). 25 additional rats were only transported to the
      stress laboratory (i.e. "sham-handled" control), either once (5 rats), for one
      week (5 rats), two weeks (5 rats), four weeks (5 rats) or eight weeks (5 rats).
      The remaining 5 rats were "untransported", resting control rats (i.e. day zero).
      The results were expressed in percent of HID-staining/total mucosa analyzed. When
      various time intervals were compared with those of day zero (i.e. horizontal
      study), it was found that one day swimming rats had a significantly lower
      percentage (p less than 0.001) of HID stained material. The fluctuations at other
      time intervals were non-significant. On the other hand, for transported rats, a
      significant increase (p less than 0.001) in the percentage of HID positive areas
      was found for rats swimming for eight weeks. When compared to day one, the
      percentage of HID positive areas increased from day one to one-eight weeks, the
      differences being significant (p less than 0.001) at four and (p less than 0.01)
      eight weeks. Similar results were found for transported rats.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1627748
TI  - Oviductal glycoproteins in sexually immature mice.
AB  - The expression of oviductal glycoproteins was studied in prepubertal mice by
      lectin overlay of electrophoretically separated cellular extracts. Two N
      acetylgalactosamine specific lectins [Maclura pomifera (MPA), and Ricinus
      communis (RCA-I)] were used to study samples obtained from 7, 14, 21 and 28 day
      old virgin mice. A total of 9 developmentally regulated glycoprotein bands were
      identified. Several patterns of glycoprotein expression were noticed:
      glycoproteins expressed equally strongly in all stages of development;
      glycoproteins that were weakly expressed or not found in 7 day old or 14 and 21
      day old mice but became more prominent and reached maximal expression in mature
      mice; glycoproteins expressed under the influence of maternal hormones at 7 days
      that became barely detectable in 14 and 21 day old mice but were strongly
      expressed in mature mice. These data show that the pattern of expression of
      oviductal glycoproteins changes during the prepubertal maturation of the oviduct.

PMID- 1627749
TI  - Relationship between preimplantation host weight and growth of the mouse
      adenocarcinoma EO 771.
AB  - Growth curves of 26 EO 771 adenocarcinomas transplanted under identical
      conditions into 26 syngeneic C57bl/6 male mice of the same age but with different
      body weight were analyzed using the method of the recursion formula of the
      Gompertz function. The results of this analysis were then related to the body
      weight of the animals at the time of tumor implantation. Although all tumors grew
      according to the Gompertz mode of growth, the growth curves differed from each
      other. Moreover, there is a statistically significant correlation between the
      parameters of the individual growth curves and the corresponding animal weight at
      the time of tumor implantation (p less than 0.025). In animals with higher body
      weight the tumors grew with a higher initial growth rate and subsequently with a
      faster growth deceleration compared to animals with lower body weight. The
      physiological basis for this relationship is unknown but the question arises
      whether this relationship also has some meaning for human malignancies.

PMID- 1627750
TI  - Distribution of a novel nuclear protein in normal and regenerating liver cells.
AB  - Monoclonal antibodies to a rat liver nuclear protein (B2, 68 kda, pI: 6.5-8.2)
      have been established and characterized to localize the distribution of this
      antigen in nuclear organization. It was demonstrated that this nuclear protein B2
      is associated with actively transcribed nucleosomes and the nuclear matrix as
      revealed by immunogold labelling. In the regenerating liver cell, the immunogold
      particles are predominantly in the euchromatin as compared to the resting liver
      cells which are mainly in nuclear matrix and heterochromatin. It was also
      demonstrated that the incorporation of 32P into the nuclear protein B2 is
      increased 6-fold in the actively transcribed nucleosomes as compared to the
      nuclear matrix, as analyzed by two-dimensional polyacrylamide gel
      electrophoresis. We hypothesize that this nuclear protein may act as an anchorage
      point either for actively transcribed RNA or for DNA replication. Once this
      protein is highly phosphorylated, it dissociates from the nuclear envelope and
      can then dynamically interact with active nucleosomes within the nucleus.

PMID- 1627751
TI  - The renal dopamine receptors.
AB  - Dopamine is an endogenous catecholamine that modulates many functions including
      behavior, movement, nerve conduction, hormone synthesis and release, blood
      pressure, and ion fluxes. Dopamine receptors in the brain have been classically
      divided into D1 and D2 subtypes, based on pharmacological data. However,
      molecular biology techniques have identified many more dopamine receptor
      subtypes. Several of the receptors cloned from the brain correspond to the
      classically described D1 and D2 receptors. Several D1 receptor subtypes have been
      cloned (D1A, D1B, and D5) and are each coupled to the stimulation of adenylyl
      cyclase. The D2 receptor has two isoforms, a shorter form, composed of 415 amino
      acids, is termed the D2short receptor. The long form, called the D2long receptor,
      is composed of 444 amino acids; both are coupled to the inhibition of adenylyl
      cyclase. The D3 and D4 receptors are closely related to, but clearly distinct
      from, the D2 receptor. They have not yet been linked to adenylyl cyclase
      activity. Outside of the central nervous system, the peripheral dopamine
      receptors have been classified into the DA1 and DA2 subtypes, on the basis of
      synaptic localization. The pharmacological properties of DA1 receptors roughly
      approximate those of D1 and D5 receptors, whereas those of DA2 receptors
      approximate those of D2 receptors. A renal dopamine receptor with some
      pharmacological features of the D2 receptor but not linked to adenylyl cyclase
      has been described in the renal cortex and inner medulla. In the inner medulla,
      this D2-like receptor, termed DA2k, is linked to stimulation of prostaglandin E2
      production, apparently due to stimulation of phospholipase A2. Of the cloned
      dopamine receptors, only the mRNA of the D3 receptor has been reported in the
      kidney. The DA1 receptor in the kidney is associated with renal vasodilation and
      an increase in electrolyte excretion. The DA1-related vasodilation and inhibition
      of electrolyte transport is mediated by cAMP. The role of renal DA2 receptors
      remains to be clarified. Although DA1 and DA2 receptors may act in concert to
      decrease transport in the renal proximal convoluted tubule, the overall function
      of DA2 receptors may be actually the opposite of those noted for DA1 receptors.
      Dopamine has been postulated to act as an intrarenal natriuretic hormone.
      Moreover, an aberrant renal dopaminergic system may play a role in the
      pathogenesis of some forms of hypertension. A decreased renal production of
      dopamine and/or a defective transduction of the dopamine signal is/are present in
      some animal models of experimental hypertension as well as in some forms of human
      essential hypertension.

PMID- 1627752
TI  - Studies to determine the basis for hyperkalemia in recipients of a renal
      transplant who are treated with cyclosporine.
AB  - Hyperkalemia is commonly encountered in patients who receive a renal transplant
      and the immunosuppressive drug, cyclosporine. There is also a high incidence of
      hypertension (which is thought to be due to expansion of the extracellular fluid
      volume) and hyperchloremic metabolic acidosis in this group of patients. This
      constellation of findings led to the suspicion of the possibility that their
      basis might be type II hypoaldosteronism. To test this hypothesis, 12 patients
      with hyperkalemia (plasma K+, 5.1 +/- 0.2 mmol/L at the time of study) while
      receiving cyclosporine were studied. Patients who had diabetes mellitus, those
      receiving drugs known to cause hyperkalemia (e.g., beta blockers, angiotensin
      converting enzyme inhibitors, K(+)-sparing diuretics), or those with a serum
      creatinine greater than 200 mumol/L were excluded. The renal response to
      hyperkalemia was inappropriate because the transtubular K+ concentration gradient
      (TTKG) was only 4.3 +/- 0.4 compared with a TTKG of 13 +/- 1, 2 h after 50 mmol
      of KCl was given to normal subjects. The TTKG, after administration of 200
      micrograms of fludrocortisone, was still very low (5.6 +/- 0.6) in the patients
      compared with that of controls (12 +/- 1). After administration of 250 to 500 mg
      of acetazolamide to increase the delivery of bicarbonate to the distal nephron,
      the TTKG rose significantly to 11 +/- 1 in patients on cyclosporine, compared
      with 17 +/- 1 in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627753
TI  - A pilot study to assess the ability of an orally available selective thromboxane
      synthase inhibitor to improve renal function in cyclosporine-treated renal
      transplant recipients.
AB  - Six cyclosporine (cyclosporine A [CsA])-treated renal transplant patients (4.3 +/
      0.6 months posttransplantation) were studied to see if selective urinary
      thromboxane (TX) inhibition with CGS 12970 (TX synthase inhibitor) would improve
      renal function and lessen CsA-induced decrements in RPF and GFR as measured by
      [99Tc]DTPA and [131I]hippuran clearances. The baseline trough CsA levels of the
      patients were 208 +/- 92 ng/mL. Before treatment with CGS 12970 (100 mg twice a
      day for 7 days), all drugs known to affect renal function or CsA pharmacokinetics
      were stopped. CGS 12970 therapy did not alter RPF (203 +/- 17 pre versus 200 +/-
      15 mL/min post), GFR (38.5 +/- 3.2 pre versus 38.2 +/- 3.9 mL/min post), or serum
      creatinine (creat) (1.9 +/- .06 pre versus 1.8 +/- 0.18 mg/dL post), despite an
      average of 81% suppression of urine TX (65 +/- 14 pg/mg of creat pre versus 12 +/
      4 pg/mg of creat post); P less than 0.01), as measured by gas
      chromatography/mass spectrometry. CGS 12970 had no significant effect on urinary
      6-keto-prostaglandin F1 alpha levels (63 +/- 4 pg/mg of creat pre versus 85 +/-
      25 pg/mg of creat post). CGS 12970 did not alter CsA pharmacokinetics or drug
      levels, blood pressure, weight, or serum electrolytes of the patients.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1627755
TI  - Acquired cystic disease in chronically rejected renal transplants.
AB  - Acquired cystic disease has been documented to complicate most forms of chronic
      renal damage; it has only infrequently been described in transplanted kidneys.
      Five patients with noncystic ESRD and chronically rejected transplants in which
      acquired cystic disease arose are reported. The diagnosis of acquired cystic
      disease was established in examination of transplant nephrectomies from four
      patients and a core biopsy from the fifth. The allografts were in place from 44
      to 80 months; three patients were treated with hemodialysis before the diagnosis
      of acquired cystic disease, whereas two received peritoneal dialysis. Three of
      the four patients evaluated had cysts in the native kidneys. Although papillary
      hyperplasia of lining epithelium was evident in four specimens, only one kidney
      was the site of neoplasms in the form of multiple small tubular adenomas. No
      malignant neoplasms were noted in this study or in the few similar previous ones;
      however, it is possible that chronically rejected transplanted kidneys may harbor
      neoplasms with the same malignant potential as those in acquired cystic disease
      in native kidneys.

PMID- 1627754
TI  - Chronic cyclosporine therapy impairs endothelium-dependent relaxation in the
      renal artery of the rat.
AB  - Cyclosporine is an immunosuppressive substance that causes structural and
      functional alterations in endothelial cells. To examine the effects of chronic
      cyclosporine therapy on endothelial function, Wistar Kyoto rats received daily
      s.c. injections of saline, cyclosporine solvent, or cyclosporine (15, 30, or 50
      mg/kg) for up to 2 wk. Blood pressure remained unchanged in all groups. Segments
      of the renal artery were suspended in organ chambers filled with physiological
      salt solution, and isometric tension was recorded. In rats treated with 30 or 50
      mg/kg/day of cyclosporine, endothelium-dependent relaxations to acetylcholine of
      the renal artery were significantly impaired when compared with vessels obtained
      from rats injected with saline or solvent. The reduced acetylcholine-induced
      relaxation of cyclosporine-treated vessels was improved by preincubation of the
      preparations with the cyclooxygenase inhibitor indomethacin. Endothelium
      independent relaxations in response to sodium nitroprusside were unimpaired in
      renal artery rings after 1 wk of cyclosporine but were reduced after 2 wk of
      treatment with 30 mg/kg/day. Contractions of the renal artery in response to
      norepinephrine and serotonin were not altered by cyclosporine. Thus, (1) high
      dose cyclosporine therapy impairs endothelium-dependent relaxations in the renal
      artery of the rat; (2) an endothelium-derived cyclooxygenase product reduces the
      effects of endothelium-derived relaxing factor in cyclosporine-treated rats; and
      (3) chronic cyclosporine treatment slightly impairs vascular smooth muscle
      relaxation, whereas vascular contractility remains unaltered.

PMID- 1627756
TI  - Potassium chloride lowers blood pressure and causes natriuresis in older patients
      with hypertension.
AB  - Epidemiologic surveys, experimental studies in animals, and clinical trials in
      young and middle-aged patients with hypertension indicate that dietary potassium
      lowers blood pressure. The mechanism of the antihypertensive effect is not well
      defined. Variations in serum potassium within the physiologic range may directly
      affect vascular smooth muscle tone. Potassium may also influence the regulation
      of blood pressure through effects on sodium handling, aldosterone secretion, the
      renin/angiotensin system, renal kallikrein, eicosanoids, and atrial natriuretic
      peptide. This study was undertaken to confirm the blood pressure-lowering effect
      of potassium in older patients and to determine the mechanism of the
      antihypertensive effect. Twenty-two patients greater than or equal to 60 yr of
      age were admitted to a Clinical Research Unit for 8 days after a 2-wk period free
      of antihypertensive medication. Patients were placed on an isocaloric diet
      containing 200 mmol/day of Na+, 70 mmol/day of K+, and 500 mg/day of Ca2+ and
      were treated in a randomized, double-blinded manner with either potassium
      chloride (120 mmol/day) or placebo. After 4 days, patients were crossed over to
      the alternate treatment. Systolic blood pressure decreased 8.6 mm Hg (95%
      confidence interval -14.6, -2.6), and diastolic blood pressure decreased 4.0 mm
      Hg (-6.9, -1.0) during potassium chloride supplementation. There was no
      significant change in blood pressure during treatment with placebo. Serum K+ was
      3.9 +/- 0.1 mmol/L after 3 days of placebo and 4.3 +/- 0.1 after 4 days of
      potassium chloride (P less than 0.002). Urinary sodium excretion averaged 192 +/-
      11 mmol/day after placebo and 221 +/- 8 after potassium treatment (P less than
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627757
TI  - Idiopathic Fanconi syndrome in a family. Part I. Clinical aspects.
AB  - Fanconi syndrome is a rare cause of rickets in children. Only six families with
      Fanconi syndrome following an autosomal dominant pattern of inheritance have been
      reported. In this report, the results of clinical studies performed in three
      generations of a family of 39 members with autosomal dominant Fanconi syndrome
      are presented. Twenty-one members of this family provided blood and urine for
      biochemical evaluation. Many family members have one or more tubular reabsorptive
      abnormalities; however, the complete Fanconi syndrome was not present in most
      members. Three children with the complete syndrome all occur in the last
      generation. When the characteristic features of this family were compared with
      those of previously reported families with autosomal dominant Fanconi syndrome,
      several differences became apparent. Two serious manifestations, diabetes
      mellitus and renal failure, which occur in previous reports did not occur in this
      family. This report provides information on apparently the largest number of
      affected individuals in a single family with Fanconi syndrome. In addition,
      variable expressivity of tubular reabsorptive defects in a family with Fanconi
      syndrome has never been reported.

PMID- 1627758
TI  - Protective effects of glutathione, glycine, or alanine in an in vitro model of
      renal anoxia.
AB  - Both glutathione and glycine provide some protection against ischemic renal
      injury in a variety of experimental models. However, results have been
      inconsistent and there may also be model heterogeneity. The effects of
      glutathione, glycine, and alanine in a cell culture model of renal
      anoxia/reoxygenation injury were tested. When primary cultures of rat proximal
      tubule epithelial cells were subjected to 60 min of anoxia and 30 min of
      reoxygenation, glutathione (2 mM) essentially eliminated lethal cell injury as
      determined by lactate dehydrogenase release. Glycine or alanine, on the other
      hand, provided only partial protection. Glutamate did not protect, although
      cysteine did. The glutathione synthesis inhibitor buthionine sulfoximine blocked
      the protective effect of exogenous glutathione, and the glutathione transport
      inhibitor probenecid partially blocked glutathione protection. A combination of
      glycine, glutamate, plus cysteine also protected against anoxia/reoxygenation
      injury. The studies suggest that both glutathione degradation with intracellular
      resynthesis and transport of intact glutathione into the cell are involved in the
      protection afforded by exogenous glutathione. These results are different from
      those obtained in other experimental models of renal ischemia, such as freshly
      isolated proximal tubules, because the protective effects of glutathione were not
      derived solely from glycine generation. These studies also suggest the need for
      caution in extrapolating results from one model of renal anoxic injury to
      another.

PMID- 1627759
TI  - Murine monoclonal anti-DNA antibodies penetrate cells, bind to nuclei, and induce
      glomerular proliferation and proteinuria in vivo.
AB  - The production of relatively high quantities of autoantibodies (autoAb) that
      react with DNA and other intranuclear antigens is characteristic of individuals
      with systemic lupus erythematosus and other autoimmune diseases. However, the
      capacity of these Ab to penetrate cells and induce functional perturbations in
      vivo is not well appreciated. To address this issue, monoclonal (m) anti-DNA Ab
      (mAb), derived from MRL-lpr/lpr and (NZB x SWR)F1 mice, were administered to
      normal mice, and the animals were examined for morphologic and functional
      abnormalities. A subset of five mAb produced intranuclear immunoglobulin deposits
      in multiple organs. Intranuclear immunoglobulin deposits were also observed after
      cross-linking the tissue before direct immunofluorescence and after i.v.
      injection of F(ab')2 fragments of one anti-DNA Ab. This phenomenon was
      reproducible and was only associated with this subset of autoAb. Furthermore,
      intranuclear deposits of anti-DNA Ab within glomeruli were associated with
      morphologic and functional abnormalities including: hypercellularity, epithelial
      foot process fusion, new fiber bundle formation within the mesangium suggestive
      of new collagen synthesis, and proteinuria. These results indicate that a subset
      of autoAb may penetrate cells in vivo to influence normal cellular and nuclear
      function and to contribute to functional and pathologic abnormalities in
      individuals with systemic lupus.

PMID- 1627760
TI  - Thyroid hormone, L-T3, stimulates the expression of the angiotensinogen gene in
      cultured opossum kidney (OK) cells.
AB  - Angiotensinogen (ANG) messenger RNA is expressed in opossum kidney (OK) proximal
      tubular cells. To examine whether thyroid hormone, L-T3, could stimulate the
      expression of the ANG gene in OK proximal tubular cells, fusion genes, consisting
      of various lengths of the 5'-flanking region of the rat angiotensinogen gene
      linked to a human growth hormone reporter gene, were constructed and introduced
      into OK cells. As a negative control, they were introduced into a nonkidney cell
      line, a human choriocarcinoma cell line (JEG-3). The level of the expression of
      fusion genes in these cells were determined by the level of immunoreactive human
      growth hormone secreted into the culture medium. The expression of ANG-growth
      hormone (ANG-GH) fusion genes pOGH (ANG N-1498/+18), pOGH (ANG N-688/+18), pOGH
      (ANG N-110/+18), pOGH (ANG N-53/+18), and pOGH (ANG N-35/+18) was 226-, 4.5-, 1.0
      , 12-, and 2.5-fold higher than promoterless pOGH in the expression of growth
      hormone activity in OK cells. No significant expression of any of these ANG-GH
      fusion genes over the promoterless pOGH was observed in JEG-3 cells. The addition
      of L-T3 stimulates the expression of pOGH (ANG N-1498/+18) in a dose-dependent
      manner with a maximal and half-maximal effect at 10(-7) M and at 10(-8) to 10(-9)
      M, respectively. Thyroid hormone (10(-7) M) also stimulates the expression of
      pOGH (ANG N-688/+18) but not pOGH (ANG N-110/+18), pOGH (ANG N-53/+18), or pOGH
      (ANG N-35/+18).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627761
TI  - Role of the endothelium-dependent relaxing factor nitric oxide on renal function.
AB  - The role of nitric oxide in renal function has been assessed with pharmacologic
      and physiologic interventions. Pharmacologically, the renal vasodilation and, to
      some extent, the natriuresis produced by endothelium-dependent vasodilators such
      as acetylcholine and bradykinin are mediated by nitric oxide and also by
      prostaglandins. However, prostaglandins and nitric oxide do not participate in
      the renal effects produced by endothelium-independent vasodilators such as atrial
      natriuretic peptide, prostaglandin I2, and nitroprusside. Physiologically, nitric
      oxide and prostaglandins exert a strong regulation on the effects produced by
      changes in renal perfusion pressure. Increments in renal perfusion pressure
      within the range of RBF autoregulation appear to inhibit prostaglandin synthesis
      while simultaneously enhancing the formation of nitric oxide. Nitric oxide
      modulates autoregulatory vasoconstriction and at the same time inhibits renin
      release. Conversely, a decrease of renal perfusion pressure to the limit of or
      below RBF autoregulation may inhibit the synthesis of nitric oxide but may
      trigger the release of prostaglandins, whose vasodilator action ameliorates the
      fall in RBF and stimulates renin release. Nitric oxide and prostaglandins are
      also largely responsible for mediating pressure-induced natriuresis. However,
      unlike prostaglandins, mild impairment of the synthesis of nitric oxide in
      systemic circulation produces a sustained decrease in sodium excretion, which
      renders blood pressure susceptible to be increased during high-sodium intake.
      This effect suggests that a deficiency in the synthesis of nitric oxide could
      constitute the most effective single disturbance to foster the development of a
      syndrome similar to that seen in salt-sensitive hypertension.

PMID- 1627762
TI  - Glomerular epithelial cells secrete a glomerular basement membrane-degrading
      metalloproteinase.
AB  - Cultured rat glomerular epithelial cells (GEC) were examined for their ability to
      release extracellular matrix-degrading proteinases with [3H]gelatin as substrate.
      GEC-conditioned media, under serum-free conditions, contained modest amounts of
      gelatinase activity (1 to 10 U/mg of protein); the activity was maximal at
      neutral pH, was inhibited by zinc chelators, was not inhibited by tissue
      inhibitor of metalloproteinase-2, and could not be further activated by trypsin
      or organomercurials. Gelatin substrate sodium dodecyl sulfate-polyacrylamide gels
      of GEC-conditioned medium revealed several zones of lysis, with molecular sizes
      of 150 kd (major band), and 220, 86 to 93, and 52 to 54 kd (minor bands).
      Northern blot analysis demonstrated that the GEC metalloproteinase(s) were
      distinct from the 68- to 72-kd type IV collagenase/gelatinase present in
      mesangial cells or the 92-kd type IV collagenase present in neutrophils. The GEC
      gelatinolytic activity also degraded insoluble type IV collagen in glomerular
      basement membrane in a dose-dependent manner. The major metalloproteinase
      activity responsible for the type IV collagen degradation has a molecular size of
      150 kd with a type IV collagen substrate gel. Thus, GEC produce several neutral
      metalloproteinases, which, by virtue of their substrate specificity, may play an
      important role in glomerular basement membrane remodeling and in glomerular
      diseases characterized by alterations in basement membrane permeability.

PMID- 1627763
TI  - Clinical pharmacology and economics of recombinant human erythropoietin in end
      stage renal disease: the case for subcutaneous administration.
AB  - The clinical pharmacology of human recombinant erythropoietin (epoetin) was
      studied in order to compare the effectiveness of various routes and dosing
      schedules in dialysis patients. Thirty-six patients received epoetin beta three
      times a week i.v. for at least 12 wk. The mean dose needed to achieve target
      hemoglobin was 225 +/- 36 U/kg per week (median dose, 180 U/kg per week). Twenty
      eight of 36 patients who were converted to a once-a-week i.v. schedule increased
      their requirements to 429 +/- 50 U/kg per week in order to maintain a target
      hematocrit of 33 to 40 vol%. Twelve of 28 patients could maintain their target
      hematocrit when dosed once a week s.c. at 84 +/- 10 U/kg. The other 16 patients
      required 137 +/- 15 U/kg per week divided into two doses. In the entire group of
      28 patients, the weekly requirement for epoetin was reduced by 50% when the s.c.
      route was used two or three times a week. Pharmacokinetic studies performed
      during chronic therapy indicated rapid clearance of erythropoietin (t1/2 of 6.8
      +/- 0.3 h). Single i.v. doses greater than 150 U/kg were required to increase
      basal erythropoietin by 30 mU/mL at 44 h postdosing. With s.c. dosing, such
      increments in erythropoietin levels frequently persisted beyond 60 h because of
      prolonged and slow absorption. Pharmacokinetic simulations in conjunction with
      clinical correlation of the erythropoietic response suggest that the duration
      that the erythropoietin levels are maintained, and not the absolute peaks, is the
      primary determinant of efficacy. This may result from nonlinearity in the dose
      response. Pharmacokinetic simulation also indicated that i.v. dosing could not
      maintain adequate interdialytic erythropoietin levels, whereas s.c. dosing could.
      Cost analysis indicated that the use of s.c. dosing two or three times a week at
      an average total weekly dose of 110 to 120 U/kg is effective treatment of anemia
      in most dialysis patients.

PMID- 1627764
TI  - Dopamine enhances the phosphaturic response to parathyroid hormone in phosphate
      deprived rats.
AB  - Phosphate deprivation results in a resistance to the phosphaturic effect of
      parathyroid hormone. Dopamine is phosphaturic and is synthesized by kidney
      proximal tubule, the nephron subsegment where parathyroid hormone inhibits
      phosphate transport. Thus, to test the hypothesis that phosphate deprivation is
      associated with low intrarenal dopamine synthesis and that dopamine infusion will
      overcome the resistance to the phosphaturic response to parathyroid hormone, the
      following study was performed. The effect of dietary phosphate intake on
      intrarenal dopamine synthesis, as reflected by urinary dopamine excretion, was
      determined. Rats were placed in metabolic cages (N = 5) and were fed a low
      phosphate diet (0.07% Pi) for 4 days and then a high-phosphate diet (1.8% Pi) for
      4 days. Twenty-four-hour urinary dopamine excretion was significantly lower in
      rats fed a low-phosphate diet (2.53 +/- 0.06 versus 4.10 +/- 0.30
      micrograms/day). Further, the effect of dopamine infusion on the blunted
      phosphaturic response to parathyroid hormone was studied in rats fed a low
      phosphate diet for 1, 2, and 3 days. Control clearances were taken 2 h after
      thyroparathyroidectomy; then, parathyroid hormone (33 U/kg plus 1 U/kg/min),
      dopamine (25 micrograms/kg/min), or parathyroid hormone plus dopamine were
      infused for 60 min. Changes in the fractional excretion of phosphate were
      significantly greater in rats fed a low-phosphate diet infused with parathyroid
      hormone plus dopamine than in rats fed a low-phosphate diet infused with
      parathyroid hormone alone (delta 27.9 +/- 5.8 versus 11.2 +/- 2.6% for day 1;
      28.4 +/- 1.4 versus 7.1 +/- 3.6% for day 2; and 10.7 +/- 2.8 versus -0.2 +/- 0.2%
      for day 3; N = 5 for all groups).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627765
TI  - Clinical outcome of continuous ambulatory peritoneal dialysis predicted by urea
      and creatinine kinetics.
AB  - The effectiveness of urea kinetics (Kt/V, where K is urea clearance, t is
      treatment time, and V is the volume of distribution for urea) to assess the
      adequacy of continuous ambulatory peritoneal dialysis (CAPD) and clinical outcome
      has not been established prospectively, and cross-sectional clinical studies have
      been inconclusive. A minimum weekly creatinine clearance of 40 to 50 L is
      recommended, but the adequacy of this dose is unproven. We introduced a simpler
      approach to creatinine kinetics in the form of an efficacy number (EN) calculated
      from data obtained in a standardized 4-h dwell exchange. To determine the most
      effective model for predicting CAPD adequacy, residual renal function, weekly
      Kt/V urea, weekly creatinine clearance standardized to body surface area, and EN
      (liters per gram of creatinine per day) were measured in 18 stable CAPD patients
      followed prospectively for at least 12 months. Patients were divided into three
      groups, good (G), intermediate (I), and poor (P), on the basis of uremic
      symptoms, mortality, hospital days, biochemical indices, and the need for
      transfer to hemodialysis. When comparing groups G (N = 6) and P (N = 8), weekly
      Kt/V were 2.3 +/- 0.2 versus 1.5 +/- 0.1 (P less than 0.005), weekly creatinine
      clearances were 71.5 +/- 8.6 versus 35.1 +/- 1.3 L (P less than 0.001), and EN
      were 7.4 +/- 0.8 versus 3.6 +/- 0.2 L/g of creatinine/day (P less than 0.005).
      Creatinine kinetics (weekly clearance and EN) but not urea kinetics could
      differentiate group I (N = 4) from groups G or P. Both urea and creatinine
      kinetics predict clinical outcome in CAPD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627766
TI  - Pyrogenic reactions in patients receiving conventional, high-efficiency, or high
      flux hemodialysis treatments with bicarbonate dialysate containing high
      concentrations of bacteria and endotoxin.
AB  - High-efficiency (HE) and high-flux (HF) hemodialysis are becoming increasingly
      popular methods for treating patients with chronic renal failure because they
      reduce the time required for dialysis treatment. HF and HE dialyzers require
      bicarbonate dialysate, often prepared from concentrates that can support
      bacterial growth with endotoxin production. There is a concern that endotoxins or
      bacteria may cross or interact at the membranes of these dialyzers, triggering
      the release of endogenous pyrogens (cytokines) by peripheral blood mononuclear
      cells to cause pyrogenic reactions (PR). To determine the incidence of PR and to
      examine the association between PR and levels of bacteria and endotoxin in
      dialysate, a cohort of patients receiving conventional, HE, or HF hemodialysis
      with bicarbonate dialysate and reprocessed dialyzers at three dialysis centers
      during a 12-month period was studied prospectively. All dialyzers underwent a
      test of membrane integrity before use. A total of 19 PR were identified among 18
      patients in 26,877 hemodialysis treatments (0.7 PR/1,000 treatments). There was
      no significant difference in PR rates by treatment modality: conventional, 0.5
      per 1,000 (7 PR/13,123 treatments) versus HE, 0.9 per 1,000 (9 PR/11,345) versus
      HF, 1.2 per 1,000 (3 PR/2,409) (P = 0.21; chi 2 test). Throughout the study
      period, bacterial counts for dialysate at each center significantly exceeded the
      Association for the Advancement of Medical Instrumentation's (AAMI) microbiologic
      standards for dialysate of less than 2,000 CFU/mL (mean, 19,000 CFU/mL), but
      water used in the reuse of dialyzers tested less than 200 CFU/mL.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1627767
TI  - Removal of plasma porphyrins with high-flux hemodialysis in porphyria cutanea
      tarda associated with end-stage renal disease.
AB  - Plasma porphyrin levels are markedly increased in patients with porphyria cutanea
      tarda (PCT) associated with end-stage renal disease. Conventional hemodialysis
      (CHD) with lower blood flow rates (less than 250 mL/min) and cuprophan or
      cellulose acetate membranes is ineffective in removing significant amounts of
      porphyrins in this condition. Changes in plasma porphyrin levels and porphyrin
      clearances during hemodialysis with higher blood flow rates and more-permeable,
      high-efficiency cellulose acetate and high-flux polysulfone dialyzers were
      evaluated in a chronic hemodialysis patient with PCT and markedly elevated plasma
      porphyrins. The polysulfone membrane achieved significantly better fractional
      porphyrin removal (P = 0.02) and porphyrin clearances (P less than 0.01) than did
      the high-efficiency cellulose acetate membrane. After conversion from maintenance
      CHD with a standard cellulose acetate dialyzer to a 4-wk period of high-flux
      hemodialysis (HFHD) with a polysulfone dialyzer, predialysis plasma porphyrins
      fell by 37%. After returning to CHD, plasma porphyrins returned to the higher
      prestudy levels. These observations suggest that HFHD with more permeable
      membranes and higher blood flow rates removes porphyrins more effectively than
      does CHD. HFHD may be a useful adjunct to other measures used in treating
      dialysis patients with PCT.

PMID- 1627768
TI  - Acute plasma separation with hemodialysis equipment.
AB  - Although plasma separation has been reported to have a relatively small
      complication rate in large series of healthy outpatients, little attention has
      been directed to the evaluation of the safety and effectiveness of the therapy in
      acutely ill, hospitalized patients. The experience of using standard hemodialysis
      equipment and membrane plasma separators with 281 plasma separation treatments in
      49 patients over the last 7 yr is reported and analyzed. The data reveal a 1.4%
      incidence of hypotension and a 0.4% incidence of hematuria in the 281 treatments-
      rates similar to those reported in outpatients. In addition, analysis of the
      diseases and patients treated over the 7 yr reported demonstrates a marked shift
      from immunological and hematological disorders towards neurological disorders.
      The data suggest that plasma separation may be easily and safely performed by any
      institution capable of performing acute hemodialysis.

PMID- 1627769
TI  - MNF1, a leaf tissue-specific DNA-binding protein of maize, interacts with the
      cauliflower mosaic virus 35S promoter as well as the C4 photosynthetic
      phosphoenolpyruvate carboxylase gene promoter.
AB  - When gel shift assays were performed with maize nuclear extract and a DNA
      fragment containing the cauliflower mosaic virus (CaMV) 35S promoter, three DNA
      protein complexes were observed. Analyses with nuclear extracts prepared from
      green leaves, etiolated leaves, stems and roots showed that the complexes
      resulted from the existence of at least two nuclear factors. One of them is
      presumably a constitutive nuclear factor found in all tissues tested, and another
      is a leaf-specific factor present both in green and etiolated leaves. This leaf
      specific nuclear factor seemed to be identical to MNF1, previously identified as
      a factor interacting with the promoter of the maize gene for phosphoenolpyruvate
      carboxylase involved in the C4 photosynthesis. Deletion analysis revealed that
      MNF1 binds to the sequence from -281 to -235 relative to the transcription start
      site of the CaMV 35S promoter. MNF1-like nuclear protein was also found in
      tobacco nuclear extracts. The possibility that MNF1 participates as a positive
      trans-acting factor in the expression of genes in maize leaves is discussed.

PMID- 1627770
TI  - Characterisation of a wound-induced transcript from the monocot asparagus that
      shares similarity with a class of intracellular pathogenesis-related (PR)
      proteins.
AB  - We report the isolation and characterisation of a wound-induced cDNA designated
      AoPR1 from a suspension of mesophyll cells that had been mechanically isolated
      from cladodes of light-grown Asparagus officinalis seedlings by grinding in a
      mortar and pestle. The transcript abundance is up-regulated following cell
      separation and in chopped mesocotyl tissue from dark-grown seedlings. The
      expression of AoPR1 was shown by northern analysis to be located around the site
      of damage. Sequence analysis revealed similarity between the predicted AoPR1
      polypeptide and bean PvPR1 and PvPR2 proteins, the potato pSTH2 protein, the pea
      PI49 protein, the parsley PcPR1-1 protein and a major pollen allergen from birch
      (BetvI). These transcripts have been shown to be induced in response to microbial
      attack or fungal elicitation. To our knowledge, this is the first example of a
      monocot cDNA belonging to this class of intracellular pathogenesis-related
      proteins (IPRs).

PMID- 1627771
TI  - Iron induces ferritin synthesis in maize plantlets.
AB  - The iron-storage protein ferritin has been purified to homogeneity from maize
      seeds, allowing to determine the sequence of the first 29 NH2-terminal amino
      acids of its subunit and to raise specific rabbit polyclonal antibodies. Addition
      of 500 microM Fe-EDTA/75 microM Fe-citrate to hydroponic culture solutions of
      maize plantlets, previously starved for iron, led to a significant increase of
      the iron concentration of roots and leaves, albeit root iron was mainly found
      associated with the apoplast. Immunodetection of ferritin by western blots
      indicated that this iron treatment induced ferritin protein accumulation in roots
      and leaves over a period of 3 days. In order to investigate this induction at the
      ferritin mRNA level, various ferritin cDNA clones were isolated from a cDNA
      library prepared from poly(A)+ mRNA isolated from roots 48 h after iron
      treatment. These cDNAs were classified into two groups called FM1 and FM2.
      Upstream of the sequence encoding the mature ferritin subunit, both of these
      cDNAs contained an in-frame coding sequence with the characteristics of a transit
      peptide for plastid targeting. Two members of the FM1 subfamily, both partial at
      their 5' extremity, were characterized. They are identical, except in their 3'
      untranslated region: FM1A extends 162 nucleotides beyond the 3' terminus of FM1B.
      These two mRNAs could arise from the use of two different polyadenylation
      signals. FM2 is 96% identical to FM1 and contains 45 nucleotides of 5'
      untranslated region. Northern analyses of root and leaf RNAs, at different times
      after iron treatment, revealed ferritin mRNA accumulation in response to iron.
      Ferritin mRNA accumulation was transient and particularly abundant in leaves,
      reaching a maximum at 24 h. The level of ferritin mRNA in roots was affected to a
      lesser extent than in leaves.

PMID- 1627772
TI  - Dark-induced accumulation of a basic pathogenesis-related (PR-1) transcript and a
      light requirement for its induction by ethylene.
AB  - A gene encoding a basic-type pathogenesis-related protein from Nicotiana tabacum
      (prb-1b) was cloned, sequenced and characterized. It contains an open reading
      frame of 179 amino acids that is ca. 65% homologous with the acidic PR-1 class of
      pathogenesis-related proteins and 87% homologous with a different basic-type PR-1
      gene. In the light, physiological levels of ethylene rapidly (1 h) induced basic,
      but not acidic-type, PR-1 transcript. Additional elicitors acting via ethylene,
      such as alpha-aminobutyric acid, were shown to induce basic- and acidic-type PR-1
      transcript accumulation in a light-dependent manner. In contrast, xylanase, an
      ethylene-independent elicitor, induced transcript accumulation of basic- and
      acidic-type PR-1 in a light-independent manner. Dark-induced accumulation of
      basic PR-1 transcript occurred at night in greenhouse-grown plants and, to a
      greater extent, in continuously dark-treated plants. The novel dark regulation
      may point to additional nonpathogenesis-related roles for these genes in plant
      environment interactions.

PMID- 1627773
TI  - Mutational analysis of the 'conserved region' of maize streak virus suggests its
      involvement in replication.
AB  - Maize streak virus as well as other geminiviruses contain a potential hairpin
      structure with the conserved sequence TAATATTAC in the loop. We assessed the
      possible involvement of this structure in replication and symptom induction of
      the virus. A series of insertion and deletion mutants were analyzed by
      agroinfection. Deletion of the hairpin or insertions in the conserved sequence
      abolished symptom development. Viral DNA could not be detected in the infected
      tissue. However, a mutant with a point mutation in the 'conserved' sequence,
      isolated after inoculation of maize plants with an insertion mutant, was able to
      replicate and to induce symptoms.

PMID- 1627774
TI  - The isolation and characterisation of the tapetum-specific Arabidopsis thaliana
      A9 gene.
AB  - The Brassica napus cDNA clone A9 and the corresponding Arabidopsis thaliana gene
      have been sequenced. The B. napus cDNA and the A. thaliana gene encode proteins
      that are 73% identical and are predicted to be 10.3 kDa and 11.6 kDa in size
      respectively. Fusions of an RNase gene and the reporter gene beta-glucuronidase
      to the A. thaliana A9 promoter demonstrated that in tobacco the A9 promoter is
      active solely in tapetal cells. Promoter activity is first detectable in anthers
      prior to sporogenous cell meiosis and ceases during microspore premitotic
      interphase. The deduced A9 protein sequence has a pattern of cysteine residues
      that is present in a superfamily of seed plant proteins which contains seed
      storage proteins and several protease and alpha-amylase inhibitors.

PMID- 1627775
TI  - The heat shock response of pollen and other tissues of maize.
AB  - While a heat shock treatment of 40 degrees C or 45 degrees C induced the
      vegetative tissues of maize to produce the typical heat shock proteins (HSPs),
      germinating maize pollen exposed to the same temperatures did not synthesize
      these characteristic HSPs. Comparison of RNA accumulation in shoot and tassel
      tissue showed that mRNAs for HSP70 and HSP18 increased several-fold, reaching
      high levels within 1 or 2 hours. At the higher temperature of 45 degrees C these
      vegetative tissues were blocked in removal of an intron from the HSP70 mRNA
      precursor, which accumulated to a high level in tassel tissue. In germinating
      pollen exposed to heat shock, mRNAs for these HSPs were induced but accumulated
      only to low levels. The stressed pollen maintained high levels of RNA for alpha
      tubulin, a representative normal transcript. It is likely that the defective heat
      shock response of maize pollen is due to inefficient induction of heat shock gene
      transcription.

PMID- 1627776
TI  - Structure and expression during the germination of rice seeds of the gene for a
      carboxypeptidase.
AB  - The carboxypeptidase gene from rice and corresponding cDNA clones were isolated.
      The Sal I 11.2 kb fragment of DNA cloned from a size-fractionated genome library
      contained eight introns and an open reading frame that encoded 500 amino acids
      (M(r) 55,445). The structure deduced for the carboxypeptidase from rice was very
      similar to those of type III serine carboxypeptidases from barley and wheat. The
      extent of homology of the amino acid sequence to that of these carboxypeptidases
      from barley and wheat was 92.3% and 87.2%, respectively. The accumulation of mRNA
      for the rice carboxypeptidase was conspicuous in germinating endosperms that
      contained aleurone layers, but levels were lower in leaves and roots. The
      abundance of the mRNA in endosperms was enhanced by gibberellic acid (GA) and
      accumulation of the mRNA was inhibited by abscisic acid (ABA). The rice gene for
      carboxypeptidase contained some pyrimidine boxes (C/TCTTTTC/T), in the 5'
      flanking region, which are a characteristic of a GA-responsive gene.

PMID- 1627777
TI  - Suppression of gene expression in plant cells utilizing antisense sequences
      transcribed by RNA polymerase III.
AB  - Inverted sequences of the chloramphenicol acetyltransferase (CAT) reporter gene
      were fused to a soybean tRNA(met(i)) gene lacking a terminator such that the
      tRNA(met(i)) sequences caused the co-transcription of CAT antisense sequences by
      RNA polymerase III. When electroporated into carrot protoplasts, these antisense
      DNA constructs suppressed CAT enzyme activity expressed from co-electroporated
      DNAs containing the CAT gene downstream of the cauliflower mosaic virus (CaMV)
      35S RNA promoter. Our most effective construct, an antisense sequence
      complementary to the 3' portion of the CAT gene, inhibited CAT activity five-fold
      greater than an antisense construct expressed by RNA polymerase II from the
      cauliflower mosaic virus 35S RNA promoter. These results indicate that antisense
      sequences transcribed by RNA polymerase III should efficiently suppress gene
      expression in plants.

PMID- 1627778
TI  - Structure and expression of the Arabidopsis CaM-3 calmodulin gene.
AB  - Genomic and cDNA sequences encoding a calmodulin (CaM) gene from Arabidopsis
      (ACaM-3) have been isolated and characterized. ACaM-3 represents a sequence
      distinct from two previously isolated Arabidopsis CaM cDNA clones. A 2.3 kb Eco
      RI restriction fragment was sequenced and found to encode a complete CaM-coding
      sequence interrupted by a single 491 bp intron, together with 750 bp and 600 bp
      of 5' and 3' flanking sequences, respectively. The polypeptide encoded by ACaM-3
      is identical to that encoded by ACaM-2 and it differs from the one encoded by
      ACaM-1 by four of 148 residues. The putative promoter of ACaM-3 was atypical of
      CaM genes previously isolated from animals in that it contained consensus TATA
      and CAAT box sequences and lacked GC-rich regions. Two DNA sequence elements
      closely resembling cyclic AMP regulatory elements, which have been identified in
      animal CaM genes, were located in the 5' flanking region of ACaM-3. Northern blot
      and polymerase chain reaction amplification assays confirmed that each of the
      three ACaM mRNAs were expressed in similar but distinct patterns in different
      organs. ACaM-1 mRNA was the only species detectable in root RNA fractions, and
      ACaM-3 mRNA could not be detected in floral stalks. Accumulation of the three CaM
      mRNAs in leaves was induced by a touch stimulus, but the kinetics and extent of
      the induction varied among the three mRNA species. Run-on transcription assays
      indicated that a portion of the differences in accumulation of ACaM-1, 2, and 3
      mRNAs in leaves and siliques was attributable to differences in their net rates
      of transcription.

PMID- 1627779
TI  - Mutational analysis of a plant heat shock element.
AB  - A total of 32 mutations were generated within the TATA-proximal site 1 (-72 to 
      47) of soybean heat shock gene Gmhsp17.5E in order to functionally define the
      optimal configuration of sequences within the heat shock element (HSE). Mutants
      were tested in vivo utilizing sunflower tumors transformed by a T-DNA based
      vector. Promoter activity was determined by S1 nuclease hybrid protection
      analysis of tumor transcripts. A total of five repeats (5'-nGAAn-3' or 5'-nTTCn
      3') which comprise the HSE at site 1 were required for full transcription
      induction by heat stress. Analysis of non-conserved bases flanking the central
      trinucleotide block indicated that 5'-aGAAg'-3' is the optimum sequence for the 5
      bp repeat.

PMID- 1627780
TI  - Structure and expression of kin2, one of two cold- and ABA-induced genes of
      Arabidopsis thaliana.
AB  - We report the isolation of the second member, kin2, of a family of two cold
      inducible genes of Arabidopsis thaliana. The proteins corresponding to the two
      genes have similarities to the small antifreeze proteins from Winter flounder.
      Kin1 and kin2 are organized in a close tandem array in the genome of A. thaliana.
      Both have three exons separated by introns with approximately the same length and
      location. The coding regions are highly conserved while the introns and
      especially the 3' flanking sequences of the mRNAs have diverged. The kin1 and
      kin2 genes are coordinately regulated in the cold. Unlike kin1, the kin2 mRNA has
      a detectable basal level, and accumulates to a higher level during acclimation.
      Both mRNAs are induced by 10 microM ABA but only kin2 responds strongly to
      drought and salinity stresses.

PMID- 1627781
TI  - Identification and characterization of a hypoxically induced maize lactate
      dehydrogenase gene.
AB  - In cereal root tissue, hypoxia induces the enzyme lactate dehydrogenase (LDH);
      (S)-lactate:NADH oxidoreductase, EC 1.1.1.27). In barley, both biochemical and
      genetic data indicate that five isozymes are induced under hypoxia. These
      isozymes are tetramers and arise from the random association of the products of
      two Ldh genes. The induction of LDH activity in root tissue has been shown to be
      correlated to an increase in LDH protein and Ldh mRNA. In order to more fully
      characterize the hypoxic induction of LDH, we have isolated a maize Ldh genomic
      clone which has strong homology at both the amino acid and nucleotide level to
      the barley LDH cDNA clones. The Ldh1 gene consists of two exons separated by a
      296 bp intron, has the expected eukaryotic regulatory signals and a sequence that
      has strong homology to the maize anaerobic regulatory element.

PMID- 1627782
TI  - A barley cDNA clone encoding a type III chlorophyll a/b-binding polypeptide of
      the light-harvesting complex II.
AB  - The nucleotide sequence of a leaf cDNA clone encoding a Type III chlorophyll a/b
      binding (CAB) protein of light-harvesting complex II (LHCII) in barley is
      reported. Sequence comparisons and results from in vitro import into chloroplasts
      demonstrate that the cDNA clone encodes a functional transit peptide of 45 amino
      acid residues and a mature polypeptide of 223 residues with a predicted molecular
      mass of 24.3 kDa. After insertion into thylakoids, the mature protein is
      resistant to protease attack. Hybridization analysis using a gene-specific probe
      shows that the gene is expressed in dark-grown seedlings and that the amount of
      mRNA increases during illumination.

PMID- 1627783
TI  - Nucleotide sequence of a gene for an endopeptidase (EP-C1) from Phaseolus
      vulgaris.

PMID- 1627784
TI  - Nucleotide sequence of a cDNA encoding a lipid transfer protein from wheat
      (Triticum durum Desf.).

PMID- 1627785
TI  - Nucleotide sequence of a cDNA clone encoding a precursor to stearoyl-(acyl
      carrier-protein) desaturase from spinach, Spinacia oleracea.

PMID- 1627786
TI  - Tumor necrosis factor and interferon gamma: relevance for immune regulation and
      genetic predisposition to autoimmune disease.
AB  - The role of TNF-alpha and IFN-gamma in various models of autoimmune disease were
      analyzed. These include murine models of lupus, type 1 diabetes in NOD mice and
      the adjuvant arthritis model in rats. Rather than being involved mainly in the
      effector arm of the inflammatory process of autoimmune organ destruction, our
      data suggest a primary involvement of these cytokines in some of the basic
      mechanisms of the autoimmune process. Evidence has been presented that emphasizes
      the possibility of the involvement of TNF-alpha in the genetic predisposition to
      SLE. Based on the data presented, one should be cautious in extrapolating the
      effects of these cytokines in various in vitro systems to the in vivo situation.

PMID- 1627787
TI  - Interleukin-6 in autoimmune disorders.
AB  - Interleukin-6, a pleiotropic cytokine, appears to play a key role as a
      physiologically functioning molecule in host defense mechanisms. Previous reports
      have suggested that dysregulated interleukin-6 production may be involved in
      lymph node hyperplasia, plasmacytosis, immunoglobulin hyperproduction,
      thrombocytosis, mesangial cell proliferation and acute phase response, all of
      which are frequently observed in autoimmune disorders. In this report, we discuss
      the possible involvement of interleukin-6 in the pathogenesis of a variety of
      autoimmune diseases and the regulatory mechanism of expression of the interleukin
      6 gene.

PMID- 1627788
TI  - Interleukin-2, a pro-autoimmune lymphokine that interferes with post-deletional
      tolerance.
AB  - Various complementary mechanisms arranged in a fail-safe hierarchy impede the
      immune system from launching auto-aggressive attacks, namely intrathymic or post
      thymic clonal deletion, anergy, and immunosuppression. Both epidemiological and
      clinical evidence demonstrates that interleukin-2 (IL-2) may exert a pro
      autoimmune effect. Thus, IL-2 reverses immunological tolerance in determined in
      vitro or in vivo circumstances, is produced at abnormally high levels in certain
      autoimmune diseases, and induces organ-specific autoimmune lesions when
      administered to patients. To unravel the molecule and cellular mechanisms
      responsible for the pro-autoimmune nature of IL-2, our group has employed a
      recombinant hIL-2 vaccinia virus construct (IL-2. VV) as a self-replicating IL-2
      releasing device that may be administered as a source of exogenous IL-2 to
      experimentally manipulated mice. IL-2 does not interfere with clonal deletion of
      potentially autoreactive T cells in the thymus since application of IL-2. VV to
      young mice fails to augment the frequency of T cells bearing 'forbidden' T cell
      receptor (TCR) V beta gene products (i.e. T cells that recognize endogenous
      retroviral superantigens). Along the same line, IL-2. VV does not reverse the
      clonal deletion in male mice bearing a male-specific transgenic alpha/beta TCR
      that undergo depletion of CD4+ CD8+ thymocytes, nor does it abolish post-thymic
      clonal deletion of V beta 8+ T cells reactive with the bacterial superantigen
      Staphylococcus aureus enterotoxin B (SEB). In contrast with its incapability to
      abolish intra- and post-thymic elimination of T cells with unwarranted
      specificities, IL-2 abrogates anergy of T cells. Non-deleted, 'forbidden' T cells
      from congenitally athymic or neonatally thymectomized mice, under normal
      circumstances anergic, become responsive to TCR-triggering and mediate a systemic
      autoimmune syndrome upon IL-2. VV treatment. Thus, IL-2 appears to interfere with
      T cell tolerance at a post-deletional stage, reversing functional non
      responsiveness and enabling non-deleted T cells that bear a potentially
      autoreactive TCR repertoire to cause manifest autoimmunity.

PMID- 1627789
TI  - Does interleukin-2 abrogate peripheral immunologic self-tolerance in vivo?
AB  - Transgenic mice that constitutively expressed murine IL-2 in islet beta cells
      (RIP-IL-2 mice) had pancreatitis from birth which resolved into a peri- and intra
      islet infiltrate in adult animals. In spite of the impressive infiltration, these
      mice did not develop autoimmunity to islet antigens. Neither was autoimmunity
      found to extrathymic H-2Kb molecules known to induce tolerance by a peripheral
      mechanism, when IL-2 and H-2Kb were coexpressed in the beta cells. Apparently, IL
      2 can only act on activated T cells and is unable to reverse tolerance in T cells
      that have been made unresponsive through inappropriate antigen presentation in
      our system.

PMID- 1627790
TI  - Prevention of B cell clonal deletion and anergy by activated T cells and their
      lymphokines.
AB  - B cell tolerance is described as the absence of a measurable antibody forming
      response to an antigenic challenge. The establishment of antigen-specific
      tolerance requires, by definition, engagement of the B cell antigen-specific
      receptor. However, only in some circumstances does this engagement lead to
      tolerance, while in others it produces B cell activation and secretion of
      immunoglobulins. Several mechanisms occur naturally in vivo abrogating the
      expression of deleterious autoantibodies and contributing to the state of self
      tolerance. In this review, we will examine different ways in which B cell
      tolerance can be broken, focusing on evidence showing that activated-T cells
      and/or their lymphokines can prevent B cell clonal deletion and thus have a
      potential role in the pathogenesis of autoimmune diseases. This approach is based
      on the well-known association of several lymphokines, such as IL-1, IL-2, IL-4,
      IL-5, and type I interferons, with autoimmune phenomena in vivo.

PMID- 1627791
TI  - Diagnosis of thalassemia using cDNA amplification of circulating erythroid cell
      mRNA with the polymerase chain reaction.

PMID- 1627792
TI  - Growth factors affecting human thrombocytopoiesis: potential agents for the
      treatment of thrombocytopenia.

PMID- 1627793
TI  - Mutations of the red blood cell membrane proteins: from clinical evaluation to
      detection of the underlying genetic defect.

PMID- 1627794
TI  - High levels of human glucocerebrosidase activity in macrophages of long-term
      reconstituted mice after retroviral infection of hematopoietic stem cells.
AB  - Gaucher disease is a leading candidate for somatic gene therapy using bone marrow
      (BM) cells as target tissue. Towards this end, we have constructed a retroviral
      vector (LG) in which the human glucocerebrosidase (GC) cDNA is driven by the
      Moloney murine leukemia virus (MoMLV) long terminal repeat (LTR). Day 12 to 14
      colony-forming unit-spleen progenitor cells were infected by the LG virus with a
      100% efficiency, and GC messenger RNA (mRNA) and protein were detected in the
      progeny of these cells. Tissues from long-term reconstituted mice analyzed 8
      months posttransplantation with LG-infected BM contained the intact provirus at
      greater than 1 copy per cell, indicating effective infection of hematopoietic
      stem cells. Human GC mRNA generated by the viral LTR was detected in macrophages
      as well as other hematopoietic cells. Enzyme activity was increased fivefold and
      twofold in macrophages from BM and spleen, respectively, and could be
      precipitated with an antibody specific for human GC. Immunohistochemical analysis
      detected the human GC protein in 81% of the macrophages from five recipient mice.
      These data indicate that, after transduction of hematopoietic stem cells, the LG
      vector is capable of directing expression of human GC in the majority of
      macrophages from long-term reconstituted mice and producing enzyme levels
      comparable with endogenous mouse activity, suggesting that this virus may be
      useful in the treatment of Gaucher disease.

PMID- 1627795
TI  - Morphology in patients with severe aplastic anemia treated with antilymphocyte
      globulin.
AB  - One hundred and seventeen patients with severe aplastic anemia (SAA) were treated
      at our institution between 1976 and 1990 with antilymphocyte globulin (ALG)
      therapy. Seventy-nine (68%) are alive and probability of survival at 14 years,
      according to Kaplan and Meier, is 62% +/- 12%. Twenty-six patients developed a
      late clonal complication: 11 had a myelodysplastic syndrome (MDS) and 17 had
      paroxysmal nocturnal hemoglobinuria (PNH); two patients had both. The cumulative
      risk at 10 years is 42%. The development of MDS/PNH after SAA directly affects
      survival. The probability of being alive at 14 years is 81% +/- 10% for patients
      with stable disease and 36% +/- 13% for those with clonal evolution (P = .001).
      To look for predictive signs, we reevaluated peripheral blood and bone marrow
      cytomorphology at presentation, during regeneration, and in remission. We
      examined the peripheral blood values for hemoglobin, reticulocytes, granulocytes,
      thrombocytes, mean corpuscular volume (MCV), and fetal hemoglobin, as well as
      bone marrow for cellularity, erythropoiesis, myelopoiesis, and megakaryopoiesis.
      ALG therapy induces slow and incomplete recovery. Although in "remission," ALG
      patients have lower hemoglobin values, higher reticulocyte counts, lower
      granulocyte and platelet values, and a higher MCV and fetal hemoglobin than
      normal controls. They retain a reduced number of megakaryocytes and a persistence
      of atypical monocytes in bone marrow morphology as stigmata of their disease.
      Patients with late clonal complications show distinct morphologic abnormalities:
      patients with PNH have higher MCVs, higher granulocyte and reticulocyte counts,
      and more dyserythropoiesis at diagnosis and a lower hemoglobin with an increased
      proportion of erythroblasts in the bone marrow in "remission." Patients who later
      developed MDS are not different from the total patient population at diagnosis.
      After therapy, these patients are characterized by the presence of ring
      sideroblasts and atypical monocytes during regeneration and by a persistent
      increase in MCV, a higher fetal hemoglobin, lower granulocyte values, and
      megakaryocytic dysplasia during "remission." Thus, routine morphologic follow-up
      examination of blood and bone marrow can discover patients at risk for late
      hematologic complications after ALG therapy.

PMID- 1627796
TI  - Evidence that interleukin-6 does not play a role in the stimulation of platelet
      production after induction of acute thrombocytopenia.
AB  - The induction of thrombocytopenia results in elevated levels of thrombopoietin
      (TPO), which can be detected in the plasma of experimental animals. Acute, severe
      thrombocytopenia (platelet count less than 5% of control) was produced in mice by
      the administration of either guinea pig or rabbit antimouse platelet antiserum.
      Control mice received equal volumes of normal serum. At various times after the
      induction of thrombocytopenia (0.5, 1, 2, 3, 4, 6, 12, and 24 hours) citrated
      plasma was collected, and circulating interleukin-6 (IL-6) levels were measured
      using the IL-6-dependent murine hybridoma cell line B9. At no time points after
      induction of thrombocytopenia were plasma IL-6 levels significantly different
      from control animals that received normal serum. However, injection of
      heterologous serum did result in slightly elevated plasma IL-6 levels (at 2 and 3
      hours) compared with basal levels measured in uninjected animals. This brief
      increase was not related to the production of thrombocytopenia. Protein fractions
      from the plasma of thrombocytopenic rabbits were also tested for the presence of
      IL-6. Preparations that contained TPO, as shown by stimulation of megakaryocyte
      maturation in vitro, did not contain detectable levels of IL-6. The ability of
      the B9 assay to detect the elevation of IL-6 levels in murine or rabbit plasma
      was verified after the administration of bacterial endotoxin, which is known to
      increase circulating IL-6 concentrations. IL-6 levels were highly elevated in
      rabbit or mouse serum after the administration of 5 mg/kg or 1 mg/kg of
      endotoxin, respectively. Anti-IL-6 antiserum did not neutralize the in vitro
      megakaryocyte maturation activity of partially purified TPO from the plasma of
      thrombocytopenic rabbits. In addition, IgG purified from the same antiserum did
      not neutralize partially purified TPO, as shown after incubation with TPO and
      subsequent precipitation with agarose-bound protein A. These results show that,
      unlike TPO, levels of IL-6 do not increase after the induction of acute, severe
      thrombocytopenia, and strongly suggest that IL-6 does not mediate the
      thrombopoietic response to acute thrombocytopenia. Although prolonged
      administration of IL-6 has been shown to induce thrombocytosis, IL-6 and TPO are
      apparently different and immunologically distinct molecules.

PMID- 1627797
TI  - Large, chronic doses of erythropoietin cause thrombocytopenia in mice.
AB  - Both large, acute doses of erythropoietin (EPO) and short-term hypoxia increase
      platelet counts in mice, but long-term hypoxia causes thrombocytopenia.
      Therefore, we tested the hypothesis that EPO injected in large, chronic doses (a
      total of 80 U of EPO over a 7-day period) might cause thrombocytopenia. EPO
      caused increased red blood cell (RBC) production, ie, increased hematocrits, RBC
      counts, mean cell volume (MCV), and reticulocyte counts (from P less than .05 to
      P less than .0005), and decreased thrombocytopoiesis, ie, decreased platelet
      counts, percent 35S incorporation into platelets, and total circulating platelet
      counts (TCPC) (P less than .0005). Femoral marrow megakaryocyte size was
      unchanged, but megakaryocyte number was significantly (P less than .005) reduced
      in mice treated with EPO. EPO-injected mice had increased spleen volumes (P less
      than .0005), but blood volumes (BV) were unchanged. In EPO-treated,
      splenectomized mice, RBC production was also increased (P less than .05 to P less
      than .0005) and platelet counts, TCPC, and percent 35S incorporation into
      platelets were decreased (P less than .05), but BV was not altered. Therefore,
      the decrease in platelet counts observed in EPO-treated mice was not due to
      increased BV or to an enlarged spleen. In other experiments, mice were rendered
      acutely thrombocytopenic to increase thrombocytopoiesis, and platelet and RBC
      production rates were determined. In mice with elevated thrombocytopoiesis, RBC
      counts, hematocrits, percent 59Fe RBC incorporation values, and MCV were
      decreased (P less than .05 to P less than .0005). Because 59Fe RBC incorporation
      and MCV were not elevated, the decrease in RBC counts and hematocrits does not
      appear to be due to bleeding. Therefore, we show that large, chronic doses of EPO
      increase erythropoiesis and decrease thrombocytopoiesis. Conversely, acute
      thrombocytopenia causes increased thrombocytopoiesis and decreased
      erythropoiesis. These findings support the hypothesis of competition between
      precursor cells of the erythrocytic and megakaryocytic cell lines (stem-cell
      competition) as the cause of thrombocytopenia in EPO-treated mice and the cause
      of anemia in mice whose platelet production rates were increased.

PMID- 1627798
TI  - Effects of synergistic cytokine combinations, low oxygen, and irradiated stroma
      on the expansion of human cord blood progenitors.
AB  - Expansion of hematopoietic progenitor cells in the mononuclear cell (MNC)
      fraction of human cord blood was evaluated under atmospheres containing reduced
      (5%) and normal (20%) oxygen tensions. Cells were cultured with synergistic
      cytokine combinations in suspension (without stroma) and on irradiated bone
      marrow stroma. Addition of interleukin (IL)-3 and IL-6 (IL-3/IL-6) provided a
      greater expansion of both total and progenitor cells than IL-1 and IL-3 (IL-1/IL
      3). IL-3/IL-6 maintained a higher level of progenitors throughout the 8-week
      culture period, whereas progenitors disappeared earlier from cultures with IL
      1/IL-3. This indicates that an earlier cell type was affected by IL-3/IL-6,
      and/or that IL-3/IL-6 favored self-renewal while IL-1/IL-3 induced
      differentiation. Reduced oxygen tension enhanced the productivity of these long
      term hematopoietic cultures (LTHC) under all conditions tested. In suspension
      cultures, reduced oxygen increased cumulative total cell production by 125% and
      167%, and cumulative progenitor production by 68% and 21%, with IL-1/IL-3 and IL
      3/IL-6, respectively. The presence of irradiated stroma increased cumulative
      progenitor cell production almost threefold in cultures without cytokines. In
      cultures with cytokines, the beneficial effect of stroma was less significant,
      but was greater under 20% O2 than 5% O2. Cultures under 5% O2 provided more
      progenitors and often maintained progenitors for 1 to 2 weeks longer than those
      under 20% O2. To quantitate more precisely the shift in cell populations induced
      by IL-3/IL-6 and stroma in cultures under 5% O2, flow cytometry analysis was
      used. By week 3, the addition of IL-3/IL-6 stimulated a 15-fold and 25-fold
      expansion of promyelocytes (CD15+CD11b-) in suspension and stromal cultures,
      respectively. Addition of IL-3/IL-6 also increased mature granulocyte
      (CD15hiCD11b+) and monocyte (CD15loCD11b+) numbers, while no effect was seen on T
      (CD3+) or B- (CD19+) lymphocytes. Endogenous production of IL-6 was significantly
      higher under 5% O2 in both suspension and stromal cultures, and IL-6 production
      was increased threefold by the addition of IL-1/IL-3. Very little IL-1 beta was
      produced in these cultures, and endogenous IL-3 and tumor necrosis factor (TNF)
      alpha were undetectable by enzyme-linked immunosorbent assay (ELISA) analysis.

PMID- 1627799
TI  - Erythropoietin-induced stimulation of differentiation and proliferation in J2E
      cells is not mimicked by chemical induction.
AB  - The J2E cell line is a novel erythroid cell line that differentiates in response
      to erythropoietin (Epo), the physiologic stimulus for erythropoiesis. After
      exposure to Epo, the cells synthesize hemoglobin, and we show here that this
      process is tightly linked to increases in cellular proliferation and DNA
      synthesis. The hormone-induced terminal differentiation also results in
      morphologic alterations and the accumulation of transcripts for alpha, beta maj,
      and beta min globins. c-myc messenger RNA levels increase rapidly after exposure
      to Epo and precede the increase in cell division, while c-myb undergoes a
      transient decrease. Differentiation of J2E cells can also be achieved with sodium
      butyrate, but, in contrast with Epo, this is associated with a retardation of
      replication and a sudden decrease in c-myc levels. These results show that, in
      this system, chemically induced differentiation differs from terminal maturation
      promoted by Epo and that the processes of proliferation and differentiation in
      J2E cells can be uncoupled.

PMID- 1627800
TI  - Thrombocytopoiesis in normal and sublethally irradiated dogs: response to human
      interleukin-6.
AB  - The response of megakaryocytes and platelets to the administration of recombinant
      human interleukin-6 (IL-6) was investigated in normal and sublethally irradiated
      dogs. IL-6 was administered for 2 weeks at doses of 10 to 160 micrograms/kg/d to
      normal animals to assess dose-response and toxicity. Subsequently, 40, 80, or 160
      micrograms/kg/d for 2 weeks was administered to animals treated with 200 cG total
      body irradiation. Analysis of normal dogs showed a significant increment in the
      platelet count detectable approximately 11 days after initiation of IL-6 at all
      administered doses. Large platelets greater than 6.3 microns in diameter were
      observed 1 day after beginning IL-6, progressively increasing to as many as 19.1%
      of the total circulating platelets by day 10. The ploidy distribution of the
      marrow megakaryocytes did not differ from the normal at doses of less than or
      equal to 80 micrograms/kg/d, but at 160 micrograms/kg/d, a shift toward higher
      ploidy cells was noted. No change in total white count was noted; however, a
      decrease in hematocrit was seen at all doses. In the irradiated animals, the
      platelet count recovered earlier in the IL-6-treated dogs than in the controls,
      but no consistent change in the ploidy distribution was observed irrespective of
      dose. Large platelets were also noted in the treated animals, comprising up to
      6.9% of the total platelet count. Fibrinogen levels were elevated to greater than
      4 times normal. A significant decrease in hematocrit was seen in all animals,
      while no consistent change was noted in the white count. Elevations in serum
      cholesterol, triglycerides, and alkaline phosphatase, together with a decline in
      serum albumin were observed in all the treated animals (both normal and
      irradiated), but clinical symptoms were observed only in the dogs receiving
      greater than or equal to 80 micrograms/kg/d. The data show that IL-6 alone is
      capable of enhancing platelet recovery in dogs with bone marrow suppression.

PMID- 1627801
TI  - Human endothelial cells express integrin receptors on the luminal aspect of their
      membrane.
AB  - Endothelial cells (EC) form a dynamic interface between blood and the rest of the
      body. EC surface properties promoting adhesion of reactive plasma proteins and/or
      circulating cells might be of pivotal importance for the homeostasis of blood and
      tissues. EC express multiple integrin receptors that promote their attachment to
      the subendothelial matrix proteins. Among these receptors, alpha v beta 3 is of
      particular relevance on EC, since it is abundantly expressed and can bind many
      different matrix and plasma proteins. It is still unknown whether integrin
      receptors are selectively located to the basal side of EC membrane or may also be
      exposed on the cell surface in contact with blood. This issue was addressed using
      different experimental approaches. First, selective surface radioiodination using
      lactoperoxidase (LPO)-latex beads and immunoprecipitation analysis were
      performed. We found that cultured EC, similarly to human skin fibroblasts (HSF),
      expose alpha v beta 3 on both their apical (free) and basal (substratum-attached)
      surfaces. This held also for other integrins such as alpha 2 beta 1, alpha 3 beta
      1, alpha 5 beta 1, and alpha 6 beta 1. Immunoprecipitation data were verified by
      morphological techniques. Immunofluorescence and immunogold-staining of EC with
      alpha v beta 3, as well as with beta 1 subfamily antibodies, showed a diffuse and
      granular distribution of these integrins on EC surface. alpha v beta 3 and beta 1
      integrins were also detected on the apical membrane of EC at higher magnification
      by scanning electron microscopy (SEM). Finally, data obtained on cultured EC were
      confirmed in vivo on immunogold-labeled ultrathin cryosections of human vessels
      by transmission electron microscopy (TEM). Data indicate, that in addition to
      their role in promoting EC attachment to extracellular matrix proteins, integrin
      receptors of EC can be exposed to blood-stream and eventually be available for
      binding of plasma proteins and circulating cells.

PMID- 1627802
TI  - Transcellular metabolism of arachidonic acid: increased platelet thromboxane
      generation in the presence of activated polymorphonuclear leukocytes.
AB  - Human polymorphonuclear leukocytes (PMN) activated by n-formyl-methionyl-leucyl
      phenylalanine (fMLP), in the presence of cytochalasin B, are able to induce
      activation of coincubated autologous platelets "via" cathepsin G released from
      the azurophilic granules. However, thromboxane (Tx) B2 production in this system
      cannot be completely explained by cathepsin G-stimulated platelet arachidonate
      metabolism. Indeed, the amount of TxB2 found in supernatants of platelet/PMN
      suspensions challenged with 1 mumol/L fMLP was twofold to fourfold higher than
      that measured when platelets were stimulated by supernatants from fMLP-activated
      PMN. In the present report, we analyzed the possibility that PMN-induced TxB2
      production in this system is the result of transcellular metabolism of
      arachidonic acid (AA) between fMLP-activated PMN and cathepsin G-stimulated
      platelets. 3H-AA-labeled PMN were used to test if a transfer of AA or
      metabolite(s) occur from PMN to platelets. Our results showed that: (1) 3H-TxB2
      and 3H-12-HHT are synthesized when 3H-AA-labeled PMN are activated mixed to
      unlabeled platelets; (2) total radioactivity released by fMLP-stimulated PMN is
      increased in the presence of platelets, whereas the membrane content of
      unesterified 3H-AA is reduced; (3) platelet cyclooxygenase inhibition completely
      prevents 3H-TxB2 synthesis; and (4) inhibition of cathepsin G-induced platelet
      activation with the antiprotease eglin C blocks the formation of 3H-TxB2. These
      data show that in the experimental system used, platelets use PMN-derived
      unmetabolized AA to synthesize TxB2.

PMID- 1627803
TI  - Regulatory effects of gallium on transferrin-independent iron uptake by human
      leukemic HL60 cells.
AB  - Gallium, a pharmacologically important metal, resembles iron with respect to
      transferrin (Tf) binding and Tf receptor-mediated cellular uptake. In the present
      study, we examined the effect of gallium on Tf-independent iron uptake by HL60
      cells. In contrast to the inhibitory effect of Tf-gallium on Tf-iron uptake,
      gallium nitrate, in a time-, temperature-, and concentration-dependent manner,
      stimulated Tf-independent uptake of iron-nitrilotriacetic acid (Fe-NTA).
      Preexposure of cells to gallium followed by removal of gallium also resulted in
      sustained stimulation of iron uptake. The anti-Tf receptor monoclonal antibody
      42/6 blocked Tf-iron uptake, but had no effect on gallium-induced stimulation of
      Tf-independent iron uptake. Gallium increased the number of cell membrane iron
      binding sites, without a change in their affinity for iron. Ferric chloride
      stimulated Tf-independent gallium uptake. Although gallium nitrate inhibited cell
      growth in Tf-free medium, cellular proliferation was restored by Fe-NTA. Gallium
      and iron appear to share the same Tf-independent cellular uptake system in HL60
      cells. Exposure of cells to gallium results in the activation of cell membrane
      non-Tf iron carriers that may play a role in overcoming the Tf-independent growth
      inhibitory effects of gallium.

PMID- 1627804
TI  - Human embryonic zeta-globin chain expression in deletional alpha-thalassemias.
AB  - zeta-Globin chain expression in carriers of a number of deletional alpha
      thalassemias is investigated by radioimmunoassay. In a few cases, zeta-globin
      mRNAs are also studied. zeta-Globin chains are detected in (--SEA/), (--MED/),
      and (--SPAN/) deletions, but not in six other deletional mutations. These results
      suggest that the DNA element capable of suppressing zeta-globin expression in
      adult erythroid cells is present within the (--SPAN/) deletion, while the DNA
      fragment between the 5' breakpoints of the (--SA/) and the (--SEA/) deletions may
      contain sequences necessary for augmenting zeta-globin expression in adult
      erythroid cells. Furthermore, zeta-globin chains are shown by an immunocytologic
      technique to be present in all circulating erythrocytes in carriers of the (-
      SEA/) and (--MED/) deletions. This simple immunocytologic test is highly
      sensitive and specific to detect adult carriers of either the (--SEA/) or (-
      MED/) deletions, and can be used for the detection of couples at risk of
      pregnancies involving fetuses with homozygous alpha-thalassemia.

PMID- 1627805
TI  - The low risk of hepatitis C virus transmission among sexual partners of hepatitis
      C-infected hemophilic males: an international, multicenter study.
AB  - To study the transmission rate of hepatitis C virus (HCV) in the female sexual
      partners of antibody-positive hemophilic males, 106 partners from three
      hemophilia centers located in Europe, America, and Australia were tested for HCV
      seropositivity using a first-generation enzyme-linked immunosorbent assay (ELISA
      1) and, subsequently, a second-generation ELISA (ELISA-2) and a supplemental
      recombinant immunoblot assay. Additionally, the cohort was tested for the
      presence of antibody to the human immunodeficiency virus type-1 and hepatitis B
      virus markers. No female partner was HCV antibody-positive using the ELISA-1
      test, whereas five were seropositive by the ELISA-2 test. Three of these five
      female partners were seropositive on the supplemental test, the remaining two
      having indeterminate results, for an overall prevalence of 2.7%. Thus, even with
      the use of sensitive testing, the prevalence of HCV infection remains low in this
      cohort, showing that the efficiency of heterosexual transmission of HCV is poor.

PMID- 1627806
TI  - Failure to detect evidence of human T-lymphotropic virus (HTLV) type I and type
      II in blood donors with isolated gag antibodies to HTLV-I/II.
AB  - Of the 267,650 blood donations from members of the US armed forces, 72 (0.027%)
      were serologically confirmed to be positive for human T-lymphotropic virus type
      I/II (HTLVpos) and 379 (0.14%) were Western blot (WB)-indeterminate with banding
      pattern restricted to the proteins encoded by the gag gene only (HTLVind). To
      determine whether these apparently healthy HTLVind blood donors are infected with
      HTLV-I or HTLV-II, coded specimens from randomly selected military blood donors
      (n = 73) were tested for antibodies to HTLV by WB and radioimmunoprecipitation
      assay (RIPA) using HTLV-I (MT-2) antigens, by enzyme immunoassay using synthetic
      peptides representing the immunodominant epitopes of HTLV, and for sequences of
      proviral HTLV DNA by the polymerase chain reaction (PCR). Of the 73 HTLVind
      donors, none showed presence of env reactivity by HTLV WB and RIPA. Minimal
      reactivity was observed with synthetic immunodominant motifs derived from the env
      protein of HTLV-I (Env-1(191-214) and Env-5(242-257)) or HTLV-II (Env-2(187-209)
      and Env-20(85-102)) and gag protein (Gag-1a(102-117) and Gag-10(364-385)). A
      peptide corresponding to the endogenous retroviral sequence with structural
      homologies to the gag protein of HTLVs (RTVLgag) reacted with antibodies not only
      in HTLVpos (88%) and HTLVind (42% to 66%) specimens, but also reacted with normal
      control subjects (60%). Furthermore, none of the 73 HTLVind specimens
      demonstrated presence of the HTLV genome when amplified with primers for the pol
      and tax/rex region. Six to 23 months from the initial test, 27 subjects still
      gave indeterminate WB patterns, and 13 of these repeat specimens were still
      negative for the presence of HTLV genome. We conclude that individuals at low
      risk for HTLV infection who have HTLVind WB reactivity are rarely, if ever,
      infected with HTLV-I or HTLV-II.

PMID- 1627807
TI  - Detection of circulating donor white blood cells in patients receiving multiple
      transfusions.
AB  - Significant morbidities are associated with the routine administration of blood
      products. Although the exact etiology of these complications may be unknown, many
      are thought to arise from the incidental cotransfusion of "donor" lymphocytes. We
      have developed an assay to detect small numbers of male white blood cells (WBCs)
      circulating in female patients who have received multiple blood transfusions
      using the polymerase chain reaction (PCR). Twenty female patients undergoing
      major surgical procedures were studied and received an average of 9.3 U of packed
      red blood cells (4.8 U from male donors) and 11.7 U of platelets (6.1 U from male
      donors). DNA was extracted from whole blood or peripheral blood buffy coats
      posttransfusion and PCR performed using oligonucleotides designed to amplify a
      segment within the repetitive Y-chromosome DYZ1 locus. Posttransfusion, 15 of 20
      women showed evidence of circulating male WBCs for an average of 2.0 days (range,
      1 to 6). We conclude that (1) DYZ1 PCR analysis is a useful approach for the
      detection of small numbers of circulating transfused male WBCs in female
      patients; and (2) circulating donor WBCs persist for a mean of 2.0 days in the
      majority of women receiving multiple transfusions. Future application of this
      technique may detect persisting or proliferating WBCs and lead to an improved
      understanding of common transfusion-related morbidities.

PMID- 1627808
TI  - MDR1 RNA expression is an independent prognostic factor in acute myeloid
      leukemia.

PMID- 1627809
TI  - Differential expression of cytokines in human blood monocyte subpopulations.

PMID- 1627810
TI  - Long-term follow-up of a controlled trial comparing a combination of methotrexate
      plus cyclosporine with cyclosporine alone for prophylaxis of graft-versus-host
      disease in patients administered HLA-identical marrow grafts for leukemia.

PMID- 1627811
TI  - Inadequate monitoring of warfarin dosage.

PMID- 1627812
TI  - Recertification in hematology. Hematology Board of the American Board of Internal
      Medicine.

PMID- 1627813
TI  - Prognostic factors and natural history in lymph node-negative breast cancer
      patients.
AB  - The prognostic significance of clinical and histological factors as well as
      hormone receptors was analyzed in a population of 3,064 lymph node-negative
      breast cancer patients operated in the Stockholm region between 1976 and 1988.
      None of these patients received systemic adjuvant treatment. Multivariate
      analysis showed that only histological tumor size, number of examined axillary
      lymph nodes, and progesterone receptors were independent prognostic factors in
      terms of recurrence-free interval. An individual risk of recurrence was
      calculated taking into account these three factors to discriminate between three
      groups of patients with a risk of less than 15%, 15-25%, and more than 25% of
      recurrence at 5 years. Similar results were obtained taking into account only the
      first two factors. The prognostic information added by the knowledge of
      progesterone receptors only changed the recurrence rate in approximately 3%. This
      study showed that conventional prognostic factors permit the identification of
      high risk lymph node-negative breast cancer patients. Results obtained by the use
      of new more sophisticated factors should be compared with those obtained
      analyzing strong conventional prognostic factors.

PMID- 1627814
TI  - pS2 expression in primary breast carcinomas: relationship to clinical and
      histological features and survival.
AB  - pS2 protein expression has been reported to have prognostic significance in human
      breast carcinomas and to correlate with estrogen receptor positivity, although
      these findings have not been confirmed by all investigators. pS2 positivity was
      compared to various clinical and histologic parameters in a retrospective study
      of 290 patients (median follow-up 7.2 years) and significantly correlated with
      tumor grade and estrogen receptor content (p = 0.001 and p = 0.0007,
      respectively). Significant associations between pS2 positivity and lymph node
      metastases, T stage, histologic tumor type, and patient age were not observed.
      Univariate and multivariate analyses (controlling for estrogen receptor content,
      T and N stage) of the patient population at large showed that pS2 positivity was
      not predictive of disease-free or overall survival. Univariate analysis of lymph
      node negative patients demonstrated that both pS2 and estrogen receptor
      positivity were significantly associated with a better outcome. Multivariate
      analysis of these patients, however, showed that only estrogen receptor data had
      independent prognostic significance. This study suggests that immunohistochemical
      analysis for pS2 protein expression will not contribute additional prognostic
      information if the estrogen receptor content is known.

PMID- 1627815
TI  - Prognostic factors in node-positive operable breast cancer patients receiving
      adjuvant chemotherapy.
AB  - A retrospective analysis of prognostic factors in 214 consecutive node-positive
      (N+) operable breast cancer patients, receiving Melphalan + 5-fluorouracil
      adjuvant chemotherapy between 1980 and 1984 was performed. Median follow-up was
      95 months. Actuarial disease-free interval (DFI) and survival (S) were determined
      according to age, menopausal status, histology, size of primary tumor (T),
      multifocality, tumor location, hormonal receptor status, number of N+, size of
      N+, tumor spread in axillary fat, and interval between surgery and onset of
      adjuvant chemotherapy. On univariate analysis two factors were prognostic for DFI
      and S: number of N+ and T size. A comparison between traditionally classified T1
      and T2 patients revealed no significant difference, but when the cut-off point
      was shifted from 2 cm to 3 cm, T size represented a highly significant prognostic
      factor. In patients with T less than or equal to 3 cm 5-year DFI was 54% and 5
      year S was 76%, while in patients with T greater than 3 cm the respective values
      were 23% (p less than 0.001) and 41% (p less than 0.001). These significant DFI
      and S differences persisted after adjustment for number of N+ by bivariate
      analysis. Multivariate analysis supported the importance of T greater than 3 cm
      as a strong adverse predictor. Four adverse variables, T greater than 3 cm,
      number of N+ greater than or equal to 4, multifocality, and tumor spread in
      axillary fat were used to divide our patients into three subsets with
      significantly different DFI: Group I, with none of the above factors; Group II,
      with only one factor present; and Group III, with more than one factor present (5
      years DFI 66%, 45%, and 21%, respectively; p less than 0.001).

PMID- 1627816
TI  - Weekly low-dose mitoxantrone plus doxorubicin as second-line chemotherapy for
      advanced breast cancer.
AB  - Weekly low dose mitoxantrone (3 mg/m2) plus doxorubicin (8 mg/m2) was
      administered as second-line chemotherapy to 33 patients with advanced breast
      cancer. Four out of 28 evaluable patients (14%) obtained a partial response with
      a median duration of 34 weeks (range 18-67+ weeks), while 8 patients (29%) showed
      stable disease with a median duration of 28 weeks (range 11+-60 weeks).
      Gastrointestinal toxicity and alopecia were mild. Grade II and III leukopenia
      occurred in 63% of the courses without serious infectious disease. Four patients
      experienced an asymptomatic drop of 16-20% in the left ventricular ejection
      fraction (LVEF) after relatively low cumulative doses of each drug, and one
      patient with a history of pericarditis carcinomatosa and mediastinal irradiation
      developed a heart failure. In conclusion, this second-line combination treatment
      had moderate activity in breast cancer and caused only few subjective side
      effects, especially with respect to gastrointestinal symptoms.

PMID- 1627817
TI  - Comparison of pain, motion, and edema after modified radical mastectomy vs. local
      excision with axillary dissection and radiation.
AB  - Recent data suggest that prognosis is similar for women with primary breast
      cancer whether they receive modified radical mastectomy (MRM) or local excision
      and axillary dissection with radiation (XRT). The effects of either of these
      treatments on arm mobility, pain, or edema have not been compared. To assess the
      impact of MRM or XRT on mobility, pain, or edema, we evaluated patients treated
      in a prospective randomized trial designed to assess prognosis following MRM or
      XRT. All were provided a standardized physical therapy program including arm
      mobilization, shoulder strengthening, prevention and treatment of upper extremity
      edema, and education about arm function. Patients were evaluated for chest wall
      pain, arm motion, muscle strength, and edema as determined by circumferential
      measurements at the wrist, forearm, and arm. Evaluations were performed
      preoperatively and at yearly anniversaries of their surgery. Women receiving XRT
      had more chest wall tenderness at 1 and 2 years after surgery than those
      receiving MRM (p2 less than 0.0001 and p2 = 0.0007 respectively). Those receiving
      MRM were slower to reach their preoperative range of motion (ROM) (p2 = 0.043).
      Incidence of muscle weakness was similar in both groups. The few patients with
      local recurrence of tumor had more upper extremity edema than those who did not
      recur (p2 = 0.085) at 1 year and (p2 = 0.02) at 2 years. In patients who did not
      develop local recurrence, those who had received XRT had greater but
      nonsignificant increases in upper extremity circumferential measures compared
      with those receiving MRM at any anniversary evaluation. Patients receiving MRM
      and XRT are likely to have some differences in functional outcome.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1627819
TI  - Dental students go on strike.

PMID- 1627818
TI  - Human gene therapy: present and future.
AB  - The hematopoietic system and the liver are two primary target organs for
      attempting somatic gene therapy of hereditary deficiencies. Several leading
      laboratories have recently been able to demonstrate that bone marrow cells from
      rodents and non-human primates can be successfully transduced with foreign genes,
      resulting in the functional expression of these genes in culture. The genetically
      reconstituted cells can subsequently be transplanted into X-irradiated
      recipients, and expression of the transduced genes is observed in the recipients
      for more than 6 months. Subsequently, gene transfer into peripheral T-lymphocytes
      in humans has been attempted, and the clinical trials are currently in progress.
      The liver is the other major organ under intensive investigation. Primary
      hepatocytes can be isolated from rodents, rabbits, and dogs, and successfully
      transduced with recombinant retroviruses. After autologous transplantation, long
      term survival of the engrafted cells in vivo has been observed. More recently, it
      has been shown that human hepatocytes can also be efficiently transduced with
      recombinant retroviruses. These experimental results have laid the foundation for
      somatic gene therapy of hereditary deficiencies in humans in the future.

PMID- 1627820
TI  - Denturists legalized in The Netherlands.
AB  - In 1990 the Dutch Government accepted A law which made it possible for dental
      prosthetic technicians to manufacture full dentures on patients. The Dutch Dental
      Association opposed of this law. The authors explain, why this law was accepted
      and the experience with this law so far.

PMID- 1627822
TI  - Bad management, bad business.
AB  - The past ten years the market for dentists in Denmark has been shrinking. This is
      having an effect on the financial position of dental practices. It is more
      difficult for dentists to maintain a certain income level. Several problems are
      analysed and possible solutions are being discussed.

PMID- 1627821
TI  - Dentistry for children. How it is done in British Columbia, Canada. A report of
      an exchange-student from Germany.
AB  - In Vancouver, there is a Children's Hospital unique for its kind: Various
      paediatric departments are covered under one roof. Matthias Hammer, a dental
      student from Germany, describes their cooperation and the import of the dental
      department.

PMID- 1627823
TI  - Coming to Finland. The Dental School of Kuopio.
AB  - The Faculty of Dentistry at the University of Kuopio became the first dental
      school in Finland and its first dean was Heikki Luoma. Today, next to the
      undergraduate education, there is a post graduate training-program as well as
      scientific research to achieve the degree of Doctor of Dental Science.

PMID- 1627824
TI  - Selectivity in storage hexamerin clearing demonstrated with hemolymph
      transfusions between Hyalophora cecropia and Actias luna.
AB  - When Hyalophora cecropia hemolymph was injected into wandering Actias luna
      larvae, a methionine-rich hexamerin was selectively transferred to the host's fat
      body, and completely cleared from the hemolymph by the time of pupal eclosion.
      Donor arylphorin was 30-40% removed from the hemolymph, and riboflavin-binding
      hexamerin was even less completely cleared. During the pupal-adult molt, these
      rates were reversed: methionine-rich hexamerin disappeared no faster than bovine
      serum albumin, while riboflavin-binding hexamerin was rapidly and completely
      cleared from the hemolymph, even though A. luna hemolymph lacks a homologue of
      this protein; arylphorin, again, was cleared at an intermediate rate. Selective
      clearing of the three hexamerins occurred at similar stages in H. cecropia, their
      species of origin. Developmentally programmed clearing, with selectivity at least
      partially conserved between genera, was also demonstrated with transfused
      vitellogenin: in A. luna females that were forming yolk, H. cecropia vitellogenin
      was cleared more rapidly than bovine serum albumin; but in younger females, and
      in males at all stages of metamorphosis, this Mr 510,000 molecule was instead an
      indicator of nonselective, large protein clearing. Nonselective clearing was more
      complete during adult development than during pupation. It also showed signs of
      being more effective for small than for large proteins, insensitive to
      carbohydrate conjugates, and unsaturated at the protein levels used.

PMID- 1627825
TI  - Carbamoyl phosphate synthetase (CPSase) in the PYR1-3 multigene of Dictyostelium
      discoideum.
AB  - We have isolated and sequenced the genomic DNA from the slime-mould Dictyostelium
      discoideum multi-gene (PYR1-3) encoding the carbamoyl phosphate synthetase II
      domain (CPSase, EC.6.3.5.5). We describe sequencing by oligo-walking directly on
      PCR product in the solid-phase, avoiding subcloning procedures. The 2.4 kb
      fragment completes the sequence of the PYR1-3 gene, has no introns, and has the
      same structure as the rudimentary gene of Drosophila melanogaster. Comparison
      with the carbamoyl phosphate synthetases (CPSase I and CPSase II) of other
      species supports the hypothesis that this gene has arisen by tandem duplication
      from a smaller common ancestral gene in the progenote.

PMID- 1627826
TI  - Sequence analysis of the large and small subunits of human ribonucleotide
      reductase.
AB  - We have isolated and sequenced overlapping cDNA clones from a breast carcinoma
      cDNA library containing the entire coding region of both the R1 and R2 subunits
      of the human ribonucleotide reductase gene. The coding region of the human R1
      subunit comprises 2376 nucleotides and predicts a polypeptide of 792 amino acids
      (calculated molecular mass 90,081). The sequence of this subunit is almost
      identical to the equivalent mouse ribonucleotide reductase subunit with 97.7%
      homology between the mouse and human R1 subunit amino acid sequences. The coding
      region of the human R2 subunit of ribonucleotide reductase comprises 1170
      nucleotides and predicts a polypeptide of 389 amino acids (calculated molecular
      mass 44,883), which is one amino acid shorter than the equivalent mouse subunit.
      The human and mouse R2 subunits display considerable homology in their carboxy
      terminal amino acid sequences, with 96.3% homology downstream of amino acid 68 of
      the human and mouse R2 proteins. However, the amino-terminal portions of these
      two proteins are more divergent in sequence, with only 69.2% homology in the
      first 68 amino acids.

PMID- 1627827
TI  - A C. elegans gene encodes a protein homologous to mammalian calreticulin.
AB  - The gene encoding a C. elegans homologue of the mammalian reticuloplasmin,
      calreticulin, was cloned and sequenced and the amino-acid sequence of its product
      deduced. The coding region of the gene comprises three exons separated by introns
      of 95 and 55 nucleotides, followed by either 158 or 279 bases of 3' non-coding
      sequence before putative polyadenylation signals. The precursor protein of 395
      residues includes an N-terminal signal sequence of 13 residues. The C-terminus
      has the ER retention signal HDEL preceded by a polyacidic zone similar to known
      mammalian calreticulins. The sequence shows a 61% identity with mouse
      calreticulin, increasing to 82% in the proline-rich region of the molecule.
      Comparison of the C. elegans sequence with the calreticulin-related antigen RAL-1
      of Oncocerca volvulus shows 73% identity, excluding the calreticulin C-terminal
      region. The sequence of this region differs markedly from RAL-1 where the
      parasite protein has a polybasic stretch and no ER retention signal. The C.
      elegans gene described here and designated crt-1 was mapped to a region towards
      the left-hand end of Chromosome V on the physical map of the genome. Southern
      blotting of genomic DNA indicates that in C. elegans the calreticulin homologue
      exists in only one form as the product of a single gene.

PMID- 1627828
TI  - The intronless mouse gene for the tissue specific splicing protein SmN is a
      processed pseudogene containing a stop codon after thirty-one amino acids.
AB  - The SmN protein is a component of small ribonucleoprotein particles which is
      closely related to the ubiquitously expressed splicing proteins SmB and B' but is
      expressed in only a small number of cells and tissues. We have isolated a mouse
      SmN-related sequence which lacks introns and contains multiple changes from the
      SmN cDNA sequence including a stop codon after thirty-one amino acids which would
      prevent it encoding functional SmN protein. This indicates that this intronless
      gene is a processed pseudogene and that the functional gene has yet to be
      isolated. In agreement with this southern blotting of mouse DNA with SmN probes
      reveals bands, additional to those derived from the pseudogene, which are
      characteristic of an intron-containing SmN gene. The relationship of the
      pseudogene to the functional SmN gene and to an intronless SmN-related sequence
      in the rat genome is discussed.

PMID- 1627829
TI  - Transcription on lampbrush chromosome loops in the absence of U2 snRNA.
AB  - The five small nuclear RNAs (snRNAs) involved in splicing occur on the loops of
      amphibian lampbrush chromosomes and in hundreds to thousands of extrachromosomal
      granules called B snurposomes. To assess the role of these snRNAs during
      transcription and to explore possible relationships between the loops and B
      snurposomes, we injected single-stranded antisense oligodeoxynucleotides (oligos)
      against U1 and U2 snRNA into toad and newt oocytes. As shown before, antisense U1
      and U2 oligos caused truncation of U1 and complete destruction of U2 snRNAs,
      respectively. However, injection of any oligo, regardless of sequence, brought on
      dramatic cytological changes, including shortening of the chromosomes and
      retraction of the lateral loops, with concomitant shutdown of polymerase II
      transcription, as well as disappearance of some or all of the B snurposomes. When
      injected oocytes were incubated for 12 h or longer in physiological saline, these
      changes were reversible; that is, the chromosomes lengthened, transcription
      (detected by 3H-UTP incorporation) resumed on newly extended lateral loops, and B
      snurposomes reappeared. In situ hybridization showed that loops and B snurposomes
      had negligible amounts of U2 snRNA after recovery from injection of the anti-U2
      oligo, whereas these structures had normal levels of U2 snRNA after recovery from
      a control oligo. Thus, the morphological integrity of B snurposomes and lampbrush
      chromosome loops is not dependent on the presence of U2 snRNA. Because
      transcription occurs in the absence of U2 snRNA, we conclude that splicing is not
      required for transcription on lampbrush chromosome loops.

PMID- 1627830
TI  - Two genes in Saccharomyces cerevisiae encode a membrane-bound form of casein
      kinase-1.
AB  - Two cDNAs encoding casein kinase-1 have been isolated from a yeast cDNA library
      and termed CKI1 and CKI2. Each clone encodes a protein of approximately 62,000 Da
      containing a highly conserved protein kinase domain surrounded by variable amino-
      and carboxy-terminal domains. The proteins also contain two conserved carboxy
      terminal cysteine residues that comprise a consensus sequence for prenylation.
      Consistent with this posttranslational modification, cell fractionation
      experiments demonstrate that intact CKI1 is found exclusively in yeast cell
      membranes. Gene disruption experiments reveal that, although neither of the two
      CKI genes is essential by itself, at least one CKI gene is required for yeast
      cell viability. Spores deficient in both CKI1 and CKI2 fail to grow and,
      therefore, either fail to germinate or arrest as small cells before bud
      emergence. These results suggest that casein kinase-1, which is distributed
      widely in nature, plays a pivotal role in eukaryotic cell regulation.

PMID- 1627831
TI  - Extracellular signal-regulated kinases 2 autophosphorylates on a subset of
      peptides phosphorylated in intact cells in response to insulin and nerve growth
      factor: analysis by peptide mapping.
AB  - The phosphorylation of extracellular signal-regulated kinases 1 and 2 (ERK1 and
      ERK2) in response to insulin in Rat 1 HIRc B cells and in response to nerve
      growth factor (NGF) in PC12 cells has been examined. ERK1 and ERK2 are
      phosphorylated on serine in the absence of the stimuli and additionally on
      tyrosine and threonine residues after exposure to NGF and insulin. NGF stimulates
      tyrosine phosphorylation of ERK1 more rapidly than threonine phosphorylation. Two
      dimensional phosphopeptide maps of both ERK1 and ERK2 phosphorylated in intact
      cells treated with NGF or with insulin display the same three predominant
      phosphopeptides that comigrate when digests of ERK1 and ERK2 are mixed. As many
      as five additional phosphopeptides are detected under certain conditions.
      Autophosphorylated recombinant ERK2 also contains the three tryptic
      phosphopeptides found in ERKs labeled in intact cells. These experiments
      demonstrate that ERK1 and ERK2 are phosphorylated on related sites in response to
      two distinct extracellular signals. The data also support the possibility that
      autophosphorylation may be involved in the activation of the ERKs.

PMID- 1627832
TI  - Testing the in vivo role of protein kinase C and c-fos in neurite outgrowth by
      microinjection of antibodies into PC12 cells.
AB  - To define the molecular bases of growth factor-induced signal transduction
      pathways, antibodies known to block the activity of either protein kinase C (PKC)
      or the fos protein were introduced into PC12 cells by microinjection. The
      antibody against PKC significantly inhibited neurite outgrowth when scored 24 h
      after microinjection and exposure to nerve growth factor (NGF). Microinjection of
      antibodies to fos significantly increased the percentage of neurite-bearing cells
      after exposure to either NGF or basic fibroblast growth factor (bFGF) but
      inhibited the stimulation of DNA synthesis by serum, suggesting that in PC12
      cells, fos is involved in cellular proliferation. Thus, activation of PKC is
      involved in the induction of neurite outgrowth by NGF, but expression of the fos
      protein, which is induced by both NGF and bFGF, is not necessary and inhibits
      neurite outgrowth.

PMID- 1627835
TI  - Communication--a theatre art.
AB  - The art of communication is not easy. We communicate with patients by speech,
      writing, illustrations, gesture, touch and smell, sometimes singly, sometimes all
      at the same time. The firmness of a handshake carries meaning as clearly as
      words, in the same way that a smile radiates confidence and friendliness. Good
      communication carries its own reward: the trust of a patient.

PMID- 1627834
TI  - Nerve growth factor employs multiple pathways to induce primary response genes in
      PC12 cells.
AB  - Nerve growth factor (NGF) leads to neuronal differentiation of PC12 cells and
      promotes their survival in serum-free medium. Past studies have shown that purine
      analogues block some of the effects of NGF but not others and thus that they can
      be used to dissect the mechanistic pathways of its action. In the present work we
      used 2-aminopurine (2-AP) and 6-thioguanine (6-TG) to examine whether NGF causes
      activation of primary response genes through a single signaling pathway or via
      multiple pathways. Northern blot analysis and nuclear run-off transcription
      assays were used to assess the activation of c-fos, c-jun, TIS1, TIS8, and TIS11
      after exposure of PC12 cells to NGF in the presence or absence of 2-AP and 6-TG.
      Our findings indicate that NGF appears to employ at least three distinct pathways
      to induce early genes in PC12 cells. This suggests that the NGF signaling
      mechanism diverges at an early point after interaction of NGF with its receptor.

PMID- 1627833
TI  - Transmembrane-mediated changes in [Ca2+] are involved in the signaling pathway
      leading to macrophage cytocidal differentiation: implications of localized
      changes in intracellular [Ca2+] and of interferon priming on Ca2+ utilization.
AB  - Macrophage cytocidal activation requires the sequential impingement on the
      macrophage of a priming stimulus (interferon [IFN] alpha, beta, or gamma) and a
      triggering stimulus (such as polyinosinic acid:polycytidylic acid [poly [I:C]] or
      bacterial lipopolysaccharide). The mechanism of progression from the IFN-primed
      state to the cytocidal state is poorly understood. By quantifying the level of
      expression of a gene product (complement component factor B [Bf]) associated with
      cytocidal activation and through the use of phenotypically distinct populations
      of macrophages (unprimed and IFN-primed), we have investigated the functional
      necessity of changes in intracellular concentration of free calcium ions
      ([Ca2+]i) in signaling the transition from the primed to the cytocidal state.
      Elevating the [Ca2+]i by incubation of unprimed macrophages with the calcium
      ionophore, ionomycin, failed to induce the expression of Bf. By contrast, Bf was
      expressed at high levels when IFN-primed macrophages were exposed to ionomycin,
      suggesting that priming induced within the macrophages the capacity to respond to
      a nonspecific change in [Ca2+]i. Quantification of the [Ca2+]i in response to
      exposure to ionomycin revealed an initial transient elevation, followed by a
      secondary sustained component. No differences in these changes were observed
      between unprimed and IFN-primed macrophages. We therefore questioned if changes
      in [Ca2+]i were also implicated in the transition between the primed and the
      cytocidal state using the ligand, poly [I:C]. In contrast to ionomycin,
      incubation of IFN-primed macrophages with poly [I:C] did not sustain measurable
      increases in [Ca2+]i, yet fully stimulated the transition from the IFN primed to
      the cytocidal state. However, incubation of IFN-primed macrophages with poly
      [I:C] in the presence of 1) a Ca2+/ethylene glycol-bis(beta-aminoethyl ether)
      N,N,N',N'-tetraacetic acid buffer calculated to clamp the extracellular
      concentration of free calcium ions to a value approximately equal to the resting
      [Ca2+]i; 2) the calcium channel blocker verapamil; or 3) the intracellular Ca2+
      antagonists (W-7, W-13, and TMB-8) substantially inhibited the induction of Bf.
      Collectively, these data support the following conclusions. First, that changes
      in [Ca2+]i comprise an important element in the induction of progression from the
      IFN-primed to the cytocidal state. Second, the failure to detect global changes
      in [Ca2+]i in response to the ligand, poly [I:C], suggests that changes in
      [Ca2+]i or Ca2+ movement may occur in either a spatially restricted or in an
      asynchronous cyclical fashion and are not detected by population fluorescence
      measurements. Third, the source of the relevant Ca2+ is extracellular. Fourth,
      our findings suggest that priming influences macrophage functional responses at a
      locus that is distal to the changes in [Ca2+]i, thereby potentially allowing
      signaling processes to be utilized to initiate different cellular responses.

PMID- 1627836
TI  - The swab rack--an outdated ritual.
AB  - The risk of Theatre Staff becoming infected from blood borne viruses such as HIV
      and Hepatitis B is steadily increasing. Sir David Cox's report (1988) predicted
      that the number of people infected with HIV by the end of 1987 would be between
      20,000 and 50,000. Although these predictions are now thought to be more
      accurately estimated between 12,000 and 26,000, the number of people developing
      Aids is still expected to rise at an alarming rate. The precautions taken within
      the Theatre Department to reduce this risk are becoming transparently inadequate.
      It is no longer sufficient--or acceptable practice--to only be vigilant in
      avoiding blood contamination if the patient falls within a certain 'high risk'
      category. A happily married, middle aged woman may also be a virus carrier,
      particularly considering the long dormancy the HIV virus can exhibit before being
      detectable. It must be assumed that everyone is a potential carrier and the same
      precautionary measures taken for every patient, regardless of their past history,
      or present appearance.

PMID- 1627838
TI  - Supporting cast.

PMID- 1627837
TI  - African diary.

PMID- 1627839
TI  - How nurses will maintain the quality of nursing care if the skill mix changes.

PMID- 1627840
TI  - Organ donation and the theatre nurse.

PMID- 1627841
TI  - Bone transplantation.
AB  - Organ transplantation is a recognised surgical procedure. Bone transplantation
      (allografting) is a procedure being used increasingly in Orthopaedic
      reconstructive surgery. It involves the transplantation of bone between two
      unrelated individuals. This technique started expanding in the 1970's in the US
      and Canada and is rapidly gaining popularity in the UK. No blood grouping or
      tissue typing is required and the recipient does not need immunosuppressive
      therapy.

PMID- 1627842
TI  - The homograft department.
AB  - Perfusionists are highly skilled professionals providing essential life support,
      enabling patients to undergo open heart surgery. Although this is the main
      function at the Royal Liverpool Children's Hospital, Alder Hey, they also manage
      a Homograft bank. Also known as a heart valve bank, this is a completely
      independent branch of the perfusion department.

PMID- 1627843
TI  - Student nurse's experience of theatre nursing. The influence of adult learning
      theory.

PMID- 1627844
TI  - Pre-operative teaching--a literature review.

PMID- 1627845
TI  - The nurse's progress.

PMID- 1627846
TI  - Developments in post-registration education and practice.

PMID- 1627847
TI  - The shadow of PK2. Justifying learner nurse allocation to the operating
      department.

PMID- 1627848
TI  - Are we meeting their needs.
AB  - The aim of this pilot study is to discover the student nurses' learning needs and
      perceptions during their operating department allocation and whether we are
      meeting those needs. Also, what influence their perceptions have had upon
      selecting perioperative nursing as a career. The study focuses upon semi
      structured interviews with student nurses and their accounts of their experiences
      of being learners in the operating department. During their allocation, students
      are able to view surgery and to assist in the recovery of patients and to
      understand what a surgical patient experiences. They are exposed to the roles and
      responsibilities of operating department nurses. However, little is known about
      how students perceive these experiences. In this study two groups of students
      from the same year were interviewed to determine their perceptions and needs
      during the allocation and whether their learning needs had been met.

PMID- 1627849
TI  - The Children Act 1989--a brief report.

PMID- 1627850
TI  - This was your life: how your skeleton may be coaxed out of the cupboard.

PMID- 1627851
TI  - A paediatric day service.

PMID- 1627852
TI  - Quality assurance in practice.

PMID- 1627853
TI  - Paediatric anaesthesia--Portugal.

PMID- 1627854
TI  - Wound dressings.

PMID- 1627855
TI  - 'Observations on temperature changes in patients undergoing insertion of a
      dynamic hip screw.

PMID- 1627856
TI  - The Confidential Report on Peri-operative Deaths.

PMID- 1627857
TI  - Children in theatre: meeting their needs.

PMID- 1627858
TI  - Natalie. A patient care study.

PMID- 1627859
TI  - Lipid-suppressed single- and multisection proton spectroscopic imaging of the
      human brain.
AB  - Spectroscopic images of the brain have great potential in disease diagnosis and
      treatment monitoring. Unfortunately, interfering lipid signals from subcutaneous
      fat and poor water suppression due to magnetic field inhomogeneities can make
      such images difficult to obtain. A pulse sequence that uses inversion recovery
      for lipid suppression and a spectral-spatial refocusing pulse for water
      suppression is introduced. In contrast to methods that eliminate fat signal by
      restricting the excited volume to lie completely within the brain, inversion
      recovery techniques allow imaging of an entire section without such restrictions.
      In addition, the spectral-spatial pulse was designed to provide water suppression
      insensitive to a reasonable range of B0 and B1 inhomogeneities. Several data
      processing algorithms have also been developed and used in conjunction with the
      new pulse sequence to produce metabolite maps covering large volumes of the human
      brain. Images from single- and multisection studies demonstrate the performance
      of these techniques.

PMID- 1627860
TI  - Proton MR spectroscopy of gadolinium-enhanced multiple sclerosis plaques.
AB  - Magnetic resonance (MR) imaging and proton MR spectroscopy were performed in 14
      patients with clinically definite multiple sclerosis (MS). Prominent resonances
      in the 0.5-2.0-ppm region were seen in the spectra of six of nine gadopentetate
      dimeglumine-enhanced plaques in seven patients. These resonances were presumed to
      originate in lipids and other myelin breakdown products. Similar resonances were
      detected in only seven of 21 unenhancing plaques. The more frequent presence of
      such signals in the gadolinium-enhanced regions indicates that myelin breakdown
      is often associated with the inflammation that occurs in early stages of MS
      plaque evolution. It remains uncertain, however, whether active inflammation as
      indicated by gadolinium enhancement is a necessary precursor of myelin breakdown
      as detected at MR spectroscopy. Quantitative spectral analysis did not indicate
      statistically significant differences in N-acetyl aspartate and choline levels
      relative to creatine plus phosphocreatine between healthy volunteers and MS
      patients.

PMID- 1627861
TI  - MR imaging detection of calcified intracranial lesions and differentiation from
      iron-laden lesions.
AB  - Magnetic susceptibility variation caused by calcium permits limited detection of
      intracranial calcifications and/or their distinction from iron-laden lesions with
      spin-echo or gradient-echo magnetic resonance (MR) techniques. The magnetic
      susceptibility sensitivity of phase imaging has been used to detect iron-laden
      lesions. A new approach that combines the magnetic susceptibility sensitivity of
      both gradient-echo and phase imaging to yield greater imaging sensitivity to
      calcium is presented. Two-dimensional fast low-angle shot (FLASH) gradient-echo
      imaging with phase image reconstruction (gradient-echo phase [GEP]) was used at
      1.0 and 1.5 T. Twelve patients with computed tomography-proved calcified
      intracranial lesions (greater than or equal to 200 HU) and seven patients with
      iron-laden intracranial lesions having a characteristic appearance on T1- and T2
      weighted and FLASH MR images were studied. The GEP imaging technique helped
      detect calcified intracranial lesions (greater than or equal to 200 HU) and
      helped distinguish them from iron-laden lesions.

PMID- 1627862
TI  - Gadolinium-enhanced high-resolution MR angiography with adaptive vessel tracking:
      preliminary results in the intracranial circulation.
AB  - To overcome problems associated with poor contrast between vessels and background
      tissue in time-of-flight magnetic resonance angiography, the role of intravenous
      gadopentetate dimeglumine in conjunction with a postprocessing adaptive vessel
      tracking scheme was studied. Vessel tracking makes it possible to discriminate
      arteries from veins, to prevent problems associated with other bright tissues on
      maximum-intensity projections, and to increase the signal-to-noise ratio. Short,
      asymmetric, velocity-compensated field echoes were used in conjunction with high
      resolution imaging techniques to spatially discriminate between adjacent vessels
      and stationary background tissue. Gadopentetate dimeglumine was shown to be
      useful for visualization of small vessels, aneurysms, and regions of slow flow,
      when used with this post-processing scheme.

PMID- 1627863
TI  - Analysis of flow effects in echo-planar imaging.
AB  - The effects on the phase of spins moving during echo-planar imaging (EPI)
      acquisition were studied. Standard single-shot and interleaved multishot blipped
      EPI acquisitions were considered, assuming either high gradient strength and slew
      rates or standard gradient strength and slew rates. A spiral k-space trajectory
      was also considered. Flow components in the section-select and phase- and
      frequency-encoding directions were analyzed separately. While the effect of flow
      in the section-select direction is identical to that in a standard two
      dimensional Fourier transform (2DFT) acquisition, flow in the phase- or frequency
      encoding directions can have substantial effects on the image, different from
      that in 2DFT imaging. The magnitude of these effects, which include displacement,
      distortion, and/or ghosting of vascular structures, is analyzed and predicted for
      a given velocity and direction of flow, the specific acquisition sequence, and
      the strength and slew rate of the gradients. For example, 50-cm/sec flow along
      the phase-encoding direction can cause a blurring of 1.25 cm full width at half
      maximum for blipped EPI with high-strength gradients, assuming a 40-cm field of
      view and 64 x 64 matrix.

PMID- 1627864
TI  - Mitral and aortic valvular flow: quantification with MR phase mapping.
AB  - When magnetic resonance phase mapping is used to quantitate valvular blood flow,
      the presence of higher-order-motion terms may cause a loss of phase information.
      To overcome this problem, a sequence with reduced encoding for higher-order
      motion was used, achieved by decreasing the duration of the flow-encoding
      gradient to 2.2 msec. Tested on a flow phantom simulating a severe valvular
      stenosis, the sequence was found to be robust for higher-order motion within the
      clinical velocity range. In eight healthy volunteers, mitral and aortic volume
      flow rates and peak velocities were quantified by means of phase mapping and
      compared with results of the indicator-dilution technique and Doppler
      echocardiography, respectively. Statistically significant correlations were found
      between phase mapping and the other two techniques. Similar studies in patients
      with valvular disease indicate that phase mapping is also valid for pathologic
      conditions. Phase mapping may be used as a noninvasive clinical tool for flow
      quantification in heart valve disease.

PMID- 1627865
TI  - MR angiography of lower-extremity arterial disease: preliminary experience.
AB  - Nineteen patients underwent magnetic resonance (MR) angiography for evaluation of
      lower-extremity arterial disease. The underlying conditions included
      atherosclerotic occlusive disease in 12 patients, femoral or popliteal aneurysms
      in four, and bypass graft stenoses or occlusion in four. In the patients with
      occlusive disease, the iliac and femoropopliteal vessels were classified as
      patent, moderately stenotic, severely stenotic, or occluded. Fifteen of 16
      occlusions (accuracy = 94%) were correctly classified. In the one missed case,
      there was a long delay between MR angiography and x-ray angiography and it is
      likely that the occlusion occurred during the interval. Three of five severe
      stenoses were correctly classified with MR angiography. In two cases of iliac
      artery stenosis, there was a signal void at the point of maximal stenosis, which
      on the basis of anatomic features could be recognized as severe stenosis rather
      than an occlusion. Three of four moderate stenoses were correctly classified.
      Correlation with x-ray angiography or surgery demonstrated the ability of MR
      angiography to accurately depict the status of runoff vessels.

PMID- 1627866
TI  - Detection of zonal renal ischemia with contrast-enhanced MR imaging with a
      macromolecular blood pool contrast agent.
AB  - The potential of magnetic resonance (MR) imaging enhanced with albumin
      (gadolinium diethylenetriaminepentaacetic acid [DTPA])35, a macromolecular blood
      pool marker, for detection of focal changes in renal perfusion was studied in a
      myoglobinuric acute renal failure (ARF) model in the rat. T1-weighted spin-echo
      postcontrast images of injured kidneys at 3 hours after glycerol injection showed
      three distinct zones: a strongly enhanced outer cortex, a low-intensity inner
      cortex, and a strongly enhanced medulla. The distinct band of low intensity in
      the inner cortex indicated zonal decreased blood volume, corresponding to
      published microsphere data showing zonal low perfusion in the inner cortex.
      Contrast differences between parenchymal zones were significant for at least 30
      minutes. No focal ischemic changes could be delineated on nonenhanced images.
      Enhanced and nonenhanced images of injured kidneys obtained at 24 hours after
      glycerol injection revealed no zonal differentiation. Contrast-enhanced MR
      imaging data in this ARF model correlated well with pathologic data and
      microsphere perfusion results. Contrast-enhanced characterization of the ischemic
      phase of renal injury with MR imaging may improve specificity for the diagnosis
      of ARF and may serve as a marker for therapeutic intervention.

PMID- 1627867
TI  - Pelvic imaging with phased-array coils: quantitative assessment of signal-to
      noise ratio improvement.
AB  - The signal-to-noise ratios (S/Ns) of two different pelvic magnetic resonance (MR)
      imaging phased arrays were compared with that of the body coil. Each array
      consisted of two coils placed anteriorly and two posteriorly, oriented
      transversely in one array and longitudinally in the other. S/N measurements were
      obtained in an adjustable water-filled phantom that stimulated the shape and
      radio-frequency loading effects of various-size patients. Depending on the
      simulated anterior-posterior thickness of the patient, the S/N produced by the
      longitudinal array ranged from 2.3 to 3.1 times higher than that of the body
      coil. The S/N of the transverse array was 3.1 to 3.4 times higher. The increased
      coil sensitivity permits imaging with shorter acquisition times, smaller fields
      of view, finer resolution, and/or thinner sections. Two examples in patients
      demonstrate the enhanced imaging capability of the phased arrays.

PMID- 1627868
TI  - Centric phase-encoding order in three-dimensional MP-RAGE sequences: application
      to abdominal imaging.
AB  - Three-dimensional (3D) magnetization-prepared rapid gradient-echo imaging has
      been proposed as a method for improving signal-to-noise ratio (S/N) and contrast
      to-noise ratio (C/N) in rapid abdominal imaging. Originally, a standard
      sequential phase-encoding order was proposed. In the present study, two
      approaches to a 3D centric phase-encoding order are presented: (a) application of
      the two-dimensional (2D) centric order to one of the 3D encoding directions, and
      (b) an interleaved square spiral order, which is the segmented 3D analog of the
      2D centric order. With use of simulation, phantom, and volunteer results, the
      proposed 3D centric methods are compared in terms of S/N, C/N, and artifacts to
      the 3D sequential method and 2D magnetization-prepared methods. The second
      centric approach was found to be superior to the first; however, in general, the
      3D technique was found to be inferior to the 2D technique for abdominal imaging
      because of motion artifact in the 3D image set caused by misregistration among
      the multiple breath holds required.

PMID- 1627869
TI  - Quantitation of total metastatic tumor volume in the rat liver: correlation of MR
      and histologic measurements.
AB  - Assessing tumor response to chemotherapy in the liver has always been difficult.
      Most investigators estimate tumor volume as either a product of the two
      perpendicular diameters of a tumor nodule, or, in animal studies, simply count
      surface tumor nodules. The authors evaluated magnetic resonance (MR) imaging as a
      technique for determining absolute tumor volume in the liver in an animal model.
      Specifically, histologic volumetric and MR imaging measurements of tumor and
      liver volumes were quantitatively compared over a wide range of tumor burdens in
      a rat model of hepatic metastasis of a colorectal carcinoma. Twenty-three rats
      were imaged, with two different section thicknesses used in each animal. Both
      section thicknesses showed highly significant correlations between MR and
      histologic measurements for both tumor and liver volumes (P less than .001). MR
      imaging may be useful for noninvasively quantifying tumor burden and temporal
      response of metastatic disease in the liver to novel antineoplastic regimens.

PMID- 1627870
TI  - Detection of acute and treated lesions of hepatosplenic candidiasis: comparison
      of dynamic contrast-enhanced CT and MR imaging.
AB  - Dynamic contrast-enhanced computed tomography (CT) was compared with 1.5-T
      magnetic resonance (MR) imaging with FLASH (fast low-angle shot), gadolinium
      enhanced FLASH (Gd-FLASH), and T2-weighted fat-suppression (T2FS) sequences in 11
      patients with hematologic malignancies, five with biopsy-confirmed hepatosplenic
      candidiasis treated with antifungal chemotherapy and six with a clinical history
      suggestive of acute hepatosplenic candidiasis. CT and MR images were separately
      interpreted in a prospective fashion. MR imaging showed lesions compatible with
      candidiasis in the liver in six patients, the spleen in five, and the kidneys in
      one. CT showed candidiasis-compatible lesions in the liver in three patients and
      the spleen in one; no renal lesions were shown. Differences between acute and
      treated candidal lesions were observed. Gd-FLASH images showed the most liver
      lesions (n = 106), followed by FLASH (n = 85), T2FS (n = 20), and CT (n = 18). MR
      imaging performed better than CT in distinguishing candidal hepatic lesions from
      recurrent lymphoblastic lymphoma in one patient and from hepatic infarcts in
      another. The results suggest that MR imaging may be superior to CT in detecting
      lesions of hepatosplenic candidiasis.

PMID- 1627871
TI  - Noise and artifact comparison for Fourier and polynomial phase correction used
      with Fourier reconstruction of asymmetric data sets.
AB  - Two processes of phase correction, Fourier phase mapping and second-order
      polynomial phase fitting, are compared in combination with four different schemes
      for Fourier reconstruction of asymmetric data, using one-dimensional simulations
      and two-dimensional human head data. Polynomial phase correction provides
      systematically less image noise and is much less affected by localized phase
      differences caused by object edges and motion.

PMID- 1627872
TI  - Selective versus nonselective preparation pulses in two-dimensional MP-RAGE
      imaging of the liver.
AB  - The use of a section-selective preparation pulse in two-dimensional (2D) T1
      weighted magnetization-prepared rapid gradient-echo (MP-RAGE) imaging of the
      liver was investigated. The images were compared with those obtained with a
      nonselective pulse. The performances of the sequences were evaluated in 11
      patients with 12 focal liver lesions, and lesion-liver and lesion-vessel signal
      difference-to-noise ratios (SD/Ns) were calculated. With the section-selective
      preparation pulse, small lesions were better differentiated from vessels, and
      multiple, consecutive images could be obtained at shorter intervals. The mean
      lesion-liver SD/N was slightly but not significantly greater for images obtained
      with a selective pulse, while the lesion-vessel SD/N was significantly greater (P
      less than .01). It is concluded that a section-selective preparation pulse can
      improve the clinical utility of the 2D MP-RAGE sequence in the evaluation of
      focal liver disease.

PMID- 1627873
TI  - Optimization of three-dimensional T1-weighted gradient-echo imaging of the
      cervical spine.
AB  - Various parameters of the three-dimensional (3D) T1-weighted magnetization
      prepared rapid acquisition gradient-echo (MP-RAGE) sequence were evaluated to
      improve spatial resolution while maintaining T1 contrast and a short examination
      time in imaging of the cervical spine in volunteers. The most dramatic
      improvements in image resolution occurred by decreasing section thickness to 1.2
      mm and increasing the in-plane matrix to 192 x 256, with a 230-mm field of view.
      The increase in imaging time due to the increased matrix was offset by the
      elimination of the preparation pulse and wait time, without dramatic changes in
      contrast-to-noise ratio or overall image quality. Optimum parameters included
      elimination of the preparation pulse and wait time, 12 degrees flip angle, 192 x
      256 matrix, 1.2-mm section thickness, nonselective excitation (coronal
      acquisition), RF spoiling, and standard k-space ordering, for an examination time
      of 5 minutes 21 seconds.

PMID- 1627874
TI  - Cardiovascular MR imaging: current level of clinical activity.
AB  - Relative to other clinical magnetic resonance (MR) imaging activities,
      cardiovascular (CV) MR imaging has been slow to demonstrate a clinical presence.
      To better understand the present situation in clinical CV MR imaging, a survey of
      Society for Magnetic Resonance Imaging (SMRI) members was conducted. A large
      majority (78%) of the 90 sites responding to the survey reported clinical
      activity in CV MR imaging. Of these 70 sites, 46% restricted such activity to
      routine clinical work, while 3% restricted it to clinical research. The remaining
      51% conducted both. At all clinical sites, the overall frequency of performance
      of clinical CV MR imaging was variable (mean, 4.2 and 13.8 cases per month at
      routine-only and combined routine-research sites, respectively). In clinical CV
      studies, gated static, multi-level spin-echo and dynamic gradient-echo (cine)
      techniques were most common. At the 68 sites involved in routine clinical CV MR
      imaging, primarily anatomic studies composed a much higher proportion of the
      total (mean, 86%) than primarily functional studies. The evaluation of acquired
      thoracic aortic disease, congenital cardiac malformation, and para- or
      intracardiac mass were the most prevalent anatomic indications overall.
      Approximately half of the same sites assessed functional aspects of CV disease.
      The assessment of ventricular dysfunction and valvular dysfunction were the most
      common functional objectives. The survey indicated that the level of clinical
      activities in CV MR imaging was low and that most responding sites were involved
      in clinical CV MR imaging primarily for detection and delineation of anatomic
      abnormalities.

PMID- 1627875
TI  - Amplification of serotonin-induced arterial contractions with thrombin.
AB  - The purpose of this study was to determine if exposure of arteries to thrombin
      increases arterial sensitivity to serotonin and could thereby promote vasospasm.
      Rings of rabbit abdominal aorta, with endothelium intact or removed, were
      pretreated with vehicle or thrombin (2.5 U/mL). Thereafter, arterial contractions
      in response to cumulative additions of serotonin were recorded. Arterial
      contractions were expressed as a percentage of maximal potassium chloride-induced
      contractions. Arterial sensitivity was expressed as the EC50, the concentration
      of serotonin that produced a half-maximal contraction. Exposure of aortic rings
      to thrombin alone produced contractions of 11% and 22% for rings with and without
      endothelium, respectively. Removal of the endothelium had no effect on maximal
      serotonin-induced contractions (93% with endothelium vs 98% without). In
      contrast, maximal serotonin-induced contractile force was increased after
      pretreatment with thrombin (107% vs 121% for rings with and without endothelium,
      respectively; P less than .01). Arterial sensitivity to serotonin was not
      affected by the removal of endothelium. However, thrombin pretreatment increased
      (P less than .01) arterial sensitivity to serotonin 2.6-fold and 4.7-fold for
      rings with and without endothelium, respectively. The results of this study
      demonstrate that arterial contractions due to serotonin are amplified by thrombin
      and suggest that vasospasm may be more likely to occur at sites in arteries where
      the endothelium is absent and both thrombin and serotonin are present.

PMID- 1627876
TI  - Hepatic ablation with use of radio-frequency electrocautery in the animal model.
AB  - The potential of percutaneous radio-frequency (RF) electrocautery hepatic
      ablation was evaluated in the animal model. RF hepatic ablation was performed
      under ultrasound (US) guidance in the liver of 10 swine with use of a
      specifically designed needle. The needle was placed through the liver capsule,
      and ablation was performed after isolating the liver at laparotomy. Animals were
      killed immediately (n = 4), at 1 week (n = 1), 2 weeks (n = 3), or at 5 weeks (n
      = 2). The US findings were correlated with the pathologic results in the animal
      livers. RF hepatic ablation was successfully performed in the animal model
      without complications. Lesions in the animal livers were typically 1 x 2 cm,
      which initially appeared highly echogenic on US scans. These images corresponded
      to an area of hepatic necrosis. The lesions became less echogenic shortly after
      initial treatment but could still be visualized with US at 5 weeks. At histologic
      study at 5 weeks, the treated livers showed central debris, a larger area of
      necrotic liver, and a zone of granulation tissue surrounded by a fibrotic
      capsule. No complications were encountered. RF hepatic ablation shows future
      promise in treatment of hepatic neoplasms.

PMID- 1627877
TI  - Enhancement of fibrinolysis with ultrasound energy.
AB  - The effect of ultrasound energy on fibrinolysis of artificial thrombus in vitro
      was investigated. Thrombi produced by the Chandler loop method were exposed to
      low-energy ultrasound (5,000-6,000 Pa) in an ultrasound bath (48 kHz) for 60
      seconds. Fibrinolysis with urokinase was enhanced from 40.6% +/- 1.8% to 59.2% +/
      2.6% (mean +/- standard deviation) with ultrasound exposure after a 60-minute
      incubation. Ultrasound alone without urokinase resulted in no fibrinolysis. In a
      second experiment, a newly developed miniature ultrasound-emitting ceramic
      element (2 x 1 x 5 mm) was attached to the tip of a catheter. Ultrasound exposure
      (225 kHz) from this device markedly enhanced fibrinolysis with urokinase from
      8.9% +/- 1.5% to 37.3% +/- 0.8% (total ultrasound exposure 60 seconds, intensity
      30 mW/cm2) after a 30-minute incubation. After a 120-minute incubation,
      fibrinolysis with ultrasound exposure was 61.1% +/- 1.8% versus 46.7% +/- 0.5%
      for the unexposed group. Ultrasound enhancement of fibrinolysis was less
      pronounced with longer incubation time (60 or 120 minutes). Ultrasound energy
      enhanced fibrinolysis with urokinase, especially in the early phase of lysis.
      This new device may shorten the time needed to complete fibrinolysis and reduce
      total drug dosage needed for treatment of thromboembolic diseases.

PMID- 1627878
TI  - Endoluminal thermal occlusion of the ureter with the electromagnetic field
      focusing device.
AB  - The authors attempted ureteral occlusion by means of heat application in nine
      ureters (24 sites) of New Zealand White rabbits with the electromagnetic field
      focusing (EFF) device. The EFF device generates heat at the tip of a grounded
      probe by focusing eddy currents that have been induced within the tissues by an
      external radio-frequency field. The power settings were varied from 30 to 150 W.
      Heat was applied at multiple sites in each ureter. Immediate functional occlusion
      was seen in all nine ureters. Long-term complete occlusion was seen in six
      ureters at power settings ranging from 40 to 150 W, while long-term partial
      occlusion was seen in two ureters at 30-50 W. All sites at 30 W resulted in
      partial occlusions. Perforation of the ureter resulted in urinoma formation in
      one ureter at a site that was treated with 150 W. The EFF device can be used to
      endoluminally occlude the ureter by causing a fibrotic reaction to thermal
      injury. The effective power range for this application appears to be 40-100 W.

PMID- 1627879
TI  - Percutaneous ureteral occlusion with use of Gianturco coils and gelatin sponge.
      Part I. Swine model.
AB  - An animal model was developed to study ureteral occlusion produced by steel coils
      and gelatin sponge. A coil nest was formed in the ureter, and in all but one pig,
      gelatin sponge pledgets were incorporated in the coil nest. Animals were killed
      at 2 hours, 1 week, 1 month, and 2 months. High-grade obstruction was present
      immediately following the procedure in all animals and was documented to be
      persistent by means of antegrade nephrostograms obtained just prior to death. At
      gross examination after death, ureteral thickening and strictures were evident.
      Histologic studies helped confirm the presence of acute and chronic inflammatory
      changes. In the in vivo model, gelatin sponge was not found necessary for acute
      ureteral occlusion. However, in an ancillary in vitro study in which a rigid
      plastic tube was used, gelatin sponge was necessary in addition to coil occlusion
      to provide acute total obstruction. The authors' findings suggest that in a
      compliant ureter, coil occlusion alone produces sufficient mechanical occlusion.
      Long-term obstruction is probably due to mechanical obstruction and stricture
      formation.

PMID- 1627880
TI  - Percutaneous ureteral occlusion with use of Gianturco coils and gelatin sponge.
      Part II. Clinical experience.
AB  - A previous report described the use of coils and gelatin sponge pledgets as a
      means of producing ureteral occlusion to achieve urinary diversion in patients
      with urinary fistulas. The authors have performed this procedure in nine ureters
      of six patients. Five of the patients had urinary leaks with extensive pelvic
      tumor, and one had severe chronic cystitis. Ureters were occluded with use of
      Gianturco coils and gelatin sponge pledgets placed via a sheath through a
      percutaneous nephrostomy tract. The procedure was successful in all patients as
      judged by means of antegrade nephrostogram or intravenous pyelogram and by marked
      improvement or complete resolution of symptoms.

PMID- 1627881
TI  - Hemorrhagic complication of transgluteal pelvic abscess drainage: successful
      percutaneous treatment.

PMID- 1627882
TI  - Spinal dural arteriovenous anomalies.
AB  - The clinical data, radiologic findings, and treatment in 14 cases of spinal dural
      arteriovenous (AV) anomaly were reviewed. All patients had typical findings of
      feeding artery, nidus, and draining vein on spinal angiograms. Radiologic
      diagnosis of spinal AV malformation was first made after myelography in 13 cases
      and after magnetic resonance (MR) imaging in one case. Thirteen patients
      underwent embolization; one patient underwent repeat embolization 14 months after
      the first procedure. The other patient underwent surgical ligation. All patients
      had clinical improvement after treatment. A high index of clinical suspicion, a
      complete myelographic examination or an MR image of good quality, and a properly
      performed complete spinal angiographic study are important for early diagnosis.
      Embolization may be the treatment of choice. For best results, the feeding artery
      next to the nidus and the draining vein close to the nidus should be occluded,
      and the nidus itself should be obliterated.

PMID- 1627883
TI  - Infantile hepatic hemangioendotheliomas: significance of portal venous and
      systemic collateral arterial supply.
AB  - This report describes four infants with hepatic hemangioendotheliomas and cardiac
      failure who had extensive portal venous and systemic collateral arterial supply
      complicating hepatic arterial embolization. One patient with diffuse hepatic
      hemangioendothelioma and extensive portal vein supply but minimal systemic
      collateral arteries showed no improvement after technically successful hepatic
      artery embolization and died with disseminated intravascular coagulation and
      sepsis. A second infant with extensive portal vein and collateral supply died
      without undergoing embolization. Two patients had portal vein-hepatic vein
      fistulas as well as an extensive systemic arterial supply. Both infants tolerated
      staged hepatic and collateral artery embolization, although one patient died of
      congestive heart failure, probably related to pulmonary hemangiomas. The authors
      conclude that angiographic study of the potential collateral vessels and portal
      venous circulation should be performed before embolization. Patients with
      shunting from the portal vein to the hepatic vein and minimal systemic arterial
      collateral circulation should not undergo hepatic artery embolization.

PMID- 1627884
TI  - Hemobilia after percutaneous transhepatic biliary drainage: treatment with
      transcatheter embolotherapy.
AB  - Thirteen of 333 patients who underwent percutaneous biliary drainage (PBD)
      developed severe hemobilia. Hepatic arteriography successfully demonstrated the
      source of hemorrhage in all 13 patients. Lesions included hepatic artery
      pseudoaneurysm in nine, hepatic artery-bile duct fistulas in four, and a hepatic
      artery-portal vein fistula in one patient. Hemobilia occurred from 1 day to 1.8
      years (mean, 100 days) following catheter placement. Embolization agents used
      included Hilal embolization microcoils, occluding spring emboli, cyanoacrylate,
      detachable balloons, and gelatin sponge pledgets. A single agent was used in
      eight cases (62%), multiple agents were used in four cases (31%), and in one case
      (7%), spontaneous thrombosis of the pseudoaneurysm occurred during catheter
      manipulation. In five patients, the source of the hemorrhage could only be
      demonstrated following removal of the biliary catheter(s) over guide wire(s).
      Initial embolization was successful in stopping hemobilia in 12 patients. One
      patient required repeat embolization after 4 months. Postembolization
      complications included hepatic abscess formation in two patients and a sterile
      hepatic infarct in one patient. This series indicates that transcatheter
      embolotherapy is an effective method for the treatment for severe hemobilia.

PMID- 1627885
TI  - Nonoperative treatment of enteric fistulas: results in 53 patients.
AB  - Fifty-three patients with enterocutaneous fistulas were treated nonoperatively.
      While most of the fistulas resulted as a complication of surgery, other causes
      included inflammatory disease, trauma, and malignancy. Fistulas originated from
      the esophagus (n = 4), stomach (n = 4), duodenum (n = 5), small bowel (n = 27),
      colonic-small bowel anastomosis (n = 2), colon (n = 10), and Hartmann pouch (n =
      1), and included both high-output (n = 29) and low-output (n = 24) types.
      Nonoperative management resulted in spontaneous fistula closure in 57%. Most of
      the spontaneous closures (83%) occurred within 2 months of treatment. Spontaneous
      closure rates were similar for low-output and for high-output fistulas (52% vs
      63%), but the treatment duration was longer for high-output than for low-output
      fistulas (mean treatment duration, 17 days vs 41 days). Colonic fistulas were
      particularly difficult to manage and closed spontaneously in only 10% of patients
      (one of 10).

PMID- 1627886
TI  - Abdominal abscesses associated with enteric fistulas: percutaneous management.
AB  - For many years, surgical dictum stated abdominal fistulas should be treated by
      means of surgical excision. Recent advances in percutaneous techniques have
      altered this. The authors reviewed 150 consecutive abdominal abscesses drained
      percutaneously over a 36-month period. Among these, 24 patients were found to
      have 26 fistulous communications to bowel, the pancreatic duct, or the biliary
      system. Initial drainage of their abscesses was performed in the hospital, but 17
      of 24 patients were discharged with a tube in place and were followed up as
      outpatients. The duration of drainage ranged from 4 days to 3 months. Fistulas
      healed in 21 of 24 patients (88%) without surgical intervention. Complications
      were few and included inadvertent dislodgment requiring tube replacement (two
      patients) and inadvertent puncture of the transverse colon (one patient).
      Treatment of abdominal abscesses with fistulas by means of percutaneous methods
      is reliable and safe. Hospital stay may be minimized with outpatient management
      after drainage.

PMID- 1627887
TI  - Biliary obstruction: treatment with self-expanding metal prostheses.
AB  - The authors percutaneously and endoscopically inserted 58 Wallstent
      endoprostheses in 42 consecutive patients with benign and malignant obstructive
      biliary stenoses. The three patients with benign obstructive jaundice were
      followed up for 48 months. Two of the stents occluded due to sludge formation,
      prompting percutaneous reentry. The 39 patients with malignant disease were
      followed up for 18 months. Twenty-six of these patients died 3 days to 1.5 years
      (mean, 133 days) after the procedure. Thirteen are alive after 2-12 months (mean,
      242 days). Recurrent jaundice occurred in 11 patients (28%): in four patients due
      to tumor growth over the proximal end of the stent, in one patient due to
      excessive gallbladder hydrops, and in six patients due to liver failure. Although
      autopsy investigations revealed the possibility of tumor growth onto the inner
      surface of the stent through the stainless steel mesh of the endoprosthesis,
      stent occlusion by tumor ingrowth into the lumen was not encountered.

PMID- 1627888
TI  - Use of the external jugular vein approach for transvenous liver biopsy.
AB  - Transjugular liver biopsy (TJLB) with use of a right external jugular vein (EJ)
      approach obviates a deep neck puncture, thereby reducing the risk associated with
      the procedure in patients with severely disordered coagulation. The EJ approach
      was successful in 21 of 24 consecutive patients referred for TJLB (88%). The
      approach was unsuccessful in three cases due to thrombosis or congenital absence
      of the right EJ. TJLB via the right EJ was successful in all cases in which EJ
      access could be obtained. In the 21 successful cases, the EJ approach simplified
      the procedure and shortened its duration. There were no procedure-related
      complications attributable to the EJ approach. The authors now use the EJ route
      routinely for patients undergoing TJLB and other transjugular procedures in their
      laboratory. The EJ approach is particularly recommended in patients with impaired
      coagulation.

PMID- 1627889
TI  - Peroral radiographic placement of biliary stents.
AB  - The authors describe a modification of peroral-transhepatic placement of biliary
      stents for patients with malignant biliary obstruction. A stent is "pulled" into
      place perorally. The procedure can be performed with simple, readily available
      commercial materials. An endoscopist is not required. This method is cost
      effective, less cumbersome, and easier to perform than the standard methods. In
      the authors' four cases, this modified approach appears equally effective.

PMID- 1627890
TI  - Percutaneous interventions in the thorax. Seventh annual Charles Dotter Memorial
      Lecture.

PMID- 1627891
TI  - Prebiopsy wire localization of a small peripheral lung nodule.
AB  - The authors report a case in which metallic microcoils were placed under computed
      tomographic guidance as wire localization devices prior to an excisional lung
      biopsy. The technique and advantages are somewhat analogous to those of pre
      excisional biopsy of a breast mass with use of wire localization performed under
      mammographic guidance. This technique was useful for localizing the mass as well
      as limiting the amount of surgically excised tissue in this case. Additionally,
      the postexcision specimen radiograph helped confirm that the lung lesion in
      question had been removed. This may be a useful preoperative technique prior to
      excisional biopsies of small lung lesions that may not be accessible with
      percutaneous biopsy techniques and in selected cases such as in patients with
      diseased lung parenchyma surrounding a lesion or in patients in whom the lesion
      to be excised is adjacent to the pulmonary root.

PMID- 1627892
TI  - Gunther vena caval filter: clinical appraisal.
AB  - The mechanical stability of the Gunther filter, caval patency, and complications
      related to filter placement were evaluated in 33 patients. Indications for
      placement included recurrent pulmonary embolism despite anticoagulation (n = 24)
      and contraindication to anticoagulation (n = 5). Four filters were placed prior
      to pulmonary lysis. Filters were positioned via the transfemoral route in 31
      patients and via the transjugular route in two. Placement was complicated by
      pneumothorax in one case and faulty filter position in another. Patients were
      followed up for 52 months (mean, 12.1 months). Four patients died of nonembolic
      complications; three patients were lost to follow-up. Among the remaining 26
      patients, caudal migration (3-6 cm) occurred in 19 (73%), cephalic migration into
      the atrium occurred in one, the inferior vena cava occluded in five, and struts
      perforated the caval wall in five. Pulmonary embolism recurred in one patient. In
      11 cases, thrombus caught inside the basket was revealed with computed
      tomography; in one case a 7-cm floating thrombus was observed. The authors
      conclude that use of the Gunther filter cannot be recommended because of the high
      prevalence of complications.

PMID- 1627893
TI  - Complications of the nitinol vena caval filter.
AB  - Simon nitinol vena caval filters were placed percutaneously in 20 patients.
      Follow-up (average, 14 months) data were available for 16 patients, and four
      patients were lost to follow-up. There were no proved or suspected cases of
      pulmonary embolism after filter insertion. Complications encountered included
      caval penetration (n = 5, one acute and four at follow-up), caval thrombus (n =
      4, two determined radiologically and two clinically), postplacement deep venous
      thrombosis (n = 2, one radiologic and one clinical), filter migration (n = 1),
      and delayed fracture of a filter leg (n = 2). Although no deaths or significant
      morbidity resulted from any complication, the relatively high complication rate,
      especially of significant caval penetration (documented in 25% of filter
      insertions), merits continued short- and long-term assessment of patient status
      after filter placement.

PMID- 1627894
TI  - Use of the Gianturco self-expanding stent in stenoses of the superior and
      inferior venae cavae.
AB  - Twenty-eight patients with severe superior and inferior vena cava syndromes were
      treated with self-expandable Gianturco stents. Nineteen patients responded, seven
      did not respond, and two were unevaluable. Fourteen of the 19 who responded had
      complete or near complete resolution of their syndrome, and five had a partial
      remission. Five of the responders did not derive any benefit from stent placement
      because of additional problems that led to their death within 3 weeks of the
      stent placement procedure. The main cause for failure was the relatively weak
      expansile force of the stent. Complications included stent migrations without
      untoward effects in one patient, stent misplacement in one patient, fracture of
      the stent wire in two patients, and hemorrhage that could be attributed to the
      stent in one patient. This uncontrolled study suggests that caval obstruction
      syndromes in some patients may be effectively palliated with Gianturco stents.

PMID- 1627895
TI  - US guidance for vascular access. Technical note.
AB  - Real-time ultrasonography (US) is frequently used to access the biliary tree,
      urinary system, and pleural cavity, as well as abscesses and other fluid
      collections, but is rarely used to access blood vessels. This article describes
      the clinically indicated circumstances and technical aspects of US-guided access
      to veins and arteries. The authors' experience suggests that appropriate use of
      this modality significantly simplifies vascular access difficulties, reduces
      procedure time and morbidity, and is cost-effective.

PMID- 1627896
TI  - Color Doppler flow imaging appearance of a popliteal venous aneurysm.
AB  - Popliteal venous aneurysms are rare lesions that usually become evident when
      thrombus from within the aneurysm embolizes to the lungs. The authors report an
      unusual case in which the patient presented without thromboembolic complications.
      The appearance of a popliteal venous aneurysm at color Doppler flow imaging is
      described.

PMID- 1627897
TI  - Summary of workshop on drinking water fluoride influence on hip fracture on bone
      health. (National Institutes of Health, 10 April, 1991)

PMID- 1627898
TI  - A case-control study of hip fracture: evaluation of selected dietary variables
      and teenage physical activity.
AB  - Recent diet, teenage physical activity and teenage calcium consumption were
      examined as risk factors for hip fracture in a case-control study. Cases were 161
      white women admitted to one of 30 participating hospitals with a first hip
      fracture. Controls included 168 white women from general and orthopedic surgical
      services frequency-matched to cases by age group and hospital. Information on
      exposure to possible risk factors was obtained by in-person interview. No
      association was found between recent intake of calcium, phosphorus, protein,
      vitamin C or caffeine and hip fracture. Also, teenage calcium intake and milk
      drinking were not related to hip fracture risk. Recreational activities in
      adolescence and early adulthood appeared to afford protection against hip
      fracture. The highest quartile of recreational activity (greater than or equal to
      4 times/week) was associated with an odds ratio of 0.24 (95% confidence interval
      0.08-0.75) relative to the lowest quartile (less than 1 time/week).

PMID- 1627900
TI  - Dual-energy X-ray absorptiometry in normal women: a cross-sectional study of 717
      Finnish volunteers.
AB  - The bone mineral density (BMD) of the lumbar spine and proximal femur was
      measured using dual-energy X-ray absorptiometry in 717 healthy women aged 20-70
      years. The maximal mean BMD was found at the age of 35-39 years in the spine and
      at the age of 20-24 in the femoral neck and Ward's triangle. No significant
      change in lumbar BMD was found from the age of 20 to 39 years. The spinal BMD
      values were relatively stable from age 20 to 39 years, whereas a linear decrease
      in BMD in the femoral neck and Ward's triangle was already apparent in the
      youngest age group (20-24 years). The major fall in BMD in all sites was related
      to the menopause. The overall decreases in BMD from the peak values to those at
      age 65-70 years were 20.4%, 19.0% and 32.6% in the lumbar spine, femoral neck and
      Ward's triangle, respectively. The correlation of trochanteric BMD with age was
      poor. BMD was positively correlated with weight in all measurement sites.
      Nulliparity was found to be a risk factor for osteoporosis. The present study
      confirmed that the menopause has a significant effect not only on spinal BMD but
      also on femoral BMD. Lumbar BMD was lower and BMDs in the proximal femur were
      higher in Finnish women than in white American women. This emphasizes the
      importance of national reference values for BMD measurements.

PMID- 1627899
TI  - Impaired bone formation in male idiopathic osteoporosis: further reduction in the
      presence of concomitant hypercalciuria.
AB  - We present iliac bone histomorphometric data and related biochemical data from 16
      nonalcoholic men (50 +/- 11 (SD) years) referred for evaluation of spontaneous
      skeletal and/or appendicular fractures and reduced spinal bone density. All men
      were eugonadal and had no known underlying disorder associated with osteopenia.
      For the group, mean serum chemistry values were within normal limits including
      immunoreactive parathyroid hormone, osteocalcin and serum 1,25-dihydroxyvitamin D
      [1,25(OH)2D]. Nine men demonstrated hypercalciuria (greater than or equal to 0.1
      mmol/kg per day) while on a constant metabolic diet of 20 mmol/day Ca. Their 24
      hour urinary calcium was significantly greater than that for the remaining 7 men
      (7.4 +/- 1.6 vs. 5.0 +/- 0.8 mmol/day, p = 0.003), as was their calciuric
      response to a 1 g oral calcium load (0.23 +/- 0.06 vs. 0.15 +/- 0.05
      Ca/creatinine, p = 0.042). Serum parameters (including parathyroid hormone and
      1,25(OH)2D) of hypercalciuric and normocalciuric men were not significantly
      different. Histomorphometric indices for cancellous bone demonstrated significant
      differences between the entire group of osteoporotic men and age-adjusted normal
      values for bone volume (11.4 +/- 4.0% vs. 23.2 +/- 4.4%), osteoid surface (5.6 +/
      3.9% vs. 12.1 +/- 4.6%), osteoblastic surface (2.0 +/- 2.3% vs. 3.9 +/- 1.9%),
      and mineralizing surface (1.9 +/- 2.4% vs. 5.1 +/- 2.7%); there were also
      significant differences in bone formation rate (total surface referent) (0.004 +/
      0.001 vs. 0.011 +/- 0.006 mm3/mm2 per year). Compared with the normocalciuric
      group the 9 hypercalciuric men had significantly lower osteoblastic surfaces (1.6
      +/- 1.9% vs. 2.5 +/- 2.6%) and mineralizing surfaces (1.4 +/- 1.5% vs. 2.7 +/-
      3.2%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627902
TI  - An evaluation of dual-energy X-ray absorptiometry and comparison with dual-photon
      absorptiometry.
AB  - Dual-photon absorptiometry (DPA) is a well-established procedure for measuring
      bone mineral density (BMD). Recently, dual-energy X-ray absorptiometry (DXA) has
      become available, which has the ability to measure BMD both regionally and in the
      total body (TB). We have evaluated the in vivo and in vitro precision of a DXA
      instrument and compared it with a DPA instrument with similar software
      characteristics. The short-term precision of BMD measurements using DXA was
      assessed in 65 postmenopausal women who had duplicate scans performed, with
      repositioning between scans. Precision was 0.9% in the lumbar spine and 1.4% in
      the femoral neck. The midterm precision of DXA was compared with DPA by scanning
      10 volunteers a mean of four times over 24 weeks, on both instruments. The
      precision of the bone mineral content (BMC) and area measurements was
      significantly better (P less than 0.05) with DXA than with DPA. Long-term in
      vitro precision was assessed by scanning an aluminium spine phantom over 42
      weeks, and a cadaveric sample over 52 weeks, on both instruments. Precision was
      similar using the aluminium phantom, but was significantly improved (P less than
      0.001) when using DXA for scanning the cadaveric sample. Highly significant
      correlations (all P less than 0.001) of BMD, BMC and area measurements were
      observed when 70 volunteers were scanned on both instruments. However, there was
      a systematic difference in BMD values between the instruments. The precision of
      TB composition measurements assessed in 16 volunteers, over a 16-week period,
      were TB BMD 0.65%, TB lean tissue 1.47%, and TB fat tissue 2.73%.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1627901
TI  - Calcitonin metabolism in senile (type II) osteoporosis.
AB  - The exact role of calcitonin (CT) in the pathogenesis of senile (Type II)
      osteoporosis remains unknown. Whole plasma calcitonin (iCT) and extracted
      monomeric calcitonin (eCT) basal levels, metabolic clearance rate (MCR) and
      production rate (PR) of iCT and eCT were measured in 41 postmenopausal women,
      including 14 hip fractures (OP II) and 27 healthy controls. No significant
      difference appeared for basal iCT levels between OP II (mean +/- SEM: 41.9 +/-
      3.4 pg/ml) and controls (mean +/- SEM: 46.2 +/- 5 pg/ml). eCT basal levels were
      similar in OP II (mean +/- SEM: 5.42 +/- 0.5 pg/ml) and in controls (mean +/-
      SEM: 7.3 +/- 0.7 pg/ml). MCR were similar in the two groups. iCT PR were similar
      in OP II (mean +/- SEM: 17.2 +/- 1.5 micrograms/24 h) and controls (mean +/- SEM:
      18.6 +/- 1.1 micrograms/24 h). No difference appeared between eCT PR in OP II
      (mean +/- SEM: 2.3 +/- 0.2 micrograms/24 h) and controls (mean +/- SEM: 3.2 +/-
      0.3 pg/ml). From these data, no evidence appears that calcitonin might be one of
      the determinant factors in the pathogenesis of senile osteoporosis.

PMID- 1627904
TI  - Evaluation of worker exposure to benzene.

PMID- 1627905
TI  - Tooth lead concentration as an indicator for environmental lead pollution in Agra
      city, India.

PMID- 1627903
TI  - Contributions of chronological age, age at menarche and menopause and of
      anthropometric parameters to axial and peripheral bone densities.
AB  - Bone mineral density (BMD) was measured in 128 normal postmenopausal women at
      different skeletal sites: lumbar spine and proximal femur, using dual-energy X
      ray absorptiometry (DXA), and the cancellous and cortical envelopes of the distal
      third of radius and tibia, using precise low-dose quantitative computed
      tomography (QCT). Multivariate analysis included chronological age, ages related
      to menstrual history (menopause and menarche) and anthropometric factors, e.g.
      height and weight, as independent predictive variables. Weight is a much-studied
      predictor of bone density. At sites of high bone turnover, i.e. cancellous
      envelope, the effect of weight appeared overshadowed by estrogen-related
      parameters: age-past-menopause was the first predictor of BMD in the cancellous
      compartment of radius and in Ward's triangle, and the number of reproductive
      years was the strongest predictor of BMD in the cancellous compartment of tibia
      and in the spine (L2-4). This suggests that in addition to menopause, the length
      of menstrual life should be considered as an explanation for the variations in
      current bone mass in postmenopausal women. At the cortical level of radius, the
      effect of chronological age was predominant. At the cortical level of tibia,
      height and weight were the best predictors of BMD. We conclude that the influence
      of parameters related to menstrual history is predominant in sites with mainly
      cancellous tissue and that anthropometric factors constitute the best predictors
      of BMD in the cortical sites of weight-bearing bones.

PMID- 1627906
TI  - Effect of cadmium on spore germination and gametophyte development in some ferns.

PMID- 1627907
TI  - Comparing Cd toxicity tests with plants in monocultures and species mixtures.

PMID- 1627908
TI  - Effects of urban pesticide applications on nesting success of songbirds.

PMID- 1627909
TI  - Biochemical and histological effects of the aphicide demeton-S-methyl on house
      sparrows (Passer domesticus) under field conditions.

PMID- 1627910
TI  - Uranyl nitrate-induced glomerular basement membrane alterations in rabbits: a
      quantitative analysis.

PMID- 1627911
TI  - Airborne contaminant control in a medical examiner facility.

PMID- 1627912
TI  - Trihalomethanes in chlorinated drinking water of Cairo, Egypt.

PMID- 1627913
TI  - Organochlorine pesticide residues and PCBs in otters (Lutra lutra) from Ireland.

PMID- 1627914
TI  - Effect of weather variables on methyl parathion disappearance from cotton
      foliage.

PMID- 1627915
TI  - Chlorinated dioxins: volatilization from soils and bioconcentration in plant
      leaves.

PMID- 1627916
TI  - Dissipation of foliar dislodgeable residues of bendiocarb following application
      to azaleas.

PMID- 1627917
TI  - New diversity index for assessing structural alterations in aquatic communities.

PMID- 1627918
TI  - Pollution chemistry of the River Niger and its tributaries: characteristics of
      industrial waste effluents.

PMID- 1627919
TI  - Effect of pulp and paper effluent on a marine fish, Pseudopleuronectes
      americanus.

PMID- 1627920
TI  - Pesticide-induced atresia in ovary of a fresh water fish, Colisa lalia (Hamilton
      Buchanan).

PMID- 1627921
TI  - Acute toxicity of wood tar and dieldrin to Lebistes reticulatus (PL).

PMID- 1627922
TI  - Ultrastructural changes induced by diazinon and neopybuthrin in skeletal muscles
      of Tilapia nilotica.

PMID- 1627923
TI  - Accumulation and release of herbicides butachlor, thiobencarb, and chlomethoxyfen
      by fish, clam, and shrimp.

PMID- 1627924
TI  - Relationship among serum levels of luteinizing hormone, estradiol, and
      progesterone during follicle stimulation and results of in vitro fertilization
      and embryo transfer (IVF-ET).
AB  - Eighty-eight IVF-ET cycles were classified into four groups according to the
      results of IVF-ET (Group A-conceptional cycles, 10 cycles; Group B-cycles with
      cleaved oocytes, 58 cycles; Group C-cycles with fertilized oocytes, 9 cycles;
      Group D-cycles without fertilization, 11 cycles). Serum luteinizing hormone (LH),
      estradiol (E2), and progesterone (P) levels during follicle stimulation were
      studied in these groups. Patients participated in our IVF-ET program due to
      irreparable tubal damage. Follicle development was stimulated with a clomiphene
      human menopausal gonadotropin (hMG)-human chorionic gonadotropin (hCG) regimen.
      Group C showed a low E2 response to follicle stimulation. Groups B and D showed
      significantly higher serum P levels on day 0 (the day of hCG injection) than
      Group A (Group A, 0.73 +/- 0.11, vs Groups B and D, 1.43 +/- 0.15 and 2.17 +/-
      0.42 ng/ml; P less than 0.01). The effects of serum P and LH levels on the
      fertilization and pregnancy rates were studied. The pregnancy rate was not
      affected by the serum LH level but was only 2.7% in cycles in which serum P was
      1.2 ng/ml on day 0, which was significantly lower than that in cycles in which
      serum P was less than 1.2 ng/ml on day 0 (19.1%) (P less than 0.05). The
      fertilization rate was significantly lower in the cycles with higher levels of
      serum P and/or LH than in cycles in which serum P was less than 1.2 ng/ml and
      serum LH was normal (50.5 vs 78.8%; P less than 0.01).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1627925
TI  - Menotropin stimulation after prolonged gonadotropin releasing hormone agonist
      pretreatment for in vitro fertilization in patients with endometriosis.
AB  - Two protocols were scheduled for in vitro fertilization and embryo transfer (IVF
      ET) in patients with various stages of endometriosis who were resistant to
      conventional therapies. In the ultralong protocol (21 patients), gonadotropin
      releasing hormone agonist (Gn-RHa) was administered for at least 60 days prior to
      ovarian stimulation along with menotropin until human chorionic gonadotropin was
      injected. In the long protocol (11 patients), Gn-RHa was started at the midluteal
      phase and exogenous gonadotropin was commenced between the third and the seventh
      day of the menstrual cycle after pituitary suppression. The estradiol response
      and the number of retrieved oocytes, fertilized oocytes, cleaved oocytes, and
      transferred embryos were similar in both groups but the clinical pregnancy rate
      per transfer was superior in the ultralong protocol (67 vs 27%). The miscarriage
      rate was 14% (2/14) in the ultralong protocol. Prolonged Gn-RHa suppression of
      ovarian function before superovulation may overcome some causes of infertility in
      patients with endometriosis.

PMID- 1627926
TI  - Transplantation of fetal germ cells.
AB  - Oogonial stem cells are short-lived and endow the ovary with its lifetime store
      of follicles during fetal life. No compensatory mechanisms exist to replace germ
      cells that are lost for whatever reason after birth. Fetal germ cells and the
      abundant primordial follicles of immature animals can be successfully stored at
      low temperatures and transplanted to hosts to generate normal ovulatory cycles.
      Sterilized hosts are restored to fertility. Such results suggest that the
      abundant reserves of germ cells in the ovaries of human abortuses offer
      opportunities for treating patients whose sterility is due to afollicular ovaries
      uncomplicated by autoimmune disease. The prospects for this treatment depend
      largely on the vigilance of the recipient's immune system and public attitudes to
      a radical treatment, though one that promises to overcome sterility and
      hypoestrogenism in women with either premature menopause or gonadal dysgenesis.

PMID- 1627927
TI  - Endogenous luteinizing hormone surges following administration of human chorionic
      gonadotropin: further evidence for lack of loop feedback in humans.
AB  - The existence of inhibitory short- and ultrashort-loop feedback mechanisms for
      luteinizing hormone (LH), while documented in animals, has been questioned in
      humans. Since human chorionic gonadotropin (hCG) binds to LH receptors but can be
      distinguished from LH in immunoassays, it is possible to identify LH surges in
      the face of exogenously administered hCG. The present study demonstrates LH
      surges at midcycle in normal volunteers and in women undergoing controlled
      ovarian hyperstimulation, given hCG. This provides further evidence for lack of
      loop feedback control of LH secretion in humans.

PMID- 1627928
TI  - Enhancing in vitro fertilization of mouse oocytes by partial zona pellucida
      digestion.
AB  - This work was undertaken in order to evaluate the effect of partial zona
      digestion on fertilization in vitro of mouse oocytes and assess zona surface
      changes induced by the procedure. Three hundred forty-six oocytes allocated for
      treatment were exposed to Ham's F-10 medium supplemented with 0.5% Pronase for
      either 3 min (188 oocytes) or 5 min (158 oocytes); 324 oocytes served as
      controls. Oocyte losses incurred as a result of the procedure were small (15
      oocytes; 4.3%). Control and Pronase-treated oocytes were each divided into four
      subgroups and inseminated with 5 x 10(5), 5 x 10(4), 5 x 10(3), or 5 x 10(2)
      sperm cells/ml. Fertilization was assessed 8 hr following insemination by the
      appearance of two pronuclei and development to the two- to four-cell stage the
      following day. The morphology of the zona pellucida following Pronase treatment
      was assessed by phase-contrast and scanning electron (SEM) microscopies performed
      immediately after treatment. Fertilization rate of control oocytes was 80% at a
      sperm concentration of 500,000/ml and gradually declined to approximately 30% at
      500 cells/ml. In contrast, treated oocytes inseminated with 500 sperm cells/ml
      demonstrated a normal rate of fertilization. At this low sperm concentration the
      longer Pronase treatment was significantly (P less than 0.05) more efficient in
      enhancing fertilization (69 and 88% for 3 and 5 min of Pronase treatment,
      respectively). Polyspermic fertilization was not observed in any of the
      subgroups. Phase-contrast microscopic examination of oocytes at the time of
      Pronase treatment showed an initial swelling of the zona pellucida for 30-60 sec
      with a time-dependent increase in its transparency.

PMID- 1627929
TI  - Effects of human serum on rat cumulus-oocyte complex functions in vitro: oocyte
      activation and endocrine secretions.
AB  - Secretion of hormones and oocyte meiotic events were assessed following in vitro
      culture of ovulated rat cumulus-oocyte complexes (COCs) in media containing
      different types of human serum. Both toxic and nontoxic (determined by mouse
      embryo test) samples of fetal cord or adult female serum were utilized for these
      experiments. After short-term culture (4.5 hr), with or without COCs, medium
      containing 10% serum was collected and analyzed for its content of estradiol,
      progesterone, and prostaglandin E (PGE), and oocytes were cytologically evaluated
      for spontaneous activation (second polar-body extrusion). Activation of oocytes
      occurred in all media tested. Steroids (progesterone and estradiol) levels were
      markedly elevated in culture medium containing cord serum as compared to medium
      containing adult female serum. The progesterone content of culture medium
      decreased after incubation of COCs with cord serum and increased when incubated
      with adult female serum. Little or no prostaglandin was detected in any control
      media. However, COCs secreted prostaglandin during culture in all media. COCs
      secreted estradiol when cultured in medium containing cord but not adult female
      serum. Results demonstrate that two types of serum utilized for in vitro culture
      of COCs varied markedly in their hormone content and differentially affected the
      secretion of hormones by COCs during culture. The results are discussed in
      relation to the success of IVF procedures.

PMID- 1627930
TI  - The effects of cooling mouse oocytes.
AB  - The effects of cooling and warming on meiotic spindles of mouse oocytes have been
      assessed by transmission electron microscopy. Intact cumulus-oocyte complexes
      were immediately cooled from 37 to 15, 4, 0, and -7 degrees C (seeding
      temperature) for 15 min in a programmed biological freezer and fixed at these
      temperatures. Other complexes, cooled to these temperatures, were rapidly warmed
      to 37 degrees C and incubated for 2 hr before fixation at 37 degrees C. Of 334
      oocytes assessed at various temperatures, at least 100 were examined for
      metaphase II spindles. Spindle microtubules completely disappear at 0 and -7
      degrees C, while complete or partial depolymerization of microtubules was
      observed at 4 degrees C. Cooling to 15 degrees C did not cause major disruptions
      of spindle structure in most oocytes. Chromosomes tended to rotate or clump at
      lower temperatures but chromosome scatter outside the spindle zone was rarely
      observed. Centrosomal material was fragmented at 4 degrees C and occasionally at
      15 degrees C and was not evident at the spindle poles at 0 and -7 degrees C.
      Kinetochores were seen at all temperatures. Spindle structure was evidently
      restored in the majority of oocytes on rewarming at 37 degrees C. Changes in the
      ooplasm induced by cooling were elongation and disruption of vesicular smooth
      endoplasmic reticulum, especially between lipid globules and disappearance of
      fibrillar inclusions. Cortical granule exocytosis was not observed on cooling,
      while microfilaments were intact. Swelling of membranous organelles was also
      observed in cumulus cells. Most of the cytoplasmic changes were also reversed on
      rewarming. The response of mouse oocytes to cooling is compared to that of human
      oocytes, reported previously.

PMID- 1627931
TI  - In vitro preimplantation mouse embryo development with incubation temperatures of
      37 and 39 degrees C.
AB  - Embryos from two strains of mice were used to assess the effect of incubation
      temperature on pronuclear and two-cell development to the morula/blastocyst (M/B)
      stage. Embryos from B6D2F2 and B6SJLF1 strains were cultured in medium M16 at
      either 37 or 39 degrees C until 120 hr post human chorionic gonadotropin (hCG) or
      0, 24, or 48 hr at 37 degrees C and the remaining time at 39 degrees C. Overall
      M/B development for pronuclear embryos was 0.6, 0, 32.3, and 52.4% for 0-96, 24
      72, 48-48, and 96-0 hr at 37 and 39 degrees C, respectively. Only 0-96 and 24-72
      hr at 37 and 39 degrees C were not different (P greater than 0.10). Overall M/B
      development for two-cell embryos was 48.1, 78.1, and 98.0% for 0-72, 24-48, and
      72-0 hr at 37 and 39 degrees C, respectively. Percentage development at each time
      was different (P less than .01) for each category. Additionally, the number of
      nuclei for morulae and blastocysts tended to be higher for embryos initiating
      culture at the two-cell stage compared to pronuclear embryos. The first cell
      cycle was most dramatically affected by a 2 degrees C increase in incubator
      temperature. More advanced embryos can tolerate slight increases in incubator
      temperature more readily than pronuclear embryos.

PMID- 1627932
TI  - The effect of caffeine on the ability of spermatozoa to fertilize mature human
      oocytes.
AB  - Although caffeine has been reported to enhance spermatozoon motility as well as
      fertilizing ability, its use in clinical practice has remained sparse. We report
      here the results carried out to assess the effect of exposing normal human
      spermatozoa to different concentrations of caffeine on their motility, their
      ability to fertilize oocytes, and the subsequent development of resulting
      embryos. Mature human oocytes were inseminated with spermatozoa washed and
      capacitated in 1.25, 2.5, and 5 mM caffeine. The fertilization rates were
      compared with control oocytes inseminated with untreated spermatozoa. While
      caffeine was observed to improve significantly various motility parameters in a
      dose-dependent manner, it did not lead to an improvement in the fertilization
      rates. At the highest concentration, 5 mM, it adversely affected the
      fertilization rate: 38%, compared with 78% in controls. Embryonic development was
      also observed to be retarded at the lower concentrations, while it was virtually
      inhibited in the 5 mM concentration group. Our results suggest that while a
      definite improvement in motility may occur when spermatozoa are exposed to
      caffeine, this improvement did not translate into enhanced fertilizing ability
      and subsequent embryonic development. We are therefore of the opinion that the
      use of caffeine as a spermatozoon motility enhancer requires further studies
      prior to wider clinical use in assisted pregnancy programs.

PMID- 1627934
TI  - Successful parents of in vitro fertilization (IVF): the social repercussions.
AB  - A matched comparison was made of 157 parents of preschool twins conceived by one
      of the following: in vitro fertilization (IVF), infertility workup combined with
      infertility drug treatment, or spontaneously. The Interview Schedule for Social
      Interaction was used to examine systematically a comprehensive range of social
      relationships and the asymmetries therein. Overall, IVF parents reported having
      deficient social relationships compared with non-IVF parents, and this deficiency
      was both in size and in affective quality of their available relationships. As
      anticipated, mothers reported less adequate and available social relationships
      when compared with their spouses. In the event of a significant finding, mothers
      from the three groups always had lower mean scores than the fathers. The finding
      of the extent to which IVF parents were not as socially integrated, compared with
      the other families of preschool twins, highlights the need to strengthen through
      mutual aid IVF parents' social networks. The data also suggest the need for
      ongoing patient care by IVF teams and for support groups to be established
      exclusively for IVF parents of twins.

PMID- 1627933
TI  - Psychological and hormonal changes in the course of in vitro fertilization.
AB  - This study was designed to investigate concurrently the psychological and
      hormonal changes at three critical points during in vitro fertilization (IVF)
      treatment. One hundred thirteen couples suffering from mechanical and unexplained
      infertility participated in the study and 23 of them conceived. Psychological
      evaluation included background questionnaires, Lubin's Depression Adjective Check
      List, and Spielberger's State Trait Anxiety inventory. Cortisol and prolactin
      levels were estimated by radioimmunoassay. The results showed that patients'
      anxiety and depression scores were significantly higher than the population norm.
      Psychological test scores and hormonal levels showed a similar pattern of change,
      increasing on oocyte retrieval day, decreasing on embryo transfer day, and rising
      again on pregnancy test day. Differences between these phases were generally
      significant. Differences in parameters' means between conceiving (C) and
      nonconceiving (NC) women were generally not significant. However, correlations
      between psychological measures and hormonal levels showed a clear disparity
      between C and NC women in the last phase. Whereas significant negative
      correlations were found in C patients, no relationship was found in NC patients.
      The findings suggest that success in IVF treatment may depend, in part, on
      differential modes of coping with anxiety and depression, involving hormonal or
      endorphin mediation.

PMID- 1627936
TI  - Genetics update: infertility due to a point mutation.

PMID- 1627935
TI  - Impaired human embryo development in Earle's culture medium compared to Ham's
      F10.

PMID- 1627937
TI  - Attitudes toward embryo research.

PMID- 1627938
TI  - Controversies and opinions in clinical microsurgical fertilization.

PMID- 1627939
TI  - Subzonal sperm insertion and the frequency of gamete fusion.
AB  - The subzonal sperm insertion technique was applied to assess the potential of
      motile human spermatozoa to form pronuclei. In 184 mature human oocytes, subzonal
      sperm insertion was used as the primary mode of insemination in cases with
      abnormal semen analyses. Oocytes (n = 131) that failed to fertilize in vitro in
      cases with normal semen profiles were also micromanipulated for secondary
      insemination. The frequency of sperm fusion, expressed as a percentage, was
      defined as the total number of male pronuclei formed divided by the total number
      of spermatozoa inserted subzonally. Our results indicate that 37% of spermatozoa
      from men with normal semen are able to fuse with the oolemma and decondense
      within the ooplasm, when placed in the perivitelline space of the oocyte.
      Excluding the oocytes that appeared morphologically abnormal (presence of
      cytoplasmic inclusions such as refractile bodies within the ooplasm), the
      frequency of sperm fusion increased to nearly 60%. Moreover, 14% of subzonally
      inserted spermatozoa from men with abnormal semen analyses demonstrated an
      ability to form a pronucleus. The incidence of polyspermy was high, ranging from
      30 to 80% in the different groups studied. It is therefore concluded that the
      human oolemma provides little protection against multiple sperm fusion and that
      the frequency of gamete fusion is unexpectedly high, even when the spermatozoa
      are derived from infertile men.

PMID- 1627940
TI  - [Relation between traditional Chinese medicine differentiation of syndromes and
      HBV antigen, HBV DNA in serum and liver tissues and pathological changes in
      chronic hepatitis B].
AB  - TCM differentiation of syndrome in 131 cases of chronic hepatitis B has been
      studied with molecular-biological and immuno-histological techniques. The results
      showed that 94.6% cases of Gan-Yu Pi-Xu (stagnancy in the liver leading to
      diminished function of the spleen) type belonged to chronic persistent hepatitis
      (CPH), whose coincidence rate of pathology of the liver biopsies with CPH was
      69.2%; the positive rate of HBeAg and/or HBV DNA in sera was 61.5%, and the
      positive rates of HBsAg and HBV DNA in liver tissues were 69.2% (of which 44.4%
      appeared diffuse pattern morphologically) and 33.3% respectively. 75.5% cases of
      Gan-Shen Yin-Xu (deficiency of Yin of the liver and kidney) type belonged to
      chronic active hepatitis (CAH) and 88.5% of the cases were pathologically
      described as CAH, the positive rates of HBeAg and/or HBV DNA in serum and HBsAg
      in liver tissues were all 80.8%, among which the diffuse pattern of HBsAg
      accounted for 85.7%, which was higher than that in Gan-Yu Pi-Xu type (P less than
      0.05), the positive rates of HBcAg and HBV DNA in liver tissues were 34.6% (of
      which 55.6% appeared cytoplasmic pattern) and 63.2% respectively, which was
      higher than that in Gan-Yu Pi-Xu type (P less than 0.05). 75.0% cases of Qi-Zhi
      Xue-Yu (stagnation of vital energy and stasis of blood) type belonged to CAH with
      early state cirrhosis, its pathological changes in liver tissues were obvious,
      replication levels of HBV corresponded to the cases of Gan-Yu.Pi-Xu type.

PMID- 1627941
TI  - [Characteristics of traditional Chinese medicine syndromes in both spontaneous
      and variant angina. An analysis of 21 cases].
AB  - An analysis of TCM syndromes is reported in 21 cases with both spontaneous and
      variant angina as compared with 147 cases with effort angina. The results showed
      that 3 characteristic features were present, which were as follows: the Biao-Shi
      syndrome of cold condensation was more than that of the control group in ratio of
      42.86% to 3.40%; the Ben-Xu syndrome of Yang deficiency was more and that of Qi
      deficiency less than those in the control group, and they were in ratio of 33.33%
      to 6.12% and 33.33% to 72.11% respectively. An absolute reduction of blood supply
      resulted from coronary spontaneous spasm in both spontaneous and variant angina
      causes severe chest pain during attacks as a cold condensation type.
      Hyperfunction of parasympathetic nerves often occurring in coronary heart disease
      with Yang deficiency is liable to vasoconstriction of the large coronary arteries
      leading to episodes of both spontaneous and variant angina. The presence of less
      Qi deficiency type may be related to the less impairment of cardiac function
      resulted from the short course in these cases and only relatively mild state of
      an illness, even no marked lesion in coronary arteries in a part of patients with
      both spontaneous and variant angina. No significant difference in TCM syndromes
      occurred between spontaneous and variant angina. Both Yang and Yin deficiency, as
      the Ben-Xu syndromes, were more present in angina of cold condensation
      type.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1627942
TI  - [Treatment of IgA nephropathy by integrated traditional and Western medicine].
AB  - 45 cases of IgA nephropathy were confirmed by renal biopsy and were divided into
      2 groups, the integrated traditional and western medicine (TCM-WM) therapeutic
      group and the western medicine (WM) therapeutic group. The WM group was treated
      by conventional western medicine (persantin, vitamin B co.), and the TCM-WM group
      was treated by the same western medicine plus differential symptomatic treatment
      with decoction of Chinese crude herbs. In this paper, most patients (30 cases)
      were present as deficiency of Yin of the Liver and Kidney type, and were treated
      by Qiju Dihuang pill plus Erzhi pill. All types in TCM-WM group were also used
      herbs of promoting blood circulation and remove blood stasis in almost every
      case. After 6 months of such treatment, the total effective rate of TCM-WM group
      and the WM group were 86.4% and 13.0% respectively. There was very significant
      difference (P less than 0.01) between them. The results showed that the curative
      effect of the TCM-WM group was much superior than WM alone for the treatment of
      IgA nephropathy.

PMID- 1627943
TI  - [Effect on anti-aging and treating yang deficiency of kidney with huanshao dan
      capsules. A clinical report of 309 cases].
AB  - In this study, with various dosages of huanshao dan capsules, an old Chinese
      medicine formula, the authors treated the patients with Yang-deficiency of kidney
      for 1.5-3 months and compared the effects of huanshao dan with those of watered
      pills and placebo. The analyses of Ridit's showed not only the scores of symptoms
      of the great-dose huanshao dan group (group 2), the great-dose watered pill group
      (group 3), the small-dose watered pill group (group 4) and but even the short
      treating course group (group 5) were remarkably improved after treatment (P less
      than 0.001, P less than 0.01); but the group 6 have not any difference after
      treatment. However, the functions of liver and kidney, the level of cholesterol,
      the concentration of blood sugar, blood pressure and heart rate remained the same
      after treatment. The scores of the ability of prompt memory as well as serum
      lipid peroxide, serum adrenocortical hormone, cellular immunological function,
      index of glycoprotein and T3, T4 had similar changes. Our data suggested that
      both huanshao dan and watered pills were beneficial for anti-aging process and
      there was no noticeable difference between the two drugs.

PMID- 1627945
TI  - [Initial clinical application of cardiac pacing needle for emergency cardiac
      pacing].
AB  - This paper deal with the newly designed cardiac pacing needle which is used as an
      electrode in temporary cardiac pacing. Animal experiment has shown that in
      emergency life-saving this needle was functional and reliable. This also has been
      identified by clinical application. By utilizing the needle, the authors have
      successfully saved three patients' life threatened by sudden death. Using this
      needle to pace the heart is simple, swift, immediate and has less side effect. It
      is specially fit for grassroot medical units to develop emergency cardiac pacing.

PMID- 1627944
TI  - [A clinical study of the effect of wuzi yanzong solution in retarding aging
      process].
AB  - Eighty men ranging from 60 to 80 years old were selected, in whom no disease was
      found through a thorough check-up except for some senility manifestation
      diagnosed as deficiency of the kidney. They were randomly divided into two
      groups, wuzi yanzong solution (WYS) being administered in 50 cases and placebo in
      30. After 5 weeks' treatment, symptoms such as hypomnsis, tinnitus, and aching of
      the back and legs, dribbling after urinary voiding, and nocturia were remarkably
      improved in the WYS group, but they remained as before in the placebo group.
      Before the treatment, plasma lipid peroxide (LPO), erythrocyte superoxide
      dismutase (SOD), blood glutathione peroxidase (GSH-Px), serum luteinizing hormone
      (LH) and follicle-stimulating hormone (FSH), plasma testosterone (T) and
      estradiol (E2) levels were determined. In comparison with the results obtained in
      33 young men in their twenties, LPO, FSH, LH level and E2/T ratio in the aged
      were greatly elevated, and SOD, GSH-Px and T markedly lowered. After the
      treatment, there was remarkable reduction of LPO and E2/T, and increase of SOD
      and T in the WYS group, but no significant change in the placebo group. The above
      results not only indicate the beneficial effect of WYS in retarding the aging
      process, but also suggest the possible mechanism of reducing the peroxidation of
      fatty acids by enhancing the antioxidant enzymes to inhibit free radical
      activity.

PMID- 1627946
TI  - [Effects of xiang sha liu jun zi tang on gastric and intestinal functions in
      animals].

PMID- 1627947
TI  - [Treatment of cholelithiasis in China--discharge, dissolution, crushing and
      removal].

PMID- 1627948
TI  - [Current status of prevention and treatment of traditional Chinese medicine for
      ototoxic effect of streptomycin].

PMID- 1627949
TI  - Lymphocyte subpopulation number and function in infancy.
AB  - Normal values for percentages of lymphocyte subpopulations and functional
      responses to mitogen stimulation in infancy are not well established. In the
      present study, lymphocyte subpopulations were examined in umbilical cord blood
      samples and in peripheral blood samples drawn before 7 and 24 months of age (mean
      age 10.4 months) from a healthy population of infants born in Tucson, Arizona.
      Results indicate significant increases occurred from birth to later infancy in
      the percentages of total T cells (CD3), T-cell subsets (CD4, CD8) and B cells
      (CD20). The CD4/CD8 ratio and the functional responses to ConA and PWM mitogens
      significantly decreased from birth to later infancy. PHA responsiveness did not
      show a significant change. Results from cross-sectional analyses (n = 271) were
      supported in a smaller longitudinal subset (n = 37). There were no detectable
      ethnic- or gender-related differences in cord blood or samples obtained in later
      infancy. The normal values established in this study will be useful in studies of
      immune-system maturation and in the clinical evaluation of newborns, infants, and
      toddlers suspected of either acquired or congenital immune-deficiency states.

PMID- 1627950
TI  - Transient developmental expression of IgY and secretory component like protein in
      the gut of the axolotl (Ambystoma mexicanum).
AB  - We previously reported that a primitive vertebrate, the Mexican axolotl
      (Amphibian, Urodela) synthesizes two classes of immunoglobulins. IgM are present
      in serum early in the development, and represent the bulk of specific antibody
      synthesis after an antigenic challenge. IgY occur in the serum later during the
      development, and are relatively insensitive to immunization. We demonstrate in
      the present work, using immunofluorescence with specific Mabs, that IgY are
      expressed in the gut epithelium, as secretory molecules. Secretory IgY are well
      expressed in the stomach and intestinal mucosae of young animals from 1 month
      after hatching to the seventh month. Thereafter, IgY progressively disappear from
      the gut and become readily detectable in the serum of 9-month-old preadult
      immunologically mature animals. Axolotl IgY are closely associated in the gut to
      secretory component-like (SC) molecules that are well-recognized by antisera to
      the SC of different mammalian species. This is the first description, in a
      primitive tetrapode, of an immunoglobulin class that could be the physiological
      counterpart of mammalian IgA.

PMID- 1627951
TI  - Thymic involution in viable motheaten (me(v)) mice is associated with a loss of
      intrathymic precursor activity.
AB  - Mice homozygous for the viable motheaten (me(v)) allele manifest abnormalities in
      thymocytopoiesis, are severely immunodeficient, and develop autoimmune disorders
      early in life. Premature thymic involution occurs in me(v)/me(v) mice, and their
      bone marrow prothymocytes are unable to repopulate the thymus of adoptive
      recipients following intravenous (i.v.) transfer. However, analysis of
      thymocytopoiesis following intrathymic (i.t.) adoptive transfer of bone marrow
      from me(v)/me(v) mice demonstrates the presence of normal numbers of
      prothymocytes. To investigate intrathymic development in me(v)/me(v) mice, we
      determined intrathymic precursor cell number and activity. Dual labeling analyses
      showed that an involuted me(v)/me(v) thymus is relatively enriched (fivefold) in
      CD4-CD8- thymocytes (intrathymic precursor phenotype) compared with wild-type
      (+/+) thymus. However, thymocytes from me(v)/me(v) mice were deficient in
      precursor activity when adoptively transferred i.t. into irradiated recipients.
      Thymocytes recovered from the involuted thymus of aged or steroid-treated normal
      mice also displayed reduced precursor activity. However, the phenotypic profile
      of thymocyte subsets from steroid-treated mice was enriched in single positive
      cells (mature phenotype) and was distinctly different from the subset
      distribution of thymocytes in me(v)/me(v) and aged mice. These results suggest
      that intrathymic precursor activity in me(v)/me(v) mice is decreased, and may be
      reflective of decreased prothymocyte seeding to the thymus in vivo. In addition,
      the results suggest that the thymic involution in me(v)/me(v) mice is not due
      solely to effects of corticosteroids.

PMID- 1627952
TI  - T-cell-specific membrane antigens in the Mexican axolotl (urodele amphibian).
AB  - Comparative analysis of SDS-PAGE patterns of axolotl spleen cells membrane
      detergent lysates showed important discrepancies between control and
      thymectomized animals. Among these, a 38-kD protein band, which appeared as a
      major protein in controls, was not or poorly expressed after thymectomy. A rabbit
      antiserum (L12) raised against the 38-kD eluted band labeled in indirect
      immunofluorescence 80-86% of thymocytes and 40-46% of mIg- lymphoid cells in the
      spleen. The anti-38-kD antibodies stained in Western blotting two antigenically
      related polypeptides of 38- and 36-kD on splenocyte membrane lysates. Two
      dimensional NEPHGE-PAGE analysis indicated that the anti-38-kD antibodies reacted
      in the spleen with several gathered spots in the 7.8-8.2 pI range, corresponding
      to 38-36-kD microheterogeneous polypeptides. Most of these spots are not further
      expressed in thymectomized animals. These results support evidence that the 38-kD
      surface antigens can be considered as specific surface markers of the axolotl
      thymus-derived lymphocytes.

PMID- 1627953
TI  - Neuropsychiatry and homosexuality: on the need for biopsychosocial
      interactionism.

PMID- 1627954
TI  - Assessment of bromocriptine intervention for the treatment of frontal lobe
      syndrome: a case study.

PMID- 1627955
TI  - A psychiatrist replies to Yudofsky's "Psychoanalysis, psychopharmacology, and the
      influence of neuropsychiatry".

PMID- 1627956
TI  - Sometimes when you hear hoofbeats ... two cases of inherited metabolic diseases
      with initial presentation of psychiatric symptoms.

PMID- 1627957
TI  - Incidence of AIDS dementia in a two-year follow-up of AIDS and ARC patients on an
      initial phase II AZT placebo-controlled study: San Diego cohort.
AB  - In a prospective study to determine the incidence of clinical dementia in
      patients with AIDS and ARC, 29 men and 3 women, 19 with ARC and 13 with AIDS,
      were examined neurologically and neuropsychologically every 6 months for 2 years
      during a placebo-controlled zidovudine (AZT) licensing trial. Most received two
      MRI brain scans. Although no patient was clinically demented at baseline, 9 (28%)
      developed dementia during the 2 years. Progression to dementia was associated
      with neuropsychological deterioration and with worsening on MRI during a
      preceding 6-month period, but not with baseline treatment group assignment. The
      results suggest that patients at CDC Stage IV who do not receive antiretroviral
      treatment earlier in their illness may develop clinical dementia at an annual
      rate of about 14%.

PMID- 1627958
TI  - Neuropsychological and neurological manifestations of HIV-1 dementia in drug
      users.
AB  - The cognitive and motor deficits associated with human immunodeficiency virus-1
      (HIV-1) infection have been studied using neurological examination and
      neuropsychological tests. However, drug users with HIV-1 infection generally have
      been excluded from such studies. Forty-four well-characterized drug users
      stratified by Centers for Disease Control staging were administered a
      standardized neurological examination and a battery of neuropsychological tests
      under single-blind conditions designed to minimize the acute effects of
      psychoactive substances. The results of the blind neurological examination were
      consistent with the previously ascertained clinical staging of HIV-1 infection.
      The pattern of neuropsychological deficits across HIV-1 states was similar to
      those found in cohorts of homosexual men.

PMID- 1627959
TI  - Staining intensity of brain iron in patients with schizophrenia: a postmortem
      study.
AB  - Evidence derived from both pharmacological and postmortem studies suggests that a
      disturbance of brain iron metabolism is involved in the pathophysiology of
      schizophrenia; i.e., the distribution of iron parallels that of dopamine, and
      variations in its brain concentration selectively modulate the binding affinity
      of the dopaminergic (D2) receptor. In the present study the authors examined the
      staining intensity of brain iron in postmortem specimens of 9 schizophrenic (SC)
      patients and 17 age-matched controls. Coronal sections were stained with the
      Perls's technique, photographed, and then studied using a computerized image
      analysis system. Optical density measurements were taken from the caudate
      nucleus, putamen, globus pallidus, and substantia nigra. This study revealed
      significant differences between groups only for the staining intensity of iron in
      the caudate nucleus (P less than 0.005). A review of the literature suggests that
      this finding may be the result of neuroleptic therapy and not a primary
      pathological feature of schizophrenia.

PMID- 1627960
TI  - Violent visual hallucinations and aggression in frontal lobe dysfunction:
      clinical manifestations of deep orbitofrontal foci.
AB  - Three patients from different racial, social, and economic backgrounds were
      studied because of sudden intrusive thoughts: visions or intrusions of
      threatening scenes--violent, aggressive, and sometimes horrifying--that lasted
      from seconds to minutes. Apart from the association with intense anxiety, fear,
      and aggression, there was no association with oculomotor, motor, sensory, or
      autonomic dysfunction or altered conscious state. Patients had abnormal
      intermittent discharges that arose from frontal areas and probably did not spread
      further. Carbamazepine was useful in two cases. The authors suggest that violent,
      brief hallucinations with no other epileptic sign may be manifestations of
      frontal lobe seizures.

PMID- 1627961
TI  - Hypothalamic lesions and intermittent explosive disorder.
AB  - The authors present two cases of patients with craniopharyngiomas who meet the
      DSM-III-R criteria for intermittent explosive disorder. Episodes of rage
      developed before and/or after surgery for removal of the craniopharyngioma.
      Magnetic resonance imaging revealed hypothalamic-hypophyseal involvement. It is
      suggested that hypothalamic lesions played a major role in the development of
      aggressive behavior in both cases.

PMID- 1627963
TI  - Alzheimer and Kraepelin describe Binswanger's disease.

PMID- 1627962
TI  - Organic mood disorder associated with the HAIR-AN syndrome.
AB  - The HAIR-AN syndrome is characterized by hyperandrogenism, insulin resistance,
      and acanthosis nigricans. The authors report the first case of an organic mood
      disorder associated with this condition that improved markedly in response to
      ovarian suppression with oral contraceptives. The proposed pathophysiology of
      this syndrome is also discussed.

PMID- 1627964
TI  - Plasma beta-endorphin levels in post-traumatic stress disorder: a preliminary
      report on response to exercise-induced stress.
AB  - Post-traumatic stress disorder (PTSD) may be associated with changes in
      endogenous opioid peptide function. To test this hypothesis, 10 male Vietnam
      combat veterans with PTSD and 8 age-matched male controls underwent a standard
      grade-incremented exercise treadmill stress test. Plasma beta-endorphin
      measurements were obtained at rest and following maximal exercise. Resting plasma
      beta-endorphin levels were comparable between groups. Post-exercise plasma beta
      endorphin levels were significantly higher than resting levels in the PTSD
      patients only (P less than 0.05). These pilot data suggest a differential
      alteration in plasma beta-endorphin response to exercise in PTSD.

PMID- 1627965
TI  - Dysnomia in the differential diagnosis of major depression, depression-related
      cognitive dysfunction, and dementia.
AB  - This study examined naming abilities in three groups of older adults with: I)
      major depression alone, II) major depression with reversible cognitive
      dysfunction, and III) dementia with depression. Groups I and II differed
      significantly from dementia patients in total correct responses to a visual
      confrontation naming task (Boston Naming Test). Qualitative aspects of naming,
      specifically types of errors characterizing each patient group, were examined,
      but no statistically significant differences among groups were observed. The
      results support the contention that the presence of dysnomia may be useful in
      discriminating cognitive abnormalities secondary to dementia from cognitive
      dysfunction associated with depression.

PMID- 1627966
TI  - Open trial of intravenous clomipramine in five treatment-refractory patients with
      obsessive-compulsive disorder.
AB  - In a preliminary trial, five oral-clomipramine-refractory patients with obsessive
      compulsive disorder (OCD) were treated openly with 14 intravenous clomipramine
      infusions each. Using standardized assessments, three patients were rated as much
      improved, one as unchanged, and one as minimally improved. Statistically
      significant improvements were noted on both the Yale-Brown Obsessive Compulsive
      Scale and the NIMH Global OCD scores. No patient discontinued treatment because
      of side effects. Although the results are provocative in that three of five
      patients were much improved at the end of the protocol, conclusions about
      preferential efficacy for the intravenous route must await a placebo-controlled
      trial.

PMID- 1627967
TI  - Contingent tolerance and reresponse to carbamazepine: a case study in a patient
      with trigeminal neuralgia and bipolar disorder.
AB  - This retrospective single-case study demonstrates the development of tolerance
      and reresponse to carbamazepine in a patient with coexisting trigeminal neuralgia
      and manic-depressive illness. After an initial positive response, tolerance to
      the antinociceptive and psychotropic effects of carbamazepine appeared during
      treatment, despite increasing doses. As in preclinical studies of contingent
      tolerance, periods of carbamazepine discontinuation were associated with
      reresponse following reinstitution. These are the first clinical data interpreted
      in a contingent tolerance formulation with reresponse following a medication-free
      interval. Controlled and prospective studies are needed of the reliability and
      the pathophysiological and therapeutic implications of this phenomenon.

PMID- 1627968
TI  - Failure of buspirone and verapamil to improve spasmodic torticollis.
AB  - The effects of buspirone and verapamil on spasmodic torticollis were investigated
      in two double-blind, placebo-controlled crossover studies. Buspirone was given in
      doses of 20-100 mg/day for 4 weeks to 14 patients; verapamil was given in doses
      of 40-100 mg/day for 3 weeks to 8 patients. Neither drug improved symptoms of the
      movement disorder (posture, motility, rigidity, tremor), pain, perceived stress,
      or mood, either in the whole group or in any individual patient.

PMID- 1627970
TI  - Diagnostic tests and information theory.
AB  - Our previous article showed that the discriminating properties of most diagnostic
      tests in medicine can be characterized by assuming that tests separate disordered
      and nondisordered individuals into two overlapping, normal distributions with
      different means and standard deviations. In this article, we explore the
      relationship between this way of describing diagnostic tests and the reason that
      clinicians use them: to gain information about their patients and to reduce
      diagnostic uncertainty.

PMID- 1627969
TI  - The application of the Screening Cerebral Assessment of Neppe (BROCAS SCAN) to a
      neuropsychiatric population.
AB  - Assessments of higher cortical functioning are often neglected in patients with
      possible coarse neurobehavioral psychiatric disease, such as dementia, stroke, or
      focal cerebral lesions. When performed, the short Folstein Mini-Mental State Exam
      (MMSE) is typically used. The authors' research on 45 neuropsychiatric patients
      compared the MMSE with a new 20-30-minute bedside examination, the Screening
      Cerebral Assessment of Neppe (BROCAS SCAN). This screens 10 areas: recall,
      recognition, orientation, organization of thought, concentration, calculation,
      agnosia, apraxia, speech, and sensory-motor-reflex phenomena. The BROCAS SCAN
      (total) correlated extremely well with neuropsychiatric prediction, MRI changes,
      and neuropsychological testing, and distinguished diagnoses, demonstrating
      construct and face validity. It also accounted for a larger proportion of
      variance than the MMSE in correlating with these parameters and was more
      sensitive in mildly cognitive impaired patients. The briefer first section of the
      BROCAS SCAN, the core SCAN, also showed statistically relevant relationships to
      age, diagnosis, MRI, and neuropsychiatric prediction.

PMID- 1627971
TI  - Is schizophrenia a neurological disorder?

PMID- 1627973
TI  - Reliability, validity, and clinical correlates of apathy in Parkinson's disease.
AB  - The authors examined a consecutive series of 50 patients for the presence of
      apathy, depression, anxiety, and neuropsychological deficits using a
      neuropsychological battery that included a recently designed apathy scale. This
      scale was found to be reliable and valid in the diagnosis of apathy in patients
      with PD. Of patients in the study, 12% showed apathy as their primary psychiatric
      problem, and 30% were both apathetic and depressed. Patients with apathy (with or
      without depression), showed significantly more deficits in both tasks of verbal
      memory and time-dependent tasks. Results suggest that apathy is a frequent
      finding in PD, is significantly associated with specific cognitive impairments,
      and may have a different mechanism than depression.

PMID- 1627972
TI  - Image processing for the study of brain structure and function: problems and
      programs.
AB  - Fundamental problems in the analysis of functional and structural imaging data
      include data transport, boundary identification (including manual tracing, edge
      detection, and tissue segmentation), volume estimation, three-dimensional
      reconstruction and display, surface and volume rendering, shape analysis, and
      image overlay. These problems require that research investigators have access to
      suitable methods of image analysis, implemented on a set of software programs, in
      order to conduct neuroimaging research. The authors describe a group of software
      programs designed to provide a comprehensive solution for these problems.

PMID- 1627974
TI  - Electroconvulsive therapy for post-stroke depressed geriatric patients.
AB  - Medical records were retrospectively reviewed for 20 medically ill geriatric
      patients who received electroconvulsive therapy (ECT) for post-stroke depression
      from January 1982 to January 1991 at Massachusetts General Hospital. Of the 19
      patients (95%) who improved with ECT, 7 patients (37%) suffered relapses despite
      maintenance anti-depressant medications. Relapses typically developed
      approximately 4 months after ECT. Five patients (23%) developed ECT-related
      medical complications. Three patients (15%) developed transient interictal
      confusion or amnesia. No patient experienced an exacerbation of preexisting
      neurologic deficits. These findings indicate that ECT is a generally well
      tolerated and effective treatment for depressed, medically ill post-stroke
      geriatric patients.

PMID- 1627975
TI  - Multiple sclerosis and ECT: possible value of gadolinium-enhanced magnetic
      resonance scans for identifying high-risk patients.
AB  - Electroconvulsive therapy (ECT) has been used effectively in treating depressed
      patients with multiple sclerosis (MS). However, several reports have observed
      that some patients with MS may suffer neurological deterioration during ECT. The
      authors describe the outcomes of 3 depressed patients with MS who were treated
      with ECT. Consistent with previous works, ECT effectively treated the psychiatric
      symptoms; however, 1 patient deteriorated neurologically during ECT. The brain
      MRI findings and clinical courses of all 3 patients are discussed, along with the
      possible value of gadolinium-contrast MRI scans for identifying high-risk
      patients.

PMID- 1627976
TI  - Magnetic resonance imaging correlates of neuropsychological impairment in
      multiple sclerosis.
AB  - The authors examined whether specific neuropsychological abnormalities in
      multiple sclerosis (MS) are associated with focal lesion areas detected by MRI.
      Lesion area, regardless of distribution, correlated with performance on the vast
      majority of neuropsychological procedures. No significant difference appeared
      between groups with normal/mild and moderate overall cognitive impairment on any
      of the MRI measures. However, patients with severe cognitive impairment had
      greater lesion area, regardless of location, and had significant atrophy of the
      corpus callosum compared with the other two groups. These results suggest that
      severe atrophy of the corpus callosum reflects global disease and provides a
      relatively focal morphological marker of severe cognitive impairment in MS.

PMID- 1627977
TI  - Regional cerebral glucose utilization in chronic organic mental disorders
      associated with alcoholism.
AB  - Localized cerebral utilization rates for glucose (CMRglu) were determined in 10
      detoxified patients with alcoholic organic mental disorders and in 7 age
      equivalent normal volunteers using [18F]2-fluoro-2-deoxyglucose positron emission
      tomography. Although gray and white matter CMRglu were not significantly
      different, normalized CMRglu was increased in the left cerebellar and parietal
      cortical regions and decreased in the right posterior white matter and anterior
      temporal regions of alcoholic patients, and the pattern of regional CMRglu
      differed between the two groups. The results suggest functional disruption of
      right-sided and frontal brain regions and hyperactivity of cerebellar-cortical
      connections in alcoholic chronic organic mental disorders.

PMID- 1627978
TI  - Magnetic resonance imaging of white matter lesions in HIV infection.
AB  - Previous studies of the frequency of high-signal lesions in human
      immunodeficiency virus (HIV) infection have had methodological weaknesses
      regarding lack of control groups, differing machine strengths, and biased subject
      selection. To obtain a more accurate estimate of prevalence, MRI scans were
      performed on 243 HIV-positive and HIV-negative homosexual or bisexual men with no
      history of intravenous drug use. Axial T2-weighted (long TR/TE, spin-echo) MRI
      scans were rated blindly for presence of focal white matter high-signal lesions.
      Incidence of hyperintensities was low in all groups, although slightly higher in
      patients with AIDS, and was not associated with neuropsychological performance.
      The lower incidence of hyperintensities appears to relate to elimination of
      methodological problems in previous studies.

PMID- 1627979
TI  - Comparison of two cognitive screening measures for efficacy in differentiating
      dementia from depression in a geriatric inpatient population.
AB  - The Folstein Mini-Mental State Examination (MMSE) and dementia screening measures
      developed by Benton (temporal orientation, oral word association, and visual
      reconstruction tasks) were compared for diagnostic efficacy with geriatric
      inpatients manifesting depression without dementia or mild or moderate dementias
      complicated by depression. Both instruments showed generally acceptable
      differentiation between dementia and depression-only cases overall. The MMSE was
      less sensitive in identifying mild and moderate multi-infarct dementias but
      showed better specificity than the Benton measures. The degree and type of
      dementia and the associated risk of classification error were found to be
      important factors in the choice of screening instruments.

PMID- 1627980
TI  - Neuroleptic malignant syndrome and preexisting brain damage.
AB  - A case of neuroleptic malignant syndrome (NMS) is described in a congenitally
      brain-damaged deaf patient. The literature suggests that NMS in patients with
      organic brain syndrome is induced by a reduction of marginal stores of dopamine
      in the hypothalamus and basal ganglia resulting from dopamine-blocking activity
      of neuroleptics, even at conventionally low doses. Brain-damaged patients should
      be recognized as being at higher risk of developing NMS.

PMID- 1627981
TI  - Depression during treatment with beta-blockers: results from a double-blind
      placebo-controlled study.
AB  - Depressive symptoms were rated during a double-blind placebo-controlled trial of
      nadolol for chronic aggression. Depressive symptoms were not significantly
      different in nadolol and placebo groups during any phase of the drug trial.

PMID- 1627982
TI  - Aggressive behavior following exposure to cholinesterase inhibitors.
AB  - The authors report four instances of significant, essentially unprovoked
      aggressive behavior, including two homicides, following exposure to
      cholinesterase inhibitors. No subject had a history of violent behavior,
      antisocial personality, or major psychiatric or neurologic disorder. After
      anticholinesterase exposure ceased, all showed sincere remorse for their actions,
      and none has since engaged in aggressive or psychopathologic behavior. Well
      controlled experimentation in animals suggests that enhanced activation of
      hypothalamic cholinergic receptors may underlie aggressive behavior in humans
      exposed to cholinesterase inhibitors. A relationship between cholinesterase
      inhibitors and aggression has important implications for public health, raising
      the possibility of unappreciated neurotoxic influences on behavior.

PMID- 1627983
TI  - Anticholinergic delirium caused by topical homatropine ophthalmologic solution:
      confirmation by anticholinergic radioreceptor assay in two cases.
AB  - The authors report two patients with prolonged metabolic delirium presumably
      initiated by systemic absorption of homatropine from a topical ophthalmologic
      solution. Anticholinergic toxicity was confirmed by muscarinic radioreceptor
      assay in both cases and by quantitative EEG in one case.

PMID- 1627984
TI  - Comparing diagnostic tests using information theory: the INFO-ROC technique.
AB  - We continue our examination of diagnostic tests that are used to assign
      individuals to one of two mutually exclusive categories, those having or not
      having a particular disorder. Our last article showed how the information yielded
      by a test depends on the choice of cutoff and on the patient's pre-test
      probability of having the disorder. In this article, we demonstrate a method of
      optimizing a test's information yield that allows us to determine which of
      several tests gives the most information. Our technique allows us to compare a
      test's performance with that of a perfect diagnostic test.

PMID- 1627985
TI  - More on ECT and delirium in Parkinson's disease.

PMID- 1627986
TI  - Fluoxetine and schizophrenia in a patient with obsessional thinking.

PMID- 1627987
TI  - The Babinski response and periodic limb movement disorder.

PMID- 1627988
TI  - Unforeseen beneficial effects of controlled-release levodopa-carbidopa (Sinemet
      CR)

PMID- 1627989
TI  - Patterns of lifetime drug use among intravenous drug users.
AB  - To obtain a clearer description of the natural history of intravenous drug use
      (IVDU), 92 intravenous drug users (IVDUs), not selected through treatment or
      contact with the legal system, were identified. Concerning lifetime use, central
      nervous system (CNS) stimulants were the most common class of drug to be injected
      (by 72.8% of IVDUs), followed by opiates (by 50.0% of IVDUs). Mean age of onset
      of IVDU in this sample was 18.5 years, following initiation of alcohol use by an
      average of 4.6 years and cannabis use by an average of 2.1 years. Any history of
      IVDU in this sample indicated substantial lifetime use of illicit drugs and early
      onset of psychoactive substance use.

PMID- 1627990
TI  - Characteristics of adult children of alcoholics.
AB  - Ninety-seven adult children of alcoholics (ACOAs), 36 adults with dysfunctional
      family histories, and 41 adults without identified dysfunctional family histories
      were compared on self-reports of 20 adult characteristics. Significant
      differences among the groups were found on 4 of the characteristics, with the
      ACOA group showing the highest frequency of occurrence on 17 of them. No
      differences due to gender of the alcoholic parent were found, and there was no
      group by gender interaction. The results suggested that the clinical
      characteristics attributed to ACOAs may have some empirical validity but the
      ACOAs seem fairly similar to adults with other types of dysfunctional family
      histories.

PMID- 1627991
TI  - The context of smoking initiation and maintenance: findings from interviews with
      youths.
AB  - The characteristics of initial cigarette-smoking situations and subsequent
      situations in which adolescents received an offer to smoke were examined by means
      of interviews with 287 youths in grades 7 through 10. Initiation of smoking
      generally took place in a social context (89%), with small groups (2.7 people) of
      same-gender, older (2.1 years), peers (and siblings) who were smokers (60%). In
      one-third of these onset situations, another novice smoked for the first time.
      Most subjects (81%) reported that they smoked their first cigarette because they
      accepted an offer. The characteristics of the onset situation did not
      significantly differ between regular and experimental smokers. The situations for
      later offers to smoke were similar: small groups of same-gender, slightly older,
      cigarette-smoking peers (and siblings). Descriptive and comparative data also are
      presented on procurement, perceived prevalence, parental influence, cravings,
      quit attempts, beliefs about ease of quitting, and intention to smoke. These data
      suggest that school-based interventions may not be sufficient to address the
      broad social context surrounding adolescent tobacco use. Community-wide
      interventions are advocated.

PMID- 1627992
TI  - Relationships among smoking status, body composition, energy intake, and physical
      activity in adult males: a longitudinal analysis.
AB  - This study evaluates the longitudinal relationships among smoking and adiposity,
      dietary intake, and physical activity in a group of adult males. Subjects were
      101 nonsmokers and 19 regular cigarette smokers. Adiposity, dietary intake, and
      physical activity were assessed annually for three consecutive years. Results
      indicated that nonsmokers had larger tricep skinfold measurements than smokers
      over the 3-year period. However, dietary intake and physical activity did not
      differ between groups. Due to the absence of differences on these two variables
      for the smoking and nonsmoking groups, it was concluded that the lower adiposity
      in smokers was largely metabolically determined, which may make difficult the
      treatment of postcessation weight gain.

PMID- 1627993
TI  - Abuse of drugs associated with eating disorders.
AB  - Concomitant bulimia nervosa and drug abuse are common in women. Drugs used by
      this group include diuretics, emetics, laxatives, and diet pills, as well as
      alcohol, cigarettes, and illicit street drugs. This paper applies principles from
      behavioral pharmacology to the problem of drug use by women with bulimia nervosa.
      The prevalence of use, primary effects, toxicity, detection, tolerance,
      withdrawal, and effects on appetite and weight are discussed for drugs used by
      bulimic women to reduce appetite or weight or to induce purging (e.g., diuretics,
      emetics, laxatives, and diet aids). Alternatives in the diagnosis and treatment
      of drug use in women with eating disorders are discussed.

PMID- 1627994
TI  - The impossible dream?--Routes to reducing alcohol problems in a temperance
      culture.
AB  - Two main prescriptions are offered for reducing rates of alcohol problems in
      English-speaking and Nordic cultures: a "dry" solution of reducing the physical
      and cultural availability of alcohol, and a "wet" solution of reducing problems
      of intoxication by better integrating drinking into the culture. Empirical
      evaluations of change in particular cultures have tended to support the dry, and
      not the wet, solution. But such studies focus on relatively short-term effects,
      and there is evidence that long-run effects may be weaker or may even be reversed
      from shortterm effects. Some particular societies that have been put forward as
      examples of the long-term success of wet strategies are considered. The most
      likely success from this perspective is the Netherlands, which is also an
      exceptional society in terms of the wetness of its drug policies. In the light of
      these cases, consideration is given to some issues concerning the criteria for
      evaluating the success of one or the other solution. It is argued that alcohol
      policy discussions need to recognize that intoxication has a particular social
      position in our societies, in terms of characteristics of the drinker and of the
      occasion, in terms of intoxication's cultural significance, and in terms of its
      entrenchment in social worlds of heavy drinking. Some implications for policy are
      noted.

PMID- 1627995
TI  - Women's health: a focus for the 1990s.

PMID- 1627996
TI  - It's time for selected routine testing of newborns for human immunodeficiency
      virus.

PMID- 1627997
TI  - Pregnant women's knowledge of the human immunodeficiency virus: implications for
      education and counseling.

PMID- 1627998
TI  - Obstetricians' and gynecologists' beliefs and preferred modes of treatment for
      women diagnosed with premenstrual symptoms.

PMID- 1627999
TI  - Women's health: the making of a powerful new public issue.

PMID- 1628000
TI  - Abortion in nineteenth century America: a conflict between women and their
      physicians.

PMID- 1628001
TI  - Sexism and medical terminology.

PMID- 1628002
TI  - Work and pregnancy.

PMID- 1628003
TI  - Alternative analysis of the review of work during pregnancy.

PMID- 1628004
TI  - Prenatal care incentives.

PMID- 1628005
TI  - Physicians and the basic human rights of women.

PMID- 1628006
TI  - The road to Rio.

PMID- 1628007
TI  - A meeting of rich and poor.

PMID- 1628008
TI  - After Windscale (Sellafield)

PMID- 1628009
TI  - Alcohol and cardiac arrhythmias.

PMID- 1628010
TI  - Percutaneous endoscopic gastrostomy.

PMID- 1628011
TI  - Implementing the patient's charter in outpatient services.

PMID- 1628012
TI  - Incidence of leukaemia and other cancers in birth and schools cohorts in the
      Dounreay area.
AB  - OBJECTIVE: To determine whether a raised incidence of leukaemia in the Dounreay
      area occurred in children born to local mothers (birth cohort) or in those who
      moved to the area after birth (schools cohort) and also whether any cases of
      cancer have occurred in children born near Dounreay who may have moved elsewhere.
      DESIGN: Follow up study. SETTING: Dounreay area of Caithness, Scotland. SUBJECTS:
      4144 children born in the area in the period 1969-88 and 1641 children who
      attended local schools in the same period but who had been born elsewhere. MAIN
      OUTCOME MEASURES: Cancer registration records linked to birth and school records
      with computerised probability matching methods. RESULTS: Five cancer
      registrations were traced from the birth cohort compared with 5.8 expected on the
      basis of national rates (observed to expected ratio 0.9, 95% confidence interval
      0.3 to 2.0). All five cases were of leukaemia (2.3, 0.7 to 5.4). In the schools
      cohort three cases were found (2.1, 0.4 to 6.2), all of which were of leukaemia
      (6.7, 1.4 to 19.5). All eight children were resident in the Dounreay area at the
      time of diagnosis; thus no cases were found in children who were born in or had
      attended school in the study area but who subsequently moved away. CONCLUSION:
      The raised incidence of leukaemia in both the birth and schools cohorts suggests
      that place of birth is not a more important factor than place of residence in the
      series of cases of leukaemia observed near Dounreay area.

PMID- 1628013
TI  - Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube
      feeding in patients with persisting neurological dysphagia.
AB  - OBJECTIVE: To compare percutaneous endoscopic gastrostomy and nasogastric tube
      feeding in patients with persisting neurological dysphagia. DESIGN: Randomised 28
      day study of inpatients requiring long term enteral nutrition. SETTING: Three
      Glasgow teaching hospitals. SUBJECTS: 40 patients with dysphagia for at least
      four weeks secondary to neurological disorders: 20 patients (10 women) were
      randomised to nasogastric feeding and 20 (eight women) to endoscopic gastrostomy.
      MAIN OUTCOME MEASURES: Treatment failure (blocked or displaced tubes on three or
      more occasions or refusal to continue treatment); duration of feeding; intake of
      liquid diets; complications; nutritional status at end of trial. RESULTS: One
      patient in each group died before starting feeding. Treatment failure occurred in
      18 of the 19 nasogastric patients and in none of the gastrostomy group. The mean
      (SE) duration of feeding for the nasogastric group was 5.2 (1.5) days. No
      complications occurred in the nasogastric group but three (16%) of the
      gastrostomy group developed minor problems (aspiration pneumonia (two patients)
      wound infection (one)). Gastrostomy patients received a significantly greater
      proportion of their prescribed feed (93% (2%)) compared with the nasogastric
      group, (55% (4%); p less than 0.001) and also gained significantly more weight
      after seven days of feeding (1.4 (0.5) kg v 0.6 (0.1) kg; p less than 0.05).
      Analyses at days 14, 21, and 28 were not possible due to the small numbers
      remaining in the nasogastric group. CONCLUSION: Percutaneous endoscopic
      gastrostomy tube feeding is a safe and effective method of providing long term
      enteral nutrition to patients with neurological dysphagia and offers important
      advantages over nasogastric tube feeding.

PMID- 1628014
TI  - Trends in deliberate self poisoning and self injury in Oxford, 1976-90.
AB  - OBJECTIVE: To review trends in deliberate self poisoning and self injury
      (attempted suicide) over 15 years (1976-90) on the basis of general hospital
      referrals. DESIGN: Prospective data collection by computerised monitoring system.
      SETTING: Teaching general hospital. SUBJECTS: All patients aged 15 and over (n =
      9605) referred to the hospital after episodes (n = 13,340) of deliberate self
      poisoning or self injury. MAIN OUTCOME MEASURES: Rates based on population of
      Oxford city; changes in substances used for self poisoning; history and
      repetition of attempts; and rates of admission to the hospital and of referral to
      the psychiatric service. RESULTS: Attempted suicide rates for women declined
      during the late 1970s and early 1980s but increased again during the late 1980s.
      Those for men remained relatively steady throughout the period. Highest mean
      annual rates occurred in women aged 15-19 (711/100,000) and in 20-34 year old men
      (334/100,000). The proportion of overdoses with paracetamol increased from 14.3%
      (125/873) in 1976 to 42% (365/869) in 1990 (chi 2 for trend = 481, p less than
      0.01). Throughout the period the proportions of referred patients admitted to
      hospital and of those attempting suicide for the first time (over two thirds) did
      not decrease. Annual rates of repetition of attempts by women declined from 15.1%
      (257/1700) in 1976-8 to 11.9% (161/1356) in 1987-9 (chi 2 for trend = 7.8, p less
      than 0.01). Lower repetition rates occurred in women admitted to hospital and
      referred to the psychiatric service (431/4585, 9.4%) than in those not referred
      (42/235, 17.9%; chi 2 = 17.2, p less than 0.0001). CONCLUSIONS: Rates of
      attempted suicide declined in the 1970s and early 1980s, in women, but there are
      probably at least 100,000 hospital referrals a year in England and Wales because
      of this problem. Prevention of paracetamol self poisoning requires urgent
      attention, and psychosocial assessment should be conducted with as many of those
      who attempt suicide as possible.

PMID- 1628015
TI  - Gonad protection in young orthopaedic patients.
AB  - OBJECTIVE: To determine whether gonad shields are correctly positioned on the
      pelvic radiographs of children with slipped capital femoral epiphysis. DESIGN:
      Retrospective study of radiographs taken of children treated by in situ pinning
      of slipped capital femoral epiphysis between 1 January 1983 and 31 December 1988.
      SETTING: Three teaching hospitals in north west England. PATIENTS: 32 patients
      with complete set of radiographs. RESULTS: An average of 10.8 anteroposterior
      pelvic radiographs plus 8.9 lateral hip radiographs had been performed per
      patient. Gonad shields had been completely omitted in 137 (40%) anteroposterior
      pelvic radiographs performed on the 32 patients at the time of completion of the
      study. In 100 (29%) the gonad shields were adequately protecting the gonads, but
      in 109 (31%) the gonad shields were not protecting the gonads due to incorrect
      positioning of the shield. The incorrect positioning of the gonad shields was
      more commonly found in girls than boys (64 vs 45; p less than 0.012), presumably
      because of the difficulty in determining gonadal position in relation to surface
      landmarks. Absence of gonad shields was also more commonly seen in girls (82 v
      55; p less than 0.005), but this is not easily explained. CONCLUSIONS: Gonad
      shields are not protecting the gonads in a large percentage of anteroposterior
      pelvic radiographs (71%) because they have been omitted or inadequately placed.
      This avoidable excess radiation exposure to the gonads, combined with the
      inability to shield the gonads in lateral hip radiographs and the large number of
      radiographs performed, results in the gonads receiving a higher dose of radiation
      than may otherwise be the case, and may increase the potential for disease in the
      future offspring of these patients.

PMID- 1628016
TI  - Murmurs in pregnancy: an audit of echocardiography.

PMID- 1628017
TI  - Acute adrenal insufficiency associated with high dose inhaled steroids.

PMID- 1628018
TI  - Cardiac arrest associated with flumazenil.

PMID- 1628019
TI  - National general practice study of epilepsy: the social and psychological effects
      of a recent diagnosis of epilepsy.
AB  - OBJECTIVES: To determine the nature and extent of psychosocial problems in
      epilepsy and their associations. DESIGN: A postal survey was used drawing data
      from prospective consecutive cases. Data on demographic, medical, and social
      backgrounds were collected. A specially designed, validated attitude
      questionnaire examined 14 areas of psychosocial adjustment to epilepsy. SETTING:
      124 primary care general practices. SUBJECTS: Adults (aged over 17) with a recent
      diagnosis of epilepsy (within previous 36 months). They were registered with the
      national general practice study of epilepsy and had a confirmed diagnosis
      according to the usual criteria. 216 subjects were approached for the survey by
      their general practitioners; 192 returned questionnaires. RESULTS: Problems in at
      least one area were experienced by 175 (91%) of the 192 subjects. Problems were
      generally mild, which contrasts strongly with findings in chronic cases. The
      areas of greatest concern were fear of seizures (80% of cases; 72% moderate or
      severe) and fear of stigma in employment (69% of cases; 40% moderate or severe).
      A highly significant relation was found between psychosocial effects and the
      frequency and recency of seizures. CONCLUSIONS: In the early stages of epilepsy
      psychosocial effects are closely related to the severity of the medical
      condition, suggesting that the argument for the stigmatising effect of the
      diagnosis by itself is less important than previously thought. The findings also
      suggest that problems may evolve as the condition becomes chronic.

PMID- 1628020
TI  - Learning from the past.

PMID- 1628021
TI  - Military expenditure and foreign aid: should they be linked?

PMID- 1628022
TI  - The great exterminator of children.

PMID- 1628023
TI  - Testicular cancer and related neoplasms.

PMID- 1628024
TI  - Too many advisers, not enough aid.

PMID- 1628025
TI  - Helping Russia.

PMID- 1628026
TI  - ABC of colorectal diseases. Diverticular disease.

PMID- 1628027
TI  - Rationing in developing countries.

PMID- 1628028
TI  - Measles, mumps, and rubella vaccination.

PMID- 1628029
TI  - Harm minimisation for drug misusers.

PMID- 1628030
TI  - Storing vaccines at the correct temperature.

PMID- 1628031
TI  - Managing drug misuse in general practice.

PMID- 1628032
TI  - For and against Eusol.

PMID- 1628033
TI  - Adrenaline in allergic emergencies.

PMID- 1628034
TI  - Steroid ulcers.

PMID- 1628035
TI  - Advanced trauma life support.

PMID- 1628036
TI  - Octreotide and urinary glycosaminoglycan in Graves' disease.

PMID- 1628037
TI  - Reversing vasectomy.

PMID- 1628038
TI  - Advanced trauma life support care.

PMID- 1628039
TI  - Behcet's disease.

PMID- 1628040
TI  - Diagnosing pulmonary embolism.

PMID- 1628041
TI  - Free For All: "Cancer positive".

PMID- 1628042
TI  - Improving postgraduate training in ophthalmology.

PMID- 1628043
TI  - Ethics and multicentre research projects.

PMID- 1628044
TI  - Ethics of embryo manipulation.

PMID- 1628045
TI  - Fellowships for doctors from Czechoslovakia.

PMID- 1628046
TI  - Sexual contact between doctors and patients.

PMID- 1628047
TI  - Living bone grafts.

PMID- 1628048
TI  - Investigating lower bowel symptoms in general practice.

PMID- 1628049
TI  - Cardiac imaging with radionuclides.

PMID- 1628050
TI  - Sexual contact in the doctor-patient relationship in The Netherlands.
AB  - OBJECTIVE: To obtain data on sexual contact between doctors and their patients.
      DESIGN: Anonymous questionnaire with 17 items sent to all working gynaecologists
      (n = 595) and all ear, nose, and throat specialists (n = 380) in the Netherlands.
      RESULTS: Response rate was 74%; a total 64 doctors gave a reason for not
      completing the questionnaire. 201 (59%) male gynaecologists and 128 (56%) male
      ear nose, and throat specialists indicated that sexual feelings are acceptable in
      the doctor-patient relationship; 286 (85%) and 186 (81%), respectively, had felt
      sexually attracted to a patient at some time, as had 14 (27%) female
      gynaecologists. More than half (59%) of the doctors who indicated that sexual
      feelings are unacceptable in the doctor-patient relationship had experienced
      these feelings, and 91% of this group had a negative attitude towards these
      feelings. 4% of respondents in each group had had actual sexual contact with
      patients. Most gynaecologists were in favour of having more attention paid to
      sexual problems during training; having their professional society take an
      official viewpoint; subsequent public support of this viewpoint; and taking on an
      impartial counsellor for the patients as well as the doctors. CONCLUSION:
      Sexuality exists in the doctor-patient relationship. Gynaecologists have a higher
      risk of having sexual contact with their patients than do ear, nose, and throat
      specialists but compensate for this greater risk by a higher state of recognition
      and acknowledgement.

PMID- 1628051
TI  - Symptoms after accelerated immunisation.
AB  - OBJECTIVE: To document the incidence of symptoms after accelerated immunisation
      with diphtheria-tetanus-pertussis vaccine. DESIGN: Controlled study of children
      immunised with adsorbed diphtheria-tetanus-pertussis vaccine at accelerated and
      standard schedules. SETTING: Colchester and north Hertfordshire. SUBJECTS: 107
      children scheduled to receive immunisation at 2, 3, and 4 months of age and 115
      children scheduled to receive immunisation at 3, 4 1/2 to 5, and 8 1/2 to 11
      months of age. MAIN OUTCOME MEASURES: Parentally recorded symptoms, axillary
      temperatures, and size of local redness and swelling at the injection site during
      the seven days after immunisation. RESULTS: In general symptoms occurred less
      frequently with the accelerated schedule. Proportions of parents reporting
      axillary temperatures greater than 37.2 degrees C or local redness or swelling
      greater than 2.5 cm after the third dose of vaccine were significantly reduced in
      the accelerated schedule group. CONCLUSION: Immunisation at 2, 3, and 4 months of
      age is likely to cause fewer reactions than immunisation at 3, 4 1/2 to 5, and 8
      1/2 to 11 months of age.

PMID- 1628053
TI  - Endoscopy facilities in general practice.

PMID- 1628052
TI  - Detection of IgA and IgM antibodies to HIV-1 in neonates by radioimmune western
      blotting.
AB  - OBJECTIVE: To detect infection with HIV-1 by IgA and IgM response at birth in
      children born to HIV-1 seropositive mothers. DESIGN: Western blotting and
      radioimmune western blotting on stored sera from infected and uninfected babies
      born to HIV-1 seropositive mothers. Sera were pretreated to remove IgG. SETTING:
      Parma and Bologna, Italy. SUBJECTS: 12 infected and five uninfected babies born
      to HIV-1 seropositive mothers and three babies born to seronegative mothers. MAIN
      OUTCOME MEASURES: Effectiveness of western blotting and radioimmune western
      blotting in detecting antibodies to HIV-1 gene products. RESULTS: With
      conventional western blotting we found IgA class antibodies to HIV-1 proteins in
      serum from three out of 12 infected children; in two of these three the serum was
      collected at age 3 months (positive controls). Radioimmune western blotting
      detected both IgA and IgM antibodies in serum from all infected children tested,
      whereas all serum from uninfected children born to seropositive and seronegative
      mothers showed no such antibodies. CONCLUSION: Although the technique should be
      tested on more patients, radioimmune western blotting seems to be a valuable tool
      for serological diagnosis of congenital HIV-1 infection at birth in neonates born
      to seropositive mothers.

PMID- 1628054
TI  - Oesophageal cancer and distilleries in Scotland.

PMID- 1628055
TI  - Unnecessary hospitalisation in a psychiatric rehabilitation unit.

PMID- 1628056
TI  - Job stress, satisfaction, and mental health among general practitioners before
      and after introduction of new contract.
AB  - OBJECTIVE: To compare measures of job stress, job satisfaction, and mental health
      among general practitioners before and after the introduction of the new contract
      in April 1990. DESIGN: Cross sectional postal questionnaire survey in July 1990.
      Comparison of results with those obtained in previous survey in November 1987.
      SETTING: General practice in United Kingdom. SUBJECTS: 1500 general practitioners
      randomly selected from general medical services lists, 917 of whom (61%) returned
      questionnaires usable for statistical analysis. MAIN OUTCOME MEASURES: Aspects of
      job causing stress, job satisfaction (Warr, Cook, and Wall scale), and mental
      health (Crown-Crisp experiential index). RESULTS: Compared with 1987, in 1990
      doctors experienced more stress from night calls (mean score 3.83 in 1990 v 3.45
      in 1987), emergencies during surgery hours (3.72 v 3.48), and interruption of
      family life by telephone (3.58 v 2.73; p less than 0.001 for all three
      variables). Scores for somatic anxiety and depression were higher in both men and
      women in 1990 (men: somatic anxiety 3.12 v 2.36; depression 3.80 v 2.94; women:
      somatic anxiety 3.56 v 2.65; depression 4.02 v 3.37; p less than 0.001). Job
      satisfaction had also decreased in 1990 (5.23 v 4.26; p less than 0.001).
      CONCLUSIONS: Doctors experienced more stress, less job satisfaction, and poorer
      mental health in 1990 than in 1987. These changes may have resulted from the
      introduction of the new contract.

PMID- 1628057
TI  - Imposed change in general practice.

PMID- 1628058
TI  - The law, medical students, and assault.

PMID- 1628060
TI  - Post-totalitarian medicine.

PMID- 1628059
TI  - Radiotherapy update.

PMID- 1628061
TI  - ABC of colorectal diseases. Colorectal neoplasia--II: Large bowel cancer.

PMID- 1628062
TI  - Managing sudden bereavement.

PMID- 1628063
TI  - Postviral fatigue syndrome.

PMID- 1628064
TI  - Postviral fatigue syndrome.

PMID- 1628065
TI  - Postviral fatigue syndrome.

PMID- 1628066
TI  - Postviral fatigue syndrome.

PMID- 1628067
TI  - Managing tuberculosis and HIV infection.

PMID- 1628068
TI  - Ernest Saunders: diagnostic dilemma.

PMID- 1628069
TI  - Cholera in Brazil.

PMID- 1628070
TI  - Provision of home births.

PMID- 1628071
TI  - Psychological treatments for patients with cancer.

PMID- 1628072
TI  - Treatment of elderly patients with breast cancer.

PMID- 1628073
TI  - Deaths from hemolytic disease of the newborn.

PMID- 1628074
TI  - Delayed diagnosis in NIDDM.

PMID- 1628075
TI  - Elderly people placed in wrong homes.

PMID- 1628076
TI  - Lung cancer and radon.

PMID- 1628077
TI  - Underfunding of inner city general practice.

PMID- 1628078
TI  - Developing a hospital information strategy.

PMID- 1628079
TI  - NHS distribution of funds unfair.

PMID- 1628081
TI  - Compulsory admission of dangerous psychopaths.

PMID- 1628080
TI  - Obstetrical history of Queen Anne.

PMID- 1628082
TI  - The future of primary health care.

PMID- 1628083
TI  - Listeriosis.

PMID- 1628084
TI  - Pernicious anaemia.

PMID- 1628085
TI  - "Macho" management in the NHS.

PMID- 1628086
TI  - Electrocardiographic abnormalities and associated factors in Chinese living in
      Beijing and in Mauritius. The Mauritius Non-Communicable Disease Study Group.
AB  - OBJECTIVE: To compare the prevalence of electrocardiographic abnormalities and to
      evaluate the association between these abnormalities and the levels of coronary
      heart disease among Chinese living in different environments. DESIGN: Cross
      sectional surveys. SETTING: Beijing, China, and the island of Mauritius.
      SUBJECTS: Random samples of people aged 35-64 years in Beijing (621 men, 642
      women) in 1984 and in Mauritius among Chinese (137 men, 130 women) and non
      Chinese (1265 men, 1432 women) in 1987. MAIN OUTCOME MEASURES: Prevalence of
      electrocardiographic abnormalities suggesting coronary heart disease and of
      associated risk factors. RESULTS: Prevalence of electrocardiographic
      abnormalities suggesting coronary heart disease was significantly lower in
      Beijing (4.0%) than in Mauritian Chinese (24.3%) and Mauritian non-Chinese
      (24.5%). Mean serum concentrations of total and non-high density lipoprotein
      cholesterol were lower in Beijing Chinese than in Mauritian Chinese, but smoking
      and hypertension were slightly more prevalent. Overall, men with
      electrocardiographic abnormalities had higher risk factor levels than those with
      a normal electrocardiogram regardless of ethnic origin. CONCLUSIONS: The
      prevalence of coronary heart disease and associated risk factors was different
      among Chinese living in two different environments: in Beijing in the People's
      Republic of China and in Mauritius. Chinese, who traditionally have a very low
      frequency of coronary heart disease, are by no means protected against coronary
      heart disease and other non-communicable diseases. Therefore, primary prevention
      of coronary heart disease is a major challenge for preventive medicine in China,
      as well as in many other developing countries.

PMID- 1628087
TI  - Growth hormone and tumour recurrence.
AB  - OBJECTIVE: To determine whether using growth hormone to treat radiation induced
      growth hormone deficiency causes tumour recurrence. DESIGN: Comparison of tumour
      recurrence rates in children treated with growth hormone for radiation induced
      deficiency and an untreated population. Computed tomograms from children with
      brain tumours were reviewed when starting growth hormone and subsequently.
      SETTING: North West region. PATIENTS: 207 children treated for brain tumour, 47
      of whom received growth hormone and 161 children with acute lymphoblastic
      leukaemia 15 of whom received growth hormone. MAIN OUTCOME MEASURES: Tumour
      recurrence and changes in appearances on computed tomography. RESULTS: Among
      children with brain tumour, five (11%) who received growth hormone had
      recurrences compared with 42 (26%) who did not receive growth hormone. Also
      adjusting for other variables that might affect tumour recurrence the estimated
      relative risk of recurrence was 0.82 (95% confidence interval 0.28 to 2.37). The
      only child with acute lymphoblastic leukaemia who relapsed while taking growth
      hormone had relapsed previously before starting treatment. Two of the five
      children with brain tumours who relapsed had abnormal appearances on computed
      tomography when growth hormone was started. 14 other children who remained
      relapse free and had follow up computed tomography showed no deterioration in
      radiological appearance during treatment. CONCLUSIONS: In this population growth
      hormone did not increase the risk of tumour recurrence but continued surveillance
      is essential. Abnormal results on computed tomography are not a contraindication
      to treatment with growth hormone.

PMID- 1628089
TI  - Effects of long term octreotide on gall stone formation and gall bladder
      function.

PMID- 1628088
TI  - Effect of serotesting with counselling on condom use and seroconversion among HIV
      discordant couples in Africa.
AB  - OBJECTIVE: To determine whether HIV testing and counselling increased condom use
      and decreased heterosexual transmission of HIV in discordant couples. DESIGN:
      Prospective study. SETTING: Kigali, the capital of Rwanda. SUBJECTS: Cohabiting
      couples with discordant HIV serology results. MAIN OUTCOME MEASURES: Condom use
      in the couple and HIV seroconversion in the negative partners. RESULTS: 60 HIV
      discordant couples were identified, of whom 53 were followed for an average of
      2.2 years. The proportion of discordant couples using condoms increased from 4%
      to 57% after one year of follow up. During follow up two of the 23 HIV negative
      men and six of the 30 HIV negative women seroconverted (seroconversion rates of 4
      and 9 per 100 person years). The rate among women was less than half that
      estimated for similar women in discordant couples whose partners had not been
      serotested. Condom use was less common among those who seroconverted (100% v 5%,
      p = 0.01 in men; 67% v 25%, p = 0.14 in women). CONCLUSIONS: Roughly one in seven
      cohabiting couples in Kigali have discordant HIV serological results.
      Confidential HIV serotesting with counselling caused a large increase in condom
      use and was associated with a lower rate of new HIV infections. HIV testing is a
      promising intervention for preventing the spread of HIV in African cities.

PMID- 1628090
TI  - Oral and dental disease in terminally ill cancer patients.

PMID- 1628092
TI  - Managing change in primary care. Meetings and chairmanship.

PMID- 1628091
TI  - Roles, risks, and responsibilities in maternity care: trainees' beliefs and the
      effects of practice obstetric training.
AB  - OBJECTIVES: To document the content of practice obstetric vocational training,
      the beliefs of general practitioner trainees about the roles of midwives and
      general practitioners in maternity care, and the risks of providing such care;
      and to ascertain if undergoing such training affects their beliefs. DESIGN:
      Confidential postal questionnaire survey. SUBJECTS: Random one in four sample of
      all general practitioner trainees in the United Kingdom on vocational training
      schemes or in training practices in autumn 1990. MAIN OUTCOME MEASURES: Beliefs
      scored on seven point Likert scales and characteristics of trainer and training
      practice. RESULTS: Of 1019 trainees sent questionnaires, 765 (75.1% response
      rate) replied; 638 (83.3%) had done some part of their practice year. Of their
      trainers, 224 (35.1%) provided full obstetric care. 749 (99%) and 364 (48%)
      trainees believed that midwives and general practitioners respectively have an
      important role in normal labour; 681 (91.7%) trainees believed that general
      practice intrapartum care is a high risk "specialty." Those trainees whose
      trainers provide full obstetric care were significantly more likely to believe
      that both midwives and general practitioners have an important role in abnormal
      labour and to see the provision of intrapartum care as an incentive to join a
      practice. CONCLUSION: In this series most general practitioner trainees believed
      that both midwives and general practitioners have important roles in maternity
      care. Exposure of trainees to the provision of full obstetric care while in their
      training practice resulted in a more positive attitude towards the provision of
      such care by general practitioners.

PMID- 1628093
TI  - How to run an induction meeting for house officers.

PMID- 1628094
TI  - ABC of colorectal diseases. Colorectal neoplasia--III: Treatment and prevention.

PMID- 1628095
TI  - Intra-arterial temazepam.

PMID- 1628096
TI  - Intra-arterial temazepam.

PMID- 1628097
TI  - Life events and breast cancer prognosis.

PMID- 1628098
TI  - Life events and breast cancer prognosis.

PMID- 1628099
TI  - Psychological influences on cancer and ischaemic heart disease.

PMID- 1628100
TI  - Altitude induced illness.

PMID- 1628101
TI  - Asthma deaths in New Zealand.

PMID- 1628102
TI  - Row over Maori cot death rate.

PMID- 1628103
TI  - Adrenaline in allergic emergencies.

PMID- 1628104
TI  - Recording HIV status on police computers.

PMID- 1628105
TI  - Eusol: the continuing controversy.

PMID- 1628106
TI  - Eusol: the continuing controversy.

PMID- 1628107
TI  - Early and late replicating DNA involved in the G1 to S transition in Allium cepa
      L meristematic cells.
AB  - The involvement of portions of the genome replicated at different times of the S
      period in the regulation of the G1 to S transition was analyzed in Allium cepa L
      meristem cells. For this, DNA bromosubstitution confined to discrete portions of
      a previous S period followed by anoxic UVA irradiation (300-400 nm light) was
      performed in synchronous cells. Sequences replicated in late S appeared to be
      involved in the positive regulation of the initiation of replication. Hence,
      cells were prevented from initiating replication if irradiated at mid G1 only
      when the DNA sequences replicated in the last third of the previous S period were
      bromosubstituted. Cycloheximide-induced inhibition of protein synthesis at late
      G1 also prevented the G1 to S transition. Sequences replicated in mid S appeared
      unrelated to any control of the initiation of replication. On the other hand,
      sequences replicated in the first third of the S period seemed to be involved in
      the negative regulation of the initiation of replication, since irradiation after
      previous bromosubstitution of early replicating DNA sequences advanced G1 cells
      into the next S phase and increased the proliferative fraction of the population.
      Finally, the simultaneous inactivation of DNA sequences involved in both positive
      and negative regulation of replication allowed the cells to enter into S.

PMID- 1628108
TI  - Cytochalasin induces spindle fusion in the syncytial blastoderm of the early
      Drosophila embryo.
AB  - Microfilament integrity is needed to maintain the regular arrangement of the
      spindle microtubules and to guarantee the normal progression of the last
      syncytial mitoses in Drosophila embryo. To investigate when and how
      microfilaments participate in this process, we incubated permeabilized embryos
      with the inhibitor of actin polymerization, cytochalasin B, at different times
      during the nuclear cycle. Our results suggest that the correct microfilament
      distribution is only required for the appropriate segregation of nuclei during
      the 11th, 12th and 13th syncytial mitoses rather than during the 10th mitosis
      when the spindles are too far apart to interact. When cytochalasin B treatment
      was performed during the last syncytial mitoses many spindles fuse among them and
      the regular mitotic progression is perturbed.

PMID- 1628109
TI  - Serum-free culture of stromal and functionally polarized epithelial cells of
      guinea-pig endometrium: a potential model for the study of epithelial-stromal
      paracrine interactions.
AB  - Stromal and glandular epithelial (GE) cells were isolated from guinea-pig
      endometrium and growth to near confluency (6-8 days) in primary culture on
      plastic surfaces in a serum-supplemented medium (SSM). The stromal cells were
      subcultured on plastic dishes and maintained for 72 h in SSM. Then SSM was
      replaced by a chemically defined medium (CDM) and the stromal cells grown to
      confluency (5-7 days). The GE cells were subcultured in CDM, on a basement
      membrane matrix (Matrigel) applied to permeable Millicell-PC filters, and grown
      to confluency (5 days). Homogeneity of the subcultured endometrial cell
      populations was ascertained immunocytochemically. The filter-cultured GE
      monolayers were polarized morphologically, and displayed epithelial-specific
      specialized structures. These monolayers had functional tight junctions as
      verified by a measurable transepithelial resistance. The subcultured cell
      populations were distinguished by an analysis of their cellular and secretory
      proteins after labelling with [35S]-methionine and analysis by polyacrylamide gel
      electrophoresis. The filter-cultured GE monolayers allowed identification of the
      proteins released vectorially in the apical or the basal secretory compartment,
      thus demonstrating the functional polarization of GE cells in this bicameral
      culture system. Within the defined conditions of this culture system, the
      paracrine factors released by the two endometrial cell populations as well as the
      interplay of stromal-epithelial interactions and ovarian hormones could be
      investigated.

PMID- 1628110
TI  - In vitro effect of fungal cyclodepsipeptides on leukemic cells: study of
      destruxins A, B and E.
AB  - The activities of three mycotoxins isolated from the hyphomycete Metarhizium
      anisopliae: destruxin A, B, and E (DA, DB and DE) are described and compared in
      vitro on leukemic cells. Their antitumor effect was investigated by flow
      cytometry on growth, cell viability and cell cycle perturbation 48 h after
      destruxin exposure. Against P388 leukemic cells, DE displayed greater
      antiproliferative activity than DA and DB. The minimum concentration required to
      inhibit 50% of cell proliferation is 0.33 microgram/ml for DE, 11.7 micrograms/ml
      for DA and 9.4 micrograms/ml for DB. Cell cycle modifications were only observed
      with DE at 50 and 10 micrograms/ml and consisted in an accumulation of the cells
      in G0/1 phase. DA and DB did not modify the number of cells in G0/1 of the cell
      cycle. Nevertheless a decrease in the number of cells in G2+M phase was induced
      by the three destruxins.

PMID- 1628111
TI  - Adriamycin resistance is characterized by ultrastructural changes in human
      leukaemic K562 cells in vitro.
AB  - Ultrastructural changes associated with adriamycin (ADM) resistance have been
      investigated in the human K562 leukaemic cell line: sensitive K562 cells, a
      resistant subline cultured in the continuous presence of ADM and resistant cells
      without ADM Transmission electron microscopy (TEM) study revealed that K562
      resistant cells displayed ultrastructural modifications of the cell surface,
      chromatin and nucleolus conformation. Alterations were not directly related to
      the presence of adriamycin as deprivated cells exhibited modificated characters
      through a slow progressive recovery phenomenon.

PMID- 1628112
TI  - Pattern of arborization of the motor nerve terminals in the fast and slow
      mammalian muscles.
AB  - A silver impregnation method and a morphometric approach were used to define
      differences existing in the motor nerve terminal branching pattern between a fast
      twitch muscle (extensor digitorum longus) and a slow-twitch one (soleus) of the
      normal adult rat. Because no single measure can describe precisely all
      geometrical properties (ie both topology and metrics) of the nerve terminals, we
      evaluated morphologic parameters defining length and angular characteristics in
      the different terminal segments classified according to their centrifugal order.
      The main results indicate that the distal free-end segments in the extensor
      digitorum longus muscle are shorter and less divergent than in the soleus nerve
      terminals. The endings in the two muscles have different fractal dimensions.
      Findings are discussed in the context of the hypothetical mechanisms governing
      motor nerve terminal size and complexity.

PMID- 1628113
TI  - Liver peroxisomes in newborns from clofibrate-treated rats. I. A morphometric
      study of the recovery period.
AB  - Morphological and morphometric parameters (volume density (Vv), numerical density
      (NA) and mean diameter (D)) of newborn liver peroxisomes were measured throughout
      the first week of life in rats born to mothers treated with clofibrate (ethyl 2 p
      chlorophenoxy isobutyrate) during the last five days of pregnancy. In control
      studies the same analyses were carried out in newborns from untreated rats. At
      birth (day 0), treated animals exhibited a proliferated, pleiomorphic peroxisomal
      population (higher Vv, NA and D, and a spread distribution of profile diameter
      with respect to the controls). In the subsequent two days, many peroxisomes
      disappeared (decrease of Vv and NA to values even lower than controls), with a
      persisting high pleiomorphism (no change of D and diameter distribution) in
      residual ones. Starting from day 3, and up to day 6, larger peroxisomes were no
      longer detectable in test animals, and a significant, not pleiomorphic
      proliferation took place (D and diameter distributions strictly comparable to the
      controls and progressively increasing Vv and NA). The correlation analysis
      validated these morphological results, from which it can be surmised that the
      postnatal peroxisome recovery period consists of a destructive phase followed by
      a proliferative one. The possible mechanism(s) of disposal of the excess of drug
      induced peroxisomes are discussed.

PMID- 1628114
TI  - Liver peroxisomes in newborns from clofibrate-treated rats. II. A biochemical
      study of the recovery period.
AB  - The fatty-acyl-CoA beta-oxidation (FAO) and catalase activities, as well as
      membrane fluidity of liver peroxisomes of newborns from normal and clofibrate
      treated rats were studied during the recovery period, ie, throughout the first
      week of postnatal life. In the test animals the enzyme activities, which are
      significantly higher than controls at birth return to normal levels showing a
      somewhat different time course with FAO rapidly decreasing to control values
      within three days but with catalase still higher than controls at day 6. The half
      life and degradation rate (Kd) of FAO are identical to those calculated by us for
      the whole organelles and to those reported by others for total catalase in normal
      or clofibrate-treated adult animals in the presence of catalase inhibitors.
      Soluble catalase shows turnover values which are similar though not identical to
      those of FAO, while total catalase has a very long half-life and a low Kd.
      Peroxisomal membrane fluidity, as determined by fluorescence anisotropy of 1
      anilinonaphthalene-8-sulfonate (ANS) bound to purified peroxisomal fractions is
      higher in tests than in controls, recovering normal values within 6 days. Our
      results demonstrate that liver peroxisomes of rats prenatally exposed to
      clofibrate return to control conditions within about 1 week. The turnover
      parameters of enzymes and the membrane fluidity values are discussed in terms of
      disposal mechanism(s) for the excess of induced peroxisomes.

PMID- 1628115
TI  - Clinical and genetic heterogeneity in X-linked deafness.
AB  - The use of molecular techniques in respect of the rare X-linked non-syndromic
      form of genetic deafness demonstrates that this is a genetically heterogeneous
      disorder, with evidence for at least two separate gene loci on the X chromosome.
      Audiological heterogeneity in this condition is emphasized by the observation of
      both mixed deafness and sensorineural deafness in pedigrees showing evidence for
      linkage to Xq13-q21. The importance and shortcomings of the audiogram in
      assessing females who are known gene carriers is discussed.

PMID- 1628116
TI  - Linking spontaneous otoacoustic emissions and tinnitus.

PMID- 1628117
TI  - Testing otolith function.
AB  - Otolithic signals contribute to; (1) perception of orientation and linear motion,
      (2) generate compensatory eye movements in response to linear acceleration of the
      head and (3) participate in the co-ordination of movement and balance. Tests of
      these functions shown to be useful in identifying clinical disorders have been
      reviewed: (1) Evaluation of orientation to gravity, as estimated by adjustment of
      the visual vertical, indicates deranged otolith function at a peripheral or
      central level and the sensitivity of this test can be enhanced by performing
      estimates during centrifugation on a motorised turntable. Estimation of
      thresholds of self motion on a parallel swing identifies global reduction or
      unilateral loss of peripheral function, with central disorders awaiting study.
      (2) Otolith ocular reflexes to linear head translation can be used to demonstrate
      overall integrity of peripheral function and reveal central abnormalities.
      Counter-rolling responses to head roll-tilt and measurements of cyclodeviation of
      the eyes demonstrate functional asymmetries, with some lateralising value,
      particularly in central lesions. Global function and asymmetries may also be
      evaluated by 'head eccentric' rotational testing, which adds a tangential linear
      acceleration to the angular stimulus. The linear acceleration enhances the canal
      response by adding an otolith component. (3) Latency and amplitude of surface
      electro-myography (EMG) responses in the limbs to sudden falls, which can be
      recorded with the subject suspended on a hinged bed, indicate gross peripheral
      abnormality of function and can lateralize disorders of CNS motor pathways. It is
      concluded that some tests of otolith function can be of use in indicating global
      loss of peripheral otolith function, others are capable of lateralizing a marked
      loss of function and all have the potential to give information about central
      disorders. They all have to be interpreted within the clinical context and,
      unfortunately, none have yet been shown to be sensitive to partial, particularly
      unilateral, dysfunction.

PMID- 1628118
TI  - Plight of unreturned tinnitus questionnaires.

PMID- 1628119
TI  - Test-retest variability using the Liverpool screening audiometer in a field
      environment.
AB  - The Liverpool Field Audiometer (LFA) has been developed as a simple, hand-held
      device for screening audiometry in developing countries. The variability in the
      outcome of screening using the LFA was studied with 275 primary schoolchildren in
      five Brisbane schools. A 30 dB HL screening level was used. The device was found
      to give low test-retest outcome variability at the test frequencies 1000 Hz, 2000
      Hz and 4000 Hz. However, variability was high at 500 Hz and caution should be
      exercised when data at this frequency are obtained. Possible reasons for this low
      frequency variability are suggested.

PMID- 1628120
TI  - The epidemiology of childhood hearing impairment: factor relevant to planning of
      services.
AB  - In the Nottingham District Health Authority we found that one in 943 babies born
      between 1983-1986 have a sensorineural or mixed hearing impairment (at 50 dB HL
      or greater in the better ear averaged over the frequencies 0.5, 1, 2, 4 kHz) that
      is either congenital or progressive in nature. If this figure is broken down
      between non-neonatal intensive care unit babies and neonatal intensive care unit
      (NICU) graduates, we find that one in 174 NICU graduates have a hearing
      impairment compared with one in 1278 non-NICU babies. Excluding from the non-NICU
      baby population those with a known family history of hearing impairment, and
      those with a known relevant syndrome at birth, there is a 10.2 to 1 odds ratio
      for babies in NICU to have such hearing impairments compared to this restricted
      'normal' baby population. In addition NICU babies with a hearing impairment were
      considerably more likely to have another disability (odds ratio 8.7 to 1).
      Acquired sensorineural or mixed impairments comprised about 9% of the children
      with impairments by 3 years of age. Twenty per cent of the patients seen at the
      Children's Hearing Assessment Centre (CHAC) with better-ear impairment of 95 dB
      HL or greater had acquired hearing impairments. The mean age of referral for
      congenital hearing impairments was found to be a function of severity and NICU
      status. For children with better-ear hearing impairments of 80 dB HL or greater,
      the mean and median ages of referral were both 8 months (s.d. 4 months).

PMID- 1628121
TI  - The effects of hearing loss and age of intervention on some language metrics in
      young hearing-impaired children.
AB  - This study examined the oral language production abilities of a group of young
      children with bilateral sensorineural hearing impairments (greater than 25 dB
      HL). The effects of age of intervention-as indexed by age of detection, referral,
      first appointment and hearing-aid fitting-and of the severity of their hearing
      impairments on spoken language and communication were the foci of the study.
      Children were aged between 27 and 80 months with hearing threshold levels ranging
      from 32 to 98 dB in the better ear. All were audio- and video-taped in their own
      homes, in an unstructured play setting with the mother. Measures of expressive
      language ability were extracted including mean length of utterance, vocabulary
      size, words per min., total utterance attempts per min., proportion of non-verbal
      utterances and the proportion of questions asked by the child. No significant
      correlations were found between the children's hearing impairments and their
      scores on the language measures once age at interview had been statistically
      controlled. However, significant correlations were found between the language
      measures and the ages at which the children received intervention for their
      hearing impairments, in particular for vocabulary and those language measures
      denoting the rate and quality of the child's interaction during the episode
      recorded. This finding is consistent with some of the arguments to be found in
      the small body of data addressing the question of early intervention.

PMID- 1628122
TI  - Reconstitution of B cell immunity following bone marrow transplantation.
AB  - Bone marrow transplant recipients are known to be immunodeficient in cellular and
      humoral immune responses for months to years. Mechanisms underlying the post
      transplant immunodeficiency are mostly unknown and therefore it has been
      difficult to design therapeutic strategies to address this problem. Here, we
      review studies of post-transplant B cell (humoral) immunity including B cell
      blood counts, phenotype, function and origin, and the morphology of lymphoid
      organs. We postulate that the aetiology of post-transplant humoral
      immunodeficiency is multifactorial, involving: B cell immaturity due to
      recapitulation of their ontogenesis, and, in some patients, insufficient T cell
      help and/or exaggerated CD8+ T cell/NK cell suppression. Implications for
      clinical practice are outlined, e.g. hypersensitivity reactions and autoimmune
      diseases as part of the differential diagnosis of post-transplant disorders,
      questionable diagnostic benefit of serologic studies, and usefulness of
      prophylactic intravenous immunoglobulin.

PMID- 1628123
TI  - A scheme for daily monitoring of oral mucositis in allogeneic BMT recipients.
AB  - A system was developed for scoring oral mucositis in order to investigate its
      connection with fever and bacteraemia due to 'viridans' streptococci. A series of
      42 allogeneic bone marrow transplant recipients given demethoxydaunorubicin and
      total body irradiation for conditioning therapy were monitored daily for the
      presence of lesions, erythema, oral oedema, pain and dysphagia, each of which was
      graded numerically at four levels. These values were added together to yield a
      daily mucositis score (DMS) with a scale of 0-15. Mucositis developed shortly
      after transplant and progressed within a few days to grade III (WHO grade 3-4) in
      the majority of patients. Bacteraemia due to 'viridans' streptococci was
      documented in 64% of cases and the organisms were first detected as fever
      developed and mucositis approached its peak. The WHO scheme defined mucositis as
      either absent or grade 3-4 corresponding to a DMS of 4 or 5, whereas a grading
      system based on the most pronounced sign or symptom resulted in three grades of
      severity which corresponded to a DMS of less than or equal to 4, 5-9 and greater
      than or equal to 10 respectively. However, only the DMS permitted monitoring of
      mucositis through all its stages of development. The scheme therefore offers the
      potential for exploring causal relationships between mucosal damage,
      granulocytopenia, fever and bacteraemia and can be included as an independent
      measure in studies of prevention and therapy of complications related to
      mucositis.

PMID- 1628124
TI  - Liver disease in patients with liver dysfunction prior to bone marrow
      transplantation.
AB  - Twenty-two patients with previous hepatic compromise who underwent allogeneic
      bone marrow transplant (BMT) for treatment of hematologic malignancy or other
      hematologic disease between 1984 and 1990 were chosen for the present study.
      After transplant, 19 (86.4%) of the patients developed hepatitis, including six
      cases (27.3%) of acute hepatitis, 12 (54.6%) of chronic hepatitis and one
      uncharacterized hepatitis. Nine chronic hepatitis patients were followed-up for 7
      56.5 months (medium 35.5 months) with biochemistry studies and ultrasonography.
      Throughout the observation period, liver cirrhosis or hepatoma were not detected
      and no patients developed veno-occlusive disease. Furthermore patients who
      developed hepatitis after transplant had worse prognoses. Based on serial
      serological survey of the various hepatitis B virus (HBV) antigens and
      antibodies, we have found that most of the recurrent viral hepatitis in
      transplant patients could be attributed to the reactivation of the virus. In
      addition, the use of immunosuppressive drugs, persisting infection by HCV and the
      development of graft-versus-host disease may also play a role in modulating the
      course of viral hepatitis in BMT patients.

PMID- 1628125
TI  - The role of recombinant cytokines and other immunomodulators on engraftment
      following allogeneic bone marrow transplantation in mice.
AB  - BALB/c mice were conditioned by total body irradiation (TBI) with a suboptimal
      (475 cGy) or optimal (600 cGy) radiation dose for induction of chimerism
      subsequent to administration of 10(7) (BALB/c x C57BL/6) F1 (F1) bone marrow
      cells in order to test whether a variety of recombinant cytokines and other
      immunomodulators caused positive or negative effects on engraftment at different
      time intervals post-bone marrow transplantation (BMT). Engraftment in recipient
      mice conditioned by the minimal dose of TBI permitting 100% induction of
      chimerism (600 cGy) was not impaired following treatment with recombinant human
      interleukin 2 (IL2) (10(4) Cetus Units x 3/day i.p.), alpha interferon (alpha
      IFN) (10(4) units/day i.p.), gamma interferon (gamma IFN) (10(4) U/day i.p.) and
      combinations of IL2 + alpha IFN as well as IL2 + gamma IFN given either 5 days
      prior to or 5 days following BMT. Likewise, neither PGE2 (50 micrograms x 2/day
      i.p.) nor indomethacin (25 micrograms x 2/day i.p.) given either immediately
      prior to or immediately following BMT for 3 consecutive days had any detectable
      effect on chimerism. To investigate the putative beneficial effects of IL2 in
      enhancing marrow engraftment, BALB/c mice were irradiated with a suboptimal dose
      of TBI (475 cGy) followed by reconstitution with 10(7) F1 marrow cells
      supplemented with 2 x 10(6) F1 spleen cells. IL2 (10(4) U x 3/day i.p. x 5 days)
      was administered either prior to TBI, between TBI and BMT, immediately following
      BMT, or starting 2 weeks post-BMT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628126
TI  - Immunity to and immunization against measles, rubella and mumps in patients after
      autologous bone marrow transplantation.
AB  - Humoral immunity to measles, rubella and mumps was studied in 63, 36 and 16
      patients 1, 2 and 3 years, respectively after autologous bone marrow
      transplantation (ABMT). Serologic examination was performed using antibody-ELISA.
      One year after ABMT, 7/57 patients (12%) who were seropositive to measles before
      ABMT, became seronegative, 8/44 (18%) to rubella and 3/51 (6%) to mumps. Among
      patients who were retested at 2 and 3 years, three more patients became
      seronegative to measles, one to rubella, and three to mumps. Nine of 12 children
      who had previously been immunized against measles were seropositive before ABMT,
      3/7 to rubella and 5/7 to mumps, respectively. After ABMT, 5/9 became
      seronegative to measles, none to rubella and 2/5 to mumps. Six seronegative
      children were immunized with a live trivalent attenuated measles, mumps, and
      rubella vaccine 1 to 2 years after ABMT. Two children seroconverted to measles,
      six to rubella, and four to mumps. No side effects were observed. Most adult
      patients who have had the diseases of measles, rubella, or mumps naturally remain
      seropositive, while children who have been immunized commonly lose their immunity
      after ABMT.

PMID- 1628127
TI  - Allogeneic bone marrow transplantation for high risk acute lymphoblastic
      leukemia. Results from a single institution.
AB  - We present our experience with bone marrow transplantation (BMT) in 30
      consecutive patients with high risk acute lymphoblastic leukemia. With a median
      follow-up of 4 years the disease-free survival (DFS) was 44% for the whole group,
      with a significant difference between patients in first or second complete
      remission (CR 1 and 2, as one group), compared with patients with more advanced
      disease (greater than CR2), 69.5% versus 15.4% (p less than 0.01). The main cause
      of BMT failure was leukemic relapse, with a relapse rate of 15% for patients in
      CR 1 and 2 and of 77% for patients with greater than CR2 (p less than 0.01).
      Among patients with active disease at BMT those who had 15% blast cells or less
      in the marrow fared better than those with more advanced disease or
      extramedullary relapse. Transplant-related death was 17%. Graft-versus-host
      disease (GVHD) was associated with an antileukemic effect; the DFS for patients
      with acute and/or chronic GVHD was better than for patients with no GVHD at all.

PMID- 1628128
TI  - Slow response to induction chemotherapy is an indicator of poor survival after
      bone marrow transplantation for acute lymphoblastic leukemia. The Leukemia
      Working Party of the European Group of Bone Marrow Transplantation (EBMT).
AB  - The prognostic value of diagnosis-remission interval on leukemia-free survival
      (LFS) after bone marrow transplantation (BMT) was investigated retrospectively in
      193 adult patients with acute lymphoblastic leukemia (ALL) transplanted in first
      remission and reported to the EBMT between 1979 and 1986. Patients achieving
      remission within 8 weeks of diagnosis ('fast responders') had better LFS after
      BMT than those with remission after 8 weeks ('slow responders'): LFS at 3 years
      was 43% vs 32% for fast and slow responders, respectively (p = 0.04). The effect
      on LFS was particularly severe for slow responders transplanted within 3 months
      of remission. Only 17% of the slow responders with short remission-BMT interval
      survived at 3 years. Decreased LFS was caused by both excess of transplant
      related mortality and increased relapse incidence. In a multivariate analysis,
      time intervals (both diagnosis-remission and remission-BMT) were the strongest
      independent prognostic factor for LFS, probability of relapse and transplant
      related mortality. We conclude that the intervals diagnosis-remission and
      remission-BMT have a strong prognostic value in adult patients with ALL not only
      for remission duration after conventional treatment, but also for LFS after BMT.

PMID- 1628129
TI  - A regional autologous bone marrow transplant network: transfers to designated
      centers on the day after transplant.
AB  - Autologous bone marrow transplantation (ABMT) is becoming increasingly prevalent
      for treatment of advanced malignant disease. In order to increase the
      availability and utility of this therapy, we assessed the feasibility of
      transferring patients to their regional referral centers on the day after marrow
      infusion (day 1), for management post-transplant. This prospective study compares
      the outcome of 77 patients either transferred the day after marrow transplant for
      subsequent management at one of six selected Canadian regional centers closest to
      their domicile, or treated entirely at The Toronto Hospital, according to a
      common protocol. Study end-points included frequency of complications during
      transfer, transplant-related morbidity and mortality and hematopoietic recovery.
      Assessment of eligibility for transplant, bone marrow harvesting, autograft
      cryopreservation, administration of intensive therapy and marrow infusion were
      conducted in all cases at The Toronto Hospital. Thirty patients received marrow
      transplants and were transferred on day 1. There were no complications during
      transfer. Compared with 47 consecutive patients treated entirely at The Toronto
      Hospital, there were no differences in treatment-related morbidity or mortality,
      use of intravenous antifungal therapy or total days of hospitalization. We
      conclude that day 1 transfer of patients after ABMT to designated centers is
      feasible and safe. The operation of a regional ABMT network appears to benefit
      patients, relatives, referring physicians, the transplant center and may also
      improve health care delivery.

PMID- 1628130
TI  - Use of IgM enriched intravenous immunoglobulin (Pentaglobin) in bone marrow
      transplantation.
AB  - In a study of 63 allogeneic and autologous bone marrow transplants, patients were
      randomized to receive the IgM and IgA enriched intravenous immunoglobulin (IVIG)
      preparation (Pentaglobin). Pentaglobin has been postulated to have anti-endotoxin
      properties and one of the aims of the study was to measure endotoxin levels in
      these patients together with the clinical sequelae of infection. The anti
      endotoxin effects of Pentaglobin were found to reside in the IgM fraction. Those
      patients who received Pentaglobin were significantly protected from dying from
      infection in the first 100 days after the transplant, although it was not
      actually possible to document bacterial infections as the cause of death in the
      control patients. Peak endotoxin levels were significantly reduced (p = 0.02) in
      those patients receiving Pentaglobin. Liver damage as assessed by liver enzyme
      abnormalities correlated significantly with the presence of endotoxaemia greater
      than 25 pg/ml and up to 70% of pyrexial episodes were associated with
      endotoxaemia. Our results suggest that Pentaglobin is useful in reducing hepatic
      toxicity and this may be related to a reduction in endotoxaemia.

PMID- 1628131
TI  - Bone marrow harvest for marrow transplantation: effect of multiple small (2 ml)
      or large (20 ml) aspirates.
AB  - The aim of this study was to evaluate the yield of nucleated cells and CFU-GM and
      the T cell composition in bone marrow harvested by means of multiple small (2 ml)
      or large (20 ml) aspirations. Eleven marrow donors were studied: each donated
      1000 ml of bone marrow in two aliquots of 500 ml for an HLA identical sibling
      transplant. In six cases the first 500 ml were harvested by means of multiple 2
      ml aspirations (A) and the second 500 ml by means of 20 ml aspirations (B). In
      five cases the opposite was done: 20 ml aspirates first (C) and 2 ml afterwards
      (D). From each 500 ml aliquot a sample was taken for enumeration of nucleated
      cells and CD3+ lymphocytes and for CFU-GM growth. Small volume aspirations
      (groups A and D) yielded more nucleated cells (p = 0.02), more CFU-GM (p = 0.03)
      and fewer CD3+ cells (p = 0.1) when compared with large volume aspirations
      (groups B and C). This study shows that marrow harvesting by means of multiple
      small volume aspirations minimizes the dilution with peripheral blood and results
      in greater numbers of cells and hemopoietic progenitors.

PMID- 1628132
TI  - Cytokine-induced resistance to microbial infections in normal, immunosuppressed
      and bone marrow transplanted mice.
AB  - We studied the efficacy of in vivo and in vitro treatments with IL-1, IL-2, IL-3,
      and GM-CSF in the protection against bacterial (Salmonella typhimurium), fungal
      (Candida albicans) and viral (influenza virus A/PR8) infections, of normal,
      sublethally irradiated and lethally irradiated, bone marrow (BM) reconstituted
      mice. In parallel, the cytokines were tested for their ability to potentiate
      hematopoietic activity in vitro and in vivo. We demonstrate that, under the
      experimental conditions employed, IL-1 had the best protective activity against
      the three micro-organisms in both normal and immunocompromised mice when
      administered in vivo. Administration of IL-2 led to increased resistance in
      normal but not in immunodeficient mice, whereas GM-CSF had no beneficial effects.
      In contrast, preincubation of BM cells in these cytokines, singly or combined,
      prior to transplantation to lethally irradiated mice, did not confer protection
      against subsequent infection, although it increased the number of BM derived CFU
      GM in culture (except in the case of IL-2). Administration of IL-1 or GM-CSF to
      BM transplanted mice facilitated WBC recovery, whereas IL-2 delayed it.
      Collectively, the data suggest that IL-1, alone or combined with other cytokines,
      may be beneficial in the prevention or treatment of microbial infections in
      immunocompromised and BM transplanted patients. It can also be concluded that
      enhanced hematopoietic recovery may not always coincide with the development of
      resistance to micro-organisms.

PMID- 1628133
TI  - Interleukin-2 (IL-2) and IL-2-activated bone marrow in transplantation:
      evaluation from a clinical perspective.
AB  - Incubation of bone marrow (BM) with interleukin-2 (IL-2) in vitro results in
      generation of killer cells providing a tool for enhancing the graft-versus-tumor
      effect in transplantation. We have evaluated the influence of IL-2 on the
      progenitor cell activity (PCA), homing pattern of BM and hemopoiesis in a
      syngeneic bone marrow transplantation (BMT) model in mice. The PCA index and
      homing pattern of BM activated with IL-2 in vitro for 24 h (ABM) were similar to
      those of fresh bone marrow (FBM). In vitro culture of BM for more than 1 day
      resulted in progressive decline in its PCA index; this was not related to the
      presence or absence of IL-2 in the culture medium. Toxicity of IL-2 was related
      to the dose and not the time of institution of IL-2 therapy after BMT. Maximum
      tolerated dose of IL-2 instituted immediately after BMT was 10 times higher than
      the dose in a non-BMT setting. The pattern of marrow reconstitution following BMT
      with ABM was comparable to that with FBM. This study shows that BMT with BM
      activated with IL-2 for 24 h results in normal hemopoiesis, and IL-2 therapy
      instituted immediately after BMT with ABM does not cause additional toxicity.

PMID- 1628134
TI  - Long-term cryopreservation of human stem cells.
AB  - Successful engraftment of autologous bone marrow depends on preserving the
      viability of stem cells during cryopreservation. While several techniques for
      effective bone marrow and peripheral blood stem cell collection and processing
      have been reported, little is known about the effect of the duration of
      cryopreservation on stem cell viability in humans. We reviewed, retrospectively,
      the engraftment data of 33 patients with leukemia treated at Brigham and Women's
      Hospital, Boston and the European Bone Marrow Transplant Group from 1981-1989 who
      received stem cells cryopreserved for greater than or equal to 2 years. Data on
      cryopreservation methods are available in 18 of 33 patients. In all cases, stem
      cells were frozen in liquid nitrogen with a programmed freezer and stored at or
      below -140 degrees C. The median duration of cryopreservation was 2.8 years
      (range 2-11 years). Thirty of 32 (94%) evaluable patients achieved granulocyte
      counts greater than 500 x 10(6)/l (median 23 days; range 10-119 days); 26 of 32
      (74%) evaluable patients achieved platelets greater than 50 x 10(9)/l (median 30
      days; range 19-128 days) while 22/32 (69%) patients achieved platelets greater
      than 100 x 10(9)/l (median 45 days; range 20-328 days). This report demonstrates
      that human stem cells cryopreserved for up to 11 years are capable of engrafting.
      Stem cells may be stored for prolonged periods and used for transplantation in
      patients harvested prior to pelvic irradiation or alkylating agent therapy.

PMID- 1628135
TI  - No increase in relapse in patients with myeloid leukaemias receiving rhGM-CSF
      after allogeneic bone marrow transplantation.
AB  - Twenty patients with leukaemia received recombinant human GM-CSF (rhGM-CSF) after
      allogeneic bone marrow transplantation (BMT) in a double blind controlled trial,
      with a significant promotion of granulopoiesis when compared with 20 control
      patients. The follow-up in survivors is now sufficiently long to assess the
      potential for promotion of relapse in the patients with myeloid leukaemias. Six
      patients with myeloid leukaemias are alive 22-38 months after transplantation.
      Eight other patients with myeloid leukaemias died within 12 weeks of
      transplantation without active active disease. None of these 14 patients with
      myeloid leukaemias have relapsed. This study supports the view that rhGM-CSF does
      not increase the probability of relapse after allogeneic BMT in patients with
      myeloid leukaemia.

PMID- 1628137
TI  - Post-irradiation somnolence syndrome in an adult patient following allogeneic
      bone marrow transplantation.
AB  - Neurologic disturbances are common following the intensive chemotherapy and
      radiotherapy of bone marrow transplantation (BMT) conditioning regimens. The
      somnolence syndrome, which occurs in most children treated for leukemia with
      prophylactic cranial irradiation, has previously not been reported following BMT.
      This syndrome consists of transient lethargy, irritability, headaches, low grade
      fevers, gastrointestinal disturbances and depression. We report the case of a 38
      year-old female with acute non-lymphocytic leukemia who developed symptoms
      typical of the somnolence syndrome 8 weeks following 1320 cGy total body
      irradiation and cyclophosphamide conditioning. Encephalographic findings were
      consistent with the syndrome, and no additional infectious or metabolic disorders
      could be identified. As predicted by the pediatric experience, the symptoms were
      transient, resolving following steroid and anti-depressant therapy. Among
      patients undergoing radiation based conditioning regimens, especially those not
      receiving concurrent steroid therapy, the appearance of post-transplantation
      somnolence may be an expression of this syndrome.

PMID- 1628136
TI  - Late marrow allograft rejection following alpha-interferon therapy for hepatitis
      in a patient with paroxysmal nocturnal hemoglobinuria.
AB  - We describe a case of allograft rejection that occurred 23 months after
      successful bone marrow transplantation for severe aplastic anemia in a patient
      with paroxysmal nocturnal hemoglobinuria. The allograft rejection appears to have
      been induced by recombinant alpha-interferon (rINF-alpha) treatment for non-A,
      non-B hepatitis that developed 11 months after transplantation. During the 9
      months of active hepatitis, the donor graft functioned normally; however, 3
      months after rINF-alpha therapy was started, pancytopenia and a chimeric
      hematopoietic state developed. rINF-alpha was discontinued, cyclosporin A was
      reintroduced, and autologous bone marrow recovery followed. rINF-alpha treatment
      may be detrimental to some recipients of allogeneic bone marrow transplants.

PMID- 1628138
TI  - Fracture of the ilium: an unusual complication of bone marrow harvesting.

PMID- 1628139
TI  - MK801 attenuates behavioural adaptation to chronic nicotine administration in
      rats.
AB  - The effect of administering MK801 (0.3 mg kg-1) during chronic nicotine (0.4 mg
      kg-1) treatment was studied on locomotor activity in rats. Sensitization of the
      locomotor activity response to nicotine was seen with chronic nicotine treatment.
      This sensitization was attenuated in rats that had received MK801 30 min before
      the daily nicotine injections during chronic treatment. These results suggest
      that the NMDA receptor may be involved in the adaptive processes seen with
      chronic nicotine administration.

PMID- 1628140
TI  - ATP modulates the efferent function of capsaicin-sensitive neurones in guinea-pig
      isolated atria.
AB  - 1. The effect of adenosine triphosphate (ATP) and its stable analogues, alpha,
      beta-methylene-ATP and beta, gamma-methylene-ATP, on the efferent function of
      capsaicin-sensitive non-adrenergic, non-cholinergic (NANC) nerves was tested in
      guinea-pig isolated atria. 2. Transmural nerve stimulation of atria isolated from
      reserpine-pretreated guinea-pigs, in the presence of 1 microM atropine and 0.3
      microM CGP 20712A, induced a transient positive inotropic effect attributable to
      calcitonin gene-related peptide (CGRP) release from NANC nerve endings. 3. ATP (1
      30 microM) concentration-dependently reduced the cardiac response to transmural
      nerve stimulation, without affecting the inotropic response to 10 nM exogenous
      CGRP. The inhibitory effect of ATP was competitively antagonized by the P1
      purinoceptor antagonist, 8-phenyltheophylline (8-PT, 1 microM), but was
      unaffected by the P2-purinoceptor antagonist, suramin (100 microM). 4. beta,
      gamma-methylene-ATP in the same concentration range as ATP, inhibited the cardiac
      response to transmural nerve stimulation. The inhibitory effect of beta, gamma
      methylene ATP was antagonized by 1 microM 8-PT. The desensitizing agonist for P2
      purinoceptors, alpha, beta-methylene ATP did not induce any inhibitory effect
      either on the cardiac response to transmural nerve stimulation or on the
      inhibitory effect curve for ATP. 5. The inhibitory effect of ATP on the NANC
      neurotransmission was inconsistently modified in the presence of 10 microM alpha,
      beta-methylene-adenosine diphosphate, an inhibitor of the 5'-ectonucleotidases.
      6. These results demonstrate that ATP modulates the efferent function of cardiac
      NANC nerve endings through prejunctional inhibitory receptors belonging to the P1
      type. The metabolic conversion of ATP to adenosine does not seem to be a pre
      requisite for the ATP agonist activity.

PMID- 1628141
TI  - Adenine nucleotide-induced inhibition of binding of sulphonylureas to their
      receptor in pancreatic islets.
AB  - 1. The effects of the Mg complex of adenosine 5'-triphosphate (MgATP) on binding
      of sulphonylureas to microsomes obtained from mouse pancreatic islets were
      examined. 2. MgATP inhibited the binding of both glibenclamide and tolbutamide to
      microsomes. 3. Binding of [3H]-glibenclamide inhibited by MgATP was not further
      diminished by Mg(2+)-bound adenosine 5'-(beta, gamma-imidotriphosphate) (AMP-PNP)
      or free adenosine 5'-diphosphate (ADP). Higher concentrations of MgAMP-PNP
      induced a partial reversal of the inhibitory effect of MgATP on [3H]
      glibenclamide binding. 4. The apparent dissociation constant (K'D) for binding of
      [3H]- glibenclamide remained constant when 5. Extracellular ADP did not markedly
      stimulate insulin release from mouse pancreatic islets. 6. It is concluded that
      sulphonylureas and cytosolic nucleotides exert their inhibitory effects on the K
      ATP-channels of beta-cells by binding to different sites. The binding properties
      of the sulphonylurea receptor seem to be modulated by protein phosphorylation.

PMID- 1628142
TI  - Effects of BRL 38227 on potassium currents in smooth muscle cells isolated from
      rabbit portal vein and human mesenteric artery.
AB  - 1. Single smooth muscle cells were isolated from the rabbit portal vein and the
      human mesenteric artery and whole cell currents recorded at room temperature from
      either cell type by the whole cell voltage clamp technique. 2. In the rabbit
      portal vein cells addition of 10 microM BRL 38227 induced a quasi-instantaneous,
      voltage-insensitive and time-independent current which had a reversal potential
      of -75 mV under experimental conditions where the calculated EK was -83 mV. 3.
      Cells were held at 0 mV and BRL 38227 was added cumulatively to construct a dose
      response relationship. BRL 38227 (0.03-10 microM) caused a dose-dependent outward
      shift in the holding current with an EC50 of 1.3 microM. 4. BRL 38227 (10 microM)
      had no effect on the delayed rectifier K+ current measured in the presence of 5
      mM tetraethylammonium and no effect on the Ca(2+)-activated K+ current measured
      in the presence of 5 mM 4-aminopyridine. Similarly BRL 38227 had no effect on the
      Ca2+ current. 5. The BRL 38227-induced current was blocked by glibenclamide (10
      microM) and phentolamine (100 microM), specific blockers of the ATP-sensitive K+
      current in single cells. 6. In human isolated mesenteric artery cells, BRL 38227
      (10 microM) induced a glibenclamide-sensitive current similar to, but smaller
      than, that observed in the rabbit portal vein. 7. We conclude that in these
      cells, BRL 38227 activates a potassium conductance which has the
      electrophysiological and pharmacological characteristics of ATP-sensitive K+
      channels.

PMID- 1628143
TI  - Effect of sulphur containing amino acids on [3H]-acetylcholine release from
      amacrine cells of the rabbit retina.
AB  - 1. The effects of the sulphur containing amino acids, homocysteic acid,
      homocysteine sulphinic acid, cysteic acid and cysteine sulphinic acid on the
      release of [3H]-acetylcholine ([3H]-ACh) from the cholinergic amacrine cells of
      the rabbit retina were examined. 2. All the compounds stimulated the spontaneous
      resting release and abolished the light-evoked release of [3H]-ACh. Except for
      homocysteine sulphinic acid these actions occurred at concentrations that did not
      affect the erg b-wave amplitude, indicating a site of action at the inner retina.
      3. N-methyl-D-aspartate (in Mg(2+)-containing medium) clearly blocked the effects
      of homocysteic acid and homocysteine sulphinic acid on the resting release of
      [3H]-ACh but had no effect on the actions of cysteic acid and cysteine sulphinic
      acid. 4. Since N-methyl-D-aspartate is an antagonist of the light-evoked
      endogenous bipolar cell transmitter released onto cholinergic cells, these
      results are consistent with the suggestion that homocysteic acid or homocysteine
      sulphinic acid may be a transmitter released from this subpopulation of bipolar
      cells. 5. The present experiments indicate the existence of excitatory amino
      acids that have closer pharmacological properties to a bipolar cell transmitter
      than glutamate but it remains to be seen whether homocysteic acid or homocysteine
      sulphinic acid occur in these particular bipolar cells.

PMID- 1628144
TI  - Different in vivo properties of three new inhibitors of catechol O
      methyltransferase in the rat.
AB  - 1. We compared three new catechol O-methyltransferase (COMT) inhibitors (OR-611,
      Ro 40-7592 and CGP 28014; 10 and 30 mg kg-1, i.p.) in male rats given levodopa (L
      DOPA, 50 mg kg-1, i.p.) and carbidopa ((-)-L-alpha-methyl dopa, 50 mg kg-1,
      i.p.). In some studies pretreatment with pargyline (80 mg kg-1, i.p.) was used to
      block the function of monoamine oxidase (MAO). 2. Decreases of hypothalamic and
      striatal 3-O-methyl-dopa (3-OMD) levels were used as measures of the inhibition
      of peripheral COMT. The inhibition of brain COMT activity was estimated by
      decreases of hypothalamic and striatal homovanillic acid (HVA) and 3
      methoxytyramine (3-MT; after pargyline) levels. 3. The three COMT inhibitors
      studied had different individual characteristics. OR-611 was primarily a
      peripherally acting COMT inhibitor, decreasing 3-OMD levels in the striatum (to
      31-52%) and in the hypothalamus (to 16-27%) both in the control and pargyline
      treated animals at 1 and 3 h. It did not have any effect on brain HVA and 3-MT.
      3. Ro 40-7592 was a broad spectrum COMT inhibitor decreasing striatal and
      hypothalamic 3-OMD (always to less than 30%), HVA (to less than 50%) and 3-MT
      levels (to less than 23%) significantly both at 1 and 3 h. It was more potent
      than OR-611. 4. CGP 28014 functioned as a weak COMT inhibitor in the periphery
      inhibiting 3-OMD formation only at 3 h. In contrast, it was fairly potent in
      decreasing the brain HVA and 3-MT levels at 1 h (to 37-22% and 42-35% in the
      striatum, and to 57-33% and 64-35% in the hypothalamus, respectively) but not at
      3 h. Since CGP 28014, unlike OR-611 and Ro 40-7592, did not generally increase
      the brain DOPA, dopamine or DOPAC levels, it was not a typical COMT inhibitor.

PMID- 1628145
TI  - Bovine polymorphonuclear leukocytes increase sensitivity to noradrenaline in
      isolated mesenteric arteries.
AB  - 1. The effects of polymorphonuclear leukocytes (PMN) on vascular function to (-)
      noradrenaline were examined in vitro. Purified bovine PMN were incubated in
      siliconized organ baths containing rings of bovine mesenteric arteries, after
      which a concentration-effect curve in response to (-)-noradrenaline was obtained.
      2. PMN-derived products induced a long lasting concentration-dependent
      contraction of the blood vessels generating 24.4 +/- 6.8% of the maximal tension
      to (-)-noradrenaline at a cell concentration of 2.5 x 10(6) ml-1. The contractile
      response was also found in endothelium-denuded vascular rings. 3. PMN present in
      the organ bath caused an increase in the sensitivity of vascular rings to (-)
      noradrenaline. At a cell number of 2.5 x 10(6) PMN ml-1 the pD2-value for (-)
      noradrenaline was augmented 0.40 +/- 0.05 (P less than 0.001), while total
      contraction at the highest concentration (-)-noradrenaline was not affected. This
      increase in sensitivity was dependent on an intact endothelium. 4. The increase
      in sensitivity to (-)-noradrenaline by PMN was inhibited by superoxide dismutase,
      but not by catalase, dimethylthiourea, indomethacin or nordihydroguaiaretic acid.
      The non-stimulated bovine PMN produced oxygen radicals as measured by
      chemiluminescence. 5. Simultaneous incubation of PMN and (-)-noradrenaline with
      arterial rings induced an increase in the release of prostacyclin, measured by an
      elevated concentration of 6-keto-prostaglandin F1 alpha in the supernatant. 6. It
      is concluded that PMN can increase vascular tone directly or indirectly probably
      via the interaction of PMN-derived superoxide anions with endothelium-derived
      relaxing factor.

PMID- 1628146
TI  - CI988, a selective antagonist of cholecystokininB receptors, prevents morphine
      tolerance in the rat.
AB  - 1. The effect of chronic treatment with CI988, a recently developed selective
      antagonist of cholecystokinin type-B receptors (CCKB receptors) on the tolerance
      to morphine analgesia was studied in rats with the hot plate test. 2. Morphine
      tolerance was induced with the use of two paradigms. Morphine was injected i.p.
      either in a schedule of increasing doses (1-32 mg kg-1) twice daily for 6 days or
      at a fixed dose (3 mg kg-1) daily for 29 days. 3. In both series of experiments,
      tolerance to the analgesic effect of morphine was prevented by simultaneous
      treatment with i.p. CI988. Chronic treatment with only CI988 daily for up to 29
      days did not reduce the analgesic effect of a weekly injection of morphine. 4.
      CI988 did not diminish the physical dependence to morphine, as examined with
      naloxone precipitated withdrawal. 5. The present results provide evidence that
      chronic treatment with a selective CCKB receptor antagonist could prevent
      tolerance to the analgesic effect of morphine without affecting morphine-induced
      physical dependence. Application of CCK antagonists may be clinically important
      in treating chronic pain patients by preventing morphine tolerance and by
      eliminating the need to increase morphine doses to unacceptable levels.

PMID- 1628147
TI  - Comparisons of the effects of ryanodine on catecholamine secretion evoked by
      caffeine and acetylcholine in perfused adrenal glands of the guinea-pig.
AB  - 1. The effect of ryanodine on catecholamine secretion induced by caffeine and
      muscarinic receptor activation was investigated in perfused adrenal glands of the
      guinea-pig. 2. Caffeine (40 mM) caused only a small increase in catecholamine
      secretion during perfusion with standard Locke solution. Caffeine-induced
      catecholamine secretion was markedly enhanced after removal of CaCl2 together
      with replacement of NaCl with sucrose. 3. In the absence of CaCl2 and NaCl, 50
      microM ryanodine had no effect on the resting catecholamine secretion. Caffeine
      (40 mM) administered 15 min after treatment with ryanodine caused an increase in
      catecholamine secretion similar to that prior to application of ryanodine, but
      failed to have any effect thereafter. Combined application of ryanodine and
      caffeine also prevented catecholamine secretion induced by caffeine applied
      subsequently. 4. Catecholamine secretion induced by 100 microM acetylcholine
      (ACh) was only partially inhibited after treatment with ryanodine plus caffeine
      under Ca(2+)-free, Na(+)-deficient conditions. 5. Preferential influence of
      ryanodine on the response to caffeine was also confirmed in catecholamine
      secretion evoked by paired stimuli with caffeine and ACh alternately, during
      perfusion with either Ca(2+)-free Locke or sucrose-substituted solutions. 6.
      These results indicate that caffeine increases catecholamine secretion by
      mobilizing Ca2+ from intracellular Ca2+ stores through ryanodine-sensitive
      mechanisms in guinea-pig adrenal chromaffin cells. Ca2+ stores sensitive to
      caffeine and muscarinic receptor activation may not overlap entirely.

PMID- 1628148
TI  - The effect of lipopolysaccharide, interleukin-1 and tumour necrosis factor on the
      hepatic accumulation of 5-hydroxytryptamine and platelets in the mouse.
AB  - 1. Injection of lipopolysaccharide (LPS; 0.5-500 microgram kg-1) into mice
      induced a dose-dependent, slowly developing increase in hepatic content of 5
      hydroxytryptamine (5-HT). This sustained increase could not be attributed to an
      LPS-induced alteration of the pharmacokinetic handling of 5-HT by stimulation of
      its uptake or inhibition of its degradation. 2. Regional differences were
      apparent in the tissue content of histamine and 5-HT between mast cell-deficient
      (W/Wv) and normal (+/+) mice. LPS administration (0.5 mg kg-1) gave comparable
      increases in the hepatic level of 5-HT in mast cell-deficient and normal mice. 3.
      Reserpine pretreatment (1 mg kg-1) selectively reduced 5-HT levels in the blood,
      spleen, liver, brain and lung of normal mice. Prior treatment with this agent
      also abolished the LPS (0.5 mg kg-1)-induced hepatic accumulation of 5-HT. 4.
      Accumulation of 5-HT in the liver by LPS (0.1 mg kg-1) was temporally associated
      with both a fall in the levels of circulating platelets, and a reduction in the
      concentration of 5-HT in the blood. The LPS dose-dependent (0.5-500 micrograms kg
      1) increase in hepatic 5-HT content was associated with a similar dose-dependent
      reduction in the circulating levels of 5-HT. 5. Interleukin-1, alpha and beta (10
      micrograms kg-1) and tumour necrosis factor alpha (TNF alpha) (1 mg kg-1)
      significantly enhanced the accumulation of 5-HT within the liver. Administration
      of TNF alpha (10 micrograms kg-1) potentiated the increase in hepatic 5-HT
      content seen with IL-1 beta (10 micrograms kg-1). 6. Electron microscopy revealed
      numerous platelets in the sinusoidal and perisinusoidal Disse spaces within the
      liver, in animals pretreated with LPS (0.1 mg kg '). The platelets retained their
      intact structure and showed no evidence of degranulation. 7. These data suggest
      that the LPS and cytokine-induced mobilization of 5-HT in the liver is associated
      with the hepatic translocation of platelets. This migration appears to be
      independent of platelet aggregation.

PMID- 1628149
TI  - Okadaic acid inhibits activation of phospholipase C in human platelets by
      mimicking the actions of protein kinases A and C.
AB  - 1. The effect of okadaic acid, a potent inhibitor of protein phosphatases 1 and
      2A (PP1 and PP2A), on human platelets has been investigated. 2. Okadaic acid
      exerts a general increase in phosphorylation of platelet proteins but did not
      induce aggregation or secretion of 5-hydroxytryptamine (5-HT). Okadaic acid,
      however, did inhibit thrombin-induced functional responses. 3. Maximally
      effective concentrations of prostacyclin, to elevate adenosine 3'-5'-cyclic
      monophosphate (cyclic AMP), or phorbol dibutyrate, to activate protein kinase C,
      inhibited the formation of inositol phosphates by thrombin by approximately 60%.
      When used in combination, prostacyclin and phorbol dibutyrate reduced the levels
      of inositol phosphates induced by thrombin to 11%. 4. Okadaic acid (1 microM)
      decreased thrombin-induced formation of inositol phosphates by approximately 55%
      and increased the inhibitory action of prostacyclin or phorbol dibutyrate.
      Okadaic acid had no further effect when prostacyclin and phorbol dibutyrate were
      used in combination. 5. These results suggest that protein kinases A and C act to
      inhibit phospholipase C by distinct mechanisms and that their action is reversed
      by PP1 and/or PP2A.

PMID- 1628150
TI  - Increased secretion of glandular-kallikrein in the bronchial washings induced by
      intravenous injection of leukotriene C4 in guinea-pigs.
AB  - 1. Intravenous administration of leukotriene C4 (LTC4) and LTD4 (1-10 nmol kg-1)
      caused a dose-dependent increase in secretion of glandular-kallikrein in the
      bronchial washings of guinea-pigs, as measured by cleavage of a synthetic
      substrate and the formation of kinin. LTC4 was more potent than LTD4 and
      pilocarpine was much less potent than peptide leukotrienes on a molecular basis.
      2. The increases in levels of glandular-kallikrein in the bronchial washings that
      were induced by LTC4 (3 nmol kg-1, i.v.) were almost completely inhibited by
      pretreatment with an antagonist of leukotrienes (ONO-1078), with an antagonist of
      thromboxane (S-1452), with an inhibitor of thromboxane synthetase (OKY-046), with
      indomethacin, with atropine or with scopolamine. These results indicate that the
      LTC4-induced increase in levels of glandular-kallikrein may have been mediated by
      the formation of thromboxane and the release of acetylcholine. 3. The increases
      in levels of glandular-kallikrein in the bronchial washings induced by STA2 (20
      pmol kg-1, i.v.), a stable analogue of thromboxane A2, were completely blocked by
      pretreatment with atropine, whereas increases induced by pilocarpine (41 mumol kg
      1, i.v.) were not blocked by pretreatment with indomethacin, although such
      increases were inhibited by atropine. This result indicates that secretion of
      kallikrein stimulated by LTC4 may have been mediated by the successive formation
      of thromboxane A2 and release of acetylcholine. 4. Intravenous administration of
      bradykinin (3-30 nmol kg-1) caused a dose-dependent increase in levels of
      glandular-kallikrein in the bronchial washings. This increase was completely
      inhibited by pretreatment with atropine, with indomethacin or with an antagonist
      of thromboxane.5. The increases in levels of glandular-kallikrein in the
      bronchial washings induced by LTC4 (3 nmol kg'- , i.v.) and pilocarpine (41 flmol
      kg- 1, i.v.) were significantly inhibited by pretreatment with an antagonist of
      bradykinin. These results suggest that intravenous LTC4 may increase secretion of
      glandular-kallikrein via formation of thromboxane A2 and release of acetylcholine
      in that order, and kinin released by kallikrein may enhance the rate of secretion
      of glandular-kallikrein.

PMID- 1628151
TI  - Characterization of P1-purinoceptors on rat duodenum and urinary bladder.
AB  - 1. The P1-purinoceptors mediating relaxation of the rat duodenum and inhibition
      of contraction of the rat urinary bladder were characterized by use of adenosine
      and its analogues 5'-N-ethylcarboxamidoadenosine (NECA), N6-cyclopentyladenosine
      (CPA) and 2-p-((carboxyethyl)phenethylamino)-5'- carboxamidoadenosine (CGS
      21680), as well as the A1-selective antagonist 1,3-dipropyl-8-cyclopentylxanthine
      (DPCPX). The stable analogue of adenosine 5'-triphosphate (ATP), adenylyl 5'
      (beta,gamma-methylene)diphosphonate (AMPPCP), was also used as previous work had
      indicated that it has a direct action on some P1 receptors in addition to its P2
      purinoceptor activity. 2. In the rat duodenum, the order of potency of the
      adenosine agonists was NECA greater than or equal to CPA greater than AMPPCP =
      adenosine greater than CGS 21680, and DPCPX antagonized CPA and AMPPCP at a
      concentration of 1 nM whereas equivalent antagonism of NECA and adenosine
      required a concentration of 1 microM. This suggests the presence of a mixture of
      A1 and A2 receptors in this tissue, with CPA and AMPPCP acting on the A1 and NECA
      and adenosine acting on the A2 receptors. 3. In the rat bladder, the order of
      potency of the adenosine agonists for inhibition of carbachol-induced
      contractions was NECA much greater than adenosine greater than CPA = CGS 21680,
      and a concentration of DPCPX of 1 microM was required to antagonize responses to
      NECA and adenosine. This suggests the presence of A2 receptors in this tissue.
      ATP and AMPPCP each caused contractions which were not enhanced by DPCPX (1
      microM) which suggests that in this tissue AMPPCP was acting only via P2
      receptors and had no P1 agonist activity. That AMPPCP was active on the A1
      receptors in the duodenum but inactive on the A2 receptors in the bladder implies
      that it has selectivity for the A1 subtype.4. That CGS 21680, which has been
      reported to bind selectively to the high affinity A2a subclass of A2 receptors,
      had a very low potency on the A2 receptors in the duodenum and in the bladder
      suggests that these receptors are of the low affinity A2b subclass.

PMID- 1628153
TI  - The influence of atropine and atenolol on the cardiac haemodynamic effects of NG
      nitro-L-arginine methyl ester in conscious, Long Evans rats.
AB  - 1. In the present study, the extent to which baroreflexes contribute to the
      cardiac effects of NG-nitro-L-arginine methyl ester (L-NAME) was assessed in
      conscious, Long Evans rats chronically instrumented with thoracic electromagnetic
      flow probes for the measurement of cardiac haemodynamics. 2. L-NAME (10 mg kg-1,
      i.v.) was administered in the absence (n = 6) and in the presence (n = 7) of
      atropine (1 mg kg-1) and atenolol (1 mg kg-1). 3. L-NAME caused a marked increase
      in mean arterial pressure and marked reductions in total peripheral conductance,
      cardiac output, heart rate, stroke volume, peak thoracic flow and the maximum
      rate of rise of aortic flow. 4. Administration of atropine, after the maximal
      bradycardic effect of L-NAME was established, restored the heart rate to resting
      levels. Concurrently, there was a reduction in stroke volume, such that cardiac
      output, although transiently elevated, did not show a sustained increase. No
      other variables were significantly affected by atropine. Additional
      administration of atenolol had no effect other than to cause a slight
      bradycardia, such that in the presence of atropine and atenolol, heart rate was
      not different from that in animals receiving atropine and atenolol before L-NAME.
      5. In the presence of atropine and atenolol, L-NAME had similar pressor,
      vasoconstrictor and cardiac haemodynamic effects to those in untreated animals,
      although the bradycardia was significantly attenuated. However, there was still a
      significant reduction in heart rate following L-NAME in the presence of atropine
      and atenolol.6. These results indicate that the major component of the
      bradycardia following L-NAME is indirect and mediated through an increase in
      vagal efferent activity. However, the substantial reduction in cardiac function
      caused by L-NAME is not dependent on the autonomic control of the heart but
      rather, may depend on the increase in afterload and/or a direct effect of L-NAME
      on the heart and/or its vasculature.

PMID- 1628152
TI  - Inhibition of endothelium-dependent vasorelaxation by arginine analogues: a
      pharmacological analysis of agonist and tissue dependence.
AB  - 1. Isolated rings of rabbit external jugular vein (RbJV) and rat thoracic aorta
      (RA) were used to study the effect of the NO synthase inhibitor L-NG
      nitroarginine methyl ester (L-NAME) on muscarinic and 5-hydroxytryptamine (5-HT)
      receptor-stimulated, endothelium-dependent vascular relaxations. 2. In RbJV
      relaxations produced by the endothelial 5-HT receptor agonist alpha-methyl-5-HT
      were potently and non-surmountably inhibited by L-NAME (10 microM), whereas
      acetylcholine relaxations in this tissue were unaffected by this concentration of
      inhibitor. By contrast, acetylcholine relaxations in RA were virtually abolished
      by 10 microM L-NAME. In each case an equivalent concentration of D-NAME was
      without effect on agonist-induced relaxations. 3. The different effect of L-NAME
      on acetylcholine relaxations in RbJV and RA was not due to muscarinic receptor
      differences. Affinity estimates for acetylcholine (pKA = 6.12 +/- 0.09; 6.09 +/-
      0.08 respectively) and for 4-diphenyl-acetoxy-N-methylpiperidine methobromide (4
      DAMP, pKB = 9.01 +2- 0.012; 9.24 +/- 0.16 respectively) indicated that the
      receptors in both tissues belong to the same M3 class. Tissue differences
      resulting from the release of a cyclo-oxygenase product or a glibenclamide
      sensitive K(+)-channel-linked hyperpolarizing factor were also ruled out by
      selective inhibition of these pathways. 4. When phenoxybenzamine was used to
      reduce the efficacy of acetylcholine in RbJV so that it behaved as a partial
      agonist in this tissue, L-NAME (10 microM) now produced non-surmountable
      inhibition of relaxation responses. In untreated tissues the same concentration
      of L-NAME also profoundly inhibited responses produced by butyrylcholine and
      pilocarpine, both of which behave as partial agonists at the M3 receptor in RbJV.
      5. A simple model was developed which describes the theoretical behaviour of
      receptor-stimulated synthesis and release of NO. The model predicts that
      competitive inhibition of NO formation results in parallel displacements of the
      agonist response curve in the case of high efficacy agonist, but right-shift with
      concomitant depression of the curve maximum in the case of low efficacy agonists.
      Simulations based on the model showed reasonable agreement with the experimental
      data. 6. It is concluded that analogues of L-arginine demonstrate tissue- and
      agonist-dependence in terms of their ability to inhibit receptor-mediated events
      involving the liberation of NO. This behaviour can reflect differences in agonist
      efficacy in the receptor systems being studied, a possibility that should be
      ruled out before apparent resistance to inhibition is taken as evidence for the
      involvement of heterogeneous endothelium-derived relaxing factors (EDRFs).

PMID- 1628154
TI  - Sustained decreases in weight and serum insulin, glucose, triacylglycerol and
      cholesterol in JCR:LA-corpulent rats treated with D-fenfluramine.
AB  - 1. The effects of D-fenfluramine were studied in the JCR:LA-corpulent rat that is
      grossly obese, hyperphagic, hyperlipidaemic, hyperinsulinaemic and
      atherosclerosis-prone. 2. Daily doses of 1, 2.5 and 5 mg kg-1 of D-fenfluramine
      produced sustained decreases in body weight and food intake over a period of 30
      days in 6 month old female rats fed ad libitum. This was accompanied by decreases
      in the circulating concentrations of glucose, triacylglycerol, free cholesterol
      and insulin. 3. Food restriction imposed by meal feeding also decreased
      circulating glucose, triacylglycerols, cholesterol and insulin and diminished the
      effect of D-fenfluramine on these parameters in male and female rats. 4. Addition
      of D-fenfluramine to drinking water to give a dose of about 0.25 mg kg-1 daily
      produced a sustained decrease in body weight and food intake of male and female
      rats over a nine week period. 5. The results show that the JCR:LA-corpulent rat
      is very sensitive to the pharmacological effects of D-fenfluramine. These rats
      should provide an appropriate animal model for determining the mechanisms of
      action of this anti-obesity agent and whether apparently beneficial changes in
      metabolism translate into long-term protection against premature atherosclerosis.

PMID- 1628155
TI  - Pharmacological characterization of angiotensin-induced depolarizations of rat
      superior cervical ganglion in vitro.
AB  - 1. The depolarizing responses to angiotensin II and angiotensin III of the rat
      superior cervical ganglion have been characterized in vitro, by the use of
      peptidase inhibitors, peptide and non-peptide antagonists and dithiothreitol
      (DTT). 2. Angiotensin II and III depolarized the ganglion in a concentration
      related manner. Angiotensin II was approximately 30 fold more potent than
      angiotensin III. 3. The endopeptidase inhibitor, bacitracin, increased the
      potency of angiotensin II and III by approximately 4 and 20 fold respectively.
      The aminopeptidase inhibitor, amastatin, further increased the potency of
      angiotensin III (but not angiotensin II) by approximately 4 fold. In the presence
      of bacitracin and amastatin, angiotensin II and III were equipotent. 4. The
      peptide antagonist [Ile7]angiotensin III (0.01-0.3 microM) produced a non
      parallel rightward displacement of the angiotensin II concentration-response
      curve, with a suppression of the maximum response. The potency of
      [Ile7]angiotensin III was increased by bacitracin and amastatin. 5. The AT1
      selective non-peptide antagonist losartan (DuP 753; 0.03 and 0.1 microM) produced
      a parallel rightward displacement of the angiotensin II concentration-response
      curve, with an apparent pKB of 8.3 +/- 0.1. A higher concentration of losartan
      (0.3 microM) depressed the maximum agonist response by 32 +/- 6.5%, possibly
      reflecting non-competitive behaviour of the antagonist. The potency of losartan
      was not influenced by bacitracin. 6. The AT2-selective non-peptide antagonist,
      PD123177 (3 microM) failed to antagonize the angiotensin II-induced
      depolarizations. 7. DTT (1 mM) produced a 22% reduction of the maximum response
      to angiotensin II.8. We conclude that the angiotensin II-induced depolarizations
      of the rat superior cervical ganglion are mediated by angiotensin II receptors of
      the AT1 subclass. The ability of peptidase inhibitors to modify the potency of
      peptide agonists and antagonists highlights the difficulties associated with the
      use of peptide agents to characterize angiotensin II receptors in this
      preparation.

PMID- 1628156
TI  - Dopamine release and metabolism in the rat frontal cortex, nucleus accumbens, and
      striatum: a comparison of acute clozapine and haloperidol.
AB  - 1. The effects of the typical and typical neuroleptic agents clozapine (CLZ) (2.5
      20 mg kg-1, i.p.) and haloperidol (Hal) (0.05-1.0 mg kg-1), were compared on
      dopamine release and metabolism in the rat prefrontal cortex (PFC), nucleus
      accumbens (ACC) and striatum (ST). Dopamine release was estimated by measuring
      the steady-state concentration of 3-methoxytyramine (3-MT) and the level of 3-MT
      10 min after pargyline (3-MT accumulation); dopamine metabolism was evaluated
      from the steady-state concentrations of its acidic metabolites. 2. Both drugs
      increased 3-MT accumulation in the PFC in a dose-dependent manner. In contrast to
      Hal, CLZ failed to increase 3-MT accumulation in the ACC or ST. The ST was the
      region most sensitive to Hal in terms of 3-MT accumulation and, by inference,
      dopamine release. 3. Both CLZ and Hal dose-dependently elevated the
      concentrations of 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid
      (HVA) in all 3 brain regions studied. The ACC appears to be the region most
      sensitive to these drugs in terms of changes in the levels of HVA. 4. The result
      of the present investigations suggest measurements of 3-MT production in the 3
      brain regions analysed might be a useful and simple pharmacological tool in the
      search for atypical neuroleptic drugs with a selectivity of action for the
      cortical systems.

PMID- 1628157
TI  - Participation of endothelium-derived nitric oxide but not prostacyclin in the
      gastric mucosal hyperaemia due to acid back-diffusion.
AB  - 1. The possible participation of prostacyclin and nitric oxide (NO) in the
      gastric mucosal hyperaemic response to acid back-diffusion through a disrupted
      gastric mucosal barrier was examined. The experiments were carried out on
      anaesthetized rats in which acid back-diffusion was elicited by gastric perfusion
      with dilute ethanol in 0.15 M HCl and gastric mucosal blood flow (MBF) was
      measured by the hydrogen gas clearance technique. 2. Indomethacin (28 mumols kg
      1, s.c.), an inhibitor of the formation of cyclo-oxygenase products including
      prostacyclin, failed to alter mean arterial blood pressure (MAP), basal MBF and
      the hyperaemic response to acid back-diffusion in urethane-anaesthetized rats. 3.
      NG-nitro-L-arginine methyl ester (L-NAME; 13 and 43 mumols kg-1, i.v.), an
      inhibitor of endothelium-derived NO formation, increased MAP in a dose-dependent
      manner. Whilst basal MBF in urethane-anaesthetized rats was not changed, the
      increase in MBF caused by gastric perfusion with dilute ethanol in acid was dose
      dependently depressed by L-NAME. The loss of H+ ions from the gastric lumen, an
      indirect measure of acid back-diffusion, was significantly enhanced by 43 mumols
      kg-1 L-NAME. In contrast, D-NAME (13 and 43 mumols kg-1) was without effect on
      MAP, basal and stimulated MBF, and acid back-diffusion. 4. Unlike in urethane
      anaesthetized rats, L-NAME led to a significant reduction of basal MBF in
      phenobarbitone-anaesthetized rats. MAP in the phenobarbitone-anaesthetized rats
      was significantly higher than in urethane-anaesthetized rats, and the
      hypertensive effect of L-NAME under phenobarbitone anaesthesia was significantly
      smaller than under urethane anaesthesia.5. The rise in MBF brought about by acid
      back-diffusion was blocked by L-NAME administered to phenobarbitone-anaesthetized
      rats. Infusion of L-arginine (120 pmol kg -1 min- ', i.v.) led to a partial, but
      significant, reversal of the effects of L-NAME on MAP and the hyperaemia due to
      acid back-diffusion.6. These findings indicate that endothelium-derived NO plays
      an important mediator role in the gastric mucosal vasodilatation caused by back
      diffusion whilst vasodilator prostanoids such as prostacyclin are not involved.

PMID- 1628158
TI  - Effects of pinacidil on guinea-pig isolated perfused heart with particular
      reference to the proarrhythmic effect.
AB  - 1. The effects of pinacidil (10, 30, 50 microM) on contractility (+dP/dtmax),
      coronary perfusion pressure (cP), and ECG intervals (PR, QRS, QT) have been
      studied on constant-flow perfused guinea-pig hearts, driven at four frequencies
      (2.5, 3, 3.5, 4 Hz). 2. Pinacidil decreased +dP/dtmax, cP and the QT interval in
      a dose-dependent manner, whereas the PR interval was increased. QRS duration was
      not modified. All these effects were independent of driving frequency. Pinacidil
      decreased the interval from Q-wave to T-wave peak (QTpeak) to a greater extent
      than the QT interval, thus decreasing the QTpeak/QT ratio. This effect, unlike
      that on QT interval, was more evident at the highest frequency of stimulation. 3.
      In 4 out of 20 hearts treated with pinacidil sustained ventricular fibrillation
      (VF) occurred following a short run of premature ventricular beats (R on T
      phenomenon). 4. In separate experiments, an attempt to induce VF electrically was
      made at drug concentrations ranging from 10 microM to 100 microM (8 experiments
      for each concentration). In control conditions and at the lowest concentrations
      of pinacidil tested (10 microM) VF could never be induced; in the presence of 30
      microM pinacidil VF was induced in 5 out of 8 experiments. Drug concentrations
      higher than 50 microM permitted the induction of VF in every case. 5. Although
      the concentrations of pinacidil producing ventricular fibrillation are 30-40
      times higher than those found in patients under long term treatment with this
      agent, it is suggested that caution should be used in prescribing this drug, at
      least in patients suffering from myocardial ischaemia.

PMID- 1628159
TI  - Anpirtoline, a novel, highly potent 5-HT1B receptor agonist with
      antinociceptive/antidepressant-like actions in rodents.
AB  - 1. The purpose of the present study was to relate the effects of the novel drug,
      anpirtoline, on 5-hydroxytryptamine (5-HT) receptor subtypes to its
      antinociceptive and antidepressant-like actions in rodents. 2. Binding assays
      with rat brain membranes have shown that anpirtoline bound with a much higher
      affinity to 5-HT1B receptor (Ki = 28 nM) than to 5-HT1A (Ki = 150 nM) and 5-HT2
      (Ki = 1.49 microM) receptors. 3. Like 5-HT, anpirtoline concentration-dependently
      inhibited forskolin-stimulated adenylate cyclase activity in homogenates from the
      rat substantia nigra. Both effects were not additive, and could be prevented by 5
      HT1B receptor antagonists such as propranolol and penbutolol. 4. In superfused
      rat and pig brain cortex slices preincubated with [3H]-5-HT, the electrically
      evoked tritium overflow was inhibited by anpirtoline and 5-HT. Whereas 5-HT was
      equipotent in both tissues (EC50 = 69 nM), anpirtoline was markedly less potent
      in pig brain cortex slices (EC50 = 1190 nM) than in rat brain cortex slices (EC50
      = 55 nM). The concentration-response curve for anpirtoline was shifted to the
      right by metitepine in both preparations. 5. In the social behaviour deficit
      test, anpirtoline and trifluoromethylphenyl-piperazine were effective in
      reversing the isolation-induced impairments in mice, an effect shown only by
      compounds with agonist properties at the 5-HT1B receptor. 6. In the
      electrostimulated pain test using mice, anpirtoline dose-dependently increased
      the pain threshold with an ED50 of 0.52 mg kg-1, i.p. The antinociceptive
      activity of anpirtoline was abolished by pretreatment with cyproheptadine or
      propranolol.7. In the forced swimming test in rats, anpirtoline induced a dose
      related increase in swimming activity. With an ED50 value of 4.6mgkg-1, i.p.,
      anpirtoline was 4 times more potent than the two standard compounds imipramine
      and desipramine. The decrease of immobility time or the increase of active
      periods in this model of behavioural despair is suggested to be characteristic of
      antidepressant drugs.8. Anpirtoline exhibits both antinociceptive and
      antidepressant-like activities in animals. It is probable that anpirtoline
      elicits these pharmacological effects via its agonist effect on 5-HT1B and 5-HT1A
      receptors.

PMID- 1628161
TI  - Platelet-activating factor (PAF) plays an important role in the immediate
      asthmatic response in guinea-pig by augmenting the response to histamine.
AB  - 1. To investigate the role of platelet activating factor (PAF) in the immediate
      asthmatic response, we examined the bronchial reactivity to histamine after
      administration of PAF to guinea-pigs or antigen challenge to passively sensitized
      guinea-pigs. 2. A bolus injection of PAF (20-40 ng kg-1), which did not cause a
      significant increase in intrathoracic pressure (ITP), augmented the bronchial
      response to histamine almost 8 fold. This airway hyperreactivity was observed
      even 1 min after PAF treatment. 3. A subthreshold dose of antigen (0.01 mg kg-1,
      i.v.) also provoked hyperreactivity to histamine, which became significant 6 and
      11 min after the antigen treatment. 4. The specific PAF-antagonists, SM-10661 and
      CV-6209 (i.v.) dose-dependently inhibited both PAF- and antigen-induced airway
      hyperreactivities to histamine. 5. These results suggest that PAF plays an
      important role in antigen-induced acute airway responses by augmenting the
      activities of spasmogens.

PMID- 1628160
TI  - The role of nitric oxide in the regional vasodilator effects of endothelin-1 in
      the rat.
AB  - 1. The role of nitic oxide (NO) derived from L-arginine in the regional
      vasodilator effects of endothelin-1 has been investigated in anaesthetized,
      spontaneously hypertensive (SH) rats in which autonomic reflexes were abolished
      by ganglion blockade. The experimental design incorporated animals infused with
      phenylephrine to mimic the peripheral vasconstrictor effects of the NO
      biosynthesis inhibitors and a single dose per animal paradigm to obviate problems
      of tachyphylaxis to the vasodilator effects of endothelin-1. 2. Infusion of the
      inhibitor of NO synthase, N-monomethyl-L-arginine (L-NMMA) at a dose (5 mg kg-1
      min-1) which maximally raised blood pressure did not influence either the fall in
      blood pressure or the vasodilator responses induced in the hindquarters and
      carotid vascular beds by endothelin-1 (1 nmol kg-1, i.v.) The duration (but not
      the initial magnitude) of the vasodepressor response to endothelin-1 was however
      significantly attenuated (by 49%) during infusion of the more potent inhibitor of
      NO synthase, NG-nitro-L-arginine methyl ester (L-NAME), 2 mg kg-1 min-1. 3.
      Increasing the dose of L-NAME to 10 and 25 mg kg-1min-1 significantly attenuated,
      but did not abolish, the falls in blood pressure and hindquarters vasodilator
      responses to acetylcholine, 1 microgram kg-1, and endothelin-1, 1 nmol kg-1 min
      1. The effects were selective in that vasodepressor responses to the endothelium
      independent vasodilator, sodium nitroprusside, 1-10 micrograms kg-1 min-1, were
      unaltered. The effects were selective in that vasodepressor responses to the
      endothelium-independent vasodilator, sodium nitroprusside, 1-l0mg kg min , were
      unaltered.4. The data indicate that NO generated de novo from L-arginine mediates
      a significant component of the vasodilator effect of endothelin-1 in the
      anaesthetized, ganglion-blocked SH rat. However, a major component of the
      vasodepressor effects of both endothelin-1 and acetylcholine may occur
      independently of this mechanism.

PMID- 1628162
TI  - The synovial lining cells in chronic arthritis.

PMID- 1628163
TI  - Non-steroidal drug-induced peptic ulceration can we really protect the stomach?

PMID- 1628164
TI  - Intermittent hydrostatic compressive force stimulates exclusively the
      proteoglycan synthesis of osteoarthritic human cartilage.
AB  - In paired observations the in vitro proteoglycan turnover was studied of human
      normal and osteoarthritic cartilage in the absence and presence of intermittent
      hydrostatic compressive force. Shortly after collection, osteoarthritic cartilage
      showed a higher proteoglycan synthesis rate than normal cartilage, whereas after
      culture the reverse was found. Exposure during culture to hydrostatic
      intermittent compression of a low physiological magnitude enhanced the
      proteoglycan synthesis rate for osteoarthritic cartilage, whereas normal was
      unaffected by this hydrostatic intermittent compression. This enhancing effect
      was reversible. We conclude that human osteoarthritic cartilage is in vivo
      synthetically more active than normal cartilage, but loses this increased
      activity in vitro. Enhanced sensitivity of osteoarthritic cartilage to
      compressive forces may contribute to the increased proteoglycan synthesis of
      osteoarthritic cartilage.

PMID- 1628165
TI  - The effect of non-steroidal anti-inflammatory drugs on faecal flora and bacterial
      antibody levels in rheumatoid arthritis.
AB  - The faecal flora and bacterial antibody levels of 22 patients with active
      rheumatoid arthritis (RA) were compared with those of 26 patients with
      osteoarthritis (OA) undergoing comparable treatment with non-steroidal anti
      inflammatory drugs (NSAIDs), and a further 22 patients with OA who were not
      receiving NSAIDs. Faecal counts of Clostridium perfringens were significantly
      higher in the RA patient group and in those OA patients receiving NSAIDs,
      compared with those OA patients not taking NSAIDs (P = 0.032, P = 0.0004
      respectively). Total aerobic and anaerobic counts were, however, identical in all
      three groups. Levels of serum IgA antibody to the alpha toxin of Cl. perfringens
      were higher in the RA group and in the OA group taking NSAIDs than in OA patients
      not taking NSAIDs (P = 0.011, P = 0.055). Serum IgG antibody to alpha toxin was
      higher in the RA group than in OA patients both on and off NSAIDs (P = 0.019, P =
      0.0072) and also a group of normal controls (P = 0.032). These results suggest
      that the increased faecal counts of Cl. perfringens together with the associated
      increased antibody levels seen in this and previous studies are more likely to
      result from NSAID therapy used to treat the disease than from a disease specific
      change in bowel flora.

PMID- 1628166
TI  - Genetic factors influencing the outcome of early arthritis--the role of
      sulphoxidation status.
AB  - A minority of individuals have an impaired ability to oxidize sulphur. An
      increased prevalence of this poor S-oxidation capacity has been observed in
      patients with established rheumatoid arthritis (RA). The role of this enzyme
      system in the development of disease was studied by testing the S-oxidation
      capacity of 54 patients with recent onset symmetrical poly-arthritis, who were
      followed up at 1 and 4 years. Those patients with persistent disease at 1 year
      had a prevalence of poor S-oxidation of 69%. At 4 years 74% of those with a
      diagnosis of RA were poor S-oxidizers compared to 31% of those who were
      asymptomatic (P less than 0.01). A defective ability to oxidize sulphur appears
      to predispose to persistent clinical disease.

PMID- 1628167
TI  - Anticardiolipin antibodies, haemolytic anaemia and thrombocytopenia in systemic
      lupus erythematosus.
AB  - Anticardiolipin antibody (ACA) levels were determined in 17 Asian female SLE
      patients with autoimmune haemolytic anaemia (AIHA) and 29 Asian female SLE
      inpatients without AIHA (control patients). Both IgG and IgM isotypes were
      measured by ELISA. Elevated IgM APA titres (greater than 5 SD of normal health
      controls) were seen in 11 (64.7%) of 17 AIHA patients and six (20.7%) of 29
      control patients (P less than 0.01). There was no significant difference in IgG
      ACA titres between the two groups. Thrombocytopenia was present in 11 (64.7%) of
      the AIHA patients and nine (31%) of the control patients (P less than 0.05). None
      of the control SLE patients with thrombocytopenia had raised IgM ACA levels and
      only one had an elevated IgG ACA titre. Autoimmune haemolytic anaemia occurring
      in the context of SLE frequently associated with the concomitant presence of
      thrombocytopenia (Evan's syndrome) and with the presence of ACA.

PMID- 1628168
TI  - Reliability of skin involvement measures in scleroderma. The UK Scleroderma Study
      Group.
AB  - Two methods have been proposed to quantify the extent of skin involvement in
      scleroderma. These are (1) a scoring system which quantifies and summates this
      severity rating in 17 areas of skin surface and (2) a method estimating the
      percentage of skin involvement using a shaded manikin. We report on a study
      comparing the inter-observer reliability of these two approaches using the
      ratings of six clinicians on 12 patients. Systematic bias between observers was
      noted with both methods, but inter-observer agreement, as-assessed by the
      intraclass correlation coefficient (ICC), was higher with the score method. The
      manikin method resulted in a greater degree of disagreement between the
      observers, as well as a higher amount of random error, reflecting the difficulty
      of defining the bounds of abnormal skin. Despite the presence of bias, the score
      method is the preferred method for assessing the level of skin involvement.

PMID- 1628169
TI  - Phthalylsulphathiazole in rheumatoid arthritis.
AB  - Sixteen patients with active rheumatoid arthritis were treated with
      phthalylsulphathiazole (4 g/day) over a period of 24 weeks. Although there was
      some statistically significant improvement in plasma viscosity, IgM, pain score,
      morning stiffness and summated change score, this was either intermittent or not
      maintained. Five patients withdrew from the trial before completion, four (25%)
      with non-serious adverse reactions and one patient from lack of efficacy; only
      one patient elected to remain on the drug beyond the 24-week period. Low free and
      total sulphathiazole serum concentrations were found, confirming that most of the
      drug remained within the gut. This investigation suggests, certainly at the dose
      used, that phthalylsulphathiazole does not have the properties of a second-line
      agent. Higher doses of the drug will not be ethically feasible.

PMID- 1628171
TI  - Rheumatologists and their patients who seek alternative care: an agreement to
      disagree.
AB  - Alternative treatment, such as homoeopathy, acupuncture and spiritual healing,
      are popular among patients with rheumatic diseases. Rheumatologists are therefore
      likely to be confronted with patients who make use of less orthodox health care.
      Patients' and rheumatologists' views on the subject and on the rheumatologists'
      role, however, have not yet been assessed. A questionnaire on alternative
      medicine was sent to all 101 practising Dutch rheumatologists (response rate:
      70%). After the results had been analysed 17 rheumatologists, seven rejecting
      alternative medicine and ten accepting it, handed out a questionnaire to a sample
      of their patients: 1466 patient questionnaires were distributed (response rate:
      80%). Of the respondents 43% had visited an alternative practitioner at least
      once for their rheumatism and 26% in the year before the survey was held. Hand
      healers, homoeopaths and acupuncturists were most often visited. Rheumatologists,
      on their part, were not too enthusiastic about these visits. Only patients'
      visits to spa treatment centres were welcomed by a majority of them; visits of
      their patients to manipulative therapists, acupuncturists and homoeopaths were
      judged positively by a large minority, whereas other therapies were strongly
      disapproved. Nevertheless, most patients informed their rheumatologist about
      their visiting an alternative practitioner. A surprisingly low percentage of
      these patients noticed that the rheumatologist did not sympathize with it.
      Although many patients paid a visit to an alternative practitioner because
      regular care did not really help them, their satisfaction with the alternative
      treatment turned out to be less than their satisfaction with the rheumatologists'
      help.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628170
TI  - Ophthalmological examinations of patients with primary Sjogren's syndrome
      selected from a rheumatological practice.
AB  - Ophthalmological examination of patients with primary Sjogren's syndrome (SS) (n
      = 44) taken randomly from a rheumatological practice revealed that in this
      population group the eyes were frequently but not seriously involved (n = 42).
      Primary SS patients (n = 44) could not be separated from patients suspected of
      primary SS, in whom the diagnosis had been excluded (n = 21) on the basis of
      ocular examination, but they were clearly distinguishable from healthy controls
      (n = 26). The diagnostic value of the tests currently in use to establish the
      diagnosis keratoconjunctivitis sicca in primary SS such as Schirmer's, tear film
      break up time and rose bengal staining tests appeared to be limited. These
      results demonstrate the heterogeneity of the syndrome, the influence of patient
      selection on patient characteristics in different primary SS populations and the
      limited value of using the present classification criteria for the diagnosis
      primary SS in individual patients.

PMID- 1628172
TI  - Osteoarticular tuberculosis of the symphysis pubis presenting as a hypogastric
      cystic mass in a woman with primary Sjogren's syndrome.
AB  - A 79-year-old woman with primary Sjogren's syndrome and immune thrombocytopenia
      presented with a hypogastric cystic mass. Twenty-three months previously she
      received a 7-month course of prednisone at moderate doses to control the
      thrombocytopenia. A computed tomography showed a cystic mass, destruction of the
      left pubis with involvement of the symphysis and erosion of the right pubis. The
      cystic mass was surgically removed. Epithelioid granulomata were found on
      pathological examination and Mycobacterium tuberculosis was grown in Lowenstein
      medium. This is the first reported case of osteoarticular tuberculosis with such
      a presentation and only the second localized to the pubis.

PMID- 1628173
TI  - Synovial cysts and sarcoid synovitis.
AB  - The case of a practice nurse who presented with painless cystic swellings in the
      popliteal and antecubital fossae and lymphoedema of the legs is reported.
      Biopsies of synovium, a breast lump, axillary lymph nodes and of the Kveim site
      demonstrated sarcoidosis. Prior to biopsy diagnosis was not obvious. Synovial
      cysts are a very rare manifestation of sarcoid joint disease and this case
      illustrates the importance of biopsy in establishing the diagnosis.

PMID- 1628174
TI  - Daily and alternate-day azathioprine treatment in rheumatoid arthritis: a twelve
      week controlled clinical trial.

PMID- 1628175
TI  - Fumaric acid therapy for psoriatic arthritis. A randomized, double-blind, placebo
      controlled study.

PMID- 1628176
TI  - Increasing patient throughput in magnetic resonance imaging: a practical
      approach. Oxford MRI Group.
AB  - A major factor governing the throughput of patients in a magnetic resonance
      imaging (MRI) service is the number and length of sequences employed. This study
      investigated the feasibility of prospectively selecting patients for whom a pre
      planned examination of the brain, spine or knee could be applied with a high
      chance of success. The implications on throughput of using these pre-planned
      examinations were determined. 173 patients were studied. A successful outcome was
      defined as an examination in which a diagnosis could be made with 100% confidence
      and without the need for further sequences. Examinations of the brain (n = 113),
      knee (n = 23) and lumbar spine (for disc degeneration, n = 14) were performed
      with success rates of 96%, 87% and 64%, respectively. Examinations of the lumbar
      spine (for radicular symptoms, n = 20) and cervical spine (n = 3) were performed
      with success rates of 85% and 66%, respectively. The examinations of the brain,
      knee and lumbar spine (for disc degeneration) were completed within the target
      time of 20 min in 92%, 95% and 69% of cases, respectively. Examinations of the
      lumbar spine (for radicular symptoms) and cervical spine were completed within 30
      min in 75% and 33% of cases, respectively. Analysis of our results suggests that
      success rates could be improved by minor changes in sequence design. Carefully
      selected patients can be successfully examined in short examination times.
      Instituting these practices would increase the efficiency of MR machine time and
      improve patient throughput by 80-125%. This would have a marked effect on the
      length of waiting lists, and would increase the general availability of MRI.

PMID- 1628177
TI  - Radiological features during and following treatment of spinal tuberculosis.
AB  - A retrospective study was performed in order to document the sequence and time
      scale of radiological changes occurring during the healing of spinal
      tuberculosis. 28 episodes occurred in 26 patients, of whom only two were
      Caucasian. All demonstrated good response to conventional chemotherapy. Soft
      tissue masses increased in size for up to 1.5 months and took about 12 months to
      resolve. Bone destruction was seen in all cases and progressed in 70% of
      patients, whilst on treatment. There was loss of vertebral body height in 79%,
      which progressed for up to 14 months; any recovery of height was a very late
      feature. Sclerosis was seen at presentation in 52% and developed in most of the
      remaining patients within 5 months of instigating treatment. It progressed for up
      to 14 months and took, on average, 31 months to return to normal. Reduction in
      disc height was commonly seen and the vertebrae fused in three-quarters of those
      affected, the time of onset of fusion being very variable. To manage patients
      with spinal tuberculosis, an appreciation of the variability of radiological
      changes that can occur during treatment is necessary.

PMID- 1628178
TI  - The musculoskeletal manifestations of epidermolysis bullosa: an analysis of 19
      cases with a review of the literature.
AB  - Epidermolysis bullosa encompasses a group of rare disorders characterized by
      marked skin fragility and blister formation. In patients with dystrophic
      epidermolysis bullosa, skeletal and soft-tissue abnormalities are an important
      feature. An analysis of the musculoskeletal manifestations in 19 patients is
      presented. In the hands and feet, features included generalized osteoporosis,
      wedge-shaped thinning and hooking of distal phalanges, overconstricted bones,
      acro-osteolysis, flexion contractures, metatarsal and metacarpal subluxation,
      distal trophic changes, webbing of digits, encasement of the whole extremity in a
      pouch of skin, soft-tissue calcification and retarded skeletal maturity.
      Previously undescribed findings in the hands and feet are bony ankylosis of the
      proximal interphalangeal joints, resorption of the metatarsal and metacarpal
      heads, shortened metatarsal bones, carpal and tarsal fusion and destruction, and
      cystic changes of the distal radius and ulna. In the remainder of the skeleton,
      hip dysplasia with premature osteoarthritis, knee joint bony ankylosis and
      thoracic and thoraco-lumbar scoliosis are other undescribed findings.

PMID- 1628179
TI  - Intramuscular myxoma: magnetic resonance features.
AB  - Magnetic resonance imaging (MRI) was performed in six cases of intramuscular
      myxoma of the extremities and revealed the following characteristics. All tumours
      were confined to muscle and had a sharply defined border. All had a signal
      intensity lower than skeletal muscles on T1-weighted images and brighter than fat
      on T2-weighted images. The signals were homogeneous on both T1- and T2-weighted
      images. This study did not include contrast enhancement. The diagnosis was
      confirmed by an open biopsy. All tumours were resected with no recurrence.
      Diagnosis based on these MRI characteristics was incorrect in two cases of
      intramuscular ganglia and in a case of intramuscular cysticercus cellulose. MRI
      features of intramuscular myxoma are typical in the majority of cases. Benign
      intramuscular lesions that contain mainly fluid can mimic intramuscular myxomas.

PMID- 1628180
TI  - Scintigraphic abnormalities in patients with painful hip replacements treated
      conservatively.
AB  - A retrospective review of the scintigraphic appearances of 98 painful hip
      replacements was made. 16 patients (16%) underwent revision surgery whereas in
      the remaining 82 hips (84%), symptoms settled with conservative management. 73 of
      these (89%) had at least one area of increased activity on delayed diphosphonate
      scintigraphy with 27% having increased activity in three or more areas around the
      femoral component. Hips with increased activity at the lesser trochanter and tip
      were less likely to undergo spontaneous resolution of symptoms. Uncemented
      prostheses were more likely to have multiple areas of increased activity.
      Abnormalities in dynamic bone scintigraphy and gallium studies were also seen in
      patients whose symptoms resolved without surgery. Whereas a normal bone
      scintigram indicates that loosening or infection is most unlikely, the presence
      of increased activity does not necessarily indicate a need for revision surgery,
      even when multiple areas are present. A period of conservative management should
      be considered before operative intervention is undertaken.

PMID- 1628181
TI  - Magnetic resonance imaging of pulsatile cerebrospinal fluid flow by spatial
      modulation of magnetization.
AB  - Various orders of binomial spatial modulation of magnetization sequences up to (1
      4 6 4 1) have been tested to find the optimum sequence for clinical application.
      Stripe width, stripe sharpness and the tolerance of the sequences to
      radiofrequency non-linearity have been investigated. The (1 3 3 1) sequence was
      found to be a good compromise between competing design criteria, and its
      application to viewing pulsatile cerebrospinal fluid motion is described.

PMID- 1628182
TI  - The value of magnetic resonance relaxation time in staging ovarian endometrial
      cysts.
AB  - We evaluated the use of magnetic resonance imaging (MRI) in the pre-operative
      staging of 15 endometrial cysts. The effect of the iron content on the T1 and T2
      relaxation times was assessed in confirmed endometrial cysts employing a 0.15 T
      MR system and a 200 MHz spectrometer. There was a positive linear correlation (r
      = 0.93) between the T1 values of the lesions obtained using the MR system (T1)
      and those of the resected cyst contents obtained using the spectrometer (sp-T1).
      A similar relationship was found between T2 and sp-T2 (r = 0.87). There was a
      negative linear relationship between the T1 value and the cyst iron content (r = 
      0.81), but there was no relationship between the T2 value and the iron content.
      T1 was 412 +/- 91 ms for Stage II cysts (n = 3), 356 +/- 126 ms for Stage III
      cysts (n = 3) and 208 +/- 30 ms for Stage IV cysts (n = 9). The T1 value for
      Stage IV cysts was significantly shorter than that for Stages II and III cysts (p
      less than 0.05). Thus, the T1 value was useful in distinguishing fresh from old
      endometrial cysts, suggesting that the MRI T1 relaxation time might be useful for
      staging ovarian endometrial cysts before surgery.

PMID- 1628183
TI  - Audit in action: significant reduction of double-contrast barium enema screening
      time with no loss of examination quality.
AB  - The double-contrast barium enema is an examination of high radiation exposure to
      the patient. As part of a departmental audit, our own fluoroscopic screening
      times were being recorded. A study was undertaken to see if a determined effort
      could reduce the screening time without having a detrimental effect on the
      quality of the examinations. Methods of screening time reduction were identified
      and then implemented by two radiologists. In the period before the study the
      average screening time for radiologists A and B was 2.6 min and 3.2 min,
      respectively (over 56 examinations). After implementation of the changes, the
      average screening time for both was 0.9 min (over 50 examinations). This is a
      statistically significant reduction (p less than 0.01). The examinations were
      assessed independently by a gastroradiologist. No difference in the quality of
      the examinations was identified. We conclude that a significant reduction of
      screening time for the double-contrast barium enema can be achieved without loss
      of examination quality.

PMID- 1628184
TI  - The application of microdosimetry in clinical bone densitometry using a dual
      photon absorptiometer.
AB  - Experimental microdosimetric methods have been used to determine absorbed dose
      values for a scanning dual-photon absorptiometer. Absorbed doses within the
      scanned field have been obtained for three different scanning speeds. For the
      normal speed setting used clinically, measurements have also been carried out in
      a water-filled phantom in order to estimate typical patient entrance, exit and
      midline doses. The results agree well with values obtained using
      thermoluminescence dosimetry and support the claims of the manufacturers with
      regard to upper limits placed on patient dose levels. The microdosimetric method
      enables changes in radiation quality to be followed and comparisons to be made
      with other low-energy photon fields used in medical diagnosis.

PMID- 1628185
TI  - A preliminary investigation of the imaging performance of photostimulable
      phosphor computed radiography using a new design of mammographic quality control
      test object.
AB  - Leeds Test Object TOR[MAM] has been designed to supplement the current FAXIL
      mammography test object TOR[MAX]. It contains a range of details that have a more
      natural radiographic appearance and has been designed as a test that more closely
      approximates the image quality achieved in clinical mammography. Physical aspects
      of the design and implementation of TOR[MAM] are presented. The TOR[MAM] has been
      used in a preliminary physical evaluation of the comparative image qualities
      produced by conventional (screen-film) and photostimulable phosphor computed
      mammography and the results are discussed. TOR[MAX] results are also presented.
      The influence of digital image processing (enhancement) on the image quality of
      computed mammograms is also considered. The results presented indicate the
      sensitivity of TOR[MAM].

PMID- 1628186
TI  - A manual afterloading technique for the treatment of patients with bronchial
      carcinoma using iridium-192 wire.

PMID- 1628187
TI  - Technique for steel coil embolization of biopsy track for use with the "Biopty"
      needle.

PMID- 1628188
TI  - Splenic cyst: demonstration of the relationship between subcapsular haematoma and
      false cyst by imaging.

PMID- 1628189
TI  - Juxtaglomerular cell tumour of the kidney as cause of hypertension: a case
      report.

PMID- 1628190
TI  - Contrast extravasation from a Pulse-Tec graft: a complication of high-dose
      recombinant tissue-type plasminogen activator therapy.

PMID- 1628191
TI  - Pancreatic metastasis from renal cell carcinoma.

PMID- 1628192
TI  - Mistaken hilar mass.

PMID- 1628193
TI  - Results from the HAD psychometric questionnaire in 54 breast cancer patients
      treated with breast conservation.

PMID- 1628194
TI  - Measurement of tissue perfusion by dynamic computed tomography.

PMID- 1628195
TI  - Mesenteric lymphadenopathy in idiopathic retroperitoneal fibrosis.

PMID- 1628196
TI  - Now you see it ... now you don't.

PMID- 1628197
TI  - Neurology of otolith function. Peripheral and central disorders.
AB  - The otolith organs detect gravitoinertial forces acting on the head providing
      signals to the brain which are essential for spatial orientation, sensing motion
      and organizing motor behaviour. Although the pathophysiology of otolithic
      dysfunction is poorly understood, a disorder of otolith function, at a peripheral
      or central level, may be suspected when a patient describes symptoms of false
      sensations of linear motion or tilt or shows signs of specific derangements of
      ocular motor and postural, orienting and balancing responses. When disorientation
      is severe the patient may describe symptoms which sound bizarre, raising doubts
      over the organic basis of the disease. Our recognition of an otolithic disorder
      and understanding otolithic involvement in a wider neurological context may be
      guided by knowledge of otolith physiology and of the characteristics of the few
      proven otolithic syndromes.

PMID- 1628198
TI  - Visuospatial attention in dementia of the Alzheimer type.
AB  - Cue-directed shifts of spatial attention were examined for a letter
      discrimination task in 15 patients with mild to moderate dementia of the
      Alzheimer type (DAT) and 15 healthy, age-matched controls. Spatial cues were
      valid, invalid or neutral in indicating probable target location and were
      presented either centrally at fixation or peripherally 6.7 degrees to the left or
      right of fixation. Stimulus-onset asynchrony (SOA) between cue and target was
      varied between 200 ms and 2000 ms. Reaction time (RT) benefits conferred by valid
      cues did not differ between the DAT group and the controls. However, RT costs
      incurred by invalid cues were significantly greater in the DAT group than in the
      control group. Group differences in RT costs plus benefits occurred at short SOAs
      (less than 500 ms) for peripheral cues and at long SOAs (greater than 500 ms) for
      central cues. Reaction time costs plus benefits were correlated with right-left
      asymmetry in resting levels of cerebral glucose metabolism in the superior
      parietal lobe for DAT patients but not for controls. The results indicate that
      focusing of attention to spatial location is intact in early DAT, whereas the
      disengagement of visuospatial attention is impaired. Automatic attention shifts
      elicited by peripheral cues reveal abnormalities earlier than attention shifts
      initiated 'effortfully' by central cues. Intact focusing and impaired
      disengagement of visuospatial attention may be linked to dysfunction in early DAT
      of cortico-cortical networks linking the posterior parietal and frontal lobes.

PMID- 1628199
TI  - White matter lesions on magnetic resonance imaging in clinically diagnosed
      Alzheimer's disease. Evidence for heterogeneity.
AB  - In a prospective magnetic resonance imaging (MRI) study we evaluated the
      prevalence and severity of white matter changes in 29 patients with Alzheimer's
      Disease (AD) and 24 age-matched healthy elderly, all without cerebrovascular risk
      factors. The AD patients were divided into two groups according to age at onset
      of symptoms, one with presenile onset AD (n = 13) and one with senile onset AD (n
      = 16), who were matched for dementia severity. Signal hyperintensities were rated
      using a semiquantitative scoring method, separately in the periventricular region
      (PVH) and in the lobar white matter (WMH), as well as in the basal ganglia (BGH)
      and in the infratentorial region (ITFH). Cortical atrophy as a parameter of grey
      matter involvement was rated on a 0 (absent) to 3 (severe) scale. We found PVH,
      WMH and BGH scores to be significantly higher in senile onset AD patients than in
      age-matched controls. By means of multiple linear logistic regression we found
      that PVH, WMH and BGH scores were significantly dependent on the diagnosis of
      senile onset AD, while the PVH score also showed a significant age dependency.
      Cortical atrophy did not differ significantly between presenile onset AD and
      senile onset AD patients. These results indicate that presenile onset AD and
      senile onset AD patients differ with respect to white matter involvement, but not
      with respect to grey matter involvement on MRI. Since cerebrovascular risk
      factors were excluded these findings may indicate that senile onset AD patients
      display more small vessel involvement (arteriolosclerosis) than presenile onset
      AD patients, suggesting additional (microvascular) factors for the dementia
      syndrome in senile onset AD. Our data lend support to the growing body of
      evidence that AD is heterogeneous, consisting of at least two types. Based on our
      findings two forms can be distinguished: (i) a 'pure' form of the disease,
      usually with early disease onset, and no more white matter changes than normal
      for age; (ii) a 'mixed' form, usually with disease onset later in life, and
      showing more white matter changes on MRI than normal for age.

PMID- 1628200
TI  - Pure amnestic seizures in temporal lobe epilepsy. Definition, clinical
      symptomatology and functional anatomical considerations.
AB  - Pure amnestic seizures (PAS) sometimes occur in patients with temporal lobe
      epilepsy. They never represent the only type of seizures in these patients. Pure
      amnestic seizures are defined as seizures during which the only clinical
      manifestation is the patients' inability to retain in memory what occurs during
      the seizure coupled with the preservation of other cognitive functions and the
      ability to interact normally with their physical and social environment. It is
      postulated that PAS result from selective ictal inactivation of mesial temporal
      (MT) structures without isocortical involvement. This occurs most often in
      patients with neuropsychological and electroencephalographic (EEG) evidence of
      bilateral dysfunction of MT structures (six out of eight patients in this study).
      In the few patients without such evidence as well as in some with bilateral MT
      dysfunction, PAS may result from seizure discharge limited to the MT structures
      of both temporal lobes. In the light of current anatomical knowledge,
      contralateral spread of seizure discharge from the MT structures of one side to
      those of the other through the dorsal hippocampal commissure is the only likely
      explanation for this situation. One observation with depth electrode stimulation
      of MT structures supports this view. In patients with evidence for bilateral MT
      dysfunction, a unilateral seizure may presumably suffice to induce a PAS, the
      contralateral MT structures being unable to ensure normal memory function. In
      most instances PAS can be distinguished from episodes of transient global amnesia
      on clinical grounds.

PMID- 1628201
TI  - Epileptic seizures in an Andean region of Ecuador. Incidence and prevalence and
      regional variation.
AB  - A large-scale neuro-epidemiological study was carried out in a population of
      72,121 inhabitants of a region of Northern Ecuadorian Andean Sierra, to identify
      prevalence and incidence rates of epileptic seizures and to identify demographic
      and geographic variations in these rates. Calculations were made using three
      datasets. First, rates were calculated from all cases identified in the field
      (raw dataset); secondly, lower rates were calculated based on a further
      diagnostic and reclassification procedure (minimum estimated dataset); thirdly,
      higher rates were derived by calculating false negative rates from the screening
      procedures, and adding these to the cases actually identified (maximum estimated
      dataset). Lifetime point-prevalence rates between 12.2/1000 and 19.5/1000 were
      recorded (minimum and maximum estimated rates), and the prevalence of active
      epileptic seizures was between 6.7/1000 and 8.0/1000 (minimum estimated and raw
      datasets). Incidence rate ranging between 122/100,000/year and 190/100,000/year
      were found (minimum, estimated and raw datasets). A marked difference in
      prevalence rates was found in two subregions of the survey area, and also in
      urban and rural areas. The reasons for these differences were not identified.

PMID- 1628202
TI  - Validation of a screening questionnaire for the detection of epileptic seizures
      in epidemiological studies.
AB  - A large-scale clinico-epidemiological study of epileptic seizures has been
      carried out in a highland area in northern Ecuador, South America. This paper
      describes the design and the two-staged validation procedures undertaken to
      authenticate the screening questionnaire, which was used to detect epileptic
      seizures in the community during this project. An initial questionnaire
      consisting of 20 questions was devised and then validated in a group of healthy
      subjects and a group of patients with known epileptic seizures. This
      questionnaire was found to have a sensitivity of 100% and a specificity of 50.8%.
      A cluster analysis of the responses rates was undertaken and a set of nine
      questions which presented a specificity of 92% and sensitivity of 98% were chosen
      to be used during the survey. The validation of this nine-question instrument was
      then undertaken by direct application to a general population of 72,121 persons.
      Positive, negative, false positive and false negative rates were derived. The
      screening instrument was found to have a sensitivity of 79.3%, a specificity of
      92.9%, a positive predictive value of 18.3%, a negative predictive value of 99.6%
      and a Youden's index of 0.79. The methodology of the study and the instruments
      developed are recommended for future neuro-epidemiological work in epilepsy. The
      problems of validation are discussed, and previous epidemiological studies of
      epilepsy reviewed with special emphasis on the handling of questions of
      validation.

PMID- 1628203
TI  - Brain energy metabolism in bilateral paramedian thalamic infarcts. A positron
      emission tomography study.
AB  - Positron emission tomography (PET) studies of the cerebral metabolic rate of
      oxygen (CMRO2) were performed in seven consecutive patients with bilateral
      paramedian thalamic infarcts (BPTI), selected on neuroradiological and clinical
      criteria. The latter consisted of sudden onset of coma or confusion followed by a
      persistent amnesia of varying severity, with or without language impairment and
      frontal lobe signs. There was a highly significant decrease of CMRO2 for the
      whole cortex as well as for all the regions analysed: medial-frontal, latero
      frontal, temporal, sensorimotor and posterior associative cortex. The mean
      regional metabolic ratios (region/whole cortex CMRO2) were not significantly
      different from controls, indicating an essentially uniform effect in the cortex,
      except the sensorimotor ratio which was significantly increased. Diffuse cortical
      hypometabolism most likely reflects thalamo-cortical deafferentation secondary to
      damage to the 'non-specific' thalamic nuclei, while sparing of the latero-ventral
      thalamus presumably explains the relative preservation of the sensorimotor cortex
      metabolism. Although no clear-cut individual relationship was found between
      magnitude of cortical hypometabolism and the severity and pattern of
      neuropsychological impairment, the data suggest that the former underlies and/or
      reflects the latter. Further studies with higher resolution PET devices might
      shed more light on the relationships between distinct cognitive patterns and
      specific topography of cortical hypometabolism in BPTI patients.

PMID- 1628204
TI  - A 2-deoxyglucose study of the effects of dopamine agonists on the parkinsonian
      primate brain. Implications for the neural mechanisms that mediate dopamine
      agonist-induced dyskinesia.
AB  - The neural mechanisms that underlie both the anti-parkinsonian effects of
      dopamine agonists and dopamine agonist-induced dyskinesia were studied in
      parkinsonian primates, using the regional brain uptake of [3H]2-deoxyglucose (2
      DG). Parkinsonian symptoms were induced in monkeys by the administration of the
      neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Some of the
      animals received chronic dopamine replacement therapy for at least 3 mths, which
      resulted in the appearance of peak-dose dyskinesia. The remaining animals spent
      an equivalent period of time relatively unexposed to dopaminergic agents,
      receiving only therapeutic doses, and at no time showed any signs of dopamine
      agonist-induced dyskinesia. The 2-DG metabolic mapping technique was applied to
      all of these animals shortly following the administration of a dose of dopamine
      agonist which was sufficient to alleviate their parkinsonian symptoms and to
      induce dyskinesia in those prone to this complication. The 2-DG uptake technique
      permits the autoradiographic measurement of local cerebral glucose uptake which
      was used as an index of regional synaptic activity. The resultant autoradiographs
      were compared with those from a previous study which examined 2-DG uptake in
      parkinsonian and normal brains from animals which had not received dopamine
      agonists prior to the terminal 2-DG uptake procedure. The pattern of 2-DG uptake
      in the animals which received a dopamine agonist prior to the terminal procedure
      was strikingly different to both of the other groups. The most affected structure
      was the subthalamic nucleus which showed a dramatic increase in 2-DG uptake in
      animals exposed to dopamine agonist immediately prior to the terminal procedure,
      especially in the ventral tip of the nucleus. The medial pallidal segment also
      showed relatively greater levels of 2-DG uptake in the dopamine agonist group
      compared with the untreated parkinsonian state whereas, in contrast, the lateral
      pallidal segment showed decreased levels of 2-DG uptake. The parkinsonian animals
      which had been sacrificed after receiving a dopamine agonist were split into
      three groups on the basis of their response to the agonist. The first group had
      their parkinsonism reversed and appeared clinically normal. The remaining animals
      had their parkinsonism reversed by the dopamine agonist but showed dyskinesia at
      peak dose. These animals were allotted to two further groups depending on whether
      their dyskinesia was of a choreic or dystonic nature.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1628205
TI  - Motor sequencing with left hemisphere damage. Are some cognitive deficits
      specific to limb apraxia?
AB  - Sixteen left-hemisphere stroke patients, who were apraxic or nonapraxic, and 17
      control subjects performed sequences of hand postures that varied in the number
      of different postures (repetitive and heterogeneous) and sequence length (one to
      five). Performance of the left hand (ipsilateral to stroke) was compared with a
      control group using the left hand. All stroke patients had slower reaction times
      and were slower to execute single hand postures, but the apraxic group was not
      slower than the nonapraxic group. Both the apraxic and the nonapraxic groups had
      similar problems scheduling or timing motor programs for both sequence types such
      that inter-response times were more affected by sequence length than the control
      group. However, only the apraxic group showed abnormalities in preprogramming
      heterogeneous sequences. The apraxic group also made more errors and had longer
      movement times (MTs) than for the other groups, but only for heterogeneous
      sequences containing more than three hand postures. The nonapraxic group did not
      show slower MTs or greater errors, regardless of the type or the length of
      sequences. These results suggested deficits in encoding, generating single
      movements and in scheduling or timing a series of actions which generally
      attributable to left hemisphere damage. However, abnormalities in temporal
      organization processes prior to and during movement were specific to apraxia. The
      dissociation between the two stroke groups on some but not all aspects of
      sequencing has implications for different cognitive mechanisms supporting motor
      sequencing.

PMID- 1628206
TI  - Performance of repetitive wrist movements in Parkinson's disease.
AB  - The timing of repetitive alternating 80 degrees flexion-extension movements of
      the right wrist was studied in 42 patients with Parkinson's disease, tested while
      not receiving dompaminergic medication and 20 age- and sex-matched controls. Five
      rates of movement (0.5 Hz, 1 Hz, 1.5 Hz, 2 Hz, 2.5 Hz) were examined. The
      interval between two successive flexion movements, as measured from the
      electromyography (EMG) records was taken as the unit of analysis or inter
      response interval (IRI). At 0.5 Hz, 1 Hz and 1.5 Hz there were no differences
      between groups in mean IRIs. At higher rates of movement (2 Hz and 2.5 Hz),
      however, the controls were significantly more accurate in timing of repetitive
      movements than the patients. At all five frequencies, the patients with moderate
      or severe Parkinson's disease were less accurate in timing of repetitive
      movements than those with mild disease, although the differences were not
      significant. In nine patients tested in the 'on' and 'off' medication states,
      administration of 250 mg of levodopa/carbidopa resulted in significantly more
      accurate timing of repetitive movements. Wing and Kristofferson's (1973b) two
      process model of repetitive movements was applied to the IRI data. At various
      rates of movement, the primary prediction of the model that lag 1
      autocorrelations should be in the 0 to -0.5 range was violated in 40-70% of the
      patient and controls. For those subjects who had lag 1 autocorrelations in the
      expected range, IRI variability was to break down into a timekeeper and a motor
      delay variance. At all frequencies, the patients had significantly higher
      variance for IRI, timekeeper and motor delay than the controls. Although not
      significant, more severe Parkinson's disease was associated with greater IRI,
      timekeeper and motor delay variance, while administration of levodopa resulted in
      reduction of the three types of variance. The validity of the Wing and
      Kristofferson model for the analysis of this type of movement is discussed.

PMID- 1628207
TI  - Quantitative somatosensory thermotest. A key method for functional evaluation of
      small calibre afferent channels.
AB  - The quantitative somatosensory thermotest (QST) assesses the function of afferent
      channels concerned with sensory submodalities served by small calibre fibres.
      Measured ramps of ascending or descending temperature are applied to the skin
      through a Peltier contact thermode, and detection thresholds are recorded as the
      subject signals the onset of a particular sensation. The present study describes
      underlying principles, methodological aspects and normal reference values for the
      QST. In patients, measurement of thresholds for cold sensation, warm sensation,
      cold-induced pain and heat-induced pain, applied to 465 individuals, yielded 13
      abnormal patterns segregated into three main groups: (i) thermal (cold or warm)
      hypoaesthesia; (ii) thermal hyperalgesia (abnormally reduced threshold for cold
      and/or heat induced pain); (iii) thermal hypoaesthesia combined with thermal
      hyperalgesia. Critical analysis of these results yielded a number of observations
      of general relevance: (i) thermal specific (warm or cold) hypoaesthesia and
      thermal (heat or cold) hyperalgesia may occur in the absence of hypoaesthesia for
      tactile submodalities served by large calibre afferents; (ii) cold hypoaesthesia
      and warm hypoaesthesia may dissociate from each other; (iii) thermal pain
      hyperalgesias may occur in the absence of hypoaesthesias for specific cold or
      warm sensations; (iv) cold hyperalgesia and heat hyperalgesia may dissociate from
      each other. Thus, a negative routine sensory examination and unimpaired sensory
      nerve action potentials do not exclude possible somatosensory dysfunction.
      Furthermore, while most methods of sensory testing only document normality or
      deficit, the QST permits additional documentation of hyperalgesia, a positive
      sensory phenomenon that implies unusual pathophysiologies such as sensitization
      of receptors, central hyperexcitability, disinhibition or, possibly, ectopic
      nerve impulse discharge. This psychophysical test does not specify the level
      within afferent channels, between skin and brainmind, where the abnormality
      resides. It is recommended that the QST for all four thermal specific and thermal
      pain functions be incorporated in routine neurological assessment.

PMID- 1628208
TI  - Determination of the segmental sensory and motor innervation of the lumbosacral
      spinal nerves. An electrophysiological study.
AB  - The knowledge of the segmental innervation of the skin and muscles of the lower
      limb in man is inadequate. For this reason, sensory and motor segmental
      innervation of the lower extremities was examined by electrophysiological methods
      in 27 normal subjects, one patient with possible L5 radiculopathy and one with
      possible lumbosacral plexus affection. Needle electrodes were placed at root
      levels from L3 to S2 using bony landmarks. The electrode was then placed close to
      the spinal nerve as indicated by a low (less than or equal to 1 mA) threshold
      necessary to stimulate motor fibres. The position was controlled by X-ray in 10
      subjects. Sensory innervation was determined by recording the sensory action
      potential evoked by stimulating the saphenous nerve at the medial epicondyle
      (mainly L3 and L4) and at the medial malleolus (mainly L4 and in some L3), the
      medial plantar nerve at the first plantar interstice (mainly S1, some L5 and S2),
      the deep peroneal nerve at the first dorsal interstice (mainly L5, some S1), the
      sural nerve at the dorsolateral aspect of the foot (mainly S1, some L5 and S2)
      and at the lateral malleolus (mainly S1, some L5 and S2), and the superficial
      peroneal nerve at the superior extensor retinaculum (mainly L5, S1). The motor
      innervation was determined by stimulating the spinal nerves supramaximally and
      recording the evoked responses from the medial and lateral vastus (mainly L3,
      L4), the anterior tibial (mainly L5), the peroneus longus (L5, S1), the extensor
      digitorum brevis (mainly S1), the gastrocnemius (mainly S1), the abductor
      hallucis (mainly S2) and the biceps femoris (mainly L5, S1). Sensory and motor
      conduction velocity measurements along the leg and across the lumbosacral plexus
      indicated that there was no difference in a disto-proximal direction, except for
      a 10% reduction along the most distal part of the sural nerve which, however,
      might be explained by utilization time. There was therefore no evidence of
      gradual tapering of nerve fibres in a distal direction. The proximal motor
      conduction velocity to the most distally placed muscle (abductor hallucis) was
      about 20% lower than to the proximally placed muscles (gastrocnemius and biceps
      femoris) suggesting a general difference in fibre calibre.

PMID- 1628209
TI  - Distal motor axonopathy and central nervous system myelin vacuolation caused by
      cycloleucine, an inhibitor of methionine adenosyltransferase.
AB  - Cycloleucine (CL), an inhibitor of methionine adenosyltransferase, has previously
      been used to produce an experimental model of subacute combined degeneration of
      the spinal cord. A re-investigation of its effects on the morphology of the
      nervous system and on brain concentrations of methionine and S-adenosylmethionine
      (SAM) was undertaken. Cycloleucine was administered as a single dose
      intraperitoneally (2 mg/g body weight) to young mice aged 21 d and adults aged 6
      or 10 wks. The 21-day-old mice showed clinical evidence of toxicity within 24 h
      and thereafter developed progressive muscle weakness and ataxia. Animals did not
      survive longer than 1 wk. Light and electron microscopic examination of the
      central and peripheral nervous systems showed that intramyelinic vacuolation
      developed in the white matter of brain and cord within 12 h. The intramyelinic
      vacuolation in the white matter of brain and cord became more severe with longer
      survival, vacuoles coalescing and secondary axonal degeneration becoming evident.
      There was no myelin vacuolation in peripheral nerves. Axonal lesions occurred in
      the distal parts of motor nerves within 12-24 h resulting in degeneration of
      intramuscular nerve fibres and terminals. Later there was evidence of axonal
      degeneration in tibial and sciatic nerves. Many dorsal root ganglion cells became
      vacuolated or necrotic and numerous degenerated fibres were noted in the white
      matter of the spinal cord, particularly in the gracile funiculus. The optic
      nerves were not affected at any stage. In adult mice the pathology consisted of
      distal motor axonal degeneration which developed at 1-2 d. Little or no
      intramyelinic vacuolation in white matter was noted. Brain concentrations of SAM
      were reduced and levels of methionine became greatly elevated. The morphological
      effects of CL are considered to be the result of SAM deficiency impairing
      transmethylation processes known to be important in the formation and
      stabilization of myelin through the methylation of myelin basic protein. The
      immature developing central nervous system is much more vulnerable than the fully
      myelinated adult brain and spinal cord. The distal, predominantly motor
      axonopathy is a new observation and may be a reflection of the importance of
      transmethylation processes in the maintenance of axonal terminal membranes and
      the mechanisms of release of acetylcholine at the neuromuscular junction.

PMID- 1628210
TI  - Correlation between behavioral sensitization to cocaine and G protein ADP
      ribosylation in the ventral tegmental area.
AB  - The ventral tegmental area is a site of action by psychostimulants in the
      production of behavioral sensitization. Recently, G proteins of the ventral
      tegmental area have been implicated in behavioral sensitization to cocaine. To
      further investigate the specific role of G proteins, rats were treated with
      either 15 or 30 mg/kg, i.p., of cocaine (x 5 days), and at 1, 6 or 24 h after the
      last injection in vitro pertussis toxin catalyzed adenosine diphosphate (ADP)
      ribosylation was used to measure the G proteins in the ventral tegmental area,
      nucleus accumbens, prefrontal cortex, substantia nigra, and striatum. A
      significant decline in the ADP-ribosylation of G proteins, specific for the
      ventral tegmental area, was observed at 1 and/or 6 h but had returned to normal
      by 24 h. A significant negative correlation was found between the percent of G
      proteins ADP-ribosylated in the ventral tegmental area and the behavioral
      activity elicited in sensitized but not acute cocaine-treated animals at 1 h
      after injection. These data suggest that the G proteins ADP-ribosylated by
      pertussis toxin may be involved in the sensitized motor response produced by
      repeated cocaine administration in rats.

PMID- 1628211
TI  - Neuropeptide-induced cytosolic Ca2+ transients and phosphatidylinositol turnover
      in cultured human retinal pigment epithelial cells.
AB  - Neuropeptide-induced mobilization of cytosolic free Ca2+ concentration ([Ca2+]i)
      and phosphatidylinositol (PI) turnover in cultured human retinal pigment
      epithelial (RPE) cells were studied and their temporal relationship was compared.
      After RPE cells were loaded with fura-2/AM, [Ca2+]i was analyzed using a digital
      imaging microscopy system. Bombesin-related peptides which include bombesin,
      neuromedin B, and neuromedin C induced significant [Ca2+]i transients in RPE
      cells, whereas other neuropeptides, neuropeptide Y, vasoactive intestinal
      polypeptide (VIP), and substance P were not effective to produce [Ca2+]i
      transients. The percentage of reactive cells which showed positive [Ca2+]i
      transients induced by bombesin-related peptides was around 50%. Bombesin (1
      microM) showed a peak concentration of 663 +/- 27.0 nM (mean +/- S.E.M., n = 61),
      neuromedin B (1 microM), 327 +/- 28.7 nM (mean +/- S.E.M., n = 38), and
      neuromedin C (1 microM), 357 +/- 22.7 nM (mean +/- S.E.M., n = 32). Ca2+
      transients occurred within 30 s and lasted less than 5 min after the application
      of the neuropeptides. Chelation of the extracellular Ca2+ by EGTA significantly
      shortened the total time of [Ca2+]i transients induced by the above. The
      measurements of phosphoinositides in RPE cells revealed that neuropeptide-induced
      PI turnover was as quick as [Ca2+]i transients. Inositol biphosphate (IP2) and
      inositol triphosphate (IP3) in RPE cells showed transient increases at 15 s after
      the stimulation by bombesin-related peptides. These data show that changes in
      [Ca2+]i and PI turnover are directly linked and both are important in the signal
      transduction system of bombesin-related peptides in RPE cells. The data also
      suggest that bombesin-related peptides may play some possible roles in RPE cells.

PMID- 1628212
TI  - An oligodendrocyte precursor cell line from rat optic nerve.
AB  - We have established permanent cell lines from the optic nerve of the rat with a
      temperature sensitive immortalizing oncogene (Simian Virus 40 large T-antigen
      carrying both the tsA58 and U19 mutations). The oncogene was transduced into
      primary cultures via a replication deficient retrovirus, and infected cells were
      selected with the antibiotic G418. A clonal cell line (tsU19-5) displayed some
      properties of oligodendrocyte precursors: it proliferated, bound the monoclonal
      antibody A2B5 (which recognizes minor ganglioside species), and expressed the
      intermediate filament vimentin and the enzyme 2',3'-cyclic-nucleotide 3'
      phosphodiesterase (CNP) at 33 degrees C (the permissive temperature for the
      oncogene). At 39 degrees C (the non-permissive temperature), some cells had the
      potential to differentiate further, and expressed several oligodendrocyte
      specific components: galactocerebroside, myelin basic protein, proteolipid
      protein and CNP. These results suggest that conditional oncogenes can establish
      neural precursor cell lines which are still capable of differentiation in vitro.

PMID- 1628213
TI  - Changes in discharge rate of cat hamstring fusimotor neurones during fatiguing
      contractions of triceps surae muscles.
AB  - Changes in the discharge rate of fusimotor neurones to hamstring muscles during
      long-lasting, fatiguing, contractions of the triceps surae muscles were studied
      in decerebrate cats. Discharges of fusimotor neurones were recorded from the
      nerve filaments. Muscle contractions were elicited by electrical stimulation of
      the muscle nerves applied until the muscle tension fell to about 30% of its
      initial value. Early and late changes could be recognized in fusimotor discharge
      rate. The early changes, at the onset of muscle contraction, occurred in 9 out of
      22 neurones and varied in both sign and duration among the cells. The late
      change, encountered in 16 fusimotor neurones, was an increase in discharge rate
      developing towards the end of the muscle contraction and outlasting it. When the
      contracting triceps muscle was made ischaemic the late increase in discharge rate
      developed earlier, as did the muscle tension fall and started to subside after
      the arterial clamp was removed. After severing the muscle nerves their
      stimulation provoked either no changes or a slight sustained decrease in
      fusimotor discharge rate. It is supposed that the late increase in discharge rate
      of fusimotor neurones to hamstring muscles appears due to reflex excitation by
      discharges in group III and IV afferent fibres from the triceps muscle provoked
      and/or enhanced by metabolic products liberated during its fatiguing contraction.
      The possibility is raised that the excitation is elicited primarily by the
      discharges from chemosensitive afferent fibres. Its functional role in muscle
      fatigue is discussed.

PMID- 1628214
TI  - A parametric analysis of the effects of cardiopulmonary vagal electrostimulation
      on the digastric reflex in cats.
AB  - The thoracic trunk and the cardiac branch of the vagus were stimulated
      electrically in chloralose-anesthetized cats. The experiments were conducted to
      determine the parameters of vagal afferent stimulation (VAS) capable of producing
      an inhibition of the digastric reflex (DGR), to assess the duration of this
      inhibition, and to test whether endogenous opioids mediate the inhibitory
      effects. In experiments using intermittent trains of pulses, the effects of pulse
      number (1, 2, 7 or 35 pulses), frequency (13, 66 or 333 Hz), intensity (0.1, 0.5,
      1, 2, 3, 4 or 5 mA), and duration (1 or 3 ms) were evaluated. A 7 pulse train (3
      mA) was sufficient to produce maximal inhibition (77 +/- 7%) of the tooth-pulp
      stimulation-evoked DGR regardless of the pulse duration or frequency. These
      effects were mediated by vagal afferents since stimulation of the central end
      produced as much inhibition as stimulation of the intact nerve. VAS also
      significantly reduced the DGR when elicited by tooth-pulp intensities at 1x -5x
      threshold. In experiments using 90 s of continuous VAS, 16 combinations of
      frequency and intensity yielded a threshold intensity for DGR inhibition between
      0.1 and 0.5 mA and a threshold frequency at 2 Hz. Maximal DGR inhibition was
      produced at 5 Hz-0.5 mA by VAS. Reflex inhibition occurred within 10 s and
      outlasted VAS for longer than 60 s. Opiate-receptor blockade did not alter VAS
      inhibition of the DGR and, thus, opioids are not likely to mediate VAS-induced
      digastric inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628215
TI  - Electrolytic lesions of the locus coeruleus or 6-hydroxydopamine lesions of the
      medial forebrain bundle protect against excitotoxic damage in rat hippocampus.
AB  - Unilateral lesioning of the rat locus coeruleus by an electric current (0.3 mA/10
      s) reduces the ipsilateral hippocampal tissue content of dopamine (DA) and
      noradrenaline (NA) by 80% and 60% respectively, and protects against the
      excitotoxic action of bilateral kainate injections (1.1 nmol/microliters) in the
      hippocampus. On the ipsilateral side hippocampal CA1, CA2 and DG cells were
      protected; lesser protection of CA1 cells was seen on the contralateral side. The
      unilateral injection of 6-hydroxydopamine (8.8 micrograms/2 microliters/5 min)
      into the medial forebrain bundle abolishes the increase in extracellular NA
      concentration induced by kainate in the ipsilateral hippocampus without altering
      the low extracellular DA levels. This medial forebrain bundle lesion protects (on
      the ipsilateral side) against kainate toxicity (500 microM through the probe for
      20 min) in the hippocampus (CA1, CA2 and DG cells). The noradrenergic innervation
      of the hippocampus apparently potentiates the excitotoxic effect of focal
      injection of kainate.

PMID- 1628216
TI  - Variations of monoamines and their metabolites in the human brain putamen.
AB  - The levels of the monoamines dopamine (DA), serotonin (5-HT) and norepinephrine
      (NE) and the monoaminergic metabolites 3,4-dihydroxyphenylacetic acid (DOPAC),
      homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were measured
      with HPLC-ECD in 42 samples from human brain putamen. The influence of gender and
      of age was investigated and correlations between the monoamines were established.
      The DAergic system shows a significant difference between males and females, with
      females having lower DA and higher DOPAC levels and a higher DOPAC/DA ratio than
      males. No gender-related differences of 5-HT and its metabolites were observed,
      nor of NE. Three different age groups (group 1: 0-9.9 years: group 2: 10-59.9
      years; group 3: 60 years and older) were defined according to previous studies on
      ontogenesis and senescence in human brain. An increase in 5-HT levels, decrease
      in 5-HIAA levels and a decrease in the 5-HIAA/5-HT ratio were observed after the
      first decade of life. Changes in the DAergic system were seen in senescence, with
      decreasing DA levels and an increase in the HVA/DA ratio. DOPAC, HVA and the
      DOPAC/DA ratio are unaffected. NE is similar in all age groups. The analysis of
      the relation of the levels of the three monoamines proved a strong correlation
      between the DAergic and 5-HTergic systems. The nature of this relationship might
      have an impact on neuro-psychiatric disorders and brain function.

PMID- 1628217
TI  - Anemia up-regulates pontine A1 adenosine receptors in fetal sheep.
AB  - A rise in central adenosine concentrations most likely triggers the inhibitory
      effects of acute hypoxia on fetal breathing movements. During prolonged O2
      deficiency, the incidence of fetal breathing increases over time, an adaptation
      which may involve down-regulation of adenosine receptors. Therefore, isovolemic
      anemia was induced in chronically catheterized fetal sheep to determine the
      effects of acute O2 deprivation on the affinity of brainstem A1 adenosine
      receptors. Compared to control values, the mean hemoglobin concentration in 4
      fetuses was lowered by 54% (to 3.7 +/- 0.4 g/dl) for 1 h and in 3 fetuses by 58%
      (to 3.8 +/- 0.6 g/dl) for 4 h. Mean preductal arterial pH during anemia was
      significantly reduced to values as low as 7.123 +/- 0.090, but mean paO2 and
      paCO2 were not significantly affected. The average incidence of fetal breathing
      movements was decreased by 80% during the first hour and by 50% during the fourth
      hour of anemia. In 3 fetuses with normal hemoglobin levels, about 32 +/- 6.0% of
      the A1 adenosine receptors in the brainstem were in the high affinity state.
      After 1 h of anemia, the percentage of high affinity receptors in the pons (but
      not medulla or midbrain) had significantly increased to 47 +/- 2.9%, but after 4
      h of anemia all 3 brainstem regions had A1 receptor affinity within the range of
      control values. It is concluded that acute anemia induces a short-lived up
      regulation of pontine A1 adenosine receptors, but anemia does not alter A1
      receptor coupling in the midbrain where A1 receptors related to breathing
      inhibition may be located.

PMID- 1628218
TI  - The role of corticotropin-releasing factor and vasopressin in hypoglycemia
      induced proopiomelanocortin gene expression in the rat anterior pituitary gland.
AB  - In this study, we examined the effect of passive immunization of endogenous
      corticotropin-releasing factor (CRF) and arginine vasopressin (AVP) on
      hypoglycemia-induced adrenocorticotropic hormone (ACTH) secretion and determined
      proopiomelanocortin messenger RNA (POMC mRNA) levels in the anterior pituitary as
      well as hypothalamic CRF mRNA levels in pentobarbital anesthetized rats. The
      response of plasma ACTH to hypoglycemia was partially inhibited by the
      administration of CRF-antiserum (CRF-As) or AVP-antiserum (AVP-As) alone, but was
      found to be completely abolished by the administration of CRF-As + AVP-As as
      compared to the response in normal rabbit serum-treated rats. The hypoglycemia
      induced POMC mRNA level in the anterior pituitary was completely inhibited by the
      administration of CRF-As alone and CRF-As + AVP-As, but was not inhibited by AVP
      As alone as compared to the response in normal rabbit serum-treated rats. The
      administration of CRF-As and/or AVP-As did not affect hypoglycemia-induced CRF
      mRNA levels in the hypothalamus. These results indicate that the synergistic
      effect of CRF and AVP is important for hypoglycemia-induced ACTH secretion, but
      CRF is essential and indispensable for hypoglycemia-induced POMC gene expression
      in the anterior pituitary (AP).

PMID- 1628219
TI  - Calbindin D-28k-immunoreactivity in rat muscle spindle; a light and electron
      microscopic study.
AB  - The localization of the vitamin D-dependent calcium-binding protein, calbindin D
      28k (CaBP), was studied immunocytochemically in rat striated muscle. CaBP-like
      immunoreactivity was found in some of the intrafusal fibres in muscle spindles.
      The spindle capsule and the perineurial sheath of the nerve bundles were
      occasionally immunoreactive to CaBP. In electron microscope the labelling for
      CaBP was found diffusely in sarcoplasm, in Z-bands and inside the terminal
      cisternae of intrafusal muscle fibres. The present findings suggest that CaBP may
      have a role in maintaining the appropriate microenvironment in the intracapsular
      space of muscle spindle and that CaBP may be involved in the function of
      intrafusal muscle fibres.

PMID- 1628220
TI  - c-fos proto-oncogene changes in relation to REM sleep duration.
AB  - Auditory stimulation has been shown to increase REM sleep periods in cats and
      humans. This effect has been attributed to an elevation of the level of
      excitability in a variety of brain stem neuronal groups. Fos-like immunostaining
      (FLI) has been useful in constructing maps of post-synaptic neuronal activity
      with single cell resolution, and has been suggested to be tightly correlated with
      ongoing neuronal activity. This study used FLI to quantify neurons from
      structures expressing c-fos in brain stem areas in animals with normal REMs and
      compared them with those showing extended REM periods. The results basically
      indicated that brain stem areas which in other studies have been described as
      having REM-ON cells, showed an increase in FLI, while no FLI changes occurred in
      areas described as having REM-OFF cells. These results are discussed in terms of
      the possibility that REM maintenance is related to a widespread increase in brain
      stem excitability.

PMID- 1628221
TI  - Phosphatidylinositol-specific phospholipase C activity in the postmortem human
      brain: no alteration in Alzheimer's disease.
AB  - The activity of phospholipase C (PLC) which hydrolyzes exogenous
      phosphatidylinositol (PI), was investigated in samples prepared from postmortem
      normal human brains and Alzheimer disease brains. The enzyme activity did not
      change significantly after rat brains were left for 24 h at room temperature. The
      PI-specific PLC activity in the Alzheimer cytosolic and particulate fractions was
      not significantly different from that in the control fractions. The PI-specific
      PLC activity as a function of the free Ca2+ concentration was also similar
      between control and Alzheimer brains. These results suggest that the PI-specific
      PLC activity is not altered in Alzheimer's disease.

PMID- 1628222
TI  - Basic fibroblast growth factor binds to filamentous inclusions of
      neurodegenerative diseases.
AB  - The extracellular matrix protein heparin sulfate proteoglycans (HSPG) has been
      found in the neurofibrillary pathology of Alzheimer disease. This study was
      performed to determine if similar proteoglycans might be present in the
      fibrillary inclusions of other neurodegenerative diseases. Basic fibroblast
      growth factor (bFGF) binding to heparinase sensitive sites was used as an assay
      for HSPGs. We found that the inclusions of Pick and Parkinson diseases as well as
      progressive supranuclear palsy contained heparinase sensitive bFGF binding sites
      while the inclusions of diffuse Lewy body disease lacked bFGF binding sites.
      These findings indicate that HSPG's interactions and possible role in the
      formation of intraneuronal inclusions are not limited to Alzheimer disease.

PMID- 1628223
TI  - Influence of task dynamics on the organization of interlimb responses
      accompanying standing human leg flexion movements.
AB  - The organization of electromyographic (EMG) and kinetic (ground reaction forces)
      responses in postural (single stance limb) and primary task (flexing limb)
      components was examined in standing human subjects during single leg flexion
      movements over a range of speeds. Interlimb responses occurred coincidently prior
      to unloading and were scaled as a function of movement speed, suggesting a
      centrally organized, synchronous mode of coordination which reflected the
      mechanical constraints related to stance support function.

PMID- 1628224
TI  - Treatment of advanced colorectal cancer with recombinant interferon alpha and
      fluorouracil: activity in liver metastasis.
AB  - A cohort of 35 patients with advanced colorectal cancer, not previously exposed
      to chemotherapy, were included in a phase II study exploring the combination of
      interferon-alpha, 9 MU subcutaneously three times weekly, and 5-fluorouracil 750
      mg/m2/day during 5 consecutive days in continuous intravenous infusion followed
      with weekly bolus injection of fluorouracil 750 mg/m2. Of 33 cases evaluable for
      activity; 5 patients achieved partial response and 3 complete response for an
      overall response rate of 24% (95%; confidence limit 11-42%). Most of the
      responses were observed in liver metastases, response rate = 30% (95%; CL 13
      53%), with little activity observed in other sites; response rate 3% (95%; CL 8
      16%), p = .0006. The median time to progression and median overall survival were
      16+ (range 1+ to 48+) and 21+ weeks (range 1+ to 52+). All patients were
      evaluable for analysis of toxicity. Severe mucositis and diarrhea, present in 14
      patients were the limiting side effects. Two patients developed progressive renal
      toxicity and died. Weakness, myalgia, and nonneutropenic fever were observed
      frequently, one patient developed dementia. This combination is able to induce
      major responses in patients with advanced colorectal cancer, particularly in
      liver metastasis. Additional trials evaluating this approach are indicated.

PMID- 1628225
TI  - Preliminary evidence that incorporation of 5-fluorouracil into RNA correlates
      with antitumor response.
AB  - A comparative study of two different species of a fluorouracil assay was
      conducted on 11 patients who had carcinoma that was deemed unresectable after the
      surgical operation. For these patients FU at a dose of 10 mg/kg was intravenously
      administered before operation, and portions of the tumors were resected within
      120-150 min to assay both the (FU)RNA/RNA and FU/protein. After surgery, all
      patients were given FU alone either intravenously or orally. The FU, which was in
      an acid-soluble material (FU/protein), was not related to the antitumor effect of
      FU. However, the FU in RNA [(FU)RNA/RNA)] was found to be related to the
      antitumor effect of FU. When the concentration of (FU)RNA/RNA was above
      approximately 200 ng/mg, FU was effectual in unresectable carcinomas. It is
      probable that the (FU)RNA/RNA may be more suitable than FU/protein for predicting
      the antitumor effect of FU.

PMID- 1628226
TI  - Treatment with ImuVert/N-acetylcysteine protects rats from
      cyclophosphamide/cytarabine-induced alopecia.
AB  - Chemotherapy-induced alopecia is a distressing problem to the cancer patient for
      which currently there is no effective preventive measure. Recently ImuVert, a
      biologic response modifier, has been shown to protect from cytarabine-induced
      alopecia in the young rat model, but not from alopecia induced by
      cyclophosphamide. In the present study, the rat model was used to examine the
      effect of N-acetylcysteine on the course of alopecia from cyclophosphamide and of
      ImuVert plus N-acetylcysteine on alopecia induced by cytarabine-cyclophosphamide
      combination. The following observations were made: (1) Cyclophosphamide-induced
      alopecia could be effectively prevented by N-acetylcysteine, administered
      parenterally or applied topically in liposomes. (2) Alopecia caused by the
      combination of cyclophosphamide and cytarabine could be prevented by the
      parenteral or topical administration of ImuVert plus N-acetylcysteine. The
      potential applicability of these observations to the clinical settings remains to
      be determined.

PMID- 1628227
TI  - Hyperthermic isolation limb perfusion for malignant melanoma: a review.

PMID- 1628228
TI  - Treatment of intractable dyspnea: clinical and ethical issues.

PMID- 1628229
TI  - Oncology drug discovery and clinical trial testing: who's listening?

PMID- 1628230
TI  - [The laryngeal mask].
AB  - The laryngeal mask (LM) is a new concept developed by Brain. Easily inserted, the
      LM allows appropriate ventilation without the disadvantages of either the facial
      mask or the endotracheal intubation with its own complications. The limits of its
      use concern all the cases of reduction of thoracopulmonary compliance and full
      stomach. The LM offers no protection against regurgitation and aspiration. Airway
      obstruction may occur following laryngospasm (light anaesthesia) or down folding
      of the epiglottis. Trauma to the uvula and the posterior pharyngeal wall have
      been reported. The LM may be useful in all cases of surgery in which intubation
      is not absolutely required. Moreover, the LM is widely used for ENT and
      ophthalmic surgeries, in paediatric and adult procedures. Many cases of
      foreseeable or unforeseeable difficult intubation have been resolved by the
      insertion of a LM, allowing secondary intubation through the mask. Further
      investigations are required in order to evaluate the real limits and indications
      for its extended use.

PMID- 1628231
TI  - [Regional anesthesia by the caudal route in adults. Apropos of 56 caudal blocks].
AB  - Caudal anaesthesia was described in 1901 but is now essentially used for
      paediatric surgery. From their experience of 56 caudal blocks in adult patients
      scheduled for pelvic surgery or endoscopy, the authors discuss the value of this
      technique. The anatomical and physiological basis and the main guidelines of
      caudal anaesthesia are recalled through some references.

PMID- 1628232
TI  - [The computerized anesthesia record].
AB  - The first anaesthetic record was introduced into medical practice in 1940. Since
      then few changes have been made to it and it remains a rudimentary memorandum.
      However, since the beginning of the 1980s, interest in automatic recording of the
      anaesthetic file has been increasing and numerous arguments can be put forward in
      its favour. Apart from theoretical and experimental arguments, in practice one
      has to master the automatic collection of data, management of alarms and the
      technology of the networks involved in order to manage the flow of information by
      channelling it and organizing it into a hierarchy. Four other objectives can be
      added to the clinical recording and its medico-legal applications: anaesthetic
      cost evaluation, quality of care, research and clinical teaching which will
      provide the basis of anaesthetic epidemiological research.

PMID- 1628233
TI  - [Poisoning by buflomedil (Fonzylane)].

PMID- 1628234
TI  - [The use of the laryngeal mask in a case of difficult intubation].

PMID- 1628235
TI  - [Coma during a hip prosthesis under spinal anesthesia. Apropos of a case].
AB  - A case is reported of a postoperative coma in a ASA I 79 years old patient
      undergoing a spinal anaesthesia for hip prosthesis. The complication occurred
      three hours after the subarachnoidal puncture and 90 minutes after the completion
      of surgery. A complete recovery was observed in the following 48 hrs with the
      help of symptomatic treatments. Possible aetiologies and mechanisms of such
      accidents are discussed. However no definite cause could be ascertained in the
      case reported above, which is to add to similar ones observed during spinal
      anaesthesia in healthy patients. Anyhow, close surveillance is always mandatory.

PMID- 1628236
TI  - [Can anesthesiologists really have control over the preoperative examination?].

PMID- 1628237
TI  - [The debut of ether anesthesia in Germany].

PMID- 1628239
TI  - [Minimum alveolar concentration?].

PMID- 1628238
TI  - [Four cases of cardio-circulatory inefficacy during anesthesia: the role of
      propofol?].

PMID- 1628240
TI  - [The reliability of slow flow isoflurane vaporizers].
AB  - Two new vaporizers for isoflurane were tested and verified with very low flows:
      Ohmeda Tec 5 and Penlon PPV Sigma vaporizers. This work completes a previous one
      [1]. The Ohmeda Tec 5 appeared to be quite reliable. The Penlon vaporizer gave
      pretty good results too. However a gas flow with vibratory component can affect
      the result by decreasing dramatically the concentration of inhaled isoflurane.

PMID- 1628241
TI  - [A comparative study of CPK during spinal surgery in the knee-chest position.
      Apropos of 93 patients].
AB  - A number of severe rhabdomyolysis with acute renal failure have been reported
      following spine surgery in knee chest position. CPK were measured postoperatively
      in 93 patients (A group), comparatively with two groups in which respectively
      neurosurgery without any muscle stretching (B group) and abdominal surgery with
      aid of retractors (C group) were performed. CPK were significantly and similarly
      increased in A and C groups only. This postoperative increase of CPK appears to
      be related more to the muscle stretching than to the posture itself.
      Intraoperative low blood pressure and an operating time longer than 4 hrs
      contribute probably to rhabdomyolysis. No renal failure was observed in our
      series. Low limb vascular insufficiency is the main contra-indication of knee
      chest position. Postoperative diuresis surveillance is mandatory in all cases,
      CPK analysis is not.

PMID- 1628242
TI  - [Anesthesia in the schizophrenic].
AB  - The preanaesthetic interview and examination is difficult in case of
      schizophrenia. The lack of communication can be responsible for late recognition
      of surgical diseases. The treatment by neuroleptic drugs should not be
      interrupted. It can interfere with anaesthesia, yet all anaesthetic methods can
      be safely used including local and regional anaesthesia to be performed under
      sedation. Postoperative care requires psychiatric nursing staff and is often
      rendered difficult by the patients agitated behaviour. In catatonic schizophrenia
      it can be difficult to diagnose a malignant syndrome of neuroleptics. Peristaltis
      is slowed by neuroleptic and antiparkinson drugs and pseudoileus may occur.
      Appropriate medical treatment to evacuate the bowels is needed.

PMID- 1628243
TI  - The pathophysiology of pain.
AB  - Attempting to relieve pain can be difficult, but with a firm understanding of the
      physiology of pain facilitation and inhibition, meaningful management strategies
      can be devised. Pain management failure will be more easily understood and less
      likely to be blamed on the patient. Good pain management requires both the
      practitioner and the patient to be knowledgeable. There are no shortcuts or
      prescriptions that will suit every patient experiencing any particular type of
      pain. This fact is both the difficult dilemma and the challenging aspect of pain
      control.

PMID- 1628244
TI  - Assessment and management of pain in the critically ill trauma patient.

PMID- 1628245
TI  - Pediatric pain management.
AB  - The management of pediatric pain is a complex, multifaceted subject. By viewing
      pediatric pain management as a priority, health care providers may diminish
      children's suffering in hospital settings. Critical care nurses can make a
      difference by increasing awareness of pain issues, incorporating pain assessment
      tools into their flow sheet, being knowledgeable about pain management
      interventions, and collaborating with the other health care team members to cope
      effectively with each child's individual pain management needs.

PMID- 1628246
TI  - Discomfort to environmental noise: heart rate responses of SICU patients.

PMID- 1628247
TI  - Diagnosing asthma by questionnaire in epidemiological surveys.

PMID- 1628248
TI  - The bronchial epithelium as a target for inflammatory attack in asthma.

PMID- 1628249
TI  - An update on PAF.

PMID- 1628250
TI  - A research method to induce and examine a mild exacerbation of asthma by
      withdrawal of inhaled corticosteroid.
AB  - This study evaluated a research method to examine an exacerbation of asthma
      induced by corticosteroid withdrawal. Ten non-smoking adult asthmatics who were
      stable on treatment with inhaled steroid underwent a graded reduction of the
      daily dose by 200 micrograms at weekly intervals until an exacerbation of
      symptoms occurred. A daily symptom, peak expiratory flow rate (PEF) and
      medication diary was kept. Weekly clinic visits were used to assess symptoms,
      spirometry, methacholine airway responsiveness (expressed as the provocative
      concentration to cause a fall in FEV1 of 20%, PC20), circulating eosinophils,
      basophils and their progenitors (Eo/B-CFU), and sputum inflammatory cells. The
      laboratory tests were performed blind to the clinical details. Each subject
      developed an exacerbation of symptoms, on average at 16 (7-26) days after the
      onset of steroid reduction. This was accompanied by a deterioration in each of
      the objective measures. There was a fall in FEV1 by 320 ml (s.e.m. 9.5) and in
      PC20 from 0.8 to 0.43 mg/ml. Circulating eosinophils rose from 114 (24) x
      10(3)/ml to 227 (50) x 10(3)/ml and Eo/B-CFU rose from 31 (5.6) to 44
      (11.3)/10(6) cells. Sputum developed in five subjects and contained 36 (5.2)%
      eosinophils and 1.98 (0.21)% metachromatic cells (mast cells or basophils). The
      symptom diary and weekly questionnaire were demonstrated to be valid and
      responsive to change. A deterioration indicated by the daily symptom score
      preceded changes in PEF. Treatment by an increase in steroid was followed by
      reversal of each of the changes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628251
TI  - The house dust mite Dermatophagoides pteronyssinus is the most important allergen
      on the island of Mauritius.
AB  - To determine the relative importance of mites as a cause of allergic sensitivity
      and asthma on the western Indian Ocean island of Mauritius, we measured specific
      IgE antibodies to common inhalant allergens in sera from Mauritians claiming to
      have allergic symptoms and we examined house dust samples for evidence of mites
      and their allergens. Seventy-two of the 110 sera tested (65%) contained
      detectable IgE antibody to at least one mite, mould or pollen allergenic extract.
      By far the most prevalent was antibody to one or both of the common house dust
      mites, Dermatophagoides pteronyssinus and Dermatophagoides farinae, being present
      in 67 (61%) of the 110 sera. Allergy to pollens, including the locally prevalent
      Bermuda grass and sugar cane, was infrequent. Antibody to a limited number of
      moulds was detected in 22% of the sera tested. Of 81 subjects whose clinical
      history was known, 60 were asthmatic, and 75% of these asthmatic individuals had
      IgE antibody to mites. In contrast, only 35% of the subjects with rhinitis
      without asthma were sensitive to mites. Different mite species, including D.
      pteronyssinus but not D. farinae, were identified microscopically in samples of
      local house dust. Mite antigen Der p I but not antigen Der f I was detected with
      specific monoclonal antibodies in extracts of these dust samples. On the bases of
      this serological and environmental survey, we conclude that our data support the
      hypothesis that the house dust mite D. pteronyssinus is the principal cause of
      allergic sensitivity and asthma in that tropical environment.

PMID- 1628252
TI  - Prediction of annual variations in atmospheric concentrations of grass pollen. A
      method based on meteorological factors and grain crop estimates.
AB  - We performed an aerobiologic observation of the grasses present in Madrid for 14
      years (1978-1991), using volumetric air samplers. The counts obtained show that
      the major grass pollen release period (average daily grass pollen counts greater
      than 50 grains/m3 of air) occurs in the months of May and June, although lower
      counts can occur some days from the end of January onward. There are wide year-to
      year variations in total atmospheric grass pollen counts, expressed as the total
      sum of the mean daily concentrations from April 1st to July 30th (ranging from
      2568 to 6624). A strong, statistically significant correlation, based on
      Spearman's rank test and/or simple and multiple linear regressions, was found
      between the total grass seasonal count and preseasonal rainfall from October to
      March (R2 = 0.64; P = 0.0429). The meteorological variable which gave the
      correlation with greatest statistical significance (R2 = 0.97; P = 0.0016) was
      the average monthly preseasonal humidity from October to March. A good
      correlation was also found between March estimates of wheat, rye and barley crops
      and the total grass count (R2 = 0.73; P = 0.006). A model was designed from the
      above mentioned humidity variable through a multilinear regression analysis, and
      it was possible to predict, at the beginning of April, total seasonal counts for
      1989 (predicted = 5468; actual = 4410; average error = 24%), 1990 (5033; 6090; 
      17%) and 1991 (3930; 2568; 53%). These data may help clinicians to predict and
      prepare themselves for the intensity of the grass pollen season and to explain
      yearly variations in the severity of symptoms.

PMID- 1628253
TI  - Monoclonal antibodies bind identically to both spores and hyphae of Aspergillus
      fumigatus.
AB  - Immunoelectron microscopy (IEM) was used to determine the binding of six
      monoclonal antibodies (MoAbs) produced against Aspergillus fumigatus antigens
      present on or within the conidia and hyphae of the fungus. Antigen-antibody
      complexes were demonstrated in EM using labelled colloidal gold particles (15
      nm). Three out of 6 MoAbs (C9, F12 and H10) reacted only with the cytoplasmic
      components of A. fumigatus while the remaining three (B12, F6G5 and D6E6) showed
      reactivity to both cytoplasm and cell wall of the conidia and hyphae. The results
      indicate that IEM is of considerable value in determining and selecting
      monoclonal antibodies having specific reactivity with diverse antigenic
      components.

PMID- 1628254
TI  - Comparison of a video questionnaire with the IUATLD written questionnaire for
      measuring asthma prevalence.
AB  - A video questionnaire (VQ) for measuring asthma prevalence in adolescents was
      assessed for repeatability and validity in relation to bronchial
      hyperresponsiveness (BHR) (PD20 less than or equal to 7.8 mumol methacholine).
      Comparison was also made with a standard, self completed written questionnaire
      (SQ), based on the IUATLD Bronchial Symptoms Questionnaire, which included five
      questions seeking comparable data to those in the VQ. Both the VQ and SQ were
      administered to 707 schoolchildren (13-16 years), in whom English was the primary
      language. One hundred and six randomly selected children subsequently underwent
      bronchial challenge to methacholine. Both the sensitivity and specificity for BHR
      were higher for a combination of three or more positive responses to the VQ (0.73
      and 0.88), than to the SQ (0.63 and 0.82), although these differences were not
      statistically significant (P = 0.24). When administered again after a two week
      interval, the VQ had a significantly higher (P = 0.03) coefficient of
      repeatability (0.79) than the SQ (0.50). We conclude that the VQ is a valid and
      reliable method of determining asthma prevalence, and propose that by providing
      data relatively free from biases due to language, culture, literacy or
      interviewing techniques it may be particularly useful when comparing asthma
      prevalence and severity in different populations.

PMID- 1628255
TI  - Can fatal asthma be prevented?--a personal view.
AB  - An increase in the mortality rate from asthma in several countries has been
      observed in recent years, notwithstanding the great improvement in
      pathophysiological findings and the introduction of new effective therapeutic
      agents. The phenomenon is difficult to explain but the causes of death and
      identification of high-risk patients have been widely studied. It is suggested
      that the most vital aim for physicians is the avoidance of those factors which
      may contribute to death from asthma. These are particularly: inadequate
      assessment of its severity by patients, general practitioners and hospital
      doctors, and inadequate and inappropriate treatment. From the diagnostic point of
      view, the measurement of airflow rates is necessary to establish the diagnosis in
      terms of reversibility, quantify the severity and assess the response to therapy.
      The different entity of reversibility of bronchial obstruction is due to the
      various mechanisms intervening in different patients. After adequate treatment,
      according to our observations, the reversibility is more complete in young people
      and when the duration of the disease is less than 2 years. Trigger factors must
      also be considered. From the therapeutic point of view, considering that the most
      important alteration in asthma is the inflammation of bronchial structures with
      intervention of several inflammatory cells and of numerous different chemical
      mediators, physicians have to apply treatment aimed at reducing inflammation
      rather than relying on symptomatic bronchodilator remedies. Treatment should be
      divided into three phases, according to symptoms: induction, consolidation and
      maintenance. Finally, on the basis of data here presented and of clinical
      experience, the essential measures for the prevention of asthma mortality are
      reported. If general practitioners take them into account, deaths from asthma
      will be reduced to a minimum.

PMID- 1628256
TI  - Magnification.

PMID- 1628257
TI  - Malignant hyperthermia.

PMID- 1628258
TI  - Clindamycin and dry socket.

PMID- 1628259
TI  - Concerns regarding infection control recommendations for dental practice.
AB  - It goes without saying that the members of any professional group are more likely
      to modify their behavior if they are provided with logical, rational reasons to
      enact the suggested change. In the mid 1980s, health care providers, including
      dental personnel, were advised to adopt universal precautions and to alter their
      infection control habits with minimal justification, apart from the general
      unease and paranoia surrounding AIDS. Therefore, it is understandable that some
      practitioners would react with scepticism to the idea that their traditional
      infection control techniques were less than adequate, while others would
      overwhelmingly embrace the new recommendations in the misguided belief that
      personal, patient, staff and family safety would be enhanced. This predictable
      confusion is epitomized by the dentist who "sterilizes" extraction forceps by
      immersing them in alcohol for 10 minutes, versus the dentist who wears gloves,
      mask and disposable gown to conduct a recall examination. And if dentists are
      perplexed, it is clear that their staffs are equally, if not more confused, since
      they are exposed to the exaggerated claims and counter claims of sales agents.
      The microbes encountered in dental practise, apart from the hepatitis B virus,
      pose no significant risk to dental personnel or their patients, and the danger of
      hepatitis B transmission is reduced most effectively by vaccination. In reality,
      the genesis of dentistry's current emphasis on infection control resides entirely
      with HIV disease. But there is no credible clinical evidence to suggest that HIV
      infection is transmitted via dental treatment. Indeed, it may be theorized that
      for such a transmission to occur, the blood stream of the susceptible recipient
      would have to be invaded directly by a pathogenic inoculum of the virus--an
      unlikely event in the normal practise of dentistry. Under such circumstances,
      infection control practises should ignore the danger of HIV transmission, but
      concentrate on: Sterilization of all surgical and invasive instruments to protect
      patients from potential cross-infection. All dental staff receiving hepatitis B
      vaccinations. Dental staff wearing gloves, especially while performing intraoral
      procedures with blood release, and handling used instruments, to protect them
      from direct contact with potential pathogens. Working in a clean environment, in
      which blood spills and splatters are removed mainly for esthetic reasons. Such
      measures reflect the actual potential for disease transmission, as it exists in
      dentistry. They are justified and economical, and will be implemented by
      concerned but knowledgeable dental staff.

PMID- 1628260
TI  - Dentists overcome AIDS rumors.

PMID- 1628261
TI  - Another perspective of AIDS.

PMID- 1628262
TI  - Dental anesthesia and shoplifting: a case study.

PMID- 1628263
TI  - Naproxen: pharmacology and dental therapeutics.
AB  - Naproxen and naproxen sodium are very commonly used and effective non-steroidal
      anti-inflammatory analgesics. In this paper, they are described and compared, and
      their pharmacokinetics and indications are discussed. Adverse reactions to these
      drugs and the mechanism of action of these effects on the gastrointestinal tract,
      central nervous system, kidneys, liver, and blood are described. A discussion of
      the effects of the drugs on the elderly and during pregnancy and lactation is
      included. Also, the allergenicity, miscellaneous rare complications and acute
      toxicity of the naproxen anion are described, followed by a description of the
      more common drug interactions. The results of several recent studies that may
      call into question the current recommendations on using these pharmaceuticals are
      cited. Until this controversy can be resolved, the practitioner should rely on
      the principle of "first do no harm" in choosing a course of drug treatment.

PMID- 1628264
TI  - Factors influencing repair and regeneration following replantation.

PMID- 1628265
TI  - Vertical extrusion: literature review and report of a case.
AB  - To date, the scientific literature has documented, primarily, successful methods
      and techniques of treatment involving vertical extrusion. The purpose of this
      article is to review the literature and report on a case that demonstrates the
      multidisciplinary approach required to successfully manage a reversible
      complication involving the restoration of an adult maxillary central incisor that
      had sustained an oblique crown-root fracture.

PMID- 1628266
TI  - [Adhesive resistance between a polymerizable glass ionomer base (Vitrabond) and a
      composite resin (P 50)].
AB  - This study attempts to measure the adhesive resistance between VitreBond and P-50
      composite resin when the VitreBond surface is submitted to grinding and to the
      application of Scotchprep. The results indicate that this adhesion is superior to
      the cohesive resistance of VitreBond independently from grinding and from the
      application of Scotchprep.

PMID- 1628267
TI  - Evaluation of the hypertensive child.

PMID- 1628268
TI  - Hypertension in the neonatal period.

PMID- 1628269
TI  - Essential hypertension in childhood and adolescence.

PMID- 1628270
TI  - Coarctation of the aorta and hypertension.

PMID- 1628271
TI  - Hypertension in the child with chronic renal insufficiency or undergoing
      dialysis.

PMID- 1628272
TI  - Pediatric post-transplant hypertension: a review of current standards of care.

PMID- 1628273
TI  - Surgical intervention in pediatric renovascular hypertension.

PMID- 1628274
TI  - Pediatric hypertension.

PMID- 1628275
TI  - Physiology of blood pressure.

PMID- 1628276
TI  - Na-Li countertransport and blood pressure in childhood.

PMID- 1628277
TI  - Normal and abnormal blood pressure in childhood.

PMID- 1628278
TI  - Diet, salt, anthropological and hereditary factors in hypertension.

PMID- 1628279
TI  - Treatment of experimentally induced atherosclerosis in swine iliac arteries: a
      comparison of self-expanding and balloon-expanded stents.
AB  - Atherosclerosis was induced in 20 Hanford miniature swine. Subsequently, one
      iliac artery lesion in each of 16 pigs was stented with either a self-expanding
      (8 pigs) or a balloon-expanded (8 pigs) stent. Immediately after stent placement,
      4 animals in each group were taken off the atherogenic diet and continued on
      normal chow for the remainder of the study. Four months after stents were placed,
      atherosclerosis and the mural changes associated with the stent were more clearly
      evident in the arteries of the pigs continued on the atherogenic diet. These pigs
      also exhibited significantly more neointimal proliferation. In addition, the
      arteries containing the balloon-expanded stents showed more extensive and complex
      intimal changes when compared with arteries with self-expanding stents. Although
      both stent designs were equally effective in maintaining vascular patency, the
      balloon-expanded stent was more traumatic to the vessel wall which resulted in a
      significantly greater neointimal thickness.

PMID- 1628280
TI  - Oscillating probe aspiration thrombectomy: comparative in vitro evaluation of two
      concepts.
AB  - Aspiration thrombectomy supported by an oscillating metal probe within the
      catheter allows continuous aspiration of large thrombi without catheter
      obstruction. Thrombus aspiration assisted by an ultrasound-driven probe
      (frequency 26 kHz) and by an electric motor-driven probe (frequency 40 Hz) was
      compared in two different in vitro models: aspiration of large clots from a Petri
      dish and recanalization of thrombotic occlusions in a flow model. Comparable
      results were found for a 1 mm ultrasound-driven probe and a 0.5 mm motor-driven
      probe. The motor-driven device, however, seems to be more appealing for in vivo
      application because of its simplicity, probe flexibility, absence of thermal
      effects, and low cost.

PMID- 1628281
TI  - Bronchial artery embolization for hemoptysis: immediate and long-term results.
AB  - The purpose of this study was to evaluate the immediate and long-term results in
      63 patients who underwent transarterial embolization for control of hemoptysis.
      Overall immediate success rate was 86.1%. At long-term follow-up 50% of patients
      showed complete remission, 22% partial remission, and 28% recurrent hemoptysis.
      Hemoptysis remained controlled for a mean of 22 months and a median of 14 months.
      The long-term results among four disease groups differed substantially. Patients
      with bronchiectasis showed the best results, followed by those with idiopathic
      disease and with inflammation; patients with neoplasm showed the worst results.

PMID- 1628282
TI  - Pulmonary arteriography.
AB  - Developments in catheter design, contrast media, and radiologic equipment have
      simplified the performance of pulmonary arteriography. With proper precautions
      the procedure is acceptably safe even in critically ill patients. This procedure
      should be part of the repertoire of any active and properly equipped angiographic
      laboratory.

PMID- 1628283
TI  - Selecting the right technique to reform a reverse curve catheter (Simmons style):
      critical review.
AB  - Reformation of the curve of the Simmons sidewinder catheter may be difficult in
      some patients, and the originally described technique using the left subclavian
      artery may be unsuccessful. We review the techniques available for curve
      reformation, identifying the limitations and problems associated with each
      technique. We believe that reformation in the descending aorta without a
      guidewire is the method of choice in most patients. Knowledge of a number of
      different techniques is advisable.

PMID- 1628284
TI  - Spontaneous splenic rupture associated with thrombolytic therapy and/or
      concomitant heparin anticoagulation.
AB  - Two cases of spontaneous splenic rupture in connection with thrombolytic therapy
      and concomitant heparin anticoagulation are reported. One patient was being
      treated for peripheral arterial graft occlusion using intraarterial urokinase,
      the other received intravenous infusion of streptokinase for acute myocardial
      infarction. Neither patient had a condition predisposing to splenic rupture.
      Although rare, previous reports of spontaneous splenic rupture associated with
      thrombolytic therapy and/or anticoagulation have been reported. Splenic rupture
      as a complication of thrombolytic therapy and/or anticoagulation should be
      considered when unexplained abdominal symptoms, hypotension, or blood loss is
      encountered.

PMID- 1628285
TI  - Focal necrosis of the ureter following CT-guided chemical sympathectomy.
AB  - Focal necrosis of the ureter was observed in our patient 7 days after CT-guided
      chemical sympathectomy. The injection of phenol was apparently rendered remote
      from the ureter and still caused ureteric necrosis. Ureteric injury may thus
      result following chemical sympathectomy, not from direct puncture of the ureter,
      but from unpredictable individual diffusion pathways.

PMID- 1628286
TI  - Percutaneous fenestration of a type I aortic dissection for relief of lower
      extremity ischemia.
AB  - A 36-year-old patient underwent successful percutaneous fenestration of a type I
      aortic dissection which had caused occlusion of the right common iliac artery and
      ischemia of the right lower extremity. The patient is currently (6 months post
      fenestration) ambulating without any signs of vascular compromise. The technique
      may be useful in patients who are at high risk for surgical procedures.

PMID- 1628287
TI  - Retrograde esophageal balloon dilatation: salvage treatment of caustic-induced
      stricture.
AB  - A 14-month-old boy with severe esophageal strictures following ingestion of
      potassium hydroxide is described. Initially, treatment was by surgical bougienage
      but following esophageal perforation, 65 balloon dilatations were performed over
      an 8-month period using a retrograde approach via a feeding gastrostomy without
      anesthesia or sedation. A further nine dilatations in the following 6 months were
      performed using a per-oral approach after establishment of full oral nutrition
      and removal of the gastrostomy. The main advantage of the retrograde approach was
      the large number of dilatations that could be performed without anesthesia in an
      infant. This has allowed nonoperative treatment of a high grade caustic
      esophageal stricture which would otherwise have required esophageal replacement.

PMID- 1628288
TI  - Subaortic aneurysm in a case of aortic coarctation: case report.
AB  - Subaortic aneurysms are very rare and of uncertain etiology. We present a unique
      case in which coarctation of the aorta and biscuspid valve predisposed to
      infective endocarditis and formation of a mycotic subaortic aneurysm.

PMID- 1628289
TI  - Human root caries: histopathology of arrested lesions.
AB  - The histopathology of arrested root caries lesions was examined in extracted
      human teeth. The main structural characteristics of arrested lesions were the
      completely mineralized surface area and the formation of a distinct sclerosis of
      the dentinal tubules. Intertubular dentin was, with the exception of the dentinal
      tubules, fully mineralized up to the surface. Dentinal tubules near the surface
      were either filled with ghosts of microorganisms or with crystals of different
      shapes. Sclerosis of the dentinal tubules was characterized by the presence of
      three different patterns of intratubular mineralization that occur in distinct
      regions of the zone of tubular sclerosis. The patterns were distinguishable by
      the type of crystals and their association with organic structures such as
      collagenous fibrils or odontoblast processes. It is suggested that arrested
      lesions are based on (1) the formation of an inner barrier that interrupts the
      diffusion of substrata from the pulp to invaded bacteria, (2) the formation of an
      outer barrier by a compact, highly mineralized surface region which blocks the
      diffusion of products of bacterial metabolism into dentin, and (3) an area of
      mineralization which extends from the outer barrier toward the root canal within
      demineralized dentin. The present study demonstrates the considerable potential
      of caries lesions in dentin to become arrested, and subsequently partially
      remineralized. These phenomena seem to depend on the severity of an active lesion
      and its location on the root surface. This should be taken into account when
      diagnosing root caries lesions. The potential of root caries lesions to become
      arrested indicates that the treatment concept of active root caries lesions
      should be reconsidered.

PMID- 1628290
TI  - Increased resistance to artificial caries-like lesions in dentin treated with CO2
      laser.
AB  - The crowns of 60 permanent human molars were sectioned transversally. The exposed
      dentin surface was divided into different parts: a first part was kept as
      control, a second part was immediately varnished, and a third part was irradiated
      with a CO2 laser using the same irradiation conditions as those applied for
      caries removal (10 impulses of the same energy; 0.2 s/impulse; energy
      density/impulse 280-715 J/cm2. After irradiation, a small portion of this area
      was varnished. The teeth were immersed for 4 weeks in a cariogenic gel (pH = 4.5)
      at 36 degrees C. Twenty teeth were studied by scanning electron microscopy, and
      longitudinal sections of the other teeth were prepared for microradiography and
      microdensitometry measurements. The lased dentin surface appeared smooth for
      energy densities lower than 425 J/cm2. Longitudinally fractured samples revealed
      a layer of dentin devoid of tubular structure (20-70 microns thick, depending on
      the energy density used), whereas below the sealed layer, the dentinal tubules
      retained their normal aspect. Although the sealed layer showed no
      demineralization when exposed to acid, demineralization of the underlying dentin
      occurred, but to a much lesser extent than in the unlased dentin.

PMID- 1628291
TI  - Effects of nine different chewing-gums and lozenges on salivary flow rate and pH.
AB  - The objectives of this study were to determine how salivary flow rate and pH vary
      with time during use of chewing-gums and lozenges. Twenty-four young adults
      collected unstimulated saliva and then, on different occasions, chewed one of six
      flavoured gums, or gum base, or sucked on one of two lozenges, for 20 min, during
      which time eight separate saliva samples were collected. Flow rate peaked during
      the 1st minute of stimulation with all nine products. With the lozenges, flow
      rate fell towards the unstimulated rate when the lozenges had dissolved. There
      were no significant differences in the flow rates elicited by cinnamon- or
      peppermint-flavoured gums or between sugar-containing or sugar-free gums. With
      the flavoured gums, the mean flow rate followed a power curve (r = -0.992) with
      time and within about 10 min was not significantly different from that when gum
      base was the stimulus. The initial stimulated flow rate with flavoured gums was
      about 10-12 times greater than the unstimulated rate (0.47 ml/min). After 20 min
      of chewing, it was still about 2.7 times that rate and about the same as the flow
      rate elicited by chewing-gum base alone. The pH of unstimulated saliva was about
      6.95. With one gum containing about 1.5% organic acids, the salivary pH fell to a
      minimum of 6.18 in the 1st minute of stimulation, but then rose rapidly to a
      level above that in unstimulated saliva. With a sucrose-containing and a sucrose
      free gum, the pH rose immediately on stimulation and then fell slightly with time
      to levels which were significantly above the pH of unstimulated saliva.

PMID- 1628292
TI  - Mutans streptococci and lactobacilli in breast-fed children with rampant caries.
AB  - This study aimed to investigate the prevalence of selected components of the oral
      microflora in breast-fed children who developed rampant caries (resembling
      nursing caries) under hitherto unexplained circumstances. Dental plaque and
      saliva samples were collected from breast-fed children, aged between 1 and 2.5
      years, with and without rampant caries. Mutans streptococci and lactobacilli were
      isolated from dental plaque of all children with rampant caries and from most
      caries-free children. None of the colonies of mutans streptococci resembled those
      of Streptococcus sobrinus. The mean counts of the mutans streptococci and
      lactobacilli were 100-fold higher in plaque samples from children with rampant
      caries as compared with caries-free children. No difference could be found
      between the numbers of mutans streptococci in plaque overlaying cavities and that
      from adjacent sound enamel. In contrast, the counts of lactobacilli in plaque
      were approximately 100-fold higher from cavities than from sound surfaces. The
      levels of mutans streptococci in saliva were directly related to the presence of
      rampant caries. The results show that caries-free and caries-active breast-fed
      children, aged 1 to 2.5 years, harbour mutans streptococci and lactobacilli on
      their teeth. Rampant caries in these children can occur in the absence of nursing
      bottles or any other feeding abuse during weaning and in the presence of an
      aciduric plaque microflora, as has been reported for children with nursing bottle
      caries.

PMID- 1628293
TI  - Validity of diagnosis of questionable caries lesions in occlusal surfaces of
      extracted third molars.
AB  - This study was to evaluate the accuracy of visual inspection, conventional
      radiography, and digital radiographic methods for the detection of occlusal
      carious lesions in third molars from a present-day adolescent population. Seventy
      eight third molars, considered clinically to be without occlusal cavities, were
      extracted from young soldiers. Before extraction, an intra-oral radiograph was
      obtained. After extraction, the teeth were examined visually as per the criteria:
      0 = no caries, 1 = chalky/stained fissure indicative of enamel caries, 2 = chalky
      and dark-stained fissure considered indicative of a dentinal lesion, and 3 = as
      per criterion 2, but with small surface defects (microcavities). The radiographs
      were digitised, and image enhancement with contrast stretch and a filtering
      procedure was performed, respectively. The three types of radiographic image were
      assessed as per the criteria: 1 = no caries/caries confined to enamel, 2 = caries
      involving the outermost dentine, and 3 = deep dentinal caries extending half-way
      or more to the pulp. Ground sections (500-600 microns in thickness) served as
      validation for lesion depth. The digital radiographic method with contrast
      stretch performed overall best of the four methods (greater than 70% detection
      rate) while visual inspection (53% detection rate) performed better than
      conventional radiography (48% detection rate). When results from visual
      inspection and conventional radiography were combined, an increase in the
      detection rate of 11% was obtained with a 7% increase in false-positive scorings.
      When digitally contrast-manipulated radiographs were combined with visual
      inspection, a gain of 33% was obtained with an 11% increase in false
      positives.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628294
TI  - The status of bite-wing radiographs in enhancing discriminatory ability in caries
      prophylactic clinical trials.
AB  - Data were taken from six randomised controlled trials of caries prophylactic
      agents in order to investigate the capacity of bite-wing radiographs of posterior
      approximal tooth surfaces to enhance discrimination between test and control
      group measurements. The findings showed that, where an active control agent was
      employed, the addition of radiographic to clinical examination data failed to
      improve discriminatory power in comparisons between 3-year caries increments.

PMID- 1628295
TI  - Caries prevalence of kindergarten children in Salzgitter and Oslo.
AB  - In a comparable epidemiological study of kindergarten children, 455 4- and 5-year
      olds in Salzgitter (FRG) and 171 4- and 5-year-olds in Oslo (Norway) were
      examined. Caries was scored at the cavitation level according to WHO criteria.
      The percentage of caries-free children was higher and the dmfs scores were lower
      in Oslo than in Salzgitter. It is postulated that this was the result of
      different levels of fluoride exposure, nutritional habits and dental treatment
      provision.

PMID- 1628296
TI  - Rampant caries and linear hypoplasia (short communication).

PMID- 1628297
TI  - Formation of neuroblastic layers in chicken retinospheroids: the fibre layer of
      Chievitz secludes AChE-positive cells from mitotic cells.
AB  - The significance of the classical subdivision of the retinal primitive
      neuroepithelium into an outer and an inner neuroblastic layer by the transient
      fibre layer of Chievitz (LOC) is little understood. We examine here the formation
      of neuroblastic layers by regenerating fully laminated retinospheroids from
      dissociated cells of the embryonic chick eye margin in rotary culture. By tracing
      cellular processes with the fibre-specific F11-antibody in retinospheroids, we
      occasionally find, in addition to an outer and an inner plexiform layer, a cell
      free F11-positive LOC homologue, subdividing the inner nuclear layer. Moreover,
      we demonstrate that the LOC precisely separates postmitotic AChE-positive cells
      of the inner retina from an AChE-negative outer part holding all BrdU-labelled
      mitotic cells. These in vitro data suggest that the inner neuroblastic layer is
      exclusively composed of AChE-positive cells, thus representing a primary
      differentiation zone of the retina.

PMID- 1628298
TI  - Chicken retinospheroids as developmental and pharmacological in vitro models:
      acetylcholinesterase is regulated by its own and by butyrylcholinesterase
      activity.
AB  - The phylo- and ontogenetically related enzymes butyrylcholinesterase (BChE) and
      acetylcholinesterase (AChE) are expressed consecutively at the onset of avian
      neuronal differentiation. In order to investigate their possible co-regulation,
      we have studied the effect of highly selective inhibitors on each of the
      cholinesterases with respect to their expression in rotary cultures of the retina
      (retinospheroids) and stationary cultures of the embryonic chick tectum. Adding
      the irreversible BChE inhibitor iso-OMPA to reaggregating retinal cells has only
      slight morphological effects and fully inhibits BChE expression. Unexpectedly,
      iso-OMPA also suppresses the expression of AChE to 35%-60% of its control
      activity. Histochemically, this inhibition is most pronounced in fibrous regions.
      The release of AChE into the media of both types of cultures is inhibited by iso
      OMPA by more than 85%. Control experiments show that AChE suppression by the BChE
      inhibitor is only partially explainable by direct cross-inhibition of iso-OMPA on
      AChE. In contrast, the treatment of retinospheroids with the reversible AChE
      inhibitor BW284C51 first accelerates the expression of AChE and then leads to a
      rapid decay of the spheroids. After injection of BW284C51 into living embryos, we
      find that AChE is expressed prematurely in cells that normally express BChE. We
      conclude that the cellular expression of AChE is regulated by the amount of both
      active BChE and active AChE within neuronal tissues. Thus, direct interaction
      with classical cholinergic systems is indicated for the seemingly redundant BChE.

PMID- 1628299
TI  - Specialized ommatidia for polarization vision in the compound eye of cockchafers,
      Melolontha melolontha (Coleoptera, Scarabaeidae).
AB  - The superposition eye of the cockchafer, Melolontha melolontha, exhibits the
      typical features of many nocturnal and crepuscular scarabaeid beetles: the
      dioptric apparatus of each ommatidium consists of a thick corneal lens with a
      strong inner convexity attached to a crystalline cone, that is surrounded by two
      primary and 9-11 secondary pigment cells. The clear zone contains the unpigmented
      extensions of the secondary pigment cells, which surround the cell bodies of
      seven retinula (receptor) cells per ommatidium and a retinular tract formed by
      them. The seven-lobed fused rhabdoms are composed by the rhabdomeres of the
      receptor cells 1-7. The rhabdoms are optically separated from each other by a
      tracheal sheath around the retinulae. The orientation of the microvilli diverges
      in a fan-like fashion within each rhabdomere. The proximally situated retinula
      cell 8 does not form a rhabdomere. This standard form of ommatidium stands in
      contrast to another type of ommatidium found in the dorsal rim area of the eye.
      The dorsal rim ommatidia are characterized by the following anatomical
      specializations: (1) The corneal lenses are not clear but contain light
      scattering, bubble-like inclusions. (2) The rhabdom length is increased
      approximately by a factor of two. (3) The rhabdoms have unlobed shapes. (4)
      Within each rhabdomere the microvilli are parallel to each other. The microvilli
      of receptor 1 are oriented 90 degrees to those of receptors 2-7. (5) The tracheal
      sheaths around the retinulae are missing. These findings indicate that the
      photoreceptors of the dorsal rim area are strongly polarization sensitive and
      have large visual fields. In the dorsal rim ommatidia of other insects,
      functionally similar anatomical specializations have been found. In these
      species, the dorsal rim area of the eye was demonstrated to be the eye region
      that is responsible for the detection of polarized light. We suggest that the
      dorsal rim area of the cockchafer eye subserves the same function and that the
      beetles use the polarization pattern of the sky for orientation during their
      migrations.

PMID- 1628300
TI  - Immunocytochemical localization of beta-1,3-glucan recognition protein in the
      silkworm, Bombyx mori.
AB  - A monospecific antibody against beta-1,3-glucan recognition protein (a 62 kDa
      protein) of the larval silkworm prophenoloxidase activating system was used to
      study the localization of the protein. Among tissues from 5th instar larvae, only
      hemocytes and plasma were shown to contain a 62 kDa polypeptide immunoreactive
      with the antibody. Ultra-thin sections of the hemocytes were stained by an
      indirect immunogold staining method. Labelling occurred in the granules and
      cytoplasm of granulocytes and in the spherules and cytoplasm of spherulocytes. It
      was most conspicuous in granules of granulocytes and uniformly labelled spherules
      of spherulocyte, whereas no labelling was evident in prohemocytes, plasmatocytes
      and oenocytoids. The results are discussed in relation to the mode of recognition
      of fungi as non-self in insect hemocoel.

PMID- 1628302
TI  - Fine structure of the paracellular junctions of terminal villous capillaries in
      the perfused human placenta.
AB  - Selected lobules of human term placentae were extracorporeally perfused for a
      recovery period of 20 min, fixed by perfusion and mordanted with ferrocyanide
      prior to processing for transmission electron microscopy. The lateral membranes
      of the endothelial cells of the terminal villous capillaries were found to be
      separated by paracellular clefts of mean width 15.6 nm. At tight junctional
      regions (1-4 sites per cleft) the two membranes approached each other more
      closely and frequently appeared to fuse. However, tilting of the sections in the
      electron microscope stage showed that the membranes were separated by a gap of
      mean width 4.1 nm in at least 94% of tight junctional profiles. When individual
      tight junctions were studied by a combination of serial sectioning and
      goniometric tilting, they were seen to widen abruptly within a distance of three
      to seven consecutive thin sections, indicating they were not continuous
      throughout the axial length of the capillaries. The wide regions of the clefts
      usually showed linkers, strands of glycocalyx-like material spanning the gap.
      Linkers may contribute to cell adhesion and possibly form part of a filter within
      the tortuous paracellular pathway provided by the discontinuous network of tight
      junctional strands. Human term placental capillaries appear to resemble closely
      other continuous non-brain capillaries.

PMID- 1628301
TI  - Evaluation of mRNA steady-state and protein levels for basement membrane proteins
      in cultured murine cells.
AB  - We have determined the mRNA steady-state levels for the six constituent
      polypeptide chains of the basement membrane proteins collagen IV, laminin and
      nidogen in murine cell lines derived from a teratocarcinoma, and in some other
      cell lines of different origin in stationary cultures and during different growth
      phases. The mRNA and protein levels change in response to growth phase. The
      amounts of the mRNAs for the single chains do not agree with the ratios needed
      for the different peptide chains of collagen IV and laminin. While the mRNA and
      protein levels for laminin are in a similar range for the teratocarcinoma-derived
      cell lines, the mRNA and protein levels vary by at least a factor of 10 for
      collagen IV. These results point to complex posttranscriptional regulatory
      mechanisms for the biosynthesis of basement membrane proteins.

PMID- 1628303
TI  - Distribution of neuropeptide Y-like immunoreactivity in the brain and hypophysis
      of the cloudy dogfish, Scyliorhinus torazame.
AB  - Using a specific antiserum raised against synthetic neuropeptide Y, we examined
      the localization of immunoreactivity in the brain and hypophysis of the cloudy
      dogfish, Scyliorhinus torazame, by the peroxidase-antiperoxidase method.
      Immunoreactive perikarya were demonstrated in the ganglion of the nervus
      terminalis, the dorsocaudal portions of the pallium dorsale, the basal
      telencephalon, and the nucleus lateralis tuberis and the nucleus lobi lateralis
      in the hypothalamus. Labeled perikarya were also found in the tegmentum
      mesencephali, the corpus cerebelli, and the medulla oblongata. Some of the
      immunoreactive neurons in the hypothalamus were of the CSF-contacting type. The
      bulk of the labeled fibers in the nervus terminalis ran toward the basal
      telencephalon, showing radial projections and ramifications. Large numbers of
      these fibers coursed into the nucleus septi caudoventralis and the nucleus
      interstitialis commissurae anterioris, where they became varicose and
      occasionally formed fine networks or invested immunonegative perikarya. In the
      diencephalon, immunoreactive fibers were observed throughout the hypothalamus,
      e.g., in the pars neurointermedia of the hypophysis, the subependymal layer of
      the lobus inferior hypothalami, and in the neuropil of the posterior (mammillary)
      recess organ. Labeled fibers were scattered throughout the rest of the brain stem
      and were also seen in the granular layer of the cerebellum. These results suggest
      that, in the dogfish brain, neuropeptide Y or a related substance is involved in
      a variety of physiological processes in the brain, including the neuroendocrine
      control of the hypophysis.

PMID- 1628304
TI  - Coated vesicles are implicated in the post-fusion retrieval of the membrane of
      rat atrial secretory granules.
AB  - Using an in situ tannic acid perfusion technique, this study presents evidence
      that the removal of membrane components from the rat atrial secretory granule
      membrane after granule exocytosis is mediated by coated vesicles. When tannic
      acid is used to arrest the post-fusion stages of granule release, coated pit
      formation occurs on granule membrane, which, although continuous with the
      sarcolemma, is easily recognised by the membrane omega profile and the continued
      presence of the granule core. Tannic acid perfusion, before aldehyde fixation,
      allows a degree of continued cell function, and granule fusions can persist after
      tannic acid has reached the cell. This results in an increase in the numbers of
      fusion profiles and the appearance of coated pits on granule membrane at these
      sites. The proportion of granules with coats increases with perfusion time,
      suggesting that endocytotic, as well exocytotic events, may be arrested by the
      action of tannic acid. Coated vesicles are also involved at earlier stages of the
      release pathway. In other types of secretory system this is considered to
      represent recycling of membrane proteins as part of the maturation process of the
      granule. Although arrested granules exhibiting this clathrin coat could have had
      the coat prior to fusion, as part of the maturation process, our results show
      that it is more likely to represent a second stage of membrane protein recycling;
      the postfusion reclamation of proteins from the sarcolemma. This facet of the
      tannic acid perfusion procedure suggests a general method for quantifying coated
      pit formation during secretory granule release.

PMID- 1628305
TI  - Subcellular fractionation of rainbow trout gonads with emphasis on microsomal
      enzymes involved in steroid metabolism.
AB  - Rainbow trout gonads were subfractionated by differential centrifugation with
      emphasis on obtaining preparations suitable for the study of steroid-metabolizing
      enzymes. A fractionation scheme was evaluated for the mature testis and for 3
      ovarian developmental stages. The distribution of cell organelles among the
      fractions was determined using enzyme-markers and electron microscopy. The
      fractionation scheme was found to be suitable for separating mitochondria and
      microsomes which were recovered at similar yields to those that had been reported
      for other extraheptic fish tissues. Fractionation of the mature ovary was fraught
      with problems probably because a large yolk protein cytosole fraction interfered
      with the recovery of microsomes. However, no difference in the specific activity
      of microsomal NADPH-cytochrome c-reductase between the various organ preparations
      was evident. The testis microsomes contained detectable amounts of cytochrome
      P450, whereas its content in the various ovary microsomes was too low to be
      detected. Progesterone 17 alpha-hydroxylase was detected in microsomes from
      testes and early developing ovaries, and microsomal aromatase activity was
      present in microsomes from early developing, mature and postovulatory ovaries.
      Furthermore, the testis microsomes contained a highly active UDP
      glucuronosyltransferase with testosterone used as a substrate.

PMID- 1628306
TI  - Immunocytochemical localization of collagen types I, III, IV, and fibronectin in
      the human dermis. Modifications with ageing.
AB  - The distribution of collagen types I, III, IV, and of fibronectin has been
      studied in the human dermis by light and electron-microscopic
      immunocytochemistry, using affinity purified primary antibodies and
      tetramethylrhodamine isothiocyanate-conjugated secondary antibodies. Type I
      collagen was present in all collagen fibers of both papillary and reticular
      dermis, but collagen fibrils, which could be resolved as discrete entities, were
      labeled with different intensity. Type III collagen codistributed with type I in
      the collagen fibers, besides being concentrated around blood vessels and skin
      appendages. Coexistence of type I and type III collagens in the collagen fibrils
      of the whole dermis was confirmed by ultrastructural double-labelling experiments
      using colloidal immunogold as a probe. Type IV collagen was detected in all
      basement membranes. Fibronectin was distributed in patches among collagen fibers
      and was associated with all basement membranes, while a weaker positive reaction
      was observed in collagen fibers. Ageing caused the thinning of collagen fibers,
      chiefly in the reticular dermis. The labeling pattern of both type I and III
      collagens did not change in skin samples from patients of up to 79 years of age,
      but immunoreactivity for type III collagen increased in comparison to younger
      skins. A loss of fibronectin, likely related to the decreased morphogenetic
      activity of tissues, was observed with age.

PMID- 1628307
TI  - Macrophage subpopulations and reticulum cells in rat placenta. An
      immunohistochemical study.
AB  - The placenta is a unique mixture of histoincompatible cells derived from mother
      and fetus. The aim of the present study was to obtain information on the
      development of macrophage subpopulations and reticulum cells during pregnancy in
      the placenta. Placentas of Wistar rats were removed at several stages of
      gestation, and were studied by immunohistochemical techniques applying monoclonal
      antibodies against macrophage subpopulations, lymphoid cells and reticulum cells.
      The expression of MHC class-II antigens was also studied. Throughout gestation
      macrophages were demonstrable in large numbers in the endometrium, in the
      myometrium and in the metrial gland, which is a compartment developing in the
      myometrium of pregnant rodents. In the labyrinth, a placenta compartment
      consisting of fetal cells, macrophages (probably of fetal origin) were already
      found on day 15. In the spongiotrophoblast and decidua basalis, which are layers
      of the placenta containing both maternal and fetal cells, only a few macrophages
      were recognized throughout gestation. The monoclonal antibody ED11, raised
      against reticulum cells, recognized fiber-like structures lining the blood
      sinuses of the spongiotrophoblast, in which only maternal blood is circulating.
      As the antigen recognized by ED11 is believed to play a role in the trapping of
      immune complexes, the spongiotrophoblast may play a role in the protection of the
      fetus from circulating immune complexes.

PMID- 1628308
TI  - Differentiation of smooth muscle cells in the fetal rat testis and ovary:
      localization of alkaline phosphatase, smooth muscle myosin, F-actin, and desmin.
AB  - The histochemical demonstration of alkaline phosphatase (AP) activity and
      localization of smooth muscle myosin (SMM), F-actin, and desmin were carried out
      on frozen sections of testes and ovaries from 15-day-old fetal to newborn rats.
      The presence of immunocytochemically localized SMM and desmin was confirmed by
      Western blot analysis of proteins from isolated gonads. The development of smooth
      muscle cells was predominant in the testis. The first SMM-positive cells with an
      increasing intensity for F-actin and desmin appeared in the testicular tunica
      albuginea and around the testicular cords by the age of 16 days. A continuous
      layer of SMM- and F-actin-positive (but not uniformly desmin-positive) myoid
      cells was detected in the newborn testis. In the early gonads and in the newborn
      ovary, a majority of the interstitial cells expressed desmin, indicating that, in
      undifferentiated tissues, non-myogenic cells may also express desmin. During
      fetal development, male and female gonocytes showed a decrease in F-actin content
      but retained their high AP activity. In the cortex of the newborn rat ovary, the
      observed high AP activity and the presence of desmin may be associated with the
      postnatal histogenesis of the follicles. The presence of SMM-containing cells in
      the hilus of the ovary may be required for the demarcation of the ovary from the
      mesonephros by the constriction of the mesovarium. The occurrence of SMM-positive
      cells predominantly in male fetuses suggests that the development of the
      contractile cells in the fetal testis may be induced by testicular androgens.

PMID- 1628309
TI  - Biogenesis of myeloid bodies in regenerating newt (Notophthalmus viridescens)
      retinal pigment epithelium.
AB  - Myeloid bodies are believed to be differentiated areas of smooth endoplasmic
      reticulum membranes, and they are found within the retinal pigment epithelium in
      a number of lower vertebrates. Previous studies demonstrated a correlation
      between phagocytosis of outer segment disc membranes and myeloid body numbers in
      the retinal pigment epithelium of the newt. To test the hypothesis that myeloid
      bodies are directly involved in outer segment lipid metabolism and to further
      characterize the origin and functional significance of these organelles, we
      examined the effects on myeloid bodies of eliminating the source of outer segment
      membrane lipids (neural retina removal) and of the subsequent return of outer
      segments (retinal regeneration) in the newt Notophthalmus viridescens. Light- and
      electron-microscopic analysis demonstrated that myeloid bodies disappeared from
      the pigment epithelium within six days of neural retina removal. By week 6 of
      regeneration, rudimentary photoreceptor outer segments were present but myeloid
      bodies were still absent. However, at this time, the smooth endoplasmic reticulum
      in some areas of the retinal pigment epithelial cells had become flattened,
      giving rise to small (0.5 micron long), two-to-four layer-thick lamellar units,
      which are myeloid body precursors. Small myeloid bodies were first observed one
      week later at week 7 of retinal regeneration. This study revealed that newt
      myeloid bodies are specialized areas of smooth endoplasmic reticulum. It also
      showed that a contact between functional photoreceptors and the retinal pigment
      epithelium is essential to the presence of myeloid bodies in the epithelial
      cells.

PMID- 1628310
TI  - Evidence for a morphological component in acid-base regulation during
      environmental hypercapnia in the brown bullhead (Ictalurus nebulosus).
AB  - Exposure of adult brown bullheads Ictalurus nebulosus (120-450 g) to
      environmental hypercapnia (2% carbon dioxide in air) and subsequent recovery
      caused transient changes in whole body net sodium flux (JnetNa+) and net chloride
      flux (JnetCl-) resulting largely from changes in whole body sodium influx
      (JNa+in) and chloride influx (JinCl-). Scanning electron microscopy (SEM)
      revealed that the fractional area of chloride cells (CCs) on the interlamellar
      regions was reduced by 95% during environmental hypercapnia. During post
      hypercapnic recovery, gill filament CC fractional area increased. The changes in
      JinCl- during and after environmental hypercapnia were closely associated with
      the changes in CC fractional area while the changes in JinNa+ did not correspond
      to the changes in CC fractional area. Transmission electron microscopy (TEM)
      supported the SEM observations of CC surface area changes and demonstrated that
      these changes were caused by covering/uncovering by adjacent pavement cells
      (PVCs). Lamellar and filament PVC microvilli density increased during hypercapnia
      while there was a subsequent reduction in the posthypercapnic period. These data
      suggest that an important mechanism of acid-base regulation during hypercapnic
      acidosis is modification of the chloride cell-associated Cl-/HCO3- exchange
      mechanism. We suggest that bullheads vary availability, and thus functional
      activity, of this transporter via reversible morphological alterations of the
      gill epithelium. The increase in density of PVC microvilli may be associated with
      sodium uptake and/or acidic equivalent excretion during acidosis.

PMID- 1628311
TI  - Influence of N-linked oligosaccharides on the processing and neurite-promoting
      activity of proteoglycans released by neurons in vitro.
AB  - Inhibitors of enzymes involved in processing of N-linked oligosaccharides were
      used to examine biosynthesis and the neurite-promoting activity of proteoglycans
      produced by and released from dissociated chick embryo spinal cord neurons in
      vitro. In the cell compartment and in conditioned medium both castanospermine and
      swainsonine inhibited 3H-glucosamine incorporation into glycoprotein but only
      castanospermine reduced 3H-glucosamine incorporation into heparan sulphate and
      chondroitin sulphate proteoglycans. All of the neurite-promoting activity of
      neuron-conditioned medium that complexed to laminin was associated with heparan
      sulphate proteoglycans as determined by heparitinase digestion. Neuron
      conditioned medium prepared in the presence of castanospermine displayed a 38 +/-
      6% (mean +/- SD) reduction in 3H-glucosamine incorporation into heparan sulphate
      proteoglycans and a 30 +/- 5% reduction in substrate-attached neurite-promoting
      activity compared to control conditioned medium and to conditioned medium
      prepared in the presence of swainsonine. When neurons were coincubated with
      castanospermine, neurite growth on a laminin substrate was 50 +/- 10% of control
      growth or growth in the presence of swainsonine. However, when neuron-conditioned
      medium was used to pretreat the laminin substrate the inhibitory effect on
      neurite growth produced by castanospermine coincubation was reversed. Influences
      on neuronal processing of N-linked oligosaccharides alter neurite growth directly
      and also alter the neurite-promoting activity of neuron-conditioned medium by
      inhibiting the synthesis of heparan sulphate proteoglycans. These studies provide
      further evidence for an autocrine role for heparan sulphate proteoglycans in
      neurite growth.

PMID- 1628312
TI  - Functional morphology of the neuroendocrine sodium influx-stimulating peptide
      system of the pond snail, Lymnaea stagnalis, studied by in situ hybridization and
      immunocytochemistry.
AB  - The functional morphology of the neuroendocrine system producing sodium influx
      stimulating (SIS) peptide in the pond snail, Lymnaea stagnalis, was studied by in
      situ hybridization and immunocytochemistry. The SIS-peptide, which is 76 amino
      acids long, stimulates sodium uptake from the ambient medium. Two synthetic DNA
      probes were used for in situ hybridization. The nucleotide sequences were chosen
      from the cDNA structure; they encode amino acids 8-17 and 64-73, respectively.
      SIS-peptide sequences 10-20 and 67-76 were synthesized and antibodies were raised
      to them and affinity-purified. In addition to these antibodies, a monoclonal
      antibody raised to a bioactive, high-pressure liquid chromatography (HPLC)
      purified brain extract was used for immunocytochemistry. Paraffin sections of
      central nervous systems and of whole snails were studied. The SIS-peptide system
      could be identified as the previously described yellow cell (YC) system by
      comparing alternate sections treated with the DNA probes, stained with the
      antibodies, or stained with alcian blue-alcian yellow. SIS-peptide neurons
      (approximately 45) occur in the ganglia of the visceral ring and in the proximal
      parts of visceral nerves. Axons run in the nerves of these and in several nerves
      of other ganglia. Numerous axon branches penetrate the perineurium forming a vast
      central neurohemal area. The SIS-peptide system innervates the pericardium, the
      nephridial gland, the reno-pericardial canal, the ureter, the spermoviduct and
      gonadal acini, the anterior aorta, the ventral buccal artery, and the penis
      protractor muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628313
TI  - Non-granulated peripolar cells exist in the rat glomerulus.
AB  - The peripolar cell is a unique cell type in the mammalian glomerulus. Peripolar
      cells are said to be identifiable during light microscopy by their cytoplasmic
      granules and by their position at the vascular pole; and during scanning electron
      microscopy by their distinctive surface morphology. We used both techniques to
      count peripolar cells in 6 normal rat kidneys. Scanning microscopy revealed that
      55(+/- 5)% of glomeruli contained at least one peripolar cell whereas light
      microscopy revealed granulated peripolar cells in only 4(+/- 2)% of glomeruli.
      Vascular poles which contained peripolar cells previously identified by scanning
      were then examined by light and by transmission electron microscopy. Serial
      sections through these peripolar cells demonstrated the absence of cytoplasmic
      granules. Our observations suggest that the majority of peripolar cells in the
      rat contain no granules.

PMID- 1628314
TI  - Mast cell types in the lymph nodes of the opossum Didelphis albiventris
      (Marsupialia, Didelphidae).
AB  - Using histological and histochemical techniques, we have found a unique
      population of mast cells in the lymphatic sinuses of lymph nodes from different
      anatomical regions of the opossum. The lymphatic-sinus mast cells of the
      medullary sinuses were numerous, and could be easily distinguished from the
      connective-tissue mast cells of the dermis and lymph node capsule by their larger
      size and their enlarged cytoplasmic granules that were also more heterogeneous in
      shape and staining properties.

PMID- 1628315
TI  - Local regulation of Leydig cell function by inhibitors of steroidogenic activity.
AB  - In the testis, local regulation of Leydig cell activity by paracrine factors can
      modify the response to LH. The identity of factors within paracrine actions has
      required the use of in vitro Leydig cell bioassay procedures, yet it has only
      recently been demonstrated that steroidogenic activity can be maintained in
      culture. There is renewed interest in the detection of both steroidogenic
      stimulatory and inhibitory activities using these systems, but this review
      presents the case for a role of inhibitory factors in the local regulation of
      Leydig cell function.

PMID- 1628316
TI  - A cell surface antigen associated with meiosis in male Staurdoderus scalaris
      (Orthopteran).
AB  - Immunofluorescence has identified seven monoclonal antibodies reactive with the
      surface of meiotic cells and absent in premeiotic cells. Analysis by immunogold
      electron microscopy indicated that these antigens were present on the external
      surface of the cells and were coincident with the presence of synaptonemal
      complexes in the nucleus. On immunoblots a common glycosylated protein of 205 kDa
      was recognized, in addition to smaller subunits, suggesting the presence of a
      protein complex comprised of smaller peptides.

PMID- 1628317
TI  - Influence of low density lipoproteins on vascular smooth muscle cell growth and
      motility: modulation by extracellular matrix.
AB  - Low density lipoproteins (LDL) are thought to play a major role in cardiovascular
      diseases such as atherosclerosis. Much remains to be done to understand the
      cellular effects of LDL and how the extracellular matrix (ECM) influences these
      effects. We found that LDL produced a dose dependent increase in vascular smooth
      muscle cell (SMC) proliferation. The ECM altered the proliferative response of
      SMC to LDL: on collagen I there was a 66% inhibition, endothelial cell derived
      ECM a 2-fold increase, and collagen IV no difference in proliferation compared to
      paired controls. LDL affected SMC motility (cell area and shape factor) but the
      extent and direction of the effect depended on whether the cells were cultured on
      uncoated or coated dishes. LDL treated cultures had a 5-fold lower migration rate
      but net movement was not different, suggesting that LDL decreased SMC random
      movement. There was a dose-dependent accumulation of lipid by SMC incubated with
      LDL and, subsequently, cytoplasmic lipid droplets were observed. Cells cultured
      on uncoated plates showed an increased cholesterol content as a function of LDL
      concentration. In contrast, cells cultured on a collagen IV matrix showed no net
      change in cholesterol content over the range of LDL concentrations studied.
      Hence, the uptake of LDL cholesterol appears to be completely inhibited by this
      matrix. These studies indicate that the influence of LDL on several SMC
      parameters is modulated by ECM components.

PMID- 1628318
TI  - Changes in tropomyosin during primary culture of embryonic myocardiocytes.
AB  - We chose the Hamburger and Hamilton's stage 29 (HH 29) to investigate the
      expression of tropomyosin in chick myocardiocytes during 14 days on culture.
      Throughout 14 days of cell culture, changes in cell morphology were accompanied
      by a redistribution of tropomyosin in different cell compartments. We used
      FACScan, SDS-PAGE and densitometric analysis to quantify total cell tropomyosin
      and concentrations of this protein in different cell fractions. Tropomyosin was
      found mostly in the cytoskeletal fraction than in the cytoplasmic. When we
      compared the densitometric values from SDS-PAGE of cells in different stages of
      development we found that in HH 19, tropomyosin was more abundant in the
      cytoplasmic than in the cytoskeletal fraction. By HH 29, the two fractions had
      become inverted, and in HH 39, tropomyosin was clearly more abundant in the
      cytoskeletal than in the cytoplasmic fraction. In the IFI analysis, tropomyosin
      was found to label the Stress fiber-like structures (SFL) in different patterns
      depending on the area of the cell which expressed this protein.

PMID- 1628319
TI  - High molecular weight microtubule-associated proteins within testes of hemipteran
      insects.
AB  - Results presented here indicate that the high molecular weight microtubule
      associated proteins isolated from the ovaries of the hemipterans, Oncopeltus
      fasciatus and Notonecta glauca, while absent from nervous tissue, are present in
      the testes of the respective species. Here they are seen to be located to
      extensive microtubule aggregates within the cells surrounding the sperm, but not
      obviously to the sperm themselves.

PMID- 1628320
TI  - Localization of chromatin in "persistent" nucleoli in okadaic acid treated HeLa
      cells.
AB  - In okadaic acid treated HeLa cells, the chromosomes sometimes condense without
      being accompanied by nuclear envelope breakdown. These cells show "persistent"
      nucleoli. Within these "persistent" nucleoli the intranucleolar chromatin
      condenses and can be observed in the region of the dense nucleolar component
      (DNC) of the nucleoli. Other nucleolar components, namely the fibrillar centre
      (FC) and the granular component (GC) remain unchanged. These observations
      strongly speak for the localization of nucleolar chromatin (ribosomal cistrons)
      within the dense nucleolar component of the interphase nucleolus.

PMID- 1628321
TI  - The interaction of Staphylococcal protein A with free coelomocytes of annelids.
AB  - The Staphylococcal protein A (SpA) binding protein was detected on the surface of
      annelid coelomocytes. The flow cytometric analysis revealed that 50% coelomocytes
      of Lumbricus terrestris react with SpA, a figure six times higher than the number
      of positive coelomocytes found in Eisenia foetida.

PMID- 1628322
TI  - Homologous antigen for T cell receptor in axial organ cells from the asterid
      Asterias rubens.
AB  - The axial organ (A.O. cells) of the sea star Asterias rubens is a primitive
      immune organ. The total population was fractionated into two populations:
      adherent (B-like) and non-adherent (T-like) to nylon wool. The adherent cells
      resemble mammalian B lymphocytes and bear homologous human T cell receptor (beta
      chain) to a higher degree than T-like cells which resemble T lymphocytes.

PMID- 1628323
TI  - Association of glycosphingolipids with intermediate filaments of mesenchymal,
      epithelial, glial, and muscle cells.
AB  - We reported recently that two glycosphingolipids (GSLs), globoside (Gb4) and
      ganglioside GM3, colocalized with vimentin intermediate filaments of human
      umbilical vein endothelial cells. To determine whether this association is unique
      to endothelial cells or to vimentin, we analyzed a variety of cell types. Double
      label immunofluorescent staining of fixed, permeabilized cells, with and without
      colcemid treatment, was performed with antibodies against glycolipids and
      intermediate filaments. Globoside colocalized with vimentin in human and mouse
      fibroblasts, with desmin in smooth muscle cells, with keratin in keratinocytes
      and hepatoma cells, and with glial fibrillary acidic protein (GFAP) in glial
      cells. Globoside colocalization was detected only with vimentin in MDCK and HeLa
      cells, which contain separate vimentin and keratin networks. GM3 ganglioside also
      colocalized with vimentin in human fibroblasts. Association of other GSLs with
      intermediate filaments was not detected by immunofluorescence, but all cell GSLs
      were detected in cytoskeletal fractions of metabolically labelled endothelial
      cells. These observations indicate that globoside colocalizes with vimentin,
      desmin, kertain and GFAP, with a preference for vimentin in cells that contain
      both vimentin and keratin networks. The nature of the association is not yet
      known. Globoside and GM3 may be present in vesicles associated with intermediate
      filaments (IF), or bound directly to IF or IF associated proteins. The prevalence
      of this association suggests that colocalization of globoside with the
      intermediate filament network has functional significance. We are investigating
      the possibility that intermediate filaments participate in the intracellular
      transport and sorting of glycosphingolipids.

PMID- 1628324
TI  - Colchicine-binding sites of brain tubulins from an antarctic fish and from a
      mammal are functionally similar, but not identical: implications for microtubule
      assembly at low temperature.
AB  - The tubulins of Antarctic fishes possess adaptations that favor microtubule
      formation at low body temperatures (Detrich et al.: Biochemistry 28:10085-10093,
      1989). To determine whether some of these adaptations may be present in a domain
      of tubulin that participates directly or indirectly in lateral contact between
      microtubule protofilaments, we have examined the energetics of the binding of
      colchicine, a drug thought to bind to such a site, to pure brain tubulins from an
      Antarctic fish (Notothenia gibberifrons) and from a mammal (the cow, Bos taurus).
      At temperatures between 0 and 20 degrees C, the affinity constants for colchicine
      binding to the fish tubulin were slightly smaller (1.5-2.6-fold) than those for
      bovine tubulin. van't Hoff analysis showed that the standard enthalpy changes for
      colchicine binding to the two tubulins were comparable (delta H degrees = +10.6
      and +7.4 kcal mol-1 for piscine and bovine tubulins, respectively), as were the
      standard entropy changes (delta S degrees = +61.3 eu for N. gibberifrons tubulin,
      +51.2 eu for bovine tubulin). At saturating concentrations of the ligand, the
      maximal binding stoichiometry for each tubulin was approximately 1 mol
      colchicine/mol tubulin dimer. The data indicate that the colchicine-binding sites
      of the two tubulins are similar, but probably not identical, in structure. The
      apparent absence of major structural modifications at the colchicine site
      suggests that this region of tubulin is not involved in functional adaptation for
      low-temperature polymerization. Rather, the colchicine site of tubulin may have
      been conserved evolutionarily to serve in vivo as a receptor for endogenous
      molecules (i.e., "colchicine-like" molecules or MAPs) that regulate microtubule
      assembly.

PMID- 1628325
TI  - Human cardiac and skeletal muscle spectrins: differential expression and
      localization.
AB  - We describe multiple human cardiac and skeletal muscle spectrin isoforms. Cardiac
      muscle expresses five erythroid alpha,beta spectrin-reactive isoforms with
      estimated MR's of 280, 274, 270, 255, and 246 kD, respectively. At least one
      nonerythroid alpha-spectrin of MR 284 kD is expressed in heart. While skeletal
      muscle shares the 280, 270, and 246 kD erythroid spectrins, it expresses an
      immunologically distinct 284 kD nonerythroid alpha-spectrin isoform. The 255 kD
      erythroid beta-spectrin isoform is specific for cardiac tissue. By
      immunocytochemistry, both erythroid beta- and nonerythroid alpha-spectrins are
      localized to costameres, the plasma membrane, and the neuromuscular junctional
      region.

PMID- 1628326
TI  - Different assembly properties of cod, bovine, and rat brain microtubules.
AB  - Assembly properties of cod, bovine, and rat brain microtubules were compared.
      Estramustine phosphate, heparin, poly-L-aspartic acid, as well as NaCl, inhibited
      the assembly and disassembled both bovine and rat microtubules by inhibition of
      the binding between tubulin and MAPs. The assembly of cod brain microtubules was
      in contrast only marginally affected by these agents, in spite of a release of
      the MAPs. The results suggest that cod tubulin has a high intrinsic ability to
      assemble. This was confirmed by studies on phosphocellulose-purified cod tubulin,
      since the critical concentration for assembly was independent of the presence or
      absence of MAPs. The results show therefore that cod brain tubulin has, in
      contrast to bovine and rat brain tubulins, a high propensity to assembly under
      conditions which normally require the presence of MAPs. Even if cod MAPs, which
      have an unusual protein composition, were not needed for the assembly of cod
      microtubules, they were able to induce assembly of bovine brain tubulin. Both cod
      and bovine MAPs bound to cod microtubules, and bovine MAP1 and MAP2 bound to, and
      substituted at least the 400 kDa cod protein. This suggests that the tubulin
      binding sites and the assembly-stimulatory ability of MAPs are common properties
      of MAPs from different species, independent of the tubulin assembly propensity.

PMID- 1628327
TI  - Differential sorting of beta tubulin isotypes into colchicine-stable microtubules
      during neuronal and muscle differentiation of embryonal carcinoma cells.
AB  - Pluripotent P19 embryonal carcinoma (EC) cells were differentiated along the
      neuronal and muscle pathways. Comparisons of class I, II, III, and IV beta
      tubulin isotypes in total and colchicine-stable microtubule (MT) arrays from
      uncommitted EC, neuronal, and muscle cells were made by immunoblotting and by
      indirect immunofluorescence microscopy. In undifferentiated EC cells the relative
      amounts of these four isotypes are the same in both the total and stable MT
      populations. Subcellular sorting of beta tubulin isotypes was demonstrated in
      both neuronal and muscle differentiated cells. During neuronal differentiation,
      class II beta tubulin is preferentially incorporated into the colchicine-stable
      MTs while class III beta tubulin is preferentially found in the colchicine-labile
      MTs. The subcellular sorting of class II into stable MTs correlates with the
      increased staining of MAP 1B, and with the expression of MAP 2C and tau. Although
      muscle differentiated cells express class II beta tubulin, stable MTs in these
      cells do not preferentially incorporate this isotype but instead show increased
      incorporation of class IV beta tubulin. Muscle cells do not show high levels of
      MAP 1B and do not express MAP 2C or tau. These results are consistent with the
      hypothesis that a subcellular sorting of tubulin isotypes is the result of a
      complex interaction between tubulin isotypes and MT-associated proteins.

PMID- 1628328
TI  - [Monitoring the effects of oxyphilline Spofa in the umbilical-placental
      circulation].
AB  - Vasodilatation treatment is an inevitable part of comprehensive therapy of
      intrauterine growth retardation of the foetus. The authors present the results of
      investigations of the effect of Oxyphylline on the umbilical and placental
      circulation of pregnant women with confirmed disorders of the flow parameters.
      Oxyphylline Spofa, 3 x 100 mg orally, is the drug of choice in treatment of
      foetal hypotrophy with a marked effect on the umbilical and placental
      circulation.

PMID- 1628329
TI  - [Treatment of toxoplasmosis in pregnant women].

PMID- 1628330
TI  - [Delivery of neonates with a birth weight of less than 1500 grams. Perinatal
      results during a 6-year period and possibilities of affecting them].
AB  - The authors evaluated the perinatal mortality and condition on delivery of 167
      neonates with a birth weight under 1500 g who were delivered and hospitalized at
      the 2nd Department of Gynecology and Obstetrics in Brno between Jan. 1, 1985 and
      Dec. 31, 1990. The perinatal mortality of neonates with a birth weight below 1000
      g was 73.1%, of those with a birth weight 1000 g-1500 g it was 25.9%. Early
      neonatal mortality was not influenced by the patient's age exceeding 30 years,
      occupation, environment, status, number of interrupted pregnancies, spontaneous
      abortions and previous spontaneous and induced deliveries, administration of
      tocolysis, corticoids, the position of the foetus, transport in utero, way of
      delivery, indication for Caesarean section and sex. Early neonatal mortality was
      influenced by the mother's age less than 20 years, administration of antibiotics,
      multiple pregnancy, grade of asphyxia, presence of RDS, necessity of respiratory
      support, incidence of intracerebral haemorrhage and birth trauma. In the
      discussion the authors mention possible ways of reducing the perinatal morbidity
      and early neonatal morbidity in the mentioned range of birth weights.

PMID- 1628331
TI  - [Use of photoplethysmography in the diagnosis of venous disorders in pregnancy].

PMID- 1628332
TI  - [Personal experience with Scheerer's emergency cerclage].

PMID- 1628334
TI  - [Reliability of the CandidaSure Test in the diagnosis of mycotic vaginal
      inflammations].

PMID- 1628333
TI  - [Morbidity after induced abortions in 1989].

PMID- 1628335
TI  - [Ovulation of insufficiently developed follicles].

PMID- 1628336
TI  - [Acardius acephalus as a complication in labor].

PMID- 1628337
TI  - [DNA flow cytometry: perspective prognostic parameters in carcinoma of the
      uterine cervix].
AB  - We studied the relation between the 5-year disease free interval and the flow
      cytometric DNA content in a group of 55 patients treated by radiation for
      squamous cell carcinoma of the uterine cervix, stages Ib-IIIb (FIGO). The diploid
      DNA content was associated with a better prognosis, while prognostically
      unfavourable tumours tended to be aneuploid. The relation was statistically
      significant in the whole group (p = 0.016), in stage II disease (p = 0.003) and
      in the subgroup formed by the combination of stages I and II (p = 0.000). In
      stage III we did not prove the relation. Analysis of the survival function
      revealed also a better prognosis of diploid tumours (p = 0.041) in the whole
      group. The division into clearly diploid and non-diploid tumours seems to be more
      suitable for evaluation (p = 0.012). The difference between the prognostically
      favourable and unfavourable groups is expressed more clearly. We consider the
      flow cytometric DNA content a perspective prognostic parameter in squamous cell
      carcinoma of the uterine cervix. Its significance is apparent especially in
      patients treated by radiotherapy, because the size of the tumour cannot be
      assessed reliably in these cases.

PMID- 1628338
TI  - [Prostaglandins and management of labor after prior cesarean section].

PMID- 1628339
TI  - [Comparison of methods of treatment in mycotic vulvovaginitis].

PMID- 1628340
TI  - [Intraperitoneal administration of noxythiolin VUFB in the prevention and therapy
      of inflammatory postoperative complications in gynecology].

PMID- 1628341
TI  - [Intrauterine insemination using cryopreserved donor sperm, a methods which
      increases therapeutic success].

PMID- 1628343
TI  - [The aggressive patient in the physician's office].

PMID- 1628342
TI  - [Continuing professional education, recertification and subspecialization].

PMID- 1628344
TI  - [A computer expert system for malignant lymphoma].
AB  - Structure of a data base for histo-oncological diagnosis of malignant lymphomas
      by expert system Fel-Expert 2.9 is introduced. The data base has a 110,000 byte
      range and an average consultation with user's high diagnostic certainty lasts 2-3
      minutes and comprises 20-25 inquiries. Possible acceleration of consultation
      process is discussed.

PMID- 1628346
TI  - [Relapsing polychondritis--ultrastructure in 2 additional cases].
AB  - A 37-year-old woman and a 74-year-old man with typical clinical history of
      relapsing polychondritis enabled electron microscopical analysis of various
      cartilages (ear, nasal septum, rib). Apoptotic lesion and degradation of
      chondrocytes combined not always with changes of their lacunae prevailed in both
      patients, fragmentation of elastic tissue in the man. Lesions of chondrocytes, a
      bit varied and asynchronous in intensity were observed as everywhere in a single
      cartilage as in cartilages from different sites.

PMID- 1628347
TI  - [Professor Pavel Kucera--the first head of the University Institute of Pathologic
      Anatomy in Brno].
AB  - Pathologist Dr. Pavel Kucera was one of the first professors of the Medical
      Faculty of Masaryk University in Brno. History of his uncommon life was described
      in detail. Some mistakes occurring in literature were corrected according to data
      from Kucera's personal file in the Archives of the Masaryk University.

PMID- 1628345
TI  - [Liver cholestasis in neonates and young children].
AB  - Liver cholestasis was found in 50 autopsies (23 per cent) among 221 neonates and
      infants who died in intensive care units. It developed from the 4th postnatal
      day, was mostly mild and present in biliary capillaries as well as in small
      interlobular biliary ducts, later there was found phagocytosis of biliary pigment
      by Kupffer cells. In protracted jaundice there was an irregular increase of small
      cholangioles derivable from a ductal transformation of periportal hepatocytes.
      Bile ducts proliferation was connected with a slight widening of portal tracts in
      infants surviving until the 6th and 8th week. The cause of cholestatic liver
      lesion remained obscure.

PMID- 1628348
TI  - [Malignant lymphomas of the mantle zone].
AB  - A series of mantle zone malignant lymphomas rendered ideas about their common
      features. Patients of higher age prevailed, prognosis was favourable even up to a
      steady state. Small cell blastic (centrocytoid) malignant lymphoma of the mantle
      zone (in lymphnodes, spleen, skin, parotid gland) tended to produce
      lymphoepithelial lesions, angioinvasion, and especially to spread into sinuses
      which did not influence prognosis in a positive way. B monocytoid medium cell
      malignant lymphoma (in lymphnodes, stomach, skin) was closer to classic malignant
      lymphomas in its behaviour but varied localization and usual mixed cytology
      produced rather controversial pictures. Independence of further variants
      (plasmacytoid, clear celled) was doubtful. Nevertheless, to be familiar with them
      was useful for their identification in mixed cytology variants which were very
      frequent. Relation of clear cell lymphomas to hairy cell leukaemias and
      independence of so called paracortex mixed malignant lymphoma as well as
      reticulohistiocytic malignant lymphoma was discussed.

PMID- 1628349
TI  - [Primary MALT-type malignant lymphomas of the salivary glands].
AB  - Six cases of primary extranodal lymphomas in big salivary glands, which met
      criteria of MALT lymphoma, were investigated with the aid of antibodies against
      Ig, light chains, LCA and EMA, in addition in two cases against Ig heavy chains
      and with antibodies KL-1 and VCHL-1. All the tumours had centrocytoid
      morphological features, one of them showed signs of focal blastic transformation
      into centrocytoid centroblastoma. Tumour cells showed twice plasmacytic and three
      times plasmacytoid differentiation with intracytoplasmic Ig monoclonality (once
      IgM/kappa, once IgA/kappa, three times kappa positivity). They were positive in
      reaction against epimyoepithelial proliferation. A picture of myoepithelial
      sialoadenitis with partial lymphomatous infiltration prevailed in two cases and a
      lymphoma picture with remnants of sialoadenitis in three cases. Features of
      inflammatory process were lacking in a case with blastic transformation. There is
      a dispute whether features of sialoadenitis belong to the defining criteria of
      MALT type lymphoma or can disappear during blastic transformation of a low grade
      malignant lymphoma.

PMID- 1628350
TI  - [Prognostic relevance of histopathologic subtyping of mixed-cell Hodgkin's
      disease].
AB  - Mixed cellular (MC) type of Hodgkin disease was studied in a group of 92 bioptic
      cases diagnosed before the start of treatment. A precise histological analysis
      showed one subtype with lower malignancy (MC 1) and a second one with higher
      malignancy (MC 2). Subtype MC 1 comprised 61 cases (66 per cent), subtype MC 2 31
      cases (34 per cent). Histomorphological subtyping was brought into correlation
      with clinical data of survival available in 65 cases (44 cases of subtype MC 1,21
      cases of subtype MC 2). Different survival in both subtypes had statistical
      significance and prognostic relevance. Suggested subtyping is simple, based on
      common histological slides, without need of special additional investigation.

PMID- 1628351
TI  - [Interfollicular Hodgkin's disease].
AB  - Two cases of so-called interfollicular Hodgkin's disease, one case lacking of all
      histological criteria and one case of lymphadenitis mimicking Hodgkin's disease,
      were identified among 76 patients with Hodgkin's disease. Case 1 and 2 rank among
      lymphocyte predominance type, case 3 showed mixed cellularity. They shared a
      progressive transformation of germinal centres which was proved by
      immunohistology. Leu M 1 antibody-positive cells were found in both cases of the
      so-called interfollicular Hodgkin's disease and not in lymphadenitis mimicking
      Hodgkin's disease.

PMID- 1628352
TI  - [The Informatorium by Komenius and modern pediatrics].
AB  - The Informatorium "The School of Infancy" by Comenius is probably the first
      treatise on the development and training of infants and children in the family
      during the first six years of life. Although this year 360 years will elapse
      since its first edition, the ideas of this work are of topical interest and are
      inspiring even today. This applies e.g. to the prenatal development, the
      relationship between biological maturing and training, the necessity to avoid
      forceful pedantic control as well as excessive permissiveness, the necessity to
      supply adequate sensory and emotional stimuli at a very early age, the necessity
      to support all natural activities of the child while taking care of his safety,
      maturity and readiness for school, emphasis on fundamental values of life, etc.
      Comenius proved himself a sensitive psychologist who understood the specificity
      of thinking and sensations of children, long before developmental psychology was
      established as a science.

PMID- 1628353
TI  - [Photoisomers of bilirubin in the blood of neonates during phototherapy].
AB  - In a group of mature neonates with hyperbilirubinaemia the authors investigated
      by chromatography, using the HPLC method, levels of bilirubin photoisomers before
      phototherapy, in the course of phototherapy and after its termination. The
      configuration isomer 4 Z, 15 E is detected in blood of all icteric neonates
      already before the onset of treatment in a mean concentration of 5.2 (s = 3.8)
      mumol/l, during phototherapy its mean concentration is 23.0 (s = 8.0) mumol/l.
      Photoisomers participate in non-conjugated bilirubinaemia on average by 10%: 92%
      are formed by isomer 4 Z, 15 E, 5% by isomer 4 E, 15 Z and 3% by the structural
      isomer lumirubin. On the day following discontinuation of treatment the mean
      photoisomer concentrations are significantly lower than during phototherapy and
      significantly higher than before its initiation.

PMID- 1628354
TI  - [Screening for alpha 1-antitrypsin deficiency in neonates].
AB  - In a two-year investigation 113,274 children were screened for alpha-1
      antitrypsin deficiency. An original and cheap method was used. In children with
      an alpha-1-antitrypsin values lower than 1.5 g/l the phenotype was assessed. In
      120 neonates alpha-1-antitrypsin was assessed by screening and also
      quantitatively. The physiological range of alpha-1-antitrypsin for neonates is:
      1.4-3.32 g/l. A low incidence of alpha-1-antitrypsin in the Czechoslovak
      population, as compared with investigations abroad, was revealed. The authors
      discuss the possibility to extend screening from the clinical, ethical and
      economic aspect to the entire republic.

PMID- 1628355
TI  - [Acoustic frequency analysis of auscultation findings in neonates].
AB  - The authors analyzed 280 auscultation findings of 35 neonates with birth weights
      of 1800-4500 g and 65 pathological neonates with birth weights of 1150-3600 g.
      For recording of the auscultation findings an electronic phonendoscope EST 40
      (Bosch) was used and the finding was recorded on a microtape recorder (Olympus).
      The frequency analysis was made on a Sonagraf analyzer (Kay Elemetric), using a
      45 Hz filter a time range of 2.4 sec. From the results of the work ensues that in
      physiological neonates two basis types of sonagrams can be detected: 1. the
      record presenting itself as a continuous zone of noise with maximal cumulation of
      acoustic energy up to 500 Hz where the ratio of acoustic energy is equal in both
      stages of the respiratory cycle. The clinical correlate is "alveolar
      respiration". 2. a record with a discontinuous zone of noise with a more
      expressive ratio of acoustic energy up to 2500 Hz during inspiration. The
      clinical correlate is "sharper bronchoalveolar respiration". In the group of
      pathological neonates with different pneumopathies further sonagraphic phenomena
      were detected: a) "rales" as discontinuous acoustic phenomena persisting for 7-35
      msec with a frequency range up to 3000 Hz, without a harmonious structure,
      present during inspiration as well as expiration, b) "transmitted phenomena"-
      discontinuous acoustic phenomena persisting for 75-150 msec with a frequency
      range up to 6000 Hz, without a harmonious structure, c) "wheezing"--continuous
      acoustic phenomena with a clearly marked harmonious acoustic structure lasting
      540 +/- 240 msec with a frequency of the basic sound of 500 +/- 240
      msec.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628356
TI  - [Kinetics of gentamycin in premature infants with a low birth weight during the
      first four days of postnatal life].
AB  - The authors investigated in a group of 19 premature neonates with a low
      birthweight (0.65-2.1 kg) during the first four days of postnatal life the
      pharmacokinetics of gentamycin after indicated administration of 2 mg/kg of the
      antibiotic by the i.v. route by a 30-minute infusion in 18-hour intervals. Serum
      concentrations of gentamycin were assessed by immunoassay 0.5 hours before
      administration and then 0.5, 5.5, 11.5 and 17.5 hours after the 5th infusion,
      i.e. in a steady state. The maximum serum concentrations detected 0.5 hours after
      the completed infusion exceeded 10 mg/l in 21% of the neonates, while the minimal
      concentrations of the antibiotic before the next administration were above 2 mg/l
      in 42% of the infants. The calculation of pharmacokinetic parameters according to
      the one-compartment model revealed considerable interindividual differences of
      all values. The authors consider particularly important the low clearance value
      of the antibiotic (30.24 +/- 14.55 ml/kg.hour-1) which may lead to cumulation of
      gentamycin and its toxic action. Gentamycin administration to premature neonates
      should be associated with monitoring of serum concentrations of the drug which
      would make individual adjustment of the dosage possible.

PMID- 1628357
TI  - [Epavit--a dietary preparation suitable for use in pediatric practice].

PMID- 1628358
TI  - [Recombinant erythropoietin--a fundamental change in the treatment of anemia?].
AB  - The authors summarize in the submitted review recent findings on erythropoietin
      (EPO) and recombinant EPO (rHuEPO), a new therapeutic preparation which changed
      fundamentally the clinical picture of many diseases associated with anaemia. The
      authors discuss the physiology of EPO, regulation of its secretion, mechanism of
      action on bone marrow and its importance in the pathogenesis of polycythaemia and
      in particular anaemia. They emphasize in particular the use of rHuEPO in the
      treatment of different forms of anaemia. They analyze the pathogenesis of renal
      anaemia and the importance of treatment with rHuEPO for improvement of the
      haemogram as well as the general condition of the patients, their adaptability,
      improved psychic condition and reduced need of transfusions. The authors draw
      attention to the great importance of treatment with rHuEPO in the treatment of
      anaemias associated with inflammatory diseases (rheumatoid arthritis, AIDS,
      Crohn's disease and others), anaemia associated with malignancies, in the
      treatment of surgical diseases and in autotransfusions, in anaemias of premature
      infants and in some congenital heart diseases. The introduction of rHuEPO into
      the treatment of anaemia is a great advance of modern pharmacotherapy, which
      moreover opened new vistas on the role of anaemia in the clinical picture of many
      diseases.

PMID- 1628359
TI  - [Chronic fatigue syndrome].

PMID- 1628360
TI  - [What is the risk of future development of ischemic heart disease in juvenile
      hypertensives?].
AB  - The investigation was focused on the incidence of some amenable risk factors of
      ischaemic heart disease in 51 adolescent men aged 15-19 years. The author
      compares the incidence of these risk factors in normotonics and hypertonics. The
      investigation revealed that the group of juvenile hypertonic subjects is from the
      aspect of future development of ischaemic heart disease at greater risk, as
      compared with the group of normotonic subjects. In families of juvenile
      hypertonic subjects the disease is more frequent in parents and grandparents and
      there are more frequent early deaths from this disease in the family. Juvenile
      hypertonics are more frequently obese and have a more risky level of serum
      cholesterol, as compared with adolescent normotonic subjects. The task of the
      general practitioner for children and adolescents is to detect by early screening
      and to include in dispensary care all subjects at risk and to recommend
      appropriate provisions to reduce the risk of development of ischaemic heart
      disease in adult age.

PMID- 1628361
TI  - [[The Jindrichuv Hradec model of clinical practice in pediatric pneumology. 1.
      Organization and screening].

PMID- 1628362
TI  - [Mortality in children below 1 year of age in the first half of 1991].

PMID- 1628363
TI  - [Summary of knowledge required for levels I-III in postgraduate training in
      pediatric pneumonology].

PMID- 1628364
TI  - Reversal of multidrug resistance by phenothiazines and structurally related
      compounds.
AB  - The multidrug-resistance (MDR)-reversal activity of 232 phenothiazines and
      structurally related compounds was tested in MDR P388 cells. Such activity was
      found among compounds exhibiting two ring structures (phenyl, cyclopentyl,
      cyclohexyl, thienyl or 5-norbornen-2-yl but not pyridinyl) linked by a variety of
      bridge types and possessing a secondary or tertiary amine group. Among 192 such
      compounds, 31.8% displayed good activity (MDR-reversal ratio, greater than or
      equal to 10) and 8.3%, outstanding activity (MDR-reversal ratio, greater than or
      equal to 30). In a subgroup comprising 56 compounds with a carbonyl residue, 4
      with sulfuryl residue and 1 with thienyl residue, 42.7% showed good activity and
      18%, outstanding activity. The contribution of these residues to the MDR-reversal
      activity was particularly evident among compounds containing a cyclic tertiary
      amine. Among 49 such compounds, 51% displayed good activity and 20.4%,
      outstanding activity, whereas among the 85 compounds lacking such groups, only
      31.8% showed good activity and 4.7%, outstanding activity. Enhancement of this
      activity by the carbonyl group is also obtained when the latter is part of an
      amide bond of a tertiary amine. As compounds with a carbonyl group located on the
      rings, on the bridge to the amine group or beyond the amine are efficient MDR
      reversers, it seems that the exact molecular location of the carbonyl group is
      not critical for the elicitation of this activity.

PMID- 1628365
TI  - Antitumor effects of N-alkylated polyamine analogues in human pancreatic
      adenocarcinoma models.
AB  - Adenocarcinoma of the pancreas presents a formidable challenge both
      experimentally and clinically, whereby effective anticancer therapy is lacking.
      We have recently explored a relatively new class of antitumor agents in
      pancreatic cancer cell lines and have found the bis-ethyl derivatives of spermine
      to show considerable promise. In the present paper, we report the results of in
      vivo studies demonstrating the antitumor activity of two of these N-alkylated
      analogues, N1,N14-bis(ethyl)homospermine (BEHSPM) and N1,N11
      bis(ethyl)norspermine (BENSPM) in athymic (nude) mouse xenografts of two human
      pancreatic ductal adenocarcinoma cell lines, PANC-1 (poorly differentiated) and
      BxPC-3 (moderately well-differentiated). BENSPM was found to exert greater
      antitumor activity in vivo than either BEHSPM or other conventional agents,
      largely because higher doses could be given due to its lower toxicity to mice.
      BENSPM shows greater activity than any other agent we have thus far tested
      against our pancreatic-cancer models. Optimal schedules of administration have
      yet to be determined. Nevertheless, of the analogues tested, BENSPM presently
      appears to be the analogue of choice for further development.

PMID- 1628367
TI  - Dose dependence of the cytokinetic and cytotoxic effects of epirubicin in vitro.
AB  - CHO cells were exposed in vitro for 1 h to concentrations of 0.1-20 micrograms/ml
      of the cytostatic drug epirubicin. Population growth, survival fractions, cell
      cycle-phase distribution, and BrdU incorporation were analyzed. A fraction of the
      cells showed a transitory cytostatic reaction at 1 microgram/ml, and greater than
      99% of the cells were killed at 10 micrograms/ml. The survival curve was biphasic
      with a steep slope at concentrations of up to 5 micrograms/ml. Approximately 0.1%
      of the cells were resistant to higher concentrations of epirubicin. Bivariate
      DNA/BrdU flow cytometry revealed that the sensitive cells were blocked and
      probably killed in the G2M phase of the cell cycle.

PMID- 1628366
TI  - Regulatory and antiproliferative effects of N-alkylated polyamine analogues in
      human and hamster pancreatic adenocarcinoma cell lines.
AB  - N-Alkylated polyamine analogues have been shown to exert antiproliferative
      effects in several tumor models, with the bis-ethyl derivatives exerting the
      greatest suppression of polyamines by virtue of down-regulation of the polyamine
      biosynthetic enzymes. Pancreatic adenocarcinoma presents a challenge both
      clinically and experimentally due to its inherent resistance to conventional
      therapy, which results in its having the worst 5-year survival rate of all
      cancers. We have previously shown that N1,N12-bis(ethyl)spermine (BESPM) is much
      more potent than the polyamine enzyme inhibitor alpha-difluoromethylornithine
      (DFMO) against pancreatic adenocarcinoma cell lines. In the present study, we
      compared the biochemical and antiproliferative effects of two N-alkylated
      polyamine analogues, N1,N14-bis(ethyl)homospermine (BEHSPM) and N1,N11
      bis(ethyl)norspermine (BENSPM) in two human pancreatic ductal adenocarcinoma cell
      lines, PANC-1 (poorly differentiated) and BxPC-3 (moderately well
      differentiated), and in the WD PaCa (well-differentiated ductal) hamster cell
      line. BENSPM displayed greater antiproliferative activity in the human pancreatic
      cancer cell lines, whereas BEHSPM was more potent in the hamster cell line. Both
      BEHSPM and BENSPM suppress the activity of the major biosynthetic enzymes
      ornithine decarboxylase and S-adenosylmethionine decarboxylase. However, the
      induction of polyamine depletion in the human cell lines was only modest for
      BENSPM and minimal for BEHSPM, which suggests that the substantial
      antiproliferative activity of these analogues may result from mechanisms other
      than polyamine depletion. The somewhat greater polyamine depletion seen following
      treatment with BENSPM is thought to result from its striking induction of
      spermidine/spermine N1-acetyltransferase. The biochemical and antiproliferative
      activity of BENSPM makes it an attractive agent for further preclinical and
      clinical development, especially in pancreatic cancer.

PMID- 1628368
TI  - A high-performance liquid chromatographic assay for CI-973, a new anticancer
      platinum diamine complex, in human plasma and urine ultrafiltrates.
AB  - CI-973 is a new platinum compound with antitumor properties that is currently
      undergoing phase II clinical trials. A high-performance liquid chromatographic
      (HPLC) assay was developed and validated for ultrafiltrates of human plasma and
      urine to support phase I clinical trials. Plasma ultrafiltrate (0.5 ml) was
      extracted using C18 solid-phase cartridges. Urine was diluted 10-fold and
      extracted first with SAX solid-phase cartridges and then with C18 cartridges. For
      both matrices, the eluate from the C18 cartridges was injected directly. A
      Whatman PAC 10 column (4.6 x 250 mm, 10-microns particle size) and ultraviolet
      detection at 205 nm were used for both analyses. The mobile-phase buffer was 0.05
      M sodium perchlorate (pH 2.3). The mobile-phase acetonitrile:buffer ratio, column
      temperature, and flow rate were 89:11 (v/v), 40 degrees C, and 2.0 ml/min,
      respectively, for the plasma ultrafiltrate assay and 85:15 (v/v), 50 degrees C,
      and 1.0 ml/min, respectively, for the urine ultrafiltrate assay. Standard curves
      were linear from 0.25 to 500 micrograms/ml and from 1.0 to 250 micrograms/ml for
      the plasma and urine assays, respectively. The accuracy of the assay lay within
      4.5% of the nominal values, and the precision was 6.2%; the recovery of CI-973
      varied from 79.2% to 105%. CI-973 remains stable in plasma for at least 6 h, at
      room temperature, in ultrafiltrates of both matrices for at least 15 days at -72
      degrees C, and in water for at least 6 months at -72 degrees C.

PMID- 1628369
TI  - Pharmacokinetics and metabolism of cyclophosphamide in paediatric patients.
AB  - The pharmacokinetics and metabolism of cyclophosphamide were studied in nine
      paediatric patients. Plasma samples were obtained from eight subjects and urine
      was collected from six children during a 24-h period after drug administration.
      Cyclophosphamide and its major metabolites phosphoramide mustard (PM),
      carboxyphosphamide (CX), dechloroethylcyclophosphamide (DCCP) and 4
      ketocyclophosphamide (KETO) were determined in plasma and urine using high
      performance thin-layer chromatography-photographic densitometry (HPTLC-PD).
      Cyclophosphamide (CP) was nearly, if not completely, cleared from plasma by 24 h
      after its administration. The plasma half-life of CP ranged from 2.15 to 8.15 h;
      it decreased following higher doses and was shorter than that previously reported
      for adult patients. Both the apparent volume of distribution (0.49 +/- 1.4 l/kg)
      and the total body clearance (2.14 +/- 1.4 l m-2 h-1) increased with increasing
      dose. Renal clearance ranged between 0.12 and 0.58 l/h (mean, 0.43 +/- 0.19 l/h).
      Between 5.4% and 86.1% of the total delivered dose was recovered as unchanged
      drug in the urine. The major metabolites identified in plasma and urine were PM
      and CX. One patient appeared to be deficient in CX formation. This study suggests
      that there is interpatient variability in the pharmacokinetics and metabolism of
      CP in paediatric patients. The shorter half-life and higher clearance as compared
      with adult values indicate faster CP metabolism in children.

PMID- 1628370
TI  - Doxorubicin and doxorubicinol plasma concentrations and excretion in parotid
      saliva.
AB  - The pharmacokinetics of doxorubicin (DOX) and doxorubicinol (DOXol) was studied
      in six patients with various advanced neoplastic diseases who received 28-72
      mg/m2 DOX (nine courses). Plasma and parotid saliva were collected over a 48-h
      period, and DOX and DOXol were quantified by high-performance liquid
      chromatography with fluorescence detection. As reported previously, a wide range
      of plasma levels were found among our patients. It appears that in addition to
      being quickly cleared from the plasma, both DOX and DOXol are excreted in
      detectable amounts in parotid saliva, a route of elimination that has been given
      little attention, if any. Excretion in the saliva exposes the mucosa of the upper
      gastrointestinal tract to drug and may play a role in causing stomatitis in
      patients receiving DOX by the i.v. route. Since huge interindividual and
      pronounced intraindividual differences were found in S/P ratios that mostly were
      not systematically related to the plasma drug concentration, the concentration in
      parotid saliva was not useful in predicting the level of free DOX and DOXol in
      plasma. For the parent drug and its metabolite, the S/P ratios increased
      significantly with time during the 48-h period after dosing.

PMID- 1628371
TI  - Pharmacokinetics and tumor concentration of intraarterial and intravenous
      cisplatin in patients with head and neck squamous cancer.
AB  - Tumor-tissue platinum levels and major pharmacokinetic parameters were determined
      in 11 patients with head and neck squamous cancer (HNSC) who were given cisplatin
      (50 mg/m2 daily x 2 days) and 5-fluorouracil (5-FU; 1000 mg/m2, continuous
      infusion x 5 days) either i.a. or i.v. The plasma peak platinum concentrations
      (cmax) and the areas under the curve for total platinum concentration versus time
      (AUC) during i.a. infusions were lower than the i.v. cmax (mean, 1.92 +/- 0.28
      and 4.08 +/- 2.80 mg/l, for i.a. and i.v. infusions, respectively) and AUC values
      (mean, 22.55 +/- 4.96 and 40.66 +/- 10.71 mg h-1 l-1 for i.a. and i.v. treatment,
      respectively), suggesting a first-passage extraction of the drug by the tumor
      mass during i.a. infusion. However, no statistically significant difference was
      found in platinum tumor concentrations after i.a. administration versus i.v.
      infusion. The lack of a difference in tumor platinum concentrations between the
      i.a. and the i.v. administration routes might be explained either by a relatively
      high blood supply to the tumor area, enabling efflux of the surplus free platinum
      from the tissue, or by the delay between drug infusion and biopsy. After three
      cycles of i.a. treatment good tumor remission was obtained with minimal local
      toxicity. Larger clinical studies testing the advantages of the i.a.
      administration route over i.v. infusion appear to be necessary.

PMID- 1628372
TI  - Phase I study of Datelliptium chloride, hydrochloride given by 24-h continuous
      intravenous infusion.
AB  - Datelliptium chloride, hydrochloride (SR 95 156B, NSC 626718X, DHE) was studied
      in a phase I trial of escalating doses given on a single 24-h continuous
      intravenous infusion schedule. Doses were escalated from 40 to 500 mg/m2 in 19
      patients who received a total of 24 courses. Courses were repeated after a
      minimal interval of 3 weeks. Local venous toxicity occurred at low doses (less
      than or equal to 100 mg/m2) and was circumvented by the use of a central venous
      access for higher doses. Other clinical adverse events occurred (greater than or
      equal to 330 mg/m2), including moderate nausea and vomiting, mild diarrhea, dry
      mouth, neuropsychiatric manifestations, and fatigue. All of these side effects
      were reversible and none was dose-limiting. The dose-limiting toxicity was
      related to hepatic laboratory-test abnormalities in the form of reversible
      elevations of levels of serum bilirubin and liver enzymes at doses of greater
      than or equal to 330 mg/m2. The maximum tolerated dose for this schedule is 500
      mg/m2. Hematologic toxicity was minimal and non-dose-limiting. Neither drug
      related deaths nor objective complete or partial responses were observed.
      However, a minor response and a long-term disease stabilization were obtained.

PMID- 1628374
TI  - Simultaneous occurrence of acute myelogenous leukemia and seminoma of the testis.
AB  - Simultaneous tumors are rarely encountered during the course of acute leukemias.
      We report on a case of seminoma of the testis that occurred during the evolution
      of acute myelogenous leukemia. To our knowledge, this simultaneous association
      has not previously been described, but a causal relationship was not apparent in
      the present case. The likelihood of a common carcinogenesis existed, but direct
      exposure to carcinogens could not be established. Although the results of a
      physical examination and echography were normal at the time of diagnosis, we
      cannot exclude the presence of microscopic cancer of the testis. Since the
      dissemination pattern of seminoma is usually slower than that observed in this
      case and the disease remains limited to the lymph nodes for long periods
      following dissemination, the rapid development of the present case might have
      been attributable to the immunosuppression and the scrotal sepsis that occurred
      during the induction therapy. Immunosuppression might have stimulated the
      progression of a primary microscopic seminoma and the development of metastasis,
      whereas the scrotal sepsis and inflammation might have favored the occurrence of
      metastasis through bypass of the lymphatic barrier.

PMID- 1628373
TI  - Methylprednisolone as antiemetic treatment in breast-cancer patients receiving
      cyclophosphamide, methotrexate, and 5-fluorouracil: a prospective, crossover,
      randomized blind study comparing two different dose schedules.
AB  - The antiemetic response and side effects resulting from treatment with
      methylprednisolone (MPA) given on two different dose schedules were evaluated in
      20 women with breast cancer who were undergoing chemotherapy consisting of
      cyclophosphamide, methotrexate and 5-fluorouracil (CMF). This randomized,
      crossover, double-blind study compared the antiemetic efficacy of a single dose
      of 125 mg MPN with that of two such doses. The study demonstrated the superiority
      of the latter protocol in preventing CMF-induced nausea and vomiting. The rate of
      antiemetic response to single vs double doses was as to follows: complete
      protection, 17% vs 30%; partial and minimal protection, 39% vs 55%; and no
      protection, 44% vs 15% of the courses, respectively (P = 0.0087). No difference
      in the antiemetic response rate was found between the first and the second
      course. Treatment with MPN was well tolerated, and no difference in the incidence
      of side effects was found between the single-dose and the double-dose schedule.
      We recommend the use of two doses of 125 mg MPN as prophylactic antiemetic
      treatment in breast-cancer patients receiving CMF chemotherapy.

PMID- 1628375
TI  - Comparison of cyclosporin A and SDZ PSC833 as multidrug-resistance modulators in
      a daunorubicin-resistant Ehrlich ascites tumor.
AB  - Recent studies by Boesch et al. have demonstrated that a nonimmunosuppressive
      cyclosporin analog, SDZ PSC 833 (an analog of cyclosporin D), is an active
      multidrug-resistance modifier that is at least 10 times more potent than
      cyclosporin A. In vitro accumulation and cytotoxicity experiments using
      daunorubicin (DNR) and vincristine (VCR) under the influence of SDZ PSC 833 and
      cyclosporin A were performed in wild-type (EHR2) and the corresponding highly DNR
      resistant (about 80-fold) Ehrlich ascites tumor cells (EHR2/DNR+). In
      accumulation experiments, both SDZ PSC 833 and cyclosporin A were found to
      reverse the multidrug-resistant (MDR) phenotype, but to the same degree at
      equimolar concentrations. Thus, in EHR2/DNR+ cells, both cyclosporins at 5
      micrograms/ml enhanced DNR and VCR accumulation to sensitive levels, but only a
      negligible effect on DNR accumulation in the drug-sensitive cells was seen. In
      the clonogenic assay, the cytotoxicity of the two modulators was equal. The
      lethal dose for 50% of the cell population (LD50) was approx. 7 micrograms/ml for
      both compounds, and no toxicity was observed at concentrations below 2
      micrograms/ml. At nontoxic doses, both cyclosporins effectively increased the
      cytotoxicity of DNR and VCR in a concentration-dependent manner. The dose
      response curves were nearly identical and did not demonstrate differences in
      modulator potency. These data permit the conclusion that cyclosporin A and SDZ
      PSC 833 do raise the intracellular accumulation of DNR and VCR to the same levels
      and that SDZ PSC 833 does not potentiate cytotoxicity better than cyclosporin A
      in EHR2/DNR+ cells. However, since the new compound is nonimmunosuppressive and
      causes less organ toxicity, clinical studies of its MDR modulating effect seem
      highly relevant.

PMID- 1628376
TI  - Salvage therapy for non-Hodgkin's lymphoma with a combination of dexamethasone,
      etoposide, ifosfamide, and cisplatin.
AB  - A total of 30 consecutive patients with refractory or relapsing non-Hodgkin's
      lymphoma (NHL) were treated with a combination of dexamethasone, etoposide (VP
      16), ifosfamide, and cisplatin (DVIP). In all, 9 subjects (30%) showed a partial
      response and 10 (33%) achieved a complete response (CR) lasting from 2.5 to 24+
      months. Aggressive histology, no prior therapy with VP-16, a CR to previous
      chemotherapy, and a treatment-free interval of greater than 6 months prior to the
      present study were associated with the high CR rate. DVIP caused pronounced
      myelosuppression (median granulocyte nadir and median platelet nadir, 380/mm3 and
      73.000/mm3, respectively), but no drug-related death occurred. We conclude that
      DVIP is an effective salvage combination, especially in aggressive NHL, that
      produces acceptable toxicity.

PMID- 1628377
TI  - A phase II study of sulofenur, a novel sulfonylurea, in recurrent epithelial
      ovarian cancer.
AB  - A total of 16 patients with recurrent epithelial ovarian cancer were treated with
      sulofenur (LY 186641), a novel oral sulfonylurea. All subjects had received
      previous chemotherapy. Anaemia occurred in all 16 patients, 14 of whom required a
      blood transfusion, and 2/16 patients received methylene blue for breathlessness
      due to methaemaglobinaemia. Treatment was discontinued in 2/16 cases due to
      rising liver enzyme values, which reverted to normal on cessation of the drug.
      There was no nausea or alopecia. Only two minor responses were seen. Plasma drug
      levels were insufficient to result in antitumour activity as extrapolated from
      animal data. Further studies that attempt to increase the bioavailability and
      improve the therapeutic index are warranted.

PMID- 1628378
TI  - Added ATP influences some responses of rat synaptosomes to glutamate.
AB  - ATP added externally to rat synaptosomes activated uptake of both Ca2+ and
      glutamate which was partially accounted for by the uptake phenomena of synaptic
      vesicles and mitochondria, as shown by using specific inhibitors of the latter.
      Increasing concentrations of glutamate stimulated Ca2+ entry linearly, as shown
      by using 45Ca or a Ca-specific electrode. The processes of glutamate and Ca2+
      uptake shared some common features and their ATP-dependence may be correlated
      with an ouabain-insensitive synaptosomal ectonucleotidase activity measured by a
      31P-NMR or a luminometric technique. The ATP hydrolysis catalysed by the
      synaptosomes was activated by both Ca2+ and glutamate. The present synaptosomal
      activities may represent a model for studying the modulatory effects of ATP on
      the glutamatergic neurotransmission.

PMID- 1628379
TI  - The relation between the synergistic effect of cytostatics and metabolism of V
      79B cells in vitro.
AB  - A single-dose simultaneous application of methotrexate (MTX; 0.002/microgram ml
      1) and cisplatin (cis-Pt; 0.0002/microgram ml-1) had a permanent synergistic
      effect on both synchronized and asynchronous cell populations of V 79B cells.
      Successive combination of the drugs was manifested synergistically when MTX was
      applied first. The synchronized cell population was more sensitive to the
      cytostatics than the asynchronous population. Treatment with MTX alone, or the
      combination of MTX-cis-Pt, as well as their successive combination with the first
      drug being cis-Pt, caused gluconeogenesis.

PMID- 1628380
TI  - Cloturin: effect on energy-producing processes in Ehrlich ascites and P388 murine
      leukaemia cells.
AB  - The main purpose of the present investigation was to study the effect of cloturin
      on aerobic glycolysis, endogenous and exogenous respiration and the level of ATP
      in both Ehrlich ascites carcinoma (EAC) and P388 murine leukaemia cells incubated
      in vitro. Also its effect on the level of total (T-SH) and non-protein (NP-SH)
      thiol groups was investigated. A significant inhibition of aerobic glycolysis was
      found only in P388 cells after 60 min of cloturin action. Cloturin inhibited both
      endogenous and exogenous respiration of EAC with succinate as substrate. Cloturin
      decreased the level of ATP after 2 h incubation in both types of tumour cell. The
      level of NP-SH was decreased more than that of T-SH in both types of cell.

PMID- 1628381
TI  - Restricted expression of recombination activating gene (RAG-1) in mouse lymphoid
      tissues.
AB  - In an attempt to determine the distribution of recombinase activity in the mouse
      thymus, spleen and lymph nodes, we used the in situ hybridization method to
      examine the expression of the recombination activating genes RAG-1 and RAG-2.
      Expression of RAG-1 was found in most cortical thymocytes but not in the majority
      of medullary thymocytes. Although hybridization signals of RAG-2 were not as
      intense as those of RAG-1, the localization of RAG-2 transcripts was similar to
      that of RAG-1. In the spleen, expression of RAG-1 was found only in limited cells
      near the sinus, and the majority of the cells within the follicle were negative
      for RAG-1 transcript. In nude mice, RAG-1-expressing cells were detected in the
      same regions, which suggests that in situ hybridization signals of RAG-1 in the
      spleen are due to the cells of B cell origin. In the lymph nodes, expression of
      RAG-1 was found only in the medullary region. Expression of RAG-2 transcript in
      the spleen and the lymph nodes, if any, was too faint to determine the specific
      localization. These results suggest that most of the cortical thymocytes and some
      cells in the spleen are capable of rearranging T cell receptor genes and
      immunoglobulin genes, respectively, but the possibility of some other explanation
      could not be ruled out in RAG-1 expressing cells of the spleen and the lymph
      nodes.

PMID- 1628382
TI  - Generation of hydrogen peroxide in resting and activated platelets.
AB  - The production of hydrogen peroxide was measured by following the oxidation of
      dichlorofluorescein (DCFH) entrapped into platelets. Resting platelets produced
      nanomolar quantities of DCF, which was proportional to the concentration of
      platelets and was steady during 1 h of incubation. A significant increase of
      basal DCF fluorescence was induced by stimuli namely thrombin, arachidonic acid,
      the Ca2+ ionophore A23187 and PMA. The effect of agonists has been also measured
      in the presence of 3-amino-1,2,4-triazole (AT) or N-ethylmaleimide (NEM),
      inhibitors of catalase and glutathione peroxidase, respectively. A further
      significant enhancement of DCF produced in stimulated platelets was detected only
      in the presence of NEM. A correlation was found between the increase in DCF and
      externally added hydrogen peroxide or the oxidizing species formed by xanthine
      oxidase plus acetaldehyde. The yield was not affected by superoxide dismutase and
      was higher in the presence of AT or NEM. A cooperative effect in the presence of
      both inhibitors was shown. Glutathione peroxidase plus glutathione diminished the
      level of DCF to basal levels.

PMID- 1628383
TI  - Differentiation of human peripheral blood monocytes to macrophages is associated
      with changes in the cellular respiratory burst activity.
AB  - When phagocytic leukocytes, e.g. neutrophils, monocytes and macrophages, interact
      with soluble or particulate stimuli, the cells respond with an increased
      production of reactive oxygen metabolites. This production can be measured with
      the luminol-amplified chemiluminescence (CL) technique. In the present study, the
      CL reaction induced in monocyte-derived macrophages was investigated and compared
      to the responses of neutrophils and monocytes. In systems without additives the
      CL response of macrophages to soluble stimuli (FMLP, PMA and ionomycin) was very
      low. Addition of a peroxidase (HRP) to the reaction mixtures resulted in a
      pronounced increase in CL activity. The cellular CL response in macrophages is
      thus limited by the amount of peroxidase available. The macrophage response
      differs qualitatively from the responses of neutrophils and monocytes, in that
      the intracellular phase of the response is missing.

PMID- 1628384
TI  - Persisting zones of slow impulse conduction in developing chicken hearts.
AB  - We performed a correlative electrophysiological and immunohistochemical study of
      embryonic chicken hearts during the septational period (Hamburger and Hamilton
      stages 13-31 [2-7 days of incubation]). The analyses yield conclusive evidence
      for slow conduction, up to 7 days of development, in the outflow tract, in the
      atrioventricular canal, and in the sinoatrial junction. The conduction velocity
      remains approximately 1 cm/sec in the outflow tract and increases in the
      ventricle 20-fold to approximately 20 cm/sec between 2 and 7 days of development.
      Transmembrane potentials of myocytes in the outflow tract and atrioventricular
      canal slowly rise (less than 5 V/sec), whereas in the atrium and ventricle, the
      upstroke velocity is eightfold to 13-fold higher. In the outflow tract,
      repolarization is completed only after the start of the next cycle. Because of
      the persistence of slow conduction, the myocardium flanking the developing atria
      and ventricle is thought to represent segments of persisting "primary"
      myocardium, whereas the more rapidly conducting "working" myocardium of the
      ventricle and atria is thought to represent more advanced stages of myocardial
      differentiation. The persisting primary myocardium was characterized by a
      continued coexpression of both the atrial and ventricular isoforms of myosin
      heavy chain. The developing atria and ventricle could be demarcated
      morphologically from the primary myocardium because the free walls of these
      segments only express their respective isoforms of myosin heavy chain. The slowly
      conducting myocardial zones appear to be essential for the function of the
      embryonic heart because 1) they provide the septating heart with alternating
      segments of slow and relatively fast conduction necessary for consecutive
      contraction of the atrial and ventricular segments and 2) their sphincterlike
      prolonged peristaltic contraction pattern can substitute for the adult type of
      one-way valves that start to develop at the end of septation.

PMID- 1628385
TI  - Reflection after delayed excitation in a computer model of a single fiber.
AB  - Reflection (reflected reentry) is a case of reentry in a one-dimensional
      structure, divided into proximal and distal segments, in which tissue excited by
      a wave front propagating in a forward direction is reexcited by electrical
      activity coming backward from the original direction of propagation. Cases of
      reflection have been demonstrated in Purkinje fibers and in ventricular muscle
      preparations containing multiple fibers. Several mechanisms possibly responsible
      for reflected reentry have been proposed. However, the difficulty in the
      interpretation of the experimental results, as well as the limited number of
      different conditions in which reflection was obtained, has kept open the question
      about conditions and mechanisms for reflection. We have developed a computer
      model in which reflection occurs. The model involves a single fiber and uses the
      DiFrancesco-Noble equations for the Purkinje fiber to model the ionic currents.
      The results show that reflection is possible in a single fiber and that diastolic
      depolarization (automaticity) is not a requirement for reflection. Active
      membrane responses to a just-above-threshold stimulus were important for
      achieving the necessary time delay. Systematic simulations showed further that
      reflection occurred only when the right coupling conditions linked a short or
      long proximal fiber to a short distal segment.

PMID- 1628386
TI  - Mechanism of flecainide's antiarrhythmic action in experimental atrial
      fibrillation.
AB  - Class Ic antiarrhythmic drugs are effective in the treatment of atrial
      fibrillation, but their mechanism of action is unknown. In previous work, we have
      found that flecainide causes tachycardia-dependent increases in atrial action
      potential duration (APD) and effective refractory period (ERP) by reducing APD
      accommodation to heart rate. The present study was designed to evaluate the
      efficacy and mechanisms of action of flecainide in an experimental model of
      sustained atrial fibrillation (AF). AF was produced by a brief burst of atrial
      pacing in the presence of vagal stimulation and persisted spontaneously until
      vagal stimulation was stopped. The actions of flecainide at two dose levels were
      compared with those of isotonic glucose placebo in each dog, with a randomized
      order of blinded drug administration. Flecainide terminated AF in all 16 dogs,
      while glucose was effective in none (p less than 0.0001). Flecainide increased
      atrial ERP and reduced conduction velocity in a tachycardia-dependent manner.
      Doses of flecainide that converted AF resulted in larger changes in ERP than in
      conduction velocity, increasing the minimum path-length capable of supporting
      reentry (wavelength). In addition, flecainide reduced regional heterogeneity in
      ERP and wavelength, an action opposite that of vagal stimulation. Atrial
      epicardial mapping with a 112-electrode atrial array was used to study the
      mechanism of flecainide action on AF. Under control conditions, multiple small
      zones of reentry coexisted. Flecainide progressively increased the size of
      reentry circuits, decreased their number, and slowed the frequency of atrial
      activation until the arrhythmia finally terminated; all changes were compatible
      with an increase in wavelength. We conclude that flecainide terminates atrial
      fibrillation in this experimental model by causing tachycardia-dependent
      increases in atrial ERP, which increase the wavelength at the rapid rates
      characteristic of AF to the point that the arrhythmia can no longer sustain
      itself.

PMID- 1628387
TI  - Alpha B-crystallin in cardiac tissue. Association with actin and desmin
      filaments.
AB  - alpha B-Crystallin is a 20-kd peptide highly homologous to the small heat-shock
      proteins. This protein forms soluble homomultimeric complexes (M(r), 300-700 kd)
      and is very abundant in cardiac muscle cells. In vitro experiments (affinity
      column chromatography and binding studies with isolated proteins) have shown that
      alpha B-crystallin interacts directly with actin and, in particular, with desmin
      filaments. The immunocytochemical localization of alpha B-crystallin within the
      cardiomyocytes showed that the protein is distributed exclusively in the central
      region of the I bands (Z lines), where desmin is localized. In vitro studies have
      further shown that the binding affinity of alpha B-crystallin to actin and desmin
      filaments increases considerably at slightly acidic pH (6.5) or after a heat
      treatment (45 degrees C). Moreover, alpha B-crystallin was found to prevent
      effectively the tendency of actin filaments to form aggregates (i.e.,
      paracrystals) at acidic pH. These in vitro data suggest a protective role of
      alpha B-crystallin during stress conditions such as ischemia of the heart.
      Crystallin could prevent the aggregation of filaments, which might occur during
      the acidification of the cytosol and lead eventually to irreversible structural
      damage.

PMID- 1628388
TI  - Hydrogen peroxide-induced cardiovascular reflexes. Role of hydroxyl radicals.
AB  - Mesenteric ischemia reflexly activates the cardiovascular system. In addition,
      mesenteric ischemia and reperfusion generate reactive oxygen species. However,
      the ability of these short-lived reactive oxygen species to generate
      cardiovascular reflexes is unknown. We therefore investigated cardiovascular
      reflexes induced by serosal application of hydrogen peroxide (H2O2) to the
      gallbladder, stomach, or duodenum in anesthetized cats. Serosal application of
      hydrogen peroxide (44 mumols) to the gallbladder (n = 14) significantly (p less
      than 0.05) increased mean arterial blood pressure (MAP) by 37 +/- 6 mm Hg, left
      ventricular dP/dt by 1,893 +/- 416 mm Hg/sec, heart rate by 6 +/- 1 beats per
      minute, and systemic vascular resistance from 0.34 +/- 0.01 to 0.42 +/- 0.04
      peripheral resistance units. The cardiovascular effects were dose-dependent over
      a range of 0.4 pmol to 132 mumols H2O2. Celiac and superior mesenteric
      ganglionectomy abolished H2O2-induced cardiovascular effects. Dimethylthiourea
      (10 mg/kg), a reactive oxygen species scavenger, significantly (p less than 0.05)
      attenuated 44 mumols H2O2-induced increases in MAP from 36 +/- 3 to 2 +/- 2 mm
      Hg. Deferoxamine (10 mg/kg) also significantly attenuated 44 mumols H2O2-induced
      increases in MAP from 40 +/- 7 to 19 +/- 10 mm Hg, but iron-loaded deferoxamine
      did not. Aspirin (50 mg/kg) did not attenuate H2O2-induced excitation of the
      cardiovascular system. These data suggest that H2O2 activates abdominal visceral
      afferents to reflexly stimulate the cardiovascular system by a mechanism
      involving hydroxyl radicals. Thus, reactive oxygen species could modulate
      systemic vascular tone by stimulating abdominal visceral afferents during
      mesenteric ischemia and reperfusion.

PMID- 1628389
TI  - Effects of complement activation in the isolated heart. Role of the terminal
      complement components.
AB  - The mechanisms of the complement-mediated myocardial injury associated with
      ischemia and reperfusion have not been elucidated fully. Complement activation
      may directly mediate injury through actions of the anaphylatoxins C3a and C5a or
      generation of the membrane attack complex C5b-9. A model was developed to examine
      the direct effects of complement activation on heart function, assess myocardial
      tissue damage, and determine which complement components mediate tissue injury.
      Isolated rabbit hearts were perfused with Krebs-Henseleit buffer by using a
      modified Langendorff apparatus. Human plasma was added to the perfusate as a
      source of complement. Rabbit tissue activates human complement. Treatment with 6%
      normal plasma resulted in complement activation as assessed by the generation of
      Bb, C3a, C5a, and SC5b-9. Functional changes in cardiac performance became
      apparent 7-15 minutes after plasma addition and developed fully over the next 20
      30 minutes. The effects were dependent on the complement titer and included 1) an
      increase in the end-diastolic pressure, 2) a decrease in the developed pressure,
      3) an increase in the coronary perfusion pressure, and 4) an increase in
      lymphatic fluid formation. These effects were not elicited when an inhibitor of
      complement activation (FUT-175) was present or when heat-inactivated plasma was
      used. The effects of complement activation on myocardial function could not be
      reproduced by treatment with recombinant human C5a, zymosan-activated plasma, or
      plasma selectively depleted of C8. Myocardial tissue accumulated sodium and
      calcium and lost potassium as a result of complement activation. Activation
      caused the release of creatine kinase from myocytes and an increase in the
      radiolabeled albumin space of the hearts. The data demonstrate that complement
      activation caused decrements in myocardial function and increased the coronary
      perfusion pressure and lymphatic fluid flow rate. The effects were not mediated
      by the anaphylatoxins but were dependent on the distal complement component C8,
      suggesting that C5b-9 was responsible for the physiological changes. Complement
      activation directly mediated tissue injury in a manner consistent with
      plasmalemmal disruption as a result of C5b-9 formation. The data suggest that the
      C5b-9 complex, which is known to form under conditions of ischemia, may
      contribute directly to myocardial cell injury.

PMID- 1628390
TI  - Isolated pulmonary resistance vessels from fetal lambs. Contractile behavior and
      responses to indomethacin and endothelin-1.
AB  - A method was developed for recording isometric tension from isolated small
      arteries (mean internal diameter, 169 microns) and veins (mean internal diameter,
      273 microns) of the term fetal lung and was then applied to the study of the
      mechanisms controlling perinatal pulmonary hemodynamics. The specific purpose was
      to determine whether the activity of the prostaglandin synthetic system in
      vessels is conditioned by the oxygen tension and the mode of action of endothelin
      1. Both preparations appeared structurally intact and, after normalizing their
      lumen diameter to either the transmural pressure in vivo (artery) or the
      contractile capacity of the vessel in vitro (vein), generated force to the
      activating solution (5 mM Ca2+ in K+ Krebs' solution) in excess of the expected
      performance under physiological conditions. Treatment with indomethacin (2.8
      microM) had no effect on arteries preequilibrated at low PO2 (21 +/- 1 mm Hg);
      however, the same treatment contracted (approximately 45% of the response to
      activating solution) arteries at either an intermediate (40 +/- 0.8 mm Hg) or
      high (70 +/- 0.9 mm Hg) PO2. Endothelin-1 contracted both arteries and veins in a
      concentration-dependent manner, the threshold being lower with veins (1-10 versus
      10-100 pM). Endothelin-1 constriction was also seen in arteries whose tone had
      been raised with a thromboxane A2 analogue, whereas in thromboxane-treated veins
      constriction was preceded by a modest relaxation over the range of 1-1,000 pM.
      The findings with indomethacin lead us to infer that small pulmonary arteries are
      endowed with a prostaglandin-relaxing mechanism that becomes functional on
      raising the PO2 from fetal to neonatal levels. Endothelin-1 is a constrictor
      regardless of the level of intrinsic tone, suggesting a possible role of the
      peptide in maintaining elevated pulmonary vascular tone in the fetus.

PMID- 1628391
TI  - Intraluminal flow increases vascular tone and 45Ca2+ influx in the rabbit facial
      vein.
AB  - The buccal segment of the rabbit facial vein exhibits a high level of myogenic
      tone in vitro that develops only in stretched vessel segments between 33 degrees
      and 44 degrees C. The infusion of physiological salt solution into the lumen of 2
      mm-long rabbit facial vein segments induced a flow rate-dependent increase in
      wall tone, both in the presence (37 degrees C) and absence (30 degrees C) of
      myogenic tone. In calcium-free physiological solution with EGTA, neither flow nor
      stretch-induced tone was observed. This flow-induced contraction was associated
      with an increase in 45Ca2+ unidirectional influx and net uptake. These
      measurements correlated positively with the level of the associated constrictor
      responses, both in the presence or absence of myogenic tone. The mean contractile
      responses to flow (10 and 40 microliters/min), stretch, and histamine (1 microM)
      were 13%, 28%, 24%, and 33% of the tissue maximal response, respectively. When
      45Ca2+ influx was expressed in relation to the force development (45Ca2+ influx
      per milligram), the amount of calcium entry was dependent on the stimulus. Values
      for 45Ca2+ influx per milligram in response to flow (10 and 40 microliters/min)
      and to histamine (1 microM) were not significantly different. The value was
      significantly lower for the response to stretch. On the other hand, 45Ca2+ net
      uptake, when expressed per unit force, was similar in response to flow (10 and 40
      microliters/min), histamine (1 microM), and stretch.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1628392
TI  - Endogenous calcitonin gene-related peptide mediates nonadrenergic noncholinergic
      depressor response to spinal cord stimulation in the pithed rat.
AB  - The role of endogenous calcitonin gene-related peptide (CGRP) in the
      nonadrenergic noncholinergic depressor response to spinal cord stimulation was
      studied in the pithed rat in vivo. Pithed rats were given hexamethonium (2 mg/kg
      per minute i.v.) to block autonomic outflow, and mean blood pressure was
      artificially maintained at approximately 100 mm Hg with methoxamine (10-15
      micrograms/kg per minute i.v.). Electrical stimulation of the spinal cord at the
      level of the lower thoracic vertebra (T9-12) caused a fall in blood pressure in a
      frequency-dependent (0.5-10 Hz), voltage-dependent (2.5-50 V), and pulse duration
      dependent (0.25-8 msec) manner. The heart rate did not change during the
      depressor response. The depressor response was long lasting, and the maximum
      response was elicited by stimulation at 4-6 Hz. The neurotoxin tetrodotoxin (100
      micrograms/kg i.v.) abolished the depressor response to spinal cord stimulation,
      whereas treatment with propranolol (0.5 mg/kg per minute i.v.), atropine (0.05
      mg/kg per minute i.v.), or a combination of pyrilamine (0.5 mg/kg per minute
      i.v.) and cimetidine (0.5 mg/kg per minute i.v.) did not affect the response. In
      pithed rats treated with capsaicin (total dose of 500 mg/kg s.c.), spinal cord
      stimulation caused a slight depressor response. Exogenous CGRP, but not
      acetylcholine, isoproterenol, histamine, or substance P, caused a sustained fall
      in blood pressure that mimicked the spinal cord stimulation-induced depressor
      response. Continuous infusion of CGRP[8-37] (60 nmol/kg per minute i.v.), a CGRP
      receptor antagonist, markedly inhibited the depressor responses not only to
      spinal cord stimulation but also to exogenous CGRP.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1628393
TI  - Time course of left ventricular function after cardiac denervation in conscious
      dogs.
AB  - The time course of left ventricular (LV) function was compared in normal (N) and
      cardiac-denervated (CD) dogs over an 8-week period after instrumentation with
      solid-state LV pressure gauges and three pairs of ultrasonic crystals to measure
      LV long and short axes and wall thickness. Baseline LV systolic, end-systolic,
      and end-diastolic pressures did not differ in N and CD dogs. Heart rate was
      higher (p less than 0.01) and LV dP/dt was lower (p less than 0.05) in CD dogs.
      LV short-axis shortening, shortening fraction, velocity of circumferential fiber
      shortening, and ejection fraction were consistently lower (p less than 0.01) in
      CD dogs. With angiotensin II to increase LV afterload, relations of LV short-axis
      shortening, shortening fraction, velocity of circumferential fiber shortening,
      and ejection fraction to average LV systolic wall stress were shifted downward (p
      less than 0.01) in CD dogs at 2, 4, and 8 weeks. Relations of LV short-axis
      shortening to LV end-diastolic wall stress also differed (p less than 0.01) in N
      and CD dogs. Ganglionic blockade abolished differences in LV function between N
      and CD dogs during elevated LV systolic wall stress with angiotensin II. Thus, in
      conscious dogs, cardiac denervation results in a sustained reduction of LV
      function over a wide range of ventricular loading conditions.

PMID- 1628394
TI  - Cultured rat aortic vascular smooth muscle cells digest naturally produced
      extracellular matrix. Involvement of plasminogen-dependent and plasminogen
      independent pathways.
AB  - Vascular smooth muscle (VSM) cell migration and proliferation play a major role
      in the development of atherosclerotic lesions, graft occlusion, and restenosis
      after angioplasty. Cell migration implies the digestion of the surrounding
      extracellular matrix. Cell-associated proteolysis has been extensively studied in
      neoplastic and inflammatory cells, but very little is known about the proteolytic
      properties of VSM. We have evaluated the ability of rat cultured VSM cells to
      solubilize [3H]amino acid-labeled extracellular matrices produced by bovine VSM.
      When plated at a density of 30,000 cells per well in 24 multiwell plates, VSM
      cells were able to solubilize 63.3 +/- 7.0% of the extracellular matrix after 10
      days in culture. Extracellular matrix digestion occurred also when the cells were
      cultured in plasminogen-depleted serum but was higher in the presence of 10
      micrograms/ml purified plasminogen (net percent digestion after the subtraction
      of the appropriate control, 8.6 +/- 3.0% versus 21.2 +/- 3.5% after 3 days in
      culture, p less than 0.005, respectively). The involvement of other enzymes in
      addition to plasmin is confirmed by the ability of VSM cells to degrade
      extracellular matrices from which the plasmin-sensitive component was removed
      with plasmin pretreatment. Rat VSM cells were able to solubilize 52.3 +/- 2.0% of
      this residual extracellular matrix-associated radioactivity after 6 days in
      culture versus 26.1 +/- 1.5% in the control dishes (p less than 0.01, n = 5).
      Cell contact was required for extracellular matrix degradation: cell-conditioned
      medium did not have any effect on extracellular matrix digestion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1628395
TI  - Physiological hyperinsulinemia inhibits myocardial protein degradation in vivo in
      the canine heart.
AB  - Myocardial protein turnover in vivo was examined in anesthetized dogs following a
      16- or 36-hour fast and again during a hyperinsulinemic (2 mU/kg per minute)
      euglycemic clamp with or without amino acid replacement or during saline
      infusion. We measured myocardial phenylalanine balance and rates of protein
      synthesis and degradation, using the extraction of intravenously infused L-[ring
      2,6-3H]phenylalanine and the dilution of its specific activity across the heart
      at isotopic steady state. After both a 16-hour (n = 19) and 36-hour fast (n =
      10), there was net myocardial release of phenylalanine indicated by the negative
      balances for phenylalanine of -52 +/- 9 (p less than 0.001) and -38 +/- 9 (p less
      than 0.005) nmol/min, respectively. Overall, the basal rate of myocardial protein
      degradation was lower in the 36-hour-fasted animals (81 +/- 13 versus 121 +/- 12
      nmol/min, p less than 0.05). Myocardial phenylalanine balance and rates of
      protein synthesis and degradation did not change during insulin and glucose
      infusion in the 36-hour-fasted animals (n = 10). In these animals, there was a 30
      40% decline in plasma amino acid concentrations, including branched chain (p less
      than 0.001) and essential amino acids (p less than 0.001).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1628396
TI  - Biomechanical properties of reperfused transmural myocardial infarcts in rabbits
      during the first week after infarction. Implications for left ventricular
      rupture.
AB  - Left ventricular (LV) rupture potential was studied after transmural myocardial
      infarction (MI) in rabbits by measuring 1) the tensile strength of infarcted
      tissue strips, 2) the force required to initiate a tear (tear threshold) in the
      central infarcted region, and 3) the intracavitary pressure required to rupture
      the infarcted ventricle. During the first week after MI, infarcts resulting from
      a permanent coronary occlusion were compared with infarcts reperfused "late"
      (i.e., 3 hours) after coronary occlusion with a resultant hemorrhagic transmural
      infarct but no reduction in infarct size. The reperfused hemorrhagic infarcted
      strips had less tensile strength than strips from permanently occluded infarcts
      in the initial 24 hours after MI (16 +/- 1 versus 24 +/- 3 g/mm2, p less than
      0.05), but the tear threshold and response to increased LV pressure were not
      influenced by infarct reperfusion at this time. By 3 days after MI, reperfused
      infarcts had equal tensile strength, had greater resistance to infarct tearing,
      and could withstand a greater LV distending pressure compared with permanently
      occluded infarcts. By 5 days after MI, reperfused infarcts maintained a greater
      tear threshold but had less tensile strength than permanently occluded infarcts,
      although all infarct values were equivalent or greater than normal LV values. By
      7 days after MI, reperfused and permanently occluded infarcts were equally strong
      by all measurements. Thus, late reperfusion of transmural infarcts increased
      resistance to infarct tearing and LV rupture above that of nonreperfused
      permanently occluded infarcts by 3 days after MI and enhanced tissue strength
      after an initial 24-hour vulnerable period. These findings suggest that late
      reperfusion may accelerate myocardial healing after MI.

PMID- 1628397
TI  - Basal metabolism adds a significant offset to unloaded myocardial oxygen
      consumption per minute.
AB  - Myocardial oxygen consumption (MVO2) includes components for 1) mechanical energy
      generation, 2) activation, and 3) basal metabolism. Whereas the first two
      components are expected to increase in proportion with heart rate, a significant
      basal level of metabolism would consume oxygen even if the heart rate were zero.
      Contrary to this expectation, however, a previous study reported that, during
      unloaded beats, MVO2 per beat (which includes basal metabolism) was independent
      of heart rate. Accordingly, unloaded MVO2 per minute would extrapolate to zero at
      zero heart rate; this result is unexpected considering basal metabolism. To
      resolve this inconsistency, we varied heart rate over a wide range after inducing
      atrioventricular block in eight isolated cross-circulated canine hearts that
      contracted isovolumically. We examined whether a term representing rate
      independent basal metabolism was needed to describe MVO2 per minute. Mechanical
      energy generated by the left ventricle was evaluated from the pressure-volume
      area, which was altered by changing isovolumic ventricular volume over at least
      five levels at each heart rate. Contractility, evaluated by the slope of the end
      systolic pressure-volume relation, did not vary significantly with heart rate in
      this study. In contrast to the previous report, unloaded MVO2 per beat (i.e.,
      MVO2 extrapolated to a pressure-volume area of zero) was not constant but fell
      monotonically with increases in heart rate in every heart. We considered that
      this trend was caused by a significant rate-independent basal level of MVO2 per
      minute. Multiple linear regression analysis confirmed that this rate-independent
      basal term differed significantly from zero in seven of the eight hearts
      studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628398
TI  - Mechanism of ergonovine-induced hyperconstriction of the large epicardial
      coronary artery in conscious dogs a month after arterial injury.
AB  - This study investigated the mechanism of ergonovine-induced hyperconstriction of
      coronary artery in conscious dogs that had undergone endothelial denudation one
      month earlier. The diameter of the large epicardial coronary artery was
      continuously measured by a sonomicrometer in 12 dogs in which two pairs of 10-MHz
      piezoelectric crystals had been surgically implanted at the denuded and
      nondenuded sites of coronary arteries. A month after the endothelial denudation,
      intravenous ergonovine (0.01, 0.1, 0.3, and 1.0 mg) produced transient dilation
      followed by dose-dependent constriction. The degrees of dilation were comparable
      between the denuded and nondenuded sites. The magnitudes of constriction induced
      by ergonovine were significantly larger in the denuded site than in the
      nondenuded site: the percent reductions in diameter evoked with 0.3 mg ergonovine
      were 14.4 +/- 2.3% and 3.8 +/- 0.8% (p less than 0.01) at the denuded and
      nondenuded sites, respectively. The magnitudes of constriction induced by
      intravenous phenylephrine (0.02, 0.06, and 0.2 mg) were comparable in the denuded
      and nondenuded sites. Methysergide (a nonselective serotonergic blocker) in a
      dose of 0.5 mg/kg significantly inhibited vasoconstriction induced by ergonovine
      (0.3 mg) from 13.1 +/- 1.1% to 2.7 +/- 1.0% (p less than 0.01) at the denuded
      site and from 4.2 +/- 0.6% to 0.8 +/- 0.3% (p less than 0.05) at the nondenuded
      site. Diltiazem (1.0 mg/kg) selectively inhibited the ergonovine-induced
      hyperconstriction. Ketanserin (0.5 mg/kg), prazosin (1.0 mg/kg), or indomethacin
      (5.0 mg/kg) did not prevent the ergonovine-induced hyperconstriction.
      Histological study revealed intimal thickening and regenerated endothelium in the
      denuded site.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628399
TI  - Indirect relation between rises in oxygen consumption and left ventricular output
      at birth in lambs.
AB  - To examine the relation between increased newborn oxygen requirements and the
      postnatal rise in cardiac output, we measured left ventricular (LV) output, organ
      blood flows, and whole-body oxygen consumption using radioactive microspheres in
      late-gestation sheep fetuses and in the same animals 1 and 4 hours after cesarean
      section delivery. LV output rose from 264 +/- 23 ml.min-1.kg body wt-1 in fetuses
      to 444 +/- 33 ml.min-1.kg body wt-1 in lambs at 1 hour after delivery (p less
      than 0.005) and was unchanged at 4 hours after delivery. This rise in LV output
      was associated with a more than fourfold increase in the LV flow contribution to
      tissues situated distal to the ductus arteriosus (fetus, 51 +/- 9 ml.min-1.kg
      body wt-1; lamb, 226 +/- 22 ml.min-1.kg body wt-1; p less than 0.005), which were
      mainly perfused by the right ventricle in utero. However, average blood flow to
      body tissues was similar in fetuses (37 +/- 4 ml.min-1.100 g tissue-1), 1-hour
      lambs (39 +/- 4 ml.min-1.100 g tissue-1), and 4-hour lambs (40 +/- 5 ml.min-1.100
      g tissue-1). Oxygen consumption increased by 58%, from 7.84 +/- 0.43 ml.min-1.kg
      body wt-1 in fetuses to 12.38 +/- 2.4 ml.min-1.kg body wt-1 in 1-hour lambs (p
      less than 0.01), and was unchanged in 4-hour lambs.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1628400
TI  - Changes in extracellular and intracellular pH in ischemic rabbit papillary
      muscle.
AB  - The extracellular pH (pHo) and intracellular pH (pHi) were simultaneously
      measured with H(+)-sensitive microelectrodes in the rabbit papillary muscle
      during normal arterial perfusion and no-flow ischemia. The preparation was kept
      in an artificial gaseous atmosphere (N2 and CO2 during ischemia) without a
      surrounding fluid layer. Cylindrical muscles of small diameters (less than 1.0
      mm) were selected to prevent major diffusion gradients of CO2 within the muscle
      cylinder during ischemia. In normal perfusion with CO2/HCO3(-)-buffered blood at
      PCO2 of 35 mm Hg, pHi was 7.03 +/- 0.03. During early ischemia, extracellular
      acidification was much more prominent than intracellular acidification.
      Consequently, the transmembrane pH gradient reversed (pHo less than pHi) at
      approximately 8 minutes. At 14 minutes of ischemia, pHo was 6.64 and pHi was
      6.93. A moderate increase in PCO2 from 35 to 67 mm Hg before ischemia enhanced
      intracellular acidification in ischemia. Simulation of CO2 accumulation (increase
      of PCO2 in the surrounding atmosphere), as encountered in midmural ventricular
      layers during in vivo ischemia, produced a significant decrease of pHo (6.30
      versus 6.64) and pHi (6.65 versus 6.93) at 14 minutes of ischemia. The presence
      of red blood cells in the intravascular space after arrest of coronary perfusion
      showed a pronounced effect on extracellular and intracellular acidosis. If the
      muscles were perfused with CO2/HCO3(-)-buffered perfusate in the absence of red
      blood cells, the changes of pHo and pHi were significantly larger (pHo, 6.00
      versus 6.64; pHi, 6.46 versus 6.93 at 14 minutes) during ischemia. Actively
      developed force during ischemia was not significantly influenced by conditions
      modulating pHi. It decreased by 82% after 5 minutes, even when no significant
      change of pHi was recorded. By contrast, ischemic contracture was dependent on
      intracellular acidification. It developed earlier in the absence of red blood
      cells or with low extracellular buffer capacity. It is concluded that during
      acute myocardial ischemia 1) extracellular acidification exceeds intracellular
      acidification, 2) the decrease in pHi is inhomogeneous because of local variation
      in CO2 accumulation and diffusion, 3) the decrease in pHi is relatively small in
      the presence of red blood cells, and 4) the development of ischemic contracture
      but not the early decline in active tension is sensitive to changes in pHi.

PMID- 1628402
TI  - EEG and evoked potentials in HIV-infected children.
AB  - Forty-seven HIV-seropositive children were investigated by EEG and evoked
      potentials (BAEP, SEP). Twenty-three children were symptomatic (P2), 8
      seropositive without symptoms (P1), and 16 children were less than 15 months of
      age (P0). Some of them were investigated at different stages of HIV infection.
      During the neonatal period, 7 newborns of drug-addicted mothers had seizures and
      frequent spikes and sharp waves in their EEGs. Among (P2) children 6/23 showed
      background slowing and 1 had rhythmic theta activity (6 with and 1 without
      neurological symptoms). In BAEP, bilateral prolonged interpeak latencies (IPL)
      were found in 1 child with severe AIDS encephalopathy. Side differences greater
      than or equal to 0.4 ms in IPL were seen in 2 (P2), 1 without and 1 with
      neurological symptoms. A late onset was seen in 2 (P1) and 4 (P2) children.
      Median SEPs were normal in 24/26 patients; N20/N13 amplitude ratio was reduced in
      2 (P1) patients. EEG and BAEP revealed nonspecific abnormal features in HIV
      encephalopathy. The the progression of the disease. However, also in the
      symptomatic group, normal results of EEG and BAEP dominated. SEP in the
      symptomatic group revealed only normal values. For monitoring the effectiveness
      of AZT treatment in HIV encephalopathy, EEG seems to be a relevant investigation;
      for evoked potentials more data and experience are needed.

PMID- 1628401
TI  - Impaired myogenic responsiveness of renal microvessels in Dahl salt-sensitive
      rats.
AB  - The mechanisms mediating abnormal renal autoregulation in Dahl salt-sensitive
      (DS) rats have not been fully defined. In the present study, we assessed myogenic
      responsiveness of interlobular arteries (ILAs), afferent arterioles (AAs), and
      efferent arterioles in isolated perfused hydronephrotic Dahl rat kidneys. Dahl
      rats were divided into four groups according to strain (Dahl salt-resistant [DR]
      or DS rats) and dietary sodium manipulation (rats fed low or high salt diets).
      Systolic blood pressure was elevated only in DS rats fed the high salt diet (202
      +/- 4 mm Hg, p less than 0.05). Myogenic responses were obtained by stepwise
      elevation of renal arterial pressure. Vessel diameters were determined by
      computer-assisted videomicroscopy. Preglomerular microvessels of DS and DR rats
      responded differently to changes in renal arterial pressure. AAs and ILAs
      manifested diminished myogenic responsiveness to increasing renal arterial
      pressure in DS rats compared with DR rats (p less than 0.05). Both AAs and ILAs
      in DS rats manifested a higher threshold pressure for eliciting myogenic
      responses and a decrease in maximal pressure-induced vasoconstriction. The
      sensitivity of the AA myogenic response to nifedipine was enhanced in DS rats
      compared with DR rats (p less than 0.05). For rats fed the high salt diet,
      preglomerular vessels exhibited reduced myogenic responsiveness in both strains.
      In contrast to preglomerular microvessels, efferent arterioles from all four
      groups of rats failed to exhibit pressure-induced vasoconstriction. Our data
      suggest that diminished myogenic responsiveness of AAs and ILAs in DS rats
      contributes to impaired renal autoregulation in this strain.

PMID- 1628403
TI  - Sleep electroencephalogram at the early stage of Creutzfeldt-Jakob disease.
AB  - We describe sleep EEG studies in three patients at the early stage of Creutzfeldt
      Jakob disease. Little work has been devoted to the study of the sleep EEG in the
      course of the CJ disease: disorganized sleep architecture was noted, associated
      with a decrease in stage 4 and an almost complete disappearance of the REM stage.
      Our patients were considered to have normal stage 2; yet spindles and K complexes
      were rare at this stage. No evolution towards stage 4 was noted. The percentage
      of rapid eye movement sleep was significantly low in two cases and normal in one
      case. Sleep disturbances in the other dementing disorders are reported.

PMID- 1628404
TI  - Can somatosensory evoked potentials predict outcome from coma?
AB  - Long-term somatosensory evoked potential (SEP) recordings for a period of 2 1/2
      years are reported for a patient rendered comatose from hypoxic encephalopathy.
      Findings are compared with previously published reports on poor outcome
      associated with bilaterally absent cortical responses. In the present case, the
      patient was admitted with poor neurological status but has preserved cortical
      responses bilaterally throughout his course until his final recovery and return
      to previous employment. Somatosensory cortical responses when bilaterally absent
      are universally associated with poor outcome; however, when persistently present
      they can indicate hope of recovery despite poor clinical status on admission.

PMID- 1628405
TI  - Subclinical cognitive deficits in cancer patients: a preliminary P300 study.
AB  - A preliminary study of event related potentials (P300) in a group of 16 cancer
      patients, without cerebral metastases or focal neurological deficits, is being
      reported. As compared to a group of 28 normal adults, 9 out of 16 cancer patients
      were found to have prolonged P300 latencies, and 6 made more than two errors in
      their cognitive performance. These subclinical cognitive impairments in cancer
      patients may be related to some remote effects of cancer. These patients had not
      undergone any chemotherapy or radiation therapy prior to P300 studies. Further
      studies in a larger group of patients with gynecological cancer are being
      conducted.

PMID- 1628406
TI  - Spindle activity in the waking EEG in older adults.
AB  - Sleep spindles are an EEG sign of light sleep under physiological conditions. We
      reported the simultaneous occurrence of sleep spindles and alpha activity in the
      waking EEG in 12 patients with a mean age of 59.0 years. Most of the patients
      were diagnosed as cerebrovascular disorders such as cerebral arteriosclerosis,
      transient ischemic attack and vascular dementia. The mean alpha frequency in the
      presence of WSA significantly decreased by 1.5 Hz. The frequency and spatial
      distribution of waking spindle activity were similar to those of sleep spindles.
      In our cases, at least the two factors of cerebrovascular involvement and older
      adults were considered to be primarily responsible for the intrusion of sleep
      spindles into wakefulness (presumably a state close to very light drowsiness) due
      possibly to the instability of sleep-waking cycle regulation.

PMID- 1628407
TI  - Cassette EEG sleep recordings in Gilles de la Tourette syndrome.
AB  - Tourette syndrome (TS) patients often complain of sleep problems, and
      questionnaire studies indicate that sleep disturbance is frequent. Decreased slow
      wave sleep and increased awakenings have been reported in laboratory
      polysomnography in TS patients, and a serotoninergic disorder of arousal has been
      postulated. We recorded outpatient sleep in 20 patients newly diagnosed with TS
      utilizing a 4-channel cassette EEG system. The newly-diagnosed patients were
      predominantly male, and ranged in age from 10 to 36 years. Some had taken
      psychotropic medications in the past, but none had been treated systematically
      for TS. Seven patients had chronic tics only, 8 had tics and attention deficit
      hyperactivity, and 5 had tics plus obsessions and compulsions. None had other
      medical, neurologic, or psychiatric disorders. All were nocturnal sleepers, and
      were recorded in their usual sleeping environments and routines. TS patients had
      reduced sleep, decreased sleep efficiency, increased awakenings, and decreased
      slow wave sleep. Tic patients had increased nocturnal awakenings and movements,
      particularly those who had tics during sleep. Sleep fragmentation and loss of
      slow wave sleep was most marked in TS patients with attention deficit
      hyperactivity. Sleep latency was increased, REM sleep reduced, and REM sleep
      latency decreased in TS patients with obsessions and compulsions. These findings
      accord with previous reports of sleep disturbance in TS, and suggest that these
      disturbances may vary with TS symptoms. Chronic tics may persist in sleep and
      cause awakenings, TS with attention deficit may be associated with a disorder of
      arousal and alertness, and obsessions and compulsions may be manifestations of a
      biochemical disturbance involving paradoxical sleep.

PMID- 1628408
TI  - Prior head injury accounts for the heterogeneity of the alcohol-epilepsy
      relationship.
AB  - Fifty-five adult male patients with alcoholism and seizures were divided into
      three groups. In group I, all seizures were consistently produced by alcohol
      withdrawal (N = 16); in group II, some seizures were clearly precipitated by
      alcohol withdrawal and others were not (n = 18); and in group III none of the
      seizures had a consistent relationship with drinking (N = 21). The three groups
      were compared for age, frequency of seizures, compliance, Bear-Fedio and Boston
      Naming scores, those for memory of words and faces, and finger-tapping scores,
      and neuropsychological impairment ratings as well as EEG background frequencies.
      The incidence of severe head injury preceding the onset of seizure disorder was
      significantly higher in groups II and III. This was further supported by a
      greater prevalence of asymmetric alpha rhythm, abnormal CT scans and multiple
      seizure types in those two groups. These data indicate that a prior head injury
      is a major variable accounting for the heterogeneity of the alcohol-epilepsy
      relationship.

PMID- 1628409
TI  - Hot water epilepsy.
AB  - The clinical and EEG features of 10 patients with hot water epilepsy were
      presented. Eight of the 10 cases were male. The mean age of onset was 4.7 years.
      In four patients partial and in six cases generalized seizures were seen. Three
      patients also had non-hot water precipitated seizures. Interictal EEGs showed
      generalized abnormalities in eight and focal abnormalities in two cases. CT was
      performed and found normal in two patients. Anticonvulsant therapy was instituted
      for all patients. In six cases with adequate follow-up, complete remission was
      obtained in four and the frequency of the seizures was decreased in two, with
      anticonvulsant therapy.

PMID- 1628410
TI  - Nitrendipine 20 mg once daily versus nicardipine slow release 40 mg twice daily
      in mild essential hypertension: evaluation by 24-hour ambulatory blood pressure
      monitoring.
AB  - The extent and duration of the blood pressure (BP) lowering effect of 20 mg
      nitrendipine (NIT) once daily and 40 mg nicardipine slow release (NIC) twice
      daily were compared in 12 men (aged 39-55 years) with mild essential hypertension
      according to a randomized, cross over study. Twenty-four-hour non invasive
      ambulatory BP monitoring (Spacelabs 5200) was performed at the end of a 2-week
      placebo run-in and after 4 weeks of each active treatment; automatic BP
      measurements were programmed at 15-min intervals. Both treatments significantly
      (p less than .01) reduced mean 24-hour and daytime systolic (SBP) and diastolic
      (DBP) BP, but had different effects on daytime BP profiles. NIT decreased SBP and
      DBP (p less than .05) in 5 out of 8 two-hour subperiods (from 8 a.m. to 6 p.m.),
      followed by a loss of effect; NIC reduced SBP and DBP (p less than .05) in 7 out
      of 8 two-hour subperiods (from 8 a.m. to 10 p.m.). During the night-time, NIT
      reduced mean SBP (p less than .05) and NIC both mean SBP and DBP values (p less
      than .05; p less than .05 vs NIT for SBP). Heart rate was not affected by either
      treatment. Thus, after short-term treatment in mild essential hypertensives
      nitrendipine once daily was not as effective as nicardipine slow release twice
      daily in reducing blood pressure throughout the 24 hours.

PMID- 1628411
TI  - Electrophysiological responses of angiotensin peptides on the rat isolated nodose
      ganglion.
AB  - Previous autoradiographic studies have identified angiotensin II (AII) binding
      sites over the nodose ganglion and along the vagal afferent neurons. In the
      present study, we examined whether these binding sites are functional receptors
      by measuring d.c. potential changes by extracellular recording techniques in the
      rat isolated nodose ganglion preparation in response to superfusion of
      angiotensin peptides. It was found that AII, as well as AI and AIII elicited
      concentration-dependent depolarisation of the nodose ganglion. However, the amino
      terminal angiotensin heptapeptide, A(1-7), failed to evoke any significant
      response. The AII receptor antagonist, saralasin had no intrinsic activity, but
      caused a concentration-dependent blockade of AII-induced depolarisation. This
      study provides evidence for direct neuronal effects of angiotensin peptides on
      rat vagal afferent neurons. Moreover, this preparation is a relatively convenient
      one in which to study functional neuronal AII receptor mechanisms on central or
      peripheral terminals of vagal sensory neurons.

PMID- 1628412
TI  - Chlorthalidone reduces vascular hyperresponsiveness in DOCA-salt hypertensive
      rats.
AB  - The mechanisms of anti-hypertensive effect of diuretics remain unknown. The
      purpose of this study was to test the hypothesis that long-term treatment with
      chlorthalidone decreases the responsiveness of resistance vessels to
      neurohormones. The study was performed in deoxycorticosterone acetate (DOCA)-salt
      hypertensive rats with and without treatment with chlorthalidone (Chlor. 8
      mg/day, for 20 days). Resting mean arterial pressure in freely moving state was
      significantly reduced in DOCA-salt-Chlor rats when compared to DOCA-salt rats
      (116 +/- 3 vs 147 +/- 7 mmHg, respectively). Chlorthalidone treatment reduced the
      high plasma sodium content observed in DOCA-salt rats to the same levels observed
      in normotensive control groups. Results obtained in isolated perfused mesenteric
      arteries showed: a) the increase in perfusion pressure elicited by norepinephrine
      (NE), serotonin (SE) and vasopressin (VP) was significantly greater in DOCA-salt
      than in DOCA-salt + Chlor rats or control normotensive rats; b) the endothelium
      removal increased the pressor responses to NE, SE and VP in a similar way in all
      groups. These data provide evidence that long-term chlorthalidone treatment
      reduces vascular hyperresponsiveness to these neurohormones. In addition, these
      results indicate that this reduction in vascular hyperresponsiveness, associated
      with a decrease in extracellular sodium level, could be a possible mechanism by
      which the diuretics reduce the high blood pressure.

PMID- 1628413
TI  - Renal nerve-mediated proximal tubule solute reabsorption contributes to
      hypertension in spontaneously hypertensive rats.
AB  - Renal nerve activity increases (Na+, K+)-ATPase activity and contributes to the
      development of hypertension in young SHR. The present study was designed to
      examine the effect of sodium intake on blood pressure and proximal tubule solute
      reabsorption in sham-operated or renal denervated, 5-week old SHR and WKY. Three
      week old SHR and WKY rats underwent sham surgery or renal denervation with 10%
      phenol and were maintained for 10 days on either a 0.6% or 2.2% NaCl diet. Blood
      pressure was obtained by indirect tail cuff measurements during this interval. Of
      the eight groups, only sham-operated SHR on a high sodium diet had hypertension,
      122.0 +/- 4.2 mm Hg vs. 98.7 +/- 3.3 mm Hg (mean for remaining groups). Renal
      plasma flow (RPF), glomerular filtration rate (GFR), and the fractional excretion
      of lithium (FELi) were determined in rats maintained on a 2.2% sodium diet at 5
      weeks of age. FELi was less in sham-operated SHR, 5.3 +/- 0.7%, compared to WKY,
      9.4 +/- 2.8% (P less than 0.02). Furthermore, denervation ameliorated the reduced
      FELi in SHR, 10.2 +/- 1.2%, without affecting FELi in WKY. RPF and GFR were
      similar between sham-operated and renal denervated SHR and WKY. No significant
      difference could be detected in net sodium balance between WKY and SHR during
      this period. These findings demonstrate 1) from the basis of FELi, young SHR, of
      this strain, exhibit enhanced proximal tubule solute reabsorption and
      hypertension while on a high sodium diet and, 2) renal denervation ameliorates
      both the enhanced proximal tubule solute reabsorption and the early development
      of hypertension. These data support the concept that renal nerve activity of
      young SHR is augmented and contributes to the development of hypertension by
      enhancing salt retention.

PMID- 1628415
TI  - Selected abstracts from the 14th annual meeting of the Japanese Societies of
      Hypertension.

PMID- 1628414
TI  - Insulin attenuates vasoconstriction by noradrenaline, serotonin and potassium
      chloride in rat mesenteric arterioles.
AB  - We investigated the effect of insulin on the vascular reactivity to
      noradrenaline, serotonin and potassium chloride in rat mesenteric resistance
      arterioles in vitro. Mesenteric artery segments were placed in a myograph system.
      Sensitivity to noradrenaline, serotonin and KCl was tested after an equilibration
      at 37 degrees C. Thereafter, arteries were incubated with buffer alone or with
      insulin (40, 100, 250 and 400 mU/ml) for one hour at 37 degrees C. Sensitivity to
      the three vasoconstrictors was retested. Incubation with noradrenaline, serotonin
      and KCl resulted in a dose dependent increase in wall force. Exposure with buffer
      did not change the shape of the dose-response-curve. The same was true for the
      lowest dose of insulin (40 mU/ml). However, incubation with insulin at
      concentrations of 100, 250 and 400 mU/ml led to a reduction in wall force by 37
      77%. The reduction in the slope of the curve and the maximal response suggest a
      non-competitive inhibition. Supraphysiological doses of insulin attenuate the
      vasoconstriction by noradrenaline, serotonin and KCl in rat mesenteric arteries
      in vitro.

PMID- 1628416
TI  - In vivo clearance by the mononuclear phagocyte system in humans: an overview of
      methods and their interpretation.
AB  - The mononuclear phagocyte system (MPS) is responsible for the elimination of
      foreign material, effete autologous material and immune complexes. To study the
      relationship between MPS function and human disease, several test substances have
      been developed, and used to determine the clearance capacity of the MPS in human
      subjects in vivo. These test substances and the multitude of factors that
      influence the elimination of these substances (and complicate the interpretation
      of the test results) are discussed. Use of these probes has provided important
      new insights, that may lead to the development of treatment modalities by which
      MPS function is modified in order to influence disease processes more
      effectively.

PMID- 1628417
TI  - IL-8 as a circulating cytokine: induction by recombinant tumour necrosis factor
      alpha.
AB  - Tumour necrosis factor-alpha (TNF-alpha) is a pivotal cytokine at the centre of a
      cascade of cytokines and inflammatory mediators which modulate the host response
      to infection and trauma, and in particular the metabolic changes resulting in
      shock and subsequent multi-organ failure. The cytokine IL-8--predominantly an
      activator and chemotactic factor for circulating polymorphonuclear neutrophil
      leucocytes--is produced in response to TNF-alpha in vitro, and high circulating
      levels of IL-8 are found in septic primates. We have studied the release of IL-8
      into the circulation of subjects with chronic hepatitis B undergoing a 10 week
      pilot trial of recombinant TNF-alpha (rTNF-alpha) therapy in doses of 15-100
      micrograms/m2. A marked dose-dependent increase in plasma IL-8 levels was seen
      commencing at 30-60 min after the start of rTNF-alpha infusion and peaking
      between 2 and 3 h (mean peak level 4300 ng/l). The temporal pattern of IL-8
      production exactly echoed that of IL-6, another component of the cytokine
      cascade, but peak plasma levels of IL-8 were up to 17 times higher than those of
      IL-6. This study confirms in vitro data suggesting that IL-8 is a component of
      the acute circulating cytokine cascade with a potential role in the modulation of
      the acute immune and metabolic response to infection and trauma.

PMID- 1628418
TI  - Monocyte cytokine secretion induced by chemically-defined derivatives of
      Klebsiella pneumoniae.
AB  - The capacity of a K. pneumoniae membrane proteoglycan (Kp-MPG) and four of its
      chemically defined derivatives to activate human monocytes was studied by
      measuring immunoreactive IL-1 beta, IL-6 and tumour necrosis factor-alpha (TNF
      alpha) in culture supernatants. Monocyte culture supernatants were also tested
      for their comitogenic activity on concanavalin A-stimulated thymocytes and for
      their cytotoxic activity on the mouse fibroblastic L929 cell line. The four Kp
      MPG derivatives were: (i) an acylpoly(1-3)galactoside (APG); (ii) an APG
      preparation submitted to acid hydrolysis which removed all fatty acids but left
      intact the galactose chain of APG (GC-APG); (iii) a preparation obtained by mild
      alkaline hydrolysis, containing additional ester-linked C14 and C16 fatty acids
      bound to the APG molecule (EFA-APG); and (iv) a polymer of the latter compound
      (APG pol). Kp-MPG induced the synthesis of IL-1 beta, IL-6 and TNF-alpha with
      dose-responses and kinetics similar to those of Salmonella minnesota
      lipopolysaccharide (Sm-Re-LPS). APG pol and EFA-APG induced the secretion of the
      three cytokines with lower potency than Kp-MPG or Sm-Re-LPS. APG did not trigger
      any detectable cytokine production and GC-APG induced only borderline and
      inconsistent responses. Our data demonstrate the critical role of ester-linked
      C14 and C16 fatty acids in the triggering of monocyte response to Kp-MPG
      derivatives.

PMID- 1628419
TI  - Cellular immune response to the cell walls of Mycobacterium leprae in leprosy
      patients and healthy subjects exposed to leprosy.
AB  - Cell walls of M. leprae consist of complex arrangements of carbohydrate, lipid,
      peptidoglycan and protein molecules. Recently, extractable proteins of a wide
      range of molecular weights were identified as components of the cell wall. We
      have examined the cellular immune responses of Nepali leprosy patients to a cell
      wall preparation of M. leprae enriched for these proteins. Strong lymphocyte
      proliferative responses to the antigens were present in half of the
      paucibacillary leprosy patients and in the majority of healthy control subjects
      with occupational exposure to leprosy. Patients with multibacillary disease
      responded poorly and patients with tuberculosis had intermediate responses.
      Proliferative responses to the cell wall protein fraction were strongly
      correlated to the proliferative responses to sonicates of the whole leprosy
      bacillus. Immunization of mice with cell wall proteins resulted in inhibition of
      growth of M. leprae following foot-pad inoculation with viable organisms.
      Therefore cell-mediated immune responses to the extractable proteins of the cell
      wall may play a role in protective immunity against M. leprae infection.

PMID- 1628420
TI  - T cell regulation of the chronic peritoneal neutrophilia during mycobacterial
      infections.
AB  - Intraperitoneal infection of mice with mycobacteria induces the persistent
      mobilization of neutrophils to the infected peritoneal cavities. The recruitment
      of the neutrophils was mediated by the immune system since it was enhanced by
      immunization and reduced in T cell-deficient nude and SCID mice. Anti-mitotic
      treatments with cyclophosphamide or X-rays led to a reduction in the number of
      mononuclear cells in the peritoneal cavity of infected mice, followed by a
      reduction in neutrophil numbers despite the presence of a normal circulating pool
      of neutrophils. The depletion of T cells with antibodies during mycobacterial
      i.p. infection led to a reduction in the number of neutrophils. Such a reduction
      was more extensive if the antibodies were administered early. Our data suggest
      that T cells are partially involved in the direct recruitment of neutrophils
      during chronic mycobacteriosis but they also play a role in the priming of other
      cell types for the mobilization of these phagocytes.

PMID- 1628421
TI  - Secretion of Toxoplasma gondii-specific antibody in vitro by peripheral blood
      mononuclear cells as a new marker of acute toxoplasmosis.
AB  - Antigen-specific antibody secretion in vitro by peripheral blood mononuclear
      cells (PBMC) reflects an in vivo stimulation of the immune system by the antigen.
      Primary infection of immunocompetent patients with T. gondii causes an acute
      infection followed by chronic toxoplasmosis. We examined in vitro anti-Toxoplasma
      antibody production by PBMC during the acute and chronic phases of toxoplasmosis.
      PBMC from patients with acute or chronic toxoplasmosis and seronegative subjects
      were cultured for up to 6 days. Anti-Toxoplasma antibodies were assayed in
      supernatants by ELISA and immunoblotting. Anti-Toxoplasma antibodies were
      detected in supernatants of PBMC from 29 pregnant women who seroconverted during
      gestation. PBMC from 17 patients who had chronic toxoplasmosis and PBMC from 10
      seronegative healthy controls did not secrete Toxoplasma-specific antibodies.
      This in vitro antibody secretion was spontaneous, active and transient since it
      disappeared between 11 and 24 weeks after seroconversion. Anti-Toxoplasma
      antibody secretion by PBMC from patients with acute toxoplasmosis is consistent
      with an in vivo stimulation of the immune system by T. gondii antigens. Our
      results represent a new approach for studying the immunological response during
      T. gondii infection and could have important implications for the diagnosis of
      acute and re-activated toxoplasmosis.

PMID- 1628422
TI  - Comparison of the properties of the CsA analogs monoacetyl CyC (o-acetyl
      threonine2 cyclosporin) and methyl-alanyl CsA (N-methyl-L-alanyl6 cyclosporin);
      monoacetyl cyclosporin is immunosuppressive without binding to cyclophilin.
AB  - Cyclosporin (CsA) is an immunosuppressant which binds to cyclophilin (Cyp). The
      relationship between Cyp binding and immunosuppression has been questioned since
      one of the analogs of CsA, N-methyl-L-alanyl6 cyclosporin (methyl-alanyl CsA)
      binds to Cyp but is not immunosuppressive. We compared the immunosuppressive
      properties of CsA, methyl-alanyl CsA and o-acetyl-threonine2 cyclosporin
      (monoacetyl CyC), since monoacetyl CyC does not bind to Cyp when tested in cell
      free assays and its immunosuppressive properties had not been tested. Cyp is a
      peptidyl-prolyl isomerase which is abundant in all human tissues, yet the
      activities of CsA are mostly confined to inhibition of T cell and thymocyte
      activation, and to neuro- and nephro-toxicity and are independent of inhibition
      of the isomerase. Activation of thymocytes and of T cells is regulated by the
      binding of a nuclear factor(s) (NFs) to the NF-AT region (-285 to -255) of the IL
      2 promoter. We studied inhibition of binding to the NF-AT region of NFs derived
      from primary cultures of thymocytes treated with CsA or its analogs. In addition,
      we compared the effect of CsA and its analogs on the expression of the IL-2 gene
      in a stably transfected Jurkat-cell line (Fgl 5) which contains three copies of
      NF-AT and the reporter enzyme beta-galactosidase; and on inhibition of
      proliferation induced by concanavalin A (Con A) or IL-2. We found that monoacetyl
      CyC which does not bind to Cyp is immunosuppressive by our criteria when tested
      in cultured cells due to either a different mechanism of action or to metabolic
      activation.

PMID- 1628423
TI  - Functionally active complement is present in human ovarian follicular fluid and
      can be activated by seminal plasma.
AB  - Human ovarian preovulatory follicular fluids (FF) from 10 women were analysed for
      their complement contents. Functionally active complement was detected in all the
      fluids studied in amounts similar to those present in normal human serum. Pooled
      FF was challenged by seminal plasma in order to determine whether seminal plasma
      could activate FF complement, the pattern of such an activation and the possible
      consequences on the reproductive function. FF complement activation occurred
      during the incubation with seminal plasma with features including alternative
      pathway activation, factor B and C3 conversion and reduction in total haemolytic
      complement, as well as an inhibition by seminal plasma of the FF complement
      response to a new activating challenge. Possible consequences for fertilization,
      implantation of a fertilized ovum and local defence mechanisms against viruses
      and bacteria are discussed.

PMID- 1628424
TI  - Abnormal production of B cell growth factor in patients with systemic lupus
      erythematosus.
AB  - In order to clarify the role of B cell growth factor (BCGF) in the pathogenesis
      of systemic lupus erythematosus (SLE), BCGF production by peripheral blood
      mononuclear cells (PBMC) and T cells was studied using a new bioassay for BCGF
      activity. For this purpose, we established an Epstein-Barr (EB) virus-transformed
      B cell line KS-3.F10 that proliferates only in response to two B cell-specific
      BCGF, low-mol. wt BCGF (LMW-BCGF) and high-mol. wt BCGF (HMW-BCGF). PBMC from
      active SLE patients produced less BCGF when stimulated with phytohaemagglutinin
      (PHA) compared with controls. The decreased BCGF production by PHA-stimulated
      PBMC from active SLE reverted to control values when SLE became inactive.
      However, PHA-stimulated T cells from active SLE patients produced more BCGF
      compared with controls, whereas those from inactive SLE showed normal BCGF
      production. Spontaneous BCGF production by T cells was not observed in active SLE
      patients. These findings suggest that decreased BCGF production by SLE PBMC is
      due to excessive BCGF consumption by B cells in vitro and that SLE T cells
      produce large amounts of BCGF with appropriate immune stimuli in vivo to promote
      polyclonal B cell activation.

PMID- 1628425
TI  - Expression of antigen reactive with a monoclonal antibody to HTLV-1 P19 in
      salivary glands in Sjogren's syndrome.
AB  - To examine the possible involvement of retroviruses in Sjogren's syndrome (SS),
      labial salivary gland sections from 99 individuals were probed with three MoAbs
      to core (gag) proteins of human T cell leukaemia virus-1 (HTLV-1) and two MoAbs
      to HIV-1. Sections from 31% of 39 patients with primary SS (pSS) contained an
      epithelial cytoplasmic protein reactive with a MoAb (197) to the p19 group
      specific antigen (gag) of HTLV-1. The antigen was also detected in samples from
      24% of 17 patients with rheumatoid arthritis (RA) and SS, 21% of 14 patients with
      sicca symptoms and 12.5% of 16 patients with other connective tissue diseases. It
      was not found in the salivary glands of 13 normal controls. A second MoAb to p19
      gag, a MoAb to the p24 gag of HTLV-1 and MoAbs to HIV-1 p17 and p24 gags gave
      negative reactions. Serum antibodies to HTLV-1 were negative, confirming that the
      antigen was not part of HTLV-1. The antigen showed properties consistent with an
      endogenous retrovirus in that it was absent in healthy tissues or resting cells
      but inducible by stimulation with phytohaemagglutinin (PHA) or interferon-gamma
      (IFN-gamma). It appeared to be distinct from the endogenous retroviral sequence
      HRES-1. These data suggest the presence of an endogenous retrovirus in salivary
      gland epithelium which could contribute to the chronic inflammation of SS.

PMID- 1628426
TI  - Reassessment of the relative prevalences of antibodies to gastric parietal cell
      and to intrinsic factor in patients with pernicious anaemia: influence of patient
      age and race.
AB  - Anti-parietal cell antibody has been reported in nearly all patients with
      pernicious anaemia in past studies, in contrast with anti-intrinsic factor (IF)
      antibody which occurs in only 50-70% of such patients. However, observations in
      the more diverse patient population at our hospital suggest that these
      prevalences, originally described in predominantly elderly, white patients of
      European origin, no longer apply. Anti-IF antibody was found in 70% of the 324
      patients, with blacks (84%) and Latin Americans (69%) having a significantly
      higher prevalence than whites (55%). In contrast, only 55% of the 266 patients
      tested had anti-parietal cell antibody. It was noteworthy that this low rate was
      similar in all racial groups. However, patients lacking anti-parietal cell
      antibody were significantly younger than those who had the antibody (54.8 +/-
      17.8 vs 59.6 +/- 16.2 years, P = 0.022). Overall, a striking 30% of all patients
      had anti-IF antibody but not anti-parietal cell antibody, while only 13% had the
      latter antibody without having anti-IF antibody. This pattern was particularly
      striking among black patients. An interesting incidental observation was that
      gastrin levels were not associated with antibody status, but were significantly
      higher not only among women than among men but also among white and black
      patients than among Latin-American patients. The findings show that anti-parietal
      cell antibody is not found nearly as often in pernicious anaemia as has been
      reported in the past, and thus has no value as a diagnostic tool in pernicious
      anaemia. They also suggest clues to different expressions of pernicious anaemia
      or of its immunologic response, particularly among younger patients with the
      disease.

PMID- 1628427
TI  - T lymphocyte anergy during acute infectious mononucleosis is restricted to the
      clonotypic receptor activation pathway.
AB  - The transient T cell anergy associated with acute infectious mononucleosis (IM)
      caused by the Epstein-Barr virus has been analysed in a sample of 14 IM children.
      Peripheral blood mononuclear cells (PBMC) obtained from IM patients showed a
      significant specific impairment in their proliferative response to both
      phytohaemagglutinin (PHA; P less than 0.05) and to an anti-CD3 MoAb (P less than
      0.001), although both responses reached normal control levels by addition of a
      submitogenic dose of either phorbol myristate acetate (PMA) or recombinant IL-2
      (rIL-2). In contrast, activation signals delivered through other surface
      molecules (CD2, CD28) or other transmembrane pathways (PMA plus a calcium
      ionophore) elicited normal or high proliferative responses in most IM PBMC. In a
      group of five patients tested, the synthesis of IL-2 by IM PBMC in the presence
      of PMA was impaired when PHA or anti-CD3 was used as stimulus, but it reached
      normal levels with anti-CD2 or ionophore. Lastly, PHA failed to induce IL-2 alpha
      receptor (IL-2R alpha) expression in IM PBMC from four tested patients, but the
      presence of PMA completely corrected this defect. Taken together, these results
      strongly suggest that the T cell anergy associated with acute IM is due to a T
      cell receptor (TCR)-specific impairment in the induction of genes involved in T
      cell proliferation (including those coding for IL-2 and IL-2R alpha) upon
      membrane signalling to otherwise normal T lymphocytes, since CD2, CD28 and
      certain transmembrane activation pathways are uncoupled from CD3 in these
      particular pathological conditions (and perhaps in most in vivo situations). This
      and other similar experimental approaches to transient secondary
      immunodeficiencies may help to unravel the physiopathological role of different
      surface molecules in T cell activation.

PMID- 1628428
TI  - Distribution of retroviral p15E-related proteins in neoplastic and non-neoplastic
      human tissues, and their role in the regulation of the immune response.
AB  - In patients with head and neck carcinomas and in patients with chronic purulent
      upper airway infections, low molecular weight retroviral p15E-like factors are
      found. These factors are responsible for partial defects in the cellular immune
      response. We studied the distribution of these p15E-related proteins in
      neoplastic, inflamed and normal human tissues and related these findings with the
      presence of p15E-like factors in patients' sera. Demonstration of p15E-like
      proteins in sera of patients with upper airway infections and of patients with
      head and neck carcinomas correlated exclusively with the presence of p15E in
      normal and pathologic epithelium of the upper respiratory tract. p15E was not
      demonstrated in epithelia of other localizations. Our results suggest that
      chronic stimulation or neoplastic transformation of the epithelia of the upper
      respiratory tract stimulates the production of p15E-like proteins leading to
      their reported immunosuppressive actions.

PMID- 1628429
TI  - IVth European Meeting of Neuropathology. Berlin, July 14-18, 1992. Abstracts.

PMID- 1628430
TI  - [Analysis of cognitive function and regional cerebral blood flow in Parkinson's
      disease by 123I-IMP SPECT].
AB  - To investigate the relationship between the alterations of regional cerebral
      blood flow (rCBF) and the cognitive impairment in parkinsonian patients, I
      studied forty-one patients affected by Parkinson's disease (19 men and 22 women)
      using single photon emission computed tomography (SPECT) and N-isopropyl-p-[123I]
      iodoamphetamine (123I-IMP) as a tracer. I evaluated the cognitive function with
      the Mini-Mental State examination (MMS), the Hasegawa's Dementia Scale (HDS), the
      Kana-pick up test (KT), and the figure drawing test (FDT). I evaluated the motor
      impairment with the Hoehn and Yahr stage. SPECT scanning was performed with a
      rotating digital gamma camera TOSHIBA 901-A. A semiquantitative method of
      assessing regional tracer uptake was used. Regions of interest (ROI; 3 x 3
      pixels, 15.9 x 15.9 mm2) were drawn on the cerebellar hemispheres, cortical
      regions (frontal, temporal, parietal and occipital), and basal ganglia
      bilaterally. The RI count index was expressed as a ratio of activity in each ROI
      to mean counting rate over cerebellar regions. I considered the RI count index as
      the index of rCBF in each ROI. There were strong positive correlations between
      MMS and rCBF of frontal, parietal and occipital lobes (p less than 0.001). There
      were positive correlations between HDS and rCBF of frontal (p less than 0.01),
      parietal (p less than 0.001) and occipital lobes (p less than 0.01). There were
      positive correlations between KT and rCBF of frontal (p less than 0.01),
      occipital (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628431
TI  - [Linkage study of Machado-Joseph disease: genetic evidence for the locus
      different from SCA1].
AB  - Spinocerebellar ataxia 1 (SCA1) is the locus symbol of hereditary
      olivopontocerebellar atrophy, and it is mapped on the short arm of chromosome 6.
      D6S89 is the polymorphic DNA marker linked tightly to SCA1. In order to examine
      whether SCA1 and Machado-Joseph disease (MJD) loci are different from each other,
      we performed linkage study for D6S89 to MJD locus. A total of 20 pedigrees of MJD
      were analysed. Number of individuals consists of 211 members. Among them, 74 were
      affected. Consequently, 14 pedigrees showed negative lod score, and 6 showed weak
      positive lod scores at most of recombination fractions. As a whole, linkage
      between MJD locus and D6S89 was excluded at recombination fraction of 0.15. Our
      results further support the concept that MJD is not an allelic disorder but
      distinct genetic entity from SCA1.

PMID- 1628432
TI  - [Linkage study of hereditary olivopontocerebellar atrophy: genetic evidence for
      locus heterogeneity in Japanese cases].
AB  - Spinocerebellar ataxial 1 (SCA1) is the locus name of autosomal dominant
      olivopontocerebellar atrophy (OPCA), and is assigned to the short arm of
      chromosome 6. The tight linkage between SCA1 and D6S89 has recently been
      reported. In order to examine possible locus heterogeneity, we studied linkage
      for D6S89 to disease loci in 16 pedigrees of dominant OPCA. D6S89 polymorphism
      was analysed with PCR amplification of genomic DNA by using specific
      oligonucleotide primers. Lod scores were computed by LIPED program with the
      correction of age-dependent penetrance. Homogeneity test was performed by using
      HOMOG program. Fifteen out of 16 pedigrees were informative to D6S89. Among them,
      7 pedigrees showed positive and 8 pedigrees showed negative lod scores throughout
      all recombination fractions. Homogeneity testing disclosed that approximately 55%
      of pedigrees are linked to D6S89, and others were not linked. Our results provide
      evidences that dominant OPCA in Japan are genetically heterogenous. At now, it
      has been still unknown whether there are any clinico-pathological differences
      among OPCA genotypes. Based on the alpha-constant from homogeneity testing, we
      divided our pedigrees into linked-pedigree (SCA1) and nonlinked-pedigrees
      (nonSCA1). Then, clinical features were compared between these two groups.
      Hyperactive DTR was more common in SCA1 than nonSCA1 group. On the other hand,
      hypoactive DTR was more significantly dominated in nonSCA1 than SCA1. Slow
      saccade and Babinski sign were common in both groups. Although not statistically
      significant, nystagmus, exteral ophthalmoparesis, mydriasis, ptosis, facio
      lingual twitching, and limb spasticity were more frequently observed in SCA1 than
      nonSCA1. These results indicate that there are possible correlation between
      disease genotype and phenotype.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628433
TI  - [An autopsy case of Degos disease with neurological symptoms--neuropathological
      observations and increased platelet aggregation].
AB  - We reported clinical and neuropathological observations of a 41-year-old man with
      Degos disease. He first noted painless skin lesions over the upper extremities in
      January, 1982. Three years later he was diagnosed as Degos disease by skin
      biopsy, and treatment with aspirin was started. In September, 1985, he complained
      of paresthesia on his right arm, followed by a series of new neurological
      manifestations suggesting multifocal spinal cord lesions. On October 28,
      examination of admission showed papules with central umblication over the whole
      body except the head, face, palms, soles and scrotum. Neurological examination
      revealed no weakness, diminished right biceps reflex, exaggerated patellar
      reflexes and Achilles reflexes, left extensor plantar reflex, hypesthesia and
      hypalgesia to the level of Th8, mild left spastic gait, and retention of urine.
      In November, he had paraparesis, loss of vibration sense of lower extremities,
      hypesthesia and hypalgesia to the level of TH4, and weakness of right upper
      extremity. In December, he showed tetraplegia, left-sided facial palsy, and
      hypesthesia and hypalgesia to the level of C5. In January, 1986, he showed right
      facial palsy, left facial hypesthesia, pseudobulbar palsy. In February, he had
      bilateral abducens nerve palsy and hiccups. On February 18, he died of
      intracranial hemorrhages. He had episodic abdominal pain several times during
      admission. His condition deteriorated progressively in four months after the
      first manifestation of neurological symptoms, despite the therapy with heparin,
      urokinase, ticlopidine, dipyridamole, and prednisolone. Laboratory studies showed
      gradual increase of CSF proteins (from 156 mg/dl to 602 mg/dl) and extremely
      increased platelet aggregation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628434
TI  - ["Dynamic" MR imaging of the cervical cord in patients with cervical spondylosis
      and ossification of the posterior longitudinal ligament--significance of dynamic
      cord compression].
AB  - This investigation was designed to assess the influence of dynamic cord
      compression on severity and course of myelopathy. Sixty-seven patients studied
      comprised 54 cases of cervical spondylosis and 13 cases of ossification of the
      posterior longitudinal ligament. These patients underwent "dynamic" MR imaging of
      the cervical spine. MR images in the sagittal view were obtained in three
      different neck positions: flexion, neutral, and extension. MR imaging was
      performed with a 0.15 T resistive unit. For technical reasons, the body coil was
      used. The pulse sequence was 500/30 (Tr msec/echo time msec) for T1 images. The
      spinal cord compression was accelerated in 32 cases when extended, in 2 cases
      when flexed, and in 4 cases when both extended and flexed. In 21 cases, we
      compared myelograms with MR images in a same neck position. Findings of
      myelograms well corresponded with those of MR images on 83 percent of
      intervertebral levels. The patients with dynamic cord compression were proved to
      have severer long tract signs, and their disability was regressive or progressive
      case by case for an average of 21-month follow-up. The "dynamic" MR imaging can
      provide dynamic nature of spinal cord compression, and prognostic clues.

PMID- 1628435
TI  - [A case of chronic progressive external ophthalmoplegia associated with familial
      hypercholesterolemia].
AB  - A 52-year-old woman with chronic progressive external ophthalmoplegia (CPEO) with
      familial hypercholesterolemia (FH) was reported. Her mother died from heart
      disease, and her elder sister has hypercholesterolemia with swelling of Achilles
      tendons. She had slowly progressive external ophthalmoplegia, bilateral ptosis,
      swelling of Achilles tendons since twenties. At 40 years of age, she was pointed
      out hypercholesterolemia. Physical examination was within normal limits except
      for bilateral swelling of Achilles tendons. Neurological findings showed
      bilateral ptosis, disturbance of eye movements, mild proximal muscle weakness and
      dysesthesia in bilateral hands. Routine laboratory findings were within normal
      limits except for high serum cholesterol level (512 mg/dl). In the biopsied
      muscle, there was mild variation in fiber size with several ragged-red fibers and
      focal cytochrome c oxidase defective fibers. Biochemical analysis of the biopsied
      muscle revealed normal values in the mitochondrial fraction. Southern blot
      analysis of the mitochondrial DNA (mtDNA) of the muscle disclosed mixed
      population of mtDNA, consisting of the normal one and partially deleted (4.9
      kilobase). Southern blot analysis of the leukocytes from the patient against the
      cDNA of LDL receptor was normal at least using the restriction enzyme of BglII,
      XbaI, EcoRI, PvuII and BamHI. This case has CPEO with deleted mtDNA associated
      with familial hypercholesterolemia, which is caused to nuclear DNA abnormalities,
      and is thought to be an important case for us to study the relationship between
      deleted mtDNA and abnormal nuclear DNA in CPEO.

PMID- 1628436
TI  - [A case of multiple sclerosis with paroxysmal attacks of facial paresthesia,
      unilateral hand tremor, epigastric pain and urinary incontinence].
AB  - A Japanese woman, aged 42, was admitted because of paroxysmal attacks consisting
      of paresthesia of the left face, tremor in the right hand, epigastric pain and
      urinary incontinence. A year prior to the admission, she noticed some difficulty
      in writing, dysarthria and unsteadiness of walking. These symptoms had been
      persistent since then. At the end of March, 1991, these symptoms rapidly
      worsened, and she fell down frequently. She also experienced pain behind both
      eyes, numbness in her left fingers and toe, urinary frequency and the above
      mentioned attacks. Neurological examination disclosed bilateral internuclear
      ophthalmoplegia and upbeating nystagmus on upward gaze, titubation in the head,
      scanning speech, dysmetria in all limbs, exaggerated reflexes in jaw and both
      legs, bilateral extensor plantar reflexes and ankle clonus. SEP showed delayed
      cortical response with stimulation of the median nerves bilaterally and of the
      right posterior tibial nerve. P40 was absent with the left posterior tibial nerve
      stimulation. VEP was normal. T2-weighted image of MRI showed multiple high
      intensity areas located around the third ventricle, crus cerebri and the right
      upper part of the pons. The diagnosis of multiple sclerosis was made. Each
      paroxysmal attack started with numbness in the left face and burning sensation in
      the neck. Almost simultaneously tremor in the right hand began. The surface EMG
      showed the rhythmic contractions in the dorsal hand muscles and wrist extensors
      at a frequency of 6-7 Hz, and sometimes it revealed synchronized contractions of
      finger flexors and the dorsal hand muscles. A few seconds later she felt painful
      sensation in the epigastric region, and the tremor gradually increased in its
      intensity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628437
TI  - [A case of motor neuron disease with dementia--cerebral blood flow and cerebral
      oxygen metabolism].
AB  - A 51-year-old man developed muscle weakness of the bilateral upper extremities,
      and mental changes beginning with personality change. There was no history of
      mental illness in his family. A neurological examination 1 year after the onset
      revealed muscle atrophy and fasciculation of his bilateral upper extremities
      Neuropsychological examination revealed concrete speech, paraphasia, and lack of
      judgment. Disorientation, amnesia, dyscalculia, and spatial agnosia, however,
      were not recognized. These neuropsychological findings were compatible with
      dementia of frontal lobe type. EMG and muscle biopsy revealed neurogenic muscular
      atrophy. There was no abnormal findings in the brain X-CT and the brain MRI. PET
      study using C15O2 and 15O2 revealed reduction of cerebral blood flow (CBF) and
      cerebral metabolic rate of oxygen (CMRO2) in the bilateral medial frontal cortex,
      the left temporal cortex and the bilateral thalamus. From these these findings
      the patient was diagnosed as having motor neuron disease with dementia. Muscle
      atrophy and dementia worsened gradually. A second PET study 2 years and 6 months
      after the onset revealed severe reduction of CBF and CMRO2 in the bilateral
      temporal cortex and the thalamus. These PET findings suggested that dysfunction
      of the temporal cortex and the thalamus related to dementia in this case.

PMID- 1628438
TI  - [Central diabetes insipidus complicated with upbeat nystagmus and cerebellar
      ataxia].
AB  - A 34-year-old male presented with central diabetes insipidus accompanied by
      upbeat nystagmus and cerebellar ataxia. The patient without family history of
      above began to walk at the age of 2 years. Polyposia and polyuria were noted at
      the age of about 4 years. Dysbasia developed at the age of about 7 years. From
      the age of 30, lalopathy appeared together with various clinical symptoms
      including cataracts, disturbed intelligence, upbeat nystagmus, abnormal ocular
      movements, ataxic speech, cerebellar ataxia and reduction of the muscle tone of
      the limbs, and hypotonic polyuria. Abnormal laboratory findings included square
      wave jerks, upbeat nystagmus, and "bow tie" nystagmus by EOG, atrophy of the
      cerebellum and the brainstem by CT, a slight prolongation of the P300 latency,
      and a central diabetes insipidus pattern by water deprivation test and Carter
      Robbins tests. There have been occasional reports of diabetes insipidus
      complicated by cerebellar ataxia, but in no earlier reports has diabetes
      insipidus been concurrent with abnormal ocular movements such as upbeat
      nystagmus. A degenerative disease primarily of the posterior lobe of the
      hypophysis, hypothalamus, cerebellum, and brainstem was suspected.

PMID- 1628439
TI  - [Hemiplegic migraine complicated with coronary vasospasm].
AB  - There are many theories and hypotheses concerning with the pathogenesis of
      migraine. The clinical effectiveness of vasoactive drugs and many investigations
      on the cerebral blood flow in patients with migraine strongly support a vascular
      theory. In present paper we report a case of 26-year-old Japanese male, who
      suffered from hemiplegic migraine and coincidental coronary vasospasm, and
      discussed the pathogenesis of migraine. In October 1986, the patient developed
      the first attack of throbbing headache in the left temporal area with nausea and
      vomiting, following typical visual aura. One week later, he developed the second
      migrainous attack and then he felt his right extremities paralyzed and numb.
      Although the headache and weakness resolved within one hour, similar migrainous
      attack with transient hemiparesis repeated two or three times a month. Although
      the longest period required for resolving weakness was three days, the MRI, the
      CT and the electroencephalogram revealed no significant abnormality. In January
      1987, during his stereotyped attack of hemiplegic migraine, he also developed
      oppressive feeling on his anterior chest and these symptoms resolved within
      fifteen minutes. Because the results of Holter electrocardiogram and ultrasound
      echocardiogram indicated angina pectoris, a coronary angiography was performed in
      February 1987. During the angiographical procedures, he began to complain of the
      oppressive feeling on his anterior chest, and the coronary angiography revealed
      the definite vasospasm in the anterior descending branch of the left coronary
      artery. Sublingual nitroglycerin administration resolved the vasospasm, but
      thereafter the patient developed his stereotyped hemiplegic migrainous
      attack.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628440
TI  - [Rapid spontaneous postpartum remission in a case of chronic inflammatory
      demyelinating polyradiculoneuropathy associated with pregnancy].
AB  - A 28-year-old woman developed numbness and weakness of the hands and arms when
      she was 8 months pregnant, and weakness worsened gradually. However, weakness
      started to spontaneously subside immediately after delivery and she felt almost
      recovered several hours later. But weakness and numbness recurred one week after
      delivery and she was admitted to our hospital. Neurological examination revealed
      moderate weakness and disturbance of the deep and cutaneous sensations in the
      upper and lower extremities, and marked decrease of the deep tendon reflexes. The
      upper extremities were more severely affected. Nerve conduction study showed
      marked decrease in the motor conduction velocities. Cerebrospinal fluid showed
      increase of protein without pleocytosis. Teased preparation of the biopsied sural
      nerve showed occasional internodal segments with thin myelination, indicating
      demyelination and remyelination. A diagnosis of chronic inflammatory
      demyelinating polyradiculoneuropathy was made. Treatment with prednisolone
      markedly improved the weakness and hyporeflexia as well as the cerebrospinal
      fluid protein. Postpartum rapid remission may have been produced by rapid
      increase of endogenous steroid hormone in the blood by its massive excretion
      during delivery.

PMID- 1628441
TI  - [Magnetic resonance imaging in Parkinson's disease--the evaluation of the width
      of pars compacta on T2 weighted image].
AB  - The width of substantia nigra (SN) in 59 cases with idiopathic Parkinson's
      disease as well as 21 normal controls was analyzed by T2 weighted image (T2WI) of
      1.5 Tesla high-field magnetic resonance image (MRI). All patients and controls
      underwent MRI with the spin-echo sequences used TR/TE: 3000/30 (short TE), and
      TR/TE:3000/80 (long TE), in 5-mm-thick volumes. The width between the red nucleus
      and the cerebral peduncle showing low signal intensity areas was measured as that
      of SN and its ratio to the distance from the aqueduct to the midline of the
      cerebral peduncle was also measured. The calculated values of the width of SN and
      its ratio were analyzed by Mann-Whitney test. The significant reduction in the
      width of SN and its ratio in Parkinson's disease were disclosed as below; the
      mean calculated values of the width of SN were 2.95 +/- 0.51 mm in controls, 2.68
      +/- 0.99 mm in Parkinson's diseases on long TE images (P less than 0.01), and the
      mean ratio of the width of SN were 13.58 +/- 4.21% in controls, 10.52 +/- 3.07%
      in Parkinson's diseases on long TE images (P = 0.0002). The narrowing of SN in
      Parkinson's disease was more prominent in men, and advanced cases with Yahr stage
      III and IV. Considering that the pars reticulata, which is normally containing
      iron, shows low signal intensity on long TE images, the width of pars compacta
      could be measured more precisely on this sequences. The evaluation of the ratio
      of SN in midbrain on long TE images seemed to be more sensitive than the
      calculated values in detecting the narrowing of SN and pars compacta in
      Parkinson's disease.

PMID- 1628442
TI  - [XYY syndrome associated with motor neuropathy].
AB  - We described a case of XYY syndrome associated with motor neuropathy. The case
      was a 27-year-old male, who had 47-XYY chromosome karyotype. His symptoms were
      distal dominant muscle weakness and muscle atrophy in his lower extremities
      without objective sensory disturbance. He had no mental retardation or family
      history of neurologic diseases. The electrophysiological and pathological
      examinations revealed that his symptoms were due to peripheral motor neuropathy
      (neuronal type). His motor neuropathy may be of sporadic type. There may be some
      relation in the pathogenesis between XYY syndrome and motor neuropathy, although
      in the literature, XYY syndrome with motor neuropathy had not been reported so
      far.

PMID- 1628443
TI  - [A case of chronic toluene intoxication with abnormal MRI findings: abnormal
      intensity areas in cerebral white matter, basal ganglia, internal capsule, brain
      stem and middle cerebellar peduncle].
AB  - We reported a case of 21 years old man of chronic toluene intoxication with
      abnormal intensity areas on MRI in cerebral white matter, basal ganglia, internal
      capsule (especially posterior limb), brain stem and middle cerebellar peduncle.
      The patient developed various neurological abnormalities such as blurred vision,
      ataxic speech, gaze evoked horizontal nystagmus, bilateral pyramidal tract sign
      and limb ataxia after 8 years sniffing of thinner (mainly toluene). MRI
      examination revealed diffuse high intensity areas in cerebral white matter on T1
      weighted image. On T2 weighted image, high intensity areas of deep cerebral white
      matter, internal capsule (especially posterior limb), cerebral peduncle, ventral
      pons and middle cerebellar peduncle were noted. Basal ganglia (caudate nucleus,
      lenticular nucleus and thalamus) were displayed as low intensity area on T2
      weighted image. These high intensity areas of internal capsule, brain stem and
      middle cerebellar peduncle on T2 weighted image would be significant for
      understanding pyramidal tract sign and cerebellar sign of this case. On the basis
      of neuropathological descriptions of chronic toluene intoxication, these high
      intensity areas of T2 weighted image were presumed to be demyelinating lesions of
      the central nervous system.

PMID- 1628444
TI  - [Rapid diagnosis of tuberculous meningitis by polymerase chain reaction (PCR)].
AB  - Using polymerase chain reaction (PCR), a rapid and highly sensitive method was
      developed for the diagnosis of tuberculous meningitis. The mycobacterium
      tuberculosis (M. tuberculosis) genome was detected in CSF of 5 of 6 patients with
      clinically diagnosed tuberculous meningitis, but not present in CSF from 10
      patients with other types of meningitis and 10 normal controls. Furthermore, we
      detected M. tuberculosis in CSF of 2 of 24 patients with clinically possible
      tuberculous meningitis. This is highly useful method for the rapid diagnosis of
      tuberculous meningitis over other conventional method.

PMID- 1628445
TI  - [Paradoxical expansion of intracranial tuberculomas during chemotherapy].
AB  - A 45-year-old female patient was admitted to a hospital because of tuberculous
      meningitis in July, 1986. She was treated with chemotherapy (oral isoniazid,
      rifampicin, ethambutol and an intramuscular injection of streptomycin). Her
      consciousness was worsened at first, but later she improved aside from some
      disabilities (incontinence, gait disturbance, disorientation and dementia). She
      was transferred to National Higashisaitama Hospital in November, 1986. Since then
      we have continued the chemotherapy, and she has improved gradually. Initially her
      cranial computerized tomography (CT) revealed no intracranial tuberculoma and
      showed mild enhancement of basal cistern. About 4 months later, her CT showed
      many tuberculomas with ringed or nodular enhancement. About 13 months later
      almost all tuberculomas disappeared. But a few were found with homogeneous
      enhancement and were enlarged in spite of adequate chemotherapy. These
      tuberculomas were enlarged while the chemotherapy was continued, but later they
      were reduced in size. About 3 and a half years later, these tuberculomas
      disappeared without any calcifications. The above facts may suggest that
      intracranial tuberculoma could appear and be enlarged on cranial CT in spite of
      adequate chemotherapy during a course of tuberculous meningitis. They also
      suggest that continuation of adequate chemotherapy might improve tuberculomas.

PMID- 1628446
TI  - [Some questions and comments for the original article entitled "autosomal
      recessive oculopharyngeal 'muscular dystrophy'"].

PMID- 1628447
TI  - [A quantitative analysis of ataxia in the upper limbs].
AB  - By using a transparent digitizer and a personal computer, we tried a quantitative
      analysis of ataxia in the upper limbs. A total of 25 upper extremities of 13
      patients with spino-cerebellar degeneration (SCD) and 140 upper extremities of 70
      normal volunteers were tested by two types of tasks. One was the free speed trace
      of a circle presented on the display (free circle), and the other was the pursuit
      of a target moving on a circle at a fixed speed (pursuit circle). The digitizer
      was put on a color display stabilized horizontally. For 1024 points with a 25
      msec sampling time, the trajectory of the stylus pen was transmitted to the
      computer in real time. Circle diameters of 3 cm and 6 cm were selected. The
      target rounded the circle at a speed of 6 or 3 times per 1024 points. The mean
      velocity (MV), mean acceleration (MA), and MA/MV ratio were calculated for the
      extent of one circle period. And the coefficient of variation (CV) of the shifted
      distance in each sampling time and the power spectrum by Fast Fourier Transform
      (FFT) to the acceleration wave were calculated for the total input data. In the
      free circles, the MV and logarithm of MA varied widely and showed positive
      correlations. In contrast, those of the pursuit circles converged narrowly near
      the values of the target. On the other hand, in the SCD group, many patients
      could not draw the small free circle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628448
TI  - [A clinicopathological study of two respirator-aided long-survival cases of
      amyotrophic lateral sclerosis].
AB  - We reported two respirator-aided 10-year-survival male patients with sporadic
      amyotrophic lateral sclerosis (ALS). Their ages at onset were 54 and 52, clinical
      features common in both cases, the durations to tracheotomy 32 months and 27
      months respectively, and the durations for respiratory support over 8 years in
      both cases. There were normal external ocular movement, normal pelvic sphincter
      function, normal sensory system and no bed sores throughout 10 years of illness.
      The brain weighted 1,295 g in case 1 and 1,430 g in case 2, being normal
      macroscopically. The spinal cord was slightly wasted with atrophic anterior
      roots. The histopathological study demonstrated the typical pattern of ALS in
      spite of the prolonged survival with artificial respiration. Neuronal loss and
      gliosis of the motor nuclei in the spinal cord and brainstem were more striking
      than those of the natural course. Neither hypertrophic astrocyte, central
      chromatolysis nor neuronophagia was observed. This finding suggested inactive
      condition of the degeneration. The pattern of white matter degeneration in the
      cord indicated some pallor of anterior and lateral columns, severe pallor of
      pyramidal tracts and intact posterior column and spinocerebellar tracts. The
      giant pyramidal cells in the precentral gyrus were lost in both cases. Pyramidal
      degeneration was traceable up to the cerebral peduncles in the case 2 and
      undetectable in that portion in the case 1. On the other hand, the extraocular
      muscle nuclei, the Onuf's nuclei, the dorsal motor nucleus of the vagus nerve,
      intermediolateral and Clarke's nuclei were relatively preserved, though no cell
      count was done in Clarke's nuclei and Onuf's nuclei.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1628449
TI  - [CSF acetylcholinesterase activity in central neurological diseases involving
      cholinergic systems].
AB  - The enzymatic activity of acetylcholinesterase (AchE) in the cerebrospinal fluid
      (CSF) is considered to be a marker of central cholinergic neuron integrity. Then,
      we evaluated CSF AchE activity in 90 cases of neurological diseases involving
      cholinergic system and their related disease, and 28 control cases without
      central organic lesions or abnormal findings in routine CSF study. AchE activity
      was evaluated according to Ellman's method using acetylthiocholine iodide as a
      substrate and tetraisopropyl-pyrophosphoramide, a specific inhibitor of
      butyrylocholinesterase. CSF AchE of Alzheimer type dementia (AD/SDAT, N = 12:
      21.9 +/- 4.7 nmol/ml/min) showed no significant change from those of both control
      group (22.1 +/- 3.9) and vascular dementia (9: 21.7 +/- 6.7). In extrapyramidal
      diseases, reduction of the activity was observed in Huntington's chorea (HC, 4:
      16.3 +/- 1.4) and progressive supranuclear palsy (PSP, 4: 17.6 +/- 1.7), whereas
      normal activity was shown in Parkinson's disease (PD, 19: 22.5 +/- 4.6),
      dentatorubropallidoluysian atrophy (DRPLA, 4: 22.6 +/- 4.2) and striatonigral
      degeneration (SND, 4: 20.4 +/- 4.3). In olivopontocerebellar atrophy (OPCA, N =
      16), we disclosed reduced CSF AchE activity (15.8 +/- 2.4) which had significant
      correlations with the atrophy of the pontine base (r = 0.6017, p less than 0.02)
      and cerebellar vermis (r = 0.5450, p less than 0.05) in MRI. AchE activity in
      cerebellar cortical atrophy (CCA, 5: 20.6 +/- 2.2) remained within the control
      values. Normal activity was demonstrated in both amyotrophic lateral sclerosis
      (6: 24.3 +/- 7.3) and spinal muscular atrophy (4: 22.9 +/- 3.9).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1628450
TI  - [Cytokine production by peripheral blood monocytes/macrophages in the patients
      with multiple sclerosis and its suppression by methylprednisolone].
AB  - The production of tumor necrosis factor alpha (TNF alpha), interleukin-1 alpha
      (IL-1 alpha), interleukin-1 beta (IL-1 beta) and interleukin-6 (IL-6) by
      stimulated peripheral blood monocytes/macrophages (PBM) was assessed in patients
      with multiple sclerosis (MS), other neurological diseases (OND) or normal
      controls (NC) using enzyme-linked immunosorbent assay (ELISA). PBM obtained from
      acute phase of MS produced significantly higher amount of all these cytokines
      than those from chronic stable MS, OND or NC (TNF alpha, IL-1 alpha, IL-6: p less
      than 0.01, IL-1 beta: p less than 0.05). Methylprednisolone (MP) inhibited the
      lipopolysaccharide-induced cytokine production in a dose-dependent manner. These
      results suggest the possible roles of activated monocytes/macrophages in the
      acute exacervation of MS and suppressive effect of MP on cytokine production by
      activated monocytes/macrophages.

PMID- 1628451
TI  - [Effects of insulin-induced hypoglycemia on catecholamine secretion and blood
      pressure in neurological disorders affecting autonomic nervous system].
AB  - The effects of insulin-induced hypoglycemia on catecholamine secretion were
      investigated in patients with various neurological disorders affecting the
      autonomic nervous system. In control subjects, insulin-induced hypoglycemia
      resulted in marked increases in plasma epinephrine and norepinephrine levels.
      Heart rates were increased within 15 minutes after the insulin injection which
      were associated with slight elevation and depression of systolic and diastolic
      blood pressure, respectively. In patients with upper level spinal cord lesions
      (C1-T6) of various etiology, Shy-Drager syndrome and familial amyloidosis,
      insulin-induced hypoglycemia failed to increase plasma epinephrine and
      norepinephrine levels and resulted in falls in systolic and/or diastolic blood
      pressure 15 minutes after the injection. Heart rates were increased at 30-45
      minutes after the injection. In patients with lower spinal cord lesions (T10-L1),
      neurosyphilis or brain stem tumor with orthostatic hypotension, the catecholamine
      responses were normal and blood pressure did not fall during insulin-induced
      hypoglycemia. In patients with Parkinson's disease and spinocerebellar
      degeneration with autonomic symptoms catecholamine responses were not impaired.
      These findings suggest that any lesion involving the sympathetic efferent systems
      of baroreflex such as the spinal descending pathway, sympathetic preganglionic
      neuron and peripheral nervous system causes both impairment of catecholamine
      secretion and a fall in blood pressure during hypoglycemia, and that lesions in
      sympatho-afferent system may not affect the secretion of catecholamine and neural
      control of blood pressure.

PMID- 1628452
TI  - [A case report of cerebral achromatopsia with bilateral occipital lesion].
AB  - An 80-year-old right-handed man suddenly became impossible to recognize any color
      7 years prior to admission. He complained that everything looked like of the same
      color, monochromatic. On admission, he could not discriminate any color and any
      familial face. Left homonymous hemianopsia associated with right lower partial
      visual filed defect was observed, but visual acuity of both eyes was well
      preserved. Visual-visual color tasks (Ishihara, matching, Hue test, Panel-D15)
      disclosed the disturbances in color perception. However, he could roughly
      distinguished red or brown from the other colors. The color test was also
      impaired regarding the visual-verbal color tasks (naming, pointing). However,
      verbal description of the color concept, which was shown by the verbal-verbal
      color tasks, was well preserved. In addition, we observed left hemispatial
      neglect, disturbance of face recognition and topographical disorientation. MRI
      revealed old hemorrhagic infarcts in the bilateral occipital and temporal lobes,
      including the bilateral lateral and medial occipito-temporal gyri. Disturbance of
      color recognition in this case was diagnosed as cerebral achromatopsia on the
      basis of clinical characteristics and MRI findings. This is the first case of
      cerebral achromatopsia of which lesions were detected by MRI in detail.

PMID- 1628453
TI  - [An acute axonal polyneuropathy affecting intrinsic hand muscles following
      Campylobacter infection--a case report].
AB  - A 24-year-old carpenter had the shakes and fever on March 13, 1990. He suffered
      from watery diarrhea on March 14 and 15. He left muscle weakness in his thumbs
      and fingers when he drove nails with a hammer on March 24. The weakness reached
      maximum by the 3rd day of illness. He was admitted to our hospital on day 4.
      Neurological examination revealed symmetrical weakness localized in the intrinsic
      hand muscles (MRC grade 2-4). The deep tendon reflexes were preserved. Sensation
      was intact except for mild disturbance of superficial sense on both plantar
      areas. Campylobacter jejuni was cultured from his stool. A complement fixation
      test indicated serologically preceding C. jejuni infection. Whereas maximum motor
      nerve conduction velocities were not reduced and distal latencies were not
      prolonged, compound muscle action potential recorded in the thenar and hypothenar
      muscles were remarkably reduced on day 5. Needle EMG showed neuropathic changes
      in four limbs. Sensory nerve conduction velocities and action potentials were
      normal. The weakness gradually improved in association with increased compound
      muscle action potentials in the thenar and hypothenar muscles. His muscle symptom
      fully resolved 2 months after the onset of his illness. Thin-layer chromatogram
      with immunostaining revealed that serum IgG from this patient reacted with GM1,
      GD1a, GD1b, but did not react with GM2 and GT1b. Enzyme-linked immunosorbent
      assay showed that anti-GM1, GD1a, GD1b antibodies titer (IgG) decreased
      concurrently with the clinical improvement.

PMID- 1628454
TI  - [A case of paraneoplastic cerebellar degeneration--success in early detection of
      cancer by anti-Purkinje cell antibody].
AB  - A 70-year-old woman was admitted to our hospital because of rapidly progressive
      cerebellar ataxia. Neurological examinations showed saccadic eye movement,
      downbeat nystagmus, scanning speech, proximal dominant muscle weakness and severe
      truncal and limb ataxia. Based on these clinical features, she was suspected to
      have paraneoplastic cerebellar degeneration (PCD), although the malignant tumor
      was not detected through clinical intensive surveys. Her serum and CSF revealed
      to have anti-Purkinje cell antibodies immunohistochemically, and western blot
      analysis showed that they reacted with 58 kd band. In view of previous reports of
      PCD, she was strongly suspected to have gynecological cancers. The trial
      laparotomy found early stage fallopian tubal cancer, which had not been detected
      by CT scan, ultrasonogram and MRI. It is important to detect and characterize
      these autoantibodies found in the PCD patients for early diagnosis and treatment
      of underlying cancer.

PMID- 1628455
TI  - [A case of herpes zoster associated with multiple cranial nerve involvement].
AB  - A 74-year-old man who had suffered from right herpes zoster ophthalmicus
      developed ipsilateral multiple cranial nerve involvement two weeks later. He
      showed right visual disturbance, total ophthalmoplegia and peripheral facial
      palsy. Pleocytosis and increased protein were found in CSF. Titer of VZV antibody
      increased in serum and CSF. CT and MRI demonstrated no abnormal findings in the
      brain stem. Within a month, peripheral facial palsy improved. Severe extra
      ophthalmoplegia began to improve after three months, and moderately recovered.
      After two and a half year, visual disturbance and mydriasis showed no
      improvement. In this case, we speculate that localized leptomeningitis caused
      multiple cranial nerve involvement.

PMID- 1628456
TI  - [Quantitative evaluation of tongue atrophy on midsagittal magnetic resonance
      images (MRIs)].
AB  - This study was undertaken mainly to establish the quantitative parameter to
      evaluate the tongue atrophy on midsagittal MRIs and to show the clinical
      usefulness of such quantitative evaluation. Midsagittal MRIs of the tongue of
      consecutive 103 patients were analyzed. They were classified into 67 patients
      showing normal size (group without atrophy), 11 patients showing atrophy (group
      with atrophy) and 25 patients showing unsatisfactory MRIs with artefacts based on
      the routine evaluation. The patients in the group without atrophy did not show
      any pathologic processes to produce tongue atrophy on clinical findings. The area
      and perimeter of tongue and oral cavity, and the ratio of tongue area to oral
      cavity area and the ratio of tongue perimeter to oral cavity perimeter on
      midsagittal MRIs were obtained in each patient of groups with and without atrophy
      by using quantitative image analysis system. In the group without atrophy,
      regression analysis of the data on age was made and the 95% confidence interval
      of the data for age was obtained. No evidence that the tongue becomes atrophic
      with aging was obtained in the group without atrophy. Patients in the group with
      atrophy were best separated from those in the group without atrophy statistically
      when the ratio of tongue area to oral cavity area was regressed on age. Among 11
      patients in the group with atrophy, 6 patients were not regarded as having tongue
      atrophy on clinical neurological examinations. Therefore, the evaluation of
      midsagittal MRIs is clinically useful.

PMID- 1628457
TI  - [A case of myasthenia gravis complicated by cyclic thrombocytopenia].
AB  - A 47-year-old woman with myasthenia gravis for last 11 years was admitted because
      of relapsed muscle weakness, hypermenorrhea and thrombocytopenia. Physical and
      neurological examinations revealed diplopia, proximal muscle weakness and
      purpuras on the left arm and bilateral legs. Repeated hematological examinations
      revealed cyclic fluctuation of platelet counts which spontaneously changed from
      the nadir levels of 12-27 x 10(3)/microliters to the peak levels of 150-400 x
      10(3)/microliters. The platelet count reached a nadir at the onset of
      menstruation. Platelet-associated IgG (PAIgG) was within normal level when
      platelet count was at an increasing phase. Survival time of autologous platelets
      was normal when platelet count was at an increasing phase. Megakaryocytes in the
      bone marrow were apparently normal at the nadir phase. The patient's serum
      obtained at the nadir of platelet count significantly suppressed megakaryocyte
      colony forming unit (Meg-CFU) formation in comparison with that after the
      stabilization of platelet count, suggesting that this cyclic thrombocytopenia was
      secondary to cyclic hypoproduction of megakaryocytes caused by a suppressive
      factor. On the other hand muscle weakness showed no cyclic fluctuation.
      Administration of 60 mg/day prednisolone stabilized the platelet count at about
      280 x 10(3)/microliters, abolished hypermenorrhea and gradually improved muscle
      weakness. These findings suggested autoimmune mechanism in the production of a
      Meg-CFU-suppressive factor might be involved in the pathogenesis of
      thrombocytopenia.

PMID- 1628458
TI  - [HTLV-I associated myelopathy with bilateral abductor vocal cord paralysis--case
      report].
AB  - We have reported a 50-year-old woman with HTLV-I associated myelopathy (HAM) who
      had bilateral abductor vocal cord paralysis. The symptoms and signs were slowly
      progressive spastic paraplegia, dysuria, inspiratory stridor, and snoring during
      sleep. She had no hoarseness. Titers of anti-HTLV-I antibody were elevated in
      both the serum and cerebrospinal fluid. FEV1.0% on the spirogram was reduced to
      66%. The fiberscopic examination demonstrated the abductor limitation of the
      vocal cords during the inspiratory phase. During induced sleep after the
      intravenous administration of thiopental sodium, this abductor paralysis was
      worsened, producing a high pitched inspiratory stridor. The adduction was not
      disturbed at all. Needle electromyogram of the posterior crico-arytenoid muscle
      which is a sole abductor muscle revealed the high amplitude up to approximately
      1.0 mV (normal less than 0.8 mV) with poor interference pattern, indicating
      neurogenic changes. After 2 months course of prednisolone (60 mg/alternative
      day), FEV1.0% was recovered to be 92% with the improvement of the gait
      disturbance, which suggests the abductor vocal cord paralysis is related to HAM.
      The abductor vocal cord paralysis in HAM would require a careful follow-up
      observation to protect the respiratory failure in the advanced stage.

PMID- 1628459
TI  - [A case of benign intracranial hypertension with bilateral reversible thalamic
      lesions on magnetic resonance imaging].
AB  - A 10-year-old girl had complained of headache, vomiting and blurred vision for
      one month before admission to our hospital. Her neurological findings were
      normal, except that the examination of the fundi revealed papilledema. The
      cerebrospinal fluid pressure was elevated to 220 mmH2O. The brain MRI showed
      bilateral and approximately symmetrical hyperintense areas located in the
      thalamus. These disappeared on the repeated MRI, and her symptoms regressed
      spontaneously within a month. Her illness was diagnosed as benign intracranial
      hypertension because of the favorable clinical course. These reversible thalamic
      lesions might be due to circulatory insufficiency associated with intracranial
      hypertension.

PMID- 1628460
TI  - [A case of optic neuritis associated with anticardiolipin antibodies].
AB  - We reported a case of optic neuritis with the persistence of severe visual loss
      and central scotoma in a 26-year-old woman who was proven to have biologic false
      positive test for syphilis, and the elevated serum titres of IgG and IgM
      anticardiolipin antibodies. C.S.F. findings showed the absence of oligoclonal
      bands and the presence of IgM anticardiolipin antibody. She was treated twice at
      intervals of two weeks with methylprednisolone 1000 mg intravenously daily for
      three days (pulse therapy), and was started on oral prednisolone 60 mg daily
      which tapered gradually. After the second treatment of the pulse therapy, her
      visual acuity was improved remarkably and the titre of anticardiolipin antibodies
      became normal. Her clinical course seemed to be different from that of the optic
      neuritis of multiple sclerosis, in which many of patients recover near normal
      visual acuity after a first attack. We suggested that antiphospholipid antibodies
      might play a role in the etiology of her optic neuritis.

PMID- 1628461
TI  - [Intramuscular degeneration process in Duchenne muscular dystrophy--investigation
      by longitudinal MR imaging of the skeletal muscles].
AB  - Intramuscular degeneration process of Duchenne dystrophy skeletal muscles was
      investigated by longitudinal skeletal muscle imaging with high-field-strength NMR
      CT of 1.5 Tesla. Thigh muscles in 10 cases ranging in age from 4 to 19 years were
      examined by T1-weighed longitudinal images (TR = 215-505 ms, TE = 19-20 ms).
      Following results were obtained: (1) Skeletal muscle degeneration was depicted as
      high signal intensity area reflecting its high fat contents. (2) These high
      signal intensity areas had a longitudinally streaky appearance in parallel
      direction with myofibers. (3) These findings were more prominent toward myotendon
      junction than muscle bellies. (4) Skeletal muscle degeneration progressed rapidly
      between 7 to 10 years of age, and reached a plateau after that.

PMID- 1628462
TI  - [DNA diagnosis of X-linked recessive bulbospinal muscular atrophy by androgen
      receptor gene mutations].
AB  - X-linked recessive bulbospinal muscular atrophy (BSMA) is an adult-onset form of
      motor neuron disease, of which androgen receptor (AR) gene mutations with
      increased size of a polymorphic tandem CAG repeat in the coding region was found
      by Fischbeck et al (1991). We investigated this AR gene abnormality by polymerase
      chain reaction (PCR) in 16 unrelated Japanese BSMA pedigrees, including 21
      patients, 11 male siblings without any neurological signs and 9 female siblings.
      PCR products for AR-CAG repeat obtained from 21 affected individuals were
      enlarged in fragment size (about 100 bp longer than normal control size), whereas
      those from clinically unaffected brothers of the patients and their offsprings
      were all normal in size. Moreover, PCR products from 8 obligate heterozygous
      females (carriers) consisted of two different fragments with enlarged and normal
      size. Our results confirmed the findings reported by Fischbeck et al, and
      indicated that the detection of this AR gene mutations with increased size of a
      polymorphic tandem CAG repeat is beneficial for pre-onset diagnosis or carrier
      detection of this disease.

PMID- 1628463
TI  - Postcircumcision urinary tract infection.
AB  - The possible association of urinary tract infection (UTI) with ritual
      circumcision on the eighth day of life was studied by analyzing the epidemiology
      of urinary tract infections during the first year of life in 169 children with
      UTI (56 males and 113 females) born in Israel from 1979 to 1984. Forty-eight
      percent of the episodes of UTI occurring in males appeared during the 12 days
      following circumcision, and the increased incidence during that period was highly
      significant. The median age of the males at the time of the UTI was 16 days,
      compared with seven months in females. Ritual Jewish circumcision as practiced in
      Israel may be a predisposing factor for UTI during the 12-day period following
      that procedure.

PMID- 1628464
TI  - The death of a child with diabetes from neglect. A case study.
AB  - This case report of a child with insulin-dependent diabetes mellitus (IDDM)
      describes a naturally occurring ABABCA design. The A condition represents poor
      diabetes management provided in the home setting, and the B and C conditions
      represent improved diabetes management in residential treatment (condition B) or
      foster care (condition C). The A condition was consistently associated with
      episodes of diabetic ketoacidosis, high glycosylated hemoglobin percentage, and
      school failure. In contrast, the B/C conditions were consistently associated with
      improved health status and school performance. On two occasions, the child was
      returned to condition A by the state's protective service agency (HRS) in direct
      conflict with the recommendations of the child's psychological and medical
      treatment staff. During her last condition A placement, the youngster died.
      Chronically ill children who are neglected may not receive the protection they
      need because of lack of awareness about the psychosomatic aspects of their
      problem.

PMID- 1628465
TI  - A treatment program for adolescents with phenylketonuria.
AB  - A treatment program for adolescents with phenylketonuria (PKU), incorporating
      education, goal-setting, self-monitoring, contracts, and rewards, was evaluated
      by measuring knowledge of PKU, blood phenylalanine concentrations, and health
      locus of control (LOC) before and after participation in the program. Of the 16
      subjects, seven subjects successfully completed the program by achieving
      behavioral goals. These subjects increased their knowledge of PKU and decreased
      their blood phenylalanine concentrations, but the nine nonsuccessful subjects did
      not. There was no significant change in LOC scores for either group. There was a
      significant relationship between baseline blood phenylalanine levels and success
      with the program. Therefore, this pilot study demonstrates that adolescents who
      have already achieved some measure of metabolic control can be expected to be
      most successful with this program and realize the greatest benefits from it in
      the form of increased knowledge of PKU and even better metabolic control.

PMID- 1628466
TI  - Growth and academic achievement in inner-city kindergarten children. The
      relationship of height, weight, cognitive ability, and neurodevelopmental level.
AB  - Measures of height, weight, nonverbal cognitive ability (Ravens progressive
      matrix), visual-motor-perceptual ability (Beery-Buktenica test of Visual Motor
      Integration [VMI]), the imitation-of-gestures technique, and academic achievement
      (Stanford Early Achievement) were obtained for a sample of 82 children from a
      poor inner-city community. In contrast to prior reports from the United States
      and about other developed countries, anthropometric measures were related both to
      academic achievement and to these measures of neurodevelopment. They were not
      consistently related to measures of nonverbal cognitive ability. Regression
      analyses revealed that general cognitive ability contributed more variance (39%)
      to predictions of achievement than all other variables, including weight for age
      (13%) and VMI (6%). Children with reduced somatic growth were likely to do poorly
      in school, but the data do not show that undernutrition causes learning failure.
      Rather, they suggest that environmental problems affecting the development of
      thought processes and nutrient intake precede both growth and learning failure.

PMID- 1628467
TI  - Fiberoptic vs conventional home phototherapy for neonatal hyperbilirubinemia.
AB  - Two methods of administering home phototherapy were compared. Twenty-two infants
      received home phototherapy with a fiberoptic cummerbund, and 26 infants received
      home phototherapy with a conventional four-bul "bililight." The two treatment
      modalities proved equally effective in lowering bilirubin levels. The duration of
      treatment was a mean of 3.09 days in the fiberoptic group and 2.77 days in the
      bililight group, and the daily decline in bilirubin levels was a mean of 1.84
      mg/dL/day in the fiberoptic group and 2.18 mg/dL/day in the bililight group.
      Differences were not statistically significant (Student's t-test, two-tailed).
      Upon completion of therapy, mothers responded to 15 statements intended to
      measure attitudes and perceptions regarding home phototherapy. In four of the 15
      statements there was a statistically significant preference for fiberoptic
      therapy, as measured with the chi-square statistic (p less than .05), while in
      the remaining statements there were no preferences expressed toward either
      treatment modality. Fiberoptic home phototherapy appears to be as effective as
      home phototherapy administered with conventional bililights and may be better
      accepted by parents.

PMID- 1628468
TI  - A new light on jaundice. A pilot study.

PMID- 1628469
TI  - Babies who don't cry.

PMID- 1628470
TI  - Lead ingestion in a pattern of repetitive injury.

PMID- 1628471
TI  - Unique congenital features in tuberous sclerosis.

PMID- 1628472
TI  - Perinatal loss. A critique of current hospital practices.
AB  - Dramatic improvements in the hospital management of perinatal loss have taken
      place in the past 20 years. However, there has been no critical examination of
      current approaches. Four possible hazards of current hospital practice are
      described: 1) Institutionalization of bereavement: Instead of offering parents an
      empathic awareness of the unique dimensions of their perinatal loss, caregivers
      often interact according to detailed behavioral protocols. 2) Idealization of
      contact with the dead baby: This approach may equate actual physical contact with
      the dead child with the more complicated and variable process of mourning. 3)
      Homogenization of grief: Counselors tend to denigrate different grief responses
      by focusing on a preconceived grief reaction. Thus, they may mistakenly label
      many such reactions pathologic if they deviate from the rigidly prescribed
      "norm." 4) Lecturing the bereaved: Telling parents the "right" thing to do may
      deprive them of a crucial aspect of the process that empowers parents after they
      experience the helplessness associated with perinatal loss--that of making their
      own decisions. These problems are illustrated by a clinical vignette, and
      alternative approaches are explored.

PMID- 1628473
TI  - Sexual abuse allegations in child custody cases: the role of the pediatrician.

PMID- 1628474
TI  - Acute acalculous cholecystitis complicating Mycoplasma pneumoniae infection.

PMID- 1628475
TI  - Case of primary erythromelalgia in a child.

PMID- 1628476
TI  - Enteroviral meningitis following Haemophilus influenzae type b meningitis.

PMID- 1628477
TI  - Temporary blindness due to sodium nitroprusside overdosage in a postoperative
      patient: an unusual adverse effect.

PMID- 1628478
TI  - Chronic fatigue syndrome.
AB  - Chronic Fatigue Syndrome appears to represent a spectrum of disorders in which a
      variety of pathophysiological mechanisms may operate. While the initiating event
      in the majority of patients is a pyrexial illness, possibly due to enterovirus
      infection, evidence of persisting infection or inflammatory changes in muscle
      and/or brain remain unconvincing. CFS patients display a definite reduced aerobic
      work capacity compared to normal control subjects, but this may reflect a state
      of deconditioning resulting from prolonged physical inactivity. They also have an
      altered perception of their level of exertion and premorbid fitness. The
      characteristic fluctuation in symptoms, with periods of relapses and partial
      remissions, may indicate that some central disorder of sensory perception is
      operational. It may be that a primary sleep disorder results in a reduced sensory
      threshold for afferent stimuli from muscle. This could well account for many of
      the subjective symptoms which patients experience. Much more research is clearly
      necessary if we are to achieve a better understanding of this distressing and at
      present enigmatic disorder.

PMID- 1628479
TI  - The role of electrodiagnostic studies in the diagnosis and management of
      polymyositis.
AB  - Polymyositis is an inflammatory muscle disease preferentially affecting proximal
      muscles. Diagnosis is suggested by an EMG study showing abnormal spontaneous
      activity in proximal muscles and the presence of myopathic motor unit changes.
      Alternative diagnoses are eliminated by nerve conduction and neuromuscular
      junction studies and the EMG. Diagnosis is confirmed by muscle biopsy. Treatment
      requires aggressive and long term immunosuppressive therapy. Expectations for
      improvement in strength are good, but complete remission or cure less
      predictable. Polymyositis may be associated with other systemic disorders such as
      collagen vascular diseases and cancer, and an appropriate evaluation should
      include these associations.

PMID- 1628480
TI  - Retinoids: uses and abuses.
AB  - There is no doubt that modern retinoids are a two-edged sword. While they appear
      to normalize many abnormal biologic processes, i.e. modulate cellular
      differentiation and cellular proliferation, at the same time they can severely
      "abnormalize" other processes, i.e. embryonic organogenesis. Pharmaceutical
      ingenuity in separating their toxicity from their efficacy will determine their
      ultimate value to the therapist.

PMID- 1628481
TI  - Priorities and diagnostic studies in the management of the injured patient.
AB  - The traumatized patient is best served by an orderly and sequential resuscitation
      and evaluation. Primary priorities include the establishment of a secure airway,
      adequate ventilation and hemodynamic status. These considerations should be
      followed by a brief history, systemic physical examination and radiographic
      studies. Studies utilized in blunt trauma include diagnostic peritoneal lavage
      and computed tomography. Nuclear magnetic resonance and ultrasound may prove
      useful in the future. In penetrating trauma, traversing missiles mandate surgical
      exploration. Stab wounds may be managed by several alternative methods. Emergency
      thoracotomy has a limited role in the blunt trauma patient but may be life saving
      in those suffering penetrating trauma.

PMID- 1628482
TI  - Current therapies using monoclonal antibodies: I. Organ transplantation,
      bacterial sepsis, bone marrow transplantation.

PMID- 1628483
TI  - Current therapies using monoclonal antibodies: II. Malignant disease.

PMID- 1628484
TI  - The basics of genetic disease.
AB  - Molecular genetics has opened new avenues for medical diagnosis, treatment and
      prevention of genetic diseases. Major ethical and legal issues regarding
      applications of this new technology have surfaced and are being discussed at a
      variety of levels. Policies for use of the new technology have been established,
      and the first use of gene replacement therapy is anticipated in the near future.

PMID- 1628485
TI  - Glycation alters collagen fibril organization.
AB  - Incubation of rat tail tendon in 0.2M ribose results in accelerated non-enzymatic
      glycosylation of collagen, with the formation of fluorescent cross-links between
      molecules and decreased solubility. Electron micrographs of tendon cross-sections
      show an increased fibril packing density with increasing degrees of glycation.
      After a one-week incubation in ribose, every fibril appears in close contact with
      all of its neighbors, and the packing density has increased to 76%, from a value
      of 62% in controls. Irregular diameters and fusion of fibrils also are seen. All
      of the fibrils in a bundle appear to become cross-linked together, creating a
      larger stress bearing unit. This model is consistent with stress-strain curves
      showing a large increase in tensile stress and stiffness after a one-week
      incubation period in ribose. The diameters of the collagen fibrils increase in
      size in glycated tendon. We hypothesize larger diameters result from an increased
      resistance to shrinkage during the specimen preparation process, as a result of
      the rigid sugar derived cross-links. Closer fibril packing, increased fibril
      diameters, and irregular diameters have been reported in diabetic tissues, and
      may result from decades of glycation induced cross-link accumulation.

PMID- 1628486
TI  - Effect of hyaluronate on physicochemical and biological properties of collagen
      solution which could be used as collagen filler.
AB  - The effect of hyaluronate (HA) on the physiochemical and biological properties of
      collagen solution was examined for two preparations of collagen with different
      rates of fibril formation. The addition of HA to the collagen preparation with
      the slower rate of fibril formation caused a prominent acceleration of fibril
      formation. A differential scanning calorimetric measurement of the collagen
      preparation demonstrated a stabilizing effect of HA on collagen solution after
      incubation at 37 degrees C. Histochemical examination of rat dermis after
      injection of the collagen solution into the tissue revealed the migration of
      fibroblast-like cells into the region occupied by the injected collagen. The
      addition of HA to collagen preparation S (slower rate of fibril formation)
      shortened the time-to-appearance of fibroblast-like cells to a similar value to
      that observed when collagen preparation F (faster rate of fibril formation) was
      used. The timing of cell appearance was in accord with the rate of fibril
      formation in vitro. Fibrils newly formed by injected collagen might provide sites
      for cell attachment, migration and proliferation.

PMID- 1628487
TI  - Effects of ascorbate-deficiency on collagen secretion and resorption in cultured
      mouse incisor germs.
AB  - The effects of ascorbic acid deficiency on mouse incisors, grown in vitro, has
      been investigated at the histological and cytological levels. In this model,
      continuously growing mouse incisors are characterized by the existence of
      different type of predentin-dentin matrix on its lingual (root-analogue) and
      labial (crown-analogue) surface and the absence of enamel on the lingual surface.
      Our observations indicated that ascorbate-deficiency affected the behavior of
      mouse tooth germs in vitro: odontoblast differentiation was disturbed and
      morphological evidence for odontoblast-mediated collagen resorption were
      observed. An abnormal amorphous predentin-dentin matrix existed and the basement
      membrane was prematurely disrupted. The dentin mineralization, as well as
      functional differentiation of ameloblasts were strongly hampered. Chronic
      deficiency led to disorganization of the dental tissues.

PMID- 1628488
TI  - Influence of interleukin-1 on the morphology and proteoglycan metabolism of
      cultured bovine articular chondrocytes.
AB  - Bovine articular chondrocytes cultured in agarose gel in the presence of serum
      elaborated a highly organized extracellular matrix rich in proteoglycans and
      collagens. The cultures were evaluated quantitatively by radiosulfate labeling of
      proteoglycans, and by densitometry following staining with alcian blue. In
      addition, immunohistochemical methods were used to demonstrate the presence of
      several components of cartilage proteoglycan molecules. Treatment with
      Interleukin-1 (Il-1) or retinol resulted in diminished synthesis and enhanced
      catabolism of matrix proteoglycans, but the chondrocytes were more sensitive to
      human recombinant Il-1 alpha than to Il-1 beta. Treatment with Il-1 alpha or
      retinol resulted in a profound disorganization of the residual matrix around the
      majority of the chondrocytes, while Il-1 beta caused much less severe changes.
      Some variation in cellular response to Il-1 alpha may result from the
      heterogeneity previously reported among articular chondrocytes.

PMID- 1628489
TI  - Hyaluronan can be non-enzymatically linked to protein through an alkali sensitive
      bond.
AB  - To test for the presence of hyaluronan to protein linkages, both purified and
      unpurified preparations of hyaluronan were blotted onto nitrocellulose, and the
      adsorbed hyaluronan was detected using a biotinylated probe derived from
      cartilage. While purified hyaluronan did not adsorb to nitrocellulose, the
      unpurified hyaluronan from rat fibrosarcoma (RFS) cells and chick embryos did.
      This adsorption appeared to require the presence of protein, since it was
      inhibited by treatment with proteases. Furthermore, when hyaluronan from RFS
      cells was subjected to conditions which break most non-covalent bonds, it
      retained its ability to adsorb to nitrocellulose, suggesting that this hyaluronan
      was covalently bound to protein which mediated its adsorption to nitrocellulose.
      While this bond was resistant to acidic buffers, it was readily broken by
      alkaline buffers. Additional experiments demonstrated that when either purified
      [3H] hyaluronan or oligosaccharide fragments of hyaluronan were incubated with a
      variety of proteins, they slowly gained the ability to adsorb to nitrocellulose.
      However, this process could be blocked by the addition of low molecular weight
      amines or by reducing the [3H] hyaluronan with NaBH4. These results are
      consistent with the possibility that the reducing terminal of the hyaluronan
      reacts with amine groups of protein to form a Schiff base which then rearranges
      to a stable bond. Such a bond could account for the association of hyaluronan
      with the surfaces of RFS cells.

PMID- 1628490
TI  - Response of plasma membrane to applied hydrostatic pressure in chondrocytes and
      fibroblasts.
AB  - Effects of applied hydrostatic pressure on transmembrane potentials were
      investigated in sheep articular chondrocytes and human skin fibroblasts in non
      confluent monolayer cultures. Resting potentials in chondrocytes (about -12 mv)
      and in fibroblasts (about -15 mV) were increased and decreased respectively by
      over 40% after pressure was applied cyclically (0.33 Hz, 120 mm Hg, 20 minutes).
      Continuous pressure (120 mm Hg, 20 minutes) caused deplorization in both cell
      types. Low frequency pressure application (less than 0.08 Hz) caused
      depolarization in chondrocytes and hyperpolarization in fibroblasts. Quinidine (2
      x 10(-5) M) blocked and verapamil (10(-5) M) reduced hyperpolarization responses,
      suggesting involvement of Ca(2+)-dependent K+ channels. A23187 (1.9 x 10(-6) M)
      caused hyperpolarization in chondrocytes, augmented further by subsequent
      pressure application (0.33 Hz). Tetrodotoxin (10(-6) M) blocked depolarization
      responses indicating that these were due to Na+ influx. Blockade of histamine H1
      receptors by chlorpheniramine maleate (5.1 x 10(-6) M), H2 receptors by
      cimetidine (7.9 x 10(-6) M) and beta-adrenoreceptors by sotolol (1.3 x 10(-4) M)
      had no effect on hydrostatic pressure-induced hyperpolarization in chondrocytes.
      Cytochalasin B (2 x 10(-5) M and at 4 x 10(-6) M) abolished pressure-induced
      hyperpolarization in chondrocytes; in contrast, applied cyclical hydrostatic
      pressure to cytochalasin-treated fibroblasts caused hyper-polarization,
      suggesting that cytoskeletal changes were involved.

PMID- 1628491
TI  - Characterization of a bovine synovial fluid lubricating factor. I. Chemical,
      surface activity and lubricating properties.
AB  - A lubricating glycoprotein (PSLF) with an apparent molecular weight of 280 kDa
      was purified from bovine synovial fluid by anion exchange, molecular sieve
      chromatography, and density gradient centrifugation. Lubrication was measured
      under boundary conditions as lowering of the coefficient of friction (mu) between
      oscillating natural latex and polished glass. Lubricating ability was first
      observed at a concentration of 200 micrograms/ml and became maximal at 260
      micrograms/ml. Hydrophobic interfacial tension measurements indicated that at the
      former concentration, monolayers of PSLF formed. Sugar digestions showed that
      lubricating ability depends upon the terminal galactose of the molecule. PSLF is
      similar if not identical to lubricin. It is proposed that a repulsive hydration
      force is the molecular mechanism for lubricating activity.

PMID- 1628492
TI  - Characterization of a bovine synovial fluid lubricating factor. II. Comparison
      with purified ocular and salivary mucin.
AB  - Boundary lubricating activity and biochemical characteristics of purified
      lubricating factor from bovine synovial fluid (PSLF) were compared to those of
      mucinous glycoprotein from human submandibular saliva and stimulated tears.
      Mammalian synovial fluid and saliva contain mucinous glycoproteins which reduce
      the coefficient of friction (mu) in a bearing of latex:glass which isolates
      boundary lubrication. In contrast, mucin secreted by the lacrimal gland did not
      lubricate. Cleveland plotting showed that these species are not identical.

PMID- 1628493
TI  - Growth of mineral crystals in turkey tendon collagen fibers.
AB  - Bone and several other vertebrate mineralized tissues are formed by the organized
      growth of crystals of carbonated apatite within a matrix of type 1 collagen
      fibers. The development of this process in isolated fibrils of young turkey leg
      tendons has been studied by transmission electron microscopy. Collagen banding,
      presumably due to ion concentration, precedes the appearance of any crystals. The
      smallest crystals observed are short needles in bands near the surface of the
      fibrils. Longer needles, up to the length of the collagen gap regions, were also
      seen, and, evidently at a later stage, single crystal belts extending partly or
      wholly through the fibrils. Finally, in mature tendon crystal platelets,
      seemingly derived from the cracking of belts, extend partly into the collagen
      overlap zone. In the least mineralized tendon, extrafibrillar mineral-containing
      vesicles have occasionally been observed adjacent to regions of radiating needle
      crystal growth in the fibrils, and, more commonly, smaller particles adjacent to
      bands of very small needles.

PMID- 1628494
TI  - New developments in adolescent health care.

PMID- 1628495
TI  - Preventive cardiology for the pediatrician.

PMID- 1628496
TI  - Portal vein thrombosis: imaging features and associated etiologies.
AB  - Thrombosis of the portal vein and its splanchnic tributaries is often unsuspected
      clinically and may be recognized only after imaging studies of the abdomen are
      performed for other reasons. Radiologists should be aware of the clinical
      situations that predispose a patient to portal or mesenteric vein thrombosis and
      should also be able to recognize the sequelae of chronic thrombosis. Different
      modalities can be used to image the patient with portal vein thrombosis; each has
      its strengths and drawbacks. This paper discusses the conditions that predispose
      to portal and mesenteric vein thrombosis, differentiating intrahepatic portal
      vein occlusion secondary to liver disease from extrahepatic portal vein occlusion
      associated with a normal liver. The imaging features of portal vein thrombosis,
      its associated causes and sequelae will be reviewed as demonstrated on computed
      tomography (CT), ultrasound, magnetic resonance imaging (MRI), angiography, and
      plain film.

PMID- 1628497
TI  - Clostridium botulinum C3 ADP-ribosyltransferase.
AB  - C3 and C3-like ADP-ribosyltransferases modify the low-molecular-mass GTP-binding
      proteins Rho and Rac. ADP-ribosylation occurs in asparagine-41, which is located
      in the putative effector region of these highly conserved regulatory proteins.
      First studies indicate that the Rho proteins are somehow involved in the
      regulation of cytoskeletal proteins, e.g., microfilament proteins. Although the
      precise mechanism of the interaction of the C3 substrate with cytoskeletal
      elements is unclear, it appears that the ADP-ribosylation by C3 renders the GTP
      binding protein biologically inactive. Thus C3 and/or C3-like ADP
      ribosyltransferases may be useful instruments with which to study the
      physiological functions of its eukaryotic substrates. Moreover, those studies may
      help to elucidate whether these exoenzymes are of pathophysiological and
      pathogenetic relevance in diseases caused by clostridia producing these agents.

PMID- 1628499
TI  - ADP-ribosylation of signal-transducing guanine nucleotide-binding proteins by
      pertussis toxin.

PMID- 1628498
TI  - Diphtheria toxin and Pseudomonas aeruginosa exotoxin A: active-site structure and
      enzymic mechanism.

PMID- 1628502
TI  - A dermatologic diary. Portrait of a practice.

PMID- 1628501
TI  - 18th World Congress of Dermatology.

PMID- 1628500
TI  - Clostridial actin-ADP-ribosylating toxins.

PMID- 1628503
TI  - Suction purpura: Part I. "Sucker daddy" or "cyclops" purpura.

PMID- 1628504
TI  - Natural history and treatment of scalp psoriasis.
AB  - The scalp is a common site of involvement at onset and throughout the course of
      psoriasis. Worldwide census studies report that approximately half of the
      psoriasis population are afflicted with psoriasis of the scalp. We describe the
      frequency, clinical aspects, and treatment of scalp psoriasis in childhood,
      adulthood, and in the geriatric age groups. Measures of prevention and control
      are reviewed.

PMID- 1628505
TI  - Solar exposure in children.

PMID- 1628506
TI  - Isolated cases of palmoplantar keratoderma, Unna-Thost type.
AB  - A study on the prevalence of hereditary palmoplantar keratoderma, Unna-Thost
      type, was carried out in Croatia. Altogether 205 cases were verified, and of
      these forty-eight were chosen for further studies. Six isolated cases of
      hereditary palmoplantar keratoderma, Unna-Thost type, were found. The following
      theories were considered to explain such a phenomenon: spontaneous mutation,
      reduced gene expression, incomplete penetration of the gene, late onset of the
      disease, unknown biological father of the proband, and involvement of genes in
      addition to the autosomal dominant one.

PMID- 1628507
TI  - Contributions to the treatment of dermatologic manifestations of Lyme
      borreliosis.
AB  - Lyme borreliosis was identified in Czechoslovakia for the first time in 1985.
      Since then, more cases have gradually been identified. Since 1989, about 1,500
      patients per ten million inhabitants have been reported every year. Having
      summarized the results of the therapy of 371 patients with dermatologic
      manifestations of lyme borreliosis (erythema migrans in 315, borrelial
      lymphocytoma in fifteen, and acrodermatitis chronica atrophicans in forty-one) we
      present the antibiotic regimens used by Czechoslovak dermatologists in clinical
      practice.

PMID- 1628508
TI  - Acanthoma supratrochantericum.
AB  - We report the cases of five patients with lesions of benign reactive hyperplasia
      of the skin in the hip joint region. In view of the distinct clinical features,
      and in analogy with previously reported cases of acanthoma fissuratum, we termed
      this condition acanthoma supratrochantericum.

PMID- 1628509
TI  - Actinic granuloma in alcoholic liver disease.
AB  - Actinic granuloma is a rare condition. Its acceptance as a defined disease has
      been queried several times. The authors observed a classic case in a patient with
      alcoholic cirrhosis of the liver and diabetes. The possible role of metabolic
      disturbances in the pathogenesis of this syndrome is reviewed.

PMID- 1628510
TI  - Therapeutic options for erythroderma.
AB  - In this work we will discuss some of the dilemmas and therapeutic options in the
      treatment of patients with erythroderma. We will mention treatment modalities for
      psoriatic erythroderma and review briefly one illustrative case in which a new
      experimental approach was utilized.

PMID- 1628511
TI  - Multiple carcinoma in patients with psoriasis caused by psoralen-ultraviolet A
      therapy, natural killer cell insufficiency, or intensified sun exposure?
AB  - A case is presented of a patient with psoriasis in whom squamous cell carcinoma
      most likely occurred due to the interaction of various factors (psoralen
      ultraviolet A therapy, sun exposure, and suppression of natural killer cell
      function). Therapy consisted of 1 mg/kg/daily of etretinate (Tegison), which
      resulted in clearing of psoriatic lesions in one month's time. New carcinomas did
      not develop and natural killer function improved.

PMID- 1628512
TI  - Autosomal recessive ectodermal dysplasia.
AB  - Seven cases of a peculiar autosomal recessive ectodermal dysplasia as a distinct
      nosologic entity are presented. The main symptoms of this rare, not fully
      delineated syndrome, are hypohidrosis, xeroderma, hypotrichosis, dystrophy of the
      teeth, benign acanthosis nigricans, and furrowed tongue. Other symptoms can
      include mental retardation, nail dystrophy, disturbances of skin pigmentation
      (perioral and periorbital hyperpigmentation, vitiligo, and perinevic leukoderma),
      and palmoplantar keratosis.

PMID- 1628513
TI  - Subcutaneous symmetrical morphea with unusual onset as nodular vasculitis.
AB  - We present a case of widespread subcutaneous symmetrical morphea that started as
      nodular vasculitis. The characteristics histologic features were abundant
      inflammatory infiltrates in the subcutis, fascia, and muscle, with numerous
      macrophages and extensive vascular changes.

PMID- 1628514
TI  - Two cases of unilateral verrucous nevus.
AB  - We report two patients with epidermal nevus: one with linear verrucous nevus and
      one with inflammatory linear verrucous epidermal nevus. The patients first showed
      manifestations of nevus at different ages (soon after birth and at the age of
      seven), and the findings progressed differently. In both cases, warty plaques
      were located unilaterally, strictly following Blaschko's lines.

PMID- 1628516
TI  - Gynecological tumors. Recent progress in diagnostic pathology.

PMID- 1628515
TI  - Sweet's syndrome in patients with kidney and liver disorders.
AB  - Two patients with Sweet's syndrome are described. In the first patient the
      disorder was associated with urinary stone disease and in the second with chronic
      hepatitis. We compared skin lesions in patients with kidney and liver diseases
      with those in Sweet's syndrome. In both patients all skin manifestations
      disappeared when the underlying disorders were treated. No corticosteroids were
      used.

PMID- 1628517
TI  - Flow cytometry of ovarian neoplasms.

PMID- 1628518
TI  - Oncogenes in gynecological tumors.
AB  - Evidence is increasing that proto-oncogenes and cancer suppressor genes are
      involved in the development and/or progression of gynecological malignancies.
      While histopathologic examination remains an indispensable tool of the surgical
      pathologist in the diagnosis and evaluation of patients with gynecological
      malignancies, the advancement to technology and the development of new knowledge
      regarding neoplastic transformation are providing a basis for new opportunities
      to improve patients care. These new opportunities will depend on the use of the
      skills and reagents developed in the basic medical science laboratories. Thus, it
      is important for those in the field of diagnostic pathology to begin to acquire a
      knowledge of proto-oncogenes and cancer suppressor genes as well as a basic
      understanding of the techniques used to detect and evaluate them.

PMID- 1628519
TI  - Cervical intraepithelial neoplasia and microinvasive carcinoma of the cervix.

PMID- 1628520
TI  - Circannual prolactin rhythm in intact dogs housed outdoors.
AB  - Prolactin (PRL) and progesterone (P4) values were collected from eight intact (4
      female, 4 male) mixed-breed dogs housed outdoors for a two-year span. A
      circannual component was significant for PRL for each dog (P less than 0.01) and
      the rhythm was validated for the population (P less than 0.004). Females had two
      estrus periods a year demonstrated by a P4 frequency of 23.5 +/- 0.47 wk. A 6
      month component was statistically significant for P4 for three dogs and of
      borderline statistical significance for the fourth dog. Circannual acrophases
      yielded a statistically significant population rhythm (P = 0.012), whereas the 6
      month component was of borderline statistical significance (P = 0.056). No time
      macroscopic relationship between PRL cycles and P4 cycles was seen. These
      findings are consistent with similar PRL rhythms in non-domestic canids and
      emphasize the importance of considering seasonal effects when interpreting PRL
      data.

PMID- 1628521
TI  - Usefulness of circadian amplitude of blood pressure in predicting hypertensive
      cardiac involvement.
AB  - Twenty-four-hour blood pressure (BP) profiles of 56 patients diagnosed as
      'hypertensive' by WHO criteria were analyzed by the fit of a 24-hour cosine curve
      according to the single cosinor method. A left ventricular mass index (LVMI) was
      also assessed by two-dimensional echocardiography on each patient as a gauge of
      target organ involvement. LVMI and the BP MESOR correlates positively for
      systolic, S (r = 0.324), mean arterial, MA (r = 0.334) and diastolic, D (r =
      0.267) BP (P less than 0.05), yet no statistically significant linear correlation
      between LVMI and the circadian BP amplitude (one-half of predictable change) was
      found. When a second-degree polynomial regression was fitted to the circadian BP
      amplitudes, an association was found (SBP: R2 = 0.138, P = 0.02; MAP: R2 = 0.167,
      P = 0.01; DBP: R2 = 0.128, P less than 0.01). The corresponding curves were
      characterized by peaks in the circadian amplitudes of SBP, MAP and DBP around a
      value of LVMI between 110 and 120 g/m2. For further scrutiny, three subgroups had
      been formed on the basis of literature, a priori with respect to the LVMI (group
      1: LVMI less than 100); group 2: 100 less than LVMI less than 130; group 3: 130
      less than LVMI). For MESORs, there was no difference between groups 1 and 2,
      whereas the MESOR of group 3 were larger than the other two groups. The circadian
      BP amplitudes of group 2 were larger than those of the other two groups for SBP,
      MAP and DBP. An increasing LVMI precedes a definitive increase of BP MESOR and
      coincides with an increase in the circadian BP amplitude; thus an increase in
      extent of circadian changes can alert the self-monitoring population of a target
      organ involvement.

PMID- 1628522
TI  - Circannual changes in ventricular function assessed by echocardiography.
AB  - Cardiac function may vary predictably along the 1-year scale. A circannual
      rhythm, more or less in phase is documented for 5 echocardiographic variables in
      clinically healthy Japanese adults.

PMID- 1628523
TI  - Gradual adjustment of circaseptan-circadian blood pressure and heart rate rhythms
      after a trans-9-meridian flight.
AB  - Circadian and circaseptan adjustment of blood pressure and heart rate after a
      transmeridian flight by a family of four was relatively fast, but it was not
      abrupt; it was not completed during the first week in the new setting. Gradual
      changes continued for the ensuing three weeks. The circadian and circaseptan
      rhythm characteristics and their adjustment in particular differed among
      variables in the husband: the circadian component of heart rate adjusted more
      rapidly than that of blood pressure. The adjustment also differed among two
      members of the family. A new phenomenon, namely a difference in circadian rhythm
      adjustment between husband and wife, is also described herein: the wife's
      circadian rhythm in blood pressure advanced by 9 hours within the 4-week span of
      recording following a 9-hour advance in living routine (after a 9-zone
      transmeridian flight); since both schedule and rhythm moved in the same direction
      (albeit not at the same rate), the behavior may be dubbed concursive. By
      contrast, the husband delayed to achieve the same adjustment: his behavior was
      anticursive. The phenomenon of a difference in direction of adjustment for
      different variables in the same subject has been described earlier as polarity,
      now qualified as intra-individual polarity, to separate it from the precedent of
      an intrafamilial or more broadly inter-individual polarity or partitioning,
      reported apparently for the first time and dubbed 'cursion'.

PMID- 1628524
TI  - Circannual modulation of blood pressure enhanced by paternal history of high
      blood pressure.

PMID- 1628525
TI  - Similarity of the nocturnal profile of serum melatonin at early puberty and early
      adulthood.
AB  - In the present study we determined the nocturnal profile of serum melatonin (MT)
      concentrations in 10 short normal children at Tanner stage I-II of pubertal
      development (12.5-14.9 yrs) and in 6 young adults (24-29 yrs). Blood was
      collected every 30 min from 00(00) to 06(00). We did not find any significant
      difference in the nocturnal profile of serum MT, as gauged by the comparison of
      MT concentrations at any time-point tested as well as of the transverse means
      (84.2 +/- 36.0 pg/ml [M +/- SD] in the children vs 78.7 +/- 10.8 pg/ml in the
      adults). Mean serum melatonin concentration was not correlated to sex hormone
      concentration or body surface area. Our findings do not support the view that MT
      concentrations fall at the beginning of pubertal development and that changes in
      body size may be the reason for age-dependent changes of serum MT concentrations.

PMID- 1628526
TI  - Dynamics of nonprotein and protein sulfhydryl compounds in rat gastric mucosa:
      possible implication for cytoprotection and ulcerogenesis.
AB  - The hypothesis that nonprotein and protein sulfhydryls in gastric mucosa may play
      some role in the defensive and offensive processes of gastric epithelium was
      tested in this study in the intact rat gastric mucosa. Both sulfhydryl compounds
      presented statistically significant changes during the 24-hour day. The content
      of nonprotein sulfhydryls was less during the dark span than during the light
      span, while the circadian acrophase of protein sulfhydryls occurred during dark
      span. These results may offer a new interpretation of the greater vulnerability
      to ulcerogenic agents of the gastric mucosa of rats during their usual activity
      span.

PMID- 1628528
TI  - Negotiating independent practice in diabetes education.

PMID- 1628527
TI  - Morningness-eveningness preference and sleep habits in Japanese office workers of
      different ages.
AB  - The Japanese version of the morningness-eveningness questionnaire and life habits
      inventory were administered to approximately 400 workers and the changes in
      morningness-eveningness scores and sleep-wake habits with aging were
      investigated. All subjects were divided into four age groups, i.e., 20's, 30's,
      40's, and 50 + 60's. Morningness-eveningness scores significantly shifted to
      morningness preference with increased age. The results of sleep-wake habits
      showed that 1) there were no age-related changes for habitual sleep parameters
      (bedtime, arising time, and sleep length), but preferential bed and arising times
      significantly advanced with aging, 2) the variability of habitual sleep
      parameters were greater in the young than in the old, especially, on the weekend,
      and 3) the older the age groups were, the better the mood on arising. These
      findings suggested that the circadian phase was advanced and/or the period was
      shortened with increased age.

PMID- 1628529
TI  - Alternative staffing strategies for community hospital-based diabetes education
      programs.
AB  - A diabetes education program can be a valuable asset to any hospital. The purpose
      of this paper was to describe one method of implementing a diabetes education
      program using minimal human and financial resources. By minimizing paperwork and
      maximizing potential in staff members who were functioning in various roles, this
      program was able to provide quality diabetes education to a population in need.
      Once the benefits of a diabetes education program are established, a plan for
      expansion should be developed to assure its long-range growth and success.

PMID- 1628530
TI  - Parents of children with diabetes: what are they worried about?
AB  - Parental worries, specific to having a child with diabetes, have been associated
      with poor diabetes control. This study addressed three questions relating to this
      issue: Does parental worry affect the metabolic control of the child with IDDM?
      What specific aspects of diabetes are the most worrisome to parents? Do these
      concerns change with the child's age and disease duration? Parents of 93 children
      with IDDM were given a modified version of the Diabetes Quality of Life measure
      to evaluate diabetes-specific worries. No correlation was found between parental
      worry and the child's metabolic control. Parents of younger children expressed
      the largest amount of worry, yet the kinds of things that parents were most
      concerned about were the same, regardless of age or duration of the child's
      disease.

PMID- 1628531
TI  - Effects of a social support group, as an adjunct to diabetes training, on
      metabolic control and psychosocial outcomes.
AB  - The purpose of this present study was to evaluate a social support group as an
      adjunct to an intensive outpatient diabetes training program. Insulin-treated and
      non-insulin-treated patients (n = 204) were randomized into two groups: the
      control group received the training program only, whereas the experimental group
      was offered the same program plus eight support group meetings. At the 7-month
      follow-up, patients in both groups showed improved metabolic control, diabetes
      knowledge, frequency of practicing recommended diabetes management behaviors, and
      emotional adjustment. Although no additional improvement was seen in those
      outcome measures in patients who attended support group meetings, results of a
      subjective evaluation of the support group showed that patients experienced
      positive feelings in the groups that may contribute to patient health. A better
      understanding of the possible contribution of support groups to health is
      necessary before such groups are routinely recommended to patients.

PMID- 1628532
TI  - Implications of diabetes mellitus and periodontal disease.
AB  - The dental profession is acutely aware of oral health problems associated with
      diabetes mellitus and clinical manifestations indicative of occult forms of the
      disease. Periodontal disease is common in patients with diabetes, and its
      effective management in diabetic patients requires cooperation involving the
      patient, physician, diabetes educator, dentist, and other allied health care
      providers. While these patients categorically appear more prone to diseases
      affecting the supporting tissues of the teeth, preservation of functional dental
      integrity can be attained by effective control of contributing systemic and local
      factors. This paper will discuss periodontal disease, its relationship to
      diabetes, proposed mechanisms of interaction, and management of periodontal
      disease in the diabetic patient.

PMID- 1628533
TI  - Coping with a chronic disease.
AB  - Interviews were conducted with 55 experienced patients with insulin-dependent
      diabetes with the aim of identifying strategies for coping with diabetes. This
      study was based on a health-oriented approach known as Antonovsky's salutogenic
      model, which conceptualizes the person as being actively involved in maintaining
      biological, psychological, and social homeostasis. All patients had developed
      some strategy for maintaining biological balance. Twenty-two also had strategies
      for coping both psychologically and socially with the disease. The remaining 33
      patients had developed either a psychological or a social strategy in addition to
      their biological strategies. The results indicate that it is important for the
      patient's well-being and self-esteem to establish all three coping strategies-
      biological, psychological, and social. The diabetes care team could be a valuable
      resource for the patient in this respect.

PMID- 1628534
TI  - Diabetes health beliefs, self-care behaviors, and glycemic control among older
      adults with non-insulin-dependent diabetes mellitus.
AB  - This descriptive study examined the relationships between diabetes-specific
      health beliefs and adherence to the diabetes regimen and glycemic control in 102
      older subjects with non-insulin-dependent diabetes mellitus. Health beliefs and
      self-care behaviors were assessed by self-report questionnaires. Glycemic control
      was assessed by HbA1c values. Perceived barriers to treatment were related to
      adherence, while perceived severity of disease was related to glycemic control.
      No significant associations were found between other health belief model
      subscales and adherence or glycemic control. Subjects not on diabetes medication
      had better glycemic control than those on medication. Subjects with more recently
      diagnosed diabetes also had better glycemic control. Practice and research
      attention should include older diabetic persons' perceived barriers to performing
      diabetes-specific self-care behaviors and perceived severity of the disease to
      identify potential health beliefs that may need to be altered for improving
      glycemic control.

PMID- 1628535
TI  - Abstracts from the 19th American Association of Diabetes Educators (AADE) Annual
      Meeting.

PMID- 1628536
TI  - The role of leukocyte-generated reactive metabolites in the pathogenesis of
      idiosyncratic drug reactions.
AB  - Evidence strongly suggests that many adverse drug reactions, including
      idiosyncratic drug reactions, involve reactive metabolites. Furthermore, certain
      functional groups, which are readily oxidized to reactive metabolites, are
      associated with a high incidence of adverse reactions. Most drugs can probably
      form reactive metabolites, but a simple comparison of covalent binding in vitro
      is unlikely to provide an accurate indication of the relative risk of a drug
      causing an idiosyncratic reaction because it does not provide an indication of
      how efficiently the metabolite is detoxified in vivo. In addition, the incidence
      and nature of adverse reactions associated with a given drug is probably
      determined in large measure by the location of reactive metabolite formation, as
      well as the chemical reactivity of the reactive metabolite. Such factors will
      determine which macromolecules the metabolites will bind to, and it is known that
      covalent binding to some proteins, such as those in the leukocyte membrane, is
      much more likely to lead to an immune-mediated reaction or other type of
      toxicity. Some reactive metabolites, such as acyl glucuronides, circulate freely
      and could lead to adverse reactions in almost any organ; however, most reactive
      metabolites have a short biological half-life, and although small amounts may
      escape the organ where they are formed, these metabolites are unlikely to reach
      sufficient concentrations to cause toxicity in other organs. Many idiosyncratic
      drug reactions involve leukocytes, especially agranulocytosis and drug-induced
      lupus. We and others have demonstrated that drugs can be metabolized by activated
      neutrophils and monocytes to reactive metabolites. The major reaction appears to
      be reaction with leukocyte-generated hypochlorous acid. Hypochlorous acid is
      quite reactive, and therefore it is likely that many other drugs will be found
      that are metabolized by activated leukocytes. Some neutrophil precursors contain
      myeloperoxidase and the NADPH oxidase system, and it is likely that these cells
      can also oxidize drugs. Therefore, although there is no direct evidence, it is
      reasonable to speculate that reactive metabolites generated by activated
      leukocytes, or neutrophil precursors in the bone marrow, could be responsible for
      drug-induced agranulocytosis and aplastic anemia. This could involve direct
      toxicity or an immune-mediated reaction. These mechanisms are not mutually
      exclusive, and it may be that both mechanisms contribute to the toxicity, even in
      the same patient. In the case of drug-induced lupus, a prevalent hypothesis for
      lupus involves modification of class II MHC antigens.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1628537
TI  - Molecular aspects of paracetamol-induced hepatotoxicity and its mechanism-based
      prevention.

PMID- 1628538
TI  - Lead-induced cell proliferation and organ-specific tumorigenicity.
AB  - While lead acetate is a renal carcinogen in rodent studies, the mechanism by
      which it induces cancer has not been established. This report proposes that the
      enhanced susceptibility of renal tubular epithelial cells to lead-induced
      mitogenicity at the levels comparable to those administered in the cancer
      bioassay may contribute to the carcinogenic response seen in this target organ.
      Of relevance is that the nonresponsiveness of the liver to lead-induced
      carcinogenicity was associated with significantly less capacity (i.e., 675-fold)
      of lead to induce the mitogenic response in the rodent liver.

PMID- 1628540
TI  - Leishmaniasis: what is new in transmission?

PMID- 1628539
TI  - Choosing an oral 5-aminosalicylic acid preparation for ulcerative colitis.

PMID- 1628541
TI  - Evaluation of topical ketoconazole in cutaneous leishmaniasis.
AB  - The efficacy of topical ketoconazole in cutaneous leishmaniasis (CL) caused by L.
      major was assessed in an open trial. Ten patients with twenty two lesions of CL,
      confirmed by smear/or biopsy, were recruited into the study. Of the twenty two
      lesions treated, three increased in size and lesion characteristics worsened, ten
      showed no change but in nine there was some improvement in lesion
      characteristics. No lesion healed completely. No side effects were reported in
      nine. Topically applied ketoconazole is safe but does not significantly alter the
      course of CL. The differences in the results of systematically administered and
      topically applied ketoconazole may be due to differences in the pharmacokinetics
      of the drug when it is administered by different routes.

PMID- 1628542
TI  - The efficacy and tolerability of enalapril--hydrochlorothiazide combination as a
      first line therapy in black patients with mild to moderate arterial hypertension:
      a clinical study in Kenya.
AB  - The study aimed at evaluating tolerability and efficacy of the combination
      enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line
      therapy in black patients with mild to moderate primary hypertension. Fifty
      patients completed a twelve weeks of open clinical study preceded by two weeks of
      washout period. They were evaluated every four weeks and haematological,
      biochemical urine microscopy and electrocardiographic tests were undertaken
      before the start and after the completion of study. Pre-treatment values of mean
      systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm
      hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage
      was one tablet which was increased to two after eight weeks in case the DBP was
      not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the
      DBP was normalised at the end of the study period; three patients (6%) were
      resistant to treatment and another three (6%) exhibited labile response to the
      treatment. Clinical tolerance was considered to be very good with only five
      episodes of headache, backache and anxiety, probably not related to the test
      drug. Biological tolerance was excellent: there was no change in the haematologic
      parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean
      serum creatinine and of 4% in the mean serum uric acid and a 5% increase in
      plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628543
TI  - Breast cancer in Kenya: a histopathologic and epidemiologic study.
AB  - During 1981-1985, 417 cases of breast cancer were seen at the Department of Human
      Pathology, Kenyatta National Hospital, Nairobi, Kenya. During this period, 8041
      cases of cancer were reported. Cancer of the breast accounted for 5% of all
      malignancies in Kenya and only second in number to cancer of the cervix. The
      incidence rate in females was 1.08 per 100,000 person-years. The incidence was
      low because the rural Kenyans have difficult access to the oncology facilities in
      Nairobi. The age specific incidence rates decreased after menopause. This is also
      found in other African countries but is in contrast with North America and
      Europe, where there is a rise after menopause. Young age of the first pregnancy,
      many pregnancies and a low fat content of the diet may contribute to the low
      incidence in post menopausal women. The distribution of the histological types
      was the same in Kenya with predominance of premenopausal cases and in the western
      world with predominance of postmenopausal cases. Invasive ductal carcinoma was
      the most common cancer type. Poorly differentiated tumours were common. This is
      probably explained by the fact that most patients seek medical help at a late
      state with advanced cancer. Only two cases of non-invasive intraductal carcinoma
      were found and in cases where lymphnodes were removed 88% had metastases.

PMID- 1628544
TI  - ABH secretor status in saliva of Calabar Municipality residents.
AB  - One hundred and seventy six healthy residents of Calabar Municipality were
      investigated for the presence of salivary ABH substances. Saliva and blood
      samples collected were analysed by haemagglutination inhibition and standard tube
      ABO grouping methods respectively. 86.90% and 13.10% of the subjects were ABH
      secretors and non-secretors respectively. A significant correlation was
      established between the secretor status frequency and ABO blood group phenotypes
      (P less than 0.001). No correlation was established with age or sex. O blood
      group subjects had higher titre of H-substances than A and B subjects while AB
      subjects had the lowest. In AB subjects, the A titre was usually higher than that
      of B substances. The gene frequencies for Se and se were 0.6390 and 0.3610
      respectively while the phenotype prevalence rates for Se/se, Se se and se se were
      40.83%, 46.15% and 13.10% respectively. It is concluded that the prevalence rate
      of non-secretors which has been associated with the occurrence of duodenal ulcer
      is low in the locality.

PMID- 1628545
TI  - Visceral leishmaniasis and malaria prevalence in West Pokot District, Kenya.
AB  - The prevalence of visceral leishmaniasis and malaria in the human population of
      West Pokot district of Kenya was studied in 1986. A total of 2139 people was
      proportionately screened for the two diseases according to four age categories (0
      4, 5-14, 15-44 and greater than 45 years). Diagnostic methods included the enzyme
      linked immunosorbent assay (ELISA) and Leishmanin skin test for visceral
      leishmaniasis, and parasitological examination for malaria. The epidemiological
      value of the spleen rate was evaluated in relation to visceral leishmaniasis and
      malaria endemicity. A general decline of infection rates with altitude was
      observed for both diseases. Visceral leishmaniasis was less prevalent than
      malaria, with less than 2% active cases in any age group and had the same
      distribution in both sexes. Malaria infection rate was highest in the younger age
      groups, declining from 21.5% in the 0-4 year old age group to 5.5% in people more
      than 45 years old. Malaria affected significantly more males than females. The
      spleen rate was inappropriate for epidemiological survey of either malaria or
      visceral leishmaniasis due to an overlap in the distribution of the two diseases.

PMID- 1628546
TI  - Prevalence of juvenile periodontitis in national youth service trainees.
AB  - The prevalence of juvenile periodontitis was studied in a group of young adults
      aged 18 to 26 years from the National Youth Service. The study group consisted of
      a random sample of 350 trainees, 250 males and 100 females. The subjects were
      examined for plaque scores, gingivitis and pocket depths. Radiographs were used
      to show bone loss and confirm diagnosis of juvenile periodontitis. Only one
      subject was diagnosed as having juvenile periodontitis. This represents a
      prevalence of 0.28% which falls within the range of published prevalence of 0.1%
      to 3.4% among young adults.

PMID- 1628547
TI  - Prevalence and distribution of trachoma in the Luapula Valley, Zambia.
AB  - A cross-sectional population based study was done to provide information on the
      extent to which xerophthalmia and trachoma contribute to blindness in the valley
      population. A total of 4271 children aged under 6 years and 2503 individuals aged
      6 years and more were examined. The overall prevalence of trachoma for those
      under 6 years of age was 17.6%, the majority of which were graded as follicular
      trachomatous inflammation. The trend in age specific prevalence was highly
      significant (x2 = 160.6, p = 0.000). Prevalence by sex was also significantly
      different (z = 2.0, P less than 0.05). Among those aged greater or equal to 6
      years, 331 (13.2%) had trachoma. Complications of trachoma (trichiasis and
      opacities) were common in this age group compared to those under 6 years of age.
      There were no differences in prevalence by district either in children or adults.
      This survey provides some of the first reliable data on prevalence of trachoma in
      this population and that it is a significant public health problem in the valley.
      The magnitude of severe complications from trachoma is low in this community,
      this may mean that the trachoma seen is the non-blinding type. We conclude that
      trachoma is of public health importance in the valley but is not a major cause of
      blindness.

PMID- 1628548
TI  - Does the "Baby Cloche" heat shield keep low birth-weight infants warm?
AB  - To determine whether the "Baby Cloche" heat shield improves temperature control
      in low birth-weight infants we compared serial temperatures in 11 preterm infants
      nursed with or without the Cloche. Mean birth weights were 1490 and 1510 gm, mean
      weights at time of study 1680 and 1710 gm and mean postnatal age 20 and 27 days
      for study and control infants respectively. Serial measurements of rectal,
      abdominal skin, dorsum of the foot, Cloche wall and room temperature were
      recorded once or twice daily for 2 to 5 days. Mean rectal temperatures increased
      with increasing age from 35.3 in the first week of life to 37.0 degrees C by the
      third week (P less than 0.001). In infants nursed under the Cloche who were over
      2 weeks of age mean rectal, abdominal and foot temperatures were 0.5, 0.6 and 1.6
      degrees C higher (P less than 0.001); in younger infants there was no significant
      difference in any of the temperatures. Our findings suggest that the "Baby
      Cloche" improves temperature control in preterm infants over 1600 gm who are more
      than 2 weeks of age.

PMID- 1628549
TI  - Sheehan's syndrome in a developing country, Nigeria: a rare disease or problem of
      diagnosis?
AB  - Over a five year period, 11 cases of Sheehan's syndrome were seen in the
      Endocrinology Unit of a teaching hospital in Ibadan, Nigeria. The mean age at
      diagnosis was 35.1 years; the mean parity was four and the average interval
      between the obstetric injury and diagnosis was 6.9 years. Four patients were in
      middle socio-economic class and seven were in low socio-economic class. The most
      frequent presenting symptoms were failure of lactation (11 out of 11 patients)
      and amenorrhoea (9 out of 11 patients). Seven patients had multiple endocrine
      insufficiency involving essentially all pituitary cell types. Six out of 8
      patients were lost to follow-up. In a review of autopsy records over a 5-year
      period at the same institution, out of 1,951 post-mortem examinations, no
      additional cases of Sheehan's were found. With an average of about two clinical
      cases per year, it would seem that Sheehan's syndrome is still a relatively rare
      entity in this part of the world in spite of the poor level of obstetric care
      generally available. There is a need for increased awareness about this disease
      on the part of practitioners in developing countries in order to establish
      whether this rarity is real or it is due to missed diagnosis.

PMID- 1628551
TI  - Coping with embedded mandibular wisdom teeth in developing countries.
AB  - Despite low incidence of embedded mandibular wisdom teeth (third molars) among
      dental patients in developing countries (less than 100/1,000), the unfavourable
      patients:dentist ratios, the limited resources and low levels of public awareness
      render them an important problem to operators in these countries. Since the
      effectiveness with which they are removed largely depends on the age with respect
      to the stage of root formation, bone resilience and relationship with adjacent
      anatomical structures, and the dexterity of the operator, whenever possible,
      early removal is recommended. To minimise occurrence of non-operative
      complications that are costly to manage, primary health care workers have a vital
      role to play in raising levels of awareness and early referral for further
      evaluation. In view of the risks involved in the removal of these teeth and the
      small number of trained oral surgeons, continuing education to the dental
      practitioners, could improve their efficiency in the management of this
      condition.

PMID- 1628550
TI  - Grinding machine injury of the hand: a preliminary report.
AB  - Case notes of 20 patients who presented with grinding machine injury to the hand
      from April 1984 to March 1990 were analysed for pattern of injury, method of
      management and outcome of treatment. Thirteen cases were seen in the last three
      years of this period (the SAP era) compared to seven cases in first three years
      of the period (the pre-SAP era). Children from low socio-economic class were the
      commonest victims. The right hand was commonly involved alone. Most injuries were
      multiple but the skin of the dorsum of the hand and ring finger were most
      commonly injured. Associated fractures of the metacarpals, carpals, joint
      dislocations in the hand and injuries to other parts of the body were uncommon.
      Thorough washing of the wound with soap and water, careful, limited initial
      debridement, elevation of the hand, antibiotics, antitetanus prophylaxis and
      early intensive hand physiotherapy yielded good to excellent results in seventeen
      patients. Eventhough the viability of the crushed skin on the dorsum of the hand
      may be questionable at initial presentation most of it will 'take' and we
      advocate that as much of this skin as is possible should be spared.

PMID- 1628552
TI  - Chloroquine related complete heart block with blindness: case report.
AB  - A 27-year old African woman with history of regular chloroquine ingestion
      presented with progressive deterioration of vision, easy fatiguability, dyspnoea,
      dizziness progressing to syncopal attacks. Ophthalmological assessment revealed
      features of chloroquine retinopathy, cardiac assessment revealed features of
      heart failure and a complete heart block with right bundle branch block pattern.
      The heart block was treated by pacemaker insertion and the heart failure resolved
      spontaneously following chloroquine discontinuation. She however remains blind.

PMID- 1628553
TI  - Studies on the epidemiology of leishmaniasis in Kenya: flight range of
      phlebotomine sandflies in Marigat, Baringo District.
AB  - A study on the flight range of phlebotomine sandflies using the mark-release
      recapture technique was undertaken in Marigat, Baringo District, Kenya, to
      determine the distance sandflies are able to travel and assess their importance
      in disease transmission. Over a period of 17 months, a total of 108,429 sandflies
      collected from their natural habitats were marked and released from a central
      point in a valley. Of these, 842 (0.8%) sandflies comprising 11 species were
      recaptured. Ninety-five percent of the recaptured sandflies were recovered within
      a radius of 50 m from the release point and 54% within a radius of 10 m. Two
      Sergentomyia ingrami females were recaptured at a distance of 1000 m from the
      release point.

PMID- 1628554
TI  - Quality in emergency medicine.

PMID- 1628555
TI  - From quality assurance to quality improvement. The Joint Commission on
      Accreditation of Healthcare Organizations and Emergency Care.
AB  - The transition from quality assurance to quality improvement is at an early
      stage, but it clearly has begun. The progressive anticipated changes in the tone
      and content of JCAHO standards will place the JCAHO in a different posture in
      relation to accredited hospitals. Standards are of course a set of requirements
      that must be met as a condition of accreditation. But the JCAHO's bottom line
      expectation will be a meaningful and demonstrated improvement in hospital
      performance. How hospitals reach this objective is their business. This shifts
      the onus of responsibility to where it belongs and suggests a more facilitative
      role for the JCAHO. Although the JCAHO is introducing standards requirements that
      are minimally essential to the achievement of improved performance, full-fledged
      adoption of CQI concepts will not be mandated. Management structures and styles
      in health care organizations vary considerably, and CQI is but one means to the
      desired end of improved performance. We believe, however, that it is the best
      means and that most organizations will discover this for themselves.
      Notwithstanding the magnitude of needed internal behavioral change, excellence in
      performance is what most health care organizations want for themselves and their
      patients. CQI offers them the opportunity to reach this lofty goal.

PMID- 1628556
TI  - Public policy and quality assurance.
AB  - The definition of quality varies widely among different key players in the
      American health care system. It is important for physicians and other providers
      to have an understanding of the public policy approach to quality assessment and
      assurance. Policy analysts use a number of techniques and methods in an attempt
      to define and balance the interests of individual patients with that of society
      as a whole. Benefit-cost, cost-effectiveness, and evaluation synthesis methods
      are used by public policy makers to arrive at rational consideration of the
      implications of allocation of scarce health care resources. Emergency medicine is
      on the forefront of many key policy decisions relative to the health care system.
      As the nation's health safety net, emergency medicine plays an integral and
      pivotal role in the definition, structure, and function of the health care
      system. In this regard, it is essential that emergency physicians and emergency
      medicine organizations play an active and formative role in the rapidly changing
      health care environment. Understanding conceptual approaches to the public policy
      approach to the health care system is an important endeavor for leadership in
      emergency medicine.

PMID- 1628557
TI  - Clinical standards.
AB  - The primary motivating force for standards development by emergency physicians
      has been the desire to establish an acceptable level of care within the
      specialty, followed by the growing emphasis on quality assessment and quality
      improvement, the measurement of which requires an existing standard of care. This
      article examines the process of developing clinical standards and the implication
      such standards will have on the practice of emergency medicine. The ACEP clinical
      policy for the management of chest pain is presented in depth.

PMID- 1628558
TI  - Industrial models of continuous quality improvement. Implications for emergency
      medicine.
AB  - CQI or TQM programs were developed from industrial models dating back to the
      1930s. The original philosophic underpinnings guiding CQI included SPC, in which
      rigorous statistical methods were used to study industrial flow processes. As
      originally adopted by the Japanese, CQI is credited, to a significant degree,
      with the emergence of the Japanese economy as a major world leader. Nonetheless,
      the original CQI concepts were developed and implemented by American researchers,
      including Deming and Juran. The application of industrial models of quality
      improvement to service businesses in general and the health care industry in
      particular have met with substantial success in a number of different settings.
      Far from representing a management fad, CQI represents a solid management
      philosophy with a strong statistical background that stands in sharp contrast to
      traditional management in this country. CQI recognizes that the majority of
      defects result from a failure of the processes through which the product or
      service is generated, as opposed to the workers themselves. To a significant
      degree, CQI empowers service providers (through the strong commitment of top
      management) to participate in improving the processes through which products and
      services are delivered. As efforts unfold to contain health care costs and
      maintain quality in the face of declining resources, CQI programs are likely to
      be essential to success. Nonetheless, adopting CQI requires a significant
      commitment on the part of top management to the training and retraining of health
      care providers and the recognition that traditional management philosophies and
      techniques have largely failed to produce the quantum leaps in quality that will
      be required in the coming years.

PMID- 1628559
TI  - The cost of quality in health care.
AB  - The potential fiscal impact of improved quality on health care providers and
      organizations is substantial. In this era of dwindling health care resources,
      proposals that may limit cost increases while improving quality represent true
      win-win situations. There is a need for a substantial amount of health care
      research in this fertile area of quality improvement.

PMID- 1628560
TI  - The management of patient complaints and dissatisfaction.
AB  - Patient satisfaction is an integral component of the measurement of health care
      quality. Proper attention to patient complaints is one part of a patient
      satisfaction management strategy aimed at revealing and alleviating the causes of
      patient dissatisfaction.

PMID- 1628561
TI  - The quality assurance-risk management interface.
AB  - Involvement with both risk management and quality assurance programs has led many
      authors to the conclusion that the fundamental differences between these
      activities are, in fact, very small. "At the point of overlap, it is almost
      impossible to distinguish the purposes and methods of both functions from one
      another." "Good risk management includes real improvement in patient care through
      organized quality assurance activities." The interface between a proactive risk
      management program and a quality assurance program is dynamic and can serve the
      legitimate interests of both. There is little to be gained by thinking of them as
      separate entities and much to be gained by sharing the lessons of both. If one
      thinks of risk management in terms of "risk" to quality patient care, and that
      "assuring quality" is the most productive type of risk management, then there is
      no practical reason to separate one from the other.

PMID- 1628562
TI  - Utilization review. Emergency medicine implications.
AB  - The medical profession has made utilization review a priority in its efforts to
      limit health care expenditures. In emergency medicine this has ranged from
      initiatives to limit inappropriate emergency department visits to guidelines to
      limit emergency department testing and criteria to limit hospital admissions. The
      emergency department observation unit is an area in which the emergency
      physicians follow these practice guidelines without compromising patient care.
      The emergency department utilization review/quality assurance committee is a
      management tool by which emergency physicians monitor and implement these
      strategies for cost-effective patient care.

PMID- 1628563
TI  - Quality assurance in EMS systems.
AB  - QA activities in EMS systems are severely hampered unless a central agency exists
      to coordinate data collection, funding, and communication between agencies and
      field providers. EMS systems must address these issues successfully to maximize
      their efforts. Some regions (San Francisco, King County, Washington, Burbank,
      California) have developed dedicated organizations for the evaluation of
      prehospital care. These organizations can greatly reduce the logistic impediments
      to evaluating EMS care and initiating improvements. A clear goal of any QA
      program is improved patient care. This noble goal by itself will not move an EMS
      system to embrace needed changes. Other compelling reasons for organizations to
      support quality management activities include decreased costs resulting from
      improved efficiency. QA programs may improve provider morale as a result of
      participation in the move toward excellence, and pride in workmanship. One survey
      found an improved sense of teamwork after initiating these programs. Patients
      must receive quality emergency medical care from the moment they enter the health
      care system. Leadership by the medical community is crucial if this goal is to be
      realized.

PMID- 1628564
TI  - Quality assurance in the teaching hospital.
AB  - The approach emergency medical service (EMS) systems take to quality assurance
      and quality improvement is evolving rapidly. Methods of quality assurance that
      have been applied to the prehospital care environment are reviewed. Impediments
      to effective quality assurance strategies are discussed and an overview of the
      scope of the activities and resources necessary to perform this task is
      presented. The potential efficacy and limitations of quality improvement in EMS
      are also discussed.

PMID- 1628565
TI  - Computer applications in quality assurance.
AB  - The computer is rapidly becoming an essential tool for the physician. Proper use
      of computers in practice will help physicians achieve both higher levels of
      quality and greater consistency in patient care. Only with computers can
      physicians rapidly access and process all the data now needed to best address the
      needs of their patients. As computer use in practice becomes the standard, the
      inability to use these tools will be incompatible with quality care. The computer
      is rapidly becoming essential to modern medical management strategies that demand
      efficiency, accuracy, and cost effectiveness in response to patient demands for
      assurance that quality care is being delivered.

PMID- 1628567
TI  - Deposition and dispersion of aerosols in the airways of the human respiratory
      tract: the effect of particle size.
AB  - Small volumes of aerosols (boluses) were inspired predominantly into the
      conducting airways of human lungs with a fast operating valve system, injecting
      preselected aerosol volumes near the end of a clean air inhalation. Particle
      recovery and bolus dispersion in the exhaled air after various periods of
      breathholding were investigated by measuring aerosol number concentration
      directly in front of the mouth with a laser photometer. Inspired and expired flow
      rates were measured with a pneumotachograph. The effect of particle size on these
      measurements has been investigated using aerosol particles with aerodynamic
      diameters (dae) between 0.9 and 5 microns. For aerosol particles smaller than 2
      microns, bolus dispersion increases with increasing periods of breathholding
      (tb). After reaching a maximum, dispersion decreases with even longer tb. An
      increase in particle size yields a smaller increase in dispersion during the
      first seconds of breathholding while it is not changed significantly without
      breathhold. Particle losses during inhalation and exhalation increases with
      particle size. However, with increasing periods of breathholding, the losses of
      the smaller particles (less than 1.5 microns) were found to be much higher than
      expected theoretically, implying particle losses by sedimentation in the same
      airway structures. The small aerosol particles are deposited in smaller airways
      than bigger particles. These observations can be explained by cardiogenic mixing
      during periods of breathholding by pulsatile flow oscillations and confirm
      measurements with enhanced heart rate as described in an earlier paper. Small
      particles with restricted settling velocities remained longer in an airborne
      state in the airways and this leads to a more efficient cardiogenic mixing.

PMID- 1628566
TI  - Interactions between airway epithelium and mediators of inflammation.
AB  - Epithelial cells lining the respiratory airways classically are considered to be
      "target" cells, responding to exposure to a variety of inflammatory mediators by
      altering one or several of their functions, such as mucin secretion, ion
      transport, or ciliary beating. Specific responses of epithelial cells in vivo or
      in vitro to many of these inflammatory mediators are discussed. Recent studies
      have indicated that airway epithelial cells also can act as "effector" cells,
      responding to a variety of exogenous and/or endogenous stimuli by generating and
      releasing additional mediators of inflammation, such as eicosanoids, reactive
      oxygen species, and cytokines. Many of these epithelial-derived substances can
      diffuse away and affect neighboring cells and tissues, or can act, via autocrine
      or paracrine mechanisms, to affect structure and function of epithelial cells
      themselves. Studies dealing with airway epithelium as a source of inflammatory
      mediators and related compounds also are discussed.

PMID- 1628568
TI  - Intratracheal injection of crocidolite asbestos depresses the secretion of tumor
      necrosis factor by pleural leukocytes in vitro.
AB  - Tumor necrosis factor (TNF) is a cytokine released predominantly by
      monocytes/macrophages that has been shown to modulate a variety of different
      immune and metabolic functions. To understand the regulatory mechanisms of TNF in
      governing responses in the pleural cavity following deposition of fibrous dust in
      the airspace of the lung, we studied the capability of leukocytes, lavaged from
      the pleural cavity, to release TNF in culture. TNF production by lavaged pleural
      leukocytes was measured using the L-929 TNF-sensitive cell line, after
      intratracheal instillation of crocidolite asbestos. A high level of TNF activity
      was found in the supernatants of normal, unstimulated pleural leukocytes; the
      addition of 100 ng/ml lipopolysaccharide to the culture increased the activity up
      to threefold. Following intratracheal instillation of 5 mg crocidolite asbestos,
      the pleural leukocytes secreted less TNF than the control. With increasing mass
      of intratracheally instilled asbestos, there was a dose-dependent reduction in
      TNF release. Changes in the population of the pleural leukocytes or their number
      could not be related to variation in TNF activity. These results suggest that
      exposure of rat lungs to crocidolite asbestos by intratracheal instillation
      affects the response of pleural leukocytes without causing changes in the
      population. Such changes in the bronchoalveolar space may be related to the
      pleural pathology found in asbestos-exposed individuals.

PMID- 1628569
TI  - Particle transport through a hollow canine airway cast by high-frequency
      oscillatory ventilation.
AB  - High-frequency oscillatory ventilation (HFV) of the mammalian respiratory tract
      can maintain good respiratory ventilation, even with tidal volumes less than half
      of the anatomic dead space. A steady bidirectional drift is established in
      airways when the frequency is greater than 2 Hz, resulting in quasi-steady axial
      streams in the airways. Convective transport from the trachea to peripheral
      airways takes place in the central core of the bifurcating network of the
      bronchial tree. It takes place in the opposite direction in the annular regions
      near the airway walls. In this study, aerosol particle transport was measured in
      a hollow cast of a canine tracheobronchial tree that extended from the trachea to
      terminal bronchioles. The 0.5 micron particles, placed in the upper trachea as a
      bolus, were transported rapidly to the terminal airways of the cast by HFV with
      tidal volumes of less than one third the volume of the cast. Carrier gases of
      different kinematic viscosity were used to investigate the fluid dynamics of the
      transport. Particle transport during HFV was fastest in a gas of high kinematic
      viscosity (helium), and slowest in a gas of low kinematic viscosity (sulfur
      hexafluoride). The results are consistent with the application of lubrication
      theory, improve our understanding of convective processes involved in HFV, and
      provide new insights into particle penetration in the airways and other aspects
      of respiratory ventilation.

PMID- 1628570
TI  - Eprazinone alters lung lavage lipid levels and transtracheal ion transport.
AB  - Eprazinone therapy improves pulmonary function and arterial pO2 in patients with
      chronic bronchitis; however, the mechanism of action is unknown. The purpose of
      this study was to determine if eprazinone alters either lung surfactant levels in
      bronchoalveolar lavage fluid (BAL) of normal rats, or ion transport across canine
      tracheal epithelium mounted in Ussing chambers. In the surfactant studies, normal
      rats were force fed three doses (50, 100, and 200 mg/kg) of eprazinone for 4
      days. Eprazinone at a dose of 200 mg/kg significantly increased total and
      individual (with the exception of phosphatidylinositol) phospholipid levels and
      decreased total neutral lipids. Lower doses of eprazinone significantly decreased
      neutral lipid levels without affecting the phospholipids. There was no change in
      BAL levels of protein or cells and no abnormal histology. In airway epithelial
      studies, mucosal addition of eprazinone produced a dose-dependent partially
      reversible decrease in short-circuit current (Isc). The decrease in Isc at lower
      eprazinone concentrations was accounted for entirely by a decrease in net
      chloride secretion while at higher concentrations both sodium and chloride
      transport were affected. Submucosal eprazinone had no affect on ion transport.
      These studies suggest that eprazinone influences both BAL lipid levels and ion
      transport, either of which could lead to a beneficial therapeutic effect.

PMID- 1628571
TI  - Changes of growth hormone, somatomedin C, and bombesin following pneumonectomy.
AB  - Left pneumonectomy (PX) was performed on 14-day-old pregnant rats. Serum growth
      hormone (GH), lung somatomedin-C-like immunoreactivity (SmC), and lung bombesin
      like immunoreactivity (BLI), using optimized radioimmunoassays and lung protein
      concentration (P), were measured 3 h, and 1, 2, 3, 5, and 7 days following
      pneumonectomy. These levels were compared to two groups of similar animals: sham
      operated animals and animals not subjected to surgery. Serum GH, lung SmC, and
      BLI levels were similar in the last two groups of animals, suggesting that
      surgery had no effect on GH, SmC, and BLI levels. These two control groups were
      combined and compared to the post-pneumonectomy animals. The post-pneumonectomy
      animals had significantly higher levels of serum GH at postoperative day 3 and
      significantly higher levels of SmC at days 2 and 5 without any significant
      difference in total BLI level and body weight. These results suggest that, first,
      GH and SmC may play a part in post-pneumonectomy compensatory lung growth and
      these two may also be interrelated in this response and, second, BLI material(s)
      perhaps do not play a role in post-pneumonectomy lung growth.

PMID- 1628572
TI  - Hierarchy of seizure states in the electrogenic limbic status epilepticus model:
      behavioral and electrographic observations of initial states and temporal
      progression.
AB  - Repeated electrical stimulation was delivered to the amygdala in a paradigm of
      electrogenic limbic status epilepticus induction in rats. We observed four
      distinct initial behavioral states associated with prolonged spiking, comprising
      an ordered hierarchy of severity: immobile, exploratory, minor convulsive, and
      clonic convulsive. The EEG and behavioral topography of the initial prolonged
      seizure state behaviorally and electrographically resembled the acute seizures
      that occurred earlier during induction. Onset of status epilepticus on limbic
      induction appears to represent not a new type of seizure activity, but instead
      the extended version of repeated brief limbic-onset seizures as seizure
      terminating mechanisms gradually become ineffective. These prolonged seizure
      states can therefore be used to study the anatomy and mechanisms of brief limbic
      seizures. We also examined the temporal progression of amygdala-induced prolonged
      seizure states. At one end of the severity spectrum, immobile-associated spiking
      was prone to terminate early, within 90 min, accompanied by normalization of
      behavior. At the other end of the spectrum, clonic convulsive status epilepticus
      slowly decreased in behavioral severity together with a change in EEG from fast
      to slow spiking. Exploratory status epilepticus was characterized by incessant
      explorationlike behavior that could last hours and was associated with slow
      periodic spike-complexes on EEG. The long-term course consisted either of slow
      devolution, with eventual cessation of spiking, or of spontaneous late ascension
      to convulsive status. Prolonged-seizure states may thus be considered to fall not
      only within an anatomic/behavioral hierarchy of severity, but also within a
      temporal physiologic progression.

PMID- 1628573
TI  - Differences of in vitro electrophysiology of hippocampal neurons from epileptic
      patients with mesiotemporal sclerosis versus structural lesions.
AB  - In vitro electrophysiologic studies of animal hippocampal slice models of
      epilepsy have generated hypotheses regarding cellular pathophysiologies
      associated with epileptogenesis. We tested some of these hypotheses using in
      vitro intracellular recordings of hippocampal neurons from patients with
      intractable temporal lobe epilepsy. We compared the electrophysiology of
      hippocampal neurons from 14 patients with mesiotemporal sclerosis with
      hippocampal neurons from 7 epileptic patients with structural lesions near the
      hippocampal biopsy. Both spontaneous and stimulus-evoked synaptic function and
      action potential firing patterns were observed. Presumed pyramidal neurons from
      sclerotic hippocampus were significantly less likely to display stimulus-evoked
      inhibitory postsynaptic potentials (IPSPs) and were more likely to fire
      spontaneously in bursts of action potentials than were hippocampal neurons from
      patients with structural lesions. No significant differences were detected in
      spontaneous postsynaptic potentials, spontaneous rhythmic synaptic events,
      spontaneous or anode break action potentials, stimulus-evoked excitatory
      postsynaptic potentials, or stimulus-evoked action potential bursts. Cellular
      membrane parameters were similar in the two groups, including resting membrane
      potential, action potential amplitude, action potential half-width, action
      potential threshold, input resistance, time constant, input/output relationship,
      and afterhyperpolarization amplitude.

PMID- 1628574
TI  - Increased pH and inorganic phosphate in temporal seizure foci demonstrated by
      [31P]MRS.
AB  - To investigate alterations of brain metabolism associated with temporal lobe
      epilepsy, [31P]MRS studies were performed on the anterotemporal lobes of patients
      with medically refractory complex partial seizures. Interictally, the pH was
      significantly more alkaline in the temporal lobe ipsilateral to the seizure focus
      (7.25 vs. 7.08, p less than 0.05), and the inorganic phosphorous concentration
      was greater on the side of the epileptogenic focus (1.9 vs. 1.1 mM, p less than
      0.05). These changes in pH and inorganic phosphate may represent metabolic
      alterations secondary to seizures. Alternatively, because alkalosis enhances
      neural excitability and may enhance seizure activity, the increased pH of the
      seizure focus may provide insight into the pathophysiologic mechanism of
      epileptic seizures.

PMID- 1628575
TI  - Neuroimaging in temporal lobe epilepsy: test sensitivity and relationships to
      pathology and postoperative outcome.
AB  - We studied patients with documented temporal lobe seizures to evaluate the
      predictive value of computed tomography (CT), magnetic resonance imaging (MRI),
      and F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for surgical
      therapy and the relationships between these tests and the pathologic diagnoses.
      CT detected abnormalities in 32.5%, with an accuracy of 19% when accuracy was
      defined as congruence with electrophysiologic studies. MRI detected abnormalities
      in 81%, with an accuracy of 67%. FDG-PET detected abnormalities in 85%, with an
      accuracy of 82%. Pathologic change was detected in 79% of the excised temporal
      neocortex, 65% of amygdalae, and 93% of hippocampi. After follow-up periods of 20
      71 months (mean 41 months), 67% of patients were free of seizures and 94% had at
      least a 90% reduction in seizure frequency. There was no relationship between the
      type of abnormality on MRI or the type of pathology and postoperative outcome.
      Better outcomes were associated with focal or regional ictal onsets as recorded
      by surface EEG. Worse outcomes were associated with hypometabolism that extended
      outside the temporal lobe. Pathologic change in the temporal neocortex was
      associated with extension of hypometabolism outside the temporal lobe.

PMID- 1628576
TI  - Comparison of the intracarotid amobarbital procedure and interictal cerebral 18
      fluorodeoxyglucose positron emission tomography scans in refractory temporal lobe
      epilepsy.
AB  - The relationship between interictal focal hypometabolism determined by 18
      fluorodeoxyglucose positron emission tomography (FDG-PET) scans and memory
      function with the intracarotid amobarbital procedure (IAP) was evaluated in 23
      patients with temporal lobe epilepsy. All patients underwent prolonged EEG/video
      monitoring. The epileptogenic focus was defined by interictal epileptiform
      discharges and ictal onsets. All 23 patients had recorded seizures arising
      exclusively from one temporal lobe. PET showed temporal lobe hypometabolism
      ipsilateral to the epileptogenic focus in 86% (20 of 23) of patients; IAP showed
      impaired memory of the hemisphere of seizure onset in 65% (15 of 23). Sixty-five
      percent (13 of 20) of patients with focal hypometabolism had ipsilateral memory
      impairment. Memory impairment contralateral to the hypometabolic zone was not
      observed. Ninety-five percent (22 of 23) of patients demonstrated functional
      impairment by either PET or IAP (or both) on the epileptogenic side.

PMID- 1628577
TI  - Long-term follow-up of stereotactic lesionectomy in partial epilepsy: predictive
      factors and electroencephalographic results.
AB  - We performed an extended follow-up study assessing the efficacy of stereotactic
      lesionectomy in 23 patients with foreign-tissue lesions and intractable partial
      epilepsy. Sixteen lesions involved functional or eloquent cortex as determined by
      anatomic localization. By definition, the surgical objective in these patients
      was excision of the lesion, and not the surrounding cerebral cortex. The mean
      duration of follow-up was 48.5 months (range 26-69 months). Seventeen patients
      (74%) had a significant reduction in seizures (greater than or equal to 90%)
      after lesionectomy. Thirteen patients (56%) had a class I operative outcome
      (seizure-free, single seizure episode, or auras only). Five of these patients
      were successfully discontinued from antiepileptic drug (AED) therapy. Patients
      with temporal lobe lesions were statistically less likely to be rendered seizure
      free (p less than 0.05). Age at operation, duration of epilepsy, and underlying
      pathology were not significant predictors of seizure outcome. The anatomic
      distribution of extracranial EEG recorded epileptiform activity did not appear to
      be an important determinant of outcome. The absence of interictal epileptiform
      activity in the 3-month postoperative EEG correlated with a significant reduction
      in seizures. Long-term follow-up indicates that lesionectomy may be effective in
      select patients with medically refractory partial seizure disorders.

PMID- 1628578
TI  - Prognosis of epilepsy in a rural African community: a 30-year follow-up of 164
      patients in an outpatient clinic in rural Tanzania.
AB  - While working as a physician in Tanzania in the early 1960s, Dr. Louise Jilek
      Aall founded an outpatient clinic for epilepsy among the Pogoro people of Mahenge
      mountains where epilepsy (locally termed Kifafa) had brought misery and death to
      an unusually high percentage of the population. With local assistance and
      overseas donations of phenobarbital (PB), this clinic treated approximately 200
      patients for less than or equal to 10 years. The area was revisited 30 years
      later to trace these patients. Of the 164 patients who had started treatment, 86
      (52.4%) achieved complete seizure suppression, 59 (36.0%) experienced reduction
      in seizure frequency, 13 (7.9%) experienced no change, and in 1 (0.6%) seizures
      were worse. The effect of treatment could not be assessed in 5 (3.0%) patients.
      After 30 years, only 36 (21.9%) of the 164 patients were known to be alive. Of
      the patients, 110 (67.1%) had died, and the whereabouts of 18 (11%) could not be
      traced. The causes of death were epilepsy related (status epilepticus, drowning,
      burns, dying in or after a seizure) in greater than 50% of the patients. Epilepsy
      related deaths were proportionately higher after drug supply was stopped and
      among patients who were receiving drugs irregularly or who had only partial
      seizure control. Patients with epilepsy showed an increased mortality rate, which
      was twice that of the general rural Tanzanian population of similar age.
      Management of epilepsy in rural Africans should also emphasize methods to prevent
      epilepsy-related causes of death among patients with epilepsy.

PMID- 1628579
TI  - Psychosocial evaluation of adults with epilepsy in Chile.
AB  - The Washington Psychosocial Seizure Inventory (WPSI) was used to assess
      psychosocial functioning of 116 epileptic outpatients being treated in an
      epilepsy program at a public health service (PHS). Disturbances in several areas
      of psychosocial adjustment were noted. Although the distribution was similar to
      those previously reported using the WPSI, the severity of the observed
      disturbances was greater. Peak-score scales were Financial Status, Emotional and
      Interpersonal Adjustment, and Overall Psychosocial Functioning. Rehabilitation
      measures in epilepsy could play a substantial role in prevention and treatment of
      psychosocial disorders.

PMID- 1628580
TI  - Epileptic seizures in elderly patients with dementia.
AB  - All inpatients aged greater than 55 years with dementia in the Dundee Psychiatric
      Service were surveyed for seizure occurrence by interviewing staff and reviewing
      records. Of 208 patients, 19 (9.1%) were recorded as having seizures. The
      seizures were major in 92% and occurred at a rate of approximately 2.3 seizures
      per patient per year. Patients with epilepsy were significantly younger than a
      control group of dementia inpatients and were significantly more cognitively
      impaired on the survey Clifton Assessment Procedure for the Elderly (CAPE), but
      not on the Mini Mental State Examination. Of 111 reported accidents, only 5
      appeared to be associated with epilepsy. Although epileptic seizures are
      relatively common in patients with severe dementia, they rarely caused severe
      problems.

PMID- 1628581
TI  - Classification of complex features of febrile seizures: interrater agreement.
AB  - As part of a prospective study of febrile seizures, three independent pediatric
      neurologists rated each of 100 febrile seizures for the presence of complex
      features: focality, long duration (greater than or equal to 10 min), and
      occurrence of multiple seizures. Seizure descriptions were assembled from all
      information available in the medical record and from a semistructured interview
      of a person who had witnessed the seizure. Interrater agreement assessed by kappa
      indicated excellent agreement with regard to whether the seizures were multiple
      or prolonged (kappa greater than or equal to 0.85) and fair to good agreement
      with regard to focality (kappa = 0.61-0.78). Disagreement occurred most often
      regarding assessment of focality. Reasons for disagreement included variation in
      interpretation of lateral eye deviation, staring episodes, and motor asymmetries
      in the context of a bilateral convulsion.

PMID- 1628582
TI  - Clinical manifestations in children with occipital spike-wave paroxysms.
AB  - The pattern of occipital-posterotemporal spike-wave paroxysms (O-PT SWPs), is a
      distinctive EEG abnormality observed primarily with occipital epilepsy of
      childhood and basilar artery migraine. We studied EEG and clinical features in 30
      children and young adults with this EEG pattern. Prolonged and brief O-PT SWPs
      were observed. Prolonged discharges (greater than 6 s) were observed only in
      children with seizures (p less than 0.001), and brief discharges (1-6 s) were
      observed immediately after eye closure. Generalized SWPs (11 patients, 37%) and
      background abnormalities (17 patients, 57%) were common. Photic activation of O
      PT SWPs was not observed. Twenty-four patients (80%) manifested paroxysmal
      phenomena-seizures (20 patients, 67%) and migraine (12 patients, 40%, 4 alone and
      8 with seizures). Fifteen patients (75%) had partial seizures, and 5 (25%) had
      absence seizures. In 7 patients with partial seizures, an etiology was evident.
      Neurologic examination was more often abnormal in patients with secondary partial
      seizures than in those with idiopathic partial seizures (p less than 0.05) and
      absence seizures. Conversely, migraine was more often associated with idiopathic
      partial seizures than with secondary partial seizures (p less than 0.05) and
      absence seizures. Six children (20%) had no paroxysmal events. Generalized SWPs
      were uncommon in patients with idiopathic partial seizures. We conclude that O-PT
      SWPs is a nonspecific epileptiform abnormality that may occur in children with
      (a) idiopathic partial, (b) symptomatic partial, and (c) absence epilepsies, but
      it may also occur in patients with no evidence of seizures.

PMID- 1628583
TI  - Controlled examination of effects of progressive relaxation training on seizure
      reduction.
AB  - We determined the efficacy of progressive muscle relaxation in reducing seizure
      frequency. Subjects were 24 people with epilepsy attending an urban neurology
      clinic. The experimental design consisted of an 8-week baseline period, a
      treatment period of six sessions of progressive relaxation training (PRT, n = 13)
      or quiet sitting (QS, n = 11) and an 8-week follow up. In the PRT group, 11
      subjects reported a decrease in seizure frequency (p less than 0.01), and in the
      QS group, 7 reported a decrease (p greater than 0.05). The mean decrease in
      seizure frequency was 29% for the PRT group (p less than 0.01) but only 3% for
      the QS group (p greater than 0.05). This is the fifth recent report of a
      controlled study documenting the success of progressive relaxation therapy in
      seizure reduction. PRT is inexpensive and noninvasive and facilitates patient
      participation. Such a technique should be incorporated into clinical practice.

PMID- 1628584
TI  - Discontinuing medication in epileptic children: a study of risk factors related
      to recurrence.
AB  - We studied 70 children who had experienced at least two seizures before age 12
      years, excluding febrile seizures, neonatal seizures, or seizures occurring
      during a metabolic, or infectious insult to the central nervous system (CNS) and
      who had been seizure free for at least 2 years. Twenty children (28.5%)
      experienced a recurrence, 75% during antiepileptic (AED) drug discontinuation or
      less than 6 months after discontinuation. Risk factors statistically related to
      seizure recurrence were greater than 10 seizures before seizure control, an
      abnormal EEG in the year before AED discontinuation, presence of focal neurologic
      signs and/or mental retardation, and presence of a mixed seizure pattern.
      Fourteen children (70%) with recurrence had two or more risk factors, whereas 36
      (72%) without recurrence had no risk factor or only one. We conclude that a
      selected group of epileptic children who remain seizure-free for a period of at
      least 2 years can have AEDs discontinued based on presence or absence of risk
      factors.

PMID- 1628585
TI  - Daytime sleep tendency before and after discontinuation of antiepileptic drugs in
      preadolescent children with epilepsy.
AB  - In 9 preadolescent children treated for epilepsy who had been free from seizures
      long enough for treatment to be discontinued, daytime vigilance was studied
      before and after discontinuation of antiepileptic drugs (AEDs). Comparisons were
      made with healthy controls. Multiple sleep latency test (MSLT), EEG, and a
      questionnaire were used. As part of the analysis of the MSLT, a new measure, the
      daily average sleep tendency (DAST), was constructed to overcome the problems
      with data censoring of the classic MSLT analysis. The patients had significantly
      (p less than 0.001) higher daytime sleep tendency, even after drug
      discontinuation, than controls, a result that could neither be attributed to AED
      treatment nor to recent epileptic seizures or complicated epilepsy.

PMID- 1628586
TI  - External leakage from feeding gastrostomies in patients receiving valproate
      sprinkle.
AB  - We reviewed the incidence of external leakage from feeding gastrostomies in 8
      patients who received valproate sprinkle (VPA-S). We also identified a control
      group of 31 children with feeding gastrostomies who were also cared for in our
      clinic, but who did not receive VPA-S. All patients in both groups have had their
      feeding gastrostomy greater than or equal to 6 months. Four of 8 children who
      received VPA-S through feeding gastrostomies developed problems with recurrent
      external leakage. The incidence of external leakage in our control group of
      children who had not received VPA-S was 2 in 31 (6.4%). We hypothesize that the
      external leakage is caused by adherence of the undissolved VPA-S particles to the
      exterior of the tube, preventing close approximation of the tube to the
      gastrostomy stoma. In most cases, VPA-S could continue to be administered and the
      problem of leakage reduced if the tubes were more frequently changed and/or a
      larger size were used. Complications with either leakage or occlusion were noted
      in all patients with the button feeding tube who had received VPA-S. Because of
      the especially high complication rate associated with administration of VPA-S in
      children with the "button" feeding tubes, we discourage VPA-S administration to
      children with that device.

PMID- 1628588
TI  - Interaction of the anticonvulsant ameltolide with standard anticonvulsants.
AB  - The newly characterized anticonvulsant ameltolide was studied in mice in
      combination with the standard antiepileptic drugs (AEDs), phenytoin (PHT),
      carbamazepine (CBZ), and valproate (VPA). In combination with either PHT or CBZ,
      ameltolide produced dose-additive effects in the maximal electroshock (MES) test
      and in the horizontal screen (HS) test for neurologic impairment. The large
      separation between the doses for the anticonvulsant effects and the
      neurologically impairing effects (protective index, PI) were maintained as well
      in the combinations as in the individual compounds. VPA was impotent in the MES
      test and did not have a clear separation between the doses that produce the
      anticonvulsant effects and those that are neurologically impairing (low PI). When
      VPA and ameltolide were combined, the effects were less than additive by
      isobolographic analysis on both the MES and HS tests. At high oral doses (20 and
      40 mg/kg, p.o.), ameltolide produced impairment on the HS test and decreased body
      temperature. The effects on the HS test were enhanced twofold, whereas the
      effects on body temperature were not markedly enhanced, by coadministration of
      the MES ED95 of PHT and CBZ. VPA (MES ED95) appeared to antagonize the
      temperature-lowering effects of ameltolide. These interaction studies suggest
      that ameltolide would be safe, with no unexpected effects, when used in epileptic
      patients concurrently receiving these standard AEDs. These studies also suggest
      that the effects of ameltolide would be lessened by simultaneous administration
      of VPA.

PMID- 1628587
TI  - Relation of plasma and brain concentrations of the anticonvulsant ameltolide to
      its pharmacologic effects.
AB  - Ameltolide, a newly described anticonvulsant, was studied to determine the
      relation between dose administered, plasma and brain concentrations, and
      pharmacologic effects. The relation of the N-acetyl metabolite and the OH-N
      acetyl metabolite to the dose administered and to the pharmacologic effects was
      also determined. Ameltolide plasma concentrations in both mice and rats were
      linearly related to dose administered over the entire dose range from low doses,
      at which the anticonvulsant effects were noted, to high doses, at which
      neurologic impairment occurred. The plasma concentrations of the metabolites were
      not as consistently linearly dose-related in the two species. In rats, the brain
      concentrations of ameltolide were highly correlated with plasma concentrations
      and the doses administered. Ameltolide was shown to have a phenytoin (PHT)-like
      anticonvulsant profile in vitro in the cortical slice preparation. These data
      confirm the potent anticonvulsant profile of ameltolide and the lack of
      significant activity of the metabolites.

PMID- 1628589
TI  - Phenytoin pharmacokinetics: before and after folic acid administration.
AB  - Phenytoin (PHT) exhibits linear and Michaelis-Menten pharmacokinetics. PHT
      decreases serum folate; the vitamin folic acid (FA) is hypothesized to be a
      cofactor in the metabolism of PHT. The depletion of serum folate may explain the
      unpredictability of measured total serum PHT concentrations and time to steady
      state as compared with the Michaelis-Menten predictive calculations. We examined
      PHT pharmacokinetics before and after FA supplementation in 13 healthy male
      volunteers. The study was divided into two phases. Phase I determined V(max)
      (mg/day) and Km (micrograms/ml) of PHT to calculate PHT doses needed for the
      second phase. Phase II was a four-way cross-over study to examine the effect of 1
      and 5 mg FA on total serum PHT concentrations 1 microgram/ml less and 5
      micrograms/ml greater than the subject's Km, Km - 1 and Km + 5, respectively.
      Predicted versus measured total serum PHT concentrations, t90% (days to steady
      state), and the effect of FA were calculated for Km - 1 and Km + 5 before and
      after 1 or 5 mg FA. The measured total serum PHT concentration was always greater
      than the calculated concentration (p less than 0.05), and t90% was always longer
      than the calculated t90% (p less than 0.05) for Km - 1 before FA (all subjects
      decreased serum FA); the same was observed for Km + 5. If folate is assumed to be
      a cofactor in PHT metabolism, these results are expected, because depletion of
      the vitamin would indicate less folate to drive the metabolism of PHT, resulting
      in higher total serum PHT concentrations and longer time to reach steady
      state.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628590
TI  - Fetal heart rate patterns and chronic exposure to antiepileptic drugs.
AB  - Fetal heart rate (FHR) characteristics of fetuses exposed and not exposed to
      antiepileptic drugs (AEDs) were studied. FHR is considered to reflect central
      nervous system (CNS) integrity. Three intervals during pregnancy were
      investigated: 20, 32, and 38 weeks. At 32 and 38 weeks, FHR was studied in
      relation to quiet (C1F) and active (C2F) sleep periods. For each tracing, a
      baseline was determined and accelerations and decelerations were identified. To
      assess FHR variability, the long-term irregularity, interval difference and
      absolute beat-to-beat indexes, and the bandwidth were calculated for 30-s
      intervals between accelerations and decelerations. No marked differences were
      noted between study and control groups concerning basal FHR and the occurrence of
      accelerations. For FHR derived from the fetal ECG, all indexes of FHR variability
      and the bandwidth were lower for the study group as compared with the control
      group, although the differences did not reach statistical significance. Our study
      shows that chronic prenatal exposure to AEDs does not seriously interfere with
      modulation of fetal heart rhythm by the CNS.

PMID- 1628591
TI  - Effect of antiepileptic drugs on growth of murine lymphoid tumor cells in single
      cell culture.
AB  - The effect of three commonly used antiepileptic drugs (AEDs), phenytoin (PHT),
      carbamazepine (CBZ), and valproate (VPA), on the growth of lymphoid tumor cells
      was assessed in vitro. A single-cell culture method was used to determine growth
      rates by direct visualization. The amount of free drug was determined by
      ultrafiltration to ascertain its correlation to therapeutic drug levels. VPA
      slowed the growth of B-myeloma (FO) and T-lymphoma (AKR-1) cells significantly
      within the range of therapeutic drug levels. CBZ and PHT likewise inhibited cell
      growth in both lineages but at two to four times the therapeutic level of free
      drug. CBZ was shown to have long-term effects on FO and AKR-1 cells, demonstrated
      by the reduced growth rates of cloned lines for 2-3 months after drug removal.
      Cloned sublines of myeloma cells secreting lambda light chain (J558L) treated
      with CBZ or PHT had a higher frequency of lambda light chain secretion loss
      mutations than the nontreated parent line.

PMID- 1628592
TI  - Effect of valproate dose on formation of hepatotoxic metabolites.
AB  - Valproate (VPA) therapy has been associated with a rare but fatal hepatotoxicity.
      4-ene-VPA and 2(E),4-diene-VPA, unsaturated metabolites of VPA, are hepatotoxins
      several times more potent than VPA. In a previous study, a dose-dependent
      excretion of hepatotoxic metabolites was noted in patients receiving VPA. Our
      study was designed to evaluate the effect of dose on VPA metabolism under
      controlled conditions. Nineteen healthy volunteers sequentially received three
      different daily doses of VPA (250, 500, and 1,000 mg). Each dose was given twice
      daily for 4 days. Urine was collected for one dosage interval (12 h) at steady
      state for each dose and assayed for 15 VPA metabolites by gas chromatography/mass
      spectrometry (GCMS). Blood samples were also obtained from eight of the subjects,
      and VPA was assayed by GCMS. No effect of dose was noted on total plasma
      clearance. There was a significant dose-dependent decrease in intrinsic hepatic
      clearance. The intrinsic formation clearance (Clf) of the 4-ene-VPA pathway
      showed a statistically significant dose-dependent increase (0.22, 0.33, 0.40
      ml/h/kg). The corresponding percentage of dose recovered as 4-ene-VPA and its
      sequential metabolites showed significant dose-dependent increases (0.15, 0.27,
      0.62%). The role of VPA dose in the pathogenesis of hepatotoxicity may be more
      important than was previously believed.

PMID- 1628593
TI  - Effects of valproate in a model nervous system (buccal ganglia of Helix pomatia):
      I. Antiepileptic actions.
AB  - Cellular actions of valproate (VPA) were studied using intracellular recordings
      of identified neuronal individuals in the buccal ganglia of Helix pomatia. Under
      nonepileptic conditions, VPA induced (a) a hyperpolarization, (b) slight changes
      in action potentials (AP), and (c) an increase in membrane resistance. Under
      epileptic conditions (i.e., during application of an epileptogenic drug),
      extracellular application of VPA decreased frequency of occurrence of epileptic
      depolarizations (early effect) and led to a decay in paroxysmal depolarizations
      (late effect). Intracellular injection of VPA could block epileptic activity in
      the treated neuron immediately. A metabolite of VPA (trans-2-en VPA) mainly
      lacked the late effect (decay in epileptic depolarizations) obtained with VPA.
      Results suggest that the early antiepileptic effect is exerted from the
      extracellular side of the neuronal membrane and that the late effect results from
      intracellular actions of VPA being delayed by slow access to an intracellular
      site.

PMID- 1628594
TI  - Effects of valproate in a model nervous system (buccal ganglia of Helix pomatia):
      II. Epileptogenic actions.
AB  - High concentrations of valproate (VPA; greater than 20 mM) depolarized identified
      neuronal individuals in the buccal ganglia of Helix pomatia and transiently
      induced paroxysmal depolarization shifts (PDS). Threshold concentration of VPA
      for the induction of PDS was decreased (a) by increased seizure susceptibility,
      (b) by increased concentrations of derivatives of VPA, and (c) by increased H+
      concentrations. Intrasomatic injection of VPA did not induce PDS. The
      epileptogenic action of VPA is believed to be exerted from the extracellular side
      of the cell membrane.

PMID- 1628596
TI  - Immobilized pH gradients (IPG)

PMID- 1628595
TI  - Dihydropyridine calcium antagonists in mice: blood and brain pharmacokinetics and
      efficacy against pentylenetetrazol seizures.
AB  - Dihydropyridine calcium antagonists are candidate anticonvulsants, but little is
      known of their penetration into brain. Nifedipine (NFD) and nimodipine (NMD)
      pharmacokinetics were compared in mouse blood and brain, and their activity
      against pentylenetetrazol (PTZ) was assessed. After intraperitoneal (i.p.)
      injection, both dihydropyridines achieved peak blood and brain concentrations in
      5 min. Estimated blood and brain elimination half-lives (t1/2) of NMD (16.7 and
      22.4 min) were slightly longer than those of NFD (11.2 and 14.7 min). Brain and
      blood concentrations correlated with both NFD (r = 0.701, p less than 0.001) and
      NMD (r = 0.572, p less than 0.001). Injection of the dihydropyridines as a
      suspension (Tween 80) did not alter brain penetration, although systemic
      absorption was more erratic. NFD (p less than 0.001), NMD (p less than 0.02), and
      carbamazepine (CBZ, p less than 0.001) i.p. inhibited PTZ-induced seizures. Brain
      concentrations of PTZ were not altered by NFD pretreatment. Combining NFD and CBZ
      was less effective than giving NFD alone (p less than 0.005). NFD (p less than
      0.002) and NMD (p less than 0.001) inhibited PTZ seizures after 2-week oral
      dosing, but low dosing was more effective than high dosing (p less than 0.002).
      NFD and NMD cross the blood-brain barrier (BBB) in mice and inhibit PTZ seizures.
      A possible therapeutic window was identified, and NFD and CBZ were less effective
      in combination than singly. A pharmacodynamic interaction may exist, inhibiting
      effective use of dihydropyridines as adjunctive therapy in epileptic patients.

PMID- 1628597
TI  - The Immobiline family: from "vacuum" to "plenum" chemistry.
AB  - We list here a total of 17 acrylamido acids and bases as potential buffers and
      titrants for isoelectric focusing separations in immobilized pH gradients. The
      chemistry of these compounds is reviewed and general guidelines are given for
      their proper use. In particular, it is shown that the most delicate compounds are
      the basic species, since they can undergo several degradation pathways,
      including: (i) spontaneous hydrolysis to acrylic acid and a diamine; (ii)
      spontaneous autopolymerization to oligomers and n-mers; (iii) oxidation to N
      oxides during the persulfate polymerization step. A hydrophobicity scale has been
      constructed, by partitioning the deprotonated species in water/1-octanol phases.
      A scale of resistance to alkaline hydrolysis for the basic acrylamido buffers is
      also given, followed by general consideration on the structure/stability
      relationship of these chemicals.

PMID- 1628598
TI  - Two-dimensional polyacrylamide gel electrophoresis, with immobilized pH gradients
      in the first dimension, of barley seed proteins: discrimination of cultivars with
      different malting grades.
AB  - The suitability of high-resolution two-dimensional gel electrophoresis for barley
      cultivar discrimination and for classification with respect to their malting
      properties was studied. Seed proteins of 14 barley cultivars with different
      malting qualities were extracted with urea/dithiothreitol/Nonidet P-40 buffer and
      subjected to two-dimensional gel electrophoresis with immobilized pH gradients in
      the first dimension (IPG-DALT). The results of IPG-DALT were compared to the
      protein patterns obtained by a standard technique, sodium dodecyl sulfate
      polyacrylamide gel electrophoresis of hordeins. Sodium dodecyl sulfate-gel
      electrophoresis yielded seven different "B" and four different "C" hordein
      patterns; "A" and "D" hordein patterns were uniform in all cultivars tested. Four
      cultivars could be distinguished unequivocally, the others were classified into
      three groups containing between two and five cultivars. In contrast to these
      findings. IPG-DALT yielded three different "A", eight different "B", four
      different "C" and two different "D" hordein patterns. When the "A", "B", "C" and
      "D" hordein patterns were combined, ten cultivars exhibited unique hordein
      patterns whereas the remaining ones were classified into two groups containing
      two cultivars each. Moreover, when albumin and globulin proteins were used for
      evaluation in addition to the hordeins, all cultivars could be discriminated by
      IPG-DALT. IPG-DALT, performed on small-scale and/or ready-made gels, proved to be
      an ideal complementary system to one-dimensional electrophoretic methods for
      routine seed testing purposes because of its speed, reliability, and simplicity.
      IPG-DALT was also applied to study the relationship between the different
      polypeptide patterns and the malting quality. Although cultivars with identical
      one-dimensional protein patterns but different malting quality could be
      successfully differentiated by IPG-DALT, a direct correlation between specific
      protein spots or protein patterns to the malting quality was not found within the
      cultivars tested.

PMID- 1628599
TI  - Monitoring by two-dimensional electrophoresis somatic embryogenesis in leaf and
      petiole explants from Vitis.
AB  - A two-dimensional electrophoretic analysis of the total proteins was carried out
      in Vitis rupestris as model system in order to characterize the different
      developmental stages--from callus to plantlets--of somatic embryogenesis events
      in the grapevine. The patterns of callus, embryogenetic callus, somatic embryos
      and plantlets derived from leaf and petiole explants were compared. Each
      differentiation step was characterized by specific peptide spots.

PMID- 1628600
TI  - Immobilized pH 2.5-11 gradients for two-dimensional electrophoresis.
AB  - Extremely wide immobilized pH gradients, pH 2.5-11, for isoelectric separation of
      complex protein mixtures are described. These pH gradients are theoretically and
      practically the maximum that can be achieved at present with the available
      acrylamido buffers and titrants. Conditions are described for reducing
      conductivity and electroendosmosis in extreme pH ranges. Furthermore, new
      conditions are described for the separation of proteins in the second dimension.
      Using this protocol, nearly all the possible cellular products can be separated
      in one single two-dimensional map.

PMID- 1628601
TI  - Analysis of recombinant proteins by isoelectric focusing in immobilized pH
      gradients.
AB  - Isoelectric focusing in immobilized pH gradients (IEF-IPG) was used to analyze
      three different recombinant proteins. Recombinant leech hirudin (65 amino acids,
      three disulfide bonds) expressed in Saccharomyces cerevisiae as a secreted
      protein and purified by anion-exchange and reversed-phase chromatography proved
      to be homogeneous with regard to its isoelectric point (pI). In addition, the
      theoretical pI, calculated on the basis of the primary structure, corresponded
      precisely to the measured pI of 4.30. IEF-IPG was further employed to follow the
      stability of recombinant hirudin at pH 9, indicating that deamidation occurred
      under these conditions. A variant of recombinant human alpha 1-antitrypsin (AAT)
      (389 amino acids, one cysteine residue) expressed in Escherichia coli and
      purified by anion-exchange, metal chelate and hydrophobic-interaction
      chromatography appeared to be homogeneous by polyacrylamide gel electrophoresis
      under reducing and denaturing conditions as well as by various high performance
      liquid chromatography methods. However, some heterogeneity was detected by IEF
      IPG between pH 5-6. The measured pI values of 5.43-5.58 were slightly lower than
      the calculated pI based on the primary structure (5.72). This indicated
      deamidations of Asn or Gln residues. A recombinant Schistosoma mansoni parasite
      antigen, p28 (210 amino acids, one cysteine residue) obtained after intracellular
      expression in Saccharomyces cerevisiae and affinity purification on glutathione
      agarose was analyzed by IEF-IPG in a pH 7.3-8.3 gradient. It appeared to be
      heterogeneous with regard to its pI, with the major component having a pI of 7.81
      compared to the calculated value of 7.17.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628602
TI  - Direct detection of carrier ampholytes in immobilized pH gradients using picric
      acid precipitation.
AB  - A protocol is described for monitoring the heterogeneity of end products of
      organic syntheses yielding amphoteric molecules containing two or more amino
      groups. This protocol was found to be a valuable aid in synthesis of carrier
      ampholytes for specific isoelectric focusing applications. This method does not
      depend on the ampholytes themselves to dictate the conditions under which they
      are analyzed. Carrier ampholytes have been found previously to be insoluble in
      picric acid and the insolubility property was not dependent upon the pI of
      individual ampholyte species. This insolubility property was exploited in the
      protocol. Immobilized pH gradients were used to focus the carrier ampholytes.
      Ampholytes were then visualized in situ by picric acid precipitation. The data
      shows that the protocol is useful for analyzing the results of chemical
      manipulations for enhancing the resolution of carrier ampholytes. A direct
      relationship was shown between carrier ampholyte heterogeneity as demonstrated by
      this protocol and the resolution of complex protein mixtures in isoelectric
      focusing gels. Picric acid formed visible precipitates with a variety of organic
      compounds which contained more than one amino group.

PMID- 1628603
TI  - Carbohydrate analysis of transferrin subfractions isolated by preparative
      isoelectric focusing in immobilized pH gradients.
AB  - Analytical isoelectric focusing of human serum transferrin has revealed the
      presence of up to nine different transferrin subfractions. The less prevalent
      subfractions have hitherto not been available for analytical work on their
      composition. Prolonged isoelectric focusing in immobilized pH gradients is
      capable of effectively separating and concentrating these subfractions from other
      fractions that are often present in over 70-fold excess in native preparations.
      Preliminary results of the carbohydrate analysis indicate a heterogeneity
      extending beyond the present concepts of the transferrin glycan structure.

PMID- 1628604
TI  - The use of immobilized pH gradients for the detection of human polymorphisms in
      the forensic identification of bloodstains.
AB  - Some polymorphic proteins (alpha 1-antitrypsin, orosomucoid, transferrin, group
      specific component, plasminogen) and enzymes (phosphoglucomutase, acid
      phosphatase, estrase D) were determined in bloodstain extracts by isoelectric
      focusing with carrier ampholytes (CA) and with immobilized pH gradients (IPGs)
      rehydrated with CA. IPGs yield superior results for typing of genetics markers in
      bloodstains since phenotypes are better distinguished and the bands are
      straighter and sharper in the presence of contaminants. Also, the sensitivity of
      IPGs with CA is similar to isoelectric focusing (IEF) with CA. A new variant,
      ACP*B1, found in Negroid west African populations and not found in Caucasians is
      described. Such a variant can only be determined by IPGs since its isoelectric
      point (pI 5.95) is close to that of the ACP*B (pI 6.05) variant.

PMID- 1628605
TI  - Studies on an apolipoprotein C-II variant occurring in Caucasians.
AB  - Apolipoproteins C (apo C-II, apo C-III0, apo C-III1 and apo C-III2) from
      delipidated very low density lipoproteins (VLDL) of 522 normo- and
      hyperlipoproteinemic Caucasians were screened by analytical isoelectric focusing.
      The immobilized pH gradient used was pH 4.0-5.0 with 7 M urea, which raised the
      apparent pH range to 4.8-5.7. As identified by immunoblotting, six unrelated
      persons had two major isoforms of apo C-II, the normal apo C-II-1 (which focuses
      between apo C-III0 and apo C-III1) and a variant, designated apo C-II-v according
      to Huff et al., focusing between apo C-III1 and apo C-III2 due to a more acidic
      pI. In narrow pH gradients, apo C-II-v can readily be discriminated from the
      minor isoform, apo C-II-2, due to its slightly more basic pI, corresponding to a
      difference of 0.01 pH units. Neuraminidase treatment did not alter the pI of apo
      C-II-v and on two-dimensional electrophoresis the molecular weights of apo C-II-1
      and apo C-II-v were indistinguishable. The frequency of apo C-II-v was 1.2%. It
      was the same in males and females and was independent of hypertriglyceridemia.
      The autosomal codominant inheritance could be demonstrated in the pedigree of one
      family. Electroblotting of apo C-II-1 and apo C-II-v onto activated glass fiber
      sheets, followed by amino acid sequence analysis of the amino terminal ends,
      revealed an exchange of the amino acid lysine at position 19 by threonine in apo
      C-II-v.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628606
TI  - Apolipoprotein E phenotyping by isoelectric focusing in immobilized pH gradients
      and silver staining.
AB  - A simple and high resolution procedure of apoprotein E (apo E) phenotyping by
      isoelectric focusing with immobilized pH gradients and silver staining is
      described. This method needs delipidated very low density lipoproteins (isolated
      from 1 mL of serum) but obviates immunoblotting as well as neuraminidase
      treatment in routine applications because the sialylated forms are clearly
      separated. Immunoblotting (with polyclonal and monoclonal anti-apo E antiserum),
      cysteamine and neuraminidase treatment, and pI markers allowed the localization
      of three main alleles, xi 2, xi 3, xi 4 and the detection of variants or rare
      alleles (6/450 determinations). The serum amyloid A (SAA) apolipoproteins
      (SAA1,SAA2) could be characterized unequivocally (especially with E3 and E4).
      Silver staining proved more sensitive than Coomassie Brilliant Blue and needs
      only 5 micrograms of protein in the sample. The results of 403 normo-or
      hyperlipidemic patients are shown. In the group of 191 normolipidemic patients
      (cholesterol less than 6.40 mmol/L triglycerides less than 2 mmol/L), the
      relative frequency of the xi 3 allele (0.83) is higher than in other reports on
      Caucasians (about 0.77) whereas the xi 4 allele is lower. As previously
      described, we find a high frequency of the 4/3 phenotype in hypercholesterolemia
      and 3/2 in hypertriglyceridemia. The high frequency of the E2/E2 phenotype,
      usually associated with hyperlipidemia, and variants in complex
      hypertriglyceridemia makes the apo E phenotyping necessary in many cases of
      dyslipidemias.

PMID- 1628607
TI  - Microheterogeneity of apolipoprotein D as revealed by electroblotting following
      isoelectric focusing in Immobiline DryPlates.
AB  - The microheterogeneity of apolipoprotein D was examined by a procedure involving,
      in sequences: (i) electrophoresis in an immobilized pH 4-7 gradient in an
      Immobiline DryPlate-polyacrylamide gel supplemented with Ampholine pH 5-7, (ii)
      covering of the gel with sodium dodecyl sulfate-containing agarose, (iii)
      electroblotting onto a polyvinylidene difluoride membrane and (iv) immunological
      identification. Seven isoforms were obtained with partially purified
      apolipoprotein D. Using this technique the apparent pI values at 15 degrees C for
      the isoforms were 4.57, 4.67, 4.78, 4.83 and 5.95, 6.06 and 6.19 (SD +/- 0.05 for
      all). Direct staining of the Immobiline DryPlate could not reveal the isoforms of
      partially purified apolipoprotein D.

PMID- 1628608
TI  - Modified silver staining for immobilized pH gradients.
AB  - Silver development of gels containing an immobilized pH gradient has proved
      difficult so far because the bonded buffers (especially the tertiary amino
      acrylamido derivatives) tend to absorb silver ions with a resultant heavy
      background of increasing darkness from the anode to the cathode. We report a
      variant of silver staining in which thiosulfate is used twice: (i) prior to
      silver impregnation, at the millimolar level, to enhance sensitivity, and (ii)
      during development, at the micromolar level, to decrease the background.

PMID- 1628609
TI  - Gain effects on performance using a head-controlled computer input device.
AB  - The purpose of this study was to use a Fitts' task to (1) determine how control
      display gain influences performance using a head-controlled computer input
      device; (2) compare relative sensitivity to gain and optimal gain between head
      control and hand/arm control; and (3) investigate control-display gain
      interactions with other task factors including target width, movement amplitude
      and direction. The task was a discrete target acquisition task using circular
      targets of 2.9 mm, 8.1 mm, and 23.5 mm, movement amplitudes of 24.3 mm and 61.7
      mm, and eight radial directions including 0 degrees, 45 degrees, 90 degrees, 135
      degrees, 180 degrees, 225 degrees, 270 degrees, and 315 degrees. Each device was
      operated at four gain levels. Ten subjects participated. The results indicated
      that gain had a significant effect on movement time for both types of pointing
      devices and exhibited local minimums. Discrete target acquisition at all gains
      was aptly described using Fitts' Law for both input devices. The mouse gain
      resulting in minimum movement time and RMS cursor deviation was between 1.0 and
      2.0. The minimum movement time and RMS cursor deviation for the head-controlled
      pointer occurred at a gain between 0.3 and 0.6. Average movement time at the
      optimal head-controlled pointer gain had a slope of 169 ms/bit and was more than
      76% greater than at the optimal mouse gain with a slope of 135 ms/bit. In
      addition, average RMS displacement was more than 27% greater for the head
      controlled pointer at its optimal gain setting than for the mouse. Gain had the
      greatest effect for small target widths and long movement amplitudes using the
      head-controlled pointer. Average movement time increased 37% when increasing the
      head-controlled pointer gain from 0.6 to 1.2 for the small target width, but only
      increased 0.3% when increasing gain for the large target width. Average movement
      time also increased 12% when decreasing the head-controlled pointer gain from 0.3
      to 0.15 for the long movement amplitude, but decreased 0.3% when decreasing gain
      for the short movement amplitude.

PMID- 1628610
TI  - Higher rate of evolution of X chromosome alpha-repeat DNA in human than in the
      great apes.
AB  - The rate of introduction of neutral mutations is lower in man than in other
      primates, including the chimpanzee. This species is generally regarded as our
      closest relative among the great apes. We present here an analysis of sequences
      of X chromosomal alphoid repetitive DNA from man and the great apes, which
      supports the closer relationship between man and chimpanzee and indicates a
      considerably increased rate of recombination in the human repeat DNA. These
      results indicate that the 'molecular clock' is running more quickly in man.

PMID- 1628611
TI  - Three-dimensional structure of transketolase, a thiamine diphosphate dependent
      enzyme, at 2.5 A resolution.
AB  - The crystal structure of Saccharomyces cerevisiae transketolase, a thiamine
      diphosphate dependent enzyme, has been determined to 2.5 A resolution. The enzyme
      is a dimer with the active sites located at the interface between the two
      identical subunits. The cofactor, vitamin B1 derived thiamine diphosphate, is
      bound at the interface between the two subunits. The enzyme subunit is built up
      of three domains of the alpha/beta type. The diphosphate moiety of thiamine
      diphosphate is bound to the enzyme at the carboxyl end of the parallel beta-sheet
      of the N-terminal domain and interacts with the protein through a Ca2+ ion. The
      thiazolium ring interacts with residues from both subunits, whereas the
      pyrimidine ring is buried in a hydrophobic pocket of the enzyme, formed by the
      loops at the carboxyl end of the beta-sheet in the middle domain in the second
      subunit. The structure analysis identifies amino acids critical for cofactor
      binding and provides mechanistic insights into thiamine catalysis.

PMID- 1628612
TI  - Mutations of Ha-ras p21 that define important regions for the molecular mechanism
      of the SDC25 C-domain, a guanine nucleotide dissociation stimulator.
AB  - The SDC25 C-domain is a very active guanine nucleotide dissociation stimulator
      (GDS) isolated from Saccharomyces cerevisiae which acts equally well on Ha-ras
      p21 and yeast RAS2. These properties make the SDC25 C-domain a suitable tool to
      study the basic mechanism of a GDS. The action of the SDC25 C-domain was analysed
      by mutation of structurally important regions of p21. Substitutions that
      influence the coordination of Mg2+.GDP or the interaction of the guanine ring
      were found to stimulate the intrinsic dissociation of GDP and suppress the action
      of the SDC25 C-domain. No relevant effects were observed with mutations in the
      phosphate binding loop L1 or by deleting the last 23 C-terminal residues of p21.
      Substitutions in the switch region 1 (loop L2) and 2 (loop L4) of p21 strongly
      impaired the action of this GDS; however, we show that this effect is not related
      to a decreased affinity of the SDC25 C-domain for the mutated p21. No functional
      competition could be found between this GDS and the catalytic domain of the human
      GTPase activating protein (GAP). This indicates that GDS and GAP bind to
      different sites of the p21.nucleotide complex, even though the same mutations in
      loops L2 and L4 regions affect the activity of both effectors. Since these two
      regions appear not to be involved directly in the interaction with GDS, we
      conclude that the negative effect induced by their mutation is related to their
      function as switches of selective conformations during the GDP to GTP exchange
      reaction catalysed by GDS.

PMID- 1628613
TI  - Evidence for the presence of a secondary structure at the dibasic processing site
      of prohormone: the pro-ocytocin model.
AB  - Bioactivation of pro-proteins by limited proteolysis is a general mechanism in
      the biosynthesis of hormones, receptors and viral protein precursors. This
      proceeds by cleavage of peptide bonds at the level of single or pairs of basic
      residues in the proforms. Examination of a number of cleavage loci in various
      precursors failed to reveal any consensus primary sequence around the dibasic
      cleavage sites. Thus it has been proposed, on the basis of secondary structure
      predictions [Rholam, M., Nicolas, P. and Cohen, P. (1986) FEBS Lett., 207, 1-6],
      that those basic residues which operate as signal loci for the proteolytic enzyme
      machinery are situated in, or next to, privileged precursor regions most often
      constituted by flexible and exposed motifs, e.g. beta-turns and/or loops.
      Peptides reproducing the N-terminal processing domain of the hormone precursor,
      pro-ocytocin-neurophysin, were examined by a combination of spectroscopical
      techniques including circular dichroism, infrared Fourier transform and one- and
      two-dimensional proton NMR. The results indicate that: (i) the region situated on
      the N terminus of the Lys-Arg doublet is organized as a beta-turn in solution;
      (ii) the sequential organization of the residues participating in the beta-turn
      determines the privileged relative orientation of the basic amino acid side
      chains and the subtype of turn; (iii) the peptide segment situated on the C
      terminal side of the dibasic, corresponding to the N-terminal octapeptide of
      neurophysin, is organized as an alpha-helix.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628614
TI  - Influenza virus hemagglutinin with multibasic cleavage site is activated by
      furin, a subtilisin-like endoprotease.
AB  - Many viruses have membrane glycoproteins that are activated at cleavage sites
      containing multiple arginine and lysine residues by cellular proteases so far not
      identified. The proteases responsible for cleavage of the hemagglutinin of fowl
      plague virus, a prototype of these glycoproteins, has now been isolated from
      Madin-Darby bovine kidney cells. The enzyme has a mol. wt of 85,000, a pH optimum
      ranging from 6.5 to 7.5, is calcium dependent and recognizes the consensus
      sequence R-X-K/R-R at the cleavage site of the hemagglutinin. Using a specific
      antiserum it has been identified as furin, a subtilisin-like eukaryotic protease.
      The fowl plague virus hemagglutinin was also cleaved after coexpression with
      human furin from cDNA by vaccinia virus vectors. Peptidyl chloroalkylketones
      containing the R-X-K/R-R motif specifically bind to the catalytic site of furin
      and are therefore potent inhibitors of hemagglutinin cleavage and fusion
      activity.

PMID- 1628615
TI  - Protein synthesis inhibitors differentially superinduce c-fos and c-jun by three
      distinct mechanisms: lack of evidence for labile repressors.
AB  - Protein synthesis inhibitors strongly augment and prolong the usually transient
      induction of c-fos and c-jun by growth factors, phorbol esters etc., a phenomenon
      termed superinduction which is conventionally regarded as a secondary consequence
      of translational arrest. Our recent demonstration that some inhibitors can act
      positively as nuclear signalling agonists compromises this view and necessitates
      a re-evaluation of superinduction. First, we show that labile repressors, widely
      postulated to act negatively on diverse superinducible genes, are not involved in
      regulating c-fos and c-jun. Secondly, two components of c-fos and c-jun
      superinduction, namely the delay in shutting off transcription and stabilization
      of their mRNAs, arise from translational arrest and are common to all protein
      synthesis inhibitors. Thirdly, the recently described capacity to act positively
      as nuclear signalling agonists to stimulate pp33/pp15 phosphorylation is
      restricted to compounds such as anisomycin and cycloheximide; these, but not
      emetine or puromycin, will induce c-fos/c-jun on their own. Fourthly, the
      translational arrest-related components of superinduction are dissociable from
      the signalling agonist effects at sub-inhibitory concentrations of anisomycin,
      under which conditions a new type of c-fos/c-jun superinduction with 'spike'
      kinetics is observed. Finally, we show that in response to EGF plus anisomycin,
      the nuclear signalling responses are themselves augmented and prolonged in a
      manner that corresponds to c-fos/c-jun superinduction under these conditions.

PMID- 1628616
TI  - OCH1 encodes a novel membrane bound mannosyltransferase: outer chain elongation
      of asparagine-linked oligosaccharides.
AB  - The Saccharomyces cerevisiae och1 mutant shows a deficiency in the mannose outer
      chain elongation at the non-permissive temperature. We have cloned the OCH1 gene
      by complementation of temperature sensitive (ts) phenotype for growth. The
      integrant of OCH1 gene in the yeast chromosome can complement the ts phenotype
      and shows the same mapping position as that of the och1 mutation, indicating that
      the cloned gene is the true gene for mutation. The OCH1 gene disruptant is not
      lethal but ts for cell growth, and lacks mannose outer chains. The OCH1 gene
      sequence predicts a 55 kDa protein consisting of 480 amino acids. It contains
      four potential asparagine-linked (N-linked) glycosylation sites and a single
      transmembrane region near the N-terminus. In vitro translation/translocation
      analysis revealed that the large C-terminal region of the OCH1 protein is located
      at the lumenal side of microsomal membranes with some sugar modification,
      indicating a type II membrane topology. The OCH1 protein was detected in yeast
      membrane fractions as four forms of 58-66 kDa, which correspond to the size of a
      glycoprotein containing four N-linked sugar chains the length of which is almost
      the same or slightly larger than the inner core (Man8GlcNAc2) formed in the
      endoplasmic reticulum (ER). Finally, the OCH1 gene was found to encode a novel
      mannosyltransferase which specifically transfers [14C]mannose to the unique
      acceptor, the core-like oligosaccharide of cell wall mannan accumulated in the
      och1 disruptant.

PMID- 1628617
TI  - Amphiphysin, a novel protein associated with synaptic vesicles.
AB  - To obtain access to novel proteins of the neuronal synapse, we have raised
      antisera against proteins of synaptic plasma membranes and used them for
      immunoscreening brain cDNA expression libraries. One of the newly isolated cDNAs
      encodes an acidic protein of 75 kDa with a distinct architecture of structural
      domains and multiple potential phosphorylation sites. Light and electron
      microscopy employing monospecific antisera raised against the expression product
      indicate a synapse-specific, presynaptic localization of this protein in many
      synapses of the chicken and rat nervous system. Its overall distribution in brain
      is very similar to that of synaptophysin, a ubiquitous protein of synaptic
      vesicles. In addition to brain, the protein or its mRNA is expressed in adrenal
      gland and anterior and posterior pituitary, but was not detected in a variety of
      other tissues. In controlled pore glass chromatography the native protein
      copurifies with synaptic vesicles and largely remains associated with them under
      various washing conditions. However, its amino acid sequence is very hydrophilic
      and it segregates into the aqueous phase in detergent phase partition. An earlier
      step of synaptic vesicle purification, sucrose cushion centrifugation, separates
      a vesicle-bound fraction of this protein from an unbound fraction. This seems to
      be a new, perhaps peripheral, protein of synaptic vesicles for which we propose
      the name, amphiphysin.

PMID- 1628618
TI  - Giant lens, a gene involved in cell determination and axon guidance in the visual
      system of Drosophila melanogaster.
AB  - Mutations in the Drosophila gene giant lens (gil) affect ommatidial development,
      photoreceptor axon guidance and optic lobe development. We have cloned the gene
      using an enhancer trap line. Molecular analysis of gil suggests that it encodes a
      secreted protein with an epidermal-growth-factor-like motif. We have generated
      mutations at the gil locus by imprecise excision of the enhancer trap P-element.
      In the absence of gil, additional photoreceptors develop at the expense of
      pigment cells, suggesting an involvement of gil in cell determination during eye
      development. In addition, gil mutants show drastic effects on photoreceptor axon
      guidance and optic lobe development. In wildtype flies, photoreceptor axons grow
      from the eye disc through the optic stalk into the larval brain hemisphere, where
      retinal innervation is required for the normal development of the lamina and
      distal medulla. The projection pattern of these axons in the developing lamina
      and medulla is highly regular and reproducible. In gil, photoreceptor axons enter
      the larval brain but fail to establish proper connections in the lamina or
      medulla. We propose that gil encodes a new type of signalling molecule involved
      in the process of axon pathfinding and cell determination in the visual system of
      Drosophila.

PMID- 1628619
TI  - Brain 4: a novel mammalian POU domain transcription factor exhibiting restricted
      brain-specific expression.
AB  - The POU domain gene family of transcription factors share a conserved bipartite
      DNA binding domain, and exhibit distinct temporal and spatial patterns of
      expression during development, particularly in the forebrain. A cDNA encoding a
      new member of the POU-III class of the POU domain gene family, referred to as Brn
      4, was isolated from a rat hypothalamic cDNA library. Like other mammalian POU
      III genes previously characterized (Brn-1, Brn-2, Tst-1), Brn-4 transcripts are
      initially widely expressed at all levels of the developing neural tube, but in
      contrast to other previously described POU-III genes, are subsequently restricted
      to only a few regions of the adult forebrain, including the supraoptic and
      paraventricular nuclei of the hypothalamus. Brn-4 was shown to bind to DNA
      sequences containing the octamer motif and to trans-activate promoters containing
      this DNA binding motif, based on the actions of a unique N-terminal information.
      This ontogenic pattern of Brn-4 expression in concert with that of Oct-2 and Pit
      1, indicates that certain POU domain genes potentially exert their primary
      functions widely during early neural development, and in a very limited set of
      neurons in the mature brain.

PMID- 1628620
TI  - Mutually exclusive expression of a helix-loop-helix gene and N-myc in human
      neuroblastomas and in normal development.
AB  - We have isolated a novel human gene encoding a helix-loop-helix (HLH) protein by
      molecularly cloning chromosome 1p36-specific CpG islands. The gene termed heir-1
      was localized to the neuroblastoma consensus deletion at 1p36.2-p36.12. Its
      predicted protein is 95.8% identical to the mouse HLH462 protein and has clear
      homology to the mouse Id and Drosophila emc proteins. Heir-1 does not encode a
      basic DNA binding domain as found in basic HLH proteins. The gene is expressed
      specifically at high abundance in adult lung, kidney and adrenal medulla, but not
      in adult brain. Despite prominent heir-1 expression in adrenal medulla, which is
      a prime target for neuroblastomas, 10 out of 12 neuroblastoma-derived cell lines
      revealed very low levels of heir-1 mRNA. Low heir-1 expression was generally
      found in tumor cell lines with N-myc overexpression, whereas the two cell lines
      displaying high heir-1 levels did not overexpress N-myc. Mutually exclusive
      expression of both genes was also found by in situ hybridization in developing
      mouse tissues, particularly in the forebrain neuroectoderm. We conclude that heir
      1 expression is reduced specifically in the majority of neuroblastomas and
      suggest an inverse correlation between heir-1 and N-myc expression in
      neuroblastoma tumors and in embryonic development.

PMID- 1628621
TI  - Transcription factor AP-2 activates gene expression of HTLV-I.
AB  - The HTLV-I LTR contains three conserved regulatory elements known as 21 base pair
      repeats which are required for stimulation of gene expression by the
      transactivator protein tax. Mutagenesis indicates that the 21 bp repeats can be
      subdivided into three motifs, A, B and C, each of which influences the level of
      tax activation. The A site in the 21 bp repeat has strong homology with
      previously described binding sites for the transcription factor AP-2. We
      demonstrated that AP-2 mRNA was present in T-lymphocytes and that cellular
      factors from both non-transformed and transformed T-lymphocytes specifically
      bound to the consensus motif for AP-2 in each 21 bp. To determine the role of AP
      2 in the regulation of the HTLV-I LTR gene expression, we used an AP-2 cDNA in
      DNA binding and transient expression assays. Gel retardation and methylation
      interference studies revealed that bacterially produced AP-2 bound specifically
      and with high affinity to all three 21 bp repeats, and that it required the core
      sequence AGGC for specific binding. Binding of AP-2 prevented the subsequent
      binding of members of the CREB/ATF family to an adjacent regulatory motif in the
      21 bp repeat. Transfection of an AP-2 expression construct into T-lymphocytes
      activated gene expression from the HTLV-I LTR. At least two 21 bp repeats were
      required for high levels of AP-2 activation and mutagenesis of the AP-2 consensus
      binding sequences in the 21 bp repeats eliminate this activation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1628622
TI  - A 22 bp cis-acting element is necessary and sufficient for the induction of the
      yeast KAR2 (BiP) gene by unfolded proteins.
AB  - The KAR2 gene of Saccharomyces cerevisiae codes for an essential chaperone
      protein (BiP) that is localized in the lumen of the endoplasmic reticulum (ER).
      The high basal rate of transcription of KAR2 is increased transiently by heat
      shock: prolonged induction occurs when unfolded proteins accumulate in the ER.
      Three cis-acting elements in the KAR2 promoter control expression of KAR2: (i) a
      GC-rich region that contributes to the high level of constitutive expression,
      (ii) a functional heat shock element (HSE) and (iii) an element (UPR) that is
      involved in the induction of BiP mRNA by unfolded proteins. By analyzing internal
      deletion mutants of the KAR2 promoter, we demonstrate here that these three
      elements regulate transcription of KAR2 independently. Furthermore, the 22 bp UPR
      element causes a heterologous (CYC1) promoter to respond to the presence of
      unfolded proteins in the ER. Extracts of both stressed and unstressed yeast cells
      contain proteins that bind specifically to synthetic HSE and UPR elements and
      retard their migration through gels. Binding proteins specific for the UPR
      element can be fractionated by ammonium sulfate precipitation. Two of the
      proteins UPRF-1 and UPRF-2 (which is apparently a proteolytic degradation product
      of UPRF-1) bind inefficiently to mutant versions of the UPR that are unable to
      confer responsiveness to unfolded proteins to the (CYC1) promoter. UPRF-1
      therefore displays the properties expected of a transcription factor that is
      involved in the sustained response of the KAR2 promoter to unfolded proteins in
      the ER. These experiments show that yeast cells can activate a transcription
      factor that stimulates expression of a nuclear gene in response to the
      accumulation of unfolded proteins in another cellular compartment.

PMID- 1628623
TI  - Activation of mammalian DNA methyltransferase by cleavage of a Zn binding
      regulatory domain.
AB  - Mammalian DNA (cytosine-5) methyltransferase contains a C-terminal domain that is
      closely related to bacterial cytosine-5 restriction methyltransferase. This
      methyltransferase domain is linked to a large N-terminal domain. It is shown here
      that the N-terminal domain contains a Zn binding site and that the N- and C
      terminal domains can be separated by cleavage with trypsin or Staphylococcus
      aureus protease V8; the protease V8 cleavage site was determined by Edman
      degradation to lie 10 residues C-terminal of the run of alternating lysyl and
      glycyl residues which joins the two domains and six residues N-terminal of the
      first sequence motif conserved between the mammalian and bacterial cytosine
      methyltransferases. While the intact enzyme had little activity on unmethylated
      DNA substrates, cleavage between the domains caused a large stimulation of the
      initial velocity of methylation of unmethylated DNA without substantial change in
      the rate of methylation of hemimethylated DNA. These findings indicate that the N
      terminal domain of DNA methyltransferase ensures the clonal propagation of
      methylation patterns through inhibition of the de novo activity of the C-terminal
      domain. Mammalian DNA methyltransferase is likely to have arisen via fusion of a
      prokaryotic-like restriction methyltransferase and an unrelated DNA binding
      protein. Stimulation of the de novo activity of DNA methyltransferase by
      proteolytic cleavage in vivo may contribute to the process of ectopic methylation
      observed in the DNA of aging animals, tumors and in lines of cultured cells.

PMID- 1628624
TI  - E.coli polynucleotide phosphorylase expression is autoregulated through an RNase
      III-dependent mechanism.
AB  - It has been previously shown that the pnp messenger RNAs are cleaved by RNase III
      at the 5' end and that these cleavages induce a rapid decay of these messengers.
      A translational fusion between pnp and lacZ was introduced into the chromosome of
      a delta lac strain to study the expression of pnp. In the presence of increased
      cellular concentrations of polynucleotide phosphorylase, the level of the hybrid
      beta-galactosidase is repressed, whereas the synthesis rate of the corresponding
      message is not significantly affected. In the absence of pnp, the level of the
      hybrid protein increases strongly. Thus, polynucleotide phosphorylase is post
      transcriptionally autocontrolled. However, autocontrol is totally abolished in
      strains where the RNase III site on the pnp message has been deleted or in
      strains devoid of RNase III. These results suggest that polynucleotide
      phosphorylase requires RNase III cleavages to autoregulate the translation of its
      message. Other mutations in the ribosome binding site region support the
      hypothesis that this 3' to 5' processive enzyme could recognize a specific
      repressor binding site at the 5' end of pnp mRNA. Implications of these results
      on the mechanism of regulation and on messenger degradation are discussed.

PMID- 1628626
TI  - Co-amplified markers alternate in megabase long chromosomal inverted repeats and
      cluster independently in interphase nuclei at early steps of mammalian gene
      amplification.
AB  - Two-colour in situ hybridization with probes for two co-amplified markers located
      several megabases apart on chromosome 1 has been used to analyse early stages of
      adenylate deaminase 2 (AMPD2) gene amplification in Chinese hamster cells. In the
      amplified chromosomal structures, the distribution of hybridization spots
      identifies megabase-long inverted repeats. Their organization is remarkably well
      accounted for if breakage-fusion-bridge cycles involving sister chromatids drive
      the amplification process at these early stages. During interphase the markers
      often segregate into distinct nuclear domains. Many nuclei have bulges or release
      micronuclei, carrying several copies of one or both markers. These observations
      indicate that the amplified units destabilize the nuclear organization and
      eventually lead to DNA breakage during interphase. We propose a model in which
      interphase breakage has a role in the progression of gene amplification.

PMID- 1628625
TI  - Primary structure and binding activity of the hnRNP U protein: binding RNA
      through RGG box.
AB  - Heterogeneous nuclear ribonucleoproteins (hnRNPs) are thought to influence the
      structure of hnRNA and participate in the processing of hnRNA to mRNA. The hnRNP
      U protein is an abundant nucleoplasmic phosphoprotein that is the largest of the
      major hnRNP proteins (120 kDa by SDS-PAGE). HnRNP U binds pre-mRNA in vivo and
      binds both RNA and ssDNA in vitro. Here we describe the cloning and sequencing of
      a cDNA encoding the hnRNP U protein, the determination of its amino acid sequence
      and the delineation of a region in this protein that confers RNA binding. The
      predicted amino acid sequence of hnRNP U contains 806 amino acids (88,939
      Daltons), and shows no extensive homology to any known proteins. The N-terminus
      is rich in acidic residues and the C-terminus is glycine-rich. In addition, a
      glutamine-rich stretch, a putative NTP binding site and a putative nuclear
      localization signal are present. It could not be defined from the sequence what
      segment of the protein confers its RNA binding activity. We identified an RNA
      binding activity within the C-terminal glycine-rich 112 amino acids. This region,
      designated U protein glycine-rich RNA binding region (U-gly), can by itself bind
      RNA. Furthermore, fusion of U-gly to a heterologous bacterial protein (maltose
      binding protein) converts this fusion protein into an RNA binding protein. A 26
      amino acid peptide within U-gly is necessary for the RNA binding activity of the
      U protein. Interestingly, this peptide contains a cluster of RGG repeats with
      characteristic spacing and this motif is found also in several other RNA binding
      proteins. We have termed this region the RGG box and propose that it is an RNA
      binding motif and a predictor of RNA binding activity.

PMID- 1628627
TI  - Unusual stability of recombination intermediates made by Escherichia coli RecA
      protein.
AB  - The structure and stability of recombination intermediates made by RecA protein
      have been investigated following deproteinization. The intermediates consist of
      two duplex DNA molecules connected by a junction, as visualized by electron
      microscopy. Although we expected the structures to be highly unstable due to
      branch migration of the junction, this was not the case. Instead, we found that
      the intermediates were stable at 37 degrees C. At 56 degrees C, greater than 60%
      of the intermediates remained after 6 h of incubation. Only at higher
      temperatures was significant branch migration observed. This unexpected stability
      suggests that the formation of extensive lengths of heteroduplex DNA in
      Escherichia coli is likely to require the continued action of proteins, and does
      not occur via spontaneous branch migration. We show that heteroduplex DNA may be
      formed in vitro by ATP-dependent strand exchange catalysed by RecA protein or by
      the RuvA and RuvB proteins of E. coli.

PMID- 1628628
TI  - Sequence-specific interaction of the Salmonella Hin recombinase in both major and
      minor grooves of DNA.
AB  - The Hin recombinase of Salmonella catalyzes a site-specific recombination event
      which leads to flagellar phase variation. Starting with a fully symmetrical
      recombination site, hixC, a set of 40 recombination sites which vary by pairs of
      single base substitutions was constructed. This set was incorporated into the
      Salmonella-specific bacteriophage P22 based challenge phage selection and used to
      define the DNA sequence determinants for the binding of Hin to DNA in vivo. The
      critical sequence-specific contacts between a Hin monomer and a 13 bp hix half
      site are at two T:A base pairs in the major groove of the DNA which are separated
      by one base pair, and two consecutive A:T contacts in the minor groove. The base
      substitutions in the major groove recognition portion which were defective in
      binding Hin still retained residual binding capability in vivo, while the base
      pair substitutions affecting the minor groove recognition region lost all in vivo
      binding. Using in vitro binding assays, Hin was found to bind to hix symmetrical
      sites with A:T base pairs or I:C base pairs in the minor groove recognition
      sequences, but not to G:C base pairs. In separate in vitro binding assays, Hin
      was equally defective in binding to either a G:C or a I:C contact in a major
      groove recognition sequence. Results from in vitro binding assays to hix sites in
      which 3-deazaadenine was substituted for adenine are consistent with Hin making a
      specific contact to either the N3 of adenine or O2 of thymine in the minor groove
      within the hix recombination site on each symmetric half-site. These results
      taken with the results of previous studies on the DNA binding domain of Hin
      suggest a sequence-specific minor groove DNA binding motif.

PMID- 1628629
TI  - An endonuclease with multiple cutting sites, Endo.SceI, initiates genetic
      recombination at its cutting site in yeast mitochondria.
AB  - Endo.SceI is a mitochondrial sequence-specific endonuclease which has multiple
      cutting sites. In order to examine the possible role of Endo.SceI in homologous
      recombination, we analyzed the mode of recombination upon mating using antibiotic
      resistance markers on the mitochondrial genome. The segregation of a marker
      located very close to one of the Endo.SceI cutting sites showed a disparity
      (polarized segregation, i.e. gene conversion). This gene conversion depended on
      the presence of the functional Endo.SceI gene. In vivo cutting of mitochondrial
      DNA upon mating was detected at the cutting site in the antibiotic marker region,
      which also depended on the Endo.SceI activity. These results suggest that
      mitochondrial recombination is induced by cleavage of mitochondrial DNA by this
      sequence-specific endonuclease. This is the first demonstration that a sequence
      specific endonuclease with multiple cutting sites induces genetic recombination.

PMID- 1628632
TI  - Controlled infusion devices: applications in anaesthetic practice.

PMID- 1628631
TI  - A novel regulatory myosin light chain gene distinguishes pre-B cell subsets and
      is IL-7 inducible.
AB  - We describe a novel regulatory myosin light chain gene (termed precursor
      lymphocyte-specific regulatory light chain or PLRLC) that is expressed
      specifically in precursor B and T lymphocytes. PLRLC is the first example of a
      regulatory myosin light chain gene which displays specific expression in non
      muscle cells. PLRLC is expressed in adult bone marrow derived normal and
      transformed pre-B cells; in the former, PLRLC expression levels are induced by
      the pre-B cell specific growth factor interleukin-7 (IL-7). PLRLC is not
      expressed in either transformed pre-B cells derived from fetal liver or in normal
      fetal liver pre-B clones grown in the presence of IL-7. Therefore this gene
      provides the first marker that clearly distinguishes these two pre-B subsets.
      Finally, several of the different PLRLC transcripts potentially encode regulatory
      myosin light chains with unique structural features. The unique distribution,
      regulation and structural features of the PLRLC gene products suggest an
      important role for PLRLC during lymphocyte development.

PMID- 1628630
TI  - Surface IgM mediated regulation of RAG gene expression in E mu-N-myc B cell
      lines.
AB  - Transgenic mice carrying either the c-myc or N-myc oncogene deregulated by the
      immunoglobulin heavy chain enhancer element (E mu) develop both pre-B and B cell
      lymphomas (E mu-c-myc and E mu-N-myc lymphomas). We report here that B cell lines
      derived from these tumors, as well as a line derived from v-myc retroviral
      transformation, simultaneously express surface immunoglobulin (a hallmark of
      mature B cells) as well as a common subset of genes normally restricted to the
      pre-B stage of development-including the recombinase activating genes RAG-1 and
      RAG-2. Continued RAG-1 and RAG-2 expression in these lines is associated with VDJ
      recombinase activity detected with a VDJ recombination substrate. Cross-linking
      of the surface immunoglobulin on these lines with an anti-mu antibody leads to
      rapid, specific and reversible down-regulation of RAG-1 and RAG-2 gene
      expression. We also find that a small but significant percentage of normal
      surface immunoglobulin bearing bone marrow B cells express the RAG-1 gene. These
      findings are discussed in the context of their possible implications for the
      control of specific gene expression during the pre-B to B cell transition.

PMID- 1628633
TI  - Spinal monitoring during vertebral column surgery under continuous alfentanil
      infusion.
AB  - An anaesthetic technique for surgical procedures on the vertebral column is
      described consisting of a continuous infusion of a short acting opioid,
      alfentanil, and a muscle relaxant, vecuronium, in combination with positive
      pressure ventilation using a nitrous oxide/oxygen mixture. It is shown that the
      two standard forms of spinal monitoring, wake-up testing and somatosensory
      cortical evoked potentials, can be employed effectively using this anaesthetic
      technique. Wake-up testing was performed in 23 patients. Average wake-up time was
      10 min (SD 3.7 min). Evoked responses suitable for spinal monitoring could be
      obtained in 60 of 61 patients.

PMID- 1628634
TI  - Anaesthetic interaction between thiopentone and ketamine.
AB  - The anaesthetic effect of thiopentone, ketamine and their combinations were
      studied in 150 patients of ASA Grades I and II. The ability to open eyes on
      command and purposeful motor response to noxious pressure on the trapezius muscle
      were used as endpoints of anaesthesia. Dose-response curves for thiopentone,
      ketamine and their combinations were determined with a probit procedure and
      compared with isobolographic analysis. The interaction between thiopentone and
      ketamine was found to be additive for both endpoints of anaesthesia.

PMID- 1628635
TI  - Halothane 2% for caesarean section.
AB  - During the induction-delivery interval for Caesarean section delivery, 2%
      halothane in pure oxygen was administered. The technique was compared to a 0.5%
      halothane in 50% oxygen/50% nitrous oxide anaesthesia. When a continuous infusion
      of oxytocin was administered, no excessive haemorrhage was seen. No maternal
      reminiscence was seen using 2% halothane, but awareness was recorded using 0.5%
      halothane in 50% nitrous oxide in 15% of the mothers. When there were no signs of
      preoperative fetal distress, the neonates were unaffected by the halothane
      concentration provided the induction-delivery interval was short. In cases of
      fetal distress, the administration of 2% halothane further aggravated the
      condition of the neonates, as indicated by lowered 1-min Apgar scores, umbilical
      oxygen tensions, pH and base excess values.

PMID- 1628636
TI  - Partial attenuation of the pressor response to endotracheal intubation. A
      comparison of the effects of intravenous clonidine and fentanyl.
AB  - In a randomized, double-blind placebo controlled study, intravenous clonidine,
      fentanyl and saline were compared for both their effect on the cardiovascular
      response to intubation, and early post-operative pain. The patients treated with
      fentanyl and clonidine were more sedated and the requirements for induction
      agents were lower compared to the control group. On intubation, both the active
      treatments resulted in a smaller increase in both heart rate and mean arterial
      pressure compared to the control group. There was no significant difference in
      recovery times in the three groups. Although the time to first request for
      analgesia was longer in the clonidine group compared to both the fentanyl and
      saline groups, the difference in morphine requirements between the groups was not
      significant. The differences between the two active treatments were not
      significant, and clonidine offered no additional benefits over fentanyl for this
      purpose.

PMID- 1628637
TI  - Dreaming and anaesthesia: total i.v. anaesthesia with propofol versus balanced
      volatile anaesthesia with enflurane.
AB  - Sixty consecutive ASA Grades I and II patients scheduled for elective ear, nose
      and throat surgery were randomly assigned to receive either total i.v.
      anaesthesia with propofol ('propofol group') or 'balanced technique' with
      thiopentone induction followed by N2O and enflurane. Patients were asked whether
      they had experienced dreams immediately after extubation when verbal
      communication was established, in the recovery room and in the ward on the
      evening of the day of surgery. Thirteen patients in the propofol group (43%) and
      three patients in the enflurane group (10%) reported dreaming (P less than 0.05)
      when asked as soon as verbal communication was established. In the recovery room
      and in the ward only three patients of the propofol group (10%) and one patient
      in the enflurane group (3%) remembered that they had been dreaming (NS). To avoid
      underestimating the frequency of peri-operative dreaming, post-operative
      interviews should take place as soon as possible after conversing is possible.

PMID- 1628638
TI  - A simple system for patient-controlled analgesia.
AB  - A simple system for patient-controlled analgesia made from disposable items and
      using hydrostatic pressure for its driving force is described. The system has
      been used in 200 patients undergoing intra-abdominal gynaecological surgery who
      were supervised in a general ward. Morphine was used as the analgesic in 150
      patients and pethidine in 50. In the morphine group, analgesia was inadequate in
      eight and use was discontinued in a further 20 patients for various reasons. In
      the remaining 122, the system worked well and the majority of patients obtained
      satisfactory analgesia. Details of analgesic administration and requirements,
      pain and sedation assessments, and patient appreciation in 50 patients are given.
      In the group receiving pethidine, analgesia was unsatisfactory in two and use was
      discontinued in eight. The 24-h consumption of pethidine in 20 patients is
      recorded together with FVC and FEV1 changes and linear analogue scores for pain.
      It is suggested that the system provides a means of making the benefits of
      patient-controlled analgesia more widely available.

PMID- 1628639
TI  - Effects of intrathecal and intraperitoneal morphine on gastrointestinal motility
      in the rat.
AB  - A method has been developed to compare gastrointestinal (GI) transit time after
      intrathecal (i.t.) drug injection in the rat. Each animal had a catheter
      implanted in the i.t. space. Eight rats, on three separate occasions, had either
      i.t. morphine 16 micrograms kg-1 (in 50 microliters) or intraperitoneal (i.p.)
      morphine (0.1%) 7.5 mg kg-1 or i.t. saline (50 microliters). The dose of morphine
      was the ED50 for analgesia by each route. After halothane and oxygen anaesthesia,
      10 steel balls and 1 ml of contrast medium were placed into the stomach, the
      whole procedure being completed within 5 min. Radiographs were taken at 5 min, 3,
      6 and 24 h, and the number of balls in the stomach, small and large intestine
      were counted. The inhibitory effect of i.t. or i.p. morphine on gut motility
      caused an equally significant delay at 6 h. In a separate series of eight rats
      the delay by i.t. morphine could be completely antagonized by i.p. naloxone 1 mg
      kg-1. Thus, i.t. morphine in an analgesic dose even though smaller than the i.p.
      dose has a similar inhibitory effect on GI tract motility in the rat. This method
      would enable comparisons on GI transit to be made between a variety of
      intrathecally administered drugs.

PMID- 1628640
TI  - Role of paf-acether in protamine-induced thrombocytopenia in rabbits.
AB  - The effects of protamine (6 mg kg-1) injected after heparin (5 mg kg-1) have been
      studied in five groups of five New Zealand white rabbits. Group I was treated
      with the sequence heparin-protamine and group II with protamine alone. The
      animals of groups III and IV received respectively intravenous indomethacin (3 mg
      kg-1) and BN 52021 (3 mg kg-1), a paf receptor antagonist before the sequence
      heparin-protamine. Group V was pre-treated with indomethacin and BN 52021 before
      heparin reversal with protamine. In group I, immediate thrombocytopenia (44.1 +/-
      4.6% of baseline level, P less than 0.05) and leucopenia (55.5 +/- 2.3% of
      baseline level, P less than 0.05) were observed 30 s after protamine reversal of
      heparin, paralleled with an increase in blood paf levels (27.6 +/- 27.6 vs. 148.2
      +/- 48.9 pg ml-1, P less than 0.05). In group II, protamine alone induced no
      change in platelet count nor in blood paf levels (55 +/- 10 vs. 52.5 +/- 20 pg ml
      1, P greater than 0.05). Pre-treatment with indomethacin alone (group III) did
      not protect the animals against the haematological changes induced by the heparin
      protamine complexes. Pre-treatment with the paf receptor antagonist, alone or in
      association with indomethacin, delayed the occurrence of thrombocytopenia 3 min
      after protamine administration but the leucopenia was the same as in group I.
      This study demonstrated that paf is implicated in the immediate thrombocytopenia
      occurring after protamine reversal of heparin in rabbit.

PMID- 1628641
TI  - The polyanion-binding domain of cytoplasmic Lys-tRNA synthetase from
      Saccharomyces cerevisiae is not essential for cell viability.
AB  - Cytoplasmic Lys-tRNA synthetase (LysRS) from Saccharomyces cerevisiae is a
      dimeric enzyme made up of identical subunits of 68 kDa. By limited proteolysis,
      this enzyme can be converted to a truncated dimer without loss of activity.
      Whereas the native enzyme strongly interacts with polyanionic carriers, the
      modified form displays reduced binding properties. KRS1 is the structural gene
      for yeast cytoplasmic LysRS. It encodes a polypeptide with an amino-terminal
      extension composed of about 60-70 amino acid residues, compared to its
      prokaryotic counterpart. This segment, containing 13 lysine residues, is removed
      upon proteolytic treatment of the native enzyme. The aim of the present study was
      to probe in vivo the significance of this amino-terminal extension. We have
      constructed derivatives of the KRS1 gene, encoding enzymes lacking 58 or 69 amino
      terminal residues and, by site-directed mutagenesis, we have changed four or
      eight lysine residues from the amino-terminal segment of LysRS into glutamic
      acids. Engineered proteins were expressed in vivo after replacement of the wild
      type KRS1 allele. The mutant enzymes displayed reduced specific activities (2-100
      fold). A series of carboxy-terminal deletions, encompassing 3, 10 or 15 amino
      acids, were introduced into the LysRS mutants with modified amino-terminal
      extensions. The removal of three residues led to a 2-7-fold increase in the
      specific activity of the mutant enzymes. This partial compensatory effect
      suggests that interactions between the two extreme regions of yeast LysRS are
      required for a proper conformation of the native enzyme. All KRS1 derivatives
      were able to sustain growth of yeast cells, although the mutant cell lines
      displaying a low LysRS activity grew more slowly. The expression, as single-copy
      genes, of mutant enzymes with a complete deletion of the amino-terminal extension
      or with four Lys----Glu mutations, that displayed specific activities close to
      that of the wild-type LysRS, had no discernable effect on cell growth. We
      conclude that the polycationic extensions of eukaryotic aminoacyl-tRNA
      synthetases are dispensable, in vivo, for aminoacylation activities. The results
      are discussed in relation to the triggering role in in situ compartmentalization
      of protein synthesis that has been ascribed to the polypeptide-chain extensions
      that characterize most, if not all, eukaryotic aminoacyl-tRNA synthetases.

PMID- 1628642
TI  - Optimization of yeast-expressed human liver cytochrome P450 3A4 catalytic
      activities by coexpressing NADPH-cytochrome P450 reductase and cytochrome b5.
AB  - Human liver P450 NF25 (CYP3A4) had been previously expressed in Saccharomyces
      cerevisiae using the inducible GAL10-CYC1 promoter and the phosphoglycerate
      kinase gene terminator [Renaud, J. P., Cullin, C., Pompon, D., Beaune, P. and
      Mansuy, D. (1990) Eur. J. Biochem. 194, 889-896]. The use of an improved
      expression vector [Urban, P., Cullin, C. and Pompon, D. (1990) Biochimie 72, 463
      472] increased the amounts of P450 NF25 produced/culture medium by a factor of
      five, yielding up to 10 nmol/l. The availability of recently developed host cells
      that simultaneously overexpress yeast NADPH-P450 reductase and/or express human
      liver cytochrome b5, obtained through stable integration of the corresponding
      coding sequences into the yeast genome, led to biotechnological systems with much
      higher activities of yeast-expressed P450 NF25 and with much better ability to
      form P450 NF25-iron-metabolite complexes. 9-fold, 8-fold, and 30-fold rate
      increases were found respectively for nifedipine 1,4-oxidation, lidocaine N
      deethylation and testosterone 6 beta-hydroxylation between P450 NF25-containing
      yeast microsomes from the basic strain and from the strain that both
      overexpresses yeast NADPH-P450 reductase and expresses human cytochrome b5. Even
      higher turnovers (15-fold, 20-fold and 50-fold rate increases) were obtained
      using P450 NF25-containing microsomes from the yeast just overexpressing yeast
      NADPH-P450 reductase in the presence of externally added, purified rabbit liver
      cytochrome b5. This is explained by the fact that the latter strain contained the
      highest level of NADPH-P450 reductase activity. It is noteworthy that for the
      three tested substrates, the presence of human or rabbit cytochrome b5 always
      showed a stimulating effect on the catalytic activities and this effect was
      saturable. Indeed, addition of rabbit cytochrome b5 to microsomes from a strain
      expressing human cytochrome b5 did not further enhance the catalytic rates. The
      yeast expression system was also used to study the formation of a P450-NF25-iron
      metabolite complex. A P450 Fe(II)-(RNO) complex was obtained upon oxidation of N
      hydroxyamphetamine, catalyzed by P450-NF25-containing yeast microsomes. In
      microsomes from the basic strain expressing P450 NF25, 10% of the starting P450
      NF25 was transformed into this metabolite complex, whereas more than 80% of the
      starting P450 NF25 led to complex formation in microsomes from the strain
      overexpressing yeast NADPH-P450 reductase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628643
TI  - Malonate decarboxylase of Malonomonas rubra, a novel type of biotin-containing
      acetyl enzyme.
AB  - Cell suspensions or crude extracts of Malonomonas rubra grown anaerobically on
      malonate catalyze the decarboxylation of this substrate at a rate of 1.7-2.5
      mumol.min-1.mg protein-1 which is consistent with the malonate degradation rate
      during growth. After fractionation of the cell extract by ultracentrifugation,
      neither the soluble nor the particulate fraction alone catalyzed the
      decarboxylation of malonate, but on recombination of the two fractions 87% of the
      activity of the unfractionated extract was restored. The decarboxylation pathway
      did not involve the intermediate formation of malonyl-CoA, but decarboxylation
      proceeded directly with free malonate. The catalytic activity of the enzyme was
      completely abolished on incubation with hydroxylamine or NaSCN. Approximately 50
      65% of the original decarboxylase activity was restored by incubation of the
      extract with ATP in the presence of acetate, and the extent of reactivation
      increased after incubation with dithioerythritol. Reactivation of the enzyme was
      also obtained by chemical acetylation with acetic anhydride. These results
      indicate modification of the decarboxylase by deacetylation leading to
      inactivation and by acetylation of the inactivated enzyme specimens leading to
      reactivation. It is suggested that the catalytic mechanism involves exchange of
      the enzyme-bound acetyl residues by malonyl residues and subsequent
      decarboxylation releasing CO2 and regenerating the acetyl-enzyme. The
      decarboxylase was inhibited by avidin but not by an avidin-biotin complex
      indicating that biotin is involved in catalysis. A single biotin-containing 120
      kDa polypeptide was present in the extract and is a likely component of malonate
      decarboxylase.

PMID- 1628644
TI  - Fluorescence study of the macrolide pentaene antibiotic filipin in aqueous
      solution and in a model system of membranes.
AB  - The polyene antibiotic filipin (a pentaene) has been studied using photophysical
      techniques. The polyene self-aggregates in water with a critical micellar
      concentration of 2 microM. Two approaches were used to evaluate the aggregate
      dimensions: (a) a lower limit of 10 nm for the aggregate radius was obtained from
      energy transfer experiments; (b) a formula for rationalizing the turbidity
      spectrum was derived, and from its application a spherical shape of radius about
      50 nm was deduced. The low value for the fluorescence anisotropy of the aggregate
      (r = 0.02) is compatible with a very loose structure, i.e. the chromophore has
      very efficient depolarization dynamics that is not controlled by the aggregate
      size. The Stern-Volmer plot of aggregated filipin fluorescence quenching by
      iodide is non-linear, presenting a downward curvature. A model was used for the
      interpretation of these data, along with a study of the quenching in transient
      state; it was concluded that all the components of the decay are affected by the
      quencher, i.e. the aggregate has a very open structure with respect to the iodide
      ion. The partition constants of the polyene, Kp, between a model system of
      membranes (small unilamellar vesicles of dipalmitoylglycerophosphocholine) and
      the aqueous phase were determined from anisotropy measurements; the values
      obtained were Kp (gel phase) = (3.4 +/- 0.8) x 10(3) and Kp (liquid crystal
      phase) = (7.7 +/- 2.2) x 10(2). The observation that the polyene incorporation is
      efficient is at variance with the belief that the presence of sterols are
      essential for the interaction of polyene antibiotics with membranes [for review
      see Bolard, J. (1986) Biochim. Biophys. Acta 864, 257-304].

PMID- 1628645
TI  - Isolation and characterization of a novel type of growth factor derived from
      serum-free conditioned medium of chicken embryo fibroblasts.
AB  - A strong mitogenic activity for fibroblastic cells has been found in serum-free
      medium of growth-arrested primary cultures of chicken embryo fibroblasts (CEF).
      This serum-free conditioned medium promoted growth of NIH/3T3 cells and primary
      as well as secondary cultures of CEF. The mitogenic activity was as potent as 5%
      serum. Half-maximum stimulation was obtained with 20% of the initial
      concentration of the conditioned medium. The activity eluted at high M(r) (1-2 x
      10(5)) from a gel-filtration column under nondenaturing conditions and was
      trypsin insensitive and thiol insensitive. Treatment with acid or urea converted
      the mitogen to a low-molecular-mass form, which showed a delayed induction of DNA
      synthesis. Purification of this factor (10000-fold) to apparent homogeneity was
      achieved by preparative isoelectric focusing, gel filtration, reverse-phase HPLC
      and nonreducing SDS/PAGE. The factor, termed CEF-derived growth factor (CDGF) was
      a 32-kDa, disulfide-linked heterodimer of a 15-kDa and a 17-kDa subunit as judged
      by SDS/PAGE, with a pI of approximately 7 in 8 M urea. It exhibited partial
      stability towards heat treatment and was trypsin sensitive. CDGF was active only
      in its dimeric form and half-maximum stimulation of NIH/3T3 cells was obtained at
      approximately 10 pM. The mitogenic activity was not suppressible by an antibody
      neutralizing the activity of transforming growth factor beta 1, 2 and 3 (TGF
      beta). The physico-chemical properties suggest that CDGF is not identical with
      one of the common growth factors like fibroblast growth factor, platelet-derived
      growth factor, epidermal growth factor, insulin-like growth factor, or TGF-beta
      but rather represents a novel type of growth factor.

PMID- 1628646
TI  - Futile cycling of glycogen in Fibrobacter succinogenes as shown by in situ 1H-NMR
      and 13C-NMR investigation.
AB  - Glycogen was synthesized during all the growth phases in the rumen anaerobic
      cellulolytic bacterium Fibrobacter succinogenes. Glycogen synthesis and
      degradation were monitored using in situ 13C and 1H-NMR spectroscopy in resting
      cells of F. succinogenes. The cells were incubated at 37 degrees C under
      anaerobic conditions with [1-13C]glucose and [2-13C]glucose. 1H-NMR spectra were
      used to quantify enrichment by 13C of metabolism products. Glucose was utilized
      for energy requirements of the bacterium, essentially via the Embden-Meyerhof
      pathway, leading to the synthesis of succinate and acetate, while glycogen was
      stored. From [1-13C]glucose, labeling occurred on C2 of succinate and acetate,
      and on both C1 and C6 of glycogen, the labeling on C1 being predominant. The C6
      labeling of glycogen may be explained by scrambling and reversal of the
      glycolytic pathway at the triose-phosphate and fructose 1,6-bisphosphate level.
      When the bacteria were incubated first with [1-13C]glucose, then washed and
      incubated with [2-13C]glucose, the pattern of 13C labeling in the products of the
      metabolism, as shown by 13C and 1H-NMR spectra, indicated that glycogen was
      degraded at the same time as it was being stored, suggesting futile cycling of
      glycogen. The hydrolysis of previously stored glycogen can provide, in the
      presence of glucose, up to 30% of the carbon source for the bacteria.

PMID- 1628647
TI  - Distinct forms of human CDC2 identified by novel monoclonal antibodies.
AB  - Studies on the functional and structural properties of the cdc2 kinase, a key
      cell-cycle regulator, have been possible thanks to the availability of cdc2
      specific immunoreagents. In an attempt to elucidate the biochemical regulation of
      the cdc2 kinase in more detail, we have raised a series of novel mouse monoclonal
      antibodies against human recombinant cdc2 protein. The five Mab reported here can
      be subclassified into two groups according to their interspecies cross-reactivity
      and distinct immunoprecipitation patterns. Thus, the target epitopes of Mab POH
      1, POH-2 and POH-7 (group 1) appear to be limited to a few mammalian species and
      the fraction of cdc2 immunoprecipitable by these Mab from cellular extracts is
      considerably enhanced by denaturation. In contrast, the POH-3 and POH-8 (group 2)
      Mab recognize a denaturation-sensitive epitope on cdc2 which is present in all
      tested mammalian species. More importantly, each of the two groups of Mab
      immunoprecipitate forms of cdc2 associated with a characteristic set of cellular
      proteins, none of which appears to be cyclin A or cyclin B. None of the
      antibodies precipitated a histone-H1 or casein-kinase activity, although an
      activity which phosphorylated some of the coprecipitated proteins was
      coprecipitated with the group 2 Mab. These novel Mab did not interfere with the
      association of cdc2 with cyclin A in vitro and efficient immunoprecipitation of a
      panel of cdc2 mutant proteins suggests that the target epitopes may not involve
      amino acid residues essential for currently known cdc2 functions. The results of
      the present study provide evidence for the existence of additional forms of the
      cdc2 protein in exponentially growing human cells, distinct from both the
      monomeric and the cyclin-bound cdc2 identified so far.

PMID- 1628648
TI  - Spectral characteristics of cadmium-containing phytochelatin complexes isolated
      from Schizosaccharomyces pombe.
AB  - Phytochelatins, heavy-metal-containing peptides with structures (gamma EC)nG,
      where n = 2-8, have been isolated from higher plants and the fission yeast
      Schizosaccharomyces pombe. The present work describes the isolation and
      characterization of several naturally occurring mixed complexes of these peptides
      from S. pombe exposed to 1 mM CdCl2. A lower-molecular-mass fraction from
      Sephadex G-50 chromatography yielded three distinct species on further
      fractionation. HPLC chromatography revealed the presence of peptides with n = 1-4
      in varying amounts in these three complexes, referred to as complexes I, II and
      III. Stoichiometries are proposed for these complexes, based on [Cd], [SH], [S2-]
      and the amino acid content. Ultraviolet absorption and magnetic circular
      dichroism spectra of complexes II and III are similar, whereas the CD spectra of
      these two complexes are strikingly different. Compared to both complexes II and
      III, the CD bands of complex I are relatively weak. Ultraviolet absorption, CD
      and magnetic circular dichroism spectra provide a basis for the discussion of
      structural differences in these complexes.

PMID- 1628650
TI  - The multimeric structure and disulfide-bonding pattern of bovine kappa-casein.
AB  - Bovine kappa-casein was analyzed by SDS/PAGE, MS and amino acid sequence analysis
      in order to determine its multimeric composition and disulfide-bonding pattern.
      SDS/PAGE revealed that kappa-casein in the native state can range in size from a
      monomer to a multimeric structure larger than a decamer. Three types of
      interchain disulfide linkage, Cys11-Cys11, Cys11-Cys88 and Cys88-Cys88, were all
      assigned in multimers purified from [14C]carboxymethylated and untreated bulk
      milk, as well as a milk sample from a kappa-casein-variant-B homozygote Co20.
      These results indicate that multimerization occurs in a random or at present
      unpredictable disulfide-bonding pattern regardless of the size of the multimer or
      the genotype.

PMID- 1628649
TI  - Generation of specific antibodies against the rap1A, rap1B and rap2 small GTP
      binding proteins. Analysis of rap and ras proteins in membranes from mammalian
      cells.
AB  - Specific antibodies against rap1A and rap1B small GTP-binding proteins were
      generated by immunization of rabbits with peptides derived from the C-terminus of
      the processed proteins. Immunoblot analysis of membranes from several mammalian
      cell lines and human thrombocytes with affinity-purified antibodies against rap1A
      or rap1B demonstrated the presence of multiple immunoreactive proteins in the 22
      23 kDa range, although at strongly varying levels. Whereas both proteins were
      present in substantial amounts in membranes from myelocytic HL-60, K-562 and HEL
      cells, they were hardly detectable in membranes from lymphoma U-937 and S49.1 cyc
      cells. Membranes from human thrombocytes and 3T3-Swiss Albino fibroblasts showed
      strong rap1B immunoreactivity, whereas rap1A protein was present in much lower
      amounts. In the cytosol of HL-60 cells, only small amounts of rap1A and rap1B
      proteins were detected, unless the cells were treated with lovastatin, an
      inhibitor of hydroxymethylglutaryl-coenzyme A reductase, suggesting that both
      proteins are isoprenylated. By comparison with recombinant proteins, the ratio of
      rap1A/ras proteins in membranes from HL-60 cells was estimated to be about 4:1.
      An antiserum directed against the C-terminus of rap2 reacted strongly with
      recombinant rap2, but not with membranes from tested mammalian cells. In
      conclusion, rap1A and rap1B proteins are distributed differentially among
      membranes from various mammalian cell types and are isoprenylated in HL-60 cells.

PMID- 1628651
TI  - The kidney as a novel target tissue for protein adduct formation associated with
      metabolism of halothane and the candidate chlorofluorocarbon replacement 2,2
      dichloro-1,1,1-trifluoroethane.
AB  - Hydrochlorofluorocarbons (HCFCs) have been identified as chemical replacements of
      the widely used chlorofluorocarbons (CFCs) that are implicated in stratospheric
      ozone depletion. Many HCFCs are structural analogues of the anesthetic agent
      halothane and may follow a common pathway of biotransformation and formation of
      adducts to protein-centered and other cellular nucleophiles. Exposure of rats to
      a single dose of halothane (2-bromo-2-chloro-1,1,1-trifluoroethane) or of the
      candidate CFC substitute HCFC 123 (2,2-dichloro-1,1,1-trifluoroethane) led to the
      formation of trifluoroacetylated protein adducts (CF3CO-proteins) not only in the
      liver, but also in the kidney as a novel target tissue for protein
      trifluoroacetylation. CF3CO-proteins in the kidney amounted to about 5% of those
      formed in the liver of the same animal. The amount of CF3CO-proteins formed
      within the kidney was roughly reflected by the capacity of metabolism of
      halothane or HCFC 123 by rat kidney microsomes in vitro which amounted to about
      10% of that observed with liver microsomes. By immunohistochemistry, CF3CO
      proteins in the kidney were mainly localized in the tubular segments of the
      cortex. In the liver, the density of CF3CO-proteins decreased from the central
      vein towards the portal triad. In vitro incubation of rat liver microsomes with
      halothane or HCFC 123 resulted in extensive formation of CF3CO-proteins and
      reproduced faithfully the pattern of liver CF3CO-proteins obtained in vivo. CF3CO
      proteins generated in vitro were immunochemically not discernible from those
      generated in vivo. Glutathione (5 mM) and cysteine (5 mM) virtually abolished
      CF3CO-protein formation; the release of Br- from halothane and Cl- from HCFC 123
      was reduced to much lesser a degree. S-Methyl-glutathione, N-acetyl-cysteine,
      methionine, and N-acetyl-methionine only slightly affected the formation of CF3CO
      proteins or metabolism of either substrate. The data suggest that metabolism and
      concomitant CF3CO-protein formation of halothane or of candidate CFC replacements
      like HCFC 123 is not restricted to the liver but also takes place in the kidney.
      Furthermore, an in vitro system for CF3CO-protein formation has been developed
      and used to show that protein-centered and glutathione-centered nucleophilic
      sites compete for intermediates of metabolism of halothane or of HCFC 123.

PMID- 1628652
TI  - Molecular cloning, sequencing and restriction mapping of the genomic sequence
      encoding human proacrosin.
AB  - In the present study, molecular cloning, sequencing and restriction mapping of
      the genomic sequence encoding human proacrosin is described. The full-length cDNA
      encoding human proacrosin was utilized to recover a 17-kb human genomic clone
      which was sequenced without further subcloning. The nucleotide sequences of the
      exons agree with the sequence of the cDNA reported previously. More than 500
      bases of the promoter region were sequenced and found to be highly GC rich but
      devoid of an identifiable TATA box. These findings are generally consistent with
      a recently published report [Keime, S., Adham, I. M. & Engel, W. (1990) Eur. J.
      Biochem. 190, 195-200]. However, further sequence analysis revealed discrepancies
      between our clone and that previously reported. Sequencing of the first intron
      showed similarity with the published data for 54 bases of the 5' region,
      beginning with the donor splice site, and for 114 bases at the 3' end. However,
      500 bases sequenced distal to the initial 54 bases at the 5' end of intron 1
      showed no similarity with the published sequence. In addition, the boundaries of
      intron 3 differed such that a cytosine residue previously reported to be in exon
      3 was found to be the first base of exon 4. Detailed studies were undertaken to
      confirm that our clone constitutes the authentic sequence of human proacrosin.
      Cloning and characterization of the human proacrosin gene may allow for
      informative studies of its regulation, and for a more detailed examination of its
      role in fertilization.

PMID- 1628653
TI  - Autoactivation of proteinase A initiates activation of yeast vacuolar zymogens.
AB  - The Saccharomyces cerevisiae PEP4 gene encodes proteinase A, an aspartyl
      protease. pep4 mutants are defective in the activation of many vacuolar
      hydrolases, including proteinase B. We have expressed a pep4 mutation which
      directs the accumulation of pro-proteinase A with a defective active site. Co
      expression with PEP4 leads to normal processing, i.e. the mutant zymogen is
      functional as a substrate for the maturation reaction in trans. We conclude that
      wild-type pro-proteinase A has the ability to mediate its own activation.
      Elimination of the co-expressed PEP4 gene did not effectively stop the processing
      of the mutant zymogen, owing to a strong, proteinase-B-dependent, phenotypic lag.
      In a proteinase-B-negative strain, processing of pro-proteinase A led to an
      active form of a higher molecular mass than the normal mature form.

PMID- 1628654
TI  - Characterisation of yeast phosphoglycerate kinase modified by mutagenesis at
      residue 21.
AB  - Site-directed mutagenesis has been used to produce mutant forms of yeast
      phosphoglycerate kinase in which the conserved active-site residue, Arg21, has
      been replaced by a methionine or a lysine. Kinetic results obtained using these
      mutant enzymes show that their Km for both 3-phospho-D-glycerate and ATP are
      significantly different from those recorded for the wild-type enzyme. The Vmax
      for the lysine mutant is reduced by a factor of two from that of the wild-type
      enzyme whereas the Vmax for the methionine mutant is reduced more than sevenfold.
      A very clean electron-density-difference map shows little, if any, evidence of a
      structural change associated with the C-terminal domain, although resonances in
      the NMR spectra associated with the ATP-binding site (C-terminal domain) are also
      affected by the mutation as one might expect from the kinetic results. The NMR
      data show that binding at both the 3-phospho-D-glycerate and the non-productive
      ATP-binding site (associated with the N-terminal domain) are affected in the
      mutant in a way which is different to that associated with the wild-type enzyme.
      These results, taken together with the X-ray and kinetic data, indicate that the
      non-productive ATP-binding site and the activating anion-binding site are both
      associated with the basic patch region of yeast phosphoglycerate kinase.

PMID- 1628655
TI  - Transcriptional activation of human (2'-5')oligoadenylate synthetase gene
      expression by the phorbol ester 12-O-tetradecanoyl-phorbol 13-acetate in type-I
      interferon-treated HL-60 and HeLa cells.
AB  - (2'-5')Oligoadenylate [(2'-5')(A)n] synthetase is a key enzyme in the interferon
      elicited antiviral response whose controlled expression in interferon-treated
      cells has been only partially elucidated. In this investigation, we have compared
      the modulation of the (2'-5')(A)n synthetase gene by interferon alone and by the
      combination of interferon and a second cellular effector, 12-O-tetradecanoyl
      phorbol 13-acetate (TPA). Although TPA alone had no effect on (2'-5')(A)n
      synthetase, it potentiated the induction of (2'-5')(A)n of synthetase by
      interferon in HL-60 and HeLa cells by increasing content of its mRNA and an
      immunoreactive 40-kDa isoenzyme. Since TPA activates protein kinase C (PKC),
      other PKC-activating phorbol-ester analogues were tested and found to be
      effective, whereas the PKC inhibitor staurosporine reduced the potentiative
      activity of TPA. By using the (2'-5')(A)n synthetase gene promoter linked to a
      reporter gene, chloramphenicol acetyltransferase (CAT), TPA and interferon were
      found to result in a doubling of CAT activity compared to cells treated with
      interferon alone. Moreover, when nuclear extracts prepared from control cells or
      cells treated with TPA and interferon (IFN), separately or together, were
      incubated with radioactively labeled oligodeoxynucleotides containing the
      interferon-responsive element (IRE), TPA was shown to down-regulate an IFN
      inducible IRE/protein complex. These data further suggest that TPA regulates (2'
      5')(A)n synthetase gene expression at the level of transcription.

PMID- 1628656
TI  - CD4 gene transcription is transiently repressed during differentiation of myeloid
      cells to macrophage-like cells.
AB  - The CD4 glycoprotein, which serves as receptor for human immunodeficiency virus
      (HIV), is expressed in several types of cells of hematopoietic origin, including
      T lymphocytes and monocytes. Triggering differentiation of peripheral blood
      monocytes, monocytic U-937 or promyelocytic HL-60 precursor cells to macrophage
      like cells by phorbol ester treatment transiently induced both a rapid reduction
      in surface CD4, demonstrated by flow-cytometry analysis, and a gradual loss of
      CD4 mRNA, revealed by Northern-blot analysis. Experiments in HL-60 cells to
      determine the cause of the observed decay in CD4 mRNA levels suggested that the
      half-life of CD4 transcripts did not diminish but increased after phorbol ester
      stimulation. Direct measurement of CD4 gene transcription by run-on analysis
      indicated that the rate of synthesis of new CD4 mRNA molecules was reduced
      approximately 10-fold after phorbol ester stimulation, whereas the rate of
      synthesis of c-fos mRNA resulted in a 2.5-fold increase. These data suggest that
      phorbol ester treatment specifically reduces CD4 mRNA levels by repressing CD4
      gene transcription. These findings may be relevant to understand the regulation
      of CD4 gene expression during differentiation.

PMID- 1628657
TI  - Evidence for a sialosyl cation transition-state complex in the reaction of
      sialidase from influenza virus.
AB  - The enzyme mechanism of sialidase from influenza virus has been investigated by
      kinetic isotope methods, NMR, and a molecular dynamics simulation of the enzyme
      substrate complex. Comparison of the reaction rates obtained with the synthetic
      substrate 4-methylumbelliferyl-N-acetyl-alpha-D-neuraminic acid and the [3,3-2H]
      substituted substrate revealed beta-deuterium isotope effects for V/Km ranging
      over 1.09-1.15 in the pH range 6.0-9.5, whereas the effects observed for V in
      this pH range increased from 0.979 to 1.07. In D2O, beta DV/Km was slightly
      increased by 2% and 5% at pD 6.0 and 9.5 respectively, while beta DV was
      unchanged. Solvent isotope effects of 1.74 were obtained for both beta DV/Km and
      beta DV at pD 9.5, with beta DV/Km decreasing and beta DV remaining constant at
      acidic pD. 1H-NMR experiments confirmed that the initial product of the reaction
      is the alpha-anomer of N-acetyl-D-neuraminic acid. Molecular dynamics studies
      identified a water molecule in the crystal structure of the sialidase-N-acetyl-D
      neuraminic acid complex which is hydrogen-bonded to Asp151 and is available to
      act as a proton donor source in the enzyme reaction. The results of this study
      lead us to propose a mechanism for the solvent-mediated hydrolysis of substrate
      by sialidase that requires the formation of an endocyclic sialosyl cation
      transition-state intermediate.

PMID- 1628658
TI  - Characterisation of a thermostable alpha-amylase from Bacillus brevis.
AB  - Biochemical characterization of a novel heat-stable alpha-amylase, produced by a
      thermophilic strain of Bacillus brevis, has been made. The pattern of the enzyme
      action on different substrates was studied. It was found that reducing groups
      were rapidly liberated from amylopectin, soluble and insoluble starch compared to
      amylose and glycogen. B. brevis alpha-amylase acted via endo-attack producing
      mainly maltopentaose during the first hour of hydrolysis. The enzyme showed high
      activity towards maltohexaose and maltoheptaose. The alpha-amylase from B. brevis
      had a neutral pI and was found to be a glycoprotein, containing 9.2% (by mass)
      neutral sugars. The enzyme protein possessed a unique high glycine content.
      Calcium or sodium ions in appropriate concentrations were required for enzyme
      thermostability.

PMID- 1628659
TI  - Metabolism of inositol phosphates in the protozoan Paramecium. Characterization
      of a novel inositol-hexakisphosphate-dephosphorylating enzyme.
AB  - Basal and stimulated levels of inositol phosphates were determined in the
      protozoan Paramecium labelled with myo-[3H]inositol. Under resting conditions,
      intracellular InsP6 (phytic acid), InsP5 and InsP4 concentrations were 140, 10
      and 2 microM, respectively. InsP5 was comprised of 56% Ins(1,2,3,4,5)P5 and/or
      Ins(1,2,3,5,6)P5, 40% Ins(1,2,4,5,6)P5 and/or Ins(2,3,4,5,6)P5 and small amounts
      of Ins(1,3,4,5,6)P5 and Ins(1,2,3,4,6)P5. InsP4 was mainly Ins(1, 4, 5, 6)P4
      and/or Ins(3, 4, 5, 6)P4. Other inositol phosphates were not detected at a
      detection limit of 50-85 nM. Using various depolarizing and hyperpolarizing
      stimuli, no significant changes in level of inositol phosphates were observed in
      vivo, indicating that in the ciliate a contribution of inositol phosphates to
      signal-transduction mechanisms is unlikely. In homogenates prepared from myo
      [3H]inositol-labelled cells, a marked relative increase in InsP3 and InsP4 over
      the concentrations in vivo was observed. These inositol phosphates were
      identified as degradation products of endogenous InsP6. A novel separation
      methodology for inositol phosphates was established to allow unequivocal
      assignment of phosphate locations of all dephosphorylated InsP6-derived products.
      The dephosphorylation was catalyzed by a phytase-like enzyme with a molecular
      mass of 240 kDa, most likely of a hexameric structure. The enzyme had a pH
      optimum of 7.0 and did not require divalent cations for activity. Substrate
      concentrations above 300 microM were inhibitory. Dephosphorylation of InsP6 by
      the Paramecium enzyme differs from that of phytases from plants in that it
      proceeds via a sequential release of phosphate groups from positions 6, 5, 4 and
      3 of the myo-inositol ring or/and positions 4, 5, 6 and 1.

PMID- 1628660
TI  - Inhibition of the acidification of endosomes and lysosomes by the antibiotic
      concanamycin B in macrophage J774.
AB  - The antibiotic concanamycin B was found to inhibit oxidized-low-density
      lipoprotein(LDL)-induced accumulation of lipid droplets in the macrophage J774 at
      a concentration of 5-10 nM. Concanamycin B inhibited cholesteryl-ester synthesis
      from [14C]oleate by 50% at 14 nM without affecting the synthesis of
      triacylglycerol and polar lipids. Degradation of internalized oxidized 125I-LDL
      was inhibited by about 80% in cells treated with 25 nM concanamycin B, while cell
      surface binding of oxidized 125I-LDL at 4 degrees C, uptake of surface-bound
      oxidized 125I-LDL and microsomal acyl-CoA:cholesterol acyltransferase activity
      were not significantly affected by the antibiotic at 25 nM. When J774 cells were
      treated with 25 nM concanamycin B at 37 degrees C for 60 min, there was a
      reduction of about 50% in the activity of cell-surface receptors. This reduction
      appeared to be due to partial trapping of the receptors within the cells.
      Concanamycin B significantly inhibited ATP-dependent acidification of endosomes
      and lysosomes of the J774 cells at a concentration of 4 nM. Since acidic
      condition of these organelles is required for receptor recycling and hydrolysis
      of lipoproteins, the results demonstrate that concanamycin-B inhibition of
      oxidized-LDL-induced accumulation of lipid droplets and cholesteryl esters in
      macrophages J774 is associated with reduced ATP-dependent acidification of these
      organelles.

PMID- 1628661
TI  - Periodic properties of proton conformational shifts in isolated protein helices.
      An experimental study.
AB  - In this work, the helix-forming residues in fragments of several proteins
      (ribonuclease, thermolysin, tendamistat and angiogenin) were identified by NOE
      and the helix proton shifts were measured as delta changes associated with helix
      population increments driven by trifluoroethanol addition. When estimated in this
      way, a regular pattern of helix conformational shifts was clearly seen in the
      delta delta versus sequence profiles of all the peptides studied. The helix
      periodicity of the H alpha and H beta resonances was especially clear, an
      observation that earlier statistical studies of protein delta values failed to
      predict. Amide protons showed the largest helix shifts, but with a less-sharply
      defined periodic character. Aromatic residues considerably distorted the
      periodicity of the helix amide shifts in some peptides, as evidenced by the delta
      shifts of a RNase A fragment 1-15 analog in which the two aromatic residues were
      replaced by Ala. The relationship between helix periodicity and peptide
      amphiphatic character is discussed.

PMID- 1628662
TI  - The cholesterol-side-chain-cleaving cytochrome P450 spin-state equilibrium. 1.
      Thermodynamic analysis.
AB  - We have investigated the spin-state equilibrium of adrenal mitochondrial P450scc
      (cholesterol-side-chain-cleaving, CYP11A1) by absorption spectroscopy in the
      Soret band as a function of pH and temperature. The van't Hoff plot of the high
      spin/low-spin equilibrium is not linear and is shifted towards high spin by
      lowering the pH. This non-linearity resolves clearly into two phases when the
      temperature range is extended from 37 degrees C to -20 degrees C using ethylene
      glycol as anti-freeze cosolvent. This enabled us to measure the enthalpy and
      entropy changes which are delta HA = 0.7 kJ.mol-1 and delta SA = 5J.K-1.mol-1 at
      low temperatures and delta HB = -42 kJ.mol-1 and delta SB = -152 J.K-1.mol-1 at
      high temperatures. The transition temperature, Tbreak, between both phases
      decreases as a function of pH. The experimental data can be fitted by a minimal
      reactional model comprising a temperature dependent conformational transition and
      two ionisation steps (one for each conformation), the pK of which is 1.5 +/- 0.5
      higher in the low-temperature conformation. The deduced conformational
      equilibrium is affected by physiological effectors: Tbreak depends on the nature
      of the substrate intermediate and on the presence of the physiological electron
      donor, adrenodoxin.

PMID- 1628663
TI  - The cholesterol-side-chain-cleaving cytochrome P450 spin-state equilibrium. 2.
      Conformational analysis.
AB  - We have confirmed and characterised structurally the enzyme conformational
      changes deduced from the preceding thermodynamic analysis of the adrenal
      mitochondrial cholesterol-side-chain-cleaving cytochrome P450 spin-state
      equilibrium. The spin-transition kinetics following rapid pH jumps were
      multiphasic in aqueous buffer and biphasic in the presence of 35% ethylene
      glycol. The activation energy between -2 degrees C and 30 degrees C of both
      phases was exceptionally high (Ea = 147 kJ.mol-1), suggesting the involvement of
      large-scale conformational changes. The pH and temperature effects on the CD
      spectrum show that the enzyme is in equilibrium between at least two
      conformations which are predicted by the thermodynamic model, but which are not
      directly correlated to the spin state. The CD changes between 260 nm and 280 nm
      indicate that the conformation prevailing at high temperatures is characterised
      by a decreased polarity of the tyrosine environments; the changes between 200 nm
      and 250 nm suggest furthermore a 4% decreased protein helical content.

PMID- 1628664
TI  - Purification and characterization of a novel thermostable 4-alpha
      glucanotransferase of Thermotoga maritima cloned in Escherichia coli.
AB  - Maltodextrin glycosyltransferase (4-alpha-glucanotransferase) of the extremely
      thermophilic ancestral bacterium Thermotoga maritima has been purified from an
      Escherichia coli clone expressing the corresponding T. maritima MSB8 chromosomal
      gene. T. maritima 4-alpha-glucanotransferase, an approximately 53-kDa monomeric
      enzyme, is the most thermophilic glycosyltransferase described to date. It
      retained more than 90% of its maximum activity at temperatures from 55 degrees C
      up to 80 degrees C. The proposed action modus is the transfer of 1,4-alpha
      glucanosyl chains, thus resulting in the disproportionation of 1,4-alpha-glucans.
      It converted soluble starch, amylopectin, and amylose, thereby changing the
      iodine staining properties of these substrates. The addition of low-molecular
      mass malto-oligosaccharides, which act as glucanosyl acceptor molecules, enhanced
      the reaction and resulted in the formation of a series of linear maltohomologues
      from two to more than nine glucose units in size. Use of either of the malto
      oligosaccharides maltotetraose, maltopentaose, maltohexaose, or maltoheptaose as
      sole substrate also yielded linear maltohomologues. On the other hand, maltose
      and maltotriose were not disproportionated by 4-alpha-glucanotransferase,
      although both were good acceptors for glucanosyl transfer. Glucose did not
      function as an acceptor in transfer reactions. Glucose also never appeared as a
      reaction product. The chain length of glucanosyl segments transferred ranged from
      two to probably far more than six glucose residues. Comparison of the N-terminal
      amino acid sequence of 4-alpha-glucanotransferase with other published protein
      sequences revealed significant similarity to sequences near the N-termini of
      various eucaryotic maltases and bacterial cyclodextrin glycosyltransferases,
      suggesting its relatedness on the molecular level with other starch- and
      maltodextrin-converting enzymes.

PMID- 1628665
TI  - Site-directed mutagenesis of the Streptomyces R61 DD-peptidase. Catalytic
      function of the conserved residues around the active site and a comparison with
      class-A and class-C beta-lactamases.
AB  - The importance of various residues in the Streptomyces R61 penicillin-sensitive
      DD-peptidase has been assessed by site-directed mutagenesis. The replacement of
      the active Ser62 by a Cys residue yielded an inactive protein which was also
      unable to recognize penicillin. The activity of the Lys65----Arg mutant with the
      peptide and thiolester substrates was decreased 100-200-fold and the rate of
      penicillin inactivation was decreased 20,000-fold or more. The mutant thus
      behaved as a poor, but penicillin-resistant, DD-peptidase. The other studied
      mutations, the mutations Phe58----Leu, Tyr90----Asn, Thr101----Asn, Phe164---
      Ala, Asp225----Glu and Asp225----Asn had little influence on the catalytic and
      penicillin-binding properties. The Asp225 mutants did not exhibit an increased
      sensitivity to cefotaxime. The Phe164----Ala mutant was significantly more
      unstable than the wild-type enzyme.

PMID- 1628666
TI  - Flow cytometric immunophenotyping: principles and pitfalls.
AB  - Within the last decade flow cytometry (FCM) has become an integral part of basic
      immunological research. Elaboration of this technology has been intensively
      stimulated by a rapidly growing sophistication in monoclonal antibody technology
      and vice versa. At present numerous applications are established that allow an
      increasingly detailed insight into the immune system, however, automation still
      must be considered the "cinderella of the arts". Thus, transition of this
      powerful approach from a basic to a routine clinical procedure is much more
      difficult than expected. Sufficient usage of flow cytometers still requires some
      knowledge of physics and its technical applications. Moreover, several problems
      arise from the complexity of the biological systems investigated. Here we give a
      brief introduction to immunofluorescence and FCM followed by a discussion of six
      exemplary pitfalls that we hope will emphasise the general importance of
      methodological considerations.

PMID- 1628668
TI  - Plasma endothelin concentration: relation with vascular resistance and comparison
      before and after balloon dilatation procedures.
AB  - Endothelin (ET) is a potent vasoconstrictor peptide with an as yet uncertain
      physiological role in cardiovascular disease. We measured blood plasma ET
      concentrations using a recently developed radioimmunoassay and analysed the
      relations between ET concentration, systemic arterial pressure and systemic
      vascular resistance. In addition, ET levels before and after percutaneous balloon
      valvuloplasty and angioplasty were measured. Fifty-one patients were studied: (1)
      13 patients with small left-to-right shunting or Kawasaki heart disease (age
      ranged from 4 to 144 months); (2) 10 patients who had undergone balloon
      valvuloplasty or angioplasty (age ranged from 1 to 233 months) and (3) 28 healthy
      infants and children (age ranged from 3 to 152 months). Systemic vascular
      resistance was calculated by the formula (mean aortic pressure--mean right atrial
      pressure) X 80/cardiac output (dyne.sec.cm-5). Plasma ET concentrations in
      healthy children less than 2 years were significantly higher than those over 2
      years (2.48 +/- 0.62 vs 1.31 +/- 0.53 pg/ml). In eight patients in groups 1 and
      2, plasma ET concentration in the pulmonary artery (2.00 +/- 0.43 pg/ml) was
      significantly lower than that in the femoral vein (2.39 +/- 0.69 pg/ml) and aorta
      (2.23 +/- 0.59 pg/ml), suggesting ET secretion derived from endothelial cells in
      peripheral pulmonary vessels. There was a significant positive correlation
      between ET concentrations in the femoral vein and systemic vascular resistance (r
      = 0.55, p less than 0.05). After balloon dilatation ET concentration rose from
      2.15 +/- 0.82 pg/ml to 2.61 +/- 1.38 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628669
TI  - Diabetes mellitus and exocrine pancreatic insufficiency in a girl with auto
      immune haemolysis.
AB  - A 7-year-old girl developed diabetes mellitus and exocrine pancreatic
      insufficiency after 3.5 years of almost continuous treatment with azathioprine
      and/or prednisone for idiopathic auto-immune haemolytic anaemia. Although both
      drugs have been reported to preserve endogenous insulin secretion and to
      interrupt the diabetogenic process they may be responsible for diabetes and
      exocrine pancreatic insufficiency in our patient.

PMID- 1628670
TI  - Hypothalamic failure as a sequela of heterozygous protein C deficiency?
AB  - Protein C deficiency can lead to cerebrovascular occlusive disease. We describe a
      patient in whom heterozygous protein C deficiency (type 1) is suspected on the
      grounds of reduced protein C activity and who suffered from multiple thrombo
      embolic events involving the brain and peripheral organs. The patient developed
      hypothalamic failure with hypernatraemia, hypodipsia, hypersomnolence and
      hyperkapnia, obesity, hyperprolactinaemia, hypogonadotropic hypogonadism and
      growth hormone deficiency. We hypothesize that protein C deficiency caused
      cerebrovascular occlusions which eventually led to hypothalamic insufficiency in
      this patient. Disorders of the anticoagulant system should be looked for in
      patients with unexplained hypothalamic disease.

PMID- 1628667
TI  - International classification of osteochondrodysplasias. The International Working
      Group on Constitutional Diseases of Bone.

PMID- 1628671
TI  - Association of rib anomalies and malignancy in childhood.
AB  - A relationship exists between tumours and malformations both generally and in
      particular combinations. This is also valid for minor errors of morphogenesis
      suggesting that embryonic tumours are an expression of aberrant intra-uterine
      morphogenesis. We speculated that these minor aberrations might also manifest in
      other morphological defects, especially in minor anomalies and malformations of
      the ribs. We reviewed chest roentgenographs of 1000 children with malignancies
      for rib anomalies and compared them to 200 patients with mainly infectious
      diseases. We found 242 rib anomalies in 218 children with tumours (21.8%) and 11
      (5.5%) in children without malignancy. This difference was statistically highly
      significant (P less than 0.001). A high incidence of cervical ribs was found in
      neuroblastoma (33%), brain tumour (27.4%), leukaemia (26.8%), soft tissue sarcoma
      (24.5%), Wilms tumour (23.5%) and Ewing sarcoma (17.1%). Only neuroblastoma
      showed a high incidence of rib bifurcation (4.5%). The increased incidence of
      these mesenchymal defects in children with malignancies may be another clue for
      an altered morphogenesis in tumour origin. In neuroblastoma the rib anomaly may
      be another expression of neurocristopathy as proposed for the association of
      congenital heart disease and neuroblastoma.

PMID- 1628672
TI  - Cold haemagglutinin disease complicating Mycoplasma pneumoniae infection in a
      child under cytotoxic cancer treatment.
AB  - Acute cold haemagglutinin disease, most commonly associated with underlying
      mycoplasma infection, is rare in children. A 3-year-old girl who developed this
      auto-immune disease under intensive cytotoxic treatment for rhabdomyosarcoma is
      presented. Clinically, a livedo reticularis skin pattern upon exposure to cold
      which was reversible at room temperature and a spontaneous red cell agglutination
      of blood samples in vitro led to the diagnosis. Together with bronchopneumonia
      the girl developed hyper-IgM, high antibody titres against Mycoplasma pneumoniae,
      as well as high titres of cold agglutinins. Laboratory signs of mild
      intravascular haemolysis were found. Positive direct antiglobulin test resulted
      from coating of red cells with C3d and C4. Three different antibodies were
      identified in serum: nonspecific cold agglutinins without complement activation,
      anti-I specific cold agglutinins with complement activation, as well as a weak
      biphasic Donath-Landsteiner haemolysin. Under antibiotic treatment and a short
      course of predisolone the clinical course was mild.

PMID- 1628674
TI  - Exomphalos, inguinal hernia, renal agenesis, skeletal dysplasia, heart disease--a
      "new" syndrome?
AB  - We report a growth retarded, male child with exomphalos, bilateral direct
      inguinal hernias, unilateral renal agenesis, congenital heart defect,
      costovertebral dysplasia, microcephaly, ventricular septal defect, and paroxysmal
      supraventricular tachycardia associated with Wolff-Parkinson-White syndrome. The
      natural history of that syndrome is poorly understood and provisional suggestion
      of a new syndrome will depend on further similar observations.

PMID- 1628673
TI  - Epidemiology of vertically transmitted HIV-1 infection in Switzerland: results of
      a nationwide prospective study. Swiss Neonatal HIV Study Group.
AB  - A nationwide study involving 286 children of human immunodeficiency virus (HIV)
      infected mothers living in Switzerland has been performed with the participation
      of all paediatricians interested in HIV infection in the country. Of these
      children 201 could be followed up prospectively from birth up to a median age of
      22 months. Prevalence of HIV infection in Swiss parturients was estimated at 0.1%
      and apparently remained stable from 1986 to 1989. Vertical transmission rate was
      estimated at 14%-20%. Variables of maternal or perinatal history were not
      associated with transmission rate. Transmission to pairs of siblings of the same
      mothers was discordant in 33% (6 of 18), with always the elder sibling being
      infected. Postneonatal mortality in infants of HIV-infected mothers followed up
      from birth was increased 15-fold over the general population with a very high
      incidence (2 in 100) of sudden infant death apparently unrelated to HIV
      infection.

PMID- 1628675
TI  - Nosocomial bacterial infections in very low birth weight infants.
AB  - The occurrence of congenital and nosocomial bacterial septicaemia has been
      documented by identifying the number of positive blood cultures by reviewing the
      laboratory and clinical records of 394 very low birth weight infants who were
      consecutively admitted to a neonatal intensive care unit over a 40-month period.
      The incidence of congenital septicaemia was 6% and of nosocomial septicaemia 17%.
      The commonest causes of congenital infection were Streptococcus agalactiae
      Staphylococcus epidermidis and Enterococcus faecalis (each in 18% of cases). The
      commonest cause of nosocomial infection was S. epidermidis (51% of cases), except
      in infants of birth weight less than 750 g. Risk factors for nosocomial infection
      were extremely low birth weight, very preterm birth and prolonged ventilation.
      Nosocomial infection was associated with significantly lengthened hospital
      admission.

PMID- 1628676
TI  - Longitudinal assessment of infant lung function following pregnancies complicated
      by prolonged and preterm rupture of the membranes.
AB  - Serial measurements of functional residual capacity (FRC) were made in 22 infants
      (median gestational age at delivery 32 weeks, range 25-40) during the first 2
      years of life. All infants had been delivered from pregnancies complicated by
      prolonged and preterm rupture of the membranes (PPROM) of at least 1 week in
      duration. The onset of membrane rupture was at a median of 26 weeks (range 15-32)
      with a median duration of 5.5 weeks (range 1-21). The mean FRC at all postnatal
      ages studied: 25 ml/kg at 6 and 12 months and 24 ml/kg at 18 and 24 months did
      not differ significantly from the control population (mean 24 ml/kg). There was,
      however, a wider scatter of results in the study population: four infants born
      very preterm consistently had FRC results above the 95% confidence limits of the
      controls but only two infants had FRCs consistently below this range. These
      results suggest PPROM may not be an invariable association of abnormal antenatal
      lung growth.

PMID- 1628677
TI  - The effects of mid-trimester amniocentesis on lung function in the neonatal
      period.
AB  - Lung function tests were carried out on 39 healthy full term babies born after
      pregnancies subjected to mid-trimester amniocentesis. The results were compared
      to 42 babies born after normal pregnancies. There were no significant differences
      in gestational age, birth weight, thoracic gas volume or crying vital capacity.
      Babies subjected to amniocentesis had a significantly lower dynamic compliance
      (6.96 ml/cm H2O vs. 8.60 ml/cm H2O) and tended to have higher resistance compared
      to controls (52.8 cm H2O/l/s vs. 37.3 cm H2O/l/s). This provides further evidence
      that mid-trimester amniocentesis does have an adverse effect on lung growth and
      development.

PMID- 1628678
TI  - Evaluation by colour Doppler and pulsed Doppler sonography of blood flow
      velocities in intracranial arteries during the early neonatal period.
AB  - Using a colour pulsed Doppler flow mapping system, we examined the intracranial
      arteries of 40 healthy infants. The anterior cerebral, basilar, intracranial
      internal carotid and middle cerebral arteries were visualized clearly enough to
      evaluate flow velocity at the success rates of 100%, 87.5%, 65% and 82.4%,
      respectively. In the anterior cerebral, intracranial internal carotid and middle
      cerebral arteries, the maximum blood flow velocity slightly decreased to a
      minimum at around 4-6 h after birth, and then gradually increased. The minimum
      blood flow velocity pattern was similar. The maximum blood flow velocity in the
      basilar artery decreased from 0-3 h, rapidly increased from 4-6 h, and remained
      at a steady level thereafter. A possible mechanism for the chronological changes
      in the intracranial blood flow velocity is discussed.

PMID- 1628679
TI  - Further evaluation of Vigabatrin therapy in 4-hydroxybutyric aciduria.

PMID- 1628680
TI  - Severe caffeine intoxication in a preterm neonate.

PMID- 1628681
TI  - VACTERL plus hydrocephalus: a monogenic lethal condition.

PMID- 1628682
TI  - Male triplets concordant for X-linked recessive nonsyndromic hypoparathyroidism.

PMID- 1628683
TI  - Longitudinal study and cost-benefit analysis of the effect of early treatment of
      posterior cross-bites in the primary dentition.
AB  - The aim of this study was to follow longitudinally a cohort of preschool children
      regarding the prevalence of lateral cross-bites and the effect of treatments
      carried out. Two-hundred-and-twenty-four children were examined when they were 3
      5 years old and re-examined at 13-15 years of age. Orthodontic treatment of
      lateral cross-bites was registered from annual dental records from the Public
      Dental Service. In the primary dentition, 23.3 per cent of the children showed
      lateral cross-bites, of whom 5.7 per cent showed a lateral edge-to-edge relation.
      Selective grinding was carried out in the Public Dental Service in 62 per cent of
      the cross-bite children. Correction was registered in 64 per cent of these cases.
      Nine (45 per cent) of the 20 children with untreated lateral deviation showed
      spontaneous correction. Of the 171 children without cross-bites in the primary
      dentition, 14 (8 per cent) developed cross-bites in the permanent dentition.
      Although the benefits of early treatment for the developing dentition are obvious
      for functional reasons, the effectiveness of grinding, the type of treatment and
      the timing can be discussed from a cost-benefit point of view.

PMID- 1628684
TI  - The PAR Index (Peer Assessment Rating): methods to determine outcome of
      orthodontic treatment in terms of improvement and standards.
AB  - In orthodontics it is important to objectively assess whether a worthwhile
      improvement has been achieved in terms of overall alignment and occlusion for an
      individual patient or the greater proportion of a practitioner's caseload. An
      objective measure is described that has been validated against the subjective
      opinions of 74 dentists. Using the weighted PAR Index it was revealed that at
      least a 30 per cent reduction in PAR score is required for a case to be
      considered as 'improved' and a change of 22 PAR points to bring about 'great
      improvement'. For a practitioner to demonstrate high standards the proportion of
      an individual's case load falling in the 'worse or no different' category should
      be negligible and the mean reduction should be as high as possible (e.g. greater
      than 70 per cent). If the mean percentage reduction in PAR score is high and the
      proportion of cases that have been 'greatly improved' is also high, this
      indicates that the practitioner is treating a great proportion of cases with a
      clear need for treatment to a high standard.

PMID- 1628685
TI  - Changes in mandibular mobility after different procedures of orthognathic
      surgery.
AB  - A prospective study including 63 adult Class II and Class III patients was
      carried out in order to examine short- and long-term effects of four different
      treatment methods on mandibular mobility. The patients were treated either (Group
      A, control-group) orthodontically alone or (Group B) by a LeFort I-osteotomy, a
      (Group C) mandibular advancement or (Group D) a two-jaw surgery/mandibular set
      back. In the surgery-groups (B, C, and D) maximum opening, protrusion and lateral
      excursions were measured 2 days pre-operatively (T0), and 3, 8, 14.5, and 25.5
      months post-operatively (T1-T4). In the control-group (A) at T0 and T4 was
      measured, only. Significantly differing effects of the four treatment methods on
      mandibular mobility were detected. (A) Orthodontic treatment alone, (B) maxillary
      advancement by LeFort I osteotomy, and (D) two-jaw surgery/mandibular set-back
      osteotomy did not influence mandibular mobility permanently. Temporary decreases
      in groups B and D (P less than or equal to 0.05) were observed, however. In
      contrast, permanent reductions after (C) mandibular advancement took place (P
      less than or equal to 0.001). Longitudinal survey showed that in all surgery
      groups recoveries were limited to a short period of 3-14.5 months, depending on
      the movement. Surprisingly, a closer similarity between the LeFort-I group (B)
      and the two-jaw surgery group (D), rather than between the sagittal-split groups
      (C and D), was seen indicating that the problem of reduced mobility after
      orthognathic surgery can be limited to Class II therapy. It was concluded that in
      Class III therapy, the application of rigid fixation in combination with a method
      of maintaining condyle-position, thereby dispensing with maxillomandibular
      fixation, prevents permanent reductions in mobility and guarantees a rapid
      recovery to pre-operative mobility levels.

PMID- 1628686
TI  - Stability of surgical correction of patients with Skeletal III and Skeletal II
      anterior open bite, with increased maxillary mandibular planes angle.
AB  - The surgical correction of eleven Class III patients and 10 Class II patients
      with a long face, increased maxillary mandibular planes angle and anterior open
      bite was undertaken using bimaxillary surgical procedures. Lateral skull
      radiographs were examined pre-operatively, 48 hours, and 1 year post-operatively,
      to quantify the amount and direction of surgical change achieved and the
      subsequent stability. There was no consistent pattern in the actual movements
      achieved in either group of patients in the maxillae or the mandibles. Some of
      the cases being impacted and continuing to impact, others impacting then
      relapsing. In the Class III patients some of the mandibular set backs remained
      stable others relapsing and some continuing to move posteriorly. However, despite
      these inconsistent patterns, there was a 7-degree reduction in the maxillary
      mandibular planes angle which relapsed by 1.7 degrees over the first year. The
      overbite was increased from -6 mm to +3.1 mm post-operatively and this relapsed
      at the 1 year stage to +2.4 mm. The overjet reduced from -4 to 1.7 mm and
      continued to improve to -0.9 mm at the 1-year stage. In the Class II patients
      some of the mandibular advancements remained stable others relapsing and some
      continuing to advance. However, despite these inconsistent patterns there was a 9
      degree reduction in the maxillary mandibular planes angle which reduced by a
      further degree at the 1 year stage. The overbite was increased from -4.6 to -1.6
      mm post-operatively and this remained stable at the 1 year stage.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1628687
TI  - Orthodontic and orthopaedic approach in the treatment of skeletal open bite.
AB  - The aim of this study was to make a detailed evaluation of the changes in the
      dentofacial structures that could be effective in the elimination of skeletal
      open bite. The study was performed on 32 skeletal open bite cases which were
      treated with Begg technique, Edgewise technique, and functional appliances and
      findings were analysed by multivariate statistical methods. Open bite was
      significantly reduced in all of the treatment groups. Apart from minor
      differences, similar changes were observed with Begg and Edgewise technique
      treatments. During fixed appliance therapy marked increases in the upper and
      lower posterior dentoalveolar height were observed, and the mandible rotated
      backwards. On the other hand, with the functional appliances vertical growth of
      the posterior upper and lower dentoalveolar region was depressed, and the
      mandible was rotated forwards and upwards with the centre at the premolars. These
      findings were confirmed by regression analysis: rotational changes in the
      maxillary and mandibular bases explained 46 per cent of variance of the reduction
      of open bite in the functional group, while 28 and 16 per cent of variance was
      explained in the Edgewise and Begg groups, respectively.

PMID- 1628688
TI  - The treatment of severe 'gummy' Class II division 1 malocclusion using the
      maxillary intrusion splint.
AB  - This paper describes a modified Maxillary Intrusion Splint (M.I.S.) system which
      incorporates a near vertical pull headgear, and its use in the management of
      severe 'gummy' Class II division 1 malocclusion. The appliance was designed to
      reduce the visibility and vulnerability of the maxillary incisors in this
      difficult clinical situation by achieving the intrusion of maxillary teeth,
      restraining maxillary growth, and encouraging an element of subsequent forward
      mandibular rotation. The authors' initial experience using this system is
      presented in a retrospective cephalometric analysis of the lateral skull films of
      26 treated patients contrasted with a similar number of comparable controls. The
      results showed that the principal effects of the M.I.S. were on the maxillary
      teeth giving decisive overjet control and incisor retraction with actual
      maxillary incisor intrusion. There was a similar effect on the maxillary molar
      and the M.I.S. provided effective en masse vertical control of the maxillary
      dentition. There was some degree of maxillary restraint in the M.I.S. group, but
      no noticeable difference in the change of mandibular position between the groups
      at the end of treatment. The possible reasons for this are discussed and
      suggestions made to improve this aspect of treatment in these patients.

PMID- 1628689
TI  - Further studies of the pressure from the tongue on the teeth in young adults.
AB  - The pressures from the tongue on the teeth were recorded simultaneously in four
      locations lingual to the upper and lower central incisors, and left first molars
      in 20 young adults with largely normal occlusion. Measurements in the rest
      position, and during chewing and swallowing were made with an extra-oral pressure
      transducer incorporated in a fluid-filled system with intra-oral mouthpieces. The
      size of the dental arches was determined from dental casts. The median pressures
      in the rest position were low and negative at the upper incisors. Negative
      pressures at rest were recorded in a few subjects at all four points of
      measurement, most frequently at the upper incisors and least frequently at the
      lower molar. The pressures during swallowing were 2-4 times greater than those
      during chewing. There were no significant correlations between the pressures
      found and those recorded in the same individuals at an examination 2 years
      earlier. Positive correlations were found between the pressures recorded in the
      four locations during the various functions. This was interpreted as being an
      effect of the size of the tongue. The relatively few correlations between the
      pressures and the parameters describing the dental arch size indicated an
      adaptive role of the tongue within the confines of the dental arches.

PMID- 1628690
TI  - A rationale for the selection of orthodontic wires.
AB  - A logical basis for the sequence of wires chosen during orthodontic treatment
      with fixed appliances is presented. This utilizes a new more realistic model for
      the radial deflection of a segment of the archwire in which the wire is
      restrained by the ligatures on the misaligned tooth, contacts the inner edges of
      the brackets either side, and is restrained by the outer ligatures on these
      brackets. The model, analysed using simple beam theory, allows the determination
      of the upper and lower bounds for the range of deflection over which orthodontic
      forces within the optimum range are produced without distortion for any given
      wire providing its flexural rigidity (EI) and yield stress in bending (sigma o)
      are known. The same model can be applied to vertical deflections. Some wire
      sequences recommended on clinical experience appear to conform to this more
      pragmatic approach, although to cater for even moderate misalignment the forces
      predicted by the model are higher than normally considered desirable.

PMID- 1628692
TI  - Immediate and dose-response related increase of biliary excretion of reverse
      triiodothyronine after propylthiouracil administration.
AB  - In a group of rats infused with L-thyroxine (0.13 micrograms T4 in 0.6 ml
      alkaline saline per hour) for 6 h to which an infusion of propylthiouracil (PTU)
      was added beginning from the 3rd hour (2 mg PTU in 0.6 ml saline per hour) a
      significant increase of biliary excretion of reverse triiodothyronine (rT3) was
      found. In another experiment a dose-response related rT3 excretion by bile was
      observed in groups of rats infused with 0.05, 0.10, 0.20 or 0.40 mg PTU in 1.2 ml
      alkaline saline per 2 h, all animals receiving a pulse dose of 1 micrograms rT3
      at the beginning of PTU infusion. It was concluded that the increase of rT3
      excretion results from the inhibition of 5'-deiodinase type I activity in the
      liver caused by PTU. It thus appears that such phenomenon may be used as in vivo
      marker of that enzyme activity.

PMID- 1628691
TI  - Pharmacokinetics of ethinylestradiol and levonorgestrel after administration of
      two oral contraceptive preparations.
AB  - Serum concentration profiles and pharmacokinetic parameters (cmax, tmax, AUC24,
      AUC0-00, MRT) of ethinylestradiol (EE2) and levonorgestrel (LNG) were obtained
      following administration of two combined oral contraceptives. The constituents of
      the preparations were as follows: Gravistat (0.05 mg EE2, 0.125 mg LNG);
      Minisiston (0.03 mg EE2, 0.125 mg LNG). In 20 of the volunteers blood samples
      were taken before and up to 36 hours following the intake of a single table. In
      11 women the investigation was carried out at day 21 of a treatment cycle (steady
      state condition). In spite of pronounced interindividual variations of the
      pharmacokinetic data, a clear dependency of EE2 concentration curves on the
      estrogen dose of the respective preparation could be demonstrated. Under the
      condition of steady-state (21st day of administration) there was a slight but
      significant rise of the EE2 peak serum concentrations and a pronounced increase
      of the LNG levels, closely reflected by elevation of the AUC values. SHBG serum
      concentration was significantly increased by the 10th day of treatment in all
      subjects receiving Gravistat, whereas the mean value in the Minisiston-group did
      not remarkably change. Although LNG is known to be bound to SHBG with high
      affinity, the missing parallelism between LNG- and SHBG-concentrations suggests
      other (additional?) mechanisms for the elevated LNG-binding capacity in women
      taking combined EE2-LNG preparations.

PMID- 1628693
TI  - Serum thyroglobulin level in patients with diffuse and nodular goiter, after
      therapeutic application of stable iodine.
AB  - This study analysed the changes in serum thyroglobulin levels in euthyroid female
      patients, suffering from diffuse and scintigraphically functional nodular goiter,
      after therapeutic administration of two preparations of stable iodine: dried
      bovine thyroid, containing 100 mcg of iodine in one dragee (Thyral, Yugoslav
      Pharmacopea) and synthetic Na-salt L-thyroxine (Vobenol, with 100 mcg of iodine,
      too), for relatively short time of following-up, 8 weeks only. Having in mind the
      key role of TSH in regulation, all aspects of thyroid gland function, the
      interrelationship between TSH and thyroglobulin concentrations in those patients
      were also investigated. Prior to the therapy females had elevated thyroglobulin
      serum concentrations, caused by existence of diffuse and nodular goiter, which
      reflected an increase in intraglandular turnover of thyroglobulin (192 +/- 140
      mcg/L in GROUP A further treated with Thyral and 121 +/- 14.80 +/- mcg/L in GROUP
      B, whose patients received Vobenol, mean +/- SD). Positive linear correlation
      between TSH and Tg levels was not established before therapy. Our data indicate
      that administration of two different preparations containing stable iodine in
      doses of 100 mcg every second day, during a two months period, resulted in
      significant decrease in the size of diffuse and nodular goiter, with diminished
      complains in a great number of patients. In thyroid humoral status, significant
      decrease of thyroglobulin concentrations was evident in both analysed groups (62
      +/- 48 mcg/L, and 60 +/- 66, respectively). Presented results confirmed positive
      linear correlation between TSH and thyroglobulin in serum samples, after therapy,
      especially strong in the group treated with dried bovine thyroid.

PMID- 1628694
TI  - Indirect effects of progesterone on the synthesis and secretion of prolactin in
      mammotroph-enriched cells.
AB  - To elucidate the role of steroid hormones in the synthesis and secretion of
      prolactin (PRL), a mammotroph-enriched cell preparation was made by centrifugal
      elutriation of trypsin-dispersed anterior pituitary cells from adult male rats.
      The mammotrophs were enriched by about 2-fold in comparison with those in the
      initial cell suspension. On the other hand, the ratio of enrichment of
      gonadotrophs, thyrotrophs and somatotrophs was less than onetenth. The separated
      mammotrophs were incubated in media containing 17 beta-estradiol and/or
      progesterone. 17 beta-estradiol increased the levels of PRL in the medium and the
      cells of 300% and 140%, respectively, and the content of messenger RNA (mRNA) to
      193%, whereas progesterone had no such effects. Furthermore, progesterone had no
      influence on the 17 beta-estradiol-induced increase in the levels of PRL and the
      contents of PRL mRNA. These results suggest that 17 beta-estradiol regulates PRL
      synthesis and secretion in mammotrophs, whereas progesterone does not.

PMID- 1628695
TI  - The effect of serum concentrations and sources on DNA synthesis and insulin
      secretion of cultured islets.
AB  - We investigated the effect of different sera, as newborn calf serum, fetal calf
      serum, rat serum and human serum at various concentrations on biofunctions of
      cultured pancreatic islets. Islets isolated from newborn LEW. 1 W rats were
      maintained at 37 degrees C in TCM 199 containing 10 mmol/l glucose and either 1%,
      10% or 50% newborn calf serum (NCS), fetal calf serum (FCS), serum obtained from
      adult syngeneic rats (RS) or different batches of human serum (HS). While
      exposure of islets to increasing concentrations of NCS significantly inhibited
      the islet DNA synthesis as well as the glucose stimulated insulin secretion after
      2, 4 and 8 days of culture, HS at different concentrations failed to inhibit
      both, the islet DNA synthesis and the secretory response to glucose at each time
      point investigated. The action of FCS, RS and 2 further batches of HS on islet
      DNA synthesis was analysed by short-term culture. The supplementation of the
      medium with 50% FCS and RS resulted in a marked decrease of H-thymidine
      incorporation into islet DNA similar to that observed with 50% NCS. In contrast,
      exposure of islets to different batches of HS never resulted in an inhibition of
      DNA synthesis. Moreover, the 50% concentration of HS 465 caused a significant
      stimulation of thymidine incorporation.

PMID- 1628696
TI  - The dynamics of beta-endorphin release by the hypothalamic nuclei and pituitary
      gland in sheep under physiological and stress condition.
AB  - The secretion of beta-endorphin (beta-End) by the infundibular nuclei--median
      eminence (IN-ME) and paraventricular nuclei (PVN) of the hypothalamus and the
      anterior lobe (AL) of the pituitary gland was determined in 18 anestrous ewes by
      RIA assay of this opioid in perfusates collected from these formations. Perfusion
      with Ringer-Locke solution was carried out on the animals under resting and
      stress-full conditions, using a pushpull cannula method. Electrical footshocks
      were used as stress stimuli. Two series of perfusion experiments were performed.
      In the first, the perfusions were carried out over two hours and perfusates were
      collected before and during stress for 1 h. In the second series of experiments
      the dynamics of the release of the opioid by the IN-ME and the pituitary gland
      were followed by collecting five or six perfusates in 20 min fractions before and
      during stress, respectively. The first series of experiments showed that the
      concentrations of beta-End in perfusates from the pituitary gland were much
      higher than those from the hypothalamic nuclei and that the concentrations of
      this opioid during stressing rose significantly only in perfusates from the IN-ME
      nuclei. In the second series of experiments the release of beta-End from the IN
      ME and pituitary gland was altered by stress. The shift was very characteristic
      in that the concentrations of the opioid during stimulation initially
      significantly rose and then gradually declined. The concentration of the opioid
      in the peripheral blood also rose at the beginning of stimulation and declined as
      stimulation continued.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628697
TI  - Altered monoamine metabolism in the hypothalamus of the genetically obese yellow
      (Ay/a) mouse.
AB  - Changes in hypothalamic monoamine metabolism were investigated in the genetically
      obese yellow (Ay/a) mouse. At the age of 6 weeks when there was no difference in
      body weight between black (a/a) and yellow (Ay/a) mice, the contents of
      norepinephrine (NE), dopamine (DA) and their main metabolites (MHPG, DOPAC) were
      already significantly reduced in yellow (Ay/a) mice. Reduction of 5
      hydroxytryptamine (5-HT) level and an increasing 5-HIAA/5-HT ratio has been
      observed. When a significant increase in body weight in the yellow (Ay/a) mouse
      at the age of 12 weeks was present, both NE and DA contents have been increased
      in the hypothalamus of the obese mouse. MHPG level was lower than in the lean
      mouse, resulting in an increase of MHPG/NE ratio. The present study suggests that
      the observed reduction in hypothalamic NE and DA metabolism might be involved in
      the development of overweight gain in the yellow (Ay/a) mouse.

PMID- 1628698
TI  - A delayed response to acute stimulation with human chorionic gonadotropin in
      scorbutic rats.
AB  - Since our previous study revealed low basal testosterone (T) levels and a failure
      in response to an acute stimulation with human chorionic gonadotropin (HCG)
      despite of a good response to chronic stimulation in scorbutic mutant rats, time
      course of the response to HCG was studied and plasma LH level was measured in
      young adult rats deficient in ascorbic acid for 3 weeks. A single subcutaneous
      injection of HCG (200 IU) elevated T levels only slightly in plasma and not in
      testicular tissues of scorbutic rats 1 h after the injection when the levels in
      ascorbutic rats reached a maximum, while it yielded the same response pattern as
      in ascorbutic rats after 3 h. A pretreatment with HCG to scorbutic rats for 1 or
      4 days resulted in the same response of plasma T as in ascorbutic rats. Plasma LH
      levels in unstimulated scorbutic rats were about 40% of those in ascorbutic rats.
      These findings indicate that a prolonged deficiency of ascorbic acid decreases
      plasma LH, and may reduce the sensitivity of testes to LH.

PMID- 1628699
TI  - Lack of stimulating effect on thyrotropic and lactotropic secretion during
      prolonged calcitriol administration.
AB  - The stimulating effect of calcitriol, administered in the dose of 3
      micrograms/day for four days, on the thyrotropic and lactotropic secretion has
      been proved in earlier studies in healthy humans. The present study was
      undertaken to confirm or eliminate the stimulatory action of the drug using
      increasing dosages of 0.75-1.50 micrograms/day for one month. In spite of the
      fact, that the biologically efficient levels of calcitriol were attained
      (confirmed indirectly by the rise of urinary calcium excretion, p less than
      0.01), the stimulating effect of calcitriol on the basal and TRH induced
      thyrotropic and lactotropic secretion has not been manifested. In conclusion, the
      clinical importance of stimulating effect of calcitriol on the thyrotropic and
      lactotropic secretion is neglected, if only commonly accepted therapeutic dosages
      up to 1.50 micrograms/day are used.

PMID- 1628700
TI  - Effect of phospholipase C induced hydrolysis of phospholipids on membrane-bound
      and water-soluble LH/hCG receptors in porcine corpora lutea.
AB  - The role of phospholipids in the function of LH/hCG receptors was studied in two
      receptor preparations: the membrane fraction of porcine corpora lutea (CL) and
      the water-soluble receptor in follicular fluid (LFF) which was characterized.
      Digestion of CL membranes with phospholipase C (PL-C) abolished, in a dose
      responsive manner, specific binding of [125I]hCG and decreased phospholipid
      concentrations in the membranes. This loss of LH/hCG receptors was prevented by o
      phenanthroline, an inhibitor of PL-C. A similar effect on membrane-bound
      receptors was observed when lipids were extracted with ethanol-diethylether. On
      the other hand, treatment of water-soluble receptors with PL-C or delipidation of
      LFF with Amberlit IRA 400 had no effect on [125I]hCG specific binding. These data
      suggest that phospholipids play an important role in the accessibility of
      membrane-bound receptors but are not involved in direct interaction of
      gonadotropin with binding sites.

PMID- 1628701
TI  - Proteins of urea-soluble high molecular weight (HMW) aggregates from diabetic
      cataract: identification of in vivo glycation sites.

PMID- 1628702
TI  - Changes.

PMID- 1628703
TI  - Purification of rat megakaryocyte colony-forming cells using a monoclonal
      antibody against rat platelet glycoprotein IIb/IIIa.
AB  - We recently reported the production and characterization of four monoclonal
      antibodies (MoAbs) against rat platelet glycoprotein IIb/IIIa (GPIIb/IIIa). In
      this study we developed a simple and efficient three-step procedure, based on
      positive selection by immunoadsorption (panning) using one MoAb, P55, to purify
      rat megakaryocyte colony-forming cells (megakaryocyte colony-forming units, CFU
      MK) from normal bone marrow. Cells obtained after each step were assayed for
      their ability to form megakaryocyte colonies in the presence of Concanavalin A
      (Con A)-stimulated rat spleen cell-conditioned medium in soft agar cultures.
      Marrow cells were first separated on discontinuous Percoll gradients. Cells
      sedimented at densities between 1.063 and 1.082 g/ml were depleted of cells
      adherent to plastic tissue culture dishes. The nonadherent cells were further
      incubated on dishes coated with P55 MoAb. CFU-MK were enriched about 50-fold in
      the adsorbed cell fraction. This sequential fractionation procedure resulted in a
      345-fold (range 276 to 412-fold) enrichment of rat CFU-MK over whole bone marrow
      cells. The average cloning efficiency of CFU-MK in the final fraction was about
      7% (range 5%-9.2%) of the nucleated cells. The overall recovery of CFU-MK
      averaged 20% (range 9%-29%). The panning step provided a 46-fold enrichment of
      megakaryocyte burst-forming cells (megakaryocyte burst-forming units, BFU-MK),
      whose average cloning efficiency in the post-panning fraction was 0.14% (range
      0.07%-0.2%). In addition, erythroid burst-forming cells (erythroid burst-forming
      units, BFU-E) were also significantly enriched by panning, but to a lesser degree
      than BFU-MK and CFU-MK. By contrast, granulocyte-macrophage colony-forming cells
      (granulocyte-macrophage colony-forming units, CFU-GM) and erythroid colony
      forming cells (erythroid colony-forming units, CFU-E) were not enriched by
      panning. CFU-MK obtained after panning formed megakaryocyte colonies in the
      presence of recombinant rat interleukin 3 (rIL-3), mouse granulocyte-macrophage
      colony-stimulating factor (mGM-CSF), or human erythropoietin (hEPO), as has been
      reported for murine CFU-MK in whole marrow cells. The highly enriched populations
      of rat CFU-MK should thus provide a basis for the further study of the regulation
      of megakaryocytopoiesis.

PMID- 1628704
TI  - In vivo administration of interleukin 6 delays hematopoietic regeneration in
      sublethally irradiated mice.
AB  - The in vivo effects of recombinant human interleukin 6 (IL-6) on the
      hematopoietic system of sublethally (4.8 Gy) x-irradiated mice were investigated.
      Animals were injected twice daily s.c. with IL-6 (10 micrograms/kg body
      weight/day) for 7 days following irradiation, and the numbers of hematopoietic
      stem, progenitor, and circulating blood cells were evaluated at 4, 7, 13, and 23
      days. IL-6 caused significant depression of early hematopoiesis (decreased
      numbers of spleen colony-forming units [CFU-S] and granulocyte-macrophage colony
      forming cells [GM-CFC]) in the spleens of irradiated mice. Marrow hematopoiesis
      was less affected by IL-6 injection, although the number of hematopoietic cells
      was also significantly lower than in irradiated mice injected with carrier alone.
      The observed decrease in the numbers of hematopoietic cells was not reflected by
      any significant change in the circulating blood cell numbers, which were similar
      to those in control irradiated animals. In contrast, IL-6 administered in 100
      times higher doses (1000 micrograms/kg/day) caused significant increases in bone
      marrow and spleen cellularity and GM-CFC numbers, thus accelerating
      postirradiation hematopoietic regeneration. Our studies show that IL-6,
      administered in relatively low doses, suppresses postirradiation hematopoietic
      recovery, decreasing the numbers of stem and progenitor cells in sublethally
      irradiated mice.

PMID- 1628705
TI  - Murine interleukin 9 stimulates the proliferation of mouse erythroid progenitor
      cells and favors the erythroid differentiation of multipotent FDCP-mix cells.
AB  - Murine interleukin 9 (mIL-9) is a T-cell-derived growth factor that stimulates
      erythroid burst-forming units (BFU-E) from murine bone marrow. We further
      investigated this activity using enriched mouse bone marrow progenitors and the
      multipotent interleukin 3 (IL-3)-dependent FDCP-Mix cell line. We report here
      that mIL-9 stimulates erythroid burst formation of total bone marrow cells and
      accessory cell-depleted bone marrow cells, even in serum-free cultures. On the
      other hand, we observed that although mIL-9 could not support proliferation of
      FDCP-Mix cells, it favors erythroid differentiation of these cells in the
      presence of both IL-3 and erythropoietin. These results strongly suggest that mIL
      9 acts directly on mouse erythroid progenitor cells.

PMID- 1628706
TI  - The effect of granulocyte-macrophage colony-stimulating factor on
      undifferentiated and mature acute myelogenous leukemia blast progenitors.
AB  - Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been used recently
      to recruit undifferentiated acute myelogenous leukemia (AML) blasts into the S
      phase of the cell cycle and increase the fraction of cells killed by cell cycle
      specific drugs. Using three AML blast colony assays combined with a suspension
      culture (delta assay), we determined the in vitro effect of GM-CSF on mature and
      undifferentiated AML blast progenitors obtained from bone marrow aspirates of six
      AML patients. GM-CSF stimulated AML blast colony proliferation at a concentration
      of 5 ng/ml in the methylcellulose and the agar clonogenic assays in six of six
      AML marrow samples. However, in the delta assay, which selects for immature AML
      progenitors, GM-CSF did not affect AML blast colony-forming cells in five of six
      AML marrow samples at concentrations ranging from 5 to 300 ng/ml. Our data imply
      that GM-CSF stimulates mature but not undifferentiated AML blast progenitors. It
      is therefore possible that GM-CSF may not be beneficial as a recruiting agent in
      most AML patients.

PMID- 1628707
TI  - Enhancement of hematopoietic recovery in gamma-irradiated mice by the joint use
      of diclofenac, an inhibitor of prostaglandin production, and glucan, a macrophage
      activator.
AB  - The effects of diclofenac (inhibitor of prostaglandin production) and
      carboxymethylglucan (immunomodulator and an agent stimulating hematopoiesis),
      when given to mice 1 day before gamma-irradiation, were studied. Both of the
      agents were administered either alone or in combination. The investigations
      included the assessment of post-irradiation hematopoietic recovery in terms of
      bone marrow and spleen cellularity and endogenous spleen colony formation, as
      well as the determination of the survival of lethally irradiated mice. The
      results demonstrated at least additive radioprotective effects when mice were
      given diclofenac and carboxymethylglucan in combination. Experimental evidence
      provided by the increased 125iodo-deoxyuridine incorporation into the spleen and
      elevated hydroxyurea kill of endogenous spleen colony-forming units indicated
      that the beneficial action of the combined treatment could be a consequence of
      increased cell proliferation in the hematopoietic tissue. It is likely that the
      inhibition of prostaglandin production (diclofenac action) and the concomitant
      increased release of growth factors (glucan action) shift the regulatory balance
      towards the predominance of positive hematopoietic control.

PMID- 1628708
TI  - Biological activities of tetrapeptide AcSDKP on hemopoietic cell binding to the
      stromal cell in vitro.
AB  - The biological activity of the tetrapeptide acetyl-N-Ser-Asp-Lys-Pro (AcSDKP) on
      hemopoietic cell binding to the stromal cells was studied by using a rosette
      formation technique that quantitatively represents the specific hemopoietic cell
      binding to the stroma. Marrow hemopoietic cell binding to the stroma was enhanced
      by AcSDKP. This enhancement was completely neutralized by addition of anti-AcSDKP
      polyclonal antibody. Furthermore, preincubation of stromal cells with AcSDKP
      increased hemopoietic cell binding to the stroma, whereas preincubation of
      hemopoietic cells with AcSDKP showed no increment of the binding. These findings
      suggest that AcSDKP enhanced hemopoietic cell binding through the activation of
      stromal cells.

PMID- 1628709
TI  - The in vitro growth patterns and drug sensitivities of leukemic blast progenitors
      among the subtypes of acute myelocytic leukemia.
AB  - The in vitro growth activities and drug sensitivities of leukemic blast
      progenitors were compared among the subgroups of acute myelocytic leukemia (AML)
      classified according to the French-American-British (FAB) cooperative group.
      Leukemic cells separated from the peripheral bloods of AML patients were cultured
      in methylcellulose media, and the plating efficiencies of primary colonies (PE1)
      and secondary colonies after replating (PE2) were determined. PE1 and PE2 have
      been considered to reflect the capacities of terminal divisions and self-renewal
      of leukemic blast progenitors, respectively. PE1 and PE2 were variable among AML
      patients; these findings suggest that AML is a heterogeneous disease in terms of
      the proliferative activities of leukemic cells. No significant correlation was
      noted between PE1 or PE2 and the AML subtype. The sensitivities to cytosine
      arabinoside (Ara-C) of leukemic blast progenitors were studied in methylcellulose
      and suspension cultures. Ara-C sensitivity was not significantly correlated with
      the AML subtype, either. In contrast, there was statistically significant
      correlation between PE2 and the remission outcome of the patients, whereas PE1
      was not significantly associated with the clinical outcome. The results in the
      present study indicate that the proliferative activity, especially self-renewal
      capacity, of leukemic blast progenitors is highly predictive of the prognosis of
      AML patients but is not significantly correlated with the AML subtype classified
      by the blast morphology.

PMID- 1628710
TI  - c-jun and c-fos are expressed by human megakaryocytes.
AB  - Expression of the main nuclear protooncogenes during terminal megakaryocyte (MK)
      differentiation is poorly understood. Because previous results have suggested
      that c-fos and c-jun protooncogenes are expressed in human leukemic cell lines
      induced to undergo megakaryocytic differentiation, we have analyzed the
      expression of these two protooncogenes in normal MK. Studies were performed, by
      in situ hybridization and immunofluorescence, on human MK obtained either
      directly from bone marrow or from culture of MK progenitors. c-fos and c-jun
      transcripts were detected in most cultured or fresh marrow MK from adult donors.
      Expression was much higher in cytologically immature than in mature MK whereas no
      expression was detected in the most mature MK. c-fos and c-jun expression
      increased dramatically with MK size. In cultured fetal MK, which all remained
      small in size, c-fos mRNA was present but at a low level. The c-fos-encoded
      protein (P62fos) was easily detectable in the great majority of MK. We directly
      demonstrated that the level of P62fos expression was correlated to MK ploidy by
      flow cytometry using a three-color staining technique. The involvement of serum
      and growth factors in the induction of P62fos in MK was studied. Whereas a 3-h
      serum deprivation resulted in the disappearance of P62fos in MK, several growth
      factors such as granulocyte-macrophage colony-stimulating factor (GM-CSF),
      interleukin 3 (IL-3), interleukin 6 (IL-6), interleukin 7 (IL-7), leukemia
      inhibitory factor (LIF), and transforming growth factor beta (TGF-beta), as well
      as normal or aplastic serum, were able to reinduce its expression within 2 h. In
      conclusion, our results suggest that c-jun and c-fos may play a role in the
      transduction of signals by several growth factors during terminal MK
      differentiation.

PMID- 1628711
TI  - Glucose uptake by rat erythroid cells: the effects of erythropoietin and
      dexamethasone.
AB  - Erythropoietin (Ep) stimulated glucose uptake by erythroid progenitor cells in
      the liver of fetal rats, as measured by [3H]2-deoxy-D-glucose uptake. This dose
      dependent stimulation was maximal at 0.2 U/ml Ep and decreased during cell
      differentiation. Dexamethasone (DEX) inhibited glucose uptake by erythroid
      progenitors; this dose-dependent effect was maximal at 10(-7) M DEX. Ep partly
      counteracted the inhibitory effect of DEX. This antagonism may contribute to the
      overall antagonism between Ep and glucocorticoids in the development of erythroid
      tissue in vivo and in vitro.

PMID- 1628712
TI  - A comparison of the fertility of Dominican, Puerto Rican and mainland Puerto
      Rican adolescents.
AB  - Data from three fertility surveys are used to examined the probabilities and
      determinants of adolescent births among Dominican and Puerto Rican women. Young
      women in the Dominican Republic are the most likely to have had a child by each
      year of age from 14 through 24, followed by young women on the Island of Puerto
      Rico; the probability of an early birth is lowest for Puerto Rican women on the
      U.S. mainland. Eighteen percent of Dominican women have had a child before their
      18th birthday, compared with 13% of women living in Puerto Rico, and 10% of
      Puerto Rican women in metropolitan New York. The cumulative probabilities that
      Puerto Rican women will have borne a child before their 20th birthday are almost
      identical, whether the women live on the island or the U.S. mainland, but the
      difference between Puerto Rican and Dominican women widens. The order is
      reversed, however, in the analysis of premarital births: The probability of a
      premarital birth during adolescence is highest for Puerto Rican women in New
      York, and lowest for Dominican women. In a separate logistic regression analysis,
      education and age at first sexual intercourse are shown to be important
      determinants of adolescent fertility in all three populations.

PMID- 1628713
TI  - Current oral contraceptive use instructions: an analysis of patient package
      inserts.
AB  - Oral contraceptive use instructions contained in manufacturers' patient package
      inserts (PPIs) are often inconsistent or conflicting, both among manufacturers
      and among different brands and regimens from the same manufacturer. Instructions
      on what to do about missed pills are often incomplete or inadequate, as are
      instructions on backup contraceptive use when pills are missed. The format of
      many PPIs is confusing and makes instructions difficult to find and read.
      Comprehending the PPIs requires the user to read at a 10th-12th-grade level, far
      higher than the generally accepted 5th-6th grade level considered standard for
      health education materials.

PMID- 1628714
TI  - High-risk sexual behavior among heterosexual undergraduates at a midwestern
      university.
AB  - Approximately 80% of a self-selected sample of 593 heterosexual undergraduate
      college students studied at a large Midwestern state university in 1988 had ever
      experienced penile-vaginal or penile-anal intercourse. One-fifth of the 477
      sexually experienced women and men said they had had heterosexual and
      intercourse. The mean age at first vaginal intercourse was 17, while the mean age
      at first anal intercourse was about 18.5. Although less than four years, on
      average, had elapsed since the respondents' first vaginal or anal intercourse,
      females reported having had an average of 5.6 sexual partners, and males reported
      an average of 11.2 partners.

PMID- 1628715
TI  - Family planning, sexually transmitted diseases and contraceptive choice: a
      literature update--Part II.

PMID- 1628717
TI  - Widespread screening seeks to lower Chlamydia prevalence.

PMID- 1628716
TI  - Medically indigent women seeking abortion prior to legalization: New York City,
      1969-1970.
AB  - If the efforts now underway to limit access to abortion services in the United
      States are successful, their greatest impact will be on women who lack the funds
      to obtain abortions elsewhere. There is little published information, however,
      about the experience of medically indigent women who sought abortions under the
      old, restrictive state laws. This article details the psychiatric evaluation of
      199 women requesting a therapeutic abortion at a large municipal hospital in New
      York City under a restrictive abortion law. Thirty-nine percent had tried to
      abort the pregnancy. Fifty-seven percent had concrete evidence of serious
      psychiatric disorder. Forty-eight percent had been traumatized by severe family
      disruption, gross emotional deprivation or abuse during childhood. Seventy-nine
      percent lacked emotional support from the man responsible for the pregnancy, and
      the majority were experiencing overwhelming stress from the interplay of multiple
      problems exacerbated by their unwanted pregnancy.

PMID- 1628718
TI  - Delaying pelvic exams to encourage contraceptive use.

PMID- 1628719
TI  - Bisexual men and HIV infection.

PMID- 1628720
TI  - Sexually transmitted synergy.

PMID- 1628721
TI  - Increased oxidized methionine residues in BAL fluid proteins in acute or chronic
      bronchitis.
AB  - Phagocytic cells such as alveolar macrophages (AM) or polymorphonuclear
      neutrophils (PMN) in the bronchoalveolar tract are a potential source of the
      oxygen-derived free radicals which are presumed to be involved in lung tissue
      damage. Previous results have shown that the methionine sulphoxide (MET(O))
      content of bronchoalveolar lavage fluid (BALF) protein is a reliable parameter to
      indicate oxidative processes in idiopathic pulmonary fibrosis (IPF). We measured
      the molar ratio between MET(O) and methionine (MET) in the BALF protein from
      healthy nonsmokers (control group), healthy smokers and patients with acute or
      chronic bronchitis (AB or CB). The MET(O)/MET ratio of the nonsmoking group (n =
      11) was 0.046 +/- 0.008 (mean +/- SEM). Healthy smokers (n = 8) had similar
      values (0.042 +/- 0.008), even though they had strongly increased AM counts in
      BALF. Patients with AB (n = 12) showed an increased MET(O)/MET ratio (0.191 +/-
      0.031) and had high PMN but normal AM counts in BALF. Patients with CB (n = 13)
      showed an increase in the MET(O)/MET ratio (0.086 +/- 0.010) and moderately
      increased PMN and markedly increased AM counts. Taking all results together, the
      MET(O)/MET ratio correlated positively with the relative PMN number (r = 0.70; p
      less than 0.0002) and inversely with the relative AM number (r = 0.67; p less
      than 0.0002). In the group with CB, the MET(O)/MET ratio correlated inversely
      with forced expiratory volume in one second (FEV1) % pred. (r = -0.77) and
      FEV1/inspiratory vital capacity (IVC) % pred. (r = -0.89).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1628722
TI  - Bronchodilator reversibility, exercise performance and breathlessness in stable
      chronic obstructive pulmonary disease.
AB  - Partial bronchodilator reversibility can be demonstrated in many patients with
      stable chronic obstructive pulmonary disease (COPD), but its relevance to
      exercise capacity and symptoms is uncertain. Previous data suggest that
      anticholinergic bronchodilators do not improve exercise tolerance in such
      patients. We studied 32 patients with stable COPD, mean age 65 yrs, in a double
      blind, placebo-controlled, cross-over trial of the inhaled anticholinergic drug,
      oxitropium bromide. From the within and between day placebo spirometry, we
      derived the spontaneous variation in forced expiratory volume in one second
      (FEV1) and forced vital capacity (FVC) of this population (FEV1 140 ml; FVC 390
      ml) and considered responses beyond this to be significant. Oxitropium bromide
      increased baseline FEV1 from 0.70 (0.28) l (mean (SD)) to 0.88 (0.36) l. The 6
      min walking distance increased by 7% compared with placebo, whilst resting
      breathlessness scores fell from 2.0 to 1.23 at rest and 4.09 to 3.28 at the end
      of exercise after the active drug. Improvements in walking distances and symptoms
      were unrelated to changes in either FEV1 or FVC, indicating that routine
      reversibility testing is not a good predictor of symptomatic benefit in these
      patients.

PMID- 1628723
TI  - Pneumocystis carinii pneumonia in HIV-infected patients: diagnostic yield of
      induced sputum and immunofluorescent stain with monoclonal antibodies.
AB  - The purpose of this study was to evaluate the diagnostic yield of induced sputum
      (IS), assessing the reliability of indirect immunofluorescent stain with
      monoclonal antibodies (IFMoAb) and methenamine silver (Met-Ag) and analysing
      factors likely to influence the sensitivity of these techniques. An analysis was
      prospectively carried out on IS specimens collected from 61 human
      immunodeficiency virus (HIV)-infected patients during 69 episodes of suspected
      Pneumocystis carinii pneumonia. Ultrasonic nebulizers with hypertonic 2% saline
      were used. IFMoAb to P. carinii and Met-Ag were performed after
      cytocentrifugation of the specimen. Results were compared with those of
      bronchoalveolar lavage (BAL) with/without transbronchial biopsy (TBB), performed
      not more than seven days after induction of sputum. P. carinii pneumonia was
      confirmed in 32 episodes, of which IS was diagnostic in 23. The sensitivity of
      the staining procedures was 69% for IFMoAb, and 28% for Met-Ag. The three
      episodes of P. carinii pneumonia in patients on oral chemoprophylaxis yielded
      negative IS results; in contrast, IS was negative in only 6 of the 29 cases not
      receiving chemoprophylaxis. IS is a non-aggressive procedure that diagnosed P.
      carinii pneumonia in 72% of our cases. The yield increased significantly when
      IFMoAb was used in patients not receiving oral chemoprophylaxis.

PMID- 1628724
TI  - Lung function impairment following mycoplasmal and other acute pneumonias.
AB  - We prospectively studied the lung function of 106 consecutive young patients with
      pneumonia. At the time of hospital admission we observed impaired spirometric
      function in 48% of the patients. During and following treatment, the frequency of
      abnormalities in pulmonary function tests decreased rapidly. However, at the 15th
      day of hospitalization, abnormal ventilatory function was still demonstrated in
      21% of the patients. Such prolonged impairment of ventilatory function was
      significantly more likely to result from pneumonia caused by Mycoplasma
      pneumoniae than from forms caused by adenovirus or Streptococcus pneumoniae.

PMID- 1628725
TI  - Branhamella catarrhalis respiratory infections.
AB  - Branhamella catarrhalis is an aerobic Gram-negative diplococcus. It has been
      traditionally regarded as an oropharyngeal commensal and until recently was only
      identified as a pathogen in cases of bronchopulmonary infections. The aim of this
      study was to analyse the characteristics of the respiratory infections caused by
      B. catarrhalis and to know the antibiotic susceptibility of this microorganism.
      We retrospectively studied 32 lower respiratory tract infections, caused by B.
      catarrhalis (20 cases of bronchial infection and 12 cases of pneumonia),
      diagnosed between 1988-1989 in our hospital. All patients had an underlying
      disease; chronic obstructive pulmonary disease (COPD) and chronic heart disease
      being the most frequent. The aetiological diagnostic procedures were: sputum
      culture in 28 cases (15 in pure culture and 13 mixed), protected specimen brush
      (PSB) in three cases and transthoracic needle aspiration (TNA) in one case.
      Twenty B. catarrhalis isolates were penicillin and ampicillin-resistant, 11 in
      the pneumonia group and 9 in the bronchial infection group. All isolates were
      sensitive to amoxycillin-clavulanic acid and second generation cephalosporin. In
      our group four patients died. We conclude that B. catarrhalis is a not infrequent
      cause of respiratory infection, particularly in COPD patients, and that the high
      incidence of antibiotic resistance to penicillin and ampicillin should be taken
      into account before considering an empirical antibiotic treatment.

PMID- 1628726
TI  - Towards a quantitative description of asthmatic cough sounds.
AB  - This study describes a method of quantitatively characterizing cough sounds using
      digital signal processing techniques. Differences between asthmatic and non
      asthmatic cough sounds are presented. Coughs from 12 asthmatic and 5 non
      asthmatic subjects were analysed. Cough sounds and flows were digitized, at a
      sampling rate of 5 kHz, before and after a free-running exercise test. Individual
      coughs were divided into two or three phases, corresponding to the initial
      glottal opening burst, the quieter middle phase, and (sometimes) the final
      closing burst. Standard signal processing techniques were then invoked to
      characterize the spectral and temporal shapes of the first two phases. Factor
      analysis indicated that the spectral shapes of the two phases are independent,
      with each being largely described by the degree of "peakedness" in the spectrum,
      and by the balance of energy between low and high frequencies. Both the duration
      of the initial burst and zero-crossing rates of the cough waveform (which
      indicates the "spectral balance") during each of the first two phases were
      smaller for asthmatic than for non-asthmatic coughs. Fewer asthmatic coughs
      contained a final burst. Discriminant analysis between the two groups gave
      classification error rates of 20-30%. The peak flow recorded during the cough was
      significantly smaller for asthmatics, and correlated very well with the peak flow
      recorded during forced expiration. Thus, significant differences exist between
      asthmatic and non-asthmatic cough sounds. An effective representation of the
      temporal structure of the cough sound is required to successfully characterize
      the cough.

PMID- 1628727
TI  - Repeated inhalation of bradykinin attenuates adenosine 5'-monophosphate (AMP)
      induced bronchoconstriction in asthmatic airways.
AB  - Repeated bronchial challenges with inhaled bradykinin lead to a rapid loss of the
      bronchoconstrictor response and this has been suggested to be due to depletion of
      contractile neuropeptides from sensory nerve endings. If adenosine 5'
      monophosphate (AMP), another potent bronchoprovocant in asthma, and bradykinin
      share a common pathway in inducing bronchoconstriction in asthmatic subjects,
      then repeated bradykinin bronchoprovocation tests should reduce the response to
      subsequent inhalation of AMP. We examined this hypothesis in eight asthmatic
      subjects in a double-blind, randomized study. On the histamine study day, two
      consecutive concentration-response studies with inhaled histamine were followed
      by a third consecutive challenge with AMP and the provocation concentration
      producing a 20% fall in forced expiratory volume in one second from the post
      diluent baseline value (PC20 FEV1) for this agonist was calculated. On the
      bradykinin study day, two consecutive bronchoprovocation tests with bradykinin
      were followed by a third inhalation challenge to obtain the PC20AMP value. On a
      further occasion, the asthmatic subjects underwent two consecutive concentration
      response studies with inhaled bradykinin followed by a third consecutive
      challenge with histamine. On the histamine study day, the geometric mean PC20AMP
      value was 28.1 mg.ml-1, whilst on the bradykinin study day, the fifteenfold
      reduction in bradykinin responsiveness after the second bradykinin challenge was
      accompanied by a significant reduction of the airway responsiveness to AMP, the
      PC20AMP being 59.8 mg.ml-1. A similar reduction in bradykinin responsiveness
      failed to alter the airway response to a subsequent inhalation with
      histamine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628729
TI  - Isolation of phenotypically and functionally distinct macrophage subpopulations
      from human bronchoalveolar lavage.
AB  - Bronchoalveolar lavage was used to obtain alveolar macrophages (AM) from the
      lower respiratory tract of healthy normal volunteers. Monoclonal antibody (MoAb)
      probes specific against macrophage determinants were then applied, in conjunction
      with density separation techniques, to identify and isolate three relatively
      homogeneous subpopulations from the AM pool. The MoAbs used, RFD1 and RFD7, have
      previously been shown to differentiate between "dendritic" cells and mature
      macrophages, respectively, in normal tissue. In addition to these two
      phenotypically distinct AM subsets (RFD1+D7- and RFD1-D7+ AM), a third AM
      subpopulation was isolated, which appeared to express both markers (RFD1+D7+).
      All three separated macrophage subsets were morphologically similar but exhibited
      distinct differences in surface receptor expression, enzyme content and
      physiology. Isolated RFD1+D7- AM (the phenotype of "dendritic" cells) did not
      adhere to the glass, had weak expression of C3b and FcR1 receptors, low
      fibronectin content and lysosomal activity; only a small proportion of these
      cells exhibited phagocytosis. The other two isolated AM subsets adhered to glass,
      expressed C3b and FcR1 receptors, had high fibronectin and acid phosphatase
      content, and a large majority exhibited phagocytic capacity; qualitative and
      quantitative differences in these features existed between the two AM subtypes.
      Furthermore, a diverse spectrum of hexose monophosphate shunt activity was
      observed throughout all three AM subpopulations, with the highest activity being
      recorded in the non-adherent AM. These data support the concept of a dynamic
      heterogeneity within the AM population. The variation in surface antigen
      expression and physiological capabilities observed amongst the three isolated AM
      subsets implies the presence of functionally distinct AM within the human lung,
      which, during steady-state conditions, may be critically balanced under the
      influence of stimuli in their local microenvironment. In support, proportional
      and functional shifts have been witnessed amongst these three AM subpopulations
      with the advent of disease.

PMID- 1628728
TI  - No influence of airway heat flux on airflow-induced bronchospasm.
AB  - We used a canine model of airway reactivity to examine the role of airway heat
      flux in the response to dry air challenge. Airflow-induced bronchospasm (AIB) was
      assessed by measuring collateral system resistance (Rcs) with a wedged
      bronchoscope technique in anaesthetized mechanically ventilated dogs. We
      manipulate post-challenge airway heat flux by exposing peripheral airways to cool
      dry air (23.9 +/- 0.3 degrees C, 0.8 +/- 0.2 mgH2O.l-1), cool humid air (24.2 +/-
      0.2 degrees C, 21.5 +/- 0.3 mgH2O.l-1), or warm humid air (35.3 +/- 0.4 degrees
      C, 40.6 +/- 0.3 mgH2O.l-1) during the recovery period (n = 14) following a high
      flow challenge (1,500 ml.min-1 for 2 min) with cool dry air. In a second series
      of experiments (n = 6), we attempted to further exaggerate airway heat flux
      during challenge by exposing peripheral airways to warm humid air during both
      baseline and recovery periods. In comparison to control (i.e. treatment with cool
      dry air before and after challenge), treatment with warm humid air during
      recovery period produced a small but significant attenuation (p less than 0.01)
      in Rcs. Cool humid air during recovery had no affect on Rcs following challenge.
      Warm humid air during both baseline and recovery tended to attenuate Rcs after
      challenge (p less than 0.05). We conclude that airway heat flux in itself has no
      significant physiological affect on AIB in the canine lung periphery.

PMID- 1628730
TI  - Fractional processing of sequential bronchoalveolar lavage fluid from intubated
      babies.
AB  - Two groups of intubated newborn babies were studied to determine the clinical
      effects of interrupted bronchoalveolar lavage (BAL) by suction catheter (S-BAL)
      and the similarities to adult fibreoptic BAL of fractional processing of
      sequential lavage fluid (BALF). Both groups were lavaged by two aliquots of 1
      ml.kg-1, instilled via a blindly placed suction catheter, wedged on two separate
      insertions through the right main bronchus. In 14 infants, (sequential lavage
      group), BALF aliquots were analysed separately. There were no differences in the
      volumes recovered or total cell counts between the first and second BALF
      aliquots. Where cell morphology was visible (n = 11), the percentage of
      macrophages, but not the absolute number, increased in the second BALF aliquot (p
      less than 0.01). BALF urea and epithelial lining fluid volume estimated by urea
      dilution were similar between the two aliquots (n = 8). In a separate group
      (blood gas group), vital signs were recorded in 10 infants undergoing S-BAL. At 1
      min after lavage there was a rise in mean arterial blood pressure (39 vs 49.5
      mmHg, p less than 0.05) and a fall in transcutaneous oxygenation (10.6 vs 7.5
      kPa, p less than 0.05). Recovery was present at 3 min post-S-BAL, but mean blood
      pressure remained elevated (39 vs 45 mmHg, p less than 0.05) and transcutaneous
      oxygen continued to be lower when compared to baseline values (10.6 vs 9.2 kPa, p
      less than 0.05). S-BAL of intubated infants appears to sample both the proximal
      and distal airways and results in changes in vital signs similar to routine non
      selective endotracheal suctioning.

PMID- 1628731
TI  - Pulmonary function in childhood connective tissue diseases.
AB  - The term connective tissue diseases (CTD) defines a group of illnesses
      characterized by the presence of immune abnormalities and by widespread
      inflammation involving various organs and tissues including the lung. These
      diseases are not frequent in the paediatric age group. Very few data on pulmonary
      function are available in paediatric CTD. We investigated possible early lung
      function abnormalities and any likely relationship with clinical activity of the
      disease in a group of 81 paediatric CTD patients, without clinical or
      radiological evidence of pulmonary involvement. Measurement of lung volumes and
      diffusion lung capacity were performed. A sample of 65 subjects, defined as
      normal on the basis of history and clinical examination, and matched by age and
      height with the group of patients, was chosen as control group. CTD patients did
      not show significant deviations from the control distribution with respect to
      functional residual capacity (FRC) and maximal expiratory flow at 75% of the
      forced vital capacity (MEF75) values. On the contrary, both vital capacity (VC)
      and diffusing capacity of the lungs for carbon monoxide (DLCO) were quite
      impaired in most CTD during the active phase of the disease. Our results show a
      functional lung impairment in most children with clinically active CTD, even in
      absence of abnormalities on chest X-ray pictures.

PMID- 1628733
TI  - Mucus clearance with three chest physiotherapy regimes in cystic fibrosis: a
      comparison between postural drainage, PEP and physical exercise.
AB  - The effects of three different regimes of chest physiotherapy were compared in
      this cross-over study. Mucus clearance was monitored in nine clinically stable
      cystic fibrosis (CF) patients. The patients performed: 1) postural drainage with
      thoracic expansion exercises + forced expiration technique (FET) in the left
      decubitus position; 2) positive expiratory pressure (PEP)-mask breathing + FET;
      and 3) physical exercise on a bicycle ergometer + FET. All treatments had the
      same duration and FET was standardized. Mucus clearance was assessed using a
      technique based on measurement of the elimination of inhaled radiolabelled
      particles. Mean clearance of tracer from the right lung by postural drainage, PEP
      and physical exercise was 18% (range 10-29%), 20% (12-43%), 16% (8-25%),
      respectively, and from the left lung 20% (8-42%), 15% (5-23%) and 13% (5-17%),
      respectively. The differences were not statistically significant. Surprisingly,
      postural drainage (PD) was the most effective technique in the left, dependent
      lung in 7 of the 9 patients.

PMID- 1628732
TI  - Growth factor activity in the lung during compensatory growth after
      pneumonectomy: evidence of a role for IGF-1.
AB  - Unilateral pneumonectomy in rats causes compensatory growth of the remaining
      lung. During this growth, there are large increases in the cell numbers and in
      the rates of collagen and non-collagen protein production. We examined possible
      mechanisms by which these changes might occur. Assessment of the effect of
      bronchoalveolar lavage (BAL) fluid on fibroblasts in vitro demonstrated the
      presence of stimulatory activity for fibroblast replication in control animals.
      This activity was greatly increased two and six days postpneumonectomy (115 +/-
      26% and 75 +/- 18% above control values, respectively), but had returned to
      normal by 14 days. Preliminary characterization suggests that the activity is
      heat labile and consists of at least two moieties with apparent molecular weights
      of 5-15 kD and 70-220 kD. The activity was partially blocked by antibodies to
      insulin-like growth factor-1 (IGF-1), and levels of IGF-1 were increased by about
      100% (p less than 0.001) two days after pneumonectomy compared with control
      values. Examination of BAL cells demonstrated an early influx of leucocytes into
      the remaining lung of pneumonectomized rats. At two days, about 25% of the
      lavageable cells were neutrophils, but macrophages were the predominant cell type
      at all times. The extravascular albumin space of the lung increased by about 65%
      (p less than 0.01), six days after pneumonectomy. The influx of circulatory
      proteins and cells are potential sources of the increased mitogenic activity
      observed in the lung.

PMID- 1628734
TI  - Hypoxaemia and liver cirrhosis: a new argument in favour of a "diffusion
      perfusion defect".
AB  - Liver cirrhosis is sometimes associated with very severe hypoxaemia, which is
      thought to be the result of intrapulmonary vascular dilatations (IPVDs). These
      vascular abnormalities, although close to the gas exchange units, are so dilated
      that diffusion of oxygen molecules to their centre is impaired, causing an
      increase in alveolar-arterial oxygen tension difference (P(A-a)O2). On the other
      hand, administration of 100% oxygen provides enough driving pressure to overcome
      this relative diffusion defect and rules out a true intrapulmonary shunt. We
      report a case in which, in spite of a normal increase in arterial oxygen tension
      (PaO2) under 100% oxygen, exercising results in a marked impairment of oxygen
      exchange and a large intrapulmonary shunt. This is probably due to the increased
      cardiac output and preferential blood flow through these low resistance IPVDs.

PMID- 1628735
TI  - Endothelial modulation of pulmonary vascular tone.
AB  - Pulmonary endothelial cells normally synthesize prostacyclin (PGI2) and nitric
      oxide (NO), which are both potent vasodilators. Although PGI2 is largely used to
      treat patients with severe pulmonary hypertension, its role in the physiology and
      pathophysiology of the pulmonary circulation is still debated. NO, which is now
      considered as the endogenous nitrovasodilator, is perhaps more involved than PGI2
      in the mechanisms that modulate pulmonary vascular tone in health and disease.
      There is evidence to suggest that background release of NO contributes to the
      normally low pulmonary vascular tone in normoxia. Although there are theoretical
      grounds to hypothesize that hypoxia reduces the synthesis of NO, lack of the
      latter does not seem to account for the acute hypoxic pulmonary vasoconstriction.
      Instead, there is evidence to suggest that NO activity is increased in order to
      modulate the pulmonary vasopressor response to acute alveolar hypoxia. However,
      more consistent, concerning the role of NO, are data gathered from studies
      performed in chronic hypoxic conditions. Both experimental data and studies
      performed in man demonstrate impairment of NO synthesis and/or release in chronic
      hypoxic pulmonary hypertension. The impaired NO production, whilst reducing the
      ability of the pulmonary vasculature to relax, also favours the occurrence of
      excessive pulmonary vasoconstriction. Lack of NO synthesis might also permit
      mitogenesis and proliferation of various cell types within the vascular wall. We
      hypothesize that functional alterations of pulmonary endothelium are likely to
      affect both reactivity and growth of pulmonary vessels. In this respect, NO
      probably has a pivotal role in modulating pulmonary vascular tone and controlling
      pulmonary vascular remodelling in health and disease.

PMID- 1628736
TI  - Extended thoracoscopy: a biopsy method to be used in case of pleural adhesions.
AB  - Extended thoracoscopy (ET) allows several large biopsies to be taken in patients
      with thick adhesions of the pleura when normal thoracoscopy is impossible. Twenty
      patients with undiagnosed pleural effusion or thickening and two with associated
      pulmonary tumour close to the chest wall underwent ET because closed adhesions
      prevented the induction of an artificial pneumothorax. Under local anaesthesia
      and neuroleptanalgesia, at the site of suspected lesions on computed tomographic
      (CT) scan, a cutaneous incision of 3-4 cm is made on the appropriate intercostal
      space. After dissection with blunt scissors, the operator introduces his finger
      to create a space in the pleural cavity. The thoracoscope is inserted to inspect
      the pleura and to take several biopsies for histopathological examination. A
      chest tube is inserted for a few minutes after checking airtightness and
      haemostasis. The procedure is well-tolerated. In three cases no pleural biopsy
      could be taken; in three patients a false negative diagnosis was observed. A
      correct diagnosis was obtained in 16 out of 19 patients (84%). If performed by a
      pulmonologist experienced with thoracoscopy ET is a rapid, safe and efficient
      method to obtain biopsies in cases where normal thoracoscopy after induction of a
      pneumothorax is not possible. It considerably reduces the need for open
      thoracotomy.

PMID- 1628737
TI  - Intrathoracic tumour.

PMID- 1628738
TI  - Mitogen-induced expression of the primary response gene cMG1 in a rat intestinal
      epithelial cell-line (RIE-1).
AB  - cMG1 is a primary response gene first identified in a rat intestinal epithelial
      (RIE-1) cell-line [(1990) Oncogene 5, 1081-1083]. A number of mitogens, including
      epidermal growth factor (EGF), angiotensin II (AII), serum and insulin rapidly
      induced 2- to 6-fold increases of cMG1 mRNA in RIE-1 cells, while transforming
      growth factor-beta caused a small reduction. Cyclic AMP-elevating agents blocked
      the increase of cMG1 mRNA induced by EGF. The AII-stimulated increase of cMG1
      mRNA was blocked by the depletion of protein kinase C, whereas the EGF-stimulated
      increase was not affected, indicating that protein kinase C-dependent and 
      independent signalling pathways stimulate cMG1 expression.

PMID- 1628739
TI  - Ordered phosphorylation of p42mapk by MAP kinase kinase.
AB  - Preparation of milligram amounts of [32P]p42mapk, phosphorylated at Tyr185 or
      diphosphorylated at Tyr185/Thr183, for use as specific protein phosphatase
      substrates is described. Tyr- but not Thr-phosphorylated p42mapk, accumulates
      when ATP is limiting. Furthermore, Tyr185-phosphorylated p42mapk exhibits an
      apparent 10-fold decrease in apparent Km (46.6 +/- 6.6 nM) for MAP kinase kinase
      compared to that for the dephospho form (approximately 476 nM). We conclude that
      Tyr185 precedes Thr183 phosphorylation, and that this is prerequisite,
      dramatically increasing the affinity of p42mapk for MAP kinase kinase.

PMID- 1628740
TI  - Expression of blood clotting factor VIII:C gene in capillary endothelial cells.
AB  - The essential role of Factor VIII:C (FVIII:C, anti-hemophilia factor A) as a
      cofactor for Factor IXa-dependent activation of Factor X has been established. In
      this paper, we describe that capillary endothelial cells from bovine adrenal
      medulla express active FVIII:C gene. Accumulation of FVIII:C in conditioned media
      from an 8-day-old culture is approximately twice as high as that stored in the
      cell when immunoprecipitated FVIII:C was analyzed for its ability to convert
      Factor X to Factor Xa. Analysis of [35S]methionine-labeled and immunoprecipitated
      FVIII:C from cells or conditioned media on SDS-PAGE under fully denatured
      conditions indicated that the newly synthesized FVIII:C consists of heavy chain
      of M(r) 200,000 and light chain of M(r) 46,000. The secreted FVIII:C in the non
      reduced condition however, has a molecular weight of 270,000 which suggests that
      in native protein, the heavy and light chains are held together by S-S bonds.
      Furthermore, susceptibility of the immunoprecipitated FVIII:C to N-glycanase
      digestion establishes that the endothelial cells derived FVIII:C contains
      asparagine-linked carbohydrate side chains.

PMID- 1628741
TI  - Alcohol dehydrogenase (ADH). Influence of homo- and heterologous ADH
      administration on albino rats craving for alcohol and on ADH isozyme activity in
      the liver.
AB  - The effects of homo- and heterologous alcohol dehydrogenase (ADH) administration
      into albino rats were investigated. It was found that homologous ADH increases
      and heterologous ADH decreases the craving for ethanol. The latter effect was
      accompanied by the appearance of anti-ADH-3 antibodies and by a decrease in ADH-3
      activity in the liver. Craving for alcohol decreased after both active and
      passive immunization against ADH.

PMID- 1628742
TI  - Differential inhibition of abortive transcription initiation at different
      promoters catalysed by E. coli RNA polymerase. Effect of rifampicin on purine or
      pyramidine-initiated phosphodiester synthesis.
AB  - The action of rifampicin on the RNA chain initiation catalysed by E. coli RNA
      polymerase over different templates has been studied. The steady-state formation
      of dinucleoside tetraphosphate under the condition of abortive initiation
      reaction was assayed. It was observed that rifampicin shows a spectrum of
      inhibitory effects on transcription initiation at different promoters. At two
      different promoters with a pyrimidine nucleotide at the 5'-initiation site, e.g.
      rrnB P2 having CTP and lacP2 having UTP, the effect of rifampicin on the abortive
      synthesis of the first phosphodiester bond was found to be total, even at low
      concentrations of the antibiotic. On the other hand, in most cases the effect of
      rifampicin on the abortive synthesis with a purine nucleotide at the 5'
      initiation site was found to be only partial, with the exception of the T7A2
      promoter, where rifampicin stimulates the abortive synthesis of pppGpC. It was
      also noticed that if there was a purine nucleotide at the second position of a
      dinucleotide which had already been synthesised by the enzyme, then further
      addition of the third nucleotide was not blocked in the presence of rifampicin.
      It appeared that a purine nucleotide at the initiation site or at the product
      terminus site of a translocated dinucleotide behaved similarly towards
      rifampicin. In the same way, if this position was occupied by a pyrimidine,
      rifampicin would inhibit further phosphodiester synthesis, even at a very low
      concentration. The stimulatory effect of rifampicin at the T7A2 promoter was
      presumably because here a ternary complex containing the promoter, enzyme and the
      abortive transcript pppGpC was initially stable, but dissociated upon addition of
      rifampicin, resulting in the rapid turn-over of the product.

PMID- 1628743
TI  - Characteristic differences in the mode of quinone reduction and stability between
      energy-coupled and -uncoupled NADH-quinone reductases from bacterial respiratory
      chain.
AB  - Bacterial respiratory chain has two types of NADH-quinone reductase (NQR): one is
      energy-coupled (type-1) and the other had no energy-transducing capacity, that
      is, energy-uncoupled (type-2). Each of the NADH-reacting flavoprotein subunits of
      NQR-1 from Escherichia coli and the marine Vibrio alginolyticus reduced quinone
      to semiquinone radicals by the one-electron transfer pathway and was very
      sensitive to preincubation with NADH. On the other hand, the NQR-2 from these
      bacteria reduced quinone to quinol by the two-electron transfer pathway and was
      insensitive to preincubation with NADH. Since the NQR-1 from E. coli functions as
      a proton pump, whereas that from the marine V. alginolyticus functions as a
      sodium pump, the formation of semiquinone radicals as an intermediate is likely
      to be a common mechanism to functioning as either proton or sodium pump.

PMID- 1628744
TI  - Phosphorylation and inactivation of HMG-CoA reductase at the AMP-activated
      protein kinase site in response to fructose treatment of isolated rat
      hepatocytes.
AB  - We have previously shown that incubation of isolated hepatocytes with fructose
      leads to elevation of AMP and activation of the AMP-activated protein kinase. We
      now show that this treatment causes marked inactivation of HMG-CoA reductase.
      Using immunoprecipitation from the microsomal fraction of 32P-labelled cells, we
      also show that this treatment leads to a 2.6-fold increase in the phosphorylation
      of the 100 kDa subunit of HMG-CoA reductase. Successive digestion of this 32P
      labelled subunit with cyanogen bromide and endoproteinase Lys-C confirmed that
      Ser-871, the site phosphorylated in cell-free assays by the AMP-activated protein
      kinase, was the only site phosphorylated under these conditions.

PMID- 1628745
TI  - Natural polypeptides in left-handed helical conformation. A circular dichroism
      study of the linker histones' C-terminal fragments and beta-endorphin.
AB  - Circular dichroism has been used to investigate the histone H1 and H5 C-terminal
      fragments and beta-endorphin conformation. It has been shown that in aqueous
      solution these polypeptides preferably adopt the left-handed helical conformation
      of the poly-L-proline II type. A break in the linear temperature dependence of
      the CD value was found in the temperature interval between 50 and 55 degrees C.
      It was proposed to be due to non-cooperative disordering of the conformation
      caused by the destruction of the hydration shell.

PMID- 1628746
TI  - Transfer of a chloroplast-bound precursor protein into the translocation
      apparatus is impaired after phospholipase C treatment.
AB  - We have studied the influence of phospholipase C treatment of intact purified
      chloroplast on the translocation of a plastid destined precursor protein. Under
      standard import conditions, i.e. in the light in the presence of 2 mM ATP
      translocation was completely abolished but binding was observed at slightly
      elevated levels. An experimental regime which allowed binding but not import of
      the precursor protein, i.e. in the dark in the presence of 10 microM ATP,
      demonstrated that translocation intermediates, normally detected at this stage,
      were missing in phospholipase treated chloroplasts. The precursor was completely
      sensitive to protease treatment, indicating that the transfer of the precursor
      from the receptor to the import apparatus was blocked by phospholipase treatment.

PMID- 1628747
TI  - A TIM barrel protein without enzymatic activity? Crystal-structure of narbonin at
      1.8 A resolution.
AB  - The major protein component in seeds is storage protein. These have no known
      enzymatic activity and act to provide amino acids as a source of metabolites in
      the developing seedling. We report here the first three dimensional crystal
      structure of a seed storage globulin at high resolution. The molecule of the 2S
      globulin, narbonin, from Vicia narbonensis L., consists of an eight-stranded
      parallel alpha/beta barrel structure similar to that observed in triose phosphate
      isomerase (TIM). Narbonin is the first protein with this topology possessing no
      known enzymatic activity. Because of the lack of sequence information most of the
      primary structure was determined directly from the electron density.

PMID- 1628748
TI  - Embryology of the eye and its adnexae.
AB  - The embryonal and fetal development of the human eye includes a series of
      sequential events starting with the fertilization of the ovum and culminating in
      the birth of a normal baby. Three main periods can be distinguished in the
      prenatal development of the eye. The first period called embryogenesis is
      characterized by the establishment of the primary organ rudiments and ends at the
      end of the 3rd week with the appearance of the optic sulci on both sides of the
      midline at the expanded cranial end of the still open neural folds. The second
      period called organogenesis includes the development of the primary organ
      rudiments and extends till the end of the 8th week. The third period involves the
      differentiation of each of the primitive organs into a fully or partially active
      organ and is called differentiation. The period of embryogenesis is characterized
      by the appearance and migration of the neural crest cells and by the formation of
      the primary brain vesicles. The period of organogenesis extends from the 4th week
      till the end of the 8th week. The 4th week shows the closure of the neural canal
      anteriorly with the subsequent evagination of its lateral wall into optic
      vesicles, the invagination of the lower nasal wall of the optic vesicle causing
      the formation of the optic cup, and the development of the lens plate, retinal
      disk and embryonic fissure. The embryonic fissure extends into the optic stalk
      which connects the cavity of the optic vesicle with the cavity of the neural
      canal; the hyaloid artery penetrates into the optic cup through the embryonic
      fissure. During the 5th week, the optic cup is concluded, and the cells of its
      external layer acquire pigmentation as a result of contact with developing
      capillaries in the periocular mesenchyme; these capillaries anastomose with each
      other and form anteriorly the annular vessel. The lens plate develops into a lens
      pit and later into a lens vesicle which separates soon thereafter from the
      surface ectoderm. Inside the optic cup, the hyaloid vessels form the capillaries
      of the posterior tunica vasculosa lentis and through the capillaries of the
      lateral tunica vasculosa lentis anastomose with the annular vessel. The primary
      vitreous forms and the surface ectoderm overlying the lens vesicle differentiates
      into a primitive corneal epithelium. The facial and orbital structures also
      develop at this stage. The 6th week shows the incipient differentiation of the
      inner layer of the optic cup into a sensory retina, the formation of the
      secondary vitreous, the transformation of the posterior cells of the lens vesicle
      into primary lens fibers, the development of the periocular vasculature and the
      appearance of the first eyelid folds and of the anlage of the nasolacrimal duct.
      However, the dominating factor is the closure of the embryonic fissure.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1628749
TI  - Retinoic acid, local cell-cell interactions, and pattern formation in vertebrate
      limbs.
AB  - Retinoic acid (RA), a derivative of vitamin A, has remarkable effects on
      developing and regenerating limbs. These effects include teratogenesis, arising
      from RA's ability to inhibit growth and pattern formation. They also include
      pattern duplication, arising as a result of the stimulation of additional growth
      and pattern formation. In this review we present evidence that the diverse
      effects of RA are consistent with a singular, underlying explanation. We propose
      that in all cases exogenously applied RA causes the positional information of
      pattern formation-competent cells to be reset to a value that is posterior
      ventral-proximal with respect to the limb. The diversity of outcomes can be seen
      as a product of the mode of application of exogenous RA (global versus local)
      coupled with the unifying concept that growth and pattern formation in both limb
      development and limb regeneration are controlled by local cell-cell interactions,
      as formulated in the polar coordinate model. We explore the possibility that the
      major role of endogenous RA in limb development is in the establishment of the
      limb field rather than as a diffusible morphogen that specifies graded positional
      information across the limb as previously proposed. Finally, we interpret the
      results of the recent finding that RA can turn tail regenerates into limbs, as
      evidence that intercalary interactions may also be involved in the formation of
      the primary body axis.

PMID- 1628750
TI  - Positive and negative DNA elements of the Drosophila grimshawi s18 chorion gene
      assayed in Drosophila melanogaster.
AB  - Germ line transformation has been used to map the cis regulatory DNA elements
      responsible for the precise and evolutionarily stable developmental expression of
      the s18 chorion gene. Constructs containing chimeric combinations of Drosophila
      melanogaster and D. grimshawi DNA regions, as well as D. grimshawi sequences
      alone, can direct expression in the follicular epithelium, in an s18-specific
      temporal and spatial pattern. The results indicate that both positive and
      negative regulatory elements can function when transferred from D. grimshawi to
      D. melanogaster. The first ca. 100 bp of the 5'-flanking DNA region constitute a
      minimal, developmentally regulated promoter, expression of which is inhibited by
      the next 100-bp DNA segment and activated by positive elements located further
      upstream. Expression of the minimal promoter can also be enhanced by more distant
      chorion regulatory elements, provided the inhibitory DNA segment is absent.

PMID- 1628751
TI  - Cell mixing in the spinal cords of mouse chimeras.
AB  - With the aim of determining whether there is significant cell mixing during
      development of the spinal cord, experimental chimeric mice containing two
      genetically distinct cell populations were produced by aggregating BALB/c or
      BALB/c x LPT hybrid embryos with C3H/HeN embryos. The BALB/c and LPT hybrid
      spinal cord cells were distinguished histochemically from the C3H/HeN spinal cord
      cells by using beta-glucuronidase as an independent cell genotype marker. BALB/c
      and LPT hybrid cells have high levels of beta-glucuronidase activity, while the
      C3H/HeN cells have low levels. The spinal cords of the chimeras were dissected
      out regionally (i.e., cervical, thoracic, and lumbar areas) and were sectioned
      serially. Each region was then analyzed by scoring large- and medium-sized
      neuronal cell bodies (greater than or equal to 10 microns) whose genotypes were
      distinguished by their beta-glucuronidase levels. Observations of seven chimeric
      mice, with coat colors that varied from one extreme (5% albino) to the other (90%
      albino), suggest that each chimeric spinal cord is a relatively homogeneous
      population throughout its length. On average only 4 to 5 percentage point
      differences were observed when comparing left-right, cranial-caudal, and dorsal
      ventral regions within a given chimera. The cell mixing, however, is not total,
      and regional variations were noted. Maximum left-right differences between
      different spinal cord levels never exceeded 18 percentage points, while in the
      entire cord the maximum left-right difference was 11 percentage points. When
      considering dorsal-ventral differences, 18 and 15 percentage points were observed
      within the spinal cord levels and the entire cord, respectively. However, when
      comparisons were made between smaller subregions (e.g., right-dorsal-cervical vs
      left-ventral-lumbar), larger differences of up to 30 percentage points were
      observed. In addition, the genotype proportions in the spinal cord were closely
      correlated with the visually estimated proportions of coat color genotypes.

PMID- 1628752
TI  - Temporal pattern of synthesis of the mouse cortical granule protein, p75, during
      oocyte growth and maturation.
AB  - We previously demonstrated that a protein of M(r) 75,000 (p75) is localized to
      cortical granules (CGs) in mouse oocytes and eggs and is released upon activation
      or fertilization of eggs (K.E. Pierce, M. C. Siebert, G. S. Kopf, R. M. Schultz,
      and P. G. Calarco, 1990, Dev. Biol. 141, 381-392). To examine the temporal
      pattern of synthesis of p75 during the early stages of CG formation, growing
      oocytes, which were isolated from juvenile mice, were incubated for 4 hr in
      medium containing [35S]methionine, and radiolabeled proteins were
      immunoprecipitated using an antiserum that detects p75. Synthesis of p75 is
      detected at low levels in the smallest oocytes examined (less than 20 microns).
      Synthesis of p75 relative to total protein synthesis increases about 12-fold
      during oocyte growth from the 20-40 microns size and then remains constant
      throughout the remaining period of oocyte growth (40-70 microns). In the fully
      grown, germinal vesicle (GV)-intact oocyte (70-80 microns), immunoprecipitated
      p75 comprises approximately 1.5% of the total amount of radiolabeled protein.
      Three hours after the transfer of these oocytes to a medium that supports
      resumption of meiosis and GV breakdown in vitro, oocytes subjected to a 1-hr
      labeling pulse display a 35% decrease in the relative level of p75 synthesis. By
      15 hr of maturation, p75 synthesis was reduced to 14% of that in the fully grown,
      GV-intact oocyte and this is similar to the level of p75 synthesis in ovulated
      eggs. The level of p75 synthesis following in vitro translation of total egg RNA
      is only 38% lower than that obtained from total oocyte RNA. In addition,
      synthesis of p75 is observed following in vitro translation of oocyte, but not
      egg, poly(A)+ RNA. These results are consistent with p75 synthesis during oocyte
      maturation being under translational control.

PMID- 1628753
TI  - Rise and fall of crystallin gene messenger levels during fibroblast growth factor
      induced terminal differentiation of lens cells.
AB  - Explanted rat lens epithelial cells differentiate synchronously in vitro to lens
      fiber cells in the presence of basic fibroblast growth factor (bFGF). We have
      monitored the expression of the three rat crystallin gene families, the alpha-,
      beta-, and gamma-crystallin genes, during this process. The expression of these
      gene families is sequentially activated, first the alpha-crystallin genes at Day
      1, then the beta-crystallin genes at Day 3, and finally the gamma-crystallin
      genes at Day 8. The steady state levels of alpha- and beta-crystallin mRNA are
      not affected by incubation with actinomycin D, suggesting that these mRNAs are
      stable. Nevertheless, all crystallin mRNAs disappear from the differentiated
      explants between Days 10 and 11, a process signaled by bFGF. At this time a novel
      abundant mRNA appears. Cloning and sequencing showed that this mRNA encoded
      aldose reductase. Our results suggest a novel model for the regulation of
      crystallin synthesis during lens cell differentiation: a gene pulse delivers a
      certain amount of stable mRNA, this mRNA is removed at a later stage of
      differentiation by a stage-specific breakdown mechanism. Each of these regulatory
      steps requires a signal from bFGF.

PMID- 1628754
TI  - Dynamic expression of a cell surface protein during rearrangement of epithelial
      cells in the Manduca wing monolayer.
AB  - The expression of cell surface protein 2F5 changes dynamically in space and time
      during morphogenesis of the Manduca wing pattern. Two cell types (generalized
      epithelial cells and scale precursors) rearrange within each of the two
      epithelial monolayers of the wing to form periodic rows of scale cells. These two
      monolayers also interact with each other during a brief period of adult
      development. Each cell type shows a different pattern of protein 2F5 expression
      during cell rearrangement and during interaction of the two wing monolayers.
      Before and after these morphogenetic movements of epithelial cells, the protein
      is expressed on only a small population of wing cells. In abdominal epithelia
      where scale cells are also present but are not arranged in periodic rows, the
      expression pattern of the surface protein is temporally and spatially very
      different. An earlier study (Nardi and Magee-Adams, Dev. Biol., 116, 278-290,
      1986) had shown that basal processes only extend from epithelial cells during
      their period of rearrangement within a monolayer and during the transient
      apposition of the wing's upper and lower monolayers. The differential
      distribution of protein 2F5 on lateral surfaces and basal processes of scale
      precursor cells and generalized epithelial cells may account in part for their
      orderly segregation into alternating rows as well as for the transient
      interaction of the two wing monolayers.

PMID- 1628755
TI  - The l(1)ogre gene of Drosophila melanogaster is expressed in postembryonic
      neuroblasts.
AB  - Previous genetic studies showed that the wild-type function of the lethal (1)
      optic ganglion reduced (l(1)ogre) gene in Drosophila melanogaster was needed,
      apparently specifically, for the generation and/or maintenance of postembryonic
      neuroblasts, i.e., those neuroblasts in the optic formation centers (primordia of
      the adult optic lobes) and giant neuroblasts scattered over the periphery of
      cortices of the larval central nervous system (CNS). In the present study
      temporal and spatial specificity of l(1)ogre expression was investigated by in
      situ hybridization and also immunofluorescence with polyclonal anti-l(1)ogre
      antibodies. l(1)ogre protein was detected, as expected, in the optic formation
      centers and giant neuroblasts in the larval CNS. l(1)ogre expression, however,
      was not specific to these neuroblasts: expression was also detected in a wide
      range of tissues including the CNS at many developmental stages. Examination of
      transcriptional pattern indicates that l(1)ogre is expressed in derivatives of
      the ectoderm, endoderm, and mesoderm (but not in the germ line) in two
      developmental contexts: (i) during and shortly after the proliferative phase and
      (ii) during histolysis of some larval tissues.

PMID- 1628756
TI  - Expression of DNA ligases I and II during oogenesis and early development of
      Xenopus laevis.
AB  - We have analyzed the expression of DNA ligase I protein during oogenesis and
      early development of Xenopus laevis. The protein is already present in stage I
      oocytes and then accumulates throughout oogenesis to reach a steady state level
      by stage VI. It remains at this level at least until tadpole stage. In stage VI
      oocytes DNA ligase I protein is almost exclusively localized in the germinal
      vesicle. We have partially purified a DNA ligase II activity from stage VI
      oocytes, unfertilized eggs, and stage 8 embryos. An 80-kDa polypeptide can be
      specifically adenylated in all three purified extracts. It is not recognized by
      antibodies directed against DNA ligase I and is active on oligo(dT)-poly(rA)
      substrate. It could therefore represent DNA ligase II protein. The presence of
      both DNA ligases I and II in oocytes and embryos is inconsistent with the DNA
      ligase model that had been previously proposed for amphibia.

PMID- 1628757
TI  - Molecular aspects of regeneration in developing vertebrate limbs.
AB  - We review embryological as well as molecular evidence that emphasizes the idea
      that both the regenerate and the developing vertebrate limb bud utilize a similar
      set of signals that regulate pattern formation. Evidence is presented to
      implicate the Hox-7.1 gene in the developmental regulation of growth,
      differentiation, and positional assignment during limb outgrowth and the proposal
      is made that the expression of this gene governs the cellular activities within
      the progress zone during limb outgrowth. Finally, we review the limited
      information known about the regenerative capabilities of limb buds in organisms
      that cannot regenerate as adults. We content that a solution to the problem of
      regenerative failure among higher vertebrates will come progressively through a
      stepwise analysis of impaired regeneration associated with increasing
      developmental age.

PMID- 1628758
TI  - DNA synthesis in the early embryo of the nematode Ascaris suum.
AB  - We have used microspectrofluorimetry to measure the rate of DNA synthesis in the
      first two embryonic cell cycles of the parasitic nematode Ascaris suum. The S
      phase of the early Ascaris cell cycles occupies at most 1 hr; G2 phase is
      prominent and occupies approximately 11 hr; no G1 phase could be detected. These
      results contrast with our previous measurements made with embryos of the free
      living nematode Caenorhabditis elegans, in which the earliest cell cycles consist
      of simple alternations between S and M phases.

PMID- 1628759
TI  - Extracellular Mg2+ induces an intracellular Ca2+ wave during oocyte activation in
      the marine shrimp Sicyonia ingentis.
AB  - In contrast to most systems in which oocyte activation is triggered by the
      fertilizing sperm, Sicyonia ingentis oocytes are activated by seawater Mg2+
      during spawning. S. ingentis oocytes were spawned into Mg(2+)-free seawater and
      microinjected with the fluorescent Ca2+ indicator Fluo-3 to study the effects of
      added Mg2+ on intracellular Ca2+ levels. The Mg2+ induced a wave of fluorescence
      across the oocyte that traveled at a speed of 13 +/- 3 microns/sec. Extracellular
      Ca2+ was not required for induction of the wave. Treatment with Ca2+ ionophore in
      Mg(2+)-free medium or a localized injection (0.3% oocyte volume) of 3-5 microM
      Ca2+ also initiated the wave; injection of 250 mM Mg2+ (up to 1.5% oocyte volume)
      had no effect. Microinjection of 750 microM EGTA (final) suppressed the Mg(2+)
      induced wave, while an identical concentration of EDTA had no inhibitory effect.
      Subsequent to the initial Mg(2+)-induced intracellular Ca2+ increase, a second
      Ca2+ increase was observed at approximately 15 min postspawning; the timing of
      this second increase appeared to be independent of when the Mg(2+)-induced wave
      was initiated, thus an event associated with spawning may be involved. While
      oocytes in normal seawater were monospermic, those in Mg(2+)-free seawater were
      polyspermic, suggesting a role for the Mg(2+)-induced Ca2+ wave in regulating
      sperm entry into the oocyte.

PMID- 1628760
TI  - Increased expression of tissue plasminogen activator and its inhibitor and
      reduced fibrinolytic potential of human endothelial cells cultured in elevated
      glucose.
AB  - In diabetic patients, elevated plasma levels of t-PA and PAI-1 accompany impaired
      fibrinolysis. To identify mechanisms for these abnormalities, we examined whether
      vascular endothelial cells exposed to high glucose upregulate t-PA and PAI-1
      production and whether ambient PA activity is decreased concomitantly. In 17
      cultures of human umbilical vein endothelial cells grown to confluency in 30 mM
      glucose, the t-PA antigen released to the medium in 24 h was (median) 52 ng/10(6)
      cells (range 10-384) and the PAI-1 antigen was 872 ng/10(6) cells (range 217
      2074)--both greater (P less than 0.02) than the amounts released by paired
      control cultures grown in 5 mM glucose--29 ng/10(6) cells (range 7.5-216) and 461
      ng/10(6) cells (range 230-3215), respectively. In the presence of high glucose,
      the steady-state levels of t-PA and PAI-1 mRNAs were increased correspondingly
      (median 142 and 183% of control, respectively, P less than 0.05); high glucose
      per se and hypertonicity contributed to the upregulation in additive fashion. The
      PA activity of conditioned medium from cultures exposed to high glucose was 0.4
      IU/ml (range 0.2-0.6), which was significantly lower (P less than 0.02) than the
      PA activity of control medium (0.5 IU/ml, range 0.2-0.9). No difference was
      observed when comparing the PA activities of acidified conditioned media,
      expected to be depleted of inhibitors. Thus, high glucose coordinately
      upregulates endothelial t-PA and PAI-1 expression through effects exerted at the
      pretranslational level and enhanced by even mild degrees of
      hypertonicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628761
TI  - Poly I:C accelerates development of diabetes mellitus in diabetes-prone BB rat.
AB  - We developed a new experimental model of accelerated diabetes mellitus in the
      genetically susceptible diabetes-prone BB rat with the administration of the IFN
      alpha inducer poly I:C. With this model, there was both an increased incidence
      and accelerated onset of insulin-dependent-diabetes in poly I:C-treated animals
      compared with saline-treated controls. All twelve rats administered poly I:C (5
      micrograms/gm body weight 3 times/wk) developed diabetes by 57 days of age (100%)
      compared with 1 of 27 (3.7%) saline-treated controls. Furthermore, the
      development of diabetes was accelerated in the poly I:C-treated group (mean age
      +/- SE at onset 52.8 +/- 0.58 days) compared with saline-treated controls (89.3
      +/- 2.4 days, P less than 0.01). Additionally, poly I:C-treated rats had higher
      mean serum IFN-alpha levels than saline-treated rats at weeks 2 and 3 of
      treatment (210 vs. 27 and 183 vs. 25 U/ml, respectively, P less than 0.001). Poly
      I:C treatment of 5 Wistar rats, the parental strain, which is not susceptible to
      diabetes, did not result in insulitis, diabetes, or hyperglycemia. The
      histopathologic findings of insulitis and decreased immunoreactive islet insulin
      in poly I:C-accelerated diabetic BB rats and in BB rats with spontaneous diabetes
      suggest a similar pathophysiology.

PMID- 1628762
TI  - Islet cell and thyrogastric antibodies in 633 consecutive 15- to 34-yr-old
      patients in the diabetes incidence study in Sweden.
AB  - The effect of age on ICA and thyrogastric antibodies at diagnosis of IDDM was
      evaluated in 633 consecutively diagnosed Swedish diabetic patients aged 15-34 yr
      and in 282 volunteers of the same age. ICAs were present in 61% (383 of 633) of
      the patients and in 2% (5 of 282) of control subjects. When the initial
      classification was considered, ICAs were detected in 69% (327 of 473) of patients
      with IDDM, 23% (19 of 83) of those with NIDDM, 50% (36 of 72) of those with
      unclassifiable diabetes, and 20% (1 of 5) of those with secondary diabetes. The
      frequency of ICA fell significantly (P less than 0.001) with age in IDDM patients
      from 77% (104/135) in those 15-19 yr old to 52% (50 of 96) in 30- to 34-yr-old
      IDDM patients. The low frequency of ICA in 30- to 34-yr-old IDDM patients was
      confined to men (42%, 28 of 66). The frequency of gastric (H+, K(+)-ATPase)
      antibodies was significantly (P less than 0.05) higher in IDDM patients (10%, 47
      of 449) than in patients with NIDDM (3%, 3 of 80) and unclassifiable diabetes
      (4%, 3 of 72). In conclusion, the frequency of ICA at the diagnosis of IDDM in
      young adult subjects decreases with increasing age, particularly in men. The
      frequent finding of ICA in patients considered to have NIDDM or unclassifiable
      diabetes indicates that misclassification of diabetes is frequent in young adult
      patients recently diagnosed with diabetes.

PMID- 1628763
TI  - An explanation for the neutral effect of DR2 on IDDM susceptibility in central
      Italy.
AB  - Susceptibility to IDDM is strongly associated with HLA. Some HLA allelic
      combinations (haplotypes) can be found in most patients, whereas other haplotypes
      are encountered only rarely. It has been proposed that this difference in
      susceptibility depends on the absence (in the DR3 and DR4 haplotypes) or the
      presence (in the DR2 haplotype) of Asp57 in the DQ beta-chain. Data on southern
      European populations challenge this hypothesis because the DR2 haplotype has not
      been associated negatively with IDDM, as reported in northern European
      populations. This study on a selected panel of DR2-positive Italian IDDM patients
      shows that 19 of 21 (90.5%) DR2 haplotypes possess a non-Asp57 DQB allele.
      Moreover, the same non-Asp57 subtype has a comparatively high frequency (9/28, or
      32.1%, DR2 haplotypes) also in the DR2-positive healthy Italian population. The
      difference between patients and control subjects is significant (P less than
      0.0001). This is the largest series of DR2-positive patients analyzed so far.
      Comparison with cumulated data in various white populations shows a distinct
      northern European-to-southern European gradient. Toward southern Europe, the
      relative frequency of the non-Asp57 DR2 subtype increases. Concomitantly, the
      apparent protective effect of the DR2 haplotype disappears. Therefore, the
      observed differences in DR2-IDDM association in white populations can be
      explained adequately by the Asp57 hypothesis, which this study's data strongly
      support.

PMID- 1628764
TI  - Free radical activity and hemostatic factors in NIDDM patients with and without
      microalbuminuria.
AB  - In non-insulin-dependent diabetes mellitus (NIDDM) patients, microalbuminuria
      predicts early mortality, predominantly from cardiovascular disease. Increased
      free radical activity and abnormalities in hemostasis have been implicated in the
      development of vascular disease. Therefore, we measured markers of free radical
      activity (nonperoxide-conjugated diene isomer of linoleic acid [PL-9,11-LA'] and
      lipid peroxides expressed as malondialdehyde [MDA]) along with the hemostatic
      variables: fibrinogen, von Willebrand factor (vWf), plasminogen activator
      inhibitor (PAI-1), tissue plasminogen activator (t-PA), and plasmin activity (B
      beta 15-42) in 24 NIDDM patients (12 patients with microalbuminuria and 12
      without microalbuminuria) and in 12 age-matched control subjects. There were no
      differences in linoleic acid (PL-9,12-LA) concentrations between the three
      groups. PL-9,11-LA' was elevated in the microalbuminuric patients compared with
      control subjects (P less than 0.05), but there was no difference between the two
      diabetic groups. MDA was elevated in the microalbuminuric diabetic patients
      compared with those patients without microalbuminuria (P less than 0.05) and
      control subjects (P less than 0.001). MDA was also increased in the patients
      without microalbuminuria compared with control subjects (P less than 0.01).
      Except for B beta 15-42, all the hemostatic variables were increased (P less than
      0.05) in the diabetic patients compared with control subjects. The
      microalbuminuric diabetic patients had further increases in vWf (P less than
      0.03) and t-PA (P less than 0.03) compared with patients with microalbuminuria.
      Our study suggests that there is an increase in free radical activity and
      abnormalities in hemostatic variables favoring a hypercoagulable state in NIDDM,
      especially in those with microalbuminuria.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628765
TI  - Susceptibility to IDDM in a Chinese population. Role of HLA class II alleles.
AB  - MHC associations with IDDM in a Chinese population were studied to investigate
      genetic susceptibility to the disorder. The frequency of HLA-DR3 was
      significantly higher in the diabetic patients (19/49 [38.7%] vs. control
      subjects, 11/105 [10.5%], Pc less than 1.3 x 10(-3), RR = 5.3 [CI 2.3-12.1]),
      whereas DR4 was not (11/49 [22.4%] vs. 28/105 [26.7%], NS). The frequency of
      DR3/4 heterozygosity was higher in the diabetic patients (6/49 [12.2%] vs.
      control subjects, 0/105 [0%], P = 1.7 x 10(-3), RR = 31.5 [CI 3.8-263.6]). The
      frequency of DR3/9 heterozygosity also was higher in the diabetic patients (6/49
      [12.2%] vs. control subjects, 2/105 [1.9%], P = 0.03, RR = 6.2 [CI 3.0-12.7]). No
      significant associations were noted between DQB1 alleles and IDDM. Among DR4
      positive subjects, the frequency of DQB1 allele DQB1*0302 was higher in the
      diabetic patients (10/11 [90.0%] vs. control subjects, 12/24 [50%], Pc less than
      0.05, RR = 7.0 [CI 1.3-38.0]), and the frequency of DQB1*0401 was significantly
      lower in the diabetic patients (2/11 [18.2%] vs. control subjects, 16/24 [66.7%],
      Pc = 0.04, RR = 0.1 [CI 0.02-0.46]). No DR4 subtype was associated significantly
      with IDDM. The frequency of DQA1*0501, a DQA1 allele, was higher in diabetic
      patients (22/41 [53.7%] vs. control subjects, 20/95 [21.1%], Pc less than 3 x 10(
      3), RR = 4.3 [CI 2.0-9.3]). The frequency of DQA1*0301, which has been associated
      consistently with IDDM in other ethnic groups, was not significantly higher in
      the diabetic patients in this study (27/41 [65.9%] vs. control subjects, 53/95
      [55.8%], NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628766
TI  - Exercise training increases glucose transporter content in skeletal muscles more
      efficiently from aged obese rats than young lean rats.
AB  - Glucose uptake in rat skeletal muscles decreases with age and obesity, but
      increases with chronic exercise training. The purpose of our study was to
      determine whether the GLUT4 content in several skeletal muscles from 1-mo-old
      young, lean rats and 12-mo-old aged, obese rats alters with exercise training.
      For exercise, a treadmill run of approximately 1 km/day was made for 4 wk by both
      groups of rats. The concentration of GLUT4 per protein in membrane fraction from
      several skeletal muscles was measured by immunoblotting. The amount of GLUT4 in
      the gastrocnemius and white quadriceps from aged rats slightly but significantly
      decreased to 73% and 78% of that from young rats, respectively. However, no
      significant difference in GLUT4 amount in the soleus, plantaris, and red
      quadriceps was observed between young and aged rats. The exercise training
      resulted in a larger increase in the amount of GLUT4 in each muscle from aged
      rats than in muscles from young rats. In aged rats, GLUT4 amount increased
      significantly with exercise training by 30, 33, 41, and 27% in the soleus,
      plantaris, gastrocnemius, and red quadriceps, respectively, compared with the
      sedentary controls. However, in young rats, exercise-induced increase of GLUT4
      amount was significant only in the plantaris, and the increase was 17%. In
      exercised aged, obese rats, decreases of body weight, plasma triglyceride levels,
      and plasma free fatty acid were also observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628767
TI  - Coordinate control of lipolysis by prostaglandin E2 and prostacyclin in rat
      adipose tissue.
AB  - PGE2 is a potent antilipolytic agent produced by adipose tissue, but its role as
      a physiological regulator of triglyceride lipolysis is controversial because
      inhibitors of prostaglandin synthesis have not enhanced hormone-stimulated
      lipolysis in adipose tissue consistently. Adipose tissue also produces PGI2, but
      this eicosanoid has not had a demonstrated effect on lipolysis under
      physiological conditions previously. We investigated both PGE2 and PGI2
      production and their effects on lipolysis in rat adipose tissue. We found that 1)
      EPI-stimulated PGE2 production (like PGI2 production) requires the cooperation of
      adipocytes and endothelial cells, 2) adipose tissue produces PGE2 and PGI2 at
      comparable rates, 3) indomethacin inhibits EPI-induced PGE2 and PGI2 production
      and has no effect on EPI-stimulated lipolysis when added to a mixture of
      adipocytes and endothelial cells or to intact epididymal fat pads, 4) PGI2 is a
      potent lipolytic agent when added to isolated adipocytes in the absence of
      endothelial cells under physiological conditions, 5) the magnitudes and the ED50s
      of the antilipolytic effect of PGE2 and the lipolytic effect of PGI2 in isolated
      adipocytes in the absence of endothelial cells are comparable, 6) PGI2
      antagonizes the antilipolytic effect of PGE2 in isolated adipocytes in the
      absence of endothelial cells in a dosage-related manner, and 7) the antilipolytic
      effect of added PGE2 in isolated adipocytes is greater in the absence of
      endothelial cells than in their presence, suggesting that endogenous eicosanoid
      production reduces the effectiveness of added PGE2. These studies demonstrate
      that catecholamine-induced lipolysis is under the coordinate control of PGE2, a
      potent antilipolytic agent, and PGI2, a potent lipolytic agent.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1628768
TI  - Improvement of nerve conduction in diabetic neuropathy. A follow-up study 4 yr
      after combined pancreatic and renal transplantation.
AB  - Eighteen patients with long-standing insulin-dependent (type 1) diabetes mellitus
      and polyneuropathy were studied after combined pancreatic and renal
      transplantation. Repeated tests were performed on peripheral nerve function
      (electroneurography) and on autonomic function (R-R test) 6 mo and 1, 2, and 4 yr
      after the transplantation. Eighteen diabetic patients with only a kidney graft
      served as controls. After initial improvement of nerve conduction in both groups,
      probably caused by the elimination of uremia, further improvement was seen only
      in the euglycemic pancreas-graft recipients. Improvement of autonomic
      (parasympathetic) function was slight after 48 mo and was similar in both groups.

PMID- 1628769
TI  - Evidence for unique distribution of Kimmelstiel-Wilson nodules in glomeruli.
AB  - Different distributions of segmental lesions within glomeruli correspond to
      different pathogenetic mechanisms. A graphic method of analysis of the position
      of segmental lesions was applied to 106 Kimmelstiel-Wilson nodules in 10 renal
      biopsies from patients with diabetic glomerulonephropathy, 4 with IDDM and 6 with
      NIDDM. The nodules were randomly distributed in a horseshoe-shaped area
      corresponding to the peripheral or intralobular mesangium. This distribution was
      different from that of segmental lesions studied previously in the glomerular tip
      lesion, in vasculitic-type glomerulonephritis, and in hyperfiltration associated
      with reduced renal mass. Our finding is consistent with ideas that Kimmelstiel
      Wilson nodules have a distinct pathogenesis not related to hyperfiltration or any
      other process previously investigated as a cause of characteristic distribution
      of segmental lesions.

PMID- 1628770
TI  - Somatic gene therapy for diabetes with an immunological safety system for
      complete removal of transplanted cells.
AB  - To develop somatic gene therapy for diabetes, we studied an animal model with
      proinsulin-producing fibroblasts with an immunological safety system. Cultured
      mouse fibroblasts of the Ltk- cell line were transfected first with the efficient
      human proinsulin expression vector pBMG-Neo-Ins. Initially, 2 x 10(6) cells with
      a proinsulin-production rate of 91 ng.24 h-1.10(6) cells-1 were transplanted i.p.
      into streptozocin-induced diabetic C3H mice. The blood glucose concentrations
      improved between the first and the 28th day, but the animals died of hypoglycemia
      between the 29th and 46th days. The proinsulin-producing Ltk- cells were further
      transfected with a second plasmid, pHEBo-CD8.2, encoding BALB/c mouse T-cell
      differentiation antigen. The CD8.2 allotype is different from CD8.1 allotype by
      only one amino acid substitution and should be only slightly antigenic to the
      recipient C3H mice. Somatic gene therapy with these doubly transfected cells
      followed by the consecutive administration of a monoclonal antibody to CD8.2
      resulted in an initial decrease of blood glucose concentrations followed by the
      permanent recurrence of hyperglycemia, thus proving the complete removal of the
      transplanted cells. Cultured fibroblasts were thus proven capable of supplying
      sufficient proinsulin to lower the blood glucose concentrations in diabetic
      animals. The immunological safety system with a combination of artificial
      expression of cell surface antigen and the administration of the specific
      monoclonal antibody was an effective safety system for somatic gene therapy.

PMID- 1628771
TI  - Linkage analysis of maturity-onset diabetes of the young with microsatellite
      polymorphisms. No linkage to ADA or GLUT2 genes in two families.
AB  - MODY is a form of NIDDM inherited as an autosomal dominant condition. We studied
      the linkage of MODY to two loci: ADA and GLUT2 in two large pedigrees with
      nonradioactive microsatellite polymorphic systems. A positive linkage of ADA to
      MODY was recently demonstrated in the large RW pedigree. Formal linkage analysis
      excluded a tight linkage between ADA and MODY with a LOD score of -5.82 and -2.24
      at a recombination fraction of 0.01 in the two families. This result suggests
      genetic heterogeneity in the molecular basis of MODY. GLUT2 is a candidate gene
      that is expressed in the liver and beta-cells of pancreatic islets. In the two
      families studied, the disease did not cosegregate with GLUT2 alleles. The LOD
      scores for GLUT2 were -7.79 and -1.9 at a recombination fraction of 0.001 in the
      two families, thus providing evidence against the involvement of GLUT2 in MODY.

PMID- 1628772
TI  - Ketone body metabolism in NIDDM. Effect of sulfonylurea treatment.
AB  - We assessed the metabolism of the two KBs, AcAc and 3-BOH; the relationships
      between ketogenesis and FFA inflow rate; and the effect of chronic sulfonylurea
      treatment in mild NIDDM patients (plasma glucose less than 10 mM). We studied 10
      nonobese NIDDM patients in a crossover, randomized, double-blind, placebo
      controlled fashion. Each patient was studied 4 times: after a run-in period with
      placebo, after 3 mo of placebo treatment, after 3 mo of glibenclamide treatments,
      respectively, and after 3 mo of sulfonylurea treatment during an acute exogenous
      Intralipid infusion. Ten normal, nondiabetic subjects served as the control
      group. Glibenclamide treatment decreased plasma FFAs. When these substrates were
      exogenously increased, plasma FFAs were comparable with placebo and baseline
      concentrations. In NIDDM patients, baseline and placebo blood total KB
      concentration was significantly higher than in control subjects (216 +/- 22 and
      244 +/- 25, respectively vs. 127 +/- 18 microM; P less than 0.01). Glibenclamide
      treatment significantly decreased total KBs to 177 +/- 19 microM (P less than
      0.05). When FFAs were exogenously increased, total KBs were similar to the
      placebo and baseline period. In the baseline study, the AcAc/3-BOH ratio was 0.72
      +/- 0.06 in control subjects, whereas in NIDDM patients, the ratio was 1.61 +/-
      0.13 at baseline (P less than 0.001 vs. control subjects), 1.66 +/- 0.15 during
      placebo, 1.57 +/- 0.09 during glibenclamide (NS vs. baseline), and 1.51 +/- 0.23
      during glibenclamide plus placebo FFAs. Both the AcAc interconversion rate to 3
      BOH and the 3-BOH interconversion rate to AcAc were significantly lower in NIDDM
      patients than in control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628773
TI  - In vitro effects of amylin on carbohydrate metabolism in liver cells.
AB  - Amylin, a peptide found in pancreatic amyloid deposits, may be involved in NIDDM.
      The effects of biosynthetic human amylin on multiple aspects of carbohydrate
      metabolism were studied in freshly isolated and cultured liver cells (rat
      hepatocytes and HepG2 cells). Acute exposure of culture liver cells to amylin had
      no effect on glucose incorporation into glycogen. Amylin directly reduced glucose
      oxidation through the hexose monophosphate shunt. The glycolytic pathway was
      unaffected. Amylin stimulated both glycogenolysis and gluconeogenesis. These
      effects were largest at amylin concentrations of 1-10 pM. Insulin partially
      inhibited both of these responses. Glucagon stimulated glycogenolysis and
      gluconeogenesis to a similar extent as amylin but required concentrations 100- to
      500-fold as high. Thus, amylin, at physiologic concentrations, can impair some
      aspects of glucose use in liver cells and is also capable of directly stimulating
      glucose production, suggesting a possible involvement of amylin in the impaired
      glucose disposal and elevated hepatic glucose output of NIDDM.

PMID- 1628775
TI  - Studies on autoimmunity for T-cell-mediated beta-cell destruction. Distinct
      difference in beta-cell destruction between CD4+ and CD8+ T-cell clones derived
      from lymphocytes infiltrating the islets of NOD mice.
AB  - Six CD4+ and three CD8+ islet-reactive T-cell clones were established from
      lymphocytes infiltrating the pancreatic islets of NOD mice. Two of six CD4+ T
      cell clones responded to NOD islet cells only, not to spleen cells. The remaining
      four clones responded to both islet cells and spleen cells from NOD mice, but not
      to cells from other strains of mice, including SJL, C3H, C57BL/6, and DBA/2 mice.
      None of the CD4+ T-cell clones had a cytotoxic effect on the cultured islet
      cells. On the other hand, all of the CD8+ T-cell clones showed both a
      proliferative response and a cytotoxic effect on the islet cells, with the
      restriction of MHC class I H-2Db. Electron microscopic studies revealed that
      islet-specific CD4+ T-cells attached closely to islet cells but did not destroy
      them. In contrast, CD8+ T-cell clones showed pseudopodialike protrusions into
      beta-cells, but not alpha- or delta-cells, leading to selective destruction of
      beta-cells. CD8+ CTLs could not be isolated from islets of NOD mice less than 10
      wk of age, even if the islets showed lymphocytic infiltration, whereas CD4+ T
      cells could be isolated from islets of these younger NOD mice. On the basis of
      these observations, we concluded that CD4+ and CD8+ T-cells interact differently
      with beta-cells at different stages in T-cell--mediated beta-cell destruction.
      CD4+ T-cells may secrete cytokines, which in turn activate effector cell
      populations, whereas CD8+ T-cells may act as a final effector directly involved
      in beta-cell destruction.

PMID- 1628774
TI  - Insulinlike effects of zinc ion in vitro and in vivo. Preferential effects on
      desensitized adipocytes and induction of normoglycemia in streptozocin-induced
      rats.
AB  - The effects of Zn2+ in mimicking insulin in vivo and in vitro are further
      characterized. Like insulin, Zn2+ stimulated the conversion of [U-14C]-, [1-14C]
      , and [6-14C]glucose to lipids in rat adipocytes. Maximum stimulation of
      lipogenesis was 55-80% of maximum insulin response after preincubation (30 min at
      37 degrees C) of adipocytes with ZnCl2 (0.4 mM). Under these conditions, the half
      maximum effect was achieved at 0.17 +/- 0.02 mM of ZnCl2. Similarly, an
      insulinlike effect of Zn2+ was observed on the oxidation of glucose by both
      pathways, glycolytic and hexose monophosphate shunt. In contrast, unlike insulin,
      Zn2+ did not inhibit lipolysis but rather exhibited a slight lipolytic activity.
      Also, the effect of Zn2+ on hexose influx did not exceed 14 +/- 3% that of
      insulin. The stimulatory effects of Zn2+ were not related to generation of H2O2.
      Catalase (100 micrograms/ml) did not inhibit Zn(2+)-stimulated glucose oxidation
      and its incorporation into lipids. Zn2+ had an additive effect on either insulin-
      or vanadate-stimulated conversion of [1-14C]glucose to fat, and together, the
      effect was approximately 140% of the maximum rate of lipogenesis. Chelation of
      intracellular Zn2+ by the cell-permeable chelator N,N,N',N'-tetrakis (2
      pyridylmethyl)ethylenediamine did not significantly affect the ability of insulin
      to stimulate lipogenesis. Adipocytes derived from STZ rats were largely
      refractory to the modulating action of insulin. In contrast, the effect of Zn2+
      on lipogenesis in these cells was more pronounced.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1628777
TI  - [Coronary angioplasty in the aged: short and long term efficacy in patients with
      unstable angina].
AB  - Coronary revascularization procedures in elderly patients are associated with an
      increase of perioperative complications and death in comparison with younger
      patients. To assess if a conservative coronary angioplasty approach is useful, 54
      consecutive patients (pts) with severe unstable angina were retrospectively
      evaluated. Mean age was 73 years (range 70-82 years). Multivessel coronary
      disease was present in 26 pts (48%), angina at rest within the last 2 days in 26
      (48%) and an episode of myocardial infarction within 2 weeks in 21 (38%). In 51
      cases, regardless of the extension of the coronary disease, only the stenosis
      considered "culprit" of the symptoms, as assessed by angiography and by
      noninvasive studies, was dilated. The angiographic success rate was 98% (53 of 54
      pts). Two pts had procedure--related myocardial infarction. One patient died
      after emergency bypass surgery for an abrupt left anterior descending artery
      occlusion. The mean hospital stay was 8 days (range 2-40 days) and in 75% cases
      was less than 6 days. Follow-up (achieved in 51 pts) ranged from 1 to 40 months
      (mean 20 months). In 3 pts a second vessel was treated with a new angioplasty 15
      30 days after the first procedure due to the persistence of symptoms. During
      follow-up three pts died (1 death was cardiac). Of the survivors, 35 were
      asymptomatic in moderate medical regimen, 1 required bypass surgery and 3 were
      managed with repeat angioplasty. Survival was 95% at 6 months and 90% at 2 years.
      At six months 86% of pts were event free (80% and 70% at one and two years,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628776
TI  - [A survey of cardiological emergencies in Piedmont].
AB  - OBJECTIVES AND DESIGN: In order to assess the current behavioural status of
      patients receiving emergency cardiological treatment and the emergency services
      in the Piedmont Region, our Division carried out a survey of the Region's DEA and
      first aid centres based on the compilation of a questionnaire for each patient
      who passed through these structures over a 5-month period. The study included
      only patients hospitalised within 12 hours of symptoms' onset. The questionnaire
      aimed to assess the time the patient took to reach a decision, the eventual call
      for a home visit, the type of doctor called, the time spent by the doctor, the
      use of either a private vehicle or of an ambulance for transport to hospital, the
      time taken to get to the hospital, and the overall time taken to admit the
      patient to the emergency cardiological ward. The statistical analysis of data was
      carried out using both single and multiple variables. The selection of prognostic
      variables was carried out using a stepwise method. RESULTS: Data presented in
      this study refer to 1705 records, collected in 39 Piedmontese hospitals (75% of
      those with DEA or First Aid Center). Patients with acute myocardial infarction
      were 970 (57%). A doctor was requested at home in nearly half of the cases
      (49.3%). There was no correlation between the type of emergency and the request
      for a home visit, whereas the latter varied in relation to the different
      geographical areas and to the patients' age. A small majority of patients used
      personal transport to get to the hospital (55.5%) in comparison to those using an
      ambulance (44.5%) (p less than 0.001). Time taken to reach a decision was related
      to the type of pathology (acute pulmonary edema less than acute myocardial
      infarction less than arrhythmia) and to geographical area; mean decision time in
      the overall sample was 125 +/- 158 minutes. The mean duration of doctors'
      intervention at home was 74 +/- 82 minutes. The mean time taken to reach the
      hospital using private transport was 22 minutes, and the time taken using
      ambulance was the same, but this should be added to the time taken for the
      ambulance to reach the patient (a mean total time of 15 minutes). Overall mean
      hospitalisation time was 192 minutes. CONCLUSIONS: The critical factors causing
      delay in hospitalisation time are the poor levels of health education of the
      population in general, and the poor activation capacity of certain peripheral
      parts of the National Health Service. In particular, it is worth drawing
      attention to the delay due to the intervention of the family doctor in the
      current organisational model. Doctors called from first aid stations are able to
      provide a more rapid intervention, but are currently unable to meet the
      requirements of patients needing emergency cardiological treatments. These data
      confirm the rationale for intervention projects in cardiological emergencies,
      considering on one hand that a fleet of special vehicles be created, and on the
      other that doctors from first aid stations be specifically trained and
      increasingly involved.

PMID- 1628778
TI  - [Ultrasonic decalcification in aortic stenosis. Clinical and doppler
      echocardiographic results].
AB  - Ten elderly patients with aortic valve stenosis and with a small calcified
      annulus (less than 20 mm) were treated by ultrasonic valve debridement (UVD)
      while 17 other elderly patients underwent aortic valve replacement (AVR) during
      the same period. The clinical and doppler results were assessed for a mean follow
      up period of 20 months. Patients with significant aortic regurgitation or
      associated valve disease were excluded. The patients were studied by m-mode, two
      dimensional and Doppler echocardiography before, immediately after, and at 6
      months interval after the procedure. A successful decalcification was achieved in
      8 patients. The valve was replaced in 2 patients because of cusp perforation or
      unsatisfactory intraoperative result. All patients showed significant
      postoperative increase in the mobility of the valve cusps, decrease in the amount
      of calcium, decrease of the aortic mean valve gradient (from 62 +/- 25 to 23 +/-
      6 mmHg, p less than 0.001) and increase of the aortic valve area (from 0.49 +/-
      0.11 to 1.21 +/- 0.3, p less than 0.001). The mean valve gradient was slightly
      higher after UVD than after AVR and showed a slight trend to further increase
      during follow-up, although only one patient had evidence of restenosis. A mild
      aortic valve insufficiency was present postoperatively in 6 patients. Worsening
      of insufficiency was noted in 2 patients during the follow-up period and one
      subject was re-operated on. Surgical ultrasonic debridement of the aortic valve
      may be effective in selected surgical candidates with small calcified valve and
      annulus, but subsequent occurrence of aortic insufficiency and restenosis may
      seriously limit its application.

PMID- 1628779
TI  - [Decalcification of stenotic aortic valves].

PMID- 1628780
TI  - [Acute surgically-treated complications of myocardial infarct. Clinical
      experience and discussion of surgical indications].
AB  - Post-infarction free-wall, papillary muscle and septal myocardium rupture yields
      a lowering mortality, not only due to the improved surgical technique but also to
      a more careful selection of surgical candidates. The value of pericardial
      decompression in cases of free-wall rupture is discussed. Echocardiographic
      evidence of blood in the pericardium after a myocardial infarction is not a
      direct indication for a diagnostic sampling, decompression or surgery.
      Pericardiocentesis is not a risk-free procedure and should be limited to patients
      with life-threatening acute tamponade. Clinical results of 34 patients operated
      upon for myocardial rupture, regardless of adopted technique or timing of
      surgery, confirm that the decision about a patient's operability should follow a
      careful evaluation of the following risk factors in this order: infarct size,
      age, cardiogenic shock, multiorgan failure, rupture site, cardiac failure and
      associated diseases.

PMID- 1628781
TI  - ["Kissing balloon" of the protected common trunk of the left coronary artery:
      description of a successfully treated case].
AB  - The authors describe a case of coronary angioplasty on a distal Left Main
      coronary lesion. The left coronary tree was protected by the left internal
      mammary connected to left anterior descending artery. The procedure was performed
      using the "kissing balloon" technique, with a single guiding catheter. Immediate
      angiographic result and one-year follow-up have been excellent.

PMID- 1628782
TI  - [Post-infarction aneurysms of the left ventricle. Review of diagnostic criteria].

PMID- 1628783
TI  - [Post-infarction aneurysm of the left ventricle. Physiopathology].

PMID- 1628784
TI  - [Post-infarction aneurysm of the left ventricle. Natural history and prognostic
      stratification].

PMID- 1628785
TI  - [Post-infarction aneurysm of the left ventricle. Ventricular thrombosis and
      embolic phenomena: the role of pharmacological therapy].

PMID- 1628786
TI  - [Post-infarction aneurysms and fatal hyperkinetic ventricular arrhythmias].

PMID- 1628787
TI  - [Post-infarct aneurysm of the left ventricle. Surgical treatment: indications,
      surgical techniques and results].

PMID- 1628788
TI  - [The untransgressable geometry of the heart].

PMID- 1628789
TI  - [Present-day role of hemodynamic monitoring in acute myocardial infarct].

PMID- 1628790
TI  - [Efficacy and efficiency: unrenounceable objectives of the Italian cardiology].

PMID- 1628791
TI  - Dental nonsteroidal anti-inflammatory drugs and prostaglandin-based drug
      interactions, Part one.

PMID- 1628792
TI  - Bulimia: dentomedical complications.

PMID- 1628793
TI  - Abuse of older persons: detection and prevention by dental professionals.

PMID- 1628794
TI  - Sonic scalers: a review.

PMID- 1628795
TI  - Periodontal-restorative considerations in the management of gingival palatal
      inflammatory hyperplasia.

PMID- 1628796
TI  - Unusual presentation of non-Hodgkin's lymphoma in a patient with HIV.

PMID- 1628797
TI  - Erupted compound odontoma: review and case report.

PMID- 1628798
TI  - Lingual lipoma.

PMID- 1628799
TI  - Immediate provisional restoration during active orthodontic therapy.

PMID- 1628800
TI  - The rocky road: a perspective on dental students and faculty members.

PMID- 1628801
TI  - Exophytic mass of the alveolar ridge.

PMID- 1628802
TI  - Unusual mandibular lateral incisor.

PMID- 1628803
TI  - Molecular genetics under an embryologist's microscope: Jean Brachet, 1909-1988.

PMID- 1628804
TI  - Serine and threonine catabolism in Saccharomyces cerevisiae: the CHA1 polypeptide
      is homologous with other serine and threonine dehydratases.
AB  - The catabolic L-serine (L-threonine) dehydratase of Saccharomyces cerevisiae
      allows the yeast to grow on media with L-serine or L-threonine as sole nitrogen
      source. Previously we have cloned the CHA1 gene by complementation of a mutant,
      cha1, lacking the dehydratase activity. Here we present the DNA sequence of a
      1,766-bp fragment of the CHA1 region encompassing an open reading frame of 1080
      bp. Comparison of the predicted amino acid sequence of the CHA1 polypeptide with
      that of other serine/threonine dehydratases revealed several blocks of sequence
      homology. Thus, the amino acid sequence of rat liver serine dehydratase (SDH2)
      and the CHA1 polypeptide are 44% homologous allowing for conservative
      substitutions, while 36% similarity is found between the catabolic threonine
      dehydratase (tdcB) of Escherichia coli and the CHA1 protein. This strongly
      suggests that CHA1 is the structural gene for the yeast catabolic serine
      (threonine) dehydratase. S1-nuclease mapping of the CHA1 mRNA ends showed a major
      transcription initiation site corresponding to an untranslated leader of about 19
      nucleotides, while a major polyadenylation site was located about 86 nucleotides
      downstream from the open reading frame. Furthermore, we have mapped the
      chromosomal position of the CHA1 gene to less than 0.5 kb centromere proximal to
      HML on the left arm of chromosome III.

PMID- 1628805
TI  - Genes required for vacuolar acidity in Saccharomyces cerevisiae.
AB  - Mutations that cause loss of acidity in the vacuole (lysosome) of Saccharomyces
      cerevisiae were identified by screening colonies labeled with the fluorescent, pH
      sensitive, vacuolar labeling agent, 6-carboxyfluorescein. Thirty nine vacuolar pH
      (Vph-) mutants were identified. Four of these contained mutant alleles of the
      previously described PEP3, PEP5, PEP6 and PEP7 genes. The remaining mutants
      defined eight complementation groups of vph mutations. No alleles of the VAT2 or
      TFP1 genes (known to encode subunits of the vacuolar H(+)-ATPase) were identified
      in the Vph- screen. Strains bearing mutations in any of six of the VPH genes
      failed to grow on medium buffered at neutral pH; otherwise, none of the vph
      mutations caused notable growth inhibition on standard yeast media. Expression of
      the vacuolar protease, carboxypeptidase Y, was defective in strains bearing vph4
      mutations but was apparently normal in strains bearing any of the other vph
      mutations. Defects in vacuolar morphology at the light microscope level were
      evident in all Vph- mutants. Strains that contained representative mutant alleles
      of the 17 previously described PEP genes were assayed for vacuolar pH; mutations
      in seven of the PEP genes (including PEP3, PEP5, PEP6 and PEP7) caused loss of
      vacuolar acidity.

PMID- 1628806
TI  - The structure and evolution of subtelomeric Y' repeats in Saccharomyces
      cerevisiae.
AB  - The subtelomeric Y' family of repeated DNA sequences in the yeast Saccharomyces
      cerevisiae is of unknown origin and function. Y's vary in copy number and
      location among strains. Eight Y's, from two strains, were cloned and sequenced
      over the same 3.2-kb interval in order to assess the within- and between-strain
      variation as well as address their origin and function. One entire Y' sequence
      was reconstructed from two clones presented here and a previously sequenced 833
      bp region. It contains two large overlapping open reading frames (ORFs). The
      putative protein sequences have no strong homologies to any known proteins except
      for one region that has 27% identity with RNA helicases. RNA homologous to each
      ORF was detected. Comparison of the sequences revealed that the known long (Y'-L)
      and short (Y'-S) size classes, which coexist within cells, differ by several
      insertions and/or deletions within this region. The Y'-Ls from strain Y55 also
      differ from those of strain YP1 by several short deletions in the same region.
      Most of these deletions appear to have occurred between short (2-10 bp) direct
      repeats. The single base pair polymorphisms and the deletions are clustered in
      the first half of the interval compared. There is 0.30-1.13% divergence among Y'
      Ls within a strain and 1.15-1.75% divergence between strains in the interval.
      This is similar to known unique sequence variation but contrasts with the 8-18%
      divergence among the adjacent subtelomeric repeats, X. Subsets of Y's exhibit
      concerted evolution; however, more than one variant appears to be maintained
      within strains. The observed sequence variation disrupts the first ORF in many
      Y's while most of the second ORF including the putative helicase region is
      unaffected. The structure and distribution of the Y' elements are consistent with
      having originated as a mobile element. However, they now appear to move via
      recombination. Recombination can account for the homogenization within subsets of
      Y's but does not account for the maintenance of different variants.

PMID- 1628807
TI  - Tryptophan analog resistance mutations in Chlamydomonas reinhardtii.
AB  - Forty single gene mutations in Chlamydomonas reinhardtii were isolated based on
      resistance to the compound 5'-methyl anthranilic acid (5-MAA). In other
      organisms, 5-MAA is converted to 5'-methyltryptophan (5-MT) and 5-MT is a potent
      inhibitor of anthranilate synthase, which catalyzes the first committed step in
      tryptophan biosynthesis. The mutant strains fall into two phenotypic classes
      based on the rate of cell division in the absence of 5-MAA. Strains with class I
      mutations divide more slowly than wild-type cells. These 17 mutations map to
      seven loci, which are designated MAA1 to MAA7. Strains with class II mutations
      have generation times indistinguishable from wild-type cells, and 7 of these 23
      mutations map to loci defined by class I mutations. The remainder of the class II
      mutations map to 9 other loci, which are designated MAA8-MAA16. The maa5-1 mutant
      strain excretes high levels of anthranilate and phenylalanine into the medium. In
      this strain, four enzymatic activities in the tryptophan biosynthetic pathway are
      increased at least twofold. These include the combined activities of anthranilate
      phosphoribosyl transferase, phosphoribosyl anthranilate isomerase, indoleglycerol
      phosphate synthetase and anthranilate synthase. The slow growth phenotypes of
      strains with class I mutations are not rescued by the addition of tryptophan, but
      the slow growth phenotype of the maa6-1 mutant strain is partially rescued by the
      addition of indole. The maa6-1 mutant strain excretes a fluorescent compound into
      the medium, and cell extracts have no combined anthranilate phosphoribosyl
      transferase, phosphoribosyl anthranilate isomerase and indoleglycerol phosphate
      synthetase activity. The MAA6 locus is likely to encode a tryptophan biosynthetic
      enzyme. None of the other class I mutations affected these enzyme activities.
      Based on the phenotypes of double mutant strains, epistatic relationships among
      the class I mutations have been determined.

PMID- 1628808
TI  - Genetic and environmental effects on the expression of peptidases and larval
      viability in Drosophila melanogaster.
AB  - The peptidase system in Drosophila melanogaster, consisting of dipeptidase-A,
      dipeptidase-B, dipeptidase-C and the leucine aminopeptidases, was used as a model
      to study the adaptive significance of enzyme activity variation. The involvement
      of the peptidases in osmoregulation has been suggested from the ubiquitous
      distribution of peptidase activities in nearly all tissues and the high
      concentration of amino acids and oligopeptides in the hemolymph. Under this
      hypothesis, larvae counteract increases in environmental osmotic stress by
      hydrolyzing peptides into amino acids both intra- and extracellularly to increase
      physiological osmotic concentration. The expression of the peptidases was studied
      by assaying for peptidase activities in third instar larvae of isogenic lines,
      which were reared under increasing levels of environmental osmotic stress using
      either D-mannitol or NaCl. Second and third chromosome substitution isogenic
      lines were used to assess the relative contribution of regulatory and structural
      genes in enzyme activity variation. Results indicate that: (1) genetic variation
      exists for peptidase activities, (2) the effect of osmotic stress is highly
      variable among peptidases, (3) changes in peptidase activities in response to
      osmotic stress depend on both genetic background and osmotic effector and (4)
      peptidase activities are correlated with each other, but these phenotypic
      correlations depend on genetic background, osmotic effector, and level of osmotic
      stress. Osmotic concentration in the larval hemolymph is correlated with leucine
      aminopeptidase activity, but changes in hemolymph osmotic concentration in
      response to environmental osmotic stress depend on the osmotic effector in the
      environment. Although these findings suggest that genetic and environmental
      factors contribute significantly toward the expression of enzymes with similar
      functions, a relative larval viability study of genotypes that differed
      significantly in dipeptidase-B (DIP-B) activity revealed that low DIP-B activity
      did not confer any measurable reduction in larval viability under increasing
      levels of environmental osmotic stress. These negative results suggest that,
      either DIP-B does not play a major role in osmoregulation or differential
      osmoregulation is not related to egg to adult viability in these tests.

PMID- 1628809
TI  - Use of a yeast site-specific recombinase to produce female germline chimeras in
      Drosophila.
AB  - We describe an efficient method for generating female germline mosaics by
      inducing site-specific homologous mitotic recombination with a yeast recombinase
      (FLP) which is driven by a heat shock promoter. These germline mosaics are
      produced in flies heterozygous for the agametic, germline-dependent, dominant
      female sterile (DFS) mutation ovoD1, where only flies possessing germline clones
      are able to lay eggs. This method, the "FLP-DFS" technique, is very efficient
      because more than 90% of females with germline clones can be recovered. We show
      that this heat-inducible, site-specific mitotic recombination system does not
      affect viability and that the germline clones recovered are physiologically the
      same as those created by X-ray induced mitotic recombination. We describe the
      parameters of FLP-recombinase induced germline mitotic recombination and the use
      of the "FLP-DFS" technique to analyze the maternal effect of X-linked zygotic
      lethal mutations.

PMID- 1628810
TI  - Molecular analysis of mutations induced in the vermilion gene of Drosophila
      melanogaster by methyl methanesulfonate.
AB  - The nature of DNA sequence changes induced by methyl methanesulfonate (MMS) at
      the vermilion locus of Drosophila melanogaster was determined after exposure of
      postmeiotic male germ cell stages. MMS is a carcinogen with strong preference for
      base nitrogen alkylation (s = 0.86). The spectrum of 40 intralocus mutations was
      dominated by AT----GC transitions (23%), AT----TA transversions (54%) and
      deletions (14%). The small deletions were preferentially found among mutants
      isolated in the F1 (8/18), whereas the AT----GC transitions exclusively occurred
      in the F2 (6/22). The MMS-induced transversions and deletions are presumably
      caused by N-methyl DNA adducts, which may release apurinic intermediates, known
      to be a time-related process. Furthermore, MMS produces multilocus deletions,
      i.e., at least 30% of the F1 mutants analyzed were of this type. A comparison of
      the mutational spectra of MMS with that produced by ethylnitrosourea (ENU), also
      in the vermilion locus of Drosophila, reveals major differences: predominantly
      transition mutations (61% GC----AT and 18% AT----GC) were found in both the F1
      and F2 spectrum induced by ENU. It is concluded that the mutational spectrum of
      MMS is dominated by nitrogen DNA adducts, whereas with ENU DNA sequence changes
      mainly arose from modified oxygen in DNA.

PMID- 1628811
TI  - Somatic instability of a Drosophila chromosome.
AB  - A mitotically unstable chromosome, detectable because of mosaic expression of
      marker genes, was generated by X-ray mutagenesis in Drosophila. Nondisjunction of
      this chromosome is evident in mitotic chromosome preparations, and premature
      sister chromatid separation is frequent. The mosaic phenotype is modified by
      genetic elements that are thought to alter chromatin structure. We hypothesize
      that the mitotic defects result from a breakpoint deep in the pericentric
      heterochromatin, within or very near to the DNA sequences essential for
      centromere function. This unique chromosome may provide a tool for the genetic
      and molecular dissection of a higher eukaryotic centromere.

PMID- 1628812
TI  - Quantitative genetic variation in body size of mice from new mutations.
AB  - To measure the amount of new genetic variation in 6-week weight of mice arising
      each generation from mutation, selection lines derived from an initially inbred
      strain were maintained for 25 generations. An analysis using an animal model with
      restricted maximum likelihood was applied to estimate a mutational genetic
      component of variance for the infinitesimal model of many genes of small effect.
      Assuming that the inbred base population was at a mutation-drift equilibrium, it
      is estimated that the heritability for body size has increased by 1.0% per
      generation, with lower and upper confidence limits of 0.6% and 1.6%,
      respectively. A model which includes a mutational genetic component of variance
      fits the data much better than one involving only base population genetic
      variance. A model with no genetic component fits the data very poorly. An
      environmental covariance of body size of mother and offspring was included in the
      model and accounts for 10% of the variance. By using information only from the
      observed response to selection, the estimated increase in heritability from
      mutation is 0.3% per generation. These values are higher than published estimates
      for the increase in variance from spontaneous mutations in bristle traits of
      Drosophila, for which there are extensive data, but similar to estimates for
      various skeletal traits in mice.

PMID- 1628813
TI  - Rat gene mapping using PCR-analyzed microsatellites.
AB  - One hundred and seventy-four rat loci which contain short tandem repeat sequences
      were extracted from the GenBank or EMBL data bases and used to define primers for
      amplification by the polymerase chain reaction (PCR) of the microsatellite
      regions, creating PCR-formatted sequence-tagged microsatellite sites (STMSs). One
      hundred and thirty-four STMSs for 118 loci, including 6 randomly cloned STMSs,
      were characterized: (i) PCR-analyzed loci were assigned to specific chromosomes
      using a panel of rat x mouse somatic cell hybrid clones. (ii) Length variation of
      the STMSs among 8 inbred rat strains could be visualized at 85 of 107 loci
      examined (79.4%). (iii) A genetic map, integrating biochemical, coat color,
      mutant and restriction fragment length polymorphism loci, was constructed based
      on the segregation of 125 polymorphic markers in seven rat backcrosses and in two
      F2 crosses. Twenty four linkage groups were identified, all of which were
      assigned to a defined chromosome. As a reflection of the bias for coding
      sequences in the public data bases, the STMSs described herein are often
      associated with genes. Hence, the genetic map we report coincides with a gene
      map. The corresponding map locations of the homologous mouse and human genes are
      also listed for comparative mapping purposes.

PMID- 1628814
TI  - Deleterious mutations and the origin of the meiotic ploidy cycle.
AB  - A population genetical model is investigated in which the organism either
      alternates between diploid and haploid states or lives entirely in the haploid
      state. The behavior of the organism is determined by the genotype at a modifier
      locus. At an independent locus deleterious mutations occur at a low but constant
      frequency. It is found that the haploid behavior is always an evolutionarily
      attainable stable trait, while the ploidy-cyclic behavior is an evolutionarily
      attainable stable trait only when a certain condition holds. This condition
      depends on the strength of selection, the degree of "sheltering" given by the
      heterozygote state, and the degree of linkage between the modifier locus and the
      locus under selection. The last result leads to the speculation that the
      eukaryotes are derived from an organism which first developed more than one
      chromosome before it evolved the ploidy cycle.

PMID- 1628815
TI  - Recombination and the evolution of diploidy.
AB  - With two copies of every gene, a diploid organism is able to mask recessive
      deleterious mutations. In this paper we present the analysis of a two-locus model
      designed to determine when the masking of deleterious alleles favors the
      evolution of a dominant diploid phase in organisms that alternate between haploid
      and diploid phases ("alternation of generations"). It is hypothesized that
      diploidy will be favored whenever masking occurs ("the masking hypothesis").
      Using analytical methods, we confirm that this masking hypothesis is essentially
      correct under free recombination: as long as the heterozygous expression of
      deleterious alleles is sufficiently masked by the wild-type allele, diploidy is
      favored over haploidy. When the rate of recombination is lower, however, diploidy
      is much less likely to be favored over haploidy. In fact, according to our model,
      the evolution of diploidy is impossible without significant levels of
      recombination even when masking is fairly strong.

PMID- 1628816
TI  - Inference of horizontal genetic transfer from molecular data: an approach using
      the bootstrap.
AB  - Inconsistencies in taxonomic relationships implicit in different sets of nucleic
      acid sequences potentially result from horizontal transfer of genetic material
      between genomes. A nonparametric method is proposed to determine whether such
      inconsistencies are statistically significant. A similarity coefficient is
      calculated from ranked pairwise identities and evaluated against a distribution
      of similarity coefficients generated from resampled data. Subsequent analyses of
      partial data sets, obtained by the elimination of individual taxa, identify
      particular taxa to which the significance may be attributed, and can sometimes
      help in distinguishing horizontal genetic transfer from inconsistencies due to
      convergent evolution or variation in evolutionary rate. The method was
      successfully applied to data sets that were not found to be significantly
      different with existing methods that use comparisons of phylogenetic trees. The
      new statistical framework is also applicable to the inference of horizontal
      transfer from restriction fragment length polymorphism distributions and protein
      sequences.

PMID- 1628817
TI  - Induction of recessive lethal and specific locus mutations in the zebrafish with
      ethyl nitrosourea.
AB  - Recessive lethal mutations and mutations at the gol-1 locus were induced in the
      zebrafish by exposure of mature sperm to the alkylating agent ethyl nitrosourea
      (ENU). Embryonic lethal phenotypes were recognized among the parthenogenetic
      progeny of mutagenized animals or among the progeny of daughters of mutagenized
      animals. Novel specific locus mutations were identified by the failure of
      mutagenized chromosomes to complement pre-existing mutant alleles at the gol-1
      locus. Each mutagenized individual harboured approximately 10 embryonic lethal
      mutations in its germ line and about 1 in 500 mutagenized animals harboured a new
      mutation at the gol-1 locus. Three lines of evidence indicate that the majority
      of mutations that were recovered following treatment of mature sperm with ENU
      were probably point mutations. First, the soma and germ lines of mutagenized
      animals were mosaic, as expected following simple alkylation of sperm DNA.
      Second, mutations induced by ENU at the gol-1 locus affected pigmentation but not
      viability, unlike the majority of mutations induced at this locus with gamma
      irradiation. Third, the ratio of specific locus:recessive lethal mutations
      induced by ENU was approximately 50-fold lower than the ratio observed following
      mutagenesis with gamma-rays. Comparison of the incidence with which embryonic
      recessive lethal mutations were induced with the incidence with which specific
      locus mutations arose indicates that there are greater than 5000 genes essential
      to the development and viability of the zebrafish embryo.

PMID- 1628818
TI  - Estimating effective population size from samples of sequences: inefficiency of
      pairwise and segregating sites as compared to phylogenetic estimates.
AB  - It is known that under neutral mutation at a known mutation rate a sample of
      nucleotide sequences, within which there is assumed to be no recombination,
      allows estimation of the effective size of an isolated population. This paper
      investigates the case of very long sequences, where each pair of sequences allows
      a precise estimate of the divergence time of those two gene copies. The average
      divergence time of all pairs of copies estimates twice the effective population
      number and an estimate can also be derived from the number of segregating sites.
      One can alternatively estimate the genealogy of the copies. This paper shows how
      a maximum likelihood estimate of the effective population number can be derived
      from such a genealogical tree. The pairwise and the segregating sites estimates
      are shown to be much less efficient than this maximum likelihood estimate, and
      this is verified by computer simulation. The result implies that there is much to
      gain by explicitly taking the tree structure of these genealogies into account.

PMID- 1628819
TI  - Mapping and characterization of a 'speciation gene' in Drosophila.
AB  - Almost nothing is known about the identity of the genes causing reproductive
      isolation between species. As a first step towards molecular isolation of a
      'speciation gene', I mapped and partly characterized a gene causing hybrid male
      sterility in Drosophila. This analysis shows that sterility of D. melanogaster
      males who carry the 'dot' fourth chromosome from D. simulans is due entirely to a
      very small region of the D. simulans chromosome (including only about 5 salivary
      gland bands or approximately 250 kb of DNA). Thus the hybrid sterility effect of
      the D. simulans fourth chromosome is almost surely due to a single gene of very
      large effect (here named hms, hybrid male sterile). Hms is zygotically acting,
      and the D. simulans allele of hms is completely recessive. Furthermore,
      complementation tests suggest that hms is not an allele of any known locus in D.
      melanogaster.

PMID- 1628820
TI  - Further observation of paternal transmission of Drosophila mitochondrial DNA by
      PCR selective amplification method.
AB  - By designing 3' ends of primers in PCR (polymerase chain reaction), a specific
      DNA fragment was selectively amplified in the presence of a 10(3)-fold excess of
      highly homologous (sequence difference ca. 2%) opponent DNA. This technique was
      applied in detecting paternal leakage of mitochondrial DNA (mtDNA) in
      intraspecific crosses of Drosophila simulans and interspecific crosses of
      Drosophila simulans and Drosophila mauritiana. The mtDNA types of their progeny
      were analysed by selective amplification of the paternal mtDNA fragment
      possessing a polymorphic restriction site and detecting its cleaved fragments.
      Paternal mtDNA was detected in the progeny of 14 out of 16 crosses. The present
      result indicates small but frequent inheritance of sperm mtDNA in Drosophila,
      which is supportive to our previous finding.

PMID- 1628821
TI  - Induction of mutations in the zebrafish with ultraviolet light.
AB  - Recessive lethal germline and specific locus somatic mutations were induced
      efficiently in the zebrafish by exposure of mature sperm to UV light. Mutagenesis
      of sperm yielded mosaic individuals: clones bearing novel mutations represented
      approximately 12-25% of the haploid germ cells and 25-50% of the somatic tissue.
      Simple methods are described for the reliable identification and propagation of
      newly arising developmental mutations in zebrafish.

PMID- 1628822
TI  - Wild-type p53 mediates positive regulation of gene expression through a specific
      DNA sequence element.
AB  - It has been reported recently that the wild-type p53 gene product can positively
      regulate the expression of a test gene adjacent to the enhancer-promoter elements
      of the murine muscle-specific creatine kinase (MCK) gene. This discussion reports
      the identification of a wild-type p53 protein-specific DNA-binding element
      located within the p53-responsive region of the MCK enhancer-promoter element.
      This p53 protein/DNA-binding element has been defined by DNase I footprint
      analysis, which identified a 50-bp region. This 50-bp sequence was sufficient to
      confer wild-type p53 responsiveness on a heterologous minimal promoter. The
      mutant forms of p53 protein are much less capable of stimulating this DNA
      element. This study has identified the first example of a naturally occurring
      wild-type p53-specific DNA-binding element that is able to mediate positive
      regulation of a test gene. The results suggest a biological function in gene
      regulation for the wild-type p53 protein that is lost or altered in the mutant
      p53 proteins.

PMID- 1628823
TI  - The human heat shock protein hsp70 interacts with HSF, the transcription factor
      that regulates heat shock gene expression.
AB  - Transcriptional regulation of the human hsp70 gene in response to heat shock and
      other forms of physiological stress occurs through the activation of heat shock
      transcription factor (HSF). Exposure of cells to a heat shock temperature of 42
      degrees C results in transient activation of HSF; its DNA-binding activity
      increases rapidly, plateaus, and attenuates, during which the intracellular
      levels of hsp70 increase. In an effort to understand whether HSF is regulated
      negatively by hsp70, we have examined whether HSF associates with hsp70. We show
      that activated HSF associates with hsp70 and that the interaction is detected as
      the levels of hsp70 increase in the cell. Addition of ATP and other hydrolyzable
      nucleotides results in the dissociation of hsp70 from HSF while nonhydrolyzable
      nucleotide analogs do not disrupt the complex. We demonstrate that exogenous
      recombinant wild-type hsp70 can associate with activated HSF, whereas no
      association is observed with an amino-terminal or a carboxy-terminal deletion
      mutant of hsp70. We also show that hsp70 blocks the in vitro activation of HSF
      from its cryptic non-DNA-binding state to a DNA-binding form; this inhibitory
      effect of hsp70 is abolished by ATP. We suggest that hsp70 may negatively
      regulate the activation of HSF.

PMID- 1628824
TI  - DnaK and DnaJ heat shock proteins participate in protein export in Escherichia
      coli.
AB  - In Escherichia coli secreted proteins must be maintained in an export-competent
      state before translocation across the cytoplasmic membrane. This function is
      carried out by a group of proteins called chaperones. SecB is the major chaperone
      that interacts with precursor proteins before their secretion. We report results
      indicating that the DnaK and DnaJ heat shock proteins are also involved in the
      export of several proteins, most likely by acting as their chaperones.
      Translocation of alkaline phosphatase, a SecB-independent protein, was inhibited
      in dnaK- and dnaJ- mutant strains, suggesting that export of this protein
      probably involves DnaK and DnaJ. In addition, DnaK and DnaJ play a critical role
      in strains lacking SecB. They are required both for viability and for the
      residual processing of the SecB-dependent proteins LamB and maltose-binding
      protein (MBP) seen in secB null strains. Furthermore, overproduction of DnaK and
      DnaJ permits strains lacking SecB to grow in rich medium and accelerates the
      processing of LamB and MBP. These results suggest that under conditions where
      SecB becomes limiting, DnaK and DnaJ probably substitute for SecB and facilitate
      protein export. This provides the cell with a mechanism to overcome a temporary
      imbalance in the secretion process caused by an abrupt expansion in the pool of
      precursor proteins.

PMID- 1628826
TI  - Gene expression during preimplantation mouse development.
AB  - To develop a resource for the identification and isolation of genes expressed in
      the early mammalian embryo, large and representative cDNA libraries were
      constructed from unfertilized eggs, and two-cell, eight-cell, and blastocyst
      stage mouse embryos. Using these libraries, we now report the first stages at
      which the cytokines interleukin (IL)-6, IL-1 beta, and interferon (IFN)-gamma are
      transcribed in the developing embryo and the presence of IL-7 transcripts in the
      unfertilized egg. Transcripts for IL-1 alpha, -2, -3, -4, or -5 were not detected
      at these stages. To identify novel genes expressed on activation of the embryonic
      genome, the egg and eight-cell stage-specific cDNA libraries were subtracted from
      the two-cell library, yielding a specialized cDNA library enriched for
      transcripts expressed at the two-cell stage. Sequence and Southern blot analysis
      of several of these cDNAs expressed predominantly at the two-cell stage of
      embryogenesis revealed them to be from novel genes, thereby providing the first
      molecular tools with which to approach the study of gene expression in the early
      mammalian embryo.

PMID- 1628825
TI  - Isolation and characterization of RAT1: an essential gene of Saccharomyces
      cerevisiae required for the efficient nucleocytoplasmic trafficking of mRNA.
AB  - We have combined techniques of genetics and histochemistry to identify genes
      required for the nucleocytoplasmic export of mRNA in the budding yeast
      Saccharomyces cerevisiae. We adapted in situ hybridization using a digoxigenin
      labeled oligo(dT)50 probe to localize poly(A)+ RNA in fixed yeast cells and used
      yeast strains carrying the rna1-1 mutation to develop an assay. The rna1-1
      mutation is the only previously described mutation that causes defects in mRNA
      export. As visualized with this RNA localization assay, rna1-1 strains
      accumulated poly(A)+ RNA at the nuclear periphery at the nonpermissive
      temperature. This was in contrast to the RNA localization pattern of wild-type
      cells or rna1-1 cells grown at permissive temperature. Wild-type cells showed
      bright uniform cytoplasmic staining with little detectable RNA in the nuclei. We
      used this RNA localization assay to screen a bank of temperature-sensitive yeast
      strains for mutants with inducible defects in mRNA trafficking. Strains
      identified in this manner are designated RAT mutants for ribonucleic acid
      trafficking. The rat1-1 allele conferred temperature-sensitive accumulation of
      poly(A)+ RNA in one to several intranuclear spots that appear to lie at the
      nuclear periphery. RNA processing was unaffected in rat1-1 strains, except for an
      inducible defect in trimming the 5' end of the 5.8S rRNA. The wild-type RAT1 gene
      was cloned by complementation; it encodes an essential 116-kD protein with
      regions of homology to the protein encoded by SEP1 (also known as DST2, XRN1,
      KEM1, and RAR5). Sep1p is a nucleic acid binding protein, a 5'----3' exonuclease,
      and catalyzes DNA strand transfer reactions in vitro. We discuss the possible
      significance of the Rat1p/Sep1p homology for RNA trafficking. We also discuss the
      potential of this RNA localization assay to identify genes involved in nuclear
      structure and RNA metabolism.

PMID- 1628827
TI  - Isolation of novel murine maternal mRNAs regulated by cytoplasmic
      polyadenylation.
AB  - The cytoplasmic polyadenylation element (CPE) is an AU-rich sequence in the 3'
      untranslated region of many stored maternal mRNAs. The CPE directs the meiotic
      maturation-specific cytoplasmic polyadenylation and translational activation of
      these dormant mRNAs in Xenopus. The work presented here demonstrates that the CPE
      controls a similar regulation in mouse oocytes and utilizes the information to
      isolate novel maternal mRNAs by polymerase chain reaction (PCR). A degenerate CPE
      primer was used in an anchored PCR reaction with cDNAs from primary mouse
      oocytes. Clones were identified that contained the canonical polyadenylation
      signal AATAAA. A novel PCR test was then used to determine the polyadenylation
      state of the respective mRNAs before and after meiotic maturation. Two mRNAs, OM
      1 and OM-2, are cytoplasmically polyadenylated upon maturation. Another mRNA is
      not polyadenylated during maturation, although it contains multiple CPE-like
      elements, indicating that this sequence element is not sufficient for adenylation
      during this time. Microinjection into primary oocytes of antisense
      oligodeoxynucleotides directed against OM-1 destroys the mRNA but does not appear
      to interfere with maturation in vitro. These experiments identify two novel
      maternal mRNAs and establish a simple strategy for isolating other maternal
      messages that control meiotic maturation, fertilization, and early mouse
      development.

PMID- 1628828
TI  - Replication of distinct scrapie prion isolates is region specific in brains of
      transgenic mice and hamsters.
AB  - Scrapie prions are composed largely, if not entirely, of PrPSc molecules. The
      prion isolates Sc237 and 139H exhibit markedly different incubation times in
      Syrian, Armenian, and Chinese hamsters, as well as in transgenic (Tg) 81 mice
      expressing Syrian hamster PrP (SHaPrP). Repassage of prions from transgenic mice
      or Chinese hamsters into Syrian hamsters revealed that the original properties of
      the prion isolates are retained. When Syrian hamsters were first inoculated with
      139H prions and subsequently challenged with Sc237 prions, the incubation period
      was determined by the faster Sc237 isolate. Regional mapping studies demonstrated
      different kinetics and patterns of PrPSc accumulation for Sc237 and 139H prions
      in the brains of Syrian hamsters as well as Tg(SHaPrP)7 mice. That distinct prion
      isolates induce different region-specific accumulations of PrPSc in brain
      suggests a novel mechanism for propagation of isolates whereby they replicate in
      particular sets of neurons. The prion isolates could be targeted to specific CNS
      cells by differing conformations of PrPSc, post-translational modifications of
      PrPSc such as Asn-linked glycosylation, or an as yet undetected macromolecule
      complexed with PrPSc in the prion.

PMID- 1628829
TI  - Translational activation of the non-AUG-initiated c-myc 1 protein at high cell
      densities due to methionine deprivation.
AB  - c-myc belongs to a small, yet growing, group of eukaryotic mRNAs that initiate
      translation inefficiently from a non-AUG codon upstream from a more efficient AUG
      codon. We have examined the translational regulation of non-AUG-initiated c-myc 1
      and AUG-initiated c-myc 2 protein synthesis in avian and mouse cells during
      proliferation. As lymphoid, erythroid, and embryo fibroblast cells approached
      high densities in culture, there was a sustained 5- to 10-fold induction in the
      synthesis of c-myc 1 protein to levels greater than or equal to c-myc 2 protein
      synthesis. Treatment with conditioned/depleted media from high-density cells was
      able to reproduce this activation in low-density cells within 5 hr. Additional
      studies with the conditioned/depleted media revealed that amino acid
      availability, specifically methionine deprivation, was responsible for this
      unique translational control. Our results describe a specific and dramatic
      regulation of dual translational initiation. Furthermore, these results represent
      a novel translational activation of a specific gene in higher eukaryotes in
      response to nutrient deprivation.

PMID- 1628830
TI  - Analysis of the functional role of the Polycomb chromo domain in Drosophila
      melanogaster.
AB  - The chromo domain was identified as a homologous protein motif between Polycomb
      (Pc)--a member of the Pc-group genes encoding transcriptional repressors of the
      homeotic genes--and HP1--a heterochromatin-associated protein encoded by the
      suppressor of position effect variegation gene Su(var)205. Together with previous
      genetic studies, this molecular similarity supports the suggestion of a common
      mechanism used for generating heterochromatin and for repressing homeotic genes.
      The evolutionary conservation of the chromo domain throughout the animal and
      plant kingdoms implies an important functional role for this protein motif. We
      have used transgenic lines as well as transient expression assays employing
      Drosophila tissue culture cells to study the functional role of the Pc chromo
      domain. Wild-type Pc protein is endogenously expressed in SL2 cells and is found
      in large immunologically visible complexes. Mutated Pc proteins were expressed as
      Pc-beta-galactosidase fusion proteins, and their nuclear distribution was
      examined by indirect immunofluorescence in tissue culture cells and on polytene
      chromosomes of transgenic larvae. We show that carboxy-terminal truncations of
      the Pc protein do not affect chromosomal binding of the fusion protein. However,
      mutations affecting only the chromo domain including in vitro generated
      deletions, as well as point mutations, abolish chromosomal binding. Our results
      demonstrate for the first time that the chromo domain is important for the
      function of Pc and that it is absolutely required for binding of Pc protein to
      chromatin. Some of the nuclear patterns generated by the mutated forms of the
      fusion proteins suggest, furthermore, that the chromo domain could be involved in
      a packaging mechanism, essential for compacting chromosomal proteins within
      heterochromatin or heterochromatin-like complexes.

PMID- 1628831
TI  - Signal transduction in Saccharomyces cerevisiae requires tyrosine and threonine
      phosphorylation of FUS3 and KSS1.
AB  - The FUS3 and KSS1 kinases are components of the pheromone-dependent signal
      transduction pathway in yeast. We show that FUS3 and KSS1 become rapidly
      phosphorylated after pheromone treatment. Similar to mammalian MAP kinases, this
      modification occurs at two amino acids of FUS3, threonine-180 and tyrosine-182. A
      mutation introduced at either position results in complete loss of function in
      vivo. Amino acid substitutions that destroy catalytic activity of the kinase do
      not prevent phosphorylation of the mutant products, a result that excludes an
      autocatalytic activation pathway. The modification of FUS3 is dependent on
      kinases encoded by the STE11 and STE7 genes. Furthermore, a hyperactive allele of
      STE11 causes increased phosphorylation of FUS3 in the absence of pheromone
      stimulation. Thus, either STE7 or STE11 could be the kinase responsible for the
      phosphorylation of FUS3.

PMID- 1628832
TI  - Constitutive mutants of the protein kinase STE11 activate the yeast pheromone
      response pathway in the absence of the G protein.
AB  - STE4 encodes the beta-subunit of a heterotrimeric guanine nucleotide-binding
      protein (G protein) that is an early and essential component of the pheromone
      signal transduction pathway. From a ste4 deletion strain we have isolated both
      dominant and recessive suppressors that show increased transcription of pheromone
      responsive genes and have regained the ability to mate, albeit at a low level.
      Each of these suppressor mutations suppresses ste4 and ste5 deletions but not
      deletions in STE7, STE11, or STE12. Among the dominant mutations, we have
      identified two alleles of STE11, a gene that encodes a protein kinase activity
      essential for mating. One allele contains an alteration in the putative
      regulatory domain of the protein kinase; the second allele has an alteration in
      the catalytic site. In strains carrying these mutations, a second protein kinase
      required for mating, STE7, becomes hyperphosphorylated, just as it does in wild
      type cells treated with pheromone. Thus, a protein kinase cascade appears to be
      an essential feature of the response pathway and probably connects the receptor/G
      protein to an identified transcription factor, STE12.

PMID- 1628833
TI  - Order of action of components in the yeast pheromone response pathway revealed
      with a dominant allele of the STE11 kinase and the multiple phosphorylation of
      the STE7 kinase.
AB  - The signal transduction pathway that mediates the response of haploid yeast cells
      to peptide mating pheromones involves several components including the protein
      kinases STE7 and STE11. We have isolated and characterized a dominant allele of
      the STE11 gene and have demonstrated that expression of an amino-terminally
      truncated form of STE11 protein causes constitutive activation of the mating
      pathway. Expression of this dominant STE11 allele also restored mating ability to
      certain sterile strains. In conjunction with the results of others, our epistasis
      results establish the following order of action of pathway components: STE2,
      GPA1(SCG1), STE4, STE5, STE11, STE7, STE12. Transduction of the signal from STE11
      to STE7 may involve phosphorylation because STE7 displays several phosphorylation
      forms, and STE7 is multiply phosphorylated in response to either pheromone or
      coexpression of dominant STE11 protein. Further signal propagation appears to
      require STE7 protein kinase activity, because a catalytically impaired STE7
      mutant is defective in the mating response.

PMID- 1628834
TI  - SPT3 interacts with TFIID to allow normal transcription in Saccharomyces
      cerevisiae.
AB  - Mutations in the Saccharomyces cerevisiae gene SPT15, which encodes the TATA
      binding protein TFIID, have been shown to cause pleiotropic phenotypes and to
      lead to changes in transcription in vivo. Here, we report the cloning and
      analysis of one such mutation, spt15-21, which causes a single-amino-acid
      substitution in a conserved residue of TFIID. Surprisingly, the spt15-21 mutation
      does not affect the stability of TFIID, its ability to bind to DNA or to support
      basal transcription in vitro, or the ability of an upstream activator to function
      in vivo. To study further the spt15-21 defect, extragenic suppressors of this
      mutation were isolated and analyzed. All of the extragenic suppressors of spt15
      21 are mutations in the previously identified SPT3 gene. Suppression of spt15-21
      by these spt3 mutations is allele-specific, suggesting that TFIID and SPT3
      interact and that spt15-21 impairs this interaction in some way. Consistent with
      these genetic data, coimmunoprecipitation experiments demonstrate that the TFIID
      and SPT3 proteins are physically associated in yeast extracts. Taken together,
      these results suggest that SPT3 is a TFIID-associated protein, required for TFIID
      to function at particular promoters in vivo.

PMID- 1628835
TI  - Acetylornithine deacetylase, succinyldiaminopimelate desuccinylase and
      carboxypeptidase G2 are evolutionarily related.
AB  - The nucleotide (nt) sequence of the Escherichia coli argE gene, encoding the
      acetylornithine deacetylase (AO) subunit, has been established and corresponds to
      a 43-kDa (M(r) 42,320) polypeptide. The enzyme has been purified to near
      homogeneity and it appears to be a dimer consisting of two 43-kDa subunits. The
      amino acid sequence deduced from the nt sequence was compared to that of the
      subunit of E. coli succinyldiaminopimelate desuccinylase (the dapE gene product
      involved in the diaminopimelate pathway for lysine biosynthesis), since both
      enzymes share functional and biochemical features. Significant similarity
      covering the entire sequence allows us to infer a common origin for both
      deacylases. This homology extends to the Pseudomonas sp. G2 carboxypeptidase
      (G2CP); this or a functionally related enzyme may be responsible for the minor AO
      activity found in organisms relying on ornithine acetyltransferase for ornithine
      biosynthesis.

PMID- 1628836
TI  - Cloning and sequence analysis of a Candida maltosa gene which confers resistance
      to cycloheximide.
AB  - A CYHR gene from Candida maltosa, which confers resistance to cycloheximide, was
      cloned in Saccharomyces cerevisiae. A 2.3-kb DNA fragment carrying this gene was
      sequenced, and an open reading frame able to encode 553 amino acids (aa) was
      found in the sequence. Computer searches of the GenBank, EMBL, SWIS-PROT and Gen
      Pept databases using the FASTA program failed to detect any proteins with
      extensive similarities to the deduced aa sequence for CYHR. The cloned gene
      transforms S. cerevisiae at a frequency similar to auxotrophic markers and can be
      used as a dominant selectable marker for introducing recombinant plasmids into
      wild-type strains of S. cerevisiae, as well as for gene disruption experiments.

PMID- 1628837
TI  - Secretion of a Cryptococcus albidus xylanase in Saccharomyces cerevisiae.
AB  - The xylanase(XLN)-encoding gene(XLN) of Cryptococcus albidus and its cDNA were
      each inserted into the vector, pVT100, for expression in Saccharomyces
      cerevisiae. Expression was under the control of either their own promoter or the
      gene encoding alcohol dehydrogenase (ADH1) promoter. Yeast transformed with
      plasmids containing the cDNA of the structural XLN gene and the XLN promoter
      produced active extracellular XLN when grown with galactose as carbon source.
      However, with glucose as carbon source, XLN was repressed. Using the ADH1
      promoter, which is stimulated by glucose, XLN was secreted into the culture
      medium. In both cases, the secreted 48-kDa enzyme corresponded to the native XLN
      produced by C. albidus. With the plasmid bearing the genomic XLN gene, there was
      transcription, but the seven introns interrupting XLN were not spliced out by S.
      cerevisiae and no enzyme was produced.

PMID- 1628838
TI  - Ligation-free gene synthesis by PCR: synthesis and mutagenesis at multiple loci
      of a chimeric gene encoding ompA signal peptide and hirudin.

PMID- 1628839
TI  - A fusion plasmid for the synthesis of lipopeptide-antigen chimeras in Escherichia
      coli.
AB  - Lipopeptides are potential vaccine candidates with a built-in adjuvant property.
      To circumvent the present chemical route of synthesis for lipopeptide-antigen
      conjugates, the lipoprotein property of the pColE2-P9-encoded lysis protein,
      CelB, was used to create the bacterial fusion plasmid, pKLY3, to produce
      lipopeptide-antigen chimeras in Escherichia coli. Plasmid pKLY3 is a derivative
      of pKK233-2 with the origin of replication of the single-stranded DNA phage, fl.
      Under control of the promoter, ptrc, is the 5' end of the celB gene coding for a
      lipoprotein signal peptide and the first five amino acids (aa) (CQANY) of the
      mature lysis protein. As model systems for the synthesis of small and large
      lipopeptide-antigens, DNA sequences coding for the P2 peptide and E. coli
      alkaline phosphatase (PhoA) were fused in frame to the region of celB coding for
      a lipoprotein signal peptide and CQANY. P2 is a 12-aa peptide including a
      tyrosine phosphorylation site of the epidermal growth factor receptor (EGF-R).
      Inducible expression of stable lipohexapeptide CQANYV, lipo-CQANY-P2, and lipo
      CQANYA-PhoA, was demonstrated. Similar expression was obtained for lipo-CIEGR-P2
      and lipo-CIEGRA-PhoA in which IEGR is a cleavage recognition site for the blood
      coagulation factor, Xa. Like QANY, IEGR is predicted to form a beta-turn
      structure. The presence of a lipid moiety on the products was confirmed by
      demonstrating the incorporation of radioactive palmitic acid and inhibition of
      processing by globomycin. The lipid-modified peptides were also identified by
      incorporation of radioactive tyrosine, and the nature of the P2 peptide was
      verified immunologically.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1628840
TI  - 'Stop-codon-specific' restriction endonucleases: their use in mapping and gene
      manipulation.
AB  - Certain restriction endonucleases recognise target sequences that contain the
      stop triplet TAG and are commonly either 4 or 6 bp in length. Interestingly,
      these restriction targets do not occur at the frequency expected on the basis of
      base composition and size. For example, the tetranucleotide MaeI recognition
      sequence (CTAG) occurs considerably less commonly (5-8-fold) in the genome of
      Escherichia coli (and many other eubacteria) than expected from mononucleotide
      frequencies. This surprising rarity is particularly evident in protein-encoding
      genes and is largely dictated by codon usage. Thus, amber (TAG) nonsense
      mutations frequently give rise to novel MaeI (CTAG) sites which are unique within
      a translated region. Such amber/MaeI sites, whether arising spontaneously or
      created in vitro by site-directed mutagenesis, act as a useful physical marker
      for the presence of the nonsense mutation and are a convenient startpoint for a
      range of diverse procedures. These features provide a useful supplement to
      protein engineering methods which use nonsense suppression to mediate amino acid
      replacements.

PMID- 1628841
TI  - Expression of the Erwinia carotovora polygalacturonase-encoding gene in Bacillus
      subtilis: role of signal peptide fusions on production of a heterologous protein.
AB  - The pehA gene encoding an endopolygalacturonase (pectinase) of Erwinia carotovora
      subsp. carotovora has been cloned previously [Saarilahti et al., Mol. Microbiol.
      4 (1990) 1037-1044]. We expressed pehA in Bacillus subtilis using a secretion
      vector based on the promoter and signal sequence of the alpha-amylase (Amy)
      encoding gene, amyE, from Bacillus amyloliquefaciens. To test whether the
      location of the junction between the secretion vector and pehA affects the
      protein yield, we made four different junctions. Two constructs contained an
      intact Amy signal sequence, whereas the other two were fusions between the Amy
      signal sequence and the polygalacturonase (PG) signal sequence. There was
      approximately fourfold variation in the production efficiency of B. subtilis
      strains carrying the different constructs. The most efficient construct contained
      the N-terminal and hydrophobic regions of the Amy signal peptide joined to the C
      terminus of PG signal peptide. This construct produced, in a shake flask culture,
      0.8 g of polygalacturonase per liter of growth medium. In a pulse-chase
      experiment, the signal peptide of the most efficient construct was rapidly
      cleaved while cleavage was slow in the other constructs. Our results suggest that
      fusions containing intact signal peptides, which are common when producing
      foreign proteins, are not necessarily the most efficient.

PMID- 1628842
TI  - In vivo inactivation of the Streptococcus mutans recA gene mediated by PCR
      amplification and cloning of a recA DNA fragment.
AB  - The inactivation of the RecA protein in pathogenic oral streptococci would
      facilitate genetic analysis of potential virulence factors in these strains.
      Comparison of recA nucleotide (nt) sequences from a number of bacteria has
      suggested that two regions of highly conserved RecA amino acid (aa) sequence
      could be used as a basis for synthesizing degenerate oligodeoxyribonucleotide
      primers with which to amplify recA homologues from the streptococci. Accordingly,
      primer mixtures were used to amplify a 693-bp fragment of the Streptococcus
      mutans chromosome by PCR. The amplified fragment was cloned and its identity
      confirmed via hybridization to an Escherichia coli recA gene probe and by nt
      sequence determination. The recA homologue fragment from S. mutans GS-5 was 63%
      and 75% homologous to the deduced aa sequences of the E. coli and Bacillus
      subtilis RecA enzymes, respectively. The S. mutans recA fragment was mutagenized
      in vitro via insertional inactivation and returned to the chromosome using
      allelic exchange. The resulting strains of S. mutans were shown to be
      substantially more sensitive to UV irradiation than the wild-type strain.
      Further, the ability to incorporate linear markers into the chromosome was
      abolished in putative S. mutans recA strains, thus indicating the functional
      inactivation of RecA in these microorganisms.

PMID- 1628843
TI  - Plasmid cloning vectors for the conjugal transfer of DNA from Escherichia coli to
      Streptomyces spp.
AB  - We have constructed cloning vectors for the conjugal transfer of DNA from
      Escherichia coli to Streptomyces spp. All vectors contain the 760-bp oriT
      fragment from the IncP plasmid, RK2. Transfer functions need to be supplied in
      trans by the E. coli donor strain. We have incorporated into these vectors
      selectable antibiotic-resistance markers (AmR, ThR, SpR) that function in
      Streptomyces spp. and other features that should allow for: (i) integration via
      homologous recombination between cloned DNA and the Streptomyces spp. chromosome,
      (ii) autonomous replication, or (iii) site-specific integration at the
      bacteriophage phi C31 attachment site. Shuttle cosmids for constructing genomic
      libraries and bacteriophage P1 cloning vector capable of accepting approx. 100-kb
      fragments are also described. A simple mating procedure has been developed for
      the conjugal transfer of these vectors from E. coli to Streptomyces spp. that
      involves plating of the donor strain and either germinated spores or mycelial
      fragments of the recipient strain. We have shown that several of these vectors
      can be introduced into Streptomyces fradiae, a strain that is notoriously
      difficult to transform by PEG-mediated protoplast transformation.

PMID- 1628844
TI  - Isolation, characterization, and sequencing of Candida albicans repetitive
      element 2.
AB  - A 1059-bp Sau3A fragment, designated Candida albicans repetitive element 2 (CARE
      2), was isolated from the genome of the pathogenic yeast, C. albicans. CARE-2 DNA
      was detected on several C. albicans chromosomes separated by transverse
      alternating-field electrophoresis. A high degree of interstrain variation in the
      pattern of hybridizing bands were observed by Southern blot analysis, with a
      minimum of 10-14 copies of CARE-2 per strain. A low frequency of new CARE-2
      polymorphisms was observed over time for three strains grown at 25 degrees C or
      37 degrees C. No new CARE-2 polymorphisms were observed from two naturally
      occurring switch phenotypes. To localize repeated DNA, oligodeoxyribonucleotide
      probes, each representing a different region of CARE-2, were hybridized to
      genomic blots. A lower number of copies were observed 5' and 3' to a 600-bp
      region of CARE-2. Nucleotide (nt) sequence analysis of CARE-2 DNA shows the
      element is characterized by six perfect direct repeats 6 bp in length and shows
      no significant DNA similarity with any known nt sequence.

PMID- 1628845
TI  - Cloning and sequence analysis of the Mucor circinelloides pyrG gene encoding
      orotidine-5'-monophosphate decarboxylase: use of pyrG for homologous
      transformation.
AB  - A 3.2-kb BamHI genomic DNA fragment containing the pyrG gene of Mucor
      circinelloides was isolated by heterologous hybridization using a pyrG cDNA clone
      of Phycomyces blakesleeanus as the probe. The complete nucleotide sequence of the
      M. circinelloides pyrG gene encoding orotidine-5'-monophosphate decarboxylase
      (OMPD) was determined and the transcription start points (tsp) were mapped by
      primer extension analysis. The predicted amino acid sequence showed homology with
      the OMPD sequences reported from other filamentous fungi, with 96% similarity
      with the OMPD of P. blakesleeanus. Analysis of the sequence revealed the presence
      of two short introns whose length and location were confirmed by sequencing a
      cDNA clone and comparing this with its genomic counterpart. The intron splice
      sites and the 5'- and 3'-noncoding flanking regions show general features of
      fungal genes. Northern-blot hybridization revealed the pyrG transcript to be
      approx. 1.0 kb. The M. circinelloides pyrG cDNA clone was able to complement the
      pyrF::Mu-1 mutation of Escherichia coli when inserted between bacterial
      expression signals. Additionally, the genomic clone complemented the M.
      circinelloides pyrG4 mutation. When an M. circinelloides autonomous replication
      sequence was included in the transforming plasmid, the average transformation
      frequency obtained was 600 to 800 transformants per micrograms DNA and per 10(6)
      viable protoplasts.

PMID- 1628846
TI  - Translational options for the pir gene of plasmid R6K: multiple forms of the
      replication initiator protein pi.
AB  - The autogenously controlled pir gene of plasmid R6K was believed to encode a
      single polypeptide that plays multiple roles in the plasmid's biology. We have
      isolated an opal (op) mutant at the 18th codon of the pir coding frame which does
      not totally abolish translation of pir mRNA. In extracts of cells containing this
      mutation two translational products (35 kDa and 30.2 kDa) have been detected. We
      propose that the 35-kDa polypeptide produced by the pir18 op mutation contains
      Trp substituted for Arg18 as the result of an opal readthrough. Translation,
      which results in the 30.2-kDa polypeptide, originates downstream from the UGA
      stop signal created by the mutation. Moreover, we realize now that the 30.2-kDa
      polypeptide is also produced in cells containing a wild-type (wt) pir gene. The
      shorter variant of the pi protein lacks replication initiation and inhibition
      functions, as well as autorepressor activity in vivo. We also show that an in
      frame fusion of seven N-terminal codons of the trpE gene with a pir gene lacking
      the first two codons produces two polypeptides which replace the 35-kDa pi
      protein and are of similar molecular weight. Thus, at least three options exist
      in the translation of the wt pir mRNA. Start codons are most likely at codon
      positions 1, 6 or 7, and 36 or 38. Each of these five AUG codons is preceded by a
      consensus ribosome-binding site (RBS).

PMID- 1628847
TI  - A genetic system to study the in vivo role of transcriptional regulators in
      Escherichia coli.
AB  - A genetic system for studying in vivo the interactions between a transcriptional
      regulatory protein and its target DNA has been developed for Escherichia coli. It
      is composed of two compatible plasmids: one high-copy-number promoter-probe
      vector, and one low-copy-number vector in which the gene encoding the desired
      protein is cloned under the control of an inducible promoter. The system was
      successfully tested for its specificity and for dosage analysis by using a
      combination of the plasmid pLS1-encoded RepA repressor and its target DNA.

PMID- 1628848
TI  - A general role for the lux autoinducer in bacterial cell signalling: control of
      antibiotic biosynthesis in Erwinia.
AB  - Micro-organisms have evolved complex and diverse mechanisms to sense
      environmental changes. Activation of a sensory mechanism typically leads to
      alterations in gene expression facilitating an adaptive response. This may take
      several forms, but many are mediated by response-regulator proteins. The luxR
      encoded protein (LuxR) has previously been characterised as a member of the
      response-regulator superfamily and is known to respond to the small diffusible
      autoinducer signal molecule N-(beta-ketocaproyl) homoserine lactone (KHL).
      Observed previously in only a few marine bacteria, we now report that KHL is in
      fact produced by a diverse group of terrestrial bacteria. In one of these
      (Erwinia carotovora), we show that it acts as a molecular control signal for the
      expression of genes controlling carbapenem antibiotic biosynthesis. This
      represents the first substantive evidence to support the previous postulate that
      the lux autoinducer, KHL, is widely involved in bacterial signalling.

PMID- 1628849
TI  - Cloning and primary structure of the wide-spectrum amidase from Brevibacterium
      sp. R312: high homology to the amiE product from Pseudomonas aeruginosa.
AB  - A Brevibacterium sp. R312 DNA fragment encoding the wide-spectrum amidase (EC
      3.5.1.4) has been cloned and sequenced, using limited amino acid (aa) sequence
      information obtained from the purified enzyme. The deduced aa sequence showed
      more than 80% strict identity with the Pseudomonas aeruginosa aliphatic amidase,
      the product of the amiE gene, suggesting a horizontal transfer of the gene during
      evolution between Gram+ and Gram- bacteria.

PMID- 1628850
TI  - Molecular heterogeneity of plasma superoxide dismutase.
AB  - A method was worked out that helped us to isolate superoxide dismutase (SOD) from
      human blood plasma. The change of enzyme's activity was shown depending on the
      period of SOD storage. Changes in activity were observed in storing protein after
      gel filtration. The activity of purified enzyme was half as much after 24 h
      storage and remained constant for a long period of time (5 mo). The change of SOD
      activity was found to be connected with a modification of its structure. The
      storage of enzyme's solution during 3 1/2 mo is accompanied by the lowering of
      protein molecular mass from 53,000 Da to 34,000 Da. The inhibitors of proteinases
      -phenyl-methylsulfonyl fluoride (PMSF) and alpha 2-macroglobulin--showed no
      protective effects on purified SOD. That's why it was possible to say that the
      lowering of protein molecular mass didn't connect with a specific proteolysis. An
      oxidative modification of SOD structure is under discussion now. The modification
      is most probably caused by oxidative destruction of aminoacid residues that are
      located outside the protein active centre.

PMID- 1628851
TI  - Movement of methylphenazyl free radicals in polar and nonpolar liquids.
AB  - A protonated, charged free radical of methylphenazine methosulfate (PMS) was
      generated at carbon electrodes in a buffered aqueous medium. This radical
      diffused from the aqueous phase into nonpolar organic solvents, where it was
      stable for extended periods. The electron spin resonance (ESR) spectrum of the
      free radical species in the nonpolar solvent was significantly different from
      that of the aqueous species. This difference was attributed to the loss of
      electric charge through deprotonation at the solution interface, followed by
      solvation of the uncharged species in the organic phase. ESR spectra are
      presented for PMS free radicals in polar and nonpolar liquid phases, along with
      electrochemical results and conclusions regarding the mechanisms of movement and
      toxicity of phenazyl free radicals in biological systems.

PMID- 1628852
TI  - The effect of ascorbate supplementation on oxidative stress in the streptozotocin
      diabetic rat.
AB  - An increase in oxidative stress may contribute to the development of diabetic
      complications. The key aqueous-phase chain-breaking antioxidant ascorbate is
      known to be deficient in diabetes, and we have therefore investigated the effects
      of ascorbate supplementation on oxidative stress in the streptozotocin diabetic
      rat. Markers of lipid peroxidation (malondialdehyde [MDA] and diene conjugates)
      were increased in plasma and erythrocytes of untreated diabetic animals, and
      levels of the antioxidants ascorbate and retinol were reduced. Plasma tocopherol
      was unchanged. Insulin treatment normalized MDA and ascorbate levels, although
      ascorbate metabolism remained disturbed, as indicated by increased levels of
      dehydroascorbate. High-dose ascorbate supplementation in the absence of insulin
      treatment restored plasma ascorbate to normal and increased plasma retinol and
      tocopherol levels. However, MDA and diene conjugate levels remained unchanged,
      possibly as a result of increased iron availability. High-dose ascorbate
      supplementation should be approached with caution in diabetes, as ascorbate may
      exert both antioxidant and prooxidant effects in vivo.

PMID- 1628853
TI  - Oxidative stress on mouse embryo development in vitro.
AB  - Oxygen radicals are involved in the in vitro block phenomenon of embryo
      development, because a low oxygen tension and superoxide dismutase (SOD) have
      been shown to promote the in vitro development of mouse embryos. One of the
      target molecules damaged by oxygen radicals may be the thiol (SH) group of
      proteins because it is readily oxidized. In this study, we evaluated the effects
      of thioredoxin, which is a powerful protein disulfide reductase, on mouse
      (Institute of Cancer Research, ICR) preimplantation embryo development. Culture
      of mouse pronuclear embryos recovered 17 h after human chorionic gonadotrophin
      (hCG) administration in the presence of thioredoxin (200 micrograms/mL)
      significantly increased the blastulation rate (75.3%) when compared to the
      control culture system (8.9%). The effects of thioredoxin were observed only from
      the pronuclear stage to the two-cell stage (17-48 h after hCG administration). An
      additive effect of thioredoxin and SOD, or thioredoxin and a low oxygen tension,
      was observed. These results suggest that the oxidation of the SH group of
      proteins is one of the causes of developmental blockage of embryos in vitro. The
      target protein for reduction by thioredoxin has not been identified yet, but
      thioredoxin will be a new clue for clarifying the mechanism of blocking
      development in vitro.

PMID- 1628854
TI  - Tolerance and safety of vitamin E: a toxicological position report.
AB  - From numerous publications on the "prophylactic" and "therapeutic" use of vitamin
      E, it may be concluded that the toxicity of vitamin E is very low. It has been
      demonstrated in animal experiments that vitamin E has neither mutagenic,
      teratogenic nor carcinogenic properties. Based on studies in humans, a daily
      dosage of 100-300 mg vitamin E can be considered harmless from a toxicological
      point of view. Using double-blind studies involving a large number of subjects,
      it has been demonstrated that large oral doses of up to 3,200 USP-Units/day led
      to no consistent adverse effects. From a large body of published data, dosage
      ranges have been deduced which can be characterized as safe for human subjects
      even where their use extends over a long period of time. It should, however, be
      noted that oral intake of high levels of vitamin E can exacerbate the blood
      coagulation defect of vitamin K deficiency caused by malabsorption or
      anticoagulant therapy. High levels of vitamin E intake are, therefore,
      contraindicated in these subjects.

PMID- 1628855
TI  - Malondialdehyde production and ascorbate decrease are associated to the
      reperfusion of the isolated postischemic rat heart.
AB  - Isolated Langendorff-perfused rat hearts after 20 min of normoxic perfusion in
      the presence of 2.5 mM Ca++ and 11 mM glucose were subjected to 30 min of global
      normothermic ischemia followed by 30 min of normoxic reperfusion with the
      starting buffer. At the end of each perfusion condition, hearts were freeze
      clamped and deproteinized by 0.6 M HClO4. Two-hundred microL of the neutralized
      tissue extracts were analyzed by a recently developed high-performance liquid
      chromatography (HPLC) method for the simultaneous determination of
      malondialdehyde (MDA), ascorbic acid, and adenine nucleotides. By means of this
      analytical technique, it was possible to demonstrate that MDA is undetectable in
      control hearts. In contrast, 30 min of ischemia induced a modest production of
      MDA (0.012 mumol/g dw), while a large amount of MDA (0.103 mumol/g dw) was
      observed in reperfused hearts. Values referring to ascorbic acid showed that the
      concentration of this antioxidant progressively decreased from 1.190 (control
      hearts) to 0.837 (ischemic hearts) and to 0.595 mumol/g dw (reperfused hearts).
      The overall conclusions of this study are that reperfusion induces an oxidative
      stress to the isolated myocardium, a decrease of ascorbate, and an increase of
      lipid peroxidation. Therefore, by means of a proper analytical method, MDA may
      represent a valid biochemical parameter to demonstrate the relationship between
      myocardial reperfusion and a detectable tissue damage.

PMID- 1628856
TI  - Pholasin: a new chemiluminescent probe for the detection of chloramines derived
      from human phagocytes.
AB  - We have previously reported that normal human polymorphonuclear neutrophils (PMN)
      release taurine-chloramine, a long-lived oxidant, in response to stimulation by
      phorbol myristate acetate (PMA) or opsonized zymosan in the presence of exogenous
      taurine. We now describe a new, simple, and highly sensitive method for the
      detection of chloramines, including taurine-chloramine, using the
      chemiluminescent probe Pholasin, the luciferin of the mollusc Pholas dactylus.
      Taurine-chloramine (N-chlorotaurine) detection was assessed with both a
      colorimetric method (based on the oxidation of potassium iodide) and with the
      Pholasin-dependent chemiluminescence (CL) method. The taurine-chloramine
      concentration in PMN supernatants determined using the potassium iodide (KI)
      method correlated closely with Pholasin-dependent CL. This CL was also assessed
      in nonoxidative conditions. No taurine-chloramine was detected in supernatants of
      lymphocytes and PMN from patients with an oxidative burst defect (chronic
      granulomatous disease, CGD) with the KI method, but Pholasin-dependent CL was
      consistently observed. The use of methionine, a specific chloramine scavenger in
      our incubation conditions, allowed us to define a methionine-inhibitable fraction
      of Pholasin-dependent CL (i.e., chloramine-induced CL).

PMID- 1628857
TI  - Peroxyl radical-mediated hemolysis: role of lipid, protein and sulfhydryl
      oxidation.
AB  - The objective of this study was to define the relationship between peroxyl
      radical-mediated cytotoxicity and lipid, protein and sulfhydryl oxidation using
      human erythrocytes as the target mammalian cell. We found that incubation of
      human erythrocytes with the peroxyl radical generator 2,2' azobis (2
      amidinopropane) hydrochloride (AAPH) resulted in a time and dose-dependent
      increase in hemolysis such that at 50 mM AAPH maximum hemolysis was achieved at
      120 min. Hemolysis was inhibited by hypoxia and by the addition of certain water
      soluble free radical scavengers such as 5-aminosalicylic acid (5-ASA), 4-ASA, N
      acetyl-5-ASA and dimethyl thiourea. Peroxyl radical-mediated hemolysis did not
      appear to involve significant peroxidation of erythrocyte lipids nor did they
      enhance protein oxidation at times preceding hemolysis. Peroxyl radicals did
      however, significantly reduce by approximately 80% the intracellular levels of
      GSH and inhibit by approximately 90% erythrocyte Ca(2+)-Mg2+ ATPase activity at
      times preceding the hemolytic event. Our data as well as others suggest that
      extracellular oxidants promote the oxidation of intracellular compounds by
      interacting with certain redox active membrane components. Depletion of
      intracellular GSH stores using diamide did not result in hemolysis suggesting
      that oxidation of GSH alone does not promote hemolysis. Taken together, our data
      suggest that neither GSH oxidation, lipid peroxidation nor protein oxidation
      alone can account for peroxyl radical-mediated hemolysis. It remains to be
      determined whether free radical-mediated inactivation of Ca(2+)-Mg2+ ATPase is an
      important mechanism in this process.

PMID- 1628858
TI  - Synergistic effects of Cu(II) and dimethylammonium 2,4-dichlorophenoxyacetate
      (U46 D fluid) on PM2 DNA and mechanism of DNA damage.
AB  - Dimethylammonium 2,4-dichlorophenoxyacetate (2,4-D . DMA) induced strand breaks
      in PM2 DNA when incubated with CuCl2, whereas 2,4-D . DMA alone or CuCl2 alone
      did not show any or only a negligible effect. The formation of single strand
      breaks increased linearly with time and concentration of 2,4-D . DMA.
      Neocuproine, a specific Cu(I) chelator totally prevented strand break formation.
      So did catalase (up to 100 mM 2,4-D . DMA), but DMSO had only a small protective
      effect. 2,4-Dichlorophenol, CO2 and formaldehyde were detected as reaction
      products of 2,4-D and CuCl2. From these results a redox reaction of Cu(II) and
      2,4-D is proposed, which could explain the DNA damaging properties of CuCl2/2,4-D
      . DMA.

PMID- 1628859
TI  - Circadian rhythm of white blood cell aggregation and free radical status in
      healthy volunteers.
AB  - Previous studies have demonstrated circadian rhythms in the onset of thrombotic
      events, which occur most commonly in the morning, and also in the fibrinolytic
      activity of the blood which has a peak in the evening and a trough in the
      morning. There has recently been increasing interest in the role of white blood
      cells (WBCs) and free radicals (FRs) in thrombosis. No one has yet investigated
      the potential circadian variation of WBC aggregation and FRs in humans. We
      studied the circadian rhythm of WBC aggregation and FR status in 10 healthy male
      volunteers. Six blood samples were collected at 4 hourly intervals from 12:00
      (mid-day) until 08:00 the following morning. The volunteers carried out normal
      daily activities until 00:00 at which time they went to bed and they remained in
      bed until 08:00. The following were measured on each sample: WBC aggregation;
      thiobarbituric acid reactive substances (TBARs), plasma thiols (PSH), red cell
      lysate thiols (LSH), glutathione (GSH) and superoxide dismutase (SOD) which are
      all altered in the presence of FR activity. The following parameters demonstrated
      significant circadian rhythms, WBC aggregation p less than 0.001, TBARs p less
      than 0.015, PSH p less than 0.001, LSH p less than 0.002. WBC aggregation was
      lowest at 09:00 and highest at 00:00-04:00. TBARs and PSH both had a peak at
      16:00 and a trough at 04:00. LSH had a peak at 12:00 and a trough at 08:00. As
      the behaviour of WBCs and FR status influence the flow properties of blood, a
      circadian rhythm in WBC function and FR status may contribute to the time of
      onset of thrombotic diseases. Moreover, with many studies being currently
      undertaken in this area, our work indicates the need to standardize sample times.

PMID- 1628860
TI  - Study of the teratogenic potential of FD & C yellow No. 5 when given in drinking
      water.
AB  - FD & C Yellow No. 5 was available to pregnant Osborne-Mendel rats throughout
      gestation at dose levels of 0.05, 0.1, 0.2, 0.4 or 0.7% in solution in distilled
      drinking-water. Based on fluid consumption, the rats received 67.4, 131.8, 292.4,
      567.9 and 1064.3 mg FD & C Yellow No. 5/kg body weight/day. Distilled water
      served as the control. No dose-related changes were seen in mean daily food
      consumption or maternal body-weight gain. Starting during the second trimester of
      gestation, fluid consumption was significantly greater in the rats given 0.7% FD
      & C Yellow No. 5 than in the controls. The females were killed on gestation day
      20. No dose-related changes were seen in maternal clinical findings,
      implantations, foetal viability or foetal size (weight and length). No dose
      related foetal terata were seen. Neither visceral development nor skeletal
      development (sternebral and other skeletal bones) was affected by the dye. The
      small numbers of statistically significant increases in skeletal variations in
      the 0.05 and 0.4% levels are considered random because they are not dose related.

PMID- 1628861
TI  - Developmental toxicity evaluation of inhaled citral in Sprague-Dawley rats.
AB  - Citral is a commonly used fragrance and flavour ingredient that has demonstrated
      a potential for teratogenicity in chick embryo screening studies. To investigate
      potential mammalian developmental toxicity, pregnant Sprague-Dawley rats were
      exposed to citral by inhalation for 6 hr/day on gestation days 6-15 at mean
      concentrations of 0, 10 or 34 ppm as vapour, or 68 ppm as an aerosol/vapour
      mixture. Dams were killed on gestation day 20 and the foetuses were removed and
      evaluated for gross, visceral and skeletal malformations. Exposure to 68 ppm was
      maternally toxic, with reduced body-weight gains, ocular opacity, breathing
      difficulty, nasal discharge and salivation noted in the dams. No maternal
      toxicity was seen at the lower vapour exposure levels. The number of corpora
      lutea, implantations, resorptions, foetal viability, litter size, and sex ratio
      were not adversely affected by citral at any exposure level tested, and no
      exposure-related malformations were observed. At a maternally toxic exposure
      level, a slight reduction in mean foetal body weight and a slight increase in the
      incidence of hypoplastic bones were noted. Results of this study indicate that
      citral does not produce developmental toxicity in the rat when administered by
      inhalation at concentrations up to a maternally toxic exposure level.

PMID- 1628862
TI  - Initial studies on the toxicokinetics of fumonisin B1 in rats.
AB  - Fumonisin B1 (FB1), the major compound in the fumonisin group of secondary
      metabolites of Fusarium moniliforme Sheldon, is associated with some human and
      animal diseases. After intraperitoneal dosing to rats (7.5 mg/kg), FB1 was
      rapidly absorbed and reached a maximum concentration in plasma within 20 min
      after injection. Thereafter, it underwent rapid removal from plasma, displaying a
      mono-exponential elimination phase that fitted a one-compartment model with a
      half-life of 18 min. Collection of 24- and 48-hr urine samples indicated that
      only 16% of the applied dose was eliminated unmetabolized in urine, all within
      the first 24-hr period following dosing. In contrast to this, a similar dose of
      FB1 given by gavage resulted in the recovery of only 0.4% of the FB1 in urine.

PMID- 1628863
TI  - Faecal elimination of lead and cadmium in subjects on a mixed and a
      lactovegetarian diet.
AB  - Faecal elimination of lead and cadmium in 16 subjects who changed from a mixed
      diet to a lactovegetarian diet has been studied. The faecal weight increased
      significantly following the change to the vegetarian diet, partly because of
      increased water content. There was a large inter-individual variation in faecal
      elimination of lead and cadmium during both the mixed-diet period (range 14 to
      118, median 31 micrograms Pb/day; range 4.5 to 21, median 12 micrograms Cd/day)
      and the vegetarian diet period (range 19 to 136, median 42 micrograms Pb/day;
      range 6.1 to 24, median 14 micrograms Cd/day). There was a tendency towards
      increased faecal elimination of lead and cadmium following the change to the
      vegetarian diet, but the differences were not statistically significant.

PMID- 1628864
TI  - Antimutagenicity of ellagic acid towards the food mutagen IQ: investigation into
      possible mechanisms of action.
AB  - The ability of the plant phenol ellagic acid to inhibit the mutagenicity of the
      food mutagen IQ was evaluated using Salmonella typhimurium strain TA98 in the
      Ames mutagenicity test. Ellagic acid caused a concentration-dependent decrease in
      the S-9- and microsome-mediated mutagenicity of IQ. The plant phenol did not
      interact directly with the IQ-derived mutagenic species and did not modify the
      cytosol-mediated activation of the promutagen. At the concentrations used in the
      mutagenicity studies, ellagic acid failed to inhibit microsomal mixed-function
      oxidase activity, including that mediated by the P450I family responsible for the
      bioactivation of IQ, despite being an essentially planar molecule as indicated by
      computer-graphic analysis. The inhibitory effect of ellagic acid was independent
      of its ability to chelate Mg2+. However, pre-incubation of ellagic acid with the
      bacteria, followed by removal of the plant phenol, did not completely prevent the
      inhibitory effect of the phenol on the mutagenicity of IQ. Intraperitoneal
      administration of ellagic acid to rats caused a decrease in total cytochrome P
      450 levels and related activities as well as in cytosolic glutathione S
      transferase activity. Finally, the possibility that the reported anticarcinogenic
      action of ellagic acid reflects nothing more than non-selective destruction of
      hepatic cytochromes P-450, and thus reduced chemical activation, is considered.

PMID- 1628865
TI  - Induction of reversible urothelial cell hyperplasia in rats by clorsulon, a
      flukicide with weak carbonic anhydrase inhibitory activity.
AB  - Clorsulon, a flukicide registered for use in treating Fasciola hepatica
      infections in cattle, has induced urinary bladder urothelial cell hyperplasia in
      rats at oral doses of 30 mg/kg/day or more. Despite previous testing at doses
      above this threshold, this lesion had not been found in subchronic or chronic
      toxicity studies in rats. After ruling out the presence of a contaminant as the
      causative factor in producing this lesion, a study was conducted in which
      clorsulon increased the pH and altered the electrolyte composition of urine,
      consistent with its weak carbonic anhydrase inhibitory activity. The acid/base
      balance of the diet markedly affected the threshold for induction of the
      urothelial cell hyperplasia: acidification by addition of 5% ammonium chloride to
      the diet reduced the incidence and severity. In additional studies it was found
      that the urothelial cell hyperplasia was most pronounced after 1 week of
      treatment compared with daily exposure for either 5 or 15 wk. The reversibility
      of the hyperplasia despite continued treatment confirms that the hyperplasia is
      not a preneoplastic lesion, a conclusion supported by negative studies of
      carcinogenicity in rodent bioassays of clorsulon and other drugs with carbonic
      anhydrase inhibitory activity.

PMID- 1628866
TI  - Proliferation and morphological transformation of BALB/3T3 cells by a prolonged
      treatment with sodium orthovanadate.
AB  - BALB/3T3 mouse embryo cells were used to study the effect of sodium orthovanadate
      on cell proliferation and morphological transformation. In the presence of the
      chemical (0.25-1.0 micrograms/ml), the cells continued to proliferate after the
      cultures were confluent. However, contact-inhibited growth was resumed after
      removal of the chemical from the culture medium. Continued exposure of the cells
      to the chemical for 4 wk led to the production of numerous foci consisting of
      morphologically transformed cells. In contrast, as in vitro transformation assay
      with a 48-hr treatment protocol followed by 4 wk of incubation without the
      chemical produced negative results. To test the stability of the transformed foci
      that were produced on prolonged exposure, we isolated 20 foci with distinctly
      transformed characteristics from treated cultures and grew them in medium without
      orthovanadate. 15 isolates gradually reverted to contact-inhibited growth and
      five maintained the transformed phenotype through ten serial subcultures. The
      results show that the majority of the transformed foci from the orthovanadate
      treated culture failed to maintain transformed characteristics in the absence of
      the chemical. However, a small fraction of the foci appeared to be altered
      permanently and exhibited a transformed phenotype in the absence of the chemical.

PMID- 1628867
TI  - Statistical evaluation of the fixed-dose procedure.
AB  - The fixed-dose procedure (FDP) was proposed by the British Toxicology Society in
      1984 as an alternative to the LD50 study in the assessment of the acute oral
      toxicity of a substance. This paper presents a statistical evaluation of this
      procedure. A mathematical description of the FDP shows that the starting dose can
      affect the toxic classification of a substance. The toxic classification based on
      the FDP is compared with that based on an LD50 test. This shows that, in general,
      the FDP is likely to result in the same classification or a less toxic one than
      the LD50 procedure. However, for substances with very shallow dose-response
      slopes, the FDP is likely to result in the same classification or a more toxic
      one. The expected number of animals that will be tested and will die using the
      FDP will be reduced compared with the LD50 study. The results from the
      international validation study carried out in 1989 showed agreement with the
      results predicted from the mathematical model.

PMID- 1628868
TI  - Nitrosamines in rubber bands used for orthodontic purposes.
AB  - Fourteen samples from eight brands of elastic-rubber bands used in orthodontics
      were tested for their nitrosamine content. The presence of N-nitrosodibutylamine
      and N-nitrosopiperidine was confirmed. The potential for nitrosamine formation
      from accelerating agents used for vulcanization and from other nitrosatable
      amines, which may be present in rubber exposed to salivary nitrite, justifies
      further investigations.

PMID- 1628869
TI  - Carcinogenic chemicals in food: evaluating the health risk.
AB  - The presence of a low level of potentially harmful chemicals in food continues to
      be a concern to many individuals. A major concern is that these chemicals, which
      can be synthetic or naturally occurring, may be a causative factor in human
      cancer. Synthetic chemicals in food may be present either as specific additives
      or as contaminants derived from environmental or agricultural chemicals. Food
      also contains a variety of naturally occurring chemicals derived from vegetables
      or other plants. These may in some cases be considered as contaminants, and are
      occasionally used as specific additives. New chemicals can also be formed during
      the cooking or preserving processes. The capacity of any of these chemicals to
      induce cellular damage and mutation is minimized by natural defence systems such
      as an efficient cellular detoxification system and DNA repair. The factors
      influencing tumour formation in humans are numerous and interrelated and exposure
      to minor dietary chemicals needs to be considered in this context. Thus, the
      results of animal carcinogenicity assays on individual chemicals need to be
      interpreted with care, taking into account the mechanisms by which mutagenic and
      other chemicals initiate cancer, as well as the level of human exposure to these
      chemicals. Further research is necessary to determine the role, if any, of minor
      dietary components in tumour formation. Meanwhile, there needs to be a more
      holistic approach to the multitude of factors, including total diet, that may
      influence human cancer incidence. In this way, the relative risk of dietary
      chemicals may be given a more meaningful perspective for health professionals and
      consumers alike.

PMID- 1628870
TI  - Propionic acid and the phenomenon of rodent forestomach tumorigenesis: a review.
AB  - Propionic acid (PA) is widely used as an antifungal agent in food. It is present
      naturally at low levels in dairy products and occurs ubiquitously, together with
      other short-chain fatty acids (SCFA), in the gastro-intestinal tract of humans
      and other mammals as an end-product of the microbial digestion of carbohydrates.
      It has significant physiological activity in animals. PA is irritant but produces
      no acute systemic effects and has no demonstrable genotoxic potential. Rats
      receiving PA at 4% in the diet develop hyperplastic lesions and tumours of the
      forestomach. Such changes are also reported to have been produced by a variety of
      other chemicals, mechanical and chemical irritants, parasites, and even various
      dietary insufficiencies or imbalances. Evidence suggests that repeated or
      persistent damage to cells of the forestomach epithelium and associated
      proliferative responses may be a common factor in rodent forestomach
      tumorigenesis. Although humans do not have a forestomach, the mouth, pharynx and
      oesophagus are lined with similar epithelium and thus are potential target
      organs. However, food contact time is considerably less in these organs than in
      the rodent forestomach. On current evidence, PA cannot be considered a
      carcinogenic risk to humans; nevertheless, to determine a safe level of dietary
      exposure it is suggested that no-observable-effect levels should be determined
      for epithelial cell damage and proliferative responses in the squamous mucosa of
      laboratory animals, particularly in those parts of the gastro-intestinal tract
      having a counterpart in humans, such as the pharynx and oesophagus.

PMID- 1628871
TI  - [Individualized therapy of fat metabolism disorders. Focusing on total
      cardiovascular risk].

PMID- 1628872
TI  - [ESVEM-Study. Life threatening arrhythmias can be controlled. Symposium: Clinical
      Trials. American College of Cardiology 41st annual scientific sessions. Dallas,
      Texas, 12-16 April 1992].

PMID- 1628874
TI  - [Consultation: Acute and chronic disorders of the locomotive apparatus].

PMID- 1628873
TI  - [Heart diseases in light of SAVE-Study. Captopril improves prognosis and symptoms
      of left ventricular dysfunction after myocardial infarction. 41st scientific
      annual meeting of the American College of Cardiology. Dallas, Texas, 12-16 April
      1992].

PMID- 1628875
TI  - Potassium channels of the insulin-secreting B cell.
AB  - Ionic and electrical events play a central role in the stimulus-secretion
      coupling of the pancreatic B cell. Potassium permeability is critically involved
      in the regulation of B cell membrane potential and insulin secretion. In the
      absence of glucose, membrane potential remains stable, around -65 mV. This
      resting potential is mainly determined by the high potassium conductance of the
      membrane. The ATP generated by glucose metabolism in B cells blocks the K+(ATP)
      channels controlling resting membrane potential. Thus, glucose metabolism leads
      to closure of the ATP-dependent potassium channels; the resulting decrease in K+
      permeability induces depolarization and opening of voltage-activated Ca-channels.
      The subsequent increase in Ca2+ influx raises the cytoplasmic concentration of
      free Ca2+, which in turn triggers exocytosis of secretory granules. Other types
      of K+ channels have also been identified in the B cell, such as voltage- and
      Ca(2+)-dependent K+ channels, which are not a target for the action of glucose,
      but may play a role in the repolarization of spikes. The modulation of insulin
      release by some hormones and neurotransmitters involves, among other mechanisms,
      an interference with the plasma membrane K+ conductance. Thus, galanine,
      somatostatin and adrenaline, which inhibit insulin release, increase K+
      conductance by a G protein-dependent mechanism; both peptides were reported to
      open ATP-sensitive K+ channels in insulin-secreting cell line RINm5F. It was also
      observed that extracellular purine nucleotides could interfere with K+ channels.
      Among the various drugs interfering with insulin secretion, sulfonylureas, such
      as tolbutamide and glibenclamide, directly inhibit ATP-dependent K+ channels in
      the B cell membrane and thereby initiate insulin release. In contrast, potassium
      channel openers such as diazoxide, antagonize the effects of glucose by
      increasing K+ permeability of the B cell membrane. Furthermore, other classes of
      drugs have recently been shown to interact with K+ (ATP) channels. Thus, K+
      channels of the pancreatic B cell, particularly ATP-dependent ones, play a
      crucial role in the electrophysiology of insulin secretion; they are an important
      target for pharmacological agents designed to modulate this secretion.

PMID- 1628876
TI  - The role of monoamine oxidase in the metabolism of exogenous noradrenaline by the
      human saphenous vein.
AB  - Human saphenous vein segments were obtained from patients subjected to coronary
      bypass surgery. As determined by HPLC-ED, the veins had a relatively low content
      of noradrenaline and high content of the deaminated metabolites,
      dihydroxyphenylglycol (DOPEG) and dihydroxymandelic acid (DOMA). In vein segments
      which had been incubated with 3H-noradrenaline (0.1 mumol/l), the oxidative
      deamination pathway predominated over the O-methylating one. Deamination occurred
      both at the neuronal and extraneuronal level; DOPEG appearing to be a good index
      of intraneuronal deamination, whereas DOMA and O-methylated and deaminated
      metabolites were mainly formed extraneuronally. Both MAO type A and MAO type B
      selective inhibitors reduced the deamination of noradrenaline; deamination was
      also found to be partially sensitive to semicarbazide. Inhibition of neuronal
      uptake or of deamination increased O-methylation. The human saphenous vein thus
      metabolizes exogenous noradrenaline following a pattern which substantially
      differs from that shown to occur in various blood vessels from other animal
      species.

PMID- 1628877
TI  - Further evidence that propentofylline (HWA 285) influences both adenosine
      receptors and adenosine transport.
AB  - We have examined the actions of a novel xanthine derivative, propentofylline (HWA
      285), that has been shown to protect against ischemic brain damage in rats and
      gerbils, on adenosine receptors (A1 and A2), and on adenosine transporters using
      several techniques, cells and tissues. Propentofylline and its hydroxylated
      metabolite A 72 0287 were about 20 times less potent than theophylline in
      displacing A1-agonist binding to membranes from rat cortex, and A1-antagonist
      binding to whole DDT, MF-2 smooth muscle cells. A1-agonist binding to adenosine
      A1-receptors in several brain structures was inhibited in a concentration
      dependent manner by A 72 0287 and propentofylline as judged by quantitative
      autoradiography (IC50-values 300-600 microM in eg striatum and in cortex layer
      IV). In two functional assays, A1-receptor mediated effects were blocked by
      propentofylline. A1-receptor-mediated inhibition of cyclic AMP accumulation was
      virtually abolished by 100 microM propentofylline. The A1-receptor-mediated
      inhibition of evoked acetylcholine release was also reduced by propentofylline,
      but in this case the effect is not due exclusively to adenosine receptor
      antagonism but also to another action since the presynaptic inhibitory effect of
      carbachol was also inhibited. Adenosine A2-receptors were also antagonized by
      propentofylline as judged by a concentration-dependent antagonism of A2-agonist
      induced cAMP accumulation in human T-leukemia cells (possessing putative A2b
      receptors; pA2-value 180 microM compared to 0.26 microM for 8-cpt), and in PC-12
      cells (possessing putative A2a-receptors, Ki-value 365 microM). Finally,
      adenosine transporters were affected by propentofylline and A 72 0287. Thus, [3H]
      nitrobenzylthioinosine-binding to guinea-pig cardiac membranes was blocked by
      propentofylline or A 72 0287 (Ki 270 microM). The present results show that
      propentofylline and its hydroxylated metabolite can influence adenosine
      mechanisms in a multitude of ways. How these different actions may contribute to
      the ability of propentofylline to reduce the magnitude of ischemic damage is
      discussed.

PMID- 1628878
TI  - Medical waste disposal in the dental office.

PMID- 1628879
TI  - Taking dentistry to the airwaves.

PMID- 1628880
TI  - Removable fixed bridge.

PMID- 1628881
TI  - Custom intra-coronal attachments for cosmetic removable partial dentures.

PMID- 1628882
TI  - An alternative method for the application of superficial heat.

PMID- 1628884
TI  - Using an office manual to fine-tune organizational effectiveness.

PMID- 1628883
TI  - An increasing Hispanic population and the practice of dentistry.

PMID- 1628885
TI  - 40 years of change: dental school applicants and students.

PMID- 1628886
TI  - How to increase your practice productivity.

PMID- 1628887
TI  - Molecular cloning, expression and characterization of the ovine IL-2R alpha
      chain.
AB  - Interleukin-2 (IL-2) stimulates the proliferation of activated antigen-specific T
      cells through its interaction with high affinity receptors. This event is largely
      regulated by the inducible expression of the alpha-chain (CD25) which, in
      combination with the beta-chain and possibly additional chains, forms the high
      affinity IL-2 receptor (IL-2R) complex. From a concanavalin A (Con A)-activated
      ovine T-cell complementary DNA (cDNA) library we have isolated two cDNA clones
      which together constitute a 2650 base pair (bp) messenger RNA (mRNA) species
      encoding the ovine IL-2R alpha chain. The nucleotide sequence has high homology
      with analogous cDNA from other species and predicts a mature protein of 254 amino
      acids. In addition to the predominate 2.6 kilobase (kb) ovine IL-2R alpha chain
      mRNA species. Northern blot analysis of activated T-cell RNA revealed two larger
      mRNA species. The ovine IL-2R alpha chain cDNA was transfected into CHO cells and
      low affinity binding of human recombinant IL-2 demonstrated. Polyclonal antisera
      generated against the transfected cells cross-reacted with Con A-activated ovine
      lymphocytes. In addition these antisera were used to immunoprecipitate a unique
      50,000 MW protein from the transfected cells. It is likely that this protein
      represents the expressed ovine IL-2R alpha chain cDNA which is heavily
      glycosylated as distinct from the 30,869 MW primary translation product. Southern
      blot analysis of ovine genomic DNA suggests that the ovine IL-2R alpha chain is
      encoded by a single copy gene.

PMID- 1628888
TI  - Induction of the expulsion of Strongyloides ratti and retention of
      Nippostrongylus brasiliensis in athymic nude mice by repetitive administration of
      recombinant interleukin-3.
AB  - A repetitive administration of recombinant interleukin-3 (rIL-3), which can
      induce the expulsion of Strongyloides ratti in athymic nude mice, did not affect
      the expulsion of Nippostrongylus brasiliensis. Nude mice infected with N.
      brasiliensis were injected i.p. with a total of 6.8 x 10(5) U rIL-3 or medium
      twice a day from Day 5 to Day 11 post-infection. The kinetics of expulsion
      estimated by egg excretion in faeces up to Day 20 post-infection and adult worm
      burden on Day 21 was not affected by the IL-3 administration. A similar
      administration with a higher dose (total 10.6 x 10(5) U) of rIL-3 did not alter
      the adult worm burden on Day 13. The number of intestinal mucosal mast cells on
      Day 13 was markedly increased by the treatment, although the number of intestinal
      goblet cells was comparable between the treated and control mice. When nude mice
      were infected concurrently with N. brasiliensis and S. ratti and then injected
      repeatedly with rIL-3 (total 2.2 x 10(5) U) from Day 5 to Day 11, adult worms of
      S. ratti were expelled from the small intestine by Day 13; however adult worms of
      N. brasiliensis were retained. Again in the concurrent infection, the number of
      intestinal mucosal mast cells was significantly increased but that of intestinal
      goblet cells was not altered by the rIL-3 administration. These results indicate
      that the expulsion of S. ratti is dependent on IL-3 whereas that of N.
      brasiliensis is less dependent on IL-3.

PMID- 1628889
TI  - Cytotoxic activity of intestinal lamina propria lymphocytes on human
      immunodeficiency virus (HIV)-infected cells.
AB  - The phenotype and cytotoxic activity of lamina propria lymphocytes (LPL) from the
      colorectal mucosa have been investigated primarily to analyse the role of LPL in
      human immunodeficiency virus (HIV) infection. The results reported here show that
      LPL strictly required a proliferative stimulus [either interleukin-2 (IL-2) or
      phytohaemaglutinin (PHA) to develop strong in vitro cytotoxicity, since freshly
      isolated LPL do not exhert cytotoxicity against either natural killer (NK)
      sensitive or NK-resistant target cells. The cytotoxicity of activated LPL against
      a large panel of myeloid tumours or colorectal carcinoma target cells shows the
      irrelevance of the tissue origin of target cells. Moreover, activated LPL lysed
      HIV-infected H9 cells more efficiently than peripheral blood lymphocytes (PBL),
      and were susceptible to HIV infection. In contrast, unstimulated LPL failed to be
      cytotoxic and susceptible to HIV. Thus, we strongly suggest that for the
      lymphocytes of the colorectal mucosa expression of cytotoxic activity and
      susceptibility to HIV-infection show two faces of the same coin, and therefore
      may be relevant in understanding the mechanisms and paths of transmission of HIV
      infection.

PMID- 1628890
TI  - Influence of H-2 genes on growth of Mycobacterium tuberculosis in the lungs of
      chronically infected mice.
AB  - Mice infected by intraperitoneal injection of Mycobacterium tuberculosis were
      studied over a 23-week period. They showed progressive infection in the lung
      (with increasing microbial count and granuloma size) whereas viable bacillary
      counts remained largely stationary in the spleen and in the liver. The influence
      of H-2 genes on the progression of the lung infection was studied in four
      congenic strains of animals with B10 and three congenic strains of animals with
      BALB backgrounds. H-2k mice had significantly higher bacterial counts in the lung
      than H-2b mice on both B10 and BALB backgrounds, BALB. K (H-2k) mice were also
      more susceptible than BALB/c (H-2d) mice. Results with recombinant strains showed
      that bacillary counts and granulomatous infiltration were lower in the B10 (KbAbE
      Db) compared with B10.A(3R) (KbAbEbDd) strain and in B10.A(4R) (KkAkE-Db)
      compared with B10.BR (KkAkEkDk) mice. This resistance to the late expansion of
      tuberculous infection in the lungs may be associated with the lack of an
      expressed I-E molecular or with the expression of the Db molecule.

PMID- 1628891
TI  - Susceptibility to Theiler's virus-induced demyelinating disease correlates with
      astrocyte class II induction and antigen presentation.
AB  - Theiler's murine encephalomyelitis virus (TMEV) is a picornavirus which induces a
      chronic demyelinating disease of the central nervous system (CNS) in certain
      susceptible mouse strains. Demyelination has been shown to result from
      immunopathological responses mediated by CD4+, major histocompatibility complex
      (MHC) class II-restricted T cells. As little or no class II is expressed in the
      normal mouse CNS, the ability of astrocytes to express these proteins and present
      antigen to T cells from TMEV-infected mice was investigated here. It is shown
      that astrocytes are capable of presenting TMEV to virus-specific T cells in
      vitro, and that this ability is dependent on prior induction of MHC class II by
      interferon-gamma (IFN-gamma) treatment. Unlike other viruses such as murine
      hepatitis virus-JHM (a coronavirus) and measles, TMEV is not capable of inducing
      class II on astrocytes directly. There is a correlation between the ease of class
      II induction on astrocytes from different mouse strains by IFN-gamma and mouse
      strain susceptibility to TMEV-induced demyelinating disease. These results
      suggest that following viral infection and initial T-cell infiltration into the
      CNS, class II induction on astrocytes is a key step allowing local antigen
      presentation and amplification of immunopathological responses within the CNS and
      hence the development of demyelinating disease.

PMID- 1628892
TI  - Human monoclonal antibodies specific for blood group antigens demonstrate
      multispecific properties characteristic of natural autoantibodies.
AB  - A panel of 72 human monoclonal antibodies with specificities for blood group
      antigens, A, Rh D, Rh C, Rh c, Rh E, Rh e, Rh G, Jka and Jkb, has been
      established from the peripheral blood of deliberately immunized donors. Previous
      work has established that the antibodies are highly specific for their respective
      blood group antigens, and a number of them are in routine clinical use as blood
      grouping reagents. This panel was screened for reactivity against six unrelated
      foreign and autoantigens by ELISA, for rheumatoid factor activity by ELISA and
      agglutination techniques, and for reactivity with a number of different tissues
      by immunofluorescence. Binding of the monoclonal antibodies to unrelated exo- and
      autoantigens was commonly seen amongst the antibodies of the IgM class, and to a
      lesser degree amongst the IgG class, with reaction patterns similar to those
      given by natural autoantibodies. Only five of the IgM antibodies failed to
      demonstrate any unexpected cross-reactivities and these included 1/13 anti-D, 2/7
      anti-E, 1/13 anti-c and 1/2 anti-A. We propose that rather than natural
      autoantibodies representing a distinct population of immunoglobulins,
      multispecificity (polyspecificity, or polyreactivity) may be a feature of
      antibodies produced in response to exogenous antigens. The implications of this
      for the study of autoantibodies are discussed.

PMID- 1628893
TI  - Stimulatory effect of interleukin-1 beta on the interferon-gamma-dependent HLA-DR
      production.
AB  - Expression of major histocompatibility complex (MHC) class II genes is induced by
      interferon-gamma (IFN-gamma) in antigen-presenting cells. When human leukaemia
      THP-1 and PL-21 cells were pretreated with phorbol ester, IFN-gamma-dependent
      induction of MHC class II gene was markedly enhanced. To elucidate the mechanism
      of the phenomenon, we examined the effect of cytokines which were secreted from
      THP-1 cells by the treatment of phorbol ester. Among those cytokines, interleukin
      1 beta (IL-1 beta) had a positive effect on IFN-gamma-dependent induction of MHC
      class II genes. In order to rule out the possibility that different clones of THP
      1 cells respond independently to IFN-gamma or phorbol ester, we showed that all
      independent single clones expressed MHC class II and produced IL-1 beta by IFN
      gamma or phorbol ester, respectively.

PMID- 1628894
TI  - Induction of IgE antibodies in mice with recombinant grass pollen antigens.
AB  - In this study, recombinant Poa pratensis (Poa p) IX allergens were examined for
      their in vivo allergenicity and antigenicity. Immunization of mice with a fusion
      protein (FP) comprising beta-galactosidase and recombinant KBG8.3 (rKBG8.3)
      allergen induced high titres of both IgG and IgE antibodies. By contrast,
      immunization with rKBG60.2, which represents the N-terminal fragment of rKBG8.3,
      induced only IgG antibodies. The IgE antibody titre specific to Kentucky
      Bluegrass (KBG) was significantly higher than that to beta-galactosidase.
      Moreover, KBG-specific IgE antibodies showed no apparent decrease in their titres
      until 60 days after immunization, whereas the beta-galactosidase-specific IgE
      antibodies disappeared after 40 days. The antibodies induced with rKBG8.3 in mice
      were capable of inhibiting the binding of human IgE antibodies to KBG pollen
      allergens, which indicated that rKBG8.3-specific murine antibodies recognized
      epitopes similar to those recognized by human IgE antibodies. Analysis of
      allergenic cross-reactivities of rKBG8.3 with components from five other species
      of grass pollens revealed that IgE antibodies induced by this allergen are
      capable of binding in vivo to components from other grass pollens. These results
      suggest that the mouse may serve as a model for the manipulation of IgE responses
      to recombinant allergens or their chemically modified derivatives.

PMID- 1628895
TI  - Enhanced secretory IgA and systemic IgG antibody responses after oral
      immunization with biodegradable microparticles containing antigen.
AB  - Intragastric immunization may lead to the induction of antibodies in the
      secretory immune system including saliva. The antibody response is usually short
      lived. The objectives of this study were to see whether oral immunization with
      biodegradable microparticles containing antigen might lead to enhanced mucosal
      responses. Ovalbumin (OVA) was entrapped in a novel antigen delivery system
      comprising poly (D,L-lactide-co-glycolide) (PLGA) microparticles. Salivary IgA
      and serum IgG responses after three daily oral immunizations in BALB/c mice were
      assayed by ELISA at weekly intervals and compared with those to soluble antigen.
      Low levels of salivary IgA antibodies were detected at Weeks 2 and 3 in both
      groups and no significant differences were found. After a secondary series of
      intragastric immunizations at Week 4, marked differences were apparent between
      the groups. The mean salivary IgA titre at Week 6 was 959 +/- 494 U compared with
      30 +/- 5 in the soluble OVA group (P less than 0.0001). Significant differences
      were still apparent at Weeks 7-8 through the value was falling. Serum IgG
      antibodies were detectable and were significantly greater in the particle group
      (at Weeks 4 and 8) than in controls (P less than 0.001). These results suggest
      that microparticles are taken up by antigen-presenting cells in Peyer's patches,
      then slowly degrade in vivo and release entrapped antigens, and thus can function
      as potent antigen delivery systems giving rise to both mucosal and systemic
      responses. Microparticles have considerable potential as a controlled released
      antigen delivery system for the induction of longer-term immune responses at
      mucosal surfaces.

PMID- 1628896
TI  - Tissue localization of conglutinin, a bovine C-type lectin.
AB  - The distribution of bovine conglutinin (BK) in sections of frozen bovine tissues
      was studied by the indirect immunoperoxidase technique using a monospecific
      rabbit anti-BK antibody. BK was found in the cytoplasma of all hepatocytes,
      indicating that the liver is a major site of synthesis of BK. In the germinal
      centres of the spleen, tonsils and lymph nodes the anti-BK staining was
      restricted to a population of cells with a distribution and morphology
      characteristic of follicular dendritic cells. Macrophages in lung and thymus, and
      glia cells in cerebrum, revealed a granular staining reaction within the
      cytoplasma. Endothelial cells of blood vessels reacted with anti-BK. The
      intensity of this reaction varied greatly between the organs, the most pronounced
      reaction being seen in the glomeruli of the kidney, and in the capillary
      sinusoides of the cortex of the adrenal gland. The high endothelial venules of
      lymph nodes and tonsils were also stained. These findings suggest that BK, which
      until now has been described only as a circulating molecule, may exhibit a
      biological function within the BK-positive tissues.

PMID- 1628897
TI  - Stimulation of tumour necrosis factor release by cytotoxic analogues of platelet
      activating factor.
AB  - The capacity of cytotoxic analogues of platelet-activating factor (PAF) to
      stimulate tumour necrosis factor-alpha (TNF-alpha) synthesis and release by human
      monocytes was determined. Cell-associated TNF-alpha was quantified by protein
      immunoblotting and released TNF-alpha was quantified by cytotoxicity bioassay.
      Picomolar concentrations of methoxyPAF, SDZ 62-759, SDZ 68-826, SDZ 62-434 and
      SRI 62-834 induced a two- to fivefold increase in cell-associated and released
      TNF-alpha. These compounds were as potent as PAF for stimulating monocytes. In
      contrast, they lacked direct platelet-activating activity and inhibited platelet
      aggregation induced by PAF selectivity. The analogues inhibited PAF binding to
      platelets but not to monocytes. The PAF binding antagonists kadsurenone, BN52021
      and WEB2086 inhibited TNF-alpha release induced by 10(-11) M PAF or methoxyPAF by
      a maximum of only 30-60% whereas they inhibited platelet aggregation by 10(-8) M
      PAF completely. Monocyte receptors for methoxyPAF were evaluated. Scatchard
      analysis of [3H]methoxyPAF binding to monocytes revealed large numbers of
      relatively low affinity receptors (Kd = 5.9 +/- 0.5 x 10(-7) M; 9.1 +/- 4.2 x
      10(7) sites/monocyte). These values do not correspond to binding constants of
      monocyte receptors for PAF and do not account for monocyte activation by
      picomolar concentrations of methoxyPAF. Cytotoxic analogues of PAF stimulate TNF
      alpha synthesis and release but they do not stimulate monocytes by interacting
      with PAF receptors.

PMID- 1628898
TI  - Antibodies against phosphatidylinositol and inositol monophosphate specifically
      inhibit tumour necrosis factor induction by malaria exoantigens.
AB  - The active component of the exoantigens of malarial parasites which stimulates
      macrophages to secrete tumour necrosis factor (TNF) has been shown to depend upon
      a phospholipid, the activity of which was blocked by phosphatidylinositol (PI)
      and inositol monophosphate (IMP) in competitive inhibition studies. Antisera made
      against the exoantigens of Plasmodium yoelii, which inhibited their induction of
      TNF, were found by an ELISA assay to contain antibody against several other
      phospholipids. However, the inhibitory antibody was removed specifically by
      adsorption with liposomes containing PI, but not other phospholipids.
      Furthermore, PI was the only phospholipid in non-liposomal form which induced the
      production of inhibitory antisera. Mice immunized with IMP, but not inositol,
      also produced inhibitory antisera. When incorporated into liposomes several other
      phospholipids did give rise to inhibitory antibodies but, in contrast to the
      antisera against parasite exoantigens, PI and IMP, the inhibitory activity was
      removed by adsorption with heterologous phospholipid liposomes, suggesting that
      it was directed against a common determinant, presumably the phosphate ester head
      group. Inhibitory antibodies in the antisera tested were predominantly IgM and
      titres were not increased after repeated injections. Antisera raised against PI,
      IMP or the cross-reacting phospholipid liposomes also inhibited TNF secretion by
      macrophages stimulated by exoantigens of the human parasites P. falciparum and P.
      vivax, but not by bacterial lipopolysaccharide. These findings confirm our
      conclusion that exoantigens from these different species contain phosphate bound
      to inositol in their TNF-inducing moiety.

PMID- 1628899
TI  - Detection of inflammatory cytokine messenger RNA (mRNA)-expressing cells in human
      inflamed gingiva by combined in situ hybridization and immunohistochemistry.
AB  - Cells expressing messenger RNA (mRNA) for inflammatory cytokines [interleukin-1
      (IL-1), tumour necrosis factor-alpha (TNF-alpha), IL-6, IL-8] were demonstrated
      by in situ hybridization in human inflamed gingiva. When this technique was used
      in conjunction with immunohistochemistry, IL-1 alpha and/or beta and IL-8
      messages were observed predominantly on macrophages infiltrating the gingiva. TNF
      alpha messages were abundant on macrophages and T cells. In contrast, the IL-6
      mRNA were more widely distributed on many types of cells such as macrophages, T
      cells, fibroblasts, endothelial cells and B cells. This study clearly identified
      the cells which express mRNA for inflammatory cytokines in inflamed gingiva and
      suggested an involvement of cytokine network in the generation of human
      periodontitis.

PMID- 1628900
TI  - Paradoxical stimulation and inhibition by protein kinase C modulating agents of
      lipopolysaccharide evoked production of tumour necrosis factor in human
      monocytes.
AB  - Human blood monocytes were activated by bacterial lipopolysaccharide endotoxin
      (LPS) (10 ng/ml) for cytotoxicity of WEHI-164 mouse fibrosarcoma cells,
      determined by release of 51Cr from WEHI-164 tumour cells incubated with monocyte
      supernatants. The chemotactic peptide N-formylmethionyl-leucyl-phenylalanine
      (FMLP) augmented LPS-induced cytotoxicity but had no effect alone. FMLP but not
      LPS stimulated phospholipase C (PLC), determined by the release of [3H]inositol
      phosphates. Addition of tumour promoter and protein kinase C stimulant, phorbol
      12-myristate-13-acetate (PMA) at concentrations of 3 x 10(-10) M to 3 x 10(-9) M,
      resulted in an augmentation of 30-200% in LPS-evoked cytotoxicity. The effects of
      FMLP and PMA, like the effect of LPS alone, were completely blocked by antibody
      to recombinant human tumour necrosis factor-alpha (TNF-alpha), indicating that
      cytotoxicity induced by LPS, FMLP, and PMA were due solely to TNF release.
      Concentrations of PMA greater than 3 x 10(-9) M caused inhibition of TNF release.
      Okadaic acid (20 ng/ml), an inhibitor of phosphatases I and IIa, augmented the
      effects of LPS and the stimulatory effects of low levels of PMA, suggesting that
      phosphorylation was important in the actions of both LPS and PMA. The effects of
      LPS and of low levels of PMA were augmented by the protein kinase C (PKC)
      inhibitors H-7 (10-30 microM), staurosporine (2-10 nM) and calphostin C (0.1
      microM). Higher concentrations of the inhibitors prevented LPS-evoked TNF release
      and its augmentation by low levels of PMA. However, they did not prevent the
      inhibition by high levels of PMA. One possible explanation for the results is
      that different isozymes of PKC may mediate the stimulatory as compared to the
      inhibitory effects of PKC on TNF production.

PMID- 1628901
TI  - Induction of differentiation of the human myeloid cell line, ML3, by tumour
      necrosis factor and interferon-gamma is accompanied by enhanced expression of the
      CD4 protein and messenger RNA.
AB  - Tumour necrosis factor (TNF) and interferon-gamma (IFN-gamma) induce
      differentiation of human myeloid cell lines along the monocytic lineage. In this
      study we investigated the effects of TNF and IFN-gamma on the expression of the
      CD4 protein and messenger RNA (mRNA) in the two myeloid cell lines, ML3 and HL
      60. We observed that CD4 antigen expression on ML3 cells is almost undetectable
      and that TNF and IFN-gamma induced CD4 antigen expression on these cells. HL-60
      cells express surface CD4 antigen at high density and treatment with TNF and IFN
      gamma caused a decrease of CD4 expression. We also investigated the expression of
      CD4 mRNA in ML3 and HL-60 cells. ML3 constitutively express, albeit at low
      levels, CD4 mRNA. TNF induced CD4 mRNA in ML3 cells and IFN-gamma synergistically
      potentiated the effect of TNF, thus indicating that the enhanced expression of
      the CD4 protein on ML3 cells is due, at least in part, to an enhanced
      accumulation of the CD4 mRNA. CD4 mRNA is constitutively expressed in HL-60 cells
      at high levels. TNF and IFN-gamma, alone or in combination, did not cause any
      significant change of CD4 mRNA expression in HL-60 cells, thus indicating that
      decrease of surface CD4, which accompanies differentiation with these cytokines,
      is likely due to alterations of the CD4 protein synthesis and/or transport to the
      plasma membrane. These results provide evidence that myeloid cell lines are
      heterogeneous in expression of CD4, and that in ML3 cells, which constitutively
      express low levels of CD4 mRNA and undetectable amounts of surface CD4, the
      predominant effect of the two cytokines is to induce both CD4 mRNA and protein.

PMID- 1628902
TI  - Alveolar macrophages down-regulate local pulmonary immune responses against
      intratracheally administered T-cell-dependent, but not T-cell-independent
      antigens.
AB  - The role of alveolar macrophages in the pulmonary immune response against various
      antigens was studied after elimination of alveolar macrophages by intratracheal
      administration of liposome-encapsulated dichloromethylene diphosphanate. When the
      responses against T-cell-independent type 1 and type 2 antigens were compared, it
      was found that elimination of alveolar macrophages had no effect on T-cell
      independent antigens. Intratracheal antigen administration resulted in low lung
      associated, local responses, although some response was observed in the spleen.
      In contrast, elimination of alveolar macrophages resulted in an increase in local
      pulmonary immune response against T-cell-dependent antigens. We conclude from
      these experiments that alveolar macrophages play an important role in controlling
      the local pulmonary immune response against T-cell-dependent antigens by down
      regulation of local T-cell populations. The alveolar macrophages do not down
      regulate the response against intratracheally administered T-cell-independent
      antigens, although they are important in the protection against inflammatory
      damage caused by bacterial endotoxins.

PMID- 1628904
TI  - Molecular cloning, reconstruction and expression of the gene encoding the alpha
      chain of the bovine CD8--definition of three peptide regions conserved across
      species.
AB  - We report the cloning of a cDNA encoding the alpha-chain of the bovine CD8 (BoCD8
      alpha). A bovine thymus cDNA library was hybridized at low stringency with a
      human CD8 alpha cDNA clone. The first round of screening of 5 x 10(4) independent
      colonies yielded 12 clones containing incomplete BoCD8 alpha genes. Two further
      rounds of colony hybridization were conducted, each using as a probe the 5'
      fragment from the longest BoCD8 alpha clone previously isolated. The final
      screening yielded a clone containing a 2 kilobase (kb) insert. We mapped and
      sequenced the 2 kb BoCD8 alpha clone and compared it with the published sequences
      of the genes encoding the human, mouse and rat CD8 alpha. Sequence analysis
      confirmed that the clone under study encoded the BoCD8 alpha. The overall
      similarity of the BoCD8 alpha coding region with the human CD8 alpha coding
      sequence is 74.7% at the nucleotide level and 62.1% at the protein level. Lower
      levels of similarity are found with the mouse and rat CD8 alpha. Interestingly,
      three separate highly homologous regions are clearly defined at the peptide level
      in bovine versus human and mouse versus rat comparisons. Two of the regions are
      highly conserved among all species analysed, while the most 5' region is not. We
      speculate that the latter region may contain the binding site of CD8 alpha to the
      alpha 3 domain of major histocompatibility complex (MHC) class I molecules.
      Sequence analysis showed that the 2 kb BoCD8 alpha clone contains an incomplete
      coding region, i.e. lacks six bases corresponding to the first two amino acids of
      the leader region. To allow efficient translation and processing of the BoCD8
      alpha gene, we constructed a chimeric gene containing the coding sequence of the
      BoCD8 alpha clone and synthetic sequences corresponding to the first two amino
      acids of the human CD8 alpha leader sequence. The chimeric gene was subcloned in
      the pKSV10 expression vector. The pKSV10-BoCD8 alpha construct is efficiently
      expressed both transiently in COS cells and stably in L cells, as determined by
      Northern blot and by FACS analysis, using the ILA-51 monoclonal antibody to BoCD8
      alpha. The latter result formally proves that the ILA-51 antibody does indeed
      recognize the product of the BoCD8 alpha gene, as previously suggested on
      serological grounds.

PMID- 1628903
TI  - Regulation of c-fgr messenger RNA levels in U937 cells treated with different
      modulating agents.
AB  - The U937 cell line was used to investigate the induction of messenger RNA (mRNA)
      for the c-fgr mRNA tyrosine kinase proto-oncogene in cells of the monocyte
      macrophage lineage. U937 cells were exposed to tumour necrosis factor-alpha (TNF
      alpha), TNF-beta and transforming growth factor-alpha (TGF-alpha), alone and in
      combination with PMA and 1,25-dihydroxycholecalciferol (1,25-DHCC). TNF-alpha and
      TNF-beta, but not TGF-alpha, decreased the proliferation of U937 cells in a time-
      and dose-dependent manner, and both TNF-alpha and TNF-beta enhanced the response
      of U937 cells to PMA during the first 24 hr of treatment and to 1,25-DHCC over 72
      hr. TNF-alpha induced a rapid increase in c-fgr mRNA levels within 4 hr, in
      contrast to slower induction by PMA and 1,25-DHCC. TNF-alpha and 1,25-DHCC
      together had an additive effect on c-fgr mRNA levels. In U937 cells exposed to
      PMA, c-fgr mRNA levels continued to increase over 72 hr. Levels of c-fgr mRNA
      induced by the various modulating agents did not correlate clearly with the
      changes in proliferation. Therefore, we suggest that although the c-fgr gene
      product may have a role in differentiation, the more significant role is likely
      to be in the fully differentiated macrophage.

PMID- 1628905
TI  - Technology assessment of periodic health examinations for school children in
      Japan.
AB  - In Japan, preventive health services have been heavily concentrated in mass
      screening. This prioritization is also true in the field of school health. Annual
      mass health screenings have been provided to 21.3 million children from
      kindergarten to university level under the School Health Law. In 1973, periodic
      health examinations were extended to include screenings for renal and heart
      diseases. This extensive screening program has been introduced without any
      evidence supporting its effectiveness. Although available data relative to these
      screenings in Japan were examined, neither the efficacy of the tests nor the
      effectiveness of the screenings were observed. Moreover, costs for the tests
      during the initial phase amounted to US $120 million and $65 million,
      respectively.

PMID- 1628906
TI  - Cost-effectiveness of misoprostol in Sweden.
AB  - Based on an American multicenter study, an economic evaluation of prophylactic
      misoprostol was undertaken in Sweden. The study included 420 patients with
      osteoarthritis and nonsteroidal anti-inflammatory drug (NSAID)-associated
      abdominal pain, but no gastric ulcer at inclusion. The frequency of ulcer
      development with and without prophylactic misoprostol was assessed at 21.7% and
      5.6%, respectively, for a 3-month period. All costs for drugs, ambulatory care,
      hospital care, loss of production, as well as other factors such as dosage and
      compliance, were transferred to Swedish conditions. It was concluded that in
      patients with osteoarthritis and NSAID-induced abdominal pain, prophylaxis with
      misoprostol is cost-effective in Sweden, which is similar to what is found for
      other countries. A prerequisite for this result is a frequency of ulcer
      development of 15%. A patient compliance to prophylactic treatment of more than
      60% is also presupposed (79% was observed in the above study). Due to the high
      age of the osteoarthritis patient population, the cost-effectiveness is
      influenced to only a minor extent by whether indirect costs are included in the
      calculation.

PMID- 1628908
TI  - Health care technology transfer in Latin America and the Caribbean.
AB  - The greatest problem concerning health care technology for developing countries
      is that they are dependent upon the industrialized world for technology. The only
      short-term solution to this problem is to improve the choices that are available
      to them. This goal will require changes in the structure and processes of policy
      making. A particular difficulty for these countries is the lack of trained
      personnel in fields related to technology assessment.

PMID- 1628907
TI  - Nonexperimental evaluation of the effectiveness of a screening program for lung
      cancer.
AB  - The effectiveness of screening to control lung cancer was examined in the German
      Democratic Republic by analyzing data from a cancer registry and incidence and
      mortality rates for lung cancer relative to different screening policies, and by
      two case-control studies. Mortality from lung cancer did not appear to be
      affected by the screening programs studied. The high cost of mass screening,
      combined with uncertainty about the benefits of early treatment of lung cancer,
      outweigh the vague advantages of such screening.

PMID- 1628909
TI  - Organizing for cancer control. The diffusion of a dynamic innovation in a
      community cancer network.
AB  - This paper examines the diffusion of a "dynamic" innovation--research on the
      prevention and control of cancer--in a community cancer network. By analyzing the
      social structures and communication strategies of network members, as well as the
      attributes of the innovation, the authors explain why this innovation is
      diffusing more slowly than its "formed" counterpart--research on the treatment of
      cancer.

PMID- 1628910
TI  - The technology assessment and practice guidelines forum. A modified group
      judgment method.
AB  - This article describes a new group-judgment process, modified from the consensus
      development approach of the U.S. National Institutes of Health. It is called the
      "forum" method, a shorthand term for "technology assessment and practice
      guidelines forum." This approach is aimed at (a) describing the current state of
      knowledge of the technology under study; (b) developing practice guidelines for
      the use of the technology; and (c) providing information for insurers, consumers,
      policymakers, and others. A pilot study was conducted focusing on total
      parenteral nutrition. The validity of the process and of the recommendations and
      their acceptability were evaluated in a survey of participants and a selected
      group of nonparticipants. Based on the survey results, the forum method appears
      to be a valuable method for assessing technologies, defining their clinical role,
      and developing practice guidelines.

PMID- 1628911
TI  - Magnetic resonance imaging. Diffusion of technology in an ambulatory setting.
AB  - To better understand technology diffusion in an ambulatory care setting, we
      analyzed adult outpatients' use of magnetic resonance (MR) and computed
      tomography (CT) imaging in a group-model HMO between 1986 and 1989. The use of
      MR, but not CT, increased at a rapid pace with only a small proportion of the
      scans being accounted for by primary care physicians.

PMID- 1628912
TI  - An experimental ward. Improving care and learning.
AB  - The rapidly changing health care system is still largely organized according to
      old, and increasingly outdated models. The contemporary demands of patient care
      and residency training call for an experimental ward, which can develop and test
      new techniques in hospital organization and the delivery of care in a
      comprehensive way.

PMID- 1628913
TI  - Progress on firms research.
AB  - Firms research combines parallel providers of care, ongoing patient
      randomization, and continuous experimental changes and improvement. This form of
      efficient research now has a substantial track record of published studies by a
      growing number of hospitals.

PMID- 1628914
TI  - The Cleveland Veterans Affairs Medical Center firm system.
AB  - Hospital-based "firms" provide a means for combatting the fragmentation
      experienced by both patients and caregivers in the modern teaching hospital
      environment. A "firm" is an academic group practice that includes attending
      physicians, physician trainees, nurses, other staff, and patients. Each person's
      relationship with a firm lasts throughout his or her association with a
      particular institution. This article describes the firm system that was recently
      implemented on the Medical Service of the Cleveland VAMC. This system
      incorporates both inpatient and outpatient general medical services and provides
      for unbiased assignment of patients, physicians, and nurses.

PMID- 1628915
TI  - It's time to rethink health care technology assessment.
AB  - Health care technology assessment is broadly and ambiguously interpreted,
      diluting its role. It is time to recast the field. We must elucidate it in the
      contemporary context of health inquiry, explicitly relating it to such pursuits
      as quality assurance, health services research, effectiveness research, medical
      informatics, and technological innovation.

PMID- 1628917
TI  - Report from the British Columbia Office of Health Technology Assessment (BCOHTA).
      Workplan of the office.

PMID- 1628916
TI  - On the discounting of gained life-years in cost-effectiveness analysis.
AB  - A controversial issue in cost-effectiveness analysis is the discounting of gained
      life-years. What has not been realized, however, is that the different methods
      used for discounting this measurement provide fundamentally different results.
      The method used is seldom explicitly stated. In the present article the four main
      methods for the discounting of gained life-years are reviewed and compared. The
      conclusion is that if we wish to continue comparing results, researchers must
      employ the same methodology.

PMID- 1628918
TI  - Report from the Conseil d'Evaluation des Technologies de la Sante (CETS). Mandate
      of the conseil.

PMID- 1628919
TI  - Report from the Canadian Coordinating Office for Health Technology Assessment
      (CCOHTA). Experimental drug policies in Canada.

PMID- 1628920
TI  - Report from the Health Council of The Netherlands. Heart transplants: from
      recommendation to report.

PMID- 1628921
TI  - Report from the U.S. Institute of Medicine (IOM). The artificial heart:
      prototypes, policies, and patients.

PMID- 1628922
TI  - [Bradycardic arrhythmias].

PMID- 1628923
TI  - [The effect of extensive surgical intervention on cellular immune response].

PMID- 1628924
TI  - [Assessment of the preoperative risk of existing lung diseases].

PMID- 1628925
TI  - [Perioperative management of the diabetic patient].

PMID- 1628927
TI  - [Perioperative anesthesiologic management].

PMID- 1628926
TI  - [Gastrointestinal diseases in perioperative risk assessment].

PMID- 1628928
TI  - [Chemotherapeutic prevention of infection in invasive interventions in high-risk
      internal medicine patients].

PMID- 1628929
TI  - [Postoperative neuropsychiatric disorders and transitory syndromes].

PMID- 1628930
TI  - [Painless macrohematuria].

PMID- 1628931
TI  - [Unusual clinical manifestation of lymphangiosis carcinomatosa of the lungs].

PMID- 1628933
TI  - Toluidine blue staining and early detection of oral precancerous and malignant
      lesions.

PMID- 1628932
TI  - Chronic mucositis.

PMID- 1628934
TI  - What is the optimal treatment for mild/moderate hypertension?

PMID- 1628935
TI  - Tuberculosis elimination in Europe.

PMID- 1628936
TI  - Good communication is good medicine.

PMID- 1628937
TI  - Transoesophageal echocardiography--widening the scope.

PMID- 1628938
TI  - The extensor plantar response.

PMID- 1628939
TI  - Childhood leukaemia in Ireland.
AB  - In response to professional and public concern about health consequences, in
      particular cancer risk, from previous and current levels of ionising radiation in
      the Irish Sea, a study of incidence and mortality from acute lymphoid leukaemia
      (ALL) and other lymphoid malignancies in children was undertaken. Overall rates
      were similar to those found in other western populations and distribution of high
      rates was quite random over the country as a whole. There was a small but
      significant excess in incidence of ALL for the years 1974-76 in a narrow three
      mile wide strip along the east coast. It is not possible in the context of this
      study to postulate aetiological factors which might explain this finding.

PMID- 1628941
TI  - Changing characteristics of Irish menopausal women seeking assistance.
AB  - In the two years since its inception 425 patients have been seen at the Menopause
      Clinic. Audit of the first 100 women attending against 100 first seen one year
      later have revealed some significant differences in referral patterns. The
      earlier group were likely to have significantly more social problems whereas in
      the latter, more were likely to show concern for osteoporosis or need
      modification of ongoing treatment.

PMID- 1628940
TI  - An explanation for the difference in general practitioner consultation rates
      between GMS and non-GMS patients.
AB  - This study compares annual consultation rates between 3,111 General Medical
      Services and private patients, and their family doctors in three large general
      practices in Dublin. Visiting rates were substantially different between
      practices and between GMS and private patients. However, GMS patients were older
      and had 50% more chronic illnesses. When the effects of age and illness were
      controlled in a multiple regression model, GMS status accounted for less than 5%
      of the variation in visiting rates. GMS patients consult their practitioners in
      proportion to their medical need.

PMID- 1628942
TI  - DES clinic--the first six months.
AB  - In October 1990 a DES (Diethylstilbestrol) clinic was established at the National
      Maternity Hospital, Dublin. We describe the results of the first six months of
      the clinic. During this time, 172 inquiries were received; 95 women were seen at
      the clinic, 16 were deemed to be DES--exposed and eight were classified as
      possibly DES exposed. Classical cervicovaginal signs of DES exposure were noted
      in 15 women, a further eight women showed cervical epithelial abnormalities at
      colposcopy, the history of in utero DES exposure was confirmed in eight cases. No
      cases of cervical intraepithelial neoplasia or vaginal clear-cell adenocarcinoma
      were detected. Pregnancy related problems possibly attributable to DES exposure
      were documented in six women.

PMID- 1628943
TI  - Changing trends in approach to wheezy children by family doctors.
AB  - The prevalence of asthma in children appears to have increased dramatically over
      the past 20 years. There is evidence that some of this increase is due to earlier
      recognition and relabeling of symptoms such as wheeze. In this study we set out
      to see if increased awareness of the presentation of asthma in young children has
      led to earlier diagnosis by family doctors and a decrease in the number of
      courses of antibiotics given before the introduction of bronchodilators. The
      family doctor records of 769 children aged 0-5 years were examined
      retrospectively by an independent paediatrician. One third had at least one
      documented episode of wheeze and the prevalence of asthma was 10.5%. The mean age
      of diagnosis was 2.59 years although the mean age at which bronchodilators were
      introduced was 2.22 years. 22 children, who were never recorded as being
      asthmatic, were nevertheless appropriately treated with bronchodilators.

PMID- 1628944
TI  - Early experience with pre-deposit autotransfusion in elective orthopaedic
      surgery.
AB  - Pre-deposit autotransfusion has been shown to be an effective method of providing
      blood for planned surgery. This study discusses preliminary experience with pre
      deposit autotransfusion an alternative to homologous blood from those patients
      considered suitable donors according to established guidelines. In the first 24
      weeks, 31 patients pre-donated 59 units of autologous blood for planned surgery.
      Twenty-nine patients (94%) underwent surgery and 24 (83%) of these did not
      require additional homologous blood. Two donations (3.6%) were complicated by
      minor reaction. All donors expressed satisfaction with the service. The authors
      conclude that in elective orthopaedic surgery pre-deposit autotransfusion is a
      safe and effective alternative to homologous transfusion.

PMID- 1628945
TI  - An Irish out-patient based in-vitro fertilisation service.
AB  - The first year's activity of a fully out-patient based, self financing, in vitro
      fertilisation service is reported. 98 couples had superovulation regimes tailored
      to need. 138 cycles were started. 109 retrievals were attempted using the vaginal
      ultrasound probe under Fentanyl and Midazolam sedation. In 106, oocytes were
      successfully retrieved (average seven per patient). In 80, embryos were
      transferred (average three). 13 patients achieved clinical pregnancies giving an
      overall pregnancy rate of 9.4% per cycle, 12% per oocyte retrieval, 16.5% per
      embryo transfer and 13% per patient who embarked on the programme. One pregnancy
      was ectopic, two aborted, and 10 are ongoing; this includes seven singleton
      foetuses and three sets of twins. All pregnant patients were referred back to
      their unit of origin for antenatal care and delivery.

PMID- 1628946
TI  - Lyme disease in Ireland.
AB  - The data pertaining to Irish specimens sent to the Lyme disease Laboratory at
      Charing Cross Hospital since 1986 is presented and discussed. In the period up to
      June 1990, 484 specimens were tested, 14% of these were positive by enzyme linked
      immunosorbent assay or indirect immunofluorescent assay. Only 13 of these were
      confirmed as positive by immunoblotting.

PMID- 1628947
TI  - Growth hormone therapy in Turner's syndrome.
AB  - Girls with Turner's Syndrome respond to growth hormone therapy. In combination
      with anabolic steroids, studies show a synergistic effect that does not cause an
      undue increase in bone age. As studies progress, patients are growing taller than
      their predicted final heights. Whether the increase in linear growth velocity
      will be sufficient to bring the Turner's Syndrome patient in to the normal range
      (greater than 150cms) and remove short stature as a necessary stigma for these
      unfortunate patients remains to be seen.

PMID- 1628948
TI  - Duodenal rupture with avulsion of the bile duct: an unusual injury.
AB  - Blunt abdominal trauma may give rise to infrequent and unusual patterns of organ
      damage requiring prompt and complete exploratory laparotomy if the full extent of
      injury is to be recognised. We present a case of avulsion of the common bile duct
      in association with duodenal rupture to illustrate the importance of this
      strategy.

PMID- 1628949
TI  - Mammographic needle localisation of impalpable breast lesions.
AB  - Refinements in mammography have led to an increased number of needle localised
      breast biopsies for impalpable breast lesions. This paper review 139 needle
      guided biopsies from June 1986 to December 1990 in 132 patients. Forty four
      patients (32%) biopsied had malignant lesions the vast majority (91%) of which
      were reported as either non-invasive or invasive less than 2 cm in diameter.
      Fourteen patients in this group had ductal carcinoma in-situ. When compared with
      100 consecutive palpable breast carcinomas during the same period, needle
      localised biopsies had a higher proportion of non-invasive lesions and fewer were
      associated with lymph node involvement. Needle guided breast biopsy detects
      carcinoma at an earlier stage and may reduce morbidity and mortality from breast
      cancer.

PMID- 1628950
TI  - A survey of rugby injuries attending an accident & emergency department.
AB  - A prospective study was carried out on 242 patients attending an Accident &
      Emergency Department with injuries sustained while playing rugby football. The
      average age was 19.8 years. Head and neck injuries were more prevalent but less
      serious then in studies carried out before recent law changes. The lower limb was
      still the part of the body most frequently injured but again there were fewer
      serious injuries. There was a marked increase in upper limb injuries. Wing
      forward was the position most likely to give rise to injuries and prop was the
      least. Poor compliance is still a significant problem with rugby injuries can
      only lead to an improvement in the safety of the game.

PMID- 1628951
TI  - Trichobezoar--a condition to think of in case of mobile abdominal mass.
AB  - A twenty year old girl was referred to the surgical out-patients clinic with a
      history of intermittent epigastric pain and vomiting of five months duration. The
      patient enjoyed good health prior to this and her past medical history was
      uneventful. Findings on physical examination included pallor, patchy alopecia and
      a soft mobile, non-tender mass in the epigastrium and left upper quadrant of the
      abdomen. When questioned she admitted to a history of trichophagia for as long as
      she could recall. A provisional diagnosis of gastric trichobezoar was made.
      Radiological investigations included an abdominal ultrasound which showed a large
      ill-defined mass lesion with poor transonic features, situated in the upper
      abdomen and extending from the left upper quadrant across the midline to the
      liver margin. Barium meal revealed that the greater part of the lumen of stomach
      was occupied with material of an indeterminate nature. Her haematological
      investigations showed Haemoglobin 9.5 gm/dl and Leucocyte Count 9.0 x 10(9)/L.
      Her Urea and Electrolytes were within normal range. At laparotomy a large hair
      ball extending from the Stomach into the duodenum and proximal jejunum was
      removed through a vertical gastrotomy incision. The patient had a satisfactory
      post-operative convalescence and was discharged two weeks later.

PMID- 1628952
TI  - Promoting health.

PMID- 1628953
TI  - Comparison of the ease of handling of four different drug dispenser types in
      rheumatoid arthritis.

PMID- 1628954
TI  - A cluster of diaphragmatic hernias! Where to now?

PMID- 1628955
TI  - Renal haemangioma complicated by a fatal hepatic bleed.

PMID- 1628956
TI  - Irish Heart Foundation nutrition policy.

PMID- 1628957
TI  - Headache responses following m-chlorophenylpiperazine in bulimics and controls.
AB  - We have previously reported that the serotonin (5-HT) agonist meta
      chlorophenylpiperazine (m-CPP) induced late occurring migraine-like headaches in
      a group of patients with eating disorders and controls (n = 52). In this report,
      we extend our analyses of these data and describe results indicating that
      headache responses following m-CPP are greater in patients with bulimia nervosa
      than controls, regardless of the presence of anorexia nervosa or major
      depression. Although patients with severe migraine-like headaches had higher peak
      m-CPP levels than patients without severe headaches, these levels are not higher
      than other groups studied who did not get headaches. These findings suggest that
      post-synaptic 5-HT receptor sensitivity is altered in the vascular tissues of
      bulimic patients. Additional disturbances in 5-HT function, perhaps presynaptic
      ones, may be associated with anorexia nervosa and major depression. Similar
      alterations in other 5-HT pathways at or above the level of the hypothalamus may
      contribute to binge eating and other behavioral symptoms of bulimia nervosa.
      Further studies exploring the functional integrity of 5-HT receptors and their
      subtypes are warranted in bulimic patients, as well as in patients with
      nonbulimic anorexia nervosa, minor and major depression without an eating
      disorder, and migraine and other headache patients.

PMID- 1628958
TI  - Medication use and disability among migraineurs: a national probability sample
      survey.
AB  - OBJECTIVE: To measure the use of prescription medication in treating migraine
      headache and the associations between medication use and sociodemographic
      factors, and headache characteristics. DESIGN: National sample survey using a
      mailed questionnaire to determine symptoms accompanying or preceding severe
      headaches; frequency, duration, and disability from severe attacks: use of
      medications to control pain; and medical-care use for severe headaches. SETTING:
      A stratified sample of United States households. PATIENTS: A sample of 20,468
      respondents, aged 12 to 80 years, who responded to a survey on "severe" headaches
      during the prior year. MEASUREMENTS AND MAIN RESULTS: Overall, 20.2% of
      respondents reported severe headaches. Migraine was found in 17.6% of females and
      5.7% of males. Of the migraineurs, 40.1% of female and 28.3% of male migraineurs
      reported using prescription drugs to control pain. Blacks were less likely than
      whites to report prescription use. Insignificant differences were seen in rates
      of prescription use among various income levels and regions of the country. Use
      of prescription medication varied considerably by symptoms and characteristics of
      migraine attacks. Vomiting and sensory aura were most frequently associated with
      medication use, as were severity and duration of attacks. Use of urgent-care
      services for severe headache attacks was associated with frequent use of
      prescription medications. Patients who reported a physician diagnosis of migraine
      were more likely to use prescription medication than other migraineurs.
      CONCLUSIONS: Most migraineurs in the United States are not being treated with
      prescription medications. Many active migraine patients would benefit from
      appropriate treatment if care was sought and diagnosis made.

PMID- 1628959
TI  - Platelet gamma-aminobutyric acid levels in migraine and tension-type headache.
AB  - Gamma-aminobutyric acid (GABA) levels in platelets were measured in 19 patients
      with migraine (7 males and 12 females, average age: 36.5 years) and 27 patients
      with chronic tension-type headache (TH; 9 males and 18 females, average age: 48.9
      years). Twenty-one normal healthy volunteers composed the control group (11 males
      and 10 females, average age 34.9 years). The GABA levels in platelets were
      determined using high performance liquid chromatography with fluorescent
      detection (HPLC-FC). The GABA levels in platelets were 30.8 +/- 11.7 pmol/10(9)
      platelets (mean +/- S.D.) in the patients with migraine, 43.1 +/- 11.8 pmol/10(9)
      platelets in the patients with TH and 34.7 +/- 8.1 pmol/10(9) platelets in the
      healthy controls. The platelet GABA levels in the patients with TH were
      significantly higher than in the migraine patients and the healthy controls (p
      less than 0.05). The possible role of GABA in headache is discussed. We consider
      that TH may be a state of neuronal hyperexcitability similar to migraine and that
      GABA in the platelets of patients during TH attacks may be elevated to
      counterbalance it. Alternatively, we suggest that the rise of GABA levels in
      platelets is related to emotional factors, such as depression, in the TH
      patients. Further studies must be undertaken concerning the relationship between
      platelet GABA levels and headache.

PMID- 1628960
TI  - Olfaction in migraineurs.
AB  - Many investigators have described olfactory dysfunction among migraineurs.
      Olfactory stimuli can precipitate migraine, and olfactory hallucinations can
      occur as auras of migraines or as part of the symptom complex. Despite many
      reports linking olfactory phenomena and migraine, no evaluations of the olfactory
      abilities of migraineurs have been documented. To begin such assessments, sixty
      seven consecutive migraine patients were given Pyridine odor threshold tests.
      Twelve of them (18%) scored as hyposmic or anosmic. In comparison, 1% of the
      general population of the U.S. is hyposmic or anosmic. Aside from possible
      diagnostic or methodological error, several possibilities may account for our
      result: migraine may induce olfactory pathology; olfactory pathology may induce
      migraine, or; a common pathogen may induce both olfactory dysfunction and
      migraine. The association of migraine with the emotional component of the limbic
      system has long been recognized, and our results strengthen its association with
      the olfactory component as well. Headache patients should be tested for olfactory
      loss and warned of such risks as inability to detect gas leaks and spoiled food.

PMID- 1628961
TI  - Hemicrania continua: attacks may alternate sides.
AB  - Hemicrania continua (HC) is characterized by a continuous unilateral headache of
      moderate severity, occurring in 2 patterns; a continuous form in which headaches
      persist continuously without remission for years, and a remitting form,
      consisting of headache phases separated by periods of pain-free remission. The
      remitting form of HC must be distinguished from other cyclical headache disorders
      such as episodic paroxysmal hemicrania and episodic cluster headache.
      Characteristically, the headache of HC is unilateral and without sideshift. We
      now report a case of HC in which headaches alternate sides.

PMID- 1628962
TI  - Psychometric characteristics of the Headache-Specific Locus of Control scale.
AB  - Martin and colleagues have described their development of a Headache-Specific
      Locus of Control scale (HSLC) which contains 11 items for each of its three
      subscales: internal, health care professional, and chance orientations. In this
      replication study, we gathered data from patients who came to a Headache Clinic
      in a medical center (n = 151) and from a comparison sample (n = 192). Factor
      analysis and alpha coefficients were similar to those reported by Martin. Only
      small correlations were found between the subscale scores although some of them
      were statistically significant. This suggests that the HSLC is a psychometrically
      competent instrument. Additionally, mean scores of its three subscales
      differentiated the patient population from those whose headaches were less severe
      and thus did not seek help.

PMID- 1628963
TI  - More on mCPP and migraine.

PMID- 1628964
TI  - [Regulation of the epidermal permeability barrier by lipids and
      hyperproliferation].
AB  - The stratum corneum, the permeability barrier between the internal and external
      milieu, is composed of protein-enriched cells and lipid-enriched intercellular
      domains. Lipid synthesis is localized in the keratinocytes. The lamellar bodies
      located in the keratinocytes secrete lipids (sphingolipids, free fatty acids and
      cholesterol) into in the intercellular spaces of the stratum corneum. A
      disturbance of barrier function results in an increase in the synthesis of free
      fatty acids, non-saponified lipids and cholesterol in all nucleated layers of the
      epidermis. Cholesterol synthesis is regulated by the enzyme HMG-CoA reductase.
      After acute disturbance of barrier function by acetone treatment the increase in
      cholesterol synthesis occurs mainly in the lower epidermis (stratum
      basale/stratum spinosum), while after chronic disturbance by a diet deficient in
      essential fatty acids the increase shifts to the upper epidermis (stratum
      granulosum). After barrier disturbance not only lipid but also DNA synthesis is
      stimulated. Stimulation of DNA synthesis leading to epidermal hyperplasia may be
      a second mechanism by which the epidermis tries to correct defects in barrier
      function. Artificial barrier repair with latex occlusion prevents an increase in
      lipid and in DNA synthesis. Chronic barrier impairment by topical application of
      lovastatin, an inhibitor of cholesterol synthesis, or by a diet deficient in
      essential fatty acid also leads to an increase in lipid and DNA synthesis and to
      epidermal hyperplasia. Epidermal lipid and DNA synthesis in essential fatty acid
      deficiency is independent of prostaglandin E2, but depends on n-6-unsaturated
      fatty acids such as linoleic and columbinic acid.

PMID- 1628965
TI  - [Toxic oil syndrome--an example of an exogenously-induced autoimmune disease].
AB  - In 1981 epidemic poisoning with adulterated cooking oil occurred in Spain,
      affecting more than 20,000 people. The condition caused has since become known as
      the toxic oil syndrome (TOS). About 10-15% of the patients with acute symptoms
      developed a chronic disease with scleroderma-like skin manifestations,
      polyneuropathy and myositis. While the acute phase of the TOS was characterized
      by eosinophilia and elevated IgE, the chronic stage involved humoral autoimmune
      phenomena, such as antinuclear and antinucleolar antibodies, in many cases. In
      women with the chronic phase of TOS there was a possible prevalence of HLA-DR3
      and HLA-DR4. The recently characterized eosinophilia-myalgia syndrome (EMS),
      which is thought to have been induced by contaminated L-tryptophan preparations,
      is similar to the TOS in some particulars. Understanding of the toxicological,
      immunological and genetic pathways leading to these diseases might give us some
      insight into the pathogenesis of spontaneously occurring autoimmune diseases,
      such as systemic scleroderma.

PMID- 1628966
TI  - [The effect of UV-A and UV-B irradiation on the skin barrier. Skin physiologic,
      electron microscopy and lipid biochemistry studies].
AB  - In order to gain insight into the effects of UV-irradiation on the skin barrier,
      functional (skin reactivity), electron microscopic and lipid-biochemical studies
      were performed. In three different irritation models, both UV-A-irradiated and UV
      B-irradiated areas proved to be more resistant to damage than normal skin,
      providing evidence for improvement of barrier function after UV irradiation.
      Electron microscopic evaluation showed that UV-B induced a significant increase
      in horny cell layers, whereas after UV-A no change was detected. However, both UV
      B and UV-A exposure resulted in an increase in the amount of all stratum corneum
      lipids. This was also observed in all major ceramide subfractions, which are
      believed to be the essential lipid constituents for the epidermal barrier
      function. These findings may explain the known beneficial effects of phototherapy
      in dermatoses with impaired barrier function, i.e., atopic dermatitis.

PMID- 1628967
TI  - [Local and systemic humoral immune response to protein I of Neisseria
      gonorrhoeae].
AB  - Knowledge of the immune response to natural infection with Neisseria gonorrhoeae
      is presupposition for the development of a gonococcal vaccine. Pili and protein I
      have gained importance for a subunite vaccine. A pilus vaccine proved to be
      ineffective in a field trial due to extensive pilus variability. According to an
      alternative strategy protein I may represent an important vaccine candidate for a
      gonococcal vaccine. To study the local and systemic, humoral immune response to
      N. gonorrhoeae cervical secretion, vaginal fluid and serum from prostitutes and
      family planning patients were compared by the use of a protein I ELISA. In local
      secretions and in serum patients in the study group showed significantly higher
      anti-protein-I-IgA-levels than patients in the control group. In cervical
      secretion immune response to an acute gonococcal infection consisted of a short
      lived, significant increase of anti-protein-I-IgA, while anti-protein-I-IgG
      showed a lower, but longer lasting significant increase. The course of the immune
      response in vaginal fluid reflected the immune response of cervical secretion at
      a lower level. In serum antigenic stimulus of a local gonococcal infection
      resulted in a significant but short lived protein I specific IgG immune response.
      In local infection with N. gonorrhoeae protein I represents a target antigen of
      the local and systemic immune response. Clear differences exist between local and
      systemic humoral immune response in the protein I reactive immunoglobulin class
      and in the course of reactivity. In the future it may be possible to define
      epitopes on protein I which induce protective immunity.

PMID- 1628968
TI  - [Ross syndrome].
AB  - We report on a 25-year-old patient with hyporeflexia, progressive segmental
      hypohidrosis and dry, scaly skin mimicking tinea manuum on the affected palm.
      This case is the fourth with Ross syndrome and skin manifestations as a result of
      segmental hypohidrosis.

PMID- 1628969
TI  - [Mycobacterium kansasii seroma of the skin in HIV infection].
AB  - We report on an HIV-infected patient with AIDS in whom a smoothly demarcated area
      of resistance in the size of a fist was found on the inside of the thigh.
      Investigation by sonography for clinical differential diagnosis confirmed that a
      haematoma, a seroma or an abscess might be present. Upon puncture of the cavity,
      serous exudate was obtained. The microbiological investigation resulted in the
      growth of Mycobacterium kansasii. The detection of this agent in throat and
      sputum samples from the patient and the occurrence of an osteomyelitis lesion at
      the same time indicate that the seroma was a partial manifestation of a
      disseminated Mycobacterium kansasii infection. No indications of a transcutaneous
      route of infection was found. Upon antimicrobial chemotherapy after the
      determination of resistance the seroma disappeared.

PMID- 1628970
TI  - [Perforating cutaneous amyloidosis].
AB  - Two patients, a 79-year-old man suffering from familial lichen amyloidosus and a
      44-year-old women with biphasic cutaneous amyloidosis, developed small, centrally
      ulcerated papules. Histological and ultrastructural examination confirmed
      transepidermal elimination of amyloid. In contrast to other transepidermal
      elimination diseases, the material eliminated in perforating cutaneous
      amyloidosis is of epidermal origin.

PMID- 1628971
TI  - [Dowling-Degos disease with exclusively genital manifestations].
AB  - We report on two women with pigmented lesions of the vulva. The histopathology
      (filiform downgrowth of pigmented epithelial strands two to four cells wide,
      extending from the interfollicular epidermis and from follicular infundibula; no
      increased numbers of melanocytes; horn pseudocysts) was specific for Dowling
      Degos disease. One patient also had acne inversa, and the other patient had been
      treated surgically for a pilonidal sinus some years before. The spectrum of
      conditions that should be considered in the differential diagnosis of genital
      pigmented lesions is discussed. Vulvar melanosis, genital lentigo, malignant
      melanoma, acanthosis nigricans maligna and benigna and syndromes occurring
      concomitantly with pigmentation of the mucosa need to be excluded. The
      association of Dowling-Degos disease with acne inversa, which was recently
      described for the first time, is discussed.

PMID- 1628972
TI  - [Bowenoid actinic keratosis: therapy with intralesional injection of recombinant
      beta-interferon].
AB  - Biopsy-proven bowenoid actinic keratosis located in the pretibial region in each
      of two elderly women (61 and 81 years) were treated with intralesional injections
      with a new recombinant beta-interferon. The treatment took the form of
      intralesional injections three times a week over 3 consecutive weeks. The dose
      per single injection was 1.5 or 1.0 MU interferon, respectively. Clinical and
      histological examinations showed a complete response in both patients. Controls
      up to 18 months showed no relapse. There were no flu-like side-effects. Leukocyte
      counts decreased by 2700 and 500 cells per microliter during therapy.

PMID- 1628973
TI  - [Sneddon syndrome with detection of anti-phospholipid antibodies].
AB  - The association of livedo racemosa and neurological lesions is described as
      Sneddon's syndrome. A 48-year-old woman with Sneddon's syndrome accompanied by
      antiphospholipid antibodies is presented.

PMID- 1628974
TI  - [Onset of disseminated Bloch-Sulzberger incontinentia pigmenti].
AB  - The case report of a 2-week-old girl suffering from incontinentia pigmenti (Bloch
      Sulzberger Syndrome) with disseminated urticarial erythemas, papules and vesicles
      at the onset is presented. Histological examination showed eosinophilic
      spongiosis. The peripheral blood eosinophilia and the development of typical
      lesions led to the diagnosis of incontinentia pigmenti. Eosinophilic spongiosis
      and peripheral blood eosinophilia are important symptoms in the diagnosis of
      atypical incontinentia pigmenti.

PMID- 1628975
TI  - [Transmission of infectious dermatoses by hand towels and soaps].

PMID- 1628976
TI  - [Resochin in HIV infection].

PMID- 1628977
TI  - [The tree, from which chrysarobin was isolated].

PMID- 1628978
TI  - [The First Bruno Bloch Memorial Lecture].

PMID- 1628979
TI  - [Sun protection].

PMID- 1628980
TI  - The relationship of personal values to concerns about radioactive waste
      transport.

PMID- 1628981
TI  - Experimental release of 131I: the Green Run.
AB  - In December 1949, a large amount of 131I was released to the air at Hanford
      during the dissolving of irradiated uranium fuel for a classified military
      experiment called the "Green Run." Reports of the release have varied from about
      0.15-0.3 PBq. Using, as a guide, the reported measurements of 133Xe released
      during the experiment, the amount of 131I released has been reanalyzed. The
      results indicate that about 0.40 +/- 0.12 PBq (11 +/- 3 kCi) was released,
      somewhat larger than the largest previous estimates.

PMID- 1628982
TI  - Area and time distribution of external and internal doses from Chernobyl fallout:
      the lack of correlation in Norway.
AB  - Population doses from external radiation and internal food-based radioactivity
      were calculated each month for each municipality for 3 y immediately following
      the Chernobyl contamination in Norway. The main polluted regions are sparsely
      populated but comprise important food production areas. The external dose data
      base was calculated based on fallout deposition and measurements in dwellings,
      whereas the totally independent internal dose data base was calculated on a large
      number of food measurements and knowledge of both the food distribution system
      and the countermeasures taken. The internal dose in the densely populated
      municipalities was comparably higher than expected from local deposition, despite
      the fact that countermeasures had some effect. Thus, the correlation between
      internal and external dose for individual municipalities is rather weak. This
      study shows that a traditional deposition/transfer factor approach may be
      inappropriate if used in countries with large variation in population density and
      agricultural ecosystems and in combination with effective countermeasures.

PMID- 1628983
TI  - In-situ determination of deposited radionuclide activities: improved method using
      derived depth distributions from the measured photon spectra.
AB  - When applying the standard method of in-situ gamma spectrometry to determine
      deposited radionuclide activities, an assumption is needed regarding the depth
      distribution of radionuclides in the ground. The method can be improved by
      assessing, from information contained in the spectrum, the attenuation of the
      radiation by the soil and vegetation. By comparing the count rates of the x ray
      and the gamma-ray lines of its daughter nuclide 137mBa, the 137Cs activity per
      area can be determined. The range of applicability of the method is discussed by
      means of an uncertainty analysis, and the method is applied to post-Chernobyl
      measurements. A comparison with the results of the standard method of in-situ
      spectrometry demonstrates the progress achieved by the proposed method.
      Nevertheless, the method still has some shortcomings for the peak analysis that
      could be improved by better detector resolution or better computer software.

PMID- 1628984
TI  - Radioactivity in size-separated municipal incinerator ashes.
AB  - Radionuclide concentrations of the 238U- and 232Th-decay series, as well as 40K
      and 137Cs, were determined in size-separated fly ashes and bottom ashes from two
      municipal incinerators. Secular equilibrium was observed for several of the
      series' radionuclides, though 222Rn losses during combustion were evident. The
      fly-ash samples showed increasing enrichment of 40K, 137Cs, and 210Pb as particle
      diameters decreased, due to their volatility and subsequent condensation, and
      typically contained higher activities of these volatile radionuclides. Radon
      emanation from the bottom ashes was not detected but the fly ashes had an
      emanting power near 7%. Only 40K and 137Cs were found to be water-soluble, with
      significantly greater solubilities occurring for the fly ashes. Overall
      concentrations suggest that municipal incinerator ashes contain the equivalent
      radioactivity of surface soil and substantially less than ashes from coal
      combustion. It is shown that an incinerator's contribution to the atmospheric
      radionuclide burden is minimal and, from a radiological viewpoint, their residual
      ashes can be safely used in construction materials.

PMID- 1628985
TI  - Preparation of a 99mTc wipe standard for survey instrument calibration in nuclear
      medicine.
AB  - A method was developed for the preparation of a standard source to satisfy the
      U.S. Nuclear Regulatory Commission requirement for calibration of wipe-assay
      procedures used in nuclear medicine laboratories. An essential element of this
      standard was that a locally prepared calibration wipe could be used with thin
      window Geiger-Muller detectors that detect 99mTc conversion electrons with high
      sensitivity. This proposed calibration wipe was evaluated with both a NaI(Tl)
      well counter and a thin-window Geiger-Muller pancake probe. Average detector
      sensitivities of 1,540 and 160 counts min-1 per 2000 disintegrations min-1,
      respectively, were found for 99mTc. An analysis of the errors for each step of
      the procedure showed most to be less than 3% (95% confidence level). The nuclear
      medicine dose calibrator, used to assay the activity from which the wipe was
      prepared, was estimated to contribute a 9% absolute calibration error. Use of the
      pancake probe contributed a 12% geometry-reproducibility error. The total error
      associated with the use of the calibration wipe standard to calibrate a typical
      99mTc wipe-assay procedure, exclusive of the count-dependent error associated
      with the number of counts acquired, was found for the NaI(Tl) well counter to be
      given by a percentage of 2 SD = 10% and for the thin-window Geiger-Muller pancake
      probe, percentage 2 SD = 16%. Coating of the calibration wipe with an acrylic
      spray, to prevent it from contaminating instruments during use, was evaluated.
      This coating was effective while it reduced the detectability of the wipe
      activity by a negligible degree.

PMID- 1628986
TI  - Reducing transmitted radiation in dental radiography.
AB  - A significant amount of radiation escapes the rear of an image receptor in
      conventional dental radiographic procedures despite the placement of a lead
      containing backing at the rear of the film pack. The purpose of this
      investigation was to place additional layers of lead on the film pack in an
      attempt to reduce transmitted radiation to tissues behind the film. Reduction of
      dose to tissues behind the film causes a reduction in scatter radiation to
      critical organs such as the thyroid gland and salivary glands. A
      thermoluminescent lithium fluoride dosimetry system (TLD) was used and calibrated
      in both the beam of interest and tissue of interest. A tissue-equivalent
      anthropomorphic phantom was used for dose determination. Successive layers of
      lead foils were added to the image receptor, and dose was determined for each
      additional lead foil in the tissues behind the image receptor. Two sets of
      exposure conditions were used, namely: 70 kVp, 10 mA, and 0.6 s, and 90 kVp, 10
      mA, and 0.6 s. The beam-film-patient orientation used was for a first molar
      bitewing radiographic projection. Four lead layers (three additional foils
      equalling 3.92 x 10(-3) mm of lead) on the conventional film package resulted in
      a significant dose reduction. Four layers of lead resulted in a dose less than
      one-third that of the conventionally shielded package.

PMID- 1628987
TI  - Long-term retention of 210Pb in man: a unique case of internal contamination.
AB  - Knowledge of the long-term effective half-life of 210Pb in man is essential for
      estimating the cumulative exposure to inhaled short-lived radon daughters from
      measured values of the 210Pb skeletal burden. For this purpose, the effective
      half-life has been obtained from sequential measurements of 210Pb made in vivo
      during a 10-y period and by bioassay of 210Pb excreted in the urine of an
      individual with a 43-y-old body burden. The long-term effective half-lives
      obtained by these two methods were 18.1 +/- 4.8 y and 15.8 +/- 0.8 y,
      respectively. These values are not very different from the estimate of 12.3 y
      previously adopted by the ICRP.

PMID- 1628988
TI  - Fractional absorption of ingested barium in adult humans.
AB  - A reanalysis of available data on gastrointestinal absorption of soluble barium
      indicates that absorption has been underestimated in most human studies. There
      appears to be little basis for assigning a substantially lower absorption
      fraction to soluble barium than to other alkaline earth elements, particularly
      radium, in radiation protection guidance.

PMID- 1628989
TI  - Determining the normal concentration of uranium in urine and application of the
      data to its biokinetics.
AB  - A method was developed to determine the concentration of uranium (238U) in urine.
      This method involved preconcentration of uranium from urine with calcium
      phosphate neutron activation followed by simple radiochemical separation. Using
      this method, it was possible to detect 0.2 ng of 238U. The average and geometric
      mean concentration of uranium found in urine of subjects from a normal background
      environment was 12.8 and 9.4 ng L-1, respectively. The concentration of uranium
      in the urine and the daily intake of uranium by the same population was used to
      arrive at the gastrointestinal absorption factor (f1) for uranium incorporated in
      the diet. The f1 factor was estimated to be 1.6%.

PMID- 1628990
TI  - A methodology for estimating the radiological consequence of an acute aqueous
      release.
AB  - Assumptions supporting a chronic aqueous release methodology are inappropriate
      for estimating dose from accidental discharges. A method of modeling acute or
      accidental releases is being developed for predicting maximum individual dose.
      Standardization of consumption rates and usage factors for acute aqueous releases
      is necessary. Water-to-sediment transfer models describing waterborne deposition
      should be reviewed for applicability during short time regimes.

PMID- 1628991
TI  - In-situ gamma-ray site characterization of the Tatum Salt Dome Test Site in Lamar
      County, Mississippi.
AB  - Field surveys of gamma-ray emitting nuclides and soil core sampling were
      conducted at 12 sites on the Tatum Salt Dome Test Site and surrounding control
      areas to determine exposure rates from surficial radioactivity. 137Cs was the
      only man-made radionuclide detected and was most abundant at three off-site
      locations on cultivated lawns. 137Cs inventories at all of the on-site survey
      locations were lower than expected, given the high annual precipitation in the
      area. The vertical distributions were more extended than those reported for
      undisturbed sites. Pressurized ion chamber measurements indicated no significant
      differences in exposure rates on and off the test site.

PMID- 1628992
TI  - Optimum 222Rn-adsorbing activated charcoals.
AB  - Adsorptive and desorptive data are presented for 20 activated charcoal (AC) types
      that may be used in passive 222Rn sampling devices. Open-faced AC canisters were
      exposed for 3 d at room temperature to known radon and water vapor
      concentrations. Gamma measurements of radon progeny activity show that the
      optimum radon-adsorbing ACs are Calgon-PCB, Norit (RI, RBI, or PK), and, to a
      lesser degree, Witco-965 and ENV-EI-1220.

PMID- 1628993
TI  - In-line Kevlar filters for microfiltration of transuranic-containing liquid
      streams.
AB  - The Department of Energy Rocky Flats Plant has numerous ongoing efforts to
      minimize the generation of residue and waste and to improve safety and health.
      Spent polypropylene liquid filters held for plutonium recovery, known as
      "residue," or as transuranic mixed waste contribute to storage capacity problems
      and create radiation safety and health considerations. An in-line process-liquid
      filter made of Kevlar polymer fiber has been evaluated for its potential to: (1)
      minimize filter residue, (2) recover economically viable quantities of plutonium,
      (3) minimize liquid storage tank and process-stream radioactivity, and (4) reduce
      potential personnel radiation exposure associated with these sources. Kevlar
      filters were rated to less than or equal to 1 mu nominal filtration and are
      capable of reducing undissolved plutonium particles to more than 10 times below
      the economic discard limit, however produced high back-pressures and are not yet
      acid resistant. Kevlar filters performed independent of loaded particles serving
      as a sieve. Polypropylene filters removed molybdenum particles at efficiencies
      equal to Kevlar filters only after loading molybdenum during recirculation
      events. Kevlars' high-efficiency microfiltration of process-liquid streams for
      the removal of actinides has the potential to reduce personnel radiation exposure
      by a factor of 6 or greater, while simultaneously achieving a reduction in the
      generation of filter residue and waste by a factor of 7. Insoluble plutonium may
      be recoverable from Kevlar filters by incineration.

PMID- 1628994
TI  - Sealants for 222Rn exclusion.

PMID- 1628996
TI  - The twentieth anniversary of Heart & Lung: the Journal of Critical Care.

PMID- 1628995
TI  - Comments on maximum permissible concentrations.

PMID- 1628997
TI  - Take pride in our past: be challenged by the future.

PMID- 1628998
TI  - Infection control issues for critical care units: an overview and challenge-
      physician and nurse perspective.

PMID- 1628999
TI  - Pharmacotherapy update.

PMID- 1629000
TI  - Perceived threats of individuals recovering from myocardial infarction.
AB  - Lazarus' phenomenological theory of stress and coping provided the basis for this
      descriptive study of perceived threats after myocardial infarction (MI). Sixty
      four post-MI subjects enrolled in phase II cardiac rehabilitation programs
      identified threats they had experienced in the past month. Perceived threats were
      defined as situations that were difficult or troubling to the individual and were
      described by respondents in narrative form. Degree of threat was then measured by
      one item on which subjects indicated the degree of concern the threatening event
      had caused them. Responses to the one item were analyzed and categorized into the
      following five areas: physical problems; medical therapy/self-care; work/physical
      activity; interpersonal/family; and financial. The results provide an overview of
      the multiple concerns individuals deal with after a major life-threatening
      cardiac event.

PMID- 1629001
TI  - Coping with acute myocardial infarction.
AB  - This study examines how patients with acute myocardial infarction (AMI) cope. The
      nonrandom sample consisted of 30 acutely ill patients with AMI. Data were
      collected with an open-ended interview derived from cognitive coping theory and
      the Jalowiec Coping Scale. Interview content was analyzed with qualitative
      methods; data collected by use of the JCS were quantitatively examined. From the
      patients' appraisals emerged a unique description of coping with AMI that
      differed from the denial-focused description proposed by earlier investigators.
      In addition, patients used many and varied coping strategies during the first 3
      days of illness. Among those contributing most to the total coping efforts of the
      group were the optimistic-, confrontive-, self-reliant-, and supportant-type
      strategies. Contrary to findings of earlier investigators, there was little
      evidence of attempts by patients with AMI to deny the existence of the illness as
      a means of coping.

PMID- 1629002
TI  - An examination of stressors in the patient undergoing cardiac electrophysiologic
      studies.
AB  - This study was undertaken to (1) identify stressors that medically treated
      patients who undergo cardiac electrophysiologic studies (EPS) experience from the
      points of view of patients and the staff nurses who care for them, (2) compare
      patients' and nurses' perceptions of such stressors, and (3) evaluate a tool
      developed by the investigator, the EPS Stressor Scale. Stressors were measured by
      scores on a scale from one to five. Demographic and health-related information
      was also obtained from patient subjects. The sample comprised 28 patients
      receiving EPS and 13 nurses. In general, illness-related stressors were most
      stressful to both patient and nurse subjects, whereas hospital-related stressors
      were least stressful. Patient and nurse subjects rank ordered stressors
      similarly; however, t tests revealed significant differences between patients'
      and nurses' mean stress scores on stressors. The EPS Stressor Scale appears to be
      a useful tool in evaluating the stress experienced by patients undergoing EPS;
      however, this tool will need to be validated in different groups of these
      patients. Implications for nursing practice are also discussed.

PMID- 1629003
TI  - Sleep patterns and stress in patients having coronary bypass.
AB  - This study examined the self-reported sleep patterns of adult patients undergoing
      coronary artery bypass graft (CABG) surgery and the relationship between their
      perceived illness-related stress and sleep disturbances. Twenty-four patients
      completed data at all three collection points: preadmission, and the third and
      sixth postoperative mornings. Patients responded to the Verran/Snyder-Halpern
      Sleep Scale and the Carr and Powers Stressor Scale for patients having CABG. By
      use of a within-subject, one-factor, repeated measures analysis of variance,
      statistically significant differences were found in each of the three sleep
      dimensions measured over time (disturbance, effectiveness, and supplementation).
      With the Pearson correlation, the hypothesis that sleep disturbances in patients
      having open-heart surgery are related to psychologic stress associated with
      illness was not supported. Additional analyses indicated that hospital and
      illness-related stress, duration of cardiopulmonary bypass, anesthesia time, and
      sleep medication were related to patients' sleep disturbance, effectiveness, or
      supplementation in different ways and at different times during the study
      periods.

PMID- 1629004
TI  - Treatment of paroxysmal supraventricular tachycardia with adenosine: implications
      for nursing.
AB  - Paroxysmal supraventricular tachycardia (PSVT) is a frequently occurring
      arrhythmia. Currently, verapamil and manual vagal stimulation are the first-line
      interventions for PSVT. Although verapamil is widely used for the treatment of
      PSVT, it can result in hypotension and ventricular fibrillation if given to a
      patient with ventricular tachycardia. Because the differential diagnosis of broad
      QRS complex tachycardia is difficult, the development of a safer drug for the
      treatment of both narrow- and broad-complex tachycardia is extremely important.
      Adenosine is a promising new drug for the treatment of PSVT. Its use is reviewed
      in three presentations.

PMID- 1629005
TI  - Transcatheter closure of ventricular septal defect: a nonsurgical approach to the
      care of the patient with acute ventricular septal rupture.
AB  - Acute ventricular septal rupture is a potentially fatal complication of
      myocardial infarction. In the past, surgical repair was the only treatment option
      for this life-threatening event. However, not all patients are good surgical
      candidates. Transcatheter closure of a ventricular septal defect (VSD) with a
      prosthesis called the Rashkind Patent Ductus Arteriosis Occluder System allows
      closure of the VSD without the possible complications associated with open-heart
      surgery. This treatment has potential as a temporary measure for patients
      awaiting surgical repair of VSD. Transcatheter closure may also be used as a
      permanent treatment for those patients considered to be poor surgical candidates.
      This case presentation addresses the use of a state-of-the-art nonsurgical
      approach to VSD closure. The focus is on the unique medical and nursing
      interventions used in caring for the patient suffering from a myocardial
      infarction complicated with postinfarction ventricular septal defect.

PMID- 1629006
TI  - Coronary precautions: should caffeine be restricted in patients after myocardial
      infarction?
AB  - The effect of caffeine on heart rate, blood pressure, and cardiac rhythm has long
      been a controversial issue. A review of the literature reveals numerous articles
      evaluating the effects of caffeine on normal subjects, fewer evaluating the
      effects of caffeine on patients with cardiac disease and patients after
      myocardial infarction. Although the findings for the various populations have
      been inconsistent, recent studies with large cohorts have clarified the issue.
      Moderate consumption of caffeine does not significantly increase the risk of a
      coronary event nor increase the frequency of cardiac arrhythmias. This conclusion
      applies to healthy persons, patients with ischemic heart disease, and those with
      serious ventricular ectopy. Patients with cardiac disease should be allowed to
      consume four to five cups of caffeinated beverages per day while in the coronary
      care unit or progressive care unit under the surveillance of nursing staff.

PMID- 1629007
TI  - Recommendations for improving cardiopulmonary resuscitation skills retention.
AB  - Massive community efforts are devoted to delivering cardiopulmonary resuscitation
      (CPR) training to health professionals and lay people. However, although most
      people can successfully learn to perform CPR, skills retention is universally
      poor. Beginning as early as 2 weeks after initial training, CPR skills begin to
      deteriorate in a wide variety of subjects including nurses, physicians, emergency
      medical technicians, family members of patients with cardiac disease, and other
      lay people. Methods tested to improve retention are reviewed, and the role of
      practice and review is examined. The failure of many factors to improve retention
      of CPR skills is discussed. Finally, suggestions for improvement in retention of
      CPR skills based on a review of the literature and pertinent theory are offered.

PMID- 1629008
TI  - Challenges in nursing: infants with congenital diaphragmatic hernia.
AB  - Despite advances in the care of infants born with congenital diaphragmatic
      hernia, mortality rate continues to be high. Immediate survival is directly
      related to the degree of pulmonary hypoplasia present. The spectrum is wide, from
      minimal pulmonary hypoplasia, in which neonates do well, to severe pulmonary
      hypoplasia, which is incompatible with life. Between these two extremes lie
      infants with compromised pulmonary function whose long-term survival depends on
      the clinical strengths of their multidisciplinary team. Over the past year, 23
      infants with congenital diaphragmatic hernia were cared for in the
      Multidisciplinary Intensive Care Unit at Children's Hospital, Boston. A
      retrospective chart review enabled the authors to describe the trajectory of
      illness and generate nursing practice guidelines. This article presents the
      nursing care issues that were identified in this challenging population.

PMID- 1629010
TI  - Guidelines for critique of a research report.
AB  - Before findings reported in a research article are used to change clinical
      practice, the research must be evaluated for evidence of credibility, integrity,
      and potential for replication. This paper provides guidelines for use in
      evaluating deductive, empirical research. The standards presented in this paper
      are derived from the tenets of the scientific method, measurement theory,
      statistical principles, and research ethics. The guidelines may be used to
      evaluate each section of a research report, from the title to the interpretation
      of findings.

PMID- 1629009
TI  - Maximal rate response in a permanent pacemaker during chest physiotherapy.
AB  - Rate-responsive pacing is designed to allow a near-physiologic heart rate
      response to patient activity. One means of generating the desired response has
      been achieved with the use of pacemakers that respond to vibration generated by
      skeletal muscle activity. In this article, we report a case of increased paced
      rate in an activity-sensing rate-responsive pacemaker caused by the sensing of
      skeletal muscle vibration during chest physiotherapy. Potential clinical
      complications and possible solutions to this problem, as well as significant
      aspects of nursing care, are discussed with respect to patients with rate
      responsive pacing devices.

PMID- 1629011
TI  - Spotlight article: the effect of familiar and unfamiliar voice treatments on
      intracranial pressure in head-injured patients. (Treolar DM, Nalli BJ, Guin P,
      Gary R. J Neuroscience Nurs 1991;23(5):295-9.).

PMID- 1629012
TI  - Herpes simplex meningoencephalitis.

PMID- 1629013
TI  - Labelling of leukocytes with 99mTc-HMPAO for scintigraphy of inflammatory lesions
      and abscesses.
AB  - A simplified and efficient procedure for 99mTc-HMPAO-labelling of leukocytes is
      described. For this purpose, the pH and concentration of the 99mTc-HMPAO
      preparation was modified. Leukocytes were isolated from a 20 mL mixture of
      patient blood, 5 mL ACD and 0.8 mL methylcellulose after 1 h sedimentation of
      erythrocytes and centrifugation (at 400 g) of the obtained plasma layer.
      Simultaneously, 99mTc-HMPAO was prepared (one single-dose kit for two patients)
      by adding 2.2 mL 99mTc-generator eluate and, after 10 min, 0.3 mL of phosphate
      buffer to lower the pH to 7. The isolated WBCs were then labelled by the addition
      of 1-1.2 mL of 99mTc-HMPAO solution and incubated for 20 min. The unbound tracer
      was then discarded, the labelled WBC washed and finally resuspended in autologous
      cell-free plasma. Leukocytes labelled by this procedure were used for
      scintigraphic localization of inflammatory lesions and abscesses in the gastro
      intestinal tract. The labelling efficiency was 60 +/- 9%, with a separation yield
      of 55 +/- 11%.

PMID- 1629014
TI  - Estrogen receptor imaging with 17 alpha-[123I]iodovinyl-11 beta-methoxyestradiol
      (MIVE2)--Part I. Radiotracer preparation and characterization.
AB  - It is important to know the estrogen receptor rate in breast carcinoma
      management. Thus, an in vivo and atraumatic method would be very useful.
      Different ligands have been proposed for this. We present here the specific
      synthesis of 20E- and 20Z-17 alpha-iodovinyl-11 beta-methoxyestradiols and their
      biological characterization as estrogen receptor ligands. The two isomers were
      analysed by current chemical methods (NMR) and purified by HPLC. We carried out
      an in vivo study with 21-day-old Swiss mice to compare properties of the two
      ligands. The 20E-MIVE2 showed the best affinity for estrogen receptors, the
      uterus-to-blood ratio was 15-fold higher for the trans derivative. We enhanced
      the in vivo and in vitro properties of the 20E-MIVE2: the affinity constant was
      determined by Scatchard analysis, Kd = 16 x 10(-10) M, and biodistributions were
      performed with unlabelled estradiol pre-injection. We concluded that 20E-MIVE2
      can be used for a feasibility study in patients with breast carcinoma.

PMID- 1629015
TI  - Estrogen receptor imaging with 17 alpha-[123I]iodovinyl-11 beta-methoxyestradiol
      (MIVE2)--Part II. Preliminary results in patients with breast carcinoma.
AB  - 17 alpha-[123I]Iodovinyl-11 beta-methoxyestradiol was injected into 19 women:
      group 1 (n = 8), initial evaluation of breast cancer; group 2, (n = 11)
      postoperative follow-up including 9 patients with bone metastases. The primary
      tumor (size: 8-10 mm) was visualized by breast tomoscintigraphy in 2/4 patients
      of group 1 with high estrogen receptor concentration (162-445 fmol/mg) and was
      not detectable in 4 patients with low estrogen receptor concentration (6-32
      fmol/mg). Axillary lymph node metastases were detected in 1 patient of group 1
      and in 1 patient of group 2. In 4 patients of group 2 with previous primary tumor
      containing estrogen receptors, MIVE2 uptake in bone metastases was demonstrated.
      MIVE2 scintigraphy is an original, specific and non-invasive method for breast
      cancer estrogen receptor imaging in primary and in metastatic tumors.

PMID- 1629016
TI  - Labeling proteins with fluorine-18 using N-succinimidyl 4-[18F]fluorobenzoate.
AB  - Two methods were investigated for the no-carrier-added synthesis of N
      succinimidyl 4-[18F]fluorobenzoate (S[18F]FB). The first, an attempted
      nucleophilic aromatic substitution by [18F]fluoride on N-succinimidyl 4
      nitrobenzoate was unsuccessful. The second method involved three steps;
      [18F]fluoride for trimethylammonium substitution on 4-formyl-N,N,N
      trimethylanilinium triflate, oxidation to 4-[18F]fluorobenzoic acid, followed by
      reaction with N-hydroxysuccinimide and dicyclohexylcarbodiimide to form S[18F]FB.
      Total synthesis and purification time was 100 min and the overall radiochemical
      yield was 25% (decay corrected). A monoclonal antibody F(ab')2 fragment could be
      labeled in 40-60% yield by reaction with S[18F]FB for 15-20 min. The tissue
      distribution in normal mice and in vitro tumor binding of the antibody F(ab')2
      labeled by reaction with S[18F]FB were comparable to those observed for the
      fragment after radioiodination using N-succinimidyl 4-[125I]iodobenzoate.

PMID- 1629017
TI  - Incorporation of radioiodinated IPPA and BMIPP fatty acid analogues into complex
      lipids from isolated rat hearts.
AB  - Heart lipids were extracted by the Folch technique from Langendorff-perfused rat
      hearts after administration of 15-(p-[131I]iodophenyl)pentadecanoic acid and 15
      (p-[125I]iodophenyl)-3-R,S-methylpentadecanoic acid. Techniques utilizing
      successive high performance liquid chromatographic (HPLC) analyses have been
      developed for the evaluation of the uptake of the tracers into neutral lipids and
      phospholipids of the rat hearts. Phospholipids were separated on a SiO2 column
      eluted with a gradient of acetonitrile/water (97.5/2.5) and acetonitrile/water
      (85/15) followed by separation of the neutral lipids on a C-18 reversed phase
      column with a gradient consisting of acetonitrile and 2-propanol/hexane (60/40)
      containing 1 N H2SO4 (5 microL/100 mL). Both tracers show the incorporation into
      the expected major lipid classes.

PMID- 1629018
TI  - N-(m-[125I]iodophenyl)maleimide: an agent for high yield radiolabeling of
      antibodies.
AB  - In an effort to radiolabel antibodies, N-(m-[125I]iodophenyl)maleimide (m
      [125I]IPM) was prepared by the demetallation of an N-[m-tri-(n
      butyl)stannylphenyl]maleimide intermediate. The unlabeled intermediate was
      synthesized in greater than or equal to 75% yield using a palladium catalyzed
      reaction of hexabutylditin with m-bromoaniline, followed by reaction with maleic
      anhydride and ring annulation. All products were confirmed by NMR and elemental
      analysis. Labeling with 125I was carried out in a biphasic mixture containing
      chloramine-T (radiochemical yield greater than or equal to 70%). Rabbit IgG
      modified with the heterobifunctional crosslinking agent N-succinimidyl-3-(2
      pyridyldithio)propionate (SPDP) and bovine serum albumin were conjugated with m
      [125I]IPM (yield: 40 and 80%, respectively). In addition, m-[125I]IPM was
      conjugated to rabbit IgG subunits (HL) in 70% yield. The in vitro stability of
      the radiolabeled proteins in serum showed less than 1% deiodination over 24 h.

PMID- 1629019
TI  - m-[125I]iodoaniline: a useful reagent for radiolabeling biotin.
AB  - Biotinyl-m-[125I]iodoanilide (BIA) was synthesized by coupling biotin to m
      [125I]iodoaniline via a mixed anhydride reaction. m-[125I]Iodoaniline was
      produced from the tin precursor, which was prepared using a palladium catalyzed
      reaction of hexabutylditin with m-bromoaniline. The radioiodinated BIA derivative
      is characterized by a stable amide and/or intact ureido group on the biotin
      molecule; it may thus be a useful carrier for targeting radionuclides to avidin
      conjugated antibodies previously localized on tumors.

PMID- 1629020
TI  - Technetium-99m p-iodophenethyldiaminodithiol (DADT-IPE): potential brain
      perfusion imaging agent for SPECT.
AB  - A new ligand, an N-p-iodophenethyl diaminodithiol (DADT-IPE), an anlog of N
      isopropyl-p-iodoamphetamine (IMP), was synthesized and subsequently complexed
      with 99mTc, using stannous chloride as a reducing agent. Two complexes (a and b)
      were separated from 99mTc-DADT-IPE by high performance liquid chromatography
      (HPLC). Competitive inhibition studies showed that the IC50 value of DADT-IPE (70
      microM) was similar to that of IMP (49 microM). Biodistribution studies of one of
      the complexes [99mTc-DADT-IPE(a)] in rats showed that 0.65% of the injected dose
      of the tracer remained in the brain at 5 min after intravenous injection, with
      0.53% of the dose remaining in the brain at 60 min post-injection, whereas the
      corresponding values for the other complex [99mTc-DADT-IPE(b)] were 0.34% dose in
      the brain at 5 min and 0.28% dose in the brain at 60 min post-injection. The half
      life for clearance of 99mTc-DADT-IPE(a) from rat brain was found to be more than
      5 h. These results suggested that 99mTc-DADT-IPE(a) has characteristics which are
      suitable for cerebral perfusion imaging.

PMID- 1629021
TI  - 4-Borono-2-[18F]fluoro-D,L-phenylalanine: a possible tracer for melanoma
      diagnosis with PET.
AB  - The potential of 4-borono-2-[18F]fluoro-D,L-phenylalanine ([18F]FBPA), a
      flurodinated derivative of a target compound for boron neutron capture therapy,
      for melanoma imaging by positron emission tomography (PET) was studied using
      animal models. A high uptake of [18F]FBPA was found in murine B16 melanoma or in
      Greene's melanoma No. 179, a melanotic cell line in hamsters, for the first 6 h
      after injection. Whole body autoradiography using [18F]FBPA gave a clear image of
      the B16 tumor. The acid-insoluble 18F in the B16 increased to 27% by 6 h, and
      most of the free 18F was detected as [18F]FBPA in both B16 and plasma. In the
      hamster models, No. 179 showed a 1.7 times higher uptake than amelanotic Greene's
      melanoma No. 178 at 6 h post-injection, although both melanomas indicated similar
      metabolic activities when examined by a tracer uptake study using L
      [14C]methionine, 2-deoxy-D-[14C]glucose and [3H]thymidine. [18F]FBPA may be a
      very promising PET tracer for melanoma imaging.

PMID- 1629022
TI  - Potential 67Ga radiopharmaceuticals for myocardial imaging: tris(1-aryl-3-hydroxy
      2-methyl-4-pyridinonato)gallium(III) complexes.
AB  - A series of highly lipophilic complexes of 1-aryl-3-hydroxy-2-methyl-4
      pyridinones with gallium(III)-67 has been evaluated in vitro and in vivo as
      potential radiopharmaceuticals. The pyridinones have different substituents at
      the para-position of the phenyl ring: R = H, CH3, OCH3 and NO2. Biodistribution
      studies of 67Ga complexes have been carried out in rabbits, mice, rats and a dog.
      High heart uptake of the radionuclide has been shown in rabbits and the dog. The
      different biodistribution patterns in mice and rats indicate that there is a
      species difference in the biodistribution of these complexes. Rabbits and the dog
      show rapid heart uptake and blood clearance. The speciation of the Ga3+ ion in
      vivo is simulated in vitro with a simple blood plasma model based on the
      available thermodynamic data.

PMID- 1629023
TI  - Radioiodinated 2-hydroxy-3-(4-iodophenyl)-1-(4-phenylpiperidinyl)propane:
      potential radiotracer for mapping central cholinergic innervation in vitro.
AB  - Radioiodinated 2-hydroxy-3-(4-iodophenyl)-1-(4-phenylpiperidinyl)propane, 5 (4
      HIPP), was synthesized and evaluated as a simple vesamicol-like radiotracer for
      mapping cholinergic pathways in the brain. Both enantiomers of 5 exhibit
      significant accumulation (approx. 2% of injected dose) and prolonged retention
      (t1/2 greater than 3 h) within the rat brain. The accumulation of radioiodinated
      5 in the rat brain was reduced by up to 70% in the presence of vesamicol and its
      analogs. The levorotary isomer (-)-4-[123I]HIPP exhibits significant accumulation
      in the monkey brain, with a half-life of about 9 h. Radioiodinated 5 may
      therefore be a useful tool for studying cholinergic pathways in the brain.

PMID- 1629024
TI  - Assessment of iodohexadecenoic acid as a tracer of fatty acid metabolism by
      external detection: a study on isolated rat heart.
AB  - Labelled fatty acids have been proposed to explore cardiac metabolism. For the
      analysis of the external detection curve obtained with 16-iodo 9-hexadecenoic
      acid (IHA), we developed a mathematical 4-compartment model with compartments 0,
      1, 2 and 3 representing vascular IHA, intracellular IHA, esterified forms and
      iodide, respectively. This model, used here for isolated rat hearts perfused in a
      recirculating system, is validated by an intracellular analysis, then tested in
      various metabolic conditions. Thus, the mathematical analysis of the external
      detection curve gives us numerical data on IHA metabolism, especially the
      distribution between degradation and storage. Our results confirm the suitability
      of IHA for assessing myocardial metabolism.

PMID- 1629025
TI  - Evaluation of osmium(II)-nitrosyl complexes as a method to increase the yield of
      the 191Os-191mIr generator.
AB  - The nitrosyl complexes pentachloronitrosylosmate(II), [OsCl5(NO)]2-, and
      hydroxytetranitronitrosylosmate(II), [Os(OH)(NO2)4(NO)]2-, were evaluated as
      parent species for use on the 191Os-191mIr generator in an attempt to increase
      the 191mIr yield of the generator by providing a direct route to a chemically
      stable 191mIr daughter. The uptake of the 191Os-labeled complexes by the
      inorganic ion-exchangers ZrO2, SnO2, PbS, MnO2 and Al2O3 and the organic resin AG
      MP-1 was measured and prototype generators were prepared using those exchangers
      that demonstrated greater than 90% uptake of the 191Os-labeled complexes. The
      191mIr(III)-nitrosyl complexes produced subsequent to beta- decay of the 191Os
      nitrosyl parent complexes were found to undergo secondary chemical reactions to
      form nitro (NO2-) complexes that were tightly retained on the ion exchanger
      limiting 191mIr yield to less than 5%.

PMID- 1629026
TI  - Preparation and evaluation of 17-ethynyl-substituted 16 alpha
      [18F]fluoroestradiols: selective receptor-based PET imaging agents.
AB  - We have prepared and studied six new analogs of 16 alpha-fluoroestradiol (FES):
      17 alpha- and 17 beta-ethynyl-FES (7 [FEES] and 7a), and the 11 beta-ethyl (8 and
      8a) and 11 beta-methoxy (9 and 9a) derivatives, novel estrogen receptor-based PET
      imaging agents. The relative binding affinity (RBA) for the estrogen receptor
      (ER) versus FES is increased for 7, 9 and 9a but decreased for 7a, 8 and 8a. All
      six analogs have been labeled in the 16 alpha position with 18F by the
      nucleophilic displacement of the corresponding 16 beta-trifluoromethanesulfonate
      with nBu4N18F. Subsequent ethynylation with lithium trimethylsilylacetylide
      yielded the FEES analogs (total synthesis time: 120 min; effective specific
      activity: 200-2400 Ci/mmol). Selective uptake in the uterus was high for [18F]7,
      [18F]8, [18F]9 and [18F]9a (% ID/g values at 1 h: 11.2, 12.9, 9.9 and 8.3,
      respectively), while uptake was effectively blocked by coinjection of an excess
      of unlabeled estradiol. The FEES analogs, [18F]7, [18F]8 and [18F]9, exhibited
      the highest selectivity, in terms of target (uterus)-to-blood ratios, ever seen
      amongst estrogen radiopharmaceuticals, 154, 145 and 169, respectively. The
      analogs [18F]7a and [18F]8a displayed no uptake in the uterus, consistent with
      their low RBAs. Metabolism studies revealed that most of the uterine activity is
      unmetabolized while the blood exhibits a rapid and subsequently sustained mixture
      of metabolites. The muscle shows a metabolic profile intermediate to the uterus
      and blood. These analogs provide an array of desirable characteristics for the
      optimal PET imaging of ER-rich target tissues.

PMID- 1629027
TI  - Non-beta-oxidizable omega-[18F]fluoro long chain fatty acid analogs show
      cytochrome P-450-mediated defluorination: implications for the design of PET
      tracers of myocardial fatty acid utilization.
AB  - The nature of the in vivo defluorination of non-beta-oxidazable no-carrier-added
      omega-[18F]fluoro long chain fatty acid (LCFA) analogs was studied with the aim
      of developing PET tracers of LCFA utilization. Extensive defluorination of 15
      [18F]fluoro-3-thia-pentadecanoic acid (FTPA) in mouse was evidenced by
      radioactivity uptake by bone. [18F]Fluoride in the blood was verified
      analytically. Incubations of FTPA in rat-liver homogenates and subcellular
      fractions thereof showed a strong defluorination process in microsomes which was
      O2- and NADPH-dependent. In contrast, defluorination of FTPA was relatively slow
      in Langendorff perfused rat heart. High bone uptake in mouse was also observed
      with 14-[18F]fluoro-13,13-dimethyl-3-thia-tetradecanoic acid, where gem-dimethyl
      substitution precludes direct elimination of H18F. These data indicate that the
      defluorination of non-beta-oxidizable omega-[18F]fluoro LCFA analogs is primarily
      governed by cytochrome P-450-mediated omega-oxidation. Therefore, labeling at the
      (omega-3) carbon was proposed to provide a more stabile 18F-label. Defluorination
      of the (omega-3)-labeled 13 (R,S)-[18F]fluoro-3-thia-hexadecanoic acid was lower
      than that of FTPA in mouse and was independent of O2 and NADPH in vitro. Thus,
      (omega-3) labeling with 18F is preferable to omega labeling of non-beta
      oxidizable LCFA analogs.

PMID- 1629028
TI  - Lung scintigraphy with [123I]IMP in patients with pulmonary tuberculosis.
AB  - Lung scintigraphy using N-isopropyl-p-[123I]iodoamphetamine (IMP) was performed
      on 26 patients with pulmonary tuberculosis. Early (5 min after injection) and
      late images (4 h after injection) were obtained with a large-field gamma-camera
      equipped with a digital computer. Lung scintigraphy using [99mTc]MAA (MAA) was
      also done. Although early IMP images showed the same findings as [99mTc]MAA,
      images, a discrepancy between delayed IMP images and [99mTc]MAA images was seen
      in some patients. Increment of activities seen in late images was demonstrated in
      most patients whose chest x-ray findings included exudative inflammatory changes.
      Uptake and clearance of IMP was considered to be affected by the active phase of
      pulmonary tuberculosis.

PMID- 1629029
TI  - In vivo studies of unlabeled and radioiodinated rhodamine-123.
AB  - Radioiodinated rhodamine-123 (Rh123), potential tumor imaging agent, was injected
      in mice bearing experimentally-induced tumors to investigate its tissue
      distribution. Some accumulation of radioactivity was found in tumors; most of it
      cleared rapidly from the blood after injection. Also, the radioiodinated Rh123
      had metabolized to water-soluble species which was excreted in urine and feces.
      Unlabeled Rh123, on the other hand, accumulated only marginally in the tumors.
      However, it was found to accumulate significantly in the heart; as much as
      seventy times the level in blood at 4 h post-injection. Accumulation of unlabeled
      Rh123 increased steadily even at 24 h post-injection; whereas, it cleared rapidly
      from the blood via the kidney. This finding of selective accumulation of Rh123 in
      heart could be exploited in synthesizing 11C- and 18F-labeled Rh123 for use in
      PET studies of the myocardium.

PMID- 1629030
TI  - Quantitative assessment of lipoprotein metabolism by positron emission tomography
      with an 18F-containing residualizing label.
AB  - Residualizing labels for proteins are designed to remain entrapped within cells
      following uptake and degradation of the carrier protein. In the present work we
      report the synthesis of a novel residualizing label, N-lactitol-S
      ([18F]fluorophenacyl)-cysteamine ([18F]LCSH, and its use for quantifying the
      accumulation of low density lipoprotein in tissues in vivo by positron emission
      tomography (PET). The retention of degradation products in tissues from
      lipoprotein or from other rapidly catabolized protein pharmaceuticals tagged with
      [18F]LCSH reduces leakage of tracer into the plasma compartment. Thus,
      residualizing labels provide a valuable tool for enhancing signal-to-noise
      ratios, even during the relatively short interval of PET studies.

PMID- 1629031
TI  - Streptavidin-biotinylated IgG conjugates: a simple procedure for reducing polymer
      formation.
AB  - Disulfide links of the IgG2ak anti-ovarian carcinoma antibody, 5G6.4, were site
      specifically biotinylated [approximately 2 biotins/IgG2a] using a novel
      crosslinking procedure using the biotin derivatized ETAC (equilibrium transfer
      alkylation crosslink reagent) 1a. Complexation of ETAC 1a biotinylated 5G6.4 on a
      column of immobilized protein A at high dilution, followed by passage of
      [125I]streptavidin, washing and pH change leads to elution of a streptavidin-free
      product with a molecular mass in the 200-300 kDa range. By contrast, direct
      mixing with [125I]streptavidin rapidly gave larger oligomers of much greater than
      669 and approximately 440-669 kDa molecular mass, respectively. The
      biodistribution of the 200-300 kDa complex showed significantly diminished liver,
      kidney and spleen uptake as well as higher blood activity than the 440-669 kDa
      complex. The methodology represent the first application of ETAC chemistry to
      disulfide-bond directed biotinylation of antibodies and the synthesis of
      streptavidin antibody conjugates which minimizes their polymerization.

PMID- 1629032
TI  - Repeated DNA sequences of Aegilops markgrafii (Greuter) Hammer var. markgrafii:
      cloning, sequencing and analysis of distribution in Poaceae species.
AB  - Total DNA of Aegilops markgrafii (Greuter) Hammer var. markgrafii was shot gun
      cloned. From all the recombinants containing repetitive sequences 1-2% hybridized
      preferentially with the Ae. markgrafii genome and were almost absent in wheat.
      The cloned sequences are disperse distributed over the Aegilops chromosomes and
      show the typical features of eukaryotic repetitive DNA. Five specific probes were
      tested for their applicability in a screening program on 68 Poaceae accessions.

PMID- 1629033
TI  - National psychology, national socialism, and analytical psychology: reflections
      on Jung and anti-semitism. Part II.
AB  - The paper is a critical study of the intellectual relations of analytical
      psychology and national socialism. I try to show that it was Jung's attempt to
      establish a psychology of nations that brought him into the same frame as Nazi
      anti-semitic ideology. In addition, Jung was absorbed by the question of
      leadership, also a pressing issue during the 1930s. Exploring these ideas as
      thoroughly as possible leads to a kind of reparation, for I think that post
      Jungians do have reparation to make. Then it is possible to revalue Jung's
      overall project in more positive terms. By coupling a less simplistic methodology
      and a more sensitive set of values to Jung's basic intuitions about the
      importance of a psychology of cultural difference, analytical psychology has
      something to offer a depth psychology that is concerned with processes of
      political and social transformation.

PMID- 1629034
TI  - 'There is no such thing as a liberal dictatorship': discovery and first
      publication of a letter on politics by C. G. Jung.

PMID- 1629035
TI  - Oedipus in Gethsemane: archetypal aspects of homosexuality.
AB  - In the history of depth psychology, we often come upon the theme of 'father-son'
      relationships, which, although initially positive, ultimately become destructive.
      I submit that repressed homosexual aspects may be responsible for this turn of
      events and illustrate this hypothesis with archetypal motifs found in Greek and
      Judaeo-Christian culture.

PMID- 1629036
TI  - Looks that kill the capacity for thought.
AB  - In this paper I explore ways in which the fundamental balance between life and
      death forces is portrayed within the Oedipus myth, showing how there are times
      when, as theorists, we are blind to the on-going dynamic polarities contained
      within the myth. Using clinical case material I explore the vicissitudes of the
      theme of infanticide and the impact of the infanticidal impulse on thinking
      processes and how things come together in the mind. I consider the link between
      the infanticidal impulse and what may be being symbolized by physiological
      problems with eyes and wombs. I give examples of the clinical use I have made of
      a variety of theoretical ideas which enabled my capacity for thought at those
      times when much of what was taking place was unthinkable.

PMID- 1629037
TI  - The therapeutic function of altered states.

PMID- 1629038
TI  - Incidence of otitis media in CBA/J and CBA/CaJ mice.
AB  - The inbred CBA/J mouse has become a standard experimental animal for auditory
      study because of its lifelong good hearing. In a newly established mouse breeding
      colony that housed CBA/J and CBA/CaJ mice to reared as auditory subjects, otitis
      media frequently afflicted CBA/J mice, reaching an incidence of 90% in animals
      greater than 400 days of age. Otitis media was not found in CBA/CaJ mice. Three
      attempts to establish a colony that was free of otitis were unsuccessful.
      Although the primary pathogen was not clearly established, Pasteurella
      pneumotropica was isolated from infected bullae. Partial control of otitis media
      followed the introduction of tetracycline prophylaxis. The CBA/CaJ mice may be
      suitable replacements for CBA/J mice in studies that require inbred mice with
      good hearing, since their auditory thresholds did not differ significantly from
      those of otitis-free CBA/J mice.

PMID- 1629039
TI  - Analytic listening by the goldfish.
AB  - A stimulus generalization paradigm was used with classical respiratory
      conditioning to study analytic listening in the goldfish. Animals were first
      conditioned to suppress respiration upon the presentation of a long-duration
      complex sound comprised of two sinusoidal components, 166 and 724 Hz. Conditioned
      animals were then presented with a set of eight novel test tones with frequencies
      between 95 and 1514 Hz, and including 166 and 724 Hz. Response magnitudes were
      greatest at the frequencies of the components making up the complex to which the
      animals were initially conditioned. This is a demonstration that the goldfish had
      acquired independent information about the frequencies of the individual
      sinusoidal components making up a complex sound, and thus had listened to the
      complex analytically. To my knowledge, this is the first demonstration of
      simultaneous frequency analysis and analytic listening by a nonhuman animal, and
      suggests that this fundamental aspect of human hearing may be a primitive
      character shared with the fishes and perhaps with all living vertebrates.

PMID- 1629040
TI  - Maturation of kinocilia in amphibian hair cells: growth and shortening related to
      kinociliary bulb formation.
AB  - New hair cells are added to the amphibian sacculus throughout life, primarily at
      its outer edge. The stereociliary bundles near that edge are heterogeneous, but
      eventually develop the more homogeneous morphology of the overwhelming majority
      of mature cells near the center of the epithelium. During their development the
      kinocilium grows and a kinociliary bulb forms. It has been proposed that initial
      elongation of the kinocilium is followed by shortening, and that the bulb may
      form during shortening. To test those hypotheses, amphibian sacculi were examined
      by scanning electron microscopy and the length of the kinocilium, the width of
      the kinociliary bulb, and the length of the tallest stereocilia were measured for
      159 hair cells. The length of the tallest stereocilia on each hair cell was used
      as an indicator of the relative maturity of that cell, so that changes in the
      structure of each cell's kinocilium could be related to that cell's stage of
      development. Results indicate that initial elongation of the kinocilium is
      followed by shortening. Kinociliary bulbs first appear and increase in volume as
      shortening proceeds. These findings support the hypotheses. Models are proposed
      to explain how the formation of the bulb could result from depolymerization of
      apical cytoskeletal elements, and how kinocilium growth and shortening may
      contribute to hair bundle reorientation in the developing ear.

PMID- 1629041
TI  - Enkephalin-like immunoreactivity in cochlear efferents in the bat, Rhinolophus
      ferrumequinum [corrected].
AB  - The cochlear efferent of the bat is anatomically different from other mammals.
      The olivocochlear bundle of the greater horse shoe bat, Rhinolophus
      ferrumequinum, projects only to inner hair cells. To examine the neurochemical
      nature of the olivocochlear bundle, we examined methionine-enkephalin-like
      immunoreactivity in this species. We observed immunoreactivity in the inner
      spiral bundles and in nerve fibers in the osseous spiral lamina. Sometimes
      immunostained inner spiral bundles were found to project towards inner hair
      cells. These data, as well as data from previous studies, suggest that cochlear
      efferents of different species of mammals share some common neurochemical
      features [corrected].

PMID- 1629042
TI  - Evoked otoacoustic emissions in a nonlinear model of the cochlea.
AB  - A nonlinear, transmission-line-analog model of the ear is presented for the
      purpose of simulating the experimental data of delayed evoked otoacoustic
      emissions (DEOAEs). The model produces echoes very similar to DEOAEs in the
      latency, saturation and spectral features when hypothetical, highly damped points
      arranged on the BM with an equal spacing are assumed. Special attention is payed
      to the reason for the long latency of DEOAEs. In the model, the delay occurs
      spuriously by cancellation of components scattered from the irregular points and
      is longer than the simple round trip time of the travelling wave from the stapes
      to the place of characteristic frequency. The echoes in the model are basically
      linear for the low intensity stimuli and only when the stimuli surpass a certain
      level they saturate owing to the nonlinearity of the BM damping.

PMID- 1629043
TI  - A precedence effect in the perception of inter-aural cross correlation.
AB  - Does the precedence effect, well known in the field of sound localization or
      lateralization, also apply to other percepts based on binaural processing? We
      have compared, with one and the same experimental paradigm, a manifestation of
      the traditional precedence effect in lateralization with a possible similar
      effect in the perception of diffuseness or compactness of a sound image. With
      dichotic headphone stimulation, lateralization was controlled by the inter-aural
      time delay (IATD), and diffuseness/compactness by the inter-aural cross
      correlation (IACC). The experimental paradigm rests on the principle of
      estimating the over-all sensation of a 20-ms noise burst, which was subdivided in
      two parts, with the relevant dichotic information (IATD or IACC) in the leading
      part being opposite to that in the trailing part. When each part is 10 ms, it is
      found that the overall sensation is slightly dominated by the information in the
      leading part, both for lateralization and for compactness/diffuseness. This
      dominance of the leading part can be compensated by a certain decrease of its
      duration and/or amplitude relative to that of the trailing part. It is found that
      this quantitative measure for the 'strength' of the precedence effect for the
      present stimulus is essentially the same for IATD and IACC, suggesting that the
      precedence effect does not apply exclusively to sound localization or
      lateralization, but to at least one other percept based on binaural processing as
      well, namely the processing of inter-aural cross correlation.

PMID- 1629044
TI  - Effects of various noise exposures on endocochlear potentials correlated with
      cochlear gross responses.
AB  - Changes in endocochlear potentials (EP), cochlear microphonics (CM), and compound
      action potentials (CAP) with noise exposure were investigated in guinea pigs. The
      animals were anesthetized and immobilized and exposed to white noise at
      intensities ranging from 105 to 125 dB. The negative EP (N-EP) was induced by
      anoxia and was investigated during and after noise exposure. It was found that
      the general EP (G-EP, the sum of both positive EP (P-EP) and N-EP) increased
      remarkably during exposure to 115 dB noise but decreased during exposure to 125
      dB noise. A smaller absolute value of N-EP was encountered only during exposure
      to 125 dB noise. The results shed light on the relationship between EP and CM,
      CAP changes, and the potential mechanism of EP change and its significance in
      noise-induced hearing loss.

PMID- 1629045
TI  - Physiological correlates of off-frequency listening.
AB  - Recordings are made from inner hair cells (IHC) in the second turn of the guinea
      pig cochlea where characteristic frequencies (CF) are approximately 4000 Hz.
      Results from experiments using two stimulus inputs suggest that the
      characterization of two-tone suppression at this more-basal recording location is
      similar to the reported for IHCs in the third turn (Cheatham and Dallos, 1989,
      1990a, 1990b). For example, introduction of a suppressor causes IHC frequency
      response functions to become narrower with the smallest magnitude reductions
      occurring between 1/2 to 1 octave below CF. In this frequency region, where
      suppression is minimal, it was also observed that suppressor magnitude was
      reduced by the probe. In other words, the mutual suppression of probe and
      suppressor may contribute to the sharpening of these functions. Since the peak of
      the frequency response function shifts to a lower frequency in the presence of
      the suppressor, these results may provide a physiological correlate of the
      psychophysical phenomenon known as 'off-frequency listening.'

PMID- 1629046
TI  - Hair cell regeneration in the adult budgerigar after kanamycin ototoxicity.
AB  - Adult budgerigars were given kanamycin at a dose of 200 mg/kg/day for 10
      successive days. At 1, 7, 14 and 28 days after the drug treatment, the cochleae
      of the birds were processed for scanning electron microscopy (SEM). Complete
      degeneration of sensory hair cells was observed in the basal 55-75% of the
      basilar papilla immediately after the treatment. Regenerating hair cells,
      characterized by clusters of microvilli and small apical surfaces, were present
      in the basal end of the papilla as early as one day post-treatment. During the 28
      day recovery period, the number of hair cells progressively increased beginning
      at the base and spreading toward the apex. Although the appearance of the basilar
      papilla had improved considerably by 28 days post-treatment, the sensory
      epithelium still contained a number of pathologies, most noticeably, incomplete
      restoration of hair cell number in the most apical part of the damaged region and
      the disorganization of hair cell packing. These remaining pathologies may be
      responsible for the permanent threshold shifts observed in budgerigars exposed to
      the same dose of kanamycin treatment (Hashino and Sokabe, 1989).

PMID- 1629047
TI  - Hypothetical roles of middle ear muscles in the guinea-pig.
AB  - The attenuation of incoming sounds induced by acoustic reflex triggering was
      evaluated from the cochlear microphonic response to test tones in 45 awake guinea
      pigs. Although control electromyographic measurements proved that the stapedius
      muscle was contracting, neither impedance changes nor attenuation induced by
      contralateral reflex-eliciting sounds were detectable in 30 cases out of 45. For
      ipsi- and bilateral stimulations, an attenuation was detectable for 7 guinea-pigs
      out of 10. In the guinea-pigs for which a reflex-induced change was found on CM,
      the mean attenuation was weak i.e. of the order of 2 dB at 20 dB above reflex
      threshold. These results were quite different from those obtained during control
      experiments in the rabbit for which CM attenuation was much larger. However,
      large attenuations associated with middle ear muscle contractions were found in
      the guinea-pig in other circumstances, i.e. during self-vocalization or when
      spontaneous muscle contractions occurred during anaesthesia. It is concluded that
      middle ear muscles can have several different functions, and that even when it
      exists, attenuation of loud sounds might not be their primary role.

PMID- 1629048
TI  - Enhancement and suppression in the auditory midbrain nucleus (MLD) of the pigeon.
AB  - Auditory evoked potentials (AEPs) and spike responses were recorded from the same
      recording site in the nucleus mesencephalicus lateralis pars dorsalis (MLD) in
      pigeons with a tungsten microelectrode. Depending on the recording sites within
      the MLD, enhancement and suppression of the AEPs in response to clicks were
      observed at particular frequencies of a background continuous pure tone. Post
      stimulus time histograms (PSTs) of the spike responses, if available in such
      cases, were recorded from the same position by the same electrode. Suppression of
      the AEPs always occurred but enhancement occurred in only 21% of the trials. The
      frequencies of tone bursts that caused maximum AEP were vaguely related to the
      frequencies of continuous pure tones that elicited maximum suppression of the
      AEPs in response to clicks. However, enhancement was produced by a continuous
      pure tone of approximately 1.5 kHz, independent of the frequencies of tone bursts
      that produced maximum AEPs. Most of the PSTs in such instances showed parallel
      relations between the spike responses and the amplitudes of the AEPs. The nature
      of the enhancement and suppression of the click evoked AEPs during continuous
      pure tones was clearly different from those in recordings from the nucleus
      magnocellularis, nucleus angularis and Field L in respect to the probability of
      occurrence of enhancement and suppression.

PMID- 1629049
TI  - Streptomycin blocks the afferent synapse of the isolated semicircular canals of
      the frog.
AB  - This study aimed to define the acute electrophysiological effects of the
      perilymphatic perfusion of streptomycin in the sensory apparatus of the
      semicircular canals of the frog. The ampullary DC potential, the vestibular nerve
      multiunit discharge, the nerve DC potential and the unitary EPSP activity were
      recorded in isolated semicircular canals of the frog (Rana esculenta L). The
      results demonstrated that perilymphatic microperfusion of streptomycin (0.1, 0.3,
      1 and 3 mM) reduced both resting and mechanically evoked afferent discharge,
      while the response of the hair cells remains unchanged. Intracellular recordings
      from single afferent axons showed that the reduction of the afferent discharge
      was mainly due to a reduction of the amplitude, but not the frequency, of the
      EPSPs. These results indicate that streptomycin, when applied in the fluid
      bathing the synaptic pole of the sensory cells, can act as an antagonist of the
      vestibular afferent transmitter at the postsynaptic level.

PMID- 1629050
TI  - Effects of organic acids on the edema of the stria vascularis induced by
      furosemide.
AB  - Furosemide is a loop diuretic which is ototoxic. Investigations have shown the
      stria vascularis to be the target tissue of this ototoxic drug. The purpose of
      the present study was to investigate the effects of furosemide on the stria
      vascularis in chinchillas, in controls and in animals pretreated with the above
      organic acids. Control animals were injected with 0.5 ml alkalinized saline
      followed by furosemide IV 30 min later. Experimental animals received probenecid,
      penicillin or sodium salicylate IV. Thirty minutes later, furosemide was injected
      in the same dose as in the controls. The basal turn of the stria vascularis was
      rapidly removed at various times from 10 to 30 min after furosemide
      administration and processed for transmission electron microscopy. Control
      animals were found to have reversible edema of the stria vascularis. Experimental
      animals had variable findings. Those animals pretreated with penicillin had
      virtually no edema of the stria vascularis at any time. Salicylate and probenecid
      pretreated animals had significantly less edema from one to 10 min after
      furosemide injection, but more edema than controls at later times. These findings
      suggest a discrepancy between ultrastructural pathology and functional status of
      the cochlea in experimental animals pretreated with probenecid or sodium
      salicylate followed by furosemide. On the other hand, good structure function
      correlations were seen in controls and in experimental animals pretreated with
      penicillin.

PMID- 1629051
TI  - Spontaneous synaptic potentials from afferent terminals in the guinea pig
      cochlea.
AB  - Records of spontaneous activity from units likely to be radial afferents were
      analyzed to find the origin of spontaneous action potentials in single auditory
      nerve fibers. Single synaptic events (excitatory postsynaptic potentials or
      EPSPs) nearly all triggered action potentials (spikes). An abrupt increase in
      slope during the rising phase of the EPSP often signalled the initiation of an
      action potential. Synaptic potentials that did not trigger spikes occurred
      frequently during the refractory period. These events sometimes appeared to be
      composed of subunits. Refractoriness appears to be the primary reason these EPSPs
      were ineffective. Distributions of the onset slopes of postsynaptic potentials
      were highly skewed. Skewing was not a consequence of refractoriness, but most
      likely because the amplitude distribution of spontaneous potentials is not
      gaussian.

PMID- 1629052
TI  - Cochlear IgG in the C3H/lpr autoimmune strain mouse.
AB  - The inner ear of the C3H/lpr autoimmune strain mouse was evaluated to identify
      potential mechanisms by which systemic autoimmune disease interferes with
      auditory function. The inner ears were immunohistochemically stained for IgG at
      ages before (2 months) and after (6-10 months) autoimmune disease onset and
      compared to age-matched nonautoimmune C3H/HeJ controls. Immunoreactivity for IgG
      was not seen in the 2 month C3H/lpr autoimmune mice or in either age group of the
      C3H/HeJ controls. On the other hand, all older C3H/lpr mice showed reaction
      product in the vessels of the cochlea, particularly the stria vascularis and bony
      capsule. Less frequent sites of staining were the geniculate ganglion, marrow
      cavities of the bony capsule, tensor tympani muscle, and on one occasion, a hair
      cell of the organ of Corti. These findings indicate that IgG is widespread within
      the cochlea and its vessels during systemic autoimmune disease and not directed
      against any specific sensorineural structure. This suggests a generalized or
      indirect mechanism whereby such systemic disease affects the inner ear.

PMID- 1629053
TI  - American Society of Animal Science, Southern Section. 84th Annual Meeting.
      Lexington, Kentucky, February 2-5, 1992. Abstracts.

PMID- 1629054
TI  - You just can't find good help nowadays!

PMID- 1629055
TI  - Significance of plasma skimming and plasma volume expansion.
AB  - The organs associated with plasma volume expansion, i.e., the red bone marrow,
      the enlarged spleen, and the uteroplacental complex, are arteriovenous shunts
      with an interposed sinusoidal stroma able to skim off plasma-rich blood. In the
      spleen, plasma separation is an integral part of the hemoconcentration. In the
      red bone marrow, plasma skimming might provide a washout mechanism for the many
      newly formed erythrocytes and platelets from the sinusoids to the peripheral
      blood circulation. In the uteroplacental complex, skimming of plasma-rich blood
      is beneficial in increasing blood flow in the myometrium, kidneys, and skeletal
      musculature. The hypervolemic status with anemia will simulate a negative iron
      balance, which speeds up the absorption of iron. Thus a conceptual unit seems to
      exist in which rheological factors influence such functions as transport of newly
      formed blood cells into the circulation (in the red bone marrow),
      hemoconcentration (in the spleen), and iron balance during pregnancy (in the
      uteroplacental complex).

PMID- 1629056
TI  - Functional adaptations of rat skeletal muscle arterioles to aerobic exercise
      training.
AB  - This study tested the hypothesis that both structural and functional adaptations
      of arterioles occur within the skeletal muscle of rats aerobically trained for 8
      10 wk with treadmill exercise. The training regimen used has been shown to elicit
      a 37% increase in plantaris citrate synthase activity but did not result in an
      elevation in citrate synthase activity in the spinotrapezius or gracilis muscles
      of rats used in this study. In the in vivo resting spinotrapezius muscle,
      arteriole diameters were similar in sedentary (SED) and trained (TR) rats.
      However, large- (1A) and intermediate- (2A) sized arterioles dilated
      proportionately more in TR than in SED rats during 1- to 8-Hz muscle
      contractions, even though the passive mechanical properties (circumference
      passive wall tension relationships) were similar between groups. Vascular casts
      demonstrated a trend for an increase in the number of small (3A) arterioles and
      an approximately 20% increase in the passive diameter of 1A and 2A arterioles in
      the spinotrapezius muscle of TR rats. In contrast, in the gracilis muscle,
      arteriole diameters and density were identical in SED and TR rats, but the
      capillary-to-muscle fiber ratio was approximately 15% higher in TR rats. The
      results suggest that aerobic exercise training can greatly increase functional
      vasodilation and induce a slight increase in vascular density in skeletal muscle
      tissues, even if the oxidative capacity of these tissues is not increased by the
      training regimen.

PMID- 1629057
TI  - Measurements of volume changes and venous pressure in the human lower leg during
      walking and running.
AB  - This study investigates whether walking or running prevents the formation of
      edema in the lower leg. In 18 volunteers changes in calf volume were measured
      using strain gauge plethysmography during slow (3 km/h) and fast (6 km/h) walking
      or running (10 km/h) on a treadmill for 20 min each. Venous pressure was measured
      in a superficial vein near the ankle. Low-pass filtering removed motion artifacts
      from the signals. Slow walking reduced the calf volume in a biphasic manner: a
      rapid decrease was followed by a slow decline, lasting from about minute 2 to
      minute 20, its mean rate being -0.073%/min. Besides a rapid initial decrease, no
      significant change was observed during fast walking. During running, the calf
      volume first increased within 7 min to a maximum of 2.5% and subsequently
      decreased with a mean rate of -0.096%/min. The medians of venous pressure were
      84.0, 23.5, 30.4, and 29.5 mmHg during quiet standing, slow and fast walking, and
      running, respectively. The experimental results prove the hypothesis that walking
      prevents dependent edema formation. This effect, however, cannot be fully
      explained by the lowered venous pressures.

PMID- 1629058
TI  - Relationship between quasi-static pulmonary hysteresis and maximal airway
      narrowing in humans.
AB  - Two groups of subjects were studied: one with (group 1: 5 healthy and 4 mildly
      asthmatic subjects) and another without (group 2:9 moderately and severely
      asthmatic subjects) a plateau of response to methacholine (MCh). We determined
      the effect of deep inhalation by comparing expiratory flows at 40% of forced
      vital capacity from maximal and partial flow-volume curves (MEF40M/P) and the
      quasi-static transpulmonary pressure-volume (Ptp-V) area. In group 1, MEF40M/P
      increased from 1.58 +/- 0.23 (SE) at baseline up to a maximum of 3.91 +/- 0.69
      after MCh when forced expiratory volume in 1 s (FEV1) was decreased on plateau by
      24 +/- 2%. The plateau of FEV1 was always paralleled by a plateau of MEF40M/P. In
      group 2, MEF40 M/P increased from 1.58 +/- 0.10 at baseline up to a maximum of
      3.48 +/- 0.26 after MCh when FEV1 was decreased by 31 +/- 3% and then decreased
      to 2.42 +/- 0.24 when FEV1 was decreased by 46 +/- 2%. Ptp-V area was similar in
      the two groups at baseline yet was increased by 122 +/- 9% in group 2 and
      unchanged in group 1 at MCh end point. These findings suggest that the increased
      maximal response to MCh in asthmatic subjects is associated with an involvement
      of the lung periphery.

PMID- 1629059
TI  - Spontaneous resolution of pulmonary edema caused by short periods of cyclic
      overinflation.
AB  - Mechanical ventilation with high or even moderate peak inspiratory pressure
      produces pulmonary permeability edema. Besides the level of overinflation,
      duration may affect both severity and type of edema. We studied the effect of 2
      min of 35-mmHg peak pressure mechanical ventilation (HV) on microvascular
      permeability and deep lung fluid balance in rats. It resulted in increased
      extravascular lung water (+50%), bloodless dry lung weight (+25%), and albumin
      uptake in lungs (+450%). The increase in dry lung weight and albumin uptake
      compared with that of lung water suggested major permeability alterations.
      Ultrastructural examination showed the presence of numerous endothelial blebs.
      Epithelial lining fluid (ELF) volume, its potassium and protein concentrations,
      and cellular composition were assessed by bronchoalveolar lavage. There was an
      increase in ELF volume (+180%), a decrease in ELF potassium concentration (-50%),
      and an increase in ELF protein content (+76%). A few blood cells were recovered,
      suggesting the presence of a few large epithelial breaks. Some animals were
      allowed to recover for periods less than or equal to 180 min after HV.
      Extravascular lung water, dry lung weight, and albumin distribution space
      returned to control levels within 45 min. ELF volume diminished but remained
      larger than in controls, and ELF protein concentration increased probably because
      of alveolar fluid resorption. No further hemorrhage was observed. These results
      indicate that periods of HV as short as 2 min transiently alter microvascular
      permeability in rats.

PMID- 1629061
TI  - Thermoregulatory, cardiovascular, and psychophysical response to alcohol in men
      in 40 degrees C water.
AB  - The goals of the study were to test the hypotheses that ethyl alcohol (ETOH) in
      low-to-moderate doses would alter thermo-regulation and/or disrupt the normal
      relationship between physiological and psychophysical indexes of heat stress
      during 40 degrees C water immersion and to characterize the cardiovascular
      response to the combined stimuli of heat, water immersion, and ETOH. Six healthy
      men underwent three trials of 21 min of immersion in water at 40.0 +/- 0.1
      degrees C after consuming 0, 0.27, or 0.54 g ETOH/kg. Esophageal temperature
      (Tes) rose by approximately 1.0 degrees C during immersion for each trial. Per
      unit of Tes rise, changes during immersion in skin temperature, sweat rate, heart
      rate, systolic and diastolic blood pressure, and psychophysical assessments of
      comfort and overheating did not differ significantly by trial. Across trials,
      there was an apparent threshold for activation of thermoregulatory responses at
      an approximately 0.5 degrees C increase in Tes occurring after approximately 9
      min of immersion. This threshold was identified psychophysically by increased
      ratings of overheating and decreased comfort. Above the threshold, there was an
      attenuation of the rate of increase of Tes. Cardiovascular stress was mild (rate
      pressure product approximately 12,000) and not significantly increased by ETOH.
      Hypotension and tachycardia when subjects stood to exit the tub were observed.
      The data suggest that ETOH at the doses administered does not affect
      thermoregulatory, cardiovascular, or psychophysical indexes of heat stress during
      40 degrees C water immersion.

PMID- 1629062
TI  - Rapidly alternating curvature ("oil canning") as a mechanism preventing alveolar
      edema.
AB  - This study has been designed to investigate the concept that the passage of red
      blood cells (clearly seen "bulging" into the air space in all scanning electron
      micrographs of the alveolar surface) can produce a net force tending to return
      any excess fluid to the interstitium. Measurements of surface tension over the
      time frame and probable surface area excursion incurred by a passing red blood
      cell show an appreciably higher value corresponding to the expanding surface,
      which is convex with respect to air, than when it is compressing and concave. The
      mean difference in surface tension of about 16 dyn/cm (mN/m) translates into a
      net driving force of approximately 6 mmHg induced by this rapidly alternating
      microcurvature reflecting the highly dynamic state of the living alveolar wall.
      The significance of the microcurvature of the alveolar surface is emphasized in
      relation to surfactant function.

PMID- 1629060
TI  - Bronchial vasodilation by histamine in sheep: characterization of receptor
      subtype.
AB  - Histamine has been shown to mediate features of pulmonary allergic reactions
      including increased tracheobronchial blood flow. To determine whether the
      increase in blood flow was due to stimulation of H1- or H2-histamine receptors,
      we gave histamine base (0.1 micrograms/kg iv) or histamine dihydrochloride as an
      aerosol (10 breaths of 0.5% "low dose" or 5% "high dose") before and after H1- or
      H2-receptor antagonists. Blood velocity in the common bronchial branch of the
      bronchoesophageal artery (Vbr) was continuously measured using a chronically
      implanted Doppler flow probe. Pretreatment with H2-receptor antagonists
      cimetidine, ranitidine, or metiamide did not affect the increase in Vbr induced
      by intravenous histamine [106 +/- 45% (SD)]. Addition of the H1-receptor
      antagonists diphenhydramine or chlorpheniramine, however, reduced the Vbr
      response to 16 +/- 22, 21 +/- 28, 23 +/- 23, and 37 +/- 32% of the unblocked
      responses (P less than 0.05) when intravenous histamine was given at 3, 10, 20,
      and 30 min, respectively, after the H1 antagonist. At 40, 50, and 60 min the H1
      receptor blockade appeared to attenuate, but subsequent continuous infusion of
      chlorpheniramine (2 mg.kg-1.min-1) then blocked the histamine response for 60
      min. Low-dose histamine aerosol did not change mean arterial or pulmonary
      arterial pressures, cardiac output, or arterial blood gases but increased Vbr
      transiently from 15.2 +/- 3.4 to 37.6 +/- 8.4 (SE) cm/s. After chlorpheniramine,
      the Vbr response to histamine, 16.3 +/- 2.2 to 22.6 +/- 3.6 cm/s, was
      significantly reduced (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629063
TI  - Diurnal variations in serum erythropoietin levels in healthy subjects and sleep
      apnea patients.
AB  - We measured arterial oxygen saturation (SaO2) and serum erythropoietin (EPO)
      levels in patients with obstructive sleep apnea syndrome (OSAS) and in healthy
      subjects. SaO2 profile was analyzed as the cumulative distribution of SaO2 over
      time. OSAS patients spent 25.5 +/- 30.9% (SD) of the time at SaO2 of less than
      88% vs. 0.64 +/- 1.6% in healthy subjects (P less than 0.05) and had 59 +/- 25
      desaturations (greater than 4%) per hour vs. less than 5 per hour in healthy
      subjects (P less than 0.05). EPO measurements (radioimmunoassay) were made in
      blood samples withdrawn every 1 or 2 h over a 24-h period. The mean EPO
      concentration was higher (P less than 0.05) for OSAS patients (45 +/- 33 mU/ml)
      than for normal subjects (17 +/- 8 mU/ml). There was a significant variability in
      EPO values over the 24-h period. To analyze the EPO pattern over 24 h, EPO time
      series were fit to a general cosine function. Data from normal subjects conformed
      to a cosine function with an amplitude of 3.5 +/- 2.1 (CV of 60%) and an
      acrophase of 1,000 +/- 184 min after 0800 (CV of 18%), indicating a zenith about
      1 A.M. and a nadir around 1 P.M. Data from OSAS subjects fit a similar cosine
      function with an amplitude of 19.9 +/- 41.0 (CV of 206%) and acrophase of 582 +/-
      408 min (CV of 70%), indicating a greater variability in the magnitude and the
      timing of peak serum EPO levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629064
TI  - Pulmonary vascular impedance and wave reflections in the hypoxic calf.
AB  - The alterations in pulsatile hemodynamics that occur during hypoxic pulmonary
      vasoconstriction have not been well characterized. Changes in oscillatory
      hemodynamics, however, may affect right ventricular-pulmonary vascular coupling
      and the dissipation of energy within the lung vasculature. To better define
      hypoxic pulsatile hemodynamics, we measured main pulmonary artery proximal and
      distal micromanometric pressures and ultrasonic flow in four open-chest calves
      during progressive hypoxia. Main pulmonary artery impedance and pressure
      transmission spectra were calculated using spectral analysis methods. Measured
      pressure and flow signals were separated in the time domain into forward and
      backward components. Hypoxia increased pulmonary blood pressure and resistance
      and produced multiple modifications in the impedance and pressure transmission
      spectra that indicated increased wave reflections and elasticity. The impedance
      and apparent phase velocity first-harmonic values were increased in amplitude,
      and the pressure transmission modulus plot showed an increased peak value. In
      addition, the impedance modulus plot demonstrated a rightward shift and increased
      oscillation in the mid- to high-frequency range. The time domain analysis also
      confirmed increased wave reflections and elasticity. Hypoxia produced large
      backward-traveling (reflected) pressure and flow waves. The initial portions of
      these waves arrived at the heart during systole, producing characteristic changes
      in the measured pressure and flow waveforms. With prolonged hypoxia, main
      pulmonary artery pulse wave velocity increased by 30%. Thus, hypoxia is
      associated with complex alterations in pulmonary artery elasticity and wave
      reflections that act to increase the oscillatory afterload of the right
      ventricle.

PMID- 1629065
TI  - Influence of airway resistance on hypoxia-induced periodic breathing.
AB  - We studied the effects of changing upper airway pressure on the variability of
      the dynamic response of ventilation to a hypoxic disturbance in 11 spontaneously
      breathing dogs. Supralaryngeal pressure, instantaneous inspiratory flow, end
      expiratory lung volume, and the inspiratory and expiratory O2 and CO2
      concentrations were continuously recorded at baseline and after a 1.5-min hypoxic
      stimulus (abrupt normoxic recovery). Arterial blood gases were obtained at
      baseline, at the end of the hypoxic period, and after 1 min of recovery. Airway
      resistances were modified during the recovery by changing the composition of the
      inspired gas (all with an inspiratory O2 fraction of 20.9%) among four different
      trials: two trials were realized with air (density 1.12 g/l), and the other two
      were with He or SF6 (respective density 0.42 and 4.20) in random order. There was
      no difference between baseline minute ventilation, arterial blood gases, and
      supralaryngeal resistance values preceding the trials. The hypoxemic and
      hypocapnic levels and the hypoxia-induced hyperventilation reached during the
      hypoxic tests were identical for the different hypoxic stimuli. The
      supralaryngeal resistance measured at peak flow was dramatically influenced by
      the composition of the inspired gas: 8.8 +/- 1.8 and 6.9 +/- 1.7 (SE) cmH2O.l-1.s
      with air, 7.2 +/- 2.2 with He, 21.9 +/- 5.5 with SF6 (P less than 0.05).
      Ventilatory fluctuations were consistently seen during the posthypoxic period.
      They were characterized by a strength index value (M) (Waggener et al. J. Appl.
      Physiol. 56: 576-581, 1984).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629066
TI  - Human cold air habituation is independent of thyroxine and thyrotropin.
AB  - Thyroxine (T4) is required in species possessing brown adipose tissue (BAT) for
      the maintenance of cold tolerance and adaptation. In humans, who possess
      negligible quantities of BAT, the importance of T4 has not been demonstrated. We
      studied the effects of decreased serum T4 and thyrotropin (TSH) on human cold
      habituation after repeated cold air exposures. Eight men (T3+) received a single
      daily dose of triiodothyronine (T3; 30 micrograms/day), and another eight men (T3
      ) received a placebo. All 16 normal thyroid men underwent a standardized cold air
      test (SCAT) under basal conditions in January and again in March after eighty 30
      min 4.4 degrees C air exposures (10/wk). Measurements of basal metabolic rate
      (BMR), O2 consumption (VO2), mean arterial pressure (MAP), plasma norepinephrine
      (NE), serum TSH, free and total T4, and free and total T3 were repeated before
      and after 8 wk of exposure. TSH, free T4, and total T4 were 50% lower for T3+
      than for T3- subjects. Total and free T3 were not different between groups. BMR
      was unchanged after habituation, whereas the cold-stimulated VO2, MAP, and NE
      were significantly reduced for all subjects in March. The relationship between
      VO2 and NE (r2 = 0.44, P less than 0.001) during the initial SCAT was unchanged
      with habituation. We suggest that human cold habituation is independent of major
      changes in circulating T4 and TSH.

PMID- 1629067
TI  - Anesthetic effects on pulmonary allergic responses in rats: changes in
      sensitivity to serotonin.
AB  - Subsequent to observations that pulmonary responses to antigen challenge are of
      different magnitudes in sensitized rats that are anesthetized with different
      drugs, we conducted studies to test whether the alterations in responses were due
      to changes in airway responsiveness to cholinergic or serotonergic challenge,
      opioid-receptor mediated events, or changes in mast cell mediator release.
      Immunoglobulin E-sensitized rats anesthetized with ketamine/urethan had larger
      changes in lung resistance and plasma histamine after pulmonary antigen challenge
      compared with rats anesthetized with fentanyl-droperidol. Blockade of opioid
      receptors with naloxone did not affect the responses. In unsensitized rats,
      airway responses to aerosolized methacholine were similar for the two
      anesthetics, indicating unchanged smooth muscle responsiveness; however, airway
      responses to intravenous serotonin were enhanced by ketamine and ablated by
      droperidol. We conclude that ketamine- and droperidol-induced alterations of
      pulmonary allergic responses are due to changes in sensitivity to serotonin and
      in mast cell mediator release. We speculate that mast cell mediator release may
      be modulated by a serotonin receptor-linked mechanism.

PMID- 1629068
TI  - Antagonists of EDRF attenuate acetylcholine-induced vasodilation in isolated
      hamster lungs.
AB  - To evaluate the role of endothelium-dependent relaxing factor (EDRF) in
      acetylcholine- (ACh) induced vasodilation in the intact pulmonary circulation, we
      examined the effects of atropine and three EDRF antagonists that have been shown
      to be effective in vitro: nitro-L-arginine (NOARG), hemoglobin (Hb), and
      methylene blue (MB). We studied ACh-induced dilation after preconstriction with
      angiotensin II and prostaglandin F2 alpha (PGF2 alpha) in hamster lungs perfused
      with Krebs solution containing Ficoll (4 g/dl) and indomethacin (10 microM). In
      the constricted lungs with no blockers, infusion of ACh (1 microM) decreased the
      constriction by 67%, and this effect was completely abolished by atropine
      pretreatment (1 microM). Treatment of hamster lungs with each of the three EDRF
      blockers, NOARG (30 microM), Hb (10 microM), and MB (250 microM), augmented the
      pressor responses to angiotensin II and PGF2 alpha. However, NOARG and MB
      inhibited the ACh-induced dilation by 49 and 60%, respectively, without affecting
      vasodilatory responses to isoproterenol, an agent that relaxes vascular smooth
      muscle independent of EDRF synthesis. In contrast, Hb significantly inhibited
      both ACh- and isoproterenol-induced vasodilations. Because all these EDRF
      antagonists attenuated ACh-induced vasodilation in intact hamster lungs, we
      conclude that EDRF plays a role in this response. Nonselective inhibitory effects
      of Hb in hamster lungs, however, suggest that mechanisms other than inhibition of
      EDRF by this agent are also involved.

PMID- 1629069
TI  - Elevated muscle vitamin E does not attenuate eccentric exercise-induced muscle
      injury.
AB  - The purpose of this study was to evaluate the effect of elevated muscle vitamin E
      content on skeletal muscle damage from eccentric exercise. Sixty Sprague-Dawley
      rats were put on a normal (40 IU vitamin E/kg food) or supplemented (10,000 IU
      vitamin E/kg food) diet for 5 wk. Injury in soleus muscle was determined using
      several criteria: reductions in maximal tetanic force and number of intact fibers
      per square millimeter and elevations in muscle glucose 6-phosphate dehydrogenase
      activity and plasma creatine kinase activity, either immediately (0 h) or 2 days
      (48 h) after a downhill walking protocol. Sedentary animals were also tested but
      did not exercise. Muscle vitamin E levels were significantly elevated
      (approximately 3- to 4-fold), and susceptibility of the muscles to oxidant stress
      was decreased, after supplementation. However, vitamin E supplementation did not
      attenuate injury by any of the criteria employed. Maximal tetanic force decreased
      approximately 20% at 0 and 48 h after exercise in both groups. The number of
      intact fibers per square millimeter decreased approximately 30-35% in both groups
      at 0 and 48 h. Glucose 6-phosphate dehydrogenase activity increased approximately
      50-100% in both groups at 48 h, and plasma creatine kinase activity was elevated
      approximately 2- to 2.5-fold at 0 h in both groups. These findings do not support
      a major role for free radical damage to muscle membranes in the initiation of
      injury from eccentric exercise, although they do not disprove free radical
      involvement in the etiology.

PMID- 1629070
TI  - Extracorporeal circulation in the isolated in situ lamb placenta: hemodynamic
      characteristics.
AB  - Decreased placental perfusion and respiratory gas exchange have been observed
      after experimental fetal cardiopulmonary bypass (CPB). To better characterize
      placental hemodynamics during CPB, seven isolated in situ lamb placentas were
      placed on a CPB circuit by use of umbilical arterial and venous cannulation.
      Measures were taken to simulate normal placental hemodynamics. Perfusion flow
      rates were varied from 15 to 300 ml.min-1.kg fetal wt-1 during normothermia and
      hypothermia. Placental vascular resistance (PVR) remained constant when perfusion
      pressure and flow were varied above 40 mmHg and 150 ml.min-1.kg-1, respectively.
      Below these values, PVR varied inversely. This increase in PVR was more marked
      when CPB was performed with hypothermia than with normothermia. The clinical
      implication is that decreased placental flow and pressure on CPB may lead to a
      vicious cycle, resulting in further impairment of placental perfusion and
      respiratory gas exchange. Hypothermia promotes this impairment.

PMID- 1629071
TI  - Use of bioelectrical impedance to assess body composition changes at high
      altitude.
AB  - This study determined the feasibility of using bioelectrical impedance analysis
      (BIA) to assess body composition alterations associated with body weight (BW)
      loss at high altitude. The BIA method was also evaluated relative to
      anthropometric assessments. Height, BW, BIA, skinfold (SF, 6 sites), and
      circumference (CIR, 5 sites) measurements were obtained from 16 males (23-35 yr)
      before, during, and after 16 days of residence at 3,700-4,300 m. Hydrostatic
      weighings (HW) were performed pre- and postaltitude. Results of 13 previously
      derived prediction equations using various combinations of height, BW, age, BIA,
      SF, or CIR measurements as independent variables to predict fat-free mass (FFM),
      fat mass (FM), and percent body fat (%Fat) were compared with HW. Mean BW
      decreased from 84.74 to 78.84 kg (P less than 0.01). As determined by HW, FFM
      decreased by 2.44 kg (P less than 0.01), FM by 3.46 kg (P less than 0.01), and
      %Fat by 3.02% (P less than 0.01). The BIA and SF methods overestimated the loss
      in FFM and underestimated the losses in FM and %Fat (P less than 0.01). Only the
      equations utilizing the CIR measurements did not differ from HW values for
      changes in FFM, FM, and %Fat. It was concluded that the BIA and SF methods were
      not acceptable for assessing body composition changes at altitude.

PMID- 1629072
TI  - Endurance training amplifies the pulsatile release of growth hormone: effects of
      training intensity.
AB  - The effects of intensity of run training on the pulsatile release of growth
      hormone (GH) were investigated in 21 eumenorrheic untrained women. The O2
      consumption (VO2) at the lactate threshold (LT); fixed blood lactate
      concentrations (FBLC) of 2.0, 2.5, and 4.0 mM; peak VO2; maximal VO2; body
      composition; and pulsatile release of GH were measured. Subjects in both the at
      lactate threshold (/LT, n = 9) and above-lactate threshold (greater than LT, n =
      7) training groups increased VO2 at LT and FBLC of 2.0, 2.5, and 4.0 mM and
      VO2max after 1 yr of run training. However, the increase observed in the greater
      than LT group was greater than that in the /LT group (P less than 0.05). No
      change was observed for the control group (n = 5). No among- or within-group
      differences were observed for body weight, although trends for reductions in
      percent body fat (P less than 0.06) and fat weight (P less than 0.15) were
      observed in the greater than LT group, and both training groups significantly
      increased fat-free weight (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629073
TI  - Eccentric exercise induces transient insulin resistance in healthy individuals.
AB  - Euglycemic-hyperinsulinemic clamps were performed on six healthy untrained
      individuals to determine whether exercise that induces muscle damage also results
      in insulin resistance. Clamps were performed 48 h after bouts of predominantly 1)
      eccentric exercise [30 min, downhill running, -17% grade, 60 +/- 2% maximal O2
      consumption (VO2max)], 2) concentric exercise (30 min, cycle ergometry, 60 +/- 2%
      VO2max), or 3) without prior exercise. During the clamps, euglycemia was
      maintained at 90 mg/dl while insulin was infused at 30 mU.m-2.min-1 for 120 min.
      Hepatic glucose output (HGO) was determined using [6,6-2H]glucose. Eccentric
      exercise caused marked muscle soreness and significantly elevated creatine kinase
      levels (273 +/- 73, 92 +/- 27, 87 +/- 25 IU/l for the eccentric, concentric, and
      control conditions, respectively) 48 h after exercise. Insulin-mediated glucose
      disposal rate was significantly impaired (P less than 0.05) during the clamp
      performed after eccentric exercise (3.47 +/- 0.51 mg.kg-1.min-1) compared with
      the clamps performed after concentric exercise (5.55 +/- 0.94 mg.kg-1.min-1) or
      control conditions (5.48 +/- 1.0 mg.kg-1.min-1). HGO was not significantly
      different among conditions (0.77 +/- 0.26, 0.65 +/- 0.27, and 0.66 +/- 0.64 mg.kg
      1.min-1 for the eccentric, concentric, and control clamps, respectively). The
      insulin resistance observed after eccentric exercise could not be attributed to
      altered plasma cortisol, glucagon, or catecholamine concentrations. Likewise, no
      differences were observed in serum free fatty acids, glycerol, lactate, beta
      hydroxybutyrate, or alanine. These results show that exercise that results in
      muscle damage, as reflected in muscle soreness and enzyme leakage, is followed by
      a period of insulin resistance.

PMID- 1629074
TI  - Effect of prior exercise and insulin on potential thermogenic systems in rat
      skeletal muscle.
AB  - We previously reported that insulin stimulates oxygen consumption by the perfused
      rat hindquarter after high-intensity exercise. The purpose of the present study
      was to examine whether fructose 6-phosphate-fructose 1,6-bisphosphate cycling or
      an uncoupling of mitochondrial respiration contributes to this phenomenon.
      Hindquarter skeletal muscle was analyzed after perfusion in the absence or
      presence of insulin (150-200 microU/ml) for high-energy phosphate content,
      fructose 6-phosphate-fructose 1,6-bisphosphate cycling of glucose before
      incorporation into glycogen, and mitochondrial respiratory control. Muscle from
      exercised rats perfused with insulin did not display greater rates of glucose
      cycling or mitochondrial uncoupling; in fact, insulin decreased the rate of
      fructose 6-phosphate cycling and tended to increase respiratory control in
      skeletal muscle mitochondria. In addition, the concentrations of ATP and creatine
      phosphate and the calculated free ADP level in muscle of previously exercised
      rats perfused with insulin were similar to those of control rats. The results do
      not exclude the possibility that localized subcellular changes in ADP occurred,
      however. In conclusion, the results suggest that insulin-induced increases in
      other substrate cycles, ion transport systems, and/or as yet unidentified energy
      requiring processes account for the 25-30% increase in hindquarter oxygen
      consumption after intense exercise.

PMID- 1629075
TI  - Effect of hindlimb unweighting on tissue blood flow in the rat.
AB  - The purpose of this study was to characterize the distribution of blood flow in
      the rat during hindlimb unweighting (HU) and post-HU standing and exercise and
      examine whether the previously reported (Witzmann et al., J. Appl. Physiol. 54:
      1242-1248, 1983) elevation in anaerobic metabolism observed with contractile
      activity in the atrophied soleus muscle was caused by a reduced hindlimb blood
      flow. After either 15 days of HU or cage control, blood flow was measured with
      radioactive microspheres during unweighting, normal standing, and running on a
      treadmill (15 m/min). In another group of control and experimental animals, blood
      flow was measured during preexercise (PE) treadmill standing and treadmill
      running (15 m/min). Soleus muscle blood flow was not different between groups
      during unweighting, PE standing, and running at 15 m/min. Chronic unweighting
      resulted in the tendency for greater blood flow to muscles composed of
      predominantly fast-twitch glycolytic fibers. With exercise, blood flow to
      visceral organs was reduced compared with PE values in the control rats, whereas
      flow to visceral organs in 15-day HU animals was unaltered by exercise. These
      higher flows to the viscera and to muscles composed of predominantly fast-twitch
      glycolytic fibers suggest an apparent reduction in the ability of the sympathetic
      nervous system to distribute cardiac output after chronic HU. In conclusion,
      because 15 days of HU did not affect blood flow to the soleus during exercise,
      the increased dependence of the atrophied soleus on anerobic energy production
      during contractile activity cannot be explained by a reduced muscle blood flow.

PMID- 1629076
TI  - In vivo effects of Escherichia coli endotoxemia on diaphragmatic microcirculation
      in rats.
AB  - We investigated the effects of Escherichia coli endotoxin administration on
      diaphragmatic microcirculation in rats by in vivo videomicroscopy. Rats were
      allocated into three groups: 1) intravenous inoculation of 10 mg/kg of E. col
      endotoxin (group E, n = 25), 2) intravenous inoculation of sterile 0.9% NaCl
      (group C, n = 20), and 3) induction of a controlled hemorrhage by reducing the
      vascular volume via an arterial catheter (group H, n = 15). Mean blood pressure
      (BP) and arteriolar diameters were measured at 15-min intervals and capillary
      perfusion pattern at 30-min intervals for 1 h. BP decreased similarly in groups E
      and H, whereas it was maintained in group C. Arterioles were classified as second
      (A2, n = 46), third (A3, n = 22), and fourth (A4, n = 21) order, according to
      their relative localization in the network. Basal diameters were the same in the
      three groups: 38.16, 17.33, and 6.80 microns in group C; 38.17, 17.41, and 7.04
      microns in group E; and 37.82, 19.19, and 6.99 microns in group H for A2, A3, and
      A4, respectively. During the observation period, a significant and similar
      vasoconstriction of A2 arterioles was observed in groups E and H but not in group
      C. By contrast, in the three groups, no significant changes in diameter were
      found for the A3 and A4 arterioles. Capillary perfusion was markedly impaired in
      group E: at 60 min the percentage of non-perfused capillaries was 40.92 +/- 6.65%
      in group E compared with 21.17 +/- 5.45% in group C (P less than 0.05) and 18.18
      +/- 8.11% in group H (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629077
TI  - A fractal continuum model of the pulmonary arterial tree.
AB  - The extant morphometric data from the intrapulmonary arteries of dog, human, and
      cat lungs produce graphs of the log of the vessel number, (N) or length (l) in
      each level vs. the log of the mean diameter (D) in each level that are
      sufficiently linear to suggest that a scale-independent self-similar or fractal
      structure may underlie the observed relationships. These data can be correlated
      by the following formulas: Nj = a1Dj-beta 1, and lj = a2Dj beta 2, where j
      denotes the level (order or generation) number measured from the largest vessel
      at the entrance to the arterial tree to the smallest vessel at the entrance to
      the capillary bed. With the hemodynamic resistance (R) represented by Rj = 128
      microliterj/(Nj pi Dj4) and the vascular volume (Q) by Qj = Nj pi Dj2lj/4, the
      continuous cumulative distribution of vascular resistance (Rcum) vs. cumulative
      vascular volume (Qcum) (where Rcum and Qcum represent the total resistance or
      volume, respectively, upstream from the jth level) can be calculated from
      [formula: see text] where r = Dj/Dj+1 is a constant independent of j. Analogous
      equations are developed for the inertance and compliance distributions, providing
      simple formulas to represent the hemodynamic consequences of the pulmonary
      arterial tree structure.

PMID- 1629078
TI  - Brain adaptation to chronic hypobaric hypoxia in rats.
AB  - Rats were exposed to hypobaric hypoxia (0.5 atm) for up to 3 wk. Hypoxic rats
      failed to gain weight but maintained normal brain water and ion content. Blood
      hematocrit was increased by 48% to a level of 71% after 3 wk of hypoxia compared
      with littermate controls. Brain blood flow was increased by an average of 38% in
      rats exposed to 15 min of 10% normobaric oxygen and by 23% after 3 h but was not
      different from normobaric normoxic rats after 3 wk of hypoxia. Sucrose space, as
      a measure of brain plasma volume, was not changed under any hypoxic conditions.
      The mean brain microvessel density was increased by 76% in the frontopolar
      cerebral cortex, 46% in the frontal motor cortex, 54% in the frontal sensory
      cortex, 65% in the parietal motor cortex, 68% in the parietal sensory cortex, 68%
      in the hippocampal CA1 region, 57% in the hippocampal CA3 region, 26% in the
      striatum, and 56% in the cerebellum. The results indicate that hypoxia elicits
      three main responses that affect brain oxygen availability. The acute effect of
      hypoxia is an increase in regional blood flow, which returns to control levels on
      continued hypoxic exposure. Longer-term effects of continued moderate hypoxic
      exposure are erythropoiesis and a decrease in intercapillary distance as a result
      of angiogenesis. The rise in hematocrit and the increase in microvessel density
      together increase oxygen availability to the brain to within normal limits,
      although this does not imply that tissue PO2 is restored to normal.

PMID- 1629079
TI  - Dynamics of ventilation, circulation, and gas exchange to incremental and
      decremental ramp exercise.
AB  - Transient responses of minute volume (VE), O2 uptake (VO2), CO2 output (VCO2),
      heart rate (HR), and cardiac output (Q) to a step change and ramp changes with
      slopes ranging from 33.3 to 14.3 W/min were studied in five healthy human
      subjects over the load range from 25 to 125 W. The ramp responses were fitted to
      a first-order model with a pure time delay (td) and a time constant (TC), while
      most of the step responses fitted better to a second-order model, consisting of a
      fast and a slow component. No significant asymmetry was observed between the on-
      and off-responses to step forcing. The mean response time (MRT = td+TC) of the
      incremental ramp response was prolonged, whereas the MRT of the decremental ramp
      response was shortened or unchanged, with decreasing ramp slope. The asymmetry
      was commonly observed in respiratory and gas exchange variables and, to a lesser
      extent, also in circulatory variables. Neural and humoral factors that might be
      responsible for this phenomenon are discussed.

PMID- 1629080
TI  - Effect of aspartic acid on control of ventilation in androgenized and
      ovariectomized female rats.
AB  - Previously we observed that acute subcutaneous administration of aspartic acid
      (580 mg/kg) depressed ventilation in awake male, but not female, rats, suggesting
      that this agent may be used as a marker for sexual dimorphism in the control of
      ventilation. Moreover, males castrated postpubertally showed a response similar
      to that of intact male rats. Thus the hormonal milieu of male rats appear not to
      be necessary to elicit the masculine type of ventilatory response to aspartic
      acid. The purpose of this study was 1) to determine whether adult female rats
      androgenized by the administration of testosterone propionate (TP) 1 day after
      birth would alter their ventilation in response to aspartic acid to be more
      malelike and 2) to compare these results with those of intact (I) and
      ovariectomized (O) female rats. Minute ventilation and O2 consumption in air and
      in response to aspartic acid administration were evaluated in awake animals in
      all three groups. Furthermore the minute ventilation of all rats to a hypercapnic
      challenge was also evaluated. Ovariectomy resulted in rats increased body weights
      but decreased weight-corrected ventilation and O2 consumption compared with TP
      treated and I animals. Minute ventilation after hypercapnic challenge in the
      three groups was similar. TP-treated rats responded to aspartic acid
      administration with a marked depression of ventilation similar to that previously
      noted in males, whereas neither I nor O rats showed such a response. The
      depression of ventilation in the TP-treated group in response to aspartic acid
      was not a consequence of a depression of O2 consumption.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1629081
TI  - Intracellular pH and oxygen chemoreception in the cat carotid body in vitro.
AB  - To test the hypothesis that O2 chemoreception in the carotid body (CB) is
      mediated by cellular acidosis, we simultaneously measured responses of the
      chemosensory and intracellular pH (pHi) to agents that are known to change pHi
      and studied the effects of hypoxia and ischemia on these variables in the cat CB.
      The CB was perfused and superfused in vitro with a modified Tyrode's solution at
      36.0 +/- 0.5 degrees C with or without CO2-HCO3- (pH 7.40) and equilibrated at a
      given PO2. Chemosensory discharges were recorded from the whole carotid sinus
      nerve. To measure pHi changes, the CB was loaded with the pH-sensitive indicator
      2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein, and the fluorescence
      (excitation 420-490 nm, emission greater than 515 nm) was detected by an
      intensified charged coupled device camera with an epifluorescence macroscope.
      Boluses of Tyrode's solution (0.5 ml, free of CO2-HCO3-) containing sodium
      acetate or NH4Cl prolonged perfusion of acid Tyrode's solution (pH 7.20-6.50),
      and boluses of Tyrode's solution with CO2-HCO3- were used. A decrease of
      fluorescence indicated pHi turning acid, and an increase of fluorescence
      indicated a change in alkaline pHi. Chemosensory activity varied inversely with
      the fluorescence change after application of these agents. Interruption of
      perfusate flow or application of hypoxic perfusate resulted in large increases in
      chemosensory discharge without any change in the fluorescence. The results
      indicated that chemosensory responses to brief ischemia and hypoxia were not
      mediated by a fall of pHi of CB cells, whereas those to CO2 and extracellular
      acidity were associated with decreases in pHi.

PMID- 1629082
TI  - Mechanism of detection of resistive loads in conscious humans.
AB  - Conscious humans easily detect loads applied to the respiratory system. Resistive
      loads as small as 0.5 cmH2O.l-1.s can be detected. Previous work suggested that
      afferent information from the chest wall served as the primary source of
      information for load detection, but the evidence for this was not convincing, and
      we recently reported that the chest wall was a relatively poor detector for
      applied elastic loads. Using the same setup of a loading device and body cast, we
      sought resistive load detection thresholds under three conditions: 1) loading of
      the total respiratory system, 2) loading such that the chest wall was protected
      from the load but airway and intrathoracic pressures experienced negative
      pressure in proportion to inspiratory flow, and 3) loading of the chest wall
      alone with no alteration of airway or intrathoracic pressure. The threshold for
      detection for the three types of load application in seven normal subjects was
      1.17 +/- 0.33, 1.68 +/- 0.45, and 6.3 +/- 1.38 (SE) cmH2O.l-1.s for total
      respiratory system, chest wall protected, and chest wall alone, respectively. We
      conclude that the active chest wall is a less potent source of information for
      detection of applied resistive loads than structures affected by negative airway
      and intrathoracic pressure, a finding similar to that previously reported for
      elastic load detection.

PMID- 1629084
TI  - Dependence of muscle fatigue on stimulation protocol: effect of hypocaloric diet.
AB  - This study tested the hypothesis that the decreased resistance of skeletal
      muscles to fatigue after a period of inadequate nutrition is a consequence of the
      type of fatigue test employed. Rats (n = 8) were fed hypocalorically for 10 days,
      resulting in a 33.5 +/- 3.0% (SE) reduction in body weight. The fatigue
      resistance of muscles was assessed with use of isolated soleus muscles at a
      temperature of 25 degrees C. Fatigue resistance was determined from the decline
      in isometric force during a series of tetanic contractions. Two contrasting
      contraction protocols were devised to test the susceptibility of muscles to
      fatigue. One protocol was designed to require high rates of energy supply and
      hence force a dependence on glycolytic energy supply pathways. The second
      protocol required much lower rates of energy supply that could be entirely met by
      oxidative energy supply processes. During the high energy demand (glycolytic)
      protocol, the force produced by muscles from a control group of rats decreased to
      78.7 +/- 0.8% (n = 12 muscles) of the initial value. Hypocaloric feeding
      significantly reduced the resistance of muscles to fatigue: force declined to
      61.3 +/- 3.5% (n = 16 muscles) during the contraction protocol. In contrast, when
      fatigue was quantified using the low energy demand (oxidative) contraction
      protocol, the effect of nutritional status on fatigue resistance was entirely
      abolished. This result supports the hypothesis that resistance to fatigue is
      critically dependent on the fatigue test employed.

PMID- 1629083
TI  - Effect of Pseudomonas aeruginosa rhamnolipids on mucociliary transport and
      ciliary beating.
AB  - Pseudomonas aeruginosa rhamnolipid causes ciliostasis and cell membrane damage to
      rabbit tissue, is a secretagogue in cats, and inhibits epithelial ion transport
      in sheep tissue. It could therefore perturb mucociliary clearance. We have
      investigated the effect of rhamnolipid on mucociliary transport in the
      anesthetized guinea pig and guinea pig and human respiratory epithelium in vitro.
      Application of rhamnolipid to the guinea pig tracheal mucosa reduced tracheal
      mucus velocity (TMV) in vivo in a dose-dependent manner: a 10-microgram bolus
      caused cessation of TMV without recovery; a 5-micrograms bolus reduced TMV over a
      period of 2 h by 22.6% (P = 0.037); a 2.5-microgram bolus caused no overall
      changes in TMV. The ultrastructure of guinea pig tracheal epithelium exposed to
      10 micrograms of rhamnolipid in vivo was normal. Application of 1,000
      micrograms/ml rhamnolipid had no effect on the ciliary beat frequency (CBF) of
      guinea pig tracheal rings in vitro after 30 min, but 250 micrograms/ml stopped
      ciliary beating after 3 h. Treatment with 100 micrograms/ml rhamnolipid caused
      immediate slowing of the CBF (P less than 0.01) of human nasal brushings (n = 7),
      which was maintained for 4 h. Mono- and dirhamnolipid had equivalent effects. The
      CBF of human nasal turbinate organ culture was also slowed by 100 micrograms/ml
      rhamnolipid, but only after 4 h (CBF test, 9.87 +/- 0.41 Hz; control, 11.48 +/-
      0.27 Hz; P less than 0.05, n = 6), and there was subsequent recovery by 14
      h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629085
TI  - Electrical activation of expiratory muscles increases with time in pentobarbital
      anesthetized dogs.
AB  - Although the pentobarbital-anesthetized dog is often used as a model in studies
      of respiratory muscle activity during spontaneous breathing, there is no
      information regarding the stability of the pattern of breathing of this model
      over time. The electromyograms of several inspiratory and expiratory muscle
      groups were measured in six dogs over a 4-h period by use of chronically
      implanted electrodes. Anesthesia was induced with pentobarbital sodium (25 mg/kg
      iv), with supplemental doses to maintain constant plasma pentobarbital
      concentrations. Phasic electrical activity increased over time in the
      triangularis sterni, transversus abdominis, and external oblique muscles
      (expiratory muscles). The electrical activity of the costal diaphragm, crural
      diaphragm, and parasternal intercostal muscles (inspiratory muscles) was
      unchanged. These changes in electrical activity occurred despite stable plasma
      levels of pentobarbital and arterial PCO2. They were associated with changes in
      chest wall motion and an increased tidal volume with unchanged breathing
      frequency. We conclude that expiratory muscle groups are selectively activated
      with time in pentobarbital-anesthetized dogs lying supine. Therefore the duration
      of anesthesia is an important variable in studies using this model.

PMID- 1629086
TI  - Effects of pharyngeal lubrication on the opening of obstructed upper airway.
AB  - We examined the effect of electrical stimulation of the hypoglossal nerve and
      pharyngeal lubrication with artificial surfactant (Surfactant T-A) on the opening
      of obstructed upper airway in nine anesthetized supine dogs. The upper airway was
      isolated from the lower airway by transecting the cervical trachea. Upper airway
      obstruction was induced by applying constant negative pressures (5, 10, 20, and
      30 cmH2O) on the rostral cut end of the trachea. Peripheral cut ends of the
      hypoglossal nerves were electrically stimulated by square-wave pulses at various
      frequencies from 10 to 30 Hz (0.2-ms duration, 5-7 V), and the critical
      stimulating frequency necessary for opening the obstructed upper airway was
      measured at each driving pressure before and after pharyngeal lubrication with
      artificial surfactant. The critical stimulation frequency for upper airway
      opening significantly increased as upper airway pressure became more negative and
      significantly decreased with lubrication of the upper airway. These findings
      suggest that greater muscle tone of the genioglossus is needed to open the
      occluded upper airway with larger negative intraluminal pressure and that
      lubrication of the pharyngeal mucosa with artificial surfactant facilitates
      reopening of the upper airway.

PMID- 1629087
TI  - Alterations in diaphragmatic oxidative and antioxidant enzymes in the senescent
      Fischer 344 rat.
AB  - We investigated age-related changes in antioxidant, glycolytic, beta-oxidation,
      and tricarboxylic acid cycle enzyme activity in the diaphragm and plantaris
      muscle of female Fischer 344 rats. Tissue samples from the costal and crural
      diaphragm and plantaris muscle were obtained from 30 animals in the following age
      groups: 1) 6 mo old (n = 10), 2) 26 mo old (n = 10), and 3) 30 mo old (n = 10).
      Aging had no effect (P greater than 0.05) on the activities of citrate synthase
      (CS) and 3-hydroxyacyl-CoA dehydrogenase (HADH) in the costal or crural
      diaphragm. Similarly, no age-related differences existed (P greater than 0.05) in
      the crural diaphragm in lactate dehydrogenase (LDH) or glutathione peroxidase
      (GPX) activity. In contrast, the activities of LDH and GPX were significantly (P
      less than 0.05) higher in the costal diaphragm in the 30- than in the 6-mo old
      animals. In addition, the ratio of LDH to CS activity increased (P less than
      0.05) as a function of age in the costal diaphragm. Conversely, the ratio of CS
      to GPX activity in the costal diaphragm was lower (P less than 0.05) in the 30-
      than in the 6-mo old animals. No significant (P greater than 0.05) age-related
      differences existed in LDH-to-CS or CS-to-GPX activity ratios in the crural
      diaphragm. Finally, aging resulted in a significant decrease (P less than 0.05)
      in the activities of LDH, CS, and HADH in the plantaris muscle. These data
      demonstrate that, unlike many hindlimb locomotor muscles, the oxidative capacity
      of the Fischer 344 rat diaphragm does not decrease in old age.

PMID- 1629088
TI  - Effects of cricothyroid muscle contraction on upper airway flow dynamics in dogs.
AB  - We studied the effects of cricothyroid muscle (CT) contraction on upper airway
      flow dynamics in eight prone open-mouth anesthetized dogs. Animals were
      mechanically ventilated via a tracheostomy while a constant airflow (Vuaw) passed
      through the isolated upper airway. Nasal airflow (Vn) was monitored using a nasal
      mask and pneumotachograph. Bilateral CT contraction was induced by electrical
      stimulation of the external branches of the superior laryngeal nerves. During CT
      contraction with Vuaw of 100-443 ml/s in the inspiratory direction, total upper
      airway resistance (Ruaw) fell by 49.1 +/- 5.4% (SE) while supraglottic resistance
      fell by 63.6 +/- 3.6%; simultaneously Vn fell by 55.3 +/- 3.8% and Vuaw increased
      by 7.2 +/- 1.7%. Similar results were obtained when Vuaw was in the expiratory
      direction. In three dogs in which the attachments of the CT to either the thyroid
      or cricoid cartilage were severed, superior laryngeal nerve stimulation had no
      systematic effect on Ruaw. Because visual assessment during CT contraction
      consistently revealed dilation of the piriform recesses, we suggest that CT
      contraction is associated with pharyngeal dilation, which in open-mouth dogs
      (with overlapping soft palate and epiglottis) redistributes flow to the oral
      route with a net reduction in Ruaw. Thus the CT may have a respiratory role as a
      pharyngeal dilator.

PMID- 1629089
TI  - Relative intensity of muscular contraction during shivering.
AB  - The intensity of cold-induced shivering, quantified by surface electromyography
      (EMG) and then expressed as a function of the maximal myoelectrical activity
      (integrated EMG) obtained during a maximum voluntary contraction (MVC), was
      examined in this study in individuals classified by body fat. In addition, the
      relationship between shivering and metabolic rate (MR) and the relative
      contribution of various muscle groups to total heat production were studied. Ten
      seminude male volunteers, 5 LEAN (less than 11% body fat) and 5 NORM (greater
      than 15% body fat) were exposed to 10 degrees C air for 2 h. EMG of six muscle
      groups (pectoralis major, rectus abdominis, rectus femoris, gastrocnemius, biceps
      brachii, and brachioradialis) was measured and compared with the EMG of each
      muscle's MVC. A whole body index of shivering, determined from the mass-weighted
      intensity of shivering of each muscle group, was correlated with MR. After the
      initial few minutes of exposure, only the pectoralis major, rectus femoris, and
      biceps brachii continued to increase their intensity of shivering. Shivering
      intensity was higher in the central muscles, ranging from 5 to 16% of MVC
      compared with that in the peripheral muscles, which ranged from 1 to 4% of MVC.
      Shivering intensities were similar in the peripheral muscles for the LEAN and
      NORM groups, whereas differences occurred in the trunk muscles for the pectoralis
      major and rectus abdominis. The whole body index of shivering correlated
      significantly with each individual's increase in MR (r = 0.63-0.97).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1629090
TI  - Tissue and airway impedance of excised normal, senile, and emphysematous lungs.
AB  - We partitioned pulmonary resistance (RL) in excised normal, senile, and
      emphysematous human lungs at various distending pressures; peripheral resistance
      (Rp) was measured by means of retrograde catheters and lung tissue resistance
      (Rti) by means of pleural capsules. By subtracting Rp from RL and Rti from Rp, we
      obtained, respectively, central (Rcaw) and peripheral (Rpaw) airway resistance.
      We determined also lung volumes, the elastic recoil pressure-volume curve, and
      the forced expiratory volume in 1 s-to-vital capacity ratio (FEV1/VC). The
      functional data were related to morphometry: mean linear intercept (Lm), diameter
      (d), and density (n/cm2) of membranous bronchioles. In the three groups of lungs,
      Rti demonstrates a marked negative frequency dependence and increases with
      transplumonary pressure. In emphysematous lungs, the increase of RL is mainly due
      to an increase of Rpaw; in addition, Rcaw and Rti are higher than normal. In the
      group of senile lungs, airway resistances are within normal range, but Rti is
      slightly increased. FEV1/VC is related to Rpaw and elastic recoil pressure; Rpaw
      is related to d and n/cm2, and Rti is related to dynamic elastance and to Lm.

PMID- 1629091
TI  - Ventilatory and hematopoietic responses to chronic hypoxia in two rat strains.
AB  - Hilltop (H) and Madison (M) strains of Sprague-Dawley rats exhibit strikingly
      different susceptibilities to the effects of chronic altitude exposure. The H
      rats develop greater polycythemia, hypoxemia, and pulmonary hypertension. We
      studied ventilation, pulmonary gas exchange, tissue oxygenation, and hematologic
      adaptations in the two rat strains during a 50-day exposure to a simulated
      altitude (HA) of 5,500 m (18,000 ft). There were no strain differences among the
      variables we studied under sea level (SL) conditions. Within the first 14 days of
      hypoxic exposure, the only significant strain differences were that
      erythropoietin (EPO) rose much higher and erythroid activity was greater in the H
      rats, even though arterial Po2 and PCo2 (Pao2 and PaCo2, respectively), renal
      venous PO2 (Prvo2), and ventilation (VE) were equivalent in the two strains
      during this time. By day 14 at HA, the H rats had significantly higher erythroid
      activity, hematocrit (Hct), and EPO levels, significantly lower PaO2 and PrvO2,
      but equivalent VE and PaCO2. These changes persisted for the remainder of the
      exposure, except that the Hct continued to rise and the increase was greater in H
      rats. Despite the greater O2-carrying capacity of H rats in the later stages of
      hypoxic exposure, PaO2 and PrvO2 were significantly lower in H rats. There were
      no strain differences at either SL or HA in ventilatory responses to hypercapnia
      or hypoxia, in blood O2 affinity or 2,3-diphosphoglycerate, in extrarenal
      production of EPO, or in EPO clearance. We conclude that early in the hypoxic
      exposure the H rats produce more EPO at apparently equivalent levels of hypoxia,
      and this is the first step in the pathogenesis of the maladaptation to HA
      manifest by H rats. We find no consistent evidence that differences in VE
      contribute to the variable susceptibility to hypoxia in the two rat strains.

PMID- 1629092
TI  - Effect of hand heating by a warm air box on O2 consumption of the contralateral
      arm.
AB  - Arterialization of venous blood is often used in studying forearm metabolism.
      Astrup et al. [Am. J. Physiol. 255 (Endocrinol. Metab. 18): E572-E578, 1988]
      showed that heating of the hand by a warming blanket caused a redistribution of
      blood flow in the contralateral arm and thus introduced errors in forearm
      skeletal muscle flux calculations. The present study was undertaken to
      investigate how hand heating by a warm air box (60 degrees C) would affect
      metabolism and blood flow in the contralateral arm before and during 3 h after a
      glucose load. Eleven healthy volunteers (5 males, 6 females) underwent an oral
      glucose tolerance test (70 g) on two different occasions, one test with and one
      without heating of the contralateral hand, in random order. Heating the hand for
      30 min before glucose intake did not affect skin temperature, rectal temperature,
      deep venous oxygen saturation, forearm blood flow, or oxygen consumption of
      forearm skeletal muscle. Although, after the glucose load, heating significantly
      increased forearm blood flow (P less than 0.05), the integrated response after
      glucose was not significantly different between control and heating experiments
      [67 +/- 43 and 117 +/- 41 (SE) ml/100 ml tissue]. With both conditions, there was
      an increase in skin temperature (P less than 0.001, integrated response control:
      369 +/- 79 and heating: 416 +/- 203 degrees C) and oxygen consumption of forearm
      muscle (control: 290 +/- 73, P less than 0.05 and heating: 390 +/- 130 mumol/100
      ml, P less than 0.05) after glucose intake. These responses did not significantly
      differ between the conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629093
TI  - Postinspiratory neuronal activities during behavioral control, sleep, and
      wakefulness.
AB  - Cells that discharge in early expiration and inhibit other respiratory cells
      purportedly cause a separate phase of the respiratory cycle that has been named
      "postinspiration." Our objective was to study these postinspiratory cells in the
      intact unanesthetized cat during sleep, wakefulness, and behavioral inhibition of
      inspiration, but we were unable to find cells with strong and consistent activity
      confined to early expiration. Instead, we found that various cell types were
      active in early expiration. They included inspiratory-expiratory phase-spanning
      cells, retrofacial augmenting expiratory cells with bursts in early expiration,
      retrofacial decrementing expiratory cells, tonic expiratory cells, and cells with
      variable activity in the early part of expiration. Just as the cell types active
      during early expiration were heterogeneous so too were their activities during
      behavioral inhibition of inspiration and during sleep. These results suggest that
      the state of early expiration is determined by many different cell types rather
      than a single class of postinspiratory cells.

PMID- 1629094
TI  - Spatial correlation of regional pulmonary perfusion.
AB  - Despite the heterogeneous distribution of pulmonary blood flow, perfusion appears
      to be spatially ordered, with neighboring regions of lung having similar
      magnitudes of flow. This premise was tested by determining the spatial
      correlation of regional flow [rho(d)] as a function of distance (d) between
      regions. Regional pulmonary perfusion was measured in both supine and prone
      positions in seven anesthetized mechanically ventilated dogs with radiolabeled
      microspheres. After excision and drying, the lungs were cubed into pieces 1.2 cm
      on a side, with a three-dimensional coordinate assigned to each piece. The
      microsphere-determined flow to each piece was measured by radioactive counts, and
      rho(d) was calculated for all paired pieces within the same lobe. rho(d) was
      greatest for adjacent pieces (d = 1.2 cm) and decreased with increasing d,
      becoming negative at large distances in all dogs and positions. The spatial
      correlation of flow between adjacent pieces, rho(1.2 cm), was greater in the
      supine than in the prone position (0.66 vs. 0.72, P less than 0.05). The
      observations for each dog and position were fit to the equation rho(d) =
      d(a)+b.d+c, and the coefficients were used to compare rho(d) in the supine and
      prone positions. rho(d) differed in the two positions (P less than 0.05), with
      rho(d) falling off more rapidly with distance in the supine position. When trends
      in flow due to gravity were mathematically removed, differences between supine
      and prone positions were no longer observed. The spatial correlation of regional
      pulmonary perfusion was anisotropic in both supine and prone positions. The
      observation that regional pulmonary perfusion is highly correlated over large
      spatial distances has important implications for models of flow distribution.

PMID- 1629095
TI  - Effects of endothelin-1 and conversion of big endothelin-1 in the isolated
      perfused rabbit lung.
AB  - We examined the effects of endothelin-1 (ET-1) on pulmonary hemodynamic and
      transvascular fluid filtration and the conversion of big endothelin-1 (big ET-1),
      a precursor of ET-1, in isolated perfused rabbit lungs at constant vascular and
      airway pressures. Furthermore we examined whether ET-1 contributes to
      cyclooxygenase metabolism. The perfusate flow decreased significantly after bolus
      administration of 1 or 0.1 nmol of ET-1. Lung weight did not increase throughout
      the experimental period. Big ET-1- (1 nmol) induced decrease in the flow was slow
      in developing, although the maximum response was comparable to that induced by
      the same dose of ET-1. The concentration of bit ET-1 in the perfusate
      progressively decreased, while that of ET-1 increased in a time-dependent manner.
      Phosphoramidon, an inhibitor of metalloproteinase, suppressed the pressor effect
      of big ET-1 (P less than 0.01) and the increase in the concentration of ET-1 in
      the perfusate (P less than 0.05). The present findings provide the first evidence
      suggesting that the potent vasocontractile effect of big ET-1 in pulmonary
      circulation can be attributed to the production of ET-1 by the conversion from
      big ET-1 in the vascular bed. ET-1-induced perfusate flow changes were not
      affected by indomethacin, and the concentration of 6-ketoprostaglandin F1 alpha,
      a metabolite of prostacyclin, did not increase after ET-1 administration.

PMID- 1629096
TI  - Role of endothelium-derived relaxing factor in active hyperemia of the canine
      diaphragm.
AB  - To assess the effect of endothelium-derived relaxing factor (EDRF) on
      diaphragmatic vascular resistance at rest and during contractions, we studied an
      in situ isolated diaphragm preparation in anesthetized and mechanically
      ventilated dogs. The arterial supply of the left diaphragm (phrenic artery) was
      catheterized and perfused with arterial blood at a fixed flow rate. Drugs were
      infused through a side port of the arterial catheter at 1/100th of the phrenic
      arterial flow. The inferior phrenic vein was catheterized to complete the
      isolation from the systemic circulation. Three sets of experiments were
      performed. In set 1 (n = 3), we infused endothelium-dependent (acetylcholine,
      ACh) and endothelium-independent (sodium nitroprusside, SNP) dilators at
      increasing concentrations. ACh and SNP infusion elicited a dose-dependent decline
      in phrenic vascular resistance (Rphr) at concentrations greater than 10(-8) M and
      0.50 micrograms/ml, respectively. In set 2 (n = 15), we infused an inhibitor of
      EDRF synthesis and release, L-argininosuccinic acid (ArgSA), at increasing
      concentrations (10(-4), 3 x 10(-4), and 6 x 10(-4) M). ArgSA produced a dose
      dependent increase in Rphr. Infusion of another EDRF inhibitor (NG-nitro-L
      arginine, LNA, 6 x 10(-4) M) elicited increase in Rphr similar to that induced by
      ArgSA. In set 3 (n = 25), we infused ArgSA or LNA (6 x 10(-4) M) simultaneously
      with ACh and SNP and during sustained (2-Hz) contractions of the diaphragm. Both
      ArgSA and LNA completely reversed ACh vasodilation, whereas SNP vasodilation was
      reversed by 26 and 11%, respectively. ArgSA or LNA infusion during contractions
      reversed vasodilation by 48 and 52%, respectively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1629097
TI  - Physical models of the smaller pulmonary airways.
AB  - Any internalized flow exhibits closely coupled interactions with its confining
      geometry. Efforts to gain an understanding of in vivo airway transport phenomena,
      therefore, dictate that careful attention to be paid to those anatomic airway
      features that constrain and modify regional air movement. We present a series of
      analyses of human small airway casts to refine and extend the current geometric
      description of small airway bifurcations. Airway shape factors believed to have a
      high propensity to alter the fluid dynamics of airflows within this region are
      specifically addressed. The results of these anatomic and fluidic analyses are
      used to develop two average symmetrical and asymmetrical bifurcation patterns.
      Finally, methods for the production of physical bifurcation models conforming to
      these requirements are presented to develop a rational representation of anatomic
      as well as flow similitude during airway research.

PMID- 1629098
TI  - Effects of lung inflation and blood flow on capillary transit time in isolated
      rabbit lungs.
AB  - In a previous study, direct measurements of pulmonary capillary transit time by
      fluorescence video microscopy in anesthetized rabbits showed that chest inflation
      increased capillary transit time and decreased cardiac output. In isolated
      perfused rabbit lungs we measured the effect of lung volume, left atrial pressure
      (Pla), and blood flow on capillary transit time. At constant blood flow and
      constant transpulmonary pressure, a bolus of fluorescent dye was injected into
      the pulmonary artery and the passage of the dye through the subpleural
      microcirculation was recorded via the video microscope on videotape. During
      playback of the video signals, the light emitted from an arteriole and adjacent
      venule was measured using a video photoanalyzer. Capillary transit time was the
      difference between the mean time values of the arteriolar and venular dye
      dilution curves. We measured capillary transit time in three groups of lungs. In
      group 1, with airway pressure (Paw) at 5 cmH2O, transit time was measured at
      blood flow of approximately 80, approximately 40, and approximately 20 ml.min
      1.kg-1. At each blood flow level, Pla was varied from 0 (Pla less than Paw, zone
      2) to 11 cmH2O (Pla greater than Paw, zone 3). In group 2, at constant Paw of 15
      cmH2O, Pla was varied from 0 (zone 2) to 22 cmH2O (zone 3) at the same three
      blood flow levels. In group 3, at each of the three blood flow levels, Paw was
      varied from 5 to 15 cmH2O while Pla was maintained at 0 cmH2O (zone 2).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1629099
TI  - Effects of moderate hypothermia on O2 consumption at various O2 deliveries in a
      sheep model.
AB  - The effects of modest hypothermia on oxygen consumption (VO2) were studied at
      various levels of oxygen delivery (DO2) in six sheep. Each animal was placed on
      cardiopulmonary bypass by extrathoracic cannulations. DO2 was varied by changing
      blood flow through an extracorporeal circuit. VO2 was measured spirometrically
      across a membrane lung. VO2 was initially measured at various levels of DO2 at
      normothermic temperatures (39 degrees C). The animals were then cooled to 33
      degrees C. DO2 was varied, and the corresponding VO2's were determined. The data
      at both temperatures demonstrated the biphasic relationship of VO2 to various
      levels of DO2. A critical level of DO2 (DO2 crit) was defined to reflect the
      transition area between the dependent and independent portions of the consumption
      delivery curve. The average baseline VO2's on the delivery independent portion of
      the curve were calculated to be 5.33 and 3.17 ml O2.kg-1.min-1 at 39 and 33
      degrees C, respectively (P less than 0.001). The corresponding DO2 crit's were
      6.17 and 4.57 ml O2.kg-1.min-1 (P less than 0.05). The oxygen extraction ratios
      at DO2 crit for each of these temperatures did not differ significantly. We
      conclude that hypothermia, by lowering baseline VO2, reduces DO2 crit.
      Hypothermia may therefore reduce or eliminate the anaerobic metabolism and
      subsequent acidosis that would otherwise occur during normothermia at low levels
      of DO2.

PMID- 1629100
TI  - Muscle accounts for glucose disposal but not blood lactate appearance during
      exercise after acclimatization to 4,300 m.
AB  - We hypothesized that the increased blood glucose disappearance (Rd) observed
      during exercise and after acclimatization to high altitude (4,300 m) could be
      attributed to net glucose uptake (G) by the legs and that the increased arterial
      lactate concentration and rate of appearance (Ra) on arrival at altitude and
      subsequent decrease with acclimatization were caused by changes in net muscle
      lactate release (L). To evaluate these hypotheses, seven healthy males [23 +/- 2
      (SE) yr, 72.2 +/- 1.6 kg], on a controlled diet were studied in the
      postabsorptive condition at sea level, on acute exposure to 4,300 m, and after 3
      wk of acclimatization to 4,300 m. Subjects received a primed-continuous infusion
      of [6,6-D2]glucose (Brooks et al., J. Appl. Physiol. 70: 919-927, 1991) and [3
      13C]lactate (Brooks et al., J. Appl. Physiol. 71:333-341, 1991) and rested for a
      minimum of 90 min, followed immediately by 45 min of exercise at 101 +/- 3 W,
      which elicited 51.1 +/- 1% of the sea level peak O2 uptake (65 +/- 2% of both
      acute altitude and acclimatization peak O2 uptake). Glucose and lactate
      arteriovenous differences across the legs and arms and leg blood flow were
      measured. Leg G increased during exercise compared with rest, at altitude
      compared with sea level, and after acclimatization. Leg G accounted for 27-36% of
      Rd at rest and essentially all glucose Rd during exercise. A shunting of the
      blood glucose flux to active muscle during exercise at altitude is indicated.
      With acute altitude exposure, at 5 min of exercise L was elevated compared with
      sea level or after acclimatization, but from 15 to 45 min of exercise the pattern
      and magnitude of L from the legs varied and followed neither the pattern nor the
      magnitude of responses in arterial lactate concentration or Ra. Leg L accounted
      for 6-65% of lactate Ra at rest and 17-63% during exercise, but the percent Ra
      from L was not affected by altitude. Tracer-measured lactate extraction by legs
      accounted for 10-25% of lactate Rd at rest and 31-83% during exercise. Arms
      released lactate under all conditions except during exercise with acute exposure
      to high altitude, when the arms consumed lactate. Both active and inactive muscle
      beds demonstrated simultaneous lactate extraction and release. We conclude that
      active skeletal muscle is the predominant site of glucose disposal during
      exercise and at high altitude but not the sole source of blood lactate during
      exercise at sea level or high altitude.

PMID- 1629101
TI  - Individuality of breathing patterns during hypoxia and exercise.
AB  - Breathing was recorded via a pulsed ultrasonic flowmeter in 11 healthy subjects,
      at rest and during steady-state exercise (at 50% of their maximal O2 consumption)
      at both sea level (200 m) and simulated altitude (4,500 m in a hypobaric
      chamber). The pattern of breathing was quantified breath by breath in terms of
      classical respiratory variables (tidal volume and inspiratory and expiratory
      times), and the shape of the entire airflow profile was quantified by harmonic
      analysis. Statistical tests were used to compare the within-individual with the
      between-individual variations. In comparing the sea level vs. altitude rest (16%
      increase in ventilation) and sea level vs. altitude exercise (40% increase in
      ventilation) airflow profiles, we found a significantly greater resemblance
      within the individual than between individuals. Comparisons of sea level rest and
      exercise (295% increase in ventilation) and altitude rest and exercise (375%
      increase in ventilation) revealed no similarity within individuals. Despite
      airflow profile changes between rest and exercise, it is still possible to attest
      to a diversity of flow profile between individuals during exercise. Hypoxia at
      rest or during exercise does not alter the phenomenon of the individuality of
      breathing patterns.

PMID- 1629102
TI  - Measurement of interrupter resistance in rabbits exposed to methacholine
      aerosols.
AB  - We studied the effect of increasing airway resistance on equilibration of airway
      and alveolar pressure during passive expiratory airflow interruption. In 10
      anesthetized and paralyzed rabbits, airway and alveolar pressures were compared
      before and after airway resistance was increased with methacholine. In all
      studies, airway pressure rose to equilibrate with alveolar pressure immediately
      after the interruption (delta Pinit) regardless of increases in airway
      resistance. The pressures then remained equal during the interruption while
      gradually increasing to plateau (delta Pdiff). Before methacholine exposure,
      delta Pdiff was small (0.6 +/- 0.3 cmH2O). Steady-state resistance calculated
      from the sum of delta Pinit and delta Pdiff was similar to airway resistance
      calculated from delta Pinit alone. After methacholine, increased airway
      resistance was accompanied by increased delta Pdiff (2.0 +/- 0.5 cmH2O), causing
      disproportionate increase in steady-state resistance. delta Pdiff increases were
      equal in the airway and alveoli, implying resistive changes distal to the sampled
      alveoli. Thus increasing airway resistance did not delay pressure equilibration
      across airways. However, increases in airway resistance were accompanied by
      tissue resistive changes that were greater than the increases in airway
      resistance.

PMID- 1629103
TI  - Effect of vagal stimulation and parenteral acetylcholine on canine trachealis
      muscle shortening.
AB  - Canine trachealis smooth muscle shortening (TMS) in response to vagal nerve
      stimulation is approximately 30%, far less than the 70% predicted from in vitro
      studies. We hypothesized that in vivo airway smooth muscle activation during
      vagal stimulation may be submaximal, and in this study we wished to determine TMS
      during maximal activation. TMS was studied in 12 alpha-chloralose-anesthetized
      dogs during vagal stimulation, systemic acetylcholine injection, and local
      acetylcholine injection. Bilateral vagal stimulation produced TMS of 26 +/- 5%
      (SE) length at functional residual capacity (LFRC). Maximal TMS during systemic
      injection of acetylcholine was 28 +/- 12% LFRC but may have been limited by
      delivery of acetylcholine to the muscle because asystole occurred at higher
      concentrations. TMS was greatest during local injection of acetylcholine (48 +/-
      7% LFRC). There was a greater increase in pulmonary resistance and decrease in
      dynamic compliance during systemic acetylcholine injection than during vagal
      stimulation. We conclude that bilateral vagal nerve stimulation does not
      maximally activate trachealis smooth muscle but that the maximal shortening
      achieved with local injection of acetylcholine is still less than isotonic
      shortening in vitro. These data suggest that maximal shortening in vivo is
      limited by the afterload provided by the tracheal cartilaginous rings.

PMID- 1629104
TI  - Evaluation of prostaglandin F2 alpha and prostacyclin interactions in the
      isolated perfused rat lung.
AB  - To characterize the interactions between prostaglandin F2 alpha and prostacyclin
      in controlling tone in the pulmonary circulation, isolated rat lungs were
      ventilated, perfused with blood, and subjected to challenge by prostaglandin F2
      alpha in increasing doses. The pulmonary resistance was evaluated using occlusion
      techniques that separate the resistance into segments of large and small arteries
      and veins. The total vascular compliance was evaluated using outflow occlusion.
      Resistance increased after prostaglandin F2 alpha, and this resistance change was
      primarily in the small artery segment. The maximum resistance increase by
      prostaglandin F2 alpha (Rmax,PGF2 alpha), calculated from the Michaelis-Menton
      equation, was 16.6 +/- 3.6 cmH2O.l-1.min.100 g-1 for total vascular resistance
      with a concentration required to produce 50% Rmax (K0.5) of 5.26 +/- 3.57 nM. The
      Rmax,PGF2 alpha for small artery resistance was 13.5 +/- 2.4 cmH2O.l-1.min.100 g
      1 with a K0.5 of 2.35 +/- 1.57 nM. The vascular compliance decreased during
      vasoconstriction by prostaglandin F2 alpha, and the maximum decrease in
      compliance (Cmin,PGF2 alpha) was -0.43 +/- 0.12 ml/cmH2O with a K0.5 of 2.84 +/-
      2.99 nM. At each dose of prostaglandin F2 alpha, prostacyclin was administered in
      increasing doses to reverse the vasoconstriction caused by prostaglandin F2
      alpha. For each concentration of prostaglandin F2 alpha, prostacyclin almost
      completely reversed the resistance increases and approximately one-half the
      compliance decrease. The maximum change in vascular resistance or compliance
      produced by prostacyclin was dependent on the dose of prostaglandin F2 alpha; yet
      the K0.5 for prostacyclin was within the picomolar range for all doses of
      prostaglandin F2 alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629105
TI  - Comparison of arousal responses to tracheal and face mask occlusions in sleeping
      newborn piglets.
AB  - The arousal responses after occlusion of the airway at the mid-trachea were
      compared with the responses after occlusion of the airway in a face mask in
      chronically instrumented 3- to 5-day-old piglets. For each site of occlusion
      arousal latency was significantly longer from active sleep than from quiet sleep.
      There was a significant increase in the frequency of early arousals after face
      mask occlusions compared with tracheal occlusions in both sleep states. During
      quiet sleep the frequency of arousal by 1 s after occlusion was 0.55 with face
      mask occlusions compared with 0.28 with tracheal occlusion (P less than 0.01).
      During active sleep the frequency of arousal by 3 s after a face mask occlusion
      was 0.32 compared with 0.08 after tracheal occlusion (P less than 0.05). Arousal
      from quiet sleep occurred before changes in arterial oxygen saturation. During
      active sleep mean saturation at arousal was not different between face mask and
      tracheal occlusions. Exposure of the upper airway to the pressures generated
      during airway occlusions results in earlier arousal in both quiet and active
      sleep, indicating a potential role for upper airway mechanoreceptors in
      initiating arousal in the newborn piglet.

PMID- 1629106
TI  - Regulation of glucose turnover at the onset of exercise in the dog.
AB  - The early responses of endogenous glucose production (Ra), glucose utilization
      (Rd), and glucoregulatory hormones to moderate treadmill exercise (12% incline,
      100 m/min, 60 min) were examined in dogs. Rd increased rapidly and progressively
      from the start of exercise. The change in Ra, as estimated with a variable-volume
      model of glucose kinetics, was biphasic, with an abrupt increase by 8.5 +/- 2.3
      mumol.min-1.kg-1, followed by a delayed further increase that matched Rd 11-22
      min after the onset of exercise. The plasma glucagon-to-insulin molar ratio fell
      slightly at the onset of exercise and then increased gradually. The glucagon-to
      insulin ratio was correlated with Ra over the entire exercise period (r = 0.63, P
      less than 0.0001), but not during the early part of exercise, when Ra increased
      rapidly. The catecholamine- (epinephrine plus norepinephrine) to-insulin molar
      ratio was correlated with Ra during the early period (r = 0.52, P less than 0.01)
      and over the entire period of exercise (r = 0.66, P less than 0.0001). Our
      results confirm previous demonstrations that the glucagon-to-insulin molar ratio
      is an important regulator of Ra during exercise. We hypothesize that the
      catecholamine-to-insulin molar ratio is important during the early period of
      exercise and possibly during late exercise as an additional regulatory factor to
      the glucagon-to-insulin molar ratio.

PMID- 1629108
TI  - Estimation of glucose production during exercise with a one-compartment variable
      volume model.
AB  - A variable-volume one-compartment model of glucose kinetics and step increases in
      the rate of tracer infusion were examined for estimation of endogenous glucose
      production (Ra) during moderate exercise in dogs. A primed infusion of D-[3
      3H]glucose was left constant or increased 1.5-, 2-, 3-, 4-, or 5-fold at the
      onset of a 60-min period of exercise. Application of a regression method, in
      which Ra and the effective distribution volume were estimated over time, revealed
      dynamic changes in Ra that were not evident during the constant tracer infusion
      with a fixed-volume model. Application of the fixed-volume model to studies
      performed with a two- or three-fold step increase in tracer resulted in the
      lowest sum-of-squares difference from the regression method. Our results
      demonstrate that application of a variable-volume model can be achieved during
      exercise by enrichment of the plasma specific activity through step increases in
      the rate of tracer infusion and application of a regression method. Alternately,
      estimates of Ra with a fixed-volume model can be improved by enrichment of the
      plasma specific activity through a single step increase in the rate of tracer
      infusion. Our results suggest that when endogenous Ra is changing rapidly, such
      as at the onset of exercise, these methods will provide a more accurate estimate
      of Ra than the standard fixed-volume model and constant tracer infusion.

PMID- 1629109
TI  - Radiological case of the month. Tardus parvus abnormality in renal artery
      stenosis.

PMID- 1629107
TI  - Effects of nonideal input functions on PET measurements of pulmonary blood flow.
AB  - Regional pulmonary blood flow (rPBF) can be measured with an intravenous infusion
      of 15O-labeled water and positron emission tomography (PET). The current method
      depends on two assumptions related to the input of activity to the lung during
      the scan: 1) the pulmonary arterial tracer input is constant (i.e., a "step
      function" in shape), and 2) the scan begins at the instant of arrival of the step
      function. To determine the effect that departures from these assumptions might
      have on the measurement of rPBF, we performed a series of mathematical
      simulations for three different input functions: 1) a step function that arrived
      either 1 or 2 s before or after scan start; 2) a dispersed input function, with
      activity rising during the scan period; and 3) a combination of these two errors.
      Calculated values, based on the standard assumptions, were compared against the
      "known" values used in generating the simulated data. The results show that
      timing errors associated with starting the scan late cause an overestimation of
      rPBF, whereas timing errors due to low regional flow or departures from the
      assumed step input function both cause an underestimation of true rPBF. Thus, in
      actual practice, the combined errors probably partially offset one another.
      Except for states of truly high rPBF and low lung density, the errors remain less
      than 15% of the true value. We conclude that PET measurements of rPBF are not
      highly sensitive to these presumably common departures from the assumed pulmonary
      arterial input function to lung regions of interest.

PMID- 1629110
TI  - Doctor traps.

PMID- 1629111
TI  - Age as a prognostic factor in cancer of the cervix: the UAMS experience.
AB  - Current literature has conflicting reports as to the effect of age on prognosis
      in cancer of the uterine cervix. In order to evaluate this in our patient
      population we undertook a retrospective chart review of 235 cases of cervical
      cancer that were seen at the Central Arkansas Radiation Therapy Institute (CARTI)
      and the University of Arkansas for Medical Sciences (UAMS) from March 1974 to
      June 1985 and were followed for a minimum of 54 months. State, grade and age
      greater than 70 years were significant predictors. Factors that were not
      statistically significant were race and morphology. Age less than 40, approached
      statistical significance as a predictive value. Our patients younger than age 40
      had a tendency toward a slightly decreased survival when compared to those ages
      40-60 and also a much decreased disease-free interval (50 months versus 97
      months). This paper was presented on October 25, 1990 at Student Research Day at
      UAMS.

PMID- 1629112
TI  - Tobacco--masters of misinformation.

PMID- 1629113
TI  - Arkansas pharmacists to begin patient counseling.

PMID- 1629114
TI  - Problem-based curriculum and its value to Indian medical schools: description of
      the curriculum.
AB  - The decade of the 80's has seen the implementation of the problem-based
      curriculum (PC) (also called "parallel" or "student-centred" curriculum) in
      several medical schools in the United States. This new educational technique
      emphasizes active student participation and a hands-on learning process
      supplemented by judicious intervention by the faculty teachers. The students
      (often volunteers) are usually selected for their motivation rather than for
      highest intelligence or class ranking. For a period of two years, they meet twice
      or thrice-weekly in group sessions to explore problem cases developed by faculty
      for that special purpose. We describe the parallel curriculum here in some detail
      and suggest that medical educators in India give serious consideration to
      implementation of such a curriculum or its modification in their institutions.
      Medical graduates will benefit from the hands-on emphasis of this curriculum as
      well as the development of a disciplined approach in the handling of clinical
      problems. PC diminishes the stress levels associated with the traditional
      curriculum and lets the students play an active role in their education. PC will
      make them better prepared to face challenges during their clinical years and
      subsequent careers and should offset some of the weaknesses in the current
      educational system.

PMID- 1629115
TI  - Thrombotic thrombocytopenic purpura.

PMID- 1629116
TI  - Refractory hypotension. A clue to myxedema coma.

PMID- 1629117
TI  - Normal maximal expiratory and inspiratory pressures in healthy teenagers.
AB  - Maximal expiratory pressure at total lung capacity and maximal inspiratory
      pressure at residual volume were measured in 364 male and 325 female healthy
      teenage subjects. Predictive equations have been drawn based on coefficients of
      age, height and weight. The pressures may be used to evaluate respiratory muscle
      strength and follow the progress in patients with neuromuscular disorders,
      dyspnoea and respiratory failure.

PMID- 1629118
TI  - Trace elements.

PMID- 1629119
TI  - Carcinoma in an oesophageal diverticulum.
AB  - A young male who had minimal dysphagia since childhood complained of increasing
      difficulty in swallowing for a few months. Upper Gastrointestinal endoscopy was
      normal on two occasions done by two gastroenterologists. Barium swallow showed
      minimal extrinsic pressure on the oesophageal wall. X-ray chest was normal. CT
      scan showed a large growth close to the oesophagus. Resection of the growth
      showed a carcinoma completely filling an oesophageal diverticulum with a normal
      oesophageal lumen.

PMID- 1629120
TI  - Spinal epidural abscess in E coli septicaemia.

PMID- 1629121
TI  - Saddle embolism of aorta.
AB  - Aortic saddle embolus is a rare but serious form of arterial embolisation in
      patients with myocardial infarction. Four patients with aortic saddle embolism
      with peripheral propagation of the clott are reported. Two patients had suffered
      an attack of acute anterior myocardial infarction (one and four weeks
      respectively) prior to the embolic episode. One patient had a transmural
      myocardial infarct five years ago, and the 4th patient had dilated
      cardiomyopathy. The onset was sudden, marked by pain, parasthesias, pallor,
      pulselessness in three patients, and gradual in one. Two of the three patients
      (both females) in whom clott migration occured in only one limb developed below
      knee gangrene of the affected side. In one patient (a young male) clott migration
      occurred in both popliteal arteries and the limbs were spared from developing
      gangrene although he continues to have leg angina. One patient presented with
      intermittent calf claudication only. All our patients reported late due to which
      none could be subjected to embolectomy.

PMID- 1629122
TI  - Antiphospholipid antibody syndrome of systemic lupus erythematosus presenting as
      deep vein thrombosis.
AB  - We are reporting a young lady with protracted deep vein thrombosis of her left
      leg which turned out to be antiphospholipid (anticardiolipin) antibody syndrome
      of ANA positive systemic lupus erythematosus. Lupus anticoagulant was
      demonstrated by prolongation of activated partial thromboplastin time and
      Russell's viper venom time. She had no anti-thrombin III deficiency.

PMID- 1629123
TI  - Carotid sinus syndrome associated with carcinoma of the pyriform fossa.
AB  - A patient who developed syncope due to carotid sinus syndrome is described. The
      patient was suffering from carcinoma of the pyriform fossa for the past one year
      and received radiotherapy in the region of the neck for the same. Demand pacing
      was ineffective in alleviating syncopal episodes. The patient responded to oral
      administration of an anticholinergic (belladonna) and a sympathomimectic agent
      (orciprenaline).

PMID- 1629124
TI  - Spontaneous passage of nasogastric tube through the gut.

PMID- 1629125
TI  - Efficacy and safety studies on ayurvedic drugs.

PMID- 1629126
TI  - Prognosis and therapy in chronic myeloid leukaemia.

PMID- 1629127
TI  - Falciparum malaria and jaundice.

PMID- 1629128
TI  - Eosinophilic polymyositis without peripheral eosinophilia.

PMID- 1629129
TI  - Haemorrhagic meningitis due to Bacillus anthrax.

PMID- 1629130
TI  - Tubercular colitis in a patient with systemic lupus erythematosus: diagnosis by
      stool examination.

PMID- 1629131
TI  - Hypoglycemia presenting as hemiparesis in a diabetic patient.

PMID- 1629132
TI  - Renal dysfunction in enteric fever.

PMID- 1629133
TI  - Epilepsy as a manifestation of neurocysticercosis.

PMID- 1629135
TI  - Confusing insulin syringes.

PMID- 1629134
TI  - Atrial flutter in myocardial infarction.

PMID- 1629136
TI  - IgM ELISA follow-up of spiramycin treatment for toxoplasmosis: should the drug be
      prescribed in India?

PMID- 1629137
TI  - Carrier detection in muscular dystrophy.

PMID- 1629138
TI  - Hypertension monotherapy with ACE inhibitors.

PMID- 1629139
TI  - Amoebic liver abscess--an unusual presentation report of a case.

PMID- 1629140
TI  - Short PR interval and abnormal systolic time interval as a method of carrier
      detection in maternal relations of patients with muscular dystrophy.
AB  - Seventeen relatives of patients with Duchenne's muscular dystrophy (Group A) and
      6 relatives of patients with adult type of muscular dystrophy (Group B) were
      studied. Short PR interval on electrocardiogram and abnormal systolic time
      interval (STI) were consistent findings in 14 of 15 female relatives (93.35%) in
      group A, while these criteria were lacking in group B. Myopathic pattern (i.e.
      tachycardia, short PR interval, R/S ratio in V1 greater than 1.5, significant Q
      wave in V4, V5, V6 on electrocardiogram) was present in two (13.35%) of 15 female
      relatives from group A. It was absent in group B. Male relatives in both the
      groups had normal electrocardiogram and normal systolic time interval.

PMID- 1629141
TI  - Tuberculosis and leprosy--not uncommon association.

PMID- 1629142
TI  - Enalapril monotherapy in essential hypertension.
AB  - Thirty adults with essential hypertension (systolic BP greater than 150 mmHg or
      diastolic BP greater than 100 mmHg) were treated with 5-20 mg of enalapril to
      study its anti-hypertensive efficacy and safety. Ten patients had mild
      hypertension (diastolic BP greater than 90 mmHg and less than 105 mmHg), 10 had
      moderate hypertension (diastolic BP greater than 105 mmHg and less than 115 mmHg)
      and 6 had severe hypertension (diastolic BP greater than 115 mmHg). Of the 20
      patients who completed the trial, 9 (45%) showed optimum reduction of BP to less
      than 130/90 mmHg) and a further 7 (35%) showed significant reduction. The mean
      fall in systolic BP was 32.5 mmHg (0-80 mmHg) and in diastolic BP was 18.5 mmHg
      (0-50 mmHg). The peak fall in BP was achieved in 3.5 weeks (1-6 weeks) with a
      mean dose of 7.2 mg of enalapril daily (5-15 mg/day). Mild side effects not
      needing drug withdrawal were seen in 8/20 patients (40%). Monotherapy with
      enalapril appears to be effective and safe as step one therapy for patients with
      essential hypertension.

PMID- 1629143
TI  - Endosulfan poisoning: a study of 22 cases.
AB  - Twenty two cases of endosulfan poisoning with their symptomatology are reported.
      The management and lack of awareness regarding specific treatment are
      highlighted.

PMID- 1629144
TI  - Percutaneous transluminal coronary angioplasty in distal lesions.
AB  - Of 210 patients in whom percutaneous transluminal coronary angioplasties [PTCA]
      were performed during the period of 2 years (June 1987 to August 1989), 55 had
      distal lesions. These included 50 males and 5 females with the lesions in left
      anterior descending [LAD] artery after the origin of the second diagonal branch,
      circumflex [Cx] artery after the origin of the obtuse marginal [OM], and right
      coronary artery [RCA] after the acute marginal branch. There were a total of 71
      distal lesions, involving the LAD [51%], Cx [20%], and RCA [29%]. The overall
      success rate with PTCA was 91%. There were 4 acute closures of vessels; all were
      redilated with balloon angioplasty. One of these was sent for emergency bypass
      surgery after balloon dilatation. There was no death. With improvement in balloon
      catheters and guidewires, the feasibility and success of PTCA in distal lesions
      have increased remarkably, thus expanding the horizon of PTCA.

PMID- 1629145
TI  - Mitral annular calcification in untreated chronic renal failure.
AB  - Clinical, biochemical, radiological and echo-cardiographic (echo) evaluation was
      done prospectively in 50 patients of untreated end stage chronic renal failure
      (CRF). While clinically congestive cardiac failure (CCF) was diagnosed in 24%,
      low ejection fraction on echo was found in only 16%. Echo in these cases showed
      evidence of cardiac chamber dilatation in most (mean LVID (D) 54.1 +/- 6.51 and
      (S) 36.4 +/- 6.9 mm, but parameters of cardiac functions were normal in most.
      Mitral annular calcification (MAC) was detected on echo in 26%. On comparing
      patients with MAC (Group I) and those without MAC (Group II), the aetiological
      factor found more frequently in Group I was diabetes (61.5% vs 35.1%, P less than
      0.05). Clinical features such as older age (mean age 54 years vs 45.5 years),
      severe hypertension, and grade IV and above murmur (15.2% vs none) were more
      common among group I patients. However, the difference was not statistically
      significant. Parameters of calcium metabolism were similar in the two groups.
      Conduction disturbances (30.7% vs 5.4%) were significantly more common in Group I
      (P = 0.05). The mitral regurgitation due to MAC was of no haemodynamic
      significance. Complications of MAC syndrome were rare.

PMID- 1629146
TI  - Gene therapy: a status report.
AB  - Gene therapy is a way to treat disease by transfer of genetic material into the
      cells of a diseased organism. Generally it is transferred in the form of one or
      few genes. There is a tremendous potential for application of this technique to
      the treatment of human hereditary diseases, particularly single gene disorders.
      Due to ethical and practical reasons, it is currently being used only as somatic
      cell therapy but it could be achieved by germline also. The major problem in gene
      therapy is achieving an efficient gene transfer and a persistent gene expression
      in appropriate somatic cells.

PMID- 1629147
TI  - Philadelphia chromosome.

PMID- 1629148
TI  - A squid that glows in the night: development of an animal-bacterial mutualism.

PMID- 1629149
TI  - Multiple transcripts encoded by the ilvGMEDA gene cluster of Escherichia coli K
      12.
AB  - We report here that, using Northern (RNA) blots, we identified two relatively
      stable transcripts of 4.6 and 1.1 kb that correspond to the products of the
      ilvEDA and ilvE genes and two relatively unstable transcripts of 6.7 and 3.6 kb
      that correspond to the products of the ilvGMEDA and ilvDA genes. The transcripts
      were identified by the use of eight probes derived from segments of the ilvGMEDA
      cluster. In addition, we used two strains with deletions of ilvG or ilvDA and
      observed the expected decrease in transcript size in Northern blots. Primer
      extension with reverse transcriptase generated a 169-nucleotide product
      corresponding to a 5' end within the ilvED intercistronic region, 37 nucleotides
      from the AUG codon of the ilvD gene. This primer extension product presumably
      indicates the 5' end of the ilvDA transcript that we detected in Northern blots.
      The stability of the transcripts was monitored, and RNase E was found to play a
      major role in ilv transcript degradation. Transcript levels varied in response to
      growth in the presence of the end product amino acids and in response to the
      presence of the polar frameshift site in ilvG. Although there have been
      speculations about the identities and numbers of transcripts derived from the
      ilvGMEDA cluster on the basis of the identification of some of the sites of
      transcription initiation and termination, this is the first report of the use of
      Northern blots to determine the actual sizes and distribution of mRNAs present in
      vivo.

PMID- 1629150
TI  - Characterization of a Bacillus subtilis sporulation operon that includes genes
      for an RNA polymerase sigma factor and for a putative DD-carboxypeptidase.
AB  - At early stages of sporulation, the spoIIA locus is transcribed as a tricistronic
      (1.7-kb) operon, coding for sigma F and for two proteins that modulate the
      activity of sigma F. The locus is transcribed as a longer (2.9-kb) transcript at
      the late stages of sporulation. We show here that the longer transcript contains
      an additional open reading frame whose product has extensive sequence homology
      with DD-carboxypeptidases; the corresponding gene is designated dacF.
      Cotranscription of a morphogene, such as dacF, with the gene for a sigma factor
      suggests a way to couple transcription regulation with morphogenesis. The
      predicted N-terminal sequence of the DacF protein and the inhibition of
      sporulation by a translational dacF-lacZ fusion both suggest that the protein has
      a signal peptide for transport into or across a membrane. Expression of a dacF
      lacZ transcriptional fusion was in the forespore. The 5' end of the 2.9-kb
      transcript was determined by primer extension analysis. The region 5' to the end
      showed no homology to promoters recognized by known sigma factors but was
      homologous to the corresponding region of the forespore-specific 0.3-kb gene of
      Bacillus subtilis.

PMID- 1629151
TI  - Mechanism of Na(+)-dependent citrate transport in Klebsiella pneumoniae.
AB  - Citrate transport via CitS of Klebsiella pneumoniae has been shown to depend on
      the presence of Na+. This transport system has been expressed in Escherichia
      coli, and uptake of citrate in E. coli membrane vesicles via this uptake system
      was found to be an electrogenic process, although the pH gradient is the main
      driving force for citrate uptake (M. E. van der Rest, R. M. Siewe, T. Abee, E.
      Schwartz, D. Oesterhelt, and W. N. Konings, J. Biol. Chem. 267:8971-8976, 1992).
      Analysis of the affinity constants for the different citrate species at different
      pH values of the medium indicates that H-citrate2- is the transported species.
      Since the electrical potential across the membrane is a driving force for citrate
      transport, this indicates that transport occurs in symport with at least three
      monovalent cations. Citrate efflux is stimulated by Na+ concentrations of up to 5
      mM but inhibited by higher Na+ concentrations. Citrate exchange, however, is
      stimulated by all Na+ concentrations, indicating sequential events in which Na+
      binds before citrate for translocation followed by a release of Na+ after release
      of citrate. CitS has, at pH 6.0 and in the presence of 5 mM citrate on both sides
      of the membrane, an apparent affinity (K(app)) for Na+ of 200 microM. The
      Na+/citrate stoichiometry was found to be 1. It is postulated that H-citrate2- is
      transported via CitS in symport with one Na+ and at least two H+ ions.

PMID- 1629152
TI  - Secretion of CyaA-PrtB and HlyA-PrtB fusion proteins in Escherichia coli:
      involvement of the glycine-rich repeat domain of Erwinia chrysanthemi protease B.
AB  - Protease B from Erwinia chrysanthemi was shown previously to have a C-terminal
      secretion signal located downstream of a domain that contains six glycine-rich
      repeats. This domain is conserved in all known bacterial proteins secreted by the
      signal peptide-independent pathway. The role of these repeats in the secretion
      process is controversial. We compared the secretion processes of various
      heterologous polypeptides fused either directly to the signal or separated from
      it by the glycine-rich domain. Although the repeats are not involved in the
      secretion of small truncated protease B carboxy-terminal peptides, they are
      required for the secretion of higher-molecular-weight fusion proteins. Secretion
      efficiency was also dependent on the size of the passenger polypeptide.

PMID- 1629153
TI  - Localization of upstream sequence elements required for nitrate and anaerobic
      induction of fdn (formate dehydrogenase-N) operon expression in Escherichia coli
      K-12.
AB  - Two transcriptional activators, the FNR and NARL proteins, are required for
      induction of the fdnGHI operon, encoding Escherichia coli formate dehydrogenase
      N. The FNR protein is required for anaerobic expression, while the NARL protein
      mediates nitrate induction. We used primer extension to locate the transcription
      initiation site 29 nucleotides upstream of the fdnG translation initiation codon.
      Expression assays with single-copy phi (fdnG-lacZ) gene fusions containing
      various deletions in the fdn 5'-regulatory region delimited three distinct cis
      acting elements. One site, which is located at approximately -110, was required
      for nitrate induction. Two other sites share sequence similarity with the FNR
      protein binding site core consensus. The first site, centered at -42.5, was
      required for anaerobic induction. We used site-specific mutagenesis to change
      this putative FNR protein binding site into the CRP protein binding site core
      consensus. This change caused the fdn operon to be expressed aerobically, subject
      to CRP protein control. On the other hand, converting this putative FNR protein
      binding site into the FNR protein binding site core consensus resulted in
      elevated anaerobic induction of the fdn operon and also caused weak aerobic
      expression. The other putative FNR protein binding site, centered at -97.5, was
      not involved in anaerobic induction. It might play a negative role in fdn operon
      expression during anaerobic growth in the absence of nitrate.

PMID- 1629154
TI  - An efficient screen for peroxisome-deficient mutants of Pichia pastoris.
AB  - We describe a rapid and efficient screen for peroxisome-deficient (per) mutants
      in the yeast Pichia pastoris. The screen relies on the unusual ability of P.
      pastoris to grow on two carbon sources, methanol and oleic acid, both of which
      absolutely require peroxisomes to be metabolized. A collection of 280 methanol
      utilization-defective (Mut-) P. pastoris mutants was isolated, organized into 46
      complementation groups, and tested for those that were also oleate-utilization
      defective (Out-) but still capable of growth on ethanol and glucose. Mutants in
      10 groups met this phenotypic description, and 8 of these were observed by
      electron microscopy to be peroxisome deficient (Per-). In each per mutant, Mut-,
      Out-, and Per- phenotypes were tightly linked and therefore were most likely due
      to a mutation at a single locus. Subcellular fractionation experiments indicated
      that the peroxisomal marker enzyme catalase was mislocalized to the cytosol in
      both methanol- and oleate-induced cultures of the mutants. In contrast, alcohol
      oxidase, a peroxisomal methanol utilization pathway enzyme, was virtually absent
      from per mutant cells. The relative ease of per mutant isolation in P. pastoris,
      in conjunction with well-developed procedures for its molecular and genetic
      manipulation, makes this organism an attractive system for studies on peroxisome
      biogenesis.

PMID- 1629155
TI  - Characterization of Pseudomonas putida mutants unable to catabolize benzoate:
      cloning and characterization of Pseudomonas genes involved in benzoate catabolism
      and isolation of a chromosomal DNA fragment able to substitute for xylS in
      activation of the TOL lower-pathway promoter.
AB  - Mutants of Pseudomonas putida mt-2 that are unable to convert benzoate to
      catechol were isolated and grouped into two classes: those that did not initiate
      attack on benzoate and those that accumulated 3,5-cyclohexadiene-1,2-diol-1
      carboxylic acid (benzoate diol). The latter mutants, represents by strain PP0201,
      were shown to lack benzoate diol dehydrogenase (benD) activity. Mutants from the
      former class were presumed either to carry lesions in one or more subunit
      structural genes of benzoate dioxygenase (benABC) or the regulatory gene (benR)
      or to contain multiple mutations. Previous work in this laboratory suggested that
      benR can substitute for the TOL plasmid-encoded xylS regulatory gene, which
      promotes gene expression from the OP2 region of the lower or meta pathway operon.
      Accordingly, structural and regulatory gene mutations were distinguished by the
      ability of benzoate-grown mutant strains to induce expression from OP2 without
      xylS by using the TOL plasmid xylE gene (encoding catechol 2,3-dioxygenase) as a
      reporter. A cloned 12-kb BamHI chromosomal DNA fragment from the P. aeruginosa
      PAO1 chromosome complemented all of the mutations, as shown by restoration of
      growth on benzoate minimal medium. Subcloning and deletion analyses allowed
      identification of DNA fragments carrying benD, benABC, and the region possessing
      xylS substitution activity, benR. Expression of these genes was examined in a
      strain devoid of benzoate-utilizing ability, Pseudomonas fluorescens PFO15. The
      disappearance of benzoate and the production of catechol were determined by
      chromatographic analysis of supernatants from cultures grown with casamino acids.
      When P. fluorescens PFO15 was transformed with plasmids containing only benABCD,
      no loss of benzoate was observed. When either benR or xylS was cloned into
      plasmids compatible with those plasmids containing only the benABCD regions,
      benzoate was removed from the medium and catechol was produced. Regulation of
      expression of the chromosomal structural genes by benR and xylS was quantified by
      benzoate diol dehydrogenase enzyme assays. The results obtained when xylS was
      substituted for benR strongly suggest an isofunctional regulatory mechanism
      between the TOL plasmid lower-pathway genes (via the OP2 promoter) and
      chromosomal benABC. Southern hybridizations demonstrated that DNA encoding the
      benzoate dioxygenase structural genes showed homology to DNA encoding toluate
      dioxygenase from the TOL plasmid pWW0, but benR did not show homology to xylS.
      Evolutionary relationships between the regulatory systems of chromosomal and
      plasmid-encoded genes for the catabolism of benzoate and related compounds are
      suggested.

PMID- 1629156
TI  - A mutant sigma 32 with a small deletion in conserved region 3 of sigma has
      reduced affinity for core RNA polymerase.
AB  - sigma 70, encoded by rpoD, is the major sigma factor in Escherichia coli. rpoD285
      (rpoD800) is a small deletion mutation in rpoD that confers a temperature
      sensitive growth phenotype because the mutant sigma 70 is rapidly degraded at
      high temperature. Extragenic mutations which reduce the rate of degradation of
      RpoD285 sigma 70 permit growth at high temperature. One class of such suppressors
      is located in rpoH, the gene encoding sigma 32, an alternative sigma factor
      required for transcription of the heat shock genes. One of these, rpoH113, is
      incompatible with rpoD+. We determined the mechanism of incompatibility. Although
      RpoH113 sigma 32 continues to be made when wild-type sigma 70 is present, cells
      show reduced ability to express heat shock genes and to transcribe from heat
      shock promoters. Glycerol gradient fractionation of sigma 32 into the holoenzyme
      and free sigma suggests that RpoH113 sigma 32 has a lower binding affinity for
      core RNA polymerase than does wild-type sigma 32. The presence of wild-type sigma
      70 exacerbates this defect. We suggest that the reduced ability of RpoH113 sigma
      32 to compete with wild-type sigma 70 for core RNA polymerase explains the
      incompatibility between rpoH113 and rpoD+. The rpoH113 cells would have reduced
      amounts of sigma 32 holoenzyme and thus be unable to express sufficient amounts
      of the essential heat shock proteins to maintain viability.

PMID- 1629157
TI  - Cloning, nucleotide sequences, and enzymatic properties of glucose dehydrogenase
      isozymes from Bacillus megaterium IAM1030.
AB  - Bacillus megaterium is known to have several genes that code for isozymes of
      glucose dehydrogenase. Two of them, gdhI and gdhII, were cloned from B.
      megaterium IAM1030 in our previous work (T. Mitamura, R. V. Evora, T. Nakai, Y.
      Makino, S. Negoro, I. Urabe, and H. Okada, J. Ferment. Bioeng. 70:363-369, 1990).
      In the present study, two new genes, gdhIII and gdhIV, were isolated from the
      same strain and their nucleotide sequences were identified. Each gene has an open
      reading frame of 783 bp available to encode a peptide of 261 amino acids. Thus, a
      total of four glucose dehydrogenase genes have been cloned from B. megaterium
      IAM1030. In addition, this strain does not seem to have other glucose
      dehydrogenase genes that can be distinguished from the four cloned genes so far
      examined by Southern hybridization analysis. The two newly cloned genes were
      expressed in Escherichia coli cells, and the products, GlcDH-III and GlcDH-IV,
      were purified and characterized and compared with the other isozymes, GlcDH-I and
      GlcDH-II, encoded by gdhI and gdhII, respectively. These isozymes showed
      different mobilities in sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      (GlcDH-I greater than GlcDH-III = GlcDH-IV greater than GlcDH-II), although they
      have the same number of amino acid residues. Double-immunodiffusion tests showed
      that GlcDH-I is immunologically different from the other isozymes and that GlcDH
      III and GlcDH-IV are identical to one another but a little different from GlcDH
      II. These glucose dehydrogenases were stabilized in the presence of 2 M NaCl. The
      effect of NaCl was especially large for GlcDH-III, which is most unstable enzyme.
      Kinetic studies showed that these isozymes are divided into two groups with
      respect to coenzyme specificity, although they can utilize both NAD and NADP:
      GlcDH-III and GlcDH-IV prefer NAD, and GlcDH-I and GlcDH-II prefer NADP. The
      phylogenic relationship of these glucose dehydrogenase genes is also discussed.

PMID- 1629158
TI  - Light and oxygen regulation of the synthesis of bacteriochlorophylls a and c in
      Chloroflexus aurantiacus.
AB  - Control of the synthesis of bacteriochlorophylls (Bchls) a and c by light and
      oxygen was studied in Chloroflexus aurantiacus grown in batch or chemostat
      culture with serine as the growth-limiting substrate. For comparison, inhibition
      by gabaculine of the formation of selected tetrapyrroles was studied. The
      inhibitory effect of gabaculine decreased in the following order of tetrapyrrole
      formation: coproporphyrin greater than Bchl c greater than Bchl a. Not only did
      addition of 5-aminolevulinate (ALA) reverse the inhibition by gabaculine, it also
      caused an increase in Bchl c content when the cultures grew at high
      concentrations of ALA. Inhibition of Bchl a, Bchl c, and coproporphyrin formation
      by oxygen was similar to inhibition by gabaculine. Addition of ALA to aerated
      cultures led to significant accumulation of coproporphyrin. These results suggest
      that oxygen inhibits tetrapyrrole formation at a site before ALA formation.
      Control by light was studied with chemostat cultures transferred from 5 klx to 25
      klx. This resulted in only a transient increase of the protein level of the
      culture, while specific contents of Bchls c and a and the ratio Bchl c/Bchl a
      decreased to lower steady states. However, the specific content of coproporphyrin
      increased. Addition of ALA to chemostat cultures adapted to 50 klx increased
      specific coproporphyrin and Bchl c contents by factors of about 20 and 4,
      respectively, while the specific Bchl a content was only slightly increased and
      protein levels were unaffected. Increasing the serine concentration caused an
      initial increase in the specific Bchl c content, which returned to the original
      value as soon as the protein content had attained its maximal level. These
      results suggest that light does not control ALA formation as strictly as oxygen
      and that competition of biomass formation and tetrapyrrole synthesis for common
      precursors may be influenced by light.

PMID- 1629159
TI  - Osmoprotection of Escherichia coli by ectoine: uptake and accumulation
      characteristics.
AB  - Ectoine (1,4,5,6-tetrahydro-2-methyl-4-pyrimidinecarboxylic acid) is a cyclic
      amino acid, identified as a compatible solute in moderately halophilic bacteria.
      Exogenously provided ectoine was found to stimulate growth of Escherichia coli in
      media of inhibitory osmotic strength. The stimulation was independent of any
      specific solute, electrolyte or nonelectrolyte. It is accumulated in E. coli
      cells proportionally to the osmotic strength of the medium, and it is not
      metabolized. Its osmoprotective ability was as potent as that of glycine betaine.
      The ProP and ProU systems are both involved in ectoine uptake and accumulation in
      E. coli. ProP being the main system for ectoine transport. The intracellular
      ectoine pool is regulated by both influx and efflux systems.

PMID- 1629160
TI  - Lignin peroxidase gene family of Phanerochaete chrysosporium: complex regulation
      by carbon and nitrogen limitation and identification of a second dimorphic
      chromosome.
AB  - Lignin peroxidases (LiP) of Phanerochaete chrysosporium are encoded by a family
      of six closely related genes. Five LiP genes have been localized to the same
      dimorphic chromosome. In this investigation, relative transcript levels of the
      LiP genes were determined. Transcripts of the LiPA, LiPB, and O282 genes were at
      similar levels in both carbon- and nitrogen-limited cultures. In contrast,
      transcription of the GLG5, V4, and GLG4 genes was dramatically altered by culture
      conditions. Under carbon-limited conditions, GLG4 transcripts were, by far, the
      most abundant. Southern blot analyses of clamped homogeneous field gels were used
      to map the GLG4 gene to a dimorphic chromosome separate from the other LiP genes.

PMID- 1629161
TI  - Production and characterization of a monoclonal antibody to the O-acetylated
      peptidoglycan of Proteus mirabilis.
AB  - A monoclonal antibody (PmPG5-3) specific for the O-acetylated peptidoglycan of
      Proteus mirabilis 19 was produced by an NS-1 myeloma cell line and purified from
      ascites fluid by a combination of ammonium sulfate precipitation and affinity
      chromatography. The monoclonal antibody (an immunoglobulin M) was characterized
      by a competition enzyme-linked immunosorbent assay to be equally specific for
      both insoluble and soluble O-acetylated peptidoglycan but weakly recognized
      chemically de-O-acetylated P. mirabilis peptidoglycan, the non-O-acetylated
      peptidoglycans from Escherichia coli and Bacillus subtilis, and the peptidoglycan
      monosaccharide precursors N-acetylglucosamine and N-acetylmuramic acid dipeptide.
      The monoclonal antibody did not react with D-alanine or lipopolysaccharide
      isolated from P. mirabilis. Based on this evidence, the binding epitope on the P.
      mirabilis peptidoglycan is predicted to be linear and to comprise the glycan
      backbone, including both the N- and O-acetyl moieties. Monoclonal antibody PmPG5
      3 was used to localize the O acetylation of the P. mirabilis peptidoglycan by
      immunoelectron microscopy. Murein sacculi of P. mirabilis were heavily and
      randomly labelled with the immunogold, whereas very little labelling and no
      labelling were observed on the sacculi isolated from de-O-acetylated P. mirabilis
      and E. coli, respectively. Based on the apparent pattern of immunogold labelling,
      a physiological role for peptidoglycan O acetylation in P. mirabilis is proposed.

PMID- 1629162
TI  - Menaquinone (vitamin K2) biosynthesis: nucleotide sequence and expression of the
      menB gene from Escherichia coli.
AB  - In Escherichia coli, the biosynthesis of the electron carrier menaquinone
      (vitamin K2) involves at least seven identified enzymes. One of these, naphthoate
      synthase, forms the bicyclic ring system by catalyzing the conversion of o
      succinylbenzoyl-coenzyme A to 1,4-dihydroxy-2-naphthoic acid. The gene for this
      enzyme has been previously identified as menB. By genetic and biochemical tests,
      a 1.349-kb DNA fragment from the E. coli men locus complements menB mutants. This
      fragment contains a single 285-codon open reading frame (ORF). Recombinant
      plasmids containing deletions of either the amino or the carboxy region of the
      ORF fail to complement the mutants. The ORF is preceded by consensus sequences
      for a ribosomal binding site and a sigma 70 promoter. menB transcription
      sufficient to complement the menB mutant in vivo and in vitro can be initiated
      from the identified putative promoter, and that in the constructs, menB
      expression, can be made independent of read-through transcription from the lac
      promoter. However, multicopy plasmids containing menB fail to generate the
      expected levels of enzymatic activity.

PMID- 1629163
TI  - Sequence organization and regulation of the Bacillus subtilis menBE operon.
AB  - Menaquinone (MK) plays a central role in the respiratory chain of Bacillus
      subtilis. The biosynthesis of MK requires the formation of a naphthoquinone ring
      via a series of specific reactions branching from the shikimate pathway. "Early"
      MK-specific reactions catalyze the formation of o-succinylbenzoate (OSB) from
      isochorismate, and "late" reactions convert OSB to dihydroxynaphthoate, by
      utilizing an OSB-coenzyme A intermediate. We have cloned and sequenced the B.
      subtilis menE and menB genes encoding, respectively, OSB-coenzyme A synthase and
      dihydroxynaphthoate synthase. The MenB open reading frame encodes a potential
      polypeptide of 261 amino acid residues with a predicted size of 28.5 kDa, while
      the MenE open reading frame could encode a 24.4-kDa polypeptide of 220 amino acid
      residues. Probable promoter sequences were identified by high-resolution primer
      extension assays. Organization of these genes and regulatory regions was found to
      be menBp menB menEp menE. Expression of menE was dependent on both menEp and
      menBp, indicating an operonlike organization. A region of dyad symmetry capable
      of forming a stable RNA secondary structure was found between menB and menE.
      Culture cycle-dependent expression of menB and menE was measured by steady-state
      transcript accumulation. For both genes, maximal accumulation was found to occur
      within an hour after the end of exponential growth. The menBp and menEp promoters
      have sequences compatible with recognition by the major vegetative form of B.
      subtilis RNA polymerase, E sigma A. Both promoter regions also were found to
      contain homologies to a sequence motif previously identified in the menCDp region
      and in promoters for several B. subtilis tricarboxylic acid cycle genes.

PMID- 1629164
TI  - Occurrence of novel groups of the domain Bacteria as revealed by analysis of
      genetic material isolated from an Australian terrestrial environment.
AB  - A molecular ecological study was performed on an Australian soil sample to
      unravel a substantial portion of the bacterial diversity. A large fragment of the
      16S rRNA gene was amplified, using DNA isolated by lysing the microorganisms
      directly within the soil matrix, and a clone library was generated. Comparative
      sequence analysis of 30 clones and dot blot hybridization of 83 additional clones
      with defined oligonucleotide probes revealed the presence of three major groups
      of prokaryotes of the domain Bacteria. The first one comprises 57 clones that
      indicate relatives of nitrogen-fixing bacteria of the alpha-2 subclass of the
      class Proteobacteria; the second group of 7 clones originates from members of the
      order Planctomycetales that, however, reveal no close relationship to any of the
      described Planctomycetales species; 22 clones of the third group are indicative
      of members of a novel main line of descent, sharing a common ancestry with
      members of planctomycetes and chlamydiae.

PMID- 1629165
TI  - In vitro activation of the Serratia marcescens hemolysin through modification and
      complementation.
AB  - The hemolytic activity of Serratia marcescens is determined by two polypeptides,
      termed ShlA and ShlB. ShlA is synthesized as an inactive precursor (ShlA*) and
      secreted with the help of ShlB, which is located in the outer membrane. In this
      study, it is shown that a cell lysate containing ShlB as well as partially
      purified ShlB converted ShlA* to the active ShlA hemolysin. ShlA remained active
      after removal of ShlB by column chromatography. In contrast to the stable
      modification of ShlA* by ShlB, a reversible activation was achieved by adding to
      ShlA* an N-terminal fragment of ShlA (ShlA16), consisting of 269 amino acid
      residues of ShlA and 18 residues of the vector. The nonhemolytic ShlA16
      complemented ShlA* only when it was synthesized in an ShlB-producing cell. A
      deletion derivative of ShlA*, lacking residues 4 to 117, was complemented by
      ShlA16 but not activated by ShlB. Activation of ShlA* by ShlB at 4 degrees C
      proceeded at a much slower rate than complementation by ShlA16. It is concluded
      that ShlA* is modified by ShlB. ShlA16 modified by ShlB complements the missing
      modification of ShlA* in trans. Modification by ShlB occurs in the N-terminal
      part of ShlA*, which is also the reaction in vivo which results in active ShlA
      hemolysin in the culture supernatant. The HpmA hemolysin of Proteus mirabilis,
      which is very similar to ShlA, was also activated in vitro by ShlB and
      complemented by ShlA16.

PMID- 1629166
TI  - Alkaline pH decreases expression of the accessory gene regulator (agr) in
      Staphylococcus aureus.
AB  - The effect of alkaline pH on expression of the accessory gene regulator (agr) in
      Staphylococcus aureus was examined. agr, a global regulator, affects the
      expression of numerous exoproteins, including alpha-hemolysin, toxic shock
      syndrome toxin 1, protein A, and staphylococcal enterotoxins types B, C, and D.
      agr contains two major, divergent transcripts, designated RNAII and RNAIII. In
      this study, the level of RNAIII was used to monitor agr expression because this
      transcript and/or its protein product(s) appears to be responsible for altering
      target gene expression. S. aureus FRI1230 and its Agr- derivative were examined
      in a fermentor system which allowed batch cultures to be maintained at a constant
      pH. FRI1230 cultures were grown at pH 6.5, 7.0, 7.5, and 8.0. Northern (RNA blot)
      analysis of samples revealed that maximal agr expression occurred at pH 7.0, with
      virtually no RNAIII observed at pH 8.0. The effect of alkaline pH on an agr
      target gene, sec, was also evaluated. sec expression was reduced at alkaline pH
      in strain FRI1230 (Agr+) but not in its Agr- derivative, indicating that an
      intact agr allele is required for the pH effect on sec. Examination of batch
      cultures under conditions of nonmaintained pH gave results that were also
      consistent with a role for alkaline pH in repressing agr expression.

PMID- 1629167
TI  - Anaerobic control of colicin E1 production.
AB  - Expression of the cea gene, which is carried by the ColE1 plasmid and which
      encodes colicin E1, was found to be greatly increased when the cells were grown
      anaerobically. By using cea-lacZ fusions to quantitate expression, aerobic levels
      were found to be only a few percent of the anaerobic levels. The anaerobic
      increase in expression was observed both in protein and in operon fusions,
      indicating that its regulation occurred at the level of transcription. It was
      also found to require a functional fnr gene and to occur when the cea-lacZ fusion
      was present as a single copy in the bacterial chromosome instead of in the
      multicopy ColE1 plasmid. Anaerobic expression was regulated by the SOS response
      and catabolite repression as is aerobic expression. The start site of the mRNA
      produced under anaerobic conditions was mapped by primer extension and found to
      be the same as the start for mRNA produced under aerobic conditions. These
      observations show that the cea gene is anaerobically regulated and that the Fnr
      protein is a positive regulator of transcription of this gene.

PMID- 1629168
TI  - Interaction of LexA repressor with the asymmetric dinG operator and complete
      nucleotide sequence of the gene.
AB  - The dinG gene was originally isolated during a search for Escherichia coli
      promoters which are components of the SOS regulon. The regulatory region of this
      gene contains a potential binding site for LexA repressor which is quite
      different from other known sites. All previously described chromosomal LexA
      operators are imperfect palindromes containing the sequence CTG(N10)CAG. The
      noncanonical dinG sequence breaks the symmetry and takes the form TTG(N10)CAG. In
      the present study, a search for mutations within dinGop::galK fusion plasmids
      which render transcription independent of intracellular levels of LexA has
      yielded mutations only within this 16-bp sequence. Electrophoretic mobility shift
      assays performed with purified mutant and wild-type operator fragments revealed
      that the affinity of LexA for each of the mutant sites is greatly reduced
      compared with that of the wild type. One of the mutants contained an alteration
      in the putative promoter of dinG which increased the similarity of the -35 region
      to the consensus sequence (TTGGCT----TTGACT); the apparent promoter activity of
      this construct was subsequently found to be approximately eight times higher than
      that of the wild type in vivo. Additional experiments have established the
      complete nucleotide sequence of the dinG gene. A long open reading frame located
      immediately downstream of the asymmetric operator segment which could potentially
      encode a 72.9-kDa DinG protein was identified.

PMID- 1629169
TI  - Membrane ultrastructure of alkaliphilic Bacillus species studied by rapid-freeze
      electron microscopy.
AB  - Cells of Bacillus firmus OF4 and Bacillus alcalophilus were examined by rapid
      freeze freeze-fracture and freeze-substitution electron microscopy. No special
      vesicular structures linked to growth at alkaline pH were found, either within or
      associated with the cytoplasmic membrane. The cytoplasmic membranes of the
      alkaliphilic bacilli and the neutrophilic Bacillus subtilis BD99 were
      indistinguishable. Distinctive intramembrane particle rings, presumed to be
      flagellar structures on the basis of distribution and morphological
      characteristics, were found in all of these species. These observations indicate
      that the adaptations required to effect oxidative phosphorylation and flagellar
      rotation at extreme alkaline pH occur without gross morphological rearrangement.

PMID- 1629170
TI  - Homology among Escherichia coli K1 and K92 polysialytransferases.
AB  - The neuS-encoded polysialytransferase (polyST) in Escherichia coli K1 catalyzes
      synthesis of polysialic acid homopolymers composed of unbranched sialyl alpha 2,8
      linkages. Subcloning and complementation experiments showed that the K1 neuS was
      functionally interchangeable with the neuS from E. coli K92 (S. M. Steenbergen,
      T. J. Wrona, and E. R. Vimr, J. Bacteriol. 174:1099-1108, 1992), which
      synthesizes polysialic acid capsules with alternating sialyl alpha 2,8-2,9
      linkages. To better understand the relationship between these polySTs, the
      complete K92 neuS sequence was determined. The results demonstrated that K1 and
      K92 neuS genes are homologous and indicated that the K92 copy may have evolved
      from its K1 homolog. Both K1 and K92 structural genes comprised 1,227 bp. There
      were 156 (12.7%) differences between the two sequences; among these mutations, 55
      did not affect the derived primary structure of K92 polyST and hence were
      synonymous with the K1 sequence. Assuming maximum parsimony, another estimated 17
      synonymous mutations plus 84 nonsynonymous mutations could account for the 70
      amino acid replacements in K92 polyST; 36 of these replacements were judged to be
      conservative when compared with those of K1 polyST. There were no changes
      detected in the first 146 5' or last 129 3' bp of either gene, suggesting, in
      addition to the observed mutational differences, the possibility of a past
      recombination event between neuS loci of two different kps clusters. The results
      indicate that relatively few amino acid changes can account for the evolution of
      a glycosyltransferase with novel linkage specificity.

PMID- 1629171
TI  - Production of an extracellular milk-clotting activity during development in
      Myxococcus xanthus.
AB  - We describe here an extracellular proteolytic activity secreted during both
      growth and submerged development by Myxococcus xanthus DK1622. This activity
      yields the clotting of kappa-casein at pH 6 and is inhibited by specific
      inhibitors of aspartic proteases. Secretion of this milk-clotting proteolytic
      activity (of Mcp) is time regulated during the developmental cycle, with a large
      increase near 9 h poststarvation, but its production does not require cell-cell
      contact. The lack of secretion of this activity by several developmental mutants
      in submerged development conditions shows that Mcp production is developmentally
      regulated.

PMID- 1629172
TI  - A macrolide 3-O-acyltransferase gene from the midecamycin-producing species
      Streptomyces mycarofaciens.
AB  - The Streptomyces mycarofaciens mdmB gene encodes a 3-O-acyltransferase that
      catalyzes the addition of acetyl and propionyl groups to position 3 of the
      lactone ring in 16-member macrolide antibiotics like midecamycin and spiramycin.
      A putative O-methyltransferase gene (mdmC) is immediately downstream of mdmB, and
      both of these genes are closely linked to the mdmA midecamycin resistance gene.

PMID- 1629173
TI  - Phosphate taxis in Pseudomonas aeruginosa.
AB  - Pseudomonas aeruginosa was shown to be attracted to phosphate. The chemotactic
      response was induced by phosphate starvation. The specificity of chemoreceptors
      for phosphate was high so that no other tested phosphorus compounds elicited a
      chemotactic response as strong as that elicited by phosphate. Competition
      experiments showed that the chemoreceptors for phosphate appeared to be different
      from those for the common amino acids. Mutants constitutive for alkaline
      phosphatase showed the chemotactic response to phosphate regardless of whether
      the cells were starved for phosphate.

PMID- 1629174
TI  - Altered murein composition in a DD-carboxypeptidase mutant of Streptococcus
      pneumoniae.
AB  - The muropeptide composition of a Streptococcus pneumoniae mutant in which the DD
      carboxypeptidase (penicillin-binding protein 3) gene was interrupted by plasmid
      insertion close to the 3' end of the gene was examined. Extensive compositional
      changes were observed: the linear pentapeptide, a minor component of the parental
      cells, became the most abundant monomeric peptide in the mutant wall, while the
      proportion of tripeptides that represent the main monomers in the parental cells
      was greatly reduced. The amount of the major dimer of parental cells, the
      directly cross-linked tri-tetrapeptide, was also reduced by a factor of 4. It was
      partially replaced by a novel dimer: the cross-linked product of a linear
      pentapeptide and a pentapeptide carrying a serylalanine dipeptide substituent on
      the epsilon-NH2 group of its lysine residue. This dimer together with two other
      dimeric peptides, each containing the serylalanine cross bridge, became the
      quantitatively major components of the mutant peptidoglycan.

PMID- 1629175
TI  - Activation defects caused by mutations in Escherichia coli rpoA are promoter
      specific.
AB  - Escherichia coli RNA polymerases containing mutated alpha subunits were tested
      for their ability to respond to three different positive regulators (activators)
      in vitro. The two alpha (rpoA) mutants, alpha-256 and alpha-235, have deletions
      of the C-terminal 73 and 94 amino acids, respectively. In runoff transcription
      assays catalyzed by reconstituted holoenzyme, the effects of the mutations on
      each of three promoters tested were different: activation of the lambda pRM
      promoter by cI protein (repressor) was nearly normal, activation of the lambda
      pRE promoter by cII protein was reduced approximately fivefold, and direct
      activation of the trpPB promoter of Pseudomonas aeruginosa was completely
      inhibited. We also found that the reconstituted mutant enzyme was defective in
      recognition of trpPI in the absence of activator. The differential responses of
      the three promoters to their activators in the presence of the mutant enzymes
      indicate that the location of an activator-binding site does not by itself
      determine the region of RNA polymerase with which the activator interacts.

PMID- 1629177
TI  - Construction and characterization of Streptomyces coelicolor A3(2) mutants that
      are multiply deficient in the nonessential hrd-encoded RNA polymerase sigma
      factors.
AB  - Previous studies showed that Streptomyces coelicolor A3(2) has four genes (hrdA,
      hrdB, hrdC, and hrdD) that appear to encode RNA polymerase sigma factors very
      similar to the sigma 70 subunit of Escherichia coli and that hrdC and hrdD could
      be individually disrupted without causing obvious phenotypic defects. Here, hrdA
      was cloned and stable null hrdA and hrdD mutants were constructed by gene
      replacement. These two mutants and a previously constructed hrdC null mutant were
      used in crosses to generate hrdAC, hrdAD, hrdCD, and hrdACD strains. The
      inability to synthesize one, two, or all three of the nonessential hrd-encoded
      sigma factors had no obvious phenotypic consequences.

PMID- 1629176
TI  - The Agrobacterium tumefaciens virD3 gene is not essential for tumorigenicity on
      plants.
AB  - Genetic studies indicate that three of the four polypeptides encoded within the
      virD operon of the Agrobacterium tumefaciens Ti plasmid are essential for
      virulence. In order to determine whether the fourth polypeptide, VirD3, has any
      role in virulence, complementation analysis was used. An A. tumefaciens strain,
      A348 delta D, which lacked the entire virD operon in the Ti plasmid pTiA6, was
      constructed. Plasmids containing defined regions of the virD operon were
      introduced into this strain, and virulence was tested by the strains' abilities
      to form tumors on Kalanchoe leaves, tomato stems, and potato tubers. As expected,
      deletion of the virD operon led to an avirulent phenotype. The virulence of this
      strain could be restored by providing virD1, virD2, and virD4 in trans. No
      requirement for virD3 in tumor formation was observed in these assays.

PMID- 1629178
TI  - A general method for cloning recA genes of gram-positive bacteria by polymerase
      chain reaction.
AB  - An internal fragment of the recA gene from eight gram-positive organisms has been
      amplified by using degenerate primers in a polymerase chain reaction. The
      internal 348- or 360-bp recA DNA segments from Bacillus subtilis, Clostridium
      acetobutylicum, Lactobacillus bulgaricus, Lactobacillus helveticus, Leuconostoc
      mesanteroides, Listeria monocytogenes, Staphylococcus aureus, and Streptococcus
      salivarus subsp. thermophilus were amplified, cloned, and sequenced. The G + C
      contents of the DNA from these species range from 28 to 52%. The sequences of the
      bacterial recA genes show strong relatedness. This method is particularly useful
      for the recovery of the recA genes of gram-positive bacteria and avoids the
      difficulties of using a genetic complementation test for cloning.

PMID- 1629179
TI  - mRNP4, a major mRNA-binding protein from Xenopus oocytes is identical to
      transcription factor FRG Y2.
AB  - Previous work has revealed a striking similarity between the sequence of mRNP4, a
      major mRNA-binding protein of Xenopus laevis oocytes and FRG Y2, a transcription
      factor specific for Y-box-containing promoters. However, the apparent molecular
      mass of mRNP4 exceeds by 50-60% the cDNA-deduced molecular mass of FRG Y2. To
      resolve this discrepancy we have measured the real molecular mass of mRNP4 by
      sedimentation equilibrium. The molecular mass of mRNP4 closely agrees with that
      of FRG Y2. We conclude that mRNP4 is identical to FRG Y2 and has a dual function
      in oocytes. As a DNA-binding protein, mRNP4 stimulates transcription from a
      specific set of promoters. As a mRNA-binding protein, mRNP4 favors accumulation
      of the transcripts it contributes to produce.

PMID- 1629180
TI  - The matrix metalloproteinase pump-1 catalyzes formation of low molecular weight
      (pro)urokinase in cultures of normal human kidney cells.
AB  - The enzyme responsible for the metalloproteinase activity which cleaves the
      Glu143-Leu144 bond of (pro)urokinase has been isolated from the conditioned
      medium of cultured normal human kidney cells. Using S-Sepharose and Cibacron Blue
      agarose chromatography, then C-4 reversed phase high pressure liquid
      chromatography, a protein of about 20,000 Da was isolated. Through an identical
      amino-terminal sequence, the protein was shown to be the matrix metalloproteinase
      previously referred to in the literature as "pump-1" (putative
      metalloproteinase). When aprotinin was added during the course of the
      purification, the major species isolated was the zymogen form (28,000 Da) of pump
      1. Pump-1 has been shown to efficiently cleave the susceptible bond of both pro
      urokinase (single-chain) and active (two-chain) urokinase and thereby produce the
      corresponding low molecular weight forms. The amino-terminal sequences of the A
      and B chains of low molecular weight urokinase prepared by action of pump-1 on
      recombinant high molecular weight urokinase are identical to those of the low
      molecular weight urokinase isolated from human kidney cell culture. Since the
      reaction of urokinase with this metalloproteinase results in separation of its
      serine proteinase region from the domain which mediates binding to the urokinase
      receptor, it may be of importance in the regulation of the functional activity of
      the plasminogen activator in cellular processes.

PMID- 1629181
TI  - Specificity of G protein beta and gamma subunit interactions.
AB  - Multiple heterotrimeric guanine nucleotide binding protein (G protein) subunits
      have evolved to couple a large variety of receptors to intracellular effectors. G
      protein beta gamma subunits are essential for efficient coupling of alpha
      subunits to receptors, and they are also important for modulation of effectors.
      Several different beta and gamma subunits exist, but it is not known whether all
      possible combinations of beta and gamma can form functional dimers. To answer
      this question, we have compared the ability of in vitro translated beta 1, beta
      2, and beta 3 to form dimers with either gamma 1 or gamma 2. Dimerization was
      monitored by gel filtration, resistance to tryptic digestion, and chemical cross
      linking. The results indicate that beta 1 binds both gamma subunits, beta 2 binds
      only gamma 2, and beta 3 will bind neither gamma 1 or gamma 2. Hence, the
      occurrence of beta gamma dimers may be partially regulated by the ability of the
      subunits to associate. Specificity of dimerization might allow cells to co
      express multiple beta and gamma subunits while maintaining efficient and specific
      signal transduction.

PMID- 1629182
TI  - Rapid assembly and disassembly of complementary DNA strands through an
      equilibrium intermediate state mediated by A1 hnRNP protein.
AB  - A1 hnRNP protein, which rapidly renatures complementary strands of nucleic acids
      in vitro, affects both the equilibrium and kinetic properties of the reaction
      (single-stranded DNA in equilibrium with double-stranded DNA). A1 lowers the
      melting transition of duplex DNA. However, at temperatures above this new Tm,
      both single- and double-stranded DNAs are present at equilibrium and are rapidly
      interconverting. Although the ratio of single and double strands under these
      conditions is a function of both the A1 protein and complementary DNA strand
      concentrations, it is not strongly affected by further increases in temperature.
      These surprising results demonstrate that A1 does not act as a simple catalyst in
      promoting renaturation and indicate how A1 and other proteins could act to speed
      the turnover of intermediate complexes in important biological processes.

PMID- 1629183
TI  - Chondroitin sulfate proteoglycan form of the Alzheimer's beta-amyloid precursor.
AB  - The Alzheimer's amyloid beta protein is derived from a family of membrane
      glycoproteins termed amyloid precursor proteins (APP). Here we show that APP
      exists as the core protein of a chondroitin sulfate (CS) proteoglycan, ranging in
      apparent molecular size from 140 to 250 kDa, secreted by glial cell line C6.
      After partial purification on ion-exchange and gel chromatography, the secreted
      APP proteoglycan was recognized on Western blots by several antibodies specific
      to different regions of APP. Chondroitinase AC or ABC treatment of our samples
      completely eliminated the high molecular weight proteoglycan with a concomitant
      increase in the APP protein. This digested product reacted with an anti-stub
      antibody which recognizes 4-sulfated disaccharide. Sequencing of the N terminus
      of the core protein of this CS proteoglycan yielded 18 residues identical to the
      N terminus sequence of the mature APP. Quantitative analysis showed that, in this
      cell line, about 90% of the secreted nexin II form of APP occurs in the
      proteoglycan form, suggesting that the CS chains have a role in the biological
      function of this protein. The close proximity of two consensus CS attachment
      sites to both the N terminus of the amyloid beta protein and the secretase
      cleavage site, suggests that the CS chains may affect the proteolysis of APP and
      production of the amyloid beta protein.

PMID- 1629184
TI  - U73122 inhibits Ca2+ oscillations in response to cholecystokinin and carbachol
      but not to JMV-180 in rat pancreatic acinar cells.
AB  - Stimulation of rat pancreatic acinar cells with low concentrations of
      phosphatidylinositol (PI)-linked secretagogues induces [Ca2+]i oscillations,
      without measurable changes in the formation of inositol 1,4,5-trisphosphate.
      Therefore, we tested U73122 a new phospholipase C inhibitor to determine if PI
      turnover is necessary for the generation of [Ca2+]i oscillations. In acini
      prelabeled with [3H]inositol, PI hydrolysis on stimulation with either
      cholecystokinin or carbachol was inhibited dose-dependently by U73122, with a
      maximal effect seen at 10 microM; the formation of inositol 1,4,5-trisphosphate,
      measured using a radioreceptor assay, was also similarly inhibited. By contrast
      secretin- or vasoactive intestinal peptide-stimulated production of cAMP was
      unaffected by 10 microM U73122. These studies indicate that U73122 is a
      relatively specific inhibitor of G-protein-mediated phospholipase C activation in
      pancreatic acini. In fura-2-loaded acini, U73122 inhibited the increases in
      [Ca2+]i stimulated by these high concentrations of secretagogues which can be
      demonstrated to elicit PI turnover. The [Ca2+]i signal generated by directly
      stimulating G-proteins with sodium fluoride was also inhibited by U73122;
      however, the [Ca2+]i rise induced by thapsigargin was unaffected. These data
      indicate that the mechanism of inhibition was distal to the occupation of cell
      surface receptors but did not involve an interference of Ca2+ metabolism in
      general. When [Ca2+]i oscillations were elicited by low concentrations of
      cholecystokinin or carbachol, U73122 rapidly inhibited the oscillating [Ca2+]i
      signal. In contrast, oscillations induced by an analogue of cholecystokinin, JMV
      180, which does not stimulate changes in PI metabolism at any concentration, were
      unaffected. This indicates that cholecystokinin- and carbachol-induced
      oscillations are probably initiated by small, localized changes in PI metabolism,
      which are not readily detectable. However, the inability of U73122 to inhibit JMV
      180-induced oscillations indicates that PI metabolism may not necessarily be a
      prerequisite for the generation of [Ca2+]i oscillations.

PMID- 1629185
TI  - Deletion of lactose repressor carboxyl-terminal domain affects tetramer
      formation.
AB  - The carboxyl-terminal sequence of the lac repressor protein contains heptad
      repeats of leucines at positions 342, 349, and 356 that are required for tetramer
      assembly, as substitution of these leucine residues yields solely dimeric species
      (Chakerian, A. E., Tesmer, V. M., Manly, S. P., Brackett, J. K., Lynch, M. J.,
      Hoh, J. T., and Matthews, K. S. (1991) J. Biol. Chem. 266, 1371-1374; Alberti,
      S., Oehler, S., von Wilcken-Bergmann, B., Kramer, H., and Muller-Hill, B. (1991)
      New Biol. 3, 57-62). To further investigate this region, which may form a leucine
      zipper motif, a family of lac repressor carboxyl-terminal deletion mutants
      eliminating the last 4, 5, 11, 18, and 32 amino acids (aa) has been constructed.
      The -4 aa mutant, in which all of the leucines in the presumed leucine zipper are
      intact, is tetrameric and displays operator and inducer binding properties
      similar to wild-type repressor. The -5 aa, -11 aa, -18 aa, and -32 aa deletion
      mutants, depleted of 1, 2, or all 3 of the leucines in the heptad repeats, are
      all dimeric, as demonstrated by gel filtration chromatography. Circular dichroism
      spectra and protease digestion studies indicate similar secondary/tertiary
      structures for the mutant and wild-type proteins. Differences in reaction with a
      monoclonal antibody specific for a subunit interface are observed for the dimeric
      versus tetrameric proteins, indicative of exposure of the target epitope as a
      consequence of deletion. Inducer binding properties of the deletion mutants are
      similar to wild-type tetrameric repressor at neutral pH. Only small differences
      in affinity and cooperativity from wild-type are evident at elevated pH; thus,
      the cooperative unit within the tetramer appears to be the dimer. "Apparent"
      operator binding affinity for the dimeric proteins is diminished, although
      minimal change in operator dissociation rate constants was observed. The
      diminution in apparent operator affinity may therefore derive from either 1)
      dissociation of the dimeric mutants to monomer generating a linked equilibrium or
      2) alterations in intrinsic operator affinity of the dimers; the former
      explanation is favored. This detailed characterization of the purified mutant
      proteins confirms that the carboxyl-terminal region is involved in the dimer
      dimer interface and demonstrates that cooperativity for inducer binding is
      contained within the dimer unit of the tetramer structure.

PMID- 1629186
TI  - Prostaglandin endoperoxide synthase substituted with manganese protoporphyrin IX.
      Formation of a higher oxidation state and its relation to cyclooxygenase
      reaction.
AB  - The heme in prostaglandin endoperoxide synthase (PGH synthase) was substituted
      with Mn(III)-protoporphyrin IX. The resulting enzyme, Mn-PGH synthase, showed
      full cyclooxygenase activity but only 0.9% of the peroxidase activity of the
      native iron enzyme. During the reaction with exogenous or endogenously produced
      hydroperoxides, a spectral intermediate of Mn-PGH synthase was observed. The
      electronic absorption bands of the resting enzyme at 376, 472, and 561 nm
      decreased, and the intermediate's bands at 417, around 513, and 625 nm appeared.
      The rate constant of the formation of the intermediate was about 10(4) M-1.s-1 at
      22 degrees C, three orders of magnitude lower than with the iron enzyme. Spectral
      properties, conditions of formation, and the suppressed formation in the presence
      of electron donors provide evidence for a higher oxidation state of Mn-PGH
      synthase, tentatively a Mn(IV) species. This species was assigned to an
      intermediate in the peroxidase reaction of Mn-PGH synthase, the low activity of
      which was explained by the rate-limiting slow reaction of Mn-PGH synthase with
      hydroperoxides. The findings and interpretation are consistent with the published
      properties of other manganese-substituted peroxidases. Although the
      cyclooxygenase activity was similar to that of Fe-PGH synthase, the
      cyclooxygenase reaction of Mn-PGH synthase showed distinct differences in
      comparison with Fe-PGH synthase. A longer activation phase was observed which
      resembled the time course of the formation of the higher oxidation state.
      Glutathione peroxidase with glutathione, a hydroperoxide-scavenging system,
      inhibited the cyclooxygenase of Mn-PGH synthase at concentrations where the
      activity of Fe-PGH synthase was not affected. It is demonstrated that Mn-PGH
      synthase requires higher concentrations of hydroperoxides for the activation of
      the cyclooxygenase. These findings suggest that the substitution of iron with
      manganese in PGH synthase does not change the mechanism of the enzyme. The main
      difference is the much lower rate of the reaction with hydroperoxides which
      affects both the peroxidase activity and the hydroperoxide-dependent activation
      of the cyclooxygenase. A reaction scheme for Mn-PGH synthase is proposed
      analogous to that suggested for Fe-PGH synthase (Karthein, R., Dietz, R.,
      Nastainczyk, W., and Ruf, H. H. (1988) Eur. J. Biochem. 171, 313-320).

PMID- 1629187
TI  - Differentiation-dependent expression of retinoid-binding proteins in BFC-1 beta
      adipocytes.
AB  - Recently, we demonstrated that adipose tissue plays an important role in retinol
      storage and retinol-binding protein (RBP) synthesis. Our data suggested that RBP
      expression in adipose tissue is dependent on the state of adipocyte
      differentiation. To examine this possibility, we explored the differentiation
      dependent expression of RBP using BFC-1 beta preadipocytes, which can be
      stimulated to undergo adipose differentiation. Total RNA was isolated from
      undifferentiated (preadipocytes) and differentiated (adipocytes) BFC-1 beta cells
      and analyzed by Northern blotting. RBP mRNA was not detected in the
      preadipocytes, but considerable RBP mRNA was present in differentiated BFC-1 beta
      cells. In BFC-1 beta cells, induced to differentiate with insulin and thyroid
      hormone, RBP mRNA was first detected after 4 days, reached a maximum level by day
      10, and remained at this maximum level for at least 2 more days. Cellular retinol
      binding protein was expressed at low levels in the BFC-1 beta preadipocytes and
      the level of expression increased for 6 days after induction to differentiate and
      slowly declined on later days. Neither the maximum level of RBP expression nor
      the day on which this level was reached was influenced by the level of retinol
      provided in the BFC-1 beta culture medium. BFC-1 beta cells secreted newly
      synthesized RBP into the culture medium at a rate of 43 +/- 14 ng RBP/24 h/10(6)
      adipocytes. When the BFC-1 beta adipocytes were provided 1.0 microM retinol in
      the medium, they accumulated the retinol and synthesized retinyl esters. These
      studies with BFC-1 beta cells confirm that RBP synthesis and secretion and
      retinol accumulation are intrinsic properties of differentiated adipocytes.
      Furthermore, they suggest that RBP and cellular retinol-binding protein gene
      expression are regulated as part of a package of genes which are modulated during
      adipocyte differentiation.

PMID- 1629188
TI  - Identification of TIMP-2 in human alveolar macrophages. Regulation of
      biosynthesis is opposite to that of metalloproteinases and TIMP-1.
AB  - We have identified the metalloproteinase inhibitor TIMP-2 as a secreted product
      of human alveolar macrophages. In contrast to human fibroblasts, TIMP-2 was
      released from macrophages free of any apparent complexed metalloproteinases. Also
      in marked distinction to fibroblasts, TIMP-2 secretion from mononuclear
      phagocytes was subject to modulation by a variety of agents. TIMP-2 was
      synthesized by macrophages placed in culture under basal conditions in amounts
      approximately 30% of those secreted by fibroblasts on a per cell basis. The
      additions of lipopolysaccharide, denatured type I collagen, and zymosan to
      culture medium each resulted in a dose-dependent and profound decrease in
      macrophage TIMP-2 protein production and steady-state mRNA levels. In contrast,
      all of these agents markedly enhanced the biosynthesis of macrophage interstitial
      collagenase and TIMP-1 as assessed by analysis of identical cell and conditioned
      media samples. In human fibroblasts, TIMP-2 biosynthesis was unaffected by
      interleukin-1, tumor necrosis factor-alpha, platelet-derived growth factor, and
      phorbol ester despite the massive collagenase stimulation induced by each of
      these agents. We conclude that TIMP-2 is a potentially important mononuclear
      phagocyte product whose biosynthesis is regulated in a distinct and completely
      opposite manner to that of collagenase and TIMP-1.

PMID- 1629189
TI  - Ligand binding specificity of the leukocyte response integrin expressed by human
      neutrophils.
AB  - The ligand binding specificity of the leukocyte response integrin (LRI) expressed
      by polymorphonuclear leukocyte (PMN) was investigated by examining its
      interaction with two adhesion motifs within fibrinogen: the alpha chain sequence
      RGD and the gamma chain sequence KQAGDV. The effect of the hexapeptides KQAGDV,
      KQRGDV, and KGAGDV on fibrinogen-stimulated phagocytosis, a LRI-dependent
      function, was examined. Surprisingly, the sequence KGAGDV was most potent for
      inhibition of fibrinogen-stimulated ingestion; the order of potency of these
      peptides was KGAGDV greater than KQAGDV greater KQRGDV = GRGDSPA. Latex spheres
      coated with multivalent KGAGDV bound specifically to PMN and antibodies that
      recognized either the LRI beta chain (7G2) or an associated protein (IAP)
      abrogated bead binding. Various control and anti-beta 1 and anti-beta 2
      antibodies did not affect bead binding. Monovalent peptides KGAGDV and KQRGDV
      were equipotent for inhibition of bead binding to unstimulated PMN (ID50 = 19
      microM). In contrast, KGAGDV was more potent than KQRGDV for inhibition of bead
      binding to N-formylmethionylleucylphenylalanine-stimulated PMN (ID50 = 2.5 microM
      versus ID50 = 60 microM). A control peptide, KGALEVA, did not inhibit LRI ligand
      binding or function. These data suggest that the unique amino acid sequence
      KGAGDV may represent a specific ligand for LRI and that LRI ligand binding
      specificity may be regulated by the activation state of the cell.

PMID- 1629190
TI  - Regulation of intracellular pH values in higher plant cells. Carbon-13 and
      phosphorus-31 nuclear magnetic resonance studies.
AB  - The regulation of the cytoplasmic and vacuolar pH values (pHc and pHv) in
      sycamore (Acer pseudoplatanus L.) cells was analyzed using 31P and 13C nuclear
      magnetic resonance spectroscopy. Suspension-cultured cells were compressed in the
      NMR tube and perfused with the help of an original arrangement enabling a tight
      control of the pH (external pH, pHe) of the carefully oxygenated circulating
      nutrient medium. Intracellular pH values were measured from the chemical shifts
      of: CH2-linked carboxyl groups of citric acid below pH 5.7; orthophosphate
      between pH 5.7 and 8.0; 13C-enriched bicarbonate over pH 8.0. pHc and pHv were
      independent of pHe over the range 4.5-7.5. In contrast intracellular pH values
      decreased rapidly below pHe 4.5 and increased progressively at pHe over 7.5.
      There was an acceleration in the rate of O2 consumption accompanied with a
      decrease in cytoplasmic ATP concentration as pHe decreased. When the rate of O2
      consumption was approaching the uncoupled O2 uptake rate, a loss of pHc control
      was observed. It is concluded that as pHe decreased, the plasma membrane ATPase
      consumed more and more ATP to reject the invading H+ ions in order to maintain
      pHc at a constant value. Below pHe 4.5 the efficiency of the H+ pump to react to
      back leakage of H+ ions became insufficient, leading to an acidification of pHc
      and to an alkalinization of pHe. On the other hand, over pHe 7.5 a passive influx
      of OH- ions was observed, and pHc increased proportionally to the increase of
      pHe. Simultaneously appreciable amounts of organic acids (malate and citrate)
      were synthesized by cells during the course of the alkalinization of the
      cytoplasmic compartment. The synthesis of organic acids which partially
      counteract the alkalinization of the cytoplasmic compartment may result from a
      marked activation of the cytoplasmic phosphoenolpyruvate carboxylase induced by
      an increase in cytoplasmic bicarbonate concentration. The fluctuations of pHv
      followed a similar course to that of pHc. It is concluded that the vacuole, which
      represents a potentially large H+ ions reservoir, can counteract H+ (or OH-) ion
      invasion observed at acidic (or alkaline) pHe contributing to the homeostasis of
      pHc.

PMID- 1629191
TI  - Isolation of a carotenoid-containing sub-membrane particle from the chloroplastic
      envelope outer membrane of pea (Pisum sativum).
AB  - Chloroplastic envelope membranes isolated from pea (Pisum sativum) leaves are
      rich in carotenoids, containing approximately 2 micrograms of carotenoid mg-1
      protein. We report here that envelopes can be surfactant-solubilized while
      maintaining association of carotenoids with protein components of the membrane.
      Treatment of isolated chloroplastic envelope membranes with 0.5% Deriphat 160 (N
      lauryl-beta-imminodipropionate) causes general solubilization but preserves an
      envelope sub-membrane fragment which is fractionated by centrifugation in a
      sucrose gradient and by chromatography on a column of DEAE-Sephacel. The isolated
      submembrane complex contained five major proteins with M(r) values equivalent to
      75,000, 36,000, 34,000 17,500, and 14,500. Spectroscopic and chromatographic
      analyses revealed that the complex contains violaxanthin and at least one other
      carotenoid. Carotenoid content of the fractionated complex was estimated as 4.8
      micrograms mg-1 protein. Immunoblot analysis reveals that the constituent
      proteins of this complex are derived from the chloroplastic outer envelope
      membrane. These data suggest that at least some of the carotenoids of the
      chloroplastic envelope may be organized by apoproteins.

PMID- 1629192
TI  - Phosphorylation of casein kinase II by p34cdc2 in vitro and at mitosis.
AB  - In human epidermal carcinoma A431 cells, the beta subunit of casein kinase II is
      phosphorylated at an autophosphorylation site and at serine 209 which can be
      phosphorylated in vitro by p34cdc2 (Litchfield, D. W., Lozeman, F. J., Cicirelli,
      M. F., Harrylock, M., Ericsson, L. H., Piening, C. J., and Krebs, E. G. (1991) J.
      Biol. Chem. 266, 20380-20389). Given the importance of p34cdc2 in the regulation
      of cell cycle events, we were interested in examining the phosphorylation of
      casein kinase II during different stages of the cell cycle. In this study it is
      demonstrated that the extent of phosphorylation of serine 209 in the beta subunit
      is significantly increased relative to phosphorylation of the autophosphorylation
      site when chicken bursal lymphoma BK3A cells are arrested at mitosis by
      nocodazole treatment. This result suggests that serine 209 is a likely
      physiological target for p34cdc2. In addition, the alpha subunit of casein kinase
      II also undergoes dramatic phosphorylation with an associated alteration in its
      electrophoretic mobility when BK3A cells or human Jurkat cells are arrested with
      nocodazole. Phosphopeptide mapping studies indicate that p34cdc2 can
      phosphorylate in vitro the same peptides on the alpha subunit that are
      phosphorylated in cells arrested at mitosis. These phosphorylation sites were
      localized to serine and threonine residues in the carboxyl-terminal domain of
      alpha. Taken together, the results of this study indicate that casein kinase II
      is a probable physiological substrate for p34cdc2 and suggest that its functional
      properties could be affected in a cell cycle-dependent manner.

PMID- 1629193
TI  - The protein-protein complex between pp60v-src and hsp90 is stabilized by
      molybdate, vanadate, tungstate, and an endogenous cytosolic metal.
AB  - In a recent study demonstrating the cell-free reconstitution of the pp60v-src
      hsp90 complex, we found that the tyrosine kinase-hsp90 complex is stabilized by
      molybdate (Hutchison, K. A., Brott, B. K., De Leon, J. H., Perdew, G. H., Jove,
      R., and Pratt, W. B. (1992) J. Biol. Chem. 267, 2902-2908). In this paper, we
      examine in detail the stabilization of this protein-protein interaction by
      transition metal oxyanions. The pp60v-src-hsp90 complex is stabilized by sodium
      molybdate with the same concentration dependence as the glucocorticoid receptor
      hsp90 complex. As with the steroid receptor heterocomplexes, vanadate and
      tungstate also stabilize the pp60v-src-hsp90 interaction. Passage of cytosol
      through a Chelex-100 metal-chelating resin destabilizes the native pp60v-src
      hsp90 complex, suggesting that the complex is normally stabilized by an
      endogenous metal factor. Readdition of either the heat-stable components of
      cytosol or a partially purified endogenous metal factor stabilizes the metal
      depleted complex. Molybdate also stabilizes the presence of p50, a known hsp90
      associated protein, in the pp60v-src heterocomplex. Given the identical effects
      of transition metal oxyanions on both pp60v-src- and steroid receptor-hsp90
      complexes and the lack of any sequence homology between pp60v-src and the
      receptors, it seems very likely that it is the common component, hsp90, that
      contains the site of the metal interaction.

PMID- 1629194
TI  - Cloning and expression of wild-type and mutant forms of the cardiotonic
      polypeptide anthopleurin B.
AB  - Venom of the sea anemone Anthopleura xanthogrammica contains a minimum of three
      polypeptide toxins capable of prolonging the repolarization phase of the action
      potential. A synthetic gene for the most toxic of the Anthopleura toxins,
      anthopleurin B (ApB), has been designed, synthesized, and expressed as a fusion
      protein with the gene 9 product of bacteriophage T7 in Escherichia coli. The
      fusion protein has been purified and its disulfide bonds reoxidized using
      glutathione redox couples. Upon cleavage with staphylococcal protease, this
      protocol yields approximately 1 mg of native ApB/liter of original culture. The
      recombinant protein has been shown to be identical to natural ApB with respect to
      amino acid composition, amino-terminal sequence, secondary structure, high
      pressure liquid chromatographic mobility, and biological activity. A second form
      of ApB containing additional residues of glycine and arginine at its amino
      terminus has also been characterized. This protein, termed GR-ApB, is identical
      in specific activity to the wild-type form. This work lays the groundwork for a
      detailed analysis of ApB structure and action by site-directed mutagenesis.

PMID- 1629195
TI  - Two mechanisms of iron uptake from transferrin by melanoma cells. The effect of
      desferrioxamine and ferric ammonium citrate.
AB  - The effects of ferric ammonium citrate (FAC) and desferrioxamine (DFO) on iron
      (Fe), and transferrin (Tf) uptake have been investigated using SK-MEL-28 human
      melanoma cells, which express the Tf homologue, melanotransferrin, in high
      concentrations. Previously we demonstrated two separate Fe uptake mechanisms from
      Tf, viz. a specific process mediated by the transferrin receptor (TfR) and a
      nonspecific process (Richardson, D. R., and Baker, E. (1990) Biochim. Biophys.
      Acta 1053, 1-12). Cells exposed to DFO demonstrated up-regulation of the TfR with
      a concurrent increase in the rate of Fe uptake. Desferrioxamine also stimulated
      the nonspecific process of Fe uptake, resulting in a further increase in
      accumulation of Fe over Tf after saturation of the specific TfR. Ferric ammonium
      citrate had two effects. First, it resulted in down-regulation of the TfR.
      Second, and paradoxically, it markedly stimulated the rate of Fe uptake from Tf
      by the nonspecific process without increasing the rate of nonspecific Tf uptake.
      These data conclusively demonstrate that two entirely different mechanisms of
      iron uptake from Tf exist in melanoma cells and that ferric ammonium citrate may
      be a useful experimental tool to further characterize the specific and
      nonspecific mechanisms of Fe uptake from Tf.

PMID- 1629196
TI  - The Ser-Arg-Tyr-Asp region of the major surface glycoprotein of Leishmania mimics
      the Arg-Gly-Asp-Ser cell attachment region of fibronectin.
AB  - The major surface glycoprotein of Leishmania, gp63, a fibronectin-like molecule,
      plays a key role in parasite-macrophage interaction. Binding of gp63 to
      macrophage receptors is inhibited by Arg-Gly-Asp-Ser (RGDS)-containing synthetic
      peptides of fibronectin and by antibodies to these peptides. However, gp63 lacks
      an RGDS tetrapeptide. We sought to identify the region of gp63 that antigenically
      and functionally mimics the RGDS-containing region of fibronectin. We thus
      synthesized on polyethylene rods overlapping tetracosapeptides covering the whole
      sequence of Leishmania major gp63. gp63 affinity-purified antibodies raised
      against fibronectin and against the RGDS-containing fibronectin decapeptide
      RGDSPASSKP bound specifically to gp63 residues 241-264. Subsequently, by the use
      of smaller peptides, the gp63 tetrapeptide 252-255 (SRYD) was identified as the
      minimum antibody binding segment. Single residue substitution peptide analogues
      showed that indeed Tyr and Gly can be alternatively substituted in the SRYD- and
      RGDS-containing peptides of gp63 and fibronectin, respectively, without major
      effects on their antibody binding capacity. Subsequently, we investigated the
      effect of an SRYD peptide on promastigote-macrophage interaction in vitro;
      treatment of macrophages with an SRYD-containing gp63 octapeptide efficiently
      inhibited parasite attachment to macrophage receptors. Thus, the conserved among
      species sequence SRYD of gp63, with significant hydrophilicity, flexibility, and
      beta-turn propensity features, mimics antigenically and functionally the RGDS
      sequence of fibronectin. We suggest that this segment constitutes the putative
      gp63 adhesion site.

PMID- 1629197
TI  - cDNA cloning and molecular characterization of MSE55, a novel human serum
      constituent protein that displays bone marrow stromal/endothelial cell-specific
      expression.
AB  - Hemonectin is a lineage-specific cytoadhesive protein that may be involved in the
      developmentally regulated adhesion of granulocytic cells to bone marrow stroma.
      Immunoblot analysis using an anti-hemonectin antibody recognizes two distinct
      immunoreactive species in endothelial cell lysates (approximately M(r) 65,000)
      and human serum (approximately M(r) 55,000). Initial characterization of the 55
      kDa protein has now been completed by isolating the cDNA from a human endothelial
      cell expression library. Sequence analysis of overlapping clones identifies a
      composite sequence spanning 2030 nucleotides with an open reading frame of 1173
      base pairs. No significant sequence similarity was observed on analysis of
      current GenBank databases. The open reading frame was expressed as a recombinant
      protein in Escherichia coli and used as an immunogen for the production of a
      specific polyclonal antibody. Immunoblotting with this antibody identifies a
      single immunoreactive species of apparent M(r) 55,000 in HUVEC lysates and human
      serum, confirming that a secreted form normally circulates as a serum constituent
      protein. This antibody fails to recognize purified hemonectin, suggesting that
      the M(r) 55,000 protein is not hemonectin. Cross-species Southern blot analysis
      reveals persistent hybridizing fragments in all species tested, suggestive of a
      developmentally conserved function. Northern blot analysis demonstrates
      expression limited to endothelial and bone marrow stromal cells, but not poly(A)
      RNA from monkey liver, spleen, brain, lung, and kidney. On this basis, we have
      designated this novel protein MSE55, for marrow stromal/endothelial cell protein
      with a molecular mass of 55,000 daltons. Its tissue-specific expression may
      suggest a functional role in hematopoiesis.

PMID- 1629198
TI  - Iodophenylarsine oxide and arsenical affinity chromatography: new probes for
      dithiol proteins. Application to tubulins and to components of the insulin
      receptor-glucose transporter signal transduction pathway.
AB  - In our studies of the effects of the trivalent arsenical phenylarsine oxide on
      insulin-dependent hexose uptake in 3T3-L1 adipocytes, we needed direct methods to
      study arsenical-protein interactions. In this report, we describe two such new
      tools. The first is the radiolabeled covalent affinity reagent 4
      [125I]iodophenylarsine oxide. This compound has effects on 3T3-L1 adipocytes
      similar to those of phenylarsine oxide both with respect to effects of hexose
      uptake and the accumulation of pp15, a phosphotyrosine-containing putative
      mediator of insulin action. Iodophenylarsine oxide labels numerous proteins in
      intact cells in a concentration-dependent, but apparently insulin-independent
      fashion. The second tool is trivalent arsenical affinity chromatography, which we
      use to show novel direct interactions between trivalent arsenicals and several
      proteins from 3T3-L1 adipocytes including the insulin-responsive glucose
      transporter GLUT4, the insulin proreceptor, and both the alpha and beta subunits
      of tubulin. The non-insulin-dependent glucose transporter GLUT1, the mature
      insulin receptor, and the fatty acid-binding protein 422(aP2) do not show strong
      interactions with arsenical resin. These results provide a new chemical approach
      to the study of both insulin-dependent hexose transport and tubulin function.

PMID- 1629199
TI  - Identification and characterization of neutral endopeptidase in endothelial cells
      from venous or arterial origins.
AB  - Neutral endopeptidase (NEP; enkephalinase, EC 3.4.24.11) is a cell membrane
      associated zinc metalloprotease, which cleaves peptides like atrial natriuretic
      peptide (ANP) on the amino side of hydrophobic amino acids. Although NEP is
      mainly located in reabsorptive epithelia (kidney proximal tubule), it is also
      present in non-epithelial cells such as neuronal cells. As the renal NEP cannot
      account for the entire ANP metabolism, other locations were postulated. The
      present experiments show its expression in endothelial cells (EC) from arterial
      (bovine pulmonary, porcine, and human aorta) and venous (human umbilical, rabbit
      ear marginal) origins. Three different methods were used to demonstrate the
      presence of the protein and its mRNA. 1) NEP enzymatic activity was estimated
      using both a synthetic ([D-Ala2,Leu5]enkephalin) and a natural substrate
      (bradykinin). Using the synthetic substrate, the enzymatic activity in EC was
      completely blocked by thiorphan, a specific NEP inhibitor with an IC50 value in
      the nanomolar range. In contrast, captopril, bestatin, [2
      guanidinoethylmercapto]succinic acid, inhibitors of angiotensin-converting
      enzyme, aminopeptidases, and carboxypeptidases, respectively, were 10,000 times
      less active, revealing an inhibition profile similar to that of the purified
      enzyme. Bradykinin, a natural substrate of NEP, was in part metabolized by NEP,
      in the presence of captopril, since 50% of the formation of the major metabolite
      bradykinin 1-7 was inhibited by thiorphan. 2) Immunoreactive NEP was detected on
      the plasma membrane of rabbit EC using a monoclonal antibody directed against the
      homologous renal enzyme. 3) NEP mRNA was detected by Northern blot analysis of
      rabbit EC as a major transcript of 3.9 kilobases. Reverse transcriptase
      polymerase chain reaction amplification showed the presence of a specific
      transcript in all EC tested. Therefore, endothelial NEP may play an important
      role in the inactivation of ANP, bradykinin, and endothelins by its localization
      facing the circulating vasoactive peptides.

PMID- 1629200
TI  - Vascular endothelial cell adhesion and spreading promoted by the peptide REDV of
      the IIICS region of plasma fibronectin is mediated by integrin alpha 4 beta 1.
AB  - We have recently reported the attachment and spreading of human umbilical vein
      endothelial cells (HUVECs) upon substrates containing covalently grafted Arg-Glu
      Asp-Val (REDV) peptide (Hubbell, J. A., Massia, S. P., Desai, N. P., and
      Drumheller, P. D. (1991) Bio/Technology 9, 568-572). This peptide has been
      reported to be the minimal active sequence within the CS5 site of the
      alternatively spliced type III connecting segment (IIICS) region of fibronectin,
      and the integrin alpha 4 beta 1 has been identified as the receptor on melanoma
      cells for this site. The integrin alpha 4 beta 1 has also been identified as the
      receptor for the CS1 site in the IIICS region on cells of neural crest origin,
      melanoma cells, lymphocytes, and hematopoietic stem cells. In this study, we
      demonstrate that this integrin also serves as a receptor on HUVECs for the
      peptide REDV from the CS5 site. The alpha 4 subunit was shown to be expressed
      upon HUVEC membranes by whole-cell enzyme-linked immunosorbent assay.
      Antifunctional antibodies directed against integrin subunits alpha 4 and beta 1
      inhibited cell adhesion on REDV-grafted substrates, but not on RGD-grafted
      substrates. The alpha 4 subunit localized into fibrillar structures within spread
      cells on the REDV-grafted substrates, but not within spread cells on RGD-grafted
      substrates. Two proteins (144 and 120 kDa) were isolated from HUVEC extracts by
      REDV ligand affinity chromatography and were demonstrated by immunoprecipitation
      and Western blot to be the integrin subunits alpha 4 (144 kDa) and beta 1 (120
      kDa); furthermore, the immunoprecipitation analyses demonstrated that the
      subunits formed a complex. HUVEC binding to REDV-grafted substrates was inhibited
      by both soluble REDV and RGD, demonstrating that adhesion was biospecific and
      that the REDV peptide is RGD-like. In this report we demonstrate for the first
      time that alpha 4 is present in the endothelial cell membrane, in contrast to
      previous reports by others, and that integrin alpha 4 beta 1 is the receptor for
      REDV-mediated adhesion to the IIICS region of region of plasma fibronectin.

PMID- 1629201
TI  - Exolytic hydrolysis of toxic plant glucosides by guinea pig liver cytosolic beta
      glucosidase.
AB  - We demonstrate that although the guinea pig liver cytosolic beta-glucosidase does
      not catalyze the hydrolysis of gentiobiose, it does hydrolyze, disaccharide
      containing glycosides such as p-nitrophenyl-beta-D-gentiobioside (Glc beta 1---
      6Glc beta-pNP) and mandelonitrile-beta-D-gentiobioside (amygdalin). Furthermore,
      we establish that the enzyme attacks disaccharide glycosides exolytically;
      specifically, we document the exolytic deglucosylation of amygdalin and the
      generation of the intermediate monosaccharide glycoside mandelonitrile-beta-D
      glucoside prior to the formation of the aglycone (mandelonitrile). We also show
      that the cytosolic beta-glucosidase catalyzes the hydrolysis of various phenolic
      (e.g. arbutin and salicin) and cyanogenic plant glucosides (e.g. prunasin). Using
      the everted gut-sack technique, we demonstrate that the plant glucosides,
      amygdalin, prunasin, and vicine, are transported across the small intestine of
      the guinea pig efficiently and without being hydrolyzed. Based on these data we
      speculate that the cytosolic beta-glucosidase may participate in
      biotransformation of toxic plant glucosides.

PMID- 1629202
TI  - Insect lipid transfer particle can facilitate net vectorial lipid transfer via a
      carrier-mediated mechanism.
AB  - The mechanism of facilitated lipid transfer by insect or mammalian plasma lipid
      transfer proteins has not been elucidated. Transfer catalysts may act as carriers
      of lipid between donor and acceptor lipoproteins or, alternatively, transfer may
      require formation of a ternary complex. This study was designed to determine if
      Manduca sexta hemolymph lipid transfer particle (LTP) can facilitate net
      vectorial transfer of lipid without concomitant contact between donor and
      acceptor lipoproteins and LTP. M. sexta [3H]diacylglycerol-high density
      lipophorin-larval ([3H]DAG-HDLp-L) and human low density lipoprotein (LDL) were
      covalently bound to Sepharose matrices and packed into separate columns. In
      incubations lacking LTP, greater than 98% of the recovered DAG remained
      associated with HDLp-L. An unrelated hemolymph storage protein, arylphorin, was
      unable to catalyze the transfer of DAG between solid-phase lipoproteins.
      Facilitated transfer of DAG from HDLp-L to LDL was observed when LTP was
      circulated between the columns. Under these conditions, facilitated transfer
      occurred at a rate of 2.24 ng of DAG/h (versus 0.16 microgram of DAG/h in the
      control), and after 16 h greater than 26% of recovered labeled DAG was
      transferred to LDL. This corresponds to a 14-fold rate enhancement induced by
      LTP. The LTP-specific transfer of DAG between physically separated lipoproteins
      demonstrates the ability of LTP to facilitate net lipid transfer via a carrier
      mediated mechanism in the absence of a ternary complex involving donor, acceptor,
      and catalyst. In experiments aimed at assessing the relative contribution of
      ternary complex formation to DAG transfer, acceptor LDL was circulated with HDLp
      L remaining immobilized. Under these conditions, LTP induced a 13-fold rate
      enhancement from 1.3 to 16.3 micrograms of DAG/h. The similar rate enhancements
      observed with both lipoproteins bound and only donor bound suggest the overall
      contribution of ternary complex formation to facilitated lipid transfer is
      insignificant. The described system should prove useful in mechanistic studies of
      other transfer proteins as well as studies of transfer of other lipids.

PMID- 1629203
TI  - Interaction between G-actin and myosin subfragment-1 probed by covalent cross
      linking.
AB  - The topography of rapid equilibrium complexes formed between G-actin and myosin
      subfragment-1, which are the first kinetic intermediates in the polymerization
      process into F-acto-S1 filaments, has been probed by chemical cross-linking. In
      the absence of ATP, cross-linking of G-actin-S1 complexes by 1-ethyl-3-(3
      dimethylaminopropyl)-carbodiimide (EDC) yielded a major 165-170-kDa and a fainter
      200-205-kDa doublet polypeptide. The actin:S1 molar ratio was 1 in the EDC-cross
      linked complexes, using either double labeling techniques or the method combining
      EDC + N-hydroxysuccinimide. Chemical cleavages of the covalently cross-linked
      complexes by formic acid and N-hydroxylamine (Sutoh, K. (1983) Biochemistry 22,
      1579-1585) showed that in the main cross-linked 165-kDa polypeptide, the 1-12
      acidic N-terminal region of actin was covalently linked to the lysine-rich region
      connecting the central 50-kDa domain to the C-terminal 20-kDa domain of S1, as in
      F-acto-S1 complexes. G-actin, but not F-actin, was covalently cross-linked to S1
      by N,N'-paraphenylenedimaleimide (p-PDM). A major 195-kDa and a minor 165-kDa
      polypeptide were obtained, could be separated from actin and S1 by DEAE-cellulose
      chromatography, and did not exhibit actin-activated Mg-ATPase activity. Both EDC
      cross-linked and p-PDM-cross-linked complexes between G-actin and S1 could be
      incorporated into F-acto-S1 decorated filaments. The C-terminal cysteine 374 of
      actin is involved in the p-PDM cross-linked 195-kDa complex. Accordingly, a
      covalent photocross-linked 200-kDa conjugate was formed between S1 heavy chain
      and benzophenone-G-actin, obtained by covalent modification of Cys374 by
      benzophenonemaleimide (Tao, T., Lamkin, M., and Scheiner, C. J. (1985) Arch.
      Biochem. Biophys. 240, 627-634). These results demonstrate that (i) G-actin-S1
      and F-actin-S1 complexes display a large similarity in the EDC-cross-linked
      electrostatic close contacts and (ii) a change in the environment of Cys374 is
      linked to the polymerization into F-actin-S1 decorated filaments.

PMID- 1629204
TI  - Monovalent cation selectivity for ATP-dependent association of the glucocorticoid
      receptor with hsp70 and hsp90.
AB  - We have reported previously that incubation of the immunopurified transformed
      hormone-free glucocorticoid receptor with rabbit reticulocyte lysate
      reconstitutes the receptor complex with hsp90 and that reconstitution is
      accompanied by concomitant repression of DNA binding activity and regeneration of
      the steroid binding conformation (Scherrer, L. C., Dalman, F. C., Massa, E.,
      Meshinchi, S., and Pratt, W. B. (1990) J. Biol. Chem. 265, 21397-21400). In this
      work we further characterize this system by defining the small M(r) components of
      reticulocyte lysate required for both structural and functional reconstitution of
      the receptor-hsp90 complex. Reconstitution is ATP-dependent and there is a direct
      relationship between the extent of hsp90 binding to the receptor and the number
      of specific steroid binding sites that are generated. Dialysis of reticulocyte
      lysate inactivates its reconstituting activity. Addition of an ATP-regenerating
      system or readdition of small M(r) lysate components (in the form of a Centricon
      C30 filtrate) has little effect, but the presence of both restores full
      reconstituting activity to dialyzed lysate, as assayed by steroid binding
      activity and by the binding of hsp90 and hsp70 to the receptor. The small M(r)
      activity is heat-stable, and it can be completely replaced by NH+4, K+, and Rb+,
      with K+ producing a maximal effect at the concentration normally present in
      undialyzed lysate. Na+ and Li+ have no reconstituting activity. This ion
      selectivity demonstrates that a monovalent cation binding site is involved in
      receptor heterocomplex reconstitution. It is intriguing that the protein
      unfoldase (e.g. clathrin uncoating ATPase) activity of hsp70 is known to have a
      similar monovalent cation dependence, and that under all conditions where hsp90
      becomes bound to the receptor, we find that hsp70 is also bound.

PMID- 1629205
TI  - Activation of a Gi protein in mouse sperm membranes by solubilized proteins of
      the zona pellucida, the egg's extracellular matrix.
AB  - Zona pellucida (ZP)-induced acrosomal exocytosis in mammalian spermatozoa is
      thought to be mediated by signal transduction cascades similar to those found in
      hormonally responsive cells. In order to characterize this process further, we
      have examined the role of GTP-binding regulatory proteins (G proteins) in
      coupling sperm-ZP interaction to intracellular second messenger systems in mouse
      sperm. An in vitro signal transduction assay was developed to assess ZP-G protein
      dynamics in sperm membrane preparations. Guanosine 5'-3-O-(thio)triphosphate (GTP
      gamma S), a poorly hydrolyzable analogue of GTP, bound to these membranes in a
      specific and concentration-dependent fashion which reached saturation at 100 nM.
      Incubation of the membrane preparations with heat-solubilized ZP resulted in a
      significant increase in specific GTP gamma S binding in a concentration-dependent
      fashion with a half-maximal response at 1.25-2 ZP/microliters. Solubilized ZP
      also caused a significant increase in high affinity GTPase activity in the
      membranes over basal levels. Mastoparan increased specific GTP gamma S binding to
      the sperm membranes and stimulated high-affinity membrane GTPase activity to
      levels consistently greater than that seen with the solubilized ZP. Mastoparan,
      together with solubilized ZP, gave the same level of stimulation of GTP gamma S
      binding as mastoparan alone. Pertussis toxin completely inhibited the ZP
      stimulated GTP gamma S binding, but only decreased mastoparan-stimulated GTP
      gamma S binding by 70-80%. Purified ZP3, the ZP component which possesses
      quantitatively all of the acrosomal exocytosis-inducing activity of the intact
      ZP, stimulated GTP gamma S binding to the same level as solubilized ZP; ZP1 and
      ZP2 did not stimulate GTP gamma S binding. ZP from fertilized eggs (ZPf), which
      does not possess acrosome reaction-inducing activity, also failed to stimulate
      GTP gamma S binding to sperm membranes. These data demonstrate the direct
      activation of a Gi protein in sperm membrane preparations in response to the ZP
      glycoprotein, ZP3, that induces the acrosome reaction. These data imply that Gi
      protein activation is an early event in the signal sequence leading to sperm
      acrosomal exocytosis.

PMID- 1629206
TI  - Pulsatile Ca2+ extrusion from single pancreatic acinar cells during receptor
      activated cytosolic Ca2+ spiking.
AB  - Ca2+ extrusion was measured simultaneously with the free intracellular Ca2+
      concentration ([Ca2+]i) from single pancreatic acinar cells placed in
      microdroplets of extracellular solution (Tepikin, A. V., Voronina, S. G.,
      Gallacher, D. V., and Petersen, O. H. (1992) J. Biol. Chem. 267, 3569-3572).
      Submaximal stimulation with cholecystokinin usually evoked discrete cytosolic
      Ca2+ spikes and each of these spikes was associated with a discrete and virtually
      synchronous pulse of Ca2+ extrusion into the extracellular microdroplet solution.
      When ACh evoked repetitive discrete [Ca2+]i spikes, each spike was also
      accompanied by a discrete pulse of Ca2+ extrusion. The velocity of Ca2+ extrusion
      oscillated with a time course similar to that of [Ca2+]i. The extracellular
      solution in our experiments had a low total calcium concentration (15-35 microM)
      and only a limited number of [Ca2+]i spikes (2-8) could be evoked. The magnitudes
      of the [Ca2+]i spikes and the amounts of Ca2+ extruded during each spike
      gradually decreased in each experiment. During the first cholecystokinin-evoked
      cytosolic Ca2+ spike the Ca2+ extrusion corresponded to a loss of 15-70% (mean
      value 39% +/- 12) of the mobilizable cellular calcium pool. The substantial
      pulsatile Ca2+ extrusion occurring synchronously with the receptor-activated
      cytosolic Ca2+ spikes is therefore an important element in repetitively bringing
      back [Ca2+]i to the resting level.

PMID- 1629207
TI  - Evidence that a salt bridge in the light chain contributes to the physical
      stability difference between heavy and light human ferritins.
AB  - Human ferritin, a multimeric iron storage protein, is composed by various
      proportions of two subunit types: the H- and L-chains. The biological functions
      of these two genic products have not been clarified, although differences in
      reactivity with iron have been shown. Starting from the hypothesis that the high
      stability typical of ferritin is an important property which may be relevant for
      its iron storage function, we studied ferritin homopolymers of H- and L-chains in
      different denaturing conditions. In addition we analyzed 13 H-chain variants with
      alterations in regions conserved within mammalian H-chains. In all the
      denaturation experiments H-chain ferritin showed lower stability than L-chain
      ferritin. The difference was greater in guanidine HCl denaturation experiments,
      where the end products are fully unfolded peptides, than in acidic denaturation
      experiments, where the end products are peptides with properties analogous to
      "molten globule." The study on H-chain variants showed: (i) ferritin stability
      was not affected by alterations of regions exposed to the inner or outer surface
      of the shell and not involved in intra- or inter-chain interactions; (ii)
      stability was reduced by alterations of sequences involved in inter-subunit
      interactions such as the deletion of the N-terminal extension or substitutions
      along the hydrophobic and hydrophilic channels; (iii) stability was increased by
      the substitution of 2 amino acids inside the four-helix bundle with those of the
      homologous L-chain. One of the residues is involved in a salt bridge in the L
      chain, and we concluded that the stability difference between H- and L-ferritins
      is to a large extent due to the stabilizing effect of this salt bridge on the L
      subunit fold.

PMID- 1629208
TI  - Effect of temperature on the creatine kinase equilibrium.
AB  - The effect of temperature on the apparent equilibrium constant of creatine kinase
      (ATP:creatine N-phosphotransferase (EC 2.7.3.2)) was determined. At equilibrium
      the apparent K' for the biochemical reaction was defined as [formula: see text]
      The symbol sigma denotes the sum of all the ionic and metal complex species of
      the reactant components in M. The K' at pH 7.0, 1.0 mM free Mg2+, and ionic
      strength of 0.25 M at experimental conditions was 177 +/- 7.0, 217 +/- 11, 255 +/
      10, and 307 +/- 13 (n = 8) at 38, 25, 15, and 5 degrees C, respectively. The
      standard apparent enthalpy or heat of the reaction at the specified conditions
      (delta H' degree) was calculated from a van't Hoff plot of log10K' versus 1/T,
      and found to be -11.93 kJ mol-1 (-2852 cal mol-1) in the direction of ATP
      formation. The corresponding standard apparent entropy of the reaction (delta S'
      degree) was +4.70 J K-1 mol-1. The linear function (r2 = 0.99) between log10 K'
      and 1/K demonstrates that both delta H' degree and delta S' degree are
      independent of temperature for the creatine kinase reaction, and that delta Cp'
      degree, the standard apparent heat capacity of products minus reactants in their
      standard states, is negligible between 5 and 38 degrees C. We further show from
      our data that the sign and magnitude of the standard apparent Gibbs energy (delta
      G' degree) of the creatine kinase reaction was comprised mostly of the enthalpy
      of the reaction, with 11% coming from the entropy T delta S' degree term. The
      thermodynamic quantities for the following two reference reactions of creatine
      kinase were also determined. [formula: see text] The delta H degree for Reaction
      2 was -16.73 kJ mol-1 (-3998 cal mol-1) and for Reaction 3 was -23.23 kJ mol-1 (
      5552 cal mol-1) over the temperature range 5-38 degrees C. The corresponding
      delta S degree values for the reactions were +110.43 and +83.49 J K-1 mol-1,
      respectively. Using the delta H' degree of -11.93 kJ mol-1, and one K' value at
      one temperature, a second K' at a second temperature can be calculated, thus
      permitting bioenergetic investigations of organs and tissues using the creatine
      kinase equilibria over the entire physiological temperature range.

PMID- 1629209
TI  - O-glycosylation of the coronavirus M protein. Differential localization of
      sialyltransferases in N- and O-linked glycosylation.
AB  - It has previously been shown that the M (E1) glycoprotein of mouse hepatitis
      virus strain A59 (MHV-A59) contains only O-linked oligosaccharides and localizes
      to the Golgi region when expressed independently. A detailed pulse-chase analysis
      was made of the addition of O-linked sugars to the M protein; upon sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis, three different electrophoretic forms
      could be distinguished that corresponded to the sequential acquisition of N
      acetylgalactosamine (GalNAc), galactose (Gal), and sialic acid (SA). A fourth and
      fifth form could also be detected which we were unable to identify. Following
      Brefeldin A treatment, the M protein still acquired GalNAc, Gal, and SA, but the
      fourth and fifth forms were absent, suggesting that these modifications occur in
      the trans-Golgi network (TGN). In contrast, in the presence of BFA, the G protein
      of vesicular stomatitis virus (VSV), which contains N-linked oligosaccharides,
      acquired Gal and fucose but not SA. These results are consistent with earlier
      published data showing that Golgi compartments proximal to the TGN, but not the
      TGN itself, relocate to the endoplasmatic reticulum/intermediate compartment.
      More importantly, our data argue that, whereas addition of SA to N-linked sugars
      occurs in the TGN the acquisition of both SA on O-linked sugars and the addition
      of fucose to N-linked oligosaccharides must occur in Golgi compartments proximal
      to the TGN. The glycosylation of the M protein moreover indicates that it is
      transported to trans-Golgi and TGN. This was confirmed by electron microscopy
      immunocytochemistry, showing that the protein is targeted to cisternae on the
      trans side of the Golgi and co-localizes, at least in part, with TGN 38, a marker
      of the TGN, as well as with a lectin specific for sialic acid.

PMID- 1629210
TI  - Structure-function relationships in an antifreeze polypeptide. The role of
      neutral, polar amino acids.
AB  - An alanine-rich, alpha-helical antifreeze polypeptide (AFP) from the winter
      flounder and seven analogs with variations in the arrangement of neutral, polar
      amino acids were synthesized. Circular dichroism studies determined that all of
      the peptides, except for one containing a proline residue, were essentially 100%
      alpha-helical. Freezing point depression data, analyzed by three methods, showed
      that rearrangement of polar residues resulted in moderate to complete loss of
      anti-freeze activity. It was observed that ice crystals grow as hexagonal
      bipyramids in dilute solutions, with a constant c to alpha axis ratio of about
      3.3. Above a critical threshold concentration, which may depend on the AFP to ice
      binding constant and reflect the onset of cooperative interactions, growth ceases
      until the temperature is lowered to the freezing point. We conclude that a
      specific arrangement of both threonine and asparagine (or aspartic acid) residues
      is critical for maximal activity and that the AFPs probably bind to the pyramidal
      faces of ice with a specific orientation. These conclusions are consistent with a
      recent report (Knight, C. A., Cheng, C. C., and DeVries, A. L. (1991) Biophys. J.
      59, 409-418) that a similar AFP adsorbs to the [2021] pyramidal planes of ice in
      dilute solution.

PMID- 1629211
TI  - Coagulation factor X activating enzyme from Russell's viper venom (RVV-X). A
      novel metalloproteinase with disintegrin (platelet aggregation inhibitor)-like
      and C-type lectin-like domains.
AB  - We determined the complete amino acid sequence of RVV-X, the blood coagulation
      factor X activating enzyme, isolated from Russell's viper venom and studied
      structure-function relationships. RVV-X (M(r) 79,000) consists of a disulfide
      bonded two-chain glycoprotein with a heavy chain of M(r) 59,000 and a light chain
      of heterogeneous M(r) 18,000 (LC1) and 21,000 (LC2). These chains were separated
      after reduction and S-pyridylethylation, and the isolated major component LC1 was
      used for sequence analysis. The heavy chain consists of 427 residues containing
      four asparagine-linked oligosaccharides, and its entire sequence was similar to
      that of the high molecular mass hemorrhagic protein, HR1B, isolated from the
      venom of Trimere-surus flavoviridis. The heavy chain contains three distinct
      domains, metalloproteinase, disintegrin (platelet aggregation inhibitor)-like and
      unknown cysteine-rich domains. On the other hand, light chain LC1 consists of 123
      amino acid residues containing one asparagine-linked oligosaccharide and shows
      sequence homology similar to that found in the so-called C-type (Ca(2+)
      dependent) lectins. Therefore, RVV-X is a novel metalloproteinase containing a
      mosaic structure with distintegrin-like, cysteine-rich, and C-type lectin-like
      domains. RVV-X potently inhibits collagen- and ADP-stimulated platelet
      aggregations, probably via its distintegrin-like domain, although this domain
      does not contain the Arg-Gly-Asp sequence which is conserved in various venom
      distintegrins and which is thought to be one of the interaction sites for
      platelet integrins. Our findings also indicate that snake venom factor IX/factor
      X-binding protein with a C-type lectin structure (Atoda, H., Hyuga, M., and
      Morita, T. (1991) J. Biol. Chem. 266, 14903-14911) inhibits RVV-X-catalyzed
      factor X activation; hence, the light chain of RVV-X probably participates in
      recognizing some portion of the zymogen factor X.

PMID- 1629212
TI  - The all-D-configuration segment containing the IKVAV sequence of laminin A chain
      has similar activities to the all-L-peptide in vitro and in vivo.
AB  - Laminin is a basement membrane glycoprotein that has diverse biological
      activities. A sequence on the A chain containing IKVAV (Ile-Lys-Val-Ala-Val) has
      been shown to promote neurite outgrowth, cell adhesion, and tumor growth and
      metastasis. Here we have determined the structural requirements of this synthetic
      peptide for biological activity. Twelve-amino acid-long all-L- (LAM-L) and all-D
      peptide (LAM-D) segments as well as an alternating D- and L-amino acid-containing
      peptide (LAM-DL), which included the IKVAV sequence (residues 2097-2108), were
      synthesized. Circular dichroism spectral analysis revealed a mirror image
      conformation of LAM-D and LAM-L with mainly beta-sheet and to a minor extent
      alpha-helical structure. LAM-DL did not exhibit any significant ordered
      conformational features. LAM-D and LAM-L showed similar cell attachment
      activities for rat pheochromocytoma cells (PC12), whereas LAM-DL was inactive. A
      peptide analog with randomized IKVAV sequence (LAM-RM) was also inactive. A
      similar trend was observed in competition experiments of the four peptides with
      laminin in analogous cell attachment assays. In in vivo experiments, both LAM-D
      and LAM-L were capable of increasing tumor growth when subcutaneously injected
      into mice with murine melanoma cells B16F10. Results indicate that the
      conformational status of the IKVAV domain is a contributing factor in determining
      the biological activity but that there is no strict requirement for a specific
      chirality. There is a likely sequence specificity to the IKVAV region.

PMID- 1629213
TI  - Upstream sequence elements required for NarL-mediated activation of transcription
      from the narGHJI promoter of Escherichia coli.
AB  - Transcription of the narGHJI operon (encoding nitrate reductase) in Escherichia
      coli is primarily dependent on the activation of the pleiotropic transacting
      factor Fnr, which interacts with the promoter through a cis element (Fnr box)
      located near the transcription start site. Further stimulation of transcription
      occurs in the presence of nitrate and is dependent on activation of the
      transacting factor NarL and a cis-acting sequence (NarL box) located
      approximately 200 base pairs upstream from the transcription start site. To
      define the structure of the NarL box, alterations in the NarL box region,
      generated by saturation mutagenesis of the sequence from positions -184 to -202
      in the narGHJI promoter of a narG::lacZ fusion-bearing plasmid, were analyzed for
      their effects on NarL-mediated stimulation of transcription. Single base
      substitutions that significantly reduced the NarL-mediated stimulation were
      restricted to a 6-base sequence, TACTCC, located at positions -193 to -198 in the
      narGHJI promoter. When 2 bases were modified, NarL-mediated stimulation was
      severely reduced when one or both alterations were located within the 6-base
      sequence. Attempts to restore NarL-mediated stimulation with an inverted NarL box
      were not successful. Although previous studies suggested that NarL-mediated
      stimulation of transcription may occur by a DNA looping mechanism, the results
      presented here demonstrate that it does not involve the passive formation of a
      simple DNA loop. Replacement of 94 or 108 bases of the approximately 150 base
      sequence between the Fnr box and the NarL box with an unrelated sequence resulted
      in elimination of NarL-mediated stimulation of transcription. Furthermore,
      shifting of most of the intervening sequence or defined segments of the sequence
      by 4 bases while maintaining the position of the NarL box relative to sequences
      required for Fnr-dependent, anaerobic transcription also eliminated the NarL
      mediated stimulation. We conclude that in addition to the 6-base NarL box located
      on a specific face of the promoter DNA, the stimulation of transcription by NarL
      requires some specific sequences and/or higher order structure specified by the
      DNA that separates the NarL box from the Fnr box.

PMID- 1629214
TI  - Quantitative analysis of SH2 domain binding. Evidence for specificity and
      competition.
AB  - We report the development of a quantitative assay for measuring SH2 domain
      binding in vitro. Using this assay we have analyzed the binding of purified
      recombinant SH2 domains from ras GTPase activating protein (GAP) and the 85-kDa
      subunit of phosphatidylinositol 3-kinase (p85) to proteins from epidermal growth
      factor-stimulated and v-src-transformed cells. The purified recombinant SH2
      domains from GAP and p85 bind to the tyrosine phosphorylated epidermal growth
      factor receptor with nanomolar affinities. Moreover, competition studies suggest
      that these two proteins bind to equivalent or overlapping sites on this receptor.
      In v-src-transformed cells the purified recombinant SH2 domains from GAP and p85
      bind to distinct but overlapping sets of proteins.

PMID- 1629215
TI  - Processive proofreading is intrinsic to T4 DNA polymerase.
AB  - DNA replication occurs in vivo with very high processivity, meaning that the
      replication complex assembles at the origin(s) of replication and then performs
      template-directed synthesis of DNA over virtually the entire genome without
      dissociation. Such processivity also characterizes reconstituted replication
      holoenzyme complexes in vitro. However, the isolated DNA polymerases are much
      less processive, especially under physiological conditions. In this paper we
      monitor the degree of processivity displayed by the bacteriophage T4-coded DNA
      polymerase while in its proofreading mode by asking whether an isolated
      polymerase can "edit-out" the 3'-terminal nucleotide from the primer (using the
      3'----5'-exonuclease activity of the polymerase) and then switch into the
      synthesis mode without dissociating from the DNA template. This "switch
      experiment" is accomplished by using mismatched primer/template substrates as an
      experimental tool to mimic the situation that T4 DNA polymerase encounters after
      a misincorporation event has occurred. By performing experiments under single
      turnover conditions (obtained using a heparin trap), we demonstrate that T4 DNA
      polymerase, upon encountering a misincorporated base, neither synthesizes the
      next base nor dissociates into solution. Instead, with a greater than 80%
      probability, it removes the misincorporated base and then continues synthesis in
      a fully processive manner. We also show that the removal of a doubly mispaired
      sequence from the 3'-terminus of the primer, followed by synthesis, is comparably
      processive. In contrast, the apparent processivity of removing a triply mispaired
      terminus is much reduced. Taken together, these observations are consistent with
      the notion that the "editing active site" of the T4 enzyme optimally accommodates
      only two unpaired nucleotide residues. Our results do not support the idea that
      the exonuclease activity of T4 DNA polymerase is highly selective for mismatched
      termini; they suggest instead that the dwell time at a misincorporated base
      determines overall editing efficiency. The integrated results of this study
      provide additional insight into the structure of the T4 DNA polymerase, as well
      as into the interactions between the polymerase and the polymerase accessory
      proteins that are required to provide the holoenzyme complex with full
      processivity.

PMID- 1629216
TI  - Biochemical and biophysical characterization of human recombinant IgE-binding
      protein, an S-type animal lectin.
AB  - IgE-binding protein (epsilon BP) was originally identified by virtue of its
      affinity for IgE. It is now known to be a beta-galactoside-binding lectin with
      the characteristic of an S-type carbohydrate recognition domain. The protein is
      composed of two domains: the amino-terminal domain consisting of tandem repeats
      and the carboxyl-terminal domain containing sequences shared by other S-type
      carbohydrate recognition domains. The amino-terminal domain also contains a
      number of potential recognition sites for collagenase cleavage. In this study,
      human epsilon BP was first expressed in Escherichia coli, and the carboxyl
      terminal domain (epsilon BP-C) was then generated by collagenase digestion of
      epsilon BP. By equilibrium dialysis, the association constants of epsilon BP and
      epsilon BP-C for lactose were found to be similar (6.0 +/- 0.70) x 10(4) M-1 and
      (4.7 +/- 0.27) x 10(4) M-1, respectively. Both polypeptides contain only one
      lactose-binding site/molecule. By an assay involving binding of 125I-labeled
      epsilon BP or epsilon BP-C to solid phase IgE, and inhibition of this binding by
      saccharides, it was determined that epsilon BP-C retains the saccharide
      specificity of epsilon BP. Importantly, although unlabeled epsilon BP-C inhibited
      the binding of the radiolabeled epsilon BP to IgE, unlabeled epsilon BP caused
      increased binding to IgE, suggesting self-association among epsilon BP molecules.
      Oligomeric structures resulting from self-association of epsilon BP were
      confirmed by chemical cross-linking studies. Furthermore, epsilon BP possesses
      hemagglutination activity on rabbit erythrocytes, whereas epsilon BP-C lacks such
      activity. Based on these results, we propose a structural model for multivalency
      of epsilon BP: dimerization or oligomerization of epsilon BP occurs through
      intermolecular interaction involving the amino-terminal domain.

PMID- 1629217
TI  - Induction of interleukin 1 beta expression from human peripheral blood monocyte
      derived macrophages by 9-hydroxyoctadecadienoic acid.
AB  - Oxidatively modified low density lipoproteins (LDL) have recently been proposed
      to play a role in atherogenesis by promoting foam cell formation and endothelial
      cell toxicity. The purpose of the present study was to determine whether modified
      LDL could also induce macrophage release of interleukin 1 beta (IL-1 beta), a
      cytokine which enhances vascular smooth muscle cell proliferation, another
      feature of the atherosclerotic process. LDL were oxidatively modified by
      incubation with either Cu2+ (Cu(2+)-LDL) or human peripheral blood monocyte
      derived macrophages (M-LDL). Incubation of these modified LDL with macrophages (6
      x 10(6) cells/culture) resulted in a dose-dependent induction of IL-1 beta
      release. At 300 micrograms protein/ml, Cu(2+)-LDL and M-LDL induced 422 and 333
      pg of IL-1 beta/culture, respectively. Saponified Cu(2+)-LDL and M-LDL were shown
      to contain 9- and 13-hydroxyoctadecadienoic acid (HODE), lipid oxidation products
      of linoleate. When tested for activity in macrophage culture (3 x 10(6)
      cells/culture), it was found that 9-HODE and 13-HODE (final concentration 33
      microM) induced the release of 122 and 43 pg of IL-1 beta/culture, respectively,
      whereas untreated cells released only 4 pg of IL-1 beta/culture. Incubation of
      macrophages with cholesteryl-9-HODE also induced IL-1 beta release; however, the
      degree of induction of IL-1 beta release by 9-HODE or its cholesteryl ester
      relative to modified LDL suggests that other components in oxidized LDL may also
      contribute to IL-1 beta induction. 9-HODE was rapidly taken up by macrophages,
      and the kinetics were similar to IL-1 beta release. A 1.5- to 6-fold increase in
      the level of IL-1 beta mRNA was detected as little as 3-h post-9-HODE treatment.
      The induction of IL-1 beta release from human monocyte-derived macrophages by 9
      HODE and cholesteryl-9-HODE suggests a role for modified LDL, and its associated
      linoleate oxidation products, in vascular smooth muscle cell proliferation.

PMID- 1629218
TI  - Cytochrome P-450terp. Isolation and purification of the protein and cloning and
      sequencing of its operon.
AB  - Cytochromes P-450 are extremely important in the oxidative metabolism of a
      variety of endogenous and exogenous compounds in pro- and eukaryotic organisms.
      Progress in understanding the structure and mechanism of action of this
      superfamily of enzymes has been hampered by the properties of the eukaryotic
      enzymes and the availability of only one well-characterized prokaryotic enzyme as
      a model. We report here the isolation of a Pseudomonas species which will utilize
      a monoterpene natural product, alpha-terpineol, as its sole source of carbon and
      energy. Approximately 1% of the soluble protein in the cell-free extract is a
      novel cytochrome P-450 (P-450terp). This enzyme and its associated iron sulfur
      protein electron carrier (terpredoxin) have been purified to homogeneity and
      their NH2-terminal amino acid sequences determined. The amino acid sequences of
      six tryptic peptide fragments of cytochrome P-450terp have also been determined.
      This sequence information was used to clone the gene encoding cytochrome P
      450terp. Three clones representing approximately 8 kilobase pairs of unique
      sequences were selected and sequenced. Five non-overlapping open reading frames
      (ORFs) were found in the sequences, and the translated sequences were used to
      search the Protein Identification Resource for comparable proteins. The ORFs were
      identified as: 1) an alcohol dehydrogenase, 2) an aldehyde dehydrogenase, 3)
      cytochrome P-450terp, 4) terpredoxin reductase, and 5) terpredoxin. The
      identification of both the cytochrome P-450terp and terpredoxin DNA sequence was
      confirmed by the presence of each of the corresponding amino acid sequences found
      in the purified proteins. The five ORFs were bounded on both the 5' and 3' ends
      by consensus factor-independent terminator sequences. A consensus promoter
      sequence was found immediately 5' to the first ORF. These results indicate that
      we have sequenced the complete terp operon. Comparison of the amino acid sequence
      of cytochrome P-450terp to that of all other cytochromes P-450 has shown that it
      is the first member of the gene family CYP108. Preliminary characterization of
      the chemical and physical properties and the preparation of crystals of this new
      cytochrome P-450, suitable for x-ray diffraction analysis, indicate that it will
      be useful in comparison studies with other members of this class of proteins.

PMID- 1629220
TI  - Acetylcholinesterase. Two types of modifications confer resistance to
      insecticide.
AB  - Quantitative and qualitative changes in acetylcholinesterase confer resistance to
      insecticides. We have constructed several Drosophila melanogaster strains
      producing various amounts of enzyme by P-mediated transformation. Toxicological
      analysis of these strains demonstrates that resistance to organophosphorus
      insecticides is correlated with the amount of acetylcholinesterase in the central
      nervous system. Resistance may also be qualitatively determined. Comparison of
      the Drosophila acetylcholinesterase gene between a resistant strain caught in the
      wild and a wild type susceptible strain only revealed one nucleotide transition
      resulting in the replacement of a phenylalanine by a tyrosine. Flies mutant for
      acetylcholinesterase and rescued with a minigene mutagenized for this same
      transition produced an altered enzyme which renders flies resistant to
      pesticides.

PMID- 1629219
TI  - Bovine bone activin enhances bone morphogenetic protein-induced ectopic bone
      formation.
AB  - A 25-kDa homodimeric protein was purified from demineralized bovine bone extract
      and identified as activin A. The bovine bone activin enhanced formation of
      ectopic bone in rat subcutis when implanted in combination with partially
      purified bovine bone morphogenetic protein (BMP-2, BMP-3) in collagen/ceramic
      carrier. The implants, removed at 14 days, contained markedly elevated levels of
      alkaline phosphatase activity. Histological examination revealed an extensive
      formation of woven bone with very little cartilage. In contrast, a combination of
      transforming growth factor-beta 2 and BMP promoted formation of bone with an
      abundance of cartilage. The implants with BMP alone exhibited some osteoinductive
      activity, while the implants with activin alone showed no activity. These results
      demonstrate that bone is a rich source of activin and that activin plays an
      important role in modulating bone formation.

PMID- 1629221
TI  - Proteoglycans from the swarm rat chondrosarcoma. Structure of the aggregates
      extracted with associative and dissociative solvents as revealed by electron
      microscopy.
AB  - Proteoglycan aggregates were extracted from Swarm rat chondrosarcoma tissue in
      the native state and compared with proteoglycan aggregates isolated
      dissociatively with 4 M guanidine HCl. Purified aggregates were examined with a
      variety of electron microscopic techniques. In some cases they showed a structure
      of the central filament identical to that of the link-stabilized central filament
      observed in earlier experiments where the separated constituents were allowed to
      reconstitute (Morgelin, M., Paulsson, M., Hardingham, T. E., Heinegard, D., and
      Engel, J. (1988) Biochem. J. 253, 175-185). The tight packing of proteoglycan
      monomers along the hyaluronate with a minimum distance of 12 nm between adjacent
      E1 strands also could thus be confirmed for never dissociated aggregates. The
      results therefore show that the organization of proteoglycan aggregates assembled
      in vitro from the participating molecules is representative for conditions in
      situ. An additional structural type of central filament was observed in the
      preparations. This contained long stretches of free hyaluronate interspaced by
      short stretches of central filament with condensed arrays of link protein
      proteoglycan. Chemical cross-linking in combination with low shear electron
      microscopical techniques showed that this discontinuous central filament
      structure is not an artifact of specimen preparation. The addition of
      suprastoichiometric amounts of exogenous link protein did not affect the central
      filament structure with the low packing density. Densely and loosely packed types
      of central filament were isolated in varying relative amounts with different
      associative and dissociative solvents.

PMID- 1629222
TI  - Activation of human furin precursor processing endoprotease occurs by an
      intramolecular autoproteolytic cleavage.
AB  - Human furin is a calcium-dependent serine endoprotease that can efficiently
      cleave many precursor proteins on the carboxyl side of the consensus cleavage
      sequence, -Arg-X-Lys/Arg-Arg-, both in vivo and in vitro. Analysis of furin
      proteins in extracts of cells infected with a vaccinia recombinant expressing
      human furin show that the enzyme is present as two prominent forms of 90 and 96
      kDa. Because the structurally related bacterial subtilisins require
      endoproteolytic removal of the NH2-terminal pro-region by an autocatalytic
      intramolecular cleavage, we speculated that the size heterogeneity in the furin
      doublet similarly may result from a proteolytic removal of an NH2-terminal pro
      region. Here we report identification of the 90-kDa furin NH2 terminus and, based
      on the reported sequence of the furin cDNA, demonstrate that this furin protein
      is derived from a larger precursor by an endoproteolytic cleavage on the COOH
      terminal side of a consensus furin cleavage site, -Arg-Thr-Lys-Arg107-.
      Expression of mutant furin molecules containing an altered cleavage site (Arg104-
      --Ala or Arg107----Gly) resulted in the production of only the 96-kDa furin
      protein. Assays of furin-dependent cleavage of a protein substrate in vitro
      showed that proteolytic activity was associated with the 90-kDa and not the 96
      kDa furin protein, demonstrating that removal of the NH2-terminal pro-region is
      required for furin activity. Expression of a third furin construct containing a
      mutation of the active site aspartate (Asp153----Asn) similarly resulted in the
      expression of only the 96-kDa protein, suggesting that furin activation occurs by
      an autoproteolytic cleavage. Finally, the production of 90-kDa furin from either
      site-directed furin mutant could not be potentiated by overexpressing active
      furin, suggesting that the autoproteolytic activation was an intramolecular
      event.

PMID- 1629223
TI  - Precursor for the light-harvesting chlorophyll a/b-binding protein synthesized in
      Escherichia coli blocks import of the small subunit of ribulose-1,5-bisphosphate
      carboxylase/oxygenase.
AB  - When synthesized in Escherichia coli, the light-harvesting chlorophyll a/b
      binding protein (LHCP) precursor accumulates in inclusion-like bodies (Abad, M.
      S., Oblong, J. E., and Lamppa, G. K. (1991) Plant Physiol. 96, 1220-1227). In
      this study we show that after solubilization in 6 M urea and dialysis into 20 mM
      Tris-HCl (pH 8.0) the recombinant LHCP precursor (preLHCP) was not found as a
      monomer (31 kDa), but instead produced a heterogeneous population of oligomeric
      complexes, ranging from 60-300 kDa as determined by gel filtration
      chromatography. Circular dichroism analysis indicated that the oligomers had
      folded structure, and that it was composed of both alpha-helix and beta-sheet.
      Approximately half of recombinant preLHCP found in these complexes was cleavable
      at the transit peptide-mature protein junction by a soluble chloroplast
      processing enzyme in an organelle-free reaction. At 1.5 microM the recombinant
      precursor inhibited the import of radiolabeled preLHCP and the precursor of the
      small subunit of ribulose-1,5-bisphosphate carboxylase/oxygenase generated by
      reticulocyte lysate translations. When chloroplasts were preincubated with the
      precursor, followed by their reisolation, import was still blocked, providing
      evidence that competition between recombinant preLHCP and these substrates
      occurred at the chloroplast per se. Recombinant preLHCP was visualized on the
      envelope by immunofluorescence microscopy, and its presence there was mediated by
      a thermolysin-sensitive factor.

PMID- 1629224
TI  - Regulation of mitochondrial and microsomal phospholipid synthesis by liver fatty
      acid-binding protein.
AB  - Recently we have detected and partially purified a 15-kDa cytosolic L-alpha
      lysophosphatidic acid (LPA)-binding protein (LPABP), which stimulates export of
      LPA from mitochondria (Vancura, A., Carroll, M. A., and Haldar, D. (1991)
      Biochem. Biophys. Res. Commun. 175, 339-343). Now we have purified this protein
      to homogeneity. By Western immunoblot analysis, amino acid sequence analysis, and
      binding characteristics we have shown that LPABP is identical with liver fatty
      acid-binding protein (L-FABP). This protein binds LPA, and stimulates
      mitochondrial and microsomal glycerophosphate acyltransferase (GAT) and the
      export of LPA from both the organelles. The mitochondrially synthesized LPA
      exported by L-FABP can be converted to phosphatidic acid by microsomes. L-FABP
      also stimulates microsomal conversion of LPA to phosphatidic acid but strongly
      inhibits this reaction in mitochondria. However, in the absence of L-FABP
      mitochondria predominantly synthesize PA. Taken together, these findings are
      suggestive that L-FABP plays a major role in mitochondrial and microsomal
      phospholipid metabolism by regulating both the synthesis and utilization of LPA.

PMID- 1629225
TI  - Purification of BBF, a DNA-binding protein recognizing a positive cis-acting
      element in the mouse alpha 1(III) collagen promoter.
AB  - A positive cis-acting element, the B element, located between -83 and -61 in the
      mouse alpha 1(III) collagen promoter, binds a factor present in nuclear extracts
      of NIH 3T3 fibroblasts and HeLa cells. We have purified this factor using ion
      exchange chromatography, sequence-specific DNA affinity chromatography, and
      sodium dodecyl sulfate-polyacrylamide gel fractionation. The DNA sequence used
      for the affinity chromatography was a single-base substitution in the B element
      that increased the stability of the B element-protein complex by 50%.
      Purification of the B element-binding factor (BBF) by DNA affinity chromatography
      resulted in the apparent loss of most or all of the DNA-binding activity of this
      factor. The DNA-binding activity could, however, be reconstituted by combining
      two chromatographic fractions: the high-salt eluate and the column flow-through.
      When the partially purified high-salt eluate was size-fractionated by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis with subsequent renaturation
      of gel fractions from guanidine HCl, the purified BBF (apparent molecular weight
      of about 95,000) bound to the B element with high affinity. These results suggest
      that during DNA affinity purification of BBF a factor that inhibits BBF DNA
      binding was co-eluted with BBF. This inhibition of BBF DNA binding was reversed
      by the addition of the DNA affinity column flow-through. The binding of BBF to
      the B element of the mouse alpha 1(III) collagen promoter is therefore an
      apparently complex process involving interactions between BBF and other protein
      factors.

PMID- 1629226
TI  - Carboxyl-terminal consensus Ser-Lys-Leu-related tripeptide of peroxisomal
      proteins functions in vitro as a minimal peroxisome-targeting signal.
AB  - The minimal sequence requirement for a peroxisome-targeting signal was
      investigated using an in vitro import system. Carboxyl-terminal sequences Ser-Lys
      Leu (SKL) and Leu-Gln-Ser-Lys-Leu (LQSKL) of acyl-CoA oxidase (AOX) directed to
      peroxisomes the fused proteins with import-incompetent forms of AOX and catalase
      that had been truncated, implying that the SKL tripeptide functions as a
      targeting signal. Elimination of the entire SKL sequence or deletion of any 1 or
      2 amino acids in the sequence abolished the import activity of AOX. Substitution
      of alanine for serine did not affect the import activity. Topogenic activity was
      retained when lysine was mutated to either arginine or histidine, whereas
      mutation to glutamic acid completely abolished the activity. A synthetic peptide
      comprising the carboxyl-terminal 10 amino acid residues of AOX inhibited the
      import of the authentic AOX polypeptide, whereas other peptides in which SKL was
      mutated, deleted, or internally located were not effective. The uptake of AOX was
      little affected by the peptide with an amidated alpha-carboxyl group. These
      results strongly suggest that the carboxyl-terminal SKL motif sequence (Ser/Ala)
      (Lys/Arg/His)-Leu functions as a topogenic signal in translocation of proteins
      into peroxisomes, requiring the whole tripeptide sequence with a free alpha-COOH
      group at the carboxyl terminus.

PMID- 1629227
TI  - An isoform of protein disulfide isomerase isolated from chronic myelogenous
      leukemia cells alters complex formation between nuclear proteins and regulatory
      regions of interferon-inducible genes.
AB  - We have previously shown that the electrophoretic mobility of complexes formed in
      vitro between nuclear proteins and the regulatory domains of interferon-inducible
      genes is altered by an extranuclear protein present in elevated levels in the
      myeloid cells of chronic myelogenous leukemia patients. Interferon-alpha reduces
      the level of this activity only in the cells of patients who are clinically
      sensitive to the antiproliferative effects of interferon-alpha. We have purified
      this protein to homogeneity and found it to be a 57-kDa protein which corresponds
      to an isoform of protein disulfide isomerase. Protein disulfide isomerase is an
      oxidoreductase which catalyzes the interconversion between the reduced and
      oxidized states of proteins which contain multiple sulfhydryl groups and
      disulfide bonds. These studies suggest that this protein may play an important
      role in the transcriptional activation of interferon-inducible genes, perhaps
      through redox mechanisms.

PMID- 1629228
TI  - The cytoskeletal protein talin is O-glycosylated.
AB  - Talin is a 215-kDa cytoskeletal protein implicated in linking actin filaments to
      the plasma membrane. We show here that chicken gizzard talin is galactosylated by
      incubation with UDP-[3H]galactose and galactosyl-transferase. The labeled
      carbohydrate moiety is removed by beta-elimination and comigrates with Gal beta 1
      4GlcNAcitol, indicating that talin belongs to a recently discovered class of
      cytosolic proteins carrying N-acetylglucosamine (GlcNAc) O-linked to serine or
      threonine (Holt, G. D., and Hart, G. W. (1986) J. Biol. Chem. 261, 8049-8057).
      Two glycosylated sequences were identified in the tail domain of talin:
      ANQAIQMAXQNLVDPAXTQ and GILANQLTNDYGQLAQQ, corresponding to amino acids 1470-1488
      and 1883-1899, respectively, of the mouse talin amino acid sequence (Rees, D. J.
      G., Ades, S. E., Singer, S. J., and Hynes, R. O. (1990) Nature 347, 685-689). The
      putative glycosylation sites are PAXTQ and QLTND. At most 6% of chicken gizzard
      talin and 3% of porcine stomach talin are galactosylated by
      galactosyltransferase. Furthermore, human platelet talin is not labeled at all by
      the procedure, indicating that it may not be glycosylated.

PMID- 1629229
TI  - A novel site-directed mutant of myoglobin with an unusually high O2 affinity and
      low autooxidation rate.
AB  - Mutants of sperm whale myoglobin were constructed at position 29 (B10 in helix
      notation) to examine the effects of distal pocket size on the rates of ligand
      binding and autooxidation. Leu29 was replaced with Ala, Val, and Phe using the
      synthetic gene and Escherichia coli expression system of Springer and Sligar
      (Springer, B. A., and Sligar, S. G. (1987) Proc. Natl. Acad. Sci. U. S. A. 84,
      8961-8965). Structures of the ferric forms of Val29 and Phe29, and the oxy form
      of Phe29 myoglobin were determined to 1.7 A by x-ray crystallography. The ferric
      mutant proteins are remarkably isomorphous with the wild type protein except in
      the immediate vicinity of residue 29. Thus, the protein structure in the distal
      pocket of myoglobin can accommodate either a large "hole" (i.e. Ala or Val) or a
      large side chain (i.e. Phe) at position 29 without perturbation of tertiary
      structure. Phe29 oxymyoglobin is also identical to the native oxy protein in
      terms of overall structure and interactions between the bound O2 and His64,
      Val68, Phe43, and Ile107. The distance between the nearest side chain atom of
      residue 29 and the second atom of the bound oxygen molecule is 3.2 A in the Phe29
      protein and 4.9 A in native myoglobin. The equilibrium constants for O2 binding
      to Ala29, Val29, and Leu29 (native) myoglobin are the same, approximately 1.0 x
      10(6) M-1 at 20 degrees C, whereas that for the Phe29 protein is markedly
      greater, 15 x 10(6) M-1. This increase in affinity is due primarily to a 10-fold
      decrease in the O2 dissociation rate constant for the Phe29 mutant and appears to
      be the result of stabilizing interactions between the negative portion of the
      bound O2 dipole and the partially positive edge of the phenyl ring. Increasing
      the size of residue 29 causes large decreases in the rate of autooxidation of
      myoglobin: k(ox) = 0.24, 0.23, 0.055, and 0.005 h-1 for Ala29, Val29, Leu29
      (native), and Phe29 myoglobin, respectively, in air at 37 degrees C. Thus, the
      Leu29----Phe mutation produces a reduced protein that is remarkably stable and is
      expressed in E. coli as 100% MbO2. The selective pressure to conserve Leu29 at
      the B10 position probably represents a compromise between reducing the rate of
      autooxidation and maintaining a large enough O2 dissociation rate constant to
      allow rapid oxygen release during respiration.

PMID- 1629230
TI  - xP2, a new member of the P-domain peptide family of potential growth factors, is
      synthesized in Xenopus laevis skin.
AB  - Similarly to epidermal growth factor (EGF) and EGF-like repeats, the "P-domain"
      represents a cysteine-rich module that has been detected in the past in a variety
      of polypeptides, as well as in high molecular weight proteins. Here, a precursor
      for a secretory polypeptide (xP2) is characterized that consists of two P
      domains. xP2 has been discovered in Xenopus laevis with the help of the
      polymerase chain reaction. In contrast to all other P-domain peptides, it is
      synthesized in the skin but not in the stomach or the pancreas. By this and other
      criteria, it cannot be considered simply as the X. laevis homologue of recently
      described P-domain peptides, viz. the spasmolytic polypeptides (PSP/hSP/mSP).
      Furthermore, a polyclonal antiserum was generated against the deduced C-terminal
      end of xP2. Due to its immunoreactivity with granular glands, as well as with the
      epidermis, the possibility of a growth factor activity for xP2 in the germinal
      layer is discussed.

PMID- 1629231
TI  - Adipocyte differentiation of 3T3-L1 cells involves augmented expression of a 43
      kDa plasma membrane fatty acid-binding protein.
AB  - A previously described 43-kDa plasma membrane fatty acid-binding protein (FABPPM)
      was not observed by immunohistochemical methods in proliferating 3T3-L1
      fibroblasts. However, it was detectable in plasma membranes by the second day of
      confluent growth, prior to accumulation of visible lipid droplets, and was
      strongly expressed in 8-day differentiated adipocytes. These observations were
      confirmed by extraction of plasma membrane proteins and subsequent
      immunoblotting. Kinetics of initial [3H]oleate uptake by both fibroblasts and
      adipocytes consisted of the sum of a saturable and a non-saturable component.
      During differentiation the saturable component increased progressively. Vmax
      increased from 3 to 25 to 110 pmol.s-1.mg cell protein-1 between the fibroblast,
      the 4-day, and 8 day adipocyte stages; Km was 24 nM in fibroblasts and
      approximately 55 nM in both 4- and 8-day differentiated adipocytes. By contrast,
      the rate constant for nonsaturable oleate influx decreased progressively from
      0.026 to 0.010 ml.s-1.mg protein-1 between the fibroblast and 8 day adipocyte
      stages. In 8-day adipocytes saturable oleate uptake was inhibited by up to 55% by
      antibodies against rat liver FABPPM; these antibodies had no effect on uptake of
      2-deoxyglucose or the medium chain fatty acid octanoate. They also had no effect
      on oleate uptake by fibroblasts. These studies support the hypothesis that FABPPM
      is a component of a saturable transport mechanism for long chain fatty acids.

PMID- 1629232
TI  - Deletion of the membrane anchoring region of tissue factor abolishes
      autoactivation of factor VII but not cofactor function. Analysis of a mutant with
      a selective deficiency in activity.
AB  - The activation of human blood coagulation factor VII can occur by the feedback
      activity of either factor VIIa (autoactivation) or factor Xa. Both of these
      reactions are known to be enhanced by the presence of tissue factor, an integral
      membrane protein and the cofactor for factor VIIa. We examine here the activation
      of 125I-factor VII by both factor VIIa and factor Xa employing a mutant soluble
      form of tissue factor which has had its transmembrane and cytoplasmic domains
      deleted (sTF1-219). This mutant soluble tissue factor retains cofactor activity
      toward factor VIIa in a single-stage clotting assay but shows a strong dependence
      on initial plasma levels of factor VIIa (from 1 to 10,000 ng/ml) when compared to
      wild-type tissue factor. We show that this dependence is due to a deficiency of
      sTF1-219 in ability to both promote autoactivation and enhance the factor Xa
      catalyzed activation of 125I-factor VII. sTF1-219 does not, however, inhibit the
      tissue factor-independent activation of 125I-factor VII by factor Xa. The results
      strongly suggest that the phospholipid anchoring region of tissue factor is
      essential for autoactivation and beneficial for factor Xa-catalyzed activation of
      125I-factor VII. In addition, when taken together with the dependence of clotting
      times on initial factor VIIa levels observed with sTF1-219, these results
      indicate that factor VII autoactivation may be of greater importance in the
      initiation of blood coagulation via tissue factor than has been previously
      realized.

PMID- 1629233
TI  - Acute desensitization of muscarinic receptors in the isolated guinea-pig ileal
      longitudinal muscle.
AB  - 1. The effects of acute desensitization of muscarinic receptors mediating
      contractile responses of the guinea-pig ileal longitudinal muscle were studied in
      vitro, using similar conditions for both functional and radioligand binding
      studies. 2. The pA2 values for a number of muscarinic antagonists (pirenzepine,
      methoctramine, (+/-)para-fluoro-hexahydro-siladifenidol and 4-diphenylacetoxy-N
      methyl piperidine-methiodide) indicated that the contractile response to
      carbachol was mediated through an M3 muscarinic receptor. In binding experiments
      the muscarinic receptor subtype population in ileal longitudinal muscle was found
      to be heterogeneous, consisting of approximately 77% M2 and 23% M3 receptors. 3.
      Pre-exposure of ileal longitudinal muscle to 10 microM carbachol for 30 min
      produced a reduction (28 +/- % of control maximum) in the maximum contractile
      response and a dextral shift in the concentration-effect curve to carbachol.
      Prior equilibration (60 min) with (+/-)p-F-HHSiD (1 microM), but not with
      methoctramine (1 microM) or pirenzepine (0.3 microM), prevented the
      desensitization. Desensitization under these conditions did not alter either the
      apparent affinity, the total number of binding sites or the relative, proportions
      of M2 and M3 muscarinic receptors, as determined in radioligand binding studies.
      Desensitization did not cause any meaningful change in either the apparent
      affinity of carbachol or the proportion of the high and low affinity binding
      sites. 4. It is concluded that desensitization of the contractile responses of
      the guinea-pig ileal longitudinal muscle is a result of M3 but not M2 muscarinic
      receptor desensitization. Acute desensitization, therefore, is not accompanied by
      meaningful changes in the total number of both M2 and M3 receptors or by
      alterations in the affinity of the receptor to ligands.

PMID- 1629234
TI  - Mediation of contraction by cholinergic muscarinic receptors in the
      ureterovesical junction.
AB  - 1. The muscarinic receptor profile of the sheep ureterovesical junction has been
      studied by means of in vitro techniques. The relative potency (pD2 = -log EC50)
      and maximum effect (Emax) observed with carbachol were 51-fold and 25% greater
      than with acetylcholine respectively. This could be due to the presence of active
      acetylcholinesterase in this tissue. 2. The pA2 values obtained with the
      muscarinic antagonists were pirenzepine (8.52), AF-DX 116 (8.05), 4-DAMP (9.41)
      and hexahydroxiladifenidol (8.66). The slope values of Schild plots were not
      significantly different from unity, indicating competitive antagonism.
      Furthermore, when the slopes were constrained to 1, no significant differences
      were found between the pA2 values. These pA2 values were similar to those
      observed in other mammalian smooth muscles. 3. It is concluded that muscarinic
      receptors in the sheep ureterovesical junction smooth muscle belong to the M1, M2
      and M3 subtypes and mediate contraction of the ureterovesical junction, which
      suggests that during parasympathetic stimulation they might prevent
      vesicoureteral reflux.

PMID- 1629235
TI  - Post-Golgi membrane traffic: brefeldin A inhibits export from distal Golgi
      compartments to the cell surface but not recycling.
AB  - Recent studies using the fungal metabolite brefeldin A (BFA) have provided
      important insights into the dynamics and the organization of the ER/Golgi
      membrane system. Here we examined the effect of BFA on the functional integrity
      of the distal part of the secretory pathway, i.e., transport between trans-Golgi
      cisternae and the cell surface. To assay export via the constitutive pathway, we
      followed the movement of vesicular stomatitis virus (VSV) G glycoprotein that had
      been accumulated in the trans-Golgi network (TGN) by incubation of infected BHK
      21 cells at 20 degrees C. Addition of BFA rapidly and reversibly inhibited cell
      surface transport of G protein. The block to secretion was not due to
      redistribution of externalized G protein to internal pools. It was also not due
      to collapse of TGN to the ER, since VSV G protein blocked in treated cells
      resided in compartments that were distinct from the ER/Golgi system. Similar
      effects were found with a bulk-flow marker: BFA blocked constitutive secretion of
      glycosaminoglycan chains that had been synthesized and sulfated in the trans
      Golgi cisternae. To examine export via the regulated secretory pathway, we
      assayed secretion of [35S]SO4 labeled secretogranin II from PC12 cells, a marker
      that has been used to study secretory granule budding from the TGN (Tooze, S. A.,
      U. Weiss, and W. B. Huttner. 1990. Nature [Lond.]. 347:207-208). BFA potently
      inhibited secretion of sulfated secretogranin II induced by K+ depolarization.
      Inhibition was at the level of granule formation, since BFA had no effect on
      regulated secretion from preformed granules. Taken together, the results suggest
      that BFA blocks export via both the constitutive and the regulated pathways. In
      contrast, endocytosis and recycling of VSV G protein were not blocked by BFA,
      consistent with previous studies that endocytosis is unaffected (Misumi, Y., Y.
      Misumi, K. Miki, A Takatsuki, G. Tamura, and Y. Ikehara. 1986. J. Biol. Chem.
      261:11398-11403). These and earlier results suggest that the exo/endocytic
      pathway of mammalian cells consist of two similar but distinct endomembrane
      systems: an ER/Golgi system and a post-Golgi system. BFA prevents forward
      transport without affecting return traffic in both systems.

PMID- 1629236
TI  - Characterization of TPM1 disrupted yeast cells indicates an involvement of
      tropomyosin in directed vesicular transport.
AB  - Disruption of the yeast tropomyosin gene TPM1 results in the apparent loss of
      actin cables from the cytoskeleton (Liu, H., and A. Bretscher. 1989. Cell. 57:233
      242). Here we show that TPM1 disrupted cells grow slowly, show heterogeneity in
      cell size, have delocalized deposition of chitin, and mate poorly because of
      defects in both shmooing and cell fusion. The transit time of alpha-factor
      induced a-agglutinin secretion to the cell surface is longer than in isogenic
      wild-type strains, and some of the protein is mislocalized. Many of the TPM1
      deleted cells contain abundant vesicles, similar in morphology to late secretory
      vesicles, but without an abnormal accumulation of intermediates in the delivery
      of either carboxypeptidase Y to the vacuole or invertase to the cell surface.
      Combinations of the TPM1 disruption with sec13 or sec18 mutations, which affect
      early steps in the secretory pathway, block vesicle accumulation, while
      combinations with sec1, sec4 or sec6 mutations, which affect a late step in the
      secretory pathway, have no effect on the vesicle accumulation. The phenotype of
      the TPM1 disrupted cells is very similar to that of a conditional mutation in the
      MYO2 gene, which encodes a myosin-like protein (Johnston, G. C., J. A.
      Prendergast, and R. A. Singer. 1991. J. Cell Biol. 113:539-551). The myo2-66
      conditional mutation shows synthetic lethality with the TPM1 disruption,
      indicating that the MYO2 and TPM1 gene products may be involved in the same, or
      parallel function. We conclude that tropomyosin, and by inference actin cables,
      may facilitate directed vesicular transport of components to the correct location
      on the cell surface.

PMID- 1629237
TI  - Localization of capping protein in chicken epithelial cells by immunofluorescence
      and biochemical fractionation.
AB  - We have localized capping protein in epithelial cells of several chicken tissues
      using affinity-purified polyclonal antibodies and immunofluorescence. Capping
      protein has a distribution in each tissue coincident with proteins of the cell
      cell junctional complex, which includes the zonula adherens, zonula occludens,
      and desmosome. "En face" views of the epithelial cells showed capping protein
      distributed in a polygonal pattern coincident with cell boundaries in intestinal
      epithelium, sensory epithelium of the cochlea, and the pigmented epithelium of
      the retina and at regions of cell-cell contact between chick embryo kidney cells
      in culture. "Edge-on" views obtained by confocal microscopy of intact single
      intestinal epithelial cells and of retinal pigmented epithelium showed that
      capping protein is located in the apical region of the epithelial cells
      coincident with the junctional complexes. These images do not resolve the
      individual types of junctions of the junctional complex. Immunolabeling of
      microvilli or stereocilia was faint or not detectable. Capping protein was also
      detected in the cytoplasm of intact intestinal epithelial cells and in nuclei of
      cells in the pigmented retina and in the kidney cell cultures, but not in nuclei
      of cells of the intestinal epithelium or sensory epithelium. Biochemical
      fractionation of isolated intestinal epithelial cells shows capping protein in
      the brush border fraction, which contains the junctional complexes, and in the
      soluble fraction. These results are consistent with the results of the
      immunolabeling experiments. Highly purified microvilli of the brush borders also
      contained capping protein; this result was unexpected based on the low intensity
      of immunofluorescence staining of microvilli and stereocilia. The microvilli were
      not contaminated with junctional complexes, as defined by the absence of several
      markers for cell junctions. The cause and significance of this discrepancy is not
      certain at this time. Since capping protein binds the barbed end of actin
      filaments in vitro, we hypothesize that capping protein is bound to the barbed
      ends of actin filaments associated with one or more of the junctions of the
      junctional complex.

PMID- 1629239
TI  - Kinetochore microtubules in PTK cells.
AB  - We have analyzed the fine structure of 10 chromosomal fibers from mitotic
      spindles of PtK1 cells in metaphase and anaphase, using electron microscopy of
      serial thin sections and computer image processing to follow the trajectories of
      the component microtubules (MTs) in three dimensions. Most of the kinetochore MTs
      ran from their kinetochore to the vicinity of the pole, retaining a clustered
      arrangement over their entire length. This MT bundle was invaded by large numbers
      of other MTs that were not associated with kinetochores. The invading MTs
      frequently came close to the kinetochore MTs, but a two-dimensional analysis of
      neighbor density failed to identify any characteristic spacing between the two MT
      classes. Unlike the results from neighbor density analyses of interzone MTs, the
      distributions of spacings between kinetochore MTs and other spindle MTs revealed
      no evidence for strong MT-MT interactions. A three-dimensional analysis of
      distances of closest approach between kinetochore MTs and other spindle MTs has,
      however, shown that the most common distances of closest approach were 30-50 nm,
      suggesting a weak interaction between kinetochore MTs and their neighbors. The
      data support the ideas that kinetochore MTs form a mechanical connection between
      the kinetochore and the pericentriolar material that defines the pole, but that
      the mechanical interactions between kinetochore MTs and other spindle MTs are
      weak.

PMID- 1629238
TI  - Association of calmodulin and an unconventional myosin with the contractile
      vacuole complex of Dictyostelium discoideum.
AB  - mAbs specific for calmodulin were used to examine the distribution of calmodulin
      in vegetative Dictyostelium cells. Indirect immunofluorescence indicated that
      calmodulin was greatly enriched at the periphery of phase lucent vacuoles. The
      presence of these vacuoles in newly germinated (non-feeding) as well as growing
      cells, and the response of the vacuoles to changes in the osmotic environment,
      identified them as contractile vacuoles, osmoregulatory organelles. No evidence
      was found for an association of calmodulin with endosomes or lysosomes, nor was
      calmodulin enriched along cytoskeletal filaments. When membranes from
      Dictyostelium cells were fractionated on equilibrium sucrose density gradients,
      calmodulin cofractionated with alkaline phosphatase, a cytochemical marker for
      contractile vacuole membranes, at a density of 1.156 g/ml. Several high molecular
      weight calmodulin-binding proteins were enriched in the same region of the
      gradient. One of the calmodulin-binding polypeptides (molecular mass
      approximately 150 kD) cross-reacted with an antiserum specific for Acanthamoeba
      myosin IC. By indirect immunofluorescence, this protein was also enriched on
      contractile vacuole membranes. These results suggest that a calmodulin-binding
      unconventional myosin is associated with contractile vacuoles in Dictyostelium;
      similar proteins in yeast and mammalian cells have been implicated in vesicle
      movement.

PMID- 1629240
TI  - A fibronectin self-assembly site involved in fibronectin matrix assembly:
      reconstruction in a synthetic peptide.
AB  - The active form of fibronectin is its extracellular matrix form, which allows for
      the attachment of cells and influences both the growth and migration of cells.
      The matrix form is assembled by cells; however, many cells are defective in this
      regard. Several regions within fibronectin have been shown to play a role in
      matrix assembly by cells. One such region has been localized into the first type
      III repeat of fibronectin (Chernousov, M. A., F. J. Fogerty, V. E. Koteliansky,
      and D. F. Mosher. J. Biol. Chem. 266:10851-10858). We have identified this site
      as a fibronectin-fibronectin binding site and reproduced it as a synthetic
      peptide. This site is contained in a 14-kD fragment that corresponds to portions
      of the first two type III repeats. The 14-kD fragment was found to bind to cell
      monolayers and to inhibit fibronectin matrix assembly. The 14-kD fragment only
      slightly reduced the binding of fibronectin to cell surfaces but it significantly
      inhibited the subsequent incorporation of fibronectin into the extracellular
      matrix. The 14-kD fragment also bound to purified fibronectin and inhibited
      fibronectin-fibronectin binding. A synthetic 31-amino acid peptide (P1)
      representing a segment of the 14-kD fragment retained the ability to inhibit
      fibronectin-fibronectin binding. Peptide P1 specifically bound fibronectin from
      plasma in affinity chromatography, whereas a column containing another peptide
      from the 14-kD fragment did not. These results define a fibronectin-fibronectin
      binding site that appears to promote matrix assembly by allowing the assembly of
      fibronectin molecules into nascent fibrils. The 14-kD fragment and the P1 peptide
      that contain this site inhibit matrix assembly by competing for the fibronectin
      fibronectin binding.

PMID- 1629241
TI  - Coordinate role for cell surface chondroitin sulfate proteoglycan and alpha 4
      beta 1 integrin in mediating melanoma cell adhesion to fibronectin.
AB  - Cellular recognition and adhesion to the extracellular matrix (ECM) has a complex
      molecular basis, involving both integrins and cell surface proteoglycans (PG).
      The current studies have used specific inhibitors of chondroitin sulfate
      proteoglycan (CSPG) synthesis along with anti-alpha 4 integrin subunit monoclonal
      antibodies to demonstrate that human melanoma cell adhesion to an A-chain
      derived, 33-kD carboxyl-terminal heparin binding fragment of human plasma
      fibronectin (FN) involves both cell surface CSPG and alpha 4 beta 1 integrin. A
      direct role for cell surface CSPG in mediating melanoma cell adhesion to this FN
      fragment was demonstrated by the identification of a cationic synthetic peptide,
      termed FN-C/H-III, within the fragment. FN-C/H-III is located close to the amino
      terminal end of the fragment, representing residues #1721-1736 of intact FN. FN
      C/H-III binds CSPG directly, can inhibit CSPG binding to the fragment, and
      promotes melanoma cell adhesion by a CSPG-dependent, alpha 4 beta 1 integrin
      independent mechanism. A scrambled version of FN-C/H-III does not inhibit CSPG
      binding or cell adhesion to the fragment or to FN-C/H-III, indicating that the
      primary sequence of FN-C/H-III is important for its biological properties.
      Previous studies have identified three other synthetic peptides from within this
      33-kD FN fragment that promote cell adhesion by an arginyl-glycyl-aspartic acid
      (RGD) independent mechanism. Two of these synthetic peptides (FN-C/H-I and FN-C/H
      II) bind heparin and promote cell adhesion, implicating cell surface PG in
      mediating cellular recognition of these two peptides. Additionally, a third
      synthetic peptide, CS1, is located in close proximity to FN-C/H-I and FN-C/H-II
      and it promotes cell adhesion by an alpha 4 beta 1 integrin-dependent mechanism.
      In contrast to FN-C/H-III, cellular recognition of these three peptides involved
      contributions from both CSPG and alpha 4 integrin subunits. Of particular
      importance are observations demonstrating that CS1-mediated melanoma cell
      adhesion could be inhibited by interfering with CSPG synthesis or expression.
      Since CS1 does not bind CSPG, the results suggest that CSPG may modify the
      function and/or activity of alpha 4 beta 1 integrin on the surface of human
      melanoma cells. Together, these results support a model in which the PG and
      integrin binding sites within the 33-kD fragment may act in concert to focus
      these two cell adhesion receptors into close proximity on the cell surface,
      thereby influencing initial cellular recognition events that contribute to
      melanoma cell adhesion on this fragment.

PMID- 1629243
TI  - How do cells sense and respond to adhesive contacts? Diffusion-trapping of
      laterally mobile membrane proteins at maturing adhesions may initiate signals
      leading to local cytoskeletal assembly response and lamella formation.

PMID- 1629242
TI  - Topology and phosphorylation of soybean nodulin-26, an intrinsic protein of the
      peribacteroid membrane.
AB  - Soybean nodulin-26, a homologue of bovine eye lens major intrinsic protein (MIP
      26), is an integral protein of the peribacteroid membrane in symbiotic root
      nodules. It comprises 271 amino acids with six potential transmembrane domains
      and lacks an amino-terminal signal sequence. A full-length nodulin-26 cDNA and
      its various deletion derivatives were transcribed in vitro after linking them to
      bacteriophage T3 promoter. In vitro translation of these transcripts in a rabbit
      reticulocyte lysate, in the presence or absence of canine pancreatic microsomal
      membranes, suggested that nodulin-26 is cotranslationally inserted into the
      microsomes without a cleavable signal peptide. The first two transmembrane
      domains (103 amino acids) of the protein are sufficient for microsomal membrane
      insertion. Membrane-translocated nodulin-26 binds to Con-A and is sensitive to
      endoglycosidase-H treatment, suggesting that it is glycosylated. Native nodulin
      26 from root nodules retains its sugar moiety as it, too, binds to Con-A.
      Chemical cleavage mapping at cysteine residues, a trypsin protection assay, and
      the Con-A binding affinity of nodulin-26 suggested that both the NH2 and COOH
      termini of this protein are on the cytoplasmic surface of the peribacteroid
      membrane, while the glycosidic residue is on the surface of the membrane facing
      the bacteroids. In vitro phosphorylation experiments showed that nodulin-26 is a
      major phosphorylated protein in the peribacteroid membrane. This phosphorylation
      is mediated by a Ca(2+)-dependent, calmodulin-independent protein kinase located
      in the peribacteriod membrane. Externally supplied acid phosphatase
      dephosphorylates this protein, but alkaline phosphatase does not. Based on its
      homology with several eukaryotic and prokaryotic channel-type membrane proteins,
      nodulin-26 may form a channel translocating specific molecules to the bacteroids
      during endosymbiosis in legume plants.

PMID- 1629244
TI  - Visualization of centromeric and nucleolar DNA in fission yeast by fluorescence
      in situ hybridization.
AB  - The nucleolar and centromeric DNAs of the fission yeast Schizosaccharomyces pombe
      were visualized in the nucleus by fluorescence in situ hybridization using
      repetitive ribosomal and centromeric DNAs as the probes. The rDNAs were seen in
      the nuclear domain previously assigned as nucleolar, that is, the region into
      which the rod-like chromatin protrudes from the hemispherical chromosomal domain.
      Using mitotically-arrested cells containing condensed chromosomes, it was
      demonstrated that the rDNAs were present on the smallest chromosome III,
      consistent with genetic data. Using a centromeric repetitive element as the
      hybridization probe, the centromere of chromosome III, cen3, which contains the
      largest number of the repetitive elements, was visualized. The centromere in
      interphase cells is located near the periphery of the nucleus as a single dot.
      Early in mitosis, however, it divides into two and is situated in the middle of
      the short mitotic spindle. After spindle extension in anaphase, the centromeric
      DNA is present at both ends of the spindle, that is, near the spindle pole
      bodies. The movement of cen3 during mitosis (anaphase A and B) is discussed in
      relation to spindle dynamics and chromosome separation.

PMID- 1629245
TI  - Protein kinase C involvement in focal adhesion formation.
AB  - Matrix molecules such as fibronectin can promote cell attachment, spreading and
      focal adhesion formation. Although some interactions of fibronectin with cell
      surface receptors have now been identified, the consequent activation of
      intracellular messenger systems by cell/matrix interactions have still to be
      elucidated. We show here that the kinase inhibitors H7 and HA1004 reduce focal
      adhesion and stress fiber formation in response to fibronectin in a dose
      dependent manner, and that activators of protein kinase C can promote their
      formation under conditions where they do not normally form. Fibroblasts spread
      within 1h on substrata composed of fibronectin and formed focal adhesions by 3h,
      as monitored by interference reflection microscopy (IRM) and by labeling for
      talin, vinculin and integrin beta 1 subunits. In addition, stress fibers were
      visible. When cells were allowed to spread for 1h and then treated with kinase
      inhibitors H7 and HA1004 for 2h, IRM indicated a reduction in focal adhesion
      formation at concentrations where protein kinase C (PKC) should be inhibited. In
      contrast, focal adhesions formed normally at concentrations of these inhibitors
      where cyclic AMP- or cyclic GMP-dependent kinases should be inactivated.
      Inhibition of PKC, but not that of cyclic AMP- or cyclic GMP-dependent kinases,
      also prevented the formation of stress fibers and induced a dispersal of talin
      and vinculin, but not integrin beta 1 subunits, from small condensations present
      at 1h. Consistent with the reduction in focal adhesion formation when PKC was
      inhibited, activation of PKC by 30 minutes of treatment with phorbol esters
      induced focal adhesion formation in cells spread for 3h on substrata composed of
      the cell-binding (RGD-containing) fragment of fibronectin, while untreated cells
      or those treated with inactive phorbol esters did not form these structures.

PMID- 1629246
TI  - Isolation of a sea urchin egg kinesin-related protein using peptide antibodies.
AB  - To understand the roles of kinesin and its relatives in cell division, it is
      necessary to identify and characterize multiple members of the kinesin
      superfamily from mitotic cells. To this end we have raised antisera to peptides
      corresponding to highly conserved regions of the motor domains of several known
      members of the kinesin superfamily. These peptide antibodies react specifically
      with the motor domains of kinesin and ncd protein, as expected, and they also
      react with several polypeptides (including kinesin heavy chain) that cosediment
      with microtubules (MTs) precipitated from AMPPNP-treated sea urchin egg cytosol.
      Subsequent fractionation of ATP eluates of these MTs yields a protein of relative
      molecular mass 330 x 10(3) that behaves as a complex of three polypeptides that
      are distinct from conventional kinesin subunits or fragments thereof. This
      complex contains 85 kDa and 95 kDa polypeptides, which react with our peptide
      antibodies, and a 115 kDa polypeptide, which does not. This triplet of
      polypeptides, which we refer to as KRP(85/95), binds to purified sea urchin egg
      tubulin in an AMPPNP-enhanced, ATP-sensitive manner and induces the formation of
      microtubule bundles. We therefore propose that the triplet corresponds to a novel
      sea urchin egg kinesin-related protein.

PMID- 1629248
TI  - Bone-marrow-derived chondrogenesis in vitro.
AB  - Bone marrow stromal cells from embryonic, neo-natal and adult chickens were grown
      in vitro over a 21-day period. Marrow stromal cells from embryonic and neonatal
      chicks produced clonally derived chondrocytic colonies. The cells within the
      colonies were surrounded by a refractile, Alcian-blue-positive matrix and their
      cartilagenous nature was shown biochemically and immunocytochemically by the
      synthesis of collagen types II and X. The ability of chick bone marrow cells to
      form chondrocytic colonies decreased during development and was lost by
      adulthood. In addition to chondrocytic colonies, fat cells and fibroblasts were
      also observed in the cultures. Our data demonstrate that chick bone marrow stroma
      contains cells that are capable of differentiating along different pathways
      within the same culture, providing further evidence for the presence in bone
      marrow of a stromal stem cell.

PMID- 1629247
TI  - Evidence for kinesin-related proteins in the mitotic apparatus using peptide
      antibodies.
AB  - To identify kinesin-related proteins that may be important for mitotic function
      in embryonic and tissue culture cells we have generated polyclonal antibodies to
      two synthetic peptides corresponding to conserved regions of the kinesin motor
      domain. In Xenopus eggs we have identified a family of microtubule-binding
      proteins, recognized by one or both affinity-purified peptide antibodies but not
      by monoclonal antibodies that recognize conventional kinesin heavy chain. Like
      kinesin, most of these proteins bind to microtubules only upon addition of AMP
      PNP or nucleotide depletion and are released upon subsequent addition of ATP. At
      least one protein, however, exhibits markedly distinct properties, binding
      readily to microtubules in the absence of AMP-PNP and/or nucleotide depletion. We
      also report that, unlike antibodies to conventional kinesin, the peptide
      antibodies to the kinesin motor domain immunofluorescently label spindles and
      kinetochores in mitotic tissue culture cells, suggesting that kinesin-like
      proteins may have important roles in chromosome movement and mitosis.

PMID- 1629249
TI  - Transport of the cationic fluorochrome rhodamine 123 in an insect's Malpighian
      tubule: indications of a reabsorptive function of the secondary cell type.
AB  - The pathway of rhodamine 123 was examined after injection into Sarcophaga flies
      and after in vitro labeling of the Malpighian tubules. After in vitro labeling
      the primary cells only retained this potential-sensitive dye for a short period
      while all secondary cells accumulated the dye from the tubule lumen. In vivo the
      secondary cells also accumulated rhodamine 123 from the lumen, but the primary
      cells in the distal parts of all four tubules retained the dye for prolonged
      periods. This was most pronounced in the distal part of the anterior Malpighian
      tubules, where rhodamine 123 was eventually precipitated on the luminal
      concretions. Rhodamine 123 initially accumulated in the secondary cell
      mitochondria and eventually in intensely fluorescing vesicles, probably
      lysosomes. No evidence for endocytotic processes from the lumen was found using
      Lucifer Yellow CH, fluorescent dextrans and fluorescent albumin. Prior incubation
      with the ionophores valinomycin, nigericin, CCCP (all 1 micrograms/ml),
      dinitrophenol (1 mM) and NaN3 (10(-2) M) inhibited the selective accumulation of
      rhodamine 123 to a large extent while monensin (1-5 micrograms/ml) showed little
      inhibitory effect. Furthermore, only cationic and no anionic or neutral dyes were
      accumulated by the secondary cells. In the fleshfly Calliphora and the fruitfly
      Drosophila, the dye rhodamine 123 also selectively accumulated in the secondary
      cells, as well in vitro as in vivo.

PMID- 1629250
TI  - Salt-stable interaction of the amino-terminal head region of vimentin with the
      alpha-helical rod domain of cytoplasmic intermediate filament proteins and its
      relevance to protofilament structure and filament formation and stability.
AB  - Previous studies have shown that the non-alpha-helical, amino-terminal head
      region of vimentin is essential for the formation and stability of vimentin
      intermediate filaments (IFs). In order to specify its target site on companion
      protein subunits, it was cut off from vimentin at amino acid position 96 with
      lysine-specific endoproteinase and allowed to react with intact vimentin and
      other IF proteins. In solution of high salt concentration (500 mM KCl), the
      isolated polypeptide (vim NT) showed a high affinity for all cytoplasmic IF
      proteins tested, but not for nuclear lamins. Employing limited digestion of the
      IF proteins with different proteinases, the binding site was shown to reside in
      their alpha-helical rod domains. Other polypeptides possessing alpha-helical
      regions with the potential to form coiled-coil structures like tropomyosin and
      myosin subfragment 2 did not react with vim NT. The binding to IF proteins was
      strongly inhibited by phosphorylation of vim NT and totally abolished in the
      presence of 200 mM arginine hydrochloride, whereas the same concentration of
      lysine hydrochloride was ineffective. Limited chymotryptic digestion of vim NT
      produced polypeptides that were unable to react with the alpha-helical region of
      vimentin at high salt concentration. Consistent with these observations, vim NT
      strongly inhibited filament formation in vitro from protofilamentous vimentin. A
      14-mer oligopeptide comprising the amino acids 3 to 16 of the amino terminus also
      inhibited filament formation, though to a lesser extent. Conversely, vim NT and,
      with a lower efficiency, the 14-mer oligopeptide also severely affected the
      structure of preformed vimentin filaments by unraveling them. Phosphorylated vim
      NT was considerably less active in this respect. Further digestion of the rod
      domain of vimentin with chymotrypsin yielded 17.4 and 21 kDa polypeptides, which
      were tentatively characterized as originating from the carboxy- and amino
      terminal half of the rod domain, respectively. Both formed salt-stable complexes
      with vim NT, the smaller polypeptide with a higher efficiency than the larger
      one. These results suggest that the staggered, antiparallel arrangement of the
      two coiled-coils in the protofilaments of IF proteins is, at least in part,
      determined by the twofold, symmetrical association of the amino-terminal head
      regions of one coiled-coil rope structure with the carboxy-terminal halves of the
      alpha-helical rod domains of the other coiled-coil and that similar interactions
      occur during filament assembly and in the intact filament.

PMID- 1629251
TI  - Attachment of steroidogenic lipid droplets to intermediate filaments in adrenal
      cells.
AB  - Light microscopy of living and extracted adrenal cells (Y-1 mouse adrenal tumour
      cells and cultured bovine fasciculata cells), using Nomarski optics and
      fluorescence with nile red to stain lipid, revealed in both cell types that lipid
      droplets remain attached to intermediate filaments when the cells are extracted
      to prepare these structures. Electron microscopy of thin sections shows the
      presence of lipid droplets in both cell types. The droplets differ in appearance
      but are, in both cases, surrounded by a complete capsule 5 nm wide. The droplets
      in Y-1 cells include those associated with lysosomes and crystalline structures
      in addition to typical rounded forms. Only the latter type is seen in bovine
      fasciculata. Intermediate filaments apparently ending in droplets can also be
      seen. Immunoelectron microscopy with anti-vimentin and Protein A conjugated to
      gold particles together with measurement of the diameter of these structures
      identifies them as intermediate filaments. When adrenal cells are permeabilised
      and extracted under mild or severe conditions using Triton X-100, thin sections
      showed that lipid droplets remain associated with the cytoskeleton and in
      particular intermediate filaments. Extraction under mild and severe conditions
      cleared the cell contents, revealing attachment of intermediate filaments to
      lipid droplets with greater clarity than in unextracted cells, i.e. homogenised
      cells or cells subjected to lysis. Such attachment was unequivocally demonstrated
      in stereo pairs. These observations support our earlier studies showing
      attachment of droplets to intermediate filaments, which suggests a role for these
      filaments in intracellular transport of cholesterol.

PMID- 1629252
TI  - Alpha-actinin and vinculin in human neutrophils: reorganization during adhesion
      and relation to the actin network.
AB  - We have studied the reorganization of vinculin and alpha-actinin during the
      process of adhesion in human neutrophils using immunofluorescence microscopy and
      interference reflection microscopy (IRM). Neutrophils in contact with uncoated
      glass formed black IRM areas in the cell periphery, indicative of very close
      contact with the substratum. Eight to twelve minutes after addition of cells to
      glass, vinculin was found to become concentrated in small patches at the cell
      periphery, partially colocalizing with the black IRM areas and with small F-actin
      containing adherent protrusions. In contrast, vinculin was not significantly
      enriched in the less adherent F-actin-rich large pseudopods. alpha-Actinin became
      enriched during cell adhesion in retraction fibers and, in 40-50% of the
      inspected cells, also in large less adherent pseudopods where it colocalized with
      F-actin. The latter finding suggests a continuous dynamic reorganization of
      pseudopods, with incorporation of alpha-actinin at a certain stage. Disruption of
      the actin network with cytochalasin D revealed a differential interaction of
      alpha-actinin and vinculin with the actin network. alpha-Actinin was strongly
      influenced by cytochalasin D, comparable to F-actin, and both proteins formed
      colocalizing peripheral caps in 10(-5) M of the drug. Vinculin organization in
      contrast was not affected by up to 10(-6) M cytochalasin. At 10(-5) M of the
      drug, however, the patches disappeared completely, vinculin now assuming a
      diffuse cytoplasmic location. Our results suggest a specialized function of
      vinculin in adhesion sites of human neutrophils, whereas alpha-actinin may
      structure the actin network in retraction fibers and in less adherent pseudopods.

PMID- 1629253
TI  - Tracking of cell surface receptors by fluorescence digital imaging microscopy
      using a charge-coupled device camera. Low-density lipoprotein and influenza virus
      receptor mobility at 4 degrees C.
AB  - A fluorescence imaging system, based on using a cooled slow-scan CCD camera, has
      been developed for tracking receptors on the surfaces of living cells. The
      technique is applicable to receptors for particles such as lipoproteins and
      viruses that can be labeled with a few tens of fluorophores. The positions of
      single particles in each image are determined to within 25 nm by fitting the
      fluorescence distribution to a two-dimensional Gaussian function. This procedure
      also provides an accurate measure of intensity, which is used as a tag for
      automated tracking of particles from frame to frame. The method is applied to an
      investigation of the mobility of receptors for LDL and influenza virus particles
      on human dermal fibroblasts at 4 degrees C. In contrast to previous studies by
      FRAP (fluorescence recovery after photo-bleaching), it is found that receptors
      have a low but measurable mobility at 4 degrees C. Analysis of individual
      particle tracks indicates that whilst some receptors undergo random diffusion,
      others undergo directed motion (flow) or diffusion restricted to a domain. A
      procedure is proposed for subdividing receptors according to their different
      types of motion and hence determining their motional parameters. The finding that
      receptors are not completely immobilised at 4 degrees C is significant for
      studies of receptor distributions performed at this temperature.

PMID- 1629254
TI  - Localised application of an activating signal to a cell: experimental use of
      fibronectin bound to beads and the implications for mechanisms of adhesion.
AB  - Small beads derivatised with fibronectin or with bovine serum albumin are allowed
      to attach to BHK cells in suspension at low ratios of beads to cells. In this way
      populations of cells bearing predominantly one bead per cell can be prepared. We
      show that the attachment of one bead per cell affects the adhesion and spreading
      of that cell on substrata, raising adhesion and increasing spreading if the
      signal molecule is fibronectin, decreasing these quantities if the bead bears
      BSA. The experiments are conducted in the absence of other sources of exogenous
      fibronectin and in some cases in the additional absence of endogenous sources.
      The effects are especially marked if the substratum is adsorbed haemoglobin on
      which control cells show little attachment or spreading. We further show by
      interference reflection microscopy and by scanning electron microscopy that the
      beads are found on the non-adhering side (uppermost or outer) of the cell when
      fibronectin-bearing beads are used, presumably because fibronectin will not
      attach to haemoglobin. The increased adhesion and spreading found in such cases
      must be attributed to an activation produced by the bead, which spreads to other
      parts of the cell and which activates a fibronectin-independent mode of adhesion.

PMID- 1629255
TI  - Endosomal system of Paramecium: coated pits to early endosomes.
AB  - A detailed morphological and tracer study of endocytosis via coated pits in
      Paramecium multimicronucleatum was undertaken to compare endocytic processes in a
      free-living protozoon with similar processes in higher organisms. Permanent pits
      at the cell surface enlarge, become coated and give rise to coated vesicles (188
      +/- 41 nm in diameter) that enclose fluid-phase markers such as horseradish
      peroxidase (HRP). Both the pits and vesicles are labeled by the immunogold
      technique when a monoclonal antibody (mAb) raised against the plasma membrane of
      this cell is applied to cryosections. The HRP is delivered to an early endosome
      compartment, which also shares the plasma membrane antigen. The early endosome,
      as shown in quick-freeze deep-etch replicas of chemically unfixed cells, is a
      definitive non-reticular compartment composed of many individual flattened
      cisternal units of 0.2 to 0.7 microns diameter, each potentially bearing one or
      more approximately 80-nm-wide coated evaginations. These coated evaginations on
      the early endosomes contain HRP but are not labeled by the mAb. The coated
      evaginations pinch off to form a second group of coated vesicles (90 +/- 17 nm in
      diameter), which can be differentiated from those formed from coated pits by
      their smaller size, absence of plasma membrane antigen and their location
      somewhat deeper into the cytoplasm. This study shows a striking similarity
      between protozoons and mammalian cells in their overall early endosomal machinery
      and in the ability of early endosomes to sort cargo from plasma membrane
      components. The vesicles identified in this study form two distinct populations
      of putative shuttle vesicles, pre-endosomal (large) and early endosome-derived
      vesicles (small), which facilitate incoming and outgoing traffic from the early
      endosomes.

PMID- 1629256
TI  - Cloning and expression of Drosophila HP1 homologs from a mealybug, Planococcus
      citri.
AB  - The mealybug chromosome cycle is one of the most dramatic examples of genomic
      imprinting known. In embryos that are to become male the entire paternal
      chromosome set becomes heterochromatic and inactive at the blastoderm stage,
      while the maternal set remains active and euchromatic. HP1 is a protein from
      Drosophila melanogaster, which binds preferentially to heterochromatin on
      polytene chromosomes and is likely to be a modifier of position effect
      variegation. This paper describes the isolation and sequencing of two cDNA clones
      encoding HP1 homologs from the mealybug, Planococcus citri. The protein product
      of the cDNA clone that was closer to HP1 in sequence was expressed as a fusion
      protein in Escherichia coli, and polyclonal rat antibodies were raised against
      it. Immunohistochemistry to mealybug squash preparations showed that this protein
      was a male-specific nuclear protein, but that it was not specifically associated
      with the heterochromatic set of chromosomes.

PMID- 1629257
TI  - Ambulatory blood pressure monitoring: clinical uses.
AB  - Ambulatory monitoring is a strategy that may effectively address the phenomenon
      of "white coat" hypertension and determine whether the peaks and troughs that
      typify circadian variations should be considerations in blood pressure
      management. In selected patients, ABPM may indeed be useful both for diagnosing
      hypertension and for monitoring response to therapy.

PMID- 1629258
TI  - Non-Q-wave myocardial infarction: a prognostic paradox.
AB  - It is now clear that non-Q-wave MI, whose incidence appears to be rising, carries
      an increased risk of reinfarction and recurrent ischemia. Indeed, non-Q-wave late
      mortality may equal or exceed that of its Q-wave counterpart. The management
      question: Should the patient with non-Q-wave MI have myocardial revascularization
      or strictly medical therapy?

PMID- 1629259
TI  - Scientific paper or political 'white paper'?

PMID- 1629260
TI  - Of birds and blood cells. Bruce Glick unravels the secret of the bursa of
      Fabricius.

PMID- 1629261
TI  - Primary hyperparathyroidism: problems in management.
AB  - Most hyperparathyroidism is subclinical, with no complaints of bone pain,
      constipation, mental confusion, or depression, no skeletal findings on x-ray, and
      no history of kidney stones. Routine hyperparathyroidectomy for asymptomatic
      hypercalcemia, with normal bone density and normal calciuria, particularly with
      moderate elevations of serum calcium, is now generally rejected.

PMID- 1629262
TI  - A partnership of patient, physician, and payer.

PMID- 1629263
TI  - Framing disease: studies in cultural history. Introduction. Framing disease:
      illness, society, and history.

PMID- 1629264
TI  - A new vista in Natchitoches.

PMID- 1629265
TI  - Framing disease: studies in cultural history. From Bright's disease to end-stage
      renal disease.

PMID- 1629266
TI  - Acute suppurative parotitis in a middle-aged woman.

PMID- 1629267
TI  - A slow pulse and a loud murmur in an elderly woman.

PMID- 1629268
TI  - The ups and downs of gastroesophageal reflux disease.

PMID- 1629269
TI  - Occult constipation.

PMID- 1629270
TI  - Malnutrition in the elderly.

PMID- 1629271
TI  - Studies on steroids. CCLIV. Gas chromatographic-mass spectrometric determination
      of 4- and 6-hydroxylated bile acids in human urine with negative ion chemical
      ionization detection.
AB  - A method for the determination of 4- and 6-hydroxylated bile acids with a vicinal
      glycol moiety in human urine by gas chromatography-mass spectrometry with
      negative ion chemical ionization detection is described. The 4 beta-hydroxylated
      bile acids labelled with 18O and 2H were prepared as internal standards by the
      exchange reaction of the carbonyl group on the steroid nucleus with H2(18)O,
      followed by metal deuteride reduction. Bile acids in urine were extracted with a
      Sep-Pak C18 cartridge and, after solvolysis and hydrolysis of the conjugated
      forms, transformed into pentafluorobenzyl ester diethylhydrogensilyl ether
      diethylsilylene derivatives. Subsequent resolution into individual 4- and 6
      hydroxylated bile acids was carried out on a cross-linked fused-silica capillary
      column; a characteristic carboxylate anion, [M-PFB]-, was used to monitor each
      bile acid in the negative ion mode. The newly developed method was applied to the
      separation and determination of 4- and 6-hydroxylated bile acids in a urine
      specimen from a newborn infant.

PMID- 1629272
TI  - Determination of fluvoxamine in human plasma by high-performance liquid
      chromatography with fluorescence detection.
AB  - Fluvoxamine and nortriptyline, the assay internal standard, were extracted from
      plasma with ethyl acetate, then reacted with dansyl chloride. The derivatives
      were quantitated by isocratic reversed-phase high-performance liquid
      chromatography with fluorescence detection. The assay calibration range for
      fluvoxamine was 10-1000 ng/ml using a 1-ml plasma sample. Pooled plasma quality
      control sample relative recoveries at 25 and 250 ng/ml were 103 and 105%,
      respectively. Estimates of quality control inter-day precision during validation
      were less than or equal to 3% relative standard deviation. The assay was cross
      validated with a gas chromatographic method and has been employed in therapeutic
      drug level monitoring.

PMID- 1629273
TI  - Simultaneous determination of free catecholamines and epinine and estimation of
      total epinine and dopamine in plasma and urine by high-performance liquid
      chromatography with fluorimetric detection.
AB  - Epinine (N-methyldopamine) is the pharmacologically active hydrolysis product of
      the prodrug ibopamine, which is currently being widely studied for the treatment
      of congestive heart failure. This paper reports a sensitive and reliable method
      for the simultaneous determination of free catecholamines and epinine in plasma
      and urine. The compounds are isolated from plasma or urine by a specific liquid
      liquid extraction, derivatized with the selective fluorogenic agent 1,2
      diphenylethylenediamine, and quantitated by high-performance liquid
      chromatography with gradient elution and fluorimetric detection. The limits of
      detection for the derivatized catecholamines and epinine are 0.3-0.6 pg of
      injected compound. Intra- and inter-assay coefficients of variation of all four
      compounds are good (1-8%), as are the accuracy and linearity. A method is also
      reported for the determination of total dopamine and epinine in plasma and urine
      based on the same principle. This method, in which deconjugation is accomplished
      by acid hydrolysis at 95 degrees C, also shows good sensitivity and
      reproducibility.

PMID- 1629274
TI  - Direct analysis of whole blood by internal surface reversed-phase chromatography:
      an examination of the binding and metabolism of technetium dioxime complexes.
AB  - We have developed a method using internal surface reversed-phase (ISRP) packing
      for rapid on-line separation of small hydrophobic compounds from cellular whole
      blood components. This is achieved by the use of 75-microns ISRP chromatographic
      material packed into a small high-performance liquid chromatographic (HPLC)
      column, in conjunction with column switching. We have applied this analytical
      method to study the in vitro metabolism of 99mTc-BATO (boronic acid adducts of
      technetium dioxime) cerebral and myocardial perfusion tracers in whole blood. The
      results from the ISRP procedure were compared with a conventional centrifugation
      method of analysis. This novel HPLC methods provides a rapid, convenient and
      reliable method for the analysis of radioactive and non-radioactive lipophilic
      components in whole blood.

PMID- 1629275
TI  - Determination of cicletanine enantiomers in plasma by high-performance capillary
      electrophoresis.
AB  - A sensitive and selective high-performance capillary electrophoresis procedure
      was developed for the determination of S(+) and R(-) enantiomers of cicletanine
      in human plasma. The procedure consisted in extraction of the drug with diethyl
      ether and analysis by micellar electrokinetic capillary chromatography in a fused
      silica capillary using gamma-cyclodextrins in the run buffers and ultraviolet
      detection. The method was linear from 10 to 500 ng/ml and the limit of detection
      was 10 ng/ml for each enantiomer in plasma samples. The within-run precision of
      the method, expressed as relative standard deviation, was 10.4 and 9.6% at 25
      ng/ml for S(+) and R(-) cicletanine, and 4.2 and 4.6% at 500 ng/ml, respectively.
      This method has been used to follow the time course of the concentrations of the
      cicletanine enantiomers in human plasma after a single therapeutic dose of
      cicletanine given by mouth.

PMID- 1629276
TI  - Standardization in the determination of red blood cell polyamines by high
      performance liquid chromatography.
AB  - The choice of the standardization method in the high-performance liquid
      chromatographic determination of dansyl polyamines (spermidine and spermine) in
      red blood cell extracts is discussed. 1,6-Hexanediamine, commonly used as an
      internal standard, is unsuitable for the quantification of spermidine and
      spermine in red blood cells because their percentage recoveries are significantly
      different (100% for 1,6-hexanediamine, and 70% for spermidine and spermine). The
      external standard method and the standard addition method are better suited. The
      procedure for the preparation of the standard mixture before dansylation has an
      influence on the values of red blood cell polyamines. Two procedures are compared
      and the corresponding percentages of variation were found to be high for
      spermidine and spermine. Thus the procedure in which the standard is treated in a
      strictly similar way as the red blood cells is certainly the most appropriate one
      for the quantification.

PMID- 1629277
TI  - Improved method for the determination of 5,6-dihydroxytryptamine and 5,7
      dihydroxytryptamine in tissue using high-performance liquid chromatography with
      electrochemical detection.
AB  - A liquid chromatographic method with electrochemical detection is described for
      the determination of the 5-hydroxytryptamine (5-HT) neurotoxins 5,6
      dihydroxytryptamine (5,6-DHT) and 5,7-dihydroxytryptamine (5,7-DHT) in rat brain
      tissue. This method has also been used for the determination of 5
      hydroxyindoleacetic acid, homovanillic acid and 5-HT in other tissue samples. The
      method is based on extraction of the indoles from brain samples with perchloric
      acid followed by reversed-phase liquid chromatography with electrochemical
      detection. The detection limit is 1 ng per 100 mg of tissue. This paper describes
      a quick and reliable method of assaying the 5-HT neurotoxins 5,6-DHT and 5,7-DHT
      in brain tissue, which is improved compared to currently available assays.

PMID- 1629278
TI  - Study of the measurement of chondroitin sulphates in rabbit plasma and serum.
AB  - A highly sensitive high-performance liquid chromatography method, which was
      established by us for the determination of chondroitin sulphates in biological
      substances as their unsaturated disaccharides, was applied to elucidate the
      qualitative and quantitative differences in chondroitin sulphates in rabbit
      plasma and serum samples. In this work, it was found that rabbit plasma contains
      low-sulphated chondroitin 4-sulphate (approximately 40% sulphation at the 4
      position of N-acetyl galactosamine), while serum contains the low-sulphated
      chondroitin 4-sulphate and fully sulphated chondroitin 4-sulphate (approximately
      96% sulphation). The latter was released from platelets during coagulation of
      blood.

PMID- 1629279
TI  - Tissue sulfate determination by ion chromatography.
AB  - The application of controlled-flow anion chromatography to assay inorganic
      sulfate in biological fluids and tissues is described. The eluent used in
      previous methods for analyzing sulfate in biological fluids has been modified by
      adding 4.5% acetonitrile to separate sulfate from a co-eluting peak. To markedly
      increase the life of the column, the tissue samples were further diluted,
      extracted with chloroform, and analyzed at a lower detection range (0.3 microS).
      The method has been shown to be applicable for determining sulfate in tissues as
      well as biological fluids.

PMID- 1629280
TI  - Rapid and selective isolation of radiolabelled inositol phosphates from cancer
      cells using solid-phase extraction.
AB  - A method is described for rapid and selective determination of radiolabelled
      inositol phosphates in cancer cells using solid-phase extraction with Bond Elut
      strong anion-exchange minicolumns. The inositol phosphates IP1, IP2 and IP3 are
      selectively eluted with 0.05, 0.3 and 0.8 M ammonium formate-0.1 M formic acid,
      respectively. Cancer cells are extracted with 10% perchloric acid which is then
      neutralised prior to loading samples on to the minicolumns. Recovery is 54.1,
      66.6 and 61.3% for IP1, IP2 and IP3 with between-day coefficients of variation of
      7.6, 6.8 and 1.9%, respectively. When the method was applied to cancer cells high
      performance liquid chromatographic analyses confirmed both the identity of the
      IP1, IP2 and IP3 fractions and showed that there was no detectable cross
      contamination of these inositol phosphates with each other.

PMID- 1629281
TI  - Determination of 8-methoxypsoralen in plasma by gas chromatography-mass
      spectrometry using selected-ion monitoring.
AB  - A sensitive and accurate assay was developed for the measurement of 8
      methoxypsoralen in plasma using electron-impact positive-ion mass
      fragmentography. 4,5,8-Trimethylpsoralen was used as an internal standard. Sample
      preparation consisted of a two-step liquid phase extraction using acetonitrile
      and methylene chloride. The calibration curve showed a linear relationship
      between the peak areas of 8-methoxypsoralen and 4,5,8-trimethylpsoralen over a
      wide range of 8-methoxypsoralen concentrations (1-500 ng/ml). With-in- and
      between-run precisions, measured at five different drug concentrations, varied
      from 0.82 to 1.41% and from 0.82 to 1.86%, respectively.

PMID- 1629282
TI  - Determination of 4-aminopyridine in serum by solid-phase extraction and high
      performance liquid chromatography.
AB  - An assay for the determination of 4-aminopyridine in serum has been developed
      using 3,4-diaminopyridine as internal standard and reversed-phase high
      performance liquid chromatography with detection at 244 nm. A mobile phase of
      acetonitrile-methanol-ethanol-1% ammonium carbonate (75:10:10:5) provided
      excellent separation of both compounds. Samples were extracted on solid-phase
      columns. The linearity, precision, recovery and the limit of detection were all
      sufficient for the routine use of this assay in clinical studies of patients
      treated with 4-aminopyridine.

PMID- 1629283
TI  - Monitoring of the uptake and metabolism of aminooxy analogues of polyamines in
      cultured cells by high-performance liquid chromatography.
AB  - A high-performance liquid chromatographic method for the determination of
      polyamines and their aminooxy analogues is described. Oxime derivatization with a
      ketone is used to protect the aminooxy group during post-column reaction with o
      phthalaldehyde. The amount of the polyamines and of the oximes of their aminooxy
      analogues can be determined simultaneously in cultured cells and cell culture
      media. The limit of detection is 20-30 pmol, and the response of the fluorescence
      detection is linear up to 4 nmol. The separation of the aminooxy analogues from
      the naturally occurring polyamines can be varied by using different ketones for
      oxime formation. The method was used to measure the stability of aminooxy
      analogues of putrescine (1-aminooxy-3-aminopropane) and spermidine [N-(2
      aminooxyethyl)-1,4-diaminobutane and 1-aminooxy-3-N-(3-aminopropyl)aminopropane]
      in cell culture media and the uptake into cultured baby hamster kidney
      (BHK21/C13) cells.

PMID- 1629284
TI  - High-performance liquid chromatographic determination of rifapentine in serum
      using column switching.
AB  - A high-performance liquid chromatographic method with column switching has been
      developed for the determination of rifapentine in serum. The serum samples were
      injected onto a precolumn packed with Corasil RP C18 (37-50 microns) after simple
      dilution with an internal standard in a 1% ascorbic acid solution. Polar serum
      components were washed out using 0.05 M phosphate buffer. After valve switching,
      the concentrated drugs were eluted in the back-flush mode and separated by a mu
      Bondapak C18 column with acetonitrile-tetrahydrofuran-0.05 M phosphate buffer (pH
      7.0) (42:5:53, v/v/v) as the mobile phase. The method showed excellent precision
      with good sensitivity and speed, and a detection limit of 0.1 microgram/ml. The
      total analysis time was less than 25 min and the mean coefficients of variation
      for intra- and inter-assay were less than 4.8%. The method has been successfully
      applied to serum samples from dogs after the oral administration of rifapentine.

PMID- 1629285
TI  - Reversed-phase chromatography of phenylthiocarbamyl amino acid derivatives of
      physiological amino acids: an evaluation and a comparison with analysis by ion
      exchange chromatography.
AB  - Reversed-phase chromatography of phenylthiocarbamyl (PTC) amino acid derivatives
      of physiological amino acids was evaluated and compared with the traditional
      method of ion exchange. The PTC amino acid derivatives were stable for at least
      32 h at ambient temperature before injection. The relationship of detector
      response to concentration for the PTC derivatives was linear from 39 to 1250
      pmol. With few exceptions, the within- and between-run precisions of plasma amino
      acid retention times were less than 0.2 and 0.3%, respectively; the within- and
      between-run precisions of their concentrations were less than 4.0 and 5.0%,
      respectively. Twenty-four plasma samples were quantitated by both reversed-phase
      and ion-exchange chromatography; fifteen of the twenty amino acids determined had
      correlation coefficients in the range 0.81-1.00. Nine non-standard amino acids
      and ten therapeutic drugs were added to plasma; D-glucosaminic acid and alpha
      amino-beta-guanidinopropionic acid co-eluted with alpha-aminoadipic acid and
      threonine, respectively. Of the ten drugs added, only metronidazole and
      theophylline co-eluted with beta-alanine and histidine, respectively. The
      precision, stability, and sensitivity of the method render it ideal for the
      quantitation of plasma amino acids.

PMID- 1629286
TI  - Sensitive determination of cystathionine and assays for cystathionine beta- and
      gamma-lyase, as well as cystathionine beta-synthase, using high-performance
      liquid chromatography.
AB  - Cystathionine was cleaved into 2-ketobutyric acid, cysteine and ammonia by
      cystathionase. 2-Ketobutyric acid was converted into 3-ethyl-2-hydroxy-6,7
      dimethoxyquinoxaline (EHDQ) by reaction with 1,2-diamino-4,5-dimethoxybenzene.
      When EHDQ was measured in a mobile phase of pH 2.1 using high-performance liquid
      chromatography with ultraviolet detection, 250 pmol of L-cystathionine in 250
      microliters of the reaction mixture could be determined. Because EHDQ has a
      strong fluorescence in a mobile phase of pH 6.5 at 447 nm, on excitation at 365
      nm, as little as 2.5 pmol of cystathionine in 250 microliters of the reaction
      mixture could be determined by high-performance liquid chromatography with
      fluorimetric detection. Cystathionase activity was assayed on the basis of the
      same principle by determining cystathionine in as little as 63 ng of rat liver by
      fluorimetric detection. Cystathionine beta-synthase activity was measured by the
      same method by determining cystathionine formed in only 113 ng of wet weight of
      rat liver. Using these methods, both cystathionine beta- and gamma-lyase
      activities in Saccharomyces cerevisiae were determined, because quinoxaline
      derivatives from pyruvate and 2-ketobutyrate could be measured simultaneously by
      high-performance liquid chromatography.

PMID- 1629287
TI  - Enzymatic shot-gun 5'-phosphorylation and 3'-sister phosphate exchange: a two
      dimensional thin-layer chromatographic technique to measure DNA deoxynucleotide
      modification.
AB  - DNA adducts occur through environmental, therapeutic, dietary, oxygen stress, and
      aging processes. A modified thin-layer chromatographic (TLC) technique can asses
      base composition and adduct formation. This requires labeling DNA by "shot-gun"
      5'-phosphorylation of representative 32P-alpha-deoxyribonucleotide
      monophosphates. Subsequent 3'-monophosphate digest "sister exchanges" a
      radioactive 32PO4(2-) to the neighboring cold nucleotide. Separation in two
      dimensional polyethyleneimine-cellulose TLC is carried out in acetic acid,
      (NH4)2SO4, and (NH4)HSO4. The technique was applied to control DNA, cold
      substitution of dUMP, methylation, depurination, and pBR322. This technique
      quantifies low-molecular-mass adducts and DNA integrity both in vivo and in
      vitro.

PMID- 1629288
TI  - High-performance liquid chromatographic determination of spironolactone and its
      metabolites in human biological fluids after solid-phase extraction.
AB  - A simple and sensitive high-performance liquid chromatographic procedure to
      determine spironolactone and its three major metabolites in biological specimens
      is described. The assay involves sequential extraction on C18 and CN solid
      phases, and subsequent separation on a reversed-phase column. In plasma samples,
      spironolactone and its metabolites were completely separated within 8 min using
      an isocratic mobile phase, while in urine samples a methanol gradient was
      necessary to achieve a good separation within 14 min. Recoveries for all analytes
      were greater than 80% in plasma and 72% in urine. Linear responses were observed
      for all compounds in the range 6.25-400 ng/ml for plasma and 31.25-2000 ng/ml for
      urine. The plasma and urine methods were precise (coefficient of variation from
      0.8 to 12.5%) and accurate (-12.1% to 7.4% of the nominal values) for all
      compounds. The assay proved to be suitable for the pharmacokinetic study of
      spironolactone in healthy human subjects.

PMID- 1629289
TI  - Studies on cyclic peptides related to gratisin by reversed-phase high-performance
      liquid chromatography.
AB  - The chromatographic behaviour of several synthetic peptides related to the
      antibiotic peptide gratisin was investigated using reversed-phase high
      performance liquid chromatography. The influence of the concentration of the
      peptides, column temperature and flow-rate on the chromatographic separation was
      examined. Of these peptides, some analogues with the D-X-D-Y-L-Pro or L-Pro-D-X-D
      Y sequences and strong activities gave double peaks in the chromatogram. The
      isomeric conformers were separated from each of the double peaks and were in
      equilibrium with each other at low temperatures. It is proposed that the presence
      of the sequences of D-X-D-Y-L-Pro and L-Pro-D-X-D-Y in these peptides gives rise
      to the stabilization and various degrees of hydrophobicity of their conformers.

PMID- 1629290
TI  - Determination of ethyl biscoumacetate and its metabolite 7-hydroxyethyl
      biscoumacetate in human serum by high-performance liquid chromatography and mass
      spectrometry.
AB  - An efficient reversed-phase high-performance liquid chromatographic method has
      been developed for the determination of ethyl biscoumacetate (EBA) and its
      metabolite in human serum, using the mu Bondapak C18 column and methanol-water
      phosphoric acid (56:46.8:0.2, v/v/v) as the mobile phase. This method permitted
      the determination of both EBA and a metabolite in human serum. The latter has
      been mentioned by other authors only in urine samples, where significant
      concentrations were found. Identification of the metabolite as 7-hydroxyethyl
      biscoumacetate was based on its chromatographic separation, followed by isolation
      from the eluate and direct mass spectrometric identification. It has been found
      that the higher EBA concentrations in human serum described by Brodie et al. [J.
      Pharmacol. Exp. Ther., 106 (1952) 453] were caused by the insufficient resolving
      power of the spectrophotometric method used, leading to overlapping of the UV
      spectra of the parent drug and its metabolite.

PMID- 1629291
TI  - Sensitive stereospecific assay of warfarin in plasma: reversed-phase high
      performance liquid chromatographic separation using diastereoisomeric esters of (
      )-(1S,2R,4R)-endo-1,4,5,6,7,7-hexachlorobicyclo[2.2.1]-hept-5- ene-2-carboxylic
      acid.
AB  - A stereospecific reversed-phase high-performance liquid chromatographic (HPLC)
      assay for warfarin in plasma has been developed. The assay involves a rapid,
      simple clean-up procedure which separates warfarin from plasma constituents and
      warfarin metabolites. Warfarin enantiomers were assayed as their (-)-(1S,2R,4R)
      endo-1,4,5,6,7,7-hexachlorobicyclo[2.2.1]hept-5-ene -2- carboxylic acid
      diastereoisomeric esters by reversed-phase HPLC. Excellent resolution of the
      diastereoisomers was achieved in less than 10 min. Sensitivity of the assay was
      approximately 5-10 ng/ml for each isomer.

PMID- 1629292
TI  - Simultaneous direct determination of the enantiomers of verapamil and
      norverapamil in plasma using a derivatized amylose high-performance liquid
      chromatographic chiral stationary phase.
AB  - Chiralpak AD is a commercially available high-performance liquid chromatographic
      column containing a chiral stationary phase composed of 3,5
      dimethylphenylcarbamate-derivatized amylose coated on silica. This column was
      applied to the assay for the plasma concentrations of the enantiomers of
      verapamil and its major metabolite norverapamil. After the extraction from
      plasma, the analytes were separated on a diol silica column (LiChrocart DIOL) and
      Chiralpak AD column which were connected in series in this order and detected
      using a fluorescence detector (excitation at 272 nm, emission at 317 nm). The
      enantiomers of verapamil and norverapamil were separated from each other and
      other metabolites using a mobile phase of hexane-isopropanol-ethanol (85:7.5:7.5,
      v/v/v) containing 1.0% triethylamine. The calibration curves were linear (R
      greater than 0.9989) in the plasma concentration range 2.5-100 ng/ml for
      verapamil enantiomers and 5.0-100 ng/ml for norverapamil enantiomers. The intra
      day and inter-day reproducibility tests showed good reproducibilities;
      coefficients of variation of each enantiomer were less than 14.9% at the lowest
      concentration and less than 2.0% at the highest concentration. The effect of
      organic modifier content and column temperature upon the retention and the
      enantioseparation were also discussed.

PMID- 1629293
TI  - High-performance liquid chromatographic assays for the quantification of amikacin
      in human plasma and urine.
AB  - Amikacin, an aminoglycoside antibiotic, is frequently coadministered with
      penicillins and broad-spectrum cephalosporins to synergize the activity of these
      agents. Sensitive, selective and reproducible high-performance liquid
      chromatographic assays have been developed for the quantification of amikacin in
      plasma and urine collected from human subjects. The plasma method involves the
      ultrafiltration of plasma prior to derivatization. An aliquot of plasma
      ultrafiltrate or urine is mixed with dimethyl sulfoxide and
      tris(hydroxymethyl)aminoethane followed by derivatization of amikacin with 1
      fluoro-2,4-dinitrobenzene at 58 degrees C for 30 min. The reaction mixture is
      then injected directly onto a reversed-phase C18 column preceded by a guard
      column. The column is eluted with a mobile phase containing acetonitrile and 2
      methoxyethanol in 1% Tris buffer. Amikacin derivative is detected at 340 nm. The
      methods were applied for the analysis of amikacin in plasma and urine samples
      from volunteers receiving amikacin and cefepime, a fourth-generation
      cephalosporin, in a clinical pharmacokinetic drug interaction study.

PMID- 1629294
TI  - Quantification of distinct molecular species of the 2-lyso metabolite of platelet
      activating factor by gas chromatography-negative-ion chemical ionization mass
      spectrometry.
AB  - The biological activity of platelet-activating factor (PAF) is comprised by a few
      molecular species of phosphatidylcholine which contain a fatty alcohol connected
      by an ether linkage to the sn-1 position of the glycerol backbone and an acetate
      ester at the sn-2 position. The various molecular species of PAF differ in chain
      length and degree of unsaturation in the fatty alcohol residue side-chain. PAF is
      rapidly hydrolyzed to lyso-PAF by an acetylhydrolase enzyme which is quite active
      in a number of cells that synthesize PAF. We describe a method for quantitation
      of lyso-PAF which involves conversion to its propionate derivative in the
      presence of an internal standard (deuterium-labelled PAF), digestion to the
      diglyceride with Bacillus cereus phospholipase C, conversion to the
      pentafluorobenzoate derivative and capillary column gas chromatographic-negative
      ion methane chemical ionization mass spectrometric analysis. Distinct molecular
      species of lyso-PAF can be individually quantitated at levels of 1 ng or less.
      These methods are applied to the demonstration of lyso-PAF accumulation in renal
      tissue from transplanted allografts undergoing acute rejection, in renal tissue
      from kidneys subjected to cold storage and autotransplantation, and in intestinal
      mucosa subjected to warm ischemia and reperfusion.

PMID- 1629295
TI  - Liquid chromatography-mass spectrometry of hydroxy and non-hydroxy fatty acids as
      amide derivatives.
AB  - A useful method for analyzing fatty acids by liquid chromatography-mass
      spectrometry with an atmospheric-pressure chemical-ionization interface system
      has been developed. The sensitivity of six kinds of palmitamide derivatives
      monitored by a single ion of [M+H]+ was, in decreasing order: N-n-propylamide
      greater than anilide greater than N,N-diethylamide, amide greater than N,N
      diphenylamide greater than N-1-naphthylamide. Individual fatty acids were
      identified from a mixture of amide derivatives of authentic fatty acids from
      C16:0 to C30:0 on a mass chromatogram. This method was used to detect both
      hydroxy and non-hydroxy fatty acids. Many kinds of fatty acid, including hydroxy
      fatty acids of the rat brain, were detected in a single run.

PMID- 1629296
TI  - High-performance liquid chromatography with electrochemical detection for the
      determination of levodopa, catecholamines and their metabolites in rat brain
      dialysates.
AB  - A high-performance liquid chromatographic assay with electrochemical detection is
      described for the simultaneous determination of levodopa, 3-O-methyldopa,
      dopamine, dihydroxyphenylacetic acid, homovanillic acid, 3-methoxytyramine,
      noradrenaline, adrenaline, 3-methoxy-4-hydroxyphenylethylene glycol and 5
      hydroxyindoleacetic acid in rat brain dialysates. Samples are obtained in vivo
      using the microdialysis technique. Microdialysis probes are placed in the brain
      area to be studied and neurochemicals are collected by perfusion of the probe
      with modified Ringer's solution. Direct injection of the dialysates allows rapid
      and reliable results to be obtained.

PMID- 1629297
TI  - Analysis of proenkephalin A, proopiomelanocortin and protachykinin neuropeptides
      in human lumbar cerebrospinal fluid by reversed-phase high-performance liquid
      chromatography, radioimmunoassay and enzymolysis.
AB  - A comprehensive high-performance liquid chromatographic, radioimmunoassay, and
      enzymatic degradation scheme has been developed to analyze several intact
      neuropeptides and the corresponding peptides created by in vivo enzymolysis of
      precursors to study neuropeptides in human lumbar cerebrospinal fluid (CSF) and
      to test the hypothesis that defects in the metabolism (synthesis, degradation) of
      neuropeptide precursors, neuropeptides, and metabolites play a role in low back
      pain. CSF samples were obtained from three different patient groups: controls
      (C), whose low back pain was relieved without lidocaine; pharmacological
      responders (PR), whose pain was relieved by lidocaine and who were candidates for
      surgery; and pharmacological non-responders (PNR), whose pain was not relieved by
      lidocaine and a mid-thoracic anesthetic, and who were not candidates for surgery.
      The metabolic activity involved during synthesis and degradation of the peptides
      was assessed by measuring intact, native neuropeptide immunoreactivity in pre
      incubated and post-incubated CSF samples, where samples were incubated at 37
      degrees C for 1 h. Pre-incubation radioimmunoassay measurements reflected the
      content of intact peptides present in lumbar CSF at the time of sampling, and
      post-incubation measurements assayed the amount of peptide that had remained
      embedded within its precursors [cryptic methionine enkephalin (ME)] and that had
      been released by the action of CSF peptidases. Significant differences were found
      in post-incubation samples for the amount of proenkephalin A [ME, leucine
      enkephalin (LE)] and tachykinin [substance P (SP)] peptides. For example,
      significant differences were observed for ME-like immunoreactivity (C versus
      cryptic), SP-like immunoreactivity (PNR versus PR), and LE-like immunoreactivity
      (PR versus C). No significant differences were observed among the peptides within
      the pre-incubation samples.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629298
TI  - Coupling of m-aminophenylboronic acid to s-triazine-activated Sephacryl: use in
      the affinity chromatography of glycated hemoglobins.
AB  - An improved process is described for covalent coupling of m-aminobenzeneboric
      acid to s-triazine-activated Sephacryl matrices. The derivatized Sephacryl gel
      contained up to 150-200 mumol boronate per ml. It has been applied to the
      separation of glycated and non-glycated hemoglobins (Hbs) present in red-cell
      hemolysate. The new bioaffinity support was evaluated by the analysis of 67
      diabetic patients and 20 normal adults. The mean value for glycated Hb was 6.6 +/
      0.8% for non-diabetics and 11.2 +/- 2.9% for diabetics. The method effects group
      specific separation between glycated and non-glycated Hbs even in presence of
      foetal Hb and abnormal Hb variants. There is an excellent correlation between the
      glycated Hb levels obtained by the new method and two established procedures,
      namely high-performance liquid chromatography (r = 0.933) and affinity Merckotest
      (r = 0.991). The inter-assay and intra-assay coefficient of variations of less
      than 3.0% suggest that the method is reproducible. The results indicate that the
      method may serve as an alternative procedure for the study of glycated proteins.
      The s-triazine-activated Sephacryl could also be used for immobilizing enzymes
      and for preparing biospecific absorbents.

PMID- 1629299
TI  - Liquid chromatographic monitoring of pseudocholinesterase activity: comparison of
      methods.
AB  - In order to study the activity of pseudocholinesterase in vitro, two liquid
      chromatographic techniques have been developed. One is based on phase transfer
      catalyzed (PTC) esterification of the carboxylic acid formed during hydrolysis of
      the substrate, and the other on the use of a radioisotopically labeled substrate.
      In both cases, the substrate used was a long-chain choline ester. The PTC method,
      utilizing (N-9-acridinyl)bromoacetamide as a fluorogenic labeling reagent in an
      aqueous-organic two-phase system, gives esters with very high fluorescence
      intensity. The radiochromatographic method makes use of on-line radioactivity
      monitoring of the substrate and product in order to follow the hydrolysis
      reaction. In both methods reversed-phase liquid chromatography is used. A method
      for the synthesis of 3H-labeled choline esters is also described. Both techniques
      are compared with regard to sensitivity, reproducibility and practical
      considerations.

PMID- 1629300
TI  - Determination of concentrations of adenosine and other purines in human term
      placenta by reversed-phase high-performance liquid chromatography with photodiode
      array detection: evidence for pathways of purine metabolism in the placenta.
AB  - A robust analytical method, using reversed-phase high-performance liquid
      chromatography with gradient elution and photodiode-array detection, was used to
      measure six purines and beta-NAD+ in acid-soluble extracts of samples taken from
      six different regions of human term placenta. Resolution of the analyte peaks in
      chromatographic profiles of the extracts, and the use of optimized integration,
      allowed simultaneous quantitation of all seven analytes from a single
      chromatogram. Peak purity was confirmed via on-line analysis of peak spectra,
      utilizing the purity parameter treatment of spectral data. Major placental
      purines were adenosine, inosine, hypoxanthine and adenine. Except for adenine,
      concentrations of the purines varied by two-fold or more between different
      regions of each placenta, but concentration ratios, i.e., adenosine/inosine and
      inosine/hypoxanthine, were similar. The findings indicate that the pathway of ATP
      breakdown to hypoxanthine in ischemic human term placenta is via adenosine, and
      that regional differences in placental concentrations of adenosine and its
      metabolites may result from regional differences in degree of ischemia.

PMID- 1629301
TI  - Direct determination of the enantiomeric ratio of verapamil, its major metabolite
      norverapamil and gallopamil in plasma by chiral high-performance liquid
      chromatography.
AB  - Two methods for the determination of the enantiomeric ratio of verapamil in
      plasma by high-performance liquid chromatography have been developed. On an alpha
      1-acid glycoprotein chiral stationary phase (Chiral-AGP) verapamil was separated
      after the acetylation of the main metabolite norverapamil, which interferes with
      the resolution of verapamil. On an amylose tris-3,5-dimethylphenylcarbamate
      column (Chiralpak AD) verapamil and norverapamil were determined simultaneously
      without prior derivatization. Gallopamil was separated on both columns under
      similar conditions.

PMID- 1629302
TI  - Simultaneous determination of nefiracetam and its metabolites by high-performance
      liquid chromatography.
AB  - A reversed-phase high-performance liquid chromatographic assay was developed to
      simultaneously quantitate nefiracetam (NEF), a novel nootropic agent, and its
      three known oxidized metabolites (N-[(2,6
      dimethylphenylcarbamoyl)methyl]succinamic acid (5-COOH-NEF), 4-hydroxy-NEF and 5
      hydroxy-NEF) in human serum and urine. The quantitative procedure was based on
      solid-phase extraction with Sep-Pak C18 and ultraviolet detection at 210 nm. The
      calibration curves of NEF and the metabolites were linear over a wide range of
      concentrations (0.5-21.5 nmol/ml for NEF and 0.4-9.5 nmol/ml for metabolites in
      serum and 4-86 nmol/ml for NEF and 8-190 nmol/ml for metabolites in urine). Intra
      and inter-day assay coefficients of variation for the compounds were less than
      10%. The limit of detection was 0.1 nmol/ml for NEF, 5-COOH-NEF and 4-hydroxy
      NEF, and 0.2 nmol/ml for 5-hydroxy-NEF in both serum and urine. This method is
      applicable for the determination of NEF and its metabolites in human serum and
      urine with satisfactory accuracy and precision.

PMID- 1629303
TI  - Simultaneous determination of furosemide and amiloride in plasma using high
      performance liquid chromatography with fluorescence detection.
AB  - A high-performance liquid chromatographic method using fluorescence detection for
      the simultaneous determination of furosemide and amiloride is described. The
      chromatographic system is based on reversed-phase ion-pair chromatography with
      sodium dodecylsulphate as ion-pairing agent. The same counter-ion is used for the
      ion-pair liquid-liquid extraction to ethyl acetate. The minimum detectable
      concentration amounts to 0.3 ng of furosemide and 0.03 ng of amiloride per ml of
      plasma. The applicability of the method is demonstrated by the analysis of plasma
      samples taken from volunteers receiving both drugs.

PMID- 1629304
TI  - Simultaneous determination of the camptothecin analogue CPT-11 and its active
      metabolite SN-38 by high-performance liquid chromatography: application to plasma
      pharmacokinetic studies in cancer patients.
AB  - CPT-11 (I; 7-ethyl-10-[4-(1-piperidino)-1- piperidino]carbonyloxycamptothecin) is
      a new anticancer agent currently under clinical development. A sensitive high
      performance liquid chromatographic assay suitable for the simultaneous
      determination of I and its active metabolite SN-38 (II) in human plasma, and
      their preliminary clinical pharmacokinetics, are described. Plasma samples were
      processed using a solid-phase (C18) extraction step allowing mean recoveries of
      I, II and the internal standard camptothecin (III) of 84, 99 and 72%,
      respectively. The extracts were chromatographed on a C18 reversed-phase column
      with a mobile phase composed of acetonitrile, phosphate buffer and
      heptanesulphonic acid, with fluorescence detection. The calibration graphs were
      linear over a wide range of concentrations (1 ng/ml-10 micrograms/ml), and the
      lower limit of determination was 1 ng/ml for both I and II. The method showed
      good precision: the within-day relative standard deviation (R.S.D.) (5-1000
      ng/ml) was 13.0% (range 4.9-19.4%) for I and 12.8% (6.7-19.1%) for II; the
      between-day R.S.D. (5-10,000 ng/ml was 7.9% (5.4-17.5%) for I and 9.7% (3.5
      15.1%) for II. Using this assay, plasma pharmacokinetics of both I and II were
      simultaneously determined in three patients receiving 100 mg/m2 I as a 30-min
      intravenous infusion. The mean peak plasma concentration of I at the end of the
      intravenous infusion was 2400 +/- 285 ng/ml (mean +/- standard error of the
      mean). Plasma decay was triphasic with half-lives alpha, beta and gamma of 5.4 +/
      1.8 min, 2.5 +/- 0.5 h and 20.2 +/- 4.6 h, respectively. The volume of
      distribution at steady state was 105 +/- 15 l/m2, and the total body clearance
      was 12.5 +/- 1.9 l/h.m2. The maximum concentrations of the active metabolite II
      reached 36 +/- 11 ng/ml.

PMID- 1629305
TI  - Diagnosis of disseminated candidiasis based on serum D/L-arabinitol ratios using
      negative chemical ionization mass spectrometry.
AB  - The main objective was to appraise the diagnostic specificity of the serum D/L
      arabinitol ratio technique in a patient population biased for renal dysfunction.
      The D/L ratio (mean +/- S.D.) in normal serum (n = 29) was 1.76 +/- 0.47 (range
      0.77-2.75). D/L-Arabinitol greater than 3.18 (mean + 3 S.D.) are considered
      indicative of disseminated candidiasis. Of 49 patients without candidiasis, but
      46% with serum creatinine greater than 1.5 mg/dl, diagnostic specificity was 88%.
      In confirmed candidiasis (n = 16) sensitivity was 94% (D/L range 3.2-50.1).
      Switching from positive to negative chemical ionization permits the use of as
      little as 5 microliters sample (20 microliters used routinely; D/L ratios
      constant in the 5-200 microliters range) permitting the extension of the
      technique to pediatric applications. Results can obtained in 2 h. Suggested areas
      of clinical application include aiding diagnosis, monitoring patients as risk so
      that treatment could be initiated while fungus load is still small, and following
      the course of antifungal chemotherapy.

PMID- 1629306
TI  - Artifact formation during gas chromatographic-mass spectrometric analysis of a
      methylsulfinyl-containing metabolite.
AB  - During gas chromatographic-mass spectrometric analysis using a heated injector, 1
      methylthio-4-methylsulfinyltetrachlorobenzene degraded to form
      tetrachlorothioanisole. Similar reductive defunctionalizations have been reported
      during in vivo metabolisms. Caution should be used to distinguish metabolites
      from artifacts which may be formed during the analysis of methylsulfoxides.

PMID- 1629307
TI  - Identification and quantification of ergotamine in human plasma by gas
      chromatography-mass spectrometry.
AB  - A highly sensitive and simple gas chromatographic-mass spectrometric method is
      described for the identification and quantification of ergotamine in plasma or
      serum. Ergotamine is extracted with chloroform from the alkalinized sample and
      detected by electron ionization mass spectrometry. This analytical method was
      selected for an intense high-mass ion ideal for the specific quantification. It
      shows good linearity in the range from 50 pg/ml to 50 ng/ml for ergotamine in
      plasma. The practicability of this method is demonstrated by determining the
      plasma concentration of ergotamine in a sample from a patient.

PMID- 1629308
TI  - Identification of new urinary metabolites of trimeprazine in rats by gas
      chromatography-mass spectrometry.
AB  - The metabolites of trimeprazine were identified in urine of rats by gas
      chromatography-mass spectrometry. After the oral administration of trimeprazine,
      the urinary metabolites were extracted with diethyl ether before or after
      hydrolysis with beta-glucuronidase. The identified metabolites were N
      demethyltrimeprazine,3-hydroxytrimeprazine,N-demethyl-3-++ +hydroxytrimeprazine
      and trimeprazine sulphoxide.

PMID- 1629309
TI  - Measurement of trazodone in plasma and brain of rat by capillary gas
      chromatography with a nitrogen-selective detector.
AB  - A specific and highly sensitive method for the measurement of trazodone in plasma
      and brain of rat is presented. The compound and the internal standard were
      extracted from alkalinized samples with hexane and analysed by capillary gas
      chromatography with nitrogen-selective detection. The method was demonstrated to
      be accurate and precise. The limits of determination were 2 ng/ml for plasma and
      24 ng/g for brain, which makes this procedure suitable for pharmacokinetic
      analysis.

PMID- 1629310
TI  - Plasma determination of the novel anticonvulsant D,L-3-hydroxy-3-ethyl-3
      phenylpropionamide and preliminary pharmacokinetic studies in the rat.
AB  - A sensitive gas chromatographic method with flame ionization detection was
      developed for the analysis in plasma of the novel anticonvulsant D,L-3-hydroxy-3
      ethyl-3-phenylpropionamide (HEPP), using D,L-2-hydroxy-2-ethyl-2-phenylacetamide
      as the internal standard. HEPP was extracted from alkalinized plasma into
      dichloromethane and quantified after derivatization with bis(trimethylsilyl)
      trifluoroacetamide: Standard curves were linear from 0.5 to 50 and from 2 to 100
      micrograms/ml of plasma, using 1.5 and 5 micrograms of the internal standard,
      respectively. The lower limit of detection at a signal-to-noise ratio of 3
      standard deviations was 0.33 micrograms/ml of sample. The sensitivity, accuracy
      and reproducibility of the method were shown to be satisfactory for
      pharmacokinetic studies of HEPP. After intraperitoneal administration of 50 mg/kg
      to Wistar rats, the principal kinetic parameters were: absorption half-life =
      0.04 h; volume of distribution = 1.32 l/kg; clearance = 4.40 ml/min; peak
      concentration = 50 micrograms/ml; peak time = 0.25 h; mean residence time = 4.55
      h.

PMID- 1629311
TI  - Simultaneous determination of caffeine and its primary demethylated metabolites
      in human plasma by high-performance liquid chromatography.
AB  - An improved high-performance liquid chromatographic method for the simultaneous
      determination of caffeine and its three primary metabolites (theophylline,
      theobromine and paraxanthine) in human plasma is described. The four substances
      were separated on a reversed-phase column (5 microns TSK gel ODS-80TM, 150 mm x
      4.6 mm I.D.) by use of the mobile phase methanol-0.1 M NaH2PO4 (30:70, v/v) with
      a flow-rate of 0.8 ml/min. Absorbance was monitored at 274 nm. The detection
      limit was 5 ng/ml for theobromine and caffeine and 10 ng/ml for paraxanthine and
      theophylline. The linearity and reproducibility were sufficient for drug
      monitoring of caffeine and its primary methylxanthines.

PMID- 1629312
TI  - Determination of the enantiomers of a novel 20,21-dinoreburnamenine derivative in
      rat plasma and brain by high-performance liquid chromatography using a chiral
      stationary phase.
AB  - A high-performance liquid chromatographic method with solid-phase extraction was
      developed for the assay of the enantiomers of a novel 20,21-dinoreburnamenine
      derivative (RU 49041) in rat plasma and brain using a chiral stationary phase
      (Nucleosil Chiral 2) and ultraviolet detection. The limit of detection was 10
      ng/ml (or ng/g) in both tissues and the intra-assay precision was satisfactory
      (plasma, ca. 5%; brain, ca. 1%). The pharmacokinetic profiles of the two
      enantiomers were determined following oral administration of the racemate (10
      mg/kg). The results show that their pharmacokinetics are very different: whereas
      both enantiomers appear in the brain, only the 3 alpha,16 beta-enantiomer is
      detected in plasma.

PMID- 1629313
TI  - Determination of the novel hydroxymethyl glutaryl coenzyme A reductase inhibitor
      (RP 61969) and its dihydroxy acid hydrolysis product in human plasma by reversed
      phase high-performance liquid chromatography.
AB  - A method is described for the determination of the novel hydroxymethyl glutaryl
      coenzyme A reductase inhibitor RP 61969 (I) and its hydrolysis product, the
      dihydroxy acid RP 62420 (II), in human plasma. A structural isomer of I is used
      as internal standard. Both I and II were extracted from acidified plasma with
      diethyl ether. The dried residues were reconstituted in the high-performance
      liquid chromatography mobile phase and chromatographed on a 5 microns ODS2
      column. The mobile phase used was aqueous dipotassium phosphate +tetra-n-butyl
      ammonium bromide (both 10 mM)-acetonitrile-methanol (60:40:5, v/v). At a flow
      rate of 1.5 ml min-1 and ambient temperature, the retention time of II is 3.5
      min, that of the internal standard is 5 min, and that of I is 8 min. The method
      has been validated and applied to the assay of plasma samples resulting from a
      cell-plasma distribution experiment in human whole blood.

PMID- 1629314
TI  - Comparison of a novel thin-layer chromatographic-fluorescence detection method
      with a spectrofluorometric method for the determination of 7-hydroxycoumarin in
      human urine.
AB  - A novel method for the determination of 7-hydroxycoumarin in human urine which
      combines thin-layer chromatography (TLC) with fluorescence detection (FD) has
      been devised. The limit of detection (1 ng/ml) enables determination of 7
      hydroxycoumarin after both administration of coumarin and environmental exposure
      to this fragrance material. When compared to a spectrofluorometric method of
      analysis, the TLC-FD method proved to be more selective for the analysis of 7
      hydroxycoumarin in human urine.

PMID- 1629315
TI  - Detection of vancomycin resistance in Enterococcus species.
AB  - Enterococcus faecalis and Enterococcus faecium isolates that are resistant to
      vancomycin have recently been identified in North America and Europe. Of 155
      clinical isolates of enterococci (113 E. faecium and 42 E. faecalis), we found
      that 98 were resistant, 52 were moderately susceptible, and 5 had intermediate
      susceptibilities to vancomycin by using broth microdilution susceptibility
      testing according to the National Committee for Clinical Laboratory Standards
      (NCCLS) (Approved Standard M7-A2). Using NCCLS disk diffusion methodology
      (Approved Standard M2-A4), we evaluated the NCCLS supplemental M100-S3 revisions
      for zone diameter interpretive standards and incubation conditions and found 5.8%
      minor errors. A total of 234 isolates, which included an additional 79 E. faecium
      isolates that were moderately susceptible to vancomycin, were used to evaluate
      the Vitek GPS-TA card (bioMerieux, Inc., Hazelwood, Mo.) and the Pos MIC type 6
      panel (MicroScan; Baxter Health Care Corp., West Sacramento, Calif.) for the
      detection of vancomycin resistance. The Vitek card was 100% specific and 72%
      sensitive, whereas the MicroScan panel with the Walk/Away system was 98%
      specific, with a sensitivity of 93% which increased to 99% when readings were
      performed manually. An agar screen plate method was evaluated with vancomycin
      concentrations of 6, 8, 10, or 12 micrograms/ml; plates were inoculated so as to
      obtain a final concentration of 10(5) CFU per spot. This method was found to be
      100% sensitive and specific at all concentrations.

PMID- 1629316
TI  - Efficient culture of Chlamydia pneumoniae with cell lines derived from the human
      respiratory tract.
AB  - Two established cell lines, H 292 and HEp-2, originating from the human
      respiratory tract, were found to be significantly more efficient and practical
      than the currently used HeLa 229 cells for growth of Chlamydia pneumoniae. Six
      strains of C. pneumoniae recently isolated from patients with respiratory
      ailments were used as test cultures. The H 292 and HEp-2 cells yielded much
      higher inclusion counts for all the test strains than did HeLa 229 cells. When
      they were compared with each other, H 292 cells yielded more inclusions than did
      HEp-2 cells, and the differences were statistically significant in 10 of 18 test
      sets. A simple system with these two cell lines appeared to be very efficient for
      culturing C. pneumoniae. It does not require treatment of tissue cells with DEAE
      dextran before infection, and it may eliminate the need for serial subpassages of
      specimens to increase culture sensitivity. Monolayers of these cells remained
      intact and viable in the Chlamydia growth medium so that reinfection could take
      place, resulting in greatly increased inclusion counts for specimens containing
      few infectious units. This system may make it more practical for laboratories to
      culture for C. pneumoniae for treatment of infections and outbreak intervention
      and will facilitate studies on this recently recognized pathogen.

PMID- 1629317
TI  - Antibodies to shiga holotoxin and to two synthetic peptides of the B subunit in
      sera of patients with Shigella dysenteriae 1 dysentery.
AB  - Acute- and convalescent-phase sera from 18 Thai patients and convalescent-phase
      sera from two Israeli patients and one Bangladeshi patient with Shigella
      dysenteriae 1 (Shiga) dysentery were tested by enzyme-linked immunosorbent assay
      to detect antibodies that bind S. dysenteriae lipopolysaccharide (LPS), Shiga
      holotoxin, or two synthetic peptides representing epitopes from the B subunit of
      Shiga toxin. Paired sera from 24 Maryland adults with Shigella flexneri 2a or
      Shigella sonnei diarrhea served as negative controls. Of the 16 paired Thai serum
      samples tested for immunoglobulin G LPS antibody, 10 had greater than or equal to
      4-fold rises (the two subjects with the highest convalescent-phase titers
      exhibited toxin-neutralizing activity); acute-phase specimens from four of the
      remaining six individuals already had elevated Shiga LPS titers in their acute
      specimens ranging from 1:800 to 1:12,800. Similarly, convalescent-phase sera from
      the two Israeli patients and the Bangladeshi patient revealed LPS titers of 1:800
      to 1:3,200. In contrast, none of the Maryland volunteers with S. flexneri or S.
      sonnei diarrhea manifested rises in Shiga anti-LPS (P less than 0.00001 versus 10
      of 16 Thai patients). Only 4 of the 18 Thai patients had significant rise in
      antibody to purified Shiga toxin, while one of the two Israeli patients and the
      one Bangladeshi patient had elevated convalescent-phase titers. None of the sera
      that reacted with Shiga holotoxin had antibody that bound to the peptides. This
      report, which describes a search for serum antibodies that bind Shiga toxin in
      patients with Shiga dysentery, demonstrates such antibodies in only a minority of
      patients with bacteriologically confirmed disease. During Shiga dysentery, Shiga
      toxin may be elaborated in such small quantities in vivo that it fails to elicit
      an immune response in most patients even though it may exert biological effects.
      In this behavior Shiga toxin resembles tetanus toxin, another potent exotoxin
      that fails to elicit antitoxic responses in people who recover from clinical
      tetanus.

PMID- 1629318
TI  - Detection of Borrelia burgdorferi DNA in urine samples and cerebrospinal fluid
      samples from patients with early and late Lyme neuroborreliosis by polymerase
      chain reaction.
AB  - A polymerase chain reaction (PCR) was developed for use in the identification of
      a 248-bp fragment of the Borrelia burgdorferi flagellin gene in urine and
      cerebrospinal fluid (CSF) from patients with Lyme neuroborreliosis. The
      specificities of the PCR products were confirmed by DNA-DNA hybridization with an
      internal probe. The assay had a detection limit of 10 in vitro-cultivated B.
      burgdorferi. The PCR assay seemed to be species wide as well as species specific,
      since DNA from all 21 B. burgdorferi isolates from humans tested but not from
      Borrelia hermsii or Treponema pallidum could be amplified. We tested 10
      consecutively diagnosed patients with untreated neuroborreliosis. There was
      lymphocytic pleocytosis and intrathecal B. burgdorferi-specific antibody
      synthesis in the CSF of all patients. Urine and CSF samples were investigated by
      PCR before, during, and up to 8.5 months after therapy. B. burgdorferi DNA was
      detected in urine samples from nine patients; five patients, including two
      patients with chronic neuroborreliosis, were PCR positive prior to treatment,
      whereas urine samples from the remaining four patients obtained 3 to 6 days after
      the onset of therapy became PCR positive. All urine samples obtained greater than
      4 weeks after therapy were negative by PCR. PCR of CSF was less sensitive, and
      samples from only four patients, including one with chronic neuroborreliosis,
      were positive. We conclude that urine is a more suitable sample source than CSF
      for use in B. burgdorferi DNA detection by PCR. Normalization of inflammatory CSF
      changes and the negative PCR results during follow-up even in patients with
      chronic neuroborreliosis do not point to a persistent infection. The future role
      of PCR as a diagnostic tool for Lyme neuroborreliosis is still uncertain.

PMID- 1629319
TI  - Detection of Staphylococcus aureus by polymerase chain reaction amplification of
      the nuc gene.
AB  - Synthetic oligonucleotide primers of 21 and 24 bases, respectively, were used in
      the polymerase chain reaction (PCR) to amplify a sequence of the nuc gene, which
      encodes the thermostable nuclease of Staphylococcus aureus. A DNA fragment of
      approximately 270 bp was amplified from lysed S. aureus cells or isolated DNA.
      The PCR product was detected by agarose gel electrophoresis or Southern blot
      analysis by using a 33-mer internal nuc gene hybridization probe. With S. aureus
      cells the lower detection limit was less than 10 CFU, and with the isolated
      target the lower detection limit was 0.69 pg of DNA. The primers recognized 90 of
      90 reference or clinical S. aureus strains. Amplification was not recorded when
      80 strains representing 16 other staphylococcal species were tested or when 20
      strains representing 9 different nonstaphylococcal species were tested. Some of
      the non-S. aureus staphylococci produced thermostable nucleases but were PCR
      negative. The PCR product was generated when in vitro-cultured S. aureus was used
      to prepare simulated clinical specimens of blood, urine, cerebrospinal fluid, or
      synovial fluid. No PCR product was generated when the sterile body fluids were
      tested. However, the sensitivity of the PCR was reduced when S. aureus in blood
      or urine was tested in comparison with that when bacteria in saline were tested.
      With the bacteria in blood, the detection limit of the PCR was 10(3) CFU. A
      positive PCR result was recorded when a limited number of clinical samples from
      wounds verified to be infected with S. aureus were tested, while the PCR product
      was not detected in materials from infections caused by other bacteria.
      Generation of PCR products was not affected by exposure of S. aureus to
      bactericidal agents, including cloxacillin and gentamicin, prior to testing, but
      was affected by exposure to UV radiation. The PCR for amplification of the nuc
      gene has potential for the rapid diagnosis of S. aureus infections by direct
      testing of clinical specimens, including specimens from patients with ongoing
      antimicrobial therapy.

PMID- 1629320
TI  - Investigation of ampicillin-intermediate strains of Haemophilus influenzae by
      using the disk diffusion procedure and current National Committee for Clinical
      Laboratory Standards guidelines.
AB  - It was noted in our laboratory that certain strains of Haemophilus influenzae
      yielded zone sizes interpreted as resistant to the ampicillin (AMP) disk on
      chocolate-Mueller-Hinton agar (CMH) but showed no evidence of beta-lactamase
      (beta-Lac) activity. Although it is known that a second mechanism of AMP
      resistance exists, strains with this mechanism are uncommon. To investigate this
      apparent discrepancy, a study of 100 consecutive clinical isolates of H.
      influenzae collected over a 6-month period was performed. Isolates were
      simultaneously tested against five antibiotics (AMP, chloramphenicol, cefotaxime,
      ciprofloxacin, and AMP-sulbactam) on CMH and on two brands of Haemophilus test
      medium (HTM) by using the disk diffusion procedure and National Committee for
      Clinical Laboratory Standards (NCCLS) standards. By using CMH and NCCLS standard
      M2-A3-S2, strains of H. influenzae showing zone sizes of greater than or equal to
      20 mm with AMP were considered sensitive. By using HTM and NCCLS standard M2-A4,
      strains showing zone sizes of greater than or equal to 25 mm to AMP on HTM were
      considered sensitive. Intermediate strains had zone sizes of 22 to 24 mm. The
      majority of isolates (68%) were sensitive to all antibiotics. Two percent of the
      isolates were resistant to chloramphenicol. Seventeen percent of the isolates
      were AMP-resistant, beta-Lac-producing strains of H. influenzae. Thirteen percent
      of the isolates gave at least one intermediate or resistant zone for AMP but were
      beta-Lac negative. MIC determinations with NCCLS standard M7-A2 were performed
      with resistant and intermediate strains. MICs for beta-Lac-producing strains of
      H. influenzae were >/= 8.0 microgram/ml. MICs for beta-Lac-negative strains were
      </= 1.0 microgram/ml and were highly reproducible. If one uses the current NCCLS
      zone diameter interpretive criteria, results should be viewed with caution.
      Further investigation of zone size interpretive criteria is warranted. It is
      suggested that in the case of serious infections with H. influenzae, beta-Lac
      negative, AMP-resistant or -intermediate strains be confirmed by the MIC
      procedure.

PMID- 1629322
TI  - Evaluation of the rapid CORYNE identification system for Corynebacterium species
      and other coryneforms.
AB  - The Rapid CORYNE system for identification of aerobic, nonsporeforming, gram
      positive rods was evaluated according to the manufacturer's instructions with 177
      organisms. After inoculation with a heavy suspension of growth, strips containing
      20 cupules were incubated for 24 h, reagents were added, and the results of 21
      biochemical reactions were recorded as numerical profiles. The strains consisted
      of pathogenic species of the genus Corynebacterium, primarily C. diphtheriae (n =
      29), opportunistic species of Corynebacterium including C. jeikeium (n = 75),
      recognized species of non-corynebacteria such as Gardnerella and Arcanobacterium
      (n = 51), and Centers for Disease Control (CDC) coryneform groups (n = 22).
      Results from single tests read after 24 h yielded correct identifications to
      species level with no additional tests for 26 (89.7%) of the pathogenic species;
      64 (85.3%) of the opportunistic organisms; 51 (100%) of the non-corynebacteria,
      and 8 (36.4%) of the CDC coryneform groups. Supplemental tests produced the
      correct identification for three additional pathogenic isolates (100% total) and
      four additional isolates from the opportunistic species (90.6% total). Twelve of
      the 15 isolates not identified by the system were in the CDC coryneform groups.
      Four of the six misidentified and one of the unidentified isolates were C.
      matruchotii, which was not included in the data base. The system is an excellent
      rapid alternative to conventional biochemical tests.

PMID- 1629321
TI  - Detection of methicillin-resistant staphylococci by using the polymerase chain
      reaction.
AB  - A polymerase chain reaction (PCR)-based test was developed for the detection of
      mecA in staphylococci. To facilitate this process, a rapid cell lysis procedure
      was established for the release of DNA from staphylococcal strains. Primers based
      on the DNA sequence of the mecA gene from Staphylococcus aureus were used in PCRs
      to screen for the presence of this gene in a total of 98 staphylococcal isolates.
      Fifty-one isolates were mecA positive (17 S. aureus strains and 34 coagulase
      negative staphylococci including S. epidermidis, S. haemolyticus, and S.
      simulans). Results obtained with PCRs were generally consistent with those of
      standard microbiological assays. PCRs designed to detect the femA gene (factor
      essential for methicillin resistance) revealed the presence of the gene in all S.
      aureus strains examined regardless of the susceptibility profiles of the strains
      to methicillin. In contrast, femA could not be detected in coagulase-negative
      staphylococci by PCR with the same primers. Low-stringency hybridization
      suggested the presence of a gene structurally related to femA in S. epidermidis
      and other coagulase-negative staphylococci examined.

PMID- 1629323
TI  - Pulsed-field gel electrophoresis of NotI digests of leptospiral DNA: a new rapid
      method of serovar identification.
AB  - Fingerprints for 72 reference serovar strains of pathogenic Leptospira spp. were
      obtained by pulsed-field gel electrophoresis (PFGE) following NotI restriction
      digests of the chromosome. These strains included the serovar reference strains
      of serogroups Australis, Ballum, Bataviae, Grippotyphosa, Panama, Pomona, and
      Pyrogenes. Sixty-four serovars could be identified by a unique NotI restriction
      profile. The remaining serovars were differentiated by chromosomal digestion with
      SgrAI. These included four serovars from serogroup Australis, two serovars from
      serogroup Ballum, and two serovars from serogroup Bataviae. Thirteen of 18 recent
      clinical isolates identified by microagglutination test and cross-adsorption
      procedure were correctly typed by PFGE. The results indicate that PFGE, which is
      considerably more rapid than serology, should be useful for identification and
      epidemiological studies.

PMID- 1629324
TI  - Conserved sequences of the adenovirus genome for detection of all human
      adenovirus types by hybridization.
AB  - The application of DNA hybridization directly to clinical specimens has the
      potential of improving the diagnosis of fastidious types of adenovirus. In this
      study, the genome of one adenovirus type from each human subgenus (A to F) was
      systematically evaluated by hybridization for homologous sequences to find the
      optimal common probe for detection of all human adenovirus types. The area of
      cross-hybridization, most closely defined with adenovirus type 2 (Ad2), mapped
      from map units 11.4 to 16.1 and 26.9 to 29.7 and, principally, to a central area
      of the genome between map units 47.5 and 65.2. The last area, enclosing the hexon
      gene, was highly conserved. Cloned probes generated from this area demonstrated
      the greatest homology to heterologous types by hybridization analysis. A HindIII
      BglII clone containing the hexon gene of Ad2 within narrow confines reacted most
      evenly with all adenoviral types and detected the DNA of all other subgenera with
      a sensitivity 2 logs greater than that of a complete genomic Ad2 probe. The most
      homologous adenoviral gene sequences were observed in genes involved with DNA
      replication or intimately connected to the hexon in the early capsid formation.
      These results show that the hexon gene constitutes the best single region of the
      adenovirus genome for use as a genus-specific probe for the diagnosis of all
      human adenoviral subgenera by DNA hybridization.

PMID- 1629325
TI  - Efficacy of an enzyme-linked immunosorbent assay for detection of urinary tract
      immunoglobulins for diagnosis of urinary tract infections.
AB  - Results of the Uristat test (Shield Diagnostics Ltd.), a novel enzyme-linked
      immunosorbent assay (ELISA) for detection of urine antibodies to seven common
      bacterial pathogens, were compared with results of urine culture, urinalysis, and
      clinical history to determine the usefulness of Uristat in the diagnosis of
      urinary tract infections (UTIs). Midstream, catheterized, and indwelling catheter
      urine specimens sent to the laboratory for culture were included in the study.
      Quantitative cultures were performed on both 5% sheep blood agar and eosin
      methylene blue agar. Uristat ELISAs were performed according to the
      manufacturer's instructions. By using a Bacillus subtilis bioassay technique,
      antibacterial activity was detected in the urine of 236 (22.2%) of 1,061
      patients. Probable, possible, or asymptomatic UTIs were diagnosed for 258 (24.3%)
      of the 1,061 patients. Of those infections, 219 (84.9%) were caused by bacterial
      species whose antibodies were detectable by Uristat. Uristat's sensitivity and
      specificity were 76.7 and 56.0%, respectively. Uristat's predictive values of
      positive and negative results were 31.2 and 90.2%, respectively. Further
      development of the Uristat test is necessary before it can be of assistance in
      the diagnosis of UTIs.

PMID- 1629326
TI  - Murine antibody responses distinguish Rochalimaea henselae from Rochalimaea
      quintana.
AB  - Rochalimaea henselae causes persistent bacteremia, bacillary angiomatosis, and
      parenchymal bacillary peliosis. Detection of a specific antibody response to R.
      henselae infection may represent an alternative to cultivation as a means of
      diagnosis. We assessed the specificity of induced murine antibodies for antigens
      from R. henselae and the closely related species R. quintana. Groups of CD-1 mice
      were inoculated with whole organisms of six strains of R. henselae and two of R.
      quintana. Pre- and postinoculation blood specimens were collected. Enzyme
      immunosorbent assays were performed by using as antigens preparations of
      immunogenic proteins from one isolate of R. henselae or from the R. quintana type
      strain. These demonstrated high specificity of R. henselae-induced antibodies for
      proteins of R. henselae and of R. quintana-induced antibodies for proteins of R.
      quintana. Protein preparations extracted from all of the strains were separated
      electrophoretically. After their transfer to membranes, immunoblots were
      performed by using 1:1,000 dilutions of all of the pre- and postinoculation sera
      in combination with proteins from all of the strains. Preinoculation sera had
      minimal reactivity. All of the R. henselae-induced immune sera reacted with
      numerous proteins of all of the R. henselae strains but cross-reacted minimally
      with proteins of R. quintana. Immune sera from R. quintana-inoculated mice had
      similar species specificity. An immunofluorescence assay was developed by using
      antiserum to one strain of R. henselae. A 1:1,000 dilution yielded fluorescence
      with all strains of R. henselae but with none of R. quintana, Bartonella
      bacilliformis, or Afipia felis. Acinetobacter calcoaceticus subsp. anitratus was
      also unreactive with a dilution of 1:500. A 1:10 dilution yielded weak
      fluorescence with R. quintana but none with Staphylococcus epidermidis.

PMID- 1629328
TI  - Ongoing group B Neisseria meningitidis epidemic in Sao Paulo, Brazil, due to
      increased prevalence of a single clone of the ET-5 complex.
AB  - Beginning in 1988, the incidence of meningococcal disease in the area of greater
      Sao Paulo began to surpass the upper confidence limit of an 8-year average
      incidence (from 1979 to 1986), thus characterizing a new epidemic in the region
      of greater Sao Paulo. This epidemic, which extended to 1990, was different from
      previous epidemics in that it was caused by serogroup B. The increased incidence
      of meningococcal disease was paralleled by an increased prevalence of a single
      group B clone, B:4:P1.15, of the ET-5 complex. ET-5 strains have been present in
      the greater Sao Paulo area since 1979; however, they have been associated with a
      high percentage of the group B disease only from 1987 to the present. On the
      basis of the increased incidence of group B disease in Sao Paulo, a mass
      vaccination program with a serotype 4:P1.15 meningococcal protein vaccine was
      undertaken. The impact of this vaccination program is under analysis.

PMID- 1629327
TI  - Rapid detection of the mecA gene in methicillin-resistant staphylococci by
      enzymatic detection of polymerase chain reaction products.
AB  - In order to identify methicillin-resistant staphylococci from clinical sources
      with ease and reliability, enzymatic detection of polymerase chain reaction (ED
      PCR) was applied. ED-PCR is based on the capture of amplified products via biotin
      streptavidin affinity and the detection of an incorporated hapten in amplified
      products with an enzyme-linked antibody. In order to identify methicillin
      resistant staphylococci of all species, a 150-bp fragment of the mecA gene was
      targeted for ED-PCR. After PCR was performed with a pair of biotin and
      dinitrophenol 5'-labeled primers, the reaction mixture was applied to a
      microtiter well precoated with streptavidin. Thereafter, bound PCR products were
      detected colorimetrically with alkaline phosphatase-conjugated anti-dinitrophenol
      antibody. The extraction of DNA from staphylococcal cells for PCR was simplified
      so that it could be performed within one tube. The total assay, including PCR,
      took less than 3 h. The sensitivity of mecA gene detection ranged from greater
      than 5 x 10(2) CFU per tube for Staphylococcus aureus to greater than 5 x 10(3)
      CFU per tube for Staphylococcus epidermidis. Genotyping results obtained by ED
      PCR of 161 tested strains from the colonies (97 strains of S. aureus and 64
      strains of coagulase-negative staphylococci) were compared with the phenotypic
      susceptibilities of the strains to oxacillin. The results of ED-PCR showed
      excellent agreement with the MICs of oxacillin with very few exceptions; only one
      strain of S. aureus and two strains of coagulase-negative staphylococci were
      found to possess the mecA gene, which was discrepant with their phenotypes. Fifty
      five blood culture samples were also tested by ED-PCR. For staphylococcal
      isolates in 33 of the cultures, oxacillin MICs were >4 microgram/ml; 31 of the 33
      staphylococcal isolates were determined by ED-PCR to be mecA gene positive. These
      results suggest that ED-PCR can be used with reasonable confidence in the
      clinical microbiological laboratory.

PMID- 1629329
TI  - Reliability of a bioluminescence ATP assay for detection of bacteria.
AB  - The reliability of bioluminescence assays which employ the luciferin-luciferase
      ATP-dependent reaction to evaluate bacterial counts was studied, both in vitro
      and on urine specimens. Bioluminescence and cultural results for the most common
      urinary tract pathogens were analyzed. Furthermore, the influence of the culture
      medium, of the assaying method, and of the phase of growth on bioluminescence
      readings was studied. Results show that Proteus, Providencia, and Morganella
      strains are not correctly detected, neither in vitro nor in urine samples, by the
      standard assaying method. The analysis of assaying parameters demonstrated that
      some modifications to the extraction procedure of bacterial ATP could improve the
      reliability of this technique.

PMID- 1629330
TI  - Immunoglobulin G antibodies to Helicobacter pylori in patients with dyspeptic
      symptoms investigated by the western immunoblot technique.
AB  - Helicobacter pylori is a gram-negative, curved, rod-shaped bacterium known to
      cause gastritis and to be an important factor in the pathogenesis of peptic
      ulcers. Serological testing has recently been proposed as an aid in diagnosis of
      H. pylori infections. In this study, we used the Western immunoblot technique to
      evaluate the possibility of using one or more of the antigens from H. pylori for
      this purpose. Thirteen major bands and about 30 minor bands could be identified
      by Western blotting when sera from 53 consecutive dyspeptic patients, 27 healthy
      children, and 25 blood donors were evaluated. Antibodies against most of the
      major bands were found significantly more frequently in patients with H. pylori
      infections than in patients without such infections. However, antibodies against
      a single polypeptide were not produced by all patients with H. pylori infection.
      Polypeptides with molecular masses of 120, 50, and between 19 and 36 kDa seem to
      be the most specific polypeptides for the diagnosis of H. pylori infections. This
      study showed only minor differences in antigenic composition between different
      clinical isolates of H. pylori, and serological cross-reactions with other
      bacteria were limited. Major serological cross-reactions were found only with
      Campylobacter jejuni and with bacterial lipopolysaccharide. However, one band at
      60 kDa reacted with antiserum to the Legionella micdadei common antigen, which
      may indicate a cross-reaction with common antigen from several other bacteria.
      This study demonstrates that a number of bands may be useful as antigens in
      serological tests after isolation and purification.

PMID- 1629331
TI  - Absolute quantitation of viremia in human immunodeficiency virus infection by
      competitive reverse transcription and polymerase chain reaction.
AB  - A competitive polymerase chain reaction (PCR)-based assay for the quantitative
      detection of human immunodeficiency virus type 1 (HIV-1) viremia was developed
      and optimized. This method consists of the reverse transcription and subsequent
      amplification in the same tube of two similar RNA templates, the wild-type
      template to be quantified and a known amount of the internally deleted synthetic
      template, both with identical primer recognition sites. The same strategy also
      proved to be useful in the quantitative assay of HIV-1-specific cellular
      transcripts and proviral DNA sequences from peripheral blood mononuclear cells by
      using competitor DNA. The method might be of interest in the study of the precise
      level of HIV-1 activity during the different clinical phases of the infection and
      in the simple, fast, and methodologically correct molecular investigation of
      patients treated with specific antiviral compounds.

PMID- 1629332
TI  - Typhus and typhuslike rickettsiae associated with opossums and their fleas in Los
      Angeles County, California.
AB  - The recent discovery of cat fleas (Ctenocephalides felis) infected with a
      typhuslike rickettsia (designated the ELB agent) raises the question of whether
      similar rickettsial infections exist in wild cat flea populations. We verified
      the presence of the ELB agent and Rickettsia typhi in urban and suburban areas of
      Los Angeles, Calif. Opossums trapped in close proximity to the residences of
      human murine typhus cases in Los Angeles county and other areas within the city
      of Los Angeles were tested for the presence of typhus group rickettsiae by the
      polymerase chain reaction (PCR). The presence of rickettsiae in the spleen
      tissues of three opossums (n = 9) and in 66 opossum fleas (n = 205) was
      determined by PCR and was verified by dot blot and Southern transfer
      hybridization. Further analysis of the amplified PCR products generated by a
      series of primer pairs derived from either the 17-kDa antigen gene or the citrate
      synthase gene revealed that both R. typhi and the ELB agent were present in the
      tested samples. Dual infection was not noted in the samples; however, the fleas
      were infected with either R. typhi or the ELB agent. The presence of the ELB
      agent in the cat flea population may have implications for public health. Whether
      this agent is responsible for the mild cases of human murine typhus in urban and
      suburban areas of Los Angeles or in other endemic foci remains to be determined.

PMID- 1629333
TI  - Human immunodeficiency virus type 1 is present in the cerebrospinal fluid of a
      majority of infected individuals.
AB  - Cerebrospinal fluid (CSF) specimens from 63 patients with different severities of
      human immunodeficiency virus (HIV-1) infection, including asymptomatic virus
      carriers, were examined for the presence of HIV-1 by using polymerase chain
      reaction (PCR) and virus isolation. Polyadenylated RNA, presumably associated
      with virus particles, was extracted and reverse transcribed, and the pol region
      was amplified in a nested PCR. Virus could be detected in 90% of the CSF
      specimens examined by PCR, and data on isolation of virus from CSF were in
      agreement with these figures. In fact, when several CSF specimens from the same
      individual were studied, HIV-1 could be isolated from 80% of the patients. The
      presence of the viral RNA in CSF was independent of the clinical stage of
      infection and of neurological symptoms. These results show that the spread of HIV
      1 to the brain represents an early event during infection and occurs in the
      majority of asymptomatic individuals.

PMID- 1629334
TI  - Secondary immune response in a vaccinated population during a large measles
      epidemic.
AB  - The rates of secondary immune response (SIR) and secondary vaccine failure (SVF)
      during a measles epidemic (10,184 notifications) were evaluated. A patient with
      SIR was defined as a subject for whom all sera were immunoglobulin G (IgG)
      positive and IgM negative with a significant increase in complement fixation
      titer. A patient with SVF was defined as a vaccinated symptomatic subject showing
      a SIR. Sequential sera from 898 subjects were tested for measles antibody by
      enzyme-linked immunosorbent assay (IgG and IgM) and by complement fixation.
      Evidence of recent anti-measles virus specific immune response was found in 496
      subjects (55.5%). The vaccination rate was estimated at 74.6% (99% confidence
      interval [CI], 67.9 to 80.7%). The number of exposed vaccinated subjects was
      estimated at 370 (74.6% of 496). The SIR rate was 4.03% (20 of 496) (99% CI, 2.1
      to 6.9%) among subjects with immune response. These 20 subjects were 2 with
      measles (Centers for Disease Control's definition), 6 with measles with rash of
      unknown duration, 8 with presumed measles with either rash or fever, 3
      asymptomatic subjects (2 with recent contact with a measles case), and 1
      undocumented subject. Since 3 patients with SIR were asymptomatic and 2 others
      were documented as not vaccinated, there was a maximum of 15 probable occurrences
      of SVF among the 20 patients with SIR. The SVF rate among exposed vaccinated
      subjects was estimated at 4.05% (15 of 370) (99% CI, 1.9 to 7.5%). In conclusion,
      neither prior vaccination nor detectable SIR ensures protective immunity. Measles
      virus may induce asymptomatic SIR in IgG-seropositive subjects. SVF led to
      typical or modified measles but did not seem to have played an important role
      during this epidemic.

PMID- 1629335
TI  - Evaluation of the bead enzyme-linked immunosorbent assay for detection of cholera
      toxin directly from stool specimens.
AB  - A highly sensitive bead enzyme-linked immunosorbent assay (bead ELISA) for
      detection of cholera toxin (CT) was evaluated for direct detection of CT from
      stool specimens of patients with acute secretory diarrhea. Of the 75 stool
      samples examined, 59 yielded biochemically, and serologically confirmed strains
      of Vibrio cholerae O1. The bead ELISA was positive for CT in stool supernatants
      in 50 (84.7%) of the 59 samples from which V. cholerae O1 was isolated. In
      addition, the bead ELISA was positive for three stool specimens which were
      negative by culture. The free CT present in 48 of the 50 stool samples positive
      by culture for V. cholerae O1 and for CT by bead ELISA was completely absorbed by
      anti-CT immunoglobulin G. All of the 59 strains of V. cholerae O1 biotype eltor
      isolated in this study produced in vitro CT. The concentration of CT present in
      the bead ELISA-positive stool samples ranged between 26 pg/ml and greater than
      100 ng/ml. This evaluation study demonstrates that the bead ELISA is a sensitive
      and simple method for direct detection of CT in nonsterile stool samples, and we
      recommend routine use of this assay for detection of CT in stool samples and
      culture supernatants in clinical and reference laboratories.

PMID- 1629336
TI  - Standardization of sensitive human immunodeficiency virus coculture procedures
      and establishment of a multicenter quality assurance program for the AIDS
      Clinical Trials Group. The NIH/NIAID/DAIDS/ACTG Virology Laboratories.
AB  - An independent quality assurance program has been established by the Division of
      AIDS, National Institute of Allergy and Infectious Diseases, for monitoring
      virologic assays performed by nearly 40 laboratories participating in multicenter
      clinical trials in the United States. Since virologic endpoints are important in
      evaluating the timing and efficacy of therapeutic interventions, it is imperative
      that virologic measurements be accurate and uniform. When the quality assurance
      program was initially created, fewer than 40% of the laboratories could
      consistently recover human immunodeficiency virus (HIV) from peripheral blood
      mononuclear cells (PBMCs) of HIV-infected patients. By comparing coculture
      procedures in the more competent laboratories with those in laboratories who were
      struggling to isolate virus, optimal conditions were established and nonessential
      reagents and practices were eliminated. Changes were rapidly introduced into a
      laboratory when experience dictated that such modifications would result in a
      favorable outcome. Isolation of HIV was enhanced by optimizing the numbers and
      ratios of patient and donor cells used in cultures, by standardizing PBMC
      separation procedures, by using fresh rather than frozen donor PBMCs, by
      processing whole blood within 24 h, and by using natural delectinated interleukin
      2 instead of recombinant interleukin 2 products in existence at that time. Delays
      of more than 8 h in the addition of phytohemagglutinin-stimulated donor cells to
      freshly separated patient PBMCs reduced recovery. Phytohemagglutinin in
      cocultures and the addition of Polybrene and anti-human alpha interferon to media
      were not important in HIV isolation. The introduction of a consensus protocol
      based on this information brought most laboratories quickly into compliance. In
      addition, monthly monitoring has successfully maintained proficiency among the
      laboratories, a process that is critical for the scientific integrity of
      collaborative multicenter trials. Problems which might not be appreciated for
      months are now being resolved early, before data can be compromised unknowingly.
      This consensus protocol is recommended for any laboratory attempting to isolate
      HIV for the purpose of standardizing recovery and for accessing virologic
      endpoints in clinical trials.

PMID- 1629337
TI  - Polymerase chain reaction for diagnosis of enterohemorrhagic Escherichia coli
      infection and hemolytic-uremic syndrome.
AB  - Two pairs of oligonucleotide primers were designed to amplify fragments of the
      genes for Shiga-like toxin I (SLT-I) and SLT-II in a single reaction. A 370-bp
      segment and a 283-bp segment were amplified for SLT-I and SLT-II, respectively.
      The specificities of the polymerase chain reaction (PCR) amplification products
      were confirmed by using radioactively labeled oligonucleotide probes. SLT
      sequences were amplified from DNA isolated from 13 previously characterized
      enterohemorrhagic Escherichia coli (EHEC) strains. No amplification product was
      produced by using DNA from 20 non-EHEC strains. As little as one bacterial genome
      was detectable. PCR was then applied to DNA isolated directly from stool samples.
      We had to remove inhibitors of PCR that were present in lysates prepared from
      stool samples before amplification was achieved. First, we evaluated the
      sensitivity of PCR for the detection of known numbers of EHEC added to normal
      stools. Second, three children with SLT in their stools were shown to have SLT
      sequences in their stools by PCR. Two of these children had hemolytic-uremic
      syndrome, and a third child was asymptomatic. Stool specimens collected from
      another 26 asymptomatic children were negative by PCR for SLT sequences. PCR can
      be used to diagnose EHEC infections without prior culture of stool specimens.

PMID- 1629338
TI  - Molecular detection of sorbitol-fermenting Escherichia coli O157 in patients with
      hemolytic-uremic syndrome.
AB  - Shiga-like toxin-producing Escherichia coli strains of serogroup O157 were
      identified in 26 of 104 patients with hemolytic-uremic syndrome and in 18 of 668
      patients with diarrhea. All strains were identified by colony hybridization with
      DNA probes complementary to Shiga-like toxin I and Shiga-like toxin II gene
      sequences and characterized by biochemical tests and serotyping. Seventeen of
      these 44 patients had E. coli O157 strains which were unusual because they
      fermented sorbitol within 24 h of incubation and were positive for beta
      glucuronidase activity. Culture filtrates of these sorbitol-fermenting strains
      were highly toxic to Vero cells in culture. Serological tests and DNA analysis
      performed by restriction endonuclease digestion of B-subunit toxin genes revealed
      that all 17 isolates produced Shiga-like toxin II. Although by using molecular
      probes we established a high frequency of sorbitol-fermenting E. coli O157
      strains in the patients we examined, further studies on the prevalence of such
      isolates in other areas of endemic disease are clearly warranted.

PMID- 1629339
TI  - rRNA-based method for sensitive detection of Babesia bigemina in bovine blood.
AB  - Three synthetic oligonucleotide probes complementary to unique regions of Babesia
      bigemina small-subunit rRNA were developed for detecting the parasite in bovine
      blood. These probes specifically detected a parasitemia of 2 x 10(-5)% by
      autoradiography in less than 24 h by using a 200-microliters sample of bovine
      blood. These probes did not bind to total RNA or genomic DNA isolated from
      another closely related species, Babesia bovis, or to bovine leukocyte RNA. This
      method detected B. bigemina infections in calves inoculated with as few as 1,000
      infected erythrocytes from the second day onward for 16 days.

PMID- 1629340
TI  - Use of nonradioactive DNA hybridization for identification of enterotoxigenic
      Escherichia coli harboring genes for colonization factor antigen I, coli surface
      antigen 4, or putative colonization factor O166.
AB  - We developed an accurate nonradioactive colony hybridization assay (NCHA) using a
      digoxigenin-labeled polynucleotide probe and an antidigoxigenin alkaline
      phosphatase conjugate for the identification of enterotoxigenic Escherichia coli
      (ETEC) harboring genes for colonization factor antigen I (CFA/I), coli surface
      antigen 4 (CS4), or putative colonization factor O166 (PCFO166). In this 2-day
      assay, visual registration of color intensity could be used to distinguish
      between CFA/I-positive strains and strains with the genetic potential to express
      CS4 or PCFO166. A rapid NCHA was developed by which the results could be read
      visually 7 h and 45 min after inoculation of the bacteria. In the rapid NCHA,
      densitometry verified the visual discrimination between four groups of E. coli;
      ETEC with the CFA/I gene, ETEC with the CS4 gene, ETEC with the PCFO166 gene, and
      E. coli strains that lack such genes. As a confirmatory test, plasmids from ETEC
      with the CFA/I, CS4, or PCFO166 gene were differentiated by their characteristic
      restriction fragment patterns in nonradioactive Southern blot hybridization.

PMID- 1629341
TI  - Comparison of the VIDAS Clostridium difficile toxin A immunoassay with C.
      difficile culture and cytotoxin and latex tests.
AB  - The VIDAS Clostridium difficile toxin A immunoassay (CDA) is a new, automated,
      enzyme-linked fluorescent-antibody assay for detection of C. difficile toxin A
      antigen in stool specimens. Simultaneous, parallel testing was performed by using
      the VIDAS CDA, the Culturette brand CDT latex test for C. difficile antigens, and
      conventional laboratory cell culture tests for C. difficile, cytotoxicity and C.
      difficile culture. One hundred ninety-four consecutive fresh soft or liquid stool
      samples submitted for C. difficile testing between July and September 1990 were
      evaluated. Of the 194 samples tested, 19 (10%) were from 16 patients who met our
      case definition for C. difficile-associated disease. The in vitro tests were
      evaluated in relation to two forms of a clinical case definition. In one form, a
      positive culture for toxin-producing C. difficile or a positive cytotoxin result
      obtained directly from the stool specimen was required as laboratory evidence of
      C. difficile. In the other, a positive result of any of the four laboratory tests
      was accepted for the laboratory portion of the case definition. No significant
      difference between the sensitivity of the VIDAS CDA and that of the Culturette
      brand CDT latex test was found (48 to 58% sensitivity for the CDT latex test and
      52 to 63% sensitivity for the VIDAS CDA compared with 93 to 100% sensitivity for
      culture and 70 to 100% sensitivity for cytotoxin testing). The performance of the
      VIDAS CDA, however, was hampered by a high percentage of tests (19%) which gave
      an uninterpretable result.

PMID- 1629342
TI  - Characterization of rubella virus-specific antibody responses by using a new
      synthetic peptide-based enzyme-linked immunosorbent assay.
AB  - Rubella virus (RV)-specific immunoglobulin G antibodies were studied by enzyme
      linked immunosorbent assay (ELISA) techniques in sera from RV (RA 27/3)
      vaccinated individuals, patients experiencing natural RV infection, congenital
      rubella syndrome patients, and individuals failing to respond to repeated RV
      immunization. Results obtained by using whole-RV ELISAs (detergent-solubilized
      M33 strain or intact Gilchrist strain) and hemagglutination inhibition (HAI) and
      neutralization (NT) assays were compared with results obtained with the same sera
      by using ELISAs employing a synthetic peptide, BCH-178, representing a putative
      neutralization domain on the RV E1 protein. Murine RV E1-specific monoclonal
      antibodies with HAI and NT activities exhibited strong reactivity in ELISAs with
      BCH-178 peptide. In sera from RA 27/3-vaccinated individuals collected at 0
      (prevaccine), 1, 2, 3, 4, 5, 6, 12, and 24 to 52 weeks postvaccine, the
      development of E1-peptide-reactive antibodies closely paralleled increases in RV
      specific antibodies measured by whole-RV ELISAs and HAI and NT assays. Similarly,
      sequential serum samples obtained from patients during acute and convalescent
      phases of natural RV infection showed a coordinate increase in RV-specific
      antibodies as measured by whole-RV and peptide ELISAs. Conversely, congenital
      rubella syndrome patient sera, although exhibiting high levels of antibody in
      whole-RV ELISAs, had little or no antibody directed to the neutralization domain
      peptide. Sera from patients failing to respond to repeated RV immunization
      contained very low levels of RV-specific antibody in all ELISAs. Our results that
      the sequence represented by BCH-178 peptide may be a previously unidentified
      neutralization epitope for human antibodies on the RV E1 protein and may prove
      useful in determining effective RV immunity.

PMID- 1629343
TI  - Isotype antibody response in cows to Streptococcus agalactiae group B
      polysaccharide-ovalbumin conjugate.
AB  - Adult dairy cows were immunized with group B antigen (GBA) of Streptococcus
      agalactiae or GBA coupled to ovalbumin, both emulsified in incomplete Freund
      adjuvant, and their sera were examined by an enzyme-linked immunosorbent assay
      measuring bovine immunoglobulin isotypes (immunoglobulin G1 [IgG1], IgG2, and
      IgM) specific for GBA. All of the cows possessed naturally acquired antibodies
      against GBA, which implied that primary antibody responses could not be studied.
      At the highest dose tested (200 micrograms), free GBA elicited a slight increase
      in antibody titers only in the IgM isotype, to which most of the naturally
      acquired antibodies to GBA belonged. A second administration of antigen was not
      more effective. The conjugate was able to induce a strong humoral response
      against GBA, particularly in the IgG1 and IgG2 subisotypes, and a second
      injection of the conjugate induced a doubling of the peak antibody titers.
      Therefore, conjugation of GBA to a protein carrier markedly improved the antibody
      response, which showed the main characteristics of T-cell dependency. The opsonic
      activity of serum against an unencapsulated strain of S. agalactiae was
      reinforced by the immunization with the conjugate.

PMID- 1629344
TI  - Circumsporozoite genotyping of global isolates of Plasmodium vivax from dried
      blood specimens.
AB  - The prevalence and global distribution of two circumsporozoite (CS) genotypes of
      Plasmodium vivax (VK210 and VK247) were determined by genetic analysis of
      isolates from 234 malaria-infected patients. Whole blood specimens were collected
      on filter paper from patients infected with malaria in Thailand, Mexico, Papua
      New Guinea, Peru, Afghanistan (Pakistan), India, and western Africa and from 50
      asymptomatic smear-negative controls. Following extraction of DNA from the filter
      paper samples, the CS gene was amplified by the polymerase chain reaction and
      genotyped by using oligoprobes specific for the VK210 and VK247 repeat epitopes.
      The sensitivity of genotyping from a single blood dot was 95.2%. The VK247 CS
      genotype was identified in the blood of patients from all seven study areas and
      was the predominant form present in samples from Thailand (83%) and Papua New
      Guinea (90%). In contrast, VK247 DNA was present in only 9% of isolates from
      Mexico. Individuals infected with both genotypes simultaneously were identified
      in all study areas except Mexico and were particularly common in Thailand (58%)
      and Papua New Guinea (60%). These findings indicate that the VK247 genotype of P.
      vivax is widely distributed but that its prevalence varies geographically. In
      addition, we conclude that use of samples of whole blood on filter paper is a
      practical and sensitive method for determining the genotypes of large numbers of
      malaria isolates collected in field settings.

PMID- 1629345
TI  - Comparison of a chemiluminometric immunoassay with culture for diagnosis of
      chlamydial infections in infants.
AB  - The performance of Magic Lite (CIBA-Corning), a chemiluminescent immunoassay
      (CIA), was compared with that of culture for the diagnosis of neonatal chlamydial
      conjunctivitis and respiratory infection. We performed a retrospective evaluation
      of 51 ocular and 96 nasopharyngeal specimens previously collected for culture
      testing with the CIA. The sensitivities for the ocular and the nasopharyngeal
      specimens were 91 and 91.7%, respectively. The specificities for both sites were
      100%. A subsequent prospective study evaluating 71 ocular and 38 nasopharyngeal
      specimens revealed sensitivities of 83.3 and 20%, respectively. The specificities
      for both sites were 100%. The CIA performed favorably, compared with culture, for
      the diagnosis of chlamydial conjunctivitis; however, the CIA appeared less
      sensitive for the diagnosis of respiratory infection, including pneumonia.

PMID- 1629346
TI  - Distribution of heartwater in the Caribbean determined on the basis of detection
      of antibodies to the conserved 32-kilodalton protein of Cowdria ruminantium.
AB  - A competitive enzyme-linked immunosorbent assay (cELISA) was developed to detect
      immunoglobulin G antibodies to the major 32-kDa protein of Cowdria ruminantium. A
      total of 1,804 serum samples collected from cattle on 19 islands in the eastern
      Caribbean Basin were tested by this cELISA. A total of 133 serum samples from 10
      islands (Antigua, Dominica, Grenada, Guadeloupe, Martinique, Montserrat, St.
      Kitts, St. Lucia, St. Martin, and St. Vincent) were found to be positive. The
      presence of antibodies to C. ruminantium in cattle on these islands was confirmed
      by immunofluorescence and Western blotting (immunoblotting). In earlier studies,
      C. ruminantium has been demonstrated only on Guadeloupe, Antigua, and Marie
      Galante. This study shows that the causative agent of heartwater is now firmly
      established in the Caribbean.

PMID- 1629347
TI  - Outer membrane protein subtypes of Haemophilus influenzae type b isolates causing
      invasive disease in Victoria, Australia, from 1988 to 1990.
AB  - Outer membrane protein subtyping of 187 isolates of Haemophilus influenzae type b
      (Hib), isolated from children with invasive Hib disease in Victoria, Australia,
      showed that a single outer membrane protein subtype (1VA) was responsible for 83%
      of the infections. It was identical to that responsible for the majority of cases
      of invasive Hib disease in Europe.

PMID- 1629348
TI  - Bilophila wadsworthia isolates from clinical specimens.
AB  - Bilophila wadsworthia is an anaerobic, gram-negative, asaccharolytic, bile
      resistant, catalase-positive bacillus that is usually urease positive and was
      originally recognized in specimens of peritoneal fluid and tissue from patients
      with appendicitis. Additional isolations from clinical specimens, including a
      scrotal abscess, mandibular osteomyelitis, axillary hidradenitis suppurativa,
      pleural fluid, joint fluid, and blood, are described here.

PMID- 1629350
TI  - Selective buffered charcoal-yeast extract medium for isolation of nocardiae from
      mixed cultures.
AB  - The recovery of Nocardia species from mixed cultures is facilitated by use of a
      selective medium. We show that buffered charcoal-yeast extract medium with
      polymyxin, anisomycin, and vancomycin can be used for the selective isolation of
      nocardiae from contaminated specimens.

PMID- 1629349
TI  - Evaluation of feline immunodeficiency virus and feline leukemia virus
      transmembrane peptides for serological diagnosis.
AB  - The general model for retrovirus transmembrane (TM) proteins proposed by Gallaher
      et al. (W. R. Gallaher, J. M. Ball, R. F. Garry, M. C. Griffin, and R. C.
      Montelaro, AIDS Res. Hum. Retroviruses 5:431-440, 1989) suggests that all
      retrovirus TM proteins may contain an immunodominant domain (Imd-TM peptide)
      located at the apex of the TM polypeptide. Although this Imd-TM peptide has been
      shown to be immunodominant in a variety of lentivirus infections, there has not
      been a detailed serological analysis of an oncovirus Imd-TM peptide as a
      diagnostic agent. We describe here an analysis of the antigenic properties and
      diagnostic potentials of the predicted Imd-TM peptides of feline immunodeficiency
      virus (FIV) and feline leukemia virus (FeLV) in serological assays of sera from
      infected cats. The results of these studies demonstrate that antibodies specific
      to the FIV Imd-TM peptide are detected within 2 weeks postinfection, are
      maintained at high levels for extended periods, and are not detectable in
      uninfected or FeLV-infected cats. In marked contrast, the FeLV Imd-TM peptide
      displayed only negligible levels of serological reactivity in FeLV-infected cats.
      These studies indicate that the peptide is a useful reagent for the detection of
      antibodies to FIV.

PMID- 1629351
TI  - Molecular epidemiology unravels the complexity of neonatal Escherichia coli
      acquisition in twins.
AB  - Combined analysis of restriction fragment length polymorphism of regions of genes
      coding for rRNA (ribotyping) and esterase electrophoretic typing was used to
      document neonatal acquisition of Escherichia coli in twins. Our study shows
      vertical mother-to-infant transmission of one strain of E. coli to one twin and
      the development of neonatal septicemia with a distinct nonvirulent
      carboxylesterase type B1 E. coli strain for the other twin.

PMID- 1629352
TI  - Detection of rubella virus-specific polymeric immunoglobulin A by enzyme-linked
      immunosorbent assay in combination with streptococcal pretreatment of serum.
AB  - An enzyme-linked immunosorbent assay combined with streptococcal treatment of
      serum was assessed for its ability to detect serum polymeric immunoglobulin A.
      This technique detects rubella virus-specific polymeric immunoglobulin A
      antibody, which appears for only a short time after infection, and it is useful
      for serodiagnosis of recent rubella virus infection.

PMID- 1629353
TI  - Cross-infection risks associated with high-speed dental drills.

PMID- 1629354
TI  - Cross-infection risks associated with high-speed dental drills.

PMID- 1629355
TI  - What is APHA's future in public health?

PMID- 1629356
TI  - AIDS: the world situation.

PMID- 1629357
TI  - Budget cutting and privatization: the threat to health.
AB  - The worldwide drive for budget cutting and privatization, led by the WorldBank
      and the International Monetary Fund, has led to serious deterioration of health
      services as well as education, housing, nutrition and other social services in
      many countries. The model for this policy is the United States, which represents
      the pinnacle of private enterprise in the health field. The U.S. experience with
      this model--its effects on preventive and treatment services and health status-
      is reviewed. The example of the current drive toward privatization in Spain is
      discussed, and alternative recommendations are made to protect and improve the
      health of the Spanish public.

PMID- 1629359
TI  - Quantitative risk assessment: a tool to be used responsibly.

PMID- 1629358
TI  - Restrictive workplace smoking policies: impact on nonsmokers' tobacco exposure.
AB  - The health consequences of exposure to environmental tobacco smoke (ETS) are well
      documented. Although nonsmokers are generally aware of the health risks of ETS
      exposure, the majority of nonsmokers are regularly exposed. The most common
      source of exposure is the workplace. Restrictive workplace smoking policies are
      being used as a primary means of reducing ETS exposure. However, few studies have
      focused on the relation between workplace policy and ETS exposure. We performed
      two studies which examined the relationship between smoking policy, self-reported
      ETS exposure, and salivary cotinine concentrations. Study I, a pilot study,
      focused on a workplace-based sample of 106 volunteers; Study 2 examined exposure
      among 881 nonsmokers in workplace settings. In both studies, more restrictive
      workplace smoking policies were associated with a lower proportion of nonsmoking
      volunteers with detectable salivary cotinine. In Study 2, the larger study, the
      only other variable found to be significantly related to cotinine detection was
      the presence of smokers in the home. These results suggest that restrictive
      workplace smoking policies may reduce employees' overall ETS exposure.

PMID- 1629360
TI  - The Breast Cancer Screening Program in Rhode Island.
AB  - The Rhode Island Department of Health has undertaken a Breast Cancer Screening
      Program which incorporates assessment, policy development, and assurance
      functions, following the model proposed in the Institute of Medicine (IOM)
      report, The Future of Public Health. With the community's help, projects have
      been implemented to increase screening capacity with dedicated, state-of-the-art
      equipment, to increase screening accessibility, to publicize the need for
      mammography, and to minimize false test results. In the program's first 15
      months, the proportion of women ages 40 and over who were screened with
      mammography according to current guidelines increased from 35 to 46 percent (from
      38 to 49 percent among women ages 40-49; from 31 to 43 percent among women ages
      50 and over), including 15 percent who received their first screening mammogram.
      Providers' recommendations and knowledge of screening guidelines were important
      in explaining first-time use. The Department plans to apply the IOM model in
      other program areas. Its adoption by others is urged.

PMID- 1629361
TI  - The merging of alcohol and drug treatment: a policy review.
AB  - Alcohol and drug treatment have separate histories in the United States. The
      large public treatment systems were established as separate institutions in the
      early 1970s and have developed separate research traditions and treatment
      programs. However, as a response to current treatment financing policy and
      epidemiologic descriptions of combined alcohol and other drug use in the
      population, the two treatment systems are merging at the state and local levels.
      This large structural change is taking place without the development and
      evaluation of treatment methods for combined problems and without discussion of
      overall health service or policy implications. This paper describes the changes
      occurring, examines the literature for its contributions in providing direction,
      and presents treatment method and policy issues which need to be part of the
      overall discourse.

PMID- 1629362
TI  - Washington State's Basic Health Plan: choices and challenges.
AB  - The current turbulence characterizing the health sector has engendered a limited
      number of state-level experiments to provide health services for the nation's 37
      million uninsured. The issues and challenges generated by each program's design
      and implementation vary. By examining the experience of one such state program,
      the Washington Basic Health Plan, in some detail, this paper contributes to the
      policy debate regarding the possible range of solutions available to address the
      issue of "the uninsured." By analyzing the array of design choices available at
      the time the program was enacted, and why certain options were chosen rather than
      others, this paper points to the complex interaction of political dynamics,
      public policy development, and program implementation.

PMID- 1629363
TI  - Australia's health in the 1990s.

PMID- 1629364
TI  - Some epidemiological data on oral clefts in the northern Netherlands, 1981-1988.
AB  - Cleft lip with or without cleft palate [CL(P)] has a high prevalence [corrected]
      in the northern Netherlands. Several epidemiological parameters for oral clefts,
      including both CL(P) and cleft palate (CP), were analysed and compared with the
      literature. Except for the high prevalence at birth of isolated CL(P) no major
      differences in the pattern of occurrence described elsewhere were found. So far,
      descriptive epidemiological studies have not given any insight into the aetiology
      of this high CL(P) prevalence [corrected] in the Northern Netherlands. Therefore,
      case control studies on possible risk factors have been initiated.

PMID- 1629365
TI  - A new osteotomy for the correction of mandibular prognathism: techniques and
      rationale of the intraoral vertico-sagittal ramus osteotomy.
AB  - The sagittal split ramus osteotomy (SSRO) and the intraoral vertical ramus
      osteotomy (IVRO) are long established methods for correcting mandibular
      prognathism, each having its own advantages. However, both procedures have the
      same disadvantage: the potential for postoperative condylar displacement. The
      displacement of the condyle is mainly due to the fact that the osteotomy plane is
      not parallel to the original sagittal plane in which the mandible is
      repositioned. The author has developed a new ramus osteotomy since 1985 in which
      the osteotomy plane is theoretically parallel to the original sagittal plane and
      thereby attempting to decrease the incidence of condylar displacement. This
      osteotomy was designed additionally to decrease neurosensory disturbances and has
      the advantages of both methods, and therefore has been named 'intraoral vertico
      sagittal ramus osteotomy (IVSRO)'. Initial experience with the 24 prognathic
      patients operated on by means of the IVSRO indicated excellent clinical results.
      It has been noted clinically that the IVSRO is very effective in reducing
      postoperative iatrogenic TMJ symptoms and in treating preoperative TMJ symptoms.
      It has the additional effect of reducing neurosensory disturbances. This
      osteotomy seems to be more applicable in mandibular prognathism with excessive
      flaring of the ramus, particularly that associated with TMJ dysfunction, because
      the IVSRO has a 'condylotomy effect' and its splitting plane diverges less from
      the original sagittal plane than that of the SSRO and the IVRO.

PMID- 1629366
TI  - Mandibular autorotation in orthognathic surgery: a new method of locating the
      centre of mandibular rotation and determining its consequence in orthognathic
      surgery.
AB  - Rotation of the mandible is simulated through the centre of the condyle in
      planning orthognathic surgery. Previous studies have suggested that the initial
      mandibular movement is better characterized as multiple parts of the segments of
      a circle with the average centre located below and behind the centre of the
      condyle. This paper describes a method of locating the centre of mandibular
      rotation by computer-analysis of two lateral cephalograms with different degrees
      of opening. The method was used on 10 normal individuals showing an average
      centre of mandibular rotation 14.9 mm below and 5.0 mm behind the superior
      midsurface of the condyle for movements from occlusion to an opening of 10 mm.
      The implications of the located centre of rotation on orthognathic surgery was
      determined by simulating a closure of a 9.5 mm open bite. An error of up to 9.3
      mm in the horizontal position of the maxilla would occur if the centre of the
      condyle was used. A retrospective study on 10 patients with increased anterior
      facial height was undertaken and a mean centre of rotation 8.4 mm behind and 25.1
      mm below the centre of the condyle was found. Simulating the rotation of the
      mandible through the centre of the condyle would have resulted in a difference
      between the predicted and actual horizontal position of the maxilla ranging from
      0.4-10.4 mm. It was concluded that using the centre of the condyle as the centre
      of mandibular rotation in the planning of superior maxillary movement with a Le
      Fort I osteotomy may cause considerable error in the horizontal position of the
      maxilla in most cases.

PMID- 1629367
TI  - Long-term results after horseshoe sandwich osteotomy of the edentulous maxilla as
      a preprosthetic procedure.
AB  - The long-term results in 30 patients with maxillary atrophy who have been
      operated on using a horseshoe sandwich osteotomy and interpositional bone
      grafting are reported. The postoperative period ranges from 1-4 years. Lateral
      cephalometric X-rays, models and clinical investigations served to determine the
      resorption rate and the postoperative results. It could be shown that the
      vertical resorption rate amounts to 1.8 mm (20%) after 3 years. The sagittal
      resorption rate was about 1 mm with a wide individual range. Clinical
      investigation revealed satisfactory results in 28 patients.

PMID- 1629368
TI  - Lacrimal drainage system obstruction: management and results obtained in 70
      patients.
AB  - Causes and types of acquired obstruction of the lacrimal drainage system are
      discussed in 70 patients, as well as the results of their surgical treatment.
      Obstruction of the lacrimal drainage pathway, according to frequency, was due to:
      trauma (mainly naso-orbital and LeFort II fractures), post-inflammatory stenosis
      of the nasolacrimal duct, tumours and latrogenic injuries of the naso-lacrimal
      drainage system often following Caldwell-Luc operations of the maxillary sinus.
      The ages of patients ranged from 3-70 years. Canalicular obstruction was
      diagnosed in 9 (12.9%), obstruction of the lacrimal sac in 2 (2.8%), while
      obstruction of the naso-lacrimal duct in 50 (71.4%) patients, including 3
      bilaterally. And in 9 (12.9%) patients, injury to the lacrimal system following
      excision of tumours of the eyelids and the medial canthal region occurred. In
      patients with canalicular obstruction intubation of the canaliculi was carried
      out and both ends of the drain were inserted into the nasal cavity for 6 months
      via a dacryocystorhinostomy. Total recovery was obtained in 44.5%. In lacrimal
      sac and nasolacrimal duct obstruction Dupuy-Dutemp's dacryocystorhinostomy was
      performed and 90.4% of the patients recovered. When fibrosis or extensive damage
      of the lacrimal sac had occurred, wide anastomosis with the nasal duct was
      indicated. After tumour excision, the lacrimal pathways were reconstructed by
      conjunctivo-rhinostomy, conjunctivo-sinusostomy or conjunctivo
      dacryocystorhinostomy. In 40% of the patients who underwent conjunctivo
      dacryocystorhinostomy a successful outcome ensued.

PMID- 1629369
TI  - The radial forearm free flap: our experience in solving donor site problems.
AB  - Special attention is paid to the problems of the donor site (the forearm) in a
      series of 75 patients who underwent orofacial malignancy excision. An island skin
      flap from the ulnar aspect of the forearm, used in 15 patients, is reported to be
      an improvement of the surgical technique. No healing complications were observed,
      and the aesthetic and functional results were very good.

PMID- 1629370
TI  - Neuro-ophthalmic findings in progressive supranuclear palsy.
AB  - We studied 104 patients with progressive supranuclear palsy (PSP), 38 of whom
      were examined by both a neurologist and a neuro-ophthalmologist. Neuro-ophthalmic
      findings that may help differentiate PSP from Parkinson's disease include
      vertical supranuclear ophthalmoparesis and fixation instability. Eyelid
      abnormalities, particularly lid retraction, blepharospasm, and "apraxia" of
      eyelid opening and closure, were important distinguishing signs. Although
      downgaze palsy is felt to be the clinical hallmark of PSP, upgaze and downgaze
      were equally affected at the time of diagnosis in our patients.

PMID- 1629371
TI  - Horner's syndrome caused by intra-oral trauma.
AB  - A 7-year-old boy developed a Horner's syndrome after falling on a stick that
      penetrated his peritonsillar soft palate. He did not suffer from any major
      vascular injury, and pharmacologic testing indicated a preganglionic lesion. We
      review previously reported cases of oculosympathetic paresis caused by surgical
      and nonsurgical intra-oral trauma. Because of the proximity between sympathetic
      and vascular structures in the lateral and parapharyngeal space, Horner's
      syndrome in the setting of intra-oral trauma should prompt evaluation of the
      internal carotid artery. Magnetic resonance imaging may be a reasonable
      noninvasive method for this investigation.

PMID- 1629372
TI  - Bilateral internuclear ophthalmoplegia in a patient with Wernicke's
      encephalopathy.
AB  - The most common cause of bilateral internuclear ophthalmoplegia is multiple
      sclerosis. Wernicke's encephalopathy has been reported as a cause of unilateral
      internuclear ophthalmoplegia but not of bilateral internuclear ophthalmoplegia.
      In this report, we present the case of a patient with a history of alcohol abuse
      and acute onset of bilateral internuclear ophthalmoplegia whose clinical course
      and diagnostic studies are most consistent with a diagnosis of Wernicke's
      encephalopathy.

PMID- 1629373
TI  - Simplification of the method used for biopsy of the superficial temporal artery.

PMID- 1629374
TI  - Craniopharyngioma: pitfalls in diagnosis.
AB  - A 28-year old man presented with decreased vision and a bitemporal hemianopia.
      Magnetic resonance (MR) imaging demonstrated what appeared to be an enlarged
      optic chiasm and, on T2-weighted images, hypersignal extending along the optic
      tracts. This was felt to represent an intrinsic chiasmal mass, most likely a
      chiasmal glioma. Biopsy specimens from the first craniotomy were nondiagnostic.
      With continued visual failure, the patient underwent a second operation, and the
      correct diagnosis of craniopharyngioma was established. This article emphasizes
      the difficulties encountered with neuroradiologic evaluation and histopathologic
      study of craniopharyngioma.

PMID- 1629375
TI  - Combined third and sixth nerve paresis following optic nerve sheath fenestration.
AB  - The authors report a case of transient third and sixth nerve paresis as a
      complication of optic nerve sheath fenestration in a patient with pseudotumor
      cerebri. The motility and pupillary abnormalities that are commonly associated
      with this procedure are reviewed briefly.

PMID- 1629376
TI  - Distended optic nerve sheaths in Leber's hereditary optic neuropathy.
AB  - Distension of the optic nerve sheaths is a feature of Leber's hereditary optic
      neuropathy (LHON) that has attracted attention only recently. We followed a
      patient with LHON for 23 years and obtained his eyes for pathological examination
      after death. We report the first histologic description of distension of the
      optic nerve sheaths, together with typical histopathological findings of LHON.
      Distension of the optic nerve sheaths could not be accounted for by any etiology
      other than LHON, although the precise pathogenic mechanisms remain enigmatic.

PMID- 1629377
TI  - Thyroid ophthalmopathy presenting as superior oblique paresis.
AB  - Six patients with thyroid ophthalmopathy presented with what appeared to be a
      unilateral superior oblique paresis by the three-step test, which was eventually
      followed by more typical findings of thyroid disease. This early motility defect
      in thyroid ophthalmopathy may be caused by a restrictive process due to
      involvement of the inferior rectus muscle. Clues to the proper diagnosis included
      an increase in vertical deviation in upgaze, elevation of intraocular tension in
      upgaze, and the lack of excyclodeviation. These features should be assessed in
      patients with isolated superior oblique paresis.

PMID- 1629378
TI  - Color vision in dominant optic atrophy.
AB  - The color vision of seven patients with dominant optic atrophy in four different
      families was studied with the following color vision tests: the Standard
      Pseudoisochromatic Plates part 2, the Lanthony Tritan Album, the Velhagen
      Pflugertrident plates, and Farnsworth Panel D 15, the Farnsworth-Munsell 100 hue
      test, the Nagel anomaloscope, and the Besancon anomalometer. In the first family,
      the mother, one of the sons, and one of the grandsons were affected. The mother
      had a deutantritan defect; the son and the grandson both had an undefined red
      green and a tritan defect. In the third family, the mother and the son were
      affected. Only the color vision of the son could be examined. He had a tritan
      defect. In the fourth family, the mother and the daughter were affected. Both had
      a deutan defect. In the diagnosis of dominant optic atrophy, it must be
      remembered that not only blue color vision defects occur, but that other kinds of
      defects are also possible.

PMID- 1629379
TI  - A possible new approach to the treatment of neuroleptic malignant syndrome.

PMID- 1629380
TI  - A double-blind, placebo controlled study of trazodone in patients with obsessive
      compulsive disorder.
AB  - Patients with obsessive-compulsive disorder (OCD) have been shown to be
      preferentially responsive to serotonin (5-HT) uptake-inhibiting antidepressants
      including clomipramine, fluoxetine, fluvoxamine, and sertraline. The nontricyclic
      antidepressant, trazodone, also possesses serotonin reuptake inhibiting
      properties and has been reported to be efficacious in OCD in several case reports
      and open trials. In order to investigate trazodone's potential antiobsessive
      efficacy in a controlled fashion, 21 patients with OCD were entered into a double
      blind, parallel design comparison of trazodone and placebo. There were no
      significant differences in baseline rating scores of OCD or depressive symptoms
      between those who entered the trazodone phase (N = 13) versus those who entered
      the placebo phase (N = 8). As measured by standardized OCD and depression rating
      scales, there was no significant difference in OCD or depressive symptoms in the
      17 patients who completed 10 weeks of trazodone (N = 11, mean daily dose, 235 +/-
      10 mg) versus 10 weeks of placebo (N = 6) administration. In comparison to
      clomipramine and fluoxetine treatment which we have found to be associated with
      greater than 95% reduction in platelet 5-HT concentration, there was only a 26%
      mean reduction in platelet 5-HT concentration after 10 weeks of trazodone
      administration. These results indicate that trazodone lacks substantial
      antiobsessive effects and is associated with only modest reductions in platelet 5
      HT concentrations.

PMID- 1629381
TI  - Increased pulse and blood pressure associated with desipramine treatment of
      bulimia nervosa.
AB  - The cardiovascular effects of desipramine were assessed in 74 young women with
      bulimia nervosa participating in a 6-week double-blind, placebo-controlled study.
      Desipramine treatment was associated with significant increases in pulse,
      reclining systolic and diastolic blood pressures, and orthostatic hypotension.
      These effects were clearly evident in the first week of treatment and remained
      relatively unchanged during the subsequent 5 weeks. The mean increases in
      reclining systolic and diastolic pressures were approximately 10 mm Hg. Data from
      16 patients treated for an additional 2 months indicated that most of the effects
      of desipramine on blood pressure diminished over time, whereas the effects on
      pulse persisted. These results differ from the commonly expected cardiovascular
      effects of tricyclic anti-depressants in adults. Evidence from the current study
      and from other reports suggests that the cardiovascular effects of tricyclic
      antidepressants are age-dependent.

PMID- 1629382
TI  - Haloperidol metabolism in psychiatric patients: importance of glucuronidation and
      carbonyl reduction.
AB  - In 39 patients who received haloperidol regularly we measured plasma
      concentrations of haloperidol glucuronide (HAL-GL), reduced haloperidol
      glucuronide (RHAL-GL), haloperidol (HAL), reduced haloperidol (RHAL), and HAL
      reductase activity in red blood cells. Plasma HAL-GL concentrations were
      significantly higher than HAL, RHAL, or RHAL-GL concentrations. Concentration
      ratios of total glucuronide to nonglucuronide and RHAL/HAL ratios were calculated
      as indices of glucuronidation and reduction capacity in each patient. The plasma
      glucuronidation ratios showed a significant negative correlation (r = -0.63, p
      less than 0.001) with the dose, while the reduction ratios showed a positive
      correlation (r = 0.75, p less than 0.001). No correlations were found between the
      HAL reductase activity in red blood cells and either the dose or RHAL/HAL. Based
      on these findings we suggest that glucuronidation of HAL is the major metabolic
      pathway of HAL in humans and its activity is important in determining steady
      state plasma HAL concentrations. Glucuronidation may also be a major contributing
      factor in the interindividual variability of HAL metabolism.

PMID- 1629383
TI  - A double-blind clinical trial of alprazolam, imipramine, or placebo in the
      depressed elderly.
AB  - The efficacy and safety of alprazolam as compared to imipramine or a placebo
      added to weekly interpersonal psychotherapy was compared in a 6-week double-blind
      randomized clinical trial of 35 ambulatory elderly patients with major
      depression. The average maximum dosage of alprazolam was 2.2 mg and the average
      maximum dosage of imipramine was 97.5 mg. The findings showed a rapid onset of
      action of alprazolam within 1 week on symptoms of depression and anxiety. The
      effects for imipramine were seen later in the study. There were no serious side
      effects that interfered with treatment. The anticholinergic effects of imipramine
      were the ones that most commonly interfered with treatment. Alprazolam produced
      the greatest number of symptoms with discontinuation, most of which were
      alleviated within a week. We conclude that alprazolam may be useful as an
      antidepressant for the elderly. More clinical trials are needed to test its
      efficacy in the depressed elderly with concomitant medical problems, using plasma
      levels. A double-blind discontinuation study of alprazolam is needed to determine
      the degree of symptom return.

PMID- 1629384
TI  - Nitrazepam clearance unimpaired in patients with renal insufficiency.
AB  - Eight patients with mild to moderate renal insufficiency (mean serum creatinine:
      2.4 mg/100 ml) and 9 matched control subjects with normal renal function received
      a single 5-mg oral dose of nitrazepam, cleared mainly by hepatic nitroreduction.
      Serum nitrazepam levels were determined by gas chromatography during the 72 hours
      after dosage. Renal patients and controls were well-matched for age (74 vs. 63
      years), height (165 vs. 164 cm), and weight (68 vs. 64 kg). Patients and control
      subjects did not differ significantly in nitrazepam elimination half-life (32 vs.
      24 hour) or volume of distribution (4.2 vs. 3.6 liters/kg). Clearance was higher
      in patients than in controls (4.2 vs. 1.7 ml/min/kg), but the difference was not
      significant. Nitrazepam free fraction in serum was increased in renal patients
      (16.8 vs. 15.0% unbound, p = 0.08). After correction for individual values of
      free fraction, the two groups still did not differ in kinetic variables for
      nitrazepam. Thus, mild to moderate renal insufficiency does not alter the
      kinetics of nitrazepam.

PMID- 1629385
TI  - Haloperidol and reduced haloperidol in saliva and blood.
AB  - A total of 18 outpatients (17 male, 1 female) ranging in age from 36-66 years old
      were on a constant dosage of haloperidol in equally divided doses at 9:00 a.m.
      and 9:00 p.m. for at least 1 month. DSM-III-R diagnoses included schizophrenia (N
      = 9), schizoaffective disorder (N = 3), bipolar disorder (N = 4), organic mental
      disorder (N = 1), and delusional disorder (N = 1). Blood samples for steady-state
      concentrations of plasma and red blood cell haloperidol (H) and reduced
      haloperidol (RH) were drawn at 9:00 a.m. (12 hr trough). The haloperidol dosage
      was held at 9:00 a.m. until samples of whole saliva and parotid saliva could be
      collected for flow rates and concentrations of H and RH. Haloperidol dosages
      ranged from 1 mg/day to 60 mg/day (mean 11 +/- 15). Correlation coefficients were
      calculated for saliva concentrations versus blood levels and for saliva secretion
      rates versus blood levels. The correlations between whole saliva measures and
      blood concentrations were all higher than the correlations between parotid saliva
      measures and blood concentrations. In one case the higher correlation reached
      statistical significance. There was only one case in which substitution of saliva
      secretion rate improved the correlation between measures with saliva
      concentration. Our findings suggest that saliva measures of H and RH are useful
      alternatives to plasma concentrations in monitoring maintenance haloperidol
      treatment.

PMID- 1629386
TI  - A longitudinal evaluation of dexamethasone pharmacokinetics in depressed patients
      and normal controls.
AB  - Ten depressed patients and eight control subjects received 1 mg of dexamethasone
      intravenously at two different time points. Depressed patients were studied when
      they were depressed and following an improvement in their depression. In control
      subjects the first and second studies were performed approximately 1 month apart.
      Dexamethasone and cortisol were determined at 0, 5, 15, and 30 minutes, then at
      1, 1.2, 2, 3, 4, 5, 6, 7, 9, 12, 17, and 24 hours following dexamethasone
      administration. Data from each patient was fit using a computer to a two
      compartment pharmacokinetic model and area under the time versus plasma
      concentration curve, elimination half-life, and clearance were also determined.
      Depressed patients exhibited a slower dexamethasone clearance and a larger area
      under the curve than control subjects at the first time point, but not at the
      second time point. The groups did not differ significantly in any of the other
      pharmacokinetic parameters (including distribution half-life, elimination half
      life, or volume of distribution) at either time point. The possible causes and
      implications of these findings are discussed.

PMID- 1629387
TI  - Predictive value of symptoms of atypical depression for differential drug
      treatment outcome.
AB  - Data for 401 depressed outpatients with mood reactivity who participated in a
      randomized trial comparing placebo, imipramine, and phenelzine were analyzed for
      predictors of differential response by stepwise multiple regression techniques.
      Features of the Columbia criteria for atypical depression including oversleeping,
      overeating, severe anergy, and pathologic rejection sensitivity were each
      predictive of a poorer response to imipramine than to phenelzine only when
      compared to those patients with none of the features. These features were not
      additive in their contribution to differential outcome. Lack of endogenous
      features was not predictive of a differential drug treatment response. Compared
      with patients who have no symptoms of atypical depression, patients with any of
      the four features had an inferior imipramine response rather than a superior
      phenelzine response. These analyses indicate that the clear differential
      responsivity to medication treatment in atypical depression is not simply related
      to any one defining symptom and that further correlates of this apparent
      biological heterogeneity need to be explored.

PMID- 1629388
TI  - Use of drug combinations in treatment of opioid withdrawal.
AB  - During the last 10 years new approaches for rapid opioid detoxification have
      included drug combinations such as clonidine and naltrexone to speed and ease the
      transition from opioid agonist to antagonist maintenance. Other drug combinations
      include naloxone with midazolam or methohexitone for inpatients, but rapid
      outpatient methods are more desirable. Clonidine combined with naltrexone enables
      abrupt opioid withdrawal in 3-5 days in an outpatient/day setting. This approach
      can be further improved by transition to the partial agonist buprenorphine from
      either heroin or methadone followed by a 1 day detoxification using naltrexone
      precipitated withdrawal, ameliorated by clonidine.

PMID- 1629389
TI  - Investigational protocols and physician liability.

PMID- 1629390
TI  - A patient of mine missed a period while taking fluoxetine; it turned out that she
      was not pregnant. However, the question arose about the safety of fluoxetine
      during pregnancy. What is known?

PMID- 1629391
TI  - Clomipramine treatment for generalized anxiety disorder.

PMID- 1629392
TI  - A case of mania associated with high-dose baclofen therapy.

PMID- 1629393
TI  - Abnormal liver function tests associated with lithium treatment.

PMID- 1629394
TI  - Activation associated with fluoxetine therapy.

PMID- 1629395
TI  - AIDS and dentistry.

PMID- 1629396
TI  - Endodontic success: is quick and easy the answer?

PMID- 1629397
TI  - Visuotopic organization of corticocortical connections in the visual system of
      the cat.
AB  - It has recently been demonstrated that, in contrast with the
      retinogeniculocortical projection, the corticocortical connections in the cat
      present a high degree of convergence and divergence. This suggests that some
      corticocortical connections link nonvisuotopically corresponding regions. Using
      fine-grain electrophysiological mapping and anatomical tracing, we have set out
      to test this possibility by placing a small injection of retrograde tracer in
      area 17 and by comparing the extent of visual field encoded in the region of area
      18 containing labeled cells and that represented in the uptake zone. The results
      demonstrate that the size of the labeled region on the surface of area 18 is
      independent of eccentricity and that, despite its anisotrophy, this region of
      labeling encodes a broadly circular region of visual field that is larger than
      that encoded in the uptake zone of the tracer in area 17. For example, in the
      representation of lower visual field, a virtual point in area 17 that encodes a
      visual field region 4 degrees in diameter receives afferents from a region of
      area 18 encoding a region 11 degrees wide. Examination of the density of labeled
      cells in the labeled zone in area 18 reveals that the highest density is observed
      in a region in visuotopic correspondence with the injection site. However, high
      labeling density is also occasionally found in patches that do not represent the
      same visual field region as the injection site. Many receptive fields of neurons
      recorded in the labeled zone in area 18 only partially overlap or fail to overlap
      the visual field region encoded by the injection site. The results also
      demonstrate that the extent of visual field encoded in the labeled zone in area
      18 is the same as that represented in the region of intrinsic labeling in area
      17. It is suggested that cortical afferents coming from several cortical areas
      and converging on a column of cells in area 17 cover the same extent of visual
      field and that this cortical network constitutes the structural basis for the
      modulatory regions of the receptive field as well as the synchronization of
      neurons in different cortical areas.

PMID- 1629398
TI  - The selective innervation by serotoninergic axons of calbindin-containing
      interneurons in the neocortex and hippocampus of the marmoset.
AB  - The serotoninergic input to the mammalian cerebral cortex originates in the
      median and the dorsal raphe nuclei. Median raphe neurons have been previously
      shown to give rise to beaded varicose axons which form dense pericellular arrays
      (baskets) surrounding the soma and the proximal dendrites of certain cortical
      neurons. In the present study, we have searched for specific markers
      characterizing the neurons of the marmoset neocortex and hippocampus surrounded
      by these thick varicose serotonin-containing fibers. The non-pyramidal nature of
      these neurons, suggested by their dendritic arborization, was correlated, in
      immunocytochemical experiments with double-labelling to demonstrate their
      surrounding serotonin-containing basket and their content of glutamic acid
      decarboxylase (GAD) or of the calcium-binding protein calbindin. Another calcium
      binding protein common in numerous non-pyramidal cortical neurons, parvalbumin,
      was never found in neurons surrounded by serotonin-containing baskets. This
      organization was found in all areas of the neocortex and of the hippocampus where
      serotonin-containing baskets were present. One of the serotoninergic cortical
      inputs which originates from the brainstem tegmentum, traditionally described as
      "diffuse," proves to be highly selective in that a subset of its axons terminates
      preferentially on a subpopulation of inhibitory interneurons of the cerebral
      cortex. It may be emphasized that this subset of cortical interneurons has now
      been shown to be characterized not only by its axonal and dendritic arborization
      and its neurotransmitter, but also by a specific type of input which can modulate
      cortical function in a unique manner.

PMID- 1629399
TI  - Topographic organization of the cochlear spiral ganglion demonstrated by
      restricted lesions of the anteroventral cochlear nucleus.
AB  - The morphological organization of the central projections of the cat cochlear
      spiral ganglion into the cochlear nucleus has been investigated by creating
      restricted lesions in the anteroventral cochlear nucleus (AVCN) in order to
      ablate selectively either the lateral or the medial aspect of isofrequency
      projection laminae. Such lesions induced highly selective retrograde degeneration
      of spiral ganglion cells. Ablation of the lateral part of the AVCN resulted in
      degeneration of cells within the scala tympani portion of the ganglion, whereas
      medial lesions within the AVCN induced degeneration of the scala vestibuli
      portion of the ganglion. Since most, if not all, of the primary afferent axons of
      the cochlear nerve bifurcate into ascending and descending branches as they enter
      the brainstem, it is noteworthy that selective damage to the ascending branch in
      the AVCN was sufficient to induce retrograde degeneration of the spiral ganglion
      cell somata. The peripheral and central axons also degenerated, and the losses of
      both the radial nerve fibers in the osseous spiral lamina and the central axons
      passing into the modiolus displayed selective topographies that paralleled the
      cell loss within the spiral ganglion. The results of this study support our
      previous hypothesis, based upon earlier horseradish peroxidase labeling
      experiments, that there is a topographic organization to the projection of the
      spiral ganglion within the isofrequency laminae that is orthogonal to the
      frequency representation within the ventral cochlear nuclei (VCN). That is, in
      addition to the spiral frequency organization of the ganglion, represented by the
      dorsal-to-ventral frequency map in the VCN, there is also an orderly and
      sequential distribution of inputs from the vertical (scala tympani-to-scala
      vestibuli) dimension of the spiral ganglion across the lateral-to-medial axis of
      the VCN. The interaction of these two topographic representations, distributed
      across the three dimensions of the VCN, must partly define the selective and/or
      integrative neuronal response properties at this first level of central nervous
      system processing of auditory signals within the cochlear nuclei.

PMID- 1629400
TI  - Rapid changes in protein synthesis and cell size in the cochlear nucleus
      following eighth nerve activity blockade or cochlea ablation.
AB  - Destruction of the cochlea causes secondary changes in the central auditory
      pathway through transynaptic regulation. These changes appear to be mediated by
      an activity-dependent process and can be detected in the avian auditory system as
      early as 30 minutes after deafferentation. We compared the early changes in
      cochlear nucleus neurons following deafferentation by cochlea ablation with those
      seen following activity deprivation by perilymphatic tetrodotoxin (TTX) exposure.
      Protein synthesis and size of large spherical cells in the anteroventral cochlear
      nucleus (AVCN) of 14-day-old gerbils were measured during the first 48 hours
      after the manipulations. Both cochlea ablation and TTX produced a reliable
      decrease in protein synthesis by AVCN neurons (30-40%) by 1 hour. The magnitude
      of change in tritiated leucine incorporation was similar at all survival times,
      in both experimental groups. In contrast to the rapid changes in protein
      synthesis, the decrease in cell size was first evident 18 hours after TTX
      exposure and 48 hours after cochlea ablation. There was no significant change in
      protein synthesis or cell size in control groups at any of the survival times.
      These findings are consistent with changes in the avian auditory system in
      response to deafferentation and TTX exposure. Cochlea ablation and TTX exposure
      induced similar transneuronal changes, supporting the hypotheses that activity of
      auditory afferents in young mammals plays a regulatory role in the metabolism and
      morphology of their target neurons in the central auditory pathway, and that
      early changes following destruction of the peripheral receptor are due to
      reduction of activity-dependent interactions of presynaptic and postsynaptic
      cells.

PMID- 1629402
TI  - Light-dependent plasticity of the synaptic terminals of Mb bipolar cells in
      goldfish retina.
AB  - We recently described spine-like protrusions (spinules) from the synaptic
      terminals of mixed rod-cone (Mb) bipolar cells of goldfish retina that
      invaginated about 5% of the presynaptic amacrine cell processes (Yazulla and
      Studholme, J Comp Neurol 310:11, 1991). In view of reports of a light/dark
      dependent-plasticity on the formation of dendritic spinules on goldfish
      horizontal cells (Raynauld et al., Science 204:1436, 1979; Wagner, J Neurocytol
      9:573, 1980), we investigated the possibility that Mb terminal spinules also
      might show light/dark-dependent plasticity. Retinas were obtained at noon time
      from light-adapted and 3-hour dark-adapted goldfish and processed for electron
      microscopy using conventional histological procedures and by preembedding
      immunocytochemistry to detect protein kinase C immunoreactivity. Two effects of
      light adaptation on Mb terminal morphology were observed. First, the surface of
      Mb terminals was significantly more irregular after dark adaptation than light
      adaptation. With dark adaptation, Mb terminals appeared "amoeboid," with numerous
      cytoplasmic extensions between the presynaptic processes. Second, spinules were
      sevenfold more frequent after dark adaptation than light adaptation (8% vs. 1.2%
      of the presynaptic processes were invaginated by spinules). We suggest that the
      increased frequency of spinules during dark adaptation is related to an
      enhancement of synaptic transmission from a minor amacrine cell input when the
      major input from GABAergic amacrine cells is reduced. Also, the irregular surface
      of dark-adapted Mb terminals may be related to the reduction of synaptic input
      during dark adaptation.

PMID- 1629401
TI  - Ascending general visceral pathways within the brainstems of two teleost fishes:
      Ictalurus punctatus and Carassius auratus.
AB  - The primary general visceral nucleus in goldfish (Carassius auratus) and catfish
      (Ictalurus punctatus) is located at the ventroposterior boundary of the vagal
      gustatory lobe and receives coelomic visceral, but not gustatory inputs. The
      neuronal tracer horseradish peroxidase (HRP) was employed to visualize sources of
      input to and ascending projections from the primary general visceral nucleus in
      these species. In addition, immunocytochemical techniques were utilized to define
      the cytological divisions within the pontine gustatory-visceral complex. The
      pontine secondary visceral nuclei in both catfish and goldfish contains numerous
      somata and fibers immunoreactive for calcitonin gene-related peptide (CGRP). In
      contrast, the secondary gustatory nuclei are devoid of fibers and cells
      immunoreactive for CGRP. In both the goldfish and the channel catfish, the
      primary general visceral nucleus receives input from the vagal gustatory lobe, as
      well as the medullary reticular formation. In the channel catfish, the primary
      general visceral nucleus projects bilaterally to the secondary visceral nucleus,
      which lies rostrolateral to the secondary gustatory nucleus in the dorsal pons.
      Fibers cross the midline via the rostral part of the isthmic commissure.
      Injection of HRP into the primary general visceral nucleus of a goldfish labels
      ascending fibers that project to a secondary visceral nucleus situated ventral,
      lateral, and rostral to the secondary gustatory complex. In general, the results
      indicate that general visceral systems ascend in parallel to gustatory systems
      within the brainstem, and that general visceral but not gustatory nuclei are
      immunoreactive for the peptide CGRP.

PMID- 1629403
TI  - Calcitonin gene-related peptide in nucleus ambiguus motoneurons in rat:
      viscerotopic organization.
AB  - Calcitonin gene-related peptide has been reported in the rat nucleus ambiguus.
      This nucleus comprises a dorsal division that is the source of special visceral
      efferents innervating the striated muscle of the upper alimentary tract and a
      ventral division supplying general visceral efferents primarily to the heart. The
      distribution of calcitonin gene-related peptide immunoreactive neurons in the two
      divisions was determined by using a combination of immunocytochemical techniques
      and fluorescent retrograde tracing. In 22 rats, injections of Fluoro-Gold were
      made into either the supranodosal vagus nerve, palatopharynx, larynx, esophagus,
      or heart. Following colchicine injection, medullary sections were processed
      immunocytochemically for calcitonin gene-related peptide. Injection of Fluoro
      Gold into the supranodosal vagus resulted in prominent labeling of neurons in the
      dorsal and ventral divisions of the nucleus ambiguus. The majority of fluorescent
      labeled neurons in the dorsal division were found to be immunoreactive for
      calcitonin gene-related peptide, while those labeled neurons in the ventral
      division were unreactive for the peptide. With esophageal, and palatopharyngeal
      and cricothyroid injections, many fluorescent labeled neurons that were
      immunoreactive for calcitonin gene-related peptide were found respectively in the
      compact and semicompact formations of the dorsal division. In contrast,
      injections of the heart resulted in fluorescent labeled neurons, which were
      unreactive for calcitonin gene-related peptide, localized to the external
      formation. The results demonstrate that calcitonin gene-related peptide
      immunoreactive neurons are localized entirely to the dorsal division of the
      nucleus ambiguus and that all striated muscular areas of the alimentary tract are
      innervated by calcitonin gene-related peptide containing motoneurons. The
      localization of calcitonin gene-related peptide to vagal motoneurons also known
      to contain acetylcholine and the increase in acetylcholine receptor synthesis
      caused by this peptide suggest that calcitonin gene-related peptide acts as a
      cotransmitter with acetylcholine in special visceral efferent vagal motoneurons.

PMID- 1629404
TI  - MRI of intracranial neurovascular compression.
AB  - Twelve patients with clinical indications of intracranial neurovascular
      compression (6, hemifacial spasm; 4, trigeminal neuralgia; 2, vertigo and
      tinnitus) were studied by MRI. Axial 1 mm thick slices were obtained in a 1.5 T
      unit using a three-dimensional (3D) fast low angle shot data set of 32 contiguous
      slices. The data were post-processed with multiplanar reconstruction algorithms
      to obtain oblique sagittal (along the long axis of a nerve) images or coronal
      images with a slice thickness of 0.8 mm. The MR angiographic images were also
      obtained from the same 3D data set with maximum intensity projection algorithms.
      The MR studies showed that 9 of 12 patients had neurovascular compression caused
      by one or two arteries. These findings were verified at surgery. In two of the
      remaining three patients, MRI failed to delineate the affected nerves compressed
      by a vein in one, and a previously applied prosthesis in the other. In the last
      patient no neurovascular compression was found by MRI or at surgery.

PMID- 1629405
TI  - High signal regions in normal white matter shown by heavily T2-weighted CSF
      nulled IR sequences.
AB  - Inversion recovery (IR) sequences with an inversion time (TI) designed to
      markedly reduce or null the signal from CSF (TI of approximately 2,100 ms at 1.0
      T) and a very long echo time (TE) of 240 ms were used to image the brain of two
      normal adult volunteers, one 34-year-old man with an intrinsic tumor, and one 3
      month-old infant with an infarct. Using these very heavily T2-weighted pulse
      sequences, adult gray and white matter showed similar signal intensity in many
      areas of the brain, but normal white matter in regions of the centrum semiovale,
      posterior internal capsule, parietopontile tract, occipitothalamic radiation, and
      brain stem showed a much higher signal intensity than surrounding gray or white
      matter. The infant displayed a low signal intensity in myelinated regions in the
      internal capsule and occipitothalamic radiation and a high signal in unmyelinated
      white matter. In many of the images there were strong similarities to the
      distribution of high signal within white matter seen with pulsed gradient spin
      echo sequences (TE 130 ms) designed to demonstrate effects due to anisotropic
      diffusion. Arguments are advanced to support the view that the high signal
      intensity in white matter tracts is due to one or more long T2 components that
      may be associated with unmyelinated or sparsely myelinated fibres within white
      matter. The resemblance to diffusion weighted images may reflect the fact that
      both employ long TEs and both produce a low signal from CSF. If myelin possessed
      a different susceptibility from axoplasm so that magnetic field gradients were
      generated around nerve fibres when their orientation was not parallel to B0,
      diffusion of water might then produce the observed dependence on fibre direction.
      The high signal regions in white matter are a potential source of confusion in
      image interpretation, and measurements of T2 in white matter need to be made with
      these regional variations in mind. The concept of normal appearing white matter
      also needs to be applied with a knowledge of these differences. The IR sequences
      used in this study provide a very high T2 dependence with a low signal from CSF
      and may be useful for detecting disease in the CNS of adults and children.

PMID- 1629406
TI  - Intravoxel incoherent motion (IVIM) MRI in intracranial, extraaxial tumors and
      cysts.
AB  - Intravoxel incoherent motion MRI was used to assess six intracranial, extraaxial
      cysts and tumors including two epidermoids, two cystic acoustic schwannomas, and
      two arachnoid cysts. A maximum gradient strength of 0.7 g/cm was used
      simultaneously along all axes (maximum gradient beta value: 445 s/mm2) and
      comparisons were made with an external water phantom. In epidermoid tumors the
      apparent diffusion coefficient (ADC) was similar to that of normal brain, thus
      indicating their solid nature. In acoustic schwannomas an ADC similar to the
      external water phantom indicated cystic components, whereas an ADC similar to
      brain was found in the solid portions of the tumor. The ADC of arachnoid cysts
      was similar to that of the water phantom, indicating their fluid nature. Due to
      macroscopic CSF flow, cisternal CSF showed high ADC, which enabled epidermoid
      tumors to be highlighted.

PMID- 1629407
TI  - Volume of pituitary macroadenomas: assessment by MRI.
AB  - A phantom study was performed to assess the accuracy of MRI in volume
      determination of pituitary macroadenomas, using the summation of areas technique.
      Five phantoms, 3-4 cm in diameter, simulating pituitary macroadenomas of various
      shapes, were evaluated. The volume could adequately and reproducibly be
      determined, regardless of minor rotational variations of the phantom position.
      Using a three-dimensional SE sequence with 2.5 mm slices, the error was
      independent of the shape of the phantom and did not differ significantly from
      zero (less than 5%); this sequence was found to be the best of those tested. The
      coefficient of variation between examinations with different tilts was 2%. In a
      clinical part, the volume of pituitary macroadenomas was determined with the same
      technique on coronal two-dimensional 5 mm images and was used as a "gold
      standard" to which the largest transverse, sagittal, vertical, and oblique
      diameters, a central tumor area, and the product of the three orthogonal
      diameters were correlated. In interpatient comparisons the largest diameter was
      found to be useful, but only as a rough measure of the tumor size. The formula
      0.5 x width x length x height provided a fairly adequate estimation of the tumor
      volume, except in the largest tumors. In intrapatient comparisons during
      bromocriptine treatment, the height was found to be the best of the diameters,
      but the central tumor area or the product of the orthogonal diameters was
      preferable.

PMID- 1629408
TI  - CNS mycosis fungoides: CT and MR findings.
AB  - Mycosis fungoides (MF) is a malignant T-cell lymphoma that primarily involves the
      skin, but may, in its advanced stages, metastasize to internal organs. From
      autopsy series, CNS involvement of MF can be seen in 14% of patients. We describe
      the CT and MR findings in three patients with CNS metastases. The images showed
      various manifestations of CNS MF, including parenchymal homogeneously intensely
      enhancing masses and ependymal enhancement. The CSF and biopsy results were
      eventually diagnostic in all three cases. One patient was treated prior to
      pathologic diagnosis, the other two were treated after diagnosis. The tumor
      improved following treatment in two patients. Although the imaging findings of
      CNS MF are nonspecific, they can be the first evidence of the disease.

PMID- 1629409
TI  - Spontaneous subarachnoid hemorrhage with negative angiography: CT findings.
AB  - Computed tomography of 31 patients with spontaneous subarachnoid hemorrhage (SAH)
      but negative angiography was evaluated to find out whether the pattern of SAH as
      seen in CT offers indications for a possible reexamination with angiography.
      Based on the distribution and the amount of SAH, classification into three groups
      was possible: (a) 18 cases, normal CT (but blood in the CSF, gained by lumbar
      puncture) or SAH in the basal cisterns only; repeat angiography was negative in
      all these cases; (b) nine cases, SAH in the basal cisterns as well as in one or
      both Sylvian fissures; in addition, small amounts of blood in the
      interhemispheric fissure and/or in the sulci; repeat angiography revealed an
      aneurysm in one of these cases; (c) four cases, large quantities of blood in all
      subarachnoid spaces; in all but one of these cases a vascular lesion was
      visualized with repeat angiography or verified at autopsy. In conclusion, repeat
      angiography is mandatory in cases with SAH patterns that can be classified into
      group b or c, whereas it can be omitted in patients with small amounts of blood
      confined to the basal cisterns.

PMID- 1629410
TI  - Proton MR spectroscopy of the brain in AIDS dementia complex.
AB  - Proton MR spectroscopy of the brain has been undertaken in 8 healthy volunteers
      and in 11 patients with human immunodeficiency virus infection and varying stages
      of AIDS dementia complex (ADC). Spectral appearances in patients with no ADC or
      early ADC were not significantly different from normal volunteers. Spectra from
      patients with moderate to severe ADC exhibited significant reductions in levels
      of N-acetyl aspartate (NAA) relative to creatine (Cr) and also showed elevations
      in choline containing compounds (relative to Cr). Because NAA is though to be a
      metabolic marker for normally functioning neurons, these findings suggest the
      presence of neuronal injury or loss in moderate to severe ADC. The significance
      of these findings is discussed.

PMID- 1629411
TI  - Proton MR spectroscopy of experimental radiation-induced white matter injury.
AB  - We studied the spectroscopic appearance of radiation-induced myelinolysis in cats
      to understand the characteristics of proton MR spectroscopy of demyelinating
      disorders. Eight cats received 5,000 rads to a 1.5 x 1.5 cm area of the right
      cerebral hemisphere. Eight to 9 months after irradiation, a gross area of
      abnormal postcontrast enhancement and/or high MR signal intensity was detected in
      the irradiated hemisphere of six of the eight cats. Proton spectra of a 1.0 cm3
      voxel in the affected region demonstrated depressed N-acetyl aspartate/creatine
      phosphocreatine and N-acetyl aspartate/choline-containing compound peak ratios
      compared with the contralateral non-irradiated brain in all cats. Elevated amino
      acid resonances in the 2.0-2.5 ppm range were not consistently seen in irradiated
      zones of the brain with pathologic findings of demyelination. In vivo proton MR
      spectroscopy may show differences between irradiated brain and nonirradiated
      brain even when histopathologic lesions are not apparent yet.

PMID- 1629412
TI  - MRI of the gastroepiploic artery used as a bypass graft.
AB  - The right gastroepiploic artery (RGEA) is recognized for its long-term patency as
      a coronary artery bypass graft, a property shared with the internal thoracic
      artery. The usefulness of MRI for noninvasive visualization and evaluation of the
      RGEA graft was assessed using a spine coil as the surface coil in 14 patients
      with graft patency verified by postoperative angiography. The graft was
      visualized by spin-echo imaging as a signal-void surrounded by lipomatous tissue
      with high-signal intensity in all 14 cases. Cine MRI was also performed in 13 of
      the 14 patients; in each case the graft was confirmed to contain blood flow of
      high-signal intensity.

PMID- 1629413
TI  - Evaluation of the pulmonary artery by cine MRI.
AB  - Twenty-four patients whose mediastinal (12 patients) and lung (12 patients)
      neoplasms were eventually verified were evaluated with cine MRI in addition to
      conventional methods (plain radiography, CT, MRI, and endoscopy). Using a 1.0 T
      system and gradient echo (FLASH repetition time 250-350 ms, echo time 12, flip
      angle 25-60 degrees) multislice pulse sequence, cine MRI was performed combined
      with cardiac gating. At the level of the pulmonary artery, the CT, spin echo (SE)
      MRI, and cine MRI findings were evaluated blindly by three groups of radiologists
      to determine whether the pulmonary artery was infiltrated or dynamically
      stenotic. Cine MRI allowed an overall diagnostic accuracy of 100% in comparison
      with SE MRI (91.6%) and CT (91.6%).

PMID- 1629414
TI  - CT of crack cocaine ingestion.
AB  - The imaging findings of a crack cocaine "body stuffer" are presented along with
      findings from in vitro experimentation with crack cocaine. It has been shown
      previously that contrast enhanced radiographic examinations can often outline the
      vessel in which ingested cocaine is contained; our work demonstrates that the
      crack cocaine itself may be visualized with CT performed without intravenous or
      oral contrast material. Due to the cost of CT, however, it is indicated only when
      clinically warranted to guide treatment. Positive identification of ingested
      crack cocaine by CT might prove helpful for both medical and legal indications.

PMID- 1629415
TI  - Periportal high intensity on T2-weighted MR images in acute viral hepatitis.
AB  - The frequency and degree of periportal high intensity (PHI) on T2-weighted images
      in 28 patients (32 MR studies) with acute viral hepatitis were analyzed with
      regard to the various levels of serum glutamic-oxaloacetic transaminase (SGOT)
      and clinical phases. Periportal high intensity was found in 16 of 32 MR studies
      (50%) and no definite PHI was found in 7 studies (22%). Periportal high intensity
      appeared when the SGOT level was greater than 500 IU or when the phase of the
      disease was early. Follow-up studies revealed that PHI decreased during clinical
      recovery. We conclude that the degree of PHI on T2-weighted images reflects the
      severity of the disease in acute viral hepatitis.

PMID- 1629416
TI  - CT of melanoma liver metastases: is the examination without contrast media
      superfluous?
AB  - The current method of evaluating hypervascular liver metastases with CT includes
      both contrast enhanced and unenhanced studies. The necessity of performing both
      examinations for the detection of liver metastases in the workup of malignant
      melanoma has not been specifically addressed. This study evaluates potential
      additional information derived from an unenhanced examination of the liver. We
      studied 55 patients with malignant melanoma who had both contrast enhanced and
      unenhanced CT examinations performed during the workup and staging of their
      disease. Sixteen patients had 89 measurable liver lesions seen on enhanced CT.
      Three patients had liver lesions that were too numerous to accurately measure.
      Unenhanced CT demonstrated only 62% of the measurable lesions. All liver lesions
      seen on the unenhanced images were identified on the enhanced studies. Only one
      metastasis was found to be comparatively smaller on the enhanced examinations.
      The unenhanced examinations detected no additional lesions. It is reasonable to
      perform only an enhanced examination during the workup and staging of malignant
      melanoma liver metastases.

PMID- 1629417
TI  - CT and MRI of siderotic regenerating nodules in hepatic cirrhosis.
AB  - The demonstration by CT of siderotic regenerating liver nodules in cirrhosis was
      evaluated and compared with that of MR imaging retrospectively in 27 patients
      with histologically diagnosed hepatic cirrhosis. Only in one of the two patients
      with marked iron deposits in regenerating nodules did CT demonstrate multiple
      high density nodules. In the other patient with marked iron deposits and in seven
      of the nine patients with moderate iron deposits, the liver parenchyma on CT was
      demonstrated as heterogeneous and of slightly high density without focal nodules.
      In 8 patients with mild to moderate iron deposits and in the 10 with no iron
      deposits, the liver parenchyma was homogeneous on CT. Multiple low intensity
      nodules in the liver were seen on fast low-angle shot (FLASH) MR images in all 17
      patients with iron deposits in regenerating nodules. No low intensity nodules
      were seen on FLASH MR images in the 10 patients with no iron deposits. If there
      are iron deposits above a certain level, siderotic regenerating nodules may
      appear as nodules of high density on CT or as heterogeneous regions of high
      density liver parenchyma. Magnetic resonance is more sensitive than CT in
      demonstrating siderotic regenerating nodules.

PMID- 1629418
TI  - CT of parapelvic cystic renal cell carcinoma.
AB  - Parapelvic renal cysts are benign ubiquitous lesions of the renal sinus
      frequently demonstrated on CT and ultrasonography. Occasionally a renal
      parenchymal mass will grow so that its epicenter is within the renal sinus. We
      report two cases of surgically proven cystic renal cell carcinoma centered in the
      renal sinus with no apparent connection to the renal parenchyma. Cystic renal
      cell carcinoma must be excluded whenever a parapelvic cyst with atypical features
      is encountered on cross-sectional imaging studies.

PMID- 1629419
TI  - The reliability of radiologists' quality assessment of MR pelvic scans.
AB  - The purpose of this study was to test the reliability of radiologists' subjective
      assessment of the quality of MR scans of the pelvis. A four-grade ordinal
      subjective scale, based on the degree of artifact and contrast between pelvic
      organs, was developed in a pilot study by two MR radiologists. Forty pelvic scans
      were graded "blindly" in random order by the same two "practiced" MR
      radiologists, and an objective measurement of scan artifact was obtained for each
      scan. Twenty-eight pelvic scans were also graded by two "unpracticed"
      radiologists not involved in the development of the scale. For the practiced
      radiologists, the interobserver percentage agreement was 80% (weighted kappa of
      0.78) and the intraobserver percentage agreement was 75% (weighted kappa of
      0.73). For the unpracticed radiologists the percentage agreement was 61% and the
      weighted kappa was 0.55. The correlation between the subjective and objective
      measurement was only 0.27. In conclusion, the objective measurement of scan
      artifact showed poor correlation with the radiologists' subjective assessment of
      scan quality. The subjective assessment demonstrated satisfactory reliability
      and, therefore, could be considered as an additional outcome measurement for scan
      quality in clinical trials or as a relevant measure of quality assurance.

PMID- 1629420
TI  - Knee joint hyaline cartilage defects: a comparative study of MR and anatomic
      sections.
AB  - The value of routinely used MR sequences in the detection of focal changes of
      femorotibial articular cartilage was studied. T1-weighted, proton density, and T2
      weighted SE as well as gradient echo images were acquired in 20 cadaveric knees
      (56-88 years old, mean 73.8 years). Three hundred five coronal and sagittal (3
      mm) anatomic sections were prepared, and 82 areas of cartilage defects were
      identified. Initially, in an unblinded fashion, correlation of MR scans and
      anatomic sections was performed. Fifty-nine lesions (72.0%) were detectable on T1
      weighted images, 57 (70.0%) with meniscal windowing, 49 (60.0%) on proton density
      images, 56 (68.3%) on T2-weighted images, and 54 (65.9%) on gradient echo images.
      Sixty-eight (83.0%) were visible on at least one type of imaging sequence. Most
      defects presented as a focus of abnormal signal. Subsequently, images of a subset
      of 35 pathologic and 35 normal cartilage surfaces were blindly evaluated by two
      osteoradiology fellows. Sensitivity was 71.4% for the detection of focal
      cartilage changes, specificity was 68.6%, and accuracy was 70.0%. We conclude
      that the value of those MR sequences that are routinely used in the analysis of
      internal derangements of the knee in the detection of focal defects of the
      hyaline cartilage is limited.

PMID- 1629421
TI  - MRI of patellar tendon anterior cruciate ligament autografts.
AB  - Twenty-one MR examinations were performed in 15 patients with clinically stable
      knees after arthroscopic anterior cruciate ligament (ACL) reconstruction with
      patellar bone-tendon-tibial bone autografts. The postoperative interval ranged
      from 3 months to 3 years 3 months (average 9.5 months). Proton- and T2-weighted
      sagittal images with axial and oblique sagittal T1-weighted images were obtained.
      The MR appearance of the autografts was categorized depending on distribution of
      dark signal band into type 1 (continuous, two patients), type 2 (proximal half,
      eight patients), type 3 (distal half, two patients), and type 4
      (nonvisualization, three patients). There was no change in appearance of the
      grafts in those who had a second imaging within 1 year postoperatively. We
      conclude that the normal ACL autograft has a variable appearance and that
      criteria used in evaluating the native ligament is inadequate to assess the
      autografts.

PMID- 1629422
TI  - Bone metastases from breast cancer: value of CT bone windows.
AB  - A pilot study was organized to compare the utility of scintigraphy, radiographic
      bone surveys, and conventional CT bone windows (CTBWs) in judging therapeutic
      response of bone lesions in patients with metastatic breast carcinoma. Twenty-six
      patients with stage IV disease and documented bone metastases were evaluated over
      a 2 year period. Discordance in the assessment of therapeutic response was
      greatest (56% discordance) between bone scans (BSs) and conventional CTBWs. In
      77% of the discordant observations, the assessment by conventional CTBWs agreed
      with the patients' clinical response to therapy. Our preliminary results suggest
      that posttherapy review of conventional CTBWs provides useful clinical
      information about therapeutic response and exceeds the contribution of BSs in
      this regard.

PMID- 1629423
TI  - MRI and ultrasound detection of asymptomatic thyroid nodules in
      hyperparathyroidism.
AB  - A retrospective MRI and ultrasound (US) study of 50 patients with
      hyperparathyroidism and no history of thyroid disease was done. The purpose was
      to compare the sensitivity of both methods in the detection of asymptomatic
      thyroid nodules, as well as to determine the prevalence of thyroid abnormalities
      in patients with hyperparathyroidism. All the patients underwent MR and 33 were
      also studied by high-resolution US. Magnetic resonance imaging was performed on a
      1.5 T unit, using T1-(500-700/20) and T2-(2,000/20 and 70) weighted images. Axial
      sections (5 mm with a 1 mm interval between them) were obtained along the neck.
      Ultrasonography was performed using a 10 MHz linear array transducer. The
      prevalence of thyroid nodules was 46% in the 50 patients studied by MR imaging.
      In the subgroup of patients studied by both methods, US depicted nodules in 48%
      of patients, and MR depicted nodules in 45%. Magnetic resonance imaging and US
      detected a high frequency of thyroid nodules in patients with
      hyperparathyroidism. This high frequency makes the detection of an intrathyroidal
      parathyroid adenoma problematic.

PMID- 1629424
TI  - Rapid automated algorithm for aligning and reslicing PET images.
AB  - A computer algorithm for the three-dimensional (3D) alignment of PET images is
      described. To align two images, the algorithm calculates the ratio of one image
      to the other on a voxel-by-voxel basis and then iteratively moves the images
      relative to one another to minimize the variance of this ratio across voxels.
      Since the method relies on anatomic information in the images rather than on
      external fiducial markers, it can be applied retrospectively. Validation studies
      using a 3D brain phantom show that the algorithm aligns images acquired at a wide
      variety of positions with maximum positional errors that are usually less than
      the width of a voxel (1.745 mm). Simulated cortical activation sites do not
      interfere with alignment. Global errors in quantitation from realignment are less
      than 2%. Regional errors due to partial volume effects are largest when the
      gantry is rotated by large angles or when the bed is translated axially by one
      half the interplane distance. To minimize such partial volume effects, the
      algorithm can be used prospectively, during acquisition, to reposition the
      scanner gantry and bed to match an earlier study. Computation requires 3-6 min on
      a Sun SPARCstation 2.

PMID- 1629425
TI  - Simultaneous display of multiple MR parameters with "quantitative magnetic color
      imaging".
AB  - A new technique for simultaneous display of multiple MR parameters with a single
      color-coded image is described. The method is based on the multiparametric nature
      of MR signals and benefits from the physiologic ability to discriminate color
      levels better than gray levels. The T1 and T2 relaxation rate maps are first
      obtained from multi-echo SE and partial saturation sequences. Each parameter is
      subsequently represented with one or with a combination of two fundamental colors
      (red, green, blue) into a composite quantitative magnetic color image. Each
      mixture of chromatic components in the magnetic color image represents a unique
      combination of the two relaxation parameters, easily interpretable by the human
      eye, without loss of anatomic information. The potential advantages of the
      technique are discussed and some practical applications are presented.

PMID- 1629426
TI  - MRI of absent left pulmonary artery.
AB  - Unilateral absence of a pulmonary artery, more accurately referred to as
      unilateral proximal interruption of a pulmonary artery, is a rare congenital
      anomaly that may occur as an isolated lesion or in association with other
      congenital cardiovascular abnormalities. Diagnosis of associated lesions is
      imperative as early detection and intervention may significantly improve the
      patient's prognosis. We present the case of an adult patient who had come to our
      attention after suffering neurological decompression illness related to scuba
      diving. The patient's cardiopulmonary anatomy was evaluated using MRI gated spin
      echo, cine, and breath-held fast spoiled recalled echo sequences.

PMID- 1629427
TI  - Usefulness of multiangle MRI in aortic arch dissection.
AB  - A multiangle scan technique was used in combination with usual spin echo and cine
      MR techniques to study a patient with aortic arch dissection. The intimal flap
      was seen with each technique and the jet into the entry site was observed with
      cine MR technique. Exact short axis images of aortic arch were obtained only with
      multiangle scan. Retrograde dissection and involvement of left subclavian artery
      were detected clearly on the short axis images.

PMID- 1629428
TI  - High attenuation mucous plugs in allergic bronchopulmonary aspergillosis: CT
      appearance.
AB  - Allergic bronchopulmonary aspergillosis is an immunologic disease characterized
      by bronchiectasis and recurrent mucous plugging in asthmatics. The usual CT
      appearance is that of low attenuation branching structures corresponding to
      impacted dilated bronchi. We report a patient with allergic bronchopulmonary
      aspergillosis and mucous plugging manifested by high attenuation structures on
      CT. A follow-up examination demonstrated resolution of the mucous secretions and
      residual bronchiectasis. Possible etiologies for this CT appearance are
      discussed.

PMID- 1629429
TI  - CT of pseudohydronephrosis: hydroureter in a weight lifter.
AB  - A case of bilateral pseudohydronephrosis and hydroureter produced by markedly
      hypertrophied psoas muscles in a weight lifter is presented. Plain film and CT
      findings of the case are discussed together with the topographic anatomical
      explanation of the radiologic findings.

PMID- 1629430
TI  - Diffusely calcified renal cell carcinoma: CT features.
AB  - Calcifications of renal masses are common. They are usually dense, partial,
      small, punctate, and linear opacities. Diffuse calcification is an extremely rare
      feature of renal masses. Generally, calcified renal cell carcinomas are
      hypovascular, with calcifications in the interstitium, and they also contain
      fibrotic capsules, necrotic areas, or hyalinization. We recently observed a renal
      neoplasm with diffuse calcification on CT and intermediate vascularity on
      angiography, which was diagnosed histologically as renal cell carcinoma, clear
      cell type. Interestingly, there were numerous calcific deposits within the tumor
      cells.

PMID- 1629431
TI  - Pelvic Castleman disease: CT and MR appearance.
AB  - The localized form of Castleman disease is rare and of unknown origin. Pelvic
      location of the disease is unusual. We report the CT and MR appearance of a case
      of pelvic Castleman disease presenting with characteristic calcifications and
      hypervascularity.

PMID- 1629432
TI  - MRI of sarcoid spondylodiskitis.
AB  - We report the MR appearance of a rare case of sarcoidosis of the spine presenting
      as spondylodiskitis. Vertebral and disk signal changes were typical for diskitis.
      In the appropriate clinical setting the differential diagnosis of diskitis should
      include sarcoidosis.

PMID- 1629433
TI  - Pyogenic granuloma gravidarum of the nasal fossa: CT features.
AB  - We present a case of a pregnant patient with a rapidly growing mass within the
      nasal fossa that was imaged by CT 2 weeks postpartum. Concern for malignancy
      existed and biopsy was performed, revealing pyogenic granuloma gravidarum. This
      uncommon lesion should be considered in any gravid patient when a mass occurs
      within the mouth or nasal fossa.

PMID- 1629434
TI  - MRI of concurrent spinal meningioma, ependymoma, and syringomyelia.

PMID- 1629435
TI  - Absent medial segment of the left hepatic lobe: CT appearance.

PMID- 1629436
TI  - CT-guided suprasternal approach for mediastinal biopsy.
AB  - A case involving the use of the suprasternal approach for CT-guided biopsy of
      small retrosternal lesions is discussed, with the mention of some technical
      details.

PMID- 1629437
TI  - Health: always under attack.

PMID- 1629438
TI  - Measurement of preventive resin restorations using computer profilometry.
AB  - The amount of extracoronal material placed when a tooth is restored with a
      preventive resin restoration (PRR) was quantitatively measured together with the
      projected area of each cavity preparation. Thirty-three patients (mean age 11
      yrs, 6 mos) requiring a PRR on a lower first permanent molar were selected.
      Impressions of the teeth were made with polyvinylsiloxane before and after cavity
      preparation and then restored with P-50 and Concise sealant. Following occlusal
      adjustment, a third impression was taken. Replicas were digitized using computer
      profilometry. Computer images of occlusal surfaces were superimposed using a
      "goodness of fit" method. The volume of extracoronal material placed on all molar
      teeth (n = 33) was X = 6.52 +/- 2.9 mm3. The mean depth applied was X = 222.52 +/
      83.09 mu and the mean area of material applied over the entire tooth surface was
      X = 27.13 +/- 5.72 mm2. The cavity preparations occupied, on average 19.02
      percent of the occlusal surface.

PMID- 1629439
TI  - Dental erosion associated with asymptomatic gastroesophageal reflux.
AB  - An eight-year-old girl presented with severe erosion of the primary dentition and
      early erosion of the erupted permanent teeth. Although the pattern of erosion was
      consistent with that seen with acid erosion, the diagnosis could not be
      elucidated from the patient's symptoms, or medical or dental history. A 24-hour
      pH probe study documented severe gastroesophageal acid reflux. Oral salivary pH
      tested during sleep nightly for one week revealed low oral pH. Treatment with
      metoclopramide and ranitidine was instituted to decrease acid availability for
      reflux. Custom-fitted, maxillary and mandibular trays were fashioned to deliver
      sodium fluoride gel twice daily, and fissure sealants were placed in the hopes of
      retarding erosion of existing permanent teeth, as well as preventing similar
      erosion of erupting permanent dentition.

PMID- 1629440
TI  - Mesiodens in the primary dentition stage: a radiographic study.
AB  - Five hundred and forty-three Chinese patients in the primary dentition stage were
      evaluated for mesiodens with maxillary, anterior occlusal films. Compared with
      other studies, a higher prevalence was found, using different age-groups and
      diagnostic methods. The distributions of mesiodens by sex, location, and
      direction were also studied. Because mesiodens could interfere with normal
      development of the occlusion, especially in the early mixed dentition stage,
      early diagnosis, using appropriate radiographs during the primary dentition
      stage, could lead to more comprehensive treatment planning.

PMID- 1629441
TI  - Multispecialty team management of a case with impacted maxillary permanent
      canines.
AB  - A fifteen-year-old Chinese girl presented with unerupted maxillary permanent
      canines impacted against the roots of the central incisors, causing malalignment
      of the maxillary incisors. The canines were fully formed and their apices closed.
      The potential path of eruption of the canines contraindicated surgical exposure,
      followed by orthodontic traction. It was decided to transplant the impacted
      canines to their normal positions, and then align the maxillary anterior teeth,
      using a fixed orthodontic appliance. The transplantations and the orthodontic
      treatment were successful, and neither transplant showed signs of root
      resorption, periodontal pockets, mobility, or pain, three years after surgery.
      Root canal therapy was performed on the canines after transplantation, because
      their apices were closed. They were stained by the amalgam in the access
      cavities, but both responded well to nonvital bleaching using 30 percent H2O2.

PMID- 1629442
TI  - Midline correction by extraction of the remaining mandibular canine: myth or
      reality.
AB  - Standard of practice does not always equal standard of care. When faced with a
      problematic situation, the dentist will either treat from experience, or else
      depend on what has been suggested by others. In some cases, anecdotal information
      may not be applicable. Recommended clinical procedures have not always been
      supported by adequate research. Although midline correction has been expressed as
      a certainty, it does not always occur. Patience on the part of the practitioner
      will allow the child to be observed periodically, and at the same time allow the
      dentition to develop naturally. Orthodontic treatment can always be used, once
      the permanent canines erupt.

PMID- 1629443
TI  - "Rediscovering" the health status of Native Americans.
AB  - The demographic and health characteristics of the Native American population
      differ from those of the general population. A review is provided for concerned
      pediatric dental practitioners.

PMID- 1629444
TI  - Hispanic children: an increasing reality in pediatric dental practice.
AB  - By the end of the current decade, the 11.5 million Hispanic children (less than
      eighteen years of age) in the United States will represent the largest population
      of minority children. Almost 48 percent of all Hispanic persons living in poverty
      were children (1989). Data show great need for dental care among these people,
      with only limited access to adequate care.

PMID- 1629445
TI  - Root canal filling materials for primary teeth: a review of the literature.
AB  - In summary, there is no known ideal root canal filling material for primary
      teeth. The closest to the ideal appears to be a calcium hydroxide-iodoform
      mixture. More histopathologic studies as well as long-term clinical studies are
      needed on this material.

PMID- 1629446
TI  - Ectopic eruption of a mandibular first permanent molar: report of an unusual
      case.
AB  - A case history of an ectopically erupting mandibular left first permanent molar
      is described. Most notable are the unusual findings of a missing mandibular left
      second premolar and an epithelial cyst and a horizontally impacted mandibular
      left second permanent molar. A unique treatment plan called for the extraction of
      the mandibular second primary molar, excision of the cyst, and removal of the
      mandibular left second and third molars. In hindsight, other procedures might
      have served the patient better.

PMID- 1629447
TI  - Dentocraniofacial structure with complete anodontia of permanent teeth: report of
      case.
AB  - Dentocraniofacial structure with ectodermal dysplasia, showing complete anodontia
      of permanent teeth, was examined. Except for a slight decrease of the sweat pore
      count, the patient was free of signs of ectodermal dysplasia, other than
      odontoplasia. Furthermore, her family history had no record of hypodontia or
      anodontia. We attempted to clarify the role of tooth growth in the
      dentocraniofacial development. Cephalometric analyses revealed the extreme
      limitation of the maxillary and vertical growth of the lower face, and a
      retracted mandibular alveolus front. We concluded that the role of tooth growth
      was significant in the development of the maxillary and alveolar bone, but not in
      the development of the mandible.

PMID- 1629448
TI  - Primary maxillary bilateral birooted canines: report of two cases.

PMID- 1629449
TI  - The effect of orthodontic retention on the mechanical properties of the
      periodontal ligament in the rat maxillary first molar.
AB  - The load-deformation curves obtained by extraction of the rat maxillary first
      molar from its socket in the dissected jaw were analyzed so that the effect of
      orthodontic retention on the mechanical properties of the periodontal ligament
      could be examined. An elastic band was inserted between the rat maxillary first
      and second molars for four days, and then the interdental space was filled with
      resin for four or eight days. The average interdental spaces between the teeth
      ranged from 315 to 398 microns during the experimental period. The maximum shear
      load, elastic stiffness, and failure energy in shear decreased markedly following
      application of an orthodontic force, but they increased gradually and reached
      control levels on the 8th day after the retention. Maximum shear deformation at
      maximum load was not significantly different between the experimental and control
      teeth during the experimental period. It is suggested that, following orthodontic
      tooth movement, occlusal function was restored after a relatively short retention
      period, as was the impaired mechanical strength of the periodontal ligament.

PMID- 1629450
TI  - Site-specific expression of collagen I and XII mRNAs in the rat periodontal
      ligament at two developmental stages.
AB  - In mammals, the periodontal ligament (PDL) is a highly specialized tissue which
      facilitates tooth eruption and lends mechanical support to the tooth once in
      occlusion. The PDL extracellular matrix fibers play a major role in such
      functions. During its development, the spatial arrangement of the PDL
      extracellular matrix undergoes rapid changes. So that it could be determined
      whether the structural alteration in the PDL is associated with changes in the
      expression of collagenous proteins with different functional properties, the
      transcriptional patterns of collagens I and XII were examined. The maxillary
      dento-alveolar segments, each containing three molars, from 25-day-old and 40-day
      old Sprague-Dawley rats were selected as being representative of developing and
      matured tissues, respectively. Rat alpha 2(I) collagen cDNA and rat alpha 1(XII)
      collagen cDNA were used as molecular probes for identification of the
      corresponding mRNAs by RNA transfer blot analysis, RNase protection assay, and in
      situ hybridization. The results showed that alpha 2(I) collagen mRNA was
      expressed in both developing and matured tissues. However, the level of
      expression decreased with maturity. In contrast, the expression of alpha 1(XII)
      collagen was increased in the matured tissue as compared with the developing
      tissue. In situ hybridization in these tissues indicated that the expression of
      alpha 1(XII) collagen mRNA was limited to the mature stage of PDL development. It
      is suggested that collagen fibril arrangement during PDL development may be
      related to the expression of collagen XII.

PMID- 1629451
TI  - Clinical criteria for the diagnosis of salivary gland hypofunction.
AB  - There is considerable difficulty in the making of initial clinical decisions as
      to whether a given patient has salivary gland hypofunction, and hence requires
      additional salivary gland evaluation. This study identified a set of four
      clinical measures that, together, successfully predicted the presence or absence
      of salivary gland hypofunction. The four measures were: dryness of lips, dryness
      of buccal mucosa, absence of saliva produced by gland palpation, and total DMFT;
      they were derived from discriminant analysis of data collected from 71
      individuals with normal and low salivary flow rates. These measures are proposed
      as criteria for clinical decision-making, as well as for classification of
      patients in studies of salivary gland dysfunction syndromes. This study also
      identified unstimulated whole salivary flow rates of 0.12-0.16 mL/min as the
      critical range separating individuals with salivary gland hypofunction from those
      with normal gland function.

PMID- 1629452
TI  - Progression of approximal caries in relation to iatrogenic preparation damage.
AB  - The aim of the present study was to evaluate the effect of iatrogenic preparation
      damage on the need for operative caries treatment of approximal surfaces,
      adjacent to Class II amalgam restorations. The material was collected by 77
      dentists from the Public Dental Child Health Service in Denmark. It consisted of
      die-stone models of 187 first-time Class II preparations, adjacent to 190
      unfilled approximal surfaces of 58 primary and 132 permanent teeth. The cavity
      preparations were performed in children between 4 and 17 years of age. They were
      all filled with amalgam. Information about operative treatment and exfoliation or
      extraction of the preparation teeth and the adjacent teeth during the following
      seven years was obtained from the patients' records. Stereomicroscopic
      examination of the models revealed preparation damage on 64% of the unfilled
      approximal surfaces in primary teeth and on 69% of the corresponding test
      surfaces in permanent teeth. During the observation period, operative treatment
      was performed on 10% of the undamaged test surfaces in primary teeth and on 35%
      of the damaged ones (p less than 0.05). The corresponding figures for test
      surfaces in permanent teeth were 6% and 15% (p less than 0.05). It is concluded
      that iatrogenic preparation damage is a frequent side-effect of operative
      intervention with approximal caries lesions, and represents a dental health
      problem, since the damage increases caries progression and the perceived need for
      restorative therapy of the adjacent teeth.

PMID- 1629453
TI  - The influence of denture-wearing and age on the oral microflora.
AB  - The effects of denture-wearing and age on the prevalence of selected bacteria of
      dental significance and on the carriage of opportunistic pathogens in molar
      plaque and whole saliva were determined in 120 healthy subjects, 41 of whom wore
      partial dentures. The subjects were divided into four age groups: 20-39 years
      (group A), 40-59 years (group B), 60-79 years (group C), and greater than or
      equal to 80 years (group D). The proportions, mean log10 viable counts, and
      isolation frequency of yeasts and lactobacilli in saliva and plaque were
      consistently higher in partial-denture wearers. The proportions of staphylococci
      and mutans streptococci were also raised in denture wearers, but these
      differences did not reach statistical significance. When the data were analyzed
      for age effects, both yeasts and lactobacilli were found to be increased in
      saliva with age, but statistically significant differences were generally found
      only between denture wearers in group D and subjects in the control group A. The
      isolation frequency of yeasts from plaque was also significantly higher in
      denture wearers of the oldest age group (D) compared with those in group A. A.
      viscosus predominated over A. naeslundii in the older age groups, regardless of
      the presence of dentures. Enterobacteria were isolated occasionally but only from
      the saliva of denture wearers in group D. Spirochetes and black-pigmented
      anaerobes were generally found in lower numbers in denture wearers. Collectively,
      the data show that components of the oral microflora in adults can be
      independently influenced by both age and the wearing of partial dentures.

PMID- 1629454
TI  - Fluoride intake from beverage consumption in a sample of North Carolina children.
AB  - Since the 1940's, the prevalence of dental fluorosis has increased in the US,
      concomitant with a reduction in dental decay. These changes have been attributed
      in part to the widespread use of systemic and topical fluorides. Various sources
      of increased systemic fluoride exposure have been investigated. However, little
      is known regarding fluoride intake from beverages in a sample of children of ages
      susceptible to dental fluorosis. The purpose of this study was to estimate the
      amount of fluoride ingested from beverages by a sample of North Carolina (NC)
      children of ages 2-10 years. Data on beverage consumption were collected by means
      of a diary format. A questionnaire was included so that demographic information
      and self-assessment on the accuracy of the diaries could be obtained. Beverages
      reported in the diaries were purchased, and their fluoride content was assayed.
      Daily total fluid intake ranged from 970 to 1240 mL, and daily beverage
      consumption ranged from 585 to 756 mL. The estimated mean daily fluoride intakes
      from beverages for children 2-3, 4-6, and 7-10 years of age were 0.36, 0.54, and
      0.60 mg, respectively.

PMID- 1629455
TI  - Initial dissolution rate studies on dental enamel after CO2 laser irradiation.
AB  - The influence of CO2 laser irradiation on the dissolution behavior of human
      dental enamel has been investigated. Human enamel was irradiated by a continuous
      wave CO2 laser at 10.6 microns and initial dissolution rates (IDRs) were measured
      in 0.1 mol/L acetate buffer, pH = 4.5, both with and without calcium and/or
      phosphate common ion, by means of a rotating disk assembly. The effects of (1
      hydroxyethylidene) bisphosphonic acid (EHDP), fluoride (F), and dodecylamine HCl
      (DAC) at various levels upon the IDR were also determined. All of the findings
      were consistent with the hypothesis that CO2 laser irradiation converts dental
      enamel to hydroxyapatite (HAP) possessing site #2 character (Yamamoto et al.,
      1986). The dissolution driving force function, KHAP = aCa10aPO4(6)aOH2, was found
      to have a value of 10(-129.9) after being lased, as compared with 10(-121.4)
      before being lased. The IDR values for EHDP (3 mmol/L) and DAC (3 mmol/L) were
      essentially zero as expected for site #2 HAP. For solution F, the deduced
      dissolution driving force function, KFAP = aCa10aPO4(6)aF2 was 10(-128.6) after
      being lased as compared with 10(-116.3) before being lased. These results all
      support the hypotheses (1) that laser irradiation may convert the surface of
      human dental enamel to an apatite of significantly lower effective solubility
      (i.e., site #2 HAP) than that of unlased enamel; and (2) that there is
      significant synergism between laser treatment and these chemical dissolution rate
      inhibitors (again consistent with site #2 HAP). Simple model calculations
      indicate that, in both the presence and absence of fluoride, these laser-induced
      changes in the driving force for dissolution should dramatically lessen the
      susceptibility of enamel to the types of acid challenge that might be encountered
      in the mouth.

PMID- 1629456
TI  - Synthesis and evaluation of new oxaspiro monomers for double ring-opening
      polymerization.
AB  - Polymerization with expansion in volume can be achieved with spiro orthocarbonate
      monomers through a double ring-opening process wherein two bonds are cleaved for
      each new bond formed. The resulting expansion can be applied to counter the
      polymerization shrinkage associated with the conventional methacrylate monomers
      used in dental composites and thereby provide formulations with drastically
      reduced degrees of shrinkage. New monomers have been prepared that exhibit
      enhanced reactivities and ring-opening efficiencies compared with earlier free
      radical-polymerizable oxaspiro compounds. In dental composite formulations, the
      monofunctional oxaspiro monomers provided DTS values equivalent to those of the
      controls under certain curing conditions; however, only modest reductions in
      polymerization shrinkage were observed. 2,3-Bis(methylene) spiro orthocarbonate
      monomers with a conjugated diene structure were also synthesized and evaluated.
      These novel monomers appear to offer significant potential for future development
      of free-radical ring-opening polymerization. While visible-light-cured
      formulations of the bis(methylene) compounds with methacrylate comonomers did not
      yield acceptable composite materials in this initial attempt, the high reactivity
      and the ability to form rigid, cross-linked polymers make this type of monomer
      worthy of continued investigation. These properties may allow the bis(methylene)
      oxaspiro monomers to be used alone or in concert with other ring-opening monomers
      for special applications.

PMID- 1629457
TI  - Effect of contact area size on enamel and composite wear.
AB  - The effect of contact area dimensions on the wear of composite specimens and
      their opposing enamel cusps was evaluated in vitro. Thirty-six standardized
      cylindrical composite specimens were placed into metal cavities (8 mm x 2 mm) and
      divided randomly into five groups. The composite used was a fine-particle hybrid
      and was stressed as follows: storage in 75% aqueous ethanol solution for 24 h,
      toothbrush/toothpaste-abrasion for 30 min, followed by 300 thermal cycles in
      water ranging from 5 degrees to 55 degrees C and simultaneous 120,000 occlusal
      chewing loads at a frequency of 1.7 Hz at 53 N maximum force. In group 1 (n =
      12), the occlusal chewing loads were applied by palatal cusps of extracted human
      maxillary molars with natural morphology. In groups 2 to 5 (n = 6), the cusp tips
      had standardized contact area dimensions of 0.26, 0.38, 1.18, and 4.10 mm2,
      respectively. Wear of composite specimens and antagonistic enamel cusps (means +/
      SD) was assessed in microns by means of a 3-D scanner. Additionally, the contact
      surfaces of the restorations and of the antagonistic enamel cusps were evaluated
      by SEM. Increases in enamel contact areas after being loaded were measured by
      means of a digitizer and expressed in percent of the initial size before stress
      exposure. The wear of the composite specimens varied from 69.8 +/- 19.9 to 9.5 +/
      3.6 microns, and that of antagonistic enamel cusps from 31.3 +/- 3.4 to 8.8 +/-
      1.5 microns. The increase in contact area varied between 27.8 and 0.1%.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1629458
TI  - The effects of cleaning on the kinetics of in vitro metal release from dental
      casting alloys.
AB  - The kinetics of the release of elements from six dental casting alloys into cell
      culture medium was assessed by means of atomic absorption spectroscopy. Alloys
      were evaluated in the polished and polished-cleaned conditions so that the
      effects of cleaning could be determined. Auger scanning microscopy was used for
      analysis of the surfaces of selected alloys before and after exposure to the cell
      culture medium. Release patterns for each element were characterized by the shape
      of the dissolution vs. time curve, concentration of the element at 12 h as a
      percentage of the 72-hour concentration, and the relative slope of the curve from
      48 to 72 h. Three patterns of release were observed for elements in these alloys.
      Type I patterns had logarithmic shapes with relatively large 12-hour
      concentrations and low 48-72-hour slopes. Type II patterns had logarithmic shapes
      but with moderate 12-hour concentrations and 48-72-hour slopes. Type III patterns
      were polynomial in shape, had relatively low 12-hour concentrations, and had
      large 48-72-hour slopes. Cleaning did not change the pattern of release but did
      generally significantly decrease the quantities of elements released (p = 0.05).
      The type of dissolution vs. time curve appeared to be dependent upon the element
      and the composition of the alloy. When cleaning reduced dissolution, surface
      analyses showed that the cleaning process increased the abundance of elements
      such as Au and Pd and reduced the abundance of Ag and Cu. Elements which were
      released from the alloys were more abundant on the surface than in the bulk in
      both polished and polished-cleaned conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629459
TI  - Dental plaque and calculus: risk indicators for their formation.
AB  - The aim of this study was to determine the levels of plaque and subgingival
      calculus accumulation and to evaluate their correlations with periodontal
      disease, as well as to evaluate the correlations with race, age, and gender in an
      attempt to identify risk indicators for plaque and calculus formation. A total of
      508 adults 25-73 years of age was examined, and plaque assessment, gingival
      bleeding assessment, probing pocket depth, and attachment levels were determined.
      The mean percent visible plaque was 73.5% (range, 8.3-100%), mean percent of
      bleeding surfaces 38.5% (range, 0-100%), and the mean percent teeth with
      subgingival calculus 39.6% (range, 0-100%). The mean probing pocket depth in the
      group was 2.5 +/- 0.6 mm (SD), and mean clinical attachment loss was 2.1 +/- 1.1
      mm. The majority (63%) were classified as having "Moderate" periodontal disease,
      7% were "Healthy", and the remaining 30% had "Established" periodontal disease.
      Plaque and calculus showed statistically significant relationships to the three
      disease categories (p less than 0.001). Multiple step-wise regression analyses on
      the correlations between plaque and periodontal disease, race, age, and gender
      resulted in an overall correlation coefficient of r = 0.25 (p less than 0.001).
      Disease status ("Established") contributed most (p = 0.003), followed by race
      (Blacks; p = 0.015), gender (Males; p = 0.022), and age (55-73 yr; p = 0.022), to
      the correlation with plaque. For subgingival calculus, the overall correlation
      coefficient was r = 0.44 (p less than 0.001). However, only two of the variables-
      namely, disease status (p less than 0.001) followed by race (p = 0.017)--showed
      statistically significant correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629460
TI  - Microbiological aspects of the chemical control of plaque and gingivitis.
AB  - Antimicrobial agents, delivered either by mouthrinse or toothpaste, can be used
      to maintain plaque at levels compatible with oral health by (a) reducing existing
      plaque, (b) preventing the formation of new plaque, (c) selectively inhibiting
      those particular bacteria that are associated with disease, and (d) inhibiting
      the expression of virulence determinants. Although many antimicrobial agents
      would appear to be suitable for plaque control, few have been found to possess
      clinical efficacy. This is because of inherent problems in the mode of action of
      agents in the mouth, and with difficulties with their formulation into dental
      products. Currently formulated antimicrobial agents include metal salts (e.g.,
      zinc, stannous, copper), phenols (triclosan), plant extracts (sanguinarine),
      enzymes (e.g., glucanase, amyloglucosidase/glucose oxidase), "essential oils"
      (e.g., thymol, menthol), and bisbiguanides (chlorhexidine). Although many of
      these agents exhibit a broad spectrum of antimicrobial activity in the
      laboratory, they may display valuable selective properties on plaque. The effect
      of an agent will be concentration-dependent. Initially, the inhibitor may be
      briefly at levels above its MIC, but thereafter, it will be desorbed off oral
      surfaces and operate at sub-lethal concentrations. At these latter levels, agents
      can be effective by inhibiting metabolism (e.g., acid production, protease
      activity), and slowing bacterial growth. Agents with complementary modes of
      action are being combined to increase their antibacterial effectiveness. The long
      term use of dental products containing antimicrobial agents should not (a)
      disrupt the natural balance of the oral microflora, (b) lead to colonization by
      exogenous organisms, or (c) lead to the development of microbial
      resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629461
TI  - Delivery of antiplaque agents from dentifrices, gels, and mouthwashes.
AB  - Antiplaque agents delivered from toothpastes, gels, or mouthrinses can augment
      mechanical oral hygiene procedures to control the formation of supragingival
      plaque and the development of early periodontal disease. Clinically effective
      antiplaque agents are characterized by a combination of intrinsic antibacterial
      activity and good oral retention properties. The overall oral retention of an
      antiplaque agent is determined by the strength and rate of association of the
      agent with its receptor sites and the accessibility of these sites. The
      substantivity of an antiplaque agent and its clearance from the oral cavity are
      determined by the rate of dissociation of the agent from the receptor sites and
      the salivary composition and flow rate. Positively charged and non-charged
      organic molecules, metal ions, enzymes, and surface-active agents have all been
      considered as antiplaque agents. To exert clinical antiplaque activity, an
      antimicrobial agent must be formulated in a chemically compatible delivery
      vehicle to give optimal release and uptake to the sites of action in a
      biologically active form during its time of application. In principle, antiplaque
      activity may be enhanced by combining antimicrobial agents with broadly similar,
      but complementary, modes of action. Alternatively, the activity of a single agent
      may be increased by use of a retention aid to enhance oral substantivity.
      Substantial evidence exists to demonstrate the validity of the first approach.
      However, there are few data, as yet, to support the effectiveness of the second.
      The oral mucosa is the bulk retention site for all clinically proven antiplaque
      agents. Plaque, the pellicle-coated tooth surface, and saliva are probably all
      sites of biological action. A detailed understanding of the interactions between
      agents and the various receptor sites, and of the importance of these receptor
      sites to biological activity, is generally lacking.

PMID- 1629462
TI  - Agents for the management of plaque and gingivitis.
AB  - Numerous chemical agents have been evaluated for the supplementation of patient
      dependent mechanical plaque control and thus the reduction or prevention of oral
      diseases. Agents discussed in this paper are those most frequently evaluated in
      recent studies and include chlorhexidine, essential oils, triclosan,
      sanguinarine, fluorides, oxygenating agents, quaternary ammonium agents,
      prebrushing rinses, enzymes, and antibiotics. Of the agents discussed, the
      greatest effect on the reduction of plaque and gingivitis can be expected from
      chlorhexidine, essential oils, and triclosan-containing products. These chemical
      agents vary in dosage form and include mouthrinses, gels, and dentifrices. Some
      may also be of value as irrigants. Adverse effects vary according to the chemical
      agent and include poor taste, burning sensation of oral tissue, staining of teeth
      and soft tissues, excess supragingival calculus, oral lesions in young patients,
      and allergic reactions. When a product is selected for a patient, consideration
      should be given to necessity, efficacy, adverse effects, and cost-effectiveness.

PMID- 1629463
TI  - New agents in the chemical control of plaque and gingivitis: reaction paper.
AB  - The inadequacy of traditional methods in controlling plaque and gingivitis has
      led to an increasing interest in the chemical approach, especially using
      toothpastes and mouthrinses. Various agents have been tested by a variety of
      experimental designs. Further work in this field should include monitoring the
      effect of long-term use on the oral ecology and an appraisal of the experimental
      designs used in longitudinal studies of antiplaque and antigingivitis agents.

PMID- 1629465
TI  - A case for clinical research.

PMID- 1629464
TI  - New agents in the chemical control of plaque and gingivitis--reaction paper.
AB  - The papers of Drs. Christersson, Marsh, Cummins, and Ciancio focus on the issues
      and problems associated with the efficacious delivery of chemical agents intended
      to control plaque and gingivitis. The infectious nature of periodontal disease,
      the importance of oral microbial ecology, the success of triclosan formulations,
      and the review of our current knowledge based upon clinical trials are
      emphasized.

PMID- 1629466
TI  - Consent for dental therapy in severely ill patients.
AB  - This article provides an overview of legal standards for informed consent, and
      discusses this in the context of dental care for elderly or severely ill
      patients. Legal analysis is made on variations in state common law and
      legislation, focusing on the difference between a practitioner-oriented approach
      versus a patient-oriented approach to informed consent. Analysis is also made
      regarding advance health care directives in cases of patient incapacity. The
      purposes of this article are to provide interested dental educators with an
      understanding of the important legal concepts in this area and the nuances of
      state law, and to discuss how these can be properly applied in facilities that
      treat severely ill or geriatric patients.

PMID- 1629467
TI  - Perceived mistreatment of graduating dental students: a retrospective study.
AB  - This study assessed types and sources of perceived mistreatment among graduating
      dental students. A total of 38 of 46 (83 percent) students anonymously completed
      a mistreatment questionnaire. All 38 students perceived experiencing at least one
      type of mistreatment from some source and reported an average of about 35
      separate incidents. Psychological mistreatment was most frequent with physical
      mistreatment reported relatively infrequently. Classmates and clinical faculty
      were the most frequent sources of mistreatment. Sexual harassment was perceived
      by about one-third of the students. The potentially adverse effects of perceived
      mistreatment were discussed with a view to improving dental education through an
      emphasis on stress management, environmental change, and self-responsibility for
      health designed to enhance the personal growth of each dental student.

PMID- 1629468
TI  - The search for a profile of aptitudes that characterize dentists.
AB  - This article is a reinterpretation of an unsuccessful attempt to develop a
      standard battery of aptitude measures to distinguish practicing dentists. Of 22
      potential predictors used by a firm specializing in aptitude testing and career
      counseling, the national sample of 116 dentists tested showed few differences
      from the norm group, and some differences were counterintuitive. For example
      dentists performed no better than the norm on spatial visualization and worse
      than the norm on several measures of language skill and on finger dexterity.
      Based on these findings, this paper argues that a broad conceptualization is
      required when attempting to characterize the aptitudes necessary to complete
      dental education and to maintain a dental practice. The apparent inconsistency
      between these findings and successful prediction of performance in laboratory
      courses using available admissions instruments is explained.

PMID- 1629469
TI  - Interrater agreement on subgingival calculus detection following scaling.
AB  - Accurate and reliable detection of subgingival calculus is a difficult skill
      which relies on subjective tactile sensations for determinations. This one year
      retrospective study examined the interrater agreement among a large, generalized
      pool of clinical examiners who scored residual subgingival calculus after student
      scaling. Four thousand one hundred and sixty tooth surfaces were analyzed for
      examiner agreement. Interrater reliability for all paired clinical ratings was
      low (Kappa = .33). A second, companion study evaluated accuracy and reliability
      using raters' assessments about the existence of simulated calculus on the root
      surfaces of manikin teeth. In the second study interrater reliability also was
      low (Kappa = .34); the true positive and true negative ratios were 49 percent and
      88 percent respectively, while the false positive and false negative ratios were
      12 percent and 51 percent. These data suggest that there is a need in
      periodontics for effective examiner calibration methodologies and objective
      subgingival calculus detection techniques.

PMID- 1629470
TI  - Broadening the scope of dental education.

PMID- 1629471
TI  - The Buffalo approach to changing the basic science curriculum or toiling and
      dreaming in the vineyards of dental education.

PMID- 1629472
TI  - Basic sciences instruction, the Columbia University Model.

PMID- 1629473
TI  - Status of practice administration curricula.

PMID- 1629474
TI  - Dental hygiene enrollment and institutional affiliation.

PMID- 1629475
TI  - Occluded-ear simulator with variable acoustic properties.
AB  - Ear simulators were designed to replicate acoustical characteristics of the
      average adult ear. Due to variability of ear-canal geometry and eardrum impedance
      among individuals, the possibility of any one person exhibiting such "average"
      characteristics--especially if that person is a child and/or has a conductive
      pathology--is remote. Thus, ear simulators have been of only peripheral value
      when prescribing a hearing aid (a high output impedance device) to fit the
      acoustical requirements of a particular patient. Reported herein is development
      of a programmable artificial ear (PAE) that can account for individual
      differences in ear-canal geometry and eardrum impedance. It consists of a 2.0-cc
      coupler, microphone, amplifier, computer, PAE code, and a computer card and/or
      software for digitization and Fourier transformation. Required input data
      includes ear-canal dimensions, eardrum impedance, and output impedance of the
      hearing aid being tested. Sound-pressure recordings produced in the 2.0-cc
      coupler by the hearing aid are adjusted by the computer to what they would have
      been had the recordings been made at the eardrum of a particular patient wearing
      the same hearing aid. Good agreement was observed between experiment and theory
      for one test case involving a totally occluding miniature earphone.

PMID- 1629476
TI  - Auditory nerve representation of a complex communication sound in background
      noise.
AB  - A population study of auditory nerve responses in the bullfrog, Rana catesbeiana,
      analyzed the relative contributions of spectral and temporal coding in
      representing a complex, species-specific communication signal at different
      stimulus intensities and in the presence of background noise. At stimulus levels
      of 70 and 80 dB SPL, levels which approximate that received during communication
      in the natural environment, average rate profiles plotted over fiber
      characteristic frequency do not reflect the detailed spectral fine structure of
      the synthetic call. Rate profiles do not change significantly in the presence of
      background noise. In ambient (no noise) and low noise conditions, both amphibian
      papilla and basilar papilla fibers phase lock strongly to the waveform
      periodicity (fundamental frequency) of the synthetic advertisement call. The
      higher harmonic spectral fine structure of the synthetic call is not accurately
      reflected in the timing of fiber firing, because firing is "captured" by the
      fundamental frequency. Only a small number of fibers synchronize preferentially
      to any harmonic in the call other than the first, and none synchronize to any
      higher than the third, even when fiber characteristic frequency is close to one
      of these higher harmonics. Background noise affects fiber temporal responses in
      two ways: It can reduce synchronization to the fundamental frequency, until fiber
      responses are masked; or it can shift synchronization from the fundamental to the
      second or third harmonic of the call. This second effect results in a
      preservation of temporal coding at high noise levels. These data suggest that
      bullfrog eighth nerve fibers extract the waveform periodicity of multiple
      harmonic stimuli primarily by a temporal code.

PMID- 1629477
TI  - Auditory intensity perception: successive versus simultaneous, across-channel
      discriminations.
AB  - This study measures the ability of observers to compare the intensities of two
      stimuli occupying different frequency regions. It includes three experiments,
      each experiment having two conditions. In one condition, the two stimuli to be
      compared were presented simultaneously within each interval; this condition has
      been called profile analysis. In the other condition, the two stimuli were
      presented successively within each interval. Because the overall level of the
      stimuli was randomized between intervals, the observers were encouraged to
      compare the intensities of the two stimuli within each observation interval
      rather than between intervals. The stimuli were two simple tones in experiment 1
      and two tonal complexes in both experiments 2 and 3. The stimuli used in
      experiments 2 and 3 differed in frequency. The results show that simultaneous
      comparisons are superior to successive comparisons. For simple tones, the
      difference in threshold is about 8 dB; for complexes with 10 to 11 components,
      the difference in threshold is about 15 dB. These differences can be explained by
      assuming that internal noises in different channels were partially correlated
      when stimuli in those channels were presented simultaneously and were independent
      when the stimuli were presented successively. Cancellation of the correlated
      noise is therefore possible with simultaneous comparisons, making such
      discrimination better than that achievable with successive comparisons.

PMID- 1629478
TI  - A new technique for measuring spectral shape discrimination.
AB  - A new technique is described for studying the ability of listeners to
      discriminate between sounds on the basis of spectral shape, a process called
      "auditory profile analysis." The advantage of the technique is that it reduces
      the range of the random rove in level necessary to provide a specified limit on
      the performance which listeners could achieve by "level detection;" that is, by
      employing a detection strategy based solely on comparisons of stimulus level.
      Thresholds were measured for the just-discriminable "ripple" (a pattern of
      alternating intensity increments and decrements) in an equal-amplitude, multitone
      reference spectrum for a group of normal-hearing listeners. Broadband, high-pass
      and low-pass filtered conditions were tested. The results indicated that the
      thresholds obtained using the new technique were well below the lowest level
      achievable by level detection (referred to as the "level-detection limit") in all
      conditions using a 20-dB random within-trial rove in overall level. The lowest
      threshold occurred for the broadband stimulus while the highest threshold was
      observed for the most extreme high-pass filtered condition. The new technique
      appears to be well-suited for study of profile analysis in hearing-impaired
      listeners where stimulus bandwidth and rove range are limited.

PMID- 1629479
TI  - Overshoot in normal-hearing and hearing-impaired subjects.
AB  - Overshoot was measured in both ears of four subjects with normal hearing and in
      five subjects with permanent, sensorineural hearing loss (two with a unilateral
      loss). The masker was a 400-ms broadband noise presented at a spectrum level of
      20, 30, or 40 dB SPL. The signal was a 10-ms sinusoid presented 1 or 195 ms after
      the onset of the masker. Signal frequency was 1.0 or 4.0 kHz, which placed the
      signal in a region of normal (1.0 kHz) or impaired (4.0 kHz) absolute sensitivity
      for the impaired ears. For the normal-hearing subjects, the effects of signal
      frequency and masker level were similar to those published previously. In
      particular, overshoot was larger at 4.0 than at 1.0 kHz, and overshoot at 4.0 kHz
      tended to decrease with increasing masker level. At 4.0 kHz, overshoot values
      were significantly larger in the normal ears: Maximum values ranged from about 7
      26 dB in the normal ears, but were always less than 5 dB in the impaired ears.
      The smaller overshoot values resulted from the fact that thresholds in the short
      delay condition were considerably better in the hearing-impaired subjects than in
      the normal-hearing subjects. At 1.0 kHz, overshoot values for the two groups of
      subjects more or less overlapped. The results suggest that permanent,
      sensorineural hearing loss disrupts the mechanisms responsible for a large
      overshoot effect.

PMID- 1629480
TI  - Effect of spectral envelope smearing on speech reception. I.
AB  - The effect of reduced spectral contrast on the speech-reception threshold (SRT)
      for sentences in noise and on phoneme identification, was investigated with 16
      normal-hearing subjects. Signal processing was performed by smoothing the
      envelope of the squared short-time fast Fourier transform (FFT) by convolving it
      with a Gaussian-shaped filter, and overlapping additions to reconstruct a
      continuous signal. Spectral energy in the frequency region from 100 to 8000 Hz
      was smeared over bandwidths of 1/8, 1/4, 1/3, 1/2, 1, 2, and 4 oct for the SRT
      experiment. Vowel and consonant identification was studied for smearing
      bandwidths of 1/8, 1/2, and 2 oct. Results showed the SRT in noise to increase as
      the spectral energy was smeared over bandwidths exceeding the ear's critical
      bandwidth. Vowel identification suffered more from this type of processing than
      consonant identification. Vowels were primarily confused with the back vowels
      /c,u/, and consonants were confused where place of articulation is concerned.

PMID- 1629481
TI  - Pitch discrimination and phase sensitivity in young and elderly subjects and its
      relationship to frequency selectivity.
AB  - Frequency difference limens for pure tones (DLFs) and for complex tones (DLCs)
      were measured for four groups of subjects: young normal hearing, young hearing
      impaired, elderly with near-normal hearing, and elderly hearing impaired. The
      auditory filters of the subjects had been measured in earlier experiments using
      the notched-noise method, for center frequencies (fc) of 100, 200, 400, and 800
      Hz. The DLFs for both impaired groups were higher than for the young normal group
      at all fc's (50-4000 Hz). The DLFs at a given fc were generally only weakly
      correlated with the sharpness of the auditory filter at that fc, and some
      subjects with broad filters had near-normal DLFs at low frequencies. Some
      subjects in the elderly normal group had very large DLFs at low frequencies in
      spite of near-normal auditory filters. These results suggest a partial
      dissociation of frequency selectivity and frequency discrimination of pure tones.
      The DLCs for the two impaired groups were higher than those for the young normal
      group at all fundamental frequencies (fo) tested (50, 100, 200, and 400 Hz); the
      DLCs for the elderly normal group were intermediate. At fo = 50 Hz, DLCs for a
      complex tone containing only low harmonics (1-5) were markedly higher than for
      complex tones containing higher harmonics, for all subject groups, suggesting
      that pitch was conveyed largely by the higher, unresolved harmonics. For the
      elderly impaired group, and some subjects in the elderly normal group, DLCs were
      larger for a complex tone with lower harmonics (1-12) than for tones without
      lower harmonics (4-12 and 6-12) for fo's up to 200 Hz. Some elderly normal
      subjects had markedly larger-than-normal DLCs in spite of near-normal auditory
      filters. The DLCs tended to be larger for complexes with components added in
      alternating sine/cosine phase than for complexes with components added in cosine
      phase. Phase effects were significant for all groups, but were small for the
      young normal group. The results are not consistent with place-based models of the
      pitch perception of complex tones; rather, they suggest that pitch is at least
      partly determined by temporal mechanisms.

PMID- 1629482
TI  - Test of a model of auditory object formation using intensity and interaural time
      difference discrimination.
AB  - A model of auditory object formation and an experimental evaluation of the model
      are described. Specifically, predictions for intensity discrimination and
      interaural time difference discrimination for the central component of a three
      component harmonic complex are evaluated empirically. The onset time of the
      central, target component is varied relative to the onset times of the remaining,
      interferer components in order to vary the degree of fusion (versus perceptual
      segregation) of the target and the interferers. The model, which is based on the
      idea of attenuation of the components in the nonattended auditory image (in the
      case of segregated images), predicts lower sensitivity to information at the
      target component for the fused versus segregated target, and equal sensitivities
      for completely segregated targets and targets presented in isolation. Results are
      presented for four subjects with component frequencies of 400, 600, and 800 Hz
      and with onset time differences of 0 or 250 ms. The target duration was always
      100 ms and offset times were the same for all components. The subjective results
      were as expected, with synchronous onsets yielding one sound object, and
      asynchrony of the central component yielding two sound objects. Also, the
      empirical results on interference in the synchronous case were in qualitative
      agreement with the above predictions. However, significantly more interference
      was found than was predicted for both synchronous and asynchronous conditions. In
      fact, the amount of interference found contradicts the simple attenuation model
      of object formation.

PMID- 1629483
TI  - Tongue-tip trills and vocal-tract wall compliance.
AB  - The effect of vocal-tract wall compliance on tongue-tip trills is to create a
      favorable pressure-flow relation at the tongue tip for sustained vibration. The
      governing equations are derived for a model based on this mechanism, and data on
      unvoiced trills are used to help set parameters for a numerical simulation of the
      model.

PMID- 1629484
TI  - Temporal measures of anticipatory labial coarticulation for the vowel/u/: within-
      and cross-subject variability.
AB  - The timing of upper lip protrusion movements and accompanying acoustic events was
      examined for multiple repetitions of word pairs such as "lee coot" and "leaked
      coot" by four speakers of American English. The duration of the intervocalic
      consonant string was manipulated by using various combinations of /s/, /t/, /k/,
      /h/, and /#/. Pairwise comparisons were made of consonant string duration
      (acoustic /i/ offset to acoustic /u/ onset) with durations of: protrusion
      movement beginning to acoustic /u/ onset, maximum acceleration of the movement to
      acoustic /u/ onset, and acoustic /u/ onset to movement end. There were some
      consonant-specific protrusion effects, primarily on the movement beginning event
      for /s/. Inferences from measures of the maximum acceleration and movement end
      events for the non-/s/ subset suggested the simultaneous and variable expression
      of three competing constraints: (1) end the protrusion movement during the voiced
      part of the /u/; (2) use a preferred movement duration; and (3) begin the /u/
      related protrusion movement when permitted by relaxation of the perceptually
      motivated constraint that the preceding /i/ be unrounded. The subjects differed
      in the degree of expression of each constraint, but the results generally
      indicate that anticipatory coarticulation of lip protrusion is influenced both by
      acoustic-phonetic context dependencies and dynamical properties of movements.
      Because of the extensive variation in the data and the small number of subjects,
      these ideas are tentative; additional work is needed to explore them further.

PMID- 1629485
TI  - Phonation threshold pressure: a missing link in glottal aerodynamics.
AB  - Phonation threshold pressure has previously been defined as the minimum lung
      pressure required to initiate phonation. By modeling the dependence of this
      pressure on fundamental frequency, it is shown that relatively simple aerodynamic
      relations for time-varying flow in the glottis are obtained. Lung pressure and
      peak glottal flow are nearly linearly related, but not proportional. For this
      reason, traditional power law relations between vocal power and lung pressure may
      not hold. Glottal impendance for time-varying flow should be defined
      differentially rather than as a simple ratio between lung pressure and peak flow.
      It is shown that the peak flow, the peak flow derivative, the open quotient, and
      the speed quotient of inverse-filtered glottal flow waveforms all depend
      explicitly on phonation threshold pressure. Data from singers are compared with
      those from nonsingers. The primary difference is that singers obtain two to three
      times greater peak flow for a given lung pressure, suggesting that they adjust
      their glottal or vocal tract impedance for optimal flow transfer between the
      source and the resonantor.

PMID- 1629486
TI  - Vocal intensity in speakers and singers.
AB  - Vocal intensity is studied as a function of fundamental frequency and lung
      pressure. A combination of analytical and empirical models is used to predict
      sound pressure levels from glottal waveforms of five professional tenors and
      twenty five normal control subjects. The glottal waveforms were obtained by
      inverse filtering the mouth flow. Empirical models describe features of the
      glottal flow waveform (peak flow, peak flow derivative, open quotient, and speed
      quotient) in terms of lung pressure and phonation threshold pressure, a key
      variable that incorporates the Fo dependence of many of the features of the
      glottal flow. The analytical model describes the contributions to sound pressure
      levels SPL by the vocal tract. Results show that SPL increases with Fo at a rate
      of 8-9 dB/octave provided that lung pressure is raised proportional to phonation
      threshold pressure. The SPL also increases at a rate of 8-9 dB per doubling of
      excess pressure over threshold, a new quantity that assumes considerable
      importance in vocal intensity calculations. For the same excess pressure over
      threshold, the professional tenors produced 10-12 dB greater intensity than the
      male nonsingers, primarily because their peak airflow was much higher for the
      same pressure. A simple set of rules is devised for predicting SPL from source
      waveforms.

PMID- 1629487
TI  - Controlling changes in vocal tract resistance.
AB  - There is some evidence that speech aerodynamics follows the rules of a regulating
      system. The purpose of the present study was to assess how the speech system
      manages perturbations that produce "errors" within the system. Three experimental
      approaches were used to evaluate the physiological responses to an imposed change
      in airway resistance. The first involved subjects with varying degrees of
      velopharyngeal inadequacy. The second and third approaches involved noncleft
      subjects whose airway was perturbed by bleed valves and bite blocks during
      consonant productions. The pressure-flow technique was used to measure
      aerodynamic variables associated with the production of test consonants. The
      results of this study provide additional evidence that the speech system actively
      responds to perturbations in ways that tend to minimize a change in consonant
      speech pressures. The degree of success in stabilizing pressures appears to
      reflect the capability of the system to use whatever articulatory and respiratory
      responses are available.

PMID- 1629488
TI  - Relative timing characteristics of hearing-impaired speakers.
AB  - Speech duration characteristics of phrase-level utterances produced by 26
      severely and profoundly hearing-impaired adults were examined acoustically using
      relative timing measures. The measures were then compared to the same utterances
      produced by 13 normal-hearing adults. Although absolute speech durations of the
      hearing-impaired subjects were significantly longer than their normal-hearing
      counterparts, relative timing did not differ between groups. Findings are
      discussed in relation to the biological constraint hypothesis associated with
      speech timing, as well as the role of auditory feedback in models of speech
      production.

PMID- 1629489
TI  - Speech of cochlear implant patients: a longitudinal study of vowel production.
AB  - Acoustic parameters were measured for vowels spoken in /hVd/ context by four
      postlingually deafened recipients of multichannel (Ineraid) cochlear implants.
      Three of the subjects became totally deaf in adulthood after varying periods of
      partial hearing loss; the fourth became totally deaf at age four. The subjects
      received different degrees of perceptual benefit from the prosthesis. Recordings
      were made before, and at intervals following speech processor activation. The
      measured parameters included F1, F2, F0, SPL, duration, and amplitude difference
      between the first two harmonic peaks in the log magnitude spectrum (H 1-H2).
      Numerous changes in parameter values were observed from pre- to post-implant,
      with differences among subjects. Many changes, but not all, were in the direction
      of normative data, and most changes were consistent with hypotheses about
      relations among the parameters. Some of the changes tended to enhance phonemic
      contrasts; others had the opposite effect. For three subjects, H 1-H2 changed in
      a direction consistent with measurements of their average air flow when reading;
      that relation was more complex for the fourth subject. The results are
      interpreted with respect to: characteristics of the individual subjects,
      including vowel identification scores; mechanical interactions among glottal and
      supraglottal articulations; and hypotheses about the role of auditory feedback in
      the control of speech production. Almost all the observed differences could be
      attributed to changes in the average settings of speaking rate, F0 and SPL, which
      presumably can be perceived without the need for spectral place information. Some
      observed F2 realignment may be attributable to the reception of spectral cues.

PMID- 1629490
TI  - Acoustic and perceptual characteristics of voicing in fricatives and fricative
      clusters.
AB  - Several types of measurements were made to determine the acoustic characteristics
      that distinguish between voiced and voiceless fricatives in various phonetic
      environments. The selection of measurements was based on a theoretical analysis
      that indicated the acoustic and aerodynamic attributes at the boundaries between
      fricatives and vowels. As expected, glottal vibration extended over a longer time
      in the obstruent interval for voiced fricatives than for voiceless fricatives,
      and there were more extensive transitions of the first formant adjacent to voiced
      fricatives than for the voiceless cognates. When two fricatives with different
      voicing were adjacent, there were substantial modifications of these acoustic
      attributes, particularly for the syllable-final fricative. In some cases, these
      modifications leads to complete assimilation of the voicing feature. Several
      perceptual studies with synthetic vowel-consonant-vowel stimuli and with edited
      natural stimuli examined the role of consonant duration, extent and location of
      glottal vibration, and extent of formant transitions on the identification of the
      voicing characteristics of fricatives. The perceptual results were in general
      consistent with the acoustic observations and with expectations based on the
      theoretical model. The results suggest that listeners base their voicing
      judgments of intervocalic fricatives on an assessment of the time interval in the
      fricative during which there is no glottal vibration. This time interval must
      exceed about 60 ms if the fricative is to be judged as voiceless, except that a
      small correction to this threshold is applied depending on the extent to which
      the first-formant transitions are truncated at the consonant boundaries.

PMID- 1629491
TI  - Automated detection of the tongue surface in sequences of ultrasound images.
AB  - An image processing system has been developed for a Macintosh II personal
      computer. It is designed to process sequences of sagittal tongue sections that
      are digitized in real time and stored in standard tagged image file format
      (TIFF). The successive processing steps are: (a) a low-pass filter for noise
      reduction, (b) a resampling of the sector of interest in polar coordinates, (c) a
      matched filter (vertical differentiator) for the enhancement of the tissue/air
      interface in the surface region of the tongue, and (d) an extraction of border
      points by searching for an optimal radial path along the angular dimension. This
      latter task is achieved by dynamic programming, which has the following
      advantages. First, due to the use of a global criterion to guide the detection,
      it is very robust. Second, as a result of certain restrictions of the allowable
      transitions, the extracted contours are smooth. Finally, the method permits the
      specification of particular predefined contour points. This system was
      implemented in a program that can handle image sequences in a fully automatic
      mode. Results obtained using ultrasound data are presented.

PMID- 1629492
TI  - Calculating acoustical properties of cells: influence of surface topography and
      liquid layer between cell and substrate.
AB  - In this paper, a mathematical formulation is presented to compute the V(z) of a
      tapering layered solid and applying this formulation to the determination of
      acoustic properties of biological cells and tissues. The formulation is adopted
      in the simplex inversion algorithm to obtain the acoustic properties of a
      tapering cell from its V(z) values. The influence of two parameters had been
      considered: The tapering angle and the presence of a thin liquid layer present
      between cells and the substratum to which they adhere. Up to a tapering angle
      less than 10 degrees, it can be safely neglected. However, if a larger angle is
      neglected, then the acoustic wave velocity in the cell is overestimated. Cell
      thickness estimation is not affected significantly when the tapering angle is
      ignored. The calculations of acoustic properties of cells are considerably
      influenced by the introduction of a thin fluid layer between the solid substratum
      and the overlying cell, neglecting the presence of at least a very thin layer (20
      30 nm), in general, results in a considerable overestimation of sound velocity.
      The reliability of the data calculated from V(z) values was ascertained using an
      independent method to determine cell thickness by calculating it from the
      interference fringe pattern obtained with the reflection-interference light
      microscope. The shape of the glutaraldehyde-fixed cells was similar to fried
      eggs. The highest sound velocities were found close to the periphery of the dome
      shaped cell center. In the very center and over most of the area of the thin
      periphery, sound velocity was close to that in saline.

PMID- 1629493
TI  - Identification of human myocardial infarction in vitro based on the frequency
      dependence of ultrasonic backscatter.
AB  - It has been reported previously that acute and mature myocardial infarction in
      dogs can be differentiated in vitro and in vivo by ultrasonic tissue
      characterization based on measurement of the frequency dependence of ultrasonic
      backscatter. To characterize human infarction with an index of the frequency
      dependence of backscatter that could be obtained in patients, cylindrical biopsy
      specimens from 7 normal regions and 12 regions of infarction of 6 fixed,
      explanted human hearts in 2-deg steps around their entire circumference with a 5
      MHz broadband transducer were insonified. One to six consecutive transmural
      levels were studied for each specimen. The dependence of apparent (uncompensated
      for attenuation or beam width) backscatter, /B(f)/2, on frequency (f) was
      computed from spectral analyses of radio-frequency data as /B(f)/2 = afn, where
      from theoretical considerations the magnitude of n decreases as scatterer size
      increases. Apparent integrated backscatter was computed as the average of /B(f)/2
      from 3 to 7 MHz. The average value for n for normal tissue (0.9 +/- 0.1) exceeded
      that for tissue from regions of infarction (0.6 +/- 0.1; p less than 0.05).
      Infarct manifested a significant decrease of n from epicardial to endocardial
      levels (epi----mid----endo: 0.9----0.7----0.2; p less than 0.05) whereas normal
      tissue manifested similar values for n at each transmural level (0.8----1.1---
      0.9; p = NS). Average integrated backscatter across all transmural levels for
      infarct was significantly greater than for normal tissue (-48.3 +/- 0.5 vs -53.4
      +/- 0.4 dB, infarct versus normal; p less than 0.05). The presence of fibrosis
      was associated with smaller values of n and greater integrated
      backscatter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629494
TI  - Corrected values for Annex B of ISO 1999.

PMID- 1629495
TI  - Asthma with sulfite intolerance in children: a blocking study with
      cyanocobalamin.
AB  - Sulfites have been implicated as the cause of bronchospasm in some subjects with
      asthma. However, there is still no universally accepted explanation of the
      pathogenesis of these reactions. We have studied five children with asthma with
      metabisulfite intolerance confirmed by oral challenge testing. The challenge test
      with metabisulfite was repeated after premedication of all the patients with 1.5
      mg of oral cyanocobalamin. In four of the five patients treated with
      cyanocobalamin, bronchospasm did not develop in the second metabisulfite
      challenge. The possible mechanisms are discussed.

PMID- 1629496
TI  - The allergens of Epicoccum nigrum Link. I. Identification of the allergens by
      immunoblotting.
AB  - Two atmospheric isolates of Epicoccum nigrum (EN) were grown under sporulation
      conditions. Dialyzed extracts of spores, (greater than 95% pure) and pure mycelia
      were used for skin testing, sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, and immunoblotting. By skin testing, 49 of the 126 atopic
      patients were found to be sensitive to EN in St. Louis, Mo., and Corpus Christi,
      Texas, combined. On immunoblotting, which was performed on 17 sera, 44 bands
      (12.3 to 119.0 kd) were detected; six were unique to spore, four were unique to
      mycelium, and 34 were common to both. No single band bound IgE from all sera. The
      most frequent band corresponding to 42 kd occurred in 11 sera. Five other bands
      were recognized by more than one half, whereas the remainder bound fewer sera.
      All skin test-positive patients had positive immunoblots; the number of bands
      recognized varied from three to 25. Spore or mycelium-specific, as well as common
      bands were recognized by 13 of 17 sera. Two sera recognized only spore and
      mycelium-specific bands. Only spore-specific bands were bound by two sera. No
      strain differences were detected. The binding patterns were comparable in the
      sera from both St. Louis, Mo., and Corpus Christi, Texas. These data suggest that
      EN is a significant allergen in urban communities. Allergenic proteins occur in
      both spore and mycelium, suggesting that both must be included in the reagents
      for skin testing and immunotherapy.

PMID- 1629497
TI  - Insect-sting challenge in 138 patients: relation between clinical severity of
      anaphylaxis and mast cell activation.
AB  - One hundred thirty-eight patients with a previous anaphylactic reaction to a
      yellow jacket or a honeybee sting, as well as eight volunteers, were subjected to
      an in-hospital sting challenge. Plasma levels of histamine, tryptase, and
      prostaglandin D2 (PGD2) during sting challenge were studied in relation to
      clinical symptoms. Prechallenge levels (mean +/- SD) of histamine, tryptase, and
      PGD2 were 2 +/- 1 nmol/L, 0.3 +/- 0.3 U/L, and 320 +/- 223 ng/L, respectively. In
      the volunteers and in none except for one of the nonreacting patients, these
      levels did not change significantly after challenge. In contrast, mean increases
      in the group of 18 patients with a mild reaction were significant for histamine
      and tryptase at one or more time points after the challenge. (Five patients
      demonstrated no increase in histamine; nine demonstrated no increase in
      tryptase.) Except for histamine levels in one patient, these increases were
      considerably more in all 17 patients with a severe reaction, starting from the
      first anaphylactic symptoms. Fifteen minutes later, peak values were reached of
      1275 +/- 2994 nmol of histamine per liter (range, 3 to 12800 nmol/L; median, 11
      nmol/L) and 406 +/- 1062 U of tryptase per liter (range, 1.8 to 4400 U/L; median,
      17 U/L). This rise in levels inversely correlated with the mean arterial
      pressure. Plasma levels of PGD2 in severely reacting patients did not differ
      significantly from those in patients with a mild or no reaction. In conclusion,
      only 28% of patients with a history of Hymenoptera anaphylaxis developed an
      anaphylactic reaction after an in-hospital challenge.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1629498
TI  - An approach to immunologic reactions associated with plasma exchange.
AB  - Immunologically mediated anaphylactic-type events are not uncommon with PE. The
      pathogenesis of these reactions is not well understood and demands further
      investigation. If a technique or equipment-related phenomenon can be identified,
      it should be addressed (e.g., replace the membrane for a more biocompatible
      membrane and use better rinsing procedures to eliminate ethylene oxide). Testing
      for specific relevant immunogen, either by in vivo or in vitro methods, if these
      methods are available, should be considered. If infusion of essential blood
      products is the most likely cause, then a premedication regimen may be helpful in
      preventing such reactions. As the risks and benefits of treatment are weighed, it
      is important to remember that every hive need not be eliminated. Instead, the
      goal is to prevent compromise to oxygenation and perfusion in both mother and
      fetus while comfort is maintained and drug-induced adverse effects are avoided.

PMID- 1629499
TI  - Ambophyllin, an office-dispensed tablet for asthma, contains triamcinolone.

PMID- 1629500
TI  - Proteinases in extracts of the storage mite, Aleuroglyphus ovatus.

PMID- 1629501
TI  - Increased concentrations of airborne grass allergen during lawn mowing.

PMID- 1629502
TI  - Allergenicity screening of "hypoallergenic" milk-based formulas.

PMID- 1629503
TI  - Reducing domestic exposure to dust mite allergen reduces bronchial
      hyperreactivity in sensitive children with asthma.

PMID- 1629504
TI  - Morrow Brown needle facts.

PMID- 1629505
TI  - Do the group II dust mite allergens correspond to lysozyme?

PMID- 1629506
TI  - Long-term comparison of three combinations of albuterol, theophylline, and
      beclomethasone in children with chronic asthma.
AB  - Three combination regimens, (1) inhaled albuterol (ALB) with oral theophylline
      (THEO), (2) inhaled ALB with inhaled beclomethasone dipropionate (BDP), or (3)
      inhaled ALB, inhaled BDP, and oral THEO, were evaluated and compared as optimal
      pharmacotherapy for chronic asthma in 111 children. In this double-blind,
      parallel-group, multicenter study, children, aged 6 to 16 years with moderately
      severe asthma (unstable despite daily medications), were treated with one of the
      combinations for 12 weeks. Patients were evaluated every 4 weeks by spirometry
      and serum THEO measurement. Patients kept daily symptom diaries, measured peak
      flow rates twice daily, and recorded adverse events. Treatment groups did not
      differ in disease or demographic characteristics at study entry. All three
      combination treatments provided and maintained significant improvement in FVC,
      FEV1, and FEF25%-75% volume points, and compared with that of pretreatment, with
      no significant differences between treatments. Throughout the 12-week treatment
      period, however, patients receiving BDP had lower symptom scores, fewer had more
      than one asthma attack, fewer required "bursts" of prednisone (p = 0.001), and
      fewer required rescue medication (p = 0.009). Significantly more patients
      receiving BDP said that they felt better than they did at the beginning of the
      study compared with the number of patients not receiving BDP (p = 0.002). Adverse
      events were similar among treatment groups.

PMID- 1629507
TI  - A comparative study of the effects of an inhaled corticosteroid, budesonide, and
      a beta 2-agonist, terbutaline, on airway inflammation in newly diagnosed asthma:
      a randomized, double-blind, parallel-group controlled trial.
AB  - We compared the effect of an inhaled corticosteroid, budesonide, and an inhaled
      beta 2-agonist, terbutaline, on clinical symptoms, lung function, and airway
      inflammation in 14 adult patients with newly diagnosed asthma. The study was
      conducted as a randomized, double-blind, parallel-group trial. Seven patients
      inhaled 600 micrograms, twice daily, of budesonide, the other seven patients
      inhaled 375 micrograms, twice daily, of terbutaline via identical metered-dose
      inhalers with a spacer. Bronchial biopsy specimens, obtained before randomization
      and after 3 months of treatment, were analyzed by electron microscopy. Both
      groups improved clinically budesonide was more effective than terbutaline in
      improving morning and evening peak expiratory flow rates, as well as bronchial
      responsiveness to inhaled histamine. Treatment with budesonide was accompanied by
      increased numbers of ciliated airway cells and intraepithelial nerves and fewer
      inflammatory cells, including eosinophils, especially in the epithelium, these
      changes were not observed in specimens from terbutaline-treated patients. We
      conclude that, in contrast to inhaled terbutaline, inhaled budesonide improved
      lung function and bronchial hyperreactivity in adult subjects with asthma treated
      for 3 months and that this corticosteroid was more effective in ameliorating
      abnormalities of the bronchial epithelium and decreasing inflammation in the
      airways.

PMID- 1629508
TI  - Biochemical variability of venoms from individual European and Africanized
      honeybees (Apis mellifera).
AB  - To study biochemical differences between venom from individual honeybees, venom
      sacs from 103 European (EU) bees and 92 Africanized bees representing 12
      different colonies were dissected, and the dry weight (DW) of venom from each bee
      was determined. Venom from each of these bees was studied with isoelectric
      focusing and functional assays for phospholipase A2 and melittin. Phospholipase
      concentrations in individual EU bee venoms varied between 1.8% and 27.4% (wt/wt).
      The melittin concentration in EU bee venom varied less and, on the average, was
      found to be much lower than previously reported. There was an eightfold to
      ninefold difference between lowest and highest venom sac DW contents, suggesting
      the possibility of highly variable venom delivery from bee stings. One EU bee
      contained greater than 300 micrograms of venom, three times the recommended
      maintenance dose for venom immunotherapy. Isoelectric focusing also demonstrated
      large differences between individual bees, with respect to major and minor
      components of their venoms. Africanized bees contained significantly less venom
      but more phospholipase than did EU bees. Bee venoms from different colonies
      differed in their DW content and in their concentrations of phospholipase and
      melittin. The results are relevant to the uncertainty of responses from sting
      challenges and field stings in allergic patients and massive stinging attacks on
      normal subjects.

PMID- 1629509
TI  - Outcome of short-term hospitalization for children with severe asthma.
AB  - This study presents results of a family-centered, short-term residential program
      in which medical, behavioral, and treatment assessments were provided to the
      child with severe asthma and the family. After a median stay of 15 days, forty
      four consecutively admitted children with severe asthma achieved a 93% reduction
      in hospital days (median, 7 hospital days for the year before treatment versus
      median 0 hospital days per patient per year at 20 1/2-month follow-up; p less
      than 0.001) and an 81% reduction in emergency care (median, 4 visits for the year
      previously versus median, 0.4 visits per patient per year at follow-up; p less
      than 0.01). There was also a significant reduction in corticosteroid bursts and
      improvement in FEV1. Unique to this program was mandatory family participation
      focusing on the child's and family's adaptation to severe asthma and development
      of family-specific interventions to promote compliance with the treatment
      regimen. Child and family functioning was assessed at admission and follow-up.
      Hospital use at follow-up was greater for children from dysfunctional families.
      Families demonstrating difficulties in disciplining the child with asthma
      required more hospital days both before admission and at follow-up. Short-term
      hospitalization for children with severe asthma is associated with significant
      improvement in pulmonary morbidity when the family of the child is included in
      assessment and treatment.

PMID- 1629510
TI  - The nasal response to histamine challenge: effect of the pollen season and
      immunotherapy.
AB  - To evaluate changes in the nasal response to histamine, we challenged 19 subjects
      with allergic rhinitis caused by ragweed (RW) before, during, and after the RW
      season with increasing doses of histamine diphosphate. We compared their
      response, as measured by symptoms and the levels of TAME-esterase activity and
      albumin recovered in the nasal lavage fluid, with response of two groups with
      allergic rhinitis undergoing immunotherapy with moderate-dose (N = 16) and high
      dose (N = 11) RW (2 and 24 micrograms of antigen E [Amb a I] as maintenance dose,
      respectively). Four challenges with histamine were performed in each group:
      before, at the peak of, near the end of, and 2 weeks after the RW season. The
      three groups of subjects had similar skin sensitivity to antigen and levels of
      TAME-esterase activity and albumin recovered from nasal lavages after histamine
      challenge performed before seasonal exposure. Symptom diaries obtained throughout
      the season revealed a significant reduction only in the high-dose immunotherapy
      treated group. At the peak of the season, the untreated group had more symptoms
      in response to the challenge compared with the challenges before and after the
      season (p = 0.04 for both groups). The saline challenge occurring before
      challenging with histamine also demonstrated a significant increase at the peak
      of the season compared with increases before the season (p = 0.02). This
      observation was also true for the levels of albumin and TAME-esterase activity.
      If the response after saline challenge was subtracted from each response after
      histamine challenge, no difference was found in the results between any of the
      visits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629511
TI  - Promotional activities of the non-genotoxic carcinogen bemitradine (SC-33643).
AB  - Bemitradine (SC-33643), a diuretic antihypertensive agent, was studied for its
      carcinogenicity in a 2-year bioassay in Charles River CD rats via dietary admix
      at dosages of 50, 150 and 450 mg kg-1 for up to 97 weeks (after which they were
      followed for eight additional weeks without treatment). Body weights were
      decreased compared to controls: 5-15% in the female and 10-12% in the male dosage
      groups by week 105 of the study. Prolactin values were significantly increased in
      150 and 450 mg kg-1 females. The compound caused significant increased incidences
      of liver, thyroid (both sexes) and mammary (females only) neoplasms. The
      metabolism of bemitradine was studied in both rats and man. Bemitradine and its
      primary metabolite (SC-36741; desethylbemitradine) were tested and found to be
      non-genotoxic in Ames, rat primary hepatocyte UDS, CHO/HGPRT, CHO cytogenetics,
      in vivo mouse micronucleus and mouse lymphoma TK+/- (bemitradine only) assays.
      Finally, in an altered hepatic foci (Y-glutamyl transpeptidase positive)
      promotion assay in female Charles River CD rats, bemitradine was found to be a
      promotor, though not as potent as phenobarbital. We concluded that bemitradine
      (which has been dropped from development) is a non-genotoxic carcinogen which
      appears to act by a hormonally modulated promotional activity in inducing tumors
      in the liver and mammary glands. Tumors seen in the thyroid were probably
      secondary to the effects of bemitradine on metabolism.

PMID- 1629512
TI  - Flow cytometry, morphometry and histopathology as biomarkers of benzo[a]pyrene
      exposure in brown bullheads (Ameiurus nebulosus).
AB  - Brown bullheads were given a single intraperitoneal dose of 0, 5, 25 or 125 mg kg
      1 benzo[a]pyrene (BaP), a carcinogenic polycyclic aromatic hydrocarbon, and
      evaluated over 18 months. Flow cytometric analyses of hepatocyte DNA content
      indicated an increase in DNA synthesis in BaP-exposed fish prior to day 14 post
      exposure. Thereafter, all flow cytometric variables returned to initial levels.
      Histopathological evaluation of livers from fish sampled at 18 months revealed
      significant differences among treatments in the amount of hepatic macrophage
      ceroid pigmentation and basophilic staining intensity. No neoplasms or changes in
      blood cell DNA content were detected. Significant morphometric variations existed
      among fish, but differences between sexes overshadowed differences attributable
      to dose. Flow cytometry yielded no evidence of long-term DNA alterations from a
      single exposure to BaP; however, the differences detected by DNA analysis shortly
      after the toxic event suggest that flow cytometric cell cycle analysis may be
      useful for documenting continuing exposures.

PMID- 1629513
TI  - Embryolethality and teratogenicity of butyl benzyl phthalate in rats.
AB  - Pregnant Wistar rats were given butyl benzyl phthalate (BBP) at a dose of 2.0% in
      the diet on days 0-20, days 0-11 or days 11-20 of pregnancy. Food consumption and
      body weight gain were decreased in pregnant rats given BBP. Pre-implantation loss
      in the BBP-treated groups was comparable to that in the control and pair-fed
      groups. All dams given BBP on days 0-20 or days 0-11 exhibited complete
      resorption of all the implanted embryos. No increase in post-implantation loss
      was found in pregnant rats given BBP on days 11-20. Marked teratogenicity was
      detected in fetuses of the dams given BBP on days 11-20. Cleft palate and fusion
      of the sternebrae were predominantly observed. Seventy-two of the 134 fetuses had
      a cleft palate. The incidence of malformations in this group was significantly
      and markedly higher than that in the control and pair-fed groups. In conclusion,
      the administration of BBP during the first and second half of pregnancy produced
      embryolethality and teratogenicity, respectively.

PMID- 1629514
TI  - Tannin content of tea and coffee.
AB  - The tannin content of over-the-counter Indian tea, of green coffee beans and of
      the roasted coffee beans prepared from the same green beans was determined with a
      radial diffusion-protein precipitation technique and with a spectrophotometric
      method. The green beans contained 6.6 +/- 0.6 mg g-1 weight tannic acid
      equivalents as found by protein precipitation (n = 5, +/- SD) or 6.8 +/- 2.3 mg g
      1 by spectrophotometry. The same figures for roasted beans were 18 +/- 1.7 and 17
      +/- 2.7 mg g-1, respectively. Tea contained 37 +/- 2.6 mg g-1 weight tannic acid
      equivalents as analysed by spectrophotometry and 24 +/- 2.8 mg g-1 by the protein
      precipitation technique. The latter finding may show that the biological
      reactivity of tannins is variable, although no major changes in the tannin
      precipitated albumin occurred as shown by electrophoretic analysis. Both methods
      provide an easy analysis of the reportedly carcinogenic plant tannins.

PMID- 1629515
TI  - Comparative lethality of methanol, ethanol and mixtures in female rats.
AB  - The lethalities of pure methanol and pure ethanol were compared to two mixtures
      of ethanol/methanol with the following percentages (95/5% and 65/35% v/v). This
      study was conducted to simulate situations of human exposure to denaturated
      alcohol (by 5% methanol) or adulterated alcohol (by 35% methanol). Four groups of
      female adult virgin albino rats were treated with the four mixtures. A fifth
      group was used as a vehicle control. Graded oral doses were given to eight
      animals per dose. Lethality over 24 h was used as an end-point. The LD50 was
      calculated for each of the four treatments on a molar basis. A dose-response
      function for each mixture was plotted of percentage lethality vs. mmol kg-1
      equivalent to the given ml kg-1 dose. Results showed a significantly different
      LD50 estimates (P less than 0.03) for the four mixtures. The order of lethal
      toxicity was as follows: 95/5% methanol/ethanol, pure methanol, pure ethanol then
      65/35% methanol/ethanol. Slope comparisons indicated two pairs: 65/35%
      ethanol/methanol and pure ethanol yielding a steep slope, and 95/5%
      ethanol/methanol and pure methanol yielding a shallow slope. These data indicated
      that the acute lethality of ethanol/methanol mixtures is a complex unpredictable
      function. This toxicity presumably depends in a complicated way on the
      differences in the effective molecular weights of the two alcohols in each of the
      mixtures.

PMID- 1629516
TI  - Indirect and lactation-associated changes in renal alkaline phosphatase of
      newborn rats prenatally exposed to cadmium chloride.
AB  - Pregnant Sprague-Dawley rats were intraperitoneally injected with physiological
      saline solution (vehicle) or cadmium chloride (CdCl2) at 2.5 mg kg-1 body wt. on
      days 8, 10, 12 and 14 of gestation. Offspring were examined for renal alkaline
      phosphatase activity (ALP) on postnatal days (PND) 3 and 12, and for kidney
      metallothionein (MTh) and for liver, kidney and entire gastrointestinal tract
      109Cd content at birth and on PND 3 and 12. No effects were observed on neonatal
      survival or on body, liver and kidney weights of pups up to PND 12. Newborns born
      and fed by mothers exposed to CdCl2 during pregnancy exhibited a significant
      decrease in ALP activity on PND 3. Conversely, no significant changes were
      observed in newborns lactated by surrogate non-treated mothers. Renal MTh
      increased with age but was not influenced by maternal treatment. Traces of 109Cd
      were present in the liver at birth (5-7 ng). Thereafter, 109Cd was mainly found
      in the gastrointestinal tract of newborns lactated by their biological mothers
      (610-690 ng on PND 12), with a marginal uptake in the liver (10-12 ng on PND 12).
      109Cd was not detectable in the kidneys at any age (less than 4 ng). These
      results show that prenatal exposure to Cd cannot be the sole aetiological agent
      in the induction of the subtle and transitory changes in renal biochemistry
      observed in offspring born and fed by female rats intraperitoneally injected with
      2.5 mg CdCl2 kg-1 body wt. on days 8, 10, 12 and 14 of gestation. The results
      also contradict the role of a direct effect on the kidney.

PMID- 1629517
TI  - Renal effects of N-(3,5-disubstitutedphenyl)-succinimides in the Fischer 344 rat.
AB  - Previous studies have demonstrated the importance of substitution at the 3- and 5
      positions of the phenyl ring in N-phenylsuccinimides for the production of
      nephrotoxicants in this series of compounds. The purpose of this study was to
      determine if the electronic nature of the 3,5-substituents is an important
      determinant for nephrotoxic potential. Male Fischer 344 rats (four rats per
      group) were administered a single intraperitoneal injection of a succinimide (0.4
      or 1.0 mmol kg-1) or vehicle, and the renal function was monitored for 48 h. Only
      N-(3,5-dichlorophenyl)succinimide (0.4 or 1.0 mmol kg-1) induced marked changes
      in renal function. Urine volume, BUN concentration and proteinuria were increased
      following N-(3,5-dinitrophenyl)succinimide (1.0 mmol kg-1) treatment but other
      renal parameters and renal morphology were unchanged in this treatment group.
      These results indicate that the presence of halogen atoms at the 3- and 5
      positions of the phenyl ring in N-phenylsuccinimides is more important for
      nephrotoxic potential than the presence of non-halogen substituents. The reason
      why halogen substitution is an important determinant for N-phenylsuccinimide
      nephrotoxicity is unknown.

PMID- 1629518
TI  - The local lymph node assay: results of a final inter-laboratory validation under
      field conditions.
AB  - The local lymph node assay (LLNA) assesses the sensitizing activity of chemicals
      by measurement of primary lymphocyte proliferation in lymph nodes draining the
      site of application. In this final inter-laboratory study the consistency of LLNA
      results between laboratories and with guinea pig maximization test (GPMT) data
      was examined under 'field' conditions. Nine chemicals were evaluated
      independently by each laboratory according to guidelines for test concentration
      and vehicle selection developed during previous validation studies to ensure
      assay optimization. Equivalent predictions of sensitization potential were
      obtained by all laboratories for eight chemicals. Five of seven chemicals
      identified as sensitizers in the GPMT were correctly identified in the LLNA--four
      by all laboratories and 1 (4-chloroaniline) by one laboratory only--although in
      this latter case, two other laboratories obtained clear dose responses,
      suggestive of sensitization. The LLNA identified correctly those chemicals
      predicted to be extreme or strong sensitizers in the GPMT. The remaining two
      chemicals were non-sensitizers in the guinea pig and failed to elicit positive
      proliferative responses in the LLNA. These data demonstrate that sensitivity and
      reliability of the LLNA is retained when chemicals are evaluated independently,
      and that it provides a reliable pre-screen for the identification of chemicals
      with significant sensitization potential.

PMID- 1629519
TI  - Distribution to the fetus and major organs of the rat following inhalation
      exposure to pyrene.
AB  - Concentrations of pyrene and total metabolites were determined for individual
      fetuses and selected maternal organs and tissues immediately and 6 h following a
      95-min head-only exposure of pregnant Wistar rats, on gestation day 17, to five
      levels of pyrene over the range 200-800 mg m-3 as a microcondensation aerosol.
      The influence of uterine horn, side and position, on distribution to the fetus
      was assessed. The concentration of both pyrene and its metabolites increased more
      over the exposure range (eightfold) than did those in the fetus. Concentrations
      of pyrene or its metabolites in fetal tissues were not found to be related to its
      position on the uterine horn. There was an unexplained and significant (P less
      than 0.01) higher concentration of pyrene in fetuses on the right side relative
      to the left side of the uterine horn for the animals killed immediately following
      exposure. A comparison of the levels in maternal tissues measured immediately
      following the exposure and 6 h later showed that there was some redistribution of
      pyrene and its metabolites to the fat tissues, i.e. levels in the fat increased
      over the 6 h period following the exposure. Levels in the other tissues
      diminished during this period. In general, concentrations of pyrene and its
      metabolites were lowest in the fetal tissues relative to those in the sampled
      maternal organs and tissues.

PMID- 1629520
TI  - Arterial baroreflexes are not essential in mediating sympathoadrenal activation
      in conscious endotoxic rats.
AB  - We examined the contributions of arterial baroreceptor reflexes in mediating
      sympathoadrenal activation during endotoxicosis. Conscious rats with chronic
      sinoaortic denervation (SAD) or sham-operation (SHAM) were subject to endotoxin
      treatment (5 mg/kg, i.v.). Hemodynamic responses, renal sympathetic nerve
      activity (RSNA) and plasma catecholamines were assessed at different times post
      endotoxin infusion. In both SAD and sham groups, intravenous endotoxin injection
      induced a rapid and significant sympathoadrenal activation, as indicated by a
      parallel elevation of RSNA and plasma catecholamines. Such activation peaked 15
      30 min following endotoxin and was sustained throughout the 2-3 h protocol. The
      early response of the sympathoadrenal system to endotoxin is more profound in SAD
      rats compared to sham rats. We propose that the afferent neural input from
      arterial baroreceptors is not essential in mediating sympathoadrenal activation
      during sepsis. The elimination of feedback buffering mechanisms with SAD may
      account for the augmented sympathetic response seen in SAD animals.

PMID- 1629521
TI  - Inhibitory effect of noradrenaline on acute liver injury induced by carbon
      tetrachloride in the rat.
AB  - The effect of exogenous noradrenaline (NA) on acute liver injury was investigated
      in rats receiving a single dose of carbon tetrachloride (CCl4). Animals were
      divided into the following groups: (I) no treatment, used for plasma
      catecholamine assay; (II) received CCl4 only; (III) treated with CCl4 plus
      noradrenaline (NA). Plasma levels of catecholamine (CA) were elevated in both
      groups II and III, particularly in NA: average value at 33 h after the exposure
      of CCl4 increased to 290-fold of the control in group II and to 513-fold in group
      III. Subsequently, the levels of NA decreased with time, and were comparatively
      well-preserved in the rats of group III. Hepatic changes observed in the animals
      of group II were as follows: destruction with reduced number in rough endoplasmic
      reticulum; destruction and disappearance of cristae in mitochondria, and numerous
      fat droplets (shown by electron microscopy); histologically observed marked
      centrilobular necrosis with steatosis followed by progression with time; and
      microangiographically demonstrated deranged intrahepatic microvasculature. By
      contrast, these changes were successfully prevented by NA treatment (group III).
      Furthermore, histologically observed centrilobular change was restored with time.
      It was concluded that, in a deranged state, NA takes a form quite dissimilar to
      ordinary state: Na exerts for hapatoprotective and is highly involved in liver
      injury.

PMID- 1629523
TI  - Autonomic cardiovascular reflexes in progressive supranuclear palsy.
AB  - Assessment of possible autonomic nervous system dysfunction was performed by
      testing cardiovascular reflexes in nine patients with progressive supranuclear
      palsy (PSP). The patients were significantly different from 15 control age
      matched subjects because of greater blood pressure drop on standing for 1 min,
      diminished rise of diastolic blood pressure during the sustained handgrip test,
      and lack of compensatory tachycardia measured by the 30:15 ratio on standing. The
      latter test abnormality was caused by a slow rise to erect posture. No
      differences were observed in the cold pressor test, Valsalva ratio, and heart
      rate response to deep breathing. The differences between patients and control
      subjects were usually small. Autonomic nervous system involvement in patients
      with PSP is minor and is caused by involvement of central brain stem sympathetic
      nuclei or efferent fibers.

PMID- 1629522
TI  - Salivary secretion elicited by activation of the parabrachial nuclei in the cat.
AB  - The lateral pontine tegmentum contains the parabrachial nuclei (NPB) which have
      been identified as a relay nucleus for cardiovascular, respiratory and gustatory
      systems, but their role in the regulation of these systems is not well
      understood. We examined the effects of electrical and chemical stimulation of the
      NPB on blood pressure, phrenic and hypoglossal nerve activity and salivary
      secretion. These variables were measured in eight anesthetized (alpha
      chloralose/urethane, 30/150 mg/kg, n = 5) or decerebrate (n = 3) cats before,
      during, and after trains of electrical stimulation (1 ms pulse duration, 10 Hz 5
      min train duration, currents as low as 10 microA) delivered unilaterally to NPB.
      Stimulation of the NPB elicited copious salivary secretion (1100 +/- 270 mg, mean
      +/- S.D.; P less than 0.001). Secretion was blocked completely by prior
      administration of atropine. The effects of the stimulus train on the respiratory
      and cardiovascular systems were variable and inconsistent even though short
      latency responses of phrenic and hypoglossal nerve activities to single pulses
      were consistent. The short-latency response of phrenic nerve activity was
      biphasic, a decrease followed by an increase in activity; the response of
      hypoglossal nerve activity was monophasic, a transient increase in activity.
      Effects of electrical stimulation were replicated by the injection of an
      excitatory amino acid agonist (kainic acid) into the dorsolateral pons. Injection
      of 50 nl of 10 mM kainic acid into the NPB evoked salivary secretion, indicating
      that this response was elicited by stimulation of cell bodies in the region. In
      addition, chemical excitation increased breathing frequency, peak phrenic nerve
      activity, and blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629524
TI  - Postnatal development of noradrenaline-containing nerves of the rat uterus.
AB  - The postnatal development of noradrenaline (NA)-containing nerves of the rat
      uterus and its associated blood vessels was investigated using histochemical and
      biochemical methods. These studies were carried out in conjunction with
      examination of the morphology of the uterus and the density of blood vessels at
      the prepubertal, peripubertal and adult stages. It was demonstrated that: (1) the
      rat uterus is innervated at birth; (2) the innervation of blood vessels develops
      earlier than that of the myometrium and the density of NA-containing perivascular
      nerves is not affected by puberty; (3) between birth and day 30 (prepubertal)
      there was a progressive increase in the innervation of the myometrium which was
      accompanied by a progressive increase in the total NA content of the organ; (4)
      at the first oestrus there was a marked increase in the weight of the uterus and
      isolated myometrial and parametrial tissue. Both muscle cell size and number were
      also increased. The density of myometrial innervation by NA-containing nerves was
      markedly reduced, although the total NA content did not change at this stage.
      This indicates a 'dilution' of myometrial NA-containing nerves in a greater
      amount of non-neuronal tissue; and (5) between the peripubertal and adult stages
      there was a further increase in uterine weight together with an increase in the
      number of smooth muscle cells and a reduction in the density of myometrial NA
      containing nerves. Although the density of perivascular nerves was unaffected by
      puberty, the number of blood vessels supplying the uterus increased during the
      transition to the adult stage. This was reflected by a significant increase in
      the total NA content of the uterine horn and of isolated myometrial and
      parametrial preparations.

PMID- 1629525
TI  - Comparison of locations and peptide content of postganglionic neurons innervating
      veins and arteries of the rat hindlimb.
AB  - The ganglionic location of hindlimb vasoconstrictor sympathetic neurons in
      several species is known but the locations of neurons innervating limb arteries
      or veins, specifically, have not been compared and neurochemical differences
      between them have not been examined in detail. This study was designed to
      determine whether neurons innervating arteries and veins are organized as
      distinct populations and whether neurons innervating arteries, veins or footpads
      contain the same peptides. Retrograde transport of fluorescent dyes was used to
      identify, separately, paravertebral postganglionic neurons in the 13th thoracic
      to 6th lumbar (T13-L6) chain ganglia that innervate the femoral arteries, femoral
      veins and footpads of the rat hindlimb. The proportions of venous and arterial
      vasomotor neurons and footpad neurons containing neuropeptide Y- and vasoactive
      intestinal polypeptide-immunoreactivity (NPY-Ir, VIP-Ir) were then compared.
      Venous vasomotor neurons were found mostly (62%) in the L1 and L2 ganglia. The
      majority of arterial vasomotor neurons (81%) were distributed slightly more
      caudally in L1-L3. Veins and arteries were not innervated by the same cells.
      Footpad neurons were located mostly in L4-L6. NPY-Ir was identified in 17% of the
      venomotor neurons, in 94% of arterial neurons and in 24% of footpad neurons. VIP
      Ir was found in 3% of the venomotor neurons, 8% of the arterial neurons and in
      44% of the footpad neurons. In conclusion, hindlimb venous and arterial vasomotor
      neurons are anatomically distinct, are mixed randomly within the chain ganglia
      and differ markedly in their content of NPY, consistent with reported differences
      in neuromuscular transmission to arteries and veins. The most likely hindlimb
      postganglionic neurons to contain VIP were those innervating footpads, probably
      controlling sweat gland function.

PMID- 1629526
TI  - The reflex bradycardia evoked by brain ischemia and its relation to aortic A- and
      C-fiber baroreceptors.
AB  - In urethane-anesthetized rabbits with the right aortic nerve (RAN) sectioned, we
      examined the reflex heart rate (HR) responses during brain ischemia for
      approximately 30 s, by applying the anodal block to the unsectioned left aortic
      nerve (LAN) and, subsequently, by denervating the LAN. The maximum decreases in
      HR occurred at around 30 s after the onset of brain ischemia. The anodal block
      used in this study selectively inhibited the aortic A-fiber conduction but did
      not inhibit the volley of aortic C-fibers. The maximum HR fall responses to brain
      ischemia with and without the anodal block were 143 +/- 7 and 183 +/- 7
      beats/min, respectively. When the maximum value of HR fall during brain ischemia
      in the absence of aortic nerve signals was subtracted from these two values, the
      reflex HR fall responses to brain ischemia with aortic C and A baroreceptor
      activation were 98 +/- 7 and 43 +/- 8 beats/min, respectively. In another series
      of experiments used for the same techniques, the reflex fall in HR seen during
      brain ischemia with the anodal block was totally abolished by vagotomy. The
      results indicate that the ability of aortic C baroreceptors becomes more
      prominent on the magnitude of brain ischemia-induced reflex bradycardia as
      compared to that of aortic A baroreceptors.

PMID- 1629527
TI  - Long-term care choices for geriatric residents.
AB  - Nursing home residents have been customarily excluded from participating in
      making decisions about their own care. However, gerontological nurses have
      demonstrated that giving residents choices about their daily activities enhances
      resident independence and self-esteem. Study results indicate that residents in
      long-term care facilities are not receiving opportunities to make choices about
      their daily activities as often as choices are made for them. Many of the choice
      giving behaviors did not take any more of the caregiver's time. The study assumed
      that choices about daily activities, dressing, and group participation were
      important to residents. Future study should include a survey of residents to
      determine what type of choices are important to them. Residents could be asked to
      prioritize activities that they would most like to have a choice about.

PMID- 1629528
TI  - Patients with dementia involving families to maximize nursing care.
AB  - Incorporating family members in the care of patients with dementia provided
      pertinent psychosocial data, led to mutual decision-making regarding care, and
      produced changes in the responses of the residents with dementia, as well as in
      the family and nursing staff. The experimental group experienced increases in
      psychosocial nursing diagnoses with planning and interventions to meet the
      problems, more extensive problem description, and an active focus on interaction
      and change in the nurse's notes. As a result of collaborative nursing and family
      involvement, personal articles were brought from home; family collateral visits
      and interaction increased; families were more involved in the unit, medical
      center, and support groups; and p.r.n. medication use was decreased. As health
      care technology prolongs the life of patients with chronic illness and sequelae
      such as dementia, nurses will need to continue to include families as
      collaborators in providing quality care.

PMID- 1629529
TI  - Geriatric nursing in the baccalaureate curriculum.
AB  - Increased gerontological nursing content is needed in the curriculum of schools
      of nursing because of a dramatic increase in the number of older persons, many of
      whom will need specialized health care. A review of the gerontological nursing
      content in the current courses of a college of nursing led to specific
      recommendations for change and additions to the curriculum. A published list of
      suggested gerontological nursing content was used as a guide to determine which
      topics needed to be integrated into the curriculum. An ongoing evaluation of the
      curriculum is needed to determine the appropriateness of the content changes and
      to determine if students perform better as a result of these changes.

PMID- 1629530
TI  - Musical debate.

PMID- 1629531
TI  - Patients in acute care settings. Which health-care services are provided?
AB  - Studies have shown that early discharge planning, multidisciplinary care, and a
      focus on functional abilities for older adults do reduce acute care hospital
      readmissions. Of the 101 records reviewed of acute care admissions 75 years of
      age and older, 36 had no multidisciplinary service documented and 75 had no
      discharge planning documented within 48 hours of admission. Eleven functional
      activities were assessed and documented in one record with a range of 4 to 11
      activities assessed in the remaining 100 documents. Identifying and filling gaps
      in care provided to this age group might provide substantial cost savings,
      improve care, and decrease complications. Advocacy, coordination of care, and
      greater knowledge may be keys to narrowing these service gaps.

PMID- 1629532
TI  - Focusing on dementia.

PMID- 1629533
TI  - Artificial nutrition and hydration.

PMID- 1629534
TI  - A matter of choice.

PMID- 1629535
TI  - Discharge planning predicting patients' needs.
AB  - The elderly are at higher risk for longer and more frequent lengths of hospital
      stay than other adults. Comprehensive discharge planning programs, including
      early identification of those at risk, can alter these statistics. Screening
      inventories to identify patients at risk have been available for many years, but
      they are not specific to the needs of the elderly. The Blaylock Risk Assessment
      Screen (BRASS) is administered on admission and identifies patients at risk for
      prolonged hospital stay and in need of discharge planning resources. The nurse
      can use the data BRASS provides to improve care outcomes while the patient is in
      the hospital and in the transition to home care. It shows promise for use as the
      first phase of a discharge planning program.

PMID- 1629536
TI  - The pursuit of happiness.

PMID- 1629537
TI  - Trapeziometacarpal osteoarthritis: surgical technique and results of "stabilized
      resection-arthroplasty".
AB  - Since 1973, 212 hands of 179 patients with disabling trapeziometacarpal
      osteoarthritis were treated with resection-arthroplasty stabilized by
      capsuloplasty and intermetacarpal ligament construction; 159 patients (180 hands)
      could be followed up (average, 7.8 years; range, 1 to 17.3 years). Pain relief
      was excellent in 89%, good in 10%, and fair in 1%. Patients were "delighted"
      (78%), "satisfied" (18%), "indifferent" (2%), or "disappointed" (2%) with their
      functional results. Palmar abduction improved 25%. The tip of the thumb reached
      the fifth metacarpophalangeal joint in 97% of the hands. Grip strength improved
      29%; key pinch, 19%; pulp pinch, 24%. First metacarpal was stable in 94% of the
      cases. Scaphometacarpal space averaged 5.5 mm. There were three complete failures
      (2%); complications were mild and infrequent. Because of its good, predictable
      results, "stabilized resection-arthroplasty" is our preferred surgical treatment
      for osteoarthritic trapeziometacarpal joints.

PMID- 1629538
TI  - Trapeziometacarpal joint arthrodesis: a functional evaluation.
AB  - Over a 10-year period, 39 trapeziometacarpal (TM) joint fusions were performed in
      37 patients. Pin fixation was used in 27 fusions and staple fixation in 12; all
      were bone grafted. There were five delayed unions (greater than 3 months) and
      three nonunions. Twenty-four fusions were evaluated at an average of 4 years.
      Subjectively, there were 11 excellent, 7 good, 5 fair, and 1 poor result. Grip
      and pinch strength were symmetrical, and the nine-hole peg test (a measurement of
      dexterity) was slightly better on the treated side. X-ray films were taken and
      compared with 25 normal films to assess metacarpal mobility. There was a 72%
      reduction in the adduction/abduction arc and a 61% reduction in the
      flexion/extension arc. Despite the marked decrease in motion, subjective
      functional complaints were minimal. X-ray films were evaluated independently by a
      radiologist to assess progression of degenerative changes. Only two patients were
      noted to have changes at the scaphotrapezial joint.

PMID- 1629539
TI  - Long-term follow-up of trapeziometacarpal arthroplasty with coexisting
      scaphotrapezial disease.
AB  - Visualization of the scaphotrapezial joint during basal joint arthroplasty has
      been recommended to establish the stage of degeneration. This study attempts to
      clarify that recommendation and evaluate whether moderate wear of the joint
      precludes a good result of trapeziometacarpal hemiarthroplasty. To assess the
      need for inspection of the scaphotrapezial joint, x-ray films, tomograms, and
      operative findings in 23 cases of basal joint arthroplasty were reviewed. X-ray
      findings agreed with operative findings at the scaphotrapezial joint in only 76%
      of the cases. We also evaluated 18 thumbs in 15 patients who underwent
      interposition arthroplasty of the trapeziometacarpal joint and at surgery had
      moderate degenerative changes of the scaphotrapezial joint. The scaphotrapezial
      joints were left intact and the trapeziometacarpal joints were reconstructed.
      Follow-up averaged 8 years. In no case was there x-ray or symptomatic progression
      of the disease at the scaphotrapezial joint. Clinically, 78% were rated
      excellent, 17% good, and 5% fair.

PMID- 1629540
TI  - The prevalence of carpal tunnel syndrome in patients with basal joint arthritis
      of the thumb.
AB  - Basal joint arthritis of the thumb and carpal tunnel syndrome are common
      conditions with an acknowledged coexistence. This article attempts to quantify
      the prevalence of carpal tunnel syndrome in patients with basal joint arthritis
      and to examine some of the etiologic factors that affect the coexistence of the
      two disorders. Of 246 patients who had surgery about the basal joint, 95 patients
      (39%) were identified by chart review as having carpal tunnel syndrome. Eleven of
      122 remaining patients contacted had symptomatic carpal tunnel syndrome confirmed
      by nerve-conduction studies, bringing the total to 106 (43%). The prevalence was
      higher in worker's compensation patients and those with diabetes mellitus. The
      prevalence was lower in men than in women, and patients with inflammatory joint
      disease were at less risk than those with osteoarthritis. Given this high
      association, great care should be taken to diagnose or exclude coexistent carpal
      tunnel syndrome in patients scheduled for basal joint surgery so that, if
      present, it can be treated at the same time, diminishing the risk of
      postoperative morbidity and delayed symptoms.

PMID- 1629541
TI  - Thermographic observations in unilateral carpal tunnel syndrome: report of 61
      cases.
AB  - This study was undertaken to assess the sensitivity and specificity of
      thermographic diagnosis of unilateral carpal tunnel syndrome in a patient
      population large enough to permit meaningful statistical analysis. Sixty-one
      persons with clinical diagnoses of unilateral carpal tunnel syndrome confirmed by
      electrodiagnostic examination and 40 symptom-free volunteers underwent standard
      thermographic examinations. The thermographic images were then randomly sorted
      and interpreted by an experienced physician thermographer. Fifty-seven of the 61
      patients with carpal tunnel syndrome were found to have thermographic
      abnormalities, while only one of the control group was found to have such an
      abnormality. Individual area sensitivity was highest in the dorsal area, but
      addition of other regions increased this measure; specificity ranged between 98%
      and 100%. These findings would appear to confirm the value of thermography in the
      diagnosis of unilateral carpal tunnel syndrome.

PMID- 1629542
TI  - Factors that determine reexploration treatment of carpal tunnel syndrome.
AB  - Eighteen patients (20 hands) underwent reexploration of the carpal tunnel after a
      primary carpal tunnel release. The patients complained of unrelieved symptoms
      after their initial surgical procedures. We recommend reexploration for patients
      with unrelieved carpal tunnel syndrome if they have a positive Phalen's test,
      have symptoms that cause nocturnal wakening or are exacerbated by activities, or
      have a short or transverse initial incision. If the incision is adequate and
      these symptoms are not present, we believe that reexploration will not result in
      a satisfactory outcome.

PMID- 1629543
TI  - Rotary subluxation of the scaphoid resulting in persistent carpal tunnel
      syndrome.
AB  - Rotary subluxation of the scaphoid has not been previously reported in the
      English-language literature as a factor causing persistent or recurrent carpal
      tunnel syndrome. This report describes a sixty-seven-year-old man with persistent
      carpal tunnel syndrome. X-ray films showed a scapholunate gap and the scaphoid
      maintained a flexed position. At surgery the median nerve was found to be fixed
      to the undersurface of the transverse carpal ligament on the lateral side and was
      being compressed by the distal pole of the scaphoid.

PMID- 1629544
TI  - Injection injuries to the median and ulnar nerves at the wrist.
AB  - Carpal tunnel syndrome is often treated nonoperatively with temporary wrist
      immobilization and local steroid injections. A direct injection into a peripheral
      nerve can result in permanent damage. Two cases of median nerve injection injury
      and one involving the ulnar nerve are presented; all were treated with neurolysis
      and debridement of the injected material. At follow-up ranging from 1 to 11
      years, all patients showed significant improvement, but with some functional
      loss. The literature is confusing because of the variety of injection techniques
      used for the treatment of carpal tunnel syndrome, some of which put the median
      nerve at risk. We recommend that the injection be made midway between the
      palmaris longus tendon and the flexor carpi ulnaris tendon just proximal to the
      proximal edge of the transverse carpal ligament in a line with the superficialis
      tendon of the ring finger. The injection should be stopped and redirected if the
      patient experiences paresthesia of any kind.

PMID- 1629545
TI  - The internal anatomy of the median nerve in the region of the elbow.
AB  - The internal anatomy of the median nerve in the region of the elbow has been
      studied by microdissection in 20 cadavers. Gross branching patterns were studied
      in an additional 14 cadavers. There are four major branches or branch groups: I
      to pronator teres, II to flexor carpi radialis, flexor digitorum superficialis,
      and palmaris longus; III to the anterior interosseous nerve; and IV to flexor
      digitorum superficialis. Three of these could be traced proximally within the
      main trunk of the median nerve, the average being I-10 cm; III-7.5 cm; IV-2 cm.
      This information should have clinical applications in repair and grafting of the
      median nerve near the elbow and in understanding clinical nerve compression
      sydromes.

PMID- 1629546
TI  - Pisiform-hamate coalition with ulnar neuropathy.
AB  - Two cases of pisiform-hamate coalition with compression of the ulnar nerve at the
      wrist are reported. Pisiform-hamate coalition is a rare entity previously thought
      to be exclusive to West Africans and without clinical significance. These cases
      occurred in white patients. This is the first description of a carpal coalition
      resulting in ulnar neuropathy at the wrist.

PMID- 1629547
TI  - Localized nodular synovitis: a rare cause of ulnar nerve compression in Guyon's
      canal.
AB  - A rare case of ulnar nerve entrapment at the wrist by a nodule of localized
      nodular synovitis is presented. The literature is reviewed with particular
      reference to the causes of ulnar tunnel syndrome, the uncertainty over the origin
      of this type of tumor, and its tendency to recur after incomplete excision.

PMID- 1629548
TI  - Nerve tension and blood flow in a rat model of immediate and delayed repairs.
AB  - In vivo studies of rat sciatic nerves in models of immediate and delayed repairs
      demonstrated the viscoelastic properties of the nerve and the inverse correlation
      between nerve blood flow and tension. In both the proximal and distal segments of
      the divided nerve in models of immediate and delayed repairs, the nerve blood
      flow decreased approximately 50% with substantial recovery in 30 minutes after 8%
      elongation, whereas 15% elongation produced approximately an 80% reduction in
      blood flow with minimal recovery. However, the baseline blood flow of the nerves
      in the delayed-repair model was nearly two times higher than that of the acutely
      injured nerves. Maximal decrease in nerve tension and corresponding increase in
      blood flow occurred within the first 20 minutes after elongation. The suture pull
      out with failure of the repairs occurred at more than 15% elongation for all
      nerves. The previously divided nerves had a sixfold greater decrease in length
      than the acutely divided nerves (p less than 0.02). For repairs of large nerves
      where vascular ingrowth is likely to be incomplete, elongation of more than 8%
      may cause ischemia that is detrimental to nerve regeneration. Mechanical failure
      of the repairs occurs after elongation of 16% to 17%. The combination of nerve
      ischemia and mechanical failure of suture repairs suggests that surgeons should
      be careful to limit the use of elongation in acute and delayed repairs.

PMID- 1629549
TI  - A new cause of trigger thumb.
AB  - We report a case of severe painful triggering in the thumb caused by intermittent
      locking of the interphalangeal joint by a sesamoid bone. The triggering was
      corrected by excision of the interphalangeal joint sesamoid bone.

PMID- 1629550
TI  - Adhesions between muscle and bone after forearm fracture mimicking mild
      Volkmann's ischemic contracture.
AB  - Five cases of digital flexion contractures after healed forearm fractures were
      incorrectly diagnosed as mild Volkmann ischemic contractures. All failed to
      respond to conservative therapy and were considered significant enough to require
      surgical correction. At surgery, the involved muscle-tendon units were densely
      adherent to the bone and callus of the fracture site with no evidence of ischemic
      involvement of the muscle. Lysis of adhesions and lengthening of the contracted
      muscle corrected the deformities.

PMID- 1629551
TI  - Elbow flexion contractures treated with serial casts and conservative therapy.
AB  - We report on the technique of serial casts to successfully reverse elbow flexion
      contractures in three patients. Patients considered for this technique had a
      traumatic injury to the elbow that resulted in residual soft tissue restrictions;
      their mean flexion deformity was 44 degrees, which had been present for an
      average of 6 months. Treatment consisted of traditional therapy methods to obtain
      initial stretch and elongation of tissue followed by application of a cylindrical
      fiberglass cast in the position of maximal elbow extension. The cast was worn for
      3 to 5 days, then removed, and the entire process was repeated. After the use of
      serial casts, elbow flexion contractures were reduced to a mean of 11 degrees.
      These results have been maintained over an average of 26 months. The use of casts
      in the treatment of elbow flexion contractures appears to be a viable technique
      for increasing range of motion when traditional methods of treatment alone are
      unsuccessful and surgical intervention may be the only alternative.

PMID- 1629552
TI  - Changes in wrist and forearm configuration with grasp and isometric contraction
      of elbow flexors.
AB  - The purpose of this study was to determine the changes in wrist and forearm
      configuration with grasp and elbow flexor contraction by analysis of resting and
      grasping x-ray films of 15 normal adults and forearm scanograms of 10 other
      normal subjects. With grasp, a significant proximal migration of the radius
      (averaging 0.9 mm), a decrease in the carpal height ratio, and an increase in the
      lunate uncovering index were observed. With flexor contraction, there was a
      significant decrease in the forearm interosseous space.

PMID- 1629553
TI  - Hand reconstruction with allograft demineralized bone: twenty-six implants in
      twelve patients.
AB  - A long-term study of 26 phalangeal or metacarpal defects that were reconstructed
      with allogeneic demineralized bone implants demonstrates healing comparable to
      that which follows autogenous bone grafting. Average follow-up was 54 months.
      Five patients had multiple enchondromas (Ollier's syndrome), five children had
      congenital hand deformities, and all of these had previously had bone grafts
      harvested for associated craniofacial reconstructions. With the use of
      demineralized bone implants, tourniquet and operative times were significantly
      reduced and potential donor site morbidity was eliminated. Further, regional
      anesthesia was used more frequently and hospitalization time was reduced. There
      were no postoperative complications. Demineralized bone implants have been
      particularly useful in patients who previously had refused bone grafting.

PMID- 1629554
TI  - Salvage in a case of ring avulsion injury with an immediate second-toe wrap
      around flap.
AB  - A nonreplantable complete degloving injury to the small finger of a young woman
      was treated with the immediate microsurgical transfer of a second-toe wrap-around
      flap. One year after the operation, the donor foot was free of symptoms, and the
      reconstructed finger had an excellent cosmetic appearance, a range of motion of
      0/90 degrees at both the metacarpophalangeal and the proximal interphalangeal
      joints, and a two-point discrimination of 6 mm. In selected patients, when the
      degloved skin envelope cannot be revascularized and when the skeletal and
      tendinous units are still intact, an immediate second-toe wrap-around flap may be
      a good alternative to amputation.

PMID- 1629555
TI  - Embryologic development and variations in the anatomy of the ulnocarpal
      ligamentous complex.
AB  - Eighteen fetal hand specimens were reviewed in an effort to clarify variations in
      reports of the ligamentous anatomy of the ulnar side of the wrist. Sizes ranged
      from 45 mm crown-rump length (CRL) to 325 mm CRL. Representative coronal sections
      from the 2779 sections available were reviewed. Significant variations in size of
      triquetral attachment and thickness and consistency of the ulnocarpal ligamentous
      complex (UCLC) were observed. Each of the specimens exhibited one of four UCLC
      variations: (1) 5 of 18 (28%) with an average CRL of 187 mm had a dense, thin
      UCLC, with a focal triquetral attachment; (2) 7 of 18 (39%) with an average CRL
      of 209 mm had a focal, dense attachment of a thick UCLC to the triquetrum; (3) 5
      of 18 (28%) with an average CRL of 220 mm exhibited a thick, dense UCLC with a
      broad attachment to the triquetrum; and (4) 1 of 18 (5%) with a CRL of 166 mm was
      unique, with a loose, areolar UCLC broadly attached to the triquetrum.

PMID- 1629556
TI  - Matched distal ulna resection for posttraumatic disorders of the distal
      radioulnar joint.
AB  - In 1985 we published the results of the matched ulna resection in 44 patients,
      the majority of whom had rheumatoid arthritis. The matched ulna resection
      maintains the continuity of the distal ulna to the ulnar sling mechanism,
      including the triangular fibrocartilage complex (TFCC), and resects the distal
      ulna in a smooth, curved, convex fashion to match the contour of the radius
      throughout forearm rotation. This article presents the results of the procedure
      in patients with posttraumatic and mechanical disorders of the distal radioulnar
      joint. Good to excellent results were noted in 24 of 32 patients. The outcome was
      related to the severity of the patient's initial problem.

PMID- 1629557
TI  - Wafer distal ulna resection for triangular fibrocartilage tears and/or ulna
      impaction syndrome.
AB  - Partial resection of the distal ulna (wafer resection) has been used to treat
      patients with symptomatic tears of the triangular fibrocartilage complex or mild
      ulna impaction syndrome. In this procedure, the distal 2 to 4 mm of the distal
      ulnar head is resected while preserving the ulnar styloid process and the
      ligaments attached to it. The triangular fibrocartilage is debrided, repaired, or
      partially excised as necessary. The procedure is contraindicated if there is more
      than 4 mm of positive ulnar variance. Thirteen wafer resections of the distal
      ulna were performed in 12 patients. All had good to excellent results after a
      minimum follow-up of 1 year. Wafer resection has specific advantages and avoids
      many of the potential complications of distal ulna recession and ulnar head
      resection for patients with the conditions described. The procedure is not
      indicated if instability or degenerative arthritis of the distal radioulnar joint
      is present or if there is carpal instability.

PMID- 1629558
TI  - Computerized tomographic evaluation of acute distal radial fractures.
AB  - To learn whether computerized tomography offered additional useful information
      over conventional radiographic evaluation of acute distal radial fractures in the
      younger adult, we scanned 22 consecutive injured wrists. Of the distal radial
      fractures in 19 wrists, sixteen were defined on plain films as intra-articular.
      In contrast, computerized tomography demonstrated that all fractures of the
      distal radius had intra-articular extension. In 3 wrists interpreted as being
      normal on plain films, despite clinical suspicion of a fracture, fractures were
      confirmed by computerized tomography. As a result of computerized tomography,
      injuries were assigned a higher Frykman value in 5 cases, and consideration of
      alternative patient management became necessary in 5 of the 22 patients.

PMID- 1629559
TI  - Open reduction and internal fixation for distal radius fractures.
AB  - From a series of 650 dorsally angulated fractures of the distal radius, 32 intra
      articular fractures were treated by open reduction and internal fixation. The 32
      fractures were classified according to the Frykman criteria as type VII (5) or
      type VIII (27). On the basis of the location of intra-articular involvement, the
      fractures were further subdivided into Mayo type II (4), type III (18), and type
      IV (10). Results were analyzed by the methods of Gartland and Werley (functional)
      and Lidstrom (radiographic). After open reduction and internal fixation, 90% of
      the patients had satisfactory results on the basis of the subjective criteria of
      minimal deformity, absence of pain, and good strength. Objective assessment
      demonstrated that the patients had 80% of normal motion and 73% of normal grip
      strength at a minimum of 2 years after the operation. On the basis of
      radiographic and functional evaluation, results were good to excellent in 87%.
      When intra-articular step-off exceeded 2 mm or the radius was shortened more than
      5 mm, the results were only fair and posttraumatic arthritis was evident.

PMID- 1629560
TI  - Multidirectional radiocarpal dislocation without fracture: a case report.
AB  - The first reported case of posttraumatic multidirectional instability of the
      radiocarpal joint is described with a review of the relevant literature. A 31
      year-old man sustained a palmar radiocarpal dislocation that also dislocated
      dorsally with gentle provocation and showed ulnar translation and a dorsal
      intercalated segmental instability pattern after closed reduction. Treatment
      consisted of open reduction and internal fixation with 11 weeks of
      immobilization. Follow-up at 32 months showed excellent clinical and radiographic
      results. Multidirectional instabilities of the radiocarpal joint can occur with
      radiocarpal dislocation, and one must look for them when planning treatment.
      Anatomic realignment of the bones and joints is recommended to allow soft tissue
      healing and prevention of secondary ligamentous laxity.

PMID- 1629561
TI  - Transtriquetral perihamate ulnar axial dislocation and palmar lunate dislocation.
AB  - Transtriquetral perihamate ulnar axial dislocation associated with palmar lunate
      dislocation is a rare condition. We could find no other similar cases reported.
      The mechanism of injury was a combined anteroposterior crushing force that caused
      axial disruption of the carpus and the metacarpals and wrist hyperextension that
      caused the transtriquetral lunate dislocation. Our patient was treated with open
      reduction and internal fixation with good result.

PMID- 1629562
TI  - Three-dimensional reconstruction of the carpus and its vasculature: an anatomic
      study.
AB  - Three-dimensional reconstructions of the carpus have been assembled from
      tomographic data of anatomic specimens after vascular injection with resin
      polymer of a density similar to that of bone. We have been able to produce three
      dimensional reconstruction of the relationship between carpal bones and their
      vasculature. Fine tomographic slicing, on the order of 1 mm, has yielded sharp
      definition of bone structure, particularly of the entry points of nutrient
      vessels. The use of a very fluid synthetic resin has made possible the definition
      of vessels of fine caliber. A computerized program of three-dimensional
      reconstruction was used to obtain a series of views spaced at 10 to 20 degrees at
      predetermined right-angled axes. This has provided a precise matching of vessels
      with their corresponding points of bony penetration. This new method of imaging
      has enabled us to describe the entire vasculature of the bones of the carpus. The
      technique enjoys a number of advantages over conventional methods of study of
      carpal vasculature. In practice, the various known methods of arteriographic and
      digital angiographic examination do not have the same high definition and are
      unable to eliminate the effect of superimposition of views. In addition, the
      dissections are difficult and are likely to produce significant artifact.
      Corrosion techniques are elegant, but they are time-consuming, delicate
      procedures if selective isolation of bone and vasculature is required.

PMID- 1629563
TI  - Compressive forces.

PMID- 1629564
TI  - Effects of bile acids and bilirubin on bicarbonate secretion of isolated guinea
      pig antrum.
AB  - The effects of bile acids and bilirubin, which increase in blood in obstructive
      jaundice, on bicarbonate secretion were studied experimentally using isolated
      antral mucosa of the guinea pig. Antral mucosal preparations were mounted between
      Ussing chambers. Basal and bethanechol-stimulated secretion were measured by a pH
      stat device using 5 mM HCl. After 10(-4), 10(-3), and 5 x 10(-3) M taurocholic
      acid, 10(-4) and 10(-3) M cholic acid, and 1.2 x 10(-4) and 2.4 x 10(-4) M
      bilirubin conjugate were added to the serosal solution, basal and bethanechol
      stimulated secretion were also measured. Taurocholic acid, at any dose, did not
      affect basal secretion, but bethanechol-stimulated secretion was inhibited dose
      dependently. Cholic acid and bilirubin conjugate did not affect basal secretion,
      but bethanechol-stimulated secretion was significantly inhibited. Although the
      addition of bile acid or bilirubin into the serosal solution under experimental
      conditions is not the same as obstructive jaundice, these studies suggest that
      the inhibition of bicarbonate secretion in the gastric mucosa may have an
      important role in the formation of acute gastric mucosal lesions in obstructive
      jaundice.

PMID- 1629565
TI  - Determination of gastroduodenal alkaline responses using pH deflection in the
      rat.
AB  - We set up a new system for measuring the gastroduodenal HCO3- responses using pH
      deflection and the potential difference (PD) in the anesthetized rat. The stomach
      or the proximal duodenum was perfused at a flow rate of 0.7 ml/min with saline
      (pH 4.5), the pH of the perfusate and PD were continuously monitored, and HCO3-
      output was determined as acid-neutralizing capacity by back-titration of the
      perfusate to pH 4.5. In the case of the stomach, acid secretion was inhibited by
      omeprazole (60 mg/kg i.p.). Under these conditions, the pH, PD, and HCO3- output
      were 5.5 +/- 0.03, -3.8 +/- 0.4 mV, and 1.5 +/- 0.3 microEq/10 min in the
      duodenum and 5.4 +/- 0.04, -52.4 +/- 1.8 mV, and 1.2 +/- 0.3 microEq/10 min in
      the stomach, respectively. In addition, when various amounts of NaHCO3 were added
      into the system, a linear relationship was obtained between the area of pH
      deflection and the amount of added HCO3- (r = 0.999). Both pH and HCO3- output in
      these tissues were significantly increased by intravenous administration of
      prostaglandin E2, carbachol, and YM-14673 (a TRH analogue); the net HCO3- output
      in the duodenum was 8.7 +/- 1.3, 2.3 +/- 0.5, and 5.2 +/- 0.9 microEq,
      respectively. The values of net HCO3- output measured by back-titration coincided
      well with those obtained from the area of pH deflection caused by various agents.
      These results indicate that this system using pH deflection may be useful for
      quantitative determination of HCO3- response in the gastroduodenal mucosa.

PMID- 1629566
TI  - Helicobacter pylori has an ulcerogenic action in the ischemic stomach of rats.
AB  - Helicobacter pylori (H. pylori) is now accepted as an important cause of chronic
      active gastritis. There also seems to be an association between the colonization
      of H. pylori in the gastric mucosa and peptic ulceration. However, it has not
      demonstrated that the instillation of H. pylori into the stomach produces the
      ulcerative gastric lesions in animals or humans. We carried out an experiment to
      study whether or not H. pylori has an ulcerogenic action in the ischemic stomach
      of rats, using an ex vivo gastric chamber. The rat stomachs were exposed to 1 ml
      of H. pylori solution (200 IU of urease/ml) and 1 ml of urea (400 mg/dl) for 60
      min after the creation of ischemia in the stomach (by withdrawal of 3 ml of
      blood). The exposure of the stomach to both H. pylori and urea resulted in severe
      hemorrhagic gastric mucosal lesions with a marked decrease in potential
      difference (PD) with a concomitant increase in ammonia concentration in rats with
      ischemia, whereas gastric lesions and a fall in PD were hardly observed in rats
      without ischemia. These results have demonstrated that H. pylori has an
      ulcerogenic action on the stomach subjected to mucosal ischemia.

PMID- 1629567
TI  - Protection of gastric mucosa against ethanol-induced injury by intragastric bolus
      administration of epidermal growth factor combined with hydroxypropylcellulose.
AB  - Orally administered epidermal growth factor (EGF) has been shown to protect the
      gastric mucosa against injury induced by noxious agents. However, EGF
      administered by intragastric bolus appears to have less effect on the gastric
      mucosa because of its rapid excretion from the gastric lumen. In this study,
      mouse EGF given to rats by gastric intubation was confirmed to remain in the
      stomach at significantly high concentrations when given in combination with
      hydroxypropylcellulose (HPC), an agent that retards drug release. The residual
      mouse EGF levels in the gastric luminal content and tissue 3 h after
      administration of 50 micrograms/kg of EGF dissolved in 1 ml of 2% HPC were 30 and
      60 times higher, respectively, than those obtained after EGF alone. Pretreatment
      with intragastric bolus administration of EGF and HPC at the same dose for 3 h
      attenuated significantly the development of gastric lesions induced by absolute
      ethanol compared to that with HPC alone, EGF alone, or saline (mean values of
      ulcer index: EGF + HPC, 14.3; HPC, 52.8; EGF, 50.7; and saline, 63.2 mm). There
      were no significant differences between the ulcer index in the HPC, EGF, and
      saline groups. The present study indicates that exogenous EGF given as an
      intragastric bolus protects the gastric mucosa against injury when combined with
      HPC, which can bind to EGF and prevent its rapid excretion from the gastric
      lumen.

PMID- 1629568
TI  - Changes in superoxide dismutase activity in the gastric mucosa of peptic ulcer
      patients.
AB  - A highly sensitive chemiluminescence method for determining superoxide dismutase
      (SOD) activities in human gastric mucosa obtained by endoscopic biopsy is
      described. As the chemiluminescence probe, we used Cypridina luciferin analogue
      (CLA), a very sensitive and specific probe to detect superoxide generated from
      hypoxanthine-xanthine oxidase system. SOD activity in the gastric mucosa was
      assayed by the inhibition of CLA-dependent chemiluminescence in highly diluted
      tissue homogenates. SOD activity was distributed throughout the gastric mucosa.
      The marginal mucosa of peptic ulcers showed significantly lower SOD activity when
      the ulcer was in the active stage, and during the healing stage showed high
      activity when compared to the endoscopically normal adjacent mucosa of the same
      patients. The preliminary data suggest that enzymatic SOD in the gastric mucosa
      may play an important role in the pathogenic and healing processes of human
      peptic ulcers.

PMID- 1629569
TI  - Correlations between the acute chemical and surgical vagotomy-induced gastric
      mucosal biochemistry in rats.
AB  - The aims of the present investigation were to compare the acute chemical
      (atropine given in a dose of 1.0 mg/kg s.c.) and bilateral surgical vagotomy
      induced biochemical changes in the rat gastric mucosa. The biochemical
      measurements were carried out at 1.5 h after administration of atropine and
      surgical vagotomy. The adenosine triphosphate (ATP), adenosine diphosphate (ADP),
      adenosine monophosphate (AMP), and lactate were measured enzymatically, and
      cyclic adenosine monophosphate (cAMP) was determined by RIA, from the total
      homogenate of gastric mucosa. The ratio of ATP/ADP, values of the adenylate pool
      (ATP + ADP + AMP), and energy charge [(ATP + 0.5 ADP)/(ATP + ADP + AMP)] were
      calculated. It was found that (a) no significant changes were obtained in the
      gastric mucosal levels of ATP, ADP, AMP, adenylate pool, cAMP, lactate, and ratio
      of ATP/ADP, but were with energy charge, which decreased in rats with acute
      surgical vagotomy; (b) the tissue levels of ATP, ADP, ratio of ATP/ADP, AMP, and
      adenylate pool were decreased, while the energy charge and cAMP increased in the
      atropine-treated group; and (c) significant differences were obtained between the
      chemical and surgical vagotomy-induced changes in the tissue levels of ATP, ADP,
      ratio of ATP/ADP, AMP, adenylate pool, energy charge, and cAMP. It is concluded
      that the chemical and surgical vagotomy-induced biochemical changes in the
      gastric mucosa differed significantly at 1.5 h after administration of atropine
      or surgical vagotomy, but no elevation was obtained in the gastric mucosal level
      of lactate; and chemical vagotomy regulates the membrane-bound ATP-dependent
      energy systems, but this regulation does not occur after surgical vagotomy.

PMID- 1629570
TI  - Mechanisms of vagal nerve in gastric mucosal defense: unchanged gastric emptying
      and increased vascular permeability.
AB  - Gastric cytoprotection in response to different agents (prostaglandins,
      carotenoids, etc.) failed to occur after surgical vagotomy. Decreased gastric
      emptying and the increased vascular permeability were tested in ethanol-treated
      rats without and with bilateral surgical vagotomy. The experiments were carried
      out on Sprague-Dawley rats. The animals were fasted for 24 h before experiments.
      Bilateral surgical vagotomy or only laparatomy were carried out at 30 min before
      administration of ethanol (96%, 1 ml). The animals were killed at 0, 1, 5, 15,
      and 60 min after ethanol administration, when the number and severity of gastric
      mucosal lesions were noted. In another series of experiments, the animal received
      Evans blue (1 mg/100 g) i.v. 15 min before killing. The gastric contents were
      collected and the glandular mucosa was scraped. Evans blue was extracted in
      chloroform, and its concentration was spectrophotometrically measured. It has
      been found that (a) both number of lesions and severity of ethanol-induced
      gastric mucosal damage were larger at each time period in surgically vagotomized
      rats than in rats with intact vagal nerves; (b) the increased vascular
      permeability was significantly higher in gastric mucosa at an early period in
      surgically vagotomized rats compared to rats with intact vagal nerve; (c) the
      increased vascular events preceded the development of macroscopic appearance of
      gastric mucosa damage in both groups of animals; and (d) the time-related
      responses were the same in both groups of animals. It is concluded that increased
      vascular permeability, but not gastric emptying, probably has some role in the
      failure of the development of gastric cytoprotection in surgically vagotomized
      rats.

PMID- 1629571
TI  - Stress-induced gastric mucosal lesion and platelet aggregation in rats.
AB  - The effect of cold-restraint stress on platelet function in vitro was studied in
      the rat model. Platelet function was assessed by platelet aggregation in response
      to adenosine diphosphate (ADP) and thrombin. ADP-induced platelet aggregation was
      reduced in platelet-rich plasma after 2 h of cold-restraint stress. Thrombin
      induced platelet aggregation was reduced with time during cold-restraint stress
      with a parallel increase in the lesion index. Although pretreatment of animals
      with atropine prevented the development of gastric mucosal lesions, platelet
      dysfunction was not reversed by this treatment. These results suggest that cold
      restraint stress may impair platelet function, probably due to platelet
      activation in vivo, and that the abnormalities in platelet function may be
      associated with the development of gastric mucosal lesions.

PMID- 1629572
TI  - Gastric antisecretory and antiulcer actions of interleukin-1. Evidence for the
      presence of an "immune-brain-gut" axis.
AB  - Increasing evidence suggests that interleukin-1 (IL-1), a cytokine mainly
      produced by activated monocytes/macrophages, has various biological actions in
      addition to its immunological activities. In the present study, we examined the
      effect of IL-1 on gastric secretion and gastric ulcer formation in rats. Gastric
      secretion was assessed in conscious pylorus-ligated rats weighing approximately
      200 g. The peripheral injection of IL-1 resulted in a dose-related inhibition of
      gastric acid output. The central injection of IL-1 similarly reduced gastric acid
      secretion at 100 times smaller doses than peripherally injected IL-1, suggesting
      that this gastric antisecretory action of IL-1 is mediated by the central nervous
      system. In addition, it was found that this inhibitory effect of IL-1, either
      peripherally or centrally administered, was still evident at 8 h after injection,
      indicating the long-lasting property of this IL-1 action. On the basis of these
      antisecretory actions of IL-1, we determined whether or not pretreatment with IL
      1 would prevent experimentally induced gastric ulcer formation. As expected, the
      central administration of IL-1 dose-dependently suppressed the development of
      gastric mucosal lesions induced by water-immersion restraint stress, a well
      established ulcerogenic procedure. These results clearly demonstrated that IL-1
      has potent antisecretory and antiulcer effects that are mediated by the central
      nervous system. Moreover, these findings suggest that there may exist an "immune
      brain-gut" axis, which is involved in the regulation of gastric secretion and
      mucosal homeostasis, especially under certain pathophysiological conditions that
      activate the immune system to release various cytokines including IL-1.

PMID- 1629573
TI  - Severe gastric mucosal changes following vagotomy with duodenogastric reflux.
AB  - We conducted an experimental study of the morphological changes in gastric mucosa
      following vagotomy, in particular of the chronic effects of duodenogastric
      reflux. Male Wistar rats were divided into four groups: sham operation,
      duodenogastric reflux (DGR), truncal vagotomy with duodenogastric reflux (TV +
      DGR), and truncal vagotomy with bypass (TV + bypass). The last operation was
      performed to observe the effects of vagotomy without reflux. The duodenogastric
      reflux procedure was established by cutting the duodenum just distal to the
      orifice of bile and pancreatic ducts following gastrojejunostomy. After 12 and 30
      weeks, animals were killed for morphological studies of gastric mucosa. The TV +
      DGR group showed formation of multiple elevated lesions macroscopically, and
      microscopically showed marked atrophy of gastric glands and proliferation of
      cystically dilated adenomatous lesions, which were regarded as precancerous or
      paracancerous lesions. The DGR group showed chronic gastric ulcer and hyperplasia
      of the gastric glands. However, the TV + bypass group showed no remarkable
      changes in the gastric mucosa. These results indicate that chronic effects of
      duodenogastric reflux following vagotomy induce severe inflammatory changes as
      well as structural alteration of the gastric mucosa. Therefore, a regular follow
      up observation is necessary after vagotomy when combined with a drainage
      procedure because the latter could promote duodenogastric reflux and produces
      pathological changes to the stomach.

PMID- 1629575
TI  - Epithelial renewal in premalignant conditions of the gastrointestinal tract: a
      review.
AB  - The constant rapid renewal of the epithelium of the gastrointestinal (GI) tract
      is important in the development of neoplasms that are derived from the epithelium
      as well as in maintaining the functional integrity of the mucosa. An abnormality
      of epithelial proliferation, characterized by an increase in numbers of
      proliferating cells and expansion of the proliferative zone, is common to all
      human premalignant conditions of the GI tract that have been studied, including
      Barrett's epithelium, chronic gastritis, ulcerative colitis, and colonic polyps,
      and is a consistent observation after the use of experimental carcinogens, such
      as N-methyl-N-amylnitrosamine and N-methyl-N'-nitro-N-nitrosoguanidine. These
      abnormalities also have been observed in some relatives of patients with colonic
      polyps or cancers who themselves do not have any demonstrable colonic lesion.
      Calcium, vitamins A, C, and E, and other agents have been shown to reverse the
      abnormalities in proliferation in some experimental and clinical conditions,
      which raises the question of whether some of these agents can be used to reduce
      the risk of development of cancer in patients with known premalignant conditions
      of the GI tract.

PMID- 1629574
TI  - Gastric epithelial cell proliferation after injury.
AB  - The mucosa of the gastrointestinal tract, including the stomach, undergoes
      constant renewal. The gastric mucosa is able to regenerate after injury, and this
      regeneration is associated with increases in epithelial cell proliferation.
      Gastric epithelial regeneration has been suggested to be impaired with aging.
      Using a hyperosmolar injury model, we found that gastric epithelial proliferation
      was markedly lower in aged rats. To elucidate further the regulation of gastric
      epithelial proliferation after injury, we studied the induction of ornithine
      decarboxylase and tyrosine kinase. Ornithine decarboxylase is the first and often
      rate-limiting enzyme in polyamine biosynthesis and tyrosine kinase catalyzes
      phosphorylation of protein tyrosine residues, and both enzymes have been
      implicated as important in cell proliferation. We found that hyperosmolar injury
      induction of ornithine decarboxylase and tyrosine kinase was markedly lower in
      aged rats. Furthermore, inhibition of ornithine decarboxylase or of tyrosine
      kinase greatly suppressed gastric epithelial proliferation. Our results confirm
      that ornithine decarboxylase and tyrosine kinase are important in gastric
      epithelial proliferation. Further studies of these two enzyme pathways may help
      elucidate the regulation of gastric epithelial growth and regeneration,
      particularly the potential alterations with aging.

PMID- 1629576
TI  - Prostaglandin but not cimetidine reduces spontaneous degeneration of isolated
      gastric gland cells.
AB  - We studied the effect of either placebo, 16,16-dimethyl-prostaglandin E2 (16,16
      dimethyl-PGE2), or cimetidine on spontaneous degeneration of isolated rat gastric
      glands maintained in vitro in a basic oxygenated medium for 24 h. We assessed the
      viability of gland cells with fast green exclusion, measured release of lactate
      dehydrogenase (LDH) into the medium, and assessed the cell ultrastructure using a
      scanning electron microscope. Gastric glands incubated in medium for 6, 12, and
      24 h underwent spontaneous degeneration reflected by a decrease in cell
      viability, increase in LDH release into the medium, and ultrastructural cell
      damage. 16,16-Dimethyl-PGE2 either at 0.1, 1, or 10 micrograms/ml significantly
      reduced the decrease in cell viability, increasing cell survival; reduced LDH
      release into the medium; and ultrastructural damage. Incubation with cimetidine
      at 1 or 10 micrograms/ml did not affect cell viability at 6, 12, or 24 h, whereas
      100 micrograms/ml reduced cell viability (vs. placebo) at 12 and 24 h. LDH
      release and ultrastructural damage were not affected (not reduced) by cimetidine.
      Our study indicates that 16,16-dimethyl-PGE2, but not cimetidine, directly
      protects isolated gastric gland cells against degeneration in vitro, under
      conditions independent of systemic, neural, and hormonal factors.

PMID- 1629577
TI  - Effect of sofalcone on localization of 15-hydroxyprostaglandin dehydrogenase, an
      enzyme that metabolizes prostaglandin E2, in rat gastric mucosa: an
      immunohistochemical study.
AB  - We identified the cells containing 15-hydroxyprostaglandin dehydrogenase (15
      HPGD) in rat gastric mucosa and examined the effects of sofalcone on the
      localization of the enzyme by use of an immunohistochemical technique. Also, we
      investigated the effects of sofalcone on the localization of prostaglandin E2
      (PGE2). Specific stainings for 15-HPGD and PGE2 were similarly observed in a
      granular pattern mainly in the cytoplasm of parietal and surface epithelial
      cells. The number of the stained cells for 15-HPGD, especially surface epithelial
      cells, decreased when rats were given sofalcone, with a concomitant increase in
      PGE2 staining. These results suggest that parietal and surface epithelial cells
      are responsible for the degeneration of PGE2 in the rat gastric mucosa, and that
      sofalcone increased the PGE2 level in the mucosa through inactivation of 15-HPGD
      in these cells, especially surface epithelial cells.

PMID- 1629578
TI  - Cytoprotection by 16,16-dimethylprostaglandin E2. Role of gastric juice and mucus
      gel layer.
AB  - A mechanism of cytoprotection by 16,16-dimethylprostaglandin E2 (16,16-dimethyl
      PGE2) was investigated in rats with respect to possible roles of the gastric
      juice and the mucus gel layer. 16,16-Dimethyl-PGE2 significantly increased the
      volume of gastric juice and mucus thickness. In a gastric juice-emptied stomach,
      16,16-dimethyl-PGE2 protected the gastric mucosa against 30% ethanol, but not
      against 40% ethanol. Moreover, this agent did not show any cytoprotective action
      even against 30% ethanol when both gastric juice and mucus gel were removed. In
      this situation there was no histological change in the depth of injury, whether
      16,16-dimethyl-PGE2 was given as pretreatment or not. These results suggest that
      there are two mechanisms that may play major roles in the cytoprotection of the
      gastric mucosa by 16,16-dimethyl-PGE2: (a) dilution of necrotizing agents by
      increased gastric juice and (b) thickening of the mucus gel layer.

PMID- 1629579
TI  - Early ultrastructural changes of surface epithelial cells isolated from rat
      gastric mucosa after exposure to ethanol with or without 16,16
      dimethylprostaglandin E2.
AB  - Early ultrastructural changes of surface epithelial cells isolated from rat
      gastric mucosa caused by 15% ethanol were studied. The effect of 16,16
      dimethylprostaglandin E2 (16,16-dimethyl-PGE2) on these changes was also
      examined. Findings by transmission electron microscopy showed ballooning and
      decreased density of mitochondria in addition to loss of microvilli and partial
      disruption of the surface cell membrane in cells exposed to 15% ethanol, although
      the nucleus looked normal. These ultrastructures were well preserved even after
      exposure to 15% ethanol when the cells were treated with 10(-6) M 16,16-dimethyl
      PGE2 beforehand. These results may indicate that the surface cell membrane and
      mitochondria are the major targets for early injury by ethanol and protection by
      16,16-dimethyl-PGE2 in surface epithelial cells. The mechanism by which 16,16
      dimethyl-PGE2 prevents the damage is not known.

PMID- 1629580
TI  - Role of leukotrienes in gastric mucosal injury induced by ischemia-reperfusion in
      rats.
AB  - This study was designed to clarify the role of leukotrienes (LTs) in gastric
      injury induced by ischemia-reperfusion in rats. Gastric lesions were produced by
      clamping of the celiac artery and by reoxygenation following clamping.
      Administration of AA-861, a lipoxygenase inhibitor, significantly inhibited the
      increase in the total area of the gastric erosions and the increase in
      thiobarbituric acid-reactive substances in the gastric mucosa. Administration of
      YM-638, a peptide LT antagonist, showed protective effects similar to AA-861.
      These results suggest that the protective effects of AA-861 and YM-638 against
      ischemia-reperfusion-induced gastric injury were due to their antioxidative
      action.

PMID- 1629581
TI  - Histopathological development of gastric tumors induced by N-methyl-N'-nitro-N
      nitrosoguanidine in rats.
AB  - The development of carcinoma was examined in male Wistar rats (n = 120) exposed
      to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) in the drinking water (83
      micrograms/ml) for 16 weeks. After MNNG administration, rats were investigated by
      endoscopic observation, visualization of microvascular structure, and estimation
      of lectin binding sites. Changes of bile reflux to the stomach was observed
      endoscopically at 24 weeks as well as the development of gastric mucosal
      erosions. Protruding and expansive ulcerating carcinomas developed at 36 weeks
      and had a microvascular pattern similar to that of human adenocarcinoma.
      Estimation of lectin binding site and pattern was useful to evaluate the
      malignant potential of cell proliferation. We postulate that endoscopic
      observation is valuable in investigating the development of gastric carcinoma,
      and microvascular structure and lectin binding pattern may be useful to
      demonstrate the mechanism of growth of gastric carcinoma.

PMID- 1629582
TI  - Effects of anti-acid secretory agents on various types of gastric mucus.
AB  - Total, acidic, and sulfated mucus contents in the gastric mucosa were evaluated
      after administration to rats of ranitidine and pirenzepine, antagonists of
      gastric parietal cell receptors; omeprazole, a proton-pump/inhibitor; and
      misoprostol, a prostaglandin E1 preparation. Total gastric mucus content was
      significantly decreased by ranitidine, but contents of acidic mucus and sulfated
      mucus showed a slight increase. Total mucus and acidic mucus contents were
      slightly increased after administration of pirenzepine, whereas the sulfated
      mucus content was significantly increased. The total gastric mucus content was
      significantly decreased after administration of omeprazole, but acidic mucus
      increased slightly and sulfated mucus increased significantly. All mucus contents
      were unchanged after administration of anti-acid secretory dose of midoptodyol.
      After administration of either ranitidine or omeprazole, the neutral mucus
      content decreased, but the total acid and sulfated mucus contents were not
      decreased. Changes in various mucus contents following inhibition of acid
      secretion are different for different drugs, and it was suggested that production
      of neutral mucus and secretion of acid mucus were reduced by strong inhibition of
      acid secretion.

PMID- 1629583
TI  - Demonstration of bicarbonate secretion in rat duodenal brush border membrane
      vesicles.
AB  - This study was designed to characterize the mechanisms available for bicarbonate
      transport across the apical membrane using rat duodenal brush border membrane
      vesicles (BBMVs), including the morphological findings. BBMVs were purified using
      a double Mg2+ precipitation technique. Electron microscopy of the final pellet
      showed only membrane material without contaminating organelles of cytoskeletal
      aggregates. BBMVs were enriched 15.1 +/- 3.2-fold in A-lp and 12.5 +/- 2.4-fold
      in LAP. The time course of 36Cl uptake into BBMVs demonstrated a good response
      curve and equilibrated to the intravesicular space over 120 min. In this present
      study, these BBMVs were purified and showed a stabilized structure. Therefore,
      these results suggest that this model was useful for studying HCO3- secretion and
      ulcer etiology.

PMID- 1629584
TI  - Gastric emptying in the acutely inebriated patient.
AB  - Fifty inebriated emergency department (ED) patients underwent evacuation of
      gastric contents via a nasogastric tube, in order to determine if a significant
      amount of ingested ethanol can be removed prior to absorption. Such a result
      could potentially reduce additional intoxicating effect. The gastric contents
      were assayed for total ethanol concentration, and a potential (postabsorption)
      additive blood alcohol level (PABAL) was projected and compared to the actual BAL
      on arrival. The type of beverage ingested and the time since last drink were
      recorded. BAL ranged from 108 to 637 mg/dL (mean +/- SD, 290 +/- 104.7). Gastric
      aspirate volume ranged from 50 to 700 mL (190 +/- 134), and contained alcohol in
      a range of 87 to 2271 mg/dL (475 +/- 479). Based on the distribution volume for
      alcohol calculated according to the patient's weight, this corresponded to a
      PABAL of 3 to 167 mg/dL (mean, 24.3 +/- 29.3). There was no significant
      correlation between the volume or concentration of gastric aspirate and the
      patient's stated drinking history. The authors conclude that a significant amount
      of ingested alcohol may occasionally be removed from absorption by the routine
      evacuation of gastric contents in intoxicated patients. These patients cannot be
      identified upon presentation, however, and these data cannot support routine use
      of gastric emptying in the detoxification of inebriated patients.

PMID- 1629585
TI  - Concurrence of multiple sclerosis and Hodgkin's disease.
AB  - Although multiple sclerosis and Hodgkin's disease are reported to have similar
      epidemiologic features, this is only the first case report in which there was
      concurrence of these diseases. Fourteen years after successful treatment of
      Hodgkin's disease, this 31-year-old white male developed multiple sclerosis. The
      diagnosis of multiple sclerosis was made on the basis of clinical and
      paraclinical findings that were characteristic of multiple sclerosis. In
      addition, specific tests were performed to rule out a variety of infectious,
      metabolic, and neoplastic diseases that simulate multiple sclerosis.

PMID- 1629586
TI  - Exsanguinating hemorrhage from a caput medusae: cutaneous variceal bleeding.
AB  - We report the case of a 45-year-old female who presented to the emergency
      department with massive umbilical hemorrhage from a cutaneous varix. The patient
      had a long-standing history of alcohol-related liver disease and ascites. Her
      clinical course was complicated by coagulopathy and hemorrhagic shock, and she
      ultimately expired. Ectopic or nongastroesophageal bleeding constitutes a
      significant site of variceal hemorrhage. In this report we review the literature
      and explore methods of treatment.

PMID- 1629587
TI  - Tension gastrothorax complicating acute traumatic diaphragmatic rupture.
AB  - Herniation of abdominal viscera into the thorax following traumatic diaphragmatic
      hernia can simulate acute tension pneumothorax. A case is presented of a blunt
      trauma victim with apparent acute diaphragmatic rupture, tension hemothorax, or
      tension hemopneumothorax. Nasogastric tube insertion demonstrated tension
      gastrothorax, but was followed by acute clinical decompensation. Percutaneous
      needle thoracostomy decompressed the stomach without causing spillage of gastric
      contents. Autopsy experimentation was performed to demonstrate that needle
      decompression of the distended stomach is well tolerated. Tension gastrothorax is
      a rare, life-threatening complication of traumatic diaphragmatic hernia. Although
      nasogastric tube placement should be attempted first, it may exacerbate the
      condition. Percutaneous needle decompression of the stomach through the chest
      wall can stabilize the situation and is safer and more rapid than chest tube
      placement, which might be either ineffective or dangerous. Paralyzing the patient
      with acute diaphragmatic rupture before tracheal and gastric intubation might
      prevent progression to tension gastrothorax.

PMID- 1629588
TI  - Complete recovery following an unusual cardiac stab wound.
AB  - A 17-year-old female was stabbed in the chest and found by paramedics in
      extremis. She arrived at the receiving hospital with spontaneous respirations and
      an improved blood pressure. Upon thoracotomy in the operating room, lacerations
      through the main pulmonary artery and the left atrium were found. The combined
      efforts of a sophisticated EMS system providing rapid in-field stabilization and
      transport, a ready in-house trauma team able to quickly assess and provide
      definitive care, and a prepared operating room team, including cardiopulmonary
      bypass capability, resulted in a complete and uncomplicated recovery from this
      rare and lethal injury.

PMID- 1629589
TI  - Azygos vein laceration following a vertical deceleration injury.
AB  - A 41-year-old man presented with respiratory distress and hypotension after a 30
      foot fall from a tree. Despite fluid resuscitation, the patient expired in the
      operating room. Autopsy revealed an azygos vein laceration at the junction of the
      superior vena cava as the cause of death. Azygos vein and superior vena caval
      lacerations are rare following blunt chest trauma, including vertical
      deceleration injury. Early suspicion of vascular injuries with aggressive fluid
      resuscitation and surgical intervention remain the only hope for survival from
      this highly lethal injury.

PMID- 1629590
TI  - Human parvovirus B-19: not just a pediatric problem.
AB  - Parvoviruses have long been associated with disabling and even fatal illnesses in
      animals. The discovery of the human parvovirus B-19 in 1975 (1) and subsequent
      studies of its effects in humans identified this virus as the causative agent of
      erythema infectiosum ("fifth disease") in children. (2). Erythema infectiosum
      (EI) is a common, self-limited infectious disorder in children, easily recognized
      by the classic "slapped cheek" facial erythema and fine reticular rash. Only in
      the 1980s have further investigations linked HPV B-19 infection with more
      significant clinical syndromes, among which is an adult polyarthropathy. This
      presentation in adults is more common than is currently understood and is easily
      confused with other symmetric polyarthropathies. Recognition and conservative
      treatment of this disorder are important for the emergency physician, to whom
      these patients may present.

PMID- 1629591
TI  - Neurogenic pulmonary edema: case reports and review.
AB  - Neurogenic pulmonary edema (NPE) is a relatively common though often subclinical
      complication of a variety of central nervous system insults (trauma, hemorrhage,
      seizures, etc.) in children and adults. The syndrome probably results from
      massive centrally mediated sympathetic discharge and generalized
      vasoconstriction, and often presents in the emergency department (ED). The
      symptoms are likely to be mistaken for aspiration pneumonia. Treatment consists
      of ventilatory support, including positive end-expiratory pressure, and
      aggressive measures to reduce intracranial pressure. We present four cases of NPE
      and review its recognition and emergent management.

PMID- 1629592
TI  - Minoxidil overdose with ECG changes: case report and review.
AB  - A 20-year-old female ingested an unknown quantity of minoxidil tablets as a
      suicide gesture. She presented to the emergency department about 90 minutes later
      with tachycardia, diffuse T wave inversion, and S-T segment depression on the
      ECG, labile hypotension, and a substantially elevated total serum minoxidil
      concentration of 3140 ng/mL. She responded to supportive therapy with intravenous
      fluids, and was discharged 32 hours later with stable blood pressure and mild
      residual tachycardia. The clinical toxicology, treatment, and previous case
      reports of minoxidil overdose are reviewed.

PMID- 1629593
TI  - Cocaine adsorption to activated charcoal in vitro.
AB  - Although activated charcoal (AC) is commonly used after ingestions of cocaine,
      the ability of AC to bind with this drug is unknown. We studied binding of
      cocaine to AC in vitro. Cocaine adsorption to charcoal for AC:drug ratios of 1:1,
      2.5:1, and 5:1 at pH 1.2 was 40%, 92%, and 99%, respectively; at pH 8.0, it was
      78%, 98%, and 99%, respectively. All means were significantly different (P less
      than 0.05) versus the control (no AC) at each pH. At the AC:drug ratio of 1:1,
      there was also significantly greater adsorption of cocaine at pH 8.0 than at pH
      1.2. This study shows that AC strongly adsorbs cocaine under both acidic and
      alkaline conditions.

PMID- 1629594
TI  - Mechanical performance of disposable surgical needle holders.
AB  - The mechanical performance of disposable Webster surgical needle holders supplied
      by three different surgical instrument companies was determined by recording the
      forces (clamping moment) applied by the different needle holder jaws to curved
      surgical needles. This investigation demonstrated that there was a large
      variability in the mechanical performance of the disposable needle holders
      supplied by each surgical instrument company. In addition, the mechanical
      performance of the disposable needle holder of each surgical instrument company
      was distinctly different.

PMID- 1629595
TI  - Effective hand degerming in the presence of blood.
AB  - This study evaluated the effect of blood on the antimicrobial activity of several
      agents used for handwashing. Seventy-one healthy adult volunteers used 1 of 6
      products (70% isopropyl alcohol [IPA]; liquid hand rinse containing 70% ethyl
      alcohol and 0.5% chlorhexidine gluconate [EA]; detergent containing 7.5% povidone
      iodine [PI]; detergent containing 4% chlorhexidine gluconate [CHG]; a
      nonantimicrobial soap; and a control group that used no product) in two tests:
      with and without 1.2 mL of dried sterile sheeps' blood on the hands. In the
      presence of blood, the two alcohol products (IPA and EA) resulted in
      significantly greater reductions in numbers of colony-forming units than other
      products (P less than 0.001). When no blood was present, IPA was associated with
      significantly greater reductions, whereas soap and control groups had
      significantly lower reductions (P = 0.008). We conclude that hands are
      effectively degermed with a variety of products in the presence of blood, and
      that alcohols give greater initial reductions in colonizing flora. This is of
      particular relevance in emergency situations during which contamination with
      blood is likely and handwashing facilities are inaccessible.

PMID- 1629596
TI  - Flatology.
AB  - Advances in flatology are often close-lipped but of note. Cultural constraints
      and scatologic implications at times impede meaningful research. Historical and
      contemporary perspectives on flatus range from the biblical and theatrical, to
      paleontologic and environmental concerns, to the omninauseant legal and
      psychiatric sequelae. The current state of flatal physiology, pathophysiology,
      and diagnosis of aberrancy are reviewed. Flatoanalysis, air-flow studies, and
      flatulograms are discussed, as well as various remedies.

PMID- 1629597
TI  - Alexander Fleming: the spectrum of penicillin.
AB  - The discovery of penicillin was directly linked to the inhibition by that agent
      of the growth of colonies of staphylococcus. However, subsequent resistance by
      this organism to penicillin as well as to a number of other agents has marked the
      history of staphylococcus in the antibiotic era. One of the most important
      mechanisms of this resistance has been the production of penicillinase, an enzyme
      that inactivates penicillin and related antibiotics. Penicillinase is currently
      termed beta-lactamase, and it is now recognized that there are several types of
      beta-lactamases produced by various organisms. The ability of staphylococci to
      produce this enzyme has been countered by the development of penicillinase
      resistant agents and the addition of beta-lactamase inhibitors to antibiotics.

PMID- 1629598
TI  - ED overcrowding in New York City.

PMID- 1629599
TI  - Annual reports.

PMID- 1629600
TI  - Mid-shift musings of a practicing emergency physician.

PMID- 1629601
TI  - Objectives to direct the training of emergency medicine residents on off-service
      rotations: pulmonary.
AB  - This article outlines the objectives for a resident rotation in pulmonary
      diseases. It is part of a continuing series on the goals and objectives to direct
      Emergency Medicine resident training on off-service rotations. Pulmonary disease
      accounts for a high percentage of presenting complaints and potentially life
      threatening disease in the emergency department. Because of the frequency of
      respiratory disease in Emergency Medicine, many Emergency Medicine residencies
      offer individual off-service rotations in Pulmonary Medicine. The objectives of
      this article are viewed as a one-month component of an Internal Medicine Rotation
      in the first year of training. These objectives are designed to help focus the
      resident's reading and study during a pulmonary off-service rotation.

PMID- 1629603
TI  - The natural anti-alpha-galactosyl IgG in seminal fluid. A simple means to
      determine damage to the blood-genital tract barrier in infertile males.
AB  - A simple method for detecting damage to the blood genital tract barrier (BGTB) is
      presented. The method is based on the ubiquitous presence of the natural anti
      alpha-galactosyl (anti-Gal) IgG antibodies in high titers in the serum of every
      normal individual, and the interaction between this antibody and alpha-galactosyl
      residues on rabbit red blood cells (RabRBC). The binding of the anti-Gal
      antibodies to RabRBC could be demonstrated by the rosetting antiglobulin test.
      The seminal fluid (SF), normally compartmentalized from the blood, is devoid of
      anti-Gal reactivity. The SF of a large proportion of infertile males contained
      significant anti-Gal reactivity, implying transudation of serum IgG molecules
      probably due to damage in the selective permeability of the BGTB. The diagnostic
      potential of this assay is discussed.

PMID- 1629602
TI  - Electroporation of CTL clones: a useful method to investigate signalling pathways
      leading to the expression of effector functions.
AB  - Signal transduction mechanisms leading to effector functions in mouse cytolytic T
      lymphocyte (CTL) clones were studied following the introduction of exogenous
      molecules by electroporation. Conditions were defined in which the application of
      an electric pulse permeabilized the CTL without affecting functions such as
      antigen-dependent or antibody-mediated cytotoxicity. When a non-permeant Ca2+
      chelator such as EGTA was added in the external medium during the electric pulse,
      it inhibited subsequent target cell cytolysis carried out in the presence of
      external Ca2+, thereby indicating the efficiency of EGTA uptake. Results obtained
      in this system, using a 13 amino-acid protein kinase C (PKC) pseudo-substrate
      peptide, indicated that it selectively inhibited cytolysis, whereas a substrate
      peptide with one amino-acid substitution was not inhibitory. This suggests that
      the technique could be used to study the signal transduction mechanisms of CTL
      clones which lead to the expression of effector functions.

PMID- 1629604
TI  - Measurement of PAF in blood by radioimmunoassay. Examination of interfering
      factors and problems involved in accurate quantification.
AB  - A recently developed radioimmunoassay for PAF was applied to blood extracts with
      the aims of defining and overcoming problems that lead to erroneous results and
      establishing optimum conditions for the accurate determination of PAF levels. The
      high lipid content of blood was found to interfere with the assay, and it
      appeared that phosphatidylcholine and/or sphingomyelin might be among the lipids
      responsible. Interference was eliminated by either dilution or preparative TLC of
      blood extract prior to RIA although dilution is unlikely to be generally useful
      due to the low amounts of PAF normally present in human blood. Lipid extraction
      of whole blood followed by preparative TLC proved to be necessary in the
      preparation of samples prior to performance of the RIA. The problems encountered
      in the measurement of PAF levels in blood by RIA highlight the importance of
      determining the correct method of sample preparation for any tissue/fluid prior
      to its inclusion in the assay.

PMID- 1629605
TI  - Monoclonal antibody mediated targeting of enzymes. A comparative study using the
      mouse spleen as a model system.
AB  - The aim of this study was to target enzymes specifically to cells in the murine
      spleen. Monomeric and polymeric conjugates of the enzymes horseradish peroxidase
      or alkaline phosphatase and monoclonal antibodies against cell surface
      determinants were prepared. Highly specific in vivo targeting of enzymes to
      macrophages was obtained only when monomeric MAb-enzyme conjugates were used.

PMID- 1629606
TI  - Analyses of affinity distributions within polyclonal populations of antigen
      specific antibodies. Evaluation of their accuracy in population detection using
      monoclonal antibodies.
AB  - The potential of an ELISA based detection of affinity distributions within
      polyclonal populations of antigen-specific serum antibodies was assessed by
      analyzing defined probes composed of monoclonal antibodies (MAb). In a
      competitive binding ELISA in which the concentration of antigen in the liquid
      phase and the solid phase was varied, we analyzed mixtures containing defined
      percentage compositions of MAb exhibiting apparent affinity constants (aK)
      between 3 x 10(6) and 2 x 10(9) M-1 for Pseudomonas aeruginosa exotoxin A. Our
      results indicate that the detectability of antibody populations depends on the
      antigen concentrations in the solid phase and on the affinity distribution of the
      probe to be analyzed. In wells coated with high antigen concentrations, antibody
      titers reflected antibody concentrations, whereas at low antigen concentrations
      antibody titers primarily reflect antibody affinities. Independent of their
      affinities, subpopulations less than 10% could not be detected. Low affinity
      antibodies were preferentially underestimated. The degree of distortion depended
      on the composition of the probe to be analyzed. In general, the higher the
      absolute and the relative affinity of a population, the stronger was its capacity
      to interfere with the detection of other populations. As a consequence, the
      heterogeneity of affinity distributions in polyclonal samples may be
      substantially underestimated. The experiments reported provide guidelines for an
      optimal design and an adequate interpretation of ELISA based qualitative analyses
      of polyclonal antibody samples.

PMID- 1629607
TI  - Production and characterisation of monoclonal antibodies against native and
      disassembled human catalase.
AB  - Catalase isolated from human erythrocytes was used to immunise mice, in order to
      generate hybridomas producing specific monoclonal antibodies to the enzyme.
      Hybridomas secreting anti-(catalase) antibodies were identified by a modified
      enzyme-linked immunosorbent assay (ELISA) using either monomer/dimer catalase or
      native, tetrameric enzyme. Three stable hybridoma clones were selected and the
      characteristics of the antibodies produced were investigated by ELISA,
      immunofluorescence, immunoprecipitation and immunoblotting experiments. One
      monoclonal antibody (17E10) was shown to interact with both native tetramer
      catalase and--to a lesser extent--with monomer/dimer catalase. Two monoclonal
      antibodies (10B12H9, 13A10) were found to react only with completely denatured
      catalase or with monomer/dimer catalase but not with native catalase.

PMID- 1629608
TI  - The development of a quantitative assay for the detection of anti-Ro/SS-A and
      anti-LA/SS-B autoantibodies using purified recombinant proteins.
AB  - A characteristic of patients with autoimmune diseases such as Sjogren's syndrome
      and systemic lupus erythematosus is the presence of anti-Ro/SS-A and anti-La/SS-B
      autoantibodies in their circulation. In order to investigate specific
      autoantibody levels in the sera of these patients quantitative assays for the
      detection of both anti-Ro/SS-A and anti-La/SS-B reactivity were developed. Ro/SS
      A (60 kDa) and La-SS-B (50 kDa) cDNAs were cloned and expressed in E. coli as non
      fusion proteins. These were purified to homogeneity using two different
      purification protocols. With these recombinant antigens, specific enzyme-linked
      immunosorbent assays (ELISAs) were developed. 40 sera positive for anti-Ro/SS-A
      autoantibodies in counterimmunoelectrophoresis (CIE) were tested in both the
      Ro/SS-A and La/SS-B ELISA. Activity values reproducibly ranged from 1536 to
      120,000 U in the Ro/SS-A ELISA and from 763 to 2,500,000 U in the La/SS-B ELISA.
      The suitability of these ELISAs as screening assays was further investigated by
      testing 200 sera sent to our laboratory for routine detection of autoantibodies
      to extractable nuclear antigen (ENA: anti-Sm, anti-RNP, anti-Ro/SS-A and anti
      La/SS-B). Both ELISAs showed a high sensitivity and specificity (Ro/SS-A ELISA
      85% and 94%, La/SS-B ELISA 100% and 98% respectively), when compared to the
      standard assays, the RNA-precipitation assay and the HeLa immunoblotting test.
      From these data we conclude that a quantitative analysis of both anti-Ro/SS-A and
      anti-La/SS-B autoantibodies is now possible using purified recombinant non-fusion
      proteins. For screening purposes the La/SS-B ELISA showed a great improvement in
      sensitivity for the detection of anti-La/SS-B activity in comparison to the La/SS
      B CIE, while the Ro/SS-A ELISA almost equalled the performance of the Ro/SS-A
      CIE.

PMID- 1629609
TI  - In situ immunocytochemical detection of cells containing antibodies specific for
      Eimeria tenella antigens.
AB  - A three-step immunocytochemical method for the in situ detection of antibodies
      specific for Eimeria tenella has been developed. The method is based on the
      binding of E. tenella antigens to antibodies in cryostat sections of chicken
      tissues and the recognition of these antigens by rabbit antiserum specific for E.
      tenella or mouse monoclonal antibodies specific for E. tenella. The rabbit
      antiserum and mouse monoclonal antibodies were revealed by the immunoperoxidase
      technique. Suspensions of sonicated sporulated oocysts, incubated with or without
      various concentrations of the non-ionic detergents Triton X-100 (TX-100) or
      Nonidet P-40 (NP-40), were used as antigen. Cells containing antibodies specific
      for E. tenella were detected only when detergent extracts of sonicated sporulated
      oocysts were used. After chickens were intravenously immunized with a suspension
      of sonicated sporulated oocyst antigen, cells containing antibodies specific for
      E. tenella antigens were detected in the red pulp of the spleen. After
      simultaneous immunoenzyme staining for isotype and antigen specificity, the E.
      tenella-specific antibody-containing cells were of the IgM isotype after the
      primary immunization and of the IgM and IgG isotype after the booster
      immunization. Immune complexes specific for E. tenella on the surfaces of
      follicular dendritic cells in the germinal centers were also stained. Chickens
      were also orally infected with sporulated oocysts. In these experiments, cells
      containing antibodies specific for E. tenella were detected in the lamina propria
      of the ceca and in the red pulp of the spleen. Specific immune complexes were
      also detected in the germinal centers of the cecal tonsils. When detergent
      extracts of sonicated sporulated oocysts were characterized by immunoblotting,
      rabbit antiserum specific for E. tenella reacted with proteins ranging in size
      from 16 kDa to 200 kDa, with major bands of 20 kDa, 24 kDa, 45 kDa, and 100 kDa.
      Monoclonal antibodies specific for E. tenella recognized only proteins of low
      molecular weight (20 kDa and 24 kDa) or high molecular weight (80-100 kDa).
      Immune chicken serum reacted with proteins of low and high molecular weight but
      especially with proteins of 100 kDa and 113 kDa. This method is the first by
      which immune complexes and cells containing antibodies specific for parasitic
      antigens can be detected in situ and may be of value for studies of the local
      humoral immune response to E. tenella in the mucosa of chickens.

PMID- 1629611
TI  - A simple enzyme-linked immunosorbent assay (ELISA) for the neuron-specific gamma
      isozyme of human enolase (NSE) using monoclonal antibodies raised against
      synthetic peptides corresponding to isozyme sequence differences.
AB  - Monoclonal antibodies specific for the gamma isozyme of human enolase (known as
      neuron-specific enolase or NSE) have been raised against synthetic peptides after
      coupling to carrier protein: the selected peptides were those corresponding to
      regions of amino acid sequence difference between the alpha and gamma subunits of
      these closely similar isozymes. This technique gave monoclonal antibodies of high
      specificity and affinity. Two monoclonal antibodies raised against different
      peptides were used to develop a double-antibody sandwich enzyme-linked
      immunosorbent assay (ELISA), using one as the solid-phase antibody and the other
      conjugated to horseradish peroxidase to detect the bound NSE. This assay provides
      a simple and routine method of detecting NSE in serum samples from patients with
      small-cell carcinoma of the lung and related tumours.

PMID- 1629610
TI  - Production of a functional monoclonal antibody recognizing human colorectal
      carcinoma cells from a baculovirus expression system.
AB  - The light and heavy chain cDNA of a murine monoclonal antibody (MoAb) with
      specificity for human colorectal carcinoma cells have been expressed separately,
      together, and as a dual construct in insect cells infected with recombinant
      baculoviruses. High levels of the MoAb were expressed under the control of the
      polyhedrin promoter. The antibody maintained its specific binding to human
      colorectal carcinoma cells and mediated lysis of these cells by human
      lymphocytes, monocytes, and murine macrophages, as determined in antibody
      directed cellular cytotoxicity (ADCC) assays. The recombinant immunoglobulin
      (Ig), like its ascitic counterpart, did not mediate lysis by either human or
      rabbit complement. The expression of a recombinant antibody exhibiting both
      functional binding site and Fc region capacities shows that the baculovirus
      system could be employed in the production of therapeutic Ig.

PMID- 1629612
TI  - Fluorometric determination of the DNA content of cells cultured in tissue culture
      plates.
AB  - Determining the DNA content of cultured cells with the fluorochrome
      diaminobenzoic acid (DABA) has been shown to be a sensitive and selective method.
      A procedure is described which applies this method to cells cultured in 96-well
      and 24-well plates. After removal of the medium, the cells are disrupted by
      sonication, dried and reacted with DABA. For the final read-out the DABA-DNA
      solution is transferred to standard cuvettes and the fluorescence intensity
      determined with a conventional fluorometer. The method is highly reproducible and
      suitable for the cell concentrations usually employed in microculture systems. It
      is an easy non-radioactive method for determining the numbers of both adherent
      and non-adherent cells, especially when comparing different stages of activation
      or differentiation.

PMID- 1629613
TI  - Avidin-binding to peripheral blood B lymphocytes and monocytes.
AB  - Avidin-coated magnetic beads bind peripheral blood B lymphocytes and monocytes.
      This unwanted reactivity is not due to the membrane expression of avidin target
      molecules since beads coated with a biotin-binding analogue are non-reactive and
      binding occurs even when cellular carbohydrate-binding sites are not active, in
      the absence of Mg2+ and Ca2+ cations, or when they are blocked by a alpha-D
      glucose or alpha-D-mannose in presence of Ca2+ and Mg2+. The non-polar residues
      of avidin appear not to be engaged in a hydrophobic bond with the membrane
      molecule since suroptimal quantities of serum albumin do not prevent the avidin
      binding. It is suggested that ionic interactions explain the binding of avidin
      coated beads to B lymphocytes and monocytes and that these can be inhibited with
      high molecular weight serum molecules or with 0.4 M NaCl.

PMID- 1629614
TI  - A modified colorimetric method for the measurement of phagocytosis and antibody
      dependent cell cytotoxicity using 2,7-diaminofluorene.
AB  - A sensitive and rapid colorimetric method for the in vitro determination of
      phagocytic activity and antibody-dependent cell-mediated cytotoxicity (ADCC) is
      described. The assay uses red blood cells (RBC) as target cells and relies on the
      specific oxidation of 2,7-diaminofluorene (DAF) by the pseudoperoxidase activity
      of hemoglobin (Hb). Generation of fluorene blue (FB), the chromophore formed upon
      oxidation of DAF, was a linear function of erythrocyte concentration. The
      oxidation of DAF by peritoneal macrophages (M phi) containing myeloperoxidase was
      negligible, confirming that the development of color was exclusively due to the
      pseudoperoxidase activity of Hb. A positive correlation was observed between FB
      formation and increased phagocytosis of opsonized erythrocytes. Phagocytosis
      increased as a function of time, reaching a maximum at 90 min of incubation. The
      phagocytosis of IgG-opsonized erythrocytes was greater than non-opsonized
      erythrocytes and was inhibited by high concentrations of non-specific human or
      mouse IgG, showing that phagocytosis was mediated by the Fc gamma receptor of
      macrophages. The interaction between opsonized RBC and macrophages also evoked an
      antibody-dependent extracellular lysis, however this process was slower than
      ingestion. The DAF phagocytosis assay has shown to be very sensitive, simple,
      rapid and safe.

PMID- 1629615
TI  - A novel B cell stimulation/proliferation assay using simultaneous flow cytometric
      detection of cell surface markers and DNA content.
AB  - Assessment of the specific B cell proliferative response by thymidine
      incorporation following polyclonal stimulation (e.g. with pokeweed mitogen or B
      cell growth factor) is problematic whenever the proportion of B cells in a
      particular sample is low as in blood samples. Here we describe a simple assay
      consisting of identifying the cultured B cells with anti-CD19/CD20 fluorescein
      conjugated antibody and simultaneously using propidium iodide DNA staining to
      determine the percent of S/G2/M phase cells among the gated B cells. This assay
      can be used to determine B cell responsiveness even in individuals with very low
      blood B cell counts (e.g., in recipients of bone marrow transplant), does not
      require laborious B cell purifications and does not involve radiation hazard.

PMID- 1629616
TI  - A polymerase chain reaction assay for the detection and quantitation of cytokine
      gene expression in small numbers of cells.
AB  - A reverse transcriptase-polymerase chain reaction (RT-PCR) assay is described
      that allows the rapid detection and quantitation of mRNA encoding the cytokines
      interleukin-2 (IL-2), IL-4 and interferon-gamma (IFN-gamma). Analysis of cytokine
      production by defined CD4+ T cell clones and the thymoma cell line EL4,
      demonstrates that the oligonucleotide primers used in this assay are specific for
      the genes encoding the individual cytokines, generating PCR products of different
      sizes. This allows the simultaneous and unambiguous detection of all three
      cytokine mRNAs in the same cDNA sample. The assay is sensitive enough to
      reproducibly detect cytokine mRNA expressed in as few as ten cells and requires
      10,000-fold less cells for the detection of IL-2 production than that required
      for its detection using a conventional bioassay. Reverse transcribed mRNA is
      quantitated in the PCR assay by amplifying in the presence of a known amount of
      competitive genomic DNA (gDNA) template containing a small intron using the same
      primers. The PCR products obtained form the target cDNA and gDNA templates, which
      are distinguished by size, are processed by Southern analysis and quantitated by
      scanning densitometry of autoradiographs. As little as two-fold differences in
      cytokine mRNA can be reliably detected using this assay. We have demonstrated the
      successful application of this assay to the quantitation of pg amounts of IL-2
      mRNA that is constitutively produced at low levels by fetal thymocytes in vivo
      during T cell ontogeny. The sensitivity, specificity, reliability and speed of
      this assay will facilitate the analysis of cytokine production in in vivo-derived
      or, in vitro propagated cells which are not available in sufficient numbers for
      analysis using more conventional molecular and biochemical assays.

PMID- 1629617
TI  - A blocking ELISA for the detection of specific antibodies to bovine ephemeral
      fever virus.
AB  - A blocking ELISA (B/ELISA) for detecting antibodies to bovine ephemeral fever
      virus (BEFV) in cattle is described. In this test, the binding capacity of a
      monoclonal antibody specific for an epitope on antigenic site G1 of the BEF virus
      glycoprotein is blocked in the presence of positive serum. The sensitivity of the
      B/ELISA was compared with the virus neutralisation (VN) test using a total of 380
      sera from cattle. Of these, 118 were from an area known to be free of bovine
      ephemeral fever, 181 from naturally and experimentally BEFV-infected cattle, 33
      sequential serum samples from a sentinel steer from which Berrimah virus (BERV)
      had been isolated, 9 from a sentinel cow from which Kimberley virus (KIMV) was
      isolated and a panel of 39 sera supplied as a blind trial. The B/ELISA results
      overall compared favourably with those of the VN tests. The monospecificity of
      the test was demonstrated using hyperimmune mouse ascitic fluid to other BEF
      serogroup viruses, namely KIM and BER viruses and the results showed no
      significant cross-reaction. The greater simplicity and sensitivity of the test
      when compared with the VN test makes it the preferred test for the diagnosis and
      monitoring of clinical bovine ephemeral fever.

PMID- 1629618
TI  - A method for the detection of serologically crossreacting antigens both within
      and between protein mixtures: the western cross blot.
AB  - The method described in the present paper permits the detection of antigenically
      related proteins within or between different antigen mixtures. For this purpose
      two separate SDS-polyacrylamide gels are run (the antigen mixture is applied to
      the entire width of the gel) and each gel is blotted on to a separate
      nitrocellulose paper. One sheet ('donor sheet') is incubated with antiserum and
      placed on to the other blot ('receptor sheet') so that the antigen bands are
      perpendicular to each other. Subsequently the antibodies from the donor sheet are
      blotted on to the receptor sheet in alkaline borate buffer containing 1 M NaSCN,
      which dissociates antigen-antibody complexes. After the removal of the donor
      sheet the receptor sheet containing the transblotted antibodies is equilibrated
      in phosphate-buffered saline in order to reconstitute the binding conditions.
      Antibodies which have bound to receptor antigens during this equilibration period
      are detected by the use of a peroxidase labelled 2nd antibody. Because each band
      on the donor sheet crosses each band on the receptor sheet during the transfer,
      the antibodies from each band of the donor sheet are able to react with each
      antigen band of the receptor sheet. The validity of the method was established by
      demonstrating the crossreactivity of a polyclonal antiserum against the intact
      bovine gamma globulin molecule with the heavy and light chain subunits (and
      partial reduction products of the molecule) and the absence of crossreactivity
      between heavy and light chains. In a second experiment crossreacting antigens of
      different molecular weight were detected within several strains of Escherichia
      coli. In addition, comparisons of different strains of Escherichia coli revealed
      crossreacting antigens of identical as well as of different molecular weight.

PMID- 1629619
TI  - A simple method of concentrating monoclonal antibodies from culture supernatant
      by ultrafiltration.
AB  - How to obtain concentrated monoclonal antibodies from culture supernatant is of
      great importance to many scientists today. In this report, a simple, single-step
      technique is described to concentrate monoclonal antibodies directly from
      hybridoma-culture supernatant. The contaminants can be removed from the
      supernatant by using an ultrafiltration unit which allows macromolecules of less
      than 100,000 MW to pass through leaving behind monoclonal antibodies which is
      purified and concentrated more than 25-fold.

PMID- 1629620
TI  - Factors influencing computer-assisted video image analysis of
      immunocytochemically stained lymphocytes and macrophages in the spleen of mice.

PMID- 1629621
TI  - The L929 cell bioassay for murine tumour necrosis factor is not influenced by
      other murine cytokines.

PMID- 1629622
TI  - An ELISA utilizing immobilised snowdrop lectin GNA for the detection of envelope
      glycoproteins of HIV and SIV.
AB  - A simple, reliable ELISA for the quantitative detection of the envelope
      glycoproteins of both HIV and SIV is described. It incorporates the snowdrop
      lectin GNA to capture the glycoprotein antigens and combines the high selectivity
      of GNA binding with its broad reactivity with the glycoproteins of HIV-1, HIV-2
      and SIV.

PMID- 1629623
TI  - Evaluation of labelled monoclonal antibodies by simultaneous estimation of the
      association constant, the immunoreactive fraction, and the number of effective
      binding sites on the specific target.
AB  - The reaction between a labelled monoclonal antibody (MoAb) and its specific
      target is characterised by three parameters: the association constant (Ka) of the
      labelled MoAb, the number (N) of effective binding sites on the specific target,
      and the immunoreactive fraction (F) of the labelled MoAb preparation.
      Immunological binding parameters are usually estimated graphically, by fitting
      the experimental data to linear equations derived from the first order law of
      mass action (FLMA) at equilibrium. However, only two parameters can be estimated
      simultaneously in a two-dimensional plot. Consequently, graphical estimation of
      Ka, F and N must be performed stepwise, using at least two different plots. The
      three parameters are interdependent, and therefore a stepwise estimation
      procedure might give suboptimal results. In order to investigate whether this is
      a problem of practical significance in the evaluation of labelled MoAbs, a
      computerised iterative nonlinear least squares (INLSQ) method was applied to
      estimate the three parameters simultaneously. The binding parameters in reactions
      between different 125I-labelled MoAbs and different types of targets were
      significantly changed when a graphical procedure was replaced by the computerised
      INLSQ method, and the goodness of fit to FLMA was improved. Hence, the nonlinear
      least squares method is the preferred procedure. Values were affected when only a
      subset of the data was included in the estimation procedure, indicating some
      heterogeneity even in these presumably homogeneous MoAb reactions. The
      radiolabelling procedure was presumed to be the main reason for this
      heterogeneity.

PMID- 1629624
TI  - Functional innervation of cultured skin grafts.
AB  - The aims of the present study were to determine 1) if grafts of cultured skin
      become innervated; and 2) whether tactile function of these grafts could be
      improved by implanting target tissue into them. Autologous skin equivalents were
      generated in vitro (30 d) for individual adult Sprague-Dawley rats. Some animals
      received pure skin equivalent grafts; others had target tissue consisting of 2-mm
      punch biopsies (normal skin or touch domes) inserted into their skin equivalents
      at the time of grafting. After 83 d, physiologic recordings were obtained from
      afferent nerves innervating the grafts. Tissue was processed for histology at
      various intervals. Silver staining of the tissues demonstrated many isolated
      nerve fibers in the dermis of cultured areas of skin as well as in implant zones.
      When grafts were rubbed with a glass rod or pinched with watchmaker forceps,
      impulses were evoked in nerves innervating both implant and cultured regions. In
      contrast, the afferent response to gently stroking grafts with a camel hair brush
      was severely reduced in cultured areas but was vigorous in implanted skin.
      Neuronal activity characteristic of type I neurons innervating touch domes was
      only found in cutaneous nerves innervating implants originally possessing domal
      tissue. Furthermore, grafts with good takes had better return of sensory function
      than grafts undergoing episodes of crusting. These results suggest that
      structural components or trophic factors present in implants enhanced the return
      of neural function related to the sensory modality of light touch; and this was
      also affected by the engraftment quality.

PMID- 1629625
TI  - Buschke-Ollendorff syndrome associated with elevated elastin production by
      affected skin fibroblasts in culture.
AB  - Buschke-Ollendorff syndrome (BOS; McKusick 16670) is an autosomal dominant
      connective-tissue disorder characterized by uneven osseous formation in bone
      (osteopoikilosis) and fibrous skin papules (dermatofibrosis lenticularis
      disseminata). We describe two patients in whom BOS occurred in an autosomal
      dominant inheritance pattern. The connective tissue of the skin lesions showed
      both collagen and elastin abnormalities by electron microscopy. Cultured
      fibroblasts from both patients produced 2-8 times more tropoelastin than normal
      skin fibroblasts in the presence of 10% calf serum. Involved skin fibroblasts of
      one patient produced up to eight times normal levels, whereas apparently
      uninvolved skin was also elevated more than threefold. In a second patient, whose
      involvement was nearly complete, elastin production was high in involved areas
      and less so in completely involved skin. Transforming growth factor-beta 1 (TGF
      beta 1), a powerful stimulus for elastin production, brought about similar
      relative increases in normal and BOS strains. Basic fibroblast growth factor, an
      antagonist of TGF beta 1-stimulated elastin production, was able to reduce
      elastin production in basal and TGF beta 1 stimulated BOS strains. Elastin mRNA
      levels were elevated in all patient strains, suggesting that Buschke-Ollendorff
      syndrome may result, at least in part, from abnormal regulation of extracellular
      matrix metabolism that leads to increased steady-state levels of elastin mRNA and
      elastin accumulation in the dermis.

PMID- 1629626
TI  - Human skin mast cell carboxypeptidase: functional characterization, cDNA cloning,
      and genealogy.
AB  - We functionally characterized human skin mast cell carboxypeptidase A (MC-CPA),
      and explored its evolutionary relationship to other carboxypeptidases to
      understand further the structural basis for the substrate preferences of this
      enzyme. Purified human skin MC-CPA displayed more activity than did bovine
      pancreatic carboxypeptidase A (CPA) against carboxyl-terminal leucine residues,
      about equal activity with phenylalanine and tyrosine residues, and no activity
      with tryptophan or alanine. To correlate kinetic data with structure, we isolated
      and sequenced a cDNA encoding MC-CPA from human skin, and directly sequenced 30%
      of the purified protein. These sequences agreed with that of human lung MC-CPA,
      and further support the evidence for a single MC-CPA gene in humans. Four amino
      acid replacements, resulting in a net positive change in non-hydrogen atoms in
      the S1' subsite of MC-CPA, were associated with less alteration in substrate
      specificity, relative to bovine CPA, than might be expected from studies using
      rat CPA1 and CPA2. We noted two consensus N-linked glycosylation sites in human
      MC-CPA that are not found in rat and mouse MC-CPA, or in bovine CPA; that at
      least one of these sites is glycosylated in vivo was verified by N-glycosidase F
      treatment, lentil lectin binding, and Concanavalin A-Sepharose chromatography.
      Evolutionary trees constructed from the known carboxypeptidase sequences
      suggested that MC-CPA most likely evolved from a carboxypeptidase B-like enzyme,
      independent of the pancreatic CPA. Thus, in the carboxypeptidase gene family, MC
      CPA displays a unique genealogy and several amino acid replacements in its S1'
      binding pocket that result in substrate specificity quite similar to bovine CPA.

PMID- 1629627
TI  - Comparative histochemistry of port-wine stains after copper vapor laser (578 nm)
      and argon laser treatment.
AB  - The present study compared the histologic changes occurring 15 min after copper
      vapor laser (CVL; operating at 578 nm) and argon laser (488/514 nm) treatment of
      port-wine stains (PWS) over a range of energy densities (8-32 J/cm2) with
      corresponding pulse widths of 50-200 ms. Frozen tissue sections were stained with
      nitroblue tetrazolium chloride (NBTC). This histochemical method permits an
      accurate color differentiation between blue-stained viable and unstained
      thermally damaged cells. At 8, 10, and 12 J/cm2 the argon-laser injury was
      confined to epidermal cell layers; none to superficial dermal effects were found.
      Fluences of at least 15 J/cm2 produced a diffuse NBTC-negative coagulation
      necrosis. Exposure of PWS skin to 8-12 J/cm2 at 578 nm did not alter the
      integrity of epidermal cells. In the dermis, damage was confined to blood vessels
      and surrounding collagen, showing a clear demarcation from adjacent viable
      structures. The maximum penetration depth achieved with these vessel selective
      energy densities was 0.44 mm. At 15 J/cm2, besides vascular injury, damage to the
      basal cell layer also occurred. At fluences of 17-20 J/cm2 a diffuse necrosis
      similar to that induced by the argon laser was found. Vessel selectivity of the
      578 nm wave band was achieved with pulse widths from 50-74 ms, exceeding the
      estimated "ideal" exposure time (0.1-10.0 ms) for a vascular selective laser
      effect. The NBTC method allowed identification of subtle laser-induced tissue
      changes providing accurate quantitative data relating to the extent of vascular
      injury.

PMID- 1629628
TI  - Increasing epidermal growth factor receptor expression in human melanocytic tumor
      progression.
AB  - Different results have been reported on the expression of epidermal growth factor
      receptor (EGFR) in human melanocytic lesions, which may be due to different
      methodologic approaches. Therefore, we compared EGFR expression in six human
      melanoma cell lines by utilizing the monoclonal antibodies 2E9, 425, and 225,
      applying four immunocytochemical staining procedures. The results were compared
      with those obtained by a multiple point ligand binding assay. In addition,
      Northern blot analysis was performed. A three-step immunoperoxidase method using
      the monoclonal antibody 2E9 proved most sensitive. Staining intensities,
      estimated semiquantitatively, correlated well with the quantitative data obtained
      by the ligand-binding assay. Expression on the mRNA level was also in agreement
      with these results. Immunohistochemical staining of a large series of human
      cutaneous melanocytic lesions using the method selected showed differential EGFR
      expression in various stages of melanocytic tumor progression: 19% of common
      nevocellular nevi; 61% of dysplastic nevi, 89% of primary cutaneous melanomas,
      and 91% of melanoma metastases showed staining of the melanocytic cells.
      Intralesional heterogeneity of EGFR expression was present. Although the mean
      percentage of positive melanocytic cells in positive lesions did not increase
      with progression, mean staining intensity was stronger in malignant lesions
      compared to benign lesions. Ligand binding assays showed that EGFR expression in
      the highly metastasizing cell lines MV3 and BLM was at least 40 times higher than
      in the cell lines IF6, 530, M14, and Mel57, which do not or only sporadically
      metastasize after subcutaneous inoculation in nude mice. Although the differences
      between the various stages of progression are not absolute, we provide further
      evidence that EGFR expression increases in human melanocytic tumor progression.

PMID- 1629629
TI  - The major cicatricial pemphigoid antigen is a 180-kD protein that shows
      immunologic cross-reactivities with the bullous pemphigoid antigen.
AB  - Recent studies have shown that sera from patients with cicatricial pemphigoid
      (CP) contained autoantibodies against epidermal antigens of molecular weight 230
      kD and/or 180 kD by immunoblotting, similar to those recognized by bullous
      pemphigoid (BP) sera. Previous immunoprecipitation studies have shown that BP
      sera only precipitated the 230-kD antigen. To characterize the CP antigen(s) we
      tested 10 CP sera, 10 BP sera, and four controls by both immunoprecipitation of
      radiolabeled cells and immunoblotting of epidermal extracts. For
      immunoprecipitation, we used 0.5% NP-40 extracts of both normal human
      keratinocytes and Pam cells. All CP sera precipitated a 180-kD protein that co
      migrated with the BP180 antigen precipitated by some individual BP sera. Two of
      these CP sera also faintly bound a 230-kD protein of similar molecular weight as
      the major BP230 antigen. CP and BP sera with an immunoblotting pattern of 180 kD
      immunoprecipitated a co-migrating 180-kD protein. CP sera reacting by
      immunoblotting with the 230-kD antigen precipitated the 180-kD and/or the 230-kD
      antigen. In contrast, BP sera reacting with the 230-kD antigen only precipitated
      this antigen. In further experiments, labeled 0.5% NP-40 extracts from Pam cells
      were first preabsorbed with a reference BP serum and then immunoprecipitated with
      CP sera. Under these conditions, CP sera that immunoprecipitated both 180-kD and
      230-kD proteins with the standard procedure no longer precipitated these
      proteins. Our results suggest that a 180-kD protein is the major CP target
      antigen that demonstrated immunologic cross-reactivities with the BP180 and the
      BP230 antigens.

PMID- 1629630
TI  - Stereologic estimation of volume-weighted mean nuclear volume as a predictor of
      prognosis in "thin" malignant melanoma.
AB  - At present, tumor invasion represents the most reliable prognostic factor for
      primary malignant melanoma. The 10-year survival rate of "thin" melanomas
      (Breslow less than 0.76 mm) is more than 95%, but approximately 5% of these low
      risk tumors do metastasize. In an attempt to determine prognostic markers for
      "thin" melanomas we investigated the volume-weighted mean nuclear volume (Vv) of
      primary melanomas with tumor invasions below 0.76 mm in 32 patients. Ten of these
      patients had developed melanoma metastases within a mean follow-up period of 49
      months; 22 patients who had not developed metastases and who were comparable with
      regard to clinical and histologic criteria as well as to follow-up period were
      selected as a comparison group. Vv was determined by computer-assisted image
      analysis (IBAS 20, Kontron, Germany) on hematoxylin-eosin-stained sections
      employing stereologic estimation of the volume-weighted mean nuclear volume. In
      addition, two-dimensional morphometric parameters (nuclear area and shape
      factors) as well as clinical (sex, age, location) and histologic characteristics
      (Breslow's thickness, Clark's level, and growth patterns) were recorded. The mean
      Vv (+/- SD) of primary melanomas with subsequent metastatic course was 273
      microns 3 (+/- 81.3), whereas primary melanoma lesions without subsequent
      metastases exhibited a significantly lower Vv of 154 microns 3 (+/- 25.3) (p =
      0.0008). On the other hand, two-dimensional morphometric and clinical and
      histologic parameters did not correlate with prognosis. Vv thus seems to
      represent a powerful and independent prognostic marker for "thin" primary
      melanomas. Assessment of Vv may provide a valuable tool in selecting patients
      with high-risk stage I, Breslow less than 0.76 mm, melanoma for adjuvant therapy.

PMID- 1629631
TI  - Effects of multiple applications of tumor promoters and ultraviolet radiation on
      epidermal proliferation and antioxidant status.
AB  - The dorsal skin of hairless mice (Skh:HR-1) was treated with multiple
      applications of acetone, 12-O-tetradecanoyl-phorbol-13-acetate (TPA) or ethyl
      phenylpropionate (EPP) two times per week, or exposed to ultraviolet radiation
      (UVR) three times per week for treatment periods up to 16 weeks. Epidermal
      hyperplasia, as measured by epidermal thickness, was increased in all three
      treatment groups after a single (0.5 weeks) TPA, EPP, or UVR treatment. TPA- and
      EPP-induced hyperplasia had begun to subside by 16 weeks, whereas UVR-induced
      hyperplasia was still increasing at that point. Epidermal homogenates were
      examined for ornithine decarboxylase (ODC) activity 6 h after the final treatment
      at 0.5, 2, 8, and 16 weeks of treatment. ODC activity was elevated in all
      treatment groups (TPA greater than EPP greater than UVR), with UVR induction
      returning to near control (acetone) levels by 16 weeks even though the UVR
      induced hyperplasia continued to increase at the 16-week point. Homogenates
      examined for superoxide dismutase (SOD), catalase (CAT), and xanthine oxidase
      (XO) activity 48 h after the final treatment at 0.5, 2, 4, 8, 12, and 16 weeks
      had decreased activities of both SOD and CAT. TPA and EPP elevated XO, but UVR
      had little or no effect. Our data indicate that promoter-induced hyperplasia
      persists for extended periods of time and that diminution of antioxidant defenses
      observed following prolonged tumor-promoter treatment persists through the time
      period when tumors would be expected to begin. This antioxidant diminution may be
      one of a cascade of events that leads to epidermal proliferation and tumor
      promotion in mouse skin.

PMID- 1629632
TI  - Enhanced production of plasminogen activator activity in human and murine
      keratinocytes by transforming growth factor-beta 1.
AB  - Transforming growth factor-beta (TGF beta) is the most potent known inhibitor of
      keratinocyte growth. Pericellular proteolytic activity is usually high in
      proliferating and malignant cells and decreased in resting or growth-arrested
      cells. We have therefore analyzed the effects of TGF beta 1 on the production of
      plasminogen activator activity by normal human keratinocytes and a mouse
      keratinocyte cell line under serum-free conditions. The plasminogen activator
      activity of the culture medium was analyzed using caseinolysis-in-agar and
      zymography assays, immunoblotting, and Northern hybridization analysis for the
      plasminogen activators (PA) and PA inhibitor-1 (PAI-1). Alterations of
      radiolabeled polypeptides were observed in fluorograms of gels. It was found that
      like in human epidermoid carcinoma cells picomolar concentrations of TGF beta 1
      (0.2-20 ng/ml) enhanced total plasminogen activator activity in both keratinocyte
      cell systems. Zymographic and immunoblotting analyses of the medium indicated
      that the activator was of the urokinase type (u-PA). Immunoprecipitation and
      Concanavalin A affinity chromatography of the culture medium indicated that the
      cells also started to produce PAI-1. Analysis of the pericellular matrix
      preparations of the keratinocytes showed that PAI-1 is deposited to the
      pericellular space. Evidently due to elevated u-PA activity PAI-1 was removed
      from the extracellular matrix more rapidly in TGF beta 1-treated cells than from
      control cultures. Northern hybridization analysis of human keratinocytes showed
      that TGF beta 1 rapidly elevated both u-PA and PAI-1 mRNA levels. Comparison of
      the temporal induction profiles indicated that the mRNA for u-PA increased more
      slowly but was more persistent than that of PAI-1. Actinomycin D inhibited the
      induction of both u-PA and PAI-1 mRNA, suggesting that the induction was due to
      increased transcription. The results suggest that enhanced plasminogen activator
      activity can be associated with growth inhibition also in nonmalignant cells like
      cultured human or murine keratinocytes.

PMID- 1629633
TI  - Epidermal HMG CoA reductase activity in essential fatty acid deficiency: barrier
      requirements rather than eicosanoid generation regulate cholesterol synthesis.
AB  - We showed previously that the activity of 3-hydroxy-3-methylglutaryl coenzyme A
      (HMG CoA) reductase, the rate-limiting enzyme of cholesterol biosynthesis,
      increases after both barrier disruption with organic solvents and in essential
      fatty acid deficiency (EFAD). Here, we treated EFAD hairless mice with linoleic
      acid, columbinic acid (C18: 3, n-6, trans; not metabolizable to known regulatory
      eicosanoids), prostaglandin E2 (PGE2), or latex occlusion, and determined
      transepidermal water loss (TEWL), epidermal protein content, and epidermal HMG
      CoA reductase activity. Increased TEWL rates in EFAD were accompanied by
      increased HMG CoA reductase activity (+130%, n = 6, p less than 0.01) and protein
      content (+69%; n = 6, p less than 0.025). Artificial restoration of the barrier
      by occlusion reduced the increase in enzyme activity and protein content toward
      normal, but barrier function, measured immediately after removal of the latex
      wrap, deteriorated further (TEWL: two-fold greater than EFAD unoccluded; p less
      than 0.01). Topical applications of either linoleate or columbinate (but not
      PGE2), normalized barrier function, HMG CoA reductase activity, and protein
      content. These results show that a) barrier function modulates HMG CoA reductase
      activity; b) reduction of cholesterol synthesis with occlusion results in a
      further deterioration in barrier function, suggesting that increased synthesis is
      a protective homeostatic response; and c) the barrier abnormality reflects a
      requirement for specific fatty acids for the barrier rather than resulting from
      epidermal hyperplasia or decreased prostaglandin generation.

PMID- 1629634
TI  - Relationship between cholesterol sulfate and intercellular cohesion of the
      stratum corneum: demonstration using a push-pull meter and an improved high
      performance thin-layer chromatographic separation system of all major stratum
      corneum lipids.
AB  - To investigate the role of cholesterol sulfate (CS) as an intercellular glue or
      cement in the stratum corneum, we compared the relationship between CS levels and
      magnitude of the intercellular cohesion of the stratum corneum between the palm
      and the upper arm. Using a push-pull meter, the palm displayed approximately
      seven times the magnitude of cohesion of the stratum corneum as the upper arm (n
      = 11). CS and other stratum corneum lipids were extracted from the palm and the
      upper arm (n = 22) by a cup method and determined by our improved high
      performance thin-layer chromatography (HPTLC). Despite a great difference in the
      magnitude of cohesion (p less than 0.01), CS levels and ratios of CS to ceramides
      and CS to cholesterol in the stratum corneum showed no significant differences
      between the palm and the upper arm. Our results suggest that differences in CS
      cannot account for the differences in cohesion between palm and upper arm.

PMID- 1629635
TI  - Purification of functional active epidermal Langerhans cells: a simple and
      efficient new technique.
AB  - Our knowledge of the functional activity of the epidermal Langerhans cell has
      been severely hampered by the lack of an easy method of purification of these
      cells that is both efficient and reproducible. In the present study we have used
      immunomagnetic beads directly conjugated to an IgM class mouse anti-human human
      leukocyte antigen DR monoclonal antibody to positively select human Langerhans
      cells from an epidermal cell suspension. Cells were then treated with a high
      affinity polyclonal anti-mouse immunoglobulin that detached the beads by
      competing with the antigen for the antigen-binding site on the monoclonal
      antibody. This procedure allowed removal of the immunomagnetic beads, leaving
      Langerhans cells free from bound antibody. Recovery of Langerhans cells ranged
      from 40 to 80% of the starting number of Langerhans cells. The resulting cells
      were up to 99% CD1a positive and showed potent functional activity in the
      allogeneic mixed epidermal cell - lymphocyte reaction. Keratinocytes were shown
      to exert a profound inhibitory effect on Langerhans cell function that could not
      be prevented by indomethacin. This method is technically simple and allows good
      recovery of a highly purified population of Langerhans cells that are
      functionally active.

PMID- 1629636
TI  - Quantitative 111In antimyosin antibody imaging to predict the age of myocardial
      infarction.
AB  - To establish whether quantitative 111In antimyosin uptake can be used to predict
      infarct age, we studied the heart-lung ratio in 107 images from 90 patients at
      various intervals following a Q-wave infarction. Imaging was performed 24 hours
      following 111In antimyosin injection. The HLR was measured as the ratio of the
      maximum counts in the infarcted myocardium to the adjacent lung background. The
      ratio ranged from 1.26 to 3.87, and declined with increasing infarct age.
      Infarcts were classified on the basis of age as type I (less than 3 days old),
      type II (less than 14 days), and type III (less than 90 days). True positive and
      false positive rates (TPR and FPR), and test-likelihood ratio calculations were
      performed for HLR thresholds ranging from 1 to 4, for the three infarct types. A
      FPR of 0% and likelihood ratio of infinity was obtained at a HLR threshold of 2.3
      for type I infarcts (TPR 40.8%); at a HLR threshold of 2 for type II infarcts
      (TPR 50.6%), and a threshold of 1.8 for type III infarcts (TPR 52.6%). The
      likelihood of each infarct type can be estimated directly from the HLR for values
      below the above thresholds. These results show that quantitative 111In-antimyosin
      imaging may be used to predict infarct age.

PMID- 1629637
TI  - Improvement of digital coronary angiography: high resolution processing coupled
      with a real time functional synchronization procedure.
AB  - The use of Digital Subtraction Angiography in coronary applications is restricted
      by the difficulty in: 1. Obtaining a good resolution of the distal branches. 2.
      Avoiding, for the purpose of subtraction, the motion artifacts induced by artery
      and background displacement during the cardiac and respiratory cycles. 3.
      Preserving the dynamic vascular motion. 4. And storing the digital dynamic
      information on a permanent support. We used for this study an angiography system,
      based upon a high resolution 45 MIPS-32 Mbyte image processor, interfaced with a
      2.75 Gbyte Winchester drive allowing the real time storage of either 30 frames/s
      in the 512*512*8 bits matrix or of 7.5 f/s in the 1024*1024*8 bits matrix. To
      preserve the most important dynamic informations on the basis of the 7.5 f/s
      maximal storage rate, we developed a synchronization device able to recognize in
      real time, from chronologic delays derived by using both ECG and Aortic Pressure
      curves, the functional End-Diastolic (ED) and the End-Systolic (ES) positions,
      even in the case of heart rates varying during the procedure. The ED and the ES
      images are stored together with the Mid-Systolic (MS), the 1/3-Diastolic (1/3D)
      and 2/3-Diastolic (2/3D) images. To establish the validity of this sampling
      method, which uses a reduced number of frames per cardiac cycle, 7200 coronary
      injections performed during 450 routine coronary angiographies were compared by
      two independent observers (A and B), using: first a Digital (D) 5 frames/cycle
      sequence, and secondly a cine Film (F) 50 frames/s sequence acquired immediately
      after the corresponding D injection. The D technique resulted in the best image
      and diagnostic quality, particularly when the F quality was estimated 'fair' or
      'poor' by both observers, and in an important reduction on X-Ray doses. The
      visualisation of the sequential ED, MS, ES, 1/3D and 2/3D frames gives the
      possibility: 1. of saving the dynamic information, as a regular sample of
      functional images can be displayed with a cine loop technique. 2. of facilitating
      cardiac synchronized subtractions. 3. of reducing the amount of frames per cycle,
      thus allowing an important reduction of X-ray doses and the digital and permanent
      storage of the most important cardiac cycles.

PMID- 1629638
TI  - Morphometry versus densitometry--a comparison by use of casts of human coronary
      arteries.
AB  - Geometric and densitometric methods for quantitative coronary arteriography have
      generally been compared by use of phantoms simulating arteries with circular
      lumina ('Hole phantoms'). We have used more adequate phantoms obtained by casting
      disease-free and atheromatous human coronary arteries. The phantoms, filled with
      contrast medium, were imaged digitally (1024 x 1024 x 10 matrix) under
      experimental conditions simulating routine coronary angiography. The angiographic
      'diameters' and the densitometric cross-sectional areas of 59 marked lumina were
      determined in single plane and orthogonal biplane raw images. Geometric
      calibration was performed by help of a 7F coronary catheter. For the
      densitometric calibration, we used a 'hole phantom' attached to the image
      intensifier. The obtained luminal areas were compared to their true values
      determined previously by planimetry. The mean absolute error of single plane
      cross-sections obtained geometrically was 1.53 mm2. Biplane imaging reduced it by
      a factor 2.4 to 0.64 mm2. The corresponding mean absolute errors for densitometry
      were 0.56 mm2 and 0.51 mm2. Single plane 'diameter' measurements appear thus of
      very limited value for hemodynamic conclusions. In contrast, biplane geometric
      quantification was not markedly inferior to single plane and biplane
      densitometry.

PMID- 1629639
TI  - The clinical usefulness of electrocardiogram-gated Tc-99m methoxy-isobutyl
      isonitrile images in the detection of basal wall motion abnormalities and
      reversibility of stress induced perfusion defects.
AB  - Technetium-99m methoxy-isobutyl-isonitrile (SESTAMIBI) has been recently
      introduced to trace regional myocardial perfusion. Beyond blood flow
      distribution, a quantitative index of regional myocardial wall motion from
      SESTAMIBI electrocardiogram (ECG)-gated images was obtained, according to the
      assumption that changes in the detected radioactivity reflect changes in
      myocardial wall thickness during the cardiac cycle. As a preliminary study, 20
      patients with coronary artery disease and regional wall motion abnormalities and
      15 normal subjects were studied by SESTAMIBI scintigraphy and contrast
      ventriculography. Regional wall motion was analyzed by a radial method applied to
      both techniques. Absolute systolic changes in radioactivity and its ratio to
      reference normal values (wall thickening index, WTI) were determined in 9
      anatomical cardiac regions according to the formula (endsystolic counting profile
      enddiastolic counting profile/enddiastolic counting profile) x 100. The overall
      agreement between radioisotopic and ventriculographic techniques was 88% (158 of
      180 segments). Normal, hypokinetic and akinetic ventriculographic segments showed
      WTI values of 1.1 +/- 0.2, 0.8 +/- 0.2 and 0.4 +/- 0.3 respectively (P less than
      0.001). A second clinical study was performed in 25 patients studied by
      stress/rest ECG-gated SESTAMIBI scintigraphy. The assumption of this part of the
      study was to investigate if a preserved wall thickening in segments with stress
      defects might predict those areas with normal resting perfusion. Partial or total
      normalization of regional perfusion was observed in 90% of segments with a WTI
      greater than or equal to 0.8. These studies indicate the ECG-gated SESTAMIBI may
      represent a suitable technique for the simultaneous analysis of flow distribution
      and function. Analysis of post-exercise ECG-gated SESTAMIBI can predict the
      reversibility of transient perfusion defects.

PMID- 1629641
TI  - Angiographic assessment of dimensions of 6F and 7F Mallinckrodt Softouch coronary
      contrast catheters from digital and cine arteriograms.
AB  - Coronary contrast catheters are almost exclusively used for calibration purposes
      in quantitative coronary arteriography. In this study we have assessed the
      suitability of new 6F and 7F Mallinckrodt nylon catheter with Softouch tip with
      improved imaging specifications for such calibration purposes both from digital
      and cinefilm images using new analytical QCA-software packages (Philips DCI/ACA
      and Medis CMS). The average signed differences between the angiographically
      measured dimensions at 100% contrast fillings and acquired at 3 different kV
      levels (60, 75 and 90 kV) were -3.3% and 0.6% for the 6F and 7F catheter tips,
      respectively as measured with the ACA-package on digital images, and -0.4% and
      2.1%, respectively, as measured with the CMS-system on cinefilm images. The
      pooled standard deviations were 0.102 mm and 0.107 mm for the 6F and 7F catheter
      tips, respectively, as measured with the ACA-package, and 0.080 mm and 0.083 mm,
      as measured with the CMS-system. The deviations for the nylon shafts were much
      larger. It became also clear that neither the filling of the catheters, nor the
      kV-level used, had any appreciable effect on the measurement accuracy for the
      Softouch tips, which facilitates the frame selection in QCA-studies. From these
      data it can be concluded that the nontapering parts of the 6F and 7F Mallinckrodt
      Softouch tips are very well suitable for QCA calibration purposes, but that the
      nylon shafts are not.

PMID- 1629640
TI  - Diagnostic value of transesophageal echocardiography in atrial septal aneurysm.
AB  - Transthoracic and transesophageal echocardiography was performed in 40
      consecutive adult patients with an atrial septal aneurysm. In 11 (27%) of 40
      patients transthoracic echocardiography failed to demonstrate the lesion and the
      diagnosis was established by the transesophageal approach only. Interatrial
      shunting, assessed by echocardiographic contrast study and/or color flow mapping,
      was detected in 13 (54%) of 24 patients on transthoracic imaging and in 29 (76%)
      of 38 patients during transesophageal echocardiography. Identification of
      multiple fenestrations (n = 9) and thrombi within the aneurysm (n = 2) could be
      achieved only by transesophageal ultrasound. A cerebrovascular event of suspected
      embolic origin occurred in 20 (50%) of 40 patients; 11 (55%) of the 20 patients
      had repeated cerebral events. Except for mitral valve prolapse in 2 patients and
      spontaneous left atrial contrast phenomenon in 1 patient no other potential
      cardiac source of embolism could be identified by transesophageal
      echocardiography. A marked thickening of the aneurysm was present in 14 (70%) of
      20 patients with a cerebrovascular event versus only 4 (20%) of 20 patients
      without a cerebrovascular event (p less than 0.01). The mechanism of embolization
      may be both primary thrombus formation within the aneurysm and paradoxical
      embolization through an interatrial communication as suggested by the findings on
      transesophageal ultrasound in 2 patients. Although the patients of this study
      represent a highly selected group it may be concluded that atrial septal aneurysm
      is a cardiac abnormality with embolic potential. Transesophageal echocardiography
      has to be regarded the imaging method of choice for evaluation of this lesion.

PMID- 1629642
TI  - Impact of changes in heart rate and stroke volume on the cross sectional flow
      velocity distribution of diastolic mitral blood flow. A study on 6 patients with
      pacemakers programmed at different heart rates.
AB  - The effect of changes in stroke volume on the cross sectional velocity
      distribution in the mitral orifice during passive mitral inflow was studied in
      six patients with total atrioventricular block, atrial fibrillation and VVI
      pacemakers during periods with different heart rates. The time velocity integrals
      recorded both in the left ventricular outflow tract and at the mitral orifice
      decreased significantly as the heart rate was increased from 60 to 80 and from 80
      to 100 beats per minute. Instantaneous cross sectional flow velocity profiles
      were constructed by time interpolation of the velocity data from each point in
      sequentially delayed two dimensional digital ultrasound maps. Each patient had a
      characteristic cross sectional flow velocity profile in the mitral orifice
      recorded at the level of the leaflet tips in a four chamber view. The velocity
      profiles varied between the patients. With increase in heart rate only minimal
      changes in the flow profiles from individual patients were seen. The maximum
      velocity through the mitral orifice overestimated the cross sectional mean
      velocity at the same time by a factor of 1.4-1.9. The maximum time velocity
      integral overestimated the cross sectional mean by a factor of 1.4-1.8. The
      observed cross sectional skew varied between patients but did not change
      significantly with increasing heart rate and decrease in stroke volume.

PMID- 1629643
TI  - Identification of coronary artery by-pass grafts: reliability of MRI in clinical
      practice.
AB  - In order to test MRI ability to detect the number and the sites of coronary
      artery by-pass grafts (CABGs), 22 patients with CABGs were studied. The detection
      of a neo-vessel in even one of the examination slices was considered as positive
      for the study, disregarding the difference between its origin and course. With
      such a criterion, MRI total percentage of vascular bridges identification
      resulted in 76.1% (51/67) with very low values for CABGs implanted on diagonal,
      obtuse marginal and posterior descending vessels (11/24 = 45.8%). These results
      lead to the conclusion that, although MRI has some advantages in the
      identification of CABGs implanted on the main coronary vessels in the early post
      operative period, its extensive use cannot be proposed at the present state of
      the art.

PMID- 1629644
TI  - Myocardial volume perfused by coronary artery branches--a three-dimensional x-ray
      CT evaluation in human cadaver hearts.
AB  - The volume of myocardium perfused by coronary arterial branches and cumulative
      length of the main feeder branches perfusing that volume were measured from
      multislice computed tomography images of human cadaver hearts with barium sulfate
      gel injected into the coronary arteries. Previously we have shown in in vivo pig
      hearts that the relationship between the volume (V), in mL, of perfused
      myocardium and the length (L), is well conveyed by V = M x 10(-aL) where M is
      total mass of myocardium perfused by a major epicardial artery and a is constant
      congruent to 0.01 mm-1. In the nine human hearts studied, this relationship was V
      = 115 x 10(-0.006L), r = -0.894 for the LAD; V = 48 x 10(-0.009L), r = -0.7663
      for the LCX and V = 103 x 10(-0.004L), r = -0.673 for the RCA. These results
      suggest that the angiographically delineated volume of myocardium at risk of
      infarction, due to acute blockage along a coronary artery, could possibly be
      estimated from the 3D branching geometry of the epicardial coronary arterial
      tree.

PMID- 1629645
TI  - [The manpower study of thoracic and cardiovascular surgery in Western countries-
      comparison with Japan].

PMID- 1629646
TI  - [Open heart surgery in the first month of life].

PMID- 1629647
TI  - [Long-term follow up after repair of complex heart anomalies].

PMID- 1629648
TI  - [Care and mechanical cardiac support for severe heart failure associating acute
      myocardial infarction and open heart surgery].

PMID- 1629649
TI  - [Evaluation and management of advanced lung cancer].

PMID- 1629650
TI  - [Esophageal reconstruction].

PMID- 1629651
TI  - [Coronary artery reoperation].

PMID- 1629652
TI  - [To improve the operative results of aortic arch repair].

PMID- 1629653
TI  - [Tracheal and carinal reconstruction].

PMID- 1629654
TI  - [Dissection of lymph nodes and extended operative intervention in the surgical
      management of esophageal carcinoma].

PMID- 1629655
TI  - [Repair of complex heart anomalies].

PMID- 1629656
TI  - Drosophila single-minded gene and the molecular genetics of CNS midline
      development.
AB  - Our goal is to understand the molecular mechanisms that govern the formation of
      the central nervous system. In particular, we have focused on the development of
      a small group of neurons and glia that lie along the midline of the Drosophila
      CNS. These midline cells possess a number of unique attributes which make them
      particularly amenable to molecular, cellular, and genetic examinations of nervous
      system formation and function. In addition, the midline cells exhibit distinctive
      ontogeny, morphology, anatomical position, and patterns of gene expression which
      suggest that they may provide unique functions to the developing CNS. The single
      minded gene encodes a nuclear protein which is specifically expressed in the
      midline cells and has been shown to play a crucial role in midline cell
      development and CNS formation. Genetic experiments reveal that sim is required
      for the expression of many CNS midline genes which are thought to be involved in
      the proper differentiation of these cells. In order to identify additional genes
      which are expressed in some or all of the midline cells at different
      developmental stages, a technique known as enhancer trap screening was employed.
      This screen led to the identification of a large number of potential genes which
      exhibit various midline expression patterns and may be involved in discrete
      aspects of midline cell development. Further molecular, genetic, and biochemical
      analyses of sim and several of the enhancer trap lines are being pursued. This
      should permit elucidation of the genetic hierarchy which acts in the
      specification, differentiation, and function of these CNS midline cells.

PMID- 1629657
TI  - Developmental regulation of ecdysteroid receptors in the nervous system of
      Manduca sexta.
AB  - The technique of steroid hormone autoradiography has been used to study the
      cellular distribution of ecdysteroid binding sites in the ventral nervous system
      of the tobacco hornworm moth, Manduca sexta. The ligand was 26
      [125I]iodoponasterone. Tissue was examined from the subesophageal ganglia,
      thoracic ganglia, and abdominal ganglia of larvae at two times during the larval
      pupal transient: the 2nd day of wandering and the prepupal stage. The patterns of
      neuronal binding seen were compared with those found in earlier autoradiographic
      studies of hormone binding in tissue sampled on the 1st day of wandering, in the
      pharate adult, and in the 4-day-old moth (Fahrbach and Truman, '89). The pattern
      of binding was reproducible but dependent upon developmental stage: whereas only
      a subset of neurons exhibited nuclear accumulation of radiolabeled ecdysteroids
      on the 1st day of wandering, less than 24 hours later nearly every neuron in the
      ventral nervous system was labeled. A limited pattern of binding, however, was
      seen again in the prepupal nervous system. Thus, the insect nervous system is
      able to use a single hormone both as a general cue for metamorphic development
      and as a single targeted to stage-specific subsets of neurons by alternating
      periods of ubiquitous expression of receptor with periods during which the
      capacity to bind the steroid hormone is highly restricted.

PMID- 1629658
TI  - Specificity of VIIIth nerve regeneration in lower vertebrates.
AB  - From the initial studies of Sperry (Am. J. Physiol, 144:735-741, 1945) to more
      recent investigations, the regenerative capacity of the VIIIth cranial nerve in
      nonmammalian vertebrates has been noted for its robust and accurate recovery of
      functional connections after transection. The VIIIth cranial nerve contains nerve
      fibers that link functionally distinct sensory epithelial to various areas within
      the central nervous system (CNS), yet after transection these multiple components
      of the nerve navigate back to their original central target areas, without
      innervating inappropriate nuclei. A number of factors may be required to
      establish and direct VIIIth nerve regeneration. Cellular interactions appear to
      be necessary for the initiation of outgrowth and the maintenance of neural
      connections. The release of chemotropic substances from target cells has been
      postulated as the most likely mechanism guiding the reinnervation of central
      targets. Furthermore, the growth characteristics of these neurons in tissue
      culture, without target cells present, indicates that intrinsically regulated
      growth features may also contribute to the process of VIIIth nerve regeneration.

PMID- 1629659
TI  - Development of spinal motor networks in the chick embryo.
AB  - We have examined the cellular and synaptic mechanisms underlying the genesis of
      alternating motor activity in the developing spinal cord of the chick embryo.
      Experiments were performed on the isolated lumbosacral cord maintained in vitro.
      Intracellular and whole cell patch clamp recordings obtained from sartorius
      (primarily a hip flexor) and femorotibialis (a knee extensor) motoneurons showed
      that both classes of cell are depolarized simultaneously during each cycle of
      motor activity. Sartorius motoneurons generally fire two bursts/cycle, whereas
      femorotibialis motoneurons discharge throughout their depolarization, with peak
      activity between the sartorius bursts. Voltage clamp recordings revealed that
      inhibitory and excitatory synaptic currents are responsible for the
      depolarization of sartorius motoneurons, whereas femorotibialis motoneurons are
      activated principally by excitatory currents. Early in development, the dominant
      synaptic currents in rhythmically active sartorius motoneurons appear to be
      inhibitory so that firing is restricted to a single, brief burst at the beginning
      of each cycle. In E7-E13 embryos, lumbosacral motor activity could be evoked
      following stimulation in the brainstem, even when the brachial and cervical cord
      was bathed in a reduced calcium solution to block chemical synaptic transmission.
      These findings suggest that functional descending connections from the brainstem
      to the lumbar cord are present by E7, although activation of ascending axons or
      electrical synapses cannot be eliminated. Ablation, optical, and
      immunocytochemical experiments were performed to characterize the interneuronal
      network responsible for the synaptic activation of motoneurons. Ablation
      experiments were used to show that the essential interneuronal elements required
      for the rhythmic alternation are in the ventral part of the cord. This
      observation was supported by real-time Fura-2 imaging of the neuronal calcium
      transients accompanying motor activity, which revealed that a high proportion of
      rhythmically active cells are located in the ventrolateral part of the cord and
      that activity could begin in this region. The fluorescence transients in the
      majority of neurons, including motoneurons, occurred in phase with ventral root
      or muscle nerve activity, implying synchronized neuronal action in the rhythm
      generating network. Immunocytochemical experiments were performed in E14-E16
      embryos to localize putative inhibitory interneurons that might be involved in
      the genesis or patterning of motor activity. The results revealed a pattern
      similar to that seen in other vertebrates with the dorsal horn containing neurons
      with gamma-aminobutyric acid (GABA)-like immunoreactivity and the ventral and
      intermediate regions containing neurons with glycine-like immunoreactivity.

PMID- 1629660
TI  - Functional regeneration and recovery of locomotor activity in spinally transected
      lamprey.
AB  - Spinally transected lamprey recovery locomotor function within 3-6 weeks, and
      recovery is due, in part, to functional regeneration of neural pathways in the
      central nervous system (CNS). Our data demonstrate for the first time in the
      lamprey that descending axons arising from brainstem command neurons can
      functionally regenerate and restore locomotor initiation below a healed spinal
      transection site. Immediately after behavioral recovery (3-6 weeks) the locomotor
      pattern was incomplete but returned to normal during the remainder of the
      recovery period (6-40 weeks). Initially, the extent of regeneration of descending
      axons was limited but increased to at least 30-50 mm at recovery times of 24-40
      weeks. Regenerated giant Muller axons do not contribute significantly to recovery
      of locomotor function; rather, regenerated axons of smaller reticulospinal
      neurons appear to restore locomotor initiation. The restoration of locomotor
      coordination across a spinal lesion is dependent on two mechanisms: regeneration
      of spinal coordinating neurons and mechanosensory inputs. Comparisons are made to
      spinal cord regeneration in other lower vertebrates and to the relative lack of
      CNS regeneration and behavioral recovery in higher vertebrates.

PMID- 1629661
TI  - Early innervation of abdominal swimmeret muscles in developing lobsters.
AB  - The swimmerets in the abdomen of the lobster Homarus americanus are paired
      external appendages whose back and forth propulsive movements are brought about
      largely by a group of power and return stroke muscles located in the lateral
      abdominal cavity. We find functional innervation of these muscles by several
      excitatory axons and a single inhibitor in embryonic and stage 1 larval lobsters
      before the external appendages are even formed. This early innervation is via a
      few nerve bundles in which branches of the motor axons are intertwined in a
      complex manner. As the swimmerets develop to maturity in later larval and
      juvenile stages, the innervation consisting usually of several excitor and a
      single inhibitor synaptic terminals becomes localized to individual muscles.
      Patterned synaptic activity in these muscles was not seen in the embryonic and
      larval stages but has been shown in early juvenile stages, when it coincides with
      the onset of rhythmic movement of the swimmerets. Consequently, such early
      innervation of the swimmeret muscles may be influential in establishing the
      central circuitry for the generation of patterned activity, a possibility that
      was discounted in a previous study (Proc. Natl. Acad. Sci. USA, 70:954-958).

PMID- 1629662
TI  - Molecular mechanisms of axon guidance in the developing insect nervous system.

PMID- 1629663
TI  - The mechanism of suckling in two species of infant mammal: miniature pigs and
      long-tailed macaques.
AB  - Suckling is the form of feeding unique to infant mammals. The mechanism used by
      infant mammals to withdraw liquid from the nipple is the subject of considerable
      debate. Suckling has been examined in two species of infant mammals: miniature
      pigs and long-tailed macaques. In both species radio-opaque markers were inserted
      into the tongue and jaws; the movements of the jaw and tongue (and also of
      specific regions within the tongue) plus the movement of milk containing barium
      were studied by high-speed cineradiography (100 and 150 frames/sec). In the case
      of macaques, simultaneous pressure transducer recordings were also made. In both
      species, liquid moved out of the nipple as the intraoral space was expanded by a
      combination of tongue movement (negative pressure pumping) coupled with jaw
      opening. There was no evidence for expression (positive pressure on the nipple)
      in either species, strongly supporting the view that a suction mechanism is
      responsible for acquisition of milk from the nipple. Subsequent intraoral
      transport was different in the two species. The pigs used a second pump mechanism
      at the base of the tongue to transport liquid through the pillars of the fauces
      into the valleculae. The monkeys used a "squeeze-back" mechanism similar to the
      transport mechanism documented for adult macaques. Further work with other
      species can test our tentative hypothesis that all mammals use a negative
      pressure suction for acquisition, but, as is true for adult mammals, infants may
      use different transport mechanisms to form and move the bolus.

PMID- 1629664
TI  - Secondary sex characteristics and related physiological values in male fallow
      deer (Dama dama L.) and their relationships to changes in the annual cycle of
      daylengths: frequency alterations to 4- and 3-month photoperiodic cycles, and
      subsequent re-synchronisation under natural conditions.
AB  - Five adult male fallow deer were maintained in a barn with artificial light
      control. In a previous experiment, three 6-month photoperiodic cycles entrained
      morphogenetic and associated physiological values that revealed typical
      relationships to the antler cycle. Presented here, the light cycle was
      accelerated to three 4- and one 3-month photoperiods in the same group. Each
      artificial photoperiod generally resulted not only in an almost complete antler
      cycle but also in an entire cycle of seasonal fluctuations in neck girth.
      Increases in plasma levels of alkaline phosphatase (AP), total-, LDL- and HDL
      cholesterol, were generally entrained and the maxima revealed positive
      correlations with antler formation, but the relationships slightly diverged. In
      neck girth and creatinine, positive correlations to the hard antler period as
      well as to each other prevailed but diverged. In the 3-month photoperiodic cycle,
      these relationships were out of synchrony. In the second 4-month cycle, two bucks
      "missed" shedding and subsequent casting, but commenced antler growth in the
      following cycle with an in-time shedding. The possibility of desynchronisation of
      physiological conditions and the question of an endogenous circannual mechanism
      interacting with daylight are discussed. At the end of the 3-month cycle,
      experimental indoor and natural outdoor casting was coincident so the group was
      transferred to outside conditions for re-synchronisation. After spending
      altogether 36 months in frequency altered photoperiods, the represented values
      were neither synchronized nor revealed their typical relationships to the antler
      cycle, except of AP and neck volume. In the second cycle of re-synchronisation,
      all parameters, except of creatinine, appeared to be resynchronized.

PMID- 1629665
TI  - Expansion of surface epithelium provides the major extrinsic force for bending of
      the neural plate.
AB  - Neurulation, formation of the neural tube, requires both intrinsic forces (i.e.,
      those generated within the neural plate) and extrinsic forces (i.e., those
      generated outside the neural plate in adjacent tissues), but the precise origin
      of these forces is unclear. In this study, we addressed the question of which
      tissue produces the major extrinsic force driving bending of the neural plate. We
      have previously shown that 1) extrinsic forces are required for bending and 2)
      such forces are generated lateral to the neural plate. Three tissues flank the
      neural plate prior to its bending: surface epithelium, mesoderm, and endoderm. In
      the present study, we removed two of these layers, namely, the endoderm and
      mesoderm, underlying and lateral to the neural plate; bending still occurred,
      often with complete formation of a neural tube, although the latter usually
      rotated toward the side of tissue depletion. These results suggest that the
      surface epithelium, the only tissue remaining after microsurgery, provides the
      major extrinsic force for bending of the neural plate and that the mesoderm (and
      perhaps endoderm) stabilizes the neuraxis, maintaining its proper orientation and
      position on the midline.

PMID- 1629666
TI  - Presence of a trypsin-like protease in starfish sperm acrosome.
AB  - Marthasterias glacialis sperm cells were treated with ionophore A23187,
      centrifuged, and the supernatants were assayed for esterase activity. With N
      benzoyl-L-arginine ethyl ester-HCl (BAEE) as substrate, a net activity was
      determined which was not detectable when N-acetyl-L-tyrosine ethyl ester (ATEE)
      was used. The BAEE trypsin-like activity was inhibited by soybean trypsin
      inhibitor (SBTI), N-alpha-p-tosyl-L-lysine chloromethyl ketone-HCl (TLCK), and
      phenyl methyl sulfonyl fluoride (PMSF), but not by L-1-tosylamido-2-phenylethyl
      chloromethyl ketone (TPCK). The presence of proteolytic activity in acrosomal
      exudates was further demonstrated by gelatin-sodium dodecyl sulfate
      polyacrylamide gel electrophoretic zymography (gelatin-SDS-PAGE). The presence of
      several bands of low proteolytic activity and of one band of high proteolytic
      activity, which also has the lower molecular weight, together with the fact that
      all are inhibited by benzamidine, suggests the existence of a trypsin-like
      proteinase system. The effect of the acrosomal exudate on the oocyte jelly coat
      was investigated by SDS-PAGE analysis. All jelly proteins appeared to be digested
      by the acrosomal enzymes. Furthermore, if SBTI is added shortly after
      insemination, the sperm fail to fertilize the oocytes. These results indicate
      that the starfish sperm acrosomal vesicle contains a trypsin-like protease which
      may be involved in sperm penetration through the oocyte jelly coat.

PMID- 1629667
TI  - Changes in monoamine transmitter concentration in freshwater mussel tissues.
AB  - Freshwater mussels were analyzed for biogenic amine transmitter substances in
      gill tissue, suprabranchial nerve and blood. Gill tissue from normal pondwater
      acclimated mussels contained significant amounts of monoamine neurotransmitter
      substances. In comparison with the suprabranchial nerve the gill tissue contained
      42% of the dopamine, 7% of the serotonin and 490% of norepinephrine. Exposing the
      animals to deionized water (salt-depleted) resulted in a loss of transmitter
      substances from gill tissue, but serotonin reduction was modest. The mussel gill
      tissue content of serotonin and the precursor tryptophan was regulated at nearly
      constant levels. Serotonin is an important transmitter substance in mussels and
      the many functions it controls, including sodium transport regulation, would
      depend on its continued presence.

PMID- 1629668
TI  - Discussion of "Cerebral tissue embolization due to head trauma: a case report
      with immunohistochemical confirmation".

PMID- 1629669
TI  - Calcium alginate swabs.

PMID- 1629670
TI  - Polymerase chain reaction (PCR) amplification and human leukocyte antigen (HLA)
      DQ alpha oligonucleotide typing on biological evidence samples: casework
      experience.
AB  - The polymerase chain reaction (PCR) method of specific gene amplification was
      used in casework to synthesize millions of copies of the polymorphic second exon
      of the human leukocyte antigen (HLA)-DQ alpha (or DQA1) locus from a variety of
      evidence samples. The HLA-DQ alpha allelic variants in the amplified
      deoxyribonucleic acid (DNA) were determined in a rapid non-radioactive test by
      hybridization to sequence-specific oligonucleotide probes in both the dot-blot
      and reverse dot-blot formats. This genetic typing system has been subjected to
      blind proficiency testing; the performance of this test in the analysis of
      experimentally mixed samples was also evaluated. As of August 1990, over 250
      cases have been tested and more than 2000 individual evidence (bloodstains, semen
      stains, individual hairs, bone fragments, and tissue sections) and reference
      samples have been analyzed. The first 198 of these cases are summarized in this
      paper; in 65% of the cases with conclusive results a suspect was included, and in
      35%, all suspects were excluded. Individual cases as well as some of the general
      issues relating to forensic science analysis and this genetic typing system are
      discussed. The high rate of exclusion reported here combined with the ability of
      PCR to type old evidence samples suggests the relevance of this genetic test for
      postconviction review; two cases in which the convicted suspect was excluded are
      discussed.

PMID- 1629671
TI  - Evaluation of cast methods for estimating age from the os pubis.
AB  - Age-related changes of the pubic symphysis have gained wide acceptance among
      physical anthropologists as one basis for estimating adult skeletal age. However,
      these methods have not been tested by independent observers on large samples with
      known ages at death that represent contemporary populations. In this study 202
      female and 116 male pairs of pubes collected at autopsy were blindly evaluated
      for age using the McKern-Stewart or Gilbert-McKern and Suchey-Brooks methods.
      Performance of the methods was measured by mean absolute deviation of true age
      from scored interval means and frequencies of true age falling within +/- 1 and
      +/- 2 standard deviations from the mean. The results suggest that the Suchey
      Brooks methods are superior in forensic applications and that the racially
      specific refinement for males should be used. Age estimates should include +/- 2
      standard deviations, and chances of error should be considered, especially when
      advanced age or debilitation is suspected.

PMID- 1629672
TI  - Linear models for the prediction of stature from foot and boot dimensions.
AB  - Estimation of stature from the dimensions of foot or shoeprints has considerable
      forensic value in developing descriptions of suspects from evidence at the crime
      scene and in corroborating height estimates from witnesses. This study extends
      the findings of previous researchers by exploring linear models with and without
      gender and race indicators, and by validating the most promising models on a
      large, recently collected military database. Boot size and outsole dimensions are
      also examined as predictors of stature. The results of this study indicate that
      models containing both foot length and foot breadth are significantly better than
      those containing only foot length. Models with race/gender indicators also
      perform significantly better than do models without race/gender indicators.
      However, the difference in performance is slight, and the availability of
      reliable gender and race information in most forensic situations is uncertain.
      Analogous results were obtained for models utilizing boot size/width and outsole
      length/width, and in this study these variables performed nearly as well as the
      foot dimensions themselves. Although the adjusted R2 values for these models
      clearly reflect a strong relationship between foot/boot length and stature,
      individual 95% prediction limits for even the best models are +/- 86 mm (3.4
      in.). This suggests that models estimating stature from foot/shoe-prints may be
      useful in the development of subject descriptions early in a case but, because of
      their imprecision, may not always be helpful in excluding individual suspects
      from consideration.

PMID- 1629673
TI  - A BASIC algorithm for calculating the postmortem interval from arthropod
      successional data.
AB  - A computer algorithm, implemented in the BASIC language, is presented for
      calculating the postmortem interval (PMI) from arthropod successional data.
      Entomology-assisted determination of the PMI promises to be a reliable technique
      in cases of homicide, suicide, accidental death, and unattended death due to
      natural causes. The program requires, as input, the identity of arthropod taxa
      recovered from human remains in a death scene investigation and machine-readable
      data on carrion-associated arthropod taxa and their known successional patterns
      of activity for the same geographical area. The program performs rapid
      comparisons of these lists and, on output, calculates an upper and lower estimate
      of the PMI, identifies the definitive taxa for these limits, and determines if
      the remaining corpse taxa have known successional patterns that are consistent
      for this estimate. An alternate output is provided if one or more corpse taxa do
      not overlap all the others at any single time in the succession. In that event,
      the user is prompted to recheck the identity of the non-overlapping taxon or taxa
      or reevaluate the environmental circumstances surrounding the case in question.
      Results of the analysis are saved to an ASCII file for output to a printer for
      making paper copies useful for the entomologist's Case Study Final Report. This
      program may make possible wider use of this technique in law enforcement and
      medical investigator offices that utilize both forensic entomologist expertise
      and IBM PCs (or compatible computers).

PMID- 1629674
TI  - Practical approach to investigative ethics and religious objections to the
      autopsy.
AB  - The application of investigative ethics to religious objections to the autopsy is
      essential for harmony in achieving the mission of medical legal death
      investigations. In Florida, an ethical advisory committee composed of religious,
      ethics, legal, and medical leaders established a unified statement for the
      practice of discretionary judgment and liaison with clergy. Our approach to
      religious objections to the autopsy as well as illustrative cases will be
      discussed.

PMID- 1629675
TI  - Dangerousness of the delusional misidentification of children.
AB  - Misidentification syndromes have been studied from a variety of perspectives,
      including phenomenological, biological, and nosological approaches. More
      recently, misidentification syndromes have been studied from a psychiatric-legal
      perspective, especially with regards to the problem of dangerousness. Capgras
      syndrome and other syndromes of misidentification can lead to hostile mood and
      subsequent physical violence. Little attention has so far been devoted to
      children as the objects of the psychotic person's misidentification delusion(s).
      We provide a review of cases from the anglophonic literature that have children
      as the misidentified objects, add three new cases, and then discuss the
      relationship between misidentification and potential harm to these children.

PMID- 1629676
TI  - Misidentification of self and the Riel Phenomenon.
AB  - Misidentification syndromes or phenomena are found in a number of psychiatric
      situations that may become the subject of forensic science review. One of the
      most curious is misidentification of self in which the individual perceives
      himself or herself as another being while able to explain the loss of the
      original identity. Recognizing these phenomena may be helpful in accurate
      diagnosis, in considering such conditions as psychosis of whatever type, multiple
      personality disorder, and other amnesia and fugue states, and in understanding
      the person's psychopathology. Two cases are presented to illustrate a process
      that the authors have named the Riel Phenomenon, after the person who was a party
      to what is often recognized as the most famous case in Canadian history.

PMID- 1629677
TI  - The trial of Louis Riel: a study in Canadian psychiatry.
AB  - The Riel case in 1885 is one of the most striking cases in the history of
      forensic psychiatry. On the one hand, Riel was the hero of the underprivileged,
      French Canadian-Indian halfbreeds whose futile revolt in the Canadian Northwest
      captured the imaginations of French Canadians in Quebec, for whom he became a
      hero and a martyr. Prior review in this journal has detailed the clinical data
      referrable to his mental condition. This paper reviews the actual trial, the
      questionable management by the defense, and the inadequate preparations by the
      defense psychiatrists. Subsequent to the sentence of death, the Canadian prime
      minister, Macdonald, ordered a medical review, more or less dictating the result.
      For whatever reason, the medical reports when made public did not fully reflect
      the actuality of what occurred. The result was a questionable execution, the
      creation of a martyr, and a spark for the cultural conflict that continues to
      bedevil Canada.

PMID- 1629678
TI  - Deoxyribonucleic acid (DNA) typing of human leukocyte antigen (HLA)-DQA1 from
      single hairs in Japanese.
AB  - The deoxyribonucleic acid (DNA) typing of human leukocyte antigen (HLA)-DQA1 from
      single hairs is described. HLA-DQA1 genotypes could be determined from single
      plucked hair roots. However, it was not easy to type HLA-DQA1 with hair shaft
      portions. Increase in the specimens of hair shaft portions (over 10 cm in length)
      to get sufficient DNA caused inhibition of polymerase chain reaction (PCR).
      Synthetic melanin as well as the one extracted from hairs inhibited the PCR of
      the genomic DNA template when added to the PCR reaction at the concentrations
      over than 15 ng/100 microL. Therefore, typability of hair shaft portions seems to
      depend on the delicate balance of the concentrations of DNA and the contaminated
      melanin in the final DNA extracts.

PMID- 1629679
TI  - Scanning electron microscopy: application in the identification of diatoms in
      cases of drowning.
AB  - A simple and rapid method is described for processing organ and water samples for
      the identification of diatoms so that they can be studied and recorded for
      taxonomic and diagnostic purposes. Samples are treated with concentrated nitric
      acid; the fluid obtained is centrifuged, and its sediment is dried, coated, and
      examined under the scanning electron microscope. The method does not alter the
      morphology of diatoms and allows the study of freshwater and seawater species
      present in the organs of bodies found in the water, making possible the diagnosis
      of drowning under specific conditions.

PMID- 1629680
TI  - Preliminary observations of the effect of methamphetamine in decomposing tissues
      on the development rate of Parasarcophaga ruficornis (Diptera: Sarcophagidae) and
      implications of this effect on the estimations of postmortem intervals.
AB  - Larvae of Parasarcophaga ruficornis (Fabricius) (Diptera: Sarcophagidae) were
      reared on tissues from rabbits administered different dosages of methamphetamine
      to study the effects of this drug on development of this species. The rabbits
      were given 37.5, 71.4, and 142.9 mg of methamphetamine via ear vein infusion.
      From Hours 30 to 60, larvae feeding on tissues from rabbits receiving 71.4 and
      142.9 mg of methamphetamine developed more rapidly than larvae from the control
      colony and those feeding on tissues from the rabbit receiving 37.5 mg of
      methamphetamine. The time required for pupariation was significantly greater for
      colonies fed on tissues from methamphetamine-dosed rabbits than for the control.
      These differences were sufficient to alter postmortem interval estimates based on
      larval development by up to 18 h and estimates based on puparial development by
      up to 48 h. The presence of methamphetamine or amphetamine could not be detected
      in Diptera larvae in this experiment using radioimmunoassay techniques, as there
      was a nonspecific reaction, resulting in a false positive.

PMID- 1629681
TI  - Acallosal brain in sudden infant death syndrome (SIDS).
AB  - A definitive explanation of "crib" or "cot" death remains unknown. An unusual
      incidental autopsy finding of agenesis of the corpus callosum in a case
      presenting as "near miss" sudden infant death syndrome (SIDS) is discussed.
      Hitherto, only a single case associated with SIDS has been reported in the
      literature. The condition may be easily missed outside the interest in
      neuropathology.

PMID- 1629682
TI  - Estimating the prevalence of organic brain dysfunction in maximum-security
      forensic psychiatric patients.
AB  - This is a descriptive study of 50 randomly selected male patients retained in a
      maximum-security state hospital for mentally disordered offenders. Data regarding
      the prevalence of several indicators of potential organic brain dysfunction are
      presented, including: (1) a diagnosis of any organic brain disorder, (2) a
      history of severe head injury with loss of consciousness, (3) a history of
      seizure activity, (4) evidence of cognitive impairment, (5) abnormal neurological
      findings, and (6) other relevant neurodiagnostic or historical findings. Results
      show that multiple indicators of potential brain dysfunction were present in 64%
      of the cases. At least one indicator of potential brain dysfunction was present
      for 84% of the subjects. Subjects with a diagnosis or history suggesting brain
      dysfunction were significantly more likely to have been indicted for violent
      criminal charges (p = 0.01). Implications of these findings for clinical
      treatment and forensic science decision-making are discussed.

PMID- 1629683
TI  - New perspectives in the legal psychiatry of cocaine-related crimes.
AB  - The legal criteria for the insanity defense as it applies to cocaine-related
      crimes remains elusive because of cocaine's unique spectrum of effects on human
      thought and action. This paper discusses the literature relevant to cocaine and
      forensic psychiatry/psychology, and summarizes the results of a survey of
      forensic psychiatrists on the topic of drug-induced psychosis. A conceptual
      framework is posited for the expert witness to distinguish the separable effects
      of cocaine on human behavior and to clarify their relationship to criminal
      responsibility.

PMID- 1629684
TI  - Simulated paraphilias: a preliminary study of patients who imitate or exaggerate
      paraphilic symptoms and behaviors.
AB  - In a consecutive series of admissions to the Johns Hopkins Sexual Disorders Unit,
      4 out of 20 patients appeared to have simulated paraphilic symptoms that further
      assessment indicated were either exaggerated or not present. The paper presents
      case histories of these 4 patients. A descriptive comparison is made between
      these patients and control groups of patients who admitted having paraphilic
      symptoms and a group of patients accused of having paraphilic symptoms but who
      denied them. Patients who simulated paraphilias tended to be self-referred (75%)
      and without current legal charges (100%). None of these patients was referred or
      sought treatment for pedophilia, in contrast to the other two patient groups, in
      which pedophilia accounted for 75% of the referrals. Several possible
      explanations for why patients might simulate paraphilias and implications for
      therapists who evaluate or treat sex offenders are discussed.

PMID- 1629685
TI  - Biology, violence, and antisocial personality.
AB  - Previous reports have examined separately the role of perinatal biology in the
      etiology of violent criminal behavior and the etiology of antisocial personality
      disorder (ASP). This paper brings together those two studies to test the
      hypothesis that violent behavior and ASP may result from different etiological
      factors. The two studies are on Danish birth cohorts, examined both for perinatal
      health and for violent, aggressive, and antisocial behavior later in life.
      Results suggest that while perinatal factors may be important in the etiology of
      violent criminal behavior, they do not appear to be similarly influential in the
      formation of ASP. These two studies are examined and their results and findings
      discussed in light of the limited literature in this area.

PMID- 1629686
TI  - Language disorders in disruptive behavior disordered homicidal youth.
AB  - Eight homicidal youths were assessed for language disorders and psychiatric
      diagnoses using a battery of standardized language tests and the Diagnostic
      Interview for Children and Adolescents. Both language disorders and Diagnostic
      and Statistical Manual III-R psychiatric diagnoses were present in all subjects.

PMID- 1629687
TI  - Prosecuting assaultive psychiatric patients.
AB  - For many reasons, inpatient psychiatric units are increasingly faced with
      treatment and management of violent individuals. This fosters a need to consider
      potential institutional responses to patient violence. This paper focuses on one
      response--prosecution of these persons. The existing literature on this topic is
      reviewed. In addition, the case history of a difficult but successful prosecution
      of an assaultive patient is presented. This case highlighted the development of
      guidelines, which are outlined herein, for determining the appropriateness of
      seeking legal action against patients. The paper concludes with an assessment of
      the benefits and risks associated with patient prosecution.

PMID- 1629688
TI  - Homelessness and the mentally ill offender.
AB  - This paper presents the results of a retrospective analysis of the discharge
      summaries of 69 mentally ill offenders. The subjects were patients in a New York
      State Psychiatric Hospital for a two-year period between January 1988 and
      December 1989 who were referred by the courts under New York State Criminal
      Procedure Law (CPL). The subjects were further compared as to homelessness at the
      time of the instant offense to study the association of this variable and
      criminal behavior among the mentally ill. Statistical analyses demonstrated
      significant relationships between variables of homelessness, prior offense
      history, and substance abuse.

PMID- 1629689
TI  - Assessing civil competence in the elderly.
AB  - This study was designed to establish reliability of the Community Competence
      Scale-Revised (CCS-R) and provide evidence for its validity in making
      discriminations relevant to civil competence in the elderly. The CCS-R is an
      individually administered structured interview of 17 subscales. Criterion groups
      were formed by drawing a sample of research participants from a retirement
      complex with various levels of care and with nurses having extensive knowledge of
      the residents' level of functioning. The study demonstrated high reliability and
      found converging evidence for the effectiveness of the CCS-R in making
      discrimination about competence in the elderly. The study had added to the
      growing evidence that it is possible to standardize the assessment of civil
      competence, thereby making the adjudication process a more accurate one.

PMID- 1629690
TI  - Complete sequence of maize stripe virus RNA4 and mapping of its subgenomic RNAs.
AB  - The complete nucleotide sequence of maize stripe virus RNA4 was determined and
      found to consist of 2227 nucleotides containing two significant open reading
      frames. One, in the 5' end of the viral RNA, encodes the major non-capsid protein
      of M(r) 19,815. The other is located in the 5' end of the viral complementary RNA
      and could encode a protein of M(r) 31,900. This protein has not been identified
      previously and has been designated NS4, a non-structural protein. RNA-RNA
      hybridization detected subgenomic RNAs encoding these proteins, a characteristic
      of RNA possessing an ambisense gene organization.

PMID- 1629691
TI  - Virus-specific proteins in cells infected with tomato black ring nepovirus:
      evidence for proteolytic processing in vivo.
AB  - The synthesis of proteins encoded by the RNA of tomato black ring virus (TBRV) in
      vivo was studied in protoplasts by direct labelling with [35S]methionine, and in
      protoplasts and plants by immunoblotting experiments with specific antisera.
      Comparison of the proteins synthesized in infected and mock-inoculated
      protoplasts suggested that proteins of M(r) 120K, 90K, 80K, 57K and 46K were
      virus-specific. The proteins derived from the RNA-1-encoded polyprotein detected
      by immunoblotting were a stable 120K protein and, only in protoplasts, small
      amounts of a 90K protein which contains the C-terminal part of the 120K protein
      and the polymerase domain. The results suggest that the polymerase and the
      adjacent protease function in vivo largely or solely when combined in a 120K
      protein. The proteins derived from the RNA-2-encoded polyprotein detected by
      immunoblotting were 59K and 57K proteins, which reacted with antiserum to TBRV
      particles, and a 46K protein. In extracts of infected Nicotiana clevelandii and
      Chenopodium quinoa made soon after inoculation, the 59K protein was more abundant
      than the 57K protein; later samples contained similar quantities of each protein.
      The 57K protein comigrated with protein extracted from virus particles. The
      results of amino acid sequencing suggested that the 57K protein is derived from
      the 59K protein by the loss of nine C-terminal amino acids. Antiserum to a
      peptide adjacent to the 57K protein in the 150K polyprotein detected a 46K
      protein in protoplasts and plant tissue. The results support the processing
      scheme for TBRV polyproteins proposed after analysis of the products of in vitro
      translation.

PMID- 1629692
TI  - Early embryo invasion as a determinant in pea of the seed transmission of pea
      seed-borne mosaic virus.
AB  - Seed transmission of an isolate of pea seed-borne mosaic virus (PSbMV) in several
      pea genotypes has been studied. Cross-pollination experiments showed that pollen
      transmission of PSbMV did not occur and accordingly, virus was not detected in
      pollen grains by ELISA or electron microscopy. Comparative studies between two
      pea cultivars, one with a high incidence of seed transmission and one with none,
      showed that PSbMV infected the floral tissues (sepals, petals, anther and carpel)
      of both cultivars, but was not detected in ovules prior to fertilization. Virus
      was detected equally well in seed coats of the progeny in both cultivars.
      Analysis of virus incidence and concentration in pea seeds of different
      developmental stages demonstrated that in the cultivar with a high incidence of
      seed transmission, PSbMV directly invaded immature embryos, multiplied in the
      embryonic tissues and persisted during seed maturation. In contrast, the cultivar
      without seed transmission did not show invasion of immature embryos by the virus;
      there was no evidence for virus multiplication or persistence during embryo
      development and seed maturation. Hence seed transmission of PSbMV resulted from
      direct invasion of immature pea embryos by the virus and the block to seed
      transmission in the non-permissive cultivar probably occurred at this step.

PMID- 1629693
TI  - Physical map of the Cryptophlebia leucotreta granulosis virus genome and its
      relationship to the genome of Cydia pomonella granulosis virus.
AB  - A physical map of the genome of Cryptophlebia leucotreta granulosis virus (CIGV)
      was constructed for the restriction enzymes BamHI, EcoRI, KpnI, NdeI, NruI, SacI
      and XhoI using hybridization techniques. The size of the viral genome was
      determined to be 112.4 kbp. A restriction fragment library covering almost the
      entire genome of CIGV was constructed, and the position of the granulin gene was
      identified by cross-hybridization with granulin coding fragments of Cydia
      pomonella granulosis virus (CpGV). Two further regions of intergenomic similarity
      between CIGV and CpGV were mapped. These regions were aligned and show a
      collinear arrangement.

PMID- 1629694
TI  - Persistence and expression of Microplitis demolitor polydnavirus in Pseudoplusia
      includens.
AB  - Persistence and expression of Microplitis demolitor polydnavirus (MdPDV) was
      examined in parasitized and virus-injected Pseudoplusia includens larvae. Viral
      DNA persisted in P. includens larvae for 6 days, but no increase in the amount of
      viral DNA present was detected. Viral transcripts were observed in parasitized
      and virus-injected larvae 4 h post-parasitism and expression continued for 6
      days. When specific host tissues were examined, more viral DNA and RNA was
      detected in haemocytes than in the gut, nervous system and fat body. 32P-labelled
      MdPDV DNA hybridized to approximately six different size classes of mRNAs on
      Northern blots of RNA from haemocytes of parasitized larvae. MdPDV transcription
      was first detected in haemocytes at 4 h post-parasitism and continued for 6 days.
      Similar transcripts were observed in haemocytes from larvae that had been
      injected with calyx fluid or MdPDV plus venom. First-strand cDNA probes of
      haemocyte-specific MdPDV transcripts hybridized to only certain MdPDV viral DNAs,
      suggesting that only part of the MdPDV genome is expressed in this host cell
      type.

PMID- 1629695
TI  - Scrapie in the central nervous system: neuroanatomical spread of infection and
      Sinc control of pathogenesis.
AB  - Following bilateral intraocular (i.o.) infection of Sinc s7 mice with ME7
      scrapie, sequential tissue pools were taken from retina, optic nerve, superior
      colliculus (SC), dorsal lateral geniculate nucleus (dLGN), visual cortex and
      cerebellum. The infectivity levels in these pools were estimated by intracerebral
      (i.c.) assay in C57BL/FaBtDk mice. Infectivity was first detected in retina at 35
      days post-injection (as an increase above residual injected inoculum), SC at 56
      days, dLGN at 77 days and in optic nerve, visual cortex and cerebellum at 98
      days. Pathological lesions were shown to develop in the same sequence later in
      the incubation period. Comparison of sequential retina and SC assays in congenic
      mice, which differ only in the vicinity of the Sinc locus, revealed a difference
      in the initial detection and progression of i.o. infection of between 60 and 100
      days, indicating that Sinc acts by delaying the initiation of replication. Higher
      levels of infectivity were found in retina and SC of mice infected with 79A
      scrapie, which destroys the photoreceptor layer in the retina, than with ME7
      scrapie, which does not. Retrograde transport of infection was indicated by the
      levels of infectivity in the retina after i.c. infection with ME7 or 79A scrapie.
      These results indicate that scrapie spread within the central nervous system is
      restricted to neuroanatomical pathways, and that Sinc controls the initiation,
      but not the rate of replication.

PMID- 1629696
TI  - A leucine zipper structure present in the measles virus fusion protein is not
      required for its tetramerization but is essential for fusion.
AB  - The biological role of a leucine zipper motif present in the measles virus fusion
      (F) protein has been investigated. This motif is present in all paramyxovirus F
      proteins, all coronavirus spike proteins and many if not all retrovirus envelope
      proteins. By analogy to its role in certain transcription factors, it has been
      suggested that the motif may be responsible for the oligomerization of these
      viral membrane proteins. In this study, one, two or four heptadic leucines in the
      motif were substituted using site-directed mutagenesis. We found that fusion is
      prevented when all four heptadic leucines present in the motif are mutated
      whereas cellular transport and the oligomeric state of the F protein are
      unaffected.

PMID- 1629697
TI  - Sequence analysis of the 22K, SH and G genes of turkey rhinotracheitis virus and
      their intergenic regions reveals a gene order different from that of other
      pneumoviruses.
AB  - The nucleotide and deduced amino acid sequences of three genes of turkey
      rhinotracheitis virus (TRTV) together with the nucleotide sequences of the
      relevant intergenic regions were determined. The deduced amino acid sequence of
      one of the genes shows significant identity (42%) to that of the 22K protein of
      human respiratory syncytial virus (RSV). The TRTV 22K gene, like that of RSV, has
      a second open reading frame, although the amino acid sequence deduced from this
      reading frame does not show any similarity to the equivalent predicted RSV
      protein. The other two genes and their deduced amino acid sequences do not show
      any sequence similarity to the genes of other pneumoviruses. However, the
      hydrophobicity profiles of the predicted proteins do show similarities to those
      of the small hydrophobic (SH) and attachment protein (G) genes of RSV. The TRTV G
      gene is 1193 nucleotides in length and encodes a protein of 391 amino acids (M(r)
      42984), which is rather larger than the RSV G protein (predicted M(r) 36000). The
      TRTV SH gene is 589 nucleotides in length, encoding a protein of 174 amino acids
      (M(r) 18797), which is considerably larger than the size of the RSV SH protein
      (M(r) 7500). The sequences of the intergenic regions derived from clones of
      polycistronic mRNAs and polymerase chain reaction products obtained with primers
      from different genes reveal the order on the virus genome to be 3' F-22K-SH-G 5'.
      This differs from the gene order of paramyxoviruses and morbilliviruses, which
      lack a 22K gene (and in some cases a SH gene), and the pneumoviruses RSV and
      pneumonia virus of mice, which have the F and 22K genes located after the G gene.

PMID- 1629698
TI  - Sequence analysis of the gene encoding the fusion glycoprotein of pneumonia virus
      of mice suggests possible conserved secondary structure elements in paramyxovirus
      fusion glycoproteins.
AB  - The gene encoding the fusion (F) glycoprotein of pneumonia virus of mice consists
      of 1657 bases and contains an open reading frame encoding 537 amino acids which
      is more similar to the F proteins of pneumoviruses than to those of other
      paramyxoviruses. Computer-assisted sequence analyses can be combined with data on
      the antigenicity of various F proteins to suggest a possible arrangement of
      secondary structure elements common to all pneumovirus and paramyxovirus F
      proteins.

PMID- 1629699
TI  - Nucleotide sequence and coding strategy of the Uukuniemi virus L RNA segment.
AB  - The complete nucleotide sequence of the L RNA segment of Uukuniemi virus has been
      determined from cloned cDNA. The L RNA is 6423 nucleotides in length, and is of
      negative polarity. The viral-complementary RNA contains a single large open
      reading frame of 2104 codons which corresponds to the L protein (M(r) 241039).
      Comparison with the L protein sequences of other members of the Bunyaviridae
      showed homology with the Rift Valley fever phlebovirus L protein (38% amino acid
      identity), but no detectable similarity with bunyavirus, hantavirus or tospovirus
      L proteins. These data lend further support for the recent reclassification of
      uukuviruses and phleboviruses into the same genus, Phlebovirus, in the family
      Bunyaviridae. The L RNA sequence completes the determination of the Uukuniemi
      virus genome: since the M RNA segment is 3229 and the S RNA segment 1720
      nucleotides, the whole genome comprises 11372 nucleotides.

PMID- 1629700
TI  - Activation of integrated human immunodeficiency virus type 1 in human
      neuroblastoma cells by the cytokines tumour necrosis factor alpha and interleukin
      6.
AB  - Human immunodeficiency virus type 1 (HIV-1) infection was studied in two
      different human neuroblastoma cell lines, SK-N-MC and SH-SY5Y. Results from
      immunofluorescence analysis indicate that SK-N-MC cells express a 68K
      neurofilament, and SH-SY5Y cells express additionally a 160K to 200K
      neurofilament complex and thus represent a more differentiated state. HIV-1
      infection in these cell lines was demonstrated by nested polymerase chain
      reaction and further characterized by in situ hybridization, which showed that
      about 50% of SK-N-MC cells and 20% of SH-SY5Y cells were infected by HIV-1 and
      contained integrated proviral HIV-1 DNA. Among the cytokines and growth factors
      studied, tumour necrosis factor alpha (TNF-alpha) enhanced virus production in
      both cell lines, but to a differing extent, according to our mRNA and p24 antigen
      capture assay. In SK-N-MC cells the enhancement of HIV-1 mRNA was detected after
      24 h of stimulation, and declined to the control level by 48 h. In SH-SY5Y cells
      a clear-cut stimulation was seen at both time points. By contrast, interleukin-6
      (IL-6) enhanced the virus replication only in SK-N-MC cells, as shown at the mRNA
      level. Immunochemical staining showed no differences in the proportion of HIV-1
      positive cells after 48 h of stimulation by TNF-alpha or IL-6 when compared to
      the control cells. In addition, based on a thymidine incorporation assay, TNF
      alpha inhibited, but IL-6 strongly increased, the DNA synthesis in SK-N-MC cells,
      whereas in the SH-SY5Y cell line no such differences were seen. We discuss the
      possibility that developing, less-differentiated neurons may be more readily
      infected by HIV-1 than fully differentiated neurons, and that cytokines such as
      TNF-alpha and IL-6, which are elevated in HIV-1-infected individuals, may enhance
      HIV production.

PMID- 1629701
TI  - Human immunodeficiency virus type 1 (HIV-1) superinfection of a cell clone
      converting it from production of defective to infectious HIV-1 is mediated
      predominantly by CD4 regions other than the major binding site for HIV-1
      glycoproteins.
AB  - A cell clone, L-2, which produces non-infectious doughnut-shaped human
      immunodeficiency virus type 1 (HIV-1) particles, was permissive for HIV-1
      superinfection, which resulted in the production of infectious particles. The
      superinfection showed slow kinetics compared with primary HIV-1 infection of M10
      cells, the parent of the L-2 cell clone. Inhibition studies on the superinfection
      of L-2 cells using several CD4-related reagents showed that the CD4 molecule was
      an essential component of the receptor for superinfection. Strong inhibitory
      effects were obtained using CD4 peptides such as CD4(68-130), which includes a
      portion homologous to the immunoglobulin third complementarity-determining region
      (CDR3), as well as recombinant soluble CD4. In contrast, a CD4(45-60) peptide,
      which includes most of the CDR2-related region, was not effective, although the
      Leu-3a monoclonal antibody (MAb), which recognizes a site near the CDR2-related
      region, did slightly, but significantly, delay the superinfection kinetics.
      Comparative flow cytometry of L-2 and M10 cells revealed that the cell surface of
      L-2 cells despite expressing HIV-1 env protein, reacted slightly with OKT4 or
      anti-CD4(68-130) MAb, but not with Leu-3a or OKT4A MAb. In contrast, no reaction
      was detected with any of these anti-CD4 MAbs on the surface of another HIV-1
      superinfection-resistant cell clone, MOLT-#8IIIB-14, which expresses HIV-1 env
      proteins but does not produce infectious HIV-1 particles. These results strongly
      suggest that expression of the CD4 major receptor site for primary HIV-1
      infection is preferentially decreased on the surface of L-2 cells, but that the
      OKT4 epitope and the nearby region corresponding to immunoglobulin CDR3 remain
      exposed on the cell surface. Consequently, the CD4 CDR3-related region could play
      a major role as the receptor for the superinfection reported here.

PMID- 1629702
TI  - Functional mapping of the rev-responsive element of human immunodeficiency virus
      type 2 (HIV-2): influence of HIV-2 envelope-encoding sequences on HIV-1 gp120
      expression in the presence or absence of Rev.
AB  - The human immunodeficiency virus type 1 (HIV-1) regulatory protein Rev stimulates
      expression of structural viral proteins via a target response element (RRE)
      located within gag-pol and env mRNAs. To analyse the HIV-2 Rev trans-activation
      effect on the expression of the envelope protein, we cloned a functionally active
      HIV-2 rev cDNA and showed that it contained four exons. Using transient
      expression assays, we mapped a 353 bp RRE fragment within the env gene of HIV-2
      on which both HIV-1 and HIV-2 Rev could act. Interestingly, smaller fragments
      suppressed the use of additional splice sites within the env gene and caused
      envelope protein expression independent of Rev.

PMID- 1629703
TI  - Failure to isolate human T cell lymphotropic virus type I and to detect variant
      specific genomic sequences by polymerase chain reaction in Melanesians with
      indeterminate western immunoblot.
AB  - The controversy over the endemicity of human T cell lymphotropic virus type I
      (HTLV-I) in Melanesia has been settled recently by the isolation of genetically
      distinct, highly divergent sequence variants of HTLV-I from unrelated inhabitants
      of Papua New Guinea and the Solomon Islands. Still at issue, however, is the
      significance of the high frequency of indeterminate HTLV-I Western blots (defined
      as reactivity to only gag-encoded proteins) among Melanesians. To investigate
      whether this indeterminate seroreactivity reflects specific reactivity to the
      Melanesian HTLV-I variants, 27 seroindeterminate Melanesians from Papua New
      Guinea and the Solomon Islands were studied for evidence of HTLV-I infection.
      Although antibodies against Melanesian variant-specific env gene products and
      variant-specific env gene sequences were detected by Western blot analysis and
      polymerase chain reaction, respectively, in all 11 HTLV-I Western blot-positive
      Melanesians, none of the 27 seroindeterminate Melanesians had such variant
      specific antibodies or HTLV-I proviral sequences. In addition, attempts to
      isolate HTLV-I from seroindeterminate individuals were unsuccessful. These data
      indicate that HTLV-I infection is not the cause of the indeterminate Western blot
      reactivity seen in Melanesia.

PMID- 1629704
TI  - Identification of two novel human immunodeficiency virus type 1 splice acceptor
      sites in infected T cell lines.
AB  - The regulatory and accessory proteins of human immunodeficiency virus type 1 (HIV
      1) are produced from singly or multiply spliced mRNAs. We have used HIV-1
      specific oligonucleotide primer pairs in a polymerase chain reaction procedure on
      RNA from lymphocyte cell lines infected with HIV-1(228,200). The amplified
      products were analysed by hybridization with splice junction-specific
      oligonucleotide probes to determine splice donor/splice acceptor combination
      utilization, subcloned into a plasmid vector and the nucleotide sequences were
      obtained. Two novel splice acceptor sites have been identified.

PMID- 1629705
TI  - In vitro reconstitution of active influenza virus ribonucleoprotein complexes
      using viral proteins purified from infected cells.
AB  - A procedure to obtain RNA-free preparations containing the nucleoprotein (NP) and
      polymerase (P) proteins from influenza virus-infected cell extracts has been
      developed. The influenza virus P proteins present in these preparations copied
      small synthetic RNA molecules derived from plasmid sequences. In addition, RNA
      molecules encapsidated with the NP and P proteins were amplified and packaged
      into virus particles when transfected into influenza virus-infected cells. Thus,
      the preparations of NP and P proteins display features similar to those isolated
      from purified influenza virions, and represent an alternative for the preparation
      of active influenza virus P protein.

PMID- 1629706
TI  - The role of CD8+T cells in the acute and chronic phases of Theiler's murine
      encephalomyelitis virus-induced disease in mice.
AB  - The technique of in vivo depletion with T cell subset-specific monoclonal
      antibodies was used to study the involvement of CD8+T cells in
      protection/pathogenesis during the acute and chronic demyelinating phases of
      Theiler's murine encephalomyelitis virus (TMEV)-induced disease. Mice rendered
      CD8-deficient prior to infection with TMEV were less efficient at clearing virus
      from the central nervous system compared to intact animals and also suffered
      demyelinating disease of earlier onset and increased severity. This indicates
      that CD8+ cells have a protective role in virus clearance at early times post
      infection, and may also be involved in downregulating the severity of the chronic
      demyelinating disease. How CD8+ T cells function to produce these effects is
      discussed.

PMID- 1629707
TI  - Foreign gene expression by a baculovirus vector with an expanded host range.
AB  - A nuclear polyhedrosis virus (NPV) (Baculoviridae)-based gene expression system
      was improved by DNA recombination. The BmN cell line established from Bombyx mori
      and the Sf21 cell line established from Spodoptera frugiperda are non-permissive
      for Autographa californica multicapsid NPV (AcMNPV) and B. mori NPV (BmNPV)
      replication, respectively. After cotransfection of AcMNPV DNA and BamHI-digested
      BmNPV DNA into Sf21 cells, progeny viruses were isolated by plaque purification
      on BmN cell monolayers and the host specificity of one viral isolate was
      analysed. The virus had a wider host range, and replicated and produced polyhedra
      in Sf21 cells, BmN cells and larvae of the silkworm, B. mori. DNA restriction
      endonuclease analysis showed that the isolate was a hybrid of AcMNPV and BmNPV.
      Using the AcMNPV transfer vector pAcYM1 a portion of the polyhedrin gene of the
      hybrid virus was replaced with the coding region of the firefly luciferase gene,
      producing a recombinant virus. The latter expressed firefly luciferase in both
      cell lines and in silkworm larvae under the control of the polyhedrin promoter.

PMID- 1629708
TI  - Characterization of two variants of Panolis flammea multiple nucleocapsid nuclear
      polyhedrosis virus.
AB  - The baculovirus Panolis flammea multiple nucleocapsid nuclear polyhedrosis virus
      (PfMNPV) was originally isolated from a natural virus epizootic and shown to
      consist of a mixture of variants. Two subclasses of variants (PfMNPV A and B)
      were identified by Southern blot hybridization, their polyhedrin genes being
      located on different restriction fragments. The proportion of the A and B
      variants changed according to the larval host in which the virus was propagated;
      PfMNPV(B) predominated in P. flammea but PfMNPV(A) was predominant in Mamestra
      brassicae. Bioassays of the two pure virus variants in M. brassicae larvae have
      shown the LD50 values to be 4610 polyhedron inclusion bodies (pibs) for PfMNPV(A)
      and 5937 pibs for PfMNPV(B). Genomic DNA from the two variants was compared using
      restriction endonuclease analysis, and dot blot and Southern blot hybridization.
      Reciprocal quantitative dot blot hybridization analysis in 50% formamide showed
      PfMNPV(A) and PfMNPV(B) to be only distantly related to Autographa californica
      MNPV (less than 1%) and more closely related to M. brassicae MNPV (21 to 26%).
      The two PfMNPV variants exhibited a very high degree of identity to each other
      (nearly 100%) and therefore are very closely related. This was confirmed by
      physical mapping of the virus genomes. The nucleotide sequence of the polyhedrin
      gene of PfMNPV(B) was determined and compared with the published DNA sequences of
      other polyhedrin genes.

PMID- 1629709
TI  - Partial nucleotide sequence of poplar mosaic virus RNA confirms its
      classification as a carlavirus.
AB  - The nucleotide sequence of the 3'-proximal 1328 nucleotides of poplar mosaic
      virus (PMV) was determined and shown to contain two large open reading frames
      (ORFs). The ORF nearer to the 3' terminus of the RNA is capable of encoding a
      polypeptide of 14K with a 'zinc-finger' motif, and is homologous to sequences in
      corresponding positions in five other carlaviruses. The other ORF encodes a
      protein of 36K which includes two sequences of amino acids identified in tryptic
      digests as virion capsid protein, and has amino acid sequences in common with
      both carlaviruses and potexviruses.

PMID- 1629710
TI  - Receptor for pre-S1(21-47) component of hepatitis B virus on the liver cell: role
      in virus cell interaction.
AB  - Attachment of hepatitis B virus to a hepatoblastoma cell line (HepG2) was
      examined using a synthetic peptide corresponding to the pre-S1 (21-47) region of
      the envelope protein. Scatchard analysis revealed a single class binding site of
      Kd 104 +/- 27 nM/l and 5.4 +/- 1.2 x 10(5) sites per cell. Competition of HBV
      with pre-S1 peptides was dose dependent, and demonstrated it as the dominant
      binding site. In view of the suggested sequence homology between the peptide and
      IgA, cross-competition studies were carried out. The results indicate no direct
      role of IgA receptor in HBV binding. The receptor for the pre-S1 peptide was
      identified as a single major peptide of molecular weight 31 kD using in-situ
      ligand receptor crosslinking.

PMID- 1629711
TI  - Effects of 2'-fluorinated arabinosyl-pyrimidine nucleosides on duck hepatitis B
      virus DNA level in serum and liver of chronically infected ducks.
AB  - The 2'-fluorinated arabinosyl-pyrimidine nucleosides, 1-(2'-deoxy-2'-fluoro-beta
      D-arabinofuranosyl)-5-iodocytosine (FIAC) and 1-(2'-deoxy-2'-fluoro-beta-D
      arabinofuranosyl)-5-methyluracil (FMAU), are new antiviral compounds with in
      vitro inhibitory activity against the DNA polymerase of hepadnaviruses. Those
      compounds also induced permanent inhibition of viral replication in woodchucks
      chronically infected by woodchuck hepatitis virus. The effects of these antiviral
      compounds were assessed in ducks chronically infected by duck hepatitis B virus
      (DHBV). Following intraperitoneal administration for 5 days, FMAU (2 mg/kg/day)
      and FIAC (10 mg/kg/day) induced a transient decrease in DHBV replication, as
      shown by the decrease in both the serum and liver DHBV DNA level. After stopping
      therapy, DHBV replication rebounded immediately to the pretreatment level. The
      supercoiled form of liver viral DNA was found to be less affected by the therapy.
      By contrast, no obvious antiviral effect was observed with vidarabine
      monophosphate (ara-AMP) (80 mg/kg/day) therapy. No sign of toxicity was observed
      during the course of the treatment. These preliminary results confirmed in the
      DHBV model the higher efficacy of FIAC and FMAU as compared to ara-AMP.
      Pharmacokinetic studies are needed to explain the differences observed in viral
      replication in these 2 models of HBV infection.

PMID- 1629712
TI  - Inhibition of HIV-1 infection in vitro by murine monoclonal anti-p24 antibodies.
AB  - Murine monoclonal antibodies (Mabs) to the major core protein p24 of the human
      immunodeficiency virus type 1 (HIV-1) were tested for their ability to inhibit
      the replication and spread of the virus in permanent cell cultures (Molt4/8, K37,
      H9) and in the culture of II-2 stimulated T cells of healthy donors. After
      addition of ascitic fluid containing monoclonal anti-p24 antibodies or purified
      anti-p24 antibodies or the respective control to co-cultures of infected and non
      infected cells, HIV-1 replication was evaluated by determining the percentage of
      infected cells and the activity of reverse transcriptase (RT) in cell-free
      supernatant. In addition, the supernatant's infectivity was determined. FACS
      analysis demonstrated p24 antigen in about 40% of unfixed HIV-1 infected cells at
      the cell membrane. Monoclonal anti-p24 antibodies of different epitope
      specificity added to the cells but not to the virus delayed the spread of HIV-1
      infection in permanent cell culture. Furthermore, anti-p24 Mabs inhibited the
      release of RT-active virus particles by HIV-1 infected cell lines or II-2
      stimulated T-lymphocytes, respectively, up to 60%. The mode of action of anti-p24
      antibodies after HIV-1 infection is discussed on the basis of the data obtained.

PMID- 1629713
TI  - Detection of adenoviruses in stools from healthy persons and patients with
      diarrhea by two-step polymerase chain reaction.
AB  - The use of the polymerase chain reaction (PCR) for detection of human
      adenoviruses in diluted stool samples was investigated. Two sets of nested
      primers, including primers specific for the hexon-coding region and for the E1B
      region of enteric adenoviruses (EAd), were assessed by two-step amplification.
      The primers constitute two different PCR systems designed for the detection of
      adenoviruses belonging to all six subgenera (A-F), and the two EAds Ad40 and
      Ad41, respectively. In a two-step PCR mediated amplification a single virus
      particle was detected when the two sets of general hexon primers or EAd specific
      primers were used. Earlier results from PCR detection of adenoviruses in stool
      from children suffering from diarrhea gave indications that adenovirus particles
      are commonly shed in stools without being identified as the cause of illness
      [Allard et al.: Journal of Clinical Microbiology 28:2659-2667, 1990]. Therefore,
      the general and the EAd specific PCR assays were assessed on 150 stool specimens
      from three groups including 50 healthy children, 50 healthy adults, and 50 adults
      suffering from diarrhea. When the two sets of general hexon primers were used, 25
      of the 50 specimens from the healthy children (mean age 21 months) were found
      positive by two-step PCR amplification. Nine of the 50 specimens from the healthy
      adults (mean age 32 years) were found positive whereas 12 of the 50 specimens
      from sick adults (mean age 31 years) gave amplification products, using the two
      sets of general hexon primers in a nested fashion. None of the 150 specimens were
      found to be positive by two-step PCR amplification using the two sets of EAd
      specific primers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629714
TI  - Infection with hepatitis A, B, delta, and human immunodeficiency viruses in
      children receiving cycled cancer chemotherapy.
AB  - Serological markers of hepatitis A, B, and Delta and human immunodeficiency
      viruses were studied in 25 children receiving cancer chemotherapy. Eighty-eight
      percent had pre-existing HAV immunity which was unaltered by chemotherapy. HDV
      infection was observed in 8% while HIV was conspicuous by its absence. Active HBV
      infection, observed in 76% of the children, was asymptomatic in the majority and
      was accompanied by a high incidence of HBe antigenaemia (57.9%) and its
      persistence. Pre-existing anti-HBs failed to prevent HBV infection recurrence,
      which was, however, transient and self-limiting. Multiple blood transfusions and
      repeated parenteral exposures appeared to be the possible sources of HBV
      acquisition. Transmission to close contacts was also observed. The study suggests
      that although HBV vaccine might not be protective against HBV infection in
      patients receiving cancer chemotherapy, it may prevent its persistence and
      thereby help in reducing chronic liver disease-related morbidity and a highly
      infectious reservoir. Strict HBV screening of blood donors, exclusive use of
      disposable equipment, and vaccination of close contacts of cancer patients is
      recommended, particularly in HBV endemic third-world countries.

PMID- 1629715
TI  - N-methylation of dopamine-derived 6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline,
      (R)-salsolinol, in rat brains: in vivo microdialysis study.
AB  - N-Methylation of (R)-1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline [(R)
      salsolinol] derived from dopamine was proved by in vivo microdialysis study in
      the rat brain. The striatum was perfused with (R)-salsolinol and N-methylated
      compound was identified in the dialysate using HPLC and electrochemical detection
      with multichanneled electrodes. N-Methylation of (R)-salsolinol was confirmed in
      three other regions of the brain, the substantia nigra, hypothalamus, and
      hippocampus. In the substantia nigra, the amount of N-methylated (R)-salsolinol
      was significantly larger than in the other three regions. These results indicate
      that around dopaminergic neurons, particularly in the substantia nigra, (R)
      salsolinol was methylated into N-methyl-(R)-salsolinol, which has a chemical
      structure similar to that of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, the
      selective dopaminergic neurotoxin. N-Methylation of tetrahydroisoquinolines and
      beta-carbolines have already been proven to increase their toxicity to
      dopaminergic neurons and N-methylation might be an essential step for these
      alkaloids to increase their toxicity. On the other hand, after perfusion of (R)
      salsolinol, release of dopamine and 5-hydroxytryptamine was observed and
      inhibition of monoamine oxidase was indicated. (R)-Salsolinol and its derivatives
      may be candidates for being dopaminergic neurotoxins.

PMID- 1629716
TI  - Amitriptyline prevents N-methyl-D-aspartate (NMDA)-induced toxicity, does not
      prevent NMDA-induced elevations of extracellular glutamate, but augments kainate
      induced elevations of glutamate.
AB  - The effect of amitriptyline on kainate- and N-methyl-D-aspartate (NMDA)-induced
      toxicity and release of amino acids from cerebellar granule neurons was studied.
      The ED50 for amitriptyline, imipramine, and nortriptyline protection against NMDA
      induced toxicity was 6.9, 6.5, and 1.3 microM, respectively. None of these
      compounds protected against kainate-induced toxicity. Even though amitriptyline
      was protective against NMDA-induced toxicity, it had no effect on the NMDA
      induced increase in extracellular levels of glutamate or aspartate from these
      cells, indicating a dissociation between NMDA receptor activation (as indicated
      by glutamate content elevations) and NMDA-induced toxicity. However, kainate and
      quisqualate treatment resulted in elevations of glutamate and taurine levels that
      were further augmented in the presence of 25 microM amitriptyline. These findings
      confirm the reports of others that tricyclic antidepressants have neuroprotective
      effects related to the NMDA receptor and expand on these reports by showing that
      even though there is protection against toxicity, the NMDA receptor is
      nevertheless activated, suggesting an involvement of these compounds at sites
      removed from the receptor. Furthermore, this is the first report showing an
      interaction of tricyclic antidepressants with the function of non-NMDA receptors.

PMID- 1629717
TI  - Differential effects of insulin on choline acetyltransferase and glutamic acid
      decarboxylase activities in neuron-rich striatal cultures.
AB  - We studied the effects of insulin, nerve growth factor (NGF), and tetrodotoxin
      (TTX) on cellular metabolism and the activity of glutamic acid decarboxylase
      (GAD) and choline acetyltransferase (ChAT) in neuron-rich cultures prepared from
      embryonic day 15 rat striatum. Insulin (5 micrograms/ml) increased glucose
      utilization, protein synthesis, and GAD activity in cultures plated over a range
      of cell densities (2,800-8,400 cells/mm2). TTX reduced GAD activity; NGF had no
      effect on GAD activity. Insulin treatment reversibly reduced ChAT activity in
      cultures plated at densities of greater than 4,000 cells/mm2, and the extent of
      this reduction increased with increasing cell density. The number of
      acetylcholinesterase-positive neurons was not reduced by insulin, suggesting that
      insulin acts by down-regulating ChAT rather than by killing cholinergic neurons.
      Insulin-like growth factor-1 (IGF-1) reduced ChAT activity at concentrations 10
      fold lower than insulin, suggesting that insulin's effect on ChAT may involve the
      IGF-1 receptor. NGF increased ChAT activity; TTX had no effect on ChAT activity.
      These results suggest that striatal cholinergic and GABAergic neurons are subject
      to differential trophic control.

PMID- 1629718
TI  - The adenosine receptors present on the plasma membrane of chromaffin cells are of
      the A2b subtype.
AB  - The adenosine receptors in the plasma membrane of chromaffin cells from bovine
      adrenal medulla were characterized. The presence of A1 receptors was discounted
      owing to the absence of R-[3H]phenylisopropyladenosine (R-PIA) and [3H]8
      cyclopentyl-1,3-dipropylxanthine ([3H]-DPCPX) binding. The binding of the
      specific A2a ligand CGS-21680 was low. In contrast, the binding of 5'-(N-[3H]
      ethylcarboxamidoadenosine ([3H]NECA) was relatively high (1.7 pmol/mg of protein
      at a ligand concentration up to 90 nM). This binding did not correspond to non
      adenosine receptor NECA binding sites because the specific [3H]-NECA binding was
      similar when unlabeled adenosine, NECA, or R-PIA was used to measure the
      nonspecific binding. The rank order of potency of different ligands for the
      displacement of specific [3H]NECA binding was DPCPX greater than NECA greater
      than chloroadenosine greater than R-PIA greater than theophylline = CGS-21680.
      These results indicate that the receptors present on the plasma membrane of
      chromaffin cells are exclusively of the A2b subtype.

PMID- 1629719
TI  - Brain-derived neurotrophic factor is more highly conserved in structure and
      function than nerve growth factor during vertebrate evolution.
AB  - Mammalian nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF)
      are members of a protein family with perfectly conserved domains arranged around
      the cysteine residues thought to stabilize an invariant three-dimensional
      scaffold in addition to distinct sequence motifs that convey different neuronal
      functions. To study their structural and functional conservation during
      evolution, we have compared NGF and BDNF from a lower vertebrate, the teleost
      fish Xiphophorus, with the mammalian homologues. Genomic clones encoding fish NGF
      and BDNF were isolated by cross-hybridization using probes from the cloned
      mammalian factors. Fish NGF and BDNF were expressed by means of recombinant
      vaccinia viruses, purified, and their neuronal survival specificities for
      different classes of neurons were found to mirror those of the mammalian factors.
      The half-maximal survival concentration for chick sensory neurons was 60 pg/ml
      for both fish and mammalian purified recombinant BDNF. However, the activity of
      recombinant fish NGF on both chick sensory and sympathetic neurons was 6 ng/ml,
      75-fold lower than that of mouse NGF. The different functional conservation of
      NGF and BDNF is also reflected in their structures. The DNA-deduced amino acid
      sequences of processed mature fish NGF and BDNF showed, compared to mouse, 63%
      and 90% identity, respectively, indicating that NGF had reached an optimized
      structure later than BDNF. The retrograde extrapolation of these data indicates
      that NGF and BDNF evolved at strikingly different rates from a common ancestral
      gene about 600 million years ago. By RNA gel blot analysis NGF mRNA was detected
      during late embryonic development; BDNF was present in adult brain.

PMID- 1629720
TI  - Effects of muscarinic agonists and depolarizing agents on inositol monophosphate
      accumulation in the rabbit vagus nerve.
AB  - The effects of muscarinic agonists and depolarizing agents on inositol
      phospholipid hydrolysis in the rabbit vagus nerve were assessed by the
      measurement of [3H]inositol monophosphate production in nerves that had been
      preincubated with [3H]inositol. After 1 h of drug action, carbachol,
      oxotremorine, and arecoline increased the inositol monophosphate accumulation,
      though the maximal increase induced by these agonists differed. Addition of the
      muscarinic antagonists atropine or pirenzepine shifted the carbachol dose
      response curves to the right, without decreasing the carbachol maximal
      stimulatory effects. The KB for pirenzepine was 35 nM, which is characteristic of
      muscarinic high-affinity binding sites coupled to phosphoinositide turnover and
      often associated with the M1 receptor subtype. On the other hand, agents known to
      depolarize or to increase the intracellular Ca2+ concentration, e.g., elevated
      extracellular K+, ouabain, Ca2+, and the Ca2+ ionophore A23187, also increased
      inositol monophosphate accumulation. These effects were not mediated by the
      release of acetylcholine, as suggested by the fact that they could not be
      potentiated by the addition of physostigmine nor inhibited by the addition of
      atropine. The Ca(2+)-channel antagonist Cd2+, also known to inhibit the Na+/Ca2+
      exchanger, was able to block the effects of K+ and ouabain, but did not alter
      those of carbachol. These results suggest that depolarizing agents increase
      inositol monophosphate accumulation in part through elevation of the
      intracellular Ca2+ concentration and that muscarinic receptors coupled to
      phosphoinositide turnover are present along the trunk of the rabbit vagus nerve.

PMID- 1629721
TI  - Enhancement of endogenous release of glutamate and gamma-aminobutyric acid from
      hippocampus CA1 slices after in vivo long-term potentiation.
AB  - The effect of long-term potentiation (LTP) on endogenous amino acid release from
      rat hippocampus slices was studied. LTP was induced in vivo by application of a
      tetanus (200 Hz, 200 ms) to the Schaffer collateral fibers in unanesthetized
      rats. Endogenous release of glutamate and gamma-aminobutyric acid (GABA) was
      investigated 60 min after tetanization in CA1 subslices of potentiated and
      control rats. No significant effects of LTP were observed in basal and K(+)
      induced Ca(2+)-independent release components of these amino acids. In contrast,
      K(+)-induced Ca(2+)-dependent release of both glutamate and GABA increased
      approximately 100% in slices from potentiated rats. No differences were observed
      in total content of glutamate and GABA between the subslices from control and LTP
      animals. These results suggest a persistent increase in the recruitment of the
      presynaptic vesicular pool of glutamate and GABA during LTP.

PMID- 1629722
TI  - Lipid composition in synaptic and nonsynaptic mitochondria from rat brains and
      effect of aging.
AB  - The cholesterol, phospholipid, and fatty acid compositions in synaptic and
      nonsynaptic mitochondria from rat brains and the effect of aging were studied.
      Both cholesterol and phospholipid contents were found to be significantly
      different in synaptic compared to nonsynaptic mitochondria. In both types of
      brain mitochondria, aging decreases the cholesterol content by 27% and the
      phospholipid content by approximately 12%. The difference between these decreases
      observed in the organelles causes decreases in the cholesterol/phospholipid molar
      ratios for synaptic and nonsynaptic mitochondria of 17 and 19%, respectively.
      Also, the phospholipid composition is significantly different in synaptic
      compared to nonsynaptic mitochondria. Among phospholipids, only the cardiolipin
      fraction showed a significant decrease (26%) in nonsynaptic mitochondria from the
      brains of aged rats. Instead, the fatty acid composition was not significantly
      different in synaptic compared to nonsynaptic mitochondria. The 21% aging
      decrease in linoleic acid (18:2), observed only in nonsynaptic mitochondria, may
      be related to a decrease in cardiolipin, which contains a large amount of this
      fatty acid.

PMID- 1629723
TI  - Mono-N-methylation of 1,2,3,4-tetrahydro-beta-carbolines in brain cytosol:
      absence of indole methylation.
AB  - In an accompanying report we demonstrated enzyme activity in guinea pig brain
      cell nuclei that catalyzes S-adenosylmethionine (SAM)-dependent N-methylations of
      heteroaromatic beta-carbolines (BCs) on the 2[beta]-nitrogen and subsequently on
      the 9[indole]-nitrogen, ultimately yielding N2,N9-dimethylated BCs. Presented
      here are the results of a parallel study of the N-methylation of 1,2,3,4
      tetrahydro-BCs (THBCs), which form endogenously via condensations of tryptophan
      and its derived indoles with carbonyl compounds or, like their BC oxidation
      products, are environmental constituents and plant alkaloids. THBCs were
      enzymatically methylated on the 2[beta]-nitrogen by [3H]-SAM in undialyzed
      homogenates of rat or guinea pig brain, but [3H]methyl transfer to the 9[indole]
      nitrogen was not observed. The structure of the 2[beta]-methyl THBC product was
      verified with capillary gas chromatography-mass spectrometry. Furthermore,
      whereas BC N-methylation was largely particulate and displayed micromolar Km
      values for BC substrate, THBC 2[beta]-N-methylation activity was cytosolic and
      displayed a relatively high (millimolar) Km for THBC substrate. The N-methylation
      of THBCs may be due to cytosolic N-methyltransferases that others have studied
      using different azaheterocyclics. Our overall studies indicate that N2,N9
      dimethylated BCs could be unique neurotoxic factors that are bioactivated within
      brain by sequential N-methylations of BCs. These results suggest the possibility
      of an additional route to the putative 2,9-dimethylated toxins involving, as a
      first step, 2[beta]-N-methylation of environmental or endogenously derived THBCs
      in the brain and perhaps other organs.

PMID- 1629724
TI  - Novel S-adenosylmethionine-dependent indole-N-methylation of beta-carbolines in
      brain particulate fractions.
AB  - Guinea pig brain S-adenosylmethionine (SAM)-dependent N-methyltransferase
      activity toward physiologically relevant beta-carboline (BC) substrates was
      examined with reverse-phase HPLC and radiochemical detection. Representative BCs,
      norharman and harmine, were enzymatically methylated on the 2[beta]-nitrogen by
      [3H]CH3-SAM in undialyzed homogenates to yield 2[beta]-methylated BCs and
      subsequently on the 9[indole]-nitrogen to generate 2,9-dimethylated BC products.
      This may be the first account of mammalian indole N-methyl transfer. There was no
      HPLC evidence for 9-methyl BC or (from carbon methylation) 2,6-dimethyl BC
      products. Capillary gas chromatography-mass spectrometry analysis confirmed the
      structures of the 2,9-dimethyl and 2-methyl products of norharman. The 2[beta]-
      and 9[indole]-N-methylation activities were mainly in the nuclear fractions and
      were negligible in undialyzed cytosol. This differs from the cytosolic SAM
      dependent N-methylations reported with other azaheterocyclics, including 1,2,3,4
      tetrahydro-BCs. The involvement of a single enzyme was suggested because the two
      N-methyl transfers with BC substrate had similar subcellular activity patterns,
      regional brain distributions, and Km and Vmax values. Sequential N-methylation of
      various BCs that have been observed in vivo may be a unique route to centrally
      retained N2,N9-dimethylated beta-carbolinium ions. Because they resemble the
      synthetic parkinsonian toxicant, N-methyl-4-phenylpyridinium, with respect to
      structure and neurotoxic activity, such "bioactivated" carbolinium ions could be
      endogenous causative factors in Parkinson's disease.

PMID- 1629726
TI  - Identification of a GM1-binding protein on the surface of murine neuroblastoma
      cells.
AB  - S20Y murine neuroblastoma cells appear to express a protein component(s) able to
      adhere specifically to the oligosaccharide portion of GM1 (oligo-GM1). To
      identify proteins with which the oligo-GM1 becomes closely associated, a
      radiolabeled (125I), photoactivatable derivative of oligo-GM1 was prepared. This
      was accomplished by reductive amination of the glucosyl moiety of oligo-GM1 to 1
      deoxy-1-aminoglucitol, followed by reaction of the amine with sulfosuccinimidyl 2
      (p-azidosalicylamido)ethyl-1,3'-dithiopropionate (SASD). Crosslinking studies
      using the photoactivatable probe indicated that it came in close proximity to a
      protein with an apparent molecular mass of approximately 71 kDa. In competition
      experiments, as little as a 10-fold molar excess of oligo-GM1 resulted in a
      selective reduction in labeling of this protein; preincubation with a 200-fold
      molar excess of siayllactose was necessary to observe the same change in the
      labeling pattern, lending additional support to the hypothesis that the
      approximately 71-kDa protein specifically associates with oligo-GM1. Cell surface
      location of the oligo-GM1 binding protein was confirmed using subcellular
      fractionation and morphological analyses.

PMID- 1629725
TI  - Activation of protein kinase C blocks astroglial gap junction communication and
      inhibits the spread of calcium waves.
AB  - The following two processes related to astrocytes are thought to depend on
      intercellular coupling through gap junctions: the spatial buffering of K+o and
      the spread of calcium waves in the astrocytic syncytium. We have used the
      following two independent methods to measure the open state of gap junctions:
      injection of lucifer yellow, and optical calcium imaging of calcium waves in
      response to probing the cells with a micropipette. The spread of lucifer yellow
      and calcium waves was inhibited if the cells were treated with either phorbol 12
      myristate 13-acetate (PMA) or a synthetic diacylglycerol that activates protein
      kinase C. Down-regulation of protein kinase C by a 24-h treatment with PMA
      inhibited the uncoupling effect of PMA, supporting a direct involvement of
      protein kinase C in the regulation of astroglial gap junctions. Purinergic P2Y
      receptors, which are coupled to the inositol phospholipid pathway, are expressed
      by most astroglia in culture. Activation of the P2Y purinergic receptor with the
      selective agonist 2-methylthio-ATP uncoupled astroglia in a manner similar to the
      effect of treatment with PMA. Modulation of gap junctional conductance could
      isolate specific pathways within the astrocytic syncytium to form an
      extraneuronal information transfer network in brain.

PMID- 1629727
TI  - Mobilization of the readily releasable pool of acetylcholine from a sympathetic
      ganglion by tityustoxin in the presence of vesamicol.
AB  - The present experiments tested whether preganglionic stimulation and direct
      depolarization of nerve terminals by tityustoxin could mobilize similar or
      different pools of acetylcholine (ACh) from the cat superior cervical ganglia in
      the presence of 2-(4-phenylpiperidino)cyclohexanol (vesamicol, AH5183), an
      inhibitor of ACh uptake into synaptic vesicles. In the absence of vesamicol, both
      nerve stimulation and tityustoxin increased ACh release. In the presence of
      vesamicol, the release of ACh induced by tityustoxin was inhibited, and just 16%
      of the initial tissue content could be released, a result similar to that
      obtained with electrical stimulation under the same condition. When the impulse
      releasable pool of ACh had been depleted, tityustoxin still could release
      transmitter, amounting to some 10% of the ganglion's initial content. This pool
      of transmitter seemed to be preformed in the synaptic vesicles, rather than
      synthesized in response to stimuli, as tityustoxin could not release newly
      synthesized [3H]ACh formed in the presence of vesamicol, and hemicholinium-3 did
      not prevent the toxin-induced release. In contrast to the results with
      tityustoxin, preganglionic stimulation could not release transmitter when impulse
      releasable or toxin-releasable compartments had been depleted. Our results
      confirm that vesamicol inhibits the mobilization of transmitter from a reserve to
      a more readily releasable pool, and they also suggest that, under these
      experimental conditions, there might be some futile transmitter mobilization,
      apparently to sites other than nerve terminal active zones.

PMID- 1629728
TI  - Effect of voltage-sensitive calcium channel antagonists on the release of 5
      hydroxytryptamine from rat hippocampus in vivo.
AB  - The effect of calcium channel antagonists on the release of 5-hydroxytryptamine
      from the hippocampus of the chloral hydrate-anaesthetised rat was studied using
      the technique of intracerebral microdialysis. As the basal concentration of 5
      hydroxytryptamine was close to the limit of detection of the HPLC method (8
      fmol), the 5-hydroxytryptamine reuptake inhibitor, fluoxetine (10 microM), was
      included in the perfusion fluid. The L-type voltage-sensitive calcium channel
      antagonists, PN200-110, diltiazem, and verapamil, all passed through the dialysis
      membrane, giving a recovery of 20-30%. The N-type voltage-sensitive calcium
      channel antagonist, omega-conotoxin, penetrated less readily (12% recovery). The
      dihydropyridine, PN200-110, adhered to the probe, resulting in an effective
      concentration at the membrane 30% of that in the perfusion fluid. The
      concentration of 5-hydroxytryptamine in the dialysate samples was reduced by 60%
      in the absence of calcium. The L channel antagonists had little effect on the
      release of 5-hydroxytryptamine, which was inhibited, in a dose-dependent manner,
      to a maximum of 40% by omega-conotoxin. It is concluded that, under physiological
      conditions, the release of 5-hydroxytryptamine from the rat hippocampus is
      dependent on the entry of calcium through N-type voltage-sensitive calcium
      channels, although another calcium channel may also be involved.

PMID- 1629729
TI  - Reconstitution of the brain mixed function oxidase system: purification of NADPH
      cytochrome P450 reductase and partial purification of cytochrome P450 from whole
      rat brain.
AB  - NADPH-cytochrome P450 reductase was purified to apparent homogeneity and
      cytochrome P450 partially purified from whole rat brain. Purified reductase from
      brain was identical to liver P450 reductase by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and western blot techniques. Kinetic studies
      using cerebral P450 reductase reveal Km values in close agreement with those
      determined with enzyme purified from rat liver. Moreover, the brain P450
      reductase was able to function successfully in a reconstituted microsomal system
      with partially purified brain cytochrome P450 and with purified hepatic P450c
      (P450IA1) as measured by 7-ethoxycoumarin and 7-ethoxyresorufin O-deethylation.
      Our results indicate that the reductase and P450 components may interact to form
      a competent drug metabolism system in brain tissue.

PMID- 1629730
TI  - Amino acid release from cerebral cortex in experimental acute liver failure,
      studied by in vivo cerebral cortex microdialysis.
AB  - Both increased gamma-aminobutyric acid (GABA)-ergic and decreased glutamatergic
      neurotransmission have been suggested relative to the pathophysiology of hepatic
      encephalopathy. This proposed disturbance in neurotransmitter balance, however,
      is based mainly on brain tissue analysis. Because the approach of whole tissue
      analysis is of limited value with regard to in vivo neurotransmission, we have
      studied the extracellular concentrations in the cerebral cortex of several
      neuroactive amino acids by application of the in vivo microdialysis technique.
      During acute hepatic encephalopathy induced in rats by complete liver ischemia,
      increased extracellular concentrations of the neuroactive amino acids glutamate,
      taurine, and glycine were observed, whereas extracellular concentrations of
      aspartate and GABA were unaltered and glutamine decreased. It is therefore
      suggested that hepatic encephalopathy is associated with glycine potentiated
      glutamate neurotoxicity rather than with a shortage of the neurotransmitter
      glutamate. In addition, increased extracellular concentration of taurine might
      contribute to the disturbed neurotransmitter balance. The observation of
      decreasing glutamine concentrations, after an initial increase, points to a
      possible astrocytic dysfunction involved in the pathophysiology of hepatic
      encephalopathy.

PMID- 1629732
TI  - Novel procedure for measuring psychosine derivatives by an HPLC method.
AB  - We developed a sensitive and simple method to determine galactosylsphingosine and
      glucosylsphingosine as a 4-fluoro-7-nitrobenzofurazan autofluorescent compound,
      using HPLC equipped with a Showdex sugar column. Amounts of galactosylsphingosine
      were successfully measured in the picomole range. This novel procedure is more
      stable and simpler than the previous method using o-phthalaldehyde. It was
      applied to tissues from the twitcher mouse, an animal model of human globoid cell
      leukodystrophy. The amount of galactosylsphingosine was 34-102 micrograms/kg of
      wet tissues in control cerebrum and cerebellum, whereas in twitcher mice the
      range was 2,251-4,228 micrograms/kg of wet tissues. The psychosine concentration
      was also increased in the liver and kidney of twitcher mice, respectively, 1,513
      micrograms and 1,106 micrograms/kg of wet tissue (normal liver, 125 micrograms;
      normal kidney, 74 micrograms/kg of wet tissue). This novel procedure is useful
      for the pathochemical evaluation of lysosphingolipids in various sphingolipidoses
      as well as in other neuropathological and cellular conditions.

PMID- 1629731
TI  - High sensitivity of glutamate uptake to extracellular free arachidonic acid
      levels in rat cortical synaptosomes and astrocytes.
AB  - By using both synaptosomes and cultured astrocytes from rat cerebral cortex, we
      have investigated the inhibitory action of arachidonic acid on the high-affinity
      glutamate uptake systems, focusing on the possible physiological significance of
      this mechanism. Application of arachidonic acid (1-100 microM) to either
      preparation leads to fast (within 30 s) and largely reversible reduction in the
      uptake rate. When either melittin (0.2-1 microgram/ml), a phospholipase A2
      activator, or thimerosal (50-200 microM), which inhibits fatty acid reacylation
      in phospholipids, is applied to astrocytes, both an enhancement in extracellular
      free arachidonate and a reduction in glutamate uptake are seen. The two effects
      display similar dose dependency and time course. In particular, 10% uptake
      inhibition correlates with 30% elevation in free arachidonate, whereas inhibition
      greater than or equal to 60% is paralleled by threefold stimulation of
      arachidonate release. In the presence of albumin (1-10 mg/ml), a free fatty acid
      binding protein, inhibition by either melittin, thimerosal, or arachidonic acid
      is prevented and an enhancement of glutamate uptake above the control levels is
      observed. Our data show that neuronal and glial glutamate transport systems are
      highly sensitive to changes in extracellular free arachidonate levels and suggest
      that uptake inhibition may be a relevant mechanism in the action of arachidonic
      acid at glutamatergic synapses.

PMID- 1629733
TI  - Characterization of D-aspartic acid uptake by rat hippocampal slices and effect
      of ischemic conditions.
AB  - The cellular uptake of D-aspartic acid (D-Asp) as a model compound for glutamic
      acid transport was studied in rat hippocampal slices. D-Asp is accumulated by
      both Na(+)-dependent and Na(+)-independent processes in hippocampal slices, and
      both processes are dependent on temperature. The Na(+)-dependent uptake is
      assumed to be high in affinity (apparent Km = 0.17 mM), but low in capacity,
      whereas the Na(+)-independent uptake is much lower in affinity (Km = 2.86 mM),
      but higher in capacity. L-Aspartic acid, L-glutamic acid, dihydrokainic acid, and
      threo-3-hydroxy-DL-aspartic acid markedly inhibited the uptake of D-Asp with Na+
      in the medium, whereas D-glutamic acid, glycine, and L-lysine had no significant
      effect. The Na(+)-dependent uptake of D-Asp was significantly reduced under
      "hypoglycemic," "anoxic," and "ischemic" conditions, whereas the Na(+)
      independent uptake was unaffected. Metabolic inhibitors such as NaCN and ICH2COOH
      significantly inhibited the Na(+)-dependent uptake, but not the Na(+)-independent
      uptake. These results suggest that the Na(+)-dependent component of D-Asp
      transport in rat hippocampal cells is inactivated under ischemic conditions,
      whereas the Na(+)-independent component is unaffected.

PMID- 1629734
TI  - Neuronal ganglioside increases dependent on the neuron--glia interaction in
      primary culture.
AB  - Dissociated neuronal cells from rat embryonic hemispheres were cultivated on
      astroglial layers. The increase in ganglioside content of the cocultures was more
      rapid than that of neuronal cultures seeded on polylysine surfaces for the first
      24 h, and the extent of the increase was greater 7 days after inoculation,
      probably because of interaction between the preformed astroglial layers and the
      neuronal cells in vitro. The promoted expression of the a-pathway gangliosides,
      GM1 and GD1a, was recognized by TLC and the increase in GM1 was immunologically
      ascertained. The incorporation of 3H-labeled N-acetyl-D-mannosamine into GD3 and
      b-series gangliosides was elevated for the first 24 h. However, cocultures in
      which there was no contact between neuronal cells and the astroglial sheet showed
      no appreciable increase in incorporation. Thus, cell surface changes were induced
      at the membrane glycolipid level in the neuronal cells by contact with astroglial
      layers. The synthesis and expression of neuronal gangliosides are discussed in
      relation to the onset of neuron--glia interaction.

PMID- 1629735
TI  - Lack of in vitro ceramide formation in the PNS of trembler mice.
AB  - The amidification of sphingosine by acyl donors has been investigated in a
      microsomal fraction prepared from sciatic nerves of normal and Trembler mice. In
      the control, a ceramide synthesis is observed in the presence of acyl-CoAs and
      not with free fatty acids. The synthesis increases as a function of the protein
      amount and the time and is dependent on acyl-CoA concentration. The level of
      synthesis is highly similar to that observed in vivo after palmitate injection
      into the sciatic nerves of normal mice. In the mutant, there is a major
      abnormality because a weak synthesis (20% of the control) is observed only with
      high acyl-CoA concentration (greater than 200 microM), whereas in the range of
      the physiological acyl-CoA concentrations (less than 20 microM), there is no
      ceramide formation from stearoyl-CoA or lignoceroyl-CoA.

PMID- 1629736
TI  - Ecto-5'-nucleotidase is associated with cholinergic nerve terminals in the
      hippocampus but not in the cerebral cortex of the rat.
AB  - The extracellular catabolism of exogenously added AMP was studied in
      immunopurified cholinergic nerve terminals and in slices of the hippocampus and
      cerebral cortex of the rat. AMP (10 microM) was catabolized into adenosine and
      inosine in hippocampal cholinergic nerve terminals and in hippocampal slices, as
      well as in cortical slices. IMP formation from extracellular AMP was not
      detected. alpha, beta-Methylene ADP (100 microM) inhibited almost completely the
      extracellular catabolism of AMP in these preparations. The relative rate of
      catabolism of AMP was greater in hippocampal slices than in cortical slices. AMP
      was virtually not catabolized when added to immunopurified cortical cholinergic
      nerve terminals, although ATP could be catabolized extracellularly under
      identical conditions. The comparison of the relative rates of catabolism of
      exogenously added AMP, calculated from the amount of AMP catabolized after 5 min,
      in hippocampal cholinergic nerve terminals and in hippocampal slices revealed a
      nearly 50-fold enrichment in the specific activity of ecto-5'-nucleotidase upon
      immunopurification of the cholinergic nerve terminals from the hippocampus. The
      results suggest that there is a regional variation in the subcellular
      distribution of ecto-5'-nucleotidase activity in the rat brain, the ecto-5'
      nucleotidase in the hippocampus being closely associated with the cholinergic
      nerve terminals, whereas in the cerebral cortex ecto-5'-nucleotidase activity
      seems to be located preferentially outside the cholinergic nerve terminals.

PMID- 1629737
TI  - The postsynaptic density: constituent and associated proteins characterized by
      electrophoresis, immunoblotting, and peptide sequencing.
AB  - The proteins of the postsynaptic density (PSD) fraction of cerebral cortex were
      resolved by two-dimensional electrophoresis (2DE) and more than 30 proteins
      identified by characteristic 2DE mobility, immunoblotting with specific
      antibodies, and N-terminal and peptide sequencing. The PSD fraction is enriched
      for spectrin, actin, tublin and microtubule associated protein II, myosin,
      enzymes of glycolysis, creatine kinase, elongation factor 1 alpha, and receptor
      protein. The three neurofilament proteins are detected but a 58-kDa protein is
      prominent and is, by peptide sequencing, the bovine homolog of the recently
      cloned 66-kDa neurofilament protein; in contrast to the latter, however, it is
      enriched in cerebrum compared with spinal cord. A 68-kDa protein is identified as
      a member of the hsp70/BiP family of proteins. A protein, designated dynamin,
      indicating its putative role as a microtubule motor, is identified as a major
      protein, is found, however, greatly enriched in the particulate fraction, and is
      significantly denaturant and detergent insoluble. A protein designated N
      ethylmaleimide-sensitive factor is also detected. Thus, two proteins implicated
      in vesicular transport are present in the PSD fraction. Seven polyclonal
      antibodies were produced to 2DE separated and electroeluted proteins of the PSD
      and were identified by peptide sequence analysis and 2DE profile as the hsp70/BiP
      homologous protein, the novel neurofilament protein synapsin IIa, pyruvate
      kinase, dynamin, aconitase and an unknown contaminating protein, and a 115-kDa
      protein that by subcellular fractionation and immunoblotting is a diagnostic PSD
      molecule. In addition, peptide sequences are obtained for four additional higher
      molecular weight proteins of the PSD that are not related at the level of primary
      structure to any known proteins.

PMID- 1629738
TI  - Binding and active transport of large analogues of acetylcholine by cholinergic
      synaptic vesicles in vitro.
AB  - A previous structure-activity investigation of acetylcholine (ACh) revealed a
      positive correlation between additional hydrophobic bulk and increased potency
      for inhibition of active transport of [3H]ACh by synaptic vesicles isolated from
      the electric organ of Torpedo. In the current study, several ACh analogues that
      are significantly larger than previously studied "false transmitters" were
      synthesized in the tritiated form by chemical means and tested for active
      transport. These are analogue 14 [(+/-)-(cis,trans)-1-benzyl-1-methyl-3
      acetoxypyrrolidinium iodide], analogue 15 [(+/-)-1,1-dimethyl-3
      benzoyloxypyrrolidinium iodide], and analogue 16/17 [(+/-)-(cis,trans)-1-benzyl-1
      methyl-3-benzoyloxypyrrolidinium iodide]. These analogues place significant
      additional hydrophobic bulk on one or the other (analogues 14 and 15) or both
      (analogue 16/17) of the two pharmacophores of a small, conformationally
      constrained analogue of ACh. [3H]Analogue 14 and [3H]analogue 15 are actively
      transported, with Vmax values the same as or less than that of ACh, depending on
      the vesicle preparation. The observation that Vmax is the same for an analogue
      and ACh in some vesicle preparations suggests that the rate-limiting step does
      not involve ACh bound to the transporter. [3H]Analogue 16/17 is actively
      transported very poorly. Km values for ACh and for transported ACh analogues vary
      by up to two- to threefold in different vesicle preparations. The ACh transporter
      is much less selective for transported substrates than anticipated.

PMID- 1629739
TI  - Effect of hypothyroidism on different forms of actin in rat cerebral neuronal
      cultures studied by an improved DNase I inhibition assay.
AB  - An improved DNase I inhibition assay for the filamentous actin (F-actin) and
      monomeric actin (G-actin) in brain cells has been developed. Unlike other
      methods, the cell lysis conditions and postlysis treatments, established by us,
      inhibited the temporal inactivation of actin in the cell lysate and maintained a
      stable F-actin/G-actin ratio for at least 4-5 h after lysis. The new procedure
      allowed separate quantitation of the noncytoskeletal F-actin in the Triton
      soluble fraction (12,000 g, 10 min supernatant) that did not readily sediment
      with the Triton-insoluble cytoskeletal F-actin (12,000 g, 10 min pellet). We have
      applied this modified assay system to study the effect of hypothyroidism on
      different forms of actin using primary cultures of neurons derived from cerebra
      of neonatal normal and hypothyroid rats. Our results showed a 20% increase in the
      Triton-insoluble cytoskeletal F-actin in cultures from hypothyroid brain relative
      to normal controls. In the Triton-soluble fraction, containing the G-actin and
      the noncytoskeletal F-actin, cultures from hypothyroid brain showed a 15%
      increase in G-actin, whereas the F-actin remained unaltered. The 10% increase in
      total actin observed in this fraction from hypothyroid brain could be totally
      accounted for by the enhancement of G-actin. The mean F-actin/G-actin ratio in
      this fraction was about 30% higher in the cultures from normal brain compared to
      that of the hypothyroid system, which indicates that hypothyroidism tends to
      decrease the proportion of noncytoskeletal F-actin relative to G-actin.

PMID- 1629740
TI  - Identification and purification of calcium-independent phospholipase A2 from
      bovine brain cytosol.
AB  - Substantial amounts of phospholipase A2 activity were detected in bovine brain
      cytosol. The major phospholipase A2 activity was present in the precipitate at
      40% saturation with solid ammonium sulfate. After the desaltate of the
      precipitate was loaded onto an Ultrogel AcA 54 gel filtration column, almost all
      the activity eluted in the void volume when chromatographed without 1 M KCl.
      However, when buffer with 1 M KCl was used as the eluent, two active peaks were
      obtained. One peak (peak I) eluted in the void volume, and the other (peak II)
      eluted with an apparent molecular mass of 39 kDa as compared with standards. The
      former was active with diacylglycero-3-phosphoethanolamine, whereas the latter
      was active with both diacylglycero-3-phosphoethanolamine and 1-alk-1'-enyl-2
      acylglycero-3-phosphoethanolamine (plasmenylethanolamine). The apparent molecular
      mass of peak I was estimated to be 110 kDa as compared with standards on an
      Ultrogel AcA 34 gel filtration column. Both peaks were purified further with a
      hydrophobic chromatography column (AffiGel 10 coupled with plasmenylethanolamine)
      and then by high-resolution liquid chromatography on an MA7Q column. The
      phospholipase A2 obtained from peak II migrated as one main band with a 40-kDa
      molecular mass and two minor bands with 14- and 25-kDa molecular masses.
      Phospholipase A2 obtained from peak I eluted as a single peak on high-resolution
      liquid chromatography but contained two bands with apparent molecular masses of
      100 and 110 kDa as determined by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629742
TI  - Diadenosine tetraphosphate is co-released with ATP and catecholamines from bovine
      adrenal medulla.
AB  - Secretion of adenosine(5')tetraphospho(5')adenosine (Ap4A) and ATP from perfused
      bovine adrenal glands stimulated with acetylcholine or elevated potassium levels
      was measured and compared with that of catecholamines. We have found a close
      correlation between the release of Ap4A and catecholamines elicited with all the
      secretagogues used in the presence of either Ca2+ or Ba2+, suggesting co-release
      of both constituents from the chromaffin granules. By contrast, ATP secretion, as
      measured with luciferase, showed a significantly different time course regardless
      of the secretagogue used. ATP secretion consistently decreased after 1-2 min of
      stimulation at a time when Ap4A and catecholamine secretions were still
      increasing. Measures of degradation of injected [3H]ATP to the gland during
      stimulation showed little difference in the level of uptake or decomposition of
      ATP throughout the pulse. However, a reexamination of ATP secretion by monitoring
      its products of degradation (AMP, adenosine, and inosine) by HPLC techniques
      showed that Ap4A, ATP, and catecholamines are indeed secreted in parallel from
      the perfused adrenal gland.

PMID- 1629741
TI  - K-252b selectively potentiates cellular actions and trk tyrosine phosphorylation
      mediated by neurotrophin-3.
AB  - K-252b, a protein kinase inhibitor, has been shown earlier to inhibit nerve
      growth factor actions on cholinergic neurons of the basal forebrain. In the
      present study, K-252b was found to prevent trophic actions of two other
      neurotrophins, brain-derived neurotrophic factor, and neurotrophin-3, on central
      cholinergic and dopaminergic neurons, peripheral sensory neurons, and PC12
      pheochromocytoma cells, when used at greater than 2 microM concentration.
      Comparable actions of nonneurotrophin growth factors were not affected.
      Surprisingly, at 0.1-100 nM, K-252b selectively enhanced the trophic action of
      neurotrophin-3 on central cholinergic neurons, peripheral sensory neurons, and
      PC12 cells. In PC12 cells, K-252b potentiated the neurotrophin-3-induced tyrosine
      phosphorylation of trk, a protein kinase responsible for transmitting
      neurotrophin signals. Of the three structurally related nerve growth factor
      inhibitors, K-252a, K-252b, and staurosporine, only the first two also mediated
      neurotrophin-3 potentiation. These findings indicate that K-252b generally and
      selectively potentiates the neurotrophic action of neurotrophin-3 and suggest
      that this action involves trk-type neurotrophin receptors.

PMID- 1629743
TI  - MK-801 prevents 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced parkinsonism
      in primates.
AB  - In cynomologus monkeys, systemic administration of MK-801, a noncompetitive
      antagonist for the N-methyl-D-aspartate receptor, prevented the development of
      the parkinsonian syndrome induced by the neurotoxin 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine (MPTP). MK-801 also attenuated dopamine depletion in the
      caudate and putamen and protected dopaminergic neurons in the substantia nigra
      from the degeneration induced by the neurotoxin. Nevertheless, 7 days after MPTP
      administration in the caudate and putamen of monkeys also receiving MK-801, the
      levels of toxic 1-methyl-4-phenylpyridinium were even higher than those measured
      in monkeys receiving MPTP alone. This indicates that the protective action of MK
      801 is not related to MPTP metabolism and strongly suggests that, in primates,
      the excitatory amino acids could play a crucial role in the mechanism of the
      selective neuronal death induced by MPTP.

PMID- 1629744
TI  - Quantitative autoradiography of dihydrorotenone binding to complex I of the
      electron transport chain.
AB  - Defective complex I activity has been linked to Parkinson's disease and
      Huntington's disease, but little is known of the regional distribution of this
      enzyme in the brain. We have developed a quantitative autoradiographic assay
      using [3H]dihydrorotenone ([3H]DHR) to label and localize complex I in brain
      tissue sections. Binding was specific and saturable and in the cerebellar
      molecular layer had a KD of 11.5 +/- 1.3 nM and a Bmax of 11.0 +/- 0.4 nCi/mg of
      tissue. Unlabeled rotenone and 1-methyl-4-phenylpyridinium ion competed
      effectively for DHR binding sites. Binding was markedly enhanced by 100 microM
      NADH. The distribution of complex I in brain, as revealed by DHR autoradiography,
      is unique but somewhat similar to that of cytochrome oxidase (complex IV). This
      assay may provide new insight into the roles of complex I in brain function and
      neurodegeneration.

PMID- 1629745
TI  - Brain levels of microtubule-associated protein tau are elevated in Alzheimer's
      disease: a radioimmuno-slot-blot assay for nanograms of the protein.
AB  - The microtubule-associated protein tau, which stimulates the assembly of alpha
      beta tubulin heterodimers into microtubules, is abnormally phosphorylated in
      Alzheimer's disease (AD) brain and is the major component of paired helical
      filaments. In the present study, the levels of tau and abnormally phosphorylated
      tau were determined in brain homogenates of AD and age-matched control cases. A
      radioimmuno-slot-blot assay was developed, using a primary monoclonal antibody,
      Tau-1, and a secondary antibody, antimouse 125I-immunoglobulin G. To assay the
      abnormally phosphorylated tau, the blots were treated with alkaline phosphatase
      before immunolabeling. The levels of total tau were about eightfold higher in AD
      (7.3 +/- 2.7 ng/micrograms of protein) than in control cases (0.9 +/- 0.2
      ng/micrograms), and this increase was in the form of the abnormally
      phosphorylated protein. These studies indicate that the abnormal phosphorylation-
      not a decrease in the level of tau--is a likely cause of neurofibrillary
      degeneration in AD.

PMID- 1629746
TI  - Analysis of muscarinic receptor subtypes in the mouse cochlea by means of the
      polymerase chain reaction.
AB  - Total RNA was extracted with guanidine thiocyanate from the cochleas of 16-day
      old CBAJ mice. The mRNA was purified from the total RNA using oligo-dT cellulose,
      and the mRNA was treated with DNase to degrade genomic DNA. After reverse
      transcription, resulting cDNA was amplified by polymerase chain reaction (PCR),
      using primers specific for the nucleotide sequences m1-m5, representing subtypes
      of muscarinic acetylcholine receptors. PCR products corresponding to subtypes m1,
      m3, and m5, but not to m2 and m4, were amplified. These results suggest that
      muscarinic acetylcholine receptors of these odd-numbered subtypes are expressed
      in the mammalian cochlea.

PMID- 1629747
TI  - Aztreonam plus vancomycin versus gentamicin plus piperacillin as empirical
      therapy for the treatment of fever in neutropenic patients: a randomised
      controlled study.
AB  - The efficacy of aztreonam in combination with vancomycin was compared with that
      of gentamicin plus piperacillin as empirical antibiotic treatment for fever in 61
      neutropenic patients. Aztreonam plus vancomycin was as effective, but no more
      effective, than gentamicin plus piperacillin. Aztreonam showed excellent clinical
      and in vitro efficacy against Gram-negative pathogens. Failure to respond to
      aztreonam plus vancomycin was, in most cases, due to presumed or documented
      fungal infection; by contrast, failure to respond to gentamicin plus piperacillin
      was frequently to be due to resistant or superadded infection with Gram-positive
      bacteria.

PMID- 1629748
TI  - Short vs. long cotrimoxazole courses in eradicating bacteriuria in the elderly.
AB  - To test whether longer duration of treatment of asymptomatic bacteriuria in old
      age could improve the efficacy of cotrimoxazole therapy, three regimens were
      given to 75 ambulant bacteriuric residents of a retirement home, aged greater
      than or equal to 68 years. The groups and regimens were: A:23 subjects (160/800
      mg b.i.d. orally x 3 days). B: 24 subjects (160/800 mg i.m. x 10 days); C: 28
      subjects (160/800 mg b.i.d. orally x 20 days). One week, one month and five
      months post-therapy urines were negative in 78.3% vs 52.9% vs 42.9% of group A,
      in 54.2% vs 56.5% vs 50% of group B and in 57.1% vs 60.7% vs 68% of group C
      subjects respectively. The data indicate that: 1) the efficacy of any schedule is
      only moderate irrespective of the presence of antibody-coated bacteria in urine;
      2) a 3-day course appears more effective at one week post-therapy; 3) at one and
      five months greater than or equal to 50% of the subjects were infection-free, the
      20 day treatment resulting in fewer failures; 4) subjects with long-term
      eradication had no mobility problem, low serum creatinine and a normal urinary
      tract as seen by ultrasound.

PMID- 1629749
TI  - Frequency and transferability of trimethoprim and sulfonamide resistance in
      methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis.
AB  - A total of 374 Staphylococcus aureus and 126 Staphylococcus epidermidis strains
      from 14 countries were studied for their resistance to methicillin, trimethoprim
      (Tp) and sulfonamides (Su), alone and combined (TpSu). The frequency of
      resistance to Tp, Su and TpSu was much higher in methicillin-resistant S.
      epidermidis (MRSE) than in methicillin-resistant S. aureus (MRSA). Considerable
      differences, however, existed in isolates from different countries. Resistance to
      Tp, Su or TpSu in MRSA was low or absent in isolates from Switzerland, Spain,
      Japan, Mexico, Argentina and Chile, but high in isolates from Germany and Brazil.
      High level Tp resistance mostly resided on large plasmids. It could be
      transferred in 17 out of 97 strains. Su resistance was never cotransferred.
      Strains cured of their large Tp resistance plasmids remained Su-resistant, which
      suggests a chromosomal location of Su resistance.

PMID- 1629750
TI  - Effect of a broad-spectrum cephalosporin on the oral and intestinal microflora in
      patients undergoing colorectal surgery.
AB  - The influence of ceftriaxone on oral and intestinal flora was investigated in 10
      patients undergoing colorectal surgery. Ceftriaxone was given intravenously in
      one 2g dose before anesthesia. Saliva and feces samples were collected and
      analyzed on day 0, 3, 5, 14 and 28 after drug administration. All specimens were
      cultured quantitatively for aerobic and anaerobic microorganisms; representative
      colonies of each morphologic type of organism cultured were identified. The oral
      aerobic flora was somewhat affected by the administration of ceftriaxone. In all
      patients the number of Streptococci, Staphylococci and Neisseria decreased during
      the 5 days after ceftriaxone administration. No significant changes in the number
      of anaerobic commensal occurred. The oral microflora of all patients after 14
      days had returned to normal. The aerobic fecal flora was considerably affected:
      in all patients enterobacteria were eliminated or strongly suppressed. Only minor
      changes in the number of aerobic gram-positive bacteria were observed, and the
      anaerobic intestinal flora showed only minor alterations. On day 28 the
      intestinal flora were normalized in all respects. No new colonizing
      microorganisms were isolated during the investigation period and no colonization
      with ceftriaxone-resistant bacteria was observed. No postoperative infection
      occurred and no adverse effects were registered.

PMID- 1629751
TI  - The influence of serum proteins on biological activity of anticandidal peptides
      containing N3-(4-methoxyfumaroyl)-L-2,3-diaminopropanoic acid.
AB  - The binding of several anticandidal peptides containing N3-(4-methoxyfumaroyl)-L
      2,3-diaminopropanoic acid (FMDP) to serum proteins was studied using equilibrium
      dialysis. The affinity of these FMDP-peptides for serum albumin was low and well
      correlated with their biological activity against Candica albicans ATCC 26278 in
      serum albumin solution. This binding did not affect the biological activity of
      FMDP-peptides. On the other hand, substantial raising of MIC values was observed
      when anticandidal activity of FMDP peptides was assayed in the presence of
      complete serum proteins. This effect was likely to be a result of interaction
      with non-albumin components of serum proteins. Preliminary evidence points to the
      possibility of non-specific interaction with components containing sulfhydryl
      groups. In this study Nva-FMDP-Nva peptide was shown to be the most active
      compound in the serum protein solution. Moreover Nva-FMDP-Nva was most resistant
      to inactivation by serum components in comparison to other FMDP-peptides.

PMID- 1629752
TI  - Relation of changes in hepatitis B virus replication markers to the outcome of
      interferon treatment in patients with chronic hepatitis.
AB  - The relationship between the behavior of hepatitis B virus (HBV) replication
      markers and the response to treatment with recombinant alpha-2b interferon (IFN)
      was investigated in 11 patients with chronic hepatitis. At the end of 6 months of
      treatment, 4 patients showed a complete response to IFN: 2 more patients had
      seroconversion to HBeAb after 8 and 9 months of follow-up, respectively. The
      response to IFN was partial in the remaining patients. Pre-treatment levels of
      HBV DNA in patients showing complete response were lower than pre-treatment
      levels in patients with partial response: in addition, serum HBV DNA clearance
      during the treatment was associated with sustained remission more frequently than
      changes in the HBeAg/HBeAb system.

PMID- 1629753
TI  - Trimethoprim-sulfamethoxazole plus amikacin as first-line therapy and
      imipenem/cilastatin as second empirical therapy in febrile neutropenic patients
      with hematological disorders.
AB  - One hundred and thirty-nine consecutive episodes of fever were evaluated in 55
      patients with hematological disorders during persistent neutropenia. In 121
      instances, patients were given trimethoprim-sulfamethoxazole + amikacin (TMP/SMZ
      + AMI) as an initial antibiotic regimen with clinical success in 51% (i.e.
      antibiotic treatment was not changed within the first 7 days).
      Imipenem/cilastatin (I/C) therapy was instituted in: (a) 22 episodes with
      clinical failure and fever of unknown origin during TMP/SMZ + AMI therapy and (b)
      18 episodes with a second fever episode during initially successful TMP/SMZ + AMI
      therapy. The response rate for all 40 I/C treated episodes was 80%. One
      neutropenic patient in the whole series died from infectious complications within
      four weeks from institution of therapy. TMP/SMZ+AMI seems to be a safe and
      inexpensive "standard" antibiotic regimen in neutropenic patients. I/C appears to
      have good efficacy when used as secondary therapy after failure with TMP/SMZ+AMI.

PMID- 1629754
TI  - Organizing principles for single joint movements: V. Agonist-antagonist
      interactions.
AB  - 1. Normal human subjects made discrete elbow flexions in the horizontal plane
      under different task conditions of initial or final position, inertial loading,
      or instruction about speed. We measured joint angle, acceleration, and
      electromyographic signals (EMGs) from two agonist and two antagonist muscles. 2.
      For many of the experimental tasks, the latency of the antagonist EMG burst was
      strongly correlated with parameters of the first agonist EMG burst defined by a
      single equation, expressed in terms of the agonist's hypothetical excitation
      pulse. Latency is proportional to the ratio of pulse duration to pulse intensity,
      making it proportional to movement distance and inertial load and inversely
      proportional to planned movement speed. However, these rules are not sufficient
      to define the timing of every possible single joint movement. 3. For movements
      described by the speed-insensitive strategy, the quantity of both antagonist and
      agonist muscle activity can be uniformly associated with selected kinetic
      measures that incorporate muscle force-velocity relations. 4. For movements
      collectively described by the speed-sensitive strategy, (i.e., that have direct
      or indirect constraints on speed), no single rule can describe all the
      combinations of agonist-antagonist coordination that are used to perform these
      diverse tasks. 5. Estimates of joint viscosity were made by calculating the
      amount of velocity-dependent torque used to terminate movements on target. These
      estimates are similar to those that have previously been made of limb viscosity
      during postural maintenance. They imply that a significant component of muscle
      activity must be used to overcome these forces. 6. These and previous results are
      all consistent with a dual-strategy hypothesis for those single-joint movements
      that are sufficiently fast to require pulse-like muscle activation patterns. The
      major features of such patterns (pulse intensities, durations, and latencies) are
      determined by central commands programmed in advance of movement initiation. The
      selection between speed-insensitive or speed-sensitive rules of motoneuron pool
      excitation is implicitly specified by the nature of speed constraints of the
      movement task.

PMID- 1629755
TI  - Response of auditory units in the barn owl's inferior colliculus to continuously
      varying interaural phase differences.
AB  - 1. We studied the response of single units in the central nucleus of the inferior
      colliculus (ICc) of the barn owl (Tyto alba) to continuously varying interaural
      phase differences (IPDs) and static IPDs. Interaural phase was varied in two
      ways: continuously, by delivering tones to each ear that varied by a few hertz
      (binaural beat, Fig. 1), and discretely, by delaying in fixed steps the phase of
      sound delivered to one ear relative to the other (static phase). Static
      presentations were repeated at several IPDs to characterize interaural phase
      sensitivity. 2. Units sensitive to IPDs responded to the binaural beat stimulus
      over a broad range of delta f(Fig. 4). We selected a 3-Hz delta f for most of our
      comparative measurements on the basis of constraints imposed by our stimulus
      generation system and because it allowed us to reduce the influence of responses
      to stimulus onset and offset (Fig. 3A). 3. Characteristic interaural time or
      phase sensitivity obtained by the use of the binaural beat stimulus were
      comparable with those obtained by the use of the static technique (Fig. 5; r2 =
      0.93, Fig. 6). 4. The binaural beat stimulus facilitated the measurement of
      characteristic delay (CD) and characteristic phase (CP) of auditory units. We
      demonstrated that units in the owl's inferior colliculus (IC) include those that
      are maximally excited by specific IPDs (CP = 0 or 1.0) as well as those that are
      maximally suppressed by specific IPDs (CP = 0.5; Figs. 7 and 8). 5. The
      selectivity of units sensitive to IPD or interaural time difference (ITD) were
      weakly influenced by interaural intensity difference (IID).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1629756
TI  - Response selectivity of neurons in area MT of the macaque monkey during
      reversible inactivation of area V1.
AB  - 1. Behavioral results in the monkey and clinical studies in human show remarkable
      residual visual capacities after a lesion of area V1. Earlier work by Rodman et
      al. demonstrated that visual activity can be recorded in the middle temporal area
      (MT) of the macaque monkey several weeks after a complete lesion of V1. These
      authors also tested the effect of a reversible block of area V1 on the visual
      responses of a small number of neurons in area MT and showed that most of these
      cells remain visually responsive. From the results of that study, however, it is
      difficult to assess the contribution of area 17 to the receptive-field
      selectivity of area MT neurons. To address this question, we have quantitatively
      measured the effects of a reversible inactivation of area 17 on the direction
      selectivity of MT neurons. 2. A circular part of the opercular region of area V1
      was reversibly inactivated by cooling with a Peltier device. A microelectrode was
      positioned in the lower layers of V1 to control the total inactivation of that
      area. Eighty percent of the sites recorded in the retinotopically corresponding
      region of MT during inactivation of V1 were found to be visually responsive. The
      importance of the effect was assessed by calculating the blocking index (0 for no
      effect, 1 for complete inactivation). Approximately one-half of the
      quantitatively studied neurons gave a blocking index below 0.6, illustrating the
      strong residual responses recorded in many neurons. 3. Receptive-field properties
      were examined with multihistograms. It was found that, during inactivation of V1,
      the preferred direction changed for most neurons but remained close to the
      preferred direction or to its opposite in the control situation. During
      inactivation of V1, the average tuning curve of neurons became broader mostly
      because of strong reductions in the response to directions close to the preferred
      and nonpreferred. Very little change was observed in the responses for directions
      at 90 degrees to the optimal. These results are consistent with a model in which
      direction selectivity is present without an input from V1 but is reinforced by
      the spatial organization of this excitatory input. 4. Residual responses were
      found to be highly dependent on the state of anesthesia because they were
      completely abolished by the addition of 0.4-0.5% halothane to the ventilation
      gases. Finally, visual responses were recorded in area MT several hours after an
      acute lesion of area 17.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629757
TI  - Activity of single neurons in the monkey amygdala during performance of a visual
      discrimination task.
AB  - 1. The activity of single neurons was recorded extracellularly from the monkey
      amygdala while monkeys performed a visual discrimination task. The monkeys were
      trained to remember a visual stimulus during a delay period (0.5-3.0 s), to
      discriminate a new visual stimulus from the stimulus, and to release a lever when
      the new stimulus was presented. Colored photographs (human faces, monkeys, foods,
      and nonfood objects) or computer-generated two-dimensional shapes (a yellow
      triangle, a red circle, etc.) were used as visual stimuli. 2. The activity of 160
      task-related neurons was studied. Of these, 144 (90%) responded to visual
      stimuli, 13 (8%) showed firing during the delay period, and 9 (6%) responded to
      the reward. 3. Task-related neurons were categorized according to the way in
      which various stimuli activated the neurons. First, to evaluate the proportion of
      all tested stimuli that elicited changes in activity of a neuron, selectivity
      index 1 (SI1) was employed. Second, to evaluate the ability of a neuron to
      discriminate a stimulus from another stimulus, SI2 was employed. On the basis of
      the calculated values of SI1 and SI2, neurons were classified as selective and
      nonselective. Most visual neurons were categorized as selective (131/144), and a
      few were characterized as nonselective (13/144). Neurons active during the delay
      period were also categorized as selective visual and delay neurons (6/13) and as
      nonselective delay neurons (7/13). 4. Responses of selective visual neurons had
      various temporal and stimulus-selective properties. Latencies ranged widely from
      60 to 300 ms. Response durations also ranged widely from 20 to 870 ms. When the
      natures of the various effective stimuli were studied for each neuron, one-fourth
      of the responses of these neurons were considered to reflect some categorical
      aspect of the stimuli, such as human, monkey, food, or nonfood object.
      Furthermore, the responses of some neurons apparently reflected a certain
      behavioral significance of the stimuli that was separate from the task, such as
      the face of a particular person, smiling human faces, etc. 5. Nonselective visual
      neurons responded to a visual stimulus, regardless of its nature. They also
      responded in the absence of a visual stimulus when the monkey anticipated the
      appearance of the next stimulus. 6. Selective visual and delay neurons fired in
      response to particular stimuli and throughout the subsequent delay periods.
      Nonselective delay neurons increased their discharge rates gradually during the
      delay period, and the discharge rate decreased after the next stimulus was
      presented. 7. Task-related neurons were identified in six histologically distinct
      nuclei of the amygdala.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629758
TI  - On oscillating neuronal responses in the visual cortex of the monkey.
AB  - 1. Recent studies of visual processing in the cat have shown stimulus-related
      oscillations in the 30- to 70-Hz range. We sought to replicate these findings in
      the monkey. 2. We recorded multiunit activity (MUA) and local field potentials
      (LFP) in areas V1 and middle-temporal area (MT), and MUA from the inferotemporal
      cortex (IT) of monkeys (Macaca fuscata). Recordings in all areas were made under
      conditions of anesthesia as close as possible to those in previous studies of
      oscillating responses in the cat. In addition, we recorded MUA in the IT of
      behaving monkeys while the monkeys performed a face discrimination task. 3. In
      areas V1 and MT, LFP power spectra showed broadband increases (1-100 Hz) in
      amplitude on stimulation by swept optimally oriented light bars, and not a shift
      in power from low to midfrequency, as has been reported in the cat. 4. MUA
      autocorrelograms (ACGs) classified by fitting Gabor functions, showed
      oscillations at approximately 10% of recording sites in V1 and MT, but these
      oscillations were in the alpha range (12-13 Hz). 5. MUA ACGs from IT in the
      anesthetized monkey showed no oscillations. 6. For MUA ACGs from IT in the
      behaving monkey, only two recording sites (out of 50) showed an oscillating
      response, with frequencies of 44 and 48 Hz. One oscillating response was
      associated with stimulation, and the other was associated with the absence of
      stimulation. 7. The very low incidence in the monkey of oscillating responses in
      the 30- to 70-Hz range (2 in 424 recordings made at 142 recording sites) and the
      absence of stimulus dependence suggest that such oscillations are unlikely to
      serve a function in the monkey, and that there may be a species difference
      between monkey and cat in the dynamics of neural activity in the visual cortex.
      8. We found that methods of classifying responses as oscillating used in some of
      the studies of the cat may have led to overestimation of both the number of sites
      showing oscillation and the number of pairs of sites showing phase coherence.
      These problems arise from the failure to take account of badness of fit between
      Gabor functions and their corresponding ACGs, and from Gabor functions "ringing"
      in response to short phasic phenomena that could be consistent with
      nonoscillatory activity.

PMID- 1629759
TI  - Role of monkey midbrain near-response neurons in phoria adaptation.
AB  - 1. One striking characteristic of the way in which accommodation and convergence
      of the eyes are organized is that although the two responses are usually tightly
      coupled, a brief period of binocular viewing through prisms that require extra
      convergence brings about a persistent, adaptive alteration in the relationship
      between the two responses: the vergence during monocular viewing of a target at a
      given distance is biased in a convergent direction. We sought to discover the
      role of the near-response neurons we have previously described in the monkey
      midbrain in such phoria adaptation. 2. Phoria adaptation was produced in two
      monkeys by having them view binocularly stereoscopic targets under conditions
      that mimicked prism viewing, i.e., the mirrors of the stereoscope were set so as
      to require more convergence than that associated with a real target at the same
      distance as the images seen in the stereoscope. The activity of 57 near-response
      neurons located dorsally and dorsolaterally to the oculomotor nucleus was
      recorded before and after adaptation while the monkeys monocularly viewed targets
      at a range of distances. 3. Comparison of a neuron's response in normal binocular
      viewing with the response when the accommodation and vergence stimuli were in
      conflict allowed us to distinguish 24 neurons that behaved as though they were
      related exclusively to the vergence response. 5 neurons that behaved as though
      they were exclusively related to the accommodation response, and 12 neurons whose
      firing was not so simply related to either response. We were unable to classify
      the remaining 16 near-response cells by this method. 4. In accommodation-related
      neurons, the relationship between firing rate and accommodation did not alter, or
      only altered slightly, when the animal's phoria was adapted. 5. The relationship
      between firing rate and vergence was unaltered by phoria adaptation in only a
      small proportion of vergence-related neurons, showing that most neurons do not
      carry the entire signal responsible for phoria adaptation. On the other hand, in
      the majority of vergence-related neurons the relationship between firing rate and
      accommodation was altered by phoria adaptation, showing that most neurons do
      carry part of the phoria adaptation signal. 6. The implication is that the
      increase in vergence observed after adaptation is mediated at more than one site.
      A proportion of the phoria adaptation signal is present at the level of the
      midbrain vergence-related neurons, with the remainder of the signal being added
      later, presumably at the motoneurons.

PMID- 1629760
TI  - Expression of motor learning in the response of the primate vestibuloocular
      reflex pathway to electrical stimulation.
AB  - 1. The vestibuloocular reflex (VOR) undergoes long-term adaptive changes in the
      presence of persistent retinal image motion during head turns. Previous
      experiments using natural stimuli have provided evidence that the VOR is
      subserved by parallel pathways, including some that are modified during learning
      and some that are not. We have used electrical stimulation of the vestibular
      labyrinth to investigate the temporal properties of the signals that are
      transmitted through the modified pathways. 2. Electrodes were implanted
      chronically in the superior semi-circular canal, the horizontal canal, or the
      vestibule for electrical activation of the vestibular afferents. Learning was
      induced by fitting the monkeys with spectacles that magnified or miniaturized
      vision. Before, during, and after motor learning, we measured the eye movements
      evoked by electrical stimulation of the labyrinth as well as the gain of the VOR,
      defined as eye speed divided by head speed during natural vestibular stimulation
      in the dark. 3. Trains of pulses applied to the labyrinth caused the eyes to move
      away from the side of stimulation with an initial rapid change in eye velocity
      followed by a steady-state plateau. Changes in the gain of the VOR caused large
      changes in the trajectory and magnitude of eye velocity during the plateau,
      showing that our stimulating electrodes had access to the modified pathways. 4. A
      single, brief current pulse applied to the labyrinth evoked an eye movement that
      had a latency of 5 ms and consisted of a pulse of eye velocity away from the side
      of the stimulation followed by a rebound toward the side of stimulation. To
      quantify the effect of motor learning on these eye movements, we pooled the data
      across different VOR gains and computed the slope of the relationship between eye
      velocity and VOR gain at each millisecond after the stimulus. We refer to the
      slope as the "modification index." 5. In comparison with the evoked eye velocity,
      the modification index took longer to return to baseline and showed a large peak
      at the time of the rebound in eye velocity. Increases in stimulus current
      increased both the amplitude and the duration of the modification index and
      revealed several later peaks. These observations suggest that the full expression
      of motor learning requires activation of multisynaptic pathways and recruitment
      of primary vestibular afferents with higher thresholds for electrical
      stimulation. 6. The modification index was almost always positive during the
      initial deflection in eye velocity, and the latency of the first change in the
      modification index was usually the same as the latency of the evoked eye
      movement.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629761
TI  - Changes in the response states of primate spinothalamic tract cells caused by
      mechanical damage of the skin or activation of descending controls.
AB  - 1. The responses of a population of 318 spinothalamic tract (STT) cells to
      mechanical stimulation of the skin were recorded in anesthetized macaque monkeys
      by several teams of investigators. The responses were subjected to k-means
      cluster analysis, a multivariate statistical procedure. 2. For an analysis that
      pertained to the responsiveness of the neurons, the mean responses to four
      standard mechanical stimuli (Brush, Pressure, Pinch, and Squeeze) were used.
      Although no true clusters were found, the cells could be partitioned into four
      groups (called clusters a, b, c, and d) that responded progressively more
      vigorously to the stimuli. 3. For an analysis that pertained to the selectivity
      of the cells for various stimulus intensities, from innocuous to highly noxious,
      the data were normalized by taking the ratio of the mean response evoked by each
      stimulus to the sum of the responses and multiplying by 100. This procedure does
      not have a bias toward selection of any particular number of clusters and
      resulted in three clusters of STT cells. 4. Cluster 1 STT cells responded best to
      Brush. Cluster 2 cells responded weakly to Brush and Pressure and maximally to
      Pinch. Cluster 3 cells responded weakly to Brush, Pressure, and Pinch and
      maximally to Squeeze. 5. The response states of STT cells with respect to
      mechanical stimulation of the skin can be defined by their cluster assignments on
      the basis of the responsiveness (clusters a-d) and selectivity (clusters 1-3) of
      the cells. The response states of newly recorded STT cells can be determined by
      discriminant analysis from the nearest centroids of the two types of clusters in
      the reference population of STT cells. 6. No consistent changes in response state
      were detected when a second series of mechanical stimuli was applied 1 cm from
      the site stimulated initially or when the stimulus series was alternately
      repeated at the initial site and at progressively more proximal sites. However,
      when the stimulus series was applied five times to the initial site, the response
      state of five of eight cells tested showed a change. Although a change in
      response state required repetitive damage, even a single stimulus series
      increased background activity and responses to Brush at undamaged sites. 7. The
      background activity and responses to Brush and Pressure of all five STT cells
      recorded in the superficial laminae increased after repeated testing. The
      background activity of five STT cells recorded in the nucleus proprius also
      increased, but the responses of only three of the cells to Brush and Pressure
      increased.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629762
TI  - Control of trigeminal motoneurons from the cerebellar interpositus nucleus of the
      guinea pig.
AB  - 1. Effects of stimulation of the cerebellar interpositus nucleus (IPN) on jaw
      reflexes and trigeminal motoneurons were studied along with the route responsible
      for the effects in ketamine-anesthetized guinea pigs. 2. Stimulation in the IPN
      evoked a bilateral, ipsilaterally dominant, short-latency reciprocal effect on
      jaw reflexes: a depression of the jaw-closing masseteric reflex and a
      facilitation of the jaw-opening digastric reflex. This reciprocal phase was
      followed by a non-reciprocal facilitatory phase. 3. Stimulation in the IPN evoked
      a short-latency, strychnine-sensitive inhibitory postsynaptic potential (IPSP)
      followed by a rebound depolarizing potential in the jaw-closing masseter
      motoneurons (MAMNs) and an excitatory postsynaptic potential (EPSP) in the jaw
      opening anterior digastric motoneurons (ADMNs). The time course of the
      intracellular response of MAMNs to the IPN stimulation was similar to that of the
      IPN-induced effects on the jaw-closing reflex. In contrast, the duration of the
      IPN-induced EPSP in ADMNs was shorter than the IPN-induced facilitation of the
      jaw-opening reflex. 4. After the IPN neurons were lost by injection of kainic
      acid into the nucleus, the reciprocal effect of the IPN stimulation on the jaw
      reflexes could not be seen, even though the projection fibers from the trigeminal
      sensory nucleus to the IPN remained essentially intact. 5. Stimulation in the
      superior cerebellar peduncle (SP) induced the same reciprocal effect on the jaw
      reflexes as the IPN stimulation. A lesion of the SP virtually abolished the
      reciprocal effect on the jaw reflexes of stimulation in the IPN ipsilateral with
      reference to the SP lesion. 6. Transection of the brain stem at the level
      immediately caudal to the red nucleus did not affect the reciprocal effect of the
      IPN stimulation on the jaw reflexes. 7. We conclude that the IPN output
      bilaterally induces an inhibition of jaw-closing MAMNs and an excitation of jaw
      opening ADMNs, oligosynaptically by way of a direct cerebelloreticular projection
      system via the SP.

PMID- 1629763
TI  - Hypoxia decreases intracellular calcium in adult rat carotid body glomus cells.
AB  - 1. Carotid body chemoreceptors were removed intact from adult rats and subjected
      to protease and collagenase enzymatic digestion of connective tissue. 2.
      Recordings from the sinus nerve demonstrated that chemotransduction remains
      intact for at least 2-3 h after isolation, enzyme exposure, and suspension in N-2
      hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES)-buffered saline at room
      PO2. 3. After mechanical dissociation, the interrelationship between changes in
      extracellular PO2 and pH and relative changes in intracellular calcium (Ca2+i)
      were observed in glomus cells with the use of fluo-3 and confocal microscopy. 4.
      Brief (60-s) decreases in PO2 from 150 mmHg to near 0 mmHg, at nadir, caused a
      marked reduction in Ca2+i (peak delta F/F0 = -32 +/- 3%, mean +/- SE, n = 43),
      which rapidly recovered after reoxygenation. The decrease was reproducible from
      trial to trial and was also observed in HCO3(-)-buffered Ringer solution. 5.
      Superfusion with Ca(2+)-free HEPES saline with 1 mM ethylene glycol-bis(beta
      aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA) blocked the hypoxia-induced
      increase in afferent chemoreceptor activity in vitro. Superfusion of the same
      solution over isolated cells for 15 min caused a large decrease in Ca2+i (-34 +/-
      7%, n = 16). 6. In the presence of Ca(2+)-free HEPES, reoxygenation caused
      calcium fluorescence to increase. This suggests that the Ca2+ decrease during
      hypoxia is due, at least partially, to binding to an intracellular site. 7.
      Extracellular cobalt (1 mM, 15 min) also reversibly blocked the chemoreceptor
      response to hypoxia, in vitro, and caused a reduction in Ca2+i (delta F/F0 = -37
      +/- 8%, n = 11).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629764
TI  - Gustatory neural coding in the monkey cortex: L-amino acids.
AB  - 1. Single-neuron activity in the primary gustatory cortex of the alert cynomolgus
      monkey (Macaca fascicularis) was analyzed in response to a range of taste
      stimuli. Tastants included the four prototypical stimuli (glucose, NaCl, HCl, and
      quinine), fruit juice, and 12 amino acids selected for their chemical
      characteristics, nutritional significance, and biological importance, as well as
      for the availability of human psychophysical data on their perceived qualities.
      2. Taste-evoked responses could be recorded from a cortical area that measured
      3.5 mm in its anteroposterior extent, 2.0 mm mediolaterally, and 6.0 mm
      dorsoventrally. Gustatory cells constituted 4.8% of the 1,129 neurons tested.
      Nongustatory cells gave responses associated with mouth movements (11.1%),
      somatosensory stimulation (3.8%), approach or anticipation of the taste stimulus
      (2.2%), and tongue extension (0.4%). 3. The most effective taste stimuli were
      those with qualities that humans describe as salty or sweet: NaCl, monosodium
      glutamate, glucose, proline, glycine, and fruit juice. The least effective
      tastants were those rated bitter or insipid: tyrosine, tryptophan, phenylalanine,
      and leucine. Accordingly, 79% of the gustatory neurons responded best to glucose
      (46%) or NaCl (33%) among the basic stimuli; only 19% responded best to quinine
      (13%) or HCl (6%). One cell (2%) responded exclusively to fruit juice. 4.
      Cortical gustatory neurons showed a moderate breadth of sensitivity, with a mean
      breadth of tuning coefficient of 0.71 across 54 cells. There was no evidence of
      chemotopic organization in the taste cortex. 5. The taste quality of each
      stimulus was inferred from the relative similarity of the profiles they evoked.
      The clearest distinction among stimuli was between those that humans characterize
      as sweet versus those with other qualities. Several amino acids that have
      dominant sweet (glycine and proline), salty (arginine and monosodium glutamate),
      sour (tryptophan), or bitter (phenylalanine) components to humans evoked activity
      profiles that were associated with those of the appropriate prototypical stimuli.
      Others (cysteine and lysine) were not closely related to any single prototype. 6.
      Conclusions based on the responses of cortical cells in the monkey are in close
      agreement with those that derive from human psychophysical studies of L-amino
      acids, reinforcing the value of this neural model for human taste perception.

PMID- 1629765
TI  - Excitation of motoneurons by the Mauthner axon in goldfish: complexities in a
      "simple" reticulospinal pathway.
AB  - 1. The Mauthner cell in fish and amphibians initiates an escape behavior that has
      served as a model system for studies of the reticulospinal control of movement.
      This behavior consists of a very rapid bend of the body and tail that is thought
      to arise from the monosynaptic excitation of large primary motoneurons by the
      Mauthner cell. Recent work suggests that the excitation of primary motoneurons
      might be more complex than a solely monosynaptic connection. To examine this
      possibility, I used intracellular recording and staining to study the excitation
      of primary motoneurons by the M cell. 2. Simultaneous intracellular recordings
      from the M axon and ipsilateral primary motoneurons show that firing the M cell
      leads to complex postsynaptic potentials (PSPs) in the motoneurons. These PSPs
      usually have three components: an early, small, slow depolarization (component
      1), a later, large, fast depolarization (component 2), and an even later, large,
      long-lasting depolarization (component 3). The first component has a latency of
      0.52 +/- 0.15 (SD) ms, (n = 27) and most probably is a monosynaptic input from
      the M cell. This study focused on the two subsequent, less-understood parts of
      the PSP. Motoneurons typically fire off the second part of the PSP. This is
      usually (27 of 33 cells) the largest component, and it has a mean amplitude of
      6.24 +/- 3.33 (SD) mV (n = 33) and a half-decay time of 0.44 +/- 0.18 (SD) ms (n
      = 27). The mean amplitude of the third component is 3.20 +/- 1.7 (SD) mV (n =
      35), and its half-decay is 6.73 +/- 2.66 (SD) ms (n = 35). The latency of the
      second component averages 0.66 +/- 0.21 (SD) ms (n = 32), indicating that there
      are few synapses in the pathway mediating it. 3. One candidate pathway for the
      second component of the PSP involves a class of descending interneurons (DIs)
      that are monosynaptically, chemically excited by the M cell and appear in light
      microscopy to contact motoneurons. Simultaneous intracellular recordings from the
      M axon, a DI, and a primary motoneuron show that the interneurons are
      electrotonically coupled to motoneurons and produce the fast, second component of
      the PSP. Direct excitation of an interneuron leads to a very short-latency (less
      than 0.2 ms), fast PSP in a motoneuron similar to the second component of the PSP
      produced by the M axon. The short latency and fatigue resistance of this
      connection indicate it is electrotonic, and this is supported by evidence for DC
      coupling between the two cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629766
TI  - Coordination between equilibrium and head-trunk orientation during leg movement:
      a new strategy build up by training.
AB  - 1. During unilateral leg movements performed while standing, it is necessary to
      displace the center of gravity toward the other leg to maintain equilibrium. In
      addition, the orientation of particular segments, such as the head and trunk,
      which are used as reference values for organizing the motor act, needs to be
      preserved. The aim of the present study was to investigate the coordination
      between movement, equilibrium, and local posture. 2. Experiments were carried out
      on standing subjects who were instructed to raise one leg laterally to an angle
      of 45 degrees in response to a light. Two sources of light placed in front of the
      subject indicated the side on which the movement was to be performed. Three main
      aspects of the posturokinetic sequence were investigated in two populations,
      naive subjects and dancers: 1) The body weight transfer toward the supporting leg
      was found to have two components: first, a "ballistic" one, initiated by a thrust
      exerted by the moving leg; and second, an "adjustment" component during which the
      displacement of the center of gravity (CG) reaches a final position (steady
      state). An early burst in the gastrocnemius medialis of the moving leg often
      precedes the onset of the center of pressure change. Two differences between
      naive subjects and dancers were observed: first, the new CG position was almost
      reached in one step very near to the end of the ballistic component and required
      only a short adjustment in dancers, whereas in naive subjects it was reached in
      two steps, including a much longer adjustment component. Second, the dancers were
      able to minimize the CG displacement toward the supporting side; this might be
      because they form a better internal representation of the biomechanical limits of
      stability because of their long training. 2) The onset of the lateral
      displacement of the malleolus marker of the moving leg always occurred when the
      body weight had almost completed its transfer to above the support foot. This
      shows that the positioning of the CG in a new position compatible with
      equilibrium maintenance was a prerequisite for the leg movement to be performed.
      The relative timing of events during the posturokinetic sequence was fairly fixed
      in the dancers, whereas it varied from one trial to another in the naive
      subjects. 3) The coordination between movement, equilibrium, and head-trunk
      orientation involves two control strategies. An "inclination" strategy was used
      by the naive subjects; this consisted of an external rotation of the supporting
      leg around the anteroposterior ankle joint axis. A counter-rotation at the neck
      level ensured the stability of the interorbital line in the horizontal
      plane.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629767
TI  - Visual and oculomotor functions of monkey subthalamic nucleus.
AB  - 1. Single-unit recordings were obtained from the subthalamic nuclei of three
      monkeys trained to perform a series of visuooculomotor tasks. The monkeys were
      trained to fixate on a spot of light on the screen (fixation task). When the spot
      was turned off and a target spot came on, they were required to fixate on the
      target quickly by making a saccade. Visually guided saccades were elicited when
      the target came on without a time gap (saccade task). Memory-guided saccades were
      elicited by delivering a brief cue stimulus while the monkey was fixating; after
      a delay, the fixation spot was turned off and the monkey made a saccade to the
      remembered target (delayed saccade task). 2. Of 265 neurons tested, 95 showed
      spike activity that was related to some aspects of the visuooculomotor tasks,
      whereas 66 neurons responded to active or passive limb or body movements. The
      task-related activities were classified into the following categories: eye
      fixation-related, saccade-related, visual stimulus-related, target- and reward
      related, and lever release-related. 3. Activity related to eye fixation (n = 22)
      consisted of a sustained spike discharge that occurred while the animal was
      fixating on a target light during the tasks. The activity increased after the
      animal started fixating on the target and abruptly ceased when the target went
      off. The activity was unrelated to eye position. It was not elicited during eye
      fixation outside the tasks. The activity decreased when the target spot was
      removed. 4. Activity related to saccades (n = 22) consisted of a phasic increase
      in spike frequency that was time locked with a saccade made during the tasks. The
      greatest increases occurred predominantly after saccade onset. This activity
      usually was unrelated to spontaneous saccades made outside the task. The changes
      in activity typically were optimal in one direction, generally toward the
      contralateral side. 5. Visual responses (n = 14) consisted of a phasic excitation
      in response to a visual probe stimulus or target. Response latencies usually were
      70-120 ms. The receptive fields generally were centered in the contralateral
      hemifield, sometimes extending into the ipsilateral field. The receptive fields
      included the foveal region in seven neurons; most of these neurons responded best
      to parafoveal stimulation. Peripheral stimuli sometimes suppressed the activity
      of visually responsive neurons. 6. Activity related to target and reward (n = 29)
      consisted of sustained spike discharge that occurred only when the monkey could
      expect a reward by detecting the dimming of the light spot that he was
      fixating.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629768
TI  - Midline and lateral field sound localization in the ferret (Mustela putorius):
      contribution of the superior olivary complex.
AB  - 1. The ability of ferrets to localize sound in space was determined before and
      after unilateral or bilateral lesions of the superior olivary complex (SOC).
      Lesions were made by pressure injection of kainic acid into the SOC through a
      stereotaxically positioned glass micropipette. The lesions destroyed the cell
      bodies in the superior olive without disrupting fibers of passage in the
      trapezoid body or other pathways in the auditory brain stem. The integrity of
      fibers was demonstrated by protargol staining of axonal processes and by the
      retrograde transport of horseradish peroxidase (HRP) from the inferior colliculus
      to other auditory brain stem nuclei. Behavioral tests were carried out separately
      for sound localization at midline and lateral field positions. Minimum audible
      angles were determined for single 45-ms noise bursts presented through paired
      loudspeakers positioned symmetrically around 0, -60, and +60 degrees azimuth. 2.
      Four ferrets received complete lesions of the left SOC, and two received complete
      lesions of the right SOC. In general, unilateral destruction of the superior
      olive resulted in impairments in sound localization in both left and right
      lateral fields. In some cases, deficits were also apparent on midline. Four
      additional animals received unilateral lesions that spared cells within the SOC.
      In most cases, deficits were apparent despite incomplete lesions of the SOC. The
      pattern of deficits was generally consistent with that found in animals with
      complete lesions. Most animals had difficulty localizing sounds in the lateral
      fields. 3. Four animals received bilateral lesions of the SOC. Three had complete
      or near-complete destruction of the superior olive on one side of the brain with
      relatively minor damage on the other side. Each of these animals exhibited
      behavioral deficits that were particularly severe ipsilateral to the more
      extensively damaged superior olive. One animal with complete bilateral
      destruction of the SOC was incapable of sound localization, even with 2-s noise
      bursts. This animal, however, suffered severe motor impairments after surgery
      that might have contributed to the apparent inability to localize sound. 4. Two
      animals with kainic acid lesions that caused little or no damage to the SOC were
      still capable of high levels of performance in tests of sound localization and
      had no elevation in minimum audible angles. These cases served as controls for
      the possible effects of nonspecific brain damage and demonstrated that kainic
      acid injections per se resulted in no obvious deficits in our test
      situation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629769
TI  - Separation of neuron types in the gustatory zone of the nucleus tractus solitarii
      on the basis of intrinsic firing properties.
AB  - 1. Whole-cell current-clamp recordings were made from neurons in the rostral
      nucleus tractus solitarii (NTS) in an in vitro brain slice preparation in rats.
      On the basis of previous investigations, these neurons are believed to be
      involved with processing of gustatory as well as somatosensory information. 2.
      Rostral NTS neurons had a mean resting membrane potential of -47 mV. The mean
      input resistance was 336 M omega, and by fitting a double exponential function
      the membrane time constant had fast (2.3 ms) and slow (20.6 ms) components. 3.
      Neurons were separated into four different groups on the basis of their responses
      to a current injection pulse paradigm consisting of membrane hyperpolarization of
      different magnitudes and durations immediately followed by a long (1.200 ms)
      depolarizing pulse. The regular repetitive discharge pattern of the first group
      of neurons (Group I neurons) was changed into an irregular spike train by
      membrane hyperpolarization. Hyperpolarization of Group II neurons either delayed
      the occurrence of the first action potential or increased the length of the first
      interspike interval in the action-potential train produced by membrane
      depolarization. The length of the delay was related both to the magnitude and
      duration of the hyperpolarizing prepulse. Hyperpolarization had the least effect
      on the discharge pattern of Group III neurons. The discharge pattern of Group IV
      neurons consisted of a short burst of action potentials that was often shortened
      by prior hyperpolarization of the neuron. 4. Differences exist in other intrinsic
      properties of the four neuron groups. Group I and III neurons were capable of
      initiating the highest frequency of action potentials to a 100-pA 1,200-ms
      depolarizing pulse. In response to a short depolarizing pulse. Group II neurons
      had the longest latency to the first spike and responded with the fewest action
      potentials. Group IV neurons tended to have higher input resistance and membrane
      time constants than the other neuron groups. A subset of neurons in each neuron
      group showed membrane afterhyperpolarizations (AHP) after depolarization-induced
      action-potential trains (postburst AHP). Postburst AHP amplitudes ranged from 1.0
      to 12.9 mV and were of greatest magnitude in Group II neurons. Postburst AHP
      durations ranged from 75 to 3,538 ms and were of longest duration in neurons
      belonging to Group III. Group II neurons, which had the largest postburst AHP
      magnitude, had the shortest postburst AHP duration. 5. These results demonstrate
      that neurons in the rostral NTS can be separated on the basis of their intrinsic
      membrane properties.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629770
TI  - Local serotonergic modulation of calcium-dependent potassium channels controls
      intersegmental coordination in the lamprey spinal cord.
AB  - 1. The intersegmental coordination during undulatory locomotion in lamprey is
      characterized by a constant phase lag between consecutive segments, that is, the
      ratio between the intersegmental time lag and the cycle duration remains
      constant. It is shown that the spinal 5-HT (serotonin) system can, in a graded
      fashion, control the phase lag value from a rostrocaudal to a caudorostral lag
      corresponding to a reversed direction of swimming. These effects can be explained
      by a 5-HT-induced depression of Ca(2+)-dependent K+ channels (KCa channels) in
      network neurons. 2. The actions of the spinal 5-HT system were analyzed in the
      lamprey spinal cord preparation in vitro. Fictive swimming was induced by bath
      application of N-methyl-D-aspartate (NMDA). The intersegmental phase lag between
      ventral root burst activities was measured along the ipsilateral side of the
      spinal cord. The chamber with the preparation was partitioned into two pools so
      that the rostral and caudal halves of the preparation could be perfused
      independently with solutions containing the same level of NMDA (100-150 microM)
      with or without additional 5-HT or a 5-HT uptake blocker (citalopram). 3.
      Addition of 5-HT to one of these partitioned pools changed the intersegmental
      phase lag in this pool, whereas the cycle duration remained unchanged. It was
      determined by the activity in the "non-5-HT" pool. Addition of 5-HT to the caudal
      pool resulted in an increased rostrocaudal phase lag. When 5-HT was added to the
      rostral pool, on the other hand, the phase lag shifted direction to a backward
      coordination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629771
TI  - Artificial electrical synapses in oscillatory networks.
AB  - 1. We use an electronic circuit to artificially electrically couple neurons. 2.
      Strengthening the coupling between an oscillating neuron and a hyperpolarized,
      passive neuron can either increase or decrease the frequency of the oscillator
      depending on the properties of the oscillator. 3. The result of electrically
      coupling two neuronal oscillators depends on the membrane potentials, intrinsic
      properties of the neurons, and the coupling strength. 4. The interplay between
      chemical inhibitory synapses and electrical synapses can be studied by creating
      both chemical and electrical synapses between two cultured neurons and by
      artificially strengthening the electrical synapse between the ventricular dilator
      and one pyloric dilator neuron of the stomatogastric ganglion.

PMID- 1629772
TI  - Connections between utricular nerve and dorsal neck motoneurons of the
      decerebrate cat.
AB  - 1. We studied connections between the utricular (UT) nerve and dorsal neck
      motoneurons in decerebrate cats. Electrodes were fixed in place on the UT nerve
      under visual observation; the other branches of the vestibular nerve were
      transected. 2. The N1 field potential evoked by UT nerve stimulation was recorded
      in the vestibular nuclei at the start of each experiment. The potential typically
      grew until it reached a plateau. Stimulus spread (if any) to the central ends of
      other nerve branches was revealed by an additional increase in N1 amplitude after
      the plateau was reached. 3. We recorded intracellularly from 55 motoneurons in C1
      C3. Some were identified as having axons in the dorsal rami, which innervate
      dorsal neck muscles. Others projected in nerves that were not available for
      stimulation. 4. UT nerve stimulation evoked synaptic potentials in essentially
      all motoneurons studied. The predominant pattern consisted of disynaptic
      excitatory postsynaptic potentials in ipsilateral motoneurons and inhibitory
      postsynaptic potentials that were at least trisynaptic in contralateral
      motoneurons. 5. The results demonstrate the presence of short-latency connections
      between the utricular nerve and dorsal neck motoneurons. The functional role of
      this pathway remains to be investigated.

PMID- 1629773
TI  - Effects of the GABA uptake inhibitor tiagabine on inhibitory synaptic potentials
      in rat hippocampal slice cultures.
AB  - 1. The effects of the gamma-aminobutyric acid (GABA) uptake blocker tiagabine on
      inhibitory synaptic potentials (IPSPs) were examined with microelectrode and
      whole-cell recording from CA3 pyramidal cells in rat hippocampal slice cultures.
      2. Tiagabine (10-25 microM) greatly prolonged the duration of monosynaptic IPSPs
      elicited in the presence of excitatory amino acid antagonists but had no effect
      on their amplitude. Part of the prolonged time course resulted from a GABAB
      receptor-mediated component that was not detectable under control conditions. 3.
      The mean decay time constant of the underlying GABAA receptor-mediated synaptic
      current was increased from 16 to 250 ms. Spontaneous miniature IPSPs recorded
      with whole-cell clamp were unaffected by tiagabine. Pentobarbital sodium, in
      contrast, increased the decay time constant of both evoked and spontaneous GABAA
      mediated currents. 4. Tiagabine (25 microM) inhibited spontaneous and evoked
      epileptiform bursting induced by increasing the extracellular potassium
      concentration to 8 mM. 5. We conclude that GABA uptake plays a significant role
      in determining the time course of evoked IPSPs and also limits the likelihood
      that GABAB receptors are activated.

PMID- 1629774
TI  - Haemorrhagic complications of intracerebral cavernomas: value of MRI.
AB  - The authors report a retrospective series of 10 cases of intracerebral haematomas
      consecutive to cavernomas and studied with MRI. The factors that led to the MRI
      study were the patients' age and clinical history, the site of the haematoma, the
      persistence of CT images and a negative arteriography. MRI showed that the
      haematoma was in contact with the cavernoma in 4 cases and at a distance from it
      in one case. In 5 cases only the cavernoma was seen at the site of the haematoma.
      Three patients had multiple cavernomas. In all cases, the diagnosis of cavernoma
      was confirmed at surgical excision.

PMID- 1629775
TI  - Juvenile distal cerebral ischemia: angiographic features. A study of 55 cases.
AB  - This study of juvenile distal cerebral ischaemia is based on 55 patients aged
      from 18 to 30 years. The authors describe the circumstances of discovery, as well
      as the clinical features and the course of the disease which may be severe and
      lead to non-resolutive neurological accidents and sometimes dementia.
      Paraclinical evaluation includes capillaroscopy, finger and toe pads biopsy
      (which clearly shows a pathological process with fibrocellular promontories
      narrowing the lumen of arterioles), and above all angiography which displays two
      typical signs: arterial narrowness and bands of peripheral ischaemia. In advanced
      forms of the disease angiography reveals classical signs of ischaemic lesions,
      but charateritically these are very distal. Associated abnormalities of the
      carotid siphon can also be found. Finally, positive CT scans show an isolated
      widening of the sulci which is fairly suggestive of the disease.

PMID- 1629776
TI  - Lhermitte-duclos disease. A rare cause of intracranial hypertension in adults.
AB  - In a 39-year old woman hospitalized for intracranial hypertension MRI revealed
      the presence of abnormal areas in the cerebellar cortex. The negative results of
      investigations for possible causes, as well as the appearance of radiological
      abnormalities and their persistence over a 6-month period incited the authors to
      make a tentative diagnosis of Lhermitte-Duclos disease, despite the lack of
      anatomicopathological evidence.

PMID- 1629777
TI  - MRI and CT in a case of pituitary abscess.
AB  - We report the case of a woman admitted for hypopituitarism of sudden onset, in
      whom conventional radiography, CT and MRT suggested a pituitary tumour with supra
      and intrasellar extensions. The surgical findings and the clinical course under
      antibiotic therapy transformed this diagnosis into one of pituitary abscess by a
      pyogenic micro-organism. Pituitary abscess is an exceptional lesion. Despite the
      advent of CT and MRI, its preoperative diagnosis remains difficult. However, the
      presence of an intrasellar expansive process with liquid centre and contrast
      enhanced outline should suggest the possibility of an abscess, particularly when
      the pituitary lesion is associated with a sphenoidal sinus effusion.

PMID- 1629778
TI  - Endovascular treatment of post-traumatic complex carotid-cavernous fistulas,
      using the arterial approach.
AB  - Endoarterial embolization is now the treatment of choice for traumatic carotid
      cavernous fistulas. However, traumatic or surgical occlusion of the carotid
      artery, or special cases such as unilateral double carotid-cavernous fistula, can
      make the transarterial approach hazardous or impossible. In such cases
      transvenous embolization can be an alternative treatment, although it is
      sometimes difficult or impossible to perform. Three cases of direct traumatic
      carotid-cavernous fistula and their treatments are described. In the first case,
      unilateral double carotid-cavernous fistula was treated with detachable balloons.
      In the second case, the fistula had previously been treated by trapping;
      percutaneous angioplasty was performed with subsequent plastic embolization of
      the fistula. In the third case, transarterial and transvenous approaches were
      impossible, and the patient was cured by combining a surgical procedure and an
      interventional technique.

PMID- 1629779
TI  - MRI anatomy of the acoustic-facial bundle in vivo.
AB  - In this study performed on 5 healthy volunteers the authors used oblique axial,
      coronal and sagittal MRI sections suitable to be anatomical configuration of the
      acoustic-facial bundle and were able to individualize the nerves forming this
      bundle throughout their course, with the sole exception of the intermediate nerve
      (VII2). They also analysed the relations of these nerves between themselves and
      with the other elements of the cerebellopontine angle. In addition, a proton
      density sequence (SE, 6,000/30 ms) made it possible to differentiate in vivo
      between the grey matter and the white matter sufficiently to individualize the
      principal nuclei and tracts of the brain stem, and in particular the main
      vestibulo-cochlear central pathways.

PMID- 1629780
TI  - MRI assessment of anterior callosotomy in the treatment of pharmacoresistant
      epilepsy.
AB  - Section of the anterior two-thirds of the corpus callosum is a well-known
      treatment of some forms of epilepsy of long duration resistant to anti-epileptic
      drugs and dangerous for the patient (tonic and atonic seizures). The aim of this
      functional surgery is to obtain the most complete rostral and caudal section of
      the corpus callosum without risk of disconnection syndrome. Callosotomy is seldom
      performed in Europe. We present our experience of magnetic resonance imaging
      (MRI) in the pre- and postoperative assessment of 6 patients who underwent
      anterior callosotomy and were followed up for more than six months. Our results
      were encouraging with considerable improvement of the patients' social life.

PMID- 1629781
TI  - Effect of alpha-tocopherol on oxidative hemolysis, as evaluated by impedance
      measurement.
AB  - Using a hypoxanthine-xanthine oxidase (HX-XOD) reaction system, the effect of
      vitamin E (VE) on oxidative membrane injury was studied by the impedance method.
      Both VE-sufficient and VE-deficient erythrocytes showed an elevation of low
      frequency permittivity in the early phase of reaction. In the later phase of
      reaction, VE-sufficient erythrocytes showed a sustained elevation in
      permittivity, while VE-deficient erythrocytes showed a decrease in permittivity
      with time. These changes consisted with the process of hemolysis in the HX-XOD
      system. The similarity of early phase change between VE-sufficient and VE
      deficient erythrocytes indicates that the HX-XOD system exerted a similar effect
      on both erythrocytes in the early phase. The difference in changes of later phase
      between the two types of erythrocytes suggests that VE suppressed the reduction
      in permittivity. When the results were analyzed by the Pauly-Schwan's theory
      based on the assumption that erythrocytes are spherical, the product of VE
      deficient or VE-sufficient erythrocyte size (R) and membrane capacity (Cm) showed
      a change similar to that in permittivity.

PMID- 1629782
TI  - Simultaneous determination of hydrogen, methane and carbon dioxide of breath
      using gas-solid chromatography.
AB  - The analysis of respiratory hydrogen and methane was estimated as a useful index
      of intestinal fermentation of undigestible carbohydrate. A simultaneous and
      precious analysis of these gases as well as carbon dioxide was studied. A gas
      impermeable multi-laminated film bag metalized by aluminum vapor was fitted to
      use as a storage bag; its impermeability was verified by measuring the residual
      rate of hydrogen after 3 months' storage. Hydrogen, methane and carbon dioxide of
      the breath gas even at 1 ppm could be determined simultaneously by using a gas
      solid chromatography installed with a photoionization detector and active carbon
      column. To observe the genesis of hydrogen and methane after carbohydrate
      ingestion, pectin, a typical water-soluble dietary fiber, was fed to healthy
      volunteers. Increasing excretion of pulmonary hydrogen or methane showed the sign
      of intestinal fermentation as the results of carbohydrate malabsorption.

PMID- 1629783
TI  - Metabolism of orally administered ergosterol and 7-dehydrocholesterol in rats and
      lack of evidence for their vitamin D biological activity.
AB  - Metabolism of orally administered ergosterol (Erg) and 7-dehydrocholesterol (7
      DHC) in rats and their vitamin D biological activity were investigated. Most of
      orally administered Erg and 7-DHC were excreted in feces and the remaining
      sterols were absorbed through intestine. The absorbed sterols were not
      transported in skin as the intact forms but metabolized into brassicasterol and
      cholesterol, respectively, within 25 h. Neither increment of intestinal calcium
      absorption nor plasma calcium concentrations were observed by oral administration
      of Erg and 7-DHC to vitamin D-deficient rats. Therefore, we have concluded that
      orally administered Erg and 7-DHC have no vitamin D biological activity.

PMID- 1629784
TI  - Antiobesity and antidiabetic actions of a new potent disaccharidase inhibitor in
      genetically obese-diabetic mice, KKA(y).
AB  - AO-128 is a potent and structurally novel inhibitor of the intestinal
      disaccharidases, such as maltase and sucrase. Genetically obese-diabetic mice,
      KKA(y), were used to examine the acute or long-term effectiveness of this
      compound. AO-128 decreased a postprandial rise in blood glucose after sucrose
      solution loading dose-dependently; the ED50 to reduce a delta increment of blood
      glucose by 50% was 0.22 mg/kg. The intestinal sucrase and maltase activities were
      suppressed to 7 and 48% of the control levels, respectively, at a dose of 0.21
      mg/kg. Four-week-old female KKA(y) mice were kept on a laboratory diet containing
      10 or 50 ppm of AO-128 for 12 weeks. The high dose of AO-128 reduced food intake
      and body weight gain throughout the experimental period. On the other hand, the
      low dose reduced body weight gain for the first 4 weeks without any effect on
      food intake. Development of the hyperglycemia and hyperinsulinemia characteristic
      of KKA(y) mice was moderately prevented by the low dose, and completely by the
      high dose. Hypertriglyceridemia tended to be suppressed by the AO-128 treatment.
      The high dose decreased the hemoglobin A1 level and parametrial adipose tissue
      weight. Hepatomegaly and fatty liver were ameliorated by AO-128 dose-dependently.
      Nephropathy was ameliorated by the high dose. These findings indicate that AO-128
      may be useful for treating human obesity and diabetes.

PMID- 1629785
TI  - Role of dihydropyrimidine dehydrogenase in the uridine nucleotide metabolism in
      the rat liver.
AB  - The activity of dihydropyrimidine dehydrogenase, which is the rate-limiting
      enzyme in the catabolism of pyrimidine, in livers of 5-day-old rats increased 48
      h after glucocorticoid injection. The increase in the activity of
      dihydropyrimidine dehydrogenase by glucocorticoid administration and by aging did
      not decrease the uridine, uracil and sigma UMP (the sum of acid-soluble uracil 5'
      nucleotides) pool in liver. The increase of liver uracil by a uridine diet not
      increase dihydropyrimidine dehydrogenase activity. The increase of liver uracil
      did not increase dihydropyrimidine dehydrogenase activity. However,
      dihydropyrimidine dehydrogenase activity which increased after glucocorticoid
      treatment increased the pyrimidine-degradation rate in rat livers and
      hepatocytes. Pyrimidine catabolism pathway in liver may play an important role in
      degradation of dietary pyrimidines and pyrimidines which are administered in the
      form of medicines as 5-fluorouridine.

PMID- 1629786
TI  - Effect of ingestion of excess methionine diet on aging of erythrocytes in mice.
AB  - Accelerated senescence prone mice and resistant mice (SAM-P/1 and SAM-R/1) were
      fed 10% casein diet or that supplemented with 2.5% methionine (Met) diet for 4
      weeks. Erythrocytes withdrawn from animals of each group were separated by
      density gradient centrifugation into four fractions of different cell density,
      that is, different age of erythrocytes, and were analyzed for the activities of
      glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and the level of
      oxidized protein. Excess Met decreased the specific activity of GSH-Px in each
      fraction and the whole population of erythrocytes in SAM-P/1 but not in SAM-R/1.
      The changes in SOD activities were least significant among the erythrocyte
      fractions of every dietary group. The oxidized protein level in cell lysate
      increased with the increase of cell density in both strains of animals. These
      results were interpreted as indicating that excess Met had a positive effect on
      the erythrocytes senescence, and suggested that the activity of GSH-Px may be a
      useful enzymatic marker for the age of erythrocytes.

PMID- 1629787
TI  - Lowering and delaying actions of bovine bile on plasma ethanol levels in rats.
AB  - The effects of bovine bile (50-400 mg.kg-1 BW) on plasma ethanol levels in male
      rats (6-8 weeks old) were examined. Bovine bile decreased and delayed the peak of
      plasma ethanol concentration: a dose response to bovine bile was observed in the
      concentration and time to maximum concentration of ethanol but no change in
      disappearance rate. These phenomena were observed in two conditions: 1) oral
      administration of bovine bile before oral intubation of ethanol (1.0 g.kg-1 BW)
      and 2) simultaneous oral administration of bovine bile and ethanol. Similar
      responses were obtained in taurocholic acid. No changes in hepatic alcohol and
      aldehyde (low Km and high Km) dehydrogenase activities were observed. The
      remaining rate of ethanol in stomach was significantly higher with administration
      of bovine bile. A negative correlation between the maximum ethanol concentration
      and the remaining rate of ethanol in stomach was found. The intestinal absorption
      rate of ethanol decreased significantly in the presence of bovine bile. These
      results suggest that the delay of the gastric emptying and/or the decrease of the
      intestinal absorption rate of ethanol are major mechanisms for the decreasing and
      delaying effects on plasma ethanol by bovine bile. The present paper also
      suggests that bile acids such as taurocholic acid may participate in the lowering
      and delaying actions on the peak of plasma ethanol concentration by bovine bile.

PMID- 1629788
TI  - Reduction of corticosterone-induced muscle proteolysis and growth retardation by
      a combined treatment with insulin, testosterone and high-protein-high-fat diet in
      rats.
AB  - An experiment was conducted to clarify the combined effect of simultaneous
      administrations of insulin (Ins, 4 units/100 g body weight/day) and testosterone
      propionate (TP, 2 mg/100 g body weight/day) and feeding a high-protein-high-fat
      (HPHF) diet (50% protein, 36% fat) on corticosterone (CTC, 10 mg/100 g body
      weight/day)-induced muscle proteolysis or growth retardation in young growing
      male rats. After 6 days prefeeding of the standard (STD) diet (25% protein, 9%
      fat) and the HPHF diet, hormones were injected subcutaneously for 4 days. Urine
      was collected every day for the 4-day experimental period to measure N tau
      methylhistidine excretions. The results were as follows. The growth was markedly
      inhibited and muscle proteolysis was accelerated by the CTC treatment. Feeding
      HPHF diet reduced CTC-induced muscle proteolysis and the growth retardation, and
      administrations of Ins and TP further reduced the proteolysis and the growth
      retardation. From these results, it is thought that administrations of Ins and TP
      and feeding HPHF diet minimize the muscle protein wasting by counteracting
      insulin resistance caused by CTC, and masking the CTC receptor.

PMID- 1629789
TI  - Accumulation of hypotaurine in tissues and urine of rats fed an excess methionine
      diet.
AB  - Hypotaurine increased in some tissues, especially in muscle, and urine of rats
      fed methionine excess diet. The significant depression of the body weight and
      food intake of rats caused by excess methionine was remarkably alleviated as
      previous reports and hypotaurine content in muscle and urine increased further by
      supplement with glycine to the excess methionine diet.

PMID- 1629790
TI  - Shhhhhh! Learn how to listen.

PMID- 1629791
TI  - The effect of Amalgambond on the flexural bond strength of dental amalgam.

PMID- 1629792
TI  - Pathological Society of Great Britain and Ireland. 164th Meeting. London, 8-10
      January 1992. Abstracts.

PMID- 1629794
TI  - Algorithms to rapidly achieve and maintain stable drug concentrations at the site
      of drug effect with a computer-controlled infusion pump.
AB  - Computer-controlled infusion pumps incorporating an internal model of drug
      pharmacokinetics can rapidly achieve and maintain constant drug concentrations in
      the plasma. Although these pumps offer more accurate titration of intravenous
      drugs than is possible with simple boluses or constant rate infusions, the choice
      of the plasma as the target site is arbitrary. The plasma is not the site of drug
      effect for most drugs. This manuscript describes two algorithms for calculation
      of the infusion rates necessary for a computer-controlled infusion pump to
      rapidly achieve, and then maintain, the desired target concentration at the site
      of drug effect rather than in the plasma.

PMID- 1629793
TI  - A comparative investigation of hepatic clearance models: predictions of
      metabolite formation and elimination.
AB  - Liver clearance models serve to improve our understanding of the relationships
      between the physiological determinants and hepatic clearance and predict changes
      in the disposition of substrates when homeostasis of the organ is perturbed.
      Their ability to describe metabolism was presently extended to the sequential
      formation and elimination of primary (M1), secondary (M2), and tertiary (M3)
      metabolites during a single passage of drug (P) across the liver, under steady
      state and first-order conditions. The well-stirred model is distinct from other
      models in that metabolite formation and elimination is independent of enzymic
      distributions, the number of steps involved in metabolite formation, and the
      intrinsic clearances of the precursors. This model predicts that the extraction
      ratio of a formed primary metabolite derived from drug (E[M1, P]) is identical to
      that for the preformed primary metabolite (E[M1]), and that the extraction ratios
      of a secondary metabolite derived from drug (E[M2, P]) and primary metabolite
      (E[M2, M1]) or preformed secondary metabolite (E[M2]) are identical. For the more
      physiologically acceptable, parallel-tube and dispersion models, metabolite
      sequential elimination is highly influenced by the intrinsic clearances of the
      precursors and the enzymic distributions that mediate removal of precursor
      species and the metabolites. Furthermore, the extent of sequential metabolism
      recedes as the number of steps involved for metabolite formation increases. These
      models predict that E[M1, P] less than E[M1], and E[M2, P] less than E[M2, M1]
      less than E[M2], with the magnitude of the changes being less for the dispersion
      model than for the parallel-tube model. Competing pathways that divert substrate
      from entering the sequential pathway were found to exert only minimal influence
      on the sequential pathway.

PMID- 1629795
TI  - Application of the axial dispersion model of hepatic drug elimination to the
      kinetics of diazepam in the isolated perfused rat liver.
AB  - The application of the axial dispersion model to diazepam hepatic elimination was
      evaluated using data obtained for several conditions using the single-pass
      isolated perfused rat liver preparation. The influence of alterations in the
      fraction unbound in perfusate (fu) and perfusate flow (Q) on the availability (F)
      of diazepam was studied under steady conditions (n = 4 in each case). Changes in
      fu were produced by altering the concentration of human serum albumin (HSA) in
      the perfusion medium while maintaining diazepam concentration at 1 mg L-1. In the
      absence of protein (fu = 1), diazepam availability was 0.011 +/- 0.005 (mean +/-
      SD). As fu decreased, availability progressively increased and at a HSA
      concentration of 2% (g/100 ml), when fu was 0.023, diazepam availability was
      0.851 +/- 0.011. Application of the axial dispersion model to the relationship
      between fu and F provided estimates for the dispersion number (DN) of 0.337 +/-
      0.197, and intrinsic clearance (CL(int)) of 132 +/- 34 ml min-1. The availability
      of diazepam during perfusion with protein-free media was also studied at three
      different flow rates (15, 22.5, and 30 ml min-1). Diazepam availability always
      progressively increased as perfusate flow increased, with the axial dispersion
      model yielding estimates for DN of 0.393 +/- 0.128 and CL(int) of 144 +/- 38 ml
      min-1. The transient form of the two-compartment dispersion model was also
      applied to the output concentration versus time profile of diazepam after bolus
      input of a radiolabeled tracer into the hepatic portal vein (n = 4), providing DN
      and CL(int) estimates of 0.251 +/- 0.093 and 135 +/- 59 ml min-1, respectively.
      Hence, all methods provided similar estimates for DN and CL(int). Furthermore,
      the magnitude of DN is similar to that determined for noneliminated substances
      such as erythrocytes, albumin, sucrose, and water. These findings suggest that
      the dispersion of diazepam in the perfused rat liver is determined primarily by
      the architecture of the hepatic microvasculature.

PMID- 1629797
TI  - Proceedings of the scientific meetings of The Physiological Society. December
      1991 thru April 1992. Abstracts.

PMID- 1629796
TI  - Effect of angiotensin II-induced changes in perfusion flow rate on chlorothiazide
      transport in the isolated perfused rat kidney.
AB  - Angiotensin II was used as a probe to study the effect of changes in perfusate
      flow rate on the renal clearance parameters of chlorothiazide in the isolated
      perfused rat kidney. Perfusion studies were performed in five rats with no
      angiotensin II present in the perfusate and in five rats with a 1-4 ng/min
      infusion of angiotensin II into the perfusate. Angiotensin II had a dramatic
      effect on the renal hemodynamics, resulting in a 43% decrease in perfusate flow,
      a 16% decrease in glomerular filtration rate (GFR), and a 45% increase in
      filtration fraction. Values for the fractional excretion of glucose were low and
      consistent, with or without angiotensin II. Although the unbound fraction (fu) of
      chlorothiazide was unchanged between treatments, the renal (CLr) and the
      secretion clearances were reduced by about 50% in the presence of angiotensin II;
      the excretion ratio [ER = CLr/(fu.GFR)] was reduced by 38% with angiotensin II
      present in the perfusate. Analysis of the data was complicated by the presence of
      a capacity-limited transport for renal tubular secretion. Transport parameters
      (+/- SD) were obtained and the corrected intrinsic secretory clearance
      [(Vmax/GFR)/Km] of chlorothiazide was 123 +/- 18 without angiotensin II vs. 72.8
      +/- 30.0 with angiotensin II. These results demonstrate that alterations in organ
      perfusion can significantly reduce the clearance parameters of chlorothiazide in
      the rat IPK. These flow-induced changes in intrinsic secretory transport may
      reflect perturbations other than that of perfusion flow rate alone.

PMID- 1629798
TI  - Staged major limb replantation: a concept to minimize the risk in replantation of
      the lower extremity.
AB  - The replantation of large limb segments presents two major problems: first, a
      general danger to survival because of major accompanying injuries and additional
      ischemia-reperfusion injury; second, local soft-tissue damage at the amputation
      site. Successful replantation can be compromised by infection, vessel thrombosis,
      and disturbed bone healing. Possible risk reduction may be accomplished by the
      concept of a two-staged replantation. A brief primary emergency procedure
      involving bone resection, osteosynthesis, and revascularization (with the goal of
      limb survival) is followed by a second procedure within 72 hr after trauma, for
      final debridement, completing the osteosynthesis, nerve and tendon suturing, and
      soft-tissue coverage by free flaps. The advantages of the double procedure are
      demonstrated in 27 patients by comparison of two treatment groups. Group I
      comprised 15 patients with definitive primary care. In Group 2 (n = 12), the two
      stage operation was performed. The second group showed a shorter duration of
      overall treatment, reduction of blood loss, and fewer infections.

PMID- 1629799
TI  - Vascular resistance considerations in free-tissue transfer.
AB  - The closure of complex wounds is facilitated by microvascular free-tissue
      transfer. The greatest threat to the success of a free-tissue transfer is
      thrombosis of the microvascular anastomosis. Technical and pharmacologic advances
      have decreased the thrombogenic effect of abnormalities of a vessel's endothelial
      lining, and have decreased the coagulation ability of blood. Equally important to
      patency of the microvascular anastomosis is blood flow, which is inversely
      proportional to the total resistance provided by the microcirculatory beds
      downstream. Because different tissues possess different vascular resistances,
      some flaps may display more favorable hemodynamics than others. This study was
      designed to characterize vascular resistance, weight, volume, and surface area of
      the flaps available for transfer, and to identify favorable tissues for
      reconstruction from the standpoint of outflow resistances. Data were collected on
      patients undergoing free-tissue transfers and on experimental free-tissue
      transfers harvested from canines and fresh cadavers. Results show that resistance
      is highest in fascial flaps, intermediate in composite bone and soft-tissue
      flaps, and lowest in muscle and musculocutaneous tissues. Resistance is lower in
      flaps harvested from the trunk, compared with those harvested from the
      extremities. The rate of microvascular complications increases as resistance
      within the flap increases. Muscle and musculocutaneous flaps harvested from the
      trunk have lower complication rates than fascial and fasciocutaneous flaps.
      Suggestions for choices of flaps are made, based on the inherent resistance in
      the various free flap tissues.

PMID- 1629800
TI  - Functional limb salvage combining gastrocnemius neurotization and posterior
      tibial nerve grafting: a case report.
AB  - Functional limb salvage requires motor and sensory reconstruction of the
      extremity. An avulsion of the tibial nerve in the popliteal fossa after
      arthroscopy is presented. Functional limb recovery necessitated intraoperative
      nerve mapping by awake stimulation, neurotization of the gastrocnemius muscle
      bellies, and interfascicular posterior tibial nerve grafting. Eighteen-month
      follow-up demonstrated good gastrocnemius motor function and protective sensation
      on the plantar surface. The patient is ambulatory without the need of an
      assistive device.

PMID- 1629801
TI  - The osteocutaneous fibula flap: an anatomic study.
AB  - Recent studies related to the fibula flap have disagreed regarding the anatomy of
      the cutaneous branches of the peroneal artery. To clarify this issue, various
      dissections of 35 injected fresh cadaver legs were done. Identifiable skin
      branches were found in 23 of 25 dissections. Skin branches from the proximal
      third of the peroneal artery always travelled an intramuscular course. Skin
      branches from the distal two-thirds of the peroneal artery were usually affixed
      to the posterior crural septum. Legs with peroneal artery skin branches had from
      three to seven branches (average: 4.7); each branch contributed to the fibular
      periosteal blood supply. The most reliably found skin branch was located within 2
      cm of the fibula midpoint. These findings reinforce the fact that a large skin
      island supplied by branches of the peroneal artery can be harvested with the
      fibula flap, and that the most reliable cutaneous vessels are found in the lower
      two-thirds of the leg, run posterior to the fibula in the posterior crural
      septum, and are always associated with muscular side branches.

PMID- 1629802
TI  - Phalloplasty techniques.

PMID- 1629803
TI  - The turbo gracilis myocutaneous flap.
AB  - While the gracilis muscle flap continues to be used for coverage of selected
      defects and in specialized applications such as facial reanimation, the lack of
      reliability of the distal skin component of the gracilis musculocutaneous flap
      has limited its usefulness. Reliable distal skin and muscle viability are
      particularly important when the gracilis musculocutaneous free flap is used in
      forearm flexorplasty. A method for "turbo-charging" this flap, to improve distal
      reliability, is described. The anatomy of 24 human lower extremities was studied,
      with respect to the arterial supply to the distal gracilis muscle and distal
      medial thigh skin. A consistent septal branch, originating from the superficial
      femoral artery proximal to the adductor canal, supplying the distal gracilis
      muscle as well as the overlying skin, was identified in all extremities. "Turbo
      charging" via this vessel increases the reliability of both the distal skin
      island and distal muscle of the gracilis myocutaneous flap and enhances its
      versatility, when used as either a pedicle or free flap.

PMID- 1629804
TI  - Peripheral arteriovenous anastomosis: an alternative technique in a free flap
      transfer.
AB  - Prevention of thrombosis in the inflow and outflow vessels of a free flap is a
      problem of current interest. The method of creating a peripheral arteriovenous
      anastomosis within a free flap was validated in an experimental study and
      substantiated in a clinical case. No thrombotic complications were observed in 16
      transfers of saphenous fasciocutaneous flaps in a dog model, as well as in an
      elderly patient with free radial forearm flap transfer to an irradiated foot.
      Scanning electron microscopy of the venous anastomosis proximal to the
      arteriovenous fistula revealed the difference of pathologic changes as early as 4
      hr following surgery. It is the conclusion of the authors, that performing a
      distal arteriovenous fistula in a free flap, is an effective procedure for
      prevention of early occlusion in a proximally anastomosed artery and vein.

PMID- 1629805
TI  - Reconstruction of the bones and joints of the upper extremity by vascularized
      free fibular graft: report of 46 cases.
AB  - The vascularized free fibular graft was applied in reconstructing bone and joint
      structures of the upper extremity in 46 cases between August, 1977 and December,
      1989. Among these, 30 were grafts of the fibular shaft and 16 were grafts of the
      fibular head. There were 19 bony defects after trauma or osteomyelitis, 18 bony
      or articular defects after resection of tumors, five congenital deformities or
      defects, and four replacements for fibrous dysplasia. The longest grafted fibula
      was 22 cm and the shortest, 5 cm. Thirty-one cases were followed for more than
      two years, and these were evaluated for functional ability in daily living,
      roentgenologic appearance, and 99mTc scan during follow-up. The results revealed
      quite sufficient functional restoration, solid bone healing, and adequate blood
      supply, in most cases. The vascularized free fibular head graft appears to be an
      ideal procedure for the reconstruction of defects of the lower end of the radius
      or the upper humerus, including the humeral head. The stability of the
      reconstructed wrist or shoulder joint was maintained by suturing the lateral
      collateral ligament, the palmar collateral ligament around the wrist, or by
      passing the long head of the biceps brachii through the grafted fibula at the
      shoulder. Methods for fixation of the fibular shaft to the recipient bone and the
      selection of vessels for anastomoses, both in the graft and at the recipient
      site, are discussed. The importance of postoperative functional exercise is
      emphasized.

PMID- 1629806
TI  - CO2 laser-assisted repair of esophageal lacerations.
AB  - This study was designed to evaluate the feasibility of CO2 laser-assisted repair
      of esophageal injuries. Nine-millimeter longitudinal incisions were made in the
      cervical esophagus of 40 Sprague-Dawley rats. The rats were divided into two
      groups. Twenty rats in Group 1 had their incisions closed in two layers (mucosa
      and muscularis) with the I.L. Med Unilase microsurgical CO2 laser (LAREL), using
      80 mW of power with a spot size of 200 mu (power density = 255). Twenty rats in
      Group 2 had their incisions closed in two layers using 8-0 Vicryl conventional
      suture technique (CST). Postoperatively, an intraluminal methylene blue injection
      evaluated patency and leakage. Histologic analysis was performed at 3 days, 2
      weeks, 1 month, and 6 months. Patency rates of LAREL and CST were comparable. No
      fistulas or strictures were found with either technique. Laser-assisted repair of
      esophageal lacerations (LAREL) was found to be faster and easier than CST. The
      question arises whether small esophageal tears can be safely repaired through the
      endoscope. This study demonstrates the feasibility of tissue welding the
      esophagus. Further research is mandatory to study the applicability of this
      technique in the clinical setting.

PMID- 1629807
TI  - An experimental study of the flow-through venous flap: investigation of the width
      and area of survival with one flow-through vein preserved.
AB  - A quantitative analysis was undertaken to investigate the width and area of
      survival of flow-through venous flaps in 20 ears of 10 rabbits. The 3.0- x 3.0-cm
      flap models, which included one flow-through vein, were prepared with additional
      circulation from the graft bed and surrounding tissue excluded, as far as
      possible. The flaps were divided as follows: Group A--composite grafts (n = 10),
      and Group B--flow-through venous flaps (n = 10). All flaps in Group A became
      necrotic and all those in Group B showed partial survival along the flow-through
      vein. The average survival width was 1.10 +/- 0.48 cm, and the survival rate was
      44 +/- 19.3 percent. Microangiograms revealed patency of the flow-through vein in
      all flaps of Group B. Histologically, there tended to be progressively more
      fibrous tissue in the area further away from the flow-through vein. The model is
      useful to investigate the width and area of survival in flow-through venous
      flaps.

PMID- 1629808
TI  - Reversing nerve-graft polarity in a rat model: the effect on function.
AB  - To evaluate the effect of nerve-graft polarity on function, a 1-cm segment of
      sciatic nerve was excised and reoriented in three groups of 20 adult Sprague
      Dawley rats. In one group, the nerve was cut and anastomosed in the original
      orientation to act as a control. In the second group, the nerve-graft polarity
      was reversed 180 degrees. The final group underwent reversal of polarity 180
      degrees and was rotated 180 degrees, (i.e., the posterior tibial nerve fascicles
      proximally were opposite to the peroneal nerve fascicles distally). Functional
      recovery was evaluated using Bain's modification of de Medinaceli's sciatic
      functional index (SFI). Rat-track analysis was performed over a 120-day period.
      Histologic correlation was also performed at the time of sacrifice. From our
      study, we concluded that reversing nerve-graft polarity, with or without
      rotation, does not influence subsequent function in this model.

PMID- 1629809
TI  - Transient single-digit ectopic implantation.
AB  - Although immediate replantation of an amputated digit is always preferable,
      mitigating circumstances (such as a severe concomitant injury involving the
      appropriate recipient neurovascular structures) might preclude such an attempt
      altogether. However, if these local structures have the potential, following
      adequate debridement and/or other tissue transfer, to accept this digit later,
      than an alternative for transient storage for delayed replantation should be
      considered. The deep inferior epigastric vessels are a recognized convenient site
      that could provide temporary ectopic revascularization of such a solitary finger.
      An example of this approach for thumb preservation is presented, although
      amputation of the hand before performing the secondary transfer unfortunately
      proved prudent.

PMID- 1629810
TI  - Pathology of the shoulder as it relates to the differential diagnosis of thoracic
      outlet compression.
AB  - Shoulder pathology and its diagnosis must be considered in evaluation of the
      patient suspected of having thoracic outlet syndrome (TOS). Overlooking usually
      treatable conditions in the shoulder may lead to unfavorable results, if
      treatment is directed, instead, to neurolysis of the brachial plexus or first rib
      resection.

PMID- 1629811
TI  - Blood-flow measurements of injured peripheral nerves by laser Doppler flowmetry.
AB  - The effects of injury on peripheral nerve blood flow were studied, using a
      Laserflo blood perfusion monitor. A total of 11 nerves were studied, five normal
      and six injured nerves in four patients. Two of the patients had lacerating
      brachial plexus injuries, and two other patients had compressive neuropathies of
      their ulnar nerves at the elbow. All of the readings were taken intraoperatively
      while the patients were undergoing exploration and repair under general
      anesthesia. Measurements of the damaged nerves were taken serially from the site
      of injury proximally and distally, by approximating a flexible metric ruler to
      the dorsal aspect of the nerve along the same axis. In the acutely lacerated
      injured nerves (3 to 7 days), the measurements were taken at 1, 5, 10, and 20 mm.
      The maximal amount of retraction in any of the nerves was 1 cm; thus, the overall
      architecture of the nerves was maintained. In the compressed nerves, measurements
      were taken at 1, 2 and 3 cm proximal and distal to the medial epicondyle.
      Measurement of normal undamaged nerves was performed at six different sites along
      the same axis of the nerve. The averaged results indicate that the normal blood
      flow ranged from 47 ml/100 g/min to 63 ml/100 g/min, with a mean of 56 ml/100
      g/min. In the injured nerves, blood flow was most depressed at sites closest to
      the laceration, and increased consistently and progressively at sites distant
      from the injury in both directions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629812
TI  - Pre-formed vascularized bone grafts using polyethelyne chambers.
AB  - Previous work has shown that corticocancellous bone chips placed in a titanium
      chamber with an arteriovenous vascular pedicle will result in a pre-formed
      vascularized bone graft. The present study was designed to determine whether
      these grafts can be transferred as an island or free vascularized bone graft, and
      to examine the material properties of these grafts. Thirty-two male, New Zealand
      white rabbits were divided into four groups based on the time of sacrifice
      following the initial chamber implantation. Injected molded cylindrical
      polyethelyne chambers, measuring 22 mm long and with an 8-mm inner diameter, were
      used. Corticocancellous bone chips were placed in the chambers and each chamber
      was implanted in the mid-thigh, with saphenous vessels running through the
      chamber. The chambers were implanted into the right and left thigh of each
      animal. To test the hypothesis of the possibility of transferring this graft as
      an island or free vascularized graft, ligation of the distal vascular pedicle on
      one side was achieved at re-exploration at 3, 6, 9, and 12 weeks. The
      contralateral side served as a control in which the vascular pedicle was not
      ligated. In the controls, bony bridging between the corticocancellous bone chips
      was observed after 7 weeks. A solid bone graft was present within the chamber by
      10 weeks. However, histomorphometric evaluation indicated significant bone
      resorption. By 13 weeks, resorption progressed to the point where only small
      islands of bone remained. Ligation of the distal vessels resulted in thrombosis
      of the vessels within the chamber. Necrosis of newly-formed bone was observed in
      the area adjacent to the vascular thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629813
TI  - Priority in the use of the forearm free flap in one-stage phalloplasty.

PMID- 1629815
TI  - Classification criteria--what value do they serve?

PMID- 1629814
TI  - Liver biopsies in patients with rheumatoid arthritis receiving methotrexate:
      where are we going?

PMID- 1629816
TI  - Rheumatology on the dark continent: not as dark as it was.

PMID- 1629817
TI  - Comparison of the sensitivity and specificity of the 1958 and 1987 criteria for
      rheumatoid arthritis.
AB  - The 2 variations of the new criteria for rheumatoid arthritis (RA) proposed by a
      subcommittee of the American College of Rheumatology (ACR) in 1987 were evaluated
      and compared with the earlier (1958) criteria in 2 patients data collections from
      a Dutch rheumatological outpatient clinic. One group comprised 1,570 newly
      referred, consecutive patients, including 93 patients with RA. The other
      consisted of 1,338 patients with a clinical diagnosis of RA, whose charts were
      reviewed retrospectively. The sensitivities of the 2 variations of the 1987
      criteria in the prospective and retrospective subgroups varied from 66 to 89%;
      those of the 1958 set, from 71 to 86%. Specificity was 98% for both criteria
      sets. Comparison in subgroups with different disease durations showed reduction
      in sensitivity for early RA for either variation of the new criteria. However,
      the differences between the results of the 1958 and 1987 criteria sets are small
      enough to conclude that they perform equally well.

PMID- 1629818
TI  - Protective effects of ciprofloxacin against type II collagen induced arthritis in
      rats.
AB  - Ciprofloxacin, a new fluoroquinolone antibiotic, inhibits the in vitro production
      of interleukin 1 beta and tumor necrosis factor alpha by monocytes. We
      investigated its activity against type II collagen induced arthritis in rats. It
      exerted a dose dependent preventive effect at 50 and 75 mg/kg/day against
      clinical and histologic features of collagen induced arthritis without any
      influence on the production of anticollagen antibodies and alpha 1-acid
      glycoprotein. This effect was reversible after early removal of the treatment.
      Ciprofloxacin did not inhibit collagen induced arthritis in adrenalectomized rats
      but rather caused an exacerbation of the disease. Its effect was not modified by
      the simultaneous administration of an antiglucocorticoid, RU 40555.

PMID- 1629819
TI  - Clinical liver disease in patients with rheumatoid arthritis taking methotrexate.
AB  - Between 1981 and 1989, 3 of 134 patients with rheumatoid arthritis (RA) treated
      with methotrexate (MTX) developed clinically significant hepatic dysfunction and
      showed histologic evidence of severe liver disease (fibrosis and cirrhosis).
      Factors identified in these patients that may have been linked to liver toxicity
      included diabetes, congestive heart failure and Felty's syndrome. In the patient
      group that received a post-MTX liver biopsy, pulmonary fibrosis and obesity were
      significantly associated with hepatic fibrosis/cirrhosis. Severe liver disease
      may occur in patients with RA treated with low dose MTX (less than 3%). Early
      liver biopsy is recommended in selected cases.

PMID- 1629820
TI  - Genetic studies of anti-Ro (SSA) antibodies in families with rheumatoid
      arthritis.
AB  - Forty-nine members of 4 families with multiple cases of rheumatoid arthritis (RA)
      were investigated. Nine patients with RA, one patient with primary Sjogren's
      syndrome (SS) and one patient with systemic lupus erythematosus (SLE) were
      detected among them. Anti-Ro (SSA) antibodies were found in 11 members (22%) of
      the investigated group; 6 suffered from RA, SLE or primary SS, and 5 were healthy
      first degree relatives. Anti-La (SSB) antibodies were detected in only one family
      member with primary SS. Secondary SS was evident in 5 patients with RA, 3 of whom
      had anti-Ro antibodies; HLA-DR4 was present in 7 of 9 patients with RA (78%) but
      in only 7 of 26 asymptomatic relatives (27%) (p less than 0.05). All patients
      with RA and their relatives who had anti-Ro antibodies were found to have HLA
      DR4. Our results demonstrate that anti-Ro antibodies are present in relatives of
      patients with RA and are strongly associated with HLA-DR4.

PMID- 1629821
TI  - What factors distinguish probands from multicase rheumatoid arthritis same sex
      sibships from sporadic disease?
AB  - Thirty-two of 243 same sex sibships in which the proband had rheumatoid arthritis
      (RA) had at least one same sex sibling with RA ("familial" RA) and 211 did not
      ("sporadic" RA). The most important factors accounting for familial RA were the
      sibship size, and the proportion of siblings sharing both HLA haplotypes with the
      proband. Demographic and clinical details, autoantibodies and HLA-DR status were
      similar between the 2 groups, with the exceptions of regular use of artificial
      teardrops, and involvement of distal interphalangeal joints, which were both more
      prevalent in familial RA. The extrapolation of results from familial to sporadic
      RA appears to be justified.

PMID- 1629822
TI  - Extraarticular manifestations of rheumatoid arthritis and HLA antigens in
      northern Italy.
AB  - We performed retrospective analysis of 141 Northern Italian patients with
      rheumatoid arthritis (RA). This series represents all the patients seen as in
      and/or outpatients at the rheumatologic unit of Reggio Emilia Hospital during a 2
      year period (1987-88). We observed a low frequency of nodules (16%) and
      vasculitis (2.1%). Thus, RA seems to be milder in our population compared to
      Caucasian patients with RA originating from North America or England. We observed
      a weak association with DR4 (RR = 2.4) in the total group of patients with RA. A
      low frequency of DR4 was observed in patients and controls (29 vs 14.5%, p =
      0.001). When compared with controls the frequency of DR4 was significantly higher
      in seropositive (p = 0.001), but not in seronegative patients. We found that DR4
      was significantly associated with nodules (RR = 6.4), with extraarticular
      features (EAF) (RR = 4) and with erosions (RR = 3) compared with controls. The
      subgroups with nodules and EAF had a DR4 frequency (respectively, of 52 and 40%)
      which was significantly higher than that observed in remaining patients
      (respectively, 25 and 24%). No significant difference was observed in the DR4
      frequency between the patients with erosions and those without (34 vs 18%). Thus,
      DR4 in our population seems to be predominantly associated with a subgroup of
      patients characterized by seropositivity and EAF.

PMID- 1629823
TI  - High dose intravenous methotrexate for refractory rheumatoid arthritis.
AB  - Eight patients with active rheumatoid arthritis were given high dose intravenous
      methotrexate (MTX) (500 mg/m2) followed by oral leucovorin every 2 weeks for up
      to 6 months. All patients enrolled had previously failed conventional MTX
      therapy. Five patients completed 6 months of therapy. Three withdrew early, one
      due to inefficacy, one due to gastrointestinal intolerance and one due to
      sciatica requiring hospital admission. Fifty percent or greater improvements were
      seen in 5 of 8 clinical variables in those patients who completed 6 months of
      therapy. Six of 8 improvements achieved statistical significance at 24 weeks.
      Upon discontinuing therapy, patients flared within 8 to 12 weeks. Those who were
      maintained by low dose MTX after the high dose protocol were able to sustain
      their improvement throughout the subsequent 6 months of followup.

PMID- 1629824
TI  - Japanese diagnostic criteria for mixed connective tissue disease in Caucasian
      patients.
AB  - Preliminary Japanese diagnostic criteria for the classification of mixed
      connective tissue disease (MCTD) were tested in a group of 32 Caucasian patients
      with this disease. Many clinical and laboratory similarities were found between
      Caucasian and Japanese patients. However, polyarthritis was more frequent in the
      Caucasians, while finger and hand swelling, DLCO reduction and muscle involvement
      were more frequent in the Japanese. In Caucasians the sensitivity of this
      criteria set was 87%, very similar to that found in the Japanese group (88%), and
      the specificity was 94%, higher than that of Japanese (87%). The difference
      resulted from the higher specificity of anti-nRNP antibody positivity in the
      Caucasian patients, probably due to the use of counterimmunoelectrophoresis in
      the detection of this antibody. The Japanese criteria seem more useful than
      others because they allow the use of techniques other than passive
      hemagglutination in detecting the anti-nRNP antibody. In our experience, such
      criteria also contribute to a better definition of MCTD in Caucasian patients.

PMID- 1629825
TI  - Antibiotic allergy in systemic lupus erythematosus: a case-control study.
AB  - Antibiotic allergy, especially to sulfonamides, has been reported as both a
      predisposing factor and as an exacerbating agent in systemic lupus erythematosus
      (SLE). We surveyed 221 members of The Johns Hopkins Lupus Cohort and 2 control
      groups, consisting of 178 relatives and 186 best friends, for antibiotic allergy
      to penicillin/cephalosporins, sulfonamides, tetracyclines, and erythromycin.
      Antibiotic allergy was common in patients with SLE exposed to the drug: 27%
      penicillin/cephalosporin, 31% sulfonamide, 7% tetracycline, and 13% erythromycin.
      In all cases, the most common allergic reaction was rash. Worsening of SLE
      occurred in 21% of sulfonamide allergic reactions. Allergy to
      penicillin/cephalosporin (OR 2.3, 95% CI 1.5-3.6), sulfonamides (OR 2.4, 95% CI
      1.2-4.7) and to erythromycin (OR 4.8, 95% CI 1.5-14.9) was significantly more
      common in exposed patients with SLE than in exposed controls. Thus, antibiotic
      allergy is a frequent finding in patients with SLE and, in the case of
      sulfonamide allergy, can be associated with lupus exacerbation.

PMID- 1629826
TI  - Polymyalgia rheumatica and seronegative rheumatoid arthritis may be the same
      entity.
AB  - Of 159 patients with either polymyalgia rheumatica, seronegative rheumatoid
      arthritis (RA) or an undifferentiated syndrome with features of both who were
      followed for at least 30 months, synovitis recurred in 57. Twenty of the 57
      patients had one episode of polymyalgia and another that looked like RA.
      Recurrences responded to prednisone and no joint destruction was seen. Temporal
      arteritis was seen with both diagnoses. These observations suggest that a benign
      symmetric synovitis occurs in older patients and may present as polymyalgia or as
      a polyarthritis that resembles RA.

PMID- 1629827
TI  - Giant cell arteritis and polymyalgia rheumatica in a region of Finland: an
      epidemiologic, clinical and pathologic study, 1984-1988.
AB  - The occurrence of giant cell arteritis (GCA) (considering temporal arteritis and
      polymyalgia rheumatica as its manifestations) was investigated in Western Nyland,
      Finland. Between 1984 and 1988 54 patients were diagnosed in a population of
      about 44,500. Fourteen patients (26%) had biopsy proven arteritis at the initial
      evaluation, and 2 patients became biopsy positive during followup. The
      retrospectively determined annual incidence of GCA in a 44 month period was
      22.5/10(5) in the whole population, and 69.8/10(5) in residents aged 50 years or
      older. The corresponding figures of a prospective 16 month study were 30.4/10(5)
      and 94.4/10(5). The incidence rates of the prospective study are higher than
      those reported in comparable studies. Polymyalgia rheumatica, occurring alone or
      combined with cranial symptoms, was the most frequent manifestation of GCA, being
      present in 87% of patients.

PMID- 1629828
TI  - Temporal arteritis in a northwestern area of Spain: study of 57 biopsy proven
      patients.
AB  - Fifty-seven patients, diagnosed with temporal arteritis by biopsy from 1981 to
      1990, were studied. The average annual incidence rate/100,000 population aged 50
      and older, which was slightly lower than those from other Mediterranean countries
      of Europe, was 6. Apart from a predominance of males, age, clinical and
      laboratory features were similar to those reported from other parts of the world.
      All patients received corticosteroid therapy, the majority of them recovered
      completely. Fifty-four were followed; 34 had already finished treatment (mean: 22
      months, range: 12-50). Relapses occurred more commonly after 12 months of
      therapy, when the amount of prednisone given was low or discontinued.

PMID- 1629829
TI  - Peripheral arthralgic presentation of fibrositis/fibromyalgia syndrome.
AB  - Of 216 consecutive new referrals to a general rheumatology clinic 22 (10.2%) had
      generalized fibromyalgia syndrome (FS). In 12 cases (5.6% of all referrals, 54.5%
      of patients with FS) the initial presentation was with pain in the region of the
      hand or wrist joints, but many other joints were painful or tender. Although
      there may be initial confusion with rheumatoid or osteoarthritis, the positive
      features of FS confirm the correct diagnosis.

PMID- 1629831
TI  - International symposium on psoriatic arthritis.

PMID- 1629830
TI  - Relation between fibrositic and control site tenderness; effects of dolorimeter
      scale length and footplate size.
AB  - Recent data have suggested a correlation between the tenderness measured at
      tender and control sites, differing from earlier studies indicating site specific
      tenderness. In our study, the "constant control" model is tested against the
      "correlated control" model, in which control site tenderness varies with
      fibrositic site tenderness. Our study also addresses relevant technical issues in
      dolorimetry. We measured threshold of tenderness at 4 sites (2 fibrositic and 2
      control) on 21 subjects, using dolorimeters with a 17 kg scale limit, and 3
      different footplates, 0.7, 1.4 and 2.0 cm in diameter. To measure observer
      variation, we used multiple replications by multiple observers, obtaining in all
      1,416 observations. There was a strong relationship between control and
      fibrositic site tenderness with control thresholds twice as high (half as
      tender). Scale length and dolorimeter footplate size each had important effects.
      The site specific approach is valuable diagnostically, but more broadly operative
      mechanisms should be the focus of research and therapy.

PMID- 1629832
TI  - Influence of pregnancy on disease activity in a patient with palindromic
      rheumatism.
AB  - A 30-year-old woman with a 12-year history of palindromic rheumatism without
      progression to chronic arthritis experienced pronounced reduction of arthritic
      symptoms during both of her 2 pregnancies with, on each occasion, symptoms
      recurring 3 months after delivery. This is the first reported case suggesting an
      ameliorating effect of pregnancy on disease activity in palindromic rheumatism.

PMID- 1629833
TI  - Transient myopia with severe chemosis associated with exacerbation of disease
      activity in systemic lupus erythematosus.
AB  - A 46-year-old woman with systemic lupus erythematosus (SLE) developed bilateral
      transient myopia and periorbital edema with severe chemosis. Her myopia was
      ascribed to a refractive abnormality that was caused by curvature change and
      anterior displacement of the lenses and the ciliary bodies due to anterior ocular
      edema. The conditions were not associated with systemic edema or abnormality in
      the fundi and responded well to the systemic administration of corticosteroid.
      The course of the ocular symptoms paralleled changes of serum CH50 and anti-dsDNA
      antibody levels. Thus it was concluded that her ocular symptoms were closely
      related to activity of her SLE and may be considered a feature of SLE.

PMID- 1629834
TI  - Inclusion body myositis in association with vitamin B12 deficiency and Sjogren's
      syndrome.
AB  - Autoimmune disorders are very rarely associated with inclusion body myositis
      (IBM). We describe a patient with IBM in association with Sjogren's syndrome (SS)
      and Vitamin B12 deficiency. B12 deficiency has not been reported in SS, and this
      deficiency may explain the neuropathic features of some patients with IBM.

PMID- 1629835
TI  - Trichinosis with severe myopathic involvement mimicking polymyositis. Report of a
      family outbreak.
AB  - We describe an outbreak of trichinosis in 3 members of a rural family. In the 3
      patients eating raw pork was the source of infection. They presented with
      myalgias and severe proximal muscle weakness mimicking polymyositis. The
      diagnosis was made by demonstration of larvae of Trichinella spiralis in the
      muscle biopsy and also by the presence of anti-Trichinella antibodies detected by
      double immunodiffusion in their sera. We call attention to the unusual clinical
      presentation of trichinosis in our patients that was manifested by severe muscle
      weakness that may be confused with polymyositis.

PMID- 1629836
TI  - Chronic syphilitic polyarthritis mimicking systemic lupus
      erythematosus/rheumatoid arthritis as the initial presentation of human
      immunodeficiency virus infection.
AB  - Syphilitic arthritis has been well characterized but not previously described as
      the initial presentation of human immunodeficiency virus (HIV) infection. Our
      patient presented with chronic symmetric polyarthritis and autoimmune
      abnormalities, including positive rheumatoid factor, antinuclear antibody, dsDNA,
      and initially negative syphilis serologies. Subsequent investigations revealed
      HIV seropositivity, depletion of CD4 cells, and strongly positive syphilis
      serologies. Our patient's arthritis completely resolved with penicillin therapy.

PMID- 1629837
TI  - Human T lymphotropic virus I, myelopathy, polymyositis and synovitis: an
      expanding rheumatic spectrum.
AB  - A black woman developed chronic myelopathy, polymyositis and synovitis. Although
      native of a nonendemic area the possibility of human T lymphotropic virus I
      association was considered. She tested positive and was serendipitously found to
      have been positive 16 years before. Risk factors were a transfusion and work as a
      serology technician. Sjogren's syndrome, alveolitis, gammopathy and immune
      dysfunction are other rheumatic manifestations of this virus.

PMID- 1629838
TI  - Pigmented villonodular synovitis presenting as a subcutaneous mass at the knee.
AB  - We describe a 45-year-old man who developed a painful mass about his knee.
      Magnetic resonance imaging demonstrated a well defined lesion, and biopsy
      confirmed a diagnosis of pigmented villonodular synovitis. Our case exemplifies a
      primary synovial process presenting as a subcutaneous tumor. Such diagnostic
      possibilities, although rare, should be more widely known.

PMID- 1629839
TI  - Close temporal and anatomic relationship between multicentric
      reticulohistiocytosis and carcinoma of the breast.
AB  - We describe a case of simultaneous development of a medullary carcinoma of the
      breast and multicentric reticulohistiocytosis (MRH) with identical characteristic
      histological lesions being found not only in the skin and synovium, but also in
      close proximity to the breast cancer as well as the connective tissue surrounding
      the tumor involved axillary lymph nodes. Successful treatment of the primary
      malignancy resulted in complete resolution of the MRH over 4 months. A close
      temporal relationship existed between the development and clinical remission of
      the malignancy and the course of the arthritis and skin lesions. Characteristics
      of this rare syndrome with particular reference to its association with
      malignancy are reviewed.

PMID- 1629840
TI  - Staphylococcus lugdunensis arthritis: a complication of arthroscopy.

PMID- 1629841
TI  - Favorable outcome with ketoconazole in Candida septic arthritis.

PMID- 1629843
TI  - Complications of hormone replacement therapy in post-menopausal women.

PMID- 1629842
TI  - Pathogenesis of multiple sclerosis.

PMID- 1629844
TI  - The one-tool technician.

PMID- 1629845
TI  - Magic and mountebanks in the development of psychiatric thought.

PMID- 1629846
TI  - Urinary incontinence among patients with arthritis--a neglected disability.
AB  - Urinary tract pathology may be no more common in patients with arthritis than
      among the general population, but its impact may be enhanced by disability. In
      this survey of 247 patients, as many as 38% of patients with rheumatoid arthritis
      (RA), 47% of patients with osteoarthritis (OA) and even 34% of patients with soft
      tissue rheumatism (STR) reported difficulty controlling their urine, confirming
      that incontinence is a widespread and often under-reported problem. More detailed
      enquiry in a sample of 90 patients with OA or RA did not suggest specific urinary
      tract pathology related to the underlying arthritis. Those who reported problems
      with urinary control were more disabled, and took longer to get to the toilet in
      their own environment than those without control problems. Twenty-seven per cent
      of patients felt that their problems would be solved by provision of a downstairs
      toilet. Timing of tasks performed by patients within their home is suggested as a
      method for assessing functional ability which encompasses both patient disability
      and environmental factors.

PMID- 1629847
TI  - Endometrioid carcinoma of the prostate: a misnomer?
AB  - The origin of this unusual variant of carcinoma of the prostate has provoked
      discussion ever since its first description in 1967. This is of both
      embryological interest and therapeutic importance. Four cases have been reviewed,
      and all have demonstrated immunohistochemical features consistent with an origin
      from prostatic tissue. In addition, three had evidence of disseminated disease
      which responded well to androgen ablation. It is concluded that the term
      endometrioid carcinoma is of descriptive value only, and these tumours are a
      variant of primary duct prostatic carcinoma. Patients should be treated by
      androgen ablation when metastases are present.

PMID- 1629848
TI  - Endometrial cells in the peritoneal cavity after laparoscopy and chromotubation.
AB  - The presence of endometrial cells in peritoneal fluid before and after
      laparoscopy and chromotubation was studied in 35 patients at different days of
      the menstrual cycle. Endometrial cells were found more frequently in peritoneal
      fluid samples taken in the second half of the menstrual cycle.

PMID- 1629849
TI  - Computerized assessment in neuropsychiatry using CANTAB: discussion paper.

PMID- 1629850
TI  - Computerized assessments of psychiatric disorder using PROQSY: discussion paper.

PMID- 1629851
TI  - Recombinant natural anticoagulants: a review.

PMID- 1629852
TI  - Benedict Duddell: pioneer oculist of the 18th century.

PMID- 1629853
TI  - Ancient neurilemmoma of the pelvis.

PMID- 1629854
TI  - Chronic adult T-cell leukaemia/lymphoma presenting with cutaneous manifestations.

PMID- 1629855
TI  - Ulcerative colitis and bleeding from a colonic vaginoplasty.

PMID- 1629856
TI  - Unusual telangiectasia in a nuclear veteran.

PMID- 1629857
TI  - 'Spontaneous' rectus sheath haematoma: a rare cause of abdominal pain.

PMID- 1629858
TI  - Compression screw migration with the sliding hip screw.

PMID- 1629859
TI  - Drug treatment of emotionalism following brain damage.

PMID- 1629860
TI  - Helicopters.

PMID- 1629861
TI  - Helicopters.

PMID- 1629862
TI  - Helicopters.

PMID- 1629863
TI  - Compensation for injury--re-appraisal.

PMID- 1629864
TI  - The centre thought to control sensory and motor activity in the early history of
      medicine.

PMID- 1629865
TI  - The centre thought to control sensory and motor activity in the early history of
      medicine.

PMID- 1629866
TI  - The strange case of Ms Elizabeth Trevers.

PMID- 1629868
TI  - Breastfeeding while HIV-infected.

PMID- 1629867
TI  - Renal artery embolism.

PMID- 1629869
TI  - Call to protect health workers.

PMID- 1629870
TI  - Freephone pollutants.

PMID- 1629871
TI  - Education and young people with inflammatory bowel disease.
AB  - Children and their parents are often anxious that chronic disease may interfere
      with examination performance. The provision within schools for children with
      inflammatory bowel disease (IBD) was investigated by a postal survey of
      headteachers of 98 schools with over 48,000 pupils in Leicestershire and Cardiff.
      Headteachers in Cardiff were more likely to have heard of ulcerative colitis
      (95%) than those in Leicestershire (70%), (X2 = 4.5, p less than 0.05). They knew
      of 16 children with inflammatory bowel disease. The majority of heads provide
      easy access to lavatories during examinations and would tell the examining body
      of a child's medical problem. While most heads would like more information about
      inflammatory bowel disease, few have facilities to inform teachers about chronic
      illness in young people. Most think healthy young people should be provided with
      information about chronic diseases, which they would like provided by nurses.
      Inflammatory bowel disease (IBD) affects over 1200 children in the United
      Kingdom. Children and their parents are concerned that these conditions will
      interfere with schooling, taking examinations and their employment (Rees et al
      1983, Wyke et al 1988). Provisions by schools for children with IBD were
      investigated.

PMID- 1629872
TI  - Nutrient intakes of university women in Kuwait.
AB  - This study assessed the nutrient intakes of 203 female college students, aged 20
      31 years, mean 21 years. Results from computer analysis of 3-day food records
      showed that, on the basis of group means, two thirds of Recommended Daily
      Allowance (RDAs) was met for all nutrients except iron, zinc, folacin and vitamin
      D. Nutrient intake and RDAs showed no significant differences related to marital
      status with the exception of vitamin D and manganese (p less than 0.05). The
      indexes of Nutritional Quality indicated that, on average, diets of the students
      met or exceeded nutrient density allowance for protein, vitamin A, vitamin C,
      thiamin, riboflavin, niacin, vitamin B6 and phosphorus. Nutrients for which the
      average female student consumption was below recommended standards on a calorie
      basis, were carbohydrates, fat, vitamin D, folacin, calcium, iron, zinc and
      sodium. The diets were limited in fibre, high in sugar, high in caffeine and
      slightly above recommendations in cholesterol. Female college students needed
      guidance in selecting nutrient dense foods. Attention in nutrition education
      programmes should be directed toward the individual student rather than the
      group.

PMID- 1629873
TI  - Water for thought!--Private water supplies and the consumer factor.
AB  - Individual supplies from non-mains water to private dwellings were studied in a
      local area of East Devon. Underground spring water piped from hilltop level to
      holding tanks, or gathered at ground level for household wells, was tested for
      bacterial contamination at its point of use. Purification methods if any, and
      their maintenance were observed.

PMID- 1629874
TI  - Contact between injecting drug users and general practitioners and its
      implications for health education.

PMID- 1629875
TI  - Gifted children.

PMID- 1629876
TI  - Stress, mental health and crime.

PMID- 1629877
TI  - 214 days on--has it worked for patients?

PMID- 1629878
TI  - Medicines, health and the fast of Ramadan.

PMID- 1629879
TI  - Some medical problems affecting the ethnic minorities of the UK.
AB  - As a result of numerous influences, some genetic and others environmental,
      disease patterns in many of the minor ethnic groups are often at variance with
      those affecting the long established indigenes of the United Kingdom. Also,
      several important infective conditions can be acquired during brief visits to the
      land of their birth, or of their ancestors. As integration into the life-style of
      the UK becomes increasingly established, several diseases of the 'westernised' or
      'industrialised' nations are assuming a major importance in these groups. The
      last few decades have witnessed the arrival of so many diverse groups from nearly
      all parts of the world that an intimate and in-depth knowledge of these disease
      patterns is now essential to the pursuance of competent medical practice in the
      UK.

PMID- 1629880
TI  - Malcolm Morris Memorial Lecture:-AIDS in the 1990s: a global analysis.

PMID- 1629881
TI  - Public health in the United States.

PMID- 1629883
TI  - Meat inspection and the veterinary profession by Mr K Stewart.

PMID- 1629882
TI  - Management of migraine in adults by Dr E A MacGregor, February 1992.

PMID- 1629884
TI  - Effects of sympatho-adrenal activation on the finger microcirculation in mild
      hypertension.
AB  - Finger skin circulatory responses to three forms of sympatho-adrenal activation
      were investigated in 14 patients with mild hypertension and 14 matched
      normotensive controls. Finger nailfold skin capillary blood cell velocity was
      measured by video-photometric capillaroscopy and finger pulse volume by strain
      gauge plethysmography (digital arterial pulse amplitude; DAPA). DAPA decreased
      more markedly in the normotensive as compared with the hypertensive group during
      mental arithmetic stress (38 vs. 19%; P less than 0.05) and a cold pressor test
      (55 vs. 32%; P less than 0.05). Intravenous infusions of adrenaline (0.1-0.8
      nmol/kg/min) decreased DAPA in normotensives but not in hypertensives (P less
      than 0.05). Capillary blood cell velocity was similar in the two groups at rest
      and decreased promptly and to a similar extent in both groups following mental
      arithmetic, adrenaline infusion and the cold pressor test (by approximately 60,
      60 and 35%, respectively). It is concluded that mental stress and the cold
      pressor test induce instantaneous and marked effects on the skin circulation via
      neurogenic activation. The less marked effect on DAPA in the hypertensive group
      may reflect an elevation of basal vascular tone and/or early structural vascular
      changes in mild hypertension. The discrepancy between total finger and capillary
      circulatory responses to adrenaline may be attributable to different adrenoceptor
      populations and/or sensitivity in arteriovenous shunts, as compared with
      precapillary vessels.

PMID- 1629885
TI  - ACE inhibition improves insulin-sensitivity in aged insulin-resistant
      hypertensive patients.
AB  - We have compared the cardiovascular and metabolic responses to five different ACE
      inhibitors in 86 patients matched for age, body mass index, blood pressure,
      fasting plasma glucose and insulin levels in a placebo-controlled, double-blind,
      crossover, randomised trial. In the active drug treatment phase the patients were
      randomly assigned to one of five ACE inhibitors: captopril (75 mg/day; n = 16);
      enalapril (20 mg/day; n = 14); quinapril (20 mg/day; n = 17); ramipril (5 mg/day;
      n = 21) and lisinopril (20 mg/day; n = 18). Placebo and ACE inhibition phases
      lasted two weeks and were separated by a one week wash-out period. At the end of
      each treatment period blood pressure and heart rate were recorded and a fasting
      sample intravenous glucose tolerance test was conducted. Our study demonstrated
      that ACE inhibition significantly reduces blood pressure and improves insulin
      sensitivity. All the ACE inhibitors studied had similar cardiovascular responses
      but lisinopril displayed the larger metabolic response.

PMID- 1629886
TI  - Measurement of capillary cholesterol as an aid to the management of hypertensive
      patients with hyperlipidaemia--an assessment of the Reflotron.
AB  - The Reflotron dry chemistry method of capillary cholesterol measurement has been
      widely adopted as a rapid means of population screening. We attempted to use it
      to monitor changes in cholesterol in a trial of intensive dietary intervention in
      hyperlipidaemic hypertensives. Four hundred and eighty-nine capillary cholesterol
      levels measured by the Reflotron were compared with levels for venous samples
      obtained simultaneously and assayed by the Biochemistry Department using
      conventional laboratory methods. The mean difference between them was 0.3 mmol/l
      +/- 0.8 (SD). Approximately one-third of the variability in the difference
      between the two methods was explained by the variables, Reflotron machine used
      and time (R2 = 54%, adjusted R2 = 34%). We conclude that the Reflotron is not
      suitable for accurate assessment of the modest changes in cholesterol which occur
      in individual patients during dietary intervention.

PMID- 1629887
TI  - Comparison of office and serial automatic blood pressure readings in renovascular
      and essential hypertension.
AB  - Office blood pressures were compared with those obtained using a thirty minute
      recording with an automatic device (Dinamap) in thirty patients with essential
      hypertension and nineteen subjects with hypertension and renal artery stenosis.
      When matched for age and sex, no differences were found between both groups of
      patients with respect to their office or automatically recorded blood pressures.
      The difference between office and automatically assessed systolic blood pressures
      was similar in both groups. The difference in diastolic pressures was slightly
      larger in the group with renal artery stenosis. The number of patients showing a
      pressure drop greater than 10 mm Hg was comparable in the two groups. We conclude
      that blood pressure levels obtained in the office overestimate 'true' blood
      pressure not only in essential but also in renovascular hypertension.

PMID- 1629888
TI  - Analysis of factors related to hypertension in Japanese middle-aged male workers.
AB  - A total of 789 Japanese male transport service workers between the ages of 35 and
      50 were used as subjects in an analysis of daily lifestyle factors related to
      hypertension. Multiple logistic analysis showed positive dose-response relations
      between hypertension and age, obesity and alcohol consumption. Age and obesity
      were factors having a linearly increasing odds ratios for hypertension (including
      borderline cases and those under treatment). Alcohol consumption of 56 g ethyl
      alcohol per day or more had an odds ratio about double that of those who did not
      drink. Smokers had 1/2 the odds ratio of non-smokers. Subjects working a 24-hr
      shift comprised mostly of standby duty showed a slightly lower rate of
      hypertension, but it was statistically insignificant.

PMID- 1629889
TI  - Correlates of blood pressure differ in high and in low plasma renin groups.
AB  - It has been proposed that the aetiology, pathophysiological status, and effective
      treatment of hypertensives depends on concomitant plasma renin levels.
      Epidemiological data are scarce on the interrelations of plasma renin activity
      (PRA), BP and correlates of BP in the general population. Therefore, profiles of
      BP correlates were compared between low PRA groups and high PRA groups in a
      relatively healthy population of 321 Chinese government employees working in the
      Taipei area, in the summer of 1987. The characteristics of the two PRA groups
      were similar in body mass index, urinary sodium, chloride, calcium excretion and
      fasting parathyroid hormone. However, the high PRA group was younger, smoked
      more, and had a higher mean urinary potassium excretion. Fasting plasma glucose,
      uric acid, and creatinine levels were lower in the low PRA group. Positive
      relationships between BP and urinary sodium, chloride, potassium, calcium, plasma
      cholesterol, triglyceride, and glucose, independent of age and body mass index,
      were demonstrated in the low PRA group, where a volume expansion state may exist.
      However, in the high PRA state, uric acid, haemoglobin concentration, insulin and
      parathyroid hormone level were correlated more closely with BP than in the low
      PRA state. Further studies are needed to examine whether the differing
      associations between BP and risk factors in the high and low PRA groups reflect
      different compensatory mechanisms or aetiological factors.

PMID- 1629890
TI  - First dose hypotension after captopril; can it be predicted? A study of 240
      patients.
AB  - We have studied prospectively the acute blood pressure lowering effect on an oral
      dose of captopril, 25 mg in 240 hypertensive patients. The mean relative
      reduction of systolic and diastolic BP was 16 and 15% respectively and the mean
      time to the mean arterial pressure nadir was 59 minutes. Systolic BP fell by more
      than 30% in 4.6% of patients and diastolic BP and mean arterial pressure dropped
      by more than 30% in 4.2 and 3.3% of patients respectively. Patients over 60 years
      of age showed a significantly larger fall in systolic and diastolic BP. Patients
      with renal artery stenosis reached the BP nadir in a significantly shorter time
      compared with patients with essential hypertension (50.5 vs. 59.7 minutes, P less
      than 0.05) and showed a significantly larger fall in systolic BP (20.7 vs. 15.4%,
      P less than 0.05). A forward stepwise regression analysis showed that only
      baseline plasma renin activity had a significant relation to the fall in BP (P
      less than 0.01, R = 0.57). We conclude that according to our definition of a
      greater than 30% decrease of the mean arterial pressure, a first dose hypotension
      after captopril was seen in 3.3% of 240 patients. Captopril treatment should be
      introduced carefully since not all those patients at risk of hypotension can be
      identified in advance.

PMID- 1629891
TI  - The short term effects of oral labetalol in patients with chronic renal disease
      and hypertension.
AB  - This double-blind, controlled, crossover study compared the effects on blood
      pressure control, glomerular filtration rate (GFR) and effective renal plasma
      flow (ERPF) of labetalol, methyldopa and placebo in patients with chronic renal
      disease and hypertension. When compared with placebo, BP was significantly lower
      during treatment with both labetalol and methyldopa (P greater than 0.05) but did
      not differ significantly between the two active treatment periods; post-exercise
      heart rates were also significantly lower on labetalol than placebo (P less than
      0.05). After treatment with labetalol, ERPF was significantly greater than with
      the placebo (P less than 0.05) but did not differ significantly between the
      active treatments. GFR did not differ significantly between the three groups. No
      significant differences were observed in haematology or liver function test
      results on labetalol compared with placebo. Labetalol is a safe and effective
      antihypertensive in patients with hypertension associated with chronic renal
      disease. In the short term it leads to an increase in ERPF which may be
      beneficial for such patients.

PMID- 1629892
TI  - Hypertension, obesity and response to antihypertensive treatment: results of a
      community survey.
AB  - A random sample of 2,854 subjects aged 35-64 was examined in the town of Vicenza
      (Italy) as part of the 'Hypertension Management Audit Project'. Pearson's
      correlation coefficient and multivariate analysis considering systolic and
      diastolic blood pressure, age and body mass index (BMI) were performed. SBP was
      more closely correlated with age than DBP. BMI correlated with both SBP and DBP,
      but very little with age. Fifty-seven percent of the men had a BMI of 25.5 or
      more and 49% of the women had a BMI of 24.5 or more. The quality of BP control in
      the treated patients was worse in the overweight when compared with the lean
      patients, although overweight and lean patients are treated with the same
      frequency.

PMID- 1629893
TI  - Headache in patients with uncontrolled BP on drug treatment.

PMID- 1629894
TI  - Epidemiological markers of Salmonella typhimurium isolates in Rome.
AB  - The phage type, antimicrobial resistance pattern, colicinogenic activity and DNA
      plasmid content of 172 strains of Salmonella typhimurium isolated in Rome from
      1984 to 1986 were determined; 142 isolates were from patients with enteritis, 30
      were from asymptomatic subjects. Most of the phage types identified were isolated
      during 2 or 3 of the study years; others, e.g., PT141, PT 204c and PT 194 were
      isolated during 1 year only, and only the last of these was isolated in large
      numbers. Phage typing proved most valuable in identifying epidemiologically
      related strains; DNA plasmid analysis was most useful in characterising further
      cultures of the same phage type, especially those isolated during suspected
      epidemics.

PMID- 1629895
TI  - Evaluation of methods for typing coagulase-negative staphylococci.
AB  - One hundred and forty-two coagulase-negative staphylococci (CNS) isolated from
      dialysate effluent or skin of patients receiving continuous ambulatory peritoneal
      dialysis (CAPD) were typed by extended antibiogram (16 antibiotics) and biotype
      (26 reactions). These isolates were then typed by supplementary methods to
      determine the most suitable typing method for an epidemiological study of
      antibiotic resistance. These included phage typing, reverse phage typing, plasmid
      typing, whole-cell protein typing by SDS-PAGE with analysis by densitometry, and
      immunoblotting. The percentage of isolates typed successfully by the
      supplementary methods were: phage typing 20%, reverse phage typing 0%, plasmid
      typing 66%, SDS-PAGE 100%, immunoblotting 100%. The discrimination of each method
      was: phage typing 20%, plasmid typing 37%, SDS-PAGE 69%, immunoblotting 57%.
      Reproducibility was 88% for phage typing and 97% for plasmid typing. The
      reproducibility of the whole-cell protein typing was 83% if the same extracts
      were used but only 43% when separate protein extracts were analysed on separate
      occasions. However, strain relatedness was highly reproducible. The determination
      of an antibiogram-biotype profile was not a sufficiently accurate typing method
      for an epidemiological study of antibiotic resistance. Whole-cell protein typing
      by SDS-PAGE or immunoblotting was technically demanding but was the most
      effective of the supplementary methods for detecting erroneous discrimination and
      false matching produced by antibiogram-biotype combinations.

PMID- 1629896
TI  - Cytopathic effects of Helicobacter pylori on cultured mammalian cells.
AB  - Cytopathic effects of broth-culture filtrates from eight clinical isolates and
      one reference strain of Helicobacter pylori on three cultured mammalian cell
      lines were investigated. All the strains, including NCTC 11637, produced
      cytotoxic factors that caused intracellular vacuolation on these cell lines. AGS
      and SflEp cells were more sensitive than HEp-2 cells. To examine the role of
      urease in the cytotoxic effect, a urease-negative mutant was produced. Filtrates
      from both wild-type and mutant strains produced similar vacuolation on SflEp
      cells in the absence of urea, suggesting that H. pylori produces a cytotoxic
      substance other than urease. In contrast, ammonia alone, or jack bean urease with
      urea, also induced rounding and detachment of SflEp cells, whereas ammonium salts
      induced the production of small vacuoles. The combination of the broth filtrate
      of the wild-type strain and urea induced vacuolation followed by rounding and
      detachment of SflEp cells. Evidence is presented that the latter changes are due
      to ammonia produced during incubation. Nevertheless, the amounts produced were
      less than that needed to induce cytopathic effects by itself. These results
      suggest that the cytotoxic substance induces intracellular vacuolation, and that
      the vacuolated cells are more susceptible to killing by ammonia. Thus both the
      cytotoxic substance and urease may contribute to the lethal cytotoxicity of H.
      pylori in vitro.

PMID- 1629897
TI  - Motility as a factor in the colonisation of gnotobiotic piglets by Helicobacter
      pylori.
AB  - Non-motile variants of Helicobacter pylori (strain 26695) occurred with a
      frequency of 1.6 (SD 0.4) x 10(-4) variants/cell/division cycle, and reversion to
      the motile form occurred with a frequency of less than 10(-7)
      variants/cell/division cycle. The two forms remained greater than 90% pure for up
      to 50 cell divisions and differed only in the presence or absence of motility and
      flagella. Bacteria were recovered from nine of 10 gnotobiotic piglets inoculated
      orally with motile H. pylori, but from only two of eight inoculated with the non
      motile variant. The motile form survived for 21 days in infected piglets, but the
      non-motile variant survived for only 6 days. Bacteria recovered from piglets
      inoculated with the non-motile variant were non-motile. These data support the
      hypothesis that motility is a colonisation factor for H. pylori.

PMID- 1629898
TI  - Cleavage of immunoglobulin A1, A2 and G by proteases from clinical isolates of
      Pasteurella multocida.
AB  - Several Pasteurella multocida strains were examined for their ability to produce
      extracellular enzymes that cleave immunoglobulin A and G (Ig A and Ig G)
      molecules. Two strains isolated from human pulmonary and genital infections
      produced proteases that cleaved human IgA and IgG, colostral IgA and human
      myeloma IgA1 and IgA2. Human IgM was not degraded by these enzymes. Examination
      of cleavage digests showed two main fragments with different electrophoretic
      mobilities. The two P. multocida strains produced a protease that cleaved IgA and
      IgG heavy chains outside the hinge region, and differed in this respect from the
      hinge-cutting proteases of other bacteria. Protease production may be a virulence
      mechanism for P. multocida strains.

PMID- 1629899
TI  - Effect of haemin limitation on the cytochrome complement and glucose metabolism
      of non-typable Haemophilus influenzae.
AB  - Haemophilus influenzae grown to exponential phase or stationary phase in medium
      with a low initial concentration of haemin (0.25 microgram/ml) was virtually
      devoid of cytochromes. Compared with bacteria grown in the presence of excess
      haemin (10 micrograms/ml), the haemin-limited organisms failed to respire formate
      and succinate and, generally, the respiratory rates with other substrates were
      reduced. However, growth rates were not affected by the haemin supply. Haemin
      limited growth was associated with a reduced efficiency of glucose utilisation,
      in terms of glucose growth yields, and affected the net levels of excreted
      organic acids. Haemin limitation resulted in reduced acetate and increased
      succinate accumulation in the culture medium and the novel presence of D-lactate.
      These results indicate that, in contrast to the phenotype expressed in vitro
      during conventional cultivation of H. influenzae, the haemin-limited phenotype,
      which may be expressed in vivo, is characterised by a lack of cytochromes and a
      shift towards a more anaerobic type of metabolism.

PMID- 1629900
TI  - Plasmid content and localisation of the STaI (STaP) gene in enterotoxigenic
      Escherichia coli with a non-radioactive polynucleotide gene probe.
AB  - Enterotoxigenic Escherichia coli (ETEC) strain P2200 of porcine origin possessed
      eight possibly plasmid-determined characters (K88+ Raf+ Hly+ Col+ Smr Tcr Su(r)
      STa+) and six plasmid DNA bands of 4.2-93 kb. Analysis of the spontaneous loss of
      characters and the results of matings with other E. coli strains revealed that
      the K88, Raf, Hly, Smr, Tcr and Su(r) characters could be transferred, and that
      the presence of the K88 and Raf characters was associated with an 83-kb plasmid.
      The presence and location of the STaI gene was investigated in several ETEC
      strains of bovine or porcine origin. Hybridisation with a non-radioactive
      polynucleotide probe associated the STaI gene with a plasmid in each strain;
      these plasmids were of 32-142 kb. In contrast, plasmids from a P2200 STa- variant
      and plasmids from two STa- variants of the bovine ETEC strain B41* (strain B41
      obtained from a different source) did not hybridise with the probe. One of the
      B41*STa- variants had lost the STa plasmid, whereas the second variant retained a
      plasmid of the same size which did not hybridise. In contrast, a third B41*STa-
      variant retained a plasmid of the same size that still hybridised with the STaI
      probe. Plasmid DNA restriction fragment analysis, followed by hybridisation with
      the STaI probe, showed that the STaI gene was associated with 8.3-, 6.8- and 3.5
      kb plasmid fragments in strain B41, and with 4.9-, 6.8- and 3.5-kb plasmid
      fragments in strain B41*, following digestion with EcoRI, BamHI, or EcoRI +
      BamHI, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629901
TI  - Microbes in the air--when to count! (the role of air sampling in hospitals)

PMID- 1629902
TI  - Characterisation of non-pigmented species of the genus Prevotella by
      polyacrylamide gel electrophoresis.
AB  - Gram-negative anaerobic bacilli previously known as the melaninogenicus-oralis
      group of Bacteroides have been assigned to a new genus, Prevotella. The non
      pigmented members of this genus share several general characteristics and cannot
      be readily distinguished by routine tests. A polyacrylamide slab gel
      electrophoresis procedure, with visual analysis of protein patterns, was used to
      compare cellular protein patterns from clinical isolates with those from
      collection (reference) strains. Reference strains of P. oralis, P. veroralis, P.
      buccalis, P. oris, P. buccae, P. zoogleoformans, P. bivia, P. disiens, P. oulora,
      B. (P.) capillus and B. (P.) pentosaceus, and 91 non-pigmented isolates from
      patients with adult periodontal disease were examined by conventional biochemical
      tests, gas-liquid chromatography (GLC) and enzyme tests, and whole-cell protein
      profiles were obtained by SDS-PAGE. There was close correlation between patterns
      of results in biochemical and GLC tests and the SDS-PAGE profiles, and the
      species were readily distinguished in SDS-PAGE. The periodontal isolates were
      assigned to 10 groups by conventional test reaction patterns and nine groups by
      SDS-PAGE; the profiles of 79 isolates corresponded to those of seven species
      reference strains. By SDS-PAGE, clinical isolates of P. buccae (42 isolates) and
      P. oralis (eight isolates) showed good similarity with reference strains.
      However, for P. veroralis (15), P. oris (7), P. bivia (4), P. zoogleoformans (2)
      and P. buccalis (1), clinical isolates showed some minor variations from
      reference strains. Twelve isolates remained undesignated in SDS-PAGE analysis.
      Variant SDS-PAGE profiles divided clinical isolates of P. buccae into two
      subgroups and those of P. veroralis into five subgroups.

PMID- 1629903
TI  - High prevalence of stably derepressed class-I beta-lactamase expression in
      multiresistant clinical isolates of Enterobacter cloacae from Greek hospitals.
AB  - Susceptibilities to cefotaxime (Ctx) and ceftazidime (Caz) were examined for 90
      recent clinical isolates of Enterobacter cloacae from Greek hospitals. Most (68%)
      of the isolates were resistant to both drugs, and all were resistant to
      cefoxitin. beta-Lactamase activities against cephaloridine in crude extracts from
      Ctx-Caz-resistant isolates were high, irrespective of whether or not the cells
      were grown with cefoxitin as an inducer of the chromosomal beta-lactamase,
      indicating stable derepression of the gene for the enzyme. On the other hand,
      double disk antagonism tests showed that all the Ctx-Caz-sensitive isolates
      possessed inducible expression of this beta-lactamase. Iso-electric focusing
      revealed the presence of five forms of the chromosomal beta-lactamase, randomly
      distributed amongst the Ctx-Caz-resistant and -sensitive isolates. Plasmid
      mediated beta-lactamases of TEM and PSE types also were found in many isolates.
      These data indicate that the extremely high prevalence of Ctx-Caz-resistant E.
      cloacae isolates in Greek hospitals is attributed to the dissemination of mutants
      which constitutively overproduce the class-I chromosomal beta-lactamase. Over 90%
      of these isolates exhibited cross-resistance to aminoglycosides, suggesting the
      accumulation of unrelated antibiotic resistance mechanisms.

PMID- 1629904
TI  - Analysis of genetic variability of penicillinase non-producing Neisseria
      gonorrhoeae strains with different levels of resistance to penicillin.
AB  - Genetic variability among 41 penicillinase non-producing Neisseria gonorrhoeae
      strains, isolated in Spain, with different levels of resistance to penicillin was
      investigated by multilocus enzyme electrophoresis. Based on the results obtained
      by analysis at seven enzyme loci, the strains were separated into 17
      electrophoretic types. The average number of alleles/enzyme locus was 2.85; the
      mean genetic diversity/locus was 0.49 for individual isolates and 0.516 for
      electrophoretic types. The results showed that these gonococcal strains were,
      genetically, a highly variable group of organisms.

PMID- 1629905
TI  - Activation of skeletal muscle nicotinic acetylcholine receptors.
AB  - Work over the past ten years has greatly increased our understanding of both the
      structure and function of the muscle nicotinic acetylcholine receptor. There is a
      strongly supported general picture of how the receptor functions: agonist binds
      rapidly to sites of low affinity and channel opening occurs at a rate comparable
      to the agonist dissociation rate. Channel closing is slow, so the channel has a
      high probability of being open if both agonist-binding sites are occupied by ACh.
      Results of expression studies have shown that each subunit can influence AChR
      activation and have given a structural basis for the major physiological change
      known for muscle AChR, the developmental change in AChR activation. These general
      statements notwithstanding, there are still major areas of uncertainty which
      limit our understanding. We have emphasized these areas of uncertainty in this
      review, to indicate what needs to be done. First, the quantitative estimates of
      rate constants are not as strongly supported as they should be. The major reasons
      are twofold--uncertainties about the interpretation of components in the kinetic
      data and difficulties of resolving brief events. As a result, any inferences
      about the functional consequences of structural alterations must remain tenuous.
      Second, the functional behavior of individual AChRs is not as well understood as
      it should be. The kinetic behavior of an individual receptor clearly can be
      complex (section II). In addition, there is evidence that superimposed on this
      complexity there may be stable and kinetically distinguishable populations of
      receptors (section III). Until the basis for the kinetically defined populations
      is clarified, kinetic parameters for receptors of defined structure cannot be
      unambiguously obtained. Finally, it is not surprising that the studies of AChR of
      altered structure have not given definitive results. Two reasons should be
      apparent from the preceding points: there is not a fully supported approach for
      kinetic analysis, and the "normal" population may not be clearly defined. An
      additional complication is also emerging, in that the available data support the
      idea that specific residues distributed over all subunits may influence AChR
      activation. This possibility renders the task of analysis that much more
      difficult. The muscle nicotinic AChR has served as a prototype for the family of
      transmitter-gated membrane channels, which includes the muscle and neuronal
      nicotinic receptors, the GABAA, the glycine and possibly the non-NMDA excitatory
      amino acid receptor (Stroud et al., 1990). It is interesting to note that the
      functional properties of the GABAA receptor, probably the best-studied of the
      other members of the family are rather similar.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1629906
TI  - K-induced alkalinization in all cell types of rabbit gastric glands: a novel K/H
      exchange mechanism.
AB  - Digital image processing of the pH-sensitive dye BCECF was used to examine the
      effects of high [K] media on cytoplasmic pH (pHi) of individual cells within
      isolated rabbit gastric glands. When cells were acidified to pHi 6.5 from the
      resting pHi of 7.2-7.3 and then exposed to solution containing 77 mM K plus
      amiloride (to block Na/H exchange), recovery to pHi 7.0 was observed. This K
      induced alkalinization occurred in all cell types of the gland, including cells
      within antral glands that were devoid of parietal cells (PC). This process was
      independent of extracellular Na and Cl and was unaffected by: 5 mM Ba or 200
      microM bumetanide, or acute treatment with either 500 microM ouabain or 100
      microM cimetidine, histamine or carbachol. SCH28080, which inhibits the PC H/K
      ATPase when used in the low microM range of concentrations, blocked the K effect
      on pHi at 100 microM but was ineffective at 1 microM. A similar pHi recovery was
      also stimulated by Li, Cs (both 72 mM), and Tl (10 mM), in the order Li greater
      than K greater than Cs greater than Tl (all in the presence of amiloride), and
      these alkalinizations were also blocked by 100 microM SCH28080. Parallel
      experiments were performed to test the effect of these ions on 14[C]-aminopyrine
      accumulation, an index of acid secretion by the H/K-ATPase at the lumenal
      membrane of the PC. There was no correlation between the rates of cation-induced
      pHi recovery from an acid load and H secretion as measured by the accumulation of
      aminopyrine. We conclude that the K- (and Cs- and Li-) dependent pHi recovery is
      mediated by a novel cation/H exchange mechanism that is distinct from the PC H/K
      ATPase.

PMID- 1629907
TI  - Regulatory volume increase in Ehrlich ascites tumor cells is mediated by the
      1Na:1K:2Cl cotransport system.
AB  - After swelling in hyposmotic solution, Ehrlich ascites tumor cells shrink towards
      their original volume. Upon restoration of isosmolality (300 mOsM) the cells
      initially shrink but subsequently recover volume. This regulatory volume increase
      (RVI) is completely blocked when [Na+]o or [Cl-]o is reduced by 50% in the
      presence of normal [K+]o. With normal [NaCl]o but less than 2 mM [K+]o, not only
      is volume recovery blocked but the cells lose KCl and shrink. When [K+]o is
      increased to 5 mM there is a rapid net uptake of K+ and Cl- which results in
      volume recovery. This suggests that the reswelling phase requires the
      simultaneous presence of Na+, K+, and Cl-. Although ouabain has no effect on
      volume recovery, bumetanide completely blocks RVI by inhibiting a cotransport
      pathway that mediates the net uptake of Na+, K+ and Cl- in the ratio of
      1Na:1K:2Cl. Na+ that accumulates is then replaced by K+ via the Na/K pump.

PMID- 1629908
TI  - Metastatic models and molecular genetics of prostate cancer.

PMID- 1629910
TI  - Treatment costs warrant closer look in clinical trials.

PMID- 1629911
TI  - Will NIH patent bid cause "land rush"?

PMID- 1629909
TI  - Racial variation in cancer incidence: fact or artifact?

PMID- 1629912
TI  - Doctors change breast cancer treatment practices.

PMID- 1629913
TI  - Scientists, activists discuss DES issues.

PMID- 1629914
TI  - Pilot study of interleukin-2 and lymphokine-activated killer cells combined with
      immunomodulatory doses of chemotherapy and sequenced with interferon alfa-2a in
      patients with metastatic melanoma and renal cell carcinoma.
AB  - BACKGROUND: Experiments in animal tumor models suggest that the antitumor effects
      of interleukin-2 (IL-2) or IL-2 in combination with lymphokine-activated killer
      (LAK) cells can be enhanced by chemotherapy agents such as cyclophosphamide or
      doxorubicin or by the biologic agent interferon alpha. PURPOSE: We determined the
      toxicity and clinical response rate of an IL-2-LAK cell regimen modified by the
      addition of moderate, immunomodulatory doses of chemotherapy and sequenced with
      interferon alfa-2a (IFN alpha-2a) in patients with metastatic melanoma and renal
      cell carcinoma. METHODS: IL-2 (3-6 million units/m2 per day) was administered by
      continuous infusion on days 0-5 and days 11-16. LAK cells were infused on days 11
      and 12 or on days 11, 12, and 14. Low doses of cyclophosphamide (300 mg/m2) and
      doxorubicin (25 mg/m2) were given on day 9 before the LAK cell infusions.
      Following the IL-2-LAK cell infusion, IFN alpha-2a (12 million units/m2) was
      administered for a total of nine doses to complete a cycle of treatment. A total
      of 89 patients were enrolled in the study. RESULTS: For each histology, there
      were eight partial responses in 40 assessable patients, for an overall response
      rate of 20% (90% confidence interval = 10%-33%). The median response duration was
      5 months, although two patients with renal cell carcinoma and one patient with
      metastatic melanoma had almost complete disappearance of tumor and are still
      responding after 26+, 22+, and 26+ months, respectively. Toxic effects were
      severe in patients receiving the highest dose of IL-2 administered in this study
      and similar to those reported with other high-dose IL-2-LAK cell regimens.
      Although toxic effects were completely reversible in most patients, there were
      four treatment-related deaths. CONCLUSIONS: This regimen is active in patients
      with metastatic melanoma and renal cell carcinoma and produces meaningful
      responses in a small percentage of these patients; however, it is not clear
      whether cyclophosphamide, doxorubicin, and IFN alpha-2a as used in this protocol
      appreciably augmented the antitumor activity of the IL-2-LAK cell regimen.

PMID- 1629915
TI  - Differences between black and white women with breast cancer in time from symptom
      recognition to medical consultation. Black/White Cancer Survival Study Group.
AB  - BACKGROUND: Studies in the United States have reported that Black women have
      higher fatality rates than White women following a diagnosis of breast cancer and
      are more likely to be diagnosed with late-stage cancers. PURPOSE: To evaluate
      reasons for these racial differences, we explored the difference between Black
      and White women in the length of time from symptom recognition to initial medical
      consultation. We also evaluated the extent to which other factors related to the
      length of this interval might contribute to any observed racial difference.
      METHODS: As part of a collaborative study of differences in the survival rates of
      Black patients and White patients with cancer, we interviewed a sample of 410
      Black women and 325 White women from Atlanta, New Orleans, and San
      Francisco/Oakland who were newly diagnosed in 1985 or 1986 with invasive breast
      cancer. Retrospective data were collected on symptoms, dates of symptom
      recognition and initial medical consultation, and several other factors which may
      affect the interval between symptom recognition and medical consultation. Data
      were analyzed as if from a follow-up study, using product limit procedures and
      proportional hazards regression. RESULTS: At diagnosis, Black women with breast
      cancer were two times more likely to have stage IV breast cancer and one and one
      half times more likely to have stage III breast cancer than White women with
      breast cancer and were only approximately one-half as likely to have stage I
      breast cancer. Similarly, Black women were almost twice as likely as White women
      to have tumors that were larger than 5 cm or tumors that had extensions to the
      chest wall or skin at presentation. However, the average rate at which Black
      women with breast cancer obtained an initial medical consultation lagged behind
      that for White women by only a slight but statistically significant difference
      (15%). The median time between symptom recognition and medical consultation was
      slightly longer for Black women (16 days) than for White women (14 days) (P =
      .06). Adjustment for other characteristics predictive of the length of this
      interval had little effect on racial differences. The racial differences tended
      to vary somewhat by age and metropolitan area, suggesting that the results may
      not apply equally to all demographic subgroups and regions in the United States.
      CONCLUSION: This small difference in the time from symptom recognition to medical
      consultation is unlikely to account for the large racial differences in survival
      rates and in stage of disease at the time of diagnosis.

PMID- 1629916
TI  - Racial misclassification of Native Americans in a surveillance, epidemiology, and
      end results cancer registry.
AB  - BACKGROUND: The cancer incidence for all sites has been reported to be lower in
      Native Americans than in White Americans. Concerns have been expressed, however,
      that the observed low incidence may be a result of inaccurate reporting of race.
      PURPOSE: The objective of this study was to investigate the extent to which
      racial misclassification may contribute to the observed low cancer incidence
      among Native Americans. METHODS: A registry of individuals eligible to receive
      medical services funded by the Indian Health Service was linked by computer to
      the Puget Sound Surveillance, Epidemiology, and End Results (SEER) cancer
      registry. RESULTS: Only 137 (60%) of the patients with invasive cancer registered
      with the Indian Health Service and for whom race was recorded were identified as
      Native Americans in the SEER registry. Similarly, 55 (69%) of 80 in situ cervical
      cancer case patients were classified as Native American. A strong association was
      observed between Native-American blood quantum level and racial
      misclassification. CONCLUSION: The results of this study indicate that the
      observed low cancer incidence in Native Americans relative to Whites in the
      northwest United States is at least partially attributable to racial
      misclassification in the SEER cancer registry.

PMID- 1629918
TI  - Patient education in the rural community health center.

PMID- 1629917
TI  - Relationship of polyps to cancer of the large intestine.
AB  - BACKGROUND: Pathologic and epidemiologic evidence indicates that patients with
      sporadic (nonfamilial) adenomatous polyps of the large intestine are at high risk
      of developing colorectal cancer. PURPOSE: Our primary goal in this study was to
      evaluate the colorectal cancer mortality rate among persons who have had a
      histologically confirmed benign colorectal polyp. METHODS: We used the
      retrospective follow-up method to evaluate the risk of death from colorectal
      cancer in 2872 Rhode Island men and women who were 24 through 79 years of age at
      the time of surgery for benign polyps in the years 1959 through 1975. RESULTS:
      Among 2872 subjects, the mortality from colorectal cancer, standardized for age,
      sex, and calendar time, was estimated as 1.74 (95% confidence interval = 1.44
      2.09) times the rate in the general population of Rhode Island residents.
      Colorectal cancer mortality was higher in the first 5 years of follow-up than it
      was later. There was little relationship between the numbers of polyps and
      colorectal cancer mortality, and there was only a modest association between the
      size of polyps and mortality. Colorectal cancer mortality was more than twice as
      high in subjects whose polyps were proximal to the sigmoid compared with those
      with sigmoid or rectal polyps. The observed elevation of risk of colorectal
      cancer was almost entirely confined to subjects who had an adenomatous polyp. The
      risk increased strongly with the percentage of villous features in the polyp and
      was about twice as high in subjects with villous adenoma than in those with other
      adenomatous polyps. CONCLUSIONS: Our results support the suspected relationship
      between colorectal polyps and cancer incidence and extend the association to
      colorectal cancer mortality.

PMID- 1629919
TI  - Health promotion at its best.

PMID- 1629920
TI  - Quality of care and black American patients.
AB  - Even with major advancements in medical knowledge and significant improvements in
      health sciences technology, evidence still exists that blacks do not enjoy as
      full a measure of health as do other racial and ethnic groups. To attempt a
      better understanding of this situation, literature was reviewed to consider
      relationships between being black and issues related to quality of health care.
      It was determined that these relationships have not been studied to any great
      extent, either in quantity or quality. When such studies have been undertaken,
      they have been limited to mostly qualitative designs, and appropriate controls
      for confounding variables have been minimal. The psychiatric literature reports
      most of the studies with very few studies found in the literature of other
      specialties. A conceptual model is presented regarding race-related research. It
      is argued that a first step might be to study whether the quality of care differs
      when the physician and the patient are members of different racial groups
      compared with when the physician and patient are members of the same racial
      group. In all race-related research, it is necessary to carefully consider
      specific variables that may confound results, eg, diagnostic errors, age, sex,
      socioeconomic status, level of education, geographic locale, and method of
      payment for health-care services.

PMID- 1629921
TI  - Phototoxicity and the cornea.
AB  - The cornea is sensitive to the effects of ultraviolet (UV) light and can suffer
      both acute and chronic toxicity. Ultraviolet keratitis is associated with
      relatively short exposures to light sources such as welding arcs or tanning
      lamps. The corneal effects are seen within a few hours following exposure and
      typically will resolve within 72 hours. Chronic exposure to environmental UV
      light may lead to a variety of ocular surface abnormalities that rarely resolve
      in the absence of therapy. Ultraviolet light, while potentially destructive, also
      can be used therapeutically. Recently, the photoablative properties of the
      excimer laser have been used in corneal refractive surgery. This laser uses UV
      light to break chemical bonds and remove tissue. Corneal phototoxicity is a
      reflection of the sensitivity of the ocular surface to photochemical injury.
      Fortunately, effective protection in the form of UV-blocking lenses is widely
      available.

PMID- 1629922
TI  - A culturally sensitive approach to the prevention of interpersonal violence among
      urban black youth.
AB  - Black-on-black interpersonal violence is a major problem for black youth living
      in poor urban areas. Diverse lines of research converge to suggest that
      interpersonal violence among inner-city black youth may result from a combination
      of environmental stressors, racial identity problems, and health and mental
      health problems. A culturally sensitive approach to the prevention of
      interpersonal violence among black youth is described. It is concluded that
      insensitivity to the significant role of racial or cultural factors in black-on
      black violence contributes to the relative inattention to the problem.

PMID- 1629923
TI  - Body temperature and its relationship to demographic and cardiovascular risk
      factors in a national sample of children and adolescents.
AB  - The association of body temperature with demographic, maturational,
      constitutional, and cardiovascular risk variables was investigated in a large,
      representative sample of US children and adolescents in the Health Examination
      Survey. While body temperatures in children ages 6 to 11 years were not related
      to demographic variables, temperatures in children ages 12 to 17 were lower at
      older ages, higher in females than males, and higher in whites than blacks. In
      multiple regression analyses, demographic variables, maturational variables, and
      variables related to heat production or loss explained less than 10% of the
      variation in body temperature. Body temperature was a significant independent
      correlate of resting heart rate and systolic blood pressure at ages 6 to 11 and
      12 to 17. Body temperature showed weak tracking over a follow-up interval
      averaging 44 months.

PMID- 1629924
TI  - J type diabetes revisited.
AB  - J type diabetes is grouped as a subtype of type III or malnutrition-related
      diabetes, known as protein-deficient pancreatic diabetes, (PDPD). J type diabetes
      has not been reported recently, but a clinical picture called phasic insulin
      dependent diabetes mellitus (PIDDM) has been elaborated in Jamaica, the same home
      country of PDRD and appears to be a "formes frustes" syndrome. The following
      comparative studies were performed on a group of diabetic patients and normal
      controls: insulin receptor binding; renal, hepatic, and pancreatic function; and
      abdominal ultrasonography. The results show a considerably decreased white and
      red blood cell binding to insulin (P less than .05), extensive kidney damage (P
      less than .05), and increased pancreatic echogenicity in PIDDM, supporting a
      separate identity of this latter syndrome from types I and II diabetes mellitus.
      Also, the features of relative insulin resistance, absence of ketosis even in the
      presence of severe hyperglycemia, and intermittent insulin requirement suggests
      that PIDDM, J type diabetes, and PDPD are one and the same syndrome.

PMID- 1629925
TI  - Elevated immunoreactive tumor necrosis factor and interleukin-1 in sickle cell
      disease.
AB  - To determine whether tumor necrosis factor (TNF) and interleukin-1 (IL-1) might
      be involved in the pathogenesis of sickle cell disease and its complications, TNF
      alpha and IL-1-alpha were measured using enzyme-linked immunosorbent assay in 59
      plasma samples from 34 adult subjects with Hb SS or Hb SC who did not have
      documented infections. Tumor necrosis factor was elevated on at least one
      occasion in 27 subjects, including 18 of 21 subjects in the steady state and 13
      of 19 subjects during painful crisis. Interleukin-1 was elevated on at least one
      occasion in 6 subjects, including 3 subjects in the steady state and 3 subjects
      in crisis. All subjects with elevated IL-1 also had elevated TNF. Tumor necrosis
      factor and IL-1 were similarly elevated in the steady state and during painful
      crisis. No correlation was noted between TNF or IL-1 levels and the extent of
      activation of coagulation, as measured by plasma levels of the fibrin D-dimer
      fragment, the overall severity of vascular occlusive disease in each subject, or
      the presence of specific vascular occlusive complications. We conclude that
      plasma TNF is frequently elevated in subjects with sickle cell disease, and IL-1
      is also elevated in some subjects. A direct role for these cytokines in the
      pathogenesis of vascular occlusion in sickle cell disease was not demonstrated,
      but an indirect role was not excluded.

PMID- 1629926
TI  - Rhabdomyolysis: report of eleven cases.
AB  - This article reports the results of a retrospective study of 11 patients with
      rhabdomyolysis-induced acute renal failure. All patients had multiple risk
      factors for rhabdomyolysis, the most common of which were alcoholism, illicit
      drug abuse, compression, and trauma. Patients with combined alcohol/illicit drug
      abuse had more severe electrolyte imbalances than patients without
      alcohol/illicit drug abuse. Myoglobinuria was detected in only half the patients
      despite rhabdomyolysis and urine "hematest" positivity. The serum creatine
      phosphokinase level was elevated in all of the patients, which is a good marker
      for rhabdomyolysis. Rhabdomyolysis is a relatively common disorder in municipal
      hospitals. Routine serum creatine phosphokinase levels should be checked on
      patients at risk, especially alcoholics, illicit drug abusers, and older
      patients.

PMID- 1629927
TI  - Disorders of serum calcium in acquired immunodeficiency syndrome.
AB  - This study assessed the incidence of abnormal serum calcium levels in patients
      with acquired immunodeficiency syndrome (AIDS). A retrospective review of 66
      patients with AIDS in an inner-city hospital was done. Fifty-four patients were
      intravenous drug abusers, and two patients were male homosexuals. None of the
      patients had lymphoma. Of the 66 patients, 17.9% were found to have hypocalcemia
      and 2.9% had hypercalcemia. The possible causative mechanisms are discussed.

PMID- 1629928
TI  - Multicentric gastrointestinal and extraintestinal leiomyosarcomatosis: a case
      report.
AB  - This article presents a case of synchronous polypoid primary adenocarcinoma of
      the transverse colon without lymph node or distance metastasis. During the
      postmortem examination, polypoid smooth muscle tumors in the patient's
      gastrointestinal tract and extensive extraintestinal smooth muscle tumors in the
      patient's liver, lungs, and visceral organs, including the diaphragm, parathyroid
      gland, bone marrow of the vertebrae, and subcutaneous tissue of the left wrist,
      were reviewed to determine their origin. Histomorphologically, all of the tumors
      were classified as leiomyosarcomas.

PMID- 1629929
TI  - Neonatal pneumoperitoneum of uncertain etiology.
AB  - This article describes a case of pneumoperitoneum in a newborn who had no
      evidence of an associated pulmonary air leak.

PMID- 1629930
TI  - The oath of Imhotep: in recognition of African contributions to Western medicine.

PMID- 1629931
TI  - Cancer in the African American. The annual William E. Allen, Jr, MD, Memorial
      Lecture.

PMID- 1629932
TI  - Mutagenicity of trinitrotoluene and its metabolites formed during composting.
AB  - TNT was mutagenic for Salmonella typhimurium without the need of a rat liver
      metabolic activation system (S9). The mutagenic potency of TNT decreased in
      proportion to the number of nitro groups that were reduced to the amino form. The
      presence of a nitro group on the 4 position of the diamino congener is necessary
      for mutagenicity. Among the active congeners, mutagenicity was generally greater
      for TA100 than TA98, except that for the 4-amino congener the reverse was true.
      In cases when S9 was included in the assay, there was always a decrease in the
      number of mutants induced as compared with those without S9. Tetryl behaved like
      TNT, except that it was approximately three times more potent. RDX and HMX were
      not mutagenic under the conditions of the assay. When TNT was composed, the major
      metabolites identified in organic extracts of compost samples were the 2-amino
      and 4-amino congeners. An acetonitrile extract of compost was tested and found to
      be more mutagenic for TA98 than TA100, much like the authentic 4-amino congener,
      but the amount of this congener in the extract did not account for the degree of
      mutagenicity.

PMID- 1629933
TI  - Reevaluation of benzene exposure for the Pliofilm (rubberworker) cohort (1936
      1976).
AB  - The Pliofilm cohort is the most intensely studied group of workers chronically
      exposed to benzene. Information on this cohort has been the basis for regulations
      and/or guidelines for occupational and environmental exposure to benzene. Rinsky
      et al. (1986, 1987) and Crump and Allen (1984) developed different approaches for
      reconstructing the exposure history of each member of the group. The predicted
      levels of exposure, combined with the data on the incidence of disease, have been
      used to estimate benzene's carcinogenic potency. In this paper, recent
      information from worker interviews and historical records from the National
      Archives and elsewhere were used to evaluate the accuracy of prior exposure
      estimates and to develop better ones for the cohort. The following factors were
      accounted for: (1) uptake of benzene due to short-term, high-level exposure to
      vapors, (2) uptake due to background concentrations in the manufacturing
      building, (3) uptake due to contact with the skin, (4) morbidity and mortality
      data on workers in the Pliofilm process, (5) the installation of industrial
      hygiene engineering controls, (6) extraordinarily long work weeks during the
      1940s, (7) data indicating that airborne concentrations of benzene were
      underestimated due to inaccurate monitoring devices and the lack of adequate
      field calibration mated due to inaccurate monitoring devices and the lack of
      adequate field calibration of these devices, and (8) likely effectiveness of
      respirators and gloves. Our estimates suggest that Crump and Allen (1984)
      overestimated the exposure of workers in some job classifications and
      underestimated others, and that Rinsky et al. (1981, 1986) almost certainly
      underestimated the exposure of nearly all workers. Airborne concentrations of
      benzene at the St. Marys facility during the years of its operation were found
      (on average) to be about half those of the two Akron facilities. Our analysis
      indicates that short-term, high-level exposure to benzene vapors and dermal
      exposure significantly increased (by about 25-50%) the total absorbed dose of
      benzene for some workers. One of the key findings was that, unlike prior
      analyses, the three facilities probably had significantly different airborne
      concentrations of benzene, especially during the 1940s and 1950s.

PMID- 1629934
TI  - Percutaneous penetration of 2,4-dichlorophenoxyacetic acid and 2,4-D
      dimethylamine salt in human volunteers.
AB  - The percutaneous penetration of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4-D
      dimethylamine salt (DMA) was evaluated separately in five male volunteers who
      participated in both experiments. Urine samples collected for 144 h following
      dermal applications of 10 mg to the dorsum of the hand (9 cm2) were analyzed for
      2,4-D. Following the acid application, an average of 4.46 +/- 0.849% was
      recovered in the urine and a significantly lower amount of 1.76 +/- 0.568%
      following the DMA application. Significantly higher amounts of 2,4-D DMA (7.68 +/
      0.493 mg) were washed off the hand 6 h following application as compared with
      2,4-D acid (5.35 +/- 0.384 mg). These results indicate that, in addition to the
      differences in physical and chemical properties of the two compounds that will
      affect absorption, the amount of the chemical absorbed is related inversely to
      the amount of washed off. Urinary excretion of 2,4-D was not complete in all
      volunteers 144 h following either application, but in all cases it was
      approaching the limit of detection. An average of 84.8 +/- 2.55% and 76.8 +/-
      8.05% of the total recovered in 144 h was recovered in the urine 96 h following
      2,4-D acid and 2,4-D DMA application, respectively. Average, approximated half
      lives for excretion were 39.5 +/- 8.1 h for the acid application and 58.5 +/-
      13.2 h for the DMA application.

PMID- 1629935
TI  - Dermal absorption of the phenoxy herbicide 2,4-D dimethylamine in humans: effect
      of DEET and anatomic site.
AB  - Percutaneous absorption of the 14C-ring-labeled phenoxy herbicide 2,4-D-amine
      (2,4-dichlorophenoxyacetic acid dimethylamine) was examined following topical
      applications of the herbicide to the palm and forearm of human volunteers. The
      effect of two vehicles (water and acetone) and the mosquito repellent DEET (N,N
      diethyl-m-toluamide) on dermal absorption of 2,4-D-amine also was investigated.
      The total percent dermal absorption was calculated from the mean percent urinary
      recoveries and was not corrected for nonurinary excretion. The data revealed 14
      +/- 4.5% (standard deviation) and 10 +/- 11.5% palmar absorption of 2,4-D-amine
      applied in water, with and without DEET, respectively, and 7 +/- 6.2% and 13 +/-
      5.0% forearm absorption of the herbicide applied in water or acetone,
      respectively. Soap-and-water skin washes conducted at 24 h posttreatment removed
      up to 34% of the applied dose. Successive tape strips of skin taken at 24 h
      posttreatment demonstrated generally decreasing herbicide levels in the outer
      layers. The data bring into question the complete validity of the rhesus monkey
      model to predict human dermal absorption.

PMID- 1629936
TI  - Dermal penetration of [14C]captan in young and adult rats.
AB  - Age dependence in dermal absorption has been a major concern in risk assessment.
      Captan, a chloroalkyl thio heterocyclic fungicide, was selected for study of age
      dependence as representative of this class of pesticides. Dermal penetration of
      [14C]captan applied at 0.286 mumol/cm2 was determined in young (33-d-old) and
      adult (82-d-old) female Fischer 344 rats in vivo and by two in vitro methods.
      Dermal penetration in vivo at 72 h was about 9% of the recovered dose in both
      young and adult rats. The percentage penetration was found to increase as dosage
      (0.1, 0.5, 2.7 mumol/cm2) decreased. Two in vitro methods gave variable dermal
      penetration values compared with in vivo results. A static system yielded twofold
      higher dermal penetration values compared with in vivo results for both young and
      adult rats. A flow system yielded higher dermal penetration values in young rats
      and lower penetration values in adults compared with in vivo results.
      Concentration in body, kidney, and liver was less in young than in adult rats
      given the same absorbed dosage. A physiological pharmacokinetic model was
      developed having a dual compartment for the treated skin and appeared to describe
      dermal absorption and disposition well. From this model, tissue/blood ratios of
      captan-derived radioactivity for organs were found to range from 0.35 to 3.4,
      indicating no large uptake or binding preferences by any organ. This preliminary
      pharmacokinetic model summarizes the experimental findings and could provide
      impetus for more complex and realistic models.

PMID- 1629937
TI  - Delayed health sequelae of accidental exposure to bromine gas.
AB  - The delayed health effects from accidental exposure to bromine vapors in a group
      of six people were evaluated. During the acute exposure, they had only some
      respiratory symptoms and skin burns of first to second degree involving small
      areas. All were treated in one hospital and released within 1-4 d. Six to 8 wk
      later, some still had health complaints such as cough, shortness of breath, chest
      tightness, eye irritation, headache, dizziness, fatigue, and memory, sleep, and
      sexual disturbances, but no objective laboratory or clinical evidence of effects.
      Mechanisms that might have led to manifestations of such complaints 1-2 mo after
      the accident are discussed and possible ways to alleviate similar situations are
      suggested.

PMID- 1629938
TI  - Isolation of cDNA clones encoding rat glial fibrillary acidic protein: expression
      in astrocytes and in Schwann cells.
AB  - Glial fibrillary acidic protein (GFAP) expressed by astrocytes in the central
      nervous system (CNS) has been extensively characterized but the molecular
      identity of related molecules in the peripheral nervous system (PNS) remains
      unclear. To examine possible structural differences between CNS and PNS GFAP, we
      have isolated cDNA clones for rat GFAP from both cultured astrocyte and Schwann
      cell libraries. Nucleotide sequence analysis indicated that the PNS and CNS GFAP
      clones contained identical coding regions, with a predicted protein product of
      430 amino acids. However, the 5'-untranslated region of clone rGFA15, isolated
      from the Schwann cell library, was longer than that predicted for brain-derived
      GFAP mRNA. Primer extension analysis of RNA isolated from the RT4-D6 Schwann cell
      line indicated that the start site for PNS GFAP mRNA lies 169 bases upstream from
      that used in the CNS. In addition, tryptic peptide mapping of GFAP prepared from
      cultured astrocytes and Schwann cells revealed one major peptide fragment present
      in CNS GFAP but absent from PNS GFAP. These results suggest structural
      differences between GFAP in these two cell types, at both the nucleic acid and
      protein level, and are consistent with previous observations of immunochemical
      differences existing between CNS and PNS GFAP.

PMID- 1629939
TI  - Exogenous gangliosides modulate calcium fluxes in cultured neuronal cells.
AB  - Previous work from this and other laboratories has shown that the neuritogenic
      effect due to exogenous gangliosides on primary neurons in culture is accompanied
      by several morphological and biochemical modifications. The present results
      indicate that the treatment of these neurons with gangliosides, under the
      experimental conditions which are known to produce a sprouting effect, inhibited
      the influx of 45Ca2+ and increased the release of 45Ca2+ from the cells. No
      significant differences were noted using concentrations of gangliosides (10(-8)
      10(-5) M) either below or above the critical micellar concentrations. No apparent
      specificity was observed among various species of individual sialocompounds (GM1,
      GD1a). Moreover the presence or absence of fetal calf serum in the culture medium
      influenced the levels of 45Ca2+ fluxes. This study confirms the hypothesis that
      gangliosides may be considered as Ca2+ flux modulators in neuronal cells.

PMID- 1629940
TI  - Establishment and characterization of a mouse Schwann cell line which produces
      myelin in vivo.
AB  - A Schwann cell line (MSC 80) was established from purified mouse Schwann cell
      cultures using large doses of serum. MSC 80 cell line is an aneuploid cell line
      which has a doubling time of 17 hr and has been maintained through more than 110
      passages. Most of MSC 80 cells are of bipolar or stellate (3-5 processes) shape.
      A few others are irregular in shape, gigantic, and multinucleated. All MSC 80
      cells express antigens of myelin-forming Schwann cells such as S-100, 224/58,
      laminin, and other glycoproteins of the extracellular matrix. However, they also
      express the non-myelin-forming Schwann cell antigen GFAP. By time-lapse
      cinematography, MSC 80 cells exhibit the Schwann cell characteristic rhythmical
      undulations. When induced to form aggregates in agar, they form intercellular
      junctions and basement membrane-like structures. In addition, after
      transplantation in or at a distance from a lysolecithin induced lesion, MSC 80
      cells form myelin around the host demyelinated axons. MSC 80 cells thus express,
      when isolated in vitro, some of the normal myelin-forming Schwann cell phenotype.
      In addition, they present the major advantage of forming myelin when associated
      with axons in vivo.

PMID- 1629941
TI  - Cloning of cDNAs encoding human S-100 alpha and beta subunits and their
      differential expression in human tumor cell lines.
AB  - We isolated nearly full-length clones of S-100 alpha and beta subunit cDNAs from
      a human brain cDNA library. The alpha subunit cDNA was 579 bp long and contained
      99 bp of 5'-noncoding region, 282 bp of coding region, and 198 bp of 3'-noncoding
      region. The beta subunit cDNA was 743 bp long and contained 57 bp of 5'-noncoding
      region, 276 bp of coding region, and 410 bp of 3'-noncoding region. An amino acid
      sequence comparison between human and bovine alpha subunits and between human and
      rat beta subunits showed that both subunits were nearly entirely conserved. The
      amino acid sequences of human alpha and beta subunits were conserved at both
      Ca(2+)-binding domains. Northern blot analysis of brain RNA showed that human
      alpha and beta subunit cDNA probes discriminated between alpha and beta subunit
      mRNAs. By using these subunit-specific cDNA probes, it was demonstrated that
      alpha and beta subunit mRNAs were expressed in different manners among tumor cell
      lines: beta was detected in melanoma and some glioma cell lines, while alpha was
      detected only in a melanoma cell line. Southern blot analysis showed that there
      were no major deletions and rearrangements of alpha and beta subunit genes in
      these cell lines, regardless of the level of alpha and beta subunit expression,
      suggesting that the expression of these subunits may be regulated at the
      transcriptional or RNA stability level.

PMID- 1629942
TI  - beta-Amyloid precursor protein of Alzheimer's disease in cultured bovine
      oligodendrocytes.
AB  - The production of beta-amyloid precursor protein (beta APP) in cultured
      oligodendrocytes isolated from adult bovine brains was examined by
      immunohistochemistry and immunoblotting. Immunostaining of oligodendrocytes with
      antibodies specific for the carboxy terminus of beta APP demonstrated positive
      immunoreactivity of oligodendroglial cytoplasm. Immunoblot analysis of cellular
      extracts detected two distinct bands with estimated molecular weight of 118 and
      105 kDa. The amount of these beta APP subspecies increased considerably in
      response to their attachment to the poly-L-lysine substratum.

PMID- 1629943
TI  - Expression cloning of neurotrophic factors using Xenopus oocytes.
AB  - We have explored the potential for cloning novel neurotrophic factor cDNAs via
      assay of neurotrophic activities following expression in Xenopus oocytes. In this
      report, we describe the successful application of the method to tract rat ciliary
      neurotrophic factor (CNTF) activity from mRNA purified from cultured cells and
      from mRNA synthesized by in vitro transcription of a cDNA library. Rat C6 glioma
      cells, which had been previously shown to have CNTF-like activity (Westermann et
      al., 1988), were used as source material. We tested protein extracts of C6 cells
      using an in vitro assay of primary neurons from the chick ciliary ganglion (CCG
      assay) and detected a CNTF-like activity. RNA isolated from C6 cells was shown to
      direct the synthesis of the activity following microinjection into Xenopus
      oocytes and one-step fractionation of Xenopus extract. C6 mRNA was size
      fractionated, and fractions encoding CNTF-like activity were cloned into a lambda
      phage vector at a site distal to a T7 promoter. Synthetic RNA transcribed from
      total library DNA was injected into Xenopus oocytes, and a CNTF-like activity in
      the oocyte extract was detected by the CCG assay. Further fractionation of
      library clones narrowed the presence of the clone encoding the CNTF-like activity
      to a pool containing 20,000 members. The presence of a full-length CNTF cDNA
      clone in this pool and partial clones in other pools was confirmed by Polymerase
      Chain Reaction (PCR) using oligonucleotides from the rabbit CNTF cDNA (Lin et
      al., 1989) as primers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1629944
TI  - Decorin, a chondroitin/dermatan sulfate proteoglycan is under neural control in
      rat skeletal muscle.
AB  - Proteoglycans (PGs) are abundant components of the extracellular matrices (ECM)
      of skeletal muscle. We have previously found that the synthesis of skeletal
      muscle PGs present at the ECM increase after denervation. The experiments
      reported here were undertaken to identify which PG(s) increase after denervation
      of rat leg muscles. Incorporation of radioactive sulfate demonstrated the
      presence of a chondroitin/dermatan sulfate PG of 70-90 kDa in the skeletal muscle
      ECM, which increased after denervation. The PG has a core protein of 39-45 kDa
      after treatment with chondroitinase ABC. Antibodies against rat decorin, a
      chondroitin/dermatan sulfate PG synthesized by various cell types, specifically
      immunoprecipitated this PG from a mixture of PGs. Immunocytolocalization of this
      PG indicated that the chondroitin/dermatan sulfate PG accumulates at the
      perimysium of skeletal muscle after denervation. Finally, Northern blot analysis
      indicated an increase of muscle transcripts for decorin after denervation. The
      data reported here suggest that a chondroitin/dermatan sulfate PG present at the
      skeletal muscle ECM, very similar if not identical to decorin, increases after
      denervation.

PMID- 1629945
TI  - Transcriptional regulation of glial fibrillary acidic protein (GFAP)-mRNA
      expression during postnatal development of mouse brain.
AB  - During mouse brain maturation, GFAP-mRNA undergoes a two-step developmental
      expression. It increases between birth and day 15 (period of astrocytic
      proliferation) and then decreases until day 55 (period of astrocytic
      morphological differentiation). We have developed an in vitro transcription
      procedure, as a mean to study the part of transcriptional control in this
      biphasic expression. After RNA synthesis by endogenous RNA polymerases in nuclei
      isolated from mouse brain (of 3 to 55 days and 217 days), the relative rates of
      GFAP-mRNA transcripts were analysed by hybridization with a specific cDNA probe.
      As early as 3 days after birth, the rate of GFAP-mRNA transcripts was maximal,
      whereas unexpectedly, it showed a significant decrease in mice of 15 days and
      stayed low until the 55th day. Therefore, a transcriptional control may take
      place early in mouse brain postnatal development by increasing the
      transcriptional rate of the GFAP gene in astrocytes, and during the transition
      from proliferation to differentiation phase of astrocytes (that occurs at the
      15th day after birth) by decreasing this rate. However, posttranscriptional
      events may also occur to modulate the level of the cytoplasmic GFAP-mRNA. In
      older mice (217 days), the low rate of GFAP-mRNA transcripts found is not
      concordant with the high cytoplasmic level generally observed in gliosis of the
      aging brain. Our data suggest posttranscriptional events at this age.

PMID- 1629946
TI  - Changes in taurine transport evoked by hyperosmolarity in cultured astrocytes.
AB  - Cultured astrocytes grown chronically (1-3 days) in medium made hyperosmotic (450
      mOsm) with NaCl or sucrose showed an increase in taurine concentration from 294
      to 501 nmol/mg protein in NaCl and to 382 nmol/mg protein in sucrose. The effect
      of hyperosmolarity on taurine uptake and release was examined to investigate
      whether or not changes in these processes may account for the increase observed
      in cell taurine content. Hyperosmolarity significantly affected the two
      components of taurine uptake (i.e., the Na(+)-dependent and the diffusional
      component). The Vmax of the Na(+)-dependent, active transport increased 50%,
      whereas no change was observed in the Km. The diffusion coefficient was markedly
      decreased by hyperosmolarity, being 2.2 x 10(-4) and 6.6 x 10(-6) ml/min/mg
      protein in isosmotic and hyperosmotic conditions, respectively, indicating a
      blockade of the leak pathway. These changes in the active and passive components
      of taurine transport were opposite to those induced by hyperosmolarity. The
      effect of hyperosmolarity increasing cell taurine content was insensitive to
      cycloheximide and colchicine. The basal efflux of taurine from astrocytes also
      decreased in cells exposed to hyperosmotic medium, indicating that alterations in
      both influx and efflux of taurine are involved in the mechanism responsible for
      the increase in taurine levels induced by hyperosmolarity in astrocytes.

PMID- 1629947
TI  - One hundred years of virology.

PMID- 1629948
TI  - Mechanism of attenuation of a chimeric influenza A/B transfectant virus.
AB  - The ribonucleoprotein transfection system for influenza virus allowed us to
      construct an influenza A virus containing a chimeric neuraminidase (NA) gene in
      which the noncoding sequence is derived from the NS gene of influenza B virus (T.
      Muster, E. K. Subbarao, M. Enami, B. P. Murphy, and P. Palese, Proc. Natl. Acad.
      Sci. USA 88:5177-5181, 1991). This transfectant virus is attenuated in mice and
      grows to lower titers in tissue culture than wild-type virus. Since such a virus
      has characteristics desirable for a live attenuated vaccine strain, attempts were
      made to characterize this virus at the molecular level. Our analysis suggests
      that the attenuation of the virus is due to changes in the cis signal sequences,
      which resulted in a reduction of transcription and replication of the chimeric NA
      gene. The major finding concerns a sixfold reduction in NA-specific viral RNA in
      the virion, causing a reduction in the ratio of infectious particles to physical
      particles compared with the ratio in wild-type virus. Although the NA-specific
      mRNA level is also reduced in transfectant virus-infected cells, it does not
      appear to contribute to the attenuation characteristics of the virus. The levels
      of the other RNAs and their expression appear to be unchanged for the
      transfectant virus. It is suggested that downregulation of the synthesis of one
      viral RNA segment leads to the generation of defective viruses during each
      replication cycle. We believe that this represents a general principle for
      attenuation which may be applied to other segmented viruses containing either
      single-stranded or double-stranded RNA.

PMID- 1629949
TI  - Editing on the genomic RNA of human hepatitis delta virus.
AB  - It has been shown previously that during replication of the genome of human
      hepatitis delta virus (HDV), a specific nucleotide change occurs to eliminate the
      termination codon for the small delta antigen (G. Luo, M. Chao, S.-Y. Hsieh, C.
      Sureau, K. Nishikura, and J. Taylor, J. Virol. 64:1021-1027, 1990). This change
      creates an extension in the length of the open reading frame for the delta
      antigen from 195 to 214 amino acids. These two proteins, the small and large
      delta antigens, have important and distinct roles in the life cycle of HDV. To
      further investigate the mechanism of this specific nucleotide alteration, we
      developed a sensitive assay involving the polymerase chain reaction to monitor
      changes on HDV RNA sequences as they occurred in transfected cells. We found that
      the substrate for the sequence change was the viral genomic RNA rather than the
      antigenomic RNA. This sequence change occurred independently of genome
      replication or the presence of the delta antigen. Less than full-length genomic
      RNA could act as a substrate, but only if it also contained a corresponding RNA
      sequences from the other side of the rodlike structure, which is characteristic
      of HDV. We were also able to reproduce the HDV base change in vitro, by addition
      of purified viral RNA to nuclear extracts of cells from a variety of species.

PMID- 1629950
TI  - Interferon-induced human protein MxA is a GTPase which binds transiently to
      cellular proteins.
AB  - MxA is an abundant and ubiquitous cytoplasmic protein induced by alpha/beta
      interferon in human cells. Upon full induction, it can constitute 0.5 to 1% of
      cytosolic proteins. MxA can bind elements of the cytoskeleton, such as actin and
      tubulins, and several larger cellular proteins. However, these protein-protein
      interactions seem to be transitory. The human MxA protein contains a tripartite
      GTP-binding domain consisting of GxxxxGKS, DxxG, and TKxD, where x is any amino
      acid. It is shown here that the native MxA protein has GTPase activity (GTP---
      GDP) when purified by immunoprecipitation with affinity-purified polyclonal
      antibodies directed against the C-terminal domain of MxA. The GTPase activity is
      greatly diminished by polyclonal antibodies directed against the N-terminal
      domain of MxA (the domain which contains the GTP-binding consensus elements).
      Amino acid substitution within the GTP-binding domain abolished the GTPase
      activity of the mutated MxA protein expressed in transfected CHO cells. The
      reaction is specific for GTP, and the approximate Km is 0.1 mM. The reaction has
      an absolute requirement for Mg2+. The turnover number is approximately 70
      molecules of GTP hydrolyzed per min per MxA molecule. It is suggested that the
      human MxA protein has certain characteristics of the stress proteins.

PMID- 1629951
TI  - Mutational analysis of the core, spacer, and initiator regions of vaccinia virus
      intermediate-class promoters.
AB  - Activation of vaccinia virus late gene transcription is dependent on DNA
      replication and the expression of three genes: A1L, A2L, and G8R (J. G. Keck, C.
      J. Baldick, Jr., and B. Moss, Cell 61:801-809, 1990). To fully characterize the
      promoter elements of these trans-activator genes, we prepared more than 140
      plasmid vectors containing natural and mutated DNA segments ligated to the
      Escherichia coli lacZ or chloramphenicol acetyltransferase reporter gene.
      Expression of the reporter genes occurred when the plasmids were transfected into
      vaccinia virus-infected cells and was enhanced when DNA replication was
      prevented, indicating that the A1L, A2L, and G8R promoters belong to the
      intermediate regulatory class. Deletional mutagenesis demonstrated that the
      regulatory elements of all three promoters extended between 20 and 30 nucleotides
      upstream of their RNA start sites. Single-base substitutions of the G8R promoter
      revealed two critical elements located from -26 to -13 (the core element) and -1
      to +3 (the initiator element). Mutations in these regions drastically affected
      expression, as determined by beta-galactosidase and mRNA analyses. Additional
      mutations defined the TAAA sequence as the critical initiator element. The
      length, but not the nucleotide sequence, of the segment between the core and
      initiator regions was crucial. The requirement for the spacer to be 10 or 11
      nucleotides was consistent with a single turn of a double helix. The A1L and A2L
      promoters resembled the G8R promoter, and mutations in the conserved bases had
      the predicted effects on expression. We concluded that the three intermediate
      promoters are composed of a 14-bp A+T-rich core sequence separated by one turn of
      the double helix from the TAAA initiator element.

PMID- 1629952
TI  - Deletion analysis of two tandemly arranged virulence genes in myxoma virus, M11L
      and myxoma growth factor.
AB  - Myxoma virus (MYX) is a leporipoxvirus of rabbits that induces a lethal syndrome
      characterized by disseminated tumorlike lesions, generalized immunosuppression,
      and secondary gram-negative bacterial infection. A MYX deletion mutant (vMYX-GF-
      delta M11L) was constructed to remove the entire myxoma growth factor (MGF)
      coding sequence and that for the C-terminal five amino acids of the partially
      overlapping upstream gene, M11L. Unexpectedly, this deletion completely abrogates
      the capacity of MYX to cause the characteristic disease symptoms of myxomatosis.
      Upon inoculation of rabbits with vMYX-GF- delta M11L, recipient animals developed
      only a benign, localized nodule reminiscent of a Shope fibroma virus-induced
      tumor in which a single primary lesion appeared at the site of injection and then
      completely regressed within 14 days, leaving the animals resistant to challenge
      with wild-type MYX. No evidence of the purulent conjunctivitis and rhinitis that
      always accompany wild-type MYX infection was observed. To ascertain whether the
      attenuation observed in vMYX-GF- delta M11L was due to a combined effect of the
      MGF deletion and alteration of the upstream M11L gene, two additional MYX
      recombinants were constructed: an MGF- virus (vMYX-GF-) containing an intact M11L
      gene and an M11L- virus (vMYX-M11L-) containing an intact MGF gene. Infection
      with vMYX-GF- resulted in moderated symptoms of myxomatosis, but all clinical
      stages of the disease were still detectable. In contrast, disruption of M11L
      alone dramatically reduced the virus virulence, resulting in a nonlethal syndrome
      whose clinical course was nevertheless distinct from that of vMYX-GF- delta M11L.
      Upon inoculation with vMYX-M11L-, rabbits developed primary and secondary tumors
      which were larger and more circumscribed than those of wild-type MYX recipients.
      Whereas wild-type MYX infection always includes severe, purulent conjunctivitis
      and rhinitis, vMYX-M11L- recipients remained healthy and displayed only minimal
      signs of respiratory distress. By about 30 days after infection, the tumors
      induced by vMYX-M11L- had completely regressed and these animals were immune to
      challenge with wild-type MYX. Histological analysis indicated that tumors induced
      by vMYX-M11L- are much more heavily infiltrated with macrophages and heterophils
      and that the sites of viral replication are more edematous and necrotic than
      those of wild-type infection, suggesting that the host was able to mount a more
      vigorous inflammatory response to vMYX-M11L- infection.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1629953
TI  - Spike protein-nucleocapsid interactions drive the budding of alphaviruses.
AB  - Semliki Forest virus (SFV) particles are released from infected cells by budding
      of nucleocapsids through plasma membrane regions that are modified by virus spike
      proteins. The budding process was studied with recombinant SFV genomes which
      lacked the nucleocapsid protein gene or, alternatively, the spike genes. No
      subviral particles were released from cells which expressed only the nucleocapsid
      protein or the spike proteins. Virus release was found to be strictly dependent
      on the coexpression of the nucleocapsid and the spike proteins. These results
      provide direct proof for the hypothesis that the alphavirus budding is driven by
      nucleocapsid-spike interactions. The importance of the viral 42S RNA for virus
      assembly and budding was investigated by using the heterologous vaccinia virus-T7
      expression system for the synthesis of the SFV structural proteins. The results
      demonstrate that the viral genome is not absolutely required for formation of
      budding competent nucleocapsids, since small amounts of viruslike particles were
      assembled in the absence of 42S RNA.

PMID- 1629955
TI  - Nucleotide sequence and transcriptional analysis of a gene encoding gp41, a
      structural glycoprotein of the baculovirus Autographa californica nuclear
      polyhedrosis virus.
AB  - We have identified and sequenced a region of the Autographa californica nuclear
      polyhedrosis virus (AcMNPV) genome encoding the major polyhedron-derived virus
      structural glycoprotein gp41. The open reading frame is located entirely within
      the AcMNPV SstII-M fragment. The protein sequence does not have hydrophobic
      regions characteristic of integral membrane proteins and contains a putative O
      linked GlcNAc glycosylation site. gp41 is expressed as a late gene, with
      transcripts starting within two consensus late transcription start sites (TAAG)
      located immediately upstream of the first methionine codon. A major transcription
      termination signal is bypassed, possibly generating a bicistronic message.
      Finally, the nucleotide and protein sequences of AcMNPV and Bombyx mori nuclear
      polyhedrosis virus are highly conserved.

PMID- 1629954
TI  - Mutations in the leucine zipper of the human immunodeficiency virus type 1
      transmembrane glycoprotein affect fusion and infectivity.
AB  - Many retroviruses, including the human and simian immunodeficiency viruses,
      contain a leucine zipper-like repeat in a highly conserved region of the external
      domain of the transmembrane (TM) glycoprotein. This region has been postulated to
      play a role in stabilizing the oligomeric form of these molecules. To determine
      what role this region might play in envelope structure and function, several
      mutations were engineered into the middle isoleucine of the leucine zipper-like
      repeat of the human immunodeficiency virus type 1 (HIV-1) TM protein. A
      phenotypic analysis of these mutants demonstrated that conservative mutations
      (Ile to Val or Leu) did not block the ability of the viral glycoprotein to
      mediate cell-cell fusion or affect virus infectivity. In contrast, each of the
      other mutations, except for the Ile-to-Ala change, completely inhibited the
      ability of the glycoprotein to fuse HeLa-T4 cells and of mutant virions to infect
      H9 cells. The alanine mutation produced an intermediate phenotype in which both
      cell fusion and infectivity were significantly reduced. Thus, the biological
      activity of the glycoprotein titrates with the hydrophobicity of the residue in
      this position. None of the mutations affected the synthesis, oligomer formation,
      transport, or processing of the HIV glycoprotein complex. Although these results
      do not rule out a role for the leucine zipper region in glycoprotein
      oligomerization, they clearly point to a critical role for it in a post-CD4
      binding step in HIV membrane fusion and virus entry.

PMID- 1629956
TI  - Complementation of murine cells for human immunodeficiency virus envelope/CD4
      mediated fusion in human/murine heterokaryons.
AB  - Murine cell lines expressing human CD4 are resistant to the fusogenic effect of
      the human immunodeficiency virus (HIV) envelope. Consequently, they cannot be
      infected by HIV or form syncytia with HIV envelope-expressing cells. Murine cells
      could either lack human-specific cofactors necessary for the CD4/envelope
      mediated membrane fusion or express inhibitors of this process. To address this
      question, we have tested the ability of heterokaryons made from CD4-expressing
      murine cells and human cells to undergo HIV envelope-mediated fusion. We have
      devised a rapid and specific assay based on the induction of lacZ expression, in
      which membrane fusion events with HIV-infected cells can be detected by a simple
      histochemical technique. CD4-positive murine/human heterokaryons, but not
      murine/simian heterokaryons, were found able to fuse with HIV envelope-expressing
      cells. In these experiments, the fusion resistant phenotype of murine-CD4 cells
      could be complemented by human cellular factors.

PMID- 1629957
TI  - Role of TAR RNA splicing in translational regulation of simian immunodeficiency
      virus from rhesus macaques.
AB  - The untranslated leader sequences of rhesus macaque simian immunodeficiency virus
      mRNAs form a stable secondary structure, TAR. This structure can be modified by
      RNA splicing. In this study, the role of TAR splicing in virus replication was
      investigated. The proportion of viral RNAs containing a spliced TAR structure is
      high early after infection and decreases at later times. Moreover, proviruses
      containing mutations which prevent TAR splicing are significantly delayed in
      replication. These mutant viruses require approximately 20 days to achieve half
      maximal virus production, in contrast to wild-type viruses, which require
      approximately 8 days. We attribute this delay to the inefficient translation of
      unspliced-TAR-containing mRNAs. The molecular basis for this translational effect
      was examined in in vitro assays. We found that spliced-TAR-containing mRNAs were
      translated up to 8.5 times more efficiently than were similar mRNAs containing an
      unspliced TAR leader. Furthermore, these spliced-TAR-containing mRNAs were more
      efficiently associated with ribosomes. We postulate that the level of TAR
      splicing provides a balance for the optimal expression of both viral proteins and
      genomic RNA and therefore ultimately controls the production of infectious
      virions.

PMID- 1629958
TI  - Assembly of recombinant human immunodeficiency virus type 1 capsid protein in
      vitro.
AB  - The capsid protein (CA) (p24) of human immunodeficiency virus (HIV) type 1
      expressed in Escherichia coli and purified to greater than 90% homogeneity was
      used to examine assembly in vitro and to probe the nature of interactions
      involved in the formation of capsid structures. The protein was detected in
      dimeric and oligomeric forms as indicated by molecular size measurements by gel
      filtration column chromatography, sedimentation through sucrose, and
      nondenaturing gel electrophoresis. Chemical cross-linking of CA molecules was
      observed with several homobifunctional reagents. Oligomer size was dependent on
      cross-linker concentration and exhibited a nonrandom pattern in which dimers and
      tetramers were more abundant than trimers and pentamers. Oligomers as large as
      dodecamers were detected in native polyacrylamide gels. These were stable in
      solutions of high ionic strength or in the presence of nonionic detergent,
      indicating that strong interactions were involved in oligomer stabilization.
      Limited tryptic digestion converted the putative dodecamers to octamers,
      suggesting that a region involved in CA protein multimerization was exposed in
      the structure. This region was mapped to the central portion of the protein. The
      recombinant CA proteins assembled in vitro into long rodlike structures and were
      disassembled into small irregular spheres by alterations in ionic strength and
      pH. The observation that assembly and disassembly of purified HIV type 1 CA
      protein can be induced in vitro suggests an approach for identifying possible
      control mechanisms involved in HIV viral core assembly.

PMID- 1629959
TI  - Nucleotide sequence of the jaagsiekte retrovirus, an exogenous and endogenous
      type D and B retrovirus of sheep and goats.
AB  - The complete genome of the jaagsiekte sheep retrovirus (JSRV), the suspected
      etiological agent of ovine pulmonary carcinoma, has been cloned from viral
      particles secreted in lung exudates of affected animals and sequenced. The genome
      is 7,462 nucleotides long and exhibits a genetic organization characteristic of
      the type B and D oncoviruses. Comparison of the amino acid sequences of JSRV
      proteins with those of other retrovirus proteins and phylogenetic studies suggest
      that JSRV diverged from its type B and D lineage after the type B mouse mammary
      tumor virus but before the type D oncoviruses captured the env gene of a
      reticuloendotheliosislike virus. Southern blot studies show that closely related
      sequences are present in sheep and goat normal genomic DNA, indicating that JSRV
      could be endogenous in ovine and caprine species.

PMID- 1629960
TI  - Intermonomer disulfide bonds impair the fusion activity of influenza virus
      hemagglutinin.
AB  - At a low pH, the influenza virus hemagglutinin (HA) undergoes conformational
      changes that promote membrane fusion. While the critical role of fusion peptide
      release from the trimer interface has been demonstrated previously, the role of
      globular head dissociation in the overall fusion mechanism remains unclear. To
      investigate this question, we have analyzed in detail the fusion activity and low
      pH-induced conformational changes of a mutant, Cys-HA, in which the globular head
      domains are locked together by engineered intermonomer disulfide bonds (L.
      Godley, J. Pfeifer, D. Steinhauer, B. Ely, G. Shaw, R. Kaufmann, E. Suchanek, C.
      Pabo, J. J. Skehel, D. C. Wiley, and S. Wharton, Cell 68:635-645, 1992). In this
      paper, we show that Cys-HA expressed on the cell surface is predominantly a
      disulfide-bonded trimer. Cell surface Cys-HA is impaired in its membrane fusion
      activity, as demonstrated by both content-mixing and lipid-mixing fusion assays.
      It is also impaired in its ability to change conformation at a low pH, as
      assessed by proteinase K sensitivity. The fusion activity and low pH-induced
      conformational changes of cell surface Cys-HA are, however, restored to nearly
      wild-type levels upon reduction of the intermonomer disulfide bonds. By using a
      set of conformation-specific monoclonal and anti-peptide antibodies, we found
      that purified Cys-HA trimers are impaired in changes that occur in the globular
      head domain interface. In addition, changes that occur at a great distance from
      the engineered intermonomer disulfide bonds, notably release of the fusion
      peptides, are also impaired. Our results are discussed with respect to current
      views of the fusion-active conformation of the HA trimer.

PMID- 1629961
TI  - The matrix protein of human immunodeficiency virus type 1 is required for
      incorporation of viral envelope protein into mature virions.
AB  - Accumulating evidence suggests that the matrix (MA) protein of retroviruses plays
      a key role in virus assembly by directing the intracellular transport and
      membrane association of the Gag polyprotein. In this report, we show that the MA
      protein of human immunodeficiency virus type 1 is also critical for the
      incorporation of viral Env proteins into mature virions. Several deletions
      introduced in the MA domain (p17) of human immunodeficiency virus type 1 Gag
      polyprotein did not greatly affect the synthesis and processing of the Gag
      polyprotein or the formation of virions. Analysis of the viral proteins revealed
      normal levels of Gag and Pol proteins in these mutant virions, but the Env
      proteins, gp120 and gp41, were hardly detectable in the mutant virions. Our data
      suggest that an interaction between the viral Env protein and the MA domain of
      the Gag polyprotein is required for the selective incorporation of Env proteins
      during virus assembly. Such an interaction appears to be very sensitive to
      conformational changes in the MA domain, as five small deletions in two separate
      regions of p17 equally inhibited viral Env protein incorporation. Mutant viruses
      were not infectious in T cells. When mutant and wild-type DNAs were cotransfected
      into T cells, the replication of wild-type virus was also hindered. These results
      suggest that the incorporation of viral Env protein is a critical step for
      replication of retroviruses and can be a target for the design of antiviral
      strategies.

PMID- 1629962
TI  - Dependence of minus-strand synthesis on complete genomic packaging in the double
      stranded RNA bacteriophage phi 6.
AB  - Bacteriophage phi 6 has a segmented genome consisting of three pieces of double
      stranded RNA (dsRNA). The viral procapsid is the structure that packages plus
      strands, synthesizes the complementary negative strands to form dsRNA, and then
      transcribes dsRNA to form plus-strand message. The minus-strand synthesis of a
      particular genomic segment is dependent on prior packaging of the other segments.
      The 5' end of the plus strand is necessary and sufficient for packaging, while
      the normal 3' end is necessary for synthesis of the negative strand. We have now
      investigated the ability of truncated RNA segments which lack the normal 3' end
      of the molecules to stimulate the synthesis of minus strands of the other
      segments. Fragments missing the normal 3' ends were able to stimulate the minus
      strand synthesis of intact heterologous segments. Minus-strand synthesis of one
      intact segment could be stimulated by the presence of two truncated
      nonreplicating segments. The 5' fragments of each single-stranded genomic segment
      can compete with homologous full-length single-stranded genomic segments in minus
      strand synthesis reactions, suggesting that there is a specific binding site in
      the procapsid for each segment.

PMID- 1629963
TI  - A mutation at one end of Moloney murine leukemia virus DNA blocks cleavage of
      both ends by the viral integrase in vivo.
AB  - The integration of retroviral DNA proceeds through two steps: trimming of the
      termini to expose new 3' OH ends, and the transfer of those ends to the
      phosphates of target DNA. We have examined the ability of the Moloney murine
      leukemia virus integrase protein (IN) to trim the termini of the preintegrative
      DNA of mutant viruses with alterations in the U3 inverted repeat. The mutant
      terminus of one replication-defective viral DNA, containing a 7-bp deletion in
      the U3 inverted repeat, was not trimmed to produce the normal recessed end.
      Remarkably, the other terminus of this mutant DNA was also not trimmed, even
      though its sequence is wild type. This finding suggests that the IN protein
      requires the presence of two good ends before becoming properly activated to trim
      either one.

PMID- 1629964
TI  - Rabies virus neuritic paralysis: immunopathogenesis of nonfatal paralytic rabies.
AB  - Two pathogenetically distinct disease manifestations are distinguished in a
      murine model of primary rabies virus infection with the Evelyn-Rokitnicky
      Abelseth strain, rabies virus neuritic paralysis (RVNP) and fatal
      encephalopathogenic rabies. RVNP develops with high incidence in immunocompetent
      mice after intraplantar infection as a flaccid paralysis restricted to the
      infected limb. The histopathologic correlate of this monoplegia is a degeneration
      of the myelinated motor neurons of the peripheral nerve involved. While, in this
      model, fatal encephalopathogenic rabies develops only after depletion of the CD4
      subset of T lymphocytes and without contribution of the CD8 subset, RVNP is
      identified as an immunopathological process in which both the CD4 and CD8 subsets
      of T lymphocytes are critically implicated.

PMID- 1629965
TI  - Alphavirus spike-nucleocapsid interaction and network antibodies.
AB  - Vaux et al. (D. J. T. Vaux, A. Helenius, and I. Mellman, Nature (London) 336:36
      42, 1988) recently reported the production of network antibodies that were
      suggested to have reconstructed a specific interaction between the nucleocapsid
      of Semliki Forest virus and the cytoplasmic tail of the viral E2 spike protein.
      The F13 anti-idiotype antibody, which was raised against anti-E2 tail antibodies,
      was claimed to recognize the virus nucleocapsid. In this report, we have used
      recombinant SFV viruses to demonstrate that the F13 antibody is not nucleocapsid
      specific but instead most likely recognizes some component of the viral
      replication machinery.

PMID- 1629966
TI  - Functional tolerance of the human immunodeficiency virus type 1 envelope signal
      peptide to mutations in the amino-terminal and hydrophobic regions.
AB  - We demonstrated that the leader sequence of the human immunodeficiency virus type
      1 envelope functions as signal peptide (SP) despite low scoring in a prediction
      program. As expected for SP, the hydrophobic core (HC) is essential, and no other
      sequence could compensate for HC deletion. Contrary to other SPs, major
      substitutions in the HC, such as introduction of basic, polar, or alpha-helix
      breaking residues, still allowed efficient translocation and glycosylation. Also,
      extensive deletions or substitutions of the charged residues at the N terminus
      had little if any inhibitory effect. This report, which is the first study of
      human immunodeficiency virus SP, describes the exceptional tolerance of this
      peptide to mutations.

PMID- 1629967
TI  - Envelope glycoprotein and CD4 independence of vpu-facilitated human
      immunodeficiency virus type 1 capsid export.
AB  - The effect of vpu on the release of human immunodeficiency type 1 capsid proteins
      was examined in the presence or absence of virus-encoded envelope glycoproteins
      as well as in cells which constitutively express either the CD4 or CD8 protein.
      The results show that vpu-mediated facilitated export of capsid proteins from
      HeLa cells does not require expression of the envelope glycoprotein. The
      experiments also show that export of virus capsid proteins from HeLa cells
      facilitated by vpu is not affected by coexpression of either the CD4 or CD8
      protein. The vpu protein acts in trans to facilitate export of virus capsid
      proteins from HeLa cells.

PMID- 1629968
TI  - Bipartite signal for read-through suppression in murine leukemia virus mRNA: an
      eight-nucleotide purine-rich sequence immediately downstream of the gag
      termination codon followed by an RNA pseudoknot.
AB  - The pol gene of murine leukemia virus and other mammalian type C retroviruses is
      expressed by read-through suppression of an in-frame UAG codon which separates
      the gag and pol coding regions. In this study, we have analyzed the sequence
      requirements for read-through suppression by placing different portions of wild
      type and mutant viral sequences from the gag-pol junction between reporter genes
      and testing transcripts of these constructs for suppression in reticulocyte
      lysates. We find that the read-through signal is contained within the first 57
      nucleotides on the 3' side of the UAG codon. Our results indicate that the
      identities of six conserved bases in the eight-nucleotide, purine-rich sequence
      immediately downstream of the UAG codon are critical for suppression, as is the
      existence of a pseudoknot structure spanning the next 49 nucleotides. Thus, read
      through suppression depends on a complex, bipartite signal in the mRNA.

PMID- 1629969
TI  - Determinants of thymotropism in Kaplan radiation leukemia virus and nucleotide
      sequence of its envelope region.
AB  - Radiation leukemia viruses (RadLVs) are a group of murine leukemia viruses which
      are induced by radiation and cause T-cell leukemia. Viral clones isolated from
      the BL/VL3 lymphoid cell line derived from a thymoma show variable tropism and
      leukemogenic potential. We have constructed chimeric viruses by in vitro
      recombination between two viruses, a RadLV that is thymotropic and an endogenous
      ecotropic virus that is nonthymotropic. We show here that, in contrast to
      thymotropism determinants identified previously, which lie in the long terminal
      repeat (LTR), it is the envelope region that is responsible for the thymotropism
      of BL/VL3 RadLV. The nonthymotropic virus which we have rendered thymotropic by
      transfer of the env region of RadLV in the present study has been shown
      previously to become thymotropic when the LTR of another thymotropic virus is
      inserted in its genome. Thus, the LTR and envelope gene may be involved in
      complementary action to lead to thymotropism.

PMID- 1629970
TI  - Genetic assay for multimerization of retroviral gag polyproteins.
AB  - We have established a genetic assay for the multimerization of retroviral gag
      polyproteins. This assay is based on the GAL4 two-hybrid system for studying
      protein-protein interactions (S. Fields and O. Song, Nature (London) 340:245-246,
      1989). In our initial experiments, we generated Saccharomyces cerevisiae plasmids
      that separately express the GAL4 DNA-binding and GAL4 activation domains fused to
      the human immunodeficiency virus type 1 (HIV-1) gag polyprotein, Pr55gag. The
      coexpression of these two hybrid proteins in S. cerevisiae results in the
      association of the GAL4 domains and the potent activation of an integrated GAL4
      responsive lacZ indicator gene. Similar results were obtained with plasmids
      encoding GAL4-Moloney murine leukemia virus (M-MuLV) gag polyprotein hybrid
      proteins. In contrast, the heterologous GAL4-HIV-1 gag and GAL4-M-MuLV gag fusion
      proteins were unable to interact with each other to induce lacZ expression. The
      results suggest that this yeast system provides a rapid and specific assay for
      the interactions of retroviral gag proteins that occur during virion assembly.

PMID- 1629971
TI  - Variant-specific monoclonal and group-specific polyclonal human immunodeficiency
      virus type 1 neutralizing antibodies raised with synthetic peptides from the
      gp120 third variable domain.

PMID- 1629972
TI  - Museum scholars to apply Holocaust experience to 1990s biomedical issues.

PMID- 1629973
TI  - Two years after Iraqi invasion, US Military medicine studies Desert Shield/Storm
      while looking ahead.

PMID- 1629974
TI  - Declaration has health message for politicians.

PMID- 1629975
TI  - Game's afoot in many lands for forensic scientists investigating most-extreme
      human rights abuses.

PMID- 1629976
TI  - Torture survivors find helping hands worldwide.

PMID- 1629977
TI  - Health professionals persecuted in violation of their human rights: a partial
      list of cases.

PMID- 1629978
TI  - Diagnosing streptococcal pharyngitis.

PMID- 1629979
TI  - Optimizing growth potential of children.

PMID- 1629980
TI  - Progressive multifocal leukoencephalopathy following treatment for Wegener's
      granulomatosis.

PMID- 1629981
TI  - Health care workers infected with human immunodeficiency virus.

PMID- 1629982
TI  - Disease in adopted children from Romania.

PMID- 1629983
TI  - Academic boycott of South Africa.

PMID- 1629984
TI  - Perplexing parlance of paraneoplastic pemphigus.

PMID- 1629985
TI  - Cool question: warm reply.

PMID- 1629986
TI  - Just reach out and percuss someone.

PMID- 1629987
TI  - Racial differences in coronary artery bypass rates.

PMID- 1629988
TI  - Psychiatric implications of missile attacks on a civilian population. Israeli
      lessons from the Persian Gulf War.
AB  - OBJECTIVE: To determine the proportion of hospitalized patients who had stress
      reactions as a result of missile attacks during the Persian Gulf War and evaluate
      the factors that influenced their evacuation. DESIGN: Review of medical records
      of patients hospitalized as a result of missile attacks. SETTING: During the
      Persian Gulf War in the winter of 1991, Israel received 18 missile attacks
      involving 39 surface-to-surface Scud missiles. The uncertainty in time, place,
      and type of warhead, conventional or chemical, was a source of chronic stress and
      the immediate cause for many traumatic stress reactions at or near the missile
      attack sites. PARTICIPANTS: Data from victims who were injured after each missile
      attack were available through a central hookup between 12 local hospitals and the
      Medical Corps of the Israeli Defence Force. MAIN OUTCOME MEASURE: The number of
      persons diagnosed in the hospital as psychological casualties after each missile
      attack. RESULTS: Approximately 43% of the 773 casualties evacuated to hospitals
      were diagnosed as psychological casualties, and an additional 27% had mistakenly
      injected themselves with atropine. Data also indicated that triage of
      psychological casualties to hospitals was more a function of the rescue team's
      training and preparation than the severity or extent of injury or damage.
      CONCLUSIONS: Optimal treatment during events that cause mass casualties requires
      proper preparation of rescue teams as well as reorganization of the hospital's
      psychiatric services. The threat of chemical warfare affected the number and
      nature of stress reactions.

PMID- 1629989
TI  - Thyroid nodules in the population living around Chernobyl.
AB  - OBJECTIVE: To determine the baseline incidence, prevalence, and characteristics
      of thyroid nodules in the population living around the Chernobyl nuclear power
      plant and to compare the findings with unexposed populations. DESIGN: Prevalence
      study. Population samples from seven highly contaminated villages were compared
      with six nearby control villages of the same size and type. The data were
      obtained as part of the International Chernobyl Project conducted in 1990.
      SETTING: The study was conducted 4.5 years after the Chernobyl reactor accident
      that released large quantities of radionuclides, including radioiodine. PATIENTS
      OR OTHER PARTICIPANTS: Population samples of approximately 100 persons residing
      in both highly contaminated villages and control villages since the accident were
      compared. Individuals were selected on the basis of birth date as being 5, 10,
      40, or 60 years old at the time of the study. All persons selected underwent a
      thyroid examination. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Two main outcome
      measures were used, both for thyroid nodularity: clinical palpation and high
      resolution ultrasonography. RESULTS: There was no significant difference in
      thyroid nodularity between the study groups. Nodules were palpated in 0.7% of
      children and 2.9% of adults. Discrete nodules were found by ultrasonography in
      0.5% of children and 14.9% of adults. Multinodular goiter was found in 3% of
      adults. Nodules were more common in females. CONCLUSIONS: Four and a half years
      after the Chernobyl accident, the incidence, prevalence, and characteristics of
      thyroid nodules were the same in population samples from both highly contaminated
      and control settlements and similar to results reported for unexposed populations
      in other countries.

PMID- 1629990
TI  - Estimation of radiation risks. BEIR V and its significance for medicine.

PMID- 1629991
TI  - Epidemiological and laboratory studies of power frequency electric and magnetic
      fields.

PMID- 1629992
TI  - Atropine poisoning in children during the Persian Gulf crisis. A national survey
      in Israel.
AB  - OBJECTIVE: To evaluate the effects of high doses of atropine in children
      accidentally injected with automatic atropine injectors. These were distributed
      in Israel during the Persian Gulf Crisis as an antidote for chemical warfare
      agents. DESIGN AND SETTING: A national survey in pediatric emergency departments
      in Israel, involving 22 medical centers, with prospective data collection in 14
      centers. PATIENTS: Children (n = 268) presenting to emergency departments
      following misuse of automatic atropine injectors. MAIN OUTCOME MEASURES:
      Documentation of atropine dose and clinical manifestations; determination of a
      clinical severity score and its correlation with atropine dose; measurements of
      serum atropine levels in six patients. RESULTS: Over a period of 4 months, 268
      cases were reported, of which 240 were clinically evaluated. The most common site
      of injection (75%) was the finger or palm. Doses were up to 17-fold higher than
      standard doses for age. In 116 children (48%), systemic effects of atropine were
      observed, and 20 (8%) had severe atropinization. Seizures and life-threatening
      arrhythmias were not reported, and there were no fatalities. The severity of
      atropinization was correlated with the dose following a classic nonlinear, dose
      response relationship. Serum atropine levels (6.2 to 61.0 ng/mL) were much higher
      than those observed after administration of therapeutic doses. CONCLUSIONS: The
      high incidence of injection in the hand implies accidental use of automatic
      atropine injectors among children. The lack of mortality or life-threatening
      complications from injection of large doses of atropine attests to its relative
      safety in children. The low risk from atropine injections weighed against
      expected benefit as a lifesaving antidote justifies the distribution of personal
      atropine injectors to children at risk of organophosphorus nerve agent attack.

PMID- 1629993
TI  - Efficacy of treatments for posttraumatic stress disorder. An empirical review.
AB  - OBJECTIVE--The purpose of this article is to review the empirical evidence for
      the efficacy of a range of treatments for posttraumatic stress disorder (PTSD).
      Reviewed studies focused on rape victims, combat veterans, the tragically
      bereaved, torture victims, accident victims, of physical assault, and child abuse
      victims. DATA SOURCES--Peer-reviewed journals (Psych-Info, MEDLINE), book
      chapters (PILOTS database), active investigators, abstracts from the 1990 and
      1991 International Society for Traumatic Stress Studies. STUDY SELECTION--We
      identified 255 English-language reports of treatment for PTSD. We restricted our
      focus to randomized, clinical trials that included a systematic assessment of
      PTSD using DSM-III or DSM-III-R criteria (N = 11). DATA EXTRACTION--Studies were
      assessed according to methodological strength: random assignment to the treatment
      of interest, and either an alternative treatment or control group; sample
      selection; and inclusion of statistical tests of significance. DATA SYNTHESIS-
      Drug studies show a modest but clinically meaningful effect on PTSD. Stronger
      effects were found for behavioral techniques involving direct therapeutic
      exposure, particularly in terms of reducing PTSD intrusive symptoms. However,
      severe complications have also been reported from the use of these techniques in
      patients suffering from other psychiatric disorders. Studies of cognitive
      therapy, psychodynamic therapy, and hypnosis suggest that these approaches may
      also hold promise. However, further research is needed before any of these
      approaches can be pronounced effective as lasting treatment of PTSD. CONCLUSIONS-
      Further studies should specifically address combined treatment approaches,
      optimal treatment length and timing, effects of comorbidity, and unstudied
      traumatized populations.

PMID- 1629994
TI  - Electromagnetic pulse and its effects. Board of Trustees, American Medical
      Association.

PMID- 1629995
TI  - Children and childhoods. Hidden casualties of war and civil unrest.

PMID- 1629996
TI  - Thyroid hormones in liver disease.

PMID- 1629997
TI  - Thyroid hormone levels in hepatitis B.
AB  - Thyroid hormone levels were estimated in fifty patients with hepatitis B. In
      acute phase, T3 was raised in 10% and T4 in 60%. This rise was directly
      proportional to the transaminases levels. Twenty cases were also studied in the
      recovery phase where thyroid hormones returned to within normal limits. This rise
      of T3 and T4 in acute phase is attributed to increased thyroxin binding capacity
      due to release of thyroid binding globulin into circulation from necrosing
      hepatocytes.

PMID- 1629998
TI  - Risk factors for depression.
AB  - The role of social factors in the causation of depression based on the
      aetiological model proposed by Brown and Harris was examined in a sample of 50
      depressed female patients. Loss of mother before age 11 years and lack of
      confiding relationship was found to act as a vulnerability factor whereas
      employment status and having three or more children aged 14 or under were not
      found to have an increased vulnerability in these patients. These results which
      provide general support for Brown and Harris's causal model are discussed with
      their possible implications in our socio-cultural settings.

PMID- 1629999
TI  - Glycaemic index of Pakistani staple foods in mixed meals for diabetics.
AB  - Glycaemic index of local staple foods was determined. In first phase, the post
      prandial blood glucose response of isocaloric portion of wheat chapati and gram
      flour (baisen) chapati, were compared in 11 type II diabetic patients as a part
      of mixed meal in fasting state, alternately. The glycaemic index of baisen
      chapati was 39 as compared with wheat chapati. In second phase of the study, 22
      type II diabetic patients were given isocaloric portions of wheat chapati and
      boiled rice as a part of mixed meal alternately. The glycaemic index of rice was
      98 as compared with wheat chapati. This study favours the belief that baisen
      chapati is better and refutes that rice is bad for diabetics. It also upholds
      that glycaemic index is useful for planning a diabetic diet.

PMID- 1630000
TI  - Prognostic factors in ganglionic and thalamic haemorrhages: a clinical and
      radiological study.
AB  - Clinical and radiological features of 43 patients admitted for ganglionic (21)
      and thalamic (22) haemorrhages were studied to ascertain the factors that would
      determine prognosis in the acute stage of the illness. Nineteen patients died, 16
      of them in the first week. The adverse clinical factors were an altered state of
      consciousness, decorticate/decerebrate posturing, ataxic respiration,
      abnormalities of gaze and presence of bilateral Babinski's sign. Adverse
      radiological factors were the presence of thalamic haemorrhage of 3 cm or more,
      intraventricular spread of the haemorrhage and midline shift of 0.5 cm of more.
      The significance of these findings is discussed.

PMID- 1630001
TI  - Estimation and separation of N-acetyl-beta-D-glucosaminidase isoenzymes in urine.
AB  - N-acetyl-beta-D-glucosaminidase is a lysosomal enzyme made up of two isoenzymes
      (A and B). It has been used extensively as a marker for kidney damage. However,
      its estimation in urine has not been standardized. We have established a method
      for the estimation and separation of NAG isoenzymes by ion-exchange
      chromatography. In 19 experiments done so far, this method has given reproducible
      results. The significance of this method is that with a single experiment, one
      can estimate total as well as individual isoenzyme activity. Furthermore, urine
      constituents do not appear to interfere in this assay.

PMID- 1630002
TI  - Family medicine postgraduate training in Pakistan.
AB  - There is no organized system of postgraduate training for family medicine or
      general practice in Pakistan. This paper describes the status of primary health
      care delivery in Pakistan and the growth of family medicine throughout the world.
      It stresses the need for organized postgraduate training relevant to the needs of
      primary health care in Pakistan and describes efforts currently under-way in this
      regard at the Aga Khan University Medical Centre (AKUMC) in collaboration with
      the College of Physicians and Surgeons of Pakistan.

PMID- 1630003
TI  - Abdominal complications of ascaris lumbricoides in children.

PMID- 1630004
TI  - Congenital generalized lipodystrophy.

PMID- 1630005
TI  - An unusual presentation of ischiorectal abscess.

PMID- 1630006
TI  - [Fundamentals of leukemia differentiation therapy].

PMID- 1630007
TI  - [Regulation of eosinophilopoiesis].

PMID- 1630008
TI  - [Neutrophil dysfunction].

PMID- 1630009
TI  - [Post-transfusion graft-versus-host disease].

PMID- 1630010
TI  - [Chemotherapy and FAB classification].

PMID- 1630011
TI  - [Cytogenetics and FAB classification].

PMID- 1630012
TI  - [Molecular biology and FAB classification].

PMID- 1630013
TI  - [Megakaryocyte differentiation factor isolated from cultured undifferentiated
      thyroid carcinoma supernatant--activin's biological activity].

PMID- 1630014
TI  - [Megakaryocyte-platelet hematopoietic factor produced by human lung cancer cell
      line (MC-1)].

PMID- 1630015
TI  - [The effect of vascular endothelial cells on the maturation of megakaryocytes].

PMID- 1630016
TI  - [Clinical and molecular biological study of Ph positive acute leukemia:
      comparison with blast crisis of chronic myelogenous leukemia and Ph negative
      acute lymphoblastic leukemia].
AB  - Eight cases of Philadelphia positive acute leukemia (Ph+AL) were compared with 13
      cases of Ph+ chronic myelogenous leukemia in blast crisis (BC) and 10 cases of Ph
      negative acute lymphoblastic leukemia (Ph-ALL) based on the clinical and
      molecular biological findings. Distinguishing clinical features were a high
      leukocyte count (median; 147.9 x 10(3)/microliters) for Ph+AL, and a high
      incidence of tumor formation and basophilia for BC. A cytogenetic study
      demonstrated the disappearance or marked reduction of Ph+ metaphases in Ph+AL in
      remission, while Ph+ cells persisted in BC. The major bcr gene was not rearranged
      in 4 Ph+AL cases, whereas it was found rearranged in 4 other cases of Ph+ AL and
      6 cases of BC. Reverse transcriptase polymerase chain reaction technique
      demonstrated the presence of minor bcr/abl mRNA in the former three cases, and
      major bcr/abl mRNA in the latter 4 cases. Remission rates were 63% for Ph+AL, 38%
      for BC, and 100% for Ph-ALL, and the 50% survival were 12, 5 and 29 months,
      respectively. It was concluded that Ph+AL can be differentiated from BC by a
      marked reduction of Ph+ cells at remission, and that the prognosis of Ph+AL is
      better than BC, but worse than Ph-ALL.

PMID- 1630017
TI  - [Study on the therapy of multiple myelomas--initial induction therapy (MP, IFN
      alpha, steroid pulse) and maintenance therapy (VMP, MP continuous, VEP, MCNU)].
AB  - Untreated twenty patients of multiple myeloma were treated with the chemotherapy
      protocol as follows: Initial induction therapy;MP continuous or MP intermittent--
      -IFN alpha----steroid pulse. Maintenance therapy;alkylating agents which have no
      cross resistance were used ((V) MP----(MP)----(V) EP----MCNU). Remission rate
      (CR+PR) after the initial MP therapy was 45%, and that after including IFN alpha
      and steroid pulse therapy was 50%, Fifty percent survival rate was almost as same
      as those reported previously (34M). Our protocol presented here was based on the
      idea that, initially, myeloma cells with proliferative activity could be affected
      by MP therapy, and subsequent IFN alpha therapy would have effect even on the
      residual myeloma cells. Serial checks of 3H-TdR uptake of myeloma cells during
      the therapy supported this idea. During the maintenance therapy, clinical
      responses to the initial induction therapy were not aggravated in the responded
      cases when evaluated by the variation of serum M-protein level. We propose that
      considering from a point of proliferative activity of myeloma cells is important
      for designing therapeutic protocols for multiple myeloma.

PMID- 1630018
TI  - [The significance of myelodysplasia in untreated patients with multiple myeloma].
AB  - Microscopic analysis of bone marrow smears from ten untreated patients with
      multiple myeloma (MM) revealed that seven patients had myelodysplastic changes.
      Of these, five patients had anemia alone while the other two had anemia and
      leucopenia. The myelodysplastic changes seen in MM were less extensive than those
      seen in myelodysplastic syndrome (MDS). Moreover, the dysplastic changes in MM
      were determined to be limited to two or three lineage cells. Dysplastic changes
      were observed even after clinical signs of MM had improved due to therapy. We
      consider that the myelodysplastic changes seen in MM can be attributed to MM
      itself, rather than to the coexistence of MDS and MM. Such findings suggest that
      the pathogenesis of MM involves a common stem cell which differentiates into
      multiple lineage cells.

PMID- 1630020
TI  - [Chronic myelomonocytic leukemia associated with translocation 1;7, marked
      platelet aggregation and cryofibrinogenemia: a case report].
AB  - A 64-year-old male was admitted in September 1989 with complaints of fever and
      muscular weakness in the extremities. A peripheral blood examination on admission
      revealed WBC 10,300/microliters (monocytes 32%), RBC 195 x 10(4)/microliters, Hb
      7.9 g/dl, Plt 12.8 x 10(4)/microliters with trilineage dysplasia. Bone marrow
      biopsy was normoplastic marrow with 25.7% of monocytes including immature blasts.
      Cytochemical analysis of the monocytes showed positive for peroxidase and dual
      esterase staining. Chromosomal analysis of peripheral blood revealed 46, XY, -7,
      +der(1) t(1;7)(p11;p11). A diagnosis of chronic myelomonocytic leukemia was made.
      Hemostatic studies revealed cryofibrinogenemia, marked platelet aggregation on
      blood smear, hyperfibrinogenemia and a marked increase in maximal amplitude of
      thrombelastogram. Treatment with prednisolone and VP16, resulted in a reduction
      of peripheral monocytes and a disappearance of cryofibrinogen, marked platelet
      aggregation and a decrease in muscular weakness. Nine months after diagnosis he
      died of DIC, pneumonia, lung abscess and sepsis.

PMID- 1630019
TI  - [Multiple myeloma in a patient in remission from malignant lymphoma].
AB  - A 71-year-old man was admitted because of right cervical lymph node swelling in
      February 1986. Lymph node biopsy revealed that he suffered from diffuse, large
      cell malignant lymphoma. Immunological staining showed lymphoma characterized by
      B cell markers, IgG, kappa type. Bone marrow aspiration, revealed no evidence of
      lymphoma and 0.2% plasma cells. The clinical stage was IIA. The patient was
      treated with the CHOP regimen (doxorubicin, cyclophosphamide, vincristine and
      prednisolone), which achieved complete remission. In October 1988, he was re
      admitted because of a subcutaneous abscess, and biopsy of the inguinal lymph node
      showed reactive lymphadenitis. Although he improved with antibiotic therapy,
      laboratory date on admission showed monoclonal gammopathy. Serum
      immunoelectrophoresis demonstrated a monoclonal bow of IgA kappa type, and bone
      marrow aspiration revealed hypercellularity with an increased number of plasma
      cells (76.8%). The patient was diagnosed as having multiple myeloma, and
      combination chemotherapy was begun. He now attends the out-patient department at
      our hospital. The development of multiple myeloma has not been reported
      previously during a course of malignant lymphoma. Although the association of
      these two B cell neoplasias was unknown, in this case both showed the
      characteristic of kappa type light chains. This case may provide information
      concerning tumor cell origin.

PMID- 1630021
TI  - [Isospora belli infection in a patient with adult T-cell leukemia].
AB  - An adult T cell leukemia (ATL) accompanied with Isospora belli infection was
      described. A 65-year-old male was admitted to our hospital because of a two month
      history of watery diarrhea. On admission, physical examination showed slight
      pallor but no detectable superficial lymphadenopathies. Hepatosplenomegaly was
      not observed. Laboratory examination revealed a leukocyte count 5,500/microliters
      with 10% abnormal lymphoid cells. A majority of the abnormal lymphoid cells
      expressed both CD 4 and CD 8 antigens. The patient was diagnosed as chronic ATL,
      since anti-HTLV-1 antibody in his serum and monoclonal integration of HTLV-1
      proviral DNA in his peripheral mononuclear cells were detected. Isospora belli
      was found in his feces thereafter, and trimethoprim/sulfamethoxazole was
      effective for diarrhea. In Japan, there have been only 9 reported cases of
      lymphoproliferative disorders (including five ATL patients) accompanied with
      Isospora belli infection. From the descriptions in those reports, these 9 cases
      might all be ATL patients.

PMID- 1630022
TI  - [Post-gastrectomized vitamin B12 deficient anemia with marked
      leukoerythroblastosis and ringed sideroblasts].
AB  - A 77 year-old man, who had received total gastrectomy and splenectomy 11 years
      ago for gastric cancer was transferred to our hospital because of severe
      macrocytic anemia. He had been treated with vitamin B1, B2, C and iron
      preparations for several weeks. Ten days before admission numbness developed in
      his legs. On physical examination he appeared severely anemic. Laboratory
      findings revealed severe macrocytic anemia with poikilocytosis, anisocytosis,
      polychromasia, red cell fragmentation, Howell-Jolly bodies, Cabot rings and
      marked erythroblastosis (421/100 WBC). Hypersegmented neutrophils and immature
      granulocytes were also seen in the blood. The bone marrow picture showed marked
      erythroid hyperplasia, but erythroblasts revealed only slight megaloblastic
      changes. On bone marrow iron staining all erythroblasts were classified as type
      III sideroblasts and 15% of them were ringed-form. Serum vitamin B12 was low (44
      pg/ml). Methylcobalamin given intramuscularly led to the rapid improvement of all
      hematological abnormalities including leukoerythroblastosis. Two weeks after
      vitamin B12 administration, ringed sideroblasts could no longer be detected in
      the bone marrow. Post-gastrectomy vitamin B12 deficiency anemias combined with
      erythroblastosis and ringed sideroblasts is a rare condition. Splenectomy is
      thought to play an important role in the pathogenesis of these conditions.

PMID- 1630023
TI  - [i(17q) appearing in acute phase in Ph1-negative, BCR-negative CML].
AB  - A 36-year-old woman was referred to our hospital because of splenomegaly in
      February 1989. The leukocyte count was 55,500/microliter without hiatus
      leukemicus. The leukocyte alkaline phosphatase score was low (29). The bone
      marrow showed myeloid hyperplasia (24.8% myeloblasts) but no dysplastic change.
      The karyotype of the bone marrow cells was 46, XX and a diagnosis of Ph1 (-) CML
      was made. Treatment with VCR, 6MP and prednisolone made 7-month duration chronic
      phase, but the abnormal karyotype.[46, XX, i(17q)] gradually increased to 100% of
      bone marrow cells. The patient died in June 1990. The evidence that not only a
      BCR rearrangement but also messages of BCR/ABL fusion gene were negative made us
      able to differentiate this case from Ph1(-), BCR(+) CML. The addition of an
      i(17q) results in partial monosomy of 17q (17q13;p53 gene) and partial trisomy of
      17q (17q11.2-12;G-CSF gene). We examined the rearrangement of p53 gene and G-CSF
      dependent tumor cell growth in vitro, demonstrating one allelic loss of p53 gene
      and independent cell growth on G-CSF respectively. It is thought that in Ph1 (-),
      BCR (-) CML as well as in Ph1 (+) CML, an i(17q) is related to the progression
      but not to the initiation of these leukemias. However the precise mechanism,
      including p53 gene inactivation by point mutation, is still to be elucidated.

PMID- 1630025
TI  - [CML with autoimmune thrombocytopenia observed in the course of IgG (kappa) type
      monoclonal gammopathy].
AB  - An 80-year-old male with IgG (kappa) type benign monoclonal gammopathy was
      admitted to our hospital because of marked leukocytosis. At the time of
      admission, thrombocytopenia was also noted. A bone marrow aspirate showed marked
      granulocytosis with a normal megakaryocyte count. PAIgG was elevated and the NAP
      score was low. Ph1 chromosome and rearrangement of the breakpoint cluster region
      were detected. On the basis of these findings, he was diagnosed as having CML
      with autoimmune thrombocytopenia. This case was of interest with respect to blood
      cell differentiation and immunological findings.

PMID- 1630024
TI  - [Neutrophilic dermatosis in a patient with refractory anemia].
AB  - A 46-year-old man diagnosed as refractory anemia was hospitalized because of high
      fever and extensive erythema with ulceration in the femoral region. His
      peripheral blood examination showed marked leukocytosis (WBC
      31,500/microliter:neutrophilic 90%) and anemia (Hb 8.6 g/dl. In spite of
      administration of antibiotics, the cutaneous ulcer rapidly extended to the right
      thigh and became necrotic. The bacterial culture of the cutaneous lesion showed
      no growth and a skin biopsy showed infiltration of neutrophils in the dermis. He
      became afebrile and his cutaneous lesion improved after administration of
      corticosteroid. When the dose of corticosteroid was decreased, cutaneous erythema
      and nodules appeared at other sites repeatedly, and disappeared after the dose of
      corticosteroid was increased. The cutaneous lesions had characteristics of both
      Sweet's syndrome and pyoderma gangrenosum. Moreover, the patient had
      immunological abnormalities and decreased neutrophilic functions (chemotaxis and
      O2- generation). Thus, it was suggested that the cutaneous lesions of this
      patient could be diagnosed as "neutrophilic dermatosis of MDS", and
      corticosteroid was recognized to be very effective in treating these skin
      lesions.

PMID- 1630026
TI  - [Effect of vasopressin on phospholipid metabolism in cultured rat mesangial
      cells].
AB  - Aqueous solutions containing extracts of cultured rat mesangial cells treated
      with and without arginine vasopressin (AVP) were measured by phosphorus-31
      nuclear magnetic resonance spectroscopy (31P-NMR). Ratios of the NMR signal
      intensities of phospholipids in the solutions were calculated with the areas of
      those resonance lines. Furthermore, prostaglandin E2 (PGE2) production and
      incorporation of 3H-methyl group into phospholipids in mesangial cells were
      observed in the presence and in the absence of AVP. We examined the role of AVP
      in the phospholipid metabolism of mesangial cells by the results from these three
      kinds of experiments. Ratios of (phosphorylcholine +
      glycerophosphorylcholine)/(phosphorylethanolamine +
      glycerophosphorylethanolamine), (PC + GPC)/(PE + GPE), and PC/PE increased
      significantly 5 min after AVP administration. Ratios of (GPE + GPC)/(PE + PC) and
      GPE/PE also increased significantly 30 min and 60 min after administration of
      AVP. The production of PGE2 increased with AVP treatment. This increment was
      inhibited with mepacrine and Adenosyl-S-isobutyl mercaptan (SIBA). Incorporation
      of 3H-methyl group into cellular phospholipids was accelerated with AVP, and then
      the resolution of methylated phospholipids and the release of PGE2 increased.
      These findings indicate that phospholipid methylation may be accelerated with AVP
      treatment and phosphatidylcholine, synthesized by transmethylation pathway, may
      be important as the substrate for PGE2 production in mesangial cells.

PMID- 1630027
TI  - [Charge distribution of serum IgA in IgA nephropathy with episodes of
      macrohematuria].
AB  - In order to examine further the role of the electrical change of IgA in the
      pathogenesis of IgAN, we studied the charge distribution of serum IgA in IgAN
      with episodes of macrohematuria. Blood samples were taken from 20 IgAN patients
      during bouts of macrohematuria and again more than 3 months later. Twenty healthy
      adults were used as controls. All samples were focused by Multiphor II flatbet
      electrofocusing unit apparatus (LKB) on an agarose gel (0.8% isogel agarose-EF,
      2.5% pharmalyte 4.0-6.5). The focused gels were incubated with polyclonal goat
      anti-human IgA and were washed in several changes of saline for 48 hours.
      Immunofixed materials remaining in the gels after washing were fixed and stained
      with coomassie brilliant blue R250. The stained gels were analysed by
      densitometry. The relative areas of the individual peaks and their proportional
      contributions to the total IgA spectrotype were determined by computer. The
      results were as follows: 1. The percentage of proportional contribution of IgA
      peaks (pI 4.7-5.15) in IgAN were higher in patients than in controls (p less than
      0.01). 2. The percentage of proportional contribution of IgA peaks (pI 4.9-5.05)
      in IgAN at bouts of macrohematuria was higher than in the same patients when not
      undergoing episodes of macrohematuria (p less than 0.01). These results suggest
      that the excess amount of anionic IgA may contribute to the pathogenesis of IgAN.

PMID- 1630029
TI  - [Changes in size of adult renal allografts in pediatric recipients,
      clinicopathologic study of decreased graft size in infant recipients and
      hypertrophy, renal growth in older children].
AB  - It is presumed that graft size after renal transplantation from adult donor
      decreases in infant or very young recipient and increases in older recipient.
      Measurement of graft length, width, parenchymal thickness on intravenous
      pyelography (IVP) films, measurement of area of Bowman's capsule, glomerulus,
      capillary tuft and tubule on graft biopsy specimens were compared between 3
      months and 1 year after renal transplantation. The graft sizes decreased in
      recipients below 6 years-old or body height (Ht.) 90 cm and increased in
      recipients above 6 years-old, Ht. 100 cm. The case of decreased graft size was
      found a decrease of area of Bowman's capsule, glomerulus, capillary tuft and
      tubule. We suggest that it is caused by a difference between renal blood flow in
      infant and in adult. It is suggested that graft hypertrophy depends predominantly
      on increased tubular size and capillary tuft enlargement occurs prior to
      glomerular, tubular change. But, an increase in creatinine clearance (Ccr) was
      not found following graft hypertrophy.

PMID- 1630028
TI  - [Effect of oral adsorbent AST-120 in rats with chronic renal failure--mechanism
      of progression of renal failure by dietary protein].
AB  - Progression of renal insufficiency was evaluated in partially nephrectomized
      Sprague-Dawley rats at the age of 10 weeks, fed on the low (6%), usual (20%), and
      high (36%) protein diet (group 6C, 20C, and 36C). Effects of oral adsorbent AST
      120 on these experimental uremic models were also examined (group 6A, 20A, 36A).
      All the rats underwent paired feeding, and survived during the experimental
      period of 3 weeks. GFR (inulin clearance) and RPF (para-amino hippurate
      clearance), as well as Ccr was measured before the sacrifice. Initial serum
      creatinine and Ccr were 1.7 mg/dl and 0.27 ml/min. The rats of group 36C showed
      progressive elevation of serum creatinine level and decrease in Ccr. At the end
      of the study, GFR was significantly lower in group 36C than in group 6C and 20C
      (0.19, 0.68, 0.87 ml/min respectively). Significant elevation of filtration
      fraction in group 36C suggested that the decrease in GFR mainly resulted from low
      RPF. Even in group 36C, no glomerular sclerosis was histologically demonstrated
      in the remnant kidney, and the mean planar area of the remnant glomeruli was
      significantly small, which might reflect low RPF. Tubulo-interstitial changes
      like dilatation of the urinary space and tubular epithelial flattening were
      prominent in group 36C. Beneficial effect of AST-120 was obvious in high protein
      diet groups. GFR and RPF were rather well preserved in group 36A (0.36 and 0.78
      ml/min) with normal filtration fraction. Tubulo-interstitial damage was evidently
      mild in group 36A. These data suggested the presence of some humoral factors,
      which can be adsorbed by AST-120 in gastrointestinal tract, and responsible for
      the deterioration of renal function and tubulo-interstitial damage induced by
      high protein diet in the uremic condition. Besides hyperfiltration and glomerular
      hypertrophy, such humoral factors as suggested in this study may contribute to
      the progression of chronic renal failure to some extent.

PMID- 1630030
TI  - [The investigation about age-related changes in vasoactive substances of normal
      subjects and of patients with essential hypertension].
AB  - To prove the effect of aging on the synthesis of renin-angiotensin-aldosterone
      system, renal kallikrein-kinin system, prostaglandin (PG), and thromboxane (TX)
      which regulate blood pressure, normotensive subjects and patients with essential
      hypertension (EH) were investigated in the present study. Although plasma renin
      activity (PRA) and plasma aldosterone concentration (PAC) were decreased with
      aging in both groups, there is no significant differences between each groups
      while compared among each age-groups. Urinary excretion of kallikreins (active,
      inactive and total) in EH were decreased with aging as similar extent to that of
      normal subjects. There was no age-related change of kallikrein activation ratio
      in EH in contrary to normal subjects. In comparison with each age-group, the
      amount of urinary kallikrein excretion in EH were already small in young age
      groups. The amount of urinary PGE2 excretion in female EH group was smaller than
      that of normal subjects, and there were no age-related changes in both groups.
      Urinary excretion of TXB2 and 11-dehydro-TXB2, which are the urinary major
      metabolites of TXA2 which has potent vasoconstrictive action, were increased in
      the age-group of 80-93 year-old both normal subjects and EH. There were no age
      related change in both groups. Although these hypertensive vasoactive substances
      as renin, aldosterone and TXA2 in EH show the same profile as that in normal
      subjects, the synthesis of renal antihypertensive vasoactive substances as
      kallikrein and PGE2 in EH already decrease in younger patients. These results
      suggest that the lower activities of renal antihypertensive system is a cause of
      the development of hypertension.

PMID- 1630031
TI  - [Effect of exercise on rats with renal injury].
AB  - Effect of exercise on rats with renal injury was studied. Nephritis was induced
      in rats by injection of anti-GBM antibody followed by ligation of a branch of the
      left renal artery after nephrectomy of the right kidney. Moderate daily treadmill
      exercise was forced on these experimental rats for ten weeks. Sedentary nephritic
      rats that received the same treatment described above served as controls. The
      sedentary nephritic rats suffered progressively increasing proteinuria during the
      time course of the experiment, whereas the nephritic rats with daily treadmill
      exercise experienced less proteinuria. Mild proteinuria was induced by daily
      treadmill exercise forced on non-nephritic rats that had received only
      nephrectomy of the right kidney, but no NTS injection. Light microscopy and
      immunofluorescence microscopy revealed severe glomerular injury in the sedentary
      nephritic rats, however, less glomerular injury was seen in nephritic rats with
      treadmill exercise. Serum cholesterol level was higher in the sedentary rats than
      in the rats with daily treadmill exercise. The results suggest that daily
      exercise by nephritic rats will not aggravate renal injury.

PMID- 1630032
TI  - [Clinicopathological study of membranous glomerulonephritis in patients with
      rheumatoid arthritis].
AB  - Of 103 patients with membranous glomerulonephritis proved by renal biopsy, 11
      (10.7%) had rheumatoid arthritis. Nine of these 11 patients received systemic
      treatment with anti-rheumatic remedies including gold, D-penicillamine and
      bucillamine. Two others were administered only token of nonsteroidal
      antiinflammatory drugs. Renal function of the patients was well maintained and
      within normal limits. Four patients showed nephrotic syndrome, while mild to
      moderate proteinuria was found in the other 7. Hematuria was minimal to mild, and
      it was not a major symptom. Six patients resolved proteinuria completely and 2
      patients incompletely after discontinuation of chrysotherapy. Nine cases of the
      membranous lesion in patients with rheumatoid arthritis were stage 1. Thus it was
      often difficult to identify the glomerular change only by light microscopy. IgA
      nephropathy and AA amyloidosis were associated in one patient respectively. Our
      data lead us to conclude that chrysotherapy would cause membranous lesions, but
      rheumatoid arthritis itself also induce membranous glomerulonephritis.

PMID- 1630033
TI  - [A case of familial lecithin: cholesterol acyltransferase deficiency].
AB  - Lecithin: cholesterol acyltransferase (LCAT) is an enzyme that catalyzes the
      esterifying reaction of cholesterol in plasma high density lipoprotein (HDL).
      Deficiency of LCAT is a rare hereditary disease characterized by several clinical
      symptoms such as proteinuria, corneal opacity, and anemia due to a shortened life
      span of erythrocytes. In this communication, we report a case of 40 year-old
      female patient of LCAT deficiency. She visited a hospital for work-up of
      proteinuria, corneal opacity and anemia. Activity of her serum LCAT was found to
      be extremely low, and characteristic changes in plasma lipids due to deficiency
      of LCAT was observed: those were marked decreases in HDL-cholesterol, degree of
      esterification in serum cholesterol, and apoprotein A-I, A-II, B and C-II levels.
      The diagnosis of LCAT deficiency was finally made. We studied about
      histopathological changes in the patient's kidney, and erythrocyte membrane lipid
      composition and fluidity. Histopathological findings in renal biopsy were
      follows: a) Light microscopy showed spherical deposits stained with periodic acid
      Schiff in mesangial matrix and adjacent capillary loops, and hyaline deposits in
      arterioles, b) Electron microscopy showed vacuoles in mesangial matrix and along
      the glomerular basement membranes. In erythrocyte membrane lipids, increase of
      cholesterol to phospholipid molar ratio was evident, being accompanied by changes
      in phospholipid fractions: increase of phosphatidylcholine, and decreases of
      phosphatidylethanolamine, sphingomyelin and lysophosphatidylcholine. In
      phospholipid acyl chains, increase of C18:2 and decreased of C18:1 were evident
      in the patient. Erythrocyte membrane fluidity was found to be decreased in the
      patient in a measurement by pyrene, probably being related to the changes in
      membrane lipid composition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630034
TI  - [Acute renal failure due to rhabdomyolysis--clinical investigation on our 6
      cases].
AB  - Six cases of acute renal failure (ARF) due to rhabdomyolysis were experienced
      between 1984 and 1989. Patients' ages ranged from 33 to 92 years old (average
      ages 61) and all were male. The causes of rhabdomyolysis were as follows: one
      crush syndrome, one acute arterial occlusion, one diabetic hyperosmolar
      nonketotic coma and three cases of malignant syndrome due to neuroleptica (mainly
      haloperidol). Underlying diseases included, one case of abdominal aneurysm, two
      cases of diabetes mellitus, two cases of schizophrenia and one case of reactive
      psychosis. Dehydration was considered as an important factor in the onset of
      rhabdomyolysis and ARF, because it was observed in 4 of the cases in this study.
      In all cases, the serum levels of potassium, phosphorus and uric acid as well as
      myoglobin and myogenic enzymes increased markedly. In patients with myoglobinuric
      ARF, severe metabolic acidosis and hypocalcemia in the oliguric phase and
      hypercalcemia in the diuretic phase were prominent. Muscle biopsy showed myolytic
      degeneration in 2 of 4 cases. Five cases were treated with hemodialysis and one
      case was managed conservatively. All 6 cases had relatively good prognosis.
      However, 3 cases with malignant syndrome showed outcomes more severe than in the
      other 3 cases without such syndrome.

PMID- 1630035
TI  - [A case of MCTD patient with recurrent hemoperitoneum receiving CAPD who had a
      successful recovery with an increase in steroids].
AB  - A-48-year-old man with end stage renal disease due to MCTD started CAPD in
      February 1988. He also had been treated by steroid therapy which was gradually
      decreased. He had seven hemoperitoneum episodes for ten months and two years
      since starting CARD. None of episodes were associated with CAPD catheter nor
      bacillus peritonitis. While he had had long term hemoperitoneum episode in March
      1989, he was received no steroid and had leucopenia and low compliments.
      Therefore he was treated by steroids again. He had no hemoperitoneum episodes for
      seventeen months since re-steroid therapy. And he recovered from leucopenia and
      low compliments. It seems that the mechanisms of hemoperitoneum are due to
      immunological abnormality associated with MCTD.

PMID- 1630036
TI  - [Basic understanding of retroviruses].
AB  - Retroviruses contain a reverse transcriptase in the virion that converts viral
      genomic RNA to proviral DNA. Retroviruses are divided into three groups;
      oncovirus, lentivirus, and spumavirus. The oncovirus group contains HTLV-1, which
      causes adult T-cell leukemia, encephalomyeloneuropathy, arthritis, and alveolo
      bronchopathy. The lentivirus groups contains HIV, which causes acquired
      immunodeficiency syndrome and dementia. The genomic structures and functions of
      HTLV-1 and HIV have been demonstrated to explain the pathogenesis of these
      retroviruses.

PMID- 1630037
TI  - [Pulmonary lesions of acquired immunodeficiency syndrome--analysis of 24 Japanese
      autopsy cases with AIDS].
AB  - The pulmonary lesions were studied in 24 autopsy cases of Japanese patients with
      AIDS. The major pathological findings were opportunistic infections, which were
      the major clinical symptoms in some patients. The pathogens identified were as
      follows; Pneumocystis carinii (PC) in 10, cytomegalovirus (CMV) in 14, atypical
      mycobacterium in 5, cryptococcus in 2, candida in 2, and nocardia in 1. PC
      pneumonia was prominent in 8 cases and was the cause of death. In such patients,
      the lung were heavy and appeared parenchymatous. Histological examination
      revealed numerous protozoa in the foamy material in the alveolar spaces,
      associated with swelling of the alveolar lining cells and edematous thickening of
      the alveolar septa. In some cases, only hyaline membrane formation was prominent
      without foamy material in the alveolar spaces. Immunostaining with anti-PC
      monoclonal antibody or in-situ hybridization with oligopeptide demonstrated
      pathogens in the hyaline membranes. Many cases with PC pneumonia had concomitant
      opportunistic infections such as CMV, Herpes simplex virus, and atypical
      mycobacterium. Extrapulmonary infection of PC was seen in only one case. CMV
      infection was found in 14 cases; 7 had innumerable inclusion bodies, and in some
      cases the lesions were most prominent around the bronchioles. Of the 5 cases of
      atypical mycobacterial infection, 2 were caused by M. kansaii (MK) and 3 by M.
      avium intracellulare (MAI). Both lesions of MK infection showed necrosis and
      cavitation. One of three cases of MAI infection showed cavitation. Around the
      cavitary lesions, numerous cytomegalic inclusion bodies were identified in the
      mesenchymal cells, which may have been the cause of necrosis and cavitation of
      the lesions. MAI infection was systemic and pronounced in the lymph nodes,
      spleen, and intestinal mucosa. Neoplastic lesions comprised 2 cases of Kaposi's
      sarcoma and 4 of extranodal non-Hodgkin lymphoma in other organs. Lung
      involvement was seen in only one case of Kaposi's sarcoma although very small in
      size. The lesion was situated along the pulmonary vein and appeared hemorrhagic
      macroscopically. Pulmonary lesions in AIDS are complicated, and many of
      opportunistic pathogens were identified in single patients.

PMID- 1630038
TI  - [Epidemiology of HTLV-I carriers in Hirado Island and virological and
      immunological investigation of HTLV-I associated pulmonary disease].
AB  - Adult T-cell leukemia (ATL) is endemic in Kyushu. Our study at Hirado island in
      Nagasaki prefecture revealed a higher incidence (35.9%) of HTLV-I carriers in
      villages with fishing than in those without (16.5%). HTLV-I carriers showed a
      higher incidence of abnormal findings on chest roentgenogram (21.7%) than non
      carriers (16.5%), but most were lesions of old pulmonary tuberculosis and pleural
      thickening. Virological and immunological investigations were performed for 10
      HTLV-I carriers, 3 patients with HTLV-I associated myelopathy (HAM), and 3
      patients with ATL to determine the presence of HTLV-I associated pulmonary
      disease. In HAM patients, there were high titers of anti HTLV-I antibody,
      positive IgA reaction to HTLV-I, and an increase in interleukin-2 receptor (IL-2)
      positive T-cells in the peripheral blood; and lymphocytosis and an increase in IL
      2-positive T-cells in the bronchoalveolar lavage fluid (BALF). Virological
      examination showed the presence of pX gene and tax1/rex1 mRNA in the peripheral
      blood and BALF. Similar immunological and virological findings in 2 of 10
      carriers suggested the presence of HTLV-I associated pulmonary disease.

PMID- 1630039
TI  - [Natural history of HTLV-I infection].
AB  - Adult T-cell leukemia (ATL), a disease entity first described by Takatsuki et
      al., is endemic in southwestern Japan, the Caribbean Islands, and in some parts
      of Africa. ATL patients are classified into four subtypes according to the
      clinical picture: acute, chronic, smoldering, and lymphoma type. The diagnosis of
      ATL is made from the characteristic clinical findings, the detection of serum
      antibodies to HTLV-I, and when necessary, the confirmation of monoclonal
      integration of HTLV-I proviral DNA in cellular DNA of ATL cells. Recently,
      diagnostic criteria for clinical subtypes of ATL were proposed by the Lymphoma
      Study Group in Japan: 1) smoldering type, normal lymphocyte level, no
      hypercalcemia, lactate dehydrogenase (LDH) value 1.5 times the upper limit of
      normal or lower, no lymphadenopathy, no involvement of liver, spleen, central
      nervous system (CNS), bone or gastrointestinal tract, and no ascites or pleural
      effusion: 2) chronic type, absolute lymphocytosis with T-lymphocytosis of greater
      than 3 x 10(9)/1, LDH value twice the upper limit of normal or lower, no
      hypercalcemia, no involvement of CNS, bone, or gastrointestinal tract, and no
      ascites or pleural effusion: 3) lymphoma type, no lymphocytosis, 1% or less
      abnormal lymphocytes, and histologically-proven lymphadenopathy: 4) acute type,
      remaining ATL patients who are not classified as any of the above types.
      Infection with HTLV-I is a direct cause of ATL. Furthermore, infection with this
      virus can indirectly cause many other diseases via the induction of
      immunodeficiency, such as chronic lung diseases, opportunistic lung infections,
      cancer of other organs, monoclonal gammopathy, chronic renal failure,
      strongyloidiasis, non-specific dermatomycosis, non-specific lymph node swelling,
      HTLV-I associated myelopathy (HAM/TSP), and HTLV-I uveitis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1630040
TI  - [Bronchopneumonopathy in HTLV-1 associated myelopathy (HAM) and non-HAM HTLV-1
      carriers].
AB  - Human T-cell leukemia virus type 1 (HTLV-1) causes not only adult T-cell leukemia
      (ATL), but also HTLV-1 associated myelopathy, a recently described slowly
      progressive spastic paraparesis, in its carrier state. Pulmonary involvement has
      been reported in HAM patients. Based on bronchoalveolar lavage or histological
      examination, the pulmonary involvement has been characterized by accumulation of
      T-cells, especially activated T-cells, in the lung. We reviewed our data on
      pulmonary involvement in HAM, which suggested that the characteristic pulmonary
      involvement observed in HAM was not restricted to HAM patients, but was also
      observed in non-HAM HTLV-1 carriers. Based on the data, we report that HAM is a
      systemic disease and that HTLV-1 causes characteristic pulmonary involvement,
      which we termed HTLV-1 associated bronchopneumonopathy (HAB).

PMID- 1630041
TI  - [Pathogenesis of T-lymphocyte alveolitis associated with HTLV-I infection].
AB  - Pulmonary involvement has been demonstrated in patients with spastic myelopathy
      associated with HTLV-I infection (HAM/TSP). Pulmonary lesions in these patients
      are characterized by T-lymphocytosis and increased level of soluble IL-2 receptor
      in bronchoalveolar lavage fluid. T-lymphocytes from peripheral blood and
      bronchoalveolar lavage fluid proliferated spontaneously and released IL-2 and IL
      2 receptor when cultured in vitro. Spontaneous proliferation of T-lymphocytes was
      also found in HTLV-I carriers without myelopathy, but less intensely than in
      HAM/TSP patients. Interestingly, HTLV-I-infected cells were markedly increased in
      bronchoalveolar lavage fluid from HAM/TSP patients compared to HTLV-I carriers
      without myelopathy. These results suggest that T-lymphocyte activation and
      increased HTLV-I-infected cells play an important role in the pathogenesis of
      pulmonary involvement in patients with HAM/TSP.

PMID- 1630042
TI  - [HABA (HTLV-I associated bronchiolo-alveolar disorder)].
AB  - The presence of antibodies to adult T cell leukemia (ATL) antigen: HTVL-I was
      studied in patients with chronic interstitial lung diseases such as diffuse
      panbronchiolitis (DPB) and idiopathic interstitial pneumonia (IIP). Anti-HTLV-I
      antibody was detected with a high frequency among these diseases (35% in DPB and
      7% in IIP) compared with other diseases and healthy controls. We have termed the
      clinicopathological condition that includes these two disease categories of
      interstitial lung disease (DPB or IIP) and hematologic disorder (ATL associated
      with HTLV-I carrier state) HTLV-I associated bronchiolo-alveolar disorder (HABA).
      At the same time, HTLV-I related reaction (diffuse pattern for MT-1 and/or MT-2)
      was found except positive reaction of the antibody (granular pattern for MT-1) by
      immunofluorescent assay. The incidence of HTLV-I related reaction was high in
      interstitial lung diseases with a rate of 45% in DPB and 53% in IIP. Thus, the
      total frequency of presence of antibodies and related reactions was 80% in DPB
      and 60% in IIP. In lung cancer, the frequency was also high, although it was less
      than in DPB and IIP. We termed cases of anti-HTLV-I antibody positive lung cancer
      HTLV-I associated lung cancer (HALC). One typical patient with IIP who initially
      showed HTLV-I related reaction showed a positive antibody reaction 2 years later.
      Finally he presented with adenocarcinoma with effusion a further 2 years later.
      In order to examine HTLV-I proviral DNA integration, southern blotting by PCR was
      performed in patients with HTLV-I related reaction.2+ suggesting one of the
      causes of DPB.

PMID- 1630043
TI  - [Evaluation of plasma SC5b-9 (SMAC) in patients with ARDS].
AB  - The adult respiratory distress syndrome (ARDS) occurs in patients with various
      underlying illnesses. It has been suggested that complement activation may play a
      crucial role in the pathophysiology of ARDS by direct actions of complement
      fragments and/or by release of mediators including endotoxin, superoxide anion,
      and arachidonate metabolites. Therefore, complement evaluation was performed in
      patients with ARDS, with emphasis on SC5b-9 (Membrane Attack Complex). Complement
      split products, C4d, Bb, and SC5b-9, respectively from the classical,
      alternative, and terminal complement pathway were measured by enzyme immunoassay
      (EIA) using respective monoclonal antibodies. Plasma S-protein (vitronectin)
      concentration was also evaluated by EIA. We could not detect SMAC in normal
      controls or in a C5-deficient patient with abdominal infection. In contrast, most
      patients with ARDS and patients at risk showed elevated SMAC, and an increase in
      the values in association with exacerbation of the disease. However, two patients
      with ARDS exhibited lower values of SMAC in spite of deterioration and subsequent
      death. It was suggested that in these two ARDS patients, liver dysfunction may
      have contributed to the reduced SMAC formation. The finding that S-protein
      concentration (a MAC inhibitor) in the plasma of these two patients was reduced
      supports this speculation. It is suggested that simultaneous evaluation of SMAC
      and S-protein in plasma is helpful in determining the prognosis of critically ill
      patients.

PMID- 1630044
TI  - [Use of beta-agonist inhalation concomitantly with regular beclomethasone
      dipropionate in patients with bronchial asthma--as required or on a regular
      basis].
AB  - We investigated whether regular use of beta-agonist inhalation concomitantly with
      regular beclomethasone dipropionate (BDP) inhalation is necessary in chronic
      bronchial asthma. Twenty chronic asthmatic patients who were stable on regular
      BDP and beta-agonist inhalation were studied. After a 2 week observation period,
      the patients were randomly assigned to two groups. One group received BDP 400
      micrograms/day (2 puffs 4 times) and beta-agonist inhalation as required for 4
      weeks. This period was followed by 4 weeks of treatment with BDP 400
      micrograms/day and regular beta-agonist inhalation. The other group received
      these treatments in the reverse order. No significant differences among the two
      groups were observed in attack score, ADL score, sleep score, and %PEFR. In
      addition, no differences were detected in these parameters between the periods of
      regular use of beta-agonist and the periods of use as required. The frequency of
      inhalation of beta-agonist during the use as required period correlated with the
      sleep score and difference in %PEFR between morning and night, and was
      significantly lower than the frequency of inhalation during the period of
      regular. From these results, we conclude that inhalation of beta-agonist on a
      regular basis is not necessary to achieve the same degree of relief of symptoms
      as treatment with beta 2-agonist and BDP inhalation on regular basis in patients
      with chronic asthma.

PMID- 1630045
TI  - [Distribution of ferruginous bodies in the lung in cases of malignant pleural
      mesothelioma with definite occupational history of asbestos exposure].
AB  - The distribution of ferruginous bodies in the lung in cases of malignant pleural
      mesothelioma with definite occupational history of asbestos exposure was
      examined, and the length of ferruginous bodies and the kinds of asbestos fibers
      were also evaluated. Ferruginous bodies were most numerous in the upper lobes,
      especially in S1, and were least numerous in the lower lobes. On the other hand,
      the longest ferruginous bodies were detected in the lower lobes. Amosite and
      crocidolite (amphibole groups) were found in almost all cases of malignant
      pleural mesothelioma, but chrysotile was found in only one case. The longer fiber
      length of asbestos in the amphibole group was considered to be important in the
      carcinogenicity of malignant mesothelioma, since almost all cases of malignant
      mesothelioma originated from the lower pleura.

PMID- 1630046
TI  - [Airway and alveolar inflammation assessments with bronchoalveolar lavage in
      various interstitial lung disorders].
AB  - Fractional analysis of bronchoalveolar lavage (FABAL) fluid was performed in 6
      control patients and 41 patients with various interstitial lung disease. The cell
      differential counts in the first 30 ml fraction of BAL (FBAL-I), which is
      considered to be the bronchial lavage, differed from those of the 50 ml second
      and third fraction (FBAL-III). Hypersensitivity pneumonitis, pulmonary
      tuberculosis, and sarcoidosis showed a high recovery of lymphocytes (52%);
      however, the former two disorders were occasionally, associated with neutrophil
      airway inflammation, whereas sarcoidosis was not. The percentage recovery of
      neutrophils in total FBAL was considerably high in patients with diffuse
      panbronchiolitis, and relatively high in those with collagen vascular disease,
      idiopathic pulmonary fibrosis, pneumoconiosis, and control smokers. However,
      these neutrophils were largely recovered from FBAL-I, suggesting the presence of
      airway inflammation. Thus, it is valuable to apply the FBAL method to determine
      the topographic distribution of inflammatory cells in the lungs. It was also
      found that the lymphocyte morphology in the lavage fluid was of value in
      establishing the diagnosis of hypersensitivity pneumonitis, and it is critical
      whether or not mast cells and basophils are present in BALF since they indicate
      the pathologic state of allergy or fibrosis. Although present in various fibrotic
      lung diseases in a limit number, langerhans cells are a diagnostic marker for
      histiocytosis X.

PMID- 1630047
TI  - [The candida antigen titer by CAND-TEC in patients with pulmonary disease].
AB  - In order to elucidate the background of candida infection in patients with
      pulmonary disease, we divided 100 patients into 2 groups according to their serum
      titer of CAND-TEC determined by latex agglutination test for candida antigen.
      Group C1 (83 patients) had CAND-TEC value less than 2:1, and Group C2 (17
      patients) had CAND-TEC value greater than 4:1. There was a significantly higher
      incidence of respiratory failure, hypoalbuminemia, and fever unresponsive to
      antibiotics in Group C2 compared with Group C1. Regarding the sputum culture of
      candida, there were significantly more positive cases in Group C2 than in Group
      C1. Furthermore, Group C2 showed a significantly poorer prognosis than Group C1.
      Generally, the candida antigen titer correlated well with clinical findings and
      with the course of infection and treatment with antifungal drugs. These results
      suggest that administration of antifungal drugs may be indicated in patients with
      fever unresponsive to antibiotics when the candida antigen titer is greater than
      4:1.

PMID- 1630048
TI  - [The appearance of "central core of respiratory muscle" in patients with
      respiratory failure].
AB  - We report the histological and histochemical features of core fibers present in
      respiratory muscles obtained from autopsy since 1980. Fifty autopsy cases of
      adults without neuromuscular disease were examined. "Central core" structure was
      present in 38 cases and absent in 12 cases. The duration of D.O.E. was greater
      than 1 month in 81.8% of core positive cases. In core negative cases, the
      duration of D.O.E. was less than 3 months. "Central core" structure were present
      in 80.0% of chronic respiratory failure cases and 41.7% of non-chronic cases. It
      is suggested that central core in respiratory muscles develops less than 3 months
      after the onset of D.O.E.

PMID- 1630049
TI  - [The relation between bronchial infiltration of eosinophils and bronchial
      hyperresponsiveness in two cases of eosinophilic pneumonia].
AB  - We evaluated the bronchial hyperresponsiveness to methacholine in the two cases
      of eosinophilic pneumonia with infiltration of eosinophils into bronchial mucosa.
      Bronchial responsiveness was not increased in either case in spite of marked
      infiltration of eosinophils into the bronchial mucosa and submucosa. Hypodense
      eosinophils are reported in the sputum of patients with bronchial asthma. This
      suggests that infiltration of activated eosinophils into the bronchial mucosa is
      an essential factor in bronchial hyperresponsiveness.

PMID- 1630050
TI  - [Changes in pulmonary epithelial permeability due to thoracic irradiation].
AB  - The changes in pulmonary epithelial permeability during and following radiation
      therapy were studied in 10 patients with malignant diseases of the chest; 9
      patients with bronchogenic carcinoma and one with thymoma. 99mTc-DTPA aerosol was
      inhaled during tidal breathing with the patient in supine position, and
      radioactivity was measured anteriorly by a gamma camera and recorded on a
      computer. Half time clearance (t1/2) was calculated from exponential fitting of
      time activity curves by regression analysis in various regions of interest in the
      initial 7 min following completion of aerosol inhalation. Studies were made every
      two weeks. In patients who developed radiation pneumonitis, t1/2 values decreased
      and reached the nadir at the time of manifest pneumonitis, indicating increased
      pulmonary epithelial permeability. Increased pulmonary epithelial permeability
      was observed not only in the pneumonic regions but also in the contralateral
      normal lung regions. Steroid therapy reversed these changes. Increased pulmonary
      epithelial permeability was observed in 2 out of 5 patients who did not develop
      radiation pneumonitis. In summary, pulmonary epithelial permeability changes
      occur not only in regions of radiation pneumonitis but also in non-irradiated
      lung regions following radiation therapy. We consider that the judicious use of
      this method enables detection of changes in pulmonary epithelial permeability
      prior to the development of clinical manifestations of radiation pneumonitis.

PMID- 1630051
TI  - [A case of occupational asthma caused by arrowhead scale in mandarin orange
      worker].
AB  - A 50-year-old woman with occupational asthma, whose attacks were provoked by
      inhalation of Arrowhead scale (Unapsis Yanonensis Kuwana) attached to the leaves
      of mandarin oranges is reported. She experienced asthmatic attacks while picking
      leaves and harvesting mandarin oranges. Because Arrowhead scale-dust stuck to the
      leaves was suspected to be the allergen, tests of allergy were performed using an
      extract of the allergen prepared by Unger's method in our laboratory. Asthmatic
      attack was provoked 90 minutes after inhalation of the extract of cocoon.
      Histamine was not released, but leukotriene D4 production was induced by the
      addition of the extract to whole blood. Basophils were activated by addition of
      anti-IgG anti-sera as well as the extract. These data indicate that LT released
      from target cells in response to the worm elements, as well as histamine, is
      important as a chemical mediator.

PMID- 1630052
TI  - [Inhibitory effects of alpha 1 protease inhibitor on the production of IL-1 and
      TNF alpha by alveolar macrophages in patients with lung cancer].
AB  - In the present study, we investigated the effect of alpha 1 protease inhibitor
      (alpha 1PI) on the production of interleukin-1 alpha (IL-1 alpha, ELISA), IL-1
      beta (ELISA), and tumor necrosis factor alpha (TNF alpha, ELISA) by alveolar
      macrophages (AM) recruited by bronchoalveolar lavage (BAL) from patients with
      lung cancer and benign pulmonary diseases. Levels of BALF alpha 1PI were
      significantly increased in patients with lung cancer compared with benign
      pulmonary diseases. When BALF AM were cultured and stimulated by LPS (20
      micrograms/ml) for 48 hours, production of IL-1 alpha and IL-1 beta was less
      marked in patients with lung production showed a similar tendency, but the
      difference between patients with lung cancer and benign pulmonary diseases was
      not significant. Addition of alpha 1PI to the LPS-stimulated AM culture system
      inhibited production of these cytokines dose-dependently. Thus, the local
      increase of alpha 1PI in lung cancer may act as a humoral inhibitor against the
      production of IL-1 and TNF by AM.

PMID- 1630053
TI  - [Study of the duration of antimicrobial chemotherapy in mycoplasmal pneumonia].
AB  - We assessed the period of administration of antibiotics required for cases of
      mycoplasmal pneumonia. The subjects were 38 patients with mycoplasmal pneumonia
      admitted to our hospital. These patients were treated with 100 mg minocycline or
      500 mg erythromycin by intravenous infusion twice a day. They were divided into a
      6 day-administration group (Group A; 16 cases) and a 9 day-administration group
      (Group B; 17 cases). Administration was discontinued on the 4th day or earlier in
      5 cases due to side effects. A comparative assessment was made between Groups A
      and B with respect to body temperature, WBC, erythrocyte sedimentation rate, CRP,
      and chest X-ray on the 3rd, 6th, and 9th days of treatment, but no significant
      difference was observed. Residual shadows at the end of treatment were present in
      100% of Group A and in 47% of Group B, but they disappeared gradually in both
      groups. No cases of recurrence were observed in either Group A or B within 1
      month after the completion of treatment. Regarding the treatment period for
      mycoplasmal pneumonia by intravenous infusion of minocycline or erythromycin, no
      significant clinical difference was observed between the 6 day-administration
      group and the 9 day-administration group, suggesting that 6 days of
      administration is sufficient for treatment.

PMID- 1630054
TI  - [Clinical study of respiratory infection due to Branhamella catarrhalis using
      transtracheal aspiration].
AB  - We clinically investigated 40 cases of respiratory infection due to B.
      catarrhalis by transtracheal aspiration (TTA). The cases consisted of acute
      bronchitis (13 cases), pneumonia (14 cases), and chronic lower respiratory tract
      infection (13 cases). The infection was monomicrobial in 17 cases and
      polymicrobial in 23 cases with respect to the organisms isolated from TTA. The
      principal organisms isolated in combination with B. catarrhalis in cases of
      polymicrobial infection were S. pneumoniae and H. influenzae. All of the 6 cases
      of death were patients with pneumonia who had malnutrition and immunological
      hypofunction. These results suggest that B. catarrhalis is an important pathogen
      in respiratory infection.

PMID- 1630055
TI  - [Lymphangiomyomatosis with a large retroperitoneal tumor].
AB  - A case of lymphangiomyomatosis (LAM) in a 35-year-old woman is reported. Because
      she was already severely dyspneic when she was admitted to our hospital, neither
      TBLB nor open lung biopsy was performed, and no accurate diagnosis was made. She
      died of respiratory failure three years after the development of exertional
      dyspnea, and autopsy revealed LAM. Pneumothorax, a well-known and frequent
      complication of LAM, did not occur until one month prior to her death. Although
      pneumothorax frequently complicates LAM, there are a few reports of cases in
      which pneumothorax did not occur during the course of the disease. We emphasize
      that LAM should be considered in the differential diagnosis of diffuse
      interstitial lung disease, even when the patient has no pneumothorax. The
      retroperitoneal tumor (15 x 10 x 10 cm), which was evident clinically, was later
      shown to be intra-abdominal involvement of LAM. Although only a few cases of LAM
      with a large retroperitoneal tumor have been reported, minor intra-abdominal
      involvement is relatively common. This case also suggested that the finding of a
      retroperitoneal tumor may be a diagnostic clue in LAM.

PMID- 1630056
TI  - [A case of alveolar hydatid disease of the lung in the Kansai district of Japan].
AB  - A 78-year-old man was admitted to hospital because of episodes of high grade
      fever and multiple nodular shadows on chest roentgenogram. He had a past history
      of percutaneous drainage and partial resection of the left lobe of the liver for
      liver abscess of unknown origin in 1987. The high grade fever was secondary to
      sepsis due to Citrobacter freundii. The sepsis improved with antibiotic therapy,
      but the abnormal shadows on chest roentgenogram did not improved.
      Immunoserological tests indicated a probable diagnosis of alveolar hydatid
      disease of the lung, which is very rare in the Kansai district of Japan. Open
      lung biopsy was performed and the diagnosis of alveolar hydatid disease of the
      lung was confirmed.

PMID- 1630057
TI  - [A case of occult breast carcinoma with micronodular shadows on chest x-ray
      film].
AB  - A 57-year-old woman was admitted to our hospital for the evaluation of
      roentgenological micronodular shadows of the bilateral middle and lower lung
      fields. Physical findings were normal except for left axillary lymph adenopathy.
      The level of tumor marker NCC-ST-439 was markedly elevated (2800 U/ml).
      Histological examination of the transbronchial biopsy and the swollen lymph node
      biopsy specimens showed proliferation of identical tumor cells. Breast or lung
      carcinoma was suspected as the primary site. Echogram of the left breast showed
      microcalcification without a mass. The biopsy specimen obtained from the
      calcified lesion indicated occult breast carcinoma. From these findings the
      diffuse micronodular shadows on the chest roentgenogram were considered to be the
      metastatic lesions of occult breast carcinoma. This case indicates that occult
      breast carcinoma should be considered as a possible primary site for diffuse
      pulmonary metastatic lesions.

PMID- 1630058
TI  - [A case of Wegener's granulomatosis with a giant solitary pulmonary mass].
AB  - A 44-year-old woman was admitted to hospital with a history of high fever, cough,
      and weight loss. Her chest X-ray film showed a giant solitary pulmonary mass in
      the left lower lobe. After admission, she developed bilateral eyeache and left
      exophthalmos. CT film of the head showed a massive lesion in the sinuses. Biopsy
      specimens obtained from both massive lesions showed either epithelioid granulomas
      with Langhans' giant cells or necrotising vasculitis. Antineutrophil cytoplasmic
      antibodies, which have high sensitivity and specificity for active WG, were
      found. The diagnosis of WG was thus made.

PMID- 1630059
TI  - [A case of bronchiolitis obliterans organizing pneumonia with positive anti Jo-1
      antibody preceding polymyositis].
AB  - We describe a 58-year-old female with BOOP associated with polymyositis. Four
      months prior to the appearance of distinctive manifestation of polymyositis, she
      presented with a two-week history of cough, dyspnea on exertion, and fever. Chest
      roentgenogram demonstrated bilateral basal infiltrative shadows. The patient was
      treated with prednisolone, 30 mg/day because of progressive hypoxemia. Open lung
      biopsy revealed organizing masses of granulation tissue extending from the
      respiratory bronchioles into the intra-alveolar spaces, which was consistent with
      BOOP. She developed muscle pain in her legs, fever, dry cough, hypoxemia, and
      high CPK value in the course of tapering of steroid dose. The findings of biopsy
      from the left rectus femoris muscle were compatible with polymyositis.
      Retrospective study of the patient's serum on admission showed positive anti Jo-1
      antibody.

PMID- 1630060
TI  - [A case of recurrent pulmonary alveolar proteinosis treated by pulmonary lavage:
      were the remissions due to the natural course or due to the lavage?].
AB  - We report a 39-year-old male with pulmonary alveolar proteinosis. Although no
      abnormal shadows were seen on regular check-up chest roentgenogram one year
      previously, diffuse alveolar filling shadows were noted on admission, suggesting
      fairly acute progression of the disease. He was treated with bronchoalveolar
      lavage of each segment of both lungs by flexible fiberoptic bronchoscope under
      local anesthesia. Following this treatment, the shadows on X-ray film and
      shortness of breath resolved. Oxygen tension of arterial blood, pulmonary
      function, and serum CEA recovered to almost within normal ranges. The shadows
      deteriorated twice, but therapeutic lavage performed at the outpatient clinic was
      effective on each occasion. He thus received 3 series of bronchoalveolar lavage
      over a period of more than 3 years. We followed the clinical course of this
      patient for 6 years, and he remained well 3 years after the final treatment.

PMID- 1630061
TI  - [A case of loxoprofen-induced pulmonary eosinophilia].
AB  - A 65-year-old female suffering from lumbago, headache, and hypertension had been
      treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and antihypertensive
      drugs. On June 13, 1990, 2 weeks after the commencement of loxoprofen
      administration, she developed cough and low grade fever. She was treated with
      antibiotics and NSAIDs without improvement. Laboratory data showed marked
      eosinophilia (2200/mm3), elevation of IgE (3090 IU/ml), and liver dysfunction.
      Her chest X-ray revealed no active lesion, but the percentage of eosinophils in
      BALF was elevated (38%). Because drug-induced eosinophilic pneumonia was
      suspected, all drugs were discontinued. Her symptoms improved and the
      abnormalities of laboratory data normalized. The lymphocyte stimulation test was
      weakly positive with three NSAIDs (loxoprofen, pranoprofen, and alminoprofen).
      The challenge test by loxoprofen reproduced eosinophilia and liver dysfunction,
      suggesting that she had loxoprofen-induced eosinophilic pneumonia. To our
      knowledge, this is the first reported case of loxoprofen-induced lung injury.

PMID- 1630062
TI  - [A case of vocal cord dysfunction diagnosed as bronchial asthma, that was
      improved by psychosomatic therapy].
AB  - A 19-year-old psychologically disturbed female was admitted to our hospital
      because of intractable dyspnea and wheezing for twenty two months. She had been
      diagnosed as having asthma and had received several medications including
      steroids before admission to our hospital. According to our clinical
      observations, she was considered not to have asthma because neither FEV1.0 nor
      PaO2 was decreased during the periods of wheezing and FEV1.0 was not changed by
      inhalation of bronchodilators, although she had a family history of allergy and
      false bronchial hyperreactivity by asthograph. On physical examination, diffuse
      wheezing was heard mainly over the larynx during inspiration at the times of
      dyspnea. There was flattening of the inspiratory flow-volume loop during
      wheezing. Bronchoscopy performed during an attack confirmed that wheezing was due
      to adduction of the vocal cords throughout the respiratory cycle. Therefore, this
      case was diagnosed as vocal cord dysfunction. Her symptom was considered to be a
      form of conversion reaction derived from her unhappy past history. Following
      psychosomatic therapy, all of her medications became unnecessary. She understood
      the mind-body relationship of her condition, and learned to achieve self-control.

PMID- 1630063
TI  - [A case of re-expansion pulmonary edema following water seal drainage for
      spontaneous pneumothorax--management with right and left-separated mechanical
      ventilation].
AB  - A 23-year-old male with complete collapse of the right lung due to spontaneous
      pneumothorax was admitted 11 days after its onset. Paying close attention to the
      re-expansion pulmonary edema (REPE), water seal drainage was performed. Following
      couple episodes of persistent severe cough, four hours later, he developed
      dyspnea and began to expectorate frothy massive sputum. Chest X-ray revealed
      pulmonary edema of the entire right lung field. Measurement of total proteins and
      neutrophil elastase in airway exudates showed 5.5 g/dl (ratio to plasma, 0.89)
      and 7000 micrograms/l, respectively. Because of marked difference of compliance
      between bilateral lungs, management with right and left-separated mechanical
      ventilation and PEEP applied only to the right lung was performed. Although
      transient mediastinal deviation to the left was observed, successful management
      was achieved by the maneuver. High concentrations of total proteins and
      neutrophil elastase in edema fluid suggest that increased vascular permeability
      due to endothelial cell injury via activated neutrophils is mainly responsible
      for REPE. In the present case, rapid expansion of the collapsed lung accelerated
      by severe cough seems to be a predisposing factor of REPE. In patient with
      prolonged pneumothorax, suppression of cough is thought to be important for the
      prevention of REPE even with water seal drainage.

PMID- 1630064
TI  - [Alpha 1-antitrypsin deficiency with bronchiectasis in two sisters].
AB  - Two sisters with alpha 1-antitrypsin deficiency and bronchiectasis are reported.
      The 53-year-old older sister (propositus) had pneumonia 3 times during her
      forties. She developed dyspnea on exertion in February, 1988, and a few months
      later she was seen at our hospital. Her serum alpha 1-antitrypsin level was 11
      mg/dl. Vascular markings on chest X-ray were mildly decreased. Bronchography
      showed generalized cystic bronchiectasis. The younger sister was seen at our
      hospital at the age of 50. She had been in good health until one year previously
      when she had developed pneumonia, and thereafter she had suffered from productive
      cough and dyspnea on exertion. Her alpha 1-antitrypsin level was 22 mg/dl. Chest
      X-ray showed ring-like shadows and tram lines. Chest CT scans of both sisters
      revealed cystic changes, dilatation of bronchi, and the connection of these
      lesions diffusely. The alpha 1-antitrypsin phenotype of these sisters was found
      to be PiSiiyama (homozygote). Family study revealed that alpha 1-antitrypsin
      levels of 7 members were intermediate and no members had symptoms. We consider
      that bronchiectasis may have been related to alpha 1-antitrypsin deficiency in
      these sisters.

PMID- 1630065
TI  - [A case of dimethyl sulfate intoxication manifested by persistent dyspnea].
AB  - A 35-year-old man had been exposed to the vapor of dimethyl sulfate which was
      split over the bed of a truck from an accidentally broken container. After
      receiving treatment at the critical care unit of our university hospital for
      respiratory failure, he was transferred to our ward with dyspnea persisting for
      one month. Chest X-ray showed diffuse nodular and infiltrative shadows and
      shadows suggestive of bronchial wall thickening. Bronchoscopy demonstrated
      tracheobronchial stenosis due to severe inflammation, and transbronchial lung
      biopsy revealed erosion and granulation in tissues of the bronchiolar walls.
      These findings suggested extensive inflammatory involvement of the respiratory
      tract extending from the trachea to the bronchioles. Treatment with antibiotics,
      especially agents with antipseudomonal activity, was effective against secondary
      pneumonia. Administration of corticosteroid for stenotic lesions of the airway
      was extremely beneficial. The clinical course of the respiratory lesion caused by
      dimethyl sulfate intoxication was following, including the bronchoscopic
      findings. The efficacy of treatment with corticosteroid and antibiotics was
      evaluated by successive bronchoscopic examinations of the lesions.

PMID- 1630066
TI  - Common aspects of the cerebral regulation of thirst and renal sodium excretion.
AB  - It has been shown that several mammalian species increase the excretion of sodium
      in urine as they become dehydrated. This dehydration-induced natriuresis occurs
      despite simultaneous hypovolemia, and it can be blocked by an experimentally
      induced reduction in the sodium concentration of CSF, or by ablation of the
      periventricular tissue in the vicinity of the lamina terminalis. These two
      experimental procedures also disrupt thirst and vasopressin secretion. There may
      therefore be common features involved in the central control of osmoregulatory
      thirst, vasopressin secretion and sodium excretion. Experimental evidence in
      sheep suggests that whenever the tonicity of body fluids increases, a centrally
      mediated natriuretic mechanism is engaged. This cerebral natriuretic mechanism
      may contribute along with other influences such as the extracellular fluid
      volume, aldosterone and atrial natriuretic peptide, to determine the rate of
      sodium excretion by kidneys. The efferent pathway from brain to kidney mediating
      osmoregulatory natriuresis is not known. It is probably hormonal, because renal
      denervation does not disrupt such natriuresis.

PMID- 1630067
TI  - Aging and sodium homeostasis.
AB  - Deterioration of glomerular filtration rate appears to be progressive throughout
      life whereas sodium intake tends to remain constant. The influence of aging may
      be amplified by intrinsic renal disease, unilateral nephrectomy or renovascular
      abnormalities. Changes in the tubular reabsorption of sodium will allow the
      excretory capacity of the kidney to adjust to fluctuations in normal sodium
      intake. However, restriction of dietary sodium may be associated with a sluggish
      renal response; a sodium wasting state that could lead to significant
      deterioration in renal function and orthostatic hypotension, may occur.
      Conversely, increasing dietary sodium in older subjects may result in a rise in
      arterial pressure more often than in younger subjects. Dietary sodium restriction
      should be carefully controlled in elderly subjects.

PMID- 1630068
TI  - Studies on blood pressure regulation in hypertensive ren-2 transgenic rats.
AB  - Transgenic rats harboring the mouse ren-2 gene develop severe hypertension in
      association with suppressed kidney and plasma renin levels. Extra-renal
      expression of the ren-2 gene occurs in a number of sites, and is particularly
      high in the adrenal cortex. We have investigated the response of blood pressure
      and heart rate in ren-2 rats to acute converting enzyme inhibition and to sodium
      depletion. In response to a single dose of captopril (1 mg/kg i.p.), blood
      pressure in ren-2 rats was rapidly normalized, whereas normotensive Sprague
      Dawley rats were relatively unresponsive to captopril. In response to the sodium
      depletion protocol (five days on low-sodium diet, with furosemide administered on
      day 1) both ren-2 rats and normotensive Sprague-Dawley rats underwent similar
      initial losses of sodium followed by a gradual return to net sodium balance.
      Diastolic pressure in ren-2 rats fell from 160 +/- 9 mm Hg to 105 +/- 10 mm Hg
      after 72 hours, whereas blood pressure in Sprague-Dawley rats was essentially
      unchanged. The response to captopril implies a major role for angiotensin II in
      sustaining hypertension, and this may result from tissue generation of
      angiotensin I. The response to sodium depletion suggests a volume-dependent
      component, which may result from elevated aldosterone levels, possibly due to
      enhanced adrenal renin expression.

PMID- 1630069
TI  - Spectral analysis of short-term blood pressure and heart rate variability in
      uremic patients.
AB  - Short-term fluctuations in blood pressure (BP) and heart rate (HR) were
      quantified to assess autonomic nervous system (ANS) dysfunction in six dialysis
      patients, compared to six control subjects of similar age. Indirect finger BP was
      measured by a Finapres device. Analog-to-digital conversion of the BP was used to
      determine systolic BP (SBP), diastolic BP (DBP) and HR every second. The
      equidistant sampling allowed a direct spectral analysis using a fast Fourier
      transform algorithm. Uremic patients exhibited reduced BP and HR short-term
      variabilities, with a dramatic reduction in the amplitude of the 0.1 Hz component
      (Mayer waves) of SBP and DBP spectra. Dialysis did not produce any consistent
      immediate improvement in the amplitude of the Mayer waves. Our study thus
      indicates impaired cardiovascular ANS function in uremic patients.

PMID- 1630070
TI  - Arterial pressure control in the sympathectomized rat.

PMID- 1630071
TI  - Twenty-four hour blood pressure variability: clinical implications.
AB  - Ambulatory blood pressure monitoring techniques have allowed quantification of
      blood pressure variations occurring over a 24 hour time. The evaluation of these
      phenomena has not only allowed us to investigate the mechanisms responsible for
      cardiovascular regulation, but it has also provided information of clinical
      value. In particular there is evidence that blood pressure variations are
      significantly related to cardiovascular complications of hypertension. Progress
      in technology may allow us to extend these observations by means of non-invasive
      continuous blood pressure recordings to all those conditions where intra-arterial
      methods are not allowed.

PMID- 1630072
TI  - Baroreflex control of regional vascular resistances during simulated
      orthostatism.
AB  - Orthostatic stress or moderate hypovolemia was simulated in 10 healthy volunteers
      by the lower body negative pressure technique (LBNP at -10, -20 and -40 mm Hg).
      LBNP induced a progressive and parallel decrease in central venous pressure and
      cardiac output but mean arterial pressure remained unchanged regardless of the
      LBNP level. Heart rate and pulse pressure were only significantly increased and
      decreased at LBNP -40 mm Hg, respectively, indicating that cardiopulmonary
      baroreflexes were selectively deactivated up to LBNP -20 mm Hg, whereas both
      cardiopulmonary and arterial baroreflexes were deactivated at LBNP -40 mm Hg. The
      LBNP-induced increase in total peripheral resistance was heterogeneously
      distributed within the body. Forearm vasoconstriction occurred at low levels of
      LBNP and was exclusively related to an increase in sympathetic tone. Splanchnic
      vasoconstriction also occurred at low levels of LBNP, but was related to
      activation in sympathetic and renin-angiotensin systems. Renal vasoconstriction
      occurred mainly at high levels of LBNP (-40 mm Hg), but glomerular filtration
      rate and filtration fraction increased at low levels of LBNP (-10 mm Hg). Thus,
      if renal vascular resistance is not of major importance for the control of blood
      pressure during orthostatism or moderate hypovolemia, neurohumoral mechanisms
      triggered through deactivation of cardiopulmonary receptors play a key role in
      the maintenance of intrarenal homeostasis associated with reduction in cardiac
      filling pressure.

PMID- 1630073
TI  - Sympathetic innervation of renal and extra-renal arterial vessels.
AB  - The innervation of arterial vessels has been analyzed using serial thin sections
      examined in the electron microscope. Sympathetic postganglionic noradrenergic
      axons have been found to make neuromuscular junctions on the outermost cells of
      the media of virtually all muscular arterial vessels with diameters between 20
      microns and 1 mm in rat, rabbit and guinea pig. Junctions are formed by the
      majority of varicosities which are not covered by Schwann cell on the side
      towards the artery surface. The junctions resemble those on skeletal muscle
      fibers, having a single layer of basal lamina in the synaptic cleft. Although
      post-junctional specializations have not been identified, 15 to 20% of junctions
      show electron dense regions of the prejunctional membrane with associated clumps
      of synaptic vesicles. The form of the varicose axons differs, and three distinct
      types have been distinguished on morphological grounds. Two of these occur in the
      juxtaglomerular region of the kidney, with characteristic distributions of
      junctions which differ between the afferent and efferent arterioles. The presence
      of numerous close junctions has revolutionized our thinking about how sympathetic
      neuroeffector transmission occurs in arterial vessels.

PMID- 1630074
TI  - Arterial hypertension and aneurysmal dilatation.
AB  - Hemodynamic parameters and especially systemic hypertension are considered to be
      significant factors in the progression of aortic aneurysmal dilatation. We have
      recently described an original experimental model of aortic aneurysm induced by
      transparietal infusion of elastase in the rat abdominal aorta. In order to
      evaluate the effect of hypertension on the aneurysmal remodeling of the arterial
      wall induced by perfusion of elastase activity, this experimental model was
      applied to renovascular hypertensive (N = 17), spontaneously hypertensive (N =
      18) and normotensive rats (N = 17). The aneurysms were induced by infusion of 15
      units of hog pancreatic elastase of a one centimeter isolated aortic segment in
      anesthetized rats which were sacrificed two weeks later. The aneurysmal length
      and diameter were measured in vivo using a micrometer in a surgical microscope.
      The aortas were then fixed in formalin and embedded in paraffin for standard
      histological study. The animals which died during the experimental period were
      examined. All rats presented a macroscopic aneurysm two weeks after the infusion
      of elastase. Histologically, the aneurysmal area was characterized by the
      disappearance of the normal elastic network and by the presence of a collagenic
      wall. The dimensions of the aneurysms (transversal diameter and length) were
      greater in hypertensive than in normotensive animals (F = 11, P less than 0.001)
      and aneurysmal dimensions were positively correlated with the level of blood
      pressure (r = 0.56, P less than 0.001). Moreover, the frequency of aortic rupture
      was greater in renovascular hypertensive (4/17) than in spontaneously
      hypertensive (1/18) and normotensive (0/17) rats.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1630075
TI  - Effects of monohydroxylated fatty acids on arterial smooth muscle cell
      properties.
AB  - The hydroxylated derivatives of polyunsaturated fatty acids may be potent
      modulators of basic biological responses involved in pathological processes,
      including atherosclerosis. The object of the present investigation was to study
      the effects of monohydroxylated fatty acids (namely 12-HETE) on the properties of
      aortic smooth muscle cells (SMC) in culture. The changes in cell expression of
      differentiation antigen alpha-SM actin and 2P1A2 was followed by computerized
      morphometry, using specific monoclonal antibodies and the activation of cells by
      measuring cell motility. In addition, intracellular [Ca2+]i mobilization and IP3
      formation were studied. Finally, the metabolic routes of monohydroxylated
      compounds and their effects on PGI2 secretion were reported. The results
      demonstrate that 12-HETE is able to stimulate the phenotypic modulation. PGI2
      production and motility of arterial SMCs, despite any detectable activity in
      increasing [Ca2+]i or IP3 formation. By contrast with parent compounds 15-HETE
      and 13-HODE, which appear as potent prodifferentiating molecules, 12-HETE is
      specifically metabolized via a 10-11 reductase pathway in addition to the
      classical beta-oxidation pathway. Taken together, our results suggest that
      cellular metabolism of 12-HETE, produced by platelets in the vicinity of the
      arterial intima, and also by cells present inside the atherosclerotic intima, or
      associated with modified LDL may play a key role in the atherosclerotic process.

PMID- 1630076
TI  - Regulation of membrane phospholipid metabolism in heart cell culture.
AB  - We have isolated, from newborn rats, heart cultures enriched in contractile
      muscle cells (M) and cultures of fibroblast-like cells (F). M cultures respond to
      simulated ischemia by an arrest of beating activity, by a decrease in beta
      oxydation rate, ATP and phosphocreatine content and by a loss of membrane
      phospholipids associated with neutral lipids accumulation. F cells in contrast do
      not respond to oxygen deprivation. Firstly, we observed that cocultures of M and
      F cells respond to oxygen deprivation by an arrest of beating activity and a
      decrease in cellular ATP content, but failed to exhibit any significant loss of
      membrane phospholipids. Secondly, we demonstrated that culture medium conditioned
      by F cells is able to inhibit the reaction of M cells to simulated ischemia thus
      suggesting that fibroblasts produce a diffusible factor able to block
      phospholipase activation. Heat treatment and trypsinisation failed to abolish
      this activity, indicating that the phospholipase inhibitory factor is probably
      not a polypeptide.

PMID- 1630077
TI  - Central monoamine neurons and cardiovascular control.
AB  - This review discusses the cardiovascular actions of central noradrenergic and
      serotonergic neurons, particularly with respect to the mechanism of action of the
      centrally acting antihypertensive agents clonidine, methyldopa (alpha-MD) and
      rilmenidine. The predominant actions of the noradrenergic neurons in the
      brainstem are to inhibit vasomotor and cardiac sympathetic activity and to
      facilitate cardiac vagal responses. By contrast the serotonergic neurons in the
      brainstem increase blood pressure and heart rate through excitation of cardiac
      and vasomotor sympathetic pathways and inhibition of the cardiac vagus nerve. The
      centrally acting antihypertensive drugs clonidine, rilmenidine and alpha-MD
      activate these noradrenergic pathways and inhibit the serotonergic pathways.
      Noradrenergic projections to the spinal cord tonically inhibit while the
      serotonergic neurons facilitate sympathetic vasomotor tone. In combination with
      other spinally projecting pathways, these monoamine fibers form part of a high
      gain control system for responding to changes in specific afferent information.
      However, the spinal pathways do not contribute to the actions of clonidine or
      alpha-MD. The forebrain noradrenergic projections are important for the
      noradrenergic baroreflex vagal facilitation produced by acute 6-OHDA and
      methyldopa, but not clonidine. By activating this forebrain pathway methyldopa
      minimises the baroreflex compensation that might normally be expected following a
      reduction in blood pressure.

PMID- 1630078
TI  - The cytoskeleton of arterial smooth muscle cells during human and experimental
      atheromatosis.
AB  - Smooth muscle cells (SMCs) implicated in the human atheromatous process show
      dedifferentiated features characterized by typical changes of cytoskeletal
      elements. In the normal media, quiescent SMCs express predominantly the alpha
      smooth muscle (SM) actin isoform. In the human atheromatous plaque, and in rat
      experimental intimal thickening 15 days after balloon-induced endothelial injury,
      a decrease of the alpha-SM actin isoform and a predominance of the beta
      cytoplasmic actin isoform develop. Proliferating SMCs in vivo assume fetal
      phenotypic features which are also observed in cultured SMCs. Thus, the study of
      cytoskeletal changes allows a better definition of SMC phenotype. Furthermore, in
      vitro SMCs may represent a useful experimental model to study phenotypic
      modifications of SMCs during the pathological process. Cytokines and growth
      factors, released by cells present in the atheromatous plaque, and extracellular
      components of the arterial wall, such as heparin, modulate the expression of
      alpha-SM actin in cultured SMCs and represent good candidates to exert important
      regulatory actions in vivo. A better understanding of the mechanisms leading to
      cytoskeletal modifications may help in the clarification of the mechanisms
      playing a role in the development of arterial pathological events.

PMID- 1630079
TI  - Dietary salt and risk factors for cardiovascular disease.
AB  - Sodium restriction by 50 to 100 mmol/day in populations with intakes averaging
      150 to 180 mmol/day would likely lead to a reduction of population mean blood
      pressures, and less of a tendency for blood pressures to rise with age. Fewer
      people would require antihypertensive drug therapy, and those who did would
      require less drugs. The extent of any blood pressure fall would be greatest in
      the elderly or those with established hypertension. A corresponding reduction in
      stroke incidence might be anticipated, with less certain effects on coronary
      deaths and diseases. Other factors, such as weight control, alcohol moderation
      and increased physical activity, may be of greater importance in preventing
      hypertension in many populations, while cessation of smoking, control of obesity,
      increased physical fitness and reduction in dietary saturated fat consumption
      should probably receive the highest priority in terms of overall reduction in the
      risk of atheromatous cardiovascular disease. In countries such as Japan, which
      has a relatively high incidence of stroke and a low incidence of coronary
      disease, a high sodium intake assumes relatively greater importance, in
      conjunction with obesity and alcohol, as a risk factor for cerebrovascular
      disease.

PMID- 1630080
TI  - [Antibacterial and immunocorrective therapy of diffuse purulent peritonitis].
AB  - The effectiveness of surgical treatment of 193 patients with generalized purulent
      peritonitis was analysed. The complex of bacteriologic and immunologic
      investigations contributed to optimization of antibacterial and immunocorrective
      therapy. Rational antibacterial therapy should be based on the principle of the
      use of broad and super-broad spectrum antibiotics with mandatory inclusion into
      the programme for treatment of metronidazole, administration of antibacterial
      agents before, at the time and after the operative intervention before
      identification of microflora and determination of its sensitivity to antibiotics.
      The therapeutic and tactical approach developed permitted to reduce lethality in
      generalized purulent peritonitis from 39.5 to 24.9%.

PMID- 1630081
TI  - [Informativeness of the methods of early clinical laboratory diagnosis of acute
      pancreatitis].
AB  - In 92 patients with acute pancreatitis, the informative value of the available
      methods for laboratory investigations (general blood analysis, biochemical blood
      analysis with measurement of the level of total protein, bilirubin, glucose,
      ALAT, ASAT, amylase activity, amylase activity in the urine) was analysed. The
      authors consider that the indices studied are rather informative for independent
      reliable diagnosis of acute pancreatitis and differentiation of its forms.

PMID- 1630082
TI  - [A comparative study of changes in suture materials in mammary gland tissues].
AB  - In the experiment on 75 white rats, the reactogenicity and strength of catgut,
      dexon, kacelon and PGL (native analogue of vicryl) were studied 10, 20 and 30
      days after their implantation into parenchyma of the lactating mammary gland
      (MG). Around a catgut thread, the cellular-tissue reaction according to the type
      of purulent inflammation occurred. A danger of oncogenic effect of catgut which
      manifested itself in proliferation and atypical hyperplasia of epithelium of the
      MG ducts was noted. Dexon, kacelon and PGL were characterized by similar low
      reactogenicity, but kacelon strength reduced considerably in moistening. Dexon
      and PGL due to their reactogenicity and strength properties are the materials of
      choice in surgical treatment of MG diseases.

PMID- 1630083
TI  - [Use of laser irradiation for the prevention and treatment of complications
      following surgery of the lungs and pleura].
AB  - Low-energy laser irradiation was used in treatment of 77 patients with surgical
      diseases of the lung and pleura. Laser therapy was performed by means of
      transcutaneous irradiation of the patients with the use of a semiconductor
      arsenide-gallium laser and influencing with helium-neon laser on the biologically
      active points. The use of laser therapy contributed to decrease in incidence of
      postoperative complications, shortening the duration of treatment of the patients
      at a hospital.

PMID- 1630084
TI  - [The role of sensitization of the body in the development of experimental
      peritonitis].
AB  - In the experiment, a role of preliminary sensibilization of an organism in
      increasing the reproducibility of a peritonitis model was not confirmed. A
      tendency for reduction in spreading of infection in the organism of animals in
      their intraperitoneal contamination depending on increase in a titer of specific
      antibodies and augmentation of activity of neutrophil granulocytes was revealed.

PMID- 1630085
TI  - [A method of modeling strangulation ileus].
AB  - A method for modeling of strangulation ileus consisting in passing the intestinal
      loop through a strip of cycle rubber nipple with a diameter of 2 mm, width of 4
      mm is suggested. Advantages of the method were confirmed by the findings of
      angioscopy and morphologic study in ileus modeling in 175 rats. The method
      suggested permits easy and prompt creation of a standard model of strangulation
      ileus in rats in all the cases, and study after the nipple transection of the
      changes characteristic of the postischemic period.

PMID- 1630086
TI  - [Surgical tactics in perforated stomach and duodenal ulcers].
AB  - The results of treatment of 410 patients with a perforated gastric and duodenal
      ulcer were summarized. A dependence of lethality and type of the operation
      performed on time elapsing from the moment of perforation, presence of
      concomitant diseases is shown.

PMID- 1630087
TI  - [A method of peritoneostomy for treating diffuse purulent peritonitis].
AB  - For improvement of exudate outflow and prevention of the development of
      abscesses, a modified method of peritoneostomy has been suggested and
      successfully used in treatment of 59 patients. After elimination of a source of
      peritonitis and sanitation of the abdominal cavity, the greater omentum is
      covered with a hydrocellulose film of corresponding sizes, rolled up as a
      rouleau, and placed in the epigastrium. The intestinal loops are covered with a
      perforated polyethylene film sutured to the ends of a laparotomy wound.

PMID- 1630088
TI  - [Surgical tactics in acute gastrointestinal hemorrhage].
AB  - The results of treatment of 595 patients with acute gastro-intestinal bleeding
      are presented. Ulcer disease is the most frequent cause of bleeding. In its
      diagnosis, the use of gastroduodeno-fibroscopy is effective. In ineffective
      conservative therapy, the operative intervention is indicated.

PMID- 1630089
TI  - [The use if low-stream membrane hemoxygenation and exchange plasmapheresis in the
      complex treatment of patients with peritonitis].

PMID- 1630090
TI  - [Laparocentesis as a method for early diagnosis and active dynamic observation in
      acute surgical pathology under the conditions of a district hospital].
AB  - The results of the use of laparocentesis in 75 patients for the period of 6 years
      were summarized. As a method for early diagnosis, laparocentesis was used in
      sufferers with isolated, or associated trauma to the abdomen, severe polytrauma,
      in absence of consciousness at the state of shock, or alcohol intoxication, and
      as well in patients with acute surgical pathology requiring the emergency
      operative intervention at difficult for diagnosis situations. Reliability of the
      method was 97.3%. Laparocentesis performance permitted to diagnose promptly
      damage to the visceral organs in trauma and establish necessity to use the urgent
      operation in patients with signs of acute abdomen.

PMID- 1630091
TI  - [Bacteriologic methods of study in acute appendicitis].
AB  - In the article, the results of bacteriologic study of effusion from the abdominal
      cavity in 137 patients with acute appendicitis are summarized. A value of
      bacterioscopy in urgent diagnosis of the inflammatory agent has been established.

PMID- 1630092
TI  - [Indications for relaparotomy in acute postoperative intestinal obstruction].
AB  - For the period of 1977-1987, operations on the abdominal organs were performed in
      13,306 patients. Of them, 115 (0.86%) developed 1 to 21 days after the operation
      acute ileus requiring the performance of emergency relaparotomy. Lethality in
      this complication was 33.9%. A retrospective analysis of 103 case records and
      observations on 12 patients who underwent at the early postoperative period
      emergency laparotomy for acute ileus were performed. The data were entered on a
      formalized card. The material was processed by means of a computer. The integral
      criteria for diagnosis of acute postoperative ileus which permitted to predict
      with an accuracy of 99% the complication serving an indication for relaparotomy
      were developed.

PMID- 1630094
TI  - [Choice of the approach in the performance of reconstructive surgery of the
      abdominal aorta].
AB  - The experience with surgical treatment of 630 patients with the use of
      extraperitoneal and transabdominal approaches to the abdominal aorta is
      summarized. Their advantages and disadvantages are noted. The expediency to use a
      new extraperitoneal approach to suprarenal and infrarenal portions of the
      abdominal aorta has been proved. The results of a topographic-anatomic study are
      presented. The technique for performance of a new approach to the abdominal aorta
      at this region, its advantages over the existing approaches are described.

PMID- 1630093
TI  - [Diagnosis and surgical tactics in severe closed injury to the abdomen].
AB  - The authors observed 139 patients with severe closed abdominal trauma. Diagnosis
      of the injuries mentioned is often difficult. Performance of laparoscopy permits
      to establish correct diagnosis. Severity of the state is conditioned by extensive
      character of injury to the viscera, presence of traumatic shock and internal
      hemorrhage. Lethality in closed abdominal trauma is 3.6%.

PMID- 1630095
TI  - [Experience in the organization of specialized surgical care of a patient with
      acute gastrointestinal hemorrhage under the conditions of a district hospital].

PMID- 1630096
TI  - [Organization and experience of the work of an daycare surgical hospital].

PMID- 1630097
TI  - [Postoperative peritonitis].

PMID- 1630098
TI  - [Spontaneous rupture of the esophagus].

PMID- 1630099
TI  - [Perforation of the urinary bladder by a foreign body complicated by diffuse
      peritonitis].

PMID- 1630100
TI  - [A method of treating peritonitis].

PMID- 1630101
TI  - [A method of circulating irrigation of the abdominal cavity in peritonitis].

PMID- 1630102
TI  - [Acute intestinal obstruction caused by a surgical napkin].

PMID- 1630103
TI  - [A combination of acute perforated appendicitis and pancreatic necrosis].

PMID- 1630104
TI  - [A case report of acute diverticulitis and acute appendicitis].

PMID- 1630105
TI  - [A rare complication of appendectomy].

PMID- 1630106
TI  - [A combined wound of the heart, lung and colon].

PMID- 1630107
TI  - [Severe closed trauma to the abdomen with complete circular avulsion of the
      stomach from the duodenum, and rupture of the spleen and esophagus].

PMID- 1630108
TI  - [A rare case of a thoracoabdominal wound].

PMID- 1630109
TI  - [Traumatic rupture of the right main bronchus].

PMID- 1630110
TI  - [Tactics for treating acute intestinal obstruction].
AB  - Performance of infusion-transfusion therapy before the operation, suboperative
      intravenous administration of antibiotics, metrogil, sanitation of the abdominal
      cavity with the use of antiseptics, performance of transnasal intraoperative
      intubation of the small intestine, Hartmann operation in patients with cancer of
      the left colon complicated by acute ileus (AI), liquidation of ileus at operation
      permitted considerable improvement of treatment of the patients with AI. The
      incidence of postoperative complications reduced from 9.7 to 4.1%, lethality-
      from 12.6 to 5%.

PMID- 1630111
TI  - [Continuous electrocardiostimulation in a patient with incarcerated inguinal
      hernia].

PMID- 1630112
TI  - [A chylous cyst of the abdominal cavity].

PMID- 1630113
TI  - [Plastic surgery of a duodenal defect at the time of a right-sided
      hemicolectomy].

PMID- 1630114
TI  - [Diagnosis of invagination of the small intestine in adults].

PMID- 1630115
TI  - [An incomplete turn of the small intestine in adults].

PMID- 1630116
TI  - [Personnel bottlenecks in the Zurich University Hospital. At the borders of peak
      medicine].

PMID- 1630118
TI  - [Escaped from torture].

PMID- 1630117
TI  - [Relations between fathers and their newborns].

PMID- 1630119
TI  - ["Flight is impossible ...". Interview by Martin Glauert].

PMID- 1630120
TI  - [Communication between psychogeriatric patients and their caregivers. Beyond
      words ...].

PMID- 1630121
TI  - [An evaluation instrument: the RAI--Resident Assessment Instrument].

PMID- 1630122
TI  - [Urinary incontinence in women of over 50 years. A tabu that ought to disappear].

PMID- 1630123
TI  - [Questions concerning the new regulations in nursing education. Removing
      concerns].

PMID- 1630124
TI  - ["We ourselves should know where we want to go". Interview by Monika
      Brechbuhler].

PMID- 1630125
TI  - ["Pain and suffering of the dying"--a lecture. With love and honesty].

PMID- 1630126
TI  - [How to help children to deal with painful interventions].

PMID- 1630127
TI  - [Looking back: on the essence of pain].

PMID- 1630128
TI  - [Nursing of patients with chronic pain--a term paper. What nurses can do].

PMID- 1630129
TI  - [Model of ambulatory pediatric nursing. We are nursing children at home].

PMID- 1630130
TI  - [My work place. On my way in matters of health promotion].

PMID- 1630132
TI  - [Close and partners].

PMID- 1630131
TI  - [Pain/suffering: Alice through the looking glass].

PMID- 1630133
TI  - Managing the wear and tear of dentistry.

PMID- 1630134
TI  - Blood pressure monitoring: a necessary routine?
AB  - While faculty in Oral Medicine Departments have advocated routine blood pressure
      monitoring for more than thirty years, the activity does not seem to be routine
      in many practices, but rather undertaken only when the patient indicates that
      there is a problem. This study was undertaken to ascertain if the frequency of
      abnormal blood pressure findings warrants routine monitoring on the patient who
      is already being seen by a physician or who is asymptomatic.

PMID- 1630135
TI  - Improvement in the bond strength of phosphate ester bonding systems to dentin
      surfaces.

PMID- 1630136
TI  - Special ethical issues in the management of PVS patients.

PMID- 1630137
TI  - The morality of physician-assisted suicide.

PMID- 1630138
TI  - Voluntary euthanasia and the risks of abuse: can we learn anything from The
      Netherlands?

PMID- 1630139
TI  - Mistakes and fraud in medical research.

PMID- 1630140
TI  - Germ-line gene therapy: a new stage of debate.

PMID- 1630141
TI  - Whodunit? Causal responsibility of utilization review for physicians' decisions,
      patients' outcomes.

PMID- 1630142
TI  - Current issues in biomedical ethics.

PMID- 1630143
TI  - Some ethical costs of rationing.

PMID- 1630144
TI  - Justice, politics and community: expanding access and rationing health services
      in Oregon.

PMID- 1630145
TI  - The moral standing of animals in medical research.

PMID- 1630146
TI  - An axiology for national health insurance.

PMID- 1630147
TI  - Ethical dilemmas in HIV infection: what have we learned?

PMID- 1630148
TI  - Recruitment: a survey developed for dental hygiene career awareness in Louisiana.

PMID- 1630149
TI  - When is a worker an independent contractor? A wrong answer can bring stiff
      penalties.

PMID- 1630150
TI  - Intracellular nucleotides of lymphocytes and granulocytes from normal ageing
      subjects.
AB  - Impaired lymphocyte and granulocyte function in the aged may, in part, reflect
      intrinsic aged-related biochemical alterations. In this study we compared the
      ribonucleotide contents of lymphocytes and granulocytes from young and old
      subjects evaluated by means of an HPLC-anion exchange method. We found that in
      general both populations from old subjects present higher levels of the various
      nucleotides, in particular: ATP, UDP, CTP, UDP-glucose in granulocytes, AMP, CTP,
      UDP-N-acetylglucosamine, UDP-glucose in lymphocytes. These data suggest that
      these molecules accumulate in aged subjects because of altered biochemical
      pathways. The increased pool of UDP-sugars, in particular, could be due to a
      depressed activity of some glycosyltransferases which therefore fail to
      glycosylate some plasma membrane cell proteins, thus accounting for their
      functional impairment.

PMID- 1630151
TI  - Correlation of age-associated increases in follicle stimulating hormone secretion
      with decreases in antral follicles: failure of progesterone-induced acyclicity to
      prevent these changes.
AB  - It is well known that the number of follicles in the mammalian ovary decreases
      with age. In light of previous data from this laboratory showing age-related
      alterations in the secretion and production of follicle-stimulating hormone (FSH)
      in rats by 5-6 months of age, one objective of the present study was to determine
      if alterations in FSH secretion were accompanied by changes in the number of
      antral follicles. A second objective of this study was to determine whether or
      not interruption of cyclic activity by continuous progesterone (P) treatment
      could decelerate age-associated changes in FSH secretion possibly by retarding
      the depletion of follicles through ovulation. For this study, one group of 4-day
      cycling, 7-week-old rats received one empty Silastic implant while another group
      received 3-40 mm implants containing 30 mm crystalline P. Implants were replaced
      every 2 weeks until the animals were 5 months old. Progesterone-implanted rats
      were acyclic during treatment exhibiting predominantly leukocytic vaginal smears.
      Regular 4-day cycles resumed when P implants were withdrawn (rats approximately 5
      6-months-old). A group of 2-3-month-old untreated rats were used for comparison.
      As expected from our previous results, serum FSH levels at 1600 h on estrus were
      significantly higher in 5-6-month-old rats receiving empty capsules than in
      younger rats. Serum FSH concentrations measured in P-treated rats at this time
      also were significantly higher than levels of this gonadotropin measured in
      younger rats. Ovaries of older control and P-treated rats contained significantly
      fewer medium and large antral follicles (greater than 250 microns) than the
      ovaries of younger rats despite the curtailment of estrous cyclicity and
      ovulation by continuous P treatment. Interestingly, P treatment prevented the age
      associated decrease in thymus weight. Taken together, the present observations
      suggest that a decrease in the number of growing follicles may be a factor
      contributing to early age-related alterations in FSH secretion. Furthermore, the
      prevention (at least temporarily) of age-related thymic involution by P treatment
      may be indicative of an interrelationship between thymic and reproductive aging.

PMID- 1630152
TI  - Effect of ethinyl estradiol treatment on lipoproteins and LCAT activity in aged
      rats.
AB  - The induction of hepatic lipoprotein (apo B/E) have been investigated in Fischer
      344 rats. These studies were aimed to determine the mechanism underlying the
      previously observed (Lee et al., Mech. Ageing Dev., 61 (1991) 85-98)
      hypercholesterolemia and the age-related decrease in the fractional rate of
      endogenous cholesterol esterification. Young (5 months) and aged (22 months) male
      Fischer-344 rats were treated with pharmacological doses (5 mg/kg per day) of
      ethinyl estradiol (EE) for 7 days. Reduction of plasma cholesterol (57% in young
      vs 47% in aged rats) and high density lipoprotein cholesterol (64% in young vs
      63% in aged rats) occurred in both groups upon EE treatment. Initial low density
      lipoprotein levels were very low in the plasma of young rats and consequently
      were not affected by EE treatment. However, in aged rats, the low density
      lipoprotein levels were much higher initially and were markedly reduced by EE
      treatment. (18.0 vs 10.0 mg/dl). Very low density lipoproteins were about the
      same initially but increased in aged rats and decreased in young rats upon EE
      treatment. Both the lecithin:cholesterol acyltransferase (LCAT) activity (as
      determined with a proteoliposome substrate) and the fractional rate (FR) of the
      endogenous cholesterol esterification decreased in treated animals compared to
      controls. However, the differences in the FR of the endogenous cholesterol
      esterification between young and aged rats (observed before treatment) were
      nearly abolished upon treatment. These data suggest that the previously observed
      age related decrease in the FR of endogenous cholesterol esterification is due to
      the accumulation of apolipoprotein E-rich (apo E) lipoproteins.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1630153
TI  - Quantitative evidence that the genetic basis of human mortality operates at the
      translation level: a preliminary assessment.
AB  - The dying off of human population cohorts due to different age related diseases
      rigorously follows stochastically derived rules. The existence of such rules
      suggests a common, fundamental mechanism for human mortality. We show here, by a
      simple quantitative analysis, that the progressive loss with age of genetic
      triplet code information (anticodons) in body cells, as described by the
      statistics of extremes in order theory, serves as such a mechanism.

PMID- 1630154
TI  - Longitudinal Gompertzian analysis of emphysema mortality in the US, 1962-1987:
      the differing basis for evolving mortality patterns in men and women.
AB  - Age-specific mortality rates for emphysema in the United States from 1962 through
      1987 were subjected to longitudinal Gompertzian analysis, a method that can be
      used to identify and distinguish aggregate genetic, environmental, and
      competitive influences upon mortality. Annual crude emphysema mortality rates
      (per 100,000) among men increased from 11.77 in 1962 to 20.94 in 1968, and then
      fell to 7.74 in 1987. The basis for this rise and fall is shown to be the
      corresponding changes in environmental influences upon emphysema mortality in
      men. Between 1962 and 1987, the annual crude emphysema mortality rates among
      women increased from 1.71 to 4.25. The basis for the increase of emphysema
      mortality in women, on the other hand, is shown to be an enhancement of the
      competitiveness of emphysema as a cause of mortality in women, and not the result
      of worsening environmental influences. The capability to distinguish between
      environmental and competitive influences upon evolving human mortality patterns
      could have a significant impact upon public health policy.

PMID- 1630155
TI  - Phytohemagglutinin induced changes of membrane lipid packing, c-myc and c-myb
      encoded protein expression in human lymphocytes during aging.
AB  - Three parameters which signal different stages of cell activation were analyzed
      in lymphocytes from young and old subjects. Merocyanine 540 (MC-540)
      incorporation into the membrane lipid phase was used as a very early marker of
      activation and was measured after 1 h of phytohemagglutinin (PHA) stimulation.
      The proteins coded by c-myc and c-myb protooncogenes were determined by
      appropriate antibodies and were taken as markers of the G0/G1 and G1/S phase
      transition, respectively. The number of cells which increased the uptake of MC
      540 following PHA stimulation did not differ when comparing young and old
      individuals. Both the number of the responding cells and the size of the response
      were decreased during aging when the presence of the c-myc protein was taken into
      account. A consistent decrease of the percentage of lymphocytes able to express
      the c-myb protein was observed in the cells from old donors as compared to those
      from the young ones, but the amount of detectable protein per cell remained
      unchanged. Our data suggest that the deficiency of responsiveness which
      accompanies aging is due to impairments at different points of the cell cycle.
      The very low number of cells expressing the c-myb protein is likely the result of
      step by step elimination of those cells not able to fulfill the requirements to
      progress along the cell cycle.

PMID- 1630157
TI  - Longitudinal Gompertzian analysis of ALS mortality in England and Wales, 1963
      1989: estimates of susceptibility in the general population.
AB  - Mortality statistics in amyotrophic lateral sclerosis (ALS), which is more
      commonly and generally termed motoneurone disease (MND) in the United Kingdom,
      have been shown to reflect the incidence of previously diagnosed cases of the
      disease in a more complete way than in other conditions [1,2]. An analysis of
      changing patterns of mortality may therefore be a particularly appropriate way of
      tracing the underlying trends in the disease and is in principle a useful way of
      investigating the relationship between environmental and genetically controlled
      factors in the genesis of the condition. The majority of analyses so far have
      concentrated on the crude rise in reported mortality rates evident in recent
      decades in a number of countries [2-5], on the uneven geographical distribution
      [6,7] and on the complex range of plausible causes for these reported rises.
      Debates have centred on whether the increases represent 'real' or 'artifactual'
      changes, with no apparent resolution of the issue [8,3]. Recently Riggs [9]
      proposed a novel way of analysing this issue by using a Gompertzian model and
      provided evidence of the existence of an inherently susceptible subset of the US
      population. Riggs indicated that while the rise in ALS mortality is real, it is
      for the most part the result of an increase in the size of this inherently
      susceptible sub-population due to greater longevity. In order to examine the
      wider applicability of a Gompertzian model to ALS the technique has been
      replicated with the mortality rates for England and Wales for the 27-year period
      from 1963 to 1989. The technique has been developed and extended to produce an
      estimate of the size of the inherently susceptible sub-population (both male and
      female) over the entire period.

PMID- 1630156
TI  - Hepatic cytochrome P-4503A (CYP3A) activity in the elderly.
AB  - Elderly patients exhibit decreased clearance of multiple drugs biotransformed by
      the hepatic cytochromes P-450. The cytochromes P-450 are a superfamily of
      enzymes, which comprise a central component of phase I drug metabolism. Distinct
      isoforms metabolize specific drugs. In human liver microsomes, the glucocorticoid
      inducible cytochrome P-450IIIA, CYP3A, catalyzes the N-demethylation of
      erythromycin. To examine the activity of hepatic CYP3A in elderly males and
      females, erythromycin N-demethylation was examined, as reflected by the recently
      described [14C]erythromycin breath test in 24 healthy volunteers, age 70-88. The
      [14C]erythromycin breath test was measured in normal elderly males and females
      to: (a) determine persistence of the gender-related dimorphism (evident in
      younger subjects) of CYP3A activity in the elderly population, (b) examine the
      effect of % ideal body weight, age, diet, and medication use on the activity of
      human hepatic CYP3A, and (c) compare breath test results obtained in normal
      geriatric volunteers with published results obtained in younger subjects, to
      determine aging-related alterations in CYP3A enzyme activity. Erythromycin N
      demethylation varied fivefold among these patients. Similar to earlier studies
      examining erythromycin N-demethylation in younger subjects, CYP3A activity was
      found to vary with gender in the geriatric cohort. [14C]Erythromycin N
      demethylation at 60 min was 3.14% +/- 0.75 (n = 13) in females and 2.15% +/- 0.77
      (n = 11) in males (P = 0.005). In evaluating the role of % ideal body weight and
      % dietary fat using multivariable linear regression analyses, [14C]erythromycin N
      demethylation, was found to decline significantly as % ideal body weight
      increased (P = 0.001). This was not confounded by gender. [14C]Erythromycin N
      demethylation was not related to dietary fat intake (P less than 0.13).
      [14C]Erythromycin N-demethylation in the elderly volunteers was similar to values
      reported for subjects aged 20-60. Performance of a new non-invasive test of the
      human hepatic glucocorticoid-inducible CYP3A in a geriatric cohort suggests that:
      (a) the gender-related heterogeneity in function of the glucocorticoid inducible
      human CYP3A persists during normal aging, (b) that the activity of CYP3A may
      decrease in obesity, and (c) that the activity of CYP3A is stable throughout
      normal ageing.

PMID- 1630158
TI  - Changes in glutathione content and localization in rat heart as a function of
      age.
AB  - The influence of aging on glutathione levels and distribution in the heart was
      studied in male Sprague-Dawley rats of 3 (young), 12 (adult) and 24 (old) months
      of age using biochemical and histofluorescence techniques, respectively.
      Biochemical assays of reduced glutathione (GSH) in the right and left ventricles
      and in the septum showed a significant decrease in GSH levels in adult in
      comparison with young animals. No further changes were noticeable between adult
      and old rats. GSH histofluorescence revealed a rather homogeneous distribution of
      the product of histochemical reaction within both right and left atria in 3-month
      old rats. In 12-month-old rats a reduction of GSH histofluorescence in comparison
      with younger animals was noticeable. The loss is more consistent in the
      epicardial portion of the right atrium and in the endocardial region of the left
      atrium. In the atria of 24-month-old rats GSH reactivity was homogeneously
      distributed throughout the atrial wall and was significantly lower than in young
      or adult rats. In 3-month-old rats GSH histofluorescence was slightly lower in
      the epicardial than in the endocardial portions of both ventricles. In adult rats
      a significant decrease of GSH histofluorescence was noticeable in comparison with
      3-month-old rats. The loss is particularly pronounced within the endocardial
      region of the left ventricle. In 24-month-old rats GSH histofluorescence showed
      no significant differences between adult rats. However, GSH was more
      homogeneously distributed throughout the ventricular wall than in adult animals.
      The significance of these data is discussed in relation to the role that GSH
      plays in protecting the myocytes against free radical damage.

PMID- 1630159
TI  - Effect of dietary restriction on lysosomal bodies and total protein synthesis in
      hepatocytes of aging rats.
AB  - The accumulation of lysosomal bodies has long been considered to be an important
      correlate of aging. However it is not well established whether these age related
      changes interfere with cellular function. In this study, an evaluation of
      lysosomes by ultrastructural analysis was performed in livers of 4-6 and 20-24
      month-old Sprague-Dawley female rats, fed ad libitum (A) or a restricted diet
      (R). An attempt was made to relate this parameter to hepatic protein synthesis, a
      liver function known to decrease with age and increase with dietary restriction.
      Aging was accompanied in both A and R animals with higher number and size of
      secondary lysosomes (lipofuscin) and by a decrease in total protein synthesis in
      hepatocytes. When compared to age matched ad libitum fed animals, livers of food
      restricted rats contained higher number of secondary lysosomes, yet exhibited
      higher protein synthetic capacity. Thus in hepatocytes, lipofuscin accumulation
      does not seem to interfere with cellular function.

PMID- 1630160
TI  - Catecholaminergic nucleus tractus solitarius lesions in anesthetized rats alter
      baroreflexes differently with age.
AB  - To explore whether catecholaminergic lesions produced chemically in the nucleus
      tractus solitarius (NTS) would alter the baroreflex impairment that normally
      occurs with age, we compared baroreflex responses in 3- and 14-month-old rats
      given bilateral microinjections of 6-hydroxydopamine (6-OHDA) or its vehicle into
      the NTS. After 2 weeks, basal pressures were unaffected but heart rates were
      lower in 14- than in 3-month-old rats. Sympathetic nerve inhibition elicited
      reflexly during intravenous infusions of sodium nitroprusside was reduced in 3
      month-old rats, but increased in 14-month-old rats. Depressor, bradycardiac, and
      sympatho-inhibitory responses to afferent aortic nerve stimulation were likewise
      reduced in 3-month-old rats and oppositely enhanced in 14-month-old rats.
      Enhanced bradycardia probably does not depend on increased parasympathetic
      sensitivity because responses to vagal stimulation did not differ between age
      groups. Although underlying mechanisms remain uncertain, by showing that
      baroreflex responses become altered differently in 3- and 14-month-old rats by 6
      OHDA these results suggest that the baroreflex changes normally occurring with
      age may be due, at least in part, to modified catecholaminergic mechanisms in the
      NTS.

PMID- 1630161
TI  - Quantitation of changes in mitochondrial DNA during aging and regeneration of rat
      liver using non-radioactive DNA probes.
AB  - By using DNA probes prepared from cloned cells which contain mitochondrial DNA
      (mtDNA) sequences in plasmids, the specific detection of mtDNA became possible in
      the presence of large excess of nuclear DNA by DNA-DNA hybridization. For this
      purpose, we prepared mtDNA probes labeled with non-radioactive substrate, which
      allowed a wider possibility of application. This method revealed that the
      contents of mtDNA in rat liver are strikingly decreased during aging.
      Furthermore, it was observed that although mtDNA content increased upon partial
      hepatectomy even in old rats, it decreased to the pre-operation level rather
      rapidly within 1 week after reaching peak in regenerated liver.

PMID- 1630162
TI  - Differential expression of membrane polypeptides on fetal thymic stroma co
      cultured with bone marrow cells from young and old mice.
AB  - Cell membrane polypeptides from co-cultures of lymphocyte depleted fetal thymuses
      (C57BL/Ka, H-2b, Thy 1.1) and bone marrow (BM) cells (C57BL/6J, H-2b, Thy 1.2)
      were analyzed by two-dimensional gel electrophoresis (2D-PAGE). Donors of BM
      cells were young (3 months) and old (24 months) mice. Two polypeptides, not
      detected in either the alymphoid thymus itself or the BM cells prior to seeding,
      were expressed in the co-cultures, and their levels in the presence of old BM
      cells were higher than in the presence of young BM cells. Two other polypeptides,
      originally observed in the thymic stroma, exhibited reduced levels by day 3 in
      cocultures containing BM cells from young donors, but not from old donors. It is
      concluded that distinct changes in membrane proteins are manifested in the thymic
      stroma, as well as in the colonizing BM cells.

PMID- 1630163
TI  - [The response of the growth hormone to acute effort is a function of training].
AB  - BACKGROUND: The increase of the growth hormone (GH) during exercise is known
      although the relationship of this response with other hormones, the type and
      intensity of the exercise, nutritional state and with the degree of training are
      reasons for discussion. The aim of this investigation was to study the response
      of the HG on a group of young adults with different degrees of training,
      according to the maximum consumption of oxygen (VO2 max) achieved over a short
      period of time. METHODS: Thirty-nine healthy subjects who underwent maximum
      effort on the treadmill were grouped according to VO2 max reached (less than
      3,000 ml/min; 3,000-4,500 ml/min and greater than 4,500 ml/min). Systolic blood
      pressure (SBP) and diastolic blood pressure (DBP), respiratory quotient (RQ), O2
      pulse, cardiac frequency (CF) respiratory equivalence (RE), glycemia, plasma
      insulin (PI), C peptide, lactic acid, venous pH, plasma renin activity (PRA),
      plasma aldosterone, thyrotropine (TSH), triodothyronine (T3), thyroxine (T4),
      adrenocorticotropine (ACTH), cortisol and GH were measured basally and following
      achievement of VO2 max. RESULTS: The GH was only increased in those subjects with
      a VO2 max higher than 3,000 ml/min with a significant positive correlation found
      between the GH and VO2 max and a significant negative correlation was found
      between the GH and lactic acid at the end of the test. The increase of glycemia
      at the end of the test correlated with the VO2 max. The PI and C peptide
      increased at the end of the test in the subjects with greater VO2 max capacity
      and correlated positively with the VO2 max and with the GH upon completion of the
      exercise. CONCLUSIONS: These results suggest that the response of the growth
      hormone to exercise is a function of maximum oxygen consumption although this
      only explains 24% of the variants of the growth hormone. Despite important
      hormonal and metabolic mobilization during exercise, no model of multiple
      regression has been found which substantially improves the association found
      between the growth hormone and maximum oxygen consumption.

PMID- 1630164
TI  - [Epidemiology of diabetes mellitus in the province of Leon].
AB  - BACKGROUND: Diabetes mellitus (DM) is a very important health problem because of
      its high morbidity and mortality. The aim of the present study was to investigate
      the prevalence of diabetes in the adult population of the Leon province and its
      possible association with the most common risk factors and markers. METHODS: A
      cross-sectional descriptive study was designed with a multistage stratified
      sampling (572 individuals). A questionnaire about several sociodemographic
      variables, an alimentary survey, measurements of height and weight, capillary
      baseline glycemia, and oral glucose tolerance test with 75 g glucose were carried
      out. RESULTS: The observed prevalence of diabetes mellitus was 5,6% and that of
      glucose intolerance 10,3%. The known/unknown DM ratio was 2,2/1. The prevalence
      of treated DM was 1,9%. The leading variables associated with DM were age, a
      positive family history of diabetes and obesity. A higher incidence of DM was
      found in females, in urban media, and in high social classes. BACKGROUND:
      Diabetes had been previously underrated in the Leon province. The observed
      prevalence values are close to those from other methodologically similar studies.
      In addition, an association was found between DM and some non-modifiable risk
      factors (age, sex or family history); by contrast, there is a very important risk
      factor (obesity) which may be modified by intervention.

PMID- 1630165
TI  - [Treatment of esophageal candidiasis with fluconazole in acquired
      immunodeficiency syndrome. Comparative study of 2 therapeutic schemes].
AB  - BACKGROUND: To evaluate the efficacy and pharmacological safety of 2 therapeutic
      trials with fluconazole in candida esophagitis in AIDS patients. METHODS: A total
      of 75 episodes of candida esophagitis in 70 AIDS patients were included in an
      open prospective study. In group I 36 patients were included who received 200 mg
      of fluconazole orally the first day followed by 100 mg daily for 4 weeks. In
      group II (34 patients) the length of treatment was reduced to 10 days with the
      same daily doses. Therapeutic response was evaluated by esophagoscopy, biopsy and
      fungal culture. RESULTS: The protocol was completed at 68 episodes with a cure
      being obtained in all but 2 patients in group II. No significant differences in
      clinical response were found between the 2 groups. The incidence of oropharyngeal
      colonization at the end of treatment was greater in patients from group I than
      from group II (43% vs 11%). Fluconazole was well tolerated in all the patients. A
      slight alteration of the hepatic enzymes was observed in 29 cases (40%) with a
      lower incidence in the shorter time group (p less than 0.001), however, treatment
      was discontinued only in 1 patient because of severe asymptomatic hepatic
      dysfunction to which a relation with the drug is unclear. CONCLUSIONS:
      Fluconazole in an efficient and safe agent in the treatment of candida
      esophagitis in AIDS patients. A 10 day treatment is a useful as longer treatment
      and has a lower risk of adverse effects.

PMID- 1630166
TI  - [Suicide attempts in patients with organic disease].
AB  - BACKGROUND: The aim of the present was to study the relation between organic
      disease and suicidal behavior. METHODS: The characteristics of 257 patients
      hospitalized for medical or surgical causes following attempted suicide were
      studied between June 1984 and June 1990 with 45 cases previously having had
      physical disease being compared with 212 that had not. RESULTS: Ninety-seven
      percent of the attempted suicides with organic disease fulfilled the DSM-III-R
      criteria for some psychiatric diagnosis with affective disorders predominating
      (64%). Suicides with organic illness tended to be older (p less than 0.0001),
      present a larger number of widowed patients (p less than 0.0001), have affective
      disorders (p less than 0.0001), non violent modes of suicidal behavior (p less
      than 0.008), and have a preference for non psychotropic drugs and barbiturates (p
      less than 0.007). CONCLUSIONS: Patients with organic disease who make serious
      attempts to commit suicide are characterized by high psychiatric morbidity (97%)
      with a predominance in the diagnosis of severe depression.

PMID- 1630168
TI  - [Suicides].

PMID- 1630167
TI  - [Intravesical Calmette-Guerin bacillus].

PMID- 1630169
TI  - [Management of a patient with arthritis at the emergency service].

PMID- 1630170
TI  - [Neoplastic hypercalcemia].

PMID- 1630171
TI  - [Infection caused by human immunodeficiency virus type 1 in individuals with
      negative serology. Is it really frequent?].

PMID- 1630172
TI  - [Course of human immunodeficiency virus infection and programs with adequate
      retention capacity in the control of acquired immunodeficiency syndrome and
      tuberculosis in parenteral drug addicts].

PMID- 1630173
TI  - [Retrieval and posterior use of the data contained in a database with a computer
      program].

PMID- 1630174
TI  - [Non-hodgkin's lymphoma with cranial involvement].

PMID- 1630175
TI  - [Right to reply to the reviewer].

PMID- 1630176
TI  - [Subarachnoid hemorrhage and anticoagulant treatment. Presentation of 2 cases
      associated with aneurysm].

PMID- 1630177
TI  - [Necrotic ulcers during oral anticoagulant treatment in protein C deficiency].

PMID- 1630178
TI  - [A cost-effectiveness analysis of vaccination against the hepatitis B virus].
AB  - BACKGROUND: The incidence of hepatitis B is on the increase despite immunization
      of people susceptible to risk populations. After the introduction of a
      recombinant vaccine in 1986, it has become possible to evaluate different
      alternatives of immunization, from the point of view of efficacy, with the aim of
      controlling the disease. METHODS: A cost-effectiveness analysis was performed
      with the use of decision trees and calculation of the cost per avoided case of
      infection in the different strategies evaluated, vaccination to risk groups,
      pubescent youth, newborns, and communicated accidental exposure. An evaluation of
      the different alternatives was carried out in a simple model associated to a
      passive and active immunization program of newborns of mothers who are carriers
      of HbsAg and finally, the possibility of revaccination is added. RESULTS: Costs
      and future profits are presented in pesetas for 1990 and rates of social
      discounts of 4% and 7% are applied actualizing the same. For the prevalence
      estimated in the bibliography consulted, the cost per avoided case oscillated
      between 115,000 and 310,000 ptas in the most numerous risk groups (those living
      with carriers and ADVP) with lower covering; in massive immunization of pubescent
      youth the costs are from 30,000 to 130,000 ptas; the costs for newborns is of
      about 400,000 ptas; and accidental exposure rises to 500,000 ptas per avoided
      case. CONCLUSIONS: In vaccination versus the hepatitis B virus systematic
      vaccination of adolescents is proposed as most efficient and with the aim of
      disease control a program of passive and active immunization of newborns of
      carrier mothers should be included.

PMID- 1630179
TI  - [A glucose tolerance study in the 12 months postpartum in patients with
      gestational diabetes].
AB  - BACKGROUND: It has been reported that patients with gestational diabetes have a
      considerable long term risk of developing diabetes mellitus. METHOD: Glucose
      tolerance was studied in the 12 months following birth in 155 patients diagnosed
      by the authors as having gestational diabetes and followed during pregnancy.
      RESULTS: It was observed that in 48% of the patients alterations persisted (33%
      glucose intolerance and 15% diabetes mellitus). Glucose tolerance during
      gestation and the perinatal results were retrospectively analyzed with a relation
      with the postpartum reclassification being observed. CONCLUSIONS: It was
      estimated that the percentage of alterations in glucose tolerance persisting
      postpartum is extremely high, suggesting the need for this test with a double
      objective: the reclassification of gestational diabetes and the early detection
      of glucose intolerance and diabetes mellitus.

PMID- 1630180
TI  - [Time-series analysis applied to nosocomial infection].
AB  - BACKGROUND: In this study we introduce a new view of hospital infection, to apply
      time series techniques to it. Our objective is to complement hospital infection's
      epidemiological surveillance by means of obtaining alert and alarm thresholds
      that make easy to the epidemiologist the decision of intervention, in case they
      are exceeded. METHODS: We have used the classic time series analysis described by
      Rumeau-Rouquette, and ARIMA (Autoregresive Integrated Moving Average) models
      developed by Box and Jenkins. The study focus on three hospital units: one
      intensive care, one long term care and one surgical unit. The nosocomial
      infection intervals have been calculated with a 68% (1SD) and 95% (2SD)
      confidence levels. RESULTS: We detect an ascending general trend in the last two
      units, without the detection of seasonal variations. Two ARIMA (1, 0, 0) models
      we obtained for surgery and long term care, discarding other better adjusted
      models, more complex and difficult to obtain, but with no real advantage in
      prediction power. Confidence intervals were calculated with both methods. We did
      not find general trend and seasonal variations for intensive care unit. No model
      was considered valid, because of its high random component. The nosocomial
      infection intervals have been calculated with mean +/- 1SD and mean +/- 2SD.
      CONCLUSIONS: We think that more precise knowledge of hospital infection, with a
      high random component in our study, can be in addition useful to assign priority
      to human and material resources.

PMID- 1630181
TI  - [Wegener's granulomatosis, 1992].

PMID- 1630182
TI  - [Clozapine, to be or not to be?].

PMID- 1630183
TI  - [Wegener's granulomatosis: a report of 6 patients].
AB  - The clinical and analytical manifestations and the evaluation of 6 patients
      diagnosed with Wegener's granulomatosis (WG) in the Germans Trias i Pujol
      Hospital between 1986-1990 are described. The most frequent clinical
      manifestation found were general and respiratory symptoms. Three patients
      presented an alteration in renal function and urinary sedimentation. Antibodies
      against the cytoplasm of the neutrophils (ANCA) detected by indirect
      immunofluorescence (IIF) were positive in 4 patients. All the patients underwent
      initial complete remission with immunodepressor treatment and one presented
      relapse of the disease at 19 months of diagnosis. Complications were:
      opportunistic infections obliging discontinuation of treatment in one patient,
      distal necrosis of the fingers requiring amputation in another patient and
      massive atelectasis of the right lung requiring pneumonectomy in a third patient.

PMID- 1630184
TI  - [Behcet's disease with an onset prior to the appearance of chronic myeloid
      leukemia].
AB  - The case of a Ph-positive female patient with chronic myeloid leukemia (CML) is
      reported. The patient presented a cutaneous-mucous picture prior to the
      appearance of the hemopathy consisting of genitals ulcers, buccal aphthae and
      nodular cutaneous lesions the study of which demonstrated panniculitis. The
      lesions improved with the administration of low doses of prednisone and
      colchicine. The CML evolved to a blastic crisis of a monocytic phenotype at 14
      months of diagnosis leading to death of the patient. The cutaneous-mucous picture
      was catalogued as Beccet disease (BD) according to the criteria of the
      International Study Group for Behcet Disease. Given the lack of serologic tests
      or pathognomonic histologic lesions the difficulty in the diagnosis of BD is
      commented upon and the differential diagnosis of this disease, particularly with
      respect to the Sweet syndrome, is discussed.

PMID- 1630185
TI  - [Cerebral infarct in a patient with systemic lupus erythematosus. The presence of
      lupus anticoagulant and Libman-Sacks endocarditis].

PMID- 1630186
TI  - [Pheochromocytoma: an analysis of 8 cases].

PMID- 1630187
TI  - [The treatment of cerebral abscesses].

PMID- 1630188
TI  - [The value of fine-needle aspiration puncture as a diagnostic method].

PMID- 1630189
TI  - [Chylous ascites, chylothorax and stomach cancer].

PMID- 1630190
TI  - [Health care at home: who does it? From where? Why?].

PMID- 1630191
TI  - [Treatment difficulty in familial homozygous hypercholesterolemia].

PMID- 1630192
TI  - [Streptococcus pyogenes endocarditis secondary to cellulitis].

PMID- 1630193
TI  - [Acute psychosis and biperiden].

PMID- 1630195
TI  - [Alopecia, curable or incurable?].

PMID- 1630194
TI  - [Capnocytophaga sepsis in a man with acute lymphoblastic leukemia].

PMID- 1630196
TI  - [The value of consensus conferences].

PMID- 1630197
TI  - [The norms for good clinical practice in drug trials performed in Spain. A survey
      of the pharmaceutical industry].
AB  - BACKGROUND: The objective of this survey was to assess the state of the art of
      the implementation of Good Clinical Practice in the Spanish Pharmaceutical
      Industry. METHODS: A questionnaire was sent to the sixty first laboratories
      according to their sales of ethical products. In the questionnaire there were
      questions concerning nationality of the company, personnel in clinical research,
      use and characteristics of standard operating procedures (SOPs), auditing and
      quality assurance as well as questions in connection with the future implications
      of SOPs implementation. RESULTS: The level of answer was 42%. Twenty one out of
      the 24 companies that answered the questionnaire had SOPs implemented. In total
      150 clinical research projects were carried out in 1990. One hundred one out of
      this 150 were performed under GCP. Fourteen companies agreed that with their
      current structure were able to accomplish 100% of the projects with GCP. The most
      frequent estimation of cost increase due to GCP was 30% (min. 10%; max. 70%). In
      overall 26 external audits were performed in 1990. Twenty one laboratories stated
      that they had not acceptance problems of GCP among the investigators.
      CONCLUSIONS: The sample seems to be representative of the Spanish pharmaceutical
      industry attitude with respect to GCP implementation. Although the exigency level
      was not detailed, around 42% of the clinical trials sponsored by the
      pharmaceutical industry are performed according to GCP. There is a positive
      impression as to the possibility to implement GCP as well as to the attitude of
      the investigators to this respect.

PMID- 1630198
TI  - [The cytokines that maintain living bone].

PMID- 1630199
TI  - [The health-care and economic importance of the median hospital stay].

PMID- 1630200
TI  - [New systems for making slides by computer].

PMID- 1630201
TI  - [Pleural effusion secondary to a malignant thoracic schwannoma].

PMID- 1630202
TI  - [Myelopathy secondary to electric trauma from lightning].

PMID- 1630203
TI  - [Septic pneumococcal arthritis in a female patient with chondrocalcinosis].

PMID- 1630204
TI  - [Hypertrophic osteoarthropathy and the human immunodeficiency virus].

PMID- 1630205
TI  - [Care for the diabetic patient in Catalonia. A study of a population sample].
AB  - BACKGROUND: The aim of this study was to determine the clinical and therapeutic
      profile of both types of diabetics (IDDM and NIDDM) attended at different levels
      of health care in Cataluna in order to establish quality control and rationalize
      diabetologic sanitary planning. METHODS: Fifteen centers in Cataluna participated
      in a study with a total of 1,430 patients. The centers represented different
      specialized care levels: 6 endocrinology public health out-patient clinics (EO),
      4 county hospitals (CH), 3 university hospitals (UH) and 2 private diabetic units
      (DU). RESULTS: IDDM: a) the percentage was higher in UH and DU (39 and 37) than
      in CH (26 p less than 0.01) and EO (11 p less than 0.001); b) the youngest were
      attended in UH (24 +/- 14 years) and the oldest in the EO (39 +/- 17 years, p
      less than 0.001), occupying the CH and DU at an intermediate position (34 +/- 16
      and 32 +/- 17 years) and different than the other two (p less than 0.05); c) 74%
      of those attended in UH had an evolution of less than 10 years vs 45-58% of the
      other levels (p less than 0.005); d) no differences were observed in the overall
      prevalence of complications; e) 37% of the males between 15 and 64 years of age
      were smokers; f) intensive insulin therapy is more frequently used (p less than
      0.05) in DU and UH (56% and 42%) than in EO and CH (19% and 13%); g) the
      determination of capillary glycemia is generalized (96%); h) 14% had HbA1 or
      fructosamine lower than the maximum normal value. NIDDM: a) the age of the
      patients was somewhat lower in DU (59 +/- 11) and UH (58 +/- 11) than in CH (62
      +/- 100 and EO (64 +/- 10 (p less than 0.05); b) globally, the rate of
      insulinization was 55% and home control of glycemia was 43%; c) 47% are
      hypertense (half of whom are inadequately controlled) and 55% are dyslipemic; d)
      between 15 and 64 years of age 39% of the males are smokers; e) 27% had HbA1 or
      fructosamine lower than the maximum normal value. CONCLUSIONS: a) The quality of
      medical care to diabetics in the centers analyzed is high; b) there is no
      "patient-type" for level of health care; c) there seems to be more therapeutic
      "aggressivity" among the health care workers responsible for diabetics in
      relation to the glucose vs other risk factors.

PMID- 1630207
TI  - [General practitioners in Helsingborg: better quality and service].

PMID- 1630206
TI  - [An analysis of Spanish biomedical journals by the impact factor].
AB  - BACKGROUND: One of the most frequently used parameters for evaluating scientific
      publications is that of impact factor (IF) published in the Science Citation
      Index-Journal Citation Reports (SCI-JCR) which evaluates the number of citations
      a journal receives on behalf of other journals. The present study analyzed the
      Spanish biomedical journals included in the SCI-JCR by the IF. METHODS: The IF
      were obtained from the SCI-JCR (1980-89). The journals were evaluated by the IF
      and the weighted impact factor (WIF) calculated according to WIF = (IF/MIF) x 100
      in which MIF = maximum IF of the considered area. RESULTS: Nine Spanish
      biomedical journals were included in the SCI-JCR, four being basic sciences
      (Histology and Histopathology, Inmunologia, Methods and Findings in Experimental
      and Clinical Pharmacology, Revista Espanola de Fisiologia) and five clinical
      journals (Allergologia et Immunopathologia, Medicina Clinica, Nefrologia, Revista
      Espanola de las Enfermedades del Aparato Digestivo, Revista Clinica Espanola).
      Their IF were much lower than the most important journals in each area with the
      mean (+/- standard deviation) being 0.21 +/- 0.22 (range 0.016-0.627). The mean
      WIF was 2.88 +/- 4.07 (0.16-12.82). The journals of basic sciences had higher IF
      and WIF than the clinical journals (p less than 0.05). Only the four journals of
      basic sciences were included in the SCI. Four journals, those of basic sciences,
      are preferentially or exclusively published in English and other five are
      published in Spanish. The differences in IF among these groups were not
      significant (p = 0.06) while those of WIF were significant (p less than 0.05).
      The number of Spanish biomedical journals in the SCI-JCR has risen from 1 in 1980
      to 9 in 1989 with IF which have evolved variably. CONCLUSIONS: In mind of impact
      factor, the contribution of Spanish journals is low, with that of biomedical
      sciences being higher than that of clinical journals. Language and inclusion in
      the Science Citation Index may explain, at least in part, the low impact factors
      obtained.

PMID- 1630208
TI  - [Do not destroy primary health care].

PMID- 1630209
TI  - [The right to a smoke-free occupational environment is a reasonable and natural
      demand].

PMID- 1630210
TI  - [Sleeping prone or supine--a question of life or death?].

PMID- 1630211
TI  - [Need for a humanistic and dynamic view in psychiatric care].

PMID- 1630212
TI  - [Randomization and ethics. Careful planning solves many information problems].

PMID- 1630213
TI  - [Prader-Willi syndrome or Angelman syndrome? A question of maternal or paternal
      chromosome 15].

PMID- 1630214
TI  - [Accreditation according to the international norms for better quality assurance
      in laboratory medicine].

PMID- 1630215
TI  - [Triangle revision of 3 emergency departments resulted in significant quality
      benefits].

PMID- 1630216
TI  - [Routine preoperative ECG of younger patients is not justified].

PMID- 1630217
TI  - [Depressing development since the 1970's. The incidence of sudden infant death
      has doubled in all Scandinavian countries].

PMID- 1630218
TI  - [Radiofrequency ablation--promising treatment in supraventricular arrhythmia].

PMID- 1630219
TI  - [Neurological institutes agree: they suggest new guidelines for handling of
      suspected vitamin B 12 deficiency].

PMID- 1630220
TI  - [Case management--a suitable cooperative function for patients with chronic
      mental diseases?].

PMID- 1630221
TI  - [A British system for classification of health care: "Spri" has studied the Read
      codes. It should be possible to adapt them for Swedish use].

PMID- 1630222
TI  - [Is the duration of forensic psychiatric care dependent on the type of crime or
      the need of care?].

PMID- 1630223
TI  - [The American system is nothing to imitate].

PMID- 1630224
TI  - [Clinical research improves national economy--but not with the academics isolated
      in their ivory towers].

PMID- 1630225
TI  - [What is the value of health care evaluations?].

PMID- 1630226
TI  - [More extensive psychotherapy education is needed].

PMID- 1630227
TI  - [Medical audit: how should the patients with suspected cobalamin deficiency be
      diagnosed and treated?].

PMID- 1630228
TI  - [Prevention against chickenpox in children is unnecessary!].

PMID- 1630229
TI  - [The HIV situation in Stockholm 1991. The Swedish model prevents epidemic].

PMID- 1630230
TI  - [New diagnostic and therapeutic ways for the diabetic foot].

PMID- 1630231
TI  - [New genetic findings radically improve the diagnostic possibilities in fragile X
      syndrome].

PMID- 1630232
TI  - [Unstable DNA fragment can disclose carriers of dystrophia myotonica].

PMID- 1630233
TI  - [Disturbed melatonin secretion in patients with thyroid diseases].

PMID- 1630234
TI  - [New perspectives on primary hyperparathyroidism].

PMID- 1630235
TI  - [The diabetes-nurse--a resource probably saving money and shortening the length
      of stay].

PMID- 1630236
TI  - [Group education in a diabetes school improves the metabolic control].

PMID- 1630237
TI  - [Treatment with multiple dosage insulin-pen has not only advantages].

PMID- 1630238
TI  - [Private and public ambulatory care centers--comparisons of quality, service and
      costs].

PMID- 1630239
TI  - [Local emergency care centers evaluated--radical changes are possible within the
      public health care system].

PMID- 1630240
TI  - [A critical analysis of imprecise proposals. Are priority listings a tool for
      prioritization?].

PMID- 1630242
TI  - [How much can it cost?].

PMID- 1630241
TI  - [At least half a million cases of maternal deaths per year. A chronic disaster
      with devastating effects on survival of children].

PMID- 1630243
TI  - [Child health service as a specialty].

PMID- 1630244
TI  - [Malaria and malaria prevention in Sweden].

PMID- 1630245
TI  - [What are the limits of the responsibility of the psychotherapy instructor?].

PMID- 1630246
TI  - [Acupuncture in asthma? A long-term study should decide].

PMID- 1630247
TI  - [Nephropathy induced by a contrast medium--comments on risk factors and
      prevention].

PMID- 1630248
TI  - [Bullying--to bully or being bullied. A questionnaire study in middle schools in
      Uppsala].

PMID- 1630249
TI  - [New discoveries on the etiology of type 1 diabetes--an example of molecular
      epidemiology].
AB  - During the past decade the incidence of type 1 diabetes has been on the increase
      in Sweden, as it has in many other Western countries. The paper consists in a
      review of new hypothesis as to the pathogenesis of disease, resulting from
      findings in intensive molecular, genetic, immunological and epidemiological
      studies. Reversal of the rising trend in the incidence of type 1 diabetes is
      dependent upon further detailed elucidation of the molecular biology of the
      genetic and immunological markers of the disease, and their predictive value in
      population based studies. The currently identified risk factors, which may be
      initiators or promoters of diabetes pathogenesis, also need to be further
      elucidated, for which purpose a molecular epidemiological strategy is
      recommended, as it has already been found to be a successful approach in studies
      of type 1 diabetes.

PMID- 1630251
TI  - [Chronic abscessing skin infection after a splinter in the finger].

PMID- 1630250
TI  - [Malaria in Gothenburg 1985-1990. Increasing frequency of malaria necessitates
      better knowledge of preventive measures].

PMID- 1630252
TI  - [Liver transplantation--experiences from the first 100 cases in Gothenburg].

PMID- 1630253
TI  - [Despite the shortage of personnel, time, computers and resources: a lot of
      quality assurance work is done at the Swedish surgical departments today].

PMID- 1630254
TI  - [From hygiene to environmental medicine. Need for environmental precautions and
      improvement of public health requires better education].

PMID- 1630255
TI  - [Life expectancy together with good health are health indicators of the public
      health status].

PMID- 1630256
TI  - [Abortions of female fetuses in India--a prenatal sexual discrimination].

PMID- 1630257
TI  - [From the golden years to the stormy years--role of the head of the clinical
      department through 4 decades].

PMID- 1630258
TI  - [Family practice and children].

PMID- 1630259
TI  - [Transcervical endometrial resection as an alternative to hysterectomy in
      menorrhagia].

PMID- 1630260
TI  - [Who will pay for the competence and readiness of hospitals?].

PMID- 1630261
TI  - [It is important for cancer patients to get individual planned written dietary
      guidelines].

PMID- 1630262
TI  - [Is hypertonic dehydration increasing among children with gastroenteritis?].

PMID- 1630263
TI  - [Lead poisoning in children is a serious problem in the USA].

PMID- 1630264
TI  - [Importance of examination in the choice of the right surgical method of
      treatment of facial paralysis].

PMID- 1630265
TI  - [Fertilization in vitro is successful in nearly half of the treated patients].

PMID- 1630266
TI  - [Miraculous luck in an accident].

PMID- 1630267
TI  - [Body weight of the Swedish population is increasing].

PMID- 1630268
TI  - [Housing adapted to the needs of patients with dementia. Medical competence is
      necessary during planning].

PMID- 1630269
TI  - [Research ethics in practice. Research ethics committees do not guarantee the
      right to informed consent].

PMID- 1630270
TI  - [It can take 10 years between planning and execution of an experiment in space
      research].

PMID- 1630271
TI  - [Pediatricians in primary health care--do general practitioners and pediatricians
      talk the same language?].

PMID- 1630272
TI  - [The thoracic clinic in Umea--a new experimental model for better and cheaper
      care].

PMID- 1630273
TI  - Dietary ether lipid incorporation into tissue plasmalogens of humans and rodents.
AB  - Chronic feeding of 1-O-octadecyl-sn-glycerol (batyl alcohol) to patients
      suffering from congenital deficiency in tissue ether glycerolipids showed an
      increase in the plasmalogens content of their erythrocytes. However, nothing is
      known about the ether lipid content of other tissues in these patients. Feeding 1
      O-heptadecyl-sn-glycerol to young rats showed that this uncommon ether lipid was
      incorporated to a high extent into the plasmalogens of all tissues except brain.
      Comparative studies with other precursors, such as 3-O-heptadecyl-sn-glycerol,
      heptadecanol and heptadecanoic acid, indicated a stereospecific incorporation of
      the dietary 1-O-alkyl-sn-glycerols into tissue plasmalogens without cleavage of
      the ether bond. Dietary ether lipids were also shown to be transferred from
      mothers to suckling rats, but not from pregnant rats to fetuses. The implication
      of these results to possible dietary ether lipid therapy for patients suffering
      from peroxisomal disorders is discussed.

PMID- 1630274
TI  - Characterization of a cytosolic protein in rat liver inhibiting neutral
      cholesteryl ester hydrolase.
AB  - Neutral cholesteryl ester hydrolase activity (EC 3.1.1.13) present in microsomes
      isolated from lactating rat mammary glands was found to be inhibited by a factor
      (or factors) occurring in the cytosolic fraction of male rat liver. The inhibitor
      was heat-labile, non-dialyzable, destroyed by proteolysis, and was stable
      following preparation of an acetone/diethyl ether powder of the cytosolic
      fraction. The protein also inhibited the activity of hormone-sensitive lipase
      (HSL) (from bovine adipose tissue) and esterase from Candida cylindracea, but
      seemed to be more active against the neutral hydrolase found in rat liver
      microsomes. For the mammary gland microsomal cholesteryl ester hydrolase, the
      extent of the inhibitory effect was dependent on the concentration of the
      cytosolic protein, 50% inhibition being achieved by about 100 micrograms of
      cytosolic protein, and on the method of initiating the enzyme assay. Kinetic
      analysis indicated that, under circumstances where the reaction was initiated by
      the addition of substrate, the inhibition was characterized as "uncompetitive."
      When an inhibitor/substrate complex was allowed to form in the absence of enzyme,
      an element of "competitive" inhibition was introduced into the reaction. Food
      withdrawal reduced the activity of the inhibitor in liver by 56%, but activity
      was fully restored by short-term re-feeding. In contrast, feeding a diet high in
      fat led to a 34% increase in activity. The present findings suggest that the
      inhibitory factor(s) may be involved in the regulation of the hydrolysis of
      cholesteryl esters in the liver and also in other cell types.

PMID- 1630275
TI  - The inhibition of neutral cholesteryl ester hydrolase by a cytosolic protein
      factor in female rat liver: the influence of varying hormonal and nutritional
      conditions on the inhibitory activity.
AB  - A cytosolic protein, that is inhibitory to neutral cholesteryl ester hydrolase,
      has been investigated in the livers of female rats using microsomes isolated from
      the mammary gland of lactating rats as an enzyme source. To facilitate
      comparisons, inhibitory activity is expressed in terms of the amount (micrograms)
      of cytosolic protein required to reduce esterase activity by 50% and is compared
      to the hepatic content of both cholesterol and cholesteryl esters. The
      experiments revealed a sexual difference in the level of inhibitory activity,
      with the livers of both suckling and mature male animals containing less of the
      material than the corresponding females. Alterations in the physiological status
      of the females, such as pregnancy and lactation, led to a decrease in the
      activity of the protein. This was reversed by blocking lactation with a
      combination of an antiserum to rat growth hormone and the anti-prolactin drug,
      bromocriptine, but not by premature weaning of the animals. Food withdrawal for
      24 hr also had the effect of increasing inhibitory activity. In general the
      cholesteryl ester content of the livers correlated with the level of inhibitory
      activity. Thus the activity of the cytosolic inhibitor of neutral cholesteryl
      ester hydrolase responded to changes in both the hormonal and the nutritional
      status of the female animal. It is suggested that the presence of the greater
      cholesteryl ester hydrolase inhibitory activity in the female liver may help to
      explain the lower risk of coronary heart disease in premenopausal females by
      facilitating increased hepatic storage of the sterol in the form of the ester.

PMID- 1630276
TI  - Cholestane as a digestibility marker in the absorption of polyunsaturated fatty
      acid ethyl esters in Atlantic salmon.
AB  - Salmonid fish require long-chain n-3 fatty acids in their diet. The digestibility
      of different chemical forms of fish oil fatty acids, fed as triacylglycerols,
      free fatty acids or ethyl esters, was examined in 300 g farmed Atlantic salmon
      (Salmo salar) using cholestane as an indicator of fat absorption in lieu of the
      chromium oxide (Cr2O3) which is commonly used as a marker in digestibility
      studies. It was established that the two digestibility markers gave similar
      results. Conveniently, cholestane does not require a separate analysis if fatty
      acids are to be determined by appropriate gas-liquid chromatography. The long
      chain polyunsaturated fatty acids were particularly well absorbed, the apparent
      digestibility being 90-98% when feeding triacylglycerols or free fatty acids.
      However, the digestibility of monounsaturated fatty acids (75-94%) was lower, and
      lower still for saturated fatty acids (50-80%). Ethyl esters of fatty acids were
      significantly less well absorbed (P less than 0.05) than were the corresponding
      fatty acids in free acid or triacylglycerol form. Irrespective of dietary fat
      type, only free fatty acids were identified in feces, indicating total hydrolysis
      of triacylglycerols and ethyl esters.

PMID- 1630277
TI  - Comparison of the effects of dietary fish oils with different n-3 polyunsaturated
      fatty acid compositions on plasma and liver lipids in rats.
AB  - The effects of dietary fish oils with different n-3 polyunsaturated fatty acid
      compositions on plasma lipid profiles in rats have been studied. Forty-eight male
      rats, previously maintained on a cholesterol-free diet for 15 days, were fed for
      60 days with diets supplemented with 10% fat of either marine hilsa fish (Hilsa
      ilisa, family clupeidae) or fresh-water chital fish (Notopterus chitala, family
      notopteridae). The diets had similar levels of total saturated (35-41%),
      monounsaturated (43-47%) and n-3 polyunsaturated (9-10%) fatty acids. Cholesterol
      contents of the diets were adjusted to 0.85%; gamma-linolenic acid (3.3%) in
      chital oil and eicosapentaenoic acid (4.9%) in hilsa oil diets were the major n-3
      contributors. The percentage of eicosapentaenoic acid in the chital oil diet was
      0.57 times that of the hilsa oil diet, but the eicosapentaenoic (EPA) to
      arachidonic acid (AA) ratio in the latter (4.08) was 3.2 times that of the former
      (1.27). Sixty days of hilsa oil diet feeding decreased the levels of cholesterol
      (53.3 +/- 2.9 to 50.0 +/- 1.1 mg/dL), triacylglycerol (75.7 +/- 3.8 to 64.3 +/-
      2.6 mg/dL) and phospholipid (55.8 +/- 1.5 to 51.7 +/- 3.1 mg/dL) in rat plasma.
      Similar treatment with chital oil diet elevated the plasma cholesterol level
      (53.3 +/- 2.9 to 62.3 +/- 7.6 mg/dL) while triacylglycerol and phospholipid
      contents remained unaltered. Both the dietary treatments decreased the levels of
      linoleic and arachidonic acids in liver but only under the hilsa oil diet did the
      eicosapentaenoic acid percentage increase markedly (0.8 +/- 0.06% to 5.5 +/-
      0.06%) at the expense of arachidonic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630278
TI  - A colorimetric assay for measuring cell-free and cell-bound cholesterol oxidase.
AB  - Cholesterol oxidase (cholesterol:oxygen oxidoreductase, EC 1.1.3.6) catalyzes the
      conversion of sterol delta 5-3 beta-alcohol to the corresponding delta 4-3-ketone
      with the reduction of oxygen to hydrogen peroxide. Rhodococcus species GK 1, a
      soil isolated microbe, produces an extracellular and a membrane-bound cholesterol
      oxidase; the latter is bound to the outer surface of the microbial cell membrane.
      A simple and sensitive assay is described to measure the two enzyme types; no
      enzyme extraction is needed for measuring the membrane-bound cholesterol oxidase.
      In this assay, hydrogen peroxide is reduced by the chromogen 2,2'-azino-bis(3
      ethylbenzothiazoline-6-sulfonate) (ABTS) in the presence of horseradish
      peroxidase, and the increased absorbance is followed continuously at 600 nm
      (epsilon m = 1.82 x 10(4) M-1.cm-1 at pH 7.0 and 30 degrees C). The standardized
      assay medium contained 46.9 mM sodium-potassium phosphate buffer pH 7.0, 0.16%
      Triton X-100, 312.5 microM ABTS, 50 micrograms peroxidase (12.5 units at 25
      degrees C), 6.25% isopropanol, 306.3 microM cholesterol or other sterols (kept in
      solution with isopropanol), and cholesterol oxidase. Oxidation of one molecule of
      cholesterol by cholesterol oxidase gives one molecule of hydrogen peroxide which
      reacts with two molecules of ABTS. The method is reproducible and the results
      correlate well with those obtained by measuring the absorbance of delta 4-cholest
      3-one at 240 nm (epsilon m = 1.40 x 10(4) M-1.cm-1 at pH 7.0 and 30 degrees C)
      and by the method of Allain et al. (Clin. Chem. 20, 470-475, 1974).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1630279
TI  - The effect of amino acids on choline uptake and phosphatidylcholine biosynthesis
      in mammalian hearts.
AB  - The uptake of choline in mammalian hearts in the presence of amino acids was
      examined. Isolated hamster, guinea pig, rat and rabbit hearts were perfused with
      labeled choline in the presence and absence of amino acids. Neutral amino acids
      enhanced choline uptake in the hamster heart, but not in the guinea pig, rat and
      rabbit hearts. Phosphatidylcholine biosynthesis in these hearts was not affected
      by the presence of amino acids. Choline uptake in the hamster myocytes was also
      enhanced by neutral amino acid. The enhancement of choline uptake suggests a
      direct interaction between the amino acid and the transport of choline into the
      myocardiac cells. The different responses in choline uptake to neutral amino
      acids indicate that the regulation of choline uptake in the hearts may be
      different between mammalian species.

PMID- 1630280
TI  - Changes in lipid content, fatty acid composition and lipoprotein lipase activity
      in dry goat omental adipose tissue according to tissue site.
AB  - Water and lipid contents, fatty acid distribution, and lipoprotein lipase
      activity were determined in 11 samples taken from the Omentum Majus of five dry
      Alpine goats. Samples were chosen to standardize sampling sites using geometric
      guide marks representative of different adipose tissue sites. Sample location
      explained between 20% and 30% of the total variance in water and lipid contents
      and in lipoprotein lipase activity, and from 5.5% to 45.4% of the total variance
      in fatty acid distribution. Increased sample thickness was associated with an
      increase in lipid content and in saturated fatty acid percentages. Samples taken
      in proximity of the omentum tissue attached to the rumen and abomasum had the
      highest content. We furthermore found that the levels of 18:2n-6, 18:1n-7, and of
      branched chain fatty acids were high close to a pila of the rumen which also
      corresponded to high lipoprotein lipase activity. Concomitant high levels of
      16:1n-7, 17:1n-8, and 18:1n-9 may reflect high levels of delta 9 desaturase
      activity.

PMID- 1630281
TI  - Low-density lipoprotein turnover in inbred strains of rabbits hypo- or
      hyperresponsive to dietary cholesterol.
AB  - In two inbred strains of rabbit with high or low response of plasma cholesterol
      to dietary cholesterol, low density lipoprotein (LDL) apolipoprotein (apoLDL)
      kinetics were determined with the use of a heterologous tracer isolated from a
      Watanabe heritable hyperlipidemic (WHHL) rabbit. On a diet without added
      cholesterol, the total clearance of apoLDL (which equals apoLDL production) did
      not differ significantly between rabbits of both strains. After the feeding of a
      diet containing 0.1% cholesterol for six weeks, plasma LDL cholesterol, plasma
      apoLDL and liver cholesterol concentrations rose significantly in the
      hyperresponsive but not in the hyporesponsive rabbits. Cholesterol feeding
      depressed the total fractional catabolic rate (FCR) of apoLDL in the hyper- but
      not in the hyporesponsive rabbits; this was attributed to a decrease of receptor
      dependent FCR while receptor-independent FCR was similar in the two strains. On
      the diet containing cholesterol, the receptor-mediated absolute catabolic rate
      (ACR) of apoLDL did not differ between hyper- and hyporesponsive rabbits but
      receptor-independent ACR of apoLDL was higher in hyperresponders. It is concluded
      that the higher plasma apoLDL levels in hyperresponsive rabbits fed the 0.1%
      cholesterol diet are caused by a higher production of apoLDL and not by a lower
      flux of apoLDL through the receptor-mediated pathway.

PMID- 1630282
TI  - Effect of 25-hydroxycholesterol on cholesteryl ester formation in Caco-2 cells.
AB  - Incubation of Caco-2 cells, a human intestinal cell line, with 25
      hydroxycholesterol (25-HOC) marked enhanced cellular cholesteryl ester formation
      determined by incorporation of [14C]oleic acid into intracellular cholesteryl
      [14C]oleate. The stimulation by 25-HOC of cholesteryl ester formation was
      suppressed by staurosporine, a kinase inhibitor, but not by cycloheximide or
      actinomycin D. The specific activity of microsomal acyl-coenzyme A:cholesterol
      acyltransferase (ACAT) increased two-fold in cells treated with 10 microM 25-HOC
      for 5 h. ACAT activity decreased when microsomes were incubated without sodium
      fluoride, a phosphatase inhibitor, but the decrease in ACAT activity in cells
      stimulated with 25-HOC was more pronounced. The results suggest that protein
      phosphorylation may be involved in the stimulation of cholesteryl ester formation
      by 25-HOC in Caco-2 cells.

PMID- 1630283
TI  - Comments on essential fatty acid deficient rats fed hydrogenated oil.

PMID- 1630284
TI  - The forces of bureaucracy.

PMID- 1630285
TI  - George Boole, mathematical logic, and the modern computer.

PMID- 1630286
TI  - The World Food Programme at the United Nations.

PMID- 1630287
TI  - Digital CD-ROMs.

PMID- 1630288
TI  - The concept of meaning and the mathematical theory of communication.

PMID- 1630289
TI  - Organizing the clinical data in the medical record.
AB  - We have developed a method of collecting and arranging clinical data that makes
      the medical record more useful in patient care and research. The design is based
      on two principles: that detailed clinical findings should be recorded
      independently of any diagnostic interpretation, and that time should be
      integrated as a dimension of the medical record. Analysis of the principal
      components of the medical record as we have organized it allows identification of
      clinical entities on the basis of synchronous or sequential features and
      facilitates precise tracking of symptoms, evaluation of therapeutic effects,
      comparison of treatments, identification of patients at risk of recurrence,
      transmission of observations from physician to physician, and analysis and
      reinterpretation of the observations recorded.

PMID- 1630290
TI  - A thrombolytic decision tree.
AB  - We constructed a decision analysis model based on data in the medical literature
      to estimate the possible outcomes of thrombolytic therapy in patients 50 to 80
      years old with possible myocardial infarction. We used the model to test the most
      likely effects of treatment (determined by averaging the values in reports of
      large studies) and the worst effects reported so far. The program begins by
      asking the patient's age, the hours from the onset of pain, and the probability
      of acute myocardial infarction. It then provides an opportunity to perform
      sensitivity analyses by changing the values for these variables and for the
      probability of death in the absence of thrombolytic therapy, as well as for the
      probability of major stroke and hemorrhage. The counterintuitive findings
      observed with this program are that the benefits of thrombolytic therapy increase
      with age and that young patients derive surprisingly little benefit from it.

PMID- 1630291
TI  - George Boole and the mathematics of logic. 1847.

PMID- 1630292
TI  - Spreadsheets.

PMID- 1630293
TI  - Silverplatter literature searches.

PMID- 1630294
TI  - Pen and display computers.

PMID- 1630295
TI  - Adherence and colonization mechanisms of enteropathogenic and enterohemorrhagic
      Escherichia coli.

PMID- 1630296
TI  - Purification and characterization of a Salmonella typhimurium agglutinin from gut
      mucus secretions.
AB  - One of the earliest events in Salmonella typhimurium pathogenesis seems to be the
      interaction of the bacterium with the mucus of the gut. After exposing S.
      typhimurium to guinea-pig colon, we were able to demonstrate by electron
      microscopy that S. typhimurium bacteria were trapped on, or in, the mucus layer.
      Specific components isolated from crude mucus secretions were found to aggregate
      the bacteria. The degree of bacterial aggregation was dependent on the protein
      concentration of the crude mucus and on time. Aggregation of S. typhimurium could
      be abolished by sugars: L-fucose exhibited the strongest inhibition, followed by
      D-glucose, D-galactose and D-mannose. Lectins were also capable of inhibiting
      aggregation, the lectin of Ulex europaeus (UEA I), specific for L-fucose, was
      found to be a stronger inhibitor of bacterial aggregation than Con A. The
      agglutinin for S. typhimurium isolated from guinea-pig colonic crude mucus
      preparation was characterized as a 15 kDa glycoprotein. An affinity-purified anti
      15 kD antibody inhibited, dose-dependently, the aggregation of S. typhimurium by
      crude mucus material.

PMID- 1630297
TI  - Immunosuppression induced by attenuated Salmonella: effect of LPS responsiveness
      on development of suppression.
AB  - A live, avirulent strain of Salmonella typhimurium, SL3235, was previously shown
      to afford protection against virulent Salmonella challenge in three mouse strains
      of the C3H lineage, C3H/HeJ, C3HeB/FeJ, and C3H/HeNCrlBR, which differ in their
      innate susceptibility to Salmonella infection, as well as in their responsiveness
      to lipopolysaccharide (LPS). Concurrent with protection, however, SL3235 was
      found to induce greater than 90% reduction in proliferative responses of
      splenocytes from immunized mice to a panel of B and T cell mitogens. Suppression
      appeared to be independent of susceptibility to Salmonella infection, since the
      mitogenic responses of hypersusceptible C3H/HeJ and C3HeB/FeJ, as well as
      resistant C3H/HeNCrlBR mice, were suppressed. The suppressor cell population in
      immunized C3HeB/FeJ mice was recently shown to be of monocytic lineage. Using
      transwell plates, co-culture studies indicated that suppression was mediated by
      soluble factors. In the present study, the effect of LPS responsiveness on
      susceptibility to SL3235-induced suppression was evaluated in C3H mice by
      studying their ability to mount plaque-forming cell (PFC) responses to sheep red
      blood cells (SRBC) and in vivo antibody responses to tetanus toxoid. Comparison
      of PFC responses as a function of SL3235 dose in C3HeB/FeJ and C3H/HeJ mice,
      revealed that the latter strain was markedly more resistant to the development of
      suppression, as evidenced by the significantly higher (10-35-fold) SL3235 doses
      needed to achieve comparable suppression to those seen in C3HeB/FeJ mice. In
      contrast to C3HeB/FeJ mice, suppression in C3H/HeJ mice required direct cell-cell
      contact. In both mouse strains, suppression was alleviated by pre-treatment of
      immune splenocytes with either mitomycin C or x-irradiation, indicating that
      actively proliferating cells are required for suppressor function. Resistance of
      C3H/HeJ mice to SL3235-induced suppression was not due to a lesser bacterial load
      in vivo, since a higher number of SL3235 organisms were seen in C3H/HeJ spleens
      compared to C3HeB/FeJ mice. Rather, resistance of C3H/HeJ mice correlated with
      their reduced ability to recruit macrophages and other inflammatory cells into
      the spleen, as evidenced by the significantly smaller degree of splenomegaly
      induced in these mice following immunization with SL3235.

PMID- 1630298
TI  - Examination by site-directed mutagenesis of the amino acid residues of the
      thermostable direct hemolysin of Vibrio parahaemolyticus required for its
      hemolytic activity.
AB  - The amino acid sequences of eight variants of thermostable direct hemolysin (TDH)
      and a TDH-related hemolysin, deduced from nucleotide sequences, were compared.
      Fourteen amino acid residues, mainly within conserved regions, were chosen to
      prepare mutant TDHs with one or two amino-acid replacements by site-directed
      mutagenesis. Of the 25 mutant TDHs prepared, those with replacements of Trp65
      (Trp65-His65, Trp65-Tyr65, Trp65-Leu65) or Leu66 (Leu66-Ser66) showed very
      significant reduction (more than 150-fold) of hemolytic activity. Several other
      mutant TDHs with replacements at Lys45, Arg46 and Gly90 showed weaker hemolytic
      activity than the wild-type TDH, but extents of reduction in hemolytic activity
      were much less than for mutant TDHs with replacements at Trp65 and Leu66. These
      results indicate that Trp65 and Leu66 are very important for the hemolytic
      activity of TDH.

PMID- 1630299
TI  - Evidence for three different fibrinogen-binding proteins with unique properties
      from Staphylococcus aureus strain Newman.
AB  - Binding of extracellular components of Staphylococcus aureus strain Newman to
      fibrinogen and prothrombin was investigated. Affinity-purified material from
      fibrinogen- and prothrombin-Sepharose was analysed on immunoblots, and two
      proteins with coagulase activity were identified. The two coagulases were
      produced in a sequential manner during staphylococcal growth. An 87 kDa
      fibrinogen-binding coagulase was produced mainly during the exponential growth
      phase and was replaced by a 60 kDa fibrinogen- and prothrombin-binding coagulase
      which was produced mainly during the post-exponential growth phase. In addition,
      a 19 kDa fibrinogen-binding protein was constitutively produced. Analyses of
      immunogenic properties and NH2-terminal sequences suggested that the 19, 60 and
      87 kDa fibrinogen-binding proteins are not closely related. The NH2-terminal
      sequence of the 87 kDa protein is identical to a previously described coagulase
      from Staphylococcus aureus strain 8325-4. The 19 kDa fibrinogen-binding protein,
      which spontaneously aggregates into dimers and larger molecular weight complexes,
      had a unique NH2-terminal sequence.

PMID- 1630300
TI  - Impaired resistance to infection does not increase the virulence of Salmonella
      htrA live vaccines for mice.
AB  - We have described a new class of live attenuated salmonella vaccines harbouring
      lesions in htrA, a stress protein gene previously. The virulence and invasiveness
      of Salmonella htrA mutants was investigated in three models of increased
      susceptibility to Salmonella infection. These included BALB/c mice, either given
      sublethal whole body irradiation (350 R) or administered rabbit anti-TNF alpha
      antiserum, and (CBA/NfemaleXBALB/cmale)F1 male mice which express the xid sex
      linked B cell defect of CBA/N mice and are more susceptible to salmonellae than
      female littermates. Salmonella typhimurium htrA mutants derived from virulent
      strains, C5046 (C5 htrA::TnphoA) and BRD726 (SL1344 delta htrA) were not more
      invasive in immunosuppressed mice than in normal controls in the three mouse
      models of defective immunity. The results indicate that susceptibility to S.
      typhimurium htrA vaccines derived from virulent parents is not enhanced by
      conditions of impaired resistance to infection.

PMID- 1630301
TI  - The evolution of the mitochondrial D-loop region and the origin of modern man.
AB  - The origin of modern man is a highly debated issue that has recently been tackled
      by using mitochondrial DNA sequences. The limited genetic variability of human
      mtDNA has been explained in terms of a recent common genetic ancestry, thus
      implying that all modern-population mtDNAs originated from a single woman who
      lived in Africa less than 0.2 Mya. This divergence time is based on both the
      estimation of the rate of mtDNA change and its calibration date. Because
      different estimates of the rate of mtDNA evolution can completely change the
      scenario of the origin of modern man, we have reanalyzed the available
      mitochondrial sequence data by using an improved version of the statistical
      model, the "Markov clock," devised in our laboratory. Our analysis supports the
      African origin of modern man, but we found that the ancestral female from which
      all extant human mtDNAs originated lived in a time span of 0.3-0.8 Mya. Pushing
      back the date of the deepest root of the human implies that the earliest
      divergence would have been in the Homo erectus population.

PMID- 1630303
TI  - Phylogenetic reconstruction of the Drosophila obscura group, on the basis of
      mitochondrial DNA.
AB  - We have constructed restriction-site maps of the mtDNAs in 13 species and one
      subspecies of the Drosophila obscura group. The traditional division of this
      group into two subgroups (affinis and obscura) does not correspond to the
      phylogeny of the group, which shows two well-defined clusters (the Nearctic
      affinis and pseudoobscura subgroups) plus a very heterogeneous set of anciently
      diverged species (the Palearctic obscura subgroup). The mtDNA of Drosophila
      exhibits a tendency to evolve toward high A+T values. This leads to a
      "saturation" effect that (1) begets an apparent decrease in the rate of evolution
      as the time since the divergence of taxa increases and (2) reduces the value that
      mtDNA restriction analysis has for the phylogenetic reconstruction of Drosophila
      species that are not closely related.

PMID- 1630302
TI  - Maintenance of DQB1 polymorphisms in primates.
AB  - To understand the evolution of the class II major histocompatibility complex
      (MHC) DQB1 locus in primates, the second exons of seven DQB1 alleles from five
      non-human primate species were amplified by polymerase chain reaction.
      Comparisons of these and other primate sequences show that no between-species
      diversity is greater than within-species diversity, suggesting maintenance of
      DQB1 alleles through the history of Old-World primates. There is a preponderance
      of nonsynonymous nucleotide substitutions at antigen-binding-site codons; this
      pattern is in marked contrast to what is seen at the closely related, presumably
      nonfunctional DQB2 gene. The results support the hypothesis that DQB1
      polymorphism is maintained by overdominant selection relating to antigen
      presentation.

PMID- 1630304
TI  - Phylogeny of five fungus-like protoctistan Phytophthora species, inferred from
      the internal transcribed spacers of ribosomal DNA.
AB  - Ribosomal DNA variation was used to study evolutionary relationships among five
      fungal-like protoctistan Phytophthora species. On the basis of morphological and
      ecological characteristics, four of these species--P. palmivora, P. megakarya, P.
      capsici, and P. citrophthora--were once thought to be related. Variation within a
      species was extensively studied in a fifth, outgroup species--P. cinnamomi-
      known, on the basis of ecological, isozyme, and mitochondrial DNA studies, to be
      variable. Internal transcribed spacer regions (ITS I, between the 18S and 5.8S
      rDNAs; and ITS II, between the 5.8S and 25S rDNAs) from 27 isolates of these five
      species were analyzed by polymerase chain reaction amplification and direct
      sequencing. Intraspecific variability was undetected or low. Interspecific
      nucleotide difference was 0.3%-14.6%, and comparisons of variable regions
      permitted the evaluation of phylogenetic relationships among species. Both
      neighbor-joining and parsimony analysis of ITS variability support a close
      relationship between cacao isolates of P. capsici and P. citrophthora and a
      common lineage for P. palmivora and P. megakarya. Large distance values were
      estimated between P. cinnamomi and the other species. Inferred relationships
      based on ITS variability were compared with those based on other characters. The
      catalog of sequences provides the information necessary to design taxon-specific
      probes potentially useful in taxonomic, ecological, and population-level studies.

PMID- 1630305
TI  - Molecular population genetics of Escherichia coli: DNA sequence diversity at the
      celC, crr, and gutB loci of natural isolates.
AB  - The DNA sequences of three genes--celC, crr, and gutB--have been determined for
      each of 11 or 12 natural isolates of Escherichia coli from the ECOR collection.
      These genes encode the phosphoenolpyruvate-dependent phosphotransferase-system
      enzyme III proteins specific for beta-glucoside sugars (celC), glucose (crr), and
      glucitol (gutB), respectively. There is little evidence of recombination at or
      among these loci; among these strains, relationships inferred from each gene are
      largely consistent with each other and with the relationship inferred from
      multilocus enzyme electrophoresis. DNA sequence diversity is similar for all
      three genes, particularly when silent (synonymous) sites only are considered.
      This is surprising because there is much stronger codon usage bias at crr than at
      celC or gutB. The extent of divergence in the protein sequences encoded by these
      three genes varies considerably. The constitutively expressed glucose-specific
      enzyme is completely conserved. It is surprising that the inducible glucitol
      specific enzyme, which is functional, is more variable than the cellobiose
      specific enzyme, which is cryptic; the latter might be expected to be under less
      (if any) purifying selection.

PMID- 1630306
TI  - Estimation of the number of nucleotide substitutions when there are strong
      transition-transversion and G+C-content biases.
AB  - A simple mathematical method is developed to estimate the number of nucleotide
      substitutions per site between two DNA sequences, by extending Kimura's (1980)
      two-parameter method to the case where a G+C-content bias exists. This method
      will be useful when there are strong transition-transversion and G+C-content
      biases, as in the case of Drosophila mitochondrial DNA.

PMID- 1630307
TI  - Nucleotide sequence, function, activation, and evolution of the cryptic asc
      operon of Escherichia coli K12.
AB  - The cryptic asc (previous called "SAC") operon of Escherichia coli K12 has been
      completely sequenced. It encodes a repressor (ascG); a PTS enzyme IIasc for the
      transport of arbutin, salicin, and cellobiose (ascF); and a phospho-beta
      glucosidase that hydrolyzes the sugars which are phosphorylated during transport
      (ascB). ascG and ascFB are transcribed from divergent promoters. The cryptic
      operon is activated by the insertion of IS186 into the ascG (repressor) gene. The
      ascFB genes are paralogous to the cryptic bglFB genes, and ascG is paralogous to
      galR. The duplications that gave rise to these paralogous genes are estimated to
      have occurred approximately 320 Mya, a time that predates the divergence of E.
      coli and Salmonella typhimurium.

PMID- 1630308
TI  - Similarity, in molecular structure and function, between the plant toxin
      purothionin and the mammalian pore-forming proteins.
AB  - Many proteins containing domains of a cysteine-rich repeated motif, such as
      epidermal growth factor (EGF), have been reported. Here we report strong
      similarity between the amino acid sequence of a plant toxin--i.e., purothionin
      and its homologues--and with those of a domain found in mammalian pore-forming
      cytoplasmic proteins: components of complement and perforin of cytotoxic T
      lymphocytes or natural killer-like cytotoxic cells. These similar sequences were
      found to be identical to the so-called EGF-like cysteine-rich repeated motif
      itself. Electron-microscopic observations indicated that, like complement and
      perforin, purothionin forms pores in the cytoplasmic membrane of target cells,
      resulting in their death within a few hours. On the basis of these sequence
      comparisons and physiological functions, we propose a scheme for the evolution of
      proteins containing modules of the cysteine-rich repeat motif.

PMID- 1630309
TI  - Estimation of heterozygosity for single-probe multilocus DNA fingerprints.
AB  - In spite of the increasing application of DNA fingerprinting to natural
      populations and to the genetic identification of humans, explicit methods for
      estimation of basic population genetic parameters from DNA fingerprinting data
      have not been developed. Contributing to this omission is the inability to
      determine, for multilocus fingerprinting probes, relatively important genetic
      information, such as the number of loci, the number of alleles, and the
      distribution of these alleles into specific loci. One of the most useful genetic
      parameters that could be derived from such data would be the average
      heterozygosity, which has traditionally been employed to measure the level of
      genetic variation within populations and to compare genetic variation among
      different loci. We derive here explicit formulas for both the estimation of
      average heterozygosity at multiple hypervariable loci and a maximum value for
      this estimate. These estimates are based upon the DNA restriction-pattern
      matrices that are typical for fingerprinting studies of humans and natural
      populations. For several empirical data sets from our laboratory, estimates of
      average and maximal heterozygosity are shown to be relatively close to each
      other. Furthermore, variances of these statistics based on simulation studies are
      relatively small. These observations, as well as consideration of the effect of
      missing alleles and alternate numbers of loci, suggest that the average
      heterozygosity can be accurately estimated using phenotypic DNA fingerprint
      patterns, because this parameter is relatively insensitive to the lack of certain
      genetic information.

PMID- 1630310
TI  - Sequencing errors and molecular evolutionary analysis.
AB  - Heuristic approaches were used to quantify the influence that sequencing errors
      have on estimates of nucleotide diversity, substitution rate, and the
      construction of genealogies. Error rates of less than 1 nucleotide/kb probably
      have little affect on conclusions about the evolutionary history of highly
      polymorphic organisms such as Drosophila and Escherichia coli, but organisms with
      very low nucleotide diversity, such as humans, require greater sequencing
      accuracy. A scan of GenBank for corrections of previous errors reveals that
      sequencing errors are highly nonrandom.

PMID- 1630311
TI  - Sample size for a phylogenetic inference.
AB  - The objective of this work is to describe sample-size calculations for the
      inference of a nonzero central branch length in an unrooted four-species
      phylogeny. Attention is restricted to independent binary characters, such as
      might be obtained from an alignment of the purine-pyrimidine sequences of a
      nucleic acid molecule. A statistical test based on a multinomial model for
      character-state configurations is described. The importance of including
      invariable sites in models for sequence change is demonstrated, and their effect
      on sample size is quantified. The methods are applied to a four-species alignment
      of small-subunit rRNA sequences derived from two archaebacteria, a eubacteria and
      a eukaryote. We conclude that the information in these sequences is not
      sufficient to resolve the branching order of this tree. Estimates of the number
      of aligned nucleotide positions required to provide a reasonably powerful test
      are given.

PMID- 1630312
TI  - Early events in yeast mitochondrial protein targeting.
AB  - Protein import into mitochondria involves a number of complex steps occurring in
      the cytosol, on the mitochondrial surface, and inside the organelle. Once an
      initial interaction between mitochondrial proteins and their specific receptors
      occurs, the proteins are transported into the organelle in a series of reactions
      involving (in the case of a protein to be translocated into the mitochondrial
      matrix) the mitochondrial membrane potential, ATP hydrolysis and an undetermined
      number of membrane components. Inside the organelle, mitochondrial proteins are
      processed and sorted to their final intramitochondrial destinations. The earliest
      steps in the import process take place in the cytosol and include the synthesis
      of the mitochondrial proteins themselves, their interaction with cytosolic
      factors, and perhaps the establishment of cotranslational import complexes on the
      mitochondrial surface. These early events are important because it is during this
      phase that the system as a whole is most sensitive to cytosolic conditions that
      may exert control over the entire import process.

PMID- 1630313
TI  - Human neutrophil response to recombinant neisserial Opa proteins.
AB  - Interactions of human neutrophils with recombinant Escherichia coli expressing
      gonococcal outer membrane Opa proteins were examined using chemiluminescent and
      biological assays. Seven opa loci from Neisseria gonorrhoeae MS11 4.8 were
      expressed as beta-lactamase-Opa fusion proteins that contained all but the mature
      N-terminal amino acid of the full-length Opa protein fused to three N-terminal
      amino acids derived from the mature beta-lactamase. The Opa fusion proteins were
      exported and assembled in the outer membrane of E. coli in a manner similar to
      that of Opa in N. gonorrhoeae, as evaluated by antibody binding and in situ
      proteolytic cleavage. All fusion proteins exhibited the characteristic heat
      modifiable migration in SDS-polyacrylamide gel electrophoresis that typifies Opa
      proteins of neisseriae. Opa fusion proteins conferred on E. coli the ability to
      stimulate a chemiluminescent response from human neutrophils in the absence of
      antibody or complement. The nature of the response in terms of chemiluminescence,
      phagocytosis, and killing was in all cases analogous to that seen using N.
      gonorrhoeae expressing the equivalent Opa protein. Neither E. coli nor gonococci
      expressing OpaA elicited a response from neutrophils. Use of E. coli expressing
      Opa fusions should be useful in defining their biological activities and
      pathogenic roles.

PMID- 1630314
TI  - Characterization of transformation-deficient mutants of Acinetobacter
      calcoaceticus.
AB  - Three Acinetobacter calcoaceticus transformation-deficient mutants, obtained by
      insertional mutagenesis with the nptll gene, have been characterized
      physiologically. One mutant (AAC211) was found to be completely transformation
      deficient, while two others, AAC213 and AAC214, were severely impaired in
      transformation efficiency (100-1000 times lower than the wild type). The latter
      applied to both chromosomal as well as plasmid DNA. Analysis of the chromosomal
      DNA fragments flanking the nptll gene in the mutants showed that mutants AAC213
      and AAC214 had an insertion of the nptll gene in the same chromosomal region, but
      that they were the result of two independent mutational events, whereas the
      insertion in mutant AAC211 was at a different position. None of the three mutants
      showed phenotypic or genotypic characteristics typical of a RecA-deficient
      strain.

PMID- 1630315
TI  - Molecular analysis of the lac operon encoding the binding-protein-dependent
      lactose transport system and beta-galactosidase in Agrobacterium radiobacter.
AB  - The genes coding for the binding-protein-dependent lactose transport system and
      beta-galactosidase in Agrobacterium radiobacter strain AR50 were cloned and
      partially sequenced. A novel lac operon was identified which contains genes
      coding for a lactose-binding protein (lacE), two integral membrane proteins (lacF
      and lacG), an ATP-binding protein (lacK) and beta-galactosidase (lacZ). The
      operon is transcribed in the order lacEFGZK. The operon is controlled by an
      upstream regulatory region containing putative -35 and -10 promoter sites, an
      operator site, a CRP-binding site probably mediating catabolite repression by
      glucose and galactose, and a regulatory gene (lacl) encoding a repressor protein
      which mediates induction by lactose and other galactosides in wild-type A.
      radiobacter (but not in strain AR50, thus allowing constitutive expression of the
      lac operon). The derived amino acid sequences of the gene products indicate
      marked similarities with other binding-protein-dependent transport systems in
      bacteria.

PMID- 1630316
TI  - Clarification of the structural and functional features of the osmoregulated kdp
      operon of Escherichia coli.
AB  - Expression of the Escherichia coli kdpABC operon, which is responsible for a high
      affinity potassium-uptake system, is regulated in response to a change in the
      medium osmolarity. In this study, we clarified the structure and function of the
      kdpABC promoter including its regulatory sequence at the molecular level. The
      canonical -35 and -10 regions determined for the promoter were not fully
      functional, i.e. in addition to them, a cis-acting sequence located upstream of
      the -35 region was essential for full activation of the promoter. This upstream
      sequence was demonstrated to be the target site for the trans-acting activator,
      KdpE.

PMID- 1630317
TI  - Phosphotransfer signal transduction between two regulatory factors involved in
      the osmoregulated kdp operon in Escherichia coli.
AB  - The proteins KdpD and KdpE are regulatory factors critically involved in the
      osmotic regulation of the kdpABC operon that is responsible for a high-affinity
      transport system in Escherichia coli. In this study, we obtained biochemical
      evidence supporting the view that the KdpD protein is a sensory protein kinase
      that exhibits autophosphorylation and KdpE-phosphotransfer characteristics.
      During the course of such studies we established a procedure for purifying the
      KdpE protein in large quantities. We also developed a procedure for preparing
      cytoplasmic membrane enriched with the KdpD protein that exhibits in vitro
      ability with regard to phosphorylation of KdpE protein.

PMID- 1630318
TI  - Interaction of the regulatory protein NicR1 with the promoter region of the pAO1
      encoded 6-hydroxy-D-nicotine oxidase gene of Arthrobacter oxidans.
AB  - The D,L-nicotine catabolism of the Gram-positive soil bacterium Arthrobacter
      oxidans is linked to the presence within the cells of the 160 kb catabolic
      plasmid pAO1. pAO1-cured cells lost the catabolic enzymes and reintroduction of
      pAO1 by electroporation into cured cells reestablished the nic+ phenotype. DNA
      band shift assays with extracts from cured and pAO1+ cells suggested that pAO1
      encodes the regulatory protein NicR1. Footprint analysis revealed that two
      homologous palindromes (IR1 and IR2), present in the 5'-regulatory region of the
      6-HDNO gene, were protected from DNase I digestion. Binding of NicR1 to the
      palindromes is symmetrical, co-operative, and stronger to IR1 containing the 6
      HDNO gene promoter than to IR2. Site-directed mutagenesis revealed that steric
      constraints and sequence requirements for NicR1-binding are located exclusively
      in the palindromic sequences. Deletions and insertions in the interpalindromic
      region and in the 6-HDNO promoter -10 sequence had no effect on the binding
      characteristics of NicR1 to the 6-HDNO regulatory region. Acting as a repressor,
      NicR1 prevents binding of the E. coli RNA-polymerase to the consensus sigma 70
      promoter in vitro. However, the interaction of NicR1 with the 6-HDNO promoter
      region in extracts of nicotine-induced cells from various growth stages did not
      differ from that observed with extracts of nicotine-uninduced cells.

PMID- 1630319
TI  - Occurrence of a Photosystem II polypeptide in non-photosynthetic membranes of
      cyanobacteria.
AB  - Cytoplasmic and thylakoid membranes have been purified from the cyanobacteria
      Anacystis nidulans R2 and Phormidium laminosum by sucrose density gradient
      centrifugation. Probing of Western blots of proteins from these purified membrane
      fractions with antibodies directed against the 33 kDa polypeptide of Photosystem
      II from pea indicates that this protein is present in both the thylakoid and
      cytoplasmic membranes, rather than just the thylakoid membranes. This has been
      confirmed by immunogold labelling of cells. Oxygen evolution assays have been
      used to show that the 33 kDa polypeptide is not assembled into a functional
      Photosystem II complex in the cytoplasmic membranes. This may be due to the
      absence of other Photosystem II components.

PMID- 1630320
TI  - Expression of the Escherichia coli dam gene.
AB  - The Escherichia coli dam gene and upstream sequences were cloned from the Kohara
      phage 4D4. Five promoters were found to contribute to dam gene transcription. P1
      and P2 (the major promoter) were situated approximately 3.5 kb upstream of the
      structural gene, P3 was within the aroB gene, P4 was within the urf74.3 gene, and
      P5 was in the urf74.3-dam intergenic region. The nucleotide sequence of 2280 bp
      of DNA containing P1 and P2 was determined and shown to have the potential to
      encode a protein of approximately 16 kDa between P1, P2 and the aroB gene. This
      16 kDa open reading frame has been identified as aroK, the gene for shikimic acid
      kinase I. Thus the dam gene is part of an operon containing aroK, aroB, urf74.3,
      and dam. The transcriptional start points of the promoters were determined. A
      comparison of their nucleotide sequences suggested that P1-P4 were all recognized
      by the sigma 70 subunit of the RNA polymerase.

PMID- 1630321
TI  - NtcA, a global nitrogen regulator from the cyanobacterium Synechococcus that
      belongs to the Crp family of bacterial regulators.
AB  - The gene ntcA is required for full expression of proteins subject to ammonium
      repression in the cyanobacterium Synechococcus. A 3.1 kb DNA fragment able to
      complement an ntcA mutant was digested with exonuclease III, and deleted
      fragments of different size were tested for complementation of that mutant,
      allowing the localization of its mutation within a BamHI-HindIII genomic fragment
      of c. 0.4 kb. Insertion of a chloramphenicol-resistance-encoding gene cassette
      into both the BamHI and the HindIII sites of wild-type Synechococcus resulted in
      a pleiotropic, nitrogen-assimilation-minus phenotype, corroborating the presence
      of the ntcA gene in that genomic region. Sequencing of DNA in this region showed
      the presence of an open reading frame that included both the BamHI and the
      HindIII sites. The ntcA gene product, NtcA, is a protein of 24817 Da which
      belongs to a family of bacterial transcriptional activators that, among others,
      includes Crp and Fnr from Escherichia coli. Of special biological significance,
      it appears, is the presence of a conserved helix-turn-helix motif in the sequence
      close to the C-terminal end of all the proteins in the family. The gene ntcA is
      proposed to encode a transcriptional activator of genes subject to nitrogen
      control in Synechococcus.

PMID- 1630322
TI  - Lasers and their use in dentistry.

PMID- 1630323
TI  - Clients/patients with a principal diagnosis of affective disorder served in the
      inpatient, outpatient, and partial care programs of specialty mental health
      organizations, United States, 1986.
AB  - Of the 1.7 million persons under care on April 1, 1986 in the psychiatric
      inpatient, outpatient, and partial care programs of specialty mental health
      organizations nationwide, approximately 365,500 persons, or 22 percent, had a
      principal diagnosis of affective disorder. The vast majority of these persons, 84
      percent, were under care in outpatient programs; 10 percent, in inpatient
      programs; and 6 percent, in partial care programs. Approximately 833,000, or 21
      percent, of the 3.9 million persons admitted during 1986 to these same
      psychiatric programs had a diagnosis of affective disorder. Fifty-nine percent of
      persons with affective disorders were admitted to inpatient programs; 37 percent,
      to outpatient programs; and 4 percent, to partial care programs. Overall, most
      persons with affective disorders admitted to and under care in each of the three
      program types were female, white, and between the ages of 25 and 64. Most persons
      admitted to and under care in inpatient and partial care programs had a history
      of prior inpatient mental health care, while most persons in outpatient programs
      had never been treated in an inpatient psychiatric care setting. The principal
      source of payment used by persons with affective disorders varied by type of
      program setting. Blue Cross or other commercial insurance was the most common
      source of payment used by persons within inpatient programs, personal resources
      were used most often by persons under care in outpatient programs, and some type
      of public funds was used most often within partial care programs. Most persons
      with affective disorders were referred to inpatient and outpatient programs by
      family or friends, or were self-referrals. Most persons in partial care programs
      with affective disorders were referred to the program by an inpatient,
      outpatient, or another partial care mental health service. Services received by
      persons with affective disorders also varied by program setting. In general, drug
      and individual therapy were the leading types of treatment provided in inpatient
      programs. Individual therapy was the leading type of treatment provided, followed
      by drug therapy, in outpatient programs. Within partial care programs, no single
      type of treatment predominated.

PMID- 1630324
TI  - Patient care episodes in mental health organizations, United States: selected
      years from 1955 to 1988.
AB  - The 4,930 mental health organizations providing mental health services in the
      United States during 1988 (excluding the Territories) generated just over 8.3
      million patient care episodes (table 1). However, in order to compare 1988 data
      with those for other years dating back to 1955, outpatient and partial care
      programs administered by the Department of Veterans Affairs (formerly the
      Veterans Administration) (VA) need to be omitted (table 2). Thus the 7.8 million
      patient care episodes in 1988 (exclusive of VA outpatient and partial care
      programs) represented a more than four-fold increase over the 1.7 million patient
      care episodes in mental health organizations observed more than three decades
      earlier in 1955. The major shifts in patient care episodes over the period from
      1955 to 1988 have been from inpatient to ambulatory care services in mental
      health organizations, and from State and county mental hospitals to community
      based mental health organizations. For example, in 1955, 77 percent of all
      patient care episodes were inpatient episodes, and the remaining 23 percent were
      outpatient episodes. By 1988, inpatient episodes constituted only 28 percent of
      the total, while 66 percent were outpatient episodes, and 6 percent were partial
      care episodes (table 2 and figure 1). However, the relative distribution of
      inpatient, outpatient, and partial care episodes has been relatively stable since
      1975. From 1955 to 1988, the primary locus of inpatient care shifted from State
      and county mental hospitals to non-Federal general hospitals. Also, by 1988, the
      locus of over one-half of the outpatient care episodes and almost two-thirds of
      the partial care episodes was in multiservice mental health organizations.

PMID- 1630325
TI  - Medical education and political reform.

PMID- 1630326
TI  - Sustaining and rewarding clinical teaching.
AB  - High standards of clinical teaching are essential in the training of medical
      students but greater prominence needs to be given to its importance. Strategies
      are described by which one medical school has raised the awareness of clinical
      teaching and supported those who deliver it.

PMID- 1630327
TI  - The role of expatriate advisers: effective teaching in Indonesian medical
      education.
AB  - The expatriate advisor or 'expert' working in Indonesian medical education will
      require a complex range of personal and professional qualities if he or she is to
      be effective. Personal qualities refer particularly to the nature of the
      relationships that are established. Professional qualities include expertise in
      the discipline as well as expertise in teaching and education more generally.
      None of the qualities identified in the study is simple or unidimensional. The
      qualities are complex and are also likely to vary among educators according to
      their own level of education and cross-cultural experience.

PMID- 1630328
TI  - Retention of interviewing skills learned by first-year medical students: a
      longitudinal study.
AB  - A pilot interviewing course was offered as an elective to first-year medical
      students in the spring of 1985. A quasi-experimental pre-test/post-test control
      group demonstrated that students who took the course exhibited a significant
      increase in interviewing skills. Subjects, 15 in the experimental group and 11 in
      the control group, were assessed in each of the following 3 years. Data consisted
      of five 10-minute videotaped interviews with real or stimulated patients for each
      subject and subject's responses on a degree of confidence, familiarity and
      anxiety scale. Interviews were rated on 43 behaviours by two independent coders
      with a 90% simple agreement. The experimental group did not maintain their scores
      on interviewing skills and both groups showed a significant decline in nine
      skills comprising empathy. The only significant difference between the groups in
      fourth year was on the degree of confidence experienced. While interviewing
      skills can be learned they decline in the clinical years as students learn
      medical problem-solving. If medical students are to graduate with their original
      empathy intact, a follow-up course in fourth year is indicated.

PMID- 1630329
TI  - Teaching clinical skills to new medical students: the Oman experience.
AB  - The College of Medicine at the Sultan Qaboos University (SQU) in Oman took up the
      challenge of moving away from a didactic emphasis in the teaching of family and
      community health by actively involving students in health care, requiring some
      clinical skills, as early as possible. This paper describes the experience of the
      Department of Family and Community Health at SQU of the feasibility of training
      first-year medical students in the measurement of blood pressure within a few
      days. Our experience showed that proper training before starting field-work can
      teach clinical skills to students who have had no prior exposure to medical
      subjects. There was a strong correlation between the measurements of blood
      pressure of 638 individuals by the students and the supervisors. This experience
      at SQU has encouraged us to implement the idea of family- and community-based
      clinical exposure for every class. Teaching of clinical skills is feasible in the
      field for new entrants, provided there is adequate orientation beforehand and
      skilled supervision of the students in small groups.

PMID- 1630330
TI  - Attitudes of medical students to old people: a cross-national comparative study.
AB  - Medical students' attitudes to the elderly were compared at the start and finish
      of a 5-week clinical attachment in health care of the elderly at the Christchurch
      School of Medicine. The study investigated students in their first clinical year
      (fourth year of their medical course) over five terms using a questionnaire
      employing a Rosencranz-McNevin semantic differential scale to measure general
      attitudes to old age and a Likert scale to measure attitudes to medical care. A
      question was also asked about career preferences. There was significant
      improvement in attitudes measured by both scales (Rosencranz-McNevin P less than
      0.001, Likert P less than 0.001). Students also showed an increase in interest in
      health care of the elderly as a career choice. When compared with two cohorts of
      students from Nottingham Medical School, attitudes were significantly better in
      the Christchurch group at the commencement of the run. Students at both schools
      showed an improvement in knowledge but this was more marked for Christchurch
      students.

PMID- 1630331
TI  - Teaching bioethics to medical students: the Newcastle experience.
AB  - Over the past two decades in the USA, bioethics has become an accepted component
      of medical education, whereas in Australia, 10 years or even less would encompass
      the history of most existing programmes. Given the legendary conservatism of
      medical schools in Australia and the intractability of the medical curriculum,
      this is still a remarkable achievement. But does the teaching of bioethics change
      the thinking and/or decision-making behaviour of medical students or
      practitioners exposed to such courses? Those involved know only too well how
      difficult such courses are to design and evaluate since the connection between
      ethics education and practice is not known and may never be demonstrated to the
      satisfaction of critics. Critics not only seek answers to the questions of
      whether the teaching of bioethics makes a difference, which is a fair question,
      but they also seek answers to the question of whether bioethics should be taught
      in medical schools. Can bioethics be taught? Whose bioethics is being taught?
      What does the trained bioethicist contribute? Some of these questions arise from
      misunderstanding and some reflect the still too dominant view in medical schools
      which divides disciplines into those which provide 'practical skills', and those
      which contribute only theoretical and therefore peripheral knowledge. The authors
      will address these questions in the light of their experience at Newcastle,
      Australia, where the Faculty of Medicine has been teaching bioethics for over a
      decade.

PMID- 1630332
TI  - Multiple-choice testing in anatomy.
AB  - An analysis of 596 multiple-choice questions (MCQs) on human anatomy given at
      three First Professional Examinations for medical students is reported. The MCQ
      paper at each examination was 200 items long and consisted of three item-types:
      A, K and T/F. Each A-type item comprised a stem and five options, only one of the
      latter being the correct or best answer. Items of the K-type consisted of a stem
      and four responses, any number of which may be correct. The T/F items were of the
      three-response kind, the available options being 'true', 'false' and 'don't
      know'. Test reliability was computed by internal analysis, using the Kuder
      Richardson 20 formula. Measures of concurrent validity were obtained by
      correlating the scores in the MCQ papers with the overall outcome of the First
      Professional Examination. Indices of item facility, discrimination and abstention
      were calculated. The effects of item-type and the availability of the 'don't
      know' option on examinee performance were also determined. Reliability (alpha)
      and concurrent validity (Pearson r) coefficients in the ranges of 0.71-0.85 and
      0.80-0.93 (P less than 0.05) respectively were recorded. Regression analysis
      revealed the MCQ papers to be less sensitive predictors of the aggregate
      performance than the essay papers. The proportion of highly discriminatory and
      excessively difficult items was highest for the K-type. When the same K-type
      questions were re-exhibited in the indeterminate format, the examinees performed
      significantly better. Higher scores were also recorded when candidates were
      required to respond to all the questions than when they were offered the 'don't
      know' option and the percentage gain was higher for the low-scoring examinees.
      The appropriateness of multiple-choice testing as a tool for assessing student
      achievement in human anatomy is discussed.

PMID- 1630333
TI  - The consistency of students' self-assessments in short-essay subject matter
      examinations.
AB  - This longitudinal study compares the accuracy of self-assessments of 22 students
      across four examinations during their first 2 years of medical school. The four
      examinations used a similar short-essay format and covered many of the same basic
      science disciplines at similar levels of difficulty. Immediately after answering
      an average of 20 questions on each examination, students predicted their
      performance on those questions. After assigned subject matter experts had scored
      the questions, the differences between students' predictions and the experts'
      scores were calculated for each question. The degree to which students had over-
      and underestimated their performance across all questions was determined by
      separately averaging all positive and negative differences between students' and
      experts' assessments on each examination. The results of the study indicated that
      accuracy in self-assessment improved from examination 1 to examination 3 (with
      less overestimation) and dropped on examination 4 (with more underestimation).
      The results revealed no relationship between self-assessment estimations and
      actual scores received. Furthermore, the self-assessment estimations tended to be
      statistically correlated between contiguous examinations (i.e., examinations 1
      and 2, 2 and 3, etc.) but not between non-contiguous ones (i.e., examinations 1
      and 3, etc.). The results of the study are interpreted to suggest that the
      students in the study have a self-assessment tendency towards over- or
      underestimation that is somewhat stable but that gradually evolves over time with
      experience, maturity and self-assessment practice. The most frequent direction of
      change is towards decreased overestimation and increased underestimation. These
      results are consistent with the findings of other recent longitudinal self
      assessment studies.

PMID- 1630334
TI  - An analysis of paediatric diagnostic decision-making: how should students be
      taught?
AB  - This study assesses the relative importance of history, examination and
      investigations in paediatric diagnosis, in the Paediatric Out-patient Department
      of the Central Middlesex Hospital, London, by means of a questionnaire-based
      record of 94 consecutive referrals. A diagnosis identical to the final diagnosis
      was made in 76% of referrals after taking a history. The general practitioner had
      proposed a diagnosis in 45% in the referral letter. Clinical examination changed
      the diagnosis in only 15% but increased diagnostic confidence in 33%. Ninety-one
      per cent of cases were diagnosed without recourse to investigations. Forty-two
      per cent of children referred had investigations performed. In the majority of
      paediatric cases the provisional diagnosis reached after taking a history was
      identical to that after examination or results of investigations were known.
      Although examination provided a final diagnosis in only 15% of all cases it
      played an important role in adding confidence in 33%. More educational effort
      should therefore be directed at clinical history-taking skills and the subsequent
      purpose of examination.

PMID- 1630335
TI  - The quality of student-tutor interactions in the clinical learning environment.
AB  - We surveyed 403 students in their clinical years for their perceptions of the
      quality of clinical clerkships. Between 42.6 and 67.0% of tutorials were said to
      contain positive factors such as a relaxed teaching atmosphere, enthusiasm, a
      good selection of patients and adequate preparation. Negative features in 18.2
      37.2% of tutorials included unreasonable expectations, conflicting information,
      late arrival, early departure, failure to show up and the display of anger, a
      patronizing attitude, favouritism or ridicule. While two-thirds of tutors were
      regarded as friendly and helpful, the remaining one-third were perceived as
      unconcerned, discouraging, derogatory or hostile. Overall, only half the clinical
      tutors were rated as effective teachers; more specifically in medicine and
      psychiatry, less than one-third of consultants were regarded as effective
      teachers, as compared with some two-thirds of consultants in obstetrics and
      gynaecology and paediatrics who were so regarded. Almost two-thirds of the
      students had predominantly positive reactions to interactions with their tutors,
      in terms of being motivated to learn, enthused about the subject and having their
      self-confidence increased. Some one-quarter had negative reactions such as
      indifference, depression, anger, embarrassment and fearfulness. However, the
      impact of student-tutor interactions was mainly confined to the students'
      academic well-being, with little effect on their personal-social lives. Finally,
      one-third of students had experienced at least some form of mistreatment by their
      tutors, including gender, appearance, religious and racial discrimination, unfair
      grading and public humiliation. These findings suggest that the clinical
      clerkship may not be providing an optimal learning environment for medical
      students.

PMID- 1630336
TI  - The decision to enter a medical specialty: timing and stability.
AB  - The timing and stability of the decision to enter a medical specialty were
      examined for one class of medical students. Students were asked to predict
      specialty choices for themselves on six occasions from orientation day in year 1
      to January of the senior year. Choices were compared to actual National Residency
      Matching Programme results. Forty-five per cent predicted their ultimate
      specialty choice at orientation, and 69% predicted their ultimate choice by the
      end of the second year. Specialty choices are made early, and are more stable and
      accurate than the previous literature has suggested. Variations in timing among
      the specialties are described, and implications for medical education are
      discussed.

PMID- 1630337
TI  - Medical education and medical education research and development activities in
      modern China.
AB  - The development of medical education in China occurred quite differently to
      medical education in the rest of the world. A review of the literature has been
      presented regarding the historical development and the evolution of medical
      education research and development (MERAD) units in modern China. The history of
      medical education in modern China has been divided into three periods: (1) the 17
      years before the 'Cultural Revolution' (1949-1966); (2) the period of the
      'Cultural Revolution' (1966-1976); (3) the post 'Cultural Revolution' period
      (1976 onwards). Although a number of MERAD activities had existed on China's
      medical campuses since 1949, there was no formal organizational structure for
      MERAD before 1978. The change of the political situation in 1978 led China to
      seek modernization, with education as its basis. In the process of health care
      system modernization, medical education was given priority, and the Western model
      of establishing MERAD units as a means of improving the training of health
      professionals was introduced. The evolution of medical education research and
      development in modern China appears to be following the Western pattern due to
      the multitude of Western consultants and fellowships in Western countries
      provided to Chinese medical education leaders. A group of people from medicine is
      gathering in the MERAD field and MERAD units are beginning to take shape in
      modern China.

PMID- 1630339
TI  - The dismal science and our favourite drug.

PMID- 1630338
TI  - An introductory 'survival course' for first-year medical students: a brief
      account of the course.
AB  - At the School of Medicine, Tromso, Norway, an intensive 2-day week-end course was
      offered to students in the first year of their studies. The content covered study
      approaches and study skills, learning issues, strategies for improving the
      current curriculum, and preparing for the first comprehensive final examination.
      A brief account of the content and outcome is presented.

PMID- 1630341
TI  - Medical device regulation in Australia.

PMID- 1630340
TI  - Alcohol and the brain.

PMID- 1630342
TI  - Very low energy diets.

PMID- 1630343
TI  - Alcohol abuse among young offenders.
AB  - OBJECTIVE: To investigate alcohol use and abuse among young offenders. DESIGN: A
      questionnaire survey. SETTING: Two centres in Adelaide used for the custodial
      care of young offenders. PARTICIPANTS: All consecutive admissions involving stays
      of more than 24 hours. All subjects were adjudicated delinquents. Usable
      questionnaires were obtained from 197 of the 207 subjects (95.2%) approached.
      MAIN OUTCOME MEASURE: The Adolescent Alcohol Involvement Scale (AAIS). RESULTS:
      Most respondents (72.1%) obtained AAIS scores that fell into the problem drinking
      range, with 24.4% scoring in the "alcoholic-like" drinker category. Comparison
      with a South Australian student sample indicated much higher rates of alcohol
      consumption among the young offenders. The majority (56.9%) had been drinking at
      the time of their last offence. CONCLUSIONS: Offending and the use of alcohol by
      adolescents are closely linked. Young offenders are at an extremely high risk of
      alcohol abuse. It is recommended that greater treatment and prevention efforts be
      directed toward this group.

PMID- 1630344
TI  - Psychological correlates of the level of alcohol consumption in young adults.
AB  - OBJECTIVE: To assess the psychological condition of young adults who drank no
      alcohol, moderate, or excessive amounts of alcohol. DESIGN: Subjects from a
      longitudinal study of the school-to-work transition supplied information by
      postal questionnaire, and others matched for age were interviewed. PARTICIPANTS:
      A sample of adults of average age 24 years. The 483 in the longitudinal study had
      been students at 12 metropolitan high schools in 1980, and had been followed
      annually from then until 1988; the 111 who were interviewed were mature-aged
      university students. Sex ratios and the proportion employed were similar in the
      two samples. MAIN OUTCOME MEASURES: The General Health Questionnaire was used to
      measure psychological disturbance in both samples, and alcohol consumption was
      measured by self-report in terms of number of glasses of beer, wine, spirits and
      fortified wine taken during the preceding week. RESULTS: Higher levels of
      disturbance were shown by men who drank excessively in the first study, and who
      abstained from alcohol in the second study. The latter result was related to the
      poorer health of abstainers. Women showed no psychological differences according
      to level of alcohol consumption. CONCLUSIONS: The inconsistent results for men in
      the two studies suggest that research methodology influences results in ways that
      are important for researchers in this field to take into account. The lack of
      disturbance in moderate drinkers of both samples indicates the social
      acceptability of responsible alcohol consumption in Australia, and supports
      efforts to educate the public and their medical advisors so that well-informed
      decisions can be made about alcohol use.

PMID- 1630345
TI  - Drug use in Australia: a community prevalence study.
AB  - OBJECTIVE: To estimate the prevalence of drug use in a representative Australian
      community. DESIGN: Using a Census district sampling framework supplied by the
      Australian Bureau of Statistics, we randomly selected dwellings for our survey. A
      household was defined as all those people living permanently at the postal
      address. All eligible members of each household, 15 years and older, were asked
      to participate. SETTING: The data were collected in the context of a large scale
      general population survey of health practices and attitudes, conducted in the
      Greater Newcastle area of New South Wales, during 1987 and 1988. PARTICIPANTS:
      Seventy-two per cent of eligible individuals approached (2623) agreed to
      participate in the survey. MAIN OUTCOME MEASURES: Participants were asked about
      their use of a number of drug types: medically prescribed drugs, non-prescription
      drugs, tobacco, alcohol and illicit drugs. For alcohol, only the results for use
      at a hazardous level according to the National Health and Medical Research
      Council guidelines are reported here. RESULTS: Seventy-eight per cent (95%
      confidence interval, 76%-80%) of the community sample reported having recently
      consumed at least one of these drug types. There were significant age and sex
      differences in drug use. A greater proportion of women and the older age groups
      (over 45 years) reported the use of both non-prescription and prescription
      medications than did men and the younger age groups. Conversely, a significantly
      greater proportion of men and the younger age groups reported the use of social
      and illicit drugs. CONCLUSION: The importance of regular, representative,
      methodologically comparable community studies of drug use is stressed,
      particularly in view of the inadequacy of the current routine sources of
      epidemiological data on drug use.

PMID- 1630346
TI  - Severe obesity: the use of very low energy diets or standard kilojoule
      restriction diets.
AB  - OBJECTIVES: To determine the efficacy of two dietary therapies in both the short
      term (hospitalisation) and the longer term treatment of severe obesity. DESIGN: A
      descriptive study of two patient groups with obesity defined by a body mass index
      of greater than 30 kg/m2. SETTING: A multidisciplinary weight control program in
      a tertiary care hospital. PATIENTS: All admissions to hospital of patients on the
      weight control program for initiation of weight loss during a period of 48
      months. INTERVENTION: A standard kilojoule reduction regimen or the use of
      complete, followed by partial, long term meal substitution with a very low energy
      liquid diet (VLED), coupled with an exercise and a behavioural modification
      program. OUTCOME MEASURES: Weight loss during and after hospitalisation was
      measured in both dietary regimen groups. RESULTS: Both diets induced weight loss
      in hospital. Men prescribed VLED lost significantly more weight, 8.3 +/- 0.8 kg
      (mean +/- SEM) than women prescribed this diet (5.5 +/- 0.5 kg) or standard
      kilojoule restriction (5.1 +/- 0.8 kg). CONCLUSIONS: VLED and standard kilojoule
      restriction are both effective for the treatment of severe obesity, particularly
      in a controlled environment (hospitalisation). In the longer term, VLED is an
      effective method of maintaining weight loss. Lack of continuing weight loss may
      reflect the patients who were initially placed on this regimen--small eaters with
      a presumed high metabolic efficiency.

PMID- 1630348
TI  - Juvenile myoclonic epilepsy.

PMID- 1630349
TI  - Computer-assisted learning in medical education.

PMID- 1630347
TI  - Nebuhaler versus wet aerosol for domiciliary bronchodilator therapy. A multi
      centre clinical comparison.
AB  - OBJECTIVE: To compare the clinical effectiveness and patient acceptance of a
      large spacer device (Nebuhaler) for delivery of metered dose aerosol (MDI)
      terbutaline with nebulised wet aerosol terbutaline. DESIGN: Randomised open
      crossover study over two sequential four week treatment periods, following a two
      week run-in. SETTING: Multi-centre including five adult thoracic units and three
      paediatric centres throughout Australia. PATIENTS: Thirty-eight adults and 23
      children with clinical asthma and reversible airflow obstruction (increase in
      forced expiratory volume in one second [FEV1] of greater than or equal to 15% in
      response to inhaled bronchodilator) entered the study proper. Six adults and one
      child withdrew. INTERVENTIONS: Terbutaline was administered four times daily via
      Nebuhaler/MDI or nebuliser. Clinical assessment with spirometry and peak flow
      readings was made after run-in and at the end of each treatment period. Patients
      recorded on diary cards daily peak expiratory flow rates and symptom scores and
      comparisons of these results for each treatment period were made. At the
      completion of the study patients answered a treatment preference questionnaire.
      RESULTS: No differences were found between the two treatment periods in diary
      card peak flow recordings and symptom score data, and in clinical assessment of
      spirometry and peak expiratory flow rates. There were also no differences between
      spirometry and peak flow values recorded at the clinic at randomisation and at
      the end of each treatment period, suggesting stable basal airflow obstruction
      over the period of the study. Thirty-two per cent of adults and 52% of children
      preferred the Nebuhaler/MDI combination, mainly because of convenience of use.
      Treatment preference was not related to any measured index of lung function.
      CONCLUSIONS: MDI terbutaline delivered via Nebuhaler provides clinical benefit
      similar to that of wet aerosol terbutaline in the long-term domiciliary
      management of patients with stable airflow obstruction.

PMID- 1630350
TI  - How are we doing with drugs and alcohol?

PMID- 1630352
TI  - Punch injuries to the hand in far north Queensland.

PMID- 1630353
TI  - Medicinal virtues of alcohol in moderation.

PMID- 1630351
TI  - News in dentistry.

PMID- 1630354
TI  - Trachoma in Australian aboriginals in the Pilbara.

PMID- 1630355
TI  - Fulminant hepatic failure complicating the treatment of Mycobacterium xenopi.

PMID- 1630357
TI  - Prevention in clinical practice: a checklist for general practitioners.

PMID- 1630356
TI  - Excimer laser photorefractive keratectomy: first Australian series.

PMID- 1630358
TI  - Catheter-associated urinary tract infections.

PMID- 1630359
TI  - Cultural variations in mental health.

PMID- 1630360
TI  - Suburban dogs--a reservoir of human giardiasis?

PMID- 1630361
TI  - In search of the pathogenesis of refractory cervicobrachial pain syndrome.

PMID- 1630362
TI  - Neurological complications of sarcoidosis.

PMID- 1630363
TI  - Silicone breast implants.

PMID- 1630364
TI  - Tobacco smoking in response to cigarette advertising.

PMID- 1630365
TI  - Echovirus 16 orchitis and postviral fatigue syndrome.

PMID- 1630366
TI  - Glue ear and grommets.

PMID- 1630367
TI  - Munchausen's syndrome.

PMID- 1630368
TI  - The pursuit of peace.

PMID- 1630369
TI  - Diet and coronary heart disease. The National Heart Foundation of Australia.
AB  - Over the last four decades there has been extensive research into the links
      between diet and coronary heart disease. The most recent literature is reviewed
      in this position statement. The clinical and public health aspects of the
      National Heart Foundation's nutrition policy are based on this review. The key
      points are as follows: 1. Saturated fatty acids A high intake of saturated fatty
      acids is strongly associated with elevated serum cholesterol and LDL-cholesterol
      levels and increased risk of coronary heart disease. 2. The n-6 polyunsaturated
      fatty acids The n-6 polyunsaturated fatty acids (principally linoleic acid) lower
      serum cholesterol levels when substituted for saturated fats and probably have an
      independent cholesterol-lowering effect. 3. The n-3 polyunsaturated fatty acids
      (fish oils) The n-3 polyunsaturated fatty acids reduce serum triglyceride levels,
      decrease the tendency to thrombosis and may further reduce coronary risk through
      other mechanisms. 4. Monounsaturated fatty acids Monounsaturated fatty acids
      reduce serum cholesterol levels when substituted for saturated fatty acids. It is
      not clear whether this is an independent effect or simply the result of
      displacement of saturates. 5. Trans fatty acids Trans fatty acids may increase
      serum cholesterol levels and can be reckoned to be equivalent to saturated fatty
      acids. 6. Total fat Total fat intake, independent of fatty acid type, is not
      strongly associated with coronary heart disease but may contribute to obesity.
      Associations between total fat intake and coronary heart disease are primarily
      mediated through the saturated fatty acid component. 7. Dietary cholesterol
      Dietary cholesterol increases serum cholesterol levels in some people and may
      increase risk of coronary heart disease. 8. Alcohol A high intake of alcohol
      increases blood pressure and serum triglyceride levels and increases mortality
      from cardiovascular disease. Light alcohol consumption reduces the risk of
      coronary heart disease. 9. Sugar The consumption of sugar is not associated with
      coronary heart disease. 10. Sodium and potassium High salt intake is related to
      hypertension especially in the subset of "salt-sensitive" people. Potassium
      intake may be inversely related to hypertension. 11. Overweight and obesity
      Abdominal obesity increases the risk of coronary heart disease probably by
      adversely influencing conventional risk factors. 12. Vegetarianism A high intake
      of plant foods reduces the risk of coronary heart disease through several
      mechanisms, including lowering serum cholesterol and blood pressure levels.

PMID- 1630370
TI  - Spontaneously remitting disease. Principles of management.

PMID- 1630372
TI  - A Borneo experience.

PMID- 1630371
TI  - Current status of general practice research in Australia. Analysis of a national
      database.
AB  - OBJECTIVE: To describe the current status of general practice research activity
      in Australia. DESIGN: A descriptive survey of research projects included in a
      national research database, established by the Royal Australian College of
      General Practitioners. The study instrument was a mailed questionnaire. SETTING
      AND PARTICIPANTS: Research projects involving or directly related to general
      practice that had commenced in Australia since 1 January 1989. Responses were
      specifically sought from all universities, the Family Medicine Programme and the
      Royal Australian College of General Practitioners. RESULTS: Two hundred and
      thirty-seven projects from 130 different principal investigators, one-third of
      whom were not medical practitioners, were analysed. Over 85% of research took
      place in association with a recognised tertiary institution. Over half of the
      projects were descriptive only; the most common areas were medical education,
      prevention and screening and health services research. Of the 69 projects
      completed prior to 1991, 49 had been submitted for publication and 26 had been
      accepted. CONCLUSIONS: The amount of general practice research undertaken in
      Australia is still small in relation to the size of the workforce, and most are
      descriptive studies. This national database will enable longitudinal changes in
      such patterns to be effectively monitored.

PMID- 1630373
TI  - Epidemiology of late presentation of HIV infection in Western Australia.
AB  - OBJECTIVE: To determine the incidence of and reasons for late presentation of
      patients infected with the human immunodeficiency virus (HIV), and the
      demographic characteristics of these late presenters, who first seek medical
      attention when they have an illness that defines the acquired immunodeficiency
      syndrome (AIDS). DESIGN: Retrospective analysis of clinical and demographic data
      relating to 106 sequential AIDS diagnoses in Western Australia. Surviving
      patients were questioned during routine medical and social work interviews to
      identify the reasons for late presentation. SETTING: Royal Perth Hospital, the
      sole specialist referral centre for the management of infection with the human
      immunodeficiency virus (HIV) in Western Australia. PARTICIPANTS: All patients
      presenting or referred to Royal Perth Hospital with an AIDS-defining condition
      between 1 January 1988 and 1 July 1991. RESULTS: Forty-one of 106 (39%) patients
      presenting with an AIDS-defining condition had known of their HIV status for
      eight weeks or less (late presenters). The proportion of late presenters
      decreased from 61% in 1988 to 34% in 1989 (P less than 0.05). Six of the 41 late
      presenters died during their initial admission compared with only one of the 65
      early presenters (P less than 0.02). Sixty-six per cent of late presenters
      compared with only 35% of early presenters had pneumocystis pneumonia as their
      AIDS-defining condition (P less than 0.01). There was no significant difference
      in age at diagnosis of AIDS, martial status, sex or risk factors between the
      early and late presentation groups. Reasons given for late presentation included
      lack of knowledge of advances in the treatment of HIV infection, concerns about
      confidentiality and beliefs that sexual behaviour had been relatively "safe" from
      risk of HIV infection. CONCLUSIONS: While the proportion of patients presenting
      late is decreasing, late presentation continues to be a problem. Reasons for
      delayed presentation are not entirely clear, but can be explained in terms of
      psychosocial and physiological influences. How and to what degree each of these
      contribute to timing of presentation is yet to be determined.

PMID- 1630374
TI  - Mycobacterial disease and AIDS in New South Wales.
AB  - OBJECTIVE: To determine the coincidence of mycobacterial disease and acquired
      immunodeficiency syndrome (AIDS), and whether persons with mycobacterial disease
      and human immunodeficiency virus (HIV) infection differ from those with
      mycobacterial disease alone, by age, sex and country of birth. DESIGN: A
      descriptive study. PARTICIPANTS: Persons on the NSW Tuberculosis Register in 1989
      and those on the NSW AIDS database in 1982-1989. MAIN OUTCOME MEASURE: Coincident
      appearance on the Tuberculosis Register and the AIDS database. RESULTS: People
      with atypical mycobacterial infection and HIV infection were younger and more
      likely to be male compared with those with mycobacterial disease alone. There was
      a strong association between mycobacterial disease and HIV infection. Of 438
      patients newly diagnosed with mycobacterial disease in 1989, 75 (17.1%) had HIV
      infection. Of 318 tuberculosis patients, 8 (2.5%) had HIV infection, and of 120
      patients with atypical mycobacterial infection, 67 (55.8%) had HIV infection.
      CONCLUSION: Close monitoring of HIV patients for mycobacterial infection, and
      chemoprophylaxis for persons infected with HIV who have positive Mantoux test
      results will assist in the control of mycobacterial disease. HIV testing and
      counselling should be considered for all persons with mycobacterial disease.

PMID- 1630375
TI  - Predicting AIDS deaths and prevalence in Australia.
AB  - OBJECTIVE: To describe a method for predicting deaths from, and the prevalence
      of, the acquired immunodeficiency syndrome (AIDS) in Australia and to obtain
      ranges of projections for the next five years based on data observed to 30
      September 1989 and reported by January 1990. The projections are important
      components of planning for future health-care needs. PATIENTS: All patients with
      AIDS in Australia who were known to the National Centre in HIV Epidemiology and
      Clinical Research. The data used in the analysis were date of diagnosis of AIDS,
      date of death if the patient had died, and State or Territory of diagnosis.
      RESULTS: For Australia as a whole, the doubling time of AIDS incidence changed
      from 0.83 years before mid 1987 to 4.34 years after that time. Five hundred and
      seventy patients were diagnosed with AIDS to 30 June 1987 of whom 487 had died by
      30 September 1989 and the estimated mean survival time was 1.36 years. Of 1037
      patients diagnosed with AIDS after June 1987, 352 had died and the estimated mean
      survival time was 2.42 years. Combining the estimated survival distribution with
      the projected new cases of AIDS, we forecast that there will be between 530 and
      680 deaths from AIDS in Australia in the year mid 1991 to mid 1992. Estimated
      cumulative deaths to mid 1994 range from 3390 to 4250. We predict that there will
      be between 1370 and 1850 people living with AIDS during the year ending mid 1992,
      and that this number will increase to between 1760 and 2830 for the year ending
      mid 1994. We also predict that the prevalence of AIDS in New South Wales will lie
      between 820 and 1620 for the year ending mid 1994, and that the prevalence in
      Victoria will lie between 270 and 740 in the same year. CONCLUSIONS: Any value in
      the range of predictions for AIDS incidence we give is equally likely and there
      is good agreement with the data now observed from mid 1989 to mid 1990. The
      dramatic increase in the doubling time is the result of a number of factors
      predicted by epidemic theory and the availability of treatment, zidovudine in
      particular. Our estimates of deaths and prevalence have been influenced by the
      quality of the available death data. The observed number of deaths in the year
      mid 1989 to mid 1990 has exceeded the number forecast for that year. Substantial
      improvements in survival were associated with the introduction of zidovudine into
      clinical practice in mid 1987 but the death rate has risen rapidly again in the
      very recent past, possibly due to patients becoming increasingly refractory to
      treatment with zidovudine (before or after a diagnosis of AIDS). Our approach to
      forecasting can be adjusted to accommodate a transient effect of treatment as
      further data accumulate.

PMID- 1630376
TI  - Basic immunology of transplantation.

PMID- 1630377
TI  - Mortality of former prisoners of war and other Australian veterans.
AB  - OBJECTIVE: This second summary article from an epidemiological review of the
      health of former prisoners of war (POWs) and other Australian veterans,
      commissioned by the Sir Edward Dunlop Medical Research Foundation, reports on
      studies of mortality. DATA SOURCES: The MEDLARS database, from 1966 to the
      present, under the terms military personnel, veterans, veterans' disability
      claims, combat disorders and prisoners (matched against war); databases of the
      Department of Veterans' Affairs (Victoria) and the Central Library, Commonwealth
      Department of Defense, under the term "prisoner of war"; and the microfiche
      listings of the Department of Veterans' Affairs, under "prisoner of war" and
      "repatriation". Only studies in English or French were reviewed, reaching a total
      of 172. STUDY SELECTION: Four studies in this paper constitute the main evidence
      about postwar mortality in Australians who were POWs of World War II or Vietnam
      veterans. Other mortality studies are cited in the complete literature review
      published elsewhere. DATA EXTRACTION: Only the data with an epidemiological basis
      are considered here. DATA SYNTHESIS: All-cause mortality rates were no greater in
      former POWs or Vietnam veterans than in the general Australian male population.
      There was, however, evidence of increased mortality among former POWs compared
      with other non-POW veterans, and among Vietnam veterans in one particular corps
      compared with veterans of the same era who served in Australia. CONCLUSIONS:
      Elevated early postwar mortality of young former POWs implicates diseases with
      short latent periods (including psychiatric disorders). This is consistent with
      the greater health risks of this group of survivors that were identified in the
      earlier review of morbidity. Mortality among former POWs and other veterans
      requires continued surveillance because a "healthy worker effect" (or exclusion
      of unfit persons from the armed forces) may partly conceal increased morbidity or
      mortality that should be attributed to war service.

PMID- 1630378
TI  - Antiretroviral agents in the nineties.

PMID- 1630379
TI  - Envenomated? Always check the bite site.

PMID- 1630380
TI  - Envenomation by the small-scaled snake: the world's most venomous snake.

PMID- 1630381
TI  - Patients with ciguatera: request for convalescent sera.

PMID- 1630382
TI  - Of spines, braces and steel rods.

PMID- 1630383
TI  - Treatment of ventricular arrhythmias after CAST.

PMID- 1630384
TI  - Proper use of the waist to hip ratio.

PMID- 1630385
TI  - The use of corticosteroids in dermatological practice.

PMID- 1630386
TI  - Tuberculosis in Australia.

PMID- 1630387
TI  - Tuberculosis in Australia.

PMID- 1630388
TI  - Emergencies in general practice.

PMID- 1630389
TI  - Emergencies in general practice.

PMID- 1630390
TI  - Eradication of Legionnaires' disease.

PMID- 1630391
TI  - Peripheral oedema associated with moclobemide.

PMID- 1630392
TI  - Thrombolytic therapy for coronary occlusion.

PMID- 1630393
TI  - Anticoagulants for atrial fibrillation.

PMID- 1630394
TI  - Treatment of atrial fibrillation: time for change?

PMID- 1630395
TI  - Changes in drug treatment and case fatality of patients with acute myocardial
      infarction. Observations from the Newcastle MONICA Project, 1984/1985 to
      1988/1990.
AB  - OBJECTIVE: To describe changes in medications administered to patients with acute
      myocardial infarction between 1984/1985 and 1988/1990 and changes in case
      fatality. DESIGN: Descriptive study from the Newcastle MONICA Project, which
      monitors all heart attacks in men and women aged 25 to 69 years in the Lower
      Hunter Region of New South Wales. SUBJECTS: All patients admitted to hospital
      with a "definite" acute myocardial infarction who survived at least 28 days
      during periods in 1984/1985 (513 events) and 1988/1990 (790 events). MAIN OUTCOME
      MEASURES: Changes in drugs being taken immediately before the onset of the
      myocardial infarction, prescribed during hospitalisation and on discharge from
      hospital, and changes in case fatality rates. RESULTS: From the first time period
      to the second there were significant increases in the use of aspirin, calcium
      channel blockers, angiotensin-converting enzyme (ACE) inhibitors and
      hypolipidaemic agents, and significant reductions in the use of diuretics. In
      1988/1990, 34% of patients with a definite myocardial infarction received
      thrombolytic therapy compared with fewer than 1% in 1984/1985. Among those
      patients who survived at least one hour from onset of symptoms, the case fatality
      rate declined from 13.5% to 7.9% (change -5.6%; 95% confidence limits, -8.9%, 
      2.2%). CONCLUSION: Large changes in drug treatment of patients with acute
      myocardial infarction have occurred in the second half of the 1980s. These may be
      responsible for the reduction in case fatality. Nevertheless, use of drugs of
      proven effectiveness in acute care and for secondary prevention is surprisingly
      low in this population.

PMID- 1630396
TI  - Transfusion of frozen thawed blood stored at -20 degrees C to -25 degrees C.
AB  - OBJECTIVE: To determine the clinical efficacy of transfusion of frozen-thawed
      (FT) red cells using a 5-bag system for freezing (at -20 degrees C to -25 degrees
      C), storage and reconstitution. DESIGN: A prospective, controlled, non-randomised
      clinical trial was undertaken with two groups of orthopaedic surgical patients.
      Nine patients received FT homologous blood and a control group of 10 patients
      received homologous blood stored in liquid form at 4 degrees C. Five transfusion
      dependent patients with medical conditions were also studied. OUTCOME: Thirty
      three FT units were transfused without incident to 14 patients. In addition to
      clinical assessment, haematological and biochemical parameters were monitored
      after transfusion. There were no clinical side effects and laboratory data were
      consistent with those after recent surgery or for pre-existing medical conditions
      and subsequent blood transfusion. On the practical side certain technical
      difficulties were encountered which improved with experience. CONCLUSIONS: One of
      the major advantages of the system is the 35-day shelf-life at 4 degrees C after
      reconstitution. This system has potential for pre-deposit autologous collection,
      especially where large volume replacement may be required.

PMID- 1630397
TI  - Some characteristics of blood shed into the Solcotrans postoperative orthopaedic
      drainage/reinfusion system.
AB  - OBJECTIVE: To assess the suitability of blood shed into the Solcotrans
      orthopaedic autotransfusion system as a source of autologous blood for
      transfusion. DESIGN: Blood samples were taken from patients after surgery and
      from shed blood within the Solcotrans units. SETTING: Surgery was performed at a
      public hospital. PATIENTS: All six patients underwent total knee replacements.
      MAIN OUTCOME MEASURES: Measurements were made of haemoglobin, haematocrit,
      platelets, pH, potassium, plasma haemoglobin, fibrinogen, D-dimer, plasminogen
      activator, thromboplastin and fibrinopeptide A. The non-activated partial
      thromboplastin time was estimated. Shed blood was compared with homologous whole
      blood to assess the thrombogenic potential of shed blood in vitro. RESULTS: The
      haemoglobin and haematocrit levels of the shed blood were significantly lower
      than venous blood (P = 0.008). Levels of potassium in shed blood were normal
      although there was significant haemolysis. Shed blood was depleted of clotting
      factors, with increased levels of D-dimer (16-128 g/L). Activation of the
      coagulation pathway within the shed blood was shown by a shortened non-activated
      partial thromboplastin time (90-120 s), and detectable levels of thromboplastin.
      Propionibacterium acnes was isolated from one of the units. CONCLUSION:
      Reinfusion of large volumes of shed blood should probably be avoided, but use of
      the Solcotrans orthopaedic transfusion system in conjunction with other
      autologous transfusion practices can reduce the patient's requirement for
      homologous blood.

PMID- 1630398
TI  - Haematological profile of healthy elderly Australians.
AB  - OBJECTIVE: To determine normal values for haematological parameters in healthy
      elderly persons, and document any changes in these over a 12 month period.
      DESIGN: The study was conducted as part of a randomised controlled trial of low
      dose aspirin for primary prevention of cardiovascular disease in the elderly. All
      participants (380) had a full blood examination performed at entry, which was
      repeated after 12 months. The baseline results for all patients and the 12 month
      findings in a cohort of 162 persons allocated placebo were used in the present
      study. SETTING: Community-based (general practices and residential retirement
      villages). SUBJECTS: Persons aged 70 years and over (53% females) who were
      ambulatory, living independently, and volunteered to participate. None had
      significant vascular disease, peptic ulceration, haemorrhagic symptoms or were
      currently taking non-steroidal anti-inflammatory drugs. MAIN OUTCOME MEASURES:
      Full blood examination (excluding white cell differential counts) performed with
      a Technicon H1 analyser. RESULTS: The mean haemoglobin level +/- standard
      deviation (SD) was 14.69 +/- 1.10 g/dL (for men) and 13.72 +/- 1.05 g/dL (for
      women). Significant differences (P less than 0.001) in packed cell volume, red
      cell and platelet counts were observed between the two sexes. No clinically
      significant change was observed in any of the parameters over a 12 month period.
      CONCLUSIONS: Haematological reference values for healthy elderly Australians are
      consistent with normal values reported in younger populations for both sexes. As
      a result recommendations are provided for normal reference values among this
      group in an Australian setting.

PMID- 1630399
TI  - [Solvent pollution in shoe factories].
AB  - In order to study solvent exposure in shoe factories, 43 kinds of glues and 22
      solvent products used in footwear manufacturing were analyzed. A gas
      chromatographic spectrometric method was used to identify the mixtures of
      solvents contained in glues and their diluents. Acetone, ethylacetate and
      cyclohexane were the solvents more frequently found in glues. Cyclohexane
      represented on average about 40% of the solvent mixture. Methyl ethyl ketone, 3
      methylpentane and 2-methylpentane were often present in glues (45-52% of the
      samples), but only in a few cases were they associated with n-hexane. N-hexane
      and methylcyclopentane were found in 32% of the glue samples. N-hexane
      represented 47% of the solvents only in one glue. Most of the glues contained
      less than 10% n-hexane. Other solvents (dichloropropane, toluene,
      trichloroethane, butyl acetate, iso-butyl acetate and 2,2-dimethylbutane) were
      found in few glue samples or in low percentages. The 22 solvents used as glue
      diluents were mainly acetone, ethylacetate, dichloromethane and methyl ethyl
      ketone. The results suggest that solvent exposure in shoe factories has changed
      compared with data reported about 10 years ago. Biological monitoring of shoe
      factory workers should measure exposures to the specific solvents found in each
      factory, especially acetone, cyclohexane, ethylacetate and methyl ethyl ketone.

PMID- 1630400
TI  - [The report on a divisional plan as an evaluation of results].
AB  - The adoption of norms of recommended practice (NRP) by industrial management (a
      fundamental step in ensuring a safer and healthier work environment, is in our
      opinion a suitable approach for evaluating primary prevention programmes. We
      tested this hypothesis in the shoe and leather goods manufacturing industry (55
      facilities). An ordinal scale was defined for each variable taken into account by
      NRP and for other variables related to employers' actions. A score was assigned
      to every facility with reference to the starting and ending points of the
      programme. In this way we estimated the degree of variation, in time and among
      facilities, in adopting NRP.

PMID- 1630401
TI  - [The determination of serum amino-terminal procollagen type-III propeptide
      (PIIINP) in occupational exposure to rock wool fiber].
AB  - Fifty-six males workers exposed to rock wool during production, and 20 referents
      were examined. Exposure, evaluated by personal sampling, ranged from 0.05 to 0.74
      fibres/ml (median 0.15). The subjects underwent a medical examination, chest X
      ray according to ILO recommendations and pulmonary function tests. In all
      subjects the serum levels of type III procollagen N-terminal propeptide (PIIINPs)
      were determined. No evidence of pulmonary fibrosis, nor work-related lung
      diseases were observed. PIIINPs mean values in the exposed (9.8 ng/ml; 2.8 S.D.)
      were slightly higher, but not significantly different when compared to referents
      (8.5 ng/ml; 2.5 S.D.). No significant correlation between PIIINPs and rock wool
      exposure (both airborne levels and exposure duration) was observed. Furthermore,
      peptide levels were not related to pulmonary function test results. Our results
      suggest that occupational exposure to rock wool fibres lower than 0.75 fibres/ml
      for less than 20 years does not induce definite cases of pulmonary fibrosis nor
      an increase of type III collagen synthesis in the lung.

PMID- 1630403
TI  - Occupational accidents in a selected chemical enterprise in Poland and an attempt
      to evaluate their economic effects.
AB  - An analysis was made of occupational accidents leading to temporary absence from
      work occurring in a selected chemical plant in the years 1988-1989. The authors
      also studied the possibilities of evaluating costs and financial losses for the
      enterprise due to occupational accidents. However, the results of the evaluation,
      in the Polish situation and based on records existing in the enterprise, were not
      very useful.

PMID- 1630402
TI  - [The monitoring of cholinesterases in farm workers and tradesmen exposed to
      phosphoric esters and carbamates].
AB  - Cholinesterase (ChE) levels (Ellman method) were monitored in 90 subjects (69
      males and 21 females) exposed to carbamate and organophosphate pesticides (78
      agricultural workers and 12 pesticide vendors). Pre-exposure baseline values of
      plasma and red blood cell cholinesterase activities were defined for each subject
      with two blood samples (23 workers) or three blood samples (59 workers) taken
      almost thirty days after the last exposure. After control of intra-individual
      variation, 8 subjects with only one pre-exposure value and 13 with a coefficient
      of variation above 30% were excluded. For the other 59 subjects, the intra
      individual variation of erythrocyte ChE (16%) was similar to the inter-individual
      one (15%), whereas the inter-individual variation of plasma ChE (21%) was higher
      than the intra-individual one (14%). Laboratory variation for plasma ChE
      measurements was 8%. Baseline values were analyzed (ANOVA) for sex, age, task and
      hour and season of sampling. Both erythrocyte and plasma enzymes, corrected for
      hematocrit, were lower in females. Plasma cholinesterase activity was lower in
      "re-entry" agricultural workers and in pesticide vendors. Post-exposure
      cholinesterase activity was measured in 54 workers within a few (1-21) days after
      last handling. Average relative reduction was 15.2% (95% C.I. = 4.9%-25.5%) in
      erythrocyte cholinesterase activity and 29.1% (95% C.I. = 18.2%-40.1%) in plasma
      cholinesterase activity. The one-way variance analysis showed marked plasma ChE
      reduction in mixers, loaders and appliers (36%, 95% C.I. = 24%-48%) and in
      parathion handlers (35%, 95% C.I. = 21%-49%. No significant reduction in blood
      cell cholinesterase activity in relation to task and to pesticide handled was
      observed. We conclude that the intra-individual variations of the baseline values
      were higher for three repetitions (88% and 84% of the population were within a
      variability of less than 30%, for AChE and for ChE respectively) than for two
      repetitions (91% and 88% of the population were within 30% of variability for
      AChE and for ChE respectively). The figures show a greater sensitivity of plasma
      ChE activity in acute exposure, probably due to a poor reliability in detection
      of erythrocyte ChE by local laboratories. The maximum reduction (38%, 95% C.I. =
      22%-53%) in plasma ChE activity was observed within six days of the last exposure
      in loaders and appliers.

PMID- 1630404
TI  - Monitoring of peak expiratory flow rates during occupational asthma treatment.
AB  - The purpose of this study was to evaluate the effect of anti-inflammatory drug
      treatment on respiratory symptoms and lung function in twelve subjects with
      occupational asthma while at work. PEFR was monitored for four weeks and
      antiasthmatic drugs (salbutamol, chromolyn sodium and beclomethasone
      dipropionate) were administered for three weeks, starting after the first week of
      PEFR monitoring, in an unchanged working environment. After treatment five
      subjects became asymptomatic, six improved and one continued to have unchanged
      work-related asthmatic symptoms. There were only minor increases in forced vital
      capacity (FVC), forced expiratory volume in 1 s (FEV1) and mean forced expiratory
      flow during the middle half of FVC (FEF25-75). Bronchial reactivity was studied
      in eleven subjects: six worsened and five improved. PEFR at 0600 h increased by
      9.4% in nine responders and decreased by 5.8% in three non-responders. After
      treatment diurnal variation (DV) in PEFR decreased by 28.4% in responders and
      30.8% in non-responders, even if at the fourth week it was 1.75 higher in non
      responders compared to responders. In conclusion, in this study a continuous
      treatment of occupational asthma with anti-inflammatory drugs minimized
      respiratory symptoms, slightly increased PEFR and greatly reduced DV in PEFR.

PMID- 1630405
TI  - [Lymphocyte subpopulations in workers exposed occupationally to styrene].
AB  - In a group of 32 workers occupationally exposed to styrene, the distribution of
      lymphocyte subsets was investigated by automated flow cytometry. The group under
      study consisted of 22 male and 10 female workers aged 39.7, D.S. = 10 years and
      employed for 6.8 years in factories manufacturing glass fibre-reinforced
      plastics. A control group (12 males and 7 females) recruited according to the
      same selection criteria was simultaneously examined. Environmental and biological
      monitoring was used to characterize styrene exposure. In styrene-exposed workers,
      phenotypic analysis of peripheral blood revealed a reduced proportion of T helper
      lymphocytes and a relative increase in the T suppressor subset, leading to a
      significant inversion of the helper/suppressor ratio (0.92) among heavily exposed
      workers (greater than 50 ppm, 8h-TWA) as compared to less exposed workers and
      controls (1.37 and 1.43 respectively). The proportion of natural killer (NK) T
      lymphocytes was significantly increased among styrene workers. The proportion of
      B lymphocytes was unchanged as compared to the control group. Dose-response
      relationships were clearly apparent for the observed increases in the prevalence
      of abnormalities: none of control subjects showed more than 2 (out of 8) abnormal
      values as compared to 20 and 40% of styrene workers belonging respectively to the
      low and high exposure group (p less than 0.007). Only a minority of controls
      exhibited abnormally high levels of both NK and suppressor T lymphocytes (0-5%),
      the corresponding figures for styrene workers being 7-10% (low exposure) and 45%
      (high exposure). As a whole, the findings support the hypothesis of the
      immunotoxicity of styrene, which could be due either to direct effects on
      lymphocytes or to indirect mechanisms possibly mediated by neuroendocrine
      changes.

PMID- 1630406
TI  - [Pleural fibrosis in asbestosis and ventilatory function: a study of 50 cases].
AB  - The importance of non-malignant pleural fibrosis in asbestosis in relation to
      respiratory function is still open to debate because of the differing results
      obtained in studies of different population groups. In the present study we
      selected 50 subjects with occupational exposure to asbestos presenting mono- or
      bilateral pleural fibrosis at X-ray but without lung impairment. Each subject
      underwent bronchial lavage and ventilatory function tests. The subjects were
      divided into 4 groups on the basis of the degree of pleural alterations according
      to the ILO Classification of Pneumoconioses. The results revealed that the mean
      values of CV and FEV1 in each group were within physiological limits. Moreover,
      analysis of the type of lung function showed a normal situation in 64% and
      restricted function in 28% of the cases. The prevalence of the latter finding was
      not correlated to the severity of pleural fibrosis in the various groups. Also,
      comparison between severity of pleural fibrosis and number of asbestos bodies/ml
      of BAL liquid on the one hand and frequency of alveolitis on the other did not
      reveal any relationship. Therefore, the onset of pleural fibrosis appears to be
      independent of the quantity of inhaled asbestos fibres and due to different
      mechanisms from those leading to lung fibrosis. In practice, a correct
      interpretation of the presence of pleural fibrosis from a clinical and prognostic
      viewpoint also requires other investigations such as BAL and a complete
      respiratory function study.

PMID- 1630408
TI  - [The untenable thoughtlessness of some legal judgements on the matter of
      occupational tumors].

PMID- 1630407
TI  - [Auditory evoked potentials in workers exposed to styrene].

PMID- 1630409
TI  - [The mechanisms of toxicity and risk assessment].

PMID- 1630410
TI  - [Exposure to asbestos and Decree 277].

PMID- 1630411
TI  - Flecainide for supraventricular tachyarrhythmias.

PMID- 1630412
TI  - Post-natal development of sleep organization in man: speculations on the
      emergence of the 'S process'.
AB  - We outline the development during the first year of life of both sleep-wake
      patterns and internal sleep organization (sleep states, quiet sleep-paradoxical
      sleep cycles, and slow-wave sleep), and raise the issue of the emergence of the
      'S process'. The consolidation of sleep in episodes of longer duration takes
      place during the night; the ability to maintain sleep after sleep onset decreases
      during the day in infants older than 6 months. The main contribution to the
      increase of longest nocturnal sleep episode duration comes from the quiet sleep,
      the number of quiet sleep-paradoxical sleep cycles being of minor importance. The
      temporal analysis of infant sleep structure showed a difference between the first
      and the following cycles, not only for slow wave activity in infants older than
      five months, but also for younger infants and for other individual physiological
      activities (EEG activity, respiratory and cardiac rates): is the early
      development of these peculiar features a sketch of the 'S Process' described in
      the adult?

PMID- 1630413
TI  - [Functions of paradoxical sleep and ontogenesis].
AB  - The hypotheses directly linked to cognitive and neurologic ontogenic processes ie
      consolidation of memory and learning, the maturation hypothesis of Roffwarg and
      the hypothesis of endogenous genetic programming of Jouvet, are analysed. The
      discussion of these theories are based on the analysis of: the neurophysiologic
      mechanism of REM sleep and its ontogenesis in human, the results of REM sleep
      deprivation in young animals and by a personal study of facial mimics during
      sleep in neonates. Active sleep could be assimilated, very early during
      ontogenesis, to REM sleep, it probably plays an important role in brain
      maturation during early development but the stimulation is probably, at this
      time, not very specific, later it could be a link between genetic programming and
      epigenetic processes.

PMID- 1630414
TI  - [Automatic analysis of sleep-wake states during the first year of life].
AB  - Automatic analysis on infant sleep tracing was first considered as an aid to the
      rapid construction of hypnograms. It has long been thought more complicated than
      in adults, because of the significant changes in electrogenesis during the first
      year of life, resulting in difficulty to adapt to the criteria of Rechtschaffen
      and Kales (1968), even if modified, or to those of Anders et al (1971). In fact,
      these studies have shown that automatic analysis of sleep EEG tracings permit an
      easier analysis of the changes in electrogenesis according to subject age, sleep
      stage and time of night. Moreover, automatic analysis of parameters which change
      with the sleep-wake stages shows the continuity of these changes, and therefore
      the somewhat arbitrary nature of conventional hypnogram classification. The
      mathematical treatment of this information facilitates their visualisation, and
      permits a better analysis of circadian and ultradian variations that could
      scarcely be formalized by classical hypnogram analysis. In the study of
      maturation occurring during the first months of life, automatic signal processing
      will require adaptation that will lead to new forms of reasoning.

PMID- 1630415
TI  - Physiological correlates of sleep development in premature and full-term
      neonates.
AB  - Differentiation of motor and automatic function control during different sleep
      states appears early in human ontogeny. Time of first appearance, magnitude of
      between-state differences and modifications with age depend on which particular
      parameters are considered. For some parameters, significant between-state
      differences appear at 31 weeks conceptional age (wk CA). For nearly all
      parameters, this difference is clear from 35 wk CA onwards. The analysis
      presented herein is based on studies of body movements, spontaneous skin
      potential responses, respiratory characteristics, heart rate and heart rate
      variability, and correlations between different functions. It examines clinically
      and neurologically normal premature and full-term neonates of 28-41 wk CA.

PMID- 1630416
TI  - [The frequency of respiratory variations during daytime and nighttime sleep in 35
      normal 2-month-old infants].
AB  - Daytime and nighttime polygraphic recordings were made of 35 normal 2-month-old
      infants. Respiratory rate was calculated every minute in active (AS) and quiet
      (QS) sleep states. The study indicates a difference in mean rate between the 2
      states and also shows that mean respiratory rate was lower at night than during
      the day (P less than 0.0001 for both states) and that there was a marked increase
      in rate during the first cycle. Infants with episodes of periodic breathing had a
      lower mean respiratory rate throughout the recordings. For each QS phase, both
      day and night, a marked decrease in mean respiratory rate occurred, especially
      during the first part of the sleep state, which was not found in AS. Intrasleep
      spontaneous awakening led to a marked increase in respiratory rate after sleep
      was resumed both in QS and AS. However, differences were only statistically
      significant when the awakened infant was fed. There was less difference between
      respiratory rates after spontaneous awakening without feeding since the pre
      awakening rate was more elevated than when the infant was subsequently fed.

PMID- 1630417
TI  - [Development in the metabolism of dopamine and its derivatives. Application to
      gross development disorders].
AB  - Dopamine (DA) and its metabolites homovanillic acid (HVA) in total, free and
      conjugated forms, dihydroxyphenylacetic acid (DOPAC) in total, free and
      conjugated forms, and 3 methoxytyramine (3 MT) levels were determined in the
      urine of autistic children from 2 years 8 months to 12 years of age and compared
      to those in normal children of identical age. Very significant group and age
      effects were found for DA, HVA and 3 MT. In the discussion, results are related
      to the hypothesis of a disorder in the maturation of the dopaminergic systems in
      infantile autism.

PMID- 1630418
TI  - Seat belt usage by trauma center personnel.

PMID- 1630419
TI  - Recent trends in the selection and fitting of hearing aids.
AB  - A large segment of the hearing impaired population does not utilize
      amplification. this paper reviews several factors which may account for the under
      utilization of hearing aids by the hearing impaired population. In addition, this
      paper reviews several recent developments in procedures used to select and fit
      hearing aids.

PMID- 1630420
TI  - We must be involved in the decisions that will determine medicine's role in
      society.

PMID- 1630421
TI  - U.S. Department of Health and Human Services issues final Medicare and Medicaid
      anti-kickback safe harbor regulations.

PMID- 1630422
TI  - MOMEDICO: an answer to a need.

PMID- 1630423
TI  - Is the PRO a quack?

PMID- 1630424
TI  - Invasive pulmonary aspergillosis complicated by nocardiosis in a patient with
      agnogenic myeloid metaplasia.

PMID- 1630425
TI  - Prevention and control of tuberculosis in migrant farm workers. Recommendations
      of the Advisory Council for the Elimination of Tuberculosis.
AB  - Farm workers are approximately six times more likely to develop tuberculosis (TB)
      than the general population of employed adults. These recommendations are
      presented to assist health-care providers serving migrant and seasonal farm
      workers. The following services, listed by priority, that should be available for
      migrant and seasonal farm workers and their family members are: a) detection and
      diagnosis of those with current symptoms of active TB; b) appropriate treatment
      and monitoring for those who have current disease; c) contact investigation and
      appropriate preventive therapy for those exposed to infectious persons; d)
      screening and appropriate preventive therapy for asymptomatically infected
      workers who may be immunosuppressed, such as those with human immunodeficiency
      virus (HIV) infection; e) screening and appropriate preventive therapy for
      children of migrant and seasonal farm workers; and f) widespread tuberculin test
      screening for workers and families with preventive therapy prescribed, as
      appropriate. Health-care providers should immediately perform appropriate
      diagnostic studies for persons with a productive, prolonged cough, or other
      symptoms suggestive of tuberculosis. Health departments should be immediately
      notified when TB is suspected or diagnosed to enable examination of contacts and
      initiation of other health department diagnostic, preventive, or patient
      management services. Workers and family members with uncomplicated pulmonary TB
      should be treated with a regimen that includes isoniazid, rifampin, pyrazinamide,
      and ethambutol (or streptomycin). Drug-resistant TB is an important consideration
      since it requires altered treatment regimes and because higher rates of
      resistance have been found in ethnic and social groups comprising much of the
      migrant farm worker-force. Patients should be monitored carefully for compliance,
      treatment response, and toxicity. Ideally, patients should be placed on directly
      observed therapy given by a well-trained, outreach worker from the same
      cultural/language background as the patients.

PMID- 1630426
TI  - Lyme disease knowledge, attitudes, and behaviors--Connecticut, 1992.
AB  - Lyme disease (LD), caused by infection with the spirochete Borrelia burgdorferi,
      is the most commonly reported tick-borne illness in the United States (1).
      Because no vaccine is available and effective measures to control tick
      populations are experimental, education is the most important approach to
      preventing LD. LD was identified in Connecticut in 1975 (2); in 1991, Connecticut
      had the highest rate of LD in the United States (36 per 100,000 population), and
      cases were reported in residents from 134 of Connecticut's 169 cities. To assess
      knowledge, attitudes, and behaviors related to LD, the State of Connecticut
      Department of Health Services and the University of Connecticut conducted a
      telephone survey of adults in Connecticut during the first 2 weeks of May 1992.
      This report summarizes the results of the survey.

PMID- 1630427
TI  - Transmission of multidrug-resistant tuberculosis among immunocompromised persons
      in a correctional system--New York, 1991.
AB  - During 1990 and 1991, nosocomial transmission of multidrug-resistant tuberculosis
      (MDR-TB) was documented in four hospitals in New York and Florida. Subsequently,
      additional MDR-TB outbreaks have been investigated by CDC. This report summarizes
      preliminary results of an investigation of transmission of MDR-TB in a
      correctional facility in New York.

PMID- 1630428
TI  - Sudden infant death syndrome--United States, 1980-1988.
AB  - Sudden infant death syndrome (SIDS) (the abrupt and unexplained death of an
      apparently healthy infant) is the second leading cause of infant mortality in the
      United States (1) and the eighth leading cause of years of potential life lost
      (2). This report analyzes race- and region-specific data for SIDS during 1980
      1988.

PMID- 1630429
TI  - Outbreak of type E botulism associated with an uneviscerated, salt-cured fish
      product--New Jersey, 1992.
AB  - In May 1992, the New Jersey Department of Health (NJDH) received a report of a
      man admitted to a hospital with a preliminary diagnosis of botulism.
      Subsequently, three family members of the man were diagnosed with botulism. This
      report summarizes the epidemiologic investigation of these cases that linked
      illness to consumption of an uneviscerated, salt-cured fish product.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1630430
TI  - Public-sector vaccination efforts in response to the resurgence of measles among
      preschool-aged children--United States, 1989-1991.
AB  - From 1989 through 1991, in the United States, the incidence of reported measles
      increased sixfold to ninefold over the median annual incidence (1.3 per 100,000
      population) reported from 1981 through 1988. In 1990, the peak of the resurgence,
      the incidence of measles among children aged less than 5 years was 15-fold higher
      than the median 1981-1988 incidence (4.8 per 100,000) (1). During 1991,
      approximately 9500 cases were reported (Figure 1), including 4662 cases among
      children aged less than 5 years (CDC, unpublished data). The measles epidemic is
      a consequence primarily of the failure to vaccinate preschool-aged children at
      appropriate ages (2); among children aged 16-59 months who developed measles
      during this resurgence, only 15% had received measles vaccine as recommended
      (CDC, unpublished data). This report compares the number of public clinic
      vaccinations* (i.e., all measles-containing vaccines [MCV], diphtheria-tetanus
      pertussis vaccine [DTP], and oral polio vaccine [OPV]) for 1988 with that for
      1989-1991 in response to the measles resurgence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630431
TI  - Coronary heart disease incidence, by sex--United States, 1971-1987.
AB  - Coronary heart disease (CHD) is the leading cause of death in the United States
      for both men and women, although the rates are lower among women (1). The
      incidence of CHD, however, has not been as well characterized among women as it
      has among men (2). This report presents data on sex-specific incidence of CHD and
      the risks associated with smoking, diabetes, hypertension, total cholesterol,
      body mass, and age using data from the Epidemiologic Follow-up Study of the First
      National Health and Nutrition Examination Survey (NHEFS) (3).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1630432
TI  - Estimated national spending on prevention--United States, 1988.
AB  - Despite the overall health improvements achieved through preventive
      interventions, the United States continues to be burdened by preventable illness,
      injury, and disability (1). For example, annual health-care expenditures for
      cardiovascular disease alone exceed $135 billion and injury and disability, $170
      billion (1). This report summarizes the findings of a study to estimate national
      funding for health promotion and disease prevention in the United States during
      1988 (2).

PMID- 1630433
TI  - [Studies on changes in low esophageal sphincter function after esophageal
      transection or esophago-esophagostomy in children].
AB  - An aim of the present study is to clarify the changes of esophageal function
      after surgical treatments of the esophageal varices or the congenital esophageal
      stenosis in children. Esophageal manometric studies were performed in sixteen
      children undergoing the esophageal transection with paraesophageal
      devascularization or the esophago-esophagostomy with partial esophagectomy
      before, within 1 month and over 7 months after the operation. The pressure of
      lower esophageal sphincter (LES), the length of LES, the LES relaxation test and
      the gastroesophageal reflux (GER) inducing test were measured. 1) Esophageal
      transection; The pressure dropped within 1 month and returned to the preoperative
      level over 11 months after the operation. Temporal deterioration of LES function
      was observed during the early postoperative days. However, return to the
      preoperative state was gained over 1 year. 2) Esophago-esophagostomy; The
      pressure and the length of LES were not changed after the operation. The LES
      function was disturbed preoperatively and moreover long postoperatively, in the
      case when congenital stenosis closely existed to the esophago-gastric junction.
      Degree of the postoperative disturbance of the LES function may be influenced by
      the distance to the part of the transection or the partial esophagectomy from the
      E-C junction.

PMID- 1630434
TI  - [Clinical study on responses of the upper esophageal sphincter after subtotal
      esophagectomy for esophageal cancer].
AB  - Responses of the upper esophageal sphincter (UES) to distention of the esophageal
      wall by use of a balloon catheter were measured in 30 patients after subtotal
      esophagectomy for esophageal cancer and 33 volunteers with unrelated disorders
      (control group). Patients were divided into extended dissection group and non
      extended dissection group according to the width of lymph node dissection, or
      palsy group and non-palsy group according to recurrent-laryngeal nerve palsy. The
      resting upper esophageal sphincter pressure (UESP) and the upper esophageal
      sphincter contraction (UESC) following UES induced by swallowing were measured
      after esophageal distention. Neither of UESP nor UESC without distention was
      significantly different among each group. But those of the extended dissection
      group and palsy group after esophageal distention were significantly lower values
      than those of control group. These findings suggest that responses of the UES to
      distention of esophageal wall are decreased, thus protection against aspiration
      is probably decreased.

PMID- 1630435
TI  - [Experimental studies on the effects of alpha-tocopherol in small intestinal
      ischemia and reperfusion injury].
AB  - In the present study, we quantified the biochemical [thiobarbituric acid (TBA)
      reactants, superoxide dismutase (SOD) and vitamin E] and histologic changes in
      the small intestinal tissue after ischemia and/or reperfusion. Sixty-seven Wistar
      rats were divided into 7 groups; N group: control, A-I group: 30 min. ischemia, A
      II group: 120 min. ischemia, B-I group: Declamp after 30 min. ischemia, B-II
      group: 30 min. reperfusion after 30 min. ischemia, B-III group: 30 min.
      reperfusion after 120 min. ischemia, E group: vitamin E administration 30 min.
      reperfusion after 30 min. ischemia. The levels of TBA reactants were
      significantly different between A-II and B-II, B-II and E (all p less than 0.01).
      For SOD, there were significant differences between N and B-I (p less than 0.01),
      N and E (p less than 0.05). For vitamin E, there were significant differences
      between A-I and B-I, A-I and B-I, B-II and E (all p less than 0.01). Histologic
      changes showed that the grade of tissue injury was more severe in B-I and B-II
      than in A-I, and was less in E than in B-II. It is suggested that vitamin E
      protected cells from injury due to oxygen free radicals.

PMID- 1630436
TI  - [Histopathological findings in rectal carcinomas undergoing preoperative
      irradiation combined with chemotherapy].
AB  - To evaluate the utility of preoperative irradiation (42.6 Gy) for rectal cancer,
      we examined histological specimens of surgically resected tumors, which were
      treated with (36 cases) or without (39 cases) preoperative irradiation. On the
      basis of the histological findings, irradiated cases were classified into non
      effective group (17 cases) and effective group (19 cases). According to
      quantitative analysis, cancer gland ratio (CGR) was 31.3% in non-irradiated
      group, 16.6% in non-effective group and 3.6% in effective group, while fibrosis
      ratio was 19.9%, 34.4% and 38.6%, respectively. The radiotherapy significantly
      reduced cancer gland and induced fibrosis. Influencing factors of recurrence in
      rectal cancer, such as depth of invasion, ew, vessel invasion (ly, v) and lymph
      node involvements were improved in the irradiated group, especially in effective
      cases, as compared with the non-irradiated group. In conclusion, preoperative
      irradiation therapy was thought to contribute to control of local recurrence and
      result in improvement of survival rate by decreasing several risk factors.

PMID- 1630437
TI  - [Correlation of DNA index and BrdU labeling index with clinicopathological
      factors in colorectal carcinoma].
AB  - We studied the usefulness of the DNA index (DI) and bromodeoxyuridine (BrdU)
      labeling index (BLI) using fresh material from 71 patients with colorectal
      carcinoma. We compared the DI and BLI of the biopsy specimens with those of the
      resected specimens from 17 patients. These DI and BLI values were evaluated by
      flow cytometry. Neither DNA ploidy nor DI was correlated with other
      clinicopathologic factors. Intratumoral DI heterogeneity (DIH) was found in 33.8%
      (24/71) of tumors. Lymph node metastases were observed more often in cases with
      DIH than without DIH. The incidence of DIH was correlated with histologic stage.
      BLIs were higher in well-differentiated adenocarcinoma than in moderately and
      poorly differentiated adenocarcinoma. BLIs were not correlated with histologic
      stage. A significant correlation was observed between DI and BLI (r = 0.47, p
      less than 0.001). In cases without DIH, there was a good correlation between the
      DI values of the biopsy and resected specimens (r = 0.99, p less than 0.001). A
      significant correlation was also found between the BLI values of the two types of
      specimens (r = 0.69, p = 0.002). These results suggested that 4 biopsy specimens
      were adequate to estimate DI and BLI by FCM, and that DI and BLI values
      determined by FCM could facilitate the design of treatment regimens for
      preoperative patients.

PMID- 1630438
TI  - [Experimental study of bacterial adherence to biliary tract in rabbits].
AB  - Adherence to host tissues and cell surfaces is an early step in infections.
      However nothing has been reported about bacterial adherence in biliary
      infections. The following experiment was carried out in rabbits with Escherichia
      coli isolated from the bile of a patient with acute suppurative cholangitis.
      Adhesion was observed by scanning electron microscopy. First, with cholecystic
      mucosa of normal, jaundice, acid (mucosa was injured with 0.1 N hydrochloric
      acid) and stone groups (stones were inserted into the gallbladder), bacterial
      adhesion as a virulence factor was examined in vitro. Second, in a cholangitis
      model the role of bacterial adherence to the bile duct in the development of
      localized biliary infection was examined in vivo. RESULT: (1) As compared to the
      normal, jaundice and stone groups, the number of adhering bacteria was remarkably
      increased in the acid group. The mucosa of the former groups was relatively
      intact, but that of the latter was remarkably destroyed. (2) In the cholangitis
      model, the number of bacteria adhered to the bile duct was negatively correlated
      with that of bacteria isolated from blood. These results suggest that bacterial
      adherence to the biliary tract is an important virulence factor, but not in the
      development from localized cholangitis to sepsis.

PMID- 1630439
TI  - [Long-term clinical results after aortic valve replacement with mechanical heart
      valves and mitral valve replacement with porcine valves].
AB  - Long-term clinical results of aortic valve replacement (AVR) with mechanical
      heart valves and mitral valve replacement (MVR) with porcine valves were
      analysed. Sixty-three patients received isolated AVR and 48 received isolated
      MVR. Sixty-eight patients with MVR including double or triple valve replacement
      were also added in order to evaluate the primary tissue failure (PTF). The
      patients with operative deaths were excluded. Survival rate at 11 years in AVR
      was 68 +/- 10% and 67 +/- 15% in MVR without statistical difference. At 11 years,
      76 +/- 8% of the patients in AVR were free from valve-related complications in
      contrast with the poor result of 34 +/- 31% in MVR (p less than 0.01). Main cause
      of this poor result in MVR was PTF as indicated in following event free rates; 83
      +/- 9% at 7 years, 61 +/- 25% at 10 years and 49 +/- 31% at 13 years. There was
      no statistical difference between patients of above 50 years and below 49 years
      in PTF. Valve-related death event free was 93 +/- 5% in AVR and 86 +/- 11% in MVR
      at 11 years (not significant), however, there was statistical difference in re
      operation event free rate as 94 +/- 5% in AVR and 76 +/- 11% in MVR at 11 years
      (p less than 0.001). These results suggest that the use of porcine valves in
      mitral position is confined to the selected patients.

PMID- 1630440
TI  - [Efficacy of magnetic resonance imaging in treatment of neuroblastoma].
AB  - Magnetic resonance imaging (MRI) was performed in 36 children with neuroblastoma
      at Chiba University from 1984 through 1989, and 29 patients of them were
      discussed about efficacy of MRI in treatment of neuroblastoma in this paper and
      the results were as follows. 1) MRI was difficult to differentiate tumor from
      normal kidney in the image intensity and was more efficient in determining the
      relationship of tumor to liver and to vascular structures. 2) MRI was better than
      CT in detecting the size and extent of tumor mass and in identifying lymph node
      spread using multiple planes. 3) MRI was more efficient than CT in defining
      displacement and encasement of renal vessels by tumor. It was useful to predict
      to reserve kidney before surgery. 4) MRI was useful to monitor tumor response to
      combined modalities of therapy. A favorable response was seen as a change in the
      image intensity in bone marrow metastases of neuroblastoma.

PMID- 1630441
TI  - [A case of endometrioid carcinoma arising from endometriosis of the rectum].
AB  - A very rare case with rectal endometriosis heterotopic transformed into carcinoma
      is reported. A 44-year-old female patient underwent colostomy due to ileus.
      Postoperative examinations revealed submucosal tumors all around the rectum. Low
      anterior resection and the closure of the colostomy were performed. Thickening in
      the muscular layer and serosa were observed in the resected specimen, but the
      mucosal surface was maintained. Histopathological observation revealed glands of
      the endometrium and connective fibers with glandular adenocarcinoma in the
      periphery. Transformation of the benign endometrial tissues into carcinoma and
      squamous metaplasia were observed. A diagnosis of endometrial carcinoma in the
      rectum was made.

PMID- 1630443
TI  - [Trial on MR portal blood flow measurement with phase contrast technique:
      preliminary report].

PMID- 1630442
TI  - [A case of anaplastic carcinoma of the mediastinal goiter].
AB  - We reported a case of anaplastic carcinoma of mediastinal goiter. The initial
      symptom was hoarseness, and thyroid scintigram and venogram revealed mediastinal
      thyroid malignant tumor, although cervical tumor could not be palpated. Operation
      was performed with median sternotomy. The size of the tumor was 8 x 6 x 3cm.
      Histological examination showed papillary adenocarcinoma of left lower pole of
      the thyroid gland which was transformed into anaplastic carcinoma and extended to
      the mediastinal cavity. Anaplastic carcinoma of mediastinal goiter is very rare,
      and our case showed anaplastic transformation from papillary adenocarcinoma.

PMID- 1630444
TI  - [Nuclear P53 immunoreactivity associated with poor prognosis of gastric cancer:
      preliminary report].

PMID- 1630445
TI  - [Tracheal reconstruction of extensive circumferential defects using cadaveric
      tracheal allograft: preliminary report].

PMID- 1630446
TI  - [Enhancement of cytotoxicity in the regional lymph node cells by local injection
      of carbon particles adsorbing aclacinomycin a: preliminary report].

PMID- 1630447
TI  - Subunit of an alpha-interferon-responsive transcription factor is related to
      interferon regulatory factor and Myb families of DNA-binding proteins.
AB  - Alpha interferon stimulates transcription by converting the positive
      transcriptional regulator ISGF3 from a latent to an active form. This receptor
      mediated event occurs in the cytoplasm, with subsequent translocation of the
      activated factor to the nucleus. ISGF3 has two components, termed ISGF3 alpha and
      ISGF3 gamma. ISGF3 gamma serves as the DNA recognition subunit, while ISGF3
      alpha, which appears to consist of three polypeptides, is a target for alpha
      interferon signaling and serves as a regulatory component whose activation is
      required to form ISGF3. ISGF3 gamma DNA-binding activity was identified as a 48
      kDa polypeptide, and partial amino acid sequence has allowed isolation of cDNA
      clones. ISGF3 gamma translated in vitro from recombinant clones bound DNA with a
      specificity indistinguishable from that of ISGF3 gamma purified from HeLa cells.
      Sequencing of ISGF3 gamma cDNA clones revealed significant similarity to the
      interferon regulatory factor (IRF) family of DNA binding proteins in the amino
      terminal 117 residues of ISGF3 gamma. The other IRF family proteins bind DNA with
      a specificity related to but distinct from that of ISGF3 gamma. We note sequence
      similarities between the related regions of IRF family proteins and the imperfect
      tryptophan repeats which constitute the DNA-binding domain of the c-myb
      oncoprotein. These sequence similarities suggest that ISGF3 gamma and IRF
      proteins and the c-myb oncoprotein use a common structural motif for DNA
      recognition. Recombinant ISGF3 gamma, like the natural protein, interacted with
      HeLa cell ISGF3 alpha to form the mature ISGF3 DNA-binding complex. We suggest
      that other IRF family members may participate in signaling pathways by
      interacting with as yet unidentified regulatory subunits analogous to ISGF3
      alpha.

PMID- 1630448
TI  - Inducible processing of interferon regulatory factor-2.
AB  - PRDI-BFc and PRDI-BFi are proteins that bind specifically to a regulatory element
      required for virus induction of the human beta interferon (IFN-beta). PRDI-BFc is
      a constitutive binding activity, while the PRDI-BFi binding activity is observed
      only after cells are treated with inducers such as virus or poly(I).poly(C) plus
      cycloheximide or in some cells by cycloheximide alone. In this paper we report
      that PRDI-BFc is interferon regulatory factor-2 (IRF-2), a known transcriptional
      repressor. In addition, we find that PRDI-BFi is a truncated form of IRF-2,
      lacking approximately 185 C-terminal amino acids. Thus, PRDI-BFi appears to be
      generated by inducible proteolysis. Although the affinity of PRDI-BFc/IRF-2 for
      the IFN-beta promoter does not appear to be affected by the removal of C-terminal
      amino acids, the ability of PRDI-BFi to function as a repressor in cotransfection
      experiments is significantly less than that of intact IRF-2. Studies have shown
      that IRF-2 can block the activity of the transcriptional activator IRF-1, which
      also binds specifically to the IFN-beta gene promoter. Thus, the inducible
      proteolysis of IRF-2 may be involved in the regulation of the IFN-beta gene or of
      other genes in which the ratio of IRF-1 to IRF-2 can affect the level of
      transcription.

PMID- 1630449
TI  - RCC1, a regulator of mitosis, is essential for DNA replication.
AB  - Temperature-sensitive mutants in the RCC1 gene of BHK cells fail to maintain a
      correct temporal order of the cell cycle and will prematurely condense their
      chromosomes and enter mitosis at the restrictive temperature without having
      completed S phase. We have used Xenopus egg extracts to investigate the role that
      RCC1 plays in interphase nuclear functions and how this role might contribute to
      the known phenotype of temperature-sensitive RCC1 mutants. By immunodepleting
      RCC1 protein from egg extracts, we find that it is required for neither chromatin
      decondensation nor nuclear formation but that it is absolutely required for the
      replication of added sperm chromatin DNA. Our results further suggest that RCC1
      does not participate enzymatically in replication but may be part of a structural
      complex which is required for the formation or maintenance of the replication
      machinery. By disrupting the replication complex, the loss of RCC1 might lead
      directly to disruption of the regulatory system which prevents the initiation of
      mitosis before the completion of DNA replication.

PMID- 1630450
TI  - Can, a putative oncogene associated with myeloid leukemogenesis, may be activated
      by fusion of its 3' half to different genes: characterization of the set gene.
AB  - The translocation (6;9)(p23;q34) in acute nonlymphocytic leukemia results in the
      formation of a highly consistent dek-can fusion gene. Translocation breakpoints
      invariably occur in single introns of dek and can, which were named icb-6 and icb
      9, respectively. In a case of acute undifferentiated leukemia, a breakpoint was
      detected in icb-9 of can, whereas no breakpoint could be detected in dek. Genomic
      and cDNA cloning showed that instead of dek, a different gene was fused to can,
      which was named set. set encodes transcripts of 2.0 and 2.7 kb that result from
      the use of alternative polyadenylation sites. Both transcripts contain the open
      reading frame for a putative SET protein with a predicted molecular mass of 32
      kDa. The set-can fusion gene is transcribed into a 5-kb transcript that contains
      a single open reading frame predicting a 155-kDa chimeric SET-CAN protein. The
      SET sequence shows homology with the yeast nucleosome assembly protein NAP-I. The
      only common sequence motif of SET and DEK proteins is an acidic region. SET has a
      long acidic tail, of which a large part is present in the predicted SET-CAN
      fusion protein. The set gene is located on chromosome 9q34, centromeric of c-abl.
      Since a dek-can fusion gene is present in t(6;9) acute myeloid leukemia and a set
      can fusion gene was found in a case of acute undifferentiated leukemia, we assume
      that can may function as an oncogene activated by fusion of its 3' part to dek,
      set, or perhaps other genes.

PMID- 1630451
TI  - Regulation of the junB gene by v-src.
AB  - The proteins encoded by cellular and viral src genes are believed to be involved
      in the transmission of mitogenic signals, the nuclear recipients of which are
      largely unknown. In this work, we report that four different v-src-transformed
      cell lines from three different species possess elevated levels of junB
      transcripts. Transient expression of junB promoter-chloramphenicol
      acetyltransferase constructs in NIH 3T3 cells was used to demonstrate that the
      increase in junB transcripts was specifically associated with v-src expression
      and could not be recapitulated with a c-src, v-H-ras, or v-raf expression vector.
      Deletion mutants were used to localize the v-src-responsive region in the junB
      promoter to a 121-nucleotide region encompassing the CCAAT and TATAA elements.
      This region is distinct from one in the 5' untranslated region of the junB gene
      which is required to maintain its high-level basal expression. Point mutagenesis
      of the junB TATAA box completely abolished v-src responsiveness, suggesting that
      proteins which bind to this element are modified by src transformation. Several v
      src and c-src mutants were used to demonstrate that elevated tyrosine kinase
      activity of src proteins is required for the observed effects on junB expression.
      Finally, homology between the TATAA box regions of junB and the unrelated but src
      responsive gene 9E3/CEF-4 suggests that modulation of gene activity through
      proteins which bind to this region may be a recurrent, although not exclusive,
      theme in src transforming action. Our results suggest that src proteins may
      modulate some nuclear effectors through pathways not involving cellular ras or
      raf gene products.

PMID- 1630452
TI  - Extrachromosomal homologous DNA recombination in plant cells is fast and is not
      affected by CpG methylation.
AB  - Using a sensitive transient assay, we investigated extrachromosomal homologous
      DNA recombination (ECR) in plant cells. As the plant genome is highly C
      methylated, we addressed the question of whether CpG methylation has an influence
      on DNA recombination efficiencies. Whereas the expression level of the fully CpG
      methylated DNA molecules was reduced drastically, we found no significant changes
      in ECR efficiencies between two partly CpG-methylated plasmids or between one
      fully CpG-methylated and one nonmethylated plasmid. Using a modified polymerase
      chain reaction analysis, we were able to detect recombination between two fully
      CpG-methylated plasmids. Furthermore, we characterized the kinetics of the ECR
      reaction. Cotransfection of plasmids carrying truncated copies of the beta
      glucuronidase (GUS) gene resulted in enzyme activity with a delay of only half an
      hour compared with that of the plasmid carrying the functional marker gene. This
      indicates that the ECR reaction itself requires no more than 30 min. By
      polymerase chain reaction, we were able to detect the recombined GUS gene as
      early as 2 h after transfection. This result and the time course of the transient
      GUS activity indicate that ECR occurs mainly early after transfection. The
      biological significance of this finding is discussed, and properties of ECR and
      intrachromosomal recombination are compared.

PMID- 1630453
TI  - The coat protein of the yeast double-stranded RNA virus L-A attaches covalently
      to the cap structure of eukaryotic mRNA.
AB  - The eukaryotic mRNA 5' cap structure m7GpppX (where X is any nucleotide)
      interacts with a number of cellular proteins. Several of these proteins were
      studied in mammalian, yeast, and drosophila cells and found to be involved in
      translation initiation. Here we describe a novel cap-binding protein, the coat
      protein of L-A, a double-stranded RNA virus that is persistently maintained in
      many Saccharomyces cerevisiae strains. The results also suggest that the coat
      protein of a related double-stranded RNA virus (L-BC) is likewise a cap-binding
      protein. Strikingly, in contrast to the cellular cap-binding proteins, the
      interaction between the L-A virus coat protein and the cap structure is through a
      covalent bond.

PMID- 1630454
TI  - Characterization of cis-acting elements regulating transcription from the
      promoter of a constitutively active rice actin gene.
AB  - The promoter of the constitutively expressed rice (Oryza sativa) actin 1 gene
      (Act1) is highly active in transformed rice plants (W. Zhang, D. McElroy, and R.
      Wu, Plant Cell 3:1150-1160, 1991). A region 834 bp upstream of the Act1
      transcription initiation site contains all the regulatory elements necessary for
      maximal gene expression in transformed rice protoplasts (D. McElroy, W. Zhang, J.
      Cao, and R. Wu, Plant Cell 2:163-171, 1990). We have constructed a series of Act1
      promoter deletions fused to a bacterial beta-glucuronidase reporter sequence
      (Gus). Transient expression assays in transformed rice protoplasts, as well as
      transformed maize cells and tissues, identified two distinct cis-acting
      regulatory elements in the Act1 promoter. A 38-bp poly(dA-dT) region was found to
      be a positive regulator of Act1 promoter activity. Deletion of the poly(dA-dT)
      element lowered Gus expression by at least threefold compared with expression
      produced by the full-length Act1 promoter. By gel retardation and footprinting,
      we identified a ubiquitous rice protein which specifically recognizes this
      poly(dA-dT) element in the constitutively active Act1 promoter. A CCCAA pentamer
      repeat-containing region was found to be a negative regulator of the Act1
      promoter in transformed rice protoplasts. Transient expression assays in
      different maize cells and tissues with use of the Act1 deletion constructs
      suggested that the CCCAA pentamer repeat region functions in a complex tissue
      specific manner. A CCCAA-binding protein was detected only in root extracts.

PMID- 1630455
TI  - The functional importance of a cap site-proximal region of the human
      prointerleukin 1 beta gene is defined by viral protein trans-activation.
AB  - Prointerleukin 1 beta (IL-1 beta) is a cytokine that mediates a broad range of
      biological activities. Genomic sequences that regulate IL-1 beta transcription
      include both inducible regulatory elements located more than 2,700 bp upstream of
      the transcriptional start site (cap site) and proximal elements located near the
      TATA box of this gene. In this study, we focused on the identification and
      characterization of trans-acting nuclear regulatory proteins that bind to the cap
      site-proximal region of the human IL-1 beta gene. We identified a protein, termed
      NFIL-1 beta A (NF beta A), that binds to a highly conserved 12-bp DNA sequence (
      49 to -38) located upstream of the TATA box motif in both the human and murine IL
      1 beta genes. The IL-1 alpha gene, which lacks a TATA motif, does not possess an
      NF beta A-binding sequence within the promoter region, suggesting that NF beta A
      may selectively regulate IL-1 beta expression. Using electrophoretic mobility
      shift assays, we identified several distinct DNA-protein complexes that are
      expressed in a cell-type-specific manner. In monocytic cell lines, the relative
      abundance of these complexes varies rapidly following stimulation of the cells
      with phorbol esters or lipopolysaccharide. UV cross-linking analysis identified
      two distinct DNA-binding polypeptides that comprise distinct complexes. The
      functional role of NF beta A was assessed in transient transfection assays. These
      data indicate that NF beta A is required for both basal and inducible promoter
      activity in monocytic cells. Furthermore, the human cytomegalovirus immediate
      early 1 gene product requires the presence of NF beta A in order to trans
      activate the proximal IL-1 beta promoter in a monocytic cell line. We propose
      that NF beta A is a factor that mediates either direct or indirect activation by
      the immediate-early 1 gene product. The proximity of this essential factor to the
      TATA motif suggests a possible role in transcriptional initiation.

PMID- 1630456
TI  - Two species of human CRK cDNA encode proteins with distinct biological
      activities.
AB  - Two distinct human CRK cDNAs, designated CRK-I and CRK-II, were isolated from
      human embryonic lung cells by polymerase chain reaction and by screening of a
      human placenta cDNA library, respectively. CRK-I differed from CRK-II in that it
      lacked a 170-nucleotide sequence, suggesting that CRK-I and CRK-II were the
      products of alternative splicing. The amino acid sequences deduced from these two
      cDNAs differed in the carboxyl termini and contained one SH2 and either one or
      two SH3 domains. RNAse protection analysis demonstrated both CRK-I and CRK-II
      mRNAs in various human cells. Three CRK proteins, of 42, 40, and 28 kDa, were
      identified in human embryonic lung cells by means of antibodies against the SH2
      region and the SH3 region of the bacterially expressed CRK-I protein. Transient
      expression of CRK-I and CRK-II cDNAs in COS7 cells showed that the former encoded
      the 28-kDa protein and the latter encoded the 40- and 42-kDa proteins. All human
      cell lines so far examined expressed the 40-kDa protein; however, expression of
      the 28- and the 42-kDa proteins was variable. In a comparison of the biological
      activity of the two human CRK proteins, both proteins were stably expressed in
      rat 3Y1 cells. All cell lines expressing CRK-I protein showed altered morphology,
      proliferated in soft agar, and grew as massive tumors in nude mice. Although CRK
      II-expressing cells showed a slight morphologic change, they did not make
      colonies in soft agar or grow in nude mice. These results demonstrate that the
      two species of human CRK cDNA encode proteins which differ in their biological
      activities.

PMID- 1630457
TI  - The gene for a novel human lamin maps at a highly transcribed locus of chromosome
      19 which replicates at the onset of S-phase.
AB  - A previously described human DNA fragment which is replicated early in S-phase of
      HL-60 cell DNA (C. Tribioli, G. Biamonti, M. Giacca, M. Colonna, S. Riva, and A.
      Falaschi, Nucleic Acids Res. 15:10211-10232, 1987) was used to screen a genomic
      library in lambda Ch28. A clone which contained a 13.7-kb insert (L30E) found to
      code for several transcripts was isolated. The transcription of L30E DNA
      exhibited a complex pattern and a tissue-specific and proliferation-dependent
      type of regulation. The data were consistent with two tandemly arranged
      transcription units, the 3' end of one separated from the 5' end of the other by
      a sequence of about 600 bp containing an active promoter. The isolation and
      sequencing of L30E-specific cDNAs permitted identification of two genes, one of
      which encoded a B-type human lamin (analogous to mouse lamin B2). L30E DNA was
      mapped by in situ hybridization at the G-negative subtelomeric band p13.3 of
      chromosome 19. Interestingly, in synchronized HL-60 cells, L30E DNA is replicated
      in the first minute of S-phase. Replication of the lamin gene early in S-phase
      may reflect a coupling between early replication and transcription of genes for S
      phase-specific proteins such as lamins.

PMID- 1630458
TI  - Oncoprotein-mediated signalling cascade stimulates c-Jun activity by
      phosphorylation of serines 63 and 73.
AB  - In resting cells, c-Jun is phosphorylated on five sites. Three of these sites
      reside next to its DNA binding domain and negatively regulate DNA binding. In
      response to expression of oncogenic Ha-Ras, phosphorylation of these sites
      decreases, while phosphorylation of two other sites within c-Jun's activation
      domain is greatly enhanced. Phosphorylation of these residues, serines 63 and 73,
      stimulates the transactivation function of c-Jun and is required for oncogenic
      cooperation with Ha-Ras. We now show that the same changes in c-Jun
      phosphorylation are elicited by a variety of transforming oncoproteins with
      distinct biochemical activities. These oncoproteins, v-Sis, v-Src, Ha-Ras, and
      Raf-1, participate in a signal transduction pathway that leads to increased
      phosphorylation of serines 63 and 73 on c-Jun. While oncogenic Ha-Ras is a
      constitutive stimulator of c-Jun activity and phosphorylation, the normal c-Ha
      Ras protein is a serum-dependent modulator of c-Jun's activity. c-Jun is
      therefore a downstream target for a phosphorylation cascade involved in cell
      proliferation and transformation.

PMID- 1630459
TI  - Regulation and expression of a growth arrest-specific gene (gas5) during growth,
      differentiation, and development.
AB  - The growth arrest-specific gas5 gene was isolated from mouse genomic DNA and
      structurally characterized. The transcriptional unit is divided into 12 exons
      that span around 7 kb. An alternative splicing mechanism gives rise to two mature
      mRNAs which contain either 11 or 12 exons, and both are found in the cytoplasm of
      growth-arrested cells. In vivo, the gas5 gene is ubiquitously expressed in mouse
      tissues during development and adult life. In Friend leukemia and NIH 3T3 cells,
      the levels of gas5 gene mRNA were high in saturation density-arrested cells and
      almost undetectable in actively growing cells. Run-on experiments indicated that
      the gas5 gene is transcribed at the same level in both growing and arrested
      cells. On the other hand, in dimethyl sulfoxide-induced differentiating cells a
      sharp decrease in the rate of transcription was observed shortly before the cells
      reached the postmitotic stage. These results indicate that in density-arrested
      cells accumulation of gas5 mRNA is controlled at the posttranscriptional level
      while in differentiating cells expression is regulated transcriptionally.

PMID- 1630460
TI  - Regulated degradation of ornithine decarboxylase requires interaction with the
      polyamine-inducible protein antizyme.
AB  - Intracellular degradation of vertebrate ornithine decarboxylase (ODC) is
      accelerated by polyamines, the products of the pathway controlled by ODC.
      Antizyme, a reversible, tightly binding protein inhibitor of ODC activity, is
      believed to be involved in this process. Mouse and Trypanosoma brucei ODCs are
      structurally similar, but the trypanosome enzyme, unlike that of the mouse, is
      not regulated by intracellular polyamines when expressed in hamster cells (L.
      Ghoda, D. Sidney, M. Macrae, and P. Coffino, Mol. Cell. Biol. 12:2178-2185,
      1992). We found that mouse ODC interacts with antizyme in vitro but trypanosome
      ODC does not. To localize the region necessary for binding, we made a series of
      enzymatically active chimeric mouse-trypanosome ODCs and tested them for antizyme
      interaction. Replacing residues 117 to 140 within the 461-amino-acid mouse ODC
      sequence with the equivalent region of trypanosome ODC disrupted both antizyme
      binding and in vivo regulation. Formation of an antizyme-ODC complex is therefore
      required for regulated degradation.

PMID- 1630461
TI  - The N-terminal 96 residues of MCM1, a regulator of cell type-specific genes in
      Saccharomyces cerevisiae, are sufficient for DNA binding, transcription
      activation, and interaction with alpha 1.
AB  - MCM1 performs several functions necessary for its role in regulating cell type
      specific gene expression in the yeast Saccharomyces cerevisiae: DNA binding,
      transcription activation, and interaction with coregulatory proteins such as
      alpha 1. We analyzed a set of MCM1 deletion derivatives using in vivo reporter
      gene assays and in vitro DNA-binding studies to determine which regions of MCM1
      are important for its various activities. We also analyzed a set of LexA-MCM1
      hybrids to examine the ability of different segments of MCM1 to activate
      transcription independent of MCM1's DNA-binding function. The first third of MCM1
      [MCM1(1-96)], which includes an 80-residue segment homologous to the mammalian
      serum response factor, was sufficient for high-affinity DNA binding, for
      activation of reporter gene expression, and for interaction with alpha 1 in vitro
      and in vivo. However, the ability of MCM1(1-96) to activate transcription and to
      interact with alpha 1 was somewhat reduced compared with wild-type MCM1 [MCM1(1
      286)]. Optimal interaction with alpha 1 required residues 99 to 117, in which 18
      of 19 amino acids are acidic in character. Optimal transcription activation
      required a segment from residues 188 to 286, in which 50% of the amino acids are
      glutamine. Deletion of this segment from MCM1 reduced expression of reporter
      genes by about twofold. Moreover, LexA-MCM1 hybrids containing this segment were
      able to activate expression of reporter genes that rely on LexA binding sites as
      potential upstream activation sequences. Thus, glutamine-rich regions may
      contribute to the activation function of yeast transcription activators, as has
      been suggested for glutamine-rich mammalian proteins such as Sp1.

PMID- 1630462
TI  - The yeast alpha 1 and MCM1 proteins bind a single strand of their duplex DNA
      recognition site.
AB  - The yeast cell type regulator alpha 1 cooperates with a constitutive factor, MCM1
      protein, to recognize the promoter and activate transcription of several alpha
      specific genes. I show here that the alpha 1 and MCM1 proteins bind specifically
      to one of the two strands of their recognition sequence. This single-strand
      binding activity shares several characteristics with the duplex-binding
      properties of these proteins: (i) the MCM1 protein binds alone to single-stranded
      and duplex sequences of both the alpha-specific (P'Q) and a-specific (P) binding
      sites; (ii) the alpha 1 protein requires both the MCM1 protein and the Q sequence
      to bind either single-stranded or duplex DNA; (iii) the alpha 1 protein
      stimulates binding of the MCM1 protein to both single-stranded and duplex DNAs;
      and (iv) the affinities of the proteins for single-stranded and duplex DNAs are
      comparable.

PMID- 1630464
TI  - Effects of mutation position on frequency of marker rescue by homologous
      recombination.
AB  - Homologous recombination between transferred and chromosomal DNA can be used for
      mapping mutations by marker rescue, i.e., by identifying which segment of wild
      type DNA can recombine with the mutant chromosomal gene and restore normal
      function. In order to define how much the fragments should overlap each other for
      reliable mapping, we have measured how the frequency of marker rescue is affected
      by the position of the chromosomal mutation relative to the ends of the
      transferred DNA fragments. For this purpose, we used several DNA fragments to
      effect marker rescue in two mutant hybridomas which bear mutations 673 bp apart
      in the exons encoding the second and third constant region domains of the
      immunoglobulin mu heavy chain. The frequency of marker rescue decreased greatly
      when the mutation was located near one of the ends of the fragments, the results
      indicating that fragments should be designed to overlap by at least several
      hundred base pairs. Possible explanations for this "end effect" are considered.

PMID- 1630465
TI  - Infection control. Wound management.

PMID- 1630463
TI  - Occupancy of upstream regulatory sites in vivo coincides with major
      histocompatibility complex class I gene expression in mouse tissues.
AB  - The major histocompatibility complex (MHC) class I HLA-B7 transgene carrying a
      660-bp upstream sequence is expressed in the mouse with tissue specificity that
      parallels that of the expression of endogenous mouse MHC class I (H-2) genes. We
      have performed in vivo genomic footprinting for the HLA-B7 transgene and the
      endogenous H-2Kb gene. We show that the upstream region of both the transgene and
      the endogenous gene was extensively occupied in spleen tissue, where these genes
      are expressed at high levels. In contrast, no occupancy was detected in brain
      tissue, where expression of these genes is virtually absent. Sites exhibiting in
      vivo protection correspond to cis elements previously shown to bind to nuclear
      factors in vitro, including the constitutive enhancer region I and the interferon
      response element. The strongest tissue-specific protection was detected at site
      alpha, located downstream from the interferon response element. Site alpha bound
      a constitutively expressed nuclear factor(s) in vitro that exhibited an
      overlapping specificity which may involve a nuclear hormone receptor, RXR, and an
      AP-1-related factor. Site alpha was functional in vivo, as it enhanced MHC class
      I transcription in lymphocytes. These results show that the tissue-specific
      occupancy of the MHC class I regulatory sequences in vivo correlates with their
      expression and suggest that in vivo occupancy is controlled by a mechanism other
      than the mere presence of factors capable of binding to these sites. Our results
      suggest that a sequence present in the 660-bp upstream region in a human
      leukocyte antigen gene directs tissue-specific occupancy of MHC class I genes in
      vivo, independently of their position and copy number, illustrating a potential
      advantage of using a transgene for delimitation of the sequence requirement for
      in vivo occupancy.

PMID- 1630466
TI  - Infection control. Eusol--(E) useful or (e) useless?

PMID- 1630467
TI  - Infection control. Blood-borne pathogens: safety for the healthcare worker.

PMID- 1630468
TI  - Infection control. The do's and don'ts of antiseptics.

PMID- 1630469
TI  - Infection control. Nursing management of a patient with hepatitis A and B.
AB  - The Infection Control precautions for hepatitis B are those of "Blood and Body
      Fluid Precautions" and those of "Universal Precautions". Gloves, preferably
      latex, are worn when there is to be contact with blood and body fluid.
      Goggles/masks are worn when there is a danger of splashing or aerosol of blood
      contaminated secretions. A plastic apron, or water repellant gown, may be
      indicated if there is a danger of splashing. Hand washing before and after
      contact with blood and body fluid, even if gloves are worn. Specimens are treated
      as biohazard. Refuse and linen are treated as infectious. It is important to
      establish if the patient is in the acute phase, a carrier, or not. Education of
      the patient about the disease, is very important, especially in the carrier. This
      poses a problem when there is a language barrier. This is a sensitive subject and
      must be handled tactfully, especially if the mode of transmission was sexual.
      Safe sex must be discussed. The partner, and the newborn baby must be assessed
      and immunised. The transmission of hepatitis A is mainly faeco-oral, and the
      infection control measures those called "Enteric Precautions", or blood and body
      fluid precautions. These include the wearing of latex gloves when handling
      faeces, urine, saliva, and blood. Handwashing is essential. The patient has his
      own bedpan, urinal, crockery and cutlery. Isolation is continued for the first
      two weeks of the illness, and one week after the onset of jaundice. The Infection
      Control management for hepatitis A is slightly different to that of hepatitis B,
      C, and Non-A Non-B.

PMID- 1630470
TI  - Infection control. Management of sharps injuries.

PMID- 1630472
TI  - Infection control. Infection control in a trauma unit.

PMID- 1630471
TI  - Infection control. The re-use of single-use medical devices.

PMID- 1630473
TI  - New AIDS safeguard available--and it is a must.

PMID- 1630474
TI  - Self-destructing syringes to combat AIDS.

PMID- 1630475
TI  - Al Gore's future.

PMID- 1630476
TI  - Patents for genomes?

PMID- 1630477
TI  - Audit faults US national labs.

PMID- 1630478
TI  - US drops Imanishi-Kari investigation; Baltimore withdraws Cell retraction.

PMID- 1630479
TI  - Wall Street remains bearish on value of genome project.

PMID- 1630480
TI  - Delaney's revenge: court rejects US approach to assessing cancer risks in
      processed foods.

PMID- 1630481
TI  - Multiplicity of migrants.
AB  - An informed debate on the manner in which legislation on migration from food
      packaging is introduced is badly needed. Until then, scientific resources are
      being needlessly wasted.

PMID- 1630483
TI  - Cost of brain disorders.

PMID- 1630482
TI  - Cost of brain disorders.

PMID- 1630484
TI  - Well-being and productivity.

PMID- 1630485
TI  - How to publish the unpalatable?

PMID- 1630486
TI  - Palaeontology. Wandering across time.

PMID- 1630487
TI  - Bear conservation genetics.

PMID- 1630488
TI  - Molecular replication.
AB  - Simple replicating molecules are likely to have played a critical role in the
      origin of life. Recent experiments show that non-enzymatic replication is
      conceivable in a wide range of synthetic chemical systems. The challenge now
      facing these studies is how to develop information-coding systems from simple
      prebiotic precursors.

PMID- 1630489
TI  - Atomic structure and chemistry of human serum albumin.
AB  - The three-dimensional structure of human serum albumin has been determined
      crystallographically to a resolution of 2.8 A. It comprises three homologous
      domains that assemble to form a heart-shaped molecule. Each domain is a product
      of two subdomains that possess common structural motifs. The principal regions of
      ligand binding to human serum albumin are located in hydrophobic cavities in
      subdomains IIA and IIIA, which exhibit similar chemistry. The structure explains
      numerous physical phenomena and should provide insight into future
      pharmacokinetic and genetically engineered therapeutic applications of serum
      albumin.

PMID- 1630490
TI  - Post-Jurassic mammal-like reptile from the Palaeocene.
AB  - Mammal-like reptiles of the order Therapsida document the emergence of mammals
      from more primitive synapsids and are of unique zoological and palaeontological
      interest on that account. Therapsids, first appearing in the Early Permian, were
      thought to become extinct in the Middle Jurassic, soon after the Late Triassic
      origin of mammals. Here, however, we report the discovery of a therapsid from the
      late Palaeocene, 100 million years younger than the youngest previous occurrence
      of the order. This discovery nearly doubles the stratigraphic range of therapsids
      and furnishes their first record from the Cenozoic. The documenting fossils, an
      incomplete dentary containing three teeth, and four isolated teeth from other,
      conspecific individuals (Fig. 1), are from the Paskapoo Formation, at Cochrane,
      Alberta, Canada, from beds yielding a diverse mammalian fauna of early Tiffanian
      age. These specimens are catalogued in the collections of the University of
      Alberta Laboratory for Vertebrate Paleontology (UALVP) and provide the basis for
      a new taxon, as named and described below: (see text)

PMID- 1630491
TI  - TCP1 complex is a molecular chaperone in tubulin biogenesis.
AB  - A role in folding of newly translated proteins in the cytosol of eukaryotes has
      been proposed for t-complex polypeptide-1 (TCP1), although its molecular targets
      have not yet been identified. Tubulin is a major cytosolic protein whose assembly
      into microtubules is critical to many cellular processes. Although numerous
      studies have focused on the expression of tubulin, little is known about the
      processes whereby newly translated tubulin subunits acquire conformations that
      enable them to form alpha-beta-heterodimers. We examined the biogenesis of alpha-
      and beta-tubulin in rabbit reticulocyte lysate, and report here that newly
      translated tubulin subunits entered a 900K complex in a protease-sensitive
      conformation. Addition of Mg-ATP, but not nonhydrolysable analogues, released the
      tubulin subunits as assembly-competent protein with a conformation that was
      relatively protease-resistant. The 900K complex purified from reticulocyte lysate
      contained as its major constituent a 58K protein that cross-reacted with a
      monoclonal antiserum against mouse TCP1. We conclude that TCP1 functions as a
      cytosolic chaperone in the biogenesis of tubulin.

PMID- 1630492
TI  - T-complex polypeptide-1 is a subunit of a heteromeric particle in the eukaryotic
      cytosol.
AB  - The murine t-complex encodes t-complex polypeptide-1 (TCP1), which is
      constitutively expressed in almost all cells, and upregulated during
      spermatogenesis. Mammalian sequences have greater than 96% identity with each
      other, and greater than 60% identity with Drosophila melanogaster and yeast
      orthologues. TCP1 is essential in yeast, and is postulated to be the cytosolic
      mammalian equivalent of groEL. We report here that, in the native state, murine
      and human TCP1 is distributed throughout the cytosol as an 800K-950K hetero
      oligomeric particle in association with four to six unidentified proteins and two
      Hsp70 heat-shock proteins. Negative-stain electron microscopy indicates that the
      structure is two stacked rings, 12-16 nm in diameter. Therefore, despite
      similarities with the chaperonin 60 proteins, these data indicate that TCP1 is
      biochemically and structurally unique. We suggest that TCP1 may represent one of
      a family of molecules in the eukaryotic cytosol involved in protein folding and
      regulated in part by their heteromeric associations.

PMID- 1630493
TI  - Cytotoxic T-lymphocyte activation involves a cascade of signalling and adhesion
      events.
AB  - In addition to the antigen-specific T-cell receptor (TCR), T cells bear an array
      of 'accessory' molecules that can contribute to stable adhesion to the antigen
      bearing cell and provide costimulatory signals. For several of these, T-cell
      adhesion to the ligand can be activated by TCR-dependent signalling (a signal
      from the TCR primes the coreceptor to bind to its ligand). It is unclear whether
      the individual coreceptors share common mechanisms of priming and cosignalling,
      and perhaps act in a redundant manner, or whether they act in a distinct way and
      contribute uniquely to the activation process. We report here the use of isolated
      alloantigen, class I proteins and fibronectin ligands to show that coreceptors on
      cytotoxic T lymphocytes are activated sequentially and deliver distinct
      biochemical signals on binding to their ligands. TCR engagement activates CD8 by
      a protein tyrosine kinase-dependent pathway, and CD8 then acts as a signal for
      initiation of polyphosphoinositide hydrolysis on binding to class I. In contrast,
      activated adhesion to fibronectin does not initiate polyphosphoinositide
      hydrolysis, but amplifies hydrolysis once it has been initiated. Thus, cytotoxic
      T-lymphocyte activation involves a TCR-initiated cascade of adhesion and
      signalling events leading to response.

PMID- 1630494
TI  - Superantigen implicated in dependence of HIV-1 replication in T cells on TCR V
      beta expression.
AB  - In the pathogenesis of AIDS it is not yet understood whether the small fraction
      of CD4+ T cells (approximately 1%) infected with the human immunodeficiency virus
      (HIV) are randomly targeted or not. Here we present evidence that human CD4 T
      cell lines expressing selected T-cell antigen receptor V beta gene products can
      all be infected in vitro with HIV-1, but give markedly different titres of HIV-1
      virion production. For example, V beta 12 T-cell lines from several unrelated
      donors reproducibly yielded up to 100-fold more gag gene product (p24gag antigen)
      than V beta 6.7a lines. This is consistent with a superantigen effect, because
      the V beta selectivity was observed with several divergent HIV-1 isolates, was
      dependent on antigen-presenting cells and on major histocompatibility complex
      (MHC) class II but was not MHC class II-restricted. The in vivo significance of
      these findings is supported by the preferential stimulation of V beta 12+ T cells
      by freshly obtained irradiated antigen-presenting cells from some HIV-1
      seropositive but not HIV-1-negative donors. Moreover, cells from patients
      positive for viral antigen (gp120) were enriched in the V beta 12 subpopulation.
      V beta 12+ T cells were not deleted in AIDS patients, however, raising the
      possibility that a variety of mechanisms contribute to T-cell depletion. Our
      results indicate that a superantigen targets a subpopulation of CD4+ cells for
      viral replication.

PMID- 1630496
TI  - [Gene probes and their use in microbiology].
AB  - A gene probe (nucleic acid probe) is a single-stranded nucleic acid fragment that
      interacts with a complementary sequence of a target nucleic acid. The test is
      based upon the principles of nucleic acid hybridization reactions. Different
      assay formats (dot-blot, colony, whole-cell hybridizations) can be applied. Gene
      probes can be used for the rapid and specific identification of microorganisms.
      The phylogenetic identification and in situ detection of uncultured bacteria will
      be discussed.

PMID- 1630497
TI  - ECG and electrodermal response in Rana temporaria and Bufo bufo under the
      influence of autonomic-acting drugs.

PMID- 1630495
TI  - [Molecular biology and regulatory mechanisms of antibiotic production in
      Bacillus].
AB  - Several species of the genus Bacillus produce linear and cyclic peptide
      antibiotics nonribosomally through multienzyme complexes by the so-called
      thiotemplate mechanism. Molecular genetic studies have shown that some peptide
      antibiotic biosynthesis genes are organized in operons and that they are
      expressed postexponentially under conditions that also activate the process of
      endospore formation in Bacillus. Furthermore, DNA-sequence analysis of some
      multifunctional peptide synthetase genes revealed that they contain a highly
      conserved and repeated domain structure. The same domain was also found to be
      conserved within a superfamily of peptide synthetases and adenylate-forming
      enzymes of diverse origins. Based on sequence homology and functional similarity
      I conclude that those enzymes bearing domain(s) represent a family of
      superenzymes which may have a common evolutionary origin.

PMID- 1630498
TI  - Compounds stimulating growth and multiplication in ciliates. Do also free-living
      cells release growth factors?

PMID- 1630499
TI  - U.S. health care dilemma.

PMID- 1630500
TI  - Cow dung cure.

PMID- 1630501
TI  - Environmental health. Should we be concerned?

PMID- 1630502
TI  - Environmental hazards and health risks. A public health viewpoint.

PMID- 1630503
TI  - Informed medical consent.

PMID- 1630504
TI  - Hazardous waste. A North Carolina dilemma.
AB  - North Carolina, along with the rest of the nation, faces a number of dilemmas
      regarding management of hazardous waste: 1. North Carolina businesses and
      industries generate a lot of hazardous waste, but the state lacks the capacity to
      manage it. For many, it has been acceptable to ship the waste to other states for
      treatment, storage, and disposal. Some of the receiving states have indicated
      that they are no longer willing to serve as the "dumping ground" for North
      Carolina. 2. North Carolina, along with the EPA, has identified a number of
      hazardous waste sites now listed on the NPL. However, the state was excluded from
      its regional agreement with Alabama, South Carolina, Kentucky, and Tennessee in
      January 1991, meaning that Superfund monies may be withdrawn and that cleanup
      won't be completed at these sites. 3. Every year the country produces at least
      260 million tons of hazardous waste--more than one ton for every man, woman, and
      child. Those opposed to constructing hazardous waste treatment facilities charge
      that businesses and industries should reduce their hazardous waste to zero or
      near zero, and they charge that the state is not doing enough to encourage waste
      reduction. North Carolina's hazardous waste regulations already require programs
      to minimize the amounts of waste generated by industries, but for most industrial
      processes, it is impossible to reduce the generation of waste to zero. However,
      industries must continue to reduce their waste through source reduction and
      recycling. Hazardous waste and toxic materials do pose a risk to human health and
      the environment unless properly managed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630506
TI  - Youth and alcohol.

PMID- 1630507
TI  - Health effects of indoor air pollution.

PMID- 1630505
TI  - Medical waste management. Federal perspective and North Carolina program.

PMID- 1630508
TI  - Radon in North Carolina. Does exposure create a significant health risk?

PMID- 1630509
TI  - What is the quality of water in North Carolina?

PMID- 1630511
TI  - Environmental risk assessment. Estimating risks contaminants pose to our health.

PMID- 1630510
TI  - Food safety. Lead, pesticides, antibiotics, hormones, and irradiation.

PMID- 1630512
TI  - [An arm in the wringer is not automatically lost].

PMID- 1630513
TI  - [Methylene blue and pregnancy; revision of a calamity].

PMID- 1630514
TI  - [Does a protein-poor diet delay the loss of kidney function?].

PMID- 1630515
TI  - [Epilepsy and pregnancy].

PMID- 1630516
TI  - [International reporting of adverse effects of drugs].

PMID- 1630517
TI  - [The use of drugs for euthanasia and assisted suicide in family practice].
AB  - An exploratory, descriptive, retrospective study was carried out concerning the
      use of means for euthanasia or assisted suicide, primarily regarding the period
      1986-1989. Data were collected via an anonymous written inquiry among a random
      sample of family physicians in North Holland (n = 521) and family physicians in
      the rest of the Netherlands (n = 521). The inquiry contained among others
      questions about the last case they had encountered. In addition, police reports
      of euthanasia or assisted suicide administered by family physicians in North
      Holland (n = 263) were analysed. The response to the inquiry was 67%; (non
      respondents did not differ from respondents): 388 cases could be analysed. The
      use of euthanatics by family physicians in North Holland and those in the rest of
      the Netherlands was identical. More than 40 different euthanatics were used, most
      of them incidentally. The most frequently used (combination of) means were a
      benzodiazepine with a neuromuscular relaxant (23%), a barbiturate with a
      neuromuscular relaxant (20%), barbiturates (15%) and opioids (12%). Most
      euthanatics were given intravenously (61%, of which 5% by infusion), orally 21%,
      intramuscularly 12%, rectally 3% and subcutaneously 2%. The quantities applied
      varied greatly. The average length of time from the start of the procedure till
      decrease was 3.8 hours (less than or equal to 1 minute-72 hours). In 12% of the
      cases complications or unintended effects were reported. Comparison of inquiry
      and police reports showed some differences.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630518
TI  - [Revision consensus prevention and treatment decubitus].
AB  - The text of the Consensus Meetings Prevention and Treatment of Decubitus
      (pressure sores; 1985 and 1986 respectively) was adapted to current insights into
      pathogenesis and treatment. This adaptation was important since the costs of the
      prevention and treatment of decubitus are enormous and decubitus tends to occur
      more often since the population is growing older. The so called anti-decubitus
      devices were grouped in 3 categories: 1. polyether foam mattresses, placed on top
      of the standard hospital mattresses (merely in prevention and in treatment of
      patients less than 85 kg), 2. polyether foam mattresses with or without special
      surface layout or simple alternating pressure air mattresses, replacing the
      standard hospital mattress (especially in patients greater than 85 kg) and 3.
      special beds and bed systems as low-air-loss beds and air-fluidized beds (only on
      strict indications such as thoracic operations and intensive treatments). The
      clinical manifestations of decubitus were classified in 4 stages: non-blanching
      erythema (1), blister (2), superficial decubitus (3) and deep decubitus (4). The
      existence of another form of pressure sores was identified: decubitus originating
      from operation or angiography tables, on which a deep necrosis develops,
      extending to form an abscess, erupting through the skin after 7-14 days. These
      ulcers are characterised by an impressive depth, usually to the underlying bones,
      but with vivid edges. The development of these sores is prevented in most cases
      by using a category 1 device on the tables mentioned.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1630519
TI  - [Public media and health care].

PMID- 1630520
TI  - [Developments in the scientific field in surgery].

PMID- 1630521
TI  - [Ultrasonography as initial imaging study can replace roentgen studies under
      certain conditions in suspected congenital hip dysplasia].

PMID- 1630522
TI  - [Ultrasonography as initial imaging study can replace roentgen studies under
      certain conditions in suspected congenital hip dysplasia].

PMID- 1630523
TI  - [Cerebrovascular accident].

PMID- 1630524
TI  - [Should a patient with a stroke be hospitalized?].

PMID- 1630525
TI  - [Should a patient with a stroke be hospitalized?].

PMID- 1630526
TI  - [Traumatology in The Netherlands].

PMID- 1630527
TI  - [Psychogenic aphonia; an easily and rapidly treatable conversion].

PMID- 1630528
TI  - [High-density lipoproteins].

PMID- 1630529
TI  - ['It is just a hernia'].

PMID- 1630530
TI  - [Medical activities under adverse conditions. The Medical Coordination
      Secretariat of the protestant (development aid) organizations in The
      Netherlands].

PMID- 1630531
TI  - [Hemoglobinopathies in The Netherlands; is screening of foreign women
      advisable?].

PMID- 1630532
TI  - [The treatment of familial hypercholesterolemia].

PMID- 1630533
TI  - Salt output in relation to salt intake versus salt output alone: which is a
      better predictor of effective vascular volume?

PMID- 1630534
TI  - Plasma interleukin-6 levels in continuous ambulatory peritoneal dialysis and
      hemodialysis patients.
AB  - Plasma levels of interleukin-6 (IL-6), a cytokine known to be involved in
      lymphocyte activation and in inflammation, were studied in 10 normal volunteers,
      21 continuous ambulatory peritoneal dialysis (CAPD) patients and 41 hemodialysis
      patients. Plasma IL-6 levels in hemodialysis patients were significantly higher
      than those in normal volunteers and CAPD patients (p less than 0.05). The means
      of plasma IL-6 concentrations before and after hemodialysis did not change
      significantly. While IL-6 in peritoneal dialysate was detectable in only 3 of the
      21 CAPD patients without peritonitis, it was extremely high in 2 patients with
      bacterial peritonitis. IL-6 levels decreased as peritonitis subsided.

PMID- 1630535
TI  - Production of tumor necrosis factor-alpha in patients on hemodiafiltration.
AB  - The systemic production of tumor necrosis factor (TNF)-alpha was evaluated in
      uremic patients before and after hemodiafiltration (HDF) and paired filtration
      dialysis (PFD) and in the interdialytic period. Both HDF and PFD were performed
      using polysulfone dialyzers with either standard or ultrapure dialysis fluid. TNF
      alpha was quantitated by using a specific biological assay based on its cytotoxic
      effect on a TNF-sensitive human melanoma cell line SK-MEL-109. Postdialytic mean
      plasma TNF-alpha levels decreased, albeit not significantly, in regard to
      predialytic values. These results differ from those obtained in patients on HDF
      using other high-permeability membranes such as polymethylmethacrylate and
      polyacrylonitrile (AN 69) as recently described by us. Of interest, the adoption
      of ultrapure dialysis fluid resulted in a marked reduction in the interdialytic
      production of TNF-alpha. These results suggest that the enhanced production of
      TNF-alpha in patients dialyzed with high-permeability membranes is mainly
      dependent upon the bacteriological purity of dialysis fluid.

PMID- 1630536
TI  - Selenium in renal failure patients.
AB  - The selenium (Se) concentration in plasma, serum and whole blood was determined
      in 29 healthy persons, 19 nondialyzed patients with chronic renal disease (9
      proteinuric but with otherwise normal renal function, 10 with chronic renal
      failure), and 10 dialyzed end-stage renal disease patients. No differences in Se
      concentrations of plasma, serum or whole blood were determined between patients
      and their matched controls. Total Se concentrations did not correlate with any of
      the Se carriers except with alpha 2-globulin. However, alpha 2-globulin
      concentrations were not different between patients and controls. Within the
      dialyzed patient group, Se concentrations did not change during dialysis. Se
      supplementation is not indicated in these patients. Within all groups analyzed,
      serum Se concentrations (12.7 +/- 2.5 micrograms/dl) were significantly (p less
      than 0.0001) lower than comparable plasma concentrations (15.3 +/- 3.9
      micrograms/dl). These data suggest normal concentrations of blood Se in the
      groups of patients evaluated; and they are not Se-deficient. Serum Se
      concentrations cannot be equated with plasma values.

PMID- 1630537
TI  - Role of agglomeration in calcium oxalate monohydrate urolith development.
AB  - Formation of agglomerates of calcium oxalate monohydrate (COM) crystals on semi
      batch precipitation performed at conditions relevant to urolithiasis (37 degrees
      C, pH = 6, initial ratio [Ca]/[Ox] = 10), but without any specific admixture, was
      followed by both optical and electron microscopy. COM crystals formed on
      precipitation developed into large agglomerates consisting of intergrown crystals
      by a mechanism of primary agglomeration. Primary agglomeration of COM crystals
      represents an important mechanism of COM renal calculi growth.

PMID- 1630538
TI  - Deferoxamine test and PTH serum levels are useful not to recognize but to exclude
      aluminum-related bone disease.
AB  - The use of noninvasive diagnostic tools, like the deferoxamine (DFO) test and
      serum iPTH, to identify aluminum-related bone disease has proved to be inadequate
      due to false-negative cases; therefore, bone biopsy becomes a necessary
      diagnostic procedure. Our purpose was to verify whether these non-invasive
      parameters, appropriately used, may result valid in the identification of
      patients not at risk of Al toxicity, therefore restricting the need for
      histologic evaluation. We studied 68 hemodialyzed patients, aged 49.0 +/- 11.6
      years, with a M/F ratio of 37/31 and a dialytic age of 85.0 +/- 47.0 months, by
      means of bone biopsy, DFO test and serum C-PTH. 19.1% of the cases had positive
      stainable Al and/or high bone Al content (greater than 60 mg/kg/dw) and could be
      intoxicated. To obtain the highest sensitivity, we selected the following limit
      values: the lower limit of increment so far proposed for DFO test positivity
      (greater than 150 micrograms/l) and a value capable of selecting patients with
      pathologic osteoclasia for C-PTH (greater than 15 ng/ml). With these limits, four
      different groups of patients were recognized: group A, DFO test positive and PTH
      high, n = 12; group B, DFO test positive and PTH low, n = 6; group C, DFO test
      negative and PTH high, n = 30; group D, DFO test negative and PTH low, n = 20. In
      group B, which could be anticipated as being at higher risk, we actually found
      the highest (p less than 0.05) bone Al content as compared to other groups,
      associated with a reduced bone formation rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630539
TI  - Effect of body iron stores on serum aluminum level in hemodialysis patients.
AB  - To evaluate the influence of body iron stores on the serum aluminum (Al) level,
      we studied the correlation between iron status (the serum ferritin, serum iron
      and transferrin saturation) and serum Al levels in 68 severely anemic
      hemodialysis patients. Among them, 36 underwent the desferrioxamine (DFO)
      mobilization test. These 68 patients were divided into three groups according to
      their serum ferritin level. The basal Al level in the patient group was 41.4 +/-
      37.4 micrograms/l (control, 4.1 +/- 2.4 micrograms/l). The serum Al level after
      DFO infusion of the patient group was 111.1 +/- 86.8 micrograms/l. A
      significantly higher basal Al and peak Al level after DFO infusion were found in
      group 1 patients (serum ferritin less than 300 micrograms/l) when compared to
      group 2 (serum ferritin 300-1,000 micrograms/l) and group 3 (serum ferritin
      greater than 1,000 micrograms/l) patients. A significant negative correlation
      between serum ferritin and basal serum Al (r = -0.544, p = 0.0001), as well as
      peak serum Al after DFO infusion (r = -0.556, p = 0.0001), was noted. Similarly,
      a negative relationship between serum Al (both basal and peak) and either serum
      iron or transferrin saturation was noted. However, there was no correlation
      between the serum Al level and the dosage of aluminum hydroxide. In conclusion,
      serum ferritin, serum iron and transferrin saturation were inversely correlated
      with serum Al in our hemodialysis patients. Iron deficiency may probably increase
      Al accumulation in these patients.

PMID- 1630541
TI  - Intraoperative versus routine hemodialysis in end-stage renal disease patients
      undergoing open-heart surgery.
AB  - Of 13 chronic hemodialysis end-stage renal disease (ESRD) patients undergoing
      open-heart surgery, 7 received intraoperative hemodialysis (IHD) during
      cardiopulmonary bypass and 6 received hemodialysis on a routine basis (RHD).
      Within the groups, IHD patients had significantly lower post-operative mean serum
      potassium and mean plasma creatinine concentrations compared to mean preoperative
      values. Postoperative mean BUN tended to decrease and mean serum bicarbonate
      concentration was unchanged as compared to mean preoperative values. In the RHD
      group, however, post-operative mean serum potassium concentration tended to
      increase, mean serum bicarbonate concentration significantly declined and mean
      BUN was unchanged as compared to mean preoperative values. An average of 2.1 +/-
      0.5 liters of fluid was removed from the IHD patients during cardiopulmonary
      bypass. Post-operatively, 0 of 7 IHD patients versus 4 of 6 RHD patients required
      parenteral sodium bicarbonate therapy (chi 2, p less than 0.01). On average, RHD
      patients required hemodialysis 1 day after surgery, whereas IHD patients were
      hemodialyzed 2 days after surgery (p = 0.009). We conclude that IHD lessened
      postoperative hyperkalemia and metabolic acidosis and delayed postoperative
      hemodialysis by an additional day. IHD should be considered as an adjunct to RHD
      therapy in the management of ESRD patients undergoing open-heart surgery.

PMID- 1630540
TI  - Dialysis granulocytopenia is preceded by an increased surface expression of the
      adhesion-promoting glucoprotein Mac-1.
AB  - We studied the expression of Mac-1 on granulocytes (flow cytometry) from 9
      patients (27 examinations) during hemodialysis with cuprophane membranes (CuM).
      Samples were drawn before dialysis and from the arterial and venous lines at 5,
      15 and 180 min. Granulocytopenia was most pronounced after 15 min of treatment.
      Mac-1 expression on granulocytes increased during dialysis, and a pronounced
      enhancement occurred across the dialyzer. Mac-1 expression on granulocytes
      increased 116% across the dialyzer at 5 min, and the degree of Mac-1 mobilization
      at 5 min correlated with the degree of subsequent granulocytopenia at 15 min. In
      in vitro experiments, granulocytes from healthy blood donors were incubated with
      plasma drawn from the arterial and venous lines at 5 min. Plasma drawn from the
      venous line at 5 min had a greater ability to mobilize Mac-1 than plasma from the
      arterial line (p less than 0.002). This difference correlated with the degree of
      granulocytopenia at 15 min (r = 0.76, p = 0.01). Pieces of a washed CuM were
      incubated in normal human serum (NHS) preparations for different times.
      Inactivation of the alternative pathway of complement activation (NHS-50 degrees)
      did not alter the generation of Mac-1-mobilizating capacity compared to NHS. In
      contrast, inactivation of the classical pathway (NHS-EGTA) decreased the early
      but not the late generation of Mac-1-mobilizating capacity. Our results indicate
      that the early mobilization and not the absolute expression of Mac-1 correlates
      with granulocytopenia, and that sera in vitro attain Mac-1-mobilizating capacity
      more rapidly when the classical pathway of complement activation is intact.

PMID- 1630542
TI  - Urokinase concentration in the renal artery and vein.
AB  - To compare the fibrinolytic activity between the renal artery and vein and the
      systemic circulation, we measured tissue-type plasminogen activator (t-PA),
      urokinase and total fibrinolytic activity in the blood samples from both the left
      and right renal artery and vein and the anterior cubital vein of 7 kidney donors.
      Englobulin fibrinolytic activity was significantly higher in the renal vein
      [106.6 +/- 5.6 blood activator units (BAU)] than in the renal artery (90.6 +/-
      4.1 BAU; p less than 0.001) and cubital vein (94.3 +/- 6.3 BAU, p less than
      0.005), but there was no difference between renal artery and cubital vein. t-PA
      Ag was 2.9 +/- 1.1 ng/ml in the renal vein, 2.6 +/- 1.0 ng/ml in the renal artery
      and 2.6 +/- 1.1 ng/ml in the cubital vein. There was no difference between renal
      artery, renal vein and cubital vein. Urokinase was significantly higher in the
      renal vein (3.3 +/- 0.4 ng/ml) than in the renal artery (2.4 +/- 0.4 ng/ml; p
      less than 0.001) and cubital vein (2.6 +/- 0.4; p less than 0.005), but there was
      no difference between the renal artery and cubital vein. In all cases, there was
      no difference in the fibrin(ogen) degradation product concentration between the
      renal artery and vein and the cubital vein. These findings suggest that the
      kidney may be an essential organ for providing urokinase to the systemic
      circulation.

PMID- 1630543
TI  - Plasma 1,5-anhydroglucitol concentration in patients with end-stage renal disease
      with and without diabetes mellitus.
AB  - The plasma concentration of 1,5-anhydroglucitol, a new clinical marker of
      glycemic control in diabetic patients, was evaluated as a marker of glycemia in
      83 diabetic and nondiabetic patients with end-stage renal disease. Plasma 1,5
      anhydroglucitol concentration decreased and correlated inversely with blood
      glucose, hemoglobin A1c, or fructosamine in 48 diabetic patients with normal
      renal function. In 13 nondiabetic patients with end-stage renal disease not on
      dialysis, plasma 1,5-anhydroglucitol concentrations were lower than in 23 healthy
      subjects (6.22 +/- 2.10 vs. 24.20 +/- 7.50 micrograms/ml, respectively). The
      plasma concentration of 1,5-anhydroglucitol concentration in nondiabetic patients
      with end-stage renal disease was inversely correlated to the urinary N-acetyl
      beta-D-glucosaminidase activity (r = -0.634) but not to blood glucose, hemoglobin
      A1c, or fructosamine. Renal tubular damage may contribute to the low plasma
      concentration of 1,5-anhydroglucitol in this group. The plasma concentrations of
      this polyol decreased in both diabetic (4.63 +/- 1.08 micrograms/ml) and
      nondiabetic patients on hemodialysis (4.71 +/- 0.87 micrograms/ml). In these two
      groups, there was no correlation between plasma concentration of this polyol and
      blood glucose, hemoglobin A1c, or fructosamine. The plasma concentration of 1,5
      anhydroglucitol decreased after a single hemodialysis session. The results showed
      that impaired renal function and removal of 1,5-anhydroglucitol by dialysis may
      contribute to its decreased concentration in patients with end-stage renal
      disease, but that glycemic control does not. Therefore, we should consider renal
      function when we use plasma 1,5-anhydroglucitol concentration as a marker of
      glycemic control in diabetic patients.

PMID- 1630544
TI  - Low doses of drugs able to alter intestinal mucosal permeability to food antigens
      (5-aminosalicylic acid and sodium cromoglycate) do not reduce proteinuria in
      patients with IgA nephropathy: a preliminary noncontrolled trial.
AB  - In an uncontrolled trial, patients with IgA nephropathy (IgAN) were treated with
      drugs that can alter the intestinal mucosal permeability to food antigens. These
      drugs are known to ameliorate urinary abnormalities and histological lesions of
      IgAN associated with ulcerative colitis or Crohn's disease [5-aminosalicylic acid
      (5-ASA)] or to prevent, in mice, the induction of IgAN-like disease by oral
      immunization [disodium cromoglycate (SCG)]. Nine patients [serum creatinine (s
      Cr) less than 2 mg/dl; 24-hour proteinuria higher than 1.5 g, but not nephrotic)
      were treated with 5-ASA (2.4 g/day for 6 months); 9 similar patients were treated
      with SCG (400 mg/day for 6 months); the follow-up extended to 6 months after
      stopping therapy. The 5-ASA group showed a slight but not significant decrease in
      s-Cr, 24-hour/proteinuria, IgA circulating immune complexes (IgA-CIC) and IgA
      rheumatoid factor (IgA-RF); serum beta 2-microglobulin and serum IgA were
      unchanged; 2 of 9 treated patients showed, after 6 months of therapy, a reduction
      in proteinuria of more than 50% that lasted for the subsequent 18 months. The SCG
      treated group showed a slight but not significant increase in 24-hour proteinuria
      and a significant decrease in serum IgA; unchanged were s-Cr, IgA-CIC, IgA-RF,
      serum beta 2-microglobulin; no patient treated with SCG showed a reduction in
      proteinuria of more than 50%. At the dosages and for the periods used, 5-ASA and
      SCG did not show a significant influence on clinical and laboratory parameters of
      disease in IgAN; other trials with increased dosages are warranted to definitely
      ascertain the possible therapeutic role of these drugs in IgAN.

PMID- 1630545
TI  - Two cases of persistent hypouricemia associated with diabetes mellitus.
AB  - Two patients with diabetes mellitus had persistent hypouricemia due to increased
      urate clearance; the degree of the apparent renal hypouricemia with uricosuria
      was quite mild. At the onset of diabetes, their serum urate levels were normal.
      Even after good diabetes control in both cases, hypouricemia continued. Based on
      the pharmacological evaluation in both patients, pyrazinamide administration
      could partially decrease urate clearance, however, suppression by pyrazinamide
      was less than in normal subjects, and probenecid increased urate clearance. These
      results suggest that the present cases had a renal abnormality affecting tubular
      presecretory reabsorption of urate, which might be due to diabetes mellitus.

PMID- 1630546
TI  - Detection of cellular proliferation during compensatory renal growth using flow
      cytometry.
AB  - Compensatory renal growth (CRG) consists of cellular enlargement and a small but
      consistent increase in DNA content. It has been assumed that the increase in
      total renal DNA content was due to new cell formation, however, the possibility
      of nuclear polyploidy remained an alternative explanation. To test the hypothesis
      whether cellular hyperplasia is the cause of the increase in DNA content during
      compensatory growth after renal deprivation, we performed cell cycle analysis
      using flow cytometry. Following unilateral nephrectomy, the amount of cortical
      cells in the S phase increased by 12% at 10 h while the number of cells in the
      G2M phase increased by 7% at 120 h. Medullary cells entering the S phase
      increased by 26% at 24 h and those in G2M increased by 12% at 168 h. DNA
      synthesis and replication occurs during CRG following unilateral nephrectomy as
      evidenced by an increase in cells entering both the S and G2M phases of the cell
      cycle. The increase in DNA content during CRG is a result of cellular
      proliferation and not polyploidy.

PMID- 1630547
TI  - Effect of ciclosporin on cardiac output and regional blood flow in rats:
      ciclosporin-induced nephropathy and its prevention with calcium channel blocker.
AB  - The effect of ciclosporin (CS) on cardiac output (CO) and regional blood flow was
      studied using the microsphere method in heminephrectomized rats with and without
      renal arterial clamping prior to the administration of CS. The effect of a
      calcium (Ca) channel blocker, verapamil, was also examined on CS-induced
      nephropathy. CS at a dose of 40 mg/kg per day was given orally using a gastric
      tube for 7 days. Verapamil was given in the drinking water for 7 days.
      Significant increases in blood urea nitrogen (BUN) and serum creatinine (sCr)
      with a significant decrease in renal inulin clearance (CIn) were noted after 7
      days of CS administration in both intact and ischemic-kidney groups, indicating
      the development of CS-induced nephropathy. The ischemic-kidney group showed a
      significantly severe nephropathy as compared with the intact-kidney group. As for
      change in CO and regional blood flow, CS caused a significant decrease in CO,
      renal blood flow (RBF) and brain blood flow, while hepatic arterial blood flow
      and muscular blood flow significantly increased. The renal outer cortical blood
      flow decreased markedly while the inner cortical blood flow remained unchanged.
      Although verapamil slightly but significantly decreased mean arterial blood
      pressure in CS-treated rats, CO and its distribution did not change. BUN and sCr
      were not significantly ameliorated in the intact-kidney group. However, in the
      ischemic-kidney group, verapamil caused a significant improvement in RBF,
      ameliorating CS-induced elevation of BUN and sCr, and a decrease in CIn.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1630548
TI  - Phlebotomy for erythropoietin-induced malignant hypertension.
AB  - Four patients on regular dialysis treatment whose blood pressure was well
      controlled, developed malignant hypertension while receiving maintenance
      recombinant human erythropoietin (r-Hu-EPO). None of these patients had a
      haematocrit greater than 35% at any stage, and clinically, none had any evidence
      of fluid overload. Initially, they were all managed by stopping r-Hu-EPO and
      intensification of antihypertensive therapy. However, none of the patients
      responded, and venesection of 500 ml of blood was performed in each case with
      swift and sustained response.

PMID- 1630549
TI  - Hypertension in unilateral atrophic kidney secondary to ureteropelvic junction
      obstruction.
AB  - A patient with atrophic unilateral hydronephrosis due to ureteropelvic junction
      obstruction associated with hypertension was successfully treated by nephrectomy.
      Preoperatively, plasma renin activity was elevated in both the peripheral vein
      and affected renal vein. Renin concentration in the resected kidney was high, and
      immunohistochemical localization of renin was observed along the afferent
      arterioles of the juxtaglomerular apparatus and in arterioles at some distance
      from the glomeruli.

PMID- 1630551
TI  - Helicobacter pylori infection in dialyzed patients: bismuth therapy and
      pharmacokinetics.

PMID- 1630550
TI  - Idiopathic hypercalciuria causing osteoporosis and hypocalcemia.
AB  - Idiopathic hypercalciuria, though a common cause of nephrolithiasis, has not been
      recognized to cause hypocalcemia and severe bone disease. We describe an
      adolescent with idiopathic hypercalciuria who presented initially with severe
      hypocalcemia and osteoporosis and this was later complicated by recurrent renal
      calculi formation after calcium and vitamin D supplement. After treatment with
      thiazide, hypercalciuria was controlled and serum biochemistry normalized. While
      idiopathic renal hypercalciuria may cause a negative calcium balance in adults, a
      variant of this syndrome with severe renal calcium leak occurring in a growing
      subject could lead to severe hypocalcemia and osteoporosis.

PMID- 1630552
TI  - Red cell lipid peroxidation and antioxidant system in chronic renal failure
      patients treated with recombinant human erythropoietin.

PMID- 1630553
TI  - Massive hemorrhagic necrosis of small intestine due to mesenteric vein
      thrombosis: an unusual complication of nephrotic syndrome.

PMID- 1630554
TI  - Vinorelbine therapy in a hemodialyzed patient.

PMID- 1630555
TI  - Renal cell carcinoma of the native kidney in a female renal allograft patient
      without acquired cystic kidney disease.

PMID- 1630556
TI  - Is transfusion the only risk factor for HCV infection among hemodialyzed
      patients?

PMID- 1630557
TI  - Anomalous neutrophil inositol triphosphate production in idiopathic calcium
      oxalate nephrolithiasis.

PMID- 1630558
TI  - Hydrocarbons and renal failure: primary damage in glomerulonephritis is tubular,
      not glomerular.

PMID- 1630559
TI  - Enalapril-associated anemia in a patient with IgA nephropathy and hypertension.

PMID- 1630560
TI  - Infected graft fistula following dental surgery.

PMID- 1630561
TI  - Torulopsis glabrata peritonitis in a chronic hemodialyzed patient.

PMID- 1630562
TI  - Spontaneous resolution of hydrothorax in continuous ambulatory peritoneal
      dialysis.

PMID- 1630563
TI  - [Plastic surgery for facial nerve paralysis].

PMID- 1630564
TI  - [Unbranched-site aneurysm of intracranial internal carotid artery].
AB  - Most intracranial saccular aneurysms arise from the angle between a parent vessel
      and an arterial branch. Saccular aneurysms without relation to any arterial
      branch are rare. During the last 24 years, 210 patients with intracranial
      internal carotid artery (ICA) aneurysms were directly operated on at our
      institution. We found eight saccular aneurysms arising from intracranial ICA
      without relation to any arterial branch. So we call them unbranched-site
      aneurysms of intracranial ICA, and describe their unique characteristics. Of the
      eight cases with unbranched-site aneurysm of intracranial ICA, three were men and
      five were women. The age ranged from 31 to 61 years with an average age of 48.
      Seven cases suffered a subarachnoid hemorrhage due to ruptured unbranched-site
      aneurysm, and the other case had been admitted to our department because of
      accompanying ruptured left internal carotid-posterior communicating aneurysm. All
      cases of unbranched-site aneurysm presented intraoperative and/or angiographic
      findings of arteriosclerosis, and five of the patients had a past history of
      hypertension. Of the four unbranched-site aneurysms at the C2 portion of ICA, two
      arose from the lateral wall, one arose from the superior wall and the other arose
      from the infero-lateral wall of ICA. Of the four unbranched-site aneurysms at the
      C1 portion of ICA, three arose from the superior wall and the other arose from
      the supero-medial wall of ICA. Radical operation was performed in all cases and
      intraoperative rupture occurred in two cases. It was suggested that
      arteriosclerotic change in the arterial wall, and local hemodynamic stress played
      important roles in the development of unbranched-site aneurysms of intracranial
      ICA.

PMID- 1630565
TI  - [Diagnosis and treatment of disseminated intravascular coagulation associated
      with neurosurgical diseases; a proposal of a new scoring system for DIC].
AB  - The occurrence of disseminated intravascular coagulation (DIC) is not rare in
      neurosurgical patients. We investigated the therapeutic effects of gabexate
      mesilate (FOY) for DIC or DIC preparatory state in 70 cases. Underlying diseases
      were head injuries in 31 cases, intracranial hemorrhages in 19, subarachnoid
      hemorrhages in 10, cerebral infarctions or embolisms in 5, brain tumors in 3 and
      other diseases in 2. DIC or DIC preparatory states were induced by severe brain
      damage (26 cases), infection (26 cases), failure of other organs (6 cases), shock
      (5 cases), and others. On the basis of the clinical coagulation studies of these
      patients, we retrospectively established a new scoring system for DIC
      (neurosurgical DIC score) associated with neurosurgical diseases and evaluated
      whether it was useful. Because the original DIC score proposed by the Research
      Committee on Blood Coagulation Disorders supported by the Japanese Ministry of
      Health and Welfare was not correlated with the level of consciousness
      representing the primary brain damage, it was likely to be underestimated in
      neurosurgical patients. Therefore, we included the level of consciousness with a
      new DIC scoring system. The neurosurgical DIC score was calculated from platelet
      count (score 0-3), FDP (score 0-3) and the level of consciousness (score 0-2),
      and was diagnosed as DIC preparatory state if it was 3, calculated from 2 of the
      3 parameters, and as DIC if it was over 4. The score should be checked twice if
      it was 3, especially after operation. The neurosurgical DIC score was
      significantly correlated with the original DIC score.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1630566
TI  - [Intraoperative monitoring of facial electromyographic responses during
      neurovascular decompressive surgery for hemifacial spasm].
AB  - In this paper, we reported our experience of intraoperative facial
      electromyographic recordings obtained during microvascular decompression for
      hemifacial spasm. MATERIALS AND METHODS: Intraoperative electromyographic
      recordings from the mentalis muscle during stimulation of the temporal branch of
      the facial nerve has been attempted in 31 patients. No muscle relaxants were used
      except for those before intubation. Of 31 patients, 22 were female and 9 were
      male. The age on admission ranged from 31 to 60 years with a mean of 54 years.
      RESULTS: 1. Abnormal response appeared with a latency of about 10 msec after
      stimulation. This response disappeared in 30 out of 31 patients at the end of
      operation. In 4 patients, the abnormal response disappeared prior to
      decompression of the nerve. 2. 30 patients in whom the abnormal response
      disappeared were free of spasm immediately after surgery. Hemifacial spasm has
      been relieved in 28 patients with a follow up period of 6 months to 2 years and 7
      months. The remaining two patients had mild spasm. The one patient in whom the
      abnormal response did not disappear had persistent hemifacial spasm. CONCLUSION:
      The authors think that intraoperative facial electromyographic recording is
      useful to identify the blood vessel that is causing the spasm and to ensure that
      decompression of the nerve has been accomplished.

PMID- 1630567
TI  - [An analysis of lymphokine gene expression within astrocytoma].
AB  - Expression of the lymphokine genes in human astroglial cell lineage was studied.
      Primers for 9 different human lymphokines, from IL-1 alpha to IL-8, were used to
      analyze RNA transcripts in 5 cultured human astrocytoma, one neuroblastoma cell
      line and 4 fresh brain specimens by polymerase chain reaction (PCR). mRNA
      transcripts of neither IL-1 nor IL-3, the biological activities of which were
      observed in rat primary cultured astrocytes, could be detected within these cell
      lines. Two out of 5 unstimulated astrocytomas, U138 and U373, expressed IL-6
      genes. IL-8 gene was detected within U87, U138, U251, U373 glioma cells. After
      stimulation with IL-1 beta, all astrocytoma and one neuroblastoma cell line
      expressed IL-6 and IL-8 genes. In addition to the cultured cells, we examined IL
      6 and IL-8 gene expression within human malignant astrocytoma specimens. The
      result shows that three out of four glioma specimens expressed IL-6 and IL-8
      genes. From these results, it is suspected that astroglial cell-derived IL-6 or
      IL-8 may participate in local immune reactions accompanying infection,
      degeneration and malignancies in the central nervous system.

PMID- 1630568
TI  - [Linac based radiosurgery; a technical report].
AB  - A method for highly dose-localized irradiation using a linear accelerator (linac)
      for a brain tumor has been developed. The method requires a linac, a computed
      tomography (CT) system, a CT simulator, and a treatment planning system for
      radiotherapy, with which most major radiotherapy centers are equipped. To
      immobilize a patient during irradiation, a custom-made device made of synthetic
      material which became flexible with heating was used. With the CT system and the
      CT simulator the target was identified and geometrical data for positioning the
      tumor at a point to which x-ray beams were directed (an isocenter of the linac)
      were obtained. By rotating a treatment couch it was made possible for the x-ray
      source to rotate around the isocenter on multiple planes. Dose distribution
      obtained with this method was compared to that of the gamma unit and found
      comparable. Since the method requires no invasive procedure, it appears suitable
      for treatment, with fractionated irradiation, of malignant tumors.

PMID- 1630569
TI  - [Germinoma with granulomatous reaction arising from the corona radiata; case
      report and review of articles].
AB  - We report a rare case of germinoma with granulomatous reaction arising from the
      corona radiata. This 20-year-old man was admitted to our hospital complaining of
      progressive motor weakness on the right side. CT demonstrated a poorly demarcated
      high density area in the left corona radiata, which was heterogeneously enhanced
      after administration of contrast medium. Moreover, the continuity of the mass to
      the ventricular wall was confirmed on MRI. At the first operation, subtotal
      removal of the tumor was performed through a fronto-parietal craniotomy. The
      diagnosis for the specific neoplasm was not established histologically, but
      granuloma caused by fungal infection was the most likely cause of the lesion. We
      tried amphotericin B (AmB), and remission of the tumor was obtained. However,
      during the following 3 months, the size of the tumor gradually enlarged again.
      AmB was repeatedly administered, but this time the treatment was ineffective. Six
      months later, on May 21, 1990, the second operation was performed and
      histological examination revealed typical germinoma consisting of two-cell
      pattern. Subsequently, the patient underwent focal irradiation of 33 Gy to the
      tumor site, and the tumor completely disappeared. As intracranial germinomas are
      observed to be successfully cured by radiotherapy and/or chemotherapy, choice of
      the therapeutic management must be carefully determined according to the
      histological diagnosis, especially in young people. A variety of locations of
      germinomas and the accompanying granulomatous reactions could create some
      diagnostic confusion, so great care must be taken in the treatment of much
      intracranial germinomas.

PMID- 1630570
TI  - [Subclavian artery to internal carotid artery bypass with saphenous vein graft in
      the treatment of bilateral common carotid artery occlusion; a case report].
AB  - A case of left common carotid artery occlusion, which was treated by a saphenous
      vein graft, is reported. A 49-year-old right handed male was admitted to the
      hospital because of right hemiparesis and aphasia. These symptoms disappeared
      spontaneously two weeks after admission. However, visual acuity remained impaired
      on the left side due to occlusion of the central retinal artery. Angiography
      revealed complete occlusion of the common carotid arteries as well as patency of
      the internal carotid arteries on both sides. PET and 123I-IMP-SPECT studies
      showed hypoperfusion in the left cerebral hemisphere. To restore the blood flow
      as well as to remove the source of the emboli, endarterectomy was performed on
      the left internal carotid artery. This was followed by a saphenous vein graft
      between the left subclavian and the internal carotid artery. Postoperative
      angiography revealed patency of the bypass, and a SPECT study revealed increased
      blood flow in the left cerebral hemisphere. The patient has remained in stable
      condition during the following 30 months with no neurological problems. We
      conclude that in the treatment of complete occlusion of the common carotid artery
      and subsequent cerebral hypoperfusion, a bypass graft between the internal
      carotid and the subclavian artery is quite effective, and that the site of the
      bypass graft should carefully be sought for by using preoperative angiographic
      studies.

PMID- 1630571
TI  - [A case of giant aneurysm of the posterior cerebral artery, treated with a
      detachable balloon].
AB  - We report a case with a giant PCA aneurysm successfully treated using the
      detachable balloon technique. The case was a 52 year-old man with episodes of
      minor stroke probably due to the giant aneurysm. The aneurysm was located in the
      P2 segment of the right PCA and was broad-based. Clipping of the neck was
      considered to be impossible and proximal clipping was the alternative treatment.
      Instead of surgery, proximal occlusion of the PCA was performed with the use of a
      detachable balloon.

PMID- 1630572
TI  - [A septated syringomyelia with a dramatic clinical course in a young patient with
      MELAS; a case report].
AB  - This is a report of a young girl who showed a recurrence of acute worsening and
      remission of neurological manifestations, with consistent MRI demonstration of
      transaxial septated syrinxes in the cervical and the lumbar spinal cord in
      addition to a tight filum terminale. This 8 year-old girl had developed normally
      since her birth until August 1989 when she developed a gait disturbance. This
      worsened acutely on January 1, 1990, with the additional manifestation of a
      urinary bladder disturbance. General examination failed to show any abnormality
      or scoliosis. Neurologic examination revealed a monoparesis of the right lower
      extremity with muscle atrophy and pyramidal tract sign. Fecal constipation and
      urinary retention were noted. The MRI T1 weighted sagittal image demonstrated an
      incontinuous low intensity signal in the C1-C7 as well as in the T12-L2 without
      swelling of the cord. The axial image clearly demonstrated the septations in the
      syrinx which looked like eye glasses. No definite Gd enhancement was
      demonstrated. Chiari malformation was not associated, but the tethered cord was
      well identified. With the administration of steroid, she showed a marked
      improvement of neurological manifestations. She was able to urinate without
      difficulty and also walk by herself. For one month thereafter she remained well
      with minor neurological deficits until she developed a worsening of the gait
      disturbance with a newly manifested weakness of the left upper extremity. Sensory
      impairment was also demonstrated below L3. In contrast to the worsening of the
      clinical symptoms, no definite change in the abnormalities found by MRI was
      noted.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630573
TI  - [Intrathecal dissemination of meningiomas; a case report].
AB  - A case of the cytologically verified intrathecal dissemination of benign
      meningiomas was reported. A 36-year-old man was admitted to our hospital because
      trans-sphenoidal surgery was planned for the repair of CSF rhinorrhea caused by a
      recurrent pituitary adenoma. The CT scan demonstrated incidental multiple tumors
      spread throughout in the pontomedullary and ambient cisterns. The head and spinal
      MRI showed more than fifteen small tumors in the posterior fossa and the thoracic
      spinal canal. CSF cytology revealed benign fibroblastic or meningotheliomatous
      meningioma with whorl formation and psammoma body. Several comments were made on
      the mechanism of the intrathecal dissemination of the meningiomas.

PMID- 1630574
TI  - [Clival chordoma in an infant; case report and review of the literature].
AB  - Skull base chordoma in infants is a very rare entity in spite of its congenital
      origin; only 11 clinical cases can be found in the literature so far. Here we
      report such a case and review the literature. The case is that of a 3.5-year old
      boy suffering from left abducent nerve palsy for 5 months. CT scan revealed an
      isodense mass lesion with bone destruction involving the clivus and left petrous
      apex, and was homogeneously enhanced on post-contrast study. MRI disclosed the
      clival tumor as a long T1 and long T2 mass. Angiogram showed no tumor stain. The
      tumor was preoperatively diagnosed as clival chordoma, and was partially removed
      via left transpetrosal-transtentorial approach. The tumor was found to extend
      into the subdural space through Dorrello's canal and compress the abducent nerve.
      Histological examination with H & E, PAS, mucicarmine, and reticulin stainings
      led us to a diagnosis of "typical chordoma". Electron microscopy demonstrated the
      mitochondria-endoplasmic reticulum complexes (MERC), glycogen granules, and
      vacuoles in the tumor cells. Postoperative irradiation (total dose 55 Gy) was
      performed. At present, 30 months after the operation, no evidence of tumor
      regrowth nor hypothalamus-pituitary deficiency is recognizable and the patient is
      free from left abducent nerve palsy. It is concluded that skull base chordoma in
      infants should be postoperatively irradiated in an appropriate manner.

PMID- 1630575
TI  - [A case of unilateral atypical moyamoya disease of adult onset with stenosis of
      the basilar artery].
AB  - A 29-year-old, 39-week-pregnant female who had headache and nausea was admitted
      to our hospital. She bore a baby son by natural delivery after several hours.
      After labor, her headache was continuous. Brain CT scan demonstrated
      intracerebral and intraventricular hemorrhage. After conservative treatment for
      two weeks, her only neurological deficiency was visual field defect. Angiography
      demonstrated that her left internal carotid artery had partial stenosis at the C2
      portion. Her right internal carotid artery had stenosis at the C2 portion. Her
      right middle cerebral artery was occluded at the M1 portion, and abnormal
      vascular networks had developed in the ganglionic region. Stenosis was also found
      in the basilar artery. We diagnosed her as being a case of adult-onset,
      unilateral, atypical Moyamoya disease with basilar artery stenosis. As our case
      was of adult-onset, and as she showed no ischemic signs, we did not think that
      reconstructive surgery was indicated. About the posterior circulation of Moyamoya
      or atypical Moyamoya disease, it was reported that in cases of juvenile onset the
      vertebral, basilar or posterior cerebral artery was sometimes stenosed or
      occluded, but, in adult-onset cases, stenosis or occlusion of the posterior
      cerebral artery would be an abnormality. Our case is a very rare example of
      unilateral atypical Moyamoya disease of adult onset with basilar artery stenosis.

PMID- 1630576
TI  - Ultrastructure of pre-synaptic input to motor neurons in Onuf's nucleus: controls
      and motor neuron disease.
AB  - Ultrastructural analyses of sphincteric motoneurons in Onuf's nucleus at S2 were
      undertaken in human spinal cord obtained 3-6 h post-mortem from three subjects
      with no neurological disease ('controls') and five in which death was due to
      motor neuron disease (MND). Neurons in specified locations within Onuf's nucleus
      of control subjects ranged between 17.8 and 71.7 microns diameter (mean 38.6
      microns). Analyses of synaptology revealed five ultrastructural classes of
      presynaptic terminal synapsing with the neuronal surface membrane. When
      classified by size, vesicle morphology, and synaptic site structure these
      conformed to the S, F, T, M and C-terminals defining somatic motoneurons. No
      terminals characteristic of autonomic motoneurons were found. In MND subjects,
      neurons in Onuf's nucleus at S2 were preserved despite a paucity of neurons in
      medial and lateral motor nuclei and were of similar size range to those in
      control subjects. The morphological classes of pre-synaptic terminal found in
      controls, also characterized sphincteric motoneurons in MND subjects, including
      the C-type terminal. The presence of C-terminals indicates (i) that sphincteric
      motoneurons are somatic alpha-motoneurons, and (ii) that hypotheses explaining
      the survival of sphincteric motoneurons in MND on the basis of Onuf's nucleus
      being an extension of the pre-ganglionic parasympathetic nucleus, or having
      intrinsic autonomic properties are incorrect.

PMID- 1630577
TI  - Cytoskeletal protein abnormalities in patients with olivopontocerebellar atrophy-
      an immunocytochemical and Gallyas silver impregnation study.
AB  - A highly sensitive silver technique for glial cytoplasmic inclusions (GCI) in
      olivopontocerebellar atrophy (OPCA) was applied to tissues from 15 patients with
      neurodegenerative disorders including OPCA, Joseph disease, Alzheimer's disease
      (AD), Huntington's chorea, Pick disease and three control non-neurological
      subjects. Brain tissue from both OPCA and AD impregnated positively. Neurons,
      astroglia and oligodendroglia in the putamen, pontine nucleus and inferior
      olivary nucleus all impregnated in addition to white matter oligodendroglia.
      Neuronal inclusions in the pontine nucleus appeared as compact or fibrillary
      masses, and GCI-bearing oligodendroglia and astrocytes showed homogeneously
      impregnated somata. The myelinated pontocerebellar tract and the white matter
      surrounding the inferior olivary nucleus contained a small number of impregnated
      nerve fibres with a hollow structure, which resembled the myelin sheath.
      Immunocytochemical studies to clarify these argyrophilic structures in the OPCA
      subjects employed paired helical filament (PHF), microtubule associated proteins
      (MAPs), MAP1, MAP2, MAP5, tau, ubiquitin, neurofilament (200 or 70 kilodaltons)
      and myelin basic protein (MBP) antisera. GCI-bearing white matter oligodendroglia
      expressed PHF, tau, MAP5 and ubiquitin immunoreactives and non-argyrophilic
      astroglia were positive for MAP5 antiserum alone. In the putamen, pontine nuclei
      and inferior olivary nuclei, impregnated neurons as well as the GCI-bearing
      oligodendroglia immunostained with PHF, tau, MAP5 and ubiquitin antisera and
      impregnated astroglia were also immunoreactive to these antisera except for being
      tau negative in the putamen. Silver impregnated nerve fibres showed only MBP
      immunoreactivity. These findings indicate that the argyrophilia in the OPCA
      subjects closely correlates with PHF and tau immunoreactivities.

PMID- 1630578
TI  - The number and mean volume of neurons in the cerebral cortex of rats intoxicated
      with acrylamide.
AB  - Acrylamide was given in an accumulated dose of 500 mg/kg to rats by
      intraperitoneal injection in two different dosing schedules: 50 mg/kg twice a
      week for 5 weeks and 33.3 mg/kg twice a week for 7.5 weeks. The effect of
      acrylamide intoxication on the neurons in the cerebral cortex of the rat was
      studied using unbiased stereological methods. A reduction of brain weight of 8%
      was seen in both the intoxicated groups. The volume of neocortex was
      significantly decreased in the experimental groups, but the density of neurons
      was increased resulting in an unchanged total number of neurons. The mean volume
      of neurons in neocortex was significantly decreased in both acrylamide
      intoxicated groups. There was no difference between the two different
      intoxication schedules. The possibility that acrylamide causes neuronal death and
      the effect of eventual differential cellular sensitivity is discussed.

PMID- 1630579
TI  - A preliminary investigation of promotion of brain tumours by hexachlorophane in
      Sprague-Dawley rats transplacentally exposed to N-ethylnitrosourea.
AB  - Two-stage carcinogenesis (initiation and promotion) has been demonstrated in
      various mammalian tissues, but there is no conclusive evidence that it occurs in
      the nervous system. The present work has investigated the possibility that it
      might occur in the brain of the rat. Pregnant Sprague-Dawley rats were given an
      initiating dose (10 mg/kg intravenously (i.v.)) of N-ethylnitrosourea (ENU),
      which resulted in a low but consistent yield of brain tumours in the offspring.
      The dose was determined in a prior dose-response investigation. The 'initiated'
      offspring were treated postnatally with the putative promoter, hexachlorophane,
      and its ability to increase tumour incidence was examined by standardized step
      sectioning of the brain from rats killed at 6 months. There was no evidence of
      promotion of ENU-induced brain neoplasms by hexachlorophane in the rat. The
      experimental procedure led to a reproducible incidence of glial tumours in the
      pups.

PMID- 1630580
TI  - Dying back type axonal degeneration of sensory nerve terminals in muscle spindles
      of the gracile axonal dystrophy (GAD) mutant mouse.
AB  - A disorder of the gracile axonal dystrophy (GAD) mutant mouse is characterized by
      a neuromuscular disease with sensory ataxia (detectable 30 days after birth) and
      paresis of the hindlimbs (detectable at 80 days). In the sensory ataxia stage,
      histological study of the primary sensory system shows that, in addition to the
      lesions in the central nervous system, peripherally projecting axons have also
      started to degenerate at their distal ends in muscle spindles. Although the
      structure of Ia fibre endings appear normal until 15 days after birth, initial
      changes in the annulo-spiral structure are detected around the 20th day by a
      degeneration of the terminal axons. Degeneration then progressed proximally and
      the secondary endings also start to degenerate. Neuron cell bodies located in the
      dorsal root ganglia are morphologically intact until the later stages.
      Chronological studies indicate that, although axonal degeneration progresses
      throughout life, it is accentuated during the rapid somatic growth period. Around
      50 days of age, transient regeneration takes place at axonal endings when somatic
      growth has attained a plateau. Such primary sensory endings tend to be restored
      by fine, multiple axons which gain access to the intrafusal fibres through the
      original endoneurial tubes. Ultrastructural observations at the fully affected
      stage show intrafusal muscle fibres lying scattered within spindles due to loss
      of the fine network of inner capsule layers and an almost complete loss of
      sensory endings from the surface of intrafusal muscle fibres. These results
      indicate that this mutant mouse is a useful model for naturally occurring 'dying
      back' type axonal degeneration or 'central and peripheral distal axonopathies',
      and would provide significant information about the complete evolution of the
      pathological processes involved.

PMID- 1630581
TI  - The binding of basic fibroblast growth factor to ischaemic neurons in the rat.
AB  - Transient occlusion of the right middle cerebral artery for 15 min produced a
      small ischaemic lesion in the dorsal portion of the right striatum in rats as
      seen on days 3, 7 and 14 post-operatively. The lesions consisted mainly of
      reactive astrocytes and 'ischaemic neuron's with chromatin-condensed (pyknotic)
      nuclei and homogenously eosinophilic cytoplasm. The incubation of tissue sections
      with basic fibroblast growth factor (bFGF) followed by anti-bFGF, or with
      biotinylated bFGF without anti-bFGF, labelled virtually all ischaemic neurons,
      indicating that bFGF had bound to the latter. The pretreatment of sections with
      heparitinase prevented the binding of bFGF to these cells, suggesting that the
      chemical substrate for the bFGF binding was heparan sulphate. In light of the
      findings that many normal-looking neurons were observed in the corresponding
      portion of the right striatum in most rats on post-operative days 28 and 90, the
      appearance of bFGF-binding sites in ischaemic neurons may contribute to the
      repair process of injured neurons.

PMID- 1630582
TI  - Development and control of the opioid inhibition of gonadotropin secretion during
      the sexual maturation of the male rat.
AB  - The endogenous opioid system tonically inhibits the LH-releasing apparatus in
      adult male rats but not in immature animals. To determine the relationship
      between the onset of this effect and the peripubertal testosterone rise, male
      rats were examined at 5-day intervals from day 25 through day 65. They were
      injected subcutaneously with saline, 0.25 or 1.0 mg/kg body weight naloxone and
      sacrificed 20 min later. Another group of immature males was castrated, implanted
      with testosterone-filled capsules and tested with naloxone 4 days later. The
      peripubertal increase in testosterone and the ability of naloxone to increase
      serum LH concentrations were both first statistically significant on day 45.
      Testosterone treatment of immature rats did not induce a naloxone effect. The
      ability of hypothalamic fragments to release LHRH in vitro in response to
      naloxone also appeared to occur at the same time as the peripubertal testosterone
      rise. Hypothalamic fragments obtained from immature male rats treated in vivo
      with testosterone were capable of responding to naloxone with LHRH release in
      vitro. These data suggest that in the rat the maturation of the endogenous opioid
      system is a component of male puberty that is induced by the peripubertal
      testosterone rise.

PMID- 1630583
TI  - Effect of retinoic acid deficiency on in vivo and in vitro GH responses to GHRH
      in male rats.
AB  - Retinoic acid has recently been shown to increase growth hormone (GH)-gene
      transcription rate and GH synthesis in vitro. To investigate the role retinoic
      acid plays in the neuroregulation of GH secretion we have studied GH responses to
      growth hormone-releasing hormone (GHRH) in retinoic acid-deficient rats. Compared
      to normally fed male rats, retinoic acid-deficient rats showed a marked
      impairment in body weight, which was statistically significant after 3 weeks and
      maximal after 5-6 weeks (p less than 0.001). Yet, in vivo GH responses to
      different doses of GHRH (1, 5 and 25 micrograms/kg) in pentobarbital-anesthesized
      rats were similar in both groups. Also, in vitro GH responses to GHRH, forskolin,
      and KCl were similar in perfused pituitary cells taken from control and retinoic
      acid-deficient rats. However, further studies carried out in freely-moving rats
      showed the typical GH secretory pattern usually found in male rats of the control
      group, while retinoic acid-deficient rats displayed a highly variable GH
      secretory pattern with GH peaks of much lower amplitude. Finally, after gel
      electrophoresis of in vitro 35S-labelled proteins, no differences were observed
      in the molecular forms of GH. Considering these findings on normal pituitary
      responsiveness and alterations in GH pulsatility, our data suggest that retinoic
      acid deficiency leads to an alteration in the neuroregulation of GH secretion at
      the central level.

PMID- 1630584
TI  - Type II corticosteroid receptor-like immunoreactivity in the rat cerebellar
      cortex: differential regulation by corticosterone.
AB  - Type II corticosteroid receptor-like immunoreactivity (type II-ir) was localized
      at the light- and electron-microscopic levels in the rat cerebellar cortex using
      BUGR2 monoclonal antibody. In intact rats, type II-ir was observed in the nuclei
      of basket, stellate, Golgi and Purkinje cells. After 1 week of adrenalectomy,
      type II-ir was barely resolvable in basket, stellate, Golgi and most Purkinje
      cells. Vermal Purkinje cells showed intense nuclear and cytoplasmic type II-ir.
      After 4 weeks of adrenalectomy, type II-ir was markedly reduced in most vermal
      Purkinje cells, however a few in lobules 1-3 and 9 and 10 retained diffuse
      immunoreactivity. Acute treatment with corticosterone restored nuclear type II-ir
      to basket, stellate, Golgi and Purkinje cells in the cerebellar hemispheres,
      flocculi and paraflocculi. In the vermis most Purkinje cells showed nuclear type
      II-ir following corticosterone treatment. Diffuse type II-ir was, however,
      retained in a few Purkinje cells in vermal lobules 1-3, 9 and 10. The
      distribution of GABA-like immunoreactivity (GABA-ir) in the cerebellar cortex was
      not altered by adrenalectomy or acute corticosterone treatment. 30-60% of type II
      ir Purkinje cells in intact rats were GABA-ir. In adrenalectomized and
      corticosterone-treated rats, a similar proportion of type II-ir Purkinje cells
      were GABA-ir. The differential regulation of neuronal type II-ir in the
      cerebellum by corticosterone may account for some of the known effects of
      glucocorticoids on motor coordination.

PMID- 1630585
TI  - Postnatal development of corticosteroid receptor immunoreactivity in the rat
      cerebellum and brain stem.
AB  - The postnatal development of corticosteroid receptor immunoreactivity in the rat
      cerebellum and related brainstem nuclei was studied using a type I receptor
      antiserum, MINREC4, and a type II receptor monoclonal antibody, BUGR2. Type I
      receptor immunoreactive (ir) Purkinje cells were first observed at postnatal day
      5 (P5), and increased to adult levels by P20. Type I-ir cells, presumably
      migrating granule cells, were observed in the developing molecular layer of the
      cerebellum at P5. By P30, the density of type I-ir cells in the definitive
      molecular and granular layers was still less than adult levels. In contrast, type
      II-ir Purkinje cells were first observed at P15 and increased to adult levels by
      P20. No type II-ir cells were observed in the proliferative and migratory zones
      of the molecular layer. By P30, the density of type II-ir cells in the molecular
      and granular layers was far less than adult levels. In the deep cerebellar nuclei
      and most brain stem nuclei type I-ir was observed at P5 and developed to adult
      levels by P30. Type II-ir was observed in the deep cerebellar nuclei, red and
      medial vestibular nuclei by P15. The pontine and inferior olivary nuclei showed
      type II-ir cells by P10. Type II-ir in these regions developed to adult levels by
      P30. The earlier development of type I-ir suggests that the type I receptor may
      mediate the actions of corticosteroids in the cerebellum and related brain stem
      nuclei during early postnatal life.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630586
TI  - Involvement of arachidonic acid cascade pathways in interleukin-6-stimulated
      corticotropin-releasing factor release in vitro.
AB  - We have demonstrated that centrally administered interleukin-6 (IL-6) stimulates
      adrenocorticotropin (ACTH) secretion by a direct effect on corticotropin
      releasing factor (CRF) release from the hypothalamus. Since metabolites of the
      arachidonic acid cascade (AAC) have been implicated in mediating actions of
      cytokines in different tissues and some AAC inhibitors were able to block
      pyrogenic effects of cytokines and suppress IL-1-induced ACTH secretion, we
      decided to examine the mechanism of IL-6 action on CRF release in vitro. After a
      60-min preincubation in Krebs-Ringer bicarbonate buffer, medial basal hypothalami
      (MBH) were preincubated for 30 min with dexamethasone (DEX), a phospholipase A2
      (PLA2) inhibitor, to block arachidonic acid (AA) formation, or with inhibitors of
      AA metabolism: a cyclooxygenase inhibitor--indomethacin (IND); a lipoxygenase
      inhibitor--5,8,11-eicosatriynoic acid (ETI), and an epoxygenase inhibitor-
      clotrimazole (CLO). Then, the medium was discarded and MBH were incubated with
      medium or the above compounds and/or IL-6 for 30 min, and CRF release into the
      incubation medium was measured by radioimmunoassay. As reported previously, 10(
      13) M IL-6 increased CRF release, which was significantly suppressed by DEX in a
      dose-dependent manner. The suppression was already highly significant at a
      concentration of 10(-11) M DEX and became maximal at 10(-7) M, at which
      concentration CRF release was no longer stimulated by IL-6. The response to IL-6
      was completely blocked at the highest DEX concentration evaluated (10(-5) M). CLO
      also suppressed IL-6-induced CRF release with a minimal effective dose of 10(-9)
      M. Suppression was complete at 10(-7) and 10(-5) M.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1630587
TI  - Identification of neurotensin-immunoreactive cells in the anterior pituitary of
      normal and castrated rats. A double immunocytochemical investigation at the light
      and electron-microscopic levels.
AB  - The localization of neurotensin (NT) has been studied in the rat pituitary by
      means of immunocytochemistry at the light- and electron-microscopic levels. Cells
      immunoreactive for NT (NT-IR) were observed in the anterior lobe of rats of both
      sexes. Following an elution-restaining procedure, it was found that most of these
      NT-IR cells correspond to cells also reacting to beta-LH or FSH antisera.
      However, a few NT-IR cells did not stain for beta-LH nor FSH, but for TSH. The
      subcellular localization of NT was studied at the electron-microscopic level by
      means of the immunogold procedure. The immunoreactivity was always localized over
      the secretory granules. By using two sizes of gold particles, it was shown that
      NT- and beta-LH-IR were colocalized in part of the cell granules. Castration
      caused a progressive decrease of the NT-IR in the beta-LH- or FSH-positive cells,
      while the number of NR-IR, TSH-IR cells increased. After 2 weeks, NT-IR was
      mainly observed in this latter cell type. The present work demonstrates that NT
      IR is localized within the secretory granules of the gonadotrophs and a few
      thyrotrophs, indicating that NT could be released together with gonadotrophins
      and TSH. Moreover, since gonadectomy results in typical qualitative and
      quantitative changes of NT-IR gonadotrophs, the intervention of the pituitary NT
      in the regulation of the hypophysogonadal axis is strongly suggested.

PMID- 1630588
TI  - Endothelin-induced biphasic response of lactotrophs cultured under different
      conditions.
AB  - Endothelin (ET), a recently discovered vasoconstrictor peptide, is widely
      distributed in different tissues including brain and pituitary. Although evidence
      regarding the role of ET in neuroendocrine processes is still fragmentary, it
      appears that the release of several anterior pituitary (AP) hormones can be
      modulated by peptides of the ET family. In the present study, we compared the
      effects of ET-1 and ET-3 on the release of PRL from AP cells cultured in serum
      free (SFM) or serum-containing (SCM) medium. AP obtained from adult male rats
      were enzymatically dispersed, and the cells were plated in either SFM or SCM.
      After 4 days, cells were incubated with ET-1 or ET-3 for designated periods of
      time, and PRL levels in the incubation media were measured by RIA. When AP cells
      maintained in SCM were exposed to ET for 20 min, both peptides inhibited PRL
      release, with ET-1 being a more potent inhibitor than ET-3. In contrast, a
      biphasic response was observed in cultures grown in SFM: low concentrations of ET
      peptides inhibited the secretion of PRL, while high concentrations caused a
      significant stimulation. Further characterization of the effects of ET-1 revealed
      that the stimulatory phase was relatively short (15-30 min) and was followed by
      inhibition of PRL release. The addition of either horse serum or fetal bovine
      serum to SFM on the day of plating resulted in a dose-dependent reduction in the
      ET-induced stimulation of lactotrophs. These findings indicate that the presence
      of serum in culture medium alters the expression of cell properties underlying
      inhibitory and stimulatory responses to ET in terms of PRL secretion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1630589
TI  - Effects of sub-chronic treatment with chlordiazepoxide, buspirone and the 5-HT3
      receptor antagonist, BRL 46470, on the social behaviour of mice.
AB  - Chlordiazepoxide (21.5 mg/l; 5 mg/kg daily), buspirone (12.8 g/l; 3.4 mg/kg
      daily) and the 5-HT3 receptor antagonist, BRL 46470, (40 micrograms/l; 10
      micrograms/kg daily) were each given in the drinking fluid for 12-14 days to
      adult male CD1 mice. Controls received tap water. Effects of the treatments on
      behaviour during 5 min social encounters with untreated partners were examined by
      ethological procedures in an aversive and less aversive situation, an unfamiliar
      neutral cage and the home cage. In the neutral cage all compounds increased the
      occurrence of the social act, "nose" and enhanced digging of the unfamiliar
      sawdust, at the expense of exploration. In the home cage, all compounds increased
      social investigation and reduced non-social activity. The drug BRL 46470 evoked
      more marked effects on behaviour than did buspirone or chlordiazepoxide and in
      the neutral cage it enhanced some acts of aggression. These results show that all
      compounds increased reactivity to normal social and environmental stimuli, in
      addition to their anxiolytic profile of behavioural effects.

PMID- 1630590
TI  - Tianeptine increases the extracellular concentrations of dopamine in the nucleus
      accumbens by a serotonin-independent mechanism.
AB  - The effect of various doses of tianeptine on the extracellular concentrations of
      dopamine was studied in the striatum and nucleus accumbens of the rat. At 5 (but
      not 2.5) mg/kg intraperitoneally, tianeptine increased the extracellular dopamine
      only in the nucleus accumbens. At 10 mg/kg, the effect was also seen in the
      striatum but it was less marked and shorter-lasting. At 10 mg/kg (i.p.),
      tianeptine significantly raised the extracellular concentrations of
      dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in both regions.
      The effect of 10 mg/kg tianeptine on dopamine and its metabolites was not
      significantly changed in animals which had received this dose twice daily for 15
      days. Intracerebroventricular administration of 150 micrograms/20 microliters 5,7
      dihydroxytryptamine, which markedly depleted serotonin in the brain, did not
      modify the effect of 10 mg/kg tianeptine on the extracellular concentrations of
      dopamine and HVA in the nucleus accumbens but reduced the effect on DOPAC.
      Various doses of tianeptine (1, 3 and 10 mg/kg i.p.) did not change the synthesis
      of serotonin and dopamine in the striatum and nucleus accumbens. The results show
      that tianeptine increased the extracellular concentrations of dopamine more in
      the nucleus accumbens than in striatum. The effect on the output of DA in the
      nucleus accumbens could be involved in the antidepressant activity of tianeptine.

PMID- 1630591
TI  - Effect of trimipramine on depolarization-induced and Na(+)-Ca2+ exchange-induced
      45calcium uptake in synaptosomes from the cortex of the rat brain.
AB  - The present study examined the inhibition of synaptosomal uptake of 45calcium by
      racemic trimipramine and nortrimipramine and by enantiomers of trimipramine.
      Trimipramine, nortrimipramine, (+)-trimipramine and (-)-trimipramine inhibited
      the net K(+)-induced uptake of 45calcium with IC50 values of 31, 39, 17 and 95
      microM, respectively. No significant difference could be detected between the
      parent compound trimipramine and the metabolite nortrimipramine; however, the
      levorotatory isomer had an IC50 value significantly larger than the
      dextrorotatory isomer. At normal therapeutic doses, a 25-40% inhibition of net
      K(+)-induced uptake of 45calcium, could be expected with trimipramine or 30-50%
      inhibition for trimipramine and nortrimipramine combined; these data, therefore,
      do not exclude the possibility that inhibition of voltage-dependent calcium
      channels could contribute to the therapeutic effect of trimipramine. The order of
      potency of stereoisomers of trimipramine, for inhibition of calcium channels, was
      the same as their reported order of potency in the clinic; this parallelism adds
      support to the possible involvement of blockade of calcium channels in the
      antidepressant effect. With respect to uptake of 45calcium induced by the Na(+)
      Ca2+ exchange process, all drugs inhibited this mechanism with a similar potency
      (IC50 74-91 microM); the drugs are not expected to have a significant effect on
      this exchange process, at therapeutic antidepressant doses.

PMID- 1630592
TI  - Flunarizine and R 56865 suppress veratridine-induced increase in oxygen
      consumption and uptake of 45Ca2+ in rat cortical synaptosomes.
AB  - The effect of the anti-ischemic compounds flunarizine and R 56865 on the
      veratridine-induced uptake of Ca2+ and Na+ was observed in cortical synaptosomes
      in the rat. The veratridine-induced uptake of Na+ and Ca2+ was determined by
      means of a measurement of synaptosomal oxygen consumption and a method for the
      uptake of 45Ca2+, respectively. Veratridine (10(-5) M) was found to induce a 3
      fold increase in synaptosomal oxygen consumption (uptake of Na+) and uptake of
      45Ca2+, both of which were inhibited by tetrodotoxin (10(-5) M). Nitrendipine
      (10(-5) M) and omega-conotoxin (5 x 10(-7) M) were ineffective on the veratridine
      induced response. Nimodipine (10(-5) M) suppressed the veratridine-induced uptake
      of 45Ca2+ but also diminished the unstimulated uptake of 45Ca2+. The veratridine
      induced uptake of Na+ was not influenced by nimodipine. Flunarizine (3 x 10(-6)
      10(-5) M), as well as R 56865 (10(-6)-10(-5) M), attenuated the veratridine
      induced uptake of both Na+ and 45Ca2+. In conclusion, the veratridine-induced
      uptake of Na+ and 45Ca2+ was shown to be closely correlated to the activity of
      Na+ channels but not to voltage-operated Ca2+ channels. Secondly, flunarizine and
      R 56865 seemed to evoke their effects by interfering with the permeability of Na+
      channels. Since veratridine-induced uptake of Na+ and Ca2+ shares some
      similarities with ischaemia-induced uptake of Na+ and Ca2+, it is proposed, that
      flunarizine and R 56865 exert their anti-ischaemic effects by reducing ischaemia
      induced Na+ and Ca2+ load, probably by inhibiting a TTX-sensitive Na+ channel.

PMID- 1630593
TI  - Electrophysiological evidence for a role of nitric oxide in prolonged chemical
      nociception in the rat.
AB  - The role of nitric oxide in the periphery and the spinal cord, during acute
      electrically-evoked and prolonged chemically-evoked nociceptive stimulation, was
      investigated in rats anaesthetised with halothane. The responses of single dorsal
      horn neurones to electrically-evoked A beta fibre and C fibre inputs were reduced
      by topical application (directly onto the spinal cord) of both the nitric oxide
      inhibitor, nitro-L-arginine methyl ester (L-NAME; 500-1500 micrograms) and the
      precursor of nitric oxide, L-arginine (4500 micrograms). Administration of L
      NAME, either directly into the receptive field (500-1500 micrograms) or
      intravenously (10-100 mg/kg) had little or no effect on the acute electrically
      evoked activity. Intravenous injection of L-NAME, administered 40 min prior to
      injection of formalin, significantly reduced the prolonged second peak of firing,
      with only a small effect on the short-duration first peak. Administration of L
      NAME, directly into the site of injection of formalin, as a 10 min pretreatment,
      significantly reduced the second but not the first peak of the response. Topical
      application of L-NAME onto the spinal cord, as a 30 min pretreatment,
      significantly reduced both the first and second peaks of the response. This
      inhibition was not reversed by the coadministration of L-arginine, which was
      inhibitory by itself. Thus, nitric oxide may be involved, in a complex way, in
      nociceptive events both in the periphery and within the spinal cord.

PMID- 1630594
TI  - Excitatory modulation by a spinal cholinergic system of a descending
      sympathoexcitatory pathway in rats.
AB  - Earlier studies have demonstrated that an excitatory cardiovascular response can
      be produced through activation of a spinal cholinergic system in rats. The
      present study was performed to determine whether this excitatory cardiovascular
      response was elicited through cholinergic potentiation of a descending spinal
      sympathoexcitatory pathway. Application of the cholinesterase inhibitor,
      neostigmine, directly to the surface of the spinal cord elicited increases in
      heart rate selectively when neostigmine was applied to upper thoracic segments
      (Th1-Th4), whereas all thoracic segments participated in the generation of the
      associated hypertensive response. The injection of a direct cholinergic agonist,
      carbachol, into an upper thoracic segment (Th2) produced tachycardic and pressor
      responses but only pressor responses when injected into a lower segment (Th11).
      Tachycardic responses occurred after injection of carbachol into the
      intermediolateral nucleus, a site between the intermediolateral nucleus and the
      central canal, the right lower dorsal horn and the ventral horn. At the Th11
      level, carbachol increased blood pressure only when injected into sites between
      the intermediolateral nucleus and central canal. The pressor response, induced by
      electrical stimulation of the descending spinal sympathetic tract, was markedly
      potentiated at all stimulus strengths after intrathecal (i.t.) injection of
      neostigmine and this potentiation was antagonized by atropine. The accompanying
      tachycardic response to electrical stimulation was not affected when low stimulus
      strengths were employed but means increases in the heart rate, obtained in
      response to larger stimulus intensities, were eliminated after administration of
      neostigmine. These results are consistent with the presence of an intrinsic
      spinal cholinergic sympathoexcitatory pathway, possibly relegated to
      interneurons, which elicits cardiovascular responses, at least in part through
      potentation of descending sympathetic influences.

PMID- 1630595
TI  - Toxic effects of solstitialin A 13-acetate and cynaropicrin from Centaurea
      solstitialis L. (Asteraceae) in cell cultures of foetal rat brain.
AB  - Extracts of the aerial parts of the yellow star thistle (Centaurea solstitialis
      L.) were prepared using petroleum ether, chloroform and methanol and toxicity
      assessed in primary cell cultures of striatum, frontal cortex and mesencephalon,
      containing the substantia nigra or raphe nucleus from the brain of the foetal
      rat. Chloroform extracts significantly reduced the percentage of live cells
      whereas the petroleum ether extract was inactive. The ability of the methanol
      extract to reduce the percentage of live cells could not be distinguished from
      the effects of the vehicle controls for methanol. Subsequently, the plant
      material was extracted with dichloromethane and 10 fractions were obtained by
      column chromatography. Fractions 5, 6, 7 and 8 caused concentration-dependent
      cell death in the culture of substantia nigra, the other fractions were not toxic
      at the concentrations used. In further studies, solstitialin A was isolated from
      fraction 9, solstitialin A 13-acetate from fraction 6 and solstitialin A-3
      acetate and cynaropicrin from fraction 7. Solstitialin A 13-acetate and
      cynaropicrin were toxic to cultures of substantia nigra cells. It is concluded
      that, of the compounds identified, solstitialin A 13-acetate and cynaropicrin
      have toxic potential in cell cultures, containing cells from the substantia nigra
      of the rat, the specificity of action to cells of the substantia nigra remains to
      be shown, and that a toxic action in the midbrain may contribute to the nigro
      pallidal encephalomalacia, caused by the ingestion of the yellow star thistle by
      horses.

PMID- 1630596
TI  - Learning and memory-enhancing effects of Ro 15-4513: a comparison with
      flumazenil.
AB  - Synthetic benzodiazepines produce an anterograde amnesia, which can be reversed
      by selective benzodiazepine antagonists or inverse agonists. It has therefore
      been suggested that the memory-enhancing effects of the antagonists are due to
      antagonism of an endogenous "benzodiazepine-like" endocoid. If the memory
      enhancing effects of the benzodiazepine antagonists are determined predominantly
      by the antagonism of such endogenous benzodiazepine-ligands, then it could be
      hypothesized that administration of an inverse agonist, which produces effects
      functionally opposite to those of benzodiazepine agonists, may also mimic the
      effects of benzodiazepine antagonists but not produce effects greater than those
      of the pure antagonists. The purpose of the present study was therefore to
      investigate the memory-enhancing effects of the benzodiazepine inverse agonist,
      ethyl-8-amido-5,6-dihydro-5-methyl-6-oxo-4H-imidazo [1,5a] [1,4] benzodiazepine-3
      carboxylate (Ro 15-4513) in young HSD:(ICR)BR mice and to compare these effects
      with those of the benzodiazepine antagonist, flumazenil. Pretraining injections
      of flumazenil and Ro 15-4513 (2.5 and 10.0 mg/kg) enhanced equally, both the
      acquisition and the retention of a task for 1 week requiring mice to discriminate
      the correct arm of a T-maze, to avoid a mild electric shock. Pretreatment with Ro
      15-4513 also dose-dependently protected the animals from experimental amnesia,
      induced by the cholinergic receptor antagonist, scopolamine in a second model of
      memory, in which mice were required to passively avoid a dark chamber after
      shock. In contrast, Ro 15-4513, injected prior to daily active avoidance
      sessions, failed to significantly improve either the acquisition or retention
      performance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630597
TI  - Behavioural effects of anatoxin, a potent nicotinic agonist, in rats.
AB  - Preliminary behavioural studies with the nicotinic agonist (+)-anatoxin have been
      carried with procedures sensitive to (-)-nicotine. In experimentally naive rats,
      (+)-anatoxin decreased locomotor activity; this effect resembled that of (-)
      nicotine, but it was not blocked by mecamylamine. In nicotine-tolerant rats, (+)
      anatoxin differed from (-)-nicotine because it did not increase locomotion.
      However, in rats trained to discriminate nicotine from saline in an operant
      conditioning procedure, (+)-anatoxin produced a partial nicotine-like
      discriminative stimulus effect that was blocked by mecamylamine, and a decreased
      rate of responding that was insensitive to mecamylamine. The behavioural profile
      of (+)-anatoxin differs from that of (-)-nicotine and it can be used for further
      investigations of CNS nicotinic receptors.

PMID- 1630598
TI  - Current bibliographies of neuropeptides prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1630599
TI  - Hyperthermia-induced seizures alter the levels of methionine-enkephalin in
      immature rat brain.
AB  - The effects of hyperthermia induced seizures on the amount of Methionine
      enkephalin (Met-E) in 15 day rat pups were examined. Animals exposed to an
      ambient temperature of 40 degrees C showed a gradual increase in body temperature
      reaching a maximum of 40.6 +/- 0.2 degrees C; at this time all of the animals had
      seizures. Elevated brain Met-E concentration was observed immediately after
      seizures. When the animals were exposed for 30 min to 27 degrees C environment
      maintained their normal body temperature throughout the experiments and no
      seizures were observed. The brain Met-E levels in this group were significantly
      lower than those observed in the animals exposed to 40 degrees C environment.
      These experiments suggest that enkephalinergic system may play a role in
      hyperthermia-induced seizures in the rat pups.

PMID- 1630600
TI  - Endogenous opioid peptides in brain and pituitary of rats with absence epilepsy.
AB  - The level of opioid peptides in several brain areas and in the pituitary was
      estimated in WAG/Rij rats, which are considered to be a genetic animal model for
      human absence epilepsy. In comparison with three groups of non-epileptic
      controls, these epileptic rats had an elevated level of the proenkephalin-derived
      peptide Met-enkephalin-Arg6-Gly7-Leu8 in the mesencephalon and striatum, while
      the level of the prodynorphin-derived peptide alpha-neoendorphin was increased in
      the striatum and hippocampus. In addition various age- and/or strain-related
      changes in these peptide levels were found in the hippocampus, thalamus,
      striatum, frontal cortex and neurointermediate lobe of the pituitary. No
      difference in the hypothalamic beta-endorphin level were found between epileptic
      and non-epileptic rats, though strain- and/or age-related changes in the peptide
      content were detected in both lobes of the pituitary. The increased level of
      proenkephalin and prodynorphin opioid peptides in brain structures, essential for
      the appearance of spike-wave discharges, suggests that these opioid systems, but
      not proopiomelanocortin one, may play a role in absence epilepsy.

PMID- 1630601
TI  - The behavioural effects of neuropeptide Y (NPY) injection into the rat brain
      frontal cortex.
AB  - The aim of this study was to investigate the influence of intracortical
      administration of neuropeptide-Y on the behaviour of rats. One week before the
      behavioural test the frontal cortex of rats was chronically implanted with
      intracerebral cannulae. Neuropeptide-Y (or saline in the control group) was
      injected in a volume of 1 microliter. After treatment the behaviour of the rats
      was tested in an open field apparatus and a light-beam actometer. The number of
      line crossings, episodes of rearing, sniffing, washing and head poking were
      counted. The results indicate that administration of neuropeptide-Y to the
      frontal cortex of rats slightly increased exploratory and locomotor activity.

PMID- 1630602
TI  - Inhibitory effect of D-myo-inositol-1,2,6-trisphosphate on glucose-stimulated
      insulin secretion in the mouse.
AB  - It has been demonstrated that D-myo-inositol-1,2,6-trisphosphate (PP56)
      antagonizes the effect of neuropeptide Y (NPY) in guinea pig basilar arteries.
      NPY is known to inhibit insulin secretion. We therefore examined whether PP56 is
      a NPY antagonist also on insulin secretion. Unanaesthetized mice were injected
      intraperitoneally with PP56. It was found that the plasma insulin response to a
      subsequent intravenous glucose challenge (500 mg/kg) was inhibited by PP56 at 20
      but not at 2 mg/kg. Also NPY (8.5 nmol/kg) inhibited the glucose-induced increase
      in plasma insulin levels. When given together, PP56 and NPY exerted additive
      inhibitory effect. Thus, PP56 is not a NPY-antagonist on insulin secretion, but
      rather exerts a NPY-like effect. Furthermore, in isolated mouse islets, PP56 at
      100 nmol/l, but not at lower dose levels, inhibited glucose (11.1 mM)-stimulated
      insulin secretion. Hence, PP-56 inhibits glucose-stimulated insulin secretion by
      a direct effect on the pancreatic islets.

PMID- 1630603
TI  - Cholecystokinin (CCK)-like material and CCK mRNA levels in the rat brain and
      spinal cord after acute or repeated morphine treatment.
AB  - The effects of a single or repeated administrations of morphine on the tissue
      levels of cholecystokinin-like material (CCKLM) and pre pro cholecystokinin mRNA
      (CCK mRNA) were examined in various brain and spinal cord regions (cerebral
      cortex, cerebellum, hippocampus, septum, substantia nigra, lumbar enlargement) in
      adult rats using a specific radioimmunoassay and 'Northern blot' analysis,
      respectively. Although a clear parallelism existed between the regional
      distribution of CCKLM (septum greater than cerebral cortex greater than or equal
      to hippocampus much greater than lumbar enlargement, dorsal zone greater than
      substantia nigra greater than lumbar enlargement, ventral zone much much greater
      than cerebellum) and that of CCK mRNA, some mismatch was found notably in the
      septum where CCK mRNA levels were less than in other regions except the
      cerebellum. Neither CCKLM nor CCK mRNA levels were altered one hour after an
      acute administration of morphine (5 mg/kg i.p.). Similarly, morphine addiction
      after a four-day treatment with this drug was not associated with any change in
      the tissue levels of CCKLM and CCK mRNA. These data indicate that the previously
      reported modulatory action of opioids on central CCKergic systems could occur
      without affecting the preproCCK gene transcription and the tissue peptide
      concentrations.

PMID- 1630604
TI  - Diffuse "fibrillary" astrocytomas: correlation of MRI features with
      histopathologic parameters and tumor grade.
AB  - MR images in 54 patients with biopsy-proven diffuse or "fibrillary" astrocytomas
      were analyzed and compared with the histopathologic features in order to
      determine which histopathologic characteristics underlie the radiographic
      findings in these gliomas and whether radiographic findings are more closely
      correlated with individual histopathologic characteristics than with
      histologically determined tumor grade. The MRI features studies included tumor
      heterogeneity, edema, mass effect, border sharpness, "anatomic invasion",
      contrast enhancement, hemorrhage, and the presence of flow voids, calcium and
      cyst formation. The histopathologic characteristics studied included cellular
      atypia, mitoses, cellularity, endothelial proliferation, necrosis and tumor
      grade. Edema (P less than 0.01), flow voids (P = 0.02) and contrast enhancement
      (P less than 0.01) demonstrated a direct correlation with tumor grade, but edema
      (P less than 0.01) and contrast enhancement (P less than 0.01) also demonstrated
      a significant correlation to tumor cellularity. Tumor heterogeneity was
      associated with the presence of necrosis (P = 0.01). Hemorrhage occurred only in
      high grade tumors, where it correlated with endothelial proliferation (P = 0.04).

PMID- 1630605
TI  - Trigeminal neuromas: assessment of MRI and CT.
AB  - We report four cases of trigeminal neuroma. One of the patients had von
      Recklinghausen's neurofibromatosis with plexiform neurofibromas of the branches
      of the trigeminal nerve. MRI provided more information than CT as regards the
      spread of tumour: extension to the mandibular and maxillary division of the
      trigeminal nerve was well demonstrated on sagittal and coronal sections. This
      examination yielded an accurate census of the intraocular plexiform neurofibromas
      and allowed a correct preoperative diagnosis to be obtained. With Gd-DOTA, better
      definition of the outline of the tumours and of cystic components was obtained.
      However, CT was better for demonstration of bone erosions.

PMID- 1630606
TI  - Contrast behavior between microadenoma and normal pituitary gland after
      gadolinium injection as a function of time at 1.5 T.
AB  - The behavior of contrast enhancement between a microadenoma and the normal
      pituitary gland after gadolinium injection was evaluated in 12 operatively
      confirmed cases using a repetitive sequence of four coronal T1-weighted spin echo
      series (T1 SE) (continuous acquisition, TR = 400 ms), followed by conventional
      coronal T1 SE (TR = 600 ms) and a three-dimensional fast low-angle shot sequence.
      The first and second acquisitions were useful with respect to delayed scans only
      in 3 cases (25%). Nevertheless, in these cases confident diagnosis could also be
      made on pre-contrast studies, which diminishes the real advantage of this
      finding. For a 1.5 T MRI unit we advocate starting with coronal T1 SE 30 s after
      a rapid injection of gadolinium.

PMID- 1630607
TI  - Radiological study of the brain at various stages of human immunodeficiency virus
      infection: early development of brain atrophy.
AB  - One hundred and one persons infected with human immunodeficiency virus (HIV-1),
      in whom other central nervous system infections or diseases were excluded,
      underwent brain CT and/or MRI at various stages of HIV-1 infection: 29 were
      asymptomatic (ASX), 35 had lymphadenopathy syndrome (LAS), 17 had AIDS-related
      complex (ARC), and 20 had AIDS. A control group of 32 HIV-1-seronegative healthy
      persons underwent brain MRI. The most common finding was brain atrophy, found in
      9% of controls, and 31% of ASX cases, 29% of LAS, 59% of ARC and 70% of AIDS.
      Even the difference between the ASX or LAS groups and controls was significant.
      The changes were bilateral and symmetrical, and they were more severe at later
      stages of infection. Infratentorial atrophy was seen in the early stages;
      supratentorial atrophy became more pronounced at ARC, and generalized atrophy was
      typical of AIDS. Non-specific small hyperintense foci were found on MRI in 13% of
      controls and 6-15% of the infected groups. Larger, diffuse, bilateral white
      matter infiltrates were detected in 4 demented patients with AIDS. Four patients
      with AIDS and 1 with LAS had focal hyperintense lesions in the internal capsules,
      lentiform nuclei or thalamus, often bilateral on MRI. One patient with AIDS,
      examined with CT only, had low density in the lentiform nucleus. Loss of brain
      parenchyma can occur at an early stage of HIV-1 infection, and the atrophic
      process becomes more intense at later stages (ARC and AIDS). Parenchymal
      infiltration, seen as hyperintense areas on MRI, is most often associated with
      severe clinical symptoms, in the later stages of the disease.

PMID- 1630608
TI  - Locations of cerebral infarctions in tuberculous meningitis.
AB  - The locations of cerebral infarctions were studied in 14 patients with
      tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic
      stroke (IS). In patients with TBM, 75% of infarctions occurred in the "TB zone"
      supplied by medial striate and thalamoperforating arteries; only 11% occurred in
      the "IS zone" supplied by lateral striate, anterior choroidal and
      thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in
      the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the
      cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical
      infarctions of the TB zone were common with TBM (71%) but rare with IS (5%).

PMID- 1630609
TI  - Late CT manifestations in spontaneous putaminal haemorrhage.
AB  - Serial CT studies were performed on 61 patients with putaminal haemorrhage, to
      determine outcome. The average duration of the follow-up was 2 years and 5
      months. Several types of late CT change were identified, including disappearance
      of the haematoma without a trace of haemorrhage, a residual cavity, deformity of
      the lateral ventricle, atrophy of the head of the caudate, white matter
      degeneration and linear pseudocalcification around the cavity. Small haematomas,
      comma-shaped and less than 2 cm wide might disappear without leaving any trace. A
      slit or small rounded residual cavity was a frequent result of elliptical or
      irregular haematomas with little mass effect. With prominent ventricular
      compression, there were distortion and dilatation of the lateral ventricle and
      atrophy of the head of the caudate nucleus, which might be accompanied by white
      matter degeneration and pseudocalcification around the cavity. Five cases (8%)
      were left with no trace of previous haemorrhage, 32 (52%) with a slit cavity, 10
      (16%) with a small round cavity, 8 (13%) with a large cavity, 5 (8%) with no
      residual cavity but with ventricular deformity, and 1 (3%) with only
      pseudocalcification at the site of the haemorrhage.

PMID- 1630610
TI  - Pure sensory stroke resulting from thalamic haemorrhage.
AB  - Pure sensory stroke has not previously been reported with thalamic haemorrhage
      and had indeed been considered to exclude cerebral haemorrhage. We describe a
      case of thalamic haemorrhage causing a pure sensory stroke and propose that we
      should bear in mind the possibility of haemorrhage in such cases.

PMID- 1630611
TI  - Dilatation of the temporal horn in subarachnoid haemorrhage.
AB  - CT studies of 50 patients with spontaneous subarachnoid haemorrhage (SAH) and 100
      randomly selected patients were reviewed with regard to the size of the frontal
      and temporal horns of the lateral ventricles. The temporal horn was classified
      into four grades, based on the size of its posterior portion at the level of the
      midbrain. The horn was clearly visible in 66% of patients with SAH, but in only
      2% of controls. In the SAH group, the temporal horn tended to dilate sooner than
      the frontal horn after haemorrhage and could be seen clearly in a larger
      proportion of patients. Thus, assessment of the size of the temporal horn appears
      to be a simple and sensitive method for assessing ventricular dilatation. In
      addition, dilatation of the temporal horn may prove to be an important indirect
      sign suggesting SAH in patients in whom no high density clot is seen on CT.

PMID- 1630612
TI  - Alexia without agraphia.
AB  - Two new cases of alexia without agraphia are presented. Pertinent clinical
      findings, anatomy, pathophysiology and differential diagnoses are reviewed. The
      importance of carefully examining the inferior portion of the left side of the
      splenium of the corpus callosum on CT and/or MR scans in patients who present
      with this clinical syndrome is stressed.

PMID- 1630613
TI  - The reversal sign.
AB  - We report a 36-year-old woman with a bacterial meningitis. CT after resuscitation
      showed a striking "reversal sign." Opinions on the pathogenesis of this sign are
      discussed; it indicates serious brain damage and carries a poor prognosis.

PMID- 1630614
TI  - Variability in the enhancement of the normal central skull base in children.
AB  - We studied the signal and enhancement characteristics of the central skull base
      prospectively in 40 children aged 13 days to 8 years, on a 1.5 T MRI system.
      Identical standard short TR/TE spin echo sequences in the sagittal plane were
      performed before and after intravenous gadolinium-DTPA. The sequences used for
      comparison were filmed at identical window and level settings. Three independent
      observers assessed (1) the intensity of contrast enhancement of the basisphenoid,
      basiocciput and presphenoid, (2) the signal intensity of the spheno-occipital
      synchondrosis, (3) the degree of pneumatization of the sphenoid sinus and (4) the
      uniformity of signal intensity reflecting fatty replacement of the marrow of the
      basisphenoid, basiocciput and presphenoid. In 16% and 28% respectively of cases
      there was no enhancement of the basisphenoid and basiocciput after gadolinium
      administration; in 42% and 44% there was mild enhancement, and moderate or
      intense enhancement was observed in 42% and 28% of cases. Even when there was
      irregular fatty replacement, residual hemopoietic clements could enhance
      intensely. When skull base neoplasms are being investigated, the normal signal
      irregularity and enhancement of the central skull base in children must not be
      confused with pathologic invasion of the marrow.

PMID- 1630616
TI  - MRI demonstration of Kernohan's notch: case report.
AB  - We report a left acute subdural haematoma caused by rupture of a left anterior
      cerebral artery aneurysm, which progressed to left hemiparesis. Coronal MRI was
      superior to CT for visualizing Kernohan's notch.

PMID- 1630615
TI  - Atypical MR presentation of Wilson disease: a possible consequence of
      paramagnetic effect of copper?
AB  - A 53-year-old patient with Wilsons's disease and without autonomic dysfunction
      presented on T2-weighted MR study an atypical decreased signal intensity of the
      putamina and the caudate nuclei. Possible explanations of such a signal
      abnormalities are discussed.

PMID- 1630617
TI  - Pineal teratocarcinoma with drop metastases: MR features.
AB  - In a rare case of teratocarcinoma of the pineal gland, MRI accurately depicted
      the primary tumor and diffuse enhancing drop metastases along the surface of the
      brain stem and the spinal cord.

PMID- 1630618
TI  - Diffusion of contrast media in cerebrospinal fluid: comparison of iohexol,
      iopamidol and iotrolan in vitro.
AB  - Diffusion of iohexol (300 and 240 mgI/ml), iopamidol (300 and 200 mgI/ml), and
      iotrolan (300 and 240 mgI/ml) in the cerebrospinal fluid (CSF) of 16 patients was
      studied in vitro. Test tubes containing CSF were kept in a waterbath at 37
      degrees C. Contrast medium was injected along the wall into the tubes, and
      diffusion of contrast media in the tubes was followed with repeated computed
      tomography for 5 h. The contents of the tubes were then mixed by shaking, and the
      tubes were scanned immediately and 8 h later. The contrast media first settled in
      the bottom of the tubes and then diffused upwards. Iotrolan diffused more slowly
      than the other media, but the difference was only significant at a concentration
      of 300 mgI/ml. The difference between iohexol and iopamidol was minimal. In
      general, diffusion was slower in CSF samples with an elevated protein content,
      but the difference in the diffusion of contrast medium in normal and pathological
      CSF was seldom statistically significant, perhaps owing to the small number of
      samples (5) with an elevated protein content. All contrast medium-CSF mixtures
      remained homogeneous after mixing. These experiments showed measurable
      differences in the diffusion of contrast media in CSF, but it does not seem very
      likely that these would be significant in clinical practice.

PMID- 1630619
TI  - Radicular avulsion resulting from spinal injury: assessment of diagnostic
      modalities.
AB  - The diagnostic utility of imaging techniques in injuries to the intramedullary
      and subarachnoid portions of the brachial plexus, with possibly complete avulsion
      of one or more nerve roots from the spinal cord and extramedullary meningocoele
      was compared in 18 patients studied by unenhanced computed tomography (CT),
      cervical myelography, myelographic CT (MCT) and magnetic resonance imaging (MRI).
      Emphasis was placed on the lesions of the subarachnoid roots. CM was the only
      diagnostic modality to show avulsion of 18 nerve roots and their levels in 8
      patients (100% = gold standard), and to verify 2 incomplete avulsions. MCT
      reliably revealed 8 of 18 (45%) and MRI 1 out of 18 (6%) avulsions. Myelography
      with MCT showed intact subarachnoid nerve roots in 10 additional patients. MRI
      and MCT (16 out of 16 = 100%) were superior to myelography (14/16 = 88%) for
      demonstrating 16 traumatic meningocoeles in 8 patients; follow-up MRI (6-24
      months) showed no increase in their size. We recommend a subsequent CT to role
      out fracture to the spinal column; MRI should provide significant information
      concerning oedema or haemorrhage in the spinal cord. Myelography with segmental
      MCT is performed to differentiate pre- from post-ganglionic lesions, data which
      are essential for deciding whether exploration of the plexus or a motor
      substitution operation is indicated.

PMID- 1630620
TI  - Sparganosis in the spinal canal with partial block: an uncommon infection.
AB  - A case of rare intraspinal sparganosis treated by surgical excision is described.
      In this 59-year-old male with paraparesis and voiding problem, an intradural mass
      was noted on myelogram. Magnetic resonance (MR) and computed tomographic
      appearance of spinal and associated cerebral lesion are illustrated and possible
      route of migration discussed. This represents, to our knowledge, the first MRI
      demonstration of intraspinal sparganosis reported in the literature.

PMID- 1630621
TI  - Balloon occlusion of the internal carotid artery in 40 cases of giant
      intracavernous aneurysm: technical aspects, cerebral monitoring, and results.
AB  - We have studied the results of carotid occlusion in the treatment of giant
      intracavernous carotid artery (ICA) aneurysms in 40 patients. Clinical,
      angiographic, Doppler and cerebral blood flow (CBF) criteria for tolerance of
      occlusion are discussed. The patients had headaches (47.5%), cranial nerve
      compression (87.5%), decreased visual acuity (20%), ruptured aneurysm (15%) and
      5% were asymptomatic. Balloon occlusion tests were performed under light sedation
      anaesthesia: a successful test required perfect clinical tolerance and adequate
      angiographic collateral circulation in arterial, parenchymatous, and venous
      phases. Additional criteria included xenon 133 CBF measurements, and transcranial
      Doppler sonography of the middle cerebral artery. According to these criteria, 5
      patients did not tolerate test occlusion and required an extra-intracranial (EC
      IC) bypass. Mean follow-up was 4.7 years. All patients were radiologically cured
      of their aneurysm, and in 35 the symptoms resolved, although 3 had persistent
      ocular motor nerve palsies, and in 4 visual defects were unchanged. Complications
      were 1 permanent and 3 transient neurological deficits. Balloon occlusion of the
      ICA is an effective, reliable form of treatment for intracavernous giant aneurysm
      and should replace surgical ligation of the cervical carotid artery. With CBF or
      Doppler monitoring, the risk of neurological deficit is diminished. EC-IC bypass
      prior to ICA occlusion is indicated if test occlusion is not tolerated.

PMID- 1630622
TI  - Platinum coil treatment of complex aneurysms of the vertebrobasilar circulation.
AB  - Two patients with complex aneurysms of the vertebrobasilar system were treated
      using platinum coils. During these sessions, 22 coils were placed in a basilar
      tip aneurysm in a 48-year-old woman. Almost total occlusion of the lumen was
      achieved, excepted in the area from which the right posterior cerebral artery
      arose. A large fusiform vertebral artery aneurysm in a 6-year-old boy was treated
      using 16 coils, which partially occluded the lumen at initial embolization.
      Follow-up angiography 2 weeks later revealed almost complete occlusion of the
      lumen with preservation of the vertebral artery. Our experience indicates that
      coil embolization of complex intracranial aneurysms is an acceptable treatment
      alternative to surgery or to a detachable balloon.

PMID- 1630623
TI  - Phosphorylation of Alzheimer amyloid precursor protein by protein kinase C.
AB  - The beta/A4 amyloid precursor protein is a membrane protein with one
      transmembrane domain. The accumulation and deposition of beta/A4 amyloid protein
      in Alzheimer's disease is thought to be brought about by altered processing of
      beta/A4 amyloid precursor protein. Activation of protein kinase C and/or
      inhibition of protein phosphatases 1 and 2A results in an increase in the
      proteolytic processing and secretion of beta/A4 amyloid precursor protein. These
      effects might result either from phosphorylation of beta/A4 amyloid precursor
      protein by protein kinase C or from phosphorylation of components of the beta/A4
      amyloid precursor protein processing apparatus. We have previously reported
      phosphorylation by protein kinase C of a synthetic peptide corresponding to part
      of the cytoplasmic domain of beta/A4 amyloid precursor protein. However, it was
      not known whether beta/A4 amyloid precursor protein holoprotein was
      phosphorylated in its native conformation in the cell membrane. Using a PC12 (rat
      pheochromocytoma) semi-intact cell system, we now report that mature isoforms of
      beta/A4 amyloid precursor protein are phosphorylated by protein kinase C at
      Ser655. Five COOH-terminal fragments which are generated by processing of mature
      beta/A4 amyloid precursor protein were also phosphorylated by protein kinase C at
      Ser655. The results support the idea that the beta/A4 amyloid precursor protein
      haloprotein is a physiological substrate for protein kinase C. These observations
      should facilitate our understanding of the relationship between altered protein
      phosphorylation and beta/A4 amyloid production.

PMID- 1630624
TI  - Restoration of learning ability in fornix-transected monkeys after fetal basal
      forebrain but not fetal hippocampal tissue transplantation.
AB  - Monkeys with bilateral transection of the fornix were severely but selectively
      impaired on learning and retention of visuospatial conditional discriminations,
      visual conditional discriminations and non-conditional spatial-response tasks.
      Bilateral transplantation of cholinergic-rich fetal basal forebrain tissue into
      the hippocampus abolished significant learning impairments on all those tasks
      impaired by fornix lesions when tested three to nine months after transplantation
      whereas bilateral transplants of non-cholinergic fetal hippocampal tissue into
      hippocampus showed no such beneficial effect. Acetylcholinesterase staining was
      severely depleted throughout the dentate gyrus and hippocampus in fornix
      transected monkeys compared with animals with control corpus callosum ablations.
      Staining was largely restored to normal in the host hippocampus and dentate gyrus
      in monkeys with cholinergic transplants, whereas acetylcholinesterase staining
      was abnormal in those with non-cholinergic grafts. These experiments suggest that
      where a "higher order" cognitive function, in this case the acquisition of
      specific types of information into long-term memory, is disturbed by a
      neuropharmacologically simple lesion, cognitive function can be restored by
      transplantation of neurons containing appropriate neurotransmitters.

PMID- 1630625
TI  - Alterations in the properties of hippocampal pyramidal neurons in the aged rat.
AB  - The electrophysiological and pharmacological properties of CA1 hippocampal
      pyramidal neurons were studied in slices from young (three to four months) and
      aged (25-32 months) Sprague-Dawley rats having previously performed two
      behavioral tasks. About 20% of the aged rats were impaired in either the
      spontaneous alternation task or the water maze task. Electrophysiological
      parameters were measured and compared in young and aged animals using
      intracellular recordings. No age-related differences were observed in membrane
      potential, input resistance, amplitude of action potentials or amplitude of
      calcium spikes. The amplitude and duration of individual afterhyperpolarizations
      following a single spike were unchanged. In contrast, the neuronal excitability
      was significantly decreased and the spike duration significantly enhanced in aged
      rats as compared to young rats. The comparison of afterhyperpolarizations (which
      follow a burst of spikes) between young and aged rats was more complex. An
      increase in the amplitude and duration of afterhyperpolarizations generally
      occurred in aged animals. However, this increase was not consistent among animals
      and was dependent on the holding potential of the neuron and on the number of
      action potentials used to trigger the afterhyperpolarization. The depolarizing
      effect of bath-applied carbachol, as well as the associated increase in membrane
      resistance were reduced in neurons from aged rats. In contrast, the effects of
      carbachol on the depression of synaptic events and the blockade of the
      afterhyperpolarizations were similar in young and aged animals. In addition, the
      amplitude of the slow cholinergic excitatory postsynaptic potential induced by
      stimulation of cholinergic afferents in the presence of physostigmine was also
      decreased in aged rats. Excitatory postsynaptic potentials and inhibitory
      postsynaptic potentials following electrical stimulation of stratum radiatum were
      compared. The amplitude and duration of excitatory postsynaptic potentials were
      increased in aged rats. The amplitude and duration of the fast inhibitory
      postsynaptic potential were not significantly affected in aged animals. In
      contrast, the duration of the slow inhibitory postsynaptic potential was
      decreased in aged rats. Since the mean baclofen-induced hyperpolarization was
      only slightly reduced in aged rats, the most likely explanation is a decrease in
      the release of GABA rather than an alteration in the postsynaptic response
      mediated by GABAB receptors. A statistically significant correlation was found
      between the degree of impairment in the spontaneous alternation task and the
      amplitude of the carbachol-induced depolarization.

PMID- 1630626
TI  - Hypoxia produces cell death in the rat hippocampus in the presence of an A1
      adenosine receptor antagonist: an anatomical and behavioral study.
AB  - Endogenous adenosine depresses synaptic transmission in rat hippocampal slices
      during periods of hypoxia, a potentially neuroprotective cellular response that
      is attenuated by the adenosine antagonist 8-cyclopentyltheophylline. In this
      study, rats were exposed to moderate hypoxic conditions (5% O2- 95% N2, 40 min x
      three days) in the presence or absence of 8-cyclopentyltheophylline, and the
      effects of reducing adenosinergic inhibition during hypoxia were assessed
      histologically and behaviorally. Half the rats exposed to low levels of oxygen in
      the presence of 8-cyclopentyltheophylline (10 mg/kg) suffered unilateral or
      bilateral hippocampal damage largely limited to the CA1 subfield. Animals which
      had suffered hippocampal damage were also impaired in their performance of a
      working memory version of the Morris Water Maze, but not a passive avoidance task
      (step-through). Hypoxia alone did not result in neuronal damage or behavioral
      impairment. These results provide further evidence that endogenous adenosine
      provides an important level of neuronal protection during even prolonged periods
      of hypoxia.

PMID- 1630628
TI  - Background firing activity in guinea-pig neocortex in vitro.
AB  - The background firing activity was recorded extracellularly in experiments on
      guinea-pig neocortical slices maintained in vitro. The following types of
      background firing activity were revealed: (i) high regular single spikes (48%),
      (ii) irregular single spikes (15%), (iii) bursts (7%), (iv) groups (7%), (v)
      mixed activity where single spikes alternated with bursts or groups (28%). The
      specific interspike interval distribution and the specific shape of
      autocorrelogram corresponded to each of these background firing activity types.
      Furie analysis of autocorrelograms showed periodic components in spike sequences
      with the maxima at 3, 12, and 28 Hz. When blocking synaptic transmission with 100
      mM adenosine, about 70% of the background active cells "fell silent" and the
      remaining 30% of neurons continued to generate action potentials. The latter seem
      to be actual spontaneously active neurons, i.e. they were capable of autonomous
      spike generation. We failed to find any correlation between the type of neuronal
      firing and the ability of neurons to be spontaneously active. The selective
      blockade of inhibitory synapses with 100 mM picrotoxine did not practically
      change the character of background firing activity though the responses to
      stimulation became epileptic. An important conclusion to emerge from this study
      is that the background firing activity in cortical slices can include the actual
      spontaneous discharges related to intrinsic cell properties as well as those
      concerned with synaptic actions. Furthermore, a small number of spontaneously
      active neurons seem to be able to synaptically activate twice the number of
      cells. The inhibitory interneurons did not significantly influence the
      propagation of excitation with the absence of stimulation.

PMID- 1630627
TI  - Acute systemic heat stress increases glial fibrillary acidic protein
      immunoreactivity in brain: experimental observations in conscious normotensive
      young rats.
AB  - The possibility that astrocytes participate in the pathophysiology of thermal
      brain injury caused by systemic heat exposure was examined in conscious young
      rats. The temporal and regional pattern of the astrocytic response to thermal
      injury was characterized by demonstrating the immunoreactivity of glial
      fibrillary acidic protein (GFAP) using monoclonal antibody and avidin-biotin
      complex technique. Exposure of conscious young animals to heat at 38 degrees C
      for 4 h in a biological oxygen demand incubator resulted in a marked increase of
      the GFAP immunoreactivity in specific brain regions as compared with the intact
      controls. The intensity of the increased GFAP immunoreactivity was mainly noted
      in pons, medulla and cerebellum, followed by thalamus, hypothalamus, hippocampus
      and caudate nucleus. The cerebral cortex of heat-exposed animals showed only a
      mild increase in GFAP immunoreactivity which was predominantly concentrated in
      cingulate, parietal and pyriform cortices. The immunostaining in general was seen
      in the perivascular glia, within the neuropil and the glia limitans. This
      increase in GFAP immunoreactivity was absent in animals exposed to the same
      ambient temperature (38 degrees C) for 1 h and 2 h, or at a lower temperature (36
      degrees C) for 4 h. These results show that (i) astrocytes actively participate
      in the pathophysiology of heat stress, (ii) endogenous thermal brain injury
      elicits activation and hypertrophy of astrocytes ("reactive gliosis") depending
      on the magnitude and duration of the ambient heat stimulus, and (iii) the
      astrocytic reaction (observed as increased GFAP immunostaining) could be induced
      much more rapidly within a very short survival period of 4 h, not reported
      earlier.

PMID- 1630629
TI  - Hypothalamic, dorsal raphe and external electrical stimulation modulate noxious
      evoked responses of habenula neurons.
AB  - Extracellular recording techniques were used to investigate the effects of focal
      brain stimulation and external electrical stimulation on spontaneous activity and
      on noxious evoked responses in the habenular nucleus of anesthetized Sprague
      Dawley rats. Two hundred and forty-one habenular neurons were tested to noxious
      and non-noxious stimuli. The habenular neurons exhibited three cell types
      according to their patterns of response to the noxious stimulus: 123 neurons
      (51%) responded to noxious stimulus by excitation and were classified as
      "nociceptive-on" cells; 56 neurons (23%) responded to the same noxious stimulus
      by decreasing their firing rate and were classified as "nociceptive-off" cells;
      and 62 neurons (26%) failed to respond to noxious stimulation and were classified
      as "non-nociceptive" cells. None of these 241 cells responded to non-noxious
      stimulus. One hundred and fifty-five, 160, 142 and 241 habenular neurons were
      tested following focal lateral hypothalamus stimulation, dorsal raphe
      stimulation, cerebellar stimulation and transcranial electrical stimulation alone
      and concomitant with noxious stimulation, respectively. The observations
      demonstrate that focal lateral hypothalamic, dorsal raphe and external
      (transcranial) electrical stimulation suppresses habenular noxious evoked
      responses while cerebellar electrical stimulation elicits no effect on the
      nociceptive-off cells and augmenting effects on the nociceptive-on cells. In
      addition, it was observed that low current (below threshold) external
      transcranial electrical stimulation was as effective in suppression of habenular
      noxious evoked responses as was focal brain electrical stimulation in the lateral
      hypothalamus and dorsal raphe.

PMID- 1630630
TI  - Depolarization of rat locus coeruleus neurons by adenosine 5'-triphosphate.
AB  - Intracellular recordings were performed in a pontine slice preparation of the rat
      brain containing the locus coeruleus. The enzymatically stable P2-purinoceptor
      agonist alpha,beta-methylene ATP increased the firing rate without altering the
      amplitude or shape of action potentials; the afterhyperpolarization following a
      spike was not changed either. When locus coeruleus neurons were hyperpolarized by
      current injection in order to prevent spontaneous firing, alpha,beta-methylene
      ATP produced depolarization and a slight increase in the apparent input
      resistance. A combined application of kynurenic acid and bicuculline methiodide
      failed to alter the alpha,beta-methylene ATP-induced depolarization, and
      tetrodotoxin only slightly depressed it. A gradual shift of the membrane
      potential by hyperpolarizing current injection led to a corresponding decrease,
      but no abolition or reversal of the alpha,beta-methylene ATP effect. In the
      hyperpolarized region, the current-voltage curve of alpha,beta-methylene ATP came
      into close approximation with, but did not cross, the control curve. Elevation of
      the external K+ concentration, or the intracellular application of Cs+ by
      diffusion from the microelectrode, depressed the response to alpha,beta-methylene
      ATP; external tetraethylammonium was also inhibitory. External Ba2+ and Cs+ had
      no effect or only slightly decreased the alpha,beta-methylene ATP-induced
      depolarization. A low Na+, or a low Ca2+ high Mg2+ medium, as well as the
      presence of Co2+ in the medium, markedly reduced or even abolished the
      depolarization by alpha,beta-methylene ATP. ATP itself did not produce consistent
      changes in the membrane potential or input resistance. However, in the presence
      of the P1-purinoceptor antagonist 8-cyclopentyl-1,3-dipropylxanthine, ATP
      consistently increased the firing rate and evoked an inward current. In
      conclusion, P2-purinoceptor activation appears to depolarize locus coeruleus
      neurons by inhibiting a persistent potassium current, and at the same time
      opening calcium-sensitive sodium channels or calcium-sensitive non-selective
      cationic channels.

PMID- 1630631
TI  - The partial inhibition of inflammatory responses induced by capsaicin using the
      Fab fragment of a selective calcitonin gene-related peptide antiserum in rabbit
      skin.
AB  - The effect of an anti-calcitonin gene-related peptide (CGRP) antibody on
      responses induced by the sensory C-fibre neuropeptide, CGRP, and capsaicin, which
      selectively activates C-fibre nerves, was investigated in rabbit skin. Test
      agents and antibody were injected intradermally. Local blood flow changes were
      measured by 133Xenon clearance and oedema formation by [125I]albumin
      accumulation. Preinjection intradermally with the Fab fragment of a goat anti
      human alpha CGRP antibody selectively inhibited increased blood flow induced by
      CGRP (3 x 10(-12) mol/site) and caused a partial, but significant inhibition of
      increased blood flow induced by capsaicin (3 x 10(-7) mol/site). Oedema induced
      by histamine and bradykinin was potentiated by vasodilator doses of CGRP and
      capsaicin. These potentiating effects were significantly inhibited by
      pretreatment with anti-CGRP Fab. The Fab fragment was more potent in inhibiting
      capsaicin-induced responses than the parent IgG. These results suggest that
      capsaicin releases vasodilator quantities of CGRP in rabbit skin.

PMID- 1630632
TI  - c-fos expression in rat lumbar spinal cord during the development of adjuvant
      induced arthritis.
AB  - A parallel clinical and behavioral study of adjuvant-induced arthritis in the rat
      showed four stages in the time-course of the disease: preclinical (first week),
      acute (weeks 2-4), post-acute (weeks 5-8) and recovery weeks 9-11) [Calvino et
      al. (1987) Behav. Brain Res. 24, 11-29]. As several studies have reported the
      expression of the proto-oncogene c-fos in spinal cord neurons following acute
      noxious peripheral stimuli, the aim of this study was to quantitatively assess
      Fos-like immunoreactivity in lumbar spinal cord neurons at various times of
      adjuvant-induced arthritis development, i.e. one, two, three, 11 and 22 weeks
      post-inoculation. The total number of Fos-like immunoreactive neurons in the
      lumbar enlargement correlated with the observed development of adjuvant-induced
      arthritis, i.e. Fos-like immunoreactivity was absent at one week, moderate at two
      weeks, greatly increased at three weeks, decreased at 11 weeks and returned to
      control values at 22 weeks. At three weeks, at the peak of Fos-like
      immunoreactivity distribution and acute stage of hyperalgesia, maximal labeling
      was observed in L3 and L4 spinal segments. In these segments, the most densely
      labeled region was the neck (laminae V and VI) of the dorsal horn (55%) and the
      ventral horn (35%) as compared to the superficial laminae (laminae I and II; 5%)
      and the nucleus proprius (laminae III and IV; 5%). These data indicate that c-fos
      expression induced by chronic inflammation is better expressed in deeper laminae
      than in the superficial ones, and that the number of Fos-positive cells
      correlates with behavioral studies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630633
TI  - Localization of dystrophin and dystrophin-related protein at the electromotor
      synapse and neuromuscular junction in Torpedo marmorata.
AB  - The immunological identification of dystrophin isoforms at the neuromuscular
      junction and Torpedo marmorata electromotor synapse was attempted using various
      antibodies. A polyclonal antibody raised against electrophoretically purified
      dystrophin from T. marmorata electrocyte has been thoroughly investigated. This
      antibody recognized dystrophin in the electric tissue as well as sarcolemmal and
      synaptic neuromuscular junction dystrophin in all studies species (T. marmorata,
      rat, mice and human) at serum dilutions as high as 1:10,000. At variance, no
      staining of either the sarcolemma or neuromuscular junction was observed in
      Duchenne muscular dystrophy or mdx mice skeletal muscles. In these muscles, other
      members of the dystrophin superfamily, in particular the dystrophin-related
      protein(s) encoded by autosomal genes are present. These data thus demonstrate
      the specificity of our antibodies for dystrophin. Anti-dystrophin-related protein
      antibodies [Khurana et al. (1991) Neuromusc. Disorders 1, 185-194] which gave a
      strong immunostaining of the neuromuscular junction in various species, including
      T. marmorata, cross-reacted weakly with the postsynaptic membrane of the
      electrocyte. Taken together, these observations are in favor of the existence of
      a protein very homologous to dystrophin at the electromotor synapse in T.
      marmorata, whereas both dystrophin and dystrophin-related protein co-localize at
      the neuromuscular junction as in all species studied. The electrocyte thus offers
      the unique opportunity to study the interaction of dystrophin with components of
      the postsynaptic membrane.

PMID- 1630634
TI  - The neurology of sleep.

PMID- 1630635
TI  - Neuroanatomic and neurologic correlates of sleep disturbances.
AB  - The cyclic alternations of wakefulness and sleep competing for the domain of
      brain activity are controlled by neuronal systems contained in the core of the
      brainstem, hypothalamus, thalamus, and basal forebrain. This organization
      encompasses complex neuroanatomic, neurophysiologic, and neurochemical mechanisms
      that are subject to disruption from within, or as a result of incidental
      alterations of appropriate brain centers. The first section of this article
      reviews the wake-sleep disturbances that occur with lesions in defined
      neuroanatomic structures involved in sleep mechanisms, such as the brainstem,
      hypothalamus, thalamus, and cerebral hemispheres. The second section gives an
      overview of specific sleep alterations associated with neurologic disorders.
      These include stroke, Parkinson's disease, degenerative systemic disorders,
      multiple sclerosis, myotonic dystrophy, myasthenia gravis, brain tumors, head
      trauma, coma, epilepsy, and headache syndromes.

PMID- 1630636
TI  - The thalamus and insomnia.
AB  - The thalamus has been shown to play a primary role in the organization of the
      wake-sleep rhythm. This was confirmed by experimental findings in which athalamic
      cats displayed severe and persistent insomnia, and by clinical observations that
      thalamic degeneration, with selective or prevalent involvement of the anterior or
      dorsomedial nuclei, virtually abolishes the ability to generate
      electroencephalographic sleep patterns. Loss of sleep has been associated with
      autonomic (tachycardia, hyperthermia, tachypnea) and endocrine (increased plasma
      cortisol and catecholamine levels) activation. The clinical and experimental
      evidence suggests that degeneration of the anterior and dorsomedial thalamic
      nuclei (so-called "visceral thalamus") leads to permanent loss of autonomic and
      endocrine homeostasis and restorative body processes by relieving the
      hypothalamus of cortical inhibitory control.

PMID- 1630637
TI  - Narcolepsy.
AB  - Narcolepsy is a chronic neurologic disorder characterized by excessive daytime
      sleepiness, cataplexy, and premature onset of rapid eye movement sleep. It can be
      differentiated from other disorders causing daytime drowsiness by its clinical
      symptoms and by sleep laboratory studies. The disorder usually begins in
      adolescence and remains present throughout life. Genetic susceptibility to
      narcolepsy is closely associated with specific HLAs that indicate the existence
      of a gene in the region of the major histocompatibility complex on chromosome 6
      that increases susceptibility to narcolepsy. Neurochemical studies of human and
      canine narcolepsy have demonstrated disturbed monoaminergic and cholinergic
      function that may account for impaired regulation of rapid eye movement sleep,
      but the link between these abnormalities and the genetic factors is still
      unknown. Treatment of sleepiness with stimulants and cataplexy with tricyclic
      antidepressants leads to substantial improvement but does not fully resolve
      symptoms in most patients.

PMID- 1630638
TI  - Dissociated states of wakefulness and sleep.
AB  - Both sleep clinicians and basic science researchers have been witness to a wide
      variety of unusual clinical and experimental phenomena that represent admixtures,
      incomplete declaration, or rapid oscillations of the three states of being:
      wakefulness, rapid eye movement (REM) sleep, and nonrapid eye movement sleep. The
      concept of state dissociation provides an explanation for a wide variety of
      bizarre clinical phenomena, including the symptoms of narcolepsy, REM sleep
      behavior disorder, disorders of arousal (such as sleep terrors, sleepwalking, and
      sleep drunkenness), automatic behavior, and some "out-of-body" experiences. The
      purpose of this review is to provide an overview and perspective of such
      conditions, encourage systematic and detailed study of these "experiments in
      nature," and underscore the interdependence of clinicians and researchers.

PMID- 1630640
TI  - The neurology of sleep. Introduction.

PMID- 1630639
TI  - Sleep-related obstructive and nonobstructive apneas and neurologic disorders.
AB  - Daytime breathing problems caused by neurologic lesions always worsen during
      sleep, and in certain cases abnormal breathing patterns are only seen during
      sleep or specific sleep states. The first clinical manifestation of maltase
      deficiency, myopathy, or myotonic dystrophy is often a sleep-related complaint,
      such as unexplained waking from sleep (insomnia) or daytime somnolence. Thus,
      systematic investigation during sleep of disorders impairing the loop involved in
      breathing is strongly encouraged. Lesions may involve sensory receptors, sensory
      pathways, brainstem-controlling neurons, upper motor neurons, descending motor
      pathways, lower motor neurons, motor nerves, neuromuscular junctions, or
      respiratory muscles. Most of these lesions lead to a decrease in or absence of
      inspiratory efforts (diaphragmatic apnea or hypopnea) during sleep. These events
      differ from the classic obstructive sleep apnea syndrome and the recently
      described upper airway resistance syndrome, which usually involve mild or
      significant anatomic abnormalities of the upper airway and craniofacial region.
      The treatment of abnormal breathing during sleep has been improved by the
      development of nasal ventilation methods: continuous positive airway pressure,
      intermittent positive pressure, and volume ventilation. These therapeutic
      approaches can prevent tracheostomy and diaphragmatic pacing and are more
      efficacious than drug treatments. Long-term compliance is generally much better
      in breathing disorders secondary to neurologic impairments than in cases of mild
      to moderate obstructive sleep apnea.

PMID- 1630641
TI  - Nocturnal paroxysmal dystonia and nocturnal wandering.
AB  - Nocturnal paroxysmal dystonia (NPD) and episodic nocturnal wanderings (ENWs) are
      complex motor attacks arising abruptly during sleep, especially nonrapid eye
      movement sleep. NPD is characterized by sudden arousal followed by motor
      agitation with dystonic posturing, and semipurposeful activity recurring several
      times per night. When short-lasting, NPD may respond favorably to carbamazepine.
      ENWs are unusual episodes of ambulation, with unintelligible speech, screaming,
      and complex, often violent, behavior that responds to anticonvulsants. In both
      short-lasting NPD and ENWs, electroencephalography may show some evidence of
      epilepsy; NPD is clinically similar to the frontal lobe seizures that arise
      mesially or in depth. Paroxysmal arousals (PAs) are even shorter episodes of
      arousal or awakening during nonrapid eye movement sleep, associated with
      transient dystonic posturing and related to the short-lasting NPD. PAs, short
      lasting NPD, and ENWs probably represent a spectrum of peculiar sleep-related
      epileptic seizures.

PMID- 1630642
TI  - Periodic, aperiodic, and rhythmic motor disorders of sleep.
AB  - A variety of spontaneous movements can occur during sleep. Most are unassociated
      with identifiable CNS pathology and are presumed to be caused by sleep-related
      modulation of CNS motor control systems. Individual dyskinesias occurring during
      sleep can be characterized not only by their frequency, rhythmicity, and anatomic
      predilections, but also by the stage of sleep in which they characteristically
      occur. Wake-pattern movement disorders improve during sleep but, contrary to
      common belief, they do not entirely disappear. Instead, these disorders reemerge
      in attenuated form, often during nonrapid eye movement sleep. The identification
      and proper characterization of the various sleep-related dyskinesias are greatly
      aided by careful polysomnographic study.

PMID- 1630643
TI  - Snoring, sleep apnea syndrome, and stroke.
AB  - Increasing evidence suggests that snoring and sleep apnea are associated with
      cerebrovascular diseases. Several other factors may be involved in this
      association because many established or potential risk factors for stroke are
      related to snoring and sleep apnea. These include arterial hypertension, coronary
      heart disease, age, obesity, smoking, and alcohol consumption. Recent
      epidemiologic and clinical studies indicate, however, that snoring can increase
      the risk of stroke independently of these confounding factors. Accumulating
      epidemiologic evidence of long-term harmful effects of the obstructive sleep
      apnea syndrome appears to be related to increasing vascular morbidity and
      mortality. Potential mediators among snoring, obstructive sleep apneas, and
      stroke include cardiac arrhythmias and other hemodynamic disturbances, increased
      levels of catecholamines, and disturbances in cerebral blood flow caused by sleep
      apneas, as well as hypoxemic periods that may potentiate atherosclerosis.

PMID- 1630644
TI  - Sleep in Alzheimer's disease and the sundown syndrome.
AB  - Approximately 10% of the elderly population have a dementing illness that
      manifests itself clinically by significant cognitive deficits. Half of these
      individuals have Alzheimer's disease (AD), a progressive degeneration of cortical
      and subcortical neurons. Disturbances of sleep and the sleep-wake rhythm are a
      common clinical observation in AD, as is "sundowning," the onset or exacerbation
      of delirium during the evening or night. Here we describe the neurologic basis
      for the disturbed sleep of patients with AD, the phenomenology of that
      disturbance, and its implications. Further, we describe the prevalence, possible
      causes, and treatment of sundowning.

PMID- 1630645
TI  - Basic mechanisms of sleep generation.
AB  - Most brainstem, thalamic, and cortical cellular types undergo similar processes
      during rapid eye movement (REM) sleep and wakefulness, and both these brain
      activated behavioral states are opposed to the resting EEG-synchronized sleep.
      Experimental evidence shows that during drowsiness, disfacilitation in thalamic
      and cortical neurons (by partial removal of influences from mesopontine,
      posterior hypothalamic, and basal forebrain activating systems) may coexist with
      active hypnogenic mechanisms. The idea of an active induction of sleep, however,
      still lacks firm support at the cellular level. The generation of REM sleep signs
      is probably caused, at least partially, by the disinhibition of mesopontine
      cholinergic cells, the executive elements of tonic and phasic events during
      dreaming sleep, following cessation of firing of inhibitory serotonergic dorsal
      raphe neurons.

PMID- 1630646
TI  - Outcomes and costs of inpatient AIDS care.

PMID- 1630647
TI  - Methodological issues in the study of surgical infections in war wounds.

PMID- 1630648
TI  - Nondeployability.

PMID- 1630649
TI  - Ambulatory health care needs of women deployed with a heavy armor division during
      the Persian Gulf War.
AB  - A study was undertaken to assess the health care needs of women in a combat
      deployment. During a 6-month period during the Persian Gulf War, 10,165
      ambulatory visits from an armor division were studied. The results demonstrate
      that the health care needs of women can be managed by competently and broadly
      trained practitioners. Referral sites should provide for gynecologic consultants
      along with equipment and resources needed to manage pregnancy complications,
      pelvic pain, and abnormal cervical cytology. It is unlikely that women deployed
      in this setting pose a significant health care burden attributable solely to
      their gynecologic needs.

PMID- 1630650
TI  - An analysis of gynecological problems presenting to an evacuation hospital during
      Operation Desert Storm.
AB  - Very little data are available to commanders regarding gynecological problems
      encountered by a large female population in a combat zone for extended periods of
      time. The 312th Evacuation Hospital supported Operation Desert Storm, treating
      over 12,000 patients. Of these, 577 were treated by the gynecological service.
      Only six patients with nonobstetrical conditions required evacuation out of
      theater; the remainder returned to duty. Five of these had pre-existing
      conditions. There were 49 cases of pregnancy. Excluding pregnancy, the
      gynecological problems observed were predictable, manageable in theater, and
      resulted in minimal loss of manpower.

PMID- 1630651
TI  - Psychiatric evaluation of self-referred and non-self-referred active duty
      military members.
AB  - This study examined 300 cases of active duty Air Force members seen in an Air
      Force medical center outpatient mental health clinic over a 1-year period.
      Comparisons were made between self-referred and non-self-referred (commander
      directed) patients across several areas, including chief complaints/referral
      reasons, diagnoses, personality features, dispositions, and numbers of therapy
      sessions. Results showed significantly different distributions of types of chief
      complaints, dispositions, and treatment sessions between the two groups, and
      provided relative proportions of personality types distributed within each group.
      The dual roles of the military mental health practitioner, as provider for both
      the organization and the patient, are discussed.

PMID- 1630652
TI  - Anesthesia in military conflicts: towards simpler, safer, and higher standards.
AB  - The increasing military activity in the Persian Gulf necessitates that
      anesthesiologists in the United States should gain familiarity with the use of a
      draw-over vaporizer attached to a non-rebreathing circuit. Unfortunately,
      distributors of draw-over vaporizers in the United States do not allow
      anesthetists to use this equipment on humans in North America when conventional
      anesthesia equipment is available. Since the standard of anesthesia care in the
      U.S. is high, the use of a draw-over vaporizer is not allowed in most settings.
      Hence, this article reviews the function, the advantages, and disadvantages of a
      draw-over vaporizer attached to a non-rebreathing circuit. The use of an oxygen
      concentrator is also discussed, which increases the safety of this anesthetic
      delivery system.

PMID- 1630653
TI  - Development of the laws of war as they pertain to medical units and their
      personnel.
AB  - International law provides certain protections for medical units and their
      personnel during times of war. This was not always the case, but protections were
      gradually added and finally codified in the Geneva Conventions. The development
      of these protections is traced from early recorded history to modern times, and
      the limitations and obligations placed on medical units and medical personnel by
      international law are examined.

PMID- 1630654
TI  - Disease prevention strategies for Army aviators: clues from a descriptive
      analysis of the flying duty medical examination.
AB  - The U.S. government spends approximately $300,000 to train an Army aviator.
      Maintaining a healthy aviator population is important not only to the completion
      of the aviation mission, but also for budgetary reasons. We reviewed Army aviator
      physical examinations and self-reported risk behavior questionnaires from the
      Aeromedical Epidemiological Data Repository at Fort Rucker, Alabama, to assess
      aviator health. Overall, aviators are healthy adults; however, the health status
      of aviators can be improved by reducing tobacco use, limiting cholesterol and fat
      intake, and wearing hearing protection devices both during and off duty.

PMID- 1630655
TI  - Ambulance use in a military population: epidemiology and implications.
AB  - Because no studies have been reported on ambulance use in military populations, a
      2-year epidemiologic study of all ambulance responses on Hickam Air Force Base
      was conducted. Findings included a higher utilization rate and a greater
      proportion of pediatric patients than might be expected in comparable civilian
      populations. Serious trauma was uncommon, but a wide spectrum of serious medical
      emergencies was seen. Advanced life support was indicated in 22% of all
      responses, and its availability improved patient outcome. Based on these and
      other findings, recommendations are made for upgrading military prehospital care
      to meet both base population needs and current civilian community standards.

PMID- 1630656
TI  - Previous hearing loss and susceptibility to future permanent threshold shifts.
AB  - The association between prior hearing losses and susceptibility to future
      permanent threshold shifts was examined by a matched pairs case-control study.
      Data were obtained from the United States Air Force Hearing Conservation Data
      Registry, which contains over three million audiometric records. Cases with
      permanent hearing losses were matched with normal controls for relative noise
      exposure intensity, years of exposure, and age. Based on analysis with normal or
      abnormal baseline hearing as the risk factor, cases with abnormal initial hearing
      were no more likely than controls to develop future permanent threshold shifts
      (odds ratio = 1.06, 95% confidence interval 0.61-1.85).

PMID- 1630657
TI  - Chronic pyridostigmine bromide administration: side effects among soldiers
      working in a desert environment.
AB  - The side effects of chronic pyridostigmine bromide administration were studied in
      seven male soldiers performing moderate-intensity exercise in a desert
      environment. A 2-week, double-blind, placebo-controlled crossover design was
      employed in which pyridostigmine was administered for 7 consecutive days (30 mg
      orally, t.i.d.). Four hours each day were spent in the heat (42 degrees C, 20%
      relative humidity); 2 hours rest followed by 2 hours moderate exercise (40%
      maximal aerobic power). Each day, subjects completed four symptom questionnaires
      and received three focused physical examinations. Symptoms reported did not
      differ between treatment groups except for fewer headaches during pyridostigmine
      treatment. Soldiers were unable to distinguish the effects of pyridostigmine from
      placebo. Pyridostigmine was associated with lower resting diastolic blood
      pressure (approximately 4 mmHg, p less than 0.05), smaller pupil diameter
      (approximately 0.5 mm, p less than 0.01), decreased handgrip strength
      (approximately 3%, p less than 0.05), and higher final rectal temperature
      (approximately 0.1 degree C, p less than 0.01). Effects of this magnitude are not
      likely to appreciably limit performance. We conclude that chronic pyridostigmine
      administration does not negatively impact on soldiers' ability to perform
      physical work over repeated days in a desert environment.

PMID- 1630658
TI  - A technique for subcutaneous knot inversion following running subcuticular
      closures.
AB  - Standard methods of running subcuticular closures frequently leave the completion
      knot close to the epidermis, resulting in stitch abcesses and suture extrusion. A
      simple technique for the subcutaneous placement of completion knots following
      subcuticular sutures, resulting in fewer stitch abcesses, is described.

PMID- 1630659
TI  - Efficacy of antiperspirants on feet.
AB  - Nineteen male soldiers participated in a study of the effectiveness of two
      antiperspirants (aluminum chlorohydrate and aluminum zirconium tetrachlorohydrex
      glycine) in reducing foot-sweat accumulation and injuries. Each subject was
      tested before and after antiperspirant application, with a 1-hour treadmill march
      at 5.6 km/hour in a warm environment. Both antiperspirants decreased (p less than
      0.05) foot-sweat accumulation over 50%. There was also a tendency, although not
      statistically significant, for subjects to incur fewer blisters with
      antiperspirant use. However, the antiperspirants also increased (p less than
      0.05) the incidence of irritant dermatitis. Nevertheless, these data suggest that
      the application of antiperspirants to the feet has merit in reducing serious foot
      injuries (blisters, trench foot) exacerbated by wet feet.

PMID- 1630660
TI  - Defining quality in health care.
AB  - The difficulty and importance of developing and implementing a definition of
      quality in health care is discussed. Some current definitions are considered, and
      a recommended definition of quality health care is presented.

PMID- 1630661
TI  - Decentralized operating room pharmacy services in a military teaching hospital.
AB  - The development, initiation, and evaluation of a decentralized pharmacy satellite
      within the operating room, requiring neither additional capital funding nor any
      major construction, is described. The satellite offers numerous programs to aid
      the operating room staff. Included in this effort is the complete management of
      all controlled substances within the operating room, post-anesthesia-care unit,
      and same-day-surgery unit. Pharmacists function as pharmaceutical resources
      playing a major role in the pain service unit. Success of the satellite is
      assessed via a number of parameters including staff survey response, quality
      assurance impact, and inventory management.

PMID- 1630662
TI  - High tech home care: a look at a success story.
AB  - The expansion of technology has allowed patients to receive intravenous therapy
      at home. This case study discusses the problems of a patient with diabetes
      mellitus and malignant otitis externa. This patient received intravenous therapy
      for the last 3 years of his life. In spite of several hospitalizations, he was
      able to return and remain home until his death. Management of the patient's
      discharge and home care seemed to be a major factor in his ability to remain in
      the community.

PMID- 1630663
TI  - An atypical case of brucellosis in a Turkish national.
AB  - Brucellosis is an endemic disease in many of the countries in which military
      personnel are stationed, including the Middle East, where thousands are deployed.
      The signs and symptoms of brucellosis are often nonspecific and diagnosis
      requires a high index of suspicion. This case report involves a Turkish national
      with an unusual febrile illness, subsequently diagnosed as brucellosis. The
      presentation, diagnosis, and treatment are discussed. The special relevance to
      the military physician is emphasized.

PMID- 1630664
TI  - Ambulance use in a military population: epidemiology and implications, by LTC
      Fred Leonard, USAF MC.

PMID- 1630665
TI  - [Diabetic cardiomyopathy: possible pathogenetic role of coronary
      microcirculation].
AB  - The hypothesis that diabetes mellitus provokes a specific cardiomyopathy is
      supported by numerous clinical, epidemiological and anatomopathological studies.
      However, the frequent association of diabetes mellitus with other conditions,
      such as hypertension and coronary atherosclerosis, both capable of causing the
      dysfunction of the cardiac muscle, makes it difficult to interpret many of the
      data reported in the literature and contributes to the continuing debate
      regarding the effective existence of diabetic cardiomyopathy and its possible
      pathogenetic mechanisms. In clinical terms, diabetic cardiomyopathy is manifested
      both as an altered diastolic and/or systolic phase, assessed using various non
      invasive techniques, or as congested cardiac decompensation. The pathogenesis of
      diabetic cardiomyopathy is still not altogether clear. The alteration of the
      smallest coronary vessels might be responsible for the increased interstitial
      fibrosis found in the heart of diabetic patients. In this paper numerous data
      from the literature on this argument are reported and the authors advance the
      hypothesis that endothelial dysfunction may play a pathogenetic role in the
      development of cardiopathy.

PMID- 1630667
TI  - [4'-epidoxorubicin: its cardiotoxicity. Possible cardiac protection with
      gallopamil, a drug with calcium-antagonist action].
AB  - The 4'-EPI-doxorubicin (4'-EDX) has shown antitumoral activity against a broad
      spectrum of human tumors. The same clinical reports have shown therapeutic
      activity comparable to doxorubicin (adriamycin), but a lower cardiac toxicity. 4'
      EDX cardiotoxicity appears after highest cumulative doses: 935 mg/m2 bs for 4'
      EDX vs 550 mg/m2 bs for adriamycin. Moreover we have observed a protective action
      of the calcium antagonist gallopamil. We have found an improvement in ventricular
      performance after using gallopamil, and a reduction of 4'-EDX cardiotoxicity.
      Cardiac function was evaluated by EKS, STI, echography, myocardial scintigraphy
      course. Our result indicates the possibility of treating tumors without serious
      cardiotoxic by 4'-EDX and gallopamil.

PMID- 1630666
TI  - [Progression of lesions of the arterial wall evaluated by ultrasonic biopsy in
      asymptomatic subjects and in diabetic and hyperlipidemic patients treated with
      bezafibrate. A 4-year follow-up].
AB  - Non-invasive arterial ultrasonic biopsy (UB) has been used to evaluate and follow
      up arterial wall changes in four years in asymptomatic subjects, hyperlipidemics
      and diabetics. Both groups of patients were randomised in a treatment group
      (bezafibrate 400 mg daily) and in a control group. The rate of progression (ROP)
      into the next higher UB class was recorded by UB scans repeated every six months.
      In diabetics and hyperlipidemics the rate of progression (ROP, namely the percent
      of patients progressing to the next class) was significantly higher than the ROP
      in the asymptomatic subjects. However in the bezafibrate group the ROP was
      significantly lower than that observed in the controls. As each UB class
      corresponds to different levels of risks of occult coronary ischemia and
      cardiovascular events in the following four years, the reduction of ROP with
      bezafibrate was an important and positive achievement.

PMID- 1630668
TI  - [Heart rhythm changes in patients with chronic obstructive bronchopneumopathies:
      effects of different methylxanthine drugs].
AB  - The present study was designed to assess effectiveness and safety and the
      proarrhythmic effects of two methylxanthine derivatives, doxofylline and
      aminophylline, in the management of chronic obstructive pulmonary disease
      associated with cardiac rhythm disturbances. Fourteen patients of both sexes (9
      male, 5 female) with a mean age of 54 (range 43 to 66 years) with concomitant
      chronic obstructive pulmonary disease and high incidence of ventricular (VPB)
      and/or supraventricular (SVPB) premature beats were selected. The study was
      performed in a double-blind randomized cross-over trial. Following a proper wash
      out period, in each phase patients were administered intravenously 400 mg b.i.d.
      of doxofylline or 480 mg of aminophylline b.i.d. (rate of infusion: 60 min)
      according to the cross-over design. A 24-hour Holter monitoring was carried out
      before the onset of the treatments and at the end of each venous infusion of
      methylxanthines. Spirometry for measurement of forced expiratory volume in one
      second and clinical parameters were also evaluated. Parametric variables were
      evaluated by analysis of variance. Kruskal-Wallis test was used to estimate non
      parametric variables. A p value less than 0.05 was considered statistically
      significant. We observed a significant reduction in the occurrence of VPB/24 h (p
      less than 0.05 vs basal value) and in the total number of beats (p less than 0.01
      vs basal value and p less than 0.05 vs aminophylline) after doxofylline
      administration, whereas no changes from baseline in the incidence of premature
      beats and in the mean 24-hour heart rate were reported after
      aminophylline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630669
TI  - [Effects of fibrinolytic therapy in acute ischemia of the lower limbs].
AB  - In this paper the Authors illustrate their experience of loco-regional
      fibrinolytic medical treatment in patients suffering from acute thrombotic-type
      ischemia of the lower limbs. The clinical, ultrasonographic and angiographic
      criteria leading to the choice of this form of treatment rather than surgery are
      examined. The Authors outline the reasons which led them to give preference to
      the use of plasminogen tissue activators (rt-PA) rather than other fibrinolytic
      agents; the results obtained are evaluated not only in terms of immediate
      permeability but also in relation to the additional procedures required to ensure
      a correct therapeutic iter. In conclusion, the paper underlines the need to
      assess the indications for this type of therapy with great care since "washing"
      the distal vascular bed may be decisive for successful treatment even in the
      event of possible future surgery.

PMID- 1630670
TI  - [Aortic coarctation and intracranial aneurysm: an unusual association.
      Description of an unusual case and diagnostic-therapeutic considerations].
AB  - A case of double unruptured intracranial aneurysm associated with aortic
      coarctation is presented. The main characteristics of the unusual association,
      the diagnostic criteria and the surgical strategies are reviewed.

PMID- 1630671
TI  - [Prognostic significance of thallium-201 scintigraphy in patients with previous
      myocardial infarct].
AB  - With the purpose of ascertaining the predictive value of residual myocardial
      ischemia, in stable clinical conditions at a distance after myocardial
      infarction, on the incidence of late cardiac events, we evaluated 55 patients
      24.2 +/- 11.4 months after myocardial infarction with thallium-201 stress test
      imaging. All patients were either asymptomatic or with stable effort angina
      pectoris, well controlled with medical treatment. In the next follow-up period,
      whose duration has been 22.4 +/- 14.4 months, the incidence of unfavourable
      cardiac events, like unstable angina, reinfarction, coronary bypass surgery,
      sudden cardiac death has been monitored. Thirty-one patients (56.4%) presented a
      reversible perfusion defect (RPD) in one or more myocardial segments; 17 of these
      31 showed cardiac events during follow-up. Only 2 patients of the remaining 24
      without RPD had cardiac events, with a significant difference (p less than 0.01).
      The patients with RPD only in peri-infarct areas had a relatively smaller number
      of cardiac events, with respect to those patients with RPD also or only in
      distant areas. Fifteen of 21 patients with RPD in 2 or more segments manifested
      cardiac events, compared to 2 of 10 patients with RPD in only one segment (p less
      than 0.01). In 10/55 patients, increased lung uptake of thallium-201 activity was
      observed; 8 of them presented cardiac events (p less than 0.01). This analysis
      confirms the high predicting value of thallium-201 RPD imaging on the incidence
      of cardiac events in patients controlled at a distance after myocardial
      infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630672
TI  - [AIDS in Italy: an update to 31 December 1991].

PMID- 1630673
TI  - [AIDS in the world, as of 1 October 1991].

PMID- 1630674
TI  - [Cardiac involvement in pheochromocytoma. A report of 6 cases].
AB  - Pheochromocytoma is a rare case of sustained hypertension or hypertensive crisis:
      sometimes it may occur with several aspecific symptoms or hypotension. The
      literature reports frequent myocardial involvement in patients affected by
      pheochromocytoma. Adrenergic hormone effects are responsible for a functional
      coronary insufficiency which causes myocardial damage. The cardiac involvement
      may appear with symptoms of different severity that sometimes represent the only
      symptoms of the neoplasia. Clinical and instrumental cardiac alterations observed
      in 6 patients suffering from pheochromocytoma are reported. Electrocardiographic
      abnormalities were found in 5 out of 6 patients. Inferior myocardial infarct was
      present in one case; in two patients electrocardiogram showed left ventricular
      hypertrophy and negative T wave; frequent ventricular extrasystoles in one case
      and complete atrio-ventricular block in another were found during the
      hypertensive crisis; in one patient the electrocardiogram showed STT changes and
      in the last one, left ventricular hypertrophy, more evident in the
      interventricular septum, was present at the echocardiogram. All subjects
      underwent surgical treatment after a period of drug therapy. To date surgery is
      the only possibility to eliminate myocardial malignant effects of catecholamines.

PMID- 1630675
TI  - [A clinical case: coronary vasospasm induced by exercise after stopping
      nifedipine therapy].
AB  - A 60-year-old man with atypical chest pain not submitted to adequate diagnostic
      procedures was treated on an empirical basis with nifedipine 20 mg b.i.d. The
      patient was referred to our institution where a first symptom-limited exercise
      stress-test during treatment was performed; neither S-T alterations nor clinical
      symptoms were induced at the maximal tolerated work load. Therefore we suggested
      a short period of hospital stay to repeat the stress-test after a progressive
      tapering off of the drug with the aim of obtaining a more definite diagnosis.
      However the patient refused and an at-home nifedipine withdrawal was planned.
      Some days later a second test showed marked S-T segment elevation in leads V4 to
      V6; concomitant high-grade ventricular arrhythmias and anginal pain occurred.
      Both the ECG alterations and the clinical symptom promptly regressed interrupting
      the test and administering sublingual isosorbide dinitrate. A coronary
      angiography performed few days later showed only a single and no significant
      stenosis of the left anterior descending artery (60%). The clinical and
      electrocardiographic pictures were therefore attributed to stress-induced
      vasospastic ischemia. A week later a third maximal stress-test during further
      treatment with nifedipine was totally negative. The pathophysiological mechanisms
      of rest and stress-induced vasospastic angina and the usefulness of Ca-blocking
      agents are discussed.

PMID- 1630676
TI  - [Metabolic changes in the patient with essential hypertension].
AB  - The aim of the present study was to evaluate a number of parameters in a group of
      patients with essential hypertension and then compare the results with those in a
      group of healthy normotensive subjects. One hundred and fifty-six patients with
      essential hypertension (EH) in the non-complicated form (73 males, 83) females;
      mean age: 54.8 +/- 0.9 years) were selected and compared with 150 normotensive
      subjects matched for age and sex. After a 2-week period of wash-out during which
      patients followed a diet with normal sodium and calorie content, body mass index,
      systolic and diastolic arterial pressure (AP), mean arterial pressure (MAP),
      heart rate in clino- and orthostatism were measured and blood was collected to
      assay glycemia, total cholesterolemia, LDL and HDL cholesterolemia and
      triglycerides. In the group of patients suffering from EH all the above
      parameters were found to be significantly higher than in normotensive control
      subjects. In particular, in the hypertensive population the prevalence of obesity
      was 21.3%, hyperglycemia 26.9%, hypercholesterolemia 65.1% and smoking 36.4%.
      When the possible relation between one or more risk factors and AP values was
      assessed, it was found that in hypertensive patients the presence of
      hyperglycemia alone or in association with other metabolic disorders led to the
      highest MAP findings. Moreover, having studied the correlation rate of the
      various parameters, it was seen that in both the hypertensive and normotensive
      populations systolic AP measured in clinostatism positively correlated with
      glycemia, total cholesterolemia, and age, whereas correlations were not found
      between clinostatic diastolic AP and the above parameters.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1630677
TI  - [The frequency of early coronary reperfusion assessed by electrocardiographic
      criteria in relation to the timing of thrombolytic therapy in acute myocardial
      infarct].
AB  - This study was aimed at assessing coronary reperfusion in patients with acute
      myocardial infarction (AMI) undergoing systemic thrombolysis with SK and rtPA.
      The occurrence of reperfusion was related to the time of treatment. The
      evaluation of reperfusion was performed by monitoring ST segment changes. 56
      patients with AMI were studied. 22 out of these (39.2%) showed a significant
      decrease (greater than 50%) in ST segment sum (sigma ST) at 100 minutes from the
      beginning of the treatment. Analysis of the relationship between reperfusion and
      elapsed time between the onset of symptoms and the treatment, reveals that the
      reperfusion is less frequent (p less than 0.05) in patients treated at 180
      minutes or later. The standard electrocardiogram appears as the most useful
      method to evaluate indirectly coronary reperfusion in acute myocardial
      infarction. A further refinement of this method is desirable to recommend its
      widespread clinical use. The assessment of reperfusion by means of ECG in large
      series of patients will permit the evaluation of the benefits of reperfusion, in
      terms of survival, complications and incidence of ventricular dysfunction.

PMID- 1630678
TI  - [Observations on the natural history of heart failure. Changes due to the
      therapeutic use of captopril].
AB  - The purpose of this research was a retrospective evaluation of the mortality rate
      in 138 patients, considered after the first hospitalisation due to heart failure.
      After 5 years, the mortality rate was higher in the 54 patients with dilatative
      cardiomyopathy (74.3%), compared to the 44 patients with coronary heart disease
      (54.5%), while the 40 patients with valvular heart disease showed a lower
      mortality (37.5%). The mortality rate was higher in patients admitted in higher
      NYHA class. The primary aim of this research was to assess the effects of
      captopril on mortality in 101 treated patients, compared to 37 non treated
      patients, both receiving conventional treatment for heart failure. Between the 2
      groups, the mortality rate showed lower percentage values for patients treated
      with captopril, with significant difference (p less than 0.01) at controls
      carried out every 12 months, until 5 years. Progressive heart failure was the
      greater cause of death in both groups, while the deaths classified as due to
      arrhythmia without pump failure were less frequent. Deaths due to reinfarction in
      patients with coronary heart disease showed lesser percentage values in patients
      treated with captopril. This research demonstrated the high mortality rate
      affecting a group of patients after the first hospitalisation due to heart
      failure. The addition of captopril to conventional treatment for heart failure
      significantly reduced mortality.

PMID- 1630679
TI  - [The structural aspects of the pharmacological activity of calcium antagonists. A
      general profile and the results of a pilot study of nicardipine].
AB  - The authors examine the most recent findings on arterial hypertension with
      particular emphasis to morphological changes of the arterial wall and to the
      results of nicardipine treatment in spontaneous hypertensive rats (SHR).
      According to these assumptions the authors evaluate the effects of nicardipine on
      the microvascular network by means of a funduscopic examination in 8 hypertensive
      patients. The preliminary data suggest that nicardipine has a positive structural
      and morphological effect on the vessel network.

PMID- 1630680
TI  - [The Study Group of Quinapril in Arterial Hypertension. The Steering Committee].
AB  - The efficacy and safety of the treatment of arterial hypertension with the ACE
      inhibitor quinapril, were evaluated in a multicentre study conducted in Italy.
      The study, lasting 14 weeks, after a preliminary wash-out period, allowed
      response-based titration of quinapril dose from 10 mg to 40 mg once a day, with
      provision to combine additional hydrochlorothiazide (12.5 to 25 mg), in case of
      persistently high diastolic pressure levels. The efficacy sample included 1267
      patients: at therapy week 14, 78.6% of patients were treated with quinapril
      alone. Global response rate (intent-to-treat) was 83.3%, with a mean reduction of
      diastolic pressure of 15.8 mmHg (95% confidence interval from 15.5 to 16.2 mmHg).
      91 patients reported 126 associated adverse events (7.0%); the most frequently
      reported event was cough (2.7%). First-dose hypotension was rarely reported
      (1.3%), even in elderly and diabetic patients.

PMID- 1630681
TI  - [The effect of gallopamil on myocardial perfusion in angina of effort].
AB  - To value stress tolerance and stress myocardial perfusion before and after a week
      of oral therapy with gallopamil 150 mg daily, we studied 10 patients suffering
      from stable effort angina. We performed bicycle exercise stress testing and
      thallium scintigraphy (Tl) with planar technique in 3 projections (anterior
      posterior and oblique left anterior at 45 and 70 degrees) according to the
      current standards. We valued systolic and diastolic blood pressure (SBP-DBP),
      heart rate (HR) and HR-SBP product at rest, at symptoms stress-induced and at the
      end of the procedure. Moreover we valued work threshold of chest discomfort and
      ischemia, the maximal work capacity and the perfusion defects according to a Tl
      score obtained dividing the 3 projections in 5 segments and fixing a value
      according to the observed perfusion from 0 = normal perfusion to 3 absent
      perfusion. We observed a significant reduction of basal HR (77 vs 71, p = 0.05),
      SBP (147 +/- 15 vs 131 +/- 15 mmHg, p = 0.001), DBP (91 +/- 6 vs 83 +/- 6 mmHg, p
      = 0.002). Work threshold of chest discomfort and ischemia significantly arose (8
      +/- 3 vs 11 +/- 4 min., p = 0.002; 6 +/- 3 vs 10 +/- 4 min., p = 0.001). The HR
      SBP product at the maximal work capacity and the Tl score significant decreased
      (31650 +/- 6239 vs 29406 +/- 5418, p = 0.003; 8 +/- 2 vs 5 +/- 1, p =
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630682
TI  - [Rokitamycin. The new macrolide].

PMID- 1630683
TI  - ["Multiorgan failure" in surgery: its physiopathology, prevention and treatment.
      A review of the literature].
AB  - At present multiorgan failure (MOF) is the complication with the highest
      mortality after emergency or elective general surgery. The syndrome seems to find
      its pathogenesis out of the very complex interactions of endogenous and exogenous
      mediators; instead the physiopathology seems to depend on cellular oxygen
      deficiency. The authors refer the common criteria defining organ and/or system
      damage during MOF and analyse the available possibilities for their treatment. In
      this regard they stress the role of prevention, which relies on the opportune
      treatment of earlier stage of shock, constantly preceding the syndrome, and on
      the intensive organ/systems functions monitoring to obtain an early and rational
      correction of the alterations taken away.

PMID- 1630684
TI  - [Hurthle-cell tumors of the thyroid].
AB  - In the last 10 years 20 patients with Hurthle tumors were observed at Institute
      of Surgery and Oncology of Cagliari University. 17 were females and 3 males with
      a median age of 42 years. Tumors were malignant in 7 cases and benign in 13. A
      total thyroidectomy was performed in all patients with carcinoma and in 2 with
      adenoma because of concurrent goiter. The remaining patients were treated with a
      less extensive surgery. Two patients with carcinoma had a cervical node
      metastases at 12 and 67 months, treated by surgery (followed by radioiodine
      therapy in one). All patients are alive and disease free at 72 months of median
      follow-up. None of patients with benign adenomas recurred at 47 months of median
      follow-up. A longer-term follow-up is necessary in order to evaluate the
      benignity of adenomas.

PMID- 1630685
TI  - [Intestinal obstruction in colorectal neoplasms. Our experience with 50 cases].
AB  - From January 1985 to December 1989 in our Department 178 patients were operated
      for colorectal carcinomas. Fifty (28%) underwent emergency procedure for
      intestinal obstruction. The male-female ratio is about 1. The mean age is 79.6
      (range 40-91), but 76% of patients is 60-85 years old. The rectum-sigmoid
      junction was the most affected (30%), followed by the rectum (18%) and the sigma
      (16%). Thirty-five (70%) patients underwent intestinal resection. The early
      postoperative death rate is 18% (9 cases). All the patients operated upon had
      Dukes stage B-C neoplasms.

PMID- 1630686
TI  - [The diagnosis and treatment of renal oncocytoma. Our experience].
AB  - Personal experience of the treatment of renal oncocytoma is compared with
      reported data. Furthermore the problems relating to the diagnosis and treatment
      of this tumour, characterised, in many cases, by its lack of symptoms and tricky
      histopathological classification, are examined in greater depth.

PMID- 1630687
TI  - [Perioperative treatment with thymostimulin in patients with stomach and
      colorectal neoplasms. Our experience with 114 cases].
AB  - The authors report their experience about the use of the timostimoline in the
      perioperative time in 114 cases of gastric and rectum cancer. They think that
      this method can be of help for neoplastic patients about the time of surgical
      stress.

PMID- 1630689
TI  - [A rare case of massive digestive hemorrhage. Carcinoid of the small intestine].
AB  - The authors reports a case of massive digestive hemorrhage produce by a carcinoid
      of the small intestine. Having reviewed the most frequent causes of primary
      hemorrhage of the mesenteric small intestine, attention is focused on the
      difficulties o making an etiological and topographical diagnosis, in spite of
      using the most advanced instrumental research methods. The paper concludes that
      explorative laparotomy is the sole method for making a precise diagnosis and
      performing appropriate surgical treatment.

PMID- 1630688
TI  - [Leiomyoma of the stomach. A report of a case with exogastric development].
AB  - The authors report a case of a large, exogastric, pedunculated leiomyoma of the
      stomach. Following a review of the literature, the paper describes the clinical
      and therapeutic aspects of these tumors and underlines the diagnostic
      difficulties of this relatively rare gastric pathology.

PMID- 1630690
TI  - [2 true cysts of the spleen. Case reports].

PMID- 1630691
TI  - [An aneurysm of the extracranial carotid. A report of an interesting clinical
      case].
AB  - One case of extracranial carotid artery aneurysm observed is reported. This
      uncommon and interesting vascular disorder is still under discussion even if the
      present tendency is to treat it actively by reconstructive surgical procedures
      that make it possible to avoid the natural aneurysm complications with a low risk
      of postoperative neurological lesions.

PMID- 1630692
TI  - [The use of human fibrin glue in the repair of recurrent mucosal prolapse in
      ileostomy].

PMID- 1630693
TI  - [Peptic ulcer: 3 little-known symptoms].

PMID- 1630694
TI  - [What treatment protocol for lobular carcinoma of the breast?].

PMID- 1630695
TI  - [Simvastatin in the treatment of hypercholesterolemia in the aged. An
      epidemiological and clinical study].
AB  - The paper review the literature on the subject and underlines the importance of
      hypercholesterolemia. It also reports the findings of the large trials, works and
      consensus studies, including the results of the Framingham Study, the Lipidic
      Research Clinics Program and the main international conferences. On the basis of
      these findings, it assesses the hypocholesterolemic effect of simvastatin in a
      sample group of 51 mainly geriatric outpatients following a standard period of
      preliminary dietary therapy. Subjects were treated with 20 mh/day simvastatin for
      not less than one month, after which lipidic parameters were evaluated and
      revealed significant variations: circulating cholesterin was reduced from 322 mg%
      +/- 49.4 to 225 mg% +/- 37.6 (p less than 0.001), the LDL-lipoprotein level fell
      from 229 mg% +/- 6.6 to 152 mg% +/- 36.3; HDL-lipoproteins showed no significant
      variation, nor did other tests to ascertain possible hepatic involvement or other
      parenchymas secondary to the use of simvastatin. Overall cholesterol levels
      decreased from 16423 mg% to 11511 mg%, equivalent to 29.9%. Lastly, simvastatin
      also proved to be clinical efficacious, and was easy to manage and well tolerated
      by elderly patients. All subjects responded equally well to treatment independent
      of their general condition and sex. Basal cholesterolemia in elderly subjects
      decreased from 320 mg% +/- 46.3 to 226 mg% +/- 33.2 (p less than 0.001) and in
      adults from 325 mg% +/- 56.6 to 224 mg% +/- 46.5 (p less than 0.001); LDL
      cholesterol decreased from 232 mg% +/- 46.5 to 153 mg% +/- 35.6 (p less than
      0.001) and from 224 mg% +/- 46.6 to 147 mg% +/- 38.7 (p less than 0.001)
      respectively.

PMID- 1630696
TI  - [Effects of fenoverine on biliary kinetics evaluated by hepatobiliary
      scintigraphy with 99mTc-Br-IDA].
AB  - Hepatobiliary scintigraphy was used to evaluate the action of fenoverine in 16
      patients suffering from dyskinesia of the biliary tract; the drug was
      administered in doses of 300 mg per day per os for 20 days, the patients being
      subjected to hepatobiliary scintigraphy before and after treatment. The following
      parameters--accurate indicators of the motor coordination of the biliary tract-
      were evaluated: tracer appearance time in the gallbladder (Tc) and in the
      intestine (Ti). After treatment there was a normalization of these two parameters
      which initially were extended. Statistical analysis showed a highly significant
      reduction in these times. Stress is laid on the importance of hepatobiliary
      scintigraphy in the diagnosis of biliary dyskinesia and on the effectiveness of
      fenoverine in the treatment of this conditions.

PMID- 1630697
TI  - [Antibiotic prophylaxis with aztreonam in general surgery].
AB  - Personal experience in peroperative antibiotic prophylaxis with aztreonam
      (Azactam) in 81 patients undergoing abdominal surgery of choice is reported. The
      usefulness, handiness and lack of side-effects of this parenteral drug are
      reiterated. The incidence of surgical wound infections was 2.5%, while that of
      associated infections was 6.1%. Considering these results, the use of aztreonam
      (Azctam) is recommended in peroperative prophylaxis as a drug of choice.

PMID- 1630698
TI  - [Acute renal failure caused by treatment with diuretics and ACE inhibitors in the
      absence of renal artery stenosis].
AB  - The Authors describe a clinical case of a patient affected by arterial
      hypertension of severe degree (IV grade OMS) that during therapy with ACE
      inhibitors and diuretics developed acute renal failure that reversed after
      stopping treatment. The clinical course was quite similar to acute renal failure
      induced by ACE inhibitors and diuretics in patient with bilateral renal artery
      stenosis. In interpreting the pathogenesis, the Authors suppose, beside a
      reductions of effective plasma flow, the coexistence of hyalinosis of renal
      arterioles. They underline the necessity of monitoring renal function at least in
      the first weeks of therapy when a treatment with ACE inhibitors and diuretics is
      started especially in patients with hypertension of high degree and/or reduced
      renal function.

PMID- 1630699
TI  - [Partial remission of non-Hodgkin's lymphoma (stage IV-B) following
      immunostimulating therapy with thymopentin].
AB  - Therapy of low-grade of malignancy non-Hodgkin's lymphoma in an advanced stage is
      still under discussion: aggressive poly-chemotherapies, such as radiotherapy and
      conventional chemotherapies did not prove to be more effective than conservative
      treatments. We report the case of a woman suffering from a low-grade of
      malignancy non-Hodgkin's lymphoma (stage IV-B). She was in such bad general
      conditions that she could not be treated with chemotherapy. She received an
      immunostimulating drug, thymopentin for 10 months. After this treatment, the
      general condition of the patient was improved and a partial remission of the
      lymphoproliferative disease was observed. The patient is still in constant fairly
      good health.

PMID- 1630700
TI  - [Castleman's disease. A clinical case].
AB  - Castleman's disease is an uncommon lymph node syndrome. It is usually a lymphoid
      hamartoma, rarely systemic. We report a case of Castleman's multicentric disease
      observed in our hospital and review the literature. In this work we review
      prognosis, follow-up and therapy of 46 multicentric disease reported in the
      literature.

PMID- 1630701
TI  - [Cardiotoxicity caused by radiation. Description of 2 clinical cases].
AB  - The paper reports two cases of valvular cardiac lesions and pericardial effusion
      caused by radiation. The widespread use of radiotherapy makes this a highly
      relevant problem. Radiation most frequently causes damage to the pericardium
      leading to pericardial effusion, and in some cases provokes myocardial, valvular
      and coronary lesions and even myocardial infarction. Cardiotoxicity depends on
      the radiation dose which must generally exceed 40 Gy. Radiated patients must be
      carefully monitored so as to diagnose cardiac lesions at an early stage. The
      ongoing improvement of radiotherapy techniques is the best means of preventing
      cardiac damage due to radiotherapy.

PMID- 1630702
TI  - [Acute renal damage caused by ampicillin. Description of a case].
AB  - Approximately one week after a cycle of antibiotic therapy using ampicillin for
      pulmonary inflammation, an 82-year-old woman developed symptoms of acute renal
      insufficiency reminiscent of nephrotic syndrome. Symptoms were completely
      reversible and normal renal function was recovered (even after 14 months of
      follow-up). The Authors conclude by attributing this to acute tubulo-interstitial
      nephropathy due to hypersensitivity to ampicillin.

PMID- 1630703
TI  - [Zieve syndrome. Description of a clinical case].

PMID- 1630704
TI  - [Churg-Strauss vasculitis in a 53-year-old man].
AB  - The Authors describe a 53 year old patient, who, after suffering from asthma over
      the past 10 years, presented with abdominal pain, diarrhoea, dyspnea, petechias
      on lower limbs, and subsequently developed fever, polyneuritis, pericardial
      effusion and renal failure. Laboratory showed elevated IgE, presence of
      antinuclear antibodies to DNA, serum rheumatoid factor and peripheral
      eosinophilia. The clinical course was suggestive for systemic vasculitis; lung,
      skin biopsies and renal angiography confirmed this diagnosis: the association
      with asthma and eosinophilia fulfill the diagnosis of allergic angiitis and
      granulomatosis (Churg-Strauss syndrome).

PMID- 1630705
TI  - CHAP: America's most achievable health care reform.

PMID- 1630706
TI  - Gestures of dominance, gestures of defiance.

PMID- 1630707
TI  - Managed care, Democrats' health reform, and nursing reimbursement.

PMID- 1630708
TI  - AIDS--sole cause or cofactors?

PMID- 1630709
TI  - Deemed status for CHAP. A new standard for health care.
AB  - The board chair of the Community Health Accreditation Program (CHAP) reflects on
      the implications of federal recognition of CHAP. In challenging the status quo,
      CHAP has shown that a voluntary, consumer-based alternative can protect the
      public and promote excellence.

PMID- 1630710
TI  - CHAP: nursing's legacy of leadership.
AB  - In the story of CHAP's fight for deemed status, Mitchell, CHAP's president, finds
      important opportunities for nursing to exert moral leadership and initiate
      political reforms that will have a lasting impact on the quality of community
      based care.

PMID- 1630711
TI  - Teaching health care public policy.

PMID- 1630713
TI  - General nursing education. Prerequisite to midwifery.

PMID- 1630712
TI  - The persuasive proposal. A reviewer's perspective.

PMID- 1630714
TI  - "Alternative provider" ... a way of referring to nurses ... offering primary care
      services.

PMID- 1630715
TI  - Community health nurse: canary in a mine shaft?

PMID- 1630716
TI  - CRNA credentials overlooked.

PMID- 1630717
TI  - Weaning recommendations: the scientific basis.
AB  - Current weaning recommendations are based on nutritional need, physiologic
      maturation, and the behavioral and developmental aspects of infant feeding.
      Inadequate energy and protein intake and deficiencies of iron, zinc, vitamin A,
      and vitamin D are the most commonly observed nutrient deficiencies during infancy
      and weaning recommendations have focused on their prevention. This article
      reviews the data and summarizes implications for infant weaning in both developed
      and developing countries. Current published recommendations for infant feeding
      are outlined and major concerns are highlighted.

PMID- 1630719
TI  - Vitamin D and psoriasis.
AB  - Skin can serve as the source of vitamin D when exposed to sunlight so that
      cutaneous 7-dehydrocholesterol can be converted to the vitamin. Skin is also a
      target organ for the hormone form of vitamin D: 1,25-(OH)2D3. Both skin
      keratinocytes grown in tissue culture and samples of human skin have the nuclear
      receptor for 1,25(OH)2D3. New results suggest that this hormone or its analogs
      may be effective in treating some forms of psoriasis.

PMID- 1630718
TI  - Treatment of iron-deficiency anemia complicated by scurvy and folic acid
      deficiency.
AB  - We present a case of a child with iron-deficiency anemia, folic acid deficiency,
      and scurvy. His anemia proved refractory to treatment with iron until he received
      both folic acid and vitamin C supplementation. This case illustrates the
      importance of the evaluation of ascorbic acid and folate status in treating iron
      deficiency anemia initially refractory to iron supplementation, because multiple
      nutrient deficiencies may coexist.

PMID- 1630720
TI  - Acetyl-carnitine and Alzheimer's disease.

PMID- 1630721
TI  - Supplemental dietary potassium reduced the need for antihypertensive drug
      therapy.

PMID- 1630722
TI  - Vitamin B6 and immune function in the elderly and HIV-seropositive subjects.
AB  - Vitamin B6 plays an important role in immune response. A recent investigation of
      healthy elderly subjects in a vitamin B6 depletion-repletion study indicates that
      B6 deficiency impairs interleukin-2 production and lymphocyte proliferation.
      Another study in HIV-1-infected patients found impaired immune responsiveness in
      patients with compromised vitamin B6 status.

PMID- 1630723
TI  - Health claims on foods: American style.

PMID- 1630724
TI  - Health claims: omega-3 fatty acids and cardiovascular disease.

PMID- 1630725
TI  - The homocysteine theory of arteriosclerosis.

PMID- 1630726
TI  - Mechanisms of stress: a dynamic overview of hormonal and behavioral homeostasis.
AB  - Environmental events, both physical and emotional, can produce stress reactions
      to widely varying degrees. Stress can affect many aspects of physiology, and
      levels of stress, emotional status, and means of coping with stress can influence
      health and disease. The stress system consists of brain elements, of which the
      main components are the corticotropin-releasing hormone (CRH) and locus ceruleus
      (LC)-norepinephrine (NE)/autonomic systems, as well as their peripheral
      effectors, the pituitary-adrenal axis and the autonomic system, which function to
      coordinate the stress response. Activation of the stress system results in
      behavioral and physical changes which allow the organism to adapt. This system is
      closely integrated with other central nervous system elements involved in the
      regulation of behavior and emotion, in addition to the axes responsible for
      reproduction, growth and immunity. With current trends in stress research which
      focus on understanding the mechanisms through which the stress-response is
      adaptive or becomes maladaptive, there is a growing association of stress system
      dysfunction, characterized by hyperactivity and/or hypoactivity to various
      pathophysiological states. The purpose of this review is to 1) define the
      concepts of stress and the stress response from a historical perspective, 2)
      present a dynamic overview of the biobehavioral mechanisms that participate in
      the stress response, and 3) examine the consequences of stress on the physiologic
      and behavioral well-being of the organism by integrating knowledge from
      apparently disparate fields of science.

PMID- 1630727
TI  - Oxytocin and sexual behavior.
AB  - The neurohypophyseal hormone oxytocin has been implicated in many aspects of
      reproduction including sexual behavior. This review considers the hypotheses that
      oxytocin and/or the neural events surrounding the release of oxytocin may have
      behavioral effects during sexual arousal, orgasm, sexual satiety and other
      aspects of sociosexual interactions.

PMID- 1630728
TI  - Biochemical correlates for behavioral deficits induced by secalonic acid D in
      developing mice.
AB  - Humoral signals (neurotransmitters and hormones) control cell division,
      migration, and differentiation processes which define the organization of brain
      pathways. Alterations in maternal, fetal, and neonatal biochemistry during
      critical periods of neurogenesis may irreparably alter the circuitry and, thus,
      postnatal behavior of young animals. Secalonic acid D (SAD), an ergochrome
      mycotoxin, causes behavioral and neurochemical deficits in developing mice
      following prenatal (transplacental) or early postnatal (transmammary) exposure.
      SAD-induced functional abnormalities include delays in reflex behaviors,
      integrated neuromuscular activity and strength, stress adaptation responses, and
      sensory discrimination. These behavioral changes are associated with reductions
      of brain monoamine neurotransmitter levels in both fetuses and neonates. SAD also
      alters concentrations of maternal plasma corticosteroids and fetal cyclic
      nucleotides during midgestation. SAD thus modulates several chemicals in pregnant
      mice and their fetuses which contribute to brain development, suggesting that
      this mycotoxin may pose a neuroteratogenic hazard to other immature mammals,
      including human infants.

PMID- 1630729
TI  - Hormone-dependent aggression in male and female rats: experiential, hormonal, and
      neural foundations.
AB  - Hormone-dependent aggression in both male and female rats includes the
      distinctive behavioral characteristics of piloerection and lateral attack. In
      males the aggression is dependent on testicular testosterone and is commonly
      known as intermale aggression. In females, the aggression is most commonly
      observed as maternal aggression and is dependent on hormones whose identity is
      only beginning to emerge. The present review examines the experiential events
      which activate hormone-dependent aggression, the relation of the aggression to
      gonadal hormones, and the neural structures that participate in its modulation.
      In males and females, the aggression is activated by cohabitation with a
      conspecific of the opposite sex, by competitive experience, and by repeated
      exposure to unfamiliar conspecifics. In the female, the presence of pups also
      activates aggression. In both males and females, hormones are necessary for the
      full manifestation of the aggression. The essential hormone appears to be
      testosterone in males and a combination of testosterone and estradiol in females.
      The information available suggests the neural control systems for hormone
      dependent aggression may be similar in males and females. It is argued that
      hormone-dependent aggression is behaviorally and biologically homologous in male
      and female rats.

PMID- 1630730
TI  - Do essential fatty acids play a role in brain and behavioral development?
AB  - The membrane phospholipids of the brain contain high levels of polyunsaturated
      fatty acids (PUFA), particularly arachidonic acid, 20:4n-6 and docosahexaenoic
      acid, 22:6n-3. These long-chain PUFA are synthesized from their respective
      essential fatty acid (EFA) precursors, linoleic acid, 18:2n-6 and linolenic acid,
      18:3n-3. Although the necessity of n-6 fatty acids for optimum growth has been
      established, a similar requirement for those of the n-3 family is less clear. The
      rapid accumulation of the long-chain n-3 PUFA in the brain during prenatal and
      preweaning development suggests that the provision of n-3 fatty acids to the
      developing brain may be necessary for normal growth and functional development.
      The intent of this review is to assess the experimental work which addresses this
      question, most of which has been conducted on rodents. The emphasis will be on
      studies which measure behavioral outcomes, and particular attention will be paid
      to methodological issues which affect the interpretation of these data. An
      integration of the research findings will be presented and discussed in light of
      possible implications for therapeutic interventions.

PMID- 1630731
TI  - The borderline hypertensive rat (BHR) as a model for environmentally-induced
      hypertension: a review and update.
AB  - In recent years, the burgeoning disciplines of health psychology and behavioral
      medicine have renewed interest in the important role that environmental factors
      can play in the disease process. Nowhere is this concern more well-founded than
      in the area of cardiovascular disorders, particularly hypertension.
      Epidemiologists and clinicians have long suspected that stressful life events can
      be a sufficient trigger for the expression of hypertension in some individuals.
      To understand better the ways in which these variables interact in the disease
      process, researchers have tried, with limited success, to produce experimental
      hypertension in animals by exposing them to stressful environmental paradigms.
      Additionally, recent investigations using the borderline hypertensive rat (BHR)
      have demonstrated the important role genetic factors can play in mediating both
      the behavioral and cardiovascular responses to environmental stressors. The
      current paper will review these attempts and discuss recent data from experiments
      using a relatively new animal model that appears to be especially appropriate for
      the study of environmental-genetic factors in the elaboration of essential
      hypertension. We will also discuss potential mechanisms by which environmental
      stress influences arterial pressure and suggest avenues for further inquiry into
      the stress-disease relationship.

PMID- 1630732
TI  - Genetic hypertension and increased susceptibility to cerebral ischemia.
AB  - A review of the sensitivity of genetically hypertensive rats to cerebral ischemia
      was presented together with original data describing the systematic comparison of
      the effects of focal ischemia (permanent and temporary with reperfusion)
      performed in hypertensive and normotensive rats (i.e., blood pressures verified
      in conscious instrumented rats). Microsurgical techniques were used to isolate
      and occlude the middle cerebral artery (MCAO) of spontaneously hypertensive
      (SHR), Sprague-Dawley (SD) and Wistar Kyoto (WKY) rats at the level of the
      inferior cerebral vein. Following permanent (24 h) MCAO, persistent and similar
      decreases in local microvascular perfusion (i.e., to 15.6 +/- 1.7% of pre-MCAO
      levels) were verified in the primary ischemic zone of the cortex for all strains
      using Laser-Doppler flowmetry. A contralateral hemiplegia that occurred following
      MCAO, evidenced by forelimb flexion and muscle weakness, was greater in SHR
      (neurological grade = 2.0 +/- 0.1) than SD (1.0 +/- 0.4) or WKY (0.7 +/- 0.4)
      rats (N = 7-9, p less than 0.05). SHR also exhibited sensory motor deficits
      following MCAO compared to sham-operation, with decreased normal placement
      response of the hindlimb (% normal = 20 vs. 83, N = 23-30, p decreased rota-rod
      (41 +/- 7 vs. 126 +/- 19 on rod, N = 10-15, p less than 0.05) and balance beam
      (25 +/- 5 vs. 116 +/- 29 s on beam, N = 5-7, p less than 0.05) performance.
      However, an index of general motor activity was not affected by permanent MCAO.
      Triphenyltetrazolium-stained forebrain tissue analyzed by planimetry revealed a
      significantly larger and more consistent cortical infarction in SHR (hemispheric
      infarction = 27.9 +/- 1.5%) compared to SD (15.4 +/- 4.1%) and WKY (4.0 +/- 2.4%)
      rats (N = 7-9, p less than 0.05), occupying predominantly the frontal and
      parietal areas. Also, a significant degree of ipsilateral hemispheric swelling
      (4.6 +/- 0.9%, N = 7-9, p less than 0.05) and increased brain water content (78.4
      +/- 0.3% to 80.4 +/- 0.2%, N = 8-9, p less than 0.05) was identified in SHR that
      was not observed in SD or WKY rats. A novel model of temporary MCAO also was
      evaluated in the hypertensive and normotensive rat strains. Initially, the effect
      of increasing MCAO-time followed by 24 h reperfusion in SHR was studied. During
      temporary MCAO (20 to 300 min), persistent and stable decreases in local
      microvascular perfusion (i.e., to 15-20% of pre-MCAO levels) were verified in the
      primary ischemic zones of the cortex.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1630734
TI  - Premature rupture of membranes.

PMID- 1630733
TI  - Metabolic fuels and reproduction in female mammals.
AB  - A complete reproductive cycle of ovulation, conception, pregnancy, and lactation
      is one of the most energetically expensive activities that a female mammal can
      undertake. A reproductive attempt at a time when calories are not sufficiently
      available can result in a reduced return on the maternal energetic investment or
      even in the death of the mother and her offspring. Numerous physiological and
      behavioral mechanisms link reproduction and energy metabolism. Reproductive
      attempts may be interrupted or deferred when food is scarce or when other
      physiological processes, such as thermoregulation or fattening, make
      extraordinary energetic demands. Food deprivation suppresses both ovulation and
      estrous behavior. The neural mechanisms controlling pulsatile release of
      gonadotropin-releasing hormone (GnRH) and, consequently, luteinizing hormone
      secretion and ovarian function appear to respond to minute-to-minute changes in
      the availability of metabolic fuels. It is not clear whether GnRH-secreting
      neurons are able to detect the availability of metabolic fuels directly or
      whether this information is relayed from detectors elsewhere in the brain.
      Although pregnancy is less affected by fuel availability, both lactational
      performance and maternal behaviors are highly responsive to the energy supply.
      When a reproductive attempt is made, changes in hormone secretion have dramatic
      effects on the partitioning and utilization of metabolic fuels. During ovulatory
      cycles and pregnancy, the ovarian steroids, estradiol and progesterone, induce
      coordinated changes in the procurement, ingestion, metabolism, storage, and
      expenditure of metabolic fuels. Estradiol can act in the brain to alter
      regulatory behaviors, such as food intake and voluntary exercise, as well as
      adenohypophyseal and autonomic outputs. At the same time, ovarian hormones act on
      peripheral tissues such as adipose tissue, muscle, and liver to influence the
      metabolism, partitioning and storage of metabolic fuels. During lactation, the
      peptide hormones, prolactin and growth hormone, rather than estradiol and
      progesterone, are the principal hormones controlling partitioning and utilization
      of metabolic fuels. The interactions between metabolic fuels and reproduction are
      reciprocal, redundant, and ubiquitous; both behaviors and physiological processes
      play vital roles. Although there are species differences in the particular
      physiological and behavioral mechanisms mediating nutrition-reproduction
      interactions, two findings are consistent across species: 1) Reproductive
      physiology and behaviors are sensitive to the availability of oxidizable
      metabolic fuels. 2) When reproductive attempts are made, ovarian hormones play a
      major role in the changes in ingestion, partitioning, and utilization of
      metabolic fuels.

PMID- 1630735
TI  - Introduction to premature rupture of membranes.
AB  - PROM is associated with controversies in diagnosis, management, and prognosis.
      The lack of a gold standard to confirm PROM makes it difficult to determine which
      diagnostic tool is the best and most reliable. It appears that the older methods
      of confirming PROM, which depend on properties inherent to amniotic fluid, are
      the best tools available today: ferning and nitrazine combined with patient
      history.

PMID- 1630736
TI  - Etiology of preterm premature rupture of membranes.
AB  - Numerous factors have been indicted as playing a role in causing preterm
      premature rupture of membranes (PPROM). After discussing the development of the
      amnion and chorion, this article focuses primarily on the effects that infection,
      nutrition, smoking, and cervical incompetence have on the fetal membrane and the
      subsequent advent of PPROM. However, evidence continues to support a
      multifactorial etiology for this entity, with numerous factors acting in concert.

PMID- 1630737
TI  - Neonatal morbidity and mortality secondary to premature rupture of membranes.
AB  - PROM is one of the most common complications of pregnancy that has a major impact
      on neonatal mortality and morbidity. The occurrence of PROM is either directly or
      indirectly responsible for a large number of premature births and the concomitant
      mortality and morbidity associated with preterm delivery. PROM turns a pregnancy
      into a high-risk situation and increases the need for neonatal resuscitation in
      the delivery room. The incidence of neonatal sepsis increases with PROM, but the
      overall outcome of the neonate, even with surfactant therapy, is still primarily
      dependent on the gestational age at the time of delivery. This is most relevant
      between 24 and 27 weeks' gestation. During this 3-week interval, survival
      improves by almost 2% for each additional day of in utero maturation (i.e., from
      35 to 75%). Thus the benefit to the fetus of prolonging the pregnancy in cases of
      PROM is immensely worthwhile and should be aggressively pursued as long as there
      is no significant increase in maternal morbidity.

PMID- 1630739
TI  - Expectant and active management of preterm premature rupture of membranes.
AB  - Optimal management of PPROM remains controversial. Expectant management is a
      viable alternative only if there is no evidence of infection, advanced labor, or
      fetal distress. In these cases, aggressive intervention is appropriate,
      regardless of gestational age. The goal of expectant management is the
      achievement of increased gestational age at the time of delivery, given the
      tremendous potential advantage to be gained during the period between 26 and 34
      weeks' gestation, an interval during which perinatal mortality decreases sharply.
      The potential value of corticosteroids and prophylactic antibiotics is discussed
      elsewhere in this issue. The power limitations of the previous studies, which
      considered amniocentesis and tocolytic therapy, preclude firm conclusions and
      enthusiastic recommendation for their routine inclusion in the expectant
      management of PPROM.

PMID- 1630738
TI  - Tests of fetal well-being in premature rupture of membranes.
AB  - In summarizing the published data on the use of amniocentesis and fetal
      biophysical assessment in managing patients with PROM the following conclusions
      may be drawn: 1. Both amniocentesis and fetal biophysical assessment are
      reasonably good methods to predict the fetus who is doing well and could
      therefore safely remain in utero, as well as the fetus who is at high risk for
      developing sepsis and therefore in need of delivery. 2. Consideration of routine
      transabdominal amniocentesis for Gram stain and cultures in patients with PROM is
      reasonable. Measurements of glucose levels, esterase activity, or cytokines are
      only investigational, and their use in patient management cannot be advocated at
      this time. 3. Although there are no prospective controlled randomized trials to
      prove improved pregnancy outcome by the use of either amniocentesis or frequent
      biophysical assessment, nonrandomized comparative trials as well as trials using
      historic controls suggest that the use of either or both techniques in
      combination may be beneficial in managing PROM.

PMID- 1630740
TI  - Corticosteroids after preterm premature rupture of membranes.
AB  - A review of all relevant randomized controlled trials provides strong evidence
      that corticosteroid therapy causes a significant reduction in respiratory
      distress syndrome (RDS) in preterm babies overall. This reduction in RDS is
      accompanied by a reduced incidence of neonatal death, intraventricular
      hemorrhages, and necrotizing enterocolitis. These benefits are also seen in cases
      of PROM. Corticosteroid therapy in PROM is associated with a trend toward an
      increase in neonatal infection.

PMID- 1630742
TI  - Management of premature rupture of membranes before 26 weeks' gestation.
AB  - PROM occurring before 26 weeks' gestation is associated with significant maternal
      morbidity as well as neonatal morbidity and mortality. With aggressive expectant
      management, neonatal survival can be predicted for a 23% and 54% incidence of
      patients with PROM at or less than 22 weeks' and 23 to 26 weeks' gestation,
      respectively. Of those neonates who survive, 55% to 69% will be neurologically
      intact on long-term follow-up. Conservative management leading to prolonged
      latency provides the neonate with the greatest potential for survival as outcome
      generally reflects the gestational age at birth. However, lethal pulmonary
      hypoplasia may occur with prolonged leakage and oligohydramnios. The patient who
      wishes to pursue a course of expectant management should be monitored closely for
      signs of infection and labor. Expectant management should be undertaken in a
      facility with resources capable of caring for the mother at risk of significant
      morbidity and the very low birth weight neonate. Ongoing counseling and
      psychologic support are essential in the management of this morbid pregnancy
      complication.

PMID- 1630741
TI  - Use of antibiotics for preterm premature rupture of membranes. Rationales and
      results.
AB  - PPROM is directly associated with 30% to 40% of preterm births. Reproductive
      tract infection, inflammation, or both may be primary causes or occur secondarily
      after PPROM and hasten the onset of labor. Recent carefully controlled trials
      demonstrate that antibiotic treatment (erythromycin, ampicillin) can
      significantly lengthen the "beneficial latency period" and reduce perinatal and
      maternal morbidity, as well as the costs.

PMID- 1630743
TI  - Management of premature rupture of membranes at term.
AB  - Although prelabor rupture of membranes at term is common, in most cases, the
      spontaneous onset of labor relieves the obstetrician of the need for making
      management decisions. The standard practice in the United States has been to
      induce labor with intravenous oxytocin in that minority of patients who fail to
      labor spontaneously. Controlled trials suggest that this practice is associated
      with higher rates of both chorioamnionitis and the need for cesarean delivery
      than is expectancy. Expectancy, however, has not been demonstrated to be safer
      for the perinate.

PMID- 1630744
TI  - New technologies for the management of preterm premature rupture of membranes.
AB  - The catheterization described is still incomplete, posing many problems yet to be
      solved. However, this method has shed light on new issues, including the
      intraamniotic administration of antibiotics against amniotic fluid infection and
      fetal infection, amnioinfusion of saline for oligohydramnios, and development of
      artificial amniotic fluid. These issues are much easier than the nursing of
      extremely small premature babies and should be solved by the collective wisdom of
      obstetricians.

PMID- 1630745
TI  - Antenatal care of the patient with previous preterm premature rupture of
      membranes.
AB  - Although there is a 21% recurrence risk for PPROM, little research has been
      directed to the obstetric management of women with prior PPROM. This article
      reviews indirect information regarding risk assessment, diet, lifestyle factors,
      and infections. A management plan is suggested.

PMID- 1630747
TI  - Avoiding litigation. Oral surgery in the 1990s.

PMID- 1630748
TI  - Oral surgery. From dark beginnings to a bright future.

PMID- 1630746
TI  - Pulmonary hypoplasia and deformations related to premature rupture of membranes.
AB  - In summary, fetal pulmonary development occurs in three phases. Hypoplasia
      results when an interruption occurs in or before the canalicular stage. Factors
      necessary for normal lung growth include sustained adequate amniotic fluid volume
      and normal fetal breathing movements. Pulmonary hypoplasia is most likely to
      occur with a very early rupture of membranes (less than 22 weeks) and with
      persistent oligohydramnios. Lack of sustained breathing movements and failure of
      modulation of ductal flow are strongly associated. Ultrasound measurement of
      fetal lung length may eventually be useful in monitoring intrauterine pulmonary
      development. Limb contractures resulting from prolonged oligohydramnios are
      examples of deformation-type defects. Their presence correlates most strongly
      with the length of the latent period (time from ROM to delivery) and the degree
      of oligohydramnios. Most contractures of this type are readily reversible. Early
      amnion rupture sequence, presumed to result from rupture of only the amnion in
      the first trimester, is associated with multiple severe fetal deformations. It
      usually occurs sporadically, with a minimal recurrence risk.

PMID- 1630749
TI  - Servicing the underserviced. A history of dental public health in Ontario.

PMID- 1630750
TI  - The rights of children to accept or refuse dental care.

PMID- 1630751
TI  - The treatment of enamel lesions. A CINOT perspective.

PMID- 1630752
TI  - Periodontal treatment planning. The influence of osseointegrated dental implants.

PMID- 1630753
TI  - Mucogingival considerations in orthodontics.

PMID- 1630754
TI  - Chronicles of dentistry. A former editor recalls his days at the journal's helm.

PMID- 1630756
TI  - Dentistry in the 1990s. Observations and options for the future.

PMID- 1630755
TI  - Dr. George Van Nest Relyea and the founding of the Ontario Dental Association.

PMID- 1630758
TI  - Digital diagnosis and disposable dam clamps. A look at technological advances in
      endodontics.

PMID- 1630757
TI  - Current developments in the filling of root canals.

PMID- 1630759
TI  - Corneal edema induced by cold.
AB  - We report on a patient, who regularly developed reversible corneal edema of the
      right eye after cold stress. Cycling tours in cold weather and windy conditions
      seemed to precipitate the edema. After a provocation test, we also observed
      transient, corneal edema. A few reports in the literature suggested that
      Raynaud's disease or trigeminal neuropathy might be responsible for cold-induced
      corneal opacification. None of these conditions was present in our patient, as
      proved by laboratory tests and magnetic resonance imaging. We found that contact
      lenses were an effective prophylaxis against corneal edema.

PMID- 1630760
TI  - Cilioretinal arteries in conjunction with a pit of the optic disc.
AB  - Cilioretinal arteries were noted to accompany pits of the optic disc in 16 of 25
      cases (64%). Fourteen of the 16 cases were found to have 2 cilioretinal arteries
      (86%). The cilioretinal arteries were directly related to the pit of the disc and
      emerged either from the bottom or the margin of the pit in a proportion of 86%.
      This finding reinforces the assumption that the optic disc pit belongs to the
      same spectrum of congenital anomalies which also includes optic disc coloboma,
      megalopapilla and morning glory syndrome. A fluorescein angiography study showed
      hyperfluorescence of the pit in 12/16 cases and in particular in all the cases in
      which both cilioretinal arteries emerged from the pit. Hypofluorescence was noted
      in 7/9 cases in which the pit was not associated with cilioretinal arteries. Our
      findings could support the view that hyperfluorescence of the pit, which is not a
      constant phenomenon, mostly depends on the presence of cilioretinal arteries
      emerging from the pit.

PMID- 1630761
TI  - Surgical techniques and visual prognosis in retinal detachment due to macular
      hole.
AB  - In 250 eyes with retinal detachment due to macular hole, the visual prognosis of
      each surgical technique was evaluated. (1) Macular diathermy adversely affected
      the visual prognosis. (2) Macular buckling+macular diathermy produced a poorer
      visual prognosis than macular buckling alone. (3) The visual prognosis resulting
      from gas tamponade alone or vitrectomy+gas tamponade was better than that
      resulting from macular diathermy. It is not clear whether there is a significant
      difference in visual prognosis between gas tamponade alone and vitrectomy+gas
      tamponade. (4) Macular laser photocoagulation does not adversely affect the
      visual prognosis. Judging from these results, gas tamponade, which has the
      possibility of better visual prognosis and less operation stress, should be
      selected as the initial technique.

PMID- 1630762
TI  - The pupillary light reflex. 1. Age-dependent and age-independent parameters in
      normal subjects.
AB  - A hundred and three normal subjects (14-75 years old) were examined with a
      modified infrared TV videopupillometer that had previously been developed.
      Maximal pupillary diameter (p less than 0.00001), pupillary diameter in percent
      of iris diameter (p less than 0.00001), maximal pupillary area (p less than
      0.00001), latency time of the light reflex (p less than 0.00001), maximal
      contraction velocity (p less than 0.00002), contraction velocity at 1 s (p less
      than 0.00001) and dilatation velocity at 6 s (p less than 0.0001) are strongly
      age dependent. A statistical formula is given to allow the calculation of the
      exact percentile for every parameter. Parameters which are age independent if
      they are expressed in percent of the maximal pupillary area are contraction
      velocity at 1 s (r = 0.042, p = 0.68) and dilatation velocity at 6 s (r = -0.150,
      p = 0.13). They can be used if age-matched study groups are not available.
      Furthermore, it is shown that most parameters of the pupillary light reflex
      correlate significantly with each other. The highest correlations are found with
      the maximal pupillary area. Differences between sexes are not evident. It is
      thought that this infrared videopupillometry and the given data base are useful
      for further clinical studies to investigate the autonomic nervous system.

PMID- 1630763
TI  - The pupillary light reflex. 2. Prevalence of pupillary autonomic neuropathy in
      diabetics using age-dependent and age-independent pupillary parameters.
AB  - Seventy-seven diabetics with a duration of the disease ranging from 2 to 55 years
      (average 18.5 years) were studied with infrared videopupillometry. The prevalence
      of diabetic autonomic neuropathy at the pupillary control system (pANP) was
      studied comparatively using several pupillary tests. The average prevalence using
      age-dependent parameters was 30.2% [maximal pupillary area: 22.1%, maximal
      contraction velocity: 24.7%, contraction velocity at 1 s (CV1): 28.6%, and
      dilation velocity at 6 s (DV6): 45.5%]. Comparing these percentages to
      prevalences of other diabetic late complications, e.g. retinopathy (49.4%), DV6
      seems to be good for the diagnosis of pANP. If CV1 and DV6 are expressed in
      percent of the maximal pupillary area (CV1% and DV6%), they become age
      independent. The average CV1% and DV6% of diabetics differ highly significantly
      from those of normals (CV1%: 58.6 +/- 14.5 vs. 64.1 +/- 6.4%, 2 p less than
      0.005, and DV6%: 6.0 +/- 2.9 vs. 7.3 +/- 1.1%, 2 p less than 0.001). The average
      prevalence of pANP using these age-independent parameters was 25.4%. These data
      suggest that the prevalence of pANP, especially disorders of pupillary dilation
      (DV6), is high in long-standing diabetes. Furthermore, CV1% and DV6% have proved
      to be valid parameters in finding differences in the light reflex in non-age
      matched study groups.

PMID- 1630764
TI  - C wave of electroretinogram and visual evoked response in optic neuritis due to
      demyelinating diseases.
AB  - In 21 consecutive cases with unilateral optic neuritis due to demyelinating
      disease, ERG, C wave of ERG and VER were recorded and studied in both eyes. Also
      8 cases suffering from optic atrophy due to trauma or glaucoma were included. The
      analysis of data shows that the C-wave is significantly diminished in both eyes,
      namely the affected and the sound, in the cases of optic neuritis. Also in
      comparison to VER, C wave has a comparative probability in diagnosing optic
      neuritis due to demyelinating disease. The C wave of ERG is normal in the cases
      of optic atrophy. The mechanism of C wave involvement during the course of
      demyelinating disease may be related with an abnormality of the ionic homeostasis
      of the subretinal space.

PMID- 1630765
TI  - Effects of elastase on cultured human trabecular meshwork.
AB  - We evaluated the effect of elastase, a proteolytic enzyme, on the endothelial
      meshwork of cultured human trabecular meshwork using a solid agar method. The
      tissues were obtained from 3 postmortem eyes, aged 64, 71 and 77 years. Elastase
      was added to the culture medium for 24 h at a concentration of 1 x 10(-1)-10(-4)
      mg/ml. The cultured specimens were then processed for transmission electron
      microscopy. We evaluated the electron micrographs to determine the percent area
      occupied by the cells and the extracellular materials and by the empty space in
      the endothelial meshwork using computer-assisted morphometry. A statistically
      significant decrease in extracellular materials with intact trabecular cells was
      confirmed 24 h following the administration of elastase at the concentration of 1
      x 10(-1)-10(-3) mg/ml.

PMID- 1630766
TI  - Xanthogranuloma juvenile--a rare cause of orbital swelling in adulthood.
AB  - Juvenile xanthogranuloma, a non-Langerhans-type benign proliferation, in
      adulthood is a rare condition. This article reports the second known case in the
      western literature of solitary orbital involvement. The diagnosis was confirmed
      by orbital biopsy, and symptoms were dramatically relieved by corticoids,
      although a relapse occurred after their withdrawal. The importance of
      differentiating benign conditions from malignancies is discussed.

PMID- 1630767
TI  - Beta irradiation of pterygium.

PMID- 1630768
TI  - Zinc supplements: are there ophthalmologic indications?

PMID- 1630769
TI  - Beta irradiation of pterygium.

PMID- 1630770
TI  - Treatment of rheumatoid corneal ulcers.

PMID- 1630771
TI  - Vision screening and children's access to eye care.

PMID- 1630772
TI  - Results of inpatient and outpatient cataract surgery. A historical cohort
      comparison.
AB  - PURPOSE: The transition from inpatient to outpatient cataract surgery during the
      last decade was not accompanied by prospective investigation of its effect on
      visual outcomes or surgical complications. The authors performed this study to
      assess the impact of this transition on surgical results. METHODS: The authors
      reviewed 600 extracapsular cataract extractions performed by 4 experienced
      ophthalmic surgeons during a 36-month period; in 300 cases, patients were
      hospitalized after surgery (inpatient group), and, in 300 cases, patients were
      never hospitalized (outpatient group). The same surgical techniques were used in
      all cases. Visual outcome and rates for operative and postoperative complications
      were compared. RESULTS: There were no statistically significant differences
      between the inpatient and outpatient groups for visual acuity. Excluding patients
      with pre-existing nonlenticular ocular disease, a best-corrected visual acuity of
      20/40 or better was achieved in 93.1% of inpatient cases and in 97.2% of
      outpatient cases 6 months after surgery. Postoperative, clinically apparent
      cystoid macular edema was more common in the inpatient group (P = 0.03); however,
      after exclusion of patients with diabetes, hypertension, age younger than 65
      years, and eyes with pre-existing nonlenticular disease, there was no
      statistically significant difference between groups. No significant differences
      in rates for other operative and postoperative complications were identified,
      including wound dehiscence, unplanned postoperative filtering blebs, infectious
      endophthalmitis, retinal detachment, persistent iridocyclitis, glaucoma, and
      corneal edema. CONCLUSION: This study does not demonstrate that the transition to
      outpatient cataract extractions has had an adverse effect on surgical outcomes.

PMID- 1630773
TI  - A prospective, randomized, double-masked comparison of a zonal-progressive
      multifocal intraocular lens and a monofocal intraocular lens.
AB  - INTRODUCTION: Multifocal intraocular lenses (IOLs) have been designed to provide
      improved near visual acuity without spectacles compared with monofocal IOLs.
      Early studies have reported variables amounts of decreased visual acuity and
      contrast sensitivity with multifocal IOLs, and some patients have experienced
      halos and glare. METHODS: The authors performed a prospective, double-masked,
      multicenter evaluation of 62 patients randomized between a new zonal-progressive
      optic multifocal IOL and a monofocal IOL. RESULTS: Mean postoperative spherical
      equivalent, astigmatism, and uncorrected and best-corrected distance visual
      acuity were similar between the two groups. Patients with a multifocal IOL
      achieved significantly better uncorrected near visual acuity than patients with
      monofocal IOLs (J3+ versus J7; P less than 0.0001). With distance correction
      only, mean near visual acuity was J2 versus J5- (P = 0.0001). Best-corrected near
      visual acuity was J1 for both groups, with 1.36 diopters (D) for the multifocal
      group versus 2.37 D for the monofocal group (P less than 0.0001). Regan contrast
      sensitivity was lower for the multifocal patients at all contrast levels, and
      achieved statistical significance at very low contrast (11% contrast; P =
      0.0024). Fifty-two percent of patients with a multifocal IOL reported that they
      did not need spectacles at all or used them only for their fellow eye, compared
      with 25% of the patients with monofocal IOLs. CONCLUSION: Both monofocal and
      multifocal implant patients were very satisfied with the results of their
      cataract extraction and IOL implant surgery. A small loss of contrast sensitivity
      with the multifocal IOL was demonstrated, consistent with theoretical
      predictions. The functional significance of the loss of contrast sensitivity
      appears to be small and counterbalanced by the advantage of improved uncorrected
      near visual acuity.

PMID- 1630774
TI  - Penetrating ocular fish-hook injuries. Surgical management and long-term visual
      outcome.
AB  - BACKGROUND: Ocular penetrating fish-hook injuries represent a rare yet
      potentially devastating ocular trauma. To date, only five cases have been
      reported in the medical literature. The authors present five new cases with long
      term follow-up. METHODS: All individuals who presented to the Wilmer
      Ophthalmological Institute emergency room with ocular fish-hook injuries between
      1974 and 1990 were identified, and ophthalmic follow-up evaluations were
      performed. RESULTS: Individuals were male, between the ages of 10 and 27, with
      follow-up evaluation of 2.0 to 15.5 years (mean, 6.7 years). The left eye was
      involved in 80% and in no instance had a single hook penetrated the lid and globe
      simultaneously. Initial visual acuity was uniformly poor (20/200 or worse). Using
      specialized surgical techniques, ultimate visual outcome was excellent in 80% of
      cases (4 of 5 with visual acuity of 20/30 or better). One eye was enucleated
      because of panendophthalmitis after delayed wound closure. Similar overall
      results are achieved when previous reports are included in the analysis (90% with
      visual acuity of 20/40 or better). CONCLUSIONS: These results suggest that
      penetrating ocular fish-hook injuries may have an excellent long-term prognosis
      if prompt, appropriate surgical intervention is accomplished.

PMID- 1630775
TI  - Shotgun eye injuries. Ocular risk and eye protection efficacy.
AB  - BACKGROUND: Little is known about the efficacy of shotgun eye protection.
      Shotguns can easily propel pellets with enough energy to penetrate the human eye,
      and a large percentage of shotgun eye injuries occur during shotgun sports such
      as hunting, trap, skeet, and sporting clays. Many of these injuries are
      preventable with proper eye protection. Although it is known that polycarbonate
      is the best lens material for shotgun eye protection, there has been no research
      that addresses the vision protective system design and its influence on eye
      protection. METHODS: A field study was performed during which shotshells were
      fired at 1:1 scale photographs of human faces to determine the risk of ocular
      trauma. The protective efficacy of three types of polycarbonate protective eye
      wear (standard industrial safety glasses with snap-on side shields, wrap-around
      racket sport glasses, and three-piece glasses with integral side shields) was
      tested by firing shotshells at them at various distances. Both frontal and side
      protection was evaluated. RESULTS: Results showed that the eye is at a high risk
      (55% to 100%) of being hit with shot pellets at ranges of 15 to 40 yards. It also
      was determined that the protective eye wear will give good frontal eye protection
      from shotgun pellets but integral side shields and a headband are necessary to
      obtain adequate side protection. CONCLUSION: These findings, coupled with the
      poor visual prognosis of ocular shotgun injuries, indicate that polycarbonate
      protective eye wear with integral side shields and headbands should be worn by
      all involved with shotgun sports.

PMID- 1630776
TI  - Corneal epithelial permeability of dry eyes before and after treatment with
      artificial tears.
AB  - PURPOSE: The question of whether artificial tears can lead to objective
      improvement of ocular surface disease in dry eyes is still unanswered. The aim of
      the current study is to assess the influence of artificial tears on corneal
      epithelial permeability of dry eyes. Furthermore, the effect of benzalkonium
      chloride, used as a preservative of artificial tears, on corneal epithelial
      permeability is investigated. METHODS: The corneal epithelial permeability of 40
      dry eye patients (80 eyes) was measured by computerized objective
      fluorophotometry before and 6 weeks after treatment with artificial tears
      containing either polyvinyl pyrrolidone 2% without preservative (20 patients) or
      polyvinyl pyrrolidone 2% preserved with benzalkonium chloride 0.005% (20
      patients). RESULTS: Before treatment, the epithelial permeability of the dry eye
      patients was found to be 2.7 times that of a control group. After treatment, the
      epithelial permeability of patients treated with unpreserved polyvinyl
      pyrrolidone 2% had decreased significantly (-37%; P less than 0.001), whereas
      patients who had been treated with polyvinyl pyrrolidone 2% preserved with
      benzalkonium chloride 0.005% showed an increase in epithelial permeability (+21%;
      P = 0.05%). CONCLUSION: These data suggest that, in dry eyes, treatment with
      unpreserved artificial tears may lead to an objective improvement in corneal
      surface disease. However, this effect may be counteracted by preservation of tear
      substitutes with benzalkonium chloride.

PMID- 1630777
TI  - New developments in serologic screening of corneal donors for HIV-1 and hepatitis
      B virus infections.
AB  - PURPOSE: The authors evaluated different methods to serologically screen
      potential cadaveric corneal donors for human immunodeficiency virus type 1 (HIV
      1) and hepatitis B virus (HBV) infections. METHODS: Three commercially available
      enzyme-linked immunosorbent assays (ELISAs) for antibodies against HIV-1, a
      supplemental ELISA test for HIV antigen, and a radioimmunoassay and two ELISAs
      for hepatitis B surface antigen were compared using serum from cadavers with
      acquired immune deficiency syndrome (AIDS), cadavers with high risk factors for
      HIV infection, and cadavers with no known risk of HIV infection, along with
      respective confirmatory testing. RESULTS: The ELISA tests for HIV antibodies from
      Abbott Laboratories, Electro-nucleonics, and Organon-Teknika showed sensitivities
      of 94.3%, 94.3%, and 97.1%, respectively, compared with the autopsy diagnosis of
      AIDS in 35 cadavers. The sensitivities of the HIV-1 antibody ELISAs ranged
      between 73% and 87% compared with positive Western blots in testing 118 sera from
      cadavers at high risk of HIV-infection, but not manifesting AIDS at the time of
      death. Supplemental ELISA testing for HIV-1 antigen, in an effort to close the
      seronegative window, failed to identify any HIV antigen-positive sera confirmed
      by neutralization that were not also positive for antibodies to HIV-1 by ELISA
      and Western blot. The ELISA for HBV surface antigen had an overall sensitivity of
      92.9% and specificity of only 81.3% compared with radioimmunoassay in testing 409
      sera. Monoclonal ELISAs for HIV-1 antigen and HBV surface antigen paradoxically
      had lower specificity than polyclonal ELISAs, with false positivity correlating
      with hemolysis and with increasing death to puncture time. CONCLUSION: ELISA
      testing for antibodies against HIV-1 is relatively but not absolutely effective,
      should be accompanied by historical screening for risk factors, and does not
      appear to benefit from supplemental ELISA testing for HIV-1 antigen. ELISA
      testing for HBV surface antigen has lower specificity in screening cadaveric sera
      when compared with radioimmunoassay.

PMID- 1630778
TI  - Evaluation of corneal collagen shields as a drug delivery device for the
      treatment of experimental Pseudomonas keratitis.
AB  - PURPOSE: To clarify the role of corneal collagen shields as a drug delivery
      device for the treatment of bacterial keratitis, the authors studied the
      effectiveness of topical gentamicin treatment, with and without the use of
      corneal collagen shields, in a rabbit model of Pseudomonas keratitis. METHODS:
      Forty-eight New Zealand white rabbits were infected by injecting 500 colony
      forming units (CFU) of Pseudomonas aeruginosa into the corneal stroma, and
      treatment was begun 24 hours later. A 13.6 mg/ml solution of gentamicin was
      topically administered during a 24-hour period. Collagen shields were soaked in
      gentamicin 13.6 mg/ml for 5 minutes before placing them on the cornea. Corneas
      were quantitatively cultured 1 hour after the treatment period ended. Six
      different groups of rabbits were tested, with the results analyzed as the mean
      log10 of bacterial CFU. RESULTS: An untreated control group had significantly
      more bacteria (7.96 +/- 0.74) than any of 5 treatment groups. No difference was
      found between groups given a loading dose of antibiotic drops at the beginning of
      treatment, either with (4.90 +/- 2.41) or without (6.25 +/- 0.54) an antibiotic
      impregnated collagen shield. A group treated with a collagen shield augmented
      with gentamicin drops every 3 hours had fewer bacteria (1.52 +/- 1.82) than a
      group receiving drops alone (4.15 +/- 1.83) (P less than 0.05). However,
      treatment with a collagen shield supplemented with drops every 3 hours was not as
      effective as gentamicin drops administered every 30 minutes (no bacterial growth)
      (P less than 0.05). CONCLUSION: These results show that antibiotic-impregnated
      collagen shields should not replace traditional antibiotic drop therapy as the
      mainstay of treatment but may be a useful adjunct to treatment with topical
      antibiotics.

PMID- 1630779
TI  - Corneal wound healing after excimer laser ablation. Effects of nitrogen gas
      blower.
AB  - PURPOSE: To examine the effects of blowing nitrogen gas over the cornea during
      photorefractive keratectomy. METHODS: Excimer laser ablations for myopia were
      performed on rabbit corneas with or without the blowing of nitrogen across the
      surface of the cornea. All eyes underwent a 5-diopter myopic ablation; in 8 eyes,
      a ring was used to blow nitrogen gas across the cornea, and, in 8 eyes, the same
      ring was used, but no nitrogen gas was blown. RESULTS: Epithelial healing
      occurred more rapidly in the eyes that were not treated with the gas (3.8 +/- 1.3
      days) than in the gas-treated group (6.1 +/- 0.8 days; P = 0.0025). Corneal haze
      was greater in the group treated with gas. Results of histologic examination
      showed the ablated area to have a smoother surface when nitrogen was not blown
      across the cornea surface. CONCLUSION: Superficial corneal deturgescence produced
      by the nitrogen gas appears to result in a rougher surface immediately
      postoperatively with undesirable effects on surface healing, but further studies
      will be necessary to determine the applicability of these results to humans.

PMID- 1630780
TI  - Blood-aqueous barrier in eyes with retinal vein occlusion.
AB  - PURPOSE: The purpose of this study is to examine the changes of blood-aqueous
      barrier function in cases of central or branch retinal vein occlusion. METHODS:
      In addition to fluorophotometry of the aqueous humor and posterior vitreous, the
      authors used a method that quantifies protein in the aqueous (aqueous flare) by
      measuring the intensity of scattered laser light. RESULTS: Aqueous and posterior
      vitreous fluorescein concentrations and aqueous flare were significantly higher
      than in unaffected fellow eyes or eyes of visually normal age-matched controls
      both in central and branch retinal vein occlusions. They also were significantly
      higher in eyes with central vein occlusion than in those with branch vein
      occlusion. Among those eyes with central vein occlusion, aqueous and posterior
      vitreous fluorescein concentrations and aqueous flare were significantly higher
      in the hemorrhagic than in the venous stasis type of disease. Among eyes with
      branch vein occlusion, cases at the acute stage showed significantly higher
      amounts of aqueous and posterior vitreous fluorescein concentrations and aqueous
      flare than did those with chronic occlusion. CONCLUSION: The authors believe that
      increased amounts mainly reflect blood-ocular barrier disruption. Not only the
      blood-retinal barrier but also the blood-aqueous barrier disruption is a common
      sequela in the disorder.

PMID- 1630781
TI  - Macular capillary hemodynamic changes associated with Raynaud's phenomenon.
AB  - BACKGROUND: Raynaud's phenomenon is an episodic, reversible spasm of the digital
      arterioles. Previous studies have suggested that Raynaud's phenomenon may be
      associated with alterations in the ocular circulation. The authors used the blue
      field entoptic simulation technique to study macular retinal capillary
      hemodynamics in patients with Raynaud's phenomenon. METHODS: Forty-two volunteers
      participated in the study: 18 with a connective tissue disease and secondary
      Raynaud's phenomenon, 8 with a connective tissue disease and no Raynaud's
      phenomenon, and 16 healthy volunteers. The mean of three blue field entoptic
      density and velocity measurements was determined before as well as during and 10
      minutes after the immersion of one hand in ice water. RESULTS: Patients with
      severe Raynaud's phenomenon demonstrated a statistically significant 30% decrease
      in retinal capillary flow during immersion of a hand in ice water (P less than
      0.05), which remained 17% reduced (P less than 0.05) for at least 10 minutes
      after removal. The decrease in capillary flow was not observed in control
      individuals or in individuals with connective tissue disease who demonstrated
      minimal or no Raynaud's phenomenon. CONCLUSION: The prolonged reduction in
      retinal capillary flow observed in subjects with Raynaud's phenomenon is probably
      caused by retinal arteriolar vasoconstriction and is similar to concurrent
      arteriolar vasoconstriction reported in other systemic vascular beds. In the
      retina, the recurrent ischemic episodes may result in dysfunction or injury.

PMID- 1630782
TI  - Trimethoprim-sulfamethoxazole therapy for ocular toxoplasmosis.
AB  - BACKGROUND: Toxoplasmosis is a leading cause of retinochoroiditis. Conventional
      multidrug therapy using sulfadiazine, pyrimethamine, and folinic acid is
      increasingly difficult to procure and administer safely. METHODS: To evaluate the
      efficacy of trimethoprim-sulfamethoxazole, a fixed-combination antibiotic,
      patients with active toxoplasmosis were treated with trimethoprim
      sulfamethoxazole (Bactrim DS) with or without adjunctive clindamycin and
      prednisone for 4 to 6 weeks. RESULTS: All patients in this study (n = 16) had
      resolution of active retinochoroiditis and had improved vision, with an average
      gain of 5.2 lines of vision. Two patients developed a drug allergy. CONCLUSION:
      Trimethoprim-sulfamethoxazole appears to be a safe and effective substitute for
      sulfadiazine, pyrimethamine, and folinic acid (Leucovorin) in treating ocular
      toxoplasmosis.

PMID- 1630783
TI  - Alcohol consumption and the prevalence of diabetic retinopathy.
AB  - OBJECTIVE: To determine if alcohol consumption is associated with the prevalence
      of diabetic retinopathy. PARTICIPANTS: This study surveyed a population-based
      sample (n = 1210) of younger-onset diabetic persons (diagnosed before age 30
      years and taking insulin) and a stratified random sample (n = 1780) of older
      onset diabetic persons (diagnosed after age 30 years). Baseline and 4-year follow
      up examinations completed by 996 and 891 (730 by persons age 21 or older) younger
      onset persons, respectively, and 1370 and 987 older-onset persons, respectively.
      Data analyzed are from the 4-year follow-up examination. Questionnaires
      concerning consumption were completed at follow-up. MAIN OUTCOME MEASURE:
      Diabetic retinopathy as determined from stereographic fundus photography.
      RESULTS: After controlling for known risk factors in the adult younger-onset
      group, average alcohol consumption, as determined by questionnaire, was inversely
      associated with prevalence of proliferative diabetic retinopathy (PDR), odds
      ratio, 0.49; 95% confidence interval, 0.27 to 0.92. The trend was similar for
      recent consumption, odds ratio, 0.63; confidence interval, 0.37 to 1.09. In the
      older-onset groups taking or not taking insulin, average or recent alcohol
      consumption or usage history were not significantly associated with the
      prevalence of any retinopathy or PDR. CONCLUSIONS: Alcohol consumption does not
      appear to increase the risk of retinopathy and may have a beneficial effect in
      younger-onset persons, although further study is needed.

PMID- 1630784
TI  - Prevalence of age-related maculopathy. The Beaver Dam Eye Study.
AB  - PURPOSE: The relationships of retinal drusen, retinal pigmentary abnormalities,
      and macular degeneration to age and sex were studied in 4926 people between the
      ages of 43 and 86 years who participated in the Beaver Dam Eye Study. METHODS:
      The presence and severity of various characteristics of drusen and other lesions
      typical of age-related maculopathy were determined by grading stereoscopic color
      fundus photographs using the Wisconsin Age-Related Maculopathy Grading System.
      RESULTS: One or more drusen were present in the macular area of at least 1 eye in
      95.5% of the population. People 75 years of age or older had significantly higher
      frequencies (P less than 0.01) of the following characteristics than people 43 to
      54 years of age: larger sized drusen (greater than or equal to 125 microns, 24.0%
      versus 1.9%), soft indistinct drusen (23.0% versus 2.1%), retinal pigment
      abnormalities (26.6% versus 7.3%), exudative macular degeneration (5.2% versus
      0.1%), and geographic atrophy (2.0% versus 0%). CONCLUSION: These data indicate
      signs of age-related maculopathy are common in people 75 years of age or older
      and may pose a substantial public health problem.

PMID- 1630786
TI  - Clinical experience with the surgical removal of subfoveal neovascular membranes.
      Short-term postoperative results.
AB  - BACKGROUND: Severe visual loss occurs in the presumed ocular histoplasmosis
      syndrome (POHS) and in age-related macular degeneration (ARMD) from subfoveal
      neovascularization. Although laser photocoagulation has recently been recommended
      for this complication in ARMD, treatment is inevitably associated with a loss of
      central vision. In an attempt to restore and/or preserve central vision, the
      authors undertook surgical removal of subfoveal neovascular membranes in these
      diseases. METHODS: Patients with POHS and ARMD with reduced Snellen visual acuity
      to 20/80 or less were selected if there was angiographic evidence of a
      neovascular membrane beneath the fovea. Modern vitreoretinal techniques were used
      to remove the subfoveal neovascular complex. RESULTS: The authors' first 15
      patients with POHS and 19 patients with ARMD were followed for an average of 4
      months postoperatively. Snellen visual acuity improved by 2 lines or more in 8 of
      15 (53%) cases of POHS. Although similar improvements in Snellen visual acuity
      were not observed in cases of ARMD, 14 of 19 (74%) cases showed either slight
      improvement or stabilization of their vision postoperatively. Complications
      included recurrent neovascularization in 2 of 15 (13%) and 3 of 19 (16%) eyes
      with POHS and ARMD, respectively. No retinal detachment or preretinal
      proliferation was observed. CONCLUSIONS: These results suggest that subfoveal
      neovascularization can be successfully removed with preservation of foveal vision
      in POHS and stabilization in ARMD, at least for the short term. Visual
      improvement was observed in POHS even after 6 months of decreased vision.
      Finally, visual prognosis is most dependent on the integrity of the subfoveal RPE
      after removal of the membrane.

PMID- 1630785
TI  - Extramacular disciform lesions simulating uveal tumors.
AB  - PURPOSE: The purpose of this study is to identify clinical, ultrasonographic, and
      fluorescein angiographic features of extramacular disciform lesions that allow
      differentiation from uveal tumors. METHODS: This was a retrospective study of 19
      patients referred to our ocular oncology unit with a possible malignancy who had
      a diagnosis of an extramacular disciform lesion made after complete evaluation.
      RESULTS: The level of accuracy for each diagnostic technique alone was as
      follows: clinical (79%), ultrasonography (83%), and angiography (83%).
      Fluorescein angiography had limited utility because of severe media opacities in
      seven cases. No tumor developed an intraocular malignancy during the follow-up
      period. CONCLUSION: A combination of the above, noninvasive techniques can be
      used to correctly diagnose extramacular disciform lesions.

PMID- 1630787
TI  - Clinicopathologic spectrum of primary uveal melanocytic lesions in an animal
      model.
AB  - BACKGROUND: Currently, there are no animal models of primary uveal melanoma in an
      eye large enough to allow documentation of the clinical evolution of the lesion
      by either funduscopy or fundus photography. METHODS: The authors induced primary
      uveal melanocytic lesions in the eyes of Dutch (pigmented) rabbits using a two
      stage carcinogenesis protocol involving initiation with 4 weekly topical
      applications of 10 microliters of a 1% solution of 7,12-dimethyl
      benz[a]anthracene (DMBA) in acetone (21 eyes) followed by 12 weekly topical
      applications of a 10 microliters solution of either 0.25% or 0.5% croton oil in
      acetone. They also investigated the effect of initiation with DMBA without
      promotion and the effects of chronic topical exposure to acetone and
      proparacaine. RESULTS: Exposure to DMBA followed by promotion with croton oil in
      either concentration was the most effective means of inducing clinically
      detectable fundus lesions. Histologically, a spectrum of melanocytic
      proliferations developed including benign nevi, nevi with varying grades of
      cytologic atypia, and clusters of confluent atypical melanocytes that may
      represent early melanomas. Although clinical regression of fundus lesions was
      noted in eight eyes after promotion had been stopped, five of these eyes showed
      unequivocal histologic evidence of a residual uveal melanocytic lesion. Chronic
      ocular irritation is capable of inducing cytologically benign subclinical uveal
      melanocytic proliferations. CONCLUSIONS: The conventional classification of human
      uveal melanocytic lesions includes only nevi and melanomas, but a comparison of
      the results of this study with descriptions of human uveal melanocytic nevi
      suggests the existence of a spectrum of intermediate atypical precursor lesions
      in humans.

PMID- 1630788
TI  - Intraocular and central nervous system lymphoma in a cardiac transplant
      recipient.
AB  - BACKGROUND: Although B-cell lymphomas are the most frequent cancers that evolve
      in transplant patients, histopathologic verification of intraocular lymphoma as a
      result of cyclosporine immunosuppression has not been previously recognized.
      METHODS: A complete autopsy was performed on a 67-year-old woman who died 33
      months after orthotopic heart transplantation. FINDINGS: Large cell lymphoma
      extensively involved the anterior segment of the left eye, as well as the
      vitreous, retina, subretinal pigment epithelial zone, and optic nerve. Tumor also
      was found in the ipsilateral orbitofrontal cortex and hypothalamic areas. No
      systemic lymphoma was present. CONCLUSION: Ocular and central nervous system
      lymphoma developed in a heart transplant patient. In addition to opportunistic
      infections, ophthalmologists should be aware that opportunistic
      lymphoproliferative disorders involving the eye and brain can occur in these
      immunosuppressed individuals. Epstein-Barr virus infection has been implicated as
      playing a major role.

PMID- 1630789
TI  - Long-term results of adjustable suture surgery for strabismus secondary to
      thyroid ophthalmopathy.
AB  - PURPOSE: To review the results of adjustable suture surgery in patients with
      strabismus secondary to thyroid ophthalmopathy to determine long-term outcome and
      to identify postoperative complications. METHODS: The records of 1524 patients
      with thyroid ophthalmopathy were retrospectively reviewed to identify those who
      required treatment for strabismus in the ocular motility clinic. Treatment
      consisted of adjustable suture surgery, prisms, or both. Elimination of diplopia
      in primary and reading positions was used at the criterion for success. RESULTS:
      Forty-seven patients were treated with adjustable suture surgery, with an average
      follow-up of 41 months. Results after 1 or more surgeries were: 47% excellent,
      26% good, 19% fair, and 9% poor. Significant postoperative complications included
      eyelid retraction and A-pattern exodeviation. Sixteen of 18 patients with fair or
      poor outcomes after the initial surgery were recognized within 6 months.
      Postoperative changes in vertical deviation from primary position to downgaze
      were predictive of postoperative diplopia in downgaze. Analysis of multiple
      preoperative characteristics showed no statistically significant associations
      with outcome. Eight additional patients had adequate relief of diplopia using
      prisms alone, with an average follow-up of 49 months. CONCLUSIONS: Long-term
      symptomatic relief of diplopia was obtained in the majority of patients using
      adjustable suture strabismus surgery, combined occasionally with small amounts of
      prism postoperatively. Prisms alone provided effective long-term relief in
      patients with small-to-moderate deviations.

PMID- 1630790
TI  - Negative predictive value of a population-based preschool vision screening
      program.
AB  - BACKGROUND: The Enhanced Vision Screening Program is a population-based vision
      screening program that has, at present, examined 59,782 children. Its main goal
      is to detect amblyopia, strabismus, and high refractive errors. An average of
      11,910 4 1/2- to 5 1/2-year-old children are screened yearly. The current study
      determines the negative predictive value of the screening program: For a subject
      having passed the vision screening test, what is the probability of not having
      amblyopia, strabismus, or high refractive errors? METHODS: Of the 11,734 subjects
      who passed the vision screening, 200 were randomly chosen to undergo a strictly
      defined gold standard examination by an orthoptist and an ophthalmologist.
      RESULTS: Of the 200 randomly chosen subjects, 157 underwent the gold standard
      evaluation. The negative predictive value of the Enhanced Vision Screening
      Program was 97.6% for any potentially vision-threatening ocular condition. It was
      98.7% if we considered only the visually significant ocular problems that the
      test was designed to detect. CONCLUSION: Because the negative predictive value of
      the Enhanced Vision Screening Program is not 100%, some children with amblyopia,
      strabismus, or refractive errors are missed. Occasionally, a rare, potentially
      vision-threatening condition may go undetected. Parents should be made aware of
      this when they receive the results of the vision screening.

PMID- 1630792
TI  - Lessons about quality from the IOM Report on Medicare.

PMID- 1630791
TI  - A revolution in understanding: how ethics has transformed health care decision
      making: the role of patient education.

PMID- 1630793
TI  - Medicare: a strategy for quality assurance, V: Quality of care in a changing
      health care environment.
AB  - This article, the fifth and final in a series, provides a retrospective wrap-up
      of an Institute of Medicine (IOM) study to develop a strategy for quality review
      and assurance in Medicare. Portions of that report were adapted for four articles
      in QRB in January, March, August, and October 1991. This final article reflects
      on selected developments in the period since the IOM report first appeared,
      particularly those involving other IOM activities, in the context of certain of
      the findings, conclusions, and recommendations of the IOM study committee on
      Medicare quality assurance.

PMID- 1630794
TI  - Inputs and outputs for coronary artery bypass grafting.

PMID- 1630795
TI  - A methodology for QI in the coronary artery bypass grafting procedure involving
      comparative process analysis.
AB  - This report describes an example of applying comparative process analysis to
      improve surgical procedures. This approach to health care quality improvement
      relies on combining techniques from the technical disciplines of systems analysis
      and systems engineering with concepts embodied in the philosophies of total
      quality management. Coronary artery bypass grafting (CABG) has been examined in a
      cooperative observational study involving an engineer, cardiac surgeons,
      perfusionists, nurses, and an anesthesiologist. A baseline process flow for the
      CABG procedure was developed, against which interinstitutional variations among
      the five participating medical centers have been identified. On the basis of
      analysis of the variations, efforts are under way to develop a strategy for
      incremental continuous improvement in the CABG procedure in each of the five
      institutions. On the basis of the perceived success of the first phase of the
      activity, a second phase, wider in scope, has been undertaken.

PMID- 1630796
TI  - Total quality management in a hospital.
AB  - The adaptation of the management philosophy and tools of total quality management
      (TQM) to the modern American hospital, its staff, and physicians is a major
      challenge facing health care today. The TQM "bandwagon" is one that hospitals
      both want to--and are required to--jump on, insofar as TQM is now part of the
      revised Joint Commission standards [Ed note: The standards encourage hospitals to
      adopt TQM, continuous quality improvement, or a similar approach to improve
      performance]. TQM holds out the promise of improving clinical quality while
      simultaneously reducing the "cost of poor quality." Although the actual
      realization of cost savings through TQM remains to be seen, the author provides
      an exceptionally clear overview of the issues involved in TQM implementation at
      the hospital level. This article is noteworthy in its practical and experienced
      approach to the necessary groundwork for a successful TQM program, including
      strategic commitment, human resource issues, and oversight of the TQM process as
      it unfolds. Quality review professionals may still wonder how to merge hospital
      and medical staff quality assurance efforts with TQM initiatives in the near
      future.

PMID- 1630797
TI  - Health care reform dominates "Health Agenda 1992" meeting.

PMID- 1630798
TI  - [Viral hepatitis '91].

PMID- 1630799
TI  - [Advances in the diagnosis of non-A non-B viral hepatitis].
AB  - Having constructed the serological diagnostics of Hepatitis A and B viruses there
      remained non identified agent(s): named "Non-A, non-B". The non-A, non-B
      infecting parenterally is a Flavivirus, with lipoid envelope and a diameter of 30
      60 nm, as stated very early. After having known the simple filament RNS genome,
      named as Hepatitis C. In the same time it was tried to isolate the antigen and
      antibody from ill people, without success. There were not usable the surrogate
      markers too (anti-HBc and ALT). One part of the synthetized polypeptides from
      little fragments of C virus genome was apt to antibody-detection. In the acute
      state there was 20-40, in the chronic state 60-80% anti-HCV positive during the
      illness. This seropositivity is not equal of healing, neither the potency to
      infect. The infectivity is showed by the nucleic acid's presence (of the virus)
      in the blood (PCR), the perfect healing by the neutralizing antibody.

PMID- 1630800
TI  - [Polymerase chain reaction and its application].
AB  - The polymerase chain reaction (PCR) is one of the most important new methods in
      molecular biology. It is widely used in genetic and anthropologic basic research,
      in oncology and virology, in all those fields, where molecular biologic methods
      can give answers to the questions raised. The procedure enables one to multiply
      with extreme precision targeted pieces of amounts as little as one target
      molecule of DNA or RNA by five to six logs, making them easy to be handled and
      examined by routine molecular biological methods. The method is presented through
      one possible application field, that is of great importance in the study of
      hepatocarcinogenesis. Sensitivity of PCR in detection of hepatitis B virus DNA is
      greater by four logs than animal inoculation, the last most sensitive method
      known.

PMID- 1630801
TI  - [Determination of hepatitis C antibodies, using the Abbott and the Ortho anti-HCV
      EIA kits, in chronic liver diseases and patients under hemodialysis for chronic
      renal failure].
AB  - The diagnostic usefulness of anti HCV EIA test of Abbott and Ortho companies were
      compared. The anti HCV levels determined in the sera of 173 patients with chronic
      liver diseases and of 17 haemodialysed kidney patients. 109 of 190 (57%) sera
      were found to be negative and 81 (43%) positive determined by Abbott kit, while
      127 (67%) were negative and 63 (30%) were positive by the Ortho kit. Positive
      results in patients with chronic liver disease were found in 66 patients by
      Abbott and 58 patients with Ortho Kit. Distribution of positive cases according
      to the diagnosis is as follows: 29 (57%) out of 51 chronic hepatitis, 17 (61%)
      out of 28 cirrhosis. Conflicting results were obtained in 20 cases of 190 (11%)
      when 17 sera were positive by Abbott and negative by ORTHO, and 3 sera were
      negative by Abbott, and positive by Ortho. The samples close to the cut off and
      with low positivity with conflicting results were checked again by the
      neutralization HCV EIA Abbott assay. We found the Abbott HCV EIA test more
      sensitive in our excellent for screening of large numbers of samples, we
      recommend to confirm the positive results by a neutralization type test.

PMID- 1630802
TI  - [Hepatitis B virus markers and anti-HCV antibodies in hemodialyzed patients].
AB  - Serum samples from 155 patients on haemodialysis were examined for markers of
      hepatitis B and C. Abbott and Ortho Elisa tests were used for the determinations.
      ALT levels were analysed at the same time. Of the 345 random blood donors and 366
      prisoners examined, 1.44% proved to be anti-HCV antibody positive. 13 medical
      staff workers of 147 were found to be positive for anti-HCV antibody (19.1%). In
      patients on chronic haemodialysis 41.29% anti-HCV antibody prevalence was found.
      The prevalence of anti-HBc and anti-HCV antibodies in correlation with the number
      of transfusions was examined as well, in serums of chronic uraemic patients. Anti
      HBc antibody prevalence was significantly higher in the polytransfused group (p
      less than 0.01), compared to the group without transfusion. There were no
      correlation between the number of transfusions and anti-HCV antibody occurrence.
      ALT values were in correlation with HBV and HCV seropositives. Elevated ALT
      levels were found in patients with HBV and/or HCV infection. In conclusion,
      screening for HBV and HCV markers among patients receiving blood, blood donors
      and medical staff workers seems to be necessary in the future. The results
      suggest the determination of anti-HBc to be an early and common marker of
      hepatitis B and C and the frequent occurrence of nosocomial transmission and the
      importance of prevention at high risk patients.

PMID- 1630803
TI  - [Viral hepatitis and morphology of hepatitis viruses].
AB  - Our knowledge has increased significantly about the hepatitis viruses and the
      disease caused by them. The most important hepatitis inducing viruses are the
      hepatitis A, B, C, D and E viruses, however, probably new members will be added
      soon. The possibility of differentiation and detection of these viruses was based
      on methods of molecular biology and serology.

PMID- 1630804
TI  - [Clinical significance of the hepatitis Delta virus and its incidence in virus B
      positive chronic liver diseases].
AB  - The data on hepatitis delta virus and the liver diseases caused by it are
      reviewed. The findings of hepatitis B and D virus markers in 118 hepatitis B
      virus seropositive patients suffering from histologically confirmed chronic liver
      disease are reported. The prevalence of hepatitis delta virus infection was
      13.56% of these cases, while active hepatitis delta virus replication was proved
      in 6 cases of them. Based on their findings, the role of hepatitis delta virus in
      the progression of chronic liver diseases is concluded, similarly to data
      published earlier. The importance of repeated, detailed virus-serological and
      histological examinations is stressed, especially in the cases in which the
      progression of liver disease are detected. The authors suggest that HBsAg--IgM
      complex seropositivity in patients suffering from anti-delta seropositive chronic
      liver disease supports active hepatitis delta virus infection.

PMID- 1630805
TI  - [Chronic hepatitis treated with alpha-interferon].
AB  - The newest results on the interferon treatment of chronic viral hepatitis on the
      ground of controlled trials are reported. In chronic type B hepatitis about 35
      percent of patients, while in chronic type C hepatitis 80 percent of patients
      showed good response, though in the latter disease relapse is frequent following
      the stop of interferon treatment. In hepatitis Delta infection further
      therapeutic studies are warranted. The duration of the interferon treatment in
      chronic viral hepatitis is still an unsolved question.

PMID- 1630807
TI  - [Recommendations for the diagnosis and treatment of viral hepatitis based on the
      results of the Viral Hepatitis Symposium 1991].

PMID- 1630806
TI  - [Treatment of chronic viral hepatitis with recombinant interferon-alfa].
AB  - The antiviral treatment with alfa-interferon is the first proven therapeutic
      possibility in chronic viral hepatitis. The rate of improvement to alfa
      interferon ranges between 15-40% depending on the type of hepatitis. The optimal
      dose is 5 MU/day three times a week for 6 months in chronic hepatitis B, while 3
      MU/day three times a week for months in chronic hepatitis C. Results of therapy
      can be improved using combination treatment in selected cases.

PMID- 1630808
TI  - [Significance of detailed Hepatitis B virus marker studies in chronic liver
      diseases].
AB  - The hepatitis B virus (HBV) markers were studied by Sorin RIA kits in the sera of
      390 patients suffered from histologically confirmed chronic liver disease. On the
      base of HBsAg, anti-HBs, anti-HBc seronegativity the HBV infection was excluded
      in 235 cases. In most HBV negative cases the diagnosis was fatty liver and
      alcoholic hepatitis (52%), while chronic active hepatitis and/or liver cirrhosis
      occurred only in 21.7% of patients. Past or present HBV infection was proved in
      155 patients. The diagnosis of 52.9% of cases in this group was chronic active
      hepatitis and/or liver cirrhosis, while fatty liver and alcoholic hepatitis
      occurred in 27.7%. The detailed HBV marker analysis was performed in 76 patients.
      Previous infection without replication (anti-HBs and/or anti-HBc and/or anti-HBe
      positivity) was proved in 48 cases, 12 patients have active HBV infection (HBsAg,
      HBe, IgM anti--HBc, positivity), while in 16 cases integrated HBV infection
      (HBsAg, anti-HBc, anti-HBe positivity) was proved. The HBsAg--IgM complex
      seropositivity was detected in every case with active HBV replication. Because of
      therapeutic, prognostic and epidemiologic significances the detailed HBV serology
      in chronic liver diseases is stressed.

PMID- 1630810
TI  - tek, a novel tyrosine kinase gene located on mouse chromosome 4, is expressed in
      endothelial cells and their presumptive precursors.
AB  - A search for protein tyrosine kinases expressed during murine cardiogenesis
      resulted in the isolation of a novel tyrosine kinase, designated tek, which maps
      to mouse chromosome 4 between the brown and pmv-23 loci. The deduced amino acid
      sequence of tek predicts that it encodes a putative receptor tyrosine kinase that
      contains a 21 amino acid kinase insert and which is most closely related in its
      catalytic domains to FGFR1 and the product of the ret proto-oncogene. In situ
      hybridization analysis of adult tissues, as well as sectioned and whole-mount
      embryos, showed that tek is specifically expressed in the endocardium, the
      leptomeninges and the endothelial lining of the vasculature from the earliest
      stages of their development. Moreover, examination of the morphology of tek
      expressing cells, and staging of tek expression relative to that of the
      endothelial cell marker von Willebrand factor, revealed that tek is expressed
      prior to von Willebrand factor and appears to mark the embryonic progenitors of
      mature endothelial cells. tek encodes a novel putative receptor tyrosine kinase
      that may be critically involved in the determination and/or maintenance of cells
      of the endothelial lineage.

PMID- 1630809
TI  - A high proportion of early response genes are constitutively activated in T cells
      by HTLV-I.
AB  - Immortalization of T cells by HTLV-I is mediated by the X region of the virus and
      probably involves transactivation of cellular genes. We show that T cells
      transformed by HTLV-I constitutively express a high proportion of early response
      genes that are normally transiently induced following antigenic or mitogenic
      activation of T cells. Thus, HTLV-I-infected T cells display an 'early
      activation' phenotype that is distinct from the gene expression pattern of
      continuously dividing T cells. Ten early response genes representing a diverse
      array of functional categories were assayed. Four DNA-binding
      proteins/transcription factors including the p50 subunit of NF-kappa B were
      evaluated. A protein(s) encoded by the X region of HTLV-I appeared to contribute
      to up-regulated expression of most, if not all, of the early response genes. For
      those genes that could be assayed, increased transcriptional rates, but not
      substantial changes in mRNA half-life, were demonstrated in the presence of pX
      encoded proteins, suggesting that the transcriptional transactivator, Tax,
      affects the induction or maintenance of transcription for these mitogen-inducible
      genes. Therefore, Tax may mimic or interact with a component(s) of the signal
      transduction pathway activated by antigen or mitogen treatment. These data
      demonstrate that early response genes, some of which probably play roles in
      initiating or maintaining cellular proliferation, are frequent targets of HTLV-I
      activation.

PMID- 1630811
TI  - c-Ha-ras gene mutation and activation precede pathological changes in DMBA
      induced in vivo carcinogenesis.
AB  - We have previously reported a stage-specific and sequential overexpression of the
      c-Ha-ras and c-erbB genes in 7, 12-dimethylbenzanthracene (DMBA)-induced in vivo
      carcinogenesis in hamster buccal pouch epithelium (HBPE). In this investigation,
      the immunoreactive protein product of the c-Ha-ras gene (p21 protein) was
      identified in HBPE cells, specifically in treated tissues and cultured cells
      established after 3 weeks of DMBA treatment. Microscopic examination did not show
      any histopathological changes in these tissues. The p21 protein was detected in a
      few selective cells, which were dispersed away from the more densely populated
      basal layer. The overexpression of the c-Ha-ras gene was accompanied by a point
      mutation of A----T in codon 61 (CAA), inducing an amino acid substitution from
      the wild-type glutamine to leucine in the peptide. The concurrent molecular
      modifications preceded any detectable histopathological changes. The cellular
      morphology and orientation in treated HBPE at this early stage was
      indistinguishable from the control tissue. Yet the genetic alterations, such as
      the point mutation and overexpression of the gene, were evident at the
      predysplastic stage. Amplification and overexpression of the second proto
      oncogene, c-erbB, and its product, epidermal growth factor receptor (EGFR), were
      detected in HBPE cells at the later stages of extensive cell proliferation and
      invasion. By using double antibodies and two immunoreporter systems, we
      demonstrated overexpression of both c-Ha-ras and c-erbB genes in the same HBPE
      cells during this chemically induced in vivo carcinogenesis.

PMID- 1630812
TI  - Establishment and characterization of a malignant melanocytic tumor cell line
      expressing the ret oncogene.
AB  - We established a cell line (designated Mel-ret) from a melanocytic tumor
      developed in a metallothionein/ret transgenic mouse. Unlike primary melanocytic
      tumors, which did not show malignant features, when the Mel-ret cells were
      transplanted into nude mice they invaded into surrounding tissues and had
      metastatic ability. Although the Ret proteins were expressed at similar levels in
      the cell line and the primary tumors, the level of tyrosine phosphorylation in
      the Mel-ret cells was much higher than that in the primary tumors. In particular,
      an 85-kDa tyrosine-phosphorylated band was specifically detected in the Mel-ret
      cells. These results suggest that the increase in tyrosine phosphorylation may be
      responsible for malignant transformation of the Mel-ret cells. Immunofluorescence
      and cell fractionation studies showed that the Ret proteins and most of tyrosine
      phosphorylated proteins in the Mel-ret cells localized in the membrane fraction.
      No activation of phosphatidyl-inositol-3 kinase (PI-3 kinase), a target protein
      for several tyrosine kinases, was detected in the Mel-ret cells.

PMID- 1630813
TI  - A novel sequence in the type IV collagen promoter binds nuclear proteins from
      Engelbreth-Holm-Swarm tumor.
AB  - The production of extracellular matrix proteins is an important element of tumor
      formation, and alterations in matrix protein metabolism may be critical to the
      process of tumor metastasis. Abundant expression of type IV collagen, the major
      structural protein of the basement membrane, is characteristic of the Engelbreth
      Holm-Swarm (EHS) mouse sarcoma. In the present study, we evaluated mechanisms of
      transcriptional regulation of type IV collagen genes by analysing nuclear factors
      that bind to the promoter region. Gel mobility-shift assays indicated that
      specific proteins from EHS tumor bound the promoter and generated several unique
      shift patterns. The specific sequences to which these proteins bound were
      determined using DNAase I protection assays. DNA-binding proteins protected two
      regions from DNAase I digestion. The first region was similar to a GC box, the
      binding site for the transcription factor Sp1. The other footprint was a 30-bp
      region that contained the novel sequence motif, 'CCCTCCC' present in several
      other extracellular matrix promoters. Nuclear extracts isolated from tissues that
      variably express type IV collagen bound to this protected sequence with
      distinctly different shift patterns. Furthermore, in highly expressing tissues,
      unlabeled oligonucleotides containing the 'CCCTCCC' motif effectively inhibited
      nuclear protein binding with the entire promoter. Thus, it is likely that a novel
      protein or protein complex binds to these sequences. Furthermore, these sequences
      appear to be unique to the genes that encode basement membrane proteins,
      suggesting a specific role in their regulation.

PMID- 1630814
TI  - Human pancreatic carcinomas and cell lines reveal frequent and multiple
      alterations in the p53 and Rb-1 tumor-suppressor genes.
AB  - The molecular pathology of human pancreatic cancer is poorly understood,
      particularly with regard to the role of known tumor-suppressor genes. We have
      examined the expression of the p53 and Rb-1 tumor-suppressor genes in seven human
      pancreatic carcinoma cell lines and 10 primary pancreatic carcinomas. Examination
      of the Rb-1 gene by Northern hybridization and immunoprecipitation analyses
      revealed the absence of Rb-1 protein expression in two cell lines. Moreover,
      regions of absent nuclear staining in two primary pancreatic carcinomas were
      detected by immunohistochemical analysis. Investigation of p53 by Southern,
      Northern, immunohistochemical and immunoprecipitation analyses revealed multiple
      abnormalities, including gross rearrangements in two cell lines, the absence of
      detectable p53 transcript in two cell lines and a truncated transcript in one
      line. Six cell lines overexpressed p53 protein, while one line revealed the
      absence of p53 product by immunohistochemical and immunoprecipitation analyses.
      Sequence analysis of exons 5-8 of the p53 gene confirmed these analyses,
      revealing missense mutations in all seven cell lines in codons 181, 220, 248,
      249, 265, 272 and 273. Of 10 mutations identified, nine were transitions and 50%
      were in codon 273. Immunohistochemical analyses of frozen primary pancreatic
      carcinomas revealed positive nuclear staining for p53 in 40% of cases. Mutations
      were identified in codons 238 and 286 and in intron 9 in several representative
      specimens. Alterations in the p53 and Rb-1 genes may be important features in the
      development of human pancreatic cancer.

PMID- 1630815
TI  - The HIV tat gene transforms human keratinocytes.
AB  - Skin disorders are frequently seen in patients with the acquired immune
      deficiency syndrome (AIDS). Since many of these cutaneous manifestations are
      accompanied by an early onset of epidermal hyperplasia, the keratinocyte is a
      candidate for infection by the human immunodeficiency virus (HIV). We now report
      that the HIV tat gene, under the control of the viral long terminal repeat (LTR),
      can efficiently transform human keratinocytes in culture. Our finding suggests
      that this activity of the tat gene may be responsible for the epidermal
      hyperplasia that accompanies psoriasis and precedes the development of squamous
      cell and basal cell carcinomas in AIDS patients.

PMID- 1630816
TI  - v-Myc, but not Max, possesses domains that function in both transcription
      activation and cellular transformation.
AB  - Deregulated expression of myc gene family members is associated with the
      development of malignant neoplasms in several species. Despite the evidence
      linking expression of this family of nuclear proteins with the proper control of
      cellular growth and development, the function of the myc protein remains unknown.
      Intrigued by the observed structural similarity between the myc protein and
      several eukaryotic transcription factors, we have investigated the ability of the
      MC29 viral myc protein to activate transcription of a heterologous promoter in
      C3H10T1/2 cells. Overlapping portions of v-myc coding sequences were inserted 3'
      to the yeast GAL4 DNA-binding domain and tested for their ability to activate
      transcription of a chloramphenicol acetyl transferase reporter gene containing
      GAL4 binding sites. Two transcription activation domains were identified within
      the amino terminus of v-Myc. The importance of these regions for cellular
      transformation was examined using ras/myc co-transformation assays. Our results
      demonstrate that deletion of either of the transcription activation domains, or
      the DNA-binding and protein oligomerization domains, abolishes the ability of v
      Myc to cooperate with Ras to transform C3H10T1/2 cells. Similarly, we
      investigated whether Max, the protein-binding partner of Myc, also possesses the
      potential to activate transcription. Interestingly, chimeric GAL4/Max proteins
      were not functional in our assays, suggesting that the potential of the Myc-Max
      complex to influence gene expression and function in cellular transformation
      relies primarily on sequences found within the amino terminus of Myc.

PMID- 1630817
TI  - Loss of transforming growth factor beta 1 (TGF-beta 1)-induced growth arrest and
      p34cdc2 regulation in ras-transfected epithelial cells.
AB  - Transforming growth factor beta 1 (TGF-beta 1) is a potent inhibitor of mink lung
      epithelial (CCL64) cell growth in culture. The fact that many transformed
      epithelial cells have escaped from negative growth control by TGF-beta 1 suggests
      that transfected epithelial cells may be an appropriate model for investigating
      the growth-inhibitory mechanism of TGF-beta 1. We transfected CCL64 cells with a
      mouse c-myc oncogene (pSVc-myc1), a mutated Harvey-ras (Ha-ras) oncogene, or a
      combination of both. The results indicate that cells transfected with c-myc alone
      exhibit normal morphology and maintain sensitivity to TGF-beta 1 growth arrest,
      but are unable to form colonies in soft agar in the presence or absence of TGF
      beta 1. Cells transfected with Ha-ras, or co-transfected with c-myc, display a
      transformed morphology, grow spontaneously under anchorage-independent conditions
      and acquire a complete resistance to growth inhibition by TGF-beta 1. Affinity
      cross-linking of [125I]TGF-beta 1 to cell-surface receptors from these
      transfectants revealed that all three TGF-beta receptor types were present and no
      significant differences in [125I]TGF-beta 1 labeling of these receptors was
      observed. Since we have previously demonstrated that modulation of p34cdc2 kinase
      is a marker for TGF-beta 1 growth inhibition, we investigated p34cdc2 activity in
      the CCL64 transfected clones. The results show that in the control CCL64 cells
      and in the myc-transfected clones TGF-beta 1 regulation of p34cdc2 activity is
      maintained. In the ras- and ras + myc-transfected cells p34cdc2 phosphorylation
      and histone H1 kinase activity is significantly increased and regulation by TGF
      beta 1 is lost.

PMID- 1630819
TI  - Mechanism of estrogen activation of c-myc oncogene expression.
AB  - The estrogen receptor complex is a known trans-acting factor that regulates
      transcription of specific genes through an interaction with a specific estrogen
      responsive cis-acting element (ERE). In previous studies we have shown that in
      estrogen-responsive human breast cancer cells estrogen rapidly activates c-myc
      expression. This activated expression occurs through enhanced transcription and
      does not require the synthesis of new protein intermediates; therefore, an ERE is
      present in the human c-myc gene regulatory region. To localize the ERE,
      constructs containing varying lengths of the c-myc 5'-flanking region ranging
      from -2327 to +25 (relative to the P1 promoter) placed adjacent to the
      chloramphenicol acetyl transferase reporter gene (CAT) were prepared. They were
      used in transient transfection studies in MCF-7 and HeLa cells co-transfected
      with an estrogen receptor expression vector. These studies reveal that all
      constructs containing the P2 promoter region exhibited estrogen-regulated CAT
      expression and that a 116-bp region upstream and encompassing the P2 TATA box is
      necessary for this activity. Analysis of this 116-bp region failed to identify a
      cis-acting element with sequences resembling the consensus ERE; however, co
      transfection studies with mutant estrogen receptor expression vectors showed that
      the DNA-binding domain of the receptor is essential for estrogen-regulated CAT
      gene expression. We have also observed that anti-estrogen receptor complexes can
      weakly trans-activate from this 116-bp region but fail to do so from the ERE
      containing ApoVLDLII-CAT construct. To explain these results we propose a new
      mechanism of estrogen trans-activation in the c-myc gene promoter.

PMID- 1630818
TI  - Phosphorylation and regulatory effects of the carboxy terminus of a Drosophila
      src homolog.
AB  - The kinase activities of the vertebrate src family members are repressed by
      phosphorylation of a tyrosine residue in the carboxy-terminal 'tail' of these
      molecules. To explore whether the tail of an invertebrate src homolog might also
      serve a regulatory function, we examined the ability of the carboxy terminus of a
      Drosophila src homolog (p62D), which contains a tyrosine homologous to those in
      the vertebrate src family members, to regulate the following molecules in
      mammalian fibroblasts: (1) a chimeric protein, p60CD, containing the amino
      terminus and catalytic domains of chicken p60c-src joined to the C-terminus of
      p62D; and (2) full-length p62D itself. By a variety of criteria p60CD appears to
      be a partially, rather than fully, repressed form of p60c-src. Phosphopeptide
      mapping indicates that partial repression correlates with partial phosphorylation
      of the tyrosine in the p62D tail of the chimera. Phosphorylation of the tail may
      also regulate full-length p62D. Expression of p62D in fibroblasts does not affect
      cell morphology or the overall abundance of tyrosine-phosphorylated proteins. The
      molecule is phosphorylated at its C-terminal tyrosine (Tyr-547), but not at its
      in vitro autophosphorylation sites, suggesting that it is catalytically repressed
      in fibroblasts. Expression of a truncated p62D mutant lacking Tyr-547 is
      associated with a clear alteration in cellular morphology and a two- to threefold
      increase in cellular phosphotyrosine levels. These results suggest that
      phosphorylation of the C-terminal tyrosine of the tail of an invertebrate src
      like kinase can repress the activity of adjacent catalytic domains.

PMID- 1630820
TI  - Isolation of chromosome-specific DNA sequences from an Alu polymerase chain
      reaction library to define the breakpoint in a patient with a constitutional
      translocation t(1;13) (q22;q12) and ganglioneuroblastoma.
AB  - We describe the cytogenetic and molecular characterization of a t(1;13)(q22;q12)
      constitutional rearrangement occurring in a patient with a relatively benign form
      of neuroblastoma, called ganglioneuroblastoma. Somatic cell hybrids were
      generated between mouse 3T3 cells and a lymphoblastoid cell line from this
      patient, D.G. One isolated subclone, DGF27C11, contained the derivative
      chromosome, 1pter-q22::13q12-qter, but no other material from either chromosome 1
      or 13. Using available DNA probes the 13 breakpoint was assigned proximal to all
      reported markers. In order to generate flanking markers to define this
      translocation further, an Alu polymerase chain reaction library was constructed
      from a somatic cell hybrid containing only the proximal, 13pter-13q14, region of
      chromosome 13. Seven unique sequences have been isolated from the library, three
      of which lie below and four of which lie above the 13q12 breakpoint. More precise
      mapping of the distal markers was achieved using a panel of somatic cell hybrids
      with overlapping deletions of chromosome 13. The paucity of probes in the 1q22
      region has made a precise assignment of this breakpoint difficult, however it has
      been shown to lie distal to c-SKI and proximal to APOA2. This refined
      characterization of the breakpoint is a prerequisite for its cloning, which may
      yield genes important in the pathogenesis of ganglioneuroblastoma.

PMID- 1630821
TI  - Large-scale molecular mapping of human c-myb locus: c-myb proto-oncogene is not
      involved in 6q- abnormalities of lymphoid tumors.
AB  - Chromosomal abnormalities in the 6q region have been observed frequently in
      several T-cell and myeloid leukemias. Interestingly, this region was found to
      contain three cellular oncogenes, c-myb, c-fyn and c-ros. Several of the tumors
      that exhibit 6q- abnormalities have also been found to express high levels of c
      myb and, in some cases, amplification of the c-myb gene, leading to the
      suggestion that this gene could lie in proximity to the deletions observed in
      these tumors. To determine if c-myb gene activation is associated with 6q-
      abnormalities, we developed a megabase map of the human c-myb locus using pulsed
      field gel electrophoresis. We then examined the occurrence of abnormalities near
      the c-myb gene in several hematopoietic tumor cell lines containing well
      characterized 6q- abnormalities. Our results show that no rearrangements or
      deletions occur within a region of 1.0 Mbp of the c-myb locus in these cell
      lines. However, several of the cell lines exhibited differential and partial
      methylation patterns which seem to be prevalent amongst different cell lines.

PMID- 1630822
TI  - Deletion mapping of chromosome 3p in female genital tract malignancies using
      microsatellite polymorphisms.
AB  - We have constructed deletion maps of chromosome 3p for cancers of the female
      genital tract (uterine endometrium, uterine cervix and ovary). The tumours were
      tested for loss of heterozygosity using CA-repeat polymorphisms. The high degree
      of informativeness of these markers allowed the construction of detailed deletion
      maps from a relatively small number of samples. A common region of deletion was
      identified at chromosome 3p13-21.1 in endometrial cancer and at 3p13-14.3 in
      cervical cancer; 5 out of 13 (38%) endometrial cancers and six out of eight (75%)
      cervical cancers showed loss of heterozygosity at these regions. In ovarian
      cancer a separate common region of deletion was identified at 3p21.1-22; two out
      of four (50%) ovarian cancers had alleles deleted at this region. These data
      suggest the presence of a tumour-suppressor gene(s) for endometrial and cervical
      cancer at 3p13-21.3 and a separate gene at 3p21.1-22 that is involved in the
      carcinogenesis of ovarian cancer.

PMID- 1630823
TI  - Human wild-type p53 adopts a unique conformational and phosphorylation state in
      vivo during growth arrest of glioblastoma cells.
AB  - The wild-type (wt) human tumor-suppressor gene product, p53, and its mutant form
      have been analysed in an in vivo system in which the inducible expression of wt
      p53 results in growth arrest in the G1 phase of the cell cycle. Two major pools
      of p53 are detected after wt p53 expression by their differential reactivity with
      the p53 monoclonal antibodies PAb 421 and 1801 as well as the mutant and wt
      specific monoclonal antibodies PAb 240 and 1620; one pool contains wt and mutant
      p53 and is characterized as having a mutant conformation, whereas the other pool
      contains only wt p53 with a wt conformation. As G1 arrest is entered, the amount
      of wt p53 associated with the mutant pool decreases, such that by 12 h free wt
      and mutant p53 are the major pools. Two-dimensional gel analysis of the p53 pools
      revealed that free wt p53 is phosphorylated to a greater degree than mutant p53,
      which correlated with the loss of the PAb 421 epitope on wt p53. In summary, the
      ability of wt p53 to exert an antiproliferative effect correlates with the
      presence of a unique conformational state of wt p53 characterized by increased
      phosphorylation and the loss of both the PAb 421 epitope and association with
      mutant p53 pool, whereas mutant p53 is unable to assume this conformational
      state.

PMID- 1630824
TI  - Altered conformation of the p53 protein in myeloid leukemia cells and mitogen
      stimulated normal blood cells.
AB  - Expression of the normal p53 gene promotes cell differentiation, maturation and
      apoptosis. The mutant p53 gene, which does not function normally, is frequently
      expressed at elevated levels in tumor cells [for review see Lane, D.P. &
      Benchimol, S. (1990). Genes Dev., 4, 1-8]. We have analysed the expression of and
      mutational change in the p53 gene in the peripheral blood cells of 49 primary
      acute myeloid leukemia (AML) patients. The p53 protein levels were elevated in 37
      patients (75%) when measured by immunoprecipitation with antibodies PAb1801 and
      PAb421, which recognize both normal and mutant forms of the protein. The p53
      protein from 32 of these 37 patients was immunoprecipitated by PAb240, which
      recognizes a conformation of p53 protein associated with point mutations.
      However, point mutations were detected by single-stranded conformation
      polymorphism (SSCP) assay and direct sequencing in only three patients at codons
      178, 245, 273 and 290. Growth stimulation of normal lymphocytes also generated
      p53 which was immunoprecipitable by PAb240. Thus, alteration of p53 conformation,
      rather than acquisition of point mutations, could be the mechanism underlying the
      increased proliferation of myeloid cells in most AML patients.

PMID- 1630825
TI  - The conformational change of a murine temperature-sensitive p53 protein is
      independent of a change in phosphorylation status.
AB  - Wild-type and mutant p53 proteins exhibit opposing activities in respectively
      suppressing and promoting tumour development. In a rat embryo fibroblast cell
      line transformed with a murine temperature-sensitive p53 gene, p53 functions as a
      oncogene at 37 degrees C and as a tumour suppressor at 32 degrees C [Michalovitz,
      D., Halevy, O. & Oren, M. (1990). Cell, 62, 671-680]. We have used this cell line
      to investigate whether this temperature-dependent switching of function involves
      changes in the phosphorylation of p53 protein. Monoclonal antibodies PAb246 and
      PAb240 were used to immunoprecipitate metabolically 32P-labelled p53 protein in
      the 'wild-type' or mutant conformation from cells grown at 32 degrees C or 37
      degrees C. Tryptic phosphopeptide maps were prepared from the isolated 'wild
      type' and mutant p53 proteins. At 32 degrees C and 37 degrees C phosphopeptide
      maps of the 'wild-type' and mutant protein were identical. This demonstrates that
      the temperature-dependent conformation change, and associated functional change,
      in the p53 protein does not involve a change in the state of phosphorylation.

PMID- 1630826
TI  - Chromosomal assignment of two human B-raf(Rmil) proto-oncogene loci: B-raf-1
      encoding the p94Braf/Rmil and B-raf-2, a processed pseudogene.
AB  - The B-raf gene is the human homolog of the avian c-Rmil proto-oncogene encoding a
      94-kDa serine/threonine kinase detected in avian cells. We have previously shown
      that this protein contains amino-terminal sequences not found in other proteins
      of the mil/raf gene family. These sequences are encoded by three exons in the
      avian genome. We report that these three exons are conserved in the human B-raf
      gene and that they encode an amino acid sequence similar to that of the avian c
      Rmil gene, indicating that in both avian and mammalian species the product of the
      B-raf/c-Rmil gene is a 94-kDa protein. We also identified two human B-raf loci: B
      raf-1, located on chromosome 7q34, which encodes the functional B-raf/Rmil gene
      product, and B-raf-2, an inactive processed pseudogene located on chromosome
      Xq13.

PMID- 1630828
TI  - Acoustic neuroma I. Surgical management.

PMID- 1630827
TI  - Tumorigenic effects mediated in the avian embryo by one or more oncogenes
      associated with v-myc.
AB  - We have previously shown that introduction of the v-myc oncogene in chick or
      quail embryos at E3 induces rapidly growing heart rhabdomyomas. We now report
      that a retrovirus containing one or two other oncogenes induces additional
      pathologies specified by the v-myc-associated oncogene. The v-mil/myc combination
      introduced at E3 induces, in addition to heart rhabdomyomas, tumors of
      proliferating cells aggregated onto the luminal aspect of vessels in both chick
      and quail embryos. In the quail these cells react positively with the quail
      specific mAb QH1, which recognizes endothelial and most hemopoietic cells, while
      chick intravascular cells do not react with the chick-specific mAb VIA2 that
      recognizes hemopoietic cells. Thus the v-mil/myc tumors appear to be of
      endothelial origin. The v-myb-ets/myc combination injected at E3 induces
      cardiorhabdomyomas and aggressive VIA2-positive hemopoietic tumors in chick
      embryos, but only the v-myc-induced cardiorhabdomyomas in quail embryos. When
      injected into hatched animals, v-myc alone transforms hemopoietic and perhaps
      endothelial cells, but not cardiac cells. Thus the developmental stage at which a
      cell type can be transformed by v-myc and another associated oncogene depends on
      as yet undefined species-specific factors. More importantly, several examples of
      oncogene cooperation in vivo are adduced by these experiments. The type of cell
      transformed is specified by the viral oncogene combination.

PMID- 1630829
TI  - Microsurgical anatomy of acoustic neuroma.
AB  - Because acoustic neuromas most frequently arise in the posteriorly placed
      vestibular nerves, they usually displace the facial and cochlear nerves
      anteriorly (Figs. 11, 12, and 13). The facial nerve is stretched around the
      anterior half of the tumor capsule. Variability in the direction of growth of the
      tumor arising from the vestibular nerves may result in the facial nerve being
      displaced, not only directly anteriorly, but also anterior-superiorly or anterior
      inferiorly. The nerve is infrequently found on the posterior surface of the
      tumor. Because the facial nerve always enters the facial canal at the anterior
      superior quadrant of the lateral margin of the meatus, it is usually easiest to
      locate it here, rather than at a more medial location where the degree of
      displacement of the nerve is more variable. The cochlear nerve also lies anterior
      to the vestibular nerve and is most frequently stretched around the anterior half
      of the tumor. The strokes of the fine dissecting instruments used in removing the
      tumor should be directed along the vestibulocochlear nerve from medial to lateral
      rather than from lateral to medial because traction medially may tear the tiny
      filaments of the cochlear nerve at the site where these filaments penetrate the
      lateral end of the meatus to enter the cochlea. The landmarks that are helpful in
      identifying the facial and vestibulocochlear nerves at the brain stem on the
      medial side of the tumor have been reviewed. These nerves, although distorted by
      tumor, can usually be identified on the brain stem side of the tumor at the
      lateral end of the pontomedullary sulcus, just rostral to the glossopharyngeal
      nerve and just anterior-superior to the foramen of Luschka, flocculus, and
      choroid plexus protruding from the foramen of Luschka. After the facial and
      vestibulocochlear nerves are identified on the medial and lateral sides of the
      tumor, the final remnants of the tumor are separated from the intervening segment
      of the nerves. In the three approaches to the meatus and cerebellopontine angle-
      retrosigmoid, translabyrinthine, and middle fossa--a communication may be
      established between the subarachnoid space and the mastoid air cells that
      requires careful closure to prevent a cerebrospinal fluid leak.

PMID- 1630830
TI  - Retrosigmoid approach for acoustic tumor removal.
AB  - The retrosigmoid technique has evolved from the traditional suboccipital
      operation and, when combined with removal of the posterior wall of the internal
      auditory canal, affords a wide exposure of the cerebellopontine angle. This
      approach may be used for acoustic neuromas of all sizes, from intracanalicular to
      more than 4 cm from the porus acusticus. Hearing preservation may be attempted
      and is generally successful in a substantial minority of cases. The facial nerve
      is readily visualized at the lateral end of the internal auditory canal and is at
      no greater risk than in the translabyrinthine operation. We use this approach for
      all hearing preservation surgery as well as for tumors of more than 3 cm,
      regardless of hearing.

PMID- 1630831
TI  - Translabyrinthine approach for acoustic tumor removal.
AB  - The translabyrinthine approach is the most direct route to the cerebellopontine
      angle. It is the preferred approach for removal of all tumors in patients with
      poor hearing and for large tumors when the likelihood of hearing preservation is
      slight. This approach offers the advantages of minimum cerebellar retraction,
      identification of the facial nerve proximally and medially, and the ability to
      repair immediately the facial nerve if it is severed during acoustic tumor
      removal. This approach has the lowest morbidity with regard to spinal fluid leaks
      and also postoperative headaches.

PMID- 1630832
TI  - Transotic approach to the cerebellopontine angle.
AB  - The transotic approach to the cerebellopontine angle for resection of tumors
      invading the internal auditory canal provides superior illumination and exposure
      for optimal preservation of facial nerve function. Separation of facial nerve
      from tumor is enhanced with an anterior exposure that allows visualization of the
      intracranial segment of the nerve before tumor removal without significantly
      increasing total operative time. Facial nerve grafting or hypoglossal-facial
      anastomosis may be incorporated into the procedure at the time of tumor resection
      using the transotic approach. When combined with a musculofascial patch secured
      to the dural defect, the initial subtotal petrosectomy with eustachian tube and
      middle ear cleft obliteration generally avoids the complication of an immediate
      or delayed postoperative cerebrospinal fluid leak. The transotic approach is
      indicated for tumors up to 2.5 cm in size that are not adherent to the brain
      stem.

PMID- 1630833
TI  - Middle fossa approach for acoustic tumor removal.
AB  - The middle fossa approach is well suited for the removal of small acoustic tumors
      with possible hearing preservation. The most appropriate candidates have tumors
      with less than 5 mm extension into the cerebellopontine angle and good
      preoperative hearing (speech reception threshold less than or equal to 30 dB,
      speech discrimination score greater than or equal to 70%). Measurable
      postoperative hearing can be preserved in 31% to 59% of patients, and normal or
      near normal facial function occurs in 86% to 89%. Serious postoperative
      complications are rare with this approach. With the advent of gadolinium-enhanced
      MRI, it is now possible to diagnose acoustic tumors reliably when small and
      before hearing has been significantly affected. The middle fossa approach
      provides excellent access for the removal of these small tumors.

PMID- 1630834
TI  - Selection of surgical approach to acoustic neuroma.
AB  - A variety of surgical approaches are available in the management of acoustic
      neuroma. Each procedure has certain advantages and disadvantages in terms of
      surgical exposure, the capability of preserving cranial nerve function, and
      postoperative morbidity. This article advocates tailoring the operative approach
      to each acoustic neuroma according to its size, location, and clinical
      manifestations.

PMID- 1630835
TI  - Complications in acoustic neuroma surgery.
AB  - There has been a continuous lowering of mortality and morbidity rates in the 20th
      century, thanks to increasing experience and newer technology. Despite this, the
      readership should be aware of the hazards involved in this challenging field.
      Complications occur, and their incidence, mechanism, management, and prevention
      have been outlined here so physicians performing these procedures will be better
      prepared to manage them. We have found that the occurrence of complications can
      be greatly reduced through a team approach using the combined talents of a
      neurotologist, neurosurgeon, and frequently an internist. It is apparent from
      this article that the morbidity of removing larger tumors is significantly
      greater than the morbidity of removing small tumors. The recent introduction of
      MRI to the diagnostic armamentarium of the neurotologist may permit earlier
      detection and a further reduction of morbidity and mortality rates. Only
      continued study of prevention of complications will assure the improved quality
      of our results for patients undergoing microsurgical removal of acoustic
      neuromas.

PMID- 1630836
TI  - Intraoperative monitoring of facial and cochlear nerves during acoustic neuroma
      surgery.
AB  - The likelihood of successful preservation of facial and cochlear nerve function
      during acoustic neuroma surgery has been improved by the advent of intraoperative
      monitoring techniques. The facial nerve is monitored by recording EMG from facial
      muscles, with no muscle relaxants used; mechanical irritation of the nerve during
      surgery causes increased EMG activity, which can be detected in real time using a
      loudspeaker. Brief episodes of activity associated with specific surgical
      maneuvers aid the surgeon in avoiding damage to the nerve, whereas prolonged
      tonic EMG activity may reflect significant neural injury. Electrical stimulation
      with a hand-held probe elicits evoked EMG responses, which can be used to locate
      and map the nerve in relation to the tumor. The threshold for eliciting evoked
      EMG responses provides a rough indicator of the functional status of the nerve.
      Different nerves in the posterior fossa (trigeminal, facial, spinal accessory)
      can be identified in multichannel recordings by the spatial distribution and
      latency of responses to electrical stimulation. The ability to elicit EMG
      responses from low amplitude stimulation of the facial nerve at the brain stem
      after tumor removal is a reasonable predictor of postoperative facial function.
      Cochlear nerve function is assessed by recording the ABR from ear canal and scalp
      electrodes or the CNAP with an electrode placed directly on the nerve at the
      brain stem root entry zone. The ABR is a well-known, noninvasive technique that
      can be adapted to intraoperative use relatively easily but is of limited utility
      owing to the delay inherent in signal averaging. Direct CNAP recordings require
      placement of an intracranial electrode in such a way as to contact the cochlear
      nerve without interfering with surgical access but have the distinct advantage of
      rapid feedback on changes in cochlear nerve status.

PMID- 1630837
TI  - Management of bilateral acoustic neuroma.
AB  - This article has reviewed the genetic disorder, neurofibromatosis 2. The history,
      nomenclature, genetic etiology, epidemiology, diagnostic criteria, pathogenesis,
      and presentation of neurofibromatosis 2 have been given. A related but distinctly
      different disorder, neurofibromatosis 1, has also been described. The diagnostic
      evaluation of neurofibromatosis 2 has been discussed with an emphasis on the
      importance of early diagnosis. An analysis of the surgical treatment of bilateral
      acoustic neuromas as well as nonsurgical therapeutic alternatives has been
      presented. The results and complications in the operative management of 86
      acoustic tumors in 49 patients with neurofibromatosis 2 have been described in
      detail. The poor immediate hearing results and the even poorer long-term hearing
      results have been examined in light of the invasive histopathology of these
      tumors. It has been emphasized that patients with neurofibromatosis 2 and
      asymptomatic family members require comprehensive, multidisciplined, long-term
      management.

PMID- 1630838
TI  - Stereotactic radiosurgery in the treatment of patients with acoustic tumors.
AB  - Stereotactic radiosurgery is performed under local anesthesia, and most patients
      can be discharged from the hospital within 24 hours of treatment. All patients in
      our series returned to their preoperative level of employment or function within
      5 to 7 days of treatment, and this functional level was maintained over the
      period of follow-up. "Tumor control" was achieved in 96% of patients during an
      average follow-up of 1.7 years. Tumor shrinkage occurred in 45% of patients who
      had at least 1.5 years of follow-up. Useful hearing preservation rates were 50%
      at 6 months and 30% 1 year after treatment. New delayed facial or trigeminal
      neuropathy occurred in 34% and 32% of patients, respectively, with a median onset
      of 5 to 6 months after treatment. The vast majority of cranial neuropathies were
      partial at onset and tended to improve over time. Other complications included
      tumor growth (4%), communicating hydrocephalus (4%), and transient adjacent brain
      parenchymal changes best seen on T2-weighted MRI (9%). Stereotactic radiosurgery
      is an important alternative treatment for carefully selected patients with
      acoustic tumors. Indications for treatment include sufficient medical problems to
      pose excessive surgical risk, advanced age, the presence of bilateral acoustic
      tumors or contralateral deafness, recurrent tumor despite surgical resection, or
      refusal to undergo microsurgery. Radiosurgery is contraindicated in patients with
      symptomatic brain stem or cerebellar compression from a large acoustic tumor.
      Previous posterior fossa radiotherapy is a relative contraindication that must be
      considered on a patient to patient basis. Stereotactic radiosurgery should be
      viewed as an additional weapon in our arsenal for combating acoustic tumors
      rather than feared as a potential replacement for surgical excision. The
      strategic role of stereotactic radiosurgery in the overall treatment of patients
      with acoustic tumors will continue to be refined as longer-term, carefully
      assessed results become available.

PMID- 1630839
TI  - Bladder pressure and kidney function in children with myelomeningocoele: review
      article.
AB  - Therapy of children with myelomeningocoele should achieve a double goal: on the
      one hand, obtain continence and, on the other hand, preserve kidney function
      without complications. The first goal is a social and psychological one, the
      latter is a vital one.

PMID- 1630840
TI  - Hangman's fracture in Singapore (1975-1988).
AB  - A retrospective study of 33 patients with fracture of the ring of the axis
      (hangman's fracture) admitted to the Spinal Unit of the Department of
      Rehabilitation Medicine in the Tan Tock Seng Hospital between 1975 and 1988 was
      carried out. The aims were to establish the causes, mechanism and outcome of
      injuries that lead to Hangman's fracture in Singapore. The majority were males
      (27) and their ages ranged from 16 to 82 with a mean age of 33.7 years. 63.6% (21
      cases) were due to road traffic accidents of whom 33% (11 cases) were
      motorcyclists or pillion riders and 30.3% (10 cases) were drivers or passengers
      of four wheel vehicles such as cars and vans. Using Effendi et al's
      classification, we have 21 type I, 11 type II and one type III fractures.
      Thirteen type I, 6 type II and one type III cases had no neurological deficit on
      admission. The rest had deficits ranging from tetraparesis to pure bladder
      dysfunction. After rehabilitation, 28 (84.8%) of them were able to return to
      gainful employment within a year of their injuries.

PMID- 1630841
TI  - Human osteoblast stimulation by sera from paraplegic patients with heterotopic
      ossification.
AB  - The pathophysiology of heterotopic periarticular ossification is not understood.
      Though local agents may be responsible, factors present in the serum may be
      contributory. Sera from 4 paraplegic patients with heterotopic ossification and 4
      'normal' paraplegics were incubated with human osteoblasts in tissue culture and
      their metabolic activity was measured quantitatively. There were significantly
      greater levels of osteoblast stimulating factors present in the sera of ossifying
      patients, (p less than 0.01). These factors may contribute to the pathogenesis of
      heterotopic ossification.

PMID- 1630842
TI  - Prophylactic low dose heparin anticoagulant therapy in patients with spinal cord
      injuries: a retrospective study.
AB  - A retrospective study was performed of 100 consecutive acute traumatic spinal
      injury patients with neurological deficit admitted to the Yorkshire regional
      spinal injuries centre prior to May 1990. Ninety-seven of these patients received
      prophylactic low dose subcutaneous heparin and 3 patients were excluded because
      of noted complications. Twenty-six patients developed thromboembolic
      complications. Apart from the fact that acute spinal cord injury patients are
      considered to be in an hypercoaguable state, the occurrence of deep vein
      thrombosis/pulmonary embolism (DVT/PE) in our study, even though these patients
      were on prophylactic low dose subcutaneous heparin, was related to delay in
      transfers, operative intervention, level of spinal cord injury and was possibly
      due to loss of some amount of heparin solution from the prefilled syringe during
      removal of air bubbles prior to the subcutaneous heparin injection.

PMID- 1630843
TI  - Suicide following acute traumatic spinal cord injury.
AB  - The rate of suicide following spinal cord injury has not been extensively studied
      but appears to be greater than in the general population. Six patients who died
      by suicide, from a total of 342 patients who were treated for acute spinal cord
      injury over a 5 year period are described. Clinical features shared by this group
      of patients included being male; having schizoid, depressive or narcissistic
      personality traits; alcohol or drug abuse; family or significant others favouring
      death as a preferred option; and the development of significant depression.

PMID- 1630844
TI  - Modified Brown-Sequard syndrome following coronary artery bypass graft: case
      report.
AB  - A 75 year old man underwent a triple coronary artery bypass graft performed with
      intra-aortic balloon pump assistance. Left leg weakness developed on the first
      postoperative day, progressive worsening occurred over the next 2 1/2 weeks,
      finally culminating in a modified Brown-Sequard pattern of deficit. No etiology
      was found. Previous reports of spinal cord injury following coronary artery
      bypass graft are reviewed and the microcirculation of the spinal cord is
      discussed.

PMID- 1630845
TI  - Brown-Sequard syndrome due to Semple antirabies vaccine: case report.

PMID- 1630846
TI  - The prevalence of hyperhidrosis in patients with spinal cord injuries and an
      evaluation of the effect of dextropropoxyphene hydrochloride in therapy.
AB  - The prevalence of annoying hyperhidrosis (HH) in patients with spinal cord
      traumatic lesions was investigated by a questionnaire. A total of 192 patients
      were sent the questionnaire, 154 patients answered, and 41 patients reported
      annoying sweating. Of these 41 patients, 13 had a somatic underlying cause and 28
      indicated having annoying HH without a contributing somatic cause. Twenty-five
      patients with spinal cord injury (SCI) were included in a double-blind,
      randomized, placebo-controlled, crossover trial using dextropropoxyphene
      hydrochloride (DP) in a slow release form (Abalgin Retard 150 mg Benzon Pharma
      A/S, Copenhagen) twice a day, for the treatment of annoying HH. Nineteen patients
      with lesions between C4 and L4 completed the study. Eight found the active drug
      to be so effective that they wanted to continue the treatment while 3 preferred
      placebo. Six patients dropped out, 5 due to adverse effects. There was a trend
      towards an effect on sweating in daytime (p = 0.08-0.14). Given that the patients
      had a preference, which 15 of 19 had, the true frequency of patients preferring
      active treatment ranged from 32 to 84% (95% exact confidence limits). For those
      with SCI above T6 level the limits ranged from 40 to 97%. We conclude that in
      spite of the lack of statistically significant effect, it seems worthwhile to try
      DP for annoying HH, especially in patients with lesions above T6 level.

PMID- 1630847
TI  - Sexual issues of women with spinal cord injuries.
AB  - The need for research addressing problems unique to women with spinal cord
      injuries is well documented. Consequently, 231 such women, ages 18 to 45, were
      surveyed. Demographic characteristics and data relating to physician usage,
      female hygiene, pregnancy, contraception and sexuality were collected. Analysis
      revealed that 60% of the respondents had post injury amenorrhea; the average time
      until menses resumption was 5 months. The group's post injury pregnancy rate was
      one-third its pre injury rate, but women with incomplete paraplegia had
      significantly more pregnancies than those with complete quadriplegia. Of 47 women
      who did carry babies to delivery, one-half had vaginal deliveries; 49% used no
      anesthesia. Problems during pregnancy included autonomic hyperreflexia, decubitus
      ulcers, urinary tract infections, water retention, bladder and bowel problems,
      anemia, spotting, fatigue, cardiac irregularity and toxemia. Many of these
      problems plagued the women during labor and delivery and in the post partum
      period as well. Sixty-nine percent of the women were satisfied with their post
      injury sexual experiences, although self confidence, spasticity, and lack of
      spontaneity were issues. Although satisfied with care received from physicians,
      many women were not content with the information provided during rehabilitation,
      and felt a need for more literature, counselling, and peer support.

PMID- 1630848
TI  - Septic ischial bursitis in patients with spinal cord injury.
AB  - Septic ischial bursitis is described in 4 patients with spinal cord injury. In
      these patients a pre-existing ischial bursitis probably became secondarily
      infected. Because these patients lack sensation, diagnosis may be difficult. The
      disease process in one patient with a prolonged fever was only recognized after a
      leucocyte scan detected an abscess extending to the thigh. At surgery it was
      found that the infection extended from the ischial bursa to the upper lateral
      thigh. Infection in these patients was due to beta hemolytic streptococcus, S.
      aureus, and S. epidermidis. The patients all responded well to local drainage and
      excision of the bursa.

PMID- 1630850
TI  - Anourethral reflex. Description of a reflex and its clinical significance:
      preliminary study.
AB  - A new reflex which I call the 'ano-urethral reflex' is described and its clinical
      significance discussed. It was studied in 16 volunteers with normal vesical and
      rectal functions. A concentric needle electrode was introduced into the external
      and sphincter (stimulating), and another one into the external urethral sphincter
      (recording). The reflex response was recorded by EMG apparatus. The external
      urethral sphincter basal activity was increased with stimulation of the external
      anal sphincter. This reflex response was absent when the external and sphincter
      was anesthetised. The average latency of the reflex was 129.5 ms. Reflex urethral
      sphincter contraction at defecation guards against involuntary micturition which
      may result from rectal distension and levator contraction. The anourethral reflex
      can be a valuable diagnostic tool in routine investigations of patients with
      urological and proctological complaints.

PMID- 1630849
TI  - Increased serum osteocalcin levels in patients with paraplegia.
AB  - Osteocalcin(OC) is a specific serum parameter of bone formation. Since bone
      metabolism disturbances, including osteoporosis, are seen in paraplegia, the
      serum levels of OC, midregional parathyroid hormone(mPTH), intact para-thyroid
      hormone (iPTH) and calcitonin (CT) serum levels were determined in 13 patients
      with paraplegia or tetraplegia and 15 control subjects by radioimmunoassay in a
      cross sectional study. In addition, the urinary hydroxyproline/creatine and the
      urinary calcium/creatinine ratio was determined. Serum OC levels were
      significantly increased in the patients with spinal cord injury (p less than
      0.02), whereas serum levels of mPTH, iPTH and CT were not statistically
      different. The urinary hydroxyproline/creatinine ratio was significantly higher
      in the patients than in the controls (p less than 0.02), and the urinary
      calcium/creatinine ratio also tended to be higher in the patients. In a follow up
      study over 6 months after spinal cord injury, serum OC, serum iPTH, urinary
      hydroxyproline/creatinine ratio and the calcium/creatinine ratio were determined
      in 6 patients at monthly intervals. Hyperhydroxyprolinuria preceded the gradual
      increase of serum OC from normal to clearly elevated levels. Our data suggest
      that increased bone resorption in paraplegia is linked to an enhanced
      osteoblastic activity.

PMID- 1630851
TI  - The social and vocational outcome of spinal cord injury patients.
AB  - Functional status, perception of adjustment, occupational outcome and social
      functioning were investigated in a group of spinal cord injury (SCI) patients
      (mean age 34, range 10-74 years) seen at a specialised spinal unit over the
      period January 1984-December 1988. Functional status was assessed using a
      standardised scale measuring patients' performance of specific tasks, and other
      measures of outcome were investigated by a structured interview. Almost two
      thirds (68%) of the patients were independent according to the standardised scale
      (33% quadriplegic and 84% paraplegic). Patients' autonomy appeared to be
      threatened by architectural barriers in and about the house: approximately one
      third (34%) of those classified as 'independent' on the standardised
      rehabilitation scale used needed some help in their everyday life. A negative
      occupational outcome emerged: compared to the pre-morbid situation, 43 patients
      (44%) were worse off; 48 (49%) did not experience substantial changes--though it
      must be noted that 68% of these (33/48) were virtually unemployed (ie student,
      home maker, retired, unemployed) before the injury; and for 6 (7%) some
      improvement took place. With a multivariate analysis age was the only
      statistically significant predictor of poor occupational outcome, with older
      patients being worse off irrespective of the extent of disease and functional
      autonomy. The paper discusses these results and stresses the need for integrating
      results based on the use of standardised rehabilitation scales with the analysis
      of potential barriers influencing a patient's ability to exploit his/her
      autonomy.

PMID- 1630852
TI  - The management of an old fused hip after the occurrence of paraplegia.
AB  - Two patients are reported who suffered traumatic paraplegia, and had a long
      standing fused hip joint. Both required an excision (Girdlestone) arthroplasty to
      allow them to sit and one, who made a late but substantial neurological recovery,
      eventually underwent a total hip replacement. Both suffered thromboembolic and
      urinary complications. These may not have occurred if the procedures had been
      carried out earlier. Early mobilisation of the hip joint is recommended in these
      circumstances.

PMID- 1630853
TI  - Electrical stimulation of the lumbrical muscles in an incomplete quadriplegic
      patient: case report.
AB  - The increasing number of incomplete cervical spinal cord injuries means that more
      attention needs to be focused on the rehabilitation of the incomplete
      quadriplegic hand. A case study, describing the application of electrical
      stimulation for strengthening the paretic lumbrical muscles, is presented. A 2
      week strengthening program resulted in a 33% increase in the force produced by
      the lumbrical muscles. No loss of strength had occurred 4 weeks after cessation
      of the treatment. The magnitude and speed of this result should be of interest to
      those clinicians who seek to maximise patient independence in minimal time.

PMID- 1630854
TI  - Nosocomial urinary tract infections at a pediatric hospital.
AB  - Although the epidemiology of nosocomial urinary tract infections (NUTIs) is well
      described in the adult population, there is little information on children. We
      therefore reviewed all our patients with NUTIs, to determine their age,
      underlying diagnoses, microorganisms involved, use of catheters and secondary
      bacteremias. During a 2-year period at our institution, NUTIs accounted for 10%
      of all nosocomial infections (0.8 infections/100 admissions). Of 44,948 patients
      admitted during this period 0.7% (n = 318) acquired 351 episodes of NUTI. The
      patient ages ranged from 5 days to 21 years. The highest rates of NUTIs per ward
      (NUTI/100 admissions or transfers to the ward) were seen in the neonatal surgery
      (4.8), hematology/oncology (2.7), infant neurosurgery (2.1) and neonatal
      intensive care units (1.9). The most common organisms isolated were Escherichia
      coli (26%), Enterococcus sp. (15%), Pseudomonas sp. (13%), Klebsiella sp. (10%)
      and coagulase-negative Staphylococcus (9%). Catheterrelated infections accounted
      for 48% of all the NUTIs. Secondary bacteremia occurred rarely, with an incidence
      of 2.9% (n = 7). We conclude that NUTIs represent an important proportion (10%)
      of nosocomial infections in our population of hospitalized children, but
      secondary bacteremia is uncommon.

PMID- 1630855
TI  - Nontuberculous mycobacteria in children with acquired immunodeficiency syndrome.
AB  - Among 139 children with acquired immunodeficiency syndrome at Children's Hospital
      of New Jersey, 20 had positive cultures for non-tuberculous mycobacteria. Eighty
      five percent had Mycobacterium avium complex isolated and 70% had definite
      evidence of disseminated disease. Ninety-three percent had CD4 lymphocyte counts
      less than 100 cells/mm3 and 95% had met acquired immunodeficiency syndrome
      criteria before the time of first positive culture. Clinical findings included
      failure to gain weight, anorexia, fever, abdominal pain/tenderness and anemia.
      The median age at onset of symptoms was 46 months and the median time between
      onset of symptoms and positive culture was 9 months. Outcome for patients with
      positive cultures for nontuberculous mycobacteria was poor, with 75% of the
      children surviving for less than or equal to 10 months. Nontuberculous
      mycobacteria are increasingly important causes of morbidity and indirect
      mortality in human immunodeficiency-infected children. Children with severe
      immunodeficiency are at particular risk. In addition to M. avium complex, other
      species of nontuberculous mycobacteria may be involved.

PMID- 1630856
TI  - Pharmacokinetic study of piperacillin in newborns relating to gestational and
      postnatal age.
AB  - The pharmacokinetics of piperacillin after a single 75-mg/kg intravenous
      injection as analyzed in 28 neonates with gestational ages of 29 to 40 weeks (A =
      29 to 31 weeks, B = 33 to 35 weeks, C = 38 to 42 weeks) and birth weights of 860
      to 3900 g during 35 courses. Serum concentrations of piperacillin were determined
      by high pressure liquid chromatography. A one compartment open model
      characterized the disposition of piperacillin. Twenty courses were given between
      Day 3 and Day 5 of life. The elimination half-life and total body clearance were
      related to gestational age. Differences were significant between Groups A and B
      and Group C for half-life (4.3 +/- 1.9 and 3.35 +/- 0.75 vs. 2.47 +/- 0.72 hours)
      and for clearance (1.68 +/- 0.6 and 1.8 +/- 0.4 vs. 2.46 +/- 0.36 ml/min/kg).
      Volumes of distribution were similar in the 3 groups, from 516 +/- 108 to 633 +/-
      226 ml/kg. Fourteen courses were given from Day 9 to Day 11 of life. The same
      differences were observed between Groups A and B and Group C. Elimination half
      life was significantly reduced with simultaneous increase of the total body
      clearance. In clinical practice, 75-mg/kg intravenous injections every 12 hours
      during the first week of life and every 8 hours in the second week provide
      appropriate concentrations in infants of less than 36 weeks gestational age. In
      full term newborns the 75-mg dosage is appropriate but the number of injections
      must be increased to 3/24 h for the first week and 4 times daily thereafter.

PMID- 1630857
TI  - Efficacy of Haemophilus influenzae type b vaccines in Massachusetts children 18
      to 59 months of age.
AB  - Since 1987 Haemophilus influenzae b (Hib) conjugate vaccines have been licensed
      for use in children ages 18 months and older. Before licensure there were no
      clinical trials of a single dose of any conjugate vaccine in children ages 18
      months or older. To fulfill this need we performed an age- and residence-matched
      case-control study of the efficacy of Hib vaccines. In our study population the
      protective efficacy (PE) of Hib-diphtheria toxoid conjugate vaccine was 88% (95%
      confidence interval, 45 to 98%). No vaccine failures were observed with Hib
      oligosaccharide CRM197 diphtheria protein conjugate vaccine, but usage was not
      sufficient to establish efficacy: PE = 100% (95% confidence interval, -37 to
      100%). The protective efficacy of Hib capsular polysaccharide vaccine was 18%
      (95% confidence interval -487 to 89%). We conclude that for children ages 18 to
      60 months a single dose of the Hib conjugate vaccine, PRP-D, is protective
      against invasive Hib infections. Consistent with most studies Hib polysaccharide
      vaccine provided suboptimal protection.

PMID- 1630858
TI  - Interrelationship between diarrhea and vitamin A deficiency: is vitamin A
      deficiency a risk factor for diarrhea?
AB  - A cross-sectional study, a follow-up study and an evaluation of impact of
      community-based distribution of vitamin A capsules (200,000 IU) were conducted in
      Omdurman (Sudan) between November, 1988, and March, 1989. In the cross-sectional
      survey 1441 children less than 5 years of age participated, which established the
      baseline values for plasma retinol-binding protein. During the follow-up period
      290 cases of diarrhea occurred. Low concentrations of plasma retinol-binding
      protein (less than 1.85 mg/dl) proved to be a risk factor for diarrhea,
      especially in girls. The relative risk increased after the second year of life.
      Children who received vitamin A supplementation before commencement of the study
      had a lower incidence of diarrhea. The protective effect of vitamin A
      supplementation was greater in girls (relative risk, 0.297; 95% confidence
      interval, 0.240 to 0.368) than in boys (relative risk, 0.404; 95% confidence
      interval, 0.352 to 0.464).

PMID- 1630859
TI  - Analysis of a measles outbreak in Kent County, Michigan in 1990.
AB  - New recommendations from the Immunization Practices Advisory Committee call for a
      second dose of measles vaccine for school age children. The purpose of this paper
      is to demonstrate the need for additional measures for the protection of
      preschool age children. A hospital-based measles outbreak of 25 cases in Kent
      County, MI, in 1990 provided an opportunity to study measles transmission to
      preschool age children. Twenty-two (88%) were people who had never received
      measles vaccine. Twelve of the cases were unvaccinated preschoolers, seven of
      whom were older than 15 months. Three nonvaccinated, but eligible people (one
      philosophic exemption and two vaccine-eligible preschoolers) were the source of
      most of the other cases. One school age unvaccinated child died of measles
      pneumonitis. A telephone survey indicated that improved public education
      regarding indications and contraindications to vaccination might encourage
      vaccination of children according to public health recommendations.

PMID- 1630860
TI  - Biology and molecular biology of human immunodeficiency virus.

PMID- 1630862
TI  - Disseminated Acanthamoeba infection in a child with symptomatic human
      immunodeficiency virus infection.

PMID- 1630861
TI  - Inherited C3 deficiency and meningococcal disease in a teenager.

PMID- 1630863
TI  - Ciprofloxacin treatment of multiply drug-resistant extrapulmonary tuberculosis in
      a child.

PMID- 1630864
TI  - Tuberculous peritonitis in a three-year-old boy: case report and review of the
      literature.

PMID- 1630865
TI  - Sinusitis and bacteremia caused by Flavobacterium meningosepticum in a sixteen
      year-old with Shwachman Diamond syndrome.

PMID- 1630866
TI  - Congenital staphylococcal scaled skin syndrome: report of a case.

PMID- 1630867
TI  - Imipenem therapy for melioidosis in two children.

PMID- 1630868
TI  - Prolonged fever in a 21-month-old boy.

PMID- 1630869
TI  - Maternal-infant transmission of hepatitis C virus infection.

PMID- 1630870
TI  - Significance of viridans streptococci in blood cultures from children.

PMID- 1630871
TI  - Ciprofloxacin therapy for localized melioidosis.

PMID- 1630872
TI  - Varicella in children receiving steroids for asthma: risks and management.

PMID- 1630873
TI  - Synopsis Book. Best articles relevant to pediatric allergy and immunology.
      Abstracts.

PMID- 1630874
TI  - Platinum antitumour agents: a review of (bio)analysis.
AB  - This paper summarizes analytical techniques in order to get a clear picture of
      the ins and outs of the (bio)analysis of platinum-containing compounds. The
      antitumour agent cisplatin has become an indispensable drug for the cure of a
      variety of cancer diseases. Since its introduction in the early seventies, about
      2,000 related platinum complexes were designed to devoid the dose-limiting
      nephrotoxicity. Some of them were introduced for clinical trial, such as
      carboplatin and iproplatin. To investigate the mechanism of action and pharmaco
      kinetic behaviour, several interesting assays for total and specific platinum
      determination in biological matrices have been developed, each with its own
      possibilities and limitations.

PMID- 1630875
TI  - Clinical and pharmaceutical aspects in acute poisoning.
AB  - Today there are several methods for treating intoxicated patients. If these
      patients arrive in hospital in time, the diagnosis is correct and appropriate
      therapy is instituted, nearly all survive without any physical damage. This is
      best achieved by team-work between the hospital pharmacist and the physician
      treating the patient. Both should have a sound knowledge of the toxicological
      properties of drugs and other poisons and the clinical features which they
      produce. This article emphasizes the need for close co-operation between the
      pharmacist and the physician and discusses specific therapeutic measures, such as
      prevention of absorption, acceleration of elimination, symptomatic therapy and
      administration of antagonists.

PMID- 1630876
TI  - Direct measurement of probenecid and its glucuronide conjugate by means of high
      pressure liquid chromatography in plasma and urine of humans.
AB  - Probenecid with its phase-I metabolites, and phase-II glucuronide conjugate can
      be analysed by a gradient high pressure liquid chromatographic method. Probenecid
      glucuronide in plasma with pH 7.4 is not stable and declines to 10% of the
      original value within 6 h (t1/2 approximately 1 h). Probenecid glucuronide is
      stable in urine with pH 5.0, moderately unstable at pH 6.0 (t1/2 approximately 10
      h), and unstable at pH 8.0 (t1/2 approximately 0.5 h). Probenecid glucuronide is
      stable in water and 0.01 mol/l phosphoric acid in the autosampler of the high
      pressure liquid chromatograph. The decrease in concentration in water is 5.5%
      during 9 h and 0% in diluted acid. Probenecid glucuronide and the phase-I
      metabolites were not detectable in plasma. The main compound in fresh urine is
      the phase-II conjugate probenecid glucuronide (62% of a 500 mg dose); the phase-I
      metabolites are present and only a trace of probenecid is present. The percentage
      of the dose of the phase-I metabolites varies between 5 and 10, while hardly any
      probenecid is excreted unchanged (0.33%).

PMID- 1630877
TI  - Centralized preparation of hazardous drugs. A choice between isolator and laminar
      airflow.
AB  - In 1987, the manager of the Saint-Joseph Hospital (Paris, France) requested a
      reorganization of cytotoxic drug preparation. Protection for staff who handle
      hazardous drugs was the main concern. The conclusions drawn from a first analysis
      emphasize the advantages of a centralized reconstitution unit against a
      decentralized system. Subsequently, a workload study and an economic study
      (investment, maintenance, supplies, staff costs, comparative balance sheet and a
      5-year simulation) were carried out, but to choose between a laminar airflow in
      aseptic room and an isolator in a conventional room. The selected isolator is the
      first of the conception: the central half-suit uses as a server, and four sleeves
      located on one side allow two technicians to work in a sterile and closed area
      without sterile garments.

PMID- 1630878
TI  - Hydrocortisone anaphylaxis: a new case report.
AB  - In this report we describe a case of a nonatopic patient who developed an
      anaphylactoid reaction immediately after receiving intravenous hydrocortisone.
      The patient recovered after reanimation techniques and intravenous administration
      of atropine, epinephrine and plasma expanders. Although allergic reactions to
      corticosteroids appear to be rare there are a few case reports in the literature.
      This case is presented to draw the attention of clinicians to the occasional
      hazard of intravenous corticosteroid preparations, specially hydrocortisone.

PMID- 1630879
TI  - Influence of caffeine, Ca2+, and Mg2+ on ryanodine depression of the tension
      transient in skinned myocardial fibers of the rabbit.
AB  - Ryanodine, a blocker for Ca(2+)-release channels of the sarcoplasmic reticulum
      (SR Ca(2+)-release channels), induces depression of myocardial contraction in
      isolated intact muscle, which is consistent with depression of the caffeine
      induced tension transient in skinned muscle fibers. In isolated SR, ryanodine
      binds to a specific receptor with high affinity, and this binding is enhanced by
      caffeine and increasing Ca2+ and decreased by increasing Mg2+. The aim of this
      study was to test the hypothesis that depression of myocardial contraction is
      mediated by changes in ryanodine-receptor binding properties. Accordingly,
      factors (caffeine, Ca2+, and Mg2+) affecting ryanodine-receptor binding
      properties in the isolated SR membrane were studied in skinned myocardial fibers
      from adult rabbits. The depression of the caffeine-induced tension transient by
      ryanodine (ryanodine depression) influenced by these three factors was measured.
      In a dose-dependent manner, increasing caffeine or Ca2+ concentrations enhanced
      the ryanodine depression. The concentrations for 50% ryanodine depression (IC50)
      approximated 7 mM for caffeine, and pCa 5.25 for Ca2+. When 1 microM ryanodine
      and 25 mM caffeine were combined, ryanodine depression was independent of Ca2+ at
      low Ca2+ concentrations (20%-30% at pCa greater than 8 and 7.5) and was a direct
      function of Ca2+ at higher concentrations (pCa 7.5-6.0 with IC50 approx. pCa
      6.75). In contrast, increasing Mg2+ reduced the ryanodine depression with IC50
      approximately equal to pMg 3.3. In conclusion, the caffeine- or Ca(2+)-enhanced,
      and Mg(2+)-reduced ryanodine depression observed in this study is consistent with
      known ryanodine-receptor binding properties.

PMID- 1630880
TI  - Water handling in the rat jejunum: effects of acidification of the medium.
AB  - The minute-by-minute net water movement (Jw) in the rat jejunum was studied in
      relation to the diffusive water (Pw) and mannitol (Ps) permeabilities with the
      following results. (a) Jw was a linear function of the applied hydrostatic and
      osmotic transepithelial gradients (hydrostatic permeability coefficient, Phydr =
      0.052 +/- 0.011 cm s-1; osmotic permeability coefficient, Posm = 0.0069 +/-
      0.0014 cm s-1. (b) A fraction of this absorptive Jw (transport-associated Jw, Jwt
      = 0.086 +/- 0.024 microliter min-1 cm-2) was independent of the presence of any
      osmotic, hydrostatic or chemical gradient. (c) In the absence of Na+, Jwt was not
      significantly different from zero and there was an increase in Phydr but no
      change in Posm. (d) In the presence of a hydrostatic gradient (10 cm H2O, mucosal
      side), acidification of the medium (95% CO2 bubbling, pH 6.2) simultaneously and
      reversibly increased Jw and decreased Pw. (e) When an osmotic gradient was
      present (40 mM polyethyleneglycol on the serosal side) a net increase in Jw was
      observed. CO2 bubbling in these conditions reversibly reduced Jw while increasing
      Ps. (f) These effects were not observed when the serosal or mucosal pH was
      reduced in the presence of a nonpermeant buffer (HEPES/TRIS; MES/TRIS). If we
      accept that Ps is a good marker of paracellular movements and that Pw mainly
      reflects transcellular water movements, we may conclude that acidification of the
      medium, in the presence of bicarbonate, modifies both paracellular and
      transcellular routes. The experimental evidence indicates that an increase in
      proton concentration opens the paracellular pathway and probably has a blocking
      effect on a transcellular route.

PMID- 1630881
TI  - Tedisamil inhibits the delayed rectifier K+ current in single smooth muscle cells
      of the guinea-pig portal vein.
AB  - Tedisamil is a new bradycardic agent with an inhibitory action on K+ channels in
      cardiac muscle, and secondary beneficial effects in experimentally induced
      cardiac ischemia. In whole-cell clamp studies in enzymatically dispersed, single
      smooth muscle cells from the guinea-pig portal vein, tedisamil inhibited the
      delayed rectifier K+ current (determined as the charge transferred through the
      cell membrane), the mean concentration for half-maximal inhibition being 2.9
      microM. In contrast to controls in the absence of drugs or in the presence of the
      classical K+ channel blockers barium, tetraethylammonium or 4-aminopyridine, the
      time course of the delayed rectifier K+ current in the presence of tedisamil
      could no longer be fitted by a single exponential, and signs of an accelerated
      inactivation by tedisamil were obtained. The slow onset of the response to
      tedisamil applied to the outside of the vascular myocytes, and the finding that
      tedisamil applied directly to the cytosol via the pipette was highly effective,
      suggest an intracellular site of action.

PMID- 1630882
TI  - Thyroid control of contractile function and calcium handling in neonatal rat
      heart.
AB  - Newborn rats were rendered hyperthyroid (daily subcutaneous injections of L
      triiodothyronine, 10 micrograms 100 g-1 body weight) or hypothyroid (0.05% 6-n
      propyl-2-thiouracil in drinking water to nursing mothers) during the first 3
      weeks of postnatal life. Compared with the euthyroid group, hyperthyroidism
      resulted in: (1) cardiac enlargement with right ventricular preponderance, (2)
      increased cardiac contractile function, (3) increased Ca2+ uptake by the
      sarcoplasmic reticulum (SR), (4) decreased sensitivity to the negative inotropic
      effect of verapamil and (5) greater inhibition of contractile function by
      ryanodine. Hypothyroidism generally resulted in opposite changes. The data
      suggest that the development of the heart and its contractile function during
      early postnatal life depends on the plasma level of thyroid hormones. In
      particular, the relative contribution of the SR and sarcolemmal Ca2+ transport to
      the control of cardiac contractility seems to be markedly affected by altered
      thyroid states. The postnatal maturation of the SR function is accelerated in
      hyperthyroidism but retarded in hypothyroidism. Consequently, hyperthyroid hearts
      appear to be less dependent and hypothyroid ones more dependent on trans
      sarcolemmal Ca2+ fluxes when compared with age-matched euthyroid animals.

PMID- 1630883
TI  - Active movement of cardiac myosin on Characeae actin cables.
AB  - The active sliding of cardiac myosin on actin cables was studied using an in
      vitro movement assay. Cardiac myosin prepared from either adult rabbit or rat
      hearts was mixed with small latex beads to coat them. Actin cables were obtained
      from the internodal cells of green algae, Characeae. When the myosin-coated beads
      suspended in physiological buffer were introduced into the internodal cells, the
      myosin started to interact with the actin causing the beads to move. The sliding
      movement of the beads was observed under microscopy and the sliding velocity
      measured. The observed movement was smooth and the velocity was constant over a
      long distance. The movement was physiological in nature: a) it was ATP-dependent,
      but above a certain level of ATP, the velocity was constant; b) the velocity was
      maximum at pH 7.0, and decreased in both acidic and alkaline conditions. The
      average sliding velocity of cardiac myosin obtained from rabbit ventricles (0.31
      +/- 0.11 micron/s) was slower than that from rat ventricles (1.04 +/- 0.26
      micron/s) reflecting the lower ATPase activity of rabbit cardiac myosin. This
      assay system is considered to be a useful tool linking biochemistry and
      physiology at the molecular level.

PMID- 1630884
TI  - Relationship between force and Ca2+ in anococcygeal and vas deferens smooth
      muscle cells of the mouse.
AB  - We compared the changes of the cytoplasmic Ca2+ concentration ([Ca2+]i), as
      measured with the fluorescent Ca2+ indicator fura-2, and the force development in
      intact smooth muscle of the tonic anococcygeus (AC) and the phasic vas deferens
      (VD) of the mouse, during activation by K+ depolarization and by agonists.
      Resting [Ca2+]i was observed to be 33% lower in AC (80 nM) than in VD (115 nM),
      while the Ca2+ threshold for contraction was found to be about 120 nM in AC and
      160 nM in VD. For a similar [Ca2+]i increase, the agonist stimulation induced a
      higher force development than the K+ depolarization in both muscle types. During
      prolonged depolarization, the force/calcium ratio increased in AC but strongly
      declined in VD. This decline of the force/calcium ratio in VD during
      depolarization was partially reversed by lowering [Ca2+]o. Our results indicate
      that the Ca2+ threshold for force development was about 150% of the resting
      [Ca2+]i in both cell types. The resting [Ca2+]i was lower in the tonic AC than in
      the phasic VD. Agonist-induced sensitization to Ca2+ occurred in both muscle
      types. The tonic and phasic smooth muscles essentially differed in the respective
      modulation of their Ca2+ sensitivity during contraction. The desensitization to
      Ca2+ was specific for phasic muscle, in which it occurred as an early, time- and
      Ca(2+)-dependent process that was partially reversible.

PMID- 1630887
TI  - Size and chirality of intracellularly applied anions affect the function of
      isolated photoreceptors.
AB  - The effect of intracellularly applied anions on the function of retinal rods of
      the frog Rana esculenta was investigated by means of the whole-cell patch-clamp
      technique. When the recording pipette contained a medium based on potassium
      chloride, a slow spontaneous hyperpolarization was observed presumably due to a
      diffusional loss of the photoreceptor's internal transmitter cyclic guanosine
      monophosphate (cGMP) and its precursor guanosine triphosphate (GTP). When
      chloride was replaced by organic anions such as acetate, aspartate, or gluconate
      the speed of hyperpolarization diminished and the dark voltage of the rods was
      stabilized. The extent of stabilization correlates with the molecular weight of
      the anions. A significant difference in the stabilizing effect was found for L
      aspartate and D-aspartate, suggesting an additional influence of the chirality.
      Effects of some of the anions on the configuration of the light responses were
      also observed.

PMID- 1630885
TI  - Cromakalim and lemakalim activate Ca(2+)-dependent K+ channels in canine colon.
AB  - The effects of cromakalim (BRL 34915) and its (-) optical isomer, lemakalim (BRL
      38227) on the activity of 265-pS Ca(2+)-activated K+ channels (BK channels) were
      examined in cell-attached and inside-out patches from canine colonic myocytes. In
      cell-attached patches lemakalim increased the open probability (Po) of BK
      channels. Mean NPo, where N is the number of channels per patch, at +50 mV
      increased from 0.08 to 0.26 (20 microM lemakalim). In inside-out patches,
      cromakalim and lemakalim increased channel NPo rapidly and reversibly. This
      increase in NPo was due to a shift in half-maximal activation. Glyburide (20
      microM) prevented the increase in NPo caused by lemakalim in cell-attached
      patches and reversed the increase in NPo in inside-out patches. Under conditions
      where Ca(2+)-activated K+ channels were maximally activated, lemakalim failed to
      increase current or induce a second type of K+ channel activity. When
      tetraethylammonium (200 microM) was added to the pipette solution to block the BK
      channel half maximally, lemakalim also failed to induce a second type of channel.
      Adenosine triphosphate (1 or 2 mM) applied to the inner surface of inside-out
      patches had no effect on Po of BK channels. Finally, the effects of lemakalim on
      ensemble average currents, constructed from multiple openings of BK channels in
      cell-attached patches was found to successfully mimic the effects of the drug on
      whole-cell membrane currents. We conclude that cromakalim and lemakalim activate
      BK channels in canine colonic cells. Whether this action participates in the
      membrane hyperpolarization and the decrease in frequency and duration of slow
      waves produced by these compounds in intact colonic muscles remains to be
      investigated.

PMID- 1630886
TI  - Effects of endurance training on myosin heavy-chain isoforms and enzyme activity
      in the rat diaphragm.
AB  - We investigated the effects of endurance training (20 m/min, 60 min/day, 5
      days/week) on myosin heavy-chain (MHC) isoforms and succinic dehydrogenase (SDH)
      activity in rat crural and costal diaphragms, and plantaris muscles. Although the
      4-week endurance training produced significant (P less than 0.05) increases, both
      in SDH activity and the percentage of isoform HCIIa in the plantaris of the
      trained rat compared with the sedentary control rat, these alterations did not
      occur in either the crural or costal diaphragms. After 10 weeks of endurance
      training, trained animals had significantly (P less than 0.05) higher SDH
      activity in the costal diaphragm and the plantaris. Moreover, a significant (P
      less than 0.05) decrease occurred in the percentage of HCIIb in the costal
      diaphragm, and a significant (P less than 0.01) decrease in the percentage of
      HCIIb concomitant with a significant (P less than 0.05) increase of HCIIa
      resulted in the plantaris. However, the crural diaphragm did not show any
      significant changes after 10 weeks of endurance training. These results indicate
      that endurance training induces an alteration in the expression of an MHC
      phenotype, in addition to causing an increase in oxidative enzyme activity.
      However, the alterations in response to endurance training are apparently not
      uniform, varying between regions and/or kinds of muscles.

PMID- 1630888
TI  - [MR imaging of amyotrophic lateral sclerosis].
AB  - Magnetic resonance imaging (MR imaging) provides a sensitive method for mapping
      the normal and pathological distribution of iron in the brain. High field
      strength MR imaging (1.5 T) was used to evaluate eight patients with amyotrophic
      lateral sclerosis (ALS) and 49 neurological normal control patients. All eight
      ALS patients showed decreased signal intensity in the motor cortex on T2-weighted
      images, while only one of the normal control patients showed this finding. The
      results suggested that the decreased signal intensity in the motor cortex in ALS
      was caused by the deposition of iron in this area.

PMID- 1630889
TI  - [US findings of junctional parenchymal defect of the kidney].
AB  - Junctional parenchymal defect (JPD) is a triangular or linear hyperechoic
      structure in the anterosuperior or posteroinferior surface of the kidney. The
      intermediate septum is a band-like cortex, running obliquely in the central echo
      complex. Some authors have suggested that these structures result from partial
      fusion of the embryonic parenchymatous masses called renunculi (renunculi
      theory). In a prospective study of 600 adult patients, the anterosuperior JPD of
      the right kidney was most frequently identified on ultrasonography (33.5%). The
      incidence of JPD did not depend on sex or age, and intermediate septum was
      frequently associated with JPD (71.4%). These data are compatible with the
      renunculi theory. The prominent septum of Bertin was located in the same position
      on the intermediate septum in the majority of cases (96.7%). Therefore, we
      suggest that the typical prominent septum of Bertin may be an incomplete
      intermediate septum. In order to differentiate JPD from pathologic conditions
      such as cortical scar or hyperechoic tumor, it is necessary to identify its
      characteristic location and shape.

PMID- 1630890
TI  - [Evaluation of transcatheter arterial embolization with coaxial microcatheter and
      micro-coil for vascular lesions].
AB  - Transcatheter arterial embolization using a coaxial microcatheter and micro-coil
      was performed in eight patients with vascular lesions; one each with aneurysm of
      the basilar artery, cerebellar artery, and pancreatic artery, pseudoaneurysm of
      the common hepatic artery, gastroduodenal artery, and gluteal artery, carotid
      cavernous fistula, and thoracic paraspinal arteriovenous malformation. Complete
      occlusion was achieved in five patients with aneurysm and pseudoaneurysm by
      occluding the aneurysmal cavity and/or the orifice. A patient with recurrent
      carotid-cavernous fistula was also completely embolized. A case of basilar artery
      aneurysm resulted in partial occlusion because the posterior cerebral artery
      originated from the aneurysm. The unsatisfactory result in a case of paraspinal
      AVM was due to its wide extension with multiple feeding arteries. No apparent
      complication was seen. In conclusion, super-selective arterial embolization
      therapy with coaxial microcatheter and micro-coils was found to be a useful
      method for vascular lesions that would have been technically difficult to
      embolize with the standard catheter and coils.

PMID- 1630891
TI  - [Radiation therapy for patients with obstructive jaundice caused by carcinoma of
      the extrahepatic biliary system].
AB  - From February 1980 through September 1990, 92 patients with obstructive jaundice
      resulting from biliary tract cancer registered at Shikoku Cancer Center Hospital
      or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of
      these patients (30 with carcinoma of the extrahepatic bile duct, excluding
      ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38
      patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were
      treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39
      with carcinoma of the extrahepatic bile duct and eight with carcinoma of the
      gallbladder) were not treated by RT. All jaundiced patients received external
      and/or internal biliary drainage of some kind. Among patients undergoing biliary
      drainage with a catheter, 21 patients who underwent RT (four with IORT) survived
      significantly longer than 19 patients who did not (generalized Wilcoxon test: p
      less than 0.05). There were no significant differences in survival between 7
      patients with recanalization and 11 patients with no recanalization. Concerning
      the survival of laparotomized patients, excluding those with complete resection
      or perioperative death, eight patients treated with postoperative ERT survived
      longer than 12 patients who did not have postoperative ERT (not significantly).
      Eleven patients underwent IORT. A patient with unresectable carcinoma of the
      hilar bile duct survived 2 years and 3 months after a combination treatment of
      ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II
      were observed (Oboshi and Shimosato's evaluation system for the histological
      effects of radiation therapy). Our experience suggests that RT is effective in
      patients with obstructive jaundice caused by carcinoma of the biliary system.

PMID- 1630892
TI  - [Thermoradiotherapy for adenocarcinoma of the rectum and sigmoid--application to
      primarily inoperable and recurrent cases].
AB  - Between February 1983 and May 1990, 19 rectal cancers and three sigmoid colon
      cancers were treated with thermoradiotherapy. Among four patients with primary
      rectal cancer, one received preoperative treatment and three were judged
      inoperable. All the inoperable patients responded well to treatment and were
      judged operable. Pathological examination of the resected specimens confirmed the
      effectiveness of treatment. In one case in particular, no cancer cells were
      observed in the specimen or at autopsy, 21 months after thermoradiotherapy.
      Eighteen cases of recurrent colorectal cancer were also treated. Judged by tumor
      shrinkage alone, these patients were classified into five cases of PR and 13 of
      NR. When the low density area seen on CT images after treatment was added to the
      criteria, there was one case of CR, six of PR, and 11 of NR, and the
      effectiveness ratio shown by the sum of CR and PR was 38.9%. Fourteen cases in
      the thermoradiotherapy group and 16 in the radiation therapy group were compared
      as to the reduction in postoperative perineal pain caused by recurrence at the
      pre-sacral area. It was found that thermoradiotherapy was significantly superior
      to radiation therapy in the frequency and duration of pain relief. Although most
      patients complained of the sensation of heat, this was within tolerable limits,
      and no severe side effects were experienced.

PMID- 1630893
TI  - [Long-term results of radiotherapy in stage I.II glottic carcinoma].
AB  - From 1965 to 1987, 271 patients were treated. Two hundred and sixty-two were
      male, and 9 were female. Age ranged from 36 to 91 years with a median value of 62
      years. According to the UICC classification in 1987, 149 were T1a, 56 were T1b,
      66 were T2. T2 was divided into T2a (with normal cord mobility), and T2b (with
      impaired cord mobility). Forty-seven were T2a and 19 were T2b. Total dose ranged
      from 24 to 84 Gy, and 245 received 60 Gy or more. Daily dose was 2 Gy in 249, and
      3 Gy in 22. Field size ranged from 10 to 117 cm2. All 271 patients were treated
      with 6-MV X-ray. Adjuvant chemotherapy was performed in 91 patients. Follow-up
      was complete in 269 of 271 patients (99%). Eighty-four patients died of
      intercurrent disease. Thirty out of 84 (36%) died of second malignancy. A 10-year
      overall survival rate in 271 patients was 64% and a 10-year cause-specific
      survival rate (CSSR) was 92%. Ten-year CSSR were 94% in T1a, 92% in T1b, 90% in
      T2a, and 80% in T2b. Five-year local control rates were 87%, 77%, 84%, and 68%,
      respectively. Five patients relapsed after 5 years. Ten-year local control rates
      were 85%, 74%, 80%, and 68%, respectively. There seemed to be no relationship
      between local control rates and total dose, field size, TDF, and use of
      chemotherapy. Daily doses of more than 3 Gy seemed to increase complication
      rates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1630894
TI  - [Usefulness of 111In labeled leukocytes scintigraphy combined with 99mTc phytate
      liver scintigraphy for diagnosis of hepatic abscess comparing with CT and US].
AB  - 111In labelled leukocyte scintigraphy (ILLS) was performed in five patients with
      hepatic abscess. For the accurate diagnosis of hepatic abscess, ILLS was
      superimposed on 99mTc phytate liver scintigraphy. The results of ILLS were
      compared with CT and US findings. Four of five patients (80%) showed abnormal
      accumulations in the liver. The smallest abscess detected was 46 mm x 43 mm. CT
      scan showed rim enhancement, which was a specific finding for hepatic abscess, in
      three patients. It was rather difficult to diagnose hepatic abscess by US. In two
      cases without definite rim enhancement on CT, the abscesses were diagnosed as hot
      spots by ILLS. We conclude that ILLS combined with 99mTc liver scintigraphy is
      useful for the diagnosis of hepatic abscess.

PMID- 1630895
TI  - [Experimental study of water jet angioplasty].
AB  - A newly invented angioplasty by using water jet energy was investigated for
      evaluating its safety and effectiveness in 3 dogs. The water jet was produced
      from a small tip nozzle (0.2 mm in diameter) of catheter by injecting 20 ml of
      diluted contrast medium. By using this method recanalization of femoral arterial
      occlusion produced by fresh thrombi was achieved in all 3 dogs. Post
      recanalization angiography showed no apparent small vessel occlusions. Injection
      apart more than 5 mm from the inner surface of human aorta provoked no apparent
      changes histopathologically. Water jet angioplasty may be useful in treating
      vascular occlusive disease.

PMID- 1630896
TI  - [Potential usefulness of computer-aided diagnosis (CAD) in a mass survey for lung
      cancer using photo-fluorographic films].
AB  - We investigated the potential usefulness of computer-aided diagnosis (CAD) in a
      mass survey for lung cancer. When the sensitivity of the computer output was
      adjusted nearly equal to that of the mass survey in our database which contained
      198 photofluorographic films, some shadows detected by the computer output were
      different from those detected by human observers. Therefore, the best estimated
      sensitivity of an observer using the computer output was equal to or greater than
      the sensitivity of double reading. It is expected that CAD may have a role in a
      mass survey for lung cancer using photofluorographic films.

PMID- 1630897
TI  - [Quantitative evaluation of liver function using 99mTc-GSA in rats with liver
      injury induced by ischemia-reperfusion].
AB  - We evaluated quantitatively the liver injury of rats induced by ischemia
      reperfusion, using 99mTc-DTPA-Galactosyl-Human-Serum-Albumin (99mTc-GSA). The
      vessels of the left lobe were clamped for 5, 10, or 45 minutes followed by 15
      minutes reperfusion. Then, 99mTc-GSA was intravenously administered (170
      micrograms/kg body weight) to rats. Two compartment analysis was made on
      measurement curves in the heart and liver to obtain clearance parameters.
      Significant difference was observed between the ischemic group (clamped for 10
      and for 45 minutes) and the control. These results suggest that 99mTc-GSA is
      useful in the estimation of liver injury produced by ischemia-reperfusion.

PMID- 1630898
TI  - 7-Deaza-2'-deoxyadenosine and 3-deaza-2'-deoxyadenosine replacing dA within d(A6)
      tracts: differential bending at 3'- and 5'-junctions of d(A6).d(T6) and B-DNA.
AB  - 7-Deaza-2'-deoxyadenosine (1, c7Ad) and 3-deaza-2'-deoxyadenosine (2, c3Ad) have
      been incorporated into d(AAAAAA) tracts replacing dA at various positions within
      oligonucleotides. For this purpose suitably protected phosphonates have been
      prepared and oligonucleotides were synthesized on solid-phase. The oligomers were
      hybridized with their cognate strands. The duplexes were phosphorylated at OH-5'
      by polynucleotide kinase and self-ligated to multimers employing T4 DNA ligase.
      Oligomerized DNA-fragments were analyzed by polyacrylamide gel electrophoresis
      and the bending was determined from anomalies of electrophoretic mobility.
      Replacement of dA by c3Ad decreased the bending more than replacement by c7Ad.
      Reduction of bending was much stronger when the modified nucleosides replaced one
      or several dA residues at the 3'-site of an d(AAAAAA)-tract whereas replacement
      at the 5'-site showed no significant influence [1, 2].

PMID- 1630899
TI  - Conserved sequence motifs in the initiator proteins for rolling circle DNA
      replication encoded by diverse replicons from eubacteria, eucaryotes and
      archaebacteria.
AB  - An amino acid motif was identified that consists of the sequence
      HisHydrHisHydrHydrHydr (Hydr--bulky hydrophobic residue) and is conserved in two
      vast classes of proteins, one of which is involved in initiation and termination
      of rolling circle DNA replication, or RCR (Rep proteins), and the other in
      mobilization (conjugal transfer) of plasmid DNA (Mob proteins). Based on
      analogies with metalloenzymes, it is hypothesized that the two conserved His
      residues in this motif may be involved in metal ion coordination required for the
      activity of the Rep and Mob proteins. Rep proteins contained two additional
      conserved motifs, one of which was located upstream, and the other downstream
      from the 'two His' motif. The C-terminal motif encompassed the Tyr residue(s)
      forming the covalent link with nicked DNA. Mob proteins were characterized by the
      opposite orientation of the conserved motifs, with the (putative) DNA-linking Tyr
      being located near their N-termini. Both Rep and Mob protein classes further
      split into several distinct families. Although it was not possible to find a
      motif or pattern that would be unique for the entire Rep or Mob class, unique
      patterns were derived for large subsets of the proteins of each class. These
      observations allowed the prediction of the amino acid residues involved in DNA
      nicking, which is required for the initiation of RCR or conjugal transfer of
      single-stranded (ss) DNA, in Rep and Mob proteins encoded by a number of
      replicons of highly diverse size, structure and origin. It is conjectured that
      recombination has played a major part in the dissemination of genes encoding
      related Rep or Mob proteins among the replicons exploiting RCR. It is speculated
      that the eucaryotic small ssDNA replicons encoding proteins with the conserved
      RCR motifs and replicating via RCR-related mechanisms, such as geminiviruses and
      parvoviruses, may have evolved from eubacterial replicons.

PMID- 1630900
TI  - SRF and MCM1 have related but distinct DNA binding specificities.
AB  - The mammalian transcription factor SRF and the yeast regulatory protein MCM1
      contain DNA binding domains that are 70% identical; moreover, both proteins can
      bind the serum response element in the human c-fos promoter. Here we present an
      analysis of MCM1 sequence specificity by selection of sites from random sequence
      oligonucleotides. In this assay the MCM1 DNA binding domain selects binding sites
      containing the consensus (NotC)CCY(A/T)(A/T)(T/A)NN(A/G)G, distinct from the SRF
      binding consensus CC(A/T)6GG. Carboxylethylation interference analysis of a set
      of selected sites suggests that MCM1 contacts DNA in its major groove throughout
      one helical turn. These differences in specificity are largely due to sequence
      differences between the N terminal basic parts of the SRF and MCM1 DNA binding
      domains. Comparison of the relative binding affinities of MCM1 and SRF for a
      panel of representative binding sites showed that many high affinity MCM1 sites
      have negligible affinity for SRF and vice versa. Thus MCM1 and SRF have
      significantly different sequence specificities.

PMID- 1630901
TI  - Systematic sequencing of the Escherichia coli genome: analysis of the 0-2.4 min
      region.
AB  - A contiguous 111,402-nucleotide sequence corresponding to the 0 to 2.4 min region
      of the E. coli chromosome was determined as a first step to complete structural
      analysis of the genome. The resulting sequence was used to predict open reading
      frames and to search for sequence similarity against the PIR protein database. A
      number of novel genes were found whose predicted protein sequences showed
      significant homology with known proteins from various organisms, including
      several clusters of genes similar to those involved in fatty acid metabolism in
      bacteria (e.g., betT, baiF) and higher organisms, iron transport (sfuA, B, C) in
      Serratia marcescens, and symbiotic nitrogen fixation or electron transport (fixA,
      B, C, X) in Azorhizobium caulinodans. In addition, several genes and IS elements
      that had been mapped but not sequenced (e.g., leuA, B, C, D) were identified. We
      estimate that about 90 genes are represented in this region of the chromosome
      with little spacer.

PMID- 1630902
TI  - Mapping of a Physarum chromosomal origin of replication tightly linked to a
      developmentally-regulated profilin gene.
AB  - We compared the pattern of replication of two cell-type specific profilin genes
      in one developmental stage of the slime mold Physarum polycephalum. Taking
      advantage of the natural synchrony of S-phase within the plasmodium, we
      established that the actively transcribed profilin P gene is tightly linked to a
      chromosomal replication origin and is replicated at the onset of S-phase. In
      contrast, the inactive profilin A gene is not associated with a replication
      origin and it is duplicated in mid S-phase. Mapping by two-dimensional gel
      electrophoresis defines a short DNA fragment in the proximal upstream region of
      the profilin P gene from which bidirectional replication is initiated. We further
      provide an estimate of the kinetics of elongation of the replicon and demonstrate
      that the 2 alleles of the profilin P gene are coordinately replicated. All these
      results were obtained on total DNA preparations extracted from untreated cells.
      They provide a strong evidence for site specific initiation of DNA replication in
      Physarum.

PMID- 1630903
TI  - Elk-1 protein domains required for direct and SRF-assisted DNA-binding.
AB  - The Ets-related Elk-1 protein can bind to purine-rich DNA target sites in a
      sequence specific fashion and, in addition, can form a ternary complex with the c
      fos serum response element (SRE) and the serum response factor (SRF). We
      demonstrate that Elk-1 can readily interchange between its different interaction
      partners. The amino terminal ETS-domain of Elk-1 was shown to be necessary and
      sufficient for direct DNA-binding activity. For ternary complex formation with
      the SRE and SRF, both the Elk-1 ETS-domain as well as flanking sequences up to
      amino acid 169 were required. Removal of sequences between the ETS-domain and
      amino acids 137-169 did not abolish ternary complex formation. This suggests the
      Elk-1 region spanning amino acids 137-169 to contain a protein-protein
      interaction domain. Furthermore, we have shown that a single amino acid exchange
      introduced into the ETS-domain can drastically alter the direct DNA-binding
      affinity of Elk-1 without severely affecting SRF-assisted binding to the SRE.
      Thus, Elk-1 requires different propensities of the ETS-domain to exert its
      different modes of DNA sequence recognition.

PMID- 1630904
TI  - Synthesis and properties of mirror-image DNA.
AB  - We have investigated the conformations of the hexadeoxyribonucleotide, L
      d(CGCGCG) composed of L-deoxyribose, the mirror image molecule of natural D
      deoxyribose. In this paper, we report the synthesis of four L-deoxynucleosides
      and the L-oligonucleotide-ethidium bromide interactions. The L-deoxyribose
      synthon 9 was synthesized from L-arabinose with an over all yield of 28.5% via
      the Barton-McCombie reaction. The L-deoxynucleosides were obtained by a
      glycosylation of appropriate nucleobase derivatives with the 1-chloro sugar 9.
      After derivatization to nucleoside phosphoramidites, L-deoxycytidine and L
      deoxyguanosine were incorporated into a hexadeoxynucleotide, L-d(CGCGCG) by a
      solid-phase beta-cyanoethylphosphoramidite method. This L-hexanucleotide was
      resistant to digestion with nuclease P1. The conformations of L-d(CGCGCG) were an
      exact mirror image of that of the corresponding natural one as described
      previously, and the conformations of the L-d(CGCGCG)-ethidium bromide complex
      were also the mirror images of those of the D-d(CGCGCG)-ethidium bromide complex
      under both low and high salt conditions. These results suggest that ethidium
      bromide prefers not a right-handed helical sense, but the base-base stacking
      geometry of the B-form rather than that of the Z-form. Thus, L-DNA would be a
      useful tool for studying DNA-drug interactions.

PMID- 1630906
TI  - Site-specific dissection of E. coli chromosome by lambda terminase.
AB  - We have succeeded the targeted cleavage of chromosomes by lambda terminase that
      introduces double-strand cleavages in DNA recognizing the lambda cos sequence.
      When chromosomal DNAs of various Escherichia coli K-12 strains were subjected to
      terminase digestion, all were found to contain two common cleavage sites.
      Therefore, DNAs from lambda lysogens in which lambda DNA was inserted at
      different chromosomal sites were specifically cleaved at one more additional
      site. The two sites, termed ecos1 and ecos2, were mapped at approximately 35.1'
      and 12.7' of E. coli genetic map. The ecos1 and ecos2 sites were included in qin
      and qsr' regions, respectively. Therefore, the cleavage sites were associated
      with cryptic prophages. Sequences at the ecos1 and ecos2 sites showed 98%
      homology to the lambda cos sequence, indicating high fidelity of sequence
      recognition by the terminase. Since the strategy for integration of a DNA segment
      into chromosomal DNA through homologous recombination has been established, the
      dissection method that uses lambda terminase should be applicable for gene
      mapping as well as construction of macrophysical maps of larger genomes.

PMID- 1630905
TI  - Nucleosomal histone protein protects DNA from iron-mediated damage.
AB  - Iron promotes DNA damage by catalyzing hydroxyl radical formation. We examined
      the effect of chromatin structure on DNA susceptibility to oxidant damage. Oxygen
      radicals generated by H2O2, ascorbate and iron-ADP (1:2 ratio of Fe2+:ADP)
      extensively and randomly fragmented protein-free DNA, with double-strand breaks
      demonstrable even at 1 microM iron. In contrast, polynucleosomes from chicken
      erythrocytes were converted to nucleosome-sized fragments by iron-ADP even up to
      250 microM iron. Cleavage occurred only in bare areas where DNA is unassociated
      with histone. In confirmation, reassembly of nucleosomes from calf thymus DNA and
      chicken erythrocyte histone also yielded nucleosomes resistant to fragmentation.
      Protection of DNA by histone was dependent on nucleosome assembly and did not
      simply reflect presence of scavenging protein. In contrast to this specific
      cleavage of internucleosomal linker DNA by iron-ADP, iron-EDTA cleaved
      polynucleosomes indiscriminately at all sites. The hydroxyl radical scavenger
      thiourea completely inhibited the random cleavage of polynucleosomes by iron-EDTA
      but inhibited the nonrandom cleavage of polynucleosomes by iron-ADP less
      completely, suggesting the possibility that the lower affinity iron-ADP chelate
      may allow association of free iron with DNA. Thus, oxygen radicals generated by
      iron-ADP indiscriminately cleaved naked DNA but cleaved chromatin preferentially
      at internucleosomal bare linker sites, perhaps because of nonrandom iron binding
      by DNA. These findings suggest that the DNA-damaging effects of iron may be
      nonrandom, site-directed and modified by histone protein.

PMID- 1630907
TI  - Variants of the Xenopus laevis ribosomal transcription factor xUBF are
      developmentally regulated by differential splicing.
AB  - XUBF is a Xenopus ribosomal transcription factor of the HMG-box family which
      contains five tandemly disposed homologies to the HMG1 & 2 DNA binding domains.
      XUBF has been isolated as a protein doublet and two cDNAs encoding the two
      molecular weight variants have been characterised. The major two forms of xUBF
      identified differ by the presence or absence of a 22 amino acid segment lying
      between HMG-boxes 3 and 4. Here we show that the mRNAs for these two forms of
      xUBF are regulated during development and differentiation over a range of nearly
      20 fold. By isolating two of the xUBF genes, it was possible to show that both
      encoded the variable 22 amino acid segment in exon 12. Oocyte splicing assays and
      the sequencing of PCR-generated cDNA fragments, demonstrated that the transcripts
      from one of these genes were differentially spliced in a developmentally
      regulated manner. Transcripts from the second gene were found to be predominantly
      or exclusively spliced to produce the lower molecular weight form of xUBF.
      Expression of a high molecular weight form from yet a third gene was also
      detected. Although the intron-exon structures of the Xenopus and mouse UBF genes
      were found to be essentially identical, the differential splicing of exon 8 found
      in mammals, was not detected in Xenopus.

PMID- 1630909
TI  - Homologous RNA recombination allows efficient introduction of site-specific
      mutations into the genome of coronavirus MHV-A59 via synthetic co-replicating
      RNAs.
AB  - We describe a novel strategy to site-specifically mutagenize the genome of an RNA
      virus by exploiting homologous RNA recombination between synthetic defective
      interfering (DI) RNA and the viral RNA. The construction of a full-length cDNA
      clone, pMIDI, of a DI RNA of coronavirus MHV strain A59 was reported previously
      (R.G. Van der Most, P.J. Bredenbeek, and W.J.M. Spaan (1991). J. Virol. 65, 3219
      3226). RNA transcribed from this construct, is replicated efficiently in MHV
      infected cells. Marker mutations introduced in MIDI RNA were replaced by the wild
      type residues during replication. More importantly, however, these genetic
      markers were introduced into viral genome: even in the absence of positive
      selection MHV recombinants could be isolated. This finding provides new prospects
      for the study of coronavirus replication using recombinant DNA techniques. As a
      first application, we describe the rescue of the temperature sensitive mutant MHV
      Albany-4 using DI-directed mutagenesis. Possibilities and limitations of this
      strategy are discussed.

PMID- 1630908
TI  - Functional elements of the ribosomal protein L7a (rpL7a) gene promoter region and
      their conservation between mammals and birds.
AB  - The transcriptional initiation sites of the chicken ribosomal protein L7a (rpL7a)
      gene have been determined and found to occur at three consecutive cytidine
      residues at the start of a polypyrimidine tract of 8 base pairs (bp). A
      comparative analysis of the 5' upstream regions of the mouse, human and chicken
      rpL7a genes identified two sequence elements (Box A and Box B) conserved over the
      600 million years of divergent evolution that separate mammals and birds. Only
      Box A (nts - 56 to - 39) and Box B (nts - 25 to - 4) sequences were detected to
      bind nuclear factors from mouse nuclear extracts in an analysis of the mouse
      rpL7a 5' upstream sequence. Box A and Box B bind different nuclear factors and
      the factor binding to mouse Box A and mouse Box B sequences could be effectively
      competed by corresponding homologous sequences from the human and chicken rpL7a
      promoters. These results indicate that elements of the rpL7a promoter region are
      conserved between mammals and birds. An in vivo analysis of the mouse rpL7a 5'
      upstream sequence required for efficient transcription identified the 5' border
      of the minimal promoter region as lying between nts - 50 and - 56. Constructs
      containing 56 bp of 5' upstream DNA and the first 25 bp rpL7a exon were very
      efficiently transcribed indicating that sequences within the first intron are not
      required for gene expression. No sequence similarity was detected between the
      rpL7a promoter elements and described promoter elements of other eukaryotic
      ribosomal protein genes.

PMID- 1630910
TI  - A comparison of the DNA bending activities of the DNA binding proteins CRP and
      TFIID.
AB  - Protein-induced DNA bending is of importance in the formation of complex
      nucleoprotein assemblies such as those involved in the initiation of DNA
      replication or transcription initiation. We have compared the DNA bending
      characteristics of the Escherichia coli cyclic AMP receptor protein (CRP or CAP),
      an archetypal DNA bending protein, to those of TFIID, the eukaryotic TATA-element
      binding transcription factor. By altering the helical phasing between a CRP
      binding site and the E. coli melR promoter we have mapped a DNA sequence-directed
      bend in the downstream region of the promoter. This intrinsic DNA bend may be
      important in the regulation of the melR promoter by CRP in vivo. Gel retardation
      assays and DNAse I footprinting show that human TFIID binds to the melR promoter 
      10 region. Taking advantage of this fact, and using the CRP-induced DNA bend as
      a standard, we have employed phase sensitive detection to show that the DNA bend
      angle induced by TFIID is far less than that induced by CRP. Further evidence to
      support this conclusion comes from a comparison of the relative mobilities of CRP
      DNA and TFIID-DNA complexes. These results place limits on the role of any DNA
      bending induced by TFIID alone in the initiation of transcription.

PMID- 1630911
TI  - Synthesis and properties of oligonucleotides containing aminodeoxythymidine
      units.
AB  - Procedures are described for synthesis via solid support methodology of
      oligonucleotide analogues derived in part from 3'-amino-3'-deoxythymidine or 5'
      amino-5'-deoxythymidine. Oligothymidylate decamers terminated with a 3'-amino
      group or containing a 3'-NHP(O)(O-)O-5' internucleoside link are found to form
      unusually stable complexes with poly(dA), poly(A), and oligo(dA). For related
      derivatives of 5'-amino-5'-deoxythymidine enhancement is less or absent, and in
      the case of multiple substitution destabilization of the heteroduplex may be
      observed. That the effect of the 3'-amino group is general for oligonucleotide
      derivatives is indicated by enhanced Tm values for heteroduplex complexes of the
      mixed-base oligomer, d(TATTCAGTCAT(NH2)), and the methyl phosphonate derivatives,
      TmTmTmTmTmTmTmTmTmT(NH2) and d(TmAmTmTmCmAmGmTmCmAmT(NH2)).

PMID- 1630912
TI  - Synthesis and physical properties of anti-HIV antisense oligonucleotides bearing
      terminal lipophilic groups.
AB  - A number of phosphoramidite monomers have been prepared and used in the synthesis
      of antisense phosphorothioate oligonucleotides bearing 5'-polyalkyl and
      cholesterol moieties. Similar groups have also been attached to the 3'-end of
      oligonucleotides by means of functionalised CPG. Melting temperatures of duplexes
      formed between phosphorothioate oligonucleotides with lipophilic end-groups and
      complementary DNA strands were found to be identical to those formed by the
      equivalent unmodified phosphorothioates.

PMID- 1630913
TI  - Construction of a human chromosome 4 YAC pool and analysis of artificial
      chromosome stability.
AB  - In order to construct a human chromosome 4-specific YAC library, we have utilized
      pYAC4 and a mouse/human hybrid cell line HA(4)A in which the only human
      chromosome present is chromosome 4. From this cell line, approximately 8Mb of
      chromosome 4 have been cloned. The library includes 65 human-specific clones that
      range in size from 30kb to 290kb, the average size being 108kb. In order to
      optimize the manipulation of YAC libraries, we have begun to investigate the
      stability of YACs containing human DNA in yeast cells; these studies will also
      determine if there are intrinsic differences in the properties of chromosomes
      containing higher eukaryotic DNAs. We are examining two kinds of stability: 1]
      mitotic stability, the ability of the YAC to replicate and segregate properly
      during mitosis, and 2] structural stability, the tendency of the YAC to
      rearrange. We have found that the majority of YACs examined are one to two orders
      of magnitude less stable than authentic yeast chromosomes. Interestingly, the
      largest YAC analyzed displayed a loss rate typical for natural yeast chromosomes.
      Our results also suggest that increasing the length of an artificial chromosome
      improves its mitotic stability. One YAC that showed a very high frequency of
      rearrangement by mitotic recombination proved to be a mouse/human chimera. In
      contrast to studies using total human DNA, the frequency of chimeras (i.e.,
      mouse/human) in the YAC pool appeared to be low.

PMID- 1630914
TI  - Expression of wild-type and mutant p53 proteins by recombinant vaccinia viruses.
AB  - To facilitate the purification of wild type p53 protein, we established a
      recombinant p53 vaccinia viral expression system. Using this efficient eukaryotic
      expression vector, we found that the expressed p53 proteins retained their
      specific structural characteristics. A comparison between wild type and mutant
      p53 proteins showed the conservation of the typical subcellular localization and
      the expression of specific antigenic determinants. Furthermore, wild type p53
      exhibited a typical binding with large T antigen, whereas no binding was detected
      with mutant p53. Both wild type and mutant p53 proteins were highly stable and
      constituted 5-7% of total protein expressed in the infected cells. These
      expression recombinant viruses offer a simple, valuable system for the
      purification of wild type and mutant p53 proteins that are expressed abundantly
      in eukaryotic cells.

PMID- 1630915
TI  - An experimental study of Saccharomyces cerevisiae U3 snRNA conformation in
      solution.
AB  - The conformation of Saccharomyces cerevisiae U3 snRNA (snR17A RNA) in solution
      was studied using enzymatic and chemical probes. In vitro synthesized and
      authentic snR17A RNAs have a similar conformation in solution. The S. cerevisiae
      U3 snRNA is folded in two distinct domains. The 5'-domain has a low degree of
      compactness; it is constituted of two stem-loop structures separated by a single
      stranded segment, which has recently been proposed to basepair with the 5'-ETS of
      pre-ribosomal RNA. We demonstrate that, as previously proposed, the 5'-terminal
      region of U3 snRNA has a different structure in higher and lower eukaryotes and
      that this may be related to pre-rRNA 5'-ETS evolution. The S. cerevisiae U3 snRNA
      3'-domain has a cruciform secondary structure and a compact conformation
      resulting from an higher order structure involving the single-stranded segments
      at the center of the cross and the bottom parts of helices. Compared to tRNA,
      where long range interactions take place between terminal loops, this represents
      another kind of tertiary folding of RNA molecules that will deserve further
      investigation, especially since the implicated single-strands have highly
      evolutionarily conserved primary structures that are involved in snRNP protein
      binding.

PMID- 1630916
TI  - Insertion (sufB) in the anticodon loop or base substitution (sufC) in the
      anticodon stem of tRNA(Pro)2 from Salmonella typhimurium induces suppression of
      frameshift mutations.
AB  - The dominant +1 frameshift suppressors sufA6, sufB1 and sufB2, in Salmonella
      typhimurium act at runs of C and affect tRNA(Pro)1, tRNA(Pro)2 and tRNA(Pro)2,
      respectively. A recessive +1 frameshift suppressor, sufC, has a similar
      suppressor specificity (Riddle, D.L., and Roth, J.R., Mol. Biol. 66, 483 and 495,
      1972). We show that sufC strains harbour two frameshift suppressors of which one,
      sufX201, is allelic to sufB. We cloned the sufB+ wild type allele and by
      recombination in vivo the mutations sufB1, sufB2 and sufX201. Determination of
      the DNA sequence revealed that the sufB1 and sufB2 mutations result in an extra G
      in the anticodon loop of the minor tRNA(Pro)2. The sufX201 mutation results in a
      base substitution (G43 to A43) in the anticodon stem of this tRNA. Although the
      sufB1 and sufB2 mutations were earlier shown to be dominant, the sufB+ wild type
      allele on multi copy plasmid inhibited the chromosomal sufB1, sufB2 and sufX201
      mediated frameshift suppression but not that mediated by the dominant sufA6
      mutation. These results are discussed in view of the possible coding specificity
      of these mutated tRNAs. The DNA sequence showed a potential consensus promoter
      sequence upstream of the structural gene for tRNA(Pro)2 and downstream a dyad
      symmetrical structure followed by a T cluster, a possible rho-independent
      termination signal. The Salmonella tRNA(Pro)2 gene is identical to the
      Escherichia coli counterpart reported by Komine, Y. et al. (J. Mol. Biol. 212,
      579-598, 1990). While the 5' flanking sequence similarity between the two species
      is about 83%, the similarity of the 3' flanking sequence is only 42%. Still, the
      Salmonella tRNA(Pro)2 gene has a rho-independent transcriptional termination
      signal similar to the one present in E. coli tRNA(Pro)2 gene.

PMID- 1630917
TI  - Escherichia coli promoters: neural networks develop distinct descriptions in
      learning to search for promoters of different spacing classes.
AB  - Back-propagation neural networks were trained to recognize promoter sequences of
      each of the three major spacing classes found in E. coli. These networks were
      trained with the object of maximizing their ability to generalize while
      maintaining the level of false positive identifications at a fraction of 1
      percent. These objectives were generally met. Networks for the 16 base spacing
      class captured between 78 and 100% of previously unseen promoters in different
      tests; networks for the 17 base class identified 97% of the test promoters;
      networks for the 18 base class identified 79% of the test promoters. A tandem
      poll of networks for all three spacing classes produced a cumulative false
      positive level of less than 0.5%. In each case, the weight matrices used by the
      networks in their classification were analyzed to determine the relative weight
      assigned to the occurrence of a given base at a given position within the
      promoter. In this fashion, an approximate description of the network's definition
      of the promoter can be obtained.

PMID- 1630918
TI  - A highly conserved repeated DNA element located in the chromosome of
      Streptococcus pneumoniae.
AB  - We report the discovery of a group of highly conserved DNA sequences located, in
      those cases studied, within intergenic regions of the chromosome of the Gram
      positive Streptococcus pneumoniae. The S. pneumoniae genome contains about 25 of
      these elements called BOX. From 5' to 3', BOX elements are composed of three
      subunits (boxA, boxB, and boxC) which are 59, 45 and 50 nucleotides long,
      respectively. BOX elements containing one, two and four copies of boxB have been
      observed; boxB alone was also detected in one instance. These elements are
      unrelated to the two most thoroughly documented families of repetitive DNA
      sequences present in the genomes of enterobacteria. BOX sequences have the
      potential to form stable stem-loop structures and one of these, at least, is
      transcribed. Most of these elements are located in the immediate vicinity of
      genes whose product has been implicated at some stage in the process of genetic
      transformation or in virulence of S. pneumoniae. This location raises the
      intriguing possibility that BOX sequences are regulatory elements shared by
      several coordinately controlled genes, including competence-specific and
      virulence-related genes.

PMID- 1630919
TI  - Analysis of DNA damage and repair in murine leukemia L1210 cells using a
      quantitative polymerase chain reaction assay.
AB  - The polymerase chain reaction (PCR) represents an alternative to the current
      methods for investigating DNA damage and repair in specific genomic segments. In
      theory, any DNA lesion which blocks Taq polymerase can be measured by this assay.
      We used quantitative PCR (QPCR) to determine the lesion frequencies produced by
      cisplatin and ultraviolet light (UV) in a 2.3 kilobase (kb) segment of
      mitochondrial DNA and a 2.6 kb segment of the DHFR gene in mouse leukemia L1210
      cells. The frequency of UV-induced lesions increased linearly with dose, and was
      0.58 lesions/10 kb/10 J/m2 in the mitochondrial DNA, and 0.37 lesions/10 kb/10
      J/m2 in the DHFR gene. With cisplatin, the lesion frequency also increased
      linearly with dose, and was 0.17 lesions/10 kb/10 microM in the DHFR gene, and
      0.07 lesions/10 kb/10 microM in mitochondrial DNA. This result is contrary to
      that of Murata et al., 1990 (1), in which mitochondrial DNA received greater
      cisplatin damage than did nuclear DNA. Using PCR to measure the repair of UV
      induced lesions in the DHFR gene segment, we observed that less than 10% of the
      lesions were removed by 4 h, but over 70% of the lesions were removed by 8 h.
      Repair of 43% of UV-induced lesions in mitochondrial DNA was also observed during
      a 24 h period.

PMID- 1630920
TI  - A negative regulating element controlling transcription of the gene encoding acyl
      CoA oxidase in Saccharomyces cerevisiae.
AB  - Peroxisomes are induced in Saccharomyces cerevisiae when this yeast is grown in
      the presence of oleate, and are repressed when glucose is supplied as the carbon
      source. Concomitant with this is an induction/repression of peroxisomal beta
      oxidation enzymes. We are investigating the transcriptional control of acyl-CoA
      oxidase, the first and rate-limiting enzyme in the peroxisomal beta-oxidation
      cycle. The promoter region of POX1 from S. cerevisiae has been analyzed in
      POX1/lacZ fusions. Expression of the POX1/lacZ fusion protein underwent glucose
      repression and oleate induction. By deletion, DNA band shift and DNase I
      footprinting analyses we have identified a region that is involved in
      transcriptional repression of POX1. Elimination of this DNA sequence results in
      constitutive expression of POX1 when S. cerevisiae is grown on a fermentable
      carbon source or glycerol.

PMID- 1630921
TI  - Nucleotide sequence of transfer RNA genes from the linear mitochondrial DNA of
      the yeast Williopsis mrakii and Pichia pijperi.

PMID- 1630922
TI  - Nucleotide sequence of genes for a 5.8S and 25S rRNA from rape seed (Brassica
      napus).

PMID- 1630923
TI  - Nucleotide sequence of trnI(CAU) and rpl23 from Arabidopsis thaliana chloroplast
      genome.

PMID- 1630924
TI  - Complete nucleotide sequence of a hepatitis E virus isolated from the Xinjiang
      epidemic (1986-1988) of China.

PMID- 1630925
TI  - ApaCI, an isoschizomer of BamHI isolated from Acetobacter pasteurianus.

PMID- 1630926
TI  - Nucleotide sequence of tryptophan tRNA from Bacillus subtilis.

PMID- 1630927
TI  - Cloning and sequencing of the 3' half of a potato virus Y (O strain) genome
      encoding the 5k protein, protease, polymerase and coat protein.

PMID- 1630928
TI  - Nucleotide sequence of a mouse cDNA encoding the nonhistone chromosomal high
      mobility group protein-1 (HMG1).

PMID- 1630929
TI  - Sequence of a new snRNA from the ciliate Tetrahymena thermophila.

PMID- 1630930
TI  - Nucleotide sequence of a mouse testis poly(A) binding protein cDNA.

PMID- 1630931
TI  - Prediction of oligodeoxyribonucleotides eluting salt conditions on anion exchange
      column.

PMID- 1630932
TI  - Basic peptides enhance protein/DNA interaction in vitro.

PMID- 1630933
TI  - Triplex affinity capture of a single copy clone from a yeast genomic library.

PMID- 1630934
TI  - A high-capacity column for affinity purification of sequence-specific DNA-binding
      proteins.

PMID- 1630936
TI  - A procedure to standardize CAT reporter gene assay.

PMID- 1630935
TI  - Transient expression of DNA in Drosophila via electroporation.

PMID- 1630937
TI  - A novel method for the isolation of tissue-specific genes.

PMID- 1630938
TI  - Preparation of nested deletions in single-strand DNA using oligonucleotides
      containing partially random base sequences.

PMID- 1630940
TI  - cDNA sequence of rabbit tissue factor pathway inhibitor.

PMID- 1630941
TI  - Mentor's cold shoulder left Project 2000 student demoralised.

PMID- 1630939
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1630942
TI  - Women's voices.

PMID- 1630943
TI  - Taking positive action.

PMID- 1630945
TI  - Midwifery support?

PMID- 1630944
TI  - Remember the children.

PMID- 1630946
TI  - Complementary care.

PMID- 1630947
TI  - Providing a source of support.

PMID- 1630948
TI  - Action for health.

PMID- 1630950
TI  - Management--changing times.

PMID- 1630949
TI  - A helpful assessment.

PMID- 1630951
TI  - A belated diagnosis. Interview by Ian McMillan.

PMID- 1630952
TI  - Taking pains.

PMID- 1630953
TI  - A test of ethics.

PMID- 1630954
TI  - Package deals. Learning disabilities.

PMID- 1630955
TI  - Health promotion by numbers.

PMID- 1630956
TI  - Aboriginal adventure.

PMID- 1630957
TI  - Community care for the dying.

PMID- 1630958
TI  - Understanding nursing audit.

PMID- 1630959
TI  - Springing the poverty trap. RCM supplement.

PMID- 1630960
TI  - Opening the gates? RCM supplement.

PMID- 1630961
TI  - Paying the piper. RCM supplement.

PMID- 1630962
TI  - Who can speak for women? RCM supplement.

PMID- 1630963
TI  - View from the top. RCM supplement. Interview by Jane Seymour.

PMID- 1630964
TI  - Physeal injuries of the distal humerus.
AB  - Physeal injuries of the distal humerus comprise approximately 10% of all physeal
      injuries. Diagnosis of these injuries at a young age before the ossification
      centers have ossified and become visible radiographically is difficult. Poor
      outcome of distal humeral physeal injuries is not uncommon and can be best
      prevented by knowledge of anatomy and the use of all appropriate imaging
      techniques. The focus of this article is to correlate anatomy at different ages
      with the occurrence of specific injuries.

PMID- 1630965
TI  - Supracondylar fractures of the humerus in children.
AB  - Supracondylar fractures of the humerus in children are either flexion or
      extension in type. Associated nerve or vascular injury is common. Fractures that
      remain stable after reduction can be treated with elbow flexion. If the fracture
      is unstable or if circulation is compromised, percutaneous pinning or traction
      treatment is utilized. The ischemic hand is always evaluated for brachial artery
      damage or for the presence of a compartment syndrome. Varus positioning should
      always be avoided, but other malalignments either remodel or are not of
      functional significance.

PMID- 1630966
TI  - Fractures of the distal humerus.
AB  - We present a rational approach to the classification and surgical management of
      intraarticular fractures of the distal humerus. The fractures are classified on
      the basis of the surgical anatomy of the distal humerus, which is divided into
      two skeletal columns held together by the trochlea. The basic surgical aim is to
      restore all three elements with sufficient stability to permit functional
      movement. The surgical tactics are presented in detail.

PMID- 1630967
TI  - Indications and technique of open reduction and internal fixation of radial head
      fractures.

PMID- 1630969
TI  - Elbow arthroscopy for loose bodies.
AB  - Arthroscopy is highly useful for the diagnosis and treatment of loose bodies of
      the elbow. Not all loose bodies are detected radiographically, and often there
      are multiple loose bodies, sometimes both anteriorly and posteriorly. When not
      complicated by an underlying disorder such as arthritis, loose bodies can be
      removed from any part of the elbow to provide excellent results in a predictable
      manner. This article describes techniques developed for the safe and effective
      application of this procedure in the elbow.

PMID- 1630968
TI  - Classification and treatment of coronoid process fractures.
AB  - Fractures of the coronoid process are rare as isolated injuries and usually are
      associated with significant, sometimes devastating trauma to the elbow. The
      classification system based on the degree of involvement has proven helpful to
      estimate prognosis and to help guide treatment. Severe fractures are generally
      associated with instability and portend a poor prognosis. Treatment by
      distraction, external fixation, and early motion has been encouraging.

PMID- 1630970
TI  - Posttraumatic stiffness: distraction arthroplasty.
AB  - Loss of motion after elbow trauma is a common complication. At times, the
      limitation of motion may significantly impair function. Options to improve
      posttraumatic motion by surgery depend on whether the joint surface has been
      severely involved (intrinsic vs extrinsic contracture). Increasing experience
      with the surgical release of the posttraumatic stiff elbow has been enhanced by
      the use of distraction with or without interposition arthroplasty. Current
      experience suggests that approximately 85% of patients will be satisfactorily
      treated with surgical intervention.

PMID- 1630971
TI  - Radial head fracture associated with elbow dislocation.

PMID- 1630972
TI  - The role of tracheostomy in the adult intensive care unit.

PMID- 1630973
TI  - Diuretic-induced hypokalaemia and surgery: much ado about nothing?

PMID- 1630974
TI  - Thrombocytopenia in pregnancy.

PMID- 1630975
TI  - Recent advances in cardiology.

PMID- 1630976
TI  - Experience with tracheostomy in medical intensive care patients.
AB  - Thirty-four intensive care patients who received elective tracheostomies were
      studied to determine the incidence and nature of complications associated with
      tracheostomies. Indication for tracheostomy was long-term ventilation. Adverse
      consequences occurred in 47% of the patients. The most frequent problem was
      pneumonia. There were no intraoperative complications. Two deaths occurred due to
      delayed haemorrhage. Some complications of tracheostomy were influenced by the
      preceding period of endotracheal intubation. In patients requiring prolonged
      mechanical ventilation, tracheostomy carries a considerable risk. Optimal airway
      care only will reduce the incidence of complications.

PMID- 1630977
TI  - Metastatic cervical lymph nodes: general practitioner referral patterns.
AB  - Premature excision biopsy of a cervical lymph node infiltrated by metastatic
      carcinoma may compromise patient survival since it is associated with an
      increased incidence of local wound recurrence and distant metastases. Seventy per
      cent of such patients have an identifiable head and neck primary, obviating the
      need for an excision biopsy. It is important therefore that they are examined by
      surgeons who are experienced in inspecting the upper aerodigestive tract and who
      are competent in performing definitive head and neck surgery. A questionnaire
      sent to all general practitioners of an Inner London and a District Health
      Authority revealed that only 18% and 33% respectively referred patients who they
      suspected of having a metastatic neck node to a department with an experienced
      head and neck surgeon. We conclude that greater emphasis on the correct
      management of these patients at both an undergraduate and postgraduate level may
      encourage subsequent generations of general practitioners to review their
      referral patterns.

PMID- 1630978
TI  - Extended transduodenal sphincteroplasty for bile duct stones associated with a
      periampullary diverticulum.
AB  - Extended transduodenal sphincteroplasty has been suggested as an alternative to
      choledochoduodenostomy for the surgical management of bile duct stones associated
      with a periampullary diverticulum but its value has not previously been
      investigated. Over a 3 year period, nine patients underwent extended
      transduodenal sphincteroplasty for common bile duct calculi associated with a
      periampullary diverticulum with no operative or post-operative mortality and
      minimal morbidity. Follow-up ranging from 20 to 60 months has shown remission of
      pain in all but one patient, who has had a normal endoscopic cholangiogram and no
      further episodes of jaundice or cholangitis. Extended transduodenal
      sphincteroplasty is a safe and effective alternative to choledochoduodenostomy
      for the surgical management of choledocholithiasis associated with a
      periampullary diverticulum.

PMID- 1630979
TI  - 'The Health of the Nation': the impact of personality disorder on 'key areas'.
AB  - The purpose of this response paper is to document a form of mental illness,
      namely, personality disorder: (1) whose impact is far-reaching, impinging on
      different 'key areas' identified in 'The Health of the Nation' (The Health of the
      Nation: A Consultative Document. HMSO, London, 1991), including: eating and
      drinking habits, smoking, prevention of accidents, human immunodeficiency
      (HIV)/acquired immunodeficiency syndrome (AIDS), and other mental illness itself;
      (2) which tends to be underdiagnosed by health-care professionals in spite of its
      aetiological relationship to other 'key areas' (as above); (3) which tends to be
      associated with negative therapeutic attitude in spite of well-documented, albeit
      specialist, treatment expertise; (4) which, importantly, transmits
      psychopathology from one generation to the next and hence has a pivotal role to
      play in prevention; and (5) which, for the reasons enumerated above, could form a
      'target' for various, measurable, interventions.

PMID- 1630981
TI  - Recurrent intra-cranial granulomata presenting as space-occupying lesions in a
      patient with common variable immunodeficiency.
AB  - A patient with profound panhypogammaglobulinaemia due to common variable
      immunodeficiency developed two discrete intra-cranial space-occupying lesions, 10
      years apart, requiring craniotomy. Histological examination revealed the intra
      cranial masses to be granulomata of unknown aetiology on both occasions.

PMID- 1630980
TI  - Colonoscopy in patients aged 80 years or older and its contribution to the
      evaluation of rectal bleeding.
AB  - Colonoscopies performed in patients aged 80 years or older at the Sheba Medical
      Center were analysed according to the primary indication for the procedure: 101
      colonoscopies were performed because of rectal bleeding of at least 2 months
      duration, and 335 for all other indications. Carcinoma of the large bowel was
      found in 29 (28.7%) bleeders, with the rectum being the most frequently involved
      site (12 patients). Among the non-bleeders, the prevalence of cancer was
      significantly lower (33 cases, 9.8%; P less than 0.001), and rectal carcinoma was
      less common (five patients, P = 0.04), but proximal tumours were more frequent.
      Of patients with cancer who had operations, the majority (72%) had a tumour
      confined to the bowel wall (Dukes A or B). The rate of adenomas was similar for
      both groups (34% vs 29%). The non-bleeders complained more frequently of
      abdominal pain or a change in bowel habits as compared to the bleeders, but both
      groups had similar rates for anaemia and weight loss. In all, 47% of these
      octogenarians with cancer, and 26% with adenomas were referred for colonoscopy
      because of rectal bleeding. This procedure was found to be safe in old age, as we
      recorded only four (0.9%) non-fatal complications among our series, a similar
      figure to the overall incidence of complications at our Institute. In conclusion,
      our data indicate that rectal bleeding in octogenarians warrants a complete
      colonic investigation, preferably by total colonoscopy.

PMID- 1630982
TI  - Blastomycosis-like pyoderma in a case of chronic myeloid leukaemia.
AB  - Blastomycosis-like pyoderma, a rare skin lesion which may clinically resemble
      true blastomycosis, is seen in immuno-compromised individuals. We report one such
      case in chronic myeloid leukaemia.

PMID- 1630983
TI  - Lymphomatoid granulomatosis presenting as angioedema.
AB  - We describe a patient with severe eyelid and lip angioedema lesions in whom
      biopsy specimens from angioedematous labial mucosa disclosed features of
      lymphomatoid granulomatosis. To our knowledge, angioedema lesions with
      characteristic histological findings of lymphomatoid granulomatosis have not been
      previously described as a presenting sign of this disease.

PMID- 1630984
TI  - 'Chest epilepsy' in a child.
AB  - Pain is a most unusual manifestation of epilepsy, and it is rarer still for chest
      pain to be the primary manifestation of a seizure disorder. We report here a 6
      year old boy with epileptic chest pain--'chest epilepsy'--an entity not
      previously described in children.

PMID- 1630986
TI  - Guillain-Barre syndrome in Plasmodium falciparum malaria.
AB  - A patient with Plasmodium falciparum malaria developed peripheral neuropathy.
      Clinical, cerebro-spinal fluid examination and nerve conduction studies confirmed
      Guillain-Barre syndrome, not previously reported in P. falciparum malaria.

PMID- 1630985
TI  - Lipid and lipoprotein metabolism in familial combined hyperlipidaemia during
      treatment of sporadic phaeochromocytoma: a case study.
AB  - Lipid metabolism was evaluated during management of phaeochromocytoma in a 41
      year old non-obese post-menopausal women with familial combined hyperlipidaemia.
      The main effect of the excess catecholamine secretion on lipid metabolism was
      increased lipolytic activity, lower serum triglyceride and increased HDL
      cholesterol concentrations, compared with findings following removal of the
      tumour. Before removal of the tumour, the use of beta blockers alone led to
      marked deterioration of the hyperlipidaemic state, and combined alpha and beta
      blockade additionally led to a marked reduction in fat oxidation and lipoprotein
      lipase activity. Overactivity of the adrenergic system leads to changes in lipid
      metabolism in phaeochromocytoma. Treatment of the phaeochromocytoma may lead to
      worsening of hyperlipidaemia pre-existing in such individuals.

PMID- 1630987
TI  - Congenital left ventricular diverticula: a rare cause of sudden cardiac death.
AB  - Congenital left ventricular diverticula are a rare cause of sudden cardiac death.
      We describe the first reported case of ventricular fibrillation in association
      with congenital diverticula of the heart. The diagnosis of left ventricular
      diverticula was made by cardiac catheterization and confirmed by magnetic
      resonance imaging. Treatment was initiated with anti-arrhythmic and anticoagulant
      drugs to prevent life-threatening arrhythmias and emboli.

PMID- 1630988
TI  - A case of polycythaemia vera presenting with intramuscular chest wall haematoma.
AB  - A 40 year old male, previously well, presented with a posterior chest wall
      haematoma. Computerized tomography and ultrasound showed this to be
      intramuscular. Haematological indices were consistent with a diagnosis of
      polycythaemia vera. The haematoma and indices responded to hydroxyurea and
      venesection. This rare presentation of polycythaemia vera in a young person is
      described and the haemorrhagic complications of polycythaemia vera discussed.

PMID- 1630989
TI  - Primary pulmonary hypertension and functional hyposplenism.
AB  - Primary pulmonary hypertension is a rare disease of unknown case. Functional
      hyposplenism is characterized by the appearance of abnormal circulating
      erythrocytes despite the presence of a spleen and is associated with a variety of
      disease states. A case of primary pulmonary hypertension associated with
      functional hyposplenism is described in this report.

PMID- 1630990
TI  - Graves' disease and insulin-dependent diabetes mellitus in idiopathic Addison's
      disease.

PMID- 1630991
TI  - Pneumoperitoneum without peritonitis.

PMID- 1630992
TI  - Changes in pulmonary function in systemic sclerosis.

PMID- 1630993
TI  - Third degree heart block in acromegaly.

PMID- 1630994
TI  - Masked faecal peritonitis in Cushing's syndrome.

PMID- 1630995
TI  - Trimethoprim-induced vasculitis.

PMID- 1630996
TI  - Listeria rhombencephalitis in a previously healthy adult.

PMID- 1630997
TI  - Membranous nephropathy associated with diclofenac.

PMID- 1630998
TI  - Thrombotic thrombocytopenic purpura due to Mycoplasma pneumoniae.

PMID- 1630999
TI  - Amiodarone-induced thyrotoxicosis responding to oral steroid therapy.

PMID- 1631000
TI  - Idiopathic thrombocytopenic purpura and acute polyneuritis: a coincidence or
      association?

PMID- 1631001
TI  - Early diagnosis of colorectal cancer.

PMID- 1631002
TI  - A patient's request to change GPs.

PMID- 1631003
TI  - Cervical cancer.

PMID- 1631004
TI  - Re-infection and congenital rubella syndrome.

PMID- 1631005
TI  - Negative symptoms of schizophrenia.

PMID- 1631006
TI  - Work, health and disease.

PMID- 1631007
TI  - Transplantation update.

PMID- 1631008
TI  - Childhood bone marrow transplantation.

PMID- 1631009
TI  - The oral examinations.

PMID- 1631010
TI  - Rethinking antenatal care.

PMID- 1631011
TI  - Women's concerns.

PMID- 1631012
TI  - Antenatal diagnosis.

PMID- 1631013
TI  - Childbirth and mental health.

PMID- 1631015
TI  - Oral NSAIDs: the best choice in practice.

PMID- 1631014
TI  - Breastfeeding: the GP's role.

PMID- 1631016
TI  - Control of melanocyte proliferation and differentiation in the mouse epidermis.
AB  - Melanocyte-stimulating hormone plays an important role in the regulation of
      melanocyte differentiation in the mouse epidermis by inducing tyrosinase
      activity, melanosome formation, translocation of melanosomes, and increased
      dendritogenesis. The proliferative activity of differentiating epidermal
      melanocytes of newborn mice during the healing of skin wounds is regulated by
      semi-dominant genes, suggesting that the genes are involved in regulating the
      proliferative activity of epidermal melanocytes during differentiation. From the
      results of serum-free culture of epidermal cell suspensions from neonatal mouse
      skin, basic fibroblast growth factor is shown to stimulate the sustained
      proliferation of melanoblasts in the presence of dibutyryl adenosine 3',5'-cyclic
      monophosphate and keratinocyte-derived factors. Moreover, each step of melanocyte
      differentiation is controlled by numerous coat color genes. These genes control
      melanocyte differentiation by regulating the differentiation of neural crest
      cells into melanoblasts in embryonic skin, or by regulating the differentiation
      of neural crest cells into melanoblasts in embryonic skin, or by regulating
      transcription and/or translation of the tyrosinase gene in the differentiating
      melanocytes. These results suggest that melanocyte proliferation and
      differentiation in the mouse epidermis are controlled by both genetic factors and
      local tissue environment.

PMID- 1631018
TI  - Response of transformed and normal mouse cell lines to anti-melanin compounds,
      hyperthermia, and radiation.
AB  - Five cell lines (one parental, two transformed melanin producing, and two
      transformed non-melanin producing) were evaluated for the responses to 2- and 4
      hydroxyanisole (2HA, 4HA) alone or combined with hyperthermia or radiation. All
      cells exhibited a non-specific toxic response to the two compounds and the effect
      was exposure time and concentration dependent and was greater for 4HA compared to
      2HA. In addition, the two melanin-producing cell lines were more sensitive,
      demonstrating specific toxicity to such cell lines. The treatment with either 2HA
      or 4HA combined with heat and radiation resulted mostly in additive or
      antagonistic effects, except for one combination of 2HA plus radiation in the
      melanin-producing R25 cells. Thus, while these compounds may be useful in therapy
      for pigmented melanomas, combined treatment with radiation is not recommended.

PMID- 1631017
TI  - Differentiation of new metastatic variants of B16 melanoma under different
      culture conditions.
AB  - The purpose of this study was to examine the differentiation of variant tumors of
      the B16 metastatic melanoma when tumors were grown serially under different
      culture conditions and transplanted into C57BL/6J black mice, lethal yellow Ay/a,
      albino c/c, and C+/c mutant mice. Morphological and biochemical markers of
      melanogenesis were examined in cells in culture and in the corresponding tumors.
      Cellular pigmentation was assessed in terms of the levels of DOPA and 5-S-CD and
      in terms of tyrosinase activity in the various cell lines and tumors. The
      observed change from high to low metastatic capacity, which was dependent on
      culture conditions, appeared to be unrelated to melanogenesis even though changes
      were observed in the biochemical melanotic phenotype. Overall, tumor cells from
      spontaneous pulmonary metastases appear to differentiate in ways that are
      unrelated to the instability of experimental metastatic capacity. The melanotic
      phenotype in albino c/c and C+/c mice was dependent on the phenotype of the
      parental tumors. A marked difference was observed between two pigmentation
      compartments, one of which was stable in the B16 control, while the other was
      unstable in YB16 and MB16 variant cells and in the tumors derived from them. It
      appears, therefore, that the metastatic capacity of B16 metastatic variants is
      changeable and is independent of the unstable melanogenic behavior. The
      production of metastases and the differentiation of tumors in the present
      experiments appeared to be related to the genetic background of the mice and the
      epigenetic metabolic environment of tumors and cells.

PMID- 1631019
TI  - Hyperpigmentation of chinchilla stria vascularis following acoustic trauma.
AB  - This report describes morphological alterations of the chinchilla stria
      vascularis seen 30 days after exposure to impulse noise. The observed changes
      included a dramatic increase in strial melanin content which occurred in 7 of 36
      animals exposed to electronically synthesized impluses presented in various
      temporal patterns at either 135 or 150 dB peak SPL. In these animals, densely
      pigmented areas of stria 1.5 to 3 mm in length were found in the basal cochlear
      turn. Light and electron microscopic study revealed that these areas contained
      large numbers of melanin granules situated primarily in pale-staining cells of
      the middle layer of the stria. Unlike the pigment granules present in normal
      chinchilla stria, the melanosomes found in the noise-exposed material clearly
      showed ultrastructural features characteristic of eumelanin. Melanin granules
      were also observed in marginal and basal cells of the noise-exposed stria. In
      some cases, pigment granules which had apparently been expelled from the marginal
      cells were present in the endolymphatic space beneath Reissner's membrane and on
      the strial surface. These findings support the view that the melanin-bearing
      cells of the inner ear are capable of markedly increased activity in response to
      stressful conditions.

PMID- 1631020
TI  - Tissue distribution of para-boronophenylalanine administered orally as a
      cyclodextrin inclusion complex to melanoma-bearing hamsters.

PMID- 1631021
TI  - Synergism exerted by 4-methyl catechol, catechol, and their respective quinones
      on the rate of DL-DOPA oxidation by mushroom tyrosinase.
AB  - 4-Methyl catechol and catechol, at concentrations ranging from 0.03 to 9 mM and
      0.066 to 20 mM, respectively, have a synergistic effect on the rate of DL-DOPA
      oxidation by mushroom tyrosinase to material absorbing at 475 nm. The synergism
      results from the ability of 4-methyl catechol-o-quinone (4-methyl-o-benzoquinone)
      and of catechol-o-quinone (o-benzoquinone) to oxidize DL-DOPA non-enzymatically
      to dopaquinone, with the later being immediately converted to dopachrome (lambda
      max = 475 nm).

PMID- 1631022
TI  - Does the introduction of a new player, the endoplasmic reticulum, create more or
      less confusion in understanding the mechanism(s) of pigmentary organelle
      translocations?
AB  - In 1925, Wilson listed, in his classic third edition of Cell in Development and
      Heredity, four theories for the morphological and physiological characteristics
      of cytoplasm; each theory provided some sort of explanation as to the
      mechanism(s) of organelle translocations. During the past twenty years, cell
      biologists have focused their attentions on the cell's cytoskeleton,
      microtrabecular lattice, and associated mechanochemical motors which drive
      organelles along cytoskeletal tracks. A number of cell types have been used to
      study organelle translocations, but chromatophores, pigment cells, from cold
      blooded vertebrates have been one of the more popular models. This article
      reviews some of the research findings during the past twenty years, particularly
      those involving cytoplasmic elements: i.e, microfilaments, intermediate
      filaments, microtubules, and mechanochemical motors. In addition, it contrasts
      the proposed involvement of these elements in organelle translocations with the
      endoplasmic reticulum, a tubulovesicular organelle, which we recently
      demonstrated is responsible, through its elongation or retraction, for the
      translocations of carotenoid droplets in goldfish xanthophores and swordtail fish
      erythrophores. Here, the carotenoid droplets are not free in the cytoplasm and do
      not translocate via cytoskeletal tracks, but instead are attached to or are a
      part of the endoplasmic reticulum. On the other hand, carotenoid droplets of
      squirrel fish erythrophores are free in the cytoplasm and appear to translocate
      via microtubules. Finally, the rates of pigmentary organelle translocations are
      reviewed in light of the participation of the cytoskeletal elements with the
      endoplasmic reticulum.

PMID- 1631023
TI  - Effect of different isomers of dihydroxybenzoic acids (DBA) on the rate of DL
      dopa oxidation by mushroom tyrosinase.
AB  - Dihydroxybenzoic acids (DBA), such as 3,4-DBA, 3,5-DBA, and 2,4-DBA--at all
      concentrations tested--inhibited the rate of DL-DOPA oxidation to dopachrome
      (lambda max = 475 nm) by mushroom tyro0sinase. 2,3-DBA and 2,5-DBA at relatively
      low concentration had a synergistic effect on the reaction, whereas at relatively
      high concentrations they inhibited the rate of DL-DOPA oxidation. The synergistic
      effect of 0.6-13.3 mM 2,3-DBA on the rate of DL-DOPA oxidation to dopachrome
      (lambda max = 475 nm) was found to be due to the ability of 2,3-DBA-o-quinone
      (formed by the oxidation of 2,3-DBA by mushroom tyrosinase or by sodium
      periodate) to oxidize DL-DOPA to dopachrome (via dopaquinone) non-enzymatically.
      A similar explanation is likely to be valid for the synergism exerted by 2,5-DBA
      on the rate of DL-DOPA oxidation by mushroom tyrosinase.

PMID- 1631024
TI  - Current topic: the synepitheliochorial placenta of ruminants: binucleate cell
      fusions and hormone production.

PMID- 1631025
TI  - Current topic: midgestation cord sampling: what have we learned.

PMID- 1631026
TI  - Antibodies to hCG inhibit progesterone production from human syncytiotrophoblast
      cells.

PMID- 1631027
TI  - Protein turnover in rat placenta: effects of maternal fasting and maternal
      protein restriction.
AB  - Biochemical composition and variables of protein turnover were determined in rat
      placenta at 21 days gestation in control animals and in animals subjected to 72-h
      fasting and protein/calorie restriction (6 per cent protein) throughout
      gestation. Placental protein synthesis was determined following the injection of
      'massive' amounts of 14C-phenylalanine intravenously to the pregnant rat. Protein
      content was reduced in placentas from rats that were fasted for 72 h and in those
      who were protein restricted throughout pregnancy. Placental RNA content was
      significantly reduced only in the protein-restricted animals. Fractional rates of
      protein synthesis were reduced in placentas from the protein-restricted animals
      (Ks = 17.9 +/- 0.8 per cent per day in controls versus 11.7 +/- 0.9 in protein
      restricted, P = 0.002), but not in fasted animals. Fractional protein breakdown
      was markedly enhanced in placentas following maternal fasting (Kd = 9.9 per cent
      per day in controls versus 26.0 per cent in fasted), but not affected by protein
      deprivation. These results mimic those previously reported for other fetal
      tissues under these experimental conditions.

PMID- 1631028
TI  - Uptake of zinc by human placental microvillus border membranes and
      characterization of the effects of cadmium on this process.
AB  - The uptake of Zinc (Zn) by microvillus border membrane vesicles formed from the
      trophoblast of term human placentae is markedly increased over brief periods of
      incubation with much slower increases persisting for up to 2 h of incubation.
      Zinc is both bound to membrane components and transported into intravesicular
      osmotically active space. Uptake is saturable, temperature dependent from 4 to 37
      degrees C with a Q10 of 1.7, and is inhibited by the sulphydryl agent DTNB. About
      20 per cent of the uptake is susceptible to inhibition by Cadmium (Cd) at
      concentrations from 5 to 50 microM, a significant part of the action of this
      metal being on the transmembrane component of Zn uptake.

PMID- 1631029
TI  - A fibrin matrix modulates the proliferation, hormone secretion and morphologic
      differentiation of cultured human placental trophoblast.
AB  - Term placental trophoblast epithelialize fibrin deposits attached to villi in
      vitro and trophoblast cultured on a fibrin matrix form an epithelial bilayer
      typical of the trophoblast layer on term villi. We compared the morphology of
      cells grown on fibrin with cells grown on substrates of type IV collagen,
      laminin, type I collagen, or Matrigel. We also used autoradiography, hormone
      assays, electron microscopy, and immunofluorescence to determine what functional
      activities were influenced by trophoblast-fibrin interactions. Cultured cellular
      trophoblast from term placentae differentiated to form syncytial trophoblast and
      to secrete estrogen, progesterone, and hCG in the presence or absence of
      matrices. Trophoblast proliferation was lower in cells grown on matrices and was
      inversely related to cell height after 24 h in culture. Cells grown on fibrin
      remained the tallest and had the lowest labelling index. Cells grown for 72 h on
      fibrin had the most dilated rough endoplasmic reticulum but the lowest media
      hormone levels. Only cells grown on a fibrin matrix formed a basal lamina-like
      structure at the trophoblast-substrate interface, and only a fibrin matrix
      facilitated trophoblast to form an epithelial bilayer in culture. However, this
      histology was not accompanied by a change in the amount of syncytial trophoblast
      formed by the cells grown on fibrin. The results suggest that a fibrin matrix
      uniquely modulates the trophoblast phenotype, away from the secretion of
      placental specific products like hCG in favour of a repair-oriented phenotype
      that forms basement membrane and a trophoblast bilayer.

PMID- 1631030
TI  - Characterization of human placental activity for transport of L-alanine, using
      brush border (microvillous) membrane vesicles.
AB  - To characterize the placental activity for the transport of amino acids, the
      uptake of L-alanine was investigated by rapid membrane filtration using brush
      border membrane vesicles separated from the human placenta of early pregnant (12
      13 gestational weeks) and late pregnant (37-38 gestational weeks) women. The
      uptake of L-alanine into the brush border membrane vesicles at early and late
      stage of gestation showed a pattern of transport dependent on the intra- and
      extravesicular Na+ concentration gradient (extravesicular Na+ greater than
      intravesicular Na+). The Na+ concentration gradient-dependent uptake of L-alanine
      into the brush border membrane vesicles at early and late stage of gestation also
      showed a dependency on the potential difference of the internal and external
      membrane. The transport of L-alanine into the brush border membrane vesicles was
      markedly augmented at late stage of gestation. On the basis of the double
      reciprocal plotting of the L-alanine concentration and the Na(+)-dependent uptake
      of L-alanine into the vesicles, Km and Vmax were calculated as parameters of the
      Na(+)-dependent uptake of L-alanine into the vesicles. In the early stage of
      gestation Km was 0.78 mM, and in the late stage of gestation was 0.80 mM. In the
      early stage of gestation Vmax (nmol/mg protein/20 sec) was 0.62, and in the late
      stage of gestation was 3.53. From the results, it was considered that the
      placental active transport mechanism of L-alanine is the same in the early and
      late stages of gestation, and it was shown that its transport activity increases
      greatly in late stages compared to the early stages of gestation.

PMID- 1631031
TI  - Classics revisited: Otto Grosser's monographs.

PMID- 1631032
TI  - Levels of placental protein 14, human placental lactogen and unconjugated
      oestriol in extraembryonic coelomic fluid.

PMID- 1631033
TI  - [Interstitial Lung Diseases. 22nd Scientific Meeting of the North German
      Association of Pulmonary and Bronchial Medicine. Berlin, 3-5 October 1991.
      Abstracts].

PMID- 1631034
TI  - The evolution of health promotion.
AB  - This paper describes the evolution of health promotion from its nascent roots
      which focused upon lifestyle to its global concepts of managing the future. A
      lifestyle orientation was the focus of approximately the first decade of health
      promotion efforts which followed the release of the 1974 document, "A New
      Perspective on the Health of Canadians". This was also a period of national
      health goal setting in Europe and in the United States. In 1984, the World Health
      Organization defined health promotion as the process of enabling individuals to
      take control over and to maintain their health. The focus of health promotion
      efforts thus changed from an emphasis on the individual to the more structural
      factors in society which support the types of choices that people ultimately
      make. Achieving Health for All: A Framework for Health Promotion, released in
      November 1986, further developed the concept of health promotion, suggesting
      three strategies for increasing health promotion: fostering public participation,
      strengthening community health services and healthy public policy. The health
      promotion movement has had other spin-offs such as the "Healthy Cities Movement"
      which was begun by another Canadian, Trevor Hancock. The newest evolution of the
      health promotion movement is a concern for a Healthy Future.

PMID- 1631035
TI  - Health promotion workshop.

PMID- 1631036
TI  - Public health programs.

PMID- 1631037
TI  - A multidisciplinary approach to health promotion for seniors.

PMID- 1631038
TI  - Canadian students in U.S. dental hygiene programs.

PMID- 1631039
TI  - Studies on chimeric fusion proteins of human aldolase isozymes A and B.
AB  - Several kinds of fusion proteins between human aldolases A and B were prepared by
      recombinant DNA technology and their enzymic properties were examined. AB
      chimeras, which have aldolase A at the N-terminal region and aldolase B at the C
      terminal region, were scarcely obtained, while BA chimeras were abundant
      (Kitajima et al., (1990), J. Biol. Chem., 265, 17493-17498). All the BAB
      chimeras, aldolase A fragments inserted in aldolase B, showed activity assignable
      to aldolase B type, which imply an essential role of Tyr residue at the C
      terminus of aldolase A in the binding of fructose-1,6-bisphosphate (Fru-1,6-P2).
      BAB chimeras also showed reactivity to effectors such as fructose-2,6
      bisphosphate (Fru-2,6-P2) and pyridoxal 5-phosphate (PLP), in a similar manner to
      aldolase B. BAB108 has a similarity to the BA108 chimera, but acts differently
      from other BAB chimeras, suggesting that its structure around active site looks
      like that of aldolase A.

PMID- 1631040
TI  - Uncoupling of catalysis and colipase binding in pancreatic lipase by limited
      proteolysis.
AB  - In the intestine, the hydrolysis of triglycerides by pancreatic lipase is
      performed only in the presence of colipase, whose function is to anchor lipase to
      the bile-salt-coated lipid interface. Biochemical and crystallographic data on
      porcine and human lipases have shown that the molecule is made of two well
      delimited domains. In order to get more information on the role of the domains in
      catalysis and colipase binding, we performed limited proteolysis on lipase from
      various species and obtained different patterns of cleavage. In the case of
      porcine and human lipases, only the C-terminal domain (12 kDa) could be obtained
      after chymotryptic attack, whereas in the horse enzyme the cleavage of the Leu410
      Thr411 bond gave rise to a large N-terminal (45 kDa) and a small C-terminal (4
      kDa) fragment. The isolated porcine and human C-terminal domains were completely
      inactive towards emulsified tributyrin, though were able to bind colipase.
      Conversely, the horse 45 kDa fragment retained the lipase activity but failed to
      correctly bind colipase. This work definitely proves that catalysis and colipase
      binding are separate events involving topographically distinct regions of the
      molecule and focuses attention on the role of the C-terminal domain in colipase
      binding.

PMID- 1631041
TI  - Molecular dynamics simulations of the whey protein beta-lactoglobulin.
AB  - Molecular dynamics simulations have been used to model the motions and
      conformational behavior of the whey protein bovine beta-lactoglobulin.
      Simulations were performed for the protein by itself and complexed to a single
      retinol ligand located in a putative interior binding pocket. In the absence of
      the retinol ligand, the backbone loops around the opening of this interior pocket
      shifted inward to partially close off this cavity, similar to the shifts observed
      in previously reported molecular dynamics simulations of the uncomplexed form of
      the homologous retinol binding protein. The protein complexed with retinol does
      not exhibit the same conformational shifts. Conformational changes of this type
      could serve as a recognition signal allowing in vivo discrimination between the
      free and retinol complexed forms of the beta-lactoglobulin molecule. The unusual
      bending of the single alpha-helix observed in the simulations of retinol binding
      protein were not observed in the present calculations.

PMID- 1631042
TI  - Application of free energy simulations to the binding of a transition-state
      analogue inhibitor to HIV protease.
AB  - Free energy simulations (slow-change method) have been used to estimate
      quantitatively the ratio of the binding constants of (S) and (R) isomers of a
      novel HIV protease inhibitor, JG365. As a starting geometry, we used the X-ray
      crystallographic structure of a complex of HIV protease and JG365 provided by A.
      Wlodawer. According to our results the (S) configuration, i.e. the form
      previously identified experimentally, binds considerably more tightly to the
      protease (delta delta G degrees = 2.9 kcal/mol). When the (S) inhibitor is bound,
      there is a very strong preference for protonation of the Asp125 (rather than the
      Asp25) residue of the protease. This study is the first to apply a new method for
      quantitatively assessing the precision of free energies calculated by the slow
      change method.

PMID- 1631043
TI  - The crystal state binding of dithionite to deoxy-hemoglobin.
AB  - The crystal state binding of sodium dithionite to deoxyhemoglobin is reported.
      Dithionite has been used extensively to deoxygenate hemoglobin and myoglobin and
      there has been considerable interest among users of dithionite about its effect
      on protein structure and binding site(s). We have determined that dithionite
      binds to deoxygenated hemoglobin crystals at the interface of two molecules in
      the crystal lattice. Specific residues involved in hydrogen bonds or salt
      interactions with dithionite include His116 and His117 of the beta 2 subunit and
      Lys16 of the alpha 1 subunit of the adjacent hemoglobin molecule. No binding was
      observed at the symmetry related His116 and 117 beta 1 residues. We have shown
      that dithionite does not affect the native hemoglobin structure or the binding of
      several allosteric inhibitors to hemoglobin and can be used to mount T state
      crystals in the air.

PMID- 1631044
TI  - Pattern-induced multi-sequence alignment (PIMA) algorithm employing secondary
      structure-dependent gap penalties for use in comparative protein modelling.
AB  - A multiple sequence alignment algorithm is described that uses a dynamic
      programming-based pattern construction method to align a set of homologous
      sequences based on their common pattern of conserved sequence elements. This
      pattern-induced multi-sequence alignment (PIMA) algorithm can employ secondary
      structure dependent gap penalties for use in comparative modelling of new
      sequences when the three-dimensional structure of one or more members of the same
      family is known. We show that the use of secondary structure information can
      significantly improve the accuracy of aligning structure boundaries in a set of
      homologous sequences even when the structure of only one member of the family is
      known.

PMID- 1631045
TI  - A variable gap penalty function and feature weights for protein 3-D structure
      comparisons.
AB  - We have developed a variable gap penalty function for use in the comparison
      program COMPARER which aligns protein sequences on the basis of their 3-D
      structures. For deletions and insertions, components are a function of structural
      features of individual amino acid residues (e.g. secondary structure and
      accessibility). We have also obtained relative weights for different features
      used in the comparison by examining the equivalent residues in weight matrices
      and in alignments for pairs of 3-D structures where the equivalencies are
      relatively unambiguous. We have used the new parameters and the variable gap
      penalty function in COMPARER to align protein structures in the Brookhaven Data
      Bank. The variable gap penalty function is useful especially in avoiding gaps in
      secondary structure elements and the new feature weights give improved
      alignments. The alignments for both azurins and plastocyanins and N- and C
      terminal lobes for aspartic proteinases are discussed.

PMID- 1631046
TI  - Homology model of thyroxine binding globulin and elucidation of the thyroid
      hormone binding site.
AB  - The tertiary structure of thyroxine binding globulin (TBG) has been modelled on
      the basis of its close homology to alpha 1-antitrypsin, the archetype of the
      serine protease inhibitor (serpin) superfamily. Energy minimization was applied
      to the model to refine the structure further. The putative thyroid hormone
      binding region suggested in previous labelling studies was found to exist within
      a beta-barrel structure of complementary dimensions to the thyroid hormones. The
      model also revealed that the binding cleft provides the hydrophobic environment
      and specific ionic interaction sites deemed important for thyroid hormone
      binding. The model is in good agreement with evidence derived from previously
      reported T3 and T4 binding, stability and isoelectric focussing studies of TBG
      and TBG variants. Finally, T4 analogue and drug binding studies have enabled us
      to postulate the orientation and manner of hormone binding to TBG. This may prove
      to be of assistance in the development of potent and specific, non-thyroidal
      ligands and also aid in the understanding of physiological thyroid hormone
      binding interactions.

PMID- 1631047
TI  - A robust and efficient automated docking algorithm for molecular recognition.
AB  - A completely automated method is described for determining the most likely mode
      of binding of two (macro)molecules from the knowledge of their three-dimensional
      structures alone. The method is based on well-known graph theoretical techniques
      and has been used successfully to determine and rationalize the binding of a
      number of known macromolecular complexes. In this article we present results for
      a special case of the general molecular recognition problem--given the
      information concerning the particular atoms involved in the binding for one of
      the molecules, the algorithm can correctly identify the corresponding
      (contacting) atoms of the other molecule. The approach used can be easily
      extended to the general molecular recognition problem and requires the extraction
      of maximal common subgraphs. In these studies the docking of the macromolecules
      was achieved without the aid of computer graphics or other visual aids. The
      algorithm has been used to determine the correct mode of binding of a protein
      antigen to an antibody in approximately 100 min on a DEC micro VAX 3600.

PMID- 1631048
TI  - Characterization of the interactions of a bifunctional inhibitor with alpha
      thrombin by molecular modelling and peptide synthesis.
AB  - A potent thrombin inhibitor, [D-Phe45, Arg47] hirudin 45-65, that contains an
      active site-directed sequence D-Phe-Pro-Arg-Pro, an exosite specific fragment
      hirudin 55-65 (H55-65) and a linker portion hirudin 49-54, was designed based on
      the hirudin sequence [DiMaio et al. (1990) J. Biol. Chem., 265, 21698-21798]. A
      three-dimensional model of the complex between the B-chain of human thrombin and
      the inhibitor [D-Phe45, Arg47] hirudin 45-65 was constructed using molecular
      modelling starting from the X-ray C alpha coordinates of the thrombin-hirudin
      complex and the NMR-derived structure of the thrombin-bound hirudin 55-65. The
      contribution of the H49-54 fragment to the thrombin-inhibitor interaction was
      deduced by examining a series of analogs containing single glycine substitution
      and analogs with reduced number of residues within the linker. The results were
      consistent with the molecular modelling observations i.e. the H49-54 fragment
      serves the role of a spacer in the binding interaction and could be replaced by
      four glycine residues. The studies on the interaction of the exosite-directed
      portion of the inhibitor with thrombin using a series of synthetic H55-65 analogs
      demonstrated that residues AspH55 to ProH60 play a major role in binding to human
      thrombin where the side chains of PheH56, IleH59 and GluH57 showed critical
      contributions. Molecular modelling suggested that these side chains may
      contribute to inter- and intramolecular hydrophobic and electrostatic
      interactions, respectively.

PMID- 1631049
TI  - Evidence for a second conserved arginine residue in the integrase family of
      recombination proteins.
AB  - This study was designed to search for new regions of similarity in the integrase
      family of recombination proteins which consists of 28 members found in bacteria
      and yeast. A computer method based on an information content analysis has been
      used to align local regions of homology in the set of unaligned protein sequences
      from this family. Among the aligned regions with high information content were
      those containing the known conserved histidine, arginine and tyrosine residues.
      In addition, a new region was identified containing another arginine residue that
      appears to be conserved in all members of the family. To test further the
      importance of this newly identified arginine residue, mutants in the Cre protein
      from phase P1, a member of this integrase family, have been constructed which
      alter this residue. The mutations which change arginine to lysine and arginine to
      cysteine depress catalytic activity but not site-specific binding to the lox
      site. This result is expected for a conserved active site residue. This computer
      analysis also provides a means for searching for new members of the integrase
      family.

PMID- 1631050
TI  - Minimal sequence requirements for ribozyme activity.
AB  - The hammerhead ribozyme, as engineered by J. Haseloff and W. L. Gerlach [(1988)
      Nature (London) 334, 585-591], is an RNA molecule containing two regions of
      conserved nucleotides, a double helix, called helix II, which connects the two
      conserved regions, and flanking arms of variable sequence, which hybridize the
      ribozyme to its specific target. Here we show that this ribozyme may be reduced
      in size and still retain cleavage activity by replacing helix II with just a few
      nucleotides that cannot form Watson-Crick base pairs between themselves.
      Furthermore, the nucleotides replacing helix II and the nucleotides in the
      flanking arms may be substituted with DNA, and this small, DNA-containing
      ribozyme is fully as active as the original, full-size ribozyme. Cleavage
      activity of the minimized ribozyme depends on the number and sequence of the few
      nucleotides that replace helix II; optimal activity, thus far, is achieved by
      four or five deoxyribopyrimidines. The minimized ribozyme, or "minizyme," is
      active as a monomer, as shown by its nearly constant activity over a
      concentration range varying 25,000-fold, by the mobility of the minizyme
      substrate complex in nondenaturing polyacrylamide gels as compared with other
      nucleic acid molecules of known size, and by other observations. These minizymes
      provide an excellent model system for studying the structure and mechanism of
      catalytic RNA; they might also be useful in a variety of biological applications.

PMID- 1631051
TI  - In vitro mutagenesis of biologically active transcripts of beet necrotic yellow
      vein virus RNA 2: evidence that a domain of the 75-kDa readthrough protein is
      important for efficient virus assembly.
AB  - RNA 2 of the multipartite genome of beet necrotic yellow vein virus carries the
      cistron for 21-kDa viral coat protein at its 5' extremity. The amber termination
      codon of the coat protein cistron undergoes suppression approximately 10% of the
      time so that translation continues into an adjacent 54-kDa open reading frame,
      yielding a 75-kDa readthrough protein. The roles of coat protein and the
      readthrough protein in infection were investigated with biologically active
      transcripts of RNA 2. Much of the coat protein cistron of the RNA 2 transcript
      could be deleted without interfering with viral replication and local lesion
      formation on leaves, although formation of the rod-shaped virions did not occur.
      Mutants in which the amber coat protein termination codon was replaced with an
      ochre codon or a tyrosine codon were also viable. The ochre codon was suppressed
      both in vitro and in planta. The mutant containing the tyrosine substitution
      produced only the 75-kDa read-through protein and was deficient in viral
      assembly. Deletions in the 54-kDa readthrough domain were also viable in planta
      but had different effects on virus assembly. A deletion in the C-terminal portion
      of the readthrough domain did not interfere with RNA packaging but, unexpectedly,
      deletions in the N-terminal portion were assembly deficient, although 21-kDa coat
      protein was produced in planta. Thus, the 75-kDa protein can apparently intervene
      in virion assembly even though it has not been detected in purified virions.

PMID- 1631052
TI  - Stable transformation of a mosquito cell line results in extraordinarily high
      copy numbers of the plasmid.
AB  - Stable incorporation of high copy numbers (greater than 10,000 per cell) of a
      plasmid vector containing a gene conferring resistance to the antibiotic
      hygromycin was achieved in a cell line derived from the Aedes albopictus
      mosquito. Plasmid sequences were readily observed by ethidium bromide staining of
      cellular DNA after restriction endonuclease digestion and agarose gel
      electrophoresis. The plasmid was demonstrated by in situ hybridization to be
      present in large arrays integrated in metaphase chromosomes and in minute and
      double-minute replicating elements. In one subclone, approximately 60,000 copies
      of the plasmid were organized in a large array that resembles a chromosome,
      morphologically and in the segregation of its chromatids during anaphase. The
      original as well as modified versions of the plasmid were rescued by
      transformation of Escherichia coli using total cellular DNA. Southern blot
      analyses of recovered plasmids indicate the presence of mosquito-derived
      sequences.

PMID- 1631053
TI  - Organ injury associated with extrathymic induction of immune tolerance in doubly
      transgenic mice.
AB  - The developmental fate of autoreactive T cells encountering extrathymically
      expressed self-antigen was studied in a doubly transgenic mouse model system
      where pancreatic acinar cells expressed H-2Ld and T cells expressed an antigen
      receptor (2C TCR) specific for H-2Ld. Thymocytes bearing 2C TCR differentiated
      normally. They were positively selected without evidence of intrathymic clonal
      deletion. Survival of H-2Ld-bearing skin allografts was significantly prolonged
      in pancreatic H-2Ld singly and doubly transgenic mice, consistent with an in vivo
      state of T-cell tolerance. The mechanism of tolerance induction was determined
      and found to have two components. First, up to 80% of peripheral CD8+2C TCR+ T
      cells were eliminated. Second, those T cells which escaped elimination had a
      significantly reduced proliferative response to H-2Ld. Thus, autoreactive T cells
      can be made self-tolerant through interaction with self-antigen located
      extrathymically. This is accomplished by a reduction in the percentage of
      autoreactive T cells as well as by a reduction in the functional capacity of
      residual T cells. Surprisingly, although pancreatic lymphocytic infiltration and
      organ injury were absent in exocrine tissue of singly transgenic mice, it was
      present in doubly transgenic mice. This suggests that when the percentage of
      autoreactive T cells is high, tolerance induction can be associated with an
      inflammatory infiltrate in extrathymic tissue where self-antigen is presented.

PMID- 1631054
TI  - A simple explanation of the electrostatics of the B-to-Z transition of DNA.
AB  - Whereas the phosphates of B-DNA jut out into the solution, those of Z-DNA, being
      closer to DNA matter, are less subject to electrostatic screening by counterions.
      We present simple planar models of B- and Z-DNA that reflect these geometric
      features. The ionic strength dependence of the difference in the Poisson
      Boltzmann electrostatic free energy of the models agrees with that measured by
      Pohl [Pohl, F. M. (1983) Cold Spring Harbor Symp. Quant. Biol. 47, 113-118]. This
      indicates that the electrostatics of the B-to-Z transition are primarily
      controlled by a qualitative geometrical difference and not by details of the DNA
      geometry or by complex electrostatic properties of the ionic solution.

PMID- 1631055
TI  - [Val12] HRAS downregulates GLUT2 in beta cells of transgenic mice without
      affecting glucose homeostasis.
AB  - Glucose-induced insulin release from pancreatic beta cells depends on the beta
      cell metabolism of glucose, which generates intracellular signals for secretion.
      The beta-cell glucose transporter isotype GLUT2 and the glucose phosphorylating
      enzyme glucokinase have both been implicated in coupling insulin secretion to
      extracellular glucose levels. Here we present evidence that a pronounced decrease
      in beta-cell GLUT2 has no immediate effect on glucose homeostasis. Analysis of
      transgenic mice overexpressing human [Val12]HRAS oncoprotein under control of the
      insulin promoter reveals a great reduction in plasma-membrane GLUT2 levels. These
      mice are nonetheless able to maintain normal fed and fasting plasma glucose and
      insulin levels for a period of several months. Insulin secretion studied in
      isolated islets and the perfused pancreas is characterized by a normal
      incremental response to increasing glucose concentrations. Glucose metabolism, as
      measured by glucose phosphorylation and oxidation in isolated islets, shows a
      normal dose dependence on extracellular glucose concentrations. These findings
      suggest that normal GLUT2 expression in beta cells is not essential for glucose
      sensing. The transgenic mice provide an experimental system for studying the role
      of glucose phosphorylation in regulation of insulin release in the absence of
      GLUT2.

PMID- 1631056
TI  - High-speed platelet adhesion under conditions of rapid flow.
AB  - The recognition of exposed collagen by circulating platelets is an initial step
      in the formation of the hemostatic plug or a thrombus after vascular injury.
      Theoretical calculations of the speed of platelet function required for effective
      hemostasis have suggested very short reaction times. However, it is not known how
      fast platelets can adhere to collagen under arterial flow conditions or which
      membrane proteins are involved. We have used a continuous-flow, microaffinity
      column linked to a resistive-particle counter to detect platelet adhesion.
      Adhesion of human platelets to native type I collagen was extremely rapid, with
      exponential half-times as short as 240 ms, and was nearly complete by 2 s. This
      RGD-independent process was not associated with platelet aggregation or
      secretion. The monoclonal antibody 6F1 directed against the glycoprotein Ia/IIa
      complex inhibited adhesion, suggesting that this complex plays an important role
      in the initial phases of platelet-collagen interaction under flow conditions. In
      addition, divalent cations were required for adhesion, as indicated by inhibition
      with EDTA in plasma and the dependence on Mg2+ for washed platelets.

PMID- 1631057
TI  - Evaluation of luteinizing hormone-releasing hormone antagonistic activity in
      vitro.
AB  - Antagonistic analogues of luteinizing hormone-releasing hormone (LHRH) belong to
      a class of compounds that can be utilized for treatment of some hormone-dependent
      cancers and gynecologic disorders. Recently, we synthesized and tested a large
      number of LHRH analogues for LHRH antagonistic activity in the dispersed
      pituitary cell superfusion system. This fast, reliable, and dynamic system made
      it possible for us not only to evaluate the relative amounts of an analogue
      required for suppression of the LH-releasing activity of exogenous LHRH but also
      provided quantitative data on dynamic interactions between the LHRH analogue,
      LHRH receptors, and LH secretion. Three experimental paradigms were used: (i)
      LHRH responses after preincubation with the antagonist, (ii) pulsatile,
      simultaneous infusion of LHRH and the antagonistic analogue, and (iii) effects of
      the analogues on ongoing, continuous LH secretion induced by prolonged
      stimulation with LHRH. From the data obtained, we conclude that (i) the
      suppression of the LHRH-induced LH release was more effective and longer lasting
      when the cells were preincubated with the antagonistic analogues before the LHRH
      stimulation than in the case of simultaneous exposure; (ii) not only the potency
      but also the time of onset and the duration of the LH release-suppressing
      activity varied according to the different peptides used, resulting in different
      shapes of response curves; and (iii) from the accurate data obtained in this
      dynamic system, quantitative parameters of the in vivo interactions between the
      antagonists and LHRH on the LHRH receptor can be calculated.

PMID- 1631058
TI  - Regulation of immediate early gene expression and AP-1 binding in the rat nucleus
      accumbens by chronic cocaine.
AB  - Chronic treatment of rats with cocaine leads to long-term biochemical changes in
      the nucleus accumbens (NAc), a brain region implicated in mediating the
      reinforcing effects of cocaine and other drugs of abuse. Immediate early genes
      (IEGs) and their protein products appear to play an important role in transducing
      extracellular stimuli into altered patterns of cellular gene expression and,
      therefore, into long-term changes in cellular functioning. We therefore examined
      changes in the mRNA levels for the IEGs c-fos, c-jun, fosB, junB, and zif268 in
      the NAc of rats treated acutely and chronically with cocaine. A single cocaine
      injection increased the mRNA levels of all of the IEGs examined. Following
      chronic cocaine treatment, however, IEG expression had returned to control levels
      and was not significantly increased following a further acute challenge with
      cocaine, suggesting desensitization in the ability of cocaine to induce these
      IEGs. Similarly, levels of Fos-like immunoreactivity, which are increased in the
      NAc by acute cocaine, were reduced to control levels in chronic cocaine-treated
      rats. Fos, Jun, and a number of related proteins activate or repress
      transcription of genes by binding to DNA response elements called AP-1 sites. As
      would be expected from the RNA data and immunohistochemistry, acute cocaine
      administration increased AP-1 binding activity in the NAc, an effect that
      reverted completely to control levels within 8-12 hr. In contrast, AP-1 binding
      activity in the NAc of animals treated chronically with cocaine remained elevated
      at acute levels 18 hr after the last chronic injection, a time at which c-fos and
      c-jun mRNA levels and Fos-like immunoreactivity had returned to control values.
      An additional acute cocaine challenge did not further increase AP-1 binding. The
      data suggest that chronic cocaine treatment leads to a persistent increase in AP
      1 binding activity, which may be involved in some of the physiological and
      behavioral aspects of cocaine addiction.

PMID- 1631059
TI  - Gene expression in cotton (Gossypium hirsutum L.) fiber: cloning of the mRNAs.
AB  - Cotton, an important natural fiber, is a differentiated epidermal cell. The
      number of genes that are active in fiber cells is similar to those in leaf,
      ovule, or root tissues. Through differential screening of a fiber cDNA library,
      we isolated five cDNA clones that are preferentially expressed in fiber. One of
      the cDNA clones, pCKE6, corresponded to an abundant mRNA in fiber. Transcripts
      for E6 were detected throughout the development of the fiber. Immunoprecipitation
      of in vitro translation products and Western blot analysis of fiber proteins
      showed two polypeptides in the range of 30-32 kDa as the products of E6 mRNA.
      Sequence analysis and hybrid-selected RNA translation also suggest that E6 mRNAs
      encode two polypeptides. Concentrations of E6 mRNA and protein are highest during
      the late primary cell wall and early secondary cell wall synthesis stages.
      Sequence comparison of E6 with other known eukaryotic and prokaryotic genes
      reveals no significant homology (GenBank; December 1991). E6 or a homologous
      gene(s) is conserved in several members of Malvaceae as well as in one other
      fiber-producing plant, kapok, but is not found in several other plants examined
      or in Acetobacter xylinum. A genomic clone corresponding to pCKE6 was isolated,
      and the promoter element of the E6 gene was shown to direct the expression of a
      carrot extensin mRNA in a tissue-specific and developmentally regulated fashion
      in transgenic cotton plants.

PMID- 1631060
TI  - On the definition of the concepts thinking, consciousness, and conscience.
AB  - A complex system (CS) is defined as a set of elements, with connections between
      them, singled out of the environment, capable of getting information from the
      environment, capable of making decisions (i.e., of choosing between
      alternatives), and having purposefulness (i.e., an urge towards preferable states
      or other goals). Thinking is a process that takes place (or which can take place)
      in some of the CS and consists of (i) receiving information from the environment
      (and from itself), (ii) memorizing the information, (iii) the subconscious, and
      (iv) consciousness. Life is a process that takes place in some CS and consists of
      functions i and ii, as well as (v) reproduction with passing of hereditary
      information to progeny, and (vi) oriented energy and matter exchange with the
      environment sufficient for the maintenance of all life processes. Memory is a
      complex of processes of placing information in memory banks, keeping it there,
      and producing it according to prescriptions available in the system or to
      inquiries arising in it. Consciousness is a process of realization by the
      thinking CS of some set of algorithms consisting of the comparison of its
      knowledge, intentions, decisions, and actions with reality--i.e., with
      accumulated and continuously received internal and external information.
      Conscience is a realization of an algorithm of good and evil pattern recognition.

PMID- 1631062
TI  - In vivo protein-DNA interactions at hypersensitive site 3 of the human beta
      globin locus control region.
AB  - The expression of beta-globin genes in developing erythroid cells is dependent on
      distant, upstream regulatory sequences, known as the locus control region (LCR),
      which are marked in chromatin by DNase I hypersensitive sites (HS-1 to HS-4).
      Linkage of the beta-globin gene complex LCR or fragments surrounding core regions
      of 200-300 base pairs to the human beta-globin gene permits consistent, high
      level expression of the transgene in mice. To define the array of nuclear factors
      interacting with beta-LCR HS-3, we have performed in vivo dimethyl sulfate
      footprinting of the active HS-3 core in erythroid cells by a modified procedure
      that permits assessment of protein-DNA contacts at adenine, as well as guanine,
      residues. In vivo protein occupancy differs considerably from that predicted from
      previous in vitro binding analyses. In vivo footprinting detects protein binding
      at four sites recognized by the erythroid transcription factor GATA-1, at two
      CACC/GT motifs, and at a single AP-1/NF-E2 site. The regulatory elements occupied
      in vivo in HS-3 appear similar to those described previously in globin gene
      promoters and 3' enhancers. These findings suggest that the distinctive
      properties of the HS-3 region may be attributable to the organization of these
      occupied motifs and the consequent protein interactions, rather than to the
      binding of unique LCR regulatory factors.

PMID- 1631061
TI  - Protein interaction cloning in yeast: identification of mammalian proteins that
      react with the leucine zipper of Jun.
AB  - To identify proteins that interact with Jun or Fos we have used the protein
      interaction cloning system developed by S. Fields and O.-K. Song [(1989) Nature
      (London) 340, 245-246] to clone mammalian cDNAs encoding polypeptides that
      interact with the dimerization and DNA-binding motif (bZIP; basic domain leucine
      zipper motif) of Jun. For this purpose, yeast cells lacking GAL4 activity but
      expressing a GAL4 DNA-binding domain-Jun bZIP fusion protein were transformed
      with a mouse embryo cDNA plasmid library in which the cDNA was joined to a gene
      segment encoding the GAL4 transcriptional activation domain. Several
      transformants exhibiting GAL4 activity were identified and shown to harbor
      plasmids encoding polypeptides predicted to form coiled-coil structures with Jun
      and/or Fos. One of these is a bZIP protein of the ATF/CREB protein family-
      probably the murine homolog of TAXREB67. Two others encode polypeptides with
      predicted potential to form coiled-coil structures, and seven other isolates
      encode segments of alpha- or beta-tropomyosin, classical coiled-coil proteins.
      The tropomyosin polypeptides were found to interact in the yeast assay system
      with the bZIP region of Jun but not with the bZIP region of Fos. Our results
      illustrate the range of protein interaction cloning for discovering proteins that
      bind to a given target polypeptide.

PMID- 1631064
TI  - Plants transformed with a region of the 201-kilodalton replicase gene from pea
      early browning virus RNA1 are resistant to virus infection.
AB  - The 3' proximal portion of the gene encoding the 201-kDa putative replicase
      protein from the Tobravirus pea early browning virus (PEBV) can potentially be
      expressed separately as a 54-kDa protein. Nicotiana benthamiana plants
      transformed with the open reading frame (ORF) encoding the 54-kDa protein,
      designated 54K ORF, were resistant to infection by purified PEBV at inoculum
      doses of up to 1 mg/ml, the highest concentration tested. However, resistance was
      abolished by the introduction into the 54K ORF of mutations that would cause
      premature termination of translation. This suggests that the resistance mechanism
      requires the involvement of an intact 54-kDa protein. The 54K ORF-transformed
      plants were also resistant to infection by broad bean yellow band virus and an
      uncharacterized isolate of British PEBV (PGRO R) but were not resistant to
      infection by two other tobraviruses, pepper ringspot virus and the I6 isolate of
      tobacco rattle virus. Additionally, two variants of PEBV which overcame 54K ORF
      mediated resistance have been isolated, the analysis of which might provide
      important information about both the resistance mechanism itself and the process
      of normal virus replication.

PMID- 1631063
TI  - Expression of the cholecystokinin gene in pediatric tumors.
AB  - We have examined a wide range of cultured human tumor cell lines and found that a
      specific subset of tumors expresses the cholecystokinin (CCK) gene. All
      neuroepitheliomas (eight) and Ewing sarcoma (eight) cell lines that were tested
      express CCK RNA. In addition, two of six rhabdomyosarcoma cell lines also express
      the CCK gene, suggesting that rhabdomyosarcomas are probably heterogenous and
      that a subset may be similar to Ewing sarcoma and neuroepithelioma. Very few of
      the positive tumors express completely processed immunoreactive CCK. However, we
      have used a radioimmunoassay that detects the CCK precursor to demonstrate
      synthesis of CCK precursor-like peptides by all of the Ewing sarcoma and
      neuroepithelioma lines that were tested and by the rhabdomyosarcoma cell line
      that expresses CCK mRNA. These data demonstrate a consistent association of CCK
      gene expression with a specific group of human neoplasms. The data also add
      credence to the theory that Ewing sarcoma and neuroepithelioma are derived from
      the same transformed cell type. Finally, our results suggest that CCK gene
      expression may serve as a marker to distinguish these tumors, which are
      considered to be small-round-cell tumors of childhood, from other pediatric
      tumors.

PMID- 1631065
TI  - Identification of the major soluble cuticular glycoprotein of lymphatic filarial
      nematode parasites (gp29) as a secretory homolog of glutathione peroxidase.
AB  - We have cloned and identified the major cuticular glycoprotein (gp29) of
      lymphatic filarial nematode parasites as a homolog of the antioxidant enzyme
      glutathione peroxidase. The derived amino acid sequence predicted a protein of
      25.8 kDa, with an amino-terminal hydrophobic signal peptide and two sites for N
      linked glycosylation, consistent with the documented properties of gp29.
      Transcription of a full-length cDNA in an SP65 vector and subsequent translation
      of the RNA in reticulocyte lysates in vitro generated a protein of 27 kDa, which
      was glycosylated upon the addition of pancreatic microsomal membranes. A
      postulated role for this secreted enzyme could be inhibition of the oxidative
      burst of leukocytes and neutralization of secondary products of lipid
      peroxidation, thus providing one explanation for the resistance of these
      parasites to immune effector mechanisms and their persistence in the mammalian
      host.

PMID- 1631066
TI  - Heterotrimeric G proteins in synaptoneurosome membranes are crosslinked by p
      phenylenedimaleimide, yielding structures comparable in size to crosslinked
      tubulin and F-actin.
AB  - We have treated rat brain synaptoneurosomes with the crosslinking agent N,N'-1,4
      phenylenedimaleimide under conditions that cause extensive crosslinking of
      tubulin, F-actin, and the alpha and beta subunits of three major types of
      heterotrimeric GTP-binding regulatory proteins (G(o), Gs, Gi) present in brain
      membranes. The major crosslinked products are coeluted from Bio-Gel sizing
      columns as very large structures that do not penetrate stacking gels during
      SDS/PAGE. The alpha subunits but not the beta subunits of Gs, G(o) and Gi also
      yield crosslinked products of intermediate sizes. None of the products are as
      small as the heterotrimeric G proteins extracted from brain by cholate or Lubrol.
      However, the large and intermediate crosslinked structures are strikingly similar
      to the large, polydisperse structures of the alpha subunits of Gs, Gi, and G(o)
      extracted from synaptoneurosomes by the detergent octyl glucoside, which have
      sedimentation properties of multimeric proteins. Several ways in which multimeric
      forms of G proteins can explain the dynamic and pleiotropic actions of hormones
      and GTP on signal-transducing systems are discussed.

PMID- 1631068
TI  - Determinant nucleotides of yeast tRNA(Asp) interact directly with aspartyl-tRNA
      synthetase.
AB  - The interaction of wild-type and mutant yeast tRNA(Asp) transcripts with yeast
      aspartyl-tRNA synthetase (AspRS; EC 6.1.1.12) has been probed by using iodine
      cleavage of phosphorothioate-substituted transcripts. AspRS protects phosphates
      in the anticodon (G34, U35), D-stem (U25), and acceptor end (G73) that correspond
      to determinant nucleotides for aspartylation. This protection, as well as that in
      anticodon stem (C29, U40, G41) and D-stem (U11 to U13), is consistent with direct
      interaction of AspRS at these phosphates. Other protection, in the variable loop
      (G45), D-loop (G18, G19), and T-stem and loop (G53, U54, U55), as well as
      enhanced reactivity at G37, may result from conformational changes of the
      transcript upon binding to AspRS. Transcripts mutated at determinant positions
      showed a loss of phosphate protection in the region of the mutation while
      maintaining the global protection pattern. The ensemble of results suggests that
      aspartylation specificity arises from both protein-base and protein-phosphate
      contacts and that different regions of tRNA(Asp) interact independently with
      AspRS. A mutant transcript of yeast tRNA(Phe) that contains the set of identity
      nucleotides for specific aspartylation gave a phosphate protection pattern
      strikingly similar to that of wild-type tRNA(Asp). This confirms that a small
      number of nucleotides within a different tRNA sequence context can direct
      specific interaction with synthetase.

PMID- 1631067
TI  - Whole genome amplification from a single cell: implications for genetic analysis.
AB  - We have developed an in vitro method for amplifying a large fraction of the DNA
      sequences present in a single haploid cell by repeated primer extensions using a
      mixture of 15-base random oligonucleotides. We studied 12 genetic loci and
      estimate that the probability of amplifying any sequence in the genome to a
      minimum of 30 copies is not less than 0.78 (95% confidence). Whole genome
      amplification beginning with a single cell, or other samples with very small
      amounts of DNA, has significant implications for multipoint mapping by sperm or
      oocyte typing and possibly for genetic disease diagnosis, forensics, and the
      analysis of ancient DNA samples.

PMID- 1631069
TI  - Functional conversion of the homologous proteins alpha-lactalbumin and lysozyme
      by exon exchange.
AB  - Exons of eukaryotic genes that encode proteins frequently appear to encode
      structural and/or functional protein units [Gilbert, W. (1978) Nature (London)
      271, 501; Blake, C.C.F. (1979) Nature (London) 277, 598]. alpha-Lactalbumin and c
      type lysozyme are functionally quite different but structurally highly homologous
      proteins. Their gene organizations have been shown to be virtually the same and
      their exon structures are identical. The exon 2 region of hen lysozyme contains
      most of the amino acid residues that make up its catalytic cleft. In this study,
      we engineered a hybrid protein in which the exon 2 region of goat alpha
      lactalbumin was replaced with that of hen lysozyme. This conferred catalytic
      activity on the alpha-lactalbumin, which is a nonenzymatic protein in its native
      structural form.

PMID- 1631070
TI  - Fumarase C, the stable fumarase of Escherichia coli, is controlled by the soxRS
      regulon.
AB  - Fumarase C was strongly induced by paraquat in a parental strain of Escherichia
      coli but was not induced in a strain lacking the soxRS response. Moreover, a
      strain that constitutively expresses the soxRS regulon contained more fumarase C
      than did the parental strain. The Mn-containing superoxide dismutase and glucose
      6-phosphate dehydrogenase, members of the soxRS regulon, were similarly induced
      by paraquat. Mutational defects in glucose-6-phosphate dehydrogenase increased
      the induction of fumarase C by paraquat. For Mn-containing superoxide dismutase,
      responsiveness to paraquat was also enhanced in the glucose-6-phosphate
      dehydrogenase-defective strains. Overproduction of the Mn-containing superoxide
      dismutase, elicited by isopropyl beta-D-thiogalactoside in a tac-sodA fusion
      strain, did not diminish induction of fumarase C or of glucose-6-phosphate
      dehydrogenase by paraquat, and induction of these enzymes was more sensitive to
      paraquat when the cells were growing on succinate rather than on LB medium. These
      results indicate that fumarase C is a member of the soxRS regulon and that this
      regulon does not respond to changes in O2- concentration but perhaps does respond
      to some consequence of a decrease in the ratio of NADPH to NADP+.

PMID- 1631071
TI  - Specific binding of the diphtheria tox regulatory element DtxR to the tox
      operator requires divalent heavy metal ions and a 9-base-pair interrupted
      palindromic sequence.
AB  - The structural gene for diphtheria toxin, tox, is carried by a family of closely
      related corynebacteriophages; however, the regulation of tox expression is
      controlled by a Corynebacterium diphtheriae-encoded regulatory element, dtxR. The
      molecular cloning and sequence analysis of dtxR was recently described. Previous
      studies have suggested that DtxR-mediated regulation of the diphtheria tox
      operator involves the formation of an iron-repressor complex, which specifically
      binds to the tox operator. We have expressed and purified DtxR from recombinant
      Escherichia coli. Immunoblot analysis shows DtxR to be a single M(r) 28,000
      protein band in both recombinant E. coli and the C7(-) and C7hm723(-) strains of
      C. diphtheriae. In addition, we demonstrate that the binding of DtxR to a
      diphtheria tox promoter/operator probe requires the addition of Mn2+ to the
      reaction mixture; however, binding may be blocked by addition of the chelator
      2,2'-dipyridyl, anti-DtxR antiserum, and excess unlabeled probe to the reaction
      mixture. Deletion of one of the 9-base-pair inverted repeat sequences from the
      tox operator results in a loss of DtxR binding. The results presented here
      demonstrate that regulation of diphtheria toxin expression by DtxR requires
      direct interaction between this regulatory factor and the tox operator in the
      presence of a divalent heavy metal ion.

PMID- 1631072
TI  - Clonal proliferation of murine lymphohemopoietic progenitors in culture.
AB  - We have used a two-step clonal culture system to unequivocally demonstrate that
      individual primitive lymphohemopoietic progenitor cells have the capacity for
      differentiation along either the myeloid or the B-lymphoid lineage. Highly
      enriched murine marrow cells were plated individually in culture by
      micromanipulation in the presence of pokeweed mitogen-stimulated spleen cell
      conditioned medium, erythropoietin, steel factor (SF), and interleukin (IL) 7.
      Forty-five percent of the single cells formed primary colonies expressing
      multiple hemopoietic lineages. When aliquots from individual colonies were
      replated in secondary methyl cellulose culture containing SF and IL-7, 41% of the
      primary colonies gave rise to lymphocyte colonies. Cells of the lymphocyte
      colonies were blast-like and B220+, sIg-, Mac-1-, Gr-1-, Ly-1-, L3T4-, Ly-2-, and
      CD3-. Thirty to 70% of the cells were Thy-1+. mu-chain mRNA was detected in most
      of the cells by in situ hybridization with an antisense RNA probe. When
      lymphocyte colonies derived from a single cell were pooled and individually
      injected into scid mice, donor-type IgM was measurable in the serum of mice and
      spleens contained donor-type B cells. We then carried out initial screening of
      growth factors to identify growth factors that might replace pokeweed mitogen
      stimulated spleen cell conditioned medium in the primary culture. Combinations of
      two factors that included SF plus IL-6, IL-11, or granulocyte colony-stimulating
      factor were all effective in the primary culture in the maintenance of the B
      lymphoid potential. Interestingly, IL-3 could neither replace nor act
      synergistically with SF to support the lymphoid potential of the primary
      cultures. Our observations demonstrate that many primitive progenitors previously
      believed to be myeloid-committed also possess B-lymphoid potential. This culture
      system should prove valuable for elucidation of the mechanisms regulating early
      stages of lymphohemopoiesis.

PMID- 1631073
TI  - Nonconservative recombination in Escherichia coli.
AB  - Homologous recombination between two duplex DNA molecules might result in two
      duplex DNA molecules (conservative) or, alternatively, it might result in only
      one recombinant duplex DNA molecule (nonconservative). Here we present evidence
      that the mode of homologous recombination is nonconservative in an Escherichia
      coli strain with an active RecF pathway (a recBC sbcBC mutant). We employed
      plasmid substrates that enable us to recover both recombination products. These
      plasmids carry two mutant alleles of neo gene in direct orientation, two drug
      resistance marker genes, and two compatible replication origins. After their
      transfer to the cells followed by immediate selection for the recombination to
      neo+, we could recover only one recombination product. A double-strand break at
      the region of homology increased this nonconservative recombination. If a
      nonconservative exchange should leave an end, this end may stimulate another
      exchange. Such "successive half crossing-over events" can explain several
      recombination-related phenomena in E. coli, including the origin of plasmid
      linear multimers and of transcribable, nonreplicated recombination products, and
      also in yeast and mammalian cells.

PMID- 1631074
TI  - Two mutations in Marfan syndrome resulting in truncated fibrillin polypeptides.
AB  - Biochemical and molecular genetic studies have recently suggested that mutations
      in the gene coding for fibrillin on chromosome 15 result in Marfan syndrome. To
      our knowledge, only one mutation in the fibrillin gene has been published. Here
      we report the results of screening 20 unrelated MFS patients for mutations in
      fibrillin cDNA by the single-strand conformation polymorphism technique. We found
      two mutations, both of which appear in the heterozygote form and code for a
      shortened fibrillin polypeptide. The first mutation is a large in-frame deletion
      of 366 bases of the fibrillin mRNA, shown to result in a truncated but secreted
      polypeptide found in the fibroblast culture of the patient. The second mutation
      is a G-to-A transition resulting in the substitution of a stop codon for a
      tryptophan codon and thus predicting the premature termination of the polypeptide
      chain. We screened 60 other, unrelated MFS patients for these mutations as well
      as for the previously reported mutation (arginine-239 to proline) and found none
      of the three mutations in any of these patients. These data suggest that most MFS
      families carry their own distinct mutation.

PMID- 1631075
TI  - Multiple mechanisms mediate glucose repression of the yeast GAL1 gene.
AB  - Several mechanisms contribute to the glucose repression of the GAL1 gene in
      Saccharomyces cerevisiae. We show that one mechanism involves the transcriptional
      down-regulation of the GAL4 gene and a second requires the GAL80 gene. We also
      examine the contribution of cis-acting negative elements in the GAL1 promoter to
      glucose repression. In an otherwise wild-type strain disruption of any one of
      these three mechanisms alleviates repression of GAL1 only 2- to 4-fold. However,
      in the absence of the other two mechanisms the transcriptional down-regulation of
      GAL4 is sufficient to repress GAL1 expression 40- to 60-fold and the GAL80
      dependent mechanism is sufficient to repress GAL1 expression 20- to 30-fold.
      These first two mechanisms constitute a functionally redundant system of
      repression and both must be disrupted in order to abolish glucose repression of
      GAL1. In contrast, negative elements in the GAL1 promoter are effective in
      repressing GAL1 expression 2- to 4-fold in glucose medium only when at least one
      of the other two mechanisms of repression is present. Thus, glucose repression of
      GAL1 is mediated primarily by the first two mechanisms, whereas the third
      mechanism supplements repression severalfold.

PMID- 1631076
TI  - Developmental failure of chimeric embryos expressing high levels of H-2Dd
      transplantation antigens.
AB  - The absence of expression of class I products of the major histocompatibility
      complex at early stages of development is thought to play a key role in maternal
      tolerance of the fetal allograft. To test this, we developed a strategy that
      would allow us to describe the consequences of overexpression of the H-2Dd
      transplantation antigen in the developing embryo. A construct containing the H
      2Dd gene under control of the human beta-actin promoter was transfected into
      pluripotent embryonic stem (ES) cells. Particularly in this case, since
      overexpression of major histocompatibility complex class I gene products may
      profoundly affect embryonic development, an important advantage of the ES cell
      system is the ability to analyze gene expression and study effects on cell growth
      and differentiation in vitro. ES cells do not constitutively express beta 2
      microglobulin. Consistent with this, H-2Dd H chains expressed by ES cell
      transformants were not associated with beta 2-microglobulin or transported to the
      cell surface. Significant levels of beta 2-microglobulin and H-2Dd membrane
      glycoproteins were expressed following differentiation in vitro. H-2Dd
      transfected ES cells gave rise to a wide range of differentiated cell types, and
      there was no evidence to suggest that expression of the introduced H-2Dd gene
      affects the differentiation abilities of ES cells in vitro. When introduced into
      blastocysts, H-2Dd-transfected ES cells extensively contribute to embryonic and
      extraembryonic tissues, but this results in the failure of chimeric conceptuses
      at midgestation. Considering that transgenic chimeras cannot be rescued by
      transfer into syngeneic foster females, it seems likely that nonimmunological
      mechanisms are responsible for these prenatal lethalities.

PMID- 1631077
TI  - Side-chain entropy opposes alpha-helix formation but rationalizes experimentally
      determined helix-forming propensities.
AB  - In recent host-guest studies, the helix-forming tendencies of amino acid residues
      have been quantified by three groups, each obtaining similar results
      [Padmanabhan, S., Marqusee, S., Ridgeway, T., Laue, T. M. & Baldwin, R. L. (1990)
      Nature (London) 344, 268-270; O'Neil, K. T. & DeGrado, W. F. (1990) Science 250,
      646-651; Lyu, P. C., Liff, M. I., Marky, L. A. & Kallenbach, N. R. (1990) Science
      250, 669-673]. Here, we explore the hypothesis that these measured helix-forming
      propensities are due primarily to conformational restrictions imposed upon
      residue side chains by the helix itself. This proposition is tested by
      calculating the extent to which the bulky helix backbone "freezes out" available
      degrees of freedom in helix side chains. Specifically, for a series of apolar
      residues, the difference in configurational entropy, delta S, between each side
      chain in the unfolded state and in the alpha-helical state is obtained from a
      simple Monte Carlo calculation. These computed entropy differences are then
      compared with the experimentally determined values. Measured and calculated
      values are found to be in close agreement for naturally occurring amino acids and
      in total disagreement for non-natural amino acids. In the calculation, delta
      S(Ala) = 0. The rank order of entropy loss for the series of natural apolar side
      chains under consideration is Ala less than Leu less than Trp less than Met less
      than Phe less than Ile less than Tyr less than Val. Among these, none favor helix
      formation; Ala is neutral, and all remaining residues are unfavorable to varying
      degrees. Thus, applied to side chains, the term "helix preference" is a misnomer.
      While side chain-side chain interactions may modulate stability in some
      instances, our results indicate that the drive to form helices must originate in
      the backbone, consistent with Pauling's view of four decades ago [Pauling, L.,
      Corey, R. B. & Branson, H. R. (1951) Proc. Natl. Acad. Sci. USA 37, 205-210].

PMID- 1631078
TI  - Characterization of human androgen receptor overexpressed in the baculovirus
      system.
AB  - An essential step in the process of understanding the structure and function of
      the human androgen receptor (hAR) involves the production of large quantities of
      the hAR. For this purpose, the full-length hAR has been overproduced in insect
      cells by using a baculovirus genetic expression system. The recombinant hAR is
      produced in Sf21 insect cells at approximately 7 pmol/mg of protein (1 x 10(6) AR
      molecules per cell), which is 70-150 times greater than levels detected in
      androgen target tissues. Androgen can bind to the baculovirus-expressed hAR with
      high affinity (Kd = 0.46 nM), and the specificity of hormone binding in
      baculovirus-expressed hAR is essentially identical to that of bona fide hAR. An
      anti-AR monoclonal antibody can recognize the baculovirus-expressed hAR at
      approximately 100 kDa upon Western blot analysis. Sucrose gradient analysis shows
      that baculovirus-expressed hAR complexes sediment at 4 S in a high salt medium
      and these complexes can interact with anti-AR monoclonal antibody to form
      complexes that sediment at 8-10 S. Therefore, production of recombinant hAR from
      the baculovirus expression system will provide an alternative source of
      biologically active hAR for studies on the molecular mechanisms of androgen
      action.

PMID- 1631079
TI  - Intrinsic signal changes accompanying sensory stimulation: functional brain
      mapping with magnetic resonance imaging.
AB  - We report that visual stimulation produces an easily detectable (5-20%) transient
      increase in the intensity of water proton magnetic resonance signals in human
      primary visual cortex in gradient echo images at 4-T magnetic-field strength. The
      observed changes predominantly occur in areas containing gray matter and can be
      used to produce high-spatial-resolution functional brain maps in humans. Reducing
      the image-acquisition echo time from 40 msec to 8 msec reduces the amplitude of
      the fractional signal change, suggesting that it is produced by a change in
      apparent transverse relaxation time T*2. The amplitude, sign, and echo-time
      dependence of these intrinsic signal changes are consistent with the idea that
      neural activation increases regional cerebral blood flow and concomitantly
      increases venous-blood oxygenation.

PMID- 1631080
TI  - The cytoplasmic component of the bacterial flagellar motor.
AB  - We have used electron microscopy to examine freshly isolated Salmonella
      typhimurium and Escherichia coli basal flagellar fragments, purified without
      resort to extremes of pH or ionic strength. Such fragments contain the large bell
      like basal structures visualized recently in freeze-substituted or fixed
      preparations. We have found mot (non-motile) mutants produced by lesions in fli
      genes (G, M, N) in which the bell structures do not coisolate with the flagellar
      basal body. The coisolation of the bell with the flagellar basal body was
      unaffected in strains lacking the genes for the motility-associated Mot proteins
      or for the Che family of proteins, which are necessary for chemotaxis. Proper
      assembly and interaction of the cytoplasmically located bell with the membrane
      associated flagellar basal structures appears to be necessary for motor function.
      The FliG, FliM, and FliN proteins are thought to form a structural complex
      responsible for energization and switching of the flagellar motor. Our findings
      are consistent with the existence of such a complex and imply that it forms part
      of the flagellar bell.

PMID- 1631081
TI  - Estimating substitution rates from molecular data using the coalescent.
AB  - A coalescent model is used to estimate the rate at which neutral substitutions
      occur in a DNA sequence, without the necessity for an independent estimate of
      divergence times. Given a random sample of molecular sequences from a finite
      population, the distribution of the time to a common ancestor can be obtained
      from the coalescent model. With this principle, summary statistics are developed
      that use the distribution of molecular diversity within the sample to estimate
      the relative magnitude of nucleotide substitution rates. If, in addition, the
      effective population size is known, absolute substitution rates can also be
      estimated. These techniques are illustrated by estimating the transition rates
      that underlie the evolution of the first 360 nucleotides of the mitochondrial
      control region in an Amerindian tribal population.

PMID- 1631082
TI  - A promoter element that exerts positive and negative control of the interleukin 2
      responsive J-chain gene.
AB  - In a primary immune response a signal from interleukin 2 (IL-2) induces B
      lymphocytes to express the gene for the IgM joining component, the J chain. The
      signaling mechanism was pursued in this study by examining the J-chain gene 5'
      flanking region for regulatory sequences and interacting nuclear factors. The
      analyses identified a major control region located between -75 and -45 that
      encodes two adjacent elements: a T-rich sequence (JA) containing a single
      positive regulatory motif and an A+G-rich sequence (JB) containing overlapping
      positive and negative regulatory motifs. Dissection of the two elements indicated
      that the bifunctional JB sequence is the likely target of the IL-2 signal. The
      evidence was based on findings that (i) JB activity correlated with J-chain gene
      transcription--i.e., JB acts as a repressor in J-chain-silent B cells and as an
      activator in J-chain-expressing cells, and (ii) JB activator function is mediated
      by a B-cell-specific nuclear protein, NF-JB, that exhibits an IL-2-responsive
      binding pattern.

PMID- 1631083
TI  - Identification and molecular characterization of a Salmonella typhimurium gene
      involved in triggering the internalization of salmonellae into cultured
      epithelial cells.
AB  - Penetration of intestinal epithelial cells is an important step in the
      pathogenesis of Salmonella infections. We have characterized a gene, invE, that
      is necessary for Salmonella invasion of cultured epithelial cells. The predicted
      amino acid sequence of InvE showed significant homology to the Yersinia outer
      membrane protein YopN (LcrE). Strains of Salmonella carrying mutations in invE
      were unable to penetrate Henle-407 human intestinal cells and Madin-Darby canine
      kidney cells, although they were fully capable of attaching to the same cells.
      Unlike wild-type Salmonella typhimurium, invE mutants failed to change the
      intracellular free calcium levels or the distribution of polymerized actin in
      cultured epithelial cells; neither did they alter the normal architecture of the
      microvilli of polarized Madin-Darby canine kidney cells. Wild-type S. typhimurium
      was able to rescue the invasive phenotype of the invE mutants in simultaneous
      infections of cultured epithelial cells although it did not rescue the
      Escherichia coli strain RDEC-1. We hypothesize that invE mutants are deficient in
      triggering the intracellular events that lead to bacterial internalization.

PMID- 1631084
TI  - Cloning of a cuticular antigen that contains multiple tandem repeats from the
      filarial parasite Dirofilaria immitis.
AB  - An unusual antigen composed of tandemly repeated protein units was cloned from
      the filarial parasite Dirofilaria immitis. The antigen was initially identified
      by screening a lambda gt11 cDNA library with serum from dogs immunized with
      irradiated D. immitis third-stage larvae. DNA sequence analysis of the cDNA
      clone, Di5, revealed a continuous open reading frame composed of two 399-base
      pair repeats arranged in tandem. Southern blot analysis of genomic D. immitis DNA
      showed that the gene coding for Di5 is composed of a tandem array of 25-50 copies
      of this same 399-base-pair repeat. Antiserum raised against recombinant Di5
      protein detected a protein "ladder," from about 14 to greater than 200 kDa with
      steps approximately 15 kDa apart, on immunoblots of D. immitis extract. Metabolic
      labeling of adult parasites with [35S]methionine showed that Di5 is synthesized
      as a large precursor that is subsequently cleaved to produce the ladder-like
      array. These results suggest that the characteristic ladder is created by
      proteolytic cleavage of the precursor at the same site in each monomer. The Di5
      antigen was localized to the cuticle and hypodermis of adult D. immitis by
      immunoelectron microscopy. Both male and female parasites were found to release
      Di5 when cultured in vitro. DNA hybridization analysis demonstrated that Di5 is a
      member of a gene family present in many filarial parasites that infect both
      animal and human populations.

PMID- 1631085
TI  - Binding of the Bacillus subtilis spoIVCA product to the recombination sites of
      the element interrupting the sigma K-encoding gene.
AB  - The gene encoding sigma K, a transcription factor controlling mother-cell
      specific gene expression at a late stage of sporulation, is interrupted by the
      skin element in Bacillus subtilis. The skin element is excised from the mother
      cell chromosome by a DNA rearrangement that depends on the spoIVCA gene product.
      This protein has no other role in sporulation than promoting skin excision and
      exhibits sequence similarity to a family of bacterial site-specific recombinases.
      An expression library of B. subtilis DNA in lambda gt11 was screened for the
      presence of a gene encoding a protein able to bind in vitro to an oligonucleotide
      matching the inverted repeat sequences present at the ends of the skin element.
      Several bacteriophages were found to contain the spoIVCA gene. A cell extract
      containing the SpoIVCA protein protected the inverted repeats and their
      neighboring sequences from DNase I digestion and methylation. SpoIVCA decreased
      the electrophoretic mobility of a DNA fragment containing its binding sequence
      and simultaneously bent the DNA. A single molecule of SpoIVCA bound initially to
      the repeat sequence followed by binding of a second molecule to create a complex
      straddling the recombination site.

PMID- 1631086
TI  - Early persistent activation of sperm K+ channels by the egg peptide speract.
AB  - Transduction by sperm of the instructive signal provided by the egg peptide
      speract involves rapid, complex changes in internal ion and cyclic nucleotide
      content. Here, investigations of hypotonically swollen sperm provide insight into
      the underlying processes and identify K+ channel activation as an initial ionic
      event in gamete recognition. A sustained hyperpolarization of swollen sperm is
      promoted by less than 2.5 pM speract and is followed (with greater than 100 pM
      speract) by transient repolarization and (with greater than 10 nM speract) by
      depolarization that is dependent on external Ca2+. Monophasic increases in pHi
      are produced only by greater than 25 pM speract, indicating that
      hyperpolarization may not directly promote alkalinization. Increased K(+)
      selective (K+ greater than Rb+ greater than Cs+ greater than Na+) membrane
      permeability is found after all speract greater than 2.5 pM, suggesting that
      hyperpolarization results from persistent activation of K+ channels and that
      repolarization has a different ionic basis. Supporting this contention, the K+
      channel blocker tetraethylammonium (20 mM) inhibits the increased K+ permeability
      that follows treatment of swollen sperm (and of sperm in seawater) with 2.5 pM
      speract. Such induced activation of K+ channels is observed in patch-clamped
      swollen sperm examined in the cell-attached configuration, upon application of 5
      50 pM speract to the bath medium. The efficacy of externally applied speract and
      its potency indicate that activation is indirect and probably involves an as yet
      unidentified diffusible mediator whose production is promoted by speract at
      concentrations 0.01-0.001 times those predicted from reported estimates of the Kd
      for the known speract receptor.

PMID- 1631087
TI  - Folate receptor allows cells to grow in low concentrations of 5
      methyltetrahydrofolate.
AB  - The folate receptor mediates the uptake of 5-methyltetrahydrofolate in certain
      cultured cells by a process called potocytosis. When these cells are grown in
      physiological concentrations of folate, the receptor increases the efficiency of
      vitamin uptake by 30-fold. We now show that PAM 212 cells, a mouse keratinocyte
      cell line, are unable to grow in 1 nM 5-methyltetrahydrofolate unless they
      express a functional folate receptor. These results suggest that under certain
      conditions, tissue cells in the body may depend on the folate receptor to obtain
      enough 5-methyltetrahydrofolate for growth.

PMID- 1631088
TI  - The diabetogenic effects of glucocorticoids are more pronounced in low- than in
      high-insulin responders.
AB  - We investigated in six low- and six high-insulin responders (LIR and HIR) the
      effect of dexamethasone (Dex, 15 mg orally during 48 hr) on oral glucose
      tolerance (OGTT), glucose turnover under basal conditions and during glucose
      infusion of 2 mg.kg-1.min-1, and insulin response during hyperglycemic clamp. Dex
      increased fasting glucose more in LIR (P less than 0.05). During OGTT, Dex caused
      a more prominent increment in glucose in LIR, whereas the increment in insulin
      was less in LIR (P less than 0.05). After Dex, in three LIR but in no HIR, a
      diabetic OGTT was observed. Dex significantly increased basal hepatic glucose
      production (turnover measured with [6-3H]glucose), hepatic total glucose output
      (turnover measured with [2-3H]glucose), and glucose cycling (hepatic total
      glucose output--hepatic glucose production) only in LIR. Dex decreased basal
      glucose metabolic clearance to the same extent in LIR and HIR. Hyperglycemic
      clamp revealed that Dex induced a significant increase (P less than 0.05) in
      insulin response only in HIR. Dex effects on insulin release during hyperglycemic
      clamp were negatively correlated with the glucose area during Dex OGTT (P less
      than 0.01). Thus, the double tracer method provided a new insight into the
      pathogenesis of the steroid effect on carbohydrate tolerance. Dex increased basal
      glycemia more in LIR because only in LIR was glucose production increased. During
      OGTT, the LIR who were not able to counteract the effects of Dex by an
      appropriate enhancement in insulin secretion developed a decreased OGTT. The
      evaluation of insulin response after Dex may thus allow differentiation of the
      subset of LIR that run an increased risk of non-insulin-dependent diabetes
      mellitus.

PMID- 1631089
TI  - The deep, hot biosphere.
AB  - There are strong indications that microbial life is widespread at depth in the
      crust of the Earth, just as such life has been identified in numerous ocean
      vents. This life is not dependent on solar energy and photosynthesis for its
      primary energy supply, and it is essentially independent of the surface
      circumstances. Its energy supply comes from chemical sources, due to fluids that
      migrate upward from deeper levels in the Earth. In mass and volume it may be
      comparable with all surface life. Such microbial life may account for the
      presence of biological molecules in all carbonaceous materials in the outer
      crust, and the inference that these materials must have derived from biological
      deposits accumulated at the surface is therefore not necessarily valid.
      Subsurface life may be widespread among the planetary bodies of our solar system,
      since many of them have equally suitable conditions below, while having totally
      inhospitable surfaces. One may even speculate that such life may be widely
      disseminated in the universe, since planetary type bodies with similar subsurface
      conditions may be common as solitary objects in space, as well as in other solar
      type systems.

PMID- 1631090
TI  - Biosynthesis and endocrine control of the production of the German cockroach sex
      pheromone 3,11-dimethylnonacosan-2-one.
AB  - The biosynthesis and endocrine regulation of sex pheromone production in the
      female German cockroach (Blattella germanica) were determined. Radio-TLC and
      radio-GLC were used to demonstrate the metabolism of 3,11-dimethylnonacosane, a
      major cuticular lipid component, to the corresponding alkan-2-ol and methyl
      ketone. [11,12-3H2]-3,11-Dimethylnonacosan-2-ol was efficiently metabolized to
      the methyl ketone, and radio-GLC showed that the methyl ketone product from both
      experiments was coeluted with a methyl ketone standard. A comparison of the
      metabolism of the labeled dimethylalkane and dimethylalkan-2-ol by age and sex
      showed that both males and females from day 1 through day 9 after adult emergence
      readily metabolized the alcohol to the corresponding methyl ketone, whereas only
      females of 5-9 days postemergence efficiently converted the labeled
      dimethylalkane to the corresponding methyl ketone. Application of the juvenile
      hormone analog hydroprene induced significant increases in the conversion of the
      labeled hydrocarbon to the methyl ketone in starved adult females as well as in
      females fed a protein-free diet, conditions under which endogenous juvenile
      hormone biosynthesis is nearly undetectable. These data show that the methyl
      ketone sex pheromone is formed by the hydroxylation and oxidation of the 3,11
      dimethylalkane at the 2 position, show that the age- and sex-specific step in
      this process is the conversion of 3,11-dimethylnonacosane to 3,11
      dimethylnonacosan-2-ol, and provide evidence that juvenile hormone regulates sex
      pheromone production in the German cockroach.

PMID- 1631091
TI  - Localized torsional tension in the DNA of human cells.
AB  - Torsional tension in DNA may be both a prerequisite for the efficient initiation
      of transcription and a consequence of the transcription process itself with the
      generation of positive torsional tension in front of the RNA polymerase and
      negative torsional tension behind it. To examine torsional tension in specific
      regions of genomic DNA in vivo, we developed an assay using photoactivated
      psoralen as a probe for unconstrained DNA superhelicity and x-rays as a means to
      relax DNA. Psoralen intercalates more readily into DNA underwound by negative
      torsional tension than into relaxed. DNA, and it can form interstrand DNA cross
      links upon UVA irradiation. By comparing the amount of psoralen-induced DNA cross
      links in cells irradiated with x-rays either before or after the psoralen
      treatment, we examined the topological state of the DNA in specific regions of
      the genome in cultured human 6A3 cells. We found that although no net torsional
      tension was detected in the bulk of the genome, localized tension was prominent
      in the DNA of two active genes. Negative torsional tension was found in the 5'
      end of the amplified dihydrofolate reductase gene and in a region near the 5' end
      of the 45S rRNA transcription unit, whereas a low level of positive torsional
      tension was found in a region near the 3' end of the dihydrofolate reductase
      gene. These results document an intragenomic heterogeneity of DNA torsional
      tension and lend support to the twin supercoiled domain model for transcription
      in the genome of intact human cells.

PMID- 1631092
TI  - Beta 2-microglobulin-, CD8+ T-cell-deficient mice survive inoculation with high
      doses of vaccinia virus and exhibit altered IgG responses.
AB  - Transgenic mice lacking an intact beta 2-microglobulin (beta 2m) gene fail to
      express major histocompatibility complex (MHC) class I proteins on the cell
      surface and, as a result, are virtually devoid of CD4- CD8+ lymphocytes. These
      animals provide a unique model system for directly assessing the role of CD8+
      lymphocytes in the modulation of viral infection in vivo. beta 2m- CD8- mice and
      their normal littermates were inoculated at the base of the tail with the WR
      strain of vaccinia virus and monitored for serum antibody and lesion formation.
      Both groups developed similar lesions in response to a broad virus dose range,
      and all animals had completely recovered by day 28 after inoculation. Isotype
      specific immunoglobulin levels were determined for each animal on day 7 and day
      14 after primary inoculation, and again 7 days after a virus challenge. The virus
      specific IgG1, IgG2a, and IgG2b levels were significantly different in the beta
      2m-/- group (20-, 9-, and 30-fold lower, respectively, on day 7 after challenge)
      compared with the beta 2m+/- group. Virus-specific serum IgM levels for both
      groups remained similar throughout the experiment. In a separate experiment, beta
      2m-/- mice were immunized with a nonviral antigen, 2,4,6-trinitrophenyl
      conjugated keyhole limpet hemocyanin, and both total and antigen-specific isotype
      specific immunoglobulin titers were determined. Total IgG1, IgG2a, IgG2b, and
      IgG3 tended to be lower overall in the beta 2m-/- mice compared with beta 2m+/-
      littermates. In contrast, total and antigen-specific IgE titers were similar in
      the two groups. These data indicate that CD8+ lymphocytes are not required to
      clear high doses of vaccinia virus, and they suggest that beta 2m-/- mice are
      less efficient at antigen-specific IgG production than their beta 2m+/-
      littermates.

PMID- 1631093
TI  - Beta-amyloid precursor protein cleavage by a membrane-bound protease.
AB  - The principal component of amyloid plaques in Alzheimer disease is beta-amyloid
      protein, an approximately 4-kDa peptide derived from amyloid precursor proteins.
      Previous studies have established that amyloid precursor proteins are secreted
      after proteolytic cleavage within the beta-amyloid peptide. The present
      investigation documents that, in cultured cells, amyloid precursor protein is
      cleaved on the plasma membrane by a membrane-bound endoprotease and that the
      specificity of peptide bond hydrolysis is largely independent of the primary
      sequence of the precursor. The principal determinants of cleavage appear to be an
      alpha-helical conformation and the distance (12-13 residues) of the hydrolyzed
      bond from membrane.

PMID- 1631094
TI  - Crystal structure of rat liver dihydropteridine reductase.
AB  - The structure of a binary complex of dihydropteridine reductase [DHPR;
      NAD(P)H:6,7-dihydropteridine oxidoreductase, EC 1.6.99.7] with its cofactor,
      NADH, has been solved and refined to a final R factor of 15.4% by using 2.3 A
      diffraction data. DHPR is an alpha/beta protein with a Rossmann-type dinucleotide
      fold for NADH binding. Insertion of an extra threonine residue in the human
      enzyme is associated with severe symptoms of a variant form of phenylketonuria
      and maps to a tightly linked sequence of secondary-structural elements near the
      dimer interface. Dimerization is mediated by a four-helix bundle motif (two
      helices from each protomer) having an unusual right-handed twist. DHPR is
      structurally and mechanistically distinct from dihydrofolate reductase, appearing
      to more closely resemble certain nicotinamide dinucleotide-requiring flavin
      dependent enzymes, such as glutathione reductase.

PMID- 1631095
TI  - Parametric sequence comparisons.
AB  - Current algorithms can find optimal alignments of two nucleic acid or protein
      sequences, often by using dynamic programming. While the choice of algorithm
      penalty parameters greatly influences the quality of the resulting alignments,
      this choice has been done in an ad hoc manner. In this work, we present an
      algorithm to efficiently find the optimal alignments for all choices of the
      penalty parameters. It is then possible to systematically explore these
      alignments for those with the most biological or statistical interest. Several
      examples illustrate the method.

PMID- 1631096
TI  - Coupling of adenovirus to transferrin-polylysine/DNA complexes greatly enhances
      receptor-mediated gene delivery and expression of transfected genes.
AB  - We are developing efficient methods for gene transfer into tissue culture cells.
      We have previously shown that coupling of a chimeric adenovirus with polylysine
      allowed the construction of an adenovirus-polylysine-reporter-gene complex that
      transferred the transporter gene with great efficiency into HeLa cells. We have
      now explored simpler, biochemical means for coupling adenovirus to DNA/polylysine
      complexes and show that such complexes yield virtually 100% transfection in
      tissue culture cell lines. In these methods adenovirus is coupled to polylysine,
      either enzymatically through the action of transglutaminase or biochemically by
      biotinylating adenovirus and streptavidinylating the polylysine moiety.
      Combination complexes containing DNA, adenovirus-polylysine, and transferrin
      polylysine have the capacity to transfer the reporter gene into adenovirus
      receptor- and/or transferrin-receptor-rich cells.

PMID- 1631097
TI  - Cloning of a mu-class glutathione S-transferase gene and identification of the
      glucocorticoid regulatory domains in its 5' flanking sequence.
AB  - The expression of a mu-class glutathione S-transferase gene (hGSTYBX) isolated
      from hamster smooth muscle tumor cells (DDT1 MF-2) is transcriptionally up
      regulated by glucocorticoids, and this hormonal regulation is dependent upon
      protein synthesis. To study the mechanism of regulation, we have cloned and
      sequenced hGSTYBX genomic DNA including its 5' flanking region. The hGSTYBX gene
      contains nine exons dispersed over a 6.3-kilobase region. When linked to a
      chloramphenicol acetyltransferase (CAT) reporter gene, the 5' flanking region was
      able to direct transcription of the reporter gene. With 5' deletion studies, we
      have localized the major glucocorticoid-inducible regulatory element between
      nucleotides -353 and -239. Within this region no classic glucocorticoid response
      element (TGTTCT) was identified, but four potential helix-loop-helix binding
      domains are embedded in two 16-base-pair repeats. Another glucocorticoid
      regulatory domain has been localized between nucleotides -239 and -136.
      Cycloheximide blocks glucocorticoid-induced transcription of both the -353CAT and
      -239CAT reporter genes (nucleotides -447 to -12 and nucleotides -239 to -12 of
      hGSTYBX, respectively, ligated to a CAT reporter gene); therefore, our
      observations support previous results suggesting that hGSTYBX induction by
      glucocorticoids is a secondary response.

PMID- 1631098
TI  - Structures of apo and complexed Escherichia coli glycinamide ribonucleotide
      transformylase.
AB  - The three-dimensional structure of phosphoribosylglycinamide formyltransferase
      (10-formyltetrahydrofolate:5'-phosphoribosylglycinamide formyltransferase, EC
      2.1.2.2) has been solved both as an apoenzyme at 2.8-A resolution and as a
      ternary complex with the substrate glycinamide ribonucleotide and a folate
      inhibitor at 2.5-A resolution. The structure is a modified doubly wound
      alpha/beta sheet with flexibility in the active site, including a disordered loop
      in the apo structure, which is ordered in the ternary complex structure. This
      enzyme is a target for anti-cancer therapy and now for structure-based drug
      design.

PMID- 1631099
TI  - Reconstruction of a Streptomyces linear replicon from separately cloned DNA
      fragments: existence of a cryptic origin of circular replication within the
      linear plasmid.
AB  - We report here the reconstruction of a functional linear replicon, the 12
      kilobase Streptomyces clavuligerus plasmid pSCL, from separate DNA fragments
      cloned in Escherichia coli on the pUC19 plasmid. Protein-free DNA molecules
      containing the full-length pSCL sequence, an internally inserted thiostrepton
      resistance gene, and adventitious nucleotides external to the pSCL termini were
      introduced into Streptomyces lividans, where the synthesis and functional
      attachment of replication proteins occurred and pSCL was established as an
      extrachromosomal linear replicon. Transformation of S. lividans with uncut
      supercoilded pUC19/pSCL DNA from E. coli or with a circularized 8-kilobase
      internal fragment of pSCL yielded circular replicons, indicating the existence of
      a cryptic origin of circular replication within the linear plasmid. Insertion
      mutations at sites that prevented the replication of pSCL linear plasmids also
      interfered with its replication in the circular mode.

PMID- 1631100
TI  - The endoplasmic reticulum-sarcoplasmic reticulum connection: distribution of
      endoplasmic reticulum markers in the sarcoplasmic reticulum of skeletal muscle
      fibers.
AB  - The skeletal muscle sarcoplasmic reticulum (SR) was investigated for the presence
      of well-known endoplasmic reticulum (ER) markers: the lumenal protein BiP and a
      group of membrane proteins recognized by an antibody raised against ER membrane
      vesicles. Western blots of SR fractions revealed the presence of BiP in fast- and
      slow-twitch muscles of the rabbit as well as in rat and chicken muscles. Analyses
      of purified SR subfractions, together with cryosection immunofluorescence and
      immunogold labeling, revealed BiP evenly distributed within the longitudinal SR
      and the terminal cisternae. Within the terminal cisternae BiP appeared not to be
      mixed with calsequestrin but to be distributed around the aggregates of the
      latter Ca2+ binding protein. Of the various membrane markers only calnexin (91
      kDa) was found to be distributed within both SR subfractions, whereas the other
      markers (apparent molecular masses of 64 kDa and 58 kDa and a doublet around 28
      kDa) were concentrated in the terminal cisternae. These results suggest that the
      SR is a specialized ER subcompartment in which general markers, such as the ones
      we have investigated, coexist with the major SR proteins specifically responsible
      for Ca2+ uptake, storage, and release. The differential distribution of the ER
      markers reveals new aspects of the SR molecular structure that might be of
      importance for the functioning of the endomembrane system.

PMID- 1631101
TI  - Cytosolic phospholipase A2 is coupled to hormonally regulated release of
      arachidonic acid.
AB  - Cytosolic phospholipase A2 (cPLA2) binds to natural membrane vesicles in a Ca(2+)
      dependent fashion, resulting in the selective release of arachidonic acid, thus
      implicating cPLA2 in the hormonally regulated production of eicosanoids. Here we
      report that the treatment of Chinese hamster ovary (CHO) cells overexpressing
      cPLA2 with ATP or thrombin resulted in an increased release of arachidonic acid
      as compared with parental CHO cells, demonstrating the hormonal coupling of
      cPLA2. In contrast, CHO cells overexpressing a secreted form of mammalian PLA2
      (sPLA2-II) failed to show any increased hormonal responsiveness. Interestingly,
      we have noted that the activation of cPLA2 with a wide variety of agents
      stimulates the phosphorylation of cPLA2 on serine residues. Pretreatment of cells
      with staurosporin blocked the ATP-mediated phosphorylation of cPLA2 and strongly
      inhibited the activation of the enzyme. Increased cPLA2 activity was also
      observed in lysates prepared from ATP-treated cells and was sensitive to
      phosphatase treatment. These results suggest that in addition to Ca2+, the
      phosphorylation of cPLA2 plays an important role in the agonist-induced
      activation of cPLA2.

PMID- 1631102
TI  - Enhancer of splitD, a dominant mutation of Drosophila, and its use in the study
      of functional domains of a helix-loop-helix protein.
AB  - Helix-loop-helix proteins play important roles in developmental processes, such
      as myogenesis, neurogenesis, and sex determination. The gene Enhancer of split
      [E(spl)] of Drosophila, a member of a gene complex that is involved in early
      neurogenesis, encodes a protein with a basic domain and a helix-loop-helix motif.
      We took advantage of a dominant mutation of this gene, E(spl)D, to define in vivo
      structural features of this protein for proper function. The mutation renders the
      otherwise recessive eye phenotype of spl dominant. By germ-line transformation of
      different in vitro mutagenized versions of the E(spl) gene, we could demonstrate
      that the basic domain of this helix-loop-helix protein is functional and
      necessary for expression of the dominant phenotype. These results are supported
      by in vitro DNA-binding assays, which showed that the basic domain is in fact
      necessary for DNA binding, despite the presence of a proline residue.
      Furthermore, we could show that the dominant enhancement of spl is caused by
      truncation of the E(SPL)D protein in combination with deletion of a putative
      regulatory element.

PMID- 1631103
TI  - Transfer of multiple sclerosis into severe combined immunodeficiency mice by
      mononuclear cells from cerebrospinal fluid of the patients.
AB  - To investigate the mode of the pathogenesis of multiple sclerosis (MS), we
      transferred cerebrospinal fluid (CSF) cells, predominantly mononuclear cells,
      from MS patients at both exacerbation and remission stages of the disease into
      severe combined immunodeficiency mice by intracisternal injection. As controls,
      (i) CSF cells from patients with cervical spondylosis and (ii) peripheral blood
      mononuclear cells from normal individuals were transferred. Four to 6 weeks after
      transfer, most mice transferred with CSF cells from MS patients at the
      exacerbation stage of the disease developed paralysis and ataxia. The
      histopathological examination on the sacrificed mice revealed multiple scattered,
      discrete lesions localized in the white matter of the brainstems and spinal
      cords. These lesions were characterized by various degrees of tissue necrosis,
      involving inflammatory-cell infiltration. Most infiltrating cells were
      macrophages, although a smaller number of granulocytes appeared in several foci.
      Reactive astrocytic gliosis was also seen around the necrotic foci. Furthermore,
      these lesions exhibited demyelination. These histopathological changes are
      similar to those seen in MS. In contrast, none of the severe combined
      immunodeficiency mice transferred with CSF cells from MS patients at the
      remission stage of the disease, or with CSF cells from the patients with cervical
      spondylosis, or with peripheral blood mononuclear cells from normal individuals
      showed any such histopathological changes. These observations provide convincing
      direct evidence of encephalitogenicity of mononuclear cells in CSF from MS
      patients at the exacerbation stage of the disease.

PMID- 1631104
TI  - Changes in intracellular calcium during the development of epithelial polarity
      and junctions.
AB  - The "Ca2+ switch" model with cultured Madin-Darby canine kidney (MDCK) cells is
      useful in studying the biogenesis of epithelial polarity and junction formation
      and provides insight into early steps in the morphogenesis of polarized
      epithelial tissues. When extracellular Ca2+ in the medium is changed from less
      than 5 microM to 1.8 mM, MDCK cells rapidly change from a nonpolarized state
      exhibiting little cell-cell contact (with the apical membrane and junctional
      proteins largely within the cell) to a polarized state with well-formed tight
      junctions and desmosomes. To examine the role of intracellular Ca2+ in the
      development of polarity and junctions, we made continuous spectrofluorimetric
      measurements of intracellular Ca2+ during the "switch," using the fluorescent
      indicator fura-2. Intracellular Ca2+ increased greater than 10-fold during the
      switch and gave a complex pattern of increase, decrease, and stabilization. In
      contrast, intracellular pH [monitored with 2',7'-bis(2-carboxyethyl)-5(and 6)
      carboxyfluorescein (BCECF)] did not change during the period studied. When
      intracellular Ca2+ curves in several cells were compared, considerable
      heterogeneity in the rate of increase of intracellular Ca2+ levels and in peak
      levels was evident, perhaps reflecting the heterogeneity among cells in
      establishing junctions and polarity. The heterogeneity of the process was
      confirmed by digital imaging of intracellular Ca2+ and was present even in a
      "clonal" line of MDCK cells, indicating the heterogeneity was intrinsic to the
      process and not simply a function of slight genetic variation within the
      population of MDCK cells. In pairs of cells that had barely established cell-cell
      contact, often one cell exhibited a much greater increase in intracellular Ca2+
      than the other cell in the pair. At the site of cell-cell contact, an apparent
      localized change (an increase over the basal level) in intracellular Ca2+ was
      frequently present and occasionally appeared to extend beyond the point of cell
      cell contact. Since the region of cell-cell contact is also the site where
      junctions form and where vesicles containing apical membranes fuse during the
      development of polarity, we postulate a role for global and local changes in
      intracellular Ca2+ in these events.

PMID- 1631105
TI  - DHR3: a Drosophila steroid receptor homolog.
AB  - In Drosophila the steroid hormone ecdysone triggers a genetic regulatory
      hierarchy in which ecdysone combines with a receptor protein to form a complex
      that induces the transcription of a small class of "early" genes, which encode
      transcription factors that regulate other genes. We previously reported that one
      of the early genes, E75, encodes members of the steroid receptor superfamily.
      Using an E75 hybridization probe, we have identified two additional Drosophila
      genes that encode members of this superfamily. One of these is the ecdysone
      receptor gene, EcR, as previously reported. In this work, we examine the
      sequence, genomic organization, and developmental expression of the other gene,
      DHR3, which, like E75, encodes one of a growing number of "orphan" receptors for
      which ligands have not yet been identified. The structure of the DHR3 protein is
      strikingly similar to that of the MHR3 protein (e.g., 97% amino acid identity for
      the DNA binding domains), another orphan receptor encoded by an ecdysone
      inducible early gene of another insect, Manduca sexta. The temporal developmental
      profile for DHR3 expression closely parallels that for the ecdysone titer and for
      the ecdysone-inducible E75 and E74 Drosophila early genes. The structural
      similarity to a Manduca early gene and the expression similarities to Drosophila
      early genes suggest that the DHR3 gene may also belong to the early gene class.

PMID- 1631106
TI  - The complete sequence of Drosophila beta-spectrin reveals supra-motifs comprising
      eight 106-residue segments.
AB  - The alpha and beta chains of spectrin are homologous, yet they have acquired
      different structural features that work in synergy to give the multimer its
      overall properties. The primary amino acid sequence of each spectrin subunit is
      dominated by tandemly repeated 106-residue motifs. By comparing the complete
      Drosophila beta-spectrin sequence with other spectrins we have discovered
      evidence that a higher-order, 848-amino acid supra-motif is tandemly repeated in
      both alpha- and beta-spectrin. These data argue that alpha- and beta-spectrin,
      rather than evolving independently from sequences encoding the ancestral 106
      residue motifs, must have arisen after the establishment of a large supra-motif
      composed of eight of the 106-residue motifs. Our data suggest the segment
      structure of a progenitor gene that gave rise to both alpha- and beta-spectrin as
      well as dystrophin. The structural differences that evolved after the split
      between the alpha- and beta-spectrin genes confer the independent functions that
      exist in their products today.

PMID- 1631107
TI  - Rapid decline of chronic myeloid leukemic cells in long-term culture due to a
      defect at the leukemic stem cell level.
AB  - In this report we describe a quantitative in vitro assay for the most primitive
      type of leukemic precursors yet defined in patients with chronic myeloid leukemia
      (CML). This assay is based on the recently described "long-term culture
      initiating cell" (LTC-IC) assay for primitive normal human hematopoietic cells.
      Such cells, when cocultured with competent fibroblast feeder layers, give rise
      after a minimum of 5 weeks to multiple single and multilineage clonogenic
      progenitors detectable in secondary semisolid assay cultures. Similar cultures
      initiated by seeding a highly enriched source of leukemic cells from patients
      onto normal feeders showed the clonogenic cell output after 5 weeks to be
      linearly related to the input innoculum over a wide range down to limiting
      numbers of input cells, thus allowing absolute frequencies of leukemic LTC-ICs to
      be determined using standard limiting dilution analysis techniques. Leukemic LTC
      IC concentrations in CML marrow were found to be decreased, on average to less
      than 10% of the normal LTC-IC concentration in normal marrow, but were greatly
      increased (up to greater than 10(5) times) in CML blood. Assessment of the number
      of clonogenic cells produced per leukemic LTC-IC by comparison to normal blood or
      marrow LTC-IC values showed this function to be unchanged in leukemic LTC-ICs
      [i.e., 3.1 +/- 0.4 clonogenic cells per CML LTC-IC (mean +/- SEM, n = 6) versus
      3.7 +/- 1.2 (n = 3) and 4.3 +/- 0.4 (n = 5), respectively, for normal blood and
      marrow LTC-ICs]. In contrast, leukemic LTC-IC maintenance in LTC proved to be
      highly defective by comparison to normal LTC-IC of either blood or marrow origin.
      Thus, when cells from primary LTC were subcultured into secondary LTC-IC assays,
      leukemic LTC-IC rapidly declined (greater than 30-fold) within the first 10 days
      of culture, whereas normal LTC-IC numbers remained unchanged during this period.
      These findings illustrate how self-maintenance and differentiation events in
      primitive human hematopoietic cells can be differentially modulated by an
      oncogenic process and provide a framework for further studies of their
      manipulation, analysis, and therapeutic exploitation.

PMID- 1631108
TI  - Selective stimulation of prostatic carcinoma cell proliferation by transferrin.
AB  - Aggressive prostatic carcinomas most frequently metastasize to the skeletal
      system. We have previously shown that cultured human prostatic carcinoma cells
      are highly responsive to growth factors found in human bone marrow. To identify
      the factor(s) responsible for the increased prostatic carcinoma cell
      proliferation, we fractionated crude bone marrow preparations by using
      hydroxylapatite HPLC. The major activity peak contained two high molecular weight
      bands (M(r) = 80,000 and 69,000) that cross-reacted with antibodies to human
      transferrin and serum albumin, respectively. Bone marrow transferrin, purified to
      apparent homogeneity by using DEAE-Affi-Gel Blue chromatography, anti-transferrin
      affinity chromatography, and hydroxylapatite HPLC, markedly stimulated prostatic
      carcinoma cell proliferation, whereas human serum albumin showed no significant
      growth factor activity. Marrow preparations, depleted of transferrin by passage
      over an anti-transferrin affinity column, lost greater than 90% of their
      proliferative activity. In contrast to the response observed with the prostatic
      carcinoma cell lines, a variety of human malignant cell lines, derived from other
      primary sites and metastatic to sites other than bone marrow, showed a reduced
      response to purified marrow-derived transferrin. These results suggest that rapid
      growth of human prostatic carcinoma metastases in spinal bone may result from a
      combination of conditions that include (i) drainage of prostatic carcinoma cells
      into the paravertebral circulation, (ii) high concentrations of available
      transferrin in bone marrow, and (iii) increased sensitivity of prostatic
      carcinoma cells to the mitogenic activity of transferrin.

PMID- 1631109
TI  - pH-dependent insertion of proteins into membranes: B-chain mutation of diphtheria
      toxin that inhibits membrane translocation, Glu-349----Lys.
AB  - To investigate how diphtheria toxin (DT) undergoes pH-dependent membrane
      translocation in mammalian cells, we have isolated and characterized mutants of
      the toxin that are defective in acidic-pH-dependent killing of Escherichia coli.
      Cloned DT secreted to the periplasm of E. coli kills the bacteria under acidic
      conditions (near pH 5.0) by inserting into and permeabilizing the inner membrane
      (a mechanism independent of the toxin's ADP-ribosylation activity). Mutant forms
      of DT with reduced lethality for E. coli were selected by plating the bacteria
      under acidic conditions. CRM503, one of the full-length mutants selected by this
      protocol, also showed diminished cytotoxicity for mammalian cells. We traced the
      altered cytotoxicity of CRM503 to a Glu-349----Lys mutation (E349K), one of three
      point mutations, within the B fragment. The E349K mutation alone inhibited
      cytotoxicity and membrane translocation in mammalian cells and lethality for E.
      coli but did not affect enzymic activity or receptor binding. The recently
      determined crystallographic model of DT shows that Glu-349 resides within a short
      loop connecting two long hydrophobic alpha-helices of the translocation domain.
      Protonation of Glu-349 and two other nearby acidic residues, Asp-352 and Glu-362,
      may enable these helices to undergo membrane insertion and the intervening loop
      to be transferred to the opposite face of the bilayer. The E349K mutation
      introduces a positive charge at this site, which would be expected to inhibit
      membrane insertion and the insertion-dependent activities of DT. These results
      suggest that protonation of Glu-349 and nearby acidic residues may be important
      in triggering the translocation step of toxin action.

PMID- 1631110
TI  - Reversion of recombinant toxoids: mutations in diphtheria toxin that partially
      compensate for active-site deletions.
AB  - Deleting an important active-site residue of diphtheria toxin, glutamic acid-148,
      reduces the toxin's ADP-ribosyltransferase activity by a factor of greater than
      10(4). We considered using this mutation to construct a recombinant toxoid for
      expression by live attenuated vaccines and explored second-site mutations that
      might cause reversion. Activity was partially restored by substituting glutamic
      acid for valine-147 or by extending the deletion by five residues toward the NH2
      terminus, thereby placing glutamic acid-142 immediately adjacent to tyrosine-149.
      In both mutants the indicated glutamic acid may occupy a spatial locus similar to
      that of glutamic acid-148 in the unmutated protein. Simply deleting a crucial
      residue does not, therefore, provide confidence that a second-site mutation could
      not readily restore activity to a toxoid.

PMID- 1631111
TI  - Characterization of a periplasmic thiol:disulfide interchange protein required
      for the functional maturation of secreted virulence factors of Vibrio cholerae.
AB  - A number of ToxR-regulated genes that encode products required for the biogenesis
      or function of the toxin-coregulated colonization pilus (TCP) of Vibrio cholerae
      have been identified previously by TnphoA fusions. In this study we have examined
      the role of the product of one of these genes, tcpG, to which a fusion results in
      a piliated cell lacking all of the in vivo and in vitro functions associated with
      TCP. Our results show that TcpG is not an ancillary pilus adhesin component as
      suggested by the mutant phenotype but instead is a 24-kDa periplasmic protein
      that shares active-site homology with several different bacterial thioredoxins
      and protein disulfide isomerase, as well as overall homology with the disulfide
      bond-forming DsbA periplasmic oxidoreductase protein of E. coli. Corresponding
      activity can be demonstrated in vitro for TcpG-enriched fractions from a wild
      type strain but is absent in a similarly fractionated tcpG-phoA mutant. The
      phenotype conferred by a tcpG mutation was found to be pleiotropic in nature,
      also affecting the extracellular secretion of cholera toxin A subunit and a major
      protease. This suggests a general role for TcpG in allowing a group of virulence
      associated (and perhaps other) proteins that contain disulfide bonds to assume a
      secretion or functionally competent state.

PMID- 1631112
TI  - Fragmentation of proteins in the 13- to 29-kDa mass range observed by 252Cf
      plasma desorption mass spectrometry.
AB  - Results are presented on the observation of sequence-specific fragmentation of
      proteins in the 13- to 29-kDa mass range (ribonuclease A, papain, and proteinase
      K) by 252Cf-plasma desorption mass spectrometry. For these proteins, extensive N
      terminal an, cn + 2, and dn fragment ions are observed with mass accuracies
      approaching 200 ppm for the most prominent fragment ions. The fragmentation
      pattern of these proteins shows the same fundamental behavior (arginine-directed,
      charge-remote fragmentation) that is observed in the fragmentation of small
      peptides, indicating that similar processes are occurring when large proteins and
      small peptides fragment in plasma desorption mass spectrometry.

PMID- 1631113
TI  - Interaction between G-protein beta and gamma subunit types is selective.
AB  - Signal-transducing guanine nucleotide-binding proteins (G proteins) are made up
      of three subunits, alpha, beta, and gamma. Each of these subunits comprises a
      family of proteins. The rules for association between members of one family with
      members of another to form a multimer are not known; it is not clear whether
      associations are specific or nonspecific. Other than transducin (Gt), the G
      protein in rod photoreceptors, most purified G proteins contain more than one
      subtype of beta or gamma subunits. The Gt alpha subunit is associated only with
      beta 1 and gamma 1. It is not known whether this specificity is due to the
      differential expression of these subunit types in a cell type or due to
      intrinsically different affinities between different beta and gamma subunit
      types. We have used a transfected cell assay system to examine the association of
      the beta 1, beta 2, and beta 3 proteins with the gamma 1 and gamma 2 proteins.
      Results show that gamma 1 does not associate with beta 2 and that beta 3 does not
      associate with gamma 1 or gamma 2. Differences in affinities between types of G
      protein subunits will impose restrictions on the formation of certain
      heterotrimers and determine which G protein will be active in a cell. A chimeric
      molecule of beta 1 and beta 2 was used to broadly map the regions on these
      subunits that determine specificity of association.

PMID- 1631114
TI  - Antiproliferative prostaglandins activate heat shock transcription factor.
AB  - Treatment of human K562 erythroleukemia cells with the antiproliferative
      prostaglandin A1 results in the elevated transcription of two heat shock genes,
      HSP70 and HSP90. Parallel with increased heat shock gene transcription is the
      activation of heat shock transcription factor. Heat shock transcription factor
      levels are induced within 60 min after prostaglandin A1 addition to levels
      similar to that achieved during heat shock. The requirement for protein synthesis
      for prostaglandin A1 activation of heat shock transcription factor suggests that
      effects on nascent protein synthesis may be involved in the signaling mechanism.
      Although it is unclear whether the activation of a heat shock response by
      prostaglandins is relevant to the biochemical properties of these natural
      substances, cells pretreated with prostaglandin A1 are protected against a
      subsequent heat shock, indicative of a thermotolerant state.

PMID- 1631115
TI  - Targeted oncogene activation by site-specific recombination in transgenic mice.
AB  - An efficient and accurate method for controlled in vivo transgene modulation by
      site-directed recombination is described. Seven transgenic mouse founder lines
      were produced carrying the murine lens-specific alpha A-crystallin promoter and
      the simian virus 40 large tumor-antigen gene sequence, separated by a 1.3
      kilobase-pair Stop sequence that contains elements preventing expression of the
      large tumor-antigen gene and Cre recombinase recognition sites. Progeny from two
      of these lines were mated with transgenic mice expressing the Cre recombinase
      under control of either the murine alpha A-crystallin promoter or the human
      cytomegalovirus promoter. All double-transgenic offspring developed lens tumors.
      Subsequent analysis confirmed that tumor formation resulted from large tumor
      antigen activation via site-specific, Cre-mediated deletion of Stop sequences.

PMID- 1631116
TI  - Purification and identification of bovine liver gamma-carboxylase.
AB  - The microsomal gamma-carboxylase catalyzes modification of a limited set of
      glutamyl residues to gamma-carboxyglutamyl residues in a vitamin K-dependent
      reaction that also utilizes O2 and CO2. We report the purification to apparent
      homogeneity of the bovine liver microsomal carboxylase. Affinity chromatography
      exploiting the association of the carboxylase with prothrombin precursor and
      carboxylase binding to the propeptide sequence were combined with ion-exchange
      chromatography and fractionation using immobilized lectins. A 3.5 x 10(5)-fold
      purification was obtained, which is the highest purification, by a factor of 35,
      yet reported for this enzyme. A single 98-kDa protein is obtained from this
      isolation. Carboxylase activity is associated with this protein by two different
      criteria. Antibodies prepared against the carboxylase detected the 98-kDa protein
      when used in Western analysis. In addition, the single 98-kDa protein was shown
      to comigrate with activity when electrophoresed in a nondenaturing gel system.
      The availability of purified preparations of carboxylase will facilitate an
      increased understanding of the complex biochemical reaction carried out by this
      protein.

PMID- 1631117
TI  - Complexity of sea urchin embryo nuclear proteins that contain basic domains.
AB  - We describe a quantitative two-dimensional gel electrophoretic analysis of
      nuclear extract from 24-hr sea urchin embryos. The extract was fractionated by
      using a weak cation-exchange resin, and eight known DNA-binding proteins were
      shown to be entirely included in a salt eluate that releases proteins containing
      basic domains. This fraction and a lower-salt fraction containing the majority of
      the protein species were mapped two-dimensionally by using new algorithms that
      permit reproducible spot identification, storage of intensity and map-position
      data, and subtractive comparison of one pattern with respect to another. By
      reference to a previously characterized DNA-binding factor, spot intensity could
      be interpreted in terms of the number of molecules per embryo nucleus. A map was
      constructed displaying all nuclear proteins containing basic domains that are
      present within the concentration range per nucleus of a set of known DNA-binding
      factors of the sea urchin embryo. The map includes 265 spots that fulfill both of
      these criteria, probably representing about 100 different protein species.

PMID- 1631118
TI  - An immunophilin that binds M(r) 90,000 heat shock protein: main structural
      features of a mammalian p59 protein.
AB  - In the rabbit, a p59 protein included in the untransformed, non-DNA binding, "8
      9S," steroid receptor complexes binds heat shock protein M(r) approximately
      90,000 (hsp90). Sequence data [Lebeau, M. C., Massol, N., Herrick, J., Faber, L.
      E., Renoir, J. M., Radanyi, C. & Baulieu, E. E. (1992) J. Biol. Chem. 267, 4281
      4284] and hydrophobic cluster analysis delineate, from the N terminus, two
      successive domains closely related to the immunosuppressant FK506 binding
      immunophilin FKBP (FK506 binding protein), consistent with recent purification of
      the human p56 immunophilin cognate protein by FK506 affinity chromatography [Yem,
      A. W., Tomasselli, A. G., Heinrikson, R. L., Zurcher-Neely, H., Ruff, V. A.,
      Johnson, R. A. & Deibel, M. R., Jr. (1992) J. Biol. Chem. 267, 2868-2871]. The
      first FKBP-like domain demonstrates all structural characteristics known to be
      necessary for immunosuppressant binding and for peptidylprolyl cis-trans
      isomerase (rotamase) activity. Hence, p59 is a "hsp binding immunophilin" (HBI).
      It is thus speculated that hsp binding immunophilin may help the
      assembly/disassembly mechanisms involved in steroid receptor trafficking and
      activity and participate in the poorly understood hsp90 function. ATP/GTP binding
      likely occurs within the second FKBP-like domain, near the FK506 binding site on
      the FKBP template. A third domain detected by the hydrophobic cluster analysis
      method is distantly structurally related to the two first FKBP-like domains and
      is followed by the C-terminal part of the protein, which contains a calmodulin
      binding consensus sequence. Hsp binding immunophilin may be involved in a number
      of immunological, endocrinological, and chaperone-mediated pathways.

PMID- 1631119
TI  - A microsomal endoprotease that specifically cleaves isoprenylated peptides.
AB  - A microsomal enzymatic activity is described that can specifically cleave the
      tetrapeptide N-acetyl-S-farnesyl-L-Cys-L-Val-L-Ile-L-Ser between the
      isoprenylated cysteine residue and the valine residue. Km and Vmax values are
      measured as 5.8 microM and 251 pmol/min per mg of protein, respectively.
      Proteolytic cleavage of the substrate is stereospecific because the substitution
      of a farnesylated D-cysteine residue for the L-amino acid leads to the abolition
      of substrate activity. A free carboxyl-terminal group is also required for
      substrate activity because methyl esterification renders the substrate inert. The
      tripeptide N-acetyl-S-farnesyl-L-Cys-L-Val-L-Ile and the dipeptide N-acetyl-S
      farnesyl-L-Cys-L-Val are also hydrolyzed by the protease. Again,
      stereospecificity is observed at the isoprenylated residue. Hydrolysis of the
      farnesylated tetrapeptide is not inhibited by a 5-fold excess of the
      nonfarnesylated tetrapeptide, suggesting that isoprenylation is important for
      substrate activity. This activity is probably the same as the proteolytic
      activity proposed to cleave isoprenylated proteins terminating in a Cys-Ali-Ali
      Xaa motif, where Ali refers to aliphatic amino acid. These proteins include the
      ras family of G proteins and the heterotrimeric G proteins. Proteolytic
      maturation of these essential isoprenylated signal-transducing elements is a key
      step in their activation.

PMID- 1631120
TI  - Identification of a structural domain that distinguishes the actions of the type
      1 and 2 isoforms of transforming growth factor beta on endothelial cells.
AB  - A chimeric transforming growth factor beta (TGF-beta) molecule has been
      synthesized to map the amino acids responsible for the substantially greater
      activity of TGF-beta 1 than TGF-beta 2 on growth and migration of endothelial
      cells. This chimera consists of a dimer of a monomeric unit composed of amino
      acids 1-39 of TGF-beta 2, 40-82 of TGF-beta 1, and 83-112 of TGF-beta 2.
      Structural identity of the purified recombinant protein has been confirmed by
      immunoblotting and NH2-terminal sequencing. The biological potency of the TGF
      beta 2-1-2 chimera was equal to that of TGF-beta 1 in inhibition of growth of
      both fetal bovine heart endothelial cells and rat epididymal fat pad
      microvascular endothelial cells. Similarly, the TGF-beta 2-1-2 chimera was nearly
      equivalent to TGF-beta 1 and at least 10-fold more active than TGF-beta 2 in
      inhibiting migration of bovine aortic endothelial cells. These results identify
      the sequence between amino acids 40-82 as an important region within TGF-beta
      that functions to specify a TGF-beta 1- or TGF-beta 2-like activity.

PMID- 1631121
TI  - Disruption of a binding site for hepatocyte nuclear factor 4 results in
      hemophilia B Leyden.
AB  - Hemophilia B Leyden is an X chromosome-linked bleeding disorder characterized by
      very low plasma levels of blood coagulation factor IX (fIX) during childhood.
      After puberty, plasma fIX levels gradually rise to a maximum of 60% of normal,
      probably under the influence of testosterone. Single point mutations in the fIX
      promoter region of hemophilia B Leyden patients have been reported at -20, -6, 
      5, +8 and +13. In addition, one promoter mutation (G----C at -26) has been
      detected that abolishes fIX expression throughout life (M. Ludwig, personal
      communication). We examined how one of the hemophilia B Leyden mutations (T----A
      at -20) and the G----C mutation at -26 interfere with fIX gene transcription. We
      report that the wild-type promoter of the human fIX gene contains a binding site
      (at nucleotides -34 to -10) for hepatocyte nuclear factor 4 (HNF-4), a member of
      the steroid hormone receptor superfamily of transcription factors. The binding of
      HNF-4 is disrupted by both the T----A mutation at -20 and the G----C mutation at 
      26. Whereas HNF-4 transactivates the wild-type promoter sequence in liver (HepG2)
      and non-liver (HeLa) cell types quite well, it transactivates the -20 mutated
      promoter to only a limited extent and the -26 mutated promoter not at all. These
      data suggest that HNF-4 is a major factor controlling fIX expression in the
      normal individual and that its inability to bind efficiently to the -20 T----A
      and the -26 G----C mutated promoter sequence results in hemophilia. Further, the
      severity of the hemophilia phenotype appears to be directly related to the degree
      of disruption of HNF-4 binding and transactivation.

PMID- 1631122
TI  - Localization of the Salmonella typhimurium flagellar switch protein FliG to the
      cytoplasmic M-ring face of the basal body.
AB  - The direction of rotation of the bacterial flagellum is determined by the
      flagellar switch. We have localized FliG, one of the switch proteins of
      Salmonella typhimurium, to the cytoplasmic face of the M ring of the flagellar
      basal body. This localization was made possible by the discovery of two
      spontaneous mutants in which the fliF (M ring) and fliG (switch) genes were fused
      in-frame. In the first mutant, a deletion of 7 base pairs at the 3' end of fliF
      resulted in an essentially full-length fusion protein. In the second mutant, a
      larger deletion resulted in a fusion in which 56 amino acids from the carboxyl
      terminus of FliF and 94 amino acids from the amino terminus of FliG were lost.
      Both strains were motile and underwent switching; the first strain had a
      clockwise bias, and the second strain had a counterclockwise bias. Gel
      electrophoresis and immunoblotting of isolated hook-basal-body complexes verified
      that they contained the fusion proteins. Electron microscopy revealed additional
      mass at the cytoplasmic face of the M ring, which could be decorated with anti
      FliG antibody. We conclude that the natural location for FliG is at the
      cytoplasmic face of the M ring and that the stoichiometric ratio between FliF and
      FliG in wild-type cells is probably 1:1.

PMID- 1631123
TI  - Selective decreased de novo synthesis of glomerular proteoglycans under the
      influence of reactive oxygen species.
AB  - The effect of reactive oxygen species on de novo synthesis of heparan sulfate
      proteoglycans (HSPGs) of the renal glomerulus was investigated in an organ
      perfusion system. Isolated kidneys were perfused for 7 hr with a medium
      containing [35S]sulfate to label sulfated proteoglycans or [35S]methionine to
      label total glomerular glycoproteins. For the generation of reactive oxygen
      species, xanthine and xanthine oxidase were included in the perfusion medium, and
      catalase and superoxide dismutase were used as scavenging agents. Proteoglycans
      were characterized by Sepharose CL-6B and DEAE-Sephacel chromatographies and
      SDS/PAGE analysis. The labeled glycoproteins were immunoprecipitated with anti
      HSPG, anti-type IV collagen, and anti-laminin, and their specific radioactivities
      were determined. With exposure to reactive oxygen species, a drastic dose
      dependent decrease in de novo synthesis of proteoglycans was seen, and that
      effect was reversible by catalase treatment. No alterations in the biochemical
      characteristics of proteoglycans were noted. Immunoprecipitation studies revealed
      a 16-fold decrease in the synthesis of nascent core peptide of HSPGs, while at
      comparable concentrations of xanthine and xanthine oxidase, synthesis of type IV
      collagen and laminin slightly decreased (approximately 15%). Morphologic studies
      revealed a 14-fold decrease in [35S]sulfate-associated autoradiographic grains
      overlying the glomerular basement membrane, a critical component of the
      ultrafiltration apparatus. Relevance of the selective decreased de novo synthesis
      of HSPGs of the glomerular basement membrane is discussed in terms of increased
      glomerular permeability to plasma proteins.

PMID- 1631124
TI  - Ecdysteroid-dependent regulation of genes in mammalian cells by a Drosophila
      ecdysone receptor and chimeric transactivators.
AB  - Steroid receptors are members of a large family of transcription factors whose
      activity is tightly regulated by the binding of their cognate steroid ligand.
      Mammalian steroid hormone receptors have been exploited to obtain the regulated
      expression of heterologous genes in mammalian cells. However, the utility of
      these systems in cultured cells and transgenic animals is limited by the presence
      of endogenous steroids and their receptors. We show that a Drosophila ecdysone
      receptor can function in cultured mammalian cells as an ecdysteroid-dependent
      transcription factor. The activity of the ecdysone receptor was not induced by
      any of the mammalian steroid hormones tested. The DNA-binding and transactivation
      activities of viral, mammalian, or bacterial proteins were rendered ecdysteroid
      dependent when fused to the ligand-binding domain of the ecdysone receptor. The
      ecdysone receptor may prove useful in selectively regulating the expression of
      endogenous or heterologous genes in mammalian cells.

PMID- 1631125
TI  - Androgen receptor gene mutations in human prostate cancer.
AB  - We screened human prostate cancer tissues for the presence of somatic mutations
      in the hormone binding domain of the androgen receptor (AR) gene. Exons E-H were
      amplified from genomic DNA using the polymerase chain reaction and analyzed by
      denaturing gradient gel electrophoresis (DGGE), which separates DNA fragments
      that differ by only a single base. We detected a mutation in exon E of the
      hormone binding domain in 1 of 26 specimens of untreated organ-confined stage B
      prostate cancer. The mutation was not detectable in peripheral blood lymphocyte
      DNA. Lymphocyte DNA (wild-type AR) migrated in DGGE as a single band. The tumor
      DNA migrated in DGGE as four bands, consistent with the presence of cells with
      mutant AR plus cells with wild-type AR and indicating that the tumor contained a
      somatic mutation. To our knowledge, a somatic AR gene mutation has not been
      reported previously. Sequencing revealed a G----A substitution in codon 730,
      changing valine to methionine. Codon 730 is in a region highly conserved among
      all steroid receptors. The abundance of the mutated fragment (about 50% of the
      DNA in the specimen) indicates its presence in cells with a growth advantage. A
      somatic mutation could be detected by DGGE if it represented at least 10% of the
      sample. Failure to detect mutations in other specimens analyzed may be due to
      this limit of sensitivity, the presence of mutations in other parts of the AR, or
      a low frequency of mutations in early stage disease.

PMID- 1631126
TI  - Developmental segregation in the afferent projections to mammalian auditory hair
      cells.
AB  - The mammalian ear contains two types of auditory receptors, inner and outer hair
      cells, that lie in close proximity to each other within the sensory epithelium of
      the cochlea. In adult mammals, these two classes of auditory hair cells are
      innervated by separate populations of afferent neurons that differ strikingly in
      their cellular morphology and their pattern of arborization within the cochlea.
      At present, it is unclear when or how these distinctive patterns of cochlear
      innervation emerge and become segregated during development. In the present
      study, an in vitro horseradish peroxidase labeling method was used to examine the
      formation of individual auditory neuron arbors at the same location within the
      apex of the developing gerbil cochlea. At birth, most cochlear neurons displayed
      peripheral arbors that embraced both inner and outer hair cell receptors. During
      the next 6 days, however, the arbors of individual cochlear afferents become
      confined to either the inner or outer hair cell zone, and thus there is a
      complete segregation of afferent innervation. This neural segregation occurs
      principally through the withdrawal of inappropriate connections to the outer hair
      cell system and is completed well before hearing commences.

PMID- 1631127
TI  - Mutational and nucleotide sequence analysis of S-adenosyl-L-homocysteine
      hydrolase from Rhodobacter capsulatus.
AB  - The genetic locus ahcY, encoding the enzyme S-adenosyl-L-homocysteine hydrolase
      (EC 3.3.1.1) from the bacterium Rhodobacter capsulatus, has been mapped by
      mutational analysis to within a cluster of genes involved in regulating the
      induction and maintenance of the bacterial photosynthetic apparatus. Sequence
      analysis demonstrates that ahcY encodes a 51-kDa polypeptide that displays 64%
      sequence identity to its human homolog. Insertion mutants in ahcY lack detectable
      S-adenosyl-L-homocysteine hydrolase activity and, as a consequence, S-adenosyl-L
      homocysteine accumulates in the cells, resulting in a 16-fold decrease in the
      intracellular ratio of S-adenosyl-L-methionine to S-adenosyl-L-homocysteine as
      compared to wild-type cells. The ahcY disrupted strain fails to grow in minimal
      medium; however, growth is restored in minimal medium supplemented with
      methionine or homocysteine or in a complex medium, thereby indicating that the
      hydrolysis of S-adenosyl-L-homocysteine plays a key role in the metabolism of
      sulfur-containing amino acids. The ahcY mutant, when grown in supplemented
      medium, synthesizes significantly reduced levels of bacteriochlorophyll,
      indicating that modulation of the intracellular ratio of S-adenosyl-L-methionine
      to S-adenosyl-L-homocysteine may be an important factor in regulating
      bacteriochlorophyll biosynthesis.

PMID- 1631128
TI  - MT-III, a brain-specific member of the metallothionein gene family.
AB  - A third member of the metallothionein (MT) gene family, designated MT-III, was
      cloned by virtue of its homology to a human protein that was shown previously to
      inhibit neuronal survival in culture and to be deficient in the brains of people
      with Alzheimer disease. Human and mouse MT-IIIs have two insertions relative to
      all other known mammalian MTs: a threonine after the fourth amino acid and a
      block of six amino acids near the carboxyl terminus. The genes encoding MT-III
      resemble all other mammalian MT genes in their small size and exon/intron
      organization. The MT-III genes are closely linked to the other functional MT
      genes on human chromosome 16 and mouse chromosome 8. Mouse MT-III gene expression
      appears to be restricted to brain; in addition, it fails to respond to zinc,
      cadmium, dexamethasone, or bacterial endotoxin in vivo, thereby distinguishing MT
      III from other known MTs.

PMID- 1631129
TI  - Fast sequencing of oligosaccharides: the reagent-array analysis method.
AB  - A method of oligosaccharide analysis involving controlled fragmentation resulting
      from enzymatic digestion is presented. The principle involves generating a set of
      fragments from the original oligosaccharides, characterizing them in terms of
      their hydrodynamic volumes, determining their molar proportions, and identifying
      the oligosaccharides by comparison with a computer-generated data base.
      Experimentally, this technique involves incubation of aliquots of a sample with a
      set of defined mixtures of exoglycosidases followed by pooling of the products
      and a single analysis on the product pool. This method has several practical
      advantages over current techniques, including speed and the ability to use
      smaller amounts of starting material. The detection of the intensity-versus
      hydrodynamic volume profile is limited only by the specific activity of the
      labeling method. The ability to perform the enzyme digestions is limited by the
      individual Km values of the enzymes.

PMID- 1631131
TI  - Conservation of the organization of five tightly clustered genes over 600 million
      years of divergent evolution.
AB  - The organization of the mouse surfeit locus is unusual in that it contains six
      housekeeping genes (Surf-1-Surf-6), which are unrelated by sequence homology, in
      the tightest mammalian gene cluster thus far described. A maximum of only 73 base
      pairs separates any two of the four well-characterized genes, and two of the
      genes overlap at their 3' ends. The direction of transcription of each of the
      five surfeit genes, Surf-1-Surf-5, alternates with respect to that of its
      neighbor, suggesting cis-interaction or coregulation between the genes by
      mechanisms such as the sharing of regulatory elements and/or antisense
      regulation. The Surf-3 gene has been identified as encoding the ribosomal protein
      L7a (Rpl7a). We have used the high conservation of the Rpl7a gene to clone the
      chicken gene and surrounding genomic DNA. The tight clustering and juxtaposition
      of at least five of the surfeit genes (Surf-1-Surf-5) and their associated CpG
      rich islands have been found to be conserved over the 600 million years of
      divergent evolution that separates birds and mammals. This strongly suggests that
      the surfeit locus represents a different form of gene cluster in which gene
      organization may play both a positive and negative regulatory role in gene
      expression possibly via cis-interactions between the closely spaced genes.

PMID- 1631130
TI  - Cell cycle-dependent initiation and lineage-dependent abrogation of GATA-1
      expression in pure differentiating hematopoietic progenitors.
AB  - The programmed activation/repression of transcription factors in early
      hematopoietic differentiation has not yet been explored. The DNA-binding protein
      GATA-1 is required for normal erythroid development and regulates erythroid
      expressed genes in maturing erythroblasts. We analyzed GATA-1 expression in early
      human adult hematopoiesis by using an in vitro system in which "pure" early
      hematopoietic progenitors are induced to gradual and synchronized differentiation
      selectively along the erythroid or granulocyte-macrophage pathway by differential
      treatment with hematopoietic growth factors. The GATA-1 gene, though virtually
      silent in quiescent progenitors, is activated after entrance into the cell cycle
      upon stimulation with hematopoietic growth factors. Subsequently, increasing
      expression along the erythroid pathway contrasts with an abrupt downregulation in
      the granulocyte-macrophage lineage. These results suggest a microenvironment
      directed, two-step model for GATA-1 expression in differentiating hematopoietic
      progenitors that involves (i) cycle-dependent initiation and (ii) lineage
      dependent maintenance or suppression. Hypothetically, on/off switches of lineage
      restricted transactivators may underlie the binary fate decisions of
      hematopoietic progenitors.

PMID- 1631132
TI  - Developmental expression of surface antigen genes in the parasitic ciliate
      Ichthyophthirius multifiliis.
AB  - A 1.2-kilobase (kb) cDNA encoding a major surface antigen of the holotrich
      ciliate Ichthyophthirius multifiliis (an obligate parasite of fish) has been
      isolated and used as a probe to examine the expression of immobilization antigen
      (i-antigen) genes in this system. The cDNA encodes a predicted protein of 394
      amino acids with a tandemly repeated structure characteristic of the i-antigens
      of the related free-living ciliates Paramecium and Tetrahymena. As shown by
      Northern hybridization analysis with both total and poly(A)+ RNAs, the 1.2-kb
      cDNA recognizes distinct transcripts of 1.6 and 1.9 kb which are differentially
      expressed through the parasite life cycle. During the transition from the host
      associated trophozoite stage to the infective tomite stage, steady-state levels
      of the 1.9-kb RNA undergo a marked increase of greater than or equal to 50-fold,
      while the 1.6-kb transcript increases only slightly. The absolute amounts of RNA
      encoding the i-antigen have been quantitated and were found to reach extremely
      high levels equivalent to approximately 6% of the poly(A)+ RNA of I. multifiliis
      tomites. Southern hybridization analysis with I. multifiliis genomic DNA suggests
      that at least two genes encode the i-antigen transcripts. In experiments to
      examine the effects of temperature on the expression of I. multifiliis i-antigen
      genes, levels of the 1.6- and 1.9-kb transcripts were found to remain relatively
      constant in cells maintained at different temperature extremes. These studies
      indicate that genes encoding i-antigens of I. multifiliis are developmentally
      regulated, and they suggest the existence of alternative mechanisms for the
      control of surface antigen expression in ciliates.

PMID- 1631133
TI  - Distinct sequence of gonadotropin-releasing hormone (GnRH) in dogfish brain
      provides insight into GnRH evolution.
AB  - In vertebrates, gonadotropin-releasing hormone (GnRH) belongs to a family of
      decapeptides characterized by the conservation of residues 1, 2, 4, 9, and 10. In
      the jawed vertebrates only positions 5, 7, and 8 in the GnRH molecules vary. We
      have now purified two forms of GnRH from the brains of spiny dogfish (Squalus
      acanthias) by using reverse-phase high-performance liquid chromatography. The
      primary structures were established by automated Edman degradation and mass
      spectral analysis. The distinct structure of the first form (dogfish GnRH) is
      pGlu-His-Trp-Ser-His-Gly-Trp-Leu-Pro-Gly-NH2 (pGlu represents pyroglutamyl). The
      second peptide is identical to a form of GnRH originally isolated from chicken
      brains (chicken GnRH-II; pGlu-His-Trp-Ser-His-Gly-Trp-Tyr- Pro-Gly-NH2) and is
      widespread throughout the vertebrates. We are aware of no other species of
      cartilaginous fish in which the primary structures of two forms of GnRH have been
      determined. The presence of chicken GnRH-II in dogfish supports the idea that
      chicken GnRH-II is the oldest GnRH to evolve in jawed vertebrates. With the
      addition of the dogfish GnRH structure to the family, two main structural
      branches of GnRH can be delineated. The physiological effects of dogfish GnRH
      included the release of not only gonadotropin but also growth hormone from
      goldfish pituitary fragments.

PMID- 1631134
TI  - Conformation-dependent cleavage of staphylococcal nuclease with a disulfide
      linked iron chelate.
AB  - We report the synthesis and evaluation of (EDTA-2-aminoethyl) 2-pyridyl
      disulfide. By using this easily prepared cysteine-specific hydrophilic reagent,
      an ethylenediaminetriacetic acid-Fe3+ complex (EDTA-Fe) was covalently attached
      to a single genetically engineered cysteine residue in staphylococcal nuclease.
      Upon addition of the iron reductant ascorbate, the nuclease-EDTA-Fe conjugate
      underwent a protein self-cleavage reaction mediated by reactive oxygen species.
      Sequence analysis of the products indicated that cleavage occurs close in
      tertiary structure to the EDTA-Fe attachment site. In the presence of
      denaturants, the cleavage pattern changes and the reaction is limited to residues
      proximal in sequence to the cysteine attachment site. These results indicate that
      intramolecular protein cleavage reactions mediated by EDTA-Fe can be used to
      evaluate changes in protein conformation. The reagent described should be a
      useful tool in the structural mapping of nonnative protein states populated at
      equilibrium, such as the molten globule, that are frequently refractory to
      conventional structure analysis.

PMID- 1631135
TI  - Isoprenoid addition to Ras protein is the critical modification for its membrane
      association and transforming activity.
AB  - We have introduced a variety of amino acid substitutions into carboxyl-terminal
      CA1A2X sequence (C = cysteine; A = aliphatic; X = any amino acid) of the
      oncogenic [Val12]Ki-Ras4B protein to identify the amino acids that permit Ras
      processing (isoprenylation, proteolysis, and carboxyl methylation), membrane
      association, and transformation in cultured mammalian cells. While all
      substitutions were tolerated at the A1 position, substitutions at A2 and X
      reduced transforming activity. The A2 residue was important for both
      isoprenylation and AAX proteolysis, whereas the X residue dictated the extent and
      specificity of isoprenoid modification only. Differences were observed between
      Ras processing in living cells and farnesylation efficiency in a cell-free
      system. Finally, one farnesylated mutant did not undergo either proteolysis or
      carboxyl methylation but still displayed efficient membrane association
      (approximately 50%) and transforming activity, indicating that farnesylation
      alone can support Ras transforming activity. Since both farnesylation and
      carboxyl methylation are critical for yeast a-factor biological activity, the
      three CAAX-signaled modifications may have different contributions to the
      function of different CAAX-containing proteins.

PMID- 1631136
TI  - ADP-ribosylation factor, a small GTP-binding protein, is required for binding of
      the coatomer protein beta-COP to Golgi membranes.
AB  - The coatomer is a cytosolic protein complex that reversibly associates with Golgi
      membranes and is implicated in modulating Golgi membrane transport. The
      association of beta-COP, a component of coatomer, with Golgi membranes is
      enhanced by guanosine 5'-[gamma-thio]triphosphate (GTP[gamma S]), a
      nonhydrolyzable analogue of GTP, and by a mixture of aluminum and fluoride ions
      (Al/F). Here we show that the ADP-ribosylation factor (ARF) is required for the
      binding of beta-COP. Thus, beta-COP contained in a coatomer fraction that has
      been resolved from ARF does not bind to Golgi membranes, whereas binding can be
      reconstituted by the addition of recombinant ARF. Furthermore, an N-terminal
      peptide of ARF, which blocks ARF binding to Golgi membranes, inhibits GTP[gamma
      S]- as well as the Al/F-enhanced binding of beta-COP. We show that Golgi coat
      protein binding involves a sequential reaction where an initial interaction of
      ARF and GTP[gamma S] with the membrane allows subsequent binding of beta-COP to
      take place in the absence of free ARF and GTP[gamma S]. The fungal metabolite
      brefeldin A, which is known to prevent the association of coat proteins with
      Golgi membrane, is shown to exert this effect by interfering with the initial ARF
      membrane interaction step.

PMID- 1631137
TI  - Germ-line mutations of the p53 tumor suppressor gene in patients with high risk
      for cancer inactivate the p53 protein.
AB  - Germ-line mutations in the p53 tumor suppressor gene have been observed in
      patients with Li-Fraumeni syndrome, brain tumors, second malignancies, and breast
      cancers. It is unclear whether all of these mutations have inactivated p53 and
      thereby provide an increased risk for cancer. Therefore, it is necessary to
      establish the biological significance of these germ-line mutations by the
      functional and structural analysis of the resulting mutant p53 proteins. We
      analyzed the ability of seven germ-line mutant proteins observed in patients with
      Li-Fraumeni syndrome, second primary neoplasms, or familial breast cancer to
      block the growth of malignant cells and compared the structural properties of the
      mutant proteins to that of the wild-type protein. Six of seven missense mutations
      disrupted the growth inhibitory properties and structure of the wild-type
      protein. One germ-line mutation retained the features of the wild-type p53.
      Genetic analysis of the breast cancer family in which this mutation was observed
      indicated that this germ-line mutation was not associated with the development of
      cancer. These results demonstrate that germ-line p53 mutations observed in
      patients with Li-Fraumeni syndrome and with second malignancies have inactivated
      the p53 tumor suppressor gene. The inability of the germ-line p53 mutants to
      block the growth of malignant cells can explain why patients with these germ-line
      mutations have an increased risk for cancer. The observation of a functionally
      silent germ-line mutation indicates that, before associating a germ-line tumor
      suppressor gene mutation with cancer risk, it is prudent to consider its
      functional significance.

PMID- 1631138
TI  - Localization of a DNA repair gene (XRCC5) involved in double-strand-break
      rejoining to human chromosome 2.
AB  - Complementation of the repair defect in hamster xrs mutants has been achieved by
      transfer of human chromosome 2 using the method of microcell-mediated chromosome
      transfer. The xrs mutants belong to ionizing radiation complementation group 5,
      are highly sensitive to ionizing radiation, and have an impaired ability to
      rejoin radiation-induced DNA double-strand breaks. Both phenotypes were corrected
      by chromosome 2, although the correction of radiation sensitivity was only
      partial. Complementation was achieved in two members of this complementation
      group, xrs6 and XR-V15B, derived independently from the CHO and V79 cell lines,
      respectively. The presence of human chromosome 2 in complemented clones was
      examined cytogenetically and by PCR analysis with primers directed at a human
      specific long interspersed repetitive sequence or chromosome 2-specific genes.
      Complementation was observed in 25/27 hybrids, one of which contained only the q
      arm of chromosome 2. The two noncomplementing hybrids were missing segments of
      chromosome 2. The use of a back-selection system enabled the isolation of clones
      that had lost the human chromosome and these regained radiation sensitivity.
      Transfer of several other human chromosomes did not result in complementation of
      the repair defect in XR-V15B. These data show that the gene defective in xrs
      cells, XRCC5, which is involved in double-strand break rejoining, is located on
      human chromosome 2q.

PMID- 1631139
TI  - Solution structure of a DNA-binding unit of Myb: a helix-turn-helix-related motif
      with conserved tryptophans forming a hydrophobic core.
AB  - The DNA-binding domain of the c-myb protooncogene product consists of three
      imperfect tandem repeats of 51 or 52 amino acids, each of which contains three
      conserved tryptophans, spaced 18 or 19 amino acids apart. The structure of the
      third repeat, which is essential for sequence-specific DNA binding, has been
      determined by NMR with distance geometry calculation. It includes three well
      defined helices (residues 149-162, 166-172, and 178-187) maintained by a
      hydrophobic core that includes the three conserved tryptophans, together with two
      histidines. Helices 2 and 3 form a structure related to but distinct from a
      canonical helix-turn-helix motif. In particular, the turn between these helices
      is one amino acid longer than the corresponding turn in bacterial repressors and
      homeodomains and contains a proline residue. In addition, the architecture of the
      three helices is different from those of homeodomains and DNA-binding domains of
      bacterial repressors. Based on the present structure, the binding mode of Myb
      repeat 3 with a specific DNA is also discussed.

PMID- 1631140
TI  - Three-dimensional scroll waves organize Dictyostelium slugs.
AB  - To test the hypothesis that periodic signals and chemotaxis direct later
      morphogenesis in Dictyostelium discoideum, we investigated cell behavior and cell
      movement in slugs. Trails of neutral red-stained prestalk and anterior-like cells
      were recorded by high-resolution digital image processing. Neutral red-stained
      anterior-like cells in the prespore zone of slugs move straight forward in the
      direction of slug migration and, furthermore, show coherent periodic cell
      movement. In contrast, cells in the prestalk zone move along completely different
      trajectories. Prestalk cells move perpendicular to the direction of slug
      migration; that is, they rotate around the tip. The cell movement data show that
      the chemotactic signal in the slug propagates as a three-dimensional scroll wave
      in the prestalk zone and as a planar wave in the prespore zone. The different
      behavior of prestalk and prespore cells is most likely caused by a difference in
      the oscillatory properties of the two cell types. We provide evidence that the
      slug stage of Dictyostelium behaves like an excitable system and that a (twisted)
      scroll wave organizes slug formation and migration.

PMID- 1631141
TI  - Platelet activation by simultaneous actions of diacylglycerol and unsaturated
      fatty acids.
AB  - Several cis-unsaturated fatty acids such as oleic, linoleic, linolenic,
      eicosapentaenoic, and docosahexaenoic acids added directly to intact human
      platelets greatly enhance protein kinase C activation as judged by the
      phosphorylation of its specific endogenous substrate, a 47-kDa protein. This
      enhancement absolutely requires the presence of a membrane-permeant
      diacylglycerol, 1,2-dioctanoylglycerol, or a tumor-promoting phorbol ester,
      phorbol 12-myristate 13-acetate. In the presence of ionomycin and either 1,2
      dioctanoylglycerol or phorbol 12-myristate 13-acetate, the release of serotonin
      from the platelets is also remarkably increased by cis-unsaturated fatty acids.
      The effect of these fatty acids is observed at concentrations less than 50
      microM. Saturated fatty acids and trans-unsaturated fatty acids are inactive.
      Titration of ionomycin to induce a release reaction and measurement of the
      intracellular Ca2+ level by the fura-2 procedure indicate that cis-unsaturated
      fatty acids increase an apparent sensitivity of the platelet response to Ca2+.
      The results suggest that cis-unsaturated fatty acids, which are presumably
      produced from phosphatidylcholine by signal-dependent activation of phospholipase
      A2, may take part directly in cell signaling through the protein kinase C
      pathway.

PMID- 1631142
TI  - Role of lysophosphatidylcholine in T-lymphocyte activation: involvement of
      phospholipase A2 in signal transduction through protein kinase C.
AB  - 2-Lysophosphatidylcholine (lysoPtdCho), a product of the hydrolysis of
      phosphatidylcholine catalyzed by phospholipase A2, greatly potentiates the
      activation of human resting T lymphocytes that is induced by a membrane-permeant
      diacylglycerol plus a calcium ionophore, as determined by the expression of the
      alpha subunit of the interleukin 2 receptor and thymidine incorporation into DNA.
      LysoPtdCho per se is inactive unless both diacylglycerol and a calcium ionophore
      are present. This effect of lysoPtdCho is also observed when diacylglycerol is
      replaced by a tumor-promoting phorbol ester. Other lysophosphatides including
      lysophosphatidylserine, lysophosphatidylinositol, and lysophosphatidic acid are
      inert except for lysophosphatidylethanolamine, which is far less effective than
      lysoPtdCho. Tracer experiments with radioactive choline indicate that, when T
      lymphocytes are stimulated with an antigenic signal, lysoPtdCho is indeed
      produced in a time-dependent fashion, although the concentration of this
      lysophospholipid accumulated remains to be quantitated. It suggests that
      phospholipase A2 is directly involved in the signal transduction pathway through
      protein kinase C to induce long-term cellular responses.

PMID- 1631143
TI  - Molecular basis of AMP deaminase deficiency in skeletal muscle.
AB  - AMP deaminase (AMPD; EC 3.5.4.6) is encoded by a multigene family in mammals. The
      AMPD1 gene is expressed at high levels in skeletal muscle, where this enzyme is
      thought to play an important role in energy metabolism. Deficiency of AMPD
      activity in skeletal muscle is associated with symptoms of a metabolic myopathy.
      Eleven unrelated individuals with AMPD deficiency were studied, and each was
      shown to be homozygous for a mutant allele characterized by a C----T transition
      at nucleotide 34 (codon 12 in exon 2) and at nucleotide 143 (codon 48 in exon 3).
      The C----T transition at codon 12 results in a nonsense mutation predicting a
      severely truncated AMPD peptide. Consistent with this prediction, no
      immunoreactive AMPD1 peptide is detectable in skeletal muscle of these patients.
      This mutant allele is found in 12% of Caucasians and 19% of African-Americans,
      whereas none of the 106 Japanese subjects surveyed has this mutant allele. We
      conclude from these studies that this mutant allele is present at a sufficiently
      high frequency to account for the 2% reported incidence of AMPD deficiency in
      muscle biopsies. The restricted distribution and high frequency of this doubly
      mutated allele suggest it arose in a remote ancestor of individuals of Western
      European descent.

PMID- 1631144
TI  - Viral RNA annealing activities of human immunodeficiency virus type 1
      nucleocapsid protein require only peptide domains outside the zinc fingers.
AB  - The nucleocapsid (NC) of human immunodeficiency virus type 1 consists of a large
      number of NC protein molecules, probably wrapping the dimeric RNA genome within
      the virion inner core. NC protein is a gag-encoded product that contains two zinc
      fingers flanked by basic residues. In human immunodeficiency virus type 1
      virions, NCp15 is ultimately processed into NCp7 and p6 proteins. During virion
      assembly the retroviral NC protein is necessary for core formation and genomic
      RNA encapsidation, which are essential for virus infectivity. In vitro NCp15
      activates viral RNA dimerization, a process most probably linked in vivo to
      genomic RNA packaging, and replication primer tRNA(Lys,3) annealing to the
      initiation site of reverse transcription. To characterize the domains of human
      immunodeficiency virus type 1 NC protein necessary for its various functions, the
      72-amino acid NCp7 and several derived peptides were synthesized in a pure form.
      We show here that synthetic NCp7 with or without the two zinc fingers has the RNA
      annealing activities of NCp15. Further deletions of the N-terminal 12 and C
      terminal 8 amino acids, leading to a 27-residue peptide lacking the finger
      domains, have little or no effect on NC protein activity in vitro. However
      deletion of short sequences containing basic residues flanking the first finger
      leads to a complete loss of NC protein activity. It is proposed that the basic
      residues and the zinc fingers cooperate to select and package the genomic RNA in
      vivo. Inhibition of the viral RNA binding and annealing activities associated
      with the basic residues flanking the first zinc finger of NC protein could
      therefore be used as a model for the design of antiviral agents.

PMID- 1631145
TI  - Targeting antiretroviral nucleoside analogues in phosphorylated form to
      macrophages: in vitro and in vivo studies.
AB  - A number of nucleoside analogues are active against the infectivity of human
      immunodeficiency virus (HIV); however, their use is limited by toxic side effects
      and by limited phosphorylation in the infected cells. In an attempt to overcome
      these problems, a drug delivery system has been developed. A prototype of these
      drugs in a form already phosphorylated (2',3'-dideoxycytidine 5'-triphosphate;
      ddCTP) was encapsulated into erythrocytes. Subsequently, by the addition of Zn,
      an arrangement of band 3 in clusters was induced (band 3 is the major
      transmembrane protein in erythrocytes). The immune system recognizes these
      clusters as nonself, promoting autologous IgG binding and phagocytosis by cells
      of the monocyte-macrophage lineage. In this way, ddCTP encapsulated into
      erythrocytes was delivered to macrophage cells, where concentrations greater than
      2 microM were found. Addition of ddCTP-loaded erythrocytes to macrophages
      previously infected by HIV-1 results in almost complete inhibition of HIV
      production over 3 weeks in culture. Administration of ddCTP-loaded erythrocytes
      to LP-BM5-infected mice at 10-day intervals over a period of 3 months results in
      reduction of lymphoadenopathy, splenomegaly, and hypergammaglobulinemia. Thus,
      the delivery of nucleoside analogues in phosphorylated form is feasible, and
      selective targeting to virus reservoirs (macrophage cells) can be accomplished by
      the use of autologous erythrocytes.

PMID- 1631146
TI  - Adenovirus-mediated transfer of a recombinant human alpha 1-antitrypsin cDNA to
      human endothelial cells.
AB  - To evaluate the feasibility of using a replication-deficient recombinant
      adenovirus to transfer human genes to the human endothelium, human umbilical vein
      endothelial cells were infected in vitro with adenovirus vectors containing the
      lacZ gene or a human alpha 1-antitrypsin (alpha 1AT) cDNA. After in vitro
      infection with the lacZ adenovirus vector, cultured endothelial cells expressed
      beta-galactosidase. In parallel studies with the alpha 1AT adenovirus vector,
      infected cells expressed human alpha 1AT transcripts, as evidenced by in situ
      hybridization and Northern analysis, and de novo synthesized and secreted
      glycosylated, functional alpha 1AT within 6 hr of infection, as shown by
      [35S]methionine labeling and immunoprecipitation. Quantification of the culture
      supernatants demonstrated 0.3-0.6 micrograms of human alpha 1AT secreted per
      10(6) cells in 24 hr, for at least 14 days after adenovirus vector infection. To
      demonstrate the feasibility of direct transfer of genes into endothelial cells in
      human blood vessels, lacZ or alpha 1AT adenovirus vectors were placed in the
      lumen of intact human umbilical veins ex vivo. Histologic evaluation of the veins
      after 24 hr demonstrated transfer and expression of the lacZ gene specifically to
      the endothelium. alpha 1AT adenovirus infection resulted both in expression of
      alpha 1AT transcripts in the endothelium and in de novo synthesis and secretion
      of alpha 1AT. Quantification of alpha 1AT in the vein perfusates showed average
      levels of 13 micrograms/ml after 24 hr. These observations strongly support the
      feasibility of in vivo human gene transfer to the endothelium mediated by
      replication-deficient adenovirus vectors.

PMID- 1631147
TI  - Plausible structure of the iron-molybdenum cofactor of nitrogenase.
AB  - A plausible structure of the iron-molybdenum cofactor of nitrogenase [reduced
      ferredoxin:dinitrogen oxidoreductase (ATP-hydrolyzing), EC 1.18.6.1] is presented
      based on altered substrate reduction properties of dinitrogenase containing
      homocitrate analogs within the cofactor. Alterations on each carbon of the four
      carbon homocitrate backbone were correlated with altered substrate reduction
      properties of dinitrogenase containing these analogs. Altered substrate reduction
      properties are the basis for a model in which homocitrate is oriented about two
      cubane metal clusters.

PMID- 1631148
TI  - The synapsis event in the homologous pairing of DNAs: RecA recognizes and pairs
      less than one helical repeat of DNA.
AB  - A key step in homologous recombination is the alignment and pairing of homologous
      DNAs. The Escherichia coli RecA protein initiates pairing by binding to single
      strand DNA, forming a helical nucleoprotein filament. We demonstrate that in the
      presence of the nonhydrolyzable ATP analogue adenosine 5'-[gamma
      thio]triphosphate and ADP, RecA can pair a homologous oligonucleotide 15 bases
      long with a duplex DNA to yield synaptic complexes consisting of the
      oligonucleotide and duplex DNA stabilized by RecA. RecA can pair as few as eight
      bases of homology to form such synaptic complexes. The homologous DNAs remain
      paired to each other upon removal of RecA provided that the length of shared
      homology is at least 26 base pairs. Based on our findings and the work of others,
      we propose that in vitro, one helical turn of a RecA nucleoprotein filament
      containing approximately six RecA monomers and 15 bases of single-strand DNA is
      the functional unit sufficient to carry out the homology search.

PMID- 1631149
TI  - Induced polypeptides associated with filarial worm refractoriness in Aedes
      aegypti.
AB  - Brugia malayi and Wuchereria bancrofti are mosquito-borne parasitic nematodes
      responsible for lymphatic filariasis in approximately 90 million people. The
      genetic control of the susceptibility of Aedes aegypti mosquitoes to B. malayi
      was well defined 30 years ago, but no data have since been provided regarding the
      gene products responsible for susceptibility or refractoriness or both. We
      addressed this problem by assessing polypeptide synthesis in thoracic tissue, the
      developmental site of this parasite, in susceptible and refractory strains of A.
      aegypti. Polyacrylamide gel electrophoresis of radiolabeled polypeptides
      synthesized in vivo were compared between (i) established susceptible and
      refractory strains and (ii) a refractory strain newly isolated from the
      established susceptible strain. Six polypeptide differences recognized by
      SDS/PAGE and two-dimensional gel electrophoresis were seen only in the refractory
      strains after they took a blood meal. A seventh polypeptide was present in those
      refractory mosquitoes that had ingested sucrose but increased in intensity after
      blood-feeding. The presence of parasites in the blood meal was not necessary to
      stimulate the synthesis of these polypeptides. These refractory strain-associated
      molecules may mediate genetically determined variation in susceptibility.

PMID- 1631150
TI  - Identification of murine homologues of the Drosophila son of sevenless gene:
      potential activators of ras.
AB  - Several findings suggest that signals from tyrosine kinases are transduced, at
      least in part, through ras proteins. These findings include (i) blockage of the
      transforming activity of constitutively active tyrosine kinases by inhibiting ras
      function and (ii) genetic screens in Caenorhabditis elegans and in Drosophila
      that identified ras genes as downstream effectors of tyrosine kinases. The
      recently isolated Drosophila gene Son of sevenless (Sos) is postulated to act as
      a positive regulatory link between tyrosine kinase and ras proteins by catalyzing
      exchange of GDP for GTP on ras protein. Such exchange proteins have been reported
      in extracts of mammalian cells but have not been previously characterized at a
      molecular level. As Sos appears to function in this role in Drosophila, we sought
      to isolate a vertebrate counterpart(s). We have characterized two widely
      expressed murine genes with a high degree of homology to Sos. Hybridization with
      human DNA and RNA indicates a high degree of conservation of these genes in other
      vertebrates.

PMID- 1631151
TI  - An infrequent point mutation of the p53 gene in human nasopharyngeal carcinoma.
AB  - Point mutations in the p53 gene have been detected in a variety of human cancers;
      the mutations are clustered in four "hot-spots" located in the coding region of
      exons 5, 7, and 8, which coincide with the four most highly conserved regions of
      the gene. We report the finding of a heterozygous G----C mutation at codon 280
      (exon 8), position 2, of the p53 gene in a nasopharyngeal carcinoma (NPC) cell
      line, originating from Guangdong, a province in the People's Republic of China
      that leads the world in NPC incidence. A survey of nasopharyngeal tissues and NPC
      biopsies revealed that 1 out of 12 NPC samples from Hunan, another province in
      the People's Republic of China with high NPC incidence, had the same heterozygous
      mutation at codon 280 of p53, and none of 10 biopsies from Taiwan showed a
      mutation within exons 5-8 of the p53 gene. No other alteration of gene structure,
      including gross rearrangement or loss of heterozygosity or abnormality of gene
      expression was detected in NPC cell lines or NPC biopsies. We conclude from this
      study that mutational or other alterations of the p53 gene are not common in
      nasopharyngeal carcinogenesis and that a codon-280 mutation of p53 may be
      involved in less than 10% of NPC cases. This result contrasts with the relatively
      high frequency of p53 mutations associated with several other human carcinomas
      and suggests the importance of other genes in NPC genesis.

PMID- 1631152
TI  - Modulation of adenylate cyclase toxin production as Bordetella pertussis enters
      human macrophages.
AB  - During the course of human infection, Bordetella pertussis colonizes sequential
      niches in the respiratory tract that include intracellular and extracellular
      environments. In vitro the expression of virulence factors such as the adenylate
      cyclase toxin is coordinately regulated by the bvg locus, which is an example of
      a two-component sensory transduction system. With this toxin as a reporter,
      enzyme activities were compared between a wild-type and an altered strain to
      determine whether bacterial entry into human macrophages affected gene
      expression. BPRU140, a strain containing an inducible expression vector, produced
      enzyme activity independent of bvg. Samples of the parent, the induced, and the
      uninduced BPRU140 were incubated individually with macrophages for 30 min.
      Extracellular bacteria were then killed by gentamicin. The number of viable
      intracellular bacteria and the internalized bacterial enzyme activity were
      measured over time. By 2.5 hr all samples reached a steady-state concentration of
      10(5) bacteria per 10(6) macrophages. Following an initial peak of enzyme
      activity, adenylate cyclase values for the parent and the uninduced BPRU140
      decreased to a basal level, while the values for the induced strain remained at
      least 3-fold greater. Therefore, compared with the persistence of enzyme in the
      induced strain BPRU140, the decrease in enzyme production by the parent and the
      uninduced BPRU140 upon entry into macrophages indicates in vivo down-modulation
      of gene expression. These observations support the hypothesis that sensory
      transduction contributes to adaptations for bacterial survival in the infected
      host.

PMID- 1631153
TI  - Temporal asymmetry in activation of Aplysia adenylyl cyclase by calcium and
      transmitter may explain temporal requirements of conditioning.
AB  - Cellular experiments have suggested that during classical conditioning of the
      gill and siphon withdrawal reflex of Aplysia, adenylyl cyclase may serve as a
      molecular site of convergence for Ca2+ and serotonin (5-hydroxytryptamine; 5-HT),
      the cellular representations of the conditioned and unconditioned stimuli (CS and
      US). We explored the possible molecular basis of the behavioral requirement that
      the CS and US be paired within a narrow time window and in the appropriate order.
      To examine the temporal interactions of brief pulses of Ca2+ and 5-HT in
      stimulating Aplysia neural cyclase, we used a perfused-membrane cyclase assay.
      When brief pulses of Ca2+ and 5-HT were paired, cyclase activation depended upon
      the sequence of the pulses: peak cyclase activation was greater when the Ca2+
      pulse immediately preceded the 5-HT pulse. Examination of the rising phase of 5
      HT stimulation suggested that a Ca2+ prepulse might accelerate the onset of
      activation by 5-HT, without affecting the final level of activation achieved with
      prolonged 5-HT exposure. The observed interactions between Ca2+ and transmitter
      in activating cyclase could contribute importantly to the temporal requirements
      of conditioning for CS-US pairing.

PMID- 1631154
TI  - Perceptual asymmetry in texture perception.
AB  - A fundamental property of human visual perception is our ability to distinguish
      between textures. A concerted effort has been made to account for texture
      segregation in terms of linear spatial filter models and their nonlinear
      extensions. However, for certain texture pairs the ease of discrimination changes
      when the role of figure and ground are reversed. This asymmetry poses a problem
      for both linear and nonlinear models. We have isolated a property of texture
      perception that can account for this asymmetry in discrimination: subjective
      closure. This property, which is also responsible for visual illusions, appears
      to be explainable by early visual processes alone. Our results force a
      reexamination of the process of human texture segregation and of some recent
      models that were introduced to explain it.

PMID- 1631155
TI  - Introducing mutations into the single-copy chromosomal 23S rRNA gene of the
      archaeon Halobacterium halobium by using an rRNA operon-based transformation
      system.
AB  - A vector-transformation system is described that permits replacement of a portion
      of the single rRNA operon of the archaeon Halobacterium halobium with a
      homologous fragment from a vector-borne gene. The vector construct contains three
      functional sections: (i) an entire H. halobium rRNA operon with two selective
      mutations in the 23S rRNA gene, the substitutions of A----G at position 1159
      conferring resistance to thiostrepton and C----U at position 2471 conferring
      resistance to anisomycin; (ii) the complete pHSB1 plasmid from Halobacterium sp.
      SB3, which interferes with vector maintenance in the transformed halobacterial
      cells; and (iii) a segment of the pBR322 plasmid that permits vector replication
      in Escherichia coli. Transformation of H. halobium with the vector plasmid
      generates cells resistant to both anisomycin and thiostrepton that can be
      selected for, and discriminated from spontaneous mutants, by a two-step selection
      procedure. After transformation, the plasmid recombines homologously with the
      chromosome so that the plasmid-borne rDNA segment with resistance markers
      substitutes for the corresponding region of the chromosomal rRNA operon, and the
      transforming plasmid is lost. Eventually, this leads to a homogeneous population
      of the mutant ribosomes in the cell. Other mutations that are engineered in the
      vector-borne rRNA sequences can be transferred to the chromosomal rRNA operon
      concomitantly with the selective markers. The system has considerable potential
      for ribosomal engineering.

PMID- 1631156
TI  - Evolution of major histocompatibility complex class II allelic diversity: direct
      descent in mice and humans.
AB  - The high degree of polymorphism seen at major histocompatibility complex (MHC)
      class II loci is a feature unique to the MHC. Most of the beta-chain polymorphism
      is localized in "hypervariable" regions (HVRs). HVR amino acid sequence
      similarity between distantly related species has recently been found. We have
      employed a Monte-Carlo statistic to show that shared HVR polymorphism between
      beta-chain genes of humans and mice represents direct descent of ancestral
      sequences rather than convergent evolution. Furthermore, half the sequence
      polymorphism seen in class II beta-chain genes of mice persists in evolution and
      is encoded by the same DNA sequence in humans. No evidence for increased mutation
      rate within the HVR was found. We postulate that the HVR can be considered the
      genetic unit of recombination, with selection for HVR sequences and combinations
      of HVRs constrained by functional considerations.

PMID- 1631157
TI  - Cloning and chromosomal location of human alpha 1(XVI) collagen.
AB  - We have characterized cDNA clones that encode a newly discovered collagenous
      polypeptide. A 4-kilobase (kb) cDNA clone was initially isolated by screening a
      human fibroblast cDNA library with a probe encoding the collagenous domain of the
      human alpha 3(VI) collagen. Subsequent screening of another fibroblast cDNA
      library yielded overlapping clones having a total length of 5.4 kb, which
      contained an open reading frame of 1603 amino acids including a 21-amino acid
      signal peptide. The predicted polypeptide consists of 10 collagenous domains 15
      422 amino acids long, which were interspersed with 11 noncollagenous (NC)
      domains. Except for a large N-terminal NC11 domain of 312 residues, most of the
      NC domains were short (11-39 residues) and cysteine-rich. The overall structural
      arrangement differed significantly from other known collagen chains. Further
      analysis indicated that the deduced polypeptide exhibited several structural
      features characteristically seen in members of the fibril-associated collagen,
      types IX, XII, and XIV. In addition, the cysteine-rich motifs in the NC domains
      resembled those found in the cuticle collagen of Caenorhabditis elegans. Northern
      blot analyses showed hybridization of the cDNA to a 5.5-kb mRNA in human
      fibroblasts and keratinocytes. The gene was localized by in situ hybridization to
      band p34-35 of human chromosome 1. The data clearly support the conclusion that
      the cDNA encodes a collagen chain that has not been previously described. We
      suggest that the cDNA clones encode the alpha 1 chain of type XVI collagen.

PMID- 1631158
TI  - Gene order comparisons for phylogenetic inference: evolution of the mitochondrial
      genome.
AB  - Detailed knowledge of gene maps or even complete nucleotide sequences for small
      genomes leads to the feasibility of evolutionary inference based on the
      macrostructure of entire genomes, rather than on the traditional comparison of
      homologous versions of a single gene in different organisms. The mathematical
      modeling of evolution at the genomic level, however, and the associated
      inferential apparatus are qualitatively different from the usual sequence
      comparison theory developed to study evolution at the level of individual gene
      sequences. We describe the construction of a database of 16 mitochondrial gene
      orders from fungi and other eukaryotes by using complete or nearly complete
      genomic sequences; propose a measure of gene order rearrangement based on the
      minimal set of chromosomal inversions, transpositions, insertions, and deletions
      necessary to convert the order in one genome to that of the other; report on
      algorithm design and the development of the DERANGE software for the calculation
      of this measure; and present the results of analyzing the mitochondrial data with
      the aid of this tool.

PMID- 1631159
TI  - Active nuclear import of human immunodeficiency virus type 1 preintegration
      complexes.
AB  - After cell infection by the human immunodeficiency virus type 1 (HIV-1), nascent
      viral DNA in the form of a high molecular weight nucleoprotein preintegration
      complex must be transported to the nucleus of the host cell prior to integration
      of viral DNA with the host genome. The mechanism used by retroviruses for nuclear
      targeting of preintegration complexes and dependence on cell division has not
      been established. Our studies show that, after infection, the preintegration
      complex of HIV-1 was rapidly transported to the nucleus of the host cell by a
      process that required ATP but was independent of cell division. Functional HIV-1
      integrase, an essential component of the preintegration complex, was not required
      for nuclear import of these complexes. The ability of HIV-1 to use host cell
      active transport processes for nuclear import of the viral preintegration complex
      obviates the requirement for host cell division in establishment of the
      integrated provirus. These findings are pertinent to our understanding of early
      events in the life cycle of HIV-1 and to the mode of HIV-1 replication in
      terminally differentiated nondividing cells such as macrophages (monocytes,
      tissue macrophages, follicular dendritic cells, and microglial cells).

PMID- 1631160
TI  - Structure-function relationships of the yeast fatty acid synthase: negative
      stain, cryo-electron microscopy, and image analysis studies of the end views of
      the structure.
AB  - The yeast fatty acid synthase (M(r) = 2.5 x 10(6)) is organized in an alpha 6
      beta 6 complex. In these studies, the synthase structure has been examined by
      negative-stain and cryo-electron microscopy. Side and end views of the structure
      indicate that the molecule, shaped similar to a prolate ellipsoid, has a high
      density band of protein bisecting its major axis. Stained and frozen-hydrated
      average images of the end views show an excellent concordance and a hexagonal
      ring having three each alternating egg- and kidney-shaped features with low
      protein-density protrusions extending outward from the egg-shaped features.
      Images also show that the barrel-like structure is not hollow but has a Y-shaped
      central core, which appears to make contact with the three egg-shaped features.
      Numerous side views of the structure give good evidence that the beta subunits
      have an archlike shape. We propose a model for the synthase that has point-group
      symmetry 32 and six equivalent sites of fatty acid synthesis. The protomeric unit
      is alpha 2 beta 2. The ends of each of the two archlike beta subunits interact
      with opposite sides of the two dichotomously arranged disclike alpha subunits.
      Three such protomeric units form the ring. We propose that the six fatty acid
      synthesizing centers are composed of two complementary half-alpha subunits and a
      beta subunit, an arrangement having all the partial activities of the
      multifunctional enzyme required for fatty acid synthesis.

PMID- 1631161
TI  - Cooperation between the products of different nuclei in hybrid myotubes produces
      localized acetylcholine receptor clusters.
AB  - Cultured myotubes form clusters of acetylcholine receptors (AChRs) spontaneously
      and at sites of nerve-muscle contact. To investigate the cellular mechanisms by
      which spontaneous clusters are formed, we have made hybrid myotubes between a
      mouse muscle cell variant, S27, that does not cluster AChRs, and one that does
      not make AChRs. We have also made hybrid myotubes using S27 and quail muscle
      cells. In both cases, clusters of AChRs were found near the non-S27 nuclei; in
      the case of the interspecific hybrids, mouse AChRs were associated with
      extracellular matrix components contributed by the quail nuclei. Our results
      suggest that AChRs made by one nucleus can be clustered by localized
      extracellular matrix produced by a different nucleus and provide an example of
      nuclear cooperation between the products of different nuclei within
      multinucleated muscle fibers.

PMID- 1631162
TI  - Interferon alpha induces the expression of retinoblastoma gene product in human
      Burkitt lymphoma Daudi cells: role in growth regulation.
AB  - Interferon alpha (IFN-alpha) is a regulatory secretory protein with distinctive
      biological effects such as antiproliferative actions against many tumor cell
      lines, including human Burkitt lymphoma Daudi cells. The mechanism underlying
      growth inhibition by IFN-alpha is not well established. The growth of many
      mammalian cell types is also regulated by tumor suppressor retinoblastoma (RB)
      gene product, the RB protein. In the studies presented here, we explored the
      possible involvement of RB protein in the growth inhibitory action of IFN-alpha
      in the Daudi cell model system. We observed that IFN-alpha induces a 3- to 10
      fold increased expression of RB protein in growth-sensitive Daudi cells but not
      in the growth-resistant variant of Daudi cells. IFN-alpha-mediated induction of
      RB protein was an early event that preceded the period of growth inhibition of
      Daudi cells. IFN-alpha-induced RB protein predominantly exists as the
      underphosphorylated form. Addition of antibody against IFN-alpha to Daudi cells
      resulted in the inhibition of constitutive expression of RB protein and
      stimulation of [3H]thymidine incorporation. These results demonstrate that the
      induction of RB protein expression in IFN-alpha-treated Daudi cells could
      constitute an important mechanism of IFN-alpha-mediated growth regulation.

PMID- 1631163
TI  - Functional reconstitution of the lysosomal sialic acid carrier into
      proteoliposomes.
AB  - The lysosomal carrier for the acidic monosaccharides sialic acid and glucuronic
      acid was solubilized from rat liver lysosomal membranes and reconstituted into
      phospholipid vesicles. Membrane proteins were extracted from lysosomal membranes
      with Triton X-100. Upon removal of the detergent by absorption on Amberlite XAD-2
      beads, the solubilized proteins were incorporated in egg yolk phospholipids. The
      reconstituted proteoliposomes show proton-driven carrier-mediated uptake of
      acidic monosaccharides. The reconstituted carrier was compared in several
      characteristics with the transporter as present in the native lysosomal membrane.
      Transporter substrate affinity (Kt for glucuronic acid = 0.4 mM) and specificity
      for acidic monosaccharides are completely retained. The proteoliposomes also
      demonstrate trans-stimulation properties with both substrates sialic acid and
      glucuronic acid. The transporter is inhibited, both in its native and in the
      reconstituted state, by the sulfhydryl-modifying agents p-chloromercuribenzoic
      acid, N-ethylmaleimide, and phenyl isothiocyanate. In native membrane vesicles,
      arginine and histidine modifiers phenylglyoxal and diethyl pyrocarbonate
      inactivated transport in a substrate-protectable manner. In reconstituted
      proteoliposomes, similar inhibition was observed. However, protection by
      substrates was achieved only after treatment with phenylglyoxal. These data
      suggest that arginine or histidine residues or both are present at or near the
      substrate binding site of the carrier. Possibly, other essential histidines
      become exposed in the reconstituted state. The successful functional
      reconstitution of the lysosomal sialic acid carrier represents an important step
      towards its purification and its detailed molecular characterization.

PMID- 1631164
TI  - Effects of compact volume and chain stiffness on the conformations of native
      proteins.
AB  - An investigation of the statistical properties of the native conformations of
      proteins, observed from crystal structures, is reported. Protein conformations
      were analyzed in terms of a bond vector correlation function and molecular
      volume. It was observed that, while the volume of a protein structure varies
      nearly linearly with the number of residues, the bond vector correlation function
      exhibits a universal feature for all sizes of proteins. To interpret the nature
      of the bond vector correlation function of native protein structures
      quantitatively, Monte Carlo simulations of realistic polypeptide chains of
      specific but arbitrary amino acid sequence were carried out. The molecule was
      constrained in an ellipsoidal volume determined by its chain length, and
      conformations with unacceptable nonbonded contacts between different amino acid
      residues were excluded. The interactions within a terminally blocked single
      residue, which correlate two nearest-neighbor peptide groups in a chain, were
      taken into account by an energetically biased sampling of its phi-psi space. The
      simulated chain correlation functions were found to be in good agreement with
      those of the crystal structures of beta-sheet-type and mixed-type (alpha+beta)
      proteins of similar length. On the basis of these calculations, it is concluded
      that the observed conformations of these native proteins may arise from two basic
      factors: the compactness of structures under hydrophobic interactions and the
      intrinsic stiffness of polypeptide chains due to the interactions within each
      terminally blocked residue.

PMID- 1631165
TI  - Endosulfine, an endogenous peptidic ligand for the sulfonylurea receptor:
      purification and partial characterization from ovine brain.
AB  - Antidiabetic sulfonylureas act through receptors coupled to ATP-dependent
      potassium channels. Using the binding of [3H]glibenclamide, a highly potent
      sulfonylurea, to rat brain membranes to follow the purification procedure, we
      extracted from ovine brain, purified, and partially characterized two peptides
      that are endogenous ligands for the central nervous system sulfonylurea
      receptors. These peptides, referred to as alpha and beta endosulfine, differ by
      their isoelectric points, the beta form being more basic. Each form of
      endosulfine is recognized equally by the sulfonylurea receptors from the central
      nervous system and from insulin-secreting beta cells. In the same concentration
      range that is active on the receptors, beta endosulfine releases insulin from a
      beta-cell line. Endosulfine is a good candidate for being implicated in the
      physiology of beta cells and their disorders (e.g., type II diabetes) and in
      certain pathologies related to modifications of ion fluxes.

PMID- 1631166
TI  - Mutational analysis of the human immunodeficiency virus type 1 Eli Nef function.
AB  - The studies presented here define an internally consistent experimental system
      that permits systematic analysis of the effect of nef on the rate of the human
      immunodeficiency virus type 1 (HIV-1) replication in a CD4+ tumor T-cell line and
      in primary peripheral blood mononuclear cells. The parental full-length Nef
      protein, derived from the Eli strain of HIV-1, accelerates virus replication in
      both cell types. Mutations that destabilize or alter the intracellular location
      of the protein affect the ability of the Nef protein to accelerate virus
      replication. A set of mutants was made in amino acids proposed to be required for
      Nef function, including threonine and serine residues proposed to be targets for
      phosphorylation, and in sequences thought to resemble the G-1, G-3, and G-4 sites
      of the family of G proteins. In most cases alterations of the critical amino
      acids yield stable Nef proteins of parental phenotype. These results challenge
      the existing theories for the mechanism of Nef function. The results also
      identify two residues in the carboxyl half of the protein that are important for
      Nef function.

PMID- 1631168
TI  - Crystal structure determination at 2.3-A resolution of human transthyretin-3',5'
      dibromo-2',4,4',6-tetrahydroxyaurone complex.
AB  - The crystal structure of the complex of 3',5'-dibromo-2',4,4',6
      tetrahydroxyaurone, a flavone derivative, with human transthyretin (TTR), a serum
      thyroid hormone transport protein, has been determined and refined to R = 17.9%
      for data to 2.3-A resolution and provides a detailed description of a protein
      bound flavonoid structure. This bromoaurone is a potent competitor for thyroid
      hormone binding to TTR, a 54,980-dalton alpha 4 tetrameric protein of 222
      molecular symmetry, as well as an inhibitor of iodothyronine deiodinase. Crystals
      of the TTR-bromoaurone complex are isomorphous to those of native TTR.
      Interpretation of difference Fourier electron density maps revealed two binding
      modes for the bromoaurone in each of the two independent binding sites of the TTR
      tetramer: deep in the channel near Ser-117 (mode I) and near the channel entrance
      (mode II). None of the binding modes can be fully occupied because of overlap
      between binding positions. A statistical disorder for bromoaurone binding was
      also applied, as it binds along the twofold crystallographic axis and does not
      possess such symmetry. The binding of mode I and that of mode II were refined at
      half occupancy, resulting in two molecules per tetramer. The bromoaurone binds in
      a nonplanar antiskewed conformation. The molecular pattern for TTR binding
      consists of halogen groups able to anchor between beta-sheets to form both
      hydrophobic and hydrophilic contacts. Comparison of structural data for
      bromoaurone- and thyroxine-TTR complexes indicates that bromoaurone binding mode
      I is 3 A deeper in the channel and binding mode II is 4 A further from the
      channel center than thyroxine. The bromoaurone binding observed in this TTR
      complex differs significantly from that based upon computer modeling studies.

PMID- 1631167
TI  - A family of genes encoding neurotransmitter transporters.
AB  - The genomic and cDNA clones of the mouse gamma-aminobutyric acid transporter were
      sequenced and analyzed. The genomic clone contains 12 introns including 1 intron
      prior to the initiator methionine. The second intron comes immediately after the
      stretch of amino acids that is most conserved among the neurotransmitter
      transporters sequenced so far. By using a probe constructed according to this
      conserved region, several partial genomic clones were isolated. Sequence analysis
      of those clones reveals not only homology to the family of neurotransmitter
      transporters within the reading frame but also an identical location of an exon
      intron junction after the conserved region. A search of the GenBank data base
      (April 1991) revealed that two invertebrate genes exhibit homology to the
      conserved sequence of the above family. One, a Drosophila melanogaster gene,
      encoded the N-terminal part of a protein homologous to neurotransmitter
      transporters and the second was in Caenorhabditis elegans. The Drosophila gene
      contains an intron that starts at a position identical to the corresponding
      positions of all the mammalian genes of the family.

PMID- 1631170
TI  - Neural-specific expression, genomic structure, and chromosomal localization of
      the gene encoding the zinc-finger transcription factor NGFI-C.

PMID- 1631169
TI  - Identification of a family of bacteriophage T4 genes encoding proteins similar to
      those present in group I introns of fungi and phage.
AB  - The bacteriophage T4 segA gene lies in a genetically unmapped region between the
      gene beta gt (beta-glucosyltransferase) and uvsX (recombination protein) and
      encodes a protein of 221 amino acids. We have found that the first 100 amino
      acids of the SegA protein are highly similar to the N termini of four other
      predicted T4 proteins, also of unknown function. Together these five proteins,
      SegA-E (similar to endonucleases of group I introns), contain regions of
      similarity to the endonuclease I-Tev I, which is encoded by the mobile group I
      intron of the T4 td gene, and to putative endonucleases of group I introns
      present in the mitochondria of Neurospora crassa, Podospora anserina, and
      Saccharomyces douglasii. Intron-encoded endonucleases are required for the
      movement (homing) of the intron DNA into an intronless gene, cutting at or near
      the site of intron insertion. Our in vitro assays indicate that SegA, like I-Tev
      I, is a Mg(2+)-dependent DNA endonuclease that has preferred sites for cutting.
      Unlike the I-Tev I gene, however, there is no evidence that segA (or the other
      seg genes) resides within introns. Thus, it is possible that segA encodes an
      endonuclease that is involved in the movement of the endonuclease-encoding DNA
      rather than in the homing of an intron.

PMID- 1631171
TI  - [The importance of digestive tract lipases in the hydrolysis of lipid excipients
      and substitution enzyme therapy. Part 1].

PMID- 1631172
TI  - [The effect of two lubricants (magnesium stearate and pruv) in the formation of
      tablets of four anti-ulcer agents/ by means of direct compression].
AB  - In this research we study the influence of two lubricants-Magnesium Stearate and
      Pruv--on the tablets elaboration of Cimetidine, Ranitidine, Famotidine and
      Pirenzepine by direct compression. The presence of 0.5% of lubricants improved
      the flow of all the formulations, but especially the Famotidine's formulation.
      The formulations with Magnesium Stearate had the worst results in tests of
      friability and tensile strength. All tablets with drugs and Pruv had high data in
      indentation hardness. The tablets of Cimetidine, Famotidine and Pirenzepine with
      Magnesium Stearate had less time of disintegration.

PMID- 1631173
TI  - Monthly prostaglandin bibliography prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1631174
TI  - Urinary prostanoid excretion in healthy women with different degrees of induced
      potassium depletion.
AB  - Plasma renin activity (PRA), urinary excretions of PGE2, 6-keto-PGF1 alpha
      (6KPGF), TXB2 and renal function were determined in healthy women both in normal
      potassium balance (N, n = 14) and in experimental potassium depletion (KD). KD
      was induced by natriuretic treatment--associated to replacement of net NaCl and
      water losses--in the presence of either normal (congruent to 50 mmol/d) or low
      (less than or equal to 10 mmol/d) dietary potassium intake. By using different
      depletive patterns, three groups with estimated cumulative potassium deficit
      (mean +/- SEM) of 124 +/- 38 (KD0, n = 8), 160 +/- 43 (KD1, n = 8) and 198 +/- 22
      mmol (KD2, n = 6), respectively, were obtained. Renal function by the clearance
      (cl.) method and urinary prostanoid concentrations by the RIA method were
      estimated during hypotonic polyuria (oral water load) and subsequent moderate
      antidiuresis induced by a low-dose infusion of lysine-8-vasopressin. 1. In KD0
      group the potassium depletive treatment was inefficacious in significantly
      reducing either the plasma potassium concentration (PK) or the urinary potassium
      excretion (UKV). The reductions of PK and UKV as well as the enhancement of PRA
      became significant in KD1 and KD2 groups. 2. The urinary prostanoid excretions
      were not significantly changed in the KD0 and KD1 groups while in the KD2 group
      they were reduced, mainly concerning the urinary 6KPGF excretion. 3. Furthermore
      in the KD2 group, with larger potassium depletion, some of the typical
      hypokalemic renal dysfunctions appeared. The data suggest that a
      pathophysiologically critical degree of potassium depletion is associated with an
      inhibited renal prostanoid synthesis as well as an increased renin secretion.

PMID- 1631175
TI  - Influence of leukotriene D4 on arterial pressure and gastrointestinal electrical
      activity in the conscious piglet.
AB  - In 6 conscious weaned piglets with implanted electrodes in the corpus and antrum
      of the stomach, the duodenum, jejunum, ileum and caecum the influence of
      intravenous infusion of leukotriene (LT)D4, 0.1 and 1 microgram kgmin for 10 min,
      on mean arterial pressure and gastrointestinal electrical activity was examined.
      LTD4 induced a significant increase in arterial pressure. Gastrointestinal
      electrical activity, however, was little influenced, since only the antrum pylori
      revealed a transient decrease.

PMID- 1631176
TI  - Increased concentrations of phosphatidylinositol (PI) and decreased
      esterification of arachidonic acid into phospholipids in platelets from patients
      with schizoaffective disorders or atypic phasic psychoses.
AB  - The concentration of various phospholipids (PLs) and sphingomyelin in platelets
      and the amount of [14C] arachidonic acid ([14C]-AA) esterified in
      phosphatidylinositol (PI), phosphatidylserine (PS), phosphatidylethanolamine
      (PE), and phosphatidylcholine (PC) were measured. The platelet-rich plasmas from
      unmedicated patients with psychiatric disorders and healthy controls were
      incubated for 30 min with 1 microM [14C]-AA. Platelets from patients with a
      schizoaffective disorder according to RDC criteria, a schizophreniform disorder
      (DSM III criteria) or an atypical phasic psychosis according to FC criteria
      contained twice as much PI and had significantly increased concentrations of PC
      as compared to controls (p less than 0.05, t-test). A highly significant (40-70%)
      reduced rate of esterification of [14C]-AA into PI/PS, PC and PE was found in
      platelets from patients with schizophreniform, schizoaffective and major
      depressive disorders but not in platelets from patients with chronic
      schizophrenia. The largest reduced esterification of [14C]-AA (about 70%) was
      found in PI/PS of platelets from patients with schizoaffective disorders (1.9 +/-
      0.7 vs 6.3 +/- 1.7 mumol [14C]-AA/mol PI/PS; p less than 10(-4), t-test). The
      results indicate that changes in the metabolism of arachidonic acid and
      phosphatidylinositol and, to a lesser degree, of phosphatidylcholine in platelets
      are characteristic of patients with a likely favorable outcome of a psychotic
      episode.

PMID- 1631177
TI  - Mechanical injury increases eicosanoid production in cultured cardiomyocytes.
AB  - The release of three stable metabolites of the arachidonic acid cascade was
      determined in cultures of cardiac myocytes and of non-muscle cells. In both cell
      types, the main product was 6-keto-PGF1 alpha much less PGE2 was released, while
      TXB2 was only detected in muscle cells. Preincubation with arachidonic acid
      increased the release of all the PGs in both types of culture. Mechanical injury
      had a synergistic effect on the increased PG release in AA-preincubated cells.
      However, TXB2 was not detected in F-cells in any experimental conditions. These
      results suggest that PG production serves a functional role in heart preservation
      during injury.

PMID- 1631178
TI  - Effect of adenosine analogues on the expression of opiate withdrawal in rats.
AB  - The aim of this study was to test whether convergent dependence occurs in vivo.
      The adenosine A1 receptor agonist N6-[(R)-1-methyl-2-phenylethyl]adenosine (R
      PIA), the A2 agonist 2-(phenylamino)adenosine (CV-1808), the nonselective A1, A2
      agonist (adenosine-5'-ethylcarboxamide (NECA), and the alpha 2-adrenoceptor
      agonist clonidine were screened (each at 30, 100, and 300 micrograms/kg, SC) for
      their ability to alter naloxine-precipitated withdrawal signs in morphine
      dependent rats. The results indicate that there is convergent dependence
      involving opioid and adenosine A1 receptors on those effects expressed by
      withdrawal diarrhoea, paw-shakes, teeth-chattering, body-shakes, and jumping.
      Further, dependence expressed by body-shakes involves convergence involving A1
      receptors, as well as alpha 2-adrenoceptors; while A1 receptors are involved in
      dependence expressed by jumping, stimulation of alpha 2-adrenoceptors augments
      this sign. Adenosine analogues may be of clinical value for detoxification of
      opiate addicts.

PMID- 1631180
TI  - Strain-specific alterations in consumption of a palatable diet following repeated
      stressor exposure.
AB  - Exposure to acute inescapable shock caused reductions in the consumption of a
      highly palatable diet. The magnitude and duration of the reduction varied across
      strains of mice. With repeated exposure to footshock, consumption of the diet
      returned to baseline levels, although alterations of weight appeared to be more
      persistent. The course of the adaptation varied across strains of mice; however,
      the rate of adaptation was unrelated to the extent of the alterations of
      consumption induced by the acute stressor. When mice were exposed to a series of
      different stressors, the adaptation progressed less readily, and reductions of
      diet consumption were apparent in strains that had not shown such an effect
      following acute stressor application or when repeatedly exposed to a single type
      of stressor. Data were discussed with respect to the mechanisms that might be
      operative in subserving stressor-induced anhedonia.

PMID- 1631179
TI  - Effects of neuropeptide Y on food-reinforced behavior in satiated rats.
AB  - The effect of NPY on behavior and food intake of food-satiated rats was examined
      under three different food availability conditions. Food was available during
      times when rats normally do not eat under either a fixed-ratio or fixed-interval
      reinforcement schedule, or it was freely available in the bottom of the cage
      (FF). Forty responses were required for each 45-mg food pellet under the ratio
      schedule (FR 40) and for the first response to occur 15 s after the previous
      reinforcement under the interval schedule (FI 15"). NPY (5 micrograms)
      significantly increased food intake under all conditions and increased food
      reinforced responses under the FR and FI schedules. NPY's effect on food intake
      was greatest when food was freely available and least for rats working under the
      schedule requiring the most effort (FR 40). Food intake peaked after 3 days under
      repeated daily administration of NPY. Under free food access and under the fixed
      interval schedule, eating and/or responding occurred almost immediately following
      the onset of the initial 4-h session under NPY. However, during the first session
      following NPY administration under the FR, rats emitted few responses during the
      first 2 h of the session. The onset of robust responding under the FR schedule
      began earlier with each successive daily administration of NPY. These data show
      NPY substantially increases food-maintained behavior and is a potent inducer of
      food intake even under conditions where considerable effort is required to obtain
      food. Further, the conditions under which food is made available can dramatically
      alter NPY's effect on the temporal pattern of food-maintained responding,
      feeding, and latency to eat.

PMID- 1631181
TI  - Active avoidance behavior in guinea pigs: effects of physostigmine and
      scopolamine.
AB  - Behavioral training of guinea pigs by conventional methods, such as used for rats
      and mice, appears difficult. Hence, only a few behavioral experiments with guinea
      pigs have been described in the literature. An active avoidance technique in an
      automated two-way shuttlebox is described using sound as a conditioned (CS) and a
      tactile stimulus (a stream of air ruffling their fur) as an unconditioned (UCS)
      stimulus. Acquisition is fairly rapid and reproducible. Doses of physostigmine
      that caused moderate blood acetylcholinesterase inhibition induced dose-dependent
      performance decrements. These decrements were counteracted by a sign-free dose of
      scopolamine.

PMID- 1631182
TI  - Differential effects of CCK-JMV-180 on food intake in rats and mice.
AB  - Boc-Tyr(SO3)-Nle-Gly-Trp-Nle-Asp-2-phenylether ester (CCK-JMV-180) has been
      reported to be a CCK-based heptipeptide with novel in vitro properties. Based on
      studies conducted in rat and mouse pancreatic acini, it has been proposed that
      the compound acts as an agonist at the high-affinity site and an antagonist at
      the low-affinity site in the rat, but as an agonist at both sites in the mouse.
      In the present study, we examined the effects of CCK-JMV-180 on locomotor
      activity in the rat and on intake of a liquid diet in the rat and mouse. Although
      CCK-JMV-180 slightly reduced activity on its own in the rat, it completely
      reversed the suppression produced by coadministration of CCK-8. In rat feeding
      studies, CCK-JMV-180 failed to suppress intakes of a liquid diet, but was able to
      antagonize the anorectic effects of CCK-8. In contrast, in the mouse CCK-JMV-180
      potently suppressed intakes on its own, and this effect was blocked by
      pretreatment with the selective CCK-A receptor antagonist, A-70104. The results
      of these studies suggest that similar receptor mechanisms are involved in CCK's
      ability to inhibit food intake in vivo and its effects on pancreatic function in
      vitro.

PMID- 1631183
TI  - Repeated administration of diazepam reduces [3H]Ro 5-4864 binding in cerebral
      cortex of rats.
AB  - Binding of [3H]Ro 5-4864 to mitochondrial membrane preparations of rat cerebral
      cortex was measured after repeated (5 days) IV administration of diazepam (10
      mg/kg daily) and clonazepam (2.5 mg/kg daily). The B(max) value for [3H]Ro 5-4864
      was significantly reduced in rats treated with diazepam (-49%) but not in those
      treated with clonazepam. These findings suggest the involvement of peripheral
      type binding sites in the development of rapid tolerance to the sedative effects
      of benzodiazepines. A downregulation of [3H]Ro 5-4864 (-65%) was also observed
      after repeated administration of Ro 5-4864 (4 mg/kg daily), thus confirming that
      this compound behaves as an agonist at its own recognition sites.

PMID- 1631184
TI  - "Paradoxical" effects of smoking on subjective stress versus cardiovascular
      arousal in males and females.
AB  - Cigarette smoking has sometimes been found to decrease subjective stress while
      simultaneously increasing cardiovascular arousal, contrasting effects referred to
      as the "nicotine paradox." The present study assessed acute effects of cigarette
      smoking on subjective stress vs. cardiovascular arousal in minimally deprived
      male and female smokers who smoked (n = 16) or sham smoked (unlit cigarette, n =
      15) and a comparison group of male and female nonsmokers (n = 12) who sham smoked
      only. All subjects participated in two sessions (high- or low-challenge computer
      task) in which they smoked or sham smoked prior to each of two 20-min task
      trials. Results showed reduced subjective stress in smoking smokers compared with
      sham-smoking smokers during the high- but not low-challenge task. However, this
      stress reduction occurred only immediately after smoking and dissipated midway
      through each trial. In males, smoking appeared to reduce stress below that of
      nonsmokers, while smoking in females attenuated stress only partially to the
      level of nonsmokers. In contrast with the attenuated stress effects,
      cardiovascular arousal (especially heart rate) was increased immediately after
      smoking during both tasks and did not appear to be directly related to subjective
      changes. These findings suggest that the stress-reducing effects of smoking may
      be transient, situationally specific, partly gender dependent, and dissociated
      from the effects of smoking on cardiovascular arousal.

PMID- 1631185
TI  - Limbic forebrain toxin trimethyltin reduces behavioral suppression by clonidine.
AB  - Trimethyltin (TMT) at moderate doses selectively damages hippocampus and related
      olfactory cortex and produces learning and memory impairments. TMT also increases
      forebrain beta-adrenergic ligand binding; this could be ancillary to reduced
      noradrenergic neurotransmission, which in turn could be involved in the cognitive
      deficit caused by TMT. If this hypothesis is correct, then the alpha 1-adrenergic
      agonist clonidine, which inhibits noradrenergic neurotransmission in normal
      subjects, should be less behaviourally effective after TMT poisoning. Thus, rats
      treated with water vehicle or TMT (6 mg/kg, PO) were given saline or clonidine IP
      (5, 10, or 20 micrograms/kg) 30 min before placement in a hole-board apparatus.
      Exploratory activity was reduced in controls by 10 or 20 micrograms/kg. Clonidine
      at 10 micrograms/kg was ineffective in rats given TMT. At 20 micrograms/kg, an
      apparent reduction in exploratory activity was not significant because
      variability of responding was higher after TMT treatment. The results suggest an
      impairment in noradrenergic neurotransmission following TMT poisoning.

PMID- 1631186
TI  - Test-specific effects of FG-7142 on isolation-induced aggression in mice.
AB  - Treatment with FG-7142 decreased isolation-induced attack, but not defense, by
      male mice when the residents' home cages contained only a sawdust substrate. When
      a small wooden nesting box was added to the cage (Experiment 2), however, FG-7142
      somewhat increased levels of attack. Time spent in the nesting box was also
      increased, while overall levels of social interaction were decreased, by drug
      treatment in Experiment 2. The latter findings are consistent with FG-7142's well
      documented anxiogenic properties and indicate that this drug is probably
      proaggressive in its actions. The antiaggressive effects of FG-7142 in Experiment
      1 may have resulted from drug-induced fear behaviors that were incompatible with
      attack. Alternatively, Experiment 2 suggests the possibility that species-typical
      attack may be defensively motivated under some circumstances. Although the
      antiagressive properties of eltoprazine and yohimbine were unaffected by the
      addition of the nest box (Experiment 3), the provision of some sort of refuge
      within the testing apparatus may be an important methodological consideration for
      studies employing resident-intruder paradigms.

PMID- 1631187
TI  - Opiate effect on the threat display in the crab Carcinus mediterraneus.
AB  - The well-known defense response of a crab (laterus merus display, LMD) was easily
      evoked in Carcinus mediterraneus by striking the cephalothoraxic protogastric
      region between the eyestalks. Following a program aimed at investigating the
      regulatory action of diverse neuromodulators on the LMD of this crab, a study on
      the role of opioids was started by testing the effect of morphine administration.
      Injection of morphine HC1 (MP) (40, 50, 60, 70, or 100 micrograms/g) produced a
      dose-dependent reduction of the LMD so elicited that dissipated with the
      postinjection time. Only MP doses higher than 50 micrograms/g were effective 30
      min after drug administration. The MP-induced inhibition of LMD was blocked by a
      4.8-micrograms naloxone HC1/g dose injected 10 min before MP. These results and
      those previously obtained as the action of GABA on the LMD of this crab are
      discussed in connection with results reporting a similar effect of these drugs on
      another agonistic item of behavior in the crab Chasmagnatus granulatus. The
      possibility of demonstrating habituation of the LMD to an iterated stimulation in
      C. mediterraneus and of using such a process to elucidate the acting paths of the
      drugs is discussed.

PMID- 1631188
TI  - Effects of smoking abstinence and chain-smoking on puffing topography and diurnal
      nicotine exposure.
AB  - Effects of chain-smoking, a 15-h smoking abstinence, and the nicotine yield of
      cigarettes on puff indices were studied in eight healthy smokers by using a
      controlled crossover study design. Puff parameters were measured puff by puff
      with a portable measuring device when 10 or 20 cigarettes, with nicotine yields
      of 0.3 and 1.0 mg, were smoked per day. The interval between sessions was 1 h,
      and the 20 cigarettes per day were chain-smoked 2 at a time. Serum cotinine
      indicated that smokers compensate completely for the lower nicotine delivery from
      the 0.3-mg cigarette. Smokers almost doubled total puff volume per cigarette and
      per day mainly by taking more puffs from the low-nicotine cigarettes and slightly
      prolonging puff duration. However, nicotine deprivation and chain-smoking had a
      relatively minor effect on puffing indices with both brands, a fact that agrees
      poorly with the nicotine titration hypothesis. However, in the course of every
      single cigarette of the day smokers significantly reduced puff duration and puff
      volume toward the end of the cigarette, which probably involves satiation of the
      nicotine crave but may also be due to changes in taste of the smoke.

PMID- 1631189
TI  - Acute effects of chlorpromazine in a monkey operant behavioral test battery.
AB  - The effects of acute chlorpromazine treatment were assessed using a complex
      operant test battery (OTB) containing five tasks thought to depend upon processes
      associated with short-term memory and attention [delayed-matching-to-sample
      (DMTS)], color and position discrimination [conditioned position responding
      (CPR)], motivation [progressive ratio (PR)], time perception [temporal response
      differentiation (TRD)], and learning [incremental repeated acquisition (IRA)].
      Adult male rhesus monkeys were tested 15 min after IV injection of saline or
      chlorpromazine (0.010, 0.030, 0.100, or 0.175 mg/kg). Behavioral endpoints
      measured included percent task completed, response rate or latency, and response
      accuracy. The order of task sensitivity to disruption by chlorpromazine was TRD =
      PR = IRA = DMTS = CPR in which sensitivity was defined as a significant
      alteration in any aspect of task performance. Chlorpromazine slowed response
      rates in all tasks except TRD but did decrease accuracy in that task. These
      effects were similar to those noted in previous studies of acute chlorpromazine
      treatment. Specific motoric effects suggested decreased task initiation at doses
      that left general motor ability intact. This finding is similar to that noted in
      parkinsonism caused by chronic chlorpromazine treatment.

PMID- 1631190
TI  - Novel approach to diet design for determining macronutrient preference.
AB  - Previous studies indicate that rats fed a saturated vs. unsaturated fat consume
      more of a high-protein/low-carbohydrate and less of a low-protein/high
      carbohydrate diet. Present studies were conducted to determine whether saturated
      fat-fed rats are preferring protein or avoiding carbohydrate. Three combinations
      of diets were prepared in which one macronutrient was held constant and two
      covaried: 1) high protein/low carbohydrate and low protein/high carbohydrate, 2)
      high fat/low carbohydrate and low fat/high carbohydrate, and 3) high fat/low
      protein and low fat/high protein. Male Sprague-Dawley rats (75-99 g) were fed
      either 34% tallow (n = 30) or corn oil (n = 30) diets for 4 days. These diets
      were removed and one third of each group was given one of the diet combinations.
      Rats previously fed tallow consumed more high-protein/low-carbohydrate and low
      carbohydrate/high-fat diets and less high-carbohydrate/low-fat diet than controls
      previously fed corn oil. These data suggest that tallow-fed animals are avoiding
      carbohydrate rather than preferring protein.

PMID- 1631191
TI  - Ketamine retards chronic but not acute tolerance to ethanol.
AB  - Motor impairment (tilt-plane test) was used to investigate whether the
      noncompetitive N-methyl-D-aspartate (NMDA) antagonist ketamine prevents the
      development of chronic and acute tolerance to ethanol. Rats were treated with
      ethanol or saline in the presence and absence of ketamine (separate groups) for
      10 days and tested for ethanol tolerance in the absence of ketamine on the fifth
      and tenth days. In other studies, the effect of ketamine on acute tolerance to
      ethanol was examined. Rats that received ethanol daily without ketamine showed
      significant tolerance to ethanol on days 5 and 10, but those receiving ethanol
      plus ketamine daily showed significantly less tolerance to ethanol. Thus,
      ketamine interfered with the development of chronic tolerance just as it had been
      found previously to prevent rapid tolerance. In contrast, ketamine failed to
      block acute tolerance to ethanol. These results would suggest that the phenomena
      of acute tolerance and chronic tolerance have differences not previously
      reported.

PMID- 1631192
TI  - Human visual perception and ROC methodology in medical imaging.

PMID- 1631193
TI  - Addendum to the code of practice for electron beam dosimetry in radiotherapy
      (1985): interim additional recommendations. Working Party of the IPSM.

PMID- 1631194
TI  - Registration of low resolution medical images.
AB  - There are several situations in which the registration of two medical images is
      desirable. One example is the registration of two images of the same organ taken
      using different radionuclide tracers, for example the ventilation and perfusion
      components of a V/Q lung scan, where the aim is to compare the regional uptake of
      the two tracers. Another example is the registration of images of an organ
      belonging to a single patient but taken at different times, where the aim is to
      follow changes in tracer uptake. Such techniques require a reliable method of
      registering images. One image is usually brought into registration with another
      image using a coordinate transfer function (CTF) and the central problem in image
      registration is the determination of the appropriate CTF. A new semi-automatic
      approach to the problem of finding the CTF for similar images is described which
      is especially applicable to low resolution images.

PMID- 1631195
TI  - Differences in the AC electrodynamics of viable and non-viable yeast cells
      determined through combined dielectrophoresis and electrorotation studies.
AB  - An electrode system is described for the near-simultaneous application and
      measurement of translational, levitational and rotational forces induced by AC
      electric fields, and this has been used to investigate the differences in the AC
      electrodynamics of viable and non-viable yeast cells. A new approach to the
      theoretical modelling of the experimental data has enabled these differences to
      be quantified in terms of changes in the conductivity of the cytoplasmic membrane
      and cell interior. The results are considered to have potentially important
      biomedical and biotechnological applications.

PMID- 1631196
TI  - Contrast agent CT imaging in variable sized organs using single energy
      synchrotron radiation.
AB  - A theoretical and experimental study has been performed to determine which
      element, when used as a contrast agent in CT, requires the lowest concentration
      when delivered to various sized organs. Iodine is at present the primary contrast
      agent used in contrast enhanced CT imaging. The results presented here show that
      iodine is not the optimum element to use in terms of concentration needed for
      visibility. When administered to very small organs, the use of gadolinium reduces
      the concentration required for visibility by at least a factor of 3 over that
      required when using iodine.

PMID- 1631197
TI  - The theoretical basis for the determination of optical pathlengths in tissue:
      temporal and frequency analysis.
AB  - A concise theoretical treatment is developed for the calculation of mean time,
      differential pathlength, phase shift, modulation depth and integrated intensity
      of measurements of light intensity as a function of time on the surface of
      tissue, resulting from either the input of picosecond light pulses, or radio
      frequency-modulated light. The treatment uses the Green's function of the
      diffusion approximation to the radiative transfer equation, and develops this and
      its Fourier transform in a variety of geometries. Detailed comparisons are made
      of several of these parameters in several geometries, and their relation to
      experimentally measured clinical data. The limitations of the use of phase
      measurements is discussed.

PMID- 1631198
TI  - Effects of gradient timing and spatial resolution on the NMR signal from flowing
      blood.

PMID- 1631199
TI  - Determination of serum iron and iron binding capacity by NMR.

PMID- 1631200
TI  - Should 60Co tissue-air ratios be re-evaluated?

PMID- 1631201
TI  - Living without student research projects.

PMID- 1631203
TI  - Biomechanical comparison of the energy-storing capabilities of SACH and Carbon
      Copy II prosthetic feet during the stance phase of gait in a person with below
      knee amputation.
AB  - In this study, the energy-storing capabilities of solid-ankle cushion heel (SACH)
      and Carbon Copy II prosthetic feet during the stance phase of gait were compared.
      A person with a unilateral below-knee amputation served as a component of the
      instrumentation to test the feet under dynamic loads. Ten trials per foot of
      bilateral stride at "free" velocity were collected with a video-based, three
      dimensional data-acquisition system and two force plates. There were no
      differences between the prosthetic conditions in step length, single-limb support
      time, and swing period (analysis of variance) or in double-limb support time,
      cadence, and velocity (Student's t test). Angular kinematics and moments of the
      hip and knee were unaffected bilaterally by the type of foot. The progression of
      the center of pressure under the Carbon Copy II was delayed from 15% to 80% of
      stance as compared with the SACH foot. The Carbon Copy II showed slower unloading
      in late stance and a later peak propulsive force than did the SACH foot. The
      Carbon Copy II performed greater work in both the energy-storage (Carbon Copy II
      = 2.33 J, SACH = 1.16 J) and energy-return (Carbon Copy II = 1.33 J, SACH = 0.34
      J) phases of stance and returned energy with 57% efficiency. Although the energy
      returned by the Carbon Copy II was clinically insignificant during level walking,
      these results confirm that it performs as an energy-storing device.

PMID- 1631202
TI  - Investigation of evidence for anticipatory postural adjustments in seated
      subjects who performed a reaching task.
AB  - The paradigm for study of anticipatory postural adjustments permits investigation
      of the coordination of postural and voluntary components of functional movement.
      The purpose of this study was to investigate whether there were anticipatory
      postural adjustments for voluntary movement in seated subjects under clinically
      relevant conditions. Eight neurologically normal subjects performed a reaching
      task to a target placed at shoulder height, 45 degrees to the right of midline.
      Onsets and magnitudes of lateral and fore-aft reactive forces associated with the
      movement and of electromyographic (EMG) activity of the ipsilateral deltoid and
      external abdominal oblique and contralateral paraspinal muscles were monitored.
      Conditions of trunk support, reach speed, and distance reached were manipulated.
      Onsets of deltoid muscle EMG activity preceded onsets of postural muscle
      (external oblique and paraspinal) EMG activity in 70% of all trials for seated
      subjects in contrast to reports of EMG activity onset in the postural muscles in
      advance of the prime mover in standing subjects who performed a similar task. The
      role of the trunk musculature and the significance of reactive forces in advance
      of hand movement were equivocal. This study has implications for evaluation of
      postural instability in persons unable to stand for testing.

PMID- 1631204
TI  - Clinical management of a patient following temporomandibular joint arthroscopy.
AB  - This case report describes a patient in whom arthroscopic surgery of the
      temporomandibular joint (TMJ) was used to break up adhesions between the TMJ disc
      and the articular eminence and therefore improve mobility of the joint.
      Postsurgical physical therapy procedures used were high voltage electrical
      stimulation, transcutaneous electrical nerve stimulation, moist heat, ultrasound,
      ice, mobilization, and therapeutic exercises. Postsurgical goals included
      normalization of range of motion, elimination of pain, elimination of
      inflammation, and mandibular function without restriction. Special emphasis is
      given to an unusually effective mobilization technique used to decrease
      tenderness in the TMJ. The conservative therapy described may be used for persons
      with similar symptoms and evaluation findings who do not require surgery. [Waide
      FL, Bade DM, Lovasko J, Montana J. Clinical management of a patient following
      temporomandibular joint arthroscopy.

PMID- 1631206
TI  - Changes in hand function in the aging adult as determined by the Jebsen Test of
      Hand Function.
AB  - The Jebsen Test of Hand Function is used to assess a broad range of hand
      functions required for activities of daily living. The time needed to complete a
      variety of subtests is measured, with high scores indicative of abnormality.
      Normative values have been established for men and women in two age groups: 20 to
      59 years and 60 to 94 years. The purpose of this study was to determine whether
      hand function, as measured by the Jebsen test, declines with age in subjects over
      the age of 60 years. A total of 121 men and women were given the test and grouped
      into the following age categories: (1) 60 to 69 years, (2) 70 to 79 years, and
      (3) 80 to 89 years. Hand function decreased with age in both men and women. There
      were significant positive correlations between age and time needed to complete
      the various subtests, and analyses of variance revealed significant differences
      between subjects in their 80s and those in their 60s and 70s. In only a few tasks
      were there significant differences between men and women within any age group.
      Because of the decrease in normal function with age, measurements obtained with
      the Jebsen test in the elderly should be compared with normative values that are
      obtained from similarly aged subjects. [Hackel ME, Wolfe GA, Bang SM, Canfield
      JS. Changes in hand function in the aging adult as determined by the Jebsen Test
      of Hand Function.

PMID- 1631205
TI  - Exercise response in children with and without juvenile rheumatoid arthritis: a
      case-comparison study.
AB  - The primary purpose of the study was to compare the response to bicycle ergometer
      exercise in children with and without juvenile rheumatoid arthritis (JRA). Heart
      rate, exercise duration, highest work load completed, and peak oxygen consumption
      (peak VO2) were compared. A secondary purpose of the study was to determine the
      relationship between peak VO2 and articular disease severity. Thirty children
      with JRA and 30 controls matched for age, sex, and body surface area (BSA) were
      the subjects. Peak VO2 was determined by an open-circuit computerized gas
      analysis system. Peak VO2, highest work load completed, exercise duration, and
      peak heart rate were significantly lower among the children with JRA than their
      respective controls. Submaximal heart rate was significantly higher for the
      children with JRA. There was no difference in resting heart rate between the two
      groups. There was no relationship between peak VO2 and articular disease severity
      among the children with JRA. The results suggest that aerobic conditioning
      programs may be indicated soon after diagnosis for patients with JRA, regardless
      of the severity of their articular disease. One subject with JRA and 2 control
      subjects reported light-headedness and dizziness, and 1 subject with JRA
      complained of increased knee swelling. We recommend that physical therapists
      monitor patients for signs of exercise intolerance and joint symptoms during
      exercise training sessions. [Jasso Giannini M, Protas EJ. Exercise response in
      children with and without juvenile rheumatoid arthritis: a case-comparison study.

PMID- 1631207
TI  - American Physical Therapy Association environmental statement.

PMID- 1631208
TI  - The Ilizarov method.

PMID- 1631209
TI  - Academics and clinical research.

PMID- 1631210
TI  - Fetal fracture healing in a lamb model.
AB  - A large animal model to assess fetal fracture repair and the ability to close
      excisional bony defects is presented. Incisional and excisional ulnar fractures
      were made in 14 midgestation fetal lambs, harvested at serial time points, and
      subjected to high-resolution low-kilovolt magnification radiographs, magnetic
      resonance imaging scans, and histologic analysis. Fetal fracture healing was
      characterized by early closure of excisional defects and rapid fracture healing
      with minimal or no soft-tissue inflammation or callus formation. Magnetic
      resonance imaging scans of the fractures revealed a characteristic pattern
      compatible with the histologic findings, namely, minimal inflammation in soft
      tissue adjacent to the fracture site. Histologic and magnification radiographic
      findings indicated that complete bony repair occurred within 21 days in
      incisional defects and within 40 days in excisional defects. In both cases,
      healed fetal bone resembled normal bone matrix. Excisional defects, including
      periosteum, of greater than three times the width of the bony cortex closed
      rapidly with virtually normal-appearing bony matrix and with minimal or no callus
      formation.

PMID- 1631211
TI  - Are growth alterations a consequence of surgery for prominent ears?
AB  - This study was undertaken to detect growth alterations after surgery for
      prominent ears. The cartilage excision technique was used in all 77 patients seen
      for follow-up. Two hundred students served as controls. Auricular measurements
      were done according to standardized guidelines of anthropometry. There was no
      significant difference between the retroauricular angle in the surgical group and
      in controls. The morphologic ear length in the surgical group was significantly
      smaller than in controls. Maximum ear length was significantly greater in men.
      Our measurements in the control group were significant below the reference values
      reported in the literature. Comparing the ear index of both groups with published
      data, we found a harmony between the width and the length of the ear. We could
      demonstrate that prominent ears were significantly larger in all other dimensions
      and that auricular growth does not stop following surgery for prominent ears with
      the cartilage excision method. We also evaluated subjective criteria such as
      tolerance to cold, scar formation, and patient satisfaction.

PMID- 1631212
TI  - The use of Gore-Tex implants in aesthetic surgery of the face.
AB  - Deep wrinkles and folds usually are not completely or permanently corrected with
      face lifting, fat or collagen injections, chemical peels, and other known
      procedures. It is suggested that a permanent implant, well tolerated by human
      tissues, could be helpful as an isolated or associated procedure. An expanded
      synthetic polymer known as Gore-Tex expanded polytetrafluoroethylene soft-tissue
      patch is available and is easy to use to approximate and correct defects; it also
      can be used as a filling material or to replace other kinds of prostheses to get
      better projection of frontal, orbital, malar, and chin areas. I have used this
      material in my clinic for 5 years. Indications and results of the first cosmetic
      cases are reported herein.

PMID- 1631213
TI  - The ptotic (witch's) chin deformity: an excisional approach.
AB  - Ptosis of the chin pad is common and can be seen in patients of all ages. It may
      be associated with too little or (at times) too much anterior chin projection.
      Often there is an associated deep submental skin crease present. Frequently, the
      primary concern of the patient is the appearance or exaggeration of chin ptosis
      in smiling ("dynamic" ptosis). This report describes a flexible approach to the
      correction of developmental (and some iatrogenic) ptotic chin deformities. The
      key element in the approach is the direct excision of sagging or excess chin fat,
      muscle, and skin. No attempt is made to reposition or lift ptosis-prone soft
      tissues. If a deep submental skin crease is present, it too is excised. If the
      chin needs added anterior projection, it is accomplished with a stable
      alloplastic chin implant. The approach is uniquely suited to correct anterior
      overprojection caused by an excess of soft tissue at the front of the chin and
      has been successful in correcting the "dynamic" ptosis that appears with smiling.

PMID- 1631214
TI  - Mandibular retrusion, temporomandibular joint derangement, and orthognathic
      surgery planning.
AB  - One-hundred consecutive orthognathic surgery candidates with mandibular retrusion
      were selected for retrospective analysis. Patients had undergone imaging studies
      that included magnetic resonance imaging (MRI) of both temporomandibular joints
      to assess the presence or absence, stage, and activity of suspected internal
      derangement(s). Patients were divided into stable and unstable deformity groups
      based on the presence or absence of change in their facial contour and/or
      occlusal disturbances in the 24 months prior to evaluation. Each of the 58
      unstable and 30 of 42 stable patients were found to have internal derangements of
      at least one temporomandibular joint. The degree of joint degeneration directly
      paralleled the severity of retrognathia in most cases. We concluded that
      temporomandibular joint internal derangement is common in cases of mandibular
      retrusion and leads to the facial morphology in a high percentage of patients.
      Preoperative temporomandibular joint imaging with MRI is recommended prior to
      orthognathic surgical correction of retrognathic deformities.

PMID- 1631215
TI  - The L short-scar mammaplasty: a new approach.
AB  - An improved L mammaplasty technique was employed in 178 patients aged 13 to 55
      years, with reductions of up to 1280 gm per breast, with small, well-positioned,
      and undistorted scars. I have obtained a satisfactory final shape of the breast
      with no major complications over a 3-year follow-up period. The markings are
      based on chest width and on the quantity of skin that will remain. The technique
      allows the surgeon to remove more skin, and it is indicated for minor, moderate,
      and large hypertrophies, as well as for ptotic and asymmetrical breasts. The
      resection comprises skin and mammary tissue from the inferior and middle portions
      of the breast, preserving the main lactiferous ducts. In case of hypertrophic
      breasts, the base is removed, preserving the branches of the lateral cutaneous
      nerves, which derive from the third, fourth, and fifth intercostal nerves.

PMID- 1631216
TI  - A clinical comparison of the tendency to capsular contracture between smooth and
      textured gel-filled silicone mammary implants.
AB  - The aim of this prospective, controlled clinical investigation was to find out if
      there is a difference in the capsular contracture rate between silicone implants
      with a smooth or textured surface as the only difference. Twenty-five women with
      bilateral mammary hypoplasia underwent mammary augmentation. All got a textured
      implant on one side and a smooth implant on the other. The implants were placed
      subglandularly. Follow-up examinations were done on six occasions. Three
      parameters were used for estimation of the tendency to capsular contracture: (1)
      the patient's opinion on differences in hardness of the breasts, (2) the
      investigator's classification of capsular contracture, and (3) applanation
      tonometry. At the end of the follow-up period, after 1 year, all parameters
      showed with no doubt that the breasts augmented with textured implants had a
      lower tendency to develop contracting capsules than the breasts augmented with
      smooth implants.

PMID- 1631217
TI  - Immediate breast reconstruction: why the free TRAM over the conventional TRAM
      flap?
AB  - Use of the transverse rectus abdominis myocutaneous (TRAM) flap for immediate
      breast reconstruction is controversial because of fear of flap loss and concern
      that a high complication rate could interfere with adjuvant therapy. One common
      complication of the TRAM, partial flap necrosis, can interfere with both
      institution of postoperative therapy and evaluation for recurrence. In an attempt
      to minimize this problem, we began using the free TRAM flap based on the inferior
      deep epigastric vessels. This study compares our experience with conventional
      superior-pedicled (cTRAM) flaps and free TRAM (fTRAM) flaps. A total of 68
      breasts were reconstructed in 63 patients, of which 48 of 68 (71 percent) were
      conventional TRAM flaps and 20 of 68 (29 percent) were free TRAM flaps. Of the 48
      conventional TRAM flaps, 26 (54 percent) were unipedicled and 22 (46 percent)
      were bipedicled. There were 39 of 48 (81 percent) conventional TRAM flaps and 17
      of 20 (85 percent) free TRAM flaps with T1 or T2 lesions. Node-positive patients
      occurred in 14 of 48 (29 percent) conventional TRAM flaps and 2 of 20 (10
      percent) free TRAM flaps. One-fourth of patients in both groups smoked
      cigarettes. Twenty-one of 48 patients (44 percent) with conventional TRAM flaps
      required postoperative chemotherapy, and 6 of 21 (29 percent) were delayed
      because of complications of the TRAM flap. Of the 7 of 20 (35 percent) free TRAM
      flap patients who required post-operative chemotherapy, only 1 of 7 (14 percent)
      was delayed because of TRAM flap complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631218
TI  - An anatomical basis for prognosis of malignant melanoma.
AB  - Clinical observations during surgery have led us to speculate that an anatomic
      basis may in fact exist for the poor prognosis associated with malignant melanoma
      arising in certain recognized "high-risk" areas. In our study we have treated and
      followed 45 patients with primary malignant melanoma for over 5 years. During the
      course of treatment, we identified variations in anatomic characteristics at the
      tumor sites. Criteria were established for high- and low-risk locations by the
      neurovascular structure encountered. We speculate that these sites that have
      neurovascular windows provide a readily accessible vascular pathway for the
      dissemination of malignant cells to deeper visceral structures and may account
      for the poor prognosis associated with primary lesions in these locations. Thirty
      patients were classified as being at high risk for developing metastasis, whereas
      13 were classified as being at low risk; 2 patients were in a special-risk
      category. To date, 12 of the 30 patients with "high-risk" melanoma have gone on
      to develop metastatic disease, which represents 40 percent of that group, whereas
      none of the patients classified as "low risk" have developed metastases during
      the same period.

PMID- 1631219
TI  - The extended V-Y flap.
AB  - The extended V-Y flap is a modification of the V-Y advancement flap, which is
      very useful in closing defects following excision of facial lesions. The
      modification involves the addition of an extension limb onto the advancing edge
      of the standard flap. This limb is located adjacent to the area requiring
      reconstruction and is hinged down as a transposition flap on the end of the V-Y
      advancement flap to close the most distal portion of the defect. The extended V-Y
      flap has been found to be very effective in closing large defects in areas that
      typically have inadequate subcutaneous tissue to allow extensive mobilization of
      the standard V-Y advancement flap. It has been used effectively with excellent
      cosmetic results in the temporal, scalp, forehead, and nasal areas, providing a
      well-contoured and aesthetically pleasing reconstruction.

PMID- 1631221
TI  - Full-thickness skin wound explants in tissue culture: a mechanical evaluation of
      healing.
AB  - This study was designed to evaluate biomechanically defined wound healing in full
      thickness skin explants in tissue culture. The requirement for preculture
      incubation of wounds in situ was characterized. Full-thickness skin incisions
      were made in 44 rats and closed immediately. Wounds were incubated in situ for 0,
      12, 24, 36, 48, 72, or 96 hours before harvesting and placement into tissue
      culture media for 6 weeks. Healing was evaluated by biomechanical criteria:
      tensiometric distraction to wound rupture generated true stress and energy
      absorption data. Burst-strength (maximum true stress) and toughness (energy
      absorption) were five times higher in the 48-hour group than in any other group;
      other groups were not different from each other. This study demonstrates long
      term survival of full-thickness skin in culture and shows that full-thickness
      skin explants heal in tissue culture. Possible explanations for the narrow window
      of opportunity for harvest (48 hours, no more and no less) are discussed.

PMID- 1631220
TI  - Prevention of microvascular thrombosis with low-dose tissue plasminogen
      activator.
AB  - In a blind, randomized study, two groups, each of seven rabbits, were treated
      with either a very low dose of human melanoma cell line-derived tissue-type
      plasminogen activator (t-PA) or isotonic saline. t-PA (0.067 mg/kg of body
      weight) was administered intraaortically, 20 percent being given as a 30-second
      "bolus" infusion just prior to the reperfusion of intimectomized central ear
      arteries and the rest as a continuous infusion during the next 2 hours.
      Arteriotomic bleeding times, accumulations of 32P-labeled platelets, patency, and
      sizes of thrombus deposits 2 hours after reperfusion were recorded. To confirm
      the presence of tissue plasminogen activator in plasma, fibrin-plate lysis assays
      of arterial plasma were performed immediately before and 1/2 hour and 2 hours
      after starting drug infusion. Arteriotomic bleeding times were similar in both
      groups. Transient "oozing" from wound edges occurred in 40 percent of rabbits
      treated with tissue plasminogen activator. Patency was significantly increased
      and thrombus deposits were smaller in the tissue plasminogen activator group.
      Plasma from animals treated with tissue plasminogen activator caused massive
      lysis of fibrin plates, whereas plasma from control animals caused little or no
      lysis. Platelet accumulations were very similar in both groups, indicating that
      occlusive thrombi mainly consisted of other elements than platelets (e.g., fibrin
      and red cells). Scanning electron microscopy showed normally adhering and
      aggregating platelets in both groups. This study shows that mild fibrinolytic
      stimulation with tissue plasminogen activator significantly improves patency in
      severely traumatized small-caliber arteries and indicates that such treatment may
      be one approach to prevent thrombosis at microvascular anastomotic sites.

PMID- 1631222
TI  - Where angels fear to tread.

PMID- 1631223
TI  - Juvenile breast hypertrophy: report of a familial pattern and review of the
      literature.
AB  - Juvenile hypertrophy of the breast is a relatively rare condition rapidly leading
      to gigantomastia in peripubertal females. The pathology is limited to the breast,
      with otherwise normal growth and development. We have reported the first familial
      pattern seen in this unusual condition. Ablation of the breast is always
      required. We favor reduction mammaplasty to avoid breast implants, despite the
      need for additional procedures secondary to recurrent hypertrophy. Our second
      patient provides support for this approach, demonstrating amelioration in breast
      growth despite the initial period of rapid regrowth.

PMID- 1631224
TI  - Acute repair of a full-thickness right ventricular defect with a composite
      myofascial pedicle flap.
AB  - A full-thickness defect of the right ventricle presented acutely after
      mediastinitis and sternal dehiscence. This developed 29 days after bilateral
      internal mammary artery harvest for coronary artery bypass grafting. The defect
      was managed successfully with a pedicled left rectus abdominis muscle flap using
      an attached island of the anterior rectus sheath for endocardial lining. The
      vascular anatomic basis for viability of the rectus abdominis muscle flap after
      internal mammary artery harvest is derived primarily from musculophrenic, lumbar,
      lower sixth intercostal, and subcostal artery communications. In addition, the
      advantages of a myofascial pedicle flap for reconstruction of full-thickness
      cardiac defects are its ready availability and a strong anterior fascial sheath
      that can be used as a neoendocardial lining. The patient did well and remains
      asymptomatic after 3 years.

PMID- 1631225
TI  - Augmentation of the failed pharyngeal flap.
AB  - Pharyngeal flaps are frequently used with good results to eliminate hypernasality
      and/or nasal escape. In a small percentage of patients, however, cicatricial
      contracture of the flap occurs to such a degree that velopharyngeal incompetence
      returns. The authors have devised a method of augmenting the scarred flap with
      small, superiorly based flaps lateral and adjacent to the original flap. Four
      cases are presented in which speech analysis was conducted prior to the procedure
      and then for 9 to 24 months postoperatively. The postoperative speech results are
      all within normal limits.

PMID- 1631226
TI  - Flap models in the rat: a review and reappraisal.
AB  - The laboratory rat has long provided plastic surgical investigators a model to
      study many aspects of flap physiology. Clinical advances in reconstructive
      surgery have succeeded or preceded experimental work, setting the stage for
      further advances. We have critically reviewed all reports of flap models in the
      laboratory rat. This has begun with simple skin flaps designed on various areas
      of the body and continued with a review of free-tissue transfer models. Because
      of the multitude of as yet unanswered questions remaining, the laboratory rat
      will invariably continue to be widely used as an investigatory source in this
      area. This report should allow investigators to select more easily reliable,
      reproducible experimental models, and, one hopes, to streamline their
      investigative efforts.

PMID- 1631227
TI  - Hirsutism.

PMID- 1631228
TI  - Plastic surgery and psychotherapy in the treatment of psychologically disturbed
      patients.

PMID- 1631229
TI  - Cutis aplasia.

PMID- 1631230
TI  - Human bites of the hand.

PMID- 1631231
TI  - Decompression of ophthalmopathy.

PMID- 1631232
TI  - Not augmenting the opposite breast after postmastectomy reconstruction.

PMID- 1631233
TI  - The use of bacitracin ointment to avoid shaving the scalp for rhytidectomy.

PMID- 1631234
TI  - Could tight breast capsules "squeeze" a significant amount of silicone gel out of
      an implant?

PMID- 1631235
TI  - The fan principle in skin flaps.

PMID- 1631236
TI  - Posterior auricular keloids as a complication of conchal cartilage grafts in
      blacks.

PMID- 1631237
TI  - Intraoral versus intranasal approach to lateral osteotomy.

PMID- 1631238
TI  - Breast implants, the FDA, and trial lawyers.

PMID- 1631240
TI  - Breast implants and life's dangers.

PMID- 1631239
TI  - Suprapubic "intracath" cystostomy.

PMID- 1631241
TI  - The conventional and low-bleed implants for augmentation mammaplasty.

PMID- 1631242
TI  - Endonuclease A degrades chromosomal and plasmid DNA of Escherichia coli present
      in most preparations of single stranded DNA from phagemids.
AB  - With E. coli, large and variable amounts of chromosomal and plasmid DNAs are
      observed in the supernatants of overnight cultures when the cells carry an endA
      mutation, but are not detected by gel electrophoresis when the cells carry the
      wild type allele of endA. Significant amounts of nuclease activity in DH11S endA+
      supernatants were detected by two simple assays; the rapid degradation of added
      pBR322 plasmid DNA, as judged by agarose gel electrophoresis, and a decrease of
      more than 100000 fold in transformation efficiency of the added pBR322 plasmid
      DNA. By employing isogenic endA mutant and wild type strains of DH11S and
      DH10B/F' proAB+ laclq Z delta M15, it was shown that detectable levels of
      chromosomal and plasmid DNAs are observed only in the endA mutant strains. These
      results indicate that Endonuclease I activity is responsible for degradation of
      chromosomal and plasmid DNA usually present in preparations of ssDNA. Therefore,
      a wild type endA gene is useful for the rapid and simple production of highly
      purified ssDNA from cells containing phagemid vectors.

PMID- 1631243
TI  - Removal of copper ion by Pseudomonas spp.
AB  - Copper-resistant Pseudomonas sp. 41Y, Pseudomonas pseudomallei 13-1 and
      Pseudomonas aeruginosa 7 were used in the present study. When the latter two
      organisms were added to copper-containing 1/3 strength Tryptic Soy Broth, more
      than 99.5% of the copper ion was removed from the medium within 24 h. If copper
      solution was added to hog waste slurry, a reduction in the copper ion
      concentration could be detected only when the added bacteria started to grow in
      it, whereas in a mineral medium supplemented with glycerol-2-phosphate, both
      bacteria could remove about 50% of the copper ion from the medium within 24 h.
      When cell suspension of Pseudomonas sp. 41Y was autoclaved, no copper ion removal
      was observed. Different incubation temperatures, including 30 degrees C, 37
      degrees C and 45 degrees C, had no effect on the percent of copper ion removed by
      both Pseudomonas sp. 41Y and P. pseudomallei 13-1. On the other hand, if the pH
      value of the solution was lowered from 8.2 to 6.0, there was a drastic decrease
      in copper removal. A similar reduction of copper ion removal ability was also
      observed with the addition of lead ion. When cells of Pseudomonas sp. 41Y were
      embedded in sodium alginate, there was a decrease in its ability to remove copper
      ion as compared to the free-living cells.

PMID- 1631244
TI  - Fate of the autologous tri-cusp-valved pericardial conduit in the right
      ventricular outflow tract of growing pigs.
AB  - No perfect valve or valved conduit is currently available to reconstruct the
      right ventricular outflow tract (RVOT) in pediatric patients. To investigate the
      fate of autologous pericardial valved conduit, twenty piglets weighing 12.2 +/-
      1.4 kg were divided into two groups. In 10 of them, the pericardium was immersed
      in 0.6% glutaraldehyde for 5 minutes (Gr PG) and then washed with normal saline.
      In the other 10 pigs, the pericardium was immersed in normal saline only (Gr PN)
      after procurement. Afterwards the autologous pericardium was tailored as designed
      to build a tri-cusp-valve inside the pericardial conduit with reconstruction of
      the sinus of Valsalva. This conduit was connected to the pulmonary trunk (PT)
      distally and RVOT proximally without a pump. The PT was then doubly ligated just
      above the annulus. The pigs survived 114 +/- 92 days in Gr PG and 82 +/- 50 days
      in Gr PN. The body weight increased to 42 +/- 29 kg in Gr PG and 30 +/- 9 kg in
      Gr PN. No cusps adhered to the conduit wall in either group. In Gr PN, the valve
      became retracted; in 7 of them an aneurysm developed proximal to the stenotic
      pulmonary valve, while only one pig in Gr PG developed an aneurysm. In Gr PG, the
      leaflet and conduit showed evidence of growth. In contrast, no evidence of valve
      growth was found in Gr PN. Calcification was evident more in Gr PG than in Gr PN
      either on the leaflet (9/10 vs. 5/10) or in the wall of conduit (8/10 vs. 6/10),
      but the differences were not statistically significant.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1631245
TI  - Effect of infection on nutritional status.
AB  - All infections no matter how mild decrease nutrient intakes and increase nutrient
      losses even when subclinical. The losses include decreased intestinal absorption,
      direct loss of nutrients in the gut, internal diversion for metabolic responses
      to infection and increased BMR when fever is present. Infection influences in
      this way not only protein and energy status but also that of most other
      nutrients. The clinical importance of these consequences of infection depends on
      the prior state of the individual, the nature and duration of the infection and
      the diet of the individual during the infection, particularly dietary intake
      during the convalescent period and whether full recovery takes place before
      another infection occurs. In industrialized countries particular attention must
      be paid to the nutrition of hospitalized patients since they are frequently
      debilitated by their primary disease, morbidity, and their nutritional status.
      Morbidity and mortality are increased by nosocomial infections to which the
      poorly nourished individual is more susceptible.

PMID- 1631246
TI  - A new codon 31 (-C) mutant resulting in beta zero-thalassemia.
AB  - A new beta zero-thalassemia mutation, a frameshift mutation with deletion of a
      single cytosine nucleotide in codon 31, is described. The propositus, which is
      compound heterozygous for this mutation and the 17 beta A-T beta zero-thalassemia
      mutation, has the phenotype of severe beta-thalassemia major.

PMID- 1631247
TI  - Deterioration on the Blessed test in Alzheimer's disease: longitudinal data and
      their implications for clinical trials and identification of subtypes.
AB  - One hundred eleven patients with probable Alzheimer's disease (AD) were given the
      Blessed test (BT) of information, memory, and concentration (scored 0-33) at 6
      month intervals over periods of 6-96 months. For each patient, the change in the
      total BT score between pairs of visits at 6- and 12-month intervals was measured.
      Mean deterioration scores over 6 and 12 months were 2.2 (SD = 3.2) and 4.1 (SD =
      4.1) points, respectively. There was no significant correlation between degree of
      dementia on the BT and the rate of deterioration. Gender, age of onset, and
      family history had no significant effect on the rate of deterioration. The
      implications of the results for treatment trials and investigations of clinical
      heterogeneity are discussed.

PMID- 1631248
TI  - Psychiatric disorders in the families of patients with obsessive-compulsive
      disorder.
AB  - The rate of comorbid diagnoses in a group of 92 patients with obsessive
      compulsive disorder (OCD) was examined, with particular attention being paid to
      mood disorders. The family history method was used to study the frequency of
      psychiatric disorders in the patients' families and to analyze the
      characteristics of the familial loading for OCD and mood disorders. A comorbid
      diagnosis of mood disorder occurred in 35.9% of the patients. The morbidity risk
      for OCD in the patients' families accounted for 3.4%; when 21 patients with an
      age of onset under 14 were examined, the morbidity risk in first degree relatives
      reached 8.8%. This tendency did not appear to be true for mood disorders.

PMID- 1631249
TI  - Neopterin production in acute schizophrenic patients: an indicator of alterations
      of cell-mediated immunity.
AB  - This longitudinal study analyzed how the activation of cell-mediated immunity
      (CMI) was related to the severity of symptomatology in 25 acute schizophrenic
      inpatients (DSM-III-R, 295.31). Neopterin, which was used to monitor the
      activation of T-cells and macrophages, was found to be within the normal range,
      but the lowest neopterin concentrations were measured on day 0. By day 3, a
      significant increase of neopterin was observed. Compared with healthy controls,
      patients had significantly lower neopterin levels at baseline. The highest scores
      on the Clinical Global Impressions Scale and the Brief Psychiatric Rating Scale
      occurred on day 0 and decreased significantly over the observation period. In
      general, the increase of neopterin was accompanied by a decrease in
      psychopathological symptoms. These results' indicate that at study entry, when
      patients are acutely ill, activation of the CMI is reduced rather than increased.
      Possible pathophysiological mechanisms are discussed.

PMID- 1631250
TI  - Level of haloperidol in plasma is related to electroencephalographic findings in
      patients who improve.
AB  - This study analyzed interrelationships among plasma level of haloperidol (HAL),
      electroencephalographic (EEG) changes, and clinical response in 37 acutely
      exacerbated schizophrenic patients after a 6-week period of treatment. Two
      hypotheses were tested: (1) EEG theta response to HAL depends on levels of HAL in
      plasma, and this relationship is expressed in patients showing a clear clinical
      response (responders). (2) Responders and nonresponders are characterized by a
      different neuroleptic EEG profile. EEG examinations (resting, waking EEG) were
      performed at study entry, end point of the placebo period ("baseline"), and
      weekly during the entire HAL treatment period. EEG response was measured by power
      spectral changes in four frequency bands (delta, theta, alpha, and beta);
      clinical response was assessed by the Brief Psychiatric Rating Scale. There was a
      significant relationship between HAL plasma levels and EEG theta activity for
      treatment responders, whereas no relationship was detected for the nonresponders.
      Furthermore, there were EEG changes (in the delta and alpha bands) that depended
      on clinical response but did not show any relationship, either in responders or
      nonresponders, to HAL plasma levels. These results supported both hypotheses.

PMID- 1631251
TI  - Prolactin responses to domperidone in chronic schizophrenia.
AB  - The prolactin response to 20 mg of domperidone, a peripheral dopamine receptor
      antagonist, was evaluated in a group of 17 male, drug-free, elderly, chronic
      schizophrenic patients and 8 age-matched male normal control subjects. Both
      groups of subjects were receiving a variety of nonpsychotropic medications not
      known to affect the prolactin response to dopamine receptor antagonists. Basal
      plasma prolactin levels did not differ between the two groups. However, the
      prolactin response following domperidone was significantly greater in the
      schizophrenic patients, although plasma domperidone levels did not differ between
      the two groups. This effect is opposite to the previously reported effect of
      domperidone in young schizophrenic patients compared with age-matched control
      subjects (Nerozzi et al., 1990). The prolactin response to domperidone was
      markedly smaller in the old compared with the young normal control subjects,
      whereas the young and old schizophrenic patients had identical responses.
      Possible explanations for these results are considered, especially the
      possibility of abnormalities in the release of dopamine and pituitary D2 dopamine
      receptors in the elderly schizophrenic patients compared with age-matched normal
      control subjects.

PMID- 1631252
TI  - Patterns of comorbidity in panic disorder and agoraphobia.
AB  - Diagnoses of comorbid disorders were determined in a sample of 54 patients with
      panic disorder as defined in DSM-III-R. The sample was divided into the following
      three groups: (1) uncomplicated panic disorder (PDU); (2) panic disorder with
      mild agoraphobia (PDM); and (3) panic disorder with moderate to severe
      agoraphobia (PDA). In comparison with patients with PDU, patients with PDA had
      higher comorbidity rates in general, received multiple comorbid diagnoses more
      frequently, had a higher prevalence of major depression, dysthymia, social
      phobia, generalized anxiety disorder, and obsessive-compulsive disorder, and
      scored higher on most measures of self-rated psychopathology. These findings
      support the notion that PDA may be a disorder essentially different from PDU.

PMID- 1631254
TI  - Case of neurological and behavioral abnormalities: due to Borna disease virus
      encephalitis?

PMID- 1631253
TI  - Effects of fenfluramine on plasma HVA in OCD.

PMID- 1631255
TI  - Should we add corticosteroids to the treatment of acute bacterial meningitis?

PMID- 1631256
TI  - Primary biliary cirrhosis--from Thomas Addison to the 1990s.

PMID- 1631257
TI  - Therapeutic potential of botulinum toxin in neurological disorders.

PMID- 1631258
TI  - Clonidine therapy for Shapiro's syndrome.
AB  - Shapiro's syndrome comprises agenesis of the corpus callosum in association with
      episodic hyperhidrosis and hypothermia. We describe a 25-year-old man who is the
      twentieth case to be reported. There was no evidence of epilepsy, sympathetic
      nervous system dysfunction or inappropriate vasopressin release. However,
      investigation demonstrated a central defect in temperature regulation with an
      abnormally low hypothalamic set-point and normal homeothermic reflexes. Therapy
      with clonidine, an alpha 2-adrenoceptor agonist, was associated with remission of
      symptoms: these recurred on four occasions when clonidine was withdrawn.
      Clonidine therapy was also associated with a return to normal central temperature
      regulation. We suggest that the efficacy of clonidine reflects an action on
      hypothalamic thermoregulation rather than on peripheral catecholamine release.
      These findings have implications for the use of clonidine in other patients with
      Shapiro's syndrome and in more common disorders of temperature control, including
      perimenopausal flushing.

PMID- 1631259
TI  - Metabolic studies in kidney stone disease.
AB  - Patients with kidney stones (n = 59) and healthy controls (n = 31) collected a 24
      hour urine sample and later underwent a 6-hour 'fast and load' test in which an
      oral calcium load was taken after 2 hours. In the 24-hour urine sample, mean
      calcium excretion was higher in patients than controls, while mean urate, oxalate
      and citrate levels were similar. The patients had higher levels of fasting plasma
      calcium, serum calcitriol and fasting urinary calcium, and lower levels of plasma
      phosphate than did the controls. Following the calcium load, plasma and urinary
      calcium increased similarly in both groups. Serum parathyroid hormone (PTH)
      levels were similar in both groups and decreased similarly following the calcium
      load. Multiple linear regression, relating the presence or absence of stone
      formation to all variables, found the only variables significantly related to
      stone formation to be plasma levels of calcium (p less than 0.001) and phosphate
      (p = 0.001) and fasting urinary urea (p less than 0.001), and 24-hour urinary
      calcium excretion (p less than 0.05). Urinary oxalate and citrate were not
      related to stone formation. The data do not support the hypothesis that primary
      stimulation by calcitriol produces a normal fasting plasma calcium level, with an
      exaggerated increase after an oral calcium load. The findings instead suggest an
      abnormality of parathyroid cell 'set point', such that PTH secretion continues
      until the plasma calcium level is a little higher and the phosphate a little
      lower than in controls.

PMID- 1631260
TI  - A quest for the relief of atherosclerosis: potential role of intrapulmonary
      heparin--a hypothesis.
AB  - Recent progress in the treatment of coronary artery disease is reviewed from the
      standpoint of changes in lifestyle, surgical techniques to revascularize the
      myocardium and a variety of medical interventions. Among the medical modalities,
      heparin appears to have a greater potential than any other agent tested to
      neutralize the atherogenic process at most of its stages. This potential is
      supported by success in clinical trials of heparin administered by intravenous,
      subcutaneous, pulmonary, sublingual and topical routes. The suggested self
      administration of low-dose heparin by inhalation appears to be well justified and
      easily adaptable to home therapy. The summarized evidence suggests the need for
      further clinical trials to test the use of heparin in the prophylaxis of
      atherosclerotic disease.

PMID- 1631261
TI  - Assessment of gall bladder dynamics, cholecystokinin release and the development
      of gallstones during octreotide therapy for acromegaly.
AB  - The development of gallstones is a well recognized complication of therapy with
      the long-acting somatostatin analogue, octreotide in patients with acromegaly. A
      group of nine acromegalic patients was treated with octreotide at doses of 300
      600 micrograms daily for 8 months and the changes in fasting and post-prandial
      cholecystokinin release, and gall bladder motor function (determined by a
      radiosotopic technique) were assessed at regular intervals. In addition the
      development of any gallstones was determined by serial ultrasonography. Fasting
      cholecystokinin levels showed no significant change over 6 months, whereas the
      post-prandial levels demonstrated a significant decrease (p less than 0.01)
      during therapy, yet remained significantly higher than fasting levels. Twenty
      four hours after commencing therapy gall bladder ejection fraction was decreased
      by 57 +/- 23 per cent and gall bladder ejection rate decreased by 63 +/- 19 per
      cent compared to the pretreatment values, whereas after 6 months' therapy a
      marked reduction in gall bladder ejection fraction (greater than 35 per cent) and
      gall bladder ejection rate (greater than 40 per cent) persisted in only four of
      nine patients. Three of these four patients with persistently impaired gall
      bladder motor function were subsequently shown to have developed either
      gallstones or biliary sludge during the course of therapy. We conclude that
      treatment with octreotide is associated with an impaired post-prandial release of
      cholecystokinin in all acromegalic patients, but gallstones only develop in those
      patients who, in addition, have evidence of a persistently impaired gall bladder
      motor response to cholecystokinin.

PMID- 1631262
TI  - Delirium in newly admitted elderly patients: a prospective study.
AB  - The prevalence, associated conditions and outcome of delirium were studied in a
      consecutive series of 184 patients admitted with acute illness to a department of
      health care of the elderly. Forty of these elderly subjects (22 per cent) met
      Diagnostic and Statistical Manual version 3 (revised) criteria for delirium.
      Screening for delirious patients using the abbreviated mental test on admission
      gave a high sensitivity (92 per cent). The conditions most commonly associated
      with delirium were infection and stroke. Onset of acute illness of less than 15
      days, a reported history of dementia or recent confusion, and presence of a
      definite site of infection were much more likely in those with delirium. Serial
      use of the abbreviated mental test was a sensitive means of distinguishing
      delirious from other patients and may be useful in both the clinical and research
      setting. Delirious patients had more serious pre-existing disease than non
      delirious patients. They had a higher number of admissions during the 2 years
      prior to the index admission, a higher mortality rate and a higher rate of
      transfer to long-stay care than other patients, but no difference in duration of
      admission. All acutely ill elderly people should undergo an abbreviated mental
      test on admission, and if abnormal, this should be repeated as it will aid
      detection of delirium.

PMID- 1631264
TI  - The morbidity of multiple sclerosis.
AB  - Although the clinical course of multiple sclerosis is benign in up to one-third
      of patients, it is important to recognize the high rate of morbidity in others.
      Most individuals pass through a remitting phase but in a significant proportion
      the clinical manifestations subsequently recur, persist or slowly progress, and
      disability accumulates with time. Here we describe the frequency and spectrum of
      morbidity in a population based cohort of patients with multiple sclerosis. These
      statistics will guide those providing health care resources and planning services
      for patients with multiple sclerosis.

PMID- 1631265
TI  - Iatrogenic exfoliation of a tooth following abuse of a rubber dam: a case report.
AB  - This report presents a case in which tooth exfoliation followed rubber dam abuse.
      A 40-year-old patient was referred to the prosthodontic clinic with complaints of
      mobility and discomfort in tooth 44, which had received an amalgam restoration.
      While this tooth was scaled, a piece of rubber dam appeared in the buccal sulcus.
      Removal of the rubber piece was followed by thorough scaling and tooth splinting.
      Tooth deterioration continued, and concern for the adjacent teeth necessitated
      extraction of tooth 44. To avoid such undesirable consequences, the integrity of
      the dam should be verified on its removal.

PMID- 1631263
TI  - Lupus nephritis and pregnancy.
AB  - Sixty-four pregnancies in 41 women with biopsy proven lupus nephritis between
      1965 and 1991 were analysed to record fetal and maternal outcome and identify
      risk factors for poor outcome. Of 65 fetuses, 22 (34 per cent) were lost
      (including therapeutic abortions), 19 (30 per cent) were live born but premature
      (less than or equal to 36 weeks gestation) and 24 (37 per cent) were term. Fetal
      loss after 20 weeks gestation was 19 per cent. Twelve per cent of 25 fetuses
      whose birthweight was recorded were small for gestational age. Maternal renal
      function deteriorated in 19 per cent of pregnancies but was irreversible post
      partum in only one woman (2 per cent). Hypertension was recorded in 44 per cent
      of pregnancies, developed early (less than or equal to 32 weeks gestation) in 28
      per cent and was severe in 13 per cent. Treated hypertension predated 17 per cent
      of pregnancies and in 6 per cent (included in the overall incidence of
      hypertension) exacerbation occurred during pregnancy despite continued anti
      hypertensive medication. Nine women (22 per cent) who developed de novo
      hypertension in pregnancy had permanent hypertension post-partum. Increased
      proteinuria was recorded in 48 per cent of pregnancies and was irreversible post
      partum in 5 per cent. Comparison of pregnancies occurring before or after
      diagnosis was made by renal biopsy failed to show any significant difference in
      fetal outcome. Pregnancies occurring after the diagnosis of glomerulonephritis
      were associated with a significantly lower incidence of maternal hypertension,
      early hypertension, severe hypertension and increased proteinuria. The presence
      of the circulating lupus anticoagulant was clearly associated with a
      significantly high fetal loss rate although the incidence of maternal
      complications did not differ significantly between mothers positive or negative
      for lupus anticoagulant.

PMID- 1631266
TI  - Cardiovascular effects of local anesthesia with epinephrine in periodontal
      treatment.
AB  - To assess if the association of epinephrine with local anesthesia involves
      cardiovascular risks, 14 patients undergoing periodontal treatment were observed.
      Systolic and diastolic blood pressures and mean and maximal heart rates were
      analyzed. The comparison of basal and postanesthetic periods revealed a trend
      (nonsignificant) toward an increase in systolic blood pressure and a small,
      statistically significant increase in diastolic blood pressure; the heart rate
      increased in only a few patients, and never by more than 10 beats/min. The whole
      group showed a statistically significant reduction in mean and maximal heart
      rates from the basal period to an end-session period. Thus, in these patients,
      the given epinephrine doses resulted in negligible changes in heart rate and
      blood pressure. The reduction in heart rates at the end of treatment underlines
      the important role of the autonomic nervous system in the modulation of the
      cardiovascular response during dental sessions.

PMID- 1631267
TI  - Slip-casting alumina ceramics for crown and bridge restorations.
AB  - The In-Ceram technique uses alumina ceramics and glass in a two-step firing
      procedure to create a high-strength core material for single-tooth restorations
      as well as small fixed partial dentures. Fine-grain alumina particles are
      sintered to form a porous substructure, which is infiltrated with molten glass.
      The combination of these two processes gives the material its outstanding
      properties. The sintering process is almost without shrinkage, providing an
      excellent fit, while the glass infiltration leaves practically no porosities,
      resulting in high strength.

PMID- 1631268
TI  - Intentional replantation of a removable partial denture abutment tooth: a case
      report.
AB  - Intentional tooth replantation is a last-resort procedure, recommended only when
      all other techniques, short of tooth extraction, have been exhausted or are
      impractical. Although most endodontic textbooks describe the procedure, and many
      reports of intentional replantation have appeared in the dental literature, none
      have reported use of the technique to retain a removable partial denture abutment
      tooth. This article presents such a case and the rationale for the decision to
      intentionally replant. Eighteen-month follow-up clinical and radiographic results
      are presented.

PMID- 1631269
TI  - Resin bonding to wet substrate. 1. Bonding to dentin.
AB  - An in vitro study was undertaken to evaluate the ability of a dentin-enamel
      bonding system to bond to wet, as well as to dry, dentinal substrate. The All
      Etch/All-Bond system was used to bond to wet and dry dentin using 10% and 37%
      phosphoric acid surface conditioning. The wet dentinal surfaces exhibited
      significantly higher bond strengths than did the dry surfaces. It is suggested
      that, because of the unique behavior of the resin-primer mixture, the dentinal
      surface is adapted to much more thoroughly and intimately when the surface is
      wet.

PMID- 1631270
TI  - The dentinal surface: its influence on dentinal adhesion. 2.
AB  - The first paper in this series presented a categorization of dentinal adhesive
      systems that was organized roughly according to chronology, chemistry, and shear
      bond strength values. Category I dentinal adhesives demonstrate the lowest shear
      bond strength values, approximately 5 to 7 MPa. Category II dentinal adhesives,
      including experimental ferric and aluminum oxalate pretreatments and two
      commercial products, demonstrate shear bond strength values between 8 and 14 MPa.
      This second category of dentinal adhesives is the subject of this paper. An
      attempt is made to draw a parallel between the penetrative ability of the
      adhesive (the wettability of the dentinal substrate) and the efficacy of the
      adhesive bond as determined by shear bond strength values. Category III dentinal
      adhesives will be discussed in another paper.

PMID- 1631271
TI  - Use of self-curing composite resins to facilitate amalgam repair.
AB  - Resin cements, which have been shown to adhere to various metal alloys, were
      investigated as possible repair adhesives for dental amalgam. Test bars of
      repaired amalgam, formed by condensing new alloy against previously set alloy
      with or without the use of "adhesive" resins, were subjected to three-point
      bending measurements of transverse fracture strength. The results indicated that
      application of adhesive resin did not improve the breaking strength of the
      repaired specimens from that of specimens prepared without the use of such
      resins. The breaking strength of all repaired specimens was approximately 15% of
      the transverse fracture strength of the original intact amalgam bars. Scanning
      electron microscopy revealed that there was an intermixing of fresh amalgam and
      unset interfacial resin, which led to mechanical bonding of these materials, but
      there was no evidence of adhesion of the resin to the previously set amalgam.

PMID- 1631272
TI  - Surface topography of demineralized dentin preceded by formalin fixation.
AB  - Formalin treatment of dentin, prior to burnishing demineralization, results in a
      "tufted" collagen surface that may optimize bonding of hydroxyethyl methacrylate
      dentinal bonding agents. The purpose of this study was to determine if there is a
      clinically acceptable formalin treatment time that will yield a deeply tufted
      collagen surface. The exposed dentin of periodontally healthy and periodontally
      diseased human teeth was treated with formalin for various treatment times before
      "burnishing" demineralization with citric acid. Photographs of the specimens
      revealed that there was a statistically significant difference in the number of
      tufted surfaces found in the healthy group, as a whole, and the number found in
      the diseased group. No statistically significant difference was found among
      fixation times within either tooth group. It was concluded that 2 minutes of
      fixation was sufficient to produce a tufted fibrillar surface.

PMID- 1631273
TI  - Shear bond strengths of prosthodontic adhesive systems to a nickel-chromium
      beryllium alloy.
AB  - Panavia, a composite resin luting agent containing phosphate monomers, bonds
      chemically to air-abraded base metal alloys and is particularly suited for
      cementing resin-bonded retainers. Another adhesive methodology (Silicoater
      system) incorporates a pyrolytically applied silica layer to metal substrates to
      promote bonding of a resin adhesive. The object of this study was to compare
      prosthodontic adhesive systems that incorporated the Silicoater system and/or
      Panavia. The results showed that the surface treatment that provided
      significantly higher shear bond strengths was the Silicoater system and a layer
      of unfilled resin. A second test evaluated use of Panavia as a metal opaquing
      material beneath laboratory light-curing resins. Results showed that Panavia
      Opaque material was displaced peripherally during placement of overlying
      laboratory composite resin veneers. This resulted in an uneven intermediate layer
      of Panavia.

PMID- 1631274
TI  - The combined composite resin and amalgam restoration for posterior teeth: a
      clinical report.
AB  - This paper presents a technique for restoring maxillary posterior teeth with a
      combined composite resin and amalgam restoration when the preparation extends
      buccally into an esthetically critical area. This technique has two major
      advantages over traditional combined restorations: it requires only one clinical
      appointment, and it provides an esthetically acceptable result while maintaining
      the advantages of an amalgam restoration. A clinical assessment of 12 of these
      restorations, in vivo for 0.8 to 6.4 years, is presented. All but one restoration
      received a score of excellent or acceptable.

PMID- 1631276
TI  - The female pelvis.

PMID- 1631275
TI  - Transvaginal sonography of normal pelvic anatomy.
AB  - The major structures of interest in the pelvis for sonography are the uterus and
      ovaries. TVS, with its superior imaging characteristics, provides better
      sonographic detail of this anatomy and improves our diagnostic capabilities. It
      is certainly reasonable to expect this approach to yield even greater
      improvements in the future as the refinements to the technology continue to
      evolve.

PMID- 1631277
TI  - Transvaginal sonography of adnexal masses.
AB  - In conclusion, the clinical utility of TVS has expanded since its inception so
      that numerous gynecologic applications now exist. TVS has most certainly had a
      major impact upon the diagnosis of adnexal disease. The addition of duplex and
      color Doppler capability to vaginal probes has expanded further the scope of TVS.
      In our laboratory, TVS is used as an adjunctive tool to complement TAS in cases
      of inadequate bladder distention, incomplete evaluation of the pelvis, and
      equivocal findings that require improved visualization for diagnosis. TVS is now
      recognized as the procedure of choice in the evaluation of patients who have a
      suspected ectopic pregnancy. It also can be used as the initial procedure in the
      follow-up of a known adnexal process. This article has emphasized how TVS can
      contribute to the diagnosis of cystic, complex, and solid adnexal masses. With
      continued technologic advancements, additional applications for TVS are likely to
      emerge.

PMID- 1631278
TI  - Conventional and color Doppler transvaginal sonography in gynecologic
      infertility. Current clinical applications.
AB  - TVS affords accurate follicular monitoring and guidance for follicular
      aspiration. The role of TVS in assessing the adequacy of the endometrium is still
      undergoing investigation. Our studies suggest that there is a statistically
      significant difference in the pregnancy rate when the endometrium has a
      multilayered appearance. Infertility patients who successfully achieve pregnancy
      should be monitored with TVS because of a higher incidence of ectopic pregnancy,
      anembryonic gestation, and spontaneous abortion. TVS has a secondary role in
      evaluating certain uterine malformations and tubal disorders. With TV-CDS it is
      also possible to evaluate physiologic parameters such as adnexal and uterine
      blood flow. The role of TV-CDS in the anatomic and physiologic evaluation of
      early pregnancy is now being established.

PMID- 1631279
TI  - Transvaginal ultrasonography of pelvic neoplasms.
AB  - The recent development of the high resolution transvaginal probe has increased
      the diagnostic sensitivity and specificity of transabdominal sonography. This
      article reviews the applications of transvaginal sonography with pulsed and color
      flow Doppler imaging to the diagnosis and management of uterine, ovarian, and
      metastatic pelvic neoplasms.

PMID- 1631280
TI  - Doppler ultrasonography of the pelvis.
AB  - TVS has brought the pelvic organs closer to us than ever before. Color Doppler
      probes have exposed small vessels that could not be seen with real-time technique
      alone, and pulsed Doppler is becoming an important adjunct in many physiologic
      and pathologic states. Vascular changes of the ovary and uterus during the
      menstrual cycle are now being followed during infertility protocols, are being
      investigated to determine the viability of an early pregnancy, and may increase
      our confidence in the diagnosis of an ectopic pregnancy in a few selected cases.
      Waveform analysis may be useful in discriminating benign from malignant uterine
      masses, and additional work in the diagnosis of pelvic thrombophlebitis and
      ovarian torsion is anticipated. Color Doppler sonography has an important role to
      play in the diagnosis of early ovarian cancer. A large multicenter trial is
      ongoing in this country to determine if there is a characteristic PI that will
      determine whether an adnexal mass is benign. While much of this work is
      preliminary, TV-CDS has tremendous potential in the assessment of pelvic disease.

PMID- 1631282
TI  - Transvaginal ultrasonography in postmenopausal patients.
AB  - Clearly, TVS has become an important adjunctive procedure in the evaluation of
      suspected gynecologic disease in postmenopausal women. In our laboratory, the
      additive value of TVS is approximately 50% in this population. A preliminary
      diagnosis on TAS may be completely altered--an abnormal finding better
      characterized or an equivocal lesion confirmed with certainty. Further
      investigative studies are required to establish firmly the indications for TVS in
      postmenopausal women.

PMID- 1631281
TI  - Ultrasonography of the female pelvis in childhood and adolescence.
AB  - The age of the patient is crucial in the consideration of differential diagnoses
      for pelvic disease. This is especially true in the pediatric population.
      Ultrasonography is the first, and often only, imaging required for female babies,
      children, and young adults who present with signs and symptoms referable to the
      pelvis. Usually, children come to attention because of pelvic mass, pelvic pain,
      ambiguous genitalia, or abnormal sexual development. It should be remembered that
      congenital anomalies may not become apparent until the onset of puberty. In all
      cases, good practice requires that adnexal and uterine anatomy and screening
      views of each kidney are documented on hard copy. Further evaluation, which
      consists of MR or CT scanning, depends on the results of the ultrasonograms, the
      clinical examination, and acuity of the problem.

PMID- 1631283
TI  - Magnetic resonance imaging of the normal female pelvis.
AB  - MR imaging has emerged as an important modality in the evaluation of the female
      pelvis as a result of the detailed demonstration of normal anatomy. Tissue planes
      within the uterus, cervix, vagina, and ovaries are clearly delineated, thus
      enabling a better understanding of normal anatomy and, therefore, pathology.

PMID- 1631284
TI  - Benign disease of the uterus and ovaries. Applications of magnetic resonance
      imaging.
AB  - Because of its relatively low cost, widespread availability, and patient
      tolerance ultrasound remains the primary modality for imaging the female pelvis.
      Nevertheless, MR imaging can contribute to cost-effective management in women who
      have suspected myomas or adenomyosis by establishing the diagnosis noninvasively.
      It can also improve management and reduce costs by providing precise presurgical
      mapping prior to myomectomy or correction of mullerian duct anomalies. In these
      instances, other tests such as hysterosalpingography and laparoscopy may be
      obviated if fallopian tube disease is not strongly suspected. MR imaging is also
      valuable in patients in whom suspected adnexal masses are not detected
      sonographically or in whom definitive diagnosis of juxta-uterine myoma, cystic
      teratoma, or hemorrhagic mass may alter management.

PMID- 1631285
TI  - Evaluation of gynecologic malignancy by magnetic resonance imaging.
AB  - Currently, MR imaging has demonstrated the greatest accuracy and has potentially
      the greatest clinical utility for the staging of cervical carcinoma. Endometrial
      carcinoma also can be staged by MR imaging with reasonable accuracy, although the
      clinical indications for preoperative endometrial carcinoma staging are less
      clear. MR imaging has unparalleled capacity for the tissue characterization of
      adnexal disease and has demonstrated utility for diagnosis of common adnexal
      masses such as pedunculated leiomyoma, endometrioma, and ovarian dermoid. Its use
      in the evaluation or staging of ovarian, vaginal, and vulvar carcinoma has not
      been evaluated fully. MR imaging can demonstrate complications of radiation
      therapy and surgery and can distinguish most recurrent carcinomas from
      postradiation fibrosis. New techniques such as arrayed use of surface coils,
      endoluminal surface coils, fast spin-echo acquisitions, and contrast agents show
      promise for contributing to the already rapid pace of technologic advancement in
      the field of MR imaging of the female pelvis.

PMID- 1631286
TI  - Magnetic resonance imaging of the pediatric pelvis.
AB  - The increased use of MR imaging in the pediatric population is due to the lack of
      ionizing radiation, multiplanar imaging capability, and excellent tissue contrast
      differentiation. MR imaging is most commonly indicated in the evaluation of
      tumors to provide information about resectability and extent of lesions. It is
      also useful in the evaluation of congenital anomalies of the pelvic organs. This
      is a rapidly changing field; the development of fast-scanning techniques and
      contrast agents for the bowel should further improve the utilization of MR
      imaging in pediatrics.

PMID- 1631287
TI  - Computed tomography of gynecologic neoplasms.
AB  - Both CT and MR imaging have had a major impact on gynecologic oncologic imaging,
      and new technology and imaging techniques are still being introduced. CT
      maintains a role in gynecologic pelvic cancer imaging because of cost
      effectiveness, high spatial resolution, fast examination time, and wide
      availability. CT is particularly advantageous for lymph node metastasis screening
      and guided-biopsy of metastases and recurrent tumor. CT currently is recommended
      for primary staging of ovarian cancer and advanced cancers of the cervix and
      endometrium, detection of persistent and metastatic gestational trophoblastic
      disease, and evaluation of recurrent gynecologic pelvic cancers.

PMID- 1631288
TI  - Computed tomographic evaluation of benign and inflammatory disorders of the
      female pelvis.
AB  - The use and importance of CT in the evaluation of patients who have inflammatory
      conditions of the pelvis has increased in recent years. Although its role may be
      limited in women of childbearing age, CT may provide definitive diagnostic
      information concerning benign pelvic masses frequently present in this age group.
      CT is particularly valuable in detecting infectious complications in the
      postpartum and postoperative pelvis. In patients who have known or suspected
      inflammatory conditions of the bowel, CT is the imaging modality of choice to
      identify extraluminal complications such as abscess formation. CT is frequently
      diagnostic in cases of diverticulitis and appendicitis and is of recognized value
      in guiding percutaneous drainage procedures, often sparing emergent surgical
      intervention.

PMID- 1631289
TI  - Computed tomography and magnetic resonance imaging of the female lower urinary
      tract.
AB  - Computed tomography (CT) and magnetic resonance (MR) imaging have become
      invaluable imaging modalities in the diagnosis of diseases involving the lower
      urinary tract. Both CT and MR imaging are able to accurately stage bladder
      carcinoma, with MR imaging able to distinguish between superficial and deep
      muscle invasion of tumor. CT and MR are also the studies of choice for evaluating
      retroperitoneal fibrosis, which often affects the urinary tract; MR imaging is
      often able to detect the presence of active inflammation and occasionally rule
      out a malignant cause. MR imaging holds promise for the evaluation of stress
      urinary incontinence and urethral disease. Although diseases of the distal ureter
      continue to be most accurately diagnosed by intravenous urography and retrograde
      studies, CT and MR imaging may serve a helpful secondary role.

PMID- 1631290
TI  - Method improves consistency in L5-S1 joint space films.
AB  - This article describes a new way to determine the correct angle of the central
      ray for radiography of the L5-S1 joint space in the lateral position. The methods
      described in the most widely used positioning textbooks do not result in
      consistent results. This article provides an easy-to-apply alternative.

PMID- 1631291
TI  - An analysis of radiographic repeat and reject rates.
AB  - A literature search of the past 20 years of publications on radiographic
      repeat/reject rates located 11 reports of 48 studies. A significant unpublished
      12th report added a 49th. This article evaluates these studies to propose mean
      radiographer repeat/reject rates and reasons for economic uses in administrative
      evaluations. A comprehensive bibliography provides a resource for future repeat
      rate studies.

PMID- 1631292
TI  - Mobile mammography: the technologist's role.
AB  - This article discusses the role of the radiologic technologist in a mobile
      mammography screening program targeted at the economically disadvantaged in Dade
      County, Fla. It describes the development of process, structure and outcome
      standards used to guide and evaluate both the program and the radiologic
      technologist within this setting, highlighting the technologists' valuable
      contributions to the program.

PMID- 1631293
TI  - Radiolabeled antibodies in cancer treatment.
AB  - The use of radiolabeled antibodies may play a major role in future treatment of
      cancer patients, affecting procedural operations throughout both radiology and
      radiation therapy departments. Because of the number of different radioisotopes
      that may be used, education of medical personnel will be of critical importance.
      Adaptation of current radiology procedures may enhance this therapeutic modality.

PMID- 1631294
TI  - Nebulous nonocclusion.

PMID- 1631295
TI  - Will mammographers be ready?

PMID- 1631296
TI  - Faculty development for distance educators.

PMID- 1631297
TI  - GABAergic circuits in the mammalian retina.

PMID- 1631298
TI  - Development of GABAergic neurons in the mammalian retina.

PMID- 1631299
TI  - GABAergic circuits in the lateral geniculate nucleus of the cat.

PMID- 1631300
TI  - Inhibitory GABAergic control of visual signals at the lateral geniculate nucleus.

PMID- 1631301
TI  - The distribution and function of gamma-aminobutyric acid (GABA) in the superior
      colliculus.
AB  - Laminer analysis of the distribution of GABA and GAD in the superior colliculus
      has shown that the distribution pattern of GABA within the SC is similar in
      rabbit, cat, and guinea pig. The highest levels of GABA were found in the
      superficial gray layer (SGL), averaging 37-40 mmol/kg dry weight. The GABA
      concentrations in the deep layers were each only half that of the levels in the
      SGL. The concentrations of both GABA and GAD in the upper half of SGL are the
      same as those in the substantia nigra and medial forebrain bundle which have the
      highest amounts of GABA in the CNS. Denervation studies of the fibers projecting
      to SGL suggest that the GABA concentrated in the SGL is intrinsic to the layer.
      The results obtained from immunohistochemical and electron microscopic studies on
      the localization of GABA neurons corresponds well with the regional distribution
      pattern of GABA and GAD reported here. However, pharmacological and
      electrophysiological studies do not necessarily accord well with the GABA
      distribution studies because they indicate that there are many GABA sensitive
      neurons in both the SGL and DGL. To investigate the role of GABA in the SGL, the
      effect of GABA and its agonists and antagonists on neurotransmission in SGL has
      been studied in SC slices in a perfusion system. Bath applied GABA (100 microM to
      1 mM) enhanced the amplitude of postsynaptic field potentials (PSP) in SGL in a
      dose-dependent fashion and at concentrations above 1 mM it depressed the PSP in a
      dose-dependent fashion. A similar response pattern was obtained with muscimol
      (0.1-10 microM excitation; greater than 10 microM inhibition). However (-)
      baclofen only inhibited the PSP. Bicuculline (1 microM) shifted the dose-response
      inhibitory curve of GABA to the right, while the excitatory effect was enhanced.
      These results indicate that GABA has an excitatory and inhibitory action on
      neurotransmission in the SGL. The nigro-tectal GABAergic fibers terminate in the
      intermediate and deep layers of SC. Inhibition of GABAergic activity in the SC
      causes irrepressible saccades made toward the center of the movement field while
      GABA activation delays and slows saccadic eye movements. Thus, GABA in the SC
      plays an important role in the control of eye movements. The same GABAergic
      projection is also related to the propagation of generalized seizures. There
      exist collicular neurons which suppress the propagation of seizures.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1631302
TI  - GABAergic neurons and circuits in the pretectal nuclei and the accessory optic
      system of mammals.
AB  - Two classes of GABAergic cell bodies have been described. They probably can be
      divided into GABAergic local interneurons and GABAergic projection neurons.
      GABAergic cell bodies receive few terminals which is in contrast to non-GABAergic
      somata, which receive many synaptic contacts. GABAergic dendrites that originate
      from GABAergic cell bodies, however, receive numerous terminals, both GABAergic
      and nonGABAergic. It can therefore be concluded that somatic inhibition is not
      present on GABAergic neurons, but does occur on nonGABAergic neurons.
      Furthermore, dendrites traverse large parts of the NOT/DTN forming a complex
      network that enables sampling and integration from a wide area. The projection to
      the IO is not GABAergic itself, but cells projecting to the IO receive a
      substantial GABAergic input, that probably originates in part from the MTN.
      Further investigation on the distribution of this input over a completely
      identified neuron would provide the quantitative data that are required to verify
      the above mentioned hypothesis. A GABAergic projection that originates in the
      pretectal nuclei is directed towards the superficial layers of the SC in the cat
      (Appell and Behan, 1990) and rat (Van der Want et al., 1991). A second GABAergic
      projection derives from the pretectum and reaches the LGN (Cucchiaro et al.,
      1991). Whether this projection originates from the same GABAergic cell bodies
      that project to the SC and the LGN or is derived from different populations
      remains to be determined. The ultrastructural studies of the NOT/DTN complex have
      shown that GABAergic terminals with different morphological characteristics are
      present and that the GABA positive F and P terminals are widely distributed over
      somata and the adjacent neuropil. The P terminals probably originate from
      dendrites of GABAergic interneurons while the F types originate from GABAergic
      projection and interneurons (Van der Want and Nunes Cardozo, 1988). One of these
      sources is located in the MTN differ from the intrinsic GABAergic terminals with
      respect to their relation to R terminals. GABAergic MTN terminals were never
      observed to receive R terminal input. This is in contrast with other GABAergic
      terminals which frequently do receive direct contact from R terminals. Within
      glomeruli triadic arrangements, formed by a single retinal terminal, a dendritic
      profile and second axonal profile dendritic profile and second axonal profile
      synapsing with the dendrite, were frequently encountered in the OPN (Campbell and
      Lieberman, 1985), but only occasionally in the NOT/DTN (Nunes Cardozo and Van der
      Want, 1987).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1631303
TI  - GABA in the retina and central visual system.

PMID- 1631304
TI  - The pathways and functions of GABA in the oculomotor system.

PMID- 1631305
TI  - GABA mediated inhibitory processes in the function of the geniculo-striate
      system.

PMID- 1631306
TI  - GABAergic networks of basket cells in the visual cortex.

PMID- 1631307
TI  - Lateral inhibitory interactions in areas 17 and 18 of the cat visual cortex.

PMID- 1631308
TI  - The synaptic inputs to simple cells of the cat visual cortex.

PMID- 1631309
TI  - GABA-mediated inhibition in the neural networks of visual cortex.

PMID- 1631310
TI  - Molecular properties of GABAergic local-circuit neurons in the mammalian visual
      cortex.

PMID- 1631311
TI  - Development of GABA-containing neurons in the visual cortex.

PMID- 1631312
TI  - Functional organization of GABAergic circuitry in ectotherm retinas.

PMID- 1631313
TI  - Investigation of higher order structures of proteins by ultraviolet resonance
      Raman spectroscopy.
AB  - Progress in laser technology and light detection devices have enabled us to
      explore protein structures and their dynamics by using time-resolved resonance
      Raman spectroscopy. It is in the last decade that Raman spectra of proteins
      excited at 200-240 nm have brought about rich structural information. The
      technological developments in deep UV resonance Raman spectroscopy are reviewed
      first, and the unique information on proteins obtainable from such spectra are
      summarized. As an application of this technique to investigations of the higher
      order structures of proteins, studies on the quaternary structure transition of
      haemoglobin are described.

PMID- 1631314
TI  - Experimental approaches to transduction and the receptor potential in muscle
      receptors.

PMID- 1631315
TI  - Computer simulation of 2D-NMR (NOESY) spectra and polypeptide structure
      determination.

PMID- 1631316
TI  - Effect of prostaglandin F2 alpha (PGF2 alpha) on sources of progesterone and
      pregnancy in intact, ovariectomized and hysterectomized 90-100 day pregnant ewes.
AB  - A single dose of 8 or 16 mg of PGF2 alpha per 58 kg body weight was injected
      intramuscular into intact, ovariectomized or hysterectomized 90-100 day pregnant
      sheep in three separate experiments. Both doses of PGF2 alpha decreased the
      weights of the corpora lutea (P less than or equal to 0.05) and the concentration
      of progesterone in ovarian venous plasma at 72 hr (P less than or equal to 0.05)
      compared to the 0 hr sample within treatment groups and to control ewes at 72 hr
      in intact and hysterectomized pregnant ewes. In hysterectomized pregnant ewes,
      progesterone in jugular plasma declined (P less than or equal to 0.05) from 0 to
      72 hr but never fell below 4 mg/ml and this decrease in progesterone after 8 or
      16 mg PGF2 alpha was greater than in control hysterectomized ewes (P less than or
      equal to 0.05). There was a significant decrease in progesterone over time in
      jugular or uterine venous plasma in the presence of absence of the ovaries in 90
      100 day pregnant ewes (P less than or equal to 0.05) but the profiles of
      progesterone were not different between vehicle and PGF2 alpha-treated ewes (P
      greater than or equal to 0.05). Uterine venous progesterone never declined below
      30 ng/ml in the presence or absence of the ovaries and there was a significant
      quadratic increase (P less than or equal to 0.05) in uterine venous progesterone
      toward the end of the 72 hr sampling period indicating an increase in
      steroidogenic activity of the placenta. PGF2 alpha did not affect the number of
      abortions in intact or ovariectomized pregnant ewes (P greater than 0.05). Thus,
      the corpus luteum of sheep at 90-100 days of pregnancy is functional and
      responsive to PGF2 alpha, placentomes are functional but do not appear to be
      responsive to the doses of PGF2 alpha tested and PGF2 alpha was not an
      abortifacient over the 72 hr treatment period.

PMID- 1631317
TI  - Adenosine facilitates the response to HCG, PGE1 or PGE2 and inhibits the response
      to PGF2 alpha by HCG-stimulated ovine luteal cells in vitro.
AB  - Dispersed ovine luteal cells collected on day 7 or 16 postestrus were incubated
      in vitro with hCG, PGE1 or PGE2 in the presence or absence of adenosine,
      dipyridamole (inhibitor of adenosine uptake) or PGF2 alpha in two separate
      experiments. Secretion of progesterone was increased by hCG, PGE1 or PGE2 when
      incubated with day 7 luteal cells (P less than or equal to 0.05) which was
      increased further when co-incubated with adenosine (P less than or equal to
      0.05). PGF2 alpha alone or in the presence of hCG decreased (P less than or equal
      to 0.05) the secretion of progesterone by day 7 luteal cells, PGF2 alpha
      decreased post treatment cell viability with or without hCG (P less than or equal
      to 0.05) and adenosine reduced (P less than or equal to 0.05) the inhibitory
      effect of PGF2 alpha on hCG actions and luteal cell viability. Day 16 luteal
      cells were not functional based on jugular progesterone (P less than or equal to
      0.05) and did not respond to hCG, PGE1, or PGE2 in the presence of adenosine or
      PGF2 alpha (P greater than or equal to 0.05). It is concluded that adenosine
      enhances the response of functional luteal cells to the luteotropins hCG, PGE1 or
      PGE2 and adenosine reduces the luteolytic response to PGF2 alpha by hCG
      stimulated ovine luteal cells in vitro.

PMID- 1631318
TI  - Effects of reactive oxygen species on eicosanoid metabolism in human endothelial
      cells.
AB  - The influence of reactive oxygen species (H2O2 was used as model substance) on
      the formation and release of PGI2 and TXA2 by cultured human endothelial cells
      was analyzed. In the presence of H2O2 concentrations which did not induce a
      general cell damage (analyzed by estimation of the cellular concentration of
      energy rich phosphates and extent of lipid peroxidation), the formation of both
      eicosanoids exhibited a sigmoidal shape with respect to time. Increasing H2O2
      concentration shortened the half time of PGI2 and TXA2 production. The maximum
      rates of PGI2 and TXA2 formation were separated by a delay of the TXA2
      production. The ratio of PGI2 and TXA2 formation was 100 to 1 at the time of
      maximum PGI2 formation and 1-2 to 1 at the time of maximum TXA2 formation. This
      effect of reactive oxygen species could contribute to the reduction of the
      protective function of the endothelium in hemostasis and vascular tone. Using
      antioxidants, the modulating function of reactive oxygen species on the
      eicosanoid metabolism in endothelial cells was verified.

PMID- 1631319
TI  - Specific and non specific stimulation of prostaglandin release by human skin
      fibroblasts in culture.--Are changes of membrane fluidity involved?
AB  - In order to study a bidirectional relationship between changes of membrane
      fluidity and prostaglandin synthesis, the arachidonic acid cascade was stimulated
      in cultured human skin fibroblasts by unspecific stimuli (hypotonicity, low
      calcium concentrations) and by the specific stimulus, bradykinin. Fluorescence
      anisotropy of trimethylammoniumdiphenylhexatriene was used to measure membrane
      fluidity in cell monolayers. Hypotonicity or low calcium concentrations induce
      membrane fluidisation and prostaglandin synthesis. However, after specific
      stimulation of prostaglandins with bradykinin (at normocalcic and isotonic
      conditions) a rigidification of plasma membranes was observed in living cells.
      Fluidisation of membranes and bradykinin activate phospholipase A2 and induce
      prostaglandin synthesis. Although in cell membrane preparations increased
      phospholipase A2 activity leads to fluidisation, in our model a membrane
      fluidisation was not observed after stimulation of phospholipase with bradykinin.
      This suggests that in living cells a fluidizing effect of lysolecithin resulting
      from phospholipase A2 activation may be rapidly counteracted by its removal. A
      decrease of phosphatidylcholin content and consequently a rigidification of the
      membrane may ensue. Thus, the cell culture model using two different ways of
      stimulating phospholipase activity, helps to define the directional relationship
      between changes of membrane fluidity and activation of phospholipase and the
      arachidonic acid cascade in living human cells.

PMID- 1631320
TI  - Repetition priming follows spontaneous but not prompted recognition of familiar
      faces.
AB  - Reaction times to make a familiarity decision to the faces of famous people were
      measured after recognition of the faces in a pre-training phase had occurred
      spontaneously or following prompting with a name or other cue. At test, reaction
      times to familiar faces that had been recognized spontaneously in the pre
      training phase were significantly facilitated relative to an unprimed comparison
      condition. Reaction times to familiar faces recognized only after prompting in
      the pre-training phase were not significantly facilitated. This was demonstrated
      both when a name prompt was used (Experiments 1 and 3) and when subjects were
      cued with brief semantic information (Experiment 2). Repetition priming was not
      found to depend on prior spontaneous recognition per se. In Experiment 3,
      spontaneously recognizing a familiar face did not prime subsequent familiarity
      judgements when the same face had only been identified following prompting on a
      prior encounter. In Experiment 4, recognition memory for faces recognized after
      cueing was found to be over 90% accurate. This indicates that prompted
      recognition does not yield repetition priming, even though subjects can remember
      the faces. A fusion of "face recognition unit" and "episodic record" accounts of
      the repetition priming effect may be more useful than either theory alone in
      explaining these results.

PMID- 1631321
TI  - On the relation between visual spatial attention and visual field asymmetries.
AB  - In the typical visual laterality experiment, words and letters are more rapidly
      and accurately identified in the right visual field than in the left. However,
      while such studies usually control fixation, the deployment of visual attention
      is rarely restricted. The present studies investigated the influence of visual
      attention on the visual field asymmetries normally observed in single-letter
      identification and lexical decision tasks. Attention was controlled using a
      peripheral cue that provided advance knowledge of the location of the forthcoming
      stimulus. The time period between the onset of the cue and the onset of the
      stimulus (Stimulus Onset Asynchrony--SOA) was varied, such that the time
      available for attention to focus upon the location was controlled. At short SOAs
      a right visual field advantage for identifying single letters and for making
      lexical decisions was apparent. However, at longer SOAs letters and words
      presented in the two visual fields were identified equally well. It is concluded
      that visual field advantages arise from an interaction of attentional and
      structural factors and that the attentional component in visual field asymmetries
      must be controlled in order to approximate more closely a true assessment of the
      relative functional capabilities of the right and left cerebral hemispheres.

PMID- 1631322
TI  - A sensorimotor basis for motor learning: evidence indicating specificity of
      practice.
AB  - Our previous work (Proteau, Marteniuk, Girouard, & Dugas, 1987) was concerned
      with determining whether with relatively extensive practice on a movement aiming
      task, as the skill theoretically starts becoming open-loop, there would be
      evidence for a decreasing emphasis on visual feedback for motor control. We
      eliminated vision of the moving limb after moderate and extensive practice and
      found that the movement became more dependent on this feedback with greater
      amounts of practice. In the present study, we wished to test the hypothesis,
      developed from our previous work, that at the base of movement learning is a
      sensorimotor representation that consists of integrated information from central
      processes and sensory feedback derived from previous experiences on the movement
      task. A strong test of this hypothesis would be the prediction that for an aiming
      task, the addition of vision, after moderate and relatively extensive practice
      without vision, would lead to an increasingly large movement decrement, relative
      to appropriate controls. We found good support for this prediction. From these
      and our previous results, and the idea of the sensorimotor representation
      underlying learning, we develop the idea that learning is specific to the
      conditions that prevail during skill acquisition. This has implications for the
      ideas of the generalized motor program and schema theory.

PMID- 1631323
TI  - The phonetic integration of speech and non-speech sounds: effects of perceived
      location.
AB  - The third-formant (F3) transition of a three-formant /da/ or /ga/ syllable was
      extracted and replaced by sine-wave transitions that followed the F3 centre
      frequency. The syllable without the F3 transition (base) was always presented at
      the left ear, and a /da/ (falling) or /ga/ (rising) sine-wave transition could be
      presented at either the left, the right, or both ears. The listeners perceived
      the base as a syllable, and the sine-wave transition as a non-speech whistle,
      which was lateralized near the left ear, the right ear, or the middle of the
      head, respectively. In Experiment 1, the sine-wave transition strongly influenced
      the identity of the syllable only when it was lateralized at the same ear as the
      base (left ear). Phonetic integration between the base and the transitions became
      weak, but was not completely eliminated, when the latter was perceived near the
      middle of the head or at the opposite ear as the base (right ear). The second
      experiment replicated these findings by using duplex stimuli in which the level
      of the sine-wave transitions was such that the subjects could not reliably tell
      whether a /da/ or a /ga/ transition was present at the same ear as the base. This
      condition was introduced in order to control for the possibility that the
      subjects could have identified the syallables by associating a rising or falling
      transition presented at the left ear with a /da/ or /ga/ percept. Alternative
      suggestions about the relation between speech and non-speech perceptual processes
      are discussed on the basis of these results.

PMID- 1631324
TI  - [The physician facing a diagnosis of bad prognosis. Considerations on the moment
      of certain mental discomfort].

PMID- 1631325
TI  - [Anticipatory anxiety and interpersonal relations with the radiologist of
      patients undergoing diagnostic imaging].
AB  - A pilot study has been carried out with the aim of evaluating the impact of
      updated imaging techniques (CT and MRI) versus "simple" examinations (tomography,
      X-rays, US, and nuclear medicine) on the anticipatory anxiety of the patients, as
      well as on the radiologist-patient relationship. Ninety consecutive patients
      undergoing diagnostic imaging modalities were examined according to the following
      schedule: 1) preliminary interview and anxiety assessment according to HRSA; 2)
      diagnostic imaging investigation, and 3) filling out an "ad hoc" questionnaire.
      The collected data have been divided into two groups: the "simple" group (52
      patients submitted to X-rays, tomography, US, and nuclear medicine), and the
      "complex" group (38 patients submitted to CT and MRI). Anticipatory anxiety was
      observed in all subjects and attained psychopathological rates in more than half
      of them. Anxiety proved to be related to the completion of the examination rather
      than to its complexity. The questionnaire has pointed out the need for a more
      interactive relationship between radiologist and patient during diagnostic
      imaging examinations.

PMID- 1631326
TI  - [Combined use of real-time digital subtraction radioscopy and computerized
      tomography: potential advantages in diagnostic and interventional radiology].
AB  - The idea of combining fluoroscopy and CT arose from the daily practice in
      diagnostic and interventional radiology. A Diasonics OEC high-performance image
      intensifier complete with a digital subtraction system was connected to a Siemens
      Somatom-DRH CT scanner to work in tandem. CT is used for a localization in-depth
      and fluoroscopy for the subsequent maneuvers within an organ or body compartment.
      With this combination, complex procedures such as transarterial portography,
      percutaneous embolizations, pain treatment and manipulation for catheterization
      of the bile ducts and urinary tract could be performed in one place and in one
      session. CTF is especially useful when patients should not be moved about from
      room to room or undergo an examination in several sessions, as it happens with
      children or critically ill or contagious patients.

PMID- 1631327
TI  - [Percutaneous treatment of bile duct lithiasis. Personal experience in the first
      150 cases].
AB  - Since 1983 we have percutaneously treated 150 cases of bile duct lithiasis in
      which previous endoscopic maneuvers had been incomplete or unfeasible. Complete
      resolution of lithiasis was obtained in 139 of 150 patients. In 6 cases only
      partial success was obtained but symptoms subsided. In 2 cases the treatment
      failed and the patients underwent surgery. Minor complications were observed in
      12.6% of patients and resolved either spontaneously or by percutaneous maneuvers.
      Mortality rate was 2%. After a follow-up period of 6-12 months, 9 patients had a
      recurrence, completely resolved with further percutaneous treatment. These cases
      never required surgery. We obtained the best results in patients with stones
      residual after cholecystectomy or a iatrogenic stricture of the biliary tree. We
      obtained good results in massive lithiasis with combined endoscopic, surgical and
      radiological procedures. Morbidity and mortality rates were lower than in
      surgical series and similar to the endoscopic ones. The short hospitalization,
      the low cost and the possibility of treatment on an outpatient basis should
      promote the spreading of percutaneous techniques in the treatment of bile duct
      lithiasis.

PMID- 1631329
TI  - [Bone disease in multiple myeloma. A study of 237 cases].
AB  - From 1984 to 1990 the authors reviewed the radiologic-clinical charts of 237
      patients affected with multiple myeloma (MM). The series included 127 males and
      110 females (mean age: 66 years) who had been classified according to Durie and
      Salmon clinical criteria. All the patients underwent X-rays of the skeleton, as
      recommended in international literature; moreover, 148 subjects underwent whole
      body bone scintigraphy, and 130 bone marrow scintigraphy. A selected group of
      cases (18 male/female patients) were submitted to bone densitometry employing
      both quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry
      (DXA). The results follow: 1) in the first stage of the disease, a high number of
      patients (29.5%) exhibits no skeletal abnormalities on X-rays; the most common
      lesion locations include the spine (49%), skull (35%), pelvis (34%), ribs (33%),
      humeri (22%), femora (13%) and mandible (10%); 2) the most frequent pattern is
      osteolysis, as a characteristic "punched-out" multiple lesion; the second most
      frequent lesion is osteopenia (43%), especially in the spine; pathologic
      fractures are common (54%) in the ribs, vertebral bodies, limbs; typical
      associations of features and sites are seen on X-ray images, which sometime make
      diagnosis easier; 3) whole-body scintigraphy, revealing aspecific uptake only in
      the presence of pathological fractures, is not recommended in the first staging
      of the disease, but is considered as a valuable technique in the follow-up, when
      the patients become symptomatic; 4) bone marrow scintigraphy, especially in the
      "marrow expansion" pattern, might be considered as an attempt made by the body to
      recover the central space which was destroyed by myelomatous involvement. The
      prognostic value of this technique is still to be assessed; 5) bone densitometry,
      by confirming the grade of osteopenia, reveals that osteoporosis is a peculiar
      pattern of bone disease in MM, which is not related to age only; 6) conventional
      radiography of the skeleton is the method of choice in the diagnosis of lytic
      areas of MM, and remains, as yet, irreplaceable. The other diagnostic techniques-
      i.e., CT and MRI--can be used to evaluate the extent of bone and soft tissue
      involvement, in the cases with questionable diagnosis, and to assess the degree
      of marrow involvement.

PMID- 1631328
TI  - [Loco-regional fibrinolysis in peripheral arterial bypasses. Our experience].
AB  - Thirty-one patients (29 males and 2 females) with 34 thrombosed grafts were
      treated by direct intra-arterial infusion of urokinase; the lesions were acute in
      27 cases and chronic (2-4 months) in 4. Urokinase was infused in doses of 50,000
      UI/h. Angiographic follow-up exams were performed every 12 hours. The infusion
      was stopped when lumen patency was re-established and there was no significant
      mural thrombus or peripheral embolus. Treatment usually lasted 4-72 hours
      (average: 18 hours). The hematological status was controlled by measuring plasma
      fibrinogen, coagulation time, partial thromboplastin time, prothrombin and
      antiplasmin time. Initial success rate was 76% (23 patients). Overall 1-year
      patency was 56% in 23 cases: 85% in the patients with correctable lesions by
      means of surgery or PTA, and 46% in the patients with non-correctable lesions.
      After the first period, patency remained high in the patients followed up to 5
      years. Our experience confirms that lysis of a thrombosed graft is possible by
      the local infusion of a low-dose fibrinolytic agent and exhibits high success
      rate and low complication rate in acute and chronic obstructions.

PMID- 1631330
TI  - [Magnetic resonance in the staging of multiple myeloma].
AB  - The authors retrospectively reviewed the MR examinations of 46 patients with
      clinical and laboratory findings of monoclonal gammopathies (MG). All cases had
      been submitted to radiographic examination which had shown skeletal involvement
      in 22 cases and osteoporosis in 11, with rupture of the vertebral body in 3
      patients. Scintigraphy had been performed on all patients and CT on 12; 36
      patients were subsequently submitted to follow-up (at 6, 12 and 24 months). MR
      examinations were performed with dedicated coils and standard sequences for the
      subjects with skeletal localizations on X-ray images. The extant cases, with no
      radiographic evidence of skeletal involvement, were submitted to MRI of the
      spine, skull and pelvis. In agreement with clinical and laboratory findings and
      with follow-up results (in 36 patients), MRI diagnosed MG with no skeletal
      involvement in 13 cases, osteoporosis in 8 (with rupture of the vertebral body in
      2), asymptomatic non-progressive myeloma in 4, solitary myeloma in 3, and
      multiple myeloma in 18 cases. The good identification of bone marrow and its
      multiplanarity make MRI the method of choice in the study of patients with
      suspected or known gammopathies. If compared with other modalities, MRI is more
      sensitive and accurate in depicting the tumor, its size and relationship to
      periskeletal tissues, and its possible multifocality. Moreover, the technique has
      proven to be a valid tool during the follow-up, showing tumor response to
      therapy.

PMID- 1631331
TI  - [Computerized tomography of the orbit in Graves' ophthalmopathy. New
      observations].
AB  - In order to evaluate Graves' ophthalmopathy new CT parameters have been
      introduced such as: the diameters of the five extraocular muscles, the value of
      their addition, the grade of apical crowding, the enlargement of optic nerve
      sheaths and of the superior ophthalmic vein, and the anterior displacement of the
      lacrimal gland. On this subject we report our further experience after reviewing
      68 cases in which the new ocular parameters were correlated with altered ocular
      motility and optic neuropathy. The results confirmed our previous study, dealing
      with several groups of patients, which at the moment seem to be 2, instead of 3
      groups: a) patients with increase in both muscular and fatty tissue (54/68
      cases); b) patients with main or exclusive increase in fatty tissue (14/68
      cases). Relevant clinical signs were present only in the first group of patients,
      where the medial, inferior and superior muscles were affected in 53/55, 53/55 and
      50/55 cases respectively. A muscle increase by nearly 50% was more frequently
      found in cases with altered ocular motility, an increase by 90% was often
      associated with optic neuropathy. In case of optic neuropathy apical crowding was
      often observed, mainly in coronal scans, together with significant enlargement of
      the optic nerve sheath and of the superior ophthalmic vein. As to proptosis,
      preseptal area and anterior displacement of the lacrimal gland, they demonstrated
      lower correlation with the reference symptoms, even though their occurrence was
      high in symptomatic patients.

PMID- 1631332
TI  - [Inherent problems of the use of magnetic resonance in patients with metallic
      implants currently used in orthopedic practice].
AB  - Forty-eight patients with oncologic prosthetic devices (modular rotatory
      shoulder, Kotz, custom made) and metallic means of fixation (Sherman's plates,
      Ender's rods, etc.) underwent MRI in order to: 1) assess possible physical
      changes in the magnetic field or the alloys under examination; 2) detect the
      presence and type of artifacts, and 3) verify the onset of eventual noxious
      effects of the alloy on the patient. The diagnostic investigation was preceded by
      an experimental phase which was characterized by: A) a study of the temperature
      fluctuations of the alloys when submitted to the magnetic field and to
      radiofrequency; B) the identification and characterization of the artifacts, as
      well as C) their physical interpretation. During examination, there was no
      evidence of any mobilization of the means of fixation, sensation of endogenous
      heat, or other subjective complaints on the part of the patient. The authors
      observed that, even in the presence of artifacts, MRI provided good evaluation of
      the soft tissues around the devices by identifying tumor recurrences in the
      presence of an oncological prosthesis. MRI was also capable of showing trophic
      changes in the tissues surrounding the means of fixation. Thus, the method
      exhibits no contraindications in the study of these patients but, on the other
      hand, does not allow the evaluation of the integrity or mobilization of the
      prosthetic devices.

PMID- 1631333
TI  - [Accuracy of magnetic resonance (0.5 T) in traumatic lesions of the knee.
      Controlled 87 cases].
AB  - In this study the authors investigated the diagnostic accuracy of Magnetic
      Resonance (MR) imaging as a method to recognise traumatic disorders of the knee;
      in particular its capability to identify meniscal and cruciate ligaments tears
      was examined. The results have been compared with those from arthroscopy and/or
      surgery, which were considered the gold standard of the study. Eighty-seven
      consecutive patients with suspected traumatic injury of the knee were
      prospectively studied. All patients underwent MR examination (0.5 Tesla magnet,
      gradient echo sequences, slices thickness = 5 mm) and, within 15 days/1 month,
      arthroscopy or surgery. The high diagnostic accuracy (internal meniscus = 87.5%;
      external meniscus = 88.5%; anterior cruciate ligament = 93.1%; posterior cruciate
      ligament = 96.5%) has confirmed the good diagnostic capabilities of MR in
      assessing traumatic lesions of the knee.

PMID- 1631334
TI  - [Normal anatomy and findings in traumatic pathology of the popliteal system. A MR
      study].
AB  - To date, the lesions of the popliteal system, which are responsible for the so
      called postero-lateral knee instability, are still an imperfectly known chapter
      of knee conditions. We retrospectively analyzed 215 consecutive MR examinations
      performed May-August 1991 to evaluate MR capabilities in correctly depicting both
      the normal anatomy and the pathologic conditions of the popliteal system. Using
      our standard protocols for knee study and two different magnets (0.064 and 0.5
      T), we identified 23 lesions of the popliteus and of its meniscal and peritoneal
      insertions, and 17 lesions involving also other capsular and ligamentous
      structures of the knee. Coronal T1-weighted images were the best ones to
      correctly identify normal knee anatomy, whereas sagittal T2-weighted images were
      more sensitive in detecting popliteal lesions. Our results had clinical or
      surgical confirmation in all cases.

PMID- 1631335
TI  - [Computerized tomography as a diagnostic complement of standard radiograms in the
      evaluation of traumatic lesions of the carpal scaphoid. A study of 10 cases].
AB  - The authors investigated the value of direct coronal CT as a diagnostic
      complement to plain radiography in the assessment of post-traumatic scaphoid
      conditions. The series included 10 patients who were selected either for
      disagreement of clinical and radiological findings, the latter being negative (3
      patients), or for better assessment of radiological findings, which had diagnosed
      bone lesions, in order to plan treatment (7 cases). CT provided additional
      information in 5 patients, demonstrating 2 nonunited fractures in the first group
      and 2 pseudoarthroses with no significant bone deformity and 1 osteonecrosis in
      the second group. These results, which proved essential to plan the subsequent
      treatment, show that CT has, at present, in specific cases, a definite role in
      evaluating post-traumatic scaphoid conditions, and stress the value of direct
      coronal images, which are both easy to interpret, being equivalent to radiographs
      in postero-anterior projection, and quick to perform.

PMID- 1631336
TI  - [Pelvic fractures].
AB  - Pelvic fractures, although accounting for only 2-3% of all traumatic skeletal
      lesions, are extremely important due to the frequent sequelae and complications
      that can cause the death of the patient. Moreover, their incidence is increasing
      due to road accidents, sport and work injuries. X-ray examinations, if correctly
      performed, allow the degree of residual stability of the pelvic ring to be
      assessed; they allow both the recognition of the mechanisms of injury and the
      evaluation of bone lesions. The X-ray examination can provide the orthopedist all
      the necessary information for the correct treatment planning, employing an
      external setting or, when the lesion is unstable, an open-field setting. The
      authors, after considering the major types of pelvic ring fractures, classified
      on the basis of the mechanisms of injury, suggest the best radiologic protocol,
      in their opinion, for the pelvic fractures whose diagnosis is based on X-ray
      examinations. In these cases, CT is less useful than in the study of acetabular
      fractures; it rarely provides additional information and thus remains a
      supplemental exam to X-rays.

PMID- 1631337
TI  - [Diagnostic contribution of CT in implantology: use of a new Denta-Scan
      reconstruction program].
AB  - The authors report their preliminary experience with the use of a new CT
      reconstruction program: Denta-Scan. Tomodensitometric studies of both the
      maxillary and the mandibular bones are actually mandatory for the planning of the
      correct implantation techniques. Denta-Scan, usually employed for CT studies in
      implantology and maxillo-facial surgery, suits to both pre- and postoperative
      evaluations. It provides accurate anatomical imaging, identifying details and
      landmarks which are helpful for surgical planning. Moreover, it allows TDM
      evaluation of bone structures, showing the presence of pathologic conditions
      potentially affecting the result of implantology. In the postoperative follow-up
      Denta-Scan allows to verify the correct positioning of the prosthetic implant,
      testing its integration in the bone structure as well as the rate of surgical
      failure.

PMID- 1631338
TI  - [Echographic evaluation of pancreatic dimensions in type 1 diabetes mellitus].
AB  - Aim of this study was to determine whether pancreatic size is altered in patients
      suffering from type I diabetes mellitus. Twenty-five diabetics (14 males and 11
      females) and twenty-five healthy controls entered the study. All patients and
      controls were scanned by the same operator with the same US equipment after
      overnight fasting. The longitudinal and antero-posterior diameters of the head,
      body and tail and the transverse diameter of the head as well as the total area
      of the gland were measured through longitudinal and axial scans. The two groups
      were homogeneous relative to age, sex, distribution, height, weight and body mass
      index. All measured diameters as well as the total area of the gland were
      significantly smaller in diabetic patients than in controls (1-way ANOVA: p less
      than 0.001). These results may open new perspectives to US identification of
      possible changes in pancreatic size by a new US study including high-risk
      subjects without clinical signs.

PMID- 1631339
TI  - [Hepatobiliary ascaridiasis in childhood: echographic diagnosis].
AB  - Ascaris lumbricoides infestation in the liver and biliary tract causes various
      clinical manifestations due to the migration of larvae and adult organisms.
      Parasites in the bile ducts cause obstruction and such complications as
      cholecystitis, cholangitis and liver abscesses. We report the US findings of
      biliary ascaridiasis as observed in a series of 13 children over a 3-year period.
      The patients (6 females and 7 males) presented hepatosplenomegaly, abdominal
      distension, right subcostal pain; 3 of 13 exhibited subicteric features and
      fever. The US features of Ascaris lumbricoides infestation are: hyperechoic
      linear images due to parasites within the dilated bile ducts, target images;
      mobile hyperechoic linear images within the gallbladder; intrahepatic abscesses
      with different features and sizes. Microscopic sections of hepatic tissue show
      inflammatory infiltration around the Ascaris eggs. Emergency surgery is sometimes
      to be performed. The value of US, as we assessed it, has been already stressed by
      other authors.

PMID- 1631340
TI  - [Preoperative staging and recurrence of rectal tumors. Comparison of transrectal
      ultrasonography and magnetic resonance].
AB  - The accuracy of transrectal US (TRUS) and of MRI was evaluated in the
      preoperative staging and in local recurrences of rectal cancers. Fifty-four
      patients were examined: 45, with known rectal cancer, for preoperative staging,
      and 9 for the evaluation of local recurrences. Nineteen patients were examined
      with MRI in basal conditions, 21 after rectal air enema and 5 after paramagnetic
      contrast enema (Gd-DTPA). The following parameters were evaluated for
      preoperative staging: wall infiltration, invasion of perirectal fat and adjacent
      structures, lymph node involvement. Morphologic and signal intensity (on MRI)
      changes were evaluated for the diagnosis of local recurrences. TRUS provided 2
      false positives. In the same patients, basal MRI results were poor, owing to
      difficult demonstration of the different wall layers, while in the patients
      studied after air enema, the lesion was hyperintense. In 20 patients with a fat
      infiltrating tumor, TRUS provided 3 false negatives and 2 false positives; basal
      MRI yielded poor results, while air enema and paramagnetic contrast enema clearly
      demonstrated all fat-infiltrating lesions, with only one false positive.

PMID- 1631341
TI  - [Echography in gynecologic emergencies].
AB  - The authors report their experience with US in gynecologic emergencies through a
      retrospective study on 105 patients presenting with acute abdomen of suspected
      gynecologic nature. The series included 3 groups of patients: Group I: 59
      patients all submitted to immediate surgery. The following pathologic conditions
      were observed: ectopic pregnancy (23 cases), torsion or hemorrhage from ovarian
      cysts (13 cases), pyosalpinx or tubo-ovarian abscess (9 cases), torsion of
      pedunculated uterine leiomyoma (7 cases), intraperitoneal bleeding from
      hemorrhagic corpus luteum (6 cases), hematocolpos and hematometra from
      imperforate hymen (3 cases). Two false positives, not included in this group,
      resulting from appendicular abscesses and misinterpreted as ovarian, were
      submitted to surgery in a gynecologic unit. Group II: 19 patients treated with
      medical therapy for the following conditions: torsion or hemorrhage from
      hyperstimulated ovary (10 cases), pyosalpinx or tubo-ovarian abscess (9 cases).
      Group III: 25 patients in whom neither US nor clinical examination revealed
      positive gynecologic findings. Both US and clinical follow-up were negative in
      these patients. The study was aimed at evaluating the role of US in identifying
      both lesion and peritoneal involvement, and in the diagnosis of nature. US proved
      a valuable tool in the first two diagnostic steps, allowing to confirm/dismiss
      active pathologic conditions, to indicate the medical/surgical treatment
      (immediate or delayed), to detect associated pathologies to study with further
      examinations. As for lesion nature, US alone proved poorly useful if not
      correlated with an accurate clinical history.

PMID- 1631342
TI  - [Exclusive radiotherapy in the treatment of carcinoma of the portio cervicis,
      stage IIB FIGO].
AB  - From January 1970 through December 1987, 135 patients with cervical cancer in
      stage IIB (FIGO criteria) were treated by means of exclusive radiotherapy in the
      Istituto del Radio of the Brescia University. Thirty cases were treated by
      exclusive external-beam radiotherapy (RTT), 39 by brachytherapy (CU) plus
      external-beam radiotherapy, 24 by combined RTT and CU, 41 by RTT + CU + RTT, and
      1 case by CU alone. Crude survival at 5 years is 52.4%, and NED survival is 50%.
      The differences between the values of crude and NED survival by radiotherapy
      technique were statistically significant (p 0.05), ranging from 69.8% in the RTT
      + CU group to 35.5% in the RTT alone group. Twenty-four cases (18%) failed to
      obtain complete remission, and 24 more cases recurred in the pelvis. Sequelae
      were evaluated by the French-Italian glossary; they were present in 62 cases
      (46%), but in 12 cases only (9%) they were severe. The incidence of sequelae was
      highest in the groups of patients treated with the combined techniques (RTT and
      CU) which allowed best disease control.

PMID- 1631343
TI  - [A rare complication of renal and biliary lithotripsy: subcapsular hematoma of
      the liver].

PMID- 1631344
TI  - [Positioning of stent in urethral stenosis caused by carcinoma of the prostate].

PMID- 1631345
TI  - [Acute abdomen following dislocation of transhepatic-duodenal biliary drainage.
      Resolution by use of percutaneous perihepatic drainage].

PMID- 1631346
TI  - [Spontaneous dissection of the extracranial internal carotid artery: an atypical
      angiographic finding].

PMID- 1631347
TI  - [Association of idiopathic pulmonary fibrosis and emphysema. An instructive
      case].

PMID- 1631348
TI  - [Ultrasonographic study of tubercular effusions. Apropos of 12 cases].

PMID- 1631349
TI  - [A rare case of concomitant duplication of the inferior vena cava with azygous
      vein continuation. MR aspects].

PMID- 1631350
TI  - [Epidermoid cysts arising in the proximity of the left vaginal wall].

PMID- 1631351
TI  - Dietary pesticide risk assessment.
AB  - In this review, the process of dietary pesticide risk assessment has been
      presented and three major components of the process--estimation of pesticide
      residue levels, estimation of food consumption patterns, and characterization of
      risk based on a comparison of exposure estimates with toxicological criteria-
      have been identified. Each component of the process is subject to considerable
      uncertainty that may compromise the accuracy of the final risk assessment. In
      estimating pesticide residue levels, common practices range from highly
      theoretical models assuming that all residues are present at a predetermined
      level (typically at the tolerance level) to the use of market basket survey data
      obtained at the time the food is ready for consumption. Intermediate techniques
      include using actual monitoring data (usually obtained from government residue
      enforcement programs) and/or making corrections to estimates on the basis of
      actual pesticide use. Additional corrections may be used to incorporate data on
      the effects of post-harvest practices such as processing, washing, cooking,
      peeling, and transportation that have often been shown to dramatically reduce
      residue levels, although occasional increases in residue levels and/or formation
      of toxicologically significant breakdown products may also result from post
      harvest practices. Food consumption estimates are typically derived from national
      surveys of consumer food consumption behavior and are also subject to
      considerable uncertainty. Food consumption estimates are often disaggregated into
      distinct population subgroups based on age, gender, geographic region, and
      ethnicity, although the accuracy of estimates for particular subgroups is
      commonly questioned on the basis of the adequacy of sample size. At the present
      time, data from the 1977-78 Nationwide Food Consumption Survey are still being
      used, and the incorporation of more recent data from the 1987-88 Nationwide Food
      Consumption Survey is being delayed due to major flaws in the study. On occasion,
      other food consumption surveys may be used, although they are typically much
      smaller in scope than the 1977-78 and 1987-88 studies and are considered less
      reliable. The multiplication of residue level estimates by food consumption
      estimates yields an estimate of human pesticide exposure. Commonly, the
      theoretical maximum residue contribution (TMRC) is calculated that represents the
      maximum "legal" exposure to pesticides. Calculation of the TMRC involves the
      assumptions that all pesticides legally allowed on a particular commodity will
      always be applied, that all residues are present at the tolerance levels, and
      that there are no post-harvest effects on residue levels. Often the TMRC is used
      as a sorting tool by the EPA in its preliminary assessment of dietary risks to
      pesticides.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1631352
TI  - Aflatoxins in animal and human health.
AB  - Aflatoxins remain as a threat to the health of livestock as well as humans by
      their continuing intermittent occurrence in both feeds and foods. The finding
      that aflatoxin-contaminated feeds, and eventually purified aflatoxins, were
      carcinogenic in rats and trout initiated a multitude of studies in search of the
      role of these toxins in human liver disease, especially cancer. Although
      aflatoxins have caused acute liver disease in humans, epidemiologic evidence of
      the involvement of aflatoxins in PLC has not been clarified. Earlier studies did
      not consider that the hepatitis B virus (HBV) may have contributed to the PLC in
      the selected populations. Although later studies that did include measurement of
      the HBV antigen in serum provided conflicting evidence for the role of aflatoxin
      in PLC in these populations, the latest and most comprehensive study found no
      association between aflatoxin exposure and PLC mortality. The technological
      advances and findings of the chemical, immunologic, and metabolic activities of
      aflatoxins such as binding to DNA and protein to form adducts, development of
      monoclonal antibodies, and mutational specificity of the genotoxic compounds
      will, it is hoped, help to clarify the role of aflatoxin as a risk factor, among
      many others, in the development of primary liver cancer in humans. Aflatoxicosis
      of animals is usually manifested by pathologic changes in the liver, but they
      have been found to be carcinogenic and teratogenic as well as causing impaired
      protein formation, coagulation, weight gains, and immunity. The importance of the
      carcinogenic effect in livestock is diminished because they are not fed
      contaminated diets for a sufficient time prior to marketing for slaughter.
      Animals are variably susceptible to aflatoxins, depending on such factors as age,
      species, breed, sex, nutrition, and certain stresses. Swine, cattle, and poultry
      are the domestic species of greatest economic concern in terms of aflatoxicosis.
      In all species, the evidence of disease is a general unthriftiness and reduction
      in weight gains, feed efficiency, immunity, and production. More conclusive
      evidence of aflatoxin involvement in disease includes acute to chronic liver
      disease with concomitant increases in specific liver enzymes in the serum. In
      cattle, milk production is affected, but of greater significance is that the
      aflatoxins in feeds can be rather efficiently converted to toxic metabolites in
      milk, with even small amounts being readily detectable. The poultry industry
      probably suffers greater economic loss than any of the livestock industries
      because of the greater susceptibility of their species to aflatoxins than other
      species.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1631353
TI  - [Hypofibrinolysis in coronary artery disease and predisposing conditions].

PMID- 1631354
TI  - [Brucellar sacroiliitis. A detailed review with an analysis of treatment
      efficacy].
AB  - All patients diagnosed of brucellosis in 4 regional hospitals during a period of
      nine years were reviewed, in an attempt to evaluate the efficacy of different
      antimicrobic regimens and also the clinical features. Evolution and complications
      of brucellar sacroiliitis. Of a total of 548 patients, 12% had been diagnosed of
      sacroiliitis and, of theme, 49 had complete data available with efficacy of
      different treatments, the time elapsed until fever and pain ceased was evaluated,
      together with initial therapeutic failures, relapses and length of hospital stay.
      Brucellar sacroiliitis is the most frequent osteoarthral complication of Brucella
      sp. in our setting. Keeping an stable incidence. It is predominant among young
      male (82%) population (mean age 25 +/- 12 years). The illness evolution is acute
      and less frequently subacute with a evolution mean-time before referral of 38 +/-
      44 days (minimum 4 days, maximum 180 days). Fever (81%) and pain on gluteus and
      low lumbar localizations (100%) are the more frequent clinical features. Time
      elapsed until pain ceased was longer with doxycycline plus rifampicin (68 +/- 86)
      than with doxycycline plus streptomycin (28 +/- 43) (less than 0.05) and length
      of hospital stay was also longer with said treatment (p less than 0.05). There
      were no differences concerning time frame until fever ceased, initial therapy
      failures and relapses. Sequelae are infrequent and consist in persistency of
      pain. In resume response to treatment with usual regimens, doxycycline plus
      streptomycin of doxycycline rifampicin is good, being however time elapsed until
      pain ceases of mean length in hospital stay shorter in the group receiving
      doxycycline plus streptomycin. Control studies to confirm these data are need.

PMID- 1631355
TI  - [Abdominal tuberculosis today. A review of 46 cases].
AB  - The clinical features, radiological and therapeutic response of 46 cases of
      abdominal tuberculosis (AT) seen at a university hospital are presented.
      Diagnosis was anatomopathologic in 39 cases (85%) and clinical with response to
      tuberculostatic in 7 cases (15%). Most of the patients did not have history nor
      exposition to tuberculosis. Both sexes were similar affected, mean age 43 years
      old, between 11 and 79. Clinical manifestations were no specific, the most
      frequent fever (65%), abdominal pain (63%) and constitutional syndrome with
      asthenia, anorexia and weight loss (63%). Thorax radiograph was normal in 50% and
      PPD negative in 42%, so in 10% of patients both tests were negative. More than
      half of the patients had other disease. 82% of patients were cured with
      tuberculostatic. 18% of patients died. AT seen now is different from classic
      descriptions. Is not a complication of pulmonary tuberculosis (PT) as it was to
      be in the past. Thinking in AT only in patients with PT make most patients lead
      without diagnosis.

PMID- 1631356
TI  - [Coxiella burnetii osteoarthritis].
AB  - A case of a 25-year-old female characterized by febrile osteoarthritis and
      arthromyalgias as the only clinical manifestation of a Q fever is discussed.
      Analytical data were compatible with those of an acute inflammation and serologic
      findings reached diagnostic levels. Response to Doxycycline treatment was totally
      satisfactory. Even though associated arthromyalgias are described in some cases
      of Q fever as well as sporadic cases of osteoarthal infection due to Coxiella
      burnetii, there are no oligosymptomatic cases published as the one discussed.
      Some physiopathologic considerations referred to this peculiar onset are
      suggested.

PMID- 1631357
TI  - [The fasciitis-polyarthritis syndrome].
AB  - A 56 years old woman showed polyarthritis with thickness and retraction of the
      palmar fascia: 5 months later an undifferentiated ovarian carcinoma was
      diagnosed. Symptoms improved when antineoplastic chemotherapy was started. This
      has been called fasciitis-polyarthritis syndrome. Cases published on the
      scientific literature are reviewed, discussion their etiopathology and the
      possibility of establishing an early diagnosis of neoplasia through the finding
      of this association.

PMID- 1631358
TI  - [Sneddon's syndrome: its clinical characteristics and etiopathogenic factors].
AB  - Sneddon syndrome is know as the association of idiopathic livedo reticularis and
      cerebrovascular lesions. The most characteristic trait of this syndromes is a non
      inflammatory arteriopathy in medium caliber vessels. The pathogenic role of
      antiphospholipid antibodies in this disease is not clear. Clinical
      characteristics and etiopathogenic features of eight patients with Sneddon's
      syndrome are reviewed, specially regarding its relationship with primary
      antiphospholipid syndrome. A female predominance was found (3:1) as well as a
      relationship with hypertension (five patients suffered hypertension), but no
      relation was found with contraceptive use. Three patients showed evidence of
      antiphospholipid antibodies, present as anticardiolipin antibodies with
      significative titers in three cases and lupus anticoagulant in one. Digital
      artery biopsy performed in four patients showed in all of them the pathologic
      features characteristic of this disease. Seven patients were treated with
      platelet activity inhibitors and one with oral anticoagulants. Six of them have
      had a year and half follow-up without showing any new ischemic stroke. The main
      etiopathogenic factor on Sneddon's syndrome is the presence of a non-inflammatory
      arteriopathy in medium caliber vessels. Blood hypertension and antiphospholipid
      antibodies could play a role in the development of cerebrovascular lesions in
      some cases. No relationship has been found with oral contraceptives in this
      series of patients. Medium term prognosis with platelet activity inhibitors
      therapy seems benign.

PMID- 1631359
TI  - [Eosinophilia and ascites as an expression of a subserous form of eosinophilic
      gastroenteritis].
AB  - Clinical and biological features are discussed on a 50 years old female, who
      suffered a peritonitis with eosinophilic ascites, together with a bilateral
      pleural effusion with the same cytologic findings, developing in the course of an
      hypereosinophilia. The clinical situations in which eosinophilic ascites is
      associated with blood hypereosinophilia are reviewed. The histopathological
      findings in this case support the diagnosis of eosinophilic gastroenteritis of
      subserous type.

PMID- 1631360
TI  - [Multifocal tubercular osteitis in a female patient infected with the human
      immunodeficiency virus].
AB  - We discuss the case of a 22-year-old female, carrying of antibodies to against
      human immunodeficiency virus (HIV), who developed several tumors on different
      bone localizations, which corresponded to plurifocal bone tuberculosis. We
      reviewed multifocal bone tuberculosis reports in the literature. The
      exceptionally of this case in underlined and the relationship between this
      atypical clinical presentation and immunodeficiency in discussed.

PMID- 1631361
TI  - [The treatment of AIDS and its associated pathology].
AB  - A distinction has to be made in the treatment of the acquired immune deficiency
      syndrome (AIDS), on one hand there is the treatment of the associated pathology
      that these patients suffer when their immune system is unable to cope with
      diseases such as opportunistic infections and neoplasms; on the other there is
      the treatment of the human immune deficiency virus (HIV) itself. In this work we
      review the state-of-the-art of both therapies, paying special attention to the
      treatment of opportunistic infections, because they hold responsibility for the
      deaths in 80% to 90% of these patients; the importance of the concept of
      prophylactic treatment, primary as well as secondary, in these diseases is
      outlined. The treatment of associated neoplasms has a worse outcome. Finally the
      antiviral therapies against HIV itself, are discussed, paying special attention
      to zidovudine (AZT) and didexosinosine, two of the more currently widely used
      drugs in the treatment of these patients. We end with the review of combined
      therapy, which probably will become, in the next future, the solution in the
      treatment of this disease.

PMID- 1631362
TI  - [Hypertransaminasemia of probable toxic origin].

PMID- 1631363
TI  - [Should Hodgkin's disease be considered a diagnostic criterion of AIDS?].

PMID- 1631364
TI  - [Hypoglycemia secondary to tenoxicam].

PMID- 1631365
TI  - [The different attitudes of cancer patients and their relatives facing diagnostic
      information].

PMID- 1631366
TI  - [Cardiac tamponade as the first manifestation of neoplastic disease].

PMID- 1631367
TI  - [Left pleural effusion due to a transdiaphragmatic abdominothoracic communication
      in a cirrhotic patient with ascites].

PMID- 1631368
TI  - [Fournier's gangrene in a diabetic woman: apropos a case].

PMID- 1631369
TI  - [Adrenal hemorrhage linked to systemic lupus erythematosus associated with the
      antiphospholipid syndrome].

PMID- 1631370
TI  - [Chylous ascites associated with hepatic fibrosis].

PMID- 1631371
TI  - [Antiparasitic medication in a Spanish hospital: the needs of the year 2000].

PMID- 1631372
TI  - [Tuberous sclerosis: apropos a case with a late presentation].

PMID- 1631373
TI  - [Brucellosis: a clinico-serological study in a rural health area].
AB  - We analyze retrospectively 132 cases of brucellosis evaluating the performance of
      diagnostic procedures, complications and serological and clinical evolution. We
      compare the 74 patients treated with streptomycin plus tetracycline versus the 41
      patients treated with doxycycline plus rifampicin. The more outstanding results
      we find: a) Great sensibility of the rose bengal test; b) Higher relapse rate in
      the more severe cases (p less than 0.01); c) Good evolution with scarce relapse
      rate in both treatment groups; agglutination titers were lower at one year in the
      group treated with doxycycline plus rifampicin (p less than 0.05). CONCLUSIONS:
      Both treatments showed good efficacy, controlled studies would be needed to
      determine the most adequate one.

PMID- 1631374
TI  - Deaths from poisoning in Barcelona (Spain), 1986-1989.
AB  - Between 1986 and 1989, 3226 violent deaths were recorded in Barcelona, 489 of
      which were due to poisoning. The yearly distribution of these 489 deaths was:
      1986, 74; 1987, 98; 1988, 134; and 1989, 183. Of all poisoning deaths, 316 were
      due to narcotic opiates use, 54 to the inhalation of toxic gases, 49 to the use
      of psychoactive agents, 37 to caustic products and the others 33 cases to various
      toxic agents (insecticides, methanol, solvents, mushrooms, etc.). Opioid use is
      currently the leading cause of death by poisoning in Barcelona, and affects a
      young population with a mean age between 25 and 27 years. In the groups
      corresponding to toxic gases and psychoactive drugs, the mean ages are 48 and
      45.7 years, respectively. The oldest population was found in the group where
      death was caused by caustic agents, where the mean age is 56.5 years. The male
      sex was predominant in all groups except that of caustic agents, where 56.8% of
      the victims were women. This study confirms the notable increase in opiate-
      related deaths in the city of Barcelona (up from 27 cases in 1987 to 158 in 1989)
      and shows stability in the numbers for the other groups. Among the different
      hypotheses concerning of this remarkable increase in deaths related to opiate
      use, the aging of consumers and changes in the purity or composition of the
      product seem to be the most probable.

PMID- 1631376
TI  - [Prescription of temporary sick leave to pregnant women in the absence of legal
      provisions].
AB  - Swiss legislation doesn't provide any maternity leave for pregnant women before
      the day of delivery. A retrospective study of 550 women who had just delivered,
      showed that in the absence of such provisions, 48.9% of women who worked during
      their pregnancy had been given temporary sick leaves by their physician on one or
      more occasion. The decision of giving such sick leave depends primarily on
      whether or not the woman presents obstetrical risks and is not systematic. The
      frequency of sick leaves increases also with job load. Finally, the attitude of
      each woman, related to her personal characteristics, her degree of satisfaction
      at work and her job security, are other deciding factors for prescribing sick
      leave.

PMID- 1631375
TI  - [Risk factors in cardiovascular diseases in a semi-urban community of the
      Tunisian Sahel].
AB  - Cardiovascular diseases are the leading cause of mortality in the western
      countries at the same time they are beginning to appear with increasing frequency
      in developing countries. An epidemiologic study was carried out at Kalaa Kebira
      (Sousse-Tunisia) to determine the prevalence of the different risk factors of
      cardiovascular diseases. The study was performed on a representative sample of
      555 adults of 20 years and more (response rate of 76%). There was a high
      proportion of adult males smokers (66%). The prevalence of hypertension varied
      from 15% to 25%, those of diabetes was 6.5%. An hypercholesterolemia greater than
      6.2 mmole/l was observed for 12% of the sample and obesity for 20%.

PMID- 1631377
TI  - Self-reported smoking and exercising behaviours during the postnatal period:
      assessing congruence between spouses.
AB  - The aim of the study was to assess the congruence between women's self-reported
      behaviours during the postnatal period and the answers provided by their
      husbands. One hundred nineteen couples participated. Firstly, women reported
      their own smoking and exercising behaviours for four months following childbirth.
      Subsequently, husbands evaluated their spouses' behaviours over the same period
      of time. Smoking behaviour was assessed on 5-category scale ranging from non
      smoker to daily smoker whereas physical activity was measured on a 6-category
      scale ranging from no physical activity to regular physical activity. The
      polychoric correlation coefficients and the weighted Kappa indexes indicated that
      the degree of congruence between respondent pairs were appropriate, but better
      for smoking than exercising. The results of the present study support the idea
      that the information obtained from spouses can be helpful in the assessment of
      the reliability of the answers provided by their live-in partner, particularly in
      surveys regarding smoking.

PMID- 1631378
TI  - [Mortality due to suicide, accidents and undetermined causes in hospitalized
      mental patients 1968-1982].
AB  - An analysis of the national statistics on mortality in psychiatric hospitals,
      covering 14 years from 1968 to 1982, provided rates of deaths by suicides,
      accidents and ill-defined symptoms (chapters 16 and 17 in the ICD). Death rates
      among psychiatric inpatients are compared to rates in the general population. For
      suicide, there is an increase of about 45% in patients under 75, which is higher
      than for the general population. The evolution for accidents is close to that
      found in the general population. The death rate by ill-defined symptoms is
      decreasing. The increase in the rates of deaths by suicide found both in France
      and in several other countries suggests that the major changes (sectorization
      policy and use of psychotropic drugs), in the care lead to increased risk of
      suicide for certain patients due to shortened hospital stays and subsequent
      intermittent institutional care. Specific modes of death can also be described:
      senility without mention of psychosis, airway obstruction by false passages,
      notably in subjects under 55, accidental falls, hangings and drownings are
      particularly important in the observed over-mortality.

PMID- 1631379
TI  - Decline of accident mortality in childhood, Italy, 1955-1984.

PMID- 1631380
TI  - [Occupational medicine in Morocco. Current status and future perspectives].

PMID- 1631381
TI  - Epidemiology and prevalence of seropositivity against Borrelia burgdorferi
      antigen in La Rioja, Spain.
AB  - The aim of this study was to acquire a better knowledge of the epidemiology of
      Lyme disease. A seroepidemiologic study was made by evaluating the different
      levels of antibodies to Borrelia burgdorferi in a five hundred serum
      representative sample of a population from the province of La Rioja, Spain.
      Samples were randomly selected and stratified to take into account sex, age,
      rural or urban residence, and geographical area. All subjects included in the
      study were asked to fill out a questionnaire containing this information along
      with data concerning leisure activities, occupation, contact with animals, tick
      bite and antecedent features related to Lyme disease. No statistical differences
      were found in relation to sex or age. The seroprevalence was very high (31.3%) in
      mountain areas, where Ixodes ricinus and deer are present. The risk factors
      associated with seropositivity were forestry and cattle-raising activities, as
      well as contact with animals. The best titer of antibodies associated with
      clinical antecedents of Lyme disease and related disorders was 1/256.

PMID- 1631382
TI  - [Influence of educational status on a screening test for dementia, the Mini
      Mental State Examination].
AB  - This study aimed to examine the relationships between the educational level and
      the Mini-Mental State Examination (MMSE) total scores and its different items. In
      a survey dealing with cerebral aging, the MMSE administered 2,792 subjects aged
      65 years and over, who continued to live at home. The total score decreased with
      age and increased markedly when the educational level rose. The proportion of
      failures was higher than or equal to 10% for 12 of the 30 MMSE items, including
      the 5 items designed to measure attention ability (serial subtractions) and the 3
      ones exploring delayed memory. Regarding these 12 items, the percentage of
      failures increased homogeneously with age, but the relationship with educational
      level was heterogeneous: it was very strong for the calculation items, weaker for
      the delayed memory items. These results pointed to the complex relationships
      between MMSE scores and educational level, and suggested a possible bias related
      to the screening tool in dementia surveys.

PMID- 1631383
TI  - [A mid-term clinical and hemodynamic evaluation of the Wessex and Hancock II
      bioprostheses].
AB  - The purpose of this study is to compare clinically and hemodynamically the Wessex
      and Hancock II porcine bioprostheses. We compared functional class and data from
      echo-Doppler in 34 Wessex bioprostheses (group A) with those in 42 Hancock II
      bioprostheses (group B). We subdivided group A into A1 and A2. A1 was made up of
      23 Wessex manufactured since 1986. A2 constituted 11 Wessex made before 1986
      which belonged to a series with some variations in the manufacturing process, and
      in which some early dysfunctions have been described. We compared data from these
      sub-groups between each other as well as with those of group B. The groups were
      homogeneous in age, sex, patients body surface and the time elapsed since the
      prosthetic implant. The mean mitral gradient, the mitral area, the peak aortic
      gradient and the regurgitation incidence were similar in groups A and B. In A2
      the mean mitral gradient was significantly superior to that of group B (7.1 +/-
      1.1 mmHg vs 5.4 +/- 1.4 mmHg; p less than 0.01), and the mitral area showed a
      tendency to be inferior, although with no statistical significance. The
      functional class of the patients was similar in all the groups. We conclude that
      the Wessex bioprosthesis presents hemodynamic data and functional class similar
      to those of the Hancock II, with the exception of a sub-group of Wessex
      manufactured before 1986 which presents mean mitral gradients superior to the
      others and which would warrant further studies.

PMID- 1631384
TI  - [Myocardial infarct in the geriatric patient: the short- and mid-term prognostic
      factors].
AB  - The purpose of this study was to investigate the clinical features and the
      prognostic factors related to early and late mortality in the acute myocardial
      infarction (AMI) in the geriatric population. We have studied 208 consecutive
      patients with AMI admitted to the Coronary Care Unit at the Hospital General de
      Asturias. Two groups were selected: group A included 102 patients older than 65
      years; and 106 were younger (group B). In the group A was found a significantly
      lower percentage of males (52.9% vs 89.6%; p less than 0.0001) and smokers (45.1%
      vs 89.6%; p less than 0.0001); and older patients showed a greater incidence of
      diabetes mellitus (30.7% vs 16%; p less than 0.01). In the geriatric group, the
      clinical course of AMI is characterized by a greater incidence of heart failure
      (50% vs 29.2%; p less than 0.002) and cardiogenic shock (22.5% vs 7.5%; p =
      0.002). Early mortality (first month) was significantly higher in elderly
      patients (36.3% vs 7.5%; p less than 0.001); and this increased mortality rate is
      partially related to an increased incidence of heart pump failure, despite having
      a smaller enzymatic infarct size by CPK peak (1,062 +/- 1,017 U/l vs 1,579 +/-
      1,428 U/l; p less than 0.005). The multivariate analysis by stepwise logistic
      regression, selected diabetes mellitus, heart failure and peri-infarct bundle
      branch blocks as the only independent predictive variables for the early
      mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631385
TI  - [Color-coded Doppler in the diagnosis of vascular complications following heart
      catheterization].
AB  - To determine the value of color Doppler in the diagnosis of vascular
      complications resulting from cardiac catheterization 5 consecutive patients, with
      the clinical suspicious of vascular iatrogenesis potentially requiring surgical
      repair, were analyzed. In 2 patients a femoral mass developed after a diagnostic
      catheterization but 3 patients underwent previously an interventional
      catheterization technique. In 3 patients color Doppler readily visualized a
      systolic jet originated in the femoral artery entering an anterior echo-free
      cavity, and a reversal flow in diastole, suggesting a femoral pseudoaneurysm. In
      1 patient the clinical diagnosis of arteriovenous fistulae was confirmed by color
      Doppler which demonstrated a continuous turbulent flow within the femoral vein.
      In the remaining patient a diagnosis of simple femoral haematoma was made after
      the demonstration of a relatively echogenic structure overlying the femoral
      artery and vein but not interfering with their flows. In the 3 patients with
      femoral pseudoaneurysms and in the patient with arteriovenous fistulae the
      diagnosis was confirmed by angiography and during surgery. Our preliminary
      findings underscore the value of color Doppler, using the technology currently
      available in echocardiographic laboratories, in the differential diagnosis of
      vascular complications after cardiac catheterization.

PMID- 1631386
TI  - [The value of isotopic ventriculography in the prognosis and follow-up of
      patients undergoing dynamic myocardioplasty].
AB  - Dynamic cardiomyoplasty was performed in twenty patients with dilated
      cardiomyopathy. The electrical stimulation was produced by a double chambered
      pacemaker. Patients were studied by nuclear ventriculography one week before
      surgery, in the immediate postoperative phase and 8 or 12 months later. Five
      patients died (four of them were operative deaths). In this group the left
      ventricular ejection fraction (LVEF) was lower than in survivors (22 +/- 8% vs 28
      +/- 4%; p less than 0.001). The end-diastolic volume and the mitral regurgitation
      index were greater (200 +/- 76 ml/m2 vs 153 +/- 34 ml/m2; p less than 0.001 and
      2.12 +/- 0.75 vs 1.68 +/- 0.54; p less than 0.001, respectively). The immediate
      effect of cardiomyoplasty was the significative reduction in the contractility.
      However, at 8 or 12 months of follow-up, the LVEF increased in the 72% of the
      survivors. The end-diastolic volume and the regurgitation index decreased
      significantly. The clinical status improved in the 81% of the survivors. The best
      results were obtained in those patients in which a pulse train stimulation was
      employed in the training phase. Nevertheless, the changes in LVEF are not
      consistent with the improvement in the clinical status. The improve in the
      cardiac performance should be also due to the reduction in the left ventricular
      diameters and in the mitral functional regurgitation.

PMID- 1631387
TI  - [The usefulness of isotopic ventriculography in the follow-up of left ventricular
      dysfunction].

PMID- 1631388
TI  - [The present, future, reality and fiction of cardiomyoplasty].

PMID- 1631389
TI  - [Biventricular functional adaptation during a prolonged race. An analysis of
      global and regional ventricular function].
AB  - To determine the effects of a six-hour competitive race on left and right
      ventricular performance, 99mTc gated blood pool scans were performed to 6 long
      distance runners before the race (rest), each hour during the race and one hour
      after concluding the exercise (recovery). Heart rate increased during the race,
      peaking at 4th hour of competition (55 +/- 3 to 110 +/- 9 lpm; p = 0.001).
      Evolution of right ventricular ejection fraction showed a similar behavior with
      the evolution of left ventricular ejection fraction during the competition (r =
      0.39; p = 0.006). Blood volume in the lungs increased at the end of the race
      (index 1.13 +/- 0.14) normalizing at recovery (index 1.03 +/- 0.03). Left and
      right ventricular peak filling rate had an inverse correlation with pulmonary
      blood volume (r = -0.31; p = 0.041 and r = -0.47; p = 0.001 respectively). Both
      left and right ventricular ejection fraction had an inverse correlation with
      pulmonary blood volume (r = -0.38; p = 0.006 and r = -0.34; p = 0.01
      respectively). The anteroseptal regional ejection fraction showed an inverse
      correlation with end-systolic and end-diastolic volume (r = -0.32; p = 0.03 and r
      = -0.4; p less than 0.01 respectively). The posterolateral region showed a
      parallel evolution with the global ejection fraction for both left and right
      ventricles (r = 0.57; p less than 0.0001 and r = 0.38; p = 0.009 respectively).
      In conclusion, a transient biventricular functional adaptation during a prolonged
      race is related to pulmonary blood volume redistribution and to a higher preload
      for both ventricles and a greater afterload for the right ventricle. The
      posterolateral and inferoapical regions show a similar behavior as both left and
      right ventricular ejection fraction, response that does not occur with the
      anteroseptal regional ejection fraction.

PMID- 1631390
TI  - [Diverticulum of the right ventricle with dilated myocardiopathy].
AB  - We report on a newborn infant with right ventricular diverticulum associated to
      dilated myocardiopathy, who was diagnosed by two-dimensional echocardiography
      within 24 hours after vaginal delivery. We believe this case represents the
      youngest one ever diagnosed with this disease.

PMID- 1631391
TI  - [An aortobronchial fistula 11 years after the resection of a posttraumatic aortic
      aneurysm].
AB  - A case of a 47-year-old white male who developed an aortobronchial fistula eleven
      years after resection of a posttraumatic aneurysm of the descending aorta is
      presented. The clinical picture, the diagnostic problems as well as the treatment
      are presented and commented.

PMID- 1631393
TI  - The need for advocating specialized care.

PMID- 1631392
TI  - [A diffuse pulmonary hemorrhage following thrombolytic therapy in an acute
      myocardial infarct].
AB  - A sixty-years-old man was admitted to the hospital because of acute myocardial
      infarction of anterior location. He had four episodes of ventricular fibrillation
      each requiring defibrillation and short-term cardiopulmonary resuscitation (less
      than 10 minutes). He was then managed with thrombolytic therapy, therapeutic
      doses of heparin and aspirin. He had persistent haemoptysis, chest X-ray
      revealing a diffuse bilateral alveolar infiltration. There was a continuous
      decrease in hemoglobin and hematocrit levels, with an evident clinical
      radiographic dissociation. Right cardiac catheterisation showed a normal left
      ventricular function. The single breath carbon monoxide diffusing capacity
      (DLCOsb) was high, indicative of a diffuse intrapulmonary haemorrhage causing the
      alveolar infiltration.

PMID- 1631394
TI  - Fatigue in multiple sclerosis: guidelines for nursing care.
AB  - Fatigue is a common chronic symptom of multiple sclerosis (MS) that can have
      disabling effects on the patient's quality of life. The cause of this fatigue is
      unknown, and there is no specific treatment for it. This article presents the
      major problem areas and manifestations associated with fatigue and incorporates
      suggested guidelines for the rehabilitation nurse to use in helping patients with
      MS manage this symptom. Major symptom areas include (a) physiological problems,
      (b) affective/behavioral/cognitive problems, and (c) environmental problems.
      Comprehensive intervention is addressed and the concept of fatigue as a nursing
      diagnosis is presented.

PMID- 1631395
TI  - A pediatric rehabilitation experience for undergraduate nursing students.
AB  - Pediatric rehabilitation is a specialty that will need more nurses in the future.
      A clinical rotation in this specialty was incorporated into the pediatric
      experience of junior-year baccalaureate nursing students at the University of
      Maryland School of Nursing. The experience helped students to learn more about
      the nursing care involved in pediatric rehabilitation, to appreciate the
      different disciplines within the specialty, and to view pediatric nursing from a
      holistic long-range perspective. The experience also strengthened ties between
      nursing education and practice.

PMID- 1631396
TI  - Managing crisis in a rehabilitation facility.
AB  - When crisis occurs in a healthcare facility, it involves not only the individual
      and his or her family, but also staff and management personnel--and personnel
      often are as disoriented and confused by crisis as is the individual. Healthcare
      providers, trained to manage the crises of others, are often at a loss when
      confronted with crisis in their own facility. The purpose of this article is to
      provide an outline of a strategy rehabilitation managers can follow in the event
      of a crisis in their facility.

PMID- 1631397
TI  - The evolution of rehabilitation facilities for children.
AB  - This article describes the development of rehabilitation facilities for children
      in the United States. The historical beginnings and subsequent growth of agencies
      nationwide that provide a variety of rehabilitative services for the pediatric
      population (birth to 21 years) are described. The origin of many of the modern
      day rehabilitation centers for all ages is seen in the founding of "homes" and
      other facilities for children during the late 19th and early 20th centuries. As
      the 21st century approaches, it is important to reflect on how far pediatric
      rehabilitation has come and project its continued growth and expansion through
      the year 2000.

PMID- 1631398
TI  - Restoring childhood through rehabilitation.
AB  - Nine-year-old Alesha's symptoms began with tingling in her hands, and within a
      few months she could neither walk nor talk. Alesha has Wilson's disease, a rare
      genetic condition that results in a progressive buildup of copper in the body.
      Alesha lost 2 years of her life to Wilson's disease. This article focuses on the
      clinical and rehabilitation aspects of Wilson's disease and on the efforts to
      restore to Alesha the childhood the disease cost her. Nursing care for Alesha
      involved physiological, developmental, and restorative components, with special
      attention to the home pediatric rehabilitation program.

PMID- 1631399
TI  - Deep vein thrombosis in the rehabilitation client.
AB  - Deep vein thrombosis (DVT) is a potentially life-threatening problem for both
      medical and surgical patients. The rehabilitation client is at high risk of
      developing DVT. Conditions such as spinal cord injury, paraplegia,
      cerebrovascular accident, and total hip replacement place patients at risk for
      developing DVT. Unfortunately, few articles that address nursing interventions
      for this problem in the rehabilitation population have been written. This article
      examines the scope of the problem and its causes, pathogenesis, risk factors, and
      signs and symptoms from a rehabilitation nursing perspective.

PMID- 1631400
TI  - A lesson from Mr. C.

PMID- 1631401
TI  - Early detection of pulmonary embolism.

PMID- 1631402
TI  - Clonal deletion and anergy: from models to reality. Introduction.

PMID- 1631403
TI  - A lifetime's flirtation with repertoire purging.

PMID- 1631404
TI  - Mechanisms and meaning of B-lymphocyte tolerance.

PMID- 1631405
TI  - Analysis of B-cell tolerance in mice expressing transgenic anti-CD8.2
      immunoglobulin M molecules.

PMID- 1631406
TI  - The parameters of B-cell inactivation in transgenic mice vs classical model
      studies.

PMID- 1631407
TI  - Can self/nonself discrimination be explained entirely by clonal deletion?

PMID- 1631408
TI  - What is the mechanism of induction of intrathymic tolerance?

PMID- 1631409
TI  - Peptide-mediated anergy in human CD4+ T cells.

PMID- 1631410
TI  - Tolerance to peripheral antigens must involve non-deletional mechanisms.

PMID- 1631411
TI  - Peripheral tolerance.

PMID- 1631413
TI  - T cells causing immunological disease: immunopathology or autoimmunity?

PMID- 1631412
TI  - Deletion versus anergy: the superantigen paradigm.

PMID- 1631414
TI  - Post-thymic T-cell tolerance or indifference: that is the question.

PMID- 1631415
TI  - Was everyone a "little bit right" after all?

PMID- 1631416
TI  - The self/nonself discrimination: reconstructing a cabbage from sauerkraut.

PMID- 1631417
TI  - Clonal deletion, anergy and immunosuppression are connected in series to
      guarantee self-tolerance.

PMID- 1631418
TI  - Some reasons why deletion and anergy do not satisfactorily account for natural
      tolerance.

PMID- 1631419
TI  - [Temperament and freedom: biological foundations of the free will].

PMID- 1631420
TI  - [Bone marrow graft in hereditary diseases].
AB  - Since 1968, bone marrow transplantation became the first line therapy for
      selected metabolic and immunological hereditary disorders. Actually, advances in
      the supportive care in bone marrow transplantation and a better knowledge of the
      immunology of BMT complications has been associated with a better disease
      correction and an increase in long term survival. New approaches are under
      investigation and include: hematopoietic growth factors, enzymatic replacement
      and gene therapy. However at the present time BMT is still the only curative
      treatment for selected hereditary disorders.

PMID- 1631421
TI  - [Psychological adaptation to bone marrow transplantation].
AB  - Bone marrow transplantation, used with increasing success over the past ten
      years, is recognized as highly stressful. Physiological and psychological
      rehabilitation after treatment is often difficult. This paper outlines the
      psychological issues encountered by adult patients with haematological
      malignancies through a review of the adjustment disorders associated with bone
      marrow transplantation, their prevalence, symptomatology and predictive factors.
      Some guidelines are proposed for the prevention of the stresses associated with
      hospitalization.

PMID- 1631422
TI  - [Pulmonary nodule and Osler-Rendu disease].

PMID- 1631423
TI  - [Biocompatible materials and prostheses].

PMID- 1631424
TI  - [Technique and indications for total hip prosthesis].

PMID- 1631425
TI  - [Complications in total hip prostheses].

PMID- 1631426
TI  - [Hip prosthesis: the anesthesiologist's point of view].

PMID- 1631427
TI  - [Functional readaptation in the hospital after total hip prosthesis].

PMID- 1631428
TI  - [Development of a protocol for the education of stoma patients].

PMID- 1631429
TI  - [Total hip prosthesis, a diversified practice].

PMID- 1631430
TI  - [Liver, bile ducts (1), cholecystectomy (anatomical data)].

PMID- 1631431
TI  - [Blood derivatives (2)].

PMID- 1631432
TI  - [The textile industry serving the operating bloc. Barrier textiles and double
      faced adhesive film].

PMID- 1631433
TI  - [Anatomy and physiology of the hip joint].

PMID- 1631435
TI  - [Complications of total knee replacements].

PMID- 1631434
TI  - [Total sliding knee replacement: technique of insertion].

PMID- 1631436
TI  - [Knee prosthesis: rehabilitation in the hospital service].

PMID- 1631437
TI  - [Preoperative nursing care].

PMID- 1631438
TI  - [The patient in the operating suite].

PMID- 1631439
TI  - [Role of the circulating nurse and the scrub nurse].

PMID- 1631440
TI  - [Role of the nurse anesthetist].

PMID- 1631441
TI  - [Postoperative nursing care].

PMID- 1631442
TI  - [Total knee replacement. A still difficult intervention].

PMID- 1631443
TI  - [Treatment of pain in pediatric surgery].

PMID- 1631444
TI  - [Anatomo-physiological review of the knee].

PMID- 1631445
TI  - [ What is your diagnosis? Adenovirus pneumonia].

PMID- 1631446
TI  - [Antibiotic therapy in ambulatory surgery].
AB  - Antibiotic therapy in outpatient surgical care is reviewed. In the first section
      some skin and soft-tissue infections are discussed, where antibiotics are likely
      to achieve clinical cure. In the second section we examine, where surgical
      treatment alone is essential for successful eradication of the infection. Wound
      management, where antibiotics are still controversial, is mentioned in the last
      section. Some pharmacological data on the discussed antibiotics are given.

PMID- 1631447
TI  - [Assessment and treatment of minor cranio-cerebral injuries].
AB  - Despite the usually uncomplicated course, minor head injury has a major economic
      impact because of its high frequency. The traditional evaluation and management
      using plain skull x-rays and subsequent surveillance has recently been questioned
      due to the wide-spread availability of CT and MRI. Indication and value of these
      diagnostic methods, however, are still ill-defined. The resulting uncertainty
      leads to increasing pressure on the smaller hospitals to transfer patients with
      minor head injury to specialized centres. This trend causes further financial
      escalation and the capacity of the specialized centres is not large enough to
      admit all minor injuries. The present review is focused on the initial risk
      estimation after minor head injury with the aim to derive guidelines for safe and
      efficient patient management. Adequately communicating patients without history
      of loss of consciousness have only a minimum risk of an intracranial haemorrhage
      and need not routinely be submitted to x-ray studies or in-hospital surveillance.
      Patients with a history of change of consciousness carry a risk of a few percent
      to develop intracranial haemorrhage and need therefore be admitted for 24 hours.
      A skull fracture increases the risk of haemorrhage to approximately 10%. An
      initially unsuspicious CT-scan is no absolute guarantee against subsequent
      intracranial haemorrhage. Patients who are disoriented and/or somnolent upon
      emergency room admission or who display a focal neurological deficit have a high
      risk of intracranial haemorrhage and emergency CT-scan is therefore recommended.
      The expensive MRI technique is not justified for initial diagnostic work up of
      head injuries. However, this technique represents a sensitive means to define
      organic lesions in cases of persistent neurological or neuropsychological
      deficits.

PMID- 1631448
TI  - [Acute deterioration of the CO diffusion capacity following exposure to ski-wax
      vapors].
AB  - In cross country skiing use of hot wax is of importance. 90% of the active swiss
      cross country skiers have their own, self maintained equipment. Long unprotected
      exposure to hot wax fumes may cause disturbance of lung function. To examine
      short lasting disturbance in pulmonary function, CO-diffusion capacity and
      dynamic and static lung volumes in five healthy human subjects after exposure for
      one hour to hot wax (containing Paraffin and Cera-F) were determined. The
      subjects complained about burning eyes and tears, sore throat and coughing.
      Immediately after exposure all subjects showed a significant decrease of the CO
      diffusion capacity of 10.6% (SEM 3.9), related to the ventilated alveolar space
      (DCOSB/VA). Maximal decrease of 13.6% (SEM 2.4) was after 90 min. After 24 hours
      the reduction persisted with 9.4% (SEM 2.1). The dynamic and static lung volumes
      remained unchanged. In summary a reduction of the CO-diffusion capacity after
      inhalative hot wax exposure was observed for at least 24 hours.

PMID- 1631449
TI  - [An insulin-dependent diabetes patient with bloody diarrhea].

PMID- 1631450
TI  - [A case from practice (247). Amnesic disorders in vertebral artery occlusion and
      arterial hypertension].

PMID- 1631451
TI  - [What is your diagnosis? Infectious mononucleosis. Synonyms: Pfeiffer's glandular
      fever, kissing disease, monocytic angina].

PMID- 1631452
TI  - [Gallstones: etiology and risk factors].
AB  - Cholesterin is excreted into bile together with phospholipids and bile acids,
      which are essential for the formation of micelles. Cholesterin-supersaturation of
      the bile and a relative hyposecretion of bile acids, the presence resp. the lack
      of promotors and inhibitors of nucleation and a reduced gallbladder contractility
      are the most important factors in the formation of cholesterol stones. For the
      formation of pigment stones, however, an increase of bilirubin production and
      infection of the biliary tract are the causative factors.

PMID- 1631453
TI  - [Gallstones: natural course and complications].
AB  - Cholelithiasis is a common clinical situation. In most individuals it takes an
      inconspicuous clinical course. In symptomatic patients the complications have to
      be considered: acute cholecystitis, cholangitis, choledocholithiasis,
      pancreatitis, ileus by large stones and--in a subgroup of patients--carcinoma of
      the biliary system. Therapy is warranted in symptomatic patients in order to
      prevent complications. The decision for use of surgical versus non surgical
      interventions is decided on a individual basis. In general laparoscopic
      cholecystectomy is the procedure of choice nowadays. A prophylactic
      cholecystectomy is as a rule not indicated in asymptomatic patients.

PMID- 1631454
TI  - [Drug therapy of gallstone disease].
AB  - Cholesterol stones in the gallbladder can be dissolved in 60 to 90% by oral
      administration of chenodeoxycholic acid, ursodeoxycholic acid or the combination
      of both. The effect depend on the number and size of stones. Treatment is without
      any side effects and lethality. A great number and large stones can be dissolved
      by direct instillation of methyl-tert-butyl-ether (MTBE) into the gallbladder
      using the percutaneous transhepatic method. The success rate amounts to 90%, the
      average therapy duration is 9 hours. Solvents for chemolitholysis of pigmented
      stones are being tested.

PMID- 1631455
TI  - [Biliary extracorporeal shock-wave lithotripsy].
AB  - Since 1985/86, more than 200 patients with problematic intra- and extrahepatic
      bile duct stones were treated with ESWL. Results are excellent and comparable
      with ESWL's success-story in urinary stone disease, abandoning widely open
      surgery for bile duct stones. In gallbladder-stone treatment, ESWL (always
      combined with bile acid litholysis) is only promising or successful in a
      carefully selected subset (10 to 15%) of all symptomatic patients (with good
      gallbladder contractility, limited stone volume and sonolucent stones).

PMID- 1631456
TI  - [Percutaneous and trans-papillary cholangioscopy: current diagnostic and
      therapeutic possibilities].
AB  - Peroral and transhepatic cholangioscopy represent a substantial enrichment of the
      diagnostic and therapeutic spectrum in gastroenterology. The use of
      cholangioscopy in the diagnostics of hepato-biliary disease seems to make
      especially sense in those cases where ERCP, sonography and CT do not lead to a
      sufficient clarification of the pathological findings and inspection, biopsy and
      cytology are required. An essential field of application for cholangioscopy
      consists today in the lithotripsy of giant common bile duct stones where laser
      lithotripsy means an important progress in the complication-free removal of these
      concrements. Percutaneous-transhepatic cholangioscopy as the more invasive
      procedure is especially indicated in those cases where due to former operations
      or special anatomical situations the endoscopic retrograde access is difficult or
      impossible. Further fields of application like endoluminal ultrasound via
      miniaturized probes or photodynamic diagnostics and photodynamic therapy (PDT) of
      cholangiocarcinoma seem to be valuable aims for the future.

PMID- 1631457
TI  - [How can the AIDS virus outsmart our immune system?].

PMID- 1631458
TI  - [How to interpret signals of an ultrasonic study: normal ultrasonic anatomy of
      the upper abdomen].

PMID- 1631459
TI  - [Anal incontinence: practical approach].

PMID- 1631460
TI  - [Can gastroduodenal lesions induced by non-steroidal anti-inflammatory agents be
      prevented?].

PMID- 1631461
TI  - [Viral hepatitis C].

PMID- 1631462
TI  - [Antibiotic-induced diarrhea and its prevention].

PMID- 1631463
TI  - [Role of biosynthetic growth hormone in the nutritional management of adults].

PMID- 1631464
TI  - [Asthma, allergy, current issues. Report of the "3A" of 10/26/1991: asthma and
      eosinophils].

PMID- 1631465
TI  - [Management of chronic neurologic patients: apropos of patients with severe
      cerebrovascular involvement].
AB  - We present clinical date and follow up in a rehabilitation unit with a
      multidisciplinary team for twenty two old patients with severe cerebrovascular
      disease. The patients were fully examined in the "Service de neurologie de
      Lausanne". New cerebral vascular accidents occurred in three patients. The other
      patients improved in functional status evaluated by the Barthel-Index in spite of
      no significant changes in neurological and neuropsychological status.

PMID- 1631466
TI  - [Prognosis in brain stem infarction].
AB  - A retrospective study of patients who suffered cerebrovascular accidents (CVA
      particularly brainstem damage) was conducted to look for risk factors which,
      present on admission, indicated the chance of survival. The evolution of 100
      patients, hospitalized in the Neurology Department, University Hospital Lausanne,
      after having had their first CVA was studied. The risk factors chosen were age,
      sex, hypertension, smoker, late onset diabetes, hypercholesterolemia as well as
      the conscious state, the location of the lesion and whether it was bi- or
      unilateral. Analysis of the data was performed by means of a stepwise multiple
      logistic regression program. The results demonstrated that diabetes or bilateral
      lesions, regardless of their position in the brainstem, or the combination of
      these two factors, indicated an unfavorable outcome, associated with a short term
      mortality rate greater than 30%. In their absence and despite the presence of the
      other risk factors, it was less than 2%. At one month the mortality rate was
      shown to be very high. At two month it was non insignificant and thereafter it
      became similar to that of the Swiss population. Brainstem lesions extending to
      the vital centres or respiratory complications related to the state of dependence
      were the most common causes of short term deaths. At long term the aetiology of
      death was the same as for the population as a whole. CONCLUSION: The results
      obtained show the importance of the prevention and treatment of patients at risk
      of CVA, particularly diabetes. To avoid the fatal complications, that arise from
      severe handicap in bedridden patients, the management must be rapid and efficient
      (physiotherapy and drugs).

PMID- 1631467
TI  - [Continuous infusion of a mixture of propofol, alfentanyl and atracurium in
      current anesthesiology practice. Apropos of 50 cases].

PMID- 1631468
TI  - [Individualized care in the care of the many].

PMID- 1631469
TI  - [Disaster plan of Geneva airport].

PMID- 1631470
TI  - [Dudgeon's sphygmograph (1881)].

PMID- 1631471
TI  - [HIV epidemic: an end to exceptional regulation? Response to the article which
      appeared under this title in the Revue medicale de la Suisse romande (112, 239
      241, 1991)].

PMID- 1631472
TI  - [Evaluation of the endometrium in postmenopausal women by means of vaginal
      ultrasound].
AB  - In the context of a prospective study, the authors carried out vaginal ultrasound
      examinations at the Gynecology-Obstetrics Clinic of Gottingen University of two
      groups of post-menopausal women: 233 women with hemorrhage and 539 who were
      asymptomatic. A diagnostic curettage was carried out in cases where the
      endometrium had a depth of at least 4 mm. The authors identified a 6% incidence
      of cases of adenomatous hyperplasia, 21% of endometrial cancer in women with
      hemorrhages and a 20% cancer rate in the asymptomatic women. Where the thickness
      of the endometrium was less than 4 mm, there were no cases of cancer. The
      infiltration depth examined microscopically was twice as great in the patients
      with hemorrhages (10 mm vs 4 mm).

PMID- 1631473
TI  - [Endometriosis and sterility: whom to treat and how?].
AB  - The difficulty in evaluating the efficacy of treatments for endometriosis in
      terms of sterility results from the frequent confusion between the inhibition of
      the natural progression of endometriosis and a beneficial effect on fertility.
      The authors review the supposed benefits and the drawbacks of the various medical
      and surgical treatments available and medically assisted fertilization (IVF) in
      the context of the various types of endometriosis damage. They highlight the
      inadequacy of the AFS score, which gives very similar scores for effects with
      widely differing impacts on fertility. The authors attempt to identify the
      therapeutic associations which seem currently to be useful in treating
      endometriosis and also beneficial in obtaining a pregnancy.

PMID- 1631474
TI  - [The Hellp syndrome. Clinical and laboratory test results].
AB  - The Hellp syndrome is a complication of toxemia. It may occur before, during or
      after childbirth and may not be accompanied by any sign of toxemia. The main
      clinical sign is pain in the hepatic region. Haptoglobin is the most reliable
      parameter to demonstrate hemolysis, which is one of the disorders related to this
      syndrome. In the authors' opinion, early diagnosis and immediate delivery by
      Cesarean are the appropriate methods to use to reduce maternal and perinatal
      mortality. Conservative treatment is not generally effective and is dangerous.

PMID- 1631475
TI  - [Diagnostic and prognostic value of umbilical and cerebral Doppler velocimetry in
      intrauterine growth retardation].
AB  - The diagnostic and prognostic value of Doppler velocimetry in delayed
      intrauterine growth was investigated in a series of 105 abnormal pregnancies. The
      diagnostic value of the umbilical Doppler velocimetry, whether alone or combined
      with simultaneous exploration of the umbilical and cerebral vessels was very
      limited. In contrast, the simultaneous exploration of the umbilical and cerebral
      vessels was of considerable prognostic value, since with regard to the risk of
      fetal distress, the sensitivity was 86.6%, the specificity 80% and the positive
      predictive value 63%. The negative predictive value was 95% and the prevalence
      28.5%. The authors' experience also confirms the prognostic seriousness of the
      absence of diastolic flow or of reverse flow (2 perinatal deaths out of 6 cases).
      The interval between the changes in Doppler velocimetry and fetal distress is
      variable, however, ranging from two days to three weeks or more in these cases.

PMID- 1631476
TI  - [Cancer of the endometrium caused by antiestrogens].
AB  - Tamoxifen is the most widely used non-steroidal antiestrogen compound for
      adjuvant treatment of postmenopausal breast cancer. Tamoxifen has both
      antiestrogen and estrogen-agonistic activity, which depends on the target tissue
      involved owing its systemic distribution. Upon the endometrium the agonistic
      estrogenic effect, so-called "paradoxical" effect, is suggested to induce
      proliferative changes such as hyperplasia or carcinoma. The authors report four
      cases of endometrial cancer developed in postmenopausal patients with breast
      cancer receiving tamoxifen. According to the literature data, the relationship of
      the tamoxifen to the endometrial remains uncertain: women with breast cancer are
      at increased risk for this neoplasm sharing common aetiologic hormonal factors
      and, in most published case reports, the uterine cavity has not been checked up
      before starting tamoxifen administration.

PMID- 1631477
TI  - [Intravaginal echography at the beginning of pregnancy].
AB  - Endocavity ultrasound during the first three months of pregnancy provides greater
      detail in a number of obstetrical fields. In most cases, endocavitary ultrasound
      is not simply a way of "gaining time" in comparison with conventional
      transabdominal ultrasound (time saved estimated to be one week). In some cases it
      is also offers a definite "extra". Two areas of interest are focussed on
      particularly by the authors: 1) the fetal appendages (vitelline sac, membranes,
      extra-embryonic coelom, trophoblast) which may be detected or revealed in greater
      detail by endovaginal ultrasound, make it possible to get a picture of the
      embryology of the fetus and of the prognosis of the pregnancy. The combination of
      color coded Doppler corroborates this new approach to the fetus; 2) the
      developments of this "sono-embryology" makes it possible to identify certain
      fetal malformations at a very early stage (neuro-medullary, parietal
      malformations...). However, interpreting the morphology of the fetus examined
      during the first three months must remain prudent and is no substitute for the
      morphological ultrasound scan carried out at about four and one half months of
      pregnancy.

PMID- 1631478
TI  - [Tubal sterility. What treatment to propose: IVF or surgery?].
AB  - The results of IVF in cases of tubal sterility are compared with those of surgery
      (macro- or micro-surgery, coelio-surgery). This analysis includes a continuous
      series of 1051 attempted pregnancies in 640 women (with or mixed tubal sterility
      with or without endometriosis). After an average 1.64 attempts per patient, 220
      women had achieved 241 pregnancies (pregnancy rate: 22.9% per puncture, 34.3% per
      woman). Of these 241 pregnancies, there were 172 (71.8%) which continued to term,
      57 (23.6%) miscarriages and 11 (4.6%) ectopic pregnancies. The pregnancies
      carried to term were single pregnancies in 129 cases (74.6%), twin pregnancies in
      37 cases (21.4%) and triple pregnancies in 7 cases (4%). The indication of coelio
      surgery (or microsurgery) is justified in young women with no history of genital
      tuberculosis, tubal plasty or ectopic pregnancy and presenting with purely tubal
      sterility with a good prognosis. Restoration of patency after tubal sterilization
      remains a good indication for microsurgery in young women. In all other cases,
      indication is for IVF from the outset.

PMID- 1631479
TI  - [Efficacy and acceptability of dexfenfluramine in women consulting in gynecology.
      336 overweight patients treated for 3 months].
AB  - The efficacy on bodyweight and the acceptability of a three month treatment with
      dexfenfluramine (Isomeride), combined with a prescribed diet, were evaluated in
      336 women followed by a gynecologist for overweight. These women were divided
      into three groups, those in the sexually active age group (80%) and
      perimenopausal and post-menopausal women (20%) and had the following
      characteristics: mean bodyweight 80.2 +/- 0.6 kg; excess bodyweight 35.0 +/- 0.5%
      of theoretical ideal weight, mean bodyweight index = 30.6 +/- 0.2 kg/m2.
      Simultaneously with the weight loss, a study of the change in gynecological
      symptoms was carried out at each consultation and for each group. Investigation
      of the bodyweight showed that 80% of the patient who followed the treatment for
      three months lost weight, the mean loss being 7.2 kg or 41.9% of the initial
      excess weight. Simultaneously with this loss of weight, there was an improvement
      in the gynecological symptoms in all three groups. These symptoms included those
      seen in the premenstrual phase (sexually active age group) and menopause-related
      symptoms in the perimenopausal and post menopausal groups. The acceptability and
      safety of Isomeride were also confirmed in this study.

PMID- 1631480
TI  - Sweets and other sugary products tend to be the primary etiologic factors in
      dental caries.
AB  - The aim of this study was to analyze the relationships between caries incidence
      and each of seven caries-related factors in a group of 15- to 18-yr-olds as well
      as in single and combined subgroups representing favorable or less favorable
      fractions of six of the factors. Sixty-nine 18-yr-olds were interviewed about
      consumption of sweets and other sugar-containing products during the past 3 yr
      and examined for oral hygiene, salivary counts of mutants streptococci and
      lactobacilli, salivary flow rate and oral sugar clearance time at the ages of 15
      and 18. Simple linear correlations and a stepwise multiple regression analysis
      were used to compare ranks and explanatory values. The highest correlations were
      obtained for intake of sweets and intake of other sugary products, with r values
      increasing from 0.25 and 0.16, respectively, in the total material to 0.70 and
      0.67 in less favorable fractions of oral hygiene, salivary flow rate and other
      sugary products in the former case, sweets in the latter. The stepwise multiple
      regression analysis revealed that sweets and other sugary products contributed 12
      percentage points to the total explanatory value, which was as low as 19%.

PMID- 1631481
TI  - Caries associated microflora in plaque from orthodontic appliances retained with
      glass ionomer cement.
AB  - The caries associated microflora in dental plaque adjacent to orthodontic
      brackets retained with a glass ionomer cement (GIC) and a resin based composite
      was investigated using the split-mouth technique. 3, 8, and 28 days after the
      onset of the appliances, 48-h-old plaque was sampled. An increasing prevalence of
      mutans streptococci and lactobacilli in plaque from both retaining materials was
      found. A tendency to colonize more frequently around the composite retained
      brackets was noticed for both types of bacteria. The proportion of mutans
      streptococci in relation to the total viable count was significantly higher in
      plaque samples from composite retained brackets compared to GIC retained 1 month
      after onset of treatment. The results suggest that a less caries inducing
      microflora may develop when GIC is used as luting agent in orthodontic dentistry.

PMID- 1631482
TI  - Diagnosis of dentin involvement in occlusal caries based on visual and
      radiographic examination of the teeth.
AB  - The purpose of the present study was to examine the validity of visual,
      radiographic and combined visual-radiographic examination of occlusal caries,
      with special reference to the diagnosis of dentin lesions, using the microscopic
      diagnosis after sectioning the teeth as validating criterion. Thirty extracted
      permanent molar teeth with signs of occlusal caries were selected and
      radiographed using a standard method similar to bitewing. Ten dentists, five from
      the Department of Cariology and Endodontics and five from the Department of
      Pedodontics, were asked to make a visual, radiographic and combined visual
      radiographic caries examination with an interval of at least 1 month between
      different examinations. The teeth were sectioned bucco-lingually and the caries
      assessed as enamel or dentin lesion in a stereomicroscope. The
      sensitivity/specificity of the diagnoses of dentin lesions was 0.72/0.41 for the
      visual, 0.66/0.50 for the radiographic, and 0.86/0.64 for the combined visual
      radiographic examinations. The Receiver Operating Characteristic (ROC) method
      revealed a statistically significant difference between combined visual
      radiographic examination and the two other, but not between the isolated visual
      or radiographic examination. It is concluded that the combined use of visual and
      radiographic examination is better than either visual or radiographic examination
      alone.

PMID- 1631483
TI  - Influence of transient salivary flora on assessment of mutans streptococci level
      by the "Strip mutans" method.
AB  - The Dentocult SM ("Strip mutans") method occasionally shows decoloration of broth
      and of colonies of mutans streptococci on the plastic strip, thereby making
      interpretation difficult. In an attempt to explain the phenomenon and to
      investigate the influence of the salivary flora on the "Strip mutans" method, a
      total of 46 subjects were sampled. Saliva was analyzed using the "Strip mutans"
      method and conventional plating techniques to identify mutans streptococci,
      enterococci, staphylococci, enteric bacteria, and yeasts. Approximately 85% of
      the "Strip mutans" scores coincided with the conventional MSB-plating method. Two
      samples showed decolored mutans streptococci colonies on the "Strip mutans"
      strip. Enterococcus spp. were present in the saliva of these test subjects and
      could grow in the "Strip mutans" broth. Enterococcus faecalis was able to induce
      the same type of decoloration under experimental pure culture conditions. Three
      "Strip mutans" samples showed small colonies of mutans streptococci, visible only
      under magnification (x 10-20). Staphylococcus epidermidis was present in these
      saliva samples and showed heavy growth in the broth. Under experimental pure
      culture conditions S. epidermidis also inhibited the growth of mutans
      streptococci to some extent.

PMID- 1631484
TI  - Uptake of KOH-soluble and KOH-insoluble fluoride in sound human enamel after
      topical application of a fluoride varnish (Duraphat) or a neutral 2% NaF solution
      in vitro.
AB  - The uptake of alkali-soluble fluoride (calcium fluoride-like material and
      adsorbed fluoride) and alkali-insoluble fluoride (apatitically bound fluoride) on
      sound human enamel from treatment with Duraphat or a neutral 2% NaF solution was
      investigated in vitro. Blocks from impacted third molars were used. More fluoride
      was deposited on the enamel from the neutral 2% NaF solution than from the
      Duraphat treatment. All the fluoride could be dissolved in alkali. Globules of
      calcium fluoride-like material were demonstrated by scanning electron microscopy.
      Chemical analysis showed no measurable increase in the apatitically bound
      fluoride (alkali-insoluble fluoride) after brief exposures. Duraphat-treated
      samples submerged in water after the exposure lost only about 50% of the
      deposited fluoride, whereas samples treated with 2% NaF are known to lose all
      their fluoride under similar circumstances, a condition which may be related to
      the favorable clinical effect of Duraphat.

PMID- 1631485
TI  - Efficacy of bone-fill favoring treatment on juvenile periodontitis.
AB  - In this study we evaluated the effect of bone-fill favoring mechanical treatment
      on the marginal bone level and periodontal pockets of juvenile periodontitis
      patients. A total of 10 patients (3 men and 7 women) 13-29 yr of age were treated
      until no gingivitis or periodontal pockets were present. The intensive therapy (3
      8 wk) included scaling, curettage and modified Widman flaps. The maintenance
      therapy comprised 4 recall visits during the first year after therapy and 2-5
      visits per year thereafter. The efficacy of the therapy was evaluated by
      radiologic measurements of bony defects (%) 12 and 16-65 months after the
      treatment. The results showed a significant improvement both 1 yr after treatment
      and at the end of the study. The bone loss was 10.1% less than prior to the
      treatment and no sites with new bone loss were found after therapy in any of the
      patients. The bulk of healing took place during the first year after the active
      therapy, while some further improvement was detected thereafter. Our results show
      that non-resective mechanical treatment allows excellent healing and regeneration
      of JP lesions. Our findings also suggest that an adequate follow-up period is
      needed before definite conclusions can be drawn about the efficacy of the
      treatment procedures used.

PMID- 1631486
TI  - Ultrasound image of human masseter muscle related to bite force,
      electromyography, facial morphology, and occlusal factors.
AB  - The thickness of the human masseter muscle, corresponding approximately to a
      cross-section at the most bulky part of the superficial portion, was measured by
      ultrasound scanning at three sites 1 cm apart. The study included 13 women, 21-28
      yr of age, with a minimum of 24 teeth and without craniomandibular disorders.
      Ultrasonography produced a well-defined depiction of the muscle with distinct
      tendinous structures. The average thickness at the measuring sites varied from
      8.83 to 11.08 mm with the muscle relaxed, and increased significantly during
      contraction to average values between 9.84 and 12.57 mm. The study showed a
      connection between measures of masseter thickness and function of the muscle, as
      well as parameters generally associated with masseter muscle function. Muscle
      thickness at the voluminous anterior part of the superficial portion was
      systematically and significantly correlated to bite force, occlusal tooth contact
      and cephalometric data (anterior face height, vertical jaw relation and
      mandibular inclination). In conclusion, ultrasound scanning gave an uncomplicated
      and a reproducible access to parameters of jaw muscle function and its
      interaction with the craniomandibular system.

PMID- 1631487
TI  - Improvement of oral hygiene in patients with rheumatoid arthritis.
AB  - Programs in power toothbrushing, manual toothbrushing with conventional fluoride
      toothpaste and with a chlorhexidine/fluoride gel has been evaluated for plaque
      removal in an observer blind cross-over clinical trial on 14 rheumatoid arthritis
      patients. All three regimens lead to considerable improvement in oral hygiene.
      The use of an electric toothbrush was slightly more effective than a manual
      brush. Brushing with a chlorhexidine/fluoride gel gave the best results, but its
      clinical use is limited by unacceptable taste, discoloration and possibly adverse
      soft tissue effects.

PMID- 1631488
TI  - Effect of procedure on diametral tensile strength of composite resin.
AB  - The sensitivity of the test for diametral tensile strength to variations in
      testing procedure was investigated. Composite resin specimens of four different
      surface roughnesses at both ends of the specimens were loaded at one of three
      crosshead speeds. The diametral tensile strength values varied between 43.9 and
      65.7 MPa. Diametral tensile strength was found to decrease with increasing
      loading rate, with decreasing roughness of the specimens, and with increasing
      length of the cylindrical specimens. The significant influence of the surface
      roughness is suggested to be a result of the correlation between roughness and
      length of specimens, and not the expression of a true influence on diametral
      tensile strength of surface roughness of the specimens' ends.

PMID- 1631489
TI  - Bond strength of porcelain on cast vs. wrought titanium.
AB  - The bond strength of porcelain fused to cast and wrought titanium surfaces was
      calculated from fracture loads in a 4-point bending test. Two different porcelain
      were applied (O'Hara and Duceratin). The surface of Ti-cast specimens was treated
      in two different ways to produce variations in the impurity level before
      porcelain veneering. Microhardness measurements as well as scanning electron
      microscopy with EDX analysis were conducted. The results showed no significant
      difference in bond strength between the two porcelains. Nor was any difference in
      bond capacity found between thoroughly blasted castings and wrought titanium.
      Significantly lower bond strengths were observed for lightly blasted specimens
      and for specimens treated with Gold bonding agent. Impurities in the surface
      region of the castings were found to be due to contact with the investment during
      solidification. This indicates that a thin surface layer (50-100 microns) of the
      casting should be removed before firing of the porcelain.

PMID- 1631490
TI  - The role of resective surgery in the treatment of the carcinoid syndrome.

PMID- 1631491
TI  - Acid and pepsin secretion in patients with esophagitis refractory to treatment
      with H2 antagonists.
AB  - The basis for treatment of esophagitis is suppression of gastric acid secretion.
      To determine whether lack of healing with standard treatment with H2 antagonists
      might be due to abnormal gastric secretion, 30 patients who remained unhealed
      after 12 weeks' therapy with histamine H2 antagonists were compared with 20
      patients who healed after 6 or 12 weeks' therapy. The groups were matched with
      regard to age, weight, sex, and presence of hiatal hernia or duodenal ulcer.
      There were no significant differences in fasting gastric juice volume, pH, or
      acid or pepsin concentrations. All 30 refractory patients had basal acid output
      (BAO) less than 10 meq/h, and 16 of 30 had BAO less than 2 meq/h--that is, there
      was no evidence of hypersecretion in any refractory patients. Moreover, basal and
      maximal acid and pepsin outputs were not higher in non-healing patients.
      Refractory patients had a higher prevalence of initial severe (grade 3 or 4)
      esophagitis (80% versus 35% in those who healed, p less than 0.01) and of
      strictures (73 versus 15%, p less than 0.001), both of which serve as markers for
      refractoriness to treatment. Thus 77% of patients who presented with severe
      esophagitis failed to heal versus 32% of those with mild or moderate esophagitis
      (p less than 0.01). Refractoriness of esophagitis is not related to gastric acid
      or pepsin hypersecretion but represents a constitutional susceptibility to
      esophagitis and requires both short- and long-term treatment strategies that are
      not yet well defined.

PMID- 1631492
TI  - Quantification of lipopolysaccharides in human bile with or without gram-negative
      bacteria.
AB  - Lipopolysaccharide (LPS) was assayed in 78 samples of human common-duct bile,
      obtained at endoscopic retrograde cholangiography. The LPS was assayed by a
      chromogenic limulus amebocyte lysate (LAL) test, after dilution of bile samples
      in heparinized plasma and inactivation of inhibitors. The assay was not
      influenced by other biliary constituents, as demonstrated by the recovery of
      standards. Bile pigments did not influence the results. The LAL test was positive
      in 60 of the samples, 59 of which had a positive culture for gram-negative
      bacteria or Candida sp. The levels of LPS were significantly correlated to the
      total number of bacteria (n = 16, R = 0.55, p less than 0.05). The median LPS
      level was 35,250 ng/l and showed a very large variation (140 ng/l to 27.8 mg/l).
      In four of the samples gram-negative bacteria were present, but no LPS could be
      detected. The study demonstrates the presence of LPS in great quantities in human
      bile and supports the feasibility of using the LAL test on bile samples. The
      presence of LPS (within the detection limit) appears to be associated with local
      microbial colonization.

PMID- 1631493
TI  - Evaluation of ketogenesis in seriously reduced hepatic mitochondrial redox state.
      An analysis of survivors and non-survivors in critically ill hepatectomized
      patients.
AB  - Ketogenesis was evaluated in 33 critically ill hepatectomized patients in
      relation to the arterial ketone body ratio (acetoacetate to 3-hydroxybutyrate),
      which reflects hepatic mitochondrial redox state. In 15 patients whose arterial
      ketone body ratio decreased to below 0.4, blood ketone body levels were
      significantly increased concomitant with marked increase of blood lactate and
      plasma alanine levels. In the 6 survivors of these 15 patients, the arterial
      ketone body ratio was restored within the next 2 days, and blood ketone body
      levels were decreased. By contrast, in the nine non-survivors, the arterial
      ketone body ratio remained below 0.4, and blood ketone body levels were
      decreased, accompanied by significant increases in blood lactate and plasma
      alanine levels in the terminal stages. These results suggest that ketogenesis
      acts as an alternative process for ATP synthesis in the liver in critically ill
      patients. Death occurs when the liver falls into an energy crisis concomitant
      with the cessation of ketogenesis.

PMID- 1631494
TI  - Functional aspects of small-bowel transplantation in rats.
AB  - Although clinical small-bowel transplantation is still severely hindered by
      rejection of the graft, prolonged graft survival can be achieved by using
      cyclosporin A in several experimental models of small-bowel transplantation. In
      an immunologically quiescent phase after transplantation, the important question
      arises whether a small-bowel allograft has enough functional capacity to maintain
      a normal nutritional status. We investigated the functional capacity of
      orthotopic small-bowel transplants and evaluated the ability of the total small
      bowel transplant to absorb orally given cyclosporin in the early postoperative
      period and the effect of this oral cyclosporin treatment on allograft survival as
      compared with intramuscular administration. Between 3 and 7 months
      postoperatively, recipients of syngeneic and allogeneic total small-bowel
      transplants and syngeneic jejunal segmental grafts had significantly decreased
      serum triglyceride levels. Total serum protein and albumin concentrations, serum
      cholesterol values, fecal fat excretion, and percentage of split fatty acids were
      normal. One year after transplantation the weight in the groups transplanted with
      a total small-bowel graft was not different from age-matched untreated controls.
      Animals grafted with a segmental graft, however, showed a significantly impaired
      growth and had not reached a normal weight 1 year after transplantation. Growth
      was also significantly impaired after near-total small-bowel resection. These
      animals had to be killed because of their poor condition. Cyclosporin absorption
      after small-bowel transplantation equalled that in normal controls. Graft
      survival after intramuscular treatment, however, was significantly better than
      after oral treatment.

PMID- 1631495
TI  - Binding of epidermal growth factor to receptors in preparations of enriched
      porcine parietal cells and inhibition of aminopyrine uptake.
AB  - Preparations of isolated porcine gastric cells, enriched in parietal cells, were
      used to study binding of epidermal growth factor (EGF) to receptors and
      subsequent inhibition of [14C]aminopyrine uptake. EGF in concentrations from 10(
      10) to 10(-7) M inhibited aminopyrine uptake stimulated by 10(-5) M histamine
      with an IC50 of 3 x 10(-10) M. [125]EGF bound in a saturable and specific manner
      to sites on cells in preparations containing 40-90% parietal cells. Mean apparent
      dissociation constant for the sites was 1.6 x 10(-9) M, with an average number of
      approximately 20,000 sites per cell. Endocytosis of ligand by parietal cells was
      limited, amounting to 10-20% of bound EGF after 1 h of incubation at 37 degrees
      C. Occupation of a fraction of the receptors caused a maximal reduction by 40% of
      aminopyrine uptake in histamine-stimulated cells, suggesting the occurrence of
      spare receptors. The results indicate the existence of specific receptors for EGF
      on porcine parietal cells exerting a regulatory influence on acid secretion.

PMID- 1631496
TI  - Changes in splanchnic hemodynamics in inflammatory bowel disease. Non-invasive
      assessment by Doppler ultrasound flowmetry.
AB  - An increase in splanchnic blood flow in both arterial and venous beds has been
      demonstrated in inflammatory bowel disease (IBD) by means of angiographic and
      scintigraphic studies. Doppler ultrasound (US) enables a non-invasive evaluation
      of splanchnic arterial inflow in the superior mesenteric artery (SMA) and of
      venous outflow in the portal vein. The aim of this study was to assess the role
      of Doppler US in detecting changes in the hemodynamic variables measured in
      patients with IBD. Forty-five patients with IBD were studied, including 22 with
      Crohn's disease (CD) and 23 with ulcerative colitis (UC), and compared with 45
      matched normal subjects. The mean velocity of portal flow (Vmean) and the
      resistance index (RI) of the SMA were evaluated by Doppler US. In CD the Vmean of
      portal flow was significantly higher in patients with active disease than in
      controls (p less than 0.001) and patients with inactive disease (p less than
      0.001). The RI of the SMA was significantly lower in active disease than in
      controls (p less than 0.005), but no significant difference was noted between
      active and inactive CD. Also in UC, the Vmean of portal flow was significantly
      higher in patients with active disease than in controls (p less than 0.01) and
      patients with inactive disease (p less than 0.05). The RI of the SMA was
      significantly lower in active disease than in controls (p less than 0.005) and in
      patients with inactive disease (p less than 0.005). Doppler follow-up studies
      were carried out in 10 patients after initiation of treatment.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1631497
TI  - Has smoking changed the epidemiology of ulcerative colitis?
AB  - The influence of smoking on the risk of developing ulcerative colitis is well
      documented. Compared with lifetime non-smokers, the risk is reduced in smokers
      and increased in ex-smokers. During the past 50 years general smoking habits have
      changed considerably. The proportions of smokers and ex-smokers among men and
      women have undergone significant changes and, consequently, probably also their
      risk of ulcerative colitis. A review of 56 earlier epidemiologic studies of
      ulcerative colitis from 1930 to 1990 showed that the sex distribution in
      ulcerative colitis has changed from an earlier female predominance that has now
      been replaced by a male predominance. In contemporary pediatric studies no such
      changes were seen. We propose that these changes in adults are not related to the
      disease per se but to an extrinsic factor affecting adults but not children-
      namely smoking.

PMID- 1631499
TI  - Omeprazole does not cause unscheduled DNA synthesis in rabbit parietal cells in
      vitro.
AB  - Parietal cells from rabbit gastric mucosa, enriched to greater than 90% purity,
      were used to study the effect of the H+,K(+)-ATPase inhibitor omeprazole on DNA
      in vitro. In this preparation, omeprazole undergoes acid-catalyzed conversion to
      its active form, the sulfenamide, which subsequently binds to luminal SH groups
      of the H+,K(+)-ATPase and thereby inhibits acid secretion. In the parietal cell
      fraction the S-phase inhibitor hydroxyurea (HU) decreased [3H]thymidine uptake by
      40% as measured by liquid scintillation counting (LSC), presumably due to
      inhibition of scheduled DNA synthesis in contaminating stem cells. In the
      presence of HU, irradiation with ultraviolet light (UV) or treatment with the
      gastric carcinogen, 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) increased
      [3H]thymidine uptake by a factor of 5. Autoradiography of isolated, stimulated
      parietal cells showed that UV irradiation and MNNG treatment increased the
      average number of silver grains over the nuclei 18-fold and 4-fold, respectively.
      In contrast, treatment of histamine-stimulated parietal cells with omeprazole or
      ranitidine in concentrations 100 times the IC50 value for inhibition of acid
      secretion in the parietal cells did not increase [3H]thymidine incorporation
      above the control levels, measured either by LSC or by autoradiography. Extracted
      DNA from stimulated parietal cells treated with [3H]omeprazole or [3H]MNNG showed
      no binding of [3H]omeprazole but considerable binding of [3H]MNNG. It is
      concluded that parietal cells can undergo DNA repair, but there is no indication
      that omeprazole, or its acid-derived metabolites, should cause any damage to DNA,
      nor does it bind to DNA in its target cell, where the highest concentrations of
      omeprazole and its acid-derived products are found.

PMID- 1631498
TI  - Significance of serum type-IV collagen levels in various liver diseases.
      Measurement with a one-step sandwich enzyme immunoassay using monoclonal
      antibodies with specificity for pepsin-solubilized type-IV collagen.
AB  - Serum type-IV collagen levels determined with a one-step sandwich enzyme
      immunoassay (EIA) using monoclonal antibodies with specificity for pepsin
      solubilized type-IV collagen were compared with histologic changes in liver
      biopsy specimens from 107 patients with various liver diseases. Serum type-IV
      collagen levels were increased in the groups with liver diseases compared with
      controls. The serum type-IV collagen levels in the group with alcoholic cirrhosis
      showed significantly higher values than the other groups (P less than 0.05). A
      significant positive correlation was found between the serum type-IV collagen
      level and the degree of fibrosis or cell infiltration in 107 patients.
      Immunolocalization of type-IV collagen was observed around blood vessels and bile
      ducts increased in number in the portal tracts, with cell infiltration and
      fibrosis, increased around vessels in fibrous septa, and sinusoidal walls of
      areas with cell infiltration or necrosis in hepatic lobules, and along the
      boundary between fibrous septa and hepatocytes. The present data indicate that
      serum type-IV collagen may be a sensitive marker for active fibrosis and that the
      elevation of serum type-IV collagen level primarily reflects the enhancement of
      type-IV collagen synthesis and deposition in the liver tissue at the stage of
      active fibrosis in liver disease.

PMID- 1631500
TI  - Epidemiology of nephritis. Review.

PMID- 1631501
TI  - Effect of orchidectomy on serum concentrations of testosterone and
      dihydrotestosterone in patients with prostatic cancer.
AB  - Because it is well known that prostatic cancer is dependent on testosterone, and
      that dihydrotestosterone is the active mediator of the androgen action in the
      prostatic cell, we studied serum concentrations of testosterone and
      dihydrotestosterone in 84 patients with prostatic cancer, 40 of whom were treated
      by orchidectomy, and 44 who were not treated. There was a significant correlation
      between testosterone and dihydrotestosterone concentrations in the untreated
      group, but no correlation among the patients treated by orchidectomy. The results
      indicate that the effectiveness of orchidectomy as androgen withdrawal treatment
      in prostatic cancer should be assessed by measurement of both dihydrotestosterone
      and testosterone concentrations.

PMID- 1631502
TI  - Transrectal ultrasonography in the staging of localized prostatic carcinoma. A
      pilot study.
AB  - Transrectal ultrasonography (TRUS) was evaluated as a staging procedure in ten
      patients with localized prostatic carcinoma. The ultrasound images were
      correlated to histopathological whole-mount step sections of the surgical
      specimens after radical prostatectomy. Nine of the patients had pathological
      stage T3 (pT3) and only one was pT2. TRUS gave a diagnostic accuracy of 60%
      compared to 10% both for digital rectal examination (DRE) and computer tomography
      (CT) in detecting extracapsular tumor spread. We conclude so far that TRUS is
      superior to DRE and CT in detecting extracapsular tumor spread. Further we state
      that whole-mount step section of the surgical specimens is mandatory in order to
      achieve a correct pathological staging (pT-stage).

PMID- 1631503
TI  - Adenocarcinoma of the prostate and metastatic medullary compression. A
      retrospective study of 22 patients.
AB  - A retrospective study of 709 patients with prostatic cancer was carried out.
      Twenty-two developed medullary cord compression (an incidence of 3%). All but two
      of the 22 patients were treated by radiation and 10 had additional hormonal
      treatment. Ten had some benefit from the treatment, but only 2 of 19 regained
      their ability to walk. The need for immediate diagnosis and treatment is
      stressed.

PMID- 1631504
TI  - Significance of the antireflux valve for upper urinary tract pressure. An
      experimental study in patients with urinary diversion via a continent ileal
      reservoir.
AB  - When bladder substitution is required, a low pressure receptacle and an
      antireflux valve with low resistance to flow is essential for preservation of the
      upper urinary tract. The aim of this study was to evaluate whether these criteria
      are attained in the continent ileal reservoir used for urinary diversion. The
      investigations were performed in six patients more than one year after
      supravesical urinary diversion via a continent ileal reservoir. The pressure was
      recorded simultaneously both in the afferent loop and in the reservoir during
      filling of the reservoir. There was a slow parallel increase in the basal
      pressure in the reservoir and the afferent loop. Pressure waves appeared
      sometimes simultaneously and sometimes in only one compartment at a time. Only
      during short periods of time did the pressure exceed 25 cm of water. The
      frequency of pressure waves increased with increased filling of the reservoir.
      The "total pressure" was larger in the reservoir than in the afferent loop. It is
      the antireflux valve which prevents pressure rises in the reservoir from being
      conveyed to the upper urinary tract. The resistance to urinary flow was moderate.

PMID- 1631505
TI  - Long-term partial ureteral obstruction and its effects on kidney function.
AB  - Previously it has been shown that partial ureteral obstruction present in young
      rats for 12 weeks results in small morphological changes in the kidney as well as
      slightly decreased kidney function. In the present study the aim was to examine
      whether rats obstructed for one year had more advanced changes in morphology and
      kidney function. The first group of animals examined after three weeks of
      obstruction showed only modest changes in kidney function with a reduced
      potassium concentration in the urine but no reduction in the glomerular
      filtration rate. After one year there was a reduction in urine flow as well as in
      the excretion of both potassium and sodium. Urine osmolality was also reduced.
      Glomerular filtration rate measured in this group of animals was reduced in the
      obstructed kidney by about 60% compared to the contralateral one. There were only
      small changes in the morphology with no loss in parenchymal weight or
      compensatory hypertrophy, but there was a significant deformation of the papilla
      and an increase in inflammatory cells in the parenchyma. In conclusion
      hydronephrosis during a shorter period is not harmful to kidney function but if
      sustained for an extended time period kidney function will deteriorate.

PMID- 1631506
TI  - Results of one and two year follow-up in a clinical comparison of extracorporeal
      shock wave lithotripsy and percutaneous nephrolithotomy in the treatment of renal
      calculi.
AB  - The results of 12 and 24 month follow-up of two groups of similar patients with
      renal and ureteric calculi treated by percutaneous nephrolithotomy (PCN) and
      related techniques versus first generation, Dornier extracorporeal shock wave
      lithotripsy (ESWL) alone or in combination with PCN and/or endoscopy indicated
      few major differences in the side-effects (complications, readmissions, further
      procedures) of the two approaches to renal stone treatment up to two years from
      treatment. However, PCN patients exhibited consistently higher rates of stone
      clearance whether this was measured cross-sectionally or cumulatively. The higher
      prevalence of retained fragments in the ESWL group indicates the importance of
      long-term monitoring of both groups to discover whether there are any significant
      differences in stone growth and retreatment rates associated with the observed
      difference in stone-free rates.

PMID- 1631507
TI  - Serum concentrations of calcitriol and PTH in hemo-dialysis patients on treatment
      with calcium carbonate.
AB  - The effects of calcium carbonate and aluminium hydroxide as phosphate binders
      were investigated in nine patients on chronic hemodialysis. Aluminium hydroxide,
      1 g X 3, was given during four weeks followed by a period of four weeks without
      any phosphate binders and after this calcium carbonate, 2.5 g X 3, was introduced
      for four weeks. Calcium carbonate resulted in lowering of bioactive PTH in serum
      from 22.4 to 16.4 pM and a rise of serum calcitriol from 8.0 to 11.5 pg/ml with
      maintained control of phosphate and without significant difference in the calcium
      phosphate product. Calcium in serum rose from 2.27 to 2.57 mM and mild
      hypercalcemia (less than 3.0 mM) in five of the patients could be controlled by
      dose reduction of calcium carbonate without losing control of serum phosphate
      levels. We conclude that calcium carbonate offers advantages as a phosphate
      binder compared to aluminium hydroxide in that it offers equal control of serum
      phosphate and elevates serum calcium which helps to control the
      hyperparathyroidism secondary to uremia.

PMID- 1631508
TI  - Parathyroid function in relation to intestinal function and renal calcium
      reabsorption in patients with nephrolithiasis.
AB  - Recently a technique to measure intact parathyroid hormone (PTH), i.e. the
      biologically active hormone, has been available. The aim of the present study was
      to apply this method to evaluate the parathyroid function in a material of
      recurrent renal stone formers (n = 324). Intact PTH was found to be inversely
      related to both urinary calcium (r = -0.15; p less than 0.01) and serum calcium
      (p less than 0.02) indicating that in the majority of the patients with
      hypercalciuria this was accounted for by intestinal hyperabsorption and not by
      high serum PTH. Hyperabsorption was also the likely explanation for the finding
      of a positive relationship between the urinary calcium and oxalate excretions (r
      = 0.22; p less than 0.001) in medication-free patients without intestinal
      disorders, i.e. without enteric hyperoxaluria. Altogether 25 patients (7%) had
      elevated serum PTH concentrations. They were followed up with fasting serum and
      urinary electrolytes and an oral calcium loading test (1 g of calcium) in order
      to evaluate the importance of renal and intestinal factors responsible for the
      elevated serum PTH concentrations. The investigation was carried out on a free
      diet and on low and high calcium intakes, respectively. The incidence of
      intestinal malfunction, which was sometimes present without clinical symptoms,
      was found to be approximately the same as that of impaired renal conservation of
      calcium. The findings in the patients with intestinal malfunction were a reduced
      intestinal absorption of calcium and an enhanced tubular reabsorption of calcium
      (TRCa), with greater reabsorption of calcium for higher PTH values. In patients
      with impaired renal conservation of calcium despite the raised PTH there was no
      correlation between PTH and TRCa. When PTH was suppressed during the oral calcium
      load the TRCa was found to be inappropriately low and the renal defect obvious.
      The intestinal calcium absorption was secondarily increased to compensate for the
      renal losses.

PMID- 1631509
TI  - Effect of treatment of anaemia with erythropoietin on neuromuscular function in
      patients on long term haemodialysis.
AB  - To study the effect of treatment of anaemia with recombinant human erythropoietin
      (r-HUEPO) on neuromuscular function in patients undergoing haemodialysis for
      chronic renal failure, six patients were given r-HUEPO in an initial dose of 50
      u/kg three times a week and their haemoglobin concentration was measured. The
      dose was increased by 25 u/kg every four weeks if the response was not
      satisfactory. In five patients anaemia had been corrected within 12 weeks of
      initiation of treatment. Neuromuscular function was evaluated before treatment,
      half way through, and after correction of anaemia by clinical examination and
      neurophysiological studies including motor nerve conduction velocity, distal
      latency, electromyography and test for neuromuscular fatigue. After correction of
      anaemia there was a significant increase in motor nerve conduction velocity, a
      decrease in the duration of motor unit action potential, and a lessening of
      neuromuscular fatigue. We conclude that treatment of anaemia with r-HUEPO in
      patients with chronic renal failure undergoing haemodialysis may improve
      neuromuscular function.

PMID- 1631510
TI  - Epidermoid cysts of testis.
AB  - A 27-year-old man presented with bilateral testicular pain and enlargement of the
      right testis caused by a cystic mass. Histological examination of a frozen
      section at exploration excluded malignancy and the final diagnosis after local
      excision was benign epidermoid cyst. The patient remained well three years later.

PMID- 1631511
TI  - Large cell calcifying Sertoli cell tumor of the testis.
AB  - We report on a patient with a large cell calcifying Sertoli cell tumor of the
      testis and review the literature of this recently described rare subtype of
      Sertoli cell tumor. Twenty-one cases, including ours, have been reported in the
      literature. Six of twenty cases (28%) had clinically evident endocrine
      abnormalities and eight of twenty-one cases (38%) were bilateral. This tumor has
      a low malignant potential with only one patient known to have metastatic disease.

PMID- 1631512
TI  - Distal ureteral atresia associated with ipsilateral renal dysplasia.
AB  - A 56-year-old man presented with unilateral ureteral atresia associated with
      renal dysplasia. He had no previous urinary symptoms. The diagnosis was
      established histopathologically after nephroureterectomy.

PMID- 1631513
TI  - An unusual cause of acute abdomen.

PMID- 1631514
TI  - Benign retroperitoneal schwannoma.
AB  - A rare case of benign retroperitoneal schwannoma in a 76-year-old man is
      reported. Ultrasound and computerized tomography disclosed two cystic
      retroperitoneal tumors sized 12 cm and 7 cm. The larger tumor was located
      anterior to psoas muscle and the smaller one was within the muscle. The larger
      tumor was excised via laparotomy. After 3.5 years follow-up the intramuscular
      tumor has remained unchanged and the patient has no symptoms.

PMID- 1631515
TI  - Epistaxis in renal carcinoma.
AB  - A 62-year-old man presented with recurrent epistaxis and a mass in the left
      nostril. Histological examination of the excised tissue showed clear cell
      carcinoma and he was found to have an asymptomatic carcinoma of the right kidney.
      A year after right nephrectomy, excision of the left maxilla, and radiotherapy he
      was well with no sign of recurrence. Early recognition of this rare condition and
      excision of both primary and metastatic tumours are recommended.

PMID- 1631516
TI  - [Clinical presentation of tuberculosis among immigrants seen at the
      antituberculosis outpatient clinic in Lausanne].
AB  - Between 1987 and 1990, 162 new immigrants entering Switzerland were treated for
      tuberculosis at the TB Dispensary, Lausanne. Fifty-three were smear or culture
      positive. In 93% of the cases, the diagnosis was suspected at a screening
      examination for TB shortly after arrival in Switzerland. The diagnosis of TB was
      established on the basis of radiological abnormalities and the results of
      bacteriology and the clinical and/or radiological course under treatment. The
      prevalence of TB was 174.3 cases per 100,000 among foreign workers and 1357.5 per
      100,000 among refugees in the group of immigrants entering the Canton of Vaud.
      Symptoms related to TB were mentioned by 18% of patients, clinical abnormalities
      were noted in 7.4%. The tuberculin test was positive (greater than 10 mm) in 94%
      of patients. Thirty patients, including six smear or culture positive cases, were
      lost to follow-up or stopped treatment before the scheduled end. A policy of
      active screening for TB among new immigrants allows detection at an early stage
      and, in combination with proper treatment, should prevent extension of the
      disease within groups of immigrants.

PMID- 1631517
TI  - [Colonoscopic endosonography in the diagnosis and follow-up care of colorectal
      tumors].
AB  - We studied the usefulness and accuracy of a flexible endoscopic ultrasound system
      (EUS) in preoperative staging of tumor invasion and involvement of lymph nodes of
      rectal tumors. Comparison of preoperative EUS findings with histopathologic TNM
      classification (UICC 1987) was possible in 12 patients. The depth of tumor
      invasion was correctly staged in 9/12 patients (75%), and lymph node staging was
      correctly predicted in 9/12 patients (75%). Our results indicate that flexible
      coloscopic ultrasonography is as accurate as rigid systems for staging of
      colorectal cancer. It will become a sensitive method for early diagnosis of local
      recurrence. The flexible endoscopes are well tolerated by patients and more
      proximal lesions which cannot be reached with the rigid instruments can also be
      examined.

PMID- 1631518
TI  - [Exercise and cancer. An epidemiologic short review of the effects of physical
      activity on carcinoma risk].
AB  - It is only during the past decade that occupational and leisure-time physical
      activity--whose importance for the prevention of cardiovascular diseases is well
      documented--has become a focus of research in cancer epidemiology. The most
      consistent observation of more than 15 epidemiological studies published in the
      1980s is an average increase in the risk of colon cancer of 75 to 80% for
      physically inactive men and women, as compared to their more active counterparts.
      No study at all found a direct relationship between physical activity and colon
      cancer risk. A hypothetical explanation for this likely but unproven protective
      effect of regular exercise against colon cancer is that physical activity
      stimulates colon peristalsis, hereby reducing enteral transit time and
      diminishing exposure of the intestinal mucosa to fecal carcinogens. The
      epidemiologic evidence for a protective effect of exercise against rectal cancer
      and other cancers, however, is not sufficient. Isolated observations of a direct
      relationship between physical activity and the risk of cancer (e.g. prostate)
      have even been reported. For women, there is preliminary evidence of a protective
      effect of athletic activity against cancers of the breast and the reproductive
      system for which hormonal factors may be responsible. The cancer-protective
      effect of exercise per se is apparently too modest to serve as a justification
      for a general recommendation to take regular exercise.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1631520
TI  - [Continuing education: theory and practice in close union].

PMID- 1631519
TI  - [Systemic Nocardia infection in an AIDS patient].
AB  - We report the case of a patient with Aids, Kaposi's sarcoma and a systemic
      nocardial infection. After surgical drainage and adequate antibiotic treatment
      the infection was cured. Under secondary antimicrobial prophylaxis no relapse has
      occurred to date. Generalized N. asteroides infections have been rarely described
      in patients with Aids and the possible reasons for this are discussed.

PMID- 1631521
TI  - [Do new diagnostic tests improve the differential diagnosis and therapy of
      periodontitis? A review].
AB  - New diagnostic tools give access to information that was previously not available
      by classical clinical means. This includes methods for the determination of the
      composition of the microbial flora or for monitoring specific reactions of host
      tissues to the accumulation of plaque. DNA-probes, monoclonal antibodies and
      enzyme assays have already been advertised and are sold to dentists. The
      practical value of new tests depends upon the possibility to improve the efficacy
      of treatment based on previously inaccessible information. This paper reviews
      frequently raised clinical questions, the possible answers coming from new
      diagnostica, and the potential impact of this knowledge on periodontal therapy.

PMID- 1631522
TI  - Effect of metronidazole on experimental periodontitis: cell population
      characteristics.
AB  - Systemic administration of metronidazole during an experimental periodontitis
      resulted in significantly less active tissue destruction compared to drug-free
      animals. However, the size of the inflammatory infiltrates in both groups was
      similar. The present study assessed cell populations within the infiltrates of
      metronidazole receiving and drug-free animals. In the experimental group,
      metronidazole was administered orally to 4 squirrel monkeys (100 mg/kg body
      weight per day) for 17 days. After 3 days, marginal periodontitis was induced
      around maxillary and mandibular bicuspids and molars by tying silk ligatures at
      the gingival margins. In 4 monkeys of the drug-free control group, periodontitis
      was induced around similar teeth. Biopsies of the gingiva representing 3, 7 and
      14 days of experimental periodontitis were taken in both groups. The total number
      of cells and the number of polymorphonuclear leucocytes (PMN's) were counted on
      one-micron sections. At 3 days after ligature placement, there were numerically
      less total cells and PMN's in the metronidazole receiving experimental group. At
      7 and 14 days the total number of cells and the number of PMN's was significantly
      greater in the drug-free control group, where more active periodontal breakdown
      had occurred. These results emphasize the potentially destructive role of PMN's
      in acute bursts of tissue destruction.

PMID- 1631523
TI  - [The addition of potassium rhodanide to artificial saliva in electrochemical
      corrosion research].
AB  - Polarization curves of five dental alloys and pure platinum were made in
      artificial saliva with and without potassium-thiocyanate. From 400 mV (SCE) the
      noble alloys show a current rise. The reason for this current rise not corrosion,
      but a redox reaction of the potassium-thiocyanate. For potentiodynamic
      polarization measurements the addition of potassium-thiocyanate to the artificial
      saliva is problematic.

PMID- 1631524
TI  - [Ceramic veneer shells. The use of ceramic veneer shells is presented via a
      clinical case].

PMID- 1631525
TI  - [Anterior tooth trauma. The preservation and treatment of the injured tooth].

PMID- 1631526
TI  - Biodegradation of aquatic organic matter with reference to drinking water
      treatment.
AB  - This paper presents results obtained in a pilot scale investigation of biological
      treatment for preparation of drinking water from the North Saskatchewan River at
      Edmonton, Canada. Although the concentration of natural organic matter (NOM) in
      the raw water varied substantially over the study period, parameters measuring
      the biodegradability and reactivity to chlorine of the NOM were closely
      correlated to the NOM concentration. As a result of treatment including ozonation
      and adsorption, two patterns of response emerged. Some parameters decreased
      through each step of the treatment process while others usually increased
      following ozonation and then decreased through subsequent steps. The levels of
      this latter group were decreased by biological activity in the filters (except
      for one treatment stream) and further reduced in the biologically active granular
      activated carbon (GAC) contactors.

PMID- 1631527
TI  - Quality of air in industrial cities of the USSR and child health.
AB  - In cities containing different industries, studies of the health status of
      children demonstrate a correlation between geographic structure and pollution.
      Variations and changes in the demographic and reproductive status of a
      population, total morbidity and morbidity of the respiratory tract has been
      determined. A classification of cities with different levels of atmospheric
      pollution has been performed.

PMID- 1631528
TI  - Study of environmental pollutants in and around the city of Lahore, Pakistan. II.
      Concentrations of cadmium in blood of different groups of people.
AB  - Cadmium concentrations were measured in the whole blood of six different groups
      of persons living in and around the city of Lahore. The cadmium concentrations in
      the blood of normal persons of both sexes were distributed log normally. The
      values were lower among the young and increased gradually to reach a plateau at
      an average age of 45 years and then decreased. There was a trend of a gradual
      increase of cadmium blood concentrations with age in male industrial workers and
      female exposed groups. Cadmium-blood concentrations in cancer patients were
      significantly lower when compared to the rest of the groups, however no
      statistical correlation between Cd-blood concentration and age of cancer patients
      was observed.

PMID- 1631529
TI  - Distribution of heavy metals in Elcho Island, Northern Territory, Australia.
AB  - The concentration of four metals in waters and seven metals in oysters, clams and
      sediments from Elcho Island, Northern Territory, were determined during the dry
      season of 1987. The measured concentration of cadmium, zinc, copper and lead in
      unfiltered water were: cadmium, 0.02-0.27; zinc, 0.09-3.70; copper, 0.60-4.78;
      lead, 0.12-2.39 micrograms l-1, and iron, cadmium, zinc, manganese, copper,
      nickel and lead in oysters, 13.07-273.55, 0.29-10.63, 2.39-8.51, 0.25-4.84, 0.45
      8.76, 0.16-0.59, 2.59-9.38 micrograms g-1 wet weight, and in clam, 94.84-419, 6.0
      20.3, 1.09-6.28, 2515-6256, 0.47-3.18, 1.71-5.64, 0.45-2.17 micrograms g-1 wet
      weight, and in sediments, 3219.1-10871.1, 1.36-2.68, 2.7-6.55, 19.4-105.7, 0.65
      1.91, 4.16-21.8 and 5.66-23.9 micrograms g-1 dry weight. Accumulation of
      manganese in razor clam was highest in spite of low concentration in the
      surrounding sediment, therefore it could be used as a bioindicator of manganese
      in a tropical environment. The level of cadmium and lead exceeded the National
      Health and Medical Research Council (NHMRC) recommended limit. In general, level
      of other metals were lower as compared to the concentration of these metals in
      Darwin Harbour.

PMID- 1631530
TI  - Sources of present Chernobyl-derived caesium concentrations in surface air and
      deposition samples.
AB  - The sources of Chernobyl-derived caesium concentrations in air and deposition
      samples collected from mid-1986 to the end of 1990 at Munich-Neuherberg, Germany,
      were investigated. Local resuspension has been found to be the main source. By
      comparison with deposition data from other locations it is estimated that within
      a range from 20 Bq m-2 to 60 kBq m-2 of initially deposited 137Cs activity
      approximately 2% is re-deposited by the process of local resuspension in Austria,
      Germany, Japan and the United Kingdom, while significantly higher total
      resuspension is to be expected for Denmark and Finland. Stratospheric
      contribution to the present concentrations is shown to be negligible. This is
      confirmed by cross correlation analysis between the time series of 137Cs in air
      and precipitation before and after the Chernobyl accident and the respective time
      series of cosmogenic 7Be, which is an indicator of stratospheric input. Seasonal
      variations of caesium concentrations with maxima in the winter months were
      observed.

PMID- 1631531
TI  - Evaluation of heavy metal pollution in the Venetian lagoon by using Mytilus
      galloprovincialis as biological indicator.
AB  - This study reports the analysis of heavy metal (Cd, Co, Cu, Cr, Hg, Fe, Mn, Ni,
      Pb, Zn) and As accumulated in the mollusc Mytilus galloprovincialis collected in
      the Venetian lagoon between March and September 1988. This environmental
      biomonitoring project was carried out using natural population of the molluscs
      attached to the 'Briccole', which limit the navigation canals into the lagoon.
      These data were compared with those reported by other authors in analogous
      studies published about a decade ago. A small improvement on the heavy metal
      pollution of the Venetian lagoon can be deduced from this comparison, presumably
      depicting a positive signal of a new downward trend in metal concentrations.
      Continuous monitoring of the fragile lagoonal ecosystem must be an important
      commitment due to the economic and historical importance of the Venetian lagoon.

PMID- 1631532
TI  - Reduced dietary cadmium intake in past 12 years in a rural area in Japan.
AB  - To examine possible reduction in dietary cadmium (Cd) intake, 24-h duplicates of
      diet were collected twice in the same village in north-eastern Japan, once in
      1976-1977 (71 samples) and then in 1989 (198 samples) and analyzed for Cd
      contents. The statistical analysis by sex and age decade showed that there has
      been a significant (P less than 0.01-0.05, depending on sex and age) reduction in
      Cd intake during this 12-year period. The intake by men at 30-59 years was 28.8
      micrograms/day (as a geometric mean of 41 samples) in 1976-1977 and 20.8
      micrograms/day in 1989, indicating some 28% reduction, whereas the value for
      women of the same age range was 24.9 micrograms/day in 1976-1977 and 15.7
      micrograms/day in 1989, with a reduction by 37%. A similar reduction in Cd
      contents was observed in cooked rice samples collected in 1980 and 1990 in the
      vicinity of the study field. Probable reasons for the improvement are discussed.

PMID- 1631533
TI  - Lead levels in settled dusts of Tripoli, Libya.
AB  - The levels of lead in settled dust samples collected near small streets,
      playgrounds, gas stations and main streets in the Tripoli area have been
      determined by atomic absorption spectrophotometry. The overall mean values
      observed were 417, 533, 553 and 797 micrograms g-1 dry wt for the above locations
      respectively. The overall mean concentration for main streets was significantly
      higher (P less than 0.05) than for other sites. The data were also compared with
      those reported in the literature for other cities.

PMID- 1631534
TI  - Heavy metals and selenium in stranded dolphins of the northern Tyrrhenian (NW
      Mediterranean).
AB  - Heavy metal (Hg, Cd, Pb and Zn) and selenium levels were determined in striped
      (Stenella coeruleoalba) and bottle-nosed dolphins (Tursiops truncatus) stranded
      along the coast of Tuscany and Latium, Italy in the period 1987-1989. Lead and
      zinc concentrations were quite low and there was modest accumulation of cadmium
      in the kidney of both species. Mercury levels were very high, especially in the
      liver where they reached peaks of 4400 ppm (dry weight) in the striped dolphin
      and 13,150 ppm (dry weight) in the bottle-nosed dolphin. Selenium levels were
      also high and were significantly correlated with mercury levels in some organs
      and tissues. The toxicological significance of the selenium-mercury interaction
      is discussed.

PMID- 1631536
TI  - Chirality and drug development.

PMID- 1631535
TI  - Organic chemicals entering agricultural soils in sewage sludges: screening for
      their potential to transfer to crop plants and livestock.
AB  - This paper presents a review and assessment of the pathways and transfers of
      organic contaminants applied to agricultural soils in sewage sludge. The purpose
      of the assessment has been to develop a simple screening approach to highlight
      different chemical fates of organic chemicals in soil and their potential
      transfers from soil to groundwaters, crop plants and grazing livestock using data
      on the physico-chemical properties of the compounds of interest. The fate of 46
      compounds known to be present in sewage sludges are compared to illustrate the
      applicability of the procedure. Compounds are screened for their potential to
      adsorb, volatilise, degrade and leach in soils and to be transferred to plants
      via retention by root surfaces, root uptake and translocation and foliar uptake
      and to transfer to animal tissues via soil and herbage ingestion. Recommendations
      for experimental and field studies are made. It is envisaged that this screening
      approach can be applied to other chemicals and that it will focus research and
      aid risk assessments of organic compounds in sewage sludge following land
      application.

PMID- 1631537
TI  - Thrombin and its inhibitors.

PMID- 1631538
TI  - Oct-3 and mammalian development: correction of discussion.
AB  - The title of the 5 June report on page 1445 by R. C. deL. Milton et al. should
      have been "Total chemical synthesis of a D-enzyme: The enantiomers of HIV-1
      protease show reciprocal chiral substrate specificity." Figure 3 in the same
      report (p. 1447) was inadvertently printed upside down. The labels "L-HIV
      protease" and "D-HIV protease" were therefore under the wrong illustrations. The
      correct figure is printed below. [See figure in the PDF file]

PMID- 1631539
TI  - AIDS research shifts to immunity.

PMID- 1631540
TI  - The perils of involving Congress in a 'catfight'.

PMID- 1631542
TI  - Are chemists girl crazy?

PMID- 1631541
TI  - Science funding. Is the wolf finally at the door?

PMID- 1631543
TI  - The promise and pitfalls of molecular genetics.

PMID- 1631544
TI  - Megascopic eukaryotic algae from the 2.1-billion-year-old negaunee iron
      formation, Michigan.
AB  - Hundreds of specimens of spirally coiled, megascopic, carbonaceous fossils
      resembling Grypania spiralis (Walcott), have been found in the 2.1-billion-year
      old Negaunee Iron-Formation at the Empire Mine, near Marquette, Michigan. This
      occurrence of Grypania is 700 million to 1000 million years older than fossils
      from previously known sites in Montana, China, and India. As Grypania appears to
      have been a photosynthetic alga, this discovery places the origin of organelle
      bearing eukaryotic cells prior to 2.1 billion years ago.

PMID- 1631545
TI  - Peptide binding by chaperone SecB: implications for recognition of nonnative
      structure.
AB  - The molecular basis for recognition of nonnative proteins by the molecular
      chaperone SecB was investigated with an in vitro assay based on the protection of
      SecB from proteolysis when a ligand is bound. The SecB tetramer has multiple
      binding sites for positively charged peptides. When the peptide binding sites are
      occupied, the complex undergoes a conformational change to expose hydrophobic
      sites that bind the fluorescent probe 1-anilinonaphthalene-8-sulfonate. A model
      is proposed for interaction of nonnative polypeptides with both hydrophilic and
      hydrophobic sites on SecB.

PMID- 1631546
TI  - Individual-initiated public policy.

PMID- 1631547
TI  - Miscarriage study.
AB  - In the letter of 19 June 1992 (p. 1613) by Ellen C. Weaver and Stephanie J. Bird
      of the Association for Women in Science (AWIS), an incorrect phone number was
      given for the AWIS mentoring program. The correct number is 800-886-AWIS.

PMID- 1631548
TI  - Is this your father's NIH? And other strategic questions.

PMID- 1631549
TI  - Did liability block AIDS trial?

PMID- 1631550
TI  - Gallo aide convicted on three counts.

PMID- 1631551
TI  - The evolution of sexes.

PMID- 1631552
TI  - Swallows and scorpionflies find symmetry is beautiful.

PMID- 1631553
TI  - Barbary macaques challenge theory of female choice.

PMID- 1631554
TI  - Speeding up a chemical game of chance.

PMID- 1631555
TI  - Researchers get a first look at the versatile TGF-beta family.

PMID- 1631556
TI  - How technique is changing science.

PMID- 1631557
TI  - Crystal structure of transforming growth factor-beta 2: an unusual fold for the
      superfamily.
AB  - The transforming growth factors-beta (TGF-beta 1 through -beta 5) are a family of
      homodimeric cytokines that regulate proliferation and function in many cell
      types. Family members have 66 to 80% sequence identity and nine strictly
      conserved cysteines. A crystal structure of a member of this family, TGF-beta 2,
      has been determined at 2.1 angstrom (A) resolution and refined to an R factor of
      0.172. The monomer lacks a well-defined hydrophobic core and displays an unusual
      elongated nonglobular fold with dimensions of approximately 60 A by 20 A by 15 A.
      Eight cysteines form four intrachain disulfide bonds, which are clustered in a
      core region forming a network complementary to the network of hydrogen bonds. The
      dimer is stabilized by the ninth cysteine, which forms an interchain disulfide
      bond, and by two identical hydrophobic interfaces. Sequence profile analysis of
      other members of the TGF-beta superfamily, including the activins, inhibins, and
      several developmental factors, imply that they also adopt the TGF-beta fold.

PMID- 1631558
TI  - Recovery from hemophilia B Leyden: an androgen-responsive element in the factor
      IX promoter.
AB  - One form of the inherited, X-linked, bleeding disorder, hemophilia B, resolves
      after puberty. Mutations at -20 and -26 in the clotting factor IX promoter impair
      transcription by disrupting the binding site for the liver-enriched transcription
      factor LF-A1/HNF4. The -26 but not the -20 mutation also disrupts an androgen
      responsive element, which overlaps the LF-A1/HNF4 site. This explains the
      improvement seen in patients with the -20 mutation and the failure of the -26
      patient to recover.

PMID- 1631559
TI  - Cloning of the gamma chain of the human IL-2 receptor.
AB  - A third subunit, the gamma chain, of the human interleukin-2 receptor (IL-2R) was
      identified, and a complementary DNA clone encoding this member of the cytokine
      receptor family was isolated. The gamma chain is necessary for the formation of
      the high- and intermediate-affinity receptors, which consists of alpha beta gamma
      heterotrimers and beta gamma heterodimers, respectively. The IL-2R on murine
      fibroblastoid cells can be internalized after binding IL-2 only if the gamma
      chain is present; alpha and beta are insufficient for internalization. Thus, the
      gamma chain is an indispensable component of the functional IL-2R.

PMID- 1631560
TI  - Negative inotropic effects of cytokines on the heart mediated by nitric oxide.
AB  - The direct effects of pro-inflammatory cytokines on the contractility of
      mammalian heart were studied. Tumor necrosis factor alpha, interleukin-6, and
      interleukin-2 inhibited contractility of isolated hamster papillary muscles in a
      concentration-dependent, reversible manner. The nitric oxide synthase inhibitor
      NG-monomethyl-L-arginine (L-NMMA) blocked these negative inotropic effects. L
      Arginine reversed the inhibition by L-NMMA. Removal of the endocardial
      endothelium did not alter these responses. These findings demonstrate that the
      direct negative inotropic effect of cytokines is mediated through a myocardial
      nitric oxide synthase. The regulation of pro-inflammatory cytokines and
      myocardial nitric oxide synthase may provide new therapeutic strategies for the
      treatment of cardiac disease.

PMID- 1631561
TI  - On somatic recombination in the central nervous system of transgenic mice.

PMID- 1631563
TI  - Thrombin and hemostasis: II.

PMID- 1631562
TI  - Unraveling the structure of IL-2.

PMID- 1631564
TI  - Clinical application of the synthetic thrombin inhibitor, argatroban (MD-805).

PMID- 1631565
TI  - Platelet function defects: a clinical review.
AB  - Platelet dysfunction, especially acquired forms, are common causes of hemorrhage,
      especially in association with trauma and surgery. Although the hereditary
      platelet function defects are generally quite rare, hereditary storage pool
      disease is common enough to be suspected in an individual, usually a child, with
      characteristic historical and clinical findings. The acquired platelet function
      defects, especially those resulting from drugs, are very common and should
      promptly be suspected in patients developing easy and spontaneous bruising, mild
      to moderate mucosal membrane hemorrhage, or unexplained bleeding associated with
      trauma or surgery. The template bleeding time is generally useful as a screening
      test of platelet function, but a normal template bleeding time, in the presence
      of a suggestive history, suggestive clinical findings, or in the patient frankly
      bleeding, is not reliable and platelet aggregation or lumi-aggregation should be
      done in appropriate clinical situations. The mainstay of therapy for essentially
      all these defects, if bleeding is significant, is the liberal infusion of
      appropriate numbers of platelet concentrates. The acquired platelet function
      defects, of course, should also be managed by attempts to treat or control the
      underlying disease, if possible, and offending drugs or potentially offending
      drugs should promptly be discontinued.

PMID- 1631566
TI  - Human platelet activating antibodies.
AB  - Platelet antibodies identified in the plasma of three multiply transfused
      patients and a woman who had delivered a baby with neonatal alloimmune
      thrombocytopenia were investigated for their platelet activating properties.
      Three patients possessed multispecific HLA antibodies reactive with 90 to 100% of
      the cells on a lymphocytotoxic panel. These antibodies were also detected using
      the MAIPA assay and MAb w6/32, which recognizes an epitope common to all HLA
      class I molecules. In addition to HLA antibodies, three of the patients possessed
      platelet-specific antibodies that were identified by the MAIPA assay as anti-HPA
      1a and anti-HPA-3a (one patient) and anti-HPA-1b (two patients). Each of the HLA
      antibodies when reacted with platelets expressing the corresponding HLA antigens,
      potently induced aggregation and release of ATP from dense granules. In contrast,
      the HPA-1b antibodies induced platelet agglutination, but failed to trigger ATP
      release. However, platelets coated with these latter antibodies were now
      refractory to subsequent stimulation by ADP. Similarly, when HLA antibodies were
      reacted with platelets to produce suboptimal activation, the platelets could now
      be stimulated only poorly or not at all by either epinephrine or thrombin. This
      was also true for anti-HPA-1b, which, although not inducing aggregation or ATP
      release by itself, was capable of almost completely blocking thrombin-induced
      platelet activation. The thrombin-inhibiting activity of these antibodies could
      partially be reversed by pretreating antibody-coated platelets with epinephrine
      immediately followed by stimulation with thrombin. These findings suggest that
      transfused platelets may either be activated or inhibited by reaction with
      various platelet antibodies. Therefore it is conceivable that the presence of
      platelet reactive antibodies in multiply transfused recipients may contribute to
      the increased thrombotic and hemorrhagic symptoms often observed among these
      patients.

PMID- 1631567
TI  - Thrombin-mediated increase in vascular endothelial permeability.

PMID- 1631568
TI  - Pharmacologic aspects of the development of selective synthetic thrombin
      inhibitors as anticoagulants.

PMID- 1631569
TI  - Kinetic considerations on the physiologic control of thrombin and factor Xa.

PMID- 1631570
TI  - Thrombin derivatives obtained by autolytic or limited tryptic cleavage.

PMID- 1631571
TI  - The prothrombin gene and its liver-specific expression.

PMID- 1631572
TI  - Effects of sized heparin oligosaccharide on the interactions of Chinese hamster
      ovary cell with thrombospondin.
AB  - Binding and degradation of TSP by CHO cells and adhesion of CHO cells to
      substrate-adsorbed TSP are mediated by cell surface PGs and inhibitable by
      heparin. In order to learn how these three processes are related, we studied the
      effects of defined heparin oligosaccharides up to 18-mer produced by nitrous acid
      digestion. There was a complex correlation among oligosaccharide chain length,
      affinity of oligosaccharide for TSP in a solid phase binding assay, and potencies
      of oligosaccharide in inhibition of the three cellular processes. Inhibition of
      degradation was more sensitive to shorter oligosaccharides than inhibition of
      binding. For instance, the 10-mer inhibited binding of TSP to cells by 10% and
      degradation by 70%. Punctate immunofluorescence of cell surface bound TSP was
      replaced by a diffuse pattern after incubation in the presence of the 10-mer.
      These results suggest that the clustering of TSP on the cell surface may trigger
      endocytosis and degradation. Inhibition of binding of TSP to cells, in turn, was
      more sensitive to midsized oligosaccharides than inhibition of cell adhesion to
      adsorbed TSP. Inhibition of adhesion correlated with the ability of
      oligosaccharides to block binding of 125I-heparin to adsorbed TSP.

PMID- 1631573
TI  - Zinc binding by fibrin facilitates proteolysis by a snake (puffadder) venom
      protease.
AB  - PAV protease is able to cleave between the crosslinked sites of the gamma-chain
      of fibrin and fibrin-derived D-dimer. The rate of digestion can be increased
      fourfold to tenfold by the addition of zinc ions. Although the PAV protease is a
      zinc-containing metalloenzyme, the enhanced rate of cleavage can be shown to be
      due to histidine-specific zinc binding by D-dimer. It is proposed that zinc ions
      cause a distortion of the inter-crosslink peptide chain, creating a novel
      protease-susceptible site. The physiologic relevance is uncertain due to the
      relatively low measured zinc binding constant Kd = 10(-3.88) M. Zinc binding
      could, nevertheless, create a useful fibrin-specific neoepitope for antibody
      recognition in vitro.

PMID- 1631574
TI  - Endothelial cell-mediated thrombin formation.

PMID- 1631575
TI  - Thrombin binding to platelet membrane glycoprotein Ib.

PMID- 1631576
TI  - Deep vein thrombosis: prevalence of etiologic factors and results of management
      in 100 consecutive patients.

PMID- 1631577
TI  - Thrombin induces platelet adhesion to endothelial cells.

PMID- 1631578
TI  - Unusual bugs in immuno-compromised hosts.

PMID- 1631580
TI  - Buccal carcinoma--a case comparison of two modalities of reconstruction.
AB  - Buccal carcinoma, though a rare disorder in this part of the world, is often
      advanced at the time of diagnosis requiring full thickness resection of the cheek
      resulting in a through and through full thickness defect of the cheek. Such a
      defect confronts Head & Neck Surgeons with problem of reconstruction. The author
      presents, compares and contrasts two modalities of reconstruction.

PMID- 1631581
TI  - Sudden cardiac death in the Wolff-Parkinson-White syndrome.
AB  - Sudden death in the Wolff-Parkinson-White syndrome is an uncommon event but
      strikes in otherwise healthy children or young adults, often without much
      warning. They tend to occur in symptomatic but have also been reported in
      asymptomatic individuals. Several studies have been done profiling the sudden
      death survivor in the Wolff-Parkinson-White syndrome. In general, they tend to be
      symptomatic, have a short RR interval between preexcited beats during atrial
      fibrillation, have multiple pathways and may be associated with familial
      occurrence and Ebstein's anomaly. Several noninvasive investigations can help to
      assess the risk for sudden death, but the gold standard remains the use of
      electrophysiological testing. The management of patients with documented
      ventricular fibrillation or resuscitation from sudden death is unquestionably
      ablation of the accessory pathway but for the asymptomatic patients, it is still
      controversial whether they should be routinely studied by electrophysiological
      studies.

PMID- 1631579
TI  - Leuconostoc bacteraemia.
AB  - Leuconostoc species, a gram-positive coccal bacterium that is classically
      moderately susceptible to ampicillin and penicillin and resistant to vancomycin
      is a potential pathogen in the immunocompromised host. Twenty-eight isolates were
      collected from patients' blood culture specimens in the year 1989-1990. The
      clinical history and course of nineteen of these patients were studied. Five of
      them recovered without any antimicrobial therapy and in eight patients
      Leuconostoc species was isolated with other organisms in the blood culture
      specimens. The question arises as to when Leuconostoc species is of clinical
      significance when isolated in the blood culture specimens of patients.

PMID- 1631582
TI  - Operative cholangiography.
AB  - Retrospective analysis of 174 operative cholangiograms done over a 3-year period
      confirms its substantial benefit when used selectively in patients with clinical
      criteria for common bile duct exploration. A low incidental ductal stone rate of
      1.6%, together with a 3.3% false positive cholangiogram rate and a case of bile
      duct injury resulting from the procedure makes its routine application appear
      superfluous.

PMID- 1631583
TI  - Giant cell tumours of the sacrum.
AB  - Giant Cell Tumours (GCT) of the Bone is one of the commoner primary bone tumours.
      Although considered a benign tumour, it does occasionally metastasize to the
      lungs. Treatment modalities vary according to the surgical staging and the site
      of the tumour. Treatment is further complicated when the tumour occurs in
      difficult locations like the sacrum. The paper includes a review of literature
      into treatment options and the presentation of 3 patients with sacral GCTs, one
      of which also has multiple pulmonary metastases from a "benign" giant cell
      tumour.

PMID- 1631584
TI  - ECG abnormalities in Kawasaki disease and their value in predicting coronary
      artery aneurysms.
AB  - ECG abnormalities suggestive of carditis were encountered in 20 of 25 patients
      (80%) with Kawasaki Disease. The commonest abnormalities were raised S-T segments
      (11 patients), increased Q/R ratio (11 patients) and prolonged corrected Q-T
      interval (7 patients). Six patients had coronary artery dilatation and all
      resolved on subsequent 2-D Echocardiography. These six patients all had ECG
      changes of carditis. Such changes were present in 74% of patients with normal
      coronary arteries. The differences were not significant. A similar comparison
      between the two groups using the modified Asai scoring system failed to show the
      usefulness of this scoring system in predicting the risk of coronary artery
      involvement in our patients.

PMID- 1631585
TI  - Fistulotomy and marsupialisation for simple fistula-in-ano.
AB  - Nineteen consecutive cases of simple fistula-in-ano treated with fistulotomy and
      marsupialisation were retrospectively reviewed. Fourteen cases were simple
      intersphincteric and the remaining 5 cases were uncomplicated transphincteric
      fistulae. The cases were followed up for between 3 to 10 months (mean 6.9
      months). There were no reports of bowel incontinence or recurrence of fistula.
      The advantages of this 'tissue conserving' procedure are discussed in the paper.

PMID- 1631586
TI  - Medico-legal implications of electro-convulsive therapy--a Singapore viewpoint.
AB  - The clinical characteristics of 100 consecutive cases of ECT in a state mental
      hospital were surveyed. The medico-legal implications with regards to indications
      for and consent to ECT were looked into. The findings showed that ECT was given
      mostly for management reasons rather than based on diagnosis. Only 2 patients out
      of 100 gave their own consent. The discrepancy between teaching and practice was
      discussed.

PMID- 1631587
TI  - Inheritance of susceptibility: Lamarckism revisited.
AB  - The familial nature of susceptibility to rheumatic fever has been known for
      nearly three quarters of a century but even after massive ascertainments of
      affected families in 5 major cities, viz Toronto, Belfast, London, Glasgow and
      New York, a consensus on the exact mode of inheritance could not be reached.
      Reduced penetrance was suggested 40 years ago and still cited today even though
      the fit is poor. However with the sampling bias of the observed data resolved in
      the recently formulated geometric continuum v(affected-1) x P(sibship) (where O
      less than v----infinity) all those published ascertainments clearly show a
      unilocal Mendelian recessive mode of inheritance. Since rheumatic fever is
      clearly associated with streptococcal sore throat, I have therefore demonstrated
      the inheritance of an acquired trait. This Larmarckian concept is explained using
      simple numerical examples.

PMID- 1631588
TI  - Changing trends in the epidemiology and management of gonococcal ophthalmia
      neonatorum.
AB  - Between June 1985 and December 1988, 58 cases of gonococcal ophthalmia neonatorum
      were admitted to the neonatal unit at the University Hospital (USM). Of these, 15
      (25.9%) cases were due to penicillin-resistant strains of Neisseria gonorrhoea.
      Of the 58 cases, 56 cases were treated effectively with a single dose of
      antibiotic given systemically. The mean period of recovery was shorter with
      spectinomycin in doses of 40 mg/kg than with cefotaxime (100 mg/kg). There was no
      permanent sequelae in the treated cases. An increasing incidence of infection
      with penicillin-resistant strains of N. gonorrhoea has been observed in the area
      of study.

PMID- 1631589
TI  - Postinfarction cardiac rupture in the nineties: do we know determinating factors?
AB  - Postinfarction cardiac rupture (PCR) up to the present accounts for approximately
      20 percent of autopsy infarcted cases, ranking only behind arrhythmias and
      cardiac failure in the frequency of AMI complications. We re-examined our
      observations of a previous anatomo-clinical study of 96 patients who underwent
      autopsy after death from AMI. Sixteen patients had rupture of the free wall of
      the left ventricle at the site of infarction. All the patients with rupture
      showed the following statistically significant characteristics (p less than 0.01)
      if compared to those without rupture: cardiac hypertrophy (heart weight 390 to
      1020 gm; mean: 627.5 +/- 201 gm; left ventricular wall thickness 18 mm to 29 mm;
      mean: 25.17 +/- 3.6 mm), sudden death (6 cases) without premonitory symptoms or
      with symptoms of less than an hour's duration or reappearance of chest pain not
      improved by opiates before late death, that occurred 240 to 660 minutes from
      chest pain, recorded electrocardiograms showing sinus rhythm with unchanged ST
      segment (12 cases), atrioventricular block (2 cases) and junctional rhythm (2
      cases). Hypertension pre-existing to the infarction was seen in 6 cases with
      rupture versus 9 cases without rupture (p less than 0.01). Blood pressure, heart
      weight and wall thickness of the left ventricle are the most increased parameters
      in the patients with PCR. Preventive measures against these factors can reduce
      PCR.

PMID- 1631590
TI  - Comparison of serum fructosamine and blood glucose concentrations as indices of
      glycaemic control in non-insulin dependent diabetic out-patients.
AB  - The usefulness and validity of blood glucose measurement as an index of diabetic
      control were assessed with reference to serum fructosamine. Two hundred and
      twenty-eight non-insulin dependent diabetic out-patients were studied in the
      usual clinical setting. Fasting blood glucose (FBG) concentration was positively
      correlated with serum fructosamine (r = 0.42, t = 6.78 p less than 0.01). On the
      basis of their serum fructosamine concentrations, patients were divided into 3
      groups. They were good control (fructosamine less than or equal to 288 umol/l),
      acceptable control (fructosamine less than or equal to 320 umol/l) and poor
      control groups (fructosamine greater than 320 umol/l). The mean fasting blood
      glucose concentration was significantly higher in the latter than the former 2
      groups. However, at each level of control, there was a wide range of FBG
      concentrations. Thus, the value of FBG in predicting glycaemic control is
      limited. Its positive predictive value was only 32%, and its overall accuracy as
      an index of diabetic control was only 58% though its negative predictive value
      was high (93%). In 162 patients with poor diabetic control as indicated by their
      serum fructosamine concentrations, 81 (50%) of them had FBG less than 10 mmol/l
      on their clinic visit day. Fasting blood glucose is therefore not a reliable
      measure of good diabetic control, though it is useful in predicting poor control.
      FBG is simple to measure, cheap and rapidly available on clinic day, thus
      ensuring its continuing use. Doctors should be aware of its limitations and
      should not rely solely on FBG to assess diabetic control.

PMID- 1631591
TI  - Systemic lupus erythematosus.
AB  - Systemic lupus erythematosus (SLE) is a syndrome commonly affecting young women.
      The clinical manifestations are extremely varied and any major organ of the body
      may be involved. Misdiagnosis is not uncommon in early SLE where symptoms and
      signs may be few. Auto-antibodies to DNA, RNA and other cell nucleus antigens are
      frequently present. Circulating immune complexes may deposit in major organs,
      causing inflammation and tissue damage by a number of mechanisms. The lupus
      disease is marked by exacerbations and remissions. Management is dependent on
      accurate assessment of clinical activity and severity. Patient education and co
      operation in management affect outcome of the disease. With good management, the
      ten year survival may exceed 90%.

PMID- 1631592
TI  - The fibromyalgia syndrome.
AB  - Fibromyalgia is a syndrome characterized by generalized aches, pains and tender
      points. Fatigue and unrefreshed sleep are typical features often seen. In
      addition, patients complain of vasospastic extremities, irritable bowel syndrome,
      irritable bladder syndrome, tension headaches and sexual problems. Despite the
      many complaints, investigations are invariably normal. Other chronic pain and
      fatigue syndrome may be differentiated from Fibromyalgia. The pathophysiology is
      unknown but mechanical factors and a sleep disorder are implicated. Non
      pharmacological methods of treatment are more important than drugs. This includes
      explanation regarding the disease, reassurance, physiotherapy, stress elimination
      etc. Tricyclic anti-depressants may be useful. More research is needed to better
      understand this condition.

PMID- 1631593
TI  - Electrocardiographic case. Significance of raised ST segments?

PMID- 1631594
TI  - Duodenal leiomyosarcoma: a report of a rare and aggressive tumour.
AB  - A 45-year-old Malay lady who presented with intermittent abdominal pain and a
      left hypochondrial mass was found to have a 10 x 8 x 5 cm duodenal tumour without
      local invasion at laparotomy. En bloc resection of the tumour with adequate
      margin of clearance was done and histopathological diagnosis of low grade
      leiomyosarcoma was made. Fourteen months later, she returned with multiple
      metastases in the liver and needed palliative chemotherapy for pain relief.
      Duodenal leiomyosarcomata are very rare tumour. Their prognostic indicators
      include biological grading, tumour size and presence of metastases. Recognition
      of its high malignant potential calls for close surveillance calls even after
      apparent curative surgery.

PMID- 1631595
TI  - Retinal artery occlusion in a diver.
AB  - The clinical manifestation of decompression disorders is highly variable, ranging
      from mild rashes or joint pains to central nervous system symptoms like
      scotomata, paralysis and death. The diagnosis is easily overlooked, especially if
      an occupational history is not obtained. Recompression treatment with hyperbaric
      oxygen is the specific treatment for decompression sickness and air embolism.
      Prompt recognition and treatment are vital to recovery. However, there is a place
      for treatment of decompression disorders and embolism even when significant delay
      of up to 14 days has occurred. This case report discusses decompression disorders
      in relation to an unskilled fisherman diver who present with retinal artery
      occlusion. Decompression disorder leading to retinal artery occlusion is a very
      rare presentation. The difficulty of diagnosis is discussed as well as the result
      of delayed hyperbaric treatment.

PMID- 1631596
TI  - A delayed unusual presentation of a penetrating foreign body.
AB  - Complications resulting from the penetrating percutaneous foreign bodies almost
      always arise in the early post injury period. Delayed presentations of previous
      asymptomatic foreign bodies are rare. In this case report, symptoms of tracheal
      irritation arose seven years following the initial penetrating shrapnel injury to
      the neck. Computed tomography scans enabled localisation of the foreign body at
      the tracheal wall and carotid sheath interface. The usefulness of this radiologic
      modality in the evaluation of the penetrating soft tissue injury is highlighted.
      A review of the phenomenon of the migrating and asymptomatic foreign body
      follows.

PMID- 1631597
TI  - Early roentgen diagnosis of retroperitoneal duodenal rupture due to blunt
      abdominal trauma.
AB  - Retroperitoneal duodenal rupture due to blunt abdominal trauma is relatively
      uncommon. Diagnosis is difficult because the physical signs are subtle or they
      are difficult to interpret. A case of retroperitoneal duodenal rupture due to
      blunt abdominal trauma in whom the diagnosis was delayed is reported.
      Radiographic features are discussed. The role of early roentgen diagnosis is
      stressed in order to reduce the very high mortality which is associated with
      delay in diagnosis and treatment.

PMID- 1631598
TI  - Urinary incontinence caused by prazosin.
AB  - Urinary incontinence is a common problem in elderly women. However, urinary
      incontinence secondary to the commonly used antihypertensive, prazosin, is a rare
      phenomenon. The possible mechanism of this drug in causing incontinence is
      described in this case report. The possibility of an exaggerated response to the
      drug by women suffering from borderline stress incontinence is highlighted.

PMID- 1631599
TI  - Serodiagnosis of melioidosis in Singapore by the indirect haemagglutination test.

PMID- 1631600
TI  - Towards a new approach for estimating indirect costs of disease.
AB  - Many researchers in the field of evaluation of health care doubt the usefulness
      of estimates of indirect costs of disease in setting priorities in health care.
      This paper attempts to meet part of the criticism on the concept of indirect
      costs, which are defined as the value of production lost to society due to
      disease. Thus far in cost of illness studies and cost-effectiveness analyses the
      potential indirect costs of disease were calculated. In the following a first
      step will be taken towards a new method for estimating indirect costs which are
      expected to be effectuated in reality: the friction cost method. This method
      explicitly takes into account short and long run processes in the economy which
      reduce the production losses substantially as compared with the potential losses.
      According to this method production losses will be confined to the period needed
      to replace a sick worker: the so called friction period. The length of this
      period and the resulting indirect costs depend on the situation on the labour
      market. Some preliminary results are presented for the indirect costs of the
      incidence of cardiovascular disease in the Netherlands for 1988, both for the
      friction costs and the potential costs. The proposed methodology for estimating
      indirect costs is promising, but needs further development. The consequences of
      illness in people without a paid job need to be incorporated in the analysis.
      Also the relation between internal labour reserves and costs of disease should be
      further investigated. Next to this, more refined labour market assumptions,
      allowing for diverging situations on different segments of the labour market are
      necessary.

PMID- 1631601
TI  - Quality competition in local hospital markets: some econometric evidence from the
      period 1982-1988.
AB  - This study examines whether American hospitals continued to engage in non-price
      or quality competition over the recent past as health care markets underwent
      fundamental structural changes and the economic incentives facing hospital
      managers were correspondingly altered. It also investigates the degree to which
      such rivalrous behavior contributes to losses in economic welfare. An econometric
      model of quality competition is specified that tests, among other things, for the
      effect of spending by the hospital to enhance the quality of output on annual
      changes in its share of the local (inpatient) market as well as the effects of
      competitive conditions in the local market on the annual sum spent on quality
      enhancement. The model is estimated with panel data on 195 acute care hospitals
      in the State of Florida for the years 1982-1988. The results suggest that quality
      competitive behavior continued unabated over this period and that it was
      stimulated as much by the growth in physician supply and alternative delivery
      mechanisms as it was by other competing hospitals in the local market.
      Furthermore, the results show that quality competition yields some inefficiency
      or waste, but much of it also meets the test of the market.

PMID- 1631602
TI  - Consumer information and biased selection in the demand for coverage
      supplementing Medicare.
AB  - This study examines how the relationship between health insurance knowledge and
      the health status of health insurance consumers influences their decisions to
      purchase insurance coverage. Data from the federal Medicare health insurance
      program for the elderly in the United States are used. The basic Medicare program
      provides a limited amount of coverage for health care services obtained from any
      provider in the private fee-for-service (FFS) market. Beneficiaries of this
      program may choose to supplement the basic coverage which they receive by two
      mechanisms: either they may purchase private insurance designed to fill some of
      the gaps left by the federal program ('Medigap' policies), thereby remaining in
      the FFS market and preserving their choice of provider, or they may enroll in
      health maintenance organizations (HMOs), thereby leaving the FFS market and
      agreeing to use only those providers affiliated with the HMO, and in return
      receiving broader coverage at little additional out-of-pocket cost. The study was
      made possible by a unique data set which combines measures of beneficiary
      knowledge of Medicare coverage with measures of perceived health status, socio
      economic characteristics, and insurance coverage choices for a sample of Medicare
      beneficiaries who participated in an educational workshop about their insurance
      coverage options. These data were used to estimate a multinomial logistic model
      of the determinants of insurance choices, where the options included the two
      listed above and a basic Medicare option. The study explicitly recognizes the
      interaction between insurance information and health status in health plan
      choice. These results show that knowledge of coverage does have a differential
      impact on the decision to purchase health insurance depending on health status.
      With a high level of knowledge, sicker beneficiaries are less likely to have
      basic Medicare alone, compared with HMOs or Medigap policies, while healthier
      beneficiaries are less likely to be enrolled in HMOs, compared with Medigap
      policies. This finding has important implications for the use of health status
      measures to adjust capitated payment formulas when knowledgable consumers have
      the option to enroll in HMOs or remain in the FFS environment. In the absence of
      health status adjusters for the HMO capitation payments, high levels of coverage
      knowledge may exacerbate inherent selection bias among these coverage options by
      healthier and sicker consumers of health insurance.

PMID- 1631604
TI  - The collectivisation of health insurance.
AB  - The question that is dealt with in this article concerns the reasons for
      collectivisation of health insurance. This is not the same as collectivisation of
      health care. The The theoretical model of Usher, with the assumption that a
      commodity will be socialized if and only if a majority can be found in favour of
      socialization, appears relevant for the explanation of the origin and growth of
      social health insurance. Empirical evidence for the Netherlands, where reforms in
      the social health insurance are going on and common sense suggests that the taste
      factor is not very relevant, because preferences do not diverge very much among
      voters. This makes the income factor dominant. Since a majority will profit from
      socialization of health insurance, there is a strong tendency for
      collectivisation.

PMID- 1631603
TI  - Towards a capitation formula for competing health insurers. An empirical
      analysis.
AB  - In many countries the concept of capitating health care insurers is receiving
      increasing attention. The main reason is, that capitation may induce health care
      insurers in a competitive environment to concentrate more on cost containment.
      However, if the adjusters on which capitation payments are based, are too global,
      there may be ample room for risk selection by the insurers whilst also an unfair
      distribution of funds over the insurers may result, thereby undermining the
      objectives of capitation. The prime motivation for the present study is, that the
      Dutch government, as part of proposals for a new, market oriented structure of
      health care system, is considering to capitate insurers on the basis of global
      parameters like age, gender and location. Our analysis based on panel data of
      some 35,000 individuals, shows that the proportion of variance in annual health
      care expenditures that can be predicted (R2) by such a global capitation formula,
      is only 0.024. This is less than 1/5 of our estimate of the theoretically maximum
      achievable R2 which amounts to 0.138, implying the existence of abundant
      selection opportunities, e.g. on the basis of past expenditures or other health
      indicators. Alternative capitation formulae incorporating prior-year's costs and
      reaching about 3/5 of the maximum obtainable R2, effectively remove the
      profitableness of selection on the basis of past expenditures. The findings
      suggest, however, that selection via (chronic) health status may still be
      profitable to some extent. Therefore, we also analyzed data from the Dutch Health
      Interview Survey (N approximately 20,000) which comprised better health
      indicators. It appeared that a capitation formula based on the global adjusters
      mentioned above as well as three health status indicators and several background
      characteristics, yields an R2 of about 0.114, which probably accounts for 3/4 of
      our estimate of the maximum obtainable R2. The main conclusion is, that in the
      short term information on prior expenditures, which is available in the files of
      most insurers and thus may be used for risk selection, should be included in the
      capitation formula. For the more distant future, the formula should be expanded
      with indicators of chronic health status, possibly based on diagnostic
      information from previous, non-discretionary hospitalizations.

PMID- 1631606
TI  - Some recent developments in health economics.

PMID- 1631605
TI  - International health spending forecasts: concepts and evaluation.
AB  - Health care depends on the organizational and financial decisions which
      constituted each national system. Since those decisions were made at various
      times over the preceding years under different macroeconomic conditions, current
      expenditures are a distributed lag function of GDP growth and inflation rates.
      The accuracy of forecasts from such causal econometric models are compared to
      exponential smoothing, moving average, and ARIMA methods. Data fro 19 OECD
      countries 1965-79 are used for calibration, and then ex ante forecasts are
      generated for 1980-87 so that actual forecast accuracy can be tested. The
      greatest reduction in mean absolute error was obtained with the econometric model
      estimated in aggregate across all 19 countries, although single-country models,
      exponential smoothing and international averaging were also effective. A
      combination of all four forecasts was more accurate than any one alone, reducing
      MAE by 25% relative to a constant growth projection.

PMID- 1631607
TI  - Econometric critique of the economic change model of mortality.
AB  - The application of time-series data and analysis to study the effects of changes
      in unemployment rates on mortality rates has been a controversial issue in health
      unemployment research for many years. This article presents new criticism against
      previous aggregate time-series regression models and concludes that these models
      are misspecified in functional form, and the t-ratios used in significance tests
      are grossly overstated. Future empirical analysis of the Economic Change Model of
      Mortality, i.e. the aggregate, time-series relationship between mortality rates
      and economic variables must pay more attention to the salient characteristics of
      time-series data and implications for regression results.

PMID- 1631608
TI  - To prescribe or not to prescribe: on the regulation of pharmaceuticals in less
      developed countries.
AB  - An important source of failure in markets and justification for government
      intervention in the health sector of LDCs is imperfect information.
      Pharmaceutical use is one area in which widespread problems have been noted [1,
      2] with substantial misuse, improper diagnosis and problems of compliance noted
      among both the population at large and health care providers, presumably due to a
      lack of information concerning appropriate use. One possible instrument vis-a-vis
      the regulation of pharmaceuticals in LDC's (and in developed countries as well)
      is the decision by public health officials to make a particular drug available
      over the counter (OTC) to consumers or to require a prescription from a licensed
      professional. The choice is one of balancing two competing risks. On the one
      hand, allowing self-prescription by the consumers who do not have medical
      training risks gross errors of diagnosis and mistaken prescriptions with possibly
      serious health consequences. On the other hand, requiring the intervention of a
      skilled professional runs the risk that the patient does not receive the
      appropriate, potential life saving, drug at all. With medical personnel in very
      short supply in many parts of the developing world, the real cost (including
      travel time and expense) of visiting licensed medical facilities can be
      prohibitively high. This paper presents a very general methodology for evaluating
      the tradeoff between these competing risks. The problem can be considered one of
      determining the value of information (in the form of a more accurate diagnosis
      through the intervention of a skilled professional) as a particular (and costly)
      mechanism for obtaining this information.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631609
TI  - The economic evaluation of malaria control technologies: the case of Nepal.
AB  - This paper illustrates the methodological issues arising from the use of economic
      evaluation in a developing country context, and how economic evaluation can be
      applied in developing countries to draw conclusions of relevance to policy
      makers. The paper reports research on the cost-effectiveness of the malaria
      control programme in Nepal. It outlines the heirarchy of choices presented by
      malaria control and concentrates on the evaluation of the mix of routine
      strategies employed by the programme, particularly for vector control and case
      detection and treatment. A social perspective is taken, and emphasis placed on
      identifying costs falling on households, namely private expenditure on treatment
      and loss of days of work. Conclusions are drawn relating to the application of
      economic evaluation methodology to disease control programmes in developing
      countries.

PMID- 1631610
TI  - Assessing the costs and benefits of medical research: the diabetic retinopathy
      study.
AB  - Significant amounts of scarce resources are devoted to medical research, but
      there have been few attempts to assess whether the benefits to society of these
      investments exceed the costs. A method for undertaking such an assessment has
      been developed and applied retrospectively to the Diabetic Retinopathy Study, a
      major clinical trial funded by the National Eye Institute from 1972-1981. It was
      estimated that the trial, which cost $10.5 million, generated a net saving of
      $2816 million to society ($231 million when the costs of lost production are
      excluded) (1982 prices) and a gain to patients of 279,000 vision years. This
      approach could be applied prospectively in considering priorities for medical
      research, in conjunction with traditional criteria such as the scientific merit
      of the proposal and the capabilities of the investigators. The key factors
      affecting the economic returns from medical research are the prevalence,
      incidence and economic burden of the disease in question, the costs and
      effectiveness of the medical intervention concerned, the likely impact of the
      clinical trial on clinical practice and the likely timespan of benefits from
      knowledge obtained during the trial.

PMID- 1631611
TI  - The impact of recombinant human erythropoietin on medical care costs for
      hemodialysis patients in Canada.
AB  - Recombinant human erythropoietin (r-HuEPO) is an established and effective
      therapy for anemia related to end stage renal disease. In addition to its
      clinical effects, it has been associated with significant improvements in quality
      of life for anemic hemodialysis patients. The therapy's impact on overall medical
      care expenditures for these patients remains uncertain, however. In this study,
      we examine the costs of r-HuEPO as well as potential offsetting reductions in
      other medical care costs that might result from the therapy. We used data from a
      randomized clinical trial, a longitudinal study of hemodialysis patients and the
      clinical literature to estimate the impact of r-HuEPO on transfusion
      requirements, transfusion-related illness, hospitalization and transplant success
      for these patients. We estimate that for patients that otherwise would be
      transfused, the therapy would reduce blood requirements by nearly 10 units per
      patient annually and hospital use by 8 days per year. In addition, increased
      transplant success due to r-HuEPO might result in 150 fewer patient months of
      dialysis treatments each year. Comparing the dollar value of these reductions
      with the cost of therapy yields a base case net increase in medical care
      expenditures of $3425 per patient year. Under varying assumptions, the estimates
      range from a net cost of $8320 to a net saving of $1775 per patient year.

PMID- 1631612
TI  - A cost utility analysis of mammography screening in Australia.
AB  - Cost utility analysis is the preferred method of analysis when quality of life
      instead is an important outcome of the project being appraised. However, there
      are several methodological issues to be resolved in implementing cost utility
      analysis, including whether to use generalised measures or direct disease
      specific outcome assessment, the choice of measurement technique, and the
      combination of different health states. Screening for breast cancer meets this
      criterion as mammographic screening has been shown to reduce mortality; and it is
      said that earlier treatment frequently results in less radical surgery so that
      women are offered the additional benefit of improved quality of life. Australia,
      like many other countries, has been debating whether to introduce a national
      mammographic screening programme. This paper presents the results of a cost
      utility analysis of breast cancer screening using an approach to measuring
      outcome, Healthy Year Equivalents, developed within this study to resolve these
      problems. Descriptions of breast cancer quality of life were developed from
      surveys of women with breast cancer, health professionals and the published
      literature. The time trade off technique was then used to derive values for
      breast cancer treatment outcomes in a survey of women in Sydney, Australia.
      Respondents included women with breast cancer and women who had not had breast
      cancer. Testing of (i) the effect of prognosis on the value attached to a health
      scenario; and (ii) whether the value attached to a health scenario remains
      constant over time has been reported. The estimate of the net costs of screening
      are reported. The costs of breast cancer screening include the screening
      programme itself, the further investigations and the subsequent treatment of
      breast cancer cases. Breast cancer is treated in the absence of screening, many
      commentators claim earlier treatment is costly but there is little evidence.
      Therefore we have investigated current patterns of breast cancer treatment,
      current use of investigations for women presenting with symptoms and current use
      of covert mammography screening. The results are extrapolated to obtain estimates
      of the costs and outcomes presented as cost per healthy year equivalent. This
      analysis produces important information for the Australian policy debate over
      mammography. It also contributes to the development of cost utility analysis and
      the approach developed here can be applied more generally.

PMID- 1631613
TI  - [Aortic valve stenosis].

PMID- 1631614
TI  - [Aortic valve insufficiency].

PMID- 1631616
TI  - [Extracorporeal circulation].

PMID- 1631615
TI  - [Treatment of aortic valve diseases].

PMID- 1631617
TI  - [Surveillance of the patient].

PMID- 1631619
TI  - [Oral anticoagulants, a project for patient education].

PMID- 1631618
TI  - [Education of patients taking antivitamin K].

PMID- 1631620
TI  - [The society of artificial heart valve bearers].

PMID- 1631622
TI  - [Care, ethics and management: antagonism or synergism?].

PMID- 1631621
TI  - [Follow-up of transplant patients in the day hospital].

PMID- 1631623
TI  - [A day with Veronique and Emanuel. "The profession involves you all the time"].

PMID- 1631624
TI  - [Aortic valve diseases. Anatomical data].

PMID- 1631625
TI  - [Is there an ideal model?].

PMID- 1631626
TI  - [Hepatitis B].

PMID- 1631628
TI  - [Anaphylactic shock].

PMID- 1631627
TI  - [Diseases of the aortic orifice].

PMID- 1631629
TI  - [Antitubercular agents].

PMID- 1631630
TI  - [Protocol for taking specimens for blood culture].

PMID- 1631631
TI  - [Clinical examination of patients with varicose veins].

PMID- 1631632
TI  - [Venous disorders and life hygiene].

PMID- 1631633
TI  - [Medical treatment of varicose veins and indications for surgery].

PMID- 1631634
TI  - [Treatment of leg ulcers].

PMID- 1631635
TI  - [Admission by a nurse of a patient with leg ulcer].

PMID- 1631637
TI  - [Writing, the stumbling block of the profession].

PMID- 1631636
TI  - [Leg ulcer. When nurses teach other nurses].

PMID- 1631638
TI  - [Who are you, Michele Joly-Meng?].

PMID- 1631639
TI  - [The National Hospital Center of Ophthalmology Quinze-Vingts].

PMID- 1631640
TI  - [Public health, community health, primary health care].

PMID- 1631641
TI  - [Advantages accorded the non-medical nursing personnel in public health].

PMID- 1631642
TI  - [Antifungal agents in deep mycoses].

PMID- 1631643
TI  - [Pentacarinat as an aerosol].

PMID- 1631644
TI  - [Anatomy, physiology and physiopathology of the venous return of the lower
      extremities].

PMID- 1631645
TI  - [Suicide from the aspect of legal medicine].
AB  - The authors analyzed 778 cases of suicide subjected to necropsy in the Institute
      of Forensic Medicine in Plzen in 1979-1989. They evaluated various interrelations
      between 19,000 data they assembled. In the discussion they draw attention to
      conclusions which differ those published in the literature.

PMID- 1631646
TI  - [Causes of death among prisoners in Eastern Bohemia 1980-1990].
AB  - The authors analyzed the death of 35 subject where autopsies were made in the
      Institute of Forensic Medicine in Hradec Kralove during 1980-1990 who died in
      prisons in the eastern Bohemian region. Attention was focused on the causes and
      circumstances of death. In addition to atherosclerosis and injuries attention is
      paid to suicide and possible murder. A special problem are deaths after long-term
      fasts.

PMID- 1631647
TI  - [Detection of drugs on thin layers using potassium permanganate].
AB  - The authors discuss detection of drugs and other substances during thin layer
      chromatography by means of an aqueous solution of potassium permanganate. Ninety
      drugs and other substances were divided into three groups: a) strongly reacting,
      b) weakly reacting, c) not reacting. It was revealed that all compounds
      containing non-aromatic C = C bonds or oxidizable sulphur react very intensely.
      Other drugs containing readily oxidized groups react also.

PMID- 1631648
TI  - [Suburbs in difficulty: the relegation].

PMID- 1631650
TI  - [Without your own roof: living in the city during adolescence].

PMID- 1631649
TI  - [The city and mental health].

PMID- 1631651
TI  - [The city at risk for drug abuse and AIDS].

PMID- 1631652
TI  - [The medical-psychological center of d'Ivry: a team in the heart of life].

PMID- 1631653
TI  - [Bistrot: provisional inventory of space or re-create the present].

PMID- 1631654
TI  - [Dossier: disorders in the city].

PMID- 1631655
TI  - [When the young steer themselves by boat].

PMID- 1631656
TI  - [Family-space 92].

PMID- 1631657
TI  - [Affiliation of the profession of psychiatric nursing].

PMID- 1631658
TI  - [Caring for the ills of the city].

PMID- 1631659
TI  - [Nursing diagnoses in mental health].

PMID- 1631660
TI  - [Current issues in psychoanalysis: Reich and Ferenczi].

PMID- 1631661
TI  - [A patient besieged by the absurd].

PMID- 1631662
TI  - [Megalopolis, megacrisis].

PMID- 1631663
TI  - [Psychopathological disorders of patients].

PMID- 1631664
TI  - [To be part of the nursing staff in a residential care area].

PMID- 1631665
TI  - [A new function: medical-psychiatric aide].

PMID- 1631666
TI  - [The educational and caring area].

PMID- 1631667
TI  - [Patient team work].

PMID- 1631668
TI  - [Body moulding, words from the earth age].

PMID- 1631669
TI  - [Psychomotor rehabilitation in a specialized halfway house].

PMID- 1631670
TI  - [From action to interaction: communication with psychotic retarded patients].

PMID- 1631671
TI  - [Determination of images. Confrontation between the body image/the lived image in
      the chronic psychotic patient].

PMID- 1631672
TI  - [The drum child].

PMID- 1631673
TI  - [Family therapy admission in mental disorders].

PMID- 1631674
TI  - [Program of study leading to a state nursing diploma].

PMID- 1631675
TI  - [A feverish psychotic].

PMID- 1631676
TI  - The (non)-compliant patient.

PMID- 1631677
TI  - Writing a paper for a medical journal is like cooking potatoes.

PMID- 1631678
TI  - Physicians' attitudes and practices regarding treatment of HIV-infected patients.
AB  - We conducted a statewide survey to identify physicians' experiences, attitudes,
      and practices related to HIV-infected patients. A random sample, stratified by
      medical specialty (primary care, surgery, emergency medicine), was drawn.
      Physicians were concerned about contagion and inadequate knowledge to care for
      HIV-infected patients; 40% reported refusing or referring new HIV-infected
      patients. Differences across medical specialty and respondents' interest in
      various medical education topics to remedy knowledge deficits are discussed.

PMID- 1631679
TI  - Uncomplicated cystitis: diagnosis and treatment at college health centers.
AB  - The results of recent studies have led to valuable new recommendations regarding
      optimal diagnosis and treatment of acute uncomplicated cystitis in women. To
      investigate to what degree these recommendations have been incorporated into
      clinical practice, we conducted a survey of all college health centers belonging
      to the American College Health Association regarding their current management of
      suspected uncomplicated cystitis. Sixty-one percent responded. The results
      confirm that acute cystitis is indeed frequent among college women. Nonetheless,
      our data show that there is a wide variation in the approach to this common
      problem and that many centers have not yet adopted the new recommendations for
      optimal diagnosis and treatment. If we are to improve the management of
      uncomplicated cystitis in women, we must not only learn the best medical
      approaches, but we must also find reliable ways of transmitting this information
      to clinicians.

PMID- 1631680
TI  - Tubo-ovarian abscess in postmenopausal patients.
AB  - We retrospectively reviewed 20 surgically confirmed tubo-ovarian abscesses in
      postmenopausal women for the period 1973 to 1989. Pain and bleeding were the two
      most common presenting symptoms. Nine of the 20 patients (45%) had recently had
      endometrial instrumentation. Fever and the presence of a pelvic mass and elevated
      white blood cell count, without evidence of peritonitis, were frequent findings
      on admission. At surgery, seven abscesses were already ruptured or leaking, 12 of
      18 patients with both ovaries had unilateral abscesses, and dense adhesions were
      found in 11 patients. A common intraoperative complication was inadvertent bowel
      injury. Postoperative complications included fascial dehiscence, enterocutaneous
      fistula, deep venous thrombosis, and need for prolonged ventilatory support.
      Eight patients had a coexisting gynecologic malignancy. A high index of suspicion
      is required for early recognition of postmenopausal tubo-ovarian abscess. Prompt
      surgical exploration should be done to avoid occult rupture or sepsis.

PMID- 1631681
TI  - Cavitary pulmonary cryptococcosis complicating Churg-Strauss vasculitis.
AB  - Churg-Strauss vasculitis (CSV) is an interesting but uncommon pulmonary
      vasculitis. Cavitation in CSV is distinctly unusual and should prompt a work-up
      for other causes. We have described a case of CSV complicated by pulmonary
      cryptococcosis, which was treated with a novel antifungal regimen.

PMID- 1631682
TI  - Infection due to Ehrlichia canis in children.
AB  - Human ehrlichiosis has a wide spectrum of presentation. This report presents two
      cases that demonstrate the diversity of the manifestation of ehrlichiosis, from
      life threatening to a mild viral-like illness. Diagnosis requires an
      understanding of the epidemiology and clinical manifestation of this infection
      and a high index of suspicion.

PMID- 1631683
TI  - New diagnoses in a specialty clinic: opportunities for consultants.
AB  - The role consultants play in detecting disease coincidental to the reason for
      consultation is unclear. We sought to elucidate this function in the setting of a
      specialty clinic for osteoporosis. Making no specific attempt to screen for
      general conditions, we evaluated 760 women; any new diagnosis was found in the
      course of thoroughly examining the patient for osteoporosis. A total of 274 new
      diagnoses were counted, encompassing 68 conditions. There were 211 women (28%) in
      whom a new diagnosis was detected; a higher percentage of older women than
      younger women had a new diagnosis. A diagnosis severity grouping scheme was
      devised, groups C and D being those in which further evaluation was clearly
      indicated. The diagnoses in groups C and D accounted for 70% of all new diagnoses
      made, suggesting that trivial conditions were not overrepresented. The history
      and physical examination alone was responsible for 50% of the various conditions
      diagnosed and 64% of the total number of new diagnoses. The consultant has an
      excellent opportunity to detect disease while performing a specialty
      consultation.

PMID- 1631684
TI  - Stiff-man syndrome.
AB  - Stiff-man syndrome (SMS) is a rare disorder of the central nervous system
      characterized by painful involuntary stiffening of axial muscles accompanied by
      spasms. These are often precipitated by tactile or emotional stimuli, volitional
      movement, and startling noises. Until recently, little has been known about the
      pathogenesis of SMS. There is evidence now to support the hypothesis that SMS may
      be an autoimmune disease. This is leading to changes in the way this disease is
      diagnosed and treated. We describe two patients with SMS and review the
      pathogenesis, diagnosis, and treatment.

PMID- 1631685
TI  - Antiarrhythmic response to intravenously administered magnesium after cardiac
      surgery.
AB  - We evaluated the antiarrhythmic response to magnesium given intravenously to 40
      patients who had had elective cardiopulmonary bypass for the surgical treatment
      of acquired cardiac disease. All 40 patients were found to have hypomagnesemia
      postoperatively as defined by a serum magnesium level of less than 1.8 mg/dL. The
      ventricular arrhythmias of these patients were categorized by a modified Lown
      grade classification. Magnesium sulfate (16 mEq, [2000 mg]) was administered, and
      the patients were reclassified according to their rate of ventricular ectopia.
      All arrhythmias of a higher grade responded to the treatment with a marked
      reduction in ventricular ectopia and were reclassified to a lower grade. This
      study supports the routine administration of magnesium sulfate, at a dose of 16
      mEq, in postoperative cardiac patients who are hypomagnesemic.

PMID- 1631686
TI  - Stooling problems in patients with myelomeningocele.
AB  - In children with myelomeningocele fecal and urinary incontinence lowers self
      esteem and decreases social interaction. The defects in the lumbosacral spine
      disturb the sensory and motor nerves supplying the skin and muscles of the
      perianal region, including the puborectalis muscle, and the external anal
      sphincter. The sensations in the region, as well as the motor functions of the
      striated muscles suffer, compromising the dynamics of continence and the normal
      process of stooling and leading to incontinence and constipation. Constipation
      has been treated by disimpaction of stools from the colon and rectum,
      administration of stool softeners, and a healthy diet containing adequate bulk
      forming items. Incontinence has usually been managed by behavior modification of
      self-initiating stooling after meals and positive reinforcement of this process.
      This method has helped up to 75% of patients to become socially continent.
      Biofeedback training has been helpful in patients who have preservation of some
      sensorimotor functions in the perianal region and who understand and cooperate in
      the process of biofeedback training. The enema continence catheter has been used
      to empty the rectosigmoid every 48 hours; most children treated in this manner
      have achieved social continence. Electric stimulation of the pudendal nerves
      using a neuroprosthetic device has been used in some patients. The pudendal nerve
      is stimulated continuously to achieve continence; stimulation is discontinued
      only for stooling and/or urination.

PMID- 1631687
TI  - Efficacy of the supraclavicular route for temporary hemodialysis access.
AB  - The percutaneous supraclavicular approach for temporary central venous
      hemodialysis access was successfully used in 27 of 34 cases (79%) without
      significant complications and was found to be a durable technique acceptable to
      every patient. The supraclavicular site was used from 3 to 156 days (mean, 40
      days). The average catheter life was 25 days, and 13 guidewire catheter changes
      among eight patients were required for catheter limb thrombosis or suspected
      infection. Preventable kinks resulting from technical error occurred in two
      catheters (5%), necessitating guidewire replacement in one. A total of 41
      catheters were used, and infection was documented in one (2%). Catheters were
      intentionally removed in 21 patients and were removed for proved infection (1) or
      suspected infection (5) in the remaining six patients. No new clinical evidence
      of central venous stenosis or thrombosis, such as arm swelling, prominent
      cutaneous collateral veins, or increased venous pressure at dialysis, was
      observed. We suggest the supraclavicular approach as the primary route for
      temporary central venous hemodialysis access. Continued follow-up is necessary to
      substantiate the initial favorable experience with the supraclavicular technique.

PMID- 1631688
TI  - Pancreatic pseudocyst: diagnosis and management.
AB  - Diagnosis and management of pseudocysts of the pancreas often present difficult
      clinical problems. We reviewed our 18 patients with pancreatic pseudocysts
      treated between January 1985 and October 1989 to identify criteria for operative
      and nonoperative management based on size of the lesion on computerized
      tomography. Diagnostic modalities, etiology, management, and concurrent medical
      problems were also evaluated. Alcohol (72%) was the most common etiologic agent.
      Hypertension (39%), peptic ulcer disease (28%), and chronic obstructive pulmonary
      disease (22%) were the most common associated medical problems. CT scan was the
      most frequently used (100%) and most accurate (100%) preoperative diagnostic
      tool. Preoperative ERCP modified the treatment plan in only one patient. All
      pseudocysts smaller than 3 cm on CT scan were managed nonoperatively, without
      recurrence (mean follow-up of 3 months). The most commonly performed surgical
      procedure was cystogastrostomy. External drainage procedures had a higher
      complication rate (100% vs 14%) and higher recurrence rate (33% vs 0%) than
      internal drainage procedures. Attempted percutaneous drainage in one patient
      resulted in recurrence. Pancreatic pseudocysts less than 3 cm in diameter can be
      safely managed nonoperatively. CT scan remains the diagnostic tool of choice.
      Preoperative ERCP evaluation is of limited utility and needs further evaluation.
      Internal drainage procedures provide the best surgical results.

PMID- 1631689
TI  - Pediatric chest disease: evaluation by computerized tomography, magnetic
      resonance imaging, and ultrasonography.
AB  - The initial method for evaluating pediatric chest disease remains the plain chest
      roentgenogram. When more precise definition of chest disease is required,
      computerized tomography (CT), magnetic resonance imaging (MRI), or
      ultrasonography (US) may be useful. In general, CT offers the widest spectrum of
      applicability. MRI is especially useful because no ionizing radiation is used and
      images can be acquired in multiple planes. MRI is most valuable when vascular
      anatomy needs to be defined or when tumor invasion of the spinal canal is
      suspected. US is helpful in evaluating diseases of the pleura and for
      characterizing and localizing pleural fluid and masses. US can differentiate
      normal thymus from other anterior mediastinal masses. Doppler techniques are
      valuable in evaluating suspected pulmonary sequestration and identifying the
      feeding vessel.

PMID- 1631690
TI  - Dizzy medical writing and editing: no relief in sight.

PMID- 1631691
TI  - Follow-up care for emergency patients.

PMID- 1631692
TI  - Jones fracture: relearning an old injury.
AB  - No longer should the Jones fracture be confused with more proximal injuries at
      the base of the fifth metatarsal. Historically, the lack of differentiation of
      these two injuries has led to much confusion about their natural history and
      consequently about the best method of treatment. It is presently well understood
      that the more proximal injuries typically respond satisfactorily to short-term
      immobilization. Current studies have been able to focus on defining the varied
      nature of fractures in the proximal fifth metatarsal. We have learned to
      differentiate between acute and chronic (subacute or stress) fractures and
      especially to appreciate the ramifications of the injury in an active population.
      Although significant contributions to understanding and managing these injuries
      have occurred in recent years, much of what we have described in such detail was
      already printed in Jones' original article, which was perhaps presented in much
      simpler terms, but no less accurately.

PMID- 1631693
TI  - Murine typhus endocarditis.
AB  - We have described a 28-year-old male sheepfarmer who had fever, headache, chills,
      malaise, and aortic insufficiency. Echocardiography revealed a tricuspid aortic
      valve with a large vegetation on the right cusp, an enlarged left ventricle, and
      diastolic flutter of the mitral valve. Repeated blood cultures were negative.
      Seroconversion of IgG and IgM to Rickettsia typhi was found on the 13th day of
      hospitalization. The patient was treated with tetracycline for 1 year and
      remained afebrile and free of symptoms for 9 months, when he was lost to follow
      up. IgM and IgG fluorescent antibodies to R typhi remained positive during 8
      months of the follow-up period. We believe this to be the second reported case of
      endocarditis due to R typhi and the first not treated surgically.

PMID- 1631694
TI  - Murine typhus: forgotten but not gone.
AB  - An occasional patient presents the classical symptoms of a disease that has
      become uncommon. Typhus is an example of such a disease, since it is now well
      contained through control of its rodent reservoir. It is readily treated with
      tetracycline or one of its long-acting analogues, doxycycline or minocycline.
      Because typhus is infrequently encountered, the physician may not initially
      include it in his differential diagnosis. Our case serves as a remainder that
      with the increasingly frequent movement of persons from one geographic area to
      another, the uncommon rickettsial infection, murine typhus, should continue to be
      in the differential of a febrile patient. Furthermore, our case underscores the
      importance of including typhus in the differential of typhoid fever.

PMID- 1631695
TI  - Carotid body tumor: diagnostic and therapeutic approach.
AB  - Carotid body tumor may be clinically suspected when the only clues are
      physiologic manifestations of carotid body dysfunction or when a palpable
      cervical mass is evident upon presentation. In the latter case, the physiologic
      signs of carotid body dysfunction are usually recognizable. We have presented the
      case of a patient who was completely disabled by a slowly enlarging carotid body
      tumor. An attempt at surgical excision of the tumor was unsuccessful because of
      its proximity and adhesion to vital neck structures. An endocardial pacemaker
      inserted to ameliorate the episodes of bradycardia and hypotension accompanied by
      transient complete atrioventricular block resulted in only partial and temporary
      relief. Finally, irradiation of the tumor induced fast shrinkage and rapid
      regression of symptoms.

PMID- 1631696
TI  - Postpartum transient blindness probably related to undiagnosed brain tumor.
AB  - Nausea and vomiting are so frequent under regional anesthesia during parturition
      that these symptoms can be misleading and may cause the clinician to overlook a
      potential intracranial lesion. In the case we have reported, it was not until the
      onset of blindness that an intracranial lesion was suspected. Although the
      incidence of brain tumor during pregnancy is low, it does occur with various
      manifestations and has been associated with blindness. Therefore, prompt
      neurologic investigation may be warranted in patients complaining of visual
      changes, even though transient blindness can occur in the absence of a neurologic
      lesion.

PMID- 1631697
TI  - Cryptococcosis of the larynx in a patient with AIDS: an unusual cause of fungal
      laryngitis.
AB  - We have presented a case of unsuspected cryptococcal laryngitis, clinically
      masquerading as Kaposi's sarcoma in a patient with AIDS. The spectrum of
      laryngeal disease in AIDS patients includes a variety of infections and
      neoplasms, which can be treated satisfactorily when accurate and timely diagnosis
      is made.

PMID- 1631698
TI  - Benign schwannoma of the cecum shown radiologically.

PMID- 1631699
TI  - Right middle lobe syndrome caused by Mycobacterium fortuitum in a patient with
      human immunodeficiency virus infection.
AB  - We have reported a previously undescribed syndrome of Mycobacterium fortuitum
      infection manifested as localized pulmonary disease that required lung resection
      and prolonged combined chemotherapy for clinical response in a patient with HIV
      infection. M fortuitum infections must be considered in HIV-infected patients
      with possible infectious pulmonary complications.

PMID- 1631700
TI  - Progressive systemic sclerosis causing rapidly progressive myocardial disease and
      death.
AB  - We have presented an unusually swift progression of progressive systemic
      sclerosis (PSS), with death from cardiogenic shock in a 22-year-old woman who had
      severe hypertension and acute renal insufficiency. She arrived at our hospital
      with pericardial tamponade and shock. Despite initial improvement after
      pericardiocentesis, the patient's condition soon deteriorated and she died of
      cardiogenic shock. PSS was diagnosed at autopsy. Although the course of PSS is
      frequently indolent, it may also be fulminant, leading to death before diagnosis
      is determined.

PMID- 1631701
TI  - Candidal endophthalmitis after lithotripsy of renal calculi.
AB  - Candidal endophthalmitis is most commonly due to hematogenous seeding of the eye
      by Candida albicans. Although it is most often seen as a manifestation of
      disseminated candidiasis in patients who are seriously ill, other patients may
      have candidal endophthalmitis as the only evidence of fungal infection. We have
      presented a case of endophthalmitis due to C albicans in a patient who had
      bilateral renal calculi and who had received multiple antibiotics and
      extracorporeal shock wave lithotripsy.

PMID- 1631702
TI  - Massive splenomegaly in sarcoidosis.
AB  - We have presented a case of massive splenomegaly. Our patient was initially
      thought to have lymphoma, but at operation she was found to have sarcoidosis with
      splenic involvement. At 2250 g, the spleen was one of the largest recorded in the
      literature on sarcoidosis. Although the spleen is frequently involved in
      sarcoidosis, a review of 6074 cases showed that the incidence of actual
      splenomegaly is only 10%. In 628 of these cases the authors described various
      degrees of splenomegaly, but the incidence of massive splenomegaly was only 3%.
      We conclude that sarcoidosis must be considered in the differential diagnosis of
      splenomegaly.

PMID- 1631703
TI  - Airway obstruction in the mentally handicapped.
AB  - We have presented a case of laryngomalacia in an 18-year-old mentally retarded
      woman treated with epiglottoplasty. The preoperative and postoperative appearance
      of the larynx during aspiration was documented using video and still photography.
      Diagnosis was made by fiberoptic nasopharyngoscopy and laryngoscopy.

PMID- 1631704
TI  - Talking to patients with HIV disease.

PMID- 1631705
TI  - Inpatient CPR.

PMID- 1631706
TI  - Compliance with therapy for cervical dysplasia.

PMID- 1631707
TI  - Nuance of needle sharing among intravenous drug users in Houston.

PMID- 1631708
TI  - Neuropathic (Charcot) arthropathy of the spine after traumatic spinal paraplegia.
AB  - Neuropathic (Charcot) arthropathy of the spine is a relatively rare problem that,
      nonetheless, must be considered in the differential diagnosis of any patient with
      degeneration of one or more levels of the spine associated with diminished or
      absent protective sensation. This study presents 15 patients in whom Charcot
      arthropathy of the spine developed after traumatic paraplegia. Eight were
      successfully treated with surgical fusion, and the remaining seven were treated
      nonoperatively. By the use of combined anterior and posterior fusion with
      extensive debridement, autogenous grafting, and posterior instrumentation,
      successful fusion can be achieved in patients with Charcot arthropathy of the
      spine. However, the surgical technique is demanding, the rehabilitation must be
      carefully supervised, and the postoperative complication rate remains high. The
      possibility of developing secondary levels of arthropathy below a previously
      successful fusion must be considered.

PMID- 1631709
TI  - Routine use of magnetic resonance imaging in idiopathic scoliosis patients less
      than eleven years of age.
AB  - The purpose of this study was to determine the incidence of intraspinal pathology
      presenting as idiopathic scoliosis in children less than 11 years of age and
      otherwise neurologically normal. Twenty-six consecutive patients (5 boys, 21
      girls) with idiopathic scoliosis measuring at least 15 degrees were studied with
      magnetic resonance imaging. Five children (19.2%) were diagnosed by magnetic
      resonance imaging to have Chiari-I malformations with hydromyelia (two patients),
      syringomelia (one patient), intramedullary tumor (one patient) and terminal
      lipoma (one patient). Only two of the five patients had left thoracic curves.
      Intramedullary spinal cord pathology can present as scoliosis without neurologic
      signs. Scoliosis can be the initial neurologic sign suggesting intraspinal
      pathology, and magnetic resonance imaging is indicated in routine evaluation of
      children less than 11 years of age.

PMID- 1631710
TI  - Spinal stenosis with scoliosis.
AB  - A retrospective review was carried out on 40 patients who met the criteria of 1)
      having a significant lumbar scoliosis associated with spinal stenosis, with
      symptoms of neurogenic claudication; and 2) having been treated with posterior
      decompression and pedicular screw fixation techniques. The average age of the
      patients was 61.5 years (range, 38-77 years), and 25 of the 40 patients were
      female. Eighty-eight percent of the patients had significant back pain in
      addition to lower extremity pain. All patients had pedicular screw fixation at
      all levels. Zielke instrumentation was used in 24 patients, Cotrel-Dubousset
      instrumentation in 8 patients, and Texas Scottish Rite Hospital instrumentation
      in the remaining 8 patients. After surgery, there was marked improvement in
      regard to pain status: 34 patients (83%) had severe pain before surgery, with 38
      patients (93%) reporting mild or no pain at follow-up. Average length of follow
      up was 44 months (range, 24-61 months). There were no deaths and no instrument
      related failures or pseudarthroses noted in this series. A mean correction of the
      deformity of 19 degrees was obtained. Average scoliosis was 37 degrees before
      surgery and 18 degrees at follow-up.

PMID- 1631712
TI  - Human disc phospholipase A2 is inflammatory.
AB  - Human discs have been demonstrated to contain high levels of phospholipase A2. As
      the enzyme responsible for the liberation of arachidonic acid from membranes,
      this enzyme has a theoretical inflammatory potential. Herniated lumbar discs have
      a higher level of phospholipase A2 than do normal discs. The purpose of this
      study was to evaluate the inflammatory capability of purified human disc
      phospholipase A2. Phospholipase A2 extracted and purified from human disc was
      found to be inflammatory. Its inflammatory capability was directly related to its
      ability to function enzymatically. When the enzyme was treated with
      parabromophenacyl bromide (p-BPB) to specifically alkylate the active site
      histidine and block catalytic activity, the ability of the modified protein to
      produce edema was markedly reduced. Careful regulation of the activity of this
      enzyme is important in vivo because its inflammatory potential could result in
      disc degeneration and nerve injury.

PMID- 1631711
TI  - A biomechanical study of the fatigue characteristics of thoracolumbar fixation
      implants in a calf spine model.
AB  - Clinical failures of internal fixation implants for the treatment of the
      thoracolumbar spine are generally attributed to fatigue. Few studies, however,
      have characterized changes in fixation rigidity with time or subjected spine
      implant fixation constructs to fatigue loading until failure. Fatigue
      characteristics of five dorsally applied spinal fixation implants were determined
      using lumbosacral calf spines, with an L3 vertebrectomy, loaded cyclically in
      combined compression (maximum 605 N) and flexion (maximum 16 Nm) for up to
      100,000 cycles. Displacement transducers monitored motion at the site of
      instability and at the segment above the implants. Flexibility and strain at
      these segments were then calculated. A one-way analysis of variance showed that
      there were no significant differences in flexibility of the five fixation
      constructs (P greater than .05). A multiple Bonferroni test revealed that the AO
      and Kluger fixateur interne and Steffee plates, with fixation at L2 and L4,
      allowed significantly more strain (P less than .01) across the site of
      instability than did Harrington rods and Luque plates with fixation at L1, L2,
      L4, and L5. There were no significant differences between fixation constructs in
      initial strain above the implants. After 10,000 cycles, however, there were
      significant increases in strain across the segment above the Luque and Harrington
      implants (P less than .05). Failure of the AO Schanz screw occurred in three of
      six constructs at a mean of 73,300 cycles. The Steffee screws failed in four of
      five constructs at a mean of 20,800 cycles. The rods of the Kluger fixateur
      interne broke in four of five constructs at a mean of 47,800 cycles, and one
      screw slipped at 11,000 cycles. There were no metal failures in the Harrington or
      Luque implants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631713
TI  - Human intradiscal levels with cefazolin.
AB  - The administration of prophylactic antibiotics for the prevention of discitis is
      common in the field of spinal surgery. The purpose of this study was to determine
      1) whether cefazolin administered intravenously would result in detectable
      intradiscal levels; and 2) if so, what the proper timing of the antibiotic bolus
      should be to achieve optimal intradiscal concentrations. Forty human lumbar discs
      were obtained during the study period. All subjects received a preoperative bolus
      infusion of 2 g of cefazolin during a 3-5 minute period. Serum and intradiscal
      samples were obtained at intervals ranging from 6 to 220 minutes after the
      antibiotic infusion. The respective intradiscal concentrations of cefazolin were
      then determined, and the findings were as follows: 1) cefazolin does diffuse into
      the human disc in detectable concentrations; and 2) a critical time relationship
      exists (15-80 minutes after a bolus administration of cefazolin) for the optimal
      level of intradiscal antibiotics to be achieved.

PMID- 1631714
TI  - Instantaneous axis of rotation as a function of the three columns of the spine.
AB  - A knowledge of the rotatory motion of the vertebral bodies is needed to
      understand the normal biomechanical behavior of the spine. The aims of this
      investigation were 1) to define the instantaneous axis of rotation of the lumbar
      spine in rotation; and 2) to study the effect of the loss of the anulus, facet
      joints, and ligamentous structures on the location of the instantaneous axis of
      rotation. The instantaneous axis of rotation was found in 10 human cadaver
      thoracolumbar spines by the method of Reuleaux from superimposed serial
      photographs. Long-segment specimens were tested to minimize the effect of the
      imposed axis of the testing device. The instantaneous axis of rotation was
      consistently posterior to the anulus in the intact spine. With isolated
      destruction of the columns of the spine, the instantaneous axis of rotation
      migrated to the remaining intact structures. Anterior releases enhance derotation
      by removing the primary rotatory stabilizer. Ultimate control of a rotatory
      deformity or instability lies in the recognition that the anterior structures
      have a mechanical advantage in resisting torsion.

PMID- 1631715
TI  - Response to steroid and duration of radicular pain as predictors of surgical
      outcome.
AB  - Prolonged structural compromise of spinal nerve roots can lead to chronic changes
      that surgical decompression might not be able to reverse. In this study, it was
      hypothesized that if there were a reversible structural pain component, a steroid
      injected into the patient's symptomatic nerve root should provide temporary pain
      relief and that these patients should have a favorable surgical outcome. It also
      was hypothesized that duration of radicular symptoms would correlate inversely
      with surgical outcome. For postoperative relief of radicular pain, the results
      showed that patients with pain lasting less than 1 year had a positive surgical
      result (89%), regardless of response to steroid. Patients with pain lasting more
      than 1 year and who have had a positive response to steroid injected into the
      symptomatic nerve root (roots) had a positive surgical outcome of 85%. Patients
      who did not respond to the steroid and had pain for more than 1 year (95%)
      generally had a poor surgical outcome. Although the poor outcome in the last
      group might be explained in some cases by an inadequate structural correction,
      inadequate stabilization, or functional reasons, the majority of these failures
      represented irreversible changes in the neural structures.

PMID- 1631716
TI  - Complications of lumbar spinal fusion with transpedicular instrumentation.
AB  - Transpedicular screw fixation systems are coming into wide use as an adjunct to
      lumbar spinal fusion procedures. This 5-year series included 486 patients who
      underwent 533 variable screw placement procedures for discal, degenerative, and
      spondylolytic problems. The wound infection rate was 2.6%: 0.6% deep, 0.9% graft,
      and 1.1% superficial. The neural injury rate was 1.1% overall: 0.6% related to
      posterior lumbar interbody fusion and 0.6% related to instrumentation. Technical
      problems per procedure included 8.1% difficult screw placement, 5.6% nut
      loosening, and 4.3% screw breakage (1.1% per screw placed). Device modifications
      have reduced the incidence of screw breakage and nut loosening. No device-related
      neural injuries occurred in the last 333 procedures. With experience, the device
      can be applied safely without significantly increasing the risk of neural injury
      or morbidity.

PMID- 1631717
TI  - Technique and results of fixation to the sacrum with iliosacral screws.
AB  - This article describes the technique of iliosacral screw fixation, as well as a
      retrospective review of 28 consecutive patients who had spine fusion to the
      sacrum with iliosacral screws, with a minimum follow-up of 2 years. The study
      included 6 male and 22 female patients. Average age at the time of surgery was 43
      years, and mean follow-up time was 3.5 years. There were no neurologic
      complications at final follow-up evaluation. Ninety-five percent of the patients
      had radiographic evidence of fusion. Three patients required iliosacral screw
      removal because of suboptimal intraoperative Kirschner-wire placement. Optimal
      intraoperative radiographic evaluation for accurate iliosacral screw placement is
      recommended. The use of iliosacral screws is also a useful addition to the
      armamentarium of the spine surgeon when fixation to the sacrum is required.

PMID- 1631718
TI  - Screw fixation in the human sacrum. An in vitro study of the biomechanics of
      fixation.
AB  - A load-to-failure test was used to study the biomechanical properties of sacral
      screw fixation in human cadaveric specimens. The goals of this study were 1) to
      determine the effects of the two commonly chosen sacral screw orientations of
      fixation characteristics; 2) to determine the effects of selected screw
      instrumentation linkages on the biomechanics of sacral screw fixation; 3) to
      correlate the biomechanical properties with a noninvasive assessment of sacral
      bone density; and 4) to correlate the torque during screw insertion with these
      biomechanical properties. The bone density of each specimen was measured with
      quantitative computed tomography. A screw was inserted from the dorsal surface
      either anteromedially or anterolaterally into the body of S1, and the torque
      needed to insert each screw was measured. The screw head was attached to a
      constrained or semiconstrained loading linkage. Force was applied to the screw in
      an inferior direction until the maximum load was achieved. The maximum load,
      screw translation, rotation at maximum load, and initial compliance of the bone
      screw interface were determined. It was found that the anteromedial screw
      orientation, combined with a rigidly constrained loading linkage, resulted in the
      greatest maximum load to failure, the least screw rotation, and the least initial
      compliance of the four groups studied. The maximum load and the initial stiffness
      of bone-screw fixation increased significantly with bone density. Torque
      measurements correlated significantly with maximum load to failure, initial
      interface stiffness, and bone density. It was therefore concluded that bone
      density and torque measurements can be useful in assessing sacral screw fixation.

PMID- 1631720
TI  - North American Spine Society. 6th annual meeting. Keystone, Colorado, July 31
      August 3, 1991.

PMID- 1631719
TI  - The use of preoperative erythropoietin in scoliosis surgery.

PMID- 1631721
TI  - Spinal surgery of the future.

PMID- 1631722
TI  - Atlantoaxial lateral mass osteoarthritis. A frequently overlooked cause of severe
      occipitocervical pain.
AB  - Localized C1-C2 lateral mass osteoarthritis is a degenerative disorder of the
      upper cervical spine that has a natural history markedly different from that of
      degenerative afflictions of the lower cervical spine. Atlantoaxial lateral mass
      arthritis is a distinct cause of occasionally severe occipitocervical pain in
      elderly persons. In this series, the diagnosis was suggested by the medical
      history of nine elderly patients who presented with severe occipitocervical pain
      (frequently diagnosed as occipital neuralgia). Physical examination demonstrated
      marked restriction of rotation of the cervical spine to the affected side, and
      localized tenderness unilaterally at the occipitocervical junction. The diagnosis
      was confirmed by plain radiographs of the C1-C2 articulation (open-mouth view),
      demonstrating marked, usually unilateral joint-space narrowing, osteophyte
      formation, and subchondral sclerosis. Bone scanning demonstrated focal uptake
      unilaterally at the occipitocervical junction. Additional imaging studies,
      including computed tomography, magnetic resonance imaging, or cervical myelogram,
      were performed to rule out coexisting intraspinal pathology. Conservative
      treatment was usually successful; however, C1-C2 arthrodesis was successful for
      severe occipitocervical pain due to atlantoaxial lateral mass arthritis not
      responsive to conservative treatment.

PMID- 1631723
TI  - Changes in isometric strength and range of motion of the isolated cervical spine
      after eight weeks of clinical rehabilitation.
AB  - There have been no reports in the literature objectively measuring changes in
      strength and range of motion in patients with non-spinal-cord injuries of the
      cervical spine. Ninety patients participated in an 8-week training study.
      Diagnostic groups included patients with the following: degenerative disc (n =
      6), herniated disc (n = 14), and cervical strain (n = 70). Full-range isometric
      strength tests were performed at eight equidistant positions in a device that
      constrained all motion with the exception of cervical flexion and extension. Post
      tests were performed following training. Significant gains were seen in strength
      as well as range of motion. Perceived pain was significantly reduced. This kind
      of testing can potentially provide the clinician with objective findings to
      direct patient management more adequately.

PMID- 1631724
TI  - Wear studies for development of an intervertebral disc prosthesis.
AB  - Two long-term wear behavior studies used in part of the process of selecting the
      best materials for a new all-metal orthopaedic spinal implant are presented. The
      relative and absolute wear volume rates of candidate metals were investigated
      through simulation of two bearing regions of an intervertebral disc prosthesis.
      It was determined gravimetrically that hot isostatically pressed Co-Cr-Mo alloy
      provided the lowest Co-Cr-Mo alloy wear debris generation. It had an average wear
      volume rate of 0.093 mm3/million cycles from a spring-in-pocket simulation and
      0.126 mm3/million cycles from a hinge (pin-in-slot) simulation. The estimated
      total wear volume of a hot isostatically pressed intervertebral disc prosthesis
      with titanium-6%Al-4%V alloy springs was 2.9 mm3/million cycles.

PMID- 1631725
TI  - The natural history of thoracic disc herniation.
AB  - Fifty-five patients with 72 thoracic disc herniations were retrospectively
      reviewed in an effort to ascertain the natural history of this disease. The
      treatment programs given to these patients were evaluated, and 15 (27%) of the 55
      patients eventually required surgery. The majority, however, did not require
      surgery and have continued to perform activities of daily living, some even
      participating in vigorous sports activities (eg, skiing) without any apparent
      neurologic consequences. Thoracic disc herniations, similar to cervical and
      lumbar disc herniations, do not always lead to major neurologic compromise. A
      less aggressive surgical approach therefore can be considered.

PMID- 1631726
TI  - [National seroepidemiologic survey, Mexico].

PMID- 1631727
TI  - [Methodology of the National Seroepidemiologic Survey, Mexico].
AB  - This paper briefly describes the methodology employed in the National
      Seroepidemiologic Survey (NSS). Among the aspects discussed are: previous studies
      of this kind; the master sampling frame; the sample design, the study population
      and sample size; the selection of diseases for study; the variables; instruments
      for data collection; operational design for the survey; as well as data
      processing and analysis. The overall response rate of the NSS was 78.4 per cent
      of the surveyed homes, 40 per cent of which were from rural areas (communities of
      less than 2,500 persons). The non-response rate was 41.3 per cent with the
      highest level in Baja California Sur (RNR = 26%) and the lowest in Puebla (RNR =
      50.9%). The poor response in Puebla may have been due to the fact that it was the
      first state surveyed and served as the pilot project. The variable estimates from
      the NSS were similar to those found in other national surveys and the General
      Population Census. Therefore, these is reason to believe that the results of the
      NSS were representative and comparable. The final part of the paper describes the
      NSS projects already published, national seroprevalences, considerations
      concerning inference, and the laboratory procedures utilized in each project.

PMID- 1631728
TI  - [The National Serum Bank].
AB  - A National Serum Bank was established to store sera obtained during the National
      Seroepidemiological Survey performed in Mexico in 1987. More than 70,000 serum
      samples were obtained from subjects of either sex 1-99 years of age in each of
      the 32 states of the country. The current collection of sera includes 28,704 male
      samples and 40,629 female samples. This paper describes the procedures for
      handling serum samples, including reception registry, storage and distribution to
      several laboratories for detection of measles, rubella, poliomyelitis, AIDS,
      diphtheria, pertussis, tetanus, brucella, salmonella, amoeba, toxoplasma,
      American trypanosomiasis and cysticercus. Determinations of total cholesterol
      were also made in order to describe its distribution and to identify the
      prevalence of hypercholesterolemia.

PMID- 1631729
TI  - [Seroepidemiology of measles in Mexico].
AB  - Measles is an illness of universal distribution and great social impact.
      According to the WHO, the annual deaths due to this disease amount to more than a
      million children in the world. The objectives of this paper are to estimate the
      seroprevalence of titer of antibodies to measles in the population of 12 to 59
      months of age in Mexico and identify the determinants of the immunity state. From
      the National Seroepidemiology Survey, 5,232 blood samples of children between 12
      and 59 months of age, were analyzed, their blood samples were considered positive
      when the antibody titers were greater or equal to 1:4, tested by hemagglutination
      inhibition using sensitized erythrocytes. The National seroprevalence was 76.2
      per cent. By age group, an increment in positive level was observed age
      increased. The seroprevalence was 56 per cent in children of 12 to 24 month and
      82 per cent for children 48 to 59 month of age. The history of vaccination was
      obtained verbally; 62.5 per cent of seropositive didn't have vaccination history
      and 82.5 per cent were of those vaccinated were positive. By place of residence,
      at rural level (populations less than 2,500 inhabitants) 74 per cent positives,
      compared to 79 per cent in children of urban areas. All risk factor were
      significant, based on a univariate analysis, being the one with greatest risk
      those with negative vaccine history and children of one year of age. The
      efficiency of the vaccine estimation was of 63.6 per cent. Risk factors related
      to the vinculation of immunity protection to measles or seropositives were age,
      and verbal history of vaccination.

PMID- 1631730
TI  - [Values of serum cholesterol in the Mexican population].
AB  - The National Seroepidemiologic survey was carried out by the General Directorate
      of Epidemiology of the Ministry of Health from March 1987 to May 1988. One of the
      objectives of this survey was to know the mean cholesterol levels in the whole
      country and in each of the different states of the Mexican Republic by sex and in
      the different age groups. Of the 68,257 individuals studied, 39,990 (58.6%) were
      females and 28,267 (41.1%) males. The blood samples were processed at the Lipid
      Laboratory in the Endocrinology Department of the National Institute of
      Cardiology "Ignacio Chavez". The mean serum cholesterol levels were for the
      entire country 184 and 185 mg/dl in adult males and females, respectively, and
      145 in males and 149 mg/dl in females in the age group below 20 years old. The
      northern states and two states in the southeast (Yucatan and Campeche) had the
      highest mean values of the country, and were found to be very similar to those
      observed in the United States population. When the values seen during childhood
      were compared with those attained on adult age, an increment of around 33 percent
      in the mean cholesterol levels was disclosed. This finding was similar in the
      different regions of Mexico as well as in the USA population. Also, the states
      with the highest mean cholesterol values in the young population had the highest
      values during adulthood (R2 = 0.90 and 0.91, for males and females). This
      information can be of great value for developing public health strategies to
      diminish the incidence of coronary heart disease.

PMID- 1631731
TI  - [Seroepidemiology of whooping cough in Mexico].
AB  - This paper presents the results from a serological survey developed in Mexico
      during 1987 in order to estimate the prevalence of anti Bordetella pertussis
      antibodies. Agglutinins were measured in 25,666 samples taken from children one
      to 15 years old living throughout the country. In each case survey covered some
      data about social and demographic variables such as socioeconomic stratum, number
      of DPT vaccine doses received and urban or rural settlement, among others. Titers
      greater than = 1.16 and 1.32 were considered positive; analysis is based on
      percent prevalence and geometric means of the antibody titers. We found a 65 per
      cent of total seropositivity, with higher prevalences in the northern and central
      states. Agglutinins response was higher among females subjects than in males.
      Children living in rural areas and those classified as belonging to lower
      socioeconomic level showed the lowest seropositivity prevalences.

PMID- 1631732
TI  - [Seroepidemiology of Chagas disease in Mexico].
AB  - The lack of information about Chagas disease in Mexico, as well as the
      controversy concerning its importance, was the basis for the seroprevalence study
      of Trypanosoma cruzi in the National Seroepidemiology Survey (NSS). This
      information was representative of the national situation with regard to disease
      prevalences and other factors related to the nation's health. Unfortunately the
      NSS was not a very good information source for the study of trypanosomiasis
      americana, because its coverage in the disperse rural areas was poor.
      Nevertheless, the results of the NSS indicated that Chagas disease has an
      irregular distribution in Mexico with seroprevalences of 1.6, 0.5 and 0.2 for the
      different dilution levels used in the evaluation. The survey data showed Chagas
      disease to be less important than that mentioned by other authors. The NSS data
      confirmed the areas of disease transmission already reported and identified some
      new ones in Hidalgo, Chiapas and Veracruz. The survey also detected migratory
      workers with Chagas antibodies in Baja California border cities, a situation
      which indicates a risk for blood transfusion in areas of the country presumed to
      be free of the disease. Three quarters (74.5%) of the seropositive population
      were less than 39 years old. Moreover, the fact that children of less than four
      years were infected suggests that natural transmission is still very important in
      some areas. Although the seroprevalences were greater in the lower socio-economic
      groups, some persons of the higher socio-economic level were also affected. This
      situation may be explained by the fact that many of these persons own vacation
      homes in tropical areas.

PMID- 1631733
TI  - [Seroepidemiology of cysticercosis in Mexico].
AB  - The seroprevalence of cysticercosis indicate that there is a high risk of contact
      with Taenia solium in Mexico, including both genders and all regions,
      socioeconomic group, and ages. There are some statistically significant
      differences in risk of contact, affecting principally the center and southeast of
      the country, rural areas, handicapped persons, children, old people and women.
      However, these differences are small. This study emphasizes the fact that the
      risks of infection by Taenia solium are important in all groups, and therefore,
      the programs for the control of this disease should be focused at the entire
      population and emphasize strategies for social development.

PMID- 1631734
TI  - [Determining factors of rubella in the 10 to 14 year-old population in Mexico].
AB  - The clinical and epidemiological importance of rubella relates to its teratogenic
      effects. When this disease occurs in children, adolescents and adults, it is
      usually benign. On the other hand, these age groups are source of disease
      transmission to pregnant women. The serology studies on rubella carried in Mexico
      prior to 1974, detected seropositivity levels from 87.1 to 97.7 percent in
      children younger than 14 years of age. In contrast, the National Seroepidemiology
      Survey (NSS) (1988) reported a much lower seropositivity (69.3%) in children of
      the same age group, and a rate of 80 percent in women of reproductive age. This
      situation is a particular problem for Mexico where a high proportion of the
      pregnancies occur during adolescence. While previous research has commented on
      descriptive measures of seroprevalences in women, this study, which is based on a
      logistic regression model, has the purpose of identifying the factors associated
      with the immunological status of girls between 10 and 14 years of age. The
      variable which showed the most evident relation to the antibody levels for
      rubella was years of schooling. The odds ratios (OR) for seropositivity among
      those who finished secondary schooling was 2.05 times (CI 1.28-2.56) that of the
      illiterate group. Other statistically significant variables were related to
      residence, urban vs rural (OR = 1.69; CI 1.48-2.12) and age, 10 vs 14 years (OR =
      1.93; CL 1.69-2.42). Based on the multivariate model, it was observed that the
      girls with a greater risk of seropositivity were those who live in urban areas,
      attend secondary school, and are 14 years of age, with an OR = 4.05 (G = 6,756.4
      and 5,580 gl; p less than .001). The study concludes with the following
      considerations: the immunological levels of girls from 10 to 14 years of age are
      low, and the results of the NSS suggest that Mexican public health authorities
      should evaluate the policy of vaccination against rubeola in the population
      potentially at risk, and that the factors associated with the disease, in
      descending order, are: years of schooling, age, and place of residence. It is
      also necessary to carry out analytic studies which will identify the risks and
      the etiology of congenital malformations which are likely to have been associated
      with the occurrence of rubeola virus during pregnancy.

PMID- 1631735
TI  - [Seroepidemiology of toxoplasmosis in Mexico].
AB  - This article presents to the results of the National Seroepidemiology Survey with
      regard to the prevalence of toxoplasmosis in Mexico. Some theoretical aspects of
      the disease are discussed, and the prevalences found in earlier reports are
      presented. The study measured 29,279 blood samples from persons in all 32 states
      of Mexico, for both sexes, all ages, and socio-economic groups. The samples were
      processed by indirect immunofluorescence for antibody titers of 1:16 and 1:128.
      Positivity levels were stratified by age, sex, socioeconomic level, place of
      residence, education level, number of persons in the family, state, and with or
      without rights to care in the social security medical institutions. The results
      pointed to greater prevalences in the costal areas, in lower socioeconomic
      levels, and a high incidence in women of reproductive age. Also included are a
      discussion of socio-economic aspects and the potential role of the domestic cat.

PMID- 1631736
TI  - [Seroepidemiology of brucellosis in Mexico].
AB  - Brucellosis is an important and widely distributed zoonosis in Mexican cattle
      which also affects an unknown proportion of the human population. This report
      presents the brucellosis antibody levels registered in the National
      Seroepidemiology Survey (NAS) in sera obtained from 66,982 healthy persons from
      one to 98 years of age and determined by the test of plaque microagglutination.
      Seroprevalences by states ranged from 0.24 per cent in Morelos to 13.5 per cent
      in the state of Mexico. The national mean was estimated to be 3.42 per cent. The
      analysis showed no statistical differences for brucellosis antibody levels by
      urban and rural residence and by density of family sleeping areas (three or more
      persons vs. one or two persons per bedroom). Adults between 20 and 39 years of
      age had greater seropositivity and children from one to nine years had the least.
      Women were most affected and had 48 per cent more seropositivity than men.
      According to the information obtained in the study, brucellosis in Mexico has the
      following characteristics: it is related to gender but not to occupation; affects
      persons in all age groups, social strata and is independent of size of the
      community of residence. Historically, brucellosis has been an endemic disease in
      Mexico. Recently an increasing incidence has been reported, and this is possibly
      due to a better national notification system.

PMID- 1631737
TI  - [Antibodies against Entamoeba histolytica in the Mexican Republic. 1974].

PMID- 1631738
TI  - [Endoscopic bipolar coagulation of acute gastroduodenal hemorrhage].
AB  - The authors describe one possible way of endoscopic haemostasis, i.e. by bipolar
      coagulation. First they give an account of the principle of the method and
      technique of coagulation. Then they demonstrate on their own group of patients
      with haemorrhage into the gastroduodenum a 71% effectiveness of haemostasis by
      this method. In another 10% a temporary effect was achieved with the possibility
      of effective supplementation of the blood volume and thus an improved prognosis
      of surgery. In case of failure, in particular haemorrhage according to Forest Ia,
      they warn against any delay of surgery.

PMID- 1631739
TI  - [Salmonellosis and shigellosis in the differential diagnosis of acute abdomen].
AB  - There are only very few reports in our literature on problems and pitfalls of the
      differential diagnosis and present incidence of acute abdominal salmonellosis and
      shigellosis. Based on evaluated results of a three-year investigation from their
      department the authors draw attention to the relatively frequent concurrent
      incidence of acute abdomen and infectious diarrhoeal disease, the difficulty of
      differential diagnosis and indication of surgery even when the results of
      cultivation examinations are known due to the common interlinked symptomatology
      and coincidence. The symptoms imitating acute abdomen in infectious diarrhoeal
      diseases predispose by concentration of infectious patients in surgical
      departments the development of nosocomial infections and epidemics.

PMID- 1631740
TI  - [Hemorrhage in severe distortion of the ankle joint].
AB  - The author describes a case of severe distorsion of the talus associated with
      rupture of the lig. fibulotalare anterius with complicating haemorrhage from the
      injured art. malleolaris anterior lateralis. This injury was referred to their
      department only two weeks after the injury. The author describes the therapeutic
      procedure and resulting therapeutic effect.

PMID- 1631741
TI  - [Surgical treatment of anal fissures].

PMID- 1631742
TI  - [Primary resection of the large intestine].
AB  - The authors evaluate their own group of 49 patients subjected in 1982-1990 to
      primary resection of the large intestine with an immediately established
      anastomosis. 32 patients (65.31) recovered per primam and were discharged on
      average after 14.9 days. A disorder of the anastomosis was recorded in 5
      patients, i.e. on 10.2%. In the conclusion the authors express conditions
      essential for the safety of these operations.

PMID- 1631743
TI  - [Classification of acute pancreatitis in correlation with serum protease levels].
AB  - Based on previous work of their own and data in the literature the authors
      outlined diagnostic and classification criteria of acute pancreatitis. The latter
      were applied in a prospective study. Thus a group of 71 patients with acute
      pancreatitis was obtained. In 10 patients of this group at the same time
      intervals and while the same therapeutic procedures were used, the serum protease
      levels were followed up. The authors assumed that it will be possible to express
      thus objectively the severity of the disease and to diagnose in time necrotizing
      forms of acute pancreatitis. The results re demonstrated the feasibility and
      suitability of this procedure only for assessment of the severity of the disease.

PMID- 1631744
TI  - [Gallbladder carcinoma].
AB  - The authors analyze a group of 34 operated patients with carcinoma of the
      gallbladder operated in 1984-1990. Before operation the diagnosis was established
      only in 6% of the patients. The authors draw attention to certain symptoms which
      could lead to the diagnosis of the disease on the basis of clinical and
      paraclinical examination. Even in recent years the incidence of this disease is
      not declining, difficulties with early diagnosis persist, in the majority the
      finding before operation cannot be resolved and only 1-5% patients survive for 5
      years (due to several incidentally detected cases of carcinomas during operations
      performed on account of concrements). The necessity of early treatment of all
      biliary diseases is still urgent.

PMID- 1631745
TI  - [Personal experience with comprehensive treatment in diabetic gangrene].
AB  - The author presents results of treatment of 262 patients with diabetic gangrene,
      necrosis and phlegmons; he mentions the complex of therapeutic measures incl.
      acral and high amputations, analyzes the causes of difficulties associated with
      therapy of ischaemic and infectious affections of the diabetic foot and
      possibilities how to improve the present unsatisfactory state of the problem.

PMID- 1631746
TI  - [Inflammation of the thyroid gland from the aspect of surgical treatment].
AB  - The authors submit surgeons' and endocrinologists' views on treatment of
      thyroiditis. In the course of a 16-year period an acute spell of thyroiditis was
      treated by surgery only twice, once a case of subacute thyroiditis, and in all
      other 348 instances chronic thyroiditis was involved. In the latter group
      Hashimoto's thyroiditis predominated. Among various controversial reports
      concerning its treatment the authors maintain that surgery is suitable after
      failure of short-term conservative therapy. The extent of the operation usually
      corresponds to total thyroidectomy.

PMID- 1631747
TI  - [Comments on Wang's method of preparation of the recurrent laryngeal nerve in
      total thyroidectomy].
AB  - The authors focus their attention on the problem of preparation of the recurrent
      laryngeal nerve in total thyroidectomy. Similarly as the majority of authors, the
      present authors use as the main guide during preparation of the recurrent nerve
      its relationship to the lower thyroid artery. As an alternative procedure they
      mention Wang's method which they tested in several tens of total thyroidectomies.
      In the submitted paper they discuss the advantages and disadvantages of this
      method.

PMID- 1631748
TI  - [Fibrin glue and wound healing].
AB  - Bioadhesive systems used in medicine must meet certain prerequisites on which
      their application depends. A very important relationship is that of glue and
      tissue, irritability, the influence on regeneration of tissue cells and
      histotoxicity. The authors evaluated in an experimental study the necroptic
      appearance of the peritoneal cavity, the microscopic character of the scar and
      histological appearance of tissue after treatment of an induced hepatic and
      lienal rupture in 28 rabbits and 28 baby pigs, using fibrin tissue glue. The
      typical properties of the adhesive fibrin system ensue from its physiological
      properties. Filling the wound enhances natural biological processes of healing.
      The tissue reaction to the applied tissue fibrin coagulum is favourable. The
      treated parenchymatous organs, liver and spleen, healed by a smooth scar. The
      number of adhesions in the peritoneal cavity in all thus treated experimental
      animals after treatment of the spleen was similar. Fewer adhesions were observed
      when using glue for repairing liver injuries in rabbits. The macroscopic
      appearance of the scar was similar, the scar was less visible in the liver
      parenchyma. The histological appearance was similar. The glue did not damage the
      tissue surrounding the parenchyma and did not act as a foreign body. The assessed
      results confirm the harmlessness of the fibrin glue, tissue tolerance and
      satisfactory healing with out a reaction to alien material. After healing the
      fibrin glue replaced by natural fibrous tissue.

PMID- 1631749
TI  - [The contribution of Academician Jirasek to cardiovascular surgery].

PMID- 1631750
TI  - [Extra-anatomic bypasses in reconstructive vascular surgery in the lower
      extremities].
AB  - Extra-anatomic Bypass was used in 36 patients for limb salvage at the Department
      of Surgery, University Hospital in Pilsen in a period of almost eleven years (1th
      January 1981-1th November 1991) constituting 8.2% of all vascular
      reconstructions. Amputation rate was 22.2% and mortality rate 8.3% (without
      direct connection with reconstruction). Extra-anatomic reconstruction was used in
      such cases only where the anatomic bypass was excluded for general or local
      causes.

PMID- 1631751
TI  - [Reconstruction of the femoro-popliteal and peripheral portion in saphenous
      insufficiency].
AB  - Implantation of a venous bypass is the best method of infraarticular and crural
      reconstructions. In 30%, however, a suitable saphenous vein is not available. If
      on account of severe ischemia revascularization is necessary, an alternative
      method must be selected. From a total number of 326 peripheral reconstructions
      with a distal anastomosis into the distal popliteal artery or crural artery the
      authors had to use instead of a long venous bypass a subsidiary reconstruction in
      145 patients (44.6%). The authors implanted composite venous bypasses in 36
      patients (24%), in 93 patients (64%) they combined a venous bypass with
      desobliteration of the superficial femoral artery and in 16 patients (11%) with
      an artificial prosthesis. For the end-to-end anastomosis of the prosthesis and
      vein the authors suggested a plastic operation by means of a venous patch which
      makes a short anastomosis possible with a smooth transit from a wide prosthesis
      into a narrow vein. The authors assume that in future ever more frequently the
      combination prosthesis and vein in the shape of a jump bypass will be preferred
      to other reconstructive methods, as it is relatively simple and rapid. Their
      hitherto assembled experience with this methods is favourable.

PMID- 1631752
TI  - [Metabolic aspects of hypothermic extracorporeal circulation].
AB  - The submitted paper is devoted to some aspects of metabolic and immunity
      reactions of the organism to extracorporeal circulation. The authors focused
      attention in particular on a correlation of the whole-body oxygen consumption and
      the blood sugar level. Surprising findings comprise the rise of the whole-body
      oxygen consumption which occurs before the tissue temperature rises. As far as
      toxic oxygen radicals are concerned, their release is individual. It is, however,
      important that during the perfusion proper the activation of the immune system is
      suppressed. The course of the extracorporeal circulation was satisfactory from
      the clinical aspect; despite that it cannot be considered physiological, as also
      apparent from some biochemical findings.

PMID- 1631753
TI  - [Angiodysplasia].
AB  - Angiomatous developmental changes are the therapeutic object of attention as
      regards elective interventions in particular in plastic surgery. Their
      complications in some body cavities, in particular haemorrhage or compression of
      organs, are usually dealt with by general surgeons and occasionally by vascular
      surgeons. Diseases of the central nervous system are the domain of neurosurgeons.
      After a general analysis of the problem of angiodysplasia, the author discusses
      three successfully operated patients with angiodysplasia of the stomach, spleen
      and small intestine which were manifested in two instances by severe haemorrhage
      and in one instance by compression of the surrounding tissues.

PMID- 1631754
TI  - [Mesenteric venous thrombosis as an unusual serious surgical complication in
      salmonellosis].
AB  - The authors describe a case of an extensive relapsing mesenterial thrombosis
      associated with an intestinal infection caused by Salmonella enteritidis. The
      disease had a fatal course, despite treatment based on contemporary knowledge.
      The authors discusses the method of treatment, emphasize the necessity of full
      heparinization and second look operation after extensive resection of the gut.
      They draw attention to the fact that a relapse of an apparently trivial
      salmonellosis can influence in a decisive way the results of treatment.

PMID- 1631755
TI  - [Aorto-enteric fistula as a cause of massive gastrointestinal hemorrhage].
AB  - The authors describe a rare complication following femoral reconstruction
      operations, i.e. an aorto-enteral fistula associated with massive
      gastrointestinal haemorrhage. They draw attention to limited diagnostic
      possibilities and sometimes the necessity to perform urgent laparotomy. The
      diagnosis is facilitated by endoscopy, CT, sonography and aortography. Endoscopy
      can determine the site of haemorrhage, not its cause. At present when there is a
      high number of vascular reconstruction operations, this possibility should be
      taken into account. The authors recommend to prevent this complication by
      inserting a transplant from the omentum between the intestinal wall and the
      prosthesis, or possibly to cover the wound by preaortal adipose and lymphatic
      tissue and to stitch the peritoneum to prevent direct contact. To resolve
      complications direct stitch may be used, a patch. More frequently it is, however,
      necessary to exchange the entire prosthesis and sometimes to ensure nurture by an
      extra-anatomical bypass. In urgent situations clamping of the aorta may be of
      temporary assistance.

PMID- 1631756
TI  - [The importance and urgency of pneumothorax].
AB  - In a group of 110 subject with pneumothorax some factors are evaluated which may
      influence its impact and urgency. Attention is devoted to the length of the
      disease before surgical treatment, to the most frequent basic and accessory
      diseases, methods and complications of therapy, its effect and to economic
      aspects. Treatment on account of thoracotomy was indicated in 8.2% subjects. A
      total of six patients died. The authors recorded an increase of artificial
      pneumothorax. They draw attention to the disproportionately severe sequelae which
      may be due to apparently insignificant causes. Cure within one week was achieved
      in two-thirds of the group, the mortality increased steeply with the increasing
      number of relapses of the disease.

PMID- 1631757
TI  - [On the article by Professor Milos Hajek].

PMID- 1631758
TI  - Microvascular anatomy of the hippocampal formation.
AB  - The hippocampal vessels were examined in 25 forebrain hemispheres injected with
      india ink or methylmethacrylate. There were two to seven hippocampal arteries,
      which measured 200-800 microns in diameter. The anterior hippocampal artery
      (AHA), which was present in 88.2% of the hemispheres, most often originated from
      the posterior cerebral and the anterior temporal arteries, that is, within the
      rostral hippocampo-parahippocampal arterial complex. It arose from the anterior
      choroidal artery in 29.4% of the hemispheres. The AHA extended between the uncus
      and the parahippocampal gyrus, and it supplied the head of the hippocampus. The
      middle hippocampal artery was constant. It most often arose from the posterior
      cerebral and the common temporal arteries. The middle hippocampal artery coursed
      just caudal to the uncus, in close relationship with the lateral posterior
      choroidal artery, and it usually supplied the middle part of the hippocampal
      formation. The posterior hippocampal artery, which existed in 94.1% of the
      hemispheres, most often arose from the posterior cerebral and the splenial
      arteries. It irrigated the caudal part of the hippocampal formation. The
      anastomoses connecting the posterior, middle, and the anterior hippocampal
      arteries were present in 29.4% of the hemispheres. The hippocampal arteries gave
      rise to the straight vessels, which divided into the large and the small
      intrahippocampal arteries. The highest density of the capillary network was noted
      in the pyramidal and molecular layers of the hippocampal formation. The clinical
      significance of the obtained microanatomical findings is discussed.

PMID- 1631759
TI  - Effect of graded hypoxia on cortical and spinal somatosensory evoked potentials.
AB  - Cortical somatosensory evoked potential (CSEP), spinal somatosensory evoked
      potential (SSEP), and electroencephalogram were recorded in rats under
      pentobarbital anesthesia. After baseline recordings in room air (21% O2), animals
      were subjected to a graded hypoxia at 15.75%, 10.5%, and 5.25% oxygen levels for
      10 minutes. Each level of hypoxia was followed by a 15-minute reoxygenation
      period. With a moderate hypoxia (15.75% O2), measured latencies for the CSEP and
      the SSEP were not significantly different compared with baseline (p greater than
      0.05). The CSEP amplitude showed a significant increase (p = 0.02) during
      reoxygenation after the moderate hypoxia. Change in the latency or amplitude of
      SSEP at 15.75% hypoxia or during the reoxygenation period was not significant
      compared with the room air (p greater than 0.05). No change in the
      electroencephalogram was noticed with the moderate hypoxia. At severe hypoxia
      (10.5% O2), 80% of the animals lost CSEP within 2 minutes. The loss of CSEP was
      concomitant with significant attenuation of the electroencephalogram waves. The
      SSEP was resistant to the severe hypoxia and was present in all animals. We
      concluded that hypoxia affects CSEP with the tendency to increase the amplitude
      at moderate hypoxia (15.75%) and loss of the latency and amplitude with severe
      (10.5%) and extreme (5.25%) hypoxia.

PMID- 1631760
TI  - Cranioplasty using gentamicin-loaded acrylic cement: a test of neurotoxicity.
AB  - Cranioplasty represents a formidable challenge for neuro-surgeons, with a
      significant morbidity from both early and late wound infections.
      Polymethylmethacrylate (PMMA) is one of the most widely used materials in this
      setting. Despite the advantages of this material, such as ease of handling and
      inert biochemical properties, it is still a foreign body that is prone to
      infection. We present an animal model using a gentamicin-impregnated PMMA patch
      to assess the neurotoxicity as well as the efficacy of using this as an
      alternative material to lessen the infectious morbidity in this clinical setting.
      In part two of our experiment, we used a PMMA patch of similar weight and surface
      area in a physiological saline solution to determine the rate of gentamicin
      elution from the patch. The results obtained appear promising with no evidence of
      neurotoxicity and warrant further study to assess the clinical efficacy of PMMA
      in this setting.

PMID- 1631761
TI  - Adenocarcinoma metastatic to a growth-hormone-secreting pituitary adenoma: case
      report.
AB  - Although the pituitary gland is known to harbor metastatic deposits, it is a rare
      occurrence for a metastatic deposit to appear in a pituitary adenoma. A case is
      presented of an adenocarcinoma metastatic in an acromegalic patient with a
      pituitary adenoma. This report adds to the literature of the unusual phenomenon
      of neoplasm-to-neoplasm metastasis.

PMID- 1631762
TI  - Enterogenous cyst at the cerebellopontine angle: case report.
AB  - A case of enterogenous cyst at the cerebellopontine (CP) angle is reported. A
      review of the literature yielded only seven cases of intracranial enterogenous
      cysts, and our case is the first one arising at the CP angle. The histological
      features, pathogenesis, and radiological and auditory brain stem response
      findings are discussed.

PMID- 1631763
TI  - Magnetic resonance imaging of a malignant transformation of an intracranial
      cellular blue nevus. A case report.
AB  - As a follow-up to a case previously reported, a rare case of malignant
      transformation of cellular blue nevus (CBN) in the central nervous system
      preoperatively diagnosed by magnetic resonance imaging (MRI) is reported. On MRI,
      the malignant portion of the nevus was slightly hyperintense on both T1- and T2
      weighted images. In contrast, the benign portion with a great deal of melanin was
      hyperintense on T1-weighted image and hypointense on T2-weighted image. MRI was
      useful and indispensable for detecting the malignant transformation of CBN.

PMID- 1631764
TI  - Cerebral metastasis of malignant cardiac myxoma.
AB  - A rare case of bona fide cerebral metastasis of malignant cardiac myxoma is
      presented. The parenchymal brain tumor of a 32-year-old woman with a history of
      surgical operations on cardiac myxoma and jejunal leiomyosarcoma was surgically
      extirpated. The initial pathological diagnosis was metastatic sarcoma. Ten months
      later, an occlusion of bilateral carotid arteries occurred that was due to tumor
      emboli. The postmortem examination revealed an unusually rapid recurrence of the
      cardiac tumor containing sarcomatous components that were histologically
      identical to the tumors of the brain and the jejunum and the emboli of the
      cerebral vessels. Hence it was deduced that they all originated in the primary
      malignant cardiac myxoma.

PMID- 1631765
TI  - Cavernous hemangioma over the anterior fontanelle.
AB  - This is a report of an extremely rare case of cavernous hemangioma over the
      anterior fontanelle in a 5-year-old boy. Cavernous hemangioma is most common in
      or beneath the skin of the face, neck, and extremities and sometimes occurs in
      the scalp. Although cavernous hemangioma is often quoted in the literature as a
      differential diagnosis of a mass located at the anterior fontanelle, we could not
      find an illustrative case in published articles. We discuss the characteristics
      and differential diagnosis of cavernous hemangioma over the anterior fontanelle.

PMID- 1631766
TI  - Medulla oblongata germinoma in association with Klinefelter syndrome.
AB  - A rare case of medulla oblongata germinoma in a 19-year-old Japanese man with
      Klinefelter syndrome is presented. Light microscopic examination of the resected
      specimen showed very few lymphocytes, and an immunohistochemical study for
      placental alkaline phosphatase was of great diagnostic value. Up to now there
      have been only five cases of intracranial germ cell tumors in association with
      Klinefelter syndrome. These tumors were situated along in the midline structure.
      It is emphasized that endocrinological factors at the time of embryogenesis as
      well as a genetic malignant potential are important in the pathogenesis of
      extragonadal germ cell tumors associated with Klinefelter syndrome.

PMID- 1631767
TI  - Solitary plasmacytoma of the sphenoid sinus involving the pituitary fossa: a case
      report and review of the literature.
AB  - A rare case of solitary plasmacytoma of the sphenoid sinus involving the
      pituitary fossa is reported. A 50-year-old woman with a history of diplopia and a
      mass in the sphenoid sinus and the sellar region, documented by computed
      tomography, was referred to our department with a presumed diagnosis of
      nonfunctioning pituitary adenoma. The clinical and biochemical characteristics
      were unrevealing, but magnetic resonance imaging examination demonstrated the
      extrapituitary origin of the lesion. The patient was operated on by the
      transsphenoidal approach, and the lesion was histologically diagnosed as a
      plasmacytoma. Review of the literature disclosed 11 previously described cases of
      myelomatous disease presenting clinically as a pituitary adenoma. Our case
      demonstrates that magnetic resonance imaging investigation may help in
      distinguishing the extrapituitary origin of a mass involving the pituitary fossa.

PMID- 1631768
TI  - Dissecting aneurysm of the posterior cerebral artery treated with proximal
      ligation.
AB  - A rare case of a dissecting aneurysm of the P3 segment of the right posterior
      cerebral artery is presented that seems to have occurred in association with mild
      head injury. The patient was treated surgically because of repeated intramural
      hemorrhage and enlargement of the aneurysm. Proximal ligation produced thrombosis
      of the aneurysm without resulting in infarction in the region of the posterior
      cerebral artery. The mechanisms of the dissection, diagnosis, and treatment are
      briefly discussed.

PMID- 1631769
TI  - Solitary osteochondroma presenting as a neck mass with spinal cord compression
      syndrome.
AB  - Osteochondromas are a rare cause of spinal pathology and neurological
      dysfunction. A case of cervical osteochondroma with spinal cord compression is
      reported and the pathological, clinical, and radiological features are discussed
      with a brief review of the literature.

PMID- 1631770
TI  - Aneurysm of the fenestrated basilar artery: report of two cases.
AB  - This report describes two patients with fenestrated basilar artery aneurysms, and
      one of the patients underwent a postmortem examination. In our cases, the
      aneurysms arose at the proximal end of the fenestration, which involved the
      proximal third of the basilar artery. Subtraction angiography and oblique
      projections were essential in diagnosing the aneurysms. Complete neck clipping
      was successfully performed through a lateral suboccipital approach in the two
      cases. Technical aspects of neck clipping of the aneurysm of this unique location
      are discussed. Pathogenesis of these rare aneurysms is also discussed with
      clinical and histopathological data.

PMID- 1631771
TI  - Malignant rhabdoid tumor of the central nervous system with subarachnoid
      dissemination.
AB  - A case of primary central nervous system malignant rhabdoid tumor is presented.
      Clinical, radiological, and histopathological findings are described in detail.
      Because of a relatively long clinical course after presentation, it was possible
      to assess the clinical and radiological response to different treatment
      modalities: surgery, chemotherapy, and radiotherapy. Despite the complete
      clinical and radiological response that was achieved after subtotal excision, two
      cycles of chemotherapy, and high-dose radiotherapy, the tumor recurred within 4
      months of completion of the treatment, with wide subarachnoid dissemination.
      Radiotherapy treatment of whole cranial axis is recommended.

PMID- 1631773
TI  - New drugs of 1990.

PMID- 1631772
TI  - Secretory meningioma with elevated serum carcinoembryonic antigen level.
AB  - We recently encountered a 68-year-old woman with right sphenoid wing meningioma
      of the secretory type accompanied by an elevated serum carcinoembryonic antigen
      level. This case was neuroradiologically characterized by marked brain edema.
      Histologically, the lesion was rated as having meningothelial components and was
      rich in blood vessels and pseudopsammoma bodies. Carcinoembryonic antigen,
      epithelial membrane antigen, keratin, and cytokeratin were immunohistochemically
      detected in the pseudopsammoma bodies and the cells producing these bodies.

PMID- 1631774
TI  - Mandibular restoration in the cancer patient: microvascular surgery and implant
      prostheses.
AB  - This article deals with state of the art reconstruction and rehabilitation of the
      head and neck cancer patient who requires mandibular resection. The mandible can
      be reconstructed by microvascular free tissue transfer of bone and soft tissue
      from distant body sites. The dental units and missing soft tissue contours can be
      supported by osseointegrated implants placed in the grafted bone. This article
      discusses the rationale for patient selection and sequencing of this complex and
      rewarding rehabilitation.

PMID- 1631775
TI  - Texas children biting off more than they can chew.

PMID- 1631776
TI  - Multidisciplinary teamwork in the treatment and rehabilitation of the head and
      neck cancer patient.
AB  - The advantages of multidisciplinary treatment planning of head and neck cancer
      patients is described. Planning rehabilitation concurrently with curing the
      malignancy results in the most effective application of treatment modalities
      coordinated with rehabilitative care. Concentrated multidisciplinary treatment
      reduces post treatment morbidity by shortening recovery and rehabilitation time.

PMID- 1631777
TI  - Benign cystic ovarian teratomas with prostatic tissue: a report of two cases.
AB  - We report two cases of the rare occurrence of prostatic epithelium in ovarian
      teratomas with associated transitional epithelium in one of the cases. This
      association of prostatic tissue with urothelium tends to reinforce the well
      established embryogenetic derivation of the prostate from the urogenital sinus.
      Local hormonal events may influence the formation of prostatic tissue from female
      urothelium. The histologic and immunohistological differences between adult
      prostate as seen in our cases and female paraurethral (Skene's) glands are
      discussed.

PMID- 1631778
TI  - Correlations of developmental end points observed after 2,4,5
      trichlorophenoxyacetic acid exposure in mice.
AB  - A large-scale developmental toxicology study of 2,4,5-trichlorophenoxyacetic acid
      was conducted in four inbred strains and one outbred strain of mice. The most
      significant developmental effects observed were reduced fetal weight and
      increased incidences of cleft palate (malformation) and prenatal death
      (deaths/resorptions). The correlation coefficients among the proportion of
      deaths/resorptions, proportion of malformations, average fetal weights, and
      number of viable fetuses were investigated, with each variable measured on a per
      litter basis. Generally, the correlation coefficients between average fetal
      weight and number of viable fetuses were negative for the control and low-dose
      groups in the C57BL/6, C3H/He, and BALB/c strains. Overall, the correlation
      coefficients between proportion of malformations and number of viable fetuses
      were not significant. The correlation coefficients between proportion of
      malformations and average fetal weight were negative for all but one case. The
      correlations were weak in the control and low-dose groups, in which the
      malformation rates were very low, and were strong in the high-dose groups. The
      correlation coefficients between proportion of deaths/resorptions and proportion
      of malformations were generally positive at the high doses; some negative
      correlations were observed in control and low-dose groups. The correlation
      coefficients between proportion of deaths/resorptions and average fetal weight
      were negative for the A/JAX and CD-1 strains. In summary, the strongest
      relationship observed was the negative correlation between fetal weight and
      malformation.

PMID- 1631779
TI  - Identical phalangeal defects induced by phenytoin and nifedipine suggest fetal
      hypoxia and vascular disruption behind phenytoin teratogenicity.
AB  - In previous experimental studies in rabbits, we have shown that vasodilating
      drugs (including nifedipine) cause distal digital defects. These defects were
      preceded by edema, hemorrhage, and finally necrosis of the developed cartilage in
      the phalanges. The underlying mechanism is most likely a fetal hypoxic response,
      secondary to maternal hypotension and decreased uteroplacental blood flow. Since
      phenytoin is known to cause distal digital defects both in man and rabbits, we
      decided to compare the defects provoked by oral administration of phenytoin (100
      mg/kg) versus nifedipine (8.3 mg/kg) to New Zealand White rabbits on days 6-18 of
      gestation. In order to investigate phase-specificity, phenytoin (150 mg/kg) was
      given on days 14-17. The result of single dose administration on day 16 of
      phenytoin (300 mg/kg) versus nifedipine (33.2 mg/kg) was also studied. In this
      latter experiment maternal heart rate was measured up to 21 hours after phenytoin
      administration. Phenytoin induced digital defects identical with those produced
      by nifedipine and caused marked maternal cardiodepression. The defects consisted
      of a reduction, absence, or abnormal structure of the distal phalanges. The
      distal phalanx of the fourth digit on the hindpaw was the first to be affected,
      with inclusion of other phalanges, both on the hind- and forepaws, with
      increasing dose. The sensitive period for induction and histological appearance
      of these defects was identical for phenytoin and nifedipine. These results
      suggest that vascular disruption due to a fetal hypoxic response lies behind
      phenytoin teratogenicity, as has been shown for vasodilators. A cardiodepressive
      action on the maternal and fetal hearts, possibly in combination with decreased
      uteroplacental blood flow, is discussed as a probable factor behind phenytoin
      teratogenicity.

PMID- 1631780
TI  - Microinjections of cultured rat conceptuses: studies with 4-oxo-all-trans
      retinoic acid, 4-oxo-13-cis-retinoic acid and all-trans-retinoyl-beta
      glucuronide.
AB  - 4-Oxo-all-trans-retinoic acid, 4-oxo-13-cis-retinoic acid and all-trans-retinoyl
      beta-glucuronide were intraamniotically microinjected in rat embryos on day 10 of
      gestation and cultured until day 11.5. A comparison of the concentration-effect
      relationships showed that the dysmorphogenic effects produced by these
      metabolites were qualitatively similar to those of parent all-trans-retinoic
      acid. Compared with all-trans-retinoic acid (300 ng/ml), the dysmorphogenic
      effects were elicited by a 2-fold higher concentration of 4-oxo-all-trans
      retinoic acid, an approximately 10-fold higher concentration of 4-oxo-13-cis
      retinoic acid and a 16-fold higher concentration of all-trans-retinoyl-beta
      glucuronide. A surplus of uridine 5'-diphospho-glucuronic acid, microinjected
      together with 300 ng/ml all-trans-retinoic acid, decreased the observed embryo
      toxicity of all-trans-retinoic acid, suggesting the possibility of
      glucuronidation in tissues of the conceptus per se. The results of the study
      provide further support for the hypothesis that 4-oxo-all-trans-retinoic acid and
      all-trans-retinoic acid are, in contrast to the corresponding cis-isomers and
      glucuronides, ultimate dysmorphogenic retinoids.

PMID- 1631781
TI  - Methotrexate-induced developmental toxicity in rabbits is ameliorated by 1-(p
      tosyl)-3,4,4-trimethylimidazolidine, a functional analog for tetrahydrofolate
      mediated one-carbon transfer.
AB  - Dihydrofolate reductase reduces folic acid to tetrahydrofolate as a prerequisite
      to one-carbon metabolism, which is required for normal embryonic de novo DNA
      synthesis. The developmental toxicity of methotrexate (MTX) has been attributed
      to MTX's ability to inhibit the activity of dihydrofolate reductase and thereby
      indirectly suppress one-carbon metabolism. The compound 1-(p-tosyl)-3,4,4
      trimethylimidazolidine (TTI), which is structurally unrelated to folate,
      reestablishes one-carbon metabolism by the biomimetic transfer of single carbon
      units. Whether the developmental toxicity of MTX is indeed caused via suppressed
      one-carbon metabolism was tested in New Zealand white rabbits following
      concurrent maternal treatment with MTX and TTI. TTI reduced MTX developmental
      toxicity judged by increased mean fetal body weights, decreased percentage of
      malformed fetuses, and reduced incidences of major malformations. Two doses of
      TTI (90 mg/kg, each) at 1 hr prior to and 1 hr after MTX also reduced the
      developmental toxicity, but was no more effective than the single-injection
      regimen. Treatment with TTI alone caused no developmental toxicity.
      Histologically, MTX caused enlarged intercellular spaces in limb bud mesenchyme
      that began at 6-8 hr and increased in size until 16 hr. Mesenchymal nuclei
      appeared basophilic, with angular contours. Pretreatment with TTI delayed MTX
      induced histological changes until 20-24 hr after MTX in 36-50% of embryos and
      completely protected the remainder. The sequence of MTX-induced changes was not
      altered among affected embryos, although the severity of the lesions did not
      appear as great. Saline-only or TTI-only treatments caused no alterations in limb
      buds. These data are consistent with the concept that impaired one-carbon
      metabolism is indeed the fundamental process underlying MTX developmental
      toxicity.

PMID- 1631782
TI  - In vitro development of rat embryos undergoing organogenesis in heparin-plasma.
AB  - This study examines the use of heparin-plasma as a culture medium for mammalian
      postimplantation whole-embryo culture. The growth and differentiation of head
      fold rat embryo explants over 48 hours in a standard serum medium was compared
      with development of same stage explants over 48 hours in a plasma medium prepared
      using sodium heparin. Heparin disrupted the morphological differentiation of
      embryos, in a concentration-dependent manner, from 25 micrograms sodium
      heparin/ml media (i.e., 5 IU/ml media), with overall embryo growth being
      adversely affected from a concentration of 200 micrograms sodium heparin/ml media
      (i.e., 40 IU/ml media). Defects of cranial neural tube development were the first
      apparent structural anomalies resulting from culture in heparin media. Forebrain
      development was grossly abnormal and associated with failure of eye development.
      As the heparin concentration in media increased, the cephalic neural folds
      remained widely open and the edges became increasingly everted, although
      differentiation of the heart, otic primordia, and pharyngeal arch persisted.
      Similar concentration-dependent dysmorphogenic effects were seen when embryos
      were cultured in the standard serum media with added heparin. A minimum heparin
      concentration of 100 micrograms sodium heparin/ml media (i.e., 20 IU/ml media)
      was required to effectively inhibit coagulation of the plasma medium over the 48
      hour culture period. Although embryonic growth was not adversely affected at this
      heparin concentration, morphological differentiation was severely disrupted.
      Therefore, heparin is not a suitable anticoagulant for the preparation of plasma
      for use in postimplantation whole-embryo culture.

PMID- 1631783
TI  - Thyroid hormone differentially regulates cellular development in neonatal rat
      heart and kidney.
AB  - The role of thyroid hormone in the control of cardiac and renal cell development
      was examined in neonatal rats made hyperthyroid by administration of
      triiodothyronine (T3, 0.1 mg/kg s.c. on postnatal days 1-5) or hypothyroid by
      administration of propylthiouracil (PTU, 20 mg/kg s.c. given to dams on
      gestational day 17 through postnatal day 5 and to pups on postnatal days 1-5).
      Indices of total cell number (total DNA per tissue), cell packing density (DNA
      per g tissue), and relative cell size (protein/DNA ratio) were evaluated from
      birth through young adulthood. PTU administration led to primary shortfalls in
      cell number that were of similar magnitude in both tissues, but persisted
      somewhat longer in the kidney than in the heart. Deficits in cell packing density
      and cell size in the hypothyroid animals were secondary to the effect on cell
      number, displaying smaller magnitudes of effect and a lag in appearance and
      disappearance of the deficits compared to that for total DNA; indeed, the phase
      in which tissues were restoring their cell numbers was accompanied by increased
      cell packing density, reflecting a more rapid restitution of cell numbers than
      tissue weight or cell size. In contrast to the relatively similar effects of PTU
      on developing cardiac and renal cells, the effects of T3 were selective for the
      heart. Although T3 caused general growth impairment, it evoked marked cardiac
      overgrowth that was accompanied by a striking increase in cell number and a small
      increase in cell size. The cardiac hyperplasia is unique to the developing
      animal, as post-replicative heart cells in adult animals show only hypertrophy in
      response to thyroid hormone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631784
TI  - Paternal cyclophosphamide treatment causes postimplantation loss via inner cell
      mass-specific cell death.
AB  - Treatment of the father with the anticancer alkylating agent cyclophosphamide has
      negative effects on embryonic development in the rat. Four-week treatment of male
      rats with a low dose of cyclophosphamide causes a dramatic, dose-dependent
      increase in postimplantation death of the progeny. Several recent studies have
      indicated that the paternal genome is required for the development of the
      extraembryonic tissues. Thus, the purpose of this study was to determine which
      tissues of the implanting embryo were affected by paternal exposure to
      cyclophosphamide. Male Sprague-Dawley rats were given cyclophosphamide (6
      mg/kg/day) or saline by gavage and bred to untreated female rats after 4 weeks of
      treatment. Pregnant female rats were killed on day 7 of gestation, and
      implantation sites were dissected from the uterus, fixed, embedded in Epon for
      semithin serial sectioning, and stained for subsequent light microscopy.
      Strikingly, many of the implantation sites of affected embryos sired by treated
      males displayed an apparently normal trophectoderm enclosing a region of dying
      cells, containing dark-stained pyknotic nuclei. Very few or no inner cell mass
      derived embryonic cells were present in these implantation sites. Therefore,
      there is a selective death of inner cell mass-derived cells in day 7 implantation
      sites obtained from the progeny of cyclophosphamide-treated males. The results of
      this study suggest that treatment of the male with cyclophosphamide can affect
      paternal genes specifically required for development of the inner cell mass cells
      of the embryo, without an apparent effect on those genes required for normal
      trophectoderm.

PMID- 1631785
TI  - von Willebrand disease masquerading as haemophilia A.

PMID- 1631786
TI  - Hypofibrinolysis in patients with a history of idiopathic deep vein thrombosis
      and/or pulmonary embolism.
AB  - An impaired fibrinolytic activity after a venous occlusion test is the most
      common abnormality associated with thomboembolic disease. To better characterize
      the causes of abnormal responses we have measured different fibrinolytic
      parameters, before and after 10 and 20 min of venous occlusion, in 77 patients
      with a history of idiopathic deep vein thrombosis and/or pulmonary embolism and
      in 38 healthy volunteers. The patients had a lower mean fibrinolytic response to
      venous occlusion than the controls and higher antigen levels of tissue-type
      plasminogen activator (t-PA:Ag) and plasminogen activator inhibitor type 1 (PAI
      1:Ag). Before venous occlusion, PAI-1 levels were at a molar excess over those of
      t-PA in all patients and controls. After 20 min of venous occlusion, the release
      of t-PA from the vascular endothelium resulted in a molar excess of t-PA over PAI
      1 in the majority of controls (72%) but only in a minority of patients (39%). To
      identify patients with fibrinolytic abnormalities, reference intervals (RI) for
      fibrinolytic activity, t-PA:Ag and PAI-1:Ag were established in healthy controls.
      None of the patients had low levels of t-PA:Ag, but 17 (22%) had elevated PAI
      1:Ag levels before venous occlusion and 12 (16%) exhibited low fibrinolytic
      activity after 20 min of venous occlusion. Ten of these were among the 17
      subjects with high PAI-1:Ag levels before venous occlusion. Thus, the measurement
      of PAI-1:Ag levels before venous occlusion (i.e. in samples taken without any
      stimulation) is a sensitive (83%) and specific (89%) assay for the detection of
      patients with an impaired fibrinolytic response to venous occlusion.

PMID- 1631787
TI  - D-dimer and thrombin-antithrombin III complexes in patients with clinically
      suspected pulmonary embolism.
AB  - One hundred and fifty-six consecutive patients with clinically suspected
      pulmonary embolism (PE) had blood drawn to measure levels of D-dimer and thrombin
      antithrombin (TAT) complexes and underwent ventilation/perfusion (V/Q) lung
      scanning and bilateral impedance plethysmography (IPG); pulmonary angiography was
      performed in 10 patients. Patients were classified as: PE-positive (positive
      pulmonary angiography or high probability lung scan or non-high probability lung
      scan and abnormal IPG) or, PE-negative (normal lung scan or normal pulmonary
      angiography) or PE-unlikely (non-high probability lung scan and normal serial IPG
      and absence of venous thromboembolism in follow-up). Thirty patients were
      classified as PE-positive, 64 as PE-negative and 62 patients as PE-unlikely. PE
      positive patients were treated with anticoagulants, whereas PE-negative and PE
      unlikely patients were not. PE-unlikely patients were followed for 3 months with
      repeat IPG and clinical evaluation for the occurrence of venous thromboembolism.
      The sensitivities, specificities, positive predictive values and negative
      predictive values of the D-dimer and TAT complex assays were calculated for
      patients classified as PE-positive and PE-negative. In addition, the prevalences
      of normal D-dimer and TAT complex assays were calculated for PE-unlikely
      patients. Cutoffs of 300 ng/ml for D-dimer and 3.5 micrograms/ml for TAT
      complexes provided sensitivities of 96% for both assays, negative predictive
      values of 97% for D-dimer and 96% for TAT complexes and specificities of 52% for
      D-dimer and 51% for TAT complexes. The specificities of the assays were higher in
      patients without comorbid conditions and in outpatients.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1631789
TI  - A collaborative study to establish an international standard for alpha-thrombin.
AB  - Since 1975 an International Standard for Thrombin of low purity has been used.
      While this standard was stable and of value for calibrating thrombins of unknown
      potency the need for a pure alpha-thrombin standard arose both for accurate
      calibration and for precise measurement of thrombin inhibitors, notably hirudin.
      An international collaborative study was undertaken to establish the potency and
      stability of an ampouled pure alpha-thrombin preparation. A potency of 97.5
      international units (95% confidence limits 86.5-98.5) was established for the new
      alpha-thrombin standard (89/588) using a clotting-assay procedure. Stability data
      at various elevated temperatures indicated that the standard could be transported
      and stored with no significant loss of potency. Ampoules of lyophilised alpha
      thrombin (coded 89/588) have been recommended as an International Standard for
      alpha-thrombin with an assigned potency of 100 international units per ampoule by
      the International Society for Thrombosis and Haemostasis (Thrombin and its
      Inhibitors Sub-Committee) in Barcelona, Spain in July 1990 while the Expert
      Committee on Biological Standardisation and Control of the World Health
      Organisation will consider its status at its next meeting in Geneva in 1991.

PMID- 1631788
TI  - Platelet and fibrinogen survival in calves implanted with artificial heart and
      ventricular assist device--correlation with autopsy findings.
AB  - The two main ingredients of blood clots formed on artificial surface are
      platelets and fibrinogen. In this study, we measured platelet and fibrinogen
      survival in calves implanted with total artificial heart (TAH) and left
      ventricular assist device (LVAD), and correlate these data with autopsy findings.
      Platelet survival with autologous 111In-labeled platelets was performed on nine
      calves implanted with TAH and five with LVAD. Fibrinogen survival with 131I
      labeled homologous fibrinogen was performed on six calves with TAH and three with
      LVAD. Platelet survival was significantly shortened in both groups of animals:
      5.89 +/- 0.52 days, control 6.46 +/- 0.31 days, p = 0.0013; fibrinogen survival
      was normal: 8.79 +/- 1.20 days, control 8.64 +/- 1.16 days. At autopsy two calves
      with TAH had multiorgan thromboembolism. Two other animals with TAH and four with
      LVAD had focal renal infarcts. Most animals had minor clot formation within the
      prosthetic device. Major septic complications occurred in four calves with TAH
      and one with LVAD. Continuous platelet activation by artificial surface probably
      explains the shortened platelet survival and thromboembolic complications.

PMID- 1631790
TI  - Bacterial expression of biologically active high molecular weight kininogen light
      chain.
AB  - Human high molecular weight kininogen (HK), a single chain plasma glycoprotein,
      serves as a cofactor in the contact system of blood coagulation. After cleavage
      by human plasma kallikrein, the nonapeptide bradykinin is released. The HK light
      chain (LC) contains coagulant activity, which requires both the ability to bind
      the contact system zymogens, prekallikrein and factor XI, and the ability to
      interact with negatively charged surfaces. Since bacterial expression might not
      be successful if carbohydrate was required for activity, we evaluated that
      possibility by incubating plasma HK with endoglycosydase F. Although the
      procedure removed detectable N-linked carbohydrate, no change in specific
      activity occurred. We then developed a bacterial expression system to produce
      recombinant HK LC. The cDNA coding for the HK LC was prepared by polymerase chain
      reaction (PCR), digested with restriction enzymes EcoRI and PstI, and introduced
      into the bacterial expression vector pKK223-3. E. coli harboring this recombinant
      plasmid (pSK1) expressed HK LC upon induction with isopropylthio-galactoside
      (IPTG). The recombinant protein (27 kDa), when transferred onto a PVDF membrane,
      was recognized by monospecific polyclonal anti-HK LC-antibodies. The recombinant
      HK LC was purified by heparin agarose affinity chromatography to homogeneity and
      found to have a specific activity of 28 coagulant units per mg protein, similar
      to the specific activity of the LC derived by proteolytic digestion of human
      plasma HK. We conclude: 1) The HK LC synthesized in bacteria is biologically
      active, and 2) the 40% carbohydrate content of the HK LC is not required for its
      cofactor activity.

PMID- 1631791
TI  - The effect of suramin on laboratory tests of coagulation.
AB  - The antitrypanosomal drug suramin, which has recently been under investigation as
      a cancer chemotherapeutic agent, has previously been found to induce heparin-like
      anticoagulants in treated patients. In the currently reported work suramin is
      shown to have an additional anticoagulant activity that is due to direct effects
      of the drug on procoagulant proteins. The studies were conducted with pooled
      normal plasma treated in vitro with suramin and with plasma samples obtained from
      patients who had received the drug intravenously for 2 weeks. It is demonstrated
      that in plasma suramin inhibits factors V, VIII, IX, X, XI, and XII, while
      thrombin, prothrombin, and factor VII are unaffected. The inhibition of factor V
      is virtually irreversible, although the effect of suramin on the other factors is
      readily reversed by dilution.

PMID- 1631792
TI  - Analysis of intrinsic fibrinolysis in human plasma induced by dextran sulfate.
AB  - The analysis of normal human plasma by fibrin autography revealed four species of
      plasminogen activator (PA) activity related to tissue-type PA, factor XII,
      prekallikrein and urokinase-type PA (u-PA). The u-PA activity increased
      significantly by incubating plasma with dextran sulfate. This increase was
      coincident with both the cleavage of factor XII and the complex formation of
      activated factor XII with its plasma inhibitors, which were determined by
      immunoblotting procedure. The dextran sulfate-dependent activation of u-PA
      required both factor XII and prekallikrein, but did not require either
      plasminogen or factor XI. High molecular weight kininogen was required only at a
      low concentration of dextran sulfate. Thus the results indicate that the factor
      XII and prekallikrein-mediated activation of single chain u-PA (scu-PA) operates
      as a major pathway of scu-PA activation in whole plasma in contact with dextran
      sulfate.

PMID- 1631794
TI  - Lack of stability of aggregates after thrombin-induced reaggregation of thrombin
      degranulated platelets.
AB  - The stability of platelet aggregates is influenced by the extent of the release
      of granule contents; if release is extensive and aggregation is prolonged,
      deaggregation is difficult to achieve. The relative importance of the
      contributions of released substances to aggregate stability are not known,
      although stable thrombin-induced aggregates form in platelet-rich plasma from
      patients with barely detectable plasma or platelet fibrinogen, and ADP stabilizes
      thrombin-induced aggregates of platelets from patients with delta storage pool
      deficiency which otherwise deaggregate more readily than normal platelets. We
      degranulated platelets with thrombin (0.9 U/ml caused greater than 90% loss of
      delta and alpha granule contents) and recovered them as individual platelets in
      fresh medium. The degranulated platelets were reaggregated by thrombin (2 U/ml).
      To prevent continuing effects of thrombin, FPRCH2Cl was added when thrombin
      induced aggregation of thrombin-degranulated platelets reached its maximum. EDTA
      (5 mM) or EGTA (5 mM) added at maximum aggregation did not deaggregate these
      platelets, indicating that the stability of these aggregates does not depend on
      Ca2+ in the medium. Whereas with control platelets a combination of PGE1 (10
      microM) and chymotrypsin (10 U/ml) was required for deaggregation, with thrombin
      degranulated platelets either PGE1 or chymotrypsin alone caused extensive
      deaggregation. The rate and extent of deaggregation of thrombin-degranulated
      platelets by a combination of PGE1 and chymotrypsin was greater than with control
      platelets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631793
TI  - Biochemical, thrombolytic and pharmacokinetic properties of rt-PA P47G, K49N, a
      substitution variant of human tissue-type plasminogen activator.
AB  - rt-PA P47G, K49N, a substitution variant of recombinant human tissue-type
      plasminogen activator (rt-PA), in which proline at position 47 and lysine at
      position 49 were replaced by glycine and asparagine respectively, was previously
      described by Ahern et al. (J Biol Chem 1990; 265:5540-5) to have an extended in
      vivo half-life with unaltered in vitro fibrinolytic properties. Because this
      variant might possess an increased in vivo thrombolytic potency, we have
      constructed its cDNA, expressed it in Chinese hamster ovary cells and determined
      its biochemical, thrombolytic and pharmacokinetic properties relative to those of
      home-made rt-PA and of alteplase (Actilyse). The specific fibrinolytic activities
      on fibrin plates were 160,000 +/- 17,000, 210,000 +/- 88,000 and 460,000 +/-
      72,000 IU/mg (mean +/- SEM) for rt-PA P47G, K49N, rt-PA and alteplase,
      respectively, while the catalytic efficiencies for plasminogen activation (k2/Km)
      in the absence of fibrin were comparable (1.1 to 1.7 x 10(-3) microM-1s-1).
      Fibrin enhanced the rate of plasminogen activation by rt-PA P47G, K49N 100-fold
      and by both wild-type molecules 390-fold. Binding of the variant rt-PA to fibrin
      was significantly reduced, but its affinity for lysine-Sepharose was unaltered.
      In an in vitro clot lysis system, consisting of a radiolabeled human plasma clot
      submersed in plasma, 50% clot lysis in 2 h required 0.67 +/- 0.14 micrograms/ml
      rt-PA P47G, K49N, 0.36 +/- 0.01 micrograms/ml rt-PA and 0.17 +/- 0.01
      micrograms/ml alteplase, respectively (mean +/- SEM; n = 3 or 4). At these doses
      residual fibrinogen levels at 2 h were in excess of 80%.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1631795
TI  - Inhibition by glaucocalyxin A of aggregation of rabbit platelets induced by ADP,
      arachidonic acid and platelet-activating factor, and inhibition of [3H]-PAF
      binding.
AB  - Glaucocalyxin A is a new diterpenoid isolated from the ethereal extract of the
      leaves of Rabdosia japonica (Burm f) Hara var glaucocalyx (Maxim) Hara (Labiatae)
      collected in the northeastern China. When it was incubated with washed rabbit
      platelets, glaucocalyxin A inhibited ADP- or arachidonic acid-induced platelet
      aggregation with IC50 values of 4.4 mumol/l, 14.1 mumol/l respectively.
      Glaucocalyxin A also inhibited PAF-induced aggregation of rabbit platelets which
      were refractory to ADP and arachidonic acid with an IC50 value of 13.7 mumol/l.
      Analysis of [3H]-PAF binding showed that glaucocalyxin A prevented [3H]-PAF
      binding to intact washed rabbit platelets with an IC50 value of 8.16 mumol/l,
      which was consistent with its inhibition of PAF-induced platelet aggregation.

PMID- 1631796
TI  - Induction of tissue factor synthesis in human umbilical vein endothelial cells
      involves protein kinase C.
AB  - Incubation of human umbilical vein endothelial cells with one of the following
      compounds: endotoxin, recombinant interleukin-1 beta, recombinant tumor necrosis
      factor alpha, allogenic lymphocyte subpopulations or phorbol ester resulted in
      significant induction of tissue factor synthesis. Diacylglycerol had the same
      effect and also enhanced synergistically the induction caused by endotoxin and
      interleukin-1 beta. Two different inhibitors of protein kinase C, H7 and
      sphingosine, inhibited tissue factor synthesis at concentrations which did not
      depress protein synthesis in general, suggesting that protein kinase C is
      involved in the processes leading to tissue factor synthesis. Cells down
      regulated for the tissue factor response to TPA responded essentially normally to
      endotoxin and interleukin-1 with regard to tissue factor synthesis.

PMID- 1631797
TI  - The role of venom haemorrhagin in spontaneous bleeding in Bothrops jararaca
      envenoming. Butantan Institute Antivenom Study Group.
AB  - Thirty-eight patients bitten by Bothrops jararaca were investigated. Twenty-six
      had signs of local or systemic haemorrhage. Twenty-two of these had incoagulable
      blood, and these patients were found to have low fibrinogen levels (mean 0.17 +/-
      0.03 g/l), thrombocytopenia, very high thrombin-antithrombin III complex (850 +/-
      184 micrograms/l) and D-dimer (170 +/- 44 micrograms/ml) antigen levels. Serum
      venom haemorrhagin levels were significantly higher in patients with clinical
      signs of haemorrhage (36.4 +/- 6.4 ng/ml) than those without (11.7 +/- 3.7 ng/ml;
      p less than 0.002). Twelve out of 13 patients with thrombocytopenia were
      bleeding. High levels of thrombomodulin (22.3 +/- 1.5 ng/ml) and haemorrhagin
      (35.7 +/- 7.7 ng/ml) were detected in these 12 patients, suggesting vascular
      endothelial damage. Haemorrhagin levels also correlated inversely with platelet
      count in these patients. It was concluded that thrombocytopenia is one of the
      main causes of bleeding in B. jararaca victims, possibly as a result of venom
      haemorrhagin activity.

PMID- 1631798
TI  - Down-regulation of urokinase secretion from a human lymphoma cell line RC-K8 by
      dexamethasone without inducing plasminogen activator inhibitors.
AB  - The plasminogen activator (PA) activity in various cell lines is suppressed by
      glucocorticoids. These phenomena are attributed to either a suppression of PA
      biosynthesis, to an increase of PA inhibitor or to a combination of both. The
      regulation of urokinase (UK) production in a human pre-B cell lymphoma line, RC
      K8, by dexamethasone (Dex) and phorbol myristate acetate (PMA) was investigated.
      RC-K8 is a cell line which is consistently producing a high molecular weight UK
      in the conditioned medium (Kubonishi, I., et al: Jpn. J. Cancer Res. 76, 12-15,
      1985). The cells were cultured in RPMI-1640 with Dex or PMA for 1-4 days. UK
      activity was measured using a chromogenic substrate S-2444 and the antigen by an
      ELISA kit. PAI-1 and PAI-2 antigens were also measured by ELISA kits and the
      complex between PA and PAI was examined by SDS-PAGE fibrin-zymography. The UK
      secretion in RC-K8 cells was inhibited by cycloheximide and actinomycin D. PMA at
      0.16-1.6 uM up-regulated the UK activity approximately two-fold, parallel with
      the antigen, whereas Dex at 1-10 uM decreased the UK expression approximately
      half. These were verified by SDS-PAGE fibrin-zymography. Neither PAI-1, PAI-2 nor
      PA/PAI complex was detected in the conditioned medium and in the cell lysate.
      These data suggest that PMA up-regulates the UK secretion without inducing PAIs
      and the down-regulation of the UK secretion by Dex results from the inhibition of
      the expression of UK itself but not from the induction of PAIs.

PMID- 1631799
TI  - Functional behaviour of mononuclear blood cells from patients with
      hypercholesterolemia.
AB  - Mononuclear cells were prepared from venous blood obtained from 20 patients with
      a newly diagnosed hypercholesterolemia and without clinical signs of vascular
      disease, and from 19 age and sex matched controls. Adhesiveness to plastic
      surface, phagocytic activity measured as ingestion of zymosan particles, and
      spontaneous motility of mononuclear cells from patients were significantly higher
      by 57%, 19% and 50%, respectively, when compared to controls. In controls
      chemotaxis induced by the chemotactic peptide FMLP was slightly higher than
      spontaneous motility measured in absence of FMLP, whereas in patients FMLP
      significantly inhibited cell motility by about 47%. With the exception of FMLP
      induced chemotaxis the results indicate that mononuclear cells are hyperreactive
      in hypercholesterolemia.

PMID- 1631800
TI  - A new variant of von Willebrand disease (type II I) with a normal degree of
      proteolytic cleavage of von Willebrand factor.
AB  - A variant of type II von Willebrand disease (vWd) is described in a young woman
      and her mother with severe lifelong bleeding histories. On electrophoresis with
      low-resolution agarose gels the plasma of the proband lacked large and
      intermediate-size multimers of von Willebrand factor (vWF) but the platelet
      multimeric structure was normal. On high-resolution gels, smaller multimers could
      be resolved into a broader central band and four satellite bands, which were much
      fainter than in normal plasma. In the proband plasma, the relative concentrations
      of proteolytic fragments of the vWF subunit were within the normal laboratory
      range. Since this variant of vWd appears to differ from those reported hitherto,
      the designation of type II I is proposed.

PMID- 1631801
TI  - Reduction in the ADP release from shear-stressed red blood cells by fish oil
      administration.
AB  - Fish oil concentrate (5.4 g/day) was administered to 8 young male volunteers and
      to 7 middle-aged male volunteers for 1 week. ADP released into the supernatant of
      red blood cell (RBC) suspension by a shear stress of 375/sec for 3 min was
      measured before and after fish oil administration. Before the administration the
      ADP release from shear-stressed RBCs in the middle-aged group was significantly
      higher than in the young group. After the administration the ADP release was
      reduced significantly in the young group (by 46%, p less than 0.001) and
      nonsignificantly in the middle-aged group (by 54%, p = 0.09). If the two groups
      were combined, the reduction was also significant (by 50%, p less than 0.005).
      This reduction was significantly correlated with the improvement of RBC
      filterability after fish oil administration (n = 13, r = 0.62, p less than 0.05).
      We suggest that the reduction of the ADP release from shear-stressed RBCs is one
      of the mechanisms of action of eicosapentaenoic acid against thrombotic disease.

PMID- 1631802
TI  - Thrombin inactivation and the effects of antithrombin and heparin in a
      recirculating Langendorff preparation.
AB  - A recirculating Langendorff preparation was developed in order to study the
      effects of antithrombin III (AT) and heparin on thrombin inactivation in the
      capillary bed. Using this technique, rat hearts were shown to inhibit
      approximately 50% of the recirculated thrombin, while surface-bound thrombin
      displayed no enzymatic activity towards recirculated fibrinogen. By displacing
      thrombin bound to the endothelial surface with Polybrene, thrombin enzymatic
      activity was found to be equally active against a synthetic chromogenic substrate
      (S-2238) and fibrinogen. This indicates that thrombin bound to the capillary
      endothelial surface is not coagulantly active, but, when displaced from the
      endothelium, its coagulant activity is retained. Hearts pretreated with AT or
      heparin had no effect on thrombin inhibition or surface-bound thrombin, although
      there was an uptake of both substances to the heart. These findings are in
      contrast with the results obtained from large vessel preparations, where
      pretreatment with AT increased thrombin inhibition and also demonstrated lower
      levels of surface-bound thrombin, and where heparin eluted endogenous AT from the
      endothelium. It is concluded that AT plays a more important role in the
      inhibition of thrombin on large vessels than in the microcapillary system where
      thrombomodulin is the major inactivator of thrombin.

PMID- 1631803
TI  - von Willebrand factor characterization of a severe dry-heat treated factor VIII
      concentrate, AHF (high purity).
AB  - Eight batches of a severe dry-heat treated (80 degrees C for 72 hours) Factor
      VIII concentrate manufactured by the Commonwealth Serum Laboratories (CSL Ltd.)
      were analysed for the following von Willebrand factor-related (vWf) activities:
      ristocetin cofactor activity (vWf:RCof), collagen binding activity (CBA), vWf
      antigen levels (vWf:Ag), vWf multimeric analysis and 2-stage FVIII clotting
      activity (VIII:C). The average potency per vial of vWf:Ag was 440 +/- 80 units,
      vWf:RCof 500 +/- 60 units, CBA 350 +/- 50 units and VIII:C 242 +/- 36
      International Units. Multimeric analysis indicated the presence of high molecular
      weight multimers and a triplet structure slightly different to normal plasma.
      Viral inactivation studies using a marker virus, Sindbis, demonstrated that the
      terminal severe dry- heating step reduced the viral load in the product by
      greater than 6 log10TCID50/ml. This CSL Ltd. FVIII concentrate may thus provide a
      safer, purer and more convenient source of vWf than cryoprecipitate. Clinical
      studies to establish product efficacy in patients with von Willebrand's disease
      are underway.

PMID- 1631804
TI  - A chromogenic enzymatic assay capable of detecting prourokinase-like material in
      plasma.
AB  - We report a functional assay capable of quantifying prourokinase (ProUK)- like
      material in plasma where urokinase (UK) is also present. The assay involves
      inactivation of urokinase with a specific, active site directed irreversible
      inhibitor, dansyl-glutamyl glycyl arginine chloromethylketone (dansyl- GGACK).
      Excess inhibitor is subsequently quenched with dithiothreitol (DTT). The ProUK
      like material in plasma is then converted to active urokinase with thermolysin, a
      proteolytic enzyme of bacterial origin. Alpha 2-macroglobulin in plasma inhibits
      thermolysin; however alpha 2-macroglobulin is inactivated with methylamine. The
      assay can detect as little as 20 ng of ProUK and is linear from 20 to 120 ng. The
      assay was applied to quantify the amount of ProUK-like material in plasma
      obtained from dog at various times after i.v. administration of 100,000 or 75,000
      U/kg, of pro-urokinase.

PMID- 1631805
TI  - K1K2Pu, a recombinant t-PA/u-PA chimera with increased thrombolytic potency,
      consisting of amino acids 1 to 3 and 87 to 274 of human tissue-type plasminogen
      activator (t-PA) and amino acids 138 to 411 of human single chain urokinase-type
      plasminogen activator (scu-PA). Purification in centigram quantities and
      conditioning for use in man.
AB  - K1K2Pu, a recombinant t-PA/u-PA chimera with increased thrombolytic potency in
      animal models of venous and arterial thrombosis, which consists of amino acids 1
      to 3 and 87 to 274 of human tissue-type plasminogen activator (t-PA) and amino
      acids 138 to 411 of human single chain urokinase-type plasminogen activator (scu
      PA), was produced and conditioned for use in patients. Chinese hamster ovary
      cells were transfected with an expression plasmid containing the K1K2Pu cDNA,
      high producer cell lines were selected and scaled up in 800 cm2 roller bottles,
      and 350 ml conditioned cell culture medium was harvested 3 to 7 times at 2 to 5
      day intervals. Batches of 21 +/- 4 liter (mean +/- SD, n = 28) containing 1.8 +/-
      0.6 mg/l of K1K2Pu related antigen were purified by chromatography on Copper
      chelate-Sepharose and immunoadsorption on an insolubilized murine monoclonal
      antibody (MA-1C8). Yields were 8.6 +/- 3.4 mg K1K2Pu per batch with a specific
      activity of 83,000 +/- 44,000 IU/mg. The final material, obtained at a
      concentration of approximately 0.7 mg/ml, was dialyzed against 0.3 M NaCl, 0.02 M
      Tris-HCl buffer, pH 7.5, containing 0.01% Tween 80 and 10 KIU/ml aprotinin. It
      was homogeneous on SDS-PAGE, contained 6.5 +/- 6.9 percent two chain material and
      the contamination with murine monoclonal antibody was less than 0.1 percent.
      After filtration of pools of 3 to 5 selected batches on 0.22 microns Millipore
      filters the material was sterile and virus free by routine screening; it was
      obtained at a concentration of approximately 0.5 mg/ml with a specific activity
      of 110,000 +/- 16,000 IU/mg (mean +/- SD, n = 3) and an endotoxin content of 0.5
      to 7 units/mg. Bolus injection at a dose of 1 mg/kg in mice did not produce
      weight loss within 8 days. Thus, this material appears to be suitable for the
      investigation on a pilot scale of the pharmacokinetic and thrombolytic properties
      of K1K2Pu in patients with thromboembolic disease.

PMID- 1631806
TI  - Relationship between vitamin K1 2,3-epoxide and vitamin K1 in patients treated
      with N-methyl-thiotetrazole cephalosporins.

PMID- 1631807
TI  - Platelet serotonin content and microcirculation haemostasis in spontaneous
      arterial hypertension in rats.

PMID- 1631809
TI  - [Sudden infant death and sleeping position].

PMID- 1631808
TI  - Coupled D dimer and fibrinogen levels during thrombolytic therapy of venous
      thromboembolism.

PMID- 1631810
TI  - [Medical records--both about patients and for patients].

PMID- 1631811
TI  - [Invasive treatment of coronary diseases].

PMID- 1631812
TI  - [Sleeping position and crib death in Norway].
AB  - Questionnaires to maternity hospitals in Norway in 1989 and 1991 showed that most
      units had changed the babies' sleeping position from the side position in the
      early 1970s, to predominantly prone in 1989, but back to the side position
      between 1989 and 1991. Parallel with these changes the incidence of sudden infant
      death increased steadily from 0.93 per 1,000 live births in the early 1970-74 to
      2.4 per 1,000 in 1989, and dropped dramatically to 1.4 per 1,000 in 1990. It is
      assumed that parents adopt the sleeping position preferred in the maternity ward,
      and the study therefore supports the theory that the prone position significantly
      increases the risk of sudden infant death.

PMID- 1631813
TI  - [Coronary artery stenting. A new therapeutic alternative in Norway].
AB  - In Norway the first percutaneously, transluminally placed human coronary artery
      endoprosthesis (stent) was implanted in the spring of 1991. This article
      summarizes international experience of treatment with the Palmaz-Schatz balloon
      expandable stent for coronary use and describes the first two patients treated
      with such implants at Ulleval hospital.

PMID- 1631814
TI  - [Angina pectoris after coronary angioplasty. Restenosis or partial
      revascularization].
AB  - Percutaneous transluminal coronary angioplasty (PTCA) was performed on 115
      consecutive patients with angina pectoris and the results were evaluated after an
      average of 100 days by means of bicycle exercise test and coronary angiography.
      Complete revascularization was achieved in 75% of the patients. Restenosis
      occurred in 23%. A good symptomatic effect was found in 90% of the patients with
      complete revascularization and in 72% of the patients with partial
      revascularization. Recurrence of angina pectoris 4-8 weeks after PTCA is a
      predictor of restenosis. Absence of angina and a negative bicycle exercise test 3
      4 months after PTCA are strong predictors of the absence of restenosis.

PMID- 1631815
TI  - [Intermittent bradyarrhythmia in infants and small children treated with
      permanent pacemaker].
AB  - Four children aged two, two and four months and five years respectively, with
      intermittent cardiac bradyarrhythmias and otherwise normal hearts are described.
      The diagnoses were based upon findings by telemetry and 24-hour ECG-recordings.
      Two patients had sinus node disease, one patient had intermittent complete
      atrioventricular block, and the fourth had a permanent first degree
      atrioventricular block and intermittent high grade second degree atrioventricular
      block. All patients presented serious symptoms with apparent life-threatening
      events before admission. They were given a permanent cardiac pacemaker. One
      patient experienced recurrent excessive increase in the myocardial stimulation
      threshold, leading to further syncopal episodes. All patients are developing
      adequately with normally functioning pacemakers.

PMID- 1631816
TI  - [Development and use of a database for gastroenterologic endoscopy].
AB  - With no commercially available endoscopy database manager available, a standalone
      system for gastroenterological endoscopy departments has been developed since
      1985 through joint efforts of gastroenterologists and dedicated programmers. The
      present system was implemented for daily use January 1989 and, to date,
      approximately 19,000 examinations have been recorded. Nurses and office
      assistants carry out administrative work, but the physician enters the endoscopic
      data, partly as free text, partly as structured data via automated menus and a
      mouse. In addition to the immediate printout of the result, valuable data are
      stored in the computer for administrative and research purposes. Mean data
      entering time for the physician was four minutes 17 seconds, and altogether eight
      minutes 40 seconds was spent on the computer system for each patient served.

PMID- 1631817
TI  - [Primary HIV-infection. A differential diagnosis of mononucleosis/influenza-like
      symptoms].
AB  - We describe the history of a 29 year-old heterosexual female who presented
      symptoms and signs similar to those indicating infectious mononucleosis and
      influenza. However, the diagnosis turned out to be a primary HIV infection. The
      patient is highly infective at this phase of the HIV disease, and this report
      emphasizes the importance for general practitioners to have this diagnosis in
      mind when treating patients with "sero-negative" mononucleosis or influenza-like
      symptoms. The HIV-infection was suspected earlier but not confirmed until five
      weeks after the first positive screening test was taken. This illustrates the
      importance of repeated HIV testing when primary HIV infection is suspected.

PMID- 1631818
TI  - [Synovial chondromatosis].
AB  - Synovial chondromatosis is a rare monarticular condition in which cartilaginous
      masses are formed by metaplasia of the synovial membrane. These masses may
      calcify and ossify. The disease most commonly affects the knee, and the symptoms
      include pain, swelling, locking and palpable loose bodies. Although the clinical
      features are usually non-specific, the roentgenograms often provide important
      diagnostic information. Synovial chondromatosis is rarely a difficult diagnostic
      problem, but should not be confused with other disorders that give rise to loose
      bodies, such as degenerative joint disease and osteochondritis dissecans. Two
      cases are described and synovial chondromatosis is discussed in some detail,
      including radiological features and treatment.

PMID- 1631819
TI  - [Perinatal listeriosis].
AB  - Human listeriosis is a rare disease. It may be foodborne. Listeric infection
      during pregnancy may give a fatal fetal outcome, caused by transplacental passage
      of organisms from the maternal gastrointestinal tract. We describe a case of
      perinatal listeriosis which resulted in preterm stillbirth. Perinatal listeriosis
      should be considered when flue-like symptoms are presented during pregnancy.
      Early diagnosis and treatment may improve the outcome.

PMID- 1631820
TI  - [Acute pancreatitis after treatment with sulindac].
AB  - Two women, aged 91 and 46 years respectively, developed acute pancreatitis
      following treatment with sulindac (Clinoril) for five weeks in the one case and
      four and a half years in the other. The oldest patient became acutely ill. An
      emergency laparotomy was performed which showed considerable pancreatic edema and
      typical fat necroses. The other case presented a more protracted course and was
      not operated. Restitution was remarkably quick in both patients after cessation
      of the sulindac treatment.

PMID- 1631822
TI  - [Multiple injuries in children].
AB  - Multiple injuries do not occur very often in children, but are important because
      children's general reaction to trauma is different from that of adults. This is
      due to the anatomic and physiological differences between children and adults,
      and because some injuries in children differ considerably from similar injuries
      in adults. It is important to know these facts, even if the methods used for
      resuscitation and immediate follow-up are much the same in children as in adults.
      A special type of injury that is seen with increasing frequency comprises the
      bizarre injuries caused by child abuse.

PMID- 1631821
TI  - [Multiple injuries in pregnant women].
AB  - It is relatively uncommon for pregnant women to suffer multiple injuries. In such
      a situation, however, two lives are at stake. The survival of the foetus depends
      on the mother's condition with regard to respiratory passage, oxygenation, and
      hypovolemia. This last condition implies that the blood is shunted away from the
      uteroplacental circulation, thus endangering the foetus. The principles of
      treatment are the ones described in this series of articles, and furthermore, in
      addition to concern for the foetus. Blows against the abdomen can cause abruption
      of the placenta, which is a frequent cause of death of the foetus after closed
      trauma, and can occur up to 48 hours after the accident. This necessitates
      monitoring of the foetus during this period.

PMID- 1631823
TI  - [Light therapy of newborns with hyperbilirubinemia].
AB  - In a significant fraction of newborns the skin becomes yellow for a few days
      after birth due to accumulation of bilirubin, a product of heme catabolism. If
      the concentration of bilirubin in the serum approaches the binding capacity of
      albumin, bilirubin may penetrate into the central nervous system and cause
      irreversible damage. Phototherapy is the most common form of therapy, used on 5
      10% of all newborns in Norway. Three photochemical reactions are of importance in
      this treatment: Photooxydation of bilirubin followed by fragmentation of the
      molecule and formation of water-soluble products. Reversible formation of
      (4Z,15E) and (less important) (4E,15Z) configurational isomers. Irreversible
      formation of the structure isomer Z-lumirubin, which is relatively water-soluble
      and can be excreted. The (4E,15Z) isomer is probably an intermediate in the
      formation of Z-lumirubin, whose formation therefore requires the absorption of
      two photons. Irreversible formation of Z-lumirubin, which has a quantum yield
      that increases with increasing wavelength of the light, is believed to be the
      most important reaction in phototherapy. All known side-effects of phototherapy
      are transient and not serious.

PMID- 1631824
TI  - [Technique for taking specimens for cervical and endometrial cytological tests].

PMID- 1631825
TI  - [Crib death, sleeping position and temperature].
AB  - Sudden infant death syndrome (SIDS) is the commonest cause of death in children
      over one week of age. Norway has the highest incidence in Scandinavia and the
      figure has increased during the last 20 years. There has been much discussion as
      to whether sleeping in the prone position rather than in the supine or lateral
      position may be a predisposing factor to cot death. In all 14 studies in seven
      countries where the question has been investigated, there was a higher proportion
      of prone infants in the SIDS group than in the control group. Intervention
      studies have shown that reducing the proportion of infants sleeping prone was
      followed by a reduction in cot deaths. There is also evidence that overheating is
      a risk factor for SIDS. In one British study it was found that infants who died
      of SIDS had more clothes on, and blankets covering them, and that both prone
      position and overheating were independently associated with SIDS. A possible
      mechanism is that overheating interferes with respiratory control. Although we do
      not completely understand the mechanisms underlying the links between SIDS and
      the prone position, the epidemiological evidence and the evidence from
      intervention are now so strong that it is fully justified to advice against the
      general use of the prone sleeping position for babies.

PMID- 1631826
TI  - [Patients' diary--a useful communication tool for both patients and health
      personnel].
AB  - Elderly people living at home and suffering from one or more chronic diseases
      often receive help from different sectors of the public health service. Good
      communication between these different health workers is often lacking. To improve
      this situation we are now using a supplementary journal which is kept in the
      patient's own possession and brought with him or her to hospital and
      consultations. We have tried out this method for two years, have found it very
      useful, and shall continue to use it permanently. We hope this article will serve
      to acquaint doctors with this journal. We also discuss our experiences after
      having started to use the journal.

PMID- 1631827
TI  - [Microcomputer-based medical records system for diseases of the female breast].
AB  - We describe a microcomputer-based Medical Record for diseases of the female
      mammary gland. The system is based on multiple-choice questionnaires used by the
      physician and later transferred to the computer. The computer produces written
      output for transfer to the patient record. Statistical information can be
      obtained through preprogrammed menus. The system has been used as the only
      documentation for the patient group at the Surgical Department, Ullevaal Hospital
      for more than four years. We discuss system design, statistical results and
      future development.

PMID- 1631828
TI  - [Smoking and extrauterine pregnancy].
AB  - During the last twenty years the incidence of ectopic pregnancies has doubled or
      tripled. They constitute about 1.13% of all pregnancies in Norway, and remain an
      important cause of subsequent infertility. The main risk factors are sexually
      transmitted diseases, pelvic inflammatory disease, and use of intrauterine
      device. This paper reviews some of the recently published epidemiologic and non
      epidemiologic reports that have shown a positive association between ectopic
      pregnancies and cigarette smoking. Some ectopic pregnancies would probably be
      prevented if pregnant women refrained from smoking.

PMID- 1631829
TI  - [Medical advisers and chief physicians at Norwegian somatic hospitals].

PMID- 1631830
TI  - [Delivery on the mother's or the infant's premises?].
AB  - A delivery should take place on the infant's premises. The mother's wishes and
      needs should also be taken into consideration, however, as long as they do not
      involve hazard to the child. The mother should have the right to take leave of
      absence at least four weeks before term and approximately one year after
      delivery. ABC-principles (Alternative Birth Care) during pregnancy and labour
      could be applied by making a hospital delivery more like a home delivery.

PMID- 1631831
TI  - [Methadone therapy--for whom?].

PMID- 1631833
TI  - [Incidence of scalp problems among soldiers in Sessvollmoen].

PMID- 1631832
TI  - [Health problems of women-- accidental falls and injuries?].

PMID- 1631835
TI  - [Criteria of suitability for medical education].

PMID- 1631834
TI  - [Child ombudsman, health centers and family practice].

PMID- 1631836
TI  - [On the concept of cause].

PMID- 1631837
TI  - [Doubt about atenolol in the treatment of hypertension].

PMID- 1631838
TI  - [Cholera].

PMID- 1631839
TI  - [The age of internationalism. We live in the age of internationalism and the
      Norwegian physicians and their Society must adapt to it].

PMID- 1631840
TI  - [Late diagnosis of advanced breast cancer--a challenge for health services].
AB  - From 1982 to 1987, 1,637 cancers of the breast were diagnosed in Oslo. 235 were
      classified as advanced according to one or more of the following criteria: tumour
      size greater than or equal to 5 cm (T3) or T4, metastasis within 4 months,
      pathological diagnosis pT3, pT4 or pN2. These were further studied. The
      distribution of women with advanced cancer mammae was uneven. For no obvious
      reason, incidence was significantly higher in one out of four hospitals in Oslo.
      169 of the patients discovered the tumour themselves. Many patients delayed
      seeking help. 93 waited for more than eight weeks before doing so. For patients
      with metastasis at time of diagnosis, survival was slightly more than one year,
      and for patients without metastasis it was four and a half year. The length of
      stay in hospital increased with increasing admissions.

PMID- 1631841
TI  - [Ultrasonography for early diagnosis of abdominal aortic aneurysm].
AB  - 2,654 males aged 60 years or older were invited to attend a screening examination
      using ultrasound to detect abdominal aortic aneurysm. 1,256 met up. A fee of NOK
      150 was charged. 92 aneurysms were detected (7.3%) 69 were smaller than 40 mm and
      23 were 40 mm or larger. During the observation period (18 months from start of
      the study and nine months after screening stopped) 17 of the patients with an
      abdominal aortic aneurysm of 40 mm or larger had elective operations. All
      patients survived without major complications. Owing to the high prevalence of
      abdominal aortic aneurysm, the low cost of screening, and the safety of elective
      surgery, it is suggested that screening for detection of abdominal aortic
      aneurysm should be carried out on a larger scale.

PMID- 1631842
TI  - [Ischemic hepatitis. Important differential diagnosis of increased levels of
      transaminases in the liver].
AB  - In patients with pathological findings in tests of liver function, ischemic
      hepatitis is an important differential diagnosis. This condition is most often
      seen in patients with coronary heart disease. Acute circulatory failure may
      induce reduced liver perfusion with extreme elevation in transaminase levels
      within three to five days. The values return to normal within five to ten days
      and in uncomplicated cases there is minimal cholestasis. Ischemic hepatitis may
      progress to fulminant hepatic failure. The diagnosis can be made by clinical
      examination and biochemical tests alone. Biopsy gives a characteristic picture of
      centrilobular liver cell necrosis which confirms the diagnosis, but is seldom
      necessary.

PMID- 1631843
TI  - [Systemic lupus erythematosus and pregnancy].
AB  - In patients with systemic lupus erythematosus in remission pregnancy has a good
      prognosis for mother and foetus. Pregnancy does not have a negative effect on
      systemic lupus erythematosus in remission, either in the short or the long term.
      Immuno-regulatory drugs should not be withdrawn before or after start of
      pregnancy, and flares during pregnancy can be treated with steroids and/or
      azathioprine. The risk of flare is very high in the puerperium, and can be
      prevented by steroids. All patients are at high risk of losing the foetus,
      particularly patients with antiphospholipid antibodies. Patients at high risk
      should be given low doses of aspirin (80 mg daily) from the first day of
      pregnancy. Neonatal lupus and congenital heart block are rare, and are associated
      with the presence of anti-SSA and anti-SSB antibodies in the maternal blood.

PMID- 1631844
TI  - [Tissue expansion].
AB  - Tissue expansion has now achieved an important place in reconstructive surgery,
      since the first experiments about 10-15 years ago. Expanded tissue used in
      reconstruction is usually excellently matched for colour, thickness, elasticity
      and other physical properties. This is particularly important in reconstructions
      in the head and neck region. Tissue expansion is also used increasingly for
      breast reconstruction all over the world. It is now the most common procedure for
      breast reconstruction in USA. Various options using either a temporary or a
      permanent expander are discussed.

PMID- 1631845
TI  - [Evaluation of suicidal tendency].

PMID- 1631846
TI  - [The cholera epidemic in Latin America].
AB  - An outbreak of cholera started in Peru in January 1991 and spread through most
      Latin American countries within a year. This was the first known epidemic of
      cholera in America for more than a century. In 1991, 321,334 persons were
      reported to have cholera in Peru, 119,063 were hospitalized, and 2,906 died.
      Other countries like Ecuador, Colombia, Guatemala, Brazil, Mexico, Bolivia,
      Chile, El Salvador, Venezuela and Honduras were also affected, but these
      countries combined accounted for only 20% of the cases registered in Peru. In
      April 1992, all Latin American countries except Uruguay, Paraguay and French
      Guyana have reported cholera. The mortality rate for the epidemic in Latin
      America was only 1%, mainly owing to good oral rehydration treatment provided by
      Local health services and the Pan American Health Organization. The causative
      organism was Vibrio cholerae, serogroup O1, serotype Inaba (and Ogawa) of the El
      Tor biotype. Genetic characterization shows this strain to be unique, and the
      designation is reserved for the Latin American strain, distinguishing it from the
      other El Tor isolates from the 7th pandemic.

PMID- 1631847
TI  - [Occupational anamnesis in general practice. Does it yield useful information for
      preventive procedures?].
AB  - To what extent can general practitioners elucidate connections between working
      conditions and patterns of health and disease for preventive purposes? Data were
      collected by means of questionnaires to general practitioners, interviews with
      patients and by testing out questions to establish an occupational history.
      Questions covering seven key topics revealed a multitude of possible causal links
      between working conditions and symptoms. The information may appear irrelevant to
      the general practitioner, however, if the Labour Inspection (Arbeidstilsynet) or
      the companies' health services fail to assist.

PMID- 1631848
TI  - [Leadership and professionalism].
AB  - In 1990 a new organizational structure based on decentralization and team
      leadership, where the leader (usually a doctor) is responsible for the final
      decision, was introduced at the regional and university hospital of Tromso. This
      structure replaces the traditional dual structure of leadership where the leaders
      (a doctor and a nurse) did not share responsibility for the whole department. In
      order to analyze organizational practices after the reform we constructed three
      different organization models of the hospital: the hierarchical model, the
      professional model and the workshop model. Of five teams, one functioned
      hierarchically, three resembled the professional model, and the fifth came close
      to the workshop model. The leader of the hierarchical team behaves autocratically
      and the employees are dissatisfied. In the three remaining teams conditions have
      changed very little compared with the situation before the reorganization. In the
      workshop team decisions are reached jointly. This team functions in an innovative
      way. Even though the new organizational structure has quite divergent
      consequences and some leaders have problems, the majority of the hospital
      employees support the new structure.

PMID- 1631849
TI  - [Introduction of quality assurance systems for medical technical equipment].

PMID- 1631850
TI  - [Quality assurance--where is the challenge?].

PMID- 1631851
TI  - [Diagnosis-related groups--possibilities and problems].

PMID- 1631852
TI  - [Silicone breast prostheses--a guideline or misinformation from the
      Helsedirektoratet (Office of Health Authority)].

PMID- 1631853
TI  - [Methadone treatment--for whom?].

PMID- 1631854
TI  - [Hyperkalemia--repeat potassium determination in heparin plasma].

PMID- 1631855
TI  - [Natural products can be hazardous to health].

PMID- 1631856
TI  - [Elderly physicians are discriminated against].

PMID- 1631857
TI  - [Habilitation/rehabilitation--young people and adults with congenital or early
      acquired functional disabilities].

PMID- 1631858
TI  - [The medical doctor degree under revision].

PMID- 1631859
TI  - [How can we improve hospital quality? Can hospitals learn anything from
      industry?].

PMID- 1631860
TI  - Forgotten pioneers in thoracic surgery.
AB  - The names of Carrel, Sauerbruch and Blalock are milestones in the early history
      of thoracic surgery. The recognition of contributions by less renowned
      contemporaries does not diminish the decisive part played by these founders of
      prestigious schools of thoracic surgery. Kronlein who in 1883 successfully
      performed what was probably the first lobectomy is never mentioned. The
      esophagectomy without thoracotomy publicized by Orringer in 1978 had already been
      done by Gray-Turner 47 years before, in 1931. McLean who discovered heparin, and
      Forssmann who introduced cardiac catheterisation by passing an ureteral catheter
      into his own heart ended up as small-town general surgeons. Horace Smithy of
      Charleston successfully performed an operation for mitral stenosis four months
      before Bailey and Harken. Unlike his famous contemporaries, he was unable to
      publicize his cases at medical meetings because that same year, 1948, he died
      from an aortic vascular stenosis. Vineberg, who had recommended and successfully
      performed internal mammary artery implantation since 1946, was smiled at as a
      utopian until his rehabilitation by Mason Sones' coronarography and until
      coronary bypass surgery developed into the greatest boom in thoracic surgery. Sir
      Henry Souttar, who is known to have operated successfully a mitral stenosis a
      quarter of a century before Bailey, when asked why following his 1925 success he
      did not persue mitral surgery answered: "Because I could not get another case!"
      As usual, surgical "break-throughs" met with the resistance of medical men.
      Before doctors became enthusiastic advocates and referred thousands of cases of
      pulmonary tuberculosis, and mitral and coronary stenosis, their opposition had to
      be overcome by successful operation of generally desperate cases.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1631861
TI  - Biochemical and functional effects of creatine phosphate in cardioplegic solution
      during aortic valve surgery--a clinical study.
AB  - During myocardial ischemia there is a drop in high-energy phosphates in the
      myocardium. Cold potassium cardioplegia decreases but does not altogether prevent
      this reduction. Supplementation of cardioplegic solutions with the high-energy
      compound creatine phosphate (10 mmol/L) compared to plain cardioplegic solutions
      was investigated in this study. Thirty patients scheduled for aortic valve
      replacement were included. The patients were randomized to group I (creatine
      phosphate) or group II (control). Postoperative hemodynamic evaluation revealed
      no significant differences between the groups. However, group I exhibited a
      tendency toward a better stroke-work index (135 +/- 18% vs. 102 +/- 5% recovery
      15 minutes after bypass and 145 +/- 16% vs. 119 +/- 11% recovery 105 min after
      bypass). There were fewer patients in group I (5/15) needing inotropic support
      compared to group II (9/14). The myocardial content of ATP and creatine phosphate
      showed no significant differences during ischemia and reperfusion. It is
      concluded that the myocardial protection during ischemia was sufficient to
      prevent significant reductions of myocardial ATP and creatine phosphate
      irrespective of supplementation with CP.

PMID- 1631862
TI  - New surgical techniques for the prevention of paraplegia during aortic surgery.
AB  - It has been shown in previous publications that ischemic spinal cord injury after
      aortic cross-clamping may be produced by a steal-phenomenon. The present study
      investigates this phenomenon and the direction of spinal cord blood flow by
      directly measuring the oxygen tension on the spinal cord surface in pigs. After
      simple clamping of the aorta, oxygen tension decreased significantly distal to
      the clamping site both after occlusion of the thoracic aorta at T3-4 (group I)
      and the abdominal aorta at L1 (group II). Exclusion of the thoracic aorta by
      second clamping at T 13 restored oxygen tension almost to the control level while
      segmentation of the abdominal aorta up to S1 hardly affected oxygen tension in
      the area of the Adamkiewicz artery in most animals. An additional occlusion of
      the spinal cord proximal to the measuring point did not lead to a significant
      alteration of oxygen tension. It is concluded that, after aortic cross-clamping,
      blood tends to drain away from the spinal cord rather than supply it
      longitudinally. A steal phenomenon always has to be taken into account if any
      radicular artery, especially the artery of Adamkiewicz, supplies the spinal cord
      distal to the clamping. Without cognizance of the position of the Adamkiewicz
      artery in man as well as of the competence of the collateral circulation in the
      excluded segment, a new additional strategy needs to be developed for repair of
      the aorta. Two surgical techniques for the prevention of paraplegia after aortic
      cross-clamping are described and discussed: the counter occlusion technique and
      the bypass fractionated technique.

PMID- 1631863
TI  - First clinical experiences with a new angioscopic system for diagnosing
      peripheral vascular changes.
AB  - Conventional angiography allows a global view of regional vascular anatomy but
      precise information can only be deduced indirectly using contrast medium. The use
      of the three-dimensional picture of angioscopy, however, allows a direct
      evaluation of the vascular system. In order to extend our experiences with
      angioscopy, we employed a new micro-cardio-angioscopic system which consists of
      four components: a CCD color camera (360,000 pixels); a highly flexible optical
      probe which can be resterilised (1.4-0.6 mm diameter) incorporating 10,600-6,000
      glass fibers, with a viewing angle of 140 degrees, 70 degrees, and 50 degrees and
      a focusing system that allows a distance from 2 mm to infinity; a high power
      light source and an insertion catheter with inflatable balloon. Using a known
      technique (intermittent blood-flow blockage and continual rinsing with NaCl
      solution), 36 cases involving 27 patients were examined before and after
      desobliteration of the femoral artery. In 88% of the cases it was possible to
      control the result of the intervention by angioscopy. Smaller intimal lips, the
      thrombotic wall, and intimal ruptures were clearly visible. Quantification of the
      stenoses was also successful in 88% of the cases, and in 8 patients the
      angioscopic findings deviated from the conventional angiogram. In 14% of the
      cases, angioscopic examination of the recanalisation result showed that
      thrombolytic therapy was necessary. Angioscopy offers the possibility of
      qualitative vascular diagnosis. It is a valuable addition to angiography.

PMID- 1631864
TI  - A new vascular prosthesis of bovine origin.
AB  - An experimental study on a new biologic vascular graft for reconstruction of
      small diameter arteries was carried out in 50 sheep. A follow-up period of two
      years let us conclude that the new vascular prosthesis may be "re-utilized" by
      the host. Infection and aneurysmatic degeneration could not be observed. An early
      occlusion of the graft occurred in only one case, due to technical reasons.

PMID- 1631865
TI  - Echinococcal cyst of the interventricular septum: a rare cause of myocardial
      ischemia.
AB  - A 30-year-old woman developed ischemia-like chest pain due to myocardial
      compression by an intracardiac cyst. The cyst was located in the interventricular
      septum. Its etiology could not be ascertained despite several diagnostic measures
      but exstirpation was indicated by the clinical symptoms. Intraoperatively the
      diagnosis of echinococcosis was established. The cyst was extirpated in toto
      without perforation of the thinned interventricular septum. Postoperatively the
      patient was symptomfree.

PMID- 1631866
TI  - Aorto-cutaneous fistula: a rare complication of aortic surgery.
AB  - Two cases of false aneurysm of the ascending aorta which presented with discharge
      of arterial blood from a sternal wound are discussed. The first presented 8 years
      after aortic valve surgery and was diagnosed by contrast enhanced computerised
      tomography of the thorax. The second presented 6 months following repair of an
      aortic dissection and the diagnosis was confirmed by thoracic magnetic resonance
      imaging. The diagnosis and surgical management of these cases are reviewed.

PMID- 1631867
TI  - Leiomyosarcoma of the pulmonary hilar vessels.
AB  - Leiomyosarcomas are uncommon tumors. They have a predilection for deep soft
      tissues, with a rare group arising in medium-sized or large veins, far less
      frequently in arteries. We report a case of a 63-year-old man, with an enlarging
      mass located in the left pulmonary hilar region which was discovered on a routine
      chest radiograph. Cytology of the sputum and bronchoscopic biopsies did not
      reveal any malignant cells. Over 5 months observation, there was a clear
      progression of the mass, and the patient finally underwent a left pneumonectomy
      which allowed the diagnosis of an intravascular leiomyosarcoma partially
      destroying major arteries and veins in the hilar region. A review of the
      literature reveals 67 cases of leiomyosarcoma involving the pulmonary artery.
      None of these cases had an associated venous pathology. The disease is found
      mainly in adult women. Clinical diagnosis is very difficult because most of the
      cases have no specific clinical signs; the major differential diagnosis is that
      of pulmonary thrombo-embolism. Prognosis depends on histological degree of the
      tumor and extent of the disease, metastases occur mainly in the liver, lung, and
      brain and less frequently in regional lymph nodes. Treatment is always surgical,
      chemotherapy is ineffective and the effectiveness of radiotherapy depends on the
      total dose of irradiation. Sarcomas of hilar blood vessels have a very poor
      prognosis with a one year survival estimated, from the onset of symptoms, at 20%.

PMID- 1631868
TI  - Treatment of intractable ventricular fibrillation with prompt circulatory support
      using a biventricular assist device in pigs--an experimental study.
AB  - Refractory ventricular fibrillation (VF), intractable to conventional therapy,
      can be converted into a stable cardiac rhythm by immediate ventricular volume
      unloading using a form of mechanical circulatory assist (MCA). We investigated
      the efficacy of MCA in a controlled animal study in which 20 pigs were subjected
      to intermittent occlusions (5 times) of the left descending coronary artery (5
      min. occlusion + 10 min. reperfusion). 12 of the 20 animals (60%) developed 14
      events of VF. 64% of VF developed during reperfusion (p less than 0.05).
      Countershock was attempted up to eight times and was successful in 5 of the 14
      events (36%) (primary defibrillation, PD). When conversion was not achieved,
      total biventricular bypass was instituted. Mean perfusion time between
      countershock attempts was 24.4 +/- 15.3 min. All animals (n = 9) with cardiac
      assistance were successfully defibrillated (secondary defibrillation, SD), (p
      less than 0.05). Hemodynamic parameters after SD were not significantly different
      from those after PD (p greater than 0.05). Survival rate following PD was 66.6%.
      Six animals were ultimately weaned from cardiac assistance following SD. Three
      others died of progressive cardiogenic shock in the six hour follow-up period
      following SD. These non-survivors had a significantly longer VF time than the
      survivors (41.7 +/- 10.4 vs. 15.8 +/- 8.0, p less than 0.05). Overall survival
      after SD was the same as that for PD: 66.6% (p greater than 0.05). These results
      show that prompt conversion of VF into a stable cardiac rhythm is a prerequisite
      to recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631869
TI  - Omental pedicle flap used to treat a bronchopleural fistula after diaphragma
      pericardio-pleuropneumonectomy.

PMID- 1631870
TI  - Renal cell carcinoma extending into the right ventricle: successful resection
      with cardiopulmonary bypass.
AB  - Successful total removal of a renal cell carcinoma extending through the
      tricuspid valve into the right ventricle is reported. The rarity of this case
      prompted a review of the literature in which only right atrium involvement in
      this type of tumor was found.

PMID- 1631871
TI  - Partial "anomalous" hepatic venous connection associated with secundum atrial
      septal defect.
AB  - Postnatal connection of hepatic veins with the coronary sinus represents the rare
      persistence of a normal early embryonic development. A case is presented where
      this was found intraoperatively, associated with a secundum type atrial septal
      defect. Knowledge of this anatomic variation and its specific features may
      facilitate preoperative diagnosis, thereby preventing surprises in the operating
      room.

PMID- 1631872
TI  - Protection of a transplanted kidney during aortoiliac reconstruction.

PMID- 1631874
TI  - Comparison of myectomy alone or in combination with mitral valve repair for
      hypertrophic obstructive cardiomyopathy.
AB  - Between 1/84 and 6/91 56 patients were treated for hypertrophic obstructive
      cardiomyopathy (HOCM): the Morrow technique alone was performed on 40 patients
      (group 1), in 16 patients (group 2) an additional replacement (n = 13) or
      reconstruction (n = 3) of the mitral valve was indicated. In a total of 14 cases
      coronary artery bypass grafting and aortic valve replacement was performed in
      addition. Postoperatively (mean follow-up 4.2 yrs, 141 patient-years) left
      ventricular diastolic and systolic function parameters, heart muscle mass, ECG
      findings, and symptomatology were recorded and the ratios of beta-adrenoreceptor
      density to density of the calcium channel were measured. RESULTS: Pressure
      gradient decreased from 69.2 +/- 5.2 (group 1) and 75.1 +/- 4.8 (group 2) to 23.3
      +/- 2.7 and 11.7 +/- 2.2 mmHg postoperatively. Likewise Sokolow-Lyon index
      decreased from 3.5 +/- 0.2/3.7 +/- 0.2 to 2.9 +/- 0.2/2.8 +/- 0.3. The quotient
      time-to-peak-velocity/left-ventricular-ejection-time decreased significantly in
      group 2 from 58.6 +/- 6.3 to 41.9 +/- 5.8 (p less than 0.05). The heart muscle
      mass, determined echocardiographically, decreased from 680g to 430g (p less than
      0.05). Isovolumetric tension time, isovolumetric relaxation time, and E/A ratio
      at rest and after stress showed typical characteristics. Ca(++)-channel density
      was clearly raised in all patients, with no differences between the two groups
      being observable. We conclude from our results: The most marked improvements in
      clinical and left-ventricular functional parameters were experienced by patients
      in group 2 (myectomy+MVR).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631873
TI  - Preoperative and late postoperative psychosocial state following coronary artery
      bypass surgery.
AB  - In a prospective study of psychological and neurological reactions to coronary
      artery bypass surgery, 45 patients were examined preoperatively, postoperatively,
      and 21 to 27 months after, using a variety of neurological, psychiatric, and
      psychological investigations. Within the follow-up sample, three subgroups of
      patients could be identified by cluster analysis who differed with respect to
      their emotional status and life satisfaction. One group (24% of the total sample)
      was characterized by high levels of anxiety, depression and life dissatisfaction
      and appears as a risk population. The other groups could be described as either
      average (42%) or stable (33%). At the follow up, the risk group further indicated
      a preference for depressive coping styles, a slightly higher degree of cognitive
      impairment, more neurological and psychopathological symptoms (specifically
      giving-up and hostility), a considerably lower return-to-work rate, more
      subjective physical complaints and a poorer attitude toward the outcome. While
      postoperative measurements (obtained 2-3 and 6-8 days after surgery) as well as
      intraoperative parameters did not reveal significant group differences, the
      analysis yielded an increased impairment within the risk group already prior to
      surgery, especially emotional problems, specific health-related cognitions and a
      more fatalistic attitude. The results are in line with those of other studies
      investigating the late postoperative psychological status with regard to the
      proportion of patients showing psychological impairments as well as to their
      specific psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631875
TI  - Relationship of atrial fibrillation to significant pericardial effusion in valve
      replacement patients.
AB  - Rhythm change was observed in 21 of 242 (8.7%) patients during the first four
      weeks of open heart surgery (OHS). In the valve-replacement group of 148 patients
      the rhythm change was found to be associated with significant pericardial
      effusion (PE). Seven patients had rhythm changes during the first three days of
      OHS unrelated to PE. Two patients who were in atrial fibrillation (AF) developed
      fast ventricular rate and twelve patients showed rhythm change from sinus to
      supraventricular tachyarrhythmia (AF in ten and supraventricular tachycardia in
      two) and all these fourteen patients had significant PE. With pericardiocentesis
      or open drainage or withdrawal of anticoagulation, AF reverted to sinus rhythm in
      nine patients and five patients remained in AF but with a slow ventricular rate.
      Significant PE was related to a high anticoagulation ratio. We conclude from this
      study that within the first four weeks of OHS, high anticoagulation ratio
      contributes to the development of significant PE, and tachyarrhythmia
      (particularly AF) is a forerunner of significant PE or cardiac tamponade: the aim
      of management should be to rule out or show evidence of significant PE once
      tachyarrhythmia develops, and if significant PE is present then the pressure in
      the pericardial cavity should be reduced.

PMID- 1631876
TI  - The effects of systemic intraoperative hypothermia on the acute-phase and
      endocrine response to cardiac surgery.
AB  - To determine the ability of intraoperative hypothermia to modify changes in the
      plasma protein component of the acute-phase response (APR) and the plasma hormone
      component of the endocrine response (ER) to surgical injury, 20 patients
      undergoing coronary artery surgery were randomised to an intraoperative blood
      temperature of 28 degrees C or 20 degrees C during cardiopulmonary bypass (CPB).
      Serial measurements of pack-cell-volume corrected concentrations (PCVCC) of five
      plasma proteins (albumin, prealbumin, transferrin, caeruloplasmin, ferritin) and
      six plasma hormones (adrenaline, noradrenaline, cortisol, triiodothyronine,
      thyroxine, and thyroid-stimulating hormone) were obtained twice preoperatively,
      seven times during surgery, six times in the 24 hours following surgery, and a
      further four times until the seventh postoperative day. A more profound level of
      intraoperative hypothermia significantly reduced the plasma adrenaline response
      to CPB but not the other components of the ER or APR.

PMID- 1631877
TI  - Modified preservation of all annular-papillary continuity in replacement of the
      calcified mitral valve.
AB  - The technique described here is a modification of the mitral valve replacement
      with preservation of chordae tendineae for calcified mitral stenosis. After
      commissurotomy, the middle portion of the anterior leaflet is excised to get two
      parts with accessible chordal insertion. Each thickened and calcified segment is
      debrided by means of an ultrasonic tool and then attached to the mural leaflet.
      Finally mitral valve replacement is carried out. This procedure will extend
      surgical indication of chordae-sparing methods in mitral valve replacement for
      mitral stenosis.

PMID- 1631878
TI  - Pain relief and respiratory mechanics during continuous intrapleural bupivacaine
      administration after thoracotomy.
AB  - Continuous intrapleural bupivacaine administration was assessed in a randomized
      double-blind manner with respect to its analgesic effect and its impact on
      breathing after thoracotomy. The pleural cavity was infused continuously for 48
      hours in 24 patients following thoracotomy for pulmonary resection. 12 patients
      received 10 ml/h of bupivacaine hydrochloride 0.5% solution, and 12 patients 10
      ml/h NaCl 0.9% solution. There were no differences in the patients'
      characteristics, extent of surgery, mode and duration of general anaesthesia.
      There were no complications related either to the catheter or to bupivacaine. The
      amount of postoperative opioid, given on request, was used to assess the effect
      of bupivacaine administration on pain relief. Post-thoracotomy breathing was
      assessed by measuring the forced vital capacity (VC) prior to and after
      physiotherapy. The VC values measured 24 h, 36 h and 48 h after the operation
      were similar in both groups of patients with or without bupivacaine
      administration (p greater than 0.05). Patients given bupivacaine required
      significantly less opioid analgesia than those who received NaCl 0.9% at 24 h (p
      less than 0.001), 36 h (p less than 0.001) and 48 h (p less than 0.01) after the
      operation. Continuous intrapleural bupivacaine analgesia through a paravertebral
      catheter positioned in the paravertebral groove is safe and provides efficient
      pain relief after thoracotomy.

PMID- 1631879
TI  - Primary mucoepidermoid carcinoma of the thymus--a rare cause of mediastinal
      tumour.
AB  - We present a primary mucoepidermoid carcinoma of the thymus which is an extremely
      rare cause of mediastinal tumour. Growth is slow with cure obtained after
      complete resection. Only two previous cases have been reported.

PMID- 1631880
TI  - Truncus arteriosus communis associated with interrupted aortic arch: a report on
      two uncommon cases.
AB  - The paper presents two infants with the A-4 type of truncus arteriosus communis
      (according to Van Praagh's classification). One patient who survived a surgical
      procedure demonstrated a rare variant of aortic arch interruption to the left off
      the left subclavian artery (type A according to Celoria and Patton), whereas the
      second presented an uncommon anomaly in which the right subclavian artery
      originated from the descending aorta with associated severe truncal valve
      incompetency. The authors describe the clinical picture along with the surgical
      treatment of the first infant who being six days old was subjected to a
      correction employing the wide patent ductus arteriosus to reconstruct the aortic
      arch, following the method described by Gomes and McGoon. Subsequently an aortic
      homograft was implanted in order to connect the right ventricle and the pulmonary
      artery.

PMID- 1631881
TI  - Replacement of a thrombosed St. Jude Medical prosthesis in pulmonary position
      after repeated thrombolytic therapy.
AB  - A 49-year-old man who had undergone repair of tetralogy of Fallot underwent
      replacement of a thrombosed St. Jude Medical prosthesis in pulmonary position
      after intravenous thrombolytic therapy. Dysfunction of the prosthetic valve was
      detected clinically by change of heart sound and the appearance of a new
      diastolic murmur. Cinefluoroscopy confirmed fixation of both leaflets. Although
      thrombolytic therapy using urokinase was successful twice, the prosthesis was
      replaced with a Carpentier-Edwards bioprosthesis due to recurrent prosthetic
      dysfunction.

PMID- 1631882
TI  - Introduction to multihospital systems.

PMID- 1631883
TI  - The evolution of Catholic multiinstitutional systems.

PMID- 1631884
TI  - The future of multihospital systems.

PMID- 1631885
TI  - When the system can't save the hospital: a practical overview of workouts and
      bankruptcy alternatives.

PMID- 1631886
TI  - Financial and operating performance of systems: voluntary versus investor-owned.

PMID- 1631887
TI  - Mn2+ sequestration by mitochondria and inhibition of oxidative phosphorylation.
AB  - Manganese is known to accumulate in mitochondria and in mitochondria-rich tissues
      in vivo. Although Ca2+ enhances mitochondrial Mn2+ uptake, ATP-bound Mn2+ is not
      sequestered by suspended rat brain mitochondria, and ATP binds Mn2+ even more
      tightly than it binds Mg2+. Physiological levels of the polyamine spermine
      enhanced 54 Mn2+ uptake at the low [Ca2+]s characteristic of unstimulated cells
      (approximately 100 nM). With succinate as substrate, Mn2+ inhibited oxygen
      consumption by suspensions of rat liver mitochondria after the addition of ADP
      but not after the addition of uncoupler. With glutamate/malate as substrate, Mn2+
      inhibited ADP-stimulated respiration and also slightly inhibited uncoupler
      stimulated respiration. State 4 (resting) respiration was unchanged in all cases,
      indicating that the inner membrane retained its impermeability to protons. These
      results suggest that Mn2+ was not oxidized and that it can interfere directly
      with oxidative phosphorylation, most likely by binding to the F1 ATPase. Mn2+ may
      also bind to the NADH dehydrogenase complex, but not strongly enough to affect
      electron transport in vivo. It is suggested that accumulation of manganese within
      the mitochondria of globus pallidus may help explain the distinctive pathology of
      manganism.

PMID- 1631889
TI  - The genetic toxicology of cobalt.
AB  - Genetic and related effects of cobalt compounds are reviewed and discussed with
      respect to mechanisms. In prokaryotic assays, Co(II) salts generally are
      nonmutagenic. In Saccharomyces cerevisiae, CoCl2 is mutagenic to mitochondrial
      genes and weakly mutagenic or nonmutagenic to chromosomal genes. In plants,
      Co(II) salts induced gene mutations and chromosomal aberrations. In mammalian
      cells in vitro, Co(II) compounds caused DNA strand breaks, sister-chromatid
      exchanges and aneuploidy, but not chromosomal aberrations. In two cell lines,
      CoCl2 was weakly mutagenic. Interestingly, the poorly soluble compound CoS caused
      DNA strand breaks and morphological transformation of mammalian cell lines. In
      contrast to its weak clastogenic and mutagenic properties, cobalt(II) exerts
      pronounced antimutagenicity in bacteria and mostly comutagenic effects in
      mammalian cells. In Escherichia coli CoCl2 lowered the frequency of mutations
      induced by MNNG, uv or X rays. In Chinese hamster V79 cells, CoCl2 enhanced the
      mutagenicity and clastogenicity of uv light but not of gamma rays. Regarding
      direct genotoxic mechanisms, Co(II) induces the formation of reactive oxygen
      species when combined with hydrogen peroxide in cell-free systems. At high (i.e.,
      millimolar) concentrations, Co(II) also decreases the fidelity of DNA synthesis.
      Regarding anti- and co-mutagenic mechanisms, evidence for the interference of
      Co(II) with DNA repair processes is discussed. These mechanisms are regarded as
      relevant for the risk assessment of human exposure to cobalt in combination with
      other agents.

PMID- 1631888
TI  - Differential expression and induction of UDP-glucuronosyltransferase isoforms in
      hepatic and extrahepatic tissues of a fish, Pleuronectes platessa: immunochemical
      and functional characterization.
AB  - Glucuronidation of three substrates prototypical for different UDP
      glucuronosyltransferase (UDPGT) isoforms in hepatic, renal, intestinal, and
      branchial microsomes of corn oil, 3-methylcholanthrene, Aroclor 1254, and
      clofibrate-pretreated plaice was investigated. The differential expression of
      UDPGT in the four tissues clearly demonstrated for the first time that multiple
      isoforms with differing substrate specificities were present in fish. The liver
      was quantitatively the most important site for the glucuronidation of all three
      compounds studied. Phenol UDPGT activity was ubiquitous to all tissues and was
      induced by 3-methylcholanthrene and Aroclor 1254 in hepatic tissue and by Aroclor
      1254 in renal tissue. The glucuronidation of testosterone was restricted to liver
      and intestinal tissue, while conjugation of bilirubin was expressed solely in
      hepatic tissue. The biotransformation of the endogenous compounds was not induced
      in the xenobiotic-treated animals. The presence of immunoreactive UDPGTs in the
      four tissues was demonstrated by immunoblot analysis using sheep anti-plaice
      UDPGT antibodies. Hepatic tissue displayed a range of immunoreactive polypeptides
      of 52 to 57 kDa, while a 55-kDa polypeptide was detected in extrahepatic tissues.
      An increased intensity of the latter polypeptide species was demonstrated in
      liver and kidney microsomes in which there was a concomitant induction of phenol
      UDPGT activity in xenobiotic-treated fish. The results indicate that the 55-kDa
      polypeptide was the major polyaromatic hydrocarbon-inducible UDPGT isoenzyme in
      hepatic and renal microsomes.

PMID- 1631890
TI  - Acrylamide disrupts elemental composition and water content of rat tibial nerve.
      I. Myelinated axons.
AB  - The mechanism by which acrylamide (ACR) produces distal axonopathy in humans and
      laboratory animals is unknown. The possibility that this neuropathy involves
      deregulation of elements and water in rat peripheral nerve has been investigated.
      Electron probe X-ray microanalysis was used to measure percentages of water and
      concentrations (mmol element/kg dry or wet wt) of Na, P, S, Cl, K, Ca, and Mg in
      axoplasm and mitochondrial areas of tibial nerve axons. Results show that when
      rats were intoxicated with ACR by either the oral (2.8 mM in drinking water, up
      to 60 days) or the intraperitoneal (ip, 50 mg/kg/day x 5 or 10 days) route, a
      progressive loss of internodal axoplasmic K, Cl, and Na regulation was observed
      in subpopulations of myelinated fibers. Elemental deregulation was manifest as a
      shift in mean elemental content, widening of the corresponding concentration
      range, and a statistically significant increase in data variance. In internodal
      axonal regions, elemental composition of mitochondrial areas was not altered by
      ip ACR intoxication, whereas oral exposure was associated with delayed changes in
      Na, K, Cl, Ca, and Mg. In swollen axons, axoplasm and mitochondrial areas
      exhibited complete loss of element and water compartmentalization. This global
      decompartmentalization of swollen axons was quantitatively similar regardless of
      the route or length of ACR exposure. The results of this study suggest that a
      progressive loss of elemental regulation in axoplasm of myelinated tibial nerve
      fibers might be mechanistically related to ACR neurotoxicity.

PMID- 1631891
TI  - Acrylamide disrupts elemental composition and water content of rat tibial nerve.
      II. Schwann cells and myelin.
AB  - The effects of subchronic and subacute acrylamide (ACR) intoxication on elemental
      composition (Na, P, S, Cl, K, Ca, Mg) and water content of Schwann cell body
      cytoplasm and myelin were assessed in rat tibial nerve. Electron probe X-ray
      microanalysis demonstrated that, in control rats, peripheral nerve glia and
      myelin exhibited highly characteristic distributions of elements and water and
      that ACR intoxication was associated with disruption of this normal subcellular
      distribution. When rats were intoxicated with ACR by either the oral (2.8 mM in
      drinking water for 15, 22, 30, and 60 days) or the intraperitoneal (50 mg/kg/day
      x5 and 10 days) route, an exposure-dependent loss of cytoplasmic Na, K, P, Cl,
      Mg, and water regulation was detected in Schwann cell cytoplasm. Maximum
      development of elemental deregulation occurred after 30 days of oral ACR exposure
      and 10 days of ip treatment. The cytoplasmic elements involved and their
      corresponding quantitative changes were similar regardless of the route of ACR
      intoxication. Analysis of myelin revealed that both oral and parenteral ACR
      exposure caused early, persistent increases in dry weight Na, P, and water
      content. However, Cl dry weight concentrations were increased by oral exposure
      and decreased by ip ACR injection. Results of this study indicate that ACR
      intoxication is associated with a significant disturbance of subcellular element
      and water distribution in tibial nerve Schwann cells and myelin. The pattern of
      elemental disruption is typical of reversible cell damage and, therefore, Schwann
      cell injury might play a role in the expression of ACR neurotoxicity.

PMID- 1631892
TI  - Protection of rhesus monkeys against soman and prevention of performance
      decrement by pretreatment with acetylcholinesterase.
AB  - The ability of acetylcholinesterase from fetal bovine serum (FBS AChE) to protect
      against soman, a highly toxic organophosphorus (OP) compound, was tested in
      rhesus monkeys. Intravenous administration of FBS AChE produced a minimal
      behavioral effect on the serial probe recognition task, a sensitive test of
      cognitive function and short-term memory. Pharmacokinetic studies of injected FBS
      AChE indicated a plasma half-life of 40 hr for FBS AChE in monkeys. Both in vitro
      and in vivo titration of FBS AChE with soman produced a 1:1 stoichiometry between
      organophosphate-inhibited FBS AChE and the cumulative dose of the toxic
      stereoisomers of soman. Administration of FBS AChE protected monkeys against the
      lethal effects of up to 2.7 LD50 of soman and prevented any signs of
      organophosphate intoxication, e.g., excessive secretions, respiratory depression,
      muscle fasciculations, or convulsions. In addition, monkeys pretreated with FBS
      AChE were devoid of any behavioral incapacitation after soman challenge, as
      measured by the serial probe recognition task. Compared to the current
      multicomponent drug treatment against soman, which does not prevent the signs or
      the behavioral deficits resulting from OP intoxication, use of FBS AChE as a
      single pretreatment drug provides significantly effective protection against both
      the lethal and the behavioral effects of soman.

PMID- 1631893
TI  - Therapeutic efficacy of HI-6 in soman-poisoned marmoset monkeys.
AB  - The therapeutic efficacy of the oxime HI-6 against intoxication with the
      irreversible cholinesterase (ChE) inhibitor soman was tested in marmoset monkeys.
      Five out of six marmosets, intoxicated with 5 x LD50 soman and treated
      immediately with diazepam (0.2 mg.kg-1 iv) and 15 sec later with atropine (0.5
      mg.kg-1 im) and HI-6 (50 mg.kg-1 im), survived for more than 24 hr. One of these
      animals died after 4 days. In the HI-6-treated marmosets blood ChE activity was
      inhibited at a rate slower than that in three animals treated similarly but with
      saline instead of HI-6. The latter marmosets died within 8 min after soman. HI-6
      achieved its plasma peak 5 min after injection and was eliminated with a t1/2 of
      about 40 min. In a second experiment similarly treated marmosets were euthanized
      at 5 min (three saline-treated animals) or at 10 min (three HI-6-treated animals)
      after the soman intoxication to enable the determination of acetylcholinesterase
      (AChE) activities in diaphragm and brain tissue. In addition, in these animals
      blood AChE and butyrylcholine esterase (BuChE) activities were determined. Low
      AChE activities were encountered in diaphragms and brains. These levels were not
      significantly different between saline- and HI-6-treated marmosets. In vitro
      treatment with HI-6 at 40 min after soman still led to an increase of the AChE
      activity, which was significant in diaphragm, suggesting that postmortem AChE
      inhibition had occurred. The ratio of AChE to BuChE in blood was significantly
      enhanced in HI-6-treated animals, indicating that HI-6 preferentially reactivated
      AChE. It is concluded that (i) HI-6 is an effective treatment against soman
      poisoning in marmosets and (ii) AChE reactivation or protection by HI-6
      contributed to the survival of the animals.

PMID- 1631895
TI  - Exposure to methyl mercury from birth to adulthood impairs high-frequency hearing
      in monkeys.
AB  - Hearing deficits are a frequent consequence of both developmental and adult
      methyl mercury exposure in humans. However, a detailed characterization of these
      deficits has not been performed in either humans or animals. Cynomolgus monkeys
      (Macaca fascicularis) were dosed from birth to 7 years of age with 50
      micrograms/kg/day of mercury as methyl mercuric chloride. Steady-state blood
      mercury levels during dosing were 0.6-0.9 ppm. When monkeys were 14 years old,
      pure tone detection thresholds were determined by a psychophysical procedure.
      Control monkeys exhibited thresholds at frequencies between 125 and 31,500 Hz
      comparable to previously published values for macaques. One methyl mercury
      treated monkey exhibited normal detection thresholds at all frequencies. Three
      treated monkeys were impaired at the second highest frequency tested (25,000 Hz)
      and therefore were not tested at 31,500 Hz. The fifth treated monkey displayed
      severely elevated thresholds at middle frequencies (10,000-12,500 Hz), precluding
      testing at higher frequencies. These results indicate a selective high-frequency
      deficit in monkeys exposed to methyl mercury from birth to adulthood and not
      exposed to methyl mercury in the 7 intervening years before auditory testing.
      These findings extend previous results in this group of monkeys in which deficits
      in spatial and temporal visual function were observed.

PMID- 1631894
TI  - Involvement of nonparenchymal cells in oxygen-dependent hepatic injury by allyl
      alcohol.
AB  - Allyl alcohol injury to hepatocytes in the perfused liver is oxygen-dependent. It
      is not known if this injury involves direct action of allyl alcohol on
      hepatocytes or requires participation of other cell types (e.g., Kupffer cells)
      present in the liver. Accordingly, the action of allyl alcohol (100-500 microM)
      on isolated hepatocytes was studied using cells maintained at either 95 or 21%
      O2. Allyl alcohol toxicity, as indexed by trypan blue uptake, lactate
      dehydrogenase release, and ATP content, did not differ in the two groups of
      cells, suggesting that O2 dependency of allyl alcohol toxicity involves other
      cell types. Administration of allyl alcohol (30 or 40 mg/kg, ip) to rats caused
      extensive hepatic necrosis localized primarily to periportal regions. To test the
      involvement of Kupffer cells in the genesis of this injury, male rats (200-350 g)
      were treated with gadolinium chloride (GdCl3, 10 mg/kg, iv) which diminishes
      Kupffer cell function and number. The extent of hepatic damage assessed by light
      microscopy and serum enzymes, aspartate aminotransferase and alanine
      aminotransferase, was markedly attenuated by pretreatment of rats with GdCl3 24
      hr prior to allyl alcohol injection. Thus, O2-dependent hepatic necrosis caused
      by allyl alcohol involves the presence of Kupffer cells. Since GdCl3 did not
      prevent toxicity in the perfused liver, circulating blood elements may also
      contribute to injury of the liver by allyl alcohol in vivo.

PMID- 1631896
TI  - Role of hepatic lysosomes in the degradation of metallothionein.
AB  - The degradation of metallothionein (MT) by rat liver was examined. Degradation of
      MT by liver homogenate was greater than by cytosol. In addition, MT degradation
      by the homogenate at pH 5.5 was more than that at pH 7.2. Because lysosomal
      proteases function at acidic pH, these findings suggest the importance of
      lysosomes in MT degradation. The degradation by the lysosomal fraction was about
      400-fold greater than that by the cytosol. Because cathepsins are the principal
      lysosomal proteases, we used cathepsin-specific inhibitors, such as leupeptin, E
      64 and pepstatin, to determine the relative importance of different cathepsins in
      degrading MT. The study reveals that cathepsin B and/or L is (are) probably the
      most important enzyme(s) in degrading hepatic MT, because leupeptin, which blocks
      cathepsin B and L activity, inhibited the degradation of apo-MT by about 80%.
      Cathepsin D appears to be of least importance in MT degradation, because
      inhibition of this enzyme by pepstatin reduced degradation by only 20%. Studies
      on the degradation of apo-MT, ZnMT, and CdMT indicated that apo-MT is about 1500
      fold more sensitive to degradation than ZnMT and CdMT. These data suggest that
      metals protect MT from degradation. This is further supported by a reconstitution
      experiment, which shows that with a progressive decrease of MT: metal ratio
      following titration of apo-MT by metals, there is a concomitant reduction in
      degradation. At a lysosomal pH of around 4.7, about 60% of Zn and 20% of Cd are
      displaced from MT, thereby making it susceptible to degradation. We propose,
      therefore, that lysosomes are probably important for MT degradation in vivo and
      that metal release is a prerequisite for degradation. With the release of metals,
      MT becomes susceptible to degradation, which is probably accomplished by the
      lysosomal cathepsins, in particular cathepsins B and L.

PMID- 1631897
TI  - Generation of 7,8-dihydroxy-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene by
      murine splenic macrophages.
AB  - Studies have demonstrated that macrophages are the cell types which metabolize
      benzo[a]pyrene (B[a]P) within the murine spleen. B and T cells, polymorphonuclear
      cells, or the splenic capsule did not produce amounts of B[a]P metabolites above
      those of background. Exposure of mice to B[a]P, a known inducer of isozymes of
      cytochrome P450, resulted in an increase in the amounts of some B[a]P metabolites
      generated by macrophages. Evaluation of the in vitro plaque-forming-cell response
      to several T-cell and macrophage-dependent antigens following in vivo exposure to
      B[a]P indicated that the macrophage is the cell type responsible for B[a]P
      induced immunosuppression. While suggestive, the reported data have not
      definitively established that an enriched splenic macrophage population can
      generate 7,8-dihydroxy-9,10-epoxy-7,8,9,10-tetrahydro-B[a]P (BPDE) from B[a]P
      7,8,-dihydroxy-7,8-dihydrodiol (B[a]P-7,8-diol). These data are critical to our
      hypothesis that the splenic cell type(s) which form BPDE will be the primary
      target cell responsible for B[a]P-induced immunosuppression. The first objective
      was to determine if splenic macrophages could generate BPDE. Enriched (80-90%
      purity) populations of macrophages were incubated with [3H]B[a]P for 24 hr. BPDE
      generated was quantitated by analysis of the cis- and trans-tetrol hydrolysis
      products of BPDE via HPLC procedures. Splenic macrophages generated BPDE from
      B[a]P. The cis syn was the predominate tetrol detected. Exposure of mice to B[a]P
      increased the amounts of the trans-anti-tetrols 2.2-fold, the trans-syn-tetrols
      2.0-fold, the cis-anti-tetrols 1.8-fold, and the cis-syn-tetrols 2.6-fold above
      those formed by macrophages of vehicle-exposed mice. Both cytochrome P450- and
      peroxyl radical-dependent pathways are known to oxidize B[a]P-7,8-diol to BPDE.
      Since macrophages were found to generate BPDE, the second objective was to
      investigate which enzymatic pathway was responsible for its formation. The B[a]P
      (+)-7,8-diol isomer has been shown to produce different specific BPDE isomers via
      the cytochrome P450 and peroxyl radical pathways. Macrophage populations were
      incubated with [3H]B[a]P-(+)-7,8-diol for 24 hr and the contribution of the
      cytochrome P450 and peroxyl radical pathways to BPDE formation determined by
      detection of syn-BPDE-hydrolysis and anti-BPDE-hydrolysis products, respectively.
      Based on the ratio of anti/syn BPDE-derived tetrol products, the results
      demonstrate that splenic macrophages can generate the BPDE by both a cytochrome
      P450-dependent and -independent (peroxyl radical) pathway. Macrophages are the
      cells which metabolize B[a]P within the murine spleen and may be the cell type
      responsible for B[a]P-induced suppression of humoral immune responses.

PMID- 1631898
TI  - Alterations in the cortical thymic epithelium of rats after in vivo exposure to
      2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD): an (immuno)histological study.
AB  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) induces thymic atrophy in rats. The
      present study was initiated to provide (immuno)histological data on the mechanism
      of action. Juvenile male Wistar rats were orally intubated once with 50 or 150
      micrograms/kg TCDD. They were euthanized 4 or 10 days thereafter, or were allowed
      to stay alive until Day 20 or 26. Growth retardation occurred rapidly in all TCDD
      treated animals. Lethality was demonstrated within 20-21 days after
      administration. At Days 4 and 10 after intubation, thymic atrophy was shown by
      reduction of thymic weight and cortex/medulla ratio. Staining patterns for T-cell
      markers in the atrophic thymuses coincided with the reduction of cortical areas.
      There was no evidence indicating that the effects were indirectly caused by
      stress. TCDD-induced thymic atrophy persisted until Day 26 after administration.
      Immunohistochemical analysis revealed prominent changes in the cortical thymic
      epithelium at the 150-micrograms/kg dose level. First, in the cortex epithelial
      cell aggregates were observed both at Day 4 and at Day 10 after administration.
      Apparently, the architecture of the epithelium had changed in these animals.
      Second, at 10 days after administration epithelial cells were found with the
      simultaneous expression of markers that in the normal uninvoluted thymus only
      occur either in the subcapsular/medullary area or in the cortex. This phenotype
      points to an unusual stage of differentiation. We conclude that TCDD exposure
      affects the cortical epithelium of the rat thymus at a high dose level.
      Apparently, it disturbs the epithelial network and interfers with the
      differentiation of epithelial cells.

PMID- 1631899
TI  - Cutaneous toxicity and absorption of paraquat in porcine skin.
AB  - Paraquat, a commonly used herbicide, has been shown to be toxic in exposed field
      workers. The objectives of this study were to (a) assess the cutaneous toxicity
      of paraquat in vivo in pig skin and in vitro in the isolated perfused porcine
      skin flap (IPPSF) and (b) quantitate its absorption in the IPPSF. The amounts of
      3, 24, and 200 mg of paraquat were topically applied (5 cm2 surface area) on the
      ventral abdomen of pigs and biopsied after 6-8 hr for light microscopy (LM) and
      transmission electron microscopy (TEM). IPPSFs were topically dosed with the same
      concentrations and perfused for 8 hr (n = 4/treatment). The dosed area of the
      skin was sampled for LM, TEM, and enzyme histochemistry. IPPSFs were also treated
      topically with [14C]paraquat dichloride at the aforementioned concentrations (n =
      4/dose) and hourly perfusate samples were collected for radiolabel determination
      and assessment of biochemical and physiological parameters. The epidermal changes
      were similar both in vivo and in vitro. The changes included epidermal
      intercellular edema which increased with dose and epidermal-dermal separation at
      the 200-mg dose. Acid phosphatase and nonspecific esterase activities were
      increased in the upper layers of the epidermis, while alkaline phosphatase showed
      a greater activity in the stratum basale layer. Glucose utilization of all
      treated IPPSFs was lower than that of the controls and a variation in the
      vascular resistance profiles was seen in all the treated flaps. Radiotracer
      studies indicated that a majority of the compound remained on top of the
      application site and minimal absorption or penetration into skin was observed.
      Thus, at high concentrations and prolonged exposure, paraquat may have
      deleterious effects on epidermal morphology in the absence of significant
      percutaneous absorption.

PMID- 1631900
TI  - p-aminophenol nephrotoxicity: biosynthesis of toxic glutathione conjugates.
AB  - p-Aminophenol causes necrosis of the pars recta of the proximal tubules in rats,
      and its nephrotoxicity may be due to glutathione-dependent bioactivation
      reactions. We have investigated the hepatic metabolism of p-aminophenol in Wistar
      rats and the cytotoxicity of formed glutathione S-conjugates in rat renal
      epithelial cells. After ip application of p-aminophenol (100 mg/kg), the
      following metabolites were identified in rat bile: 4-amino-2-(glutathion-S
      yl)phenol, 4-amino-3-(glutathion-S-yl)-phenol, 4-amino-2,5-bis(glutathion-S
      yl)phenol, 4-amino-2,3,5(or 6)-tris(glutathion-S-yl)phenol, an aminophenol
      conjugate (likely a sulfate or glucuronide), acetaminophen glucuronide, and 3
      (glutathion-S-yl)acetaminophen. 4-Amino-3-(glutathion-S-yl)phenol, 4-amino-2,5
      bis(glutathion-S-yl)phenol, and 4-amino-2,3,5(or 6)-tris(glutathion-S-yl)phenol
      induced a dose- and time-dependent loss of cell viability in rat kidney cortical
      cells. Cell killing was significantly reduced by inhibition of gamma-glutamyl
      transpeptidase with Acivicin. p-Aminophenol was also toxic to renal epithelial
      cells. Coincubation of p-aminophenol with tetraethylammonium bromide, a
      competitive inhibitor of the organic cation transporter, and with SKF-525A, an
      inhibitor of cytochrome P450, protected cells from p-aminophenol-induced
      toxicity. p-Aminophenol would thus be accumulated in the kidney mainly by organic
      cation transport systems, which are concentrated in the S-1 segment of the
      proximal tubule. However, p-aminophenol toxicity in vivo is directed toward the S
      2 and S-3 segments, which are rich in gamma-glutamyl transpeptidase. These
      results and the observation that biliary cannulation and glutathione depletion
      reduce p-aminophenol nephrotoxicity suggest that the biosynthesis of toxic
      glutathione conjugates is responsible for p-aminophenol nephrotoxicity in vivo.
      The aminophenol glutathione S-conjugates formed induce p-aminophenol
      nephrotoxicity by a pathway dependent on gamma-glutamyl transpeptidase.

PMID- 1631901
TI  - The hepatotoxicity of chloroform in precision-cut rat liver slices.
AB  - Chloroform hepatotoxicity was investigated in precision-cut liver slices from
      male Sprague-Dawley rats pretreated with phenobarbital to predispose animals to
      CHCl3 intoxication. Liver slices were exposed to 0.2, 0.5 and 1.0 mM chloroform
      for a total of 9 h in a roller culture system. Intracellular K+ loss was found to
      be concentration- and time-dependent over the duration of the experiment.
      Histopathological changes were also evident. Glucose 6-phosphate dehydrogenase
      and beta-glucuronidase were significantly decreased at 3 h relative to controls
      where a loss of 61% and 36% occurred, respectively. Enzyme levels of alanine
      aminotransferase and lactate dehydrogenase, both found predominantly in
      periportal hepatocytes, remained identical to controls over the duration of the
      experiment. A significant time-dependent depletion of glutathione occurred as
      early as 3 h following the administration of 0.5 mM chloroform. Mitochondrial
      viability, measured by the reduction of a specific dye, was significantly lower
      than controls in treated slices at 6 h following chloroform administration.
      Precision-cut liver slices appear to be especially useful for the biochemical and
      histopathological examination of site-specific hepatotoxicants such as CHCl3.

PMID- 1631902
TI  - Methylamine metabolism to formaldehyde by vascular semicarbazide-sensitive amine
      oxidase.
AB  - The capacity of the vascular enzyme, semicarbazide-sensitive amine oxidase
      (SSAO), to metabolize methylamine to the potentially toxic product, formaldehyde,
      was tested using rat aortic homogenates and purified porcine aortic SSAO.
      Formaldehyde production in incubations of enzyme source with methylamine (1 mM)
      was detected by high performance liquid chromatography and product was confirmed
      by desorption chemical ionization mass spectrometry (DCI-MS). Inhibitor studies
      using the specific SSAO inhibitor semicarbazide and the monoamine oxidase
      inhibitor pargyline indicate that SSAO is responsible for metabolism of
      methylamine to formaldehyde. These results suggest the possibility that elevated
      methylamine found in several pathologic states (such as uremia and diabetes
      mellitus), or generated from exogenous sources, could result in overproduction of
      formaldehyde in tissues with high SSAO activity, especially blood vessels.

PMID- 1631903
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 (Karvinskia humboldtiana) using primary
      cultures of rat hepatocytes and keratinocytes. Cell cultures were exposed to 6,
      12, 25 and 50 microM concentrations of the 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- 1631904
TI  - Actin filament alteration as a potential marker for cholestasis: a study in
      isolated rat hepatocyte couplets.
AB  - It has been suggested that modification of the pericanalicular microfilament
      network (F-actin) plays a role in cholestasis. The purposes of this study were to
      assess (i) the process of F-actin network reorganization in isolated rat
      hepatocyte couplets (IRHC) in order to define the optimal study conditions in
      this model, (ii) the effect of cholestatic and hepatotoxic but non-cholestatic
      compounds on F-actin distribution in IRHC. F-actin was stained with fluorescein
      isothiocyanate phalloidin and fluorimetric measurements were performed in single
      couplets using a scanning laser cytometer, ACAS 570. F-actin distribution was
      assessed by the ratio of canalicular area fluorescence/total couplet fluorescence
      (CF/TF). The organization of the F-actin filaments was restored in IRHC 3-6 h
      after plating. At non-cytotoxic concentrations, most cholestatic compounds
      induced a significant accumulation of F-actin around the bile canaliculus as
      indicated by increased fluorescence in the pericanalicular area and by the
      increased CF/TF ratio as compared to the controls. This accumulation could be a
      consequence of an inhibition of F-actin depolymerization or a higher organization
      of actin (redistribution, bundling or reorientation). Hepatotoxic but non
      cholestatic compounds did not induce any change in pericanalicular F-actin.
      Abnormalities of pericanalicular F-actin therefore appear to be a specific marker
      of hepatocellular cholestasis.

PMID- 1631905
TI  - Formation and identification of protein adducts to cytosolic proteins in guinea
      pig liver slices exposed to halothane.
AB  - The anesthetic halothane can be bioactivated to the reactive intermediate,
      trifluoroacetyl chloride, which can covalently bind to liver protein. The product
      of this reaction is trifluoroacetyl-N-epsilon-lysine which can act as a foreign
      epitope in altering both protein immunogenicity and antigenicity. An in vitro
      liver slice system was used to study the formation of protein adducts following
      exposure to halothane. Liver slices (30-35 mg wet weight, 250-300 microns thick)
      from adult male Hartley guinea pigs (600-800 g) were exposed to [14C]halothane
      (0.6-0.9 microCi, 1.0-1.7 mM) in 95% O2/5% CO2 for 1, 6 and 12 h. The slices were
      homogenized and subcellular fractions prepared. Proteins were resolved by
      electrophoresis and bound radioactivity was detected by scintillation counting
      and autoradiography. Greater than 80% of detectable radioactivity to whole liver
      cell protein was localized in the 20-30-kDa range and increased in a linear
      fashion over the 12-h incubation period. Covalent binding was localized to two
      proteins of 27 kDa and 26 kDa present in the cytosolic compartment. Purification
      followed by N-terminal amino acid sequence analysis of the 27-kDa protein has
      identified it to be homologous with glutathione-S-transferase b. This cytosolic
      protein appears to be the major target for trifluoroacetylation in liver slices
      exposed to halothane.

PMID- 1631906
TI  - Inhibition of protein synthesis in liver and kidney of mice by bolesatine:
      mechanistic approaches to the mode of action at the molecular level.
AB  - Protein synthesis was assayed in liver and kidney of mice treated with
      bolesatine, a toxic glycoprotein from the mushroom Boletus satanas (Lenz) which
      was previously shown to be an inhibitor of protein synthesis by cell-free systems
      in vitro and by cultured cell-lines. Protein synthesis in vivo (Swiss mice) is
      inhibited in a dose-dependent manner in liver and kidney. The mechanism of action
      does not appear to be due to RNA-N-glycosidase activity of bolesatine or a RNAase
      activity of this toxin on the ribosomal RNAs. Ribosomes do not appear to be
      damaged by pretreatment with bolesatine as judged by a poly(U) translation
      system. Thus bolesatine cannot be included in the group of protein synthesis
      inhibitors of plant origin known as ribosome-inactivating proteins (RIPs).

PMID- 1631907
TI  - Host resistance to Trichinella spiralis infection in rats and mice: species
      dependent effects of cyclophosphamide exposure.
AB  - Host resistance to Trichinella spiralis infection was compared in male rats
      (F344) and female mice (C57BL/6J) following various cyclophosphamide (CY)
      treatment schedules. Doses of CY given to mice were adjusted by body surface area
      to be comparable to rat doses. Adult parasite elimination was not affected by
      oral administration of 1.5, 3 or 6 mg CY/kg per day to rats or 1.05, 2.1 or 4.2
      mg CY/kg per day to mice for 10 days. In rats, resistance was suppressed by a
      single oral dose of 80 mg/kg given the day prior to infection, but was not
      affected at 20 or 40 mg/kg. A single oral dose of 14, 28 or 56 mg CY/kg did not
      affect parasite expulsion in mice. Rats were also given four daily
      intraperitoneal (i.p.) injections of 20, 40 or 80 mg CY/kg per day and mice
      received 14, 28 or 56 mg CY/kg per day. Infected rats did not survive at the two
      higher dose levels and parasite expulsion was suppressed at 20 mg/kg per day;
      parasite expulsion was suppressed in mice by four i.p. injections of 56 mg CY/kg
      per day, but not by lower doses. In rats, doses of CY which suppressed adult
      parasite expulsion also severely suppressed the proliferative response of
      mesenteric lymph node cells (MLNC) to an extract of T. spiralis (TsE). However,
      significant suppression of TsE-driven blastogenesis occurred at a dose of CY
      which did not affect parasite expulsion, indicating that the proliferative
      response in rats was more sensitive to suppression than actual parasite
      elimination. In contrast, the proliferative response to the T cell mitogen
      concanavalin A was elevated in the MLNC of CY-exposed rats. This was determined
      to be related to the interval between CY dosing and the day of assay rather than
      to an effect of infection with T. spiralis. Mouse MLNC proliferative responses to
      TsE were not suppressed by CY treatment, even at levels of CY which suppressed
      adult parasite expulsion. Mice differed from rats in that CY exposure did not
      affect the proliferative response to concanavalin A in infected animals. The
      species-dependent differences observed in these studies may have been secondary
      to the greater sensitivity of rats to CY. Nonetheless, these results highlight
      the potential for species-specific responses to chemical exposure and underscore
      the need for additional comparative studies of host resistance in rats and mice.

PMID- 1631908
TI  - [Anatomy and revolution of the human image].
AB  - In Bourgery's and Jacob's "Traite complet de l'anatomie de l'homme", Paris 1831
      1854, the revolution Davidienne had been introduced into the plates of anatomical
      atlasses. Unlike the Vesalian tradition of representation this demarcation
      against an old world provided a new picture of man in medical illustration. The
      cultural development taking us to this point is discussed against the background
      of converging movements in art and medicine in late 18th century France evolving
      sovereign man as a modern individual.

PMID- 1631909
TI  - [Karl Sudhoff and medical history sources. A contribution to his collections and
      exhibits].

PMID- 1631910
TI  - [The medical journal of Hans Kehr (1862-1916) from 1905 to 1910 as a medical
      history document].

PMID- 1631911
TI  - Asaph's 'book of remedies': Greek science and Jewish apologetics.

PMID- 1631912
TI  - [Anorexia nervosa in German medical literature 1900 to 1945. The role of anorexia
      nervosa in the origin of psychosomatic medicine].
AB  - German-language publications on anorexia nervosa and Simmonds' disease from
      between 1900 and 1945 are reviewed in order to trace factors inherent in medical
      thinking which have mostly hindered German-language medicine in understanding
      anorexia nervosa. It is demonstrated that a) the few German-language physicians
      who did describe central and possible characteristics of a.n. (weight-phobia,
      overactivity, bulimia, self-induced vomiting) were enabled to do so by valuing
      detailed clinical description, also of psychic characteristics, and an interest
      in the neuroses; b) the concept of anorexia nervosa was better known than
      previously assumed, though largely misunderstood; c) typical diagnostic
      misinterpretations led to typical biases in the description of the syndrome; d)
      in Germany more than in other countries a.n. was confounded with Simmonds'
      disease; and e) in addition to other factors, one reason for this lay in the
      'holistic' ideal of psychosomatic medicine in the 1930s.

PMID- 1631913
TI  - [Petrarca and the plague].
AB  - The author presents a synopsis of Petrarch's reflections and experiences during
      the plague of 1348 and the following alterations in Italian society. The great
      humanist and celebrated poet was an excellent observer of the reactions of his
      contemporaries and the various cultural and moral consequences of the "Black
      Death" catastrophe. He feels deep desperation but emphasizes stoic acceptance of
      fate and Christian humility. His letters concerning plague and death are
      impressive documents of the "interior life" of European intellectuals in
      midfourteenth century. They reveal the helplessness of scholastic medical doctors
      and the crisis of contemporary medicine.

PMID- 1631914
TI  - Treating the Grail King: astrology and medicine in book XVI of Wolfram's
      "Parzival".

PMID- 1631915
TI  - ['Physica' of Hildegard von Bingen as a source for the 'Kochbuch Meister
      Eberhards'].
AB  - In this article a previously unknown fragment of Saint Hildegards 'Physica' is
      added to the list of extant manuscripts. Extracts from three books of the
      'Physica' ("De Plantis", "De Piscibus", and "De Avibus") were found to be
      incorporated in a late-medieval German cookbook, the 'Kochbuch Meister
      Eberhards'. While the German sources for the cookbook, such as the 'Regel der
      Gesundheit' and the 'Breslauer Arzneibuch' have been known for some time, the
      Latin parts have traditionally been neglected by scholars. Neither were they
      included in the 1963-edition of the cookbook nor studied in any detail in the
      past. The discovery of the 'Physica' as their source provides us with new
      insights into Eberhard's compiler-work and the literature which was available to
      him, as well as the reception of Hildegard's medical writings in the fifteenth
      century.

PMID- 1631916
TI  - [Sudhoff's viewpoint of ancient medicine].
AB  - Sudhoff's views of the tasks of medical historians in the field of the history of
      ancient medicine were influenced by the contemporary controversy between
      classical philologists and medical historians about their competence. On the one
      hand Sudhoff thought the philologic historical method to be the appropriate one
      for the investigation of the history of ancient medicine, on the other hand he
      did not think it to be indispensable for the medical historians. Their main task
      was in his eyes to publish new items from archaeological and literary sources, as
      he himself did.

PMID- 1631917
TI  - The case for local immunosuppression.

PMID- 1631918
TI  - A decrease in graft-vs.-host disease without loss of graft-vs.-leukemia
      reactivity after MHC-matched bone marrow transplantation by selective depletion
      of donor NK cells in vivo.
AB  - It is thought that natural killer cells may play a role in graft-vs.-host
      reactions after allogeneic bone marrow transplantation, but the use of NK cell
      specific reagents has been limited. In this report, an NK allele-specific
      monoclonal antibody, anti-NK 1.1, was used to study the impact of in vivo donor
      NK cell depletion on GVH disease, graft-vs.-leukemia (GVL) reactivity and donor T
      cell chimerism after allogeneic murine BMT. AKR/J (H-2k) recipient mice were
      preconditioned with suboptimal irradiation (9 Gy = LD50) and transplanted with
      major histocompatibility complex-matched B10.BR (H-2k) BM cells with or without
      added spleen cells as a source of T cells. The addition of increasing numbers of
      spleen cells to the BM inoculum produced GVHD of varying intensities. The
      beneficial effect of NK depletion on GVHD was dependent on the intensity of the
      GVH reaction. Donor NK cell depletion had no effect on the survival of mice with
      severe GVHD after MHC-matched BMT (B10.BR into AKR) or after MHC-mismatched BMT
      (B10.BR into DBA/2; H-2k into H-2d). However, donor NK depletion increased
      survival of AKR hosts given sufficient B10.BR splenic T cells to induce mild-to
      moderate GVHD. Ex vivo depletion of donor CD8+ T cells also reduced GVH
      associated mortality, but the use of both CD8 and NK depletion offered no
      improvement over either alone, suggesting an interaction between CD8+ and NK 1.1+
      cells. In contrast to CD8 depletion, donor NK depletion did not compromise the
      rapid and complete establishment of donor T cell chimerism nor the ability of
      chimeras to mount an effective GVL reaction. Thus, elimination of donor NK cells
      provides an alternate strategy for reducing GVHD without loss of GVL reactivity
      following MHC-matched allogeneic BMT.

PMID- 1631919
TI  - Suppression of anti-skin-allograft response by photodamaged effector cells--the
      modulating effects of prednisolone and cyclophosphamide.
AB  - Using a murine model of skin allotransplantation, we have demonstrated previously
      that inhibition of specific response to alloantigen is inducible by immunization
      of the host with intravenously administered photoinactivated antigraft effector T
      cells. This hyporesponsiveness, which was demonstrated by specific inhibition of
      mixed leukocyte culture (MLC), inhibition of cytotoxic T lympholysis (CTL),
      specific suppression of the delayed type hypersensitivity (DTH) response, and
      prolongation of specific skin allograft survival, was adoptively transferable by
      CD8+ radiosensitive T lymphocytes. In this study, we extend those results to
      evaluate the effects of an immunosuppressive agent (prednisolone) and an
      alkylating drug (cyclophosphamide) on the induction of this specific suppressive
      cellular response. Our results reveal that the administration of prednisolone
      reduces the induction of the specific hyporesponsiveness to alloantigen, as
      demonstrated by maintenance of the DTH response to alloantigen and continued
      accelerated rejection of skin allografts. In contrast, the administration of
      cyclophosphamide augmented this specific suppressive response to alloantigen in
      the DTH assay and in prolongation of specific skin allograft survival. These
      results indicate that adjuvant immunomodulating chemotherapy alters the immune
      response to photoinactivated effector T cells.

PMID- 1631920
TI  - A canine model for hepatic venoocclusive disease.
AB  - Hepatic venoocclusive disease is a frequent lethal complication of bone marrow
      transplantation. It has also been associated with hepatic irradiation and
      administration of chemotherapeutic agents without BMT. The pathogenesis and
      therapy of VOD are unclear. The present studies were directed at developing a
      canine model for VOD. Three groups of dogs were studied. Group one consisted of 8
      dogs in which monocrotaline (MC) was administered at 125 mg/kg orally on an
      intermittent schedule. In 7 of the 8 dogs 6 to 9 doses of drug were administered
      between 42 and 110 days. Group 2 consisted of 6 dogs receiving busulfan 2
      mg/kg/day for 17-25 days, when platelet counts decreased to less than 5 x
      10(4)/mm3 or clinical bleeding occurred. Group 3 consisted of 2 dogs receiving 24
      Gy and 4 dogs receiving 36 Gy of whole-liver irradiation. Seven of 8 dogs in
      group 1 developed significant liver function abnormalities and evidence of portal
      hypertension. Histologic findings of VOD were present at autopsy. Group 2 dogs
      failed to develop clinical or laboratory liver abnormalities, but 3 of 6 animals
      had minimal histologic evidence of VOD. Three of 6 dogs in group 3 receiving 36
      Gy developed hepatic dysfunction and had findings of fibrosis at autopsy. It was
      concluded that MC administration produced consistent clinical and histologic
      features of VOD in dogs. Changes occurring after busulfan or total-liver
      irradiation administration were less reproducible. Dogs are a suitable large
      animal model for studies of VOD.

PMID- 1631921
TI  - Rapid and long-term changes to host cytotoxic T lymphocyte precursors reactive to
      donor antigens caused by intravenous injection of histoincompatible lymphocytes.
AB  - It has been shown previously that a single intravenous injection of mouse F1 LNC
      into either parent results in a rapid reduction in the ability of the recipient
      to generate CTL reactive against donor antigens in an in vitro MLR. The
      underlying mechanism appears to be the inactivation of host CTL precursors that
      can recognize donor lymphocytes that have entered the recirculating pool. The
      donor lymphocytes may be acting as functionally deleting APC, or veto cells.
      Here, we have injected C57BL/6 (B6) mice with (C57BL/6 x DBA/2) F1 (F1) LNC. The
      CTL response against donor LNC was maximally reduced by 2 days and stayed reduced
      for at least 6 weeks, but ultimately recovered to normal levels. The response
      reduction mechanism remained operative during the period when the response was
      reduced: Fresh FITC-labeled B6 LNC introduced into B6 recipients of an earlier
      injection of F1 LNC were as effectively deleted of F1-reactive CTLp as the
      original host B6 LNC population, the fresh FITC-labelled B6 LNC being separated
      from host B6 LNC by cell sorting before testing. When B6 mice injected with F1
      LNC ultimately recovered their response against F1 donor antigens, reinjection of
      F1 LNC did not induce a new response reduction. Instead of entering the
      recirculating pool, the injected F1 cells were rapidly removed by a specific
      immune process.

PMID- 1631922
TI  - The effects of donor-specific blood transfusion enhancement of rat renal
      allografts on host NK cell responses.
AB  - Donor-specific blood transfusion (DSBT) given 1-2 weeks prior to transplantation
      prolongs the survival of fully allogeneic ACI (RT1a) renal allografts in PVG
      (RT1c) recipients from 6-8 days to greater than 100 days. We have previously
      demonstrated that ACI kidneys transplanted to autologous blood transfusion (ABT)-
      or DSBT-pretreated PVG recipients stimulated an increase in CD8+ (OX8+) cells in
      the peripheral blood by 6 days after transplantation. To determine whether this
      increase represents a general expansion of the entire CD8+ population or only a
      subpopulation of CD8+ cells, subset analysis was performed on peripheral blood
      lymphocytes depleted of cells reactive with monoclonal antibodies against rat
      alpha beta T cell receptor (TCR), CD8, or NK cells (R7.3, OX8, or 3.2.3,
      respectively). Phenotypic studies of PBL depleted of CD8+ cells demonstrated that
      all 3.2.3+ NK cells coexpressed CD8; depletion of 3.2.3+ PBL revealed a second
      subpopulation of CD8+3.2.3- cells comprised predominantly of alpha beta TCR+ T
      cells. In naive PVG rats the prevalence of these two CD8+ subpopulations was
      approximately equal. Both ABT- and DSBT-pretreated renal allograft recipients
      demonstrated a significant and equivalent expansion of the CD8+ cell
      subpopulation that coexpresses the 3.2.3 NK marker. In contrast, the second
      subpopulation of CD8+3.2.3- cells did not change significantly after
      allografting. There were also no differences between DSBT and ABT pretreated rats
      in activity of PBL against the NK targets YAC-1 and Doxie at 6 days after renal
      transplantation, though the level of activity was modestly increased compared
      with naive controls. These findings indicate that renal transplantation in the
      rat is associated with a significant increase in PBL with the NK phenotype
      (CD8+3.2.3+) and a modest increase of NK activity, but that DSBT enhancement does
      not affect this NK cell response.

PMID- 1631923
TI  - Prevention of acute lethal graft-versus-host disease in F1 hybrid mice by
      pretreatment of the graft with anti-NK-1.1 and complement.
AB  - We studied the effect of depleting NK1.1+ cells from an allograft of lymph node
      and spleen cells on the outcome of GVH disease in the parent----F1-hybrid
      combination C57BL/6----(C57BL/6xDBA/2)F1. Four treatment groups were established:
      group I mice were transplanted with an unmodified graft from normal donors; group
      II mice were transplanted with an NK1.1-depleted graft that had been harvested
      from normal donors; group III mice received grafts from donors that had been
      injected with Poly I:C (100 micrograms i.p.) 18 hr prior to harvesting (These
      grafts were incubated with complement, but no antibody.); group IV mice were
      transplanted with depleted grafts harvested from donors that had received Poly
      I:C. Recipients in each group were monitored for splenomegaly, mitogen
      responsiveness, NK and CTL activity, histopathology, weight loss, and mortality.
      Results showed that recipients in all four groups developed splenomegaly and
      unresponsiveness to LPS, PHA, and Con A by day 12. Augmented host-derived NK
      activity and graft-derived antihost CTL activity was also demonstrated. Group IV
      showed little or no weight loss, minimal histopathological changes and a marked
      reduction in mortality. Recipients in all other groups developed features
      characteristic of GVH disease and exhibited a steady decline in body weight
      beginning by day 12. Mortality generally began on day 18 and reached 75-90% by
      day 60. We postulate that anti-NK1.1 depletes cells from the graft are intimately
      connected with the effector mechanism in acute GVH disease.

PMID- 1631924
TI  - Factors contributing to long-term kidney graft survival in Eurotransplant.
AB  - We examined the graft survival of 12,883 first unrelated kidney grafts from
      nonliving donors, transplanted between 1 January 1971 and 31 December 1987 within
      52 renal transplantation centers participating in the Eurotransplant
      organization. The 5-year graft survival increased from 38.8% for the period 1971
      1975 to 66.0% for the period 1981-1987 for patients treated with cyclosporine,
      whereas the half-life increased by only 2 years, from 9.7 years to 11.6 years
      over the same period, based on grafts functioning at 1 year posttransplantation.
      Results per HLA locus showed considerable improvements within mismatch groups
      over the entire period. Large differences between mismatch groups for the early
      years were observed, but within the cyclosporine era only HLA-B showed a
      statistically significant difference in half-lives (13.2 versus 9.0 years, for 0
      and 2 mismatches respectively, P = 0.013). When other prognostic factors were
      taken into account, it was revealed by means of an exponential model that number
      of HLA-B mismatches, donor and recipient age and sex, and recipient diagnosis of
      diabetes had significant effects on the long-term outcome of the grafts.
      Depending on the combination of these parameters, estimates of half-life varied
      from 4.9 to 14.5 years. These results show that matching for HLA-B is still of
      benefit in the longer term and that other prognostic factors play an important
      role in predicting the late outcome of renal allografts.

PMID- 1631925
TI  - Successful renal transplantation after cyclosporine-associated hemolytic-uremic
      syndrome following bilateral lung transplantation.

PMID- 1631926
TI  - Reinstitution of immunosuppression in a renal transplant recipient after
      remission of Kaposi's sarcoma.

PMID- 1631927
TI  - Use of indomethacin to minimize the adverse reactions associated with orthoclone
      OKT3 treatment of kidney allograft rejection.

PMID- 1631928
TI  - Prevalence of dyslipidemia in liver transplant recipients.

PMID- 1631929
TI  - Differential effects of preexisting uremia and a synchronous kidney graft on
      pancreas allograft functional survival in rats.
AB  - Pancreas transplant results have been better in uremic recipients of a
      simultaneous kidney than in nonuremic recipients of a pancreas alone. We studied
      the relative effect of uremia versus a double transplant on functional survival
      by performing bladder-drained pancreas transplants alone (PTA), kidney
      transplants alone (KTA), and simultaneous pancreas/kidney (SPK) transplants from
      Buffalo donors to diabetic Lewis rat recipients that were or were not made uremic
      2-3 weeks before by 1 4/5 native nephrectomy. Pancreas graft exocrine function
      was monitored by urinary amylase (UA). In the PTA and SPK recipients made
      diabetic by streptozotocin, endocrine function was monitored by measuring
      nonfasting plasma glucose (PG) levels. Kidney graft function was monitored by
      plasma creatinine (Cr). Rejection of the endocrine pancreas was defined as an
      increase of PG to greater than 200 mg/dl; of the exocrine pancreas, as a decline
      in UA to less than 6000 U/L or to less than 100 U/24 hr; and of the kidney, as an
      elevation of Cr to greater than 3 mg/dl. The mean functional survival times (MST)
      of both the endocrine (12.0 +/- 2.1 versus 10.1 +/- 1.1 days, P = 0.036) and
      exocrine (8.0 +/- 2.1 versus 6.3 +/- 1.3 days, P = 0.016) components of the
      pancreas grafts were significantly longer in SPK than in PTA recipients. The MST
      of kidney allografts, however, was not significantly longer in nonuremic SPK than
      nonuremic KTA recipients (6.7 +/- 1.4 versus 5.7 +/- 0.7 days, P = 0.13). In
      parallel experiments in recipients immunosuppressed with cyclosporine, the graft
      survival times were longer, but the relative differences between the PTA, SPK,
      and KTA groups persisted. Histologically, lymphocyte infiltration began in the
      two organs almost simultaneously, but the severity of the rejection was more
      vigorous in the kidney than in the pancreas in doubly grafted rats, and
      destruction of pancreas grafts progressed more slowly in SPK than in PTA
      recipients. Preexisting uremia delayed pancreas rejection in both SPK (exocrine
      10.6 +/- 2.3, P = 0.032, and endocrine 14.8 +/- 3.4 days, P = 0.065, versus
      nonuremics) and PTA (exocrine 8.5 +/- 1.7, P = 0.007, and endocrine 12.6 +/- 2.5,
      P = 0.026, versus nonuremics) nonimmunosuppressed recipients. The MST of kidney
      grafts was not significantly longer in uremic (8.9 +/- 2.8 days) than in
      nonuremic (6.7 +/- 1.4 days) SPK recipients (P = 0.081). A synchronous kidney
      transplant and uremia independently down-modulate the rejection response to a
      pancreas graft, and a simultaneous pancreas graft has no detrimental effect on
      the survival of a kidney graft.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1631930
TI  - Relevance of the nutritional status of donors in viability of transplanted
      hepatic allografts.

PMID- 1631931
TI  - Intraoperative color Doppler ultrasonography for partial-liver transplantation
      from the living donor in pediatric patients.

PMID- 1631932
TI  - Oxygen free radical-mediated lipid peroxidation injury in acute cardiac allograft
      rejection.

PMID- 1631933
TI  - A modified vascular "sleeve" anastomosis for rearterialization in orthotopic
      liver transplantation in rats.

PMID- 1631934
TI  - The role of reduced glutathione in heart preservation using a polyethylene glycol
      solution, Cardiosol.

PMID- 1631935
TI  - Protection of pig liver against normothermic ischemia by immunosuppressants
      cyclosporine and azathioprine.

PMID- 1631936
TI  - Tissue-specific differentiation of a natural killer cell subset in ectopically
      grafted murine uterine tissue.

PMID- 1631937
TI  - Prolongation of skin allograft survival in mice by didemnin B.

PMID- 1631938
TI  - The effect of transplanting donor spleen with an organ allograft.

PMID- 1631939
TI  - The combi-effect with regard to pancreas grafts that include the donor spleen.

PMID- 1631940
TI  - Evidence that 15-deoxyspergualin inhibits natural antibody production but fails
      to prevent hyperacute rejection in a discordant xenograft model.
AB  - Preventing hyperacute rejection (HAR) is a difficult and unsolved problem in
      xenotransplantation. This may be due, in part, to a lack of therapies that can
      suppress production of natural antibodies (NA), which are thought to be critical
      mediators of HAR. This study examined the effect of 15-deoxyspergualin (DSPG) and
      splenectomy (Spx) on NA production and return of NA after plasma exchange (PE) in
      a discordant species combination (strain 2 guinea pig to Lewis rat). A dose of 5
      mg/kg/day DSPG + Spx significantly reduced Lewis rat anti-guinea pig NA titer
      after one week of therapy. Antibody titer was not significantly reduced in rats
      treated with splenectomy alone. PE alone acutely depleted NA titers; however,
      complete rebound was seen in 48 hr. When PE was performed in rats treated with
      DSPG + Spx, an additional significant NA reduction occurred; no rebound 24-48 hr
      after PE was seen. Except for a 20% reduction in body weight, no serious
      complications occurred in DSPG + Spx recipients. Despite a profound NA titer
      reduction, treatment with DSPG, Spx, and PE did not prolong guinea pig cardiac
      xenograft survival in a clinically significant fashion. Immunopathological study
      of rejected cardiac xenografts revealed no antibody deposition but persistent
      complement deposition on vascular endothelium. We conclude that DSPG + Spx
      effectively inhibits synthesis of rat anti-guinea pig NA, that further NA titer
      reduction can be achieved with the addition of PE, and that DSPG + Spx prevents
      post-PE antibody rebound. We also conclude that the limited prolongation in
      cardiac xenograft survival achieved, despite marked suppression of NA, supports a
      complement-mediated mechanism of HAR in our animal model.

PMID- 1631941
TI  - The role of ultraviolet B-irradiated leukocyte transfusions and cyclosporine in
      intestinal transplantation.
AB  - To explore the efficacy of ultraviolet B-irradiated donor-specific leukocyte
      transfusions (UV-DSLT) with short-term cyclosporine to control intestinal
      allograft rejection, 75 adult Lewis (RT1l) rats underwent total small-intestinal
      transplantation from Brown-Norway (RT1n) donors. Recipients were randomly divided
      into ten treatment and control groups utilizing various combinations of donor
      specific and third-party (Wistar-Furth, RT1u) leukocyte transfusions (TPLT), with
      or without transfusion UVB irradiation, and either alone or in combination with
      short-term cyclosporine administration (5 mg/kg intramuscularly on days -7, 0, 1,
      and 2 relative to transplantation). Leukocytes (10(8) cells) separated from a
      spleen cell suspension were infused on day -7. Certain transfused leukocytes were
      treated with 12,000 joules/m2 of UVB irradiation. Groups were monitored for mean
      survival time (MST) and cause of death. UV-DSLT alone (MST = 19.8 +/- 4.6) or in
      combination with cyclosporine (UV-DSLT+CsA, MST = 53.1 +/- 22.5) significantly (P
      less than 0.003-0.0002, Mantel-Cox) prolonged recipient survival when compared
      with appropriate controls (i.e., no treatment, MST = 11.2 +/- 3.4; CsA, MST =
      17.2 +/- 9.0; UV-TPLT, MST = 12.4 +/- 4.0; and UV-TPLT+CsA, MST = 25.1 +/- 9.7)
      No significant increase in graft-versus-host disease occurred in any group, with
      85% (64/75) of the recipients dying of acute rejection. Conversely, the UV
      DSLT+CsA group had a significant increase (9/11; chi-square, P less than 0.0001)
      in chronic rejection. Because UV-DSLT+CsA improved survival as compared with
      third-party controls, a limited donor-specific unresponsiveness may have been
      induced. Furthermore, this treatment produces a consistent, chronic rejection
      rodent intestinal allograft model.

PMID- 1631942
TI  - Patterns of corneal graft rejection in the rabbit and reversal of rejection with
      monoclonal antibodies.
AB  - The purpose of this study was to determine whether the local administration of
      monoclonal antibodies could reverse rabbit corneal graft rejection. To provide a
      rational basis for the choice of monoclonal antibodies as potential
      immunosuppressive agents, the phenotypes of cells infiltrating rejecting rabbit
      corneal allografts were examined by immunohistochemistry. About half the
      leukocytes accumulating in these grafts bore an immunodominant T cell marker,
      over two-thirds carried MHC class II antigens, and about one-fifth carried
      myeloid cell markers. A kinetic study of the cell population appearing in rabbit
      aqueous during corneal graft rejection was performed by examination of repetitive
      anterior chamber taps taken over a ten-day period; again, the major components
      were T cells, MHC class II antigen-positive cells and myeloid cells. Monoclonal
      antibodies L11/135 (directed against a peripheral T cell determinant), 2C4
      (directed against a monomorphic MHC class II antigen), and LION 2 (directed
      against a myeloid antigen) were chosen for intracameral injection into rabbits
      with rejecting corneal grafts. Each animal received a total of 50-100 micrograms
      of antibody in two injections at 3-4-day intervals. L11/135 and LION 2 reversed
      rejection in 5/9 and 8/12 animals, respectively, in the absence of any other
      immunosuppression; 2C4 was without effect. We suggest that monoclonal antibody
      therapy in corneal transplantation deserves further attention.

PMID- 1631943
TI  - Beneficial effect of combined 3,5,3'-triiodothyronine and vasopressin
      administration of hepatic energy status and systemic hemodynamics after brain
      death.
AB  - The influence of combined replenishment of L-3,5,3'-triiodothyronine (T3) and
      vasopressin (antidiuretic hormone [ADH]) on both hepatic metabolism and systemic
      hemodynamics was assessed in brain-dead dogs. Arterial ketone body ratio (AKBR)
      was measured as a parameter of hepatic metabolism, which reflects the redox state
      (free nicotinamide adenine dinucleotide/reduced nicotinamide adenine
      dinucleotide) of liver mitochondria. Mean arterial blood pressure (MAP) was
      significantly decreased from 110.4 +/- 3.8 to 44.4 +/- 1.7 mmHg, at 1 hr after
      completion of brain death (P less than 0.01). In the control group AKBR was
      maintained thereafter at near control value of 1.0 with a significant decrease in
      serum lactate concentration in spite of marked hypotension. T3 infusion at a rate
      of 1 microgram/kg/hr elevated the AKBR but did not elevate MAP. Vasopressin
      infusion at a rate of 0.1 U/kg/hr sustained AKBR and elevated MAP significantly
      at 1 hr after administration but tended to decrease thereafter. Combined
      administration of T3 and ADH elevated the AKBR to about 2.0, and MAP was restored
      to near-normal level. Other parameters such as glutamic oxaloacetic transaminase,
      glutamic pyruvic transaminase, and lactic dehydrogenase, reflecting liver cell
      injury and serum creatinine, and blood urea nitrogen as renal function, were
      maintained within normal range. These results indicate that combined T3 and
      vasopressin administration has a beneficial synergistic effect on both hepatic
      energy metabolism and systemic hemodynamics without any detrimental influence to
      other conventional parameters. Therefore, it is suggested that this combined
      administration may contribute to the management of potential multiorgan donors.

PMID- 1631944
TI  - Sequential therapy--a prospective randomized trial of MALG versus OKT3 for
      prophylactic immunosuppression in cadaver renal allograft recipients.
AB  - We prospectively studied the use of prophylactic Minnesota antilymphocyte
      globulin vs. OKT3 in kidney transplant recipients. Between 7/1/87 and 9/1/90, 138
      adult kidney and 35 kidney-pancreas recipients were randomized after
      stratification for age (18-49 vs. greater than or equal to 50), diabetes
      (diabetic vs. nondiabetic), transplant number (1 vs. greater than 1) and, for
      retransplants, the length of survival of the first graft (less than 1 year vs.
      greater than or equal to 1 year), and then randomized to receive 7 days of either
      MALG (20 mg/kg/day) or OKT3 (5 mg/day). Immunosuppression was otherwise identical
      in both groups; prednisone and azathioprine started on the day of surgery, and
      cyclosporine started on postoperative day 6. Minimum follow-up was 9 months.
      There was no difference in one- and two-year actuarial patient or graft survival
      rates, incidence of rejection, or serum creatinine level. MALG was associated
      with a higher incidence of cytomegalovirus; it was statistically significant in
      the subgroup of CMV seronegative recipients of kidneys from seropositive donors
      (P less than .05). OKT3 was more expensive and was associated with significantly
      more side effects: fever (P less than .0001), dyspnea (P = .04), and acute
      respiratory distress syndrome (ARDS) (P = .02).

PMID- 1631945
TI  - Daily renal hypoperfusion induced by cyclosporine in patients with renal
      transplantation.
AB  - A variety of side effects are associated with the use of cyclosporine, the most
      relevant of which remains the renal toxicity. We did parallel studies on
      cyclosporine pharmacokinetics and renal function in patients who had a recent
      kidney transplant and were given cyclosporine as a part of their
      immunosuppressive therapy. Seven consecutive renal transplant patients were
      studied at the end of a month of treatment while on different oral cyclosporine
      doses (5, 3.5, 2.5, or 1.5 mg/kg, twice a day, respectively). Cyclosporine
      pharmacokinetics profiles and renal function parameters (GFR and renal plasma
      flow [RPF], as inulin and p-amino hippurate clearances, respectively) were
      determined before and over a 12-hr period after each single dose of cyclosporine.
      Plasma levels and urinary excretion rate of endothelin were also studied before
      and after the highest cyclosporine dose (5 mg/kg). Mean trough levels, area under
      the curve values, and maximum concentration of blood cyclosporine were comparable
      after 5 and 3.5 mg/kg cyclosporine and decreased in a dose-dependent manner after
      the lower doses (2.5 and 1.5 mg/kg). In the same patients GFR declined on average
      63%, 53%, 35%, and 18%, 2-4 hr after maximum cyclosporine concentration was
      reached. As blood levels of cyclosporine returned to trough, GFR progressively
      increased to baseline. Similar results were found for RPF; 5 mg/kg cyclosporine
      did not modify endothelin plasma levels. By contrast, urinary excretion of the
      peptide increased significantly (P less than 0.01) in the 6 hr that followed
      cyclosporine administration and returned within the normal range in the
      subsequent 6 hr. Following each oral administration of cyclosporine, 2-4 hr after
      peak blood concentration was reached, patients showed renal hypoperfusion,
      transient and rapidly reversible. This was associated with an increased urinary
      endothelin excretion rate that was also transient. It is speculated that an
      excessive renal synthesis of endothelin is the cause of the daily renal
      hypoperfusion observed in patients with renal transplants given cyclosporine.

PMID- 1631946
TI  - Hyperacute and acute kidney graft rejection due to antibodies against B cells.
AB  - Because of the perception of its uncertain clinical significance, the B cell
      crossmatch is not universally performed before renal transplantation. Even though
      sporadic cases of hyperacute rejection associated with B cell antibodies have
      been reported, doubts remain in light of other studies suggesting no effect on
      graft survival. This report describes 4 cases of graft rejection (3 hyperacute
      and 1 acute) that occurred in patients with anti-B-cell antibodies specific
      against donor HLA-DR or DQ antigens. Absence of anti-donor class I antibodies was
      confirmed in all cases by 2-color flow cytometry. Strong evidence for an antibody
      mediated mechanism was found in one patient with anti-class I and anti-class II
      antibodies in serum transplanted with a class II mismatched kidney. In this case,
      only anti-class II antibodies were recovered in the eluate of the nephrectomy
      specimen. These four cases were compiled from three different institutions over a
      four-year period, which confirms the infrequent occurrence of these events. While
      anti-class II antibodies may not always be detrimental for graft survival, these
      results also confirm that they have the potential to cause hyperacute or acute
      graft loss. We conclude that the information provided by the B cell crossmatch
      should be available at the time that a decision to proceed with a renal
      transplant is made.

PMID- 1631947
TI  - The efficacy and tolerability of cyclosporine G in human kidney transplant
      recipients.
AB  - Twelve consecutive first cadaveric kidney transplant recipients received
      cyclosporine G (CsG)(initial dose 12 mg/kg per day) as basic immunosuppressive
      treatment along with prednisone (initial dose 0.5 mg/kg per day) for the first
      three months after transplantation. Thereafter CsG was replaced by Sandimmun
      (cyclosporine, CsA). Evaluation of the immunosuppressive efficacy and assessment
      of possible side effects of CsG was made and compared with the results in 38
      historical control patients starting with the same dose of CsA as part of the
      same immunosuppressive dosage schedule. Statistically, there was no difference in
      patient survival at three (91% in CsG group versus 95% in CsA group) and twelve
      months (91% in CsG group versus 92% in CsA group), or in graft survival at three
      (75% in CsG group versus 89% in CsA group) and twelve months (75% in CsG group
      versus 84% in the CsA group). At equivalent oral doses of CsG and CsA
      significantly higher blood levels of CsG were observed (2P less than 0.05).
      Nephrotoxicity assessed by graft biopsy could be demonstrated to a similar extent
      in both groups, whereas hepatotoxicity was more pronounced during CsG treatment.
      Sequential measurements of bilirubin revealed a significant increase in all
      patients but median values were significantly higher in the CsG patients. A
      pronounced and concordant elevation of liver enzymes occurred during CsG
      treatment in three out of 12 patients. Liver biopsies performed in these patients
      revealed histological alterations consistent with toxic liver injury. Thus, in
      human kidney transplant recipients CsG and CsA appeared to be equally
      immunosuppressive and nephrotoxic but more hepatotoxic. On the basis of this
      limited experience we conclude that in human kidney transplant recipients CsG has
      no advantage over CsA.

PMID- 1631948
TI  - Renal hemodynamics, urinary eicosanoids, and endothelin after liver
      transplantation.
AB  - Patients with hepatic cirrhosis develop widespread abnormalities in kidney
      function and vasoactive hormones. These change rapidly after liver
      transplantation during immunosuppression with cyclosporine. The role of changing
      eicosanoid excretion and endothelin levels in regulating renal function after
      transplantation in humans remains uncertain. We studied 32 patients with regard
      to renal hemodynamics, glomerular filtration, urinary prostacyclin (6-keto-PG-F1
      alpha), thromboxane (TBX2), and endothelin before and during the first four weeks
      after orthotopic liver transplantation. Arterial pressure rose from 106 +/- 2/61
      +/- 2 to 146 +/- 4/81 +/- 2 mmHg, (P less than .001), while renal blood flow fell
      (686 +/- 38 to 453 +/- 24 ml/min/1.73 m2, P less than .05), as did GFR.
      Pretransplant excretion of 6-keto and TBX2 was above that of normal subjects and
      fell progressively after transplant, as did plasma renin activity and
      aldosterone. The 6-keto levels fell below normal after two weeks. The ratio of
      TBX2/6-keto remained elevated compared with normal subjects throughout the month
      after transplant (1.54 +/- 0.38 vs. 0.54 +/- 0.07, P less than .01). Endothelin
      levels rose during the first week (7.4 +/- 1.4 vs. 12.4 +/- 2.7 pg/ml, P less
      than .05), but fell back to baseline thereafter. These results indicate that high
      levels of urinary eicosanoids in patients with liver disease fall rapidly after
      liver transplantation during CsA immunosuppression. Unlike results in many
      experimental models, these data suggest that renal vasoconstriction in humans may
      be associated primarily with suppression in renal prostacyclin excretion rather
      than stimulation of thromboxane.

PMID- 1631949
TI  - The failure of venovenous bypass to prevent graft liver postreperfusion syndrome.
AB  - We studied 58 patients undergoing orthotopic liver transplantation, aged 42 +/-
      10 years (mean +/- SD), and weighing 65 +/- 14 kg. Anesthesia was maintained with
      fentanyl, midazolam, and vecuronium. Serum bicarbonate, serum potassium, serum
      ionized calcium and pH did not change significantly throughout the study. Usual
      hemodynamic parameters were recorded. Hemodynamic tolerance was assessed by a
      trial of clamping of the inferior vena cava, above and below the liver and the
      portal vein; patients were allocated to two groups: the group without venovenous
      bypass (NBP, n = 29) consisted of patients whose MAP did not decrease by more
      than 30% and/or cardiac output did not decrease by more than 50%; the group with
      venovenous bypass (BP, n = 29) consisted of patients whose MAP decreased by more
      than 30% and/or cardiac output decreased by more than 50% or required venovenous
      bypass for easier surgical dissection. After clamping of the vena cava and the
      portal vein, the cardiac index (CI) and mean pulmonary arterial pressure (MPAP)
      decreased significantly, whereas systemic vascular resistances (SVR) increased.
      After unclamping the inferior vena cava suprahepatically and infrahepatically, no
      hemodynamic change was observed. After unclamping the portal vein, MAP decreased,
      despite the increase in the CI, because of an significant decrease in SVR; in
      addition MPAP increased despite the decrease in pulmonary vascular resistances.
      The decrease in MAP of more than 30% during at least 1 min occurred in 6 patients
      (20%) in the NBP group and in 6 patients (20%) in the BP group. We concluded that
      the occurrence of the syndrome of cardiovascular collapse following liver
      reperfusion was similar whether venovenous bypass was used or not.

PMID- 1631950
TI  - The decrease in organ donations from 1985 to 1990 caused by increasing medical
      contraindications and refusals by relatives.
AB  - After the progressive improvement in the results of organ transplantation we now
      face the challenge of shortage in organ supply. The decreasing number of organ
      retrievals performed in 1990 at our hospital has raised questions concerning loss
      of potential organ donors and opposition to donation by the next of kin. We
      investigated these questions and the number of organs available per million
      inhabitants in the area covered by our university hospital. Our surgical
      intensive care unit provides about 85% of all organ donations for this area. To
      this end, all 375 deaths occurring in the surgical ICU during the period between
      January 1, 1985 and December 31, 1990 were analyzed. Of 138 brain-stem deaths, 43
      presented medical contraindications preventing organ harvesting for
      transplantation. Consent for donation was sought from the families of the 95
      remaining potential donors and was refused for 17 patients. Organ retrieval
      followed all of the 78 agreements to donate, so that no suitable donor was lost.
      Over the 6 years surveyed, a progressive decrease in organs procured was
      observed, due to an increase of medical contraindications to organ harvesting for
      transplantation (P less than 0.001) and a higher rate of refusals to donate
      organs (P less than 0.002). The rate of kidney retrieval was thereby reduced from
      45 to less than 25 per million population per year between 1985 and 1990 for our
      hospital's catchment area. The reasons cited by the families for denying organ
      donation suggest that the publicity campaigns aimed at the medical community and
      the public concerning organ transplant programs should be modified, and that a
      careful selection of indications for transplantation seems mandatory.

PMID- 1631951
TI  - Regulation of antibody response by an IgG-anti-Ig autoantibody occurring during
      alloimmunization. I. A few IgG molecules inactivate one B cell.
AB  - We have shown previously that alloimmunized rats develop a broadly reactive IgG
      antiimmunoglobulin autoantibody in addition to antidonor antibodies. The findings
      presented herein demonstrate that this "physiological" antibody suppresses
      antigen receptor-induced IgM production of B cells derived from rats of the same
      strain. When affinity-purified IgG-anti-Ig was added to cell cultures, the
      antibody production of B cells was maximally inhibited at the minute
      concentration of 0.9 pg/10(6) cells. Higher or lower IgG-anti-Ig concentrations
      resulted in weaker suppression. The same result was obtained when spleen
      lymphocytes were used instead of purified B cells. Based on the molecular weight
      of IgG and Avogadro's number, our results indicate that a few molecules of IgG
      anti-Ig are sufficient to inhibit the antibody production of a single B cell.
      Activity at this minuscule concentration demonstrates that IgG-anti-Ig antibodies
      are exquisitely active immunoregulatory molecules. In addition to the stimulatory
      effect of IgM-anti-Ig rheumatoid factors reported by others, our findings define
      the second component of an immunoregulatory mechanism: suppression of the B cell
      response by an IgG-anti-Ig autoantibody produced during alloimmunization.

PMID- 1631952
TI  - Regulation of antibody response by an IgG-anti-Ig autoantibody occurring during
      alloimmunization. II. Selective inactivation of antigen receptor-occupied B
      cells.
AB  - Heterologous antiimmunoglobulin antibodies are efficient regulators of the B cell
      response. We have shown that during the immune response against allogeneic cells
      the immune system develops autologous IgG-antiimmunoglobulin. A few molecules of
      this "physiological" autoantibody suppress the IgM production of one B cell in
      vitro. In the current series of experiments we further define the regulation of
      antigen receptor-activated B cells by this autoantibody. To mimic the in vivo
      situation, where IgG-anti-Ig appears a few days after alloimmunization, the
      antibody's effect on an already ongoing B cell response was studied.
      Interestingly, we found that the IgG-anti-Ig loses its suppressive effect when
      added to the cell culture 1 or 2 days after B cell activation, but that
      suppression can be completely restored when the cells are restimulated via their
      antigen receptor. Thus, the IgG-anti-Ig antibody suppresses B cells only when
      their antigen receptor is occupied. Even restimulated B cells become refractory 8
      hr after activation, and later (24 hr) regain their susceptibility to IgG-anti-Ig
      induced suppression. The Fc receptor is involved in mediating suppression since
      the antibody's suppressive capacity is abolished after removal of its Fc region.
      Possible mechanisms of B cell suppression by IgG-anti-Ig are crosslinking of
      antigen receptor with Fc receptor, or cocapping and functional interaction of the
      two receptors as a result of their separate occupancy. Our experiments
      demonstrate that B cell regulation by IgG-anti-Ig produced during an immune
      response to allogeneic cells is governed by 3 restriction mechanisms: antigen
      receptor occupancy, activation stage dependency, and optimal antibody
      concentration.

PMID- 1631953
TI  - Mouse mutations and human disorders are paired.

PMID- 1631954
TI  - Temporal regulation in the early embryo: is MBT too good to be true?
AB  - The question of how early embryonic events are temporally regulated has
      traditionally been tied to the mid-blastula transition (MBT). This concept has
      directed the studies in Xenopus and influenced the studies in other organisms. By
      examining the weaknesses in the concept of MBT, we hope to refocus the study of
      temporal regulation on the many developmental transitions that do exist and to
      clear the way for an alternative viewpoint that emphasizes the similarities
      between developmental processes in different organisms.

PMID- 1631955
TI  - Small repeated sequences and the structure of plant mitochondrial genomes.
AB  - The structure of plant mitochondrial genomes has proven to be complex and
      difficult to study. Recombination across large and small repeated sequences can
      result in genome diversity within individual plants, as well as rapid
      evolutionary change in genome structure. The role of these repeats is becoming
      more obvious as mitochondrial genomes are examined in detail.

PMID- 1631956
TI  - Hormones, puffs and flies: the molecular control of metamorphosis by ecdysone.
AB  - Pulses of the steroid hormone ecdysone during late larval and prepupal
      development in Drosophila coordinate the activation of a large number of primary
      and secondary response genes, signalling the onset of metamorphosis. Molecular
      characterization of some of these genes has provided valuable clues to regulatory
      mechanisms by which the ecdysone signal is transduced and amplified.

PMID- 1631957
TI  - The molecular basis of glucose-6-phosphate dehydrogenase deficiency.
AB  - With more than 300 different variants reported, the human enzyme glucose-6
      phosphate dehydrogenase (G6PD; EC 1.1.1.49) is one of the most polymorphic
      proteins known. An estimated 400 million people throughout the world are
      deficient in G6PD; numerous lines of evidence indicate that this is because
      female heterozygotes have a selective advantage in malaria infections. The
      cloning of the G6PD gene has made it possible to clarify the molecular basis
      underlying this enzyme deficiency and polymorphism.

PMID- 1631958
TI  - The three eras of research in experimental toxicology.

PMID- 1631959
TI  - Metabolic polymorphisms affecting activation of toxic and mutagenic arylamines.

PMID- 1631960
TI  - Cytokines and eicosanoids in cancer drug toxicity.

PMID- 1631961
TI  - Anthranoid laxatives and colorectal cancer.

PMID- 1631962
TI  - Scientific discourse, in public.
AB  - The experience of writing for a wider audience has benefits and drawbacks.
      Attempting to make scientific issues more accessible to non-scientists is no
      easier than explaining them to peers. Indeed, explaining toxicological data such
      as solvent measurements from a hazardous waste site can be even more difficult,
      especially in addressing those living next to the site. Alastair Hay reconsiders
      his experience in two cases that brought toxicology under public scrutiny.

PMID- 1631963
TI  - Cell death by apoptosis and its protective role against disease.
AB  - The involvement of cell death in control of tissue growth has long been
      neglected, but the description of apoptosis as cellular 'suicide', the functional
      opposite of mitosis, is now attracting more attention to this phenomenon.
      Physiologically unwanted cells are removed by apoptosis, and toxic chemicals and
      drugs may enhance or inhibit this type of cell death. These findings are
      providing new insights into the pathophysiology of a variety of diseases, and
      suggesting new therapeutic strategies.

PMID- 1631964
TI  - Nuclear receptors and chemical carcinogenesis.
AB  - A number of non-genotoxic chemical carcinogens can recognize specific
      intracellular proteins. These cellular targets include members of the nuclear
      receptor family of ligand-activated transcription factors. Some non-genotoxic
      carcinogens appear to mimic the action of hormones and growth factors and perturb
      signal transduction pathways. Their carcinogenic activity may therefore result
      from the persistent stimulation of such pathways, promoting the growth of
      initiated cells.

PMID- 1631965
TI  - [Endovascular treatment of arteriosclerosis].

PMID- 1631966
TI  - [Excimer laser-assisted balloon angioplasty of the femoro-popliteal segment].
AB  - In the Department of Vascular Surgery RK, The University Hospital in Copenhagen,
      the authors have treated 16 patients with ischaemia in the lower limb by means of
      laser-assisted balloon angioplasty. A pulsed ultraviolet excimer-laser was
      employed. It proved possible to break down the occluding arterial lesion in 12
      patients (75%). In one patient, this was not followed-up by balloon angioplasty
      and, in another patient, the reconstruction closed on the first day after
      operation. The primary success of the procedure, defined as breaking down of the
      occlusion with the laser-catheter followed by balloon angioplasty and an increase
      in the ankle/brachial index of greater than 15%, was found to be 10/16 or 62%.
      The remaining four patients, in whom it did not prove possible to break down the
      arterial lesion with laser, were treated by means of conventional vascular
      surgical reconstruction. On follow-up examination after an average of nine
      months, nine out of the ten patients (90%) still had a patent reconstruction
      after laser-assisted balloon angioplasty. This new endovascular laser-procedure
      appears to be suitable for selected patients, but must be assessed more
      meticulously before it is possible to determine its future placing in the
      vascular surgical therapeutic armamentarium.

PMID- 1631967
TI  - [Insulin resistance--a physiopathological condition with numerous sequelae: non
      insulin-dependent diabetes mellitus (NIDDM), android obesity, essential
      hypertension, dyslipidemia and atherosclerosis].
AB  - Recent research has demonstrated that reduced insulin-stimulated glucose
      metabolism in skeletal muscle (insulin resistance) and hyperinsulinism are common
      features in widespread diseases such as essential hypertension, android obesity,
      non-insulin dependent diabetes mellitus, dyslipidemia (in the form of raised
      serum triglyceride and reduced serum high-density lipoprotein (HDL) cholesterol)
      and arteriosclerosis. Simultaneously, investigations in a comprehensive group of
      healthy middle-aged men have revealed insulin resistance in one fourth. On the
      basis of these observations, a working hypothesis is suggested which postulates
      that genetic abnormalities in one or more of the candidate genes in the modes of
      action of insulin occur in a great proportion of the population. These may result
      in insulin resistance (primary genetic insulin resistance). Primary insulin
      resistance may be potentiated by a series of circumstances such as ageing, high
      fat diet, lack of physical activity, hormonal and metabolic abnormalities or
      drugs (secondary insulin resistance). As a consequence of the reduced effect of
      insulin on muscle tissue, compensatory hyperinsulinism develops. Depending on the
      remaining vulnerability of the individual the hyperinsulinism is presumed to
      result in development of one or more phenotypes. For example if the beta-cells of
      the pancreas are unable to secrete sufficient insulin to compensate the insulin
      resistance on account of genetic defects, glucose intolerance will develop. In a
      similar manner, hyperinsulinism in insulin-resistant individuals who are
      predisposed to essential hypertension is presumed to reveal genetic defects in
      the blood pressure regulating mechanisms and thus contribute to development of
      the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1631968
TI  - [Emphysematous pyelonephritis. A serious complication of diabetes mellitus].
AB  - Pyelonephritis emphysematous (PE) is a life threatening renal infection which is
      observed practically exclusively as a serious complication of diabetes mellitus.
      95% of the 73 cases which have been reviewed were found in diabetic patients. The
      symptomatology resembles that of severe acute pyelonephritis but the disease
      differs from this in that, in PE, emphysema develops in the actual renal
      parenchyma and/or in the perirenal tissues. The most important single factor in
      the etiology appears to be ischaemia of the tissues which are employed as growth
      media for the microorganisms involved. Infections with E. coli, Klebsiella
      pneumoniae, Aerobacter and Proteus are the most commonly found. Isolated cases
      with Candida and Cryptococcus neoformans have been observed. The mortality in
      untreated cases of PE is 100%. With medical treatment alone, the mortality
      decreases to 73% while, when combined medical and surgical intervention is
      employed, the mortality can be reduced to 30%.

PMID- 1631969
TI  - [Methylmethacrylate and organic dementia. A dose-response analysis among dental
      technicians and opticians].
AB  - The substance methylmethacrylate (MMA) is an organic solvent which is employed
      inter alii for prostheses which is suspected of being neurotoxic. With the object
      of illustrating whether there is a connection between exposure to MMA and
      symptoms of organic dementia, a cross-sectional investigation was carried out on
      a population consisting of occupationally active dental technicians and opticians
      (n = 528) and a group of dental technicians who were no longer occupationally
      active (n = 173). No noteworthy difference in the background variables, apart
      from age, was observed. Age was taken into consideration in the analysis. The
      results show a statistically significant increase in the prevalence of the
      chronic symptoms on increasing exposure. Where the acute symptoms are concerned,
      the connection is not statistically significant, but a tendency is observed. A
      chronic symptom index constructed on the basis of 13 questions concerning chronic
      symptoms is compared with the life exposure and the age. A statistically
      significant increase in the index was found with exposure to MMA, although not
      for the oldest age group. The pattern symptoms, presence of bias and other forms
      of exposure are discussed. It is concluded that this investigation confirms the
      hypothesis that symptoms of organic dementia have a connection the exposure to
      MMA. The results support the presumption that MMA causes acute and chronic damage
      to the central nervous system even with exposure below the safety limits. It is
      recommended that the occupational environment of dental technicians, including
      the present safety limits, should be revised.

PMID- 1631970
TI  - [Microbiology related to anal abscess complicated with fistula formation].
AB  - The results of operative treatment of anal abscesses with reviewed
      retrospectively for a period of three years with the object of correlating the
      microbiological findings on culture from the abscess with the presence of a
      fistula. Patients who had not been controlled postoperatively were requested to
      attend for anal examination. Fistula were demonstrated in 27 out of 83 patients.
      No fistulae nor recurrences of abscesses were found in patients in whom only
      bacteria not derived from the intestine were cultured. Culture from an anal
      abscesses is thus of considerable prognostic value.

PMID- 1631971
TI  - [Emphysematous pyelonephritis].
AB  - A case of emphysematous pyelonephritis (EPN) is described. EPN is a severe
      suppurative infection of the renal parenchyma and the perirenal tissue,
      characterized by intra-renal, and possibly perirenal, gas formation. This is a
      rare form of acute pyelonephritis. The condition is associated with a high
      mortality. Diabetic patients are particularly prone to the disease. The diagnosis
      is established with great certainty by computed tomography of the kidneys. The
      condition should be treated with an intensive combined medical-urological regimen
      with percutaneous nephrostomy guided by computed tomography or ultrasound should
      be performed. If no therapeutic response occurs, surgical incision and drainage
      or nephrectomy are recommended. In the present case of EPN, the medical treatment
      proved adequate.

PMID- 1631972
TI  - [Fatal emphysematous pyelonephritis].
AB  - A man aged 46 years with diabetes mellitus was admitted with acute right-sided
      renal symptoms. Pyelonephritis emphysematous without concretions was found. The
      patient was treated with insulin, fluids, electrolytes and antibiotics and
      nephrostomy was performed and, subsequently, an internal JJ-catheter in the
      ureter. The symptoms disappeared and he was discharged on a low dosage of
      sulphamethizol. After the planned removal of the JJ-catheter, sepsis running a
      lethal course developed. This emphasizes the importance of adequate prophylactic
      antibiotic therapy in connection with interventions in the urinary tracts.

PMID- 1631973
TI  - [Diagnosis of pulmonary fibrosis].

PMID- 1631974
TI  - [P-pills do not cause breast cancer].

PMID- 1631975
TI  - [Plant thorn synovitis].

PMID- 1631976
TI  - [The PC for down-loading, selection and storage of literature references].

PMID- 1631977
TI  - [Cesarean section].

PMID- 1631978
TI  - [Uterine rupture in Denmark during the period 1980-1987].
AB  - A retrospective review was undertaken of 128 consecutive cases of rupture of the
      uterus during the eight-year period from 1 Jan 1980-31 Dec 1987. It was found
      that rupture of the uterus occurs most commonly after previous Cesarean section
      but that it may occur after other types of operation on the uterus. Rupture of
      the uterus does not occur in primiparae unless special conditions are present.
      Potent stimulation appears to involve a slightly increased risk for rupture of
      the uterus. A great proportion of the ruptured uteri occurred in women who had
      previously been submitted to Cesarean section on account of breech presentation
      as primiparae. In subsequent pregnancies, this resulted in three dead infants and
      four children with severe brain damage.

PMID- 1631979
TI  - [Monitoring and oxygen therapy during gastrointestinal endoscopy].
AB  - Gastroenterological Societies in Britain and USA have published recommendations
      for sedation, monitoring and oxygen therapy during gastrointestinal endoscopy. No
      scientific basis for the introduction of recommendations such as these is,
      however, present as it has not yet been proved that hypoxaemia is responsible for
      morbidity and mortality on gastrointestinal endoscopy. The pathogenesis of the
      development of myocardial ischaemia during gastrointestinal endoscopy is
      considered by many to be the simultaneous arterial hypoxaemia but recent
      investigations suggest that tachycardia is a more important factor. The
      scientific data available at present in this field is not conclusive.
      Introduction of recommendations for monitoring and oxygen therapy during
      gastrointestinal endoscopy in Denmark should be delayed until elucidation of the
      mechanisms involved has been undertaken.

PMID- 1631980
TI  - [Angiomyolipomas in the kidney. A review].
AB  - Renal angiomyolipomata are rare, benign hamartomata composed of various amounts
      of fat, smooth muscle and blood vessels. The tumours may have an extremely
      variable clinical presentation which may be difficult to distinguish from other
      renal disorders. By combining the use of ultrasound- and CT-scanning, it is
      possible to make a definite diagnosis thus obviating usually unnecessary
      nephrectomy. Only symptomatic tumours require treatment. The treatment is
      directed mainly towards preventing or stopping bleeding. In cases where
      intervention is considered to be indicated, embolization should be carried out if
      possible. Otherwise, the renal surgery should preserve as much of the kidney as
      possible. Nephrectomy is indicated only for uncontrollable life-threatening
      bleeding, tumours which involve the whole kidney or in the presence of
      simultaneous carcinoma.

PMID- 1631981
TI  - [Autologous fibrin glue--preparation and clinical use].
AB  - Fibrin tissue adhesive is a tissue adhesive in which the two components are
      fibrinogen concentrate and a thrombin solution, respectively. In autologous
      fibrin tissue adhesive, the fibrinogen is prepared from the patient's own blood
      in contrast to the fibrin adhesive available commercially where the fibrinogen is
      prepared from pooled donor plasma. In 42 heart and lung operations, autologous
      fibrin tissue adhesive prepared by a new method was employed in which the
      fibrinogen is separated from the patient's own plasma by precipitation with
      ethanol. Either 44 or 88 ml blood was employed for concentration of the
      fibrinogen. This resulted in 2.5 ml and 4.9 ml fibrinogen concentrate which was
      mixed with 0.3 parts of thrombin solution containing calcium and aprotinin
      (fibrolysis inhibitor) so that the total volumes of tissue adhesive were 3.3 ml
      and 6.4 ml. Production of autologous fibrin tissue adhesive is uncomplicated and
      takes less than 90 minutes. A new method of production of autologous tissue
      adhesive based on ethanol is described. The fibrin tissue adhesive prepared in
      this manner has a high concentration of fibrinogen and is effective as a
      haemostatic and as an adhesive in surgical operations and it has the further
      advantage that it is not associated with the risk of transmission of viral or for
      immunological reactions.

PMID- 1631982
TI  - [Bacterial degradation of fibrin glue in vitro].

PMID- 1631983
TI  - [Measurement of anti-thyroid peroxidase antibodies as a substitute to
      measurements of microsomal and thyroglobulin antibodies].

PMID- 1631985
TI  - [Continuous positive airway pressure (CPAP)--does the equipment live up to its
      name?].
AB  - The purpose of this study was to evaluate the in- and expiratory pressures
      achieved by the use of different continuous positive airway pressure (CPAP)
      delivery systems. The study was performed on ten healthy adults breathing
      spontaneously with: 1) "simple CPAP", consisting of a fresh gas flow around 40
      l/min and reservoir balloons of 2, 6 and 10 l and expiration against a water
      column, 2) a high-flow system CR60 CPAP, designed for home treatment and 3)
      another high-flow system Down's CPAP. Both high-flow systems used a venturi
      device (Downs Flow Generator, Vital Signs) giving flows around 90 and 170 l/min
      in our set-up, and the same PEEP valves (Vital signs) were used. All systems were
      tested with expiratory pressures set at 5, 10 and 20 cm H2O. Individual responses
      were found, but in general the simple CPAP with a 10 l latex balloon reservoir
      gave optimal CPAP. The high-flow systems were not found to provide better CPAP,
      however, CR60 CPAP was found also to be optimal with 5 and 10 cm H2O. Down's CPAP
      provided 3-5 cm higher expiratory pressure than the intended CPAP level. We
      recommend measurement of the pressure during the CPAP treatment to ensure that
      the intended CPAP is achieved.

PMID- 1631984
TI  - [Biological monitoring in chromium-plating industry].
AB  - The purpose of the present investigation was to evaluate the role of biological
      monitoring as a means of surveillance of exposure in the Danish chromium-plating
      industry. We collected spot urine samples from 47 employees in five electro
      plating plants near Aarhus and compared the results wide 40 non-exposed workers.
      We found no increase of chromium in urine during a work shift (mean = 0.11 nmol
      chromium/mmol creatinine, p = .46). The mean urine chromium value among the
      chromium workers was twice the mean value of the referent population (p = 0.001).
      There was, however, a considerable overlap between the two populations. All of
      the urine chromium values were much lower than the proposed American biological
      exposure indices. The results do not indicate any need for implementation of
      biological monitoring in the Danish chromium-plating industry, but longitudinal
      studies concerning possible accumulation of chromium at present occupational
      exposure levels should be carried out.

PMID- 1631986
TI  - [Toxic shock syndrome after Cesarean section].
AB  - A case of toxic shock syndrome (TSS) after caesarean section is reported. Strains
      Staphylococcus aureus (phage type 80/42E/81/83A--mixed type) producing toxic
      shock syndrome toxin-1 in very great grantities amounts were isolated from the
      surgical wound. The diagnosis is often difficult in non-menstrual cases in which
      TSS is not expected.

PMID- 1631987
TI  - [Epiphysiolysis in the distal femur as a birth injury in Cesarean section].
AB  - A case of fracture-separation of the distal femoral epiphysis complicating
      cesarean section for delivery of an infant in breech presentation is described.
      Femoral fracture is a rare birth injury, particularly at cesarean section. The
      lesion can interfere with the growth of the bone, especially if overlooked.

PMID- 1631988
TI  - [Are better prenatal care and larger maternity wards the answer to the problem of
      stagnating perinatal mortality?].

PMID- 1631989
TI  - [Ambulatory labors in the county of Ringkobing].

PMID- 1631990
TI  - [Treatment of tubal dysfunction and secretory otitis media with a nasal balloon
      (Otovent)].

PMID- 1631991
TI  - [Esophageal ECG and the pill electrode--one more time].

PMID- 1631992
TI  - [Hemophilia--a commentary].

PMID- 1631993
TI  - [Drug therapy of intermittent claudication].

PMID- 1631994
TI  - [EDTA versus placebo treatment in intermittent claudication. A double-blind,
      randomized trial].

PMID- 1631995
TI  - [Intermittent claudication].
AB  - Intermittent claudication is a symptom triggered from the musculature during
      walking. The pathogenesis of the pain is unknown. All patients with peripheral
      vascular disease must abstain from smoking, perform physical exercise and dietary
      advice is sometime needed. Reconstructive vascular surgery or percutaneous
      transluminal angioplasty (PTA) are indicated when the occupational pattern and,
      in some instances, the recreational activities, are threatened. The results of
      these treatments are good. For various reasons a number of patients, however,
      cannot be offered these treatments. These patients must be informed of the
      importance of physical exercise and discontinuation of smoking. Some of these
      patients can be offered supplementary medical treatment (e.g. pentoxifylline).

PMID- 1631996
TI  - [Quality assurance of results of clinical chemical analyses in Danish hospital
      laboratories].
AB  - During the past 35 years, voluntary professional assessment of quality of the
      results of analyses in Danish hospital laboratories has been undertaken under the
      auspices of the Danish Society of Clinical Chemistry. The analytical quality of
      the laboratories is described by their "imprecision" and "accuracy" as expressed
      by "coefficient of variation" and "bias", respectively. The participation in
      these programmes was 90%. During the period between 1968 and 1987, inter
      laboratory variation decreased markedly where all analyses were concerned. To
      ensure the necessary and adequate quality, establishment of specifications of
      quality based on clinical/biological goals of quality has proved necessary. The
      commonest reasons for large imprecision and bias from the target values are less
      specific methods of analysis, errors in calibration and sporadic "outliers". As
      the result of a stable organisation for ensuring quality, Denmark is well
      equipped for the introduction of the great demands in documentation of quality
      which may be anticipated from the Common Market during the immediate future.

PMID- 1631997
TI  - [Compositae dermatitis].

PMID- 1631998
TI  - [Premature ejaculation--results of treatment of men of 2 different cultural
      backgrounds].
AB  - The object of this investigation was to compare Danish and Muslim men treated for
      premature ejaculation in the Department of Sexology, Rigshospitalet, Copenhagen.
      The investigation is a retrospective review from the period 1986-1989. The
      following variables were included in the investigation: Mode of referral,
      personal data, duration of sexual dysfunction, previous sexological/psychiatric
      treatment, methods of treatment and results of treatment. The material consists
      of 60 Danish and 32 Muslim men. The investigation reveals that the Muslim men
      predominantly receive individual therapy of brief duration. Fewer Muslims were
      instructed in sensuality training and fewer carry out stop-start-treatment. The
      Muslim men responded more poorly to treatment than the Danish men. The
      differences in the therapeutic methods and therapeutic results cannot be
      explained on the basis of the personal parameters and possible cultural obstacles
      to treatment are suggested. For example, the therapist must become familiar with
      taboos and beliefs in the Muslim culture. The referring instance should inform
      the patients about the therapeutic principles at the Department of Sexology and
      attempts must be made to motivate possible partners to participate in the
      treatment.

PMID- 1631999
TI  - [Treatment of severe respiratory distress syndrome with surfactant].
AB  - The first Danish experience of treatment of the respiratory distress syndrome
      (RDS) in preterm infants with exogenous surfactant is described. Fifteen infants
      with birthweights of 645-1,865 g and gestational ages of 25-32 weeks, all
      receiving artificial ventilation with at least 60% oxygen for severe RDS, were
      treated with purified porcine surfactant (Curosurf) within the first 28 hours of
      life. Pulmonary function improved immediately in all of the infants. Four infants
      (27%) died, four (27%) developed bronchopulmonary dysplasia (pulmonary fibrosis)
      and two (13%) had late neurological sequelae. These preliminary results are
      considered to be promising and they are in complete agreement with the results of
      randomised, controlled investigations from abroad. Systematic registration is,
      however, still necessary.

PMID- 1632000
TI  - [EDTA treatment of arteriosclerosis. Bias or manipulation?].
AB  - A 62-year-old man suffering intermittent claudication had 20 infusions of EDTA in
      a double blind, placebo controlled trial. No effect on symptoms or systolic
      ankle/brachial blood pressure index was found. Following the trial, he received
      30 further infusions of EDTA in a private clinic. The systolic ankle/brachial
      index was unchanged throughout the total period as measured in Hillerod Central
      Hospital. However, the private clinic found a significant increase in the index
      following EDTA treatment. The reason for this discrepancy could be poor technique
      in the clinic or it could be due to bias or manipulation. The discrepancy
      explains the difference between the positive results claimed by the private EDTA
      clinics and the results of the double blind placebo controlled Danish trial.

PMID- 1632001
TI  - [Reflex dystrophy after reconstruction of the axillary artery].
AB  - Reflex sympathetic dystrophy (RSD) is a complex syndrome of pain, trophic changes
      and vasomotor instability affecting the limbs. Numerous theories have been
      suggested to explain the pathophysiology. None is universely accepted. In most of
      the patients reported, an antecedant event such as trauma or surgery is
      implicated in the initiation of symptoms. We describe a case of reflex
      sympathetic dystrophy developing after reconstruction of a. axillaris. To our
      knowledge there have only been a few previous descriptions of reflex dystrophy
      following vascular surgery. The mechanism of reflex sympathetic dystrophy
      secondary to vascular trauma is discussed. Presumely, damage to the arterial wall
      by trauma may initiate abnormal reflex activity and lead to RSD. We suggest that
      vascular surgery should be considered as a potential risk factor for the
      development of RSD.

PMID- 1632002
TI  - [Diagnosis of urinary tract infections and quality of diagnostic methods].

PMID- 1632003
TI  - [Stomach ulcer and Helicobacter pylori].

PMID- 1632004
TI  - [Helicobacter pylori].
AB  - Helicobacter pylori (HP) are Gram-negative spiral bacteria which occur in the
      human stomach. The bacteria were cultured in vitro for the first time in 1983. It
      is suspected that the bacteria may cause chronic gastritis of type B and may also
      be a contributory cause of chronic ulceration and cancer of the stomach. The
      bacteria are accompanied by characteristic inflammatory changes in the gastric
      mucosa. The significance for gastritis, chronic ulceration, non-ulcer dyspepsia
      and carcinoma of the stomach is discussed. HP occurs in a great proportion of the
      population of the world and the frequency increases with age. The route of
      infection is unknown but faecal-oral infection is probable. Correlation between
      the presence of HP and the occurrence of symptoms is poor in the individual
      patient. The bacteria can be demonstrated histologically, cytologically, by
      culture, by the urease test, by the urease expiration test or serologically. The
      bacteria are sensitive for a series of antibiotics and bismuth but no effective
      treatment is known as the recurrence rate is high.

PMID- 1632005
TI  - [Testicular varicocele. Reason for surgery and recurrence frequency].
AB  - In the period 1979-1989, 63 patients were operated on for testicular varicocele.
      The study was a retrospective follow-up from case records and from a
      questionnaire. Thirty-eight had local complaints, 19 were operated on because of
      infertility and six had an asymptomatic varicocele. 10% had minor, reversible
      complications. 92% answered the questionnaire and 38% had a personal contact. 21%
      had recurrence of the varicocele although to a minor degree. In the infertility
      group, 42% succeeded in conception after operation.

PMID- 1632006
TI  - [In-hospital day for patients connected with the District Psychiatric Center in
      Svendborg. A controlled study].
AB  - As of 31.12.1990, the employment of bed-days and admissions was calculated for
      patients who had been connected with a district psychiatric centre for more than
      three years. A before-and-after comparison revealed a percentage reduction in the
      employment of bed-days as compared with a control group. This corresponds to the
      findings in other investigations. In the before-and-after analysis, various
      reductions are described according to the diagnostic groups. The reduction in bed
      day employment consisted mainly of fewer readmissions and reduction in the group
      of long-term hospitalisations. A reduction also occurred in the group of patients
      who could characterized as least ill. In this group, a marked percentage
      reduction in bed-days was observed as compared with the control group and this
      was probably due to the good and continuous treatment after discharge offered by
      the district psychiatric centre. This investigation revealed that the employment
      of bed-days for a patient population receiving district psychiatric treatment
      after discharge can be reduced. Nevertheless, the most severely ill patients will
      still require periodic admission to hospital. The value of treatment after
      discharge of the "Svendborg Model" type does not provide scientifically valid
      arguments that hospital admission can be avoided where the most severely ill
      patients are concerned.

PMID- 1632007
TI  - [Arteriosclerosis of the lower extremities--patients' contacts with alternative
      therapists].
AB  - During the period July 1987-April 1988, ninety-one patients with arterial
      insufficiency in the lower limbs were referred to the Department of Thoracic and
      Vascular Surgery at Aalborg Hospital. The mean delay between contact with the
      general practitioner and the vascular surgeon was nine months. Twenty-nine of the
      patients contacted alternative therapists before referral to the vascular
      surgeon. Twenty-five of these patients had suffered from intermittent
      claudication for at least two years and the total cost of treatment was 76,013
      Danish crowns (900 Danish crowns or approximately pounds 75 per patient).

PMID- 1632008
TI  - [Leprosy--still a possibility in Denmark].
AB  - A case of borderline tuberculoid leprosy in a 27 year old woman from the
      Philippines is presented. The diagnosis was made after repeated biopsies. Only a
      single mycobacterium was present and the histology of the initial biopsies was
      inconclusive. This case emphasizes that leprosy is still imported to Denmark, and
      that the diagnosis is often difficult and delayed for years.

PMID- 1632009
TI  - [Pseudoporphyria].
AB  - Pseudoporphyria with formation of bullae and vulnerability of skin exposed to
      light, particularly the backs of the hands, may be provoked medicinally by
      nalidixinic acid, tetracyclin, nabumeton, pyridoxine, dapsone and high-dosage
      furosemide and by excessive use of solaria. The present article demonstrates that
      the condition may also be precipitated by quinidine and ibuprophen.

PMID- 1632010
TI  - [What is the correct answer in the cholesterol debate?].

PMID- 1632011
TI  - [Emotional side effects of Halcion; an unnecessary fear?].

PMID- 1632012
TI  - [Are outpatient clinics for alcoholics an acceptable therapeutic possibility for
      all?].

PMID- 1632013
TI  - [Sex differences among clients attending the outpatient clinic for alcoholics in
      the County of Vejle].
AB  - A questionnaire investigation was undertaken in the four outpatient clinics for
      alcoholics in the County of Vejle in 1989. A total of 246 clients participated.
      The object was to illustrate differences and similarities between the sexes and
      aspects of the abuse. No differences were found as regards the frequency of
      unemployment and retirement or the housing conditions but the women were more
      frequently unemployed for 36 months or more. Where both sexes were concerned, the
      clients most frequently lived alone. The male clients had more frequently lost
      their employment, experienced failure of partnership, lost their driving licences
      or had been in detention on account of the abuse. Women were more frequently
      untrained, their incomes were lower, they had more frequently received public
      assistance and belonged most frequently to social group V. Women had more
      frequently children under the age of 16 years in the home and were more
      frequently alone with their children. Women had more frequently a partner who was
      addicted. Only women had children who had been placed under care. Women sought
      treatment earlier than men. The female clients thus appear to require particular
      attention and support because their social conditions, including those of their
      families, were, in general, worse than those of the male clients.

PMID- 1632014
TI  - [Social conditions of the clientele attending the outpatient clinic for
      alcoholics in the County of Vejle. A re-examination].
AB  - A questionnaire investigation was performed among the clients attending the four
      outpatient clinics in the County of Vejle. The object of this investigation was
      to register aspects of the social conditions of 246 clients, to illustrate the
      present conditions and to observe changes as compared with previous conditions.
      The clientele attending outpatient clinics for alcoholics is still an extremely
      stressed group but, in several respects, the conditions are now better than
      previously. Nowadays, more of the clients had had prolonged school education and
      their earnings were relatively higher. Fewer clients lived in one room, fewer had
      received economic assistance, fewer were in social group V, fewer had come down
      in the world socially, and much fewer lived under extremely stressed
      circumstances. The clients lived most frequently alone. Nearly 40% had current or
      previous mixed addiction. Despite a relatively great number of new clients, the
      duration of addiction was now apparently longer to institution of treatment.
      Considerably fewer people under the age of 30 years now sought treatment in
      outpatient clinics for alcoholics. The authors consider that it is important that
      attractive offers of outpatient treatment of alcoholics are still available, one
      of the reasons being the possibility of altering the abuse as early as possible.

PMID- 1632015
TI  - [Changes in social conditions and drinking patterns in male and female clients
      attending an outpatient clinic for alcoholics in Copenhagen].
AB  - The proportion of new female clients in the ALKO outpatient clinic in Copenhagen
      increased from 22% in 1975 to 37% in 1985. The first 100 new male and female
      clients in the ALKO outpatient clinic in 1975 and 1985 were investigated. The new
      female clients in 1985 were educated better as regards scholastic and
      occupational training than were the new female clients in 1975. Fewer of the
      clients of the ALKO outpatient clinic were married than was the case in the
      normal population in 1975 and also 1985. In 1975, fewer of the new female clients
      were registered in the occupational market than among the new female clients in
      1985. Attention is drawn to a tendency to evening out of the differences between
      male and female alcohol addicts as regards social conditions and drinking
      patterns. The therapeutic consequences of these observations are discussed.

PMID- 1632016
TI  - [The laryngeal mask. An anesthesiological reevaluation].
AB  - The larynx mask (LM) is an alternative to a mask and endotracheal tube. LM
      ensures free airway for the patient under anaesthesia while the anaesthetist has
      his hands free. The mask is introduced into the pharynx in the anaesthetized
      patient without use of muscle relaxants or laryngoscope. The literature is
      reviewed. The possibilities for employment are discussed and the authors'
      personal experience is presented.

PMID- 1632018
TI  - [The value of fine-needle aspiration cytology for a practising otologist].
AB  - The results of 100 consecutive fine-needle punctures carried out in an otological
      practice are reviewed, discussed and compared with the literature. 93% diagnostic
      aspirates with negative predictive value of 0.97 and positive predictive value of
      0.93 in histologically verified aspirates were obtained. It is concluded that
      fine-needle aspiration cytology is a very suitable method of investigation also
      in specialist practice.

PMID- 1632017
TI  - [Treatment of girls with Turner's syndrome with growth hormone and estrogen--1
      year experiences].
AB  - Girls with Turner's syndrome are characterized by growth retardation and
      defective pubertal development, among other features. In this investigation, 40
      girls with Turner's syndrome were treated with growth hormone in doses of 0.1
      IU/kg/day (group 1, n = 14), oral oestradiol in doses of 0.01 mg/kg/day (group 2,
      n = 8) or a combination of these (group 3, n = 18), depending on the bone age.
      All three forms of treatment increased the height velocity significantly. The
      combined treatment increased the height velocity more than the growth hormone of
      oestradiol alone (p less than 0.05). In group 2, a pronounced progression of bone
      age leading to a decrease in the prognosis of final height was observed. The
      serum insulin-like growth factor I was unchanged in group 2 while this rose in
      groups 1 and 3. Pubertal development was, by and large, satisfactory. No serious
      side effects were observed. Treatment of girls with Turner's syndrome with growth
      hormone should not be supplemented with oestrogen prior to the bone age of 11
      years. The initial dosage of oestradiol should be less than 0.01 mg/kg/day, but
      the subsequent increase should be adjusted individually.

PMID- 1632019
TI  - [Difficult intubation--helped by a laryngeal mask].
AB  - Two cases of difficult intubation are described in which the problem was overcome
      by use of the laryngeal mask airway. The anaesthetist should be thoroughly
      familiar with the technique before attempting to use it in difficult cases.

PMID- 1632020
TI  - [Appendiceal mucocele of unusual size].

PMID- 1632021
TI  - [Benign pneumoperitoneum and scrotal emphysema after colonoscopy].
AB  - A case of benign pneumoperitoneum and subcutaneous emphysema of the scrotum after
      elective colonoscopy with polypectomy is reported. The development and treatment
      of benign pneumoperitoneum is discussed.

PMID- 1632022
TI  - [The effect of psychotherapy].

PMID- 1632023
TI  - [Therapeutic evaluation of psychotherapy].

PMID- 1632024
TI  - [The HIV-positive surgeon].

PMID- 1632025
TI  - [A method of combined horizontal resection of the larynx with removal of the
      arytenoid cartilage and its primary reconstruction].
AB  - A modified technique of combined laryngeal resection in vestibular cancer T3-T4
      (involvement of the arytenoid cartilage) was tried in 8 patients. To compensate
      for laryngeal separative function after the radical surgery, the reconstruction
      of the posterior laryngeal wall was performed by mobilization of the upper
      corniculum of the thyroid cartilage. In satisfactory functional results the
      method did not contribute to the disease aggravation.

PMID- 1632026
TI  - [Prognostic significance of the reaction of regional lymph nodes and lymphoid
      cellular infiltration of the tumor in laryngeal cancer].
AB  - The immune response of the primary tumor and regional lymph nodes was studied
      morphologically in 239 patients with vestibular cancer of the larynx. Marked
      infiltration of the stroma developed in 48, mild response or its absence were
      recorded in 97 patients. The difference in 5-year survival was significant (84
      versus 62%). Out of 117 patients examined for B-dependent cortical and T
      dependent paracortical response of the lymph nodes, 5-year survival in
      hyperplasia of the zones appeared to be 67%, in the absence of hyperplasia 42%
      and 44%, respectively. The difference is significant. The responses were
      essential for prognostication of the patient' survival.

PMID- 1632027
TI  - [Diagnostic significance of the study of lacrimal secretion in
      otorhinolaryngology].
AB  - As shown by Schirmer's test of lacrimal secretion in 110 patients with peripheral
      paralysis of the facial nerve and in 35 patients with chronic polypous sinusitis
      subjected to vidiotomy, lacrimal secretion in both groups patients underwent
      marked changes. After dissection of the Vidian nerve a persistent decline in
      lacrimal secretion was universal, though preoperative tests in the peripheral
      paralysis patients displayed hyposecretion in 28 and hypersecretion in the rest
      cases. Nasolacrimal reflex investigation is recommended in obscure results of the
      Schirmer's test.

PMID- 1632028
TI  - [Intranasal dacryocystorhinostomy in children].
AB  - Endonasal dacryocystorhinostomy performed in 78 children gave a steady favourable
      effect. Such a surgical operation is also recommended in dacryocysts complicated
      by phlegmons. Concomitant external fistulae of the lacrimal sac usually
      spontaneously closed after the operation, large fistulas were sutured.

PMID- 1632029
TI  - [A reliable symptom in differential diagnosis of cochlear and retrocochlear
      neurosensory hypoacusis (study of sound lateralization in Weber's test and
      ultrasound)].
AB  - Sound laterality in Weber test occurs mainly in peripheral defects of the
      acoustic analyzer (lateral conduction or reception acoustic defects of the
      cochlea). In retrocochlear unilateral hypoacusis or loss of hearing, laterality
      in this test is absent in 80-90% of the cases (affection of the VIII nerve root,
      acoustic nuclei, stem and midbrain conductors). This symptom is most reliable in
      differentiation of cochlear with retrocochlear unilateral hypoacusis and
      deafness. In combination of retrocochlear hypoacusis of deafness with impaired
      sound conduction in the same ear, the sound in Weber test can show a paradoxical
      laterality in an absolutely deaf ear. This indicates that Weber test sound
      laterality definitely reflects changes in sound conduction. Ultrasound laterality
      occurs in the better hearing ear in any unilateral cochlear or retrocochlear
      lesions, thus complicating recognition of cochlear from retrocochlear affections.
      Laterality of ultrasound is a sensitive indicator of neurosensory abnormalities.
      Major trepanation bone defects of the parietotemporal skull did not influence
      sound laterality in Weber test.

PMID- 1632030
TI  - [Extracochlear prosthesis in acute experiment].
AB  - Whether the transfer of coded sound intensity is possible was studied in acute
      experiments on cats with acquired deafness, using an original transducer of the
      signals with extracochlear position of the electrodes. The stimulation results
      were compared to intracochlear prosthesis. The type of the stimulation was not
      essential for threshold values of the total electric impact. In extracochlear
      position of the electrodes and the duration of potential 0.2 msec its amplitude
      increment was the highest, while the dynamic range turned out the lowest. With
      the impulse duration 0.5 msec, these differences disappeared. When compared to
      extracochlear, intracochlear bipolar stimulation proved superior.

PMID- 1632031
TI  - [Modulators of intracellular metabolism in the treatment of diseases of the
      internal ear].
AB  - Stress reactions develop in different organs as a result of the effect of
      unfavourable factors which increase the differential threshold for men. These
      derangements mainly occur in the organs where we can observe an inadequacy
      between high level of metabolism in the cell and instability of energy supply.
      Under such conditions stress reactions in the cells have the following stages in
      succession: intensiveness of the lipolysis in mitochondria, accumulation in the
      cells of fatty acid metabolites, destruction of the membranous apparatus of the
      cells, increase in the presence of Ca++ in the cells.

PMID- 1632032
TI  - [Characteristics of the vestibulo-ocular relations in patients with lesions of
      the central regions of the vestibular system].
AB  - Vestibular-ocular relations were studied in 30 patients with central vestibular
      affections varying in origin. Use was made of sinusoidal rotation with eyes
      closed and glance fixation tests. Symptoms of vestibular-ocular dysregulation
      typical for stem-cerebellar abnormalities were identified.

PMID- 1632033
TI  - [Use of local oxygenation and dimexide in the treatment of suppurative maxillary
      sinusitis in children].
AB  - In search for high-efficacy therapy for childhood sinusitis, the author developed
      a unit providing a long-term perfusion followed by local oxygenation the
      maxillary sinuses. Intrasinus administration of 10% dimexide solution did not
      produce a negative effect on the ciliated epithelium. Out of 52 patients treated,
      cure within 2-year follow-up was achieved in 49 subjects. All the sufferers with
      maxillary sinusitis recovered. The disease relapsed in 5 cases. In control group
      treated by long-term drainage with local antibiotics recurrent inflammation was
      registered in 12 out of 52 cases.

PMID- 1632034
TI  - [Intranasal method of the diagnostic puncture of ethmoidal labyrinth cells].

PMID- 1632035
TI  - [A device for game audiometry].

PMID- 1632036
TI  - [Congenital retroauricular fistula].

PMID- 1632037
TI  - [A penetrating wound of the skull with injuries of the brain, orbit and ethmoidal
      labyrinth].

PMID- 1632038
TI  - [Marginal cholesteatoma of the mastoid process in a patient with chronic purulent
      otitis media].

PMID- 1632039
TI  - [A rare case of brain tumor associated with acute purulent maxillary sinusitis
      with a course of rhinogenic intracranial complication in a pregnant woman].

PMID- 1632040
TI  - [Association of otogenic meningoencephalitis and acute disorder of cerebral blood
      circulation].

PMID- 1632041
TI  - [Angioleiomyoma of the retropharynx].

PMID- 1632042
TI  - [Laryngeal stenosis in a child with congenital dysplasia].

PMID- 1632044
TI  - [Case report of tracheal foreign bodies].

PMID- 1632043
TI  - [Primary multiple cancer of the larynx and thyroid].

PMID- 1632045
TI  - [A system for training otorhinolaryngology specialists].

PMID- 1632046
TI  - [Otorhinolaryngologic complex of knowledge and skills in the training of family
      physician].

PMID- 1632047
TI  - [Features of diagnosis and treatment of air cysts associated with different
      diseases of the larynx].

PMID- 1632048
TI  - [Intranasal surgery (selected chapters)].

PMID- 1632049
TI  - [Electromyography of the external muscles of the larynx in the combined diagnosis
      of hypokinetic dysphonia].
AB  - Bioelectric activity of elevators and depressor of the thyroid cartilage were
      studied in 135 patients with hypokinetic dysphonia versus 30 healthy subjects. At
      the primary diagnosis and in controls this activity for the inferior muscles
      exceeded that for the superior ones 1.2-1.4-fold. One year after the diagnosis
      the superior muscles were 1.2-1.6-fold more active, whereas in later terms both
      activities correlated or the increase was less than 1.2-fold. Basing on the
      studies, early clinical signs of functional dysphonias are suggested promoting
      more precise diagnosis and decision on the voice problem treatment.

PMID- 1632050
TI  - [The effect of low temperatures on biochemical indicators in the blood of
      calves].
AB  - Twenty calves, heifers of the Holstein-Friesian breed and crossbreds with the
      Slovak Pied breed, were divided into two groups at the average age of 19 days.
      The trial group was kept outdoors in wooden hutches and the control group was
      housed in an insulated building. Blood was sampled at the age of 20, 33, 48 and
      60 days at the outdoor temperatures of 3 degrees C, -2 degrees C, -5 degrees C
      and -8 degrees C. The calves kept in hutches where temperatures were always lower
      than in the insulated calf-house had the higher level of nonesterified fatty
      acids in all observations. The largest, highly significant difference was
      determined at the age of 60 days at the outdoor temperature of -8 degrees C (271
      mumol/l vs. 224 mumol/l), and the significance of differences was also observed
      in the first and third blood samplings at the temperatures of 3 degrees C and -5
      degrees C. The differences were highly significant in the first group between the
      first and fourth, and second and fourth samplings. In the calves kept in the
      insulated building the difference was significant between the first and fourth
      observation because the content of free fatty acids was also gradually increasing
      in this case (Tab. I). Glycaemia values were also higher in the calves kept in
      hutches (Tab. II). The most noticeable (significant) difference was determined at
      the age of 48 days at the outdoor temperature of -5 degrees C (4.3 mmol/l vs. 3.9
      mmol/l). Significant differences within the group were recorded only in calves
      from the trial group kept in hutches. Insulin concentrations increased gradually
      with the older age of animals (Tab. II). At the age of 20 days the values were
      identical in fact in both groups and the highest concentrations were recorded at
      the age of 60 days. The differences between the groups were not significant, the
      largest difference was observed at the end of milk feeding period at the age of
      60 days (19 microUI/l in calves from hutches and 15.6 microUI/l in calves from
      the insulated building). Triiodothyronine concentrations decreased from the
      starting values of 0.8 nmol/l and 0.76 nmol/l in both groups at the age of 33
      days to the values of 0.61 and 0.62 nmol/l.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1632051
TI  - [Immunostimulatory effects of certain substances in experimental ascaridiasis in
      pigs].
AB  - The effects were studied of four immunomodulative substances of biological origin
      (purified glucan, glucan with porcine immunoglobulin and zinc, transfer factor
      and vitamin A) on T and B lymphocytes, along with their protective effects in
      pigs with experimental ascariasis. These substances activated T and B lymphocytes
      with different intensity. The nonspecific stimulation of these cells in the blood
      of pigs with the immunomodulative substances intensified the protective
      mechanisms; this resulted in a decreased number of migrating ascaris larvae in
      the lungs of pigs by 17% to 65%. Of the four immunomodulative substances studied,
      transfer factor and glucan-based substances with porcine immunoglobulin and zinc
      proved to be the most effective. Both the substances exerted a significant
      stimulative effect on T- and B-cell populations even in the first days after
      infection, reaching the maximum on days 7-9 p. i. (Figs. 1 and 2). The protective
      effect, assessed by the reduction of migrating ascaris larvae in the lungs of
      pigs, was 62% and 65% using transfer factor and glucan preparation with
      homologous immunoglobulin and zinc, respectively. The percentage of occurrence of
      T and B lymphocytes, obtained by the use of purified glucan and vitamin A, was
      not in correlation with their protective effect (purified glucan 17%, vitamin A
      50%). The immunomodulative effects of little effective purified glucan increased
      when combined with porcine immunoglobulin and zinc. The results are significant
      from the aspect of the nonspecific stimulation of immunity in ascariasis and in
      some other helminthoses.

PMID- 1632052
TI  - [Biochemical and histological changes in the hypothalamus in hormone-stimulated
      sheep].
AB  - The effects were investigated of a hormonal preparation of serum gonadotrophin
      (SC) on neurosecretion, PAS-positive mucopolysaccharides and on histological
      changes in the third cerebral ventricle; at the same time variations were
      determined of catecholamine concentrations of ependyma surface in the
      hypothalamic regions that control directly reproductive functions in ewes of the
      Merino and Wallachian breeds in the oestrus period. Ewe oestrus was synchronized
      by insertion of Ageline (Spofa) sponges into the vagina. A dose of 2000 IU of
      serum gonadotrophin (Bioveta, Ivanovice in Hana) was administered to stimulate
      the ewes (n = 30). Twelve ewes of the Wallachian breed, six control and six test
      ones, were used for radioenzymatic detection of catecholamines (Catechola test,
      Prague). The brains were segmented immediately after bleeding and samples were
      taken from the eminentia medialis, area preoptica and corpus mamillare pursuant
      to the stereotactic configuration of the sheep hypothalamus (Welento et al.,
      1968). The brains of ten ewes of the Merino breed, four control and six test
      ones, and of eight ewes of the Wallachian breed (four control and four test ones)
      were used for histological treatment. For the purposes of a histological study,
      the brains were treated with current histological methods. The amount of
      neurosecretory material was assessed by light microscopy (Nakahara, 1963).
      Samples for the study of ependyma of the lower part of the third cerebral
      ventricle were examined in a scanning electron microscope. The obtained results
      demonstrate a statistically significant decrease by 36.4% (P less than 0.05) in
      epinephrin concentrations in the area preoptica of hypothalamus after SG
      administration (Fig. 3), in comparison with the control group. A decrease in
      norepinephrin concentration in the corpus mamillare (Fig. 4) was statistically
      significant (P less than 0.001). The dose of 2000 IU SG influenced most markedly
      catecholamine concentrations in the eminentia medialis (Fig. 5), where a
      statistically significant decrease in epinephrin and norepinephrin concentration
      was observed (P less than 0.01). Dopamine concentrations also decreased
      significantly (P less than 0.05) in the eminentia medialis (Fig. 5). Following
      the hormonal stimulation, a significant increase in dopamine and epinephrin
      concentrations was observed in the hypophysis of sheep (Fig. 6; P less than 0.05)
      and in the epiphysis there was a significant decrease in epinephrin and dopamine
      concentration (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1632053
TI  - [Listeria monocytogenes in food].
AB  - As in recent years laboratory diagnostics of listeria has become part of food
      microbiology, the frequency of occurrence of the bacteria Listeria monocytogenes
      has been followed in various kinds of foods for a year. A total of 51 strains of
      L. monocytogenes (7.2%) was isolated from 700 kinds of samples (raw milk,
      pasteurized milk, meat surface, poultry, cheeses, thermally not treated meat
      products, food--industry machinery). As can be seen in Tab. I, the highest number
      of strains was isolated from meat surfaces (13.5%), followed by meat--industry
      machinery (12.72%), poultry (10%) and cheeses (5%). The lower numbers of strains
      were found out in thermally not treated meat products (3.8%) and in raw milk
      (3.3%). Pasteurized milk did not contain any strains. Our findings in raw milk
      (3.3%) and in pasteurized milk (0) are in agreement with the data cited e. g. by
      authors from the USA (Lovett et al., 1987), who mention the value of 4.2% in raw
      milk and the zero value in pasteurized milk. The percentage of strains monitored
      in cheeses (5%) can be evaluated as low as the assortment of investigated cheeses
      was small (all strains were isolated from soft ripening cheeses). German authors
      (Tham et al., 1988) speak about the 2.5% percentage of L. monocytogenes strains;
      this is in keeping with our findings. The findings in thermally not treated meat
      products (3.8%) can be evaluated as low although the number of strains found in
      raw meat was high.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632054
TI  - Hepatic storage of glycosaminoglycans in feline and canine models of
      mucopolysaccharidoses I, VI, and VII.
AB  - Livers from normal cats and dogs, cats with mucopolysaccharidoses (MPS) I and VI,
      and dogs with MPS VII were analyzed biochemically and morphometrically to
      determine the lysosomal storage of glycosaminoglycans (GAG) in these animal
      models of human genetic disease. Analyses were performed on liver samples from
      seven normal cats ranging in age from 13 weeks to 15 months; six MPS I-affected
      cats ranging in age from 10 weeks to 26 months; four MPS VI-affected cats ranging
      in age from 9 months to 32 months; four normal dogs ranging in age from 1 month
      to 47 months; and three MPS VII-affected dogs, 5 days, 11 days, and 14 months of
      age. All of the animals were from the breeding colony at the University of
      Pennsylvania School of Veterinary Medicine and were maintained in accordance with
      national standards for the care and use of laboratory animals. Each GAG subclass
      was quantitated, and total GAG concentration was determined. Liver from cats with
      MPS I had the highest total GAG concentration (5.7 times that of the control),
      followed by liver from dogs with MPS VII (1.8 times) and cats with MPS VI (1.5
      times). These data were very closely correlated (R2 = 0.982) with the results of
      the morphometric analyses of hepatocyte and Kupffer cell vacuolation associated
      with lysosomal storage and support the validity of both methods. This is
      particularly important for the quantification of total and individual GAG
      concentrations in tissue preparations. The values obtained should prove useful in
      future assessments of therapeutic regimes, such as enzyme replacement, bone
      marrow transplantation, and gene therapy, for these genetic diseases.

PMID- 1632055
TI  - Uptake of ferritin by follicle-associated epithelium in the colon of calves.
AB  - Uptake of macromolecules (e.g., ferritin) by M cells in follicle-associated
      epithelium in small and large intestine was investigated in three healthy,
      conventionally raised, 2- to 3-week-old, female Holstein Frisian calves. A 2.5%
      solution of ferritin was injected into the ligated loops in mid-jejunum, in
      terminal ileum, in the ascending colon adjacent to the ileocecal junction, and in
      the proximal loop of the ascending colon containing gut-associated lymphoid
      tissue. After exposure times that ranged from 82 to 165 minutes, ferritin was
      detected in M cells of domes in the small intestine, as well as in cells in
      follicle-associated epithelium of proprial lymphoid nodules and lymphoglandular
      complexes of colon that morphologically resembled M cells of small intestine.
      Ferritin was found in apical invaginations, apical vesicles, multivesicular
      bodies, basal vesicles, and adjacent intercellular spaces. In addition to
      ferritin, apical vesicles, multivesicular bodies, and intercellular spaces
      contained 50-nm membrane-bound particles. More ferritin was endocytosed by M
      cells of the small intestine than by M cells of the large intestine. In the large
      intestine, higher amounts of ferritin were found in M cells of follicle
      associated epithelium overlying proprial lymphoid nodules than in M cells of
      follicle-associated epithelium in the depth of lymphoglandular complexes. Based
      on these results, we concluded that M cells of follicle-associated epithelium in
      the colon of calves provide a route for antigen uptake into the intestinal
      lymphoid system.

PMID- 1632056
TI  - Histopathologic and ultrastructural myocardial alterations in calves deficient in
      vitamin E and selenium and fed polyunsaturated fatty acids.
AB  - We developed an experimental model of nutritional degenerative myopathy in
      ruminant cattle. Fourteen experimental calves were fed a diet low in vitamin E
      and selenium for 127 to 137 days. Six of these calves were then euthanatized.
      After 127 days, a dietary additive of linseed oil that had been treated to
      protect it against ruminal hydrogenation was added to the low vitamin E and
      selenium diet of the eight remaining calves as a source of polyunsaturated fatty
      acids. Six of these animals were euthanatized after 6 to 11 days of
      polyunsaturated fatty acid feeding; the other two died after 6 and 8 days.
      Macroscopic myocardial alterations were seen in five polyunsaturated fatty acid
      fed calves but not in any other experimental calf. Microscopic lesions,
      comprising multifocal or diffuse cardiocyte degeneration and necrosis, were seen
      in atrial and ventricular myocardium of all experimental calves. These changes
      were more severe in polyunsaturated fatty acid-fed calves than in animals that
      did not receive polyunsaturates. Ultrastructurally, sublethally damaged
      cardiocytes had lysed contractile material; vacuolated sarcoplasm; altered
      mitochondria, sarcoplasmic myelin figures, and lipofuscin granules; and multiple
      nuclei. Necrotic cardiocytes had contracted myofibrils, pyknotic nuclei,
      mineralized mitochondria, and plasmalemmal disruption; the external lamina
      remained largely intact. Necrosis was followed by macrophage invasion and
      phagocytosis of necrotic debris. Repair of the lesions was by deposition of
      collagen and elastin fibers. No alterations were seen in the hearts of control
      calves fed vitamin E and selenium-supplemented diet. The induced myocardial
      lesions are similar to those of spontaneous nutritional degenerative myopathy in
      ruminant cattle.

PMID- 1632057
TI  - Neuropathologic findings of bromethalin toxicosis in the cat.
AB  - Ten random source male domestic shorthair cats, 2 to 6 years old and 3.0-4.4 kg
      body weight, were each given a single oral dose (1.5 mg/kg) of bromethalin (cat
      Nos. 1-5) or bait vehicle carrier (cat Nos. 6-10). Bromethalin-dosed cats
      developed a toxic syndrome characterized by ataxia, focal motor seizures,
      vocalization, decerebrate posture, decreased conscious proprioception,
      recumbency, depression, and semicoma. Bromethalin-dosed cats were euthanatized if
      seizure activity or hindlimb paralysis developed. Survival times were 48 hours
      (cat No. 1), 89 hours (cat No. 2), 90 hours (cat No. 3), and 97 hours (cat No.
      4). Control cats (cat Nos. 6-10) and one bromethalin-dosed cat (cat No. 5) were
      euthanatized on day 20 after dosing. Spongy change (edema--characterized by the
      formation of vacuoles in extracellular spaces and myelin lamellae), hypertrophied
      fibrous astrocytes, and hypertrophied oligodendrocytes were observed in the white
      matter of the cerebrum, cerebellum, brain stem, spinal cord, and optic nerve of
      all bromethalin-dosed cats. Spongy change occasionally extended into contiguous
      cerebellar Purkinje cell layer and cerebral cortical gray matter. The severity of
      lesions varied among cats but was most pronounced in cat No. 5 (480 hours after
      dosing). A leukocytic inflammatory response, gitter cell (macrophage) response,
      or axonal degeneration was not observed in the vacuolated areas. Ultrastructural
      findings included separation of myelin lamellae at the interperiod lines with the
      formation of intramyelinic vacuoles (intramyelinic edema), rupture and
      coalescence of intramyelinic vacuoles into larger extracellular spaces (spongy
      change), and pronounced cytosolic edema of astrocytes and oligodendroglial cells.

PMID- 1632058
TI  - Toxic peripheral neuropathy with demyelination in Sprague-Dawley rats given CGS
      21595--a 5-lipoxygenase inhibitor.
AB  - Male and female Sprague-Dawley rats were given CGS 21595, a pro-drug that is
      almost immediately metabolized to CGS 19213, a naphthoquinone that acts as a 5
      lipoxygenase inhibitor. The compound was administered by gavage to five groups of
      Sprague-Dawley rats (group Nos. 1, 5, n = 30; group Nos. 2-4, n = 20) at daily
      doses of 0, 50, 150, 500, or 1,000 mg/kg for 13 weeks. Rats in the higher dose
      groups had a reduced weight gain, but significant neurologic signs were not
      observed. A peripheral neuropathy consisting predominantly of myelin destruction
      in the spinal nerve roots and sciatic nerves in male rats treated with greater
      than or equal to 150 mg/kg CGS 21595 and in female rats treated with greater than
      or equal to 50 mg/kg CGS 21595 for 13 weeks. This lesion was not fully reversible
      after a recovery period of 4 weeks. Lesions consisted of ballooning of myelin
      sheaths, infiltration by macrophages, demyelination, and occasional areas of
      remyelination. Axons were generally preserved, and the brain and spinal cord were
      not affected. Male and female rats in all treatment groups had cytoplasmic
      hyaline droplets in the proximal renal tubules. This change was reversible after
      4 weeks and was not associated with any other adverse effects on the kidney.

PMID- 1632059
TI  - Langerhans' cells in equine cutaneous papillomas and normal skin.
AB  - Langerhans' cells (LC) were investigated immunohistochemically and electron
      microscopically in normal equine epidermis and 133 equine cutaneous papillomas
      experimentally induced in five 2-year-old Thoroughbred horses. Class II major
      histocompatibility complex antigen-positive dendritic LC were found in the normal
      epidermis and ultrastructurally had the characteristic Birbeck's granules. In the
      developing phase of the papillomas, LC were significantly decreased in number and
      size, indicative of a hypofunctional state. In the regressing phase of the
      papillomas, LC were markedly increased in number, especially at the epidermis
      dermis junction. LC with long dendrites were rich in cytoplasm with well
      developed cytoplasmic organelles, including Golgi apparatus, lysosomes, Birbeck's
      granules, and multivesicular bodies. These LC were hyperfunctional. An
      infiltration of many T lymphocytes was also observed at the epidermis-dermis
      junction.

PMID- 1632060
TI  - An atypical neuroendocrine tumor in the lung of a beagle dog.

PMID- 1632061
TI  - Ultrastructure of a spindle cell carcinoma in the mammary gland of a dog.

PMID- 1632062
TI  - Bovine focal proliferative fibrogranulomatous panniculitis (Lechiguana)
      associated with Pasteurella granulomatis.
AB  - In southern Brazil, cattle are affected by a disease known locally as Lechiguana
      and characterized by large subcutaneous swellings. Eighteen cases were examined
      clinically; 17 of the cattle had a single swelling, and one had two swellings. In
      14 of the 18 cases, the swellings were located over the scapula and adjacent
      regions. The subcutaneous masses reached maximum dimensions of 45 x 50 cm, with
      heights above the skin surface of 5-25 cm. Growth was rapid, often taking place
      in 15 to 60 days. Histologically, all lesions were focal proliferative
      fibrogranulomatous panniculitis and consisted of focal proliferation of fibrous
      tissue that was infiltrated by plasma cells, eosinophils, lymphocytes, and
      sometimes neutrophils. An eosinophilic lymphangitis was also present, which
      sometimes resulted in the destruction of the lymphatics and the formation of
      eosinophilic microabscesses. Small granulomas, sometimes containing radiating
      clubs, and Splendore-Hoeppli material were present in the regional lymph node.
      Pasteurella granulomatis was isolated from the subcutaneous masses of 14 of the
      18 natural cases. All 11 of these cases recovered following treatment with 3 g of
      chloramphenicol daily for 5 days. Untreated animals died. Because the area of
      anatomic distribution is similar to that infested by Dermatobia hominis, we
      postulate that this insect may transmit the causative agent. In one steer, a
      subcutaneous injection of P. granulomatis caused a large subcutaneous swelling
      consisting of interlacing bundles of collagen infiltrated by neutrophils,
      eosinophils, and some lymphocytes. Microabscesses, but not lymphangitis and
      granulomas, were detected. In all 11 cattle inoculated either intramuscularly or
      subcutaneously with P. granulomatis, purulent abscesses were produced at the
      sites of the injection, and P. granulomatis was recovered from all lesions.

PMID- 1632063
TI  - A qualitative assay for beta cell antibodies. Preliminary results in dogs with
      diabetes mellitus.
AB  - Purified beta cells from a radiation-induced transplantable rat insulinoma were
      used to detect beta cell antibodies in serum from untreated diabetic dogs. Serum
      from dogs in which anti-beta cell antibodies were induced by injecting a purified
      beta cell suspension subcutaneously was used as positive control. Following
      incubation with test sera, fluorescein-labeled anti-dog immunoglobulins were used
      to visualize binding between the beta cells and dog gamma globulins. Nine of the
      23 diabetic dogs showed a strongly positive reaction which was characterized by a
      ring fluorescence, three showed a weak reaction and 11 were negative, i.e. they
      showed diffuse fluorescence. In contrast, 14 of the 15 healthy dogs showed
      diffuse fluorescence and one dog showed a weakly positive reaction. Thyroid,
      liver and kidney cells did not elicit ring fluorescence. Although females (spayed
      and intact) represented the majority of the diabetic dogs, there was no
      correlation between sex and the occurrence of antibodies in the diabetic dogs.
      There was also no correlation to the age of the dogs. In conclusion, we have
      developed a specific test for anti-beta cell antibodies. The test is reproducible
      and economical to perform on a large number of samples.

PMID- 1632064
TI  - Suppression of Ia antigen expression on gamma interferon treated macrophages
      infected with Ehrlichia risticii.
AB  - Ehrlichia risticii is an obligate intracellular bacterium of
      monocytes/macrophages. In this report, using immunofluorescence staining, flow
      cytometry, and Kolmogorov-Smirnov analysis of histograms, the response of P338D1
      and peritoneal macrophages stimulated with recombinant murine interferon-gamma
      (rIFN-gamma) was examined for the expression of major histocompatibility complex
      Class II gene product (Ia) and effect of E. risticii infection on induction of Ia
      surface expression. Maximal expression of Ia by sham-infected P388D1 cells was
      observed 2 days post rIFN-gamma addition followed by a progressive decline. These
      stimulatory effects of rIFN-gamma were dose dependent. Relative to sham-infected
      P388D1 cells, the induction of Ia by rIFN-gamma (200 U ml-1) on E. risticii
      infected P388D1 cells was significantly suppressed at each time point tested
      through Day 5 with maximal suppression of 88% occurring on Day 2. Similarly, the
      induction of Ia by rIFN-gamma on E. risticii-infected peritoneal macrophages was
      significantly suppressed by 77% (fluorescent microscopy) when compared to sham
      infected peritoneal macrophages. The higher dose of rIFN-gamma (2000 U ml-1)
      failed to restore Ia surface expression by E. risticii-infected P388D1 cells. The
      suppression of Ia on P388D1 cells in response to RIFN-gamma was not related to
      the degree of infection of these cells by E. risticii. A soluble inhibitor
      substance was not demonstrable in the supernatant from E. risticii-infected
      cells, nor were inhibitor levels of prostaglandin E2 levels found in the
      supernatant. Suppression of surface Ia expression on the macrophage suggests a
      mechanism whereby I. risticii may evade T-lymphocyte recognition, hinder antigen
      specific T-lymphocyte activation, and promote their own survival.

PMID- 1632065
TI  - Swine leukocyte antigen and macrophage marker expression on both African swine
      fever virus-infected and non-infected primary porcine macrophage cultures.
AB  - Swine leukocyte antigens (SLA) and a macrophage specific marker were monitored on
      porcine macrophages cultured with or without macrophage colony stimulatory factor
      (M-CSF) and on cells infected with African swine fever virus (ASFV). SLA
      expression was maximal either in the total cell extract or on the cell surface at
      3-4 days of culture; after 4 days these values began to decrease. Fluorescence
      analyses of immunostained macrophages cultured with or without M-CSF indicated a
      major upward shift in the number of SLA Class I molecules on individual
      macrophages whereas for SLA Class II both a novel expression of Class II and an
      upward shift in the number of molecules per cell were evident. Infection of 3-day
      old macrophage cultures with three different isolates of ASFV resulted in minor
      changes in surface expression of SLA Class I, SLA Class II, and macrophage
      markers. No differences in infection with ASFV was observed whether macrophages
      were SLA Class II positive or negative, nor was there blocking by anti-SLA Class
      I or Class II monoclonal antibodies of ASFV infection of cultured macrophages.

PMID- 1632066
TI  - Generation and functional characterization of ovine bone marrow-derived
      macrophages.
AB  - A method for the culturing and propagation of ovine bone marrow-derived
      macrophages (BMM) in vitro is described. Bone marrow cells from sterna of freshly
      slaughtered sheep were cultured in hydrophobic (teflon foil) bags in the presence
      of high serum concentrations (20% autologous serum and 20% fetal calf serum).
      During an 18 day culture period in the absence of added conditioned medium, and
      without medium change, a strong enrichment of mononuclear phagocytes was
      achieved. Whereas the number of macrophages increased four to fivefold during
      this time, granulocytes, lymphoid cells, stem cells and undifferentiated
      progenitor cells were reduced to less than 3% of their numbers at Day 0. This
      resulted in BMM populations of 94 +/- 3% purity. These cells had morphological
      and histochemical characteristics of differentiated macrophages, and they
      performed functions similar to those of non-activated, unprimed human monocyte
      derived macrophages. Thus, they avidly ingested erythrocytes coated with IgG of
      heterologous or homologous origin. They expressed a modest level of procoagulant
      activity, but upon triggering with lipopolysaccharide (LPS), a marked increase in
      cell-associated procoagulant activity was observed. LPS triggering promoted the
      secretion of interleukin-1, as evidenced by measurement of murine thymocyte
      costimulatory activity, and transforming growth factor-beta. Using the mouse L929
      cell cytotoxicity assay as an indication of tumor necrosis factor (TNF) activity,
      no TNF activity was detected in the same supernatants, a result possibly due to
      species restriction. BMM generated low levels of O2- upon triggering with phorbol
      12-myristate 13-acetate (PMA). On the other hand, no O2- production was observed
      upon stimulation with zymosan opsonized with ovine or human serum. Using luminol
      enhanced chemiluminescence (CL) as a more sensitive indicator of an oxidative
      burst, both PMA or zymosan were able to trigger CL, but the response was subject
      to partial inhibition by sodium azide, an inhibitor of myeloperoxidase. This
      points to non-macrophage cells contributing also to the CL response, and is
      consistent with the view that unprimed BMM elicit a low oxidative burst upon
      triggering with strong inducers of a burst. Our functional characterization now
      allows us to apply priming and activation protocols and to relate their effect to
      functional alterations.

PMID- 1632067
TI  - A lactogenic-immune-deficiency-syndrome in cows: unexplained phenomenon.
AB  - The majority of adult cows in a certain dairy herd, were found to have very low
      levels of immunoglobulins (Igs) in their colostrum. This phenomenon was defined
      by us as Lactogenic-Immune-Deficiency-Syndrome (LIDS). The mean IgG levels were
      44.5 and 57.2 mg ml-1 respectively (on two different occasions) as compared to
      that of a control group which was 103.4 mg ml-1. The levels of Igs in the
      colostra of heifers from the same herd were found to be higher than those of
      adult cows. The degree of LIDS was found to be closely related to the age of cows
      in the herd. The low levels of Igs in the colostra were not directly linked to
      their concentrations in the sera of the affected cows. The relatively low amount
      of IgA in the affected colostra suggests that the local production in the lymph
      tissue associated with the mammary glands is impaired as well. In order to
      investigate the etiology of the phenomenon, tests were carried out to reveal
      whether bovine leucosis virus (BLV) infection or immune complexes were involved
      in the pathogenesis of LIDS. The results were negative. The etiology of LIDS
      remains for the time being unknown.

PMID- 1632068
TI  - Changes in cell-mediated immune responses after experimentally-induced
      anaphylaxis in dogs.
AB  - Experimentally-induced type 1 hypersensitivities were induced in normal dogs to
      either ovalbumin or Ascaris antigen. In vitro and in vivo cell-mediated immune
      responses were measured before sensitization and again at 1 and 6 days after
      induction of anaphylaxis by intravenous challenge with antigen. Histamine
      modulated lymphocyte functions, such as histamine-induced suppression, histamine
      co-mitogen induced blastogenesis and the in vivo cutaneous responses to
      intradermally injected mitogens decreased post anaphylaxis. Spontaneous
      suppression of the autologous mixed-lymphocyte reaction increased post
      anaphylaxis. Lymphocyte blastogenic response to Concanavalin A (Con A) decreased
      at 6 (but not at 1) days post anaphylaxis probably due to a mediator other than
      histamine. Blastogenesis of 24 h preincubated cells by suboptimal concentration
      of Con A, declined post anaphylaxis, but Con A-induced suppression was not
      significantly altered. Dogs with atopic dermatitis have some altered cell
      mediated immune responses. Altered histamine-induced and spontaneous suppression,
      histamine suppression of mitogenesis and decreased contact sensitivity observed
      in this experimental type 1 hypersensitivity mimicked that of atopic dogs.
      Increased cutaneous response to mitogens observed in atopic dogs was not
      reproduced in the type 1 hypersensitive dogs. These findings suggest some of the
      altered cell-mediated immune functions observed in dogs with atopic dermatitis
      result from type 1 hypersensitivity. The other abnormalities may be intrinsic to
      the atopic state.

PMID- 1632069
TI  - An assay to quantitate the binding of Rhodococcus equi to macrophages.
AB  - A Rhodococcus equi radiobinding assay has been developed using organisms labeled
      with 3H-uracil. These labeled organisms resemble their unlabeled counterparts
      with respect to colony morphology, viability, and buoyant density. Bacteria
      routinely incorporate between 5 x 10(-3) and 5 x 10(-2) counts per minute per
      colony forming unit (cfu) which in this assay allows the detection of fewer than
      0.2 cfu per macrophage. Once incorporated, greater than 90% of the label remains
      bacterial associated for at least 4 h postlabeling. The majority of the label is
      trichloroacetic acid precipitable, partitions into the aqueous phase following
      phenol/chloroform extraction and is ethanol precipitable. RNAse treatment of the
      ethanol precipitate abolishes label trichloroacetic acid precipitation. This
      radiolabeling technique has been used to quantitate the attachment of R. equi to
      both murine peritoneal and equine alveolar macrophages adherent to 13 mm glass
      coverslips. R. equi binding is dose dependent, saturable, and specific to
      macrophages. Further, binding is enhanced in the presence of fresh serum.
      Inhibition of radiolabeled bacterial binding can be obtained by competition with
      cold R. equi. This radiolabeled binding assay represents a crucial step in
      identifying the receptors on macrophages involved in the recognition of R. equi
      and may help to provide information on how macrophages recognize intracellular
      bacteria in general.

PMID- 1632070
TI  - Proliferative response of mammary gland mononuclear cells to recombinant bovine
      interleukin-2.
AB  - Methods of augmenting bovine mononuclear cell responsiveness during physiological
      transitions of the udder may enhance resistance of the mammary gland to
      intramammary infections. Interleukin-2 is required for proliferation of T
      lymphocytes and may contribute to B-lymphocyte proliferation. Recombinant bovine
      interleukin-2 (rBoIL-2) was evaluated as a potential immunoenhancer of bovine
      mammary gland mononuclear cells. Bovine mononuclear cells were isolated from five
      primiparous Holstein cows at 14-18 and 28-32 days of involution and at 7-13 days
      prior to parturition. Bovine blood and mammary gland mononuclear cells were
      highly responsive to rBoIL-2. Response of mammary gland mononuclear cells to
      rBoIL-2 was comparable with response of blood mononuclear cells. These data
      suggest that rBoIL-2 may be an effective immunoenhancer of bovine mononuclear
      cells during the non-lactating and prepartum periods.

PMID- 1632071
TI  - Determination of optimal in vitro conditions for caprine alternative complement
      pathway assay.
AB  - Optimal in vitro testing conditions for caprine alternative complement pathway
      assay were determined. Effects of the following variables were tested:
      heterologous erythrocytes; pH, ionic strength and Mg2+ ion concentration of the
      complement diluent; incubation time and temperature. Rabbit erythrocytes were the
      optimal target cells. The optimal buffer conditions were: pH 8.0, ionic strength
      0.06 mmol NaCl and 5mmol Mg2+ ion. Optimal incubation time and temperature were
      75 min and 30 degrees C, respectively.

PMID- 1632072
TI  - Immunophysiological studies of interleukin-2 and canine lymphocytes.
AB  - Interleukin-2-dependent pathways of lymphocyte activation were investigated in
      canine peripheral blood lymphocytes (PBL) following stimulation with T-cell
      mitogens including phytohemagglutinin, phorbol ester (TPA), calcium ionophore
      (ionomycin), and human recombinant interleukin-2 (hrIL-2). The ability of the
      stimulated cells to produce interleukin-2 (IL-2) was determined using murine
      indicator cell lines. IL-2 receptor expression by mitogen-stimulated canine PBL
      was confirmed by the binding of hrIL-2 with high affinity, and with
      characteristics comparable to those of the human and murine IL-2 receptor.
      Examination of serum and PBL from two dogs that were treated with hrIL-2 and
      human recombinant tumor necrosis factor for systemic mast cell tumors showed that
      in one dog, IL-2 could be measured in the serum. Concurrently, the in vitro
      mitogenic response of this dog's PBL to hrIL-2 occurred earlier, possibly
      reflecting an increase in the relative number of IL-2-responsive cells within the
      PBL population.

PMID- 1632073
TI  - Effects of route of immunization, adjuvant and unrelated antigens on the humoral
      immune response in lines of chickens selected for antibody production against
      sheep erythrocytes.
AB  - Effects of intramuscular (i.m.), intravenous (i.v.) and intraperitoneal (i.p.)
      primary immunization with the T-dependent antigen, sheep red blood cells (SRBC),
      was studied in two chicken lines selected for either high (H) or low (L) antibody
      response after i.m. immunization with SRBC. The primary route of immunization
      affected the line differences in the primary response and in the secondary
      response after i.m. reimmunization. Intravenous immunization with the T-dependent
      antigen bovine serum albumin (BSA) showed line differences similar to those found
      after i.m. or i.v. immunization with SRBC. Immunization with both the partially T
      independent antigens Brucella abortus (BA) or Salmonella H-antigen (SHA) revealed
      no line effect. Immunization with SRBC in incomplete Freund's adjuvant (IFA) did
      not change the difference between lines, whereas immunization with complete
      Freund's adjuvant (CFA) diminished the difference between lines. It is postulated
      that differences in antibody production between the selected lines might be
      attributed to differences in T-cell activity.

PMID- 1632074
TI  - The production of equine monoclonal immunoglobulins by horse-mouse
      heterohybridomas.
AB  - Studies were carried out to determine the optimum conditions for the production
      of equine monoclonal antibodies (MAbs). Lymphocytes from ponies immunised with
      influenza A equine 2 virus, isolate A/Equine/Newmarket/79 (H3N8) were fused with
      mouse myeloma (NSO) cells and with horse-mouse heterohybridomas made aminopterin
      sensitive by selective growth in 8-azaguanine. Although all fusions initially
      resulted in heterohybridoma colonies that secreted equine immunoglobulin, many of
      these were unable to maintain secretion for longer than a few weeks. Increasing
      the time between immunisation and the booster injection of Newmarket/79 virus,
      the inclusion of Freund's incomplete adjuvant and the use of an aminopterin
      sensitive primary heterohybridoma as the fusion partner, improved the production
      of HIg-secreting heterohybridomas. After two clonings eight cell lines were
      established which maintained anti-Newmarket/79 antibody secretion for over a
      year. FACS analysis of the cell lines provided a useful means of predicting
      breakdown of MAb secretion by the cell lines, thus enabling re-cloning to be
      carried out in time.

PMID- 1632075
TI  - An enzyme-linked immunosorbent assay (ELISA) for von Willebrand factor antigen
      (vWf-Ag) in canine plasma.
AB  - A quantitative enzyme-linked immunosorbent assay (ELISA) has been developed to
      measure canine von Willebrand factor antigen (vWf-Ag) in plasma of the dog. A vWf
      Ag antiserum was raised in rabbits and purified by preabsorption with the low
      molecular weight vWf-Ag-deficient fraction of canine cryoprecipitate, followed by
      affinity chromatography on protein-A Sepharose. The rabbit anticanine vWf-Ag IgG
      was used to bind the vWf-Ag of the test plasmas to the solid phase and to prepare
      the enzyme-antibody conjugate in ELISA. Normal rat serum was used as blocking
      agent. The standard curve was linear (r2 greater than 0.98) and reproducible
      after logit-log transformation. The interassay coefficient of variation (CV) in
      test plasmas with various vWf-Ag concentrations was never greater than 7.7%.
      Assayed values in dilutions of pooled normal canine plasma added to canine vWf-Ag
      deficient plasma were linear between 0 and 100% (r2 = 0.99) and indicated
      excellent analytical recovery of vWf-Ag. In 18 dogs with various internal
      diseases, including von Willebrand's disease and haemophilia A, the coefficient
      of correlation between the results of the ELISA and those of
      electroimmunodiffusion (EID) was 0.93.

PMID- 1632076
TI  - Use of rats to compare atrophic rhinitis vaccines for protection against effects
      of heat-labile protein toxin produced by Pasteurella multocida serogroup D.
AB  - Four bacterin-toxoid and three bacterin commercial vaccines against atrophic
      rhinitis were tested in rats for their capacity to immunize against the lethal
      and systemic effects of purified heat-labile protein toxin (D-toxin) produced by
      Pasteurella multocida serogroup D. Only one bacterin-toxoid vaccine stimulated
      sufficient immunity to prevent the death of all rats challenged with D-toxin.
      None of the vaccines prevented weight loss, leukocytosis or increases in serum
      complement titers in rats challenged with D-toxin. Rats provide an inexpensive
      animal model for testing the capacity of vaccines to generate antitoxic immunity
      against the lethal and systemic effects of D-toxin.

PMID- 1632077
TI  - Anti-lymphocyte antibodies generated in animals immunised with Theileria annulata
      infected cells.
AB  - Complement fixing antibodies were measured in sera from animals immunised with
      either Theileria annulata sporozoites or autologous or allogeneic schizont
      infected mononuclear cells using a complement-mediated micro-cytotoxicity test.
      The test demonstrated the presence of anti-lymphocyte antibodies in allogeneic
      cell-immunised animals, which were not detectable in autologous cell- or
      sporozoite-immunised animals; also that these antibodies were directed to T.
      annulata-infected and (MHC) class I antigens. Their potential importance in
      repeated immunisations is discussed.

PMID- 1632079
TI  - Kinetics of ovine interferon-gamma production: detection of mRNA and
      characterisation of biological activity.
AB  - The kinetics of interferon-gamma (IFN-gamma) production were studied in sheep
      mesenteric lymph node (MLN) cells at the molecular level using an ovine IFN-gamma
      cDNA probe and by bioassay which was verified by blocking antiviral activity with
      a monoclonal antibody (Mab) against recombinant bovine IFN-gamma IFN-gamma mRNA
      appeared in MLN cells within 4 h of stimulation with phorbol ester and
      Concanavalin A and was not detectable by 72 h after stimulation. Biologically
      active IFN-gamma appeared in the culture supernatants 8 h after stimulation and
      was still present 96 h later when de novo synthesis had terminated. Acid dialysis
      and Mab neutralisation demonstrated conclusively that native ovine IFN-gamma is a
      pH 2 labile cytokine.

PMID- 1632078
TI  - Detection of canine interleukin-2 receptors by flow cytometry.
AB  - This study describes a method for detecting canine interleukin-2 receptors (IL
      2R) by flow cytometry, using human recombinant IL-2 labeled with phycoerythrin
      (IL-2-PE). Peripheral blood mononuclear cells from four normal dogs were washed,
      incubated with IL-2-PE, and then washed to remove any unbound IL-2-PE. Flow
      cytometric analysis of the cells was performed with a 488 nm argon laser while
      gating on lymphocytes. Cells expressing the IL-2R were identified by their
      fluorescence as compared to cells stained with an anti-mouse immunoglobulin-G
      conjugated to phycoerythrin. The average percentage of resting cells expressing
      the IL-2R was found to be 21%. The addition of unlabeled human recombinant IL-2
      to Day 3 phytohemagglutinin (PHA)-stimulated cells reduced the fluorescence
      intensity four-fold, thereby demonstrating the specificity of IL-2-PE for canine
      IL-2R. Following stimulation with optimal concentrations of PHA, the percentage
      of cells expressing the IL-2R increased daily and reached a maximum on Day 3
      (76.4%). IL-2R density, as measured by mean fluorescence intensity, also
      increased and reached maximal levels on Days 2-3 (twenty-fold greater than
      resting cells). The binding, inhibition, and kinetic experiments provide evidence
      that human recombinant IL-2-PE is a useful tool for studying canine IL-2R
      expression. Thus, a one-step direct method for the flow cytometric detection and
      quantification of the canine IL-2R is now available.

PMID- 1632080
TI  - Biochemical analysis by SDS-PAGE and western blotting of the antigenic
      relationship between Leptospira and equine ocular tissues.
AB  - The antigenic relationship between Leptospira interrogans, equine cornea and lens
      was previously noted in our studies. Serum antibodies from horses inoculated with
      serovars wolffi, pomona, icterohaemorrhagiae, and tarassovi, were able to bind to
      five antigenic fractions from both cornea and lens, as demonstrated by
      immunoblotting. These antigens seem to be made up of protein and carbohydrates.
      After treatment with periodate for cleavage of glycoside ring structures, those
      fractions kept their condition of target for anti-Leptospira antibodies.
      Nevertheless, all fractions lost that condition after being subjected to peptide
      hydrolysis.

PMID- 1632081
TI  - Effects of weaning on antibody responses in young calves.
AB  - Two experiments were performed to investigate the effects of cessation of feeding
      milk substitute (weaning) on antibody responses to Keyhole Limpet haemocyanin
      (KLH) in young calves. In the first experiment, 47 calves were weaned at 42 days
      of age, while a further 47 calves remained unweaned until 84 days of age. All
      calves were immunized with KLH at 43 and 85 days of age. Serum IgG1, IgG2 and IgA
      responses to KLH were increased in the early weaned calves compared with the late
      weaned calves following both primary and secondary immunizations. In the second
      experiment, 24 calves were immunized with KLH at 21 days of age. Subsequently, at
      35 days of age, eight calves were weaned, eight calves were sham-weaned and eight
      calves remained unweaned. Sham-weaning involved continuing to feed milk
      substitute of greatly decreased nutritional value in an attempt to isolate
      nutritional from behavioural effects of weaning. No effects of treatments on
      antibody responses were detected. It was concluded that weaning affects antibody
      responses to antigens given near weaning but not to antigens given 2 weeks before
      weaning.

PMID- 1632083
TI  - Inventory of pain data from the National Center for Health Statistics.

PMID- 1632082
TI  - Evidence for conservation of peripheral lymphocyte homing receptors between the
      bovine, murine and human species.
AB  - In rodents and humans, lymphocytes circulate throughout the body and return
      preferentially to their tissues of origin via a process termed homing. The
      specificity of homing is controlled by the binding of tissue-specific receptors
      on lymphocytes to ligands on specialized high-walled endothelial venules (HEV)
      found in lymphoid tissue. The murine and human peripheral lymphocyte homing
      receptors (PLHR) have been characterized and shown to be similar to each other.
      We present evidence for a similar receptor in the bovine. Bovine peripheral blood
      lymphocytes (PBL) bind to the HEV of murine peripheral lymph node tissue in
      vitro. The same sugars that have been shown to decrease the binding of murine or
      human lymphocytes to murine HEV also decrease the binding of bovine PBL to murine
      HEV. Neuraminidase treatment affects lymphocyte binding in a similar manner in
      the bovine, murine and human species. Phorbol myristate acetate (PMA)
      stimulation, which has been shown to reduce the expression of murine and human
      PLHR, also reduces the binding of bovine PBL to murine HEV. These data suggest
      conservation of PLHR between these species.

PMID- 1632084
TI  - [The psychosomatic approach in clinical practice].
AB  - The author summarizes demands essential for successful implementation of the
      psychosomatic, i.e. biopsychosocial approach in everyday clinical practice. With
      regard to the complete shortage of comprehensively conceived psychosomatic
      centres, the author considers it useful to replace extra-mural psychiatric and
      psychological services to a maximum extent by consultant ("liaison")
      psychiatrists and psychologists. Team cooperation of specialists, mostly with a
      biomedical orientation, with specialists from the psychosocial sphere is an asset
      for patients as well as for medical thinking. This collaboration gives
      specialists of both represented models some new demands, in particular the need
      to find a common language, to define competences and for both an extension of the
      view on the problems. It opens the possibility of more effective cooperation with
      the patient's family and moreover the psychiatrist and psychologist can try to
      reduce stressing influences and attempt their prevention which is also to the
      benefit of health professionals.

PMID- 1632085
TI  - [Genealogic study of hypertrophic cardiomyopathy in the Czech population].
AB  - In order to test the type of heredity and to assess further genealogical
      characteristics in our population the authors examined 105 families with
      hypertrophic cardiomyopathy. The families were subjected to clinical,
      electrocardiographic and echocardiographic examination of relatives (72% grade 1
      relatives) as well as to a genealogical and psychological examination. For the
      proband's siblings the empirical risk of disease was 24%, in male probands it wts
      four times higher for brothers than sisters, in female probands it was three
      times higher in sisters. The sex ratio of six siblings in men was 20:4, in women
      3:14. For children the risk was substantially higher in youner probands (under 30
      years risk 40%, above 51 years 6.7%). The proband's parents were affected in 28%,
      fathers almost twice as frequently in male probands, and equally frequently in
      female probands. Fitness (reproduction fitness, f) was substantially reduced in
      the entire group, in isolated and familial cases and in different age groups,
      more in women than in men. The gene penetrance (assuming monofactorial heredity)
      was estimated by the method of definite carriers as 50%. Earlier manifestations
      (anticipation) and a more severe course of the disease was observed practically
      in all families with occurrence of the disease in more than 2 generations
      (influence of selection--sampling error). In our group the heredity in
      hypertrophic cardiomyopathies was not simple autosomal dominance, it was not
      possible to rule out heterogeny, phenocopy, sexual influence. On the other hand,
      the group was too small to make possible unequivocal conclusions and the data
      were not quite consistent with data in the literature. Genetic counselling,
      possibly DNA diagnosis, would be needed to elucidate heredity of this disease.

PMID- 1632086
TI  - [Creatine kinase and lactate dehydrogenase in the early diagnosis of acute
      myocardial infarct].
AB  - The authors investigated in a group of 504 patients--357 men and 147 women with
      acute myocardial infarction on admission to hospital--the relationship between
      the ECG finding and values of catalytic concentrations of isoenzymes CK-MB and LD
      1 LD-2. They found that isoenzymes CK-MB and LD-1 LD-2 are a more sensitive
      indicator of acute IM than the ECG tracing. Not even a negative ECG tracing when
      the total catalytic concentrations of CK and LD are not elevated rules out the
      possibility of acute myocardial infarction.

PMID- 1632087
TI  - [Magnesium loading test in cardiovascular diseases].
AB  - The author presents an account of results of the magnesium loading test and its
      method, from a group of 50 patients with cardiovascular diseases. The magnesium
      loading test reveals shortage of bodily reserves of magnesium (mg) by calculating
      the percentage of Mg retention. In a group of examined subjects the author found
      a high percentage of Mg retention (on average 68%) which suggests an unequivocal
      deficiency of bodily Mg reserves in this group of patients. At the same time
      changes of serum concentrations and urinary excretion of other investigated
      minerals are discussed. As compared with other methods of assessment of Mg bodily
      reserves, the loading test is most suitable for clinical practice. In the
      discussion the author analyzes the assembled results and factors which lead to
      deficiency of bodily Mg reserves and deals with substitution treatment by Mg
      preparations.

PMID- 1632088
TI  - [Drug therapy in vascular occlusions of the lower extremities].
AB  - The authors report their three-year experience with application of thrombolytic
      treatment in 31 patients with vascular occlusions of the lower extremities. They
      were successful in two thirds of the patients. The authors analyze the advantages
      and shortcomings of systemic or selective administration of antithrombotic
      therapy. Concurrent administration of hyperbaric oxygen is a rational therapy.

PMID- 1632089
TI  - [Diabetic osteopathy. Favorable effect of treatment of osteomalacia with vitamin
      D and calcium on high blood glucose levels].
AB  - A group of 61 diabetics (incl. 35 treated by diet alone and 26 who were treated
      also by oral antidiabetics) with associated osteomalacia were treated with
      vitamin D (dosage 42,000 to 85,000 i. u. per day) and calcium (470-700 mg/day).
      After six weeks of this treatment the serum calcium level rose on average by 0.15
      mmol/l and the blood sugar level declined on average by 1.68 mmol/l. A linear
      negative correlation was proved between these two parameters. The fasting blood
      sugar level declined in 53 subjects (86.88%) and only in five patients (8.19%)
      the blood sugar level increased, in three subjects (4.91%) it did not change.
      Possible explanations of this phenomenon include the influence of an increased
      calcium concentration on insulin secretion and release from pancreatic beta-cells
      on the one hand and enhanced glucose utilization in the periphery on the other
      hand.

PMID- 1632090
TI  - [Plasma viscosity. The effect of plasma proteins].
AB  - The authors assessed the plasma viscosity by means of a capillary viscosimeter of
      their own design and assessed at the same time the concentration of 22 plasma
      proteins or lipids. Based on the results of these examinations it proved possible
      to elaborate an original equation which describes the plasma viscosity as a
      function of the concentration of fibrinogen, alpha-2-globulins (and among them
      most probably haptoglobin), gammaglobulins, IgA and IgM. The authors discuss in
      detail the importance of this finding for clinical haemorheology.

PMID- 1632091
TI  - [Free oxygen radicals in patients with hyperlipoproteinemia].
AB  - The authors investigated the effect of hyperlipoproteinaemia on the formation of
      free oxygen radicals to which a significant role in the genesis of
      atherosclerosis is ascribed. They cause among others peroxidation of blood lipids
      with formation of lipoperoxides with a higher atherogenity. Using the method of
      luminol-dependent chemiluminiscence, their spontaneous and activated production
      in phagocytic blood cells was examined in a group of patients investigated on a
      long-term basis on account of hyperlipoproteinaemia (n = 24). The results were
      compared with a group of healthy subjects (n = 20); concurrently also blood
      lipids were examined. The authors revealed a statistically significant reduction
      of the spontaneous production of free oxygen radicals in the group of patients
      with hyperlipoproteinaemia. On examination of the activated production the drop
      of oxygen radical formation was at the borderline of statistical significance.

PMID- 1632092
TI  - [Antibodies against gastric parietal cells and thyroglobulin in various diseases
      in humans].
AB  - The authors examined antibodies against antigen of gastric parietal cells using
      the method of reaction of complement-binding and the immunofluorescence test in
      662 patients. Concurrently they examined in 443 patients of this group also
      antibodies against thyroglobulin. The group comprised 312 men and 350 women. For
      statistical evaluation the chi 2 test was used. Antibodies against the antigen of
      parietal cells were positive at the level of significance p less than 0.05 in the
      group with other diseases, at the level of significance of p less than 0.01 in
      dyspeptic syndrome, and at the level of significance p less than 0.001 in
      hypothyroidism and in chronic hepatopathies. The immunofluorescence test was
      statistically significant at the level of p less than 0.01 only in duodenal
      ulceration, at the level of p less than 0.001 in dyspeptic syndrome,
      hypothyroidism, hyperthyroidism, chronic hepatopathies, chronic pancreatitis,
      cholecystopathies, nephropathies and in the group of other diseases. Thyroid
      antibodies were positive with titres of p less than 1: 50 in 5.63, with titres of
      p less than 1: 5000 in 3.03%. The mentioned disease have not only
      pathomorphological and aetiological similarities but there is also serological
      overlapping.

PMID- 1632093
TI  - [Asymptomatic cholecystolithiasis in an ultrasonography study from Trencin].
AB  - The author examined 1952 girls and women aged 15 to 92 years by ultrasonography.
      The incidence of cholecystolithiasis in the group without complaints was 8.19% in
      the group with atypical complaints it was 17.67% and in the group with typical
      complaints it was 75.0%. The ratio of asymptomatic cholecystolithiasis of the
      first two groups combined was 67.0% of the total. The ratio of cholecystectomies
      in the total number of cases with cholecystolithiasis was 30.9%. The clinical
      manifestation of cholecystolithiasis is influenced greatly by genetic factors,
      i.e. symptomatic lithiasis in the mother. Prophylactic cholecystectomy in case of
      asymptomatic cholecystolithiasis should not be recommended.

PMID- 1632094
TI  - [Pulmonary embolism as a rare complication of a contusion in the inguinal
      region].
AB  - In the submitted case-history the authors describe the clinical case of an
      adolescent patient who developed phlebothrombosis of the right ileofemoral area
      one year after a blunt injury in the scrotal and right inguinal area. The
      symptoms of pulmonary embolism were detected sooner than the symptoms of
      phlebothrombosis. Two-dimensional echocardiography provided valuable information
      when the authors monitored the dynamics of changes in acute cor pulmonale and the
      effect of administered treatment.

PMID- 1632095
TI  - [Quality control in hematology].
AB  - Qualified quality control is a necessary part of modern haematology: we cannot
      deem laboratory results reliable until effective quality checking is included.
      Quality assessment includes external (national, regional) and internal (intra
      laboratory) control. We suggest to found a Czech national external quality
      control agency for haematology based on principles which were declared by the
      World Health Organization. Internal control includes correct identification of
      samples, analytical control (standardization of test, evaluation of accuracy and
      precision) and biological quality control (history of patient's characteristics,
      relation to other laboratory results in clinical context). The deviation index,
      which is expressed either as a number or verbally 'excellent', 'good',
      'satisfactory', or 'unsatisfactory', can supply rapid information on the quality
      of results in the haematological laboratory.

PMID- 1632096
TI  - [Present views on the diagnosis of cavernous hemangioma of the liver using
      ultrasound].
AB  - The submitted review deals with morphometry, normal sonographic anatomy and the
      position of ultrasonography in the diagnosis of cavernous haemangiomas of the
      liver. The authors draw attention to the contemporary equipment used and analyze
      the position of other diagnostic methods in the diagnosis of cavernous
      haemangiomas of the liver. They discuss also the problem of percutaneous biopsy
      of the liver when this benign tumour is suspected. Finally the authors recommend
      the best procedure in the diagnosis of cavernous haemangiomas of the liver.

PMID- 1632097
TI  - [Modern development of cardiac pacing].
AB  - In the submitted review the author presents after a historical introduction the
      contemporary possibilities of permanent pacing. He mentions the main reasons why
      a fixed rate pacing without atrioventricular synchronization is unphysiological
      and led to the development of dual chamber DDD pacemakers and ventricular
      pacemakers with a variable frequency of pacing. The main contribution of this so
      called physiological pacing is an increase of the cardiac output and the work
      capacity of patients, as compared with fixed rate pacing. The author present also
      examples of diagnostic and antitachycardiac stimulation and discusses
      possibilities of their combination with an implantable cardioverter-defibrillator
      in ventricular tachyarrhythmias.

PMID- 1632098
TI  - Current dental chemotherapeutics.

PMID- 1632099
TI  - Prenatal diagnosis: can what counts be counted?

PMID- 1632100
TI  - Reducing distress associated with pelvic examinations: a stimulus control
      intervention.
AB  - The effect of a new pelvic examination gown on patients' experienced discomfort
      during pelvic examination was tested. It was hypothesized that a better designed
      gown would reduce reported distress. Subjects were 87 patients at a private
      gynecology clinic. Age ranged from 17 to 72. Informed consent was obtained and
      patients were randomly assigned to either the experimental gown or the standard
      drape condition. Following examination, subjects completed questionnaires
      assessing demographic characteristics, state and trait anxiety, desired changes
      in pelvic examination procedures, and reactions to the examination. The attending
      nurse recorded heart rate and blood pressure. Results supported the hypotheses.
      Experimental subjects rated the gown as more comfortable than control subjects
      rated the drape. Experimental subjects desired fewer changes in exam procedures
      than control subjects, indicating that the gown provided them with an overall
      more comfortable experience.

PMID- 1632101
TI  - Depression and maladaptive eating practices in college students.
AB  - University students (n = 234) enrolled in sections of a required undergraduate
      course were administered the Center for Epidemiologic Studies Depression (CES-D)
      Scale and the Maladaptive Eating Behavior (MEB) Scale to determine if selected
      maladaptive eating practices correlated with depressive symptoms. Stepwise
      multiple regression on data from female subjects (n = 138) revealed that four
      eating practices related to depression, and produced a multiple R = .68,
      accounting for 46.2% of the variance. Maladaptive eating practices were not
      predictive of depression among males (n = 96) with "feeling uncomfortable eating
      in the presence of others" the only significantly correlated variable. This study
      confirms previous research that has found an association between maladaptive
      eating practices and depressed mood in nonclinical samples of university
      students.

PMID- 1632102
TI  - Was it murder or insanity? Reactions to a successful paroxysmal insanity plea in
      1865.
AB  - This 1865 Harris/Burroughs trial marked the first time that the paroxysmal
      [temporary] insanity plea was supported by expert medical testimony in a U.S.
      courtroom. Jurors agreed that the female defendant was insane at the time of the
      shooting due to being "crossed in love and suffering from painful dysmenorrhea."
      Attitudinal stances of the legal system, health professionals, newspapers and the
      public are illustrated. By merely changing the antebellum language, the reactions
      could be recycled into our current tabloid newspapers and titillating TV programs
      as if the tragedy occurred yesterday.

PMID- 1632103
TI  - Worker and mother roles, spillover effects, and psychological distress.
AB  - This paper examines the relationship between the occupancy and quality of
      multiple-roles and psychological distress in a stratified random sample of 403
      women employed as licensed practical nurses and social workers. We examined the
      main effects of the quality of the employee and parent roles and the interaction
      effects between these variables. Negative- and positive-spillover effects, from
      job to parenting and from parenting to job, were examined in an attempt to
      illuminate the processes by which multiple roles affect employed mothers'
      vulnerability or resilience to psychological distress. We found no negative
      spillover effects from job to parenting or from parenting to job, but we did find
      positive-spillover effects from job to parenting. Women with rewarding jobs were
      protected from the negative mental-health effects of troubled relationships with
      their children. This protection accrued to employed mothers regardless of their
      partnership status or the age of their children. Although based on cross
      sectional analyses, these findings suggest mechanisms by which employed mothers
      reap a mental-health advantage from multiple roles, even when some of those roles
      are stressful.

PMID- 1632104
TI  - Study on the metabolism of racemic prolintane and its optically pure enantiomers.
AB  - 1. Asian and European volunteers were given racemic prolintane, and the
      metabolites in the 24 h urine were identified and quantified by g.l.c. mass
      spectroscopy using synthetic reference compounds. 2. R-(+)- and S-(-)-prolintane
      were synthesized from optically active phenylalanine. The metabolism of the
      enantiomers differs mainly in the quantitative amounts of metabolites.

PMID- 1632105
TI  - Disposition of bepridil in laboratory animals and man.
AB  - 1. The disposition and pharmacokinetics of bepridil (Bp) were studied in mouse,
      rat, rabbit, rhesus monkey, and man. Bp was essentially completely absorbed by
      all species. 2. Maximum plasma Bp concentrations were achieved within 2 h of drug
      administration. Linear but non-proportional, dose-related increases in the area
      under the curve (AUC) for plasma Bp vs. time were noted after increasing oral
      doses of Bp.HCl to rats (30-300 mg/kg) and monkeys (25-200 mg/kg). 3. Daily
      administration of Bp.HCl to rats (100 mg/kg per day for 15 days) and monkeys (200
      mg/kg per day for 13 days) produced no statistically significant changes in Bp
      pharmacokinetic parameters. 4. Oral plasma clearance (CLp) of Bp was very low in
      man (ca. 0.93 l/h per kg) compared to experimental animals (14.8-63.8 l/h per
      kg). Terminal elimination half-lives were 1.5-2.0 h for mouse and rat, ca. 4.4 h
      for monkey and ca. 48 h for man. 5. Bp and a total of 12 metabolites were
      identified and quantified. Metabolite formation in the five species was
      adequately described by four interrelated pathways, namely, aromatic
      hydroxylation, followed by N-dealkylation, N-debenzylation, and N-acetylation.
      Metabolites produced by this pathway included 4-hydroxy-Bp, N-benzyl-4
      aminophenol, 4-aminophenol, and N-acetyl-4-aminophenol. Comparison of the
      proposed pathways revealed qualitative similarity among species.

PMID- 1632107
TI  - The plasma pharmacokinetics of iophenoxic and iopanoic acids in goat.
AB  - 1. The comparative plasma pharmacokinetics of two organic iodine-containing
      compounds were evaluated in the goat for their suitability as markers in wildlife
      studies. 2. After oral administration of a single dose, the plasma elimination
      half-life for iopanoic acid was considerably more rapid (t1/2 of 1-2 days) than
      that of iophenoxic acid (t1/2 of 81 days). 3. Similar peak plasma concentrations
      were obtained after administration of iophenoxic acid (1.5 mg/kg) and iopanoic
      acid (25 mg/kg); however, the AUC0----infinity for iopanoic acid at doses of 25,
      50, and 100 mg/kg were 201 +/- 39, 604 +/- 225, and 1292 +/- 721 (micrograms h/ml
      +/- SD), respectively, which were less than the value of 36,600 +/- 6387 for the
      oral administration of iophenoxic acid at 1.5 mg/kg. 4. Iophenoxic acid was
      chosen as a suitable marker because of its persistence at detectable
      concentrations in the plasma for 5 months.

PMID- 1632106
TI  - Disposition of minaprine in animals and in human extensive and limited
      debrisoquine hydroxylators.
AB  - 1. The disposition of 14C-minaprine was studied after oral administration of 5
      and 20 mg/kg to rats, dogs and macaques, and of 200 mg to human volunteers with a
      genetic status of either limited or extensive hydroxylation of debrisoquine. 2.
      The drug was readily absorbed and a large proportion of the administered
      radioactivity was excreted within 48 h. The total excretion over 5 days ranged
      from 83% in monkeys to almost 100% in human with a status of extensive
      hydroxylators. 3. In the two limited hydroxylators Cmax values of total
      radioactivity in plasma were 4.6 and 3.7 mg equiv/l respectively. Those in the
      two extensive hydroxylators were 1.9 and 1.6 respectively. The highest value in
      the animal species was 8.1 in rats at a dose of 20 mg/kg. Plasma Cmax values of
      minaprine were 4.0 and 1.4 mg/l in limited hydroxylators and 0.35 and 0.23 mg/l
      in extensive ones. The highest value in the animal species was 2.7 mg/l in dogs
      treated with 20 mg/kg. 4. In rats and dogs, the ratios of the plasma AUC values
      for 20 mg/5 mg doses were close to those of the ratios of the doses administered,
      whereas in the macaque a slower clearance of radioactivity occurred with the
      higher dose (t 1/2 beta 5.5 h at 5 mg/kg dose versus 25.7 h at 20 mg/kg dose). 5.
      Marked species differences were observed in the metabolic pathways. The dog and
      limited hydroxylators showed higher levels of minaprine and its N-oxide (M4)
      whereas p-hydroxy-minaprine (M3) prevailed in monkey, rat and extensive
      hydroxylators. 6. In dogs only, seizures appeared within 10-15 min after dosage
      with minaprine at 20 mg/kg, when the concentrations of minaprine in erythrocytes
      (6.9 mg/l) and of M4 in plasma (0.40 mg/l) and erythrocytes (0.25 mg/l), were
      high. 7. The measurements and clinical observations indicate that onset of an
      adverse behavioural response in humans is unlikely at the dose of 200 mg.

PMID- 1632108
TI  - Involvement of FAD-dependent polyamine oxidase in the metabolism of milacemide in
      the rat.
AB  - 1. It has previously been established that monoamine oxidase (MAO)-B participates
      in the metabolism of milacemide [2-(pentylamino)acetamide]. Furthermore, in rats,
      inhibition of FAD-dependent polyamine oxidase (PAO) was found to decrease the
      urinary excretion of two milacemide metabolites, termed UK1 and UK2. 2. Using gas
      chromatography-mass spectrometry, UK1 was identified as oxamic acid and UK2 as 2
      hydroxyacetamide, confirming that PAO is involved in the metabolism of
      milacemide. 3. Thus, two FAD-dependent amine-oxidizing enzymes, MAO and PAO,
      contribute to the metabolism of milacemide. Milacemide appears to be the first
      non-polyamine xenobiotic in the metabolism of which PAO participates.

PMID- 1632110
TI  - Differentiation of cytochrome P-450 inducers on the basis of 7-alkoxycoumarin O
      dealkylase activities.
AB  - 1. The high-affinity and total activities of 7-methoxycoumarin O-demethylase and
      of 7-ethoxycoumarin O-deethylase were measured in liver microsomes isolated from
      rats treated with prototypic inducers belonging to the main classes of microsomal
      enzyme inducers currently recognized. 2. Each inducer (with the exception of
      clofibrate which was ineffective) produced a unique induction profile, indicating
      the possibility of using these two enzymes, each measured at two substrate
      concentrations, for characterization of the inducing potential of novel
      xenobiotics. 3. Differences between p,p'-DDT and phenobarbitone in the induction
      profiles indicate that DDT may not be a pure 'phenobarbitone-type' inducer as has
      been proposed hitherto.

PMID- 1632109
TI  - Metabolism of 1,2,4-trichlorobenzene in rats: examination of thiol formation.
AB  - 1. More than 60% of oral doses of 14C-1,2,4-trichlorobenzene (ca. 21 mg/kg)
      administered to rats were excreted in bile as S-trichlorophenyl-mercapturic acid
      pathway metabolites. 2. The biliary metabolites were ultimately excreted in urine
      mainly as the isomeric mercapturic acids. 3. An acetylated glutathione conjugate
      was isolated as a major metabolite in bile (8% dose). The acetyl group was shown
      by mass spectrometry to be on the glutamyl moiety. 4. A glutamylcysteine
      conjugate of trichlorobenzene was also isolated from bile as a major metabolite
      (8% dose). 5. Trichlorothiophenols were deduced not to be intermediates or end
      products of enzymic metabolism of trichlorobenzene in rats because 14C-2,4,5
      trichlorothiophenol dosed i.p. to rats was excreted as the S-glucuronide (17%
      dose) and as S-(methylsulphonyl-dichlorophenyl)-mercapturic acid (36% dose).

PMID- 1632111
TI  - Single- and multiple-dose kinetics of d-fenfluramine in rats given anorectic and
      toxic doses.
AB  - 1. High parenteral doses of a twice-daily schedule of d,l-fenfluramine (d,l-F)
      may cause long-lasting decrease of functional indices of brain serotoninergic
      neurones in rats. The single- and multiple-dose (b.i.d. x 4 days) kinetics of low
      (1.25 mg/kg) and high (12.5 mg/kg) subcutaneous (s.c.) doses of d-F, which
      accounts of the anorectic effects of the racemate, and its deethylated metabolite
      d-norfenfluramine (d-NF), were therefore examined and compared with those of
      pharmacologically effective oral doses (0.3-1.25 mg/kg) in rats. 2. There were
      dose-dependent alterations of kinetic parameters after s.c. and oral dosing,
      indicating that hepatic clearance of d-F in the rat can be saturated either by
      increasing the size of the single dose or during repeated dosing. Nonlinearity
      was also observed for d-NF. Consequently at high doses exposure of rat to the
      drug, as measured by the sum of area under the plasma concentration-time curve
      (AUC) of d-F and d-NF considerably exceeded that expected from simple dosage
      considerations, particularly with repeated administration of d-F. 3. Total
      exposure at the high doses considerably exceeded that at pharmacological doses,
      however, indicating an ample margin in favour of anorectic activity. The
      possibility that the long-term depletion of brain 5-HT by d-F and/or its
      metabolite d-NF may have relevance at the usual therapeutic dose, is discussed.

PMID- 1632112
TI  - Biotransformation of mianserin in laboratory animals and man.
AB  - 1. The biotransformation and excretion of the antidepressant mianserin were
      studied after oral administration of the labelled drug to rats, mice, rabbits,
      guinea pigs and humans. Mianserin was well absorbed and almost completely
      metabolized in all five species. 2. Major metabolic pathways of mianserin were p
      oxidation of the N-substituted aromatic ring followed by conjugation, and
      oxidation and demethylation of the N-methyl moiety, followed by conjugation.
      Direct conjugation of the N-methyl moiety was observed as a metabolic pathway
      specific for man. 3. Conjugated metabolites were isolated by h.p.l.c. and
      identified by 1H-n.m.r. and FAB spectrometry. Novel metabolites such as an N-O
      glucuronide in the guinea pig and an N-sulphonate in rat and guinea pig, were
      identified using these techniques. A quaternary N-glucuronide was found only in
      man.

PMID- 1632113
TI  - Inhibition of rat hepatic aryl sulphotransferase IV by dihydrodiol derivatives of
      benzo[a]pyrene and naphthalene.
AB  - 1. Although neither the (+)- nor (-)-enantiomer of trans-benzo[a]pyrene-7,8
      dihydrodiol was a substrate for aryl sulphotransferase IV from rat liver, both
      enantiomers inhibited the enzyme-catalysed sulphation of 1-naphthalene-methanol
      with Ki values of 3.7 +/- 0.4 microM for the (+)-enantiomer, and 4.4 +/- 0.3
      microM for the (-)-enantiomer. 2. Based on the magnitude of the Ki values, the
      binding affinity of these dihydrodiols for the aryl sulphotransferase was
      significantly greater than that for the corresponding phenolic derivatives of
      benzo[a]pyrene. That is 7-hydroxybenzo[a]pyrene and 8-hydroxybenzo[a]pyrene were
      both substrates for aryl sulphotransferase IV, with apparent Km values of 280 +/-
      41 microM and 370 +/- 72 microM, respectively. 3. Both (+)- and (-)-trans
      naphthalene-1,2-dihydrodiols were also inhibitors of aryl sulphotransferase IV,
      but with higher Ki values than would be expected from previously determined
      apparent Km and Ki values for (R)-(-)- and (S)-(+)-1,2,3,4-tetrahydro-1
      naphthols, respectively.

PMID- 1632114
TI  - [Effect of pirenzepine on motility of Oddi's sphincter].
AB  - Pirenzepine (Gastrozepin) has a proven positive effect in the treatment of peptic
      ulcers by blocking the so called muscarinic acetylcholine receptors of the
      gastric glands. Reports of positive results with pirenzepine in the treatment of
      acute pancreatitis led to new discussions about its biological effects. It is
      thought that there are three ways by which pirenzepine acts in the pancreas. It
      decreases enzymatic secretion and it increases the secretion of sodium
      bicarbonate and water. Furthermore, it is said to have a spasmolytic effect on
      the sphincter of Oddi. To prove this spasmolytic effect we performed endoscopic
      manometry at the sphincter of Oddi with intubation of the pancreatic duct in 12
      healthy patients. After two minutes of manometric registration of the normal
      sphincter activity 6 patients received 10 mg pirenzepine i.v. while a control
      group of 6 patients received 2 ml of 0.9% NaCl i.v. During the next 5 minutes the
      basal pressure of the sphincter, the amplitude of concentrations, as well as
      their frequency and duration were monitored. There were no changes noticed in the
      placebo group. However, pirenzepine caused a considerable decrease of the 4
      manometric parameters of the sphincter of Oddi in all patients. Within 5 minutes
      the basal tonus fell from 14.3 +/- 5.1 mm of mercury to 9.0 +/- 6.0 (p less than
      0.01). The frequency of contractions dropped from 5.8 +/- 2.7 per minute to 2.0
      +/- 2.1 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632115
TI  - [Cavernous liver hemangioma with arterio-portal fistula].
AB  - Evidence of a cavernous hemangioma of the liver with fistula between hepatic
      artery and the portal vein of a 52 year-old woman with colickly upper abdominal
      pain and ascites was obtained using Duplex-Doppler-ultrasound. The diagnosis was
      confirmed by selective arteriography. After ligation of the left hepatic artery
      clinical symptoms abated. The cavernous hemangioma was followed up over 7 1/2
      years with ultrasound. Ultrasound has been shown to be a valuable test for
      diagnosis and follow up of cavernous hemangioma.

PMID- 1632116
TI  - [Applicability of CCK receptor antagonists in physiologic and therapeutic
      studies].
AB  - The development of potent and specific CCK-receptor antagonists made it possible
      to evaluate the physiological role of CCK for various gastrointestinal functions.
      The results of these studies show that CCK is the hormone which principally
      mediates meal-induced gallbladder emptying. In addition, CCK appears to play an
      important role in maintaining the fasting muscular tone of the gallbladder. In
      contrast, CCK-antagonists could inhibit only about 50% of the meal-stimulated
      pancreatic exocrine secretion. Because of their marked relaxing effect on the
      gallbladder, CCK-antagonists might become an important clinical tool for
      treatment of gallbladder spasms and colics. On the other hand, long-term
      application of CCK-antagonists will increase the risk of stone formation in the
      gallbladder. CCK-antagonists also had beneficial effects in some animal models of
      acute pancreatitis. As yet, it is unclear whether CCK-antagonists might become
      useful for the treatment of human pancreatitis. Since CCK-antagonists only
      slightly inhibited pancreatic growth, it is unlikely that they will exert major
      inhibitory effects against growth of pancreatic carcinoma. CCK-antagonists failed
      to alter gastric emptying of a normal mixed solid-liquid meal, but accelerated
      gastric emptying of purely liquid meals. Thus, CCK-antagonists are not likely to
      become useful agents to treat alterations of gastric emptying. The studies with
      CCK-antagonists further showed that CCK plays only a minor role in the regulation
      of the motility of the small and large intestine. CCK is probably not involved in
      the regulation of the gastrocolonic response after a meal. Some reports indicate
      that CCK-antagonists might increase colonic transit and might therefore be useful
      to treat constipation.

PMID- 1632117
TI  - [Do patients with acute Crohn disease profit from enteral nutrition with
      oligopeptide diet?].

PMID- 1632118
TI  - [Octreotide in intestinal pseudo-obstruction?].

PMID- 1632119
TI  - [25th annual meeting of the Austrian Association for Gastroenterology and
      Hepatology. Vienna, 12-13 June, 1992. Abstracts].

PMID- 1632120
TI  - [Letter to the Journal of Gastroenterology. Comment on the article "Senna or
      bisacodyl before lavage preparation for colonoscopy: prospective randomized
      comparative study", by D. J. Ziegenhagen, E. Zehnter, W. Tacke, T. H. Gheorghiu,
      W. Kruis].

PMID- 1632121
TI  - Stress related diagnosis: increased admittance to hospital during unannounced
      warfare in Croatia?

PMID- 1632122
TI  - [Use of ERCP in pancreatic diseases].

PMID- 1632123
TI  - [The structure of fish helminth populations].
AB  - Typification and some qualitative characteristics of populations of the fish
      helminths are given which allow to explain some peculiarities of their numbers,
      genetical interrelations, action of immunological factor. Simplification of the
      structure of helminth populations provokes large fluctuations of the helminths
      number. Differences in the structure of helminth populations are to be considered
      as one of mechanisms of development of stability of parasitic system.

PMID- 1632125
TI  - Modelling of the cardiac electrical field.

PMID- 1632124
TI  - [The evolutionarily optimal rates of body development. The age of onset of sexual
      maturity and species-specific longevity as the parameters optimized during
      evolution].
AB  - Dynamics of biological community of the "resource--consumer" type considering age
      structure of consumer population is described by a system of differential
      equations with special derivatives. On the basis of such a model, a competition
      model for non-crossing populations with different individual development rates is
      elaborated. It is shown that only a population with development rates maximizing
      the Malthusian function (reaching zero value at the equilibrium state of the
      system) is able to survive under competition for food resources. Equilibrium
      density of the resources is provided being minimal. Thus maximum energy influx
      into the population is gained. Search algorithm of evolutionary values of
      puberty, age and maximal longevity of individuals belonging to the consumer
      population is proposed. Analytic dependence of maximal longevity on environmental
      factors and some other parameters are found. Aging is considered to be mechanism
      leading to death while individual approaches evolutionary optimal longevity.

PMID- 1632126
TI  - Angiographic coronary artery lesion morphology and pathogenetic mechanisms of
      myocardial ischemia in stable and unstable coronary artery disease syndromes.
AB  - The angiographic morphology of coronary artery stenoses was studied in 160
      patients referred for diagnostic coronary arteriography. Three groups of patients
      were studied: 60 patients with stable angina, 78 patients with unstable angina
      and 22 patients with a recent myocardial infarction. Complex lesions were more
      frequently observed in patients with unstable angina (59%, p less than 0.001) and
      in patients with a recent myocardial infarction (54%, p less than 0.05) then in
      patients with stable angina (25%). Angiographic signs suggestive for the presence
      of intravascular thrombi were almost exclusively observed in the patients with
      unstable angina (34%, p less than 0.001) and in the patients with a recent
      myocardial infarction (27%, P less than 0.001) and were almost completely absent
      in the patients with stable angina (1.5%). The high prevalence of complex
      coronary artery lesion morphology and of intravascular thrombi observed in
      patients with unstable angina or with a recent myocardial infarction emphasizes
      the important role of intima disruption and of subsequent thrombosis in the
      pathogenesis of myocardial ischemia in those unstable syndromes of ischemic heart
      disease.

PMID- 1632127
TI  - Influence of upright exercise on pulmonary hemodynamics in left heart failure.
AB  - Studies in severe chronic stable heart failure (HF) indicate that pulmonary
      resistance might remain unchanged during exercise and could subsequently
      contribute to limitation in exercise capacity of these patients. We assessed the
      possible role of the exercise decreases in mixed venous oxygen tension on this
      phenomenon in fifteen patients with chronic congestive heart failure (N.Y.H.A.
      functional classes II to IV) who underwent a symptom-limited treadmill exercise
      test with hemodynamic monitoring as well as repeated arterial and mixed venous
      blood gas analysis. For all patients there was an increase in cardiac output
      (from 3.7 +/- 0.2 to 6.7 +/- 0.5 l/min, p less than 0.001) and pulmonary wedge
      pressure (from 16 +/- 2 to 31 +/- 3 mm Hg, p less than 0.001) along with exercise
      with highly significant decrease in total systemic resistance and no significant
      (from 25.6 +/- 1.5 to 15.8 +/- 1.0 U, p less than 0.001) changes in pulmonary
      vascular resistances. Arterial blood oxygen tension increased from 86 +/- 3 to 99
      +/- 3 mm Hg (p less than 0.001) and mixed venous oxygen tension (PvO2) decreased
      from 33 +/- 1 to 22 +/- 1 mm Hg (p less than 0.001). Changes in pulmonary
      vascular resistance during exercise were inversely related to changes in PvO2 (r
      = -0.61; p less than 0.05). We conclude that the observed decrease in PvO2 might
      be a determinant of unchanged pulmonary vascular resistance during treadmill
      exercise test in severe heart failure patients.

PMID- 1632128
TI  - Handgrip-apexcardiographic test: a new mode of detecting patients with silent
      exercise-induced myocardial ischemia.
AB  - There are no simple noninvasive stress tests for detecting silent myocardial
      ischemia by assessing left ventricular (LV) diastolic abnormalities which are
      known to occur early on the onset of every ischemic episode. It has been proved
      that the LV apexcardiogram (ACG) reflects the LV pressure curve in early and late
      diastole and can be recorded during isometric handgrip (HG) exercise. To
      determine the clinical validity of HG-ACG-Test (HAT) in identifying patients with
      silent ischemia, 16 patients (8 with prior infarction) with angiographically
      documented coronary artery disease, positive treadmill electrocardiographic test
      and without symptoms were examined. According to the largest and lowest
      individual values in 253 healthy volunteers, the positivity of HAT was defined by
      the presence of at least one of the criteria: 1) The relative A-wave to total
      height of ACG during or/and after HG greater than 21%. 2) The total ACG
      relaxation time (TART) during HG longer than at rest and also longer than 143 ms
      or/and the heart rate corrected TART during HG less than 0.14, or 3) the combined
      index of overall diastolic function DATI (= diastolic amplitude time index)
      during HG less than 0.27. Based on this definition 14/16 (sensitivity: 88%)
      patients showed a positive test result. It is concluded that, using new
      definitions of positivity, HAT shows a high sensitivity for detecting patients
      with proved silent ischemia providing, thus, providing a new simple clinical tool
      for the identification of these patients.

PMID- 1632129
TI  - Invasive and echocardiographic evaluation of non-Q myocardial infarction with
      isolated stenosis of descending anterior coronary artery.
AB  - Prognostic and clinical characteristics of acute myocardial infarction (AMI) can
      usually justify surgical and/or angioplastic approach if the residual ventricular
      function is still good. Multivessel disease frequently complicates results
      interpretation. We studied with 2D echocardiography and coronary angiography two
      groups of patients with one vessel stenosis located on anterior descending (AD)
      and previous AMI (means 19 days): 23 patients with spontaneous non-Q infarction
      (group 1), and 23 patients with Q infarction. Left ventricular function was
      better in group 1. Percent occlusion of AD was lower in group 1 and angiographic
      AD caliber was significantly higher. Differences between groups were much more
      evident in subgroups with proximal stenosis of AD: patients of non-Q subgroups
      had very good left ventricular function but frequently had post-AMI instable
      angina (88%). Our results underline the usefulness of aggressive diagnostic and
      therapeutic approach in non-Q AMI, because of higher amount of myocardium at
      risk.

PMID- 1632130
TI  - Noninvasive evaluation of asymptomatic athletes with cardiac murmur.
AB  - The increasing number of amateur sportsmen enhances the need for a correct
      evaluation of subjects suspected of overt and mild cardiac disease. Out of 4000
      athletes, 72 subjects were clinically preselected by the sport doctor during an
      annual routine examination. They were studied with mono and 2D echo, pulsed color
      (PW) and continuous wave Doppler. Five asymptomatic patients are reported with
      congenital or acquired valvular diseases.

PMID- 1632132
TI  - Mechanocardiographic effects of an elevated central venous pressure.
AB  - Since 1985 we demonstrated that the increase of left ventricular mean diastolic
      pressure shortens the interval existing between the onset of the
      electrocardiographic P-wave and the onset of the left apexcardiographic "a"-wave
      (Aubert et al., 1981; Mortarino et al., 1985). In particular we showed that left
      P-"a" time interval shortens below 100 msec when left ventricular mean diastolic
      pressure rises above 12 mmHg. Our results thus substantiated the previous reports
      related to the P-4th heart sound shortening and 4th heart sound--1st heart sound
      increase occurring in patients with left ventricular failure (Shapira et al.,
      1982). In that same period, Kesteloot and collaborators showed a direct
      relationship between the velocity of appearance of the right internal jugular
      pulse (JVP) waves and the value of central venous pressure (CVP) (Minten et al.,
      1985). Moreover the range of variability of the right P-"a" interval (which is
      the time elapsing between the onset of the electrocardiographic P-wave and the
      onset of the "a"-wave on the JVP tracing) is, in adult subjects, of similar
      magnitude of the left P-"a" interval (respectively 60-140 msec (Fishleder, 1968)
      and 80-160 msec (Mortarino et al., 1985) suggesting a symmetric effect of an
      elevation of diastolic pressure on left and right P-"a" intervals. We therefore
      decided to test this hypothesis in a group of patients.

PMID- 1632131
TI  - Noninvasive assessment of the relationship between cardiac and autonomic function
      in diabetes.
AB  - In order to assess a possible relationship between left ventricular (LV) function
      and cardiac autonomic involvement in type-1 insulin dependent diabetes, we
      performed M-mode echocardiograms and autonomic function tests in 21 patients
      (mean age +/- SD, 38 +/- 11 years, range 18-55, 16 male and 5 female). In 7
      patients and in 21 age-matched controls the echocardiogram was also recorded
      before and during handgrip. At rest, ventricular function abnormalities were
      found only in 4 subjects, and no significant correlation was found between
      echocardiographic parameters and autonomic function tests. Unlike controls,
      during handgrip diabetic subjects failed to increase peak Vcf and peak filling
      rate, and increased their left ventricular end-systolic diameter. The changes in
      LV parameters during handgrip were significantly correlated with resting
      autonomic function tests (p less than 0.025). Our results suggest that resting
      cardiac function may be normal in diabetics despite high incidence of abnormal
      autonomic tests. Latent abnormalities of left ventricular function can be
      unmasked by acute haemodynamic challenges such as handgrip, and are correlated
      with abnormalities in autonomic function tests.

PMID- 1632133
TI  - [Enteroscopy: methods and results].
AB  - Recent advances in the instrumentation and techniques of enteroscopy now permit
      examination of the small bowel. This report is on the use of a prototypic small
      bowel enteroscopy to investigate patients with gastrointestinal bleeding of
      obscure origin. We used the sonde-type enteroscope (Olympus Corp.) that migrates
      distally responding to peristaltic activity. This instrument has neither tip
      deflection controls nor interventional capability. Small bowel enteroscopy was
      performed in 17 patients. Arteriovenous malformations were visualized in 5
      patients but three of them suffered from Rendu-Osler disease. Small bowel
      enteroscopy can be useful in the evaluation of patients with gastrointestinal
      bleeding of obscure origin. However, patients must be well selected on basis of
      negative routine examinations because this method is time-consuming.

PMID- 1632134
TI  - [Role of arteriography in the assessment and treatment of hemorrhagic diseases of
      the small intestines].
AB  - We present the indications and usefulness of visceral angiography for diagnostic
      and therapy in patients with gastrointestinal haemorrhage. This is based on the
      results of a retrospective study of 265 angiographies for gastrointestinal
      bleeding. In fifty one cases an extravasation was seen and in one hundred and
      four patients a possible etiology for the gastrointestinal hemorrhage was
      suspected from indirect signs. In 19 cases, an embolization was performed with
      good result in 16 (84%).

PMID- 1632135
TI  - [Celiac disease in adults: clinical aspects--role of endoscopy].
AB  - Adult coeliac disease has a broad clinical spectrum and remains undetected for
      years. Among subclinical deficiency states, attributable to coeliac enteropathy,
      combined iron and folic acid malabsorption is predominant. An unexplained
      recurrent iron anaemia is an indication for small intestinal biopsy. Gastro
      intestinal disorders are present in only 50% of the cases. Coeliac disease is
      frequently associated with other major histocompatibility complex (MMC)-linked
      diseases which are mediated by immunological mechanisms: dermatitis
      herpetiformis, oral ulcerations, IgA nephropathy, rheumatoid arthritis,
      sarcoidosis. Dermatitis herpetiformis is a useful model for examination of the
      spectrum of mucosal changes that typify gluten sensitivity and subliminal lesions
      without villous atrophy. An increased interest is devoted to the intra-epithelial
      T-lymphocyte population, not only in the small intestine, but at the level of the
      stomach and the colon. A "rectal challenge" test has been proposed for detecting
      gluten sensitivity in coeliac patients. Such a test could be an original method
      of screening, reducing so the need of small intestinal biopsy. The preliminary
      results are to be confirmed. Until now, jejunoscopy remains mandatory for the
      diagnosis and the survey of intestinal lesions related to coeliac disease.

PMID- 1632136
TI  - Coeliac disease "anatomic pathology".
AB  - The microscopic diagnosis of coeliac disease is discussed. The small intestinal
      mucosal lesions observed in coeliac disease consist of a combination of
      epithelial alterations and inflammatory lesions starting with pre-infiltrative
      changes. In the early (?) changes an increase of lymphocytes is noted. The
      interactions probably finally lead to destruction or atrophy of the villi.

PMID- 1632137
TI  - Serological aspects of coeliac disease.
AB  - We have evaluated the sensitivity and specificity of serum anti-gliadin, anti
      reticulin and anti-endomysium antibody determinations for the diagnosis of
      coeliac disease. Serum samples from 54 children and 9 adults with untreated
      coeliac disease were analysed for anti-gliadin antibodies and compared to the
      results obtained for 111 non coeliac controls (72 children, 39 adults) and 221
      healthy blood donors. This yields sensitivities of 87% and 86% for IgA and IgG
      antibodies. Specificities were respectively of 95.5% and 91%. Anti-reticulin and
      anti-endomysium IgA were analysed in a more limited number of sera. Specificity
      of both tests was of 100% for the IgA class of antibody. However sensitivity was
      only of 64% for anti-reticulin IgA but was of 100% for anti-endomysium IgA. These
      results indicate that combination of anti-gliadin antibodies (IgA and IgG), anti
      reticulin and anti-endomysium IgA may be recommended as screening tests to better
      select patients suspected of coeliac disease for jejunal biopsy.

PMID- 1632138
TI  - [Primary hypogammaglobulinemia in adults].
AB  - Intermittent or chronic diarrhea may be the initial symptom of
      hypogammaglobulinemia. In adult, that corresponds most frequently to common
      variable immunodeficiency. The pathogenesis of this syndrome is still
      undetermined. Diagnostic criteria are discussed as well as the therapeutic
      approach that can avoid multiple complications.

PMID- 1632139
TI  - Small bowel amyloidosis, pathology and diagnosis.
AB  - The authors describe clinical findings, radiological aspects and histological
      characteristics of small bowel amyloidosis in 8 patients. Pathogenesis of the
      small bowel related symptoms and diagnostic procedures are discussed.

PMID- 1632140
TI  - [Therapeutic approach in intestinal lymphoma].
AB  - Primary gastrointestinal lymphoma (Maltoma) represent between 1 to 4% of all
      gastrointestinal malignancies. Disseminated cases are hard to differentiate with
      advanced stages of peripheral non-Hodgkin's lymphoma. The discovery of specific
      adhesion molecules could resolve this physiopathological problem. The prevalence
      of small bowel lymphoma is higher in Middle-East and South Africa (50% vs 30%)
      than in West Europe because of the occurrence of the immunoproliferative small
      intestinal disease (IPSID). Multicenter locations and disseminated forms of small
      bowel lymphoma yield curative surgery uneasiness. An algorithm of treatment,
      including surgery, mono or polychemotherapy, colony-stimulating factors, and
      interferon, taking into account histological and clinical stages is proposed.
      Because of the rarity of the disease, treatment must be improved by activation of
      international multicenter randomized trials.

PMID- 1632141
TI  - Glaxo Prize 1992. Assessment of lipid peroxidation in humans by breath pentane
      output measurement.

PMID- 1632142
TI  - Endoscopic treatment of esophagogastric varices.
AB  - We report our current management of variceal bleeding with endoscopic
      sclerotherapy. We emphasize the importance of resuscitation and of recording at
      time zero and within the first 72 hours clinical and laboratory indicators, as
      these influence the management of these patients. Primary sclerotherapy using
      Histoacryl for active bleeding and Ethoxysclerol for recent bleeding should be
      performed as soon as the patient is stable hemodynamically. As we have identified
      factors related to the severity of hemorrhage and of liver failure degree which
      can predict early failure of sclerotherapy, patients presenting with these
      findings should be, in the future, referred quickly toward alternative therapies
      among which non-surgical intrahepatic shunt appears a promising modality.

PMID- 1632143
TI  - Non-surgical management of achalasia.
AB  - Pneumatic dilatation of the cardia is an effective procedure to treat patients
      suffering from achalasia. Eighty percent of these patients can be expected to
      have excellent or good results for 6 years after the first dilatation. A repeat
      dilatation should be performed as soon as the patient has recurrent symptoms,
      usually every 2 years. Calcium channel blockers (nifedipine and verapamil) or
      nitrates (isosorbide dinitrate) decrease LES pressure but do little to the
      clinical symptomatology of patients with achalasia; however such drug therapy may
      be tried as an adjunct in patients who remain symptomatic after pneumatic
      dilatations or myotomy. Pneumatic dilatation and surgical myotomy both reduce LES
      pressure; with pneumatic dilatation, enough residual LES pressure is retained to
      prevent gastroesophageal reflux. Indeed, reflux esophagitis seems to occur more
      often after surgery than after forceful dilatations. We think that pneumatic
      dilatation should be performed as the primary therapy and surgery reserved for
      the failures of this procedure.

PMID- 1632144
TI  - Treatment of peptic ulcer severe bleeding.
AB  - The success of a defined management policy op peptic ulcer haemorrhage which
      incorporates endoscopic therapeutic intervention depends on the early
      identification of a high risk group of patients and a high risk group of ulcers.
      The high risk group of patients consists of those likely to experience further
      bleeding on the basis of clinical prognostic indicators: shock and severe anaemia
      on admission and the pattern of bleeding; or tolerate rebleeding and emergency
      surgery poorly: patients over 60 years and those with associated disease. UGI
      endoscopy should be performed early (within 6-12 hours) in this group in order to
      identify the bleeding point and provide prognostic information regarding the risk
      of further haemorrhage. Peptic ulcers with major stigmata of recent bleeding
      (spurting or non-bleeding visible vessel) have high risk of rebleeding, the risk
      is even greater when major stigmata of recent haemorrhage (SRH) are associated
      with shock on admission. Patients with such ulcers should be monitored
      intensively and receive endoscopic haemostatic treatment in order to terminate
      active haemorrhage or prevent rebleeding thereby avoiding the need for emergency
      surgery with its attendant morbidity and mortality. Patients with ulcers with
      minor or no SRH have a very low risk of rebleeding and don't require intensive
      monitoring or endoscopic treatment and can be discharged from hospital early.
      Ulcers which cannot be completely characterized have an intermediate risk of
      rebleeding and should be managed as high risk lesions. Secondary to the anatomy
      of the visible vessel any haemostatic endoscopic treatment should be applied
      around, but avoiding, the sentinel clot. Well-designed randomized controlled
      trials of endoscopic haemostatic treatment of peptic ulcer haemorrhage in which
      stratification of risk was based on the SRH, have demonstrated for non-bleeding
      vessel a significant reduction in rebleeding and in emergency surgery, for
      spurting bleeding benefit was found only for the rebleeding risk. No advantage
      was demonstrated in each group of patients in term of mortality. Such studies
      also demonstrate the superiority of the Nd:YAG laser over the Argon laser.
      Perforation is a rare complication of Nd:YAG laser photocoagulation (less than
      1%). Precipitation or aggravation of arterial haemorrhage during treatment of a
      visible vessel, as a result of a direct hit, is a more frequent complication (0
      29%). Further laser treatment is successful in terminating 75% of these induced
      bleeds, the remainder requiring surgery. Preinjection of the ulcer with
      adrenaline does not appear to prevent this complication.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1632145
TI  - Clinical significance of pancreas divisum.
AB  - Pancreas divisum (PD), a congenital anatomic variant consisting of a separate
      pancreatic ductal system, is diagnosed in nearly 10% of patients for whom a
      successful pancreatogram was obtained. The relationship between PD and pancreatic
      disease is discussed since 1976. Some authors, reporting a higher incidence of
      pancreatitis in patients having two separate pancreatic ducts, proposed the
      concept of relative outflow obstruction of pancreatic juice through the accessory
      papilla. Based on the literature data and on our own experience, this review
      asserts that there is no definite evidence for PD being associated with a
      significantly risk of idiopathic pancreatitis. Discrepancies between
      epidemiological series could be explained by selection biases leading to an
      apparent association of PD and pancreatitis. An objective assessment of accessory
      papilla stenosis in patients with PD is not clearly available to give consistent
      results. Although controversies persist with regard to the actual abnormality of
      PD and the presence of stenosis into the accessory papilla, several endoscopic
      and/or surgical procedures have been proposed in an attempt to correct what is
      thought to be a stenosis of the orifice of the dorsal duct. More than 300
      patients have been treated until now with variable and unpredictable results,
      these treatments are not devoid of complications. We conclude that PD should be
      considered as a frequent coincidental anatomic variant having no clinical
      significance in the great majority of patients and not requiring systematic
      further therapy.

PMID- 1632147
TI  - Punitive damages.

PMID- 1632146
TI  - Operative colonoscopic endoscopy.
AB  - There are several conditions where operative colonoscopy is useful. Acute colonic
      pseudo-obstruction or Ogilvie's syndrome is characterized by a acute distension
      of the colon. Although medical management may be sufficient in many cases,
      endoscopic decompression must be performed when colonic distension is greater
      than 12 cm. Insertion of decompression tube to avoid rapid recurrence seems to be
      adequate. In case of massive lower intestinal hemorrhage, colonoscopy seems to be
      more accurate than mesenteric angiography. Such endoscopic examination requires
      an experienced endoscopist. Colonoscopic polypectomy has become the standard
      method for removal of colonic polyps. Factors influencing the rate of
      complications have been studied. While the number of complications was very low,
      we have observed that all the major hemorrhages were immediate when the blended
      current was used, but delayed when the pure coagulation current was applied.
      Endoscopic laser photocavitation is a valuable palliative method treating rectal
      adenocarcinoma in well selected patients. Indeed, if the patients survive
      sufficiently long after initial therapy, it becomes increasingly difficult to
      achieve persistent palliation with laser therapy.

PMID- 1632149
TI  - The laryngeal mask airway in the United States.

PMID- 1632148
TI  - Monitoring compliance: a sensitive indicator of change.
AB  - This article is the seventh in a series designed to help anesthetists appreciate
      the clinical applications of equipment and monitoring systems. The use of a new
      technology for monitoring compliance during general tracheal anesthesia
      techniques is presented along with an explanation of the added clinical benefits
      of visually monitoring patients' compliance compared to estimating compliance by
      feeling the tension on the rebreathing bag.

PMID- 1632150
TI  - U.S. Food and Drug Administration safety alert: cauda equina syndrome associated
      with use of small-bore catheters in continuous spinal anesthesia.

PMID- 1632151
TI  - New HCFA carrier manual instructions on Medicare payment.

PMID- 1632152
TI  - Health Care Financing Administration Medicare carriers manual. New implementing
      instructions for Medicare payment for anesthesia services.

PMID- 1632153
TI  - Criteria comparison of accreditation. Report of the National Commission on Nurse
      Anesthesia Education.

PMID- 1632154
TI  - The effect of knowledge of learning styles on anxiety and clinical performance of
      nurse anesthesiology students.
AB  - This study examined how students' knowledge of their learning styles affected
      their anxiety and clinical performance. In a graduate program of nurse
      anesthesiology with a sample size of 43 students, results indicated that, over
      time, students who were aware of their learning styles demonstrated less anxiety
      than those who were not. Knowledge of learning styles also improved clinical
      performance in the cognitive and affective domains. Recommendations for schools
      of nurse anesthesiology are discussed.

PMID- 1632155
TI  - AANA Journal course: update for nurse anesthetists--monitoring the brain for
      hypoxic events.
AB  - Monitoring of brain oxygen content is highly desirable as this organ is highly
      intolerant to hypoxia from a variety of possible etiologies, many of which can
      occur during the administration of anesthesia. Most of the modalities directed at
      brain oxygen monitoring are highly technical and currently are in various stages
      of evolution worldwide. These approaches include those which access brain oxygen
      content by both direct and indirect means. This lesson reviews the major areas of
      research currently underway and suggests that we should be optimistic that this
      technology may be available to us clinically in the foreseeable future.

PMID- 1632156
TI  - Side effects of morphine patient-controlled analgesia and meperidine patient
      controlled analgesia: a follow-up of 500 patients.
AB  - Many physicians, Certified Registered Nurse Anesthetists (CRNAs), and registered
      nurses have the clinical impression that either morphine sulfate or meperidine
      hydrochloride is a better drug to control postoperative pain. In this study, we
      evaluated pain relief and side effects for these two drugs to assess their
      potential differences. CRNAs conducted a structured interview of 500 female
      patients 24 hours after major gynecologic, urologic, or breast surgery. Patients'
      responses on 4-point scales of none, mild, moderate, and severe were collected
      for pain intensity, degree of nausea, severity of vomiting and itchiness, and
      degree of sedation experienced since the operation. There were 91 patients who
      received morphine patient-controlled analgesia (PCA) and 409 patients
      administered meperidine PCA. No statistically significant differences for pain
      intensity, degree of nausea, severity and incidence of vomiting, or degree of
      sedation were found. However, a significant difference was found in the incidence
      rates of mild itchiness, which occurred more frequently in the morphine PCA group
      (P less than .001). Patients vomited more often after vaginal hysterectomy than
      patients having laparotomy, major oncology, or tuboplasty surgeries (P less than
      .05), and vaginal repair patients reported more vomiting than patients having
      major oncology or tuboplasty surgeries. Clinical impressions that either morphine
      or meperidine should be the preferred treatment for patients following
      gynecologic operations was not found by a 24-hour review of 500 patients for pain
      relief and side effects. Although mild itchiness occurred more frequently in the
      morphine PCA group, treatment was rarely necessary.

PMID- 1632157
TI  - Adenosine: novel antiarrhythmic therapy for supraventricular tachycardia.
AB  - Adenosine (Adenocard) is a unique new agent for the acute treatment of paroxysmal
      supraventricular tachycardia (PSVT). Administered by intravenous bolus, it has an
      onset and duration measured in seconds and greater than 90% efficacy. Its primary
      effect is to slow atrioventricular nodal conduction, thus converting reentrant
      forms of PSVT to normal sinus rhythm. Side effects quickly dissipate without
      treatment because of the short duration of action. Other uses include diagnosis
      of broad or wide QRS complex tachycardias and controlled intraoperative
      hypotension. Its short duration and high efficacy in converting select forms of
      PSVT make adenosine an excellent alternative to verapamil in patients with
      compromised hemodynamics. This article will review the clinical use and
      anesthetic implications for the administration of this drug.

PMID- 1632158
TI  - Negative aspiration for cerebral spinal fluid does not assure proper placement of
      epidural catheter.
AB  - Inadvertent subarachnoid injection of a local anesthetic during the conduct of
      epidural anesthesia may have a devastating effect on the patient. The incidence
      of dural puncture with an epidural catheter has been reported to range from 0.5%
      to 0.9%. This case report demonstrates that, despite negative aspiration of
      cerebral spinal fluid from the catheter, subarachnoid injection of a local
      anesthetic can occur.

PMID- 1632159
TI  - Ketorolac tromethamine: a nonsteroidal anti-inflammatory analgesic used as an
      adjunct for general anesthesia.
AB  - This case report describes a general anesthetic where ketorolac tromethamine was
      used instead of a narcotic. The patient was a 37-year-old male, ASA II category,
      who underwent general anesthesia for a cholecystectomy. The drug is discussed in
      terms of preoperative, intraoperative, and immediate postoperative effects.
      During the preoperative phase, no effect was demonstrated. Intraoperatively, the
      drug performed poorly to attenuate responses to intense stimulation as noted by
      an increase in pulse and blood pressure of greater than 20% during intubation,
      incision, and abdominal wall retraction. During the immediate postoperative
      phase, the drug performed well to provide analgesia related to incisional pain.
      Ketorolac has not been previously discussed in terms of intraoperative uses. The
      mechanism of action by which it provides analgesia is through the inhibition of
      prostaglandin synthesis. It is similar in structure to the other nonsteroidal
      anti-inflammatory drugs and may offer certain advantages over traditional agents
      used to provide analgesia, including the absence of respiratory depression,
      addictive potential, euphoria, a decrease in gastric motility, and cardiovascular
      effects. These properties may help in the management of certain types of patients
      who are at risk for respiratory depression or in those who have a
      contraindication to narcotics.

PMID- 1632160
TI  - Epinephrine as an adjuvant to amino-amide local anesthetics does not prolong
      their duration of action in infraorbital nerve block in the rat.
AB  - The effects of epinephrine as an adjuvant to local anesthetics were studied in
      the rat infraorbital nerve block (IONB) model, using solutions of 0.5%
      prilocaine, 0.5% mepivacaine, 0.125% bupivacaine or 0.125% ropivacaine in 50
      mmol/l tris-hydroxymethylaminomethane (THAM) tested both without and with
      epinephrine (EPI) added at 2, 4, 8 or 16 micrograms/ml. Solutions of THAM and EPI
      in normal saline did not induce IONB. THAM-buffered solutions of bupivacaine
      induced IONB of longer duration than bicarbonate-buffered solutions. Intensity of
      block during onset was increased only when EPI at 2 and 16 micrograms/ml was
      included in bupivacaine solutions. The duration of block induced by prilocaine,
      bupivacaine and ropivacaine was not significantly prolonged by addition of EPI at
      any of the concentrations tested. Only at a concentration of 16 micrograms/ml did
      EPI significantly prolong the duration of mepivacaine-induced block (+48%). Low
      concentrations of EPI in solutions of bupivacaine and ropivacaine significantly
      reduced their duration of action by up to 22% and 57%, respectively. It is
      concluded that the duration of action of local anesthetics in buffered solutions
      is only moderately affected by the inclusion of EPI, the effects differing only
      slightly from one to another. The efficacy of EPI as an adjuvant would seem to be
      governed by factors affecting the local disposition of the main drugs, such as
      non-specific binding, buffering of solutions and tissue pH.

PMID- 1632161
TI  - The effects of brain temperature on temporary global ischaemia in rat brain. A 31
      phosphorous NMR spectroscopy study.
AB  - 31-Phosphorus magnetic resonance spectroscopy was used in a rat model of 10 min
      severe incomplete forebrain ischaemia (2-vessel occlusion with hypotension) to
      assess the effect of mild brain hypo- and hyperthermia (+/- 2 degrees C) on
      intracellular pH and high energy phosphates. In three experimental groups
      intracerebral temperature was maintained at levels of 34, 36 and 38 degrees C
      during ischaemia and early reperfusion. The steady level of intracellular pH
      during ischaemia was 6.63, 6.58 and 6.53 in the 34, 36, and 38 degrees C groups,
      respectively. The rate of initial recovery of intracellular pH in reperfusion was
      0.046 +/- 0.012 pH units per min (+/- s.d.) in the 36 degrees C group compared to
      0.056 +/- 0.010 (+/- s.d., P less than 0.05) in the 34 degrees C group and 0.032
      +/- 0.009 (+/- s.d., P less than 0.01) in the 38 degrees C group. The recovery in
      early reperfusion of phosphocreatine and ATP was slower in the 38 degrees C group
      compared to the other groups. The findings were consistent with recent studies,
      suggesting that even mild hypothermia may afford protection to the ischaemic
      brain, and furthermore indicate that mild hyperthermia as fever or even
      subfebricity may be deleterious for the outcome in stroke patients.

PMID- 1632162
TI  - Adenosine modulates vascular resistance and fluid filtration in isolated rat
      lungs.
AB  - In adult respiratory distress syndrome, a major concern is to reduce increments
      in pulmonary vascular resistance (PVR) and maintain the patency of lung
      microvessels. We have investigated the effects of adenosine, a potent systemic
      vasodilator, on PVR and fluid filtration rate (FFR) in isolated blood-perfused
      rat lungs. The preparations were undamaged or subjected to fat emulsion-induced
      injury simulating ARDS. In undamaged lungs adenosine caused a significant dose
      dependent reduction of hypoxia-induced increases in PVR. Furthermore, the
      increase in FFR upon elevation of left atrial pressure by 0.77 kPa was
      significantly hampered by adenosine, 24 nmol.ml-1.min-1. Employing the same rate
      of infusion, adenosine, in a group of injured preparations, significantly reduced
      the rise in PVR towards baseline and completely abolished the further increase
      upon a superimposed injection of serotonin. In another series of preparations
      with lung injury randomly assigned to an adenosine group and a control group,
      adenosine significantly reduced FFR. Thus, adenosine, even when infused at low
      rates, reduced increments in PVR and fluid filtration, both in undamaged and in
      fat emulsion-injured isolated lungs.

PMID- 1632163
TI  - Failure of hypertonic saline to resuscitate intestinal ischemia shock in the rat.
AB  - The effects of resuscitation with hypertonic saline (HS), administered as a bolus
      injection or infusion, were studied in a model of intestinal ischemia shock in
      rats. The model is characterized by severe intestinal mucosal lesions, release of
      cardioinhibitory substances and endogenous opioid peptides, and it results in
      high mortality rates. The blood pressure improved after HS given as an infusion
      for 1 h. The effects on blood pressure of HS given as a bolus and of normotonic
      saline (NS) were not significant. Plasma volume was not different from unshocked
      control animals in either HS infusion or NS infusion groups 2 and 4 h after
      infusion. Liver metabolic consequences of intestinal shock did not differ
      comparing the HS and NS groups, and the same result was found concerning the
      mucosal lesions in the small intestine. The 7-day survival decreased in the HS
      infusion group (14%) compared to untreated shock (46%) or NS infusion (54%)
      groups. We conclude that HS failed to resuscitate intestinal ischemia shock.
      These experiments indicate that HS treatment could even, in contrast to previous
      reports on hemorrhagic shock, be disadvantageous or dangerous in shock states
      characterized by extensive tissue injury.

PMID- 1632165
TI  - Gas exchange as monitored in mixed venous and arterial blood during experimental
      cardiopulmonary resuscitation.
AB  - Nineteen anaesthetized piglets were investigated. After catheterization and a
      stabilization period, ventricular fibrillation was induced with a transthoracic
      DC shock, after which a 10-min period of cardiopulmonary resuscitation (CPR) took
      place. CPR included manual chest compression and mechanical ventilation with pure
      oxygen. After 1 min of CPR, an infusion of alkaline buffer was begun and
      completed within 5 min. A total of 50 mmol of either sodium bicarbonate (n = 6)
      or tris buffer mixture (n = 7) were given. These two groups were compared with a
      third control group (n = 6) receiving the same volume of normal saline. After 8
      min of CPR all animals were given 0.5 mg adrenaline i.v., and after 10 min DC
      shocks were used to revert the heart back to normal sinus rhythm. Our results
      demonstrate that blood flow and not ventilation is the limiting factor for the
      efficient disposal of CO2 during CPR. This also applied when the demand for CO2
      transport was increased by administration of sodium bicarbonate. The respiratory
      exchange ratio increased 1.9-fold, indicating that the transport of carbon
      dioxide was less affected than that of oxygen. The estimated alveolo-arterial
      oxygen tension difference, shunt, and overall ventilation/perfusion ratio
      increased, creating an inverse hyperbolic relationship between arterial PCO2 and
      PO2. The difference between mixed venous and arterial PCO2 correlated well to the
      mixed venous PCO2, implying more efficient pulmonary elimination of PCO2 when the
      mixed venous PCO2 was high. Pulmonary gas exchange during CPR appears to be
      independent of alkaline buffer therapy in the form of sodium bicarbonate or tris
      buffer mixture.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632164
TI  - A porcine model for sequential assessments of cerebral haemodynamics and
      metabolism.
AB  - We present a physiologically stable porcine model designed for sequential
      assessments of pharmacological effects on mean hemispheric cerebral blood flow
      (CBF) and cerebral metabolic rate for oxygen (CMRO2) at sustained normocapnia.
      The dynamic influence of continuously administered fentanyl (0.040 mg.kg-1.h-1
      i.v.), nitrous oxide (70%) and pancuronium (0.30 mg.kg-1.h-1 i.v.) on these
      variables was studied in eight normoventilated pigs. CBF was reliably assessable
      at 10-min intervals by clearance of intra-arterially injected 133Xe, monitored by
      an extracranial scintillation detector. CMRO2 was calculated from CBF and the
      simultaneously measured cerebral arteriovenous difference in blood oxygen
      content. The intracerebral distribution of a contrast medium injected into the
      external and internal carotid arteries was studied by angiography, and the
      cerebral venous outflow was investigated by measurements of the distribution of
      an intra-arterially administered non-diffusible tracer, [99mTc]pertechnetate, to
      the internal and external jugular veins. After a 3-h equilibration period, CBF
      and CMRO2 were determined on six occasions over a study period lasting 1 h 40
      min. The mean ranges of these variables were 56-60 and 1.9-2.0 ml.100 g-1.min-1,
      respectively. We conclude that the model enables repeated assessments of CBF and
      CMRO2 under stable physiological background conditions and thus valid cerebral
      pharmacodynamic investigations of drugs given for anaesthesia.

PMID- 1632166
TI  - Influence of intrathecal morphine and naloxone intervention on postoperative
      ventilatory regulation in elderly patients.
AB  - Thirty elderly patients undergoing major hip surgery under spinal analgesia were
      randomly allocated in a double-blind manner into three groups. The aim was to
      evaluate the influence of intrathecal morphine and postoperative naloxone
      infusion on the regulation of ventilation. The Bupivacaine Group received spinal
      analgesia with 20 mg bupivacaine intrathecally. The Morphine Group received
      spinal analgesia with 20 mg bupivacaine + 0.3 mg morphine intrathecally. The
      Naloxone Group received spinal analgesia with 20 mg bupivacaine + 0.3 mg morphine
      intrathecally + postoperative naloxone infusion intravenously (1 microgram/kg/h
      over 12 h, 0.25 micrograms/kg/h over the next 12 h). Evaluation of resting
      ventilation and the ventilatory responses to hypercarbia and hypoxaemia was made
      on three occasions: before surgery, and 8, and 24 h after the intrathecal
      injection. Intrathecal morphine had no significant effect on ventilatory
      regulation in elderly patients undergoing major hip surgery performed under
      bupivacaine spinal analgesia. Postoperative administration of opioids or
      sedatives after intrathecal morphine as well as postoperative blood loss
      associated with a fall in blood pressure appeared to increase the risk of
      developing respiratory depression. Naloxone infusion seemed to reduce the risk of
      developing respiratory depression. Furthermore, one third of the elderly had a
      poor response to hypoxaemia before surgery.

PMID- 1632167
TI  - Do anticholinergic agents affect the occurrence of postanaesthetic nausea?
AB  - In order to establish if anticholinergic drugs might influence postoperative
      nausea and vomiting, 100 ASA I-II adult patients scheduled for minor orthopaedic
      procedures, varicose vein stripping or inguinal herniorraphy were randomised to
      receive, in a double-blind fashion, either a premedicant and a reversal dose of
      0.003 and 0.0075 mg/kg of glycopyrrolate or 0.006 and 0.015 mg/kg of atropine,
      respectively. Nitrous oxide, after thiopentone induction was used for anaesthesia
      with fentanyl and diazepam as supplements and pancuronium for relaxation. In the
      recovery room, up to 2 h after surgery, 28% of the patients in the glycopyrrolate
      group and 8% in the atropine group experienced nausea (P = 0.017). Thereafter,
      the patients complained of nausea at decreased and equal frequencies in both
      groups. The incidence of vomiting was not statistically significantly different.
      Droperidol was needed, to control persistent emesis, three times more often in
      the glycopyrrolate than in the atropine group. It is concluded that substitution
      of glycopyrrolate for atropine increases the likelihood of postoperative nausea,
      and continued use of atropine should be considered in patients at risk of
      postoperative emesis.

PMID- 1632168
TI  - Evidence against endogenously released adenosine as modulator of the pressor
      response to hypoxia in isolated rat lungs.
AB  - Unlike other vascular beds, lung vessels constrict when exposed to hypoxia.
      However, a marked difference has been noticed as regards the elicitability of
      hypoxic pulmonary vasoconstriction (HPV) in vivo as compared to in vitro models,
      like a preparation of isolated rat lungs; in the latter, HPV cannot be evoked
      from the onset of perfusion, but might be triggered gradually by repeated hypoxic
      challenges. The formation of adenosine, a potent dilator of most vascular beds,
      is enhanced during conditions of hypoxia or ischemia. Our hypothesis therefore
      was that pulmonary vasoconstriction was initially antagonized by tissue-adenosine
      accumulating during the circulatory arrest necessary for lung isolation, and
      then, gradually invigorated along with the elimination of adenosine during
      periods of perfusion with normally oxygenated blood. In a first series of
      isolated rat lungs, we studied release of adenosine in connection with the third
      and the sixth hypoxic challenges. Although the vascular responses were of
      significantly different size, there was no sign of increased adenosine formation
      during any of the two provocations, as assessed by release of its more stable
      metabolites hypoxanthine, xanthine and uric acid. In a series of tissue
      preparations taken at the height of a fully developed hypoxic pressor response
      and immediately frozen, we could not find significant changes in tissue level of
      adenosine, hypoxanthine and inosine as compared to controls that had never been
      exposed to hypoxic challenges. Further, we found no correlation between the size
      of pressor responses and concentrations of adenosine and its metabolites, in
      either blood or in lung tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632169
TI  - The accuracy of pulse oximetry at two haematocrit levels.
AB  - The object of this study was to investigate the influence of haematocrit on the
      accuracy of pulse oximetry. Seven Swedish land race rabbits were studied. The
      oxygen saturation of haemoglobin was decreased step-wise using increasing
      fractions of nitrogen to the inspiratory gas. One pulse oximeter probe was
      attached on the front leg and another probe directly over the common carotid
      artery. The pulse oximeter readings (SpO2) were compared with simultaneous oxygen
      saturation analysis (SaO2) by a haemoximeter. The pulse oximeter measurements
      were performed at the haematocrit levels of approximately 40% and 11%,
      respectively. We found a good correlation between SpO2 and SaO2 in a wide range
      of the oxygen saturation, i.e. SaO2 26-100%. After haemodilution the correlation
      was improved in the range 86-100%, but not in the range 26-85%. No correlation
      between SpO2 and SaO2 was found when the sensor was attached directly over the
      artery during normal haematocrit levels. After haemodilution a better correlation
      was however obtained. These results indicate that the accuracy of pulse oximetry
      is dependent on the haematocrit level.

PMID- 1632170
TI  - Central cholinergic action produces antagonism to ketamine anesthesia.
AB  - Ketamine sometimes produces posthypnotic emergency reactions, such as prolonged
      hallucination or delirium. In a previous paper, we showed that physostigmine, an
      anticholinesterase agent, counteracts the manifestation of effects of ketamine at
      some doses. In the present study, we investigated the mechanism of the
      antagonistic effect of physostigmine on ketamine anesthesia. At first, rats were
      given ketamine 75 mg/kg. Immediately after the loss of righting reflex, the four
      groups of rats were given one of the three central cholinergic agents,
      physostigmine 0.1 mg/kg, oxotremorine 0.05 mg/kg, 4-aminopyridine 3 mg/kg, or
      saline as the control. The sleeping times were 10.7 +/- 1.0, 12.3 +/- 0.9, 11.4
      +/- 1.3 and 21.2 +/- 0.7 min, respectively. The three cholinergic agents
      antagonized ketamine anesthesia. In the other groups of rats, the central
      anticholinergic agent, l-hyoscyamine, 0.5 mg/kg, was given subcutaneously for
      premedication before the above-mentioned procedure. The sleeping times were 16.3
      +/- 1.2 min in the physostigmine group, 18.7 +/- 1.0 min in the oxotremorine
      group and 18.6 +/- 0.8 min in the 4-aminopyridine group. The sleeping time was
      significantly longer in the premedicated group than in the non-premedicated
      group, in the case of the three central cholinergic agents. The sleeping time in
      the saline group, 20.0 +/- 0.4 min, was not significantly different from that of
      the control in the non-premedicated case. It is, therefore, considered that the
      central cholinergic action produces antagonism to ketamine anesthesia.

PMID- 1632171
TI  - Perioperative complement activation in neonates under halothane or fentanyl
      anaesthesia.
AB  - We investigated perioperative changes in complement activation in 18 neonates
      undergoing elective abdominal surgery with or without thoracotomy by measuring
      plasma concentrations of C3a and C5a, and leucocyte counts in peripheral blood.
      The 18 neonates, ranging in age from 1 to 17 days, were randomly divided into two
      groups according to type of anaesthetic procedures; the "halothane group"
      consisted of nine neonates in whom general anaesthesia was maintained with
      halothane and nitrous oxide (N2O) in oxygen, while the "fentanyl group" consisted
      of nine neonates in whom general anaesthesia was maintained with fentanyl and N2O
      in oxygen. Plasma C3a and C5a concentrations were higher in the fentanyl group
      than in the halothane group during the perioperative period. We have demonstrated
      that abdominal surgical trauma caused complement activation even in neonates
      undergoing the fentanyl rather than the halothane anaesthesia. Further studies
      are required to elucidate the precise mechanisms and the clinical implication of
      perioperative complement activation in neonates.

PMID- 1632172
TI  - High frequency jet ventilation: use of the Bain system for entrainment.
AB  - The use of a Bain system to convey anaesthetic gases for entrainment during high
      frequency jet ventilation (HFJV) was evaluated by examining the effect of varying
      the fresh gas flow (Vf) on the end-tidal carbon dioxide (PECO2) in 46 ASA
      physical status I and II patients undergoing extracorporeal shock-wave
      lithotripsy (ESWL). Anaesthesia was induced with methohexitone (1-2 mg.kg-1),
      fentanyl (1-1.5 micrograms.kg-1) and vecuronium (0.1 mg.kg-1). After endotracheal
      intubation with a Mallinckrodt Hi-Lo Jet cuffed endotracheal tube, the patient
      was immersed in a water bath and HFJV at 150 breaths per minute was instituted
      with an Acutronic AMS 1000 jet ventilator attached to the side channel of the Hi
      Lo tube. A Bain system was attached to the proximal end of the endotracheal tube
      to provide gases for entrainment. Anaesthesia was maintained with an intravenous
      infusion of methohexitone (5 mg.kg-1.h-1) and 50% nitrous oxide in oxygen for
      both the jetted and entrained gases. PECO2 was determined at 5-min intervals by a
      single-breath technique using a calibrated Engstrom Eliza capnograph. Thirty
      patients were randomly allocated to receive Vf's of 50 (Group 1), 75 (Group 2)
      and 100 (Group 3) ml.kg-1.min-1, respectively. A further eight patients (Group 4)
      received a Vf of 100 ml.kg-1.min-1 for 15 min, 75 ml.kg-1.min-1 for the next 15
      min and 50 ml.kg-1.min-1 thereafter. In a further group of eight patients (Group
      5), Vf was initially 25 ml.kg-1.min-1 for 10 min and was then switched off for
      the remainder of the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632173
TI  - Ketamine anaesthesia in a patient with septic shock.
AB  - A 71-year-old male patient was operated on in a septic state (tachycardia,
      hypotonia, fever peaks, disorientation) because of an occluding tumour of the
      biliary tract. Ketamine was used as the main anaesthetic. Mean arterial pressure
      increased markedly and diuresis started during the anaesthesia. The inotropic
      support (dopamine, dobutamine, noradrenaline) could be reduced. Ketamine
      anaesthesia seemed to have a beneficial haemodynamic effect in septic shock.

PMID- 1632174
TI  - Effect of a non-steroidal anti-inflammatory drug, diclofenac, on haemostasis in
      patients undergoing total hip replacement.
AB  - Haemostasis was studied in patients receiving diclofenac for postoperative pain
      relief. Intravenous diclofenac 75 mg over 60 min, followed first by an infusion
      of 5 mg/h for 15 h and then by 50 mg every 8 h orally was administered to 20
      patients undergoing total hip replacement. Eighteen patients receiving a placebo
      infusion and dextropropoxyfen per os served as controls. The results showed no
      statistically significant differences between the groups in blood loss, bleeding
      time (IVY), partial activated thromboplastin time and prothrombin complex assay
      or in platelet count. The measurements were performed preoperatively, 3 h
      postoperatively and on the fourth and tenth postoperative days. Plasma
      concentrations were also determined in ten patients undergoing knee arthroscopy.
      An i.v. diclofenac infusion of 75 mg over a period of 15 min was administered
      either once (to half of the patients) or twice. The mean diclofenac
      concentrations were 28 +/- 5 nmol/ml (+/- s.d.) after 15 min and 36 +/- 12
      nmol/ml after the second infusion. The bleeding time in the arthroscopy patients
      receiving one or two bolus infusions of 75 mg diclofenac remained at the control
      level. It is concluded that diclofenac given as an intravenous infusion of 75 mg
      in 60 min, then 5 mg/h for 15 h, followed by 50 mg every 8 h orally, is a safe as
      dextropropoxyfen for pain relief in patients undergoing major orthopaedic surgery
      as far as coagulation data are concerned.

PMID- 1632175
TI  - Combined use of hypothermia and buffering in the treatment of critical
      respiratory failure.
AB  - A 20-year-old male, recovering from post-traumatic ARDS, subsequently developed
      pneumonia with extreme hypercapnia (PaCO2 max 19.4 kPa) and hypoxemia (PaO2 min
      5.1 kPa), in spite of maximal mechanical ventilation. Hypothermia was induced by
      surface cooling, reducing the body temperature from 40 degrees C to a mean of
      33.3 degrees C. Buffer infusion (1375 mmol) during the first 2 days increased
      base excess from 3 to 22 mmol/l and pH from 7.16 to a median value of 7.30.
      Active cooling was discontinued on day 11. Weaning from the ventilator was
      possible 9 days later and the patient subsequently recovered fully. Combined use
      of hypothermia and buffering might offer an alternative to extracorporeal lung
      assist (ECLA) and facilitate a reduction of barotrauma and oxygen toxicity during
      mechanical ventilation.

PMID- 1632176
TI  - Interscalene plexus block for arthroscopy of the humero-scapular joint.
AB  - Interscalene plexus block was performed in nine patients subjected to shoulder
      arthroscopy. The operating conditions, including muscle relaxation, were fully
      adequate in all patients (after additional local anaesthesia of the skin in four
      patients). With the exception of one patient who experienced temporary hoarseness
      (probably due to a concomitant block of the recurrent laryngeal nerve), no side
      effects were found and the patients tolerated the surgical procedure well.
      Interscalene block might be a suitable alternative to general anaesthesia for
      shoulder arthroscopy. However, additional local anaesthesia at the site where the
      arthroscope is to be inserted is frequently required.

PMID- 1632177
TI  - Comparison of nicardipine and sodium nitroprusside in the treatment of
      hypertension after coronary bypass surgery (a pilot study).
AB  - Sodium nitroprusside is widely used in the treatment of hypertension after
      coronary artery bypass surgery despite its toxicity and its deleterious effect on
      the coronary circulation. The aim of this study was to compare the safety and
      effectiveness of nicardipine with sodium nitroprusside in a randomized study.
      Nicardipine and sodium nitroprusside are effective for controlling hypertension
      after coronary artery surgery. Oxygen myocardial balance was more often improved
      by nicardipine than by sodium nitroprusside. Hemodynamic stability was better
      with nicardipine which was also devoid of toxicity and might therefore have
      advantages over sodium nitroprusside in the management of hypertension after
      coronary artery surgery.

PMID- 1632178
TI  - Unusual complication after pelvic surgery: unilateral lower limb crush syndrome
      and bilateral common peroneal nerve paralysis.
AB  - We present a patient who developed a right anterior leg compartment syndrome and
      bilateral common peroneal nerve paralysis following radical hysterectomy in the
      lithotomy position. We describe the physiopathology of the syndrome, its various
      etiologies, the treatment, and prevention of this complication.

PMID- 1632179
TI  - Intraocular pressure changes in response to endotracheal intubation facilitated
      by atracurium or succinylcholine with or without lidocaine.
AB  - Changes in intraocular pressure (IOP) and hemodynamics (SP, DP and HR) were
      measured in 105 patients ASA I and II randomly assigned into seven equal and
      comparable groups (A to G) during induction of anesthesia and endotracheal
      intubation facilitated either by succinylcholine or atracurium with or without
      lidocaine. IOP decreased significantly (p less than 0.01) after induction of
      anesthesia with thiopentone in all the groups. While atracurium with or without
      lidocaine did not affect IOP following complete suppression of train-of-four
      (groups A, B, and C), succinylcholine per se or in combination with lidocaine
      (groups F and G) significantly (p less than 0.01) increased IOP after induction
      with thiopentone but not exceeding the baseline IOP level. IOP was significantly
      elevated (p less than 0.01) immediately after endotracheal intubation in all the
      groups when compared to IOP following thiopentone administration. In those
      patients given atracurium (groups A to E), IOP increased (p less than 0.05) in
      response to endotracheal intubation above the baseline level only in group B
      where atracurium was divided into a priming and intubating doses. However, the
      priming dose did not have any significant effect on the onset time of complete
      twitch suppression of train-of-four and did not affect the intubation conditions
      compared with the uniformly excellent conditions found with atracurium over an
      equivalent bolus dose of the relaxant. In patients who received succinylcholine
      only (group F), IOP immediately after endotracheal intubation was significantly
      greater (p less than 0.01) as compared to the baseline and did not return to the
      baseline level until 3 minutes after endotracheal intubation. The use of
      lidocaine in combination with atracurium (group D) or succinylcholine (group G)
      for a rapid sequence intubation did not affect IOP following endotracheal
      intubation. However, atracurium when used in a rapid sequence intubation could
      not produce similar intubation conditions when compared with succinylcholine.
      Consequently, we cannot endorse atracurium as an alternative to succinylcholine
      for patients with penetrated eye injuries and full stomach requiring rapid
      sequence intubations. In this context, the role of IV lidocaine in mitigating or
      preventing the systemic and ocular reactions and especially the acute increase in
      IOP associated with endotracheal intubation should be emphasized.

PMID- 1632180
TI  - The inferior conjunctiva of the monkey.
AB  - Light- and electron-microscopical techniques were used to study the structure of
      the inferior conjunctiva of monkeys including the third eyelid (nictitating
      membrane). The cell layers of the conjunctival epithelium were 8-10 at the
      margin, 6-8 near the limbus and 2-4 in other areas except in the third eyelid
      where there were 1-4 layers. The epithelium was 90-100 microns thick at the
      margin and 35-40 microns at the other areas except at the third eyelid where it
      was 10-45 microns thick; near the limbus it was 55-60 microns thick. The
      morphological differences between the epithelia of the various areas of the
      inferior conjunctiva are highlighted. The similarities and differences between
      the human and monkey inferior conjunctivas are discussed.

PMID- 1632181
TI  - Gross (mesoscopic) and applied anatomy of the anterior inferior cerebellar artery
      in man with special reference to its course through the cerebellopontine angle
      region.
AB  - In the present paper, we describe anatomical variants of the anterior inferior
      cerebellar artery in man for applicative purposes. Our goal was to provide the
      surgeon with a detailed anatomical view of the region. This is similar to what he
      may observe through the surgical microscope using modern microsurgical
      techniques. We have focused our attention on the segments of the artery
      comprising its origin, its course until it reaches the cerebellum and its main
      collateral branches. Our results confirm the great variability of the elements
      under study, but enable the establishment of a few basic variational patterns.
      These patterns together with their relative frequency may be helpful in
      microsurgery.

PMID- 1632182
TI  - Pancreatic microcirculation in the common tree shrew (Tupaia glis) as revealed by
      scanning electron microscopy of vascular corrosion casts.
AB  - Pancreatic vascular casts of the common tree shrew (Tupaia glis) were prepared by
      infusion of Batson's No. 17 plastic mixture into the blood vessels and examined
      by scanning electron microscopy (SEM). Routine histological study of the pancreas
      was also performed. It was found that the A and D cells appeared to occupy the
      core whereas the B cells were found at the periphery of the islets of Langerhans.
      With SEM, the insular arteriole, a branch of the interlobular artery, was shown
      to penetrate deeply into the core of the islets before branching off into the
      glomerular capillary network supplying the islets. These capillaries reunited at
      the periphery of the islets to become vasa efferentia and then gave off
      capillaries to anastomose with those in the exocrine part of the pancreas, the
      insuloacinar portal system. Such an insuloacinar portal system found in the
      pancreas of the tree shrew was similar to that found in the horse and monkey.
      However, there were some intralobular arterioles which did not end in the islets
      but directly branched into the interacinar capillary network and periductular
      plexus. The capillaries in the exocrine part not only gathered into intralobular
      venules which confluently formed the interlobular vein but also supplied the duct
      system. The periductular plexus also collected blood into the intralobular venule
      and interlobular vein, respectively.

PMID- 1632183
TI  - Timing and sequence of the events in the development of extraocular muscles in
      staged human embryos: ultrastructural and histochemical study.
AB  - The ultrastructure and the appearance of glycogen were studied in the extraocular
      muscles of 14 externally normal human embryos (Carnegie stages 13-21). At stage
      16, myofibrils with an immature Z line and glycogen granules appeared in the
      cytoplasm of the myoblast. The myoblasts came into cluster at stage 18, and
      fusion between the myotubes was observed at stage 20. At this stage, an M line
      appeared in the myofibrils. At stage 21, an A band with a Z line and an H band
      with an M line were observed, the sarcoplasmic reticulum appeared in the
      cytoplasm of the muscle fibers and glycogen increased in volume in the cytoplasm.
      In the previous study, we showed that the muscle-specific isoenzymes, such as
      creatine kinase, beta-enolase and glycogen phosphorylase, appeared from stage 18
      to 20 in the extraocular muscles. The previous findings and the present results
      suggest that the fusion of the muscle cells occurs in the period when some
      molecular markers of muscle differentiation are expressed in vivo.

PMID- 1632184
TI  - [Functional cytology of the apocrine glands of the anal sac in cats, Felis
      silvestris f. catus].
AB  - Apocrine glands of the anal sacs in cats (Felis silvestris f. catus) were
      examined by transmission and scanning electron microscopy. The secretory cells
      exhibit a typical equipment with organelles that varied according to the season
      as well as the animal's sex and state of reproduction. This can be mainly
      explained by seasonal differences in secretory activity. The cytological dynamics
      observed are, particularly, related to the smooth endoplasmic reticulum, which,
      for the first time, can be demonstrated in its crystalloid form in apocrine
      glands.

PMID- 1632185
TI  - Analysis of the tendinous structure in human masticatory muscles.
AB  - In the masticatory muscles, the development of bundles of the tendon was
      examined: they were composed of many collagen fibers and a few elastic fibers. In
      the masseter muscle, the property of the tendon differs in the distribution and
      size of collagen fibers and elastic fibers in comparison with those of other
      masticatory muscles. This difference is concerned with the kinetic force for the
      stress or the stretch of each tendon and muscle during jaw movement.

PMID- 1632186
TI  - Autonomic innervation of the salivary glands in cebid monkeys: a histochemical
      study.
AB  - The autonomic innervation of the major and minor salivary glands was studied in
      five species of cebid monkeys using acetylcholinesterase (AChE) and catecholamine
      histochemistry. Catecholamine-containing and AChE-positive nerve fibres were
      observed in the vessels and secretory endpieces of all glands, with no apparent
      predominance of one type over the other. In the intralobular ducts, however, the
      cholinergic innervation predominates. In the major salivary and minor sublingual
      glands the density of the nervous supply was higher, whereas in the secondary
      mandibular and posterior lingual glands it was less dense. The morphological
      patterns of salivary gland innervation found in Cebidae are compared with those
      of the related family Callitrichidae.

PMID- 1632187
TI  - Prothymosin alpha expression in lymph nodes and tonsils: an optical and
      ultrastructural study.
AB  - Prothymosin alpha (ProT alpha) distribution in human and rat lymph nodes and
      human tonsils was studied by means of immunohistochemical methods, using specific
      antibodies raised against thymosin alpha 1. We observed ProT alpha
      immunoreactivity in lymphoid cells of the germinal centers both in humans and
      rats. In human tonsils, positive cells were also seen in the basal layer of the
      surface epithelium. These results support the hypothesis that ProT alpha
      expression is restricted to actively proliferating cells. Immunoelectron
      microscopy revealed that ProT alpha was located in the nucleus, mainly in the
      border between euchromatin and heterochromatin.

PMID- 1632188
TI  - Effects of short-term treatment with calcium on the parathyroid glands in golden
      hamsters of different ages, with special reference to large vacuolar bodies.
AB  - The effects of different ages on large vacuolar bodies in the parathyroid glands
      of golden hamsters after short-term treatment with calcium were investigated. In
      the parathyroid glands of the young and adult animals 15 min and the senile
      animals 15 and 60 min after administration of calcium, the percent area occupied
      by large vacuolar bodies was significantly increased as compared to that of the
      young, adult and senile control animals, respectively. These findings suggest
      that the percent area occupied by large vacuolar bodies is increased in response
      to acute hypercalcemia. It is thought that in the parathyroid glands suppressed
      by hypercalcemia there is a relationship between the percent area occupied by
      large vacuolar bodies and aging.

PMID- 1632189
TI  - Unilateral immobilization affects contralateral rat gastrocnemius muscle
      architecture.
AB  - In order to study the effects of unilateral short length immobilization on the
      contralateral gastrocnemius muscle (GM), length measurements were conducted on
      photographs taken in the active condition (tetanic plateau). Comparison of
      geometry of experimental and control muscles was made at optimum muscle length.
      The results show that a process occurred in the muscle which can be ascribed
      predominantly in terms of atrophy. This atrophy did not reach a maximum after 4
      weeks but gradually increased in time. The altered conditions imposed on the
      muscle changed its architecture. It was shown that variables of the contralateral
      GM muscle are not representative of those of normally used muscles and should
      therefore not be used as control muscles for the determination of immobilization
      effects.

PMID- 1632190
TI  - Neural differentiation as an expression of UV sensitivity of melanocytes.
AB  - The present work is to study neural differentiation in melanocytes in relation to
      the cell cycle and UV exposure. Whole skin organ cultures of vitiliginous skin
      were exposed to a pulse of UV with and without prior Adriamycin treatment. It was
      observed that the highly dendritic marginal melanocytes are destroyed on UV
      exposure during the depigmentation phase but not during repigmentation. The
      melanocytes are resistant to UV destruction during the G2 phase as seen on
      Adriamycin treatment. They show a prominent increase in dendricity as well as
      biphasic activity to produce increased melanin and noradrenaline. Thus, the
      melanocytes form a UV-sensitive neural network in the skin. These responses are
      reminiscent of the repigmentation and depigmentation of coat color in animals
      exposed to extreme variations in the day/night cycles as seen at the poles.

PMID- 1632191
TI  - Sexually dimorphic duct system of the submandibular gland in mouse with
      testicular feminization mutation (Tfm/Y).
AB  - The X-linked testicular feminization mutation (Tfm/Y) in the mouse is
      characterized by androgen insensitivity of the target cells. The aim of this
      study was to examine sexually dimorphic development of the submandibular gland of
      Tfm/Y mutant mice in comparison with those of wild-type male, wild-type female
      and heterozygous Tfm female mice. In either 30- or 90-day-old wild-type male
      mice, the granular convoluted tubules (GCT) of the glands were more developed,
      and the relative occupied areas (ROA) of GCT were superior to those of the age
      matched wild-type and heterozygous Tfm females. In androgen-insensitive Tfm/Y
      mice, the glandular structures rather resembled the female glands, showing lower
      values of the ROA of the GCT. Sex differences in the mitotic rate were observed
      at 30 days of age, being significantly higher in the wild-type male GCT than in
      the female GCT. Thereafter, the mitotic rate of the wild-type male GCT declined
      to the female levels by 90 days of age. The mitotic rate of GCT in Tfm/Y mutants
      was as low as those of the females during observation periods. An other three
      regions, the acini, the intercalated ducts and the excretory striated ducts, were
      not significantly different in either the ROA or the mitotic rate among wild-type
      males and females, and Tfm/Y. On the other hand, either the ROA or the mitotic
      activity of GCT of the glands in Tfm/Y mutants was completely unaffected by 5
      alpha-dihydrotestosterone (DHT).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632192
TI  - SEM study on the dorsal lingual surface of the common tree shrew, Tupaia glis.
AB  - The dorsal lingual surface of the common tree shrew was examined by SEM after
      treating it with HCl to remove the mucous substance. Filiform (FI), fungiform
      (FU) and circumvallate papillae (CI) were observed. The FI exhibited a small
      circular bulge surrounded by anterior and posterior filamentous processes. FU
      were scattered among the FI. There were 3 CI separating the anterior 4/5 from the
      posterior 1/5 of the tongue. In addition, a group of conical projections with
      caudal orientation was found anterior to the palatoglossal fold on each side of
      the tongue. Microridges were widely observed on the entire dorsal lingual
      surface, except on the free surface of FI processes.

PMID- 1632193
TI  - Histochemical localization of carbonic anhydrase in the testis and epididymis of
      the rabbit.
AB  - The distribution of carbonic anhydrase (CA) was studied in the testis and
      epididymis of mature, male rabbits using a cobalt precipitation method. CA was
      found only in the endothelium of the capillaries in the testis. The epididymal
      duct was divided into initial, middle and terminal segments. Strong cytoplasmic
      CA was present in the apical cells in the initial and middle segments. Vacuoles
      with CA staining in the membranes were found in the principal cells in the middle
      segment. Intensely stained basal cells were present in the terminal segment. In
      the last part of the terminal segment and the first of the ductus deferens the
      basolateral cell membranes were also stained. The function of the enzyme is
      discussed especially in relation to acidification of the epididymal fluid and
      facilitation of CO2 diffusion.

PMID- 1632194
TI  - Effect of microbial immunomodulants on the course of LCMV infection in old mice
      with thymus involution.
AB  - Old mice with thymus involution were treated intraperitoneally with a live
      vaccine containing a mesogenic strain of attenuated Newcastle Disease Virus or
      with Mannozym (M, 1% zymosan suspension). One day after the treatments mice were
      infected with lymphocytic choriomeningitis virus (LCMV) intracerebrally. The
      fatal course of the consequent LCMV infection was stimulated by each of the
      pretreatments, indicating that the cellular immune response was stimulated. The
      results are compared with results of experiments carried out on suckling, young
      adult and old mice in similar experimental systems. The authors' previous
      publication suggesting that the direction and degree of the immunomodulant effect
      may be influenced by the actual age-dependent condition of the lymphoid system,
      have been confirmed.

PMID- 1632195
TI  - Morphological changes of Neisseria gonorrhoeae in amniotic fluid of pregnant
      women in their midtrimester.
AB  - Ten selected samples of amniotic fluid obtained through transabdominal
      amniocentesis from 10 pregnant women in their 17th-19th weeks of pregnancy were
      investigated for the survival of Neisseria gonorrhoeae in amniotic fluid. In 8
      cases an antibacterial effect was observed with morphological changes comparable
      to the effect of benzylpenicillin. When N. gonorrhoeae was inoculated in amniotic
      fluid at 10(5)-10(7) cells/ml, it survived as an average 2 h longer than after
      inoculation of 10(2)-10(4) cells/ml. Electron microscopic pictures of gonococci
      taken after 2.6 and 24 h incubation in amniotic fluid correlated with the growth
      curves. Electron microscopically there were marked morphologic changes of N.
      gonorrhoeae, viz. vacuolar degeneration of their cytoplasm with a damage to the
      bacterial wall up to its complete destruction and lysis of the cell.

PMID- 1632196
TI  - Effect of Mannozym on the course of LCMV infection in mice with undeveloped and
      normal immune system.
AB  - Adult germfree (Gf) mice with undeveloped immune system due to antigen deficient
      environment, conventional (Cv) mice with normal immune system and Cv suckling
      mice with undeveloped immune system due to age were treated intraperitoneally
      with Mannozym (M, 0.1% zymosan suspension) 4 days or 4 days and 1 day before the
      intracerebral inoculation with lymphocytic choriomeningitis virus (LCMV). One
      dose of M was equal to 40 mg/kg of zymosan. In suckling mice, both applied doses
      of M contributed the development of fatal lymphocytic choriomeningitis after
      infection with 100 LD50 dose of LCMV, thus M pretreatment increased the cellular
      immune response to LCMV infection. M pretreatments had no influence on the course
      of LCMV infection either in adult Gf or in Cv mice. Spleen hypertrophy was caused
      by applied doses of M both in adult (Gf and Cv) and Cv suckling mice, but
      modulating effect on the cellular immune response manifested simultaneously only
      in Cv sucklings.

PMID- 1632197
TI  - Epidemiological and microbiological data on Salmonella enteritidis.
AB  - The number of Salmonella enteritidis isolations started to rise in humans, eggs
      and egg products in 4 territories out of the examined 9 territories of Russia in
      1986. The spread of S. enteritidis infections was connected with the consumption
      of hen's eggs as it was demonstrated by the analysis of the local outbreaks.
      Phage type of 1142 S. enteritidis strains isolated in Russia was determined using
      the Hungarian typing scheme. The strains were typable in 95.3% and 12 phage types
      were found. Phage type 1 was the most frequent (86.7%) among human strains and
      also among strains originated from hen and egg products. The examined 18226 human
      S. enteritidis strains isolated in Hungary between 1984 and 1989 belonged to 24
      phage types and phage type 1 was predominant, the incidence of this type varying
      between 69.3% and 93.2%. The strains were sensitive to antibiotics,
      multiresistant strains were found in 1%. Plasmid content was examined of 138
      strains; a 38 Md plasmid was carried by all of them and a 96 Md plasmid was
      harboured by 11 antibiotic-resistant strains. The tested strains produced
      enterobactin but no aerobactin.

PMID- 1632198
TI  - Shigella-type pathomechanism in the "mouse model".
AB  - A strain of Escherichia coli K-12 carrying the 140-Megadalton virulence plasmid
      of the enteroinvasive E. coli--J53(pSPl)--showed high virulence in the "mouse
      model", in chick embryos, but not in the Sereny test. It expresses the outer
      membrane proteins thermoregulatedly, encoded also by the virulence plasmid. In
      orally infected streptomycin-pretreated mice this strain infects only the large
      bowel, shows adherence to the epithelial surface, but in its first step
      preferentially to the mucus excreted by the goblet cells. Epithelial penetration
      and intracellular multiplication occurs with a characteristic localization of
      bacteria in the depth of crypts. Consequence of the infection is degeneration of
      the epithelial surface, its denudation.

PMID- 1632199
TI  - Detection of Legionella pneumophila-specific antibody by indirect
      immunofluorescence assay.
AB  - Antibodies to Legionella pneumophila were found by indirect immunofluorescence
      assay in 525 samples of human serum. The samples were obtained from 451 patients
      who were suspected of having an acute infectious illness, with mainly respiratory
      symptoms; 90 patients had antibodies to L. pneumophila (19.9%). The results
      suggest that the prevalence of L. pneumophila is greater than had previously been
      supposed.

PMID- 1632200
TI  - Mixed cultivation of Trichoderma reesei and Aspergillus ochraceus for improved
      cellulase production.
AB  - Aspergillus ochraceus IMI 317911 was screened to be a high cellobiase producing
      strain (2.40 IU/ml). The mixed batch cultivation of Trichoderma reesei QM
      9414/Rut C-30 and A. ochraceus IMI 317911 resulted in a balanced enzyme as
      compared to singly grown cultures. The milled rice straw (6%, w/v) as carbon
      source was found suitable for production of cellulases resulting in a Filter
      Paper Activity (FPA) of 1.83 IU/ml and a cellobiase production of 1.63 IU/ml
      after 7 days of stirred cultivation. An overall cellulase productivity of 10.89
      IU/l/h and an enzyme ratio to cellobiase of 1.12 was achieved.

PMID- 1632201
TI  - Differences and similarities in the sensitivity of lymphocytic and macrophage
      plasma membrane to deoxycholate.
AB  - Human tonsillar lymphocytes separated on nylon wool and rat macrophages showed
      different sensitivity to deoxycholate (DOC) treatment at a low (0.24 mM, 0.01%)
      concentration for 3 h. The T cell-enriched fraction was stimulated more readily
      by PHA whereas the B-cell enriched fraction lost its adherence and a decrease of
      chromium binding capacity was observed after the detergent treatment. Rat
      peritoneal macrophages under the same conditions lost their chromium label and
      lysozyme content, whereas their adherence and phagocytic capacity decreased
      dramatically without affecting their binding capacity. Higher sensitivity to the
      detergent was observed in peritoneal macrophages compared to tonsillar
      lymphocytes when various DOC concentrations were used. These findings proved that
      this low concentration DOC treatment, at least in macrophages, touched mainly the
      adhesive proteins and the dynamics of the membrane and not its receptor
      associated properties.

PMID- 1632202
TI  - Plasmids encoding for erythromycin ribosomal methylase of Staphylococcus
      epidermidis and Staphylococcus simulans.
AB  - Two 1.7 Md plasmids of Staphylococcus epidermidis and three ones of
      Staphylococcus simulans determining inducible macrolide-lincosamide resistance
      are identical as judged by restriction endonuclease fingerprinting. These
      plasmids designated pEI2101, pEI9105, pE1107, pEI1108 and pEI6104, respectively,
      belong to the incompatibility group 12. Dot-blot hybridization by photobiotin
      labelled gene probe developed from S. aureus erythromycin ribosomal methylase
      gene showed cross hybridization between methylase-coding reference plasmids and
      the tested ones. The examined plasmids proved to be no transmissible in mating
      experiments into S. aureus recipients.

PMID- 1632203
TI  - Plasmids determining enzymatic inactivation of lincomycin in Staphylococcus
      epidermidis. A preliminary report.
AB  - Coagulase-negative staphylococcal strains isolated from immunocompromised
      patients harboured in 41% non-MLS type lincomycin resistance determinant. Two
      kinds of resistance plasmids were detected in Staphylococcus epidermidis isolates
      of this origin in connection with lincomycin resistance. One of them represented
      by pBI1 and pBI84 (1.4 Md in size) determines no other resistance marker. The
      pBI109PGL plasmid determines also penicillinase production and aminoglycoside
      resistance, its molecular mass is 31 Md. Hybridization using linA, linA' and linA
      like specific gene probes suggested occurrence of genes of lincosamid
      inactivating enzyme belonging to the lin gene family but differring from the
      previously characterized determinants.

PMID- 1632204
TI  - Chronic facial pain together with severe depression is responsive to
      electroconvulsive therapy. A case report.
AB  - Electroconvulsive therapy (ECT) is widely accepted as a treatment for severe
      depression, but is seldom used in the treatment of chronic pain even though
      chronic pain and depression frequently occur together. This study presents a case
      in which ECT relieved both severe depression and chronic pain. It seems that the
      recognition of depressive disorders merits more attention and that ECT as a
      treatment for chronic pain in patients with severe depression should be taken
      into consideration in cases in which other treatments have failed.

PMID- 1632205
TI  - Explanatory models for total edentulousness, presence of removable dentures, and
      complete dental arches in a Swedish population.
AB  - On the basis of data from a questionnaire study of 3000 inhabitants of Orebro
      County, Sweden, aged 45-69 years, the relative importance of various
      socioeconomic factors for dental conditions were analyzed in stepwise logistic
      regression models. Two different patterns were found: one in relation to the best
      dental condition (complete dental arches), another in relation to the poorest
      conditions (total edentulousness and presence of removable dentures). Next to
      age, education and income showed the highest predictive values in relation to the
      presence of removable dentures and total edentulousness. Place of residence and
      gender seemed to be of less importance than earlier. In relation to complete
      dental arches, there were lower values for most variables. One of only four
      significant variables was the attitude variable 'importance of good dental
      appearance'. The results may indicate the development of a new pattern of
      influences on dental conditions, mainly based on education and attitudes.

PMID- 1632206
TI  - Design of a socio-ecologic caries model and testing on 50-year-old citizens of
      Oslo, Norway.
AB  - The purpose of the present study was to design a socio-ecologic caries model
      based on a general health model and to test the fit of data collected from a
      random sample of 200 50-year-old Oslo citizens to this designed model. The
      intention was also to investigate the relative importance of the four items
      environmental, behavioral, human biology, and health care organization factors.
      The dependent variable, number of carious surfaces, was recorded clinically and
      radiologically. The mean number of carious surfaces was 3.0 (SD, 3.5), with a
      range from 0 to 17, and the four items explained 5%, 25%, 28%, and 13% of the
      variance in number of carious surfaces, respectively. The complete model
      explained 42%, whereas traditionally used variables on the basis of the Keyes
      triad explained only 22% of the variance. The findings from the present study
      indicate that dental caries is a multifactorial disease with both behavioral and
      biologic determinants, and the socio-ecologic caries model represents a relevant
      supplement to the Keyes triad.

PMID- 1632207
TI  - The predominant microflora of the palatal mucosa in an elderly island population.
AB  - The prevalence and microbiology of macrophotographically documented denture
      stomatitis were studied in denture wearers participating in an interdisciplinary
      health-monitoring project (Koster Health Project) on the Koster islands, Sweden.
      Upper dentures were used by 26.6% of the adult population, and 59.2% of the
      denture wearers had stomatitis. Denture stomatitis type I was identified as
      sialadenitis. The more severe forms of denture stomatitis (types II and III)
      demonstrated increased recovery of microorganisms in the palatal mucosa in
      addition to sialadenitis. Only one proband showed increased growth of fungi.
      Hemophilus spp. and Bacteroides spp. were the predominating microorganisms in
      stomatitis types II and III. Shifts in the normal oral flora are suggested to be
      an important factor for the development of denture stomatitis. It is concluded
      that bacterial colonization on the palatal mucosa may play an important role in
      denture stomatitis in this relatively healthy population.

PMID- 1632208
TI  - A clinical examination of ceramic (Cerec) inlays.
AB  - Two hundred and five Cerec ceramic inlays placed by 8 dentists in 72 patients
      were examined independently by 3 calibrated evaluators 12-24 months after
      insertion, using the criteria of the California Dental Association (CDA) and also
      certain periodontal variables. Proximal dental plaque and bleeding on probing
      were not seen more often on Cerec surfaces than on control homologous surfaces.
      Ten patients reported postoperative sensitivity after treatment with Cerec
      inlays. Excellent CDA ratings for Color and Surface were obtained in 57% and 26%,
      respectively, and for Anatomic Form and Margin Integrity in 55% and 83%,
      respectively. Obvious differences were seen among the participating dentists with
      regard to the clinical quality of Cerec inlays. At present, the long-term
      performance of the Cerec technique cannot be predicted.

PMID- 1632209
TI  - The clinical performance of two groups of functioning class-II cast gold inlays.
AB  - The length of service and the clinical performance of two groups of functioning
      class-II cast gold inlays in patients attending a private practice were assessed
      by conventional clinical and radiographic examination. In one group all inlays
      were older than 25 years (median age, 34 years), and they had an extended outline
      form. The impression technique was based on a thermoplastic material in a copper
      ring. In the other group, comprising inlays inserted during the past 25 years
      (median age, 16.5 years), the outline form was minimal and an elastic impression
      material in a copper ring was used. The inlays in the older group appeared to
      perform better than those in the younger group. In both groups recurrent caries
      appeared to be the predominant reason for repair.

PMID- 1632210
TI  - [The intact, injured and repaired knee: in-vitro experimental biomechanics and
      level walking].
AB  - In vitro simulation of knee joint movement during walking on flat ground was
      developed in this experimental study. Such movements are of interest for surgical
      and rehabilitation medicine in order to improve knowledge in the field of dynamic
      behavior of the knee joint during the entire range of motion: spatial kinematics
      and strains and stresses on the different components, in the case of intact knee,
      as well as of the operated one. As internal strains and stresses could not be
      measured directly, the aim of this experimental study was also to simulate such
      factors in a model using experimental input data. A simulator of joint flexion
      was built: it was composed of a hydraulic universal testing machine which allowed
      the main flexion-extension of the knee joint and an additional hydraulic device
      to impose the quadriceps extension force which represented the muscular action,
      synchronized with the imposed flexion-extension. The anatomical automatic passive
      rotation and valgus-varus motion were freely allowed, and these were measured
      during joint motion. In addition the lateral ligaments were fitted with strain
      sensors in order to measure their time-dependent behavior. The imposed flexion
      motion and quadriceps force were also measured to verify that they were
      accurately synchronized. The time-dependent values of force and flexion were
      taken from the literature. The analysis gave the mean result of eight reliable
      knee joint determinations: first of all intact, then after removing the
      anteroexternal cruciate ligaments, and finally after joint replacement by total
      knee prosthesis. One main conclusion was the comparison between automatic
      rotations, which decreased significantly after prosthesis surgery.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1632211
TI  - Ultrasound in the diagnosis of the early stages of hemophilic arthropathy of the
      knee.
AB  - We have studied the knees of 50 patients with hemophilia A, using ultrasound (US)
      when conventional radiology did not detect any secondary osseous changes. The
      sonographic images were compared with those obtained from 50 healthy controls.
      The mean age of this series was 14.6 years. Our results suggest that sonography
      as a diagnostic technique in the initial stages of hemophilia permits
      differentiation between suprapatellar effusion and synovial thickening. It also
      reveals early cartilaginous involvement.

PMID- 1632212
TI  - The validity and reliability of measurements in spinal deformities: a critical
      appraisal.
AB  - Quantitative measurement of spinal deformity is the preliminary step in order to
      plan a therapeutic regimen. The most commonly used methods and, for this matter,
      practically any measurement methods, may have several sources of errors, namely:
      a. errors in taking a radiograph; b. errors intrinsic to the measurement method;
      c. errors due to anatomical deformity of the vertebrae; d. observer errors in
      measurement technique. These are discussed, and suggestions are given to minimize
      them.

PMID- 1632213
TI  - [Bone anchorage and surface condition of the implant. Validity of extraction
      tests].
AB  - The mechanical strength of the bone-implant interface depends on the morphology
      and the composition of the implant surface. The great variety of coating
      materials as well as the condition of the surfaces to be covered, makes a
      comparative and preclinical evaluation of the different materials for prostheses
      necessary. The results, the validity and the limits of the extraction tests are
      discussed in this article.

PMID- 1632214
TI  - [Spatial kinematics of the femoro-tibial articulation of the human knee:
      experimental characterization and surgical implication].
AB  - The entire flexion of the human knee joint was experimentally studied by means of
      spatial solid kinematic theory. This study used postmortem joints, initially
      intact, then with the menisci removed, and finally without the antero-external
      cruciate ligament. The instantaneous velocities were defined in kinematic theory;
      then they were transformed into incremental displacements of the tibia which was
      considered as a moving solid relative to the femur, which was considered as the
      reference solid. The rotational movement of tibia was computed as being the main
      degree of freedom; then it was divided into three physiological components:
      flexion-extension, axial rotation, and varus-valgus rotation. The computation of
      the instant axis of the motion allowed definition of an area that was
      characterized as a central zone of the joint motion. This 3-dimensional approach
      was in opposition to the classical but incorrect definitions of the instant
      center of rotation, which can be described only for movement within a plane.
      Eight anatomical knee joints were tested and their mean results were used to
      elucidate conceptual problems relative to the femoro-tibial knee-joint prosthesis
      design.

PMID- 1632215
TI  - [Complex injuries of the proximal humerus treated with humeral head prosthesis.
      Apropos of 21 cases reviewed after a median 4-year follow-up].
AB  - Of a total of 35 complex fractures of the upper humeral epiphysis treated by Neer
      arthroplasty, 21 were evaluated at a mean of 4 years after operation. The
      shoulder function according to Constant was 70% of the contralateral one. The
      internal and external rotations were rarely symmetric. Clinical improvement was
      possible during the first 2 years. Late breakage and migration of wires used to
      fix the tuberosities caused failure of this method of fixation. Dynamic
      radiographs revealed significant gleno-arthroplastic movement and a constant
      medialization of the prosthetic humerus.

PMID- 1632216
TI  - [Intramedullary nailing osteosynthesis with epiphyseal fixation of fractures of
      the proximal humerus in adults. 1 to 3-year follow-up].
AB  - The authors used a medullary pinning with epiphyseal fixation in the treatment of
      superior metaphyseal fractures of the humerus for 41 patients aged 22 to 82
      years. There were 28 cases with epiphyseal fractures and 12 with metaphyseal
      fractures. The follow-up was 1 to 3 years. The pins were introduced through the
      triceps brachii after perforation of the diaphysis, 1 cm above the ulnar fossa.
      Results were very good. Strength returned within 8.5 weeks. There was only one
      case of nonunion of a proximal diaphyseal fracture due to a technical fault
      (diastasis between fragments). Rehabilitation began immediately, resulting in
      good elbow motion in 35 cases. The shoulder motion was the same as the healthy
      side in 36 cases, and inferior to 90 degrees of abduction in only two complex
      epiphyseal fracture. The proximal humerus was never perforated by the pins. The
      authors find this new instrumentation to be very effective.

PMID- 1632217
TI  - [Post-traumatic cubitus varus in children (apropos of 8 cases in African
      children)].
AB  - The author describes his experience after treatment of 8 cases of cubitus varus
      secondary to displaced supracondylar fractures of the humerus in African
      children. Measurement of the Baumann angle is necessary for the assessment of
      cubitus varus. The median angle is 24 degrees with a range of 10 degrees to 45
      degrees. Indications were dictated by functional problems, discomfort, and
      esthetic considerations. The surgical treatment consisted in a supracondylar
      osteotomy of the humerus for correction of cubitus varus.

PMID- 1632218
TI  - Inter- and intratester reliability of radiographic measurements of
      spondylolisthesis.
AB  - Thirteen radiographic methods to measure spondylolisthesis were assessed to
      determine: 1. whether or not the different methods were correlated with each
      other; 2. their precision in detecting vertebral displacements; 3. inter- and
      intra-measurer reliability among six orthopedic surgeons performing radiographic
      measurements. Several methods were found to be correlated with each other in
      detecting spondylolisthesis on radiographs. However, on simulated displacements
      only three of them showed good correlation (r greater than or equal to 0.95, p
      less than 0.01). Intra- and intergroup correlations among the orthopedic surgeons
      were equally good (r greater than 0.90; p less than 0.01).

PMID- 1632219
TI  - [Experimental carpal displacement induced by bony lesions].
AB  - Bony lesions were created experimentally in 48 fresh cadaver wrists. They
      consisted of radial and scaphoid resections along the extent of the proximal
      carpal row, representative of clinically-induced (usually traumatic) lesions. The
      displacements obtained experimentally to mirror each clinical situation modify
      the physiologic equilibrium established between the trans-osseous forces and the
      ligaments. The comparison between the experimentally-induced lesions and clinical
      displacements shows the etiology of the clinical conditions which indicates the
      proper treatment.

PMID- 1632220
TI  - Incidence of neonatal hip instability: are there seasonal variations?
AB  - We wanted to establish whether the season of birth affected the incidence of
      neonatally diagnosable hip instability in Eastern England. Data relating the
      numbers of maternities to the numbers of cases of congenital displacement of the
      hip diagnosed in neonates were analyzed month by month over a period of 8 years.
      The study covered 185,744 maternities and 154 cases of displaced hips during the
      period 1979-1986. While there were wide fluctuations in the monthly incidence,
      there was a striking excess of the malformation in late winter and early spring,
      i.e. in January, February, March and April, and a progressive decline in the
      succeeding months. The cause or causes of the seasonal variation are unknown.

PMID- 1632221
TI  - [Villonodular synovitis of the shoulder. Apropos of a case report].
AB  - The authors report a case of villonodular synovitis of the shoulder, treated by
      synovectomy. The diagnostic problems, treatment and results are reviewed.

PMID- 1632222
TI  - Chondromyxoid fibroma in the metacarpal bone of the thumb.
AB  - We present a case of a chondromyxoid fibroma in the exceptionally rare location
      of the first metacarpal bone in a 12-year-old boy. The tumor had evolved
      asymptomatically over a period of 8 years destroying all diaphyseal trabecular
      bone. No recurrence was evident 50 months following aggressive curettage of the
      metacarpal lesion, which presented a predominantly myxoid appearance.

PMID- 1632223
TI  - [Intraneural fibrolipoma of the median nerve at the thumb. Apropos of a case and
      literature review].
AB  - The authors report the case of a rare tumor of the median nerve in a 67-year-old
      man. They provide a review of the literature, and discuss the original
      macroscopic and histologic characteristics, the etiological hypotheses and the
      possibilities of treatment of this tumor.

PMID- 1632224
TI  - Kashin-Beck's disease.
AB  - A case of Kashin-Beck's disease is presented. It is an acquired, disabling,
      polyarthritic, degenerative condition of early onset, sometimes leading to a
      variable degree of dwarfism. It occurs endemically in certain Asian areas.
      Treatment is, if possible, preventive. In the established disease the therapy is
      that of any other form of secondary osteoarthritis. Reconstructive surgery and
      removal of loose bodies may be needed in severe cases (11). Early detection,
      facilitated by careful family history taking, is a prime requisite, especially in
      non-endemic areas (7).

PMID- 1632225
TI  - [Osteoid osteoma of the femoral neck in children: diagnostic problems].
AB  - The authors report a case of an osteoid osteoma of the femoral neck in a child,
      aged 3 1/2. This is a benign bone tumor, frequently painful with variable relief
      obtained with salicylates. Clinical latency is not exceptional in children, owing
      to the delayed diagnosis. When located in the femoral neck it is usually
      discovered after a delay, owing to the misleading clinical signs and the
      frequently normal standard x rays. The only treatment for cure is the excision of
      the nidus, which is usually difficult because of the anatomical location and the
      perioperative adjustment.

PMID- 1632226
TI  - [Prevention of peridural fibrosis following laminectomy. Apropos of a case of
      monoradicular paralysis due to an intracanalar hematoma on Gelfoam].
AB  - Gelfoam has routinely been used, according to Larroca and Macnab, to prevent scar
      formation about the dura mater and the nerve roots after laminectomy. We report a
      case in which postoperative monoradicular paralysis resulted from compression of
      the thecal cul-de-sac by a hematoma held in place by the Gelfoam. A review of the
      literature on prevention of adhesions after laminectomy is included.

PMID- 1632227
TI  - Aplasia of the anterior cruciate ligament with a compensating posterior cruciate
      ligament.
AB  - Aplasia of the anterior cruciate ligament is a rare condition and is usually
      associated with other abnormalities of the lower extremities. We report aplasia
      of the anterior cruciate ligament with a compensating posterior cruciate ligament
      in a 15-year-old boy.

PMID- 1632228
TI  - Tumoral calcinosis.

PMID- 1632229
TI  - HLA antigens and recurrent acute otitis media.
AB  - The frequencies of a number of HLA antigens were investigated in 45 individuals
      with clinical recurrent acute otitis media (rAOM), defined as six or more
      episodes of AOM during a 12-month period, and were compared to those in a control
      group from the same district. HLA-A2 was found to occur in 80% of the rAOM group,
      as compared to 55.9% of controls (p less than 0.01). HLA-A3 antigen occurred in
      only 11.1% of the rAOM group in contrast to 27.5% of controls (p less than 0.05).
      Among 22 prospectively followed children without any AOM during their first 3
      years of life, the frequencies of HLA-A2 and HLA-A3 antigens were comparable with
      those among controls.

PMID- 1632230
TI  - Results of uvulopalatopharyngoplasty in snoring.
AB  - Twenty-one patients (4 females and 17 males) with very annoying snoring were
      subjected to UPPP with CO2-laser technique. All patients were overweight
      (bodymass index average 30.3 kg/m2). In 71%, narrowing were found at the
      naso/oropharyngeal border. All had either abnormal uvula or soft palate. In 17
      patients, snoring was reduced to a degree no longer socially annoying. Three were
      annoying to some extent. In only one patient, snoring was completely unchanged.
      UPPP is not very difficult to perform and we did not notice any troublesome
      sequelae. We think that UPPP is an effective operation for severe snoring,
      although it does not eliminate the symptom.

PMID- 1632231
TI  - Diagnosis of psychogenic dysphonia.
AB  - Background factors, symptoms and signs were analysed in 40 consecutive patients
      with psychogenic dysphonia. Their voice profile was compared with that of 40
      patients with infectious laryngitis. The majority of the patients were young
      females, non-smokers, who were not professional voice users. Criteria for acute
      infectious laryngitis prior the voice disorder were met in no more than 10% of
      the patients. Nevertheless as many as 40% of the patients had been treated with
      various antibiotics. The prevalence of reported asthma/allergy-like symptoms was
      high, 37.5%. Perceptual analysis of voice profiles demonstrated similarity of
      aberrancies in psychogenic dysphonia and in acute laryngitis. Since it may be
      difficult to distinguish psychogenic dysphonia from acute laryngitis, careful
      analysis of anamnestic data may be helpful for a correct diagnosis.

PMID- 1632232
TI  - Computerized apnea detection in ambulatory sleep recording with the Somnolog
      system.
AB  - Apnea detection from a traditional polysomnographic sleep recording is tedious
      and time consuming. With a new portable device, the Somnolog, it is possible to
      make ambulatory sleep recording and apnea detection.

PMID- 1632233
TI  - Bilateral facial palsy caused by the Borrelia spirochete.
AB  - A case of total left peripheral and partial right peripheral facial palsy caused
      by the Borrelia spirochete is presented. The diagnosis was confirmed by the
      history of the tick-bites and elevated titers of IgG in serum and cerebrospinal
      fluid.

PMID- 1632234
TI  - Alternative treatment of obstructive sleep apnea: nasal-CPAP continuous positive
      airway pressure.
AB  - The upper airway of patients with obstructive sleep apnea is often characterised
      by a narrow lumen and increased compliance of the pharyngeal wall. During
      inspiration, a negative inspiratory pressure is developed which may produce
      occlusion in the pharynx. Continuous positive airway pressure (CPAP) works as a
      pneumatic splint dilating the upper airway and thus keeping the airway open. The
      result is a patent airway, free regular breathing during sleep with no oxygen
      desaturations and normal sleep architecture. Irregular pulse, fluctuations in
      blood pressure, increased levels of catecholamines recorded during sleep in
      patients with obstructive sleep apnea are normalised during CPAP treatment.

PMID- 1632235
TI  - Shortened reaction time during nasal CPAP treatment of obstructive sleep apnea.
AB  - In 5 patients with severe obstructive sleep apnea the effect of nasal continuous
      positive airway pressure (CPAP) treatment on daytime functioning was measured.
      During a 2-week period, when the patients were effectively treated with nasal
      CPAP, a shortening of the reaction time could be measured.

PMID- 1632236
TI  - Natural history of Bell's palsy.

PMID- 1632237
TI  - Penicillin V treatment of experimental pneumococcal otitis media prevents mucosal
      changes.

PMID- 1632238
TI  - [Patient compliance in clinical research in the primary and secondary sectors].

PMID- 1632239
TI  - Pressure recordings--a method for detecting site of upper airway obstruction in
      obstructive sleep apnea syndrome.
AB  - Polysomnography is the method of choice in diagnosis of obstructive sleep apnea
      syndrome (OSAS) establishing whether a patient has apneas or not. It does not,
      however, give any indications of where the obstructions occur. This is reflected
      in the limited success rate of current surgical procedures used in the treatment
      of this disorder. We have developed a simple method for simultaneous
      determination of OSAS and site of obstruction. The method implies continuously
      recording of pressure at different sites in pharynx. A catheter with five
      pressure transducers and corresponding markings is put into the pharynx through
      the nasal cavity and interfaced with a polygraph. Continuous pressure
      registrations were made in 12 patients. We have found characteristic patterns of
      pressure-changes which clearly indicate the level of obstruction. This may be of
      importance in selecting patients for further treatment.

PMID- 1632240
TI  - Orbital floor fractures. Diagnosis, treatment and results.

PMID- 1632241
TI  - Acute orbit from ethmoiditis drained by endoscopic sinus surgery.
AB  - Orbital complications from sinusitis are briefly reviewed. Acute orbit is
      suggested as the common term for all stages in the development. Four patients
      with acute orbit and ethmoiditis are presented. All had transnasal ethmoidectomy
      and drainage of the orbit performed by functional endoscopic sinus surgery (FES).
      Surgical indications are discussed based on clinical signs and CT examination.
      The operation can easily be staged according to the needs of the individual
      patient, starting with drainage of the primary cause, the sinusitis. Orbital skin
      incisions are avoided. Postoperative regression of clinical symptoms has been
      rapid.

PMID- 1632242
TI  - Histochemical analysis of enzymes involved in the formation and metabolism of the
      nasal septal cartilage.
AB  - Formation of the nasal septal cartilage in prenatal and neonatal rats was studied
      histologically and by histochemistry to determine the manner, degree and
      participation of the nasal septal cartilage in midface growth and in bone
      formation of the face. Chondrogenesis of the nasal septal cartilage started at
      the 13th embryonic day, premaxillary and vomerin bone formation at the 14th
      embryonic day and endochondral bone formation of the septo-presphenoid area at
      the 17th embryonic day. After differentiation of the nasal septal cartilage, this
      cartilage supported ethmoid bone formation by endochondal ossification in the
      septo-presphenoid area. Nasal septal cartilage showed intense activity of lactate
      dehydrogenase, NADH2-diaphorase and a moderate activity of acid phosphatase,
      whereas premaxillary and vomerin bone showed intense activity of alkaline
      phosphatase. Osteoblasts showed intense activity of alkaline phosphatase, lactate
      dehydrogenase and NADH2-diaphorase and osteoclasts showed intense activity of
      acid phosphatase. During the embryonal period growth of the nasal septal
      cartilage could occur in an ethmoido-rostral direction supported by endochondral
      ossification and growth in length and height supported by apposition and
      interstitial growth.

PMID- 1632243
TI  - Treatment of snoring--with and without carbon dioxide laser.
AB  - Thirty patients with bedpartners complaining of their heavy snoring which had
      resulted in separate bedrooms were treated surgically. Three different methods
      were used, each group consisted of 10 patients. In group A conventional scalpel
      excision was used for uvulopalatopharyngoplasty including tonsillectomy. In
      groups B and C, patients with small tonsils were selected and therefore the
      tonsils were saved. Group B was operated with carbon dioxide laser under a
      microscope and using micromanipulator. The same kind of excision was used as in
      group A but the tonsils were saved. Group C was operated as group B but using
      conventional scalpel excision technique. With a starting-point of snoring score 3
      preoperatively in all groups, the mean postoperative snoring score in Group A was
      1.0, in Group B 0.2 and in Group C 1.1. Patients with postoperative snoring
      scores of 0 and 1 were regarded as successful responders to surgery. No serious
      side effects were noted due to treatment.

PMID- 1632244
TI  - Quantitative assessment of esophageal transport with normalized condensed images.
AB  - Scintigraphy is one of several diagnostic procedures used to investigate
      dysphagia. Several different methods to present the bolus transport have been
      presented. The normalized condensed image enables quantitative assessments of
      patterns of bolus transport and a descriptive nomenclature of these patterns: the
      "L-h-S-E-m-system", based on results of 25 subjects without dysphagia, is
      suggested. Aberrant patterns were found in 40% of the swallows.

PMID- 1632245
TI  - Primary mandibular reconstruction after ablative cancer surgery.
AB  - Restoring of the oral functions is one of the most complicated procedures in head
      and neck cancer surgery. For the moment "primary reconstruction" using
      functionally stabile reconstruction plates in recontouring and stabilizing of the
      remaining mandibular stumps after tumour extirpation is becoming increasingly
      popular. The aim of the present study was to evaluate treatment results and
      complications of primary reconstruction after major tumour surgery.

PMID- 1632246
TI  - Influence of allergy, asthma and hypertension on nasal polyposis.
AB  - Arterial hypertension was found in 78 of 224 consecutive patients operated for
      nasal polyposis. An exacerbated degree of hypertension was significant in groups
      aged above 50 years. In total, 46% of patients whose nasal polyposis lasted for
      more than 10 years suffered from hypertension. Fifty of 78 patients developed
      hypertension after nasal polyposis had been established, and the mean duration
      time from polyposis to hypertension was 11.1 years. Eosinophilic infiltration was
      found in 88% of nasal polyps. Of the patients with eosinophilic polyps, 34.8%
      were classified as atopic. The most common allergens were house dust, tree- and
      grass pollen, mite and acetyl salicylate. Hyposensitization against known
      allergens reduced necessary polypectomy frequency in 60% of patients. The third
      most common concurrent disease was asthma (26.1%). Ten cases of the triad:
      asthma, intolerance to acetyl salicyclic acid and nasal polyps were found,
      comprising 4.4% of all patients. Fifty percent of these patients also had
      hypertension. This investigation strengthens earlier studies that hypertension is
      not an aetiologica factor for nasal polyposis but can develop secondary to nasal
      obstruction.

PMID- 1632247
TI  - Diagnosis and treatment of fractures of the orbital floor. A ten-year
      retrospective study.
AB  - In a retrospective study of 42 patients treated for fractures of the orbital
      floor at Sodersjukhuset, different diagnostic methods and the final outcome of
      the treatment were evaluated. Motility evaluation and exphtalmometry were
      performed on all patients by the same ophtalmologist. Twenty patients underwent
      computed tomography with coronal scans. The prolapse and volume of the herniated
      soft tissue from the orbit and the degree of entrapment of the inferior rectus
      muscle were measured from the CT scans. All patients who developed enophtalmos
      had according to the CT scans herniated volumes exceeding 0.7 ml. Only 2 out of 9
      patients, who did not develop enophtalmos had herniated volumes exceeding 0.7 ml.
      This difference was statistically significant. Of these patients 36 were
      operated, while 6 patients were only followed. The mean follow-up time was 6
      months. Out of 39 patients followed for more than 3 months, 28 were symptom free.
      Six patients were moderately molested by diplopia or enophtalmos. Five patients
      suffered from a persistent clinically significant diplopia or enophtalmos.

PMID- 1632248
TI  - Cellular regeneration and recovery of the maxillary sinus mucosa. An experimental
      study in rabbits.
AB  - Unilateral maxillary sinusitis was induced in 30 New Zealand White rabbits with
      Streptococcus pneumoniae or Bacteroides fragilis. In another group of 15 rabbits
      without infection, the sinus mucosa was surgically removed in defined areas. In
      both series, the sinuses were serially sectioned for histological analysis of the
      cellular regenerative capacity. In maxillary sinusitis induced by Bacteroides
      fragilis, an inflammatory and also reparative process involving all mucosal
      layers including the underlying periosteum was seen. The more superficial trauma
      as found in pneumococcal sinusitis eventually led to restitution ad integrum.
      Following surgical removal, the denuded sinus-lining was reepithelized by a
      flattened ciliated epithelium on a lamina propria displaying fibrosis and lacking
      serous glands. The restoration of the rabbit maxillary sinus mucosa after
      surgical trauma thus leads to structural abnormalities of the epithelium as well
      as the lamina propria, and these changes are likely to interfere with the normal
      function of the sinus mucosa.

PMID- 1632249
TI  - The bone-anchored hearing aid. Osseointegration and audiological effect.
AB  - The results of treatment of the first 12 Danish patients with the Branemark
      titanium implant system and the bone-anchored hearing aid (BAHA) are reported.
      All implants were osseointegrated, judged by 99mTC-scintigraphy, X-ray
      examination and clinical examination. Skin reactions were few, transient and
      short lasting. The patients experienced the BAHA to be superior to both
      conventional BC hearing aids and AC hearing aids in practically all respects.
      Speech discrimination scores in quiet and in noise were similar for the 3 types
      of hearing aids.

PMID- 1632250
TI  - Glossopexia--evaluation of a new surgical method for treating obstructive sleep
      apnea syndrome.
AB  - Uvulopalatopharyngoglossoplasty, UPPGP, is a modification of the
      uvulopalatopharyngoplasty, UPPP, technique, originally used for surgical
      treatment of the obstructive sleep apnea syndrome. The first method seems to be
      the more successful. However, polysomnography performed after UPPGP showed that
      about 35% of the patients still had obstructive apnea periods during sleep. Eight
      of these patients were reoperated with a new technique which is a combination of
      partial tongue resection and anterior suspension of the tongue (glossopexia).
      After glossopexia all the patients were subjectively relieved of their symptoms.
      However, polysomnography carried out postoperatively demonstrated that only 2
      patients were objectively cured. The authors want to stress the necessity of
      meticulous polysomnographical registration pre- and postoperatively. Subjective
      and objective parameters recorded before and after surgery are discussed.

PMID- 1632251
TI  - Palatopharyngoglossoplasty in the treatment of patients with obstructive sleep
      apnea syndrome.
AB  - A new technique (palatopharyngoglossoplasty (PPGP)) has been developed for
      surgical treatment of patients with the obstructive sleep apnea syndrome (OSAS).
      In 20 operated patients 18 reported immediate marked improvement of daytime
      sleepiness, alertness and vigilance during the day, and of working capacity.
      However, polysomnography carried out pre- and postoperatively showed that only 10
      patients were "cured", defined as 50% or more reduction in apnea/hypopnea index
      (AHI). Cephalometric analysis pre- and postoperatively indicated that
      nonresponders had a long and narrow posterior airway space, and we suggest that
      during sleep this part of the upper airway collapses before as well as after the
      operation. The discrepancy between the subjective improvement observed after PPGP
      and the postoperative reduction in AHI may be due to reduced/eliminated snoring
      and/or improvement in sleep quality after the operation.

PMID- 1632253
TI  - A new Finnish computerized rhinomanometer.
AB  - We introduce a new sophisticated Finnish rhinomanometer in which the need for
      routine work has been minimized. Technical information about the instrument is
      given, recording procedure is described and a normal material and reproducibility
      test is analyzed.

PMID- 1632252
TI  - Acute laryngitis in adults: results of erythromycin treatment.
AB  - Previous studies of acute laryngitis in adults have shown high nasopharyngeal
      isolation rates of B. catarrhalis and H. influenzae. Phenoxymethylpenicillin had
      no effect on the clinical course. In the present study, 106 patients with acute
      laryngitis were treated with erythromycin 0.5 g x 2 V or placebo. During the
      first week the isolation rate of B. catarrhalis was reduced from 60 to 10% in the
      erythromycin group compared to 34 to 27% in the placebo group (p less than 0.01).
      The elimination of H. influenzae, isolated in 19% at the acute visit, did not
      differ between the two groups. As compared to controls, erythromycin treated
      patients reported significantly lower scores of subjective voice disturbance
      after 1 week and cough after 2 weeks. Laryngological examination and voice
      evaluation failed to reveal any differences between the groups.

PMID- 1632254
TI  - Nasal packing and nocturnal oxygen desaturation.
AB  - Nasal obstruction influences respiration during sleep, and nasal packing may be
      the cause of obstructive sleep apnoea. In order to investigate this phenomenon,
      perioperative nocturnal oxygen saturation was monitored for 3 nights with
      continuous, non-invasive pulse oximetry in 12 patients who had total nasal packs
      after septoplasty. Significant extension of nocturnal accumulated time of oxygen
      saturation less than 90% was demonstrated both during the first and second
      postoperative nights. The clinical significance of these results is as yet
      unknown, but the use of partial nasal packing in association with septoplasty is
      advocated and further investigations on nocturnal oxygen saturation are called
      for.

PMID- 1632255
TI  - EMLA in local anaesthesia of the tympanic membrane.
AB  - An ideal agent for local anaesthesia of the tympanic membrane has been missing so
      far. Recently, however, a eutectic mixture of lignocaine and prilocaine (EMLA,
      Astra, Sodertalje, Sweden) has proved promising. We compared the anaesthetizing
      efficacy of EMLA, Bonain's solution (cocain, menthol, phenol ana partes) and
      Xylocain-spray (Astra, Sodertalje, Sweden) in 42 voluntary subjects. EMLA was
      applied on one tympanic membrane and either one of the other two agents in the
      other ear of each subject. Small cotton pledgets were used for application.
      Sensitivity of the ear drum was tested under otomicroscope with a cotton tipped
      wire before and after each local anaesthesia. Full anaesthesia could be reached
      with EMLA very significantly (p less than 0.001) more often than with Xylocain
      and almost significantly (p = 0.057) more often than with Bonain's solution. Most
      of the test subjects preferred EMLA to Bonain's solution of Xylocain. Undesired
      side effects, including two tympanic membrane perforations, appeared in most of
      the ears anaesthetized with Bonain's solution. In the clinical part of the study,
      EMLA topical anaesthesia was used in 127 minor policlinical tympanic membrane
      procedures like myringotomy and tympanostomy tube assembling. Eighty-three of the
      procedures were assessed as painless, 36 unpleasant and 8 painful. A 30-min
      action time of EMLA was considered sufficient in most cases. No EMLA related side
      effects appeared. In conclusion, Bonain's solution is recommended to be replaced
      by EMLA or a corresponding agent for local anaesthesia of the tympanic membrane.

PMID- 1632256
TI  - Penicillin tolerance in group A streptococci and treatment failure in
      streptococcal tonsillitis.
AB  - Penicillin tolerance in Streptococcus pyogenes has been suggested as a possible
      cause of therapeutic failure in streptococcal phryngitis treated with penicillin.
      In 144 patients with acute group A streptococcal tonsillitis treated with
      phenoxymethyl penicillin 12.5 mg per kg body weight b.i.d. for 10 days the same T
      type was recovered after treatment in 21%. The recovery rate was higher for non
      tolerant strains, 23%, than for tolerant strains, 10% (p greater than 0.05). Of
      patients with a non-tolerant strain 17% had both clinical and bacterial treatment
      failure in comparison with 5% infected with a tolerant strain (p greater than
      0.05). Reinfection with a new serotype occurred in altogether 3%. The present
      data did not indicate that penicillin tolerance in group A streptococci is of
      significance in acute tonsillitis treated with phenoxymethylpenicillin for 10
      days.

PMID- 1632257
TI  - Acute respiratory tract infections in early childhood.

PMID- 1632258
TI  - Prognostic factors in oral cavity carcinomas.
AB  - This retrospective study of 176 patients with oral cavity carcinoma showed that
      nearly 60% of the patients presented with an advanced stage of disease. The
      duration of symptoms was shorter in patients with a large tumour than with a
      small (p less than 0.001) and in patients with metastases than in those without
      (p less than 0.01). Lymph node metastases were more common in large tumours (p
      less than 0.01), in tumours with high malignancy grading (p less than 0.05) and
      in non-diploid tumours (p less than 0.001). The presence of lymph node metastases
      (p less than 0.001), tumour size (p less than 0.01) and tumour DNA ploidy (p less
      than 0.005) were the only parameters that significantly influenced survival (Cox
      regression analysis).

PMID- 1632259
TI  - Spontaneous otoacoustic emissions. Short-time stability.
AB  - We have examined 307 spontaneous otoacoustic emissions (SOAEs) from 59 ears. The
      short-time amplitude stability was very good, especially in the high-frequency
      region. A statistically significant trend for emissions to influence other
      emissions could not be demonstrated.

PMID- 1632260
TI  - Ostial function in allergic rhinitis.
AB  - In order to evaluate the maxillary ostial function a double-blind, group
      comparative study with intranasal budesonide and placebo was carried out in 20
      adult patients suffering from seasonal rhinitis. The trial started with an entry
      visit 3 weeks before pollen peak with clinical assessments (physical examination
      and ostial diameter measurements) followed by a 3-week treatment period.
      Treatment was either intranasal budesonide 200 micrograms b.i.d. or matching
      placebo b.i.d. The trail ended at pollen peak with clinical assessment. The
      results showed normal ostial diameters in the patients suffering from seasonal
      rhinitis. There were no statistical significant differences in ostial diameter
      change between the treatment groups except between budesonide and placebo in
      sitting position at measurement time 0 min. It seems that pollen does not reach
      the ostial region.

PMID- 1632261
TI  - Uvulopalatopharyngoglossoplasty (UPPGP) in the treatment of the obstructive sleep
      apnea syndrome.
AB  - Out-patient polysomnography was conducted prior to surgery in 26 male,
      obstructive sleep apnea patients. Resection of lateral aspects of the tongue base
      and conservation of the proximal part of the uvula muscle were carried out in
      addition to conventional palatopharyngoplasty. At a minimum of 6 months after
      surgery, the patients were given a questionnaire for assessment of treatment. At
      the same time, polysomnography was repeated for objective evaluation of the
      results of surgery. More than 90% of the patients were satisfied with the outcome
      of treatment. The objective results by means of apnea index and oxygen
      desaturation index matched the patients' personal experiences, which is not usual
      in this kind of treatment. Sixty-seven percent of the obstructive sleep apnea
      patients achieved more than a 50% reduction in apnea index and oxygen
      desaturation index. No more side effects than for similar surgical intervention
      (PPP) were encountered. Safety and efficiency lead us to recommend this procedure
      as standard whenever oropharyngeal surgery is indicated.

PMID- 1632262
TI  - Experience with the Wurzburg titanium miniplate system in maxillo-facial surgery.
AB  - Since late summer 1989 we have used the Wurzburg titanium miniplate system in the
      treatment of severe midface fractures and as implants in reconstruction of the
      mandible after cancer surgery of the mouth. The aim of this study was to test the
      applicability of the system.

PMID- 1632263
TI  - [Healing of tympanic membrane perforation-a complex process influenced by a
      variety of factors].
AB  - It is known that the healing of a perforated tympanic membrane can be influenced
      by mechanical procedures as well as drugs. Animal experiments have recently shown
      that local treatment with steroids delays the healing of a tympanic membrane
      perforation, whereas hyaluronan (hyaluronic acid) improves the healing rate as
      well as the quality of the scar. Hyaluronan, a non-sulphated glycosaminoglycan,
      belongs to the extracellular matrix substances. In the present study another
      glycosaminoglycan--heparin--was applied on experimental tympanic membrane
      perforations. This report confirmed that also this extracellular matrix substance
      improves the healing rate of a tympanic membrane perforation and the scar
      quality.

PMID- 1632264
TI  - Magnetic facial nerve stimulation in normal subjects. Three groups of responses.
AB  - Magnetic stimulation provides a method to stimulate the facial nerve
      transcranially. With this method, the stimulation can be directed to the
      intracranial part of the facial nerve, whereas conventional electric stimuli are
      delivered to a more peripheral part of the nerve. In 40 healthy subjects,
      ipsilateral responses with latencies of 4.5 +/- 0.4 ms were recorded on the
      nasolabial folds. The latencies were 1.1 ms longer than those elicited at the
      stylomastoid foramen by electric stimulation. Furthermore, a response with a mean
      latency of 12 ms (range 10-16 ms) appeared in 6 out of 10 healthy subjects and a
      polyphasic response with a mean latency of 32 ms in 9 out of 10 of these
      subjects. Transcranial magnetic stimulation seems to allow the examination of
      motor conduction through the proximal part of the facial nerve. In addition, the
      method may give further information concerning the facial activation mechanisms
      possibly by other central pathways.

PMID- 1632265
TI  - [An anastomotic loop between the recurrent nerves--an anatomical description].
AB  - The authors present the results of twelve dissections of the neck carried out
      during autopsy on non-conserved human corpses. The investigation, centered on the
      anatomic study of the laryngeal nerve within the framework of the European
      Research Group on the Larynx (G.R.E.L.), revealed the presence of a connecting
      nervous anatomic branch between the recurrent laryngeal nerves which was observed
      in 10 of the 12 corpses examined. Despite a revision of national as well as
      international literature concerning ramifications and anastomosis of the
      recurrent laryngeal nerves, the authors were unable to find description of this
      anastomotic ansa. The anatomic reliefs related to this branch are extremely
      interesting, although research is still in its initial phase. This ramification
      is situated between the trachea and the oesophagus and the location of the
      branching-off point from the recurrent nerves as well as the crossing point of
      the nervous bundle with the oesophagus-tracheal axis vary greatly. The detachment
      of the ansa from the recurrent trunk is located at the intrathoracic level, while
      the crossing with the posterior paries of the trachea is located in proximity of
      the cervicomediastinal junction. The constant presence of this nervous entity
      encourages us to continue and extend our research, most of all towards
      microscopic and ultrastructural anatomy as well as towards histomorphometric
      studies which can give us precious indications. Moreover, electrophysiological
      studies are in program so as to enable us to gather the largest amount of useful
      data regarding any possible use of this anatomic entity.

PMID- 1632266
TI  - [The quantitative study of nucleolar organizers (AgNOR) in the diagnosis of
      laryngeal dysplasias and in the assessment of the prognosis in invasive
      carcinoma].
AB  - Nucleolar organiser regions (AgNOR) are chromosomal segments in which ribosomal
      RNA is codified. These structures can be identified in the nuclei of cells in
      routine histological sections using a silver staining technique which reveals the
      proteins associated with transcription RNA. The number of AgNOR identified
      depends on the state of cell proliferation. The purpose of the present study was
      to evaluate the distribution of AgNOR in normal laryngeal mucosa, dysplastic and
      neoplastic, in order to establish a possible correlation with the degree of
      dysplasia and/or the entity of the malignant lesions. Ten slides each of
      specimens of laryngeal carcinoma, serious dysplasia and middle dysplasia were
      prepared with the silver staining technique. A count of the NOR in the basal,
      parabasal, intermediate and superficial levels was made. Findings show an
      increase in the average value of NOR proceeding from normal tissue to carcinoma
      in situ and malignant carcinomas. The number of AgNOR was lower always than that
      observed in the parabasal level. In the intermediate cell section the number of
      AgNOR was inferior to that in the parabasal level in normal tissue as well as in
      middle dysplasia, while it remained high in serious dysplasia and in carcinomas,
      thus indicating a great deal of biological activity in these cases. This method
      can be employed in order to better individualize those dysplastic lesions which,
      because of their tendency towards malignancy, must be kept under observation by
      means of an extremely accurate follow-up.

PMID- 1632267
TI  - [Magnetic fields evoked by auditory stimuli: a normative study].
AB  - After outlining the fundamentals of biomagnetism and their possible clinical
      applications, the authors report the results of a normative study on auditory
      magnetic fields performed on 18 normally hearing subjects between the ages of 25
      and 30. Having presented a thorough review of the literature, they then describe
      the recording technique employed, the dcSQUID biomagnetic system for signal
      detection, the shielded room, the characteristics of the stimulus. The auditory
      magnetic response is characterized by three main waves (P4Om, N100m, P200m) whose
      latency and amplitude values were calculated. Moreover, in order to localize
      dipolar activity, certain parameters, such as P and T, were taken into
      consideration. Localizations were made using a spherical volume conductor or with
      MRI, which was in any case employed in all the subjects. The waves, especially
      the N100m recorded contralaterally to the stimulus, showed a reduced latency and
      an increased amplitude when compared to those recorded ipsilaterally. Moreover, a
      systematic posterior shift of the N100m source into the left hemisphere with
      respect to the right one was detected. In conclusion, the authors emphasize the
      need to study electric as well as magnetic responses in order to better
      understand auditory cortical functions.

PMID- 1632268
TI  - [Bidirectional horizontal and tridimensional apogeotropic nystagmus: 2
      semeiological realities].
AB  - The authors take into account two different types of stationary, persistent and
      direction-changing nystagmus (ny): 1) the horizontal bidirectional ny (nyOB),
      apogeotropic (nyOBA) and geotropic (nyOBG); 2) the tridirectional apogeotropic ny
      (nyAT). The nyOBA was identified in experimental studies in 1973 but no other
      studies on the subject have been published since then. In existing literature the
      nyOBG has been reported in only one paper, whereas the nyAT has not yet been
      studied at all. The nyOBA is the combination of a 2nd degree left ny with the
      head turned right and a 2nd degree right ny with the head turned left. The nyOBG
      is the combination of a 2nd degree right ny with the head turned right and a 2nd
      degree left ny with the head turned left. The nyAT is a 2nd degree apogeotropic
      ny noticeable with the head turned left, right and in the position of Rose (head
      hanging down). From among a total of 5,960 consecutive vestibular examinations
      performed from 1986 to 1990, the authors chose those presenting nyOBA, nyOBG and
      nyAT and discuss them in the light of other vestibular findings and clinical
      diagnosis. A routine vestibular examination aims at verifying an eventual,
      spontaneous/evoked ny with the head turned right and left, in the position of
      Rose and in the two rapid Hallpike positionings. Frenzel glasses are used for
      detecting the gaze and rebound ny and these, in turn, are checked for visual
      fixation. During the caloric stimulation, according to the Fitzgerald-Hallpike
      method, the ny visual suppression test is performed at the culmination period.
      When electronystagmography is performed, visual oculomotor reflexes are often
      tested as well. The nyOB and/or nyAT were observed in 3.9% of the patients (234
      subjects). The nyOB was present in 177 patients as follows: apogeotropic ny in
      128 and geotropic in 49. This was the only vestibular finding in 46.9% of the
      nyOB cases (83 out of 177 patients). The nyAT was observed in 57 patients and in
      17.6% of them was the only pathological finding of the otoneurological
      examination. When nyOB or nyAT were observed, clinical diagnosis evidenced their
      central origin in 138 of the 234 patients, most frequently present in cranial
      trauma, vertebral-basilar vasculopathy and multiple sclerosis. In a limited
      number of cases some sign of peripheral vestibulopathy were also
      observed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1632269
TI  - [An evaluation and comparison of the methodology of 2 otophoniatric screenings
      performed in the 1989-1990 biennium on a sample of 4-year-old children attending
      nursery schools].
AB  - The Pediatric Otophoniatric Department of U.S.L.75II, the Multicenter of
      Preventive Medicine in Via Cherasco, 5, Milan, carried out two otophoniatric
      screenings on about 70 four-year-old nursery school children. While this
      screening was considered experimental in four schools, the ultimate goal is to
      extend it to all the nursery schools in the same area. The primary aim of the
      screening was to individualize several pathologies of the upper respiratory tract
      in this age range. The second aim was to identify language pathologies in
      children under the age of six in order to treat them as soon as possible with
      adequate and preventive therapy and appropriate language re-education before
      their entrance into primary school. The materials and methods employed were as
      follows: O.R.L. examination: otoscopy, rhinoscopy, oropharyngoscopy, indirect
      laryngoscopy (after individualization of dysphonia); Audiometric test: peep show
      in free field with a 250 Hz-4000 Hz frequency range at 30 dB; Language evaluation
      through examination and interpretation of questionnaires formulated in order to
      evaluate language development filled in by the children's teachers. Two
      modifications in the method used in the 1989 study were made in the 1990
      screening: The preventive use of an auditory duct cleaner and the distribution of
      the above-mentioned questionnaires at the very beginning of the study. These two
      changes improved screening planning as well as development. The results of the
      two screenings were compared and an increase in the percentage of children
      examined and subjected to the audiometric test was noted. In fact, in the 1989
      study, only 77% of the children underwent the audiometric test (23% had ear wax),
      while in the 1990 study 100% underwent the test (ear cleaner had been used). With
      regard to the questionnaires, the data were gathered four months after screening
      in the 1989 study, whereas in the 1990 study this phase was carried out on the
      same day of the screening. The new methodology saved time in the screening.

PMID- 1632270
TI  - [The senile voice].
AB  - Involutive processes which characterize aging induce substantial morphological
      and functional alteration in the pneumo-phono-articulatory system and thus bring
      about numerous effects on vocal quality. Fundamental frequency (Fo) variation,
      whose values increase in males and decrease in females, are found in voice
      patterns. Moreover, in literature many authors have described vocal substain
      intensity and timbre deficit in the elderly. Vocal emission of elderly people can
      become so peculiar that it may be possible to identify approximately the age and
      the sex of the speaker by merely hearing the voice. The aim of this work was to
      identify specific parameters of the senile voice using spectroacoustic digital
      analysis. The following points were considered in this study: the psychoacoustic
      perceptive evaluation of vocal samples in subjects of different ages in order to
      identify the sex and age of the speaker; the spectroacoustic digital analysis of
      the same vocal samples; the morphofunctional observation of the phono
      articulatory apparatus. Our results confirmed the presence of peculiar
      electroacoustic characteristics in the senile voice (mean pitch value variation
      in males and in females, vocal substain deficit, decrease in vocal intensity,
      senile tremolo, cycle-to-cycle alteration of Fo and mean amplitude) due to
      morphofunctional changes of the pneumo-phono-articulatory system. In all the
      subjects we observed anatomo-functional changes at the glottic level. The
      presence of specific vocal patterns and the quality of speech play an important
      role in the processes of senile voice identification.

PMID- 1632271
TI  - [Gardner's syndrome: a case report].
AB  - The Gardner syndrome (GS) is a dysplasia in which neoformations in the
      intestines, soft tissue and osseous tissue are associated. Since extra-intestinal
      manifestations, in particularly osteomas, appear promptly even in infants, and
      above all in the light of the possibility of malignant degeneration, the presence
      of mandibular osteomas indicates the necessity of carrying out investigations in
      order to ascertain the eventual existence of an intestinal polyposis typical of
      GS. This study describes a typical case of GS diagnosed merely upon suspicion of
      the existence of the syndrome in a patient who came to our Department with a
      mandibular osteoma. The study underlines the importance not only of carrying out
      investigations in order to ascertain the presence of GS (rectocolonoscopy), but
      also that of studying the relatives of the patient in light of the fact that this
      particular dysplasia is transmitted genetically.

PMID- 1632272
TI  - [Rehabilitation of oro-pharyngeal dysphagia of neurogenic etiology using
      radiological examination: preliminary results].
AB  - Dysphagia is more frequently observed in patients with neurologic diseases
      (stroke, bulbar or pseudo-bulbar syndrome, amyotrophic lateral sclerosis, cranial
      trauma). Furthermore, the presence of this pathology is obviously more frequently
      noted in the light of the increase in the length of the human life span. It has
      become evident that alternative feeding procedures such as the nasogastric tube
      or gastrostomy may bring about complications and deprive patients of the oral
      phase of deglutition which plays a leading role in stimulating digestive
      functions. The Authors report a systematic research on the rehabilitation aspects
      of neurogenous dysphagia. All the patients studied underwent a neurological
      examination and oropharyngeal functional evaluation using echo-videorecording of
      the oral phase of deglutition and fluoro-videorecording of the pharyngeal phase.
      The data obtained allowed for the selection of five patients considered suitable
      for the rehabilitation program. One of them had a multi-infarct encephalopathy,
      two a spastic hemiplegia f.b.c., a fourth a cerebellar syndrome and the last a
      sequela of meningioma removal of the ponto-cerebellar angle with peripheral
      paralysis of the right VII, IX, X, XI cranial nerves. This last patient also
      underwent a crico-pharyngeal myotomy. Therapy consisted in making the patient
      sensitive to swallowing movements and in training them to assume a compensatory
      posture as well as functional rehabilitation of the organs involved in
      deglutition. The first datum emerging from the study is the lack of etiological
      homogeneity found in the cases treated with evident variability in different
      deglutition organ impairment, even though there was the common denominator of the
      dysphagia symptom. With regard to the results obtained, there was a complete
      resolution in one patient, while in the other four there was such an improvement
      as to allow the patients a safe autonomous oral assumption of food. The positive
      results obtained are not only linked to the recovery of damaged organs, but also
      to the development of compensatory strategies such as the choice of appropriate
      food consistency and the assumption of postures which protect the respiratory
      tract from aspiration and favor crico-pharyngeal relaxation.

PMID- 1632273
TI  - Age-related changes in NMDA-induced [3H]acetylcholine release from brain slices
      of senescence-accelerated mouse.
AB  - From the brain slices of normal mice (ddY strain, subcloned from dd strain in
      National Institute of Health in Japan), N-methyl-D-aspartic acid (NMDA) at 0.01-1
      mM evoked [3H]acetylcholine (ACh) release in a concentration dependent manner.
      [3H]ACh release evoked by 1 mM NMDA was significantly inhibited by 2-amino-5
      phosphonovaleric acid (APV), phencyclidine (PCP) and 5-methyl-10,11-dihydroxy-5H
      dibenzo[a,d]cyclohepten-5,10-imine maleate (MK-801). The effects of NMDA were not
      seen in the Ca2+ free medium and were inhibited by physiological concentration
      (0.83 mM) of Mg2+. NMDA seems to cause ACh release from nerve terminals through
      the receptor-ion channel mediated mechanism in the mouse brain. Based upon these
      results, we determined the activity of a high K(+)- or NMDA-evoked [3H]ACh
      release using prone/8 strain of senescence-accelerated mouse (SAM-P/8) (a murine
      model of accelerated aging and memory dysfunction) and SAM-resistance/1 strain
      (SAM-R/1) (normal aging mice as the control) and these release activities were
      compared between both strains and during aging. [3H]ACh release evoked by 30 mM
      KCl was significantly lower than that of age-matched SAM-R/1 at 9 and 12 months.
      NMDA evoked the [3H]ACh release at 2, 6, 10 and 14 months in R/1 mice. In SAM-P/8
      mice the activity of NMDA-evoked release was seen at 2 months, but markedly
      decreased afterwards. Nonsignificant difference was observed on the uptake of
      [3H]choline and on the spontaneous release of [3H]ACh between SAM-P/8 and SAM-R/1
      strains, and during aging.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632274
TI  - Quantitative histochemical changes in enzymes involved in energy metabolism in
      the rat brain during postnatal development. II. Glucose-6-phosphate dehydrogenase
      and beta-hydroxybutyrate dehydrogenase.
AB  - The postnatal maturation of glucose-6-phosphate and beta-hydroxybutyrate
      dehydrogenase activity was assessed by histochemistry in rats at eight postnatal
      stages, P0, P5, P10, P14, P17, P21, P35 and the adult stage. Enzyme activities
      were revealed on cryostat brain sections with nitroblue tetrazolium. Both enzyme
      activities were low and homogeneous at birth, and increased to reach a peak in
      all areas studied, at P17 for beta-hydroxybutyrate dehydrogenase and at P21 for
      glucose-6-phosphate dehydrogenase. Then, glucose-6-phosphate dehydrogenase
      activity decreased regularly by 20-49% from P21 to adult stage, except in
      cerebellar white matter where activity did not change after P21. beta
      hydroxybutyrate dehydrogenase activity decreased regularly from P17 to adult
      stage in globus pallidus, hippocampus, thalamus, brainstem, genu of corpus
      callosum and cerebellar white matter. It sensorimotor cortex, medial geniculate
      body, caudate nucleus, hypothalamus and inferior colliculus, beta-hydroxybutyrate
      dehydrogenase activity stayed stable between P17 and P35 and decreased thereafter
      to adult levels. Finally, in parietal, auditory and cerebellar cortices, beta
      hydroxybutyrate dehydrogenase activity either stayed stable or slightly increased
      after P17. The present study shows that there is a quite good correlation between
      postnatal changes in cerebral glucose-6-phosphate and beta-hydroxybutyrate
      dehydrogenase activities and the importance of pentose phosphate pathway and
      ketone body utilization in the developing brain. Our results also reflect the
      regional heterogeneity of beta-hydroxybutyrate utilization in the adult rat
      brain, translating into a remaining high activity of beta-hydroxybutyrate
      dehydrogenase in cerebral cortex.

PMID- 1632275
TI  - Development of the cholinergic fibres innervating the cerebral cortex of the rat.
AB  - The ontogeny of innervation of the cholinergic fibres from the basal forebrain
      into the cingulate, frontal, parietal and piriform cortices of the rat has been
      examined using a modified histochemical method of acetylcholinesterase (AChE).
      The method produced crisp fibre staining with enhanced visibility and a clear
      back-ground, and a pattern of the distribution of these fibres was comparable to
      that achieved by choline acetyltransferase (ChAT) immunocytochemistry. In the
      rat, the AChE-stained fibres developed progressively from the deep cortical white
      matter towards the cortex itself. In general, a few AChE-positive fibres were
      seen in the subcortical white matter and the cingulum bundle, entering into the
      cerebral cortex by about 5 postnatal days. The number of these AChE-positive
      processes increased dramatically during the following two weeks. Thereafter, the
      general appearance of the overall pattern of distribution of the AChE fibres
      changed little, but the staining density became gradually more intense and by
      about 28 days after birth it was virtually indistinguishable from that in the
      adult. The onset and the development of the AChE-positive fibre network varied
      considerably between individual cortical regions, and indicated, in general, an
      anterior to posterior gradient. Within the dispersed AChE fibre network in the
      cerebral cortex, three bands of relatively enriched cholinergic processes, namely
      the deep cortical, mid-cortical and superficial layers, developed in an 'inside
      out' fashion. The exact position of some of these AChE-rich bands varied from one
      cortical region to another and during development. A striking correlation during
      ontogeny was observed in the cerebral cortex between the changing patterns of
      AChE fibre network and the activity of ChAT, the enzyme synthesizing
      acetylcholine. The present findings can also provide an important anatomical
      baseline for future studies related to the factors controlling the expression of
      ChAT activity and the development of cholinergic neurotransmitter system in the
      rat.

PMID- 1632276
TI  - Screening of adrenal medullary neuropeptides for putative neurotrophic effects.
AB  - Chromaffin granules, the secretory organelles of the neuron-like adrenal
      medullary chromaffin cells, have previously been shown to store and liberate
      neurotrophic activities that support in vitro survival of several neuron
      populations including those innervating the adrenal medulla. Molecules resembling
      fibroblast growth factor and ciliary neurotrophic factor have been identified
      among these activities. Since chromaffin granules store a variety of
      neuropeptides and many neuropeptides can have pleiotropic effects on neuronal
      growth and maintenance we have tested 24 different neuropeptides for their
      capacities to promote survival of embryonic chick ciliary, dorsal root and
      sympathetic ganglionic neurons. Peptides tested included several derivatives of
      proenkephalin (Leu- and met-enkephalin, fragments BAM 22, B, F and E),
      somatostatin, substance P, neuropeptide Y, neurotensin, VIP, bombesin, secretin,
      pancreastatin, dynorphin B, dynorphin 1-13, beta-endorphin, alpha-, beta-, and
      gamma-MSH. Control cultures received saturating concentrations of ciliary
      neurotrophic or nerve growth factor (CNTF; NGF), or no trophic supplements. At 1
      x 10(-5) M leu- and met-enkephalin as well as somatostatin supported sympathetic
      neurons to the same extent as NGF. At the same concentrations, leu-enkephalin,
      the proenkephalin fragments BAM 22 and E, and somatostatin maintained about half
      of the dorsal root ganglionic neurons supported by NGF, but were not effective on
      ciliary neurons. VIP promoted the survival of approximately 50% of the ciliary
      and embryonic day 10 dorsal root ganglionic neurons as compared to saturating
      amounts of CNTF, but required the presence of non-neuronal cells in the cultures
      to be effective. Neurotensin (1 x 10(-5) M had a small effect on ciliary
      neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632277
TI  - Cellular localization of nerve growth factor-like immunoreactivity in hippocampus
      and septum of adult rat brain.
AB  - The cellular localization of the nerve growth factor-like immunoreactivity (NGF
      LIR) has been studied in the intact adult rat brain at the level of the
      hippocampus and the septum. Immunolabelling for NGF combined with counterstaining
      with cresyl violet and double immunostaining technique, which allowed
      simultaneous localization of NGF-LIR and that of astroglial marker -GFAP, were
      used. The data indicate neuronal localization of NGF-like immunoreactivity and a
      lack of colocalization of NGF-LIR with the immunoreactivity of GFAP in the
      hippocampus. These data are consistent with in situ hybridization results for NGF
      and immunocytochemical results for pro-NGF localization obtained by others. At
      the septal level, apart from neuronal localization of NGF-LIR, single NGF-like
      immunoreactive astrocytes have been observed. This suggests that, although to a
      very small extent, in vivo intact brain astrocytes may, just as astrocytes
      growing in vitro, synthesize NGF-like molecules. This finding may be of
      importance in better understanding the trophic support for NGF responsive
      cholinergic neurones in the brain.

PMID- 1632278
TI  - Motor units of medial gastrocnemius muscle in the rat during the fatigue test. I.
      Time course of unfused tetanus.
AB  - Time course of tetanus recorded during 40 Hz stimulation was examined on 70 motor
      units (MUs) of medial gastrocnemius muscle in 41 rats. Three types of MUs were
      distinguished: slow(S), fast resistant to fatigue (FR) and fast fatigable (FF).
      In fast MUs of either type, the stimulation induced unfused tetanus with
      noticeable sag. It was found that in cases of tetani in FF MUs, the sag developed
      earlier than in FR MUs. Timing of tetanic peak before the sag appeared correlated
      with contraction time. Some fast MUs demonstrated a distinct time course of
      tetanus: the weakly accentuated sag appeared early and it was followed by a
      relatively significant rise in tetanic tension. However, in slow MUs, 40 Hz
      stimulation induced fused or fused-like tetani. In these MUs the sag was never
      observed. The obtained results indicate the relation between the sag time course
      in tetanus and the extent of tetanus fusing.

PMID- 1632279
TI  - Instability of hemispheric asymmetry in dyslexic children.
AB  - The study tested the hypothesis of abnormal brain asymmetry in dyslexic children.
      Two dyslexic groups classified as "phonetic disorder" and "language disorder" and
      a control group participated in two experiments. In both experiments was employed
      a dichotic listening procedure consisting in recalling pairs of words presented
      simultaneously to two ears. In Experiment I the children were to recognize four
      words presented at a level of loudness typical for natural speech. In Experiment
      II only two words were used in each trial but they were presented at a low
      intensity level. The recognition scores for stimuli presented to the left and
      right ears were compared. In Experiment I all groups of children showed a typical
      right ear/left hemisphere superiority, i.e. their recognition scores were higher
      for the right than for the left ear. Dyslexics, however, performed significantly
      less well. In Experiment II the control children and those from "phonetic
      disorder" group again performed better when words were presented to their right
      ears. Unlike those two groups, the children from "language disorder group" showed
      the right hemisphere superiority, i.e. they performed better in the left ear
      presentation condition. The results do not support the hypothesis that dyslexic
      children have abnormal lateralization of verbal functions. They suggest that the
      pattern of hemispheric asymmetry in dyslexics is less stable and depends both on
      the kind of dyslexia and on task variation.

PMID- 1632280
TI  - The effect of some exogenous factors on the formation of intranuclear
      membranaceus inclusions in the nerve cells.
AB  - The intranuclear membranaceus inclusions (IMI) appear as encapsulated irregular
      vacuoles surrounded by a single, rarely double, membrane. The vacuoles include
      floccular, fine granular content or they are translucent. They were found in
      neurones of particularly old or very young laboratory animals. Our studies
      concerning various types of intoxications and ischemia allowed to find relatively
      large number of such inclusions in laboratory animals. We observed them in four
      experimental models: (1) cyclo-phosphamide (an alkylating drug) and (2)
      dichlorvos (phosphoroorganic pesticide) given orally to rabbits, (3) complete
      ischemia also in rabbits and (4) vincristine (an antimitotic drug) given
      parenteraly to rats. The IMI were found much more frequently in experimental
      animals than in controls. We can conclude that intranuclear membranaceus
      inclusions do not appear to be pathognomonic for any particular etiologic factor,
      but this factor may influence and distort the homeostasis within nucleus.

PMID- 1632281
TI  - Biting behaviour as a tactic of escape in two bumblebee species with different
      nesting habits, Bombus terrestris L. and B. pascuorum Scopoli (Hymenoptera:
      Apidae).
AB  - Workers of two bumblebee species, Bombus terrestris L. and B. pascuorum Scopoli,
      had to find the way of escape out of a test tube closed with a paper membrane
      stretched against its open end. Nearly all of the tested individuals solved
      successfully that task by tearing a hole in the membrane closing the tube.
      However, their escape behaviour showed significant interspecific differences. B.
      terrestris started biting the membrane sooner than B. pascuorum, and they were
      biting it more persistently. These behavioural differences matched well the
      differences in the nesting ecology of these two species. Whereas B. pascuorum is
      a surface-nesting species, B. terrestris nest in underground cavities connected
      with the outside world by long tunnels. B. terrestris are thus more likely to be
      well adapted to deal with obstacles obstructing their way, and/or to have more
      experience in removing them. Neither the efficiency of biting behaviour as a
      tactic of escape, nor the total test time differed significantly between the
      tested species.

PMID- 1632282
TI  - High production of retinal melatonin in constant darkness.

PMID- 1632283
TI  - Ontogenesis of muscarinic cholinergic receptor binding in the barrel cortex of
      mice.

PMID- 1632284
TI  - Transection of the stria terminalis without damage to the medial amygdala does
      not alter behavioural sodium regulation in rats.
AB  - Damage to the medial region of the amygdala has been shown to impair
      mineralocorticoid-induced sodium appetite, while leaving intact sodium appetite
      induced through sodium depletion. This effect may result from the interruption of
      the flow of information through the stria terminalis (ST), a neural pathway
      linking the medial amygdala with the ventral forebrain. We determined the effect
      of transecting the ST of the rat, at a point remote from the medial amygdala, on
      sodium appetite induced with the administration of mineralocorticoids and with
      the natriuretic furosemide. Similar to control and amygdala lesioned rats, rats
      with ST knife-cuts displayed a normal sodium appetite following treatment with
      furosemide. However, unlike medial amygdala lesions, transection of the ST alone
      did not block mineralocorticoid-induced sodium appetite. Therefore, the inability
      of mineralocorticoids to induce a salt appetite in medial amygdala lesioned rats
      does not result from damage to the stria terminalis.

PMID- 1632285
TI  - Development of the digestive system in the North American opossum (Didelphis
      virginiana).

PMID- 1632286
TI  - Thromboxane biosynthesis and metabolism in relation to cardiovascular risk
      factors.
AB  - Enhanced platelet biosynthesis of thromboxane A2 is associated with several
      cardiovascular risk factors, as a consequence of a direct effect on platelet
      biochemistry and/or some form of endothelial dysfunction. Moreover, episodic
      increases in thromboxane biosynthesis occur in acute coronary and cerebral
      ischemic syndromes. Thromboxane-dependent platelet activation represents an
      important mechanism that amplifies the consequences of acute vascular lesions as
      well as those of long-standing metabolic or hemodynamic disturbances, and results
      in increased risk of vascular occlusive events.

PMID- 1632287
TI  - Effects of daltroban, a thromboxane (TX) A2 receptor antagonist, on lipid
      metabolism and atherosclerosis.
AB  - In rat hepatocyte cultures daltroban reduced 14C-acetate incorporation stronger
      into cholesterol (CH) esters than into free CH. Further data suggest that the
      reduction of cellular sterols by daltroban is independent from its TXA2 receptor
      antagonistic activity and caused by reduced capacity of ACAT depending CH
      esterification. In rabbits fed CH-enriched diet treatment with daltroban led to
      an inhibition of platelet aggregation and to a significant reduction of
      progression of atherosclerosis. Both reduced CH esterification and TXA2 receptor
      antagonism may contribute to the diminution of progression of atherosclerosis by
      daltroban.

PMID- 1632288
TI  - Effect of 3-morpholinosydnonimine (SIN-1), NG-nitro-L-arginine (NNA) and NG
      monomethyl-L-arginine (NMMA) on isolated anaphylactic guinea-pig hearts.
AB  - In isolated perfused ovalbumin-sensitized guinea-pig hearts modulating effects of
      nitric oxide (NO) on cardiac function and eicosanoid release were investigated.
      While the NO-donor SIN-1 exhibited a protective effect during cardiac
      anaphylaxis, inhibition of NO biosynthesis by NNA or NMMA aggravated anaphylactic
      changes of cardiac functions. Exogenous and endogenous NO seems to functionally
      antagonize the effects of vasoconstrictor mediators released during the
      anaphylactic reaction. In addition, inhibition of cysteinyl-leukotriene (cys-LT)
      release could contribute to the protective effect of SIN-1 observed.

PMID- 1632289
TI  - Effect of N-3 fatty acids on eicosanoid formation: implications for platelet
      thrombotic functions.

PMID- 1632290
TI  - Influence of omega-3 fatty acids on the prostaglandin-metabolism in healthy
      volunteers and patients suffering from PVD.

PMID- 1632291
TI  - Antithrombotic effects of the prostacyclin analogue naxaprostene after oral and
      intraduodenal application in rabbit carotid artery thrombosis.
AB  - The antithrombotic efficacy of the prostacyclin analogue naxaprostene has been
      tested in rabbits with copper coil-induced carotid artery thrombosis. With oral
      pretreatment, 10 mg/kg naxaprostene prevented thrombotic arterial occlusion; with
      intraduodenal pretreatment the efficacy of naxaprostene was enhanced and 1 mg/kg
      was sufficient to exert an antithrombotic effect. The final average carotid blood
      flow at 180 min compared to the flow immediately before thrombus induction was 85
      +/- 25% and 47 +/- 18% in animals treated with 10 mg/kg p.o. resp. 1 mg/kg i.d.
      naxaprostene. Parallel to the antithrombotic effect, naxaprostene inhibited ADP-
      and collagen-induced fall in circulating platelets. In anesthetized rabbits there
      was no dissociation between antithrombotic and hypotensive effects of
      naxaprostene.

PMID- 1632292
TI  - Pathophysiology of critical leg ischaemia and mode of action of prostaglandins.

PMID- 1632293
TI  - Association between total cholesterol and thromboxane B2 levels in offspring of
      parents suffering from premature coronary artery disease.
AB  - Relationship between plasma thromboxane B2 concentration and serum total
      cholesterol level was studied in 129 healthy 3 to 18 years old children, 77 girls
      and 52 boys, without any family history of premature coronary artery disease and
      in 181 offspring, 105 girls and 76 boys, of parents suffering from acute
      myocardial infarction before the age of 45. It was identified an enhancement in
      serum total cholesterol level of endangered children, and an elevated release of
      thromboxane A2 in affected girls. A significant negative correlation was found
      between serum total cholesterol concentration and plasma thromboxane B2 level in
      healthy girls. However, there was no correlation between serum total cholesterol
      level and plasma thromboxane B2 concentration in the children whose parents had
      premature coronary artery disease. It appears, from our results, that this in an
      alteration of thromboxane A2 release of platelets in children of families with
      high risk of cardiovascular diseases.

PMID- 1632294
TI  - Platelet PGI2-receptor behaviour change after treatment with acetylsalicylic acid
      in healthy volunteers.
AB  - After treatment of human platelet membrane fractions with different
      concentrations of acetylsalicylic acid (ASA) the Iloprost binding capacity (Bmax)
      and also the dissociation constant (Kd) of the high-affinity PGI2-receptor
      increased significantly (p less than 0.01, low-affinity receptor only an increase
      of Bmax, p less than 0.01), whereas only a significant (p less than 0.05)
      increase of the Kd of the high-affinity receptor was observed for intact
      platelets.

PMID- 1632295
TI  - Impaired PGI2-stabilization in septic shock patients.
AB  - Lipids, lipoproteins, apolipoproteins and prostacyclin-half-life (PGI2-T/2) in
      vitro were determined in patients, who suffered from severe circulatory shock.
      Extremely lowered lipids, lipoproteins and apolipoproteins and an extremely
      shortened PGI2-T/2 were found, in these patients. These findings support the data
      of Yui and Aoyama that apolipoproteins may be an important coregulator of the
      biological half-life of PGI2 and thereby contribute to hemostatic dyregulation
      seen in these patients.

PMID- 1632296
TI  - Association between total cholesterol and plasma thromboxane B2 in human adults.
AB  - Apparently healthy adults were examined for their lipid and thromboxane
      parameters. The correlation between the levels of total cholesterol in serum and
      thromboxane B2/TXB2/ in plasma was strong mainly in men (p less than 0.01).
      However, the association between atherogenic index /AI/ and TXB2 levels tended to
      be higher in women. The authors suggest that, in healthy adults, elevated
      cholesterol levels coexist with abnormalities in thromboxane metabolism.

PMID- 1632297
TI  - Effects of 9,12,15-octadecatrien-6-ynoic acid on the metabolism of arachidonic
      acid in platelets and on the platelet aggregation.
AB  - An acetylenic fatty acid: 9,12,15-octadecatrien-6-ynoic acid (dicranin),
      extracted from Dicranum Scoparium was preincubated with platelets stimulated by
      exogenous arachidonic acid (20:4 n-6). Dicranin (10(-4) M) weakly inhibited the
      cyclooxygenase activity as assessed by measurement of 12-hydroxy
      heptadecatrienoic acid (HHT) In contrast, the 12-hydroxy-eicosatetraenoic acid
      (12-HETE) synthesized by the 12-lipoxygenase was strongly increased by about
      650%. The same effects were observed with 10(-6) M of dicranin but to a lesser
      extent. The main platelet hydroxylated dicranin metabolite determined by GC-MS
      was a 13-hydroxy derivative Platelet aggregation induced either by thrombin or by
      arachidonic acid or by U46619, an structural PGH2 analogue was inhibited by 10(
      4) M of dicranin.

PMID- 1632298
TI  - Effect of BN 52256 and other mediator antagonists on ouabain-induced ventricular
      fibrillation in sensitized guinea-pigs and on ischemia-induced fibrillation in
      rats.
AB  - The threshold dose of ouabain necessary to induce ventricular fibrillation is
      decreased in sensitized guinea-pigs signalizing an enhanced arrhythmogenicity.
      Esculetine or WEB 2170 antagonists of histamine and PAF, respectively and
      especially a combination of both can increase the threshold dose of ouabain
      induced fibrillation demonstrating an antiarrhythmic effect. BN 52256 a substance
      with multi-antagonistic properties shows antiarrhythmic effect in this method,
      too. WEB 2170 and BN 52256 decrease the incidence of ventricular fibrillation
      after coronary ligation in rats.

PMID- 1632299
TI  - Influence of a cholesterol rich diet in rabbits on the formation of PGI2 and
      TXA2.
AB  - In the study was investigated whether the formation of prostanoids is changed in
      the different regions of aorta or in clotting whole blood in dependence on
      development of atherosclerosis. For this question New Zealand rabbits were fed
      for different periods with a cholesterol rich diet (0.5%). At the end of the
      different dietary periods the animals were killed and the following parameters
      estimated: blood: levels of total cholesterol, HDLcholesterol, VLDLcholesterol,
      cholesterol in the beta-migrating lipoprotein fraction, serum lipid peroxides,
      TXB2 formation capacity of clotting whole blood; aorta: surface of intima covered
      with fatty streaks, free and esterified cholesterol, triglycerides, collagen,
      formation of 6-keto-PGF1a and TXB2 by abdominal and thoracic aortas. The lipid
      parameter demonstrated a relatively strong correlation with the duration of
      cholesterol rich diet or the macroscopically detectable atherosclerosis, but the
      prostanoid formation remained unchanged.

PMID- 1632300
TI  - Increased production of platelet-derived thromboxane in patients with lupus
      anticoagulant.
AB  - The in vivo production of thromboxane A2 and prostacyclin was assessed in 31
      samples from 25 patients with lupus anticoagulant and in 32 controls. The urinary
      excretion of 11-dehydro-thromboxane B2 (a major thromboxane metabolite of
      platelet origin) was very significantly increased (p less than 0.0003) in the
      patients contrasting with a lesser increase of urinary 2,3-dinor-6-keto
      prostaglandin F1 alpha reflecting the vascular production of prostacyclin (p less
      than 0.02). Our study shows that in patients with lupus anticoagulant, platelet
      activation may occur without a compensatory increment in the vascular
      biosynthesis of prostacyclin suggesting an increased risk for thrombosis.

PMID- 1632301
TI  - Eicosanoids, other fatty acid metabolites and the cardiovascular system: are the
      present antithrombotic approaches rational?
AB  - Antiplatelet +/- anticoagulant drugs are currently used as the standard treatment
      to prevent and treat thrombosis. While this approach is beneficial, it is not
      optimal. Recent evidence suggests that constituents of the vascular endothelium
      play an important role in regulating vessel wall thrombogenecity, thereby
      inhibiting thrombogenesis. These include constituents such as PGI2, tissue
      plasminogen activator, thrombomodulin and the lipoxygenase fatty acid metabolite
      derived from linoleic acid, 13-hydroxyoctadecadienoic acid (13-HODE).
      Consequently, new strategies have been developed to maximize the use of these
      agents for antithrombotic therapy. We will review these different approaches,
      discuss their rationale, and based upon recent experimental data, introduce an
      alternative approach for antithrombotic therapy which may circumvent a number of
      limitations and side-effect of the currently used drugs.

PMID- 1632302
TI  - Antiatherosclerotic properties of oral cicaprost in hypercholesterolemic rabbits.
AB  - The effects of the orally active prostacyclin mimetic cicaprost on morphologic
      and functional alterations of rabbit aorta was investigated in experimental
      hypercholesterolemia. Oral cicaprost resulted in a significantly reduced aortic
      atheromatous plaque formation and partially prevented hypercholesterolemia
      induced impairment of endothelium-dependent relaxations. It is concluded that
      long-term substitution with PGI2 may beneficially influence the progression of
      atherosclerosis.

PMID- 1632303
TI  - Oral cicaprost reduces platelet and neutrophil activation in experimental
      hypercholesterolemia.
AB  - Oral treatment of cholesterol-fed rabbits with the PGI2 mimetic cicaprost largely
      reduces hypercholesterolemia-induced platelet and neutrophil hyperreactivity. In
      addition, cicaprost prevents atherosclerosis-induced platelet desensitization for
      PGI2. These effects persist after cicaprost treatment is withdrawn. Since
      platelets and leukocytes are supposed to contribute to atherogenesis, this
      suggests a favourable effect of long-term oral PGI2 substitution in
      hypercholesterolemia.

PMID- 1632304
TI  - Oral cicaprost protects from hypercholesterolaemia-induced impairment of coronary
      vasodilation.
AB  - Isolated Langendorff-hearts prepared from cholesterol fed rabbits (1% cholesterol
      for 3 months) showed a significant impairment in endothelium-dependent relaxation
      after short-term infusion of bradykinin (0.05 mumol/l) and carbamoylcholine (0.1
      mumol/l). Generation of the endothelial mediators nitric oxide and prostacyclin
      by bradykinin was enhanced in hypercholesterolemia. Cicaprost treatment (5
      micrograms/kg x d) largely prevented the hypercholesterolemia-related impairment
      of coronary vasodilation and nitric oxide release. It is concluded that (i)
      impairment of endothelium-dependent relaxation in the coronary microcirculation
      of hypercholesterolemic rabbits is not due to diminished endothelium-dependent
      mediator release but rather to accelerated inactivation or reduced activity of
      the released mediators and that (ii) oral cicaprost beneficially influence these
      alterations.

PMID- 1632305
TI  - Effects of ciprostene on restenosis rate during therapeutic transluminal coronary
      angioplasty.
AB  - Ciprostene, a chemically stable prostacyclin analog was studied for its effects
      on restenosis in patients with coronary artery disease undergoing therapeutic
      percutaneous transluminal coronary angioplasty (PTCA). In a double-blind,
      randomized trial 32 patients were randomized to receive either ciprostene or the
      respective placebo. The infusion started intracoronarily at a rate of 40
      ng/kg/min 20 min before introduction of the balloon catheter into the coronary
      artery. Thereafter infusion was continued intravenously for 36 hours at a rate of
      120 ng/kg/min and a tapering off period until 48 hours. The quantitative analyses
      of the degree of coronary artery stenoses on the angiographic films before PTCA,
      after PTCA and after 6 month of follow-up was performed in 24 patients available.
      In patients receiving placebo (n = 12) coronary artery stenoses was 81 +/- 3%
      before PTCA and was reduced to 34 +/- 3% by angioplasty. At the 6 month follow up
      angiography stenoses diameter was measured as 63 +/- 8%, being not significantly
      different from the % stenoses before PTCA. In contrast, coronary artery stenoses
      in patients receiving ciprostene (n = 12) measured 83 +/- 3% before PTCA, 31 +/-
      4% after PTCA and 55 +/- 9% at 6 month, being still significantly different from
      pre-PTCA value (P less than 0.05). When patients were characterized according to
      their clinical status, these differences were accounted for by patients with
      unstable angina receiving ciprostene. Ciprostene seems to reduce restenosis 6
      month after coronary angioplasty in patients with unstable angina. The infusion
      rate of 40 ng/kg/min i.c. followed by 120 ng/kg/min i.v. was tolerated well,
      although the incidence of catheter associated bleeding was increased.

PMID- 1632306
TI  - Endogenous prostacyclin preserves myocardial function and endothelium-derived
      nitric oxide formation in myocardial ischemia.
AB  - Nitric oxide (NO) and prostacyclin (PGI2) release was determined in effluents of
      Langendorff-perfused rabbit hearts under control conditions and during
      reperfusion subsequent to 2 h of global, low-flow ischemia. PGI2 release (6-oxo
      PGF1 alpha) was significantly enhanced during early reperfusion and remained
      enhanced during a total time of 70 min of reperfusion. NO formation was reduced
      during ischemia but was substantially enhanced during reperfusion. Inhibition of
      endogenous PGI2 production by indomethacin resulted in severe disturbance of
      myocardial function and NO release. Inhibition of NO generation by L-N
      nitroarginine did not affect myocardial contractility. These data suggest a
      cardioprotective and endothelium-protective role of PGI2 in myocardial ischemia
      which also involves protection of NO generation.

PMID- 1632307
TI  - Role of prostacyclin in normal and arteriosclerotic human coronary arteries
      during hypoxia.
AB  - Human coronary arteries were taken from heart transplant patients.
      Arteriosclerotic arteries were more depolarized and constricted over the whole
      PO2 range between 535 and 0 mm Hg. During oxygen deficiency, control preparations
      showed a maximal hyperpolarization of delta V = 10.9 mV and a maximal relaxation
      of delta T = 0.466 g. Arteriosclerotic arteries, however, became hyperpolarized
      by merely delta V = 7.1 mV and relaxed by delta T = 0.258 g. The isometric
      pretension was 2 g in all investigations. Two series of experiments, one with an
      application of indomethacin and another one with deendothelialized blood vessels,
      confirmed the hypothesis that the endothelium of arteriosclerotic coronary
      arteries arteries, indomethacin reduced the hypoxic hyperpolarization and
      dilatation at 30 mm Hg PO2 but about 51%. The reduction was 26% in
      arteriosclerotic vessels. The complete removal of the endothelium caused a 49%
      (74%) restriction of dilatory vascular reactivity. The relation was quite similar
      for a carbogen Krebs solution (resting, control conditions). The hyperpolarizing
      and dilatory contribution by prostacyclin was 32% in normal and 12% in
      arteriosclerotic coronaries. The rest can be attributed to the basal release of
      the endothelial dilator EDHR. Thus, it may be concluded that, in arteriosclerotic
      blood vessels, PGI2 synthesis and release are predominantly diminished or its
      effectivity is impaired. Finally we found the ratio PGI2/EDHF in the voltage and
      tension changes strongly shifted to the PGI2 side with a declining oxygen
      concentration. This is true for normal and arteriosclerotic vessels. In
      accordance with the activation curve for vascular smooth muscle, the
      hyperpolarization leads to relaxation via a closure of Ca2+ channels. 2.5 mV
      hyperpolarization reduces the tension developed by half.

PMID- 1632308
TI  - Involvement of PAF in atherogenesis. Brief review.
AB  - Crucial points have been recently explored between formation, release and
      breakdown of PAF and atherosclerotic plaque formation. Experimental and clinical
      studies suggest that an autocatalytic feedback network among PAF, cytokines and
      growth factors contributes to atherogenesis. This novel approach to atherogenesis
      deserves future therapeutical importance.

PMID- 1632309
TI  - Regulation of the concentration of free arachidonic acid in homogenates of human
      platelets.
AB  - With the intention to study the regulation of the availability of free
      arachidonic acid through the enzymes of the Lands cycle, we established a model
      system in homogenates of human platelets. Phospholipase A2, arachidonoyl-CoA
      synthetase and lysophosphatidyl acyltransferase proved to be simultaneously
      active and a steady turnover of arachidonic acid was the consequence. EGTA
      suppressed the deacylating activity that acted on endogenous membrane
      phospholipids and prevented eicosanoid formation from previously esterified
      exogenous arachidonoyl-CoA. The reacylating enzymes took part in the control of
      eicosanoid biosynthesis by re-esterification of liberated arachidonic acid.
      Blockade of the reacylation by apyrase made arachidonic acid completely available
      for further metabolization into 12-HETE and thereby induced an increase in the
      eicosanoid release.

PMID- 1632310
TI  - Sexual dimorphism in blood pressure response to thromboxane agonist U 46619 and
      to endothelin.
AB  - The blood pressure rising effect of two vasconstrictoryacting substances (the
      thromboxan agonist U 46619 and the endothelium-derived peptide endothelin-1)
      differs in male and in female rats and this fact depends on normotensive or
      hypertensive levels of blood pressure. Whereas in male rats the drug effect was
      changed by pretreatment with aspirin, in female rats aspirin was uneffective in
      changing the blood pressure response to the agents. It could be suggested that
      the mechanism(s) for blood pressure regulation, especially the vasoconstrictor
      system, is different in males and females.

PMID- 1632311
TI  - Effect of irradiation on the prostaglandin system of human hypernephroma cells.
AB  - Specific PGE1-, PGE2-, PGI2-binding sites and the eicosanoid production were
      investigated in cultured human hypernephroma cells. Low numbers of PGE1-, PGE2-
      as well as PGI2-high-affinity binding sites and high levels of PG-production were
      found as compared to normal kidney. Treatment with acetylsalicyclic acid (ASA)
      significantly (p less than 0.01) increased PGE1-, PGE2- and PGI2-binding sites
      and inhibited PG-formation. Following irradiation, PG-receptors and eicosanoid
      generation were significantly (p less than 0.01) diminished, however, were
      insignificantly lowered in the ASA-treated group. These findings suggest that ASA
      may modify the radioresponse of cultured hypernephroma cells by preventing the
      decrease of PG-receptors induced by irradiation.

PMID- 1632312
TI  - Prostaglandin (PG) E1 and 13,14-dihydro (DH) PGE1 are diminishing radiation
      induced arterial damage.
AB  - Rabbit abdominal aorta was irradiated with single or repeated doses up to 10 Gy.
      The rabbits were killed at different time intervals after irradiation. 5
      micrograms/kg x 6/hr PGE1 or its biologically active metabolite 13,14-DH-PGE1
      were administered either 6 hours before or 6 hours after irradiation. The
      administration of both PGEs reduced radiation-induced mitotic activity (3H
      thymidine incorporation) and extracellular matrix [collagen-(14C-proline) and
      glycosaminoglycan (35-S-sulphate)]-formation as determined by means of
      autoradiography. The initial peak increase in vascular PGI2-synthesis was partly
      abolished, while the long lasting depression was less pronounced. 13,14-DH-PGE1
      was only slightly less active as compared to the parent compound. Pre-radiation
      treatment was more effective than post-irradiation therapy. These findings
      suggest that both the PGs exert significant radiation-protective actions on the
      arterial wall.

PMID- 1632313
TI  - Identification of oxidatively modified lipids in atherosclerotic lesions of human
      aortas.
AB  - The oxygenated lipids of human aortas with atherosclerotic lesions were analysed
      by RP-, SP- and Chiral Phase-HPLC and compared with those obtained after
      treatment of human LDL with pure 15-lipoxygenase (LOX) of rabbit reticulocytes.
      The data suggest an indirect role of 15-LOX in the atherogenesis in aortas.

PMID- 1632314
TI  - Purification to homogeneity of an NAD dependent 11-hydroxythromboxane B2
      dehydrogenase from porcine kidney.
AB  - A protein with NAD dependent 11-hydroxythromboxane B2 dehydrogenase activity was
      purified to homogeneity from porcine kidney using a simple purification
      procedure, involving precipitation, anion exchange chromatography (DE-52),
      affinity chromatography (5'-AMP-Sepharose) and gel filtration chromatography
      (Protein Pak 300SW). The dehydrogenase was found to have a molecular mass of 50
      kDa and 42 kDa as determined by comparison with standards on SDS/PAGE and gel
      filtration chromatography respectively. The apparent Km and Vmax values for
      thromboxane B2 were 220-250 microM and 15-30 nmol min-1 mg-1 respectively. The
      enzyme was clearly separated from the proteins with 15-hydroxyprostaglandin
      dehydrogenase activity also present in the kidney. Furthermore it was found that
      11-hydroxythromboxane B2 dehydrogenase did not utilize prostaglandin D2
      prostaglandin E2 or prostaglandin F2 alpha as substrate, and that the enzyme did
      not catalyze the reverse reaction, conversion of 11-dehydrothromboxane B2 to
      thromboxane B2.

PMID- 1632315
TI  - Biosynthesis of TXB2 and 6-oxo-PGF1 alpha in the heart and other tissues under
      pathophysiological conditions.
AB  - Many organs have the capacity to form prostanoids. Under pathophysiological
      conditions the biosynthesis of TXB2 and 6-oxo-PGF1 alpha is markedly increased in
      the myocardium and the gastric mucosa. Tumor growth is linked with an enhanced
      prostanoid formation. Furthermore a rise of the PG content could be found in the
      liquor, aqueous humor and urine under diseases of the related organs. These
      results could be of some significance for diagnosis and therapy control.

PMID- 1632316
TI  - [Evaluation of complicated renal cyst: a comparison of CT and MR imaging].
AB  - We report 12 cases of renal cystic lesions that could not be diagnosed
      preoperatively. Sonography, computed tomography (CT), magnetic resonance (MR)
      imaging, and angiography were performed in all cases. Angiography was not helpful
      in evaluating cystic lesions, because all cystic lesions were hypovascular or
      avascular within the cystic mass. CT was useful in depicting the fine structural
      abnormalities, and especially bolus-contrast CT study was useful in the
      differentiation of cystic renal cell carcinoma from simple renal cyst. However,
      there were 5 false positive cases. MR imaging is superior to CT in distinguishing
      a hemorrhagic cyst or multiloculated cystic mass. In conclusion, CT is currently
      the primary imaging modality for evaluating complicated renal cysts, and surgical
      exploration is warranted for the undiagnosed cystic lesion by CT. However, MR
      imaging also has an important role in detecting the benign complicated cyst.
      Therefore if complicated cyst is thought to be benign by MR imaging, parenchyma
      sparing surgery should be considered preoperatively.

PMID- 1632317
TI  - [Detection of mutant adenine phosphoribosyltransferase genes by polymerase chain
      reaction-single strand conformation polymorphism analysis].
AB  - Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP)
      analysis is a rapid and sensitive method to identify point mutations in a given
      sequence of genomic DNA. We tried to apply the PCR-SSCP to the diagnosis of
      adenine phosphoribosyltransferase (APRT) deficiency, which is an autosomal
      recessive hereditary disease leading to 2,8-dihydroxyadenine urolithiasis.
      Genomic APRT genes, with or without mutations, were amplified and labeled
      simultaneously with 32P-dCTP by PCR. When run in a 6% polyacrylamide gel
      containing 10% glycerol, two types of mutant genes, APRT*Q0 and APRT*J, gave
      bands clearly distinct from those of the respective normal APRT genes. Since
      heterozygotes as well as homozygotes for these mutant APRT genes can be detected
      in 2 days, PCR-SSCP should be a valuable method in the diagnosis of APRT
      deficiency and in screening a large population for APRT mutant genes.

PMID- 1632318
TI  - [Clinical assessment of patients with microscopic hematuria pointed out by mass
      screening examination].
AB  - We clinically examined 445 patients with positive urine occult blood test found
      by mass screening examination. Among them, 41 cases had the history of
      macroscopic hematuria. Urological abnormalities were observed in 169 (41.8%) of
      the patients with microscopic hematuria, and in 22 (53.7%) of those with a
      history of macroscopic hematuria. Genitourinary neoplasms were found less
      frequently in the patients with microscopic hematuria (1.2%) than in those with
      macroscopic hematuria (22%). We couldn't find a correlation between the degree of
      hematuria and the severity of the underlying diseases. Hematuria is often thought
      to appear intermittently, and urinalyses of the patients with so-called
      significant disease may not be found at the first visit.

PMID- 1632319
TI  - [Indiana continent urinary reservoir: technical modifications and late
      complications].
AB  - From October, 1987 through September, 1991, 39 patients underwent construction of
      Indiana pouch for cutaneous urinary diversion. There were 35 men and 4 women, and
      their ages ranged from 38 to 77 years (a mean age of 62 years). After the first 8
      cases, Indiana pouch was constructed with several modifications which included
      complete detubularization of the cecum, construction of the pouch augmented with
      U-shaped ileal patch, and the use of stapled plication. There was no major early
      complication related to the pouch but one postoperative death of blood
      transfusion related graft versus host disease. End results were evaluated in 37
      patients who were followed for 3 to 49 months. Late complications related to
      urinary reservoir occurred in 8 patients. The early two patients experienced
      pouch deformity due to incomplete detubularization of the colonic segment. Two
      patients had difficult catheterization due to a dilatation of the plicated ileum.
      One patient had metabolic acidosis requiring hospitalization. Patients perform
      self-catheterization 4-5 times during the day and 0-2 times at night for volumes
      ranging from 300 to 1,000 cc. Of 37 patients 34 achieved acceptable urinary
      continence and one had significant leakage requiring cutaneous bag. The remaining
      two patients suffered mild nocturnal incontinence. Follow up examination with
      excretory urography showed no upper urinary tract obstruction except one with
      unilateral hydronephrosis due to ureteroanastomotic stricture. Reservoirgraphy
      showed no reflux into the upper urinary tract in all the follow up
      cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632320
TI  - [The clinical usefulness of flow cytometric DNA analysis in prostatic cancer].
AB  - Flow cytometry was used to measure the DNA content in archival paraffin-embedded
      prostatic cancer specimens from 54 patients with known outcomes. The specimens
      were obtained by transurethral resection of the prostate. DNA ploidy as a
      predictor of prognosis was compared with histological grade and clinical stage.
      Although no significant correlation between histological grade or clinical stage
      and ploidy pattern was demonstrated, an increased percentage of DNA aneuploid
      tumors was seen in higher histological grade and in advanced clinical stage. The
      survival rate calculated by Kaplan-Meier analysis showed that DNA ploidy pattern
      was a more reliable indicator to predict survival probability than histological
      grade or clinical stage. All patients with a near diploid pattern (11 patients)
      survived more than 5 years, whereas all those with an aneuploid pattern (21
      patients) died within 3.5 years. Of 22 patients with a tetraploid pattern, 15
      died of tumor progression within 5 years. The remaining 7 patients with favorable
      outcome had a relatively lower proliferation index (less than 65) in DNA
      histogram and none of them suffered from stage D disease. In conclusion, the
      results from this retrospective study suggest that flow cytometric DNA analysis
      in prostatic cancer would be useful as a means of providing prognostic
      information.

PMID- 1632321
TI  - [Clinical and pathological study of 152 cases of prostatic cancer].
AB  - A total of 152 prostatic cancer patients who underwent mainly hormone therapy was
      conducted. Our histological grading system combined with structure atypsim--SAT
      and nuclear anaplasia--NAN allowed for more accurate prognosis of prostatic
      cancer patients. The prognosis of G3 patients was obviously poor. The over-all 5
      year survival rate for prostatic cancer patients with G1, G2 and G3 was 80%, 57%
      and 17%, respectively. The 5-year reactivation rate for patients with G1, G2 and
      G3 was 14%, 32% and 87%, respectively. The period for reactivation after initial
      hormone therapy for prostatic cancer patients with G1, G2 and G3 was 11.4, 10.0
      and 3.2 years, respectively. Further improvements in survival for the patients
      with G3 prostatic cancer will require the development of effective systemic
      chemotherapy and the re-consideration of appropriate use of hormone therapy.

PMID- 1632322
TI  - [Adrenal pseudocyst: a case report].
AB  - A 23-year-old man presented with high fever and left abdominal pain.
      Ultrasonography, CT scan and angiography visualized a left adrenal cyst. Cyst
      fluid obtained preoperatively by percutaneous needle puncture under
      ultrasonographic guidance was purulent, and had a higher level of aldosterone,
      and lower level of amylase than the plasma. These findings suggested that this
      cyst originated from the adrenal gland. Histopathological examination of the
      surgically removed specimen confirmed the adrenal pseudocyst.

PMID- 1632323
TI  - [Adrenal myelolipoma associated with Cushing's syndrome: a case report].
AB  - A 42-year-old woman was referred to our hospital for evaluation of severe
      hypertension. A right adrenal tumor was revealed by CT scan, and the elevation of
      cortisol and u-17OHCS was found. We made a diagnosis of adrenal adenoma with
      Cushing's syndrome and performed right adrenalectomy. However, a small
      myelolipoma (1.5 mm in diameter) was found beside the cortical adenoma by
      histopathological examination. Adrenal myelolipoma is not a rare disease now,
      because it is easily-detected as an incidental by CT scan. The present case of
      adrenal myelolipoma, however, is interesting and uncommon in its connection with
      functioning cortical adenoma. Only 3 cases have been previously reported so far
      in English and Japanese publications. We discuss the etiology of adrenal
      myelolipoma, and suggest that myelolipoma would develop in the course of
      regressive or necrotic degeneration of cortical cells by hormonal disorders,
      stress, circulatory disturbance or other unknown factors.

PMID- 1632324
TI  - [A case of retrovesical fibrosarcoma with severe hypoglycemia].
AB  - We report a case of retrovesical fibrosarcoma with severe hypoglycemia. A 67-year
      old man was admitted to our hospital with second recurrence of the retrovesical
      tumor with hypoglycemia. The episodes of hypoglycemia were accompanied by the
      advance of tumor size. Complete tumor resection with total cystectomy was
      performed on December 21, 1989, and the tumor was diagnosed histopathologically
      as fibrosarcoma. Soon after removal of the tumor, hypoglycemia disappeared and
      the patient has been well without local recurrence or distant metastasis for more
      than 20 months.

PMID- 1632325
TI  - [Simultaneous double malignant tumors on functional solitary kidney: a case
      report].
AB  - A case of simultaneous double cancer on functional solitary kidney is reported. A
      72-year-old man was admitted to the Department of Internal Medicine with angina,
      hypertension and diabetes mellitus. After treatment involving percutaneous
      transluminal coronary angioplasty, he was sent to the Department of Urology to
      check the microhematuria. Cystoscopy showed normal interior of urinary bladder.
      Drip infusion pyelography and computed tomography demonstrated a tumor mass on
      the upper pole of the right kidney and atrophic left kidney. Preoperative
      diagnosis was right renal cell carcinoma. However, an additional pelvic tumor was
      found during surgery, and a partial nephrectomy was performed. Histologic
      examination confirmed the presence of 2 separate and distinct malignant entities:
      a renal cell carcinoma and a non-invasive transitional cell carcinoma.
      Postoperative recovery has been uneventful and without hemodialysis for 16
      months. This is the 19th case of simultaneous occurrence of renal cell carcinoma
      and transitional cell carcinoma in the same kidney and the 1st case in the
      patient with a functional solitary kidney in the Japanese literature.

PMID- 1632327
TI  - [A case of renal cell carcinoma in a horseshoe kidney].
AB  - We report a 68-year-old man with renal cell carcinoma in a horseshoe kidney.
      Abdominal computed tomography revealed a left renal tumor in a horseshoe kidney,
      and we carried out left radical nephrectomy. Histopathological diagnosis was
      renal cell carcinoma. Only 19 cases of renal cell carcinoma in a horseshoe kidney
      have been reported in Japan, and our case was the 20th.

PMID- 1632326
TI  - [A case of multilocular renal cell carcinoma].
AB  - Herein we report case of multilocular cyst of the right kidney complicated with
      clear cell type renal cell carcinoma. The chief complaint of the 51-year-old male
      patient was macroscopic hematuria. He underwent radical nephrectomy and was
      administered postoperative adjuvant chemotherapy with alpha-interferon. No
      recurrence was found 18 months after operation. Pathogenesis of multilocular cyst
      of the kidney and the mechanism of malignant transformation are discussed.

PMID- 1632328
TI  - Primary localized amyloidosis of the renal pelvis coexisting with transitional
      cell carcinoma: a case report.
AB  - Primary localized amyloidosis of renal pelvis is very rare, and only 12 cases
      have been reported. More than half of the reported cases were treated by
      nephrectomy, and the preoperative diagnosis could not be made correctly because
      of its resemblance to renal pelvic tumor. The ureteroscopy is a useful diagnostic
      means in such a condition. This case is unusual in that a papillary transitional
      cell carcinoma was present coincidentally.

PMID- 1632329
TI  - [A case of infected caliceal diverticulum].
AB  - A 60-year-old woman was admitted to our clinic with the chief complaint of high
      fever. Antibiotic therapy had produced no improvement in another hospital and she
      was referred to our hospital for further examination and treatment. Intravenous
      pyelography showed left non visualized kidney and a stone shadow in left ureter.
      Computed tomography showed a cystic lesion, 9 x 9 x 8 cm, in the upper pole of
      the left kidney. We punctured and drained 400 cc of turbid yellowish fluid by a
      transcutaneous route. The nephrostogram clearly showed a communication with
      infundibulum. A diagnosis of infected caliceal diverticulum was made. Further
      examination demonstrated no function of left kidney and we performed nephrectomy.
      She has reported no symptoms for 6 months after the operation.

PMID- 1632330
TI  - [Primary ureteral tumor in the residual ureter: a report of two cases].
AB  - Two cases of primary ureteral tumor in the residual ureter are reported. One was
      in a 40-year-old woman who had undergone simple nephrectomy for renal
      tuberculosis 6 years earlier. The other was in a 59-year-old man 11 years after
      ureterostomy for hydronephrosis. They presented with hematuria. Cystoscopic
      examination revealed a ureteral tumor out of the residual ureteral orifice.
      Computed tomographic scan showed a perivesical mass attached to the urinary
      bladder. It is useful for examination of ureteral stump's condition. We performed
      ureterectomy. The pathological study revealed the former high grade transitional
      cell carcinoma with squamous cell carcinoma and lymph nodes metastasis and the
      latter low grade transitional cell carcinoma. They have been free of disease for
      5.5 years and 1.75 years, respectively. These cases are the nine and tenth
      reports of primary ureteral tumor of the ureteral stump in the Japanese
      literature.

PMID- 1632331
TI  - [Primary carcinoma in diverticulum of the bladder: a report of three cases].
AB  - The first case was in a 48-year-old man admitted with a chief complaint of
      macroscopic hematuria and sense of residual urine. A tumor in the diverticulum of
      the bladder was detected by cystoscopy, computed tomography (CT) and magnetic
      resonance imaging (MRI). We made the diagnosis of an invasive tumor in the
      diverticulum of the bladder. Total cystourethrectomy and ileal conduit diversion
      was performed. Histopathological finding was transitional cell carcinoma
      including squamous cell carcinoma. Adjuvant chemotherapy was performed. No
      recurrence and metastasis has been recognized for 12 months. The second case was
      a 56-year-old man having an intradiverticular tumor diagnosed by cystoscopy, CT,
      and MRI. Total cystectomy and ileal conduit diversion was performed.
      Histopathological findings was squamous cell carcinoma. No recurrence has been
      recognized for 8 months. The last case was an 81-year-old man. The patient had
      the complication of a primary progressive squamous cell carcinoma of the skin.
      Transurethral resection of diverticular tumor was performed under the diagnosis
      of superficial tumor. Histopathological findings revealed transitional cell
      carcinoma. One hundred and sixty one cases of tumor in the diverticulum of the
      bladder were reviewed. Importance of aggressive treatment including total
      cystectomy was emphasized.

PMID- 1632333
TI  - [Effects of Tsumura Chorei-to and Tsumura Chorei-to-go-shimotsu-to on patients
      with urethral syndrome].
AB  - Tsumura Chorei-to or Tsumura Chorei-to-go-shimotsu-to, was administered to 71
      female patients with urethral syndrome 2.5 g three times a day for four weeks.
      Total efficacy rate of Tsumura Chorei-to in 34 cases was 71%. Tsumura Chorei-to
      was effective against pollakisuria, miction pain or discomfort, sense of residual
      urine and lower abdominal discomfort. Total efficacy rate of Tsumura Chorei-to-go
      shimotsu-to in 37 cases was 57%. Tsumura Chorei-to-go-shimotsu-to was effective
      against dysuria, sense of residual urine and lower abdominal discomfort. Uutoward
      effect rates of Tsumura Chorei-to and Tsumura Chorei-to-go-shimotsu-to were 6%
      and 14%, respectively. Many of the untoward effects of these two drugs were
      epigastral discomfort. These two drugs are thought to be effective on patients
      with urethral syndrome.

PMID- 1632332
TI  - [Repair of skin defect after extensive resection for penile cancer: report of two
      cases, and clinical observation of patients with penile cancer at Mie University
      hospital].
AB  - Case 1: A 48-year-old male with stage 4 penile cancer is reported. We used
      peplomycin (PEP) and cisplatinum (CDDP) for preoperative chemotherapy.
      Chemotherapy was effective. Radical surgery with bilateral inguinal
      lymphadenectomy was done and skin defect was covered with a skin flap. Case 2: A
      61-year-old male with stage 4 penile cancer underwent radical surgery after
      modified MBD therapy with methotrexate (MTX), PEP and CDDP. Emasculation with
      skin resection and inguinal and pelvic lymphadenectomy were performed. The skin
      defect was deep and wide. It was covered with a glacilis myocutaneous skin flap.
      Distal end of the flap became necrotic. It was covered with tensor fascia lata
      myocutaneous flap. Seventeen patients with penile cancer were treated between
      1972 and 1990 at Mie University Hospital. Nine patients were in stage 1, 4 stage
      2, 1 stage 3, 3 stage 4. Treatment consisted of surgery (3), surgery+chemotherapy
      (10), surgery+chemotherapy+irradiation (2), chemotherapy+irradiation (1), and
      surgery+irradiation(1). Cancer death was observed in 2 cases (stage 2), 2
      patients died of other diseases, 10 are alive, and 3 patients were lost to follow
      up.

PMID- 1632334
TI  - [Clinical study of levofloxacin (DR-3355) on uro-genital infections--with special
      reference to usefulness for chronic prostatitis].
AB  - The clinical usefulness of levofloxacin, an optical active isomer of ofloxacin,
      was investigated on uro-genital infections. Patients who were treated with the
      drug included 2 with complicated urinary tract infections (UTI), 29 with chronic
      prostatitis and 3 with chronic non-chlamydial epididymitis. Levofloxacin was
      given to each patient at a dose of 300 mg or 400 mg a day for 7-14 days (average
      12.0 +/- 0.5 days). In 2 cases of chronic UTI, infected by P. aeruginosa in one
      case and P. stutzeri in another case, the isolates were eradicated, and the
      clinical efficacy was moderate or excellent. For evaluating the effectiveness on
      chronic prostatitis, the patients were divided into 2 groups; group I (G-I) was
      chronic bacterial (number of isolates including GNR or E. faecalis, greater than
      or equal to 10(4) ml) and group II (G-II) was chronic non-bacterial prostatitis
      (number of isolates including GPC less than or equal to 10(3)/ml). A complete
      bacteriological response was obtained in all 7 cases, classified in G-I, but in
      20 of the 27 isolates, (74.1%) in G-II. In 3 cases of chronic non-chlamydial
      epididymitis, the response was moderate. In safety profile, there were slight
      elevations in the laboratory values of glutamic oxaloacetic transaminase (GOT),
      and glutamic pyruvic transaminase (GPT) in one case, and that of GOT in another
      case. As for side effects, a 69-year-old male complained of dizziness, and
      anorexia after 10 days on the drug, but recovered 2 days after discontinuance of
      the drug.

PMID- 1632335
TI  - Stress fractures: current concepts.
AB  - Stress fractures are extremely common lesions that occur in specific areas and
      are related to specific activities. They are caused by increased muscular
      activity on bones that are not yet ready to take the increased pull of the
      involved muscles. The insufficiency type of stress fractures found in patients
      with bone of diminished mineral content is being recognized more often as
      increasing numbers of middle-aged and elderly persons are becoming more
      physically active. A variety of imaging studies can be used to diagnose stress
      fractures. Radionuclide bone scanning and MR imaging often show abnormalities
      early in the course of the injury. However, when radiographs appear normal,
      findings on scintigrams may be more suggestive of the proper diagnosis. In
      patients with suspected stress injury, radiographs should be obtained a second
      time, 1-2 weeks after the initial study. Biopsy should be avoided until evidence
      is clear-cut that the lesion has not changed over a short time.

PMID- 1632336
TI  - Infertility in women: diagnostic evaluation with hysterosalpingography and other
      imaging techniques.
AB  - This article examines the current roles of hysterosalpingography and other
      imaging studies used in diagnostic assessment and treatment of infertility in
      women. The advantages and limitations of hysterosalpingography, transabdominal or
      transvaginal sonography, and MR imaging in detecting abnormalities of the uterus
      (congenital anomalies, intrauterine adhesions, myometrial and endometrial
      derangements) and tubal and peritubal disease are presented. The use of
      sonography to evaluate cyclical endometrial changes, to assess development of the
      follicle and corpus luteum, to determine whether ovulation has occurred, and to
      detect dysfunctional ovulatory dynamics is described, as is the role of this
      technique in improving the prognostic value of the postcoital test for assessing
      the quality of cervical mucus. With the development and availability of newer and
      improved methods for the treatment of infertility disorders in women,
      comprehensive and detailed evaluation to determine the precise underlying cause
      or causes of the infertility is important to allow formulation of the most
      appropriate therapeutic plan. With careful and thorough assessment, the cause of
      infertility can be identified in 90-95% of couples evaluated.

PMID- 1632337
TI  - Fetching the doctor.

PMID- 1632338
TI  - CT evidence for the "osseous pinch" mechanism of traumatic aortic injury.
AB  - OBJECTIVE: Our prior experiments suggested that traumatic laceration of the aorta
      induced by rapid deceleration results from pinching of the aorta between the
      spine and the anterior bony complex (manubrium, clavicle, and first rib). This
      study examines that hypothesis with in vivo CT data. MATERIALS AND METHODS: In 22
      patients with angiographically and surgically proved lacerations of the proximal
      descending aorta, chest CT scans were obtained before (18) or after (four)
      surgical repair. The point of impact of the anterior bony complex with the
      anterior surface of the thoracic spine during compression of the thorax was
      predicted by simulated rotation of the first rib based on calculations made from
      the CT scans. RESULTS: In all 22 patients, the projected site of impact of the
      anterior bony complex with the spine corresponded to the actual injured aortic
      segment as determined with angiography. CONCLUSION: Our data further support the
      proposed "osseous pinch" mechanism of injury to explain traumatic tears of the
      aorta.

PMID- 1632339
TI  - Inverted papilloma.

PMID- 1632340
TI  - Intrathoracic neurogenic tumors: MR-pathologic correlation.
AB  - An MR-pathologic correlation of nine intrathoracic neurogenic tumors (three
      neurofibromas, four schwannomas, and two ganglioneuromas) was performed to
      characterize their MR appearances. The three types of intrathoracic neurogenic
      tumor were found to have characteristic appearances on MR images that should be
      helpful when establishing the differential diagnosis of posterior mediastinal
      tumors. The MR and histologic features of these tumors are illustrated and
      described in this essay.

PMID- 1632341
TI  - Transesophageal echocardiography for the evaluation of atherosclerosis of the
      thoracic aorta.

PMID- 1632342
TI  - Interval carcinomas in the Malmo Mammographic Screening Trial: radiographic
      appearance and prognostic considerations.
AB  - OBJECTIVE: Interval carcinoma is the term used to describe malignant breast
      tumors that are detected in the intervals between mammographic screenings. These
      tumors are important because they contribute significantly to breast cancer
      mortality in the screened population. MATERIALS AND METHODS: Two radiologists
      retrospectively reviewed the mammograms of the 96 interval carcinomas (17% of all
      malignant neoplasms in the screened group) that were detected during the 10-year
      Malmo Mammographic Screening Trial in Malmo, Sweden (average time between
      screenings, 21 months), including one sarcoma, 75 invasive carcinomas, and 20
      noninvasive carcinomas. We recorded the interval between screening and detection,
      and noted the tumor's appearance on the prior screening mammogram and at the time
      of diagnosis; these data were correlated with histologic tumor type and the
      patients' mortality. The doubling time for tumor volume of the invasive
      carcinomas was estimated. RESULTS: Excluding the sarcoma, 72 carcinomas (75%)
      were detected within 18 months of screening. Retrospective review of the
      available preceding screening mammograms (94 cases) indicated that 10 tumors were
      missed (observer's error), 63 studies showed no tumor (true interval carcinomas),
      and 21 studies showed subtle signs of malignancy, mostly nonspecific densities or
      asymmetries (unrecognized sign). Of 66 invasive carcinomas in which doubling
      times for tumor volume could be calculated, 27 (41%) had doubling times of less
      than 100 days. At the end of the study, 20 of the 96 patients had died of breast
      cancer. CONCLUSION: Interval carcinomas in this series were dominated by comedo,
      medullary, and mucinous carcinomas that often had a nonspecific appearance (when
      present) on prior screening mammograms. The interval carcinomas also contained a
      subset of rapidly growing tumors with a grave prognosis.

PMID- 1632343
TI  - Evaluation of mammographic image quality: pilot study comparing five methods.
AB  - A radiograph is considered of high quality when it allows a radiologist to
      identify abnormalities with high sensitivity and specificity. Although many
      methods for assessing image quality have been devised, it is not clear which is
      most meaningful or how well these methods correlate with one another. A pilot
      study was undertaken to compare five methods of evaluating mammographic image
      quality. Each of the methods was used to form separate rankings of 11
      mammographic system configurations. In two of the methods, observers (three
      radiologists and three physicists) subjectively ranked the "image quality" of
      radiographs of phantoms obtained with each configuration. The third method ranked
      the systems according to contrast as measured densitometrically with an aluminum
      step wedge, and the fourth, in terms of lowest to highest mean glandular
      radiation doses to the breast. In the final method, observers based their
      rankings on mammograms of patients. The intra- and interobserver variabilities of
      each ranking method were assessed, as well as the correlations between methods,
      by using standard nonparametric statistical tests. Intraobserver consistency was
      high with any of the image quality ranking methods; however, image quality
      rankings based on either of the two phantoms provided better agreement among
      observers than did rankings based on images of patients. Surprisingly, no
      significant degree of correlation was found between any two image quality
      evaluation methods. Our work may have two implications for the American College
      of Radiology Mammography Accreditation Program: (1) small variations in phantom
      scores do not necessarily correlate with subjective variation in image quality in
      radiographs of patients, and (2) when small numbers of radiographs are used, the
      assessment of the quality of mammograms of patients may vary considerably among
      radiologists.

PMID- 1632344
TI  - Duodenal neoplasms: predictive value of CT for determining malignancy and tumor
      resectability.
AB  - CT examinations of 25 patients with proved primary or metastatic duodenal
      neoplasms were retrospectively reviewed to determine if morphologic features seen
      on CT scans could be used to predict the benign or malignant nature of these
      neoplasms and to assess the effectiveness of using CT findings to predict tumor
      resectability. We studied 19 malignant and six benign tumors. Histologic proof
      was obtained by means of surgery in 20 patients and by endoscopic biopsy in five.
      CT features of tumor morphology were assessed in the 22 cases in which a duodenal
      tumor was seen on CT. These features included central necrosis, ulceration or
      excavation, and the location of the tumor with respect to the bowel wall. The
      specific morphologic features used to predict that a tumor was malignant included
      the presence of an exophytic or intramural mass, central necrosis, and
      ulceration. The only criterion used to predict that a tumor was benign was that
      the mass be entirely intraluminal. Whenever vascular encasement, invasion of
      contiguous organs other than the head of the pancreas, distant lymphadenopathy,
      or metastases were present, the tumor was predicted to be unresectable for cure.
      With the exception of three benign smooth muscle tumors, all tumors with one or
      more CT morphologic features indicative of a malignant neoplasm were malignant (n
      = 16). Three of four intraluminal masses were benign. In three cases of polypoid
      tumors smaller than 2 cm, a duodenal tumor was not seen on CT. Whenever
      extraduodenal disease was found (15 cases), the neoplasms were malignant. In the
      22 cases in which a tumor was detected on CT, the sensitivity of using the
      presence of one or more morphologic features associated with a malignant neoplasm
      as a predictor was 94%; the specificity was 50%, and the accuracy was 82%. If the
      presence of any morphologic feature indicative of a malignant neoplasm was
      combined with the presence of any finding of extraduodenal disease, CT was 100%
      sensitive and 86% accurate for predicting that the tumor was malignant. CT
      appears to be reliable for predicting duodenal tumor resectability. On the basis
      of CT findings, 10 tumors were correctly predicted as being unresectable for
      cure, and 12 were predicted as being resectable; no surgery was performed in the
      remaining three cases. In conclusion, evaluation of the morphologic features of
      duodenal neoplasms is a sensitive, but nonspecific, method for predicting that a
      tumor is malignant.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1632345
TI  - CT findings in patients with small-bowel transplants.
AB  - Orthotopic small-bowel transplantation procedures are being performed
      increasingly often worldwide. CT plays an important role in both the preoperative
      assessment and the postoperative care of these patients. This pictorial essay
      serves to acquaint radiologists with the CT findings related to small-bowel
      transplantation.

PMID- 1632346
TI  - Persistence of portosystemic collaterals and splenomegaly on CT after orthotopic
      liver transplantation.
AB  - OBJECTIVE: The appearances of portosystemic collaterals and splenomegaly on CT
      before and after liver transplantation were evaluated. MATERIALS AND METHODS: The
      records of 54 patients undergoing liver transplantation during a 2.5-year period
      were reviewed retrospectively. Twenty-five of these patients, in whom both a
      preoperative abdominal CT scan and a follow-up CT scan at least 1 year after
      transplantation had been obtained, were clinically well and had had no
      significant episodes of rejection, severe recurrent hepatitis, or other
      complication at the time of study. A total of 94 abdominal CT scans in these
      patients were reviewed to assess changes in portosystemic collaterals and splenic
      volume. RESULTS: At 6 months after transplantation, portosystemic collaterals at
      one or more sites were seen in 14 (74%) of the 19 patients scanned at this time
      in whom collaterals had been seen on CT preoperatively. At 1 year after
      transplantation, splenic hilar collaterals persisted in 64% of patients,
      splenocolic ligament collaterals in 50%, retroperitoneal collaterals in 38%, and
      peripancreatic collaterals in 38% of patients with preoperative varices at these
      sites who were examined with CT at this interval. Splenic hilar, coronary, and
      retroperitoneal collaterals were found to persist for up to 4 years after
      transplantation in the single patient examined at that time. Splenic volume
      decreased in 94% of patients examined after transplantation, with a mean
      reduction of 60 +/- 19%. However, the spleen remained significantly enlarged in
      56% of patients. CONCLUSION: We conclude that portosystemic collaterals and
      splenomegaly frequently persist after liver transplantation, but that this
      finding need not indicate recurrence of hepatic disease or other
      posttransplantation complications.

PMID- 1632347
TI  - Calcifications in the portal venous system: comparison of plain films,
      sonography, and CT.
AB  - We describe 10 patients with long-standing portal hypertension and calcifications
      in the splenoportal and mesenteric venous systems or collateral vessels. The
      patients were examined with abdominal plain films (n = 10), sonography (n = 10),
      and CT (n = 9). Calcium was seen on CT scans in nine cases, on sonograms in
      seven, and on abdominal plain films in five. Calcifications appeared to be
      located in the wall of the vein in all cases. Sites of detection included the
      main portal, splenic, superior mesenteric, coronary, and peripancreatic veins. CT
      was more sensitive than sonography, and both were more sensitive than plain
      films, in showing portal venous calcification. Detection of such calcifications
      may influence surgical or percutaneous therapy of portal hypertension.

PMID- 1632348
TI  - Abnormalities of the gallbladder after extracorporeal shock-wave lithotripsy:
      imaging findings.
AB  - To qualify for treatment with biliary extracorporeal shock-wave lithotripsy
      (ESWL), patients must have sonograms that show gallstones and oral
      cholecystograms (OCGs) that show normal opacification (indicating normal
      function) of the gallbladder. We have noted that sonograms and OCGs made 6 weeks
      to 6 months after ESWL sometimes show abnormalities that were not visible on
      these images before ESWL. In these cases, the gallbladder appears contracted on
      sonograms and is poorly visualized on OCGs. To determine how often this occurs
      and to study its significance, we analyzed the posttreatment sonograms and OCGs
      in 174 patients who underwent ESWL. After ESWL, sonograms showed a contracted
      gallbladder and OCGs showed poor function in 25 (14%) of the 174 patients. One
      patient (4%) was lost to follow-up. In 17 (68%) of the 25 patients, the
      abnormalities were transient (findings on sonograms and OCGs returned to normal
      by 12 months after ESWL). In the other seven patients (28%), the abnormalities
      persisted (all seven subsequently had a cholecystectomy); this is a
      cholecystectomy rate twice that in the patients with normal findings on sonograms
      and OCGs after ESWL (20/149 or 13%). All 25 patients with abnormalities after
      ESWL had gallstone fragments at 6 weeks, as did 146 of the 149 patients with
      normal-appearing gallbladders after ESWL. When these abnormalities persist (in
      approximately one third of patients), cholecystectomy is often required. The
      cause of the abnormalities is unknown, although chronic cholecystitis, a process
      that is not detectable by pre-ESWL imaging techniques, seems likely.

PMID- 1632349
TI  - Disappearing "gallstones": biliary pseudolithiasis complicating ceftriaxone
      therapy.

PMID- 1632350
TI  - Splenosis: superparamagnetic iron oxide-enhanced MR imaging.

PMID- 1632352
TI  - Use of transperineal hydrosonovaginography to show an incomplete vaginal septum.

PMID- 1632351
TI  - The seminal tract in patients with ejaculatory dysfunction: MR imaging with an
      endorectal surface coil.
AB  - Twenty-six patients with signs and symptoms of ejaculatory dysfunction
      (hemospermia, hypospermia, oligospermia, or painful ejaculation) were examined
      with high-resolution MR imaging with an endorectal surface coil. Findings were
      abnormal in 15 patients. Abnormalities detected included four cases of mullerian
      cysts, three cases of wolffian cysts, one case of anaplastic prostatic carcinoma,
      and various noncystic abnormalities of the seminal vesicles and ejaculatory
      ducts, including ejaculatory duct obstruction and seminal vesiculitis. In all
      cases, depiction of both the normal and abnormal anatomy of the entire seminal
      tract, including the vas deferens, seminal vesicles, and ejaculatory ducts, was
      excellent. This depiction of the detailed anatomy of the prostatic cysts made it
      possible to suggest specific diagnoses. Our results show the value of MR imaging
      with an endorectal surface coil in the examination of patients with ejaculatory
      dysfunction.

PMID- 1632353
TI  - Radiologic findings of diseases involving the maxilla and mandible.
AB  - The purpose of this pictorial essay is to illustrate the radiologic appearances
      of diseases involving the maxilla and mandible. The high prevalence of dental
      disease results in inflammatory, infectious, and reactive processes that must be
      distinguished from more serious conditions with similar radiologic features.
      Because of their association with odontogenic tissues, lesions of the maxilla and
      mandible may have radiologic findings not seen in other bones. Furthermore,
      nonodontogenic cysts and tumors that occur elsewhere in the skeleton may exhibit
      unique radiologic characteristics when associated with teeth. This pictorial
      essay presents the radiologic characteristics of inflammatory lesions,
      developmental abnormalities, fibroosseous lesions, benign cysts and tumors, and
      malignant lesions of the maxilla and mandible.

PMID- 1632354
TI  - Width of the articular cartilage of the hip: quantification by using fat
      suppression spin-echo MR imaging in cadavers.
AB  - OBJECTIVE: Use of MR imaging to measure the width of the articular cartilage has
      not been thoroughly investigated. The value of a selective fat-suppression spin
      echo sequence in the quantitative assessment of articular cartilage of the hip
      was studied in cadavers. MATERIALS AND METHODS: Sagittal and coronal images were
      acquired in 10 cadaveric hips (age range at time of death, 62-81 years). On the
      coronal and sagittal MR images that were closest to the center of the femoral
      head, marks were placed every 30 degrees, with the midpoint of the femoral head
      used as a reference. Cartilage thickness was measured in 123 resulting locations.
      Sixty-three positions included both femoral and acetabular cartilages, and 60
      positions included femoral cartilage without an acetabular counterpart. The
      findings were compared with corresponding anatomic sections. RESULTS: For the 60
      locations containing only femoral cartilage, significant correlation between MR
      and anatomic sections was found (Pearson correlation coefficient = .34, p =
      .0089). Of the 63 locations containing both femoral and acetabular cartilages,
      the two cartilage layers could be differentiated on the MR images in 50
      locations. In these 50, the MR and anatomic measurements of the femoral cartilage
      correlated significant (r = .58, p less than or equal to .0001). Measurements of
      the acetabular cartilage in these 50 locations yielded no significant correlation
      (r = .25, p = .08). When the entire cartilage (femoral plus acetabular) was
      measured in all 63 locations, the correlation between MR and anatomic
      measurements was .29 (p = .02). The correlation coefficients obtained in this
      investigation indicate considerable scattering of the data. CONCLUSION: Our
      results show that measurements of articular cartilage thickness of the hip on fat
      suppression spin-echo MR images are not sufficiently accurate to be of clinical
      value.

PMID- 1632355
TI  - The cruciate ligaments of the knee: correlation between MR appearance and gross
      and histologic findings in cadaveric specimens.
AB  - OBJECTIVE: Using anatomic and histologic correlation, we investigated the reasons
      for differences in the MR signal intensity between the normal anterior and
      posterior cruciate ligaments and for the focally increased signal intensity
      within these ligaments occasionally found in elderly patients. MATERIALS AND
      METHODS: The MR images of 18 anterior and 20 posterior cruciate ligaments
      obtained from cadavers (age at death, 56-88 years old; mean, 74 years) were
      evaluated blindly. Their overall signal intensity and focal regions of increased
      signal were noted. The findings then were correlated with corresponding anatomic
      and histologic sections. RESULTS: The anterior cruciate ligament had greater
      signal intensity than did the posterior cruciate ligament in 15 of 18 knees and
      had comparable signal intensity in three knees. No histologic basis to explain
      the different MR appearances of the anterior and posterior cruciate ligaments was
      found. Rather, differences in macroscopic anatomy appeared to be the best
      explanation. In the posterior cruciate ligament, the fibers were parallel,
      whereas they were diverging and twisted in the anterior cruciate ligament,
      causing volume-averaging artifacts. A focal area of signal increase was found in
      29 of the 38 ligaments. In 17 of these 29 ligaments, mucoid and/or eosinophilic
      degeneration was found that appeared to have caused the focal MR signal change.
      In nine ligaments without focally increased signal on the MR images, only one had
      histologic evidence of degeneration. The predictive value of an abnormal finding
      on MR was 59%, and the predictive value of a normal finding on MR was 89%. The
      relationship between increased signal on MR and histologic degeneration was
      statistically significant (chi 2 test, p = .0126). CONCLUSION: The differences in
      the MR appearances of the anterior and posterior cruciate ligaments probably are
      due to differences in gross architecture. Increased MR signal within the cruciate
      ligaments occurring in elderly patients often can be attributed to degenerative
      changes.

PMID- 1632356
TI  - Knee effusion: normal distribution of fluid.
AB  - Although visualization of articular fluid on MR images of the knee is common, no
      specific MR criteria that enable assessment of the quantity of the effusion have
      been established. We performed MR of three cadaveric knee specimens after the
      instillation of increasingly large volumes of fluid and studied the distribution
      of the fluid. When 4 ml of fluid was injected, the anteroposterior diameter of
      the suprapatellar recess was 4 mm on midline sagittal MR images and 10.0-12.5 mm
      on lateral sagittal MR images, corresponding to the usual routine radiographic
      criteria for a knee effusion.

PMID- 1632357
TI  - Cerebral angiography and Egas Moniz.

PMID- 1632358
TI  - Value of acute-phase angiography in the detection of vascular injuries caused by
      gunshot wounds to the head: analysis of 12 cases.
AB  - A study of the angiographic findings in consecutive civilian patients with
      cranial gunshot wounds examined in the acute stage has not been done. Most prior
      clinical studies have evaluated the findings in survivors in the subacute or
      chronic stages and have often been of war-time casualties. We determined the
      clinicoradiologic features of six cases of posttraumatic intracranial aneurysm,
      vascular occlusion, or arteriovenous fistula caused by penetrating missiles among
      12 civilian patients who were examined in the acute posttraumatic stage (within
      48 hr of injury) during a 1-year period. Three internal carotid/vertebral artery
      aneurysms, one external carotid artery aneurysm, one combined
      aneurysm/arteriovenous fistula of the vertebrobasilar circulation, and one
      cerebral venous occlusion were identified. The 50% overall prevalence of major
      vascular lesions in this series of civilian patients with penetrating missile
      injuries examined in the acute stage suggests these injuries are more common than
      previously suspected. It may indicate that selective cerebral angiography should
      be considered in the evaluation of the cranial vascular system of such persons.

PMID- 1632359
TI  - MR angiography of the head and neck: value of two-dimensional phase-contrast
      projection technique.
AB  - MR angiography is commonly performed by using two- and three-dimensional time-of
      flight and three-dimensional phase-contrast techniques. These procedures require
      long examination times and processing of imaging data by computing maximum
      intensity projections. Two-dimensional phase-contrast projection angiography has
      neither of these disadvantages. We analyzed the value of this technique for head
      and neck MR angiography in 84 patients and 15 control subjects. Patients were
      examined to resolve specific clinical questions such as the presence of
      arteriovenous malformations (20 cases), patency of carotid and vertebral arteries
      (35 cases), patency of the superior sagittal sinus (14 cases), patency of
      saphenous vein bypass grafts (11 cases), and vascularity of masses (four cases).
      Conventional angiograms were available for correlation in 22 patients. Two
      dimensional phase-contrast projection angiograms were generated by using a
      gradient-recalled-echo sequence sensitized to flow with the use of flow-encoding
      gradients. Projection MR angiograms were obtained in approximately 3.5 min by
      combining images obtained with flow-encoding gradients applied along the axes
      defining the image plane. MR angiograms were subjectively evaluated by three
      observers without reference to routine MR images or conventional angiograms. High
      quality studies were obtained in 93% of control subjects and 90% of patients
      examined. The findings based on phase-contrast angiography were confirmed with
      conventional angiography in 21 of 22 patients for whom conventional angiograms
      were available. Evaluation of vascular grafts and of the patency of major cranial
      vessels was easily done with two-dimensional phase-contrast angiography and was
      useful in postoperative follow-up examinations. We also advocate its use for
      superior sagittal sinus thrombosis and follow-up examinations in patients with
      arteriovenous malformations.

PMID- 1632360
TI  - MR imaging of the pituitary stalk: size, shape, and enhancement pattern.
AB  - The size, shape, signal intensity, and enhancement pattern of the normal
      pituitary stalk were determined retrospectively by review of MR images of 58
      patients. The pituitary stalk was measured at the level of the optic chiasm and
      at its insertion on the pituitary gland. The contour of the stalk was smoothly
      tapering, measuring 3.25 +/- 0.56 mm in transverse diameter at the optic chiasm
      and 1.91 +/- 0.40 mm at its pituitary insertion. The signal intensity of the
      pituitary stalk on unenhanced T1-weighted images was less than that of the
      neurohypophysis in all cases and less than that of the optic chiasm in 84% of the
      cases. After the administration of contrast material, enhancement of the
      pituitary stalk occurred in all cases. A central area of nonenhancement in an
      otherwise uniformly enhancing stalk was variably present, depending on the size
      of the infundibular recess. Our study defines the size, contour, and MR signal
      characteristics of the normal pituitary stalk. These criteria can be used to
      distinguish the normal from the abnormal stalk.

PMID- 1632361
TI  - Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14
      cases.
AB  - Hypertensive encephalopathy is a syndrome consisting of headache, seizures,
      visual changes, and other neurologic disturbances in patients with elevated
      systemic blood pressure. The purpose of this study was to analyze the imaging
      findings in 14 patients with hypertensive encephalopathy. CT (n = 13), MR (n =
      12), and single-photon emission computed tomography (n = 2) examinations
      performed in these patients before and after resolution of symptoms were
      reviewed. Eight had the preeclampsia-eclampsia syndrome, and six had hypertensive
      encephalopathy due to other causes. CT and MR findings in all patients having
      these examinations were indicative of edema in the cortex and subcortical white
      matter in the occipital lobes. Two of the 14 patients also had similar findings
      in the cerebellum and frontal lobes. Single-photon emission computed tomography
      showed increased vascular perfusion adjacent to areas that appeared abnormal on
      CT and MR. The findings on the imaging studies resolved on follow-up examinations
      performed after the hypertension was corrected. Our results suggest that the
      radiologic findings associated with hypertensive encephalopathy may be useful in
      establishing the diagnosis in the appropriate clinical setting.

PMID- 1632362
TI  - Gadopentetate dimeglumine-enhanced MR imaging of the postoperative lumbar spine:
      comparison of fat-suppressed and conventional T1-weighted images.
AB  - OBJECTIVE: Gadopentetate dimeglumine-enhanced T1-weighted MR imaging has been
      used to distinguish epidural fibrosis from recurrent disk herniation in the
      postoperative lumbar spine. Potential interpretative difficulties relate to
      detection of subtle contrast enhancement and distinction of enhanced tissue from
      surrounding epidural fat. The objective of this study was to evaluate the utility
      of fat-suppressed T1-weighted imaging in improving the depiction of postoperative
      abnormalities. SUBJECTS AND METHODS: Forty-one patients with recurrent signs and
      symptoms after previous laminectomy and diskectomy were examined with
      conventional and fat-suppressed T1-weighted imaging before and after IV
      administration of gadopentetate dimeglumine. MR images were analyzed for the
      presence or absence of an epidural soft-tissue mass located anterior and/or
      lateral to the thecal sac. When such masses were identified, their contrast
      enhancement behavior was characterized according to the volume, intensity, and
      pattern of enhancement. Epidural fibrosis was diagnosed by using established MR
      imaging criteria. In patients with evidence of recurrent disk herniation,
      diagnosis was based on surgery in six patients and on MR imaging findings in the
      remainder. RESULTS: Soft-tissue masses were present at 32 of the 43 levels
      operated on, representing epidural fibrosis (n = 21) or disk herniation (n = 11).
      Fat suppression improved depiction of contrast enhancement associated with sites
      of epidural fibrosis. The extent, intensity, and homogeneity of enhancement was
      greater with fat suppression than with conventional imaging, although the ability
      to distinguish epidural fibrosis from recurrent disk herniation was not improved.
      CONCLUSION: Use of the fat-suppression technique results in increased relative
      intensity and homogeneity of contrast enhancement associated with sites of
      epidural fibrosis. However, it does not result in significant improvement in the
      ability to differentiate fibrotic tissue from recurrent disk herniation. Fat
      suppression does not appear to be indicated for routine use in imaging of the
      postoperative lumbar spine, but may be useful as a problem-solving tool in
      selected patients.

PMID- 1632364
TI  - Fast spin-echo high-resolution MR imaging of the inner ear.
AB  - Advances in MR imaging continue to improve our ability to evaluate temporal bone
      anatomy and disease. CT remains the procedure of choice for fine-detail imaging
      of bone structures such as ossicular anatomy, but it is not the ideal imaging
      technique for soft-tissue structures (e.g., the membranous labyrinth and neural
      structures). Conventional spin-echo MR techniques used to image these structures
      cannot yield excellent contrast and spatial resolution in clinically acceptable
      time frames. Conventional spin-echo T1-weighted images lack tissue contrast
      between fluid (e.g., CSF, endolymph, perilymph), neural tissue, otic capsule
      septa, and surrounding temporal bone. Conventional T2-weighted imaging of the
      inner ear is needed to reveal the natural contrast between fluid, neural
      structures, and bone; unfortunately, the use of conventional T2-weighted images
      is limited by time constraints when large-matrix, thin-section techniques with
      more than one excitation are used. Fast spin-echo imaging is a recently developed
      technique that can provide T2-weighted, thin-section (2-mm) high-resolution
      images with excellent contrast in a fraction of the time needed for conventional
      spin-echo techniques. This speed advantage allows us to obtain high-resolution
      images in clinically acceptable time frames. Images produced by this technique
      are a useful addition, in conjunction with routine T1- and T2-weighted spin-echo
      images, in the diagnosis of disorders of the inner ear.

PMID- 1632363
TI  - Ganglioglioma with leptomeningeal and subarachnoid spread: results of CT, MR, and
      PET imaging.

PMID- 1632365
TI  - Primary endodermal sinus tumor of the orbit: MR findings.

PMID- 1632366
TI  - Diagnosis of von Hippel-Lindau disease in a patient with blindness resulting from
      bilateral optic nerve hemangioblastomas.

PMID- 1632367
TI  - Influence of the stopcock on the efficiency of percutaneous drainage catheters:
      laboratory evaluation.
AB  - The effects of stopcocks on percutaneous fluid drainage were tested in a
      laboratory model by using a standard stopcock (6-French inner diameter) and a
      prototype stopcock (9-French inner diameter) connected to 8-, 10-, 12-, 14-, and
      16-French catheters. Catheters were immersed in water alone or in viscous fluid
      with particulate matter, and the system was connected to low wall suction or
      gravity drainage. The average volume of fluid aspirated in a given period with
      and without a stopcock was compared for each catheter. The standard stopcock
      decreased drainage efficiency for these catheters by 13-42%. This decreased
      drainage efficiency was worse with the larger catheters. Particulate fluid
      blocked the stopcock connection for all catheters. With the prototype stopcock,
      drainage of water alone was reduced by 0-9% for the catheters of different sizes.
      Particulate fluid did not obstruct the prototype stopcock with any size catheter.
      With gravity drainage, the volume of water aspirated was reduced by 12-42% with
      the standard stopcock and by 3-6% with the prototype stopcock. These data suggest
      that stopcock connections greatly influence the efficiency of the percutaneous
      drainage systems. Stopcocks with larger inner diameters may improve drainage over
      that achievable with the stopcocks that are currently available.

PMID- 1632368
TI  - Percutaneous extraction of biliary stones: value of endoluminal sonography.

PMID- 1632369
TI  - Desperately seeking reimbursement.

PMID- 1632370
TI  - The selling of a profession.

PMID- 1632371
TI  - Mycotic aneurysm of the bronchial artery: a rare cause of hemoptysis.

PMID- 1632372
TI  - Localized large benign fibroma of the pleura in Poland's syndrome.

PMID- 1632373
TI  - Pulmonary sequestration: diagnosis based on MR angiographic findings.

PMID- 1632374
TI  - Hair as a mammographic artifact.

PMID- 1632375
TI  - Low-cost screening mammography.

PMID- 1632376
TI  - Gastroduodenal intussusception due to a prolapsed gastric adenoma.

PMID- 1632377
TI  - Ligamentous compression of the celiac axis.

PMID- 1632378
TI  - Bilateral posttraumatic adrenal hemorrhage detected with CT.

PMID- 1632379
TI  - Meniscal tears in marathon runners.

PMID- 1632380
TI  - Transfemoral venous catheterization through inferior vena caval filters.

PMID- 1632381
TI  - Periocular pseudocyst caused by a displaced contact lens: CT appearance.

PMID- 1632382
TI  - CT of schizencephaly.

PMID- 1632383
TI  - Highlights of the ninth annual Rheumatology on the Beach.

PMID- 1632384
TI  - Panic disorder and pregnancy.

PMID- 1632385
TI  - Evaluating pain treatment programs: a literature review.
AB  - The impetus for this project is an attempt to describe by comparison and
      literature review a pain control program that would provide active patient
      participation in a highly structured, intense, objectively graded program of
      comprehensive functional restoration that meets governmental, medical, moral, and
      ethical standards. Brena indicates that "...there are too many facilities which
      claim to be pain clinics ... bewildering physicians about their choice for
      referring their patients."

PMID- 1632386
TI  - How do you know when someone is in good recovery?

PMID- 1632387
TI  - Association of patency of the infarct-related coronary artery with plasma levels
      of plasminogen activator inhibitor activity in acute myocardial infarction.
AB  - To examine the fibrinolytic capacity in patients with acute myocardial infarction
      (AMI), baseline levels of plasma plasminogen activator inhibitor (PAI) activity
      and tissue-type plasminogen activator (t-PA) antigen were measured in 47 patients
      with Q-wave AMI who underwent emergent coronary angiography 3.0 +/- 0.2 hours
      after the symptom onset. They received intracoronary injection of urokinase if
      their infarct-related arteries were occluded. They were classified into 3 groups
      according to the patency of the infarct-related artery before and after
      thrombolytic therapy: the patent group (13 patients), the recanalized group (23
      patients) and the occluded group (11 patients). The mean level of plasma PAI
      activity (IU/ml) was higher in patients with AMI as a whole than in the control
      group (12.8 +/- 1.6 vs 5.4 +/- 0.5, p less than 0.01). The level was lower in the
      patent group (3.0 +/- 1.1) and higher in the recanalized (18.6 +/- 2.2) and
      occluded (10.8 +/- 2.5) groups than in the control group (each p less than 0.01).
      The level was lower in the occluded than in the recanalized group (p less than
      0.01) and 62% of the patients in the occluded group had levels within range of
      the control group. The mean level of plasma t-PA antigen (ng/ml) was higher in
      patients with AMI as a whole than in the control group (10.3 +/- 0.8 vs 5.8 +/-
      0.3, p less than 0.01). There was no difference in the level among the 3 groups
      with AMI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632388
TI  - Clinical, angiographic and anatomic findings in acute severe ischemic mitral
      regurgitation.
AB  - Severe mitral regurgitation (MR) due to coronary artery disease unfavorably
      alters prognosis for medical therapy and is also associated with increased
      surgical mortality. In this report, the clinical, angiographic and pathoanatomic
      findings in 50 consecutive patients with severe ischemic MR were characterized.
      Forty-two patients (84%) either presented with acute myocardial infarction or a
      well-documented prior infarction. Eleven patients (22%) were in cardiogenic shock
      at the time of catheterization. Forty patients (80%) had greater than 70%
      stenosis of the right and left circumflex coronary arteries with or without left
      anterior descending coronary artery stenosis. Segmental asynergy of the left
      ventricular wall was present in 48 patients (96%) and involved the inferior wall
      in 43 (86%). Mean ejection fraction for the group was 51 +/- 7%. A total of 15
      patients had direct inspection of the mitral valve apparatus at surgery or
      autopsy. Posteromedial papillary muscle involvement was found in 14 patients,
      fibrosis or necrosis in 10 and rupture in 4, with anterolateral papillary muscle
      rupture in 1 patient. Thus, acute severe ischemic MR is usually associated with
      significant narrowing of both right and left circumflex coronary arteries, and
      posteromedial papillary muscle involvement.

PMID- 1632389
TI  - Effects of anger on left ventricular ejection fraction in coronary artery
      disease.
AB  - This study examined the comparative potency of several psychological stressors
      and exercise in eliciting myocardial ischemia as measured by left ventricular
      (LV) ejection fraction (EF) changes using radionuclide ventriculography. Twenty
      seven subjects underwent both exercise (bicycle) and psychological stressors
      (mental arithmetic, recall of an incident that elicited anger, giving a short
      speech defending oneself against a charge of shoplifting) during which EF, blood
      pressure, heart rate and ST segment were measured. Eighteen subjects had 1-vessel
      coronary artery disease (CAD), defined by greater than 50% diameter stenosis in 1
      artery as assessed by arteriography. Nine subjects served as healthy control
      subjects. Anger recall reduced EF more than exercise and the other psychological
      stressors (overall F [3.51] = 2.87, p = .05). Respective changes in EF for the
      CAD patients were -5% during anger recall, +2% during exercise, 0% during mental
      arithmetic and 0% during the speech stressor. More patients with CAD had
      significant reduction in EF (greater than or equal to 7%) during anger (7 of 18)
      than during exercise (4 of 18). The difference in EF change between patients with
      CAD and healthy control subjects was significant for both anger (t25 = 2.23, p =
      0.04) and exercise (t25 = 2.63, p = 0.01) stressors. In this group of patients
      with CAD, anger appeared to be a particularly potent psychological stressor.

PMID- 1632390
TI  - Effects of 8:00 a.m. and 2:00 p.m. doses of isosorbide-5-mononitrate during twice
      daily therapy in stable angina pectoris.
AB  - "Trough" plasma concentrations of isosorbide-5-mononitrate (IS-5-MN), an active
      metabolite of isosorbide dinitrate, of less than 95 ng/ml are considered
      necessary to prevent development of tolerance to isosorbide dinitrate and IS-5
      MN. In a double-blind, crossover, placebo-controlled study, the effects of IS-5
      MN during twice daily eccentric therapy were evaluated in 18 patients with
      reproducible exercise-induced angina who were nitrate responders. In a random
      order, patients received either placebo or IS-5-MN (20 mg) at 8 a.m. and 2 p.m.
      for 1 week each. Average trough plasma IS-5-MN concentrations before the 8 a.m.
      and 2 p.m. doses were 67 and 226 ng/ml, respectively, and increased to 382 and
      488 ng/ml 2 hours after the 8 a.m. and 2 p.m. doses, respectively. Despite a more
      than threefold higher trough plasma IS-5-MN concentration before the 2 p.m. dose
      than before the 8 a.m. dose, the increase in exercise duration 2 hours after the
      doses was similar (1.21 minutes [21%] after 8 a.m. dose, and 1.08 minutes [19%]
      after 2 p.m. dose). These increases in exercise duration after IS-5-MN were
      significantly (p less than 0.01) greater than those observed after placebo (0.17
      minutes [3%] after 8 a.m. dose, and -0.05 minute [-0.5%] after 2 p.m. dose).
      Reduction in standing systolic blood pressure at 2 hours after the doses was also
      nearly identical after the 8 a.m. and 2 p.m. doses of IS-5-MN (21 [15%] and 19
      [14%] mm Hg, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632391
TI  - Background and methods for the lovastatin restenosis trial after percutaneous
      transluminal coronary angioplasty. The Lovastatin Restenosis Trial Study Group.
AB  - Restenosis remains a critical limitation of percutaneous transluminal coronary
      angioplasty (PTCA). Recent experimental and clinical data have suggested that
      lovastatin, an hydroxymethylglutaryl coenzyme A reductase inhibitor, may reduce
      the rate of restenosis through reduction of low density-lipoprotein (LDL)
      cholesterol or possibly by direct effects. Lovastatin may therefore produce
      favorable alterations in endothelial healing, resulting in a decreased smooth
      muscle cell proliferative response to injury after angioplasty. Emory University,
      in conjunction with Merck Research Laboratories, has initiated a 10-center double
      blinded, placebo-controlled, randomized trial to assess the effect of both
      pretreatment and aggressive lipid lowering with lovastatin in reducing the rate
      of restenosis. Lovastatin achieves approximately 75% of its effect on LDL
      cholesterol by 1 week. Thus, patients scheduled for PTCA are randomly assigned
      pretreatment with lovastatin, 40 mg twice daily, or placebo 7 to 10 days before
      PTCA. Therapy is continued for 6 months, at which time repeat coronary
      arteriography is performed. A detailed safety algorithm was designed, with
      patients receiving lovastatin and matching placebo back-titrated on a 1:1 basis
      for LDL cholesterol less than 50 mg/dl. The power is a 90%, alpha = 0.05, 2
      tailed test to reduce restenosis from 30 to 15%. The sample size is 360 patients
      in the 2 arms; allowing for a 10% dropout rate, approximately 400 patients will
      be randomized. Patients with successful PTCA, less than 50% residual diameter
      stenosis and greater than or equal to 20% diameter stenosis reduction are
      analyzed for restenosis at 4 to 6 months by quantitative coronary
      arteriography.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632392
TI  - Usefulness of left ventricular size and function in predicting survival in
      chronic dialysis patients with diabetes mellitus.
AB  - To identify patients at high risk for sudden death, a group of stable patients on
      maintenance dialysis with diabetes mellitus were studied for up to 135 months to
      determine if there were clinical, laboratory or echocardiographic predictors of
      high risk. Eighty-two patients on maintenance dialysis who underwent clinical,
      laboratory evaluation and echocardiography were enrolled and followed for a mean
      of 25 months for cardiac and noncardiac complications. Thirty-seven patients with
      normal wall motion and left ventricular (LV) internal diameter had a mean
      survival of 35.8 months; 28 patients survived greater than 12 months. Seven
      patients with normal LV wall motion and dilated LV cavities had a mean survival
      of 45.7 months; 7 patients survived greater than 12 months. Fifteen patients with
      abnormal LV wall motion and normal internal LV dimensions had a mean survival of
      17 months; 7 patients survived greater than 12 months. Twenty-three patients with
      both abnormal LV wall motion and dilated LV cavities had a mean survival of 7.8
      months; 5 patients survived greater than 12 months. Although echocardiographic
      abnormalities predicted cardiac mortality at 6 and 12 months, the combination of
      an abnormal standard electrocardiogram at baseline, clinical history of angina
      pectoris, and prior documented myocardial infarction or congestive heart failure
      did not. When the study group was divided by mode or duration of dialysis,
      presence or absence of diabetes, or use of cardioactive drugs, echocardiographic
      LV wall motion abnormalities remained the most important determinant of survival.

PMID- 1632393
TI  - Prospective comparison of biphasic and monophasic shocks for implantable
      cardioverter-defibrillators using endocardial leads.
AB  - Bidirectional shocks using 2 current pathways have been used in endocardial lead
      systems for implantable cardioverter-defibrillators, but the optimal shock
      waveform for endocardial defibrillation is unknown. The clinical efficacy and
      electrical characteristics of bidirectional monophasic and biphasic shocks for
      endocardial cardioversion-defibrillation of fast monomorphic or polymorphic
      ventricular tachycardia (VT), or ventricular fibrillation (VF) were evaluated.
      Thirty-three patients (mean age 60 +/- 12 years, and mean left ventricular
      ejection fraction 34 +/- 13%) were studied. Defibrillation catheter electrodes
      were located in the right ventricular apex and superior vena cava/right atrial
      junction. A triple-electrode configuration including the 2 catheter electrodes
      and a left thoracic patch was used to deliver bidirectional shocks from the right
      ventricular cathode to an atrial anode (pathway 1) and the thoracic patch
      (pathway 2). The shock waveforms examined were sequential and simultaneous
      monophasic, and simultaneous biphasic. The efficacy of 580 V (20 J) shocks for
      fast monomorphic VT were comparable for the 3 waveforms (73% for sequential
      monophasic, 73% for simultaneous monophasic, and 100% for simultaneous biphasic).
      However, for polymorphic VT and VF, 580 V sequential monophasic shocks had a
      significantly lower efficacy (25%) than did simultaneous monophasic (75%; p =
      0.01) or biphasic (89%; p less than 0.001) shocks. Single-shock defibrillation
      thresholds with simultaneous biphasic shocks were significantly lower (9 +/- 5 J)
      than were those with simultaneous monophasic shocks (15 +/- 4 J; p less than
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632394
TI  - Comparison of decremental and burst overdrive pacing as treatment for ventricular
      tachycardia associated with coronary artery disease.
AB  - Several forms of antitachycardia pacing have been used successfully for
      terminating cardiac arrhythmias, and implantable devices now incorporate a tier
      of overdrive pacing for treating of ventricular tachycardia (VT). No consensus
      exists regarding the optimal mode of pacing therapy. Accordingly, a prospective,
      randomized, crossover study of antitachycardia pacing was performed to analyze
      the effects of 2 decremental forms (10 and 5 ms) and a synchronized burst
      overdrive pacing mode on episodes of VT. Overdrive antitachycardia pacing was an
      effective therapy (78%) for terminating VT. Burst overdrive pacing and an
      autodecremental pacing protocol, incorporating a 10 ms decrement, were found to
      be effective and comparable forms of therapy. Both of these pacing methods were
      superior in terminating VT when compared with a pacing scheme using a 5 ms
      coupling decrement (p less than 0.01). Tachycardia acceleration occurred in 6.4%
      of the episodes of VT. None of the pacing methods displayed a specific propensity
      for tachycardia acceleration, and no measure of tachycardia segments identified a
      predilection for pace terminability. Antitachycardia pacing is an effective
      therapy for VT and different pacing formulas have variable effects. Further,
      these effects appear to be independent of tachycardia cycle length and
      variability.

PMID- 1632395
TI  - Establishment of signal-averaged electrocardiographic criteria with Frank XYZ
      leads and spectral filter used alone and in combination with ejection fraction to
      predict inducible ventricular tachycardia in coronary artery disease.
AB  - Signal-averaged electrocardiographic criteria are reported for corrected Frank
      XYZ leads and a spectral filter. The new criteria were used alone and in
      combination with ejection fraction to predict inducibility of ventricular
      tachycardia (VT) at electrophysiologic testing. Signal-averaged
      electrocardiographic criteria were developed in 87 control subjects and validated
      in 182 patients (aged 63 +/- 10 years) with coronary artery disease and QRS
      duration less than 118 ms. Patients underwent electrophysiologic testing in which
      up to 3 extra-stimuli were used during 2 paced drives from 2 right ventricular
      sites. A positive finding was monomorphic VT lasting 30 seconds or needing
      intervention. An ejection fraction less than 40% was considered abnormal. Signal
      averaged electrocardiographic variables that best characterized control subjects
      and separated patients with and without inducible VT were filtered QRS duration
      less than 120 ms, low-amplitude signal duration less than 38 ms and root-mean
      square voltage greater than 20 muv. With these criteria, signal-averaged
      electrocardiographic and ejection fraction sensitivities were 87 and 45%,
      respectively, and specificities were 65 and 77%, respectively. Combining signal
      averaged electrocardiography with ejection fraction improved the predictive
      accuracy. In conclusion, diagnostic criteria for signal-averaged
      electrocardiography with use of Frank XYZ leads and a spectral filter produced
      results similar to those reported for use of bipolar XYZ leads and a Butterworth
      filter. Signal-averaged electrocardiography was a better predictor of VT than was
      ejection fraction.

PMID- 1632396
TI  - Comparison of direct-current and radiofrequency ablation of free wall accessory
      atrioventricular pathways in the Wolff-Parkinson-White syndrome.
AB  - To evaluate and compare the safety and efficacy of catheter-mediated direct
      current (DC) or radiofrequency (RF) ablation in patients with free wall accessory
      atrioventricular pathways, 95 patients with free wall accessory atrioventricular
      pathway-mediated tachyarrhythmias underwent catheter ablation. Immediately after
      ablation, 27 of 30 accessory pathways (90%) were ablated successfully with DC,
      but 2 of the 27 had early return of conduction and received a second ablation
      session; 3 of 8 (38%) and 57 of 62 (92%) accessory pathways were ablated
      successfully with RF through a small-tip (2 mm) and a large-tip (4 mm) electrode
      catheter, respectively. Complications in DC ablation included transient
      hypotension (2 patients) and pulmonary air-trapping (2 patients) and in RF
      ablation, cardiac tamponade (1 patient) and suspicious aortic dissection (1
      patient); myocardial injury and proarrhythmic effects were more severe in DC
      ablation. Procedure and radiation exposure time were significantly longer in RF
      ablation (DC, 3.6 +/- 0.2 hours, 34 +/- 4 minutes; RF 4.2 +/- 0.5 hours, 50 +/-
      10 minutes). This study confirms that RF ablation is associated with little
      morbidity and few complications, and RF ablation with a large-tip electrode
      catheter is an effective and relatively safe nonsurgical method for treatment of
      free wall accessory atrioventricular pathway-mediated tachyarrhythmias.

PMID- 1632397
TI  - Clinical implications of left atrial spontaneous echo contrast in nonrheumatic
      atrial fibrillation.
AB  - The prevalence and clinical significance of left atrial (LA) spontaneous echo
      contrast were investigated in 103 consecutive patients with chronic nonrheumatic
      atrial fibrillation (AF) using transesophageal echocardiography. LA spontaneous
      echo contrast was visualized in 25 of 103 patients (24.3%). Age, sex, LA
      diameter, left ventricular diastolic and systolic dimensions, left ventricular
      ejection fraction, and the percentage of lone AF were not significantly different
      between patients with and without LA spontaneous echo contrast; however, those
      with LA spontaneous echo contrast were less likely to have moderate or severe
      mitral regurgitation. LA thrombi were observed in 7 patients (6.8%), and all 7
      thrombi were found in the atria with spontaneous echo contrast. History of
      cerebral ischemia or peripheral embolism, or both, was significantly more
      frequent in patients with than without LA spontaneous echo contrast (84 vs 18%; p
      less than 0.001). The presence of LA spontaneous echo contrast was highly
      specific (94%) and predictive for thromboembolic events (positive and negative
      predictive values of 84 and 82%, respectively). Thus, transesophageal echo
      detected LA spontaneous echo contrast is frequently found in patients with
      chronic nonrheumatic AF. This phenomenon may represent a precursor of thrombus
      formation, and its presence is associated with an increased thromboembolic risk.

PMID- 1632398
TI  - Relation between QT and RR intervals during exercise testing in atrial
      fibrillation.
AB  - The ability to predict the RR-QT relation over a range of heart rates was
      evaluated in 10 patients with atrial fibrillation (AF) and in 10 control subjects
      in sinus rhythm. The data from each subject were fitted by regression into 3 QT
      prediction formulas (the square root formula of Bazett, the cube root formula of
      Fridericia and the exponential formula of Sarma) applied in standard form and
      modified with a weighted average of the preceding 5 RR intervals. The goodness-of
      fit of each formula was evaluated using mean square residual and Akaike
      information criterion. For AF, the mean square residuals did not differ among the
      3 standard QT prediction formulas (Bazett 624 +/- 274, Fridericia 625 +/- 274 and
      Sarma 611 +/- 267) and among the 3 modified QT prediction formulas (Bazett 507 +/
      325, Fridericia 496 +/- 255 and Sarma 495 +/- 328). The weighted average
      modification produced a significant decrease in mean square residuals for all 3
      equations (p less than 0.05) in all patients. These findings were confirmed by
      Akaike information criterion. Goodness-of-fit in sinus rhythm was similar to
      previously published reports, and significantly better than the fit for AF (p
      less than 0.0001). For 9 of the 10 patients with AF, sinus rhythm
      electrocardiograms were obtained and the above regression equations were used to
      predict QT intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632399
TI  - A controlled trial of acute and long-term medical therapy in tilt-induced
      neurally mediated syncope.
AB  - To study the efficacy of medical treatment for preventing syncopal recurrences in
      patients affected by tilt-induced neurally mediated syncope, a randomized placebo
      treatment prospective study was performed in 30 patients (10 men and 20 women,
      mean age 42 +/- 21 years) who had syncope reproduced in 2 consecutive head-up
      tilt-table tests without pharmacologic intervention (n = 20) or during
      isoproterenol infusion (n = 10). Patients were randomly assigned to 2 groups: 15
      to placebo, and 15 to drug therapy (determined on the basis of serial
      pharmacologic tilting tests). Therapy was either atenolol (n = 7),
      dihydroergotamine (n = 2), domperidone (n = 2), cafedrine (n = 1), or elastic
      compression stockings, alone or in association with drugs (n = 3). During a mean
      of 10 +/- 7 months of follow-up, syncope recurred in 3 patients (20%) in the
      treatment group and in 4 (27%) in the placebo group; actuarial rates of absence
      of syncopal recurrences after 20 months were 70 and 67%, respectively. Thus, the
      outcome of either treated or untreated patients was favorable (with a low
      recurrence rate of syncope), and the usefulness of tilting-guided medical therapy
      remains uncertain.

PMID- 1632400
TI  - Accuracy of various methods of localization of the orifice of the coronary sinus
      at electrophysiologic study.
AB  - The coronary sinus (CS) orifice is an important reference point for determining
      electrode and, thereby, accessory pathway location at electrophysiologic study.
      The reliability of fluoroscopic landmarks used to identify the CS orifice is not
      known. This study compared the accuracy of several fluoroscopic landmarks for
      identifying the CS orifice with the location defined by radiopaque contrast
      injection of the CS. Forty patients were studied. Radiographic markers of the CS
      orifice that were examined included: (1) the point at which the CS catheter
      prolapsed during advancement, (2) the point of maximum convexity of the CS
      catheter when a superior vena caval approach was used, (3) the right side of the
      ventricular septum, and (4) the relation to the underlying vertebrae. The least
      significant difference method of multiple comparisons was used for statistical
      analysis. The point at which the CS catheter prolapsed was the most accurate
      noncontrast method for determining the location of the CS orifice (p less than
      0.05), but was possible without the use of excessive force in only 48% of
      patients. The point of catheter prolapse was a median of 1 mm (range 0 to 11)
      from the true location of the os. Errors with other examined landmarks ranged up
      to 3 cm. Identification of the CS orifice is best performed by radiopaque
      contrast injection. The point of prolapse during catheter advancement in the CS
      is an accurate alternative when contrast injection is not feasible. Other
      noncontrast fluoroscopic landmarks are less reliable and are best
      avoided.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632401
TI  - Studies of Left Ventricular Dysfunction (SOLVD) Registry: rationale, design,
      methods and description of baseline characteristics.
AB  - The Studies of Left Ventricular Dysfunction (SOLVD) comprises 2 double-blind,
      randomized clinical trials to test improved survival by angiotensin-converting
      enzyme inhibitor in patients with left ventricular dysfunction, with or without
      congestive heart failure. Patients entering the trials may be a highly selected
      subset of the population of such patients; those with the worst and best
      prognosis are likely to be excluded. To obtain the clinical history of a broader
      group, a registry of 6,273 patients included a relatively unselected cohort of
      patients with heart failure or left ventricular dysfunction, or both, from SOLVD
      hospitals. Registry data were obtained from hospital records. Because data
      collection from medical records may lead to incomplete data and more
      investigations in "sicker" patients, 898 randomly chosen subjects from different
      disease strata were seen in clinic where neurohumoral measures, echocardiograms,
      x-rays and electrocardiograms were obtained, and a 6-minute walking test was
      performed. The design and methodologic features, and the baseline characteristics
      of the participants in this 2-tiered registry are described, and its use in
      complementing the results and interpretation of the SOLVD trials is discussed.

PMID- 1632402
TI  - Effects of once-daily benazepril therapy on exercise tolerance and manifestations
      of chronic congestive heart failure. The Benazepril Heart Failure Study Group.
AB  - The effects of the long-acting angiotensin-converting enzyme inhibitor benazepril
      hydrochloride on exercise tolerance and signs and symptoms of congestive heart
      failure (CHF) were evaluated in a double-blind, multicenter, placebo-controlled
      clinical trial. Patients with chronic New York Heart Association class II to IV
      symptoms of CHF and an ejection fraction by radionuclide scanning of less than or
      equal to 35% were randomized in a 2:1 ratio to treatment with ascending doses of
      oral benazepril (n = 114) or placebo (n = 58) once daily, while continuing to
      receive background therapy with digoxin and diuretics. After randomization,
      patients were evaluated clinically every 2 weeks during a 12-week, double-blind
      treatment period. Maximal exercise tolerance was measured before and at specified
      time points after randomization by graded treadmill exercise testing. At week 12,
      mean exercise time increased 95 +/- 12 (SEM) seconds in the group receiving
      benazepril, whereas the increase was 37 +/- 18 seconds in the group receiving
      placebo (p less than 0.01 for the difference between the groups). There was also
      greater improvement in overall clinical status and in the signs and symptoms of
      CHF in benazepril-treated patients than in control subjects. There were 3 deaths
      in placebo-treated patients and none in benazepril-treated patients (p less than
      0.05); the overall incidence of adverse effects was identical in the 2 groups.
      Benazepril is a well-tolerated angiotensin-converting enzyme inhibitor that
      provides clinically important improvement in exercise tolerance and in signs and
      symptoms when given once daily to patients with CHF receiving background therapy
      with digoxin and a diuretic.

PMID- 1632403
TI  - Comparison between New York Heart Association classification and peak oxygen
      consumption in the assessment of functional status and prognosis in patients with
      mild to moderate chronic congestive heart failure secondary to either ischemic or
      idiopathic dilated cardiomyopathy.
AB  - To compare the value of the New York Heart Association (NYHA) classification and
      measurement of peak oxygen consumption (VO2) in the assessment of functional
      status and prognosis in patients with mild to moderate chronic congestive heart
      failure (CHF), 94 patients with clinically stable NYHA class II and III CHF were
      prospectively studied. In all patients, left ventricular ejection fraction was
      less than or equal to 40% (mean 22 +/- 9); 49 patients were in NYHA class II, and
      45 were in NYHA class III. Mean peak VO2 was 17 +/- 5 ml/min/kg. During a follow
      up period of 23 +/- 11 months, 21 patients died. The 1-, 2- and 3-year cumulative
      survival rates for the 94 patients were 88, 79 and 69%, respectively. Functional
      status, as assessed both by peak VO2 and NYHA classification, and left
      ventricular ejection fraction were significantly worse in the group of
      nonsurvivors. The most powerful independent predictor of mortality was peak VO2.
      Although mean peak VO2 was significantly higher in NYHA class II than in NYHA
      class III (20 +/- 4 vs 13 +/- 3 ml/min/kg, p less than 0.0001), categorization
      into subgroups on the basis of the attained peak VO2 revealed a marked
      discrepancy with the NYHA classification. Nevertheless, the survival curves of
      patients subdivided at a peak VO2 of 16 ml/min/kg showed a strong resemblance
      with survival curves of both NYHA classes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632404
TI  - Ventricular septal defect in the first year of life.
AB  - Of approximately 22,000 live births in the region under study during the last 4
      years, ventricular septal defect (VSD) was identified as the primary or isolated
      congenital heart lesion in 124 infants who were followed up from birth for a
      minimum of 1 year (incidence, 5.7 per 1,000 live births). Doppler color flow
      mapping was performed in 93 of 124 patients; 47 had a muscular VSD and 46 had a
      perimembranous VSD. Only 1 patient had 2 muscular VSDs. None had a subpulmonic
      type of defect. Of 124 patients, 14 were lost to follow-up. Spontaneous closure
      was seen in 18 patients (42%) in the muscular group, in 9 (23%) in the
      perimembranous group and in 10 patients (37%) in the unclassified group by the
      end of the first year. The overall rate of spontaneous closure was 34% by the end
      of the first year. Congestive heart failure developed in 2 of 46 patients with
      muscular VSD and in 12 of 47 patients with perimembranous VSD. In the first year,
      2 patients with muscular VSD as opposed to 5 with perimembranous VSD required
      surgery. Doppler color flow mapping is a valuable aid in the diagnosis of VSD and
      may be one reason for the observed increase in the incidence of VSD. The overall
      prognosis appeared much better in the muscular than the perimembranous type of
      VSD.

PMID- 1632405
TI  - Changes in pulmonary hemodynamics with aging in a predominantly hypertensive
      population.
AB  - The impact of aging on pulmonary hemodynamics was investigated in 322 patients
      who underwent right- and left-sided cardiac catheterization and echocardiographic
      examination, and were free of coronary disease, impaired left ventricular
      systolic function and left ventricular dilatation. Most of the patients were
      black (83%) and hypertensive (78%). Mean pulmonary artery pressures increased
      progressively with age: 16.7 +/- 4.6, 17.9 +/- 6.4 and 20.6 +/- 8.0 mm Hg for
      those aged less than 45 (n = 50), 45 to 64 (n = 238) and greater than or equal to
      65 years (n = 34), respectively (p = 0.020). Pulmonary vascular resistance was 99
      +/- 42, 116 +/- 62 and 160 +/- 68 dynes s cm-5, and the ratio of pulmonary to
      systemic vascular resistance was 78, 80 and 105%, respectively, for the 3 age
      groups (p less than 0.001). Along with these changes, a decrease in cardiac
      output and an increase in systolic blood pressure and systemic vascular
      resistance with age were noted. The effect of age on mean pulmonary artery
      pressure and pulmonary vascular resistance was statistically significant after
      adjustment for gender, smoking status, body weight, left ventricular hypertrophy,
      systolic blood pressure and systemic vascular resistance. Consideration should be
      given to age-related changes in the pulmonary circulation when defining
      physiologically normal values.

PMID- 1632406
TI  - Left ventricular function and dimensions in newly diagnosed non-insulin-dependent
      diabetes mellitus.
AB  - Left ventricular (LV) function and dimensions were assessed with Doppler and M
      mode echocardiography in 26 men and 17 women with newly diagnosed non-insulin
      dependent diabetes mellitus, and in 13 healthy control men and 13 women. The
      diabetic men had lower peak filling rate normalized to mitral stroke volume than
      the control men (mean +/- standard error of the mean, 4.2 +/- 0.1 vs 4.9 +/- 0.3
      stroke volume/s, p less than 0.01). The diabetic women had increased LV mass (102
      +/- 12 vs 86 +/- 8 g/m2, p less than 0.01) and decreased fractional shortening
      (34 +/- 1 vs 38 +/- 1%, p less than 0.05) when compared with control women. At 3
      and 15 months, 23 diabetic men and 15 women were reexamined. Concomitantly with
      decreasing blood glucose levels, fractional shortening improved mainly during the
      first 3 months and was significantly higher in both diabetic men (36 +/- 2 vs 30
      +/- 2%, p less than 0.05) and women (38 +/- 1 vs 34 +/- 1%, p less than 0.05) at
      15 months than at baseline. In the diabetic men, peak filling rate increased from
      4.3 +/- 0.1 stroke volume/s at baseline to 4.8 +/- 0.2 stroke volume/s at 15
      months (p less than 0.05). At 15 months, peak filling rate was correlated (r =
      0.61, p less than or equal to 0.001) with autonomic nervous function assessed as
      heart rate variability during deep breathing test in diabetic men who also showed
      an inverse correlation between LV hypertrophy and heart rate variability
      throughout the follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632408
TI  - Questions unresolved by the Third International Study of Infarct Survival.

PMID- 1632407
TI  - Three-dimensional reconstruction of human carotid arteries from images obtained
      during noninvasive B-mode ultrasound examination.
AB  - Previous investigators have demonstrated that B-mode ultrasonography can provide
      high resolution images of the carotid arteries. When combined with Doppler flow
      measurements, quantitative estimates of luminal narrowing may also be obtained. B
      mode imaging is limited, however, in its ability to provide a composite view of
      the vessel wall, lumen and plaque. Spatial relations between structures
      visualized in individual frames must be inferred from repeated transducer passes
      over the designated site, or repeated review of recorded images, followed by a
      "mind's eye" reconstruction. Three-dimensional (3-D) reconstruction of serially
      recorded cross-sectional images from current B-mode systems represents a possible
      solution to this limited spatial display that preserves detail regarding vessel
      wall pathology. Accordingly, computer-based automated 3-D reconstruction was used
      to generate a tangible format with which to assess and compare serially and
      transcutaneously recorded 2-dimensional (2-D) B-mode images of the carotid
      arteries. One or more timed sweep recordings of the 2-D B-mode examination were
      obtained from 5 patients for 3-D reconstruction. In all cases, satisfactory 3-D
      reconstruction was accomplished in three 3-D formats: cylindrical, sagittal and
      lumen cast. Sagittal 3-D reconstruction provided information regarding pathologic
      alterations within the arterial wall. Experience with the cylindrical mode
      suggests that this 3-D format, particularly when the reconstructed vascular
      segment is hemisected, is optimally suited for those cases in which direct
      inspection of luminal topography is of special interest. The lumen cast display,
      used with a recently validated edge-detection algorithm, may enhance the use of B
      mode ultrasound for assessment of luminal cross-sectional area.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1632409
TI  - Good old boys, Texas, big numbers and coronary artery bypass grafting.

PMID- 1632410
TI  - Pulse oximetry in cyanotic congenital heart disease.

PMID- 1632411
TI  - Effects of homograft blood type and anatomic type on stenosis, regurgitation and
      calcium in homografts in the pulmonary position.

PMID- 1632412
TI  - Electrocardiographic features of restrictive pulmonary disease, and comparison
      with those of obstructive pulmonary disease.

PMID- 1632413
TI  - Usefulness of transesophageal echocardiography in diagnosing lipomatous
      hypertrophy of the atrial septum with comparison to transthoracic
      echocardiography.

PMID- 1632414
TI  - Spontaneous disappearance of cough induced by angiotensin-converting enzyme
      inhibitors (captopril or enalapril).

PMID- 1632415
TI  - Frequency of stress-induced thallium-201 defects in patients with patent internal
      mammary artery to the left anterior descending coronary artery graft.

PMID- 1632416
TI  - Angiographic follow-up after internal mammary artery graft angioplasty.

PMID- 1632417
TI  - Diagnostic significance of deep T-wave inversion induced by exercise testing in
      patients with suspected coronary artery disease.

PMID- 1632418
TI  - Increase in platelet support of thrombin generation after thrombolytic therapy.

PMID- 1632419
TI  - Prevalence of arrhythmias detected by 24-hour ambulatory electrocardiography and
      value of antiarrhythmic therapy in elderly patients with unexplained syncope.

PMID- 1632420
TI  - Multi-level analysis in epidemiologic research on health behaviors and outcomes.
AB  - Individual-level health behaviors and outcomes have multi-level determinants
      (individual and environmental). Multi-level analysis seeks to explain individual
      outcomes in terms of both individual and environmental or aggregate variables.
      Ecologic fallacy (improper inference about individual-level associations based on
      associations measured only at the aggregate level) can result from confusion
      about the level of inference that is of ultimate interest. The perspective of
      multi-level analysis acknowledges the importance of both individual and
      environmental variables in determining health behaviors and outcomes at the level
      of the indivisible unit--the individual. The authors review concepts and methods
      of multi-level analysis and their application to epidemiologic research on health
      behavior and health outcomes.

PMID- 1632421
TI  - Vitamin supplement use and reduced risk of oral and pharyngeal cancer.
AB  - Use of vitamin and mineral supplements was assessed in a population-based case
      control study of oral and pharyngeal cancer, conducted during 1984-1985 in four
      areas of the United States. There was no association with intake of multivitamin
      products, but users of supplements of individual vitamins, including vitamins A,
      B, C, and E, were at lower risk after controlling for the effects of tobacco,
      alcohol, and other risk factors for these cancers. After further adjustment for
      use of other supplements, vitamin E was the only supplement that remained
      associated with a significantly reduced cancer risk. The adjusted odds ratio of
      oral and pharyngeal cancer for "ever regularly used" vitamin E was 0.5 (95%
      confidence interval 0.4-0.6). To the authors' knowledge, this is the first
      epidemiologic study to show a reduced oral cancer risk with vitamin E use.
      Although it is not clear that the lower risk among consumers of vitamin E
      supplements is due to the vitamin per se, the findings are consistent with
      experimental evidence and should prompt further research on the role of vitamin E
      and other micronutrients as inhibitors of oral and pharyngeal cancer.

PMID- 1632422
TI  - Mortality from melanoma in migrants to Australia: variation by age at arrival and
      duration of stay.
AB  - All death records in Australia during the period 1964-1985 were analyzed to
      compare mortality from melanoma in immigrants and Australian-born individuals,
      and to investigate changes in risk in the immigrants according to their duration
      of stay and age at arrival. About 450,000 deaths were from cancer, and risks of
      melanoma were estimated by logistic regression relative to those of the
      Australian-born, with deaths from other cancers used as controls. Estimates were
      adjusted for age at death, time period, birth cohort, and state of registration
      of death in Australia. Region of birth was defined as New Zealand, other Oceania,
      England, Ireland/Scotland/Wales (including Northern Ireland and the Republic of
      Ireland), Central Europe, Eastern Europe, Southern Europe, Western Asia, or
      Eastern Asia, bearing in mind that many migrants born in Asia were of European
      descent. Overall, migrants from outside Oceania were at lower risk than the
      Australian-born, and the lowest risks in males were in Southern Europeans and
      Eastern Asians, reflecting the protective effect of a darker complexion. Risk of
      melanoma was related both to duration of stay in Australia and to age at arrival;
      although their relative importance cannot be measured, the patterns of change
      suggested that childhood migration may be more important in determining risk than
      number of years in Australia. The authors believe this study to be based on the
      largest data set ever used in migrant studies, and note that the previously found
      differences in melanoma risk between immigrants and Australian-born remained
      after adjustment for major temporal and geographic confounders. The results
      confirm the importance of the interaction between environmental and genetic risk
      factors in the etiology of melanoma.

PMID- 1632423
TI  - Reproducibility and validity of an expanded self-administered semiquantitative
      food frequency questionnaire among male health professionals.
AB  - The authors assessed the reproducibility and validity of an expanded 131-item
      semiquantitative food frequency questionnaire used in a prospective study among
      51,529 men. The form was administered by mail twice to a sample of 127
      participants at a one-year interval. During this interval, men completed two one
      week diet records spaced approximately 6 months apart. Mean values for intake of
      most nutrients assessed by the two methods were similar. Intraclass correlation
      coefficients for nutrient intakes assessed by questionnaires one year apart
      ranged from 0.47 for vitamin E without supplements to 0.80 for vitamin C with
      supplements. Correlation coefficients between the energy-adjusted nutrient
      intakes measured by diet records and the second questionnaire (which asked about
      diet during the year encompassing the diet records) ranged from 0.28 for iron
      without supplements to 0.86 for vitamin C with supplements (mean r = 0.59). These
      correlations were higher after adjusting for week-to-week variation in diet
      record intakes (mean r = 0.65). These data indicate that the expanded
      semiquantitative food frequency questionnaire is reproducible and provides a
      useful measure of intake for many nutrients over a one-year period.

PMID- 1632424
TI  - Body mass index and body girths as predictors of mortality in black and white
      men.
AB  - Anthropometric measurements collected from black and white men in the 1960 (n =
      946) and 1963 (n = 456) examinations of the Charleston Heart Study cohort
      (Charleston County, South Carolina) were examined as predictors of all cause and
      coronary heart disease mortality. Anthropometric measurements included body mass
      index, chest girth (at the third intercostal space), abdominal girth (at the
      umbilicus) and midarm circumference. Vital status of 98 percent of the cohort was
      determined through 1988. Body mass index was not associated with mortality in the
      white men; however, it was predictive of all cause and coronary heart disease
      mortality in the black men. Analyses conducted separately in the lower and upper
      range of body mass index in black men showed the adjusted relative hazard at the
      50th versus the 10th percentile of body mass index was 0.54 for all cause
      mortality, but was not significant for coronary heart disease mortality; whereas
      the adjusted relative hazard for the 90th relative to the 50th percentile was 1.7
      for coronary heart disease deaths, but not significant for deaths from all
      causes. The circumference measurements were not predictive of all cause or
      coronary heart disease mortality in the white men. In the black men, the adjusted
      relative hazard ratios for all cause mortality for the 85th relative to the 15th
      percentiles were 0.22 for midarm circumference and 2.0 for abdominal
      circumference.

PMID- 1632425
TI  - Methods for inference on transmission in seroprevalence data for multiple
      infections.
AB  - When risk factors for an infectious disease are unknown, a method commonly
      employed is to investigate parallels with known infections (covariate
      infections). Data sets of value here are those for specified populations in which
      the seroprevalence of antibodies for multiple infections has been ascertained.
      The use of markers of covariate infections in multivariable analyses is
      problematic when the covariate infection is not itself an independent risk factor
      for the outcome of interest. In the performance of these analyses, the authors
      recommend the following strategy: 1) For estimates of the effects of measured
      risk factors on the outcome, adjustment for the covariate infection should not be
      done; this will avoid problems of overadjustment. 2) After control for the
      measured risk factors, an estimate of the "effect" of the covariate infection may
      be used as an indicator of the presence of unmeasured shared risk factors. 3)
      When shared, measured risk factors exist, the authors propose the use of methods
      developed for analysis of repeated measures of categorical variables to assist in
      inference about shared mechanisms of action of these risk factors. This analytic
      strategy takes advantage of the method of analogy for building understanding of
      transmission of new agents through their parallels with better known ones and is
      useful in the development of hypotheses.

PMID- 1632426
TI  - Serial changes in blood pressure from adolescence into adulthood.
AB  - High blood pressure is an established risk factor for cardiovascular disease
      outcomes in adulthood. Furthermore, numerous longitudinal studies of blood
      pressure in childhood with length of follow-up from 1 to 17 years indicate that
      blood pressure levels track over the short term. This study addresses the
      question of the predictive value of childhood blood pressure readings for adult
      levels, using repeated blood pressure determinations from a sample of 501
      participants in the Fels Longitudinal Study, an ongoing cohort study in
      southwestern Ohio that began in 1929. A damped autoregressive model indicated
      tracking correlations from 0.39 (4-year intervals) to 0.24 (20 years) for
      systolic pressure and 0.37 (4 years) to 0.20 (20 years) for diastolic pressure.
      These results indicate that tracking of blood pressure persists from age 13 years
      to age 40 years, which translates into moderate levels of relative risk for adult
      hypertension (diastolic pressure above 90 mmHg) for adolescents with high normal
      blood pressure. The estimated relative risks of hypertension at age 35 for white
      15-year-olds with a true mean diastolic pressure of 80 mmHg were 1.9 for males
      and 2.6 for females, relative to 15-year-olds with a true diastolic pressure of
      60 mmHg.

PMID- 1632427
TI  - Re: "Breast cancer and cigarette smoking: a hypothesis".

PMID- 1632428
TI  - Re: "Breast cancer and cigarette smoking: a hypothesis".

PMID- 1632429
TI  - Re: "Statistical reasoning in epidemiology".

PMID- 1632430
TI  - Preaxial polydactyly of feet in infants of diabetic mothers: epidemiological test
      of a clinical hypothesis.
AB  - Using data from the Spanish Collaborative Study of Congenital Malformations
      (ECEMC), we tested the hypothesis of Carey et al. (Proc Greenwood Genet Cent
      9:95, (1990) on maternal diabetes and preaxial polydactyly of feet in infants
      born to diabetic mothers. Our results seem to confirm their suggestion, although
      the hallucal type of preaxial polydactyly that they described seems to be much
      less frequent. Nevertheless, a high risk exists (OR = 24.60, P = 0.0004) for
      preaxial polydactyly of the feet in relation with other types of birth defects or
      postaxial polydactyly. This analysis shows the importance of clinical
      observations for epidemiologists, because such observations constitute hypotheses
      and provide actual issues for study, and clinicians will get epidemiological
      confirmation for their individual observations and hypotheses.

PMID- 1632431
TI  - Phenotypically normal girl with male pseudohermaphroditism, hypoplastic left
      ventricle, lung aplasia, horseshoe kidney, and diaphragmatic hernia.

PMID- 1632432
TI  - Psoriasis vulgaris, fetal growth, and genomic imprinting.
AB  - We report on 2 independent lines of evidence suggesting genomic imprinting of a
      major gene for psoriasis vulgaris. First, the birth weight of children from
      psoriatics is influenced by the sex of the psoriatic parent. Children from
      fathers with psoriasis are considerably (270 g) heavier than children from
      mothers with psoriasis (P less than 0.004). Second, the disease manifestation
      (penetrance) depends in part on the sex of the psoriatic parent. Offspring from
      fathers with psoriasis and male "gene carriers" are significantly (P less than
      0.015 and P less than 0.007) more often affected than offspring from mothers with
      psoriasis and female "gene carriers." Of 91 grandchildren with psoriasis 59 (65%)
      have an affected grandfather and 32 (35%) a psoriatic grandmother. This deviation
      from the expected distribution is significant (P less than 0.04). Genomic
      imprinting is considered a special case of epigenetic modification. We propose
      that epigenetic modifications of a major predisposing gene in somatic tissues
      could cause differences in disease activity of psoriasis and could account for
      the often unpredictable clinical course the disease takes.

PMID- 1632433
TI  - Growth hormone deficiency and empty sella syndrome in a boy with dup(X) (q13.3---
      q21.2).
AB  - A 2 8/12-year-old boy with severe growth failure and mental retardation was found
      to have a maternally derived tandem duplication of the long arm of X chromosome,
      dup(X) (q13.3----q21.2). Karyotypic interpretation was further confirmed in this
      patient by a double gene dose for red blood cell phosphoglycerate kinase. DNA
      replication study showed that the duplicated X chromosome was always late
      replicating in peripheral blood lymphocytes as well as in skin fibroblasts from
      the mother. Endocrine studies in the patient demonstrated growth hormone
      deficiency. Magnetic resonance imaging of the head then disclosed the empty sella
      syndrome. This appears to be the first report of a dup(Xq) patient associated
      with a growth hormone deficiency and the empty sella syndrome. We emphasize that
      duplication of the proximal Xq in males represents another microduplication
      syndrome (Thode-Leonard syndrome).

PMID- 1632434
TI  - del(18p) syndrome with complex tetralogy of Fallot in an infant with
      45,X,t(Y;18)(q12;q11.2).
AB  - We report on an infant with multiple congenital anomalies, tetralogy of Fallot,
      and Karyotype 45,X,t(Y;18)(q12;11.2). The infant's anomalies are consistent with
      a del(18p) syndrome, except for the exceptional severity of the heart defect.

PMID- 1632435
TI  - Growth hormone therapy in achondroplasia.
AB  - A pilot study was carried out to examine the safety and efficacy of recombinant
      human growth hormone for growth-promoting therapy of achondroplasia. The data
      suggest that the agent in doses used to treat non-GH-deficient forms of short
      stature (0.3 mg/kg/wk) modestly increases overall height velocity in some
      children with achondroplasia. The effect was seen mainly in children with the
      lowest growth velocities prior to treatment. No untoward effects were noted.
      Several questions were raised that require further study.

PMID- 1632436
TI  - Unique karyotypes in two patients with Prader-Willi syndrome.
AB  - A physical disruption of the Prader-Willi syndrome (PWS) chromosome region is
      thought to cause PWS. We describe 2 girls with PWS phenotype, who had unique
      chromosome 15 abnormalities. The first patient showed mosaicism:
      45,XX,t(15;15)(qter----p11.1::q11.200----qter)/46,XX,t(15;15)(qter----p1 1.1::q
      11.200----qter), +mar. The band 15q11.2 apparently remained intact in the
      t(15;15) chromosome, and the mar chromosome was considered as r(15) (p11.1q11.1).
      The second patient had a karyotype of 47,XX,del(15)(q11.200----q11.207), +idic
      (15)(pter----q11.1::q11.1----pter). The complex breakage and reunion involving
      the 15q11.2 regions of the father's homologous chromosomes 15 at meiosis appeared
      to have resulted in the idic(15) and the del(15) chromosomes. These cytogenetic
      findings suggest that the PWS chromosome region may be localized on the very
      proximal portion of band 15q11.2.

PMID- 1632437
TI  - Interstitial deletion 8p21.3----p23.1 in a 6-year-old girl.
AB  - We present a 6-year-old mentally retarded girl. Chromosome analysis showed an
      interstitial deletion of chromosome 8; 46,XX,del(8) (pter----p23.1::p21.3---
      qter). The proposita had normal activities of glutathione synthetase reductase
      (GSR) and factor VII. Parental chromosomes were normal.

PMID- 1632438
TI  - Short stature, Robin sequence, cleft mandible, pre/postaxial hand anomalies, and
      clubfoot: a new autosomal recessive syndrome.
AB  - We report on 5 unrelated Brazilian children with short stature, Robin sequence,
      cleft mandible, pre/postaxial hand anomalies, and clubfoot. Genetic aspects and
      phenotypic manifestations are compared with those of previous reports of
      acrofacial dysostoses and with other Robin sequence syndromes. We suspect that
      these patients present a previously undescribed autosomal recessive syndrome.

PMID- 1632439
TI  - Two distinct mutations in a single dystrophin gene: chance occurrence or
      premutation?
AB  - We report on a kindred segregating 2 distinct mutations of a dystrophin gene. DNA
      analysis showed that the second mutation, a deletion, arose in the same gene
      carrying the primary defect which produced a Becker phenotype in the affected
      males. The DNA data for this family are reported and the alternative explanations
      of chance occurrence and premutation are discussed to explain these unusual
      findings.

PMID- 1632440
TI  - beta-Glucuronidase deficiency as a cause of fetal hydrops.
AB  - Mucopolysaccharidosis type VII (MPS VII) was diagnosed in a case of severe fetal
      hydrops. beta-glucuronidase deficiency was demonstrated in the amniotic fluid,
      which was obtained at 25 weeks of gestation, and in the fibroblasts of the child,
      which were cultured after fetal death in the 26th week of gestation. In the
      amniotic fluid the two-dimensional electrophoresis pattern of glycosaminoglycans
      was in agreement with MPS VII. Based on these results, prenatal diagnosis could
      be offered to the couple for the next pregnancy.

PMID- 1632441
TI  - Glycogen storage disease type III with muscle involvement: reappraisal of
      phenotypic variability and prognosis.
AB  - A review of the case histories of 19 Japanese patients with enzymatically proven
      glycogen storage disease (GSD) III who developed muscular symptoms at various
      ages illustrates the phenotypic variability of this disease. There seem to be 4
      subgroups of GSD III with muscle involvement according to the clinical symptoms.
      The first group of patients is characterized by the childhood onset of muscle
      weakness and hepatic disorders. The second group of patients develops muscular
      symptoms in adult years while the liver symptoms start in childhood. The third
      group includes the patients whose muscle weakness started in adult years long
      after liver symptoms in childhood had disappeared. The fourth group shows only
      muscular symptoms as adults without any sign or history of liver dysfunction
      since childhood. The prognosis for each subgroup seems to be different; however,
      none of them appears to be better than that for GSD I, as has been suggested
      previously.

PMID- 1632442
TI  - Ocular albinism in a male with del (6)(q13-q15): candidate region for autosomal
      recessive ocular albinism?
AB  - We describe a boy with an interstitial deletion of 6(q13-q15) and include
      "coarse" facial features, upslanting palpebral fissures, thin vermilion border of
      the upper lip, elongated philtrum, developmental delay, and profound hypotonia.
      The child's eye findings, pedigree, paucity of maternal ocular changes, and lack
      of melanin macroglobules in the skin suggest that this individual's phenotype is
      clinically similar to that of autosomal recessive ocular albinism. Though it is
      possible that this deletion and his ophthalmic disorder are coincidental, we
      postulate that the ocular albinism may be due to hemizygosity for a paternally
      derived ocular albinism gene located on chromosome 6 in the region q13-q15. This
      patient's deletion is secondary to a recombination of a maternal intrachromosomal
      inverted insertion of this region. Of the 7 reported 6q1 deletions, this is the
      only case that is due to a familial chromosome rearrangement.

PMID- 1632443
TI  - New skeletal dysplasia with unique brachydactyly.
AB  - We report on 2 male propositi, their mothers, and a maternal aunt with a new
      skeletal dysplasia associated with a unique pattern of digital malformation,
      variable mild short stature, and mild bowleg with proximal overgrowth of the
      fibula. The digital malformations comprise a pattern of brachydactyly which
      includes short, abducted thumbs, short index fingers, and markedly short,
      abducted great toes. The radiographic findings include hypoplastic thumbs and
      great toes with short first metacarpals and first metatarsals, absent distal
      phalanges of the index fingers and second toes, and coalescence of the carpal and
      tarsal bones. Radiographs of the long bones show mild metaphyseal and epiphyseal
      irregularity, tibial spurs, and relative elongation of the fibulae. The males are
      very similarly affected whereas the females show phenotypic variation and are
      generally less severely affected. The family histories from 2 fairly extensive
      pedigrees suggest X-linked dominant inheritance.

PMID- 1632444
TI  - Congenital absence of the vas deferens: recurrence in a family.
AB  - We report on 2 brothers with congenital absence of the vas deferens discovered in
      childhood during inguinal hernia repairs. The vas is absent unilaterally in one
      sib and bilaterally in the other. The unusual presentation of inguinal hernias in
      these children is discussed as well as mechanisms of inheritance and associated
      risk of renal anomalies.

PMID- 1632445
TI  - Segregation of three reciprocal translocations in the same family: t(3;4),
      t(5;10), and t(15;21).
AB  - A male infant with static antenatal encephalopathy and epilepsy was found to have
      a duplication of 5p12----5pter and deficiency of 10p13----10pter. Each of his
      parents was a carrier of a balanced reciprocal translocation. A third
      translocation was found in the maternal grandfather. The pedigree of each
      translocation and the segregation of parental reciprocal translocations are
      discussed.

PMID- 1632446
TI  - Identification of the origin of ring/marker chromosomes in patients with Ullrich
      Turner syndrome using X and Y specific alpha satellite DNA probes.
AB  - Fluorescent in situ hybridization (FISH) using X and Y chromosome-specific alpha
      satellite DNA probes hybridizing to loci DXZ1 and DYZ3 was performed to identify
      the origin of ring/marker chromosomes in 6 patients with Ullrich-Turner syndrome
      (UTS). All patients had a mosaic karyotype, 5 with 45,X/46,X,r(?) and one with
      45,X/46,X,mar. We demonstrated that the marker/ring chromosome in each of these 6
      patients originated from the X. A timely knowledge of the X or Y origin of ring
      and marker chromosomes can be crucial in genetic counseling and medical
      management since the presence of Y chromosome material in phenotypic females is
      known to increase the risk for developing gonadoblastoma.

PMID- 1632447
TI  - Dwarfism, rhizomelic limb shortness, and abnormal face: new short stature
      syndrome sharing some manifestations with Robinow syndrome.
AB  - We describe a child with short stature of prenatal onset, rhizomelic limb
      shortness affecting the upper limbs particularly, and an unusual face. She had
      frontal balding, mid-face hypoplasia, a small nose, macrostomia with down-turned
      corners of the mouth, gingival hypertrophy, and hypoplasia or absence of the
      clitoris. There was no gross modelling defect of the skeleton and the vertebral
      column was normal. Some of these manifestations overlap with those of Robinow
      syndrome.

PMID- 1632448
TI  - Charcot-Marie-Tooth neuropathy related to chromosome 1.
AB  - One family with documented male-to-male transmission of Charcot-Marie-Tooth (CMT)
      neuropathy was studied clinically and by genetic linkage. Patients had
      progressive distal weakness and atrophy, areflexia, and distal sensory loss, but
      early onset (before age 3 years) in all 5 cases, and phrenic nerve involvement in
      the propositus (a 39-year-old woman) requiring CPAP ventilator support during the
      night. Motor-nerve conduction velocities (MNCVs) were significantly slow,
      consistent with severe demyelinating neuropathy. Electromyography (EMG) data were
      normal. Two-point and multipoint linkage analyses strongly suggested the presence
      of a CMT gene on chromosome 1q. A maximum multipoint lod score of 2.70 was
      obtained at MUC1 (theta = 0), with the locus order centromere-MUC1-SPTA1-Fc gamma
      RII-AT3-telomere. Multipoint linkage analysis excluded the CMT locus from
      chromosome 17 markers in this family.

PMID- 1632449
TI  - New case of Bartsocas-Papas syndrome surviving at 20 months.
AB  - We report on patient with Bartsocas-Papas syndrome surviving at age 20 months.
      Similar to 7 previously reported families, this patient is of Mediterranean
      ancestry, pointing to clustering of the responsible mutant gene in Southern
      Europe. In 3 of the 11 Bartsocas-Papas syndrome patients described so far,
      including the present case, the condition has not been neonatally lethal. This
      suggests that about one-fourth of these patients could survive. This information
      is important for genetic counseling.

PMID- 1632450
TI  - Absent thumb, immune disorder, and congenital anemia presenting with hydrops
      fetalis.
AB  - A patient is described who presented with severe congenital anemia, hydrops
      fetalis, immune disorder, and absent thumbs. No toxic, infectious, or metabolic
      cause was found to explain these symptoms. Immunologic and cytogenetic studies
      excluded several syndromes that combine radial ray anomalies with hematological
      involvement. After careful study of the literature, it is concluded that the
      disorder described here represents a new syndrome that can be added to a growing
      list of hematological-radial syndromes.

PMID- 1632451
TI  - Heterogeneity in ataxia-telangiectasia: classical phenotype associated with
      intermediate cellular radiosensitivity.
AB  - We identified a subgroup of ataxia-telangiectasia (AT) patients (2 sibs and 1
      unrelated case) characterized by typical clinical manifestations of the disease
      and cellular radiosensitivity intermediate between classical AT and normal
      subjects. Our data and a literature review of the intermediate radiosensitivity
      AT cases show that radioresistant DNA synthesis, cellular radiosensitivity
      (measured in terms of survival and chromosome breakage), and the clinical
      hallmarks behave independently. This raises a number of interesting questions
      about the correlation between radiobiological and clinical features, and about
      the nature of the AT gene(s).

PMID- 1632452
TI  - Prenatal diagnosis of the Pallister-Killian mosaic aneuploidy syndrome by CVS.
AB  - Prenatal cytogenetic analysis at 11 weeks of gestation revealed an abnormal
      karyotype 47,XX,+mar in all metaphases obtained from a chorionic villi sample
      after 24 h culture. Karyotyping of amniotic fluid cells in the second trimester
      showed mosaicism 47,XX,+i(12p)/46,XX with 10% aneuploid cells. The pregnancy was
      terminated at 20 weeks of gestation on the patient's request. The aborted fetus
      showed typical manifestations of the Pallister-Killian mosaic aneuploidy
      syndrome. The identity of the supernumerary isochromosome 12p was proven by LDH
      isozyme electrophoresis using cultured fibroblasts and by nonradioactive in situ
      hybridization using a biotinylated set of chromosome 12-specific DNA probes.

PMID- 1632453
TI  - Incidence of tuberous sclerosis in patients with cardiac rhabdomyoma.

PMID- 1632454
TI  - Lumping of CFC and Baraitser-Patton Noonan-like syndromes.

PMID- 1632455
TI  - Duty to disclose to family members in medical genetics.

PMID- 1632456
TI  - Basic fibroblast growth factor promotes proliferation of rat glomerular visceral
      epithelial cells in vitro.
AB  - Glomerular visceral epithelial cells (vGEC) play an important role in the
      synthesis of the glomerular basement membrane (GBM), and together with glomerular
      endothelial cells and the GBM, in glomerular ultrafiltration. Therefore
      clarification of the properties of vGEC is essential to investigations of
      glomerular morphology and function in both physiologic and pathologic conditions.
      This article demonstrates that basic fibroblast growth factor (bFGF) is mitogenic
      to vGEC in vitro. Its effect was found at concentrations as low as 1.25 ng/ml,
      and was synergistic with epidermal growth factor (EGF). In contrast, EGF by
      itself had no demonstrable mitogenic effect at concentrations of 1.25-100 ng/ml.
      In addition, mRNA for bFGF was identified in cultured vGEC by the method of
      reverse transcriptase polymerase chain reaction and the immunoreactivity of bFGF
      was found in GEC of the Sprague-Dawley rat kidney. These results suggest that
      bFGF stimulates the proliferation of vGEC in an autocrine manner in vivo. A
      unique relationship similar to that observed in endothelial cells may also exist
      among bFGF, vGEC, and the extracellular matrix (ECM). In a word, bFGF may be
      produced by vGEC and stored in the ECM, that is the GBM, and may be one factor
      that stimulates vGEC to proliferate when vGEC are injured and lost in vivo.

PMID- 1632457
TI  - Plasminogen activator inhibitor-1 deposition in the extracellular matrix of
      cultured human mesangial cells.
AB  - Human mesangial cells secrete tissue-type plasminogen activator (t-PA) and
      plasminogen activator inhibitor 1 (PAI-1), the latter being secreted in large
      excess in vitro. We demonstrate that PAI-1 is a major component of the
      extracellular matrix of cultured human mesangial cells, where its deposition is
      dependent on cell density. By immunogold silver staining, epipolarization
      microscopy and dispersive X-ray spectrometry, we have shown that matrix
      associated PAI-1 is synthesized by spreading human mesangial cells, as indicated
      by the time-dependent accumulation of PAI-1 and the inhibitory effect of
      cycloheximide. Furthermore, by in situ hybridization, PAI-1 mRNA was detected in
      cultured mesangial cells. t-PA is present inside the cells, or at the cell
      surface, but is never associated with the extracellular matrix. Exogenous t-PA
      can remove matrix-associated PAI-1 without affecting cell adhesion. A similar
      effect was obtained by addition of urokinase-type plasminogen activator (u-PA)
      but not with fibrinolysis unrelated enzymes. In conclusion, PAI-1 is synthesized
      by human cultured mesangial cells and is deposited in the extracellular matrix by
      nonconfluent cells, whereas less PAI-1 is seen between confluent cells. This can
      explain the absence of detectable PAI-1 in normal human kidney biopsies. t-PA
      released by mesangial cells can bind and detach matrix PAI-1.

PMID- 1632458
TI  - Interleukin-6, but not interleukin-4, is expressed by Reed-Sternberg cells in
      Hodgkin's disease with or without histologic features of Castleman's disease.
AB  - Hodgkin's disease (HD) is a neoplastic disease that is characterized by
      unbalanced and/or unregulated cytokine production. Information accumulated in our
      own and other laboratories indicates that the cytokines interleukin-1 (IL-1), IL
      5, IL-9, tumor necrosis factor-alpha (TNF-alpha), granulocyte colony-stimulating
      factor (G-CSF), macrophage CSF (M-CSF), and transforming growth factor-beta (TGF
      beta) are secreted by Hodgkin's and Reed-Sternberg (H-RS) cells. These and
      perhaps additional cytokines are likely to be responsible for the unique
      histopathologic and clinical alterations seen in patients with HD. In this study,
      we confirmed that IL-6 is produced by cultured H-RS cells as well as by H-RS
      cells in tissues. By using an enzyme-linked immunosorbent assay, we found that
      approximately 2 to 10 ng/ml of IL-6 was secreted by cultured H-RS cells (10(6)
      cells/ml). In tissues, we were able to immunolocalize IL-6 in the cytoplasm in 10
      to 30% of H-RS cells by using rabbit polyclonal and mouse monoclonal anti-IL-6
      antibodies. There was no correlation among the IL-6 staining intensity, number of
      H-RS cells stained, and the degree of plasma cell infiltration. However, in 3 of
      17 cases studied, a large number (60%) of H-RS cells were positive for IL-6, and
      in these patients, abundant plasma cells were present. In one patient, the
      involved lymph node also showed histologic features similar to those of
      Castleman's disease. In this patient, we noted abundant IL-6 expression not only
      in H-RS cells, but also in most reactive histiocytes. The cultured H-RS cells did
      not express functional receptors for IL-6, and exogenously added IL-6 did not
      induce proliferation of these cells. We also conducted studies with specific anti
      IL-4 antibodies, which did not show IL-4 production by H-RS cells in both
      cultures and tissues. In tissues, only rare IL-4 positive lymphoid cells or
      dendritic cells were identified. Thus, the study demonstrated that adequate
      amounts of IL-6 are required for an abundant plasma cell reaction, and that an
      additional source of IL-6 from histiocytes is essential for the formation of
      Castleman's disease-like changes in lymph nodes involved by HD. Furthermore, IL-4
      is not likely to be responsible for the T-lymphocyte reaction in tissues, by a
      mechanism distinct from that in T-cell-rich B-cell lymphomas.

PMID- 1632459
TI  - Immunopathology of glomerulonephritis associated with chronic woodchuck hepatitis
      virus infection in woodchucks (Marmota monax).
AB  - Retrospective analysis of necropsy findings of 705 woodchucks was performed to
      determine the prevalence and morphology of immune-mediated glomerulonephritis,
      its relationship to woodchuck hepatitis virus (WHV) infection, and the presence
      of major WHV antigens. Twenty-six woodchucks had glomerular lesions. Renal tissue
      of the 26 animals was evaluated histologically and immunohistochemically for
      immune-mediated glomerulonephritis. Of these 26 animals, immune-mediated
      glomerulonephritis was diagnosed in six, all of which were chronic WHV carriers.
      Membranous glomerulonephritis was identified in three animals, two of which also
      had mesangial proliferation. Host immunoglobulin was present within the mesangium
      and along capillary loops in all three. Woodchuck hepatitis virus core antigen
      (WHcAg) was present along capillary loops of two of these animals, one membranous
      and one mixed, and in the mesangium of all three. Woodchuck hepatitis virus
      surface antigen (WHsAg) deposition was similar to WHcAg deposition but was only
      present along capillaries in those animals with mixed nephritis. The remaining
      three animals had mesangial proliferation. WHsAg and host immunoglobulin
      deposition were predominately mesangial; WHcAg was not detected. Transmission
      electron microscopy showed thickening of the capillary loop basement membranes
      and subepithelial electron-dense deposits in animal one, and deposits in the
      mesangium in animal six.

PMID- 1632460
TI  - Detection of extracellular neutrophil elastase in hamster lungs after
      intratracheal instillation of E. coli lipopolysaccharide using a fluorogenic,
      elastase-specific, synthetic substrate.
AB  - Repeated intratracheal instillations of E. coli lipopolysaccharide (LPS) in
      hamster lungs cause an influx of polymorphonuclear leukocytes (PMNs) into the
      alveolar walls, with concomitant development of severe emphysema. It has been
      suggested that elastase, released by these PMNs, is involved in the development
      of emphysema. This study demonstrates the release of elastase from recruited PMNs
      in cryostat sections of hamster lungs, after being treated once, twice, or thrice
      with LPS, intratracheally. Elastase activity was visualized using two elastase
      specific synthetic substrates, to which a methoxynaphthylamine (MNA) group had
      been bound covalently. Liberated MNA, when made insoluble by coupling with 5
      nitrosalicylaldehyde, fluoresces strongly. The authors observed that the interval
      between start of incubation and appearance of fluorescence and the intensity of
      fluorescence correlated with the number of LPS administrations. Fluorescence was
      observed to be located in or in close vicinity to alveolar walls. No fluorescence
      was observed in sections of untreated hamsters. Liberation of MNA from synthetic
      substrates was delayed strongly by the addition of a recombinant secretory
      leukocyte proteinase inhibitor or a substituted cephalosporin neutrophil elastase
      inhibitor. The authors conclude that LPS-mediated PMN influx into the lung is
      accompanied by release of elastase from these cells and speculate that this PMN
      elastase is involved in the development of LPS-mediated emphysema.

PMID- 1632461
TI  - Macrophage differentiation in atherosclerosis. An in situ immunohistochemical
      analysis in humans.
AB  - The differentiation of macrophages present in diffuse intimal thickening, fatty
      streaks, and atheromatous plaques, was analyzed with immunohistochemical methods,
      using segments of aorta, coronary, and carotid arteries obtained at autopsy.
      Various differentiation antigens were studied with the monoclonal antibodies anti
      HLA-DR, EBM-11, Leu M3, OKM1, and OKM5. Adjacent sections were stained for lipids
      (oil red O) and lysosomal activity (acid phosphatase). Almost all macrophages
      identified with the pan-macrophage antibody EBM-11, also stained with the anti
      HLA-DR antibody. Diffuse intimal thickening showed a predominance of Leu M3+
      cells; fatty streaks also showed OKM1+ and OKM5+ macrophages. Classical
      atheromatous plaques showed a gradual shift in phenotypic expression towards the
      center of the lesion. Cells in the superficial layers were positive only with Leu
      M3, deeper localized cells showed double expression of Leu M3 and OKM1 or double
      expression of OKM1 and OKM5. Cells that were localized adjacent to the
      atheromatous debris stained only with OKM5. The phenotypic changes occurred in
      parallel with an increase in both fat uptake and lysosomal activity of the
      macrophages. This shift in phenotypic expression suggests a process of
      differentiation and maturation of the macrophages involved. The results indicate
      that macrophages within the arterial intima are activated and mature towards
      cells that express receptors for adhesion proteins and complement during the
      development of atherosclerotic plaques. This may imply that the macrophages
      involved in lipid metabolism also have a potential to act as effector cells in a
      chronic inflammatory process, and thus, may contribute to the progression of an
      atherosclerotic plaque. Functional studies of macrophage subpopulations are
      needed to verify this hypothesis.

PMID- 1632462
TI  - Chronic hemodynamic unloading regulates the morphologic development of newborn
      mouse hearts transplanted into the ear of isogeneic adult mice.
AB  - The morphologic development of newborn mouse hearts transplanted into the pinna
      of the ears of isogeneic adult mice was assessed in comparison to in situ
      ventricular myocardium of recipients. The grafted hearts became vascularized from
      the auricular artery at the base of the ear, and although these preparations
      appeared not to be intrinsically innervated, most of them showed grossly visible
      pulsatile activity. Since they were not subjected to hemodynamic load due to
      working against a pressure gradient, this technique provided an interesting
      experimental model for studies on the growth of chronically unloaded tissue. The
      ultrastructure of the myocardium from neonatal mouse hearts, which were fixed
      immediately after dissection, revealed no differences in comparison to previously
      published observations. By 2 months, there was virtually no change in the
      myocardial cell size as compared with newborn mouse cardiac tissue. The
      heterotopic hearts showed a mature ultrastructural appearance, with parallel
      bands of myofibrils alternating with rows of mitochondria and differentiated
      intercalated discs comparable to in situ myocardium. The interstitial space was
      widened due to fibrous tissue, with activated fibroblasts and a few mononuclear
      cells. In contrast, by 6 months after transplantation, the heterotopic myocardium
      showed a dispersion of the measured cell diameter of myocytes, with atrophy of a
      certain population of cells and hypertrophy in others; nevertheless, the mean
      cell diameter was similar to that observed in 2-month grafts. The myocytes showed
      significant dissociation from each other in fibrous tissue and a cellular
      infiltrate composed predominantly of mononuclear cells, and greater variability
      of the parallel arrangement of cells. They often contained myofibrils coursing in
      different directions rather than in parallel. Normal-sized or predominantly
      atrophic degenerated myocytes, characterized by a wide variety of ultrastructural
      alterations, were present. By 12 months after transplantation, the myocytes of
      heterotopic hearts were smaller in size in comparison to those after 2 or 6
      months. The graft cells were separated from each other by fibrous tissue and
      mononuclear cells and were not aligned in parallel within the tissue; often, they
      appeared to have lost their connections with adjacent cells. The myofibrils
      within cells were strikingly disorganized, coursing in different directions.
      Severely degenerated myocytes were commonly seen. These results, without
      precluding the possible role of neural and hormonal stimuli, clearly indicate
      that hemodynamic work load regulates the developmental growth of newborn mouse
      heart transplanted into the pinna of the ear of isogeneic adult recipient mice.
      In other words, the mass of cardiac tissue would be adjusted to meet the
      prevailing hemodynamic demands.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1632463
TI  - The bcl-2 gene translocation is undetectable in Hodgkin's disease by Southern
      blot hybridization and polymerase chain reaction.
AB  - B-cell associated antigens are frequently expressed by the Reed-Sternberg (RS)
      cells of lymphocyte predominance (LP) Hodgkin's disease (HD) and are sometimes
      expressed by those of nodular sclerosis (NS) and mixed cellularity (MC) HD.
      Clonal immunoglobulin gene rearrangements have been detected in some HD cases as
      well. These findings suggest that at least some cases of HD may be of B-cell
      derivation. Rearrangements of the bcl-2 gene, associated with the
      t(14;18)(q32;q21) are present in more than 75% of follicular and 30% of diffuse
      lymphomas of B-cell origin, suggesting that this translocation plays an important
      role in B-cell lymphomagenesis. In this study, we investigated 34 cases of HD (10
      LP, 14 NS, and 10 MC) for bcl-2 gene rearrangements to determine if this B-cell
      lymphoma-associated translocation also plays a role in the pathogenesis of HD.
      The cases of HD were analyzed by Southern blot hybridization, using DNA probes
      that detect the major and minor breakpoint cluster regions and a 5'bcl-2
      breakpoint region recently cloned and found to be involved in B-cell chronic
      lymphocytic leukemia, and by the polymerase chain reaction (PCR), using
      oligonucleotides capable of amplifying and detecting the major breakpoint region
      (mbr) and minor cluster region (mcr) breakpoint regions in t(14;18). bcl-2
      translocations were not detected in any of the 34 cases of HD by Southern blot
      hybridization or by PCR. This is in spite of the fact that RS cells expressing B
      cell-associated antigen CD20 were detectable in 7/8 cases of LP HD and 6/24 cases
      of NS and MC HD with monoclonal antibody L26. Therefore, these results indicate
      that the bcl-2 gene translocation does not play an important role in the
      pathogenesis of HD and did not provide evidence for the B-cell origin of HD.

PMID- 1632464
TI  - Flow cytometric analysis of pulmonary fluids and cells for the detection of
      malignancies.
AB  - Cells from a pulmonary or bronchial origin were analyzed with flow cytometry to
      assess the sensitivity and specificity of this method in diagnosing malignancy.
      In all instances, cells submitted for flow cytometry analysis were excess cells
      from specimens submitted for routine cytology. Less than 3% of all samples were
      rejected for insufficient material. Overall sensitivity from all sources was 86%,
      specificity 96%. Although cytology results were the standard for determining
      accuracy of flow cytometry, in a few patients cytology appeared normal and
      initial evidence for malignancy was obtained from flow cytometry. For this
      reason, flow cytometry may be a valuable adjunctive technology in the diagnosis
      of malignancy.

PMID- 1632465
TI  - In vitro spontaneous synthesis of beta 2-microglobulin amyloid fibrils in
      peripheral blood mononuclear cell culture.
AB  - beta 2-microglobulin-related amyloidosis (A beta 2M), in long-term dialysis
      patients, is a new and frequent complication for which the pathogenesis remains
      unknown. The authors documented, by light and high resolution electron
      microscopy, the spontaneous polymerization of beta 2-microglobulin to amyloid
      fibrils in mononuclear cell culture supernatants from dialysis patients. These
      data provide significant information about the pathogenesis of dialysis
      amyloidosis, revealing an unusual and different fibrillogenic mechanism for beta
      2-microglobulin and dialysis-amyloidosis than for other forms of amyloidosis.
      beta 2-microglobulin does not appear to require a proteolytic process before
      polymerization into amyloid fibrils and deposits. This study represents the first
      cell culture system in which beta 2-microglobulin amyloid fibrils have been
      spontaneously created.

PMID- 1632466
TI  - Beta amyloid is focally deposited within the outer basement membrane in the
      amyloid angiopathy of Alzheimer's disease. An immunoelectron microscopic study.
AB  - The fine structure of cerebral amyloid angiopathy, especially in small and
      presumably early deposits, was examined by immunolabeling of the beta/A4 protein
      in semithin and ultrathin sections from brains with Alzheimer's disease. The
      following findings emerged: 1) in large leptomeningeal arteries, small, focal
      amyloid deposits appear to consist of clusters of delicate (approximately 8 nm
      diameter) amyloid fibrils, not previously described, in the outermost part of the
      basement membrane (BM) at the media-adventitia junction; 2) in small
      leptomeningeal arteries and perforating cortical arterioles, small foci of
      delicate amyloid fibrils were observed within the BM. They appeared mostly in the
      outer portion of the BM, around intact smooth muscle cells, rather than in the
      subendothelial region. In larger and presumably more advanced deposits, coarse
      amyloid fibrils (approximately 10 nm) occupied the abluminal BM, and adjacent
      smooth muscle cells showed degeneration; and 3) in capillaries, small amounts of
      delicate (approximately 8 nm) amyloid fibrils, not previously described, were
      seen within the BM in the smallest discernible deposits. The BM at these sites
      was abnormally folded and layered. In larger deposits, amyloid fibrils appeared
      to extravasate from the outer BM of the capillary into the neuropil and were
      surrounded by astrocytic foot processes and/or microglia. Our results suggest
      that vascular amyloid fibrils may first be formed within the abluminal vascular
      BM, that is, outside of cells. The BM may trap degradative intermediates of the
      amyloid precursor protein that contain the beta/A4 region, and local proteases
      may then cleave them further to yield amyloidogenic fragments.

PMID- 1632467
TI  - Overexpression of p53 protein in basal cell carcinomas of human skin.
AB  - Basal cell carcinoma (BCC) of the skin is the most common human cancer, but its
      molecular-genetic pathogenesis is unclear. In many other types of cancer,
      mutations of the tumor-suppressor gene p53 occur frequently and may lead to
      overexpression of a long-lived mutant form of p53 protein. In this study,
      overexpression of p53 protein was detected immunohistochemically in 30 (83%) of
      36 specimens of BCC of the head and neck. The same regions of tumor typically
      were reactive both with a monoclonal antibody (PAb240) specific for the mutant
      protein and with one (PAb1801) directed against an epitope common to both wild
      type and mutant p53 protein. Keratinocytes of chronically sun-exposed epidermis
      adjacent to BCCs also focally overexpressed p53 protein in the majority of cases,
      whereas those of sun-protected buttock skin did not. Mutation of p53 may form an
      important part of the pathogenetic sequence in a majority of cases of BCC.

PMID- 1632468
TI  - The NIH-3 immunodeficient mouse is a model for Lyme borreliosis myositis and
      carditis.
AB  - Experimental infection of immunodeficient NIH-3 (N:NIH-bg-nu-xid) mice with
      Borrelia burgdorferi was found to result in multisystem histopathologic lesions.
      In addition to T-cell deficiency due to the nude mutation, these mice have an x
      linked defect affecting the B-cell maturation and the beige mutation resulting in
      the absence of NK cells. NIH-3 mice were susceptible to progressive infection
      with B. burgdorferi resulting in pancarditis, synovitis, and skeletal
      interstitial myositis whereas controls remained normal. Cardiomyopathy was
      characterized by inflammatory mononuclear infiltration and fibrillar necrosis.
      Synovial hyperplasia and inflammation were seen in the tibiotarsal and ulna
      carpal joints. Advanced myositis was observed in peripheral skeletal muscle.
      Gastrointestinal submucosa, heart, and skeletal muscle were heavily colonized
      with B. burgdorferi. This mouse is proposed as a model for Lyme borreliosis
      carditis, synovitis, and myositis.

PMID- 1632469
TI  - Characterization and immunohistochemical localization of alpha 2-macroglobulin
      receptor (low-density lipoprotein receptor-related protein) in human brain.
AB  - Proteinase inhibitors have been implicated in brain development and in
      degenerative processes such as Alzheimer's disease. Low-density lipoprotein
      receptor-related protein (LRP) is a multifunctional cell-surface receptor that
      binds activated forms of the proteinase inhibitor, alpha 2-macroglobulin (alpha
      2M) and apolipoprotein E. Solubilized plasma membranes of human cerebral cortical
      gray matter were subjected to affinity chromatography on alpha 2M-methylamine
      sepharose. A single receptor was purified; this protein was LRP as determined by
      molecular mass, peptide structure, and immunoreactivity with monoclonal and
      polyclonal antibodies. In adult human brain, LRP immunoreactivity was abundant on
      neuronal cell bodies and proximal processes. Other cells within the neuropil,
      including glia and microvascular cells (endothelium and pericytes), were
      immunonegative. Weak LRP immunoreactivity was identified in a perivascular
      pattern corresponding to the location of astrocytic foot processes. The
      distribution of LRP in the central nervous system is consistent with the
      potential function of this receptor in the regulation of proteinase activity,
      cytokine activity, and cholesterol metabolism.

PMID- 1632470
TI  - Follicular colonization in thyroid lymphoma.
AB  - The presence of neoplastic (light chain restricted) B-cell follicles in low-grade
      B-cell gastrointestinal (GI) lymphoma of mucosa-associated lymphoid tissue (MALT)
      has been explained on the basis of specific colonization of reactive follicles by
      centrocyte-like (CCL) cells. Low-grade B-cell thyroid lymphomas have been
      included in the category of MALT lymphoma, but the frequent presence of a
      follicular pattern in these tumors has contributed to the view that they are
      follicle center cell (FCC) tumors. We have reviewed the histology and
      investigated the phenotype and genotype of nine cases of primary low-grade B-cell
      lymphoma of the thyroid, all of which were distinguished by a predominantly
      follicular pattern. All cases also demonstrated features of MALT lymphoma,
      including CCL cells and lymphoepithelial lesions. The appearances and
      immunohistology of the follicles were those of follicular colonization as
      described in GI MALT lymphoma rather than FCC follicular lymphoma. The
      predominant pattern of follicular colonization was replacement of the follicle
      center by slightly enlarged CCL cells that showed a strikingly high proliferation
      rate. No evidence of the t(14;18) translocation was found in any case, using the
      polymerase chain reaction (PCR) on DNA extracted from fresh (n = 1) or paraffin
      embedded (n = 9) tissue. These findings argue against a FCC lineage for primary
      thyroid lymphomas and support their inclusion in the MALT category.

PMID- 1632471
TI  - Experimental pneumococcal meningitis causes central nervous system pathology
      without inducing the 72-kd heat shock protein.
AB  - We examined whether experimental pneumococcal meningitis induced the 72-kd heat
      shock protein (HSP72), a sensitive marker of neuronal stress in other models of
      central nervous system (CNS) injury. Brain injury was characterized by
      vasculitis, cerebritis, and abscess formation in the cortex of infected animals.
      The extent of these changes correlated with the size of the inoculum (P less than
      0.003) and with pathophysiologic parameters of disease severity, i.e.,
      cerebrospinal fluid (CSF) lactate (r = 0.61, P less than 0.0001) and CSF glucose
      concentrations (r = -0.55, P less than 0.0001). Despite the presence of numerous
      cortical regions having morphologic evidence of injury, HSP72 was not detected in
      most animals. When present, only rare neurons were HSP72 positive. Western blot
      analysis of brain samples confirmed the paucity of HSP72 induction. The lack of
      neuronal HSP72 expression in this model suggests that at least some of the events
      leading to neuronal injury in meningitis are unique, when compared with CNS
      diseases associated with HSP72 induction.

PMID- 1632472
TI  - Diarrheal disease as a cause of malnutrition.
AB  - Although long associated with infectious diseases, malnutrition is recognized as
      a major effect of specific infections, especially those of the gastrointestinal
      tract. Synergistic exacerbation of infections and nutritional deficiency commonly
      begin with weaning, where the impact of repeated infections and possible monocyte
      mediator release may have an even greater effect on malnutrition of young
      children than that of deficient diets in many areas. Reviewed here are the
      detailed host alterations seen with specific enteric infections that lead to
      malnutrition. These include mucosal dysfunction, systemic metabolic responses,
      impaired intake, digestion and absorption, nutrient losses, altered immune
      responses, and ultimately, impaired growth, development, and nutrition. The
      tremendous health impact of diarrhea on both morbidity and mortality in many
      developing areas must be recognized and controlled along with correction of food
      shortages in order to improve the nutrition, growth, and survival of impoverished
      children.

PMID- 1632473
TI  - Tumor necrosis factor in the malnutrition (cachexia) of infection and cancer.
AB  - This review presents a history of tumor necrosis factor, considers the biology of
      this pleiotropic mediator, and summarizes the evidence that implicates it as a
      mediator of cachexia.

PMID- 1632474
TI  - Diarrhea as a cause and an effect of malnutrition: diarrhea prevents catch-up
      growth and malnutrition increases diarrhea frequency and duration.
AB  - Diarrhea and malnutrition, alone or together, constitute major causes of
      morbidity and mortality among children throughout the tropical world. Data from
      northeast Brazil, taken with numerous other studies, clearly show that diarrhea
      is both a cause and an effect of malnutrition. Diarrheal illnesses impair weight
      as well as height gains, with the greatest effects being seen with recurrent
      illnesses, which reduce the critical catch-up growth that otherwise occurs after
      diarrheal illnesses or severe malnutrition. Malnutrition (whether assessed by
      impaired weight or height for age) leads to increased frequencies and durations
      of diarrheal illnesses, with a 37% increase in frequency and a 73% increase in
      duration accounting for a doubling of the diarrhea burden (days of diarrhea) in
      malnourished children. A multi-pronged approach focusing on those with prolonged
      diarrhea and severe malnutrition is suggested.

PMID- 1632475
TI  - Nutrition and infection.

PMID- 1632476
TI  - Visceral leishmaniasis: a model for infection-induced cachexia.
AB  - Parasitic infections and malnutrition coexist in many tropical and subtropical
      areas. Studies of Leishmania donovani and of experimentally infected Syrian
      hamsters have provided important insights into the complex interrelationships
      between malnutrition and this parasitic disease. Malnutrition, which adversely
      affects cell-mediated immunity, is associated with the development of visceral
      leishmaniasis (kala-azar) in children living in endemic areas. In turn, L.
      donovani can cause wasting as well as hepatosplenomegaly, fever, and anemia.
      Syrian hamsters infected with L. donovani develop a disease that is comparable to
      that of humans with kala-azar. Weight loss in infected hamsters is associated
      with splenic macrophage secretion of potentially catabolic cytokines as measured
      by the D10.G4.1 assay for interleukin-1 and the L929 cytotoxicity assay for tumor
      necrosis factor/cachectin. Although decreased food intake contributes to wasting
      in infected hamsters, studies of skeletal muscle function indicate that it is not
      the sole factor. Leishmania donovani-infected hamsters have also been used to
      study drugs with the potential to prevent or reverse cachexia.

PMID- 1632477
TI  - Genetic control of eosinophilia in guinea pig strains inbred for high or low
      bronchial allergic reactivity.
AB  - Development of eosinophilia was studied in four strains of guinea pigs (gp),
      selectively bred for either high or low respiratory anaphylactic reactivity. One
      high-asthma strain (IMM/S 209) and one low-asthma strain (IMM/R 203) developed
      spontaneous high blood eosinophilia. The 2 other gp strains - one high-asthma
      strain (IMM/S 740) and one low-asthma strain (IMM/R 201-16) - maintained normal
      low levels of eosinophilic granulocytes (eos). The levels of eos in various
      tissues showed similar differences between the gp strains. Following immunization
      with ovalbumin/Al(OH)3 the levels of blood eos increased significantly only in gp
      of strain 209. The blood eos levels in gp of all 4 strains decreased
      significantly following immunization with ovalbumin in Freund's complete adjuvant
      (FCA).

PMID- 1632478
TI  - Detection of allergens in a cat pelt extract.
AB  - Allergenic components of cat pelt extract fractionated by SDS-polyacrylamide gel
      electrophoresis (PAGE) and transferred to nitrocellulose membranes were
      identified using sera from 15 allergic patients who showed positive skin test and
      RAST to cat extract. Two components showed the highest IgE-binding frequency; 14
      kD (being recognized by 86% of the sera examined) and 29 kD (73% of the sera
      tested). Both components were purified by electroelution and subjected to RAST
      inhibition assays. The 29 kD fraction was able to bind specific IgE to D.
      pteronyssinus and inhibited a RAST assay of 29 kD component (Der p I) purified
      from a D. pteronyssinus extract. These results could explain the finding of
      positive skin test with some commercial cat allergen solutions in patients with
      D. pteronyssinus allergy.

PMID- 1632479
TI  - A clinical index: a new method to assess efficacy of allergen immunotherapy.
AB  - Assessment of efficacy in immunotherapy trials is difficult: a number of
      parameters can be measured; these may give conflicting results and it is not
      clear which best represents the clinical state. We therefore derived a Clinical
      Index (CI), by combining five individual parameters-diary card symptom score,
      visual analogue symptom score, drug score, nasal challenge and skin prick test-by
      rank analysis. The CI has been used to express the results in a trial of house
      dust mite (D. pteronyssinus) immunotherapy for allergic rhinitis, comparing two
      active treatments, Pharmalgen and Allpyral, with placebo. The derived index
      correlated well with all parameters measured. Correlations between the five
      individual parameters were variable: with the exception of the skin test, good
      correlations were seen, each parameter correlating with two or three of the
      others, but the visual analogue showed the closest association with other
      parameters. Results from a single parameter taken alone could be misleading, e.g.
      in the Allpyral group, nasal challenge improved significantly, but symptoms
      assessed either by visual analogue or diary card score did not. The CI showed
      significant improvement in the Pharmalgen group but not in the Allpyral group.
      The CI gave a more reliable measure of outcome than individual parameters.

PMID- 1632480
TI  - Anaphylactic shock after skin test with phytohaemoagglutinin.
AB  - A young woman (26 years old), with gastrointestinal candidosis of 8 months
      duration, was hospitalized in our department to study her cell immunity. Five
      minutes after an id injection of PHA (bactophytohaemoagglutinin M, Difco, 1 mg),
      mix monilieae, mix tricophyton and PPD Berna, she showed an extensive wheal and
      flare reaction in the PHA injection area, eyelid oedema and respiratory distress.
      In spite of adrenaline, corticosteroid and antihistamine drug administration, the
      patient collapsed and was admitted to the resuscitation department, where she
      quickly recovered. In the following days, the patient underwent immune and
      allergy testing: 1) total Ige immuno-enzymatic assay: 72 KU/1; 2) specific IgE
      and IgE immuno-enzymatic assay for Candida: negative; 3) in vitro lymphocyte
      transformation test (thymidine 2-C14) with PHA Difco was positive. This finding
      and the positivity of the id injection with PHA could indicate an allergic type I
      immunoreaction, the description of which we have not found in the international
      literature (the presence of IgG STS cannot be totally excluded).

PMID- 1632481
TI  - Pathophysiology of itching in urticaria and atopic dermatitis.

PMID- 1632482
TI  - Presence of viable mould propagules in indoor air in relation to house damp and
      outdoor air.
AB  - The presence of viable mould propagules in indoor air was investigated using the
      N6-Andersen sampler in combination with DG18-agar, in relation to house damp
      (characterized with a checklist) and in relation to the presence of moulds in
      outdoor air. The first part of the study was conducted in 46 houses in the autumn
      of 1987, the second part in 84 houses in May 1989. Further, in the second part,
      the results obtained with settlement plates (OPD) were compared with those
      obtained with the N6-Andersen sampler. The number of CFU/m3 in the indoor and
      outdoor air varied widely. A large variety of mould genera and species was
      isolated. Species of Cladosporium, Penicillium and Wallemia predominated. The
      variability in time was high and the reproducibility of the measurements in terms
      of CFU/m3 and of species isolated was only moderate. The low predictive value of
      these measurements limits their use in epidemiological studies of the
      relationship between exposure to moulds and respiratory symptoms. Overall, the
      geometric mean concentration was somewhat higher outdoors than indoors. However,
      the clear differences found between the number of CFU/m3 belonging to different
      mould species in in- and outdoor air show that the presence of viable mould
      propagules in indoor air is not simply a reflection of the presence of moulds in
      outdoor air. The presence of moulds in indoor air was only weakly related to
      house damp as characterized by the checklist. High, statistically significant
      correlations were found between the CFU yield obtained with the OPD and the
      CFU/m3 yield obtained with the N6-Andersen sampler.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1632483
TI  - Study of the allergenic fractions of latex.
AB  - Two latex (Hevea brasiliensis) raw materials, one from the cytosolic fraction,
      the other from the total natural latex have been characterised by immunoblotting
      techniques. The two latex fractions A and B were studied by immunoprints using
      eight sera from patients who were allergic to latex. They gave different profiles
      though there were also allergens of common molecular weights (60, 35, 30, 25, 20,
      18, 15, and 10 kD). This study confirms the importance of allergic reactions to
      latex, that may in some patients cause anaphylactic shock.

PMID- 1632484
TI  - Cytogenetic approaches to genome mapping.

PMID- 1632485
TI  - Determination of the in vivo redox status of cysteine, cysteinylglycine,
      homocysteine, and glutathione in human plasma.
AB  - An assay that measures the reduced, oxidized, and protein-bound forms of
      cysteine, cysteinylglycine, homocysteine, and glutathione in human plasma is
      described. Oxidized and protein-bound thiols are converted to their reduced
      counterparts by the use of NaBH4, and, following derivatization with
      monobromobimane (mBrB), the thiol-bimane adducts are quantified by reversed-phase
      ion-pair liquid chromatography and fluorescence detection. The presence of 50
      microM dithioerythritol provides linearity of the standard curves at very low
      thiol concentrations. Selective determination of the oxidized forms was
      accomplished by blocking free sulfhydryl groups with N-ethylmaleimide (NEM) and
      excess NEM is inactivated by the subsequent addition of NaBH4. The reduced forms
      of the thiols in plasma were trapped with minimal oxidation by derivatizing blood
      samples at the time of collection. This was attained by drawing blood directly
      into tubes containing isotonic solutions of mBrB or NEM. The assay is
      sufficiently sensitive (less than 2 pmol) to detect the various forms of the four
      thiol compounds in human plasma. The analytical recovery of cysteine,
      cysteinylglycine, homocysteine, and glutathione was close to 100%, and the within
      day precision corresponded to a coefficient of variation of 7, 8, 6, and 7%,
      respectively. The assay has been used to determine the various forms of the four
      thiol compounds in human plasma.

PMID- 1632486
TI  - Assay of thiols and disulfides based on the reversibility of N-ethylmaleimide
      alkylation of thiols combined with electrolysis.
AB  - A simple and specific method for analyzing thiols and disulfides on the basis of
      the reversibility of N-ethylmaleimide (NEM) alkylation of thiols is described.
      When the adduct of NEM and glutathione (GSH) was electrolyzed at neutral pH, all
      of the GSH was recovered. When the adduct was exposed to pH 11.0 for 15 min at 30
      degrees C before electrolysis, GSH was not detected. The same behavior was
      observed after protein thiols reacted with NEM. This pH-dependent production of
      thiol from the adduct was used to assay GSH and oxidized glutathione in yeast
      cells, to assay sulfhydryl groups and disulfide bonds in authentic proteins, and
      to protect thiols from oxidation during enzymatic digestion of protein. This
      method is useful for assay of thiols and disulfides of both small and large
      molecules and can be used to identify labile thiols in biological samples that
      are oxidized during extraction procedures.

PMID- 1632487
TI  - A modified colorimetric method for the determination of orthophosphate in the
      presence of high ATP concentrations.
AB  - We describe a modified colorimetric method that quantitates inorganic phosphate
      linearly up to 60 nmol, with high stability of the developed color and with a low
      interference by ATP concentration (up to 30 mM). This method is very suitable for
      use in ATPase enzymatic assays, especially with enzymes that have low specific
      activities and (or) high Km values for ATP.

PMID- 1632488
TI  - A gel electrophoresis assay for phytochelatins.
AB  - Phytochelatins are metal-binding peptides produced by higher plants and some
      fungi in response to heavy metal exposure. Established methods for analyzing cell
      free extracts for the presence of phytochelatins include gel-filtration
      chromatography and HPLC. We have developed a nondenaturing polyacrylamide gel
      electrophoresis assay for phytochelatins that combines a small sample size with
      detection via metal binding. This assay can be used for the measurement of the
      relative affinity of phytochelatins for a variety of metal and semimetal ions.

PMID- 1632489
TI  - Xerographic paper as a transfer medium for western blots: quantification of
      bovine alpha S1-casein by western blot.
AB  - We have found that xerographic paper (regular photocopy or laser printer paper)
      can be used as a transfer medium for protein blots for the immunodetection of low
      concentrations (a few nanograms) of bovine alpha S1-casein. With paper blotting,
      we could detect the protein with three times more sensitivity than with
      polyvinylidene difluoride. Blotting was achieved by transfer from sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis to the methanol-wet paper. The blot
      was incubated with chicken anti-casein antibodies, sequentially peroxidase
      labeled rabbit anti-chicken antibodies, and diaminobenzidine substrate. The blots
      were directly scanned and the pixel intensity of the band areas was integrated.
      An analysis of the scanned blots showed that the log of protein concentration was
      linearly related with the square root of an integrated pixel intensity (r2
      greater than 0.96). This linear relationship was observed in a wide range of
      protein concentration from 5 ng to 15 micrograms. The coefficients of variation
      were 12.4% for intraassay and 15.7% for interassay. This new analytical procedure
      can be applied to estimate the concentration of proteins by immunological
      blotting.

PMID- 1632490
TI  - Simultaneous determination of 3-hydroxyanthranilic and cinnabarinic acid by high
      performance liquid chromatography with photometric or electrochemical detection.
AB  - A convenient and rapid method for the simultaneous determination by HPLC of 3
      hydroxyanthranilic acid and the dimer derived by its oxidation, cinnabarinic
      acid, is described. Buffers or biological samples containing these two Trp
      metabolites were acidified to pH 2.0 and extracted with ethyl acetate with
      recoveries of 96.5 +/- 0.5 and 93.4 +/- 3.7% for 3-hydroxyanthranilic and
      cinnabarinic acid, respectively. The two compounds were separated on a reversed
      phase (C18) column combined with ion-pair chromatography and detected
      photometrically or electrochemically. The method was applied successfully to
      biological systems in which formation of either 3-hydroxyanthranilic or
      cinnabarinic acid had been described previously. Thus, interferon-gamma-treated
      human peripheral blood mononuclear cells formed and released significant amounts
      of 3-hydroxyanthranilic acid into the culture medium and mouse liver nuclear
      fraction possessed high "cinnabarinic acid synthase" activity. In contrast,
      addition of 3-hydroxyanthranilic acid to human erythrocytes resulted in only
      marginal formation of cinnabarinic acid. We conclude that the method described is
      specific, sensitive, and suitable for the detection of the two Trp metabolites in
      biological systems.

PMID- 1632491
TI  - Affinity-mediated modification of electrical charge on a cell surface: a new
      approach to the affinity partitioning of biological particles.
AB  - Polylysine has been covalently bound to human transferrin in a 1:1 molar ratio
      over a disulfide bond that can be easily split by reducing agents such as
      dithiothreitol. The association constant for the binding of the transferrin
      polylysine derivative to transferrin receptors present on rat erythroblasts and
      the number of binding sites were identical to the corresponding values found for
      native transferrin. The incubation of the cells with transferrin-polylysine
      affected the partitioning of erythroblasts in a charge-sensitive aqueous two
      phase system containing Dextran and polyethylene glycol. The polylysine part
      introduced a nonspecific influence on the partitioning that could be eliminated
      by preincubation of the cells with an excess of sialic acid. The partition ratio,
      G, of the erythroblasts changed with a factor of 1.9 for each set of 100,000
      polylysine chains attached per cell.

PMID- 1632492
TI  - An indirect-labeling procedure for the study of specific interactions of proteins
      with DNA.
AB  - A semiquantitative and reproducible indirect-labeling procedure for the study of
      specific protein/DNA interactions using nitrocellulose-filter-immobilized
      proteins and linear or superhelical DNA molecules is reported. Proteins were
      immobilized on nitrocellulose filters either by direct dotting or by
      electrotransfer from polyacrylamide electrophoretic gels. After incubation with
      the respective DNA (linear restriction fragments or closed circular recombinant
      DNA plasmids) the paper strips were washed, and specifically bound DNA was
      denatured by alkali and detected by hybridization with 32P-nick-translated DNA.
      The quantitation of the reaction was performed by scanning of the autoradiograms
      of the radioactive spots and determination of the area under the respective
      peaks. The intensity of the radioactive spots was proportional to the amount of
      protein present in the dot. The sensitivity of the assay depends primarily on the
      affinity of the respective DNA to the protein and in the case of mouse liver
      histone H1AB/mouse alpha-globin gene approximately 50 ng of protein per dot was
      enough for determination.

PMID- 1632494
TI  - Automated solid-phase peptide synthesis: use of 2-(1H-benzotriazol-1-yl)-1,1,3,3
      tetramethyluronium tetrafluoroborate for coupling of tert-butyloxycarbonyl amino
      acids.
AB  - 2-(1H-Benzotriazol-1-yl)-1,1,3,3-tetramethyluronium tetrafluoroborate (TBTU) has
      been adapted for use as a coupling reagent for tert-butyloxycarbonyl (Boc) amino
      acids in automated solid-phase peptide synthesis. When compared to the existing
      preformed symmetrical anhydride procedure employing dicyclohexyl-carbodiimide
      (DCC), the use of TBTU in the presence of 1-hydroxybenzotriazole (HOBt) provides
      a more efficient coupling procedure for Boc-amino acid derivatives. Overall cycle
      times using TBTU/HOBt coupling reagents (30 min) compare favorably to those of
      the DCC-mediated procedure (approx 65 min). Dimethylformamide can be used as the
      sole solvent for both activation and coupling reactions. Implementation of
      TBTU/HOBt coupling conditions does not require replumbing of any lines of the
      Applied Biosystems Model 430A instrument and necessitates changes to only three
      reagent bottle positions. The variable coupling efficiencies of Boc-asparagine
      following activation with TBTU/HOBt (as low as 89%) can be overcome by protection
      of the amide function of Boc-asparagine with the 9-xanthyl group. Examples of the
      synthesis and characterization of a number of peptides ranging in length from 13
      to 29 residues are given.

PMID- 1632493
TI  - Characterization and quantification of diadenosine hexaphosphate in chromaffin
      cells: granular storage and secretagogue-induced release.
AB  - The presence of diadenosine hexaphosphate (Ap6A) in chromaffin cells is
      described. The characterization of Ap6A has been accomplished by HPLC techniques,
      using three different elution conditions, rechromatography, and coelution with
      standards. Treatment with phosphodiesterase from Crotalus durissus produced AMP
      and adenosine pentaphosphate. The HPLC techniques described allowed the
      quantification of Ap6A in the picomole range. Chromaffin granules store Ap6A in a
      quantity of 48.5 +/- 9.7 nmol/mg protein, with a molar ratio ATP/Ap6A of 27. In
      chromaffin cells the Ap6A value was 1.46 +/- 0.32 nmol/10(6) cells. Diadenosine
      hexaphosphate was released from chromaffin cells by the action of carbachol and a
      value of 64 +/- 15 pmol/10(6) cells was obtained, which represents 4-5% of the
      total cellular content.

PMID- 1632495
TI  - Use of delta-(alpha-aminoadipoyl) chromogenic amides in screening for
      aminoadipoyl amidohydrolases.
AB  - The synthesis of delta-(alpha-aminoadipoyl) aromatic amides and their use in
      screening for enzymes able to cleave delta-(alpha-aminoadipoyl) residues off the
      synthetic amides and cephalosporin C are described. A number of commercially
      available proteases and peptidases were not active with delta-(alpha
      aminoadipoyl) chromogenic amides. Also, most tested microbial strains known to
      produce acylases did not hydrolyze these compounds. Only one microbial strain,
      Xanthomonas maltophila, had an appreciable activity toward the racemic form of
      chromogenic substrates. Activity measured in crude extracts from Xanthomonas
      cells indicated that this bacterium produces predominantly L-specific
      aminoadipoyl amidohydrolase and gamma-glutamyl hydrolase. A low level of
      cephalosporin C and glutaryl-cephalosporin acylase activities was also found.

PMID- 1632496
TI  - Extending CD spectra of proteins to 168 nm improves the analysis for secondary
      structures.
AB  - The CD spectra for 10 proteins with known secondary structure have been extended
      from 178 to 168 nm. Combined with the data for 6 other proteins investigated
      previously, this produces a basis set of 16 proteins, which can be used to
      analyze CD spectra for secondary structure. Extending the spectra adds another CD
      band to the data and increases the information content from the equivalent of
      five to six. Analyzing the CD for each of the 16 proteins in the basis set with
      the 15 other proteins shows a modest improvement in the prediction of secondary
      structure with the extended CD spectra.

PMID- 1632497
TI  - High-performance liquid chromatographic determination of catecholamines and their
      precursor and metabolites in human urine and plasma by postcolumn derivatization
      involving chemical oxidation followed by fluorescence reaction.
AB  - A high-performance liquid chromatographic method for the determination of
      catecholamines and their precursor and metabolites [amino compounds
      (norepinephrine, epinephrine, dopamine, normetanephrine, metanephrine, 3
      methoxytyramine, and L-DOPA), acidic compounds (3,4-dihydroxyphenylacetic acid,
      vanillyl-mandelic acid, and homovanillic acid), and alcoholic compound [4-hydroxy
      3-methoxyphenyl)ethylene glycol)] in human urine and plasma. Urine and plasma
      samples deproteinized with perchloric acid in the presence of isoproterenol and
      3,4-dihydroxyphenylpropanoic acid (internal standards) are fractionated by solid
      phase extraction on a strong cation-exchange resin cartridge (Toyopak IC-SP S)
      into two fractions (amine fraction and acid-alcohol fraction). The compounds in
      each fraction are separated by an ion-pair reversed-phase chromatography on a TSK
      gel ODS-80TM with isocratic elution and on-line derivatized by periodate
      oxidation followed by a fluorescence reaction using meso-1,2
      diphenylethylenediamine. The detection limits (S/N = 5) vary from 0.5 to 95
      pmol/ml, depending on the compounds.

PMID- 1632498
TI  - Western blotting and immunochemical detection of histones electrophoretically
      resolved on acid-urea-triton- and sodium dodecyl sulfate-polyacrylamide gels.
AB  - We have developed a method for the efficient transfer of histones from acetic
      acid-urea-Triton X-100 (AUT)-polyacrylamide minislab gels to nitrocellulose. The
      AUT gel was equilibrated with 50 mM acetic acid and 0.5% sodium dodecyl sulfate
      and then with 62.5 mM Tris-HCl, pH 6.8, and 2.3% sodium dodecyl sulfate. An
      alkaline transfer buffer [25 mM 3-(cyclohexylamino)-1-propanesulfonic acid, pH
      10, with 20% methanol] was used to electrophoretically transfer the strongly
      basic proteins from AUT or sodium dodecyl sulfate gels to nitrocellulose. The
      applicability of this approach in the immunochemical detection of ubiquitinated
      histone species is demonstrated.

PMID- 1632499
TI  - Ion-exchange high-performance liquid chromatography analysis of
      oligodeoxyribonucleotide phosphorothioates.
AB  - Oligodeoxynucleotide-containing phosphorothioate backbones have been used to
      regulate viral as well as cellular gene expression. The studies carried out in
      tissue culture have shown promising results on the use of oligonucleotide
      phosphorothioates as antiviral agents and, at present, study is underway to
      develop these oligonucleotide analogues as chemotherapeutic agents. To analyze
      and purify oligonucleotide analogues, high-performance liquid chromatography
      using weak anion exchange column has been described. The separation of
      oligonucleotide phosphorothioate is found to be length dependent.

PMID- 1632500
TI  - Beta-II conformation of all-beta proteins can be distinguished from unordered
      form by circular dichroism.
AB  - The CD spectrum of certain all-beta globular proteins resembles that of unfolded
      proteins with a characteristic negative band around 200 nm. The conformation of
      this class is tentatively termed beta-II, which had two features that were absent
      for unfolded proteins. First, beta-II proteins usually had CD bands due to
      aromatic side groups in the near-ultraviolet region. Second, the CD intensities
      both in the far- and in the near-uv region of these compact and rigid proteins
      usually showed a sharp transition upon thermal denaturation, whereas those of an
      unordered form changed linearly with rising temperature.

PMID- 1632501
TI  - Continuous spectrophotometric assays for beta-glucosidases acting on the plant
      glucosides L-picein and prunasin.
AB  - The neutral pH optimum beta-glucosidases of mammalian liver and almonds are each
      capable of hydrolyzing a number of plant glucosides, including L-picein (p
      hydroxyacetophenone-beta-D-glucoside) and prunasin (D-mandelonitrile-beta-D
      glucoside). Taking advantage of the marked differences in the spectra of the
      substrate/product pairs of L-picein/p-hydroxyacetophenone and
      prunasin/mandelonitrile, we have devised spectrophotometric assays that permit
      the continuous monitoring at pH 7.0 of p-hydroxyacetophenone (piceol) release
      from L-picein by guinea pig hepatic cytosolic beta-glucosidase and mandelonitrile
      from prunasin by almond beta-glucosidase. When L-picein hydrolysis was monitored
      at 320 nm and prunasin at 282 nm, the molar absorption coefficients determined
      for their products, namely piceol and mandelonitrile, were 3200 and 1360 M-1 cm
      1, respectively. The kinetic parameter Km and Vmax values obtained using these
      spectrophotometric procedures for the guinea pig liver cytosolic beta-glucosidase
      acting on L-picein were 0.88 mM and 5.29 x 10(5) units/mg protein and for the
      almond beta-glucosidase acting on prunasin, Km 1.1 mM and Vmax 5.24 x 10(6)
      units/mg protein. These values agreed well with previously reported values
      obtained using less convenient, discontinuous assay procedures.

PMID- 1632502
TI  - Chromatography of proteins on columns of polyvinylpolypyrrolidone using adsorbed
      textile dyes as affinity ligands.
AB  - A simple and inexpensive chromatography system for proteins is introduced. When
      the amino derivatives of chlorotriazine dyes or other azo dyes were added to an
      aqueous slurry of the crosslinked polymer polyvinylpolypyrrolidone they were
      adsorbed, thus forming an immobilized dye chromatographic matrix. The association
      of the textile dyes with polyvinylpolypyrrolidone did not prevent them from
      acting as affinity ligands for proteins. Parameters such as ionic strength, dye
      concentration, and column size modulated the affinity effect exerted by the
      immobilized dyes. Lysozyme present in an egg white protein mixture bound to a
      column onto which the amino derivative of Procion Brown H-A was adsorbed and was
      eluted with a linear gradient of KCl. The resulting purification of the enzyme
      was 37-fold with 80% of the original activity being recovered. Free dye eluting
      with the lysozyme was removed on a column of polyvinylpolypyrrolidone
      equilibrated with 0.5 M KCl. After chromatography, the dye column was regenerated
      with 0.5 M NaOH and recharged with dye. The system presented here allows one to
      initially screen large numbers of potentially useful protein ligands to optimize
      a protein separation, followed by scaleup to a system size determined by the
      user.

PMID- 1632503
TI  - Large-scale cell separation by centrifugal elutriation.
AB  - Countercurrent elutriation is a powerful method for fast and gentle large-scale
      isolation of cells according to size and density. Current limitations of this
      approach are the suboptimal selectivity that is obtained and the fact that the
      total number of cells that can be separated per run is restricted. We describe a
      new separation chamber, which was calculated according to the hydrodynamic
      boundaries of the counterflow separation. In comparison to the chamber commonly
      in use, a fivefold higher cell number can be separated with this chamber at an
      increased separation selectivity. Furthermore the use of this chamber, which fits
      to the standard Beckman equipment, avoids large sampling volumes.

PMID- 1632504
TI  - Detection of acyl-coenzyme A thioester intermediates of fatty acid beta-oxidation
      as the N-acylglycines by negative-ion chemical ionization gas chromatography-mass
      spectrometry.
AB  - An analytical method for the separation and quantitation of acyl-CoA thioesters
      by gas chromatography-mass spectrometry is described. The method utilizes glycine
      aminolysis of the acyl-CoA thiolesters, esterification with pentafluorobenzyl
      bromide followed by gas chromatographic separation, and detection by negative
      chemical ionization mass spectrometry of the N-acylpentafluorobenzyl glycinates.
      The glycine aminolysis provides over 100-fold discrimination against oxygen
      esters and obviates the difficulty of removing trace contaminants of free fatty
      acids. The limit of detection of the described methodology for palmitoyl-CoA has
      been found to be 300 fmol, which improves at shorter chain lengths. Baseline
      separation was obtained for a standard mixture of seven acyl-CoAs (60 pmol
      injected) containing butyryl-CoA, hexanoyl-CoA, octanoyl-CoA, decanoyl-CoA,
      lauroyl-CoA, myristoyl-CoA, and palmitoyl-CoA. The above procedure is also
      applicable to the alpha-beta unsaturated and 3-hydroxyacyl-CoA derivatives,
      making it possible to quantify all of the intermediates in fatty acid oxidation,
      except the 3-ketoacyl-CoAs, in a single procedure.

PMID- 1632505
TI  - Evaluation of differential pulse polarography for the quantification of
      metallothionein--a comparison with RIA.
AB  - Two methods to quantify metallothionein (MT), differential pulse polarography
      (DPP) and radioimmunoassay (RIA), were compared for MT analysis of liver from Zn-
      and Cd-injected perch (Perca fluviatilis). Nine perch were intraperitoneally
      injected, twice a week during 2 weeks with ZnSO4 and CdCl2 to yield a total dose
      of 30 mg Zn and 3 mg Cd per kilogram body weight. Two samples, 100 and 200 mg
      from each liver, were homogenized separately and further prepared for DPP, RIA,
      and atomic absorption spectroscopy. MT values obtained by DPP were in good
      agreement with the MT values determined by RIA (r = 0.92). The relationship
      between the MT values analyzed with the two methods is described by the formula
      MTRIA = MTDPP x 0.99-0.048. Analysis of MT was not affected by sample size. MT
      values from individual liver samples plotted against the Cd and Zn content of the
      corresponding samples provided a high correlation. The correlation coefficient
      was 0.86 for MT values obtained by DPP and 0.92 for MT measured by RIA. It is
      concluded that DPP is a reliable method for analyzing MT in liver.

PMID- 1632506
TI  - A zymographic assay for detection of hyaluronidase activity on polyacrylamide
      gels and its application to enzymatic activity found in bacteria.
AB  - A zymographic assay for the determination of hyaluronidase activity in cell-free
      extracts on native polyacrylamide gels has been developed. In this assay an
      agarose replica of the polyacrylamide gel which contains hyaluronic acid and
      bovine serum albumin (BSA) was used. After an incubation at 37 degrees C to allow
      transfer and development of enzymatic activity, the hyaluronic acid and BSA were
      precipitated in the agarose gel with 2 M acetic acid. Areas of enzymatic activity
      appeared as clear zones in the agarose replica. The assay was sensitive and was
      used to demonstrate hyaluronidase activity in cell-free extracts from a number of
      bacterial and mammalian species.

PMID- 1632507
TI  - Analysis of macromolecular interactions using immobilized ligands.

PMID- 1632508
TI  - Preparative capillary electrophoresis based on adsorption of the solutes
      (proteins) onto a moving blotting membrane as they migrate out of the capillary.
AB  - A micropreparative capillary electrophoresis apparatus equipped with a new type
      of fraction collection device is described: solutes, such as proteins, are
      adsorbed onto a moving blotting membrane (for instance a polyvinylidene
      difluoride membrane) as they migrate electrophoretically out of the capillary.
      The adsorbed proteins are visualized by conventional protein staining methods or
      by fluorescent labeling. Specific identification of separated components by an
      immunological technique is demonstrated. The method also offers the potential to
      analyze proteins and peptides collected on the membrane by gas phase sequencing
      and mass spectrometry.

PMID- 1632509
TI  - Characterization of disulfide bond position in proteins and sequence analysis of
      cystine-bridged peptides by tandem mass spectrometry.
AB  - Tandem mass spectrometry employing high-energy, collisionally activated
      dissociation (CAD) is shown to be a useful method for sequencing through the
      cystine bridge of intermolecularly disulfide-bonded peptides. A characteristic
      triplet of intense fragment ions is observed corresponding to cleavage through
      and to either side of the disulfide bridge. These fragments define the masses of
      the linked peptides. Fragments due to peptide chain cleavage are also observed at
      lower abundance in the product-ion spectra and can be sufficient to sequence both
      of the disulfide-linked peptides without any prior knowledge of the peptide or
      protein sequence. Even in cases where the peptide sequence-related product-ion
      yields are poor, the intensities of the disulfide cleavage ions are usually
      sufficient to determine the molecular weights of the component cystine-bridged
      peptides. In this paper we demonstrate that the high-energy CAD tandem MS
      approach may be used to characterize disulfide-bonded peptides directly in
      complex enzymatic or chemical digests of native proteins. This obviates the need
      for individual purification of intermolecularly disulfide-linked peptides prior
      to analysis. The techniques are illustrated here for synthetic, inter- and
      intramolecularly disulfide-linked peptides and for human transforming growth
      factor-alpha (des-Val-Val-TGF-alpha), a compact protein containing 48 residues
      and three disulfides.

PMID- 1632510
TI  - Protein purification using a soluble affinity matrix: purification of estrogen
      receptor with estradiol-polylysine conjugate.
AB  - A new strategy for protein purification using a soluble affinity matrix is
      described. The method was used for purification of estrogen receptor. Cytosols
      from rat uteri and human fibroid uterine tissue, after fractionation by ammonium
      sulfate, were treated with estradiol-polylysine conjugate. The highly basic
      affinity complex was separated from other proteins by DEAE-Sephacel
      chromatography. After dissociation of the eluted complex with excess estradiol,
      the receptor was recovered by CM-Sephadex chromatography. A 2000-fold
      purification of the rat uterine estrogen receptor was obtained with an activity
      recovery of 35%.

PMID- 1632511
TI  - The precise radioimmunoassay of adenosine: minimization of sample collection
      artifacts and immunocrossreactivity.
AB  - Anti-adenosine antibodies were produced in rabbits immunized with N6
      carboxymethyladenosine conjugated to methyl albumin. 125I-N6-Aminobenzyladenosine
      was synthesized and used as a high-specific-activity, high-affinity ligand. A
      radioimmunoassay (RIA) was developed that can detect 6.25 nM (312.5 fmol) of
      underivatized adenosine and cross-reacts less than 0.02% with adenine nucleotides
      and guanosine and not at all with 1 mM inosine. The sensitivity of the RIA can be
      increased to a detection limit of 0.125 nM (6.25 fmol) by derivitizing samples
      with benzyl bromide to form N6-benzyladenosine. The assay was adapted to an
      automated RIA procedure. Assay precision was increased by: (i) inhibiting slight
      adenosine deaminase activity present in anti-sera; (ii) treating buffers and
      albumin used in the RIA with charcoal to remove contaminating adenosine; and
      (iii) correcting for a small but variable component of immunoreactivity not
      attributable to adenosine. A second antibody prepared with a 2',3'
      disuccinyladenosine-albumin conjugate was also found to detect some non-adenosine
      mediated immunoreactivity in plasma samples. Immunointerference in human plasma
      was eliminated in samples treated with ZnSO4/Ba(OH)2 or partially purified over
      C18 Sep Paks to remove nucleotides and assayed after sample benzylation or
      succinylation. Human blood was mixed with a novel "stop" solution that was
      optimized to inhibit adenosine formation from AMP by greater than 99% and to
      inhibit adenosine uptake into red cells and degradation by greater than 94%.
      Human plasma/stop solution was assayed by RIA and HPLC with equivalent results.

PMID- 1632512
TI  - Internal protein sequence analysis: enzymatic digestion for less than 10
      micrograms of protein bound to polyvinylidene difluoride or nitrocellulose
      membranes.
AB  - A procedure for the generation and isolation of internal peptide fragments for
      less than 10 micrograms of protein bound to either polyvinylidene difluoride
      (PVDF) or nitrocellulose membranes after electrophoretic transfer from sodium
      dodecyl sulfate-polyacrylamide gels (SDS-PAGE) is presented. This technique has
      produced internal sequence data for 120 peptides, with an average initial yield
      of 20 pmol. Membrane-bound proteins were enzymatically digested with either
      trypsin or endoproteinase Lys-C in the presence of 1% hydrogenated Triton X
      100/10% acetonitrile/100 mM Tris-HCl, pH 8.0, for 24 h at 37 degrees C. The
      eluted peptides were then directly isolated by microbore HPLC for subsequent
      sequence analysis. One percent hydrogenated Triton X-100 did not inhibit
      enzymatic activity, distort HPLC resolution of peptides, or contain uv-absorbing
      contaminants that could interfere with peptide identification. Reproducible
      peptide maps and consistent recoveries are presented for standard proteins (3.5
      8.0 micrograms) bound to either membrane, with higher recoveries for PVDF-bound
      proteins. Ninety percent of the proteins analyzed by this technique have produced
      results; representative peptide maps and sequence data are presented. This
      technique has a wide range of applications, particularly for proteins with
      blocked amino termini or those that can only be purified by SDS-PAGE or 2D
      isoelectric focusing SDS-PAGE.

PMID- 1632513
TI  - Determination of hydroxyproline by high pressure liquid chromatography.
AB  - A rapid, precise, and simple HPLC method provides an assay of hydroxyproline from
      tissue extracts or solutions of collagen. Samples are hydrolyzed with 6 N HCl,
      derivatized with phenyl isothiocyanate, and chromatographed on a small, C18
      reverse-phase HPLC column. Hydroxyproline (Hyp) is separated from other amino
      acids and detected by absorption at 254 nm. The method detects 0.40 to 36
      micrograms of Hyp with a linear response. Separation requires a total of 6 min,
      including column cleanup and reequilibration. All components are commercially
      available, making this a convenient method for routine measurement of collagen
      concentration.

PMID- 1632514
TI  - Polymerase chain reaction amplification of single-stranded DNA containing a base
      analog, 2-chloradenine.
AB  - By utilization of polymerase chain reaction techniques, single-stranded DNA of
      defined length and sequence containing a purine analog, 2-chloroadenine, in place
      of adenine was synthesized. This was accomplished by a combination of standard
      polymerase chain amplification reactions with Thermus aquaticus DNA polymerase in
      the presence of four normal deoxynucleoside triphosphates, M13 duplex DNA as
      template, and two primers to generate double-stranded DNA 118 bases in length. An
      asymmetric polymerase chain reaction, which produced an excess of single-stranded
      98-base DNA, was then conducted with 2-chloro-2'-deoxy-adenosine 5'-triphosphate
      in place of dATP and with only one primer that annealed internal to the original
      two primers. Standard polymerase chain reaction techniques alone conducted in the
      presence of the analog as the fourth nucleotide did not produce duplex DNA that
      was modified within both strands. This asymmetric technique allows the
      incorporation of an altered nucleotide at specific sites into large quantities of
      single-stranded DNA without using chemical phosphoramidite synthesis procedures
      and circumvents the apparent inability of DNA polymerase to synthesize fully
      substituted double-stranded DNA during standard amplification reactions. The
      described method will permit the study of the effects of modified bases in
      template DNA on a variety of protein-DNA interactions and enzymes.

PMID- 1632515
TI  - The size dependence of cholate-dialyzed vesicles on phosphatidylcholine
      concentration.
AB  - The size dependence of vesicles prepared by dialysis of cholate from
      phosphatidylcholine (PC) dispersions has been investigated as a function of lipid
      concentration (at a constant applied lipid: detergent molar ratio of 0.7). Gel
      filtration of dialyzed samples produced a symmetrical profile shape, although
      quasielastic laser light scattering analysis of the fractions revealed an
      asymmetrical range of sizes about the peak for solutions containing elevated
      lipid concentrations. Vesicle diameters increased by approximately 20 nm for PC
      concentrations ranging from 10 to a maximum of 45 mg/ml. This was attributed to
      mixed micelle sizes being proportional to lipid concentration, since the
      diameters of vesicles produced from dialysis are determined by mixed micelle
      sizes. Before commencement of dialysis, mixed micelle sizes are proportional to
      lipid concentration and, although dialysis causes an increase in mixed micelle
      sizes, the phase ratios attained are larger for solutions containing elevated
      lipid concentrations.

PMID- 1632516
TI  - The use of three ferguson-plot-based calculation methods to determine the
      molecular mass of proteins as illustrated by molecular mass assessment of rat
      plasma carboxylesterases ES-1, ES-2, and ES-14.
AB  - The molecular masses of three rat-plasma carboxylesterases (ES-1, ES-2, and ES
      14) were estimated by transverse-gradient polyacrylamide gel electrophoresis and
      subsequent application of Ferguson-plot-based calculation methods. Two
      electrophoretic buffer systems were used and the data subjected to either
      weighted or unweighted regression analysis. The Tris-boric acid buffer system
      produced significantly higher retardation coefficients than the Tris-glycine
      system. Molecular mass estimates were significantly higher with the Tris-glycine
      buffer system. Unweighted instead of weighted analysis produced significantly
      higher molecular mass estimates. Molecular mass estimates also depended on the
      calculation method, that is, the choice of calibration relationship with
      molecular size as a function of retardation coefficient. Three commonly used
      calibration relationships were compared. On the basis of their accuracy, both the
      weighted log[retardation coefficient] versus log[molecular mass] plot and the
      square root of retardation coefficient versus molecular radius were found
      suitable, provided that the Tris-boric acid buffer was used for electrophoresis.
      Using the former calibration relationship, the molecular masses of rat-plasma ES
      1, ES-2, and ES-14 were 55.5, 61.1, and 65.3 kDa, respectively.

PMID- 1632517
TI  - Purification of brush border membrane vesicles from rat renal cortex by size
      exclusion chromatography.
AB  - Size-exclusion chromatography with controlled pore glass (CPG) was used in the
      further purification of renal brush border membrane vesicles (BBMV) isolated by
      the Ca precipitation method. The BBMV obtained had an almost spherical shape and
      their average diameter was about 95 nm in isotonic solution. The specific
      activities of alkaline phosphate and leucine aminopeptidase in the BBMV
      preparation were increased 18- and 17-fold, respectively, over those in the crude
      homogenate. The uptake of D-glucose by the purified BBMV in the presence of a
      sodium gradient reached 8.53 nmol/mg protein at 20 s. These results indicate that
      CPG chromatography is suitable procedure by which to obtain purified renal BBMV
      of homogenous size and with high specific marker enzyme activity for use in the
      study of membrane transport.

PMID- 1632518
TI  - Leaching of concanavalin A during affinity chromatographic isolation of cell
      surface glycoproteins from human fetal neurons and glial cells.
AB  - Preparation of surface glycoproteins from human fetal brain cells by affinity
      chromatography on Con A-Sepharose 4B was a problematic endeavor due to leaching
      of Con A from the matrix. Dissociation of Con A from the matrix took place
      irrespective of the presence of lipid and/or detergent and the buffer composition
      during chromatography and was apparently related to the nature of the protein
      under study. Pretreatment of Con A-Sepharose with 6 M guanidine or 8 M urea
      reduced Con A leaching. The Con A eluate also contained noncovalently associated
      glycolipid. Elution at 25 degrees C rendered fractions containing a higher degree
      of Con A and glycolipid contamination compared to the negligible contamination by
      these two components when elution was carried out at 4 degrees C. This phenomenon
      was attributed to the formation of heterogeneous mixed micelles of glycoprotein.

PMID- 1632519
TI  - Antibody from hen's eggs against a conserved sequence of the gametophytic self
      incompatibility proteins of plants.
AB  - A convenient way of producing effective antibodies to plant proteins is
      presented. It takes into account the following facts: (1) many plant proteins are
      highly glycosylated, thus giving rise to nonspecific antibodies which cross-react
      with other glycoproteins, (2) it is more common nowadays to know the DNA sequence
      of a protein coding gene than to have significant amounts of that protein well
      purified as antigen, and (3) eggs from immunized hens are very convenient sources
      of large amounts of antibodies. An antibody which specifically detects self
      incompatibility proteins (S-proteins) in Solanaceae was isolated. The published
      cDNA sequences and deduced amino acid sequences of Nicotiana alata (an ornamental
      tobacco) S-proteins were computer analyzed in order to recognize a peptide with a
      conserved sequence which would effectively give rise to antibodies. An adequate
      amount of this peptide was synthesized and part of it was coupled to a
      macromolecular carrier (bovine serum albumin). Antibodies to this peptide-carrier
      complex were recovered from egg yolks of immunized hen in amounts corresponding
      to 300 ml of antiserum per month. From the total immunoglobulin fraction
      isolated, the antibody specific for S-proteins was affinity purified over 100
      fold on a peptide-coupled column. The antibody showed high levels of specificity
      for putative S-specific sequences in N. alata and in petunia. Also the size,
      polymorphy, and quantity of the detected antigens were in very good accordance
      with previously published data. In addition to the present application, this
      procedure should be useful for a wide variety of proteins.

PMID- 1632520
TI  - Electroluminescent lamp-based phase fluorometer and oxygen sensor.
AB  - We have tested 454-nm violet-emitting solid state electroluminescent lamps (ELLs)
      as inexpensive intensity-modulated excitation light sources for phase
      fluorometric oxygen sensors. Compared with blue-emitting silicon carbide LEDs,
      planar surface ELLs can be produced in various shapes and in large sizes.
      Accordingly, the overall optical output power emitted by ELLs is much higher than
      that of blue LEDs. By arranging a large-size ELL close to a large-size
      fluorescent chemical sensor, we obtained a large number of fluorescence photons
      allowing for the use of a pin photodiode instead of a photomultiplier tube as the
      detector. For a sinusoidal driving voltage at a frequency f, the ELL output light
      is modulated at 2f and at harmonics of 2f. Because of this nonlinear modulation
      characteristic, we used a square wave driving signal, resulting in a pulsed light
      output at a repetition rate twice the square wave frequency. The shortest light
      pulses obtained had a FWHM close to about 1 microsecond. This means that the
      violet ELLs used in our tests provide modulation frequencies at twice the square
      wave driving frequency and at all harmonics thereof up to about 1 MHz. This would
      allow the use of fluorescent chemical sensors with decay times as short as 30 ns,
      assuming that a phase shift of 10 degrees is adequate for the application. Due to
      the high ELL driving voltage, effective shielding is required to avoid
      electromagnetic interference between the modulated light source and the
      photodetector. Depending on the driving frequency and voltage applied, the ELLs
      showed a decrease in the optical output power to 50 or even 10% during the first
      100 h of operation.

PMID- 1632521
TI  - Measurement of doxorubicin-induced lipid peroxidation under the conditions that
      determine cytotoxicity in cultured tumor cells.
AB  - We have investigated doxorubicin-induced lipid peroxidation by the measure of
      malondialdehyde (MDA) formation in rat glioblastoma cells and human breast
      carcinoma cells in culture. There was a significant production of MDA when the
      cells were incubated with pharmacologically relevant doxorubicin concentrations,
      i.e., concentrations that produce a significant cytotoxicity (0.1 micrograms/ml).
      At equitoxic doses, vincristine provided no lipid peroxidation, indicating that
      MDA formation is not a consequence of cell death. Doxorubicin-induced lipid
      peroxidation was maximal 24 h after incubation of the cells with doxorubicin,
      indicating that a delay was necessary for the free radical-mediated membrane
      damage induced by doxorubicin. In the presence of alpha-tocopherol in the culture
      medium, the doxorubicin-induced MDA formation was inhibited. The development of
      this method will help in defining the role of free radicals and lipid
      peroxidation in the cytotoxicity of doxorubicin.

PMID- 1632522
TI  - Genomic DNA microextraction: a method to screen numerous samples.
AB  - Many experimental designs require the analysis of genomic DNA from a large number
      of samples. Although the polymerase chain reaction (PCR) can be used, the
      Southern blot is preferred for many assays because of its inherent reliability.
      The rapid acceptance of PCR, despite a significant rate of false
      positive/negative results, is partly due to the disadvantages of the sample
      preparation process for Southern blot analysis. We have devised a rapid protocol
      to extract high-molecular-weight genomic DNA from a large number of samples. It
      involves the use of a single 96-well tissue culture dish to carry out all the
      steps of the sample preparation. This, coupled with the use of a multichannel
      pipette, facilitates the simultaneous analysis of multiple samples. The procedure
      may be automated since no centrifugation, mixing, or transferring of the samples
      is necessary. The method has been used to screen embryonic stem cell clones for
      the presence of targeted mutations at the Hox-2.6 locus and to obtain data from
      human blood.

PMID- 1632523
TI  - Carbohydrate composition analysis of bacterial polysaccharides: optimized acid
      hydrolysis conditions for HPAEC-PAD analysis.
AB  - The capsular polysaccharide from Haemophilus influenzae type b (polyribosyl
      ribitol-phosphate; PRP) and the capsular polysaccharides from Streptococcus
      pneumoniae types 6B, 14, 18C, and 23F (Pn6B, Pn14, Pn18C, and Pn23F) were
      subjected to acid hydrolysis using hydrofluoric (HF) and/or trifluoroacetic acid
      (TFA) and high-pH anion-exchange chromatography with pulsed amperometric
      detection in an effort to identify optimum hydrolysis conditions for composition
      analysis of their carbohydrate components. With the exception of PRP, composition
      analyses of polysaccharides containing a phosphate moiety in the repeating unit
      structure (Pn6B, Pn18C, and Pn23F) are significantly improved by subjecting the
      sample to HF hydrolysis (65 degrees C, 1 h) followed by TFA hydrolysis (98
      degrees C, 16 h). This results in essentially quantitative hydrolysis of the
      phosphodiester bond to the carbohydrate components, which otherwise remained
      predominantly phosphorylated and poorly accounted for in the analysis. Optimum
      analysis of PRP was achieved following a 2-h hydrolysis with TFA at 80 degrees C,
      whereas Pn14 showed optimum results after a 16-h hydrolysis with TFA at 98
      degrees C. These analyses also provide information about the relative
      susceptibility to acid hydrolysis of the various glycosidic and phosphodiester
      bonds in these polysaccharides, with evidence to suggest that the acid lability
      of a given bond can be dramatically different from one polysaccharide to another.

PMID- 1632524
TI  - Hydrophobic interaction chromatography fractionates lipoteichoic acid according
      to the size of the hydrophilic chain: a comparative study with anion-exchange and
      affinity chromatography for suitability in species analysis.
AB  - Hydrophobic interaction chromatography fractionated the lipoteichoic acid of
      Enterococcus faecalis into species of decreasing poly(glycerophosphate) chain
      length and decreasing extent of substitution with alpha-kojibiosyl residues (Glcp
      alpha 1----2Glcp alpha 1----). The chain length varied between 14 and 33
      glycerophosphate residues per lipid anchor, the extent of glycosylation between
      0.18 and 0.44 mol of alpha-kojibiosyl residues per mole of phosphorus, and,
      accordingly, the number of alpha-kojibiosyl substituents per chain between 3 and
      15. Almost identical values were obtained when the same lipoteichoic acid was
      chromatographed on DEAE-Sephadex and concanavalin A, which separate molecular
      species according to increasing number of phosphate groups and alpha-kojibiosyl
      residues, respectively. Species from all three columns, which were identical in
      chain length and glycosylation, also had similar fatty acid patterns. These
      results prove the suitability of all three procedures for species analysis. One
      advantage of hydrophobic interaction chromatography over the other two procedures
      lies in its broader applicability since it is not dependent on negative charges
      or specifically binding oligosaccharide structures. Another advantage is the
      capacity of hydrophobic interaction chromatography to separate molecular species
      differing in the number of fatty acids [W. Fischer, H.U. Koch, and R. Haas (1983)
      Eur. J. Biochem. 133, 523-530] and render them accessible to molecular analyses.

PMID- 1632525
TI  - A particle beam-liquid chromatography-mass spectrometry method for the
      determination of lipoxygenase metabolites of arachidonic acid.
AB  - An application of the particle beam-liquid chromatography-mass spectrometry
      technique to the quantification of hydroxyeicosatetraenoic acids (15-, 12-, and 5
      HETE) in biological samples is presented. The acids are extracted with Ethyl
      acetate and then transformed into pentafluorobenzyl esters, thus increasing the
      sensitivity of their detection by negative chemical ionization mass spectrometry.
      Reverse-phase HPLC separation of HETEs is performed in about 10 min with a water
      methanol gradient. The procedure shows a detection limit of nearly 0.5 pmol,
      about one order of magnitude lower than that of the widely used HPLC/UV methods.
      The quantitative determination is linear (r2 greater than 0.998) for all of the
      HETEs in the range tested (3-1500 pmol) and a CV lower than 8.5% was observed for
      repeated analysis of samples. As an application of the method, HETEs formed from
      endogenous arachidonate were evaluated in extracts obtained from coincubates of
      platelets and neutrophils stimulated with calcium ionophore A23187.

PMID- 1632526
TI  - Purification of human leucocyte DNA: proteinase K is not necessary.
AB  - A rapid nontoxic method for the purification of DNA from human leucocytes is
      described. Preliminary experiments which tested different methods of DNA
      purification indicated that digestion of proteins with proteinase K was
      unnecessary. This led to the development of a simple procedure involving lysis of
      the cells in SDS followed by extraction with 6 M NaCl. The method described
      overcomes the requirement for lengthy incubations in the presence of expensive
      proteinase K and subsequent extraction with toxic chemicals.

PMID- 1632527
TI  - A spectrophotometric microtiter-based assay for the detection of hydroperoxy
      derivatives of linoleic acid.
AB  - An assay for the detection of hydroperoxy derivatives of linoleic acid formed by
      the action of 15-lipoxygenase is described. The assay developed is based on a
      method first reported by Ohishi et al. (1985) Biochem. Int. 10, 205-211) with
      some important modifications. The assay described herein takes advantage of the
      ability of (9Z,11E)-13-hydroperoxyoctadecadienoic acid (13-HPODE), the product of
      the action of 15-lipoxygenase on linoleic acid, to oxidize N-benzoyl
      leucomethylene blue to methylene blue in the presence of hemoglobin. The
      resultant blue color is stable to light and air and can be quantified
      spectrophometrically at 660 nm. The linear range of the assay is 1.6-32 nmol (0.5
      10 micrograms) of 13-HPODE. The utility of the assay can be extended to detect
      other peroxides as well as inhibitors of 15-lipoxygenase. The assay is a rapid,
      reliable method for the detection of lipid hydroperoxide production.

PMID- 1632528
TI  - Pressure support ventilation: technology transfer from the intensive care unit to
      the operating room.

PMID- 1632529
TI  - Convulsions associated with pediatric regional anesthesia.

PMID- 1632530
TI  - Pressure support ventilation decreases inspiratory work of breathing during
      general anesthesia and spontaneous ventilation.
AB  - Spontaneous ventilation may offer advantages over controlled mechanical
      ventilation (CMV), but increase in work of breathing may diminish its usefulness.
      During general anesthesia, respiratory depression and increased work of breathing
      often preclude spontaneous ventilation, and patients then receive CMV. We
      compared the inspiratory work of breathing of anesthetized patients who breathed
      with pressure support ventilation (PSV) with that associated with a demand gas
      flow and a standard anesthesia circle system. We studied nine consenting patients
      who underwent general inhaled anesthesia with or without regional
      supplementation. An anesthesia/ventilator system (Siemens 900D, Solna, Sweden)
      provided PSV (5 cm H2O) or demand gas flow during spontaneous inspiration. Gas
      flow during demand breathing and PSV was initiated when inspiration produced a 2
      cm H2O reduction in airway pressure. An anesthesia machine (Drager Narkomed 3,
      Telford, Pa.) provided a gas flow rate of 6 L/min through a standard semiclosed
      circle system. Airway pressure, airway gas flow rate, and esophageal pressure
      were continuously transduced, and data or signals were conveyed to a computer.
      Tidal volume and respiratory rate were computed from the flow curve. The
      inspiratory work of breathing was calculated as the integral of the area
      subserved by a plot of esophageal pressure and tidal volume during inspiration.
      Heart rate and mean arterial blood pressure were recorded, and arterial blood was
      sampled for gas tension and pH analysis. No differences were found in pHa, Paco2,
      Pao2, tidal volume, respiratory rate, heart rate, or mean arterial blood pressure
      among the three modes of ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632531
TI  - Long-term hypotensive technique with nicardipine and nitroprusside during
      isoflurane anesthesia for spinal surgery.
AB  - Short-term infusion of nicardipine can be used to induce deliberate hypotension
      but may result in plasma drug accumulation. To assess long-term nicardipine
      administration for deliberate hypotension in 10 patients in a moderately
      hemodiluted state who were undergoing spinal surgery, hemodynamics and plasma
      nicardipine concentrations were concomitantly measured before and 20, 80, and 140
      min after starting nicardipine, at drug discontinuation, and 20 and 80 min later.
      A dose of 6.2 +/- 0.9 mg (mean +/- SEM) of nicardipine was initially required to
      obtain mean arterial blood pressures at 55-60 mm Hg. Maintenance doses of
      nicardipine were 3-5 mg/h. The duration of nicardipine administration was 270 +/-
      20 min (mean +/- SEM). Hypotension was associated with decreased systemic and
      pulmonary vascular resistances, increased cardiac index, and decreased
      arteriovenous difference in O2 contents. Only two patients required homologous
      blood transfusion. Plasma nicardipine concentrations peaked at 110 +/- 21 ng/mL
      (mean +/- SEM) and then decreased to 38 +/- 11 ng/mL (mean +/- SEM) without
      changes in arterial blood pressure. After vasodilator discontinuation,
      hypotension was observed during a mean time of 43 min (range 27-88 min) despite
      plasma concentrations less than 20 ng/mL. No relationship was found between
      plasma nicardipine concentrations and hemodynamics. These findings suggest that
      an increasing effect of nicardipine over time may occur during prolonged
      administration. Because the reasons for this hysteresis remain unclear, use of
      nicardipine infusion during major surgery and anesthesia requires particular
      caution.

PMID- 1632532
TI  - Halothane and isoflurane inhibit endothelium-dependent relaxation elicited by
      acetylcholine.
AB  - The purpose of this study was to determine whether volatile anesthetics modify
      the release of endothelium-derived relaxing factor. We examined the effects of
      halothane and isoflurane on endothelium-dependent relaxation and 3',5'-cyclic
      guanosine monophosphate formation elicited by acetylcholine and ionophore A23187
      in isolated rat aorta. Halothane and isoflurane (1%-2%) significantly attenuated
      acetylcholine-induced relaxation of the phenylephrine-contracted aorta but had no
      significant effect on relaxation induced by A23187, nitroprusside, and
      nitroglycerin. Basal and A23187 (10(-7) M)-stimulated levels of 3',5'-cyclic
      guanosine monophosphate were slightly lowered by halothane and isoflurane (2%).
      In contrast, the increase of 3',5'-cyclic guanosine monophosphate elicited by
      acetylcholine (10(-5) M) was significantly attenuated by halothane (2%) and
      abolished by isoflurane (2%). These findings indicate that halothane and
      isoflurane strongly inhibit the release of endothelium-derived relaxing factor
      elicited by acetylcholine.

PMID- 1632533
TI  - Effects on biliary tract pressure in humans of intravenous ketorolac tromethamine
      compared with morphine and placebo.
AB  - This study compared the effect of ketorolac tromethamine with that of morphine
      and placebo on biliary tract pressure. Intraoperatively, 31 anesthetized patients
      received either ketorolac (30 mg IV, n = 16) or morphine (5 mg IV, n = 15) after
      a cholecystectomy or gallstone removal. Intrabiliary tract pressure was measured
      5 min after dosing. Postoperatively, 11 patients who had undergone biliary tract
      surgery received 10 mg of ketorolac or placebo, according to a randomized
      crossover design on 2 consecutive days. Intraoperatively, the biliary tract
      pressure did not change significantly from baseline after ketorolac
      administration. In the morphine group, there was significant increase in pressure
      over baseline. Postoperatively, there was no significant difference between
      ketorolac and placebo. We conclude that ketorolac has little or no effect on
      biliary tract dynamics; therefore, ketorolac may be a logical choice for
      analgesia in those situations in which spasm of the biliary tract is undesirable.

PMID- 1632534
TI  - Effects of ketorolac and bupivacaine on recovery after outpatient arthroscopy.
AB  - The effects of intraarticular bupivacaine, systemic ketorolac, and a combination
      of both treatments on postoperative pain and mobilization were evaluated in 60
      healthy outpatients undergoing arthroscopic knee surgery under general
      anesthesia. After induction of anesthesia, patients received 2 mL of either
      ketorolac (60 mg) or saline solution (1 mL IV and 1 mL IM). On completion of
      surgery, the patient's knee joint was injected with 30 mL of either 0.5%
      bupivacaine or saline solution, according to a randomized, double-blind protocol.
      Only one patient (6%) receiving both medications complained of pain on awakening,
      compared with seven patients receiving either bupivacaine (37%) or ketorolac
      (41%) alone. Postoperative fentanyl was required by significantly fewer patients
      receiving combined therapy (n = 4, 21%) than either bupivacaine (n = 13, 62%) or
      ketorolac (n = 12, 60%) alone; however, there were no significant differences
      among the three treatment groups in terms of perioperative pain, nausea, or
      sedation visual analogue scale scores. Similarly, there were no differences in
      the times to ambulation or discharge or in analgesic requirements at home. In
      conclusion, a combination of systemic ketorolac and intraarticular bupivacaine
      decreased analgesic requirements and pain on awakening after arthroscopic
      surgery. However, the use of ketorolac alone or in combination with bupivacaine
      offered no advantage over bupivacaine alone with respect to recovery times after
      outpatient arthroscopy.

PMID- 1632535
TI  - Echocardiographic analysis of dysfunctional and normal myocardial segments before
      and immediately after coronary artery bypass graft surgery.
AB  - Echocardiography has revealed evidence of "subnormal" regional contraction
      patterns that result from myocardial ischemia and are often accompanied by
      nonadjacent "hyperkinetic" regions. Whether these regions of hyperkinetic wall
      motion persist unchanged or revert to normal after coronary artery bypass graft
      (CABG) surgery has not been studied in humans. Using echocardiography, we
      evaluated both dysfunctional and normal myocardial regions for changes in
      segmental wall motion and percent of systolic wall thickening that occurred
      immediately after CABG surgery in 32 patients. Segmental wall motion analysis
      before CABG surgery in these patients revealed that 170 (66%) of 256 myocardial
      segments were subnormal, of which 115 (67%) improved and 102 (60%) returned to
      normal immediately after CABG surgery. Eleven myocardial segments that were
      hyperkinetic before CABG surgery returned to normal after CABG surgery.
      Preoperatively, 162 (63%) of 256 myocardial segments had systolic wall thickening
      less than 30%, which increased from 11.8% +/- 8.9% to 24.3% +/- 14.3% (mean +/-
      SD) (P less than 0.01) postoperatively. Conversely, a reverse trend was found
      when systolic wall thickening was greater than 30% before CABG surgery:
      thickening decreased from 46.2% +/- 13.8% to 33.4% +/- 14.8% after CABG surgery
      (P less than 0.01). Thus, we conclude that immediately after CABG surgery, there
      is a recovery of function in some myocardial segments and a reduction in function
      in others. Furthermore, we conclude that the semiquantitative assessment of
      percent of systolic wall thickening is a more reliable (consistent)
      echocardiographic index of myocardial function compared with the qualitative
      assessment of segmental wall motion immediately after CABG surgery.

PMID- 1632536
TI  - Continuous endobronchial insufflation during internal mammary artery harvest.
AB  - Endobronchial insufflation of oxygen offers possible advantages over conventional
      ventilation modes in some clinical situations in which nonmovement of the chest
      may be desirable; however, endobronchial insufflation of oxygen has yet to be
      used during thoracic surgery in humans. Furthermore, the physiologic mechanisms
      underlying gas exchange during endobronchial insufflation of oxygen are unclear.
      This study assessed endobronchial insufflation of oxygen at 45 L/min in 11
      patients with an open chest during internal mammary artery harvest.
      Cardiorespiratory function was measured at baseline during conventional
      mechanical ventilation and at 5-min intervals during the study period of 20-30
      min. In all patients, clinically acceptable gas exchange was achieved, although
      PaCO2 increased from 32 +/- 3.2 to 44 +/- 7.5 mm Hg (mean +/- SD) at 5 min, but
      thereafter was unchanged (P greater than 0.1). Cardiac output, vascular
      pressures, and heart rate were unchanged, although pHa decreased. Surgical access
      for internal mammary artery harvesting was improved. No mucosal damage or
      complications occurred. During endobronchial insufflation of oxygen, efficacy of
      gas exchange and body weight were not correlated, but both subject height and age
      were correlated with high PaO2 and low PaCO2. We conclude that (a) endobronchial
      insufflation of oxygen can be used in patients with an open chest; (b) the
      efficacy of endobronchial insufflation of oxygen is probably improved by
      increased lung size and by collateral ventilation; and (c) cardiogenic gas mixing
      contributes little to gas exchange during endobronchial insufflation of oxygen.

PMID- 1632537
TI  - Modification of a new catheter for air retrieval and resuscitation from lethal
      venous air embolism: effect of nitrous oxide on air retrieval.
AB  - A modification of a new Arrow prototype catheter was evaluated for its ability to
      retrieve venous air emboli and for its effect on the success rate of
      resuscitation from venous air emboli in dogs anesthetized with isoflurane and
      nitrous oxide (66%) in oxygen. In an additional group of dogs, nitrogen was
      substituted for nitrous oxide in the inspired gases to determine whether the
      presence of nitrous oxide (as traditionally used in this model of lethal venous
      air emboli) increased the apparent amount of gas retrieval or altered the success
      rate of resuscitation. Dogs were placed in the seated position with the head 90
      degrees to the horizontal. The modified Arrow prototype catheter was placed with
      the proximal orifice just above the superior vena cava-right atrial junction and
      the distal orifice near the mid-right atrium. Dogs were then given a
      predetermined lethal dose of air (5 mL/kg) over 30 s through the jugular vein.
      Attempts to aspirate venous air emboli were begun with the first decrease in
      expired CO2. The amounts of gas retrieved, expressed as a percent of the injected
      air, and the incidence of successful resuscitation were compared between groups.
      In both treatment groups (nitrous oxide and nitrogen), the percent of injected
      venous air retrieved (73% +/- 13% and 65% +/- 21%, mean value +/- SD,
      respectively) and success rate of resuscitation (four of six dogs in each group)
      were significantly increased compared with the control group in which no attempt
      was made to retrieve injected venous air, and none of the six dogs
      survived.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632538
TI  - Methylprednisolone does not decrease eicosanoid concentrations or edema in brain
      tissue or improve neurologic outcome after head trauma in rats.
AB  - Methylprednisolone was recently reported to significantly improve motor and
      sensory function after acute spinal cord injury in patients. Our study was
      designed to determine whether methylprednisolone exerts a beneficial effect after
      head injury. Diethyl ether-anesthetized rats were assigned to receive surgery
      with no cranial impact and no methylprednisolone (group A, n = 13); surgery with
      no cranial impact and intraperitoneal methylprednisolone (greater than or equal
      to 60 mg/kg) (group B, n = 8); surgery with cranial impact and no
      methylprednisolone (group C, n = 8, and group E, n = 8); or surgery with cranial
      impact and methylprednisolone (greater than or equal to 60 mg/kg) (group D, n =
      15, and group F, n = 13). Neurologic severity score was determined at 1, 2, 4,
      and 24 h (when appropriate) after injury, and brain tissue eicosanoid levels and
      cerebral edema were determined when the animals were killed (4 h after injury in
      groups C and D and 24 h after injury in groups E and F). Treatment with
      methylprednisolone did not improve neurologic severity score or edema formation
      and did not alter brain tissue levels of prostaglandin E2, thromboxane B2, or 6
      keto-prostaglandin F1 alpha at any time period. The authors conclude that
      methylprednisolone does not exert a beneficial effect on brain tissue edema or
      functional activity after cranial impact in rats.

PMID- 1632539
TI  - Alfentanil-induced rigidity in newborn infants.
AB  - The authors evaluated whether alfentanil could be given before treatment
      procedures in critically ill mechanically ventilated neonates without adverse
      effects. Alfentanil (mean dose 11.7 micrograms/kg, range 9-15) was given
      intravenously to 20 mechanically ventilated critically ill newborn infants (mean
      birth weight 2510 g, range 1490-3990) during the first 3 days of life before
      treatment procedures. Heart rate, arterial blood pressure, transcutaneous partial
      pressure of O2, respiratory rate, and general activity were observed continuously
      from 10 min before the administration of alfentanil until 1 h after it. Plasma
      alfentanil concentrations were measured in 15 subjects. The pharmacokinetics of
      alfentanil varied greatly among the subjects. The hemodynamic changes were not
      clinically significant, and the most important side effect was muscle rigidity.
      Nine infants had mild or moderate rigidity, which had little or no effect on
      ventilation. Four infants had severe rigidity and jerking comparable to
      convulsive activity, transiently impairing ventilation and oxygenation for
      approximately 5-10 min. Increased inspired oxygen and increased pressure by
      manual ventilation were needed to prevent hypoxemia. Electroencephalographic
      recordings for three infants during alfentanil administration showed no evidence
      of increased seizure activity. We conclude that alfentanil should not be used for
      newborn infants without simultaneous muscle relaxation because of the danger of
      rigidity.

PMID- 1632540
TI  - Preoperative screening for pediatric ambulatory surgery: evaluation of a
      telephone questionnaire method.
AB  - The purpose of this study was to determine whether preoperative screening of
      pediatric patients, accomplished by means of a preoperative telephone call to
      their parents, would decrease the rate of cancellation or postponement of
      ambulatory surgical procedures. Data from 5031 patients scheduled for ambulatory
      surgery were collected. During phase I of the study, when phone calls were
      attempted only during business hours, we contacted 805 of 1662 (48%) of patients'
      parents. The contact rate improved to 71% (2403 of 3369 patients) during phase II
      of the study, when phone calls were made in the evening, and parents were
      encouraged by the surgeons to call the ambulatory unit. Approximately 13% of the
      contacted parents reported a history of medical problems in their children. A
      preoperative anesthesia consultation was required in 2.8% of the patients whose
      parents were contacted. The rate of postponed or canceled surgery among those who
      could not be screened was 14.8%; among patients who were screened, it was 9.7% (P
      less than 0.001). Patients in the former group were more likely than those in the
      latter group to require inpatient care for monitoring or treatment of underlying
      medical problems (1.3% vs 0.3%, respectively; P less than 0.05). We conclude that
      a preoperative telephone interview is an effective method for screening pediatric
      ambulatory surgical patients.

PMID- 1632541
TI  - Continuous low-dose 3-in-1 nerve blockade for postoperative pain relief after
      total knee replacement.
AB  - We have investigated the value of a 3-in-1 nerve block, followed by a continuous
      low-dose infusion of bupivacaine into the femoral nerve sheath for postoperative
      analgesia after total knee replacement. Thirty-seven patients were randomly
      allocated to either a control group or a study group. The study group had a
      catheter placed in the ipsilateral femoral nerve sheath. A 3-in-1 nerve block was
      then performed in the study group with injection of 30 mL of 0.25% bupivacaine
      through the catheter. This was followed by a continuous infusion of 0.125%
      bupivacaine at 6 mL/h. The study group had significantly lower pain scores 4 and
      24 h postoperatively (P less than 0.01) and required less postoperative opioid
      analgesic medication (P less than 0.01) than the control group. The authors
      conclude that a continuous low-dose infusion into the femoral nerve sheath
      results in better pain relief than conventional intramuscularly administered
      narcotics after total knee arthroplasty.

PMID- 1632542
TI  - Continuous interpleural infusion of bupivacaine for postoperative analgesia after
      surgery with flank incisions: a double-blind comparison of 0.25% and 0.5%
      solutions.
AB  - Postoperative analgesia, as assessed by visual analogue scale scores (0-10) and
      patient-controlled analgesia morphine requirements, pulmonary function (forced
      vital capacity and forced expiratory volume in 1 s), and plasma bupivacaine
      concentrations were studied in patients receiving interpleural blockade with
      bupivacaine after surgery with a flank incision. Two groups of 10 patients
      received either 0.5% or 0.25% bupivacaine, both with epinephrine (5
      micrograms/mL). Pain relief was initiated when patients had visual analogue scale
      scores greater than or equal to 4. Patients received 21 mL of bupivacaine 0.25%
      or 0.5% in a double-blind fashion. One hour later, a continuous infusion of 5
      mL/h of the study solution was started. At the same time, patient-controlled
      analgesia became accessible to the patients. The onset time of pain relief and
      the area under the visual analogue scale score-time curves over the first 8 h
      were similar in both groups. Patient-controlled analgesia morphine use was also
      similar in the 0.25% (21.3 +/- 14.6 mg) and 0.5% (21.0 +/- 16.0 mg) groups (mean
      +/- SD). In both groups, forced vital capacity and forced expiratory volume in 1
      s improved significantly within 60 min (P less than 0.05). Peak plasma
      concentrations (Cmax) and the area under the plasma concentration-time curve
      (AUC) over 24 h were higher (P less than 0.001) in the 0.5% group (Cmax, 1.47 +/-
      0.37 micrograms/mL; AUC, 1511 +/- 323 micrograms.mL-1.min) than those in the
      0.25% group (Cmax, 0.55 +/- 0.22 micrograms/mL; AUC, 680 +/- 118 micrograms.mL
      1.min) (mean +/- SD).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632543
TI  - Compartment syndromes: concepts and perspectives for the anesthesiologist.

PMID- 1632545
TI  - Succinylcholine-induced hyperkalemic arrest in a patient with severe metabolic
      acidosis and exsanguinating hemorrhage.

PMID- 1632544
TI  - Seizures occurring in pediatric patients receiving continuous infusion of
      bupivacaine.

PMID- 1632546
TI  - Succinylcholine-induced hyperkalemia 8 weeks after a brief paraplegic episode.

PMID- 1632547
TI  - Vertebral artery pseudoaneurysm: a rare complication of internal jugular vein
      catheterization.

PMID- 1632548
TI  - Craniotomy in a patient with Eisenmenger's syndrome.

PMID- 1632549
TI  - A "new" needle?

PMID- 1632550
TI  - A simple method of MDI administration in the intubated patient.

PMID- 1632552
TI  - Labeling of syringes to prevent "drug swaps".

PMID- 1632551
TI  - Use of a Wilson Convex Frame in removing "irretrievable" epidural catheters.

PMID- 1632553
TI  - A simple device to demonstrate the law of Laplace.

PMID- 1632554
TI  - The 3.5/4.5 modification for fiberscope-guided tracheal intubation using the
      laryngeal mask airway.

PMID- 1632556
TI  - When is a fact, in fact, a fact?

PMID- 1632555
TI  - Effect of propofol in brainstem auditory evoked responses.

PMID- 1632557
TI  - Plug it in!

PMID- 1632558
TI  - What caused the unilateral epidurogram and bilateral epidural analgesia?

PMID- 1632560
TI  - Contralateral anesthesia following interscalene block.

PMID- 1632559
TI  - Reinserting a catheter into a single-use adapter: an unsafe method.

PMID- 1632561
TI  - Ventilatory depression and midazolam.

PMID- 1632562
TI  - Anesthetic management in Charcot-Marie-Tooth disease.

PMID- 1632563
TI  - Interpleural regional analgesia--a simple cause of catheter obstruction.

PMID- 1632564
TI  - Effect of cardiac dysfunction upon diastolic cerebral blood flow.
AB  - The transcranial Doppler (TCD) studies performed in 54 patients with various
      forms of cardiac dysfunction were reviewed and the results compared with those of
      normal individuals. There were 4 patients with aortic insufficiency, 5 being
      treated by intra-aortic balloon pumps, 12 patients with atrial fibrillation, 11
      with syncope, and 22 undergoing cardiopulmonary resuscitation. In all instances,
      significantly low or even absent diastolic cerebral perfusion was found. The
      importance of this parameter, in the future evaluation and management of similar
      patients, is discussed.

PMID- 1632565
TI  - Electrocardiographic prediction of the success of coronary reperfusion by
      intravenous thrombolytic therapy: an experimental study.
AB  - The accuracy of electrocardiograms (ECGs) in predicting the success of coronary
      reperfusion by intravenous (IV) thrombolytic therapy was studied in 49 canine
      acute myocardial infarctions (MI), induced by occlusive thrombus in the left
      anterior descending (LAD) coronary artery. Two hours after the onset of MI,
      urokinase (UK, 3 x 10(4) U/kg) was administered IV and the heart was observed for
      one further hour. LAD flow and epicardial ECGs were recorded continuously. LAD
      flow was restored by UK in 26 of 49 animals (Group I); restored LAD flow was
      stable in 17 of the 26 (Group IA) and unstable with repeated fluctuations in the
      other 9 (Group IB) during the follow-up period. No coronary reflow was obtained
      by thrombolysis in 23 of 49 animals (Group II). The best electrocardiographic
      criterion for predicting coronary reperfusion was reduction of ST elevation by
      more than 25%, which had a predictive accuracy of 86%. There was a significant
      correlation between the grade of improvement of coronary blood flow and reduction
      of ST elevation in Group IA (p less than 0.01), but not in Group IB, indicating
      that unstable coronary blood flow following thrombolysis due to residual thrombus
      appears to be one of the major factors preventing accurate prediction of coronary
      reperfusion with thrombolysis on the basis of changes in ST elevation.

PMID- 1632566
TI  - Clinical and angiographic features of patients from the Indian subcontinent
      treated with intravenous streptokinase for acute myocardial infarction:
      experience in Qatar.
AB  - The authors reviewed their experience with 245 patients who were treated with
      intravenous streptokinase for acute myocardial infarction at an average time of
      less than three hours from the onset of chest pain. Of these, 148 patients were
      from the Indian subcontinent (Group 1) and the remaining (Group 2) were
      predominantly from an Arabic background. Group 1 patients were younger and had
      lower serum cholesterol and fibrinogen levels than the Group 2 patients. Group 1
      patients had a lower incidence of previous myocardial infarction (p = 0.0006) and
      antecedent angina pectoris (p = 0.017). A patency rate of 77.5% was seen in all
      patients studied at 5.37 +/- 2.96 days after admission and was similar in both
      the groups. Group 1 patients had a lesser extent of coronary artery disease (p =
      0.01) manifested as a higher incidence of single-vessel disease (p = 0.06) and a
      lower incidence (p = 0.06) of three-vessel obstruction. The overall mortality for
      the initial hospitalization was 2.18% and showed no difference between the two
      groups. Patients from the Indian subcontinent presenting with acute myocardial
      infarction appear to be a unique population in that they are younger, have a
      somewhat lower cardiac risk profile, and have less extensive coronary artery
      disease than their Arabic counterparts.

PMID- 1632567
TI  - Differential exercise effects of captopril and nadolol in patients with essential
      hypertension.
AB  - In a crossover study, 12 patients with mild to moderate hypertension were given
      placebo, captopril (12.5 to 50 mg three times a day), and nadolol (20 to 160 mg
      once a day) to control the resting diastolic blood pressure to a nearly identical
      degree (p less than 0.0001) (106.1 +/- 4 placebo, 89.6 +/- 8 captopril, 89.8 +/-
      7 nadolol). Both drugs lowered (p less than 0.0004) systolic and diastolic blood
      pressure at rest and during exercise. However, systolic blood pressure lowering
      during exercise was more pronounced (p less than 0.05) with nadolol than with
      captopril (difference of 6 mmHg, 16 mmHg, and 21 mmHg at 5.0, 7.0, and 9.0
      metabolic equivalents (METS) respectively). Heart rate was lower (p less than
      0.05) at rest and during exercise with nadolol as compared with placebo and with
      captopril. These data imply different mechanisms of action of the two drugs at
      rest and during exercise and may help in selection of drug therapy in special
      patient subsets.

PMID- 1632568
TI  - Coronary angioplasty in patients with previous coronary artery bypass grafting.
AB  - Between 1982 and 1990, in 134 patients with prior coronary artery bypass grafting
      and recurrent angina, repeat coronary angiography and balloon angioplasty of
      stenoses in grafts or native arteries were attempted. Mean age of grafts was 45.6
      months, range three days to twelve years. At the time of angioplasty, 6 patients
      had one-vessel-disease, 33 had two-vessel-disease, and 95 had three-vessel
      disease. A total of 182 lesions were dilated: 55 venous grafts, 3 internal
      mammary artery grafts, and 124 native vessels. Forty-nine of 55 (89%) venous
      grafts could be successfully dilated, and in 3 internal mammary artery grafts, a
      stenosis reduction greater than 50% was achieved. In 65 of 88 (74%) grafted
      native arteries, dilation success was achieved. Twenty-seven of 36 (75%) patients
      with prior bypass surgery to other arteries had successful angioplasty of
      nongrafted native arteries. Three patients underwent emergency bypass surgery
      after dissection and acute occlusion: one of them died in cardiogenic shock
      secondary to acute myocardial infarction. The angiographic success rate in grafts
      was slightly higher than in native arteries (90% vs 74%). These data indicate
      that percutaneous transluminal coronary angioplasty in patients after bypass
      surgery is possible at a low risk (3%) and constitutes an effective therapy in
      symptomatic patients.

PMID- 1632569
TI  - Comparison of three progressive exercise protocols in peripheral vascular
      occlusive disease.
AB  - Although claudication pain and hemodynamic responses to exercise are usually
      clinically assessed via graded treadmill walking, measuring these responses to
      other commonly performed tasks may yield a more nearly complete evaluation of
      peripheral vascular occlusive disease. Thus, the purpose of this study was
      twofold: (1) to determine the reliability of claudication and hemodynamic
      responses to level walking and stairclimbing and (2) to compare these responses
      with those obtained with graded walking at similar oxygen consumption. Ten
      patients with stable claudication symptoms performed graded walking, level
      walking, and stairclimbing progressive protocols with respective increases in
      grade, walking speed, and stepping rate on a modified stairclimbing device every
      two minutes. Similar peak oxygen consumption (13.60 to 14.18 mL/kg/min) was
      attained with the three protocols (P = NS). Reliability coefficients for the
      times to onset and to maximal claudication pain during level walking (R = 0.95
      and 0.95, respectively) and during stairclimbing (R = 0.92 and 0.82,
      respectively) were similar to those previously obtained during graded walking.
      Reliability coefficients for foot transcutaneous oxygen tension during and
      following level walking (R = 0.78 to 0.96) and stairclimbing (R = 0.65 to 0.98)
      and for ankle systolic blood pressure following level walking (R = 0.95 to 0.97)
      and stairclimbing (R = 0.90 to 0.98) were also similar to those previously found
      with graded walking. Additionally, claudication and hemodynamic measurements were
      similar among the three exercise protocols. Thus, because graded walking, level
      walking, and stairclimbing progressive exercise protocols yield reliable and
      similar information about the hemodynamic severity of peripheral vascular
      occlusive disease, only one is needed for evaluation.

PMID- 1632570
TI  - Spontaneous idiopathic subclavian arteriovenous fistula: a case report.
AB  - Systemic arteriovenous (AV) fistulas are a rare but correctable cause of
      hyperkinetic circulation and congestive heart failure. They are generally due to
      catheterization procedures, surgery, trauma, or aneurysms. A case of truly
      spontaneous AV fistula between left subclavian artery and left innominate vein is
      described. This patient presented with symptoms that might clinically be mistaken
      for a carpal tunnel syndrome. The discovery of a continuous to-and-fro murmur on
      her left upper sternal border led to the correct diagnosis. Surgical ligature of
      the fistula provided complete relief of the woman's symptoms.

PMID- 1632571
TI  - Cerebral microcirculatory changes after cerebral embolization induced by glass
      bead injection in rabbits.
AB  - The authors investigated microcirculatory changes in cerebral embolization
      induced by an injection of glass beads (mesh size 20/400, 15 mg/body) using
      intravital microscopy and reflectance spectrophotometry in normal rabbits.
      Cerebral embolization with the glass bead injection reduced the inner diameter of
      cerebral arterioles, the index of cerebral hemoglobin concentration (IHb), and
      the index of oxygen saturation (ISO2). Moreover, platelet aggregation rates and
      plasma levels of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto
      PGF1 alpha) appreciably increased. During observation of the pial vasculature,
      "white bodies" became visible at the entrance of arteriolar branchings two to
      three minutes after the glass bead injection. After indomethacin administration
      (3 mg/kg, IV), they could not observe white bodies, and platelet aggregation
      rates were significantly reduced. The plasma levels of TXB2 and 6-keto-PGF1 alpha
      were also significantly reduced. These findings suggest that glass beads do
      injury to the microvascular endothelial cells leading to development of white
      bodies, ie, "flying thrombi." Therefore, the cerebral microvascular embolization
      induced by the glass bead injection appears to be an experimental model for
      evaluating efficacy of remedies for the cerebral microcirculatory disorders.

PMID- 1632572
TI  - Diagnosis of atrial septal aneurysm by two-dimensional echocardiography--a case
      report.
AB  - A patient who was evaluated for a syncopal episode was found by two-dimensional
      (2D) echocardiography to have an aneurysm of the atrial septum. The atrial septal
      aneurysm appeared as a localized outpouching of the atrial septum that protruded
      into the left atrium during systole and into the right atrium during early
      diastole. The 2D echocardiography permits the definitive diagnosis of this
      condition by a noninvasive technique.

PMID- 1632573
TI  - Right-sided cardiac thromboembolism and its successful treatment with
      streptokinase: case report.
AB  - A sixty-eight-year-old woman with a clinical diagnosis of pulmonary embolism and
      large right-heart embolus on echocardiography is presented. Because of the
      critical clinical condition of the patient and the inability to perform surgical
      intervention, thrombolytic treatment (streptokinase) was administered. The
      patient's condition improved, the right-heart embolus disappeared, and on the
      perfusion lung scan there was only one small perfusion defect in the right lung.
      The authors consider thrombolysis to be appropriate treatment for right-heart
      thromboembolism whenever surgical embolectomy is not possible.

PMID- 1632574
TI  - Holt-Oram syndrome in an elderly patient--a case history.
AB  - The authors present a typical case of Holt-Oram syndrome in an eighty-year-old
      woman. The patient had atrial-septal defect and phocomelia but was independent in
      the activities of daily living.

PMID- 1632575
TI  - Cellular actions of opiates and cocaine.

PMID- 1632576
TI  - Cortico-subcortical interactions in behavioral sensitization: differential
      effects of daily nicotine and morphine.

PMID- 1632577
TI  - Cellular mechanisms of behavioral sensitization to drugs of abuse.

PMID- 1632578
TI  - Mesocorticolimbic dopamine systems: cross-sensitization between stress and
      cocaine.

PMID- 1632579
TI  - Effects of chronic ethanol and benzodiazepine treatment and withdrawal on
      corticotropin-releasing factor neural systems.

PMID- 1632580
TI  - Alterations in biodistribution of 11C-methamphetamine (MAP), 14C-MAP, and 123I-N
      isopropyl-iodoamphetamine (IMP) in MAP- and cocaine-sensitized animals.
AB  - Alterations in brain distribution of 11C-MAP, 14C-MAP, and 123I-IMP in MAP- and
      cocaine-sensitized animals were examined to investigate the mechanism involved in
      increased dopaminergic transmission and behavioral sensitization. First, a
      significant increase in 11C-MAP radioactivity in the striatum and hypothalamus
      was found in the mice pretreated with MAP for 7 days. Secondly, in MAP-sensitized
      rats, marked increases in 14C-MAP radioactivity were found in the striatum and
      limbic forebrain, respectively (370% and 650%). These findings may propose a new
      hypothesis that subchronic MAP administration may result in a long-term change in
      the presynaptic cell membrane at the nerve terminal which may in turn cause an
      increase in both MAP and DA uptake accompanied by an increased release of DA at
      the synaptic cleft.

PMID- 1632581
TI  - A lasting vulnerability to psychosis in patients with previous methamphetamine
      psychosis.
AB  - Chronic MAP abuse may produce a lasting vulnerability of the brain which leads to
      a paranoid delusional psychosis with hallucinations similar to schizophrenia.
      This view is based on the clinical observations that duration of the psychotic
      episodes could last quite long after excretion of MAP in the urine, and that
      reuse of MAP, alcohol ingestion and nonspecific psychological stressors lead to
      acute recurrence of psychotic episodes whose clinical features are almost
      identical to the initial episode in patients with prior MAP psychosis. The
      experimental studies indicate that a lasting change at the nerve terminal
      membranes, namely transporters of MAP and dopamine at the uptake sites, in the
      striatum and nucleus accumbens may be a cause for induction and expression of
      stimulant-induced sensitization, which may relate to vulnerability to
      schizophrenia-like psychotic episodes in MAP psychosis.

PMID- 1632582
TI  - Neural mechanisms of drug reinforcement.
AB  - The brain substrates involved in the effect of cocaine on brain stimulation
      reward, in the psychomotor activation associated with cocaine, and in cocaine
      self-administration appear to be focused on the medial forebrain bundle and its
      connections with the basal forebrain, notably the nucleus accumbens. Chronic
      access to cocaine produces a withdrawal state as reflected in increases in brain
      stimulation reward thresholds, and this change in reward threshold appears to be
      opposite to the actions of the drug administered acutely. These effects are
      thought to reflect a change in the activity of reward elements in the medial
      forebrain bundle and may be responsible for the negative reinforcing state
      associated with the anhedonia of cocaine withdrawal. Opiate receptors
      particularly sensitive to the reinforcing effects of heroin also appear to be
      located in the region of the nucleus accumbens and the ventral tegmental area.
      There is good evidence for both dopamine-dependent and dopamine-independent
      opioid interactions in the ventral tegmental-nucleus accumbens connection. In
      addition, the opiate receptors in the region of the nucleus accumbens may become
      sensitized during the course of opiate withdrawal and thus become responsible for
      the aversive stimulus effects of opiate dependence. Reliable measures of the
      acute reinforcing effects of ethanol have been established in rat models, and
      substantial evidence exists to show that non-deprived rats will orally self
      administer pharmacologically relevant amounts of ethanol in lever-press choice
      situations. Neuropharmacological studies of ethanol reinforcement in non
      dependent rats suggest important roles for serotonin, GABA and dopamine. A role
      for opioid peptides in ethanol reinforcement may reflect more general actions of
      opioid peptides in consummatory behavior. Studies of ethanol dependence have
      implicated brain GABAergic and CRF systems in the more motivational aspects of
      withdrawal. Future studies will need to focus on the common neurobiologic changes
      associated with all these drugs, particularly regarding their hedonic and
      motivational properties.

PMID- 1632583
TI  - Self-stimulation and drug reward mechanisms.

PMID- 1632584
TI  - Drug motivation and abuse: a neurobiological perspective.

PMID- 1632585
TI  - Neurochemical correlates of cocaine and ethanol self-administration.

PMID- 1632586
TI  - Cortical regulation of self-administration.

PMID- 1632587
TI  - High potency cocaine analogs: neurochemical, imaging, and behavioral studies.

PMID- 1632588
TI  - Methamphetamine-induced neurotoxicity: structure activity relationships.

PMID- 1632589
TI  - Genetic determinants of ethanol reinforcement.
AB  - In this paper, we present examples of some of the several behaviors which have
      been taken to indicate the reinforcing efficacy of drugs, including ethanol.
      Efforts to identify the genetic determinants of these behaviors have employed
      diverse pharmacogenetic methods. For example, we have used selective breeding to
      develop mice selected for severe or attenuated ethanol withdrawal and have found
      that Withdrawal Seizure Prone mice show a greater conditioned preference for
      ethanol-associated locations than the selected Withdrawal Seizure Resistant line.
      Similarly, HOT mice, selected for insensitivity to ethanol-induced hypothermia,
      had greater conditioned place preference after ethanol training than COLD mice,
      selected for ethanol hypothermic sensitivity. We have also developed selected
      mouse lines responsive or unresponsive to ethanol-stimulated locomotor activity.
      These FAST and SLOW lines develop sensitization rather than tolerance to ethanol
      induced activity. Using inbred strains of mice, others had shown that strains
      differed in preference for drinking ethanol solutions. We found that these
      strains also differed in acceptance of ethanol. Single-gene techniques have been
      used to show that preference drinking is significantly altered in mutant rodent
      strains lacking hypothalamic vasopressin, or with nephrogenic diabetes insipidus.
      In a specific panel of Recombinant Inbred mouse strains, we found that a single
      gene appeared to control a significant portion of the variance in preference
      drinking. These examples show that traits putatively related to drug
      reinforcement show substantial genetic control. Specifically, single-gene methods
      show promise of identification and mapping of genes related to drug
      reinforcement.

PMID- 1632590
TI  - Chromosome mapping of gene loci affecting morphine and amphetamine responses in
      BXD recombinant inbred mice.

PMID- 1632591
TI  - Behavioral and pharmacological determinants of drug abuse.

PMID- 1632592
TI  - Conditioned sensitization to the psychomotor stimulant cocaine.

PMID- 1632593
TI  - Classical conditioning in drug-dependent humans.
AB  - Repetitive use of psychoactive drugs produces a variety of learned behaviors.
      These can be classified in the laboratory according to an operant/classical
      paradigm, but in vivo the two types of learning overlap. The classically
      conditioned responses produced by drugs are complex and bi-directional. There has
      been progress in classifying and predicting the types of conditioned responses,
      but little is known of mechanisms. New techniques for understanding brain
      function such as micro-dialysis probes in animals and advanced imaging techniques
      (PET and SPECT) in human subjects may be utilized in conditioning paradigms to
      "open the black box." Because the existence of conditioned responses in drug
      users is now well established, clinical studies have been instituted to determine
      whether modification of conditioned responses can influence clinical outcome. A
      recently completed study in cocaine addicts has produced evidence that outcome
      can be improved by a passive extinction technique over an 8-week outpatient
      treatment program.

PMID- 1632594
TI  - Cocaine-induced changes in extracellular levels of striatal dopamine measured
      concurrently by microdialysis with HPLC-EC and chronoamperometry.

PMID- 1632595
TI  - Behavioral temperature regulation during withdrawal from ethanol dependency in
      mice.

PMID- 1632596
TI  - Methamphetamine-induced conditioned place preference or aversion depending on
      dose and presence of drug.

PMID- 1632597
TI  - Cocaine and other local anesthetics block hippocampal long-term potentiation.

PMID- 1632598
TI  - Effect of a benzodiazepine derivate Ro 15-4513 on ethanol-free selection and CNS
      mitochondrial energetics in rats.
AB  - 1) Females are higher EtOH drinkers than males in E.F.S. experiments in rats. 2)
      Ro 15-4513 inhibited intake of EtOH. 3) Hypothalamus mitochondrial energetics,
      studied at Sites I and II, showed Ro 15-4513 inhibition of these parameters at
      different doses by sex: effects were seen in females at 15 mg and in males at 10
      mg/kg rat/24 h. An uncoupled effect between electron transport and ADP/O was
      found.

PMID- 1632599
TI  - Sensitization and individual differences to IP amphetamine, cocaine, or caffeine
      following repeated intra-cranial amphetamine infusions.

PMID- 1632600
TI  - Solubilization of the cannabinoid receptor from rat brain membranes.

PMID- 1632601
TI  - Different pharmacodynamics for diazepam and flunitrazepam?

PMID- 1632602
TI  - Psychomotor stimulant effect of cocaine is affected by genetic makeup and
      experimental history.

PMID- 1632603
TI  - Nifedipine blocks the development of tolerance to the anticonvulsant effects of
      ethanol.

PMID- 1632604
TI  - Influence of chronic cocaine on monoamine neurotransmitters in human brain and
      animal model: preliminary observations.

PMID- 1632605
TI  - Repeated injection of cocaine potentiates methamphetamine-induced toxicity to
      dopamine-containing neurons in rat striatum.

PMID- 1632606
TI  - Opioid modulation of alcohol intake in monkeys by low doses of naltrexone and
      morphine.

PMID- 1632607
TI  - Seizure incidence enhancement with increasing alcohol intake.

PMID- 1632608
TI  - Studies of the mechanism of inhibition of the dopamine uptake carrier by cocaine
      in vitro using rotating disk electrode voltammetry.

PMID- 1632609
TI  - Evidence for a possible role of the 5-HT2 antagonist ritanserin in drug abuse.

PMID- 1632610
TI  - Prenatal neurochemistry of cocaine.

PMID- 1632611
TI  - Ingested ethanol as a factor in double vision.

PMID- 1632612
TI  - Effect of haloperidol on craving and impaired control following alcohol
      consumption in alcoholic subjects.

PMID- 1632613
TI  - Locomotor responses of FAST and SLOW mice to several alcohols and drugs of abuse.

PMID- 1632614
TI  - Ethanol produces rapid biphasic hedonic effects.

PMID- 1632615
TI  - Dramatic depletion of mesolimbic extracellular dopamine after withdrawal from
      morphine, alcohol or cocaine: a common neurochemical substrate for drug
      dependence.

PMID- 1632617
TI  - Morphine withdrawal in the hamster.

PMID- 1632616
TI  - System of aldehyde metabolism in brain of rats during development of tolerance to
      the hypnotic effect of ethanol.

PMID- 1632618
TI  - Weak base model of amphetamine action.

PMID- 1632619
TI  - Methylxanthines (caffeine and theophylline) blocked methamphetamine-induced
      conditioned place preference in mice but enhanced that induced by cocaine.

PMID- 1632620
TI  - Comparison of evoked potentials in men and women admitted for alcohol
      detoxification.

PMID- 1632621
TI  - Vasopressin system is impaired in rat offspring prenatally exposed to chronic
      nicotine.

PMID- 1632622
TI  - A state by state picture of the changing practice of dentistry in the 1980s.
AB  - A review is provided of the changing practice of dentistry at the state level.
      Emphasis is placed on the economics and ownership of practice, and the evolving
      gender and specialist composition of the profession.

PMID- 1632623
TI  - Denture hyperplasia and oncocytic metaplasia.
AB  - A case of denture hyperplasia of the upper labial sulcus with concomitant
      oncocytic metaplastic changes is described. The patient concerned is an elderly
      male wearing an ill-fitting upper full denture.

PMID- 1632624
TI  - Leiomyoma of the incisive papilla region: a case report.
AB  - Leiomyomas are benign neoplasms of smooth muscle origin. They represent rare
      entities in the oral cavity. A case arising from the incisive papilla region of a
      3-month-old infant is described and the histogenesis as well as the biologic
      potential of this tumor are discussed.

PMID- 1632625
TI  - Central mucoepidermoid carcinoma of the jaws. Review of the literature and case
      report.
AB  - A CMEC which occurred within the right maxillary canine-third molar region of a
      34-year-old male was presented. The clinical symptoms were swelling and pain.
      Radiologically the lesion looked like an ameloblastoma or residual cyst.
      Hemimaxillectomy was the treatment. No evidence of recurrence has been observed
      for ten months after the operation.

PMID- 1632626
TI  - The Sturge-Weber syndrome: a case involving a 13-year-old black male.
AB  - A 13-year-old black male patient with Sturge-Weber Syndrome is presented. The
      report describes the classic presentation of the syndrome, emphasizing the oral
      manifestations. The case presentation includes a discussion of the differential
      diagnosis of gingival enlargement, and suggestions for subsequent therapy.

PMID- 1632627
TI  - Nifedipine-induced gingival hyperplasia.
AB  - Gingival hyperplasia is an adverse reaction of nifedipine therapy. Oral
      manifestations of this condition include enlarged and painful gingiva accompanied
      by spontaneous bleeding. Nifedipine-induced gingival hyperplasia may be
      reversible once a proper drug substitution is made. Two cases of gingival
      hyperplasia resulting from nifedipine are described and the drug's possible mode
      of action is discussed.

PMID- 1632628
TI  - Localization of impacted teeth utilizing inherent panoramic distortions.
AB  - Distortions in the size of images seen on panoramic radiographs can assist the
      clinician in determining the site of impacted teeth in relation to the dental
      arch. Application of this principle can often eliminate the necessity for
      additional radiographic views and prevent exposure of the patient to unnecessary
      radiation.

PMID- 1632629
TI  - Hydroxylation of 5 alpha-androstane-3 beta,17 beta-diol by rat prostate
      microsomes: effects of antibodies and chemical inhibitors of cytochrome P450
      enzymes.
AB  - The purpose of the present study was to test the hypothesis that rat prostate
      microsomes contain a single cytochrome P450 enzyme responsible for the conversion
      of 5 alpha-androstane-3 beta,17 beta-diol to a series of trihydroxylated
      products. The three major metabolites formed by in vitro incubation of 5 alpha
      [3H]androstane-3 beta,17 beta-diol with rat prostate microsomes were apparently 5
      alpha-androstane-3 beta,6 alpha,17 beta-triol, 5 alpha-androstane-3 beta,7
      alpha,17 beta-triol, and 5 alpha-androstane-3 beta,7 beta,17 beta-triol, which
      were resolved and quantified by reverse-phase HPLC with a flow through
      radioactivity detector. The ratio of the three metabolites remained constant as a
      function of incubation time, microsomal protein concentration, ionic strength,
      and substrate concentration. The ratio of the three metabolites was dependent on
      pH, apparently because the hydroxylation of 5 alpha-androstane-3 beta,17 beta
      diol shifted from the 6 alpha- to the 7 alpha-position with increasing pH (6.8
      8.0). The V(max) values were 380, 160, and 60 pmol/mg microsomal protein/min for
      the rate of 6 alpha-, 7 alpha-, and 7 beta-hydroxylation, respectively. Similar
      Km values (0.5-0.7 microM) were measured for enzymatic formation of all three
      metabolites, which suggests that formation of all three metabolites was catalyzed
      by a single, high-affinity enzyme. Testosterone, 5 alpha-dihydrotestosterone, and
      5 alpha-androstane-3 alpha,17 beta-diol did not appreciably inhibit the
      hydroxylation of 5 alpha-androstane-3 beta,17 beta-diol, suggesting that this
      enzyme exhibits a high degree of substrate specificity. Formation of all three
      metabolites was inhibited by antibody against rat liver NADPH-cytochrome P450
      reductase (85%) and by a 9:1 mixture of carbon monoxide and oxygen (60%). Several
      chemical inhibitors of cytochrome P450 enzymes, especially the antimycotic drug
      clotrimazole, also inhibited the formation of all three metabolites. Polyclonal
      antibodies that recognize liver cytochrome P450 1A, 2A, 2B, 2C, and 3A enzymes
      did not inhibit 5 alpha-androstane-3 beta,17 beta-diol hydroxylase activity.
      Overall, these results are consistent with the hypothesis that the 6 alpha-, 7
      alpha-, and 7 beta-hydroxylation of 5 alpha-androstane-3 beta,17 beta-diol by rat
      prostate microsomes is catalyzed by a single, high-affinity P450 enzyme. This
      cytochrome P450 enzyme appears to be structurally distinct from those in the 1A,
      2A, 2B, 2C, and 3A gene families.

PMID- 1632630
TI  - Hydroxylation of 5 alpha-androstane-3 beta,17 beta-diol by rat prostate
      microsomes: potent inhibition by imidazole-type antimycotic drugs and lack of
      inhibition by steroid 5 alpha-reductase inhibitors.
AB  - 5 alpha-Dihydrotestosterone, the principal androgen mediating prostate growth and
      function in the rat, is formed from testosterone by steroid 5 alpha-reductase.
      The inactivation of 5 alpha-dihydrotestosterone involves reversible reduction to
      5 alpha-androstane-3 beta,17 beta-diol by 3 beta-hydroxysteroid oxidoreductase
      followed by 6 alpha-, 7 alpha-, or 7 beta-hydroxylation. 5 alpha-Androstane-3
      beta,17 beta-diol hydroxylation represents the ultimate inactivation step of
      dihydrotestosterone in rat prostate and is apparently catalyzed by a single, high
      affinity (Km approximately 0.5 microM) microsomal cytochrome P450 enzyme. The
      present studies were designed to determine if 5 alpha-androstane-3 beta,17 beta
      diol hydroxylation by rat prostate microsomes is inhibited by agents that are
      known inhibitors of androgen-metabolizing enzymes. Inhibitors of steroid 5 alpha
      reductase (4-azasteroid analogs; 10 microM) or inhibitors of 3 beta
      hydroxysteroid oxidoreductase (trilostane, azastene, and cyanoketone; 10 microM)
      had no appreciable effect on the 6 alpha-, 7 alpha-, or 7 beta-hydroxylation of 5
      alpha-androstane-3 beta,17 beta-diol (10 microM) by rat prostate microsomes.
      Imidazole-type antimycotic drugs (ketoconazole, clotrimazole, and miconazole; 0.1
      10 microM) all markedly inhibited 5 alpha-androstane-3 beta,17 beta-diol
      hydroxylation in a concentration-dependent manner, whereas triazole-type
      antimycotic drugs (fluconazole and itraconazole; 0.1-10 microM) had no inhibitory
      effect. The rank order of inhibitory potency of the imidazole-type antimycotic
      drugs was miconazole greater than clotrimazole greater than ketoconazole. In the
      case of clotrimazole, the inhibition was shown to be competitive in nature, with
      a Ki of 0.03 microM. The imidazole-type antimycotic drugs inhibited all three
      pathways of 5 alpha-androstane-3 beta,17 beta-diol hydroxylation to the same
      extent, which provides further evidence that, in rat prostate microsomes, a
      single cytochrome P450 enzyme catalyzes the 6 alpha-, 7 alpha-, and 7 beta
      hydroxylation of 5 alpha-androstane-3 beta,17 beta-diol. These studies
      demonstrate that certain imidazole-type compounds are potent, competitive
      inhibitors of 5 alpha-androstane-3 beta,17 beta-diol hydroxylation by rat
      prostate microsomes, which is consistent with the effect of these antimycotic
      drugs on cytochrome P450 enzymes involved in the metabolism of other androgens
      and steroids.

PMID- 1632631
TI  - Formation of intraprotamine disulfides in vitro.
AB  - When mammalian protamine is dissolved in aqueous buffers at neutral or alkaline
      pH, both ends of the protein fold inward toward the center of the molecule and
      form disulfide crosslinks that stabilize several different structures. In the
      absence of reducing agents, these folded forms of protamine may be visualized and
      quantitated by gel electrophoresis. Using this technique, we have examined the
      formation of bull protamine disulfides in solution and describe a variety of
      factors that affect this process. At pH 8, disulfide-stabilized folded forms of
      protamine appear within minutes after solubilization of the fully reduced
      protein. Five different monomers are detected by electrophoresis. Each of these
      monomers is stabilized by at least one disulfide crosslink and migrates with a
      distinct mobility, ahead of the fully reduced and extended protein. Under certain
      conditions, dimers of these folded structures crosslinked by interprotamine
      disulfides are also formed. The appearance of these disulfide-crosslinked forms
      of protamine is effected by air oxidation, accelerated at alkaline pH, inhibited
      upon lowering the pH below pH 7 and eliminated by modifying the protein's
      cysteine residues. Similar intramolecular disulfides are also produced after the
      protamine molecule binds to DNA. These results suggest that only those cysteines
      located within the amino- and carboxyterminal ends of the protein appear to
      participate in forming intramolecular disulfides in vitro.

PMID- 1632632
TI  - Tissue-specific binding of testis nuclear proteins to a sequence element within
      the promoter of the testis-specific histone H1t gene.
AB  - The rat histone H1t gene is transcribed only in testis germinal cells. This
      testis-specific chromosomal protein is first synthesized during spermatogenesis
      in pachytene spermatocytes and the entire complement of testis histones is
      replaced during the midspermatid stage of spermiogenesis by positively charged
      transition nuclear proteins TP1 and TP2. Mobility shift assays conducted using
      crude nuclear protein extracts from different tissues and an 18-bp DNA sequence
      element within the H1t promoter as a probe reveal binding only with nuclear
      proteins from testis. The binding is specifically competed with an excess of the
      same unlabeled DNA fragment but not with heterologous competitors. A larger
      oligonucleotide corresponding to the same sequence element plus 18 bp of the
      adjacent downstream H1/CCAAT element binds nuclear proteins from all tissues
      tested, but a unique low mobility band is formed only with testis extracts.
      Protein-DNA crosslinking experiments reveal that two major polypeptides with
      molecular weights of approximately 13 and 30 kDa bind to the 18-bp H1t promoter
      sequence element. This strong correlation between the tissue where the H1t gene
      is transcribed and the presence of testis-specific nuclear proteins that bind to
      a sequence element within the testis histone H1t promoter supports the
      possibility that these DNA-binding proteins may participate in formation of an
      active transcription initiation complex with the testis H1t promoter.

PMID- 1632633
TI  - Properties of monoglycerol acyltransferase in rat adipocytes.
AB  - Previous studies by Coleman and Haynes (1986, J. Biol. Chem. 261, 224-228)
      indicated the presence of two different tissue specific monoacylglycerol
      acyltransferases (MGAT) in intestinal mucosa and suckling rat liver. The evidence
      was based upon the differential responses of these two isoenzymes to various
      treatments including, the effects of temperature, proteolysis, protein
      modification reagents, detergents, and divalent cations. In the present
      investigation, we have used some of these criteria to determine the identity of
      adipose enzyme with the MGAT present in liver and intestinal microsomes. The
      properties of adipose and intestinal enzymes were similar in several respects,
      but differed from the liver enzyme. This suggests the possibility that MGAT
      activities from adipose and intestine may be mediated by the same enzyme protein,
      whereas the liver MGAT may be a separate isoenzyme as proposed earlier. The most
      distinguishing feature of the liver enzyme was its ability to sustain both high
      temperature (52 degrees C) and resist proteolysis. However, when disrupted
      microsomal preparations were used, the liver enzyme was both thermolabile and
      protease sensitive, as observed for the intestinal and adipose MGAT. Possibly,
      the location of liver MGAT within the membranes may be responsible for such
      unique properties of liver MGAT.

PMID- 1632634
TI  - Thrombin-activated and factor Xa-activated human factor VIII: differences in
      cofactor activity and decay rate.
AB  - The decay of human coagulation factor VIIIa has been studied by kinetic methods
      that ensure no interference through proteolytic feedback. The rate of decay of
      factor VIIIa activity was found to vary with the activator used to activate
      factor VIII. Thrombin-activated factor VIII-von Willebrand factor complex (fVIII
      vWf) decayed at a rate of 0.31 min-1, whereas factor Xa-activated fVIII-vWf
      decayed at 0.11 min-1 under the same conditions. Factor VIII free of von
      Willebrand factor (factor VIII: C), although decaying at a generally slower rate
      after activation, still showed a dependence of decay rate on activator: thrombin
      activated factor VIII:C decaying at a rate of 0.06 min-1, and factor Xa-activated
      factor VIII: C at 0.01 min-1. Readdition of von Willebrand factor (18
      micrograms/ml) to factor VIII:C did not alter the observed activity or decay
      rate. The decay of the two species of factor VIIIa was studied, using the fVIIIa
      vWf complex, in the presence of varying levels of factor IXa. Plots of reciprocal
      decay rates vs factor IXa concentration were linear, and nearly parallel for the
      two factor VIIIa species, with a mean slope of 0.56 min.nM-1. In addition to
      these studies, we have confirmed previous studies showing that the two forms of
      factor VIIIa differ in cofactor activity, but they do so in the same ratio as in
      their decay rates. We suggest that this difference and that observed in decay
      rate have a common cause, and incorporate this into a potential kinetic model of
      factor VIII activation and decay.

PMID- 1632635
TI  - Esterase-1: developmental expression in the mouse and distribution of related
      proteins in other species.
AB  - Esterase 1 (Es-1) is a sexually dimorphic 65-kDa glycoprotein present in plasma
      and other murine tissues able to hydrolyze a variety of esters including fatty
      acid esters of estradiol. Like most other carboxylesterases, its function is
      unknown. To gain insight into the function of Es-1 and by analogy other
      carboxylesterases, we have examined the developmental regulation of Es-1 in the
      mouse and have looked for the presence of related proteins in the plasma of other
      species. Northern blot analysis of total RNA from the livers of mice of various
      ages using a 32P-labeled 470-bp Es-1 cDNA probe showed clear postpartum induction
      with no detectable Es-1 mRNA in fetal liver. Similarly, immunoblotting after
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis with an affinity
      purified rabbit antibody to Es-1 showed no cross-reacting proteins in the plasma
      until after birth. Northern blot analysis of total RNA from a variety of adult
      mouse tissues showed the presence of substantial levels of Es-1 mRNA only in
      liver with lower levels in kidney, testes, and ovaries. Liver mRNA and plasma
      protein levels rose in parallel attaining full adult levels between 15 and 20
      days of age. When plasma proteins were electrophoresed on 7% polyacrylamide gels
      under nondenaturing conditions, the antibody to Es-1 recognized a low mobility
      protein in mouse, rat, human, baboon, guinea pig, bovine, horse, and canine but
      not in chicken plasma. Consistent with the immunoblotting results, the Es-1 cDNA
      probe hybridized to restriction fragments from human, monkey, rat, and rabbit as
      well as mouse genomic DNA but not from chicken DNA indicating conservation of the
      esterase (or esterase-like) gene in mammalian species. The low mobility antigens
      in mouse and human plasma appeared also to cross-react with antibodies to human
      thyroglobulin, although antibodies to human thyroglobulin did not appear to
      recognize Es-1 under these conditions.

PMID- 1632636
TI  - Purification and characterization of a novel 12,000-Da calcium binding protein
      from smooth muscle.
AB  - A new low molecular weight calcium binding protein, designated 12-kDa CaBP, has
      been isolated from chicken gizzard using a phenyl-Sepharose affinity column
      followed by ion-exchange and gel filtration chromatographies. The isolated
      protein was homogeneous and has a molecular weight of 12,000 based on sodium
      dodecyl sulfate-gel electrophoresis. The amino acid composition of this protein
      is similar to but distinct from other known low molecular weight Ca2+ binding
      proteins. Ca2+ binding assays using Arsenazo III (Sigma) indicated that the
      protein binds 1 mol of Ca2+/mol of protein. The 12-kDa CaBP underwent a
      conformational change upon binding Ca2+, as revealed by uv difference
      spectroscopy and circular dichroism studies in the aromatic and far-ultraviolet
      range. Addition of Ca2+ to the 12-kDa CaBP labeled with 2-p-toluidinylnaphthalene
      6-sulfonate (TNS) resulted in a sevenfold increase in fluorescence intensity,
      accompanied by a blue shift of the emission maximum from 463 to 445 nm. Hence,
      the probe in the presence of Ca2+ moves to a more nonpolar microenvironment. Like
      calmodulin and other related Ca2+ binding proteins, this protein also exposes a
      hydrophobic site upon binding calcium. Fluorescence titration with Ca2+ using TNS
      labeled protein revealed the presence of a single high affinity calcium binding
      site (kd approximately 1 x 10(-6) M).

PMID- 1632637
TI  - Catalysis of the oxidation of steroid and stilbene estrogens to estrogen quinone
      metabolites by the beta-naphthoflavone-inducible cytochrome P450 IA family.
AB  - Diethylstilbestrol (DES) or catecholestrogens are metabolized by microsomal
      enzymes to quinones, DES Q or catecholestrogen quinones, respectively, which have
      been shown to bind covalently to DNA and to undergo redox cycling. The isoforms
      of cytochrome P450 catalyzing this oxidation of estrogens to genotoxic
      intermediates were not known and have been identified in this study by (a) using
      microsomes of rats treated with various inducers of cytochrome P450; (b) using
      purified cytochrome P450 isoforms; and (c) examining the peroxide cofactor
      concentrations necessary for this oxidation by microsomes or pure isoenzymes. The
      highest rate of oxidation of DES to DES Q was obtained using beta-naphthoflavone
      induced microsomes (14.0 nmol DES Q/mg protein/min) or cytochrome P450 IA1 (6.4
      pmol DES Q/min/pmol P450). Isosafrole-induced microsomes or cytochrome P450 IA2
      oxidized DES to quinone at one-third or one-fifth of that rate, respectively. Low
      or negligible rates of oxidation were measured when oxidations were catalyzed by
      microsomal rat liver enzymes induced by phenobarbital, ethanol, or pregnenolone
      16 alpha-carbonitrile or by pure cytochromes P450 IIB1, IIB4, IIC3, IIC6, IIE1,
      IIE2, IIG1, or IIIA6. Cytochrome P450 IA1 also catalyzed the oxidation of 2- or 4
      hydroxyestradiol to their corresponding quinones. The beta-naphthoflavone-induced
      microsomes and cytochrome P450 IA1 had the highest "affinity" for cumene
      hydroperoxide cofactor (Km = 77 microM). Cofactor concentrations above 250 microM
      resulted in decreased rates of oxidation. The other cytochrome P450 isoforms
      required much higher cofactor concentrations and were not inactivated at high
      cofactor concentrations. The data demonstrate that beta-naphthoflavone-inducible
      cytochrome P450 IA family enzymes catalyze most efficiently the oxidation of
      estrogenic hydroquinones to corresponding quinones. This oxidation may represent
      a detoxification pathway to keep organic hydroperoxides at minimal
      concentrations. The resulting quinone metabolites may be detoxified by other
      pathways. However, in cells with decreased detoxifying enzyme activities,
      quinones metabolites may accumulate and initiate carcinogenesis or cell death by
      covalent arylation of DNA or proteins.

PMID- 1632638
TI  - 1,2-Diacylglycerol does not mediate the stimulatory effect of phorbol 12
      myristate 13-acetate on phosphatidylcholine synthesis in NIH 3T3 fibroblasts.
AB  - In HeLa cells, increased 1,2-diacylglycerol (1,2-DAG) has been suggested to
      mediate the stimulatory effect of phorbol 12-myristate 13-acetate (PMA) on
      phosphatidylcholine (PtdCho) biosynthesis (A. K. Utal, H. Jamil, and D. E. Vance,
      1991, J. Biol. Chem. 266, 24,084-24,091). The aim of this study was to examine if
      1,2-DAG might have a similar mediatory role in NIH 3T3 fibroblasts. In these
      cells, PMA-induced hydrolysis of PtdCho and the formation of secondary product
      1,2-DAG was inhibited by exposing the cells to either 300 mM ethanol for 15 min
      (less than 80% inhibition) or 43 degrees C for 60 min (less than 50% inhibition).
      In contrast, neither ethanol nor heat-treatment caused significant inhibition of
      PMA-stimulated PtdCho synthesis. These data indicate that in NIH 3T3 fibroblasts,
      1,2-DAG is not a mediator of the stimulatory action of PMA on PtdCho synthesis.

PMID- 1632639
TI  - Kinetic mechanism of the cytosolic malic enzyme from human breast cancer cell
      line.
AB  - The kinetic mechanism of the cytosolic NADP(+)-dependent malic enzyme from
      cultured human breast cancer cell line was studied by steady-state kinetics. In
      the direction of oxidative decarboxylation, the initial-velocity and product
      inhibition studies indicate that the enzyme reaction follows a sequential ordered
      Bi-Ter kinetic mechanism with NADP+ as the leading substrate followed by L
      malate. The products are released in the order of CO2, pyruvate, and NADPH. The
      enzyme is unstable at high salt concentration and elevated temperature. However,
      it is stable for at least 20 min under the assay conditions. Tartronate (2
      hydroxymalonate) was found to be a noncompetitive inhibitor for the enzyme with
      respect to L-malate. The kinetic mechanism of the cytosolic tumor malic enzyme is
      similar to that for the pigeon liver cytosolic malic enzyme but different from
      those for the mitochondrial enzyme from various sources.

PMID- 1632640
TI  - Stimulation by heme of steryl ester synthase and aerobic sterol exclusion in the
      yeast Saccharomyces cerevisiae.
AB  - Saccharomyces cerevisiae sterol and heme auxotrophs were used to elucidate a role
      for hemes in sterol esterification. Steryl ester synthase (SES) activity was
      stimulated on average fourfold in cells supplemented with 50 micrograms/ml delta
      aminolevulinic acid (ALA). This stimulation was not dependent on ALA per se, but
      on the ability of this precursor to effect heme competency. The addition of ALA
      stimulated SES activity of yeast on either fermentative or respiratory carbon
      sources. The elevation of SES activity was independent of intracellular free
      sterol, unsaturated fatty acid, or methionine levels. SES activity increases as
      the cells enter stationary phase, and this increase is enhanced by heme
      competency. SES was directly inhibited by the hypocholesterolemic drug lovastatin
      (mevinolin). The inhibition of SES activity by lovastatin was enhanced in heme
      competent cells.

PMID- 1632641
TI  - Indole protects tryptophan indole-lyase, but not tryptophan synthase, from
      inactivation by trifluoroalanine.
AB  - Trifluoroalanine is a mechanism-based inactivator of Escherichia coli tryptophan
      indole-lyase (tryptophanase) and E. coli tryptophan synthase (R. B. Silverman and
      R. H. Abeles, 1976, Biochemistry 15, 4718-4723). We have found that indole is
      able to prevent inactivation of tryptophan indole-lyase by trifluoroalanine. The
      protection of tryptophan indole-lyase by indole exhibits saturation kinetics,
      with a KD of 0.03 mM, which is comparable to the KI for inhibition of pyruvate
      ion formation (0.01 mM) and the Km for L-tryptophan synthesis. Fluoride electrode
      measurements indicate the formation of 28 mol of fluoride ion per mole of enzyme
      during inactivation of tryptophan indole-lyase, and 121 mol of fluoride ion are
      formed per mole of enzyme in the presence of 2 mM indole during the same
      incubation period. 19F NMR spectra of reaction mixtures of tryptophan indole
      lyase and trifluoroalanine showed evidence only for fluoride ion formation, in
      either the absence or the presence of indole, and difluoropyruvic acid was not
      detected. The partition ratio, kcat/kinact, is estimated to be 9. Tryptophan
      indole-lyase in the presence of trifluoroalanine exhibits visible absorption
      peaks at 446 and 478 nm, which decay at the same rate as inactivation. However,
      in the presence of 1 mM indole and trifluoralanine, tryptophan indole-lyase
      exhibits a peak only at 420 nm, and the spectra show a gradual increase at 300
      310 nm with incubation. In contrast, tryptophan synthase is not protected by
      indole from inactivation by trifluoroalanine, and the absorption peak at 408 nm
      for the tryptophan synthase-trifluoroalanine complex is unaffected by indole.
      These results demonstrate that inactivation of tryptophan indole-lyase occurs via
      a catalytically competent species, probably the beta,beta-difluoro-alpha
      aminoacrylate intermediate, which can be partitioned from inactivation to
      products by a reactive aromatic nucleophile, indole.

PMID- 1632642
TI  - Purification, molecular cloning, and expression of lipase from Pseudomonas
      aeruginosa.
AB  - An extracellular lipase secreted by Pseudomonas aeruginosa TE3285 was purified. A
      genomic library of this strain was constructed in lambda EMBL3, and a DNA
      fragment 2.7 kb long containing the lipase gene, lipA, was isolated with an
      oligonucleotide probe synthesized on the basis of the partial amino acid sequence
      of a purified preparation of the enzyme. Nucleotide sequence analysis showed an
      open reading frame of 933 bases, and the deduced amino acid sequence agreed well
      with the molecular mass and partial amino acid sequences of mature lipase. The
      results of alignment of the amino acid sequences of five lipases from Pseudomonas
      species considered together with the published crystal structure studied with
      human pancreatic lipase showed that Ser82, His251, and Asp209 were catalytic
      residues and that a surface loop from residues 172 to 204 was responsible for the
      substrate specificity. About 50 bases downstream of lipA, there was another gene,
      lipB. The sequence of lipB was highly homologous to that of putative modulators
      of the production of active lipases in other Pseudomonas species. Expression
      plasmids encoding lipA followed by the complete or incomplete lipB gene
      downstream of the lac promoter of pUC18 were constructed. lipA was expressed in
      Escherichia coli 1100 only in the presence of the complete lipB gene.

PMID- 1632643
TI  - Binding of Saccharomyces cerevisiae extracellular proteins to glucane.
AB  - Interactions of Saccharomyces cerevisiae cell wall proteins with purified yeast
      glucane were studied. Using the beta-glucanase (BGL2 gene product) as the model
      cell wall protein, strong binding to glucane was demonstrated at pH lower than 7,
      while at pH higher than 8 the reaction did not occur. NaCl (2 M) did not
      influence the binding, while urea in concentrations higher than 4 M affected the
      interactions. It was also found that most other cell wall proteins, as well as
      intracellular proteins, reacted with glucane in the same way, showing that the
      interactions of proteins with glucane are rather nonspecific. Soluble periplasmic
      proteins invertase and acid phosphatase failed to react with glucane under the
      same conditions, indicating that these proteins have certain structural features
      preventing their interactions with glucane.

PMID- 1632644
TI  - Topical tocopherol acetate reduces post-UVB, sunburn-associated erythema, edema,
      and skin sensitivity in hairless mice.
AB  - Exposure of the skin of the back of skh-1 hairless mice to UVB (310 nm peak)
      irradiation at doses of 0.115-0.23 J/cm2 results after 24-48 h in an erythema
      which can be quantified using an erythema meter, providing a useful model of
      sunburn. Application of pure d-alpha-tocopherol acetate, a thick oil, to the skin
      immediately following the exposure to UVB significantly reduces the increase in
      erythema index, by 40-55%. At the lower dose (0.115 J/cm2), skin thickness
      (associated with edematous swelling of the sunburned skin) was measured by a
      novel non-invasive technique not previously reported for this purpose--magnetic
      resonance imaging (MRI). In two experiments the UVB-induced increase in skin
      thickness was significantly reduced at 24 hr by 29 and 54%, and at 48 hr by 26
      and 61%. After 8 days the untreated irradiated mouse skin still showed a
      significant increase in thickness (24%) compared to the untreated unirradiated
      control, while the treated irradiated control was not significantly thicker than
      the unexposed control. Skin sensitivity was tested using a modification of the
      technique of esthesiometry, by observing rapid avoidance responses of the mouse
      to a pressure of 0.96 g/cm2 exerted by applying to the skin the tip of a nylon
      esthesiometer fiber extended to 60 mm in length. The untreated irradiated mice
      were more sensitive (p less than 0.07, Wilcoxon test) than the treated irradiated
      mice, and also significantly different from the untreated unirradiated control
      mice (p less than 0.04, Wilcoxon test), but the treated irradiated mice were not
      significantly differently sensitive when compared to the unirradiated controls (p
      less than 0.32). Taken together these data indicate that the erythema, edema, and
      skin sensitivity commonly associated with UVB-induced sunburn are significantly
      reduced by topical application of tocopherol acetate even after the exposure has
      occurred. This observation suggests that treatment of sunburn may be possible
      even after the irradiation has stopped, by a derivative of d-alpha-tocopherol
      which is stable to autooxidation.

PMID- 1632645
TI  - The binding of estrogen and estrogen antagonists to the estrogen receptor.
AB  - The model of the estrogen receptor as a dimer of identical, interacting subunits
      and data obtained by Sasson and Notides (1988, Mol. Endocrinol. 2, 307-312) were
      used to find the standard free energy changes that describe the binding of
      estradiol and 4-hydroxytamoxifen to the estrogen receptor. For the binding of
      estradiol or 4-hydroxytamoxifen to the estrogen receptor the data do not deviate
      systematically from the best fit to the model. The standard free energy change
      for binding of one molecule of estradiol at one site and one molecule of 4
      hydroxytamoxifen at the second site of estrogen receptor indicates that 4
      hydroxytamoxifen antagonizes the binding of estradiol to the estrogen receptor.

PMID- 1632647
TI  - Structural analysis of five new monosialylated oligosaccharides from human milk.
AB  - The total monosialylated oligosaccharide fraction from pooled human milk was
      isolated by gel filtration and ion-exchange chromatography. Further separation by
      HPLC using a mobile phase containing an ion-pairing reagent of triethylamine gave
      five new monosialylated oligosaccharides. Structural analysis was carried out by
      chemical analyses, fast atom bombardment mass spectrometry, and 500-MHz NMR
      spectroscopy. Combined structural data revealed the following new structures:
      [formula: see text]

PMID- 1632646
TI  - Lipid peroxidation, antioxidant concentrations, and fatty acid contents of muscle
      tissue from malignant hyperthermia-susceptible swine.
AB  - Homogenates of semitendinosus muscle from malignant hyperthermia (MH)-susceptible
      pigs produced threefold more pentane than those from MH-resistant pigs,
      indicating enhanced free radical-mediated peroxidation of n-6 fatty acids. This
      did not reflect a deficiency in tissue antioxidants or antioxidant-enzymes but
      glutathione concentrations and glutathione peroxidase activities were increased
      in the tissue from MH-susceptible swine, consistent with an adaptive response to
      a sustained oxidant stress. A lower proportion of linoleic acid (18:2 n-6) in
      phospholipids and neutral lipids in muscle from MHS pigs indicated increased
      peroxidation or metabolism (desaturation and elongation). The increased oleic
      acid (18:1 n-9) in the MHS muscle indicated that desaturase activity was elevated
      in all lipid classes. The results are consistent with the hypothesis that
      enhanced free radical activity and lipid peroxidation contributes to the
      abnormalities in Ca2+ homeostasis and polyunsaturated fatty acid metabolism in
      MH.

PMID- 1632648
TI  - Activation of rat liver microsomal glutathione S-transferase by hydrogen
      peroxide: role for protein-dimer formation.
AB  - The mechanism of oxygen radical-dependent activation of hepatic microsomal
      glutathione S-transferase by hydrogen peroxide was studied. Glutathione S
      transferase activity in liver microsomes was increased 1.5-fold by incubation
      with 0.75 mM hydrogen peroxide at 37 degrees C for 10 min, and the increase in
      activity was reversed by incubation with dithiothreitol. Purified glutathione S
      transferase was also activated by hydrogen peroxide after incubation at room
      temperature, and the increase in the activity was also reversed by
      dithiothreitol. Immunoblotting with anti-microsomal glutathione S-transferase
      antibodies after sodium dodecyl sulfate-polyacrylamide gel electrophoresis of
      hydrogen peroxide-treated microsomes or purified glutathione S-transferase
      revealed the presence of a glutathione S-transferase dimer. These results
      indicate that the hydrogen peroxide-dependent activation of the microsomal
      glutathione S-transferase is associated with the formation of a protein dimer.

PMID- 1632649
TI  - Purification and characterization of a putative proenkephalin cleaving enzyme.
AB  - A putative proenkephalin-cleaving enzyme (PCE) extracted from bovine adrenal
      chromaffin granules was purified with soybean trypsin inhibitor high-performance
      affinity chromatography. The 12,600-fold purified enzyme was maximally active at
      pH 8.0. The enzyme was completely inhibited with lima bean trypsin inhibitor (0.1
      mg/ml), soybean trypsin inhibitor (0.1 mg/ml), and p
      (chloromercuri)benzenesulfonic acid (1.0 mM), indicating PCE is a serine protease
      with cysteine residues likely to be involved in its structure or activity. It
      exhibited significant autoproteolysis without specific substrates present. The
      substrate specificity and kinetic constants with the enkephalin-containing (EC)
      peptides Leu-9 and proenkephalin Peptides B, E, and F as substrates were studied.
      The cleavage patterns were substantially different than with trypsin digestion.
      PCE specifically recognized the paired basic amino acid residues and
      predominantly cleaved the peptide bonds between Lys and Arg sites and peptide
      bonds after Lys-Lys and Arg-Arg sites. Different Km and Vmax values for the
      different Lys-Arg sites indicate sequences in addition to the paired basic
      residues can affect enzyme activity. Also, the lower Km and Vmax of Peptide E
      suggest a higher affinity for this peptide but much slower cleavage. The C
      terminally located Lys-Arg site appears responsible for this high affinity. Based
      on these observations, we propose the following: (a) the primary structure of
      these peptides contains enough information to be processed correctly by PCE and
      (b) PCE may be regulated by pH and Peptide E to prevent extensive processing of
      the intermediate EC peptides which are the major opioid peptides found in the
      adrenal chromaffin granules.

PMID- 1632650
TI  - The lysosomal membrane glycoprotein lamp-1 is transported to lysosomes by two
      alternative pathways.
AB  - It has been demonstrated that lysosomal membrane proteins are directed to
      lysosomes by a tyrosine-containing structural motif in their cytoplasmic tails.
      It is presently unclear whether lysosomal membrane proteins are directly
      transported to lysosomes or first taken to the plasma membrane and then directed
      to the lysosomes via the endocytic pathway. In the present study, the transport
      pathways taken by one of the members of highly glycosylated lysosomal membrane
      proteins, lamp-1, were examined in human HL-60 cells. Pulse-chase labeling,
      combined with cell surface biotinylation and Percoll density gradient
      fractionation, was used to measure the kinetics of transport to the cell surface
      and lysosomes. The results show that the majority of lamp-1 is directly
      transported to lysosomes by a fast pathway (half-time 60 min), which involves
      sorting at an intracellular site, presumably in the trans-Golgi network. A minor
      part of lamp-1 is transported out to the cell surface, where it is internalized
      and eventually delivered to lysosomes. Transport by this pathway requires a long
      transit time (half-time greater than 2 h). After granulocytic differentiation of
      HL-60 cells by dimethyl sulfoxide, the synthesis of lamp-1 was increased
      approximately twofold. In these cells, the sorting in the Golgi apparatus is more
      effective, leaving only a minute fraction of lamp-1 for the bulk flow to the cell
      surface. This study establishes that the majority of lamp-1 is directly
      transported to lysosomes and that, in certain cells, the minority of the
      molecules is transported to lysosomes via the cell surface.

PMID- 1632651
TI  - A possible in vivo mechanism of intermediate transfer by glycolytic enzyme
      complexes: steady state fluorescence anisotropy analysis of an enzyme complex
      formation.
AB  - Rate constants of dissociation (k(off)) and association (k(on)) of the bienzyme
      complex yeast glyceraldehyde-3-phosphate dehydrogenase--yeast alcohol
      dehydrogenase have been determined in the absence and presence of NAD or NADH by
      fluorescence anisotropy measurements. We found that dissociation of the complex
      is considerably slower than catalytic turnover of either of the enzymes (that is
      k(off) much less than kcat) irrespective of the presence of coenzymes. A perusal
      of the literature reveals that this relation invariably applies to all systems
      studied so far. These observations all taken together constitute compelling
      evidence that direct metabolite transfer in enzyme complexes cannot be
      satisfactorily described by invoking the dynamic model but requires a model
      assuming more lasting complexes. This seems to support the case of the temporary
      stationary model suggested by one of us. Implications of this conclusion are
      treated in depth and further evidence is cited under Discussion.

PMID- 1632652
TI  - Production and characterization of recombinant lignin peroxidase isozyme H2 from
      Phanerochaete chrysosporium using recombinant baculovirus.
AB  - Recombinant Phanerochaete chrysosporium lignin peroxidase isozyme H2 (pI 4.4) was
      produced in insect cells infected with a genetically engineered baculovirus
      containing a copy of the cDNA clone lambda ML-6. The recombinant enzyme was
      purified to near homogeneity and is capable of oxidizing veratryl alcohol,
      iodide, and, to a lesser extent, guaiacol. The Km of the recombinant enzyme for
      veratryl alcohol and H2O2 is similar to that of the fungal enzyme. The guaiacol
      oxidation activity or any other activity is not dependent upon Mn2+. The purified
      recombinant peroxidase is glycosylated with N-linked carbohydrate(s). The
      recombinant lignin peroxidase eluted from an anion exchange resin similar to that
      of native isozyme H1 rather than H2. However, the pI of the recombinant enzymes
      is different from both H1 and H2 isozymes. Further characterization of native
      isozymes H1 and H2 from the fungal cultures revealed identical N-terminus
      residues. This indicates that isozymes H1 and H2 differ in post-translational
      modification.

PMID- 1632653
TI  - Coordinated regulation of cerebral glycolytic and oxidative metabolism, mediated
      by mitochondrially bound hexokinase dependent on intramitochondrially generated
      ATP.
AB  - Hexokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) of rat brain
      mitochondria is associated with membrane regions thought to correspond to contact
      sites (regions of close interaction of the inner and outer mitochondrial
      membranes). Two intramitochondrial compartments of ATP also appear to be located
      at contact sites, and are dependent on oxidative phosphorylation for their
      generation. Neither of these compartments was associated with the intermembranal
      space containing adenylate kinase, nor was there detectable intramitochondrial
      compartmentation of ATP generated by the adenylate kinase reaction. Formation of
      these compartments was not dependent on the presence of bound hexokinase since
      equivalent amounts of compartmented ATP were found in mitochondria from which a
      major portion of the hexokinase had been removed by treatment with Glc-6-P.
      During active oxidative phosphorylation, mitochondrially bound hexokinase is
      totally dependent upon intramitochondrially compartmented ATP as a substrate.
      Both the levels of ATP in the intramitochondrial compartments and the rate of
      glucose phosphorylation by mitochondrially bound hexokinase were shown to be
      correlated with the rate of oxidative phosphorylation. This dependence of
      hexokinase on intramitochondrial ATP levels that reflect the status of
      mitochondrial oxidative metabolism provides a mechanism by which hexokinase can
      serve as a mediator, coordinating the rate at which glucose is introduced into
      the glycolytic pathway with terminal oxidative stages of metabolism and avoiding
      the accumulation of lactate which has been associated with toxic effects on the
      brain.

PMID- 1632655
TI  - Inhibition of human serine proteases by substituted 2-azetidinones.
AB  - trans-4-Ethoxycarbonyl-3-ethyl-1-(4-nitrophenyl-sulfonyl)-azetidin -3-one
      described by Firestone et al. (1990, Tetrahedron 46, 2255) as an inhibitor of
      human leucocyte elastase (HLE) displayed potent, time-dependent inhibition of
      both HLE and human cathepsin G (Cat-G). The cis-isomer was 7- and 180-fold less
      active, respectively. The mechanism likely involves opening of the beta-lactam
      ring by the active site serine to form an acyl-enzyme intermediate(s). This
      intermediate partitions with ratios of 4:1 between turnover of the inhibitor and
      formation of relatively stable enzyme-inhibitor complexes from both enzymes. The
      final HLE-inhibitor complex reactivated with a half-life of 48 h at 25 degrees C
      and was 16-fold more stable than the Cat-G-inhibitor complex. The stability of
      the acyl-enzymes supports a "double hit" chemical mechanism involving both serine
      acylation and alkylation of the histidine. These observations suggest that beta
      lactams may be developed as a class of serine protease inhibitors.

PMID- 1632654
TI  - ATP-Mg/Pi carrier activity in rat liver mitochondria.
AB  - The ATP-Mg/Pi carrier in liver mitochondria is activated by micromolar Ca2+ and
      mediates net adenine nucleotide transport into and out of the mitochondrial
      matrix. The purpose of this study was to characterize certain features of ATP
      Mg/Pi carrier activity that are essential for understanding how the mitochondrial
      adenine nucleotide content is regulated. The relative importance of ATP and ADP
      as transport substrates was investigated using specific trap assays to measure
      their separate rates of carrier-mediated efflux with Pi as the external
      counterion. Under energized conditions ATP efflux accounted for 88% of total
      ATP+ADP efflux. With oligomycin present to lower the matrix ATP/ADP ratio, ATP
      efflux was eliminated and ADP efflux was relatively unaffected. Mg2+ was
      stoichiometrically required for ATP influx and is probably transported
      simultaneously with ATP. Ca2+ and Mn2+ could substitute for the stoichiometric
      Mg2+ requirement. ADP influx and Pi-induced adenine nucleotide efflux were
      unaffected by external Mg2+. Experiments with Pi analogues suggested that Pi is
      transported as the divalent anion, HPO4(2-). The results show that ATP-Mg and
      divalent Pi are the major transport substrates; the most probable transport
      mechanism for the ATP-Mg/Pi carrier is an electroneutral exchange. The results
      are consistent with the hypothesis that the direction and magnitude of net
      adenine nucleotide movements are determined mainly by the (ATP-Mg)2- and HPO4(2-)
      concentration gradients across the inner mitochondrial membrane.

PMID- 1632656
TI  - Can man's best friend provide clues to the aetiology of systemic lupus
      erythematosus?

PMID- 1632657
TI  - Radiographic patterns of osteoarthritis of the knee joint in the community: the
      importance of the patellofemoral joint.
AB  - The intimate relation which the patella has with the knee joint and quadriceps
      muscle suggests that patellofemoral joint osteoarthritis is likely to be an
      important cause of knee pain and disability. Two hundred and seventy three
      subjects who reported knee pain in a postal questionnaire survey and 240 control
      subjects consented to have anteroposterior weightbearing and lateral knee
      radiographs. Each subject completed a Stanford Health Assessment Questionnaire
      (HAQ). Radiographic knee osteoarthritis was found in 53% of symptomatic and 17%
      of asymptomatic subjects. Three patterns predominated patellofemoral, medial, and
      medial/patellofemoral joint disease in 11, 21, and 7% of the men and in 24, 12,
      6% of the women respectively. The occurrence of isolated symptomatic
      patellofemoral joint osteoarthritis in this sample aged more than 55 years was
      estimated as 8% in women and 2% in men. All patterns of symptomatic knee joint
      osteoarthritis increased with age in women but peaked at 70 years in men. Medial
      joint and patellofemoral joint osteoarthritis were significantly associated with
      disability (46 v 17% in controls and 64 v 25% in controls respectively) but
      higher HAQ scores were more common in subjects with patellofemoral joint
      osteoarthritis. Patellofemoral joint osteoarthritis is common, associated with
      disability, occurs in the absence of tibiofemoral disease, and can no longer be
      omitted from future studies of osteoarthritis of the knee joint.

PMID- 1632658
TI  - Reduction of the concentration and total amount of keratan sulphate in synovial
      fluid from patients with osteoarthritis during treatment with piroxicam.
AB  - To study the effects of piroxicam on cartilage metabolism in vivo, a three phase
      (placebo/piroxicam 20 mg/day by mouth/placebo) double blind controlled trial was
      conducted in patients with osteoarthritis of the knee joint. Twenty one patients
      were recruited, 19 of whom (11 women, eight men, median age 70 years) completed
      the treatment schedule. The knee joint under study was aspirated to dryness at
      four week intervals. Treatment with piroxicam was accompanied by a decrease in
      the pain score, an improvement in the functional index, and an increased range of
      movement. Reductions in the concentration (mean (SEM) 120 (6) to 110 (8)
      micrograms/ml) and the total amount (1.22 (0.34) to 0.99 (0.37) mg) of keratan
      sulphate, but not the effusion volume (9.4 (2.5) to 8.3 (2.6) ml) were observed
      during treatment with piroxicam. These findings are consistent with decreased
      proteoglycan catabolism during treatment with piroxicam. Neither depressed
      synthesis nor enhanced clearance of degraded proteoglycan fragments can be
      excluded, however.

PMID- 1632659
TI  - Population study of the importance of rheumatoid factor isotypes in adults.
AB  - Blood samples collected from 13,858 randomly selected subjects participating in a
      health survey in Iceland from 1974 to 1983 were tested for rheumatoid factor.
      Samples that were positive in a sensitive RF screening test were analysed further
      by the Rose-Waaler technique and an isotype specific enzyme linked immunosorbent
      assay (ELISA). In 1987 the 173 available participants who were RF positive and
      156 matched RF negative controls were evaluated clinically for rheumatoid
      diseases. RF levels and isotype patterns were more persistent in the patients
      with rheumatoid arthritis (RA) than in RF positive subjects who did not have
      overt RA. The prevalence of RA was only 19% in the participants who were RF
      positive in 1987. Forty per cent of the participants who had a persistent (four
      to 13 years) increase of IgA RF combined with either IgM or IgG RF were diagnosed
      as having RA. A positive correlation was found between RF levels and various
      manifestations of RA. This association was stronger for the IgA and IgG RF
      isotypes than for IgM RF. Excluding RF positivity as a diagnostic parameter, RA
      was diagnosed in 33 of the participants and 20 (61%) of these patients had
      increased levels of IgM and IgA RF. Patients with RA with bone erosions in their
      hands had higher levels of IgA RF than patients without erosions, but an
      association was not found between bone erosions and other RF isotypes. None of
      the RF negative participants who were symptom free when the original blood sample
      was taken developed RA during the four to 13 year follow up period. In contrast,
      five symptom free RF positive participants developed RA during this period. These
      five patients had all had increased levels of at least two RF isotypes before the
      onset of their symptoms. It is concluded that the IgA and IgG RF isotypes have a
      closer association with the clinical parameters of RA than IgM RF. Furthermore,
      increases in RF can precede clinical manifestations of RA and this applies in
      particular to the IgA and IgG RF isotypes.

PMID- 1632660
TI  - Pathogenic importance of fibronectin in the superficial region of articular
      cartilage as a local factor for the induction of pannus extension on rheumatoid
      articular cartilage.
AB  - To identify the local factors in cartilage that are responsible for the induction
      of pannus invasion, a 14 day organ culture study in which rheumatoid synovium was
      grown in contact with cartilage pieces was carried out. Rheumatoid synovium
      preferentially extended over hyaluronidase treated cartilage pieces, but detached
      from untreated pieces. Rheumatoid synovium extended over hyaluronidase treated
      cartilage surfaces containing fibronectin more extensively than over surfaces
      treated with hyaluronidase only. Extension over hyaluronidase treated cartilage
      surfaces containing immune complexes was small. The adherence of synovial cells
      to hyaluronidase treated cartilage slices in vitro was specifically inhibited by
      the synthetic peptide, Gly-Arg-Gly-Asp-Ser-Pro, which is the adhesive portion of
      the fibronectin molecule. Furthermore, synovial fibroblast-like cellular
      extension, morphologically similar to rheumatoid pannus, was observed in the
      organ culture experiments in which rheumatoid synovium grew over hyaluronidase
      treated cartilage surfaces containing fibronectin. Synovial tissue extension over
      fibronectin coated surfaces was inhibited when hyaluronic acid and chondroitin-4
      sulphate, major components of cartilage proteoglycans, were present on the
      cartilage surface. These findings suggest that fibronectin present in the
      superficial region of cartilage potentiates rheumatoid synovial extension and
      proteoglycans and immune complexes inhibit rheumatoid synovial extension. It is
      likely that fibronectin deposited on the eroded surface of articular cartilage
      induces pannus formation in rheumatoid arthritis.

PMID- 1632661
TI  - Predictive value of synovial fluid analysis in estimating the efficacy of intra
      articular corticosteroid injections in patients with rheumatoid arthritis.
AB  - The predictive relevance of synovial fluid analysis and some other variables for
      the efficacy of intra-articular corticosteroid injections in 30 patients with
      rheumatoid arthritis and hydropsy in a knee joint was evaluated in a prospective
      study. At the onset of the study, the knee joints were aspirated and 30 mg
      triamcinolone hexacetonide injected intra-articularly. The circumferences and the
      tenderness scores of the knee joints were measured at onset, after two months,
      and at the end of the six months' follow up. Of the variables studied, synovial
      fluid C4, percentage of synovial fluid polymorphonuclear leucocytes, blood
      haemoglobin, and serum C3 correlated significantly with the decrease in knee
      joint circumference after two months, whereas only the percentage of synovial
      fluid polymorphonuclear leucocytes correlated significantly after six months.
      Between the patients with and without improvement in the tenderness scores of the
      knee joints, only serum IgM differed at the examination after two months; this
      was higher in patients whose scores showed no improvement.

PMID- 1632662
TI  - Effect of fish oil on neutrophil chemiluminescence induced by different stimuli
      in patients with rheumatoid arthritis.
AB  - Lipid composition plays an important part in the structural and metabolic
      functions of cell membranes. In particular the production of inflammatory
      mediators such as prostaglandins and leukotrienes is dependent on polyunsaturated
      fatty acid precursors. Neutrophil leucocytes participate in inflammatory
      processes by their phagocytic and killing activities which can be monitored by
      measuring the photon emission (chemiluminescence). Chemiluminescence was measured
      in a luminol dependent system after stimulation by either particulate (zymosan)
      or soluble (phorbol myristate acetate) stimulus in a group of 10 patients with
      rheumatoid arthritis before and 21 and 45 days after treatment with a diet
      supplemented with eicosapentaenoic and docosahexaenoic acids. Ten patients with
      rheumatoid arthritis continuing their usual diet were used as control subjects. A
      progressive reduction of chemiluminescence stimulated by zymosan and phorbol
      myristate acetate was found in the patients treated with fish oil
      supplementation. This result correlated well with the reduction in erythrocyte
      sedimentation rate and an improvement of clinical parameters. The effects of fish
      oil derived lipids on neutrophil chemiluminescence are probably due to a change
      of the lipid composition of the cell membrane which is dependent on the
      esterification of eicosapentaenoic acid and docosahexaenoic acid in cellular
      membrane phospholipids. The modification of membrane lipid composition seems to
      interact in a non-specific way with the metabolic activation of neutrophils
      during phagocytosis.

PMID- 1632663
TI  - Short term effects of intravenous pulses of cyclophosphamide in the treatment of
      connective tissue disease crisis.
AB  - A predominantly outpatient regimen of low dose intravenous cyclophosphamide was
      used to treat patients with serious progressive connective tissue diseases. Fifty
      five patients were treated with a total of 211 intravenous pulses of
      cyclophosphamide. Forty five patients had previously shown no response to a
      variety of other treatments. Low dose intravenous cyclophosphamide (500 mg) was
      given in 179 pulses and repeated pulses were given in most patients at weekly
      intervals for one to three weeks to induce disease remission. A good response was
      noted in 37 of 55 (67%) patients assessed four weeks after the pulses. Only 20
      patients needed more than one such course of three pulses of intravenous
      cyclophosphamide during the observation period. The non-responders were
      characterised by longstanding disease and irreversible histological findings in
      renal and muscle biopsy samples. Patients with vasculitis, notably Wegener's
      granulomatosis, showed the most immediate response, and in most patients the
      amount of corticosteroids required was markedly reduced. In some patients
      steroids were completely stopped during the follow up period. The most striking
      observation of this effective but more conservative regimen was the low incidence
      of major side effects such as neutropenia and infections. It is concluded that
      low dose pulses of intravenous cyclophosphamide are well tolerated and are an
      effective treatment for patients with aggressive connective tissue diseases.

PMID- 1632664
TI  - Isotype profile and clinical relevance of anticardiolipin antibodies in Sjogren's
      syndrome.
AB  - The purpose of this study was to determine the occurrence and clinical value of
      anticardiolipin antibodies in patients with Sjogren's syndrome. Thirty one
      patients with primary Sjogren's syndrome (all women, mean (SD) age 48.3 (11.2)
      years) and 32 patients with secondary Sjogren's syndrome with rheumatoid
      arthritis (all women, mean (SD) age 54.9 (11) years) were studied. IgG, IgM, and
      IgA anticardiolipin antibodies were determined by a standard enzyme linked
      immunosorbent assay (ELISA) technique. Anticardiolipin antibodies were found in
      five patients (16%) with primary Sjogren's syndrome and in seven patients (22%)
      with secondary Sjogren's syndrome. There was no correlation between
      anticardiolipin antibodies and the clinical features of the antiphospholipid
      syndrome (thrombotic events, fetal loss, thrombocytopenia) or extraglandular
      manifestations of Sjogren's syndrome (arthritis, skin lesions, myositis,
      polyneuropathy, central nervous system disease, pulmonary and renal disease) in
      either group. Among the various serological features studied, anticardiolipin
      antibodies correlated with antinuclear antibodies and antibodies to RNP only in
      patients with primary Sjogren's syndrome. These results indicate that although
      anticardiolipin antibodies are often found in serum samples from patients with
      Sjogren's syndrome, their clinical significance remains unclear.

PMID- 1632665
TI  - Effects of coagulation temperature on measurements of complement function in
      serum samples from patients with systemic lupus erythematosus.
AB  - Blood samples from 15 patients with systemic lupus erythematosus (SLE) and 15
      healthy blood donors were allowed to coagulate for one hour at room temperature,
      followed by one hour at 4 or 37 degrees C. The complement activity of the serum
      samples was assessed by three different functional assays. Serum samples from
      patients with SLE obtained by coagulation at 37 degrees C had a lower complement
      activity than serum samples from blood coagulated at 4 degrees C when the
      capacity of the serum samples to solubilise precipitable immune complexes and to
      support the attachment of complement factors to solid phase immune complexes was
      determined. Haemolytic complement activity was not affected by the coagulation
      temperature. The content of C1q binding immune complexes in paired serum samples
      obtained after coagulation at 4 and 37 degrees C was similar and the size
      distribution of the immune complexes, determined by high performance gel
      permeation chromatography, was also similar. This study shows that the results of
      functional complement assays, applied to serum samples from patients with SLE
      cannot be compared unless the conditions for blood coagulation and serum handling
      are defined and are the same. The data also indicate that assays measuring
      complement mediated solubilisation of immune complexes and the fixation of
      complement factors to solid phase immune complexes are more sensitive indicators
      of complement activity than the haemolytic assay.

PMID- 1632666
TI  - Gait analysis in ankylosing spondylitis.
AB  - A study was conducted to compare the gait pattern of 12 patients with ankylosing
      spondylitis with axial disease only with that of 11 healthy controls using a
      telemeterised electrogoniometer gait analysis system. The reproducibility of the
      gait variables was found to be acceptable. Angles for movement at the hip and
      knee were less in patients with ankylosing spondylitis, but hip/knee angle ratios
      did not differ between the two groups. The stride length was shorter in the
      patients with ankylosing spondylitis. These findings are due to the increased
      rigidity of the spine, which results in decreased shock absorption and
      consequently a more cautious gait pattern in the absence of clinically and
      radiologically detectable peripheral joint disease.

PMID- 1632668
TI  - Infectious discitis caused by Enterobacter cloacae.
AB  - The case is reported of a patient who developed a vertebral osteomyelitis caused
      by Enterobacter cloacae. The organism was isolated in cultures of blood and
      vertebral puncture biopsy samples. The patient was satisfactorily treated with
      trimethroprim and sulphamethoxazole. Enterobacter cloacae, a Gram negative
      organism, has been confirmed as the cause of bacteremia in patients with burns,
      urinary infections, in adults with pneumonia, and in children with joint
      infections. Spondylodiscitis caused by Enterobacter cloacae has not previously
      been described.

PMID- 1632667
TI  - Giant cell arteritis of the female genital tract with temporal arteritis.
AB  - The clinical and pathological features of a patient with giant cell arteritis of
      the uterus and ovaries are described. A 61 year old woman had fever and weight
      loss over a period of eight months. A hysterectomy with bilateral salpingo
      oophorectomy was performed for a large cystic ovarian mass. Histological
      examination showed a benign ovarian cyst and unexpected giant cell arteritis
      affecting numerous small to medium sized arteries in the ovaries and myometrium.
      The diagnosis of temporal arteritis was confirmed by a random temporal artery
      biopsy, despite the absence of symptoms of temporal arteritis. This observation
      is compared with previously reported cases and the relation between granulomatous
      arteritis of the genital tract and temporal arteritis is discussed. The main
      differential diagnosis in this localisation was represented by Wegener's
      granulomatosis and periarteritis nodosa.

PMID- 1632669
TI  - Digital vasculitis after splenectomy in a patient with Felty's syndrome.
AB  - The case is reported of a man with Felty's syndrome in whom digital cutaneous
      vasculitis developed after a splenectomy. This may be a coincidental occurrence
      but a possible mechanism is suggested by which the splenectomy may have modified
      the immunopathology of the disease.

PMID- 1632670
TI  - Salvage of the infected arthroplasty.

PMID- 1632671
TI  - Health of the nation and osteoporosis.

PMID- 1632672
TI  - Adhesion of peripheral blood lymphocytes to high endothelial venules of gut
      mucosa.

PMID- 1632673
TI  - Potential for drug interactions in elderly patients with arthritis.

PMID- 1632674
TI  - Bronchiolitis obliterans in systemic lupus erythematosus.

PMID- 1632675
TI  - Pamidronate associated hallucinations.

PMID- 1632676
TI  - The 103rd Annual Scientific Session of the Southern Surgical Association. Hot
      Springs, Virginia, December 1-4, 1991.

PMID- 1632677
TI  - Prostaglandin E2 production during hepatic regeneration downregulates Kupffer
      cell IL-6 production.
AB  - The liver possesses the remarkable ability to regenerate to its original size
      after a 70% partial hepatectomy. There has been little effort to characterize the
      Kupffer cells' role in this unique mammalian reparative physiologic phenomenon.
      The capacity of rat Kupffer cells (KC) isolated at specific intervals after
      partial hepatectomy to produce interleukin-6 (IL-6) and prostaglandin E2 (PGE2)
      in response to endotoxin was evaluated in standard RPMI-1640 (1200 microM L
      arginine) and arginine-depleted RPMI-1640 (10 microM L-arginine) media.
      Regenerating liver KC 48 to 120 hours after partial hepatectomy responded to
      endotoxin stimulation with a significantly greater (p less than 0.05) production
      of IL-6 in standard RPMI-1640. Because Kupffer cells function in an environment
      where high arginase activity results in negligible L-arginine levels, the 10
      microM L-arginine RPMI-1640 was used to simulate the true hepatic
      microenvironment. Production of IL-6 by regenerating liver KC was further
      increased (p less than 0.05) by placing these same KC in 10 microM L-arginine
      RPMI-1640 tissue culture media. During the same period, regenerating liver KC
      produced significantly (p less than 0.01) more PGE2 than sham-operated KC in both
      standard and low-arginine media. When the cyclo-oxygenase inhibitor indomethacin
      (1 x 10(-5) M) was added to cultures, the PGE2 production was inhibited, and IL-6
      production was upregulated (p less than 0.05) in arginine-depleted cultures. The
      authors conclude that during hepatic regeneration KC IL-6 production is elevated
      but controlled in an autoregulatory fashion by KC PGE2 production.

PMID- 1632678
TI  - Percutaneous catheter drainage compared with internal drainage in the management
      of pancreatic pseudocyst.
AB  - The records of 92 patients with symptomatic pancreatic pseudocysts referred for
      surgical management over a 27-year period were retrospectively reviewed to
      compare outcome in 42 patients managed with operative internal drainage
      procedures (group I) with that in 52 patients managed with computed tomography
      directed percutaneous catheter drainage (PCD) (group II). The two groups were
      similar for patient age, sex, pseudocyst location, and cause. The frequency of
      antecedent pseudocyst-associated complications was less in group I (16.7 versus
      38.5%, p less than 0.05). Seven group I patients and four group II patients had
      major complications (16.7 versus 7.7%, not significant). Group II mean duration
      of catheter drainage was 42.1 days, and the drain track infection rate was 48.1%.
      The frequency of antecedent operative cyst drainage was similar (14.2 versus
      13.5%), as was the frequency of subsequent operations for complications related
      to chronic pancreatitis (9.5 versus 19.2%, not significant). Mortality rate was
      greater in group I (7.1% versus 0%, p less than 0.05). Pseudocysts can be
      effectively managed either by open operation with internal drainage or by PCD.
      Drawbacks of PCD include the controlled external pancreatic fistula and the risk
      of drain track infection. Percutaneous catheter drainage has the following
      advantages: (1) low mortality rate, (2) does not require a major operation, (3)
      does not violate the operative field in cases when subsequent retrograde duct
      drainage procedures are required. Neither PCD nor internal drainage is
      definitive, and with either technique subsequent correction of underlying
      pancreatic pathology may be necessary.

PMID- 1632679
TI  - The use of UW solution in clinical transplantation. A 4-year experience.
AB  - The development of the University of Wisconsin (UW) cold storage solution has
      extended safe preservation of the liver and pancreas from 6 to 24 hours or more.
      From May 1987 until November 1991, 288 livers and 163 simultaneous
      pancreas/kidney transplants were performed using UW solution. The mean
      preservation times were: liver, 12.7 +/- 4.4 hours, pancreas 17.2 +/- 4.4 hours,
      and kidney, 19.2 +/- 4.3 hours. Included in this series were 35 reduced-sized
      liver transplants, 7 cluster transplants, and 132 combined liver/pancreas
      retrievals. No differences in allograft function or graft-related complications
      were seen in organs preserved for less than or longer than 12 hours or in grafts
      from combined liver/pancreas retrievals. All pancreas/kidney transplants and most
      liver transplants were performed semi-electively. Actuarial 1-month patient and
      graft survival after liver transplantation was 91.4% and 80.2%, and at 4 years
      was 74.0% and 62.0%, respectively. After pancreas/kidney transplantation, the
      actuarial patient survival at 1 month and 4 years was 99.4% and 90.5%,
      respectively, whereas pancreatic and renal allograft survival at 1 month was
      97.5% and 96.8%, and at 4 years was 83.0% and 83.4%, respectively. The ability to
      extend preservation times with UW solution has many advantages; however, the most
      important contribution of UW solution to clinical transplantation has been the
      increased utilization of scarce donor organs for more recipients because the
      previously imposed constraints on preservation time have been removed.

PMID- 1632680
TI  - Pancreas transplantation. An initial experience with systemic and portal drainage
      of pancreatic allografts.
AB  - Pancreas transplantation has evolved dramatically since its introduction in 1966.
      As new centers for transplantation have developed, the evaluation of
      complications associated with pancreas transplantation has led to advances in
      surgical technique. Furthermore, surgical alterations of the pancreas resulting
      from transplantation (systemic release of insulin and denervation) are of
      unproven consequence on glucose metabolism. Since 1988, the authors have
      performed 21 transplants (16 combined pancreas/kidney, 3 pancreas alone, which
      includes 1 retransplantation, 1 pancreas after previous kidney transplant, and 1
      "cluster") in 20 patients aged 18 to 49 years; mean, 35 +/- 1 years. Overall
      patient survival is 95%. Three pancreatic grafts failed within the first year
      because of technical failure; one additional pancreas was lost to an immunologic
      event on postoperative day 449, for an overall pancreatic graft survival of 81%.
      No renal grafts were lost. To evaluate causes of graft failure, demographic data
      were compared, which included age and sex of the donor and the recipient,
      operative time, intraoperative blood transfusion, and ischemic time of the graft.
      No statistically significant differences were found between groups except for
      ischemic time (11.7 +/- 6.4 hours for the technical success group versus 19.8 +/-
      3.7 hours for the technical failure group; p less than 0.05 by unpaired Student's
      t test). Quadruple immunosuppression was used, which included prednisone,
      cyclosporine, azathioprine, and antilymphoblast globulin. A mean of 1.2 (range, 0
      to 3) rejection episodes per patient occurred. Mean hospital stay was 24 +/- 11
      days. Surgical and infectious complications were evaluated by comparing the
      technical success (TS) group (n = 17) with the technical failure (TF) group.
      Surgical complications in the TS group revealed a mean of 1.3 episodes per
      patient, whereas the TF group had 3.7 episodes per patient. The TS also had a
      reduced incidence of infectious complications compared with the TF (1.7 versus
      4.3 episodes per patient). Cytomegalovirus was common in both groups, accounting
      for 11 infectious episodes, and occurred on a mean postoperative day of 38. Mean
      postoperative HbA1C levels dropped to 5 +/- 1% from 11 +/- 3%. The authors
      developed a new technique that incorporates portal drainage of the pancreatic
      venous effluent in three recipients. Preoperative metabolic studies disclosed a
      mean fasting glucose of 211 +/- 27 mg/dL and a mean stimulated glucose value of
      434 +/- 41 mg/dL for all patients; the mean fasting insulin was 23 +/- 4
      microU/mL.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1632681
TI  - The interrelation between sclerosing cholangitis and ulcerative colitis in
      patients undergoing liver transplantation.
AB  - Thirty-six patients underwent orthotopic liver transplantation (OLT) for primary
      sclerosing cholangitis under cyclosporine, azathioprine, and steroid
      immunosuppression. Of these patients, 29 suffered from chronic ulcerative
      colitis. The purpose of this study is to determine (1) whether replacement of the
      diseased liver and the altered immunocompetence suppresses the manifestation of
      chronic ulcerative colitis, and (2) if active colonic disease alters allograft
      function. Thirty of 36 patients survived OLT. After OLT, seven of 14 patients
      with symptomatic colon disease at the time of transplantation continue to suffer
      from active chronic ulcerative colitis, and three of 13 who were asymptomatic
      developed clinically active disease. Intractable colonic disease was the
      indication for post-OLT proctocolectomy in three patients, and one refused an
      indicated colectomy. Despite the long duration of the disease, none developed
      colonic malignancy. Long-term graft assessment showed good hepatocyte synthetic
      function in patients suffering from either active or inactive disease. Liver
      alkaline phosphatase, however, was significantly higher in patients suffering
      from active colonic disease. Furthermore, the alkaline phosphatase in symptomatic
      patients was higher than that seen in a matched cohort undergoing OLT for chronic
      active hepatitis or primary biliary cirrhosis. These results suggest that (1)
      liver replacement and immunosuppression in patients suffering from sclerosing
      cholangitis and ulcerative colitis do not alter the course of the colon disease,
      and (2) active chronic ulcerative colitis does not adversely affect allograft
      function, although elevation of alkaline phosphatase may be the harbinger of
      recurrence over the long term.

PMID- 1632682
TI  - Benefits of quadruple immunosuppressive therapy in recipients of living related
      donor kidneys. A review of 855 operations.
AB  - Eight hundred fifty-five living related donor transplant recipients were analyzed
      according to 15 potential risk factors with regard to patient and graft survival
      according to immunosuppression. Group I, 1968 to 1983, (n = 440 patients)
      received azathioprine and prednisone; group II, 1984 to 1987, (n = 229 patients)
      received triple therapy--azathioprine, prednisone, and cyclosporine; and group
      III, 1988-1991, (n = 186 patients), quadruple therapy--azathioprine, prednisone,
      cyclosporine, and Minnesota antilymphocyte globulin. Three important risk factors
      included immunosuppression, tissue typing, and race. Groups II and III had
      improved allograft survival over group I (p = 0.03). Patients with two haplotype
      matches had similar survival in all three groups. Kidney survival in one
      haplotype-matched recipients improved in group II and was equal to that of the
      two-haplotype-matched patients in group III. Cyclosporine improved allograft
      survival in both races when combined with azathioprine and prednisone. Quadruple
      therapy improved early survival in one-haplotype black patients, even though long
      term results remained better in whites. Cyclosporine did not improve graft
      survival in two-haplotype recipients. The addition of cyclosporine and quadruple
      therapy did not increase morbidity and mortality rates.

PMID- 1632683
TI  - Efficacy of a single pretransplant donor-specific transfusion and cyclosporin A
      administered 24 to 48 hours before one-haplotype-mismatched living related donor
      kidney transplant.
AB  - During the 7-year period from March 1984 to June 1991, 86 haploidentical living
      related kidney recipients were entered into one of three donor-specific
      transfusion (DST) and cyclosporine treatment protocols: (1) Multiple
      pretransplant DSTs with cyclosporine begun after transplant, n = 34; (2) Multiple
      pretransplant DSTs with cyclosporine begun pretransplant, n = 31; and (3) a
      single DST 24 to 48 hours before transplant with intravenous cyclosporine
      initiated after the transfusion, n = 21. Triple immunosuppression (prednisone,
      azathioprine, and cyclosporine) was continued in all groups after transplant. The
      1-year patient (97%, 97%, and 93%, p = not significant) and graft (91%, 90%, and
      87%, p = not significant) survival were similar for the three groups. No
      differences were seen in the incidence of rejection at 1 year (61%, 45%, and 60%,
      p = not significant) or in the incidence of infectious complications (26%, 42%,
      and 47%, p = not significant). It is concluded that a single DST given 24 to 48
      hours before operation followed by pretransplant cyclosporine is as effective as
      classic DST conditioning of recipients using either pretransplant or post
      transplant cyclosporine. The single DST protocol has the advantage of not
      eliminating any donors because of sensitization and was less costly and easier to
      administer.

PMID- 1632684
TI  - Management of diabetic midfoot ulcers.
AB  - Diabetic midfoot ulcers are caused by bone and joint disruption that occur as a
      consequence of progressive peripheral neuropathy associated with this disease.
      This results in osseus deformities and areas of high pressure on the plantar
      surface of the midfoot, which cause the ulcers. These lesions are difficult to
      heal and frequently lead to amputation. In a series of 348 patients, 40 developed
      54 midfoot ulcers. Limb preservation was achieved in 33 (61%). Wound closure was
      achieved in 32 (60%). The amputation rate was highest (83%) in the 10 of 12
      patients with peripheral vascular disease. Successful therapy for limb
      preservation most often included an operation combining resection of underlying
      osseus deformities with debridement of affected soft tissues.

PMID- 1632685
TI  - Is type II diabetes mellitus (NIDDM) a surgical disease?
AB  - Since February 1, 1980, 515 morbidly obese patients have undergone the Greenville
      gastric bypass (GGB) operation. Of these, 212 (41.2%) were euglycemic, 288
      (55.9%) were either diabetic or had glucose intolerance, and 15 (2.9%) were
      unable to complete the evaluation. After the operation, only 30 (5.8%) patients
      remained diabetic (and 20 of these improved), 457 (88.7%) became and have
      remained euglycemic, and inadequate data prevented classification of the other 28
      (5.4%). The patients who failed to return to normal glucose values were older and
      their diabetes was of longer duration than those who did. The effect of the GGB
      was not only limited to the correction of abnormal glucose levels. The GGB also
      corrected the abnormal levels of fasting insulin and glycosylated hemoglobin in a
      cohort of 52 consecutive severely obese patients with non-insulin-dependent
      diabetes. The GGB effectively controls weight. If morbid obesity is defined as
      100 pounds over ideal body weight, 89% of the patients are no longer "morbidly"
      obese within 2 years. In most patients, the control of the weight has been well
      maintained during the 11 years of follow-up; most of the upward creep in weight
      of 20.8% between 24 and 132 months was from the 49 (9.5%) patients who had staple
      line breakdowns between the large and small gastric pouches. Non-insulin
      dependent diabetes, previously considered a chronic unrelenting disease, can be
      controlled in the severely obese by the gastric bypass. Whether the correction of
      glucose metabolism affects the complications of diabetes is unknown. Whether the
      gastric bypass should be considered for patients with advanced non-insulin
      dependent diabetes but who are not severely obese deserves consideration. The GGB
      has an unacceptably high rate of staple line failure. Accordingly, the authors
      have recently changed their procedure to one that divides the stomach rather than
      partitions it with staples.

PMID- 1632686
TI  - The surgical management of infants and children with ambiguous genitalia. Lessons
      learned from 25 years.
AB  - Over a 25-year period, 91 children with ambiguous genitalia have received
      surgical management. Female sex assignment was made for 79. Of these, 60 patients
      underwent extensive clitoral reconstruction consonant with the female assignment.
      Forty-two patients had vaginal reconstruction. Factors relating to success
      include: (1) prompt and appropriate sex assignment; (2) early and accurate
      diagnosis; (3) conservative reconstruction of the clitoris at an early age (less
      than 1 year); and (4) choice of vaginal reconstruction based on the severity of
      the malformation. Long-term follow-up demonstrates satisfactory anatomic and
      functional results when clitoral surgery alone was required. Functional results
      for patients with extensive vaginal reconstruction have been compromised.
      Physicians caring for children with congenital intersexual anomalies can expect
      to encounter a wide spectrum of anatomic and physiologic derangements. Cosmetic
      appearance alone is an inadequate measure of success because endocrinologic,
      social, psychological, and sexual factors must be blended into comprehensive
      evaluation of these patients. The management plan must be flexible and
      individualized, incorporating long-term follow-up to adulthood.

PMID- 1632687
TI  - Nissen fundoplication in children with profound neurologic disability. High risks
      and unmet goals.
AB  - Anti-reflux procedures have been advocated in children with profound neurologic
      disability referred for feeding gastrostomy when gastroesophageal reflux is
      present. Facilitation of care, reduction in pneumonia and vomiting, and
      improvement in the general health and survival of these children have been major
      goals of fundoplication and gastrostomy. In large pediatric series, these
      procedures have been reported to have low risk and negligible mortality rates.
      Recent reports, however, document an increased incidence of sequelae of
      fundoplication in children with profound neurologic disability. This paper
      retrospectively reviews a series of 35 nonverbal, nonambulatory pediatric
      patients undergoing a total of 39 fundoplications (37 Nissen, 1 Thal, and 1
      Belsey) over an 11-year period. Neurologic impairment of 17 (49%) patients was
      acquired, 13 (37%) congenital, and 5 (14%) due to a syndrome. Perioperative
      complications occurred in six (17%). Three additional complications led to early
      postoperative death. A fourth early death was unexplained. Fourteen (40%) had
      recurrent pneumonia, 11 (31%) recurrent vomiting, 8 (23%) choking-gagging
      retching complex, and 3 (9%) bowel obstruction requiring laparotomy. Recurrent
      gastroesophageal reflux was documented in seven (20%) patients. A second ARP was
      performed in six (17%). There were 14 (40%) late deaths. Although the major goals
      of anti-reflux procedure are clearly achieved in many severely impaired children
      with gastroesophageal reflux, the use of Nissen fundoplication to resolve the
      complications of swallowing disorders and improve outcome with an acceptably low
      risk in this complex set of patients does not appear to be established.

PMID- 1632688
TI  - Formal hepatic resection of colorectal liver metastases. Ploidy and prognosis.
AB  - Fifty consecutive patients who underwent 52 formal hepatic resections (excluding
      isolated wedge resections) for metastatic colorectal cancer were analyzed to
      determine whether DNA content was of prognostic significance. The Dukes' stages
      of the colorectal primaries were: A (10%), B (20%), C (40%), D (28%), and unknown
      in 2%. Four patients whose liver metastases were discovered at the time of
      resection of the primary bowel cancer underwent concomitant liver resection, and
      the remaining patients underwent delayed resections. The hepatic resections
      performed were right lobectomy (50%), extended right lobectomy (19%), left
      lobectomy (13%), left lateral segmentectomy (6%), left lobectomy and right wedge
      (6%), extended left lobectomy (4%), and right lobectomy and left wedge (2%). The
      overall morbidity rate was 29%. The in-hospital mortality rate was 9%. As of
      November 1991, 36 patients have recurred. The 5-year actuarial survival was 28%.
      Flow cytometry could be performed on 37 archival specimens, 15 of which were
      found to be diploid whereas 22 were aneuploid. All metastases from Dukes A
      colorectal primaries demonstrated a diploid DNA content. In addition, there was
      no difference in actuarial survival between diploid and aneuploid tumors. These
      data suggest that in selected patients, formal hepatic resection of colorectal
      liver metastases can be performed with an acceptable morbidity rate, mortality
      rate, and survival, but ploidy of the resected tumor is not of prognostic
      significance.

PMID- 1632689
TI  - Composite resection of posterior pelvic malignancy.
AB  - Advanced pelvic cancer is a formidable challenge to surgical resection. These
      tumors commonly invade the bony pelvis, may involve other viscera, and usually
      have been irradiated previously. The authors are presenting experience with 76
      patients who had composite resection of posterior or lateral pelvic malignancy.
      Fifty-eight patients had secondary cancers involving the musculoskeletal pelvis.
      This included 47 patients with advanced carcinoma of the rectum (41 curative, 6
      palliative), 10 epidermoid cancers of the anorectum (8) or cervix (2), and 1
      bladder cancer. Among the 18 patients with primary pelvic tumors were three
      patients with chordomas, six with bone tumors (osteosarcoma chondrosarcoma, grade
      III giant cell tumor), and nine with soft tissue tumors. All required major
      resection of the sacrum or pelvic side walls, and one half had an additional
      exenterative procedure. The overall mortality rate was 7.9%. Long-term estimated
      survival was 24% in patients having curative resection of recurrent rectal
      cancer, and 22.5% in 10 patients with advanced epidermoid cancer. Fifty per cent
      of patients with primary bone or soft tissue tumors survived from 13 to 88
      months. Most patients had reasonable return of function, and were able to return
      to work or resume their normal previous lifestyle.

PMID- 1632690
TI  - Does preoperative radiation therapy enhance the probability of local control and
      survival in high-risk distal rectal cancer?
AB  - One hundred forty-eight patients were treated with preoperative radiation therapy
      and surgery for resectable rectal adenocarcinoma at the University of Florida
      between 1975 and 1986. All patients had at least 5 years' follow-up; no patient
      was lost to follow-up. Three treatment protocols were used over the study period:
      1975 to 1978, 3500 cGy in 20 fractions; 1979 to 1983, 4000 to 5000 cGy at 180 cGy
      per fraction; and 1984 to 1986, 3000 cGy in 10 fractions. The change was made to
      3000 cGy in 10 fractions to reduce the inconvenience and expense associated with
      preoperative radiation therapy without sacrificing any improvement in local
      control or complication rates. There were no significant differences in the rates
      of local control, absolute survival, cause-specific survival, or complications
      between the three preoperative radiation therapy protocols. The results were
      compared for the 132 patients who underwent complete resection after preoperative
      radiation therapy and a series of 135 patients who underwent a complete resection
      alone for adenocarcinoma of the rectum at the University of Florida between 1959
      and 1976. The results at 5 years, calculated by the product-limit method, for
      preoperative radiation therapy and surgery compared with surgery alone,
      respectively, were as follows: for local recurrence-free survival, 96% and 67%;
      for absolute survival, 66% and 40%; and for cause-specific survival, 77% and 50%.
      All of these differences are significant (p = 0.0001 or less). A subset of 56
      patients with locally advanced lesions, based on tethering or circumferential
      involvement of the rectal lumen, treated with preoperative radiation therapy and
      surgery were compared with patients treated with surgery alone for stage B2 and C
      cancers. There was a significant improvement in local control and survival rates
      in the group irradiated before operation. There was no apparent increase in the
      incidence of postoperative complications in the patients irradiated before
      operation.

PMID- 1632691
TI  - Endovascular surgery.

PMID- 1632692
TI  - Acute appendicitis following blunt abdominal trauma.

PMID- 1632694
TI  - Routine choledochotomy with cholecystectomy.

PMID- 1632693
TI  - Acute appendicitis following blunt abdominal trauma: incidence or coincidence.

PMID- 1632695
TI  - Choledocholithiasis, endoscopic sphincterotomy or common bile duct exploration.

PMID- 1632697
TI  - Restrictions suggested, or enacted for residency training programs.

PMID- 1632696
TI  - Use of Swan-Ganz catheter to reduce morbidity and mortality rates after lower
      extremity revascularization procedures.

PMID- 1632698
TI  - Importance of adequate staging and of hormone receptors in women older than age
      70 with breast cancer.
AB  - This report includes 479 women older than 70 years of age who were operated on
      between January 1980 and January 1988 and who were followed for 2.5 to 10.5 years
      (mean, 4.6 years). There were no operative deaths. Staging was available on
      90.8%. Eighty-one per cent of patients were estrogen receptor positive (ER+), and
      64% had negative lymph nodes (LN-). There were 50 deaths from breast cancer
      (10.4%), and 56 (11.6%) from other causes (mostly cardiovascular). Estrogen
      receptor negativity was significant by both univariate and multivariate analysis
      for increased risk of death from breast cancer (by factors of 3 and 1.4). Only
      four of 152 (2.6%) women who were node negative and estrogen receptor positive
      died during the follow-up of 4.9 years. The results of this study suggest that
      elderly women should be fully staged with axillary node dissections, and the
      hormone receptor assay should be performed because these are important indicators
      of prognosis. Because only 2.6% of the LN- and ER+ women in this study died of
      breast cancer, and only 3% in this group were treated with adjuvant systemic
      therapy (tamoxifen), the authors conclude that this therapy is unnecessary,
      although a prospective randomized study of elderly women would be required to
      state this definitively.

PMID- 1632699
TI  - The application of positron emission tomographic imaging with fluorodeoxyglucose
      to the evaluation of breast disease.
AB  - Positron emission tomography (PET) is a computer-aided tomographic imaging
      technique that uses positron-emitting compounds to trace biochemical processes of
      tissue, and construct images based on them. The authors applied a whole-body PET
      imaging technique to patients with breast masses or mammographic abnormalities
      using the isotope 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG), in a clinical trial to
      evaluate the feasibility of using PET to identify primary breast cancer, axillary
      lymph node involvement, and systemic metastases, before surgical resection.
      Fourteen patients have been entered on this study, 10 of whom proved to have
      breast cancer. Positron emission tomography correctly predicted the nature of 12
      of the 14 primary breast lesions, and correctly determined the lymph node status
      of 11 of the 14 patients. The authors conclude that PET with FDG has potential as
      a diagnostic modality for detection of primary breast cancer, particularly in the
      patient with radiodense breasts by conventional mammography, and that it has
      potential for the preoperative identification of axillary lymph node metastases.

PMID- 1632700
TI  - Complications of gastroesophageal reflux disease. Role of the lower esophageal
      sphincter, esophageal acid and acid/alkaline exposure, and duodenogastric reflux.
AB  - The factors contributing to the development of esophageal mucosal injury in
      gastroesophageal reflux disease (GERD) are unclear. The lower esophageal
      sphincter, esophageal acid and acid/alkaline exposure, and the presence of
      excessive duodenogastric reflux (DGR) was evaluated in 205 consecutive patients
      with GERD and various degrees of mucosal injury (no mucosal injury, n = 92;
      esophagitis, n = 66; stricture, n = 19; Barrett's esophagus, n = 28). Manometry
      and 24-hour esophageal pH monitoring showed that the prevalence and severity of
      esophageal mucosal injury was higher in patients with a mechanically defective
      lower esophageal sphincter (p less than 0.01) or increased esophageal
      acid/alkaline exposure (p less than 0.01) as compared with those with a normal
      sphincter or only increased esophageal acid exposure. Complications of GERD were
      particularly frequent and severe in patients who had a combination of a defective
      sphincter and increased esophageal acid/alkaline exposure (p less than 0.01).
      Combined esophageal and gastric pH monitoring showed that esophageal alkaline
      exposure was increased only in GERD patients with DGR (p less than 0.05) and that
      DGR was more frequent in GERD patients with a stricture or Barrett's esophagus. A
      mechanically defective lower esophageal sphincter and reflux of acid gastric
      juice contaminated with duodenal contents therefore appear to be the most
      important determinants for the development of mucosal injury in GERD. This
      explains why some patients fail medical therapy and supports the surgical
      reconstruction of the defective sphincter as the most effective therapy.

PMID- 1632701
TI  - A comprehensive multi-institutional study on postoperative adjuvant immunotherapy
      with oral streptococcal preparation OK-432 for patients after gastric cancer
      surgery. Kyoto Research Group for Digestive Organ Surgery.
AB  - The current study was designed to compare the effects of oral administration of
      the streptococcal preparation, OK-432, as an adjuvant immunotherapy versus those
      of intradermal administration of OK-432 on the survival of patients after surgery
      for gastric cancer. The patients were stratified into two groups after surgery: a
      curative surgery stratum and a palliative surgery stratum. Then the patients in
      each stratum were randomly assigned into three groups: an oral placebo group, an
      oral OK-432 group, and an intradermal OK-432 group. All of the patients were
      given fluoropyrimidines orally in combination with OK-432 or placebo for 2 years
      after surgery. A total of 1011 patients were registered between 1982 and 1985,
      and 970 patients were eligible for statistical analysis. The survival rate of the
      oral OK-432 group was significantly higher than those of the other two groups
      after curative surgery. There were no significant difference in the survival
      rates between the three groups after palliative surgery, however. The effect of
      oral OK-432 was quite pronounced in patients after curative surgery for stage II
      to IV gastric cancer, especially in those patients with regional node
      involvement. Furthermore, it was found that the spleen is necessary for effective
      immunotherapy with oral OK-432, because the survival rate of the oral OK-432
      group was significantly improved in patients whose spleens were preserved, when
      compared with splenectomized patients. These results demonstrate that oral
      adjuvant immunotherapy with OK-432 is beneficial after curative surgery for
      gastric cancer.

PMID- 1632702
TI  - Prognostic value of CA 19.9 levels in colorectal cancer.
AB  - Pretreatment serum levels of carbohydrate antigen 19.9 (CA 19.9) and
      carcinoembryonic antigen were measured in 293 patients with colorectal cancer.
      Carbohydrate antigen 19.9 was above the cut-off limit of 37 U/mL in 35% of
      patients. Carbohydrate antigen 19.9 sensitivity was related to tumor stage.
      Carcinoembryonic antigen was above the cut-off level of 3.5 ng/mL in 61% of
      patients, and the simultaneous use of two markers increased sensitivity to 66%.
      The main use of pretreatment levels of CA 19.9 in locoregional cancer is in
      prognosis. Carbohydrate antigen 19.9 provided more prognostic information than
      that obtained by conventional staging methods. In patients with Dukes' C tumors,
      additional information was obtained for allocation of these patients into groups
      at low or high risk of recurrence. Prognostic significance of carcinoembryonic
      antigen was not independent of Dukes' classification.

PMID- 1632703
TI  - Continuous dual oximetry in surgical critical care. Indications and limitations.
AB  - Continuous dual oximetry combines pulse and venous oximetry to provide real-time
      information about oxygen utilization and pulmonary function. The authors
      undertook this study to examine the accuracy, utility, and limitations of the
      technique in surgical critical care. Twelve critically ill patients underwent
      placement of a modified pulmonary artery catheter and a pulse oximeter, both
      connected to an on-line computer. Paired blood gas and oximeter measurements were
      recorded every 4 to 6 hours, with a minimum of six sets per patient. Blood-gas
      derived shunt fraction correlated well with oximeter-derived ventilation
      perfusion index (r = 0.78, p less than 0.01). Further, the continuous oxygen
      extraction ratio (O2EI) and mixed venous oxygen saturation (SpvO2) correlated
      with the oxygen utilization coefficient (O2EI:r = 0.6, p less than 0.01; SpvO2, r
      = 0.76, p less than 0.01). Computer modeling of ventilation-perfusion index found
      limitations in accuracy that occur at high arterial oxygen saturations and when
      pulse oximetry errors are present. The authors conclude that (1) Continuous dual
      oximetry offers a significant advantage over routine blood gas analysis for
      monitoring cardiopulmonary parameters in critically ill patients because of its
      real-time display; (2) Oximeter-derived determinations parallel traditional
      parameters; and (3) The most significant technical limitations occur primarily at
      high arterial saturations and with pulse oximetry errors.

PMID- 1632704
TI  - Body composition and surgical treatment of obesity. Effects of weight loss on
      fluid distribution.
AB  - Obesity is associated with absolute and relative expansion of the extracellular
      water compartment (ECW). The effects of substantial and prolonged weight
      reduction on body water distribution are unknown, however. The authors studied
      total body water (TBW) by tritiated water dilution, ECW by 35SO4 dilution,
      exchangeable sodium (Na(e)) by 24Na, and total body potassium (TBK) by 40K whole
      body counting in 25 severely obese women (body mass index [BMI] = 48 +/- 7 kg.m
      2, mean +/- standard deviation) aged 36 +/- 8 years before and at intervals after
      gastric restrictive (GR; n = 12) and malabsorptive (MA; n = 13) operations for
      obesity. Results are compared with a control group of 26 healthy normal-weight
      women (BMI = 21 +/- 2). Before operation, the obese patients had absolute
      elevations of all water compartments compared with controls, with significantly
      higher ratios of Na(e) to TBK (1.17 +/- 0.13 versus 0.91 +/- 0.10; p less than
      0.05) and ECW to intracellular water (ICW) (E/I = 0.82 +/- 0.17 versus 0.63 +/-
      0.06; p less than 0.05). After weight loss of 52 +/- 20 kg in MA and 47 +/- 19 kg
      in GR patients (nonsignificant between groups) to a stable level 22 +/- 8 months
      after operation, there were statistically significant reductions in TBW, ICW,
      TBK, and Na(e) in both groups, but a significant reduction in ECW only after GR.
      Adjusting for preoperative weight, duration of follow-up, and rate of weight
      loss, E/I was greater after MA than GR (1.09 +/- 0.25 versus 0.82 +/- 0.14; p
      less than 0.05). The elevated preoperative E/I ratio did not normalize with
      weight loss after surgery, and the response was related to the type of operation.
      The finding remains to be explained although the increased E/I after MA may
      reflect mild protein-calorie malnutrition not detectable in the blood. The
      persistence of elevated E/I with significant weight loss after GR might imply an
      intrinsic or irreversible imbalance of fluid distribution in obese patients.

PMID- 1632705
TI  - Infrainguinal anastomotic arterial graft infections treated by selective graft
      preservation.
AB  - The purpose of this study was to determine whether the type of graft material and
      bacteria involved in an infrainguinal arterial anastomotic infection can be used
      as guidelines for graft preservation. Between 1972 and 1990, the authors treated
      35 anastomotic infections involving a common femoral or distal artery. The graft
      material was Dacron in 14 patients, polytetrafluoroethylene (PTFE) in 14, and
      vein in 7. Of the 14 Dacron grafts, immediate graft excision was required for
      overwhelming infection in eight patients (bleeding in five, sepsis in three) and
      for an occluded graft in one patient. Three of five patients failed attempted
      graft preservation because of nonhealing wounds. Thus, 12 of the 14 Dacron grafts
      ultimately required graft excision. Of the 21 "smooth-walled" vein and PTFE
      grafts, 10 required immediate graft excision for occluded grafts (five PTFE, one
      vein) or bleeding (three PTFE, one vein). Ten of the remaining 11 (91%) patients
      with patent "smooth-walled" grafts, intact anastomoses, and absence of sepsis
      managed by graft preservation healed their wounds and maintained distal arterial
      perfusion. Wound cultures grew pure gram-positive cocci in 17 of 21 "smooth
      walled" graft infections versus 8 of 14 Dacron graft infections. In the absence
      of systemic sepsis, graft preservation is the treatment of choice for gram
      positive infections involving an intact anastomosis of patent PTFE and vein
      grafts. Regardless of the bacterial cause, the authors recommend that any
      infrainguinal anastomotic infection of a Dacron graft be treated by immediate
      excision of all infected graft material.

PMID- 1632706
TI  - Carl John Wiggers' visionary views on vivisection.

PMID- 1632707
TI  - Dr. Halsted's secret operation on Dr. Matas.

PMID- 1632708
TI  - Clinical variables associated with high risk of associated abdominal injury.

PMID- 1632709
TI  - Adverse effect of therapeutic vasoconstrictors in experimental acute
      pancreatitis.

PMID- 1632710
TI  - [The implantable defibrillator-cardioverter in the treatment of malignant
      ventricular arrhythmias].

PMID- 1632711
TI  - [Bilateral infundibula in congenital cardiopathies].
AB  - The goal of this paper has been to count and describe congenital heart disease
      associated with double conus. We studied 196 pathologic specimens from to the
      Pathologic Collection of the Department of Embryology of the National Institute
      of Cardiology "Ignacio Chavez" of Mexico. We found 3% of double conus in classic
      tricuspid atresia with concordant ventriculoarterial connection, 53% with double
      outlet right ventricle, 16% with discordant ventriculoarterial connection, 91%
      with double outlet single ventricle, 8% with one outlet right ventricle with
      pulmonary atresia, 20% with one outlet left ventricle and 25% with one outlet
      single ventricle. The morphological data of the associated anomalies were
      gathered in an informatized sheet designed according the segmental and sequential
      approach to diagnose congenital heart disease. From our results we conclude that
      double conus cannot be considered pathognomonic of any congenital cardiopathy,
      although they appear associated more frequently with truncoconal anomalies and
      single ventricle. It is frequent the association between double conus and
      stenosis of one of them, specially the subpulmonary one. We found great
      association between left juxtaposition of the atrial appendages and double conus.

PMID- 1632712
TI  - [The clinical and electrophysiological characteristics of patients with
      idiopathic ventricular tachycardia].
AB  - Clinical and electrophysiological characteristics in 20 patients with clinical
      ventricular tachycardia and normal hearts documented by physical examination,
      echocardiography, and angiocardiography were analysed. There were 11 males and 9
      females. All patients had sustained ventricular tachycardia without hemodynamic
      instability during tachycardia. A right bundle branch block morphology of
      ventricular tachycardia was present in 14 patients and left bundle branch block
      morphology in six patients. During electrophysiologic studies, ventricular
      tachycardia was induced in 10/15 (66%) patients. Intravenous verapamil terminated
      the ventricular tachycardia in 9/10 (90%) of cases. However oral verapamil not
      prevented recurrences. Among 14 patients on whom exercise tests were performed,
      only two had exercise-induced ventricular/tachycardia. Late potentials were
      positive in 3/14 (21%) cases and one patient died suddenly during exercise
      without antiarrhythmic drugs.

PMID- 1632714
TI  - [The usefulness of transesophageal echocardiography during percutaneous balloon
      mitral valvulotomy].
AB  - The purpose of this study is to report the experience at Instituto de Cardiologia
      de Mexico with transesophageal echocardiography during percutaneous mitral
      valvulotomy and to compare its utility with transthoracic echocardiography.
      Sixteen patients with isolated or predominant mitral stenosis were examined and
      underwent percutaneous mitral valvulotomy with a single balloon catheter (Inoue
      [correction of Ionue] technique). Transthoracic echocardiography was done in all
      cases previous to the procedure. The procedure orientation was done with
      transesophageal in thirteen patients and with. Transthoracic echocardiography in
      the other three. The results were successful in all cases. Transesophageal
      echocardiography was more useful in the initial evaluation in patients with poor
      transthoracic windows, in those with clinical and/or transthoracic evidence of
      atrial thrombosis, as well as in procedure orientation, spontaneous contrast
      detection, mitral regurgitation and atrial septal defect evaluation after the
      procedure. Transesophageal echocardiography is superior to transthoracic
      technique in procedure orientation, early evaluation of results and potential
      complications. However, its practical utility is limited and its routine use is
      not recommended.

PMID- 1632713
TI  - [Atrioventricular and ventriculoatrial conduction in patients operated on for the
      Wolff-Parkinson-White syndrome].
AB  - Over the last decade the surgical treatment of the Wolff-Parkinson-White syndrome
      has been well accepted. It is important to make an early diagnosis for surgical
      success. For this purpose we utilized programmed electrical stimulation to assess
      the functional characteristics of atrioventricular and ventriculoatrial
      conduction in our post-operative patients. In 55% of the cases we found
      accelerated nodal conduction. Programmed electrical stimulation correctly
      identified 90% of successfully treated patients. We did not found any false
      positive curve, therefore, this method has a high specificity. We concluded that
      in post-operative patients with the Wolff-Parkinson-White syndrome: 1- There is a
      high incidence of accelerated nodal conduction and 2- programmed electrical
      stimulation can correctly identify most of the patients who were successfully
      treated.

PMID- 1632715
TI  - [An electro- and vectorcardiographic study of ventricular activation in
      scleroderma].
AB  - Electrical ventricular activation was studied by means of electrocardiogram and
      vectorcardiogram in 62 patients, 55 women and 7 men, affected by systemic
      sclerosis of average disease duration of 10.3 years. 45% of the patients showed
      the "diffused form" of the disease and 55% the "limited form". The
      vectorcardiogram showed some alterations of the ventricular activation in 55% of
      the recorded cases. The previous electrocardiogram found only 18%. The
      alterations, which are more frequent in the diffuse form than in the limited one,
      are the presence of loss of forces in septal, lateral or inferior or combined
      areas and intraventricular conduction disorders as complete and incomplete right
      bundle branch block, left anterior subdivision block, left posterior subdivision
      block, or combination between incomplete right bundle branch block and left
      anterior or posterior subdivision block. The vectorcardiogram was more sensitive
      than the electrocardiogram in showing loss of forces, also in patients with the
      limited form of systemic sclerosis, when the electrocardiogram was normal.
      Moreover the vectorcardiogram is helpful to identify left posterior subdivision
      block. The vectorcardiographic investigation seems to be a useful complement of
      the electrocardiogram especially for the identification of cases with myocardial
      involvement that is clinically silent.

PMID- 1632716
TI  - [An assessment of myocardial ischemia in women with the exercise test validated
      by coronary angiography].
AB  - Ischemic heart disease has been studied in men and women only as a group. We
      studied the sensitivity and specificity of the exercise stress testing in women.
      The exercise stress testing (EST) was validated with the coronary arteriography.
      We studied 72 women and 129 men, the mean age was 55 years for women and 51 years
      for men. We found in women 83.2% of estimated maximal heart rate; the rate
      pressure product was 2.4, no different from the values recorded in men (p greater
      than 0.06). The blood pressure response to exercise was higher in women, and the
      maximal work capacity was more elevated in men (p less than 0.006). We found
      normal coronary arteries in 41 women, 70.7% with a positive (EST) compared with a
      87.07% in men. The sensitivity and specificity of the exercise stress testing for
      the diagnosis of ischemic heart disease is smaller in women.

PMID- 1632717
TI  - [Premature atherosclerosis in a 17-year-old male with diabetes mellitus and
      familial dyslipoproteinemia].
AB  - A 17-year-old male was admitted with an acute myocardial infarction. A
      coronarography showed 90% occlusion in of the descendent anterior artery. A
      coronary angioplasty was done with excellent response. As coronary risk factors
      he had diabetes mellitus for 5 years and dyslipidemia with a phenotype IIb and
      hypo-alpha-lipoproteinemia. The case is discussed in regard to the possible
      etiopathogenic causes for his premature atherosclerosis.

PMID- 1632718
TI  - [The effects of captopril in stable angina pectoris].
AB  - Eighteen normotensive patients with coronary disease and stable effort-induced
      angina were selected. The effect of captopril was studied. A Bruce stress test
      was obtained before and after administration of conventional treatment with
      captopril or placebo. The captopril induced less systolic pressure elevation
      during maximal exercise without modification of heart rate. By decreasing
      myocardial oxygen consumption, increasing the time in which angina appears during
      exercise. Captopril may prove to be useful adjunct to the antianginal drug
      regimens of patients with stable angina and systolic arterial pressure greater
      than 110 mm Hg.

PMID- 1632719
TI  - [The prevalence of hypertension and associated factors in a political district of
      Mexico City].
AB  - A cross-sectional study was conducted in order to know the prevalence of
      hypertension and some characteristics related as age, sex, obesity, smoking,
      heredity and exercise, in a mexican population; their possible causal role is
      discussed. Other variables related with the treatment and control of hypertension
      were explored as the awareness of personal blood pressure figures and regularity
      of treatment among hypertensives. The global hypertension prevalence was 26.9%
      (CI 95% 24.0-29.0), male's prevalence was 33.7% (CI 95% 29.0-38.0) and female's
      prevalence was 24.3% (CI 95% 22.0-27.0). Age, sex, obesity and heredity were the
      most associated characteristics on systolic and diastolic mean figures. The
      Prevalence Odds Ratios (POR) were 1.79 (CI 95% 1.4, 2.29) for obesity; for
      smoking 1.41 (CI 95% 1.1, 1.82), heredity 1.23 (CI 95% 0.92, 1.64), and sport
      practice 0.95 (CI 95% 0.64, 1.39). Among population studied only 61.1% knew their
      habitual blood pressure figures, and among known hypertensives only 27.1% were on
      regular anti-hypertensive treatment.

PMID- 1632720
TI  - [Intraesophageal electrocardiography: an old technic under a new concept].
AB  - Transesophageal recording of heart potentials is a fully accepted procedure for
      the electrical study of the heart. However, the intraesophageal ECG could be
      explored even better by using multipolar catheter electrodes and by considering
      various characteristics of the tracing such as amplitude, frequency and velocity.
      The authors describe their experience with the use of these electrodes and
      recording characteristics applied to the field of investigation and diagnosis of
      the electrical activity of supraventricular region. This objective can also by
      achieved by constructing esophagus-thoracic wall bipolar derivations.

PMID- 1632721
TI  - Homotopic transplant of fetal cortex to lesioned motor cortex of adult rats. A
      comportamental and anatomical study.
AB  - Previous investigations have shown that the transplant of fetal nervous tissue in
      adult, formerly injured, brain induces an improvement of the neurological
      deficits. The process underlying this finding is not yet known. It has been
      proposed that this process is favourably supported by the reconstruction of the
      damaged circuitry, replacing the injured neurons with the transplanted fetal
      cells. In the present study we have investigated the relation between the
      improvement of the neurological deficits and the anatomical integration of the
      transplanted neurons within the host brain. The plan of the investigation
      included two steps: the first step consisted of inducing neurological deficits by
      kainic acid lesion of the motor cortex and then studying the changes in the motor
      learning following a homotopic transplant of fetal cortex in the side of the
      lesion. The second step consisted of studying the anatomical integration of the
      transplanted cortex with the thalamus of the host. The results showed that the
      rats with injury of the motor cortex followed by solid transplant of fetal cortex
      (E 17) had a significantly greater recovery of the motor learning with respect to
      non-transplanted rats with a lesioned motor cortex. In the same rats, the
      connections between the transplanted cerebral cortex and the thalamus of the host
      has been investigated. WGA-HRP solution was injected in the thalamus and both
      labeled fiber terminals and labeled cells were searched for in the transplants.
      The results showed that: 1) the host thalamus projects to the transplanted cortex
      with a lower density than to the host cortex surrounding the transplant; 2) the
      thalamic projection to the host cortex is topographically organized, whereas the
      projection to the transplant is arranged in patches without any topographical
      organization; 3) the transplant does not send a significant projection to the
      thalamus of the host. In conclusion, the experimental findings demonstrate that
      the reconstruction of an injured thalamo-cortical circuitry of adult rats
      transplanting fetal neurons is not possible. The improvement of the functional
      deficits by the transplant of fetal tissue may be referred to aspecific factors
      enhancing the functional activity of the host cortex undamaged by the initial
      injury. The identification of the nature of the hypothesized factors requires
      further investigation.

PMID- 1632722
TI  - Neuronal mechanisms of interaction of Deiters nucleus with the cerebral cortex.
AB  - The effects of stimulation of the vestibular nerve and five different cerebral
      cortex areas on the neuronal activity of the lateral vestibular nucleus of
      Deiters were studied. Stimulation of the cerebral cortex is shown to lead to
      antidromic and synaptic activation of Deiters neurons. The synaptic potentials of
      Deiters neurons evoked from the cerebral cortex were of mono- and polysynaptic
      origin. In particular, stimulation of the cerebral cortex evoked in Deiters
      neurons mono- and polysynaptic excitatory postsynaptic potentials. Collaterals of
      vestibulospinal neurons reaching different cortex fields as well as convergence
      of influences from these cortex fields on Deiters neurons were revealed.
      Inhibitory effects of the cerebral cortex on Deiters neurons were of polysynaptic
      origin and occurred rarely. The topical correlation between Deiters nucleus and
      different areas of the cerebral cortex was found. The peculiarities and
      functional significance of the effects obtained are discussed.

PMID- 1632724
TI  - A comparison of the interferon gamma assay with the absorbed ELISA for the
      diagnosis of Johne's disease in cattle.
AB  - Two interferon gamma (IFN-gamma) assays, the IFN-gamma enzyme immunoassay (EIA)
      and the IFN-gamma bioassay and an absorbed ELISA were used to screen 6 cattle
      herds for Johne's disease. Each herd had a history of Johne's disease but the
      majority of infected animals did not show clinical signs. The disease status of
      the cattle, which were removed from the herds, was confirmed by bacteriological
      culture of faeces or histopathological examination and culture of tissues
      collected at necropsy. The sensitivities of the IFN-gamma assays and the absorbed
      ELISA were determined using test results from infected animals. The sensitivity
      of the IFN-gamma EIA in detecting subclinical (71.8 to 93.3%) and clinical
      animals (100%) was not significantly different. However, the IFN-gamma bioassay
      and the absorbed ELISA were more sensitive in detecting cattle with advanced
      infections (80%) than those that were subclinically affected (16.7 to 33.3%).

PMID- 1632723
TI  - Effects of microinjection of vasopressin in dorsal pontine reticular structures
      on the gain of vestibulospinal reflexes in decerebrate cats.
AB  - 1. The possibility that vasopressin (VP) acts on the dorsal pontine reticular
      formation (pRF) and the related medullary inhibitory reticulospinal (RS) system
      to control posture as well as the vestibulospinal reflexes has been investigated
      by injecting small doses of VP in precollicular decerebrate cats. 2. Unilateral
      microinjection of VP (0.25 microliters at the concentration of 10(-11)
      micrograms/microliters saline) in the pRF decreased the extensor rigidity in the
      ipsilateral limbs, while that of the contralateral limbs either decreased or
      increased. The same injection also produced a moderate or a prominent increase in
      gain of the multiunit EMG responses of the ipsilateral triceps brachii to roll
      tilt of the animal (t-test, P less than 0.001 for either group of responses). In
      the first instance the response gain of the contralateral triceps brachii to
      animal tilt slightly increased, while the pattern of response remained always of
      the alpha-type, as shown for the ipsilateral responses (increased EMG activity
      during ipsilateral tilt and decreased activity during contralateral tilt). In the
      second instance, however, the response gain showed only slight changes, while the
      pattern of responses reversed from the alpha- to the beta-type. These findings
      occurred 5-20 min after the injection, fully developed within 30-60 min and
      disappeared in about 2-3 hours. 3. The structures responsible for the postural
      and reflex changes described above were located in the dorsal pontine tegmental
      region immediately ventral to the LC, and included the peri-LC alpha and the
      surrounding dorsal pRF. The induced effects depended upon the injected
      neuropeptide, since previous injection of an equal volume of saline stained by
      the pontamine sky blue dye into the same dorsal pontine area was ineffective. 4.
      We postulated that VP exerts an excitatory influence on ipsilateral dorsal pRF
      neurons. The increased discharge of these neurons and the related medullary
      inhibitory RS neurons would lead to a decreased postural activity in the
      ipsilateral limbs. However, since these inhibitory RS neurons fire out of phase
      with respect to the excitatory vestibulospinal neurons, it appears that the
      higher the firing rate of the RS neurons in the animal at rest, the greater the
      disinhibition that affects the limb extensor motoneurons during ipsilateral tilt.
      These motoneurons would then respond more efficiently to the same excitatory
      volleys elicited by given parameters of stimulation, thus leading to an increased
      gain of the EMG responses.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1632725
TI  - Genetic diversity among Australian and New Zealand isolates of Leptospira
      interrogans serovar pomona.
AB  - Restriction endonuclease analysis of 16 Australian and 4 New Zealand isolates of
      Leptospira interrogans serovar pomona showed that they could be divided into 3
      genetic groups. Most of the isolates closely resembled the serovar kennewicki
      reference strain, and they all differed from the reference strain of serovar
      pomona. Based on these findings, it is suggested that vaccine manufacturers re
      evaluate their choice of serovar pomona vaccine strain.

PMID- 1632726
TI  - The occurrence of Dirofilaria immitis in dogs in South Australia.
AB  - Heart, lung and samples of blood from 230 dogs were examined for infections of
      filarial parasites. Dirofilaria immitis worms and microfilariae were detected in
      one dog. Blood samples from a further 1428 dogs were examined for microfilariae
      and 22 were found to be infected. Eighteen dogs were infected with D immitis
      microfilariae and four with Dipetolonema reconditum microfilariae. The histories
      were available for 18 of the dogs infected with heartworm and only seven dogs had
      not travelled outside South Australia. It was concluded that heartworm infection
      was endemic in South Australia but the apparent prevalence was only about 1%.

PMID- 1632727
TI  - Myodegeneration in rats fed Melia azedarach.

PMID- 1632728
TI  - Further analysis of bile crystals from sheep grazing Panicum schinzii (sweet
      grass).

PMID- 1632729
TI  - The efficacy of synthetic pyrethroid insecticides applied to the backline of
      sheep against four strains of lice (Damalinia ovis).

PMID- 1632730
TI  - Acute interstitial pneumonia in cattle associated with consumption of mould
      damaged sweet potatoes (Ipomoea batatas).

PMID- 1632731
TI  - Bacterial inhibitory residues in pigs fed mouldy grain.

PMID- 1632732
TI  - A congenital haemolytic anaemia and jaundice of Murray Grey calves.

PMID- 1632733
TI  - Amyloidosis in an Angora goat.

PMID- 1632734
TI  - Confocal microscopy of the antigen-antibody reaction site in nematode larvae.

PMID- 1632735
TI  - Performance of Australian wethers in Arabian Gulf feedlots after transport by
      sea.

PMID- 1632736
TI  - Dirofilaria immitis in cats.

PMID- 1632737
TI  - The multiple, sclerotic form of osteogenic sarcoma.

PMID- 1632738
TI  - The post therapy breast.
AB  - Both systemic and local therapy, for conditions of the breast and unrelated to
      it, may produce mammographic changes. Some of these are characteristic, such as
      the pattern of scarring seen in reduction mammoplasty. In many other instances,
      however, the changes produced overlap features commonly seen in malignancy. A
      knowledge of the timing, natural history and spectrum of these changes will aid
      mammographic interpretation.

PMID- 1632739
TI  - CT demonstration of complex dorsal spinal dysraphism.
AB  - An unusual case of dorsal spinal dysraphism in a four year old child is
      presented. Various abnormalities including diastematomyelia, an extradural
      arachnoid cyst arising from one of the two dural tubes, and lipomeningomyelocele
      with a related rib-like bony structure were demonstrated with Iohexol CT and
      subsequently confirmed at surgery.

PMID- 1632740
TI  - Radiological imaging of urinary tract infection in Malaysian children--a private
      hospital experience.
AB  - The results of radiological investigations performed on 81 children with urinary
      tract infection (UTI) were reviewed. Investigations included 91 voiding
      cystourethrograms (VCU), 59 intravenous urograms (IVU) and 36 ultrasonograms
      (US). The aim was to study the local spectrum of renal tract abnormalities in
      childhood UTI and to compare the diagnostic yield of combining US and VCU against
      IVU and VCU. Renal tract abnormalities were detected in 37%. Vesico-ureteric
      reflux (VUR) was the commonest, detected in 26%, with renal scarring found in 9%
      of refluxing units. Ultrasound should replace IVU in the initial diagnostic work
      up of these children.

PMID- 1632741
TI  - Hydrocolpos in siblings--percutaneous management.

PMID- 1632742
TI  - Malignant mesothelioma of the tunica vaginalis testis.
AB  - A patient is described with an indolent scrotal mass complicated by acute
      hydrocoele which was proven to be due to malignant mesothelioma of the tunica
      vaginalis testis. Although uncommon, the possibility of scrotal mass lesion
      should be considered in ultrasound examination of hydrocoeles with atypical
      presentations.

PMID- 1632743
TI  - Computed tomography of the abdomen with fat density oral contrast medium.
AB  - A 12.5% corn oil-emulsion (COE) was tested as an oral contrast agent for
      abdominal computed tomography (CT) examinations in 100 patients. The results were
      compared with those obtained from another group of patients who received a
      conventional, high-density, oral contrast agent (2-3% iodinated solution). There
      was no statistically significant difference in the subjects' tolerance to the two
      agents (P greater than 0.05). There was, however, a significant improvement in
      image quality with COE (P less than 0.05). Gastrointestinal tract discrimination,
      and mucosal and mural visualisation was of higher quality with fat density oral
      contrast medium than with the high-density contrast agent. These data suggest
      that COE should be considered for routine use as an alternative to conventional
      high density oral contrast agents in upper abdominal CT.

PMID- 1632744
TI  - Primary hypothyroidism with pituitary enlargement and a visual field abnormality.
AB  - A 23 year old man presented with classical hypothyroidism of 9 years duration.
      This was associated with pituitary enlargement, documented on magnetic resonance
      imaging (MRI), and abnormal half-field visual evoked responses (VERs). Following
      the initiation of thyroxine therapy the pituitary enlargement and the VER
      abnormalities resolved. The final diagnosis was of primary hypothyroidism with
      secondary pituitary hyperplasia.

PMID- 1632745
TI  - CT findings in tuberculous spondylitis.
AB  - The computed tomographic (CT) features of ten documented cases of spinal
      tuberculosis were analyzed. All cases showed evidence of vertebral body
      destruction, with paravertebral soft tissue masses. Four cases revealed extension
      of involvement into the neural arches. Calcification within the paraspinal soft
      tissue was found in only two cases. Two of four cases who received intravenous
      contrast medium demonstrated evidence of rim enhancement around multilocuated
      fluid collections. Compared to conventional roentgenography, CT better delineated
      the extent of bony destruction, involvement of the spinal canal and existence of
      paraspinal soft tissue masses.

PMID- 1632746
TI  - Magnetic resonance imaging in carotid dissection.
AB  - Magnetic Resonance Imaging was performed in two cases of suspected internal
      carotid artery dissection. In both cases it was possible to demonstrate the
      dissection. It is suggested that magnetic resonance imaging (MRI) could replace
      more invasive techniques in the diagnosis of this condition.

PMID- 1632747
TI  - Co-axial needle for use with the Biopty Gun.

PMID- 1632748
TI  - Echographic, radiological and anatomo-pathological evaluation of a foetus with
      Neu-Laxova syndrome.

PMID- 1632749
TI  - Comparison of duplex ultrasound with angiography in assessment of carotid
      bifurcation disease.
AB  - This is a study comparing duplex ultrasound against the "gold standard" of
      angiography in assessing atherosclerotic disease of the carotid bifurcation,
      prior to prospective endarterectomy surgery. Thirty-nine patients were studied
      with both sonography and angiography studies being performed within one month of
      each other. Plaques were described by sonography as being "smooth" or "irregular"
      in surface and "homogeneous" or "heterogeneous" in composition. Ultrasound showed
      an overall 92% sensitivity, against the standard of angiography, in its ability
      to assess the degree of internal carotid stenosis. There was only a 63%
      sensitivity with the common carotid arteries and only a 65% sensitivity with the
      external carotid arteries. Ultrasound did not show a high accuracy in detecting
      plaque ulceration when compared against angio-graphy.

PMID- 1632750
TI  - Pulmonary artery pseudoaneurysm secondary to Swan-Ganz catheterization--a case
      report.

PMID- 1632751
TI  - Meckel syndrome: prenatal ultrasonographic diagnosis in two cases showing marked
      differences in phenotypic expression.
AB  - Two consecutive siblings with the Meckel-Gruber syndrome are presented. They
      demonstrate variation in phenotypic expression which may render diagnosis
      difficult when the pattern of malformation is significantly different from that
      traditionally accepted. The diagnosis was only made with confidence because a
      sibling with typical features had been seen first. The usefulness of ultrasound
      in prenatal diagnosis, even when the abnormalities are atypical, is well
      illustrated.

PMID- 1632752
TI  - Embolisation in the management of peripancreatic pseudoaneurysm--a case report.
AB  - Peripancreatic pseudoaneurysms are an unusual cause of haemorrhage in patients
      with chronic pancreatitis and pseudocysts. We describe a 28 year old alcoholic
      male with documented chronic pancreatic pseudocysts, who presented with melaena
      and a large pulsatile epigastric mass. Ultrasound and digital subtraction
      angiography revealed a pseudoaneurysm of the gastroduodenal artery. This was
      successfully embolised with stainless steel coils. Surgical intervention in such
      cases is associated with high mortality, and the role of embolisation as an
      initial therapy is well established. The role of embolisation as definitive
      therapy is less clear.

PMID- 1632753
TI  - Agenesis of the right lobe of the liver: diagnosis by computed tomography.
AB  - Agenesis of the right lobe of the liver is a rare congenital anomaly with
      characteristic features on computed tomography (CT). We present a case diagnosed
      as an incidental finding and describe the CT appearances.

PMID- 1632754
TI  - Mammographic microcalcification in axillary lymph nodes.

PMID- 1632755
TI  - CT in complete congenital eventration of diaphragm with aplasia of lung.
AB  - Complete eventration of the diaphragm and pulmonary aplasia, though rare
      anomalies, should be considered in new-borns with respiratory distress. Such
      anomalous conditions occurring either alone or in combination elude diagnosis and
      pose problems for management. CT is a very effective, non invasive means of
      diagnosis which in the past depended largely on invasive procedures such as
      bronchography, angiography and thoracotomy.

PMID- 1632756
TI  - Gastric dilatation and necrosis in bulimia: a case report.
AB  - Gastric dilatation and perforation is a rare complication in anorexia/bulimia
      sufferers. We describe a 24 year old female who presented with severe abdominal
      pain and vomiting, in whom radiographs demonstrated gross gastric dilatation and
      subsequent perforation. Although gastric perforation is rare, one can anticipate
      a rising incidence, with the apparent increase in the incidence of bulimia.

PMID- 1632757
TI  - Acute osteomyelitis: early diagnosis by ultrasonography.
AB  - A prospective study was carried out to evaluate the role of ultrasound in early
      detection of infections of bone. Presence of a hypoechoic collection adjacent to
      bone was considered highly suggestive of osteomyelitis whereas a hypoechoic
      collection away from the bone implied a soft tissue abscess. Cellulitis presented
      as increased subcutaneous thickness. Of the 31 patients clinically suspected to
      have osteomyelitis, and subjected to ultrasound, 25 were proven to be
      osteomyelitis at surgery or by subsequent radiological changes, 4 had soft tissue
      abscesses and the remaining 2 had cellulitis. Co-existent hip joint effusion was
      seen in 2 patients. It is felt that ultrasound is simple and non-invasive
      investigation, capable of detecting bone and soft tissue infections.

PMID- 1632758
TI  - Magnetic resonance imaging in occult spinal dysraphism.
AB  - A prospective study was carried out in 100 cases of suspected occult spinal
      dysraphic anomalies with Magnetic Resonance Imaging in order to determine its
      diagnostic efficacy as the initial imaging modality. MR imaging provided accurate
      preoperative information in 91 out of 92 cases (98.9%). Some of the unusual and
      interesting findings in the series were: presence of intrinsic cord abnormality
      in 19 out of 21 cases (90.4%) with a normal plain radiograph, 4 cases of
      diastematomyelia with a dermoid in the dorsal and lumbar region associated with
      syringohydromyelia, intradural fibrous/glial bands,
      syringohydromyelia/myelomalacia of the conus with tethered cord syndrome having a
      normally placed conus, and myelocystocele. It is concluded that MRI is an
      excellent primary diagnostic tool, together with a plain radiograph, for complete
      preoperative evaluation of mid-line spinal anomalies.

PMID- 1632759
TI  - Inadvertent duodenal stenting: a case report.
AB  - A Gianturco type metallic stent placed in the common bile duct migrated into the
      duodenum. The device remains in situ, and has caused no ill-effects to date. This
      raises the possibility that such stents may be deployed in the gastrointestinal
      tract.

PMID- 1632760
TI  - Editor's case quiz (1). Xanthogranulomatous pyelonephritis with bronchorenal
      fistula.

PMID- 1632761
TI  - Novel glycosylation-defective baby hamster kidney cells.
AB  - The plant lectin wheat germ agglutinin (WGA) has previously been used to select
      more than ten different glycosylation-defective phenotypes in a variety of
      mammalian somatic cells. Three WGA-resistant phenotypes have now been obtained
      spontaneously from baby hamster kidney (BHK) cells. These mutant BHK cells
      exhibit a pattern of cross resistance and sensitivity to multiple plant lectins,
      suggesting that the cell surface carbohydrates of these cells are altered. Two
      WGA-resistant BHK phenotypes appear similar to WGA-resistant CHO cells that lack
      terminal sialic acid and galactose residues on their cell surface carbohydrates.
      The third WGA-resistant BHK cell phenotype has not previously been seen in WGA
      resistant mammalian cells.

PMID- 1632762
TI  - Properties of 1-methyladenine receptors in starfish oocyte membranes: involvement
      of pertussis toxin-sensitive GTP-binding protein in the receptor-mediated signal
      transduction.
AB  - In response to a meiosis-inducing hormone, 1-methyladenine (1-MA), starfish
      oocytes undergo reinitiation of meiosis with germinal vesicle breakdown. The 1-MA
      initiated signal is, however, inhibited by prior microinjection of pertussis
      toxin into the oocytes, suggesting that a guanine nucleotide-binding protein (G
      protein) serving as the substrate of pertussis toxin is involved in the 1-MA
      receptor-mediated signal. We thus investigated properties of 1-MA receptors by
      means of binding of the radiolabeled ligand to the oocyte membranes. There were
      apparently two forms of 1-MA receptors with high and low affinities in the
      membranes. The high-affinity form was converted into the low-affinity one in the
      presence of a non-hydrolyzable analogue of GTP. A 39-kDa protein, which had been
      identified as the alpha-subunit of the major substrate G protein for pertussis
      toxin, was also ADP-ribosylated by cholera toxin only when 1-MA was added to the
      membranes. The ADP-ribosylated 39-kDa alpha-subunit could be immunoprecipitated
      with antibodies raised against the carboxy-terminal site of mammalian inhibitory
      G-alpha. These results indicate that 1-MA receptors are functionally coupled with
      the 39-kDa pertussis toxin-substrate G protein in starfish oocyte membranes.

PMID- 1632763
TI  - Gene synthesis and expression in E. coli for pump, a human matrix
      metalloproteinase.
AB  - The gene for PUMP (putative metalloproteinase), a human matrix metalloproteinase,
      was synthesized by a PCR-based method. The DNA fragment of 546 bases containing
      the PUMP gene was generated by overlap extension of six long oligonucleotides
      (length ranging from 101 to 116 bases) and subsequent amplification by two short
      terminal oligonucleotide primers (length from 20 to 48 bases) in one pot without
      using restriction and ligation enzymes. The synthetic gene was cloned into a T7
      expression vector in two ways to express PUMP as a non-fusion protein. Both
      constructs showed high level expression in E. coli.

PMID- 1632764
TI  - Nitric oxide from endothelium and smooth muscle modulates responses to
      sympathetic nerve stimulation: implications for endotoxin shock.
AB  - The influence of nitric oxide (NO) on vascular responses to transmural
      stimulation (TNS) of noradrenergic nerves was studied in isolated rings of rat
      iliac arteries. TNS produced frequency-dependent contractions in all vessels. The
      NO synthase inhibitor NG-monomethyl-L-arginine (L-NMMA) significantly enhanced
      TNS responses in intact vessels, but not in those in which the endothelium had
      been removed. However, in endothelium-denuded rings incubated for 8 hours, L-NMMA
      increased the contractions induced by nerve stimulation, an effect which was
      prevented by treatment with dexamethasone or cycloheximide, and enhanced by
      incubation with lipopolysaccharide and gamma-interferon. Addition of L-arginine
      reversed the effect of L-NMMA in intact rings; however, it significantly
      decreased below control values TNS-induced contractions in vessels without
      endothelium. The results indicate that a) the arterial response to noradrenergic
      nerve stimulation is modulated by NO originating either in endothelial cells or
      in smooth muscle cells after induction of NO synthase activity, and b) once NO
      synthase is induced, the limiting step in NO production is the availability of
      the substrate L-arginine. An overproduction of vascular NO in the presence of
      endotoxin or other inflammatory stimuli may prevent the vascular response to
      sympathetic stimuli and contribute to the vasodilation observed in inflammation
      or endotoxic shock.

PMID- 1632765
TI  - Biosynthesis of trans,trans,trans-geranylgeranyl diphosphate by the cytosolic
      fraction from rat tissues.
AB  - The cytosolic fractions from rat liver, brain, kidney, spleen and testis
      demonstrate the capacity to synthesize two products from [3H]isopentenyl
      diphosphate, i.e., farnesyl diphosphate and geranylgeranyl diphosphate. The
      highest rate of geranylgeranyl diphosphate synthesis was found in brain, testis
      and spleen, accounting for up to 30% of the total incorporation of radioactivity
      under optimal conditions. In all tissues examined the geranylgeranyl diphosphate
      formed was identified as the trans,trans,trans-isomer. The ratio of
      geranylgeranyl diphosphate to farnesyl diphosphate produced was specific for the
      tissue investigated and could be altered by the addition of divalent cations. The
      results in this study demonstrate the presence of a specific trans,trans,trans
      geranylgeranyl diphosphate synthetase showing high affinity for farnesyl
      diphosphate.

PMID- 1632766
TI  - Effects of epidermal growth factor on apo B mRNA levels and apo B accumulation in
      the media of primate hepatocytes in culture.
AB  - EGF has been shown to augment albumin and apolipoprotein A-I secretion by
      cynomolgus monkey hepatocytes in primary culture without stimulating cell
      division. This study was undertaken to determine what effect EGF had on apo B
      secretion by those hepatocytes. The results indicate that EGF (3 nM final
      concentration) severely inhibits the rate at which apo B accumulates in the
      culture medium of primate hepatocytes. That effect was evident within 48 hours of
      treatment, and by 72 hours the rate that apo B accumulated was less than half
      that of cells treated with a hormone-free medium. However, the apo B mRNA levels
      in the EGF-treated cells were more than double those of hepatocytes given the
      hormone-free medium. These data indicate that EGF has a potent effect on the rate
      at which apo B accumulates in the culture medium of primate hepatocytes and that
      the effect is independent of apo B gene expression.

PMID- 1632767
TI  - Intermolecular homologies of human interferon-alpha.
AB  - Human interferon-alpha 2 (IFN) was analyzed by homology search computer program
      with the use of protein primary structures data bases. Results indicate that four
      domains with heightened ability to form homology pairs with different proteins
      exist in the IFN molecule. These domains occupy regions 35-56, 72-85, 97-110 and
      124-136, mainly between the alpha-helical cylinders on the tertiary structure
      models. Additionally, results show in IFN structure the presence of amino-acid
      motifs that create the opportunity for this cytokine to influence directly the
      processes of DNA functioning in cell nuclei.

PMID- 1632768
TI  - Enhanced expression of membrane phosphoproteins tyrosine phosphorylation in
      estrogen-induced kidney tumors.
AB  - We demonstrate for the first time that the expression of tyrosine containing
      membrane phosphoproteins is elevated in estrogen-induced kidney tumors, which is
      evident from both the types of experiments, i.e., alkali-resistant
      phosphorylation of membrane proteins and immunoprecipitation of tyrosine
      containing phosphoproteins. Tyrosine phosphorylation of proteins or peptides was
      modulated by the growth factors (EGF, IGF-I) and by the inhibitors of tyrosine
      protein kinase(s). The kinetic analyses revealed that tumor membranes have high
      affinity and catalytically more efficient tyrosine phosphorylating kinase
      enzyme(s) compared to that of normal membranes which have low affinity and
      catalytically less efficient kinase enzyme(s). It is proposed that overexpression
      of tyrosine containing membranal phosphoproteins may be involved in the induction
      and growth of estrogen-induced renal neoplasm.

PMID- 1632770
TI  - Characterization of a novel arachidonic acid-derived neutrophil chemoattractant.
AB  - The oxidation of arachidonic acid in a superoxide-generating environment results
      in the formation of a potent chemoattractant that appears to be identical to a
      chemotactic material generated by hepatocytes when they metabolize alcohol. The
      product was extracted, chromatographed and characterized by physical methods
      including GC/MS. The physical properties are consistant with the parent
      structure: 19-hydroperoxy, 20-hydroxyarachidic acid. This novel saturated 20
      carbon product, derived from arachidonic acid by free radical-generating
      reactions, may play a role in the neutrophilic infiltration observed during the
      course of acute alcoholic hepatitis.

PMID- 1632769
TI  - Cytokines stimulate lipolysis and decrease lipoprotein lipase activity in
      cultured fat cells by a prostaglandin independent mechanism.
AB  - We previously showed that indomethacin blocked the effect of tumor necrosis
      factor (TNF) and other cytokines on lipolysis. We now show that TNF stimulates
      prostaglandin (PG) production, enhances lipolysis and decreases lipoprotein
      lipase (LPL) activity in 3T3-F442A adipocytes and indomethacin blocks these
      activities, suggesting that the actions of TNF are mediated by PG's. However,
      exogenous PGE2 at the levels induced by TNF is not sufficient to affect lipolysis
      or LPL activity and low doses of indomethacin and flurbiprofen block PG
      production without affecting TNF's action. Interleukin-1 and interferon-alpha and
      gamma induce lipolysis and decrease LPL activity but do not stimulate much PG
      production. These results demonstrate that cytokines enhance lipolysis and
      decrease LPL activity in 3T3 adipocytes by a PG independent mechanism.

PMID- 1632771
TI  - Angiotensin II receptor subtypes play opposite roles in regulating
      phosphatidylinositol hydrolysis in rat skin slices.
AB  - Among the many functions of angiotensin II (Ang II) it now appears that Ang II is
      a growth factor. The concentration of Ang II in rat skin has been shown to
      increase during wound healing. To investigate the intracellular effect of Ang II
      in skin we determined the levels of total cytoplasmic inositol phosphates after
      incubation of skin slices with different doses of Ang II. 10(-6) M of Ang II
      increased significantly the phosphatidylinositol (PI) hydrolysis, and the effect
      was dose dependent up to 10(-4) M Ang II. The majority of inositol phosphates
      yielded after 1 hour incubation in the presence of lithium was InsP1, with lesser
      amount of InsP2. Losartan, the Ang II AT1 antagonist, at a dose of 10(-4) M
      blocked the effect of Ang II, while PD123319, the Ang II AT2 antagonist, had no
      antagonistic action; PD123319 at the higher dose of 10(-3) M, however,
      potentiated the effect of Ang II on PI hydrolysis. The results suggest that PI
      hydrolysis is a second messenger system for Ang II in rat skin. Also, the two
      subtypes of Ang II receptors mediate opposite effects on PI hydrolysis: Ang II
      binding to AT1 receptors increases inositol phosphate production, while Ang II
      binding to AT2 receptors decreases inositol phosphate production.

PMID- 1632772
TI  - Characterization of mouse inhibin alpha gene and its promoter.
AB  - Inhibin suppresses the pituitary secretion of FSH but not LH. The two forms of
      inhibin are composed of a common alpha subunit linked to either a beta A or a
      beta B subunit. The mouse inhibin alpha gene was isolated and shown to have two
      exons spanning a 1.7 Kb intron. The proximal 5' flanking region has neither TATA
      and CAAT boxes nor GC-rich area. Using the 5' flanking region of mouse inhibin
      alpha gene linked to luciferase gene, transfection of rat granulosa cells
      indicated that the first 165 bp of the promoter region is required for basal
      expression. The mouse inhibin alpha genomic clone should be useful for analysis
      of hormonal control of inhibin alpha transcription and the generation of mice
      with targeted deletion of this gene.

PMID- 1632773
TI  - Low density lipoprotein inhibits accumulation of nitrites in murine brain
      endothelial cell cultures.
AB  - Endothelial cells produce nitric oxide which is considered to serve as a major
      source of endothelial derived relaxing factor activity. It has been demonstrated
      that activation of mouse brain endothelium by TNF-alpha and IFN-gamma led to
      accumulation of nitrite which is presumably formed by oxidation of nitric oxide.
      A number of studies suggest that reactive oxygen species produced by cytokine
      activated cells are involved in the conversion of nitric oxide to nitrites and
      nitrates. We investigated whether low density lipoprotein (LDL), acting as a
      radical scavenger, is able to inhibit nitrite accumulation in mouse brain
      endothelial cell cultures and in a cell-free system in which sodium nitroprusside
      was used as a source of nitric oxide. A comparison of these two models indicates
      the active involvement of LDL in suppressing nitrite accumulation in murine
      endothelial cultures.

PMID- 1632775
TI  - Suppression of crossbridge motions of isolated thick myofilaments in ATP-free
      medium by thiourea.
AB  - Thiourea is known to suppress the contractile response of Mytilus anterior byssus
      retractor muscle and toad sartorious muscle following electrical or chemical
      stimulation without abolishing of the electrical responses. In addition, it
      blocks the shortening of glycerinated sartorious muscle induced by Ca2+. With
      dynamic laser light scattering method we found that thiourea suppresses the
      increase of the average linewidth of the photoelectron count autocorrelation
      function, gamma, of isolated thick filaments of Limulus striated muscle induced
      by depletion of ATP. The results obtained suggest that thiourea prevents the
      crossbridges from moving away from the thick myofilament backbones which will, in
      turn, prohibit the crossbridges from interacting with the thin myofilaments.

PMID- 1632776
TI  - Photothermal spectroscopy of bacteriochlorophyll-lipoprotein complexes.
AB  - Photoacoustic spectra at room and 85 K temperatures as well as photothermal beam
      deflection spectra of bacteriochlorophyll-lipoprotein complexes from purple
      bacterium Chromatium minutissimum were measured. Spectra were compared and
      obtained differences were tentatively explained by various inertion of these two
      methods. Photothermal beam deflection method measure the heat which is generated
      in close surroundings of absorbing pigment molecule, whereas usage of more inert
      photoacoustic signal is averaged over contributions from various pigments located
      in a larger sample volume and therefore is similar to absorption spectra.

PMID- 1632774
TI  - Androst-5-ene-7,17-dione: a novel class of suicide substrate of aromatase.
AB  - 5-En-7-one steroid 1 was found to be a potent inhibitor of aromatase. This along
      with its 19-hydroxy derivative 7 was characterized as suicide substrate of human
      placental aromatase (k(inact)'s of 0.069 and 0.058 min-1 and KI's of 143 nM and
      11.1 microM, respectively, for steroids 1 and 7). The results suggest that the 19
      oxygenation would be involved in the irreversible inactivation of aromatase by
      the 5-en-7-one steroids.

PMID- 1632777
TI  - Membrane fusion of influenza virus with phosphatidylcholine liposomes containing
      viral receptors.
AB  - pH-dependent membrane fusion of influenza virus with liposomes made of
      phosphatidylcholine was studied by the spin-labelling method. Efficiency of viral
      fusion with liposomes composed of dimyristoyl phosphatidylcholine or dipalmitoyl
      phosphatidylcholine was considerably lower compared to dioleoyl phosphatidyl
      choline or egg yolk phosphatidylcholine, suggesting importance of unsaturation of
      acyl chains of lipid bilayers. Reconstitution of specific viral receptors such as
      Glycophorin or sialylparagloboside strongly enhanced fusion with liposomes
      composed of dimyristoyl phosphatidylcholine. A direct comparison between the
      activities of the receptors showed that Glycophorin was about 50 times more
      effective than sialyparagloboside at the same receptor/phosphatidylcholine molar
      ratio.

PMID- 1632778
TI  - Increased plasma post-heparin diamine oxidase activity and plant sterol levels in
      streptozotocin diabetic rat.
AB  - Plasma post-heparin diamine oxidase (DAO) activity and plasma levels of plant
      sterols were examined in streptozotocin diabetic rats fed with chow containing
      plant sterols, to investigate the enzyme activity in relation to the
      morphological changes of small intestine as well as sterol absorption in the
      diabetic rats. Diabetic rats showed increased small intestinal mass and surface
      area compared with control rats. Plasma post-heparin DAO activity and plant
      sterol level were also increased more than 2.5-fold in the diabetic rats. Insulin
      treatment improved these abnormalities. Plasma DAO activity correlated to both
      the small intestinal hyperplastic change and plasma plant sterol levels. These
      results indicate that plasma post-heparin DAO activity may be used as a marker of
      intestinal hypertrophy as well as ability to absorb dietary sterols.

PMID- 1632779
TI  - Cloning and disruption of the cefG gene encoding acetyl coenzyme A:
      deacetylcephalosporin C o-acetyltransferase from Acremonium chrysogenum.
AB  - Acetyl CoA: deacetylcephalosporin C o-acetyltransferase(DCPC-ATF) catalyses the
      final step in the biosynthesis of cephalosporin C (CPC) in Acremonium
      chrysogenum. The gene encoding DCPC-ATF, cefG, has been isolated from an A.
      chrysogenum genomic library using a DCPC-ATF cDNA probe. Nucleotide sequence
      analysis revealed that cefG contains two short introns of 79bp and 65bp. The gene
      was found to be closely linked to the cefEF gene encoding deacetoxycephalosporin
      C synthetase/deacetylcephalosporin C synthetase, which catalyses the preceding
      two steps in the pathway. The two genes are separated by a 1114 bp segment from
      which they are divergently transcribed. Introduction of the cloned cefG gene to
      A.chrysogenum resulted in an increased level of DCPC-ATF activity. A plasmid
      carrying a cefG gene interrupted in the coding region by a selectable marker for
      resistance to hygromycin B was constructed and used to disrupt the cefG locus in
      A.chrysogenum. The cefG-disrupted strains were found to lack the ability to
      produce CPC, and accumulated its precursor, deacetylcephalosporin C in the
      culture broth. Southern hybridization analysis confirmed that the disruption
      resulted from a gene replacement event at the cefG locus.

PMID- 1632780
TI  - A novel saccharide structure, Xyl 1----3 Gal 1----(SO3-)3,4 Fuc----, is present
      in acrosome reaction-inducing substance of the starfish, Asterias amurensis.
AB  - The jelly coat of echinoderm eggs contains a glycoconjugate, acrosome reaction
      inducing substance (ARIS), that is essential for triggering the acrosome reaction
      in homologous spermatozoa. In the starfish, Asterias amurensis, ARIS is a
      sulfated glycoprotein of an apparent molecular size of greater than 10(7). Since
      its biological activity is dependent mostly on its sugar moiety, oligosaccharides
      liberated by hydrolysis with 10 mM H2SO4 for 60 min at 100 degrees C from pronase
      digests of ARIS (P-ARIS) were chemically analyzed. The main oligosaccharide
      purified by high-performance anion-exchange chromatography was determined to be
      Xyl1----3Gal1----(SO3-)3,4Fuc by compositional analysis and FAB mass
      spectrometry. This structure indicates that ARIS possesses a novel saccharide
      chain having sulfated fucose as an internal residue.

PMID- 1632781
TI  - Rat hypothalamic proopiomelanocortin messenger RNA is unaffected by
      adrenalectomy.
AB  - The negative feedback control of hypothalamic cortocotrophin releasing factor
      (CRF) and anterior pituitary proopiomelanocortin (POMC) by corticosteroids is
      well understood. However, less is known about the mechanisms that regulate POMC
      gene expression in the arcuate nuclei in the medial basal hypothalamus (MBH).
      Using a sensitive and specific S1 endonuclease protection assay, we have examined
      the effect of adrenalectomy on POMC mRNA in the rat MBH and pituitary. Our
      results show that adrenalectomy does not change POMC mRNA levels in the MBH at 7
      or 14 days post surgery. The neurointermediate lobe of the pituitary was
      similarly unaffected by adrenalectomy, while in the anterior lobe, POMC mRNA
      increased 7-10 fold at both time points, effects that were prevented by
      dexamethasone treatment. We conclude that while POMC mRNA in the anterior lobe of
      the pituitary is regulated by plasma glucocorticoids, in the MBH and
      neurointermediate lobe, it is not.

PMID- 1632782
TI  - Posttranslational isoprenylation of rho protein is a prerequisite for its
      interaction with mastoparan and other amphiphilic agents.
AB  - The amphiphilic agents melittin, compound 48/80 and mastoparan inhibit ADP
      ribosylation of porcine brain rho protein by Clostridium botulinum exoenzyme C3.
      However, ADP-ribosylation of recombinant rhoA expressed in E.coli was not
      inhibited by these agents. Accordingly, steady state GTP hydrolysis by
      recombinant rhoA was not stimulated by mastoparan, whereas GTP hydrolysis by
      porcine brain rho was stimulated 2.5-fold in the presence of this wasp venom.
      After microinjection of recombinant rhoA into Xenopus laevis oocytes the
      inhibitory effect of mastoparan on C3 ADP-ribosylation was restored. The data
      suggest that the amphiphilic agents tested are only active at the
      posttranslationally processed form of rho and that they exert their effects via
      the C-terminal end.

PMID- 1632783
TI  - Kupffer cells play a major role in insulin-mediated hepatic glucose uptake in
      vivo.
AB  - The effect of insulin on the in vivo glucose utilization by different hepatic
      cells was investigated using the euglycemic, hyperinsulinemic clamp, combined
      with the 2-deoxyglucose tracer technique. Rats were infused with insulin at a
      rate of 2.8 or 9.0 mU/min/kg for 220 min, resulting in plasma concentrations of
      the hormone of about 80 microU/ml and 340 microU/ml, respectively. Glucose use by
      the whole liver was elevated by more than 200% following insulin. However,
      glucose uptake by the parenchymal cells was only elevated by 50-60%. By contrast
      nonparenchymal cells were more responsive to insulin. Glucose uptake by
      endothelial cells was increased 100% and Kupffer cells displayed the most marked
      response to insulin showing a 3- to 6-fold increase in glucose uptake. These data
      indicate that the sinusoidal nonparenchymal cells are the major sites of the
      insulin-mediated increased glucose utilization by the liver.

PMID- 1632784
TI  - Complement inhibitor C4-binding protein in amyloid deposits containing serum
      amyloid P in Alzheimer's disease.
AB  - Complement C4-binding protein (C4BP) is a plasma protein that complexes with
      serum amyloid P and is involved in inhibition of the complement cascade. We used
      immunochemical methods to demonstrate C4BP in brains of subjects with Alzheimer's
      disease and normal controls. C4BP antibodies stained cerebral amyloid deposits
      that were indistinguishable from those recognized by antibodies to serum amyloid
      P or by thioflavin S. Immunoblots of solubilized proteins from cerebral cortex,
      cerebral microvessels and cerebrospinal fluid showed specific antibody reactivity
      to 70-90 kDa bands. Our results suggest the involvement of complement regulatory
      proteins in the pathogenesis of Alzheimer's disease.

PMID- 1632785
TI  - In vitro interaction between Saccharomyces cerevisiae CDC25 and RAS2 proteins.
AB  - In Saccharomyces cerevisiae the CDC25 protein is a positive regulator of RAS/cAMP
      pathway [1-4], enhancing the GDP-releasing rate of RAS2 protein [5]. In this work
      we have tried to detect a direct interaction between CDC25 and RAS2 gene
      products. The results indicate that both the whole RAS2 protein and a truncated
      version that lacks approximately 25 C-terminal residues interact specifically
      with the CDC25 protein. On the contrary, a derivative of RAS2 that lacks the 112
      C-terminal residues as well as the p21TI-ras is not able to bind the CDC25
      protein in our assay conditions. The 310 C-terminal aminoacids of CDC25 bind RAS2
      while a C-terminus deletion within this aminoacid stretch abolishes the binding.
      The possible physiological significance of these findings is discussed.

PMID- 1632786
TI  - Mitochondrial tRNA(Ile) mutation in fatal cardiomyopathy.
AB  - A patient with mitochondrial encephalomyopathy who died from progressive
      intractable cardiac failure at the age of 18 is reported. At the age of 4, he
      presented with short stature, but multiorgan disorders including deafness, focal
      glomerulosclerosis, epilepsy and dilated cardiomyopathy appeared later in his
      clinical course. Laboratory tests showed hyperlactatemia and hyperpyruvatemia.
      Histopathological findings demonstrated mitochondrial myopathy with ragged red
      fibers and focal cytochrome C oxidase-deficient fibers in skeletal and cardiac
      muscles. The activity of cytochrome C oxidase was 30% less than the control level
      in skeletal muscle. Sequencing of the entire mitochondrial tRNA genome revealed a
      novel point mutation in the tRNA(Ile) region (nt 4269). This A-to-G substitution
      was found in none of the 30 controls by screening using mispairing PCR and Ssp I
      digestion methods, suggesting that this new mutation was pathogenic in our case.

PMID- 1632787
TI  - A novel low-density lipoprotein with large amounts of phospholipid found in the
      egg yolk of crustacea sand crayfish Ibacus ciliatus: its function as vitellogenin
      degrading proteinase.
AB  - Low-density lipoprotein (LDL) with large amounts of phospholipid but not
      triacylglycerol was isolated from the egg yolk of crustacea sand crayfish Ibacus
      ciliatus as well as lipovitellin. LDL possessed vitellogenin-degrading proteinase
      activity. Hemolymph vitellogenin was degraded by incubating with LDL at pH 4.5
      for 72 hr at 35 degrees C and apolipoprotein profiles of vitellogenin degraded by
      LDL were very similar to those of lipovitellin in the egg.

PMID- 1632788
TI  - p56lck stably associates with a 115 kDa substrate.
AB  - Using antibodies directed against p56lck, we have identified a 115 kDa protein
      (p115) that is specifically immunoprecipitated with p56lck from whole cell
      lysates. The p56lck/p115 complex is stable in the presence of nonionic
      detergents. p115 becomes phosphorylated on tyrosine residues in p56lck immune
      complex kinase assays. Treatment of whole cells with 12-O-tetradecanoyl phorbol
      13-acetate decreases the subsequent tyrosine phosphorylation of p115 in immune
      complex kinase assays.

PMID- 1632789
TI  - Stimulatory effects of estrogen and progesterone on proliferation and
      differentiation of normal human osteoblast-like cells in vitro.
AB  - Here we report that osteoblast-like cells derived from female and male adult
      human trabecular bone are able to directly respond to 17 beta-estradiol (E2) and
      progesterone (P). In short-term (1 day) cultures using serum-free and phenol red
      free medium, both steroid hormones were found to stimulate DNA synthesis and
      growth of the human osteoblast-like cells. P was more potent in stimulating
      osteoblast growth compared to E2. On the other hand, E2 showed a stronger
      differentiation-inducing effect as determined by analysis of the number of cells
      displaying cytochemical alkaline phosphatase (AP) activity, a marker for the
      mature osteoblast phenotype. Combination of E2 and P resulted in a further
      increase in DNA synthesis, but did not further affect the number of cells
      expressing AP activity. In conclusion, female sex steroids may be involved in
      regulating bone mass in human adults via a direct anabolic action on the bone
      forming cells.

PMID- 1632790
TI  - Growth inhibition of leukemia cell line CEM-C1 by farnesol: effects of
      phosphatidylcholine and diacylglycerol.
AB  - Acute leukemia cells of the established line CEM-C1 were treated during growth in
      serum-free medium with various concentrations of trans-trans farnesol. At
      concentrations ranging from 9.0 to 31.5 microM, farnesol inhibited growth of
      these cells without causing cell lysis. This effect was preceded by very rapid
      inhibition of choline incorporation in cellular lipid fraction. The growth
      inhibitory effect was prevented to a large extent by incubation with
      phosphatidylcholine or diacylglycerol.

PMID- 1632791
TI  - The cysteine residues in the carboxy terminal domain of tropoelastin form an
      intrachain disulfide bond that stabilizes a loop structure and positively charged
      pocket.
AB  - Analysis of purified bovine tropoelastin with Ellman's reagent and
      [14C]iodoacetamide demonstrated that the only two cysteine residues in the
      molecule form an intrachain disulfide bond. Molecular modeling suggests that the
      cysteine residues are juxtaposed as the result of a tight turn that produces an
      antiparallel beta structure. Protruding from the C-terminal end of the turn is
      the sequence Arg-Lys-Arg-Lys which forms the floor of a positively charged pocket
      created by the extension of the arginine and lysine side chains on opposite sides
      of the peptide chain perpendicular to the plane of the turn. The side chain of a
      conserved lysine residue in the disulfide-bonded loop forms the top of the
      pocket. This positively charged pocket may define a binding site for acidic
      microfibrillar proteins that mediate elastic fiber assembly.

PMID- 1632792
TI  - Synergistic action of two oxysterols in the lowering of HMG-CoA reductase
      activity in CHO-K1 cells.
AB  - 3 beta-Hydroxy-5 alpha-cholest-8(14)-en-15-one (I) and (25R)-26
      hydroxycholesterol (II), both potent regulators of sterol biosynthesis, have been
      found to show synergism in the reduction of the levels of HMG-CoA reductase
      activity in CHO-K1 cells. When equimolar concentrations of I and II were added in
      combination, synergistic reduction (p less than 0.0001) of enzyme activity was
      observed at total oxysterol concentrations of 0.1 microM, 0.2 microM, and 0.5
      microM. Maximal synergistic effect in the lowering of reductase activity (28%
      greater than predicted) was observed at 0.1 microM total oxysterol concentration.
      Five additional experiments conducted with 50 nM oxysterols confirmed the
      synergistic effect at 0.1 microM total sterol concentration. These results
      suggest that the in vivo importance of I and II may be greater than that
      anticipated on the basis of the concentrations of the individual sterols.

PMID- 1632793
TI  - On the mechanisms of Ku protein binding to DNA.
AB  - The in vitro DNA-binding activity of Ku protein, a heterodimer of 70 and 86 kDa
      subunits, was studied using affinity-purified protein. Ku protein bound to
      different DNA probes and displayed a multiple-band pattern in band mobility shift
      assays. The protein-DNA complex formation was effectively blocked by different
      DNA competitors, indicating a non-sequence specific binding of Ku protein to DNA;
      no preference of binding of Ku protein to regulatory sequences derived from U1
      snRNA, U6 snRNA or nucleolar protein p120 genes was observed. The number and size
      of the Ku protein-DNA complexes increased with increasing of the protein
      concentration and the size of DNA probe, suggesting that the protein accumulates
      on the DNA fragment until saturation of the binding sites. In UV-crosslinking
      experiments, the binding of Ku protein to DNA was shown to start with the 70 kDa
      subunit contacting free DNA ends.

PMID- 1632794
TI  - Volatile anesthetics selectively alter [3H]ryanodine binding to skeletal and
      cardiac ryanodine receptors.
AB  - The effect of clinical concentrations of volatile anesthetics on ryanodine
      receptors of cardiac and skeletal muscle sarcoplasmic reticulum was evaluated
      using [3H]ryanodine binding. At 2 volume percent, halothane and enflurane
      stimulated binding to cardiac SR by 238% and 204%, respectively, while isoflurane
      had no effect. In contrast, halothane and enflurane had no effect on
      [3H]ryanodine binding to skeletal ryanodine receptors, while isoflurane produced
      a significant stimulation. These results suggest that volatile anesthetics
      interact in a site-specific manner with ryanodine receptors of cardiac or
      skeletal muscle to effect Ca2+ release-channel gating.

PMID- 1632795
TI  - NADPH-dependent inhibition of lipid peroxidation in rat liver microsomes.
AB  - Microsomal NADPH-driven electron transport is known to initiate lipid
      peroxidation by activating oxygen in the presence of iron. This pro-oxidant
      effect can mask an antioxidant function of NADPH-driven electron transport in
      microsomes via vitamin E recycling from its phenoxyl radicals formed in the
      course of peroxidation. To test this hypothesis we studied the effects of NADPH
      on the endogenous vitamin E content and lipid peroxidation induced in liver
      microsomes by an oxidation system independent of iron: an azo-initiator of
      peroxyl radicals, 2,2'-azobis (2,4-dimethylvaleronitrile), (AMVN), in the
      presence of an iron chelator deferoxamine. We found that under conditions NADPH:
      (i) inhibited lipid peroxidation; (ii) this inhibitory effect was less pronounced
      in microsomes from vitamin E-deficient rats than in microsomes from normal rats;
      (iii) protected vitamin E from oxidative destruction; (iv) reduced chromanoxyl
      radicals of vitamin E homologue with a 6-carbon side-chain, chromanol-alpha-C-6.
      Thus NADPH-driven electron transport may function both to initiate and/or inhibit
      lipid peroxidation in microsomes depending on the availability of transition
      metal catalysts.

PMID- 1632796
TI  - Feedback repression of polyamine uptake into mammalian cells requires active
      protein synthesis.
AB  - Two mammalian cell lines, rat hepatoma (HTC) and Chinese hamster ovary (CHO),
      were fed 10 to 50 microM spermidine while changes were monitored in intracellular
      polyamine levels and spermidine uptake activity. Normal feedback control
      preventing excessive polyamine uptake was found to be completely blocked by the
      addition of inhibitors of protein synthesis at the time of polyamine exposure.
      Under these conditions the cells accumulated abnormally high, toxic
      concentrations of spermidine. Further, continuous protein synthesis was needed to
      maintain repression of polyamine transporter proteins that had been inhibited
      previously by normal or elevated intracellular polyamines. These results suggest
      that a major factor in the regulation of polyamine uptake is the rapid,
      reversible inactivation of existing polyamine carrier molecules by an unstable
      protein whose synthesis is stimulated by intracellular polyamines.

PMID- 1632797
TI  - Apolipoprotein A-1 interacts with the N-terminal fusogenic domains of SIV (simian
      immunodeficiency virus) GP32 and HIV (human immunodeficiency virus) GP41:
      implications in viral entry.
AB  - Previous studies showed that apoA1, the major protein component of HDL (High
      Density Lipoprotein), inhibited HIV infectivity and virus-induced syncytia
      formation. The mechanism of inhibition is unknown. We bring here evidence that
      the amphipathic helices of apoA1 interact with the N-terminal peptides of SIV
      gp32 and HIV gp41. These peptides have been shown to be associated with the
      initial steps of the fusion between the host cell and the virus. Binding of apoA1
      to these peptides prevents the insertion of the fusogenic domains into the cell
      membrane and inhibits the fusion and the entry of the virus into the host cell.

PMID- 1632798
TI  - Studies on the intracellular Ca2+, protein kinase activity, and ATP contents of
      cisplatin- and rIFN-Y-treated non-adherent mononuclear cells.
AB  - The in vitro effect of cisplatin or rIFN-Y on the intracellular free calcium,
      protein kinase activity and ATP content of non-adherent mononuclear cells (nMNC)
      from human peripheral blood was assessed. We observed that treatment of nMNC with
      cisplatin enhanced the [Ca2+]i, ATP level, and protein kinase activity; whereas
      rIFN-Y-treated nMNC showed significant rises in ATP level and protein kinase
      activity only. We also observed that cisplatin-treated nMNC showed an
      instantaneous rise in [Ca2+]i when NK-sensitive K562 cells were added to the
      effector cells.

PMID- 1632799
TI  - Use of immunoadsorbent column chromatography for improved purification of
      arylsulfatase B from human placenta.
AB  - A simple and rapid procedure involving immunoadsorbent column chromatography has
      been developed for the isolation of lysosomal arylsulfatase B from human
      placenta. Using this method, we purified the enzyme over 20,000-fold with better
      recovery (16%) compared to that achieved by the conventional procedure. The
      enzyme appeared to be homogeneous and had an apparent molecular weight of 58,000
      on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) under
      nonreducing conditions. The purified enzyme migrated as two bands with apparent
      molecular weights of 43,000 and 8,000 by reductive SDS-PAGE.

PMID- 1632800
TI  - Pluronic micelles as a tool for low-molecular compound vector delivery into a
      cell: effect of Staphylococcus aureus enterotoxin B on cell loading with micelle
      incorporated fluorescent dye.
AB  - Micelles of pluronic P85 (poly(oxyethylene)-poly(oxypropylene) block copolymer)
      are used as microcontainers for in vitro delivery of fluorescein into Jurkat and
      MDCK cells. In order to target the fluorescein containing micelles into the cell,
      Staphylococcus aureus enterotoxin B (SEB) is covalently conjugated with a
      pluronic molecule and the conjugate is incorporated into the micelle content. The
      incorporation of SEB capable of receptor-mediated endocytosis results in a
      drastic enhancement of the efficiency of cell loading with the fluorescent dye.
      This effect is not observed under the conditions (4 degrees C) when endocytosis
      is abolished.

PMID- 1632801
TI  - Adenosine deaminase from bovine brain: purification and partial characterization.
AB  - Bovine brain adenosine deaminase cytoplasmatic form was purified about 450 fold
      by salt fractionation, column chromatography on DEAE-cellulose, octyl-sepharose
      4B and affinity chromatography on CH-sepharose 4B 9-(p-aminobenzyl)adenine. The
      purified enzyme was homogeneous on disc gel electrophoresis; the enzyme had a
      molecular mass of about 65 kDa with an isoelectric point at pH 4.87. The Km
      values for adenosine and 2'-deoxyadenosine were 4 x 10(-5) and 5.2 x 10(-5) M,
      respectively. The enzyme showed a great stability to temperature with a half life
      of 15 hours at 53 degrees C significantly different compared to that known for
      other mammalian forms of this enzyme. Aza and deaza analogs of adenosine and
      erythro-9-(2-hydroxy-3-nonyl) adenine were good inhibitors of the bovine brain
      enzyme with little difference with respect to those reported for the adenosine
      deaminases purified from other sources. Kinetic constants for the association and
      dissociation of coformycin and 2'-deoxycoformycin with the bovine brain adenosine
      deaminase are reported.

PMID- 1632802
TI  - DIDS-effect on Ser/Thr- and Tyr-phosphorylation of membrane proteins in human
      erythrocytes.
AB  - Band 3, the major transmembrane multifunctional protein of human erythrocytes,
      has been found to be phosphorylated-dephosphorylated on both Ser/Thr- and Tyr
      residues by specific protein kinases and protein phosphatases. The results
      reported here would indicate that the ghosts prepared from human erythrocytes
      pretreated with DIDS, well known inhibitor of band 3-mediated anion transport,
      exhibit a markedly reduced Ser/Thr-phosphorylation of spectrin and band 3, when
      incubated with [gamma-32P]ATP in the presence of Mg2+. On the other hand, Tyr
      phosphorylation of this latter protein is practically unchanged or even slightly
      enhanced. This suggests that Ser/Thr- and Tyr-phosphorylation of band 3 display a
      different functional role.

PMID- 1632803
TI  - Expression of pS2 gene in human breast cancer cell line MCF-7 is controlled by
      retinoic acid.
AB  - We established a simplified method for the quantitative measurement of pS2 mRNA
      using the reverse transcriptase-polymerase chain reaction (RT-PCR) method.
      Expression of the pS2 gene, which is transcriptionally induced by estrogen in
      breast cancer cell line MCF-7 cells, can be repressed by retinoic acid (RA) in
      unstimulated cells. The suppressive effect of RA on pS2 mRNA was inhibited by
      cycloheximide.

PMID- 1632804
TI  - Inhibition of Helicobacter pylori glycosulfatase activity toward gastric
      sulfomucin by nitecapone.
AB  - A glycosulfatase activity toward gastric sulfomucin was identified in the
      extracellular material elaborated by H. pylori. The enzyme exhibited maximum
      activity at pH 5.7 in the presence of Triton X-100 and CaCl2, and displayed on
      SDS-PAGE an apparent molecular weight of 30kDa. The H. pylori glycosulfatase
      effectively caused desulfation of N-acetylglucosamine-6-sulfate and galactose-6
      sulfate of the carbohydrate chains of mucins, as well as that of glucose-6
      sulfate of glyceroglucolipids, but was ineffective towards galactosyl- and
      lactosylceramide sulfates which contain galactose-3-sulfate. The glycosulfatase
      activity towards human gastric sulfomucin was affected by an antiulcer agent,
      nitecapone, which at its optimal concentration (100 micrograms/ml) caused a 61%
      inhibition. The results show that H. pylori through its glycosulfatase activity
      causes desulfation of sulfated mucins and glyceroglucolipids of the protective
      mucus layer, and that nitecapone is able to interfere with this detrimental
      action.

PMID- 1632805
TI  - A simple method for detecting protein antigens in flour.
AB  - Wheat, barley, rye or oat flour was dissolved in 0.2N NaOH using magnetic
      stirring followed by sonication. The ensuing clear solutions contained 95% of
      protein in the dry matter. Aliquots were electrophoresed on 12% polyacrylamide
      gels which were either stained with Coomassie brilliant blue or Western-blotted
      on nitrocellulose membrane. Incubation of the latter with serum from persons
      sensitized to flours allowed the detection of antigenic flour protein classes. It
      seems that many antigens are present in common kitchen flour.

PMID- 1632806
TI  - Unfolding of lysozyme by breaking its disulphide bridges results in exposure of
      hydrophobic sites.
AB  - The interaction of 1-anilino-naphthalene-8-sulphonate (ANS), a probe whose
      fluorescence is strongly dependent on hydrophobicity of the environment, with
      native lysozyme and lysozyme partially unfolded by breaking the disulphide
      bridges and reacting the free -SH groups with iodoacetamide, has been
      investigated. Monitoring the intensity of ANS fluorescence and the position of
      the emission maximum in the presence of native and partially unfolded lysozyme
      indicated that unfolding resulted in the exposure of hydrophobic sites.
      Hydrophobic sites could not be detected when native and partially unfolded
      lysozyme were denatured with urea or guanidinium chloride. Protein components of
      the cells export machinery like 'chaperones' associate only with partially
      unfolded proteins and not native, folded proteins. Hence, hydrophobic regions of
      proteins, exposed on partial unfolding, could be the sites of recognition by
      'chaperone' proteins.

PMID- 1632807
TI  - Phospholipid polar heads affect the generation of oxygen active species by Fe2+
      autoxidation.
AB  - The possibility that phospholipid polar heads may influence Fe2+ reaction with
      molecular oxygen and, thus, the generation of oxygen active species was
      investigated. Dipalmitoyl phosphatidylcholine (DPPC) and DPPC/dipalmitoyl
      phosphatidic acid (DPPA) were utilized as model liposomes. Fe2+ oxidation, oxygen
      consumption, nitro blue tetrazolium reduction and 2-deoxyribose degradation were
      the parameters evaluated. Comparison of the results obtained clearly shows that
      the two types of polar heads differently affect iron chemistry. DPPC liposomes
      are ineffective. By contrast, Fe2+ oxidation by oxygen occurs in the presence of
      DPPC/DPPA liposomes. During this reaction, species able to reduce nitro blue
      tetrazolium and to degrade 2-deoxyribose are generated. The results obtained
      indicate that the polar heads of phospholipids, by influencing Fe2+ autoxidation,
      generate dangerous oxygen species which may exert an active role in the oxidation
      of the associated hydrophobic components of the phospholipids.

PMID- 1632808
TI  - Induction of ornithine decarboxylase by transcriptional inhibitors in quiescent
      thymocytes.
AB  - The transcriptional inhibitors actinomycin D and
      dichlororibofuranosylbenzimidazole induced ornithine decarboxylase activity in
      isolated, quiescent thymocytes, which otherwise did not show detectable levels of
      the enzyme. This paradoxical induction was transient and dependent on the
      presence of serum and continuous protein synthesis. However, alpha-amanitin,
      another inhibitor of transcription, did not affect ornithine decarboxylase
      activity. Dichlororibofuranosylbenzimidazole and actinomycin D were unable to
      enhance the activity of spermidine acetyltransferase or S-adenosyl-methionine
      decarboxylase, which are other inducible and short-lived enzymes involved in the
      metabolism of polyamines.

PMID- 1632809
TI  - Catabolism of platelet-activating factor by human colonic mucosa. Calcium
      dependence of the catabolizing enzymes.
AB  - The catabolism of platelet-activating factor (PAF) and lyso PAF by a supernatant
      fraction of human colon mucosa homogenates has been studied in vitro. PAF is
      initially catabolized to lyso PAF by mucosal enzymes via removal of its acetyl
      group. Incubates in Ca(2+)-free Tris with EDTA showed that the acetyl hydrolase
      was Ca2+ independent. Addition of the hydrolase inhibitor, phenyl methyl
      sulphonyl fluoride, significantly reduced the catabolism of PAF. Lyso PAF was
      further catabolized in at least two ways. An acyl group was incorporated into the
      sn-2 position of lyso PAF to give 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine
      (alkyl acyl GPC); this step was Ca2+ independent as shown by omitting Ca2+ and
      adding EDTA to the incubate. Formation of alkyl acyl GPC was confirmed by HPLC.
      Alternatively, choline was removed from the head group of lyso PAF by a calcium
      dependent lyso phospholipase D. Under the experimental conditions utilized a
      neutral lipid product was formed but significant amounts of the intermediate
      lysophosphatidic acid could not be detected. A substance with a chromatographic
      mobility of Rf = 0.8 on TLC plates having an intact phosphorylcholine head group
      was also formed but has not yet been identified. It is concluded that the human
      colon mucosa contains enzymes that actively catabolize pro-inflammatory PAF and
      lyso PAF.

PMID- 1632810
TI  - Comparative affinity of steroidal and non-steroidal antioestrogens, cholesterol
      derivatives and compounds with a dialkylamino side chain for the rat liver
      antioestrogen binding site.
AB  - Steroidal and non-steroidal antioestrogens, steroidal compounds with
      (disubstituted) dialkyl amino side chain, cholesterol derivatives, histaminic and
      (anti)-progestational compounds were tested for their ability to compete with
      [3H]tamoxifen for the specific antioestrogen binding site (AEBS) in the post
      mitochondrial fraction of rat liver homogenates. Relative binding affinity was
      highest for compounds with diethylamino or pyrrolidino ethoxy side chains.
      Affinity decreased with shortening of this side chain. No connection could be
      established between the carbon backbone of the compound and affinity, except for
      the presence of (sometimes aromatic) ring structures. Steroidal ring structures
      do not seem to be necessary for binding. The cholesterol derivatives, tested in
      our laboratory, showed very little affinity for the rat liver AEBS. Histamine,
      melatonin and the (anti)-progestational compounds showed no affinity for the
      AEBS; and we therefore conclude that the AEBS is not identical to receptors for
      these compounds. Results of these experiments could be useful in other
      investigations on the development of resistance of breast cancer to
      antioestrogens.

PMID- 1632811
TI  - The S-thiolation of hepatocellular protein thiols during diquat metabolism.
AB  - The effects of diquat metabolism on the protein thiol (PrSH) status of bis
      chloronitrosourea-pretreated hepatocytes have been studied. Using a conventional,
      dithionitrobenzene-based assay for free PrSH in trichloroacetic acid-precipitated
      protein, control levels of PrSHs (83 +/- 6 nmol/mg protein) were unaltered during
      the initial 60 min of incubation of the cells with 1 mM diquat. However, using a
      radiochemical method for the determination of glutathionylation of PrSH [Grimm et
      al., Biochim Biophys Acta 844: 50-54, 1985], in which the hepatocytes were
      prepared from diethylmaleate-pretreated animals and reloaded with reduced
      glutathione (GSH) in the presence of [35S]methionine and cycloheximide, oxidation
      of hepatocellular PrSH by stimulated S-thiolation with GSH could be demonstrated.
      The S-glutathionylation of the protein was maximal after 30 min of treatment of
      the cells and preceded the onset of membrane leakage. However, the quantity of
      GSH mixed disulfide formed was limited to a maximum of 1.4 +/- 0.4 nmol GSH/mg
      protein, indicating the oxidation of only 2% of the total hepatocellular PrSH by
      S-thiolation. This percentage depletion is below the working variability of the
      colourimetric PrSH assay utilized and indicates strongly the use of the S
      thiolation assay in the study of the possible effects of other redox-cycling
      cytotoxins on cellular PrSH status, as these may not be evident with conventional
      spectrophotometric techniques. The analysis of the cellular protein from diquat
      treated cells by SDS-PAGE and autoradiography indicated the S-glutathionylation
      of a variety of cellular proteins, including species with molecular masses 17,
      24, 26, 30, 40, 43 and 46 kDa. Although the identities of these species are
      uncertain (the 30-kDa protein may be equivalent to carbonic anhydrase as reported
      by Rokutan et al., Biochemistry 179: 233-239, 1989), it may be that oxidative
      modification of these proteins by stimulated S-glutathionylation may be an
      important early event in the mechanism of the hepatotoxicity of diquat.

PMID- 1632812
TI  - Modulation of the levels of cytochromes P450 in rat liver and lung by dietary
      lipid.
AB  - This study was undertaken to investigate the effect of dietary lipid on the
      regulation of several constitutive P450 isozymes. Male Sprague-Dawley rats with
      body weights of 130-140 g were fed either a 20% corn oil (CO) diet or a fat-free
      (FF) diet for 4 days following 2 days of fasting. Using liver microsomes, the
      catalytic activities and immunochemically detectable protein levels of P450s 1A1
      and 2, 2A1, 2B1 and 2, 2C11, 2E1, and 3A were determined. The microsomes from
      rats fed the 20% CO diet exhibited 2-fold higher levels in N-nitrosodimethylamine
      demethylase activity and P450 2E1 protein than those from rats fed the FF diet.
      The CO group also showed 2.5-fold higher levels in 6 beta-hydroxylation of
      testosterone and P450 3A protein than the FF group. In contrast, the CO diet did
      not affect the immunodetectable level of P450 2C11 protein and its catalytic
      activities such as benzphetamine demethylase activity and 2 alpha-hydroxylation
      of testosterone. P450 1A1 was not detectable in either group, but 1A2 was 2.5
      fold higher in the CO group than in the FF group. In the liver, the P450 2B1
      level was very low in both groups as measured by pentoxyresorufin dealkylase
      activity and the protein level, whereas 2B2 was 2.5-fold higher in the CO diet
      group. In lung microsomes from rats fed different amounts of CO, an inverse
      relationship was observed between the P450 2B1 level and the dietary CO level.
      The results suggest that the constitutive levels of P450 isozymes are modulated
      by dietary lipid in a selective manner; the levels of hepatic P450s 1A2, 2B2,
      2E1, and 3A were regulated positively but the level of pulmonary P450 2B1 was
      suppressed by dietary lipid.

PMID- 1632813
TI  - Metabolic activation of lidocaine and covalent binding to rat liver microsomal
      protein.
AB  - Incubation of [14C]lidocaine with rat liver microsomes in the presence of an
      NADPH-generating system resulted in covalent bindings of a 14C-labelled material
      to microsomal protein. The covalent binding of radioactivity needed NADPH and
      atmospheric oxygen, and was diminished by purging of carbon monoxide and the
      addition of SKF-525A. Hence the covalent binding of a 14C-labelled material
      resulting from a reactive metabolite of lidocaine formed by cytochrome P450
      dependent monooxygenation. The covalent binding measured at various
      concentrations of lidocaine (2.5-30 microM) followed Michaelis-Menten kinetics,
      and the Km value (4.52 microM) of the activation reaction was close to the Km
      value (1.78 microM) of lidocaine 3-hydroxylation. The metabolism-dependent
      covalent binding of lidocaine to microsomal protein as well as lidocaine 3
      hydroxylase activity was much lower in the Dark Agouti strain rat, which is known
      as a poor-metabolizer animal model of debrisoquine 4-hydroxylation, than in the
      Wistar rat for the corresponding sexes. The covalent binding in male rats was
      greater than that in females of both strains, but the extent of the sex
      difference in the binding was smaller than that of the lidocaine N-deethylase
      activity in Wistar rats. Propranolol and quinidine, specific inhibitors of
      debrisoquine 4-hydroxylase, markedly inhibited lidocaine 3-hydroxylase activity
      of Wistar male rats, but not N-deethylase activity. These compounds also
      inhibited the metabolism-dependent covalent binding of lidocaine to microsomal
      protein. These strain difference and inhibition studies showed that the reaction
      converting lidocaine to a reactive metabolite capable of binding covalently to
      microsomal protein was related to lidocaine 3-hydroxylation, and may be catalysed
      by cytochrome P450 isozyme(s) belonging to the CYP2D subfamily. The covalent
      binding of radioactivity to rat liver microsomal protein was diminished by
      nucleophiles, reduced glutathione and cysteine, indicating that the reactive
      metabolic intermediate of lidocaine is an electrophilic metabolite such as an
      arene oxide.

PMID- 1632814
TI  - Interactions of amiodarone with model membranes and amiodarone-photoinduced
      peroxidation of lipids.
AB  - The potent antiarrhythmic drug, amiodarone (AMIO) exhibits phototoxicity, which
      is thought to be related to its interaction with biological membranes. We report
      here a spectroscopic study of the interactions of this drug with
      phosphatidylglycerol (PG) and phosphatidylcholine (PC) liposomes used as membrane
      model systems. A linear increase in absorbance at 300 nm was observed with
      increasing addition of AMIO to dimyristoyl-DL-PC (DMPC) liposomes over all the
      drugs-lipid molar ratio (Ri)s tested. In contrast, in the dimyristoyl-DL-PG
      (DMPG) liposomes, there was a dramatic increase in absorbance at values of Ri
      above unity. Light scattering by DMPG liposomes at 350 nm increased with
      increasing AMIO concentration up to a Ri = 1, and then decreased with increasing
      drug concentration. Such changes were not observed with the DMPC liposomes.
      Moreover, addition of AMIO changed the fluorescence polarization rate of 1,6
      diphenyl 1,3,5-hexatriene embedded in these liposomes. It reduced the rate below
      the phase transition temperature (Tt) of the lipid, but increased it above this
      temperature. These effects on the lipidic phases observed at low Ri were more
      pronounced on the DMPG than on the DMPC liposomes. The strong interactions of
      AMIO with phospholipids, especially the acidic ones, were confirmed by liposome
      size determinations. All these data strongly suggest that the drug was
      incorporated in the core of the lipid bilayers. Such a penetration would favor a
      drug-photoinduced peroxidation of lipids. Indeed, UV irradiation of AMIO-DOPG
      mixtures led to the disappearance of the unsaturated fatty acids of
      phospholipids, checked by gas chromatography measurements, which was correlated
      with the amount of oxygen consumed. This showed that AMIO did photosensitize
      phospholipid peroxidation.

PMID- 1632815
TI  - Transport of sulfonated tetraphenylporphine by lipoproteins in the hamster.
AB  - We have examined the transport and distribution properties of a bisulfonated
      tetraphenylporphine (TPPS-2A), an amphiphilic photosensitizer that spontaneously
      associates to lipoproteins. At different times after intravenous injection of
      TPPS-2A in hamsters, plasma was fractionated by density ultracentrifugation and
      porphyrin concentrations were measured in the different plasma (lipo)protein
      fractions. In order to mimic human lipoprotein composition hamsters were
      preinjected with 23 mg of apolipoprotein/kg human low density lipoprotein. In
      addition, the whole body distribution is described as detected by a novel method
      for the tissue quantification of TPPS-2A. At 5 min after injection into the
      penile vein, more than 50% of the injected dose appears to be associated with
      lung tissue, while only 30% is present in plasma and bound exclusively to plasma
      lipoproteins. After the initial phase, a more retarded decrease in plasma
      porphyrin concentration is observed. Between 5 min and 6 hr after administration,
      a redistribution of TPPS-2A from the lungs to the liver takes place. It is
      concluded that in the hamster, an animal model representing human lipoprotein
      composition, TPPS-2A is transported essentially exclusively by plasma
      lipoproteins. No depletion or accumulation of TPPS-2A in a particular plasma
      lipoprotein fraction could be observed, suggesting a continuous redistribution of
      the compound. The molecular skeleton of TPPS-2A may serve as a model for the
      development of new drugs that either have improved in vivo properties due to
      transport by lipoproteins or have a beneficial effect on the lipoprotein particle
      itself.

PMID- 1632816
TI  - Thermodynamics of the anthracycline-nuclei interactions in drug-resistant and
      drug-sensitive K562 cells.
AB  - Fluorescence emission spectra from anthracycline-treated cells suspended in
      buffer have been used to measure the uptake of three anthracycline derivatives:
      Adriamycin (ADR), 4'-o-tetrahydropyranyl-Adriamycin (THP-ADR) and aclacinomycin
      (ACM) in drug-sensitive and drug-resistant K562 cells. The concentration of drug
      bound to the nucleus and free in the cytoplasm, at steady state, as well as the
      concentration of drug bound to the nucleus at equilibrium state have been
      determined at temperatures ranging from 6 degrees to 40 degrees. The enthalpies
      for the binding of ADR, THP-ADR and ACM to nuclei equal -35 +/- 3, -35 +/- 3 and 
      30 +/- 3 kJ/mol, respectively. These values compare with the enthalpies of
      binding of these drugs to naked DNA.

PMID- 1632817
TI  - Relationships between the aqueous chemistry and the in vitro cytotoxic activities
      of mixed-amine cisplatin analogues.
AB  - The possibility that variations in the cytotoxic activities of cisplatin
      analogues could be a result of differences in the aqueous chemistry of the
      compounds was investigated. A series of structurally related mixed-amine
      dichloroplatinum complexes (cis-coordinated with amine and various
      diphenylmethylamines and 1,2-diphenylethylamines) was prepared and selected
      physicochemical properties of the new compounds were characterized. Cytotoxicity
      was determined in two human breast cancer cell lines (MDA-MB-231 and MCF-7) and
      one human ovarian cancer cell line (SK-OV-3) by means of a microtiter assay.
      There is no apparent relationship between the hydrophobicities of the compounds
      and their cytotoxic potencies. There is no evidence for an inverse relationship
      between the aqueous stability of the dichloroplatinum complexes and cytotoxic
      potency, as has been reported for nitrogen mustards and some nitrosoureas. The
      differences in cytotoxic activity cannot be explained by inter-compound
      variations in the area under the concentration-time curves (AUC) of the
      dichloroplatinum complexes in culture medium. Thus, it appears that the
      differences in the cytotoxic potencies of this series of cisplatin analogues are
      related to factors other than dissimilarities in these physiochemical properties.
      Nevertheless, a relationship was found between the AUC of a dichloroplatinum
      complex in medium and the efficacy of the compound in the MCF-7 cell line.
      However, the AUC-efficacy relationship does not always hold in the MDA-MB-231 and
      SK-OV-3 cell lines. In these cells, treatment with a "high" bolus dose of
      platinum complex over finite exposure times is often less cytotoxic than
      treatment with lower doses of the same compound but over a continuous exposure
      time, although the cells are subjected to the same AUC of dichloroplatinum
      complex.

PMID- 1632819
TI  - Covalent binding of morphine to isolated rat hepatocytes.
AB  - Incubation of [3H]morphine with isolated hepatocytes caused covalent binding of
      [3H]-morphine to hepatocellular proteins. Sulfhydryl compounds protected against
      morphine-induced toxicity and decreased covalent binding. Analysis of covalently
      bound proteins in the cytosol by electrophoresis indicated that covalently bound
      radiolabel was associated with macromolecules greater than 25 kDa and increased
      throughout the incubation. In contrast, covalent binding to the particulate
      fraction was highly selectively associated with three protein bands of 50-53 and
      33 kDa. Covalent binding of morphine to particulate fraction proteins was
      observed in hepatocytes which exhibited cellular damage. We conclude that the
      covalent binding of morphine to protein is associated with morphine-induced
      cytotoxicity.

PMID- 1632818
TI  - Microsomal lauric acid hydroxylase activities after treatment of rats with three
      classical cytochrome P450 inducers and peroxisome proliferating compounds.
AB  - In order to investigate a proposed relationship between induction of hepatic
      microsomal lauric acid hydroxylase activity and peroxisome proliferation in the
      liver, male Wistar rats were treated with peroxisome proliferating compounds, and
      the lauric acid hydroxylase activity, the immunochemical detectable levels of
      cytochrome P450 4A1 and the activities of peroxisomal enzymes were determined. In
      addition, the levels of cytochrome P450 4A1 and lauric acid hydroxylase
      activities were studied after treatment of rats with three cytochrome P450
      inducers. After treatment with aroclor-1254, phenobarbital or 3
      methylcholanthrene total cytochrome P450 was 1.7-2.7 times induced. However, no
      induction of lauric acid omega-hydroxylase activities or P450 4A1 levels were
      found. After treatment of rats with di(2-ethylhexyl)phthalate (DEHP) a dose
      dependent induction of lauric acid omega-hydroxylase activities, levels of
      cytochrome P450 4A1 and peroxisomal fatty acid beta-oxidation was found. Even at
      a dose-level of 100 mg DEPH/kg body weight per day a significant induction of
      these activities was observed. The main metabolites of DEHP, mono(2
      ethylhexyl)phthalate and 2-ethyl-1-hexanol, also caused an induction of levels of
      P450 4A1, lauric acid omega-hydroxylase activities and the activity of
      peroxisomal palmitoyl-CoA oxidase. 2-Ethyl-1-hexanoic acid did not influence
      lauric acid omega-hydroxylase activities, but did induce levels of P450 4A1 and
      palmitoyl-CoA oxidase activities. Three other compounds (perfluoro-octanoic acid,
      valproate and nafenopin) induced both lauric acid omega-hydroxylase activity and
      peroxisomal palmitoyl-CoA oxidase activity. The plasticizer, di(2
      ethylhexyl)adipate, did not induce levels of P450 4A1, lauric acid omega
      hydroxylase activities or palmitoyl-CoA oxidase activities. With the compounds
      tested a close association between the induction of lauric acid omega-hydroxylase
      activities and peroxisomal palmitoyl-CoA oxidase activity was found. These data
      support the theory that peroxisome proliferating compounds do induce lauric acid
      omega-hydroxylase activities and that there might be a mechanistic inter
      relationship between peroxisome proliferation and induction of lauric acid omega
      hydroxylase activities.

PMID- 1632820
TI  - Dolastatin 15, a potent antimitotic depsipeptide derived from Dolabella
      auricularia. Interaction with tubulin and effects of cellular microtubules.
AB  - Dolastatin 15, a seven-subunit depsipeptide derived from Dolabella auricularia,
      is a potent antimitotic agent structurally related to the antitubulin agent
      dolastatin 10, a five-subunit peptide obtained from the same organism. We have
      compared dolastatin 15 with dolastatin 10 for its effects on cells grown in
      culture and on biochemical properties of tubulin. The IC50 values for cell growth
      were obtained for dolastatin 15 with L1210 murine leukemia cells, human Burkitt
      lymphoma cells, and Chinese hamster ovary (CHO) cells (3, 3, and 5 nM with the
      three cell lines, respectively). For dolastatin 10, IC50 values of 0.4 and 0.5 nM
      were obtained with the L1210 and CHO cells, respectively. At toxic concentrations
      dolastatin 15 caused the leukemia and lymphoma cells to arrest in mitosis. In the
      CHO cells both dolastatin 15 and dolastatin 10 caused moderate loss of
      microtubules at the IC50 values and complete disappearance of microtubules at
      concentrations 10-fold higher. Despite its potency and the loss of microtubules
      in treated cells, the interaction of dolastatin 15 with tubulin in vitro was
      weak. Its IC50 value for inhibition of glutamate-induced polymerization of
      tubulin was 23 microM, as compared to values of 1.2 microM for dolastatin 10 and
      1.5 microM for vinblastine. Dolastatin 10 noncompetitively inhibits the binding
      of vincristine to tubulin, inhibits nucleotide exchange, stabilizes the
      colchicine binding activity of tubulin, and inhibits tubulin-dependent GTP
      hydrolysis (Bai et al., Biochem Pharmacol 39: 1941-1949, 1990; Bai et al. J Biol
      Chem 265: 17141-17149, 1990). Only the latter reaction was inhibited by
      dolastatin 15. Nevertheless, its structural similarity to dolastatin 10 indicates
      that dolastatin 15 may bind weakly in the "vinca domain" of tubulin (a region of
      the protein we postulate to be physically close to but not identical with the
      specific binding site of vinca alkaloids and maytansinoids), presumably in the
      same site as dolastatin 10 (the "peptide site").

PMID- 1632821
TI  - Investigation of the mechanism by which cyclophosphamide alters cytochrome P450
      in male rats.
AB  - The effects of administration of the cytotoxic agent cyclophosphamide on
      cytochrome P450 have been examined in the liver microsomes of male rats.
      Microsomes were prepared after cyclophosphamide administration 1, 4 or 7 days
      prior to killing. The coadministration of cyclophosphamide with N-acetylcysteine
      has also been investigated. The microsomes were assayed for NADPH cytochrome P450
      reductase, aminopyrine demethylase, erythromycin demethylase and androstenedione
      hydroxylase activities. Activities were generally unchanged 1 and 4 days after
      cyclophosphamide administration and were significantly decreased at 7 days. N
      Acetylcysteine did not alter the effects of cyclophosphamide at 7 days. The
      effect of cyclophosphamide in vitro has also been examined. Microsomes from
      untreated animals were subjected to the above assays following in vitro metabolic
      activation of cyclophosphamide in a reconstituted system in the presence and
      absence of N-acetylcysteine. All enzyme activities were significantly reduced by
      the cyclophosphamide metabolites. The presence of N-acetylcysteine prevented this
      inactivation. The results of these investigations suggest that cyclophosphamide
      inactivates hepatic cytochrome P450 in vitro and in vivo via different
      mechanisms.

PMID- 1632822
TI  - Immobilization of solubilized UDP-glucuronosyltransferase from rat liver
      microsomes to Sepharose 4B.
AB  - A method for the covalent binding of rat liver UDP-glucuronosyltransferase to a
      cyanogen bromide-activated agarose matrix is described. The rat liver microsomal
      fraction was solubilized with 8 mM 3-[(3-cholamidopropyl)dimethylammonio]-1
      propanesulfonate (CHAPS); 90% of the microsomal protein was solubilized. Some 50
      60% of this protein became bound covalently to the activated agarose matrix. The
      immobilized UPD-glucuronosyltransferase remained completely active for 50 days
      when stored at 4 degrees in a 20% (v/v) glycerol buffer (pH 7.4). The immobilized
      enzyme has a temperature optimum around 37 degrees, and a broad pH optimum (pH 5
      7.4). The enzyme displayed linear kinetics over a period of 1 hr; it conjugates a
      large variety of substrates.

PMID- 1632823
TI  - Effects of chronic ethanol feeding on rat liver mitochondrial energy metabolism.
AB  - Chronic alcohol consumption is known to decrease hepatic mitochondrial
      respiration rate. It was shown here that the proton leak through the
      mitochondrial inner membrane was unaffected by chronic ethanol treatment. This
      indicates that changes in proton leak are not responsible for the alterations in
      respiration found in mitochondria isolated from ethanol-treated rats. Therefore,
      the lowered coupled respiration rate is solely due to a decrease in the activity
      of the electron transport chain. However, this alteration was only evident in
      coupled respiration (i.e. state 4) and was not apparent in uncoupled respiration.
      Thus, chronic ethanol treatment decreases the activity of the mitochondrial
      electron transport chain components which have control over coupled, but not
      uncoupled, respiration. Mitochondrial energy metabolism is regulated by thyroid
      hormone status. It was shown that the chronic alcohol treatment did not affect
      the circulating levels of thyroxine. Furthermore, the activity of mitochondrial
      alpha-glycerophosphate dehydrogenase, which is strongly affected by thyroid
      hormones, was unaltered by alcohol treatment. Thus, the effects of ethanol
      treatment on mitochondria occur independently of changes in circulating thyroid
      hormone levels.

PMID- 1632824
TI  - GABA in pancreatic islets: metabolism and function.

PMID- 1632825
TI  - Differential effects of cisplatin on the expression of chimeric marker genes in
      CV-1 cells.
AB  - The effect of the antitumor drug cisplatin on marker gene expression in CV-1
      monkey cells was measured. When non-replicating test genes were introduced by
      transient transfection, there was strong differential inhibition caused by the
      drug. Expression of certain genes was relatively insensitive, but expression of
      others was inhibited as strongly as was DNA replication. Stronger promoters led
      to stronger inhibition. This selective inhibition was not observed with the
      pharmacologically inactive isomer transplatin. The results raise the possibility
      that inhibition of strongly expressed genes by cisplatin may contribute to the
      antitumor activity of the drug.

PMID- 1632826
TI  - Chronic physical activity: hepatic hypertrophy and increased total
      biotransformation enzyme activity.
AB  - Does chronic voluntary physical activity alter hepatic or intestinal capacities
      for xenobiotic biotransformation? This question was investigated by comparing
      biotransformation enzyme activities in liver and small intestine of active and
      sedentary rats. Male rats allowed unlimited access to a running wheel and fed ad
      lib. for 6 weeks were weight-matched to sedentary controls; the active rats ate
      22% more food than the sedentary rats (P less than 0.05). Active rats ran 2.8 +/-
      0.6 miles/day. Liver weights were higher in the active rats (11.2 +/- 0.2 vs 9.8
      +/- 0.2 g; P less than 0.05), as were total liver protein, and liver microsomal
      and cytosolic protein (P less than 0.05). As a result of liver hypertrophy, the
      active rats showed higher total liver activity of several biotransformation
      enzymes, including 2-naphthol sulfotransferase, styrene oxide hydrolase,
      benzphetamine N-demethylase, ethacrynic acid glutathione S-transferase and
      morphine UDP-glucuronosyltransferase (P less than 0.05). In contrast, there was
      no detectable difference in total liver N-acetyltransferase activity toward p
      aminobenzoic acid, 2-naphthylamine, and 2-amino-fluorene as well as, relative
      hepatic enzyme activity (expressed per g liver or per mg protein) and total and
      relative intestinal enzyme activity. We conclude that chronic voluntary physical
      activity, accompanied by an increased food intake, results in liver hypertrophy
      and potentially increases total hepatic capacity to biotransform certain
      xenobiotic chemicals.

PMID- 1632827
TI  - Acetaminophen-induced depletion of glutathione and cysteine in the aging mouse
      kidney.
AB  - Glutathione (GSH) plays an essential role in the detoxification of acetaminophen
      (APAP) and the prevention of APAP-induced toxicity in the kidney. Our previous
      results demonstrated that a GSH deficiency is a general property of aging
      tissues, including the kidney, suggesting a hypothesis that senescent organisms
      are at greater risk to APAP-induced renal damage. To test this, C57BL/6NIA mice
      of different ages through the life span were injected with various doses of APAP,
      and the extent of GSH and cysteine (Cys) depletion and recovery were determined.
      At time intervals up to 24 hr, kidney cortex samples were obtained, processed and
      analyzed for glutathione status, namely GSH, glutathione disulfide (GSSG), Cys
      and cystine, using an HPLC method with dual electrochemical detection. In the
      uninjected controls, GSH and Cys concentrations decreased about 30% in the aging
      mouse, but the GSSG and cystine levels were unchanged during the life span. APAP
      administration depleted the kidney GSH and Cys contents in a dose- and time
      dependent manner. Four hours after APAP administration, GSH levels of the young,
      growing (3- to 6-month) and the mature (12-month) mice decreased 34 and 58%,
      respectively, and recovered to near control values by 24 hr (95 and 98%). In
      contrast, the extent of depletion in old (31-month) mice was greater (64%) and
      the 24-hr recovery was less, returning only to 56%. Likewise, Cys levels of the
      young and mature mice decreased 49 and 65%, respectively, 4 hr following APAP,
      and increased to 99 and 85% by 24 hr. In contrast, in old mice, there was a 78%
      depletion after 4 hr followed by a recovery of only 65% by 24 hr. These results
      demonstrated clearly that in the aging mouse kidney, a GSH and Cys deficiency
      occurs that is accompanied by an impaired APAP detoxification capacity.

PMID- 1632828
TI  - Effects of interleukin-6 on cytochrome P450-dependent mixed-function oxidases in
      the rat.
AB  - Intravenous treatment of male rats with recombinant human interleukin-6 (rhIL6)
      at 50, 100 and 200 micrograms/kg (corresponding to 4, 8 and 16 x 10(4) U/animal,
      respectively) reduced the activities of hepatic microsomal cytochrome P450
      dependent monoxygenases to varying degrees. Ethylmorphine-N-demethylase activity
      fell to 53% of control values, an effect similar to that induced by 2.5 mg/kg
      Escherichia coli lipopolysaccharide (LPS). Ethoxycoumarin-O-deethylase activity
      was also sensitive to inhibition, whereas IL6 had little effect on the activities
      of other P450-dependent enzymes, including ethoxyresorufin-O-deethylase.
      Pentoxyresorufin dealkylase activity, which is representative of the cytochrome
      P450 IIB 1/2 subfamily, was unaffected by IL6 whereas LPS reduced it to 33.7% of
      control values. Another hepatocyte-related parameter, serum concentration of
      alpha 1-acid glycoprotein (AGP), was increased by up to 3.5-fold over baseline by
      IL6 and 10-fold by LPS. Recombinant human interleukin-1 beta (rhIL1 beta) (10
      micrograms/kg, corresponding to 5 x 10(4) U/rat) and recombinant human tumor
      necrosis factor alpha (rhTNF) (150 micrograms/kg corresponding to 24 x 10(4)
      U/rat) were both as potent as LPS (2.5 mg/kg) in increasing serum AGP levels and
      reducing hepatic microsomal monoxygenase activities. IL6 did not potentiate the
      effects of rhIL1 beta. Hepatic microsomal glucuronyltransferase activities were
      little affected by LPS and unaffected by rhIL6. Finally, rhIL6 was more potent
      after i.p. injection than after i.v. or s.c. injection. These results suggest
      that the effects of LPS, TNF and IL1 on the mixed-function oxidase system in vivo
      may be due partly to an induction of IL6 in vivo. The different sensitivities of
      the enzymes to IL6 but not to IL1 or TNF may be due to the involvement of two
      distinct mechanisms.

PMID- 1632829
TI  - New isoflavonoids as inhibitors of porcine 5-lipoxygenase.
AB  - The inhibitory activity of new isoflavonoids on 5-lipoxygenase of porcine
      leukocytes was investigated. Isoflavans (I) proved to be stronger inhibitors than
      isoflavones (II). The isoflavans containing ortho-hydroxy groups in ring A showed
      the lowest Ki values (0.8-50 microM). In comparison, isoflavans with meta
      dihydroxy groups exhibited Ki values higher than 150 microM. The effect of
      commercial antioxidants was tested also on porcine 5-lipoxygenase. Butylated
      hydroxyanisole (Ki: 25 microM) and butylated hydroxytoluene (Ki: 55 microM)
      revealed moderate inhibitory activity, whereas L-ascorbic acid, L-ascorbyl
      palmitate, dl-alpha-tocopherol and n-propyl gallate showed weak inhibitory
      activities (Ki: 100-260 microM).

PMID- 1632830
TI  - The toxicological relevance of paracetamol-induced inhibition of hepatic
      respiration and ATP depletion.
AB  - In order to elucidate the role of mitochondrial dysfunction in paracetamol
      induced hepatotoxicity, the effects of paracetamol on the oxygen consumption and
      ATP content of the isolated perfused rat liver were correlated with parameters of
      hepatic viability and hepatotoxicity. Paracetamol at 5 g/L reduced the oxygen
      consumption of the livers by about 80% and hepatic ATP content by 96%.
      Hepatotoxicity was evident from the nearly complete interruption of bile
      secretion, a marked release of enzymes [glutamate-pyruvate transaminase (GPT),
      lactate dehydrogenase (LDH)] in the perfusate, a depletion of hepatic glutathione
      and an accumulation of calcium in the liver. Paracetamol-induced hepatotoxicity
      could be prevented completely by using livers from non-fasted rats as well as by
      addition of fructose to the perfusate of livers from fasted animals. Both
      treatments resulted in an increased energy supply from anaerobic glycolysis as
      evidenced by a large release of lactate and pyruvate into the perfusate, but did
      not inhibit paracetamol-induced decline of oxygen consumption. The decrease in
      hepatic oxygen consumption depended on the dose of paracetamol and occurred first
      at a concentration of 0.2 g/L (-10%). LDH and GPT release, on the other hand, was
      elevated at 2 and 5 g/L and calcium accumulation occurred at 5 g/L paracetamol
      only. Inhibition of mixed-function oxidases by dithiocarb did not prevent the
      decrease in oxygen consumption and the resulting hepatic injury induced by
      paracetamol. The oral administration of the high dose of 5 g/kg paracetamol in
      vivo to rats exerted strong hepatotoxicity but produced maximal serum levels of
      800 mg/L paracetamol only and did not decrease hepatic oxygen consumption as
      measured in vitro. Our results show that in the isolated perfused rat liver in
      vitro, only high concentrations of paracetamol can produce "chemical hypoxia" by
      attacking mitochondria so as to cause hepatic injury. Such high concentrations of
      paracetamol are not attained in vivo, however. "Chemical hypoxia", thus, seems
      not to be relevant to the well-known hepatotoxic action of paracetamol.

PMID- 1632831
TI  - Monoclonal antibodies distinguish between carboxylesterase isoenzymes in
      different tissues of rat and guinea pig.
AB  - The carboxylesterase (CarbE) activity in the main tissues (lung, liver, plasma
      and small intestine) of both the rat and guinea pig was separated by
      chromatofocusing. The three CarbE isoenzymes in the small intestine from both
      species showed nearly identical pI values. Monoclonal antibodies (MAbs) raised
      against rat lung CarbE (pI 5.8) were used in enzyme-linked immunosorbent assays
      to distinguish between these closely related CarbE isoenzymes. None of the MAbs
      did bind to the active site as no inhibition of the enzyme was seen when the MAbs
      were added. The immunological study showed a strong relationship between lung
      CarbE (pI 5.8) and the rat liver CarbE (pI 6.0). The MAbs were also strongly
      bound to the high pI forms of the CarbE isoenzymes in plasma and small intestine
      from both rat and guinea pig, but not with the low pI forms. These results
      indicate that two immunochemically distinct categories of CarbE isoenzymes are
      present in the plasma and small intestine.

PMID- 1632832
TI  - Synergism in insulin-like effects of molybdate plus H2O2 or tungstate plus H2O2
      on glucose transport by isolated rat adipocytes.
AB  - The effect of molybdate, tungstate, molybdate plus H2O2 or tungstate plus H2O2 on
      3-O-methylglucose (3-O-MG) uptake was studied in isolated rat adipocytes to
      investigate whether these agents possess an insulin-like action. High
      concentrations (10-30 mM) of molybdate or tungstate significantly stimulated the
      uptake of 3-O-MG while 1 mM of the metaloxides did not. The combination of 1 mM
      molybdate and 1 mM H2O2, or 1 mM tungstate and 1 mM H2O2 induced striking
      stimulation of the uptake of 3-O-MG in a synergistic manner, whereas 1 mM H2O2
      alone showed only a small effect. The effect of metaloxides plus H2O2 (1 mM) and
      the effect of insulin (20 nM) were not additive, and both effects were ATP or
      energy dependent based on experiments using KCN. These results indicate that a
      weak insulin-like effect of molybdate or tungstate is potentiated synergistically
      with H2O2, presumably by producing peroxocompounds. Based on the present
      findings, these new agents may be useful for investigating the mechanism of
      insulin action and may indicate a new class of drugs for diabetes mellitus.

PMID- 1632833
TI  - Inhibition of transketolase and pyruvate decarboxylase by omeprazole.
AB  - Omeprazole inhibited two thiamin diphosphate-dependent enzymes, pyruvate
      decarboxylase (EC 4.1.1.1, PDC) from Zymomonas mobilis and transketolase (EC
      2.2.1.1, TK) from human erythrocytes. Inhibition of PDC was competitive with the
      coenzyme with a Ki value of 42 +/- 3 microM, whereas inhibition of TK was
      complex.

PMID- 1632834
TI  - Detection of human lung cytochromes P450 that are immunochemically related to
      cytochrome P450IIE1 and cytochrome P450IIIA.
AB  - We have used monoclonal antibodies that were prepared against and specifically
      recognize human hepatic cytochromes P450 as probes for solid phase
      radioimmunoassay and Western immunoblotting to directly demonstrate the presence
      in human lung microsomes of cytochromes P450 immunochemically related to human
      liver cytochromes P450IIE1 (CYP2E1) and P450IIIA (CYP3A). The detected levels of
      these cytochromes are much lower than levels in human liver microsomes, but
      similar to the levels seen in microsomes from untreated baboon lung. Proteins
      immunochemically related to two other constitutive hepatic cytochromes P450,
      cytochrome P450IIC8 (CYP2C8) and cytochrome P450IIC9 (CYP2C9), were not
      detectable in lung microsomes.

PMID- 1632835
TI  - Stimulation of macrophage tumouricidal activity by 5,6-dimethyl-xanthenone-4
      acetic acid, a potent analogue of the antitumour agent flavone-8-acetic acid.
AB  - The new antitumour drug 5,6-dimethylxanthenone-4-acetic acid (5,6-MeXAA; NSC
      640488) was 14-fold more potent than the investigational chemotherapeutic drug
      flavone-8-acetic acid (NSC 347512) in stimulating tumouricidal activity in
      cultures of resident murine peritoneal macrophages. The tumouricidal activity of
      thioglycollate-elicited and Bacillus Calmette-Guerin-primed macrophages was also
      significantly enhanced by 5,6-MeXAA. Stimulation of macrophage tumouricidal
      activity by 5,6-MeXAA was not affected by inhibitors of superoxide and nitric
      oxide production, but was reduced by cyclosporin A, an inhibitor of protein
      secretion. Inhibitors of neutral proteases had no effect. Cortisone,
      dexamethasone, indomethacin, dibutyryl cAMP, prostaglandin E2 and prostacyclin,
      but not prostaglandin F2 alpha, inhibited stimulation, suggesting the involvement
      of tumour necrosis factor-alpha (TNF). However, antibodies to TNF did not inhibit
      stimulation. The results suggest that 5,6-MeXAA acts on macrophages in a manner
      similar to that of endotoxin, utilizing a pathway which includes arachidonic acid
      metabolism and requiring cell-cell contact with target cells for a tumouricidal
      effect.

PMID- 1632836
TI  - Action of ebselen as an antioxidant against lipid peroxidation.
AB  - The action of ebselen (2-phenyl-1,2-benzoisoselenazol-3(2H)-one) as an
      antioxidant was studied under various conditions to clarify how it prevents
      oxidative damage. It did not react with diphenylpicrylhydrazyl nor did it
      suppress the oxidation of methyl linoleate in acetonitrile solution or in aqueous
      dispersions induced by free radical initiator, suggesting that ebselen does not
      act as a potent radical scavenging antioxidant. On the other hand, it suppressed
      the oxidation of methyl linoleate emulsions in aqueous dispersions induced by
      iron. It also suppressed the spontaneous oxidation of rat brain and liver
      homogenates, but it did not suppress the oxidation of these homogenates induced
      by a free radical initiator. It was also found that ebselen reduced the fatty
      acid hydroperoxides to their corresponding alcohols and this reaction was
      enhanced by the presence of glutathione. These results suggest that ebselen acts
      as an antioxidant by reducing hydroperoxides, but that it does not act as a
      radical-scavenging antioxidant.

PMID- 1632838
TI  - Altered regulation of Cyp1a-1 gene expression during cultivation of mouse
      hepatocytes in primary culture.
AB  - Alterations in Cyp1a-1 gene expression in adult C57BL/6 mouse hepatocytes were
      followed after transferring them to primary culture during the initial 5 days.
      Changing the medium to a fresh one was associated with considerable amounts of
      Cyp1a-1 gene mRNA with a peak at around 6 hr after the medium change, followed by
      a decrease to negligible levels 24 hr later. Treatment of hepatocytes with
      cycloheximide increased the medium change-associated mRNA expression, the levels
      being equivalent to those observed after treatment with 3.2-25.6 nM 3
      methylcholanthrene plus cycloheximide. With increasing length of culture period,
      cycloheximide-aided enhancement of the medium change-associated mRNA
      transcription increased. Although the chemical alone did not induce Cyp1a-1 gene
      transcripts in hepatocytes at day 1 or 2 of cultivation, for which medium had
      been changed 24 hr previously, prominent induction of transcripts was evident at
      later periods, the levels being elevated in accordance with length of time in
      culture. To examine whether or not the mRNA transcribed under these culture
      conditions was translatable, the cells were treated with actinomycin D after
      washing out the cycloheximide, in order to inhibit degradation of the generated
      mRNA (Nemoto N and Sakurai J, Carcinogenesis 12: 2115-2121, 1991). After these
      procedures significant elevation of aryl hydrocarbon hydroxylase activity was
      observed in hepatocytes, the rise being well correlated with elevated levels of
      mRNA transcripts. The observations suggest that the Cyp1a-1 gene might be
      expressed at low levels during the initial phase of cultivation of mouse
      hepatocytes in primary culture. Whether this expression might be essential for
      mouse hepatocytes to adapt to culture conditions is unclear. The findings do
      suggest, however, that superinducibility of the gene expression after
      cycloheximide treatment might be a result of a regulatory mechanism operating
      after adaptation to culture.

PMID- 1632837
TI  - Biscoclaurine alkaloids inhibit receptor-mediated phospholipase A2 activation
      probably through uncoupling of a GTP-binding protein from the enzyme in rat
      peritoneal mast cells.
AB  - The mechanism underlying the inhibitory effect of biscoclaurine
      (bisbenzylisoquinoline) alkaloids on phospholipase A2 activation in the
      signalling system of stimulated rat peritoneal mast cells was studied.
      Cepharanthine, berbamine and isotetrandrine inhibited antigen- and compound 48/80
      induced arachidonic acid liberation, but not diacylglycerol formation or
      histamine release. They had no effect on A23187-induced arachidonic acid
      liberation, which was prevented by p-bromophenacyl bromide, a known phospholipase
      A2 inhibitor, and also did not affect phospholipase A2 activity in a cell-free
      system including an exogenous phospholipid substrate. Each alkaloid also
      inhibited arachidonic acid liberation induced by guanosine 5'-O-(3
      thiotriphosphate) in saponin-permeabilized mast cells, and by mastoparan or NaF
      plus AlCl3 intact cells. Furthermore, each alkaloid abolished the inhibitory
      effect of islet-activating protein on the compound 48/80-induced arachidonic acid
      liberation. These data suggest that these alkaloids suppress the receptor
      mediated phospholipase A2 activation through, at least in part, uncoupling of a
      GTP-binding protein from the enzyme, rather than by affecting the enzyme
      directly.

PMID- 1632839
TI  - The cytotoxicity, DNA crosslinking ability and DNA sequence selectivity of the
      aniline mustards melphalan, chlorambucil and 4-[bis(2-chloroethyl)amino] benzoic
      acid.
AB  - Three aniline derivatives melphalan (L-PAM), chlorambucil (CHL) and 4-[bis(2
      chloroethyl)amino] benzoic acid (BAM) have been compared on the basis of their in
      vitro cytotoxicities, DNA interstrand crosslinking ability and DNA sequence
      selectivity. Cytotoxicity was assessed in the human colonic adenocarcinoma LS174T
      and leukaemic K562 cell lines using the sulpho-rhodamine B and tetrazolium dye
      reduction assays. The order of cytotoxicities was L-PAM greater than CHL greater
      than BAM in both cell lines with K562 being less sensitive than LS174T. This was
      different from the order CHL greater than L-PAM greater than BAM which would be
      predicted from simple chemical reactivity or rate of hydrolysis, parameters which
      have been used previously as indicators of biological potency for aromatic
      nitrogen mustards. DNA interstrand crosslinking in cells as determined by
      alkaline elution showed a correlation with IC50 values. The ranking order of
      activity was further predicted by the ability of the agents to produce
      interstrand crosslinks in isolated DNA. The extent of guanine N-7 alkylation,
      assessed using a modified DNA sequencing technique, mirrored cytotoxicity and
      crosslinking ability, but at equivalent levels of alkylation there was no
      significant difference in DNA sequence selectivity. These data demonstrates that
      simple chemical reactivity or hydrolysis rate is not a good indicator of DNA
      reactivity or cytotoxicity for a number of aniline mustards, whereas DNA
      interstrand crosslinking ability either measured directly in cells or in isolated
      DNA, gives a good indication of biological activity.

PMID- 1632840
TI  - Substoichiometric inhibition of microtubule formation by acetaldehyde-tubulin
      adducts.
AB  - We have shown previously that acetaldehyde forms stable covalent adducts with
      tubulin, resulting in impaired microtubule formation. The present study explored
      the mechanism responsible for impaired microtubule formation caused by the
      substoichiometric stable binding of acetaldehyde to tubulin. The free tubulin
      dimer was much more reactive with acetaldehyde than microtubules, binding more
      than twice as much aldehyde. The dimer also formed nearly twice as many stable
      adducts on its alpha-chain as on its beta-chain, whereas microtubules exhibited
      an equal distribution of adducts between the two subunits. These data confirm
      that the alpha-chain of free tubulin, but not microtubules, has an accessible
      highly reactive lysine (HRL) residue that is a preferential target of
      acetaldehyde binding. Adduct formation with the HRL residue also correlated with
      impaired tubulin polymerization, and only 0.08 moles of acetaldehyde bound per
      mole of HRL was required for complete inhibition; however, adducts with other
      lysine residues (bulk adducts) did not affect assembly. Adducts to microtubule
      associated proteins (MAPs) also impaired the assembly of tubulin, but were much
      less effective than HRL adducts. In a copolymerization assay, HRL-adducted
      tubulin, in addition to being itself assembly incompetent, also interfered with
      polymerization of normal (unadducted) tubulin. Bulk adducts did not alter
      assembly and were incorporated normally into the growing polymer. When tubulin
      was cleaved by the proteolytic enzyme, subtilisin, microtubule formation could
      readily take place in the absence of MAPs. In this polymerization system, HRL
      adducts, but not bulk adducts, still markedly inhibited assembly. When low
      concentrations of acetaldehyde (50 microM) were used to generate HRL adducts, an
      adduct on only 1 out of 20 tubulin molecules was sufficient to totally block
      polymerization. These findings indicate that substoichiometric amounts of
      acetaldehyde bound to HRL of tubulin can markedly inhibit microtubule formation
      via direct interference of dimer-dimer interactions, and further suggest that low
      concentrations of acetaldehyde could generate sufficient amounts of HRL adducts
      in cellular systems to alter microtubule formation and function.

PMID- 1632841
TI  - Ethanol metabolism in rat brain homogenates by a catalase-H2O2 system.
AB  - Homogenates of perfused rat brains incubated in the presence of ethanol (50-100
      mM) and glucose (10 mM) were found to oxidize ethanol to acetaldehyde. The
      addition of glucose oxidase, a known hydrogen peroxide generator, to the
      incubation medium, significantly (P less than 0.05) increased the generation of
      acetaldehyde. The presence in the incubation medium of metyrapone, an inhibitor
      of cytochrome P450, or pyrazole, an alcohol dehydrogenase inhibitor, did not
      affect the levels of acetaldehyde obtained. Conversely, the presence of 3-amino
      1,2,4-triazole, a known catalase inhibitor, induced a concentration-dependent
      reduction of the amount of acetaldehyde generated after incubation, even in the
      presence of glucose oxidase. Homogenates of perfused brains of rats treated with
      3-amino-1,2,4-triazole or cyanamide (another H2O2-dependent catalase blocker)
      also showed a dose-dependent reduction of the acetaldehyde obtained. These
      findings support the notion that a catalase-mediated oxidation of ethanol is
      present in rat brain homogenates. It is suggested that this local oxidation of
      ethanol may have important biological implications. The data of both studies
      increase support for the notion that acetaldehyde is produced directly in the
      brain and that it may be the agent mediating some of the psychopharmacological
      properties of ethanol and be one of the factors determining the propensity of an
      animal to voluntarily consume ethanol.

PMID- 1632842
TI  - Metabolism of 5-fluoro-dopa and 6-fluoro-dopa enantiomers in aggregating cell
      cultures of fetal rat brain.
AB  - The cerebral metabolism of enantiomers of 5-fluoro-DOPA (5F-DOPA) and 6-fluoro
      DOPA (6F-DOPA) was characterized in organotypic cell cultures of fetal rat brain.
      This system permits the investigation of metabolic processes in brain tissue
      exclusively, without the effects of peripheral metabolism and transport.
      Metabolic profiles for each substrate were determined in comparison with those of
      L-DOPA and D-DOPA. The uptake of DOPA and fluoro-DOPA in aggregating brain cell
      cultures is strongly preferential for L-enantiomers. Decarboxylation by aromatic
      L-amino acid decarboxylase is an active step: the major products are dopamine
      (DA) or 6F-DA and their corresponding products of oxidative deamination, i.e.
      dihydroxyphenylacetic acid (DOPAC) or 6F-DOPAC, respectively. Decarboxylation
      products of D-enantiomers occur in lower amounts, and 5F-D-DOPA is not
      decarboxylated. However, 5F-DOPA is O-methylated to a great extent, and levels of
      3-O-methyl-5F-DOPA are higher after incubation with 5F-D-DOPA than with 5F-L
      DOPA. These data may serve as a support for more detailed modeling of [18F]F-DOPA
      metabolism than can be applied to the evaluation of the cerebral biochemistry of
      the DA system with positron emission tomography in vivo.

PMID- 1632843
TI  - Carotid stenosis is a powerful predictor of a positive exercise electrocardiogram
      in a large hyperlipidemic population.
AB  - Hypercholesterolemia is a major risk factor in coronary heart disease (CHD) and
      ischemic stroke. However, there is no general agreement on the usefulness of
      systematic screening of patients with hyperlipidemia by stress exercise
      electrocardiogram (ECG). The feasibility of this approach would depend on
      selecting patients with a high risk of CHD, since the sensitivity and specificity
      of the test depends on the prevalence of the disease. In view of the association
      of CHD and ischemic stroke, we undertook a study to determine whether the
      presence of atherosclerosis in the carotid arteries was predictive of a positive
      exercise ECG in a group of 778 asymptomatic patients referred to their
      hyperlipidemia. We a much higher percentage of positive exercise ECG in patients
      with carotid atherosclerosis in our ultrasonographic examinations. In a multiple
      regression analysis which included 13 parameters (age, sex, body mass index,
      arterial blood pressure, lipid parameters, serum level of glucose, smoking status
      and the severity of carotid lesions), the strongest predictors of a positive
      exercise ECG test were age (P = 0.014) and the degree of carotid atherosclerosis
      (P = 0.010). We therefore conclude that hyperlipidemic patients with
      atherosclerotic lesions on carotid arteries would benefit most from screening by
      the exercise ECG.

PMID- 1632844
TI  - U-73482: a novel ACAT inhibitor that elevates HDL-cholesterol, lowers plasma
      triglyceride and facilitates hepatic cholesterol mobilization in the rat.
AB  - U-73482, a novel acylCoA:cholesterol acyltransferase (ACAT) inhibitor with
      systemic activity, has been evaluated for its effects on a variety of lipid
      metabolic parameters in the rat. The compound inhibits ACAT in vitro in cultured
      Fu5AH rat hepatoma cells and demonstrates systemic activity through inhibition of
      hepatic ACAT in rats receiving the drug orally. U-73482 also lowers plasma
      triglycerides at 40 mg/kg per day in the rat and elevates high density
      lipoprotein cholesterol (HDL-chol) in a dose-related fashion over the range of
      daily intakes of 0-40 mg/kg in the rat. Elevations in HDL-chol are followed by
      elevations in total plasma cholesterol in normal rats but the compound exerts
      hypocholesterolemic activity in cholesterol-fed rats and promotes clearance of
      stored hepatic sterol in rats pretreated with a hypercholesterolemic diet and
      then changed over to normal chow. The triglyceride-lowering and HDL-chol
      elevating effects of U-73482 coupled with its ability to promote tissue sterol
      clearance and block the hypercholesterolemic effects of dietary cholesterol in
      animals, suggests that the compound has potential as a therapeutic agent for
      treatment of lipid disorders in man.

PMID- 1632845
TI  - Probucol and atherosclerosis in the Watanabe heritable hyperlipidemic rabbit-
      long-term antiatherogenic effect and effects on established plaques.
AB  - We performed two studies to investigate the effect of probucol on atherogenesis
      in vivo in the Watanabe heritable hyperlipidemic (WHHL) rabbit. In the first
      study (Study A), probucol was administered to 2-month-old WHHL rabbits, to
      evaluate its long-term effect. When killed at about 1.5 years of age, the
      percentage area of aorta covered with atherosclerotic plaque in probucol-treated
      rabbits was markedly less than that seen in non-treated rabbits (23.0 +/- 11.4%
      vs. 87.7 +/- 8.1%, M +/- S.D., P less than 0.001). In the second study (study B),
      administration of probucol was commenced with 8-month-old WHHL rabbits to
      investigate whether the drug was effective for limiting atherosclerosis in
      rabbits in which plaques had already developed. When killed after 6 months of
      treatment, the percentage area of aorta covered with plaque was 38.1 +/- 12.1% in
      treated rabbits and 82.7 +/- 22.6% in non-treated rabbits (P less than 0.02).
      Microscopic observations of lesions also supported the effect of probucol.
      Probucol treatment resulted in a change not only in the size but also the
      composition of lesions. Thus, probucol was effective in preventing
      atherosclerosis in long-term studies at both early and late stages.

PMID- 1632846
TI  - A prospective study of obesity, lipids, apolipoproteins and ischaemic heart
      disease in women.
AB  - The aim of the study was to examine the relationships of obesity, lipids and
      apolipoproteins with the risk for subsequent ischaemic heart disease in middle
      aged women, using a case-control study nested within a cohort study. A total of
      3634 women aged 26-88 were recruited in Guernsey between 1977 and 1985 and
      followed until June 1986 by abstraction of their general practitioners' records.
      Fifty-one cases of incident ischaemic heart disease (11 myocardial infarction, 40
      angina) were identified. For each case up to 4 controls were selected, matched
      for age and date at recruitment. Odds ratios for the development of ischaemic
      heart disease in the middle and upper thirds of the distribution for each
      variable in the controls, relative to the lowest third (and two-sided P-values
      for linear trends), were: 3.0, 2.6 (0.015) for Quetelet's index; 3.3, 5.1 (0.003)
      for total cholesterol; 0.5, 0.6 (0.102) for apolipoprotein A-I; 1.8, 2.4 (0.015)
      for apolipoprotein B; 1.3, 2.1 (0.155) for apolipoprotein(a). The increased risks
      associated with increased Quetelet's index and total cholesterol were independent
      of each other and these variables were more strongly related to myocardial
      infarction than to angina. The relationships of risk with serum cotinine, fatty
      acids, dehydroepiandrosterone sulphate and sex hormone binding globulin were weak
      and did not approach statistical significance.

PMID- 1632847
TI  - The oxidative modification of low density lipoprotein by human lymphocytes.
AB  - Oxidation of low density lipoprotein in atherosclerotic lesions may be involved
      in converting macrophages into lipid-laden foam cells. Lesions contain
      endothelial cells, smooth muscle cells, macrophages and lymphocytes. The first
      three types of cells have been shown previously to modify low density lipoprotein
      so as to increase its uptake by macrophages. We report here that lymphocytes from
      human blood are also capable of doing this. The modification process was an
      oxidative one because there was an increase in the thiobarbituric acid-reactive
      substances in media containing lymphocyte-modified low density lipoprotein and
      the modification could be inhibited by the antioxidants butylated hydroxytoluene
      and probucol. The lymphocyte-modified low density lipoprotein was taken up and
      degraded by macrophages by their scavenger receptor(s).

PMID- 1632848
TI  - Non-macrophage-related accumulation of cholesterol during probucol treatment in
      familial hypercholesterolemia: report of two cases.
AB  - Two patients receiving long-term (3-4 years) treatment with probucol for familial
      hypercholesterolemia (FH) developed diffuse yellow lesions over the upper eyelids
      suggesting lipid storage in those tissues (diffuse lipid-storage lesions).
      Interestingly, each patient had shown a substantial reduction in their
      cholesterol levels together with a marked regression of their tendon xanthomas or
      typical xanthelasmas during treatment. To evaluate the role of probucol in this
      unusual finding we conducted histological and immunochemical evaluations of the
      lesions (removed surgically) and compared them with those of a non-probucol
      treated subject with FH and typical audinal xanthelasma. In both probucol-treated
      patients the lesions were filled with foam cells and contained large amounts of
      cholesteryl ester. However, immunochemical analysis of the lesions of one patient
      using anti-monocyte monoclonal antibody (HAM56) demonstrated that they were not
      composed of macrophage-derived foam cells in contrast to those of the non
      probucol-treated subject which stained clearly with anti-monocyte monoclonal
      antibody. In each case the foam cells did not react with muscle-actin-specific
      monoclonal antibody (HHF35). It appears that non-macrophage-related diffuse lipid
      storage lesions may occur even during treatment with probucol despite the
      reduction in cholesterol levels and the regression of xanthomas, suggesting that
      probucol may alter the distribution of cholesterol from the macrophage to other
      cells.

PMID- 1632849
TI  - Interleukin 6 gene transcripts are expressed in atherosclerotic lesions of
      genetically hyperlipidemic rabbits.
AB  - We have investigated the involvement of interleukin 6 (IL-6), a growth-regulatory
      molecule for vascular smooth muscle cells (SMC), in the development of
      atherosclerotic lesions of Watanabe heritable hyperlipidemic (WHHL) rabbits. In
      in situ hybridization analysis, quite low levels of IL-6 mRNA were expressed in
      'quiescent' SMC cultured from WHHL rabbits; however, high levels of IL-6 mRNA
      were induced in SMC exposed to 10% fetal bovine serum (FBS), suggesting that
      growth-stimulated SMC themselves can synthesize IL-6. In in vivo WHHL aortae,
      transcripts for the IL-6 gene were clearly observed in the fibrous plaques. These
      findings support the premise that IL-6 is an important autocrine and/or paracrine
      regulator of SMC proliferation and of pathogenesis of atherosclerosis in this
      animal model.

PMID- 1632850
TI  - Acid cholesteryl ester hydrolase activity of mononuclear leukocytes in patients
      with non-insulin-dependent diabetes mellitus: studies before and after treatment
      of diabetes.
AB  - The change of acid cholesteryl ester hydrolase activity in mononuclear leukocyte
      following treatment of diabetes mellitus was studied in 21 patients with non
      insulin-dependent diabetes mellitus (NIDDM). Enzyme activity before treatment in
      the patients was significantly lower than that in 14 age-matched healthy subjects
      (1.20 +/- 0.15; mean +/- S.E. vs. 2.20 +/- 0.17 nmol/mg protein/h, P less than
      0.01). Enzyme activity before treatment in the patients was significantly
      increased (P less than 0.05) after 4-8 weeks of treatment. However, enzyme
      activity of 1.43 +/- 0.14 nmol/mg protein/h observed after treatment in the
      patients was significantly lower (P less than 0.01) than that in the healthy
      subjects. There was a significant negative correlation between enzyme activity
      before treatment and the increase in enzyme activity following treatment (rs = 
      0.555, P less than 0.01, n = 21). These results indicate that low level of enzyme
      activity may be insufficiently improved by the treatment of diabetes, and the
      risk for the development of atherosclerosis as viewed from the enzyme activity
      may persist even after the treatment in NIDDM.

PMID- 1632851
TI  - Familial defective apolipoprotein B100: clinical characteristics of 54 cases.
AB  - Familial defective apolipoprotein B100 (FDB) is a recently identified dominantly
      inherited genetic disorder, which is characterized by a decreased affinity of low
      density lipoprotein (LDL) for the LDL receptor. 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. To
      determine the consequences of the arginine(3500)----glutamine mutation on plasma
      lipid levels and other clinical features, we have investigated 54 FDB
      heterozygotes from Germany (24 men, 30 women, mean age 37.2 (4-73) years). The
      average total cholesterol level in plasma was 308 mg/dl (average LDL-cholesterol
      242 mg/dl), which was 116 mg/dl (120 mg/dl) above the 50th percentile of the age
      and sex-matched controls reported in the LRC population studies (Lipid Research
      Clinics' Program 1980). Tendon xanthoma and arcus lipoides were present in 25.9%
      and 22.2% of the patients, respectively. Plaques in the carotid arteries,
      determined by duplex scanning, were present in 38.9%, and coronary artery disease
      was present in 22.2%. This study shows that the combination of tendon xanthoma,
      arcus lipoides and premature atherosclerosis is no longer totally appropriate for
      the diagnosis of familial hypercholesterolemia (FH). It rather seems that these
      features are characteristic of a defective LDL receptor pathway, which could be
      caused by a defective LDL receptor or a defective ligand apo B100. The
      distinction between FH and FDB may have therapeutic implications, because certain
      lipid lowering drugs act by stimulation of the LDL receptor, which has a normal
      function in FDB.

PMID- 1632852
TI  - Effect of long-term insulin deficiency and insulin treatment on the composition
      of triglyceride-rich lipoproteins and triglyceride turnover in rats.
AB  - The effect of long-term (4 months) insulin deficiency on triglyceride turnover
      was examined using Triton WR1339 in rats. Triglyceride secretion rate was
      estimated in rats 2 weeks and 4 months after induction of diabetes with 40 mg/kg
      of streptozotocin. By the second week diabetic rats showed prominent
      hyperglycemia and the plasma insulin level was very low. In spite of a lower
      triglyceride secretion rate compared to non-diabetic control rats, diabetic rats
      showed normotriglyceridemia. Thus, the estimated fractional catabolic rate for
      plasma triglyceride was decreased in the diabetic rats of 2 weeks duration. By
      the fourth month diabetic rats still showed a suppressed triglyceride secretion
      rate but plasma triglyceride was markedly higher than in the non-diabetic control
      rats. Therefore, their estimated fractional catabolic rate for plasma
      triglyceride was severely suppressed. They also showed hyperglycemia and
      hypercholesterolemia. The triglyceride-rich lipoprotein particles obtained after
      Triton injection in long-term diabetic rats were significantly cholesterol
      enriched and triglyceride-depleted compared to control rats. These changes were
      already present in 2-week diabetic rats but the magnitude was significantly
      smaller that those in long-term diabetic rats. All of these abnormalities
      (including triglyceride turnover and the particle composition) were almost
      normalized by 2 weeks of insulin treatment (6 units/day). Thus, it was concluded
      from the present data that duration of insulin deficiency is an important
      determinant of triglyceride removal rate from the circulation in rats. Further
      modification of lipid composition of triglyceride-rich lipoprotein particles by
      long-term insulin-deficiency could be one of the reasons for this removal
      defect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632853
TI  - Cellular damage in mouse peritoneal macrophages exposed to cholesteryl linoleate.
AB  - Mouse peritoneal macrophages readily oxidize cholesteryl linoleate/bovine serum
      albumin emulsions to produce soluble lipid oxidation products, some of the latter
      being thought to cause cell damage. Mouse peritoneal macrophages were therefore
      incubated in the presence of cholesteryl linoleate/bovine serum albumin emulsion
      with and without the addition of dl-alpha tocopherol. The macrophages were
      observed morphologically and cell damage was estimated by three methods: trypan
      blue exclusion, lactate dehydrogenase release and tritiated adenine release. All
      the methods showed significant cell damage which was reduced in the presence of
      physiological levels of dl-alpha tocopherol. Cholesteryl oleate/bovine serum
      albumin, which is taken up by macrophages but is not oxidized, was not toxic. dl
      Alpha tocopherol was itself toxic in higher concentrations. This self-inflicted
      macrophage damage might explain the onset of necrosis in atherosclerotic plaques.

PMID- 1632854
TI  - Low serum cholesterol, cancer and other noncardiovascular disorders.
AB  - There has been much concern and discussion whether reduction of serum cholesterol
      by diet or drugs, while preventing coronary heart disease, might cause an
      increase in the risk of dying from noncardiovascular disorders, in particular
      cancer. A review of the evidence from ecological, cross-cultural comparisons,
      prospective epidemiological cohort studies and intervention trials provides no
      indication for a cause-and-effect association between low serum cholesterol or
      serum cholesterol lowering and the risk of cancer, except possibly at very low
      levels. An inverse relationship between noncardiovascular-noncancer mortality and
      serum cholesterol level does exist but the link is unlikely to be causal; for
      better understanding, there is a need for studying the biological, lifestyle and
      social correlates of this association. Continuing observations should pay
      attention to the accuracy of information on specific causes of noncardiovascular
      deaths, especially mortality not due to disease. Further research needs to
      include investigations into the determinants of low serum cholesterol levels and
      their possible influence on biological functions. It is concluded that the
      current recommendations for coronary heart disease prevention, aimed at lowering
      elevated serum cholesterol levels in individuals (the 'high-risk strategy') and
      in populations at high risk (the 'population strategy') require no basic
      modification in the light of present knowledge on the relationships between
      cholesterol and noncardiovascular disease mortality.

PMID- 1632855
TI  - Atherogenic effects in a non-human primate of Fusarium moniliforme cultures added
      to a carbohydrate diet.
AB  - Adding less than 0.5% w/w of culture material of strain MRC 826 of the fungus
      Fusarium moniliforme to a carbohydrate diet low in fat resulted in an atherogenic
      plasma lipid profile in a non-human primate. Simultaneously increased plasma
      fibrinogen and activity of blood coagulation factor VII could enhance
      atherogenesis. This unique potential for promotion of atherosclerosis was
      probably secondary to chronic hepatotoxicity as indicated by liver fibrosis and
      elevated cholesterol, albumin and the enzymes AST, ALT, LD, GGT and ALP in serum.
      The cholesterol and enzymes responded in proportion to the calculated doses of
      fumonisin mycotoxins in the F. moniliforme MRC 826 cultures. Fumonisins are water
      soluble and heat stable. Thrombotic, hepatotoxic, carcinogenic and cerebral
      effects of MRC 826 culture material and fumonisins are well known in non
      primates. The estimated fumonisin concentrations tested fall within a range due
      to natural contamination of human foods. The results suggest that all maize grain
      products should be analysed for fumonisins.

PMID- 1632856
TI  - Comparative studies on acid cholesterol esterase in renal blood vessels and aorta
      of control and hypercholesterolemic rabbits.
AB  - Decreased acid cholesterol esterase has been linked to cholesteryl ester
      accumulation and may be fundamental in the development of atherosclerosis. The
      present study compared cholesterol esterase activity with the accumulation of
      cholesterol and its esters in aorta, renal artery and renal preglomerular
      microvessels. Tissue was obtained from white New Zealand rabbits fed either a
      control or 2%-cholesterol diet for 1 month. Cholesterol esterase was increased in
      microvessels from cholesterol-fed animals when compared to aorta and renal
      artery. Cholesterol feeding generally produced an increase in cholesterol and
      cholesteryl ester accumulation in all vascular tissues. The percent distribution
      of esterified/total cholesterol in renal microvessels was decreased consistent
      with the concomitant increase in cholesterol esterase. In contrast, aorta and
      renal artery exhibited an increase in cholesterol and cholesteryl ester
      accumulation and an increase in the percent of esterified cholesterol consistent
      with a decrease in acid cholesterol esterase after cholesterol feeding. The data
      suggest that renal microvessels, when compared to aorta and renal artery, may be
      relatively protected from developing atherosclerotic microvascular lesions
      through an organ-specific increase in acid cholesterol esterase activity.

PMID- 1632857
TI  - The effect of EDTA on the oxidation of low density lipoprotein.
AB  - Low density lipoprotein (LDL) is routinely isolated and stored in buffers
      containing ethylene-diaminetetra-acetic acid (EDTA) to inhibit its autoxidation.
      We have investigated the effect of EDTA on LDL oxidation by both copper ions and
      macrophages. LDL oxidation by macrophages in Ham's F-10 medium containing 6
      microM iron showed a large and concentration-dependent increase when EDTA was
      added up to about 10 microM. EDTA concentrations above about 10 microM
      progressively inhibited LDL oxidation as measured by macrophage degradation,
      thiobarbituric acid-reactive substances and electrophoretic mobility. The
      oxidation of LDL by 1 microM copper in Ham's F-10 medium, measured by macrophage
      degradation, also showed a large increase with low concentrations of EDTA (1-3
      microM), with higher concentrations (10 microM or above) strongly inhibiting the
      oxidation. In a simple phosphate buffer, however, EDTA simply inhibited the
      oxidation of LDL by copper with equimolar amounts of EDTA to copper giving a
      complete inhibition. The results of this study indicate that when LDL oxidation
      by cells or by copper in Ham's F-10 medium is investigated, more oxidation may be
      obtained if the EDTA is not previously removed from the LDL preparation.

PMID- 1632858
TI  - Genetic and environmental determinants of factor VII coagulant activity in ethnic
      groups at differing risk of coronary heart disease.
AB  - It has been shown previously that individuals possessing the Gln353 allele of
      factor VII have significantly lower factor VIIc levels. In this population based
      study of Europeans, Afro-Caribbeans and Gujarati Indians, the Gln353 allele was
      associated with lower factor VIIc in all groups, carriers having factor VIIc
      levels 20-25% below the group mean. Although the Afro-Caribbeans had the lowest
      factor VIIc levels, the frequency of the Gln353 allele was not different from the
      European sample. However, in the Gujaratis, the frequency of the Gln353 allele
      was significantly higher than in the Europeans (0.25 compared to 0.09, P less
      than 0.001). Factor VIIc is known to be positively correlated with plasma
      triglyceride levels, although the Gujaratis, having the highest mean triglyceride
      levels, did not have the highest mean factor VIIc levels. On examination of the
      relationship between triglycerides and factor VIIc in the Gujaratis there was a
      correlation (r = 0.23, P = 0.13) in individuals homozygous for the factor VII
      Arg353 allele, but no correlation (r = 0.001, P = 0.5) among Gln353 carriers.
      This striking difference suggests that the effect of triglycerides on factor VIIc
      is genotype specific and thus provides an example of gene-environment
      interaction. The high frequency of the Gln353 allele, with its associated lack of
      relationship between triglyceride and factor VIIc levels, may explain the lower
      than expected factor VIIc levels in the Gujaratis.

PMID- 1632859
TI  - The effect of probucol on HDL-mediated sterol translocation and efflux from
      cells.
AB  - It has been suggested that the antioxidant drug probucol can prevent arterial
      cholesterol accumulation in part by promoting HDL-mediated cholesterol removal
      from cells. In this study, the effect of probucol in vitro on the interaction of
      HDL3 with cultured skin fibroblasts, bovine aortic endothelial cells and human
      monocyte-derived macrophages was tested. Treatment of cholesterol-loaded cells
      with up to 20 microM probucol had no effect on [3H]cholesterol efflux from plasma
      membranes. No effect of probucol on HDL3-mediated efflux of labeled sterol was
      seen after intracellular sterol was labeled either with the biosynthetic
      precursor [3H]mevalonolactone or after incubation with lipoprotein-associated
      [3H]cholesterol linoleate. Further, no effect of probucol on cell cholesterol
      mass efflux was observed. Thus these results demonstrate that probucol does not
      affect movement of sterol from different cellular radiolabeled sterol pools.
      Within the limitations of cell culture studies, it is suggested that the proposed
      antiatherogenic effect of probucol in vivo is not likely to be the result of
      modulation of major cellular pathways for removal of cholesterol.

PMID- 1632860
TI  - Glucose tolerance, plasma insulin, HDL cholesterol and obesity: 12-year follow-up
      and development of coronary heart disease in Edinburgh men.
AB  - The insulin response to a standard oral glucose tolerance test (OGTT) and other
      anthropometric and biochemical risk factors for coronary heart disease (CHD) were
      measured in a random sample of 107 Edinburgh men, who were initially studied in
      1976 when they were 40 and who were reexamined in 1988-89. Fasting glucose and
      glucose response to OGTT were higher in 1988-89 than in 1976. In contrast,
      insulin levels did not differ between the initial and follow-up study either
      before or after the glucose load. Body mass indices increased, except triceps
      skinfold. Changing patterns in both fasting and OGTT insulin or glucose levels in
      individuals were related to changes in bodyweight or in subscapular skinfolds.
      Modifications in serum total and HDL cholesterol were related to changes in
      fasting insulin and insulin area, respectively, but not to glucose data. Eleven
      men developed clinical CHD. Neither glucose nor insulin measures obtained in 1976
      differed between those with and without CHD. Weight-height index and abdominal
      skin-folds were higher in those with CHD. HDL cholesterol was significantly lower
      (P less than 0.05). Abdominal skin-fold but not body mass index remained
      significant when adjusted for HDL cholesterol. This small study confirms the
      importance of central obesity and low HDL cholesterol but failed to identify
      insulin as a risk factor for CHD in this Scottish population.

PMID- 1632861
TI  - Inhibition of cholesterol synthesis in vitro by extracts and isolated compounds
      prepared from garlic and wild garlic.
AB  - Using a modified liver homogenate model to assay for the inhibition of
      cholesterol biosynthesis, different garlic and wild garlic extracts as well as
      pure compounds isolated from them were investigated for their influence on
      cholesterol synthesis. Chloroform and acetone/chloroform extracts of garlic and
      wild garlic inhibited cholesterol synthesis 44-52% at a concentration of 166
      micrograms/ml, while the 5 individual sulfur-containing compounds ajoene,
      methylajoene, allicin, 2-vinyl-4H-1,3-dithiin and diallydisulfide inhibited
      cholesterol synthesis by 37-72% (10(-3) M corresponding to 234, 208, 162, 144,
      146 micrograms/ml, respectively). Ajoene, 2-vinyl-4H-1,3-dithiin and allicin show
      IC50 values of 6.4, 7.2 and 9.4 x 10(-4) M, respectively. The results demonstrate
      that garlic and wild garlic may reduce serum cholesterol levels primarily by
      inhibiting cholesterol synthesis if taken in sufficient amount and that this
      effect arises from a mixture of multiple compounds from the sulfur-containing
      class of thiosulfinates, ajoenes and dithiines. Wild garlic extracts showed
      nearly identical efficiency to garlic extracts.

PMID- 1632862
TI  - Neopterin levels in patients with coronary artery disease.

PMID- 1632863
TI  - Endothelial cell damage and homocysteine.

PMID- 1632864
TI  - Human serum gangliosides in hypercholesterolemia, before and after extracorporeal
      elimination of LDL.
AB  - Total content, pattern and transport by lipoproteins of gangliosides have been
      studied in the sera of 10 patients with hypercholesterolemia and manifest
      cardiovascular disease. Half of the patients with hypercholesterolemia and 3
      healthy controls were treated with heparin-induced extracorporeal LDL
      precipitation (HELP). In the sera of the untreated group total gangliosides and
      cholesterol were elevated about 2-fold. Ratios of normal ganglioside components
      were not altered and abnormal ganglioside species not detected. Treatment with
      HELP resulted in an almost selective removal of lipid-bound sialic acid carried
      on LDL. The re-increase of total serum gangliosides was strictly correlated to
      that of LDL-cholesterol and apolipoprotein B. Total gangliosides and ratios of
      individual components carried on single LDL- and HDL-particles were not altered
      by the HELP treatment. Our results indicate that gangliosides are excreted into
      the serum along with nascent apolipoprotein B-containing lipoproteins, which are
      of hepatic origin. In hypercholesterolemia excretion of gangliosides into the
      circulation is elevated and surplus of circulating gangliosides is bound to
      increased numbers of 'atherogenic' LDL. Biosynthesis of different ganglioside
      components, most probably by the liver, and total amount of gangliosides bound to
      lipoprotein particles seem not to be altered.

PMID- 1632865
TI  - Metabolic effects of dietary stearic acid in mice: changes in the fatty acid
      composition of triglycerides and phospholipids in various tissues.
AB  - The fatty acid patterns of triglycerides and phospholipids extracted from adipose
      tissue, liver, heart, kidney, spleen, and lung of 3 groups of C57BL/6 mice were
      determined after feeding diets rich in palmitic acid (16:0) (high palmitic: 16:0
      = 45.1% of total fatty acids), stearic acid (18:0) (high stearic: 18:0 = 42.9% of
      total fatty acids) and oleic acid (18:1) (high oleic: 18:1 = 79.7% of total fatty
      acids) for 9 months. Triglyceride content of adipose, liver, heart, kidney, lung
      and spleen tissues was significantly enriched in palmitic acid in mice fed the
      high palmitic diet (range among all tissues: 19.9% +/- 0.2% to 29.0% +/- 1.9% of
      total fatty acids) and in oleic acid in mice fed the high oleic diet (range 56.0%
      +/- 1.9% to 71.6% +/- 1.2%). The stearic acid content of organ triglycerides in
      mice fed the high stearic diet ranged from 3.7% +/- 0.3% to 10.8% +/- 1.2%;
      however, the content of oleic acid on this diet (range: 57.0% +/- 1.8% to 71.4%
      +/- 1.7%) was similar to the one observed in mice fed the high oleic diet. In all
      organs, phospholipids had a significantly higher percentage of stearic acid
      (range: 23.5% +/- 0.9% to 51.5% +/- 6.6%) than triglycerides, regardless of diet.
      To evaluate the production of oleate from stearate and palmitate, 2 groups of
      mice were fed the high palmitic and the high stearic diets for 1 week and then
      injected intravenously with [1-14C]palmitate and [1-14C]stearate and the amount
      of labelled oleate in liver triglycerides was measured.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1632866
TI  - Lipid levels in monocytes of patients with moderate hyperlipoproteinemia.
AB  - Recent studies suggest that circulating blood monocytes may serve as a lipid
      clearance system in early atherosclerotic lesions. To evaluate the influence of
      moderate hyperlipoproteinemia on monocyte lipid concentrations, we measured
      fasting serum and monocyte lipid levels in 7 healthy individuals, in 7 patients
      with primary hypercholesterolemia and in 17 patients with secondary dyslipidemia
      due to chronic renal failure; 10 of these patients were treated by hemodialysis
      (HD) and 7 patients by continuous ambulatory peritoneal dialysis (CAPD). The
      hypercholesterolemic patients had elevated serum levels of total cholesterol, LDL
      cholesterol and apolipoprotein (apo) B, but normal plasma triglycerides. Patients
      on dialysis had elevated serum levels of triglycerides, serum cholesterol (CAPD
      only) and VLDL- and LDL-cholesterol (CAPD only) and apo B (CAPD only), whereas
      HDL-cholesterol and apo A-I levels (HD only) were decreased. In monocytes, we
      measured the content of free cholesterol (FC), cholesteryl esters (CE) and
      triglycerides (TG). The normal mean intracellular concentrations of FC, CE and TG
      were 48.3, 1.7 and 2.4 micrograms/mg cell protein, respectively. All monocyte
      lipid levels were similar in patients and controls, with the exception of a
      decreased content of FC (30.8 micrograms/mg) in monocytes of HD patients. We
      conclude that moderate increases in serum lipoprotein lipid levels are not
      associated with lipid accumulation in monocytes.

PMID- 1632867
TI  - Heparin stimulates proteoglycan synthesis by vascular smooth muscle cells while
      suppressing cellular proliferation.
AB  - We studied the effect of heparin on proteoglycan synthesis by bovine aortic
      smooth muscle cells in culture. Confluent, growth-arrested cells were incubated
      with [35S]sulfate, [3H]glucosamine or [3]serine in the presence of 0-600
      micrograms/ml heparin. Metabolically labeled proteoglycans secreted into the
      culture medium and associated with the cell layer were analyzed. In cultures
      treated with heparin there was a dose-dependent increase in [35S]sulfate
      incorporation into secreted proteoglycans which reached a maximum (35% above
      controls) at 100 micrograms/ml heparin. At higher concentrations of heparin, the
      stimulatory activity declined and finally disappeared. Radioactivity in cell
      associated proteoglycans increased significantly (16% above controls) only in
      cultures treated with 100 micrograms/ml heparin. Heparin also produced similar
      increases in the incorporation of [3H]glucosamine and [3H]serine into secreted
      and cell-associated proteoglycans. While chondroitin sulfate, dermatan sulfate
      and heparan sulfate were elevated in the media, only chondroitin sulfate and
      heparan sulfate were increased in the cell layer. Heparin did not alter the
      degradation of proteoglycans. Heparin, while inhibiting the proliferation of
      subconfluent smooth muscle cells, also stimulated to a greater extent the
      incorporation of [35S]sulfate into proteoglycans. Other glycosaminoglycans, such
      as heparan sulfate, dermatan sulfate, heparin hexasaccharide and Sulodexide
      caused a significant but lesser stimulation of proteoglycan synthesis, while
      chondroitin sulfates and hyaluronic acid had no effect. Gel filtration
      chromatography of proteoglycans and their constituent glycosaminoglycans from
      heparin-treated and untreated cultures showed no differences in their molecular
      size. The results indicate that heparin can stimulate proteoglycan synthesis by
      vascular smooth muscle cells irrespective of their state of proliferation. This
      might have implications in vessel wall repair and arterial wall lipid deposition.

PMID- 1632869
TI  - Dietary vitamin E and the attenuation of early lesion development in modified
      Watanabe rabbits.
AB  - Modified Watanabe heritable hyperlipidemic rabbits (M-WHHL) were fed either
      standard rabbit diet or diet supplemented with 0.5% wt/wt of the lipophilic
      antioxidant vitamin E (d,l-alpha-tocopherol). Animals of 10-12 weeks of age were
      divided into two groups matched for distribution of serum cholesterol levels at
      the beginning of the 12 week study period. A significant hypocholesterolemic
      response to vitamin E feeding was observed throughout the study. Vitamin E
      supplementation increased serum vitamin E levels approximately fourfold and
      restricted ex-vivo copper mediated oxidative modification of low density
      lipoprotein (LDL) as quantitated by fluorescence at 430 nm. Post mortem
      examination of aortic tissue revealed a significant (32%) inhibition of surface
      area lesion involvement in the arch region as determined by image analysis. It is
      concluded that administration of vitamin E to M-WHHL rabbits brings about a
      significant hypocholesterolemic response, confers on LDL significant protection
      against oxidative modification and either or both contribute to the inhibition of
      early aortic lesion development.

PMID- 1632868
TI  - Hyperhomocyst(e)inemia, anti-estrogen antibodies and other risk factors for
      thrombosis in women on oral contraceptives.
AB  - Hyperhomocyst(e)inemia was shown to be associated with vascular occlusion in
      atherosclerotic patients. We have conducted a study to determine if
      hyperhomocyst(e)inemia was also related to the vascular events observed in women
      on oral contraceptives, presumably having little or no atherosclerosis. Two
      hundred women receiving oral contraceptives were included in the study: 100 were
      healthy controls and 100 had documented vascular occlusion. Determination of
      serum homocyst(e)ine and anti-estrogen antibody levels wore performed under blind
      conditions. They were evaluated in logistic regression models in which age and
      smoking were also included. Women with vascular occlusion had higher levels of
      homocyst(e)ine (P less than 0.001) and of anti-estrogen antibodies (P less than
      0.001) when compared to controls. They were also older (P less than 0.001) and
      more frequently smokers (P less than 0.05). The above mentioned variables were,
      in isolation, independent predictors of vascular occlusion. Moreover, a model
      assessing those variables and their interactions indicated that the levels of
      anti-estrogen antibodies and smoking increased the predictability in older women,
      as well as the levels of age-adjusted homocyst(e)ine. The study suggests that the
      above factors can identify women at risk and that determination of anti-estrogen
      antibodies and homocyst(e)ine levels may help to detect women predisposed to
      vascular occlusions when taking oral contraceptives.

PMID- 1632870
TI  - Adipose tissue fatty acids in Scottish men and women: results from the Scottish
      Heart Health Study.
AB  - The fatty acid composition of adipose tissue from 4114 men and women across 22
      districts of Scotland is described. A biopsy of subcutaneous adipose tissue was
      obtained from the upper arm using a skin biopsy punch. Overall the proportion of
      saturated fatty acids was lower in women and those of monounsaturated and
      polyunsaturated higher than in men. There were significant effects of age on
      adipose tissue fatty acid composition, particularly in women, where the
      proportion of saturated fatty acids decreased and that of monounsaturated fatty
      acids increased with advancing age. The fatty acid composition of adipose tissue
      varied among the districts studied. The district standardised mortality ratio for
      coronary heart disease was positively correlated with the district mean oleic
      acid value and inversely correlated with the district mean linoleic acid value.
      This paper supports the importance of adipose tissue fatty acids as indicators of
      risk factor status for coronary heart disease.

PMID- 1632871
TI  - Visceral fat accumulation measured by magnetic resonance imaging in relation to
      serum lipids in obese men and women.
AB  - In 91 apparently healthy obese subjects (45 premenopausal women and 46 men) the
      associations between specific fat depots and serum lipids were studied. Magnetic
      resonance imaging was used to quantify fat depots at abdominal and hip level. In
      women, an accumulation of visceral fat was associated with a less favourable
      lipid profile, even after adjustment for age and body fat percentage: higher
      triglycerides levels (P less than 0.001), lower levels of HDL-cholesterol (P less
      than 0.01) and a diminished HDL-cholesterol/LDL-cholesterol ratio (P less than
      0.01). In men, however, the significant inverse relationship between an abundance
      of visceral fat and the HDL-cholesterol/LDL-cholesterol ratio and the significant
      positive correlations with total-, LDL-cholesterol and triglycerides disappeared
      after adjustment for age and fat percentage. Within each sex, subcutaneous fat
      neither at abdominal level nor at hip level was significantly related to serum
      lipids. It is concluded that there are gender differences in the associations
      between visceral fat accumulation and serum lipids.

PMID- 1632872
TI  - Antioxidant status in relation to free radical production during stable and
      unstable anginal syndromes.
AB  - Lipid peroxidation and the antioxidant status were studied in male patients
      having stable angina (SA) and unstable angina (UA) pectoris and the results were
      compared with that of controls. Lipid peroxides (LPx) and conjugated dienes (CD)
      were found to be elevated in patients with both SA (LPx: 3.96 +/- 1.07, P less
      than 0.001; CD: 357.09 +/- 66.23, P less than 0.01) and UA (LPx: 4.66 +/- 1.33,
      CD: 373.33 +/- 49.82, P less than 0.001) than in controls (LPx: 3.22 +/- 0.86,
      CD: 335.15 +/- 60.27). In SA, the erythrocytes expressed a diminished activity of
      superoxide dismutase (SOD) (SA: 435.59 +/- 76.02, control: 651.69 +/- 145.90, P
      less than 0.001) and normal activities of catalase and glutathione peroxidase,
      whereas in UA it showed enhanced activities of both SOD (UA: 735.72 +/- 145.67, P
      less than 0.01) and catalase (UA: 21.94 +/- 6.26, control: 18.69 +/- 6.37, P less
      than 0.01). A significant increase was also noticed in the levels of
      ceruloplasmin and vitamin E during both types of angina, but not alteration was
      observed in the levels of transferrin. Further, the patients with diabetes showed
      maximum levels of lipid peroxides compared to smokers and hypertensives. The
      level of lipid peroxides was also observed to increase with the severity of
      disease. This study indicates that free radicals are involved in the pathogenesis
      and progression of atherosclerotic heart disease.

PMID- 1632873
TI  - Evaluation of elastic structural change in coronary atherosclerosis using
      scanning acoustic microscopy.
AB  - Coronary atherosclerotic lesions were observed by scanning acoustic microscopy
      (SAM), a technique which can visualize regions of differing elasticity. Three
      regions, i.e., dark (dR), intermediate (iR) and bright (bR) demonstrating
      differences in acoustic reflection intensity and the velocity of surface acoustic
      waves, were seen in the lesions. Furthermore, lipid-positive areas were found to
      be dR and iR and fatty crystalline areas were observed only in iR regions by
      polarizing microscope. These phase transitions of fat affected the acoustic
      properties in each region. According to SAM images, intimal structural changes
      were classified into three types, minimum structural change (type I), the
      overcrowded net-like dR structure (type II) and markedly disturbed structure with
      a decrease of dR (type III). The medial structure change was also classified into
      three types paralleling the decrease of dR (types M1, M2 and M3). Intimal type II
      with a large degree of thickening and intimal type III with medial type M3 were
      highly prominent in the acute myocardial infarction (AMI) group (P less than
      0.01). Therefore these results suggest that the anisotropic elasticity induced by
      micro-elastic changes in the arterial wall may be associated with functional
      disturbance of the vascular wall.

PMID- 1632874
TI  - Vascular contraction in perfused carotid arteries of cholesterol-fed rabbits.
AB  - The purpose of the present study was to investigate the effects of
      hypercholesterolemia on sympathetic vascular responsiveness in the perfused
      rabbit carotid artery. Two groups of rabbit carotid arteries were evaluated for
      the simultaneous measurement of noradrenaline (NA) release and vasoconstrictor
      response induced by electric nerve stimulation and for exogenous NA-induced
      vasoconstriction in vitro. One group of rabbits was fed a diet containing 0.5%
      cholesterol for 2 weeks and the other group was fed standard rabbit chow. By
      scanning electron microscopy, monocytes adhering to the endothelial cells and
      penetrating into the subendothelium were observed. Neither endothelial denudation
      nor platelet adhesion could be detected. Rabbit carotid arteries were cannulated
      and perfused with a physiological solution at a constant flow rate. The vessels
      were subjected to both transmural field stimulation (TFS; 1.5-24 Hz) and
      exogenous NA administration. TFS caused a frequency-dependent increase in
      endogenous NA release with subsequent pressor responses in both groups. Exogenous
      NA also induced a dose-dependent pressor response, but a significant reduction
      was observed in the cholesterol-fed group. Methoxamine induced a similar response
      in both groups. It was concluded that hypercholesterolemia decreased the
      sensitivity of extrajunctional alpha-receptors in the perfused rabbit carotid
      artery.

PMID- 1632875
TI  - Alcohol dose and low density lipoprotein heterogeneity in squirrel monkeys
      (Saimiri sciureus).
AB  - The present study was designed to determine whether normolipidemic male squirrel
      monkeys (Saimiri sciureus) exhibit low density lipoprotein (LDL) heterogeneity
      similar to that observed in humans and if present, whether LDL subfractions are
      altered by consumption of low vs. high dose ethanol (EtOH). Primates were divided
      into three groups designated control, low, and high EtOH and fed isocaloric
      liquid diets containing 0%, 12% and 24% of calories as EtOH, respectively, for 6
      months. The 12% EtOH caloric level resulted in a modest, non-significant increase
      in high density lipoprotein (HDL) cholesterol and no change in LDL cholesterol or
      plasma apolipoprotein B (apo B), while the 24% dose produced significant
      elevations in plasma, LDL and HDL cholesterol and apo B. Using a single-spin
      density gradient ultracentrifugation procedure developed for humans, three
      distinct LDL subclasses designated LDL1a (d = 1.031 g/ml), LDL1b (d = 1.038 g/ml)
      and LDL 2 (d = 1.046 g/ml) were isolated from all three treatment groups. Monkey
      LDL subfractions were nearly identical to very light, light and heavy LDL
      subspecies isolated from human plasma in terms of their: (1) isopycnic densities
      following ultracentrifugation; (2) co-migration as single bands with beta
      electrophoretic mobility in cellulose acetate and agarose electrophoretic gels;
      (3) size-dependent migration pattern in polyacrylamide gradient electrophoretic
      gels; (4) co-migration as a single band corresponding to apo B-100, following SDS
      polyacrylamide gel electrophoresis; and (5) decrease in total cholesterol/protein
      ratios with increasing LDL subclass density. Although there were no treatment
      differences in LDL particle size, within each treatment group, mean particle size
      for each LDL subfraction was significantly different from every other
      subfraction. Low (12%) dose alcohol had no effect on LDL subfraction mass
      relative to controls while high alcohol consumption resulted in marked increases
      in all lipid (except triglyceride) and protein of the larger, buoyant LDL
      subspecies (LDL1a and LDL1b). Moreover, the best correlation between plasma apo B
      and LDL subfraction total mass was demonstrated with LDL1b (r = 0.735). Since
      neither the lipid nor the protein concentration of the small, dense, purportedly
      more atherogenic, LDL2 changed with the 24% EtOH dose, we propose that the LDL
      subfraction alterations associated with high alcohol intake in squirrel monkeys
      (increased LDL1a, increased LDL1b, LDL2 no effect) may represent a compensatory
      response to modulate the overall atherogenic lipoprotein profile associated with
      elevations in total LDL cholesterol and plasma apolipoprotein B.

PMID- 1632876
TI  - The possible role of hemorheology in atherothrombogenesis.
AB  - Conventional risk factors predict only about 30-50% of incidental cases in
      cardiovascular diseases, which are still the leading cause of death in western
      societies. During the last decade, the importance of thrombosis as an essential
      mechanism in acute myocardial infarction (AMI) and stroke has been established.
      The introduction of thrombolysis has led to an impressive reduction in AMI case
      fatality and possibly also to a substantial amelioration of its prognosis.
      Evidence from experimental, clinical and epidemiological studies suggest, that
      several hemostatic and hemorheological factors (e.g., fibrinogen, Factor VII,
      plasma viscosity, hematocrit, red blood cell aggregation, total white cell count)
      might not only play an important role in the evolution of acute thrombotic
      events, but may also take part in the pathophysiology of atherosclerosis. An
      increasing number of studies reports altered hemostatic and hemorheological
      parameters to be associated with smoking, hyperlipoproteinemia, and high blood
      pressure, as well as with adverse dietary habits and other life-style factors. To
      date, their way of interaction with the atherosclerotic process is poorly
      understood. Hemorheological or hemostatic mechanisms that might promote
      thromboatherogenesis include the predisposition to thrombosis via a
      hypercoagulable state, the enhancement of atherosclerosis by fibrinogen and its
      metabolites, and finally the reduction of blood flow through various rheological
      effects (e.g., increase in plasma viscosity and red cell aggregation, or
      leukocyte activation). Future research should focus in more detail on the
      interrelationship between accepted risk factors and the hemostatic system as well
      as hemorheological parameters. Deeper insight into the mechanisms involved might
      lead to new preventive strategies as well as to therapeutic procedures in the
      management of atherosclerosis and associated thrombotic events.

PMID- 1632877
TI  - Learning and consciousness during general anesthesia.

PMID- 1632878
TI  - Retroviruses that express different ras mutants cause different types of tumors
      in chickens.
AB  - We have used replication-competent retroviral vectors to express avian and murine
      ras genes in cultured chick embryo fibroblasts (CEF) and in chickens. Since the
      viral vectors are identical, it is possible to compare the oncogenic potential of
      the ras genes directly. The normal (12 gly) form of chicken c-Ha-ras is not
      oncogenic in vivo, nor does high-level expression transform CEF. Expression of
      murine v-ras or modified forms of chicken c-Ha-ras with either lysine or
      glutamine at position 12 transforms CEF and causes tumors in birds. However, the
      oncogenic potential of the transforming ras genes is different; the viruses that
      express the genes with lysine and glutamine at position 12 cause a distinct
      spectrum of tumors.

PMID- 1632880
TI  - The molecular basis of CD46 polymorphic expression and demonstration of a
      protective role against lysis by xenosera.

PMID- 1632879
TI  - Expression of the CD46 antigen, and absence of class I MHC antigen, on the human
      oocyte and preimplantation blastocyst.
AB  - Expression of CD46 and class I major histocompatibility complex (MHC) antigens by
      human oocytes and 6-8-day unhatched expanded preimplantation blastocysts has been
      studied by immunocytochemistry. The CD46 antigen, a cell surface complement
      regulatory protein, was expressed by unfertilized oocytes as well as strongly by
      both the inner cell mass and trophectoderm of preimplantation blastocysts. In
      contrast, class I MHC antigens were not usually expressed by either oocytes or
      blastocysts. These data support the concept that gametes and embryonic cells
      involved in fertilization and early implantation events, respectively, may be
      protected from immunological recognition or attack both by the lack of class I
      MHC antigens and by expression of the CD46 complement regulatory protein.

PMID- 1632881
TI  - [Severe respiratory insufficiency as the first manifestation of AIDS].

PMID- 1632882
TI  - Chemical prospecting: hope for vanishing ecosystems?

PMID- 1632884
TI  - [Ethical and deontological problems in the use of electronic data processing in
      nursing].
AB  - This article deals with the ethical and moral dilemmas the nursing profession
      faces today in regards to issues related to the computer technology. Such ethical
      dilemmas in nursing have been documented in four major areas: (a) Safeguarding
      confidentiality, (b) determining the right to know and the right to decide, (c)
      allocating limited resources, and (d) maintaining professional standards.

PMID- 1632883
TI  - Transfer of DDT used in malaria control to infants via breast milk.
AB  - The transfer of p,p'-DDT (1,1,1-tricholoro-2,2-bis(4-chlorophenyl)ethane) and its
      metabolites to infants via breast-feeding was studied in an area of KwaZulu,
      South Africa, where DDT is used to interrupt malaria transmission. Samples of
      whole blood were collected from 23 infants, together with samples of breast milk
      from their respective mothers. The mean sigma DDT (total DDT) in the whole blood
      was 127.03 micrograms.l-1 and that in the breast milk, 15.06 mg.kg-1 (milk fat).
      The % DDT (% DDT of sigma DDT) was significantly higher in the infant blood than
      in the breast milk (P less than 0.05). A multiplicative regression analysis
      indicated that sigma DDT increased significantly (P less than 0.01) in infant
      whole blood with infant age. Multiple regression showed that 70.0% of the
      variation in sigma DDT was due to the variation in parity of the mother, age of
      the infant, and the sigma DDT in breast milk. These variables accounted also for
      76.3% of the variation in p,p'-DDE but only for 38.2% of that in p,p'-DDT.
      Organochlorines were therefore largely transferred to the infant from the mother,
      with DDT in the environment playing a secondary role.

PMID- 1632886
TI  - [Computer technology in nursing].

PMID- 1632885
TI  - [Autologous blood transfusion].
AB  - Homologous blood is not always available in adequate amounts and it has a number
      of undesirable effects for the patient. Autotransfusion prevents these problems.
      In this review, the criteria for patient selection, the technical procedures, the
      advantages and the potential risks are described.

PMID- 1632887
TI  - [Computers in nursing practice].

PMID- 1632888
TI  - [Development of health information systems as part of an integrated hospital
      information system].

PMID- 1632890
TI  - The search for genes for psychiatric illness.

PMID- 1632889
TI  - [Psychosocial problems in the aged--nursing interventions].
AB  - This article deals with age-related problems, due to social structure and several
      other factors. Loneliness, confusion, and dementia of the aged, when they co
      exist with acute disease, are often reversible. When they happen independently
      create serious psychosocial problems, and gradually become irreversible.
      Appropriate nursing interventions for the prevention, control and correction of
      these geriatric problems are described.

PMID- 1632891
TI  - A systematic search for a bipolar predisposing locus on chromosome 5.
AB  - Chromosome 5 markers spanning the pter to the qter were used to examine linkage
      to bipolar illness in 14 pedigrees. Twenty-four loci were examined in 237
      individuals, of whom 69 were either bipolars or schizoaffectives. Marker
      genotypes were determined for each individual and lod scores were calculated
      under a dominant disease model with a maximum penetrance of 85%, a disease gene
      frequency of 0.015, a variable age of onset, and a phenocopy rate of 0.001. Under
      the assumption that bipolar illness is genetically homogeneous, the total lod
      scores from all pedigrees with each marker were uniformly lower than -2.0,
      suggesting the absence of linkage to disease at any of these loci. Multipoint
      analysis allowed exclusion of intervals between markers. When lod scores were
      calculated allowing for heterogeneity, no subset of linked families was found.
      These results indicate that in our pedigree series almost the entire mapped
      region of chromosome 5 can be excluded for linkage to bipolar illness.

PMID- 1632892
TI  - Quantitative instrumental measurement of tardive dyskinesia: a review.
AB  - In this paper we review currently available quantitative instrumental techniques
      for the assessment of tardive dyskinesia (TD). We discuss the advantages and
      disadvantages of the use of accelerometers, electromyography, force gauges,
      position transducers, and Doppler ultrasound from both a diagnostic and a
      utilitarian perspective. Data obtained using these techniques appear to correlate
      significantly with patient scores on clinical rating scales. In some cases, the
      use of these techniques has facilitated the detection of subclinical dyskinesia
      and helped to differentiate TD from other movement disorders. We believe that a
      review of these qualitative techniques will be of interest to the clinician, as
      well as to investigators involved in studying TD.

PMID- 1632893
TI  - Applications of magnetic resonance spectroscopy to the investigation of
      neuropsychiatric disorders.
AB  - Magnetic resonance spectroscopy (MRS) can noninvasively characterize tissue
      composition and metabolism in vivo without the need for radioactive isotope
      administration. For the neuropsychiatrist interested in the functional basis of
      disease, MRS offers an investigative tool capable of studying a wide variety of
      neuropsychiatric disorders. This report provides an overview of how MRS works,
      current and potential clinical applications for specific psychiatric populations,
      and limitations of the technology.

PMID- 1632894
TI  - Phosphorylation of prolactin and growth hormone.
AB  - To determine whether GH and prolactin could be phosphorylated, turkey GH, chicken
      GH, chicken prolactin and turkey prolactin were incubated in vitro with the
      catalytic subunit of protein kinase A and [gamma-32P]ATP. Phosphorylation was
      assessed after sodium dodecyl sulphate-polyacrylamide gel electrophoresis,
      Western blotting and autoradiography. Polyacrylamide electrophoresis showed that
      both purified native chicken GH and turkey GH were phosphorylated under the
      conditions employed. However, the glycosylated variant of chicken GH did not
      appear to be labelled. Chicken prolactin, turkey prolactin and the glycosylated
      variant of turkey prolactin were all intensely phosphorylated by protein kinase
      A. Ovine and rat prolactins could also be phosphorylated by protein kinase A. The
      phosphate content of different native prolactin (turkey, ovine and rat) and GH
      (ovine and chicken) preparations was also determined and found to be significant.
      Chicken pituitary cells in primary culture incorporated 32P in GH- and prolactin
      like bands isolated by non-denaturing polyacrylamide gel electrophoresis, and
      this was stimulated by phorbol myristate acetate. Phosphorylation of GH and
      prolactin may thus explain some of the charge heterogeneity of these hormones.

PMID- 1632895
TI  - RNA-protein interactions in the 5' untranslated region of preproinsulin mRNA.
AB  - A comparison between species of the 5' untranslated region of preproinsulin mRNA
      revealed conserved sequences associated with a potential stem-loop structure. The
      present study was undertaken to determine whether specific protein interactions
      exist with mRNA sequences involved in the formation or stabilization of this
      structure in the 5' untranslated region. 32P-Labelled RNA probes corresponding to
      sequences from this region were synthesized by an in-vitro transcription reaction
      and used in electrophoretic mobility shift and u.v.-crosslinking studies with
      cytoplasmic protein extracts from a number of cell lines. Specific protein-RNA
      interactions were mapped to a sequence located between nucleotides -21 and -50
      upstream of the AUG start codon. A number of proteins of molecular mass 25 kDa,
      40kDa, 46kDa, 58kDa, 69kDa, 97kDa, 110kDa and 160kDa were specifically
      crosslinked to this sequence. The observed specific protein-RNA interactions in
      the 5' untranslated region may affect the activity of preproinsulin mRNA.

PMID- 1632896
TI  - Hormonal induction of malic enzyme in rat hepatocytes cultured on laminin-rich
      gels.
AB  - The levels of malic-enzyme mRNA and activity were determined in primary cultures
      of adult rat hepatocytes maintained on either rat-tail collagen or a laminin-rich
      substratum. Cells plated on laminin-rich gels exhibited substantially improved
      patterns of albumin and malic-enzyme expression when compared with cells
      maintained on rat-tail collagen. Moreover, hepatocytes plated on the laminin-rich
      matrix displayed marked malic-enzyme inducibility in response to tri
      iodothyronine and dichloroacetate, especially in the presence of insulin.
      However, Northern blot analysis revealed that the ratio of the amounts of the two
      major malic-enzyme mRNA species (2.0 and 3.1 kb) was reversed when compared with
      that found in the liver in vivo, the altered levels of these two species being
      closer to those found in non-hepatic tissues. These findings indicate that,
      although the hormonal responsiveness of isolated hepatocytes maintained on
      laminin-rich gels is markedly improved, and approaches the degree of induction
      demonstrated in the liver in vivo, the mechanisms of control differ, indicating a
      loss of liver-specific expression.

PMID- 1632897
TI  - Ovine follistatin: characterization of cDNA and expression in sheep ovary during
      the luteal phase of the oestrous cycle.
AB  - We have isolated ovine follistatin cDNA from an ovarian follicle cDNA library and
      determined its sequence. The deduced amino acid sequence of the ovine follistatin
      precursor is highly homologous (greater than 97%) to the porcine, human and rat
      follistatins. Northern analysis was used to characterize follistatin gene
      expression in ovaries of adult ewes, collected from days 11 to 13 of the oestrous
      cycle. Two major (about 2.7 kb and 1.5 kb) and one minor (about 0.5 kb)
      transcripts were detected in polyadenylated RNA extracted from ovarian follicles
      and corpora lutea. The degree of expression of the transcripts varied in the two
      ovarian compartments, with the 2.7 kb species predominating in the follicles and
      the 1.5 kb species being more abundant in the corpora lutea. No transcripts were
      detected in stromal tissue containing preantral follicles of less than 1 mm.

PMID- 1632899
TI  - [St. Laurentius Hospital Roermond. Unearthly noises].

PMID- 1632898
TI  - [Continuing education oncologic nursing].

PMID- 1632900
TI  - [316 days--Werner update 8].

PMID- 1632901
TI  - [Research in Higher Nursing Education. Study day of the Society of Faculty in
      Higher Education Nursing].

PMID- 1632902
TI  - [Nursing models in nursing of the mentally retarded].

PMID- 1632903
TI  - [Roy in the Z (mental retardation nursing)].

PMID- 1632904
TI  - [Composition of the patient group. According to a type classification of
      therapeutic milieus in psychiatric care].

PMID- 1632905
TI  - [Nutrition in psychiatry. Carbohydrates and depression].

PMID- 1632906
TI  - [The significance and use of somatometric reference values of weight and height
      in pediatric and epidemiologic practice].
AB  - If we know growth as cellular phenomenon to addition of matter to protoplasm, is
      valid how a generic phenomenon, within normality range, is a species attribute,
      and in the human would be of psychosocial order. It is a appointed with only
      somatometrie is not valid criterion in the diagnosis of desnutrition, but is a
      excellent point in order to identification of risk population. In this order is
      necessary reference values useful, well elaborated, with adequate samples. It is
      commented about weight and height as a adequate parameters for measuring growth.
      It is convenient the adoption of an unique international somatometric reference
      tables if we considered growth how a generic and species phenomenons. Were
      analyzed 2 works of reference tables used in our country. Finally is commented
      the convenience of use of an unique international reference tables. It is
      proposed the somatometric reference tables published for the WHO, in 1983, and
      were discussed the razons for this recommendation.

PMID- 1632907
TI  - [The molecular genetics of cystic fibrosis: the delta F508 allele in Mexican
      families].
AB  - We have initiated the screening of the delta F508 cystic fibrosis (CF) mutation
      in our country basing our study on the polymerase chain reaction technique. In a
      sample of 10 western and a northeastern Mexican families that have at least one
      CF affected child, we found a delta F508 frequency of 59.1% among CF chromosomes.
      This frequency is similar to those reported for Spain. Furthermore, we found a
      correlation between the delta F508 allele and pancreatic insufficiency. This
      paper points out the advantage of the polymerase chain reaction technology for
      the analysis of Mendelian disorders.

PMID- 1632908
TI  - [The prevalence of elevated arterial pressure and risk factors in adolescents in
      the Federal District of Mexico].
AB  - To develop studies on blood pressure (BP) of young population, such as
      adolescents, is important, because it is an early way to obtain information about
      the factors that could influence or modify the levels of BP. A group of 1,146
      junior high school students from Mexico City was studied, by means of a
      questionnaire to identify risk factors, which were classified as: 1. inherent
      factors, 2. acquired risks and 3. family background. A significant association
      was observed related to inherent factors in scholars, mainly at monarch age with
      an odds ratio of 2.45; and confidence intervals of (1.05-5.63) for systolic blood
      pressure (SBP) and 8.81 (4.44-17.54) for diastolic blood pressure (DBP). In
      relation to acquired risks, there was a positive association with the use of
      contraceptives. As for family background there was as important association, in
      the following order: obesity, diabetes and hypertension. Therefore, it may be
      said that since early ages there are risk factors for BP; although some of them
      were not significantly, they can not be excluded as risk factors because there is
      a possibility that a longer latency period may be needed for them to act as such.

PMID- 1632909
TI  - [The determination of pulmonary phospholipids in the gastric contents for an
      assessment of the respiratory distress syndrome].
AB  - Since hyaline membrane disease (HMD) is an important cause of mortality and
      morbidity in preterm newborns, we decided to evaluate the utility of pulmonary
      phospholipid (PP) determination in gastric aspirate for confirmatory diagnosis.
      For that purpose we studied 31 preterm and 30 term babies and compared the
      results between them and PP in gastric aspirate and amniotic fluid from their
      mothers. All the term newborns were normal, with mean weight of 3,221, and 39
      weeks of gestational age; the results of phosphatidyl inositol (PI) and
      phosphatidyl glycerol (PG) were positive. The premature babies had a mean weight
      of 2,424 g and 35 weeks of gestational age. Thirteen had respiratory distress, 4
      transient tachypnea and 9 HMD. In this group the babies with PI present and PG
      absent developed respiratory distress without HMD. The test had sensibility of
      69% and specificity of 100%, and in patients without PG and PI the sensibility
      and specificity was 100%. We concluded that this test has enough sensibility and
      specificity for the confirmation of HMD in gastric aspirate when the PI and PG
      are not present.

PMID- 1632910
TI  - [An evaluation of the 4 years of the Oral Rehydration Service of the Hospital
      Infantil de Monterrey].
AB  - At four years of being founded the Service of Oral Hydration from Hospital
      Infantil de Monterrey, we carried out this investigation to know its
      productivity, to determine costs of internments, death rates due to diarrhea and
      dehydration in the hospital and at a State level. The statistics from the
      hospital were revised in the previous and subsequent years to the institution of
      the Service in September of 1986, so as the statistics of death due to diarrhea
      from the State Health Department. The cases attended were 12,139, from which
      9,024 belonged to plan A, 2,983 to plan B and 72 to plan C. Three hundred (300)
      doctors were trained and nine (9) research studies were accomplished. A decrease
      was achieved from the hospital rate admission by diarrhea and dehydration, throw
      the oral dehydration therapy in a 66%, the mortality rate was reduced 72% and an
      expenditure of $619,243,480.00 pesos in drugs and auxiliary examinations of
      diagnostic was avoided. At a State level the general death rate due to diarrhea
      got a cutdown of 13.1 to 5.8, and in infants under a year old decreased from 275
      to 122.3. The oral hydration therapy applied in the State seems to be the main
      reason in that results.

PMID- 1632911
TI  - [Fascioliasis in children. A study of 10 cases].
AB  - These are the observation found in ten children with fascioliasis diagnosis at
      the Servicio de Parasitologia, of the Instituto Nacional de Pediatria, from 1979
      to 1990; six children in scholar age; one prescholar and three teenagers; only
      one was female. Four of them lined at the State of Mexico; three at Morelos; one
      at Puebla, another one at Oaxaca and the other one at Mexico City. In nine of the
      watercress eaten was confirmed. The most important clinic manifestations were:
      fever, weight lose, paleness, hepatomegaly, hiporexia, right hypochondrium pain
      and diarrhoea. Diagnosis was established by: counterimmunoelectrophoresis,
      indirect haemagglutination and there were found eggs by simple sedimentation,
      Ritchie's method and microscopic study of duodenal sample. Leukocytes counts were
      between 11,000 and 34,000/mm3. Eosinophils were to 77% with 24,430 totals. Only
      in three of them haemoglobin was found under 9 g/dL. All of them had
      hypergammaglobulinemia. In nine patients the alkaline phosphatase was found in
      higher levels; only in three of them, transaminase, oxalacetic and glutamic
      piruvic were found in higher levels. The most effective drug in the treatment was
      dehidroemetine.

PMID- 1632912
TI  - [Cerebral infarct secondary to an intraoral injury from a spoon. A case report].
AB  - We report the case of a 4-year-old female who developed an extensive cerebral
      infarction after trauma to the right peritonsillar area with a spoon. Blunt
      injury to the intima of the interna carotid artery promotes thrombus formation or
      clot embolization which results in an ischemic cerebrovascular event. We
      emphasize the need to prevent this rare complication of intraoral trauma in
      childhood.

PMID- 1632913
TI  - [Acute kidney failure due to stings by Africanized bees].
AB  - Africanized bees are unique in their aggressive behavior, characterized by
      massive attacks during which the victims are injected an important amount of
      venom. For this reason, Africanized bees are extremely dangerous. Their venom
      contains biological toxic substances, mainly mellitin, phospholipases, histamine,
      hyaluronidase and apamin. Non-sensitized persons that survive a massive attack
      may develop acute renal failure, as a consequence of the severe hemolysis,
      rhabdomyolysis and shock. These complications may lead to acute renal tubular
      necrosis. Also, the clinical pattern and treatment of the acute renal failure
      secondary to bee stings are discussed.

PMID- 1632914
TI  - [Functional bladder capacity in enuretic patients].

PMID- 1632915
TI  - [The diagnosis of human immunodeficiency virus infection in children under 18
      months].

PMID- 1632916
TI  - Untoward clinical effects after stereotactic radiosurgery for intracranial
      arteriovenous malformations.
AB  - Stereotactic radiosurgery has become one of the most acceptable means of treating
      deep-seated intracranial arteriovenous malformations, as well as being a useful
      adjunct in a number of other pathologies. One hundred and sixty patients are
      discussed, having follow-up of at least 2 years. Radionecrosis occurred in six
      patients and haemorrhage in the latent period prior to thrombo-obliteration in a
      further six. Successful thrombo-obliteration was ultimately achieved in 76% of
      patients. As a bonus, epilepsy was improved in 29 of 48 patients presenting with
      seizures and worsened transiently in only three of these.

PMID- 1632917
TI  - Paediatric craniopharyngiomas: a regional review.
AB  - Forty paediatric craniopharyngioma cases treated between 1956 and 1987 by
      conservative surgery (15), radical surgery (10), conservative surgery and
      radiotherapy (9) and shunting (6) are reviewed. The conservative surgery and
      radiotherapy group's local control and survival (100%) is significantly better
      than that of any other group. This group also achieved the most consistent level
      of employment or tertiary education. Overall morbidity was high. Overall survival
      has improved since 1976. Whether given as an adjuvant or salvage a radiotherapy
      dose of TDF 83 or greater gave a significantly better survival (100%) than lower
      doses.

PMID- 1632918
TI  - The fate of tumour rests following removal of acoustic neuromas: an MRI Gd-DTPA
      study.
AB  - The fate of capsular fragments left attached to vital structures at the time of
      otherwise total tumour removal was studied in 14 of 21 such patients who
      underwent acoustic neuroma surgery. Imaging using magnetic resonance Gd-DTPA at
      post-operative intervals of 6 months-12 years (mean 70 months) showed evidence of
      persistent tumour in half the patients. None of the patients had developed new
      symptoms and computed tomography had failed to demonstrate tumour recurrence.
      Persistence of the tumour was more likely if the residual fragments were not
      cauterized at the time of operation. Four of the seven persisting tumour rests
      showed evidence of gradual enlargement. The implications for patient management,
      particularly if an attempt is made to preserve hearing, are discussed.

PMID- 1632919
TI  - Unusual presentations of cerebral hydatid disease in children.
AB  - Three children with hydatid disease of the central nervous system (CNS) were
      seen. In two patients the lateral ventricles were involved, whilst one case
      involved the cerebellar hemisphere. In addition, one child presented with a
      deposit in the maxillary antrum, and deposits were also found in the liver.
      Operative removal of the deposits was performed, followed by post-operative
      treatment with praziquantel and albendazole. Investigation of other sites outside
      the CNS was undertaken for occult lesions. All hydatid cysts were clearly
      demonstrated on CT, but two cases posed the pre-operative problem of differential
      diagnosis from arachnoid cysts.

PMID- 1632920
TI  - Effect of pre- and postganglionic lesioning of the trigeminal nerve on cerebral
      blood flow and glucose metabolism following a subarachnoid haemorrhage in the
      squirrel monkey.
AB  - Simultaneous cerebral blood flow (CBF) and glucose metabolism (CMRglu) studies
      with a double isotope autoradiographic technique were applied to squirrel monkeys
      submitted to a unilateral pre- or postganglionic trigeminal lesion. The CBF
      values were not affected following a pre- or postganglionic lesion per se. In
      contrast, there was a global increase in the cerebral glucose uptake of about 50%
      as compared to controls following both kinds of lesions. Following a subarachnoid
      haemorrhage (SAH) 2-4 weeks after pre- or postganglionic trigeminal lesioning,
      there was a decrease in CBF similar to that seen in the control group. In the
      animals with a preganglionic lesion, the 50% increase in glucose uptake was not
      further augmented by a SAH and the increase in CMRglu was comparable to that
      found in control SAH animals. In the postganglionically lesioned monkeys, a SAH
      induced an additional increase in glucose uptake of about 50%. The findings
      suggest that the trigeminal system is involved in the regulation of cerebral
      metabolism via a brainstem centre.

PMID- 1632921
TI  - The outcome from acute subdural and epidural intracranial haematomas in very
      elderly patients.
AB  - Out of a consecutive series of 1082 operations performed on head-injured patients
      over a 9-year period, 28 cases of acute subdural haematomas (SDHs) or epidural
      haematomas (EDHs) occurring in patients aged between 80 and 100 years were
      selected. Mortality rates in these patients (100% in 2 EDHs, 88% in 26 SDHs) were
      significantly higher (p less than 0.01) compared with patients under 80 years
      (12% in 308 EDHs, 57% in 215 SDHs). Pre-existing diseases, primary events
      precipitating falls, and multiple system failure complicating the postoperative
      course accounted for most of the deaths. None of the patients operated upon with
      a Glasgow Coma Scale score of 11 or less survived. A typical 'talk and die'
      course occurred in two cases. Three patients, all operated on for SDH, survived
      and returned to their pre-injury conditions. It was concluded that, whilst the
      question as to whether to submit very old comatose patients to life-prolonging
      measures remains unsettled, there is a case for the prompt evacuation of extra
      axial clots in patients with minimal impairment of consciousness.

PMID- 1632922
TI  - Incidental pituitary macroadenomas.
AB  - Five cases of incidentally detected pituitary macroadenomas are described. All
      five had suprasellar extensions, but none had visual field defects as tested by
      computed perimetry. One patient had sellar changes seen on an X-ray film taken
      following a head injury, while the others were detected by computed tomography
      performed for seizures, stroke and meningitis. Four patients underwent trans
      sphenoidal surgery for suprasellar extensions with or without hypopituitarism,
      while one was managed conservatively as he had normal visual fields and pituitary
      function and there was a spontaneous decrease in size of the adenoma. The
      management of such incidental pituitary macroadenomas is discussed.

PMID- 1632923
TI  - New instrumentation for the assembly of shunt systems by a non-touch technique.
AB  - In modern neurosurgery there are many types of ventricular shunts, ventricular
      drains and access devices. These are composed of a variety of components which
      are best assembled and manipulated using a non-touch technique. A comprehensive
      and inexpensive set of instruments is described which is easy to sterilize and
      which will facilitate the easy manipulation and assembly of a wide range of these
      devices by a true non-touch technique.

PMID- 1632924
TI  - Carpenter's syndrome (acrocephalopolysyndactyly type II) with normal
      intelligence.
AB  - A 6-year-old girl with Carpenter's syndrome is reported who, in spite of a
      considerably distorted and small calvarium at birth, has normal mental
      development. Cranio-facial surgery was carried out in infancy, but its role in
      respect to mental development is difficult to assess since unoperated patients
      with normal intelligence and Carpenter's syndrome have been widely reported.
      Nevertheless, early cranio-facial surgery is recommended for cosmetic reasons.

PMID- 1632925
TI  - Solitary brainstem abscess successfully treated by microsurgical aspiration.
AB  - A case of pyogenic pontine abscess detected by computerized tomography scan in a
      10-year-old boy is presented. While on broad-spectrum antimicrobial treatment, he
      deteriorated and developed new symptoms of respiratory distress. Microsurgical
      exposure of the abscess and aspiration of pus resulted in rapid improvement in
      his neurological state and radiological resolution of the lesion. The aim of this
      article is to emphasize the importance of prompt diagnosis and the role of
      surgical drainage of pus in the management of brainstem abscesses.

PMID- 1632926
TI  - Malignant paraganglioma of the glomus jugulare: a case report.
AB  - Jugular paragangliomas are noted for their tendency to recur, but frank malignant
      behaviour is rare. We report a case in which a patient harbouring a recurrent
      tumour of the glomus jugulare re-presented with metastatic spread to mediastinal
      lymph nodes. Review of the 16 reported cases provides information which can be a
      basis for management of the malignant form of this tumour.

PMID- 1632927
TI  - Ventriculo-ureteral shunt without nephrectomy.
AB  - Some patients with hydrocephalus cannot be adequately treated with either
      ventriculo-peritoneal or ventriculo-atrial shunts. Ventriculo-ureteral (VU)
      shunts are seldom considered in this group of patients because of the belief that
      nephrectomy is an essential part of the procedure. We report a case in which a VU
      shunt was performed with direct ureteral re-implantation and we suggest that a VU
      shunt is a reasonable alternative for the treatment of a patient with difficult
      to-manage hydrocephalus.

PMID- 1632928
TI  - Successful treatment of a pineal region epidermoid cyst by stereotactic
      aspiration.

PMID- 1632929
TI  - Fibromuscular hyperplasia of the internal carotid artery. A further cause of the
      'moyamoya' collateral circulation.
AB  - Fibromuscular hyperplasia is a rare cause of internal carotid artery occlusion.
      We present a case where long stenoses of both internal carotid arteries were
      associated with terminal carotid occlusions and a ruptured basilar aneurysm.

PMID- 1632930
TI  - Paraganglioma of the cauda equina.

PMID- 1632931
TI  - Heterogeneity of hypertension.
AB  - Although all forms of hypertension have in common the finding of elevated blood
      pressure, further examination reveals great heterogeneity. The risk of
      hypertension is related not only to the level of blood pressure but also to the
      presence of other risk factors; the prevalence of hypertension is affected by
      demographic, clinical, and psychologic characteristics; the pathophysiology of
      hypertension reflects varying participation of salt-sensitivity, the renin
      angiotensin system, and other control mechanisms; and treatment responses differ
      among patients both with regard to the degree of blood pressure lowering by
      various therapies and the clinical benefit obtained. Knowledge of these
      heterogeneities at present is useful but only partial. Additional research is
      needed to improve prediction of hypertension, to enhance stratification of
      patients by the mechanisms and risk of their hypertension, to refine the matching
      of specific therapies and treatment goals to the underlying pathophysiology, and
      to facilitate transfer of evolving information to the clinician.

PMID- 1632932
TI  - Cell type and cell state specific antibodies in the analysis of early lesions of
      human atherosclerosis.
AB  - Studying the cell composition of lesions of human atherosclerosis can yield
      important information regarding the cellular interactions involved in the
      pathogenesis of this disease. We have used a panel of monoclonal antibodies, many
      developed in this laboratory, to study the cell composition of human fatty
      streaks. Results indicate that the predominant cell type in these lesions is the
      smooth muscle cell rather than the macrophage. Furthermore, using single and
      double labeling techniques, it was demonstrated that: (a) no expression of class
      II HLA antigens by smooth muscle cells could be documented; (b) the beta-chain of
      the platelet derived growth factor could be demonstrated within some macrophages
      in a small subset of lesions; and (c) only a very small fraction of the cell
      population express markers associated with cell proliferation, and those that do
      are largely macrophages and lymphocytes.

PMID- 1632933
TI  - Proliferative response of smooth muscle cells in hypertension.
AB  - A significant increase (up to 20% from about 10% in normals) in the number of
      smooth muscle cells (SMC) with tetraploid DNA content was found in the media and
      intima of human hypertensive aorta. A similar process was detected during normal
      human vessel aging. It was found that SMC from normal human aorta and
      normotensive rat aorta, which were able to incorporate 3H-thymidine, had
      diminished proliferative potency and a tendency to polyploidization in primary
      culture. We failed to detect a similar phenomenon in SMC obtained from aorta from
      spontaneously hypertensive rats. It was found that 10 mumol/L of norepinephrine
      significantly increased (by approximately twofold) the frequency of true
      polyploid cells in a subculture of rat aortic SMC. The effect of norepinephrine
      was blocked only by simultaneous action of alpha- and beta-adrenoreceptor
      antagonists. SMC polyploidization was also stimulated by simultaneous application
      of two direct activators of the second messenger systems, forskolin and phorbol
      12-myristate-13-acetate. Thus, a subpopulation of SMC prone to polyploidization
      exists in normal vessels, and norepinephrine may be one of the mediators of the
      "hypertensive" response of vessel wall SMC, which probably occurs due to the
      synergism of two second messenger systems.

PMID- 1632934
TI  - Contractile rabbit aortic smooth muscle cells in culture. Preparation and
      characterization.
AB  - Investigations were conducted to determine whether rabbit aortic smooth muscle
      cells (SMC) reproduce their essential in situ features in culture. Enzymatically
      isolated cells in culture were compared with their in situ state in terms of
      myosin and caldesmon isoform expression, sensitivity to Ca(2+)-mobilizing
      agonists, and contractility. Protein marker expression was assessed by
      electrophoresis and quantitative immunoblotting, and intracellular free Ca2+
      ([Ca2+]i) measurements were accomplished using indo-1, a Ca(2+)-sensitive
      fluorescent dye. Contraction of SMC grown on deformable silicone films was
      monitored optically. Before the onset of cell division (3 to 6 days in culture),
      SMC still contained significant although decreasing amounts of smooth muscle
      myosin (SM1 and SM2 isoforms) and they started to express nonmuscle-type myosin.
      The relative content of 150-kDa caldesmon decreased, whereas the expression of 77
      kDa caldesmon increased during this period. In the confluent primary culture (11
      days), SM1 was expressed, but 150-kDa caldesmon was hardly detectable. Histamine
      (10(-5) mol/L), serotonin (10(-6) mol/L), and thrombin (1.5 units/mL) contracted
      deendothelialized rings of rabbit aorta, but only histamine was able to elevate
      [Ca2+]i 2.5- to 3-fold and induce reversible contraction of primary nondividing
      cells. [Ca2+]i elevation in response to histamine was due both to Ca2+
      mobilization from intracellular stores and Ca2+ flux across the plasma membrane.
      After the onset of proliferation, SMC regained the ability to elevate [Ca2+]i in
      response to serotonin and thrombin but lost the ability to contract. Thus,
      primary cultured quiescent rabbit aortic SMC (3 to 6 days in culture) retain the
      essential features of vascular SMC in situ (eg, smooth muscle specific
      contractile and regulatory proteins, vasoactive hormone sensitivity, and
      contractility).

PMID- 1632935
TI  - Humoral factor, intraplatelet calcium, and hypertension.
AB  - Plasma humoral factors which modulate the transmembrane distribution of sodium
      and calcium have been identified in hypertensive patients and have been
      hypothesized to be involved in the etiology of essential hypertension. In cross
      incubation experiments, we have found that plasma of hypertensive subjects
      elevated basal and stimulated intraplatelet calcium levels, while plasma of
      normal subjects has an opposite effect on platelets from hypertensives. Basal
      intraplatelet calcium in normal platelets was 108 +/- 5 nmol/L and rose to 142 +/
      3 nmol/L (P less than .001) after incubation in plasma from hypertensive
      patients. Platelets from hypertensive patients had basal calcium levels of 182 +/
      11 nmol/L which fell to 127 +/- 11 nmol/L (P less than .01) after incubation in
      normal plasma. Hypertensive plasma potentiated the rise in intraplatelet calcium
      in response to ADP and PAF. Hypertensive patients treated experimentally with
      plasmapheresis exhibited a disappearance of the plasma factor responsible for
      elevating intraplatelet calcium. These results indicate the presence of a plasma
      humoral factor in hypertensives which elevates intraplatelet calcium and
      sensitizes platelets to agonist stimuli.

PMID- 1632936
TI  - Altered sympathetic tone in hypertensives with angina and lowered threshold for
      pacing ischemia.
AB  - To determine the role of the sympathetic nervous system in myocardial ischemia
      with essential hypertension, plasma norepinephrine, heart rate (HR), blood
      pressure (BP), and the HR.BP double product at the time of silent ischemia during
      pacing and exercise treadmill test (ETT) were compared with basal values in 20
      patients with sustained essential hypertension and stable angina, 3 to 60 days
      (12.6 +/- 11.6) after discontinuation of all antihypertensive and coronary
      vasodilator therapy. Group I (N = 6) had silent ischemia with a higher HR.BP
      product at ETT than at pacing (ratio = 157 +/- 10.4% [+/- SD] v a value in group
      II [N = 5] of 102 +/- 18.8 [P less than .01]. Group III (N = 9) had no silent
      ischemia at ETT or pacing. Group I v group II plasma norepinephrine levels at
      rest and with pacing silent ischemia were 76 +/- 37 v 138 +/- 36 pg/mL, P less
      than .02, and 101 +/- 50 v 230 +/- 43 pg/mL, P less than .01, respectively. In
      groups I and II plasma norepinephrine levels were significantly lower than those
      of group III. Eleven of 20 patients had ischemia on pacing or ETT. Left
      ventricular myocardial mass were greater (224 +/- 49 v 180 +/- 28 g, p less than
      .05), HR (67 +/- 13 v 76 +/- 11 beats/min, P = NS) and plasma norepinephrine
      levels at rest (104 +/- 47 v 241 +/- 99 pg/mL, P less than .01), pacing (160 +/-
      81 v 338 +/- 94 pg/mL, P less than .01), and ETT (758 +/- 268 v 1203 +/- 611
      pg/mL, P less than .05), were lower in patients with ischemia (N = 11, group II)
      than in patients without ischemia (N = 9, group III) on pacing or ETT. Eight
      patients were on reserpine prestudy; reserpine prestudy was associated with lower
      basal HR (63 +/- 9 v 76 +/- 12 beats/min, P less than .05) and plasma
      norepinephrine (106 +/- 48 v 169 +/- pg/mL, P less than .07) and greater ratio of
      HR.BP double product on ETT/pacing, (141 +/- 33 v 111 +/- 19, P less than .02).
      The sympathetic nervous tone of group I was low at baseline but there may have
      been raised alpha/beta-receptor responsiveness to laboratory stresses with
      concomitant micro/macrovascular constriction at higher oxygen demand.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1632937
TI  - Silent myocardial ischemia in patients with essential hypertension.
AB  - The aim of this study was to determine the significance of the "coronary factor"
      in patients with essential hypertension (EH). Electrocardiogram Holter monitoring
      was performed in 61 patients with EH stage II (according to the World Health
      Organization criteria). Silent, ie, painless ST-segment depression, was found in
      34 patients on whom echocardiography, a treadmill test, and transesophageal
      pacing were performed. In 21 patients with EH and silent ischemia, the
      examination included 201Tl stress scintigraphy, coronary angiography, and a
      platelet aggregation test. In 15 patients, catecholamines and beta-endorphins
      were obtained in blood samples during silent ischemia. 201Tl scintigraphy showed
      transient defects of perfusion without clearance abnormalities (group I) and with
      clearance abnormalities (group II). The patients in group I had more severe left
      ventricular hypertrophy (LVH) and a significantly higher platelet aggregation
      response to 0.5 mumol/L adenosine diphosphate; one patient in this group had
      coronary atherosclerosis. LVH and the platelet aggregation response was less
      pronounced in the patients in group II, but atherosclerotic lesions of a coronary
      artery were observed in four patients. In both groups, norepinephrine and beta
      endorphin levels were increased during silent episodes of ischemia. The results
      suggest that there are different pathogenetic mechanisms of coronary
      insufficiency in patients with EH, a hypertensive heart, and silent ischemia.

PMID- 1632938
TI  - Left ventricular mass as a measure of preclinical hypertensive disease.
AB  - The ability to identify the hypertensive patient who is destined to suffer a
      morbid or fatal complication in the long presymptomatic phase of this condition,
      when its natural history would be most subject to amelioration, is limited by the
      weak relation between the level of blood pressure and the occurrence of
      complications. Recent research indicates that the level of left ventricular (LV)
      mass--most conveniently measured by echocardiography--reflects the combined
      effects of a variety of factors involved in the pathophysiology of hypertension,
      including obesity, exaggerated blood pressure responses to everyday activity,
      high sodium intake and blood viscosity, and genetic factors predisposing to
      hypertension. Prospective studies indicate that LV mass is a stronger predictor
      of subsequent morbid events and death than blood pressure or other conventional
      risk factors except age. Preliminary findings of close relations between LV mass
      and arterial disease and between the change in LV mass during antihypertensive
      treatment and subsequent events contribute to explaining the strong predictive
      value of LV mass. Further research is needed to clarify the biologic basis of
      these observations and to determine whether stratification of hypertensive
      patients based on their level of LV mass can improve the treatment of
      hypertension.

PMID- 1632939
TI  - Evaluation of cardiac performance in hypertension.
AB  - Myocardial perfusion and left ventricular (LV) diastolic filling were studied in
      67 patients with mild to moderate hypertension and left ventricular hypertrophy
      (LVH). The control group consisted of 28 subjects with no cardiac pathology. LV
      mass assessed by M-mode echocardiography was obtained in all patients. LV
      diastolic filling was estimated by pulsed Doppler echocardiography before and
      after intravenous administration of verapamil (0.145 mg/kg) and contrast
      ventricular angiography during intracoronary administration of verapamil (1 to
      1.5 mg). Myocardial perfusion was estimated by technetium-99m scintigraphy with
      albumin microspheres and thallium-199 scintigraphy in combination with
      intravenous dipyridamole. Coronary artery disease was excluded in 42 patients by
      coronary angiography. Pulsed Doppler echocardiography demonstrated an inverse
      correlation between the LV mass index and the ratio of peak early to peak atrial
      velocity (r = -65, P less than .001). Twelve of 20 patients experienced transient
      "normalization" of LV diastolic filling during intravenous administration of
      verapamil. In addition, 6 of 22 patients with LVH had an increase in end
      diastolic volume owing to enhanced segment relaxation of the injected artery
      during intracoronary administration of verapamil. Myocardial perfusion defects
      assessed by scintigraphy with albumin microspheres were observed in 8 of 13
      patients but in no controls. According to 199T scintigraphy data, myocardial
      perfusion defects were more common in patients with LVH (P less than .05). Thus,
      essential hypertension combined with LVH appears to result in severe cardiac
      dysfunction, which is probably associated with changes in small vessel walls.

PMID- 1632940
TI  - Chronic hypotension. In the shadow of hypertension.
AB  - Understanding the causes and treatment of chronic hypotension is of benefit to
      affected patients and may also shed light on the physiology and genetics of
      mechanisms of blood pressure control. Symptomatic hypotension (almost always with
      a blood pressure fall greater than or equal to 20/10 mm Hg) may reflect
      unrecognized medication effects or a variety of other causes. Autonomic
      neuropathies include those secondary to diabetes, peripheral autonomic impairment
      (the Bradbury-Eggleston syndrome), central autonomic impairment (the Shy-Drager
      syndrome), or newly described gene defects such as dopamine-beta-hydroxylase
      deficiency (which causes the absence of norepinephrine with an accumulation of
      dopamine). Baroreceptor dysfunction causes wide swings in blood pressure that are
      unrelated to posture, whereas a variety of stimuli (cough, micturition, or
      carotid sinus pressure) may precipitate paroxysmal parasympathetic activation,
      and sympathetic orthostatic hypotension associated with hypovolemia may occur
      with mitral valve prolapse or as an idiopathic condition. The differentiation of
      these and other causes of symptomatic hypotension may in many cases lead to
      beneficial therapy.

PMID- 1632941
TI  - Effects of subacute exposure to noise on the noradrenergic innervation of the
      cardiovascular system in young and aged rats: a morphofunctional study.
AB  - The effects of subacute noise stress on the noradrenergic pattern and receptor
      mediated responses were examined in aorta and atria of young and aged rats. Noise
      exposure increased the density of noradrenergic fibres and responses to the beta
      adrenergic agonist isoprenaline in the cardiac tissue of young animals. In aged
      rats, the stressing stimulus markedly increased the maximal response to the alpha
      agonist on the aortic musculature; on the contrary, a reduced responsiveness to
      the beta-agonist was observed at the cardiac level, without any noteworthy
      changes in the noradrenergic pattern in comparison to aged controls. The present
      results indicate that subacute noise stress induces both morphological and
      functional modifications of the noradrenergic nervous system and also that after
      subacute noise stress, morphological changes do not necessarily correspond
      exactly to functional data; the latter show responses that are more widely
      differentiated than the morphological ones.

PMID- 1632942
TI  - Differential effect of guanethidine on dopamine and norepinephrine in rat
      peripheral tissues.
AB  - The changes of dopamine (DA) and norepinephrine (NE) were investigated in rat
      peripheral tissues after guanethidine treatment (50 mg/kg i.p. five days each
      week) during one week (group 1, n = 10, five injections) and during 2.5 weeks
      (group 2, n = 8, 13 injections). Guanethidine greatly reduced NE levels in all
      the analyzed tissues but only partially depleted DA in kidney, bladder, stomach,
      intestine, lung and liver and in sympathetic ganglia. The differential pattern of
      changes between DA and NE induced by guanethidine suggests that peripheral DA is
      distributed in several neuronal or non-neuronal pools, whose presence, nature and
      contribution varies in the different tissues. Both noradrenergic cell bodies and
      small intensely fluorescent cells (SIF cells) can contribute to the DA in the
      superior cervical ganglion. Noradrenergic neurons seem to be the main sources of
      DA in seminal vesicles, vas deferens, heart and spleen. In addition to
      noradrenergic nerves, extraneuronal sources could account for a meaningful
      portion of DA in kidney, gastrointestinal tract, lung and liver. The bladder is
      the peripheral tissue where DA exhibits the highest resistance to the neurotoxin.
      Accordingly, these tissues may provide meaningful sources of non-precursor DA
      pools.

PMID- 1632943
TI  - The pharmacological effect of citalopram residues in the (S)-(+)-enantiomer.
AB  - The enantiomers of citalopram and N-demethylcitalopram have been investigated.
      Based on the inhibition of 5-HT uptake in vitro and the potentiation of 1-5-HTP
      in vivo the pharmacological activity resides in the (+)-enantiomers (the
      eutomers*) with the 1-(S) absolute configuration. In the 5-HT uptake test
      eudismic ratios of 167 and 6.6 are obtained for the enantiomers of citalopram and
      N-demethylcitalopram, respectively. The pharmacological profile of the eutomers
      of citalopram and N-demethylcitalopram very much resembles the profile of the
      respective racemates.

PMID- 1632944
TI  - Transient reduction of cerebral blood flow leads to longlasting increase in GABA
      content in vulnerable structures and decreased susceptibility to bicuculline
      induced seizures.
AB  - Rats were exposed for 24 min to bilateral clamping of the common carotid arteries
      (BCCA) in pentobarbital anaesthesia. The GABA content was measured 24 hours, 48
      hours, 4 days, 14 days and 3 months after BCCA. In other groups of rats seizures
      were elicited by i.p. injection of (+)-bicuculline (3 mg/kg) 24 hours, 48 hours,
      4 days, 14 days and 3 months after BCCA. Analysis of the GABA content revealed
      significant increase compared with controls in the hippocampus, frontal cortex
      and substantia nigra from 24 hours up to 3 months. Bicuculline treatment induced
      tonic/clonic seizures and status epilepticus in sham operated animals; these
      effects were drastically diminished at various time points after BCCA. The
      present results suggest that BCCA produces a longlasting increase in GABA content
      and as a consequence protection from bicuculline-induced seizures.

PMID- 1632945
TI  - Biosensors for environmental monitoring.
AB  - In this article we will outline several biosensor applications which may fill
      existing technology gaps in the area of environmental monitoring. The
      requirements for these environmental biosensors, as well as difficulties in
      commercialization, are also addressed.

PMID- 1632946
TI  - A lysine dehydrogenase-based electrode for biosensing of L-lysine.
AB  - An amperometric biosensor for L-lysine based on the recently isolated enzyme
      lysine dehydrogenase is described. Immobilization of the enzyme onto a platinum
      electrode is achieved via entrapment within a gelatin support on a cellulose
      membrane. Anodic detection (at 0.4 V vs. Ag/AgCl) is facilitated by the presence
      of a redox-mediating ferricyanide ion. The effect of experimental variables such
      as pH, enzyme loading, applied potential, cofactor and mediator concentrations
      were evaluated in order to optimize the analytical performance. A detection limit
      of 7 x 10(-8) M, and linearity up to 7 x 10(-4) M are reported. The fast response
      permits adaptation for flow injection operation with good precision (RSD = 1.9%)
      and high sample throughout (40 samples per hour). The high specificity offered by
      this new enzyme is indicated by the lack of interference by other L-amino acids,
      alcohols or carbohydrates.

PMID- 1632947
TI  - Sensitive detection of pesticides using amperometric sensors based on cobalt
      phthalocyanine-modified composite electrodes and immobilized cholinesterases.
AB  - The determination of organophosphate and carbamate pesticides was carried out
      using cobalt phthalocyanine-modified carbon epoxy composite electrodes coupled
      with acetylcholinesterase or butyrylcholinesterase. Covalent immobilization of
      enzymes on Immobilon membranes or nylon nets was examined; the highest
      sensitivity to inhibitors was found for the nylon net containing low enzyme
      loading and this was subsequently used for the construction of an amperometric
      biosensor for pesticides. Analyses were done using acetyl- or butyrylthiocholine
      as substrates; thiocholine produced by hydrolysis in the enzyme membrane was
      electrochemically oxidized at +300 mV (vs. Ag/AgCl reference). The decrease of
      substrate steady-state current caused by the addition of pesticide was used for
      evaluation. With this approach, 1.5 and 8.4 micrograms l-1 of paraoxon and
      heptenophos, respectively, can be detected in less than 3 min. These detection
      limits are similar as those obtained when analyses were performed using free
      cholinesterase and 10 min incubation with inhibitor.

PMID- 1632948
TI  - Evaluating in vitro and in vivo the interference of ascorbate and acetaminophen
      on glucose detection by a needle-type glucose sensor.
AB  - The aim of this work was to assess, in vitro and in vivo, the interference of
      ascorbate and acetaminophen on glucose measurements by a needle-type glucose
      sensor detecting hydrogen peroxide generated during the enzymatic oxidation of
      glucose, and to ascertain whether the protection against interference by the
      membranes used in the construction of the electrode is feasible. The oxidation of
      ascorbate and acetaminophen on a platinum electrode set at a 650 mV potential
      yielded a current representing 75 +/- 5% and 25 +/- 6% of that generated by the
      oxidation of an equimolar concentration of hydrogen peroxide, respectively. The
      bias introduced by the presence of 100 mumol l-1 ascorbate on the reading of 5
      mmol l-1 glucose by the complete sensor (electrode + membranes) would be minimal
      (approximately 0.4 mmol l-1). By contrast, the bias introduced by 200 mumol l-1
      of acetaminophen (a plasma concentration easily reached in clinical practice) was
      about 7 mmol l-1. The sensor was implanted subcutaneously in anaesthetized rats
      (n = 3). Using the current generated in the presence of a plasma acetaminophen
      concentration of about 200 mumol l-1 for glucose monitoring would lead to a major
      underestimation (approx. 6 mmol l-1) of subcutaneous glucose concentrations.

PMID- 1632949
TI  - Electrochemically modulated optrode for glucose.
AB  - One of the problems with fibre-optic sensors is the difficulty of finding
      reversible indicator reagents. This is a particular problem for fibre-optic
      glucose sensors. The development of an electrochemically modulated fibre-optic
      probe or optrode has been proposed as a convenient solution. Here the indicator
      reagent is regenerated electrochemically. In this work a design is proposed that
      offers considerable advantages in practical applications. In particular, it can
      be used in the same way as conventional optrodes. The optimization of working
      parameters and the application of the optrode to flow analysis under steady-state
      and flow-injection conditions is described.

PMID- 1632950
TI  - Glucose biosensor based on carbon black strips.
AB  - Amperometric biosensors for the determination of beta-D-glucose have been
      constructed. They were based on a porous matrix of carbon blacks--'Ketjenblack'
      (KB) and 'Shawinigan black' (SB) wet-proofed with polytetrafluorethylene. Glucose
      sensitive elements were prepared by subsequent adsorptional immobilization of
      1,1'-dimethylferrocene (DMFc) and nickel-ocene (Nc) on 'Shawinigan black' or
      tetracyanoquinodimethane (TCNQ) on 'Ketjenblack' together with Penicillium
      chrysogenum glucose oxidase. Maximum surface concentrations of DMFc, Nc and TCNQ
      on carbon black electrodes were 95, 116 and 151 nmol cm-2. The biosensor based on
      KB and TCNQ (KB-TCNQ biosensor) could be used at a potential of 0.5 V (vs.
      Ag/AgCl reference electrode) in the concentration range up to 7 mM. This
      biosensor possessed an approximately ten times higher sensitivity than the ones
      based on SB and DMFc (SB-DMFc biosensor) and on SB and Nc (SB-Nc biosensor) which
      acted at 0.3 V and 0.05 V, respectively. The biosensors were suitable for
      practical use longer than one week.

PMID- 1632951
TI  - Immobilization of flavoproteins on silicon: effect of cross-linker chain length
      on enzyme activity.
AB  - The effect of cross-linker chain length on the activities of choline oxidase
      (ChO) and glucose oxidase (GOx) immobilized on oxidized silicon wafers has been
      investigated for the cross-linkers N-succinimidyl 4-maleimido-butyrate (GMBS) and
      N-succinimidyl 6-maleimidocaproate (EMCS). Enzyme activities were determined with
      an indirect fluorometric assay based on the production of hydrogen peroxide.
      Immobilization of ChO or GOx onto oxidized silicon with either cross-linker
      resulted in an 86-99% loss in enzymatic activity relative to the soluble form of
      the flavoprotein. However, the different cross-linkers had distinctly different
      effects on enzyme activity: EMCS-immobilized GOx was four times more active than
      GMBS-immobilized GOx; EMCS-immobilized ChO had a sevenfold higher activity than
      GMBS-immobilized ChO.

PMID- 1632952
TI  - Amperometric enzyme electrode for determination of theophylline in serum.
AB  - This paper describes an amperometric enzyme electrode for the rapid determination
      of theophylline in serum. The method is based on the catalysed oxidation of
      theophylline by the haem-containing enzyme theophylline oxidase. Results are
      presented for two approaches. First, ferrocene monocarboxylic acid was used as a
      mediator. The second-order rate constant was 1.1 x 10(3) 1 mol-1 s-1. Secondly,
      the organic conducting salt NMP.TCNQ was used to construct enzyme electrodes.
      These electrodes were employed for the rapid (60 s) measurement of theophylline
      in serum at a working potential of +100 mV versus Ag/AgCl. Linear calibration
      curves were obtained over the clinically relevant range (y = 0.13x + 0.22, n =
      8). Caffeine, theobromine and 3-methylxanthine at levels up to 100 mg l-1 do not
      interfere and 1-methylxanthine shows cross-reactivity at concentrations greater
      than 50 mg l-1.

PMID- 1632953
TI  - Effects of lengthened immobilization on functional and histochemical properties
      of rabbit tibialis anterior muscle.
AB  - The imposition of long-term lengthened immobilization on rabbit tibialis anterior
      (TA) muscles resulted in rapid increases in slow oxidative (SO) fibre number.
      After 2 weeks, SO number had increased 2-fold and was 5 times greater after 6
      weeks immobilization. There were also fibre-type-specific effects on SO, fast
      oxidative glycolytic (FOG) and fast glycolytic (FG) fibre areas. Twitch strength
      was unchanged throughout immobilization whilst production of tetanic tension was
      impaired during the initial period but had returned to control levels by 6 weeks.
      Twitch contraction times and isometrically determined rates of rise and
      relaxation were largely unaffected by immobilization despite the marked increase
      in expression of slow myosin. The change in phenotypic expression of the
      lengthened TA was not attributable to chronically increased levels of activation
      since integrated EMG activity was unchanged from control values throughout the
      immobilization period. Thus it is suggested that a chronic increase in tension
      consequent on the lengthening procedure is a potent stimulus for fast-to-slow
      myosin transformation.

PMID- 1632954
TI  - Diversity and homogeneity within endplates associated with physiologically
      identified static gamma-axons in cat tenuissimus muscle.
AB  - The terminations of static gamma-axons on chain fibres may be associated with a
      muscle surface contour thrown into complex folds at one extreme, ranging through
      lesser degrees of folding to being apparently uninfluenced by the presence of the
      terminals. The folding is not necessarily confined to the postsynaptic membrane.
      As a quantitative indicator of the degree of folding seen in cross-sections, the
      perimeters of the two halves of the intrafusal fibre with, and without the ending
      were compared. Both complexity of endplate structure and an undifferentiated
      appearance could co-exist within individual endings (of six static gamma-axons on
      thirteen chain fibres), associated with axons that supplied only chain fibres in
      the spindle isolated. (It should be noted, however, that the type of intrafusal
      fibres innervated by a particular axon was definitively identified only for the
      spindle isolated.) Endings of three other static gamma-axons on six chain fibres
      had a more homogeneous and less complex endplate structure; these supplied bag2
      fibres in addition to the chain fibres and their endplates on the bag2 fibres
      were less folded than those of three axons which supplied bag2 fibres only. A
      sensory inhibitory influence on folding was not apparent because complexly folded
      endplates on chain fibres lay close (less than 500 microns) to sensory endings.
      All the endings studied were functional. In our experimental conditions all nine
      static gamma-axons which innervated chain fibres, alone, or together with a bag2
      fibre, drove the Ia afferent at some stimulus frequencies; none of the three
      static gamma-axons innervating bag2 fibres alone caused driving at any frequency.
      These findings are discussed in relation to the concept of a dynamic remodelling
      of ending structure during life, to the relationship between the motor axon and
      the intrafusal fibre it innervates, and to the possibility that subgroups of
      static gamma-motoneurones might exist which could release different amounts of
      the trophic substances responsible for moulding the endplate structure.

PMID- 1632955
TI  - Reflex vascular responses to changes in left ventricular pressures, heart rate
      and inotropic state in dogs.
AB  - Dogs were anaesthetized with chloralose, artificially ventilated and the chests
      widely opened. Left ventricular mechanoreceptors, including those in or near the
      coronary arteries, were stimulated by changing the pressure in the aortic root.
      The pressures distending the left atrium and the aortic and carotid baroreceptors
      were controlled. Reflex vascular responses were assessed from changes in
      perfusion pressures to a hind limb and to the rest of the systemic circulation,
      which were perfused independently at constant flows. Physiological increases in
      peak left ventricular and coronary arterial pressures resulted in vasodilatation
      in both regions. These responses were not influenced by changes in the heart
      rate. Stimulation of the left cardiac sympathetic nerves resulted in increases in
      peak ventricular pressure and in the maximal rate of change of pressure
      (dP/dtmax). This also resulted in increases in perfusion pressures
      (vasoconstriction) at all levels of peak ventricular pressure although there was
      little effect on the responses to changes in ventricular pressure. Sympathetic
      stimulation had little effect on the relationship between perfusion pressures and
      aortic root pressure. Increases in ventricular filling also resulted in
      vasoconstriction at all levels of peak ventricular pressure. Increases in
      filling, however, did not affect the relationship between either perfusion
      pressure and aortic root pressure. Conversely, decreases in left ventricular
      filling, by bypassing some of the left atrial blood, resulted in vasodilatation
      at all levels of peak ventricular pressures but had no effect on the perfusion
      pressures at any aortic root pressure. The combination of sympathetic stimulation
      with decreased ventricular filling resulted in little effect on perfusion
      pressures or on their responses to changes in either aortic root or ventricular
      systolic pressures. We conclude that the vascular responses to stimulation of
      left ventricular mechanoreceptors are not enhanced by sympathetic stimulation,
      decreases in ventricular filling or the combination of the two. The apparent
      effects of each of these interventions alone on the relationships between
      perfusion pressures and ventricular, but not aortic root, pressure, could be
      explained if the receptors responsible were sensitive more to changes in aortic
      root and coronary arterial pressures than to pressure changes in the ventricle
      itself.

PMID- 1632956
TI  - The effects in the rat of two fragments of parathyroid hormone-related protein on
      uterine contractions in situ.
AB  - Synthetic parathyroid hormone fragment PTH(1-34) has been reported recently to
      inhibit uterine contractions stimulated by a variety of agonists. We have studied
      the effect in this system of the parathyroid hormone-related protein fragment
      PTHrP(1-34) which shows 60% homology with PTH over the first thirteen amino acid
      residues. The effects of two different PTHrP fragments on acetylcholine
      stimulated uterine contractions in vitro were studied. Whereas synthetic
      hPTHrP(75-86 amide) (10(-9)-10(-7) M) was without effect, synthetic hPTHrP(1-34)
      (10(-9)-10(-7) M) was capable of inhibiting, in a dose-related fashion, uterine
      muscle contractions precontracted with 10(-6) M-acetylcholine. In a second series
      of experiments the bovine PTH(3-34) fragment itself was shown to have no
      stimulatory effect on acetylcholine-stimulated contractions. Also this fragment
      in an equimolar concentration (10(-7) M) failed to antagonize the effects of
      PTHrP(1-34) on acetylcholine-stimulated uterine contractions. However, a 100-fold
      excess molar concentration of bPTH(3-34) (10(-6) M) completely abolished the
      inhibitory action of hPTHrP(1-34) (10(-8) M) on acetylcholine-stimulated uterine
      contractions. These results clearly show that the inhibitory action of PTH(1-34)
      and PTHrP(1-34) on uterine contractions depends on the integrity of the amino
      terminal region of the molecule.

PMID- 1632957
TI  - Segmental differences of short-chain fatty acid transport across guinea-pig large
      intestine.
AB  - Unidirectional fluxes of short-chain fatty acids (SCFAs) were measured under
      short-circuit current conditions across guinea-pig caecum, proximal and distal
      colon. Fluxes increased linearly with concentration. In the caecum with equal
      concentrations on both sides of the mucosa the serosal-to-mucosal (sm) fluxes
      were nearly twice the mucosal-to-serosal (ms) fluxes for all SCFAs; in the distal
      colon ms fluxes were always higher than sm fluxes. Thus, in the caecum the net
      effect was secretion while in the distal colon net absorption occurred. In
      caecum, ms fluxes decreased with chain length while sm fluxes were similar for
      the three fatty acids, acetic, propionic and butyric acid. In the distal colon
      both unidirectional fluxes increased with chain length. Fluxes across the mucosa
      of the proximal colon were intermediate to those in caecum and distal colon. A
      paracellular transport of short-chain fatty acids is not present. The results
      indicate that other processes are involved in transcellular transport of SCFA
      besides non-ionic diffusion.

PMID- 1632958
TI  - Growth-related change in specific force but not in specific power of rat fast
      skeletal muscle.
AB  - The effect of growth on the dynamic performance of rat medial gastrocnemius
      muscle was studied. From approximately 1.5 to 5 months of age specific force
      increased by 18%. Reductions were found in both optimal stimulation frequency
      (from 120 to 100 Hz) and optimal shortening velocity (by 16%) indicating that the
      fibres became slower. Specific power did not change during growth but was
      obtained at a lower shortening velocity. Possible mechanisms for the observed
      changes are discussed.

PMID- 1632959
TI  - Evidence for involvement of nitric oxide in the non-adrenergic non-cholinergic
      (NANC) relaxation of human lower oesophageal sphincter muscle strips.
AB  - Electrical field stimulation of circular muscle strips from human lower
      oesophageal sphincter reveals a predominant relaxation response. This relaxation
      is non-adrenergic non-cholinergic (NANC). The nitric oxide synthesis-blocking
      agent N omega-nitro-L-arginine (10-100 microM) reduces or abolishes this NANC
      relaxation, suggesting involvement of nitric oxide in the response.

PMID- 1632960
TI  - Evidence for simultaneous bidirectional fluid flux across synovial lining in knee
      joints of anaesthetized rabbits.
AB  - A recent model predicted a local synovial circulation of extravascular fluid in
      which capillary filtrate entered a joint cavity and fluid simultaneously drained
      out of the cavity via intercellular pathways distant from capillaries. Here,
      solutions of albumin (10-250 g l-1) were infused continuously into the knee joint
      cavity in fifteen anaesthetized rabbits at 3-18 cmH2O pressure and steady-state
      net trans-synovial flow was recorded. The intra-articular fluid collected after
      15-30 min was substantially diluted despite a sustained net efflux from the
      cavity. This supports the prediction that net efflux comprises an influx of low
      protein plasma ultrafiltrate and a larger efflux of joint fluid.

PMID- 1632961
TI  - Involvement of carbonic anhydrase in ammonia flux across rumen mucosa in vitro.
AB  - Carbonic anhydrase activity in mucosa of the sheep rumen wall was completely
      inhibited by acetazolamide and ethoxyzolamide. This inhibition significantly
      reduced ammonia flux across mucosal discs in vitro but was ineffective if short
      chain fatty acids were present in the bathing solution. The findings are
      discussed in relation to the mechanism of ruminal ammonia absorption.

PMID- 1632962
TI  - Appearance of phloridzin-sensitive glucose transport is not controlled at mRNA
      level in rabbit jejunal enterocytes.
AB  - Glucose uptake by rabbit intestine has been shown to be confined to the upper two
      thirds of jejunal villi. Inhibition by phloridzin shows most of this transport to
      take place through the Na(+)-glucose linked transporter (SGLT1). Parallel
      measurements on the other hand show SGLT1 mRNA expression to increase rapidly as
      enterocytes reach the crypt-villus junction. Levels of SGLT1 mRNA then remain
      elevated in all villus enterocytes. These results provide direct evidence that
      SGLT1-mediated glucose transport is subject to post-transcriptional control.

PMID- 1632963
TI  - Evidence for presynaptic depression of monosynaptic excitation in neonatal rat
      motoneurones by (1S,3S)- and (1S,3R)-ACPD.
AB  - Both the (1S,3S) and (1S,3R) stereoisomers of 1-aminocyclopentane-1,3
      dicarboxylate (ACPD), but not the (1R,3R) or (1R,3S) isomers, potently depress
      the fastest (presumed monosynaptic) component of dorsal root-evoked ventral root
      potentials in hemisected isolated spinal cord of the newborn rat. This effect is
      not due to antagonism of known excitatory amino acid (EAA) receptors on
      motoneurones and may reflect an action of the two ACPD isomers at presynaptic EAA
      receptors of the L-2-amino-4-phosphonobutyrate (L-AP4) type.

PMID- 1632964
TI  - Horizontal integration and cortical dynamics.
AB  - We have discussed several results that lead to a view that cells in the visual
      system are endowed with dynamic properties, influenced by context, expectation,
      and long-term modifications of the cortical network. These observations will be
      important for understanding how neuronal ensembles produce a system that
      perceives, remembers, and adapts to injury. The advantage to being able to
      observe changes at early stages in a sensory pathway is that one may be able to
      understand the way in which neuronal ensembles encode and represent images at the
      level of their receptive field properties, of cortical topographies, and of the
      patterns of connections between cells participating in a network.

PMID- 1632965
TI  - Pathway selection by ectopic motoneurons in embryonic zebrafish.
AB  - Primary motoneurons in embryonic zebrafish innervate cell-specific muscles.
      During pathfinding, motoneuronal growth cones encounter three distinct regions: a
      common pathway, a choice point, and separate cell-specific pathways. To learn
      whether the order in which these regions are encountered influences pathway
      choice, we transplanted individual motoneurons to the choice point region. These
      cells selected their appropriate cell-specific pathways. Thus, the sequence in
      which pathway regions are encountered may not be important for accurate path
      finding, and the cell-specific pathways may be delineated by distinct cues that
      individual growth cones recognize. Moreover, these cues are unlikely to be
      general ones, since primary sensory neurons transplanted to the same location do
      not extend growth cones along the motoneuronal pathways.

PMID- 1632966
TI  - Temporal limits on the rise in postsynaptic calcium required for the induction of
      long-term potentiation.
AB  - The induction of long-term potentiation (LTP) in hippocampal CA1 pyramidal cells
      requires a rise in postsynaptic intracellular Ca2+ concentration ([Ca2+]i). To
      determine the time for which Ca2+ must remain elevated to induce LTP, the
      photolabile Ca2+ buffer diazo-4 was used to limit the duration of the rise in
      postsynaptic [Ca2+]i following a tetanus. The affinity of diazo-4 for Ca2+
      increases approximately 1600-fold upon flash photolysis, permitting almost
      instantaneous buffering of [Ca2+]i without disturbing resting [Ca2+]i prior to
      the flash. Photolysis of diazo-4 1 s following the start of the tetanus blocked
      LTP, while delaying photolysis for more than 2 s had no discernible effect on
      LTP. Photolyzing diazo-4 at intermediate delays (1.5-2 s) or reducing photolysis
      of diazo-4 often resulted in short-term potentiation (STP). These results
      indicate that a tetanus-induced rise in postsynaptic [Ca2+]i lasting at most 2
      2.5 s is sufficient to generate LTP. Smaller increases or shorter duration rises
      in [Ca2+]i may result in STP.

PMID- 1632967
TI  - The amyloid protein precursor of Alzheimer's disease is a mediator of the effects
      of nerve growth factor on neurite outgrowth.
AB  - The beta A4 protein, the major component of the amyloid deposition characterizing
      Alzheimer's disease, derives from the amyloid protein precursor (APP), an
      integral membrane protein with soluble derivatives. The function of APP is
      unknown. Both soluble and membrane-associated human brain APP (10(-10) M)
      significantly increased (P less than 0.025) neurite length and branching in
      pheochromocytoma PC12 cells, but did not affect the number of neurites per cell.
      At higher concentrations, APP was cytotoxic, with a half-maximal concentration of
      5 x 10(-9) M. Nerve growth factor (NGF) is known to affect APP expression in vivo
      and in vitro. Antibodies to APP specifically diminished the effects of NGF on
      neurite length and branching. Thus APP may act to mediate neurite outgrowth
      promotion by NGF.

PMID- 1632968
TI  - Generation and migration of cells in the developing striatum.
AB  - The development of the rat striatum was investigated using a combination of two
      histochemically distinguishable retrovirus vectors. Using this method, it was
      possible to identify clonal boundaries within the embryonic striatum and thus
      determine patterns of proliferation, migration, and some lineal relationships.
      Several novel aspects of striatal histogenesis were discovered. Striatal
      progenitor cells do not exhibit a stem cell pattern of division between embryonic
      day 15 (E15) and E19; a progenitor-progeny relationship appears to exist for
      ventricular zone and subventricular zone (SVZ) cells; striatal progenitors
      produce a variety of clone types; some SVZ cells migrate radially, and some
      migrate tangentially within the SVZ; and radial glia and presumptive neurons can
      occur in the same clone.

PMID- 1632969
TI  - Involvement of neuronal cell surface molecule B2 in the formation of retinal
      plexiform layers.
AB  - The B2 molecule is a 220 kd neuronal cell surface protein of Xenopus, recognized
      by monoclonal antibody B2 (MAb B2). Immunohistochemistry using MAb B2 revealed
      that the B2 molecule was expressed in both the inner and outer plexiform layers
      within the neural retina. During development of the neural retina, the B2
      molecule first appeared at stages 35/36 in the newly formed plexiform layers.
      When embryonic eyes were cultured in the presence of anti-B2 antiserum (Fab
      fragments), the formation of the retinal plexiform layers was impeded. These data
      suggest that the cell surface molecule B2 plays a role in the development of
      retinal plexiform layers.

PMID- 1632970
TI  - A partial cDNA sequence of the Dlx-2 cDNA.

PMID- 1632971
TI  - Breast cancer and smoking, vodka drinking and dietary habits. A case-control
      study.
AB  - The relationship between cigarette smoking, vodka drinking and consumption of 44
      food items typical of the Polish diet were analysed in a case-control study in
      Cracow, Poland, among 127 cases of breast cancer and 250 controls randomly
      selected from the general population. Cigarette smoking was not significantly
      influencing the breast cancer risk. Compared with never-drinkers, the habit of
      vodka drinking 20 years earlier significantly increased breast cancer risk in
      women below 50 years of age (multivariate OR was 4.4 with 95% CI 1.6-12.4).
      Frequent consumption of boiled vegetables 20 years earlier (greater than 3 times
      per week) was associated with a decreased risk of breast cancer in women aged 50
      years and more (multivariate OR was 0.4 with 95% CI 0.2-0.8).

PMID- 1632972
TI  - Clinical examination, mammographic findings and cytological diagnosis in patients
      with breast disorders. Results of 9 years' follow-up.
AB  - In January through March 1978, 482 consecutive patients sought advice and
      examination for different kinds of breast disorders at the Breast Unit of
      Radiumhemmet; 171 of them (32.8%) came without any prior known medical
      consultation. All patients were seen by a doctor and examined clinically; 385
      underwent mammography and 196 fine-needle aspiration for cytology. Combined
      clinical and mammographic examination showed an estimated specificity with
      respect to 'breasts with no need of follow-up' of 77%. The corresponding
      sensitivity was 88%. Fine-needle aspirations showed an estimated specificity and
      sensitivity of 96% and 88% respectively. In the total material 26 malignant cases
      were found, of which 16 cancers were detected at the first examination. During a
      follow-up period of nine years, 10 additional breast cancers were found in the
      national cancer registry. This number could be compared to the expected number of
      6.6 (SIR 1.52, 0.73-2.79) breast cancer cases if the studied women had had the
      same standardized incidence as the total female Swedish population. The mean
      number of visits to the Breast Unit was 1.6 for the 466 patients with benign
      disorders, of whom 322 had no need of follow-up. The mean follow-up time for
      these 482 patients was 113 days. During the follow-up time, 22 patients died. Ten
      patients, one of them with a breast cancer diagnosed, emigrated.

PMID- 1632973
TI  - Tumors after radiotherapy for thyroid cancer. A case-control study within a
      cohort of thyroid cancer patients.
AB  - A case-control study of Swedish thyroid cancer patients was conducted to evaluate
      the possible influence of 131I treatment and external radiotherapy on the risk of
      developing a subsequent cancer. Both cases and controls derived from a cohort of
      Swedish thyroid cancer patients treated with 131I (n = 834) or by other means (n
      = 1,121). Thirty-six breast, 13 stomach, 12 kidney, and 5 bladder cancers were
      found more than 2 years after 131I treatment/thyroid cancer diagnosis.
      Individual, absorbed dose in the organs was calculated by using ICRP tables,
      administered activity of 131I, and 24-h 131I uptake. In studying the effect of
      131I and external radiotherapy no statistically significant dose-response
      relationships were found for cancers of the breast, stomach, bladder or kidney.
      When the absorbed dose from 131I was analyzed separately the risks remained
      essentially the same. The present follow-up time and the relatively low absorbed
      dose that the patients received from 131I and external radiotherapy necessitate
      studies with a longer follow-up time or a larger patient material before more
      firm conclusions can be made.

PMID- 1632974
TI  - Protein tyrosine kinase activity in human thyroid papillary carcinoma.
AB  - We compared the protein tyrosine kinase (PTK) activity in the acytosolic and
      particulate fractions of homogenates obtained from 10 papillary thyroid
      adenocarcinomas with the corresponding activity in 10 specimens from adjacent
      normal thyroid tissue and 8 follicular adenomas. The cytosolic PTK activity of
      papillary adenocarcinomas was significantly elevated compared to normal and
      adenoma tissue. The particulate PTK activity was also significantly elevated in
      the papillary adenocarcinomas. The cellular distribution of PTK activity
      (cytosolic activity in percentage) in normal thyroid tissue, adenomas, and
      papillary adenocarcinomas showed no significant difference (62%, 64% and 63%
      respectively). These findings indicate that elevated cytosolic PTK activity may
      be a potentially useful marker for papillary thyroid carcinoma.

PMID- 1632975
TI  - Soluble interleukin-2 receptor levels in patients with malignant melanoma and
      renal cell cancer.
AB  - Soluble interleukin-2 receptor (sIL-2R) levels were measured in sera from 33
      patients with metastatic malignant melanoma and 14 patients with metastatic or
      advanced renal cell cancer. Significantly elevated levels were found in both
      groups compared to 30 healthy controls. No correlation was found between the
      levels of sIL-2R and clinical parameters such as disease-free interval and tumour
      burden. Neither was there any correlation between receptor-levels and survival.
      This contrasts with the observations in lymphoma patients, but is in accordance
      with findings in other solid tumours. sIL-2R is possibly a marker of the host
      immune response to the tumour, but further investigations are needed to see if it
      has any predictive value concerning prognosis or response to immune therapy.

PMID- 1632976
TI  - Serum tumour necrosis factor alpha levels in benign and malignant lesions of the
      endometrium in postmenopausal women. A preliminary study.
AB  - Tumour necrosis factor alpha (TNF alpha) concentration was determined by a solid
      phase immunoradiometric assay in sera of 20 healthy postmenopausal women
      (reference group), 10 women suffering from postmenopausal bleeding with
      histologically confirmed cystic glandular hyperplasia, and 10 postmenopausal
      bleeding patients with histologically confirmed endometrial adenocarcinoma. In
      cases of endometrial adenocarcinoma serum TNF alpha (157.6 +/- 28 pg/ml) was
      found to be significantly higher than in controls (80.6 +/- 4.1 pg/ml). The rate
      of abnormally high values of serum TNF alpha increased with advancing stage of
      the disease. On the other hand, serum TNF alpha level in cases of endometrial
      hyperplasia (38 +/- 6 pg/ml) was significantly lower than in healthy individuals.
      It seems that the rise of serum TNF alpha in cases of endometrial carcinoma
      represents a possible mechanism of immune surveillance. The results suggest
      clinical usefulness of serum TNF alpha estimations for the differential diagnosis
      of benign and malignant lesions of the endometrium in women with postmenopausal
      bleeding.

PMID- 1632977
TI  - Crude isolation of DNA from unselected human pancreatic tissue and amplification
      by the polymerase chain reaction of Ki-ras oncogene to detect point mutations in
      pancreatic cancer.
AB  - Human pancreatic tissue obtained during surgery was divided into two samples, one
      stored in formalin for histology and the other frozen directly for DNA studies. A
      small bit of the frozen tissue was excised without prior differentiation of
      malignant from non-malignant tissue and crude DNA prepared. The DNA was used to
      amplify the Ki-ras oncogenes with the polymerase chain reaction (PCR) using
      primers for codons 12, 13 and 61. The PCR products were hybridized with
      oligonucleotides to detect mutations in these codons. No mutations were seen in
      patients histologically free from pancreatic cancer, having cancer of the papilla
      of Vater or endocrine pancreatic cancer. In the 9 cases of pancreatic cancer,
      point mutations were detected in codon 12 in 7 cases and in codon 13 in one
      patient. Thus, the PCR technique can be used to detect point mutations in Ki-ras
      oncogenes even in crude DNA without selection of malignant from non-malignant
      tissue.

PMID- 1632978
TI  - Droloxifene--a new anti-estrogen. A phase II study in advanced breast cancer.
AB  - Twenty-six patients with advanced breast cancer were treated with a new anti
      estrogen, Droloxifene (3-hydroxy-tamoxifen). They had all used tamoxifen either
      in the adjuvant or the advanced situation. The dose schedule was 100 mg orally
      daily. Partial remissions were observed in 4 (15%) of the patients, and in
      another 5 patients stable disease (greater than 24 weeks of duration) was
      observed. Three of the responders were resistant to tamoxifen. Fourteen of the 26
      patients had no side-effect. In 2 patients therapy had to be stopped due to
      fatigue. Droloxifene seems to be an interesting new anti-estrogen which should be
      further exploited.

PMID- 1632979
TI  - Interferon combined with irradiation in the treatment of operable head and neck
      carcinoma. A pilot study.
AB  - Twenty-two patients with operable head and neck cancer were randomized to receive
      natural leukocyte alpha interferon (IFN) and radiotherapy, or radiotherapy alone
      (control) before operation. IFN was administered at 6 MU i.m. daily for 4 weeks
      and thereafter 3 times per week for 2 months. IFN treatment was introduced
      simultaneously with radiotherapy (2 Gy daily, 5 fractions per week). The
      preoperative dose was 30-32 Gy. Tumor response and side-effects were registered.
      The patients underwent radical surgery 3 weeks after the preoperative
      irradiation, followed by postoperative irradiation with 22-32 Gy. After
      preoperative treatment there were one complete response and 4 partial responses
      among 10 patients receiving IFN and 2 partial responses among 12 patients treated
      with irradiation alone. No difference in survival was demonstrated between the 2
      groups. In the histologic examination of the surgical samples malignant cells
      were found in 6 of the IFN patients and in 8 of the control patients. The IFN
      patients had considerably more pronounced mucosal radiation reactions than the
      controls. The accrual of patients to the study was discontinued due to the side
      effects.

PMID- 1632980
TI  - Radiobiological cell survival models. A methodological overview.
AB  - A central issue in clinical radiobiological research is the prediction of
      responses to different radiation qualities. The choice of cell survival and dose
      response model greatly influences the results. In this context the relationship
      between theory and model is emphasized. Generally, the interpretations of
      experimental data depend on the model. Cell survival models are systematized with
      respect to their relations to radiobiological theories of cell kill. The growing
      knowledge of biological, physical, and chemical mechanisms is reflected in the
      formulation of new models. The present overview shows that recent modelling has
      been more oriented towards the stochastic fluctuations connected to radiation
      energy deposition. This implies that the traditional cell survival models ought
      to be complemented by models of stochastic energy deposition processes and repair
      processes at the intracellular level.

PMID- 1632981
TI  - Application of radiation effect models in combined external and intracavitary
      radiotherapy of carcinoma of the uterine cervix.
AB  - A retrospective analysis of 291 patients with cancer of the uterine cervix
      treated with a combination of external and intracavitary radiotherapy was carried
      out. Patients were treated with an external radiotherapy dose of 45 Gy in 20
      fractions, 5 fractions per week, or 42 Gy in 14 fractions, 3 fractions per week.
      For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy
      per hour. Treatment results in terms of survival, local disease-free survival and
      complication rates were compared with cumulative radiation effect (CRE) and
      extrapolated response dose (ERD) values for point A (CRETA and ERDTA
      respectively) and for rectum (CRETr and ERDTr respectively). CRETA and ERDTA
      values did not significantly correlate with local disease-free and survival
      rates. Correlations of CRETA and ERDTA with overall complication rate and with
      rectal complication rate (p-value less than 0.025) were good. No significant
      correlation was observed between CRETr or ERDTr and overall complication rate and
      rectal complication rate. In order to limit grades II and III rectal
      complications to acceptable level, in combined external and intracavitary
      treatment, CRETA and ERDTA values of less than 2,500 and 93 respectively are
      suggested.

PMID- 1632982
TI  - Combined radiotherapy and surgery in the treatment of neck node metastases from
      squamous cell carcinoma of the head and neck.
AB  - A prospectively recorded series of 107 patients with clinical neck node
      metastases from head and neck squamous cell carcinomas, treated in 1983-1988, and
      with initial local control, is evaluated. Eighty-eight patients received
      preoperative, and were operated 4-6 weeks after radiotherapy, and 19 received
      postoperative radiotherapy. Forty-four of the neck specimens in the
      preoperatively treated patients showed vital tumor tissue, 7 with positive and 37
      with negative resection margins. Nine of the latter 37 patients died due to
      regional recurrence. Twenty-three of the preoperatively treated patients had no
      palpable residual tumor following radiotherapy, but histological examination
      showed vital tumor tissue in five, of whom two had N1 neck disease. The overall
      regional failure rate was 19%. Eleven patients (10%) died from local recurrence
      and 11 from distant metastases. Forty-one patients (38%) are alive without
      evidence of disease and three (3%) alive with disease (mean observation time 30
      months). Combined treatment is recommended for all cases of neck node metastases.

PMID- 1632983
TI  - Effects of glucan on the reticuloendothelial system and on the development of
      tumors in 90Sr-exposed mice.
AB  - A series of experiments was conducted to examine the effect of glucan on the
      reticuloendothelial system (RES) and on the development of 90Sr-induced
      osteosarcomas and malignant lymphomas in CBA/S mice. Glucan demonstrated a strong
      RES-stimulating effect, as evidenced by a dose-related increase in lysozyme
      levels in the plasma and an enlargement of the liver and spleen. Weekly
      injections of glucan between 150 and 250 days after exposure to 90Sr suppressed
      the actuarial appearance of the fibroblastic type of osteosarcomas and stimulated
      the emergence of malignant lymphomas. Glucan itself had no tumorigenic effect in
      mice not exposed to 90Sr.

PMID- 1632984
TI  - Normal tissue reactions in mice after combined treatment with metoclopramide and
      ionizing radiation.
AB  - We have previously shown that metoclopramide potentiates the effect of ionizing
      radiation and cisplatin treatment of human squamous cell carcinomas from the head
      and neck region xenografted to nude mice. In the present tumor study, the dose
      scheduling of metoclopramide in combination with radiation was evaluated, and
      metoclopramide was shown to be most effective in potentiating the cytotoxic
      effect of radiation when administered one hour before radiation. The effect of
      radiation in combination with metoclopramide on normal tissue was also studied in
      two well-established models. Acute skin reactions to radiation exposure were
      studied in 129-type mice, and metoclopramide did not enhance the acute skin
      reaction in this in vivo model. Survival after whole body irradiation was studied
      in heterozygote Balb/c nu/+ mice as a measure of bone marrow toxicity.
      Metoclopramide was not found to affect the LD50/30 in this in vivo model. The
      absence of potentiation of radiation damage to normal tissue in these animal
      studies, makes metoclopramide an interesting possibility for future clinical
      evaluation.

PMID- 1632985
TI  - Metastasis in the male breast from a lung adenocarcinoma.

PMID- 1632986
TI  - Genetic mapping and biochemical characterization of suppressor mutations sukA and
      sukB for a dnaK7(Ts) mutation of Escherichia coli K-12.
AB  - Temperature-resistant pseudorevertants were isolated from a dnaK7(Ts) mutant of
      Escherichia coli K-12. Two of these pseudorevertants were shown to carry
      suppressor mutations, sukA and sukB, respectively. Genetic mapping by conjugation
      and P1-transduction revealed that these suppressor mutations were located at two
      distinct sites between 76 and 77 min close to the suhA and rpoH genes. Labeled
      cellular proteins were extracted from suppressor mutants grown at various
      temperatures and subjected to SDS-gel electrophoresis. Autoradiograms of the gels
      indicated that these suppressor mutations each resulted in increased synthesis of
      the heat shock protein Lon (an ATP-dependent protease, La) at both permissive and
      nonpermissive temperatures.

PMID- 1632987
TI  - [Revista Portuguesa de Cardiologia. Quality and prestige to the service of
      cardiovascular medicine].

PMID- 1632988
TI  - [Pharmaceutical companies as sponsors of clinical trials--advantages and
      limitations].
AB  - The therapeutic progress achieved in the second half of this century was made
      possible only due to the interest taken by the pharmaceutical industry in the
      research field. It can be considered as the primum movens of the therapeutic
      revolution which has strongly benefited the humanity in these last decades. The
      clinical trials of new drugs constitute an integral part of the pharmaceutical
      and medical research. However its complexity and the costs involved make its
      execution impossible without the help or sponsorship of the pharmaceutical firms.
      Even in the more advanced countries it would be unthinkable that clinical trials
      could be carried out without the assistance of the pharmaceutical industry. The
      sponsorship by the pharmaceutical firms turns the relationship doctor-firm into a
      symbiotic association as both the parties reap benefits thereof: the physician
      because he is able to satisfy his inquisitiveness and his interest for the
      clinical research and the pharmaceutical firm because through these trials it
      will collect the information it requires. Besides having to bear the expenses
      inherent to the research, the sponsoring firms equally contribute for other
      pursuits usually of academical character and of interest to the investigator.
      Therefore it is not rare that these firms assume the costs of presence of these
      investigators in scientific meetings or to contribute for the arrangements of
      such meetings or even subsidise the acquisition of the equipment for the hospital
      services, etc.--measures which in countries with poor investments in research
      sector, such as Portugal, may constitute the only possibility to be carried
      out.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1632989
TI  - [Surgical treatment of ventricular septal defect in the first year of life].
AB  - Forty six infants with a large ventricular septal defect (VSD) underwent surgical
      treatment during the first 12 months of life. Forty three patients ranging in age
      from 3 to 12 months (mean age 10.4 months) and weighting from 3.0 to 8.2 kg (mean
      weight 6.8 kg) had primary surgical closure of their VSD. All infants were below
      the third percentile for weight preoperatively. In 40 patients (93%) the defect
      was closed through the right atrium. Three patients (7.0%) died in the early
      postoperative period. Surgically induced heart block occurred in one patient
      (2.3%). Late results were assessed in 29 surgical survivors (mean follow-up 26
      months). There was no late mortality. Relief of congestive heart failure was
      prompt in all patients following closure of VSD. Right bundle branch block with
      left anterior hemiblock developed in 5 patients (17.2%), and right bundle branch
      block alone in 10 patients (34.5%). Three patients (mean age 4.3 months, mean
      weight 2.7 kg) underwent initial palliative pulmonary artery banding (PAB). There
      were no operative or late mortality. Closure of VSD and pulmonary artery
      debanding was performed in two of these patients, with no mortality. Prior to
      intracardiac correction the pulmonary artery pressure distal to the band was
      normal; no band related complications were found. Early primary closure is the
      treatment of choice for symptomatic infants with large VSDs. In particular
      circumstances, however, PAB may provide effective palliation.

PMID- 1632990
TI  - [Echocardiographic assessment of interventricular septal defect corrected during
      the first year of life].
AB  - OBJECTIVE: To evaluate the medium term results of surgical closure of ventricular
      septal defect (VSD) performed during the first year of life, using
      echocardiography (echo). MATERIAL AND METHODS: We studied prospectively 29
      patients aged from 17 to 68 months (mean = 37) who underwent surgical closure of
      perimembranous VSD during the first year of life. The postoperative follow-up
      time ranged from 6 to 60 months (mean = 26). Fifteen age-matched normal children
      were used as a control group in evaluating the left ventricular (LV) systolic
      function. The echo study included: 1) the assessment of LV systolic function
      using the shortening fraction, ejection fraction, pre-ejection to ejection time
      ratio (PET/ET), aortic flow acceleration time, acceleration to ejection time
      ratio, mean aortic flow acceleration; 2) detection and quantification of residual
      VSD as well as tricuspid and or aortic regurgitation; 3) determination of right
      ventricular systolic pressure (RVSP). The RVSP was evaluated from the maximum
      flow velocity from a residual VSD or tricuspid regurgitation, using the
      simplified Bernoulli equation. RESULTS: The LV systolic function parameters from
      patients versus (vs) normals showed a significantly different shortening fraction
      (34 +/- 5 vs 39 +/- 4; p = 0.005) and PET/ET ratio (0.34 +/- 0.04 vs 0.31 +/-
      0.03; p = 0.02). None of the other studied parameters was significantly different
      from normal. Five (17%) patients had a small residual VSD. Two (7%) patients had
      mild aortic regurgitation. Tricuspid regurgitation was detected in 23 (79%)
      patients being trivial in 20 and mild to moderate in 3. The RVSP was quantified
      in 22 (76%) patients, ranging from 30 to 45 mmHg (mean +/- SD = 36 +/- 4). None
      of the remaining 7 patients showed changes in the end-systolic interventricular
      septal configuration. CONCLUSIONS: Our study shows that surgical closure of
      perimembranous VSD performed during the first year of life was possible without
      significant mobility. Furthermore, the echo allowed a complete and noninvasive
      cardiac evaluation of the anatomic, functional and hemodynamic status of this
      group of patients, thus limiting the need for postoperative control cardiac
      catheterization.

PMID- 1632991
TI  - [Echocardiographic study of 53 patients with rheumatoid mitral stenosis].
AB  - In 53 patients with rheumatic mitral stenosis we performed echocardiographic
      study in order to define anatomic and functional alterations. We used 3.5 MHZ
      probe and obtained images from apical and parasternal windows. Determinations
      were performed by standards of the American Society of Echocardiography. Thirteen
      patients were men and forty women. Men's mean age was 43.5 years and women's mean
      age 40 years. In the men anatomic mitral valve area was 1.1 cm2 and in the women
      1.3 cm2. Correlation anatomic to functional valve area was strong (r = 0.9).
      Mitral diastolic gradient had correlation with cardiac output, mitral valve area
      and ejection fraction. Pulmonary artery pressure had strong correlation with
      valve area and cardiac output. In conclusion, our study showed the usefulness of
      functional valve area in the graduation of mitral stenosis, the dependence of the
      mitral diastolic gradient of several cardiac events, the independence of the left
      atrium dimensions and also the strong dependence of pulmonary artery pressure of
      cardiac output and valve area.

PMID- 1632992
TI  - [Dyslipidemia as coronary risk factor].

PMID- 1632993
TI  - [Annuloaortic ectasia: report of a case].
AB  - The authors describe a case of a patient with annuloaortic ectasia (AAE) and
      severe aortic regurgitation. The diagnostic was made by angiography. He was
      submitted to a Bentall's procedure; replacement of the ascending aorta by a
      conduit and of aortic valve by a mechanical prosthesis with reimplantation of
      coronary arteries into the conduit. The only complication was atrial fibrillation
      with fast ventricular response. Nowadays he is clinically well, in NYHA class I.
      The authors make some considerations about AAE, its surgical treatment and its
      results.

PMID- 1632994
TI  - [Oxygen free radicals in cardiology].

PMID- 1632995
TI  - [Classification of anti-arrhythmia drugs and their mechanism of action. Iatrogeny
      of anti-arrhythmia agents].

PMID- 1632996
TI  - [Choice of anti-arrhythmia agents: the arrhythmia-patient binomial].

PMID- 1632997
TI  - [Anti-arrhythmia agents and sudden death].

PMID- 1632998
TI  - Promoting prevention services in primary care: a controlled trial.
AB  - We used a two-group hybrid, multiple baseline and reversal design to assess the
      efficacy of a prompt--an in-chart checklist--for increasing screening,
      counseling, and referral for 11 risk behaviors. Chart reviews for randomly
      selected patients of each provider showed very low baseline levels of these
      services for routine visits (0.2% to 3.8%). But significant increases occurred in
      discussion and prescription of change (although not in referrals) during
      intervention. Patient visits for routine gynecologic care and birth control
      showed higher baseline levels (10.8% to 21.0%) and also had a significant
      increase in discussion of risk behaviors. However, no significant change occurred
      in prescription or referral for these patients. Follow-up interviews of providers
      supported the reliability of the results and raised issues about attitudes toward
      primary care health promotion. Provider variability in response to the
      intervention suggests that more tailored interventions might increase provision
      of comprehensive health promotion services by a broad spectrum of primary care
      providers.

PMID- 1632999
TI  - The patient's view of hypertension and compliance.
AB  - Noncompliance has been identified as the predominant reason for failure of
      hypertension therapy. Patients may perceive hypertension as a symptomatic
      condition, and this view may affect compliance. In a cross-sectional study of
      outpatients attending a hypertension clinic, we assessed 125 veterans'
      understanding of hypertension, hypertension history, comorbidities, and pharmacy
      refills for hypertension medications. Though over 70% viewed hypertension as a
      symptomatic condition, symptoms were not significantly associated with pharmacy
      compliance. In univariate analyses, variables significantly associated with
      better pharmacy compliance were perceived lifetime treatment of hypertension,
      greater than 5-year history of medication use, perceived cause of hypertension
      other than diet, use of more than one hypertension drug, lack of reported
      departure from the prescribed medication regimen, absence of drug abuse history,
      and race (Caucasian). In multivariate analyses, the best predictive model of
      pharmacy compliance included three variables: drug abuse history, perceived cause
      of hypertension, and pattern of medication use. This type of information should
      be included in the assessment of medication compliance among hypertensive
      patients.

PMID- 1633000
TI  - Physician assessment of patient motivation: influence on disposition for follow
      up care.
AB  - This study of 3,318 outpatient visits evaluated the influence of the physician
      assessed level of patient motivation on the level of physician involvement in
      follow-up care. Data collected included patient demographics, health risk
      factors, physician-assessed level of patient motivation, and the disposition for
      follow-up care (return office visit or self-care). Physicians more frequently
      scheduled patients for a return office visit, regardless of assessed level of
      patient motivation, when they presented with a traditional biomedical problem.
      Patients with health promotion-disease prevention problems were more frequently
      relegated to self-care; patients physicians judged to be poorly motivated were
      four times as likely to be relegated to self-care. We discuss the implications of
      physician overuse of self-care strategies on the health status of poorly
      motivated patients. Factors influencing such physician behavior may include prior
      unrewarding experiences with poorly motivated patients, perceived lack of skill
      in affecting behavior change, time constraints, lack of reimbursement for
      preventive care services, and the actual process of physician education and
      professional socialization.

PMID- 1633001
TI  - Risk factors and recommendations for 230 adult primary care patients, based on
      U.S. Preventive Services Task Force guidelines.
AB  - We used a computer program based on the U.S. Preventive Services Task Force
      guidelines to identify recommendations for 230 adult patients who presented to an
      ambulatory family practice residency clinic. We entered risk factors into the
      computer program from sex-specific questionnaires that patients completed. On
      average, patients had 15.4 risk factors and 24.5 recommendations for preventive
      services (13.0 recommendations for screening, 10.5 for counseling, and 1.1 for
      immunizations). We noted a significant increase in the number of risk factors and
      recommendations with increasing age, except for counseling recommendations. The
      average patient incurs a large number of recommendations, which depend on many
      different risk factors, making the task of complete clinician compliance with the
      U.S. Preventive Services Task Force guidelines difficult. Many of these
      recommendations include counseling, which may take more time and require skills
      that clinicians may think they lack. Complete adherence may require several
      visits for the physician to address all recommendations. Measures to increase
      patient responsibility for health maintenance and innovations using
      comprehensive, interactive, and educational computer programs may help solve
      these problems.

PMID- 1633002
TI  - Weight reduction diets and health promotion.
AB  - Obesity is an important health problem. Despite record rates of dieting and the
      availability of numerous programs, the problem is not abating. This article
      discusses the popularity of fad diets, the safety and effectiveness of commonly
      used approaches to weight loss, and the health effects of weight change. We
      propose an approach in which the search for a best treatment is secondary to the
      development of criteria to match patients to different treatments. This approach
      provides an opportunity for the health professional to take advantage of the
      multiple weight reduction resources in the community.

PMID- 1633003
TI  - Attendance patterns and characteristics of participants in public cholesterol
      screening.
AB  - We conducted free, voluntary, public cholesterol screenings in supermarkets in
      the Rochester, New York, area during a four-month period for demonstration and
      research purposes. We assessed demographic characteristics and attendance
      patterns of the 8,583 participants. Compared with 1980 census data for the same
      census tracts, our participants were likelier to be white, older, female, and
      better educated than the general population in the area. Most screenees knew
      about the screenings in advance, and 79% came to the store just for screening.
      Weekend and weeknight screenings attracted more men and more younger people, in
      comparison to weekday screenings. However, referral rates based on high
      cholesterol (HC) test results were similar during all screening times. Overall,
      22% of screenees reported a previous diagnosis of HC, but in the highest
      cholesterol-level group, 45% of screenees reported a history of HC. Previous
      awareness of HC did not vary according to screening time. These findings indicate
      that, like other screenings, cholesterol screenings in a public setting do not
      attract a representative sample of the whole population. The screenings did,
      however, attract a large number of high-risk individuals, many of whom had no
      prior awareness of HC. These results should be valuable in planning and targeting
      future cholesterol screenings.

PMID- 1633004
TI  - Application of the MRFIT smoking cessation program to a healthy, mixed-sex
      sample.
AB  - The Multiple Risk Factor Intervention Trial (MRFIT) included a smoking cessation
      program that was highly successful (40.3% abstinence prevalence rate at 48-month
      follow-up) when used with other interventions for a male, middle-aged population
      at high risk for coronary heart disease (CHD). Our study employed the MRFIT
      cessation program alone with a mixed-sex, mixed-age, healthy population. We
      wished to determine its effectiveness when applied in a manner similar to other
      smoking cessation programs. Fifty-six subjects participated in a 10-week
      intervention followed by maintenance or extended intervention programs. The 52%
      abstinence prevalence rate at the end of the 10-week intervention dropped to 32%
      after four months, 25% at eight months, 25% at 12 months, and 27% at 16 months.
      The higher cessation rates of the original MRFIT study may be related to
      motivation and other characteristics of the high-risk population and to the
      combination of the smoking component with other interventions for CHD, rather
      than to the characteristics of the smoking intervention itself. Although the
      MRFIT program is comprehensive and includes vigorous maintenance activities, it
      is also expensive and may not be cost-effective or as desirable as programs with
      slightly lower cessation rates.

PMID- 1633005
TI  - Evaluation of the impact of dissemination of smoking cessation methods on the low
      birthweight rate and on health care costs: achieving year 2000 objectives for the
      nation.
AB  - Nationwide dissemination of efficacious and cost-effective smoking cessation
      methods during the 1990s represents an important part of the solution to reducing
      the low birthweight (LBW) rate and associated health care costs. A minimum of
      250,000 LBW births must be prevented during the 1990s to achieve the year 2000
      LBW rate objective of 5% of total births. Annually 1,500 to 6,000 LBW births
      might be prevented between 1991 and 2000, and cumulatively 29,000 to 44,000, by
      dissemination of tested smoking cessation methods. Twelve to eighteen percent of
      the objective might be accomplished by dissemination. LBW births attributable to
      smoking might be reduced from the current 20% to 26% rate to a rate of 9% to 12%
      if the overall maternal smoking prevalence rate is reduced to 10% as projected in
      the Year 2000 Objectives. Smoking-attributable health care cost savings from
      dissemination would range from $22 million to $59 million.

PMID- 1633006
TI  - Follow-up of the use of local health department clinics for preventive care among
      young children.
AB  - We followed 18,490 infants from their first visit to a county child health clinic
      (CHC) in Maryland through visits through their third year of age to investigate
      whether their continued use of the CHCs was related to their characteristics or
      to the services they were provided as an infant. We classified as provided
      services immunization, an Early and Periodic Screening, Diagnosis, and Treatment
      Program (EPSDT) recommended screening, and number of visits. Immunization was
      associated with an increased percentage of infants who returned to the CHCs at
      two and three years of age. Half of the children, on the other hand, never
      returned to the clinics if they were not immunized as infants. These findings
      persisted, regardless of race, Medicaid status, completion of a screening, or
      number of visits in the first year of life. One-fifth of infants did not receive
      an immunization during one or more visits to CHCs in their first year. Failure to
      administer an immunization to infants appears to impede subsequent use of public
      health clinics for well child care.

PMID- 1633007
TI  - Repeat mammography among women over 50 years of age.
AB  - Mammography decreases mortality among women 50 years of age and older. Although
      recent surveys show that mammography use has increased since 1983, it continues
      to be underused by women at risk for breast cancer. The frequency of repeat
      screening at recommended intervals remains an important unanswered question. This
      record audit study included all visits from 1986 to 1988 for active female
      patients, 51-64 years of age, in a family medicine practice. The practice has a
      disproportionately black patient population, many of whom are on public
      assistance, characteristics associated with lower compliance with cancer
      screening guidelines. I reviewed medical records for a physician's recommendation
      for mammography and also for a radiology report documenting receipt of the
      mammogram. I also abstracted from the medical record the reason for mammography,
      a history of breast cancer risk factors, and sociodemographic information. In
      addition, I noted documentation of a clinical breast examination (CBE) and CBE
      results. Records for 150 patients were included in the analysis. The results
      indicate that repeat screening mammography is not common: 3% had three mammograms
      during the study period; 19% had two; 33% had one; and 44% had none. Physician
      recommendation for first-time mammography and clinical examination occurred with
      low frequency. As others report, mammography use is strongly associated with
      physician recommendation for a mammogram.

PMID- 1633008
TI  - The epidemiology of school-related injuries: new perspectives.
AB  - Among school-aged children, unintentional injuries are the leading cause of
      morbidity and mortality. We began this prospective study in a sample of nine
      schools within the Boulder Valley School District (Colorado) during the 1988-1989
      school year in an effort to explore the etiology of school-related injuries and
      to provide information relevant to their prevention. During the study period, 509
      injuries were reported among a population of 5,518 students, yielding an
      incidence of 9.22 per 100 students. Boys were nearly one and one-half times more
      likely to have sustained a school-related injury than girls (risk ratio (RR) =
      1.41; 95% confidence intervals [CIs] 1.18, 1.68). We found a significant
      difference among injury rates by school level (P less than .001). Middle/junior
      high students had the highest rate, followed closely by elementary students and
      distantly by high school students. Sports activities accounted for the largest
      percentage of school injuries (53%), and the percentage of sports-related
      injuries increased with increasing grade level. Analysis of injury rates by
      school location revealed that high school students were most frequently injured
      in the gym (1.52 per 100), middle/junior high students on the athletic field
      (4.26 per 100), and elementary students on the playground (6.12 per 100). Using
      injury location as the focal point, we examined relationships among the variables
      sport/activity, body site, and nature of injury. We found that a large percentage
      of injuries sustained on the athletic field or in the gym were similar and
      affected similar body sites, whereas playground injuries differed in their nature
      and in body site affected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633009
TI  - What's in a name?

PMID- 1633010
TI  - [Effect of growth hormone and parenteral nutrition on the catabolic phase
      following major digestive surgery].
AB  - The purpose of the present study was to determine if the administration of a
      biosynthetic human growth hormone (bGH) was able to enhance the efficacy of total
      parenteral nutrition (PN). Patients (n = 38) who had undergone major
      gastrointestinal surgery were randomly divided in two groups. Group I (n = 20)
      treated only with PN and Group II (n = 18) treated as in Group I plus bGH (4
      UI/daily). Our study shows that the administration of bGH produces a significant
      increase in serum levels of growth hormone and Somatomedin-C. It also caused a
      positive nitrogen balance from the first 24 hours on (p less than 0.01). In Group
      II on day 12 after operation a statistically significant increase in transferrin
      (p less than 0.05), albumin (p less than 0.01) and total proteins (p less than
      0.02) was observed. Our study suggest that the administration of bGH produces,
      perhaps through Somatomedin-C as mediator, an increase in protein synthesis.

PMID- 1633011
TI  - [Role of the vagal system in changes in small intestinal motility induced by
      psychological stress. Experimental study on dogs].
AB  - The objectives of the present study were: 1) to describe the modifications in
      motility of the small intestine in response to situations of psychic stress
      during fasting and postprandial periods. 2) To analyse the possible involvement
      of the vagal system in these modifications. For this we used a total of 40 dogs.
      The motility of the small intestine was recorded using electromyography
      techniques (monopolar electrodes) and manometric techniques (submucous
      microballons). The stress stimulus consisted in the complete body immobilization
      of the animal in plaster. We show that stress induced a significant increase in
      the intestinal motility index (percentage of show waves followed by the action
      potential) in the three locations of the intestine studied (duodenum, angle of
      Treitz and proximal part of the jejunum) during the fasting (p less than 0.001)
      and postprandial periods (p less than 0.001). Finally, we demonstrate that
      vagotomy prevents the effect of hypermotility causes by the psychic stress. We
      can conclude that psychic stress does indeed modify the normal motility of the
      small intestine, both in the fasting and postprandial periods, and the vagus is
      implicated in this hypermotility response.

PMID- 1633012
TI  - [Complications and possible risk factors in endoscopic polypectomy of the colon].
AB  - We review the incidence of iatrogenic complications in a serie of 661 patients
      who underwent endoscopic polypectomy, performed by the same team of endoscopists
      and using similar technique. We discuss the role of age, sex, associated
      diseases, coagulation abnormalities and polyp features (size, location, shape and
      malignancy) in the development of complications. Five severe complications
      (0.75%, 3 hemorrhages and 2 perforations) were detected. Two patients required
      blood transfusion and two other patients surgical treatment. Recovery was
      successful in all patients. In eight patients (1.21%) mild complications which
      did not required further treatment were present. According to previously
      published data, these results are satisfactory. Polyp size proved to be the only
      risk factor with statistical significance; 23.36 +/- 14.17 mm. in complicated
      polypectomies vs 8.12 +/- 4.21 mm. in non-complicated cases (p less than 0.001).
      The remaining parameters analyzed showed no significance and therefore no
      predictive value.

PMID- 1633013
TI  - [Synchronous carcinoma of the colon and the rectum (21 cases)].
AB  - We present a retrospective study on 610 patients with colorectal cancer diagnosed
      over a 10 year period; 21 patients (3.4%) had synchronous multiple primary
      carcinomas. Age and clinical symptoms were similar to those with single
      carcinomas. In 57% of patients, the presence of synchronous neoplasms was
      diagnosed preoperatively by colonoscopy and/or barium enema, in 38%
      peroperatively and in 5% postoperatively. The more frequent localizations were
      rectum-sigmoid colon (24%) and descendent colon-sigmoid colon (19%). Three
      patients had 3 synchronous tumors, respectively. According to the Dukes
      classification, 80% of the patients had stage B or C. The five-year survival rate
      was 61%, similar to that for colon cancer in general. We emphasize the importance
      of preoperative identification of synchronous lesions; the whole colon should be
      investigated before surgery in order to ensure that no synchronous tumor has been
      missed or to change planned surgery.

PMID- 1633014
TI  - [Cholelithiasis in the region of Cartagena: an approximation to its real
      incidence based on the study of its symptomatic group].
AB  - We have studied the frequency of cholelithiasis in a group of patients who
      complained of clinical symptoms of cholelithiasis and lived in the region of
      Cartagena. This group of patients accounts for 40% of all the patients suffering
      from cholelithiasis this would account for 0.5% of the whole population and 1% of
      the exposed population over 30 year-of-age. Our results suggest that the
      population living in the region of Cartagena has a low-risk for cholelithiasis.

PMID- 1633015
TI  - [Cholelithiasis and cancer: a study using precursor changes in a population with
      low incidence of cholelithiasis].
AB  - In order to assess the role of cholelithiasis in the pathogenesis of gallbladder
      carcinoma in a low-risk population for cholelithiasis and gallbladder cancer, we
      have studied the relationship between cholelithiasis and cancer. Our findings
      suggest that, both the relationship between cancer and cholelithiasis, and the
      frequency of precursors lesions, are very similar to those obtained in surveys
      carried out in high-risk populations for both conditions. Our findings bear out
      our hypothesis that cholelithiasis plays a main role in the pathogenesis of
      gallbladder carcinoma.

PMID- 1633016
TI  - [Biliary ileus: enterolithotomy only or radical surgery?].
AB  - Eleven patients, 8 women and 3 men, mean age 69.9 years (range 54-81) were
      operated with a gallstone ileus during a seven years period. Echography and
      barium study of small bowel were made in 8 and 2 patients, and gave a diagnostic
      rate of 37% and 100%, respectively. A preoperative diagnosis was made in 72.2% of
      cases, simple enterolithotomy was made in 8 cases and in three cases a definitive
      treatment of biliary pathology was added. There was no mortality and a major
      complication was observed in 1 patient without biliary surgery (evisceration and
      recurrence of biliary ileus); no major complications were seen in patients with
      primary biliary surgery. With a careful, selection, surgery can be made without
      mortality nor morbidity.

PMID- 1633017
TI  - [Wilson's disease].

PMID- 1633018
TI  - [Phlegmonous gastritis. Report of a case induced by Pseudomonas aeruginosa].
AB  - The authors present a case of phlegmonous gastritis in a 65 year old patient. The
      diagnosis was made in the operating room and the treatment was conservative; no
      gastric resection was done. This clinical entity is interesting because it is a
      least frequent pathology, the pathogenic bacteria which was the cause (Pseudomona
      aeruginosa) has at this time not been reported in the literature, including the
      favorable outcome of the patient without gastric resection.

PMID- 1633019
TI  - [Digestive hemorrhage caused by vascular malformation (Rendu-Osler-Weber). A
      diagnostic and therapeutic challenge].
AB  - We present a case of gastrointestinal bleeding due to vascular malformation
      (Osler-Weber-Rendu disease), without cutaneous manifestations but with mucous
      manifestations and familiar and personal history of epistaxis. Until diagnosis,
      the patient underwent multiple radiologic and endoscopic tests and two surgical
      procedures. We would underline the diagnostic and therapeutic difficulty of
      recurrent gastrointestinal bleeding secondary to vascular malformation.

PMID- 1633020
TI  - [Cystic lymphangioma of the colon: endoscopic treatment and diagnosis].
AB  - We present a case of cavernomatous cystic lymphangioma in the hepatic angle of
      the colon, a extremely rare benign tumor developed in a patient under continued
      radiologic and endoscopic surveillance because of multiple polyps and colon
      carcinoma. The lesion was asymptomatic and was diagnosed in a routine follow-up
      colonoscopy. The endoscopic appearance was similar to that of an adenomatous
      polyp and was safely resected by polypectomy without evidence of relapse to the
      present time. Trends in the treatment of lymphangioma have been changing since
      the development of snare polypectomy; thus before 1980 it was treated mainly by
      surgery, while at present lymphangiomas less than 2 cm have been removed more
      frequently by polypectomy.

PMID- 1633021
TI  - [Endoscopic retrograde cholangiopancreatography in Mirizzi's syndrome].
AB  - Mirizzi's syndrome is characterized by compression and or stenosis of the common
      duct as a consequence of impaction of a stone in the gallbladder neck, the cystic
      duct and eventually by a cholecystobiliary fistula. Preoperative diagnosis is
      important to avoid iatrogenic injury of the biliary tree. We present two cases
      with Mirizzi's syndrome confirmed at operation in whom ERCP was done prior to the
      operation. In one of them the examination was diagnostic, while in the other,
      cystic duct compression and absence of the gallbladder image were the non
      specific findings.

PMID- 1633022
TI  - [Peritoneal mesothelioma].

PMID- 1633023
TI  - [Stercorous perforation of the colon].

PMID- 1633024
TI  - [Intestinal inflammatory disease or Behcet's disease].

PMID- 1633026
TI  - [John Arderne (c. 1307-1390). Father of proctology].

PMID- 1633025
TI  - [Hemoperitoneum following spontaneous rupture of ileal varix].

PMID- 1633027
TI  - [Measurements of MEG].

PMID- 1633028
TI  - [What the dipole tracing method can do at present and in future].

PMID- 1633029
TI  - [Magnetoencephalography in clinical epileptology].

PMID- 1633030
TI  - [Magnetoencephalography of cerebral evoked responses].

PMID- 1633031
TI  - [Effect of ulinastatin on postischemic brain edema in cats].
AB  - The effect of ulinastatin on postischemic brain edema was investigated in adult
      mongrel cats. Focal brain ischemia was produced by occlusion of the left middle
      cerebral artery (MCA) through the transorbital approach. Following two hours of
      occlusion, the brain was reperfused for two hours. In all seven animals of the
      ulinastatin-treated group, ulinastatin was administered intravenously at a dose
      of 50000 U/kg before and after occlusion. In the control group, six animals were
      given only vehicle. Measurements of regional cerebral blood flow (rCBF) were
      performed before MCA occlusion by the hydrogen clearance method, and then
      repeated every 30 minutes during and after occlusion. Following two-hour
      reperfusion, the animals were sacrificed by intravenous KCl injection. Specific
      gravity of the cortex, where rCBF was measured, was determined by
      microgravimetric method. In the analysis of specific gravity of the cortex, in
      which mean rCBF during ischemia was above 15ml/100g/min, no significant
      difference was found between the ulinastatin-treated and control groups. In the
      specimen with mean rCBF below 15ml/100g/min during ischemia, cortical specific
      gravity was reduced remarkably in the control group, while not decreased in the
      ulinastatin-treated group. The difference was statistically significant between
      two groups (p less than 0.001). These findings suggest antiedema effect of
      ulinastatin.

PMID- 1633032
TI  - [Effects of stimulation of the vertebral nerve around the proximal vertebral
      artery on pupil and the autonomic nervous system--a contribution to
      pathophysiology of Powers' intermittent vertebral artery compression syndrome].
AB  - In order to elucidate the pathophysiology involved in Powers' intermittent
      vertebral artery compression syndrome, the author investigated sympathetic and
      parasympathetic changes produced by stimulation of nerves around the proximal
      vertebral artery (the vertebral nerve) in anesthetized and immobilized cats.
      These changes were observed mainly through pupillary changes, pulse and blood
      pressure, evoked potentials in the lateral horn of the upper thoracic cord
      (centrum ciliospinale), in the cervical sympathetic trunk, and in the short
      ciliary nerve. Electrical stimulation of vertebral nerve and local application of
      K ion around the vertebral artery produced stimulus-dependent ipsilateral
      mydriasis; when stimulation of higher strength was applied pronounced ipsilateral
      and mild contralateral mydriasis and hypertension occurred. Electrical
      stimulation of perivascular tissue around the subclavian artery proximal to
      origin of the vertebral artery showed ipsilateral mydriasis; while on stimulating
      the distal subclavian, the costcervical, the omocervical and the internal
      thoracic arteries did not show any pupillary response. Neuronal discharges in the
      lateral horn of upper thoracic cord and in the cervical sympathetic trunk showed
      stimulus-dependent increases on stimulating the vertebral nerve; while,
      inhibitory responses were observed in the short ciliary nerve formed by
      parasympathetic nerve fibers. From the data available, it seems likely that the
      stimulation of periarterial neural structure of the vertebral artery produced
      sympathetic excitatory as well as parasympathetic inhibitory neuronal discharges
      simultaneously may probably be derived from the integrating autonomic center in
      the hypothalamus.

PMID- 1633033
TI  - [A case of motor neuron disease with IgM gammopathy which showed anti-cerebrum
      antibody].
AB  - A patient, 50-year-old female, developed progressive weakness of lower
      extremities, and gait disturbance for 2 years. Neurological examination revealed
      hyperreflexia with pathological reflex, fasciculation in the limbs and tongue,
      muscle weakness and atrophy in distal limbs, but no sensory disturbance. Needle
      EMG showed neurogenic findings compatible with motor neuron disease (MND).
      Laboratory data showed polyclonal IgM hyperimmunoglobulinemia, positive several
      autoimmune antibodies including antisingle strand DNA antibody (Ab), ENAab, SS-A
      ab and RA. There were no antibodies for gangliosides and Myelin-associated
      glycoprotein (MAG), but positive antibody for 54KD protein of cerebral gray and
      white matter. The clinical manifestations including gait disturbance and muscle
      weakness, and serum IgM level were moderately improved by plasmapheresis which is
      considered important for consideration of causes of MND.

PMID- 1633034
TI  - [Agenesis of the internal carotid artery--report of a case combined with
      arachnoid cyst in a child].
AB  - A case of agenesis of the internal carotid artery combined with arachnoid cyst is
      reported. This 11-year-old boy had occasionally complained headache and nausea
      since he was of 9 years old. He was admitted to our hospital because of an
      epileptic seizure. Physical and neurological examinations on admission were
      normal. A CT scan showed a cystic mass in retrocerebellar region. MRI suggested
      absence of flow void area indicating internal carotid artery in the cavernous
      sinus on left side. Left common carotid angiogram showed absence of the internal
      carotid artery. Bilateral A2 segments were supplied by right A1 with tortuous
      anterior communicating artery. Left middle cerebral artery and left ophthalmic
      artery were supplied via dilated left posterior communicating artery on left
      vertebral angiogram. Thin slice, axial target image of the CT revealed absence of
      the left bony carotid canal. MRI by 3D TOF method confirmed no blood flow in this
      area. MR angiography provided sufficient information about cervical vessels non
      invasively. 123I-IMP SPECT image ascertained no hypoperfusion area in left
      cerebral hemisphere. Convulsion was controlled with sodium valproate. Association
      of agenesis of the internal carotid artery and arachnoid cyst could be a
      coincidence.

PMID- 1633035
TI  - [A case of acute subdural hematoma in the posterior fossa with idiopathic
      thrombocytopenic purpura].
AB  - Intracranial bleeding is one of fatal complications in idiopathic
      thrombocytopenic purpura although its reported incidence is low. A case of
      spontaneous acute subdural hematoma complicated with idiopathic thrombocytopenic
      purpura was reported. He was hospitalized complaining of sudden onset of headache
      and nasal bleeding without neurological deficit. CT scan revealed subdural
      hematoma in the posterior fossa especially below the tentorium cerebelli. Further
      hematological examination proved very low platelet count (1,000/mm3) and
      antiplatelet antibody in confirmation of a diagnosis of idiopathic
      thrombocytopenic purpura. As his neurological status was good, he was treated
      medically. His symptoms and platelet count improved gradually with corticosteroid
      therapy. Reviewing the literature, acute subdural hematoma with idiopathic
      thrombocytopenic purpura was quite rare and only three cases reported.

PMID- 1633036
TI  - [Oculomotor nerve palsy due to small midbrain infarct--functional topography
      based on MRI findings].
AB  - This is a report of 3 cases presented with oculomotor nerve palsy caused by small
      midbrain infarct. The aim of this report is to clarify the functional topography
      of intranuclear and intrafascicular portion of the oculomotor nerve with MRI.
      Three cases are 2 males and 1 female, ranging 51 to 68 years in age. Except for
      the long tract signs at the acute stage, cardinal sings were all eye-related,
      incomplete in 1 case and pupil sparing-type in 2 cases. In MRI, the size of the
      lesion extended 5 to 12 mm. In the incomplete palsy case, the infarction extended
      from the level immediately below the 3rd ventricle into the whole length of
      midbrain, whereas in the pupil-sparing types, more limited lesion excluding the
      upper part of the midbrain was noted. Anatomically the longitudinal size of the
      nucleus is 10mm and nerves functionally related to pupil reaction, eye motion and
      eyelid elevation are arranged in rosrocaudal order. Therefore, it is speculated
      that in midbrain, intrafascicular location of nerve fibers associated with pupil
      reaction is rostral and oculomotor nerve palsy of pupil sparing type is caused by
      the lesion excluding the rostral midbrain. MRI findings of the present 3 cases
      are compatible with this speculation. The lowest border of red nucleus is at the
      level of superior colliculus, whereas oculomotor nucleus has its lowest margin at
      the inferior colliculus. Therefore, red nucleus becomes an informative landmark
      to visualized the level of oculomotor nerve injury, since the red nucleus is
      clearly demonstrated in high intensity in T2 weighted image.

PMID- 1633037
TI  - Ductus arteriosus aneurysm imaging using modern diagnostic methods.
AB  - An aneurysm of the ductus arteriosus carries a high risk of rupture. The
      radiologic findings are described, based on a review of the literature, and on
      our experience of 5 patients, successfully diagnosed and treated. A left-sided
      mediastinal mass is always present, obscured only if the aneurysm has already
      ruptured. Although the lesion seems to be congenital, conventional radiology
      sometimes demonstrates wall calcifications. Ultrasonography is well suited to
      demonstrate the vascular nature of the mass, but interpretation may be difficult
      because of intervening air-containing lung parenchyma. CT, especially using
      dynamic scanning with contrast enhancement, is an excellent noninvasive
      diagnostic method. Angiography is frequently necessary to demonstrate patency or
      occlusion of the aortic and pulmonary ends of the ductus. The differential
      diagnosis must include a large number of mediastinal tumors. A temporary widening
      of the ductus in the newborn is common and must be differentiated from a true
      aneurysm. Surgical treatment today is usually successful.

PMID- 1633038
TI  - Iliac artery stenting--clinical experience with the Palmaz stent, Wallstent, and
      Strecker stent.
AB  - A total of 82 iliac artery lesions (62 stenoses and 20 occlusions) were treated
      with 3 different types of endovascular metallic stents (12 lesions with the
      Palmaz stent, 36 with the Wallstent, and 34 with the Strecker stent). The
      complication rate was 12%. Occlusion of 2 Wallstents occurred 4 and 12 weeks
      after stent placement, respectively. Both stents were recanalized by local
      fibrinolysis. One Strecker stent occluded after 8 months. The observation period
      was 3 to 26 months (mean 9.7 months). The patency rate with secondary
      intervention (fibrinolysis) was 100% after 3 and 6 months, and 98% after 9
      months. All 3 stent designs turned out to be effective in the treatment of
      complicated iliac artery occlusive disease.

PMID- 1633039
TI  - Clinical utility of real-time compression ultrasonography for diagnostic
      management of patients with recurrent venous thrombosis.
AB  - In the diagnostic management of patients with clinically suspected recurrent deep
      vein thrombosis (DVT), there are potential limitations to all available
      diagnostic techniques. Since venous abnormalities may persist for some time after
      an acute thrombosis, the usefulness of compression ultrasonography (US) for the
      detection of recurrent DVT may be jeopardized. We determined the rate of
      normalization of an abnormal compression US test of the popliteal and the common
      femoral veins in patients after a first episode of proximal DVT. In a cohort of
      60 consecutive patients, the test result was normalized in only 29, 44, 54, and
      60% of patients at 3, 6, 9, and 12 months, respectively. The investigation shows
      that for the detection of recurrent DVT of the leg, real-time compression US
      (using the single criterion of compression of the common femoral and popliteal
      vein) is of limited value. Future studies need to be performed, using more subtle
      interpretation of the compression US result, by quantifying the extent of
      residual thrombus, which may increase the usefulness of this test in patients
      with recurrent symptoms.

PMID- 1633040
TI  - Complications of percutaneous pericardiocentesis under fluoroscopic guidance.
AB  - Complications in 352 cases of fluoroscopy-guided percutaneous pericardiocentesis
      accomplished through an indwelling catheter were reviewed following surgery and
      non-surgery. Thirteen major complications were found, namely 3 cardiac
      perforations, 2 cardiac arrhythmias, 4 cases of arterial bleeding, 2 cases of
      pneumothorax in children, one infection, and one major vagal reaction. No
      significant difference in complications was found between pericardiocenteses for
      pericardial effusions after cardiac surgery (n = 208) and those for effusions of
      non-surgical (n = 144) origin. Fluoroscopy-guided pericardiocentesis by the
      subxiphoid approach with placement of an indwelling catheter is a safe method for
      achieving pericardial drainage in both surgical and non-surgical effusions.
      Accidental cardiac perforation with a fine needle is a minor complication as long
      as the needle is directed towards the anterior diaphragmatic border of the right
      ventricle and drainage is achieved with a reliable indwelling catheter.

PMID- 1633041
TI  - Influence of CT on tumor classification of laryngeal carcinomas.
AB  - The routine use of CT in 51 consecutive patients with squamous cell carcinoma of
      the larynx revealed cartilage involvement or extralaryngeal tumor growth
      consistent with a T4 tumor which made 14 patients candidates for laryngectomy.
      Only 5 of these had a T4 classification by clinical examination while 8 cases
      were upstaged from T3. Except for one supraglottic tumor upstaged from T2 to T4,
      CT did not change the classification for T1 and T2 tumors, whose localization was
      mainly glottic, and there were 2 false-negative examinations. It is concluded
      that CT is mandatory only in advanced tumors of the glottic region or when the
      anterior commissure is involved. However, in suspected malignancies of the sub-
      or supraglottic regions CT should always be carried out because these patients
      are at an increased risk of unexpected deep tumor growth.

PMID- 1633042
TI  - Gd-DTPA-enhanced MR imaging of pituitary macroadenomas.
AB  - In a study comprising 40 patients with pituitary macroadenomas, MR imaging was
      performed before and after administration of Gd-DTPA. Before contrast
      administration T1- and T2-weighted images were obtained, and after the injection,
      frontal and/or sagittal T1-weighted images. Tumour extension and delineation,
      relationship to adjacent structures, and signal intensity patterns were
      evaluated. Compared with pre-contrast T1-weighted images only, post-contrast
      images provided considerable additional information, but not infrequently this
      information could also be extracted from pre-contrast T2-weighted images. Post
      contrast images were superior regarding the tumour relationship to the cavernous
      sinus and to the normal pituitary tissue. T2-weighted images were helpful in the
      diagnosis of degenerative changes, in particular intratumoural haemorrhage. A
      positive correlation was found between the T2 value (from dual echo sequences)
      and the degree of enhancement in areas with an appearance of solid tumour tissue,
      and the enhancement was significantly lower in GH-secreting tumours than in non
      secreting ones. It is concluded that the use of Gd-DTPA is often justified in
      pituitary macroadenomas, particularly in pre-operative evaluation.

PMID- 1633043
TI  - CT showing early ventricular dilatation after subarachnoidal hemorrhage.
AB  - We performed a retrospective analysis of 398 patients with subarachnoidal
      hemorrhage (SAH) confirmed by CT. On the first CT examination the temporal horns
      were enlarged in 84%, the frontal horns in 32%, and the third ventricle in 21% of
      the patients. The amount of blood in the basal cisterns was highly correlated to
      dilatation of the temporal horns. The temporal horns were enlarged even when
      small amounts of blood were found in the cisterns. The frontal and temporal horns
      were dilated only when moderate or large amounts of blood were present in the
      cisterns. In 24 patients no blood was seen in the basal cisterns on CT performed
      within 5 days of the hemorrhage; none of the 3 patients with aneurysms showed
      normal temporal horns while 18 without demonstrable aneurysms had normal, and 3
      had moderately dilated, temporal horns. Because the temporal horns cannot usually
      be seen at CT of healthy individuals, dilatation could be a useful sign in the
      diagnosis of SAH.

PMID- 1633044
TI  - MR imaging of spinal lymphoma.
AB  - Fourteen patients with spinal lymphoma examined by MR imaging were reviewed.
      Thirteen of them also had extraspinal lymphoma. Vertebral involvement was found
      in 12 patients, epidural in 10, and paraspinal in 8 patients. On the basis of MR
      imaging at 0.3 T, spinal lymphoma may be divided into three types of growth
      pattern according to the main location: paraspinal, vertebral, and epidural. Most
      frequently, all three locations were found simultaneously on MR (7/14). In one
      patient the location was vertebral with epidural extension, in one paraspinal
      with vertebral extension, in 3 it was entirely vertebral, and in 2 entirely
      epidural. Multiple plane T1-weighted imaging gave complete information about the
      extent of spinal lymphoma. The signal intensity was lower than or equal to muscle
      and lower than bone marrow in paraspinal and vertebral lesions on T1-weighted
      images and high on T2-weighted images. Epidural lesions showed a hypo- or
      isointense signal relative to the cord on T1-weighted images except in one case
      and a hyperintense signal on T2-weighted images. Compression of the cord and
      cauda equina due to bulging of diseased vertebral bodies and epidural lesions was
      well demonstrated. MR imaging was also found useful in the follow-up of
      treatment.

PMID- 1633046
TI  - Assessment of liver iron overload in thalassemic patients by MR imaging.
AB  - The use of MR imaging has been proposed for the assessment of the hepatic iron
      overload in transfusion-dependent thalassemic patients treated with
      desferrioxamine. The aim of the study was to correlate serum ferritin levels and
      MR signal intensity of the liver parenchyma. Results on 12 patients showed that
      the ratios between the signal intensity of liver parenchyma and muscle and fat
      are promising parameters for predicting iron overload.

PMID- 1633045
TI  - Abdominal ultrasonography in myelofibrosis.
AB  - The findings at abdominal ultrasonography (US) in 40 patients with myelofibrosis
      were reviewed, 20 patients being examined at initial diagnosis and 31 at later
      stages. Splenomegaly was found in 80% at initial diagnosis and in 97% at later
      stages. The spleen of 2 patients appeared homogeneously hypoechoic and
      inhomogeneous in one. Focal splenic lesions were seen in 5, and calcifications in
      6. Mixed splenic lesions proved to be metastases in one and hyperechoic lesions
      in another patient were due to extramedullary hematopoiesis. Hepatomegaly was
      found in 25% at primary diagnosis and in 39% at later stages. Focal hepatic
      lesions were seen in 7 patients, and proved to be metastases in 3. The focal
      lesions in 2 of these patients were extramedullary hematopoiesis, which was
      hypoechoic in one and hyperechoic in the other. Ascites was seen in 4 patients
      and lymphadenopathy in one. US could not reliably differentiate between
      extramedullary hematopoiesis and malignancy. Fine-needle biopsy may be performed
      for definitive diagnosis.

PMID- 1633047
TI  - Experimental transjugular portacaval shunt. Use of a fine-needle puncture device
      for the implantation of Strecker stents.
AB  - A transjugular portacaval intrahepatic stented shunt was created in 16 pigs
      without induced portal hypertension. A fine needle (OD 0.7 mm) was used for the
      transjugular puncture of the portal vein. The puncture was done directly from the
      inferior vena cava in 5 cases and from the right liver vein in 11 cases. The
      puncture tract was dilated and subsequently supported by a Strecker stent. The
      stented shunt was patent in all cases immediately after the stent placement, but
      was obstructed by fibrous tissue in 7 of 8 cases reexamined by angiography and
      autopsy after 4 weeks. Complications seem to be related to the choice of the
      puncture site, with fewer complications when the puncture was done via the right
      hepatic vein.

PMID- 1633048
TI  - Air enema revisited in assessment of colitis.
AB  - Plain radiographs and air enema were performed in 37 patients with ulcerative
      colitis, 7 patients with proctitis, and 8 patients with Crohn's disease. The air
      enema was superior to plain radiographs for diagnosing colitis, and for
      delineating the extent of disease and the degree of mucosal involvement. The air
      enema is simple to perform and easy to evaluate as shown by an almost complete
      agreement between 2 observers.

PMID- 1633049
TI  - CT demonstration of fat density in renal cell carcinoma.
AB  - The presence of fat in a renal mass is almost pathognomonic of angiomyolipoma. We
      report a rare instance of CT demonstration of foci of fat density in a renal cell
      carcinoma.

PMID- 1633050
TI  - Iopentol in urography. A clinical comparison between iopentol and metrizoate
      including delayed reactions.
AB  - A double-blind comparative study of the nonionic contrast medium iopentol and the
      ionic contrast medium metrizoate for urography was carried out in 200 adult
      outpatients. Significantly less discomfort and other side effects were observed
      following iopentol than following metrizoate. No serious adverse reactions and no
      clinically significant alterations in heart rate or blood pressure were observed.
      A questionnaire was used to record delayed symptoms, from 30 min after contrast
      medium injection and for one week. The response rate was 92% and delayed adverse
      events were reported by 45%. The incidence of delayed reactions was significantly
      lower following iopentol than following metrizoate, i.e., delayed arm pain,
      fatigue, headache, diarrhea, nasal congestion, and rash. Delayed arm pain was
      probably due to contrast medium induced thrombosis in 1% following iopentol and
      in 8% following metrizoate. Most other symptoms were probably related to a
      combination of nocebo effect and coincidentally occurring symptoms. The urograms
      with both media were of similar high quality. Iopentol was found a suitable
      contrast medium for urography.

PMID- 1633052
TI  - Monte Carlo simulation of multiple scattering in Compton spectroscopy.
AB  - The Compton scattered photons from a scattering medium can be analyzed in a
      Compton spectrometer and the primary energy spectrum derived using the Compton
      equation. Since the reconstruction algorithm assumes that only singly-scattered
      photons from the scatterer are detected, multiply-scattered photons introduce
      errors into the measurements unless they can be accurately corrected for. In this
      work, a Monte Carlo collision density estimator was used to determine the
      contribution from photons multiply-scattered from a Lucite scatterer in the form
      of a square rod. The ratio of multiply- to singly-scattered photons was
      determined for rod thicknesses from 0.5 to 5 mm and photons of energy 20 to 110
      keV. The ratio in percent can be well approximated as a linear function of energy
      with slope 2.2. For thicknesses below 2 mm, the ratio is less than 5% at all
      energies.

PMID- 1633051
TI  - Granulocyte adherence is inhibited by radiographic contrast media in vitro.
AB  - Different amounts of diatrizoate, ioxaglate, iohexol, iodixanol, NaCl 1,000
      mOsm/kg, mannitol 1,098 mOsm/kg, and meglumine (meglumine concentrations
      corresponding to the content in the diatrizoate solutions) were added to either
      whole blood or a suspension of granulocytes in autologous plasma, and the
      adherence to nylon fibers was determined. At high concentrations all the
      investigated contrast media (CM) inhibited granulocyte adherence. The degree of
      inhibition was significantly greater when the ionic CM diatrizoate and ioxaglate
      were used, as compared with the nonionic media. Meglumine solutions at high
      concentrations also inhibited adherence but significantly less than diatrizoate
      solutions containing the same amount of meglumine. Diatrizoate showed the
      greatest inhibitory effect on granulocyte adherence, and significant inhibition
      could be detected even with a 1.25% solution.

PMID- 1633054
TI  - Work redesign: ensuring success.

PMID- 1633053
TI  - Collaboration: the future of health care.

PMID- 1633055
TI  - Of quorums and quality: integrating shared governance and continuous quality
      improvement.

PMID- 1633056
TI  - Power spectral EEG analysis and EEG variability in obsessive-compulsive disorder.
AB  - Spectral EEG characteristics of thirteen patients with severe Obsessive
      Compulsive Disorder (OCD) were investigated topographically. The finding of
      predominantly left posterior frontal to mid-temporal theta-2 is discussed in
      light of previous EEG studies and recent neuroradiologic findings.

PMID- 1633057
TI  - Dipole tracing in childhood epilepsy with special reference to rolandic epilepsy.
AB  - To assess the clinical applicability of dipole tracing in childhood epilepsy, the
      location and stability of electric source generator of focal spikes seen in EEG
      of epileptic children were investigated using this method. The patients were
      divided into 3 groups; benign childhood epilepsy with centrotemporal spikes
      (BCECS, Group A, n = 14), other types of epilepsy with centrotemporal spikes
      (Group B, n = 15) and epilepsy with focal spikes in other areas (Group C, n =
      13). The spike dipole in each group was analyzed using dipole tracing method. The
      following results were obtained. (1) The spikes of BCECS were characterized by
      constantly stable dipoles, compared to those of the other types of childhood
      epilepsy. The spikes of epileptic children with mental retardation mostly lacked
      the stability of dipoles. These seemed to suggest that the stability of dipoles
      was closely related to the prognosis and pathophysiology of epilepsy. (2) The
      dipoles of BCECS were localized strictly in the Rolandic area. Dipole tracing
      from EEG spikes was considered to contribute to the elucidation of the
      pathophysiology of childhood epilepsy.

PMID- 1633058
TI  - Topographic distribution of the periodic discharges in Creutzfeldt-Jakob disease
      (CJD).
AB  - A characteristic EEG abnormality in patients with Creutzfeldt-Jakob disease (CJD)
      consists of periodic high voltage bilateral diphasic or triphasic sharp waves
      widely distributed over both hemispheres. The mechanism underlying these
      electrographic manifestations is, however, unclear. To increase our understanding
      of these phenomena, we have employed the technique of microcomputer brain
      mapping, to analyze the electrical fields of the bilaterally-distributed
      complexes in four patients with CJD. Ten generalized discharges were studied in
      each patient. The EEG analysis demonstrated variability in the area of onset as
      well as the field maxima between the different complexes among patients as well
      as between discharges in each patient. The generalized pattern seen in routine
      EEG was clearly shown on brain mapping to be not strictly generalized from onset,
      nor bilaterally symmetrical. These findings may suggest multifocal areas of onset
      of the generalized discharges, or alternating pathways of activation of the
      cortical areas by a subcortical pacemaker.

PMID- 1633059
TI  - Equivalent EEG sources determined by FFT approximation in healthy subjects,
      schizophrenic and depressive patients.
AB  - In recent years, as a result of increasing calculation power of computers and
      with the aid of appropriate computer programs it has been made possible to
      calculate equivalent dipoles as intracranial representations of cerebral
      electrical activity. The present study investigated the localization of
      intracerebral equivalent dipoles in healthy controls and psychiatric patients.
      The equivalent dipole sources were calculated for conventional frequency bands of
      the background EEG. This was performed using the FFT approximation by Lehmann and
      Michel. Results showed more anterior equivalent sources for alpha and beta
      activity in all patients compared to controls. The beta activity was also
      generated in deeper brain structures in controls compared to patients. These
      results indicate that frequency bands may be generated in different brain
      structures in patients suffering from psychiatric diseases as compared to healthy
      controls and that the calculation of equivalent dipole sources may be a way to
      perform a sensible and substantial data reduction.

PMID- 1633060
TI  - Topographic analysis of visual evoked potentials from flash and pattern reversal
      stimuli: evidence for "travelling waves".
AB  - In this mapping study of the entire scalp area, the responses to flash (FL) and
      pattern reversal (PR) stimuli were studied in 34 normal subjects. The N70, P100,
      N135 and P180 were similar from both stimuli but with some differences in
      amplitude and latency, especially the variability of the latency of P100 from FL.
      A polarity inversion was usually seen for all components, especially at opposite
      ends of the scalp and a zero-potential was noted for all four components near Cz
      Pz. Evidence is seen that the frontal N100 is likely not the other end of a
      dipole involving the posterior P100. Lateral components as P120, N150 and N200
      were also described. The major finding was evidence of "travelling" waves that
      appear to move in both the AP and PA directions throughout the scalp that
      eventually arrive on the posterior regions and appear as N70, P100, N135 and
      P180.

PMID- 1633061
TI  - The EEG mapping in the evaluation of patients with late onset epilepsy.
AB  - In 62 patients with late onset epilepsy the findings of EEG mapping routine EEG
      and CT were compared. Forty four patients had generalized, 18 partial seizures.
      In 39 patients (63%) EEG mapping revealed focal changes but only in 24 patients
      (39%) using routine EEG alone. Thus the EEG mapping showed focal abnormalities
      significantly more often and this could be demonstrated in the separated groups
      of patients with generalized or partial seizures as well. Lesions in CT occurred
      in 39 patients (63%). The focal abnormalities in EEG mapping were significantly
      related to the lesions in CT. Moreover focal changes corresponding to CT lesions
      were obtained by means of EEG mapping in 32 patients (82%) but only in 20
      patients (51%) using routine EEG and in that way the EEG mapping could indicate
      focal lesions in CT significantly more often than routine EEG. Regarding etiology
      this was especially seen in the group with vascular origin of epilepsy.

PMID- 1633062
TI  - Antimalarial pharmacokinetics and treatment regimens.

PMID- 1633064
TI  - Captopril augments both basal and frusemide-induced natriuresis in normal man by
      suppression of circulating angiotensin II.
AB  - 1. We studied the renal effects of reinfusing low dose angiotensin II (1 ng kg-1
      min-1) into seven salt-replete healthy volunteers after pretreatment with the
      angiotensin converting enzyme (ACE) inhibitor captopril (25 mg) to establish
      whether the natriuretic and renal haemodynamic responses to ACE inhibition in
      normal man result from suppression of circulating angiotensin II. In the same
      subjects we also studied the effect of captopril (25 mg) with and without
      exogenous angiotensin II (1 ng kg-1 min-1) on the natriuretic response to
      intravenous frusemide (20 mg). 2. In the pre-frusemide study captopril increased
      absolute and fractional excretion of sodium and paraaminohippurate clearance but
      had no effect on inulin clearance. 3. Reinfusion of angiotensin II after
      captopril pretreatment completely suppressed the renal effects of ACE inhibition,
      yielding renal vasoconstrictor and antinatriuretic effects equivalent to those
      produced by infused angiotensin II in the absence of captopril. 4. Frusemide
      increased renal sodium excretion without affecting paraaminohippurate or inulin
      clearance. Captopril augmented frusemide-induced natriuresis and again this
      effect was reversed by angiotensin II reinfusion. 5. We conclude that captopril
      augments both basal and frusemide-induced renal sodium excretion in normal man.
      Our findings suggest that these renal responses to ACE inhibition may be mediated
      by inhibition of circulating angiotensin II, specifically its renal tubular salt
      retaining actions, rather than via effects on other neurohumoral systems.

PMID- 1633063
TI  - Medical management of hypercalcaemia.
AB  - 1. Hypercalcaemia is a common disorder, which frequently requires specific
      treatment either to control symptoms, or to prevent the development of
      irreversible organ damage or death. Although the best and most effective way of
      controlling hypercalcaemia in the long-term is to treat the underlying cause,
      medical antihypercalcaemic therapy is often required in clinical practice, either
      as a holding measure, or because the primary disease cannot itself be treated. 2.
      The mainstays of medical antihypercalcaemic therapy are firstly, to promote
      calcium excretion by the kidney by restoring extracellular volume with
      intravenous saline and secondly, to administer pharmacological agents which
      inhibit bone resorption. Measures which seek to reduce intestinal calcium
      absorption are seldom effective. 3. Intravenous bisphosphonates are the treatment
      of first choice for the initial management of hypercalcaemia, followed by
      continued oral, or repeated intravenous bisphosphonates to prevent relapse. These
      drugs have a relatively slow onset of action (1-3 days) but have potent and
      sustained inhibitory effects on bone resorption, resulting in a long duration of
      action (12-30 days). 4. Of the other agents available, calcitonin has an
      important place in the management of severe hypercalcaemia where a rapid effect
      is desirable; calcitonin is best used in conjunction with a bisphosphonate
      however, because of its short duration of action. Intravenous phosphate also has
      a place in the emergency management of severe hypercalcaemia, but is probably
      best reserved for patients in whom other less toxic therapies have failed.
      Corticosteroids are generally ineffective except in certain specific instances
      and are best avoided in the routine treatment of undiagnosed hypercalcaemia.

PMID- 1633066
TI  - Effects of a non-absorbable osmotic load on drug absorption in healthy
      volunteers.
AB  - 1. We have studied the effects of a non-absorbable osmotic load on the absorption
      of a multicomponent solution of frusemide, atenolol, hydrochlorothiazide and
      salicylic acid in six healthy volunteers. 2. Each subject was studied on up to
      four separate occasions. The drugs were administered in one of four solutions: a)
      a mannitol/electrolyte solution, b) a double-strength mannitol/electrolyte
      solution, c) a glucose/electrolyte solution and d) water. Lactulose or
      sulphasalazine were added as oro-caecal transit markers. Lactulose was included
      in the mannitol- and glucose-based solutions, adding a further non-absorbable
      osmotic load, and sulphasalazine was added to the water, adding little osmotic
      load. 3. The absorption of atenolol and hydrochlorothiazide was two- to three
      times less from all lactulose-containing solutions than from the sulphasalazine
      containing solution. The absorption of frusemide and salicylic acid was similar
      from all four solutions. 4. The largest non-absorbable osmotic load impaired the
      absorption of atenolol and hydrochlorothiazide most and the incorporation of
      glucose only partly restored absorption. 5. These results suggest that
      transmucosal water movement is an important determinant of atenolol and
      hydrochlorothiazide absorption but is less relevant for the absorption of
      frusemide and salicylic acid. Furthermore, these data demonstrate a previously
      unrecognised interaction between a commonly prescribed laxative--lactulose, and
      atenolol and hydrochlorothiazide.

PMID- 1633065
TI  - The influence of gastrointestinal transit on drug absorption in healthy
      volunteers.
AB  - 1. The effect of variability of gastric emptying and oro-caecal transit on the
      absorption of a multicomponent solution of frusemide, atenolol,
      hydrochlorthiazide and salicylic acid has been studied in six healthy subjects.
      Each subject was studied on five separate occasions: three times under basal
      conditions, once following metoclopramide and once following codeine pretreatment
      in an attempt to speed and slow transit respectively. 2. Inter-subject
      variability of gastric emptying, oro-caecal transit and the rate and extent of
      drug absorption was considerable. 3. The absorption of salicylic acid appeared
      rate-limited by gastric emptying but the rate and extent of frusemide, atenolol
      and hydrochlorthiazide absorption were unrelated to measures of gastric emptying
      or oro-caecal transit. 4. Codeine phosphate caused a two-fold delay in oro-caecal
      transit but did not influence gastric emptying while metoclopramide had no
      significant effect on either function. 5. Metoclopramide and codeine had no
      significant effect on the rate or extent of absorption of any of the study drugs.
      6. Within the limits of this experiment, oro-caecal transit time did not appear
      to be an important determinant of frusemide, atenolol, hydrochlorothiazide or
      salicylic acid absorption. Other factors must account for the observed
      variability in drug absorption.

PMID- 1633067
TI  - Discrepancy between bioavailability as estimated from urinary recovery of
      frusemide and total diuretic effect.
AB  - 1. Frusemide was given at a dose of 60 mg as two oral controlled release (CR)
      formulations and as plain tablets in a randomised, balanced, three way cross over
      design to 26 healthy volunteers. Urinary volume, and contents of frusemide,
      sodium, chloride and potassium were measured in samples taken over 24 h. 2. There
      was a marked difference between the CR formulations on one hand and the plain
      tablets on the other, in excretion of frusemide and diuresis vs time. The total
      diuretic/saluretic effect was only marginally lower (19 and 28% respectively, P
      less than 0.05) after CR compared with plain tablets although the fraction
      absorbed was markedly decreased (39 and 51% lower, respectively, P less than
      0.05), estimated as urinary recovery of frusemide. The total diuresis of the two
      CR formulations did not differ although the urinary recovery was significantly
      different (P less than 0.05). 3. The diuretic effect vs frusemide excretion rate
      showed minimal counter-clockwise hysteresis after plain tablets while the CR
      formulations produced clockwise hysteresis indicating tolerance. 4. In agreement
      with the concept of efficiency, the higher diuretic/saluretic effect per amount
      of excreted frusemide may be a consequence of the slower output of frusemide in
      urine with the CR formulations compared with plain tablets. The major part of the
      pharmacological effect was produced with a higher efficiency after CR compared
      with plain tablets. It should be noted that the pharmacokinetics of a drug and
      its pharmacodynamic potency independently determine the total response.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1633068
TI  - The influence of renal function on the renal clearance of morphine and its
      glucuronide metabolites in intensive-care patients.
AB  - 1. The relationships between renal creatinine clearance and the renal clearances
      of morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) were
      studied in fifteen intensive-care patients who were receiving morphine sulphate
      by constant intravenous infusion and who had diverse renal function. 2. An
      arterial blood sample was collected before and after a 4-5 h urine collection.
      Plasma and urine concentrations of morphine, M3G and M6G were measured by
      h.p.l.c. Plasma binding of all three compounds in drug-free plasma from healthy
      volunteers was determined by ultrafiltration. Measured renal creatinine clearance
      (CLCr,meas) was calculated from plasma and urinary creatinine concentrations
      (from h.p.l.c.). Also, creatinine clearance was predicted (CLCr,pred) from
      routine laboratory determination of plasma creatinine (Jaffe method). 3. There
      were significant linear relationships (P less than 0.001) between CLCr,meas and
      the renal clearances of morphine, M3G and M6G. The unbound renal clearance of
      morphine exceeded CLCr,meas (P less than 0.002) while the unbound renal
      clearances of M3G and M6G did not differ from CLCr,meas (P greater than 0.5). 4.
      In ten of the patients who received a constant infusion of morphine for at least
      6 h, the dose-normalised plasma concentrations of M3G and M6G increased with
      decreasing CLCr,pred. Significant (P less than 0.001) relationships were observed
      between the reciprocal of CLCr,pred and the dose-normalised plasma concentrations
      of M3G and M6G. 5. The results indicate the importance of renal function in
      determining the renal clearances and plasma concentrations of M3G and M6G during
      intravenous infusion with morphine in intensive-care patients.

PMID- 1633069
TI  - Enhancement of the oral absorption of cyclosporin in man.
AB  - 1. The oral absorption of cyclosporin from three new semi-solid oral formulations
      was compared with the standard soft gelatine preparation in twelve healthy male
      volunteers. One formulation was based on a solid micellar solution, while the
      other two, with different in vitro release properties, were based on a
      microemulsion principle. 2. The results showed that the solid micellar solution
      and the faster releasing microemulsion formulation increased the extent of
      absorption on average by 45.2 and 49.0%, respectively, compared with the
      reference soft gelatine capsule.

PMID- 1633070
TI  - Contrasting effects of fluconazole and ketoconazole on phenytoin and testosterone
      disposition in man.
AB  - Nine healthy male subjects received oral fluconazole 400 mg daily, ketoconazole
      200 mg twice daily or no treatment for 6 days according to a randomized, cross
      over design. A single 250 mg oral dose of phenytoin suspension was administered
      on day 5 and serum phenytoin concentrations were measured over the following 48
      h. Serum testosterone concentrations were measured for 10 h after each dose of
      phenytoin. Ketoconazole had no significant effect on phenytoin concentrations
      while the mean AUC(0,48) for phenytoin was significantly higher with fluconazole
      (195.2 +/- 47.8 micrograms ml-1 h) than control (146.3 +/- 49.6 micrograms ml-1
      h). At 48 h, the serum phenytoin concentration averaged 1.72 micrograms ml-1
      under control conditions and 3.99 micrograms ml-1 with fluconazole (132%
      increase). AUC(0,10) for testosterone was 42% lower than control after
      ketoconazole administration (P less than 0.05) but increased by 33% from 55.6 +/-
      9.4 ng ml-1 h (control) to 73.8 +/- 12.6 ng ml-1 h with fluconazole. AUC(0,10)
      values for the testosterone precursors androstenedione and 17 alpha
      hydroxyprogesterone were significantly higher in the fluconazole treatment phase
      as were concentrations of luteinizing hormone. The mechanism and clinical
      significance of the increase in testosterone concentration caused by fluconazole
      remains to be determined.

PMID- 1633071
TI  - Plasma and cerebrospinal fluid concentrations of paracetamol after a single
      intravenous dose of propacetamol.
AB  - Since the antipyretic and probably the analgesic effects of paracetamol are, at
      least in part, centrally mediated, its plasma and cerebrospinal fluid (CSF)
      concentrations were measured in 43 patients with nerve-root compression pain.
      Each subject was given a short i.v. infusion of 2 g propacetamol, a prodrug which
      is hydrolysed to paracetamol within 7 min. Single blood and CSF samples were
      drawn concomitantly in each patient at intervals between 20 min and 12 h. Maximum
      CSF drug concentrations were observed at the 4th hour, subsequent concentrations
      exceeding those in plasma. The elimination half-life of paracetamol calculated
      from pooled data was shorter in plasma (2.4 h) than in CSF (3.2 h). The time
      course of paracetamol in CSF may parallel that of analgesic effect.

PMID- 1633072
TI  - Update on nitrate tolerance.
AB  - 1. It is now recognised that nitrate therapy designed to provide effects
      throughout 24 h each day induces tolerance. Such tolerance may be partial or
      complete and is associated with diminished haemodynamic and clinical effects. 2.
      The mechanism of tolerance is not completely understood but it seems to be
      related to the depletion of reduced sulphydryl groups in vascular smooth muscle
      and to the activation of counter-regulatory forces. These include elevated plasma
      catecholamines, arginine vasopressin and plasma renin activity. Activity of the
      renin-angiotensin system is associated with sodium and water retention and plasma
      volume expansion. The increase in vasoconstrictor influences and augmented plasma
      volume could modulate the effect of nitrate-induced vasodilatation.

PMID- 1633073
TI  - Plasma profile and haemodynamic tolerance to isosorbide-5-mononitrate in
      controlled-release form.
AB  - 1. Plasma concentrations and some haemodynamic parameters known to be affected by
      nitrates, were monitored in healthy volunteers who received three different dose
      regimens of isosorbide-5-mononitrate (5-ISMN) over 5 day study periods. 2. No
      haemodynamic tolerance was found in the 60 mg once-daily dose schedule which
      produced high plasma concentrations during the daytime but concentrations no
      greater than 100 ng ml-1 at night. In contrast, a dose regimen of 60 mg followed
      by 30 mg 12 h later and thereafter every 8 h until the fifth day induced complete
      haemodynamic tolerance. With this dose regimen the minimum plasma concentrations
      were never below 300 ng ml-1. A significant attenuation of haemodynamic effects
      was also found with the third dose regimen, 60 mg followed by 30 mg 6 h later for
      5 days, which produced minimum plasma concentrations of between 100 ng ml-1 to
      300 ng ml-1; the degree of attenuation rose as trough plasma concentrations
      increased. 3. In conclusion, 60 mg 5-ISMN in a controlled-release (Durules)
      preparation given once daily was the only dose regimen not inducing nitrate
      tolerance.

PMID- 1633074
TI  - Prophylactic nitrate therapy in angina pectoris--is there an optimal treatment
      regimen?
AB  - 1. Nitrates have a place in the prophylactic treatment of patients with angina
      pectoris. Their efficacy is not in doubt. 2. However, there may be some practical
      problems associated with their use, such as unreliable absorption, short duration
      of action, treatment-induced headache, development of nitrate tolerance and a
      suggested rebound phenomenon observed during intermittent dosing. Furthermore,
      patient convenience with treatment schedule and patient compliance have to be
      considered during prophylactic treatment. The present article discusses how many
      of these problems may be solved by selection of formulation as well as nitrate
      compound. 3. The development of controlled-release formulations producing
      sufficiently high nitrate plasma concentration during part of the day followed by
      nitrate-poor rather than nitrate-free interval, have the potential to prevent
      both nitrate tolerance and rebound phenomenon, and produce a sufficiently long
      duration of action with a convenient once daily regimen.

PMID- 1633075
TI  - Effects of nitrates on mortality in acute myocardial infarction and in heart
      failure.
AB  - 1. Seven randomized controlled trials of intravenous nitroglycerin in a total of
      about 850 patients have been reported. Overall, there were 51 deaths (12.5%) in
      the nitroglycerin group and 87 (20%) in the control group. This indicates a 48%
      reduction in the odds of death (P less than 0.001, 95% confidence limits (25% to
      64%)). 2. There are five randomized trials of oral nitrates after acute
      myocardial infarction. In these trials, 11.8% of the patients in the nitrate
      group compared with 13.3% in the control group died. This indicates a
      nonsignificant 12% reduction in the odds of death but the 95% confidence interval
      overlaps widely with the i.v. trials. If all trials of i.v. or oral nitrates are
      considered the reduction in the odds of death is 32% (P less than 0.01). 3.
      Nitrates have a beneficial effect on haemodynamics in heart failure but the data
      on mortality effects are sparse. In combination with hydralazine, however, long
      term mortality was reduced in the V-HEFT trial of chronic heart failure.

PMID- 1633077
TI  - Nitrates today and tomorrow: introduction.

PMID- 1633076
TI  - Endogenous and exogenous nitrates and their role in myocardial ischaemia.
AB  - 1. Although nitrates have been prescribed in patients with angina pectoris for
      more than a century, their mechanism of action has only been understood recently.
      2. The discovery of the endogenous nitrovasodilator nitric oxide, which is formed
      in endothelial cells by the enzyme nitric oxide synthase, has greatly expanded
      our knowledge. Nitric oxide, if released from endothelial cells can interact with
      vascular smooth muscle as well as circulating blood cells such as platelets.
      Nitric oxide activates soluble guanylate cyclase, which in turn leads to an
      intracellular increase in cyclic GMP. In vascular smooth muscle, this causes
      vasorelaxation, in platelets dysaggregation and prevention of platelet adhesion.
      This protective pathway both reduces the effects of vasoconstrictor substances,
      can produce profound vasodilation, if activated appropriately and acts as a
      regulator of platelet-vessel wall interaction. In addition, nitric oxide inhibits
      the production and action of endothelin, a 21 amino acid vasoconstrictor peptide
      formed by endothelial cells. 3. Exogenous nitrovasodilators also exert their
      action by releasing nitric oxide from the molecule. Their action is particularly
      pronounced in blood vessels with a low basal production of nitric oxide and is
      enhanced after removal of the endothelium. In coronary artery disease, the
      formation of endothelium-derived nitric oxide is reduced, its breakdown is
      increased, but only at later stages, is the action of endogenous and therapeutic
      nitrates depressed. 4. Hence, nitrates are an appropriate therapeutic tool in
      patients with coronary artery disease to substitute the effects of the impaired
      activity of the endothelial L-arginine/nitric oxide pathway.

PMID- 1633080
TI  - Expanded programme on immunization (EPI). Progress towards poliomyelitis
      eradication.

PMID- 1633079
TI  - Do nitrates differ?
AB  - 1. The organic nitrates all share a common biochemical and physiological
      mechanism of action. 2. The organic nitrates differ substantially in their
      pharmacologic potency and pharmacokinetics. In vitro potency differences appear
      larger than the corresponding in vivo activities. 3. The duration of action of
      organic nitrates, after a single immediate-release dose, is governed by the
      pharmacokinetics of the drug. However, the duration of action of available
      sustained-release preparations, whatever the nitrate or formulation, is limited
      to about 12 h, due to the development of pharmacologic tolerance. 4. Nitrates do
      not appear to differ in their production of undesirable effects.

PMID- 1633078
TI  - Clinical relevance of endothelium-derived relaxing factor (EDRF).
AB  - 1. In addition to metabolic and neurohumoral factors endothelium-derived
      autacoids like the nitric oxide radical NO and prostacyclin are effective
      regulators of vascular tone and thus tissue perfusion. NO is produced in
      endothelial cells from L-arginine by a Ca2+/calmodulin-dependent enzyme NO
      synthase. In addition, the NO radical is ultimately cleaved from all
      nitrovasodilators and resembles their vasoactive and antiaggregatory principle,
      which is used under pathological conditions as substitution therapy for impaired
      endothelial function and autacoid production. Impaired endothelium-dependent
      vasomotor control has been documented in hypercholesterolaemia, atheromatosis,
      diabetes, hypertension, and in reperfusion damage. L-arginine supplementation is
      effective in a few instances.

PMID- 1633082
TI  - Continuing education: opening up on education.

PMID- 1633081
TI  - Clinical enteral nutrition [continuing education credit].
AB  - There are many reasons why an individual may become malnourished. It is important
      for nurses to be able to recognise people at risk, and to understand the
      processes that will safeguard their nutritional status in hospital and in the
      community.

PMID- 1633083
TI  - Homelessness: exploding a modern myth. Interview by Charlotte Alderman.

PMID- 1633084
TI  - Extended role: taking a giant leap towards freedom.

PMID- 1633085
TI  - Intensive care: pulmonary artery pressure monitoring.
AB  - Pulmonary artery pressure monitoring is an important aspect of the nurse's role
      in intensive care units. This article describes the advantages such monitoring
      can offer in the assessment of critically ill patients, and some of the common
      problems nurses face when using the specialised equipment.

PMID- 1633086
TI  - Analysing mandatory continuing education.
AB  - Of all the contentious issues surrounding the United Kingdom Central Council's
      continuing education proposals, the introduction of mandatory continuing
      education is perhaps the most controversial. This article sets out the issues
      surrounding it, including the postulated infringement of the voluntary principles
      of adult education, the effect it has on the learning process, and the
      possibility of it leading to uniform and inferior learning. The main issue,
      however, is whether mandatory continuing education achieves its objective of
      enabling staff to improve their practice. More research is required, the author
      argues, before this crucial question can be answered.

PMID- 1633087
TI  - Oral candidiasis and HIV infection.
AB  - Helping patients cope with the unpleasant symptoms of oral candidiasis is among
      the many challenges facing nurses caring for people with HIV infection. The
      features, treatment and prevention of this distressing condition are described.
      Nurses are identified as having a major part to play in educating patients to
      manage the symptoms.

PMID- 1633088
TI  - Reviewing the nurse-patient partnership.
AB  - One of the vital components of contemporary professional nursing is the idea of
      nurses working in 'partnership' with patients. In an effort to establish a
      framework for examining the concept of partnership and how this is viewed and
      utilised by the profession, a formal review of the literature relevant to this
      area was undertaken. British and overseas journals and also textbooks of nursing
      from the UK and the USA were reviewed. The results of the review are discussed in
      an effort to offer some clarity to this somewhat complex concept.

PMID- 1633089
TI  - Should employers be given the chance to remedy poor standards of care before a
      whistleblower goes public?

PMID- 1633090
TI  - Dual-needs provision: everybody else's client.

PMID- 1633091
TI  - Breaking professional barriers.

PMID- 1633092
TI  - The Clay column.

PMID- 1633093
TI  - Care of elderly people. Thoughts from a train.

PMID- 1633094
TI  - Care of elderly people. Carer support: it's up to us.

PMID- 1633096
TI  - Care of elderly people. 'I've got to see Angie'.

PMID- 1633095
TI  - Care of elderly people: a change of scene.

PMID- 1633097
TI  - LED perimeter for visual field analysis by mapping of small field evoked
      potentials.
AB  - A new type of visual field perimeter, equipped with conic light emitting diodes
      (LEDs) located at 10 degrees intervals automatically programmable is described.
      The device is meant for visual field analysis by mapping of the evoked responses
      derived from the retina and specific cortical projection areas.

PMID- 1633098
TI  - Mapping of VEPs and ERG responses to punctual stimulations in the visual field.
AB  - Visual field projection maps were obtained using retinal and cortical EP
      amplitude values. Single meridian investigations were also performed. Stimulation
      was done with punctual photic stimuli delivered by the LED perimeter built for
      the purpose. Schedule with 28 stimulation loci was adopted. The B wave of the
      average ERG and P100 component of the cortical VEP were measured. The maps were
      obtained by interpolation of amplitude values on a grid of 21 x 21 characters. By
      comparing the retinal and cortical visual field maps, conclusions regarding the
      normality of visual structures (peripheral or central) can be drawn. Our
      procedure adds to the previous data on visual field investigation (cynetic or
      static) important elements concerning vision electrophysiology.

PMID- 1633099
TI  - Advances in the pathogeny of migraine.

PMID- 1633100
TI  - Vocabulary grammatical structure in aphasic patients.
AB  - In 10 aphasics (7 Broca's and 3 Wernicke's) of vascular etiology and 10 normal
      controls, a corpus of 2,500 words was selected in each subject by means of a
      standard interview. The 10 grammatical classes of the Romanian language were
      studied. The vocabulary reduction observed in aphasics was produced by the loss
      of nouns, adjectives and verbs. In exchange, proportionally to their vocabulary,
      they used more adverbs, pronouns and numerals than the normals. Articles,
      prepositions and conjunctions showed a similar use with that of the normals. The
      aphasic patients preserved basic words for each part of speech, the loss of
      vocabulary operated among the non-basic words. It was revealed by the Token-Type
      ratio that the verbal creativity was lower in aphasics than in controls. However,
      in normals as in aphasics verbal creativity was higher in the non-basic words
      than in the basic ones. The results are discussed by the action of different
      factors as: the semantic and syntactical constraints, semantic characteristics
      and syntactical functions proper to each class as well as the influence of the
      different amounts of words comprised in each grammatical class on the selection
      of the necessary word.

PMID- 1633101
TI  - Type and frequency of phonetic errors in aphasics: therapeutic aspects.
AB  - Fifty aphasics were studied in three separate groups: nonfluent Broca, fluent
      Wernicke and fluent anomics in order to form a therapeutic guide of their
      phonetic errors (omission substitution, addition, repeated phonemes,
      perseveration of phonemes belonging to the preceding word, reversed order,
      phonematic targetting and misplacing. Frequency of phonetic error was also
      assessed.

PMID- 1633102
TI  - Serum immunoglobulin levels in schizoaffective disorders (manic and depressive).
AB  - Immunoglobulin levels (A, G, M) were measured with Mancini's radial
      immunodiffusion technique (RID). IgA and IgG levels showed a statistically
      significant increase in schizoaffective patients compared to normals, and
      schizophrenics, but no modification in comparison with the affective patients.
      IgM also showed a statistically significant increase which may constitute a trait
      marker for the schizoaffective disease.

PMID- 1633103
TI  - Modalities of collateral supply of cerebral circulation through the circle of
      Willis in stenoses and occlusions of extracranial carotid arteries.
AB  - The intracranial cerebral circulation was studied in 6 patients with bilateral
      ischemic lesions due to lesions of the internal carotid artery in the
      extracranial segment (2 significant bilateral stenosis cases; 1 case with
      bilateral thrombosis and 3 cases of unilateral thrombosis and significant
      controlateral stenosis). All the patients were males their age ranging between
      the 5th and 8th decades of life. In a single case, the neurological examination
      showed secondary left hemiplegia and recent right paresis of remittent type
      whereas the other 5 patients had only transient ischemic attacks with hemiparesis
      or transient aphasia. The lesions were revealed by duplex system echotomography
      (Aloka-Hellige Model SSD-630) and spectral analysis of Doppler signal (Vasoscan
      Sonicaid) and were later confirmed by bilateral carotid arteriography in all
      patients. The intracranial circulation was also watched by noninvasive methods
      using the spectral analysis of the Doppler signal with pulsed wave on TC-2 64-B
      apparatus. As for the modalities of blood flow compensatory mechanisms by the
      circle of Willis, it may be noted that in none of the patients investigated did
      the collateral supply observe a "mathematical model".

PMID- 1633104
TI  - The influence of trauma on the proliferating potential in neurofibromatosis. Case
      report.

PMID- 1633105
TI  - NSCL-2: a basic domain helix-loop-helix gene expressed in early neurogenesis.
AB  - We have identified a new basic domain helix-loop-helix (bHLH) gene, NSCL-2, which
      was cloned because of its homology to the previously described putative
      hematopoietic transcription factor, SCL. NSCL-2 has been identified in both human
      and murine DNA. NSCL-2 complementary DNA clones were obtained from an 11.5-day
      murine embryo library. The coding region is 405 base pairs and encodes a
      predicted protein of 15.6 kilodaltons. There is 74% homology at the nucleotide
      level with the coding region of the murine SCL and 27% protein homology. Unlike
      the majority of previously described bHLH genes, the NSCL-2 coding region ends
      only six amino acids beyond the second amphipathic helix of the HLH domain. The
      NSCL-2 gene shows a markedly restricted pattern of expression predominantly
      confined to murine embryos at days 11-13 of development, although low level
      expression can be detected in murine embryos flanking this time point.
      Examination of 11- and 12-day mouse embryos by tissue in situ hybridization
      reveals expression of NSCL-2 in the developing nervous system, most likely in
      developing neurons. The NSCL-2 gene maps to murine chromosome 3. The temporally
      and tissue restricted pattern of expression of this gene and its identification
      as a member of a family of transcription factors relevant to growth and
      development in a wide variety of species suggest a role for NSCL-2 in the
      development of the eukaryotic nervous system.

PMID- 1633106
TI  - Cell type and differentiation dependent heterogeneity in retinoblastoma protein
      expression in SCID mouse fetuses.
AB  - The expression pattern of retinoblastoma (Rb) protein has been studied at the
      single cell level in frozen sections of 16- to 18-day-old SCID mouse fetuses by
      immunofluorescence staining with mouse monoclonal and rabbit polyclonal
      antibodies, using conventional epifluorescence and confocal laser scanning
      microscopy. The nuclei of megakaryocytes, hemopoietic islands of the fetal liver,
      osteo-, amelo-, and odontoblasts, and skeletal muscle were strongly stained.
      There was no detectable Rb staining in the basal cell layers of stratified
      squamous epithelia, but the differentiating, more superficial layers were
      positive. Intestinal crypts were negative, whereas the villi were positive. In
      the retina, Rb protein was detectable in the inner ganglion layer but not in the
      outer neuroblastic layer. In the central nervous system, Rb protein was present
      in neurons and glia cells as well. The nuclei in the collecting tubules of the
      kidney, the pancreas, and the adrenal cortex were Rb positive. Analysis of the
      differentiation dependent expression of Rb protein in relation to the prospective
      life cycle of the cells in which it appears may pave the way toward an
      understanding of the tissue specific oncogenic effect of Rb loss in families with
      hereditary retinoblastoma.

PMID- 1633107
TI  - mmCGM1a: a mouse carcinoembryonic antigen gene family member, generated by
      alternative splicing, functions as an adhesion molecule.
AB  - Carcinoembryonic antigen is a human tumor marker and the prototype of a large
      family of immunoglobulin-like proteins. We have been developing a mouse model for
      this large protein family and have cloned a complementary DNA (cDNA) for a mouse
      carcinoembryonic antigen gene family member (mmCGM1a). Two transcripts expressed
      in several different adult mouse tissues hybridize to this cDNA, a 1.8-kilobase
      and a 4.6-kilobase mRNA. Sequences of many related cDNA clones indicate that they
      are most likely encoded by a single gene which undergoes alternative splicing.
      The protein encoded by the mmCGM1a cDNA shares 69% of the amino acid residues in
      the NH2-terminal domain with a rat liver ecto-ATPase and with the human biliary
      glycoprotein. Mouse fibroblast transfectant cells expressing the mmCGM1a protein
      on their cell surface exhibit calcium- and temperature-independent adhesion in
      vitro which can be specifically inhibited by an antibody raised against a
      carcinoembryonic antigen-related 120 kilodalton protein.

PMID- 1633108
TI  - Anti-immunoglobulin treatment of murine B-cell lymphomas induces active
      transforming growth factor beta but pRB hypophosphorylation is transforming
      growth factor beta independent.
AB  - Cross-linking of B-cell membrane immunoglobulin (Ig) receptors induces growth
      arrest at G1-S, leading to apoptosis and cell death in the immature lymphomas
      WEHI-231 and CH31, but not in the CH12 B-cell line. In this system, which has
      been used as a model for B-cell tolerance, we have established that these
      lymphomas produce active transforming growth factor beta (TGF-beta) when treated
      with anti-Ig and that their hierarchy of sensitivity to TGF-beta generally
      correlates with their growth inhibition by anti-Ig. TGF-beta, in turn, has been
      shown to interfere with the phosphorylation of the retinoblastoma gene product,
      pRB. Herein, we also demonstrate that in WEHI-231 B-lymphoma cells treated with
      anti-Ig for 24 h, the pRB protein is found to be predominantly in the
      underphosphorylated form, as previously reported for cells arrested by the
      exogenous addition of TGF-beta. However, neutralizing antibodies to TGF-beta
      failed to prevent growth inhibition by anti-Ig in WEHI-231 and CH31. When WEHI
      231 lymphoma cells were selected for growth in TGF-beta, the majority of the TGF
      beta-resistant clones remained sensitive to anti-Ig-mediated growth inhibition.
      In these clones, the retinoblastoma gene product was found to be in the
      underphosphorylated form after 24-h treatment with anti-Ig, but not with TGF
      beta. These data show that anti-Ig treatment of murine B-cell lymphomas
      stimulates the production of active TGF-beta but that a TGF-beta-independent
      pathway may be responsible for the pRB underphosphorylation and cell cycle
      blockade.

PMID- 1633109
TI  - Regions within the c-Myc protein that are necessary for transformation are also
      required for inhibition of differentiation of murine erythroleukemia cells.
AB  - The c-, L-, and N-Myc nuclear phosphoproteins share several highly conserved
      regions that partially overlap putative functional domains of the c-Myc protein.
      All three myc oncogenes can cooperate with an activated ras gene to transform
      primary rat embryo cells (REC), and deregulated expression of c- and L-myc can
      block differentiation of murine erythroleukemia (MEL) cells. In the present
      study, we demonstrate that N-myc also can block MEL cell differentiation, and we
      identify regions within the c-Myc protein that are necessary for inhibition of
      MEL differentiation. C19 MEL cells were transfected with six human c-myc genes
      which were partially deleted in different areas of the coding region. Four of the
      genes lack sequences that overlap either the putative transcriptional activation
      domain, the helix-loop-helix motif, or the leucine zipper motif and were
      previously shown to have lost REC cotransforming activity (J. Stone, T. DeLange,
      G. Ramsay, E. Jakobovitz, J.M. Bishop, H. Varmus, and W. Lee, Mol. Cell. Biol.,
      7: 1697-1709, 1987). In this study, we demonstrate that they also fail to inhibit
      N,N'-hexamethylene-bis-acetamide-induced differentiation of MEL cells. In
      contrast, two partially deleted c-myc genes, one lacking a short NH2-terminal
      region and the other lacking 118 amino acids at the center of the coding region,
      which were fully active in REC cotransformation, also exhibited full activity
      associated with the former and only partial activity with the latter in blocking
      MEL differentiation. We conclude that the mutated genes tested in this study
      behave similarly in inhibition of MEL cell differentiation and in REC
      cotransformation.

PMID- 1633110
TI  - Complex expression of the genes coding for plasminogen activators and their
      inhibitors in HeLa-smooth muscle cell hybrids.
AB  - As cells progress through the multistep process of neoplastic transformation,
      they eventually acquire the property of invasive behavior. Although both
      plasminogen activators (PA) and their inhibitors (PAI) contribute to this
      process, their regulation in normal and transformed cells remains poorly defined.
      Because somatic cell hybrids provide useful tools for examining the
      transformation pathway, tumorigenic and invasive HeLa cells were fused with human
      normal vascular smooth muscle cells and tested for invasion-related parameters,
      including the expression of PA and PAI genes, and matrix degradation. Both
      parental cell lines produced large amounts of PAI activities with no detectable
      PA in either cellular or secreted form. Opposite findings were obtained with the
      hybrid cell lines, which demonstrated the presence of receptor-bound and secreted
      PA but absence of enzymatically measurable PAI activities. Both urokinase-type
      and tissue-type PA were found in cell-associated and secreted form in the hybrid
      cells. In addition, expression of the urokinase-type PA receptor gene was found
      in the three hybrid cells and the vascular smooth muscle cells but not in the
      HeLa cells. Expression of active, receptor-bound and secreted PA provided the
      nontumorigenic hybrid cells with the enzymatic tools to degrade extracellular
      proteins in a plasminogen-dependent manner. Thus, the hybrid cells lost
      tumorigenicity while retaining the tissue-degrading capability of HeLa cells.
      These hybrid cell lines should prove to be important reagents for investigating
      the complex regulatory control of PA and PAI gene expression.

PMID- 1633111
TI  - Transforming growth factor beta 1 regulation of c-myc expression, pRB
      phosphorylation, and cell cycle progression in keratinocytes.
AB  - Transforming growth factor beta 1 (TGF-beta 1) is a potent inhibitor of cellular
      proliferation in a variety of cell types, including skin keratinocytes. TGF-beta
      1 suppression of c-myc transcription has been implicated in the mechanism of TGF
      beta 1 inhibition of keratinocytes, and evidence suggests that the protein
      product of the retinoblastoma gene (pRB) is a necessary component in this
      pathway. Following growth factor stimulation of quiescent keratinocytes, TGF-beta
      1 can inhibit cell cycle progression into S phase at any point prior to the G1-S
      transition but does not inhibit progression through the S phase of the cell
      cycle. Since pRB is hypophosphorylated during G1 and hyperphosphorylated during S
      and G2, the G1-S-specific phosphorylation of pRB becomes an attractive target for
      the growth-inhibitory activities of TGF-beta 1. However, in TGF-beta 1-treated
      primary human keratinocytes and in a series of human papilloma virus and SV40
      immortalized human keratinocyte cell lines, the phosphorylation status of pRB
      strictly correlated with cell growth. No evidence was found for a direct effect
      of TGF-beta 1 on the phosphorylation state of pRB in these cells. It was further
      demonstrated that synthesis of c-myc protein can be rapidly inhibited by TGF-beta
      1 addition throughout G1 and S phases, indicating that the phosphorylation state
      of pRB, at least as it varies during the cell cycle, does not alter the ability
      of TGF-beta 1 to suppress c-myc expression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633112
TI  - Shift from posttranscriptional to predominant transcriptional control of the
      expression of the GM-CSF gene during activation of human Jurkat cells.
AB  - The expression of the granulocyte-macrophage colony-stimulating factor (GM-CSF)
      gene is differentially regulated in various cell types. We investigated the
      mechanisms controlling its expression in 12-O-tetradecanoylphorbol-13-acetate
      plus phytohemagglutinin-stimulated Jurkat cells, a human T-cell line. In
      unstimulated cells, GM-CSF mRNA was undetectable by Northern blot. Upon
      activation, it was detected from 3 h onward, with a progressive increase in the
      levels of the transcript up to 24 h of stimulation. Whereas cycloheximide
      treatment at the time of stimulation blocked mRNA induction, its addition at
      later times resulted in a marked increase in transcript levels. Run-on analysis
      showed that transcription of the GM-CSF gene was low to undetectable in
      unstimulated cells; stimulation led to transcriptional activation, which was weak
      at 6 h but had increased 16-fold at 24 h. In addition, the mRNA half-life
      decreased during activation, from 2.5 h at 6 h down to 45 min at 24 h.
      Cycloheximide treatment increased GM-CSF mRNA half-life (3- and 4-fold,
      respectively). Our results show: (a) both transcriptional and posttranscriptional
      signals regulate GM-CSF mRNA levels in activated Jurkat cells, (b) de novo
      protein synthesis is required for mRNA induction, whereas destabilizing labile
      proteins control the transcript stability, and (c) a shift from a
      posttranscriptional to a predominant transcriptional control of GM-CSF gene
      expression occurs during activation.

PMID- 1633113
TI  - Regulation of EGR-1, c-jun, and c-myc gene expression by oncostatin M.
AB  - Oncostatin M (OM) is a cytokine that shares a structural and functional
      relationship with interleukin 6, leukemia-inhibitory factor, and granulocyte
      colony-stimulating factor. In this report, we tested for correlations between
      immediate-early gene expression and some of the cellular responses elicited by
      OM. We determined that OM stimulated a rapid and transient elevation of EGR-1, c
      jun, and c-myc mRNA in human fibroblasts prior to their proliferation. OM also
      stimulated a transient induction of these genes in M1 leukemic cells that
      differentiated into nonreplicating, macrophage-like cells. The expression of c
      myc, however, decreased significantly as the cells stopped dividing.
      Interestingly, OM had no detectable effect on the expression of EGR-1, c-jun, and
      c-myc during the cell cycle arrest of human A375 melanoma cells. Our results
      indicate that an early nuclear event associated with OM action is the regulation
      of immediate-early gene expression. We suggest that the transcription factors
      encoded by the EGR-1, c-jun, and c-myc genes are utilized in both cell
      proliferation and differentiation but are not part of the mechanism by which OM
      inhibits A375 cell growth.

PMID- 1633114
TI  - Regulation of epidermal growth factor receptor gene expression in murine
      embryonal carcinoma cells.
AB  - The protooncogene c-erbB1 [epidermal growth factor receptor (EGF-R)] is expressed
      in a wide variety of cell types and in most adult tissues. The precise roles of
      the EGF-R in vivo are largely unknown, especially their role in growth and
      development of embryonic tissues. We reported earlier that EGF-Rs are not
      expressed on the cell surface of undifferentiated embryonal carcinoma (EC) cells,
      but intracellular receptor protein is detectable (A. Weller, J. Meek, and E. D.
      Adamson, Development, 100: 351-363, 1987). We document here that in embryonal
      carcinoma cells, low levels of both receptor mRNA and protein are observed, but
      after 4 days of retinoic acid-induced differentiation, large increases are seen.
      Most notable is the 35-70-fold rise in the levels of EGF-R transcripts during the
      differentiation of P19 embryonal carcinoma cells to neural and glial cells, and
      this is paralleled by a 10-fold rise in protein. Measurements of the degradation
      rates of EGF-R mRNA and receptor protein show that both are rather stable and may
      partially explain the steady-state increases during differentiation. Run-on
      transcription assays of the EGF-R gene show very low rates of transcriptional
      activity at all stages: about 2-fold changes in transcription rate can be
      detected. It is concluded that transcriptional mechanisms may also partially
      account for increased levels of gene products. We hypothesize that the appearance
      of EGF-Rs at the cell surface leads to the slow induction of further receptor
      levels by EGF/transforming growth factor alpha stimulation, and this contributes
      to the driving force of differentiation and to the stability of the
      differentiated state.

PMID- 1633115
TI  - The ets gene family.

PMID- 1633116
TI  - Therapeutic strategies and outcomes: perspectives from different cultures.
AB  - Two forms of psychological therapy, one Japanese the other Euro/American, are
      described and compared. It is suggested that each identifies comparable goals for
      individual change. However, each differs in the means by which change is induced.
      The consensus concerning goals is taken as evidence of universal values in the
      definition of the fully functioning self. However, the divergence in means by
      which these goals are attained reflects specific cultural differences. The
      implications of these differences are related to individualistic versus
      relational values within the cultures discussed. It is proposed that the
      comparisons have implications for the practice of any specific form of
      psychotherapy on members of a culture other than that within which the therapy
      has developed.

PMID- 1633118
TI  - Sense of self in recovery from severe mental illness.
AB  - This report based on research interviews conducted with persons struggling to
      recover from prolonged psychiatric disorders suggests that the rediscovery and
      reconstruction of an enduring sense of the self as an active and responsible
      agent provides an important aspect of improvement. This process of developing a
      functional sense of self in the midst of persisting psychotic symptoms and
      dysfunction is described, and its implications for understanding severe mental
      illness and processes of change are discussed. It is suggested that viewing the
      development of a dynamic sense of self as central to the improvement process
      provides a coherent thread which ties together diverse research findings
      concerning factors influencing course and outcome of illness. It is also
      suggested that for treatment and rehabilitation to elicit and foster a more
      functional sense of self, models of improvement will need to allow for, and
      encourage, a more active and collaborative role for the person with the disorder.

PMID- 1633117
TI  - The belief in the transmigration of souls: psychotherapy of a Druze patient with
      severe anxiety reaction.
AB  - In this paper the culture-sensitive psychotherapy of a 19-year-old Druze patient
      with severe anxiety reaction is described. The patient explained his anxiety and
      his symptoms as stemming from violent death in his former life and subsequent
      transmigration. The therapists joined the patient's explanatory model and
      previous traditional healing, adding hypnotic suggestion which relieved the
      symptoms. The relationship of patient symptomatology to cultural background,
      multiple personality disorder, possession and dissociation is discussed. The
      strategic combination of culture-specific and modern psychiatric approaches is
      advocated in similar cases.

PMID- 1633119
TI  - Therapy factors in treating severely ill psychiatric patients.
AB  - We studied therapeutic factors influencing suicide during out-patient treatment
      in severely ill discharged psychiatric in-patients. A subsample of 25 suicide and
      27 control patients were all treated by psychiatrists at the time of their
      suicide or at a corresponding point of time. We were not able to identify any
      significant psychosocial or clinical pre-discharge differences between the two
      groups. After discharge, the patients of the control group were treated by
      psychiatrists with substantially longer professional training-plus-experience,
      the therapist's experience being the most important therapy factor contributing
      to the different outcome. On the whole, the contribution of the therapy factors
      was modest, however, explaining only 26 per cent of the group variance.

PMID- 1633120
TI  - Structural equation modelling of some of the determinants of suicide risk.
AB  - Much of the psychological research with suicidal patients has examined,
      individually or in combination, correlates and predictors of the various measures
      in the suicide process. The present study investigated suicidal risk as an
      outcome measure. Several questionnaires were administered to a sample of 94
      soldiers, 61 of whom had manifested some suicidal symptoms. Using LISREL
      analysis, the data showed that the best model had suicide risk as directly
      influenced by depression and indirectly by impulsivity.

PMID- 1633121
TI  - How specific are negative automatic thoughts to a depressed population? An
      exploratory study.
AB  - This paper is concerned with the relationship between negative or dysfunctional
      automatic thoughts and dysphoric mood in a non-clinical population. It addresses
      the question of how specific are these automatic thoughts to a depressed
      population. Negative automatic thoughts were obtained from 27 normal subjects via
      a thought-sampling method using the Daily Record of Dysfunctional Thoughts Form
      (Beck, Rush, Shaw & Emery, 1979) over a two-week period. A thought-content
      analysis was conducted. The resultant data were compared using X2 with Blackburn
      & Eunson's (1989) data from depressed patients. The results presented in this
      paper indicate that basic cognitive distortions occur in a normal population, but
      differ qualitatively and quantitatively from those found in depressed patients.

PMID- 1633122
TI  - Mood states and minor illness.
AB  - Mood and health reports from 65 administrative and clerical staff were obtained
      daily over a period of several weeks. Three mood factors emerged from the
      aggregated data which appear to be most suitably labelled: happiness, tense
      depression and hostile depression. Subjects high on hostile depression suffered
      more from colds. Subjects scoring highly on tense depressed mood reported more
      insomnia, head and neck aches. The results, especially in regard to hostile
      depression, are discussed in a wider context, including possible overlap with
      core affective aspects of the well-known Type A coronary risk construct. Finally,
      psychoimmunological interpretations of the link between hostile depression and
      vulnerability to colds are considered.

PMID- 1633123
TI  - Beliefs and fears underlying the Type A behaviour pattern in adolescents.
AB  - The present study was designed to test Price's (1983) cognitive social learning
      model of Type A in an adolescent population. A questionnaire measuring beliefs
      and fears thought to underlie Type A together with two measures of Type A (the
      Bortner scale and the student version of the Jenkins Activity Survey, SJAS) were
      administered to over 300 adolescents. Results showed that subscales measuring
      Type A beliefs and fears had acceptable levels of internal reliability and formed
      two separate components (beliefs and fears). Measures of beliefs and fears
      correlated significantly but modestly with measures of Type A thus providing some
      support for Price's cognitive social learning model. Furthermore, some striking
      sex differences were found. Results are discussed in terms of the implications of
      these beliefs and fears in studying the Type A behaviour pattern in children and
      adolescents and the modification of the behaviour pattern in the younger
      population.

PMID- 1633124
TI  - The effect of olfactory stimulation on fluency, vividness of imagery and
      associated mood: a preliminary study.
AB  - Twenty-two subjects were asked to visualize positive and negative phrases
      following exposure to either chamomile oil or placebo. Chamomile oil
      significantly increased the latency for all images, and shifted mood ratings and
      frequency judgements in a more positive direction, suggesting a possible mode of
      action for such oils.

PMID- 1633125
TI  - The effect of pre-assessment information on clients' satisfaction, expectations
      and attendance at a mental health day centre.
AB  - An information sheet describing the nature of initial assessment sessions was
      sent to people referred to a mental health day centre. This study examines the
      effect of receiving the information on attendance at assessment, expectations of
      the session and subsequent satisfaction. A group of subjects who were sent the
      information were compared with a control group who were not. The former group
      were more likely to attend the initial appointment (82 per cent attended) than
      those who did not receive the information (57 per cent attended). Of those
      subjects who attended, the experimental group expressed greater satisfaction
      overall and with the session itself. There were no differences between the groups
      on other satisfaction measures, levels of state anxiety and expectations. It is
      concluded that the effect of the information sheet is most likely to be mediated
      by changes in satisfaction levels which may be raised by increased levels of
      personal attention.

PMID- 1633126
TI  - Psychoanalytic views of aggression: some theoretical problems.
AB  - Various problems in relation to psychoanalytic theories of aggression are
      considered in a review which is by no means exhaustive but includes areas which
      have puzzled and interested the author. First to be considered is why the concept
      of aggression as a major drive was a relative late-comer in psychoanalysis; next
      the contentious concept of a 'death instinct' and some of the factors in Freud's
      lifetime which may have contributed to both. Then it is suggested that we seem to
      have theories of aggression which might be called primary or secondary in two
      different senses. First is the question whether aggression is innate or secondary
      to frustration. In another sense, primary and secondary theories of aggression
      seem to survive paralleling Freud's original primary and secondary theories of
      anxiety. In this sense the primary theory survives as an explanation of
      psychosomatic disorder. Lastly, the link between suicide and murder is considered
      and the turning of aggression against the self in depression and self-destructive
      attacks.

PMID- 1633127
TI  - Effects of selective pressure block of Y-type optic nerve fibers on the receptive
      field properties of neurons in the striate cortex of the cat.
AB  - In an aseptic operation under surgical anesthesia, one optic nerve of a cat was
      exposed and subjected to pressure by means of a special cuff. The conduction of
      impulses through the pressurized region was monitored by means of electrodes
      which remained in the animal after the operation. The pressure was adjusted to
      selectively eliminate conduction in the largest fibers (Y-type) but not in the
      medium-size fibers (X-type). The conduction block is probably due to a
      demyelination and remains complete for about 3 weeks. Within 2 weeks after the
      pressure-block operation, recordings were made from single neurons in the striate
      cortex (area 17, area V1) of the cat anesthetized with N2O/O2 mixture
      supplemented by continuous intravenous infusion of barbiturate. Neurons were
      activated visually via the normal eye and via the eye with the pressure-blocked
      optic nerve ("Y-blocked eye"). Several properties of the receptive fields of
      single neurons in area 17 such as S (simple) or C (complex) type of receptive
      field organization, size of discharge fields, orientation tuning, direction
      selectivity indices, and end-zone inhibition appear to be unaffected by removal
      of the Y-type input. On the other hand, the peak discharge rates to stimuli
      presented via the Y-blocked eye were significantly lower than those to stimuli
      presented via the normal eye. As a result, the eye-dominance histogram was
      shifted markedly towards the normal eye implying that there is a significant
      excitatory Y-type input to area 17. In a substantial proportion of area 17
      neurons, this input converges onto the cells which receive also non-Y-type
      inputs. In one respect, velocity sensitivity, removal of the Y input had a weak
      but significant effect. In particular, C (but not S) cells when activated via the
      normal eye responded optimally at slightly higher stimulus velocities than when
      activated via the Y-blocked eye. These results suggest that the Y input makes a
      distinct contribution to velocity sensitivity in area 17 but only in C-type
      neurons. Overall, our results lead us to the conclusion that the Y-type input to
      the striate cortex of the cat makes a significant contribution to the strength of
      the excitatory response of many neurons in this area. However, the contributions
      of Y-type input to the mechanism(s) underlying many of the receptive-field
      properties of neurons in this area are not distinguishable from those of the non
      Y-type visual inputs.

PMID- 1633128
TI  - Effects of selective pressure block of Y-type optic nerve fibers on the receptive
      field properties of neurons in area 18 of the visual cortex of the cat.
AB  - Recordings were made from single neurons in area 18 of anesthetized cats (N2O/O2
      mixture supplemented by continuous intravenous infusion of barbiturate) in which
      one optic nerve had been pressure blocked to selectively block conduction in the
      largest (Y-type) fibers. Cortical neurons were stimulated visually via the normal
      eye or via the eye with the pressure-blocked optic nerve ("Y-blocked eye").
      Several properties of the receptive fields such as their spatial organization (S
      or C cells), orientation tuning, and the presence and strength of end-zone
      inhibition appear to be unaffected by removal of the Y input. By contrast, the
      removal of the Y input resulted in a small but significant reduction in the size
      of the discharge field and in the direction-selectivity index. In three respects,
      peak response discharge rate, eye dominance, and velocity sensitivity, removal of
      the Y input had strong and highly significant effects. Thus, the mean peak
      discharge frequency of responses evoked by the stimulation of binocular neurons
      via the Y-blocked eye was significantly lower than that of responses evoked by
      the stimulation via the normal eye. Accordingly, the eye-dominance histogram was
      shifted markedly towards the normal eye (more so than in the homologous
      experiment conducted on area 17-Burke et al., 1992). Finally, the mean preferred
      velocity of responses of cells activated via the normal eye was in the vicinity
      of 145 deg/s, whereas for cells activated via the Y-blocked eye the value was
      about 35 deg/s. Overall, the results of the present study imply that (1) apart
      from Y-type excitatory input there are significant excitatory non-Y-inputs to
      area 18; these inputs at least partially consist of indirect X-type input relayed
      via area 17; (2) in neurons of area 18 that receive both Y-type and non-Y-type
      excitatory inputs, the Y-type input has a major influence on strength of the
      response and velocity sensitivity and a lesser influence on the direction
      selectivity and size of the discharge fields; and (3) area 18 contains mechanisms
      determining such receptive-field properties as S- or C-type organization,
      orientation tuning, and direction selectivity which can be accessed either by the
      Y input or by non-Y input.

PMID- 1633129
TI  - A psychophysically motivated model for two-dimensional motion perception.
AB  - A quantitative model is developed to predict the perceived direction of moving
      two-dimensional patterns. The model incorporates both a simple motion energy
      pathway and a "texture boundary motion" pathway that incorporates response
      squaring before the extraction of motion energy. These pathways correspond to
      Fourier and non-Fourier motion pathways and are hypothesized to reflect
      processing in the V1-MT and V1-V2-MT pathway, respectively. A cosine-weighted sum
      of these pathways followed by competitive feedback inhibition accurately predicts
      the perceived direction for patterns composed of two cosine gratings at different
      orientations ("plaids"). The model also predicts direction discrimination,
      differences between foveal and peripheral viewing, changes in perceived direction
      with exposure duration, motion masking, and motion transparency.

PMID- 1633130
TI  - Visual callosal projections in the adult ferret.
AB  - The laminar and tangential organization of visual callosal projections of areas
      17 and 18 were investigated in the adult ferret, using histochemical methods to
      visualize axonally transported horseradish peroxidase (HRP). Normal adult ferrets
      were given injections of HRP throughout one visual cortex or had gelfoam soaked
      in HRP applied to the transected corpus callosum. The ferret callosal cell
      distribution has a greater tangential extent in area 18 than in area 17. In
      addition, the radial organization of callosal cells in areas 17 and 18 differs:
      three times as many infragranular cells are present in area 18 than in area 17,
      although the number of supragranular cells is similar for both areas 17 and 18.
      Since the projections of alpha retinal ganglion cells are reported to be
      exclusively contralateral in the ferret (Vitek et al., 1985), callosal
      projections may make a major contribution to the binocularity of neurons in area
      18.

PMID- 1633131
TI  - A model of the perception of area.
AB  - A psychophysical experiment was performed to measure the ability of human
      observers to compare the areas of two geometrical figures (squares and
      rectangles). The results show a systematic overestimation of rectangle area with
      respect to that of the squares. A formal model of area perception and its
      consequent estimation is proposed, which is based on the concept of an 'image
      function'. It assumes that not the original figure but some specific isocline
      defined on the image function surface determines area perception. The systematic
      error observed in the experiment is explained by the model. We discuss the role
      of different definitions of the image function as well as its parameters on the
      model performance.

PMID- 1633132
TI  - Sequential mapping of weighting functions for visual location.
AB  - The effect upon perceived location of adding an extra dot offset from the centre
      of a cluster of pseudorandom dots was investigated using a vernier acuity task.
      With this technique, weighting functions showing the extent to which the added
      dot pulls the apparent location of the entire cluster can be defined as a
      function of distance from the centre of the cluster. When dot density within the
      cluster is high, the weighting functions approximate to what would be expected on
      the basis of centroid alignment. With low dot densities, it appears that
      performance is determined by aligning the outermost dots within each cluster. The
      peak amplitudes of these weighting functions are proportional to the square root
      of dot density within the clusters. The results are consistent with the view that
      each vernier element is localised in an orthoaxial direction prior to
      discrimination of the vernier offset.

PMID- 1633133
TI  - Are direction and speed coded independently by the visual system? Evidence from
      visual search.
AB  - Three visual search experiments examined whether motion is coded as two separate
      features, speed and direction. Increasing the heterogeneity of the directions in
      which stimuli moved disrupted detection of a target defined by speed (fast among
      medium and slow nontargets), suggesting that speed is coded integrally with
      direction. However, heterogeneity in speed did not disrupt detection of a target
      moving in a particular direction among nontargets with different directions. This
      suggests that direction is coded independently of speed. The apparent paradox
      raised by these contrasting conclusions is consistent with neurophysiological and
      computational models of motion-detection, which suggest that low-levels of the
      visual system contain direction-detectors insensitive to speed, while speed is
      coded at higher levels by detectors which are also sensitive to direction.
      Evidence consistent with the existence of the latter conjunction detectors was
      obtained in a final experiment which found search for a conjunction of speed and
      direction to be parallel.

PMID- 1633134
TI  - Can human texture discrimination be mimicked by a computer model using local
      Fourier analysis?

PMID- 1633135
TI  - Spatial code interference on directional responses.
AB  - The interference from an irrelevant position cue was compared in a reaction-time
      paradigm using voice and manual responses. The subjects were required to say
      'left' or 'right' or to press left or right keys in response to arrow directions,
      and the arrows were presented at left or right side display positions irrelevant
      to the task. Display position significantly increased latency when it did not
      match the response to the relevant direction cue for both spatial (key-press) and
      non-spatial (voice) responses (73 and 59 ms, respectively). When presented alone,
      the position cue was processed faster than the direction cue for both manual and
      verbal responses. Results are discussed in terms of a common abstract mediator
      for left-right responses between modes and the processing speed difference
      between the relevant and irrelevant cue. The irrelevant left-right position code
      may occupy some limited-capacity channel ahead of the left-right code derived
      from processing the relevant direction cue.

PMID- 1633136
TI  - The perceived image: efficient modelling of visual inhomogeneity.
AB  - When we fixate on a certain location in a scene, the image that our visual system
      provides us with is not like a snapshot of the scene. Because of visual
      inhomogeneity, the image we perceive is sharp and clean only around the fixation
      location, and it gradually blurs and loses detail with increasing distance from
      that location. In this paper, a procedure is presented that allows one to obtain
      the luminance distribution in the perceived image of a scene. The procedure is
      based on a stack distribution model of spatial visual processing, with parameters
      obtained experimentally. An application of this procedure is presented which
      allows an explanation of data on the decrease of visual acuity with eccentricity.
      The advantages of this procedure for taking visual inhomogeneity into account
      when seeking explanations for perceptual phenomena are also discussed.

PMID- 1633137
TI  - Cat keratoplasty wound healing and corneal astigmatism.
AB  - BACKGROUND: A major contributor to postkeratoplasty astigmatism may be
      donor/recipient disparity. Deficient or excess cornea at the wound is thought to
      influence the directions of the steep and flat meridians. Using an established
      model of penetrating keratoplasty in the cat, this study evaluated the
      morphometry of histopathologic wound features in the steep and flat meridians.
      METHODS: Thirteen cats had successful penetrating keratoplasties after
      intentionally misshapen donor corneas were misaligned in misshapen recipient
      beds. At 9.50 +/- 0.32 (mean +/- 1 SEM) months after keratoplasty,
      photokeratography was performed and analyzed, corneas were sectioned along the
      steep and flat meridians, and four histologic sections were processed. Features
      of the wounds were measured using a Zeiss Videoplan. The relationships between
      the morphometry of each feature and every other feature, between the morphometry
      of each feature and eccentricity, and between the steep and flat section
      morphometry of each feature were statistically evaluated. RESULTS: Epithelial
      thickness, area of lamellar alteration, length of Descemet's membrane produced
      postoperatively, and the depth that preoperative Descemet's membrane was embedded
      in the stroma were correlated with eccentricity (corneal astigmatism). Stromal
      thickness and the presence or absence of folded and fragmented Descemet's
      membrane were not correlated with eccentricity. Wound morphometry at the steep
      meridians was neither correlated with nor significantly different from wound
      morphometry at the flat meridians. CONCLUSIONS: Differences between healing at
      the steep and flat meridians were not likely contributors to astigmatism.
      Disproportionate availability of tissue in wound regions may have affected
      healing throughout the entire wound over time. The absence of Bowman's layer in
      cats restricts application of our results to understanding the etiology of
      corneal astigmatism after penetrating keratoplasty in humans.

PMID- 1633138
TI  - Circular keratotomy for the correction of astigmatism.
AB  - BACKGROUND: Mathematical and physical considerations that are contained in Gauss'
      law lead to the concept of a circular cut for the correction of corneal
      astigmatism. METHODS: The method applied is the coupling of the aspheric corneal
      surface to the spherical obturator of the Guided Trephine System and cutting of
      90% of the parenchyma. Nineteen human eyes were treated with this technique,
      using a double-running suture closure. RESULTS: Results of reduction of
      astigmatism can regularly be obtained but are of different amounts depending on
      the origin of astigmatism. Mean preoperative refractive astigmatism was 5.41
      diopters and mean postoperative refractive astigmatism was 1.34 D. Six eyes
      required additional tranverse arcuate keratotomy. CONCLUSIONS: The procedure is
      effective, but the results are variable. It may be improved by the use of
      obturators that fit the radius of curvature of the cornea.

PMID- 1633139
TI  - Photorefractive keratectomy as a second attempt to correct myopia after radial
      keratotomy.
AB  - BACKGROUND: Undercorrection after radial keratotomy is not uncommon. To correct
      the residual refractive error, several techniques are available including
      photorefractive keratectomy. METHODS: We report five eyes of four patients, which
      remained undercorrected following radial keratotomy and underwent photorefractive
      keratectomy with an excimer laser (193 nm) to correct the residual myopia, with a
      follow up of 6 months to 1 year. RESULTS: The corneal-healing response was
      similar to that of corneas treated by photorefractive keratectomy alone. No
      permanent corneal scarring occurred. The average preoperative refraction before
      photorefractive keratectomy was -2.25 +/- 0.55 diopters; it was close to plano
      (+0.12 +/- 0.26 D) after 6 months. One eye regressed 0.50 D between 6 months and
      1 year. Best-spectacle corrected visual acuity did not change. CONCLUSIONS:
      Excimer laser photorefractive keratectomy seems to be effective as a second
      procedure in eyes undercorrected following radial keratotomy.

PMID- 1633140
TI  - Intraoperative and early postoperative complications in 466 radial keratotomies.
AB  - We have retrospectively studied the intraoperative and early postoperative
      complications of 466 radial keratotomies. These complications included:
      microperforations and macroperforations, incisions into the optical zone, and
      early bacterial corneal ulcers and endophthalmitis.

PMID- 1633141
TI  - Quantitative measurement of wound spreading in radial keratotomy.
AB  - BACKGROUND: Many studies of radial keratotomy have been performed, however
      quantitative laboratory evaluation of the biomechanics of this procedure is still
      incomplete. Furthermore, most measurements of strain in the past have utilized
      strip testing, thus destroying the normal physiological structure and water
      balance of the cornea. METHODS: We report on a membrane inflation method of wound
      spreading in intact human corneas using the Baribeau Micronscope. RESULTS: We
      measured a secant elastic modulus of 7.58 x 10(6) N/m2 between 25 and 100 mm Hg.
      The spreading of radial keratotomy incisions as a function of intraocular
      pressure showed a maximum spreading of approximately 50 mu at 25 mm Hg at a
      radius of 3.50 mm from the optical center. A slight increase in spreading was
      observed in proceeding from a single to four radial incisions. CONCLUSIONS:
      Quantitative measurement of wound spreading is an important parameter of radial
      keratotomy and can provide important information regarding opposing theories of
      the biomechanics of this operation.

PMID- 1633142
TI  - A comparison of corneal stromal edema induced from the anterior or the posterior
      surface.
AB  - BACKGROUND: Many differences between the anterior and posterior corneal stroma
      have been reported. The physiological and mechanical properties of the cornea are
      a summation of these properties across each of the corneal regions. This article
      investigates corneal stromal swelling that is experimentally induced through each
      surface. METHODS: Corneal stromal swelling was induced in human and rabbit
      corneas through either the anterior or posterior surface. The rate of stromal
      swelling was analyzed with a linear regression model. RESULTS: Swelling in the
      rabbit stroma was 3.65 x faster when induced through the posterior surface than
      through the anterior surface (p less than .0001), while the human stroma swelled
      13.1 x faster through the posterior surface (p less than .0001). The hydration of
      the stroma increased during swelling through the posterior surface, but
      paradoxically decreased during swelling through the anterior surface.
      CONCLUSIONS: These experiments showed that stromal swelling occurs more rapidly
      through the posterior corneal surface than through the anterior surface. These
      results may have implications for the refractive surgeon performing laser
      ablative procedures on the anterior surface of the cornea.

PMID- 1633143
TI  - An in-vivo technique for monitoring keratocyte migration following lamellar
      keratoplasty.
AB  - BACKGROUND: We have recently developed a method for labeling and following the
      migration of keratocytes using the fluorescent dye, 4',6-diamidino-2-phenylindole
      (DAPI), which intercalates specifically into the adenine-thymine base pairs of
      deoxyribonucleic acid (DNA). METHODS: DAPI was applied to a 2-millimeter area of
      the corneal stroma, at the edge of the microkeratome wound, prior to placement of
      the autograft. RESULTS: DAPI-labeled keratocytes were identified by
      epifluorescence microscopy along the microkeratome wound and in the mid-periphery
      of the lamellar graft by day 7. In contrast, no DAPI-labeled keratocytes were
      observed in the graft immediately following surgery, indicating that the DAPI
      labeled keratocytes observed in the graft at day 7 resulted from keratocyte
      migration, and not from diffusion of DAPI from the host into the graft.
      CONCLUSIONS: These investigations suggest that DAPI could be a useful probe for
      monitoring the migration of keratocytes into corneal grafts following lamellar
      keratoplasty and other corneal transplant surgical techniques.

PMID- 1633144
TI  - On the safety of 193-nanometer excimer laser refractive corneal surgery.
AB  - Current literature on the potential hazards of 193-nanometer excimer laser
      corneal surgery is reviewed. The healing process of the different layers involved
      in the procedure is examined. The epithelium regenerates without delay or
      abnormal adhesion. A certain loss of corneal transparency seems to be only a
      short-term complication. The phototoxic risk for the endothelium and the lens has
      not yet been fully investigated. This risk is presently thought to be minimal.
      Factors such as improper corneal centering could lead to degradation of best
      corrected visual acuity or to loss of contrast sensitivity. Results of the first
      clinical trials indicate that vision quality does not appear to be adversely
      affected. The last section reviews studies designed to investigate the
      mutagenicity and cytotoxicity of 193-nanometer UV radiation. In vivo experiments
      could find no evidence of cellular transformation.

PMID- 1633145
TI  - Subepithelial reticular cicatrization following radial keratotomy in a patient
      with inactive trachoma.
AB  - BACKGROUND: Opacification of the clear optical zone following radial keratotomy
      has not been observed before. METHODS AND RESULTS: The authors noted the
      appearance of subepithelial dense white reticular cicatrization in the central
      area following radial keratotomy in a patient with inactive trachoma and clear
      cornea. The corneal changes resulted in regression of the surgical effect and
      decrease in visual acuity. A good visual result was obtained by performing
      homoplastic myopic keratomileusis in situ. Clinical and histopathological
      findings are presented. CONCLUSIONS: Patients undergoing radial keratotomy should
      be carefully screened for inactive trachoma which may contribute toward
      postoperative reticulate opacity of the central cornea.

PMID- 1633146
TI  - The correction of high myopia.
AB  - There are welcome signs that the ophthalmic profession is at long last facing up
      to its responsibilities to those unfortunate enough to suffer from high myopia.
      At this time, it is my opinion that the safest and most effective option is the
      use of the ZB5M anterior chamber implant inserted into phakic eyes, the updated
      technique devised by Baikoff and Domilens. In the long term, the future probably
      lies with the use of corneal inlays using a high refractive index thermoplastic
      such as polysulfone.

PMID- 1633147
TI  - The concept of using a different sized diameter corneal graft and host bed has
      been used in ophthalmology for many years.

PMID- 1633148
TI  - Epikeratoplasty in the management of keratoconus with aphakia.

PMID- 1633149
TI  - Binding of the H-ras p21 GTPase activating protein by the activated epidermal
      growth factor receptor leads to inhibition of the p21 GTPase activity in vitro.
AB  - There is strong, albeit indirect, evidence for a mitogenic signal transduction
      pathway comprising growth factors, growth factor receptors, the GTPase activating
      protein (p120-GAP), and p21ras. To demonstrate a direct physical association
      between these proteins in the absence of other cell constituents, their
      interaction was studied in vitro. Our results obtained with homogeneous protein
      preparations show that the activated epidermal growth factor (EGF) receptor
      phosphorylates p120-GAP at one site. Phosphorylated p120-GAP remains firmly bound
      to the receptor at physiological salt concentration; this leads to product
      inhibition of the receptor kinase activity as shown by diminished
      autophosphorylation activity and lack of turnover in p120-GAP phosphorylation.
      Phosphorylated p120-GAP is as active in stimulating the p21ras.GTPase as
      unphosphorylated GAP. p120-GAP, however, when bound to the EGF receptor is by a
      factor of 2 less active in stimulating the p21ras.GTPase than free p120-GAP. This
      effect might contribute to regulate the steady-state level of p21-GTP.

PMID- 1633150
TI  - High-pressure 31P NMR study of dipalmitoylphosphatidylcholine bilayers.
AB  - High-pressure 31P NMR was used for the first time to investigate the effects of
      pressure on the structure and dynamics of the phosphocholine headgroup in pure
      1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) multilamellar aqueous
      dispersions and in DPPC bilayers containing the positively charged form of the
      local anesthetic tetracaine (TTC). The 31P chemical shift anisotropies, delta
      sigma, and the 31P spin-lattice relaxation times, T1, were measured as a function
      of pressure from 1 bar to 5 kbar at 50 degrees C for both pure DPPC and DPPC/TTC
      bilayers. This pressure range permitted us to explore the rich phase behavior of
      DPPC from the liquid-crystalline (LC) phase through various gel phases such as
      gel I (P beta'), gel II (L beta'), gel III, gel IV, gel X, and the
      interdigitated, Gi, gel phase. For pure DPPC bilayers, pressure had an ordering
      effect on the phospholipid headgroup within the same phase and induced an
      interdigitated Gi gel phase which was formed between the gel I (P beta') and gel
      II (L beta') phases. The 31P spin-lattice relaxation time measurements showed
      that the main phase transition (LC to gel I) was accompanied by the transition
      between the fast and slow correlation time regimes. Axially symmetric 31P NMR
      lineshapes were observed at pressures up to approximately 3 kbar but changed to
      characteristic axially asymmetric rigid lattice lineshapes at higher pressures
      (3.1-5.1 kbar).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633151
TI  - Barnase has subsites that give rise to large rate enhancements.
AB  - Barnase is found to have a series of subsites for binding its substrates that
      confers large rate enhancements. Ribonucleotide substrates of the type Zp0Gp1Xp2Y
      have been synthesized, where p is phosphate, X, Y, and Z are nucleosides, and G
      is guanosine. G occupies the primary specificity site. The most important subsite
      is for p2, followed by that for Y. There appears to be no subsite for the Z or p0
      positions. Occupation of the subsite for p2 gives rise to a 1000-fold increase in
      kcat/Km, composed of a 100-fold increase in kcat and a 10-fold decrease in Km.
      The Y subsite gives rise to further 20-fold increase in kcat/Km. Rates
      approaching diffusion control for kcat/Km are observed. kcat for the dinucleotide
      monophosphate GpU = 0.55 s-1, and Km = 240 microM; this compares with 53 s-1 and
      20 microM for GpUp, and 3.3 x 10(3) s-1 and 17 microM for GpApA (the best
      substrate tested). Cleavage occurs at the 3'-phosphate of guanosine in all cases.
      There are differences in base specificity at the two subsites for X and Y
      downstream of the scissile bond. The binding energies of different substrates
      have been analyzed using thermodynamic cycles. These show that the contributions
      of the X and Y sites are nonadditive.

PMID- 1633152
TI  - Comparison of conformational features of staphylococcal nuclease in ternary
      complexes with pdTp, pdGp, and nitrophenyl-pdTp.
AB  - The conformations of wild-type staphylococcal nuclease (SNase) in the ternary
      complexes with thymidine 3',5'-bisphosphate (pdTp), 2'-deoxyguanine 3',5'
      bisphosphate (pdGp), and thymidine 3'-phosphate 5'-(p-nitrophenylphosphate)
      (NpdTp) with Ca2+ were examined by two-dimensional NMR NOESY and ROESY
      experiments. The results of these experiments indicate that the conformational
      features of the SNase are quite similar in the three ternary complexes. This
      suggests that the conformational features of SNase, in these ternary complexes,
      are not strongly dependent on whether the 5'-phosphate is a mono- or diester.
      This is in contrast to our prior studies on substitutions of active site charged
      amino acids which indicated that the conformational features of SNase in the
      ternary complex are quite sensitive to substitutions for active site charged
      amino acids (Hibler et al., 1987; Wilde et al., 1988; Pourmotabbed et al., 1990).
      The similarity of the SNase conformational features in the ternary complexes with
      pdTp and pdGp indicates that the features of the nucleotide bound at the active
      site are not strong determinants of the enzyme conformation in the ternary
      complexes. These conclusions are in general agreement with the results on pdApdT
      ternary complexes with SNase which suggested that it is the conformational
      features of the bound nucleic acid which determine the differences in catalysis
      observed for SNase with different substrates (Weber et al., 1991), more so than
      the conformational features of the enzyme.

PMID- 1633153
TI  - Phospholipase A2 engineering. Structural and functional roles of highly conserved
      active site residues tyrosine-52 and tyrosine-73.
AB  - Site-directed mutagenesis was used to probe the structural and functional roles
      of two highly conserved residues, Tyr-52 and Tyr-73, in interfacial catalysis by
      bovine pancreatic phospholipase A2 (PLA2, overproduced in Escherichia coli).
      According to crystal structures, the side chains of these two active site
      residues form H-bonds with the carboxylate of the catalytic residue Asp-99.
      Replacement of either or both Tyr residues by Phe resulted in only very small
      changes in catalytic rates, which suggests that the hydrogen bonds are not
      essential for catalysis by PLA2. Substitution of either Tyr residue by
      nonaromatic amino acids resulted in substantial decreases in the apparent kcat
      toward 1,2-dioctanoyl-sn-glycero-3-phosphocholine (DC8PC) micelles and the v(o)
      (turnover number at maximal substrate concentration, i.e., mole fraction = 1)
      toward 1,2-dimyristoyl-sn-glycero-3-phosphomethanol (DC14PM) vesicles in scooting
      mode kinetics [Berg, O. G., Yu, B.-Z., Rogers, J., & Jain, M. K. (1991)
      Biochemistry 30, 7283-7297]. The Y52V mutant was further analyzed in detail by
      scooting mode kinetics: the E to E* equilibrium was examined by fluorescence; the
      dissociation constants of E*S, E*P, and E*I (KS*, KP*, and KI*, respectively) in
      the presence of Ca2+ were measured by protection of histidine-48 modification and
      by difference UV spectroscopy; the Michaelis constant KM* was calculated from
      initial rates of hydrolysis in the absence and presence of competitive
      inhibitors; and the turnover number under saturating conditions (kcat, which is a
      theoretical value since the enzyme may not be saturated at the interface) was
      calculated from the vo and KM* values. The results indicated little perturbation
      in the interfacial binding step (E to E*) but ca. 10-fold increases in KS*, KP*,
      KI*, and KM* and a less than 10-fold decrease in kcat. Such changes in the
      function of Y52V are not due to global conformational changes since the proton
      NMR properties of Y52V closely resemble those of wild-type PLA2; instead, it is
      likely to be caused by perturbed enzyme-substrate interactions at the active
      site. Tyr-73 appears to play an important structural role. The conformational
      stability of all Tyr-73 mutants decreased by 4-5 kcal/mol relative to that of the
      wild-type PLA2. The proton NMR properties of Y73A suggested significant
      conformational changes and substantially increased conformational flexibility.
      These detailed structural and functional analyses represent a major advancement
      in the structure-function study of an enzyme involved in interfacial catalysis.

PMID- 1633154
TI  - Kinetic isotope effect analysis of the reaction catalyzed by Trypanosoma
      congolense trypanothione reductase.
AB  - African trypanosomes are devoid of glutathione reductase activity, and instead
      contain a unique flavoprotein variant, trypanothione reductase, which acts on a
      cyclic derivative of glutathione, trypanothione. The high degree of sequence
      similarity between trypanothione reductase and glutathione reductase, as well as
      the obvious similarity in the reactions catalyzed, led us to investigate the pH
      dependence of the kinetic parameters, and the isotopic behavior of trypanothione
      reductase. The pH dependence of the kinetic parameters V, V/K for NADH, and V/K
      for oxidized trypanothione has been determined for trypanothione reductase from
      Trypanosoma congolense. Both V/K for NADH and the maximum velocity decrease as
      single groups exhibiting pK values of 8.87 +/- 0.09 and 9.45 +/- 0.07,
      respectively, are deprotonated. V/K for oxidized trypanothione, T(S)2, decreases
      as two groups exhibiting experimentally indistinguishable pK values of 8.74 +/-
      0.03 are deprotonated. Variable magnitudes of the primary deuterium kinetic
      isotope effects on pyridine nucleotide oxidation are observed on V and V/K when
      different pyridine nucleotide substrates are used, and the magnitude of DV and
      D(V/K) is independent of the oxidized trypanothione concentration at pH 7.25.
      Solvent kinetic isotope effects, obtained with 2',3'-cNADPH as the variable
      substrate, were observed on V only, and plots of V versus mole fraction of D2O
      (i.e., proton inventory) were linear, and yielded values of 1.3-1.6 for D2OV.
      Solvent kinetic isotope effects obtained with alternate pyridine nucleotides as
      substrates were also observed on V, and the magnitude of D2OV decreases for each
      pyridine nucleotide as its maximal velocity relative to that of NADPH oxidation
      decreases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633155
TI  - A kinetic investigation of phosphoenolpyruvate carboxylase from Zea mays.
AB  - The reaction catalyzed by phosphoenolpyruvate carboxylase from Zea mays has been
      studied kinetically. Results of initial velocity patterns and inhibition studies
      indicate that phosphoenolpyruvate carboxylase has a random sequential mechanism
      in which there is a high level of synergism in the binding of substrates. The
      preferred order of addition of reactants is Mg2+, phosphoenolpyruvate, and
      bicarbonate. The binding of Mg2+ is at equilibrium. Values for the various
      kinetic parameters are KiMg = 2.3 +/- 0.4 mM, KPEP = 3.6 +/- 0.6 mM, KiPEP = 0.2
      +/- 0.07 mM, and Kbicarbonate = 0.18 +/- 0.04 mM. In addition, double inhibition
      experiments have been performed to examine the nature of the active site
      interactions with the putative intermediates, carboxy phosphate and the enolate
      of pyruvate. Highly synergistic inhibition of phosphoenolpyruvate carboxylase was
      observed in the presence of oxalate and carbamyl phosphate (alpha = 0.0013).
      However, an antisynergistic relationship exists between oxalate and
      phosphonoformate (alpha = 2.75).

PMID- 1633156
TI  - Hydrolysis of phosphoenolpyruvate catalyzed by phosphoenolpyruvate carboxylase
      from Zea mays.
AB  - In addition to the normal carboxylation reaction, phosphoenolpyruvate carboxylase
      from Zea mays catalyzes a HCO3(-)-dependent hydrolysis of phosphoenolpyruvate to
      pyruvate and Pi. Two independent methods were used to establish this reaction.
      First, the formation of pyruvate was coupled to lactate dehydrogenase in assay
      solutions containing high concentrations of L-glutamate and aspartate
      aminotransferase. Under these conditions, oxalacetic acid produced in the
      carboxylation reaction was efficiently transaminated, and decarboxylation to form
      spurious pyruvate was negligible. Second, sequential reduction of oxalacetate and
      pyruvate was achieved by initially running the reaction in the presence of malate
      dehydrogenase with NADH in excess over phosphoenolpyruvate. After the reaction
      was complete, lactate dehydrogenase was added, thus giving a measure of pyruvate
      concentration. At pH 8.0 in the presence of Mg2+, the rate of phosphoenolpyruvate
      hydrolysis was 3-7% of the total reaction rate. The hydrolysis reaction catalyzed
      by phosphoenolpyruvate carboxylase was strongly metal dependent, with rates
      decreasing in the order Ni2+ greater than Co2+ greater than Mn2+ greater than
      Mg2+ greater than Ca2+. These results suggest that the active site metal ion
      binds to the enolate oxygen, thus stabilizing the proposed enolate intermediate.
      The more stable the enolate, the less reactive it is toward carboxylation and the
      greater the opportunity for hydrolysis.

PMID- 1633157
TI  - Mechanistic studies of phosphoenolpyruvate carboxylase from Zea mays with (Z)-
      and (E)-3-fluorophosphoenolpyruvate as substrates.
AB  - The catalytic mechanism of phosphoenolpyruvate (PEP) carboxylase from Zea mays
      has been studied using (Z)- and (E)-3-fluorophosphoenolpyruvate (F-PEP) as
      substrates. Both (Z)- and (E)-F-PEP partition between carboxylation to produce 3
      fluorooxalacetate and hydrolysis to produce 3-fluoropyruvate. Carboxylation
      accounts for 3% of the reaction observed with (Z)-F-PEP, resulting in the
      formation of (R)-3-fluorooxalacetate, and for 86% of the reaction of (E)-F-PEP
      forming (S)-3-fluorooxalacetate. Carboxylation of F-PEP occurs on the 2-re face,
      which corresponds to the 2-si face of PEP. The partitioning of F-PEP between
      carboxylation and hydrolysis is insensitive to pH but varies with metal ion. Use
      of 18O-labeled bicarbonate produces phosphate that is multiply labeled with 18O;
      in addition, 18O is also incorporated into residual (Z)- and (E)-F-PEP. The
      13(V/K) isotope effect on the carboxylation of F-PEP catalyzed by PEP carboxylase
      at pH 8.0, 25 degrees C, is 1.049 +/- 0.003 for (Z)-F-PEP and 1.009 +/- 0.006 for
      (E)-F-PEP. These results are consistent with a mechanism in which carboxylation
      of PEP occurs via attack of the enolate of pyruvate on CO2 rather than carboxy
      phosphate. In this mechanism phosphorylation of bicarbonate to give carboxy
      phosphate and decarboxylation of the latter are reversible steps. An irreversible
      step, however, precedes partitioning between carboxylation to give oxalacetate
      and release of CO2, which results in hydrolysis of PEP.

PMID- 1633159
TI  - Bis-ANS as a specific inhibitor for microtubule-associated protein induced
      assembly of tubulin.
AB  - 5,5'-Bis[8-(phenylamino)-1-naphthalenesulfonate] (bis-ANS), the fluorescent probe
      which binds to tubulin, inhibits its assembly into microtubules [Horowitz et al.
      (1984) J. Biol. Chem. 259, 14647-14650]. The results described in this paper
      demonstrate that bis-ANS is quite distinct from other well-known microtubule
      inhibitors in its specificity of action. The inhibitory potentials of bis-ANS and
      its three structural analogues ANS, Prodan [6-propionyl-2
      (dimethylamino)naphthalene], and NSA (naphthalenesulfonic acid) have been
      compared. It is found that they can be arranged in the following order according
      to their polymerization inhibitory potentials: bis-ANS approximately equal to
      Prodan much greater than ANS greater than NSA. Interestingly, the naphthalene
      nucleus is sufficient to cause inhibition of polymerization. Detailed experiments
      were carried out to examine the mode of assembly inhibition by aminonaphthalenes
      at the molecular level, using bis-ANS as a representative. It was found that
      there was little or no effect of bis-ANS on the assembly of tubulin when
      polymerization was induced by assembly promoters like taxol, DMSO, or glutamate,
      or on the assembly of subtilisin-digested protein (tubulin S), for all of which
      half-maximal inhibition could not be achieved even at 120 microM bis-ANS. On the
      contrary, bis-ANS acts as an inhibitor in the case of MAP- (MAP2 and tau) and
      poly(L-lysine)-induced assembly of tubulin, with half-maximal inhibitory
      concentrations ranging from 1.5 to 7.6 microM. Our results place bis-ANS as a
      novel inhibitor, which seems to specifically inhibit C-termini-mediated assembly.
      Of all assembly inhibitors known so far, none exhibits such selection.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1633158
TI  - Nucleic acid interactive properties of a peptide corresponding to the N-terminal
      zinc finger domain of HIV-1 nucleocapsid protein.
AB  - An 18-residue peptide (NC-F1) with an amino acid sequence corresponding to the N
      terminal zinc finger of human immunodeficiency virus-1 nucleocapsid protein has
      been shown to bind to nucleic acids by fluorescence and NMR methods. Previously,
      this peptide has been shown to fold into a defined structure when bound to zinc
      (Summers et al., 1990). We have used a fluorescent polynucleotide,
      poly(ethenoadenylic acid), to monitor binding of this peptide to nucleic acids.
      In the presence of zinc, the peptide had a smaller site size (1.75 nucleotide
      residues/peptide) than in the absence of the metal ion (2.75). The salt
      sensitivity of the interaction indicated that two ion pairs are involved in the
      association of Zn2+ (NC-F1) with polynucleotide, whereas one ion pair is found in
      the metal-free peptide-nucleic acid complex. Competition experiments with single
      stranded DNA (ss DNA) in either the presence or absence of Zn2+ showed that the
      peptide bound to ss DNA. Using NMR methods, we monitored the binding of a
      synthetic oligonucleotide, d(TTTGGTTT), to Zn(NC-F1). The hydrophobic residues F2
      and I10, which are on the surface of the peptide and have been implicated in
      viral RNA recognition, were shown to interact with the oligomer. In accord with
      this observation, analysis of the salt dependence of the polynucleotide-peptide
      interaction indicates a nonelectrostatic component of about -6 kcal/mol, a value
      consistent with theoretical estimates of stacking energies of phenylalanine with
      nucleic acid bases.

PMID- 1633160
TI  - Structural comparison of apomyoglobin and metaquomyoglobin: pH titration of
      histidines by NMR spectroscopy.
AB  - Proton NMR spectroscopy was applied to myoglobin in the ferric, water-liganded
      form (metMbH2O) and the apo form (apoMb) to probe the structure and stability of
      the latter. Proteins from sperm whale and horse skeletal muscles were studied to
      simplify the spectral assignment task. Nuclear Overhauser effects and the
      response of chemical shifts to variations of pH were used as indicators of
      residual native holoprotein structure in the apoprotein. The investigation was
      focused in the histidine side chains and their environment. In metMbH2O, the
      resonances of all imidazole rings not interacting with the heme were assigned by
      applying standard two-dimensional methods. These assignments were found to differ
      from those reported elsewhere [Carver, J. A., & Bradbury, J. H. (1984)
      Biochemistry 23, 4890-4905] except for His-12, -113, and -116. Only one histidine
      (His-36) has a pK(a) higher than 7, two (His-48 and His-113) have a pK(a) lower
      than 5.5, and two (His-24 and His-82) appear not to titrate between pH 5.5 and pH
      10. In the apoproteins, the signals of His-113 and His-116, as well as those of
      His-24, -36, -48, and -119 previously assigned in the horse globin [Cocco, M. J..
      & Lecomte, J. T. J. (1990) Biochemistry 29, 11067-11072], could be followed
      between pH 5 and pH 10. A comparison to the holoprotein data indicated that heme
      removal has limited effect on the pK(a) and the surroundings of these residues.
      Five additional histidines which occur in the two helices and connecting loops
      forming the heme binding site were identified in the horse apoprotein. Four of
      these were found to have pK(a) values lower than that expected of an exposed
      residue. The NOE and titration data were proposed to reflect the fact that
      several holoprotein structural elements, in particular outside the heme binding
      site, are maintained in the apoprotein. In the heme binding region of the
      apoprotein structure, the low pK(a)'s suggest local environments which are
      resistant to protonation.

PMID- 1633161
TI  - Stimulation of the type III olfactory adenylyl cyclase by calcium and calmodulin.
AB  - Characterization of adenylyl cyclases has been facilitated by the isolation of
      cDNA clones for distinct adenylyl cyclases including the type I and type III
      enzymes. Expression of type I adenylyl cyclase activity in animal cells has
      established that this enzyme is stimulated by calmodulin and Ca2+. Type III
      adenylyl cyclase is enriched in olfactory neurons and is regulated by stimulatory
      G proteins. The sensitivity of the type III adenylyl cyclase to Ca2+ and
      calmodulin has not been reported. In this study, type III adenylyl cyclase was
      expressed in human kidney 293 cells to determine if the enzyme is stimulated by
      Ca2+ and calmodulin. The type III enzyme was not stimulated by Ca2+ and
      calmodulin in the absence of other effectors. It was, however, stimulated by Ca2+
      through calmodulin when the enzyme was concomitantly activated by either GppNHp
      or forskolin. The concentrations of free Ca2+ for half-maximal stimulation of
      type I and type III adenylyl cyclases were 0.05 and 5.0 microM Ca2+,
      respectively. These data suggest that the type III adenylyl cyclase is stimulated
      by Ca2+ when the enzyme is activated by G-protein-coupled receptors and that
      increases in free Ca2+ accompanying receptor activation may amplify the primary
      cyclic AMP signal.

PMID- 1633162
TI  - Characterization of the specific antigenicity of Mycobacterium fortuitum.
AB  - Mycobacterium fortuitum, biovar, fortuitum, the cause of serious skin and soft
      tissue infections, can be differentiated from M. fortuitum, biovar. peregrinum,
      and other rapidly growing opportunistic mycobacteria by the presence of a unique
      antigenic glycolipid. The glycolipid is among the simplest of the acyl-trehalose
      containing lipooligosaccharide class. The application of 1H and 13C NMR,
      methylation analysis, FAB/MS, and other procedures demonstrated the structure,
      beta-D-Glcp-(1----6)-2-O-acyl-alpha-D-Glcp-(1 in equilibrium with 1)-3,4,6-tri-O
      acyl-alpha-D-Glcp. Thus, practically all environmental mycobacteria, many of them
      opportunistic pathogens, can be differentiated serologically and chemically on
      the basis of unique sugar arrangements within a few classes of glycolipids. The
      simplicity of the structure in M. fortuitum fortuitum combined with the distinct
      roughness of the parent strain raises the intriguing possibility that it is a
      spontaneous rough variant of the other mycobacteria with more elaborate
      glycolipids.

PMID- 1633163
TI  - The three-dimensional structure in solution (pH 5.8) of a DNA 9-mer duplex
      containing 1,N2-propanodeoxyguanosine opposite deoxyadenosine. Restrained
      molecular dynamics and NOE-based refinement calculations.
AB  - The solution structure of the complementary d(C1-A2-T3-G4-X5-G6-T7-A8-C9).d(G10
      T11-A12-C13-A14-C15-A 16-T17-G18) nonanucleotide duplex (designated X.A 9-mer)
      that contains a 1,N2-propanodeoxyguanosine exocyclic adduct, X5, opposite
      deoxyadenosine A14 in the center of the helix at pH 5.8 is investigated by use of
      restrained molecular dynamics followed by NOE-based back-calculation refinement.
      The molecular dynamics calculation is based on 91 interresidue and 97
      intraresidue interproton distance restraints derived from two-dimensional nuclear
      Overhauser enhancement data on the X.A 9-mer at mixing times of 50 and 250 ms
      [Kouchakdjian, M., Marinelli, E., Gao, X., Johnson, F., Grollman, A., & Patel,
      D.J. (1989) Biochemistry 28, 5647-5657]. Separate runs start from classical A and
      B DNA and converge to essentially identical structures (atomic root mean square
      difference of 0.69 A). Both structures are B-type DNA in character and satisfy
      the experimental distance restraints with the rms difference of only 0.001 A
      between the calculated and experimental interproton distances. The dynamics
      behavior of the A----B DNA transition is monitored and analyzed. Our results
      clearly indicate that the driving force of the convergence is the experimental
      interproton distance restraints. The molecular dynamics structures are further
      refined by a back-calculation dynamics which directly minimizes the difference
      between the observed 2D NOE intensities and those calculated by the full
      relaxation matrix approach. The fit of the refined structures to the NOE
      intensities is measured by the NOE R value, which is analogous to the
      crystallographic residual index. These R values of the final structures are only
      0.17. The refined structures are generally B type, and their convergency improves
      slightly to an atomic root mean square difference of 0.64 A, despite relatively
      large structural shifts (approximately 1 A) which occur during the back
      calculation refinement in both cases. These results suggest that the converged
      refined structures represent reasonable approximations of the solution structure.

PMID- 1633164
TI  - Secondary structure of streptokinase in aqueous solution: a Fourier transform
      infrared spectroscopic study.
AB  - The secondary structure of streptokinase (Sk) in aqueous solution was
      quantitatively examined by using Fourier transform infrared (FT-IR) spectroscopy.
      Resolution enhancement techniques, including Fourier deconvolution and derivative
      spectroscopy, were combined with band curve-fitting procedures to quantitate the
      spectral information from the amide I bands. Nine component bands were found
      under the broad, nearly featureless amide I bands which reflect the presence of
      various substructures. The relative areas of these component bands indicate an
      amount of beta-sheet between 30 and 37% and an alpha-helix content of only 12-13%
      in Sk. Further conformational substructures are assigned to turns (25-26%) and to
      "random" structures (15-16%). Additionally, the correlation of a pronounced
      component band near 1640 cm-1 (10-16% fractional area) with the possible presence
      of 3(10)-helices is discussed.

PMID- 1633165
TI  - Penetration of analogues of H2O and CO2 in proteins studied by room temperature
      phosphorescence of tryptophan.
AB  - The influence of the protein matrix on the reactivity of external molecules with
      a species buried within the protein interior is considered in two general ways:
      (1) there may be structural fluctuations that allow for the diffusive penetration
      of the small molecules and/or (2) the external molecule may react over a
      distance. As a means to study the protein matrix, a reactive species within the
      protein can be formed by exciting tryptophan to the triplet state, and then the
      reaction of the triplet-state molecule with an external molecule can be monitored
      by a decrease in phosphorescence. In this work, the quenching ability (i.e.,
      reactivity) was examined for H2S, CS2, and NO2- acting on tryptophan
      phosphorescence in parvalbumin, azurin, horse liver alcohol dehydrogenase, and
      alkaline phosphatase. A comparison of charged versus uncharged quenchers (H2S vs
      SH- and CS2 vs NO2-) reveals that the uncharged molecules are much more effective
      than charged species in quenching the phosphorescence of fully buried tryptophan,
      whereas the quenching for exposed tryptophan is relatively independent of the
      charge of the quencher. This is consistent with the view that uncharged triatomic
      molecules can penetrate the protein matrix to some extent. The energies of
      activation of the quenching reaction are low for the charged quenchers and higher
      for the uncharged CS2. A model is presented in which the quenchability of a
      buried tryptophan is inversely related to the distance from the surface when
      diffusion through the protein is the rate-limiting step.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1633166
TI  - Construction and characterization of a spectral probe mutant of troponin C:
      application to analyses of mutants with increased Ca2+ affinity.
AB  - A spectral probe mutant (F29W) of chicken skeletal muscle troponin C (TnC) has
      been prepared in which Phe-29 has been substituted by Trp. Residue 29 is at the
      COOH-terminal end of the A helix immediately adjacent to the Ca2+ binding loop of
      site I (residues 30-41) of the regulatory N domain. Since this protein is
      naturally devoid of Tyr and Trp, spectral features can be assigned unambiguously
      to the single Trp. The fluorescent quantum yield at 336 nm is increased almost 3
      fold in going from the Ca(2+)-free state to the 4Ca2+ state with no change in the
      wavelength of maximum emission. Comparisons of the Ca2+ titration curves of the
      change in far-UV CD and fluorescence emission indicated that the latter was
      associated only with the binding of 2Ca2+ to the regulatory sites I and II. No
      change in fluorescence was detected by titration with Mg2+. The Ca(2+)-induced
      transitions of both the N and C domains were highly cooperative. Addition of Ca2+
      also produced a red shift in the UV absorbance spectrum and a reduction in
      positive ellipticity as monitored by near-UV CD measurements. The fluorescent
      properties of F29W were applied to an investigation of five double mutants:
      F29W/V45T, F29W/M46Q, F29W/M48A, F29W/L49T, and F29W/M82Q. Ca2+ titration of
      their fluorescent emissions indicated in each case an increased Ca2+ affinity of
      their N domains. The magnitude of these changes and the decreased cooperativity
      observed between Ca2+ binding sites I and II for some of the mutants are
      discussed in terms of the environment of the mutated residues in the 2Ca2+ and
      modeled 4Ca2+ states.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633167
TI  - Ionization of amino acid residues involved in the catalytic mechanism of
      aspartate transcarbamoylase.
AB  - The chemical and kinetic mechanisms of the reaction catalyzed by the catalytic
      trimer of aspartate transcarbamoylase have been examined. The variation of the
      kinetic parameters with pH indicated that at least four ionizing amino acid
      residues are involved in substrate binding and catalysis. The pH dependence of
      K(ia) for carbamoyl phosphate and the K(i) for N-(phosphonoacetyl)-L- aspartate
      revealed that a protonated residue with a pK value of 9.0 is required for the
      binding of carbamoyl phosphate. However, the variation with pH of K(i) for
      succinate, a competitive inhibitor of aspartate, and for cysteine sulfinate, a
      slow substrate, showed that a single residue with a pK value of 7.3 must be
      protonated for binding these analogues and, by inference, aspartate. The profile
      of log V against pH displayed a decrease in reaction rate at low and high pH,
      suggesting that two groups associated with the Michaelis complex, a deprotonated
      residue with a pK value of 7.2 and a protonated group with a pK value of 9.5, are
      involved in catalysis. By contrast, the catalytically productive form of the
      enzyme-carbamoyl phosphate complex, as illustrated in the bell-shaped pH
      dependence of log (V/K)(asp), is one in which a residue with a pK value of 7.0
      must be protonated while a group with a pK value of 9.1 is deprotonated. This
      interpretation is supported by the results from the temperature dependence of the
      V and V/K profiles and from the pH dependence of pK(i) for the aspartate
      analogues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633168
TI  - 13C isotope effects as a probe of the kinetic mechanism and allosteric properties
      of Escherichia coli aspartate transcarbamylase.
AB  - 13C kinetic isotope effects have been measured in carbamyl phosphate for the
      reaction catalyzed by aspartate transcarbamylase. For the holoenzyme, the value
      was 1.0217 at zero aspartate, but unity at infinite aspartate, with 4.8 mM
      aspartate eliminating half of the isotope effect. This pattern proves an ordered
      kinetic mechanism, with carbamyl phosphate adding before aspartate. The same
      parameters were observed in the presence of ATP or CTP, showing that there is
      only one form of active enzyme present, regardless of the presence or absence of
      allosteric modifiers. These data support the Monod model of allosteric behavior
      in which the equilibrium between fully active and inactive enzyme is perturbed by
      selective binding interactions of substrates and modifiers, and there are no
      enzyme forms having partial activity. Isolated catalytic subunits of the enzyme
      showed similar 13C isotope effects (1.0240 at zero aspartate, 1.0039 at infinite
      aspartate, 3.8 mM aspartate causing half of the change from one value to the
      other), but the finite isotope effect at infinite aspartate shows that the
      kinetic mechanism is now partly random. With the very slow and poorly bound
      aspartate analog cysteine sulfinate, the 13C isotope effects were 1.039 for both
      holoenzyme and catalytic subunits and were not decreased significantly by high
      levels of cysteine sulfinate. The value of 1.039 is probably close to the
      intrinsic isotope effect on the chemical reaction, while the kinetic mechanism
      with this substrate is now fully random because the chemistry is so much slower
      than release of either reactant from the enzyme.

PMID- 1633169
TI  - 13C and 15N isotope effects as a probe of the chemical mechanism of Escherichia
      coli aspartate transcarbamylase.
AB  - 13C and 15N isotope effects have been measured for the aspartate transcarbamylase
      (ATCase) reaction in an effort to elucidate the chemical mechanism of this highly
      regulated enzyme. The observed 15(V/K(asp))H2O value for the ATCase holoenzyme at
      saturing carbamyl phosphate and 12 mM L-aspartate is 1.0045 at pH 7.5, and this
      value remains unchanged in the presence of 5 mM ATP (activator) or 5 mM CTP
      (inhibitor). The fact that the isotope effect is not changed by the allosteric
      modifiers supports the conclusion that the kinetic properties of the active form
      of ATCase are not influenced by ATP or CTP. The observed 15(V/K(asp)) values for
      the catalytic subunit of ATCase are also the same as those determined for the
      holoenzyme, suggesting that the chemical mechanisms of both enzyme species are
      the same. Quantitative analysis of 13C and 15N isotope effects in both H2O and
      D2O has led to the proposal of a chemical model for the ATCase reaction which
      involves a precatalytic conformational change to form an activated complex that
      facilitates deprotonation of L-aspartate by an enzyme functional group.
      Nucleophilic attack on the carbonyl carbon of carbamyl phosphate by the alpha
      amino group of L-aspartate results in the formation of a tetrahedral
      intermediate. An intramolecular proton transfer leads to formation of products N
      carbamyl-L-aspartate and inorganic phosphate.

PMID- 1633170
TI  - Steady-state kinetics and isotope effects on the mutant catalytic trimer of
      aspartate transcarbamoylase containing the replacement of histidine 134 by
      alanine.
AB  - A detailed kinetic analysis of the catalytic trimer of aspartate
      transcarbamoylase containing the active site substitution H134A was performed to
      investigate the role of His 134 in the catalytic mechanism. Replacement of
      histidine by alanine resulted in decreases in the affinities for the two
      substrates, carbamoyl phosphate and aspartate, and the inhibitor succinate, by
      factors of 50, 10, and 6, respectively, and yielded a maximum velocity that was
      5% that of the wild-type enzyme. However, the pK values determined from the pH
      dependence of the kinetic parameters, log V and log (V/K) for aspartate, the
      pK(i) for succinate, and the pK(ia) for carbamoyl phosphate, were similar for
      both the mutant and the wild-type enzymes, indicating that the protonated form of
      His 134 does not participate in binding and catalysis between pH 6.2 and 9.2. 13C
      and 15N isotope effects were studied to determine which steps in the catalytic
      mechanism were altered by the amino acid substitutions. The 13(V/K) for carbamoyl
      phosphate exhibited by the catalytic trimer containing alanine at position 134
      revealed an isotope effect of 4.1%, probably equal to the intrinsic value and,
      together with quantitative analysis of the 15N isotope effects, showed that
      formation of the tetrahedral intermediate is rate-determining for the mutant
      enzyme. Thus, His 134 plays a role in the chemistry of the reaction in addition
      to substrate binding. The initial velocity pattern for the reaction catalyzed by
      the H134A mutant intersected to the left of the vertical axis, negating an
      equilibrium ordered kinetic mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633171
TI  - The contribution of threonine 55 to catalysis in aspartate transcarbamoylase.
AB  - Heavy-atom isotope effects and steady-state kinetic parameters were measured for
      the catalytic trimer of an active site mutant of aspartate transcarbamoylase,
      T55A, to assess the role of Thr 55 in catalysis. The binding of carbamoyl
      phosphate to the T55A mutant was decreased by 2 orders of magnitude relative to
      the wild-type enzyme whereas the affinities for aspartate and succinate were not
      markedly altered. This indicates that Thr 55 plays a significant role in the
      binding of CbmP. If, as had been suggested previously, Thr 55 assists in the
      polarization of the carbonyl group of CbmP, the carbon isotope effect for the
      T55A mutant should increase relative to that observed for the wild-type enzyme.
      However, the opposite is seen, indicating that Thr 55 is not involved in
      stabilizing the oxyanion in the transition state. Quantitative analysis of a
      series of 13C and 15N isotope effects suggested that the rate-determining step in
      the reaction catalyzed by T55A trimer may be a conformational change in the
      protein subsequent to formation of the Michaelis complex. Thus, Thr 55 may
      facilitate a conformational change in the enzyme that is a prerequisite for
      catalysis. An altered active site environment in the binary and Michaelis
      complexes with T55A trimer is reflected in the pH profiles for log V, log
      (V/K)asp, and pK(i) succinate, show a displacement in the pK values of ionizing
      residues involved in aspartate binding and catalysis relative to the wild-type
      enzyme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633172
TI  - 13C isotope effect studies of Escherichia coli aspartate transcarbamylase in the
      presence of the bisubstrate analog N-(phosphonoacetyl)-L-aspartate.
AB  - 13C isotope effects have been measured for the aspartate transcarbamylase
      holoenzyme (ATCase) and catalytic subunit catalyzed reactions in the presence of
      the bisubstrate analog N-(phosphonoacetyl)-L-aspartate (PALA). For holoenzyme
      catalyzed reactions in the physiological direction with very low levels of L
      aspartate as substrate, or with L-cysteine sulfinate as substrate, or in the
      reverse direction with carbamyl-L-aspartate and phosphate as substrates, the
      isotope effect data show a slight dependence on PALA concentration. Under these
      conditions, PALA first stimulates the rate and then inhibits it at higher
      concentrations. The observed isotope effect at maximum stimulation by PALA is
      slightly smaller than in the absence of the analog, but as the PALA concentration
      is increased to reduce the rate to its original value, the observed isotope
      effect also increases and approaches the value of the isotope effect determined
      in the absence of PALA. These data suggest that the kinetic properties of the
      active enzyme are affected by the number of active sites occupied by PALA,
      indicating communication between subunits, and a mathematical model is proposed
      which explains our experimental observations. In contrast to these results with
      the holoenzyme, isotope effects measured for the reaction catalyzed by the
      isolated catalytic subunits are not altered in the presence of PALA. Taken
      together, these data are consistent with the two-state model for the homotropic
      regulation of ATCase.

PMID- 1633173
TI  - Differential scanning calorimetric study of the thermal unfolding of beta
      lactamase I from Bacillus cereus.
AB  - The irreversible thermal unfolding of the class A beta-lactamase I from Bacillus
      cereus has been investigated at pH 7.0, using differential scanning calorimetry
      (DSC) and inactivation kinetic techniques. DSC transitions showed a single peak
      with a denaturation enthalpy of 646 kJ.mol-1 and were moderately scan rate
      dependent, suggesting that the process was partially kinetically controlled. The
      inactivation kinetics at constant temperature showed that the irreversible
      denaturation of the enzyme occurs as the sum of two exponential terms whose
      amplitudes are strongly temperature dependent within the transition range so
      that, at the lowest temperatures within this interval, irreversible inactivation
      would proceed mainly through the slow phase. The fraction of irreversibly
      denatured enzyme (D) as a function of temperature for a given scanning rate was
      calculated by numerical integration of the kinetic equation with temperature,
      using previously determined kinetic parameters. This D form was the most
      populated of the unfolded states only at temperatures well above the maximum in
      the calorimetric transition. Combination of the results of kinetic and DSC
      experiments has allowed us to separate the contribution of the final D state to
      the excess enthalpy change from the contribution arising from the reversibly
      denatured forms of the enzyme (I(i), i = 1,..., n), with the resulting conclusion
      that the scan rate dependence of the calorimetric traces was the result of two
      different dynamic effects, viz., the irreversible step and a slow relaxation
      process during formation of the reversibly denatured intermediate states.
      Finally, the problems of using results obtained at a single scan rate to validate
      the two-state kinetic model are commented on.

PMID- 1633174
TI  - Characterization of the copper- and silver-thiolate clusters in N-terminal
      fragments of the yeast ACE1 transcription factor capable of binding to its
      specific DNA recognition sequence.
AB  - N-terminal fragments of ACE1 protein spanning residues 1-122 or 1-110, termed
      ACE1(122*) and ACE1(110*), respectively, were investigated in regard to their
      metal- and double-stranded DNA-binding properties. Band mobility shift assays
      showed that binding to a specific oligonucleotide (termed UASc), containing two
      ACE1(122*) binding sites, requires the presence of Cu(I) or Ag(I) but does not
      occur in the presence of divalent metal ions. Both the Ag(I) and the Cu(I) forms
      of ACE1(122*) were characterized spectroscopically. The Tyr and metal cluster
      luminescence emission of Cu-ACE1(122*) was specifically quenched by the
      oligonucleotide UAScL, but not by an oligonucleotide of the same length and base
      composition but scrambled sequence. The room-temperature luminescence of Cu(I)
      ACE1(122*) was assigned to a phosphorescence emission, on the basis of its long
      lived luminescence of approximately 3.5 microseconds. We report the first
      observation of a Ag(I) metal cluster in solution for Ag(I)-ACE1(122*), which was
      found to exhibit a quantum yield and average luminescence lifetime that are ca.
      6% of that of Cu(I)-ACE1(122*). The three-dimensional structure brought about by
      the binding of either metal ion appears to be very similar, since dynamic
      tyrosine fluorescence lifetime measurements, as well as circular dichroism
      spectra, were nearly identical for Cu- and Ag-ACE1(122*). Based on these results,
      we present a hypothetical model for the structure of the metal cluster in this
      class of proteins.

PMID- 1633175
TI  - Near-infrared Yb(3+) vibronic sideband spectroscopy: application to Ca(2+)
      binding proteins.
AB  - We have used near-infrared (NIR) vibronic fluorescence spectroscopy to study the
      vibrational structure of ligands associated with model complexes of the
      lanthanide Yb(3+). This technique exploits the similar binding properties of the
      lanthanide Yb(3+) to probe Ca(2+)-binding sites in proteins. The (NIR)
      fluorescence of complexed Yb(3+) exhibits, in addition to main 0-0 (2F5/2---
      2F7/2) electronic transition of Yb(3+), weak vibronic sidebands which provide
      infrared-like, local vibrational spectra of the chelates (inner sphere ligands)
      of Yb(3+). A similar approach has been used for the lanthanide Gd(3+) (MacGregor,
      R.B., Jr (1989) Arch. Biochem. Biophys. 274, 312-316) which fluoresces in the UV
      and which is usually complicated by amino-acid residues fluorescing in the same
      spectral region. In this same spectral region, other complications in studying
      photosynthetic membranes occur in the form of the excitation wavelength being
      actinic, promoting photodegradation of the membranes, as well as the reabsorption
      of Gd(3+) fluorescence. NIR excitation and fluorescence detection of Yb(3+) avoid
      these problems when studying photosynthetic membranes. A preliminary study has
      been conducted here on rat muscle parvalbumin.

PMID- 1633176
TI  - Uncoupling activity and physicochemical properties of derivatives of fluazinam.
AB  - The physico-chemical properties and uncoupling activity of eight derivatives of N
      phenyl-2-pyridinamines related to the fungicide fluazinam were analyzed using rat
      liver mitochondria. The uncoupling activity of these compounds relies on the
      deprotonable secondary amino group. One of the derivatives tested (B-3) was
      slightly more efficient than fluazinam. By phase-distribution analysis we could
      show that the N-phenyl-2-pyridinamines are chemicals with moderate
      hydrophobicity. Deprotonation of the compound reduces the water/octanol partition
      coefficient by about one order of magnitude. The pKA value of the deprotonable
      group is affected equally by electron withdrawing substituents of the phenyl- and
      the pyridinyl-ring, and could be predicted simply from the sum of the Hammett
      coefficients. The uncoupling efficiency was not dependent on the hydrophobicity
      of the compound, but appeared to be governed by the pKA of the deprotonable
      group. This structure/uncoupling characteristic is different from that of the
      generally more hydrophobic uncouplers of the salicylanilide-type. The pKA
      resulting in the most efficient uncoupling was found to lie in the range of the
      pH of the reaction medium. A model based on a solution complexation mechanism,
      which describes this behaviour, is presented. We conclude that the N-phenyl-2
      pyridinamines uncoupled the mitochondria by a simple protonophoric cycle
      involving protonation/deprotonation in the bulk phase, and that the kinetics of
      uncoupling were primarily governed by the total concentration of the limiting
      uncoupler species.

PMID- 1633177
TI  - Ferredoxin and flavodoxin from the cyanobacterium Synechocystis sp PCC 6803.
AB  - The unicellular cyanobacterium Synechocystis sp PCC 6803 is capable of
      synthesizing two different Photosystem-I electron acceptors, ferredoxin and
      flavodoxin. Under normal growth conditions a [2Fe-2S] ferredoxin was recovered
      and purified to homogeneity. The complete amino-acid sequence of this protein was
      established. The isoelectric point (pI = 3.48), midpoint redox potential (Em = 
      0.412 V) and stability under denaturing conditions were also determined. This
      ferredoxin exhibits an unusual electrophoretic behavior, resulting in a very low
      apparent molecular mass between 2 and 3.5 kDa, even in the presence of high
      concentrations of urea. However, a molecular mass of 10,232 Da (apo-ferredoxin)
      is calculated from the sequence. Free thiol assays indicate the presence of a
      disulfide bridge in this protein. A small amount of ferredoxin was also found in
      another fraction during the purification procedure. The amino-acid sequence and
      properties of this minor ferredoxin were similar to those of the major
      ferredoxin. However, its solubility in ammonium sulfate and its reactivity with
      antibodies directed against spinach ferredoxin were different. Traces of
      flavodoxin were also recovered from the same fraction. The amount of flavodoxin
      was dramatically increased under iron-deficient growth conditions. An acidic
      isoelectric point was measured (pI = 3.76), close to that of ferredoxin. The
      midpoint redox potentials of flavodoxin are Em1 = -0.433 V and Em2 = -0.238 V at
      pH 7.8. Sequence comparison based on the 42 N-terminal amino acids indicates that
      Synechocystis 6803 flavodoxin most likely belongs to the long-chain class,
      despite an apparent molecular mass of 15 kDa determined by SDS-PAGE.

PMID- 1633178
TI  - Electron-transfer self-exchange kinetics of trimethylphosphine horse-heart
      myoglobin.
AB  - Electron self-exchange has been measured by an NMR technique for horse-heart
      myoglobin. The rate is 3.1 x 10(3) M-1 s-1 at 23 degrees in 0.1 M phosphate at pH
      6.9. The rate was weakly dependent on ionic strength up to 0.7 M in added KCl
      (3.9 x 10(3) M-1 s-1). The enthalpy of activation was 12.1 +/- 0.5 kcal mol-1,
      and the entropy of activation was -1.2 +/- 0.5 cal mol-1 deg-1. Analysis of the
      data in terms of the Marcus theory gives a reorganization energy, lambda, for
      self-exchange of 1.6 eV mol-1.

PMID- 1633179
TI  - Mitochondrial inner membrane permeability changes induced by octadecadienoic acid
      hydroperoxide. Role of mitochondrial GSH pool.
AB  - The effect of exogenous octadecadienoic acid hydroperoxide (HPODE) on the
      functional properties of inner membrane of isolated rat liver mitochondria, as
      evaluated by the measurement of the membrane potential (delta psi) has been
      studied. Very low concentrations of HPODE (1.5-4.5 nmol/mg prot.) do not modify
      the delta psi of control mitochondria appreciably while bringing about the drop
      of delta psi, in a concentration-dependent mode, in mitochondria with a GSH level
      diminished by approx. 60%. Mitochondrial GSH depletion was obtained by
      intraperitoneal administration of buthionine sulfoximine, a specific inhibitor of
      GSH synthesis, to rats. The presence in the incubation system of GSH-methyl ester
      which normalizes mitochondrial GSH, fully prevents any drop in levels of delta
      psi induced by HPODE. The same protective effect has been presented by EGTA,
      which chelates the available Ca2+. Neither an antioxidant nor a specific
      inhibitor of mitochondrial phospholipase A2 are able to prevent the HPODE effect.
      From the results obtained we can assume that HPODE itself, at the concentrations
      used here, induces permeability changes in the inner membrane, with the loss of
      coupled functions, when the GSH mitochondrial level is below a critical value.

PMID- 1633180
TI  - Trails of inquiry and thought leading toward today's bioenergetics.
AB  - Significant experimental observations and concepts leading from various sources
      toward today's bioenergetics are briefly sketched. To limit the essay to
      manageable proportions main consideration is given to origins in research on
      metabolism and biological oxidations and attendant energy conversions. Relevant
      data and dates are summarized in table form.

PMID- 1633181
TI  - The photosystem I-like P840-reaction center of green S-bacteria is a homodimer.
AB  - An operon encoding the P840 reaction center of Chlorobium limicola
      f.sp.thiosulfatophilum has been cloned and sequenced. It contains two structural
      genes coding for proteins of 730 and 232 amino acids. The first protein resembles
      the large subunits of the Photosystem I (PS I) reaction center. Putative binding
      elements for the primary donor, P840 in Chlorobium and P700 in PS I and for the
      acceptors A(o), A(1) and FeS-center X are conserved. The second protein is
      related to the PS I subunit carrying the FeS-centers A and B. Since all our
      efforts to find a gene for a second, large subunit failed, the P840 reaction
      center probably is homodimeric.

PMID- 1633182
TI  - Structure-function relationships of cytochrome b by the genetic approach:
      intragenic revertants derived from frameshift mutations in the Saccharomyces
      cerevisiae apocytochrome b gene.

PMID- 1633183
TI  - Engineering protein structure for electron transfer function in photosynthetic
      reaction centers.
AB  - A basic relationship is defined that incorporates the three parameters that
      effectively modulate the rate of intraprotein electron transfer, namely distance,
      free energy and reorganization energy. This empirically validated relationship is
      used to explore the minimal requirements for protein-catalyzed conversion of
      excited electronic states into stable charge separated states, the essence of
      photosynthesis.

PMID- 1633184
TI  - The energy-transducing NADH-quinone oxidoreductase (NDH-1) of Paracoccus
      denitrificans.

PMID- 1633185
TI  - Human mitochondrial complex I dysfunction.
AB  - In humans, complex I dysfunction has been observed in a high percentage of
      patients with mitochondrial myopathy. Analysis of mitochondria from these
      patients suggests the function and assembly of complex I is particularly
      susceptible to abnormalities of mitochondrial DNA, involving either point
      mutations of tRNA genes or major deletions. The evidence for a complex I defect
      in Parkinson's disease is accumulating, although the cause of this deficiency or
      the role it plays in the events that culminate in dopaminergic cell death remains
      unresolved.

PMID- 1633186
TI  - Gene defects in Leber hereditary optic neuroretinopathy.

PMID- 1633187
TI  - The lactose permease of Escherichia coli: a paradigm for membrane transport
      proteins.

PMID- 1633188
TI  - The involvement of cyclosporin A binding proteins in regulating and uncoupling
      mitochondrial energy transduction.
AB  - The uncoupling of mitochondrial energy transduction by excess Ca2+ may be a
      factor in the pathogenesis of tissue injury brought about by energy deprivation,
      for example, in ischaemia. In isolated mitochondria the lesion appears as a
      large, 20 A, pore in the inner membrane. The pore is blocked potently by the
      immunosuppressant cyclosporin A. Cyclosporin A also markedly retards collapse of
      the mitochondrial inner membrane potential in energy-deprived (respiration
      inhibited) cardiomyocytes as judged by changes in rhodamine 123 fluorescence, and
      prolongs cell viability. A potential mitochondrial target for cyclosporin A is
      the matrix protein cyclophilin. Purified cyclophilin activates the respiratory
      chain of submitochondrial particles. This might reflect not only a physiological
      function of this protein, but also a component involved in the generation of the
      20 A pore under pathological conditions.

PMID- 1633189
TI  - Mitochondrial substrate carriers.

PMID- 1633190
TI  - The energetics of protein import into mitochondria.

PMID- 1633191
TI  - Purification and electrospray mass spectrometry of aldose reductase from pig
      lens.
AB  - Aldose reductase (alditol: NADP+ 1-oxidoreductase, EC 1.1.1.21) has been purified
      from pig lens to homogeneity by a rapid and efficient three-step procedure
      involving poly(ethylene glycol) fractionation, ion-exchange chromatography and
      chromatofocusing. The homogeneity of the purified enzyme was examined by
      polyacrylamide gel electrophoresis under native and denaturing conditions, by
      isoelectric focusing and by high-performance liquid chromatography on a size
      exclusion column. The highly purified enzyme is a monomeric protein with a
      molecular mass of 35,775 +/- 3 Da as determined by electrospray mass spectrometry
      (ESMS). This purification procedure is particularly suited for the preparation of
      triclinic single crystals of pig lens aldose reductase, which are currently used
      in X-ray studies of this enzyme.

PMID- 1633192
TI  - Characterisation of a tryptic peptide from human placental ribonuclease inhibitor
      which inhibits ribonuclease activity.
AB  - Affinity-purified human placental ribonuclease inhibitor (PRI) was digested by
      trypsin. Subsequent fractionation of the hydrolysate by HPLC yielded 44
      fractions, 3 of which retained the ability to inhibit ribonuclease. One of these,
      the most active, was a 15 amino acid peptide which had an amino acid composition
      corresponding to a tryptic fragment of PRI. This peptide was synthesised, and
      preliminary experiments were carried out on its interactions with ribonuclease.
      These experiments suggested that the behaviour of the peptide in terms of effect
      of pH, and effect of salt concentration were similar to the protein from which it
      was derived. These studies together with the strategic positioning of the peptide
      in the sequence of the ribonuclease inhibitor, suggest that this segment of PRI
      has an important role in the inhibitory activity of the intact protein.

PMID- 1633193
TI  - Close amino acid sequence relationship between the new plasmid-mediated extended
      spectrum beta-lactamase MEN-1 and chromosomally encoded enzymes of Klebsiella
      oxytoca.
AB  - Isolated from an Escherichia coli strain MEN-1 is a plasmid-mediated beta
      lactamase that confers resistance to methoxy imino third-generation
      cephalosporins. The protein purified to homogeneity was digested by trypsin,
      chymotrypsin and endoproteinase Asp-N. Amino acid sequence determinations of the
      resulting peptides gave rise to the alignment of the 263 residues of the beta
      lactamase. From amino acid sequence comparison MEN-1 was found to share more than
      72% identity with the chromosomally mediated beta-lactamases of Klebsiella
      oxytoca. Therefore, MEN-1 is the first transferable extended-spectrum beta
      lactamase which is not directly derived from the widespread TEMs or SHV-1
      penicillinases with which it presents less than 39% identity.

PMID- 1633194
TI  - Hydrogen bond network of cytochrome P-450cam: a network connecting the heme group
      with helix K.
AB  - During investigations of the structural character of a mutant P-450cam where Glu
      286 is replaced with lysine, we obtained evidence of a hydrogen bond network
      between helix K and the heme group via helix L of P-450cam. This mutant protein
      loses the ability to maintain the heme group in a proper position, possibly due
      to a break in the hydrogen bond network.

PMID- 1633195
TI  - Inhibition of D-3-aminoisobutyrate-pyruvate aminotransferase by 5-fluorouracil
      and alpha-fluoro-beta-alanine.
AB  - Among pyrimidine derivatives, we found that 5-fluorouracil potently inhibited
      purified rat liver D-3-aminoisobutyrate-pyruvate aminotransferase, whereas 5
      fluorouridine did so to a much lesser extent. 5-Fluorouracil acted as a
      competitive inhibitor against beta-alanine with a Ki of 56 microM, and was
      uncompetitive against pyruvic acid, with a Ki of 73 microM. alpha-Fluoro-beta
      alanine, a metabolite of 5-fluorouracil, was also a competitive inhibitor with
      respect to beta-alanine with a Ki of 8.0 mM. 5-Fluorouracil acted also as a
      competitive inhibitor of 4-aminobutyrate aminotransferase with respect to beta
      alanine with a Ki value of 1.9 mM, and was uncompetitive against 2-oxoglutaric
      acid, with a Ki of 1.8 mM.

PMID- 1633196
TI  - Characterization of aldehyde reductase of Sporobolomyces salmonicolor.
AB  - An NADPH-dependent aldehyde reductase (EC 1.1.1.2) isolated from Sporobolomyces
      salmonicolor AKU 4429 was further characterized. The enzyme also catalyzed the
      reductions of D-glucuronate, D-glucose, D-xylose and D-galactose at high
      concentrations. Km values for D-glucuronate and D-glucose are 345 and 4270 mM,
      respectively. Quercetin, dicoumarol and some SH-reagents inhibited the enzyme
      activity. NH2-terminal amino acid sequence analysis showed that the S.
      salmonicolor enzyme is partially the same as the aldo-keto reductase family
      proteins in primary protein structure.

PMID- 1633197
TI  - Highly homologous cytochromes P-450 and b5: a model to study protein-protein
      interactions in a reconstituted monooxygenase system.
AB  - Cytochrome b5 from mouse and rat liver formed a type I spectral complex with two
      murine cytochrome P-450 isozymes, the P450Coh and P450PBI. Mouse b5 stimulated
      the reactions catalyzed by reconstituted P450Coh and an equimolar amount of b5 to
      P450Coh was needed for maximal effect. In contrast, rat b5 inhibited P450Coh
      mediated reactions progressively starting from 1:1 ratio of b5 to P-450. Neither
      b5 had any effect on reactions catalyzed by P45015 alpha, an isozyme highly
      homologous to P450Coh, but with a point mutation (Arg-129----Ser) at site
      considered important for P-450-b5 interactions. In case of P450PBI, neither b5
      protein had any effect on the associated activities at b5: P-450 ratios below 1,
      and a progressive inhibition occurred when b5: P-450 ratio was above 1. The
      results were similar with either rat or mouse liver NADPH-cytochrome P-450
      reductase used in reconstitution demonstrating that the critical differences take
      place in P-450-b5 interactions. Kinetic and spectral experiments revealed that
      the stimulatory and inhibitory effects of b5 on the enzymatic reactions were due
      to corresponding changes in the reaction velocity, and that b5 does not compete
      with the flavoprotein nor with the substrate for binding to P-450. These results
      indicate that the high spin shift of P-450 does not necessarily correlate with
      enhanced reaction rates. Also, the increase in the coupling efficiency of P450PBI
      may result from the increased affinity for substrate in the presence of b5.
      Sequenation of mouse b5 peptides generated with proteinases revealed three amino
      acid changes between the mouse and rat b5, two of which appeared at the
      hydrophobic domain necessary for the P-450-b5 interaction. This could explain the
      species specificity of b5 proteins in supporting the P-450-mediated reactions.
      This is the first time functionally important differences in the interaction of
      highly homologous cytochromes P-450 and b5 have been demonstrated. Isozymes
      P45015 alpha and P450Coh, and mouse and rat b5 could serve as an excellent model
      for further studies on the nature and significance of P-450-b5 interactions.

PMID- 1633198
TI  - Biochemical and physiological studies on two T-kininogen species using monoclonal
      antibodies.
AB  - Rat T-kininogens were characterized in plasma, urine and liver slice incubation
      medium in different physiological conditions using monoclonal antibodies that
      allow to distinguish between the two forms of T-kininogen. T-kininogen purified
      from the plasma of both normal and inflamed Wistar and Sprague-Dawley rats was
      found to contain the two forms of T-kininogen, TI and TII, separated by non
      denaturing polyacrylamide gel electrophoresis. The two forms were also found in
      the plasma of several strains of normal and inflamed rats, except in the plasma
      of the Buffalo rat which contained only TII-kininogen. The two forms of T
      kininogen were also found in the media in which liver slices from inflamed and
      non-inflamed wistar rats had been incubated. The urine T-kininogen of normal rats
      was chiefly TI-kininogen, but both forms were found in the urine of inflamed
      rats. T-kininogen in the plasma of normal and inflamed rats was further
      characterized by chromatography on Con A-Ultrogel. In normal plasma, we observed
      a ratio of non-retained to retained T-kininogen of 0.41. The retained T-kininogen
      was eluted as two peaks, one eluted with 45 mM and the other with 120 mM alpha
      methyl-D-glucoside. The ratio of non-adsorbed to adsorbed T-kininogen in inflamed
      Wistar rat plasma was 1.40 and the retained material was almost exclusively in a
      single peak, which eluted with 50 mM alpha-methyl-D-glucoside. The non-adsorbed
      and adsorbed fractions contained both forms of T-kininogen, but the protein bands
      in the non-retained fraction had greater mobilities on non-denaturing PAGE. SDS
      PAGE analysis of T-kininogen deglycosylated by N-glycosidase F showed a major
      band with a molecular mass of 50 kDa, whereas the molecular mass of the native
      form was 66 kDa. We concluded that both forms of T-kininogen exist in the non
      inflamed and the inflamed rat plasma, except for the Buffalo rat, and that T
      kininogen displays a different chromatographic pattern on Con A-Ultrogel after
      inflammation suggesting altered glycosylation.

PMID- 1633199
TI  - Overproduction, purification and characterization of SecD and SecF, integral
      membrane components of the protein translocation machinery of Escherichia coli.
AB  - SecD and SecF proteins were overproduced by means of recombinant DNA technology.
      Immunoblot and amino-acid sequencing analysis revealed that the overproduced
      proteins are SecD and SecF. The SecD- or SecF-overproduced membrane fraction was
      subjected to differential solubilization. The SecD protein was then purified
      through ion-exchange and size-exclusion chromatographies. The SecF protein was
      purified through size exclusion chromatography. Proteoliposomes reconstituted
      from the purified SecD and SecF together with SecE and SecY were used to analyze
      the translocation activity. SecD and SecF did not exhibit significant effects on
      the translocation activity of proteoliposomes. The amounts of SecD and SecF in
      overproducers were determined densitometrically on a stained SDS gel and their
      overproduction (fold) was determined by means of immunoblot analysis. Then the
      number of these molecules in one normal cell were estimated. From these numbers,
      together with those of other Sec proteins, the number of the translocation
      machinery existing in one Escherichia coli cell was inferred to be around 500.

PMID- 1633200
TI  - Purification, characterization and preliminary X-ray study of fumarase from
      Saccharomyces cerevisiae.
AB  - Fumarase (fumarate hydratase, EC 4.2.1.2) from Saccharomyces cerevisiae has been
      purified to homogeneity by a method including acetone fractionation, DEAE ion
      exchange and dye-sorbent affinity chromatography. The suggested method allows
      fumarase purification with a yield higher than 60% and may be used to obtain
      large enzyme quantities. The native protein consists of four subunits with a
      approximately 50 kDa molecular mass each and has an isoelectric point at pH 6.5
      +/- 0.3. The equilibrium constant for fumarate hydration is about 4.3 (25 degrees
      C, pH 7.5), the Michaelis constants for fumarate and 1-malate are approximately
      30 microM and approximately 250 microM, respectively. The enzyme is activated by
      substrates and multivalent anions, the activation seems to be of a non
      competitive type. The fumarase complex with meso-tartaric acid has been
      crystallized by the vapor diffusion method. The unit cell parameters are a =
      93.30, b = 94.05 and c = 106.07 A, space group P2(1)2(1)2(1). The unit cell
      contains 2 protein molecules. The crystals diffract to at least 2.6 A resolution
      and are suitable for X-ray structure analysis.

PMID- 1633201
TI  - Unfolding and trypsin inactivation studies reveal a conformation drift of glucose
      6-phosphate dehydrogenase upon binding of NADP.
AB  - Binding of NADP to glucose-6-phosphate dehydrogenase (G6PD) from Dicentrarchus
      labrax liver has stabilized its native structure against thermal inactivation,
      guanidine hydrochloride unfolding and inactivation by tryptic digestion. The time
      course of G6PD inactivation by guanidine hydrochloride in the presence of NADP
      has provided experimental evidence in favor of a conformational drift upon NADP
      binding to the bass enzyme. Based on the inactivation patterns obtained when the
      enzyme was treated with guanidine hydrochloride and trypsin, it is proposed that
      the enzyme conformation induced upon NADP binding is in slow equilibrium with the
      conformation stabilized in the absence of NADP. FPLC studies have shown that
      micromolar concentrations of NADP induced oligomerization of G6PD. In addition,
      the different K0.5 values of NADP binding to the enzyme, ranging from 1-2 microM
      (from trypsin inactivation) to 90 microM (from titration of the intrinsic
      fluorescence), suggest a step-wise binding of NADP to the oligomer, with negative
      cooperativity in the saturation process.

PMID- 1633202
TI  - [35 years of organized emergency medicine--what remains to be done?].

PMID- 1633203
TI  - [The scientific basis of cardiopulmonary and cerebral resuscitation].
AB  - A survey is given on the scientific background of cardiopulmonary-cerebral
      resuscitation, which supposedly will be the basis of all clinical practice in
      this field. Haemodynamic, respiratory, acid-base, and cerebral problems are
      discussed in detail. As for haemodynamics, the pathomechanisms of the
      conventional "heart pump" and the "thoracic pump" as background of the "New CPR"
      are compared, the flow being generated by a direct compression of the heart in
      the former and by a phasic increase of the intrathoracic pressure in the latter
      case. Combined effects of both modalities mainly depending on the geometry of the
      thoracic cage, are usually seen. Improvement of flow by modifying the criteria of
      thorax compression (duration, frequency, strength) is then discussed, and new
      methods or CPR as e.g. simultaneous/synchronous compression/respiration, Vest
      CPR, MAST-CPR, abdominal compression and Cough-CPR are mentioned and their
      mechanisms explained. Finally, open cardiac massage is no doubt superior to all
      the other indirect and closed methods of cardiac resuscitation. Defibrillators
      and heart-lung "thumpers" are then described, mentioning the improvements in
      respect of automatic and semi-automatic defibrillation and the progress made by
      developing flexible and individually adaptable types of "thumpers". On assessing
      the sympathicomimetic drugs, it is evident that epinephrine is the method of
      choice in the acute phase of resuscitation; the pure beta-adrenergics
      isoprenaline and orciprenaline are not used any more, whereas the alpha-mimetics,
      although acutely effective similar to epinephrine, cannot produce positive long
      term effects; the combination of dobutamine and dopamine seems to be ideal for
      establishing stable haemodynamic situations following a successful acute
      reanimation procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633204
TI  - [Intravenous thrombolysis in acute myocardial infarct: optimization of the
      therapeutic strategy by informing the patients and physicians].
AB  - Intensive education of patients and physicians helps to increase the incidence of
      thrombolytic therapy in patients with myocardial infarction. Important factors in
      this process are: 1. Reduced delays in patients' awareness of the severity of his
      symptoms, 2. shorter time periods from patients' hospital admission to the
      initiation of thrombolytic therapy, 3. more indications by educated physicians
      with a higher degree of precision, and 4. reduced catalogue of contraindications.

PMID- 1633205
TI  - [Resuscitation of patients using a cardiopulmonary bypass].
AB  - The use of cardiopulmonary bypass within the framework of resuscitation justifies
      hopes for better results after cardiovascular arrest. By restituting sufficient
      cardiovascular conditions both the global and especially the cerebral blood flow
      situation are improved, so that, in turn, better neurological results can be
      expected after cardiopulmonary resuscitation. However, further decisive successes
      by using the cardiopulmonary bypass can be expected only in connection with new
      therapeutic concepts of reanimation.

PMID- 1633206
TI  - [New standards for catecholamine therapy in cardiopulmonary resuscitation?
      Results of a modified application in a resuscitation model].
AB  - Using a standardized porcine CPR-model (3 min of cardiac arrest induced by
      ventricular fibrillation) the effects of epinephrine (10 micrograms/kg iv, 50
      micrograms/kg iv, 100 micrograms/kg endobronchially, eb) and norepinephrine (10
      micrograms/kg iv, 100 micrograms/kg eb) on resuscitability and early post
      resuscitation haemodynamics were compared. Success rate was 100% after
      epinephrine 10 micrograms/kg iv and 100 micrograms/kg eb, 75% after epinephrine
      50 micrograms/kg iv, 80% after norepinephrine iv and 60% after norepinephrine eb.
      In an unmedicated control group 50% of all animals were successfully
      resuscitated. Early post-resuscitation haemodynamics in the high dose epinephrine
      group were characterized by tachycardia and progredient myocardial failure, while
      in the norepinephrine groups a low cardiac output was accompanied by small
      cardiac stroke volumes and an increased vascular resistance. It is concluded that
      iv or eb epinephrine given in standard doses has still to be considered as the
      drug therapy of choice after short term cardiac arrest or in the presence of
      ventricular fibrillation. Before different drugs or dosing strategies can be
      recommended, further experimental and clinical validation is required.

PMID- 1633207
TI  - [Current aspects of resuscitation. Introduction].

PMID- 1633208
TI  - [New developments and standards for mechanical measures in cardiopulmonary
      resuscitation].

PMID- 1633209
TI  - [Buffer therapy in cardiopulmonary resuscitation--indication or routine?].

PMID- 1633210
TI  - [Limits of cerebral resuscitation. Pathophysiologic background and therapeutic
      approaches].

PMID- 1633211
TI  - [The effect of first aid (layman) resuscitation on cardiopulmonary
      resuscitation].

PMID- 1633212
TI  - [Suture fixation of a Swan Ganz catheter to the left brachiocephalic vein during
      re-thoracotomy].
AB  - This case report describes the intraoperative fixation of a Swan-Ganz catheter at
      the left brachiocephalic vein by a suture during rethoracotomy in a cardiac
      surgical patient. In case of a rethoracotomy by median sternotomy the right-sided
      veins should be preferred for the insertion of a Swan-Ganz-catheter. Furthermore
      the free mobility of the catheter should be controlled before closure of the
      thorax.

PMID- 1633213
TI  - [Historical vignette (4) "A new apparatus for optical pulse control in
      anesthesia"].

PMID- 1633214
TI  - Control of staphylococcal adhesion to polystyrene surfaces by polymer surface
      modification with surfactants.
AB  - The adherence of three clinical isolates of Staphylococcus epidermidis to model
      polystyrene surfaces was studied in vitro using epifluorescent image analysis. A
      series of 16 Pluronic surfactants (A-B-A block copolymers where A is
      poly(ethylene oxide) (PEO) and B is poly(propylene oxide) (PPO)) were used as
      surface modifiers for the model polystyrene surfaces. Substantial reductions (up
      to 97%) in bacterial adhesion levels were achieved with all copolymers tested,
      irrespective of the PPO or PEO block lengths. It appears likely that such
      treatments create a sterically stabilized surface with adsorbed PEO chains,
      conferring nonspecific anti-adhesive properties which can limit bacterial
      attachment.

PMID- 1633215
TI  - Heparin-poly(ethylene glycol)-poly(vinyl alcohol) hydrogel: preparation and
      assessment of thrombogenicity.
AB  - Heparin was immobilized on to poly(vinyl alcohol) hydrogel (PVA) through the free
      isocyanate end-group on a poly(ethylene glycol) (PEG2000) which had been
      previously covalently linked to the hydrogel via a urethane moiety. The intention
      was to reduce the platelet reactivity of the PVA while also suppressing fibrin
      formation. Elemental nitrogen analysis revealed that the total amount of bound
      heparin was 19 +/- 7 mumol/g of dried gel. An increase in the in vitro whole
      blood clotting time of PVA was observed. This was attributed to bound heparin, as
      the elution rate of heparin from the gel (23 pmol/m2 min) was too low to produce
      a significant bulk concentration to interfere with fibrin formation. Ex vivo
      assessment using a chronic canine A-V shunt showed that the bound heparin
      hydrogel had no effect on the drop in the number of platelets induced by PVA
      hydrogel, but increased the fractional rate of platelet destruction from
      approximately 0.35/d to an average value of 0.42/d.

PMID- 1633216
TI  - Grafting reactions and heparin adsorption of poly(amidoamine)-grafted
      poly(urethane amide)s.
AB  - Differently terminated poly(amidoamine) (PAA) oligomers were grafted on the
      surface of poly(ether urethane amide)s (PEUAm), with fumaric or maleic acid
      moieties. The grafting reaction was Michael-type addition of amino groups to
      activated double bonds in the PEUAm backbone. PAAs having primary amino, or
      secondary amino end-groups were directly grafted on the surface of PEUAm sheets.
      For vinyl-terminated chains an alpha, omega amino-polyether spacer was introduced
      initially, following the same addition mechanism. Ungrafted and grafted materials
      were characterized, besides other analytical techniques, by ATR FT-IR
      spectroscopy. The heparin adsorption on PEAUm films was analysed after its
      elution from heparinized samples, quantified by coagulation tests (aPTT), and
      related to the presence of the PAAs chains grafted on to the surface. Results
      indicate that PAA-grafted PEUAm elastomeric biomaterials, display enhanced
      heparin adsorption abilities.

PMID- 1633217
TI  - Synthesis and physicochemical characterization of a hydrophilic polyurethane able
      to bind heparin.
AB  - The synthesis of a new segmented polyurethane containing quaternary ammonium
      groups in the side-chain is reported. The quaternization was carried out both on
      the polymer dissolved in an organic solvent and on polymer films. Polymeric films
      quaternized by both techniques were heparinized. The amount of bonded heparin,
      determined by spectrophotometry, was remarkably higher than previously described.
      Polymer quaternized in solution bonded more heparin than that heparinized
      directly on film. In vitro evaluations of antithrombogenicity by activated
      partial thromboplastin time (APTT) carried out on the films confirmed these data.
      The polymers were also characterized by chemical, i.r., n.m.r., differential
      scanning calorimetry and viscometric techniques.

PMID- 1633218
TI  - New artificial connective matrix-like structure: thrombogenicity and use as
      endothelial cell culture support.
AB  - The recently described artificial connective matrix made of elastin solubilized
      peptides, type I+III collagens and connective proteins is shown to have
      structural and biological properties very close to the natural arterial
      subendothelium: the capacity to promote endothelial cell cultures maintaining
      their phenotype expression and its non-thrombogenicity. This new bioactive
      composite material could be used to replace arteries.

PMID- 1633219
TI  - Degradation of collagen suture in vitro and in vivo.
AB  - In vitro and in vivo degradation of collagen suture was investigated focussing on
      the change in the mechanical properties and weight. The in vitro hydrolysis was
      carried out for catguts using collagenase (pH 7.4) and pepsin (pH 1.6),
      simulating the in vivo environments. The kinetic study on the weight loss of the
      fibre at the collagenase hydrolysis suggested that the degradation proceeded
      gradually from the surface of the fibre into the core. The enzymatic hydrolysis
      was different from the non-enzymatic acidic hydrolysis which resulted in almost
      homogeneous degradation throughout the cross-section of the fibre from the
      beginning of the hydrolysis reaction. The rate of weight loss with enzymatic
      hydrolysis was in good agreement with that predicted under the assumption of
      continuous erosion from the surface. When the collagen sutures were implanted in
      the subdermal tissue of rabbits, severe infiltration of macrophages and
      neutrophils was observed at 4 wk post-implantation, probably because of the
      degradation products from the implanted sutures. Comparison of the tensile
      strength decrease with the weight loss observed at the in vivo degradation
      revealed that enzymatic and non-enzymatic hydrolysis occurred concurrently in the
      subcutaneous tissue.

PMID- 1633220
TI  - Investigation of Ti/Al2O3 joints with intermediate tantalum and niobium layers.
AB  - The microstructure of TiTa30 alloys diffusion bonded to a 99.7 wt% Al2O3 ceramic
      was subdivided into a reaction double layer containing the intermetallic phases
      TiAl and Ti3Al and the (alpha + beta) Ti microstructure. Excellent fracture
      toughness data of the TiTa30/Al2O3 joints of about 37 J/m2 were obtained after
      welding at 1200 degrees C for 1 h. The fracture energies of the joints were
      strongly dependent on the welding temperature which also influenced the thickness
      of the reaction double layer. The uptake of aluminium and oxygen into the
      reaction layer and the metal caused an embrittlement and decreased the yield
      stress and ductility of the metal. Introducing an Nb or Ta layer between pure Ti
      and Al2O3 before welding resulted in high fracture energies of 40 J/m2 for the
      Ti/Al2O3 joints. The thermal-induced stresses at the metal-ceramic interface were
      reduced by the occurrence of an Nb- or Ta-enriched region. The intermediate metal
      foils also decreased the O and Al uptake of the metal and therefore reduced the
      brittleness of the reaction zone and the adjacent metal. The thermal-induced
      stresses at the metal-ceramic interface caused a deflection of the crack into the
      ceramic during fracture mechanical testing in four-point bending.

PMID- 1633221
TI  - Solubility and disintegration of zinc phosphate cement.
AB  - The mechanism of erosion of a zinc phosphate cement was studied using two
      experimental procedures: discs of dental cement were immersed in distilled water
      under unrenewed conditions as defined by ISO standard; or discs were immersed
      under continuously running distilled water to simulate the oral environment. Both
      experiments revealed no physical disintegration mechanism, and suggest that
      erosion is only controlled by dissolution.

PMID- 1633222
TI  - Evaluation of the calcium phosphate ceramic implant by non-invasive techniques.
AB  - Current routine radiological procedures do not quantify the degree of calcium
      phosphate ceramic implant integration with the host bone, nor the rate of
      remodelling processes in the latter. The successful clinical use of non-invasive
      techniques in assessing bone mass deserves attention from surgeons and scientists
      dealing with hard tissue prosthetics and implants. Two suitable techniques for
      such non-invasive sequential analysis of the ceramic implant and host bone are
      outlined.

PMID- 1633223
TI  - Determination of three-dimensional morphometry of adherent cells by surface
      profilometry.
AB  - A three-dimensional, non-contacting surface profiler was used to analyse cells
      that had been previously prepared for scanning electron microscopy. The height of
      ten attached and spread cells was measured in both two- and three-dimensions (2-D
      and 3-D). The 2-D scan is a typical, linear profilometer output, while a 3-D
      image is produced with a 3-D detector. The 3-D contour plots of each cell were
      then compared with scanning electron microscopy micrographs by digitizing four
      morphological parameters: perimeter, surface area, long axis and short axis of
      each cell. A paired Student's t test showed that the two imaging techniques are
      not equivalent. Non-equivalence was attributed to a difference in the method of
      calibration. However, when combined with scanning electron microscopy, the
      profiler allowed complete three-dimensional quantitative analysis of cellular
      morphology.

PMID- 1633224
TI  - Biodegradable polymers. I. Synthesis of hydrolysis-sensitive
      poly[(organo)phosphazenes].
AB  - Polyphosphazenes with hydrolytic labile substituents have potential as
      biodegradable materials. By proper choice of the substituents, polymers can be
      prepared which degrade in vivo to form harmless products. The rate of
      biodegradation and the nature of the degradation products can be varied by
      changing the chemical composition of the polymers. A series of new degradable
      polyphosphazene derivatives are described. The synthesis of phosphazene polymers
      with various amounts of ethyl 2-(O-glycyl)lactate or ethyl 2-(O-alanyl)lactate as
      cosubstituents is described. These polymers are prepared by reaction of
      poly[(dichloro)phosphazene) with the corresponding amine compound. Total halogen
      replacement was achieved by subsequent introduction of glycine ethyl ester
      cosubstituents. Introduction of these hydrolysis-sensitive side-groups along the
      polymer chain increases the degradability of poly[(amino acid
      ester]phosphazenes).

PMID- 1633225
TI  - Haemostatic activity of ethamsylate and aminocaproic acid adsorbed poly(2
      hydroxyethyl methacrylate) particles.
AB  - A haemostatic material suitable for embolization was prepared by the adsorption
      of haemostatics--ethamsylate and aminocaproic acid in the spherical particles of
      porous poly(2-hydroxyethyl methacrylate) (p(HEMA)). The degree of purification of
      ethamsylate-treated particles was tested by an analysis of donor blood in contact
      with the material. An evaluation of the haemostatic properties of these materials
      was obtained by the determination of the indicators of blood clotting: activated
      partial thromboplastin time, thrombin time, and prothrombin time. Ethamsylate or
      aminocaproic acid-containing p(HEMA) has a distinct haemostatic effect on
      pathological blood of patients suffering from focal alterations of the liver.
      These haemostatic emboli materials show promise for the immediate control of
      various haemorrhages; when introduced into a zone with increased haemorrhage,
      they may help to correct disturbed haemostasis.

PMID- 1633226
TI  - Minimodule dialyser for quantitative ex vivo evaluation of membrane
      haemocompatibility in humans: comparison of acrylonitrile copolymer, cuprophan
      and polysulphone hollow fibres.
AB  - Minimodule hollow fibre dialysers, representing clinical dialysis modules on a
      scale of 1/25, enable quantitative evaluation of the haemocompatibility of hollow
      fibre membranes in an ex vivo flow system in humans. On line heparinization,
      adjusted for donor sensitivity, is maintained at a minimal level (approximately
      0.14 units/ml). Blood samples collected at the minimodule exit over 30 min are
      analysed for heparin (anti-Xa activity), activated partial thromboplastin time,
      fibrinopeptide A, platelet count and beta-thromboglobulin, complement fragment
      C3a, leucocyte count and polymorphonuclear neutrophil elastase. Initial
      experiments were performed using well-characterized reference materials:
      acrylonitrile copolymer (AN 69 HF), polysulphone and cuprophan (CUP). Activation
      of coagulation and platelets was low for AN 69 HF, intermediate for CUP and
      greatest for polysulphone, while complement activation was negligible in the
      presence of AN 69 HF, moderate for polysulphone and most important for CUP.
      Future applications will be directed towards haemocompatibility screening of
      prototype membranes with the aim of developing clinical dialysers with improved
      biocompatibility.

PMID- 1633227
TI  - Studies on the effect of degree of hydrophilicity on tissue response of
      polyurethane interpenetrating polymer networks.
AB  - Interpenetrating polymer networks of polyurethane and vinyl monomers such as
      polyacrylamide, polyvinyl pyrrolidone, poly(hydroxyethyl methacrylate) and
      poly(methyl methacrylate) were implanted intramuscularly in rabbits. Attempts
      were made to correlate the morphological aspects of the interpenetrating polymer
      networks to their histological response. A relatively increased hydrophilicity of
      hydrophobicity of the interpenetrating polymer networks as in the case of
      polyurethane-polyvinyl pyrrolidone and polyurethane-poly(methyl methacrylate)
      interpenetrating polymer networks, respectively, could elicit an inert response
      whilst degradation of materials promoted reactivity.

PMID- 1633228
TI  - In vitro erosion of 20 commercial glass ionomer cements measured using the lactic
      acid jet test.
AB  - The lactic acid jet test has been proposed for incorporation in international
      standards for dental cements, since results correlate well with in vivo erosion.
      In the literature, jet test results have been reported on only six glass ionomer
      cements. This study examines three types of glass ionomer, restorative, luting
      and metal reinforced, twenty materials from six manufacturers. A wide range of
      erosion rates was found particularly for restorative cements. The hypotheses put
      forward by previous workers to explain differences in erosion rates found on
      their limited range of glass ionomers do not apply to the wider range that we
      tested.

PMID- 1633229
TI  - Adsorption of glycosaminoglycans to commercially pure titanium.
AB  - Aqueous solutions of the glycosaminoglycans (GAG), chondroitin-4-sulphate (C4S),
      chondroitin-6-sulphate (C6S), heparan sulphate (HS) and hyaluronan (HY) were
      reacted with 5 g samples of both native and calcium-treated titanium powder
      (99.5% pure) for 0-48 h in 10 ml volume at 37 degrees C. Residual GAG was
      detected in the supernatant following recovery of the TiO2-GAG complex by
      centrifugation (5000 g for 1 min) as hexuronic acid using the carbazole
      tetraborate method of Bitter and Muir. No adsorption on to native TiO2 was
      evident. In contrast, prior treatment of TiO2 with calcium produced a significant
      adsorption of C4S to a maximum of 60 micrograms of GAG per gram Ti. Only trace
      amounts of C6S, HS and hyaluronan interacted in the same way. Further evidence of
      interaction was obtained following the liberation of bound GAG from the TiO2-Ca
      GAG complex with EDTA and identification using cellulose acetate electrophoresis.
      These findings suggest that calcium ions are required for adsorption of GAG to
      TiO2 which is mediated through the anionic determinants of the GAG surface and
      that the special configuration of C4S, the predominant chondroitin sulphate
      isomer found in alveolar bone, is important in the adsorption process. The
      implication of these findings in relation to the interaction between bone and
      titanium implants is discussed.

PMID- 1633230
TI  - Hydration and preferential molecular adsorption on titanium in vitro.
AB  - Surface sensitive spectroscopies, Auger electron and X-ray photoelectron (XPS),
      were used to determine changes in titanium oxide composition, oxide
      stoichiometry, and adsorbed surface species as a function of exposure to human
      serum in a balanced electrolyte (serum/SIE) and 8.0 mM ethylenediaminetetraacetic
      acid in a balanced electrolyte (EDTA/SIE) at 37 degrees C. Before immersion, the
      oxide was near ideal TiO2, covered by two types of hydroxyl groups: acidic OH(s)
      with oxygens doubly coordinated to titanium, and basic Ti-OH groups singly
      coordinated. After extended exposure to both solutions, up to 5000 h (ca. 208 d),
      the surface concentration of OH groups increased and non-elemental P appeared.
      The P LVV Auger transition and P 2p spectra indicated the peak positions were
      similar to reference phosphate compounds. The adsorbed phosphate species were
      presumed to be either Ti-H2PO4 or Ti-HPO4-. The XPS data suggested that a
      lipoprotein and/or glycolipid film was adsorbed to the specimens exposed to
      serum/SIE. Analysis of the preferential lipoprotein/glycolipid adsorption using
      electrostatic bonding concepts contributed to the refinement of the hierarchical
      model for the Ti-tissue interface. The salient features are that Ti metal is not
      in direct contact with the biological milieu, rather there is a gradual
      transition from the bulk metal, near-stoichiometric oxide, Ca and P substituted
      hydrated oxide, adsorbed lipoproteins and glycolipids, proteoglycans, collagen
      filaments and bundles to cells.

PMID- 1633231
TI  - Reaction of skeletal muscle to small implants of titanium or stainless steel: a
      quantitative histological and autoradiographic study.
AB  - Small wire implants of titanium or stainless steel were inserted into mouse leg
      muscles to test the reaction of regenerating skeletal muscle. Muscle fibres
      regenerated rapidly, starting at 3 d; by 2 wk all implants were encapsulated in
      thin (10 microns) fibrous tissue capsule surrounded by myotubes for 15-20
      microns. Quantitatively there were no detectable differences in muscle
      regeneration between the two metals. The initiation of myoblast precursor cell
      replication was determined in regenerating muscle next to the implants. Tritiated
      thymidine was injected 18-156 h after implant insertion and labelled myotube
      nuclei in the regenerated muscle indicated that their precursors had started DNA
      synthesis 24 h after implant insertion. This is similar to myogenesis in many
      other muscle lesions and indicated that neither titanium nor stainless steel
      retarded muscle regeneration.

PMID- 1633232
TI  - [The tuberculosis of AIDS: a new tuberculosis?].

PMID- 1633233
TI  - [Role of oral candidiasis as a predictive marker of tuberculosis in patients with
      HIV infection].
AB  - We present a prospective follow-up study of 114 patient infected by Candida and
      HIV, in order to assess the role of oral candidiasis (OC) as a predictive marker
      of tuberculosis and opportunistic infections (OI) which define the Acquired
      Immunodeficiency Syndrome (AIDS). We compared the study group with an homogeneous
      control group of 152 patients infected by HIV without OC during the same period.
      TBC findings in the first group were discriminant with respect to the control
      group (p less than 0.0001) with and average period of 2.5 months between the
      diagnosis of OC and the development of TBC. These findings suggest that OC is an
      early evolutive marker of TBC and a late marker of AIDS.

PMID- 1633234
TI  - [Clinical-endoscopic-histologic correlations in gastric pathology. II].
AB  - Some authors do not accept as valid the clinical diagnosis of gastritis, due to
      the latter being mainly an anatomical-pathological term. Others, however, argue
      that such diagnosis may be establish through a correct anamnesis. A cross
      sectional study of a hundred and fifty patients undergoing fibrosgastroscopy with
      antral biopsy and anamnesis, as well as clinical exploration in accordance with
      specific protocols, has been conducted. We have concluded that there does not
      exist as symptomatology associated to a concrete pathology, despite the presence
      of certain symptoms as, for example, the pain, that may be related with certain
      pathologies (14/20 of those developing H.H.E.D., 22/34 of those developing UB and
      7/10 of those developing neoplasia). We also inferred that many of the patients
      (46/50) with endoscopic and histological normal findings (20/23), present as many
      as or more symptoms than those with pathological findings. This symptomatology
      may be due to a somatic disorder that could be hiding the process.

PMID- 1633235
TI  - [Association between post-initial remission and HLA phenotype in Type I
      diabetics].
AB  - Our goal was to estimate the occurrence rate of the post-initial remission and
      its relation with HLA phenotype in type I diabetics (DMI). We studied 50 type I
      diabetics, 22 women and 28 men, with an average age at the onset of the disease
      to 15.8 +/- years (range 3-30 years). All patients were conventionally treated
      with insulin therapy, diet and regular exercise. Six (12%) of the diabetics
      presented a complete remission during 57.3 +/- 46 weeks, whereas fifteen (30%)
      patients presented partial remission during 20.1 +/- weeks. No significant
      differences were observed with regard to age at the onset of the disease, sex,
      BMI, initial ketoacidosis and stage of gonadal development between those
      diabetics presenting remission and those who did not presented so. We observed a
      higher incidence of the HLA-DR4 antigen among diabetics with remission (complete
      and partial, 61.9%), compared with patients without remission (20%, p less than
      0.5). In conclusion, our results support the findings suggesting the presence of
      a clinical-immunological heterogenicity in DMI, genetically determined and linked
      to the HLA system.

PMID- 1633236
TI  - [Zinc and osteoporosis].
AB  - The relevant role of zinc in osteoporosis, its correlation with nutrient intake
      and the modifications of its urinary and serum levels, have been demonstrated. In
      this paper, we have studied the plasmatic, urinary and intraerythrocitary levels
      of zinc in a group of patients with extended primary osteoporosis, most of them
      women with postmenopausic osteoporosis. No significant differences were observed
      in zinc levels between osteoporotic patients and controls. We think that certain
      aspects regarding the correlation between zinc and bone mineral content still
      have to be defined, as well as zinc intake and osteoporosis.

PMID- 1633238
TI  - [Late detection of Bartter's syndrome. Presentation of a case].
AB  - A 27-year-old patient with a chronic clinical history of asthenia and
      palpitations was diagnosed with Bartter's syndrome based on clinical and
      biochemical criteria. This case is especially interesting due to the late
      detection of the syndrome, its association to hyperuricemia and hypomagnesemia
      and the presence of tonic-clonic convulsions.

PMID- 1633237
TI  - [Spinal cord compression as a primary manifestation of occult thyroid carcinoma].
AB  - Metastatic disease is the first clinical manifestation of differentiated thyroid
      carcinoma (DTC) in less than 5% of cases. Bone metastases as the first sign of
      DTC are associated with a poor prognosis, both for being resistant to treatment
      and for complications due to them. Spinal cord compression is a rare development
      in DTC, which may present late in the course of the disease. An initial
      presentation of DTC with a spinal cord compression is an extremely rare
      condition.

PMID- 1633239
TI  - [Rhabdomyolysis and cocaine consumption: presentation of 13 cases].
AB  - We present 13 cases taken care at the Emergency Service, whose diagnosis was
      acute rhabdomyolysis related to consumption of illicit drugs. In all cases, the
      presence of cocaine in the urine was detected. Clinical features, other
      associated factors and complications are described, stressing the etiopathogenic
      mechanism of presentation of cocaine-related rhabdomyolysis.

PMID- 1633240
TI  - [Intermittent claudication as a presenting form of hypothyroidism].
AB  - Two cases of patients affected for years by intermittent claudication symptoms
      with normal arterial flow are presented. In both of them, the diagnosis of
      hypothyroid myopathy was finally established, subsiding the symptoms with the
      appropriate treatment.

PMID- 1633241
TI  - [Splenic abscess: presentation of a case and literature review].
AB  - A case of a patient with splenic abscess, a rare pathology, is presented. In
      large hospitals, no more than 12 cases per year are usually diagnosed and they
      are only observed in 0.2-0.7% of all necropsies performed in North American
      hospitals. Its diagnosis is difficult, frequently late and, if untreated, it has
      a very poor prognosis. Forms of presentation, concomitant diseases, methods of
      diagnosis and therapeutical alternatives are discussed.

PMID- 1633242
TI  - [Tuberculosis and corticosteroids. Physiopathological and therapeutical
      implications].

PMID- 1633243
TI  - [New biological parameters in the study of pleural effusions].

PMID- 1633244
TI  - [Pustular arthroosteitis: diagnostic difficulty in the initial stages].

PMID- 1633245
TI  - [Celiac disease and pericarditis].

PMID- 1633246
TI  - [Neonatal hypothyroidism after amiodarone therapy during pregnancy].

PMID- 1633247
TI  - [Kikuchi diseases: presentation of a case with severe cutaneous affliction].

PMID- 1633248
TI  - [Significant increase of transaminases levels in a patient with
      choledocholithiasis].

PMID- 1633249
TI  - [Cholestatic hepatitis from amoxicillin-clavulanic acid].

PMID- 1633250
TI  - [Addison-Biermer megaloblastic anemia: Weil's encephalopathy].

PMID- 1633251
TI  - [Anxiety caused by nifedipine].

PMID- 1633252
TI  - [ECG alterations in extreme hyperpotassemia in a patient with a pacemaker].

PMID- 1633253
TI  - [Minimal model for representing the central and peripheral pulse based on the
      pulse wave theory].
AB  - The present paper discusses an optimized model for describing central and
      peripheral pulse waves. On the basis of these computer-aided calculations,
      further haemodynamic data may be evaluated with the aim of improving the
      possibilities of clinically invasive diagnostic evaluation of cardiovascular
      diseases.

PMID- 1633254
TI  - [A measuring device for calculating electrical impedance of the heart in clinical
      conditions].
AB  - Changes in the electrical impedance of tissue can indicate structural changes.
      This suggests a technique for the noninvasive detection of allograft rejection
      after heart transplantation. The direct electrical connection to the heart and
      the application of a measuring current to the myocardium requires a high standard
      of safety. A device was developed for measuring cardiac impedance using a
      sinusoidal current of 20 microA at a frequency of 15 kHz. The control logic
      ensures a slow current onset and also an immediate cessation in case of conductor
      fracture or excessive voltage. Initial results in patients with normal recovery
      after heart transplantation revealed a rapid drop in impedance to about 70% of
      the initial value in the 1st 48 hours and then a stable course. In the sole
      rejection episode observed so far, the impedance increased again to 85% of the
      initial value. This paper discusses the technical safety requirements and the
      design of the device, and presents initial results of clinical examinations.

PMID- 1633255
TI  - [Biomechanically induced stimulation of postoperative bone remodeling].
AB  - Bone remodelling after prosthetic surgery involving the skeleton should create a
      durable and intimate connection between the bone and the prosthesis. A prosthesis
      that is not adapted to the biological mechanics is known to cause growth
      reactions which may lead to failure of the biotechnical system. The stimulation
      of growth reactions by local, specific changes in loading is defined in this
      paper. Analogously to the classical laws of continuum mechanics a model for
      calculating the post-operative remodelling processes is developed.

PMID- 1633256
TI  - [Recording of data and immediate interpretation of myoelectric activity of the
      stomach--electrogastrography].
AB  - Unlike other electrophysiological measurements such as electrocardiography (ECG)
      and electroencephalography (EEG), the cutaneous measurement of the electrical
      activity of the stomach (electrogastrography, EGG) is not an established clinical
      diagnostic procedure. To overcome common problems in acquiring very-low-frequency
      signals in the presence of large and unstable voltages we developed a real time
      data acquisition and analysis system based on linear-phase digital signal
      processing instead of analog filtering. FFT's computed on line from highly
      overlapping time sets are displayed as pseudo-3D or grey-scale graphic plots.

PMID- 1633257
TI  - Phase transitions of phospholipid vesicles under osmotic stress and in the
      presence of ethylene glycol.
AB  - The effects of poly(ethylene glycol) (PEG) on the phase transition of
      phospholipid multilamellar vesicles (MLVs) were investigated by using
      differential scanning calorimetry (DSC). Main transition temperature (Tm) and the
      pre-transition temperature (Tp) of neutral phospholipid-, DMPC-1, DPPC- and DSPC
      MLVs increased with an increase in PEG concentration. The subtransition
      temperature of DPPC-MLV also increased with an increase in PEG concentration.
      These results could be qualitatively explained by enhancement of the lateral
      packing on the basis of the osmoelastic coupling theory. The pretransition
      temperature increased faster than the main transition temperature did with an
      increase in PEG concentration. The increment of Tm depended on the hydrocarbon
      chain length, the shorter the hydrocarbon chain length was, the larger the
      increment was. The transition width in the DSC peak was broadened with an
      increase in PEG concentration. These three above-mentioned effects are the main
      differences between the effects of the osmotic stress on the phase transition of
      MLVs and those of hydrostatic pressure. On the other hand, ethylene glycol (EG),
      which is the monomer of PEG, had a biphasic effect on transition temperature of
      DPPC-, DSPC-, and DMPC-MLV, reducing Tm and Tp at low concentrations, but
      increasing Tm and extinguishing pretransition at high concentrations. This is
      explained by the induction of an interdigitated gel phase at high concentrations
      of EG, which indicates that EG can easily penetrate into the head group region of
      the lipid, in contrast with PEG 6K, because EG is small. Temperature-EG
      concentration phase diagrams for the various PC-MLVs were determined.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1633258
TI  - Acetylcholine receptor-enriched membrane vesicles in response to ethanol:
      activity and microcalorimetric studies.
AB  - The activity of acetylcholinesterase (AChE) in acetylcholine receptor (AChR)
      enriched membrane vesicles isolated from electric organ of Torpedo californica
      exhibited a biphasic response to ethanol action. Below an ethanol concentration
      of 35 mM, AChE activity increased with increasing concentration of ethanol. At
      ethanol concentrations greater than 35 mM, the activity was found to decrease
      montonically. In contrast, ethanol (35-400 mM) increased the activity of soluble
      AChE. This biphasic behavior was consistent with the proposed important role of
      ethanol-membrane interaction. Microcalorimetric measurements revealed that the
      enthalpy change in acetylcholine (ACh) hydrolysis reaction was 586 J/mol in
      association with membrane-bound AChE in AChR-enriched membrane vesicles, as
      compared to -544 J/mol with the isolated soluble AChE. This discrepancy was
      attributed to the presence of membranes. Unlike its action on the enzyme
      activity, ethanol did not affect enthalpy change in ACh hydrolysis reaction
      catalyzed by either membrane-bound or soluble AChE. Comparison of results on
      activity and heat measurements suggested that the interaction of ethanol with
      membrane vesicles was nonspecific with no ethanol-induced membrane structural or
      conformational change.

PMID- 1633259
TI  - Kinetics of oxygen binding and subunit assembly for the hemoglobin alpha subunit.
AB  - A thorough kinetic characterization of the O2-binding and self-association
      reactions of alpha-subunits of human hemoglobin A has been performed. All of the
      rate constants for a five step reaction model linking the monomer-dimer reaction
      to the O2-binding steps have been determined for the first time. Our analysis of
      the ligand binding reaction shows that both monomer and dimer have nearly
      identical intrinsic O2-association and dissociation rate constants and therefore
      identical affinities for oxygen. During this investigation we discovered a small
      absorbance difference between the oxy-monomer and oxy-dimer alpha-subunits. This
      difference spectrum enabled direct measurements of the alpha O2 self-association
      reaction. We find an association rate constant of, 2.0 10(5) M(-1)s-1, similar to
      that for other subunit assembly processes in the hemoglobin system. Our results
      also suggest that the deoxy-subunit assembly kinetics must be similar to that for
      the oxy-subunit. These kinetic results together with the equilibrium constants
      obtained for these solution conditions by Ackers and coworkers provides, for the
      first time, a complete kinetic and thermodynamic description of all the intrinsic
      ligand binding and association reactions for alpha-subunits.

PMID- 1633260
TI  - Interpretation of the X-ray scattering profiles of chromatin at various NaCl
      concentrations by a simple chain model.
AB  - In order to interpret the change in the X-ray scattering profiles from rat thymus
      chromatin, extensive model calculation was carried out. Chromatin is modelled as
      a string of subunits (nucleosomes) in which disorder is introduced into the
      positions of adjacent subunits. Disposition parameters characterizing the
      arrangement of subunits were estimated for various states of chromatin, so that
      the main feature of the scattering profiles is described. The result indicated
      that the structure of chromatin changes, as the NaCl concentration increases,
      from the extended "beads-on-a string" structure to the condensed helical
      structure. The latter has an outer diameter of about 26 nm with 3-4 nucleosomes
      per turn. In the intermediate state, it has a loose helical structure. The
      estimation of disorder suggested that the arrangement of subunits is appreciably
      disordered even in the condensed helical filament at 50 mM NaCl. Our model for
      chromatin condensation seems to support models of the "crossed linker" type.

PMID- 1633261
TI  - D-factor and growth hormone enhance tumor necrosis factor-induced increase of Mn
      superoxide dismutase mRNA and oxygen tolerance.
AB  - D-Factor (differentiation-inducing factor or leukemia inhibitory factor) and
      growth hormone are proteins that regulate growth and differentiation of cells. In
      this study, we demonstrated that recombinant human D-factor and growth hormone
      caused a slight but significant protection of adult rats against oxygen toxicity
      without affecting levels of pulmonary manganous superoxide dismutase (MnSOD)
      mRNA. D-Factor and growth hormone also markedly enhanced tumor necrosis factor
      (TNF)-induced oxygen tolerance. This latter effect was associated with a marked
      enhancement of TNF-mediated induction of pulmonary MnSOD mRNA.

PMID- 1633262
TI  - Further aspects of IL-1 beta secretion revealed by transfected monkey kidney
      cells.
AB  - Because the cytokine interleukin-1 beta (IL-1 beta) lacks a classical hydrophobic
      signal sequence, it has been unclear how it is released from cells, and whether
      release proceeds via a novel mechanism or through non-specific leakage. To
      address this issue, we have examined the secretion of the recombinant forms of
      human IL-1 beta from COS monkey kidney cells, which express low levels of
      endogenous IL-1 beta. Four proteins were expressed: precursor and mature IL-1
      beta and precursor and mature IL-1 beta fused to an amino terminal hydrophobic
      signal sequence from human tissue plasminogen activator. By monitoring the
      appearance of a known cytosolic protein (ATP citrate lyase) in the medium, we
      find that the unmodified IL-1 beta s are non-specifically released in very small
      quantities from the cytosol. On the other hand, the signal sequence-modified IL-1
      beta s are glycosylated and efficiently secreted by the ER/Golgi pathway. The
      secreted, modified-mature protein is also biologically active, suggesting that
      this pathway has been bypassed for reasons other than maintaining the structural
      integrity of IL-1 beta. More likely the alternative pathway is a critical aspect
      of IL-1 biology. The differences in kinetics and quantity of IL-1 beta release
      from monocytic and COS cells suggest that COS cells lack critical components for
      the rapid release seen in monocytes.

PMID- 1633263
TI  - In vitro production of TNF-alpha, IL-1 beta and IL-6 by mononuclear blood cells
      of patients with renal cell carcinoma undergoing rIL-2 treatment. Relation
      between clinical response and TNF-alpha production.
AB  - The purpose of this study was to examine the production of IL-1 beta, IL-6 and
      TNF-alpha by peripheral blood mononuclear cells in patients with renal cell
      carcinoma treated with recombinant interleukin 2 (rIL-2). Peripheral blood
      mononuclear cells (PBMC) were purified from blood samples obtained six times
      during therapy and the production of IL-1 beta, IL-6 and TNF-alpha were
      determined after 18 h culture of the PBMC in culture medium or in medium
      containing 10 micrograms lipopolysaccharide (LPS)/ml, 10 ng LPS/ml or 1000 units
      rIL-2/ml. In vivo therapy with rIL-2 resulted in substantial changes in the
      production of the three cytokines. Only the production of TNF-alpha following in
      vitro stimulation with rIL-2 was related to the clinical response, being
      significant lower in responding patients than in non-responders (P less than
      0.05). These findings suggest that the rIL-2-induced TNF-alpha production of PBMC
      in vitro is lower in renal cancer patients that respond to rIL-2 therapy than in
      non-responding patients.

PMID- 1633264
TI  - Immunological and biological identification of tumour necrosis-like factor in
      sponges: endotoxin that mediates necrosis formation in xenografts.
AB  - Xenografts of the sponge Geodia cydonium in its closely related species G.
      rovinjensis resulted in a rapid rejection of the graft within a period of 5 days.
      We identified an immunoreactive tumour necrosis factor (TNF)-like activity in the
      xenograft (Mr of 30,000) two days after grafting. In-vivo injection of 5
      micrograms human recombinant TNF-alpha induced cytotoxicity in sponge cells in
      the same pattern and time course as during natural xenograft rejection. Anti-TNF
      alpha polyclonals were found to react with xenograft extracts, by Western blot
      analysis, as from day 2 after grafting. Using ELISA we detected the TNF-like
      activity from day 2 after grafting with peak levels at days 4 and 5, where the
      amount was 0.72 ng/micrograms tissue DNA. By day 1, gp27 (inhibitory aggregation
      factor) is already formed in the xenograft. In-vitro experiments on isolated G.
      cydonium cells showed that addition of purified gp27 induced the production of
      the TNF-like activity (up to 13.5 ng/ml). Evidence is presented that gp27 is a
      product of the gp180 lectin receptor. We conclude that gp27 induces TNF-like
      factor production, resulting in destruction and dissolution of the xenograft
      after 5 days.

PMID- 1633265
TI  - Isolation of an mRNA encoding a soluble form of the human interleukin-6 receptor.
AB  - Soluble forms of the interleukin (IL)-2, IL-4 and IL-7 receptors which lack the
      transmembrane domain have been described. IL-6 is a growth factor important in
      the final differentiation of B-cells into plasma cells and in the pathogenesis of
      multiple myeloma. To determine whether the receptor for IL-6 may exist as a
      soluble molecule, RNA was analysed from the transformed B-cell lines U266, CESS
      and Daudi, from bone marrow from two myeloma patients, and from normal
      leukocytes. Using polymerase chain reaction, oligonucleotide primers which flank
      the transmembrane domain were selected to generate a 339 bp fragment. All samples
      produced equivalent amounts of the expected 339 bp fragment plus a smaller 245 bp
      fragment except Daudi which exhibited virtual absence of both. Sequence analysis
      of the smaller fragments from each of the five samples demonstrated the deletion
      of the entire transmembrane region from codons 356 (G-TG) to 387 (AG-G). The
      boundaries of this deletion were identical in all cases. Partial sequence
      analysis of the ligand-binding domain for U266 demonstrated identical sequences
      for the membrane-bound and soluble forms of the IL-6 receptor cDNAs. In summary,
      an mRNA which encodes a soluble form of the IL-6 receptor is expressed in both
      normal and myeloma cells.

PMID- 1633266
TI  - Characterization of monoclonal IgG antibodies produced by hybridomas derived from
      rheumatoid synovial cells.
AB  - IgM rheumatoid factors (RF) are the predominant autoantibody found in rheumatoid
      arthritis. They are polyclonal, fix complement, and are directed against epitopes
      in the Fc portion of IgG. One hypothesis regarding the induction and persistence
      of RF production in rheumatoid arthritis is that the Fc of IgG is somehow
      altered, rendering it antigenic. In this study, to better understand the
      derivation and pathogenicity of RF in rheumatoid arthritis, monoclonal IgG (mIgG)
      constitutively secreting hybridomas were established by fusing rheumatoid
      synovial mononuclear cells (RSC) from patients with a mouse/human heteromyeloma
      cell line, F3B6. To clarify the primary structure of IgG Fc constant regions
      produced locally by RSC, we amplified the cDNA corresponding to the CH2 and CH3
      domains of an IgG1-, IgG2-, and an IgG3-producing hybridoma derived from RSC. The
      amplified DNA segments were cloned in M13 vectors and sequenced. Interestingly,
      very few differences in the nucleotide sequences were observed, and the deduced
      amino acid sequences were identical, except for the allotype, with those encoded
      by the human germline genes GEA and CL. Thus, the primary structure of the IgG1,
      IgG2, and IgG3 Fc regions produced by RSC were not altered when compared with
      those encoded by the unmutated human germline gene. These results suggest that
      factors other than altered IgG induce and sustain high avidity RF production in
      rheumatoid arthritis.

PMID- 1633267
TI  - Structural and functional properties of mouse-human chimeric IgD.
AB  - A gene encoding mouse-human chimeric secreted IgD was constructed using the
      rearranged murine variable region specific for the hapten dansyl and the genomic
      gene sequences for the constant region of the heavy (H) chain of human IgD. When
      expressed with the dansyl-specific chimeric light (L) chain, chimeric IgD
      specific for the hapten dansyl was synthesized and secreted as an H2L2 molecule.
      The pathway of assembly was H + L----HL----H2L2. The chimeric IgD heavy chain
      contains three N-linked carbohydrate moieties; one of these appears to be added
      co-translationally, and the other two appear to be added post-translationally. In
      secreted chimeric IgD some of the N-linked carbohydrate remains in the high
      mannose form. The chimeric IgD heavy chain also contains O-linked carbohydrate,
      which is added at the time of secretion. Inhibition of N-linked glycosylation
      with tunicamycin halts assembly at the HL half-molecule stage and prevents
      secretion. Like natural human IgD, the chimeric IgD binds to and upregulates the
      IgD receptor (IgD-R) on human peripheral blood T cells, and it is equivalent to
      human myeloma IgD in the competitive inhibition of rosette formation between IgD
      R-bearing cells and IgD-coated Ox-RBC, Cross-linking by dansyl-BSA is needed for
      the chimeric IgD in soluble form to cause IgD-R upregulation.

PMID- 1633268
TI  - The detection of anti-Ro/SS-A and anti-La/SS-B activity of human serum monoclonal
      immunoglobulins (monoclonal gammopathies).
AB  - The sera of 340 patients with monoclonal gammopathies were examined for the
      presence of anti-Ro/SS-A and anti-La/SS-B activity. An enzyme-linked
      immunosorbent assay (ELISA) technique was employed. Forty-six sera (13.5%) bound
      to Ro/SS-A, while 79 sera (23.2%) bound to La/SS-B. The anti-Ro/SS-A and anti
      La/SS-B antibodies were found in sera of patients with IgG, IgM, and IgA
      gammopathies. Forty-two of the 46 sera (91.3%) with positive anti-Ro/SS-A
      activity were found to bind La/SS-B as well, while only 53.2% (42 out of 79) of
      the sera that had anti-La/SS-B activity also bound Ro/SS-A. The activity against
      Ro/SS-A and La/SS-B was further confirmed by immunoblotting with purified
      immunoglobulins. Antibodies to Ro/SS-A and La/SS-B are common in systemic lupus
      erythematosus, Sjogren's syndrome, and other rheumatic disorders. Yet none of the
      patients whose serum was found to contain high titres of anti-Ro/SS-A or anti
      La/SS-B human monoclonal antibodies presented with symptoms related to such
      autoimmune diseases. Our results of a high incidence of anti-Ro/SS-A or anti
      La/SS-B activity in the sera of patients with monoclonal gammopathies support
      previous reports of autoantibody properties characteristic of these
      immunoglobulins.

PMID- 1633269
TI  - Lymphocyte surface marker expression on hybridomas secreting human monoclonal
      antibodies.
AB  - The expression of human leucocyte markers on the surface of hybridoma cell lines
      producing human monoclonal antibodies was studied using immunofluorescence
      analysis (FACS). We tested 36 different hybridoma cell lines from fusions of
      lymphocytes of different organs of fetal and adult organisms with the mouse
      myeloma line P3 X63 Ag8.653 or the mouse-human heteromyeloma line CB-F7 (IgM-,
      IgG-, and nonproducer) with a panel of 21 murine monoclonal antibodies against
      human differentiation and activation antigens. CD2, 3, 4, 5, 8, 10, 23, 25
      antigen and major histocompatibility complex (MHC) class II determinants could
      not be detected on all hybridomas analyzed. The antigens CD22, 69, 71, and 72
      were expressed on few of the hybridomas tested. The majority of the cell lines
      carried the surface markers CD19, 20, 40, 45 as well as the plasma cell markers
      CD38 and O/C11. The activation antigen 4F2 was expressed on all the cell lines
      tested. However, a direct connection between the expression of a lymphocyte
      marker and the capacity for Ig production (high and low producer; Ig isotype),
      the origin of the lymphocytes, and the fusion cell line used could not be
      detected.

PMID- 1633270
TI  - Characterization of an antibody to the integrin beta 3 subunit (GP IIIa) from a
      patient with neonatal thrombocytopenia and an inherited deficiency of GP IIb-IIIa
      complexes in platelets (Glanzmann's thrombasthenia).
AB  - Patient A.F. is a 28-year-old polytransfused woman with an inherited bleeding
      disorder, Glanzmann's thrombasthenia. An abnormal platelet function is linked to
      severe decreases in the platelet content of the integrins GP IIb and GP IIIa. In
      1987 the patient gave birth to a child with severe anemia and thrombocytopenia.
      Serological tests revealed the presence of anti-platelet antibody together with
      an anti-Rhesus D. Western blotting identified a major antibody that reacted with
      a protein of 90-95 kDa present in platelets and endothelial cells. This was
      identified as the beta 3 integrin subunit (GP IIIa). Antibody-binding required
      intact disulfides, while controlled digestion with proteases showed the
      determinant(s) to be retained within chymotrypsin- (50, 63 kDa) and
      Staphylococcus aureus V8 protease-derived (25-38 kDa) fragments of GP IIIa.
      Direct binding assays performed in the presence of monoclonal antibodies specific
      for different epitopes on GP IIb-IIIa complexes confirmed that the epitope was
      exposed on intact platelets and revealed a specific inhibition of A.F. IgG
      binding by the monoclonal antibody, AP-3. Other tests confirmed that the antibody
      reacted independently of the PlA or Pen polymorphisms carried by GP IIIa. IgG
      purified from A.F. plasma by adsorption and elution from paraformaldehyde-fixed
      normal platelets or electrophoretically separated GP IIIa was an inhibitor of ADP
      induced platelet aggregation. Unexpectedly, Western blotting showed trace amounts
      of abnormally migrating GP IIIa in A.F. platelets, which retained an ability to
      react with her antibody. This suggests that the patient has formed an
      autoantibody reactive with an active site of the beta 3 integrin subunit and
      linked to the development of neonatal thrombocytopenia.

PMID- 1633271
TI  - Postnatal shift of tonotopic organization in the chick auditory cortex analogue.
AB  - The existence of an ontogenetic shift of tonotopic organization throughout the
      auditory pathway concomitant with cochlea maturation is a matter of controversy.
      Using the 2-deoxyglucose method we demonstrate here for the first time the shift
      phenomenon in an auditory forebrain structure, field L, the auditory cortex
      analogue of the chick. During the first postnatal month isofrequency contours
      move to positions where, in younger chicks, lower frequencies (up to half an
      octave) are represented. This developmentally changing place code of sound
      frequencies at the forebrain level is similar to the one previously reported for
      brain stem auditory nuclei. It raises the question of constancy of frequency
      related pitch perception during development and may be a complication of early
      auditory learning and memory.

PMID- 1633272
TI  - Unit activity to click CS changes in dorsal cochlear nucleus after conditioning.
AB  - Recordings were made of single unit activity (n = 360 units) from the dorsal
      cochlear nucleus of cats. Different patterns of activity were elicited by
      acoustic stimuli before and after Pavlovian conditioning. The peak response to a
      forward paired click conditioned stimulus (CS) increased whereas that to a
      backward paired hiss discriminative stimulus (DS) did not. The percentage of
      units responding to the CS increased from 34% to 46% after conditioning. The
      findings do not support the widely accepted hypothesis that learning has no
      effect on transmission through the first brain stem relay of the auditory system
      and indicate, instead, that the cochlear nucleus can participate in complex
      adaptive acoustic signal processing.

PMID- 1633273
TI  - Temporal priority of premotor cortex over nearby areas in receiving visual cues
      in primates.
AB  - Neuronal activities in the premotor cortex (PM), supplementary motor area (SMA),
      and precentral motor cortex (MC) were recorded while monkeys performed a visually
      triggered task. Kendall's partial correlation coefficient analysis was applied to
      the data, to determine whether changes in neuronal activity were dependent on
      visual-stimulus or movement-onset. The proportion of cells in which neuronal
      activity changes were significantly related to visual-stimulus was 22% in PM
      cells, 7% in SMA cells, and 0% in MC cells. The sampling populations for visual
      stimulus related coefficients were greatest in PM, followed by SMA, then MC.
      These results indicate that the PM has temporal priority over the SMA and MC in
      the receipt of visual cues.

PMID- 1633274
TI  - Projections to Botzinger expiratory neurons by dorsal and ventral respiratory
      group neurons.
AB  - Botzinger complex (BOT) augmenting expiratory neuron efferent connection are well
      established, but little is known concerning the afferent neural projections to
      BOT. The dorsal (DRG) and ventral (VRG) respiratory groups were extensively
      searched in 17 pentobarbital anaesthetized cats for inspiratory neurons that were
      anti-dromically activated from BOT. Only 1 of the 60 VRG inspiratory neurons with
      confirmed spinal projection was antidromically activated from BOT. Another 3 VRG
      inspiratory neurons and 4 of the 30 DRG inspiratory neurons were activated from
      BOT, but none of these neurons had confirmed spinal cord projections. All 15
      early burst neurons were antidromically activated from BOT. Neural projections to
      BOT from DRG and VRG inspiratory neurons are rare, but neural projections from
      early burst neurons are common.

PMID- 1633275
TI  - Left hemisphere preponderance in trajectorial learning.
AB  - The present study examines the organisational principle of a trajectorial storage
      mechanism for isochronically controlled overlearned movements. 48 right-handed
      subjects were trained on new ideograms at five different sizes. After the
      trajectory had been overtrained with one hand, learning transfer to the
      contralateral hand was analysed. Results indicate a significant transfer of
      trajectorial information after training with the right hand towards the left hand
      which points to a preponderance of the dominant left hemisphere in generalizing
      storage of learned trajectories to either upper extremity. The trajectorial
      storage system has clear geometrical restraints.

PMID- 1633276
TI  - Neuropeptide Y m-RNA and peptide are transiently expressed in the developing rat
      spinal cord.
AB  - The distribution of neuropeptide Y (NPY) m-RNA and peptide were studied during
      the ontogeny of the rat spinal cord, by means of in situ hybridization and
      immunohistochemistry. NPY expressing neurons were visualized by both techniques,
      although by in situ hybridization they appeared slightly more abundant than by
      immunohistochemistry. In the ventral horn, a few neurons transiently expressed
      NPY from the embryonic day 15 to birth, but not in the adult animals. In the
      embryonic dorsal horn, NPY expressing neurons were numerous and seen as early as
      embryonic day 15 (E15). In contrast, in the postnatal and the adult dorsal horn,
      the number of neurons expressing the NPY phenotype was dramatically lower.

PMID- 1633277
TI  - BDNF and NGF treatment in lesioned rats: effects on cholinergic function and
      weight gain.
AB  - Effects of chronic intraventricular administration of recombinant human brain
      derived neurotrophic factor (rhBDNF) or recombinant human nerve growth factor
      (rhNGF) on presynaptic hippocampal cholinergic function in adult rats with
      partial fimbrial transections were measured. Partial fimbrial transections
      reduced synaptosomal high affinity choline uptake, choline acetyltransferase
      activity, and [3H] acetylcholine synthesis by approximately 50-75%. Chronic
      treatment with rhBDNF failed to attenuate these lesion-induced decreases. In
      contrast, chronic rhNGF treatment increased all three parameters by 50-90%
      compared to lesioned control values. Chronic treatment with rhBDNF or rhNGF
      attenuated weight gain of the animals. The findings failed to provide evidence
      for a prominent role of BDNF in the function of adult cholinergic neurons,
      however, they suggest an action on central neurons involved in the regulation of
      food intake.

PMID- 1633279
TI  - Cholinergically-induced theta-like oscillations in the hippocampal formation of
      freely moving cats.
AB  - The present investigation was undertaken to assess the role of the cholinergics
      in the production of theta (theta) rhythm in the cat hippocampal formation.
      Intrahippocampal injections of carbachol, muscarine or eserine produced a well
      synchronized high frequency cholinergic theta activity (HFC) in a range of 5-12
      Hz. Subsequent intrahippocampal injection of muscarinic antagonist, atropine
      sulphate, completely blocked this cholinergic-induced EEG pattern. The nicotinic
      antagonist, hexamethonium, was without any effect on the cholinergic-induced
      rhythmical waves. We suggest that HFC may result from the activation of the
      oscillatory mechanism intrinsic to the cat hippocampal formation.

PMID- 1633278
TI  - Role of nitric oxide in NMDA-evoked release of [3H]-dopamine from striatal
      slices.
AB  - Evidence that excitatory amino acids act via N-methyl-D-aspartate (NMDA)
      receptors to evoke the release of catecholamines from axonal terminals and
      synaptosomes has been used to argue for the presence of pre-synaptic NMDA
      receptors. NMDA receptor agonists also generate nitric oxide (NO) which rapidly
      diffuses through neural tissue. We find that exogenously applied NO evokes [3H]
      dopamine release from cultured neurons. This release is not blocked by the NMDA
      antagonist MK-801 nor by tetrodotoxin. Both NG-nitroarginine which inhibits NO
      synthesis, and hemoglobin which binds extracellular NO, block NMDA-evoked [3H]
      dopamine release from striatal slices. A major role of endogenously-synthesized
      NO may be to evoke neurotransmitter release in local volumes of neural tissue.

PMID- 1633280
TI  - Amino alcohol modulation of hippocampal acetylcholine release.
AB  - The synthesis and release of 3H-acetylcholine was measured in hippocampal slices
      of adult rat brain following acute in vitro exposure to ethanolamine. Evoked
      release of 3H-acetylcholine was elevated by 60-70% but 3H-acetylcholine synthesis
      was unaffected. Other amino alcohols were also found to significantly increase
      evoked 3H-acetylcholine release. The effect may be stereochemically mediated
      since only one of four possible propanolamine configurations, R-alaninol, was
      active. The most potent compound tested was R-prolinol which showed an EC50
      nearly 10-fold lower than that of either R-alaninol or ethanolamine; S-prolinol
      was inactive. Slices taken from adult rats which had been fed active compounds
      for two weeks also exhibited enhancements in evoked 3H-acetylcholine release.
      These results indicate that amino alcohols modulate acetylcholine release in the
      rat hippocampus.

PMID- 1633281
TI  - Age-dependent decrease in histamine H1 receptor in human brains revealed by PET.
AB  - Age-related changes in histamine H1 receptors were studied using [11C]pyrilamine
      or [11C]doxepin by positron emission tomography (PET). The frontal, parietal and
      temporal cortices showed age-related decreases in binding of approximately 13%
      per decade. In contrast, the thalamus showed no apparent decrease in binding
      during normal ageing because of its higher nonspecific binding. Post mortem
      studies also indicated that the nonspecific binding of [3H]pyrilamine in the
      thalamus was approximately 112% higher than that in the cortex. However, no
      significant decrease in histamine H1 receptors with age was observed by in vitro
      binding assays of autopsied human frontal cortex. Possible reasons are given for
      the larger effects of age observed in the PET study than in the in vitro post
      mortem binding study.

PMID- 1633282
TI  - Kainic acid injection in NTS evokes hypertension and c-fos expression in spinal
      cord.
AB  - Kainic acid injected into rat nucleus tractus solitarius (NTS) caused a slowly
      developing hypertension, with a 2-fold increase in Fos-immunoreactive (Fos-IR)
      nuclei in the area of the presympathetic bulbospinal neurons in the rostral
      ventrolateral medulla (RVLM) and a widespread activation of sympathetic
      preganglionic neurons (SPN) in the spinal cord, particularly in the mid to lower
      thoracic cord. The highest segmental concentration of Fos-IR SPN was in T8, with
      Fos-IR nuclei increased 12-fold compared with the vehicle injected group. More
      than 60% of retrogradely labelled sympathoadrenal neurons in T8 were Fos-IR after
      kainic acid injection, consistent with the 60-fold increases in plasma adrenaline
      levels observed in these rats.

PMID- 1633283
TI  - Muscimol suppresses rCGU increase in the substantia nigra after destruction of
      the caudate nucleus.
AB  - Injection of ibotenic acid into the caudate nucleus caused an increase in the
      uptake of 2-deoxyglucose (2DG) in the ipsilateral substantia nigra pars
      reticulata (SNr). Increased 2DG uptake was completely suppressed by chronic
      infusion of muscimol, the gamma-aminobutyric acid (GABA) agonist. While delayed
      shorter infusion of muscimol from the 3rd to the 7th day, when 2DG accumulation
      was the most prominent, partially prevented this increase. These data suggest
      that GABA-mediated transneuronal processes play an important role in the delayed
      elevation in 2DG uptake in SNR but hyperexcitation due to disinhibition by the
      loss of GABAergic inputs may play only a partial role in this increase.

PMID- 1633284
TI  - Kanji word reading process analysed by positron emission tomography.
AB  - Positron emission tomography, involving the H2(15)O injection technique, was used
      to study changes in regional cerebral blood flow during Japanese kanji word
      reading. Three-times intrasubject averaging analysis revealed that the main
      cortical responses occurred in the bilateral (left-side dominant) posterior
      inferior temporal area for visual input. We believe the left posterior inferior
      temporal area processes highly complex morphological features of kanji. For
      language output, left-side dominant activation of the posterior inferior frontal
      gyrus and the basal ganglia was found.

PMID- 1633285
TI  - Visually induced destabilization of human stance: neuronal control of leg
      muscles.
AB  - With subjects standing on a treadmill both the treadmill and an optical flow
      pattern were moved sinusoidally (0.25 Hz) and the effect of delaying the
      presentation of the image with respect to treadmill movement was analysed. Around
      the posterior turning point of treadmill movement a modulation of the tibialis
      anterior EMG was observed, the onset, duration and amplitude of which were
      dependent upon the phase-shift between the movements of the legs and the image.
      At times around the anterior turning point a corresponding modulation, but only
      of EMG amplitude, occurred in the extensor muscles. Little adaptational changes
      in EMG activity were seen during successive cycles. Consequently during a
      specific sensitive phase of the sinus tibialis anterior EMG, responses are evoked
      in which strength depended on the velocity of the optical flow pattern. The
      modulation of the extensor activity is necessary for a 'resetting' of the neutral
      body position.

PMID- 1633286
TI  - Genetically engineered toxins.

PMID- 1633287
TI  - The structure of plant toxins as a guide to rational design.

PMID- 1633288
TI  - Chemical and genetic characterization of the enzymatic activity associated with
      ricin A chain.

PMID- 1633289
TI  - Chimeric proteins containing ricin A chain.

PMID- 1633290
TI  - Studies on ribosome-inactivating proteins from Saponaria officinalis.

PMID- 1633291
TI  - Cloning and expression of trichosanthin and alpha-momorcharin cDNA.

PMID- 1633292
TI  - Cloning and expression of a Luffa ribosome-inactivating protein-related protein.

PMID- 1633293
TI  - The Aspergillus ribonucleolytic toxins (ribotoxins).

PMID- 1633294
TI  - An efficient expression system for alpha-sarcin in Escherichia coli.

PMID- 1633295
TI  - Diphtheria toxin cloning and expression in Corynebacterium diphtheriae.

PMID- 1633296
TI  - Genetically engineered toxins. General methods.

PMID- 1633297
TI  - Diphtheria toxin expression in Escherichia coli.

PMID- 1633298
TI  - The structure of diphtheria toxin as a guide to rational design.

PMID- 1633299
TI  - Protein engineering of diphtheria toxin. Development of receptor-specific
      cytotoxic agents for the treatment of human disease.

PMID- 1633300
TI  - In vivo studies with chimeric toxins. Interleukin-2 fusion toxins as
      immunosuppressive agents.

PMID- 1633301
TI  - Initial clinical experiences with an interleukin-2 fusion toxin (DAB486-IL-2).

PMID- 1633302
TI  - Pseudomonas aeruginosa exotoxin A.

PMID- 1633303
TI  - Expression of growth factor-toxin fusion proteins.

PMID- 1633304
TI  - Cloning strategies.

PMID- 1633305
TI  - The structure of Pseudomonas exotoxin A as a guide to rational design.

PMID- 1633307
TI  - Genetically engineered toxins in perspective.

PMID- 1633306
TI  - Generation of chimeric toxins.

PMID- 1633308
TI  - Appendix. Primary amino acid sequences of toxins.

PMID- 1633309
TI  - Protein engineering strategies.

PMID- 1633310
TI  - General strategies in in vivo animal modeling.

PMID- 1633311
TI  - Molecular cloning of ricin.
AB  - A variety of strategies have been used to obtain cDNA and genomic clones encoding
      ricin. Since their isolation these sequences have been manipulated to allow
      expression of A chain (19) and A chain mutants (15,20,34), B chain (14,21-23) and
      proricin (24). Utilizing structural information (35), precise changes have been
      introduced into both A and B chains with the aim of probing catalytic and sugar
      binding residues, respectively. In the longer term, such manipulations, coupled
      with successful expression and purification schemes, will allow the delineation
      of functional residues and domains, ensuring that ricin remains the prototype
      plant toxin with which to study cellular intoxication and ribosome inactivation
      and to utilize in pharmaceutical product development.

PMID- 1633312
TI  - Expression of plant-derived ribosome-inactivating proteins in heterologous
      systems.

PMID- 1633313
TI  - Ontogenetic aspects of the intestinal immune system in man.
AB  - The development of the mucosal immune system in the human fetus has been studied
      in some detail. Aggregates of T and B cells form early Peyer's patches by 16
      weeks gestation and by 19 weeks organised Peyer's patches with T and B cell zones
      are seen. T cells populate the mucosal lamina propria and epithelium from 11
      weeks gestation and increase in number thereafter. As in the adult, most
      intraepithelial lymphocytes are CD8+ and most lamina propria T cells are CD4+. By
      20 weeks, villus epithelial cells are HLA-DR+ and secretory component is also
      expressed. In the absence of lumenal stimulation in the fetus there is no
      intestinal secretory IgA antibody response. A few IgA plasma cells are present in
      fetal salivary glands but the number does not dramatically increase until after
      birth.

PMID- 1633314
TI  - Autoimmune mechanisms in the pathogenesis of the acquired immunodeficiency
      syndrome.

PMID- 1633315
TI  - Bispecific antibodies and retargeted cellular cytotoxicity: novel approaches to
      cancer therapy.
AB  - We have used a relatively new technology to increase the number of human
      lymphocytes that will react with human ovarian carcinoma cells. This technology,
      often called "retargeting of the immune system," can temporarily redirect the
      activity of immune cells that were originally committed to react with foreign
      substances other than cancer cells. In the example presented here, the antitumor
      effects of retargeted human T lymphocytes, collected from normal donors, were
      tested in immunodeficient mice with a human ovarian carcinoma line growing
      intraperitoneally. We retargeted T cells in vitro with a bispecific antibody that
      reacted with the T cell receptor complex and with a cell-surface antigen
      expressed by the ovarian carcinoma cells. Retargeted lymphocytes, injected
      intraperitoneally into mice 4 days after intraperitoneal injection of the tumor
      cells, impeded tumor growth and doubled the host survival time. These findings
      provide support for the concept that treatment of ovarian cancer patients with
      retargeted T cells could prove beneficial.

PMID- 1633316
TI  - Bifunctional antibodies and their potential clinical applications.
AB  - Bifunctional antibodies are monovalent, bispecific, antibody-derived molecules.
      They have been produced by both chemical and biological means. They are thought
      to have several advantages over monoclonal antibodies in both immunotherapy and
      immunodiagnosis. Bifunctional antibodies have been shown to be efficient in the
      targeting of drugs, toxins, radiolabelled haptens and effector cells on to
      diseased tissues, primarily cancer cells. In addition, bifunctional antibodies
      have been used to develop novel immunoassays. The full potential of bifunctional
      antibodies has yet to be realised.

PMID- 1633317
TI  - Anti-idiotype vaccines in toxicology.
AB  - The majority of naturally occurring biological and chemical toxins are highly
      lethal, nonproteinaceous, low molecular weight substances which exert their
      toxicity through a variety of mechanisms. Their relative small size and extreme
      in vivo toxicity have hampered the development of protective vaccines. We have
      investigated the feasibility of anti-idiotype-based vaccines which utilize
      antibodies for inducing a systemic and protective immunity against the in vivo
      toxicity of some of these toxic substances. A murine IgG1 monoclonal anti-T-2
      mycotoxin antibody protective against mycotoxin toxicity was generated. This
      antibody was used to produce a second generation monoclonal anti-idiotype
      antibody which was capable of serologically mimicking the tertiary conformation
      of the nominal antigen, i.e., T-2 mycotoxin. Administration of the monoclonal
      anti-idiotype antibody to mice induced a circulating and protective antibody
      response against the in vitro and in vivo toxicity of T-2 mycotoxin. Antibody
      based vaccines may represent the only safe and effective strategy for the design
      of protective vaccines against small nonproteinaceous toxic compounds whose
      extreme toxicity prevents their use as safe immunogens. The potential of antibody
      based vaccines for producing protective immunity against low molecular weight
      chemical and biological toxins is discussed.

PMID- 1633318
TI  - A method for detecting specific anti-C100 protein antibodies of IgM isotype in
      hepatitis C virus infection.
AB  - A method for the determination of specific IgM antibodies to C100 protein, a
      hepatitis C virus-associated antigen, was developed which employed fractionation
      of serum proteins by gel chromatography and an enzyme-linked immunosorbent assay.
      Detection of IgM anti-C100 proved to be specific and reproducible in purified IgM
      fractions. Separation of IgM from IgG was necessary before IgM could be measured,
      because of the detrimental effect of the simultaneous presence of IgG antibodies
      with anti-C100 rectivity on IgM determination. IgM anti-C100 was not found in
      sera containing rheumatoid factors or IgM antibodies to other hepatotropic
      viruses. IgM anti-C100 was detected in 19 (44%) of 43 patients with hepatitis C
      virus-related chronic liver disease. When compared with the histological picture
      of liver disease, IgM anti-C100 was absent in patients with minimal changes and
      was most common (66.7%) in patients with progressive disease. It is suggested
      that IgM anti-C100 could reflect an active state of hepatitis C virus infection.

PMID- 1633319
TI  - Blood zinc status and zinc treatment in human immunodeficiency virus-infected
      patients.
AB  - We investigated the zinc concentration in blood and the effect of zinc
      supplementation in 11 male outpatients seropositive for human immunodeficiency
      virus at stage 5 according to the Walter Reed classification. Zinc concentration
      was measured in serum, platelets, mononuclear and polymorphonuclear cells, and
      erythrocytes. There was a significant increase in serum zinc concentration after
      zinc administration, but the zinc level in blood cells remained unchanged. All
      patients showed a progressive gain in body weight and a slight elevation in
      levels of CD4+ cells. No adverse side-effects were noticed.

PMID- 1633320
TI  - Serum beta 2-microglobulin levels and p24 antigen, lymphocyte depletion and
      disease progression in human immunodeficiency virus infection.
AB  - Abnormally elevated serum beta 2-microglobulin levels have been associated with
      progression of human immunodeficiency virus disease. In this study we have
      analyzed the relationship between serum beta 2-microglobulin levels of patients
      at different stages of the disease and serological and immunological parameters
      commonly used for monitoring the infection. The investigation was performed on
      150 patients and 30 controls during the period from March 1989 to March 1990. At
      that time, 30 patients had the acquired immunodeficiency syndrome or its related
      complex and 120 had persistent generalized lymphadenopathy or were asymptomatic.
      Thirty-nine antibody-negative subjects, belonging to a high-risk group for the
      acquired immunodeficiency syndrome, were used as controls. All patients had
      normal renal function. There was a significant relationship between increased
      serum beta 2-microglobulin levels and the presence of p24 antigen, a decrease in
      the total number of lymphocytes (less than or equal to 1500/mm3) and a decrease
      in CD4+ T lymphocytes (less than or equal to 200/mm3). No significant
      relationship between serum beta 2-microglobulin levels and CD3+ T lymphocytes was
      found.

PMID- 1633321
TI  - Hypereosinophilic syndromes: an update.

PMID- 1633322
TI  - Relation of cathepsin D level to the estrogen receptor in human breast cancer.
AB  - Seventy-three primary human breast cancers were analyzed to assess the presence
      of estrogen and progesterone receptors, the p29 protein, and the total cathepsin
      D status. No significant relationship was found between cathepsin D concentration
      and the presence of ER or PR, either by Fisher's exact test or Spearman's rank
      correlation (P greater than 0.1). However, a significant association was found
      between cathepsin D and p29 (Fisher's exact test, P less than 0.001) and between
      cathepsin D and steroid receptor status in samples expressing both estrogen and
      progesterone receptors (positive by steroid binding assay and enzyme immunoassay)
      (P less than 0.05). This association was more significant in tissues expressing
      estrogen and progesterone receptors as well as p29 (P less than 0.001). In
      contrast, cathepsin D synthesis was not related to tumor size, lymph node
      involvement, or patient's age (P greater than 0.05). Steroid receptors and
      cathepsin D were also assayed in samples of non-malignant tissue from 16
      mastectomies; there was a significantly higher relative concentration of
      cathepsin D in the malignant specimens (Student's t-test, P less than 0.001).

PMID- 1633323
TI  - Bleeding time and antiplatelet agents in normal volunteers.
AB  - Clinical trials have shown that antiplatelet agents are effective in the
      prevention of thrombosis in arterial diseases and increase bleeding time. To
      compare the effects of three such drugs [acetylsalicylic acid (ASA) at two dose
      levels, ticlopidine and indobufen] on bleeding time, we performed a randomized
      cross-over study on 12 normal subjects. All received the four treatments (ASA 300
      mg daily and 500 mg twice daily, ticlopidine 250 mg twice daily and indobufen 200
      mg twice daily, each for 6 days plus one dose on day 7) in a sequential manner
      with a washout period of 15 days between the treatments. Bleeding time was
      measured using a Surgicut device (Ortho, Milan, Italy) before treatment, 2 and 24
      h after the first administration, and before and 2, 24, 48 and 72 h after the
      last administration. ASA (at both doses) and indobufen quickly induced a
      significant prolongation of bleeding time, but the effect of indobufen soon wore
      off after the treatment was stopped, unlike that of ASA. In contrast, ticlopidine
      treatment prolonged bleeding time only after the first 24 h, and after 7 days the
      mean value was significantly higher than with ASA (both doses) and indobufen.
      This significant difference in bleeding time between ticlopidine and the other
      drugs was still present 48 h after the end of treatment.

PMID- 1633324
TI  - Fluorescent labelling of sequencing primers for automated oligonucleotide
      synthesis.
AB  - A fluorescein derivative is described which can be used as a normal
      phosphoramidite in oligonucleotide synthesis, giving high yields of fluorescein
      labelled sequencing primers. The labelled primers were used in automated DNA
      sequence analysis without modification of existing protocols, the computer
      processed sequences being reproducibly readable up to 400 bases. The procedure
      described makes the fluorescent labelling of oligonucleotides much easier, and
      the time of labelling can be significantly reduced. It speeds up the "primer
      walking" approach of automated DNA sequencing.

PMID- 1633325
TI  - DNA sequencing by a subcloning-walking strategy using a specific and semi-random
      primer in the polymerase chain reaction.
AB  - In its basic concept, in vitro DNA amplification by the polymerase chain reaction
      (PCR) is restricted to those instances in which segments of known sequence flank
      the fragment to be amplified. Recently, techniques have been developed for
      amplification of unknown DNA sequences. These techniques, however, are dependent
      on the presence of suitable restriction endonuclease sites. Here, we describe a
      strategy for PCR amplification of DNA that lies outside the boundaries of known
      sequence. It is based on the use of one specific primer, homologous to the known
      sequence, and one semi-random primer. Restriction sites in the 5' proximal
      regions of both primers allow for cloning of the amplified DNA in a suitable
      sequencing vector or any other vector. It was shown by sequence analysis that the
      cloned DNA fragments represent contiguous DNA fragments that are flanked at one
      side by the sequence of the specific primer. When omitting the semi-random
      primer, a single clone was obtained, which originated from PCR amplification of
      target DNA by the specific primer in both directions.

PMID- 1633326
TI  - Rapid and reliable fluorescent cycle sequencing of double-stranded templates.
AB  - Automated DNA sequencing is an extremely valuable technique which requires very
      high quality DNA templates to be carried out successfully. While it has been
      possible to readily produce large numbers of such templates from M13 or other
      single-stranded vectors for several years, the sequencing of double-stranded DNA
      templates using the ABI 373 DNA Sequencer has had a considerably lower success
      rate. We describe how the combination of a new fluorescent, dideoxy sequencing
      method, called cycle-sequencing, coupled with modifications to template isolation
      procedures based on Qiagen columns, makes fluorescent sequencing of double
      stranded templates a reliable procedure. From a single five milliliter culture
      enough DNA can be isolated (up to 20 micrograms) to do 4-8 sequencing reactions,
      each of which yields 400-500 bases of high quality sequence data. These
      procedures make the routine use of double-stranded DNA templates a viable
      strategy in automated DNA sequencing projects.

PMID- 1633327
TI  - Conserved signals in the 5' flanking region of eukaryotic nuclear tRNA genes.
AB  - The statistical analysis of 5' flanking regions of eukaryotic tRNA genes was
      done. The analysis of nucleotides in the sequence of fungi and invertebrates
      showed a high content of A and T in the flanking regions versus coding regions
      where G and C dominate. In contrast to these results in vertebrates sequences the
      preferences of any nucleotide in flanking regions was not observed. The analysis
      of tetrads showed five conserved signals: TTGT, (T/A)(T/A)ATA, A(C/T)(C/A)A in
      the tRNA genes of fungi, (A/T)TGA of invertebrates and (A/T)GAG of vertebrates.
      The analysis of 3' flanking regions did not show any conserved signals except
      well known poly-T tracks.

PMID- 1633329
TI  - Characterization of the primate-specific repetitive DNA element MER1.
AB  - Computer analyses of the 3'-flanking DNA sequence of the human elastase I gene
      revealed a significant degree of similarity with seven human gene sequences in
      the GenBank and EMBL databases. Genomic Southern analysis indicates that the
      shared nucleotide sequences are a primate-specific family of short interspersed
      elements. These elements are members of MER1 sequences (medium reiteration
      frequency sequences). The consensus sequence of MER1 repeats spans 543
      nucleotides and contains several inverted repeats. Since the copy number of MER1
      elements seems to be much smaller than that of Alu and L1 repeats, MER1 elements
      may provide useful landmarks marks for human genome mapping.

PMID- 1633328
TI  - Genomic organization of the human homologue of the rat pancreatic elastase I
      gene.
AB  - The homologue of the rat pancreatic elastase I gene was found in the human
      genome, but its transcription was completely suppressed in the adult human
      pancreas as we reported previously. In this study, we characterized the complete
      structure of the eight putative exons of the silent gene for human elastase I. A
      genotype analysis of the exon 1 DNA sequence revealed that at least two allelic
      elastase I genes are present in human genomes. A primate-specific repetitive DNA
      element (MER1) was identified in the 3'-flanking region of the human elastase I
      gene. The primary structure of human preproelastase I, deduced from the sequences
      of the eight exons, showed an 89% identity with that of porcine or rat pancreatic
      preproelastase I. The amino acid residues of the serine protease catalytic triad
      and the eight cysteine residues conserved in the elastase family were present at
      positions equivalent to those observed in porcine and rat elastase I, suggesting
      that the gene product may function as an elastolytic enzyme if this gene is
      expressed in any tissue.

PMID- 1633331
TI  - A memorial issue to Bernard L. Diamond.

PMID- 1633330
TI  - Difference in the genomic organizations of the related transcription factors Sp1
      and Krox-20; possible evolutionary significance.
AB  - We report here part of the genomic sequence of the mouse homolog of the human
      gene encoding the transcription factor Sp1. This gene belongs to a subfamily of
      zinc finger proteins, which includes another transcription factor, Krox-20. The
      analysis of the mouse Sp1 nucleotide sequence revealed that (i) the C-terminal
      part of the protein is conserved between man and mouse, consistent with a
      possible role in transcriptional activation; (ii) while the there Krox-20 zinc
      fingers are encoded by a unique exon, an intron separates the regions encoding
      fingers 2 and 3 of Sp1. On the basis of this latter observation, we propose a
      model for the evolution of the Sp1/Krox-20 gene family which might shed some
      light on the role of introns in the evolution of modular proteins.

PMID- 1633332
TI  - In memoriam: Bernard L. Diamond December 8, 1912-November 18, 1990.

PMID- 1633333
TI  - The forensic psychiatrist: consultant versus activist in legal doctrine.

PMID- 1633334
TI  - A personal view of the ethics and values of Bernard L. Diamond.

PMID- 1633335
TI  - "The Fallacy of the Impartial Expert" revisited.
AB  - This article, in memory of Bernard Diamond, revisits his seminal editorial on the
      "Fallacy of the Impartial Expert." In a later article he formulated his thesis
      most succinctly: "There is no such thing as an impartial expert witness; the
      objectivity of the expert witness is largely a myth." I argue that the
      implications of his challenging assertion have as yet not been fully recognized.
      Ultimately, they also invite a revision of the American Academy of Psychiatry and
      Law's Guidelines for the Practice of Forensic Psychiatry. The Guidelines should
      emphasize more than they do experts' commitment to honesty and to informing fact
      finders about the extent and limits of their scientific knowledge, the facts on
      which their opinions are based, as well as the scientific and value assumptions
      that underlie their testimony.

PMID- 1633336
TI  - Forensic psychiatry: the need for self-regulation.
AB  - The shortcomings of forensic psychiatrists in the courtroom fall into two
      categories: failure to meet expected levels of performance in evaluation and
      testimony; and unethical behavior or deliberate misfeasance. Legal mechanisms for
      controlling the quality of testimony have been inadequate to the task. Courts
      rarely make use of their powers to screen expert witnesses with care; and post
      hoc remedies, such as malpractice actions or charges of perjury, are almost
      unheard of. Psychiatry has been equally ineffective to date in responding to
      these problems, with educational programs usually reaching those least in need of
      help, and ethical codes either not addressing forensic issues or lacking powers
      of enforcement. Each class of problem calls for a distinct response. Inadequate
      performance in forensic work can be monitored and corrected by implementation of
      a program of peer review of forensic testimony. Preliminary attempts indicate the
      feasibility and utility of this effort. Unethical behavior, on the other hand,
      should be addressed by clear standards of forensic ethics, enforced by the
      relevant professional organizations. Forensic psychiatry bears the responsibility
      of cleaning its own house.

PMID- 1633337
TI  - Professional versus personal ethics: methods for system reform?
AB  - It has been suggested that changes in, and more vigorous enforcement of,
      professional ethical codes might lead to significant improvements in the quality
      of expert testimony by mental health professionals. The author examines the
      arguments for and against this thesis, and concludes that lack of consensus on
      controversial issues is likely to impede implementation and enforcement of
      meaningful ethical codes. He argues that attempts to educate the courts and
      legislatures through writings, testimony, and interdisciplinary teaching are more
      likely to be effective for the foreseeable future.

PMID- 1633338
TI  - Diminished capacity as an alternative to McNaghten in California law.
AB  - Dr. Diamond's courageous defense of the diminished capacity plea in People v.
      Gorshen (1959) emphasized mental disturbances negating malice aforethought.
      Diminished capacity as a defense in California remained effective from 1978 to
      1982 until overturned by a modified American Law Institute rule. Diamond's
      advocacy of psychologic elements, including motivation, did much to enliven
      forensic thinking re: the death sentence and the fated diminished capacity
      defense.

PMID- 1633339
TI  - "Therapist-patient sex syndrome": the perils of nomenclature for the forensic
      psychiatrist.
AB  - The escalating problem of sexual misconduct has heightened clinicians' awareness
      of the consequences of therapist-patient sexual relations. One consciousness
      raising device, the definition of "therapist-patient sex syndrome," may pose more
      problems than remedies in the forensic, rather than clinical context. The author
      reviews the conceptual, diagnostic, and teleological dimensions of this addition
      to diagnostic nomenclature.

PMID- 1633340
TI  - "A terror to their neighbors": beliefs about mental disorder and violence in
      historical and cultural perspective.
AB  - This tribute to the enduring legacy of Bernard Diamond explores public
      perceptions of a link between mental disorder and violent behavior. Research on
      contemporary American beliefs is summarized and compared both to historical
      accounts of public perceptions in Western cultures and to anthropological
      investigations of public perceptions in non-Western cultures. The conclusion of
      these reviews is that the belief that mental disorder bears some moderate
      association with violent behavior is both historically invariant and culturally
      universal.

PMID- 1633341
TI  - The death penalty and Bernard Diamond's approach to forensic psychiatry.
AB  - Bernard Diamond would testify only for the defense in criminal cases, but only if
      the whole psychiatric truth would be introduced during a trial and the facts of
      the case supported the defense position. Otherwise, he would refuse to
      participate. Although few other forensic psychiatrists have personal or
      professional ethical concerns regarding ever participating for the prosecution,
      many more have such problems in capital cases. Bernard Diamond's approach to
      forensic psychiatry should be considered at least as an option by those opposed
      to the death penalty. Bias in capital cases is not a persuasive reason to
      withdraw from involvement if the forensic psychiatrist remains honest.

PMID- 1633342
TI  - The evolution of legal methods for dealing with mind-state in crimes.
AB  - From its very beginnings, British and American common law have attempted to deal
      with the mind-state of perpetrators of crime. This has taken various procedural
      and statutory forms that have often been characterized by confusion and
      contradictions in purpose. Clarification of the psychological and legal issues
      may assist in bringing the criminal treatment process to a more rational basis.

PMID- 1633343
TI  - Clinical assessment of the voluntariness of behavior.
AB  - There are a variety of therapeutic and forensic contexts in which the clinician
      is called upon to assess the voluntariness of behavior. Because the assessment
      has such complex moral and scientific dimensions, it has been difficult to
      conceptualize how it is done. By considering the behavior of clinicians and other
      relevant theoretical issues, the author has prepared a framework for thinking
      about the assessment of voluntariness. The relevance of diagnostic and
      philosophical issues is considered. Most of the factors which influence
      assessment are related to the nature of the patient's pathological experience,
      hypotheses of causation, and method of treatment. Dr. Diamond had a deep interest
      in questions of voluntariness and responsibility. I know that he would have
      disagreed with, at least, some of the material, but I believe that he would have
      thoroughly enjoyed discussing and arguing the issues. I know that I would have
      loved the dialogue.

PMID- 1633344
TI  - Nocturnal blood pressure monitored by ambulatory blood pressure measurement in
      elderly hypertensive patients.
AB  - This study was designed to characterize the nocturnal fall of blood pressure
      (NFBP) of elderly hypertensive patients (EH), with or without cerebrovascular
      disease or diabetes mellitus, as measured by automated blood pressure (BP)
      monitoring. Systolic and diastolic BP and heart rate was measured every 15
      minutes in 133 hospitalized patients with nearly similar schedules and diets. The
      patients were divided into five groups: I, normotensive elderly patients over age
      65: II, EH without cardiovascular diseases, controlled without medication: III,
      EH with cerebral infarction, chronic stage: IV, EH with noninsulin-dependent
      diabetes mellitus: and V, hypertensives under age 65, without cardiovascular
      diseases. A significant NFBP was observed in the patients of groups I and V, a
      significant but smaller NFBP in the hypertensives of groups II and IV, and no
      NFBP in the patients of group III. Administration of the antihypertensive drugs,
      enalapril and nifedipine, tended to augment the NFBP. These preliminary
      observations showed that NFBP did occur in elderly hypertensives but the fall was
      smaller than that observed in younger hypertensives or elderly normotensives.
      Although the ambulatory BP measurements were useful in the overall clinical
      evaluation of elderly patients, NFBP in elderly patients was affected by
      hypertensive drugs and therefore NFBP should be interpreted with caution.

PMID- 1633345
TI  - Diurnal change in heart rate variability in healthy and diabetic subjects.
AB  - We assessed the hourly coefficient of variance of RR intervals (CVRR) in 29
      subjects with non-insulin-dependent diabetes mellitus and 19 age-matched healthy
      subjects using an ambulatory 24-hour ECG monitoring system. We also evaluated
      CVRR during 100 beats in both groups in the supine posture at 07:00 and 10:00 in
      the morning. Hourly CVRR showed an overt diurnal variation in both groups
      especially in the daytime and at midnight, but was significantly lower (p less
      than 0.05) in diabetic patients. CVRR during resting 100 beats at 07:00 was
      significantly higher (p less than 0.05) than that at 10:00 in both groups. These
      findings indicate that HRV shows an obvious diurnal variation in both groups. As
      a steep and marked change occurs in the morning, careful consideration is
      necessary to assess the test performed for a short time span at random times
      throughout the day, particularly in the morning.

PMID- 1633346
TI  - Diffuse pulmonary alveolar hemorrhage in acute promyelocytic leukemia.
AB  - A 60-year-old male with acute promyelocytic leukemia demonstrated bilateral
      diffuse air-space consolidation on chest X-ray. An autopsy on the next day
      revealed pure pulmonary alveolar hemorrhage without leukemic infiltration or
      inflammation. Disseminated intravascular coagulation was confirmed
      microscopically. In severe hemorrhagic diathesis and leukopenia, it is impossible
      to distinguish pulmonary hemorrhage from pneumonia by X-ray alone. Bronchalveolar
      lavage may be the only possible diagnostic approach.

PMID- 1633347
TI  - A case of papillary carcinoma of the thyroid associated with parathyroid adenoma
      without hyperparathyroidism.
AB  - A rare occurrence of the association of parathyroid adenoma in a case of thyroid
      papillary carcinoma is described. The patient was incidentally found to have
      parathyroid adenoma which was preoperatively diagnosed to be a metastatic lymph
      node. Analysis of her serum obtained before operation showed an elevation of
      serum parathyroid hormone (PTH) concentration without hypercalcemia. Since the
      association of hyperparathyroidism is high in patients with thyroid diseases,
      examination of not only serum levels of calcium and PTH but also careful
      interpretation of computed tomography (CT) and/or nuclear magnetic imaging (MRI)
      is necessary in the diagnosis of co-existing asymptomatic hyperparathyroidism.

PMID- 1633348
TI  - Syndrome of inappropriate secretion of antidiuretic hormone associated with
      multiple sclerosis.
AB  - A 63-year-old man who developed episodes of the syndrome of inappropriate
      secretion of antidiuretic hormone (SIADH) twice in the course of multiple
      sclerosis (MS) is reported. SIADH in this patient occurred only during the
      administration of antibiotics (sulbactam/cefoperazone, SBT/CPZ). At autopsy,
      demyelinating lesions in the optic nerves, cervical and thoracic spinal cord, and
      areas adjacent to the lateral ventricles were observed. Destruction and loss of
      neuronal cells were found in the supraoptic nuclei. Lymphocytic infiltration was
      observed in the area adjacent to the supraoptic nuclei. Destruction and swelling
      of axons and reactive astrocytic gliosis were observed in the hypothalamus. SIADH
      associated with MS is rare and the histological findings in such a case have not
      yet been reported. It is suggested that the development of SIADH in MS may be
      related to the damage in the supraoptic nuclei of the hypothalamus.

PMID- 1633349
TI  - Acute adrenal insufficiency due to symptomatic Rathke's cleft cyst.
AB  - A 65-year-old Japanese man who suffered from secondary hypopituitarism due to
      Rathke's cleft cyst is reported. Although computed tomography failed to detect
      any pituitary abnormality, magnetic resonance imaging demonstrated the presence
      of a cystic intrasellar mass, initially suggesting craniopharyngioma or abscess.
      Operative findings revealed Rathke's cleft cysts within the pituitary fossa which
      resulted in secondary hypopituitarism. Among cases of secondary hypopituitarism
      with abnormal findings in the pituitary, symptomatic Rathke's cleft cysts should
      be included in the differential diagnosis of adrenal insufficiency.

PMID- 1633350
TI  - Four Japanese cases of episodic angioedema with eosinophilia.
AB  - Here we describe four young Japanese women aged 25-33 years, whose clinical
      findings are characterized by episodic angioedema, marked leukocytosis with
      eosinophilia, benign course with spontaneous remission or low-dose prednisolone
      treatment. The recognized causes of eosinophilia, such as allergy, parasite, and
      collagen diseases, and the causes of edema, such as heart, kidney, and liver
      diseases, were ruled out. The findings in these patients are very similar to
      those reported as episodic angioedema with eosinophilia, which is clearly
      distinct from the so-called hypereosinophilic syndrome. We suggest that this
      syndrome is not rare, and should be widely recognized as a new clinical entity
      for accurate and prompt diagnosis.

PMID- 1633351
TI  - Sjogren's syndrome with hydronephrosis caused by pseudolymphoma.
AB  - A 67-year-old woman with Sjogren's syndrome was found to have left hydronephrosis
      and stenosis of the left ureter. Exploratory laparotomy disclosed a nodule at the
      ureteropelvic junction of the left ureter. Histopathological examinations of the
      biopsied specimen of this nodule showed lymphoid hyperplasia within the ureteral
      wall. Low dose prednisolone improved hydronephrosis and pseudolymphoma within
      several months. Hydronephrosis secondary to pseudo-lymphomatous infiltration of
      the ureter is a rare but, if properly treated, reversible complication of
      Sjogren's syndrome.

PMID- 1633352
TI  - A case of anorexia nervosa with acute renal failure induced by rhabdomyolysis;
      possible involvement of hypophosphatemia or phosphate depletion.
AB  - A 16-year-old girl with anorexia nervosa first presented with malnutrition, liver
      dysfunction, and rhabdomyolysis. Administration of fluid and nutrition saved her
      from the initial critical state, but acute renal failure followed. Laboratory
      examination revealed intrinsic renal failure induced by rhabdomyolysis. Latent
      phosphate depletion and refeeding-induced hypophosphatemia was implicated as the
      cause of rhabdomyolysis; however coexisting hypotension, dehydration, and liver
      dysfunction may have contributed to the renal failure. The patient recovered from
      azotemia by hemodialysis. This is the first reported case of anorexia nervosa
      with acute renal failure resulting from rhabdomyolysis induced by
      hypophosphatemia or phosphate depletion.

PMID- 1633353
TI  - Sideroblastic anemia associated with multiple myeloma in Turner's syndrome.
AB  - A 67-year-old female was admitted to our hospital because of pancytopenia. Forty
      six percent of erythroblasts in the bone marrow were ringed sideroblasts.
      Laboratory findings showed an IgG-kappa monoclonal gammopathy. She was diagnosed
      as having sideroblastic anemia associated with multiple myeloma in mosaic (45,
      X/46, XX/47, XXX) Turner's syndrome. There was no response to therapy. The
      chromosomal pattern of the patient was varied, and was accompanied by the
      development of refractory anemia with an excess of blasts from refractory anemia
      with ringed sideroblast 4 months after presentation. Cytogenetic studies
      suggested that the abnormal clone was restricted to the monosomic cell line.

PMID- 1633354
TI  - Electrical alternans of the T-U wave without change in the QRS complex.
AB  - A patient with myelocytic leukemia who showed electrical alternans of the T-U
      wave with no change in the QRS complex following chemotherapy is described.
      Electrocardiogram taken 4 days later showed ventricular quadrigeminy in which the
      T-U wave of the first sinus beat after the ventricular premature contraction was
      markedly less prominent compared to the successive two sinus beats which showed
      marked prolongation and inverted T-U waves. The causative factors for alternans
      of T-U waves may include hypochloremic alkalosis with hypopotassemia and
      myocardial damage by anticancer drugs such as daunomycin and aclarubicin chloride
      used for the underlying disease.

PMID- 1633355
TI  - Multiple osteomyelitis due to Mycobacterium avium with no pulmonary presentation
      in a patient of sarcoidosis.
AB  - A 31-year-old man with multiple osteomyelitis due to Mycobacterium avium is
      reported. The patient had been on prednisolone for systemic lymphadenopathy which
      was thought to be caused by sarcoidosis. In June 1990, he noticed high fever and
      general bone pain. He was found to have multiple lytic lesions in the bones which
      were biopsied showing acid-fast bacilli. This organism was revealed to be M.
      avium. The chest radiograph film revealed no abnormal pulmonary findings.
      Multiple bone lesions in the absence of pulmonary disease is reported to be rare
      for atypical mycobacterial infection.

PMID- 1633356
TI  - Development of rheumatoid arthritis after chronic hepatitis caused by hepatitis C
      virus infection.
AB  - We describe a patient with rheumatoid arthritis (RA) who had preceding evidence
      of post-transfusion, non-A, non-B hepatitis. The patient showed positive
      serological tests for anti-hepatitis C virus (HCV) antibody. The manifestations
      of RA, including progressive polyarthritis and positive serum rheumatoid factors,
      emerged after the ameriolation of hepatitis and persisted for more than 3 years,
      indicating that the polyarthritis in this patient was not the prodrome of the
      hepatitis. This patient had HLA-DR4 and HLA-Bw54 which are found to be strongly
      associated with RA in Japan. It is therefore suggested that HCV may trigger the
      development of RA especially in genetically susceptible individuals.

PMID- 1633357
TI  - A case of malignant lymphoma accompanied by Klinefelter's syndrome.
AB  - A 66-year-old Japanese male with diffuse non-Hodgkin's lymphoma, of the
      pleomorphic type, complicated with Klinefelter's syndrome is reported. His
      phisique was characterized by a long arm span, disproportionately longer lower
      body dimensions and a small sized penis. He had no children. Chromosomal study
      revealed 47, XXY and hormonal quantification showed hypergonadtropic
      hypogonadism. Although chemotherapy was administered, his disease took a
      progressive course and he died. A discussion of chromosomal alteration and
      oncogenesis and review of the literature are included.

PMID- 1633359
TI  - An outbreak of Legionnaires' pneumonia in a nursing home.
AB  - An outbreak of Legionnaires' pneumonia occurred at a nursing home in December
      1990. A 79-year-old female and a 73-year-old male clerk who were staying at the
      nursing home developed pneumonia with only a 5-day interval. Legionella
      pneumophila serogroup I was isolated from transtracheal aspirate of the former
      and sputum of the latter. After treatment with a combination of erythromycin and
      rifampicin both patients improved. Serological surveillance of inpatients and
      staff of the nursing home was performed in February 1991. Seven out of 51 samples
      (14.0%) showed a titer higher than 1:128 of anti-Legionella pneumophila serogroup
      I antibody determined by indirect immunofluorescence; two of these seven
      complained of respiratory symptoms. Molecular epidemiology analyzed by
      restriction endonuclease digestion of isolated L. pneumophila showed an identical
      pattern which suggested a common origin.

PMID- 1633358
TI  - Ticlopidine treatment in idiopathic plasmacytic lymphadenopathy with polyclonal
      hyperimmunoglobulinemia accompanied by nephrotic syndrome.
AB  - A 36-year-old woman was admitted for idiopathic plasmacytic lymphadenopathy with
      polyclonal hyperimmunoglobulinemia (IPL) associated with nephrotic syndrome. She
      was expected to lapse into renal failure because renal biopsy showed focal
      glomerulosclerosis. VEMP chemotherapy and bolus methyl prednisolone were not
      effective against excessive urine protein of over 10 g/day. We thus began
      administration of ticlopidine (6 mg/kg/day), prednisolone (0.4 mg/kg/day) and
      cyclophosphamide (1 mg/kg/day). After 3 months of this regimen, the urine protein
      level decreased to less than 0.5 g/day, and renal function was maintained for
      more than 3 years. It is suggested that ticlopidine is effective for nephropathy
      complications associated with IPL.

PMID- 1633360
TI  - Primary epidural non-Hodgkin's lymphoma in clinical stage IEA presenting with
      paraplegia and showing complete recovery after combination therapy.
AB  - A 70-year-old man was admitted to our hospital because of paraplegia. A spinal
      epidural tumor (Th VII-XI) was diagnosed by magnetic resonance imaging and
      resected. Histological examination of the tumor showed non-Hodgkin's lymphoma of
      the diffuse large cell type (Lymphoma Study Group classification), with a B cell
      phenotype. The clinical stage was IEA by the Ann Arbor classification. Radiation
      therapy of the involved field was performed (total dose: 40 Gy), followed by six
      courses of modified cyclophosphamide, adriamycine, vincristine, prednisolone
      (CHOP) therapy. He was discharged walking unaided 10 months later and has shown
      no evidence of relapse in the 26 months since discharge.

PMID- 1633362
TI  - A patient with protein-losing enteropathy associated with systemic lupus
      erythematosus.
AB  - A 46-year-old woman previously diagnosed as having systemic lupus erythematosus
      presented with severe hypoalbuminemia and anasarca. She was demonstrated to have
      protein-losing enteropathy without any other active symptoms of SLE. Her bowel
      habit was normal and endoscopic examination revealed non-specific colitis and a
      small ulcer in the duodenum. Serum biochemistry showed an abnormal profile of the
      serum protein, including severe hyperlipoproteinemia and hyperfibrinogenemia. The
      process of protein-losing was not selective in terms of the molecular size. All
      of these symptoms and the abnormalities in laboratory data were improved by
      corticosteroid therapy.

PMID- 1633361
TI  - A case of common bile duct stone with cholangitis presenting an extraordinarily
      high serum CA19-9 value.
AB  - A 63-year-old male complained of right upper abdominal pain and jaundice.
      Laboratory data on admission showed hyperbilirubinemia, elevation of biliary
      enzymes and an extraordinarily high value of serum CA19-9 (60,000 U/ml).
      Diagnostic imaging modalities including abdominal ultrasonogram, abdominal CT and
      PTC suggested a stone impaction of the common bile duct. Jaundice subsided after
      PTC-drainage in association with decreasing serum CA19-9 value, which returned to
      the normal level six weeks later. Spontaneous delivery of the stone via the
      fistula was confirmed by cholangiography through the drainage tube. Though there
      are few reports of such a high serum CA19-9 level, the possibility of benign
      biliary tract disease should be considered in patients showing an extraordinarily
      high serum CA19-9 value.

PMID- 1633363
TI  - Lung cancer with eosinophilia in the peripheral blood and the pleural fluid.
AB  - A case of lung cancer associated with eosinophilia in the peripheral blood and
      pleural fluid is reported. A 55-year-old man with a tumor in the right lower lung
      lobe and right pleural effusion was admitted to Ehime University Hospital.
      Histology of specimens biopsied under a bronchoscope revealed that he had poorly
      differentiated squamous cell carcinoma. On admission, his peripheral blood
      leukocyte count was 11,500/microliters with 7.8% eosinophils and the pleural
      fluid showed a high eosinophil count (60.5%). After chemotherapy, blood
      eosinophilia disappeared and the pleural effusion was decreased with the
      reduction of the tumor. The patient's serum had the activity to stimulate
      eosinophil proliferation in human bone marrow cell culture, suggesting that the
      tumor may have produced an eosinophil proliferating factor.

PMID- 1633364
TI  - Hypertension in an adult with unilateral renal dysplasia.
AB  - We report a 29-year-old Japanese female with severe hypertension and unilateral
      renal dysplasia, which is rarely found in adults. The involved kidney was
      surgically removed and then the blood pressure fell to borderline levels without
      any changes in plasma renin activity or plasma aldosterone concentration.
      Histological examinations revealed typical renal dysplasia without hyperplasia of
      the juxtaglomerular apparatus. Unilateral renal dysplasia may be a cause of
      secondary hypertension in adults, though the mechanisms are still unknown.

PMID- 1633365
TI  - Allergic granulomatosis and angiitis with severe cardiac disease: a case in which
      cardiac function was extremely improved by long-term steroid therapy.
AB  - A 38-year-old man with a history of bronchial asthma developed marked
      eosinophilia, mononeuritis multiplex and transient pulmonary infiltration.
      Pathological findings from the lung and nerve biopsy were helpful in determining
      the diagnosis as allergic granulomatosis and angiitis (AGA). Echocardiogram
      indicated dilation of the left ventricle with impaired systolic contraction.
      Coronary arteriography demonstrated significant stenosis only in the peripheral
      segment of the circumflex artery. After 1 year of corticosteroid therapy,
      echocardiogram revealed improvement of left ventricular contractility evaluated
      by ejection fraction (from 28% to 67%). To our knowledge, no previous reports
      have described amelioration of severe cardiac lesions during long-term steroid
      treatment in patients with AGA.

PMID- 1633366
TI  - Superinfection of chronic necrotizing pulmonary aspergillosis by Mycobacterium
      tuberculosis.
AB  - A 63-year-old woman with chronic necrotizing pulmonary aspergillosis complicated
      by active pulmonary tuberculosis is reported. A small infiltrative shadow
      appeared, but no definite diagnosis was made. Six years later the shadow was
      found to have increased in size; chest CT revealed a fungus ball, while a
      transbronchial lung biopsy revealed aspergillus hyphae. The intrabronchial
      inoculation of amphotericin B proved ineffective, and a lobectomy was performed.
      Histopathologic findings showed necrotic granulomas containing aspergillus and
      some acid-fast bacilli. While the superinfection of healed tuberculous lesions by
      Mycobacteria or Aspergillus species is well documented, their coexistence is
      rare.

PMID- 1633367
TI  - Successful treatment of primary amyloidosis with dimethylsulfoxide and
      cytoreductive chemotherapy.
AB  - A 42-year-old Japanese male was admitted to our hospital because of congestive
      heart failure (CHF). A diagnosis of primary amyloidosis was made on the basis of
      a heavy deposition of amyloid in the gastric submucosal tissue in addition to the
      hematological and immunological findings. Intermittent chemotherapy in
      combination with daily oral dimethylsulfoxide (DMSO) resulted in a dramatic
      decrease of plasma cells in the marrow as well as a gradual improvement of CHF.
      With this therapy, the cardiac ejection fraction was markedly improved. This case
      indicates that the long-standing administration of DMSO combined with
      cytoreductive chemotherapy is therefore effective in treating some cases with
      primary amyloidosis.

PMID- 1633368
TI  - Successful treatment of idiopathic plasmacytic lymphadenopathy with polyclonal
      hypergammaglobulinemia.
AB  - A 51-year-old male was admitted because of eyelid edema and anosmia, which
      developed in 1985. He showed bilateral cervical lymphadenopathy, with nodes
      larger than 2 x 2 cm, and remarkable eyelid edema. Anemia,
      hyperimmunoglobulinemia with hypo-albuminemia (no M-protein) and liver
      dysfunction were found. Bone marrow, renal function, urine analysis and LDH level
      were normal. Cervical lymph node biopsy showed interfollicular proliferation of
      plasma cells without any malignant appearance. On day 3 of oral prednisolone
      (PD), anosmia abruptly improved from day 7, eyelid swelling, cervical
      lymphadenopathy and gammopathy subsided gradually. Since PD was tapered off, no
      relapse has been observed thus far.

PMID- 1633369
TI  - Multiple space-occupying lesions of the spleen in a case of Gaucher's disease.
AB  - A 50-year-old female patient was admitted because of an enormously enlarged
      spleen and thrombocytopenia. Ultrasonography and magnetic resonance imaging
      revealed multiple space-occupying lesions in the spleen. She was diagnosed as
      having Gaucher's disease based on the low level of beta-glucosidase activity in
      leukocytes and Gaucher's cells present in bone marrow aspirate. Severe
      hypersplenism necessitated splenectomy. Pathological studies of the excised
      spleen, including ultrastructural examinations, demonstrated that multiple space
      occupying lesions in the spleen were composed of typical Gaucher cells.

PMID- 1633370
TI  - Hypocalcemic cardiomyopathy in a patient with idiopathic hypoparathyroidism.
AB  - An idiopathic hypoparathyroidism-induced cardiomyopathy patient had severe long
      lasting hypocalcemia. The dramatic improvement of cardiac function with
      correction of only the serum calcium concentration could be quantitatively
      demonstrated on both echocardiogram and ventriculogram. The concentration of the
      extracellular calcium ion was considered to have a direct effect on the strength
      of the myocardial contraction through excitation-contraction coupling.
      Furthermore, elevated serum creatine phosphokinase and lactate dehydrogenase
      levels which were thought to be delivered from skeletal muscle returned to the
      normal range concomitant with the correction of hypocalcemia. The serum calcium
      concentration and these enzyme level showed significant inverse correlations.

PMID- 1633371
TI  - Primary esophageal non-Hodgkin's lymphoma.
AB  - A 77-year-old woman with primary esophageal non-Hodgkin's lymphoma in clinical
      stage IEA (Ann Arbor Classification) developed pain and difficulty in swallowing.
      An upper gastrointestinal examination revealed a submucosal tumor from the upper
      to the middle portion of the esophagus. Histopathological examination at
      endoscopic biopsy with endoscopic partial incision showed non-Hodgkin's lymphoma
      (diffuse type--large cell). Immunohistological examination of tumor cells
      disclosed LCA (+), CD3(DAKO) (+), MT1 (+), UCHL1 (+), MB1 (+), MxPanB (-) and EMA
      (-) reactivity and showed T cell lymphoma. The clinical stage was determined to
      be IEA after further work-up. Improvement of swallowing difficulty and esophageal
      findings on upper gastrointestinal series were noted after modified CHOP therapy
      and radiotherapy (total 50 Gy).

PMID- 1633372
TI  - Lyme disease acquired outside of Japan.

PMID- 1633373
TI  - Clinical management of chronic pain in spinal cord injury.
AB  - Spinal cord injury (SCI) can cause paralysis; sensory impairment; autonomic
      nervous system dysfunction; and bowel, bladder, and sexual dysfunction. These
      impairments may lead to immobility, physical dependence, and alterations in
      lifestyle and self-esteem. The addition of chronic, intractable pain to these
      impairments can be truly devastating. Chronic pain superimposed on spinal cord
      injury can virtually drain the individual of strength, motivation, and will. For
      the spinal cord injury survivor who already faces functional loss, severe pain
      can further restrict even the diversional activities that are available. Thus, it
      may become impossible for the individual to escape his or her pain even
      temporarily. The various medical, physical, and surgical treatments considered to
      be efficacious in treating this pain are reviewed. However, although chronic pain
      in SCI may be managed by these therapies, a permanent cure may not result.

PMID- 1633374
TI  - Psychological interventions for chronic pain following spinal cord injury.
AB  - Currently, no literature is available regarding the clinical efficacy and
      treatment outcome of psychological interventions for chronic pain among spinal
      cord injured (SCI) persons. The present article provides a framework for
      cognitive-behavioral interventions used with other pain populations and suggested
      application for the SCI population with chronic pain. Primary focus is upon a
      biopsychosocial model with patient self-management as the treatment goal. SCI
      rehabilitation has traditionally relied upon self-management strategies, as have
      recent psychological treatment approaches for chronic pain. In addition,
      recommendations for treatment outcome research are provided with the emphasis on
      using existing standardized assessment and measurement protocols.

PMID- 1633376
TI  - Pain-specific beliefs, perceived symptom severity, and adjustment to chronic
      pain.
AB  - Cognitive theories of appraisal argue for the importance of beliefs as
      determinants of adjustment to stress. The current investigation sought to examine
      the relation between beliefs about chronic pain and adjustment in a group of
      chronic pain patients. Patients' belief in themselves as disabled was found to be
      inversely related to activity level for patients reporting low and medium levels
      of pain severity. This same belief correlated with professional services
      utilization and was negatively related to psychological functioning. Believing in
      a medical cure for pain was also positively related to professional services
      utilization. Finally, an expressed belief in the appropriateness of solicitous
      responses from family members was negatively related to psychological functioning
      for patients reporting relatively low levels of pain. Although these findings
      support the broad-based hypothesis that the illness-relevant beliefs of chronic
      pain patients are associated with their multidimensional pain adjustment, they
      emphasize the importance of beliefs concerning whether or not one is disabled by
      pain. The findings also highlight the fact that the belief/functioning relation
      is not always direct and can be moderated by perceived pain severity.

PMID- 1633375
TI  - Chronic pain and spinal cord injury: review and comment.
AB  - The problem of severe chronic pain following spinal cord injury (SCI) has been
      well delineated for many years. However, progress has been slow in determining
      which treatment procedures work for which type of SCI pain in a particular
      individual at a particular time. Reasons for such slow progress include the low
      incidence and prevalence of SCI making large series of patients unavailable for
      trials in many centers. Lack of a widely accepted SCI pain classification scheme
      has also limited the comparability of similar interventions carried out by
      different investigators. Design limitations of many existing studies that can be
      remedied in future investigations are reviewed. Finally, discussion of two
      conceptual models of SCI pain is presented and an argument raised for the utility
      of both.

PMID- 1633377
TI  - Living with fibromyalgia. Consequences for everyday life.
AB  - The influence of chronic pain on daily life was studied in 58 patients (55 women
      and three men) with fibromyalgia. The mean age was 45 +/- 11 (SD) years. A mail
      questionnaire including a 2-day diary was used for data collection. Information
      was gathered on social background, employment status, symptoms, physical training
      habits, patients' experience of general health, physical condition, and
      difficulties in performing motor tasks. The patient reported every half hour in
      the activity diary the degree of pain and fatigue, whether the activities were
      difficult to perform, and whether the patient considered them to be enjoyable,
      valuable, and meaningful. Fifty-five percent of the group had gainful employment.
      Most were working shorter hours and with changed work tasks. Motor tasks, such as
      carrying, holding, and running were more difficult to perform than before the
      onset of the symptoms, and half of the group reported most of their activities as
      strenuous to perform. Thirty-nine persons (67%) reported no, or very short, pain
      free periods during the 2 days. In conclusion, symptoms influenced daily life
      considerably, and almost all patients reported changes in habits and routines as
      a consequence of fibromyalgia. An assessment of the patient's total life
      situation gives valuable information for understanding the patients' ability to
      handle everyday life.

PMID- 1633378
TI  - Postoperative pain relief and hospital stay after total esophagectomy.
AB  - Intraoperative and postsurgical epidurally administered pain relief is associated
      with reduced morbidity. We reviewed the charts of 19 patients who had total
      esophagectomy to see whether the method of postoperative pain relief influenced
      the length of hospital stay and cost of the procedure. The patients received
      either intravenous (group M) or epidural (group E) morphine for postoperative
      pain. The length of stay in the intensive care unit was reduced by 2 1/2 days and
      total hospital stay by 7 days in the epidural group. This resulted in a saving of
      Canadian $12,770 per patient.

PMID- 1633379
TI  - A survey of pain in hospitalized patients aged 4-14 years.
AB  - One hundred fifty randomly selected hospitalized children between the ages of 4
      14 were interviewed to assess their pain experience in the hospital. Follow-up
      information was obtained through parent interviews 3 weeks, 3 months, and 6
      months later. On enrollment, more than 87% of children reported having had pain
      within 24 h and, of those, 19% reported their usual pain intensity as in the
      severe range. Thirty-eight percent of children had received analgesic medication
      during the preceding 24 h. Children who had undergone surgery were three to four
      times more likely to have received narcotic analgesic than nonsurgical patients,
      although similar proportions in both groups reported moderate to severe pain
      intensity. In spite of these reports of significant pain by a substantial number
      of children during hospitalization, at the 3-week follow-up check, by parent
      report, 68% were pain free. The parents of those with pain were contacted at 3
      and 6 months postenrollment, and 96% of children were no longer experiencing
      pain. Five children reported pain at all contact points; three of these were
      suffering chronic diseases and the other two had suffered major trauma from motor
      vehicle accidents.

PMID- 1633380
TI  - Chronic pain: fix or manage?

PMID- 1633381
TI  - Migraine and tension-type headaches: in response to comment by Dr. Campbell.

PMID- 1633382
TI  - Somatosensory evoked potentials and stellate ganglion block.

PMID- 1633383
TI  - The needle and the brain: psychophysiological factors involved in nerve blocking
      for chronic pain. In response to article by Drs. Brena, Chapman, and Sanders.

PMID- 1633384
TI  - In response to the position paper of the NCAHF on acupuncture.

PMID- 1633385
TI  - Phantoms and follow-up.

PMID- 1633386
TI  - Drug abuse, dependence, and addiction in chronic pain patients.
AB  - It is claimed that a significant percentage of chronic pain patients suffer from
      drug/alcohol abuse/dependency/addiction. To address this question, 24 articles
      alluding to chronic pain patient drug/alcohol dependence/addiction were reviewed
      according to the following criteria: method for drug misuse diagnosis, which drug
      misuse diagnosis used (abuse, dependence, or addiction), and percentage of
      patients within each diagnostic category of drug misuse. The result of the review
      indicated that only seven studies utilized acceptable diagnostic criteria and/or
      definitions for the drug misuse diagnoses and gave percentages of drug misuse.
      Within these seven studies, the prevalence percentages for the diagnoses for drug
      abuse, drug dependence, and drug addiction were in the range of 3.2-18.9%. It is
      concluded that these diagnoses occur in a significant percentage of chronic pain
      patients. However, there is little evidence in these studies that addictive
      behaviors are common within the chronic pain population.

PMID- 1633387
TI  - Chronic pain and spinal cord injury.
AB  - With the medical progress that has given spinal cord injured individuals greater
      longevity and better overall health, chronic pain has emerged as a major
      challenge in treating this population. Over the past 40 years, estimates of
      prevalence of severe/disabling chronic pain in spinal cord injury (SCI) patients
      have ranged from 18% to 63%. Beyond this finding, the extant literature is
      extremely limited. This review summarizes the empirical findings with regard to
      the prevalence and clinical significance of chronic pain in the SCI population.
      In spite of widespread clinical beliefs, there is little evidence that
      characteristics of the SCI such as the level, completeness, or etiology of the
      injury are associated with either the development or severity of pain. Until
      recently, psychosocial issues have been almost totally ignored in spite of the
      importance such variables have demonstrated in chronic pain in other populations.
      A major purpose of the present article is to expand the scope of inquiry to
      include these factors and to emphasize the importance of employing a
      biopsychosocial model. Evidence is reviewed which suggests that chronic pain is
      associated with psychosocial impairment in this population. It is concluded that
      rather than being a minor problem in comparison to the other limitations imposed
      by SCI, chronic pain represents a significant additional challenge to the SCI
      patient that may be best addressed by a multidisciplinary approach.

PMID- 1633388
TI  - Pain assessment in spinal cord injury.
AB  - Pain management is a serious problem for individuals with spinal cord injury
      (SCI). Recent developments in pain assessment indicate that multiaxial
      approaches, assessing medical, psychosocial, and behavioral/functional
      dimensions, are necessary to measure adequately the impact of chronic pain. The
      application of this multiaxial system to persons with SCI and chronic pain is
      presented. A review of the literature indicates that the psychometric properties
      and test utility for most pain measures have not been established for persons
      with SCI. The assessment task is further confounded by the functional limitations
      and psychosocial impairments that may accompany SCI. Recommendations are made for
      adapting established pain measures for use with SCI individuals. The choice of
      assessment tools for these patients is guided by the multidimensional nature of
      the pain experience, functional limitations, and the goals of treatment.

PMID- 1633389
TI  - Ultrafast MR imaging of water mobility: animal models of altered cerebral
      perfusion.
AB  - "Single shot" magnetic resonance (MR) diffusion imaging was used to study the
      details of signal decay curves in experimental perturbations of cerebral
      perfusion induced by hypercapnia or death. Despite large perfusion increases
      observed with dynamic susceptibility-contrast MR imaging, no correlation with
      these changes was seen in either the diffusion coefficient or any other
      intravoxel incoherent motion (IVIM) model parameters in dog gray matter as
      arterial carbon dioxide pressure increased. Non-monoexponential signal decay in
      cat gray matter was seen both before and after death. In addition, cat gray
      matter demonstrated a steady decrease in the diffusion coefficient after death.
      These data are strong evidence that the fast component of the non-monoexponential
      diffusion-related signal decay is not due solely to perfusion. The authors
      believe that a second compartment of nonexchanging spins, most likely
      cerebrospinal fluid, accounts for the non-monoexponential decay.

PMID- 1633390
TI  - In vivo Na-23 MR imaging and spectroscopy of rat brain during TmDOTP5- infusion.
AB  - In vivo sodium-23 and hydrogen-1 magnetic resonance (MR) imaging and spectroscopy
      of the rat brain during infusion of the shift reagent thulium DOTP5- (1,4,7,10
      tetraazacyclododecane-1,4,7,10-tetra[methylene phosphonate] was performed to
      assign the various peaks observed during infusion and to evaluate the shift
      reagent in discriminating tissue compartments. Na-23 spectra collected during the
      infusion showed two shifted peaks that were assigned to intravascular Na+ and
      extracellular muscle Na+, respectively, and one unshifted peak assigned to intra-
      and extracellular brain Na+ and cerebrospinal fluid Na+. These assignments were
      validated with H-1 and Na-23 MR imaging and Na-23 chemical shift imaging (CSI).
      The H-1 and Na-23 images showed that a surface coil placed on a rat head can
      detect a substantial amount of signal from muscle surrounding the skull. Na-23
      CSI spectra from successive 1-mm-thick coronal sections indicated that the shift
      reagent did not cross the blood-brain barrier. The study also showed that bulk
      susceptibility shifts are quite small with Tm-DOTP5-. This reagent may be useful
      in determining compartmental Na+ concentrations and blood flow kinetics in brain
      and in examining the integrity of the blood-brain barrier.

PMID- 1633391
TI  - Thin-section MR imaging of rat brain at 4.7 T.
AB  - The brains of anesthetized 7-month-old male hooded rats were imaged in coronal,
      sagittal, and horizontal planes at 4.7 T. Images were obtained with a section
      thickness of 0.6 mm and in-plane pixel size of 0.18-0.20 mm, resulting in finer
      combined spatial and contrast resolution than in most previously published
      reports. This allowed detailed anatomic assignment of many brain structures on
      the basis of comparison with a histologic brain atlas. T1, apparent T2, and water
      proton density values of gray matter, white matter, and cerebrospinal fluid (CSF)
      were derived from saturation-recovery and multi-echo measurements. These values
      were used to calculate expected contrast-to-noise ratios as a function of TR and
      TE in spin-echo imaging sequences. The optimal simultaneous contrast between gray
      and white matter and between CSF and gray matter was obtained on images with
      moderate T2 weighing, with a TR of 3.6 seconds and a TE of 45 msec. The use of
      thin sections was found to be essential for resolving many fine structures, and
      the improved sensitivity provided by the high magnetic field strength was crucial
      for imaging such thin sections at adequate signal-to-noise ratios.

PMID- 1633392
TI  - Gadolinium-enhanced magnetization transfer contrast imaging of intracranial
      tumors.
AB  - The magnetization transfer contrast (MTC) technique was used in low-field
      strength (0.1 T) magnetic resonance (MR) imaging of 28 patients with intracranial
      tumors. MTC images were generated with an off-resonance, low-power radio
      frequency pulse applied during the interpulse delay period of a gradient-echo
      partial-saturation sequence (TR msec/TE msec = 200/20). Images in the presence
      and absence of the MTC pulse were concurrently acquired before and after
      injection of gadopentetate dimeglumine at a dose of 0.1 mmol/kg. The contrast
      agent enhanced 27 of 28 tumors. Application of the MTC pulse improved the
      contrast-to-noise ratio (C/N) between tumor and normal white matter in 26 of 28
      cases on the preinjection images and in 25 of 28 cases on the postinjection
      images. On the gadolinium-enhanced images, the mean C/N was 2.6 +/- 1.7 without
      the MTC pulse and 3.2 +/- 1.9 with the MTC pulse. The greatest contrast
      improvement with the MTC technique was obtained in tumors showing the strongest
      paramagnetic enhancement. The results indicate that MTC can improve contrast
      between normal brain and some intracranial neoplasms. The use of gadopentetate
      dimeglumine generally intensified this effect.

PMID- 1633393
TI  - Effect of perfusion on exercised muscle: MR imaging evaluation.
AB  - An ischemic clamp model of exercise was used to evaluate the potential role of
      blood flow in mediating changes in the magnetic resonance imaging appearance of
      skeletal muscle. Proton relaxation times of muscle were serially estimated in 10
      healthy subjects (a) before exercise, (b) after exercise in the presence of
      vascular occlusion (VO1), (c) during vascular reocclusion after 1 minute of
      reperfusion (VO2), and (d) after reinstitution of continuous flow. T1 and T2 of
      active muscles were increased during VO1. During VO2, there were additional
      increases in relaxation times of active muscles. Reinstitution of continuous flow
      was associated with a continuous decrease in the T2 of exercised muscle. Hence,
      blood flow was not required for increases in T1 and T2 with exercise. Additional
      relaxation time increases occurred after a brief period of reperfusion; however,
      continuous flow was associated with a decrease in T2.

PMID- 1633394
TI  - Cardiac masses: signal intensity features on spin-echo, gradient-echo, gadolinium
      enhanced spin-echo, and TurboFLASH images.
AB  - Fifteen patients with cardiac or paracardiac masses underwent magnetic resonance
      (MR) imaging with spin-echo (n = 15), cine gradient-echo (n = 15), gadopentetate
      dimeglumine-enhanced spin-echo (n = 15), and TurboFLASH (fast low-angle shot) (n
      = 7) sequences. All masses had either histologic confirmation (n = 11) or
      confirmation with other imaging modalities (n = 4). Myxomas (n = 6) were
      characterized by an intermediate signal intensity (SI) on spin-echo (n = 6) and
      low SI on cine gradient-echo (n = 6) images and moderately high-SI contrast
      enhancement (n = 5). Percent contrast enhancement for myxomas was 57% +/- 11%.
      Thrombus (n = 4) had intermediate (n = 3) or high (n = 1) SI on spin-echo images
      and low (n = 2) or intermediate (n = 2) SI on gradient-echo images and did not
      show substantial contrast enhancement. Postcontrast first-pass TurboFLASH images
      were useful by clearly demonstrating the nonenhancing mass lesion in a high-SI
      blood pool. Other cardiac and paracardiac tumors (n = 5) showed variable pre- and
      postcontrast spin-echo SI; however, no other tumor showed low SI on cine gradient
      echo images.

PMID- 1633395
TI  - MR imaging of blood vessels with an intravascular coil.
AB  - A method for producing high-resolution magnetic resonance (MR) images of blood
      vessel walls is described. The authors review a theoretical analysis of receiver
      coil design and present a coil well suited for intravascular MR imaging. The
      design is based on two coaxial solenoids separated by a gap region and with
      current driven in opposite directions. Placement of this receiver coil within the
      vascular space is shown to provide a substantial increase in sensitivity over
      that external surface coils. Experimental verification of these predictions was
      obtained in a vessel phantom in which a 13-cm surface coil was compared with a
      3.5-mm-diameter opposed-solenoid intravascular coil. This intravascular coil had
      a cylindric region of high sensitivity that offered a 10-fold improvement in
      signal-to-noise ratio over that of an external coil near the vessel wall. The
      performance of this coil was also tested in the jugular vein of a swine.

PMID- 1633396
TI  - MR angiography with adiabatic flow excitation.
AB  - A new method of magnetic resonance (MR) angiography is presented that produces
      signal from flowing spins and suppresses that from stationary spins by means of a
      flow excitation pulse sequence consisting of adiabatic 90 degrees and 180 degrees
      radio-frequency (RF) pulses interleaved with flow-dephasing gradient lobes.
      Stationary spins are refocused along the z axis, while flowing spins are dephased
      by the gradient lobes and generate a transverse component that can be measured
      directly to produce the angiogram. Adiabatic RF pulses and unipolar gradient
      lobes give the pulse sequence a high degree of immunity to RF and magnetic field
      inhomogeneity. The pulse sequence can be successfully applied with a
      transmit/receive surface coil. The disadvantage of adiabatic RF pulses is that
      their long duration makes it difficult to suppress the signal of stationary spins
      with short T2.

PMID- 1633397
TI  - High-speed black blood imaging of vessel stenosis in the presence of pulsatile
      flow.
AB  - Stenosis phantoms were created to study the ability of "black blood" methods to
      image a vessel stenosis in the presence of pulsatile flow. Black blood images
      were acquired with a modified TurboFLASH (fast low-angle shot) method that
      eliminates flow signal by applying a set of prepulses before segmented data
      acquisition. With this high-speed approach, imaging can be completed within 16
      seconds. This technique was compared with conventional spin-echo black blood,
      gradient-echo black blood, and gradient-echo bright blood methods. Loss of flow
      signal, which extended beyond the site of the stenosis, was seen on the gradient
      echo bright blood images. The pattern of signal loss varied with the type of
      stenosis. Flow voids were achieved with spin-echo black blood imaging; however,
      substantial ghosting artifacts were seen. With gradient-echo black blood imaging,
      it was difficult to eliminate all flow signal, particularly for in-plane flow.
      The modified TurboFLASH method produced high-quality black blood images in a
      fraction of the time needed for spin-echo imaging. It showed no ghosting
      artifacts even in the presence of pulsatile flow.

PMID- 1633398
TI  - Comparison of velocity-encoded MR imaging and fluid dynamic modeling of steady
      and disturbed flow.
AB  - The contrast of flow-encoded magnetic resonance (MR) images obtained in vivo and
      the accuracy of velocity measurements are complicated by the presence of complex
      flow states. The effects of complex flow states on MR flow-encoded images were
      studied and quantitative flow information was obtained with an MR phase
      subtraction technique. Regions of complex flow, including flow stagnation and
      separation and laminar flow, could be clearly identified on the phase images. The
      MR imaging velocity measurements were validated by comparison with numerical
      simulation results for three-dimensional velocity distributions. The velocity MR
      images and the profiles obtained from the simulation generally agreed well for
      flow rates of 660 and 1,680 mL/min. This agreement lends support to both the
      fluid dynamic model and the physical basis of the phase imaging technique and
      establishes the validity of flow-encoded phase imaging as an in vivo flow
      quantitation method, especially under low Reynolds number flow conditions.

PMID- 1633399
TI  - Mechanisms of flow-induced signal loss in MR angiography.
AB  - Mechanisms of signal loss in magnetic resonance angiography were studied with a
      stenotic flow phantom. The results indicate that while signal loss induced by
      mean fluid motions is localized about the stenosis, the fluctuating component of
      fluid motion induces signal loss over a much larger region, primarily distal to
      the stenosis. For both motion components, use of gradient moment nulling (GMN)
      above first order was found to be an ineffective means of reducing signal loss.
      In contrast, shortened gradient durations were found to reduce signal loss
      substantially. However, though a zeroth-order gradient is generally of the
      shortest duration, use of a slightly longer, first-order gradient was found to be
      the most robust means of reducing signal loss.

PMID- 1633400
TI  - Diagnosis of fatty liver with MR imaging.
AB  - The diagnosis of fatty liver with magnetic resonance (MR) imaging was evaluated
      in experimental rat models of simple fatty infiltration and fatty liver with
      hepatocellular injury. T1 and T2 were measured ex vivo and correlated with the
      histologic degree of fatty infiltration. Enhancement of fatty liver with four
      different cells-specific contrast agents was studied with ex vivo relaxometry and
      in vivo MR imaging. Quantitative analysis of conventional and chemical shift MR
      images was correlated with biochemically determined fat content of the liver.
      Diet-induced simple fatty infiltration of the liver caused a decrease in T1 of
      15%, whereas the T1 of L-ethionine-induced fatty liver with hepatocellular injury
      increased by 12%. T2 showed a positive correlation with the degree of fatty
      infiltration in both models. Cell-specific hepatobiliary contrast agents showed
      the same liver uptake and relaxation enhancement in fatty livers as in normal
      livers. Conventional T1-weighted images and chemical shift images showed good
      correlation (r = .83 and .80, respectively) between signal intensity and the
      degree of fatty infiltration. However, only chemical shift imaging was reliable
      in the diagnosis of fatty liver.

PMID- 1633401
TI  - Echo-planar imaging of the central nervous system at 1.0 T.
AB  - Echo-planar imaging (EPI) on the authors' 1-T prototype imager provides high
      quality 100-msec images of the central nervous system. Contrast parameters can be
      chosen freely. Three-dimensional EPI sequences provide isotropically resolved
      data sets with 1-mm resolution. Brain perfusion and blood-brain barrier
      disruption can be assessed in time-course studies with gadopentetate dimeglumine.
      The current state of development of the authors' midfield research EPI system is
      discussed and its image quality illustrated through selected patient studies.

PMID- 1633402
TI  - Incremental hydraulic jaw opener for MR imaging of the temporomandibular joint.
AB  - Magnetic resonance (MR) imaging in the open- and closed-mouth positions is the
      method of choice for visualizing the temporomandibular joint (TMJ). To analyze
      the TMJ in response to various degrees of mouth opening, the authors constructed
      a hydraulic incremental jaw opener. This apparatus enables obtaining of
      reproducible and stable positions of TMJ articulation. With modified gradient
      pulse sequences, the technique yields good spatial resolution of joint anatomy,
      including that of the articular disk. The application of a cine program allows
      cinematographic display of TMJ motion, which in conjunction with static open- and
      closed-mouth views can be useful in the diagnosis of TMJ dysfunction. The authors
      used the incremental jaw opener to examine the disk-condyle complex at each open
      mouth position, with particular attention to extreme open-mouth positions.

PMID- 1633403
TI  - Fast spin-echo studies of contrast and small-lesion definition in a liver
      metastasis phantom.
AB  - A liver-metastasis model was used to study the ability of fast spin-echo (FSE)
      imaging to show small lesions (1 pixel in diameter) relative to conventional spin
      echo imaging. FSE images of the liver-metastasis phantom were acquired with
      various phase-encode reordering schemes to manipulate T2 contrast. The imaging
      time for multisection acquisitions was 27 seconds for FSE imaging and 6 minutes
      48 seconds for conventional spin-echo imaging. Computer simulations were
      performed to determine how the point spread function varies with the different
      phase-encoding orders in FSE imaging. Contrast-to-noise ratios and signal
      profiles of the lesions were measured as a function of the effective TE and
      lesion size. Experimental results and theoretical simulations showed that T2
      weighted FSE imaging provides high contrast and good edge definition even for
      small lesions. The results indicate that FSE imaging may become a powerful method
      for the early detection of liver metastases.

PMID- 1633404
TI  - Why we should speak out for restriction of handguns.

PMID- 1633405
TI  - Developmental expression of estrogen receptor mRNA in the rat cerebral cortex: a
      nonisotopic in situ hybridization histochemistry study.
AB  - The distribution of estrogen receptor mRNA expression was studied in the
      developing rat cerebral cortex by in situ hybridization histochemistry. We used a
      specific, nonisotopically (digoxigenin) labeled, synthetic
      oligodeoxyribonucleotide complementary to a 48 base sequence in the region of the
      estrogen-binding domain of rat uterine estrogen receptor cDNA. During
      development, estrogen receptor mRNA was observed in all forebrain regions
      previously reported to bind estrogen, as determined by steroid autoradiography or
      nuclear binding assay. In the developing cerebral cortex, estrogen receptor mRNA
      was extensively expressed in the ventricular zone, primitive plexiform layer, and
      immature cortical plate at least as early as embryonic day 16. During the first 3
      postnatal weeks, cortical mRNA expression was increasingly restricted to the
      upper third of the cerebral cortex and to the neurons of the cortical subplate
      (layer VIb/VII) and decreased to low levels by postnatal day 28. In the cerebral
      cortex, the spatial distribution of estrogen receptor mRNA expression overlapped
      that reported for the encoded protein. The extensive distribution of estrogen
      receptor mRNA throughout the late prenatal and early postnatal cerebral cortex
      points to an important role for estrogen in the differentiation and maturation of
      the cerebral cortex.

PMID- 1633407
TI  - Cholinergic immunoreactive fibers in monkey anterior temporal cortex.
AB  - Cholinergic processes in anterior temporal cortex of rhesus monkeys were
      identified using immunocytochemical techniques for ChAT. Labeled fibers were
      present throughout the temporal pole and anterior aspects of the superior
      temporal, middle temporal, and inferior temporal gyri. ChAT-immunoreactive fibers
      were most dense in layer I to superficial layer III throughout anterior temporal
      cortex. In temporal pole, agranular and dysgranular regions had a greater density
      of labeled fibers in superficial layers as compared to granular regions. In
      addition to the superficial concentration of cholinergic fibers in lateral
      temporal regions, numerous labeled fibers were also present in deep cortical
      layers in the inferior temporal gyrus of lateral temporal cortex, with lesser
      concentrations of immunoreactive fibers present in these layers in superior and
      middle temporal gyri. These patterns of cholinergic innervation may reflect the
      degree of cholinergic modulation of functions in anterior temporal cortex.

PMID- 1633406
TI  - Early expression of GABA-containing neurons in the prefrontal and visual cortices
      of rhesus monkeys.
AB  - Light and electron microscopic immunohistochemistry was used to examine the time
      of emergence and distribution of GABA-containing cells in an association
      (prefrontal) and primary sensory (visual) region of the telencephalon at
      progressive fetal and postnatal stages of cortical maturation in the rhesus
      monkey. Thirty fetuses and six postnatal monkeys were examined beginning at
      embryonic day 41 (E41), the start of cortical neurogenesis, to birth (E165) and
      proceeding to maturity (greater than 5 years of age). The emergence and major
      developmental modifications in the distribution of immunoreactive neurons in both
      areas examined were nearly identical. GABA-immunolabeled neurons were present
      throughout the full thickness of the cerebral wall, including the cortical plate
      and the developmentally transient marginal, subplate, and ventricular zones, as
      early as E41. An important and surprising result was that a subset of bipolar
      migrating neurons in the subplate zone also contained GABA at these early stages.
      GABA-containing neurons in the ventricular and subventricular zones disappeared
      after E100, when neurogenesis is completed. In contrast, the number of
      immunoreactive multipolar and bipolar neurons within the subplate zone diminished
      between E100 and E131. By the first postnatal week, the distribution and density
      of GABA-containing neurons in the cortex appeared qualitatively similar to that
      observed in mature monkeys. The early appearance of GABA in cortical neurons and
      its expression by a population of migrating neurons suggest that a subset of
      cortical neurons may be committed to a transmitter phenotype independent of
      synaptic interactions and prior to attaining their adult positions in the
      maturing cerebral cortex.

PMID- 1633408
TI  - Nonphosphorylated neurofilament protein and calbindin immunoreactivity in layer
      III pyramidal neurons of human neocortex.
AB  - Subpopulations of pyramidal neurons in the neocortex have been shown to contain
      nonphosphorylated neurofilament protein (NPNFP) and calbindin D28K (Morrison et
      al., 1987; Campbell and Morrison, 1989; Hof et al., 1990; Kobayashi et al., 1990;
      Hof and Morrison, 1991; Mesulam and Geula, 1991). However, it is not known what
      relations, if any, exist between the pyramidal neurons containing each of these
      proteins. In this study, the expression of NPNFP and calbindin immunoreactivity
      was compared in six regions of human neocortex. Characteristic laminar patterns
      of immunoreactivity for each protein were seen in most regions examined, and both
      NPNFP- and calbindin-labeled pyramidal neurons were found in layer III. However,
      the pyramidal neurons labeled with NPNFP and calbindin differed in several
      respects. First, the sublaminar distribution of NPNFP-labeled pyramids within
      layer III differed across regions, ranging from an even distribution throughout
      the layer in a visual association region (area 18) to a predominance of labeled
      neurons in the deep half of that layer in a higher association region (area 20).
      The distribution of calbindin-immunoreactive pyramidal neurons also varied
      regionally, but in a different manner than that of the NPNFP-labeled neurons.
      Second, in every region examined, the average size of NPNFP-labeled layer III
      pyramids was greater than that of calbindin-immunoreactive pyramids. However,
      there was substantial regional heterogeneity in the extent to which the size
      distributions of neurons in each of the two populations overlapped. Third, in the
      regions in which NPNFP- and calbindin-immunoreactive neurons were most similar in
      size, the amount of colocalization (as identified by double-labeling studies) was
      also greatest. Similarly, in the regions in which there was minimal overlap in
      the size of the NPNFP- and the calbindin-immunoreactive neurons, there was
      minimal colocalization. These regional characteristics of NPNFP- and calbindin
      immunoreactive layer III pyramidal neurons have implications for the involvement
      of these neuronal populations in Alzheimer's disease.

PMID- 1633409
TI  - Positron emission tomography study of letter and object processing: empirical
      findings and methodological considerations.
AB  - The study of functional-anatomical correlations of higher-order cognitive
      processing has benefited from recent advances in brain imaging techniques such as
      positron emission tomography (PET) measurements of regional cerebral blood flow
      (CBF). Comparisons of CBF changes by paired image subtraction provide the
      opportunity to isolate cerebral areas participating in the realization of the
      processes that differentiate two tasks. However, the subtraction method is based
      on assumptions that are not entirely compatible with cerebral cognitive
      processing, and the derived pattern of activation specifically associated with
      the processes that differentiate two tasks is relative to the activation
      associated with the subtracted task and may therefore vary as a function of the
      processes actually performed in this subtracted task. To examine the implications
      of this procedure, a PET study with the 15O water bolus technique was carried out
      on normal adults. Subjects performed three tasks that made nonoverlapping
      cognitive processing demands: a semantic categorization of visual objects, a
      spatial discrimination of visually presented letters, and a phonological decision
      on visually presented single letters. Each task produced distinct patterns of
      activation consistent with evidence from neurological patients, specifically in
      the left occipital cortex in the semantic categorization of objects, in the
      parietal cortex of both hemispheres in the letter-spatial task, and in the left
      frontal and superior temporal cortex in the letter-sound task. However, the
      comparisons between the two letter tasks did not result in the expected CBF
      changes even though these two tasks make distinct processing requirements and are
      dissociable by brain injury. In addition, the phonological task resulted in
      activation of areas of the frontal cortex that earlier PET studies had identified
      as participating in semantic operations, whereas letters have no semantic
      property. These results suggest that the interpretation of patterns of activation
      is confronted with difficulties due to the automatic, and uncontrolled,
      processing of verbal stimuli that raises the threshold for significant CBF
      changes between two conditions that use the same stimuli but different task
      demands.

PMID- 1633410
TI  - Mechanisms underlying somatosensory cortical dynamics: II. In vitro studies.
AB  - The response of the sensorimotor cortical slice to repetitive, single-site
      afferent drive is mapped using both evoked potential and metabolic mapping [2
      deoxyglucose (2DG)] methods. Systematic changes (increases or decreases) in the
      evoked potential occur during repetitive 3-5 Hz stimulation. These resemble the
      changes in SI neuron response observed in the in vivo studies of the preceding
      companion article; they occur rapidly, recover within 1 min and are reproducible
      if stimulus parameters remain unchanged. Place, timing, and intensity of
      repetitive stimulation influence the amplitude and form of the response
      alterations observed at a given cortical locus. The neuron populations that
      exhibit different response modifications to the same repetitive stimulus are
      distributed nonrandomly in the slice: neurons occupying column-shaped aggregates
      undergo a common response alteration (either an increase or decrease) during
      repetitive stimulation, with sharp boundaries separating neighboring aggregates
      distinguishable on the basis of their dynamic behaviors. The distribution of
      stimulus-evoked 2DG uptake in the slice is "columnar," the dimensions of the 2DG
      columns corresponding to those mapped with neurophysiological methods. Taken
      together, the findings support the concept that repetitive stimulation causes the
      intrinsic network of somatosensory cortex to modify dynamically the network's
      response to extrinsic excitatory drive so that the local differences in the
      pattern of extrinsic excitatory drive to neighboring cortical columns are
      enhanced.

PMID- 1633412
TI  - Immediate and delayed changes of rat motor cortical output representation with
      new forelimb configurations.
AB  - These experiments examined motor cortical representation patterns after forelimb
      postural adjustments in rats. The experiments tested the hypothesis that postural
      adjustments that stretch muscles that are most strongly activated from the
      primary motor cortex (MI) enlarge their cortical representation. Intracortical
      electrical stimulation within MI, forelimb muscle activity and movements, and
      vibrissa movements were used to evaluate the border between the MI forelimb and
      vibrissa representations before and after forelimb position changes in
      anesthetized adult rats. The forelimb was originally maintained in retraction
      (wrist extension and elbow flexion) and then changed to protraction (wrist
      flexion and elbow extension). Movements and forelimb EMG evoked by electrical
      stimulation were evaluated during this period (up to 3 hr) through a set of four
      electrodes implanted in layer V of MI. Changing the forelimb configuration had
      both immediate and delayed effects on forelimb muscle activity evoked from MI. At
      some sites, the magnitude of evoked forelimb muscle activity immediately
      increased with forelimb protraction. At one-quarter of all sites, forelimb muscle
      activity was evoked where it was not previously detected following an average
      delay of 22-31 min after forelimb protraction. This change can be interpreted as
      an expansion of the forelimb area into the vibrissa representation. These data
      further support the hypothesis that motor cortical representations are flexible
      and show that sustained changes in somatic sensory input to MI are sufficient to
      reorganize MI output.

PMID- 1633411
TI  - Effects of continuous noise maskers on tone-evoked potentials in cat primary
      auditory cortex.
AB  - In nine barbiturate-anesthetized cats, cortical evoked potentials for tones
      presented to the contralateral ear were studied for the effects of continuous
      wideband noise masking. In five animals, input-output functions for tones were
      obtained in the presence of continuous noise masking at the same ear. Tone
      thresholds were raised by the presence of the masker, and they closely tracked
      the level of the masker, such that increments in masker level brought about tone
      threshold elevations of the same magnitude. In four animals, we compared the
      effect on responses to contralateral tones of continuous maskers presented to the
      same ear as the tone, to the opposite ear, and to both ears simultaneously. The
      presence of the masker at the ear opposite the tone had a small and variable
      effect on the response to the stimulus at the ear with the tone, whether or not
      noise was also present at that ear. Consideration of extant single-neuron
      evidence provides an interpretation of these findings. Whereas maskers at the ear
      with the tone are known to reduce signal sensitivity for almost all cortical
      neurons, the effects of masking at the ear opposite the tone (ipsilateral to the
      cortex) are likely to be very heterogeneous. It is likely that the perceptual
      salience of signals that have different binaural configurations to concurrent
      maskers resides in which neuronal elements are activated, rather than in the
      total number of cells excited, and it is perhaps for this reason that the evoked
      potentials show only modest effects of this masking parameter.

PMID- 1633413
TI  - A cortico-subcortical model for generation of spatially accurate sequential
      saccades.
AB  - This article provides a systems framework for the analysis of cortical and
      subcortical interactions in the control of saccadic eye movements, A major thesis
      of this model is that a topography of saccade direction and amplitude is
      preserved through multiple projections between brain regions until they are
      finally transformed into a temporal pattern of activity that drives the eyes to
      the target. The control of voluntary saccades to visual and remembered targets is
      modeled in terms of interactions between posterior parietal cortex, frontal eye
      fields, the basal ganglia (caudate and substantia nigra), superior colliculus,
      mediodorsal thalamus, and the saccade generator of the brainstem. Interactions
      include the modulation of eye movement motor error maps by topographic inhibitory
      projections, dynamic remapping of spatial target representations in saccade motor
      error maps, and sustained neural activity that embodies spatial memory. Models of
      these mechanisms implemented in our Neural Simulation Language simulate behavior
      and neural activity described in the literature, and suggest new experiments.

PMID- 1633414
TI  - 1992 Krieg Cortical Kudos Awards presented at the Cajal Club.

PMID- 1633415
TI  - Cortical Discoverer Award: Jennifer Lund, Department of Anatomy and Neurobiology,
      University of Pittsburgh, Pittsburgh, Pennsylvania.

PMID- 1633416
TI  - Cortical Explorer Award: Sharon Juliano, Department of Anatomy, Uniformed
      Services University of the Health Sciences, Bethesda, Maryland.

PMID- 1633417
TI  - Cortical Scholar Award: Christopher Muly, Department of Neurobiology, Duke
      University Medical Center, Durham, North Carolina.

PMID- 1633419
TI  - Oncogenes and cell proliferation.

PMID- 1633420
TI  - Regulation of p21ras by GTPase activating proteins and guanine nucleotide
      exchange proteins.
AB  - Ras proteins play a critical role in controlling normal cellular growth and, when
      activated by mutation, in causing malignant transformation. Regulation of p21ras
      is achieved by GTPase activating proteins, which control the rate of hydrolysis
      of GTP to GDP, and also by GDP dissociation stimulators, which catalyze the
      exchange of guanine nucleotides. Several such proteins have now been identified
      and their control mechanisms characterized.

PMID- 1633421
TI  - Viral genetics.

PMID- 1633418
TI  - Mechanisms underlying somatosensory cortical dynamics: I. In vivo studies.
AB  - The experiments of this study demonstrate that relatively modest rates of
      repetitive tactile stimulation are accompanied by rapid and reversible
      modifications (either increases or decreases) in the response of SI neurons.
      Complete recovery occurs in a few minutes following cessation of stimulation. The
      modifications are reproducible (1) if stimulus parameters remain the same and (2)
      if time for recovery is provided between successive exposures. In contrast,
      repetitive tactile stimuli identical to those that modify SI neuron response
      rarely lead to changes in the response of cutaneous mechanoreceptive afferents.
      SI neuron functional properties conventionally regarded as immutable [e.g.,
      directional selectivity, and distribution of sensitivity within the receptive
      field (RF)] also modify with repetitive stimulation. While the changes in RF
      organization differ in detail from one neuron to the next, they are similar in
      form: the response generated by stimulus contact with one (or more rarely,
      several) RF region(s) becomes enhanced relative to the response the same stimulus
      evokes from neighboring regions. Neurons in the same column (sampled in the same
      radial penetration) exhibit very similar changes in the distribution of
      sensitivity within the RF, whereas neurons sampled in tangential penetrations
      exhibit diverse, apparently unrelated changes in RF organization in response to
      the same repetitive stimulus. Simultaneous multichannel recordings reveal that a
      repetitive tactile stimulus exerts similar effects on the response and RFs of the
      neurons within local (no more than 100 microns) neuron groupings. A model that
      incorporates a manner of SI topographical organization (segregate organization)
      and well-known aspects of neocortical cellular, neurotransmitter/receptor, and
      connectional architecture accounts for the changes in SI neuron behavior observed
      during repetitive stimulation.

PMID- 1633422
TI  - Crossed signals: oncogenic transcription factors.
AB  - Transcription factors operate at key regulatory junctions in the cell's responses
      to diverse extracellular stimuli. We discuss how the transforming activity of
      mutated transcription factors encoded by several oncogenes (v-erbA, v-fos, v-jun
      and v-rel) may result in part from a loss of the integrated response to the
      signalling network.

PMID- 1633423
TI  - Negative regulators of growth.
AB  - The proliferation of cells is regulated by countervailing positively- and
      negatively-acting signaling networks. The anti-proliferative signals, the study
      of which has been much neglected until recently, are often conveyed by growth
      inhibitory peptides. Elements that mediate the cellular response to growth
      inhibitors are encoded by tumor suppressor genes that if lost may lead to the
      runaway growth of the cancer cell.

PMID- 1633424
TI  - Proto-oncogenes in mammalian development.
AB  - The phenotypic analysis of mice carrying germline mutations in protooncogenes is
      beginning to provide convincing genetic evidence for the important role that
      these genes play in mammalian development and differentiation. Two approaches are
      being taken to elucidate the biological function of proto-oncogenes in vivo. The
      first involves the molecular analysis of existing mouse developmental mutants,
      while the second approach involves the generation of specific germline mutations
      by gene targeting using homologous recombination in embryonic stem cells. Several
      key points have already emerged from these genetic approaches. First, many proto
      oncogenes are important to more than one cell lineage and function both during
      embryogenesis and in the adult. Second, the patterns of expression of these genes
      provide only a guide to their biological function. Third, mutant phenotypes are
      generally less severe than would be expected from their expression patterns,
      suggesting that there may be functional overlap between two or more members of a
      gene family.

PMID- 1633425
TI  - Tyrosine kinases and their interactions with signalling proteins.
AB  - Recent progress has been made in identifying signal transduction pathways
      controlled by receptor protein-tyrosine kinases. The receptors for nerve growth
      factor and hepatocyte growth factor have been identified as the Trk and Met
      tyrosine kinases. The stimulation of intracellular signal transduction pathways
      by activated receptors appears to involve the association of SH2-containing
      cytoplasmic signalling proteins with autophosphorylated receptors.

PMID- 1633427
TI  - Inherited cancer genes.
AB  - The identification of several genes associated with inherited cancer syndromes
      has opened a door to understanding mechanisms of carcinogenesis in common, non
      inherited forms of cancer. Each of these genes appears to play a role in the
      control of cell growth and differentiation.

PMID- 1633426
TI  - Learning about cancer genes through invertebrate genetics.
AB  - Genetic studies in yeast, nematodes and Drosophila are revealing the signal
      transduction pathways that regulate differentiation and cell proliferation. Some
      of the critical molecules involved are homologous to proto-oncogenes and others
      are likely to be analogous to the products of tumor suppressor genes.

PMID- 1633428
TI  - Genetic variation and quasi-species.
AB  - During the past year the relative fitness, that is, overall replication ability,
      and the fitness gain of animal virus variants have been quantified, providing new
      insight into the dynamics for the generation of RNA virus quasi-species.
      Measurements of mutant frequencies and rates of genetic diversification have
      confirmed the extreme complexity of RNA virus and retrovirus populations.

PMID- 1633429
TI  - Genetic analysis of influenza virus.
AB  - The newly developed ribonucleoprotein reconstitution and transfection systems
      have facilitated the characterization of cis and trans functions required for
      transcription and replication of the influenza virus genome. For the first time,
      the genome of a negative-strand RNA virus can be manipulated using recombinant
      DNA techniques.

PMID- 1633430
TI  - Genetic analysis and gene expression of human immunodeficiency virus.
AB  - Ten years after the initial description of acquired immune deficiency syndrome,
      its causative agent, the human immunodeficiency virus, remains the subject of
      intense scientific interest. Recent research has focused on the detailed analysis
      of the molecular principles governing gene expression and virion formation and on
      the cause of immune system dysfunction. Within the past year, considerable
      progress has been made regarding both the role of the regulatory proteins and the
      mechanism by which they function, and the determinants of cell tropism and of
      virion formation.

PMID- 1633431
TI  - Transcriptional and translational control of gene expression in cauliflower
      mosaic virus.
AB  - Cauliflower mosaic virus sequences have developed as a powerful tool for the
      study of various aspects of gene expression in plants. Analysis of the
      promoter/enhancer region has led to the discovery of several transcription
      factors and factor-binding sites. Studies on RNA processing and polyadenylation
      reveal a viral strategy to obtain terminal redundancy of retrovirus pregenomic
      RNA. Striking differences between plant and vertebrate polyadenylation signals
      have been disclosed. The mechanisms for translation of the polycistronic 35S RNA
      are novel in the eukaryotic field and may give new insight to translational
      control in general.

PMID- 1633432
TI  - Differential effects of the novel antidepressant tianeptine on L-5
      hydroxytryptophan (5-HTP)-elicited corticosterone release and body weight loss.
AB  - Biochemical and behavioural experiments have indicated that the novel
      antidepressant tianeptine stimulates 5-hydroxytryptamine (5-HT) reuptake. The
      present study has explored the influence of acute tianeptine pretreatment upon
      corticosterone release and body weight loss following L-5-hydroxytryptophan (5
      HTP) administration in conscious rats. Administration of 5-HTP (20 mg/kg i.v.)
      increased plasma corticosterone levels to a similar extent in rats pretreated
      either with saline or tianeptine (10 mg/kg i.p., 60 min beforehand). Besides,
      prior administration of benserazide (50 mg/kg i.p., 30 min beforehand), an
      inhibitor of peripheral aromatic L-amino acid decarboxylase, prevented 5-HTP
      induced corticosterone release in both saline- and tianeptine-pretreated rats.
      However, combined administration of benserazide and 5-HTP decreased overnight
      body weight in saline-, but not in tianeptine-pretreated rats. These results
      suggest that tianeptine preferentially activates 5-HT reuptake in central
      serotonergic neurones.

PMID- 1633433
TI  - Double-blind cross-over study of phosphatidylserine vs. placebo in patients with
      early dementia of the Alzheimer type.
AB  - Thirty-three patients with mild primary degenerative dementia according to DSM
      III (MMS between 15 and 27) took part in a double-blind cross-over study of
      phosphatidylserine (Fidia, 300 mg/d) versus placebo. Both treatment phases lasted
      for 8 weeks with an 8 week washout phase in between and a 4 week washout phase
      before treatment phase one. Clinical global improvement ratings showed
      significantly more patients improving under BC-PS than under placebo during
      treatment phase one. The improvement carried over to the following wash-out and
      treatment phases. There were no significant improvements in GBS dementia rating
      scale, psychometric tests or P300-latency. 16-channel EEG mapping findings
      indicated that the patients initially showed higher power values in all frequency
      bands (except alpha), when compared to a younger, healthy control group. BC-PS
      reduced the higher power values compared to placebo, shifting EEG power more
      towards the normal level.

PMID- 1633434
TI  - Adding lithium to antidepressant therapy: factors related to therapeutic
      potentiation.
AB  - Lithium augmentation of antidepressant drugs was studied in 51 patients with
      endogenous refractory depression. The remission after 28 days of lithium was
      obtained in 28 patients (55%). Better effect of lithium was shown in bipolar than
      unipolar patients, with subjects with lower pre-lithium severity of depression
      and in those with rapid improvement (within 7 days) on lithium addition. Factors
      such as age, gender, number of prior antidepressant (or ECT) treatments, type of
      preceding antidepressant, mean plasma lithium concentration and the results of
      DST did not show any association with the outcome of lithium augmentation. The
      'priming' effect of lithium may contribute to the mechanism of lithium
      potentiation in a proportion of depressed patients.

PMID- 1633435
TI  - The human skeletal alpha-actin gene is regulated by a muscle-specific enhancer
      that binds three nuclear factors.
AB  - The tissue-specific distal promoter of the human skeletal alpha-actin gene (-1282
      to -708) induces transcription in myogenic cells approximately 10-fold and, with
      the most proximal promoter domain (-153 to -87), it synergistically increases
      transcription 100-fold (Muscat and Kedes 1987). We report here that it is a short
      fragment of the distal promoter, the distal regulatory element (DRE) from -1282
      to -1177 that functions as a muscle-specific, composite enhancer. An internal
      deletion in the DRE (delta -1282/-1151) in the context of the full-length 2000 bp
      promoter, resulted in a 10-fold reduction in transcription. Three distinct
      nuclear proteins, DRF-1, DRF-2, and DRF-3, interact specifically with the DRE
      between positions -1260 and -1193. A site specific mutation that abolishes DRF-2
      binding also results in a 10-fold reduction in transcriptional activity. The DRF
      2 nuclear protein has characteristics similar to those of the muscle-specific
      regulatory factor, MEF-2 (Buskin and Hauschka 1989; Gossett et al., 1989). Like
      the MEF-2 binding site in the muscle creatine kinase enhancer, the critical DRF-2
      binding site is also an A/T-rich sequence element. The DRF-2 nuclear protein
      binds equally well to the MCK MEF-2 binding site and to the A/T-rich regulatory
      element of the skeletal muscle fast-twitch troponin C gene (Gahlmann and Kedes
      1990). Furthermore, this troponin C site competes in vivo for DRF-2 driven
      expression of the skeletal alpha-actin gene in C2 cells. The DRF-2 site alone,
      however, does not activate transcription in muscle cells when linked to the SV40
      promoter. We conclude that the DRF-2 binding element is a MEF-2 binding site that
      is required but insufficient for regulation of muscle-specific skeletal alpha
      actin gene expression by the DRE. Thus, muscle-specific regulation of the human
      skeletal alpha-actin gene appears to require interactions between the other
      elements of the composite DRE enhancer with the protein:DNA complex formed by DRF
      2.

PMID- 1633436
TI  - Mechanism of tissue-specific transcription: interplay between positive and
      negative regulatory factors.
AB  - At least four regulatory cis-acting DNA sequences, CCAAAAGTGG (element A),
      TTATTTTTA (element B), TATTTATT (element C), and TATTACCTTTAT (element S), were
      identified in cardiac myosin light chain-2 (MLC2) proximal promoter as target
      sites for sequence-specific binding of nuclear proteins. For muscle-specific
      transcription, the proximal promoter (-53 to +1) consisting only of elements B
      and C is required. Addition of element A to this promoter results in a muscle
      specific up-regulation, whereas the addition of element S exerts a negative
      effect on transcription. The negative and positive regulatory effects of elements
      S and A respectively were demonstrated by site-specific mutations of the promoter
      following transient transfection of cardiac muscle cells in culture. Elements S
      and A interact separately with distinct nuclear protein factor present in both
      muscle and non-muscle cells, even though their regulatory activities are
      restricted to muscle cells. Among the multiple complexes resulting from the
      interaction of nuclear proteins and elements S and A DNAs, one requires both S
      and A sequences together for binding. Element B, which exerts a muscle-specific
      positive effect on transcription, binds to a nuclear protein present in cardiac
      muscle, but not in non-muscle cells. DNA-protein binding assays and mutational
      analysis of the MLC2 promoter suggest that the contribution of the functionally
      opposed cis-elements depends upon an interplay between the positively and
      negatively acting DNA-binding proteins via protein-protein interactions to
      mediate opposite regulatory effects on gene transcription.

PMID- 1633437
TI  - Detecting interactions between eukaryotic proteins in bacteria.
AB  - Few convenient genetic assays are available to study protein-protein
      interactions. This report describes a genetic scheme in E. coli to detect protein
      protein interactions based on the concept of cooperative DNA binding of two
      interacting proteins. The yeast regulatory proteins GAL4 and GAL80, which are
      known to interact with each other, were used to test the scheme. A fusion
      protein, LexA-GAL80, was found to exert a cooperative effect on the DNA-binding
      activity of GAL4 as monitored by a bacterial repression assay.

PMID- 1633438
TI  - Differential protein-DNA interactions at the promoter and enhancer regions of
      developmentally regulated U4 snRNA genes.
AB  - In the chicken genome there are two closely-linked genes, U4B and U4X, that code
      for different sequence variants of U4 small nuclear RNA (snRNA). Both genes are
      expressed with nearly equal efficiency in the early embryo, but U4X gene
      expression is specifically down-regulated relative to U4B as development
      proceeds. At the present time, little is known about the mechanisms that regulate
      differential expression of snRNA genes. We have now identified a novel chicken
      factor, PPBF, that binds sequence-specifically in vitro to the proximal
      regulatory region of the U4X gene, but not to the proximal region of the U4B
      gene. PPBF is itself regulated during development and may therefore be a key
      factor involved in differentially regulating U4X gene transcription relative to
      U4B. The U4X and U4B enhancers contain distinct sequence variants of two
      essential motifs (octamer and SPH). The Oct-1 transcription factor binds with
      similar affinities to both the U4X and U4B octamer motifs. However, a second
      essential snRNA enhancer-binding protein, SBF, has a 20- to 30-fold lower
      affinity for the SPH motif in the U4X enhancer than for the homologous SPH motif
      in the U4B enhancer. A potential role therefore exists for SBF, as well as PPBF,
      in the preferential down-regulation of the U4X RNA gene during chicken
      development.

PMID- 1633440
TI  - Histone 3' ends: essential and regulatory functions.

PMID- 1633439
TI  - The basic RNA polymerase II transcriptional machinery.
AB  - All genes encoding proteins in eukaryotes are transcribed by RNA polymerase II.
      The first step in analyzing transcriptional regulation requires understanding the
      general mechanisms of RNA polymerase II-specific gene transcription. The basal
      promoter, a template containing a TATA box devoid of upstream regulatory
      sequences, has been used to identify and characterize the factors which, together
      with RNA polymerase II, govern transcription in mammalian systems: TFIIA, TFIIB,
      TFIID, TFIIE, TFIIF, TFIIG, TFIIH, and TFIIJ. Interactions between regulatory
      transcription factors and basal elements of the transcriptional machinery affect
      the transcriptional rate in a positive or negative fashion. As these multiple
      proteins are purified, and their coding sequences are isolated, we come closer to
      reproducing these processes in vitro with pure components, and thus to
      elucidating the complex interactions among them.

PMID- 1633442
TI  - Stereotactic radiosurgery.

PMID- 1633441
TI  - Identification of three mammalian proteins that bind to the yeast TATA box
      protein TFIID.
AB  - The TATA box binding transcription factor TFIID of S. cerevisiae was used as a
      ligand for affinity chromatography. Polypeptides that bind specifically to yeast
      TFIID (TFIID-associated proteins, DAPs) were purified from human HeLa (heDAPs)
      and calf thymus (ctDAPs) whole cell extracts. Both heDAP and ctDAP fractions
      altered the binding of TFIID to the TATA element, and substituted for the TFIIA
      transcription activity in a reconstituted in vitro system. The heDAP fraction
      also behaved like TFIIA in its ability to form a promoter-TFIID-TFIIA complex and
      to recruit TFIIB to such a complex. The interaction of DAPs with TFIID can confer
      heat-resistance (47 degrees C) on recombinant yeast or human TFIID. SDS-PAGE
      analysis revealed that three polypeptides from HeLa extracts specifically bound
      to yTFIID columns (heDAP35, heDAP21, and heDAP12). These data suggest that a
      multi-subunit transcription factor with the properties of TFIIA can bind to TFIID
      in the absence of DNA.

PMID- 1633443
TI  - Radiation physics for particle beam radiosurgery.
AB  - For the particles and energies considered suitable for radiosurgery, with
      increasing particle charge, the Bragg peak height reaches a maximum with helium
      and then decreases, the Bragg peak width narrows, the distal fall-off steepens,
      and the exit dose increases (Table 1). The helium-ion beam is superior to a
      proton beam because of the higher peak-plateau ratio, more rapid dose fall-off,
      and smaller beam deflection, and it suffers only in the modest exit dose.
      Comparison of the therapeutically useful parameters of these beams is complicated
      by the change in beam quality (LET) with depth. Considerations of RBE values,
      which change with the ion species and with depth of penetration, may alter the
      relative rankings based on one or more of these beam characterization values. For
      all these beams, the RBE increases with increasing LET. The effect for protons is
      small and occurs just at the end of range of the particles. Effective isodose
      distributions based on modeled beams have been reported for helium, carbon, and
      neon ions. These distributions include the effects of a varying RBE with changes
      in the beam quality (as measured by a dose-weighted LET) and the change in dose
      fraction size with depth (the dose per fraction is a function of the depth of
      penetration). These calculations suggest that the optimal charged-particle beam
      for radiosurgery might be carbon. Heavy charged-particle beams can produce dose
      distributions superior to those obtainable with photon or electron beams. In
      clinical trials, these dose distributions have proved to be useful for the
      treatment of human diseases, including neoplasia and life-threatening
      intracranial disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633444
TI  - Linear accelerator radiosurgery at the University of Florida.
AB  - The University of Florida radiosurgical project began in 1986 with the following
      design criteria: the most accurate radiosurgical device possible, state-of-the
      art computer hardware and software for dose planning, and a number of collimators
      sufficient to treat any lesion homogeneously. In this article we have reviewed
      how these goals have been met. Physical aspects of this device (accuracy, dose
      gradient, and dose-planning speed) as well as clinical results compare favorably
      with any other radiosurgical experience. We believe that LINAC radiosurgical
      systems are advantageous in terms of cost, variety of collimator sizes available,
      and currently available sophistication of computerized dose planning. In the near
      future, the development of conformal treatment may significantly change the
      entire field of radiosurgery by offering heretofore unobtainable dose plans for
      irregularly shaped lesions. In addition, LINAC systems may be adapted for
      stereotactically focused fractionated radiation therapy and for radiosurgical
      treatment of lesions elsewhere in the body. Accuracy and computer sophistication
      notwithstanding, we cannot emphasize strongly enough our belief that the least
      important determinant of radiosurgical results is the machine used to deliver the
      radiation. It is absolutely vital that all groups undertaking radiosurgery
      include neurosurgeons, radiation physicists, and radiation therapists who have
      spent considerable time studying and learning the myriad details necessary to
      produce consistently good results. All radiosurgical patients must be followed up
      carefully and studied so that we can learn how to better apply this technique.
      Only patients who are not candidates for conventional surgery should be treated
      radiosurgically, at least until much more is known about long-term success and
      complication rates. A patient never should be treated radiosurgically simply
      because the referring or treating neurosurgeon is uncomfortable with proven
      conventional procedures. All groups performing radiosurgery should strive to
      adhere to the highest possible standards. We are all responsible for verifying
      the adequacy of our radiosurgical systems. We are all responsible for selecting
      our patients well, treating them with a team approach that applies the latest
      available knowledge of our field, following up closely, and reporting our results
      honestly and thoroughly so that all can benefit. We owe this, at least, to our
      patients and to neurosurgery.

PMID- 1633445
TI  - Radiosurgery using a modified linear accelerator.
AB  - Stereotactic radiosurgery using modified LINACs is a powerful new technique that
      offers a versatile method for administering high-dose radiation in a single
      session. Treatment-planning techniques currently in use enable individual
      isocenter field shaping, three-dimensional optimization of isocenter placement
      (including the use of multiple isocenters), and real-time analysis of isodose
      distribution in three dimensions relative to specifically defined anatomic
      structures from MR imaging or CT data. Modified linear accelerators offer
      successful control of both arteriovenous malformations and benign tumors
      (acoustic neuromas, craniopharyngiomas, and meningiomas), with results equal to
      the best series reported by users of the gamma knife or heavy-particle systems.
      More recent work indicates that radiosurgery may play an important role in
      controlling recurrent pediatric malignant tumors, metastatic cerebral lesions,
      and even malignant astrocytomas in some patients. Improved correlation of isodose
      distributions with imaging data allows for sophisticated analysis of results and
      specific complications, ultimately enabling improved patient care using this
      exciting new technique.

PMID- 1633446
TI  - Stereotactic radiosurgery for acoustic tumors.
AB  - Stereotactic radiosurgery is an important alternative treatment for carefully
      selected patients with acoustic tumors. We perform radiosurgery under local
      anesthesia, and 91% of our patients have been discharged from the hospital within
      24 hours after treatment. All returned to their preoperative level of function or
      employment within 5 to 7 days after treatment. Our current tumor control rate is
      97%, but reduction in tumor size, judged by strict, objective criteria, was
      achieved in only 23%. Our actuarial rate of useful hearing preservation after
      radiosurgery is 38% at 1 year. Three tumors increased in size after treatment.
      Only one of the three demonstrated increased mass effect on surrounding brain
      structures by neuroimaging criteria. No increase has led to worsened clinical
      symptoms or has required surgical excision at this point in follow-up. The 1-year
      rates for developing new facial or trigeminal neuropathies after radiosurgery
      were 30% and 33%, respectively. Cranial neuropathies had a delayed onset, with
      the median onset occurring after 5 to 6 months. The vast majority were partial at
      onset, and most improved over time. Communicating hydrocephalus requiring
      ventriculoperitoneal shunts developed after radiosurgery in four patients. Eight
      patients developed increased signal within adjacent brain parenchyma on T2
      weighted MR imaging, consistent with edema or blood-brain barrier breakdown. It
      is unlikely that stereotactic radiosurgery using the gamma knife will obviate the
      need for microsurgical removal performed by skilled and experienced
      microsurgeons. However, radiosurgery is a safe and effective treatment for
      patients whose medical problems make surgery unacceptably dangerous, those with
      bilateral tumors or a tumor in their only hearing ear, those who have recurrent
      tumor despite surgical resection, or patients who refuse microsurgical excision.

PMID- 1633447
TI  - Gamma knife surgery for sellar and suprasellar tumors.
AB  - Recent advances in neuroimaging, coupled with stereotactic delivery of ionizing
      radiation, permit precise, single-treatment irradiation of various intracranial
      tumors. This article describes the authors' experience with the 201-source 60Co
      gamma knife. Initial results indicate a potential therapeutic role for
      radiosurgery in controlling tumor growth and hormone hypersecretion in most
      patients. The authors believe that radiosurgery should be considered for small
      pituitary adenomas when prior microsurgery has failed to control tumor growth.
      Radiosurgery is a primary treatment alternative for patients who are elderly,
      medically infirm, or refuse microsurgical removal. Further follow-up is necessary
      to evaluate the long-term tumor control rate, hormonal effects, and tolerance of
      surrounding critical structures to stereotactic radiosurgery.

PMID- 1633448
TI  - Radiosurgery of meningiomas.
AB  - In early experience, radiosurgery proved to be a relatively safe and effective
      therapy for selected patients with symptomatic meningiomas, including those for
      whom surgical resection failed. Radiosurgery also has been an effective primary
      treatment alternative for patients whose advanced age, medical condition, or high
      risk tumor location preclude microsurgery. The long-term response to treatment,
      as defined by imaging and clinical findings, is not yet available. In addition,
      further clinical and laboratory work is necessary to determine the appropriate
      tumoricidal radiosurgical dose, dose-volume relationships for individual tumors,
      and the variable radiation tolerance of the different brain structures that
      closely surround meningiomas.

PMID- 1633449
TI  - The role of radiosurgery in the treatment of malignant brain tumors.
AB  - Most studies describing the results of radiosurgery have concentrated on the
      definitive treatment of small, histologically benign lesions such as vascular
      malformations, acoustic neurinomas, and pituitary adenomas. More recently, the
      role of radiosurgery using the gamma knife or LINAC-based systems to treat
      malignant neoplasms has become better defined. Most solitary metastases,
      ependymomas, well-circumscribed (on imaging studies) AAs, and a few glioblastomas
      (and other tumors) have responded dramatically to radiosurgery. Provided that the
      tumor volume was small (less than or equal to 14 cm3; 30-mm diameter),
      radiosurgery safely has caused tumor disappearance, shrinkage, or stabilization,
      regardless of prior surgery, conventional fractionated irradiation, or tumor
      radioresistance. For patients with recurrent or persistent, small, malignant
      intracranial tumors, radiosurgical treatment has obviated the need for prolonged
      hospitalization and has eliminated the risks associated with general anesthesia
      and open craniotomy.

PMID- 1633450
TI  - Stereotactic radiosurgery for pineal region tumors.
AB  - Our present treatment strategy for treating pineal region tumors is shown in
      Figure 5. We believe that stereotactic biopsy should be the first procedure in
      pineal region tumors so that a histologic diagnosis can be obtained. Based on the
      biopsy findings, the appropriate subsequent therapy, whether microsurgery,
      fractionated irradiation, or stereotactic radiosurgery, can be administered.
      Although our experience currently is limited to nine patients, we have found that
      stereotactic radiosurgery is a valuable alternative to microsurgery in the
      treatment of selected pineal region tumors.

PMID- 1633451
TI  - Physics and dosimetry of the gamma knife.
AB  - Since 1968, the gamma knife has been one of the major radiosurgical devices.
      Although approximately 4300 patients worldwide had been treated with the gamma
      knife units through June 1990, gamma knife installments in the United States are
      still rather scarce compared to linear accelerators adapted for radiosurgery.
      This article describes the basic physical characteristics of the gamma knife,
      patient set-up procedures, the existing treatment-planning system, the
      measurements of dosimetry and physical parameters, dose delivery accuracy, and
      quality assurance procedures. It also includes a vision of future developments
      and improvements in these areas.

PMID- 1633452
TI  - Dose prescription and dose-volume effects in radiosurgery.
AB  - The optimal use of radiosurgery as a treatment technique requires thorough
      planning, including careful fitting of the high-dose treatment volume to the
      target volume, and an understanding of the effects of high-dose single-fraction
      irradiation on both the target volume and the surrounding normal brain. The
      integrated logistic formula appears to be useful as an aid for predicting the
      risks of complications from radiosurgery, but greater understanding of the
      radiation tolerance for all the different areas of the brain (particularly the
      cranial nerves) is needed. The risk of developing MR imaging-defined changes
      after radiosurgery for AVMs was significantly related to predictions from the
      integrated logistic formula. The obliteration rate of AVMs after radiosurgery was
      volume dependent. Our assessment of the integrated logistic formula to date also
      indicates that it provides a reasonable guide for predicting complications in the
      radiosurgical treatment of meningiomas and in the treatment of solitary brain
      metastases using a combination of fractionated whole-brain irradiation and
      radiosurgery. The formula did not adequately predict complications in the
      treatment of AOVMs, however. In the treatment of acoustic tumors, the risks of
      injury to cranial nerves V, VII, and VIII clearly varied with treatment volume.
      Further data are needed to fully understand the therapeutic dose-response
      functions and volume effects for the obliteration of AVMs, the prevention of
      rebleeding from AOVMs, and growth arrest of meningiomas and acoustic neuromas.

PMID- 1633453
TI  - Radiobiologic models for radiosurgery.
AB  - A series of initial radiobiologic investigations have been performed using three
      animal models. The baboon model proved to be a valuable technique to assess the
      in vivo radiobiologic response of single-fraction irradiation doses delivered to
      the primate brain stem. Multimodality neurodiagnostic testing, including CT, MR
      imaging, xenon-enhanced CT, evoked potential studies, and analysis of CSF myelin
      basic protein levels, all of which eventually were correlated with
      neuropathologic examination, enabled detection of lesions produced with high-dose
      (150 Gy) radiosurgery as early as 6 weeks. Within the first 6 months after
      radiosurgery, lower doses (20 Gy, 50 Gy) did not result in clinically or
      neurodiagnostically detectable lesions. The rat arteriovenous fistula model
      permits analysis of the delayed histopathologic effects of radiosurgery on an
      experimentally created fistula designed to mimic an AVM. The rat C6 glioma model
      is designed to evaluate the effect of radiosurgery in an infiltrative tumor that
      simulates a human malignant brain tumor. These studies are intended eventually to
      increase our knowledge about the safety and efficacy of radiosurgery in both the
      normal and tumor-implanted brains. We believe that such fundamental studies
      ultimately will improve our ability to reach the goals of radiosurgery: to
      destroy the target and spare the surrounding brain. Eventually, it may become
      feasible to achieve these goals by combining radiosurgical technique with both
      radiation sensitizers (for the treated volume) and brain protectors.

PMID- 1633454
TI  - Stereotactic radiosurgery of brain vascular malformations.
AB  - Stereotactic radiosurgery using the gamma unit was performed in 251 patients with
      brain vascular malformations in a 3-year interval. Our efforts include the
      identification of factors related to both success and complications, including
      analysis of the malformation location, volume, and dose used. Radiosurgery is a
      valuable alternative treatment for many patients with brain vascular
      malformations, including those currently believed to be poor surgical candidates.

PMID- 1633455
TI  - Physics for radiosurgery with linear accelerators.
AB  - Radiosurgery had a long development period and, for more than three decades, was
      used only in a few specialized centers around the world. The development of LINAC
      based radiosurgical techniques combined with the concurrent advances in imaging
      modalities during the 1980s, however, caused so much interest in this treatment
      modality that most major radiotherapy centers now offer this service or at least
      plan to offer it in the near future. When considering a LINAC for radiosurgical
      use, one should remember that technical and clinical requirements for accurate
      radiosurgery are far more stringent than those applied to standard radiotherapy.
      This is because in radiosurgery, the targeted volumes are much smaller and the
      dose is usually delivered in a single irradiation session, whereas in
      radiotherapy, the dose is delivered to a relatively large target volume on a
      fractionated basis. Linear accelerator-based radiosurgery broadens the scope of
      radiotherapy departments. The impetus to introduce this service at a medical
      center usually comes from neurosurgeons, however. Even after the service becomes
      routine at an institution, it is the neurosurgeon who refers the patient and who
      plays the most important role in determining the target volume and its location
      within the brain. The decision on the choice of isodose surface and the
      prescribed dose, however, belongs to the radiotherapist. It is becoming clear
      that radiosurgery is a complex treatment modality for which a successful outcome
      requires a collaborative team effort by several hospital-based professionals,
      including neurosurgeons, radiation oncologists, neuroradiologists, and medical
      physicists. As in standard radiotherapy, physics plays an important role in
      radiosurgery, not only in the development of target localization, treatment
      planning, and dose delivery techniques, but also in the actual patient contact,
      from the diagnostic target localization procedures, through treatment planning,
      to patient preparation on the device and dose delivery.

PMID- 1633456
TI  - Charged-particle radiosurgery for intracranial vascular malformations.
AB  - Heavy charged-particle radiation has unique physical characteristics that offer
      several advantages over photons and protons for stereotactic radiosurgery of
      intracranial AVMs. These include improved dose distributions with depth in
      tissue, small angle of lateral scattering, and sharp distal fall-off of dose in
      the Bragg ionization peak. Under multi-institutionally approved clinical trials,
      we have used stereotactic helium-ion Bragg peak radiosurgery to treat
      approximately 400 patients with symptomatic, surgically inaccessible vascular
      malformations at the UCB-LBL 184-in synchrocyclotron and bevatron. Treatment
      planning for stereotactic heavy charged-particle radiosurgery for intracranial
      vascular disorders integrates anatomic and physical information from the
      stereotactic cerebral angiogram and stereotactic CT and MR imaging scans for each
      patient, using computerized treatment-planning calculations for optimal isodose
      contour distribution. The shape of an intracranial AVM is associated strongly
      with its treatability and potential clinical outcome. In this respect, heavy
      charged-particle radiosurgery has distinct advantages over other radiosurgical
      methods; the unique physical properties allow the shaping of individual beams to
      encompass the contours of large and complexly shaped AVMs, while sparing
      important adjacent neural structures. We have had a long-term dose-searching
      clinical protocol in collaboration with SUMC and UCSF and have followed up over
      300 patients for more than 2 years. Initially, treatment doses ranged from 45 GyE
      to 35 GyE. Currently, total doses up to 25 GyE are delivered to treatment volumes
      ranging from 0.1 cm3 to 70 cm3. This represents a relatively homogeneous dose
      distribution, with the 90% isodose surface contoured to the periphery of the
      lesion; there is considerable protection of normal adjacent brain tissues, and
      most of the brain receives no radiation exposure. Dose selection depends on the
      volume, shape, and location of the AVM and several other factors, including the
      volume of normal brain that must be traversed by the plateau portion of the
      charged-particle beam. The first 230 patients have been evaluated clinically to
      the end of 1989. Using the clinical grading of Drake, about 90% of the patients
      had an excellent or good neurologic grade, about 5% had a poor grade, and about
      5% had progression of disease and died, or died as a result of unrelated
      intercurrent illness. Neuroradiologic follow-up to the end of 1989 indicated the
      following rates of complete angiographic obliteration 3 years after treatment:
      90% to 95% for AVM treatment volumes less than 4 cm3, 90% to 95% for volumes 4 to
      14 cm3, and 60% to 70% for volumes greater than 14 cm3.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1633457
TI  - Infections in neurologic surgery.

PMID- 1633458
TI  - Infective agents in the central nervous system.
AB  - Almost all agents can cause infection within the central nervous system. The
      extent of infection ranges from diffuse involvement of the meninges, brain, or
      spinal cord to localized involvement presenting as a space-occupying lesion.
      Epidemiologic considerations, appreciation of the presenting clinical syndrome
      (acute bacterial meningitis, acute aseptic meningitis, chronic meningitis, or
      space-occupying lesion), and cerebrospinal fluid analysis facilitate arrival at a
      diagnosis.

PMID- 1633459
TI  - Infections in neurologic surgery. Host defenses.
AB  - Normal host defense mechanisms are effective in preventing central nervous system
      (CNS) infection. Opsonins and compliment levels are normally low in the CNS,
      however. The relationship of these factors to CNS infection, specifically
      surgical wound infection and shunt infection, is discussed.

PMID- 1633460
TI  - Laboratory diagnostic methods for central nervous system infections.
AB  - Infections of the CNS have a high mortality, and rapid laboratory diagnosis and
      adequate antimicrobial therapy are critically important for their management. New
      techniques assist the clinical microbiology laboratory to isolate and identify
      micro-organisms more rapidly and accurately than with the use of classic
      procedures. Microbial identification using immunologic and DNA hybridization
      techniques has importantly reduced the time needed for the diagnosis of
      infectious diseases. Culture, however, is still the standard method to confirm
      the identity of an organism isolated from CSF or CNS sites. With the increase in
      the number of antimicrobial agents and the recognition of resistance in many
      isolates, antimicrobial susceptibility testing has become extremely important in
      the selection of optimal antimicrobial therapy. Communication between the
      physician and the clinical microbiology laboratory is essential for optimum
      patient care.

PMID- 1633461
TI  - Image-guided stereotactic management of non-AIDS-related cerebral infection.
AB  - Every neurosurgeon can appreciate Dandy's recognition that the drainage of brain
      abscesses causes trauma to the delicate parenchyma. Over the years, brain surgery
      has evolved toward management of problems by using less and less invasive
      techniques and thus gaining ever lower morbidity. Clearly, the advent of better
      imaging techniques has improved the outcome in patients afflicted with
      intracerebral infections. The combination of stereotaxy with these imaging
      techniques is contributing a "zero mortality" in the treatment of these
      infections. In our series of 29 consecutive patients with non-AIDS-related
      infections, no patient died as a direct result of a stereotactic surgical
      procedure. Two patients (7%) had new neurologic deficits after surgery. The only
      patient left with a permanent disability had a kidney allograft and subacute
      bacterial endocarditis. His condition deteriorated 6 hours after aspiration of a
      sterile abscess, when an intra-abscess hematoma was diagnosed and evacuated. In
      retrospect, this complication may have been avoided by less vigorous aspiration.
      Three of the four patients with nonviral infections who died were iatrogenically
      immunosuppressed for their organ transplants. These patients are difficult to
      treat, and given the current popularity of transplantation procedures,
      neurosurgeons will face more and more opportunistic infections. In general, the
      patients with abscesses did well. On the other hand, nonoperative mortality was
      extremely high for patients with viral encephalitides. This high mortality may
      have resulted from a delay in diagnosis and treatment or from the unavailability
      of highly effective antiviral agents at the time the biopsies were performed. The
      importance of early diagnosis and treatment of infection cannot be
      overemphasized. T.H. Flewett's warning about the management of HSE applies to the
      management of all cerebral infections: "It seems clear from everybody's published
      results [in the papers already given] if we wait to do biopsy until the clinical
      indications are unmistakable, we have waited so long that the patient, if he
      survives, will be left a severe neurological cripple." Because it is relatively
      noninvasive, stereotactic neurosurgery has been used increasingly to diagnose
      brain masses in patients with AIDS. We recommend its use for establishing
      diagnoses in all suspected cases of cerebral infection. We agree with Rosenblum
      et al: Empiric treatment of brain infections should be regarded as "radical."
      Such treatment should be reserved for patients who have an identifiable source of
      infection and causative organism or for patients who are clinically too unstable
      to undergo surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1633462
TI  - Imaging of intracranial infection.
AB  - Modern imaging techniques define the anatomic region infected and the evolution
      of the disease, help to evaluate treatment efficacy, and frequently can help to
      determine extra-central nervous system sources of infection, such as sinusitis or
      mastoiditis. These techniques are discussed by anatomic region, and differential
      diagnosis based on image pattern is formulated. Special attention is given to the
      findings in the immunocompromised host and in congenital infection.

PMID- 1633463
TI  - Use of antimicrobial agents to treat central nervous system infection.
AB  - When dealing with infections of the central nervous system (CNS), the clinician
      is often faced with a daunting diagnostic and therapeutic challenge. The clinical
      presentation can vary from an insidious course that allows time for a full
      diagnostic examination to fulminant catastrophic events that require immediate
      therapeutic intervention. Fortunately, a thorough clinical evaluation combined
      with current laboratory and imaging techniques often allows for a prompt
      provisional diagnosis of infection. Clinical experience and scientific
      investigation have laid the basis for rational empiric antimicrobial therapy of
      CNS infection. The role of antibiotics in the treatment of CNS infections is
      reviewed and updated, emphasizing current rationale for empiric therapy as well
      as the proper use of specific antibiotics for specific pathogens.

PMID- 1633464
TI  - Infections in neurologic surgery. The intraventricular use of antibiotics.
AB  - Intraventricular antibiotic therapy appears to be a useful treatment modality in
      those CSF infections in which systemic therapy may fail. Consideration should be
      given to using this form of treatment when infecting organisms are only sensitive
      to antibiotics with poor penetration of the CSF (e.g., aminoglycosides and
      vancomycin) and for cases in which intravenous therapy has failed to sterilize
      the CSF, toxicity from systemic therapy precludes further increases in dosages,
      and shunts or other CSF hardware might be expected to reduce the efficacy of
      systemic therapy by providing a foreign body to harbor organisms. Shunts or
      reservoirs that are infected may be successfully sterilized with IVT therapy
      alone or in conjunction with systemic therapy, but this has a lower success rate
      than cases in which the shunt is removed. There is a wealth of clinical
      experience with IVT vancomycin and gentamicin that suggests that they are
      relatively safe. Until more data are available on other aminoglycosides and newer
      antibiotics, these two agents should be considered the antibiotics of choice for
      IVT therapy. In situations in which the organism is sensitive to both vancomycin
      and gentamicin, vancomycin should be used in view of the documented neurotoxicity
      seen with gentamicin. When gentamicin resistance occurs, amikacin and tobramycin
      are appropriate alternatives. The high risk of epilepsy with the penicillins and
      cephalosporins makes them less suited for IVT therapy, although the newer
      cephalosporins have some promise for IVT therapy. CNS fungal infections can be
      treated effectively with IVT amphotericin B but with a high risk of significant
      toxicity. Miconazole appears to be safer than amphotericin B but there is less
      clinical experience with this drug. Table 1 summarizes the dosages, indications,
      and toxicity of those antibiotics commonly used for intraventricular
      administration, which have been reported previously.

PMID- 1633465
TI  - Antibiotic prophylaxis in neurosurgery. The controlled trials.
AB  - Systemic antibiotics are effective in reducing the risk of infection after clean
      neurosurgical procedures. They are less effective in preventing shunt infection,
      but are strongly recommended in institutions experiencing a shunt infection rate
      exceeding 15%. The role for antibiotic prophylaxis using topical agents and in
      the prevention of meningitis associated with cerebrospinal fluid drainage is
      uncertain.

PMID- 1633466
TI  - Craniotomy infections.
AB  - The incidence of craniotomy infections, usually less than 5%, is dependent on
      many factors, such as how the information is collected and how the percentage is
      calculated. Because these factors may vary from report to report, incidence
      figures should be read with skepticism. It is difficult to prove that a given
      factor contributes to infection. Most routines are based more on personal
      convictions than on solid evidence. CSF leak is one factor known to have great
      impact; it should be avoided with painstaking technique and, if it occurs, it
      should be treated promptly. Solid evidence favoring prophylactic antibiotics for
      persistent CSF leak is not available; but, until a well-designed randomized study
      tells otherwise, the high risk of meningitis justifies prophylaxis. Penicillin is
      adequate for leaks through the nose or the ear. For leaks through the skin, the
      antibiotic should be effective against staphylococci. The infection register
      should provide information about prevailing bacteria. In many hospitals, the
      prophylaxis should cover gram-negative bacilli. CRP is a useful diagnostic aid
      for detecting postoperative infections. The operation, however, also causes a CRP
      rise. Daily CRP monitoring, at least for patients with elevated temperature, is
      recommended. The third-generation cephalosporins are a welcome contribution to
      the treatment of bacterial meningitis. To avoid side effects, and to keep them
      potent when they are really needed, they should be used with caution. Most
      postoperative cases of meningitis are in fact aseptic. If the patient is
      moderately ill, chloramphenicol is still eligible as the first choice antibiotic.
      When the bacterial culture is negative, the antibiotic should be stopped. The
      standard treatment for bone flap infection is removal of the bone flap. The bone
      flap is essentially devascularized and comparable to a foreign body. The
      justification of vancomycin prophylaxis has been shown in a randomized study.

PMID- 1633467
TI  - Cerebrospinal fluid shunt infection.
AB  - There are distinct clinical situations in which the various methods of treatment
      are generally used: 1. Medical therapy may be used in the circumstance of an
      infected, but functioning shunt. However, once a shunt is shown to be
      malfunctioning, it must be treated surgically to correct both the malfunction and
      the infection. 2. The one combination therapy that continues to treat the
      hydrocephalus while obeying surgical principles to remove an infected prosthesis
      is that of immediate shunt replacement. However, this mode of therapy has worked
      infrequently. 3. The form of combined surgical and medical therapy that allows
      time to sterilize the CSF in the absence of a foreign body in situ is that of
      delayed replacement following removal of the infected shunt. However, this method
      temporarily discontinues the treatment of hydrocephalus. 4. External ventricular
      drainage removes the foreign body and continues to treat the hydrocephalus;
      however, this therapy places the patient at increased risk for more virulent
      infection. With these points in mind, an algorithm for the treatment of shunt
      infection can be developed as depicted in Figure 8. Using this common sense
      approach, most circumstances commonly encountered in the practice of pediatric
      neurosurgery are dealt with, and the best hope of cure is obtained.

PMID- 1633468
TI  - Diagnosis and management of brain abscess.
AB  - Over the past 20 years, the diagnosis and management of brain abscess has been
      facilitated by a number of technologic advances that have resulted in a
      significant reduction in mortality. Despite these advances in technology,
      however, brain abscess remains a serious disease. In this article the nature,
      pathogenesis, and diagnosis of brain abscesses are discussed. Issues regarding
      surgical versus nonsurgical management, optimal surgical therapy, choice and
      duration of antibiotics, and the use of corticosteroids are examined in terms of
      their impact on mortality and long-term neurologic sequelae.

PMID- 1633469
TI  - Neurosurgical infections in the compromised host.
AB  - Granulocytopenia, cellular and humoral mediated immune dysfunction are
      predisposing factors to the development of CNS infections in immunosuppressed
      patients. Brain abscess formation in the compromised host is most commonly caused
      by enteric bacilli, the bacterium N. asteroides, the fungus Aspergillus
      fumigatus, or the parasite T. gondii. Mucor and the JC virus cause invasive
      encephalitis in this patient population. CT and MR imaging have greatly aided in
      the diagnosis of intracranial lesions because of these agents. Stereotactic
      biopsy-aspiration for diagnosis and to relieve mass effect combined with systemic
      antimicrobial therapy is the treatment of choice for intracerebral abscess in the
      compromised host. Organ rejection and chronic immunosuppressive therapy can
      complicate surgical intervention in these patients. Only with a high index of
      suspicion, an aggressive approach to diagnosis, and rapid vigorous therapy may we
      hope to alter the clinical course in this difficult group of patients.

PMID- 1633470
TI  - Neurosurgical aspects of human immunodeficiency virus infection.
AB  - The spectrum of neurologic disease that complicates human immunodeficiency virus
      (HIV) is extremely broad. This article deals with those HIV-related diseases that
      may occur with a frequency of more than 1% and are of potential neurosurgical
      importance: those that result from a direct involvement of the nervous system by
      HIV and those that result either directly or indirectly from the concomitant
      immunosuppression. Infectious complications are the most common but not the sole
      cause of neurologic disability in the latter category. Other causes of neurologic
      disease seen in association with HIV infection include neoplasms, metabolic
      nutritional disorders, and vascular complications.

PMID- 1633471
TI  - Cysticercosis cerebri.
AB  - With increasing immigration from endemic regions, the incidence of cysticercosis
      in North America is rising. This fascinating disease with its varied
      presentations may pose complex management dilemmas whose resolutions often
      require a combined approach to treatment involving medical and, in some cases,
      selected surgical intervention. The treatment course must be individualized
      depending on the symptomatology, anatomic location of the cysts, and host
      inflammatory response.

PMID- 1633472
TI  - Chronic or recurrent meningitis. Neurosurgical perspectives.
AB  - Chronic meningitis is not a commonly encountered clinical problem in the day-to
      day patient care responsibilities of neurosurgeons. It is, however, important for
      the neurosurgeon to be familiar with the clinical problems, diagnostic
      challenges, and therapeutic options required to establish a definitive diagnosis.
      This article concentrates on specific entities causing chronic or recurrent
      meningitis that may require neurosurgical participation.

PMID- 1633473
TI  - Pathology of hypertensive arteriopathy.
AB  - The material covered in this article is divided into two parts: the initial
      portion summarizes information pertaining to the definition of structural
      abnormalities, attributed to arterial hypertension, that affects the
      intraparenchymal cerebral blood vessels. After a brief mention of the brain
      parenchymal lesions that accompany hypertensive arteriopathies, important modern
      mechanistic concepts that are derived primarily from animal observations are
      summarized.

PMID- 1633474
TI  - Spontaneous intracerebral hemorrhage.

PMID- 1633475
TI  - Cerebral vascular physiology in hypertensive disease.
AB  - Experimental advances during the last decade have greatly expanded our knowledge
      of mechanisms that control cerebral blood flow. In addition to local metabolites,
      many other factors are important in control of cerebral blood vessels. During
      chronic hypertension, several mechanisms of cerebral vascular control are
      altered, with both beneficial and detrimental consequences. The changes should be
      considered carefully during treatment of chronic hypertension.

PMID- 1633476
TI  - Hypertensive intracerebral hemorrhage. Epidemiology and clinical pathology.
AB  - Hypertension is the major risk factor for intracerebral hemorrhage (ICH) and is
      present in about 50% of patients with ICH. Common clinical findings are focal
      neurologic deficits at onset, gradually progressive deterioration, and the
      presence of headache, vomiting, and depressed level of consciousness. The
      clinical syndromes of ICH at common locations are reviewed. CT scanning has
      dramatically changed our thinking about ICH and allowed better correlation of
      neurologic findings with lesions at various sites.

PMID- 1633477
TI  - Management controversy. Medical versus surgical therapy for spontaneous
      intracerebral hemorrhage.
AB  - The controversy surrounding the management of intracranial hemorrhage seems to
      have been quieted by a large group of recent studies. Future efforts must focus
      on expansion of the current population screening projects for early detection of
      hypertension. Whereas some potential exists for new innovative surgical
      techniques to offer some benefit, it should be kept in mind that most of these
      patients suffer from end-stage cardiovascular, cerebrovascular, and peripheral
      vascular disease.

PMID- 1633478
TI  - Aneurysmal intracerebral hemorrhage.
AB  - Approximately 20% of all massive nontraumatic intracerebral hemorrhages are
      caused by ruptured intracranial aneurysms. The possibility for repeated and
      catastrophic rebleeds, potentially reversible increased intracranial pressure
      effects, and the need for cerebral vasospasm treatment make the early
      identification of this cause of hematoma mandatory.

PMID- 1633479
TI  - Infectious intracranial aneurysms.
AB  - Infectious cerebral aneurysms are uncommon, accounting for only 2.6% to 6% of all
      intracranial aneurysms according to autopsy studies. These aneurysms may arise
      from an intravascular or extravascular source of infection. The vast majority
      occur in the setting of bacterial endocarditis with an intravascular source of
      infection due to embolization of fragments of infected cardiac valve emboli.
      Infectious aneurysms are usually discovered after a devastating intracranial
      hemorrhage that carries a 60% to 90% mortality. More recently, fungal infectious
      aneurysms, which carry an even graver prognosis, have become more common. A high
      index of suspicion and early diagnosis of infectious aneurysms prior to
      hemorrhage is an important factor in reducing morbidity and mortality. Some
      lesions are effectively treated with antibiotics alone, but other require
      surgical intervention.

PMID- 1633480
TI  - Intracerebral hemorrhage due to cerebral arteriovenous malformations.
AB  - The most common presentation of a pial arteriovenous malformation (AVM) is
      spontaneous intracerebral hemorrhage (ICH). The peak incidence of ICH is early in
      the third decade of life. This article discusses the management of ICH of unknown
      etiology, ICH from angiographically visible AVM, and ICH from angiographically
      occult vascular malformations based on the current understanding of the natural
      history of these disease entities.

PMID- 1633481
TI  - Intracerebral hemorrhage due to dural arteriovenous malformations and fistulae.
AB  - Intracerebral hemorrhage is the most devastating complication of dural AVMs. The
      lesions most at risk are those located at the tentorial incisura and in the
      anterior cranial fossa. The more common dural AVMs located at the transverse
      sigmoid sinus and cavernous sinus typically do not hemorrhage and more frequently
      present with insidious symptoms such as a cranial bruit, tinnitus, or headache.
      Angiographic appearance of pial draining veins or an intervening varix identifies
      those patients most at risk for bleeding. An aggressive clinical stance must be
      taken in this group of patients, with the goal being complete extirpation of the
      lesion, because any residual AVM can enlarge and recruit pial veins, thus
      increasing the chances of future hemorrhage. Hemorrhage, which frequently is
      massive, can be spontaneous or occur after endovascular embolization. When
      hemorrhage does occur, medical and surgical management must be immediately
      instituted to avoid secondary brain injury. Therapeutic options include surgery
      and embolization using particulate material or polymerizing glues, alone or in
      combination. Although surgery remains the most effective and versatile method for
      treating dural AVMs, endovascular therapy and stereotactic radiosurgery will
      likely play more significant roles in treating these lesions in the future.

PMID- 1633482
TI  - Intracranial hemorrhage associated with primary and secondary tumors.
AB  - Intracranial hemorrhages are a recognized but relatively uncommon complication of
      brain tumors. Metastatic tumors are more often associated with hemorrhages than
      are primary tumors. The types of hemorrhages found include intraparenchymal,
      subarachnoid, subdural, and epidural. Treatment must be directed at both the
      hemorrhage and the underlying tumor.

PMID- 1633483
TI  - Hemorrhagic transformation. The spectrum of ischemia-related brain hemorrhage.
AB  - Hemorrhagic transformation of ischemic cerebral injury occurs commonly in embolic
      strokes. The incidence, timing, and clinical consequences of hemorrhagic
      transformation are reviewed. Hemorrhagic complications resulting from heparin
      therapy and results from recent preliminary thrombolytic treatment trials are
      discussed.

PMID- 1633484
TI  - Hemorrhagic stroke due to cerebral vasculitis and the role of immunosuppressive
      therapy.
AB  - Cerebral vasculitis may occur in isolation or in conjunction with a systemic
      illness. Although a relatively infrequent cause of intracerebral or subarachnoid
      hemorrhage, it should be considered in a setting of relevant systemic symptoms,
      an unexplained progressive neurologic disorder, or in a patient lacking risk
      factors for hemorrhagic stroke. Diagnosis may be difficult because the results of
      most studies may be normal or nonspecific. Because treatment is effective in many
      of the cerebral vasculitides, vigorous pursuit of the diagnosis is warranted.

PMID- 1633485
TI  - Cerebral amyloid angiopathy and moyamoya disease.
AB  - The incidence, clinical manifestations, diagnosis, and management of cerebral
      hemorrhage from amyloid angiopathy and moyamoya disease are reviewed. Particular
      attention is given to pathophysiologic mechanisms producing cerebral hemorrhage
      in these conditions, the diagnosis based on characteristic CT and angiographic
      appearances, and the role of surgery in comprehensive management.

PMID- 1633486
TI  - Hematologic causes of intracerebral hemorrhage and their treatment.
AB  - Spontaneous ICH is an unusual and potentially disastrous event that may
      complicate primary and secondary hemostatic abnormalities. Among the primary
      abnormalities, deficiencies of coagulation factors I, VII, VIII, IX and XIII as
      well as von Willebrand factor have been clearly associated with ICH. Specific
      factor replacement or supportive management to normalize the hemostatic defect is
      indicated in each case. Among secondary alterations in hemostasis,
      thrombocytopenia, platelet function abnormalities, or factor consumption
      contribute to the risk of ICH in patients with ITP, TTP, disseminated
      intravascular coagulation, myeloproliferative or myelodysplastic disorders, and
      exposure to certain medications. The precise incidence of spontaneous hemorrhage
      among these disorders is unknown but low. Platelet transfusion and fibrinogen
      replacement are appropriate in specific cases; however, treatment of the
      underlying cause is usually required. The association of hemorrhage with
      antithrombotic agents in several settings is better defined. Cessation of the
      medication is required in each instance. Fibrinogen replacement may be required
      after the use of fibrinolytic agents. In all cases, an assessment of the precise
      hemostatic defect is recommended.

PMID- 1633487
TI  - Delayed traumatic intracerebral hemorrhage.
AB  - Delayed traumatic intracerebral hemorrhage refers to the appearance of hemorrhage
      (usually within 48 hours of head trauma) in areas of the brain that were normal
      in appearance or nearly so on the CT scan taken shortly after injury. Neurologic
      deterioration is common but is not universally the rule. The frequency of delayed
      traumatic intracerebral hemorrhage is variable but is reported to occur in 1% to
      8% of patients with severe head injury. The pathogenesis is multifactorial and
      may result from one or more of the following: coagulation abnormalities, necrosis
      of blood vessels in areas of brain injury, dysautoregulation, and release of
      tamponade effect with evacuation of extra-axial hematomas. Outcome is poor, and
      most series report a mortality of 50% or higher.

PMID- 1633488
TI  - Iatrogenic intracerebral hemorrhage.
AB  - Intracerebral hemorrhage as a result of a diagnostic or therapeutic procedure is
      a rare but potentially devastating event. The fear of hemorrhagic complications
      influences neurosurgical decision making. The incidence of iatrogenic
      intracerebral hemorrhage and risk factors for this complication are reviewed for
      neurosurgical procedures as well as for non-neurosurgical procedures with a known
      risk of intracerebral hemorrhage.

PMID- 1633489
TI  - The role of stereotactic technology in the management of intracerebral
      hemorrhage.
AB  - Stereotactic techniques have been utilized for more than 40 years in clinical
      neurosurgical practice. There has been considerable experience with stereotactic
      techniques in the drainage of intracerebral hemorrhages, although its
      effectiveness remains controversial. Stereotactic craniotomy, often incorporating
      advanced computer guidance, is increasingly applied to effect complete resection
      of small, deep brain lesions. Radiosurgery has become a viable alternative for
      the treatment of arteriovenous malformations that, in most cases, are untreatable
      by other means. Currently, stereotaxis is a valuable part of the therapeutic
      armamentarium available to cerebrovascular neurosurgeons.

PMID- 1633490
TI  - The future. Prospects of innovative treatment of intracerebral hemorrhage.
AB  - Aggressive surgical as well as medical management strategies have had limited
      success with improving outcomes from spontaneous intracerebral hematomas. Future
      prospects of treatment will undoubtedly focus on less invasive, better tolerated
      procedures to remove hematomas in select patients. Some success has been achieved
      with a coupling of stereotactic technology, fibrinolytic agents, and mechanical
      devices, which can remove solid portions of hematoma through narrow probes. Newer
      technology also has involved laser endoscopic and small ultrasonic probes to
      facilitate morcellation and subsequent aspiration without the problems associated
      with a major intracranial procedure.

PMID- 1633491
TI  - The tomato 66.3-kD polyphenoloxidase gene: molecular identification and
      developmental expression.
AB  - A gene coding for a polypeptide abundant in tomato floral meristems was isolated
      and shown to represent a tomato 66.3-kD polyphenoloxidase. Analysis of cDNA
      clones and a corresponding intronless genomic clone indicated that the plastid
      bound 587-residue-long polypeptide, designated P2, contains two conserved copper
      binding domains, similar to those found in fungal and mammalian tyrosinases. P2
      transcripts and polypeptides are accumulated in the arrested floral primordia of
      the anantha mutant inflorescences and are equally abundant in primordia of wild
      type flowers; the gene continues to be expressed at high levels in developing
      floral organs. In young expanding leaves, P2 protein is concentrated in palisade
      cells and in epidermal trichomes. Expression patterns of P2 in plant meristems
      permit molecular distinction between floral and vegetative primordia, and, in a
      companion study, comparison with dUTPase suggests that the two genes mark two
      alternative complementary developmental programs in the floral and vegetative
      meristems of the tomato plants.

PMID- 1633492
TI  - Localization of protein-protein interactions between subunits of phytochrome.
AB  - We have used a novel assay based on protein fusions with lambda repressor to
      identify two small regions within phytochrome's carboxy-terminal domain that are
      capable of mediating dimerization. Using an in vivo assay, fusions between the
      DNA binding, amino-terminal domain of lambda repressor and fragments from oat
      PhyA phytochrome have been assayed for increased repressor activity, an indicator
      of dimerization. In this assay system, regions of oat phytochrome between amino
      acids V623-S673 and N1049-Q1129 have been shown to increase repressor activity.
      These short spans are highly conserved between proteins belonging to the
      phytochrome PhyA family. Embedded within these sequences are four segments that
      could potentially form amphipathic alpha helices. Two of the segments are well
      conserved between PhyA phytochrome and phytochromes encoded by the phyB and phyC
      genes, suggesting that heterodimers might form by way of subunit interaction at
      these sites.

PMID- 1633493
TI  - The Commelina yellow mottle virus promoter is a strong promoter in vascular and
      reproductive tissues.
AB  - Commelina yellow mottle virus (CoYMV) is a double-stranded DNA virus that infects
      the monocot Commelina diffusa. Although CoYMV and cauliflower mosaic virus (CaMV;
      another double-stranded DNA virus) probably replicate by a similar mechanism, the
      particle morphology and host range of CoYMV place it in a distinct group. We
      present evidence that a prompter fragment isolated from CoYMV confers a tissue
      specific pattern of expression that is different from that conferred by the CaMV
      35S promoter. When the CoYMV promoter is used to drive expression of the beta
      glucuronidase reporter gene in stably transformed tobacco plants, beta
      glucuronidase activity occurs primarily in the phloem, the phloem-associated
      cells, and the axial parenchyma of roots, stems, leaves, and flowers. Activity is
      also detected throughout the anther, with highest activity in the tapetum. In
      contrast, the CaMV 35S promoter is active in most cell types. The CoYMV promoter
      is a strong promoter, and when the activity of the CoYMV promoter is compared
      with that of a duplicated CaMV 35S promoter, it is 30% as active in tobacco
      suspension cells and up to 25% as active in maize suspension cells. These
      properties of the CoYMV promoter make it potentially useful for high-level
      expression of engineered genes in vascular cells.

PMID- 1633494
TI  - Coordinate regulation of replication and virion sense gene expression in wheat
      dwarf virus.
AB  - We have investigated the relationship between viral DNA replication and virion
      sense gene expression in wheat dwarf virus (WDV), a member of the geminivirus
      group, by testing a series of deletion mutants in transfected Triticum monococcum
      (einkorn) protoplasts. Mutants contained a transcription fusion of the
      chloramphenicol acetyltransferase coding sequence to the virion sense promoter
      that replaced the viral coat protein coding sequence. The deletion analysis
      revealed that WDV replication and virion sense transcription can proceed
      independently and are controlled in part by nonoverlapping elements in the large
      intergenic region. These data and those from a C2 open reading frame (ORF)
      frameshift mutant also showed that the product of the C2 ORF (C1-C2 protein) is
      independently involved in both DNA replication and activation of the virion sense
      promoter. The amino acid sequences encoded by C2, which are highly conserved in
      the geminivirus group, show some homology to the DNA binding domain of the myb
      related class of plant transcription factors. The possible involvement of the
      host in controlling the function of the C1-C2 protein and the implication of
      these data for the development of WDV-based gene vectors are discussed.

PMID- 1633496
TI  - The five key areas of administration.

PMID- 1633497
TI  - Decision-making and delegating tasks.

PMID- 1633495
TI  - A maize ribosome-inactivating protein is controlled by the transcriptional
      activator Opaque-2.
AB  - Although synthesis of the cytosolic maize albumin b-32 had been shown to be
      controlled by the Opaque-2 regulatory locus, its function was unknown. We show
      here that b-32 is a member of the large and widely distributed class of toxic
      plant proteins with ribosome-inactivating activity. These ribosome-inactivating
      proteins (RIPs) are RNA N-glycosidases that remove a single base from a conserved
      28S rRNA loop required for elongation factor 1 alpha binding. Cell-free in vitro
      translation extracts were used to show that both maize and wheat ribosomes were
      resistant to molar excesses of b-32 but not to the dicotyledonous RIP gelonin. We
      extracted RIP activity from kernels during seed maturation and germination. The
      amount of RIP activity increased during germination, although the amount of b-32
      protein remained fairly constant. Expression of a maize RIP gene under the
      control of an endosperm-specific transcriptional regulatory may be an important
      clue prompting investigation of the biological basis for RIP expression in seeds
      of other plants.

PMID- 1633498
TI  - Where will you be? Financial planning for the registered nurse.

PMID- 1633499
TI  - Peruvian nurse visits Saskatchewan.

PMID- 1633500
TI  - The Children's Wish Foundation: making a wish a reality for a dying child.

PMID- 1633501
TI  - Traditions and transitions.

PMID- 1633502
TI  - Victorian Order of Nurses: a part of SRNA history.

PMID- 1633503
TI  - Caring for practice: the value of nurses.

PMID- 1633505
TI  - Need for foot care standards.

PMID- 1633504
TI  - KMK's column. In a prayerbook case, well worn.

PMID- 1633506
TI  - Advance health care directives: the living will and enduring power of attorney.

PMID- 1633507
TI  - Applications of intravenous immunoglobulin in haematology.
AB  - Intravenous immunoglobulin (IVIgG) has many potential applications in haematology
      both as antibody replacement therapy and as an immune-modulater in autoimmune
      disorders. Antibody replacement appears to be of value in the prophylaxis of
      infection in low-grade B-cell malignancies, in bone marrow transplant recipients
      and in children with AIDS, although optimal treatment strategies have not been
      assessed and determining which patients are likely to derive greatest benefit has
      been problematic. IVIgG appears to be effective in the prevention or amelioration
      of CMV-related pathology if given frequently and has also dramatically improved
      the survival of patients with established interstitial pneumonia when used in
      combination with ganciclovir. Intriguingly, IVIgG appears to moderate the
      severity of GVHD in adult transplant recipients. IVIgG has short term efficacy in
      most patients with ITP but, as long term remissions are uncommon, it has become
      necessary to be more selective in the use of IVIgG in this disorder. The response
      to IVIgG in other immune-mediated cytopenias is similar with generally transient
      improvement but also with occasional spectacular cures. The treatment of the
      acquired haemophilias with IVIgG has yielded in vivo and vitro evidence to
      support the idiotype-antiidiotype theory of IVIgG immune-modulation and has also
      demonstrated significant differences in the sensitivity of coagulation factor
      autoantibodies and alloantibodies to IVIgG therapy. IVIgG has several roles in
      pregnancy related disorders, including the management of both mother and fetus in
      ITP during pregnancy, the antenatal and postnatal management of platelet
      alloimmunisation and also in the management of severe rhesus isoimmunisation.
      IVIgG is safe and well tolerated. The expense of this therapy should be balanced
      against the likely gains and the overall costs of alternative approaches.

PMID- 1633508
TI  - Transcription factors, translocations and haematological malignancies.
AB  - Haematological malignancies arise as a consequence of clonal evolution driven by
      an accumulation of somatic mutations. Many haematological malignancies are
      associated with chromosome translocations that have provided powerful tools for
      the identification of proto-oncogenes implicated in the pathogenesis of
      leukaemia/lymphoma. The recent characterisation of several translocation
      breakpoints associated with human haematological tumours has demonstrated that
      genes encoding transcription factors are frequently involved. Direct alteration
      of transcription factor activity by somatic mutation may represent a particularly
      powerful leukaemogenic event.

PMID- 1633509
TI  - The detection of minimal residual disease in acute lymphoblastic leukaemia.
AB  - The detection of minimal residual disease in acute lymphoblastic leukaemia (ALL)
      can be achieved by assessing leukaemia-specific features at a cellular,
      chromosomal or molecular level. The application of the polymerase chain reaction
      to the amplification of leukaemia-specific chromosomal translocations and clone
      specific immunoglobulin and T-cell receptor gene rearrangements allows assessment
      of the majority of cases of ALL. The sensitivity of detection of this technique
      is around one leukaemia cell in 10(5) normal marrow cells. A comparative review
      of the advantages and pitfalls of the different methods of detecting minimal
      disease is presented. The clinical relevance of such detection is discussed, with
      early results suggesting that this may have predictive value for future disease
      relapse.

PMID- 1633510
TI  - Platelet-neutrophil interactions: their significance.
AB  - In the vicinity of an acute inflammatory response both cellular and non-cellular
      elements may interact to modify the overall response. Evidence suggests that
      leukocytes may play an active role in the modulation of platelet function and
      vice-versa. This interaction may be abnormal in certain pathological states.
      Neutrophils have been found to alter platelet behaviour by several mechanisms.
      These include transcellular metabolism of eicosanoids. Neutrophils utilize
      platelet-derived arachidonate to increase leukotriene synthesis. Other
      arachidonate metabolites result from platelet-neutrophil interaction and these
      differ quantitatively and qualitatively from those arising from either cell-type
      alone. Another mechanism is the release of a nitric oxide-like factor by
      neutrophils. Nitric oxide inhibits platelet adhesion and aggregation via
      guanylate cyclase stimulation. Neutrophils, under different conditions, are
      potent inducers of platelet calcium flux, aggregation and secretion. This
      activity is mediated by a neutrophil-derived protease, most likely to be
      cathepsin G. The interaction of platelets with neutrophils may help to explain
      some of the pathophysiological events associated with different clinical states.

PMID- 1633511
TI  - Vitamin K metabolism and nutriture.
AB  - Vitamin K functions as a co-factor for the post-translational carboxylation of
      specific glutamate residues to gamma-carboxyglutamate (Gla) residues in several
      blood coagulation factors (II, VII, IX and X) and coagulation inhibitors
      (proteins C and S) in the liver; as well as a variety of extrahepatic proteins
      such as the bone protein osteocalcin. This review outlines some recent advances
      in our understanding of the metabolism of vitamin K and its role in human
      nutriture. The introduction of new methodologies to measure the low endogenous
      tissue concentrations of K vitamins and circulating plasma levels of des-gamma
      carboxyprothrombin (PIVKA-II) have provided correspondingly more refined indices
      for the assessment of human vitamin K status. The assays for vitamin K have also
      been used to study the sources, intestinal absorption, plasma transport, storage
      and transplacental transfer of K vitamins and the importance of phylloquinone
      (vitamin K1) versus menaquinones (vitamins K2) to human needs. The ability to
      biochemically monitor subclinical vitamin K deficiency has reaffirmed the
      precarious vitamin K status of the newborn and led to an increased appreciation
      of the risk factors leading to haemorrhagic disease of the newborn and how this
      may be prevented. Biochemical studies are leading to an increased knowledge of
      the mode of action of traditional coumarin anticoagulants and how some unrelated
      compounds (e.g. antibiotics) may also antagonize vitamin K and cause bleeding.
      There is also an awareness of the possible deleterious effects of vitamin K
      antagonism or deficiency on non-hepatic Gla-proteins which may play some subtle
      role in calcium homeostasis.

PMID- 1633512
TI  - Setting the agenda for health in Europe.

PMID- 1633513
TI  - Selective serotonin reuptake inhibitors.

PMID- 1633514
TI  - London's health care again.

PMID- 1633515
TI  - New research in tuberous sclerosis.

PMID- 1633516
TI  - Over the counter treatment for candidiasis.

PMID- 1633517
TI  - Comparison of spontaneous ascites filtration and reinfusion with total
      paracentesis with intravenous albumin infusion in cirrhotic patients with tense
      ascites.
AB  - OBJECTIVE: To compare the effectiveness and safety of spontaneous ascites
      filtration and reinfusion and total paracentesis plus intravenous albumin
      infusion in cirrhotic patients with tense ascites. DESIGN: Randomised trial of
      the two treatments. SETTING: Teaching hospital and district general hospital in
      Milan. PATIENTS: 45 consecutive cirrhotic patients with recurrent tense ascites
      and urinary sodium excretion rate less than 20 mmol/day. 35 fulfilled admission
      criteria and completed the study. 17 received spontaneous ascites filtration and
      18 paracentesis plus albumin infusion. MAIN OUTCOME MEASURES: Body weight;
      urinary volume; serum and urinary electrolyte, serum fibrinogen, and plasma
      aldosterone concentrations; and plasma renin activity before the procedure and 24
      hours and eight days afterwards. RESULTS: Both procedures were effective in all
      patients. Weight decreased in both groups and showed no substantial increase
      after eight days. In patients receiving ascites filtration, values decreased
      significantly (p less than 0.01) after 24 hours for platelet count (mean relative
      change 0.92; 99% confidence interval 0.86 to 0.98) and serum fibrinogen
      concentration (0.92; 0.88 to 0.98) but returned to pretreatment values after
      eight days; no laboratory and clinical signs of disseminated intravascular
      coagulation were noted. Three patients in this group had fever, which receded
      spontaneously. One patient in each group had dilutional hyponatraemia.
      CONCLUSIONS: Spontaneous ascites filtration and reinfusion is an effective
      treatment for tense ascites. Reinfusion of the patient's concentrated proteins
      provides savings without compromising safety.

PMID- 1633518
TI  - Trends in perinatal mortality and cerebral palsy in Western Australia, 1967 to
      1985.
AB  - OBJECTIVE: To analyse the trends in stillbirths, neonatal deaths, and cerebral
      palsy in all infants born in Western Australia from 1967 to 1985. To relate these
      trends to changes in perinatal care, particularly in relation to avoidance of
      intrapartum asphyxia in term infants and the increased survival of low
      birthweight infants. DESIGN: Descriptive epidemiological study calculating
      population rates for perinatal deaths and cerebral palsy according to year of
      birth and birth weight. SETTING: Western Australia. SUBJECTS: All infants born
      after 20 weeks' gestation or weighing at least 400 g (live and stillborn). MAIN
      OUTCOME MEASURES: Stillbirths, neonatal deaths (from perinatal death
      certificates), and cerebral palsy (from a population based register). RESULTS:
      Overall stillbirth rates fell from 12.1/1000 total births in 1967-70 to 8.1 in
      1983-5. Early neonatal mortality fell from 13.0/1000 live births to 4.4 over the
      same period whereas total cerebral palsy rates remained at around 2-2.5/1000 live
      births. Death rates fell in all birth weight categories, particularly in low
      birthweight infants between 1975 and 1985, the period when birthweight data were
      available. In contrast, cerebral palsy rates in infants under 1500 g rose
      significantly over this period (from 12.1 in 1968 to 64.9 in 1985). The rise was
      seen in all spastic categories, including severely and multiply handicapped
      children. CONCLUSIONS: Large increases in the use of interventions aimed at
      reducing birth asphyxia and handicaps had not (by 1985) resulted in lower rates
      of cerebral palsy. This suggests that birth asphyxia is not a major cause. The
      increased survival of low birthweight infants has resulted in more cerebral palsy
      in this group, due either to postnatal complications of immaturity or prenatal
      damage to the fetal brain. These findings have implications for planning
      perinatal care and for litigation for putative obstetric malpractice in cerebral
      palsy cases.

PMID- 1633520
TI  - Regular balloon inflation for patients with chronic bronchitis: a randomised
      controlled trial.

PMID- 1633519
TI  - Alcohol consumption as a risk factor for poor outcome after aneurysmal
      subarachnoid haemorrhage.
AB  - OBJECTIVE: To evaluate the effect of factors existing before aneurysmal
      subarachnoid haemorrhage on outcome of haemorrhage. DESIGN: Prospective follow up
      study. SETTING: Helsinki University Hospital. PATIENTS: 291 consecutive patients
      (149 men) aged 15 to 65 years admitted within 96 hours after the bleeding. MAIN
      OUTCOME MEASURES: Potential risk factors (baseline characteristics, health
      habits, and clinical variables) for poor outcome after haemorrhage (dependent
      state in the activities of daily living, or death) were studied using multiple
      logistic regression. RESULTS: One year after haemorrhage, 179 (62%) patients were
      independent in the activities of daily living and 28 (10%) dependent; 84 (29%)
      had died. Risk of poor outcome was predicted, after adjustment for sex and age,
      by clinical condition at admission according to the Glasgow coma scale (p less
      than 0.0001); occurrence of rebleeding (relative risk 7.1, 95% confidence
      interval 2.8 to 18.0, p less than 0.0001) or delayed cerebral ischaemia (10.3,
      4.2 to 25.4, p less than 0.0001); surgery on an aneurysm (0.13, 0.05 to 0.35, p
      less than 0.0001); and heavy consumption of alcohol (4.5, 1.8 to 11.0, p =
      0.0014). Heavy drinking remained a significant risk factor after additional
      adjustment for hypertension, body mass index, and presence of intracerebral
      haematoma. Heavy drinkers had a more unfavourable outcome after rebleeding and
      delayed ischaemia than did others with rebleeding or ischaemia. Those who had
      salicylates in urine on admission had delayed ischaemia with fixed neurological
      deficits less commonly than others. CONCLUSIONS: Heavy drinking impairs outcome
      mainly through severe rebleeding and delayed ischaemia and to a lesser extent
      through a poor initial condition and presence of intracerebral haematoma.

PMID- 1633521
TI  - Pharmacy beyond the dispensary: general practitioners' views.
AB  - OBJECTIVES: To ascertain general practitioners' attitudes to an extended role for
      community pharmacists. DESIGN: Postal questionnaire to a 1 in 6 sample of general
      practitioners in the Northern, West Midlands, and Oxford regions (total sample
      size 1087). MAIN OUTCOME MEASURES: Attitudes towards specific extended roles,
      pharmacist prescribing of particular drugs, the role of the pharmacist, and the
      relationship between the professions. RESULTS: 744 questionnaires were returned
      in a usable form, an overall response rate of 68.4%. Attitudes varied, from a
      majority in favour of pharmacists reporting adverse drug reactions to a majority
      against their supervising repeat prescriptions (81% and 36% in agreement
      respectively). A similar range of attitudes was shown to pharmacist prescribing,
      from 84% in agreement with their prescribing nicotine chewing gum (deregulated
      since the survey) to 11% agreeing to their prescribing cimetidine. About half the
      respondents thought general practitioners should be allowed to dispense and a
      third that pharmacists "should stick to dispensing." 27% agreed that pharmacists
      were too influenced by commercial pressures to give unbiased advice. CONCLUSIONS:
      Most doctors would favour an extension of the activities of community pharmacists
      but worry about their role in screening and counselling patients and in
      prescribing. Despite relationships being generally felt to be good, there may be
      a need for better communication and cooperation locally and for proper evaluation
      of initiatives to extend the role of the pharmacist.

PMID- 1633522
TI  - Practice managers and practice management.

PMID- 1633523
TI  - Health services research: a case of need or special pleading? The Committee of
      Heads of Academic Departments of Public Health.

PMID- 1633524
TI  - ABC of colorectal diseases. Intestinal stomas.

PMID- 1633525
TI  - Non-Hodgkin's lymphoma. I: Characterisation and treatment.

PMID- 1633526
TI  - Potentiation of aluminium absorption by effervescent analgesic tablets in a
      haemodialysis patient.

PMID- 1633528
TI  - Diets that protect against coronary heart disease.

PMID- 1633527
TI  - Cholesterol and total mortality: need for larger trials.

PMID- 1633529
TI  - Doctors and control of major releases of chemicals.

PMID- 1633530
TI  - Progression of borderline abnormalities on cervical smear testing.

PMID- 1633531
TI  - Progression of borderline abnormalities on cervical smear testing.

PMID- 1633532
TI  - Progression of borderline abnormalities on cervical smear testing.

PMID- 1633533
TI  - Tuberculosis contact tracing.

PMID- 1633534
TI  - Tuberculosis contact tracing.

PMID- 1633535
TI  - Hazards of transmission of HIV during invasive procedures.

PMID- 1633536
TI  - Life insurance and HIV tests.

PMID- 1633537
TI  - Minimising psychosocial disabilities of multiple sclerosis.

PMID- 1633538
TI  - Medical abortion.

PMID- 1633539
TI  - PPP and physiotherapy for senior citizens.

PMID- 1633540
TI  - Study of factors in atherogenesis.

PMID- 1633541
TI  - Patterns of hospital medical staffing.

PMID- 1633542
TI  - Neonatal intensive care and the NHS reforms.

PMID- 1633543
TI  - Patterns of hospital medical staffing.

PMID- 1633544
TI  - Checking quality of health care records.

PMID- 1633545
TI  - Doctors and managers.

PMID- 1633546
TI  - Giving more information about drug treatment.

PMID- 1633547
TI  - Public attitudes to smoking in Avon.

PMID- 1633548
TI  - Ethics and multicentre research projects.

PMID- 1633549
TI  - Ethics and multicentre research projects.

PMID- 1633550
TI  - Ethics and multicentre research projects.

PMID- 1633551
TI  - Central-peripheral and rostral-caudal organization of the innervation of the
      saccule in a cichlid fish.
AB  - Saccular eighth nerve arbors were examined in the cichlid fish Astronotus
      ocellatus to determine if their morphology varies with saccular location. The
      saccule was divided into four regions: rostral-central, rostral-peripheral,
      caudal-central, caudal-peripheral. Arbors were filled with cobaltous-lysine. Axon
      diameter, maximum arbor width, and number of terminal points were taken as
      quantitative measures. Differences in these measures among the four different
      saccular regions were evaluated using an analysis of variance. The results
      indicate two types of organization: central-peripheral and rostral-caudal. The
      central-peripheral differences involve all three quantitative measures. The
      central saccule is innervated by arbors with larger axon diameters, larger arbor
      widths, and more terminal points than the peripheral saccule. The rostral-caudal
      organization involves only two measures. The rostral saccule is innervated by
      arbors having larger axon diameters and smaller arbor widths than the caudal
      saccule. In the oscar, we know of no other parameters that are organized along
      the rostral-caudal dimension. These findings of a spatial organization of
      innervation suggest to us that the oscar saccule is not homogeneous in function.

PMID- 1633552
TI  - Retinal projections in the cane toad, Bufo marinus.
AB  - The location and extent of retinorecipient areas in the cane toad, Bufo marinus,
      were established by anterograde transport of cobaltic-lysine complex from the cut
      optic nerve. Most of the labeled optic axons travelled in the marginal optic
      tract, while others were in the axial optic tract, and/or the basal optic tract.
      Retinal projections terminated in both contralateral and ipsilateral targets. In
      addition to the optic tectum, the main visual center, retinorecipient areas
      included the suprachiasmatic nucleus, rostral visual nucleus, neuropil of
      Bellonci, corpus geniculatum thalamicum, ventrolateral thalamic nucleus (dorsal
      part), posterior thalamic neuropil, uncinate neuropil, pretectal nucleus
      lentiformis mesencephali and basal optic nucleus. While all of these
      retinorecipient areas receive optic fibers from both eyes, the ipsilateral
      retinal projections were observed to be generally sparser than those from the
      contralateral retina. A sparse optic fiber projection covers the surface of the
      ipsilateral optic tectum and is most prominent rostromedially and caudolaterally.
      The position and the extent of each of the retinorecipient areas were determined
      in relation to a three-dimensional coordinate system. Morphometric analysis
      showed that 85.3% of the retinorecipient area is in the contralateral optic
      tectum, 10.4% in contralateral non-tectal areas, 1.6% in the ipsilateral optic
      tectum and 2.7% in ipsilateral non-tectal areas. The presence of an ipsilateral
      tectal projection and the well defined pretectal visual neuropil complex may be
      related to the highly developed visual behavior and visual acuity of Bufo
      marinus.

PMID- 1633553
TI  - Axial motor organization in postmetamorphic tiger salamanders (Ambystoma
      tigrinum): a segregation of epaxial and hypaxial motor pools is not necessarily
      associated with terrestrial locomotion.
AB  - The axial motor column has undergone a major reorganization during the evolution
      of vertebrates. In aquatic anamniotes including lampreys, goldfish, and
      mudpuppies, epaxial and hypaxial motoneurons are intermingled in the column. In
      contrast, epaxial and hypaxial motoneurons are spatially segregated in water
      snakes, rats, and monkeys, apparently as a consequence of an isomorphic mapping
      of motoneuron location onto the position of innervated muscle in the embryonic
      myotome. The presence of these two very different arrangements of motoneurons
      requires a major restructuring of the motor column during vertebrate evolution.
      The time of this reorganization is unknown. All amniotes studied to date have an
      epaxial/hypaxial segregation, and all anamniotes do not, suggesting that the map
      arose with the origin of amniotes. All the anamniotes examined previously were
      permanently aquatic, however, and the map might therefore be associated with
      terrestrial locomotion. If so, we would expect terrestrial anamniotes to have an
      arrangement of motoneurons like that in amniotes. We studied the organization of
      motoneurons innervating the trunk muscles of postmetamorphic, terrestrial tiger
      salamanders and asked whether their motor columns are more like those of amniotes
      or those of aquatic anamniotes. The motor column in tiger salamanders is similar
      to that seen in aquatic anamniotes and very like that in mudpuppies--permanently
      aquatic salamanders. There are several classes of motoneurons with morphological
      similarities to the primary and secondary motoneurons characteristic of aquatic
      anamniotes. Epaxial and hypaxial motoneurons show no obvious morphological
      differences and occupy extensively overlapping positions in the motor column. The
      only epaxial/hypaxial distinction is the presence of a few, small, relatively
      undifferentiated motoneurons located subadjacent to the ependymal layer. These
      motoneurons are filled only by horseradish peroxidase (HRP) applied to hypaxial
      nerves. They are probably newly born motoneurons, and their presence suggests
      continued addition of motoneurons, even in adult salamanders. We conclude that
      the epaxial/hypaxial segregation seen in amniotes is not necessarily associated
      with terrestrial locomotion. The segregation and the topographic map it reflects
      may have arisen in conjunction with the origin of amniotes. If they instead arose
      prior to the origin of extant amphibians, they must have been secondarily lost in
      those salamanders studied to date. An examination of the motor column of other
      amphibians should help to resolve this issue.

PMID- 1633554
TI  - Call patterns and basilar papilla tuning in cricket frogs. I. Differences among
      populations and between sexes.
AB  - Male cricket frogs (Acris crepitans) produce a broad-band, high frequency
      advertisement call with a single spectral peak (the dominant frequency). We
      measured the dominant frequencies of male calls from six populations in central
      Texas and one from Indiana and compared them to the tuning of basilar papilla
      afferents in males and females. Averaging over all populations, mean call
      dominant frequency was 3.69 kHz, mean male basilar papilla tuning was 3.63 kHz,
      and mean female basilar papilla tuning was 3.17 kHz. Among populations, mean
      dominant frequency varied from 3.56 kHz to 3.82 kHz. Dominant frequencies were
      slightly higher in the more eastern Texas populations occupying pine forest
      habitats than in the more western populations occupying open grassland habitats.
      Changes in dominant frequency in a population coincided with changes in tuning of
      both male and female basilar papillae. Furthermore, within populations females
      were tuned on average lower than males and lower than the mean dominant frequency
      of calls in their own population. We suggest that the coincident changes in calls
      and basilar papilla tuning plus the sexual difference in tuning indicate that
      female mate choice would be directed toward males from her home population with
      low frequency calls or toward males from foreign populations with average calls
      lower in frequency than those in her home population. This in turn suggests that
      any gene flow between populations would be biased from east to west and from
      forest to open habitats.

PMID- 1633556
TI  - Oculomotor and sensory mesencephalic trigeminal neurons in lungfishes:
      phylogenetic implications.
AB  - The location and number of neurons in the brainstem with projections to the eye
      muscles were investigated by means of fluorescent tracers in the African lungfish
      Protopterus dolloi. The oculomotor nucleus (M III) projects bilaterally with a
      ratio of 3:1 (70 ipsilateral, 20 contralateral neurons). Three subdivisions of
      this nucleus can be differentiated: one projects exclusively ipsilaterally,
      another projects exclusively contralaterally, and a third component projects
      bilaterally. The trochlear nucleus (M IV) is located caudally, distinct from M
      III, and projects predominantly to contralateral eye muscles with a ratio of 6:1
      (18:3 neurons). The abducens nucleus (M VI) contains about 30 neurons with
      ipsilateral projections only. There is no evidence for an accessory abducens
      nucleus in Protopterus. Intraocular injections of tracers do not reveal any
      retinopetal projections in Protopterus. The mesencephalic trigeminal nucleus (Mes
      V) of Protopterus and Neoceratodus contains about 540-590 neurons on each side.
      In juvenile Protopterus, up to 75 Mes V neurons are located caudally in a ventral
      projection of the tectum above the velum medullare anterius. Fifty-five Mes V
      neurons (10% of the total number) have processes that exit the brain with the
      trochlear nerve. The relatively large number of Mes V neurons in lungfishes
      correlates with the well developed jaw musculature. The present study provides
      the first conclusive evidence for the location of oculomotor subdivisions in the
      brain of a lepidosirenid lungfish. The organization of the oculomotor nucleus is
      consistent with the observation that lungfishes possess the pattern of eye-muscle
      innervation seen in elasmobranchs and supports the unconventional view that
      lungfishes may be the sistergroup of elasmobranchs.

PMID- 1633555
TI  - Call patterns and basilar papilla tuning in cricket frogs. II. Intrapopulation
      variation and allometry.
AB  - We determined the influence of body size on the male advertisement call's
      dominant frequency and basilar papilla's (BP) tuning in male and female cricket
      frogs (Acris crepitans) in two Texas populations (Wimberley and Stengel Ranch).
      In both populations, call and tuning characters correlated negatively with body
      size; females were larger than males and their BPs were tuned to a lower
      frequency. Analysis of covariance showed that neither the sex difference in
      tuning nor the population differences in calls or tuning were due to the
      difference in body size alone, but instead represented differences in the
      allometric relationships of each character with body size. The analysis implied
      that differences between sexes or populations were due more to shifts in the Y
      intercept rather than the slope of the relationship with body size. This suggests
      a developmental model in which sexes or populations possess resonant structures
      in the ear or larynx with similar growth rates but different starting points or
      initial growth phases, resulting in different frequency characteristics as
      adults. The examination of the relationship between female BP tuning and male
      call dominant frequency predicts potentially different patterns of sexual
      selection in the two populations, with the Wimberley population males subject to
      much greater directional selection for low frequency calls.

PMID- 1633557
TI  - [Description of a new disease, pancreatic lithiasis with radiotransparent
      calculi].
AB  - 118 patients presenting with pancreatic lithiasis were consecutively observed in
      our service. They underwent both an endoscopic pancreatography and good plain
      films of the abdomen. Calculi were classified in 3 groups: 1) Radiolucent calculi
      (17 cases, 5 females; 4 hereditary cases) are build up of amorphous residues of
      lithostathine S. This disease is not related to either alcohol, diet or tobacco.
      2) Taget calculi (27 cases, 4 females; 3 hereditary cases) have a radiolucent
      core as in 1 and a peripheral calcification. They are a late evolutionary stage
      of radiolucent lithiasis. The frequency of females and of hereditary cases is
      significantly greater in form 1 + 2 than in form 3. These two forms are a newly
      described disease without relationship with nutrition, alcohol or tobacco but the
      peripheral calcification of radiolucent calculi is favoured by alcohol and
      tobacco. This disease could be hereditary. 3) Calcic lithiasis (74 cases, 8
      females, 2 hereditary cases) is the most frequent form of pancreatic lithiasis.
      Its cause is nutritional.

PMID- 1633558
TI  - [Eulogy of Pierre Bourgeois (1901-1991)].

PMID- 1633559
TI  - [Potentiation of the acute toxic effects of cocaine by ethyl alcohol].
AB  - Ethyl alcohol increases significantly the lethality of cocaine intoxication in
      the rat. This lethality is not modified by nicardipine or flunarizine, antidotes
      to cocaine, and might be due to the formation of a newly identified active
      metabolite cocaethylene. In addition alcohol like cocaine inhibits the baro
      receptor reflex.

PMID- 1633560
TI  - [Detection of anti-HIV antibodies prenatally, prenuptially and at the time of
      induction into national service].

PMID- 1633561
TI  - [Juvenile amyotrophic lateral sclerosis. Study of 43 cases].
AB  - The authors reported 17 cases of common form of juvenile amyotrophic lateral
      sclerosis (ALS), 14 cases with spastic paraplegia and peroneal atrophy, and 12
      other cases belonging to one single family with spastic pseudo-bulbar paraplegia.
      The absence of sensory disturbances, the normal motor and sensory conduction
      velocities, the normal feature of sensory nerve biopsy allowed to include these 3
      groups of patients in the frame of Juvenile ALS which is chronic and benign
      disease. The authors discussed these observations on the light of the literature
      data on familial spastic paraplegia and primary lateral sclerosis.

PMID- 1633562
TI  - [Recent data on the epidemiology of dengue fever].
AB  - Because of its haemorrhagic forms often with shock syndrome, dengue fever is
      presently one of the most important pediatric health problems, particularly in
      South-east Asia. The natural reservoir of dengue is now constituted by urban
      human populations; travellers are the only dissemination factor of the viruses
      from one country to another, and all vectors are domestic species of the genus
      Aedes; in these mosquitoes, a vertical transmission can take place. The
      persistence mechanisms of dengue fever are closely related to demographic
      explosion, uncontrolled growth of towns and deterioration of urban environment
      which comes of it. The spreading mechanisms of outbreaks are related to dramatic
      increase of travels and the variable susceptibility of the natural Aedes
      populations to the viruses. All these factors appear to be directly connected
      with human activities; they were submitted to considerable changes since World
      War II and the epidemiology of the disease has been widely modified; the
      incidence of the disease is continuously growing year after year, building up a
      very worrying situation, more especially as we have no etiologic treatment nor
      vaccine against it.

PMID- 1633563
TI  - [Occupational dust exposure and chronic obstructive bronchopulmonary disease.
      Etiopathogenic approach to the problem of compensation in the mining
      environment].
AB  - In order to support the hypothesis of a causal relationship between exposure to
      respirable coal mine dusts and chronic obstructive pulmonary disease (COPD),
      investigations were performed to assess the biological disorders affecting the
      distal air spaces in coal workers with pneumoconiosis. Broncho alveolar lavage
      studies demonstrated a continual influx of mononuclear phagocytes loaded with
      mineral particles, associated with neutrophils in small number, in smokers as
      well as in non smokers. The alveolar macrophages were in activated state,
      spontaneously releasing various mediators, particularly interleukin I, Tumor
      necrosis factor alpha and superoxide anion. So, they appeared as responsible both
      for a chronic inflammation of the distal airways and for a protease-antiprotease
      imbalance leading to pulmonary emphysema, partly due to an oxidative inactivation
      of alpha 1 antiprotease inhibitor. In spite of additive effect of tobacco smoke,
      as shown by longitudinal studies of lung function in coal miners, it is now
      reasonable to consider the evidence of association between coal mine exposure and
      COPD to be sufficiently strong to infer causality, and to justify compensation
      for COPD in coal miners with or without radiological evidence of pneumoconiosis.

PMID- 1633565
TI  - An algorithm to fit the Gompertz function to growth curves.
AB  - An algorithm to fit the Gompertz growth function is presented. This algorithm is
      easy to program on a microcomputer. The algorithm is based on employing a
      searching technique to solve a set of equations derived from the Gompertz
      function. Its application may prove valuable when access to a computer mainframe
      is difficult. Such a method may be useful in construction of a specific growth
      curve in biology, or as a managerial tool in livestock enterprise, as well as in
      the clinical treatment of tumors. Demonstration of the successful application of
      this algorithm in experimental livestock growth data are presented.

PMID- 1633564
TI  - Redesigning, implementing and integrating Escherichia coli genome software tools
      with an object-oriented database system.
AB  - This paper reports our exploratory work to redesign, implement and integrate a
      collection of genome software tools with an object-oriented database system. Our
      software tools deal with genome data from Escherichia coli K-12, a bacterium that
      has been studied intensively and provides richer data sets than any other living
      organism. The object-oriented DBMS used for the integration is ONTOS, a
      commercial object-oriented system from Ontologic Inc. This redesign and
      implementation task was performed in two steps. First, C programs were converted
      into C++, and then the C++ version programs were modified and integrated with an
      object-oriented modeling of the data to form an ONTOS database application. The
      first step helps us develop a conceptual view for a DBMS-independent object
      oriented construct. The second step elucidates what additional DBMS-dependent
      modification steps are needed to provide persistency to the objects. Examples are
      included to illustrate steps of the redesign and implementation. Overall, the
      outcome of this project demonstrates that programs and data can be successfully
      integrated with an object-oriented database, while providing the objects with
      persistency and shareability. This paper includes discussions using concrete
      examples on what advantage the object-oriented database approach provides over
      the relational database approach.

PMID- 1633566
TI  - PATMAT: a searching and extraction program for sequence, pattern and block
      queries and databases.
AB  - A program has been developed that provides molecular biologists with multiple
      tools for searching databases, yet uses a very simple interface. PATMAT can use
      protein or (translated) DNA sequences, patterns or blocks of aligned proteins as
      queries of databases consisting of amino acid or nucleotide sequences, patterns
      or blocks. The ability to search databases of blocks by 'on-the-fly' conversion
      to scoring matrices provides a new tool for detection and evaluation of distant
      relationships. PATMAT uses a pull-down, menu-driven interface to carry out its
      multiple searching, extraction and viewing functions. Each query or database type
      is recognized, reported, and the appropriate search carried out, with matches and
      alignments reported in windows as they occur. Any of the high scoring matches can
      be exported to a file, viewed and recalled as a query using only a few keystrokes
      or mouse selections. Searches of multiple database files are carried out by user
      selection within a window. PATMAT runs under DOS; the searching engine also runs
      under UNIX.

PMID- 1633567
TI  - A method for delineating structurally homogeneous regions in protein sequences.
AB  - A homogeneous region in a protein sequence is a set of contiguous residues that
      share common features, concerning physico-chemical, structural and mutational
      information. This paper presents a method for identifying such homogeneous
      regions. From a profile describing a given type of biological information along
      the sequence, the algorithm allows the segmentation of the sequence by optimizing
      a criterion characterized by two user-defined control parameters: the
      'homogenizing degree' of the regions and the 'site neighbourhood' size. We apply
      the method to the envelope proteins of the human immunodeficiency virus HIV-1,
      for the identification of homogeneous regions in a hydrophobicity profile and the
      delineation of variable and conserved regions in a variability profile.

PMID- 1633568
TI  - A new approach for displaying identities and differences among aligned amino acid
      sequences.
AB  - An algorithm is presented for computing degrees of sequence conservation found
      among aligned amino acid sequences. Sequence identities are calculated for each
      position of an alignment and average identity values of neighboring positions are
      figured. The average identity value of the whole alignment is chosen as a limit
      to discriminate between well and less conserved sequence sections. A second
      algorithm is given to calculate the degree of divergence of individual sequences
      compared to the other sequences of the alignment. The approach is easy to use on
      microcomputers and gives an exact picture of sequence identities and differences
      in order to determine, first, protein regions of high functional or structural
      importance among homologous proteins, and, second, significant differences of
      single sequences that may contribute to individual properties of the analysed
      protein. The method is illustrated by an example analysing a sequence alignment
      of higher plant nitrate reductases.

PMID- 1633569
TI  - Construction of simple pathways and simple cycles in ecosystems.
AB  - We present software tools for overcoming the problem of combinatorics in the
      enumeration of simple pathways and simple cycles in a first flow-through analysis
      of carbon transfer in large ecosystems. Rather than search through the very large
      number of potential routes in a reasonably sized ecosystem for the relatively
      small number of actual routes, our main algorithm performs an efficient rule
      based construction of the actual routes. The enumeration of the unique pathways
      becomes tractable in terms of CPU time, which increases linearly with ecosystem
      size and connectedness. Networks of up to 80 entities can be evaluated using our
      software.

PMID- 1633570
TI  - The rapid generation of mutation data matrices from protein sequences.
AB  - An efficient means for generating mutation data matrices from large numbers of
      protein sequences is presented here. By means of an approximate peptide-based
      sequence comparison algorithm, the set sequences are clustered at the 85%
      identity level. The closest relating pairs of sequences are aligned, and observed
      amino acid exchanges tallied in a matrix. The raw mutation frequency matrix is
      processed in a similar way to that described by Dayhoff et al. (1978), and so the
      resulting matrices may be easily used in current sequence analysis applications,
      in place of the standard mutation data matrices, which have not been updated for
      13 years. The method is fast enough to process the entire SWISS-PROT databank in
      20 h on a Sun SPARCstation 1, and is fast enough to generate a matrix from a
      specific family or class of proteins in minutes. Differences observed between our
      250 PAM mutation data matrix and the matrix calculated by Dayhoff et al. are
      briefly discussed.

PMID- 1633571
TI  - STATUS, SEQSTAT, CSTATUS and LOAD: computer programs that facilitate large DNA
      sequencing projects.

PMID- 1633572
TI  - A simple method of avoiding the computational problems of the delta method for
      the end-user of statistical packages.

PMID- 1633573
TI  - SERPENT--an information storage and analysis resource for protein sequences.

PMID- 1633574
TI  - The phantom of the operatory.

PMID- 1633575
TI  - The KAL-technique.

PMID- 1633576
TI  - Making every minute count: effective time management.
AB  - Managing ourselves and putting first things first. That's the essence of fourth
      wave time management. It's about prioritizing, organizing with set priorities in
      mind and finding the discipline to achieve these goals. If you and your team can
      master this, the important, not the urgent, will dictate how you use your time.

PMID- 1633577
TI  - Patient profiles: worth a thousand words.

PMID- 1633578
TI  - Psychosocial predictors and sequelae of facial change.

PMID- 1633579
TI  - Function: the basis of facial esthetics.
AB  - Inadequate primary surgery, or a failure to establish muscular balance of the
      anterior face, causes muscular dysfunction. Muscular dysfunction has a nefarious
      effect on subsequent facial growth. Establishment of muscular balance, as early
      as possible, provides the best foundation for good esthetics.

PMID- 1633580
TI  - Assessment of the effectiveness of dental sterilizers using biological monitors.
AB  - This study was undertaken to evaluate the effectiveness of steam, chemical vapor,
      and dry heat sterilizers, over a three-year period, in dental operatories
      subscribing to the University of British Columbia's sterilization monitoring
      service. A total of 4,579 sterilizer loads were tested. The results demonstrated
      an overall failure rate of 4.4 per cent. Individual failure rates for each type
      of sterilizer were: chemiclaves, 4.9 per cent; steam autoclaves, 2.3 per cent;
      and dry heat ovens, 7.9 per cent. In 38 per cent of these cases, the reasons for
      failure could be attributed to a definite cause.

PMID- 1633581
TI  - The ideal composite material.

PMID- 1633582
TI  - Temporomandibular disorders, facial pain and headache following motor vehicle
      accidents.
AB  - Temporomandibular disorders are known to be a possible sequela of motor vehicle
      accidents, particularly when flexion-extension injury occurs. This paper
      recognizes the relationship between cervical injury and dysfunction, and
      temporomandibular dysfunction and headache. The literature related to motor
      vehicle accidents, whiplash injury, and temporomandibular dysfunction is
      reviewed, and the etiology, prognosis and management of the trauma associated
      with head and neck pain and dysfunction are presented.

PMID- 1633583
TI  - Subcutaneous emphysema following dental treatment: a report of two cases and
      review of the literature.
AB  - Subcutaneous emphysema is an uncommonly reported complication of routine
      dentistry. Two cases are presented, one occurring during root canal therapy and
      the second during routine restorative dentistry. The etiology and consequences of
      this phenomenon are reviewed, and the prompt recognition and management of this
      condition are discussed.

PMID- 1633584
TI  - Longevity of partial, complete and fixed prostheses: a literature review.
AB  - A review of the dental literature reveals a lack of consensus as to the longevity
      of conventional prosthodontic therapy. The reasons for this are suggested and
      best estimates of the longevity of partial, complete and fixed prostheses are
      presented based on the available literature. A renewed interest in survival
      studies, hopefully based on sound parameters that outline the reasons for
      failure, as well as replacement indicators, is required to update our knowledge
      of survival rates.

PMID- 1633585
TI  - Ultraviolet exposure.

PMID- 1633586
TI  - A method of teaching indirect ophthalmoscopy to beginning residents.
AB  - The authors describe an effective tool for teaching indirect ophthalmoscopy that
      is easily constructed from a roll of tape. The materials are inexpensive and
      readily available. The hollow interior of the roll affords a large pupillary
      opening, and one does not risk scratching the condensing lens on the metal
      surface of a commercial model eye.

PMID- 1633587
TI  - Effect of vitrectomy and cytopreparatory techniques on cell survival and
      preservation.
AB  - Obtaining vitreous fluid by means of vitrectomy frequently results in a specimen
      that is difficult to assess cytologically. We devised an experimental model to
      examine the effect of the vitrector on human leukemic cancer (HL60) cells in
      suspension and to evaluate the cytopreparatory techniques of membrane filtration
      and cytocentrifugation. Eighteen 3-mL specimens of cells at concentrations
      ranging from 1 to 9 x 10(5)/mL were vitrectomized, and eighteen 3-mL control
      samples matched for cell concentration were obtained atraumatically. No
      significant difference in cell loss, as determined by means of staining with
      nigrosin vital dye, was found at any cell concentration between the vitrectomized
      and control specimens. The specimens were then processed cytologically. On
      cytologic assessment it was not possible to distinguish the vitrectomized and
      control specimens. A higher degree of cell preservation was noted at higher cell
      concentrations regardless of the cytopreparatory technique, but at lower
      concentrations membrane filtration resulted in a higher proportion of
      cytologically assessable specimens than did cytocentrifugation (42% vs. 22%). The
      results suggest that the vitrector causes minimal cellular damage and that to
      obtain optimal results both cytopreparatory techniques should be used with all
      vitrectomy specimens.

PMID- 1633588
TI  - Night myopia: implications for the young driver.
AB  - A total of 380 randomly selected patients aged 16 to 80 years who did not have
      eye disease underwent testing for night myopia between August and October 1989
      with a laser speckle generator under both photopic and scotopic conditions. For
      the first 308 subjects the speckles were continuously run, and for the next 72
      subjects a timer was used to minimize the accommodative stimulus. An increase in
      myopia of 0.75 dioptres or more from the photopic to the scotopic state,
      equivalent to a visual acuity of 20/45 or less, was considered indicative of
      night myopia. Overall, 17% of the subjects were found to have night myopia. Of
      the 26 subjects aged 16 to 25 years in the timer group 38% had night myopia of
      0.75 D or more, 23% had night myopia of 1.00 D or more, and 4% had night myopia
      of 2.50 D, which is equivalent to an acuity of 20/265. The results indicate that
      driving in the dark could create visual difficulties for certain younger patients
      that a night myopic correction would eliminate.

PMID- 1633589
TI  - Hemorrhage associated with localization of melanoma margins during radioactive
      plaque placement.
AB  - Accurate placement of a radioactive plaque is essential in brachytherapy of
      choroidal melanoma. Various localization techniques, including transillumination
      of anteriorly located tumours and scleral indentation to mark the anterior margin
      of posteriorly located tumours, have been used in initially placing a plaque over
      the base of the tumour. Of 40 consecutive patients treated for choroidal melanoma
      between 1986 and 1990, 8 had posteriorly located tumours, all localized by means
      of scleral indentation; subretinal hemorrhage occurred in 3 of the 8 during
      marking of the tumour margins. No hemorrhages occurred in the 32 patients with
      tumours localized by means of transillumination (p less than 0.01). It is not
      clear whether the method of marking or the location of the tumour itself
      contributed to the development of the hemorrhage. Hemorrhage around the base of a
      tumour may mask the tumour margins, making assessment of the response to therapy
      difficult. Caution should be used when marking posteriorly located tumours.

PMID- 1633590
TI  - Oral administration of tranexamic acid in the management of traumatic hyphema in
      children.
AB  - In a prospective study 163 patients aged 17 years or less admitted to a
      children's hospital between April 1985 and December 1990 with traumatic hyphema
      were treated with tranexamic acid, 25 mg/kg given orally every 8 hours to a
      maximum of 1500 mg every 8 hours for 5 days. Secondary hemorrhage occurred in 5
      patients (3%), none of whom had more than one rebleeding episode. In contrast, 24
      (8%) of 316 patients aged 17 years or less admitted to the same hospital between
      January 1977 and March 1985 with traumatic hyphema who were not treated with
      antifibrinolytics had a secondary hemorrhage, several more than once, giving a
      rebleeding rate of 33/316 (10%). The results suggest that tranexamic acid reduces
      the incidence and number of secondary hemorrhages in children, without
      significant ocular or systemic side effects.

PMID- 1633591
TI  - Idiopathic conjunctival granulomas.
AB  - A 12-year-old white boy presented with a 1-year history of intermittent bilateral
      follicular conjunctivitis with yellowish bulbar and limbal nodules and few
      symptoms. Histopathological examination of conjunctival biopsy specimens showed
      non-caseating epithelioid cell granulomas with giant cell formation. The lesions
      partially responded to therapy with topical corticosteroids but persisted for
      another 4 years and then gradually cleared over the next 5 years. A systemic
      investigation failed to disclose a specific cause. At the time of writing, the
      nodules had completely resolved and no associated systemic disease had developed.

PMID- 1633592
TI  - Initial identification of antinuclear-antibody-negative systemic lupus
      erythematosus on ophthalmic examination: a case report, with a discussion of the
      ocular significance of anticardiolipin (antiphospholipid) antibodies.
AB  - A 21-year-old man presented with an acute life-threatening illness that was
      diagnosed and treated as thrombotic thrombocytopenic purpura. The patient
      survived and during his recovery noted that his central vision was markedly
      impaired in both eyes. An ophthalmologic examination showed inflammatory and
      ischemic changes in the retinal vasculature consistent with a diagnosis of
      systemic lupus erythematosus (SLE). Review of the patient's clinical and
      laboratory findings did in fact support a diagnosis of SLE that was negative for
      antinuclear antibody but positive for anticardiolipin antibody. The authors
      discuss the importance of an ophthalmic examination in patients with SLE-like
      syndromes and the significance of positivity for anticardiolipin antibody and
      other antiphospholipid antibodies in patients with thrombosis in the eye or
      elsewhere.

PMID- 1633593
TI  - Psammomatoid ossifying fibroma of the orbit.
AB  - Psammomatoid ossifying fibroma of the orbit is a distinctive solitary fibro
      osseous lesion of the orbital bones that histologically has characteristic small,
      round structures resembling psammoma bodies within a benign spindle cell stroma.
      We describe a 19-year-old woman with this uncommon orbital tumour.

PMID- 1633595
TI  - Public information programs: three-ring circus or part of medical practice?

PMID- 1633594
TI  - Corneal melting after pterygium removal followed by topical mitomycin C therapy.
AB  - Right corneal melting and scleral necrosis developed in a 77-year-old man 5
      months after pterygium excision followed by topical administration of mitomycin C
      drops (0.4 mg/mL) for 4 weeks. We believe that these were delayed complications
      of the mitomycin C therapy, and we caution against prolonged use of the drug
      postoperatively.

PMID- 1633596
TI  - Laser refractive keratectomy and intraocular pressure.

PMID- 1633597
TI  - Structural determination of alginic acid and the effects of calcium binding as
      determined by high-field n.m.r.
AB  - The nature of the solution conformations of the alginic acid components D
      mannuronan (poly-ManA) and L-guluronan (poly-GulA) from Azotobacter vinelandii
      were investigated by both one- and two-dimensional n.m.r. methods. Unequivocal
      proton assignments for both polymers as well as their constituent monomer units
      were made based on chemical-shift theory, coupling constant analysis, and nuclear
      Overhauser enhancement measurements. These data were used to investigate the
      interactions of poly-GulA and poly-ManA with Ca2+ ion in aqueous medium. Based on
      relative crosspeak integrals measured in two-dimensional phase-sensitive NOESY
      spectra of free and calcium-bound polymer, a model for calcium binding is
      proposed.

PMID- 1633598
TI  - A convenient method for the preparation of a variety of 13C-substituted D
      fructose phosphates using readily available enzymes of the glycolytic pathway.
AB  - Methods are presented for the preparation of a variety of D-fructose phosphates,
      13C-substituted at any single carbon site or at any two symmetrically disposed
      carbon sites, from either 13C-substituted pyruvate or L-alanine. It is
      demonstrated that millimole quantities of product can be obtained in good yield
      following a "one-pot" incubation of 13C-substituted precursors with commercially
      available enzymes and cofactors of the glycolytic pathway. Since it has
      previously been shown that a wide variety of aldehydes serve as acceptable
      substrates for the final rabbit muscle aldolase-catalyzed condensation step, the
      method can potentially be applied to prepare a wide variety of 13C-substituted
      sugars and sugar phosphates.

PMID- 1633599
TI  - Analysis of glycosaminoglycan-derived oligosaccharides using fast-atom
      bombardment mass-spectrometry.

PMID- 1633600
TI  - Synthesis of a glycosidic affinity ligand for purification of cytidine-5'
      monophosphosialate synthase.

PMID- 1633601
TI  - Synthesis of p-trifluoroacetamidophenyl 2-acetamido-4-O-(2-acetamido-2-deoxy-beta
      D-glucopyranosyl)-2-deoxy- beta-D-mannopyranosiduronic acid, an artificial
      antigen corresponding to a disaccharide repeating unit of the capsular
      polysaccharide of Haemophilus influenzae type e.

PMID- 1633602
TI  - Structure of the acidic exopolysaccharide secreted by Rhizobium leguminosarum
      biovar. phaseoli CFN42.

PMID- 1633603
TI  - PCILO quantum-mechanical relaxed conformational energy map of methyl 4-thio-alpha
      maltoside in solution.
AB  - A theoretical study is presented of the conformational properties of methyl 4
      thio-alpha-maltoside. Quantum-chemical PCILO (perturbed configuration interaction
      with localized orbitals) energy minimization with evaluation of the solvent
      effect has been used to calculate semi-rigid and relaxed (phi, psi)
      conformational-energy surfaces in 1,4-dioxane, methanol, dimethyl sulfoxide, and
      water. The inclusion of molecular flexibility in the conformational analysis of
      this disaccharide derivative was found to have a significant effect upon the
      allowed conformational space of the molecule. Calculations revealed the existence
      of 15 stable conformers having different internal geometries. The relative
      abundance of these conformers is strongly influenced by solvent. The locations of
      the global minima and "virtual" conformations vary with solvent and the
      flexibility of methyl 4-thio-alpha-maltoside significantly decreases from 1,4
      dioxane to water. It was found that the conformational properties of methyl 4
      thio-alpha-maltoside differ from those of the corresponding 4-oxygenated
      analogue, methyl alpha-maltoside. The calculated solution behaviour is supported
      by very good agreement between the theoretical values mean value of 3JC-4,H-1' =
      2.67 and mean value of 3JC-1',H-4 = 5.24 Hz calculated as ensemble averages over
      all conformers on the relaxed map and the experimental values of 2.95 and 5.15 Hz
      in water solution.

PMID- 1633604
TI  - 1H-N.m.r. spectral assignments for two series of heparin-derived
      oligosaccharides.
AB  - Six heparin-derived oligosaccharides, ranging in size from di- to octa-saccharide
      and forming two closely related series differing in structure by the substitution
      of an unsulfated D-glucuronate for a 2-sulfated L-iduronate residue, have been
      characterized by 2-dimensional 1H-n.m.r. spectroscopy. In addition to providing
      new data on hexa- and octa-saccharides, several important changes to previously
      published data have been found for the two tetrasaccharides. The D-glucuronic
      acid H-5 proton is assigned to a resonance in the same region as resonances for
      the H-3 and H-4 D-glucuronate protons, rather than downfield from these
      resonances as earlier reported. The presence of D-glucuronic acid in the heparin
      sequence of the series-1 fragments affects the positions of neighboring D
      glucosamine resonances, in particular shifting the anomeric proton signal in the
      preceding D-glucosamine 0.1-0.2 p.p.m. downfield. Resonances from the reducing
      end D-glucosamines differ from internal D-glucosamine resonances both in relative
      position and in the degree of chemical shift difference between the H-6 and H-6'
      protons. This work illustrates the usefulness of two-dimensional techniques in
      determining heparin structure and emphasizes the need for direct analysis, rather
      than assignment by comparison to model compounds.

PMID- 1633605
TI  - Mode of formation of quinoxaline versus 2[1H]-quinoxalinone rings from dehydro-D
      erythorbic acid.
AB  - The mode of formation of the quinoxaline versus 2[1H]-quinoxalinone rings by the
      reaction of o-diamines with dehydro-D-erythorbic acid has been investigated. The
      study was carried out by using one and two molar equivalents of 1,2-diamino-4,5
      dimethylbenzene (3b) to give 6,7-dimethyl-3-(1-oxo-D-erythro-2,3,4
      trihydroxybutyl)-2[1H]-quino xalinone (4b) and 2-(2-amino-4,5
      dimethylphenylcarbamoyl)-3-(D-erythro-glycerol-1-yl )- 6,7-dimethylquinoxaline
      (6), respectively. The former product exists predominantly as the two furanosyl
      anomers. Sequential reaction of 4a with 3b has been studied, and the location of
      each diamine in the product was deduced by using 1H-n.m.r. spectroscopy. A
      mechanism for the reaction is proposed. Acetate and acetal derivatives of the
      compound are prepared.

PMID- 1633607
TI  - Spacer-modified, photolabile tetrasaccharides as analogues of maltopentaose are
      versatile probes for porcine pancreatic alpha-amylase.
AB  - The syntheses are described of methyl 4'-O-[4-S-(3-azi-4-alpha-D
      glucopyranosyloxybutyl)-6-deoxy-4 -thio-alpha-D-xylo-hex-5-enopyranosyl]-alpha
      maltoside (28), methyl 4-O-[4-S-(3-azi-4-alpha-maltosyloxybutyl)-6-deoxy-4-thio-
      alpha-D-xylo-hex-5-enopyranosyl]-alpha-D-glucopyranoside (29), and methyl 4-S-(3
      azi-4-alpha-maltotriosyloxybutyl)-6-deoxy-4-thio- alpha-D-xylo-hex-5
      enopyranoside (30), which are analogues of maltopentaose in which a central
      glucosyl unit is replaced by an acyclic, four-membered hydrocarbon spacer
      carrying a photolabile azi group. Only 30 was slowly cleaved by high
      concentrations of pancreatic alpha-amylase. The Ki values (mM) were 0.15 (28),
      2.1 (29), and 2.5 (30). Deactivation of the enzyme by irradiation in the presence
      severely of 28-30 was 96.4%, 98.1%, and 40%, respectively. There is an indication
      for regiospecific photoaffinity labelling of the binding subsites of the enzyme.

PMID- 1633606
TI  - Spacer-modified saccharides for the regioselective photoaffinity labelling of the
      binding site of an immunoglobulin.
AB  - The spacer-modified trisaccharides that mimic (1----6)-linked beta-D
      galactotetraose (Gal4), namely, O-beta-D-galactopyranosyl-(1----6)-S-beta-D
      galactopyranosyl-(1----11)-8 -azi- 6,7,8,9,10-pentadeoxy-11-thio-D-galacto
      undecose (12) and O-beta-D-galactopyranosyl-(1----6)-O-beta-D-galactopyranosyl-
      (1----13)-8-azi-6,7,8,9,10,11,12-heptadeoxy-D-galacto-tri decose (20) were
      synthesised by coupling disaccharide derivatives with 8-azi-6,7,8,9,10-pentadeoxy
      1,2:3,4-di-O-isopropylidene-11-O -tosyl-alpha-D-galacto-undecopyranose (10) and 8
      azi-6,7,8,9,10,11,12-heptadeoxy-1,2:3,4-di-O-isopropyli den e-alpha-D-galacto-
      tridecopyranose (17), respectively. Compounds 12 and 20 had affinities for the
      combining sites of the antibodies IgA X24 and IgA J 539 similar to those of O
      beta-D-galactopyranosyl-(1----6)-O-beta-D- galactopyranosyl-(1----11)-8-azi
      6,7,8,9,10-pentadeoxy-D-gal acto-undecose (7) and the native ligand Gal4. Tritium
      labelled 7 chemically modified the heavy and light chains of IgA J 539, whereas 8
      azi-6,7,8,9,10-pentadeoxy-D-(11-3H)galacto-undecose (5a) reacted only with the
      heavy chain.

PMID- 1633608
TI  - Current bibliography of cell calcium prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1633609
TI  - The effects of Ca2+ and calmodulin on adenylyl cyclase activity in plasma
      membranes derived from neural and non-neural cells.
AB  - The regulation of adenylyl cyclase activity by varying concentrations of Ca2+ was
      examined in plasma membrane preparations derived from a number of neural and non
      neural cells. Enzyme activity in neural tissue (i.e. cerebellum) neural-derived
      pheochromocytoma PC12 cells and certain endocrine cells (i.e. pancreatic RINm5f
      and parathyroid cells) was stimulated by physiologic concentrations of Ca2+ by a
      calmodulin (CaM)-dependent mechanism. In contrast, adenylyl cyclase activity in
      non-neural cells (e.g. platelets and GH3 cells) was not stimulated by Ca2+. In
      these latter sources, enzyme activity was inhibited by increasing concentrations
      of Ca2+, independent of CaM. In liver membranes, Ca2+ and/or CaM did not alter
      adenylyl cyclase activity. These results demonstrate that the effects exerted by
      physiologic concentrations of Ca2+ on adenylyl cyclase activity range from CaM
      dependent stimulation of activity to no effect, to CaM-independent inhibition of
      activity. The actions of Ca2+ on adenylyl cyclase may be major contributors to
      the various synergistic or antagonistic interactions that are seen between cAMP
      generating and Ca(2+)-mobilizing systems.

PMID- 1633610
TI  - The effect of endotoxemia on concanavalin A induced alterations in cytoplasmic
      free calcium in rat spleen cells as determined with Fluo-3.
AB  - The effects of acute (3 h) and chronic (30 h) in vivo infusions of Escherichia
      coli endotoxin on the Ca2+ homeostasis of rat spleen cells was investigated.
      Conditions were established for obtaining reliable estimates of [Ca2+]i in these
      cells using the newly-developed Ca2+ indicator Fluo-3. The resting [Ca2+]i of
      splenocytes and T lymphocyte-enriched preparations were 119 +/- 35 and 102 +/- 31
      nM, respectively. Treatment of the cells with concanavalin A (Con A) resulted in
      a rapid increase in [Ca2+]i. The magnitude of the increase was positively
      correlated with the concentration of Con A, whereas the time required to reach
      the maximum [Ca2+]i was inversely related to the amount of Con A. The peak
      [Ca2+]i was attained more rapidly in splenocytes (i.e. less than or equal to 30
      s) than in the T cell-enriched fraction (i.e. 1.5-2.0 min). Both the resting
      [Ca2+]i and the Con A-induced increase in [Ca2+]i were similar to values
      previously reported for other lymphocyte cell types using different Ca2+
      indicators, thereby supporting the values obtained with Fluo-3. Infusions of
      saline or endotoxin prior to the isolation of the cells did not result in
      significant alterations of either resting [Ca2+]i or the cells' response to Con
      A. Since chronic infusions of endotoxin have previously been shown to cause a
      reduction in blastogenic responsiveness of splenocytes to Con A, these data
      suggest that the endotoxin-induced lesion occurs distal to the mobilization of
      intracellular Ca2+.

PMID- 1633612
TI  - Presence of Na+/Ca2+ exchange activity and its role in regulation of
      intracellular calcium concentration in bovine adrenal chromaffin cells.
AB  - The presence of a Na+/Ca2+ exchanger in bovine adrenal chromaffin cells was
      demonstrated by measuring the efflux of 45Ca2+ which had been preloaded into
      cells by a brief depolarization. The efflux of 45Ca2+ was dependent on
      extracellular Na+ (Na+o); 45Ca2+ efflux was significantly decreased by replacing
      Na+o with N-methylglucamine (NMG), or Li+. Replacement of Na+o by NMG increased
      the resting intracellular Ca2+ concentration ([Ca2+]i) of freshly isolated
      chromaffin cells. This could be reversed by adding Na+, suggesting that Na+/Ca2+
      exchanger activity was involved in maintaining [Ca2+]i at its resting level. The
      initial rate of Na(+)-dependent [Ca2+]i recovery after Ca2+ loading by
      depolarization was dependent on the level of [Ca2+]i. There was an apparent
      linear relationship between the activity of the Na+/Ca2+ exchanger and [Ca2+]i
      both in the presence and absence of Na+o. When cells were treated with other
      stimuli, including 10 microM DMPP or 40 mM caffeine, the ability of the
      stimulated cells to decrease [Ca2+]i was significantly reduced upon replacing
      Na+o with NMG. Our data show that the Na+/Ca2+ exchanger is one of the major
      pathways for regulating [Ca2+]i in chromaffin cells in both resting and
      stimulated states.

PMID- 1633611
TI  - Subcellular distribution of cytosolic Ca2+ in isolated rat hepatocyte couplets:
      evaluation using confocal microscopy.
AB  - Ca2+ agonists induce Ca2+ waves and other non-uniform Ca2+ patterns in the
      cytosol of epithelial cells. To define subcellular Ca2+ transients in the cytosol
      of hepatocytes we examined Fluo-3-loaded isolated rat hepatocyte couplets using
      confocal microscopy. Optical sections of less than 1 micron in thickness were
      observed in couplets, and fluorescence from cytosolic Ca2+ signals was readily
      distinguished from nuclear, mitochondrial, and lysosomal fluorescence. The nature
      of the noncytosolic components of the fluorescent images was verified by double
      labelling with the mitochondrial dye DiOC6(3) and with the lysosomal marker
      acridine orange. Using the line scanning mode of confocal microscopy,
      measurements of cytosolic Ca2+ were made with a frequency of up to 250 Hz and
      without significant bleaching. It was found that phenylephrine-induced Ca2+
      signals generally began at the basal pole of the hepatocytes, then spread to the
      canaliculus at average speeds of 80 micron/s. These findings demonstrate the
      utility of confocal line scanning microscopy for detecting rapid changes in the
      subcellular distribution of cytosolic Ca2+ in hepatocyte couplets, and suggest
      that phenylephrine-induced Ca2+ waves radiate in a basal-to-apical direction in
      this cell type.

PMID- 1633614
TI  - Does Zimbabwe need geriatric services?

PMID- 1633613
TI  - Pathways to psychiatric care in Harare, Zimbabwe.
AB  - A study was carried out on the pathways to psychiatric care in Harare, Zimbabwe.
      Encounter forms were completed on 48 patients admitted to psychiatric beds.
      Analysis indicated that there was a by-pass of primary care facilities, with a
      significant number presenting directly to tertiary care facilities, here were
      lengthy delays before seeking care, but delays while receiving care were
      moderate. The sample as a whole was composed of major disorders, displaying
      severe symptoms, and there was a suggestion that some patients become more
      disturbed along the pathway. As a whole, the sample is very different to samples
      screened from primary care settings, and the consequences of this are discussed.

PMID- 1633615
TI  - Malignant lymphomas in Jos, Nigeria: a ten-year study.
AB  - One hundred-and-sixty-seven cases of malignant lymphomas (ML) diagnosed in the
      Jos University Teaching Hospital, Jos, Nigeria, over a ten-year period (1979-88)
      were reviewed. The overall incidence rate is 13.4 per 100,000 with a median age
      of 29 years and a male:female ratio of 3:1. Non-Hodgkin's lymphoma (NHL) and
      Hodgkin's disease (HD) represent 67.7 pc and 32.3 pc cases respectively. Low,
      intermediate and high grade NHLs account for 51.4 pc, 17.7 pc and 30.0 pc of
      cases respectively; the collective median age at presentation is 31 years and the
      male:female ratio is 2:1 (Follicular: 13.3 pc; diffuse 86.7 pc). The small
      lymphocytic lymphoma is the commonest NHL (38.1 pc); the small non-cleaved cell
      type (African Burkitt's lymphoma type) accounts for 24.7 pc with an incidence
      rate of 2.2 per 100,000 within the general population and a median age of 10
      years. Hodgkin's disease (median age: 28 years) is the commonest form of ML
      exhibiting only a single peak in the 21-30 years range. The male:female ratio is
      8:1 and histological types associated with poor prognosis predominate. The
      prevalent clinical presentations is with a painless peripheral lymphadenopathy,
      the cervical group of lymph nodes is often involved representing 55 pc and 67 pc
      of NHL and HD cases respectively. Burkitt's lymphoma present primarily as an
      abdomino-pelvic tumour (67.8 pc of cases). Primary extradonal presentation is
      seen in 90 pc of MLs, all of which are the NHL group with Burkitt's lymphoma
      accounting for 80 pc of all cases.

PMID- 1633617
TI  - Peri-umbilical cellulitis in Nigerian neonates.
AB  - A retrospective analysis was made of 32 neonates with peri-umbilical cellulitis
      seen at Wesley Guild Hospital, Ilesa, Nigeria from 1979 through 1989. All were
      full term and delivered after a normal pregnancy. The male:female ratio was
      1.3:1. On admission, the mean (Standard Deviation) post-natal age, weight and
      duration of symptoms were 7.3 (2.7) days, 3.21 (0.5) kg, and 1.9 (1.3) days
      respectively. Major features were abdominal distension, extensive peri-umbilical
      induration and inflammation, and foul-smelling discharge. Most mother had
      antenatal care, but 60 pc were delivered at home or in the mission house. There
      were no recognisable maternal risk factors. Hot fomentation and unsterile
      materials applied to the cord were the apparent causative factors. The case
      fatality rate was very high (71.9 pc). Recommended treatment was antibiotics and
      surgical debridement. If hospital delivery were accessible to the less privileged
      poor, this highly lethal condition could be prevented by facilitating instruction
      in simple sterile cord care.

PMID- 1633616
TI  - Child survival in a rural area in Zimbabwe: are we winning?
AB  - Health teams in a rural district in Zimbabwe have been implementing child
      survival programmes since 1984. A prospective study of the causes of morbidity
      and mortality in under-five children was done. Community based surveys assessing
      nutrition status, immunisation coverage and knowledge and use of sugar and salt
      solution for diarrhoea were carried out. Malnutrition, acute respiratory
      infections and diarrhoea accounted for 69.7 pc of the 902 under-fives admissions
      while 33 (67.4 pc) of the hospital deaths were under-fives. The mortality pattern
      parallelled that of morbidity. Malnutrition was more common in the dry communal
      areas and on the commercial estates. Full immunisation coverage rates in the 12
      23-month-olds increased from 44.3 pc in 1984 to 70 pc in 1989; and up to 69 pc of
      the mothers correctly prepared and used sugar and salt solution for diarrhoea
      management. Although there appears to have been little impact on malnutrition,
      respiratory infections and diarrhoea, the study shows that a lot can be achieved
      even in a remote rural district given political will, community involvement, and
      dedicated staff. The maintenance of the current momentum and the introduction of
      further socio-economic reforms is a big challenge facing the health teams,
      community members and politicians.

PMID- 1633618
TI  - Unusual complications of celestin tube.

PMID- 1633619
TI  - The second tour.

PMID- 1633620
TI  - Seasonal variation in the food consumption patterns of the people of Mutambara
      district of Zimbabwe.
AB  - The pattern of food consumption among the people of Mutambara was studied during
      periods in December/January, May, and August. A total of 146 food items were
      consumed. The largest number of meals missed, mainly lunches, was in May. Home
      grown foods were consumed to a greater extent in May and August than in the
      December/January period. Wild and semi-wild vegetables and insects were consumed
      only in December/January when they were available.

PMID- 1633621
TI  - The discovery of cell wall active antibacterial antibiotics.

PMID- 1633622
TI  - ACV synthetase.
AB  - ACV synthetase (ACVS) is the first enzyme and plays a key role in the
      biosynthesis of all natural penicillins and cephalosporins. The enzyme is
      extremely unstable and little had been known about it until recently. This
      article summarizes the progress in research on this enzyme, including the
      establishment of a cell-free assay system, stabilization, purification,
      characterization, and gene cloning. A possible reaction sequence for ACVS
      catalysis is suggested.

PMID- 1633623
TI  - Overexpression of vinculin suppresses cell motility in BALB/c 3T3 cells.
AB  - The content of vinculin, a cytoplasmic protein found in focal contacts and cell
      cell junctions, was increased in BALB/c 3T3 cells by gene transfection. The
      vinculin expressed from the full length chicken cDNA, incorporated into focal
      contacts and its pattern was identical to that of the endogenous protein. Cells
      stably expressing vinculin by 20% over the endogenous level had altered
      locomotory properties. In these cells, the ability to migrate into a wound formed
      in a confluent monolayer and the locomotion of individual cells were drastically
      reduced. The results provide direct evidence that cell locomotion can be
      regulated by modulating vinculin expression.

PMID- 1633624
TI  - Actin based motility on retraction fibers in mitotic PtK2 cells.
AB  - When PtK2 cells round up in mitosis they leave retraction fibers attached between
      the substrate and the cell body. Retraction fibers and the region where they meet
      the cell body are rich in actin filaments as judged by phalloidin staining and
      electron microscopy. Video microscopy was used to study actin dependent motile
      processes on retraction fibers. Small, phase-dense nodules form spontaneously on
      the fibers, and move in to the cell body at a rate of 3 microns/minute. As they
      move in they increase progressively in phase-density. This movement appears to be
      related to actin dependent centripetal movement which has been previously studied
      in lamellipodia. Despite its generality, the mechanism of such movement is
      unknown, and retraction fibers present some special advantages for its study.
      Cytochalasin treatment causes nodules to stop moving and dissolve. Withdrawal of
      the drug causes them to reform and start moving. Surprisingly, movement after
      cytochalasin withdrawal was often outward, indicating a local reversal of
      cortical polarity. After a few minutes correct polarity is reestablished by a
      global control mechanism. The implications of these observations for the
      mechanism and polarity of actin dependent motility is discussed.

PMID- 1633625
TI  - Dynamics of neuronal intermediate filaments: a developmental perspective.

PMID- 1633626
TI  - Lung myofibroblasts.

PMID- 1633627
TI  - Sibling response to childhood cancer: a new approach.
AB  - It is well recognized that serious illness in children can have important
      consequences for siblings who may manifest their concerns as behavioural
      difficulty. The aim of the present study was to explore sibling psychological
      response to childhood cancer and to observe the effects that sibling knowledge
      had on their response. Siblings and parents of patients at the Children's
      Hospital, Birmingham, were interviewed using the Achenbach Child Behavior
      Checklist and semi-structured 'Illness Knowledge' questionnaires designed by the
      first author. Siblings were not experiencing significant behaviour problems. The
      level of sibling knowledge about cancer was related to the level of sibling
      social competence but not to the prevalence of behaviour problems. One-third of
      the siblings were talking to no one at all about their feelings, and sibling
      feedback yielded some important sibling needs. It was concluded that sibling
      response to childhood cancer may not necessarily be pathological and may also be
      mediated by the level of sibling social competence as well as sibling knowledge.

PMID- 1633628
TI  - NACB 15th annual symposium: Advances in clinical laboratory evaluation of
      cartilage, bone, and systemic rheumatic diseases. Washington, DC, July 26-27,
      1991.

PMID- 1633629
TI  - Biochemistry of articular cartilage in health and disease.
AB  - Articular cartilage covers the ends of long bones in synovial joints, providing
      smooth articulation and cushioning of the underlying bone during joint movement.
      The tissue can be viewed as a viscoelastic, composite material composed of
      collagen type II (and smaller amounts of other collagens) entrapping compressed
      (underhydrated) proteoglycan aggregates which generate a high osmotic/swelling
      pressure. This abundant extracellular matrix (ECM) is synthesized and turned over
      by relatively few cells, the chondrocytes. These cells produce a
      compartmentalized ECM, the components of which are heterogeneous and vary with
      anatomical location. They also undergo changes with age and altered functional
      requirements. Articular cartilage contains no separating basement membranes,
      nerves, lymphatics, or blood vessels. Access to nutrients and elimination of
      waste products occur via diffusion through the extracellular matrix. The turnover
      of collagen is much slower than that of proteoglycans. Products of the metabolic
      turnover of the matrix macromolecules are released continuously into the synovial
      cavity and ultimately reach the blood circulation where they can be measured as
      "markers" of metabolic changes.

PMID- 1633630
TI  - National Academy of Clinical Biochemistry Kodak Lectureship Award Recipient.

PMID- 1633631
TI  - Cartilage matrix metabolism in osteoarthritis: markers in synovial fluid, serum,
      and urine.
AB  - Osteoarthritis is a major cause of disability and early retirement. Yet we lack
      the means to diagnose the disease in its early stages or to monitor the effects
      of treatment on the target tissue, the joint cartilage. Neither can we identify
      the disease mechanisms at the tissue or cell level. Current research focuses on
      the use of markers of cartilage matrix metabolism in body fluids as a means to
      diagnose and monitor osteoarthritis. Cartilage proteoglycan, collagen and
      glycoprotein fragments, as well as proteinases and their inhibitors, are being
      suggested for this purpose. Structural information on matrix molecule fragments
      released into body fluids may also help to identify the enzymes active in the
      destruction of the cartilage, a central issue in osteoarthritis.

PMID- 1633632
TI  - Serum keratan sulfate--a marker of predisposition to polyarticular
      osteoarthritis.
AB  - We have used an ELISA to quantify a highly sulfated epitope present on keratan
      sulfate, a carbohydrate chain found principally in cartilage proteoglycans. The
      serum level of the epitope provides an indirect measure of the rate of
      degradation of cartilage proteoglycans during normal turnover and can be used to
      diagnose specific abnormalities in keratan sulfate metabolism. Serum levels of
      the epitope are elevated in a high percentage of patients with osteoarthritis and
      correlate with the number of joints involved. The elevated rate of proteoglycan
      turnover in these patients appears to be systemic, affecting not only the
      degenerating articular surfaces but apparently normal articular cartilages as
      well. We have postulated that this acceleration in the rate of proteoglycan
      turnover precedes clinical evidence of degenerative changes; and we discuss the
      rationale for the contention that this elevation may predispose adult humans to
      polyarticular osteoarthritis.

PMID- 1633633
TI  - Autoimmune diseases: overview and current concepts of pathogenesis.
AB  - No single theory or mechanism can adequately explain all features or pathogenesis
      of autoimmune diseases. The clinically wide spectrum of autoimmune diseases is
      best considered as the mosaic of autoimmunity and the many factors involved are
      genetic, hormonal, immunological, and environmental. These multifactorial
      considerations help to explain not only the diversity of various clinical
      diseases encountered but also the differences in clinical manifestations from
      patient to patient within the same disease group.

PMID- 1633634
TI  - HLA molecules in autoimmune diseases.
AB  - The association of certain autoimmune diseases with HLA molecules is being
      refined through the use of sequence-specific oligonucleotide probes and amino
      acid sequencing, together with continuing elucidation of the functional features
      of HLA molecules derived from the milestone description by Bjorkman of the HLA
      molecular structure. The association of insulin-dependent diabetes mellitus and
      HLA began with weak associations of Class I antigens (B8 and B15) and progressed
      to Class II antigens (DR3 and DR4), then to subtypes of DR4 (Dw4, 10, and 14),
      and now to DQ molecules including the absence of aspartic acid at position 57 of
      the DQ beta chain and the presence of arginine at position 52 of the DQ alpha
      chain. In rheumatoid arthritis (RA) the HLA antigen association remains with
      certain Class II molecules of the DR series (DR4 and DR1) that share amino acid
      sequences with a restricted number of other DR antigens seen in RA, as well as a
      segment of the gp 110 protein of the Epstein-Barr virus. Although ankylosing
      spondylitis has a strong association with the Class I antigen B27, that
      association is not explained by any of the B27 subtypes defined by monoclonal
      antibodies, by the eight variable amino acids in B27 subtypes, or by the two
      unique amino acids on B27. The remarkable antibody cross-reactivity among
      lymphocytes bearing B27, a synthetic peptide sequence (63-84) of B27, and the 188
      193 sequence of K. pneumoniae nitrogenase has provided strong support for
      molecular mimicry being an important mechanism in the association of HLA
      molecules with disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633635
TI  - Thyrotropin receptor antibodies: advances and importance of detection techniques
      in thyroid diseases.
AB  - The study of autoimmune thyroid disorders (AITD) has greatly contributed to our
      knowledge of autoimmunity. Graves' disease and Hashimoto's thyroiditis represent
      two ends of the range of autoimmune responses seen in AITD. Autoantibodies
      reactive to cytoplasmic antigens are associated with cell damage, and thyrotropin
      (TSH)-receptor antibodies (TRAb) influence the function and growth of the gland
      and play a major role in pathogenesis. The heterogeneous nature of TRAb is well
      accepted. Besides their long-known thyroid stimulating activity, TRAb can act as
      blocking antibodies or growth-promoting antibodies and, thus, cause
      hypothyroidism (primary myxedema) or endemic and sporadic goiters, respectively.
      Advanced methodologies for detection of these antibodies with the TSH-receptor
      assay and thyroid cell bioassay allow various activities to be measured. Current
      data using these assays confirm the presence of heterogeneity of functional
      activities of TRAb(s) in vivo. The activity of predominating antibody may relate
      to clinical presentation. This indicates a need for paired determinations of both
      TSH-binding inhibitory immunoglobulin (TBII) and thyroid-stimulating
      immunoglobulin (TSI) for accurate clinical correlations. Cloning the TSH-receptor
      gene has clarified its structure and function. The future identification of its
      epitopes will further delineate the clinical role of these antibodies and may
      allow development of new diagnostic and therapeutic approaches.

PMID- 1633636
TI  - Serological detection of disease activity in SLE.
AB  - Laboratory tests are commonly used to aid in monitoring disease activity in
      patients with systemic lupus erythematosus. Typically, tests for antinative DNA,
      complement, acute phase reactants, and sometimes circulating immune complexes are
      used for this purpose. More recently, tests for complement activation products
      and immunocyte activation have been suggested. We measured antinative DNA, C4,
      Westergren sedimentation rate, iC3b, Bb, and sIL-2R levels in a group of 100
      patients with SLE evaluated clinically for activity by a modified version of the
      Systemic Lupus Activity Measure (SLAM); iC3b and Bb were studied in 71 of the
      patients and sIL-2R in 52. We found that sIL-2R and sedimentation rate correlated
      best with SLAM, anti-DNA was intermediate, and C4, iC3b, and Bb correlated the
      least. None of the tests predicted severity of disease, but sIL-2R was highest in
      patients with active renal disease.

PMID- 1633637
TI  - Laboratory evaluation of patients with Sjogren's syndrome.
AB  - Sjogren's syndrome (SS) is a chronic autoimmune disorder characterized by
      lymphocytic infiltration of the lacrymal and salivary glands, leading to severe
      dryness of eyes (keratoconjunctivitis sicca) and mouth (xerostomia). SS may exist
      as a primary disorder (1 degree-SS) or in association with other autoimmune
      diseases including rheumatoid arthritis (RA), systemic lupus erythematosus or
      progressive systemic sclerosis (scleroderma). Diagnosis of 1 degree-SS is
      confirmed by minor salivary gland biopsy and the presence of circulating
      autoantibodies. Minor salivary gland biopsies exhibit focal lymphocytic
      infiltrates that are present in the majority of lobules. Incorrect methods of
      biopsy and failure to determine the average focus score are common causes for
      false-positive and false-negative biopsies. SS patients frequently have a
      positive antinuclear antibody test due to presence of SS-A (Ro) and SS-B (La)
      autoantibodies. Molecular analysis has revealed multiple "SS-A" proteins (60 kd,
      54 kd, 52 kd) that react with sera from SS patients, as well as a 48 kd SS-B
      protein. Rheumatoid factor (anti-IgG Fc antibody) in 1 degree-SS patients
      exhibits restriction in its light chain-associated idiotype, in contrast to RA
      patients where no restriction of idiotype was detected. Other autoantibodies
      found in a subpopulation of SS patients include anti-ADP ribose polymerase, anti
      cardiolipin, anti-mitochondrial, anti-mitotic spindle apparatus, anti-parietal
      cell, and anti-thyroid associated antibodies. Due to the high frequency of
      dryness syndromes in patients due to other causes (ranging from drug side effects
      to normal aging processes), the use of strict criteria for diagnosis of SS will
      lead to improved cost-efficient medical care avoiding needless anxiety in the
      patient.

PMID- 1633638
TI  - Autoantibody specificity in drug-induced lupus and neutrophil-mediated metabolism
      of lupus-inducing drugs.
AB  - A long-term side effect of therapy with a variety of drugs is a syndrome
      resembling the idiopathic autoimmune disease, systemic lupus erythematosus.
      Essentially all patients with drug-induced lupus display autoantibodies to
      nuclear histone components whose specificity appears to be related to the higher
      order structure of histones existing in chromatin. IgG antibodies to H1 and the
      (H2A-H2B)-DNA complex were observed in most patients with lupus induced by
      procainamide, hydralazine, and quinidine, whereas the H3-H4 tetramer, comprising
      half the mass of the nucleosome core particle, was largely nonantigenic. IgM
      antibodies to (H2A-H2B)-containing chromatin subunits were common also. IgM
      reactivity was observed with the DNA-free H3-H4 tetramer and with H1, especially
      in hydralazine-induced lupus. These results suggest that IgM antihistone
      antibodies may result from autoimmunization with a nonnative form of chromatin,
      whereas IgG antibodies may be selected for reactivity with H1 and a native form
      of the (H2A-H2B)-DNA subunit of the nucleosome. The chemical basis for induction
      of autoimmunity by drugs is unclear because lupus-inducing drugs do not have a
      common structural feature or biological activity nor are they capable of specific
      reactions with histones, the principal target antigen. However, in the presence
      of activated neutrophils, procainamide is transformed metabolically to the
      cytotoxic procainamide-hydroxylamine. Mixing experiments and cell-free studies
      demonstrated that procainamide was cooxidized with H2O2 by myeloperoxidase
      released when neutrophils undergo the respiratory burst and degranulation
      reactions. Preliminary results indicate other lupus-inducing drugs are also
      biotransformed by this mechanism suggesting that a common denominator linking
      these drugs may be the capacity to be oxidized to reactive metabolites by the
      action of activated phagocytic cells.

PMID- 1633639
TI  - Gaucher patients with oculomotor abnormalities do not have a unique genotype.
AB  - Sixteen non-Ashkenazic American children with Gaucher disease who demonstrate
      slowing of the horizontal saccades are described. Attempts to correlate this
      specific clinical phenotype with a unique genotype were unsuccessful. Focusing on
      the three most common mutations, at least five different genotypes were present
      in these patients. Children with this isolated oculomotor abnormality generally
      had a diffusely slowed background on EEG, but an otherwise normal neurologic
      examination, and exhibited earlier and more severe systemic manifestations and
      mortality. This study emphasizes the need for careful sequential neuro
      ophthalmologic examinations in Gaucher patients and the need for caution in
      attempting to make clinical predictions regarding the course of Gaucher disease
      on the basis of current DNA mutational analysis.

PMID- 1633640
TI  - Birth prevalence studies of the Crouzon syndrome: comparison of direct and
      indirect methods.
AB  - An indirect method for estimating the birth prevalence of the Crouzon syndrome is
      presented. The fraction of Crouzon 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.
      Crouzon syndrome makes up approximately 4.8% of all cases of craniosynostosis.
      Using a weighted average estimate, birth prevalence was calculated to be
      16.5/1,000,000. 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 circumstances.

PMID- 1633641
TI  - Mental retardation with blepharo-naso-facial abnormalities and hand
      malformations: a new syndrome?
AB  - A syndrome involving facial abnormalities (telecanthus, epicanthus, broad
      flattened nose, large inverted W-shaped mouth and malformed ears), malformed
      extremities (camptodactyly, clinodactyly, interdigital webbing and joint
      hyperlaxity) and mental retardation is described in a girl at birth and at 11
      years old. A comparison with Pashayan-Pruzansky syndrome, fetal alcohol syndrome,
      VATER association, Marden-Walker syndrome and Tel-Hashomer syndrome is discussed.
      We suggest this patient represents a new malformation syndrome or an extreme
      phenotypic variant of one of the above-mentioned syndromes.

PMID- 1633642
TI  - Interstitial deletion of chromosome 1 del (1) (q32 q42): case report and review
      of the literature.
AB  - We describe the case of a female infant with multiple congenital anomalies who
      was found to have a de novo distal intestinal del (1) (q32 q42). The clinical
      features of other reports of similar deletions are briefly reviewed. No
      characteristic phenotype seems to be as yet definable due to the limited number
      of cases published.

PMID- 1633643
TI  - Further evidence consistent with Yqh as an indicator of risk of gonadal blastoma
      in Y-bearing mosaic Turner syndrome.
AB  - An 8-year-old girl with some features of Turner syndrome and karyotype 45X/46XY
      had developed a bilateral gonadoblastoma in her rudimentary ovaries. Her normal Y
      chromosome showed the characteristic distal fluorescence, as seen in her
      father's. Another mosaic, this time 45X/46XidicY, and also with some Turner
      features had rudimentary ovaries, but no gonadoblastoma had developed at age 14.
      The nature of her idicY, which showed no fluorescent distal Yq and had one of the
      centromeres inactivated, was confirmed by in situ hybridisation with a Yp
      specific probe. Using primers from a human Yp-specific sequence, we amplified DNA
      extracted from paraffin-embedded ovarian tissue from both cases, and from a
      normal testicle and a normal ovary as controls. The finding of the expected Y
      derived PCR product in the rudimentary gonads from these mosaic patients
      indicates the presence of their Y chromosome in both. We discuss the validity of
      the findings, and the possible role of sequences in or near the fluorescent part
      of Yq in the origin of gonadoblastoma in Y-bearing mosaic Turner syndrome.

PMID- 1633644
TI  - Fragile site Xq27.3 in a family without mental retardation.
AB  - Routine parental blood analysis for a couple undergoing prenatal diagnosis
      because of maternal age, revealed a 47,XXX karyotype in the mother and expression
      of the fragile site Xq27.3 in the father. Additional family studies show the
      fragile site in the father's sister and her two sons. There is no history of
      intellectual handicap in this family, nor of any physical manifestations of the
      Fra(X) mental retardation syndrome.

PMID- 1633645
TI  - Trisomy 18 mosaicism with complete peripheral lymphocyte trisomy and normal
      intelligence.
AB  - We report a patient with trisomy 18 in all peripheral lymphocytes, mosaicism in
      cultured fibroblasts, mild nonspecific dysmorphic features, and normal
      intelligence. Trisomy 18 mosaicism with complete peripheral lymphocytic trisomy
      has not been previously described. The karyotype of lymphocytes is not diagnostic
      in the absence of congruent morphologic features.

PMID- 1633646
TI  - On the variable expression of the Brachmann-de Lange syndrome.
AB  - A mother of normal intelligence and her moderately mentally retarded son, both
      with the typical facial features of the Brachmann-de Lange syndrome, are
      reported. We discuss the variable expression of the Brachmann-de Lange syndrome
      by comparing the autosomal dominant cases with the sporadic or presumed autosomal
      recessive cases. The autosomal dominant cases show milder symptoms in general. In
      our opinion, a de novo autosomal dominant mutation causes the severe form of the
      syndrome, recurrence within sibships being explained by germline mosaicism. In
      all convincingly autosomal dominant cases we found that the mother is the
      transmitting parent, suggesting genomic imprinting.

PMID- 1633647
TI  - Treatment for B-cell-type lymphoma in a girl associated with Bloom's syndrome.
AB  - A 12-year-old girl suffering from Bloom's syndrome developed B-cell-type lymphoma
      in the epipharynx. She was identified as having Bloom's syndrome at the age of 3.
      While the tumor was eradicated completely by induction chemotherapy, the bone
      marrow suppression was severe and persistent. For this reason, we modified
      subsequent chemotherapy to a milder form. Thus the remaining therapy could be
      safely completed. This is the first case clearly diagnosed as having
      epipharyngeal B-cell-type lymphoma in the Bloom's Syndrome Registry.

PMID- 1633648
TI  - Severe Silver-Russell syndrome and translocation (17;20) (q25;q13)
AB  - An 8-year-8-month-old girl with Silver-Russell syndrome (SRS) and a paternally
      inherited balanced t(17;20)(q25;q13) is described. This observation suggests that
      an SRS gene(s) maps on chromosome 17 or 20 and that the patient phenotype
      resulted from either unmasking of heterozygosity or genomic imprinting via
      paternal disomy.

PMID- 1633649
TI  - A unique de novo interstitial deletion del(17)(q21.3q23) in a phenotypically
      abnormal infant.
AB  - We report on an infant with multiple congenital anomalies possessing a de novo,
      interstitially deleted no. 17 chromosome. The phenotype includes brachycephaly,
      club feet, delay of growth and development, and hypertelorism with upslanted
      palpebral fissures. We are unaware of other reported cases involving such
      interstitial deletion of 17, or of translocations involving the breakpoint
      regions observed in our case.

PMID- 1633650
TI  - An HLA study in 74 Danish haemochromatosis patients and in 21 of their families.
AB  - HLA-A and -B alleles in 74 Danish patients and 21 homozygous relatives with
      idiopathic haemochromatosis (IH) were compared with those in a sample of 1719
      chromosomes from healthy Danish control subjects. The following alleles occurred
      with higher frequencies in IH compared to controls: A3: 53.6% vs. 15.1% (Pc less
      than 0.001); B7: 33.1% vs. 15.6% (Pc less than 0.001); B14: 6.9% vs. 3.0% (Pc
      greater than 0.05); B38: 5% vs. 0.9% (Pc greater than 0.05); B47: 4.0% vs. 0.4%
      (Pc greater than 0.05). Pedigree analyses disclosed 19 different haplotypes in IH
      subjects, compared to 286 haplotypes in controls. The following haplotypes
      occurred with higher frequency in IH compared to controls: A3,B5: 10.3% vs. 0.3%
      (Pc less than 0.001); A3,B7: 25.6% vs. 6.6% (Pc = 0.001); A3,B14: 3.4% vs. 0.6%
      (Pc greater than 0.05); A3,B47: 6.9% vs. 0.2% (Pc greater than 0.05). The major
      IH marker HLA-A3 was found in 56% of the haplotypes. The patterns of HLA-alleles
      associated with IH in Denmark show similarities to those in Central Europe,
      Australia, USA and Canada, being A3,B7 dominated and those in Central Sweden,
      England and Ireland, being A3,B14 dominated.

PMID- 1633652
TI  - HIV infection in obstetrics and gynaecology.

PMID- 1633651
TI  - Human immunodeficiency virus and the immunology of infection.

PMID- 1633653
TI  - The management of HIV disease in pregnancy.

PMID- 1633654
TI  - Nosocomial infection and infection control procedure.

PMID- 1633655
TI  - Clinical manifestations, management and therapy of HIV infection in children.
AB  - Perinatal infection accounts for the majority of cases of HIV infection in
      children both in developed and developing countries. Transmission may occur in
      utero, intrapartum or postpartum as a result of breast-feeding. The actual risk
      of transmission through breast-feeding is unknown. The majority of infants
      reported to be infected through breast milk have been infected as a result of a
      recently acquired HIV infection in the mother. Infants with HIV infection
      frequently present with clinical symptoms early in life. There is a broad
      spectrum of clinical findings in paediatric HIV infection, with opportunistic
      infections and multiorgan system involvement being common. The management of
      infants born to seropositive mothers includes routine paediatric care as well as
      careful clinical and laboratory monitoring for evidence of HIV infection. Infants
      who are seronegative with normal clinical and immunological findings at 18 months
      of age are considered uninfected. The prognosis and outcome of infants with HIV
      infection have improved considerably with earlier diagnosis and the availability
      of specific antiviral therapy. Modalities of therapy include frequent medical
      evaluation, aggressive diagnosis and treatment of infection, prophylaxis for
      Pneumocystis carinii infection, the use of intravenous gamma-globulin and
      specific antiviral therapy, such as zidovudine, didanosine or other drugs in
      development through clinical trials. HIV infection in children is a chronic
      illness and requires a comprehensive, family-oriented approach to care. With
      longer survival, children require support systems and an atmosphere of care and
      understanding to give them a good quality of life as well as prolonged survival.

PMID- 1633656
TI  - The situation in Africa.
AB  - More than three million women world-wide are infected with HIV, and women will
      constitute 40% of the new AIDS cases in 1990-1991. Unlike in the industrialized
      world, HIV in Africa is heterosexually transmitted and thus affects at least as
      many women as men. Already the leading cause of death in a major African city,
      HIV may be spreading to rural areas. In spite of improvement in surveillance,
      under-reporting makes it difficult to project trends, document differences within
      and between urban and rural areas, and identify at-risk groups. Increasing
      evidence shows that STDs play a major role in spreading the HIV epidemic. Male-to
      female transmission is more efficient owing to factors related to the pathogen
      and the host. Ulcerative STDs such as chancroid, syphilis and herpes facilitate
      HIV entry through mucosal discontinuation and recruitment of HIV target cells.
      The role of non-ulcerative STDs such as gonorrhoeal, chlamydial and trichomonal
      infections needs further elucidation. Lack of circumcision, traditional healing
      practices and oral contraceptives may affect the risk of viral transmission, but
      may not be major or modifiable risk factors. Pregnancy and pregnancy-associated
      immune alterations do not seem to affect the clinical course of HIV/AIDS in
      African women or impair immunocompetence. Maternal HIV can adversely affect
      pregnancy outcome in Africa, causing low birth-weight, prematurity, intrauterine
      and intrapartum fetal death. The risk for these outcomes is likely to depend on
      the degree of immunological and clinical deterioration. Breast-feeding does not
      appreciably increase the risk of HIV transmission to the infant and should be
      actively promoted in Africa. Control of HIV/AIDS in Africa, in the absence of an
      effective vaccine, will focus on behavioural changes through health education and
      condom use. High frequency STD transmitter core groups, mainly prostitutes and
      their clients, are currently the target of prevention campaigns which are proving
      to be successful and affordable.

PMID- 1633657
TI  - Gynaecological problems and infertility.

PMID- 1633658
TI  - Contraception and safer sex.

PMID- 1633659
TI  - HIV testing programmes in pregnancy.

PMID- 1633660
TI  - HIV counselling for women of reproductive age.
AB  - As the HIV pandemic has evolved over the past decade, the numbers of women
      affected by this virus have swelled. HIV counselling and testing is increasingly
      becoming a standard of obstetric and gynaecological practice, and women's health
      care providers will need to incorporate the appropriate knowledge and skills in
      order to provide these services. This article discusses preparation for
      integrating HIV counselling and testing into the women's health-care setting and
      the provision of HIV pre-test and post-test counselling and follow-up to women of
      reproductive age. Key preparation issues, including those of documentation,
      consent, confidentiality and risk assessment, are described. Counselling issues
      of particular significance for HIV-positive women, including reproduction,
      sexuality, care-giving, maintenance of health and long-term planning, are
      addressed. Planning and commitment are critical factors in the implementation of
      HIV counselling and testing in women's health-care delivery settings.

PMID- 1633661
TI  - The effect of HIV infection on pregnancy outcome.

PMID- 1633662
TI  - Vertical transmission.
AB  - Since AIDS was first described in children, much has been learnt about the
      epidemiology, clinical presentations and natural history of perinatally acquired
      HIV disease. As yet, several questions remain unanswered about the pathogenesis
      of vertical transmission, the relative risk associated with each mode of
      transmission, the rate of transmission from mother to child, and the factors that
      might contribute to the efficiency of transmission. Data presented thus far
      suggest that intrauterine exposure poses the greatest risk, but more recent
      reports have reopened speculation that infection could occur at or around the
      time of delivery. The prospects for intervention, to stop transmission from
      mother to child, rest on the ability to identify HIV-infected women; the
      knowledge of how and when the virus infects the fetus; and how to identify, as
      early as possible, those truly infected infants. Resources should therefore be
      set aside for routine screening for HIV in antenatal women. There is also a need
      to quantify the contribution made by intrauterine versus intrapartum events.
      Lastly, promising new techniques designed to detect neonatal HIV infection must
      be properly evaluated against standard methods, and correlated with clinical
      outcome. Only then can the efficacy of antiretroviral therapy be tried, to
      prevent vertical transmission.

PMID- 1633663
TI  - Burn rehabilitation and reconstruction.

PMID- 1633664
TI  - Burn rehabilitation: dimensions of the problem.
AB  - Recent improvements in the mortality rates of burned patients are attributed to
      the expansion of specialized burn centers. Satellite treatment areas with trained
      personnel need to be developed, located away from the burn center, and efforts
      should be made to increase the number of patient programs at existing burn
      centers. In addition, studies need to be conducted on cost consequences,
      hypertrophic scarring, peripheral and central nervous system involvement,
      musculoskeletal changes, sleep deprivation, and the comparison of various
      treatment techniques to determine what protocols provide the best treatment
      outcome.

PMID- 1633665
TI  - The cost of burn care and the federal government's response in the 1990s.
AB  - This article attempts to predict the federal government's response to the cost of
      burn care in the 1990s by examining the explosive growth of health care costs in
      the 1980s and the impact that this had on hospitals with burn centers. The
      Prospective Payment System (PPS) was enacted in 1983, which limited the
      government's liability to hospitals by effectively capping the amount of federal
      dollars in the system. The inequities of the classification of burn patients by
      the PPS is discussed and a proposal for modification is outlined.

PMID- 1633666
TI  - Rating burn impairment.
AB  - We have described the method of rating impairment published by the American
      Medical Association (AMA) and the method requested by the Social Security
      Administration (SSA). For various reasons it will be some time before burn
      centers will be able to report impairment as easily as they now report length of
      stay and other parameters, but in time it will come. When it is possible, the
      methods used will probably not be identical with the AMA method nor the SSA
      method described previously. But whatever method is used, it will surely
      incorporate concepts from each and portions of each--and the two exist and are
      used right now. Therefore, it is useful for burn physicians to understand the two
      methods and be prepared to use either.

PMID- 1633667
TI  - Reintegrating the healed burned adult into society: psychological problems and
      solutions.
AB  - This article reviews important psychosocial factors that effect reintegration of
      the burned patient into society. Issues of pain, brain injury, the psychological
      reaction, posttraumatic stress, the impact on the family, and alcohol and
      substance abuse are discussed, and possible solutions to these problems are
      offered.

PMID- 1633668
TI  - Helping the burned child to adapt.
AB  - Adaptation in burned children is multifaceted and complex due not only to
      etiologic variables but also to age-specific developmental issues and the level
      of family development. Parental and peer support are identified in the literature
      as major contributors to higher levels of self-esteem and adaptation. The
      potential for these levels of adaptation is complicated by the number of burn
      injured children residing in chaotic, dysfunctional families with limited ability
      to support psychosocial rehabilitation. Various interventions are presented as
      methods of addressing the social/emotional needs of higher-functioning patients
      and families.

PMID- 1633669
TI  - Ethical issues of burn management.

PMID- 1633670
TI  - Reconstructing the burned face.
AB  - The priorities, timing, techniques, and philosophies of reconstruction of the
      burned face are outlined in this article. Each anatomic area is analyzed, and the
      appropriate procedure is described.

PMID- 1633671
TI  - Ear reconstruction.
AB  - This article discusses both the surgical and nonsurgical management of the burned
      ear. Partial and total autologous reconstruction, as well as osseointegrated
      prosthetic reconstruction, are described.

PMID- 1633672
TI  - The thermally injured ear: a systematic approach to reconstruction.
AB  - The ears are special and unique structures that ordinarily are ignored during our
      daily routines. A thermal injury of relatively moderate proportions can
      irreparably alter their shape and appearance. Many reconstructive techniques have
      been garnered to restore these delicate structures. Herculean efforts will
      consistently fall short of these goals if tissue preservation is not in the
      forefront of our treatment protocol. Iontophoresis coupled with topical
      antimicrobial agents have been shown to ameliorate cartilage loss, allowing for
      delayed operative intervention, when more consistent results may be obtained.
      Early radical resection of ear soft tissue or structural cartilage should be an
      endeavor of last resort in all but a few instances, such as unresponsive
      suppurative chondritis. Segmental restoration of the injured ear allows for
      dismantling of the various parts to recreate the whole. A facsimile of the
      original is possible if the major visible distinguishing landmarks are salvaged.
      Flap resurfacing of exposed cartilage yields closer tissue match, color, and
      texture, and it affords a greater proclivity for survival than does graft
      closure. Sacrifice of the helical lip relegates the ear to that of a flat, less
      than-optimal appearance. Tissue expansion coupled with cutaneous flap closure
      will usually preclude this situation. Skin grafting is a valuable tool in our
      armamentarium but should be used judiciously in situations where graft coverage
      is either necessary or desired to produce enhanced results. In such instances,
      the thickness of the graft must be considered, ranging from an almost translucent
      quality for the antihelix to that of a much thicker graft for the helix.
      Application and direction of the graft will be determined by the underlying
      surface contours. Until the reconstruction has been completed, burn patients and
      their families usually do not view the injured ear that has been snatched from
      the fires of adversity. The unveiling frequently effects a felicitous atmosphere,
      because they perceive a relatively normal-looking ear. The final result is all
      that matters.

PMID- 1633673
TI  - Making the burned hand functional.
AB  - The goal of treatment of the burned hand is to make the hand functional at the
      conclusion of treatment. Function should ideally include both fine pinch and
      power grip but will ultimately be determined by the individual patient's needs.
      At no time, however, can the care of the burned hand be performed in a vacuum,
      losing sight of the patient as a whole. It must also be remembered that the hand
      functions as part of the upper extremity. Full hand motion is useless if
      significant contractures of the elbow or axilla prevent the patient from
      positioning the hand so that this motion can be utilized. Rehabilitation must
      render the entire extremity functional. Thus, it becomes obvious that a team
      effort is mandatory. This usually will include the following individuals:
      physician, nurse, occupational therapist, physical therapist, vocational
      rehabilitation counselor, and social worker. A functional upper extremity means
      that the goal must be to return patients to their preburn vocations and
      avocations. A clear understanding of job requirements and work habits will allow
      realistic goals to be established. However, when the goal of optimal function
      cannot be reached, early retraining will help to obtain optimal rehabilitation.

PMID- 1633674
TI  - The burned small finger.
AB  - Postburn deformities are common in the small finger. A boutonniere-like deformity
      may develop when no injury has been noted in the central slip of the extensor
      tendon. Attention to the anatomic differences of the fifth digit and principles
      of graft contraction make this deformity preventable. In the long-standing burn
      hyperextension deformity of the metacarpophalangeal joint, recurrence of the
      deformity may occur after reconstruction. Evaluation of extrinsic extensor
      tightness may indicate an alteration in the soft tissue-to-skeleton relationship.
      Composite tissue expansion of the tendon and overlying skin graft provides an
      alternative reconstruction method.

PMID- 1633675
TI  - Reconstruction of burns of the trunk and breast.
AB  - This article discusses the pathogenesis and reconstruction of hypertrophic
      scarring of the burned trunk. General reconstruction schemata are provided.
      Reconstruction of specific problems of the chest, abdominal wall, breasts, and
      perineum are also discussed.

PMID- 1633677
TI  - Splints and accessories following burn reconstruction.
AB  - Splints, exercise, traction, and compression garments are commonly accepted
      methods to minimize disabling scar formation. Although burn rehabilitation
      treatment has improved over the past 10 years, there is still no overnight cure
      for scars and contracture. The extent and depth of the burn injury, emotional
      strength and patience of the burn victim, and support systems available play an
      important role in scar treatment. Scar contracture is a frustrating complication
      for the recovering patient and burn team. Surgical reconstruction to correct
      functional impairment is often needed before wound maturation is complete.
      Splints are usually part of the postoperative treatment plan. When this is the
      case, patient understanding, compliance, motivation, and comfort are important to
      assure splint effectiveness. The treatments reviewed are specific for scar
      contracture limiting function of the upper body. Although they were presented as
      treatment of neck, mouth, axilla, and hand contractures, many of the principles
      and materials can be used after burn reconstruction of the lower extremities.
      Regardless of the area treated, assessment of patients is important to determine
      their specific needs in splint design.

PMID- 1633676
TI  - Reconstruction of the burned lower extremity.
AB  - Many of the long-term sequelae and deformities are preventable by early wound
      closure and aggressive physical managements. Concurrent and associated injuries
      and medical problems may place a patient with lower extremity burn injury into
      different clinical subsets. The standard care may have to be modified to
      accommodate these differences. The scars, the deformities, and the morbidity have
      decreased dramatically with early aggressive care and physical management. When
      contractures and deformities are recognized early in the rehabilitation phase,
      many of these can be satisfactorily corrected by physical means. If the
      contractures cause functional limitations, surgical release is indicated. The
      donor defects of free grafts or flaps should not be more deforming than the
      original injury. The goal is to return the patient to society as normal in
      function and appearance as possible.

PMID- 1633678
TI  - Pressure techniques for the prevention of hypertrophic scar.
AB  - No ideal or all-purpose method of scar control exists. Successful management of
      hypertrophic scar depends on early and aggressive treatment. The creative use of
      available products facilitates the production of a cosmetic and functional scar.
      Selection of the appropriate contact media will be influenced by the size,
      location, and depth of the injury; the scar's ability to tolerate shear and
      pressure; the availability of various products; and, most importantly, the
      patient's involvement in his or her own rehabilitation. The use of pressure is
      only one segment of the total rehabilitation of the thermally injured patient.
      Its use in conjunction with exercise, splinting, positioning, and reconstructive
      surgery allows an optimal level of function and cosmesis to be achieved.

PMID- 1633679
TI  - Skin care of the healed burned patient.
AB  - Many complications beset the skin formed over burn wounds, whether by primary re
      epithelialization or grafting techniques, and these can evolve over days to
      decades. Mechanisms by which re-epithelializations, reattachment, and remodeling
      may result in skin prone to blistering, dryness, itching, contact dermititis,
      photosensitivity, and hypertrophic changes relatively early in the course of
      healing are considered, and therapeutic approaches are discussed. Late
      development of benign and malignant lesions calls for long-term surveillance of
      the healed skin of burned patients.

PMID- 1633680
TI  - Antibodies to platelet glycoproteins in haemophiliacs infected with HIV.
AB  - The techniques of Western blotting and the monoclonal antibody specific
      immobilization of platelet antigen (MAIPA) assay were used to detect antibodies
      to platelet glycoproteins in 43 samples of serum from 23 anti-HIV positive
      haemophiliacs (8 with severe thrombocytopenia, 6 with moderate thrombocytopenia,
      and 9 with a normal platelet count), six anti-HIV negative haemophiliacs and ten
      controls. Antibodies were present in the majority of anti-HIV positive patients'
      sera even before the onset of thrombocytopenia. Thrombocytopenia was associated
      with an increase in the incidence of antibodies to GPIIIa and GPIb, whereas the
      antigen most frequently recognized in patients without thrombocytopenia was
      GPIIb. Anti-GPIIb and/or GPIIIa reactivity was also seen in three out of the six
      anti-HIV negative patients. There was no correlation between the absolute
      platelet count and the detection of antibodies in either assay. Effective therapy
      for thrombocytopenia with zidovudine, interferon or splenectomy did not influence
      the presence of antibody. Eight of nine patients with AIDS were negative in the
      MAIPA assay, consistent with their depressed immune status. It is concluded that
      the production of antibodies to platelet membrane glycoprotein in anti-HIV
      positive haemophiliacs is influenced by factors other than HIV. The presence of
      such antibodies is independent of the platelet count and is therefore unlikely to
      play a causative role in HIV-related thrombocytopenia.

PMID- 1633681
TI  - Antigen expression of frozen platelets.
AB  - Platelet antigens of platelet samples from 36 donors, frozen for different
      intervals, were evaluated by the platelet suspension immunofluorescence test
      (PSIFT). A, B, PLA1(HPA-1a) and various HLA antigens were tested by their
      corresponding antisera. The antigen could be detected in almost all the samples
      after one month of freezing. After 3 and 6 months, the platelet antigens could
      only be detected in 29.2% and 3.7% of the samples, respectively. There was no
      difference in decay of antigen expression among A, B, PLA1 and HLA antigens. When
      compared with the freshly prepared platelets, frozen platelets presented stronger
      antigen expression after 2 to 4 weeks of storage. This may suggest that the
      frozen platelets could be used for platelet crossmatching procedures without loss
      of their antigenicity within one month.

PMID- 1633682
TI  - Successful use of liposome encapsulated amphotericin to treat invasive
      aspergillosis following failure of conventional amphotericin.
AB  - We describe a case of proven invasive pulmonary aspergillosis in a neutropenic
      patient in whom disease progression occurred during treatment with conventional
      amphotericin B despite neutrophil recovery. Treatment with liposomal encapsulated
      amphotericin B resulted in clinical and radiological improvement and the
      clearance of aspergillus spores from the sputum.

PMID- 1633683
TI  - The selection of laboratory equipment.
AB  - The last few years have seen dramatic changes in laboratory haematology.
      Technological developments with increasing levels of automation have resulted in
      a plethora of new instruments. The choice of which to buy, often confused by
      conflicting advice and persuasive salesmanship, must be balanced by the need for
      cost containment. This calls for an understanding of the principles of selection
      to ensure that the system that is chosen will provide reliable results in the
      most efficient manner at the lowest possible cost. Most of the instruments which
      are currently available perform their intended tasks reasonably well albeit with
      some inter-instrument differences, usually due to different operating procedures
      and different methods of calibration. The task is to find a system that performs
      the required tests correctly and reliably, fits into the work requirements of the
      laboratory and is accepted by the staff who will operate it, whilst its cost both
      capital and recurrent, should be within the department's financial constraints.
      The selection of laboratory equipment is thus a complex and time consuming task.

PMID- 1633684
TI  - In vitro effects of ethanol on the phagocytic and microbial killing activities of
      normal human monocytes and monocyte-derived macrophages.
AB  - Human blood monocytes were cultured within the wells of chamber slides in growth
      medium to which 0, 1, 2, or 3 mg ethanol per ml was added at the start of the
      culture. After incubation for 1 h, 1 day and 7 days, their ability to phagocytoze
      IgG-sensitized red cells and to phagocytoze and kill non-opsonized Candida
      albicans was assessed. In all alcohol-containing wells, the concentration of
      alcohol in the growth medium fell progressively, reaching negligible values after
      3 days. When compared with control cells, monocytes incubated with 1, 2 or 3 mg
      ethanol/mg for 1 h showed impaired phagocytosis of IgG-sensitized RBC and non
      opsonized C. albicans and those incubated with 1 or 2 mg ethanol/ml for 1 h
      showed impaired killing of Candida. After incubation for 7 days, the monocyte
      derived macrophages in wells initially containing 1, 2 or 3 mg ethanol/ml showed
      increased phagocytic activity towards C. albicans but not towards sensitized RBC.
      In addition, in 4 of 5 experiments, the percentage of phagocytozed organisms
      killed was increased in wells initially containing 1 mg ethanol/ml. The results
      support the view that the susceptibility of chronic alcoholics to certain
      infections may be partly dependent on an ethanol-induced depression of the
      phagocytic and killing functions of macrophages. They also suggest that a few
      days after a brief period of exposure to ethanol there may be stimulation of
      certain but not all effector functions of macrophages.

PMID- 1633685
TI  - Diffuse intracerebral involvement in B-cell chronic lymphocytic leukaemia. A case
      report.

PMID- 1633686
TI  - Vacuolated Burkitt-like cells in adult T-cell leukaemia/lymphoma.

PMID- 1633687
TI  - Clostridium perfringens septicaemia and massive intravascular haemolysis as a
      terminal complication of autologous bone marrow transplant.

PMID- 1633688
TI  - Myelodysplastic syndrome with t(8; 12) (q22; q13) translocation.

PMID- 1633689
TI  - RDW in vitamin B12 and folate deficiency and in patients with alcohol-related
      macrocytosis.

PMID- 1633690
TI  - Survival in adult leukaemia.
AB  - The evaluation of treatment and outcome in adult leukaemia requires unselected
      data. Such data is available from one Health Region in the United Kingdom with an
      adult population of 3.1 million. In the period July 1982 to December 1989, 676
      cases of acute myeloid leukaemia (AML), 136 of acute lymphoblastic leukaemia
      (ALL) and 141 of chronic granulocytic leukaemia (CGL) were registered. The median
      survival for AML was 21 weeks and 26% of these patients died within 4 weeks of
      diagnosis. For ALL, the corresponding figures were 81 weeks and 21%. In CGL, the
      median survival was significantly different for males and females: 113 weeks and
      173 weeks respectively. The 5-year survival in AML was 9%, in ALL, 31% and in
      CGL, 29% (20% for males, 45% for females). Age at presentation was the single
      most powerful prognostic factor and probably accounts for survival differences
      between patients referred to tertiary centres and those treated in district
      general hospitals. (DGH). Survival may be improving overall as supportive care
      improves.

PMID- 1633691
TI  - [Nightingale's perspective of nursing administration].

PMID- 1633692
TI  - [The Nightingale nurses: the myth and the reality].

PMID- 1633693
TI  - [A round-table talk: Florence Nightingale; the woman who lived in the reality].

PMID- 1633695
TI  - [History and education of nursing as seen in 'Kyoiku Zasshi (Education
      Periodical)].

PMID- 1633694
TI  - [Superintendent's quarterly reports to the Governors of Nursing Home at Harley
      Street, 1853-4].

PMID- 1633696
TI  - [Asking about 'nursing and medicine'].

PMID- 1633697
TI  - [The world of Hildegard von Bingen].

PMID- 1633698
TI  - [What is psychiatry?].

PMID- 1633699
TI  - [Searching for logic of children's recognition].

PMID- 1633700
TI  - Contact dermatitis in hairdressers' clients.
AB  - The aim of our study was to report the frequency of sensitization to hairdressing
      allergens in a group of patients with contact dermatitis, in whom previous
      treatments with hair dyes or permanent wave solutions were suspected to be the
      cause. 49 of 261 hairdressers' clients (18.7%), who were patch tested with the
      hairdressers' screening series in the years 1985-1990, showed one (27) or more
      (22) positive reactions to hairdressing chemicals. This study confirms hair
      dyeing to be the procedure associated with the highest risk of sensitization
      among hairdressers' clients. Among hair dye allergens, PPD is the most frequent
      sensitizer (7.3%). A low rate of sensitization to the PPD derivatives PAP, ONPPD
      and PTD was detected in these clients, there being no differences in the
      frequency of sensitization to the 3 substances (4.2%, 4.6% and 4.6%,
      respectively). Only 0.4% of clients were positive to resorcinol, while pyrogallol
      showed a 2.3% rate of sensitization. Sensitization to GMTG was found in 3.3% of
      patients. ATG was an infrequent sensitizer (1.1%). Allergic contact dermatitis
      due to APS is quite rare (2.7%), in view of the widespread use of this compound.
      A positive open patch test in 1 hairdressers' client, who complained of
      generalized urticaria after hair bleaching, confirmed the diagnosis of immediate
      contact reaction due to APS. Sensitization to hairdressing allergens among
      consumers (18.7%) is possibly more frequent than sensitization to other cosmetic
      ingredients. We previously detected a 14.3% rate of sensitization to cosmetic
      ingredients in patients with suspected allergic contact dermatitis caused by
      cosmetics. On the other hand, reactions to cosmetic ingredients were also common
      in our patients. This may indicate that hairdressers' clients make greater use of
      cosmetics than average.

PMID- 1633701
TI  - Allergic contact dermatitis in children. A multicenter study of the Portuguese
      Contact Dermatitis Group (GPEDC).
AB  - The authors report a study of allergic contact dermatitis in 329 Portuguese
      children of 14 years or younger. 170 children (64 male and 106 female) reacted to
      1 or more allergens. Most of these were in the 11-14 years group. The main
      allergens were nickel, thimerosal, cobalt, mercury, fragrance-mix and potassium
      dichromate. Nickel reactivity predominated in females over the whole group, but a
      greater number of males younger than 5 years reacted to nickel. The number of
      positive reactions increased with age, but this was not accompained by an
      increase in the % of relevant tests. 12 children, all of them 13 or 14 years-old,
      had an occupational allergic contact dermatitis.

PMID- 1633702
TI  - Effect of a new topical cyclosporin formulation on human allergic contact
      dermatitis.
AB  - We studied the effect of a new topical cyclosporin (CS) formulation on the
      suppression of allergic contact dermatitis. 4 test sites were outlined on the
      back of healthy male volunteers. For 7 consecutive days, the test sites were
      treated as follows: #1: CS formulation (10%), #2: placebo formulation, #3:
      flumethasone pivalate (FP) formulation (0.02%; #4: no treatment. On day 8, we
      challenged all test sites in the diphenylcyclopropenone (DCP) sensitized
      individuals. Photographic and clinical documentation was performed daily. 24 h
      after the DCP skin challenge, a marked redness accompanied by severe itching and
      slight pain occurred in the test sites pretreated with CS (#1) and placebo (#2).
      A considerably milder reaction was noted in the untreated test site (#4) and only
      a faint redness was noted in the test site pretreated with FP (#3). After 36 h, a
      further increase in the cutaneous reaction was documented in CS and placebo
      pretreated test sites (#1, 2). In agreement with other workers, topical CS did
      not suppress experimentally-induced allergic contact dermatitis in man. On the
      contrary, in CS and placebo pretreated areas (#1, 2), an increased cutaneous
      reaction was observed. This observation may be explained by the extensive
      pretreatment with the topical formulation of CS and placebo, which possibly
      caused a profound perturbation of the stratum corneum, enabling excessive
      allergen penetration compared to the untreated area with intact stratum corneum.

PMID- 1633703
TI  - Comparative evaluation of permeation testing of protective gloves to solvents: in
      vitro in permeation cells versus in vivo in guinea pigs.
AB  - Most current data on the protective effect of gloves against chemicals are
      obtained in vitro, using permeation cells. In vivo testing would give additional
      information on efficiency but is both expensive and time-consuming. It would
      therefore be valuable to know whether any definitive relationship exists between
      results obtained in vivo and in vitro. Gloves of natural rubber, butyl rubber and
      polyvinyl chloride (vinyl) were tested against 3 organic solvents, toluene, 1,1,1
      trichloroethane and butanol, in vivo in guinea pigs and in vitro in permeation
      cells. Breakthrough times, absorption rates and steady state permeation rates
      were determined and compared on a relative basis. Some of the gloves that had a
      low degree of resistance to the test solvent in vitro nevertheless showed a
      rather good reducing capacity on the percutaneous absorption in vivo. However,
      for 2 gloves where no breakthrough was noted for butanol in vitro, permeation
      occurred at a degree lower than the minimum detection level. At this low
      concentration, the solvent was not absorbed through intact skin but through
      damaged skin. The breakthrough times for the 3 solvents corresponded well for the
      2 test systems. The relative absorption rates and relative steady-state
      permeation rates varied considerably and no definitive relationship between the 2
      sets of test results could be seen.

PMID- 1633704
TI  - Contact urticaria from dog saliva.

PMID- 1633705
TI  - Guitar-string dermatitis.

PMID- 1633706
TI  - False positive reaction to patch testing with aqueous mercuric chloride in an
      aluminum Finn Chamber.

PMID- 1633707
TI  - An unusual late reaction to PTBP.

PMID- 1633708
TI  - Nickel in jewellery and associated products.

PMID- 1633709
TI  - Compositae dermatitis: a survey.
AB  - Compositae dermatitis in an allergic contact dermatitis, frequently chronic,
      triggered by plants of the Compositae family. The condition, which is seen, in
      particular, in middle-aged and elderly persons, typically starts in the summer
      months with an acute eczema either corresponding to areas exposed to light and
      air, or corresponding to areas of plant contact; it disappears spontaneously
      during the fall of the year. Repeated exposure over a number of years may cause
      severe intractable dermatitis affecting the patient throughout the year. The
      responsible allergens are sesquiterpene lactones, and investigations to date
      indicate that the frequency of the allergy is similar to that seen with some of
      the contact allergens of the standard patch test series. The diagnosis, however,
      is difficult, partly due to the fact that the clinical picture may be mistaken
      for a photodermatosis, and partly owing to the difficulty in obtaining
      commercially available allergens for patch testing. The diagnosis is therefore
      based on testing with plant extracts, which can cause pronounced local reactions
      and possibly active sensitization. A survey is given of the possible modes of
      sensitization, sex and age distribution, the relationship to photosensitivity and
      atopy, as well as the possible treatment. It is concluded, on the basis of the
      chronic nature of the disease, and the diagnostic and treatment problems, that
      continued intensive research into the condition is urgently needed.

PMID- 1633710
TI  - The molecular genetics of autosomal-dominant polycystic kidney disease of the
      PKD1 type.

PMID- 1633711
TI  - Isolation and characterization of a candidate gene for autosomal-dominant
      polycystic kidney disease.

PMID- 1633712
TI  - MEGABASE/PKD: a genetic database for polycystic kidney disease.

PMID- 1633713
TI  - Genetic heterogeneity of polycystic kidney disease in Europe.

PMID- 1633714
TI  - Regulation of cell proliferation and fluid secretion in the progressive
      enlargement of renal cysts.

PMID- 1633715
TI  - Pathophysiology of renal tubular cyst formation in murine models of polycystic
      kidney disease.

PMID- 1633716
TI  - Rat models of polycystic kidney disease.

PMID- 1633717
TI  - A chimaeric mouse model for autosomal-dominant polycystic kidney disease.

PMID- 1633718
TI  - Polycystic kidney disease: thoughts on the meaning of prevention.

PMID- 1633719
TI  - Effect of a low-protein diet on the rate of progression of chronic renal failure
      in patients with polycystic kidney disease.

PMID- 1633720
TI  - Therapeutic effects of hidrosmin on chronic venous insufficiency of the lower
      limbs.
AB  - A double-blind, placebo-controlled trial was carried out to assess the
      effectiveness of a new synthetic bioflavonoid, hidrosmin, in patients with
      chronic venous insufficiency of the lower limbs. Fifty-seven patients, showing
      varicose veins and ankle swelling and suffering from local pain and heaviness of
      the legs, were allocated at random to receive treatment for 45 days with 1
      capsule 3-times daily of either 200 mg hidrosmin (30 patients) or placebo (27
      patients). Pain and heavy legs were assessed using rating scales; swelling was
      assessed by a photographic method. The results showed that hidrosmin produced a
      significant clinical improvement in all of the parameters evaluated; compared
      with placebo, there was a marked reduction in the main subjective symptoms
      accompanied by a 10% reduction in swelling. Apart from 1 patient who complained
      of epigastric pain, there were no reports of adverse events during the study
      period.

PMID- 1633721
TI  - Cefetamet pivoxil in community-acquired pneumonia: an overview.
AB  - A total of 305 patients with community-acquired pneumonia have participated in
      comparative or non-comparative studies involving cefetamet pivoxil. Of these, 211
      (55 adults and 156 children) were involved in a series of open, prospective,
      comparator-controlled, multi-centre studies. Adults were randomized to receive
      either cefetamet pivoxil 1000 mg twice daily or amoxycillin 750 mg 3-times daily
      for 10 days. Children received either cefetamet pivoxil 10 mg/kg twice daily,
      cefetamet pivoxil 20 mg/kg twice daily or cefaclor 10 mg/kg 3-times daily for 7
      to 8 days. The remaining 94 patients were treated openly with cefetamet pivoxil,
      with most patients receiving cefetamet pivoxil 500 mg twice daily for an average
      of 10 days; an elderly sub-group of these patients aged 70 to 103 years received
      therapy for an average of 11 days. The main causative organisms isolated were
      Streptococcus pneumoniae and Haemophilus influenzae. In adult patients, a
      successful clinical outcome was achieved in 100% of assessable patients receiving
      cefetamet pivoxil 1000 mg twice daily, and about 90% in those receiving 500 mg
      twice daily. The success rate in children was 98% for both dose levels of
      cefetamet pivoxil and 90% for those receiving cefaclor. In elderly patients, the
      percentage was 78% for the 500 mg twice daily patients. Thus, the standard dose
      of cefetamet pivoxil (500 mg twice daily in adults, 10 mg/kg twice daily in
      children) was well tolerated and proved to be at least as effective as the
      comparator drugs which were given 3-times a day.

PMID- 1633722
TI  - Efficacy and tolerability of enteric-coated naproxen in the treatment of
      osteoarthritis and rheumatoid arthritis: a double-blind comparison with standard
      naproxen followed by an open-label trial.
AB  - One hundred and twenty-three patients with osteoarthritis (n = 50) or rheumatoid
      arthritis (n = 73) were enrolled in a 6-week, double-blind, randomized,
      controlled, parallel trial comparing enteric-coated naproxen with standard
      naproxen. Ninety-eight patients subsequently entered a 20-week, open-label trial
      of enteric-coated naproxen. The study demonstrated that naproxen in both its
      standard formulation and its new enteric-coated formulation is a highly effective
      form of therapy for osteoarthritis and rheumatoid arthritis. The tolerability
      profiles of the two formulations were similar in terms of the types of complaints
      reported. It is concluded that enteric-coated naproxen is an efficacious and well
      tolerated formulation for the treatment of osteoarthritis and rheumatoid
      arthritis.

PMID- 1633723
TI  - Open-label tolerability study of enteric-coated naproxen in the treatment of
      osteoarthritis and rheumatoid arthritis.
AB  - Two hundred and ninety-six patients were enrolled in a 6-month, open-label
      tolerability study of enteric-coated naproxen in patients with rheumatoid
      arthritis (n = 174) and osteoarthritis (n = 122). Thirty percent of the patients
      were greater than 65 years of age. Under standard clinical prescribing
      conditions, enteric-coated naproxen 500 mg twice daily and 375 mg twice daily
      demonstrated an acceptable tolerability profile that was not different from what
      one would expect with standard naproxen.

PMID- 1633724
TI  - The efficacy of pre-operative controlled-release indomethacin in the treatment of
      post-operative pain.
AB  - A double-blind, placebo-controlled study in patients undergoing lumbar
      laminectomy was carried out to assess the morphine-sparing effect of a controlled
      release indomethacin formulation ('Flexin Continus' tablets, 75 mg). Thirty
      patients were randomly allocated to receive 1 tablet of active or placebo study
      medication pre-operatively and their pain scores on visual analogue scale (VAS)
      and their morphine consumption, delivered by Patient Controlled Analgesia (PCA),
      were recorded over the 24-hour post-operative period. Over the first 4-hour post
      operative period, the patients who had received active treatment reported less
      pain on VAS than those in the placebo group and this difference was statistically
      significant on recovery (p = 0.033) and at 1 hour post-recovery (p = 0.013). By
      4, 8, 12 and 24-hours post-recovery the mean cumulative amount of morphine used
      by patients in the active treatment group was reduced by 25%, 23%, 37% and 30%,
      respectively, compared to the control group. At the 12-hour time point, the
      difference in morphine consumption approached statistical significance (p =
      0.074). It is concluded that the pre-operative administration of controlled
      release indomethacin reduces post-operative morphine requirements and
      significantly reduces VAS pain scores on recovery.

PMID- 1633725
TI  - Non-random distribution of abnormal mitoses in heteroploid cell lines.
AB  - We have performed absorption-cytometric DNA measurements of the DNA contents of
      the G0/G1, G2, metaphase, and telophase cells of the heteroploid MCa-11 and HL-60
      lines, as well as the WCHE-5 line which has a narrowly restricted number of
      chromosomes. We found that morphologically unbalanced mitoses occurred much more
      frequently in telophase-cell pairs of the heteroploid MCa-11 and HL-60 lines than
      in those of the chromosomally stable WCHE-5 line. Furthermore, the
      morphologically unbalanced mitoses represented unequal segregation of DNA into
      each of the daughter telophase nuclei. Such mitotic segregation errors (MSE)
      occurred almost exclusively in telophase cells with DNA contents which were
      above, or below, the DNA content of the modal telophase population. The net
      effect of these non-random, unblanced divisions of heteroploid cells with non
      modal DNA contents is to produce one daughter cell with a DNA content that tends
      to return to the modal DNA content peak.

PMID- 1633726
TI  - Semi-automated detection of aberrant chromosomes in bivariate flow karyotypes.
AB  - A method is described that is designed to compare, in a standardized procedure,
      bivariate flow karyotypes of Hoechst 33258 (HO)/Chromomycin A3 (CA) stained human
      chromosomes from cells with aberrations with a reference flow karyotype of normal
      chromosomes. In addition to uniform normalization of normal and abnormal flow
      karyotypes, the main purpose is detection of structurally abnormal chromosomes in
      often complex karyotypes of tumor cells. The method, which has been implemented
      in a computer program, consists of a comparison of individual chromosome peaks
      with the positions of peaks in the flow karyotype constituted by normal
      chromosomes and takes into account the natural variability in base composition of
      normal chromosomes among healthy individuals. Flow-karyotypes are normalized
      using an iterative fitting procedure, using corrections for (1) amplification of
      HO and CA fluorescence, (2) cross-talk between the fluorescence signals of HO and
      CA, and (3) offset of the HO and CA origin. Flow karyotypes of two cell lines,
      one with a simple deletion and the other with more complex karyotypic changes,
      were analyzed. The results of flow analysis were found to be in general agreement
      with the cytogenetic analysis of quinacrine banded karyotypes.

PMID- 1633727
TI  - Influence of different cell extraction methods on cytometric features.
AB  - The purpose of this study was to investigate the influence of different cell
      extraction procedures on relative nuclear DNA content (IOD), nuclear area, and
      texture features of Feulgen-stained nuclei. In imprints and smears of fine-needle
      aspirates and suspensions from one human liver specimen, 50 diploid, 50
      tetraploid, and 25 octaploid nuclei were measured from each slide. In addition,
      for DNA measurements, the progressive mean of IOD and tetraploid/diploid and
      octaploid/diploid ratios was calculated. The results show that the progressive
      mean of the IOD is constant after measuring 25-30 nuclei. For the three types of
      specimens, the IOD of diploid nuclei varied slightly. The average coefficient of
      variation was about 5% for the fine-needle aspirates, imprints, and suspensions.
      For all tissue sampling methods, the 99% confidence limits of the
      tetraploid/diploid ratio and octaploid/diploid ratio were within the range of 1.9
      2.1 and 3.7-4.3, respectively. The nuclear area and most of the texture features
      showed a significant difference (p less than 0.01) between the three sampling
      methods in all nuclear populations. In conclusion, different tissue sampling
      methods have little or no effect on DNA-related IOD measurements, whereas the
      outcome of nuclear area and texture features is very dependent of the cell
      extraction procedure.

PMID- 1633728
TI  - A quantitative method for evaluating bivariate flow cytometric data obtained
      using monoclonal antibodies to bromodeoxyuridine.
AB  - A method is presented for analyzing data from bivariate analysis of cell
      populations exposed to bromodeoxyuridine and subsequently examined both for the
      presence of BrdUrd and for the cellular DNA content. It is shown that certain
      features may be defined in the bivariate data which are constant independent both
      of cell type and, within limits, experimental variability. These landmark
      features include the ratio of red, DNA, fluorescence of G2 + M cells to G1 cells,
      the ratio of green fluorescence corresponding to the non-specific binding of
      unlabeled G2 + M cells to unlabeled G1 cells, and the distribution of green
      fluorescence in unlabeled cells. The landmarks make it possible to standardize
      rules for establishing the separation line between-labeled and unlabeled cells as
      required in these experiments to obtain estimates of cytokinetic parameters.
      Values obtained for the DNA synthesis time and the potential doubling time which
      result from different decision rules for distinguishing labeled from unlabeled
      are compared in two murine tumor lines. The potential doubling time, but not the
      DNA synthesis time is shown to depend sensitively on the separation line.
      Suggestions are presented for analyzing clinical data with this procedure.

PMID- 1633729
TI  - Flow cytometric detection of the mitochondrial BCL-2 protein in normal and
      neoplastic human lymphoid cells.
AB  - The bcl-2 proto-oncogene, rearranged and deregulated in B-cell lymphomas bearing
      the t(14;18) translocation, encodes an inner mitochondrial membrane protein that
      blocks apoptotic cell death. We have developed a sensitive immunofluorescence
      assay for the single- and multicolor flow cytometric analysis of bcl-2 protein in
      relation to other markers and cell cycle, based on a fixation-permeation step of
      cells with paraformaldehyde and Triton X100 and the use of a bcl-2 specific
      monoclonal antibody (MoAb). As an application of this method, we have examined
      the expression of bcl-2 in normal and neoplastic lymphoid cells. We have found
      that greater than 80% of normal T-and B-cells are bcl-2 positive; following in
      vitro mitogen activation, the bcl-2 reactivity decreased slightly in the former
      but markedly in latter cells. In both cases the bcl-2 expression was not
      restricted to a specific phase of the cell cycle, as evidenced by two-color
      analysis. On lymphoblastoid cell lines, the bcl-2 staining intensity was variable
      and not necessarily correlated to molecular rearrangements of the bcl-2 gene.
      Among fresh B-cell non-Hodgkin's lymphomas (B-NHL), most sporadic Burkitt's cases
      were bcl-2 negative. Of four centroblastic-centrocytic cases with rearrangements
      of the bcl-2 gene, only two presented elevated amounts of bcl-2 protein,
      indicating that the levels of bcl-2 are not diagnostic of the
      translocation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633730
TI  - Flow cytometric analysis of opposite effects of a monokine on proliferation and
      differentiation of murine B lymphocytes.
AB  - A 35,000 mw factor able to replace macrophages (FRM) in the induction of the in
      vitro antibody response to sheep erythrocytes has been isolated from the
      supernatant of murine resident peritoneal macrophage cultures. Purified FRM, when
      added at the outset of cultures, induced B cells to generate an antigen-specific
      antibody response. The signals provided by FRM in the process of B cell
      activation were analyzed using a polyclonal model. Cell cycle analysis by
      multiparameter flow cytometry after acridine orange staining showed that FRM, on
      its own, did not trigger the transition of B cells from the G0 to the G1 stage of
      the cell cycle. In addition, FRM affected neither the basal intracellular free
      calcium level ([Ca2+]i) nor the rapid increase in [Ca2+]i induced by crosslinking
      of membrane immunoglobulin (mIgM) with anti-mu antibodies. In parallel with its
      positive effect on B cell differentiation, FRM markedly reduced both
      proliferation and cell cycle progression of B cells stimulated with anti-mu plus
      interleukin 4 (IL-4). Indeed, the addition of FRM to such cultures led to a
      preferential accumulation of cells in the early G1 compartment of the cell cycle
      and to a decreased frequency of cells in all other phases including G1B, S and
      G2/M.

PMID- 1633732
TI  - NADH-dependent dehydrogenase activity estimation by flow cytometric analysis of 3
      (4,5-dimethylthiazolyl-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction.
AB  - MTT reduction is usually analysed by colorimetric assay to study mitochondrial
      dehydrogenase activity as a test of cytotoxicity. This enzymatic reaction
      produces dark-blue granules of formazan, which increase cell refringency. In this
      work, we define the conditions for MTT use in quantitative flow cytometric
      analysis. MTT reduction provides a non-fluorescent dye usable by this technique
      to study an intracellular NADH-dependent dehydrogenase activity in vital cells.
      We observe that formazan production increases asymptotically with cell
      concentration and that this temperature-dependent Michaelis enzymatic reduction
      is produced essentially by mitochondrial dehydrogenases. In isolated mitochondria
      from rat hepatocytes and in whole L1210 murine leukemia cells, the Michaelis
      constants (KM) observed in the presence of respiratory substrates were,
      respectively, 10 microM and 500 microM. The inhibition of mitochondrial protein
      synthesis by chloramphenicol, which induces a rise of MTT reduction due to the
      correlative stimulation of glycolysis (Pasteur effect), is a limit of the MTT
      assay as a cytotoxicity test.

PMID- 1633731
TI  - Seric factors influence cell cycle modifications during commitment of murine
      erythroleukemia cells to differentiation.
AB  - Cell cycle modifications are among the early events which take place during the
      induced differentiation of murine erythroleukemia (MEL) cells; a transient
      accumulation of the cells in the G1 phase of the cell cycle, followed by a re
      entry of the cells into a proliferation state, has been described. In order to
      characterize a putative role of serum in such variations, we have studied the
      modifications of the cell cycle parameters when cells were induced to
      differentiate in the presence or in the absence of seric factors. We show that,
      in the absence of exogenous factors brought by serum, the G1 accumulation was
      enhanced both in amplitude and in duration, but cells were still able to bypass
      the G1 block and re-enter into the S phase. These results indicate that the
      resumption of cell proliferation after the transient block is under synergistic
      control of seric and endogenous factors, but these later are sufficient to
      overcome the block. However, MEL cells were unable to differentiate in the
      absence of seric factors, as measured by the number of benzidine-positive cells
      during induction with hexamethylene-bisacetamide (HMBA) or butyric acid. This
      capacity to differentiate was recovered when serum was added back to the culture
      medium, and the efficiency of recovery was maximal when cells underwent a full
      round of DNA replication in the presence of serum after the G1 block. The
      analysis of two molecular markers of cell differentiation confirmed these
      results.

PMID- 1633733
TI  - Aggregation of Escherichia coli B/r A during agar filtration: effect on
      morphometric measurements.
AB  - We have investigated the phenomenon of particle aggregation in a sample of 71,038
      Escherichia coli B/r A cells in balanced exponential growth, during preparation
      for electron microscopy by agar filtration. The bacteria were photographed in a
      transmission electron microscope and the dimensions and spatial relationships
      among all the members of each aggregate were recorded using an interactive image
      processing system. The proportion of aggregated cells, 22%, is much greater than
      that found by direct count in a light microscope (7%), implying that most
      aggregation takes place during the preparation stages. The aggregated cells are
      about 1% narrower than the free cells, because of mutual compression, and 1.5%
      longer, because of a selection bias in favor of longer cells. From a statistical
      analysis of the data, we conclude that the clustering of cells into aggregates in
      the course of sample preparation is the result of random encounters during the
      settling on the collodion membrane and of the changing surface tension during the
      drying process. A method is proposed to correct morphometric measurements for the
      distortion caused by cellular aggregation of this kind.

PMID- 1633734
TI  - Method to improve the sensitivity of flow cytometric membrane potential
      measurements in mouse spinal cord cells.
AB  - We have developed a technique to improve the sensitivity of relative membrane
      potential measurements in mouse spinal cord cells using the fluorescent, anionic,
      voltage sensitive dye, DiBa-C4(3) (Oxonol) and flow cytometry. In order to
      attribute cellular fluorescence primarily to membrane potential, signal
      variability due to cell size and shape was reduced by dividing the log
      fluorescence signal from each cell by either its log forward angle light scatter
      or log side scatter signals. The use of these ratios in place of log oxonol
      fluorescence reduced the coefficient of variation of the distributions while
      leaving the changes in mean fluorescence largely unaffected. Kolmogorov-Smirnov
      analysis of pre- vs. postkainate stimulation (an excitatory amino acid) showed
      improved sensitivity of the assay with the use of this ratio technique.

PMID- 1633735
TI  - On the measurement of cytokinetics by continuous labeling with bromodeoxyuridine
      with applications to chick wing buds.
AB  - The cytokinetic properties, specifically the phase-transit times, TG1, TS, and
      TG2+M, of chick wing bud cells were estimated using data obtained from continuous
      labeling of stage 20 embryos with bromodeoxyuridine (BrdUrd). The presence of
      BrdUrd was detected with monoclonal antibodies, and the amount of DNA in the
      cells was determined with propidium iodide. The fraction of cells in each cell
      cycle phase, the fraction of labeled cells, and the relative movement, a measure
      of the mean DNA content, of all labeled cells were evaluated using bivariate flow
      cytometry at successive times following introduction of the label. Equations are
      presented to describe the fraction of unlabeled cells in G2 + M, which gives a
      direct estimate of TG2+M; the fraction of all labeled cells, which can then be
      used to estimate TG1; and, finally, the relative movement, which provides an
      estimate of TS. Thus, the data measured in these experiments together provide
      estimates of the progression through the cell cycle of limb mesoderm cells.

PMID- 1633736
TI  - Some new aspects on adipose tissue development.

PMID- 1633737
TI  - T-cell cloning in human type I diabetes.

PMID- 1633738
TI  - Autoimmune diabetes mellitus in the BB rat.

PMID- 1633739
TI  - Platelet function in diabetes mellitus.

PMID- 1633740
TI  - The pharmacology of diabetic neuropathy.

PMID- 1633741
TI  - Electrophysiologic findings in optic nerve dysfunction associated with multiple
      evanescent white-dot syndrome.
AB  - Electrophysiologic findings in a case of multiple evanescent white-dot syndrome
      were studied. A 37-year-old woman presented with multiple white dots, granularity
      of the macula, and optic disc swelling in her left fundus. The electroretinogram
      and electro-oculogram revealed abnormal findings indicative of changes in the
      retinal pigment epithelium and photoreceptors. In addition, relative afferent
      pupillary defect, enlargement of the blind spot, a decrease in the critical
      fusion frequency, staining of the optic disc on fluorescein angiography and
      prolonged latency of the P100 component with decreased amplitude in pattern
      reversal visual evoked cortical potential strongly suggested dysfunction of the
      optic nerve in this patient.

PMID- 1633742
TI  - Clinical and ERG data in a family with autosomal dominant RP and Pro-347-Arg
      mutation in the rhodopsin gene.
AB  - In a family with autosomal dominant retinitis pigmentosa, documented over six
      generations, a previously undescribed point mutation in the rhodopsin gene could
      be identified. The mutation found in the six affected members examined but in
      none of the controls, including healthy members of the family, was a point
      mutation in codon 347 predicting a substitution of the amino acid arginine for
      proline, designated Pro-347-Arg. Six affected members from two generations were
      examined clinically and with ganzfeld rod and cone electroretinography. The cone
      and, more dramatically, the rod electroretinograms were reduced to residual b
      wave amplitudes or were non-detectable as early as ages 18 to 22 years. The Pro
      347-Arg mutation resulted in a subjectively and clinically homogeneous phenotype:
      early onset of night blindness before age 11, relatively preserved usable visual
      fields until about age 30, blindness at ages 40 to 60, and change from an initial
      apparently sine pigmento to a hyperpigmented and atrophic fundus picture between
      30 and 50 years of age.

PMID- 1633743
TI  - Electrophysiologic evaluation of the visual pathway in children. Case reports.
AB  - Clinical findings and results of electrophysiologic evaluation of the visual
      pathway were studied in seven children ranging in age from 10 months to 13 years.
      Using skin electrodes for electroretinographic and visual evoked potential
      testing, we obtained reliable results without sedation or pupil dilation. The
      half-field stimulation was indispensable for localizing lesions along the visual
      pathway and thus for specific diagnosis.

PMID- 1633744
TI  - Pattern electroretinogram as a function of spatial frequency after retrobulbar
      optic neuritis.
AB  - Steady-state (8-Hz) pattern electroretinograms in response to counterphased
      sinusoidal gratings of variable spatial frequency (0.6-4.8 c/deg) were recorded
      in 17 patients who had had retrobulbar optic neuritis in one or both eyes (23
      eyes with a clinical history of optic neuritis) and in 21 age-matched normal
      subjects. Amplitude and phase of the Fourier-analyzed pattern electroretinogram
      second harmonic were measured. The mean pattern electroretinogram amplitude of
      patients was significantly reduced compared with that of controls. Amplitude
      reductions were more marked at intermediate (1-1.4 c/deg) than at lower or higher
      spatial frequencies. Therefore, the average amplitude versus spatial frequency
      response function differed significantly in patients compared with controls,
      displaying a lowpass instead of a band-pass shape. No significant differences in
      the mean pattern electroretinogram phase were observed between groups at any
      spatial frequency. These results indicate spatial frequency-dependent
      abnormalities in the pattern electroretinogram amplitude after optic neuritis,
      suggesting a specific loss of retinal neurons sensitive to stimuli of
      intermediate spatial frequencies.

PMID- 1633745
TI  - Empiric limits of rod photocurrent component underlying a-wave response in the
      electroretinogram.
AB  - The corneally recorded rod photocurrent component (photoresponse) underlying the
      a-wave feature of the electroretinogram was analyzed. The results set empiric
      limits on critical photoresponse variables. Measurements were obtained from four
      normal adult subjects on a-wave amplitude, a-wave velocity, b-wave amplitude, b
      wave implicit time and b-wave height above baseline. At high intensity,
      interference from the b-wave component was minimized and the amplitude of the
      saturated photoresponse component was approximated by the a-wave feature. At
      lower intensities, the a-wave feature represented progressively less of the
      underlying photoresponse amplitude. Photoresponse amplitude saturation was
      signaled by the abrupt slowing of the rate of decline of b-wave peak latency and
      occurred at an intensity about 2.5 log units above the first appearance of the b
      wave. At the intensity of photoresponse saturation, the peak amplitude of the a
      wave feature was only about 25% of the maximum amplitude of the underlying
      photoresponse component. A-wave leading edge velocity was found to increase up to
      3 log units above the intensity of photoresponse amplitude saturation and to
      provide a good estimate of photoresponse velocity at higher intensities. A
      cascaded low-pass filter model with modifications to accommodate amplitude and
      timing nonlinearities was used to generate a set of probable underlying
      photoresponses from the analysis of a-wave amplitude and velocity. Movement of
      the a-wave leading edge to the left at higher intensities in algebraic
      combination with a static b-wave leading edge above the intensity of
      photoresponse amplitude saturation was found to explain the second rise of the b
      wave amplitude function and the decline of b-wave amplitude above baseline at
      high intensities. This analysis provides a basis for modeling the underlying
      photoresponse on a biochemical level and for interpreting photoreceptor damage in
      disease states.

PMID- 1633746
TI  - Light adaptation and the luminance-response function of the cone
      electroretinogram.
AB  - Cone electroretinograms are typically isolated by presenting stimulus flashes
      against rod-desensitizing adapting fields. To investigate the manner in which
      adapting-field luminance affects cone electroretinogram response properties, we
      measured cone electroretinogram luminance-response functions of two normal
      subjects, with stimuli presented against adapting fields that ranged in luminance
      from -1.2 to 2.1 log cd/m2. A flicker rate of 31.1 Hz was used to isolate cone
      electroretinograms under all adaptation conditions. A hyperbolic equation of the
      form (R/Rmax) = Ln/(Ln + Kn) was fitted to each luminance-response function by a
      least-squares criterion. As adapting field luminance increased, the best-fit
      values of the variables K and n increased, which is in general agreement with
      results of electrophysiologic studies of light adaptation in retinal neurons.
      However, Rmax values also increased with adapting field luminance. The change in
      all three of these variables with adapting field luminance must be considered in
      the interpretation of cone electroretinogram luminance-response functions from
      patients with retinal disorders.

PMID- 1633747
TI  - Use of 10-Hz flash visual evoked potentials in prediction of final visual acuity
      in diabetic eyes with vitreous hemorrhage.
AB  - In 44 diabetic eyes with vitreous hemorrhage, monocular steady-state visual
      evoked potentials were elicited through closed eyes by a 10-Hz flash. Visual
      evoked potentials were rated as normal or abnormal on the basis of amplitude and
      waveform. Abnormal visual evoked potentials were subdivided into mildly abnormal,
      markedly abnormal and nonrecordable categories. Patients with normal potentials
      were predicted to have visual acuities of 6/15 (20/50) or better. Patients with
      abnormal potentials were predicted to have visual acuities of 6/18 (20/60) or
      worse. Final visual acuities were the best visual acuities recorded in the 6
      months after vitreous surgery (vitrectomy) or spontaneous clearing of the
      vitreous hemorrhage. The visual evoked potential categories and final acuities
      were compared with a 2 x 2 contingency table. The accuracy was 86%. The visual
      evoked potential categories and final acuities were associated at a statistically
      significant level.

PMID- 1633748
TI  - Visual evoked potential estimation of visual activity with a Laplacian
      derivation.
AB  - Visual acuity was estimated with visual evoked potentials in 13 healthy subjects.
      A Laplacian derivation of 5 electrodes was used to improve the signal-to-noise
      ratio and to enhance striate cortical activity selectively. In 6 subjects, the
      Laplacian derivation gave a more reliable estimation of visual acuity than did a
      single midline derivation. In the other 7 subjects, the quality of both
      estimations was comparable.

PMID- 1633750
TI  - Pathogenesis of alcoholic myopathy: roles of ethanol and malnutrition.

PMID- 1633749
TI  - The neural retina of the frog contributes a slow cornea-positive potential to the
      electroretinogram.
AB  - A c-wave-like cornea-positive potential in the isolated rabbit retina has been
      described. In this study, frog retinas were investigated to see if the neural
      retina contributes a slow cornea-positive component to the c-wave of the
      electroretinogram. The eye cups of both Rana esculenta and Rana temporaria
      exhibited a normal electroretinogram with c-wave, a larger proximal light-induced
      extracellular potassium increase, a small distal extracellular potassium increase
      and an extracellular potassium decrease around photoreceptors. Isolated frog
      retinas kept receptor side-upward in a moist chamber without perfusion showed the
      well-known slow PIII generated by the potassium decrease around receptors. If the
      isolated retinas were well perfused, the slow PIII was not seen, but a cornea
      positive d.c. potential sometimes appeared after the b-wave. The different slow
      potentials seemed to relate to different light-induced potassium changes in the
      proximal retina. There was a long-lasting proximal potassium increase in the
      superfused retinas but a quick return of the proximal potassium increase to the
      baseline in the retinas lacking oxygen at the vitreal side. The lasting proximal
      potassium increase in adequately maintained retinas may counteract the potassium
      decrease around receptors and cancel slow PIII.

PMID- 1633751
TI  - Experimental approaches to the evaluation of alcohol abuse and dependence
      development.
AB  - In rats, a complex longitudinal analysis of alcohol intake behaviour and
      electrophysiological sleep pattern was performed during different periods of
      stable voluntary alcohol consumption. By the sleep pattern, the existence of
      alcohol abuse and dependence development could be confirmed. Acute ethanol
      withdrawal was shown to be the obligatory and necessary element in alcohol abuse
      and dependence evaluation. The proposed behavioural and sleep pattern models
      might be used in the search for anti-alcoholic drugs in combination with the
      study of alcoholic aging processes.

PMID- 1633752
TI  - Craving: consensus of status and agenda for future research.
AB  - The term craving is used frequently in relationship to drug abuse and its
      treatment but there is disagreement over its definition and role. In February
      1991, a meeting of experts from several disciplines, sponsored by the Addiction
      Research Center (ARC) of the National Institute on Drug Abuse, was convened with
      the goal of reaching consensus about the importance of craving and to suggest a
      future research program. The participants agreed that craving is a subjective
      state in humans that is associated with drug dependence but little is known about
      its determinants, relationship to drug taking, and measurement. To advance our
      knowledge, a substantial research program is required. The outcome of this
      research effort could have important consequences for increasing our
      understanding of the determinants of drug abuse.

PMID- 1633753
TI  - Triazolam as a discriminative stimulus in humans.
AB  - Seven healthy normal male and female volunteers (19-42 years) were trained to
      discriminate between the benzodiazepine triazolam (0.32 mg/70 kg; e.g. drug A)
      and placebo (e.g. drug B). During the first four daily sessions, drug A and drug
      B were administered orally in capsules 60 min prior to the session on alternate
      days and subjects were informed of the drug label at the time of drug
      administration. Subsequently, drug A and drug B were administered in a randomized
      block fashion and subjects identified the drug code they thought they received.
      Subjects were informed of the drug code post-session. Once the criterion for
      discrimination was met (i.e. correct drug code identification on four consecutive
      sessions), the dose-effect curve for triazolam (0.1-0.75 mg/70 kg) was
      determined. The discrimination was acquired in all subjects; triazolam (0.32
      mg/70 kg) and placebo produced approximately 85-95% correct responding. During
      the dose-effect curve determination, triazolam produced dose-related increases in
      triazolam-appropriate responding and self-reported sedation and drug strength.
      These results indicate that a triazolam-placebo discrimination can be acquired
      and that the triazolam discriminative stimulus effect is related to dose and to
      self-reported sedation.

PMID- 1633754
TI  - The scientific/clinical response to the cocaine epidemic: a MEDLINE search of the
      literature.
AB  - Index Medicus (1966-1990) was searched to quantify and characterize the
      scientific/clinical community's responses to the cocaine epidemic. The rate of
      growth in the cocaine literature was compared with the rate of growth in the
      heroin and marijuana literatures in the 1960s and 1970s. Articles on cocaine
      increased dramatically over the past 7 years suggesting a clear response from the
      scientific/clinical community to the public health problems presented by the
      cocaine epidemic. That literature spans a wide range of areas addressing many
      scientific and health-care issues. This increase in cocaine citations is similar
      to that which occurred previously in response to use of heroin and marijuana.

PMID- 1633755
TI  - Alcohol abuse and dependence in an urban primary care clinic in Nigeria.
AB  - A two-stage epidemiological survey was conducted in an urban walk-in clinic in
      Nigeria to detect, among other disorders, the prevalence of alcohol abuse and
      dependence using DMS-IIIR criteria. At the first stage, respondents were
      administered the 12-item General Health Questionnaire and the Alcohol Use
      Disorders Identification Test (AUDIT). A proportion of the respondents were
      selected for detailed interview at the second stage using the Composite
      International Diagnostic Interview (CIDI). An estimated 1.7% of this sample met
      the criteria for alcohol abuse or dependence. All the identified cases were
      males, thus giving an estimated prevalence of 5.2% in males. In this setting, the
      AUDIT performed poorly as a screening instrument. It has a sensitivity of 32% but
      a specificity of 93%. Apart from reasons relating to the low base rates of the
      disorders under investigation, cultural factors influencing the ways alcohol use
      are perceived may explain this poor performance.

PMID- 1633756
TI  - Acupuncture fails to improve treatment outcome in alcoholics.
AB  - Fifty-six alcoholics (49 male, 7 female) of lower socioeconomic class attending
      an outpatient treatment program in Brooklyn, New York were prospectively
      randomized to one of three treatment group: point-specific acupuncture, sham
      transdermal stimulation or standard care (control). One third of the subjects
      reported a history of drug use in addition to alcohol. Results in this small
      sample showed no significant differences in attendance at Alcoholics Anonymous
      meetings, number of outpatients sessions attended, number of weeks in either the
      study or in the outpatient program, number of persons completing treatment or in
      the number of relapses. It is therefore concluded that in this small racially
      mixed sample of urban outpatient alcoholics, fixed point-specific standardized
      acupuncture did not improve outcome. We caution against the routine use of this
      treatment until more randomized controlled trials demonstrate a beneficial
      effect.

PMID- 1633757
TI  - Dexamethasone suppression test in alcohol withdrawal: relationship to depression
      and liver function.
AB  - The relationship between dexamethasone suppression test (DST) response,
      depressive symptoms and liver function tests was investigated in 15 male alcohol
      dependent patients for 2 weeks during alcohol withdrawal. Six of the patients
      relapsed into drinking within the investigation period. There was no association
      between DST response and relapse, which suggests that abnormal DST response has
      no predictive value for relapse into drinking. About 50% of the patients had
      abnormal DST responses during the first week of alcohol withdrawal. There was no
      relationship between DST response and depression or depressive symptoms.
      Depression remitted within 1-2 weeks, whereas DST responses remained abnormal for
      at least 2 weeks in 2 of the non-relapsing 9 patients. Abnormal DST response in
      alcohol withdrawal is unlikely to be due to alterations in liver function but may
      be attributable to the effect of alcohol on the hypothalamic-pituitary
      adrenocortical axis.

PMID- 1633758
TI  - Measuring the learning potential of abstinent alcoholics.
AB  - The performance of 89 Finnish alcoholics was measured on a Vygotskian test of
      learning potential. There were four questions to analyse: (1) can the performance
      of alcoholics be improved by means of instruction in non-verbal problem solving
      tasks; (2) how extensive is the transfer effect; (3) how does the duration of
      abstinence affect test performance; and (4) how does the actual performance level
      affect post-test results? Results indicated that instruction had a clear positive
      effect on the performance of alcoholics in simple tasks, but no transfer effect
      was evident in the more complex tasks. The duration of abstinence had no general
      effect. Although analysis of the mean scores of time-level groups showed some
      improvement in performance with increasing duration of abstinence, intra-group
      deviation was so high that the trends were not statistically significant. The
      subjects' actual performance level, on the other hand, was a very relevant
      factor. This was particularly evident in complex transfer tasks.

PMID- 1633759
TI  - Hip and knee joint replacements.

PMID- 1633760
TI  - [The long-term therapy of familial hypercholesterolemia with heparin-induced
      extracorporeal LDL precipitation].
AB  - The long-term tolerance to and effectiveness of heparin-induced extracorporeal
      LDL precipitation (HELP) in combination with lipid reducing drugs and diet was
      tested in six patient (5 males, 1 female; mean age 48 +/- 4 years). Follow-up
      period was over 50 months, in one patient over 24 months, while one man had a
      sudden cardiac death 57 weeks after starting treatment. The study was divided
      into three phases. In phase I (24 months) treatment consisted of HELP and
      conventional lipid-reducing drugs; in phase II (12 months) of lovastatin (80 mg
      daily) and cholestyramine (12-24 g daily); and phase III (14 months) of HELP,
      lovastatin and cholestyramine. In phase I it was possible to lower the pre
      treatment level of LDL-cholesterol from 306 +/- 18 mg/dl to 173 +/- 13 mg/dl
      (43.5%). A similar effect (from 307 +/- 21 mg/dl to 155 +/- 17 mg/dl [-49.5%])
      was obtained in phase II. The resumption of HELP reduced the pre-treatment LDL
      concentration to 136 +/- 9 mg/dl (-55.7%). The various treatment regimens were
      well tolerated. Biochemical data remained unchanged except for iron loss
      requiring substitution. Thus combined HELP, lovastatin and ion exchange offer for
      the first time an effective and reliable means in familial hypercholesterolaemia
      of clearly reducing long-term the mean LDL cholesterol level below the
      atherosclerosis threshold of 120 mg/dl.

PMID- 1633761
TI  - [The Shy-Drager syndrome].
AB  - For 15 years a now 70-year-old woman had been having occasional episodes of
      circulatory collapse which 7 years ago were diagnosed as being caused by severe
      idiopathic orthostatic hypotension. These episodes had recently become much more
      frequent and she was hardly able to be upright for more than one minute. In the
      Schellong test the blood pressure fell from 80/50 mm Hg when lying to 70/30 mm Hg
      on standing, the pulse rate remaining unchanged at 60/min. The standing test had
      to be abandoned after 90 seconds. Serum catecholamine concentrations (epinephrine
      65 ng/l, norepinephrine 100 ng/l) did not rise on standing (epinephrine 25 ng/l,
      norepinephrine 105 ng/l). 24-hour urinary excretion of vanillyl mandelic acid was
      at the lower limit of normal (2.2 mg). The autonomic dysfunction of circulatory
      control suggested a Shy-Drager syndrome. Other signs of autonomic failure
      included gastroparesis, decreased tear and sweat secretion and transitory urinary
      incontinence. Symptomatic treatment with elastic stockings, fludrocortisone,
      etilefrine, dihydroergotamine, L-dopa, yohimbine and amezinium methylsulfate gave
      the patient greater mobility without achieving normal blood pressure responses.

PMID- 1633763
TI  - [The plasma hyperviscosity syndrome as an oncological emergency].

PMID- 1633762
TI  - [Severe digitalis poisoning after the ingestion of 1 g of digoxin].
AB  - A 50-year-old, previously healthy, woman swallowed 1 g digoxin powder, dissolved
      in water, with suicidal intent. On admission to hospital one hour later, having
      vomited three times at home, the prominent signs were somnolence and
      hypersalivation. Serum digoxin level was 3.37 ng/ml. There followed repeated
      episodes of asystole alternating with ventricular fibrillation requiring
      cardiopulmonary resuscitation over 90 min and adrenaline administration. Repeated
      electrical defibrillation, administration of dopamine, phenytoin and lidocaine,
      as well as transitory transvenous electrical stimulation became necessary. Anti
      digoxin antibody fragments were administered, initially 80 mg, to a total of
      3,280 mg over 24 hours. After 3 days of intensive care and a further 21 days in
      hospital she was discharged and referred to psychiatric treatment. This case
      demonstrates that even severe digoxin poisoning can be successfully treated
      without sequelae by the appropriate administration of digoxin antidote. The main
      problems in this case were regulation of the dosage and acquiring the necessary
      amount of antidote which greatly exceeded the hospital's own depot.

PMID- 1633764
TI  - [Autosomal-dominant polycystic kidney disease].

PMID- 1633765
TI  - [Johann Friedrich Dieffenbach: 1792-1847. The "father of plastic surgery" in
      Germany].

PMID- 1633766
TI  - [The draft of a law on technical assistants in medicine].

PMID- 1633768
TI  - [Tumor necrosis factor and multiple sclerosis].

PMID- 1633767
TI  - [The long-term action of caffeine].

PMID- 1633769
TI  - Endoscopic ultrasonography in the diagnosis, staging and follow-up of esophageal
      and gastric cancer.
AB  - The accumulating data show that endoscopic ultrasonography (EUS) is highly
      compatible with the UICC/AJCC staging classification for esophageal and gastric
      cancer, based on the TNM system expressing anatomical extent of disease. The
      great strength of EUS in staging these cancers is its ability to image the gut
      wall and adjacent structures in unique detail. EUS is more accurate than computed
      tomography in staging the depth of primary tumor invasion (T) and regional lymph
      node metastases (N). High frequency EUS is not useful in staging for distant
      metastases (M) due to limited depth of the field. EUS also has limitations in
      reliably distinguishing between neoplastic and inflammatory tissue. Thus, the
      major use of EUS is in staging rather than in diagnosis. However, initial reports
      indicate that EUS may be helpful in the detection of malignancy in Barrett's
      esophagus, in diagnosing post-operative recurrent cancer, and in evaluating the
      response to non-operative therapy. EUS appears to represent an important advance
      in the staging and follow-up of patients with esophageal and gastric cancer.
      Instruments and techniques will continue to evolve, but the next level of
      research should be designed to show that the improved staging provided by EUS has
      clinical utility and can affect patient outcome.

PMID- 1633770
TI  - Endoscopic ultrasonography in diagnosis and staging of pancreatic and biliary
      tumors.

PMID- 1633771
TI  - Endosonography of colorectal diseases.

PMID- 1633772
TI  - Endosonographic diagnosis of metastatic lymph nodes in gastric carcinoma.

PMID- 1633773
TI  - Enlarged lymph nodes: malignant or not?
AB  - Prospective controlled data of lymph node evaluation by endoscopic ultrasound in
      esophageal, gastric and pancreatic cancer is presented. Lymph node pattern,
      changes of boundaries and echogenicity were considered. Preoperative findings of
      endoscopic ultrasound were classified according to TNM staging. Only those cases
      with subsequent histologic examination of the resected specimen were entered into
      the study. Sensitivity of endoscopic ultrasonography (EUS) was 90% for esophageal
      and 87% for gastric cancer. The specificity was 72% and 88%, respectively. In
      spite of the overall satisfactory results of EUS in evaluation of lymph nodes,
      further improvement in detection and differentiation of benign and malignant
      nodes is required.

PMID- 1633774
TI  - Endosonography-guided treatment of esophageal carcinoma.
AB  - Endosonography is helpful in managing patients with esophageal cancer due to its
      capacity to stage the tumor for the depth of tumoral invasion and the presence of
      metastatic lymph nodes. Thus, ES will help the surgeon to determine if surgery is
      advisable. If the patient does not undergo surgery, it will provide a very
      accurate prognosis and allow the adaptation of non-surgical multimodal therapy to
      determine tumor extension. Finally, following the initial phase of treatment. ES
      will be useful in the follow-up, especially to detect and stage recurrences.

PMID- 1633775
TI  - Application of ultrasonic probes prior to endoscopic resection of early gastric
      cancer.
AB  - The development of a new strip biopsy technique for endoscopic mucosectomy
      utilizing endoscopic saline injection and a double-channel endoscope permits the
      safe and simple resection of superficial type early gastric cancer which has been
      difficult to perform with conventional polypectomy techniques. Preresection
      assessment of the depth of invasion and postresection assessment of efficacy are
      important with regard to treatment of early gastric cancer, but conventional
      endoscopic ultrasonography employed for this purpose requires special equipment
      and involves intricate procedures. An ultrasonic probe which can be used
      endoscopically has recently been developed and is currently in the trial stage.
      The authors have conducted studies with respect to a 7.5 MHz radial scanning type
      Miniature Ultrasonic Probe as well as a 20 MHz manual linear scanning type
      Sonoprobe System. Experimental studies indicated that the former type is capable
      of delineating postresection ulcers, while the latter permitted delineation of
      tumors as hypoechoic images in 9 of 11 cases of early gastric cancer.

PMID- 1633776
TI  - EUS-guided therapy in rectal tumors and other fields of minimal invasive surgery.

PMID- 1633777
TI  - The role of endoscopic ultrasonography in esophageal motility disorders.

PMID- 1633778
TI  - Value of endoscopic ultrasonography in the management of portal hypertension.
AB  - Using endoscopic ultrasonography (EUS) a large part of the portal venous system
      can be visualized. In 40 patients with portal hypertension (PH) and in 48 control
      subjects EUS displayed the azygos, splenic, mesenteric and portal veins in both
      groups. However, esophageal and gastric varices, peri- esophageal and peri
      gastric collateral veins and submucosal gastric venules were displayed only in
      patients with PH. EUS was inferior to endoscopy for detecting and grading
      esophageal varices (p less than 0.0005), but superior in the detection of varices
      in the fundus of the stomach (p less than 0.0005). EUS cannot be considered a
      reliable method for the study of esophageal varices: it has an overall
      sensitivity of 50%, does not permit flow measurements, and does not provide
      information that could be used to estimate the risk of bleeding. EUS has been
      demonstrated to be superior to endoscopy in the diagnosis of gastric varices.
      This finding is extremely important for the optimal selection of treatment of
      patients with portal hypertension. EUS can detect portal hypertensive
      gastropathy; thus inflammatory gastritis can be more easily distinguished from
      congestive gastropathy and therapeutic decisions are strongly influenced.

PMID- 1633779
TI  - Endoscopic ultrasonography in the diagnosis of chronic pancreatitis.
AB  - Endoscopic ultrasonography (EUS) is highly accurate in the diagnosis of chronic
      pancreatitis. Both parenchymal and ductal changes indicative of chronic
      pancreatitis can be identified. Parenchymal changes include small cystic
      abnormalities and hyperechoic foci scattered throughout the gland; the entire
      gland may be enlarged in early chronic pancreatitis, or small and atrophic in
      advanced disease. Ductal changes include enlargement of the main pancreatic duct
      or secondary branches, and the presence of stones or proteinaceous plugs within
      the ducts. Pseudocysts appear as cystic structures of mixed echogenicity; EUS is
      able to detect small pseudocysts or masses not identified by conventional imaging
      modalities. EUS has some difficulty in distinguishing benign from malignant
      pancreatic masses, particularly when the lesions are small. EUS should not
      supplant the use of CT scan or ERCP in the differential diagnosis of pancreatic
      disease, but is rather an adjunct to these studies. Future clinical research
      should focus on determining the appropriate indications for EUS in pancreatic
      disease, and determining if patient outcomes are favorably affected by the
      diagnostic information obtained.

PMID- 1633780
TI  - Value of endoscopic ultrasonography in the assessment of inflammatory bowel
      diseases.
AB  - The value of EUS in the assessment of inflammatory bowel diseases was determined.
      EUS was useful for estimation of the histological changes of inflammatory bowel
      diseases. In ulcerative colitis, EUS findings were classified into five types,
      which correlated with the colonoscopic and histological findings. Studies in
      surgical cases and further prospective investigations are necessary, however, to
      determine whether EUS can contribute to the management of inflammatory bowel
      diseases.

PMID- 1633781
TI  - Endosonographic differentiation of mucosal and transmural nonspecific
      inflammatory bowel disease.
AB  - Thirty-seven patients with nonspecific inflammatory bowel disease were examined
      with an ultrasonic colonoscope and the inflammation classified as mucosal or
      transmural. Mucosal inflammation was characterized by preservation of the five
      layer structure of the wall with thickening of the submucosa. Transmural
      inflammation was endosonographically defined as sectional interruption or loss of
      the five-layer structure. In 14 of the 37 patients a colectomy was performed.
      Examination of 3 of the 14 resected specimens revealed inflammation confined to
      the mucosa. This was consistent in all three cases with the preoperative
      endosonographic evaluation. Eleven of the 14 resected specimens showed sectional
      transmural inflammation. Ultrasonographically all of the 11 patients fulfilled
      the criteria for transmural inflammation, whereas endoscopic and microscopic
      signs were consistent with transmural inflammation in 9 of the 11. Endosonography
      of the colon enables definition of mucosal inflammation thus providing criteria
      for selection of patient for ileoanal pouch construction.

PMID- 1633782
TI  - Clinical application of linear ultrasound probes.
AB  - The linear ultrasound probe should be viewed as an adjunct to conventional
      endoscopic ultrasonography with combined ultrasound endoscopes. It certainly does
      not replace these instruments for staging neoplasms and imaging extraintestinal
      organs such as the pancreas. It can be a simpler alternative to these instruments
      when applied at the time of endoscopy to obtain more information about wall
      thickness and the cause of an intramural mass. It can add information when used
      to image within impassable malignant strictures. Further development of the
      linear probes with the addition of a balloon over the transducer and the advent
      of new probes that utilize other scanning mechanisms is anticipated and should
      make this imaging system even more useful.

PMID- 1633783
TI  - Clinical application of ultrasonic probes in the biliary and pancreatic duct.
AB  - The clinical use of an ultrasonic probe with the radial scan transducer in the
      biliopancreatic ducts is reported in 35 patients with biliopancreatic lesions,
      including 11 cases of bile duct and 5 of pancreatic carcinoma. Two approaches are
      available for the intraductal scanning of bile and/or pancreatic ducts. One is
      the percutaneous insertion via a percutaneous transhepatic biliary fistula
      established for cholangioscopy. The other approach is the transpapillary
      insertion of the probe via the working channel of the duodenoscope. Using both
      approaches, ultrasonographic images of the bile duct wall, pancreas head and
      neighboring major blood vessels could be observed clearly. The extent of bile
      duct and pancreatic carcinoma could also be visualized. We believe that
      intraductal scanning using ultrasonic probes is a promising method in the staging
      of biliopancreatic malignancy.

PMID- 1633784
TI  - Intravascular ultrasonography in tumor staging.

PMID- 1633785
TI  - Manual materials handling I: general research issues. A special issue in honour
      of Professor M. M. Ayoub.

PMID- 1633786
TI  - Discriminability of load heaviness: implications for the psychophysical approach
      to manual lifting.
AB  - The main objective of this study was to investigate human ability to discriminate
      between different levels of load heaviness in manual lifting. Twelve male college
      students participated in the laboratory experiment. Twenty-eight sequences of
      five boxes that weighed from 5 to 64 lbs (2.27-29.1 kg) were used. The subjects
      were asked to arrange boxes in each sequence in order of the perceived
      (increasing or decreasing) heaviness, i.e., from lightest to the heaviest box, or
      from heaviest to the lightest box. The subjects were also asked to assign
      linguistic descriptors of perceived load heaviness to each box in the sequence,
      and to indicate the confidence levels regarding correctness of the assigned box
      order and assignment of linguistic values. The independent variables included
      magnitude of weight and load differential between the successive weights in a
      sequence. The number of sequential ordering errors, assignment of linguistic
      variables, and estimated confidence levels were highly dependent on the load
      differential and weight range. It was concluded that in order to assure reliable
      results of the psychophysical approach to determining the values of maximum
      acceptable weight of lift, the adjustment process for male subjects should
      require using small weights of at least 4 lbs (1.8 kg) to be added or removed
      from the lifted box. The results of this study also suggest that the error rate
      in load discriminability can be controlled below the 10% level, if the relative
      difference in weight between successive boxes lifted is at least 12%. Given the
      above findings, it is suggested that usefulness of some of the recommendations
      for setting safe limits for manual lifting tasks, which were reached based on the
      psychophysical approach and broadly reported in the past, may need to be
      carefully re-examined. Finally, this study showed that the Weber fraction for
      load heaviness over the range of lifted weights from 8.6 to 29.1 kg is between
      0.03 and 0.04.

PMID- 1633787
TI  - Psychophysical capacity of industrial workers for lifting symmetrical and
      asymmetrical loads symmetrically and asymmetrically for 8 h work shifts.
AB  - This paper presents comprehensive maximum acceptable weight of lift
      (psychophysical lifting capacity) database for male and female industrial workers
      for lifting symmetrical and asymmetrical loads symmetrically and asymmetrically
      for 8 h work shifts. The experimental data collected in previous studies on
      experienced (industrial) and inexperienced (non-industrial) materials handlers
      (Mital 1984a, Mital and Fard 1986) and the patterns of responses between the two
      populations (Mital 1985, 1987) were used to generate this database. Since
      previous work (Mital 1985, 1987) showed that responses of both experienced and
      inexperienced materials handlers to task variables are similar and also provided
      multipliers relating the psychophysical lifting capacities of the two
      populations, it was possible: (1) to convert psychophysical capacity data for
      asymmetrical lifting of symmetrical and asymmetrical loads, collected on
      inexperienced workers to reflect psychophysical lifting capacity of experienced
      workers for asymmetrical lifting; and (2) to take psychophysical lifting capacity
      data of experienced industrial workers for symmetrical lifting of symmetrical
      loads and generate from it their psychophysical lifting capacity for symmetrical
      and asymmetrical lifting of symmetrical and asymmetrical loads by using the
      response patterns of inexperienced workers to lifting symmetrical and
      asymmetrical loads symmetrically and asymmetrically. Both approaches were used
      and, as expected, provided almost identical values for the psychophysical lifting
      capacity of industrial workers for symmetrical and asymmetrical lifting of
      symmetrical and asymmetrical loads. Therefore, the final database tables provided
      in this paper used combined values generated by the two methods.

PMID- 1633789
TI  - The load on the lumbar spine during asymmetrical bi-manual materials handling.
AB  - Previous biomechanical analyses of typical load manipulation tasks were mainly
      limited to sagittal-plane activities or to static cases. This paper includes the
      biomechanical determination and assessment of lumbar load during asymmetrical bi
      manual materials handling tasks which involve lateral turning of the body, trunk
      inclination, and sagittal flexion and lateral bending of the spine. Diagonal
      lifting tasks were analysed for different values for load weight (0-40 kg) and
      task duration (0.75-1.5 s). Whereas a constant grasp height of 15 cm was assumed,
      the height for releasing the load differed (50, 100, 150 cm). A dynamic spatial
      human model ('The Dortmunder') was used for calculating the torque in the
      sagittal, frontal, and transversal planes through the lumbosacral joint and for
      determining the compressive and the sagittal and lateral shear force at the L5-S1
      disc. The trajectories of body segments and load are computer-simulated on the
      basis of postures adopted during the movement. During diagonal lifting of loads,
      lumbosacral torque in the sagittal plane is considerably larger than the lateral
      bending and torsional torque components. Dynamic analyses result in higher
      maximum values in the lumbar-load time curves than static analyses. The shorter
      the time for task execution, the higher the resultant dynamic effects and, in
      consequence, the higher the lumbar load. Lumbosacral compression and shear
      increase with increasing load-release heights due to higher acceleration and
      retardation of body and load when the same grasp position and task duration are
      assumed. The maximum load-bearing capacity of the lumbar spine was determined on
      the basis of strength data for isolated lumbar segments provided in the
      literature. The compressive strength falls within the same range as the
      compressive forces calculated for asymmetrical lifting of loads up to 40 kg. On
      account of the wide scattering of the compressive strength values, the main
      influences were determined (age and gender). At an age of 40 years, strength is
      approx. 6.7 kN for males and 4.7 kN for females (decrease with age per decade:
      1.0 kN males, 0.6 kN females). In order to avoid overestimating an individual's
      lumbar compressive strength, predicted values should be reduced, e.g., by the
      standard deviation in the male or female samples (2.6 kN or 1.5 kN). Although
      only a few maximum shear force values are available in the literature, comparison
      with the calculated values for diagonal lifting leads to the conclusion that
      sagittal and lateral shear should not be ignored in the assessment of lumbar load
      during asymmetrical handling tasks.

PMID- 1633788
TI  - Margin of safety for the human back: a probable consensus based on published
      studies.
AB  - Despite numerous efforts to control occurrences of work-related low back pain, it
      continues to be a significant problem. Since the causation of low back pain is
      under multifactorial control, it is suggested that the factor most vulnerable at
      any given time will determine the safety. Epidemiological, biomechanical,
      physiological, and psychophysical information presented in published literature
      has been analysed. The data available are related to injuries and the projected
      margin of safety. This paper therefore, is an integrative, inferential synthesis
      of the published work to discern the margin of safety. An attempt has been made
      to conclude, on the basis of objective evidence, an all encompassing criterion to
      ensure the safety of the back. The psychophysical approach appears to integrate
      biomechanical and physiological variables on a short term basis in the studies
      surveyed. However, it remains to be proven that the sensory conditioning due to
      prolonged and repetitive occupational tasks will remain responsive to cumulative
      load and fatigue failures.

PMID- 1633790
TI  - Manual materials handling capabilities in non-standard postures.
AB  - Research efforts to establish manual materials handling (MMH) capabilities of
      individuals and populations have been conducted for many years. Most of the
      previous efforts have explored 'standard postures', utilizing two-handed,
      symmetric, sagittal plane MMH using unrestricted postures. Recognizing that many
      industrial MMH activities do not utilize 'standard postures', recent research
      projects have explored psychophysically determined MMH capacities in a variety of
      non-standard postures. Among the non-standard postures examined were: twisting
      while lifting or lowering, lifting and lowering from lying, sitting, kneeling,
      and squatting positions, and carrying loads under conditions of constricted
      ceiling heights. This paper presents the results of a series of previous research
      efforts at Texas Tech University. The results are presented in the form of
      population capabilities of both males and females for 99 MMH tasks using 'non
      standard postures'. The data tables contain means and standard deviations of the
      data, as well as percentile distributions for the subject populations. Sample
      sizes for the experimental populations ranged from 45 to 50 subjects of each sex
      in the first three experiments to 20 subjects of each sex in the fourth set of
      experiments.

PMID- 1633791
TI  - The effects of speed, frequency, and load on measured hand forces for a floor to
      knuckle lifting task.
AB  - The purpose of this study was to describe and quantify measured hand forces
      during floor to knuckle lifting of various loads. Hand forces of five subjects
      were measured with a strain gauge apparatus for normal and fast speeds of lifting
      at 1, 4, and 8 l/min. The pattern of hand force over time exhibited peaks in
      force in the shape of a spike for all fast lifts, indicating that subjects did
      not lift smoothly. For normal speed of lift, only one of the five subjects
      executed some lifts smoothly, indicating that it may be possible to lift
      smoothly, but most lifters probably do not. Peaks of horizontal and vertical
      components of hand force were tabulated by speed of lift, frequency, and load.

PMID- 1633792
TI  - Quantification of back motion during asymmetric lifting.
AB  - The objective of this study was to determine how trunk motion characteristics (in
      all three planes of the trunk) change as a free dynamic lifting task becomes more
      asymmetric. Trunk motion characteristics included range of motion, velocity (peak
      and average), and acceleration. Previous studies have shown that trunk motion
      characteristics affect trunk strength as well as the action of the trunk
      musculature. These trunk motion characteristics were quantified as a function of
      seven task asymmetries and three task weights. The experimental task required the
      subject to lift materials in positions commonly seen in the workplace. The range
      of motion, peak velocity, average velocity, and peak acceleration in each plane
      of the body were documented during the tasks. Generally, trunk motion
      characteristics in all three planes increased with an increase in task asymmetry.
      However, with an increase in task weight all the sagittal plane parameters and
      one transverse plane parameter decreased. Models were constructed to predict
      trunk motion characteristics given a task asymmetry and weight. When these motion
      components were compared to dynamic strength estimates from previous studies it
      was found that dynamic asymmetric lifts could reduce available strength up to 21%
      of maximum static strength. The results provide new insight into factors
      associated with the risk of developing low back disorders.

PMID- 1633793
TI  - Static and dynamic lifting strength at different reach distances in symmetrical
      and asymmetrical planes.
AB  - Postural and therefore biomechanical standardization in strength testing has not
      been rigorously and consistently applied. To develop a quantitative relationship
      between strength and posture (body position, symmetry, and reach) 30 normal
      subjects (18 male and 12 females) were required to stoop and squat lift or exert
      in the relevant posture against a standardized instrumented handle. The isometric
      lifting efforts and isokinetic lifts were studied. The isokinetic lifts were done
      at a linear velocity of 50cm/s of the hand displacement from the floor to the
      knuckle heights of the respective subjects in stoop and squat postures. The
      isometric stoop lifting efforts were exerted in two standardized postures: (a)
      with 60 degrees hip flexion; and (b) with 90 degrees hip flexion. The isometric
      squat lifting efforts were also exerted in two standardized postures: (a) with 90
      degrees knee flexion; and (b) with 135 degrees knee flexion. All isometric
      lifting efforts and isokinetic lifts were performed at half, three-quarters, and
      full horizontal reach in sagitally symmetrical, 30 degrees left lateral, and 60
      degrees left lateral planes. Isometric stoop and squat lifting efforts were also
      measured in self-selected optimal postures. These 56 conditions were tested in
      random order. The analysis of variance revealed that the gender, the mode of
      lifting, the postural asymmetry and reach of lifting affected the strength
      significantly (p less than 0.0001). Most two-way and three-way interactions were
      significant (p less than 0.01). Of 108 prediction regression equations, 103 were
      significant with up to 90% of the variation explained by anthropometric variables
      and sagittal plane strength. The reach affected the strength most profoundly
      followed by postural asymmetry and the mode of lifting.

PMID- 1633794
TI  - Biomechanically and electromyographically assessed load on the spine in self
      paced and force-paced lifting work.
AB  - The purpose of this study was to measure dose of spinal load when different
      pacing methods were applied to lifting work and to develop methodology for such
      measurements. The compressive load on the spine computed by a dynamic
      biomechanical model and the electromyographic activity of back muscles were used
      for describing the spinal load. Five men and five women worked in a laboratory on
      two days lifting a box up and down for 30 min on both days, on one day force
      paced (4 lifts/min), and on the other self-paced in random order. The weight of
      the box was rated by the subjects to be acceptable for the work done. The lift
      rate of our female subjects was higher and that of the male subjects lower in
      self-paced than in force-paced work. There were no significant differences in
      peak lumbosacral compressions nor in the amplitude distributions of
      electromyography between the two pacing methods. The biomechanically-calculated
      compressive forces on the spine were lower (about 2.7 kN for the men and 2.3 kN
      for women) than the biomechanical recommendations for safe lifting, but the EMG
      activity showed quite high peaks so that for 1% of work time the activity was on
      women above 60% and on men above 40% of the activity during maximum isometric
      voluntary test contraction.

PMID- 1633795
TI  - An electromyographic analysis of seated and standing lifting tasks.
AB  - The objective of this project was to compare the muscular effort exerted during
      manual lifting tasks performed in standing versus seated posture. Six male
      undergraduate and graduate students performed 12 different static and dynamic
      lifts in both sitting and standing positions. During each effort
      electromyographic (EMG) data were collected on four muscles groups (low back,
      upper back, shoulder, and abdominals). Four contractions were designed to elicit
      maximum muscular effort in the four groups being monitored. The remaining data
      were then expressed as a percentage of maximum EMG. Each subject performed the
      following: maximum static lift when sitting; maximum static lift when standing;
      sitting, static lift with 15.9 kg; standing, static lift with 15.9 kg; dynamic
      sit-forward lift with 15.9 kg, dynamic stand-forward lift with 15.9 kg, dynamic
      sit-twist with 15.9 kg, dynamic stand-vertical lift with 15.9 kg. Each of the
      lifts was performed with a wooden tray with slotted handles. Root mean square
      (RMS) values of the EMG data were calculated for three second periods. EMG
      activity in the low back, upper back, and shoulder was greater during sitting
      lifting than during standing lifting. The sit-twist lift resulted in the highest
      EMG in the abdominal muscles. Dynamic lifts resulted in more muscle activity than
      did static lifts. From these data it was concluded that sitting-lifting results
      in greater stress in the low back, upper back, and shoulders than does lifting
      while standing.

PMID- 1633796
TI  - An exponential model of isometric muscular fatigue as a function of age and
      muscle groups.
AB  - Despite the recommendations that an important design criterion is not to exceed
      15% of an operator's maximum voluntary contraction (MVC) with any muscle that
      must be used for a long period of time, many tasks involve the exertion of much
      higher forces coupled with long-term contractions. Many studies have investigated
      the force-time relationship of isometric muscle contractions to determine the
      endurance time of a given relative force. To date, however, direct studies of
      muscle performance throughout fatiguing tasks have not been conducted to the same
      degree. This research was concerned with studying the effects of different muscle
      groups (biceps vs quadriceps) of subjects with different age groups (20-29 vs 50
      59 years of age) on long-term muscular isometric contractions at different levels
      of %MVC (20%, 40%, 60%, 80%, and 100% MVC), and modelling the functional data to
      describe the time course of strength decrement. The data revealed that the time
      course of strength decrement was best modelled by the function: [formula: see
      text] An experiment, using 20 subjects with each subject performing 10 conditions
      (two muscle groups x five levels of %MVC), showed that this function accounted
      for over 95% of the variance of strength decrement. All parameter estimates were
      statistically significant.

PMID- 1633797
TI  - Bibliography.

PMID- 1633798
TI  - Nervous control of liver metabolism and hemodynamics.

PMID- 1633799
TI  - Molecular cloning of a glucoamylase gene from a thermophilic Clostridium and
      kinetics of the cloned enzyme.
AB  - Clostridium sp. G0005 produces a cell-bound glucoamylase (CGA). The gene encoding
      CGA has been sequenced. The deduced amino acid sequence begins with a putative 21
      residue signal sequence for secretion of bacterial lipoproteins, which suggests
      that a putative CGA precursor is modified and secreted like other bacterial
      lipoproteins in Clostridium sp. G0005, and that the modified residue is important
      in the cell-bound form of mature CGA. Comparison of the amino acid sequence of
      the CGA precursor with known eukaryotic enzymes showed several regions of high
      similarity in spite of low similarity throughout the overall primary structure.
      CGA is the first bacterial glucoamylase to be cloned. The CGA gene was expressed
      in Escherichia coli cells with an inducible expression plasmid, in which the 5'
      non-coding region and the N-terminal coding region of the gene were replaced with
      the lac promoter. Kinetic studies of the cloned enzyme purified from E. coli were
      performed with a set of linear malto-oligosaccharides as substrates, and the
      subsite affinity was calculated from the kinetic parameters. CGA had typical
      kinetic properties for a glucoamylase, but this bacterial enzyme had higher
      isomaltose-hydrolyzing activity than other eukaryotic glucoamylases.

PMID- 1633800
TI  - Identification of cholecystokinin/gastrin peptides in frog and turtle. Evidence
      that cholecystokinin is phylogenetically older than gastrin.
AB  - Peptides homologous to mammalian cholecystokinin (CCK) and gastrin in brain,
      antrum, and small intestine of an amphibian (the bullfrog, Rana catesbeiana) and
      a reptile (the turtle, Pseudomys scripta) were characterized. All tissues
      contained peptides reacting with antisera specific for the carboxyamidated C
      terminal tetrapeptide common for CCK and gastrin. Extracts of all tissues, except
      the turtle antrum, also reacted with an antiserum specific for mammalian sulfated
      CCK, while no extract contained peptides reacting with an antiserum specific for
      mammalian gastrin. Both species contained predominantly small acidic forms in the
      brain and larger less acidic forms in the antrum and intestine. The antral
      peptides of both species were identified. The largest frog gastrin was a 47
      residue peptide: DLLASLTHEQ KQLIMSQLLP ELLSELSNAE DHLHPMRDRD YAGWMDF.NH2. The
      largest turtle gastrin was a 52-residue peptide: DLLEALSQDQ KLLMAKFLPH IYAELANREG
      NWHEDAALRP LHDHDYPGWM DF.NH2. They display 51% similarity. Having Tyr in position
      7 from the C-terminus, both resemble structurally mammalian CCK rather than
      gastrin, which suggests that CCK is phylogenetically older than gastrin. The
      turtle antral peptide contains a Tyr followed by Pro as in chicken gastrin. Thus,
      apparently at the stage of reptiles, a route different from the mammalian was
      taken in order to evolve a specific gastrin function.

PMID- 1633801
TI  - A correlation-coefficient method to predicting protein-structural classes from
      amino acid compositions.
AB  - A protein is usually classified into one of the following four structural
      classes: all alpha, all beta, (alpha + beta) and alpha/beta. In this paper, based
      on the maximum correlation-coefficient principle, a new formulation is proposed
      for predicting the structural class of a protein according to its amino acid
      composition. Calculations have been made for a development set of proteins from
      which the amino acid compositions for the standard structural classes were
      derived, and an independent set of proteins which are outside the development
      set. The former can test the self consistency of a method and the latter can test
      its extrapolating effectiveness. In both cases, the results showed that the new
      method gave a considerably higher rate of correct prediction than any of the
      previous methods, implying that a significant improvement has been achieved by
      implementing the maximum-correlation-coefficient principle in the new method.

PMID- 1633802
TI  - Inhibition of triosephosphate isomerase from Trypanosoma brucei with cyclic
      hexapeptides.
AB  - Two series of oligopeptides have been synthesized. Their effects on the activity
      of purified triosephosphate isomerase from Trypanosoma brucei and various other
      organisms have been studied. Using detailed three-dimensional structure
      information, the first series consisted of both cyclic and linear hydrophilic
      peptides that were designed to mimic the beta turns of the subunit interface
      loops of the trypanosome triosephosphate isomerase dimer. None of these exerted
      any inhibitory effect. The second series consisted of more hydrophobic cyclic
      peptides, originally designed to inhibit a hepatic transport system. Several of
      these were very effective in inhibiting the trypanosome triosephosphate
      isomerase, but not the homologous enzymes from rabbit, dog, yeast or Escherichia
      coli. The most active peptide, cyclo[-Trp-Phe-D-Pro-Phe-Phe-Lys(Z)-], exerted 50%
      inhibitory activity at a concentration of 3 microM. The nature of the inhibitory
      action of one of these compounds cyclo[-Trp-Tyr(OSO3Na)-D-Pro-Phe-Thr(OSO3Na)
      Lys(Z)-] was studied in more detail. Its inhibition was noncompetitive and
      reversible and more than one peptide was able to bind/active site.

PMID- 1633803
TI  - Identification and purification of the ornithine/citrulline carrier from rat
      liver mitochondria.
AB  - The ornithine/citrulline carrier from rat liver mitochondria, solubilized with
      Triton X-100 and partially purified on hydroxyapatite, was identified and
      completely purified by PD-10, DEAE-Sephacel and celite chromatography. On
      SDS/polyacrylamide gel electrophoresis, the purified ornithine/citrulline carrier
      consisted of a single protein band with an apparent molecular mass of 33.5 kDa.
      When reconstituted into liposomes the ornithine carrier protein catalyzed an
      active mersalyl sensitive ornithine/ornithine exchange. It was purified 438-fold
      with a recovery of 38% and a protein yield of 0.09% with respect to the extract
      derived from mitoplasts. The purified and reconstituted protein did not catalyze
      a significant unidirectional transport of ornithine. Citrulline was found to be
      the best countersubstrate for the transport of ornithine, followed by lysine and
      arginine. The exchange activity was inhibited by several sulphydryl reagents.

PMID- 1633804
TI  - Lipoamide dehydrogenase from Azotobacter vinelandii: site-directed mutagenesis of
      the His450-Glu455 diad. Kinetics of wild-type and mutated enzymes.
AB  - Three amino acid residues in the active site of lipoamide dehydrogenase from
      Azotobacter vinelandii were replaced with other residues. His450, the active-site
      base, was replaced with Ser, Tyr or Phe. Pro451, from X-ray analysis found to be
      in cis conformation positioning the backbone carbonyl of His450 close to N3 of
      the flavin, was changed to Ala. Glu455, from X-ray analysis expected to be
      involved in modulating the pKa of the base (His450), was replaced with Asp and
      Gln. The general conclusion is that mutation of the His-Glu diad impairs
      intramolecular electron transfer between the disulfide/dithiol and the FADH-/FAD.
      The wild-type enzyme functions according to a ping-pong mechanism in the
      physiological reaction in which the formation of NADH is rate-limiting. Above pH
      8.0 the enzyme is strongly inhibited by the product NADH. The pH dependence of
      the steady-state kinetics using the NAD+ analog 3-acetylpyridine adenine
      dinucleotide (AcPyAde+) reveals a pKa of 8.1 in the pKm AcPyAde+ plot indicating
      that this pKa is related to the deprotonation of His450 [Benen, J., Berkel van,
      W., Zak, Z., Visser, T., Veeger, C. & Kok de, A. (1991) Eur. J. Biochem. 202, 863
      872] and to the inhibition by NADH. The mutations considerably affect turnover.
      Enzymes with the mutations Pro451----Ala, His450----Phe and His450----Tyr appear
      to be almost inactive in both directions. Enzyme His450----Ser is minimally
      active, V at the pH optimum being 0.5% of wild-type activity in the physiological
      reaction. Rapid reaction kinetics show that for the His450-mutated enzymes the
      reductive half reaction using reduced 6,8-thioctic acid amide [Lip(SH)2] is rate
      limiting and extremely slow when compared using reduced 6,8-thioctic acid amide
      [Lip(SH)2] is rate-limiting and extremely slow when compared to the wild-type
      enzyme. For enzyme Pro451----Ala it is concluded that the loss of activity is due
      to over-reduction by Lip(SH)2 and NADH. The Glu455-mutated enzymes are
      catalytically competent but show strong inhibition by the product NADH (enzyme
      Glu455----Asp more than Glu455----Gln). The inhibition can largely be overcome by
      using AcPyAde+ instead of NAD+ in the physiological reaction. The rapid reaction
      kinetics obtained for enzymes Glu455----Asp and Glu455----Gln deviate from the
      wild-type enzyme. It is concluded that this difference is due to cooperativity
      between the active sites in this dimeric enzyme.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1633805
TI  - Lipoamide dehydrogenase from Azotobacter vinelandii. The role of the C-terminus
      in catalysis and dimer stabilization.
AB  - The 10 C-terminal residues are not visible in the crystal structure of lipoamide
      dehydrogenase from Azotobacter vinelandii, but can be observed in the crystal
      structures of the lipoamide dehydrogenases from Pseudomonas putida and
      Pseudomonas fluorescens. In these structures, the C-terminus folds back towards
      the active site and is involved in interactions with the other subunit. The
      function of the C-terminus of lipoamide dehydrogenase from A. vinelandii was
      studied by deletion of 5, 9 and 14 residues, respectively. Deletion of the last 5
      residues does not influence the catalytic properties and conformational stability
      (thermoinactivation and unfolding by guanidinium hydrochloride). Removal of 9
      residues results in an enzyme (enzyme delta 9) showing decreased conformational
      stability and high sensitivity toward inhibition by NADH. These features are even
      more pronounced after deletion of 14 residues (enzyme delta 14). In addition
      Tyr16, conserved in all lipoamide dehydrogenases sequenced thus far, and shown
      from the other structures to be likely to be involved in subunit interaction, was
      replaced by Phe and Ser. Mutation of Tyr16 also results in a strongly increased
      sensitivity toward inhibition by NADH. The conformational stability of both Tyr16
      mutated enzymes is comparable to enzyme delta 9. The results strongly indicate
      that a hydrogen bridge between tyrosine of one subunit (Tyr16 in the A.
      vinelandii sequence) and histidine of the other subunit (His470 in the A.
      vinelandii sequence), exists in the A. vinelandii enzyme. In the delta 9 and
      delta 14 enzymes this interaction is abolished. It is concluded that this
      interaction mediates the redox properties of the FAD via the conformation of the
      C-terminus containing residues 450-470.

PMID- 1633806
TI  - Characterisation of a haem active-site mutant of horseradish peroxidase, Phe41---
      Val, with altered reactivity towards hydrogen peroxide and reducing substrates.
AB  - A horseradish peroxidase variant ([F41V] HRP-C*), in which Val replaces the
      conserved Phe at position 41 adjacent to the distal His, has been constructed.
      Its composition and spectroscopic, catalytic and substrate-binding properties
      were compared with those of the wild-type recombinant (HRP-C*) and plant (HRP-C)
      enzymes. Presteady-state kinetic measurements of the rate constant for compound I
      formation (k1) revealed an eightfold decrease in the reactivity of the Phe41---
      Val variant towards H2O2, in comparison with HRP-C or HRP-C*. Measurement of the
      remaining rate constants, k2 and k3, for the two single-electron reduction
      reactions of [F41V] HRP-C with para-aminobenzoic acid as reducing substrate,
      showed that they were 2.5-fold and 1.3-fold faster, respectively. In contrast,
      analysis of data from steady-state assays with 2,2'-azinobis(3
      ethylbenzthiazoline-6-sulphonate) as reducing substrate, showed decreased
      reactivity of the mutant enzyme to this compound, indicating a change in
      substrate specificity. Over the substrate range studied, the data for HRP-C* and
      for [F41V] HRP-C conformed to a simple modification of the accepted peroxidase
      mechanism in which a first-order step (ku), assumed to be product dissociation,
      becomes rate-limiting under our standard assay conditions. Calculations of rate
      constants from steady-state data yielded values of k1 for both enzyme forms in
      adequate agreement with those from pre-steady state measurements. They showed,
      furthermore, that both k3 for 2,2'-azinobis(3-ethylbenzthiazoline-6-sulphonate)
      and ku were substantially decreased, fivefold and tenfold, respectively, in the
      mutant. Analogous to the decrease in ku, we observed a twofold increase in the
      affinity of the mutant variant for the inhibitor benzhydroxamic acid. The
      coordination-state equilibrium of the haem iron also appeared shifted towards the
      hexacoordinate high-spin form. These observations indicate that in addition to
      affecting reactivity to H2O2, mutations in the distal region and close to the
      haem iron also affect reactivity towards different reducing substrates, inducing
      perturbations in the neighbourhood of the aromatic-substrate-binding site, known
      to be 0.8-1.2 nm from the haem iron.

PMID- 1633807
TI  - Structural studies by proton-NMR spectroscopy of plant horseradish peroxidase C,
      the wild-type recombinant protein from Escherichia coli and two protein variants,
      Phe41----Val and Arg38----Lys.
AB  - Wild-type recombinant horseradish peroxidase isoenzyme C and two protein
      variants, Phe41----Val and Arg38----Lys, have been characterised using both one-
      and two-dimensional NMR spectroscopy. Proton NMR spectra recorded in both resting
      and cyanide-ligated states of the proteins were compared with those of the
      corresponding plant peroxidase. The latter contains 18% carbohydrate in eight N
      linked oligosaccharide side chains whereas the recombinant proteins are expressed
      in nonglycosylated form. The spectra of the plant enzyme and refolded recombinant
      protein are essentially identical with the exception of carbohydrate-linked
      resonances in the former, indicating that their solution structures are highly
      similar. This comparison also identifies classes of carbohydrate resonances in
      the plant enzyme which provides new information on the local environment and
      mobility of the oligosaccharide side chains. Comparison of the spectra of the
      cyanide-ligated states of the two variants and those of plant horseradish
      peroxidase C indicated that there were significant differences with respect to
      haem and haem-linked resonances. These could not be rationalised simply on the
      basis of the local perturbation expected from a single-site substitution. The two
      substitutions made to residues on the distal side of the haem apparently
      influenced the degree of imidazolate character of the proximal His170 imidazole
      ring thus perturbing the magnetic environment of the haem group. Inspection of
      the spectra of the Phe41----Val variant also showed that the resonances of a
      phenylalanine residue in the haem pocket had been incorrectly assigned to Phe41
      in a previous study. A new assignment, based on additional information from two
      dimensional nuclear Overhauser enhancement spectroscopy, was made to Phe152. The
      assignments made for the Phe41----Val variant were also used as a basis to
      investigate the structure of the complex formed with the aromatic donor molecule,
      benzhydroxamic acid.

PMID- 1633808
TI  - The essential active-site lysines of clostridial glutamate dehydrogenase. A study
      with pyridoxal-5'-phosphate.
AB  - Glutamate dehydrogenase (GDH) of Clostridium symbiosum, like GDH from other
      species, is inactivated by pyridoxal 5'-phosphate (pyridoxal-P). This
      inactivation follows a similar pattern to that for beef liver GDH, in which a non
      covalent GDH-pyridoxal-P complex reacts slowly to form a covalent complex in
      which pyridoxal-P is in a Schiff's-base linkage to lysine residues. [formula: see
      text] The equilibrium constant of this first-order reaction on the enzyme surface
      determines the final extent of inactivation observed [S. S. Chen and P. C. Engel
      (1975) Biochem. J. 147, 351-358]. For clostridial GDH, the maximal inactivation
      obtained was about 70%, reached after 10 min with 7 mM pyridoxal-P at pH 7. In
      keeping with the model, (a) inactivation became irreversible after reduction with
      NaBH4. (b) The NaBH4-reduced enzyme showed a new absorption peak at 325 nm. (c)
      Km values for NAD+ and glutamate were unaltered, although Vmax values were
      decreased by 70%. Kinetic analysis of the inactivation gave values of 0.81 +/-
      0.34 min-1 for k3 and 3.61 +/- 0.95 mM for k2/k1. The linear plot of 1/(1-R)
      against 1/[pyridoxal-P], where R is the limiting residual activity reached in an
      inactivation reaction, gave a slightly higher value for k2/k1 of 4.8 +/- 0.47 mM
      and k4 of 0.16 +/- 0.01 min-1. NADH, NAD+, 2-oxoglutarate, glutarate and
      succinate separately gave partial protection against inactivation, the biggest
      effect being that of 40 mM succinate (68% activity compared with 33% in the
      control). Paired combinations of glutarate or 2-oxoglutarate and NAD+ gave
      slightly better protection than the separate components, but the most effective
      combination was 40 mM 2-oxoglutarate with 1 mM NADH (85% activity at
      equilibrium). 70% inactivated enzyme showed an incorporation of 0.7 mM pyridoxal
      P/mol subunit, estimated spectrophotometrically after NaBH4 reduction, in keeping
      with the 1:1 stoichiometry for the inactivation. In a sample protected with 2
      oxoglutarate and NADH, however, incorporation was 0.45 mol/mol, as against 0.15
      mol/mol expected (85% active). Tryptic peptides of the enzyme, modified with and
      without protection, were purified by HPLC. Two major peaks containing
      phosphopyridoxyllysine were unique to the unprotected enzyme. These peaks yielded
      three peptide sequences clearly homologous to sequences of other GDH species. In
      each case, a gap at which no obvious phenylthiohydantoin-amino-acid was detected,
      matched a conserved lysine position. The gap was taken to indicate
      phosphopyridoxyllysine which had prevented tryptic cleavage.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1633809
TI  - S100P, a novel Ca(2+)-binding protein from human placenta. cDNA cloning,
      recombinant protein expression and Ca2+ binding properties.
AB  - A novel member of the S100 protein family, present in human placenta, has been
      characterized by protein sequencing, cDNA cloning, and analysis of Ca(2+)-binding
      properties. Since the placenta protein of 95 amino acid residues shares about 50%
      sequence identity with the brain S100 proteins alpha and beta, we proposed the
      name S100P. The cDNA was expressed in Escherichia coli and recombinant S100P was
      purified in high yield. S100P is a homodimer and has two functional EF
      hands/polypeptide chain. The low-affinity site (Kd = 800 microM), which, in
      analogy to S100 beta, seems to involve the N-terminal EF hand, can be followed by
      the Ca(2+)-dependent decrease in tyrosine fluorescence. The high-affinity site,
      provided by the C-terminal EF hand, influences the reactivity of the sole
      cysteine which is located in the C-terminal extension (Cys85). Binding to the
      high-affinity site (Kd = 1.6 microM) can be monitored by fluorescence
      spectroscopy of S100P labelled at Cys85 with 6-proprionyl-2
      dimethylaminonaphthalene (Prodan). The Prodan fluorescence shows a Ca(2+)
      dependent red shift of the maximum emission wavelength from 485 nm to 502 nm,
      which is accompanied by an approximately twofold loss in integrated fluorescence
      intensity. This indicates that Cys85 becomes more exposed to the solvent in
      Ca(2+)-bound S100P, making this region of the molecule, the so-called C-terminal
      extension, an ideal candidate for a putative Ca(2+)-dependent interaction with a
      cellular target. In p11, a different member of the S100 family, the C-terminal
      extension which contains a corresponding cysteine (Cys82 in p11), is involved in
      a Ca(2+)-independent complex formation with the protein ligand annexin II. The
      combined results support the hypothesis that S100 proteins interact in general
      with their targets after a Ca(2+)-dependent conformational change which involves
      hydrophobic residues of the C-terminal extension.

PMID- 1633810
TI  - A tungsten-containing active formylmethanofuran dehydrogenase in the thermophilic
      archaeon Methanobacterium wolfei.
AB  - Methanobacterium wolfei is a thermophilic methanogenic archaeon which requires
      tungsten or molybdenum for growth. We have found that the organism contains two
      formylmethanofuran dehydrogenases, one of which is a tungsten enzyme. Indirect
      evidence indicates that the other formylmethanofuran dehydrogenase is a
      molybdenum enzyme. The tungsten enzyme was purified and characterized. The native
      enzyme had an apparent molecular mass of 130 kDa. SDS/PAGE revealed a composition
      of three subunits of apparent molecular mass 35, 51 and 64 kDa, the N-terminal
      amino acid sequences of two of which were determined. 0.3-0.4 mol tungsten/mol
      enzyme was found but no molybdenum. The pterin cofactor was identified as
      molybdopterin guanine dinucleotide. The purified enzyme exhibited a specific
      activity of 8.3 mumol.min-1.mg protein-1 and an apparent Km for
      formylmethanofuran and methylviologen of 13 microM and 0.4 mM, respectively. The
      optimum temperature for activity was 65 degrees C. At 40-60 degrees C, the rate
      increased with a Q10 of 1.9; the activation energy of the reaction was 45 kJ/mol.
      The enzyme was found to require potassium ions for thermostability. The oxygen
      sensitive enzyme was not inactivated by cyanide.

PMID- 1633811
TI  - The role of retinal in the thermal stability of the purple membrane.
AB  - Differential scanning calorimetry demonstrates that the bleached form of the
      purple membrane does not possess any measurable thermal transition in water, up
      to 105 degrees C, whereas in 0.1 M phosphate pH 7.5 it shows a transition at
      about 82 degrees C, with an enthalpy of 110 kJ/mol. In the latter medium, the
      native membrane shows the main transition at 97 degrees C, with an enthalpy of
      390 kJ/mol. The reduced form of the purple membrane shows two small transitions
      in water, as well as in 0.1 M phosphate, which do not seem to be related to the
      main thermal transition of the native membrane. Fourier-transform infrared
      spectra in D2O show that the two modified samples, as well as the native one,
      undergo similar secondary structural changes upon thermal denaturation. These
      changes appear to extend through a wide temperature range for both modified
      forms, particularly for the bleached one. The results suggest that the main
      thermal transition in the purple membrane is due to a cooperative conformational
      change involving the disruption of the network of electrostatic and hydrogen
      bonding interactions which originate from the protonated Schiff base. In the two
      modified membranes, these conformational changes appear to proceed smoothly
      through a rather low or non-cooperative process. The thermal behaviour of the
      bleached membrane in water resembles that of the molten globule state described
      for several globular proteins.

PMID- 1633812
TI  - A rat cerebellar protein containing the cdc10/SWI6 motif.
AB  - Systematic analysis of soluble proteins in developing rat cerebellum by an
      automated two-dimensional liquid-chromatography system detected a number of
      proteins which increased transiently during the initial stage of postnatal
      development. One of the proteins, V-1, was isolated using a liquid-chromatography
      system, and its amino acid sequence was determined by analysis of the purified
      protein. The sequence showed that the V-1 protein consists of 117 amino acids
      with an acetylated N-terminus, and has 2.5 internal sequence repeats of 33 amino
      acids. Computer retrieval of the sequence indicated that the repeated sequences
      have a structural characteristics of the cdc10/SWI6 motif, which is found in a
      series of proteins, including those involved in cell-cycle control and cell-fate
      determination in yeast, Drosophila melanogaster and Caenorhabditis elegans. The
      structure of V-1, coupled with its controlled expression in early postnatal
      development, implies a potential role for V-1 in cerebellar morphogenesis.

PMID- 1633813
TI  - Prosomes and their multicatalytic proteinase activity.
AB  - Prosomes were first described as being mRNA-associated RNP (ribonucleoprotein)
      particles and subcomponents of repressed mRNPs (messenger ribonucleoprotein). We
      show here that prosomes isolated from translationally inactive mRNP have a
      protease activity identical to that described by others for the multicatalytic
      proteinase complex (MCP, 'proteasome'). By RNase or non-ionic detergent
      treatment, the MCP activity associated with repressed non-globin mRNP from avian
      erythroblasts, sedimenting at 35 S, could be quantitatively shifted on sucrose
      gradients to the 19-S sedimentation zone characteristic of prosomes, which were
      identified by monoclonal antibodies. The presence of small RNA in the enzymatic
      complex was shown by immunoprecipitation of the protease activity out of
      dissociated mRNP using a mixture of anti-prosome monoclonal antibodies; a set of
      small RNAs 80-120 nucleotides long was isolated from the immunoprecipitate.
      Furthermore, on CsCl gradients, colocalisation of the MCP activity with prosomal
      proteins and prosomal RNA was found, and no difference in the prosomal RNA
      pattern was observed whether the particles were fixed or not prior to
      centrifugation. These data indicate that the MCP activity is a property of
      prosomes, shown to be in part RNP and subcomplexes of in vivo untranslated mRNP.
      A hypothesis for the role of the prosome-MCP particles in maintaining homeostasis
      of specific protein levels is proposed.

PMID- 1633814
TI  - Detailed structural analysis of asparagine-linked oligosaccharides of the
      nicotinic acetylcholine receptor from Torpedo californica.
AB  - The structures of the major oligosaccharide moieties of the nicotinic
      acetylcholine receptor (AcChoR) protein from Torpedo californica have been
      reported [Nomoto, H., Takahashi, N., Nagaki, Y., Endo, S., Arata, Y. and Hayashi,
      K. (1986) Eur. J. Biochem. 157, 233-242] to be high-mannose types. Here we report
      detailed analyses of the structures of the remaining oligosaccharides in this
      receptor. The sialylated oligosaccharides released by glycopeptidase (almond)
      digestion were separated according to the number of sialic acid residues using
      high-performance anion-exchange chromatography with pulsed amperometric
      detection. After removal of sialic acid from each fraction, the resulting neutral
      oligosaccharides were separately pyridylaminated and were analyzed by a
      combination of sequential exoglycosidase digestion and HPLC, then identified on a
      two-dimensional sugar map. The structures of two desialylated pyridylamino
      oligosaccharides were further analyzed by high-resolution proton NMR. Each
      oligosaccharide was composed of species containing varying numbers of sialic
      acids. The desialylated complex-type oligosaccharides of AcChoR consisted of ten,
      eight and one different biantennary, triantennary and tetraantennary
      oligosaccharide, respectively. The biantennary oligosaccharides were divided into
      two groups; oligosaccharides with fucose at the proximal N-acetylglucosamine (six
      varieties) and oligosaccharides without fucose (four varieties). Each group
      consisted of species differing in the number of terminal galactose residues. The
      major component of the biantennary oligosaccharides had two galactose residues at
      the non-reducing termini. The terminal alpha-galactose residue(s) linked to C3 of
      beta-galactose were found in the fucose-containing biantennary oligosaccharides
      (two varieties). The triantennary oligosaccharides were also divided into two
      groups; oligosaccharides with (four varieties) and without (four varieties)
      besecting N-acetylglucosamine. These groups were composed of species differing in
      the number of terminal galactose residues. The major component of the
      triantennary oligosaccharides was fully galactosylated with three galactose
      residues. An unusual group, Gal beta 1-3GlcNAc, was present in low levels in the
      triantennary oligosaccharides. In contrast, the tetraantennary oligosaccharide
      was composed of only one species, which is fully galactosylated with four
      galactose residues.

PMID- 1633815
TI  - Primary-structural and evolutionary analyses of the growth-hormone gene from
      grass carp (Ctenopharyngodon idellus).
AB  - The growth-hormone (GH) gene of grass carp, one of the fastest-growing species of
      farmed fish, was isolated and the DNA sequenced. Only one GH gene is found in
      this species. This gene, which is 2.5 kb in length, has five exons and four
      introns, in common with all of the mammalian and the recently published common
      carp GH genes. In the course of vertebrate evolution, the total lengths of the
      intron and the non-coding region of exon 5 of the GH gene have been shortened by
      40-70%, whereas the encoding exons of the gene have been slightly increased. The
      more closely related species exhibit the closest sequence similarity in their GH
      genes. For example, the similarity of the exons is 84.1-93.2% between grass carp
      and common carp (within the same family of Syprinedae), 43.5-82.1% between grass
      carp and rainbow trout (in different orders of Teleostei) and 45.8-58.6% between
      grass carp and rat (in different grades of Vertebrata). In addition, similar DNA
      domains, such as thyroid-hormone-receptor-complex-binding site and cell-type
      specific cis elements involved in regulation of expression of rat and human GH
      genes, have been localized in the corresponding regions of the grass-carp GH
      gene.

PMID- 1633816
TI  - Characterization of the promoter region of the porcine opn (osteopontin, secreted
      phosphoprotein 1) gene. Identification of positive and negative regulatory
      elements and a 'silent' second promoter.
AB  - Osteopontin (secreted phosphoprotein-1, Opn) is a phosphorylated glycoprotein
      expressed by transformed cells, macrophages, activated T-lymphocytes, specialized
      epithelial cells and bone cells that is characteristically enriched in milk and
      in the mineralized matrix of bone. The synthesis of Opn by bone cells is
      regulated by glucocorticoids and growth factors, which promote bone formation,
      and by the osteotropic hormone calcitriol (1,25-dihydroxycholecalciferol) and
      retinoic acid, which mediate bone resorption, indicating a bifunctional role for
      this protein in bone remodelling. To study the transcriptional regulation of the
      opn gene, two genomic clones (10 and 15 kb) encoding the opn gene were isolated
      from a porcine liver genomic library cloned into lambda phage. From the 15-kb
      clone a 4-kb EcoRI fragment containing the first two exons and 2.6 kb of the 5'
      flanking region of the opn gene was sequenced, and the transcriptional start site
      determined by primer extension analysis and S1 nuclease mapping. To identify the
      opn promoter, chimeric chloramphenicol acetyltransferase constructs were prepared
      using fragments from the first intron and the 5' flanking region of the opn gene.
      Transient transfection of porcine bone cells with these constructs showed strong
      promoter activity located within 74 bp upstream from the transcription initiation
      site. Within this region a TATA sequence, TTTAAA, was identified at positions -26
      to -31. However, the highest transcription rate was observed in a construct
      extending 180 bp upstream that included a CCGCCC Sp1 binding sequence (-63 to 
      68), and an AP1 site (-74 to -80). Further upstream in the 5' flanking region and
      within the first intron of the opn, a number of consensus sequences could be
      identified. Chimeric constructs containing a GGGTCAtatGGTTCA direct repeat
      consensus sequence for a vitamin D3 response element located at nucleotides -2245
      to -2259 responded to the addition of 0.1 microM calcitriol by a 2.5-fold
      stimulation of transcription, although a greater than 2-fold increase was also
      observed in shorter constructs -180 to -905 lacking such a consensus sequence.
      Promoter activity was also exhibited by a region containing a TTTAAA sequence in
      the first intron that corresponded to the putative promoter site reported for
      mouse opn in macrophages (Miyazaki, Y., Setoguchi, M., Yoshida, S., Higuchi, Y.,
      Akizuki, S. & Yamamoto, S. (1990) J. Biol. Chem. 265, 14432-14438).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1633817
TI  - O-glycosylation and stability. Unfolding of glucoamylase induced by heat and
      guanidine hydrochloride.
AB  - We have examined the stabilities of the catalytic and binding domains of
      glucoamylase 1 from Aspergillus niger and how these stabilities are affected by
      the O-glycosylated linker glycopeptide which separates the domains. On heating,
      the catalytic domain unfolds irreversibly, whereas the binding domain unfolds
      reversibly as shown by differential scanning calorimetry and by 1H NMR. The
      stability of three functional peptides, derived from glucoamylase 1, containing
      the binding domain alone and with 10 or 38 residues of the linker glycopeptide
      [Williamson, G., Belshaw, N.J. and Williamson, M. (1992) Biochem. J. 282, 423
      428] was examined. Refolding in each case was reversible after thermal or
      chemical denaturation. beta-Cyclodextrin stabilised the binding domain by the
      same amount when it was part of glucoamylase 1 or an isolated domain. The thermal
      stability of the catalytic domain was not affected by the binding domain;
      however, the catalytic domain increased the melting temperature of the binding
      domain. Furthermore, the linker glycopeptide stabilised the binding domain
      against reversible thermal and chemical denaturation by about 10 kJ/mol, but only
      a portion of the O-glycosylated residues were required for stabilisation. On a
      simple molecular mass basis, the linker glycopeptide does not contribute as much
      as expected to the denaturational enthalpy of glucoamylase 1 and, in addition,
      shows only a small conformational change on chemical or thermal denaturation;
      this supports an extended structure for the linker. The results demonstrate that
      the unfolding pathway of glucoamylase 1 depends on the concentration of beta
      cyclodextrin and that the presence of the catalytic domain and/or the linker
      glycopeptide stabilises the binding domain.

PMID- 1633818
TI  - The chloroplast-targeting domain of plastocyanin transit peptide can form a
      helical structure but does not have a high affinity for lipid bilayers.
AB  - Conformational properties and interactions with lipid membranes were studied for
      the chemically synthesized peptides PC(1-37) and PC(1-43), corresponding to the N
      terminal 37 and 43 residues, respectively, of the transit peptide of the
      precursor to plastocyanin of Silene pratensis. PC(1-43) covers the entire
      chloroplast targeting domain of the transit peptide. CD spectra of PC(1-37) and
      PC(1-43) showed that both peptides have little ordered structure in aqueous
      solutions but form partially helical conformations in the presence of detergent
      micelles or in methanol. Vesicle disruption and direct-binding experiments
      revealed, however, that neither PC(1-37) nor PC(1-43) had a high affinity for
      lipid membranes. Since in the intact plastocyanin transit peptide the chloroplast
      targeting domain is followed by a hydrophobic thylakoid-transfer domain, the
      plastocyanin precursor may well be transported to the chloroplast surface first
      with the aid of the thylakoid-transfer domain. The chloroplast-targeting domain
      may then form a helical structure in the lipid environments, and a chloroplast
      specific motif displayed on the helical structure may be recognized by a receptor
      protein located at the chloroplast envelope membranes.

PMID- 1633819
TI  - Determination of DNA-binding parameters for the Bacillus subtilis histone-like
      HBsu protein through introduction of fluorophores by site-directed mutagenesis of
      a synthetic gene.
AB  - A synthetic gene encoding the histone-like DNA-binding protein HBsu from Bacillus
      subtilis has been expressed in Escherichia coli. Yields of the purified protein
      are at least 20 mg/l culture medium. The recombinant HBsu protein is
      chromatographically, immunologically and functionally identical with the
      authentic wild-type protein. N-terminal sequencing of the purified protein
      confirms the fidelity of expression of the synthetic gene in E. coli. Site
      directed mutagenesis of the synthetic gene was employed to replace several amino
      acid residues of HBsu protein with tryptophan to facilitate the determination of
      DNA-binding parameters by fluorescence spectroscopy. According to gel-retardation
      experiments, the mutant protein [Phe47----Trp]HBsu shows identical DNA binding to
      wild-type HBsu protein. Analysis of fluorescence binding data reveals that [Phe47
      ---Trp]HBsu binds double-stranded DNA with a dissociation constant in the
      micromolar range. Computer-assisted fit of binding models to the experimental
      data renders positive cooperativity of binding unlikely. A dimer of [Phe47---
      Trp]HBsu appears to contact three or four base pairs of DNA. These results are in
      partial disagreement with earlier measurements on closely homologous proteins
      which tended to show cooperative binding and a longer DNA contact region.

PMID- 1633820
TI  - In vivo and in vitro characterization of overproduced colicin E9 immunity
      protein.
AB  - We report the overproduction of the immunity protein for the DNase colicin E9 and
      its characterization both in vivo and in vitro. The genes for colicin immunity
      proteins are normally co-expressed from Col plasmids with their corresponding
      colicins. In the context of the enzymatic colicins, the two proteins form a
      complex, thereby protecting the host bacterium from the antibiotic activity of
      the colicin. This complex is then released into the medium, whereupon the colicin
      alone translocates (through the appropriate receptor) into sensitive bacterial
      strains, resulting in bacterial cell death. The immunity protein for colicin E9
      (Im9) has been overproduced in a bacterial host in the absence of its colicin, to
      enable sufficient material to be isolated for structural studies. As a prelude to
      such studies, the in-vivo and in-vitro properties of overproduced Im9 were
      analysed. Electrospray mass spectrometry verified the molecular mass of the
      purified protein and analytical ultracentrifugation indicated that the native
      protein approximates a symmetric monomer. Fluorescence-enhancement and gel
      filtration experiments show that purified Im9 binds to colicin E9 in a 1:1 molar
      ratio and that this binding neutralizes the DNase activity of the colicin. These
      results lay the foundations for a full biophysical and structural
      characterization of the colicin E9 DNase inhibitor protein, Im9.

PMID- 1633821
TI  - The GppNHp-activated adenylyl cyclase complex from turkey erythrocyte membranes
      can be isolated with its beta gamma subunits.
AB  - The adenylyl cyclase complex, derived from turkey erythrocyte membranes, was
      activated using guanosine 5'-[beta, gamma-imido]triphosphate (Gpp[NH]p) and
      separated under low-detergent and low-salt conditions using conventional
      molecular-sieve chromatography followed by high-pressure ion-exchange and
      molecular-sieve chromatography. Although the complex remains activated with
      Gpp[NH]p throughout the isolation, the beta gamma subunits copurify with the
      cyclase. The stoichiometry of the cyclase to the alpha subunit of the stimulatory
      guanosine-nucleotide-binding regulatory protein (alpha s) to the beta subunit is
      close to unity, demonstrating that the beta gamma subunits do not dissociate from
      the Gs.cyclase complex (Gs, guanosine-nucleotide-binding regulatory protein) upon
      activation of the enzyme. If the final purification step was performed at high
      salt concentrations, the beta gamma subunits could be separated from the alpha
      s.cyclase complex. Previously reported results on bovine brain cyclase also
      showed that the Gs.cyclase complex remains intact subsequent to activation by
      hormone and Gpp[NH]p [Marbach, I., Bar-Sinai, A., Minich, M. and Levitzki, A.
      (1990) J. Biol. Chem. 265, 9999-10,004]. These results, using adenylyl cyclase
      from two different sources, support our previous kinetic experiments which first
      suggested that beta gamma subunits are not released from Gs upon cyclase
      activation. We, therefore, argue that the mode of adenylyl cyclase inhibition by
      the inhibitory guanosine-nucleotide-binding regulatory protein cannot be via
      shifting the alpha s to beta gamma equilibrium as is commonly believed, and an
      alternate hypothesis is proposed.

PMID- 1633822
TI  - Novel aerobic 2-aminobenzoate metabolism. Nucleotide sequence of the plasmid
      carrying the gene for the flavoprotein 2-aminobenzoyl-CoA monooxygenase/reductase
      in a denitrifying Pseudomonas sp.
AB  - Pseudomonas KB 740 degrades 2-aminobenzoate aerobically via a chimeric pathway
      which combines characteristics of anaerobic and aerobic aromatic metabolism.
      Atypically, 2-aminobenzoyl-CoA is an intermediate, and the activated aromatic
      acid is not only hydroxylated but also reduced to an alicyclic compound in a
      single step. The bacterial strain possesses a small plasmid, pKB 740, which
      carries all essential information of this new pathway. Its total nucleotide
      sequence was determined. It consists of 8280 bp and contains the genes for the
      two initial enzymes of the pathway; 2-aminobenzoate-CoA ligase catalyzes the
      activation of the aromatic acid, and the flavoenzyme 2-aminobenzoyl-CoA
      monooxygenase/reductase catalyzes the hydroxylation (monooxygenase activity) and
      subsequent reduction (reductase activity) of the aromatic ring of 2-aminobenzoyl
      CoA. Furthermore, five open reading frames (ORF) possibly coding for polypeptides
      are on the plasmid. Putative promoter sequences were found for two of the ORF. A
      nucleotide sequence able to form a possible termination loop was located
      downstream of the gene for 2-aminobenzoyl-CoA monooxygenase/reductase. This gene
      consists of 2190 bases. The deduced amino acid sequence of the protein (730
      residues; calculated molecular mass of the native 729-residue protein, 83,559 Da)
      contains a consensus sequence for an FAD-binding site at the N-terminus and a
      possible NAD(P)H-binding site approximately 150 amino acid residues apart from
      the N-terminus. The monooxygenase/reductase shows low sequence similarity to the
      flavoprotein salicylate hydroxylase. Functional and evolutionary aspects of this
      work are discussed.

PMID- 1633823
TI  - Photochemical trapping of a bacteriopheophytin anion in site-specific reaction
      center mutants from the photosynthetic bacterium Rhodobacter sphaeroides.
AB  - The mutant YY in the reaction center of Rhodobacter sphaeroides, in which Phe181
      on the L chain has been replaced by Tyr, and the double mutant FY, with Tyr210 on
      the M chain replaced by Phe and Phe181 on the L chain replaced by Tyr, have been
      constructed by site-directed mutagenesis. The studies described here were
      performed to complement a previous mutational analysis of mutant FF with Tyr210
      replaced by Phe. Both new strains grow photoheterotrophically. The optical
      absorption spectra of reaction centers isolated from these mutants have band
      shifts attributable to the monomer bacteriochlorophylls in the vicinity of the
      substitutions. Photochemical trapping of the bacteriopheophytin anion (I-)
      indicates that the bacteriopheophytin on the B branch is reduced to a much
      greater extent in FF and FY as compared to YY and wild-type YF. Low temperature
      (77 K) absorption spectra clearly show that in the wild-type (YF) and YY reaction
      centers only the 545-nm-absorbing bacteriopheophytin is reduced while in the FF
      and FY reaction centers both the 535-nm and 545-nm-absorbing bacteriopheophytins
      are reduced. A simple kinetic analysis is used to explain these results. This
      analysis suggests that, in order for the observed trapping results to occur, a
      decrease in the 'cycling' time must take place, that is changes in the rate(s) of
      charge recombination must accompany the already known decrease in the forward
      electron transfer rate.

PMID- 1633824
TI  - A mutation at Gly314 of the beta subunit of the Escherichia coli pyridine
      nucleotide transhydrogenase abolishes activity and affects the NADP(H)-induced
      conformational change.
AB  - Escherichia coli RH1 contains a mutation causing complete loss of pyridine
      nucleotide transhydrogenase activity. A single base change in the chromosomal DNA
      resulted in the replacement of Gly314 of the beta subunit by a Glu residue. The
      mutant enzyme was partially purified and its trypsin cleavage products examined.
      The distinct pattern of polypeptides given by proteolysis of the normal
      transhydrogenase in the presence of NADP(H) was absent when the mutant enzyme was
      treated with trypsin. However, the beta subunit of the mutant enzyme retained its
      ability to bind to NAD-agarose. Further substitutions were made at Gly314
      converting it to Ala, Val or Cys by the use of site-directed mutagenesis. All
      substitutions for Gly314 abolished the activity completely. The enzyme containing
      the Gly314----Ala mutation was studied in detail and behaved exactly as the
      enzyme containing the Gly314----Glu mutation. It is concluded that the mutation
      in the beta subunit abolished the NADP(H)-induced conformational change in the
      mutant enzyme. This conformational change, caused by NADP(H) binding, is required
      to cleave the normal beta subunit at Arg265 by trypsin. The genes encoding the
      pyridine nucleotide transhydrogenase were completely resequenced and several
      corrections have been made to the previously published sequence [Clarke et al.
      (1986) Eur. J. Biochem. 158, 647-653].

PMID- 1633825
TI  - Evidence that rat liver mitochondrial and cytosolic fumarases are synthesized
      from one species of mRNA by alternative translational initiation at two in-phase
      AUG codons.
AB  - Rat liver contains two isozymes of fumarase, mitochondrial and cytosolic enzymes.
      Recently, we suggested that the precursors of both isozymes might be synthesized
      by one species of mRNA [Suzuki, T., Sato, M., Yoshida, T. & Tuboi, S. (1989) J.
      Biol. Chem. 264, 2581-2586]. To examine this possibility, we have isolated and
      characterized rat genomic clones for fumarase. The isolated clones covered almost
      all of the 5' half of the fumarase gene consisting of five exons. The first exon
      contained the whole 5' non-coding region and the signal peptide of mitochondrial
      precursor. The second exon encoded 45 amino acid residues of both mature
      proteins, starting from the N-terminal alanine. By using the boundary region of
      the first intron and the second exon as an S1-nuclease-analysis probe, we
      obtained conclusive evidence that rat liver contains no other mRNA specific for
      the cytosolic isozyme of fumarase. Two transcription-initiation sites were
      identified by further S1-nuclease-mapping analysis and were shown to be located
      very close to each other, differing by only four bases in length. Therefore,
      these sites were considered to be functionally the same. The results obtained by
      hybrid-selected translation, with a DNA fragment of the 5' non-coding region as a
      hybridization probe for selecting mRNA, were consistent with the above findings.
      We found a plausible secondary structure within the 5' non-coding mRNA sequence
      that may impede initiation and so alter the efficiency of translation. We also
      discuss the mechanism regulating translational initiation.

PMID- 1633826
TI  - The serine-protease inhibitor of cartilage matrix is not a chondrocytic gene
      product.
AB  - Human articular cartilage contains significant amounts of antileukoprotease, a
      cationic low-molecular-mass serine-protease inhibitor, which was originally
      purified from mucous secretions (synonym: secretory leukocyte proteinase
      inhibitor). As it was not known whether the inhibitor molecule is also
      synthesized locally, we investigated antileukoprotease gene expression in
      chondrocytes. No antileukoprotease-specific mRNA was detected in adult or foetal
      human chondrocytes by in situ hybridization, Northern-blot analysis or polymerase
      chain reaction. Concurrently, the chondrocytes remained unstained on
      immunohistology, whereas immunoreactive antileukoprotease was demonstrated in the
      cartilage matrix. By Northern-blot analysis, the antileukoprotease message was
      detected in the promyelocytic cell line HL60, the myelomonocytic cell line U937
      and even in mature polymorphonuclear leukocytes from the peripheral blood of
      healthy donors. Immunoperoxidase staining of polymorphonuclear leukocytes for the
      antileukoprotease protein indicated that this cell is likely to be the
      physiological source of the inhibitor in serum. The results further suggest an
      accumulation of the inhibitor in the cartilage matrix.

PMID- 1633827
TI  - The structure of neutral protease from Bacillus cereus at 0.2-nm resolution.
AB  - The crystal structure of the neutral protease from Bacillus cereus has been
      refined to an R factor of 17.5% at 0.2-nm resolution. The enzyme, an
      extracellular metalloendopeptidase, consists of two domains and binds one zinc
      and four calcium ions. The structure is very similar to that of thermolysin, with
      which the enzyme shares 73% amino-acid sequence identity. The active-site cleft
      between the two domains is wider in neutral protease than in thermolysin. This
      suggests the presence of a flexible hinge region between the two domains, which
      may assist enzyme action. The high-resolution analysis allows detailed
      examination of possible causes for the difference in thermostability between
      neutral protease and thermolysin.

PMID- 1633828
TI  - X-ray absorption spectroscopy of soybean lipoxygenase-1. Influence of lipid
      hydroperoxide activation and lyophilization on the structure of the non-heme iron
      active site.
AB  - X-ray absorption spectra at the Fe K-edge of the non-heme iron site in Fe(II) as
      well as Fe(III) soybean lipoxygenase-1, in frozen solution or lyophilized, are
      presented; the latter spectra were obtained by incubation of the Fe(II) enzyme
      with its product hydroperoxide. An edge shift of about 2-3 eV to higher energy
      occurs upon oxidation of the Fe(II) enzyme to the Fe(III) species, corresponding
      to the valence change. The extended X-ray absorption fine structure shows clear
      differences in active-site structure as a result of this conversion. Curve
      fitting on the new data of the Fe(II) enzyme, using the EXCURV88 program, leads
      to a coordination sphere that is in agreement with the active-site structure
      proposed earlier (6 +/- 1 N/O ligands at 0.205-0.209 nm with a maximum variance
      of 0.009 nm, including 4 +/- 1 imidazole ligands) [Navaratnam, S., Feiters, M.
      C., Al-Hakim, M., Allen, J. C., Veldink, G. A. and Vliegenthart, J. F. G. (1988)
      Biochim. Biophys. Acta 956, 70-76], while for the Fe(III) enzyme a shortening in
      ligand distances occurs (6 +/- 1 N/O ligands at 0.200-0.203 nm with maximum
      variance of 0.008 nm) and one imidazole is replaced by an oxygen ligand of
      unknown origin. Lyophilization does not lead to any apparent differences in the
      iron coordination of either species and gives a much better signal/noise ratio,
      allowing analysis of a larger range of data.

PMID- 1633829
TI  - Biochemical analysis of the biogenesis and function of the Escherichia coli
      export factor SecY.
AB  - SecY is an integral plasma-membrane protein of Escherichia coli which is
      essential for the export of periplasmic and outer-membrane proteins containing
      cleavable signal sequences. We have synthesized SecY in vitro using an E. coli
      transcription/translation system. In the absence of membranes, SecY remained
      largely soluble but cosedimented on sucrose gradients with the membrane fraction
      when inside-out plasma-membrane vesicles (INV) had been added cotranslationally.
      Membrane association of SecY was unaffected if the endogenous SecY of the INV had
      been inactivated by either antibodies, a mutation or trypsin treatment. In
      contrast, inactivation of the INV SecY interfered with membrane targeting and,
      consequently, the processing of precursors to beta-lactamase and lambda receptor.
      When SecY-deprived INV were, however, first functionally reconstituted with in
      vitro-synthesized SecY, targeting and translocation of the lambda receptor were
      partially restored. Thus, the assembly of SecY into INV in vitro leads to an
      active enzyme. In addition, we show that the prlA4 allele of the secY gene
      suppresses signal-sequence mutations of the lambda receptor in vitro.
      Collectively, our results demonstrate that SecY, while functioning as a membrane
      located receptor for precursors of exported proteins, appears to be virtually
      independent of pre-existing SecY for its own membrane integration.

PMID- 1633830
TI  - Expression of recombinant soluble and membrane-bound catechol O-methyltransferase
      in eukaryotic cells and identification of the respective enzymes in rat brain.
AB  - The rat and human recombinant soluble and membrane-bound catechol O
      methyltransferase (S- and MB-COMT, respectively) were expressed using mammalian
      and baculovirus vectors. Low levels of rat and human S-COMT polypeptides were
      detected by immunoprecipitation in K-562 cell lines transfected with the S-COMT
      vectors. From K-562 cells transfected with the rat MB-COMT construct, both S- and
      MB-COMT recombinant proteins were detected by a rat COMT-specific anti-serum.
      Infection of lepidopteran Spodoptera frugiperda cells with recombinant S- or MB
      COMT baculovirus constructs yielded high amounts of enzymically active and
      immunoreactive S- or MB-COMT proteins, respectively. Pulse/chase experiments with
      [35S]methionine-labelled insect cells infected with the MB-COMT baculovirus
      showed that the 30-kDa recombinant human MB-COMT polypeptide was not processed
      into the 25-kDa S-COMT form. Subcellular fractionations of insect cells, followed
      by immunoblotting with COMT antiserum, showed that recombinant S-COMT was found
      only in the soluble, cytoplasmic fraction, whereas MB-COMT resided both in
      soluble and membrane fractions. The recombinant MB-COMT sedimented in Percoll
      gradients at the density of 1.042 g/ml cosedimenting with the plasma-membrane
      marker. Fractionation and immunoblotting experiments on homogenized total rat
      brains indicated that the rat S-COMT (24 kDa) and some of the rat MB-COMT (28
      kDa) was recovered in soluble fractions, whereas the microsomal material having
      COMT activity contained the MB-COMT polypeptide. The rat brain microsomal MB-COMT
      had a density of 1.042 g/ml in Percoll gradients, cosedimenting with the plasma
      membrane and rough-endoplasmic-reticulum marker enzymes. The meta/para
      methylation ratio of dihydroxybenzoic-acid substrate by different recombinant and
      rat brain COMT-containing subcellular fractions was analysed.

PMID- 1633831
TI  - Classification of dynamical diseases by new mathematical tools: application of
      multi-dimensional phase space analyses to the pulsatile secretion of parathyroid
      hormone.
AB  - The biological importance of dynamic hormonal secretion has been demonstrated.
      There is good evidence from recent studies that parathyroid hormone (PTH) which
      plays an important role in bone physiology is secreted in a pulsatile manner. In
      this study we performed a classification of two 'dynamical diseases' namely
      osteoporosis and hyperparathyroidism by the visualization of dynamic PTH
      secretion in multidimensional phase spaces.

PMID- 1633832
TI  - Verapamil increases serum ionized calcium and serum phosphate in patients with
      post-surgical hypoparathyroidism.
AB  - The calcium homeostasis in eight patients with postoperative hypoparathyroidism
      was examined before and after 2 weeks of administration of verapamil in an oral
      dose of 80 mg three times daily. Serum ionized calcium increased during verapamil
      treatment (from mean +/- SD of 1.10 +/- 0.06 to 1.24 +/- 0.38 mmol l-1; P less
      than 0.05), as well as total serum calcium corrected for protein (from 2.11 +/-
      0.13 to 2.18 +/- 0.13 mmol l-1; P less than 0.05). During treatment with
      verapamil there was an increase in serum phosphate (from 1.08 +/- 0.15 to 1.19 +/
      0.20 mmol l-1 P less than or equal to 0.05) and in the urinary excretion of
      phosphate (P/creatinine ratio from 1.22 +/- 0.69 to 1.83 +/- 0.97; P less than or
      equal to 0.05). The serum 1,25-dihydroxyvitamin-D3 and serum parathyroid hormone
      were below the detection limits both before and after verapamil treatment. There
      were no significant changes either of the intestinal absorption of calcium or of
      the urinary calcium excretion. Serum osteocalcin was insignificantly reduced
      after treatment (1.60 +/- 0.70 before treatment and 1.25 +/- 0.71 micrograms l-1
      after treatment). Thus in patients with post-surgical hypoparathyroidism
      verapamil has effects on calcium and phosphorous homeostasis. Since calcium
      absorption was not influenced by verapamil, it is suggested that verapamil
      affects bone mineral metabolism.

PMID- 1633833
TI  - Effects of cholestyramine and acipimox on subfractions of plasma low density
      lipoprotein. Studies in normolipidaemic and hypercholesterolaemic subjects.
AB  - Two independent studies were designed to investigate the separate and combined
      effects of acipimox and cholestyramine on plasma low density lipoprotein
      subfractions. In the first study, normolipidaemic subjects were given
      cholestyramine (16 g day-1, 4 weeks), followed, after an 8-week wash-out period,
      by acipimox (750mg day-1, 4 weeks). In the second study, moderately
      hypercholesterolaemic subjects were prescribed acipimox (1250mg day-1, 10 weeks),
      followed by acipimox in combination with low dose cholestyramine (12g day-1) for
      a further 10 weeks. In the normal subjects, cholestyramine decreased total LDL
      mass (density (d) = 1.019-1.063g ml-1) by selectively reducing the largest, least
      dense LDL-I (d 1.025-1.034 g ml-1, P less than 0.05) and LDL-II (d 1.034-1.044 g
      ml-1, P less than 0.005) subfractions. The small, dense LDL-III (d 1.044-1060 g
      ml-1) showed a variable response to the resin. In the same subjects acipimox
      produced no overall change in total LDL mass but showed a tendency to
      redistribute LDL towards LDL-I (+10%) and LDL-II (+10%) in a manner related to
      the changes in plasma triglyceride (TG) (TG vs. LDL-III r = 0.75, P less than
      0.05). In the hypercholesterolaemic subjects acipimox induced a substantial
      redistribution of LDL subfractions (LDL-I +84% P less than 0.05; LDL-III -50%)
      without affecting total LDL mass. The addition of cholestyramine produced a
      significant decrease in total LDL mass which was again confined to the LDL-I (
      28%) and LDL-II (-23%) subfractions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1633834
TI  - Functional and structural determinants of glomerulosclerosis in the fawn-hooded
      rat.
AB  - The effect of uninephrectomy (UN) at 4 months of age was studied on several
      parameters involved in the development of glomerulosclerosis (GS) in male
      spontaneously hypertensive Fawn-Hooded rats. Protein excretion per animal was
      significantly more increased in UN rats at 2 months after operation compared to
      sham operated controls (202 +/- 104 vs. 88 +/- 37 mg 24 h-1, P = 0.005) and
      remained significantly higher throughout the rest of the observation period. At
      11 months of age UN rats had a marked increase in the incidence of GS, 37 +/- 16%
      compared to 5 +/- 3% (P less than 0.001) in controls. No differences were
      observed in mean arterial blood pressure. Functional studies in separate groups
      of rats at 5 months of age showed an increase in single kidney glomerular
      filtration rate in UN rats (0.40 +/- 0.07 vs. 0.28 +/- 0.09 ml min-1 100 g, P =
      0.006). Single kidney renal plasma flow and filtration fraction were not altered.
      Mean glomerular volume was increased 1 month after UN (1.86 +/- 0.25 vs. 1.39 +/-
      0.25 x 10(6) microns 3, P = 0.003). Urinary noradrenaline excretion per animal
      (24-h) showed a high sympathic nervous tone in both sham and UN rats. Total
      urinary dopamine and kallikrein excretion per animal were not influenced by UN.
      These data indicate that after UN the development of GS in this rat strain is
      accelerated in association with compensatory hyperfiltration and glomerular
      volume expansion, which may play a role in the pathogenesis of GS.

PMID- 1633835
TI  - Identification of the defective NADPH-oxidase component in chronic granulomatous
      disease: a study of 57 European families.
AB  - Chronic Granulomatous Disease (CGD) manifests as a predisposition to infection as
      a result of defective function of the NADPH oxidase of phagocytic cells. Proteins
      identified as part of this system include two subunits of a cytochrome b
      (cytochrome b-245) and two cytosolic factors. The affected oxidase component was
      determined in 63 CGD patients from 57 families, by Western blotting of extracts
      of their neutrophils with antibodies to those proteins. 38 (67%) of the families
      were X-linked with a defect of the beta subunit of the cytochrome. 13 (23%)
      lacked p47-phox, 3 (5%) p67-phox, and 3 (5%) the alpha subunit of the cytochrome.

PMID- 1633836
TI  - Sustained high plasma 5-aminolaevulinic acid concentration in a volunteer: no
      porphyric symptoms.
AB  - The pathogenesis of the acute porphyric attack is not known. One hypothesis is
      that porphyrin precursors, especially 5-aminolaevulinic acid (ALA), are toxic for
      neuronal tissue. This was tested by infusing ALA in a male volunteer after a
      loading dose at a rate of 50-80 mg h-1 for 92.5 h. During the experiment plasma
      ALA concentration was 9-11 mumol 1-l and porphobilinogen concentration 3-6 mumol
      1-l which are the levels seen during acute attacks. Urinary excretion of these
      porphyrin precursors was also markedly increased. ALA infusion caused no
      subjective symptoms and no change in pulse rate, blood pressure, or autonomic
      nerve function or conduction velocity of peripheral nerves. Photosensitivity was
      not demonstrable. It is concluded that sustained high plasma ALA concentration
      does not cause porphyria-like symptoms.

PMID- 1633837
TI  - Influence of clinical findings, positional manoeuvres, and systolic ankle
      arterial pressure on transcutaneous oxygen tension in peripheral arterial
      occlusive disease.
AB  - The mutual effects of systolic ankle arterial pressures, positional manoeuvres,
      and calf artery occlusions on transcutaneous oxygen partial pressures (tcpO2)
      were studied in 388 legs of 258 patients with peripheral arterial occlusive
      disease (PAOD). The tcpO2-vs-perfusion pressure relationship could be
      satisfactorily fitted by a non-linear regression model deduced from the tcpO2
      theory. Flow-insensitive ranges of tcpO2-vs-flow hyperbolas were reduced by both
      leg lowering and moving the electrode towards proximal measuring sites. Lower
      tcpO2 values were found in case of occluded compared to patent calf arteries at
      ankle arterial pressure indices below 0.4. The tcpO2 positional variability
      increased with worsening hemodynamic compensation and was most pronounced in
      critical limb ischaemia (ischaemic rest pain, non-healing ulcerations). According
      to a retrospective analysis, a critical ischaemia could be assumed if supine and
      sitting tcpO2-values exceed neither 10 nor 45 mmHg, respectively.

PMID- 1633838
TI  - Antibodies to cathepsin G in Crohn's disease.
AB  - Antibodies directed against antigens in human neutrophils have proved to be of
      great diagnostic value in certain systemic vasculitides. Recent reports have
      focused the attention on these antigens as targets of antibodies in sera of
      patients with inflammatory bowel disease. We investigated the sera drawn from 60
      patients suffering from biopsy proven Crohn's disease and 15 patients with active
      ulcerative colitis. Using sensitive enzyme-linked immunosorbent assays with
      purified antigens and Western blotting the following antibodies could be
      demonstrated: cathepsin G (cat-G) antibodies IgG 38.3%, IgM 13.3%, IgA 23.3% and
      antibodies against human leucocyte elastase (HLE) IgG, IgA, IgM 3.3%. Low but
      significant correlations could be found for cat-G antibodies (IgG) and the van
      HEES index of activity. 73.9% of the cat-G (IgG) positive patients had colon
      involvement. In the sera of patients with ulcerative colitis no antibodies to cat
      G or HLE were detectable. Only 8.3% of the patients with Crohn's disease had
      antibodies against proteinase 3 (C-ANCA). Our data indicate that cat-G among
      other myeloid lysosomal enzymes seems to be an important target antigen of
      antibodies in sera of patients with Crohn's disease. Cat-G antibodies might be
      helpful to distinguish Crohn's disease from ulcerative colitis.

PMID- 1633839
TI  - Attempts to accelerate glucagon absorption: effects of adding a vasodilator and
      of injection using a 'sprinkler' needle.
AB  - Glucagon injected subcutaneously or intramuscularly may take up to 30 min to
      reverse hypoglycaemia. We investigated whether glucagon absorption could be
      accelerated by two manoeuvres known to enhance insulin absorption: addition of a
      powerful local hyperaemic agent (10 nmole alpha-calcitonin gene-related peptide;
      CGRP), and injection using a multihole 'sprinkler' needle. Glucagon (1 mg) given
      by conventional injection to six normal subjects produced peak plasma glucagon
      concentrations of 1.48 +/- 0.23 (SEM) ng ml-1 after 20 min and a peak glycaemic
      response of 7.8 +/- 0.8 mmol l-1 at 25 min. Glucagon injected with CGRP or using
      the sprinkler needle did not produce any significant differences in plasma
      glucagon or glycaemia profiles, compared with conventional injection. Further
      studies demonstrated that glucagon is itself a powerful vasodilator, causing a
      300-500% increase in local blood flow, comparable to that induced by CGRP.
      Because of its intense local hyperaemic action, the absorption of subcutaneously
      injected glucagon may be optimal and seems unlikely to be accelerated by
      pharmacological or other means.

PMID- 1633840
TI  - Order and disorder in 30 nm chromatin fibers.
AB  - The tendency of DNA to form fibers upon condensation with counterions is
      reviewed. It is shown that chromatin fibers may acquire a relatively constant
      diameter of about 30 nm simply as an optimal size achieved upon neutralization of
      DNA, without requiring a repetitive internal structure. Thus the size of
      chromatin fibers would not be determined by any specific spatial interaction
      between DNA and histones. The driving force for the formation of fibers in
      chromatin would be similar to that found in proteins when they acquire a compact
      globular shape.

PMID- 1633841
TI  - Different sequence environments of cysteines and half cystines in proteins.
      Application to predict disulfide forming residues.
AB  - Protein sequences are often derived by translating genetic information, rather
      than by classical protein sequencing. At the DNA level cysteines and half
      cystines are indistinguishable. Here we show that the sequential environments of
      'free' cysteine and half cystine are different. A possible origin of this
      difference is discussed and a simple method to predict cysteines and half
      cystines from the amino acid sequence is also presented.

PMID- 1633842
TI  - Isolation and characterization of the MHC linked beta-type proteasome subunit
      MC13 cDNA.
AB  - We have cloned and analysed the second mouse MHC-linked proteasome subunit,
      designated MC13, which appears to be homologous to the human RING10 proteasome
      protein. The isolated cDNA has an ORF encoding a protein of 276 amino acids with
      a molecular weight of ca. 30 kDa. Sequence alignment reveals that the subunit
      MC13 and several other mammalian proteasome subunits are encoded by a second
      proteasome gene family. This second gene family encodes subunits of the beta
      type, reveals striking sequence similarities with the beta-subunit of
      archaebacterial proteasomes and is related to, but distinct from, the genes
      encoding the so-called alpha-type subunits.

PMID- 1633843
TI  - Evidence that dopachrome tautomerase is a ferrous iron-binding glycoprotein.
AB  - Dopachrome tautomerase (DT) (EC 5.3.2.3) is a melanocyte-specific, membrane
      associated, heat-labile, non-dialyzable, protease-sensitive factor which
      catalyzes the isomeric rearrangement of dopachrome to 5,6-dihydroxyindole-2
      carboxylic acid (DHICA), apparently through a tautomerization reaction. Metal
      ions such as Cu, Ni, Co, Zn, Mn, Ca, Al, and Fe can also catalyze the
      dopachrome/DHICA isomerization. How is the reaction regulated in vivo? An
      attractive possibility would be that DT is a metalloenzyme. Here we present
      evidence that this may indeed be the case. Purified preparations of DT and
      tyrosinase, obtained from Cloudman S91 mouse melanoma cells, were assayed in the
      presence of a variety of metal chelators including EDTA (predominantly Ca and
      Mg), EGTA (predominantly Ca), phenylthiourea (PTU) (predominantly Cu), 2,2'
      dipyridyl (predominantly Fe); 1,10-phenanthroline (predominantly Fe), and 2,3
      dihydroxybenzoic acid (predominantly Fe). In addition, DT activity was assayed in
      the presence of two non-chelating structural analogs of 1,10-phenanthroline.
      Results were as follows: (i) iron chelators inhibited DT activity with no effects
      on tyrosinase activity; (ii) inhibition by the chelators was reversible with the
      addition of ferrous iron; (iii) 1,10-phenanthroline pre-complexed to ferrous iron
      was not inhibitory to DT; (iv) non-chelating analogs of phenanthroline were not
      inhibitory to DT; (v) PTU was inhibitory to tyrosinase but not DT; (vi) Ca2+ and
      Mg2+ chelators had little effect on either enzyme activity. Finally, studies with
      glycosylation inhibitors, glycosylase enzymes, and immobilized lectins, indicated
      that DT is a glycoprotein. The results suggest that DT is a metal-containing
      glycosylated enzyme, possibly with ferrous iron at its catalytic center.

PMID- 1633844
TI  - The oligosaccharides in a recombinant hepatitis B virus surface antigen (HBsAg)
      carrying the pre-S2 region derived from yeast.
AB  - The N- and O-linked oligosaccharides in a yeast-derived HBsAg M protein (pre-S2 +
      S) were analyzed. Two major structures of the N-linked oligosaccharides bound to
      residue Asn4 were determined to be high-mannose type oligosaccharides,
      Man7GlcNAc2 and Man8GlcNAc2, by two-dimensional sugar mapping of the
      corresponding pyridylamino oligosaccharides. Peptide mapping of the M protein,
      sequence analysis of the glycopeptides after beta-elimination under reducing
      conditions and sugar-composition analysis revealed that the O-linked
      oligosaccharides were composed solely of mannose and bound to residue Ser5, Thr6,
      Thr7, Ser27, Ser28, Ser29 and Thr31 in the pre-S2 region.

PMID- 1633845
TI  - Effective detergent/lipid ratios in the solubilization of phosphatidylcholine
      vesicles by Triton X-100.
AB  - Effective detergent:lipid ratios (i.e. molar ratios in the mixed aggregates,
      vesicles or micelles) have been estimated for the solubilization of
      phosphatidylcholine vesicles by Triton X-100. Effective molar ratios are given
      for both the onset and the completion of bilayer solubilization; small
      unilamellar, large unilamellar and multilamellar vesicles have been used.
      Effective detergent:lipid ratios are independent of phospholipid concentration,
      and their use allows a deeper understanding of membrane-surfactant interactions.

PMID- 1633846
TI  - Identification and characterization of two dermorphins from skin extracts of the
      Amazonian frog Phyllomedusa bicolor.
AB  - Skin extracts of South American hylid frogs of the subfamily Phyllomedusinae
      contain dermorphins and deltorphins, opioid heptapeptides highly selective for
      either mu or delta receptors. In all these peptides, a D-amino acid is present in
      the second position. The structure of the precursors for Ala-deltorphins was
      recently deduced from cloned cDNAs derived from skin of Phyllomedusa bicolor
      (Richter et al. (1990) Proc. Natl. Acad. Sci. USA 87, 4836-4839). From the amino
      acid sequence of these precursors, the existence of three peptides related to
      dermorphin could be predicted. From methanol extracts of skin of Ph. bicolor we
      have isolated two of these peptides, [Lys7]dermorphin-OH and
      [Trp4,Asn7]dermorphin-OH. The biological activity of these new dermorphins and
      their amidated counterparts is presented.

PMID- 1633847
TI  - Oligo(2'-O-methyl)ribonucleotides. Effective probes for duplex DNA.
AB  - To find novel probes for duplex DNA, we prepared four types of triplexes
      containing a homopurine-homopyrimidine 15-mer duplex DNA, and examined their
      thermal stabilities (Tm values). The single strand used for triplex formation
      were a DNA 15-mer having a defined C-T mixed sequence, and its sugar-modified
      analogs, namely 2'-fluoro DNA, RNA, and 2'-O-methyl RNA. The 2'-O-methyl RNA and
      the RNA-containing triplexes were similar in their enhanced stabilities at pH 6.1
      and, amongst the four triplexes, the 2'-O-methyl was the most stable at pH 5.0.
      Furthermore, an experiment using a 34-mer duplex DNA suggested that the 2'-O
      methyl RNA-triplex was destabilized, mostly as a result of the incorporation of a
      mismatched triplet, as compared to the DNA triplex counterpart. Thus, 2'-O-methyl
      RNA can serve as an effective probe for duplex DNA.

PMID- 1633848
TI  - Primary structure of three minor isoforms of amphioxus sarcoplasmic calcium
      binding proteins.
AB  - Previously we reported the amino acid sequences of 4 well-defined sacroplasmic,
      high-affinity Ca(2+)-binding proteins in the protochordate amphioxus,
      Branchiostoma lanceolatum [1]. Here we report on the complete amino acid sequence
      determination of 3 additional minor isoforms. The seven isoforms differ from each
      other in 9 positions of a contiguous 17-residue-long segment (positions 20-36)
      and can be classified in a alpha (ASCP I, III and IV) and a beta lineage (ASCP
      II, V, VI and VII).

PMID- 1633849
TI  - Functional expression of a plant plasma membrane transporter in Xenopus oocytes.
AB  - A full-length cDNA clone for the H+/hexose co-transporter (STP1) from Arabidopsis
      thaliana has been transcribed in vitro and the mRNA injected into Xenopus
      oocytes. Under optimized conditions, oocytes injected with the STP1 mRNA
      accumulated 3-O-[methyl-14C]glucose at rates of more than a 1000-fold greater
      than water-injected control oocytes. A hexose-elicited depolarization of the
      oocyte membrane potential was demonstrated, and uptake was shown to be stimulated
      by low external pH, confirming the activity of a H+/hexose co-transport system.
      This is the first example of the functional expression of a plant membrane
      transporter in oocytes.

PMID- 1633850
TI  - Protein deamidase from germinating wheat grains.
AB  - A new enzyme catalyzing the deamidation of seed storage proteins was found in
      germinating wheat grains and was partially purified. It also acts on egg
      lysozyme, horse hemoglobin and reduced RNAse, glutamine and Gly-L-Gln-L-Tyr. No
      activity was observed when using ovalbumin, serum albumin, RNAse, insulin,
      asparagine and an asparagine-containing peptide. Only glutaminyl residues appear
      to be deamidated by this enzyme. It differs from transglutaminase and proved to
      be a true protein deamidase.

PMID- 1633851
TI  - Fluorescence study of the nucleic acid binding site of vimentin.
AB  - A selective tyrosine fluorescence quenching is found on interaction of vimentin
      with poly(dT) and poly(rA). However, addition of poly(dA) does not result in
      tyrosine quenching. The number of nucleotides covered by vimentin upon binding
      (n) of poly(dT) (50 +/- 4) appeared to be approximately the same as for poly(rA)
      (44 +/- 4), while the apparent binding constant (K(app)) of the latter is
      slightly larger (5.0 +/- 2.0 x 10(7) M-1.cm-1 vs. 2.5 +/- 0.5 x 10(7) M-1.cm-1).
      The finding that there exists a specific strong interaction between vimentin and
      nucleic acids could help in the search for cellular functions of intermediate
      filament proteins.

PMID- 1633852
TI  - The application of 1H NMR chemical shift calculations to diastereotopic groups in
      proteins.
AB  - We have calculated chemical shifts for a range of diastereotopic protons in
      proteins (i.e. methylene protons, and the methyl groups of valine and leucine
      residues), using a recently optimised method for chemical shift calculation. The
      calculations are based on crystal structure coordinates, and have been compared
      with experimental stereospecific assignments. The results indicate that chemical
      shifts can be used to suggest stereospecific assignments with about 80%
      probability of being correct, in cases where both the experimental and the
      calculated chemical shift differences between a pair of diastereotopic protons
      are greater than 0.3 ppm. Inaccurate calculations are shown to be caused in most
      cases by differences between crystal and solution structures. Furthermore,
      chemical shift calculations based on NMR structures are shown to be capable of
      acting as a further constraint on structure, by limiting the range of side-chain
      conformations adopted in structures calculated from NMR data.

PMID- 1633853
TI  - Intranuclear topological distribution of HIV-1 trans-activators.
AB  - Subcellular localization of human immunodeficiency virus type I (HIV-1) Tat and
      Rev was examined using a confocal laser scanning microscope (CLSM). In
      transfected COS-7 cells, Tat resided exclusively in the perinocleolar region,
      while Rev infiltrated fully into the nucleoli. The chimeric Tat in which the
      nucleolar targeting signal was replaced by that of Rev, which retains trans
      acting activity of Tat, remained still in the perinucleolar region as wild-type
      Tat. Perinucleolar distribution of Tat protein suggests the existence of a novel
      nucleolar architecture that affects transcription.

PMID- 1633854
TI  - Thermoregulatory, carboxyatractylate-sensitive uncoupling in heart and skeletal
      muscle mitochondria of the ground squirrel correlates with the level of free
      fatty acids.
AB  - Thermoregulatory uncoupling of oxidative phosphorylation has been studied in
      heart and skeletal muscle mitochondria of ground squirrels. The respiratory rate
      of mitochondria in the presence of oligomycin was found to be much higher in
      winter (in hibernating, arousing, or aroused animals) than in summer. This
      additional respiration is strongly (arousing animals) or completely (hibernating
      and aroused animals) inhibited by carboxyatractylate (CAtr) and bovine serum
      albumin (BSA). The CAtr- and BSA-induced decreases in the rate of respiration are
      accompanied by membrane potential increases. The rate of the CAtr- and BSA
      sensitive respiration is proportional to the content of free fatty acids which,
      in the heart, decreases in the order: arousing greater than aroused = hibernating
      greater than summer animals. Maximal respiratory rates observed in the presence
      of dinitrophenol (arousing greater than aroused greater than summer greater than
      hibernating animals) do not parallel the fatty acid level. It is assumed that
      some heat production in the winter animals is due to fatty acid-induced, ATP/ADP
      antiporter-mediated uncoupling in heart and skeletal muscle mitochondria. The
      peak of heat production during arousal after hibernation also includes some other
      stimulatory effect on mitochondrial respiration.

PMID- 1633855
TI  - Identification of the polypeptides of the major light-harvesting complex of
      photosystem II (LHCII) with their genes in tomato.
AB  - Using an improved SDS-PAGE system, the polypeptides of the major chlorophyll a/b
      light-harvesting complex of PSII (LHCII) from tomato leaves were resolved into
      five polypeptide bands. All the polypeptides were matched with the genes encoding
      them by comparing amino acid sequences of tryptic peptides with gene sequences.
      The two major LHCII bands (usually comigrating as a '27 kDa' polypeptide) were
      encoded by cab1 and cab3 (Type I LHCII) genes. A third strong band of about 25
      kDa was encoded by cab4 (Type II) genes. Polypeptides from two minor bands of 23
      24 kDa were not N-terminally blocked; their N-terminal sequences showed they were
      Type III LHCII proteins. One complete cDNA clone and several incomplete clones
      for Type III polypeptides were sequenced. Combined with the peptide sequences,
      the results indicate that there are at least four different Type III genes in
      tomato, encoding four almost identical polypeptides. Thus, all the LHCII CAB
      polypeptides have been identified, and each type of LHCII polypeptide is encoded
      by distinct gene or genes in tomato.

PMID- 1633856
TI  - Primary structure and functional expression of a choline transporter expressed in
      the rat nervous system.
AB  - Synthesis of the neurotransmitter acetylcholine in cholinergic nerve terminals is
      regulated by a sodium-driven high-affinity choline uptake system in the plasma
      membrane. We have isolated cDNAs from rat spinal cord and brainstem which encode
      a choline transporter (CHOT1). The predicted protein shares considerable amino
      acid identity and several structural features including twelve putative
      transmembrane regions with other neurotransmitter transporters. Expression of in
      vitro transcribed CHOT1 RNA in Xenopus oocytes generated Na(+)-dependent choline
      uptake, which was not seen in control oocytes. Amplification by polymerase chain
      reaction (PCR) revealed significant amounts of CHOT1 mRNA in brain, cerebellum,
      spinal cord and, to a lesser extent, heart, but only very low expression in lung,
      kidney and muscle.

PMID- 1633857
TI  - Caf1R gene and its role in the regulation of capsule formation of Y. pestis.
AB  - A new transcription unit of the f1 gene cluster was found. The DNA sequencing
      revealed one long open reading frame. Deletion and frame shift mutation analyses
      have demonstrated the importance of a corresponding gene product for the F1
      antigen biosynthesis. A homology of the deduced amino acid sequence with that of
      AraC family DNA-binding regulators was shown. A potential regulatory DNA region
      is discussed.

PMID- 1633858
TI  - Structure and expression of Xenopus prohormone convertase PC2.
AB  - The multifunctional prohormone, proopiomelanocortin (POMC), is processed in the
      melanotrope cells of the pituitary pars intermedia at pairs of basic amino acid
      residues to give a number of peptides, including alpha-melanophore-stimulating
      hormone (alpha-MSH). This hormone causes skin darkening in amphibians during
      background adaptation. Here we report the complete structure of Xenopus laevis
      prohormone convertase PC2, the enzyme thought to be responsible for processing of
      POMC to alpha-MSH. A comparative structural analysis revealed an overall amino
      acid sequence identity of 85-87% between Xenopus PC2 and its mammalian
      counterparts, with the lowest degree of identity in the signal peptide sequence
      (28-36%) and the region amino-terminal to the catalytic domain (59-60%). The
      occurrence of a second, structurally different PC2 protein reflects the
      expression of two Xenopus PC2 genes. The expression pattern of PC2 in the Xenopus
      pituitary gland of black- and white-adapted animals was found to be similar to
      that of POMC, namely high expression in active melanotrope cells of black
      animals. This observation is in line with a physiological role for PC2 in
      processing POMC to alpha-MSH.

PMID- 1633859
TI  - A molecular model for the tumour-associated antigen, p97, suggests a Zn-binding
      function.
AB  - The primary structure of p97 (melanotransferrin) has been compared with other
      members of the transferrin superfamily. A molecular structure of p97 has been
      modelled based on the crystal structure of diferric rabbit serum transferrin. The
      most significant amino acid substitutions in p97 are almost exclusively limited
      to only two regions; the C-lobe iron-binding cleft and the interlobe contact
      region. The latter includes within the N-terminal lobe a Zn-binding consensus
      sequence found in metallopeptidases, and in the C-terminal lobe a glutamic acid
      residue (Glu-394) capable of completing a potential thermolysin-like Zn-binding
      site. Thus, p97 may have a Zn-binding potential, unique amongst the transferrin
      superfamily.

PMID- 1633860
TI  - Time-resolved fluorometry of purple membrane of Halobacterium halobium. O640 and
      an O-like red-shifted intermediate Q.
AB  - The photocycle of the light-adapted purple membrane was studied with a time
      resolved fluorometry apparatus: fluorescence of the sample suspension (greater
      than 660 nm) was pumped with a 633-nm cw laser and the temporal change induced by
      a 532-nm pulsed laser was measured with a photon-counting-type transient
      recorder. The formation and the decay of the O640 intermediate were clearly
      observed in the pH region between 4.0 and 11.4. A photochemical cycle of N560 was
      apparently driven in alkaline suspension (pH greater than 9.3). An O-like
      fluorescent intermediate Q appears and decays with time constants of less than
      0.1 ms and 1.7 +/- 0.2 ms, respectively.

PMID- 1633861
TI  - The polyoxyethylene/polyoxypropylene block co-polymer poloxamer-407 selectively
      redirects intravenously injected microspheres to sinusoidal endothelial cells of
      rabbit bone marrow.
AB  - Small colloidal particulates (150 nm and below, in diameter) can be redirected
      specifically to the rabbit bone marrow following intravenous administration by
      coating their surface with the block co-polymer poloxamer-407, a non-ionic
      surfactant. The coated colloids are sequestered by the sinusoidal endothelial
      cells of the bone marrow and are accumulated in dense bodies within these cells.
      The uptake of poloxamer-407-coated colloids by marrow endothelial cells suggests
      that the steric repulsive barrier, imposed by the polyoxyethylene segment of the
      polymer, to particle-cell interaction can apparently be overcome by a specific
      interaction mechanism(s) with the cell surface. Such a dramatic uptake cannot be
      achieved with other block co-polymers of similar structure to poloxamer-407. The
      application of the current model for the site-specific targeting of drug carriers
      to bone marrow and the prevention of the adherence of metastases of tumours which
      selectively colonize the bone marrow endothelium is discussed.

PMID- 1633862
TI  - Transcripts of the viroid central conserved region contain the local tertiary
      structural element found in full-length viroid.
AB  - The viroid central conserved region (CCR) is highly conserved among different
      viroids and is thought to be involved in viroid replication. A novel tertiary
      structure occurs in the CCR of native circular potato spindle tuber RNAs. To
      permit more detailed studies of this structural element, a small RNA
      oligonucleotide containing the CCR of the viroid genome was synthesized. The
      tertiary structure of these CCR transcripts was examined by UV-crosslinking of
      the RNA, followed by mapping of the crosslink using limited alkaline digestion
      and classical RNA secondary analysis. The CCR transcript was found to undergo UV
      crosslinking between the same two bases as in full-length viroid, indicating that
      the tertiary structure is the same and that the CCR transcript will be useful for
      the affinity purification of host components.

PMID- 1633863
TI  - A functional tomato ACC synthase expressed in Escherichia coli demonstrates
      suicidal inactivation by its substrate S-adenosylmethionine.
AB  - 1-Aminocyclopropane-1-carboxylate (ACC) synthase is a key enzyme in the
      biosynthesis of the plant hormone, ethylene. We have isolated, sequenced and
      expressed a functional tomato (cv Pik-Red) ACC synthase gene in Escherichia coli.
      ACC synthase expressed in E. coli was inactivated by incubation with S
      adenosylmethionine (SAM), the half-time of which was concentration dependent.
      Mixing the tomato fruit protein extract with the cell-free extract from
      transformed E. coli did not affect SAM-dependent inactivation of ACC synthase
      activity. Thus, single isoforms of the ACC synthase enzyme, which demonstrate the
      biochemical features expected of the tomato fruit enzyme, can be expressed in E.
      coli and their structure-function relationships investigated.

PMID- 1633864
TI  - A rapid-kinetic study of the class C beta-lactamase of Enterobacter cloacae 908R.
AB  - The individual rate constants for acylation and deacylation (k2 and k3,
      respectively) of the class C beta-lactamase of Enterobacter cloacae 908R by
      ampicillin and carbenicillin have been determined. For several other beta
      lactams, the value of k2 was too high to be determined and the k2/k3 ratio could
      be larger than 10,000. Branched pathways were also shown to occur with several
      penicillins and cephalosporins.

PMID- 1633865
TI  - Crystal structure of Pseudomonas aeruginosa apo-azurin at 1.85 A resolution.
AB  - The 3D structure of apo-azurin from Pseudomonas aeruginosa has been determined at
      1.85 A resolution. The crystal structure is composed of two different molecular
      forms of apo-azurin arranged as hetero-dimers in the tetramer of the asymmetric
      unit. Form 1 closely resembles the holo-protein lacking copper. Form 2 shows
      differences in the metal binding site region induced by the incorporation of a
      solvent molecule into this site. The positions of the copper ligands His46 and
      His117 are shifted by 0.6 A and 1.6 A. The His117 side chain adopts a position at
      the surface of the protein, thereby facilitating access to the copper site. The
      presence of two different molecular forms of apo-azurin in the crystal lattice
      may reflect an equilibrium between the two forms in solution. 1H-NMR spectra of
      apo-azurin recorded as a function of pH show that at high pH the line broadening
      of His35, His46 and His117 resonances is consistent with an interconversion
      between forms 1 and 2. At low pH, no broadening is observed. This may indicate
      that here the interconversion is fast on the NMR timescale.

PMID- 1633867
TI  - On the functional role of the Tyr-639 residue of bacteriophage T7 RNA polymerase.
AB  - Substitution of Asp for a Tyr residue normally present at position 639 of the
      bacteriophage T7 RNA polymerase leads to a drastic drop in the enzymatic
      activity. This mutation does not affect the enzyme-promoter interaction but
      decreases the ability of the RNA polymerase to discriminate between GTP and ATP
      molecules, resulting in a decrease in the rate of the incorporation of the
      nucleotide into the RNA chain.

PMID- 1633866
TI  - Photogeneration of NADH under coupled action of CdS semiconductor and hydrogenase
      from Alcaligenes eutrophus without exogenous mediators.
AB  - Photoreduction of NAD has been accomplished by a system consisting of the NAD
      dependent hydrogenase from Alcaligenes eutrophus immobilized on CdS particles
      with formate as artificial electron donor. Enzymatically active NADH is formed
      under illumination of this system by visible light. Accumulation of the coenzyme
      dimer (NAD)2 was not detected. NAD photoreduction is supposed to proceed via the
      direct electron transfer from the semiconductor to the enzyme electron transport
      chain. However, NADH formation as a result of hydrogenase interaction with anion
      radicals (CO2.-) formed in the course of formate photooxidation cannot at present
      be excluded.

PMID- 1633868
TI  - Evidence for the tetraplex structure of the d(GT)n repetitive sequences in
      solution.
AB  - The ability of oligonucleotides 3'-d(GT)5pO(CH2)6Opd(GT)5-5' (anti[d(GT)]) and 3'
      d(GT)5pO(CH2)6Opd(GT)5-3' (par[par[d(GT)]) to form tertiary structures has been
      studied. Circular dichroism (CD) as well as the fluorescence of the ethidium
      bromide (EtBr) complexes with oligonucleotides and hydrodynamic volume
      measurements in solutions containing 0.01 M phosphate buffer, pH 7 and NaCl in
      concentrations from 0.1 M to 1 M, have been used. The data obtained in the
      temperature interval from 3 degrees C to 10 degrees C are in good agreement with
      the structure suggested earlier where the par[d(GT)] and anti[d(GT)] form
      structures with four parallel strands in which layers of four G-residues
      alternate with unpaired bulged-out T-residues. Ethidium bromide interacts with
      the structure in a cooperative manner. Two ethidium bromide molecules intercalate
      between two layers of four G-residues.

PMID- 1633869
TI  - Transmembrane electron transport in ascorbate-loaded plasma membrane vesicles
      from higher plants involves a b-type cytochrome.
AB  - The possible involvement of a high-potential b-type cytochrome in plasma membrane
      electron transport was tested using ascorbate-loaded membrane vesicles.
      Absorption spectra demonstrated that the cytochrome was about 89% reduced in
      these preparations. Use of ascorbate oxidase and washing of the vesicles further
      indicated that reduction was mediated by intra-vesicular ascorbate. Addition of
      low concentrations of ferricyanide caused a rapid cytochrome oxidation followed
      by a slower re-reduction. The kinetics of this response indicate that the
      electron acceptor was fully reduced before re-reduction of the cytochrome
      occurred. These observations suggest that the b-type cytochrome mediates
      transmembrane electron transfer.

PMID- 1633870
TI  - Generation of Gla-domainless FVIIa by cathepsin G-mediated cleavage.
AB  - Coagulation factor VII contains ten gamma-carboxyglutamic acid residues in the N
      terminal region (Gla-domain) which are essential for the hemostatic function of
      FVII. The present study shows that granulocyte cathepsin G degrades the Gla
      domain of FVIIa in vitro. Characterization of the truncated FVIIa by SDS-PAGE and
      N-terminal amino acid sequence analysis revealed that cleavage had occurred
      between Tyr-44 and Ser-45 and that further cleavage was only obtained on
      extensive cathepsin G exposure. Cleavage of vitamin K-dependent coagulation
      factors by cathepsin G may play a role in vivo, and it offers a convenient way of
      obtaining proteins deprived of their Gla-domain for functional and structural
      studies.

PMID- 1633871
TI  - Induction of thromboxane synthase and prostaglandin endoperoxide synthase mRNAs
      in human erythroleukemia cells by phorbol ester.
AB  - The effects of 12-O-tetradecanoyl-phorbol-13-acetate (TPA) on the mRNA levels of
      two enzymes, thromboxane synthase (TXS) and prostaglandin endoperoxide synthase
      (PES), responsible for the synthesis of thromboxane A2 from arachidonic acid,
      were studied in human erythroleukemia (HEL) cells by RNA blot analysis. TPA
      induced both TXS and PES mRNAs in HEL cells in a dose-dependent manner at 36 h.
      The half-maximal and maximal effects for the induction of both mRNAs were at
      approximately 3 x 10(-9) M and at 10(-8) M, respectively. TXS and PES mRNA levels
      increased in a time-dependent fashion by TPA, and reached to 7- and 3.5-fold of
      the control, respectively after 48 h of TPA treatment. These results suggest that
      expression of TXS and PES genes in HEL cells were simultaneously stimulated by
      TPA.

PMID- 1633872
TI  - Expression of c-fos, c-jun, jun-B, metallothionein and metalloproteinase genes in
      human chondrocyte.
AB  - Normal and osteoarthritic (OA) human articular cartilage chondrocytes, released
      enzymatically in the presence of 0.5% fetal calf serum, display constitutive
      expression of early response activating protein (AP-1) genes; c-fos, c-jun and
      jun-B. Among the late AP-1 responsive genes, total metallothionein (MT) and
      stromelysin mRNAs were expressed at high levels in both normal and OA
      chondrocytes, while collagenase and hMT-IIA mRNA levels were elevated only in OA
      individuals. Despite the common AP-1 sequences present in their promoter regions,
      the three late genes were differentially expressed.

PMID- 1633873
TI  - Ca2+/calmodulin is involved in growth factor-induced retinoblastoma gene product
      phosphorylation in human vascular endothelial cells.
AB  - In human vascular endothelial cells, both growth factor-induced DNA synthesis and
      retinoblastoma gene product (RB) phosphorylation are absolutely dependent on
      extracellular Ca2+, and are potently inhibited by an active calmodulin
      antagonist, W-7, but not an inactive analogue, W-12. A reduction in the
      extracellular Ca2+ or an addition of W-7 as late as 8 h after growth factor
      stimulation still inhibits both RB phosphorylation and DNA synthesis to the full
      extent. However, once RB phosphorylation occurs 12-16 h after addition of the
      growth factors, it is not reversed by subsequent Ca2+ reduction or W-7. These
      results suggest the existence of a Ca2+/calmodulin-dependent process relatively
      late in the mitogenic signalling cascade, at a step proximal to RB
      phosphorylation reaction itself.

PMID- 1633874
TI  - Molecular cloning of a novel ras-like protein from chicken.
AB  - We have isolated a cDNA clone from a chicken DNA expression library which codes
      for a ras-like polypeptide of 216 amino acid residues. This polypeptide is
      closely related to the human protein TC4 and to the yeast protein Spil, two novel
      proteins that may be involved in the coordination of the cell cycle. In the amino
      terminal region, the three polypeptides possess a P-loop motif characteristic of
      GTP-binding proteins. At the carboxy-terminal end, however, they lack the typical
      CAAX-box which is usually responsible for membrane anchorage of ras-like
      proteins. It is therefore likely that the three polypeptides define a new
      subclass of GTP-binding proteins within the ras-like superfamily.

PMID- 1633875
TI  - Crystal and molecular structure of RNase Rh, a new class of microbial
      ribonuclease from Rhizopus niveus.
AB  - The crystal structure of RNase Rh, a new class of microbial ribonuclease from
      Rhizopus niveus, has been determined at 2.5 A resolution by the multiple
      isomorphous replacement method. The crystal structure was refined by simulated
      annealing with molecular dynamics. The current crystallographic R-factor is 0.200
      in the 10-2.5 A resolution range. The molecular structure which is completely
      different from the known structures of RNase A and RNase T1 consists of six alpha
      helices and seven beta-strands, belonging to the alpha+beta type structure. Two
      histidine and one glutamic acid residues which were predicted as the most
      probably functional residues by chemical modification studies are found to be
      clustered. The steric nature of the active site taken together with the relevant
      site-directed mutagenesis experiments (Irie et al.) indicates that: (i) the two
      histidine residues are the general acid and base; and (ii) an aspartic acid
      residue plays a role of recognizing adenine moiety of the substrate.

PMID- 1633876
TI  - Age and sex influence expression of plasmid DNA directly injected into mouse
      skeletal muscle.
AB  - Direct injection of plasmid DNA into the skeletal muscle has been proposed as a
      means of effecting somatic gene therapy. We examined the influence of age and sex
      on the level of expression of an SV40-CAT construct injected into mouse muscle.
      Age markedly affected expression, with peak values in the 4-6 week age class
      which were significantly higher than in animals older than 10 weeks. Sex also
      altered expression, with higher levels of CAT activity seen in males compared to
      females. We conclude that the rate of growth is important in determining levels
      of expression of directly injected DNA.

PMID- 1633877
TI  - Identification of a novel transthyretin variant (Val30----Leu) associated with
      familial amyloidotic polyneuropathy.
AB  - A novel variant transthyretin which contains a leucine-for-valine substitution at
      position 30 was isolated and identified in the serum of a patient with familial
      amyloidotic polyneuropathy (FAP). The amino acid substitution was proven to
      result from a guanine-to-cytosine change at the first base of codon 30 located in
      exon 2 in the mutated transthyretin gene by restriction fragment length analysis
      on the amplified transthyretin gene using Cfr13 I. The study indicates that the
      point mutation of the transthyretin gene is a cause of the disorder.

PMID- 1633878
TI  - Independence of the carotene and sterol pathways of Phycomyces.
AB  - Light, chemicals, and mutations that affect the carotene content of the fungus
      Phycomyces blakesleeanus had practically no effect on the ergosterol content.
      Lovastatin, a specific inhibitor of hydroxymethylglutaryl coenzyme A reductase,
      blocked growth at 1 microM; sodium DL-mevalonate (10 mM) fully reversed this
      inhibition. In the presence of [14C]mevalonate, a carS mutant accumulated 16
      times more beta-carotene than the wild-type with a specific radioactivity five
      times lower. The specific radioactivity of ergosterol was different from that of
      beta-carotene, even when calculated in terms of the constituent isoprene units,
      and unaffected by the carS mutation. The carotene and sterol pathways of
      Phycomyces are independently regulated and physically separated in different
      subcellular compartments.

PMID- 1633879
TI  - Loss of transcriptional repression contributes to the ectopic expression of the
      calcitonin/alpha-CGRP gene in a human lung carcinoma cell line.
AB  - The calcitonin/alpha-CGRP (CT/CGRP) gene is ectopically expressed in a wide
      variety of neoplasia. We have investigated the molecular mechanisms responsible
      for this ectopic expression in the human cell line BEN, which is derived from a
      poorly differentiated squamous cell lung carcinoma. We show that a trans-acting
      factor which represses expression of the CT/CGRP gene in HeLa cells is absent or
      inactive in BEN cells, and have localised the repressor binding site to a 53 bp
      fragment 1500 bp upstream of the transcription start site.

PMID- 1633880
TI  - Di-myo-inositol-1,1'-phosphate: a new inositol phosphate isolated from Pyrococcus
      woesei.
AB  - A new inositol derivative could be isolated from the Archaeum Pyrococcus woesei
      and identified as di-myo-inositol-1,1'-phosphate by 1H, 31P NMR spectroscopy,
      mass spectrometry and thin layer chromatography. In P. woesei, this inositol
      phosphate represents the dominant counterion of K+ which ranges from 500 to 600
      mM. The role of the potassium salt of di-myo-inositol-1,1'-phosphate as
      thermostabilizer is discussed.

PMID- 1633881
TI  - Stabilization of basic fibroblast growth factor with dextran sulfate.
AB  - Dextran sulfate protected bFGF from heat and acid inactivation and from
      proteolytic degradation. The protective effect was stronger than that of heparin
      which is known as a stabilizer of bFGF. Dextran sulfate and bFGF formed a high
      molecular weight complex via ionic interaction when mixed together in aqueous
      solution. The complex was dissociated when the ionic strength was increased and
      the protective effect was completely abolished. Successive digestion of bFGF with
      Staphylococcus aureus V8 protease and pepsin followed by affinity chromatography
      on an immobilized dextran sulfate column and reversed-phase high performance
      liquid chromatography yielded three positively charged fragment peptides, Tyr24
      Phe30, Tyr106-Trp114 and Tyr124-Leu138. These results suggest that dextran
      sulfate stabilizes bFGF by binding close to the putative heparin binding sites of
      the bFGF molecule.

PMID- 1633882
TI  - Fast and slow kinetics of porin channels from Escherichia coli reconstituted into
      giant liposomes and studied by patch-clamp.
AB  - E. coli porins (OmpF and OmpC) were purified and reconstituted into liposomes
      which were enlarged to giant proteoliposomes by dehydration-rehydration and
      studied by patch-clamp. The porins could be closed by voltage pulses under -100
      mV. The kinetics of closure was slow, with closure events of about 200 pS in 0.1
      M KCl. Rapid fluctuations (in the millisecond range) of about one third (60-70
      pS) of the large closure steps were also observed. The data are interpreted as
      follows: an increase in membrane potential favours the cooperation transition of
      multimers towards an inactivated state, while monomers which have not been
      inactivated can flicker rapidly between an open and a short-lived closed state.

PMID- 1633883
TI  - Construction and functional analysis of hybrid interleukin-6 variants.
      Characterization of the role of the C-terminus for species specificity.
AB  - We have constructed several hybrid human interleukin-6 (IL-6) variants in which
      the carboxyl-terminus, which includes a receptor binding site of IL-6 has been
      replaced with the C-terminus of various proteins homologous to human IL-6. IL-6
      hybrids with the C-terminus of human growth hormone and human granulocyte-colony
      stimulating factor maintain part of the biological activity of human IL-6.
      Replacing the C-terminus of human IL-6 with the C-terminus of mouse and rat IL-6
      resulted in a normal or increased activity on a mouse cell line; however, this
      gave a low (to 200-fold less) activity on a human cell line compared to wild-type
      human IL-6. We therefore conclude that the C-terminus of IL-6 plays an important
      role in the species specificity of IL-6.

PMID- 1633884
TI  - Two different Ca2+ ion binding sites in factor VIIa and in des(1-38) factor VIIa.
AB  - The Ca2+ ion binding of factor VIIa and the derivative lacking the gamma
      carboxyglutamic acid domain, des(1-38) factor VIIa, was investigated using
      intrinsic protein fluorescence and Tb3+ ion phosphorescence methods. Binding of
      Ca2+ ions giving rise to a decrease in the intrinsic protein fluorescence
      (approximately 50% at saturating conditions) is seen with both proteins. Each of
      the saturation curves is in accordance with the formation of a 1:1 complex of
      factor VIIa-Ca2+ (KD approximately 30 microM) and des(1-38) factor VIIa-Ca2+ (KD
      approximately 40 microM)). Yet another Ca2+ ion binding site reveals itself in
      each protein in Tb3+ ion phosphorescence experiments. Ca2+ ion competition
      studies have showed 1:1 complexes (KD's approximately 2 mM). The results are
      interpreted in terms of two different Ca2+ ion binding sites, one in the EGF-1
      domain and one in the Gly-209-Gln-221 loop of the serine proteinase part.

PMID- 1633885
TI  - Regeneration of vitamin E in rat polymorphonuclear leucocytes.
AB  - The objectives of this study were to determine whether the recycling of
      tocopherol occurs in elicited rat polymorphonuclear leukocytes and if so, whether
      the recycling process is enzymic or chemical. When incubated with hemoglobin,
      tocopherol was oxidized in cell homogenates in a time- and concentration
      dependent manner. The oxidized tocopherol could be regenerated by addition of
      ascorbate, glutathione or nordihydroguaiaretic acid. Time course studies showed a
      rapid regeneration of tocopherol which peaked at 1 min after the addition of
      reductants. Determination of the regeneration reaction in the presence of CHCl3
      and MeOH indicated that under these enzyme-denaturing conditions, a considerable
      amount of tocopherol was still regenerated, suggesting that the regeneration
      reaction is predominantly a chemical reaction. This study provided direct
      evidence from mass analysis that oxidized vitamin E can be regenerated by
      cellular water-soluble reductants such as ascorbate and glutathione.

PMID- 1633886
TI  - Carbon-by-carbon discrimination of 13C incorporation into liver fatty acids.
AB  - Quantitative carbon-by-carbon analysis would be useful in determining the origin
      and fate of carbons involved in fatty acid metabolism. Incorporation of 13C from
      2-[13C]acetate into specific carbons of liver fatty acids was lowest at the n-2
      carbon of saturates and monoenes but was 47% greater at acyl C1 than at C2,
      suggesting substantial redistribution of the 13C from C2 to C1 of acetyl CoA or
      malonyl CoA prior to 13C incorporation into fatty acids during de novo synthesis
      or during elongation. Thus, 13C derived from exogenous acetate can be
      quantitatively measured and is differentially incorporated into individual
      carbons depending on position in the fatty acid molecule.

PMID- 1633887
TI  - On the activation-inactivation coupling in Shaker potassium channels.
AB  - The 'ball-and-chain' model suggests the existence of a negative site which may
      attract the positively charged inactivation ball to occlude the pore when the
      channel is in the open state. For Shaker K+ channels, we propose that the state
      dependent negative site be tryptophan-435, which becomes negatively charged after
      receiving an electron from tyrosine-445. The kinetic scheme for the channel's
      activation-inactivation coupling as derived from the YW-gated model resembles a
      successful 'scheme 8' proposed by Zagotta and Aldrich. Our model suggests that
      the final rapid voltage-independent transition to the open state is due to the
      deprotonation of tyrosine-445.

PMID- 1633888
TI  - Barley (1----3,1----4)-beta-glucanase isoenzyme EI gene expression is mediated by
      auxin and gibberellic acid.
AB  - Treatment of young barley leaves with indole acetic acid (IAA) or gibberellic
      acid (GA3) results in a dramatic increase in levels of (1----3,1----4)-beta
      glucanase isoenzyme EI transcripts. In young roots of comparable age, levels of
      isoenzyme EI mRNA are high; IAA inhibits expression while GA3 has no effect on
      mRNA levels. The addition of both abscisic acid and GA3 to leaves, roots and
      aleurone layers leads to higher levels of (1----3,1----4)-beta-glucanase
      isoenzyme EI mRNA than is found with Ga3 alone. Little or no expression of (1---
      3,1----4)-beta-glucanase isoenzyme EII is detected in vegetative tissues, but in
      isolated aleurone layers GA3 enhances levels of isoenzyme EII transcripts, as
      does IAA. Thus, the two barley (1----3,1----4)-beta-glucanase genes respond quite
      differently to phytohormone treatment, depending on the tissue and its stage of
      development.

PMID- 1633890
TI  - Immunology and endometriosis.

PMID- 1633889
TI  - Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention
      and treatment.
AB  - OBJECTIVE: To overview the world literature on ovarian hyperstimulation syndrome
      (OHSS) and modes of prevention and treatment of OHSS. STUDY SELECTION: All the
      pertinent literature on OHSS, its prevention, and strategies for treatment were
      reviewed. PREVENTION: Key to prevention is proper identification of the
      population at risk, which includes women with either the hormonal or the
      morphological signs of polycystic ovarian disease, high serum estradiol (E2)
      before human chorionic gonadotropin (hCG) administration (E2 greater than 4,000
      pg/mL), multiple follicular response (greater than 35), younger age, and lean
      habitus. When a high risk situation is recognized, ovulatory dose of hCG may be
      reduced, avoided (with cycle cancellation), or substituted by gonadotropin
      releasing hormone or its agonist. Luteal support with hCG is to be bypassed. To
      minimize risk of OHSS, endogenous pregnancy-drived hCG may be eluded by judicious
      cryopreservation of all embryos. Last, follicular aspiration will allow higher
      levels of E2 and larger number of follicles to be matured with lesser risk of
      OHSS than conventional ovulation induction without follicular aspiration.
      TREATMENT: In-house for the severe and intensive care for the critical form.
      Meticulous fluid and electrolyte balance using both crystalloids and colloids
      (albumin) until hemoconcentration abates. Paracentesis is indicated for tight
      ascites, deteriorating kidney functions, and symptomatic relief. Diuretics may be
      prudently used once hemodilution is achieved. Dopamine drip may be used as a
      renal rescue, whereas heparin is indicated for thromboembolic phenomena and
      surgery reserved for abdominal catastrophies. Therapeutic interruption of an
      early gestation may be lifesaving when all other measures have failed.
      CONCLUSIONS: Although severe and critical OHSS may not be completely avoided,
      early recognition of high-risk factors, judicious prevention schemes, and
      treatment strategies should reduce the complication and long-term sequelae of
      this iatrogenic syndrome.

PMID- 1633891
TI  - Menstrual cyclicity of CA-125 in patients with endometriosis.
AB  - OBJECTIVE: To examine the serum levels of CA-125 in the menstrual, follicular,
      and luteal phases of the menstrual cycle in women with endometriosis and to
      determine if serum CA-125 levels drawn during menses improve the clinical utility
      of the test in diagnosing endometriosis. DESIGN: Serum CA-125 was measured in the
      menstrual, follicular, and luteal phases of the cycle preceding surgery. CA-125
      levels for each phase were categorized by postoperative diagnosis and
      endometriosis stage. SETTING: The reproductive endocrine unit of a tertiary care
      university-affiliated hospital. PATIENTS: A total of 65 patients were recruited
      from the Fertility and Endocrine Unit and the Gynecology Service of Brigham and
      Women's Hospital. MAIN OUTCOME MEASURE: Serum CA-125 levels were measured by an
      immunoradiometric assay and were stratified by menstrual cycle phase, diagnosis,
      and stage of endometriosis. The menstrual cycle phase was confirmed by serum
      estradiol and progesterone measurements. RESULTS: Serum CA-125 levels in patients
      with stages II to IV endometriosis were significantly elevated in the menstrual
      phase compared with levels drawn in the nonmenstrual follicular and luteal
      phases. The sensitivity and specificity of CA-125 for the diagnosis of
      endometriosis were not significantly better in the menstrual than in the
      follicular or luteal phases. CONCLUSIONS: Despite menstrual cyclicity of CA-125,
      measurement of serum CA-125 during menses does not improve the clinical utility
      of the test in the diagnosis of endometriosis.

PMID- 1633893
TI  - The natural killer activity of peritoneal fluid lymphocytes is decreased in women
      with endometriosis.
AB  - OBJECTIVE: To investigate the local natural killer (NK) activity of the
      peritoneal fluid mononuclear cells (PFMC). DESIGN PATIENTS: In a prospective way,
      the NK activity (K562-assay) was measured in peripheral blood (PB) and peritoneal
      fluid (PF) of 44 women who underwent a laparoscopy for infertility and/or pain at
      the University Hospital of Gasthuisberg, Leuven, Belgium. MAIN OUTCOME MEASURE:
      The NK activity of peripheral blood mononuclear cells and PFMC, the number and
      concentration of PFMC, the percentage of lymphocytes versus macrophages by May
      Grunwald-Giemsa staining and the estradiol and progesterone concentration of the
      PF were correlated together and with the severity of endometriosis. RESULTS: We
      demonstrated that there is a significant NK activity in PF and that this activity
      is decreased in women with endometriosis. This defect was more pronounced in the
      follicular phase of the cycle compared with the postovulatory phase. In PB of the
      same 44 women, the decreased NK activity correlated with the severity of the
      disease. This confirms our previous report on another 34 women. CONCLUSIONS: The
      NK activity is decreased in women with endometriosis and correlated significantly
      with the severity of the disease in both the PB and PF of women with
      endometriosis.

PMID- 1633892
TI  - Glucocorticoid treatment decreases sera embryotoxicity in endometriosis patients.
AB  - OBJECTIVE: To investigate the effect of short-term glucocorticoid administration
      on embryotoxicity of sera from infertile patients with mild to moderate
      endometriosis. DESIGN: Prospective longitudinal study. SETTING, PATIENTS: Eight
      infertile patients with mild to moderate endometriosis and a control group of
      eight infertile patients with tubal infertility were selected on the basis of
      laparoscopic examination. INTERVENTIONS: Basal (B) serum collection and day 1
      (T1), day 3 (T2), day 6 (T3), and day 12 (T4) serum drawn after a 3-day
      glucocorticoid treatment in endometriosis patients. MAIN OUTCOME MEASURE:
      Embryotoxicity of endometriosis sera, before and after glucocorticoid treatment,
      was investigated using a bioassay performed on two-cell mouse embryos.
      Interleukin 1 alpha (IL-1 alpha) and antismooth muscle, antimitochondrial, and
      antinuclear autoantibodies were also tested in these sera. RESULTS: At 50%
      concentration, endometriosis serum is embryotoxic in comparison with control; 0%
      versus 61% of the embryos reached the blastocyst stage at 72 hours, respectively
      (basal versus control, P less than 0.001). However, this embryotoxicity
      significantly decreases 12 days after glucocorticoid treatment in comparison with
      untreated sera; 32.4% versus 0% of the embryos reached blastocyst stage at 72
      hours, respectively (T4 versus basal, P less than 0.001), although they did not
      reach nontoxic levels (greater than 50%). Interleukin 1 alpha was undetectable in
      all samples analyzed. In endometriosis sera, antismooth muscle antibody was
      detected. CONCLUSIONS: At 50% concentration, serum from infertile patients with
      minimal to moderate endometriosis appears to be embryotoxic to the in vitro
      development of two-cell mouse embryos. However, this embryotoxicity significantly
      decreases 12 days after a 3-day treatment with glucocorticoids.

PMID- 1633894
TI  - Elevated interleukin-6 levels in peritoneal fluid of patients with pelvic
      pathology.
AB  - OBJECTIVE: To determine if interleukin 6 (IL-6) is a normal constituent of
      peritoneal fluid (PF), and if various types of pelvic pathology influence its
      presence within the PF microenvironment. STUDY DESIGN: Peritoneal fluid from 73
      women obtained at the time of laparoscopy was examined for the presence of IL-6
      using an IL-6 specific sandwich enzyme-linked immunosorbent assay. Thirty-nine
      patients had pelvic endometriosis, 17 had nonendometriotic pelvic adhesive
      disease, and 17 subjects undergoing tubal sterilization without evidence of
      pelvic pathology served as controls. RESULTS: Immunoreactive IL-6 was observed in
      the PF of all 73 subjects (range 0.26 to 11.16 ng/mL). The mean concentration of
      IL-6 was higher in women with nonendometriotic pelvic adhesions as compared with
      control subjects (1.28 +/- 0.16 versus 0.80 +/- 0.06 ng/mL, P less than 0.03).
      There was no difference in the mean peritoneal concentrations of IL-6 between
      women with endometriosis (1.16 +/- 0.28 ng/mL) and controls, P = 0.38. Twenty
      seven of 73 patients (37%) demonstrated elevated levels (greater than 1.0 ng/mL)
      of IL-6. Patients with pelvic adhesions were significantly more likely to have
      elevated concentrations of IL-6 than controls (10/17 [59%] versus 3/17 [18%], P
      less than 0.02). Alternatively, the percentage of patients with elevated IL-6
      concentrations did not differ between patients with endometriosis or controls
      (14/39 [36%] versus 3/17 [18%], P greater than 0.10). CONCLUSIONS: These findings
      demonstrate that IL-6 is a normal constituent of PF and that elevated levels are
      found in many patients with pelvic adhesions.

PMID- 1633895
TI  - Peripheral plasma met-enkephalin levels in ovulatory and anovulatory human
      menstrual cycles.
AB  - OBJECTIVE: To test the hypothesis that met-enkephalin has a role in human
      ovulation and that plasma levels may differ between ovulatory and anovulatory
      ovarian cycles. DESIGN: This is a descriptive study comparing levels of plasma
      met-enkephalin, gonadotropins, and ovarian steroids in 12 ultrasonically
      confirmed ovulatory cycles and 12 anovulatory cycles. SETTING: The study took
      place in the infertility clinic of a large teaching hospital receiving primary
      and tertiary referrals of both private and public sector patients. PATIENTS: All
      patients (n = 16) had infertility greater than or equal to 3 years and normal
      findings on previous investigation including evidence of ovulation.
      INTERVENTIONS: Ovarian cycles were defined using transabdominal ultrasound
      scanning. Biochemical analyses were by radioimmunoassay. MAIN OUTCOME MEASURES:
      The differences between plasma met-enkephalin levels in the two groups of cycles
      were compared. RESULTS: Met-enkephalin levels are significantly higher in
      ovulatory cycles with a significant peak in the 2 postovulatory days (Duncan's
      multiple range test; P less than 0.05). CONCLUSION: Human ovulation is associated
      with cyclic elevation of plasma met-enkephalin. Further studies are required to
      elucidate causality.

PMID- 1633896
TI  - Human chorionic gonadotropin stimulation of relaxin secretion by luteinized human
      granulosa cells.
AB  - OBJECTIVE: To determine the effect of human chorionic gonadotropin (hCG) on
      relaxin secretion by long-term cultures of luteinized human granulosa cells (GC).
      DESIGN: Luteinized human GC were collected from 10 women undergoing in vitro
      fertilization (IVF) cycles. Luteinized human GC from each woman were plated in
      replicate wells at 1 x 10(5) cells/well and exposed to medium 199 (GIBCO, Grand
      Island, NY), medium 199 with 1 IU/mL hCG, and/or medium 199 with 100 IU hCG/mL.
      Luteinized human GC were maintained for up to 40 days in culture. Spent media
      were changed every 2 days and assayed for relaxin and progesterone (P) at the
      conclusion of each experiment. SETTING: Tertiary care center. PATIENTS,
      PARTICIPANTS: Luteinized human GC were obtained from women undergoing controlled
      ovarian hyperstimulation for IVF with one of the following regimens: (1)
      clomiphene citrate with human menopausal gonadotropins (hMG); (2) hMG alone; or
      (3) hMG with leuprolide acetate. All women were less than 40 years of age, in
      good health, and were not taking medications other than those used in the
      ovulation-induction regimen. MAIN OUTCOME MEASURES: Levels of P and relaxin in
      spent media. RESULTS: Relaxin secretion by luteinized human GC was dependent on
      hCG stimulation and was detected only after a time lag in culture. After relaxin
      secretion was detected, it was maintained throughout the culture period (10 to 22
      days). Luteinized human GC produced P immediately under both basal and stimulated
      conditions. Progesterone production continued throughout the culture period with
      hCG-stimulated cells producing significantly greater P after 4 to 8 days in
      culture. CONCLUSIONS: Luteinized human GC obtained at the time of oocyte
      retrieval secrete relaxin in response to hCG stimulation and secrete P under both
      basal and hCG-stimulated conditions, thereby serving as a model to explore luteal
      function and control.

PMID- 1633897
TI  - Prospective study of anticardiolipin antibodies in immunized and untreated women
      with recurrent spontaneous abortions.
AB  - OBJECTIVE: To investigate whether active leukocyte immunization increases levels
      of anticardiolipin antibodies in women with recurrent spontaneous abortions. To
      assess the impact of anticardiolipin antibodies on pregnancy outcome in these
      women. DESIGN: Patients who had received various treatments in an ongoing
      randomized trial were studied prospectively. SETTING: A department of clinical
      immunology investigating women with recurrent spontaneous abortions from all over
      Denmark. PATIENTS: Eighty-nine patients with unexplained recurrent spontaneous
      abortions whose pregnancies had been completed during the course of the trial.
      INTERVENTIONS: After randomization, 44 patients were actively immunized with
      husband's or third party leukocytes, and 27 patients received placebo. Eighteen
      patients received anticoagulation therapy in pregnancy. MAIN OUTCOME MEASURES:
      Changes in levels of immunoglobulin (Ig)M class and IgG class anticardiolipin
      antibodies after active immunization. Frequency of new miscarriages in patients
      who were positive or negative for anticardiolipin antibodies. RESULTS: Neither
      IgM nor IgG anticardiolipin antibodies changed significantly after active
      immunization (P greater than 0.2). The interim results of the immunization trial
      showed a success rate of 68% in the treated group versus 56% in the placebo group
      (not significantly different). Relative risk of miscarriage in anticardiolipin
      antibody-positive patients compared with anticardiolipin antibody-negative
      patients was 1.3 (95% confidence interval 0.7 to 2.2; P = 0.4) in the combined
      study groups. CONCLUSIONS: Patients eligible for active immunization did not
      exhibit significant changes in anticardiolipin antibody levels subsequent to the
      treatment. The treatment did not seem to provide any overall benefit with respect
      to pregnancy outcome. Prospectively, the risk of miscarriage in patients positive
      for anticardiolipin antibodies was not significantly increased.

PMID- 1633898
TI  - Immunohistochemical analysis of estrogen and progesterone receptors in fallopian
      tubes during ectopic pregnancy.
AB  - OBJECTIVE: To study decidualization, estrogen receptor (ER), and progesterone
      receptor (PR) expression in fallopian tubes containing an ectopic pregnancy (EP).
      DESIGN: Assessment of decidual reaction by light microscopy, staining of ER and
      PR in epithelium and stroma by immunohistochemical methods. SETTING: Academic
      hospital. PATIENTS: Twelve women with an ampullary located EP. INTERVENTION: A
      partial or complete tubal resection. RESULTS: Only minimal decidualization was
      observed in five tubes. Estrogen receptor expression was noted in glandular cells
      in seven tubes. No correlation was found between decidualization and ER staining.
      No PR expression was seen in glandular epithelium or in stroma. CONCLUSIONS: It
      is postulated that absence of PR is correlated to poor decidualization and to
      failure of treatment of EP with antiprogestins (RU486).

PMID- 1633900
TI  - Zygote intrafallopian transfer or in vitro fertilization and embryo transfer for
      the treatment of male-factor infertility: a prospective randomized trial.
AB  - OBJECTIVE: To compare zygote intrafallopian transfer (ZIFT) and in vitro
      fertilization and embryo transfer (IVF-ET) as treatments of male-factor
      infertility. DESIGN: Patients were prospectively randomized to ZIFT or IVF-ET.
      SETTING: In vitro fertilization program of the Centre for Reproductive Medicine
      of the Dutch-speaking Brussels Free University, Belgium, which is a tertiary
      referral institution. PATIENTS: One hundred fifty-seven couples were enrolled in
      the study. Inclusion criteria allowed only first trials of couples with long
      standing infertility caused by a male factor. Female factors were excluded.
      INTERVENTIONS: In ZIFT, up to three fertilized oocytes were transferred into one
      single patient fallopian tube by means of laparoscopy 18 hours after
      insemination. In IVF-ET, cleaving embryos were replaced into the uterine cavity
      about 48 hours after insemination. MAIN OUTCOME MEASURES: Fertilization and
      transfer rates, implantation and pregnancy rates, pregnancy outcome, and cost per
      procedure were evaluated. RESULTS: Implantation rates of 12.3% and 10% per
      replaced conceptus were achieved for ZIFT and IVF-ET, respectively. CONCLUSIONS:
      This study demonstrates no therapeutic advantage of ZIFT over IVF-ET in male
      factor infertility in terms of reproductive outcome or economic benefit.

PMID- 1633899
TI  - Interruption of endometrial maturation without hormonal changes by an
      antiprogesterone during the first half of luteal phase of the menstrual cycle: a
      contraceptive potential.
AB  - OBJECTIVE: To examine hormonal and endometrial responses to intermittent low-dose
      RU486 administration in the luteal phase of the menstrual cycle. DESIGN:
      Prospective open trial in which subjects serve as their own controls.
      PATIENTS/PARTICIPANTS: Eight normal cycling women. INTERVENTIONS: RU486 (10 mg,
      orally) was administered 5 and 8 days after urinary luteinizing hormone (LH)
      surge of treatment cycle. MAIN OUTCOME MEASURES: Daily serum concentrations of
      LH, follicle-stimulating hormone, estradiol (E2), and progesterone (P) were
      determined in control, treatment, and recovery cycles (n = 5) or treatment and
      recovery cycles (n = 3). Changes in endometrial morphology and
      immunohistochemical staining for P receptor (PR) and E2 receptor (ER) were
      determined during control (or recovery) and treatment cycles. RESULTS: Cycle
      length and hormonal patterns were unaltered after treatment with RU486. As
      demonstrated by reduced stromal edema and delayed glandular development,
      endometrial dyssynchrony occurred in all eight treatment cycles. In addition,
      seven of eight treatment cycle endometria demonstrated a decrease in PR staining
      without consistent change in ER staining. CONCLUSIONS: Two low doses of RU486
      given 72 hours apart during the luteal phase of the cycle disrupted ongoing
      endometrial maturation without altering the hormonal and time course of the
      menstrual cycle. This study provides a basis for the development of a novel form
      of luteal contraception.

PMID- 1633901
TI  - Transvaginal embryo aspiration--a safe method for selective reduction in multiple
      pregnancies.
AB  - OBJECTIVE: To evaluate pregnancy outcome after transvaginal selective embryo
      aspiration and to compare the results with those reported previously with other
      techniques for selective abortion. DESIGN: Retrospective case series. SETTING:
      University-based in vitro fertilization (IVF) program. PATIENTS: Nineteen women
      with multiple pregnancy who conceived after ovulation induction or IVF/gamete
      intrafallopian transfer. INTERVENTION: Transvaginal ultrasound-guided aspiration
      of the embryo(s) was performed at 7 to 8 weeks of gestation. MAIN OUTCOME
      MEASURES: Early and late complications related to the procedure, outcome of
      pregnancy, and birth weight. RESULTS: In 18 cases, the initial number of embryos
      (3 to 7) was reduced to two. In 1 case, the number of embryos was reduced from 4
      to 3. None of the remaining fetuses vanished after the procedure. One patient
      delivered at 25 weeks and all other patients delivered healthy, viable infants (a
      pregnancy loss rate of 5.3%). CONCLUSIONS: Transvaginal embryo aspiration in
      early gestation appears to be a simple and relatively safe procedure for
      selective termination in patients with high-order multiple pregnancy. The
      cumulative loss rate of selective termination procedures previously reported by
      others is three times higher than the loss encountered in our series. This
      earlier procedure may be more acceptable to patients from emotional and religious
      points of view.

PMID- 1633902
TI  - A prospective randomized study comparing aspiration only with aspiration and
      flushing for transvaginal ultrasound-directed oocyte recovery.
AB  - OBJECTIVE: To compare aspiration only with aspiration and flushing of ovarian
      follicles during transvaginal ultrasound (US)-directed oocyte recovery. DESIGN:
      Prospective randomized study. PATIENTS: One hundred patients who were undergoing
      an in vitro fertilization (IVF) treatment cycle. INTERVENTIONS: All patients
      underwent pituitary desensitization before the administration of gonadotropins.
      Monitoring of ovarian stimulation and the criteria for the administration of
      human chorionic gonadotropin were similar in both groups. In patients in whom
      aspiration alone was used, each follicle was aspirated until it was empty. The US
      probe was then rotated until every drop of follicular fluid had been aspirated
      before the next follicle was aspirated and the procedure repeated. For patients
      who had aspiration and flushing, each follicle was aspirated and then flushed up
      to a maximum of six times before moving to the next follicle. In both groups, all
      follicles greater than 10 mm were aspirated. RESULTS: The indication for IVF and
      mean age of the patients were comparable in the two groups. There were no
      significant differences between the aspiration and the aspiration and flushing
      groups in terms of the number of oocytes retrieved (11 versus 9), the oocyte
      recovery rates (77.5% versus 77.0%), the fertilization rates (55.6% versus
      60.0%), the number of embryos transferred (2 versus 2), or the number of clinical
      pregnancies (12 versus 13). The time taken for oocyte recovery was significantly
      shorter (15 versus 30 minutes, P less than 0.00001), and the dose of pethidine
      required significantly less (50 mg versus 100 mg, P less than 0.00001) in the
      aspiration only group. CONCLUSIONS: Aspiration alone produces comparable oocyte
      recovery rates as aspiration and flushing while significantly reducing the length
      of the procedure and the dose of analgesia required. Aspiration alone suffices
      for virtually all cases during transvaginal US-directed oocyte recovery.

PMID- 1633903
TI  - Failed oocyte retrieval after lack of human chorionic gonadotropin administration
      in assisted reproductive technology.
AB  - OBJECTIVE: To document the absence of oocytes in follicular aspirates in women
      who, during controlled ovarian stimulation with gonadotropin-releasing hormone
      agonist (GnRH-a) and menotropins, fail to receive human chorionic gonadotropin
      (hCG) administration. DESIGN: Retrospective analysis of clinical laboratory data.
      SETTING: Multicentric. PATIENTS: Five women undergoing controlled ovarian
      hyperstimulation with GnRH-a and menotropins for programs of assisted
      reproductive technologies. RESULTS: The documented absence of an hCG injection
      produced "empty follicles" at transvaginal guided aspiration, despite numerous
      follicular lavages and aspiration of peritoneal fluid. The lack of oocytes and
      granulosa-cumulus complex in the follicular fluid was reverted in other cycles in
      the same patients when hCG was properly administered. CONCLUSIONS: (1) This study
      emphasizes the importance of proper patients' and nurses' instructions for
      preparation of hCG injections and proper mixture of vehicle and powder before
      follicular aspiration. (2) In the absence of cumulus-corona-oocyte complex at
      aspiration, measure serum beta-hCG to ascertain whether hCG injection was
      administered or not. (3) Routine preoperative beta-hCG levels may be helpful to
      avoid unnecessary surgeries.

PMID- 1633904
TI  - The appearance of one-pronuclear human oocytes is associated with a better
      ovulation-induction response and successful pregnancy outcome.
AB  - OBJECTIVE: To study the relationship between the presence of one-pronuclear
      oocytes in in vitro fertilization (IVF) patients and ovulation-induction
      response, oocyte and embryo development, and clinical outcome. DESIGN:
      Retrospective analysis of 535 consecutive IVF retrievals. Retrievals in which one
      or more oocytes exhibited one pronucleus were compared with retrievals in which
      no one-pronuclear oocytes (control) were observed. The following one-pronuclear
      versus control subgroups were also examined: leuprolide acetate/human menopausal
      gonadotropin (LA/hMG) ovulation inductions, high estradiol (E2) response cases,
      and retrievals in which a large number of oocytes (greater than or equal to 15)
      were recovered. SETTING: Brigham and Women's Hospital, a tertiary care,
      university-affiliated hospital. PATIENTS: Three hundred forty-six IVF patients
      were treated between January 1989 and May 1991. MAIN OUTCOME MEASURES: Parameters
      examined included E2 concentration and number of follicles with maximum diameter
      greater than or equal to 12 mm on day of human chorionic gonadotropin
      administration; number of total and mature oocytes retrieved; total fertilization
      rates; number of embryos; and percent per retrieval of embryo transfers (ETs),
      clinical pregnancies, and ongoing-livebirths. RESULTS: The one-pronuclear
      patients had higher E2 levels and larger number of follicles, yielded
      significantly more total and mature oocytes, had a higher overall fertilization
      rate, produced more embryos, and had higher ET, clinical pregnancy and ongoing
      livebirth rates per retrieval than did the control patients. Analysis of the
      subgroup populations revealed no significant differences in the majority of the
      main outcome measures studied; however, the one-pronuclear patients yielded
      significantly more total and mature oocytes per retrieval. CONCLUSIONS: Although
      there was an increase in the clinical and ongoing-livebirth pregnancy rates (PRs)
      in one-pronuclear patients, this was probably associated with an improved
      ovulation-induction response in the one-pronuclear patients. They achieved
      significantly higher E2 levels, recruited a larger number of follicles, and
      yielded more oocytes and embryos per retrieval than the control patients. When
      only the LA/hMG, E2 greater than or equal to 1,500 pg/mL, or the greater than or
      equal to 15 oocytes/case retrievals were analyzed, the PRs were no longer
      different; however, the one-pronuclear patients still yielded significantly more
      total and mature oocytes per retrieval than the controls. Therefore, the
      appearance of one-pronuclear oocytes is probably associated with the maturation
      stage of the oocytes obtained and is indicative of an ovulation induction in
      which a large number of preovulatory, metaphase II oocytes have been recruited.

PMID- 1633905
TI  - Can a single, early quantitative human chorionic gonadotropin measurement in an
      in vitro fertilization-gamete intrafallopian transfer program predict pregnancy
      outcome?
AB  - STUDY OBJECTIVE: To assess the predictive value of a single serum human chorionic
      gonadotropin (hCG) measurement obtained on day 14, 15, or 16 after transfer in in
      vitro fertilization or gamete intrafallopian transfer pregnancies. DESIGN:
      Retrospective. SETTING: Assisted reproductive technology (ART) programs.
      PATIENTS: One hundred thirty-four consecutive pregnancies from two ART programs
      were reviewed. RESULTS: The incidence of livebirth was only 6% when day 14 to 16
      hCG values were less than 100 mIU/mL, but increased to 82% with levels greater
      than 100 mIU/mL (P less than 0.001). The incidence of livebirth and multiple
      birth correlated with rising hCG levels. Only 1% (1/71) of pregnancies with serum
      hCG values greater than 100 mIU/mL was ectopic, and this case was a bilateral
      (double) ectopic. CONCLUSIONS: A single serum hCG measurement obtained 14 to 16
      days after embryo or gamete transfer not only is diagnostic but also has good
      predictive value for pregnancy outcome.

PMID- 1633906
TI  - The administration of glucocorticoids for the prevention of ovarian
      hyperstimulation syndrome in in vitro fertilization: a prospective randomized
      study.
AB  - OBJECTIVE: To determine if the administration of glucocorticoids reduced the rate
      of ovarian hyperstimulation syndrome (OHSS) in high-risk patients after ovarian
      stimulation for in vitro fertilization (IVF). DESIGN: Prospective randomized
      study. PATIENTS: Thirty-one patients who were stimulated with human menopausal
      gonadotropin (hMG) after pituitary desensitization by gonadotropin-releasing
      hormone agonist and who developed greater than 20 follicles greater than 12 mm
      and/or had a serum estradiol (E2) level of greater than 10,000 pmol/L on the day
      of administration of human chorionic gonadotropin (hCG). INTERVENTIONS: Patients
      were randomly divided into two groups. Those who were randomized to receive
      glucocorticoids (group A) (n = 17) were administered intravenous hydrocortisone,
      100 mg, immediately after ultrasound (US)-directed oocyte recovery. Prednisolone,
      10 mg three times per day, was given for 5 days starting on the day of oocyte
      recovery followed by prednisolone 10 mg two times a day for 3 days and 10 mg/d
      for 2 days. Those in group B (n = 14) did not receive any glucocorticoid
      treatment. In both groups, luteal support was provided by intramuscular
      injections of gestone 100 mg/d. RESULTS: The two groups of patients were
      comparable in terms of age, duration of infertility, and total dose of hMG used.
      All had polycystic ovaries on US examination. On the day of hCG administration,
      the mean number of follicles in the two groups were 26.76 +/- 2.49 and 25.93 +/-
      1.44 and the serum E2 concentration 13,404 +/- 710 and 13,915 +/- 901 pmol/L,
      respectively. There were no significant differences in the number of oocytes
      collected or in the fertilization, cleavage, and implantation rates in the two
      groups. The pregnancy rates per initiated cycle were 41.18% and 35.71%,
      respectively. Seven of the 17 patients (41.2%) who received glucocorticoids
      developed ovarian hyperstimulation syndrome compared with 6 of the 14 patients
      (42.9%) who did not receive glucocorticoids. CONCLUSIONS: Administrations of
      glucocorticoids to high risk patients did not reduce the rate of OHSS after
      ovarian stimulation for IVF.

PMID- 1633907
TI  - A study of the detection of sperm antibody in cervical mucus with a modified
      immunobead method.
AB  - OBJECTIVE: To develop a new immunobead binding test (IBT) procedure that will
      detect sperm antibody in cervical mucus (CM), especially in very small samples of
      mucus. DESIGN: After the interaction of donor sperm with bromelin-dissolved CM,
      the motile sperm cells were separated from other cells and debris and then tested
      with a standard immunobead method. SETTING: The CM and serum samples were
      obtained from a sequence of referred patients who were sent to this testing
      laboratory. PATIENTS: There were 60 women who provided 64 samples of CM and 41
      samples of blood serum. They were partners in infertile couples. INTERVENTIONS:
      None. MAIN OUTCOME MEASURE: A useful distinction was made between positive and
      negative results for the mucus samples by this CM-IBT procedure. The usable
      samples of mucus could be as little as 0.05 g (wet weight). RESULTS: From the 60
      women, seven mucus samples were positive; in the repeated testing, the same
      results were obtained with five of the six positive samples and seven of seven
      negative samples. CONCLUSION: This method (CM-IBT) can be clinically useful for
      detecting sperm antibody in CM, especially because it is effective for tiny
      samples. In this method, the motile sperm cells are better separated from the
      debris after the incubation step. When the IBT was applied to the serum samples
      from the same women, there was no correlation between serum-IBT and CM-IBT,
      showing that both materials must be tested.

PMID- 1633908
TI  - Novel model for study of human sperm chemotaxis.
AB  - OBJECTIVE: To develop and test an adequate method for the study of sperm
      chemotaxis. DESIGN: A model based on a double-chamber design and a matrix of 0.5%
      hyaluronic acid was used to test the response of human sperm to chemotactic
      signals from follicular fluid (FF). RESULTS: A plateau of migration was reached
      at 10 minutes of incubation; under this condition, 70% of sperm migrated toward
      chambers with FF, less than 20% to the opposite side, and the rest remained at
      the site of application. Intra-assay and interassay coefficients of variation
      using pools of FFs were 17.2% and 23%, respectively. CONCLUSION: These data
      confirm previous findings and support the use of this novel model for the study
      of chemotaxis on human gametes.

PMID- 1633909
TI  - The fertilization antigen-1 does not have proteolytic/acrosin activity, but its
      monoclonal antibody inhibits sperm capacitation and acrosome reaction.
AB  - OBJECTIVE: To determine if human sperm surface fertilization antigen exhibits
      proteolytic or acrosin activity and to investigate the mechanism(s) whereby
      monoclonal antibody (mAb) to fertilization antigen inhibits human sperm
      penetration of zona-free hamster ova. DESIGN: Proteolytic and acrosin activities
      of human fertilization antigen were determined. Acrosomal status, acrosin
      activity, and motion characteristics were evaluated after incubation of human
      sperm with immunoaffinity-purified mAb to fertilization antigen. SETTING:
      Academic research environment. PARTICIPANTS: Fertile donors used as controls for
      infertile patients for fertility evaluation. INTERVENTIONS: Human spermatozoa
      were treated with mAb to fertilization antigen and induced to undergo acrosome
      reaction using calcium ionophore A23187. MAIN OUTCOME MEASURES: Proteolytic and
      acrosin activities of fertilization antigen. Sperm penetration assay, acrosomal
      status, and motion parameters. RESULTS: Fertilization antigen does not exhibit
      proteolytic or acrosin activity; however, its mAb completely blocks human sperm
      penetration of zona-free hamster ova. The mAb to fertilization antigen inhibits
      ionophore-induced acrosome reaction and blocks development of the hyperactivated
      state of human sperm cells. CONCLUSIONS: Monoclonal antibody to fertilization
      antigen blocks fertilization by inhibiting capacitation and acrosome reaction.

PMID- 1633910
TI  - Immunoneutralization of gonadotropin-releasing hormone and subsequent treatment
      with testosterone Silastic implants in rats: an approach toward developing a male
      contraceptive.
AB  - STUDY OBJECTIVE: To determine the extent to which increasing doses of exogenous
      testosterone (T) administered via Silastic implants can restore spermatogenesis
      and fertility to rats made azoospermic by active immunization against
      gonadotropin-releasing hormone (GnRH). DESIGN: Male rats were made azoospermic by
      active immunization against GnRH. Increasing doses of exogenously administered T
      (via Silastic implants) were administered for 8 weeks, and testicular sperm
      concentration and ability to impregnate female rats were evaluated. SETTING:
      Reproductive Endocrinology Laboratory, Department of Obstetrics and Gynecology,
      University of Colorado Health Sciences Center, Denver, Colorado. ANIMALS:
      Sexually mature male Sprague Dawley rats (SASCO, Omaha, NE). RESULTS: Suppression
      of gonadotropins and azoospermia was achieved by actively immunizing rats against
      GnRH. Testosterone was capable of restoring quantitatively complete
      spermatogenesis and fertility in GnRH-immunized azoospermic rats. This
      relationship was dose-dependent, as evidenced by the partial restoration of
      spermatogenesis and fertility observed in animals replaced with smaller T
      Silastic implants. CONCLUSION: Gonadotropin-releasing hormone immunization and T
      filled Silastic implants may provide a model to study isolated gonadotropin
      deficiency and for the development of a reversible male contraceptive.

PMID- 1633911
TI  - Predictors of uterine volume reduction in women with myomas treated with a
      gonadotropin-releasing hormone agonist.
AB  - A retrospective analysis of 104 women with leiomyomata uteri treated with LA for
      at least 12 weeks demonstrated a negative correlation between the percent
      reduction in uterine volume and serum E2 concentration at treatment week 12. The
      patient's age, height, or pretreatment uterine volume were not correlated with
      the degree of uterine shrinkage.

PMID- 1633912
TI  - Massive ascites after leuprolide acetate administration for the treatment of
      leiomyomata uteri.
AB  - The administration of GnRH-a for decreasing the size of uterine leiomyomata is
      tolerated by most of our patients with a minimum of side effects and difficulty.
      An unusual case of pseudo-Meigs' syndrome developed after a single dose of depot
      LA that resulted in an emergent operation in this young woman. The treatment of
      large leiomyomata uteri with GnRH-a warrants careful clinical surveillance.

PMID- 1633913
TI  - What is the minimal uterine cavity needed for a normal pregnancy? An extreme case
      of Asherman syndrome.
AB  - There are no reports on the subsequent anatomic findings in women with
      intrauterine adhesions who conceived and delivered after therapy, but our
      experience indicates that most of these women menstruate and conceive normally.
      The recurrence of intrauterine adhesions, together with preserved fertility in
      this patient, suggest that fertility, while usually correlated with subsequent
      resumption of normal menstruation and anatomy, may sometimes be independent of
      these features.

PMID- 1633914
TI  - Pseudomyxoma peritonei associated with secondary infertility.
AB  - In summary, we report a case of secondary infertility attributed to pseudomyxoma
      peritonei caused by ruptured appendiceal mucocele. Resection of the tumor and
      visible mucinous ascites resulted in spontaneous conception. We hypothesize
      secondary infertility was caused by significant peritoneal inflammation and
      inhibition of sperm-oocyte interaction from the ascites.

PMID- 1633915
TI  - Pregnancy-associated subacute hemorrhage into a prolactinoma resulting in
      diabetes insipidus.
AB  - A young woman with a small pituitary tumor associated with hyperprolactinemia
      developed subacute intrapituitary hemorrhage during the third trimester of
      pregnancy and presented with central diabetes insipidus. Magnetic resonance
      imaging established the diagnosis. After transsphenoidal surgery, her visual
      findings resolved, and the patient had an uneventful spontaneous delivery.

PMID- 1633916
TI  - In vitro fertilization and embryo transfer in well-controlled, insulin-dependent
      diabetics.
AB  - Five IDD patients achieved strict preconception glycemic control and then
      underwent nine IVF-ET cycles. All patients had high E2 response with an adequate
      number of preovulatory oocytes retrieved and normal fertilization and cleavage
      rates; one conceived. Follicular fluid analysis revealed similar E2, P, A, hCG,
      PRL, and IGF-I levels to non-IDD controls. The source of the insulin detected in
      the FF of IDD patients was probably from the insulin doses administered
      intensively during the tight diabetes management; insulin was absent in non-IDD
      participants. It seems that patients with IDD have conventional responses to
      gonadotropin stimulation for IVF and their follicular milieu resembles that of
      non-IDD patients. Nevertheless, in view of the significant advantages of
      preconceptional diabetes control in regard to pregnancy outcome, they should be
      allowed to participate in IVF programs only after tight preconception metabolic
      control has been obtained.

PMID- 1633917
TI  - The effect of consecutive day inseminations on semen characteristics in an
      intrauterine insemination program.
AB  - This study demonstrates a statistically significant decrease in semen volume,
      sperm concentration, and sperm motility in samples obtained on the 2nd day of
      consecutive day inseminations in an IUI program. This diminution in semen
      characteristics persists despite sperm washing. The effects of a second
      ejaculation on semen parameters in oligospermic and asthenospermic men were
      mixed. Thus, in general, sperm-washing procedures cannot overcome the natural
      reduction in semen quality produced by frequent ejaculations. Clinicians may wish
      to use this information in timing IUI cycle inseminations.

PMID- 1633918
TI  - Motility longevity of sperm samples processed for intrauterine insemination.
AB  - This study demonstrates that sperm from men with male factor infertility and
      sperm obtained by electroejaculation have reduced motility longevity when
      compared with normal specimens. After 24 hours, normal samples lost only 34% of
      initial motility, whereas male factor patients lost 48%, and electroejaculation
      patients dropped 66%. Based on these data and previous clinical studies of
      insemination timing, it is recommended that sperm retrieval and artificial
      insemination for male factor infertility, especially when electroejaculation is
      necessary, be performed 24 to 36 hours after urinary detection of the LH surge or
      as close to the time of ovulation as possible.

PMID- 1633919
TI  - Sperm peritoneal recovery in infertile couples with male factors.
AB  - Several studies (1-3) dealing with the presence of spermatozoa in preovulatory
      peritoneal liquid have shown a low correlation with the situation prevailing in
      the uterine cervix. Although all previous studies have worked with normospermic
      populations, we aimed at answering whether alterations of seminal variables are
      associated with alterations in transportation along the feminine tract. Different
      sperm migrations (in concentration and motility) were found, depending on the
      number of seminal variables altered.

PMID- 1633920
TI  - Intrafollicular insemination for male factor infertility.
AB  - Intrafollicular insemination is a promising new development that may have a major
      impact on ART, notably in the treatment of male factor infertility. Reported is
      the first successful intrafollicular insemination in the United States and the
      first successful intrafollicular insemination for male factor infertility.
      Although the results are encouraging, further investigations are currently
      underway to critically evaluate intrafollicular insemination.

PMID- 1633921
TI  - Pathophysiology of ovarian hyperstimulation syndrome.

PMID- 1633922
TI  - Pathophysiology of ovarian hyperstimulation syndrome.

PMID- 1633923
TI  - Intravenous immunoglobulin therapy for recurrent abortion: "state of the art" or
      "experimental therapy"?

PMID- 1633924
TI  - Electronically united?--bibliographic omissions.

PMID- 1633925
TI  - Electronically united--at last editorial comment.

PMID- 1633926
TI  - Efficacy of immunotherapy preceding in vitro fertilization and embryo transfer.

PMID- 1633927
TI  - Selective salpingography technique.

PMID- 1633928
TI  - [Hormones and growth of cancer].
AB  - Estrogen and androgen play essential roles in the development of breast cancer
      and prostate cancer, respectively. However, only 30% of breast cancer mass and
      70% of prostate cancer mass are found to be hormone-dependent when they have been
      treated clinically. These findings show that hormone dependency of cancer
      disappears rather easily. Recently, it has been found that the growth of hormone
      dependent cancer is mediated through sex steroid-induced growth factors in an
      autocrine manner. Future studies on sex steroid-induced growth factor(s) will
      play important roles in order to understand the molecular mechanisms of the
      development and growth of breast cancer and prostate cancer.

PMID- 1633929
TI  - [The possibility of hereditary factors in the susceptibility to diabetic
      nephropathy in NIDDM].
AB  - Diabetic nephropathy is the most important complication of diabetes, because it
      is a major cause of morbidity and mortality for diabetic subjects. Since not all
      subjects with diabetes are at risk of developing this complication, we conducted
      a study to determine if heredity might be a possible risk factor for diabetic
      nephropathy in non-insulin dependent diabetes. Twenty-one factors including
      inheritance of nephropathy and hypertension were investigated in 109 individuals
      with NIDDM: 50 patients without proteinuria (Group I), 20 patients with
      intermittent proteinuria (Group II), and 39 patients with continuous proteinuria
      (Group III) matched for age and duration of diabetes. Of those patients, 55
      patients with inheritance of diabetes were also divided into three groups: 29
      patients without proteinuria (Group I), 9 patients with intermittent proteinuria
      (Group II), and 17 patients with continuous proteinuria (Group III). Individuals
      in Groups II and III has significantly higher frequency of inheritance of
      diabetic nephropathy than those in Group I, and also individuals with inheritance
      of diabetic nephropathy had significantly higher frequency of diabetic
      nephropathy than those without it. Frequency of hypertension, retinopathy and
      body mass index in the past were significantly higher in subjects in Groups II or
      Group III than in those in Group I. There were no significant differences between
      subjects in Groups II and III. These findings suggest that susceptibility to
      diabetic nephropathy in NIDDM may be hereditary, although hypertension and
      obesity may also be important risk factors for diabetic nephropathy.

PMID- 1633930
TI  - [Role of growth hormone in the pathogenesis of dawn phenomenon in IDDM].
AB  - The early morning hyperglycemia of diabetic patients has been commonly referred
      to as the "dawn phenomenon". Recently the nocturnal surges of growth hormone (GH)
      have been suggested as an important factor in the pathogenesis of the dawn
      phenomenon. In order to reassess the role of the nocturnal GH secretion in the
      dawn phenomenon, seven C-peptide negative diabetic patients were studied during
      48hr-feedback control using a closed-loop insulin infusion device (Biostator).
      They received oral sleeping medication only on the first night (control) and
      sleeping medication with anticholinergic agent (pirenzepine 75mg) on the second
      night, and blood glucose, insulin requirements, GH and cortisol concentrations
      during 0000hr and 0700hr were measured. The peak of sleep-induced GH secretions
      was markedly suppressed by pirenzepine in comparison with the control night (19.8
      +/- 3.7 vs. 3.0 +/- 1.2ng/ml; p less than 0.05). Insulin requirements during
      0500hr and 0700hr were suppressed significantly by pirenzepine (3.0 +/- 0.2 vs.
      2.0 +/- 0.2U/2hr; p less than 0.05). Insulin infusion ratio, i.e. insulin
      requirements during 0500hr and 0700hr divided by those during 0000hr and 0200hr,
      was decreased by pirenzepine (2.2 +/- 0.3 vs. 1.5 +/- 0.2; p less than 0.05).
      There were no significant differences in blood glucose and cortisol
      concentrations whether or not the anticholinergic agent was given. In conclusion,
      these results have shown that an anticholinergic agent may be useful in the
      management of insulin-treated patients with marked dawn phenomenon.

PMID- 1633931
TI  - [Forty-one cases of Cushing's syndrome: a comparison between Cushing's syndrome
      (adrenal adenoma) and Cushing's disease (adrenal hyperplasia)].
AB  - We experienced 41 cases of Cushing's syndrome (12 males and 29 females, 15 years
      old - 65 years old) during the last 20 years. These included 20 patients with
      unilateral adrenal adenoma (Cushing's syndrome), 19 patients with bilateral
      adrenal hyperplasia (Cushing's disease), one patient with adrenal carcinoma and
      one patient with primary adrenocortical nodular dysplasia (PAND). Moreover, these
      cases included some special ones, i.e. 5 cases with destructive thyroiditis after
      treatment, 2 cases with aggravation of arthritis after treatment, a case of
      Carney's complex with PAND, one case with paradoxical response to dexamethasone,
      and one case combined with empty sella syndrome. The most specific clinical signs
      were moon face (95% occurrence), hypertension (95%) and subcutaneous bruising
      (80%). Other significant signs were eye edema (66%), buffalo hump (68%),
      subcutaneous purpura (63%) and osteoporosis (49%). Skin striae was not a common
      sign in our cases (41%). Renal stone was observed in only 20% of our patients but
      was a significant sign in this syndrome. There was no difference in the
      occurrence of each clinical sign between Cushing's syndrome and Cushing's
      disease. The elevation of white blood cell count (WBC) and serum sodium, a
      decrease of serum potassium, and a decrease of reabsorption of phosphate (%TRP)
      were observed. Thyroid-stimulating hormone (TSH) and human growth hormone (HGH)
      were suppressed in patients with Cushing's syndrome and patients with Cushing's
      disease. These results were consistent with those of previous reports. However,
      luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin (PRL)
      were high in those patients with Cushing's syndrome and those with Cushing's
      disease. Oral glucose tolerance test was carried out in 34 patients before and
      after treatment. Thirty-one percent of those had diabetes mellitus and 26% had
      impaired glucose tolerance (IGT). The response of IRI in this test was high in
      patients with Cushing's syndrome and patients with Cushing's disease, and
      decreased 4 weeks after treatment in those with Cushing's syndrome but remained
      high in those with Cushing's disease. Plasma ACTH level and urinary 17-OHCS
      excretion were significantly higher in Cushing's disease than in Cushing's
      syndrome. During an 8mg-high-dose dexamethasone suppression test, urinary 17-OHCS
      excretion in 13 of 14 patients with Cushing's disease (93%) was suppressed by
      more than 50% of baseline on the second day of testing. However, all of 18
      patients with Cushing's syndrome, who had an 8mg-dexamethasone suppression test,
      failed to suppress urinary 17-OHCS by 50% of baseline.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1633932
TI  - The gram-negative outer membrane: structure, biochemistry and vaccine potential.

PMID- 1633933
TI  - The effect of Cu(II) ions on the optical rotation of heparin.

PMID- 1633934
TI  - Growth substances in context: a decade of sensitivity.

PMID- 1633935
TI  - The pyruvate kinase of Thermoplasma acidophilum: purification, kinetic
      characterisation & use as a phylogenetic marker.

PMID- 1633936
TI  - Inter-species variants of the 5-HT3 receptor.

PMID- 1633937
TI  - Enzyme activity in organic media.

PMID- 1633938
TI  - Muscarinic receptor subtypes: inositol phosphates and intracellular calcium.

PMID- 1633939
TI  - Multiple heterotrimeric guanine nucleotide binding proteins: roles in the
      determination of cellular signalling specificity.

PMID- 1633940
TI  - The generation of free acid SBFI within the matrix of isolated rat heart
      mitochondria and its use to estimate matrix [Na+].

PMID- 1633941
TI  - Factors affecting the steady-state distribution of lithium in the sheep-heart
      Purkinje fibre.

PMID- 1633942
TI  - Mitochondrial Ca2+ transport and the role of matrix Ca2+ in mammalian tissues.

PMID- 1633943
TI  - Hormonal regulation of the glucose transporter GLUT I in the lactating rat
      mammary gland.

PMID- 1633944
TI  - Intracellular calcium measurements in response to histamine stimulation in DDT1
      MF-2 cells.

PMID- 1633945
TI  - Polarimetry of mixtures of Cu(II) ions and chemically modified heparins.

PMID- 1633946
TI  - Antibody engineering.

PMID- 1633947
TI  - Catalytic antibodies--a new window on protein chemistry.

PMID- 1633948
TI  - Beetroot and red urine.

PMID- 1633949
TI  - Mechanism and regulation of galactomannan biosynthesis in developing leguminous
      seeds.

PMID- 1633950
TI  - Properties of immobilised bromelain.

PMID- 1633951
TI  - Immune-mediated cell separation methods.

PMID- 1633953
TI  - Rat liver L-threonine dehydrogenase.

PMID- 1633952
TI  - Immunochemical tests of potential fertility.

PMID- 1633954
TI  - Near infra-red reflection measurements and the applicability of the absorption
      law.

PMID- 1633955
TI  - Cloning and sequence determination of the feline calicivirus strain F9.

PMID- 1633956
TI  - Alginates: biosyntheses and some structure-function relationships relevant to
      biomedical and biotechnological applications.

PMID- 1633957
TI  - Gel retardation analysis of ribonucleotide reductase gene expression in African
      swine fever virus.

PMID- 1633958
TI  - Isolation of a gene from Xenopus borealis containing a paired box.

PMID- 1633959
TI  - Decrease in carboxylate absorption during heparin-poly L-lysine interaction.

PMID- 1633960
TI  - A sequence comparison of the VP72 gene of African swine fever virus.

PMID- 1633961
TI  - Kinetic evidence for the existence of an unstable intermediate in the
      trinitrophenylation-induced rhodanese inactivation reaction.

PMID- 1633962
TI  - Inactivation of glucose-6-phosphate dehydrogenase from various sources by a
      bifunctional isothiocyanate.

PMID- 1633963
TI  - General acid-base catalysis of 2,4,6-trinitrobenzene-sulphonate-induced rhodanese
      inactivation.

PMID- 1633964
TI  - Restoration of rat liver L-threonine deaminase by pyridoxamine 5'-phosphate.

PMID- 1633965
TI  - Multiple-specular-reflectance i.r. spectroscopy of glycosaminoglycan
      cetylpyridinium complexes.

PMID- 1633966
TI  - Drug interference in the 2,2'-bicinchoninic acid protein assay.

PMID- 1633967
TI  - Bacterial cellulases.

PMID- 1633968
TI  - Problems in the interpretation of ATP concentration in blood fractions.

PMID- 1633969
TI  - Primer extension analysis of mouse U7 small nuclear RNA gene expression.

PMID- 1633970
TI  - Fungal cellulases.

PMID- 1633971
TI  - Purine metabolism in normal and HIV-1 infected lymphocytes. Purine nucleotide
      content.

PMID- 1633972
TI  - Purine metabolism in normal and HIV-1 infected lymphocytes. Analysis of
      nucleotides through HPLC.

PMID- 1633973
TI  - Physical map of a 257 kilobase-pairs region from the genome of Halococcus
      saccharolyticus.

PMID- 1633974
TI  - Extraction of a calcification inhibitor from Corallina officinalis.

PMID- 1633975
TI  - Thermodynamics of talin and talin-vinculin binding to G-actin.

PMID- 1633976
TI  - Elicitation of peroxidase production in cell suspension cultures.

PMID- 1633977
TI  - PCR amplification of specific cDNA sequences using mixed oligonucleotide primers-
      a cautionary note.

PMID- 1633978
TI  - The effect of immunophotodynamic therapy using the monoclonal antibody HMFG-1
      linked to hematoporphyrin on MCF-7 cell in vitro.

PMID- 1633979
TI  - The relationship between 111In-labelled immunoscintigraphy and serum CA-125
      levels in ovarian carcinoma patients postchemotherapy.

PMID- 1633980
TI  - Identification of a dipeptidyl aminopeptidase type-II in the cytosolic fraction
      of bovine brain.

PMID- 1633981
TI  - Treatment of hypothyroid rats with T2 (3,5-di-iodo-L-thyronine) rapidly
      stimulates respiration in subsequently isolated mitochondria.

PMID- 1633982
TI  - Chemical production of bifunctional antibodies.

PMID- 1633983
TI  - Effects on oral bacteria of a peptide derived from human cathepsin G.

PMID- 1633984
TI  - Respiration deficiency in the pathogenic yeast, Candida albicans.

PMID- 1633985
TI  - Pathogenicity of Xenorhabdus luminescens.

PMID- 1633986
TI  - Stress responses of Bacillus subtilis.

PMID- 1633987
TI  - Enzymatic incision of UV-irradiated DNA at sites of purine photoproducts.

PMID- 1633988
TI  - Molecular cloning and characterization of the lux genes from the secondary form
      of Xenorhabdus luminescens, K122.

PMID- 1633989
TI  - Increased calpain activity in skeletal muscle of rats maintained on caloric
      restricted and fasting dietary regimes.

PMID- 1633990
TI  - Starch granules large and small.

PMID- 1633991
TI  - Evidence for the presence of GTP-binding proteins in tobacco leaf and maize
      hypocotyl plasmalemma.

PMID- 1633992
TI  - Purification and conjugation of anti-insulin IgG from guinea pig serum for use in
      proinsulin immunoassay.

PMID- 1633994
TI  - Streptavidin production by Streptomyces avidinii in a laboratory fermenter.

PMID- 1633993
TI  - The concanavalin A-glycoprotein interaction as a convenient method for the assay
      of endoglycosidases.

PMID- 1633995
TI  - Shake flask studies of streptavidin production in synthetic and complex media.

PMID- 1633996
TI  - X-irradiation- and carcinogen-induced proteins in cultured CHO cells.

PMID- 1633997
TI  - Identification of genes for the ethylene-forming enzyme and inhibition of
      ethylene synthesis in transgenic plants using antisense genes.

PMID- 1633998
TI  - Dye-mediated photodynamic inactivation of Bacillus subtilis.

PMID- 1633999
TI  - The role of calcium in the induction of apoptosis in human tumour cell lines.

PMID- 1634000
TI  - The regulatory role of zinc in apoptosis in human tumour cell lines.

PMID- 1634001
TI  - Sensitivity of protein phosphorylation in tobacco thylakoids to protein kinase C
      inhibitors and synthetic peptides.

PMID- 1634002
TI  - Control of cell division in plants.

PMID- 1634003
TI  - TNF-induced, cytotoxicity-linked IL6 gene expression in L929 cells may require
      factors other than NF-kappa B.

PMID- 1634004
TI  - Maltogenic alpha-amylase of Saccharomonospora viridis.

PMID- 1634005
TI  - Effects of phosphate on the binding of FMN and riboflavin by apoflavodoxin from
      Desulfovibrio vulgaris (Hildenborough).

PMID- 1634006
TI  - Apoptosis induced by Actinomycin D, Camptothecin or Aphidicolin can occur in all
      phases of the cell cycle.

PMID- 1634007
TI  - A Fasciola hepatica cathepsin L proteinase prevents the adherence of eosinophils
      to newly excysted juveniles.

PMID- 1634008
TI  - Purification and characterisation of a cysteine proteinase secreted by Fasciola
      hepatica.

PMID- 1634009
TI  - Patterns of exoprotein production in isolates of Staphylococcus schleiferi and
      Staphylococcus lugdunensis.

PMID- 1634010
TI  - Plasminogen activator inhibitor type 1 and 2 in human breast cancer.

PMID- 1634011
TI  - Specific immune detection and partial purification of G-proteins from Arabidopsis
      thaliana.

PMID- 1634012
TI  - Expression of auxin-responsive genes in soybean and transgenic tobacco.

PMID- 1634013
TI  - The forest, the trees and the anterior pituitary.

PMID- 1634014
TI  - Autoradiographic demonstration of in vivo 125I-growth hormone-releasing hormone
      (GHRH) binding by human GH-secreting pituitary adenomas transplanted on athymic
      nude mice.
AB  - This study was designed for the purpose of investigating a method for in vivo
      tumor labelling of human GH (hGH) secreting pituitary adenomas. Pituitary adenoma
      tissue removed from four acromegalic patients was transplanted into 62 athymic
      nude mice. After positive GHRH stimulation tests 125I-GHRH(1-44) NH2 was injected
      intravenously (i.v.) in ten nude mice. 10 min after 125I-GHRH injection, the nude
      mice were sacrificed, the transplants excised and prepared for light
      microscopical autoradiography. The mouse pituitary and skeletal muscle specimens
      served as controls. After the i.v. injection of 125I-GHRH we observed a marked
      accumulation of silver grains within the adenoma tissue indicating tumor
      labelling. This study is a first step in investigating a new method for labelling
      small residues of hGH secreting pituitary adenomas intraoperatively.

PMID- 1634015
TI  - Synergistic interaction of growth factors and albumin in regulating estradiol
      synthesis in breast cancer cells.
AB  - Estradiol 17 beta-hydroxysteroid dehydrogenase acts to convert estrone to the
      biologically active estrogen, estradiol, in breast tumors and MCF-7 breast cancer
      cells in vitro. In this study we have examined the ability of albumin to
      influence the effect of growth factors (insulin-like growth factor-I (IGF-I),
      epidermal growth factor (EGF), transforming growth factor-alpha (TGF alpha)) and
      cytokines (interleukin (IL)-1, IL-6) on estradiol 17 beta-hydroxysteroid
      dehydrogenase activity in MCF-7 cells. IGF-I (80 ng/ml) or albumin (30
      micrograms/ml) stimulated estradiol 17 beta-hydroxysteroid dehydrogenase activity
      by 144% and 102% (p less than 0.01). The combination of IGF-I and albumin,
      however, produced a marked (704%) synergistic stimulation of estradiol 17 beta
      hydroxysteroid dehydrogenase activity. EGF or TGF alpha failed to stimulate
      estradiol 17 beta-hydroxysteroid dehydrogenase activity and no synergism with
      albumin was detected. IL-1 (10 ng/ml), but not IL-6, also stimulated estradiol 17
      beta-hydroxysteroid dehydrogenase activity and acted synergistically with albumin
      to stimulate enzyme activity. MCF-7 cells were shown to specifically bind 125I
      albumin and binding is increased by pretreatment of cells with IGF-I (80 ng/ml)
      for 48 h. It is concluded that the synergism that results from treating MCF-7
      cells with albumin and IGF-I may result from increased albumin uptake and
      subsequent biological effect.

PMID- 1634016
TI  - The priming effect of luteinizing hormone-releasing hormone (LHRH) but not LHRH
      induced gonadotropin release, can be prevented by certain protein kinase C
      inhibitors.
AB  - The priming effect of LHRH in vitro (which results in increased responsiveness of
      gonadotropes to both LHRH receptor-mediated and receptor-independent stimuli) is
      brought about by an unknown mechanism. The present results indicate that
      induction of the LHRH priming effect is inhibited in a concentration-dependent
      manner by the protein kinase C (PKC) inhibitors staurosporine, K252a, H7 and by
      the novel highly-selective PKC inhibitor, Ro 31-8220. In contrast, a range of
      other compounds that are relatively selective inhibitors of other kinases such as
      tyrosine kinases and Ca2+/calmodulin-dependent kinases were unable to prevent
      priming. The PKC inhibitors prevented priming without affecting initial LHRH
      induced gonadotropin secretion. Thus, the priming-elicited increment in secretion
      was selectively removed, restoring hormone release to the level measured during
      an initial response to LHRH. Similar results were obtained on different days of
      the estrous cycle where the magnitude of the priming effect varies. Experiments
      on the time course of PKC inhibitor action revealed that the critical period was
      in the induction of the priming effect, not its expression. The PKC inhibitors
      had neither acute nor delayed effects on gonadotropin secretion induced by
      ionomycin. Staurosporine, K252a and Ro 31-8220 inhibited LHRH priming with
      identical potencies to their inhibition of phorbol ester-induced gonadotropin
      secretion. The reduced potency of H7 seen on LHRH priming compared to phorbol
      ester-induced gonadotropin release parallels results seen with this inhibitor on
      phorbol ester-induced secretion of growth hormone (Johnson and Mitchell (1989)
      Biochem. Soc. Trans. 17, 751-752) and on the pharmacological characteristics of
      PKCs partially purified from anterior pituitary tissue. In all aspects of this
      study, effects on luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
      secretion appeared to be entirely similar.

PMID- 1634017
TI  - Ovarian aromatase cytochrome P-450 mRNA levels correlate with enzyme activity and
      serum estradiol levels in anestrous, pregnant and lactating rats.
AB  - We examined the changes in P-450AROM mRNA, aromatase enzyme activity and serum
      estradiol levels (E2) in anestrous, pregnant mare's serum gonadotropin (PMSG)
      treated immature, pregnant, and lactating rats to determine if: (a) the various
      mRNA species encoding P-450AROM in rat ovarian tissue are differentially
      expressed during different hormonal states, and (b) a positive relationship
      exists between P-450AROM mRNA and enzymatic activity in rat ovarian tissue and
      serum estradiol levels from the same animals. Utilizing three different cDNAs
      encoding rat P-450AROM, levels of P-450AROM mRNA were determined by RNA blot
      analysis and scanning densitometry. Probe 1, a 5' probe, detects all three P
      450AROM mRNA species in rat ovarian tissue (i.e. at 1.7, 2.2 and 2.7 kb). Probe 2
      contains an unspliced intronic sequence in place of the heme-binding domain at
      its 3' terminus and thus the mRNA detected by this probe must encode a
      nonfunctional aromatase protein. Only the two smaller (i.e. nonfunctional) mRNA
      species at 1.7 and 2.2 kb are detected by probe 2. Probe 3 contains the heme
      binding region and hybridizes to principally the largest mRNA transcript at 2.7
      kb (but hybridizes also to a 1.7 kb mRNA transcript). Aromatase enzyme activity
      was measured by using a saturating concentration of [1 beta-3H]testosterone as
      substrate in the [3H]water-release assay while serum estradiol levels were
      determined by radioimmunoassay. In immature rats (IR) or lactating animals (LA) P
      450AROM mRNA was not detectable along with low serum estradiol (IR approximately
      2.8 pg/ml; LA approximately 0.2 pg/ml) and aromatase activity levels (IR
      approximately 0.8 pmol/h per mg protein; LA less than 0.5 pmol/h per mg protein).
      Anestrous animals treated with 5 IU of PMSG resulted in a clear increase (24 h
      later) in P-450AROM mRNA levels, in concert with a 4-fold increase in serum E2
      (approximately 12.5 pg/ml) and aromatase activity (approximately 4.2 pmol/h per
      mg protein). During pregnancy, all three mRNA species were clearly detectable,
      but low serum E2 levels (approximately 0.6 pmol/ml) and P-450AROM mRNA abundance
      were observed at 3 days of gestation (DG). Levels of all three P-450AROM mRNA
      species increased markedly at 15 and 18 DG; thereafter, the levels declined at 20
      DG and further decreased at 22 DG. However, regardless of the probe utilized
      (probe 1, 2 or 3) in the RNA blot analyses, the mRNA transcripts detected by each
      probe were expressed in a concerted fashion with respect to abundance and
      pattern.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1634018
TI  - Comparison of the biological and immunological properties of glycosylation
      deficient human chorionic gonadotropin variants produced by site directed
      mutagenesis and chemical deglycosylation.
AB  - Appropriate glycosylation of gonadotropins is essential for the full expression
      of their biological activity. In this investigation we have compared the
      properties of glycosylation deficient human chorionic gonadotropin (hCG) produced
      by chemical deglycosylation (HF treatment--DG-hCG) or recombinant techniques
      (site directed mutagenesis). Among the recombinant hCG molecules secreted into
      the culture medium, the following variants containing selective N-glycosylation
      deletions at delta alpha 1 or delta alpha 1,2 or in both subunits could not
      stimulate steroidogenesis in mouse Leydig tumor cells (MA-10 cell line) and in
      this respect were very similar to DG-hCG. The other variants were fully active
      like native hCG, but the alpha + delta beta 1,2 recombinant hCG was a partial
      agonist. In radioimmunoassay with antibodies against native hCG, the DG-hCG as
      well as all recombinant hCG variants, including the wild type (WT), were similar.
      However, with antisera against DG-hCG or affinity purified antibodies specific to
      DG-hCG the alpha/delta 1,2 beta mutant, the WT hormone and native hCG were less
      active. In this assay mutants containing N-glycosylation deletions in the alpha
      subunit as well as the delta alpha 1,2/delta beta 1,2, variant showed higher
      activity. A similar pattern was evident in reaction with a selected monoclonal
      antibody showing preferential binding of 125I-labeled DG-hCG (antagonist).
      Affinity purified antibody directed against native hCG conformation was
      successful in converting DG-hCG and some inactive glycosylation deficient
      variants into an active form by stimulating progesterone in MA-10 cells. These
      data suggest that there are similarities as well as subtle differences in
      conformation of DG-hCG and various recombinant hCG molecules.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1634019
TI  - Regulation of inhibin beta B-subunit mRNA expression in rat Sertoli cells:
      consequences for the production of bioactive and immunoreactive inhibin.
AB  - In Sertoli cells from 21-day-old rats, the expression of the mRNA encoding the
      alpha-subunit of inhibin, and the production of immunoreactive inhibin are
      stimulated by follicle-stimulating hormone (FSH). In contrast, the amount of beta
      B-subunit mRNA is not increased after FSH treatment of the cells, and the ratio
      between bioactive and immunoactive inhibin decreases after stimulation with FSH.
      These data suggest that the beta B-subunit is the limiting factor in the
      production of bioactive inhibin. The aim of the present experiments was to
      investigate the effect of changes in the amount of beta B-subunit mRNA on the
      production of bioactive and immunoreactive inhibin. During early postnatal
      testicular development, the relative amounts of the 4.2 kb and 3.5 kb mRNAs
      encoding the beta B-subunit of inhibin changed markedly. The meaning of this
      changing ratio between beta B-subunit mRNAs is not clear, since both mRNAs are
      actively translated, as demonstrated by polysomal analysis. The total amount of
      beta B-subunit mRNA correlated with the in vitro production of bioactive inhibin
      as published earlier. Prolonged stimulation of cultured Sertoli cells from 14-day
      old rats with 4 beta-phorbol 12-myristate 13-acetate (PMA) caused a decreased
      expression of the beta B-subunit mRNAs, presumably by down-regulation of protein
      kinase C. A similar effect was obtained after addition of the calcium ionophore
      A23187. Concomitantly, a decreased production of bioactive inhibin was observed.
      Furthermore, Western blotting revealed that secretion of the 32 kDa inhibin alpha
      beta-dimer was decreased, whereas secretion of the combination of the C-terminal
      part with the pro-region of the alpha-subunit was increased. It is concluded that
      the level of the beta B-subunit of inhibin is rate-limiting for the production of
      bioactive inhibin in cultured Sertoli cells, and that its expression can be
      influenced by modulation of protein kinase C, and/or intracellular calcium
      levels.

PMID- 1634020
TI  - Selections from current literature: treatment of hypertension.
AB  - The three papers reviewed for this issue deal with unrelated aspects of
      hypertension, illustrating the broad range of questions that still exist about
      optimal diagnosis and management. Physicians have for years been unsure about the
      efficacy, safety, and impact on morbidity of treating ISH. The result of these
      concerns has been that many, if not most patients with ISH never received
      treatment. The SHEP data are a powerful argument for routine treatment of ISH,
      which would represent a new standard of care for this condition. Only clinical
      experience and future trials will indicate whether treatment of ISH in the
      general population will be accompanied by the low incidence of side effects and
      morbidity observed in the more highly selected population of the SHEP trial. The
      study of Zeller et al. adds to the evidence that less is more, or at least the
      same, when it comes to treatment of hypertensive urgencies. The practice of oral
      'loading' doses was not shown to improve therapeutic results. It is still not
      completely clear what criteria physicians should use in making a decision about
      inpatient parenteral therapy versus outpatient oral therapy. In patients with
      evidence of acute onset and end-organ injury, it is probably prudent to admit. In
      the absence of these risk factors, institution of an outpatient oral
      antihypertensive regimen can probably be accomplished with safety and at
      dramatically lower cost. The study of Koren et al. demonstrated a marked
      additional risk when LVH was present in hypertensive patients.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1634021
TI  - Chronic illness in the community and the concept of 'social prevalence'.
AB  - General practice is an important source of information on the occurrence and
      distribution of chronic disease in the population. In this study, the burden of
      chronic illness was expressed as different indices of prevalence. Data were
      provided by 42 general practitioners in 15 computerized practices, collaborating
      in the Registration Network Family Practices of the University of Limburg in the
      Netherlands. Morbidity data concerning the actual health status of 25,357
      subjects, as recorded by their GPs, were classified following the International
      Classification of Primary Care using the diagnostic criteria of the International
      Classification of Health Problems in Primary Care-2-Defined. The most frequent
      single disease was asthma (3.5%), while locomotor problems represented the most
      prevalent category (8.3%). The overall prevalence of chronic disease was 29.4%,
      with a clear positive correlation with age and, to a lesser extent, with a lower
      educational level. The 'social prevalence' of chronic illness (including
      individuals related to chronically diseased patients via their households) could
      be measured in a subset of the database (n = 4577), and amounted to 56%. It is
      concluded that the role of the GP as a family doctor involved with chronic
      disease concerns the majority of the general population.

PMID- 1634022
TI  - The general practitioner and laboratory utilization: why does it vary?
AB  - In a study of the practice patterns of 128 general practitioners in Northern
      Norway information concerning 6848 surgery consultations was registered. The
      ordering of haemoglobin and sedimentation tests was noted as well as urinalyses,
      forwarding of biological specimens (blood, urine, smears, etc) to other
      laboratories, and referrals for X-ray examinations. The extent to which doctors
      ordered these tests varied widely (haemoglobin 0-72% of encounters, urinalyses 0
      70%, forwarding of tests 0-56%). Fee-for-service doctors ordered urine microscopy
      more frequently than did their salaried colleagues, but the ordering of
      haemoglobin or sedimentation test, and the forwarding of biological samples was
      about the same. Female and older doctors as well as doctors trained in Norway
      tended to request tests more often. Laboratory utilization was higher in
      municipalities with a high turnover of doctors, but the doctors' years of
      postgraduate experience per se did not affect the extent of test ordering. Tests
      were requested more often for female patients and with increasing age of the
      patient. However, only 10% of the variation in laboratory utilization was
      explained by the variables used in the analyses. This may imply that the medical
      condition at hand is the strongest determinant of test ordering behaviour.

PMID- 1634023
TI  - Diagnostic impact of the erythrocyte sedimentation rate in general practice: a
      before-after analysis.
AB  - Despite its frequent use and long history, little is known about the diagnostic
      impact of the measurement of the erythrocyte sedimentation rate (ESR) in general
      practice. We prospectively followed 362 patients who were seen by their general
      practitioner (GP) because of a new complaint, for which the GP wanted to know the
      ESR. The GPs recorded the most probable diagnosis, as well as their clinical
      judgements in terms of 'severe' and 'not severe', and the expected ESR values,
      before and after the determination of the ESR in the local hospital laboratory.
      Having compared the results before ESR determination with the results after, we
      conclude that ESR is valuable in reassuring the patient and the doctor when 'no
      pathology' is suspected rather than in confirming the presence of inflammatory
      diseases and malignancies.

PMID- 1634024
TI  - Continuity of care: general practitioners' knowledge about, and sense of
      responsibility toward their patients.
AB  - The aim of the present study was to examine the relations between continuity of
      care and the general practitioners' accumulated knowledge about their patients. A
      further objective was to evaluate the link between continuity of care and the
      doctors' sense of medical responsibility towards the patients. Emphasis was
      placed on the chronological, or longitudinal component of continuity of care. In
      a cross-sectional record study a representative sample of 133 Norwegian general
      practitioners each registered 30 consecutive consultations. Two aspects of
      longitudinal care were recorded: the duration of the patient-doctor relationship,
      measured as time from the first visit to the present, and the density, measured
      as the number of consultations (office or home visits) within the last 12 months.
      The physicians subjectively evaluated their accumulated knowledge about the
      patient's medical history, personality, and social network, on multinomic scales.
      Their sense of medical responsibility was indicated as one of three alternatives.
      Of 3990 possible recordings, 3918 (98%) were evaluated. In about one-third of all
      encounters the doctors reported extensive knowledge about their patients. It took
      at least one, and often 5 years, or at least 4-5 visits last year, to create such
      an extensive knowledge base. The physician's sense of responsibility increased
      more rapidly, and to a higher degree with the density of visits, than with
      duration of the relationship. The findings indicate firm links between
      longitudinal care and accumulated knowledge, and between longitudinal care and
      the doctors' sense of responsibility towards their patients.

PMID- 1634025
TI  - Factors associated with the decision to refer patients with anxiety disorders or
      sexual dysfunction.
AB  - The decision to refer patients to outside agencies is a complex one, seemingly
      related to patient, doctor and practice variables. Although there is a wide
      variation in referral rates between doctors, attempts to specify relevant
      demographic characteristics have been largely unsuccessful. The present study
      involves an examination of the factors which general practitioners report would
      affect their decision to refer, or not refer, patients portrayed in four case
      studies, two with anxiety disorders and two with sexual dysfunction. The results
      suggest that very different variables may be relevant for apparently similar
      conditions. The factor which most consistently distinguished between frequent and
      infrequent referers was the time they believed was required for treatment, but
      perceived responsibility for treatment was also important. Seventy per cent of
      the variance in referral decisions for sexual dysfunction but only 26% of the
      variance for anxiety disorders was accounted for by such variables as perceived
      expertise, time required for treatment and confidence in agencies. Demographic
      factors, such as age and level of training, were not associated with referral
      behaviour. Suggestions for further research, especially to do with the processes
      involved in decision making, are outlined.

PMID- 1634026
TI  - Determinants of maternal tolerance of vaccine-related risks.
AB  - In a time when informed consent requires knowledge of the risks and benefits of
      medical care and technology to be communicated to the public, perceptions of
      benefits and risks of these techniques and procedures take on special importance.
      The purpose of the present study was to examine the determinants of maternal
      tolerance of vaccine-related side-effects in their children. A questionnaire was
      sent to 226 mothers of young children in southwestern Ontario seeking their
      opinion of the benefits and risks of selected medical procedures. It asked them
      to identify the risk of serious reactions they would tolerate for a new vaccine
      with benefits similar to that of pertussis vaccine. The response rate to the
      questionnaire was 92%. This group of young, well-educated mothers had high regard
      for some of the most common procedures and treatments used in family practice.
      The less common and more invasive procedures (heart surgery, brain surgery) were
      viewed as carrying almost as much risk as benefit. Abortion was perceived as
      involving more risk than benefit. Levels of acceptable risk with respect to a
      hypothetical new childhood vaccine were determined. A risk level of 1 in 1
      million was the most popular level of acceptable risk, chosen by 25% of the
      respondents. The next most frequently chosen risk level was 1 in 100,000, chosen
      by 22%. Tolerance of possible vaccine side-effects did not differ with maternal
      age, education or prior experience with adverse vaccine or drug reactions. A
      summary net benefit score was derived for four technologies commonly used in
      family practice (antibiotics, vaccinations, birth control pills and X
      rays).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634027
TI  - Risk management in the community: lessons for family medicine.
AB  - Three polyurethane factories in Israel were examined using a combination of
      qualitative and quantitative methodologies. The study contrasts the effects of
      differing factory social and economic organization on occupational health and
      safety conditions as well as workers' attitudes and awareness. The central focus
      of the research addresses how each factory and community manages the risks
      associated with a particular industrial process. Surprisingly, the results show
      that the worker-owned and -operated plant, where knowledge and control of hazards
      was broadly shared and awareness high, had the worst safety, health, and hygiene
      conditions and outcomes. Worker involvement does not ensure worker protection and
      safety. These findings can be explained only by a careful examination of the
      social, economic, cultural and environmental settings in which they are embedded.
      Such an approach is well suited to family medicine research and training since it
      emphasizes the role of context on illness and disease.

PMID- 1634028
TI  - Life after divorce--a five-year follow-up study of divorced middle-aged men in
      Sweden.
AB  - Twenty-seven men, between 35 and 49 years of age, were asked via a questionnaire
      for information about their life circumstances (housing and working conditions,
      economic situation), actual symptoms, perceived health and health-related
      behaviour 5 years after they had divorced. The information was compared to
      corresponding data from an earlier study carried out within 7 months after the
      legal divorce. Housing conditions and personal economy had improved and working
      conditions were still satisfactory. Perceptions of health were more positive and
      in particular earlier, frequently recorded psychological symptoms (uneasiness,
      anxiety, depression) had diminished. Alcohol and smoking habits remained
      unchanged and common, especially among manual workers with more than one divorce.
      Men living in a stable relationship with a new partner or who had custody of
      children had fewer social and medical problems than men living alone. These
      findings support the connection between social support and health.

PMID- 1634029
TI  - Doctors' interviewing technique and its response to different booking time.
AB  - There is a burgeoning literature on communication in general practice. It is
      often assumed that trained GPs know and practice the techniques described, but
      that time is a major constraint. In two experimental studies patients were given
      shorter or longer appointments, and the doctors' use of different verbal
      interventions was measured. Our analysis focused on how individual doctors varied
      in their use of interviewing techniques according to the time available. When
      more time was available some interventions were used more frequently by all
      doctors, but for other interventions the response was variable. For example, GPs
      who normally used facilitation frequently used it more often when greater time
      was available, whereas doctors who used this technique less frequently tended not
      to change when more time was available. This suggests that, at least in the short
      term, there is a differential response to changes in the time available in the
      consultation, with increased time being a necessary but not sufficient condition
      to promote the greater use of the communication techniques which doctors use less
      frequently.

PMID- 1634030
TI  - What can doctors do to achieve a successful consultation? Videotaped interviews
      analysed by the 'consultation map' method.
AB  - Positive consultations, where both the GP and the patient had a positive
      impression, were compared with negative consultations, where both the GP and the
      patient had a negative impression. The consultations were compared with respect
      to tasks listed by Pendelton et al. in their 'consultation map', constituting
      satisfying and efficient consultation. The determining points in the positive
      consultations were that the GP and the patient were in agreement about the reason
      for the consultation and that the GP asked about the patients' ideas and concerns
      or health beliefs. In consequence, the GP used more time to achieve a share
      understanding with the patient and involved the patient in the management. This
      last point seemed to be the most discriminating between the positive and the
      negative consultations.

PMID- 1634031
TI  - Worry: a particular determinant of consultation illuminated.
AB  - In this study, exploring the worry experienced by patients in the GP waiting room
      and the reasons for being worried, 791 patients completed a structured
      questionnaire just before they consulted their GP, and afterwards. The
      perceptions of the patients concerning the complaint and the need for more
      information about the complaint played an important role in the degree of worry.
      Patients who wanted more information about the complaint were more worried than
      the patients who did not feel they needed more information. Not surprisingly, the
      more serious the patients perceived the complaint to be and the greater the
      perceived chance of serious disease, the more worried they were. General health
      status and frequency of consultations per year were related to the degree of
      general worry. According to the patient self-reports, worry was almost never due
      to information from the mass media or from other persons, or to a concern for the
      consultation itself. Patients generally evaluated the consultation as positive
      with respect to the way their worry was discussed. The decrease in worry after
      consulting the GP, in patients who were positive about the consultation was
      significantly higher than that in patients who were less positive. The
      theoretical and practical implications of this study are discussed.

PMID- 1634032
TI  - Patient satisfaction and the detection of psychiatric morbidity in general
      practice.
AB  - This study explores the relationship between the detection of psychiatric illness
      during general practice consultations and patient satisfaction. Psychiatric
      illness was defined as a score of greater than or equal to 3 on the 12-item
      General Health Questionnaire (GHQ-12). The hypothesis was that patient
      satisfaction would be higher after consultations during which psychiatric illness
      was correctly identified by the GP than after those during which it was 'missed'.
      Two hundred and twenty two patients attending seven doctors at one inner London
      practice participated. One hundred and ten patients (50%) scored greater than or
      equal to 3 on the GHQ-12. The GPs classified 76 of these 110 patients as having a
      psychiatric component to their illness and 34 as having an entirely physical
      illness. Only one significant difference in satisfaction was found between these
      two groups--patients in whom psychiatric illness was correctly identified
      reported more benefit from the consultation than patients in whom psychiatric
      illness was present but 'missed'. Possible explanations for the largely negative
      findings are discussed including the difficulties of measuring patient
      satisfaction and the distinction between detection and management of psychiatric
      illness in general practice.

PMID- 1634033
TI  - Research training for general practitioners: an experiment in The Netherlands.
AB  - One of the great problems in the field of primary health care research is the
      lack of qualified general practice researchers. The same is true for General
      Practitioners working in the University Departments of General Practice.
      Therefore the Department of General Practice at the University of Limburg in
      Maastricht in the Netherlands, developed a one-year research training programme
      for young General Practitioners. The aim was to provide a sufficient number of
      trained and qualified staff members in primary health care research for the
      various University Departments of General Practice. This article describes the
      main ideas behind this training course, as well as its contents and
      characteristics.

PMID- 1634034
TI  - Qualitative research and family practice: a marriage made in heaven?
AB  - Recent years have seen the development of interest in the usefulness of
      qualitative methods in family practice research. This paper shows how the
      underlying concerns of family practice medicine parallel those of the qualitative
      research tradition. After contrasting the philosophical underpinnings of both
      quantitative and qualitative methods, we go on to describe the methodological
      commitments of qualitative research. We relate this emerging debate within family
      practice to that which has taken place in other disciplines, particularly that of
      education. We discuss the relative strengths of qualitative and quantitative
      methods, and argue that these two traditions have complementary contributions to
      make to the discipline of family practice medicine.

PMID- 1634035
TI  - Patient perceptions of continuity of care: is there a socioeconomic factor?
AB  - This study aimed to assess perceptions of continuity of care by patients from
      different socioeconomic areas using focus group interviews augmented by postal
      replies. Patients were randomly selected from two contrasting primary medical
      care locations: a middle class suburb and a less affluent suburb in Adelaide,
      South Australia. The Ethnograph was used to analyse the content of the interviews
      and postal responses. Analysis used the framework described by Curtis and Rogers
      in the USA and Freeman in the UK. The response rate was much lower from the lower
      socioeconomic group (5% focus group; 20% when postal replies included). They
      emphasized access factors and importance of records, and alleged situations where
      they were taken too casually and their problems were not dealt with. Those from
      the middle class area (response rate 25%) emphasized interpersonal ('art of
      care') factors and were more likely to use their presenting problem as a
      criterion to decide whether they needed to postpone the problem to a time when
      they could see their personal doctor. Focus groups can be useful evaluation tools
      in general practice, but oversampling of lower socioeconomic groups is needed.
      Continuity of care should be considered as an aid to consistent quality of care,
      rather than its essence. Well controlled intervention-outcome studies in
      different types of practice organization in differing socioeconomic situations
      will increase our understanding of continuity of care.

PMID- 1634036
TI  - Goals and methods of research: the challenge for family medicine.
AB  - This article suggests that motivations to engage in research, as in any other
      human activity, are both explicit and implicit. Explicit motivations tend to be
      objective and rationalist, concerned with such goals as the advancement and
      organization of knowledge. But implicit motivations, the 'hidden agendas' of
      research, also exist and can influence the objectives, methods, and conclusions
      of the research process. In addition, a highly affectively charged activity such
      as research also develops its own set of symbolic meanings, which further
      complicate its various expressions. In this article, three such symbolic meanings
      are identified: purpose and seriousness; maturity and adulthood; and legitimacy
      and belonging. The article highlights qualitative research as a methodology
      compatible with much of family medicine's philosophy and theoretical foundations;
      and discusses the role of behavioural scientists in participating in a research
      agenda for the field. The article concludes with a plea for the discipline of
      family medicine to opt for authenticity in research, rather than settling for a
      superficial legitimacy in the eyes of other medical specialties.

PMID- 1634037
TI  - Turning anecdotes into data--the critical incident technique.
AB  - This article describes the critical incident technique and offers practical
      guidance on how the technique can be used to investigate dilemmas in medicine. It
      extols the particular virtue of this research method for general practice that it
      can be used to exploit the natural tendency of doctors to tell anecdotes. How the
      principles of the technique relate to significant event analysis, a form of
      medical audit, is also discussed.

PMID- 1634038
TI  - A revolution in medicine like no other.

PMID- 1634039
TI  - Molecular biology: impact on human disease.

PMID- 1634040
TI  - Assessing the underlying pattern of human germline mutations: lessons from the
      factor IX gene.
AB  - Germline mutations cause or predispose to most disease. Hemophilia B is a useful
      model for studying the underlying pattern of recent germline mutations in humans
      because the observed pattern of mutation in factor IX more closely reflects the
      underlying pattern of mutation than the observed pattern for many other genes. In
      addition, it is possible to identify and correct for biases inherent in
      ascertaining only those mutations that cause hemophilia. Aspects of the pattern
      of germline mutation in the factor IX gene are becoming clear: 1) in the United
      States, two-thirds of mutations causing mild disease arose from three founders
      whereas almost all the mutations resulting in either moderate or severe disease
      arose independently, generally within the past 150 years; 2) direct estimates of
      the rates of mutation in humans indicate that transitions are more frequent than
      transversions, which in turn are more frequent than deletions and insertions; 3)
      transitions at CpG are elevated approximately 24-fold relative to transitions at
      non-CpG dinucleotides; 4) transversions at CpG are elevated approximately
      eightfold relative to transversions at non-CpG dinucleotides; 5) the sum total of
      the dinucleotide mutation rates produces a bias against G and C bases that would
      be sufficient to maintain the G+C content of the factor IX gene at its
      evolutionarily conserved level of 40%; and 6) the pattern of mutation is similar
      for Caucasians residing in the United States and for Asians residing in Asia. Two
      ideas emerge from this and from an analysis of the pattern of recent deleterious
      mutations compared with ancient neutral mutations that have been fixed during
      evolution into the factor IX gene. First, the bulk of germline mutations are
      likely to arise from endogenous processes rather than environmental mutagens.
      Second, the factor IX protein is composed mostly of two classes of amino acids:
      critical residues in which all single-base missense changes will disrupt protein
      function, and "spacer" residues in which the precise nature of the residue is
      unimportant but the peptide bond is necessary to keep the critical residues in
      register. More work is necessary to assess the veracity and generality of these
      ideas.

PMID- 1634041
TI  - Leber's hereditary optic neuropathy: a model for mitochondrial neurodegenerative
      diseases.
AB  - A number of human diseases have been attributed to defects in oxidative
      phosphorylation (OXPHOS) resulting from mutations in the mitochondrial DNA
      (mtDNA). One such disease is Leber's hereditary optic neuropathy (LHON), a
      neurodegenerative disease of young adults that results in blindness due to
      atrophy of the optic nerve. The etiology of LHON is genetically heterogeneous and
      in some cases multifactorial. Eleven mtDNA mutations have been associated with
      LHON, all of which are missense mutations in the subunit genes for the subunits
      of the electron transport chain complexes I, III, and IV. Molecular, biochemical,
      and population genetic studies have categorized these mutations as high risk
      (class I), low risk (class II), or intermediate risk (class I/II). Class I
      mutations appear to be primary genetic causes of LHON, while class II mutations
      are frequently found associated with class I genotypes and may serve as
      exacerbating genetic factors. Different LHON pedigrees can harbor different
      combinations of class I, II, or I/II mtDNA mutations, as shown by the complete
      sequence analysis of the mtDNAs of four LHON probands. The various mtDNA
      genotypes included an isolated class I mutation, combined class I+II mutations,
      and combined class I/II+II mutations. The occurrence of such genotypes supports
      the hypothesis that LHON may result from the additive effects of various genetic
      and environmental insults to OXPHOS, each of which increases the probability of
      blindness.

PMID- 1634042
TI  - Genetic factors in the etiology and pathogenesis of autoimmunity.
AB  - Family and population studies indicate that several different genes can increase
      susceptibility to autoimmune diseases. Established genetic risk factors include
      genes encoding histocompatibility molecules, complement proteins,
      immunoglobulins, peptide transporter proteins, and genes controlling the
      production of sex hormones. Each factor may independently enhance the
      immunogenicity of autoantigens, either by increasing their processing and
      presentation by B lymphocytes and macrophages or by increasing the chance for
      recognition by autoreactive T and B lymphocytes. Genetic factors may also
      influence immune responses to infectious agents that can trigger autoimmunity.
      Because of the somatic generation of immune diversity, genetically identical
      individuals have different immune systems. The ability of genetic diagnosis to
      predict autoimmune disease in outbred populations cannot easily exceed the
      disease concordance rates in monozygotic twins, which usually are less than 50%.
      However, genetic diagnosis can target populations that should be monitored for
      serologic evidence of autoimmunity, which may precede clinical signs and
      symptoms. In the future, it may be possible to match different forms of
      immunotherapy with specific genetic defects.

PMID- 1634043
TI  - The diffusion of new genetic tests for predicting disease.
AB  - This paper examines the pathways by which new genetic tests will become available
      to the public. In view of the scarcity of genetic specialists, the pathway is
      likely to involve primary care physicians. Other pathways entail state-mandated
      testing, community-based programs, or testing by laboratories without much
      involvement of primary care physicians. When testing does become available the
      "destination" will be either family-centered testing or population-oriented
      screening. The deterrent to screening will not be the inability to detect disease
      causing mutations but the costs and attitudes of providers and the public. When
      tests are provided primarily to provide information about risks to future
      children, some people will oppose screening on religious or moral grounds. When
      there are no inexpensive treatments, some will fear that insurance companies and
      employers will use tests to deny them health care coverage. Some may not want to
      know their risks for disorders about which little can be done. For common,
      multifactorial disorders, genetic tests will have low predictive value. Because
      of these problems, the decision to be tested, regardless of the destination,
      requires that "testees" be fully informed and consent to testing. When acceptance
      rates are low, screening is less likely to be cost-effective; family-centered
      testing becomes the default destination.

PMID- 1634044
TI  - Ethical implications of screening asymptomatic individuals.
AB  - There has been a long-standing consensus on the principles that should guide
      screening asymptomatic individuals whether for treatment, counseling, or
      research. Advances in molecular biology will increase the rate of new
      opportunities for such screening. The benefits and risks, for individuals as well
      as the public health, will vary with each new test. As with all new technologies,
      these benefits and risks will have to be assessed in well-designed and well
      reviewed studies if individuals are to be allowed to make informed decisions
      regarding whether or not to be tested.

PMID- 1634045
TI  - The recombinant congenic strains for analysis of multigenic traits: genetic
      composition.
AB  - The genetic control of susceptibility to many common diseases, including cancer,
      is multigenic both in humans and in animals. This genetic complexity has
      presented a major obstacle in mapping the relevant genes. As a consequence, most
      geneticists and molecular biologists presently focus on "single gene" diseases.
      To make the multigenic diseases accessible to genetic and molecular analysis, we
      developed a novel genetic tool, the recombinant congenic strains (RCS) in the
      mouse (4). The RC strains are produced by inbreeding of mice of the second
      backcross generation between two inbred strains, one of which serves as the
      "donor" and the other as the "background" strain. A series of RCS consists of
      approximately 20 strains, each carrying a different set of genes: approximately
      12.5% genes from the common donor inbred strain, the remaining 87.5% from the
      common background inbred strain. As the set of donor strain genes in each RC
      strain is different, the nonlinked genes of the donor strain involved in the
      control of a multigenic trait, e.g., cancer susceptibility, become distributed
      into different RC strains where they can be analyzed one by one. Hence, the RCS
      system transforms a multigenic trait into a series of single gene traits, where
      each gene contributing to the multigenic control can be mapped and studied
      separately. Recently we demonstrated that the RCS system is indeed capable of
      resolving multigenic traits, which are hardly analyzable otherwise, by mapping
      four new colon tumor susceptibility loci (8; P. C. Groot, C. J. A. Moen, W.
      Dietrich, L. F. M. van Zutphen, E. S. Lander, and P. Demant, unpublished
      results). For successful application of the RCS system, extensive genetic
      characterization of the individual recombinant congenic strains is essential. In
      this paper we present detailed information about the genetic composition of three
      series of RC strains on the basis of typing of 120-180 markers distributed along
      all autosomes. The data indicate that the relative representation of the donor
      strain genes in the RC strains does not deviate from the theoretical expectation,
      and that the RC strains achieved a very high degree of genetic homogeneity and
      for all practical purposes can be considered inbred strains. The density and
      distribution of markers reported here permits an effective mapping of unknown
      genes of donor strain origin at almost all autosomal locations. Much of this
      information has been obtained using the new class of genetic markers, the simple
      sequence repeat polymorphisms.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1634046
TI  - Immune tolerance to a defined heterologous antigen after intrasplenic hepatocyte
      transplantation: implications for gene therapy.
AB  - Development of a host immune response against gene products expressed by
      genetically modified cells could be a serious limitation for gene therapy. During
      examination of whether site-specific differences in antigen presentation could
      regulate the host immune response, we observed an absence of antibodies against
      hepatitis B virus surface antigen (HBsAg) when HBsAg producing transgenic
      hepatocytes were transplanted into the spleen. Intrasplenic transplantation
      resulted in translocation of a large number of cells into the portal vascular bed
      and liver sinusoids. In these recipients, HBsAg secreted by the transplanted
      hepatocytes circulated indefinitely in the blood. In contrast, subcutaneous or
      intraperitoneal transplantation of the transgenic hepatocytes induced an anti-HBs
      response, followed by clearance of serum HBsAg. Rechallenge with HBsAg in a
      highly immunogenic form failed to break the tolerance in intrasplenic hepatocyte
      recipients even though these animals responded to another antigen (keyhole limpet
      hemocyanin). Immunization with HBsAg in intraperitoneal recipients of HBsAg
      producing hepatocytes further elevated anti-HBs titers. Our results indicate that
      hepatocyte transplantation into the portal vascular bed via injection into the
      spleen can confer immune tolerance to secreted heterologous antigens. This
      finding should have important implications for human gene therapy as well as for
      analyzing the mechanisms of immune tolerance.

PMID- 1634047
TI  - Dynamic changes in HIV-1 quasispecies from azidothymidine (AZT)-treated patients.
AB  - The emergence of azidothymidine (AZT)-resistant human immunodeficiency virus
      (HIV) variants in clinical samples was studied by a direct genomic sequencing
      method. Sequential lymphocyte samples from four patients, who had been treated
      with AZT for up to 27 months, were shown to gradually accumulate multiple
      nucleotide changes, some of which are known to be associated with AZT resistance.
      Several samples were shown to contain mixtures of wild-type and mutated genomes,
      indicating gradual rather than sudden changes in the HIV-1 quasispecies. These
      results demonstrate for the first time that automated solid-phase DNA sequencing
      is a rapid and useful tool for investigation of antiviral drug resistance and
      suggest that DNA sequencing may be important in routine clinical diagnostics in
      the future.

PMID- 1634048
TI  - Ataxia-telangiectasia: linkage analysis of chromosome 11q22-23 markers in Turkish
      families.
AB  - To further pinpoint the location of the genes for ataxia-telangiectasia on the
      long arm of chromosome 11, we performed linkage analysis and analysis of
      recombinants of genetic haplotypes on 14 Turkish families with ataxia
      telangiectasia, 12 of which were consanguineous. These studies used more than 25
      polymorphic genetic markers spanning a region of the long arm of chromosome 11
      that is larger than 50 cM. Seven markers gave significant LOD scores to AT: CJ5,
      DRD2, CJ208, S144, CD3E, PBGD, and S147, as did haplotypes created with pairs of
      markers DRD2/CJ5 and S144/CJ208, giving recombination fractions (theta) of 0.00,
      0.00, 0.05, 0.08, 0.03, 0.09, 0.07, 0.00, and 0.06, respectively. Monte Carlo
      analysis of these 14 Turkish families indicated the best location for a single AT
      gene to be within a 6 cM sex-averaged (3 cM male-specific) interval defined by
      STMY and CJ77; this was three times more likely than the next most likely
      location (peak III) at the DRD2 locus. The analysis also revealed a peak (peak
      II) between S147 and S133, which may represent the complementation group D gene.
      Recombinant analysis of haplotypes also localized an AT locus to the STMY-CJ77
      interval. Taken together, these results suggest that at least two distinct AT
      loci exist (ATA and ATD) at 11q22-23, with perhaps a third locus, ATC, located
      very near to the ATA gene. This genetic heterogeneity further complicates plans
      to isolate the major ATA and ATC genes and to begin identifying AT carriers in
      the general population.

PMID- 1634049
TI  - Intrathymic implants of genetically modified fibroblasts.
AB  - Implantation of autologous rodent fibroblasts genetically altered to express
      human growth hormone has recently been shown to be a feasible approach to the
      delivery of new gene products in somatic gene therapy. However, the novel gene
      product elicited in its recipients an intense antibody response that would have
      curtailed the effectiveness of such therapy. The possibility of inducing
      tolerance to foreign gene product was explored by implanting allogeneic
      fibroblasts transfected with the human growth hormone gene into rat thymus, a
      site recently shown to be immunologically privileged and able to induce donor
      specific tolerance to transplanted tissues. In the circulation of the implanted
      rats, human growth hormone was detected at 4-15 ng/ml serum within the first day
      and subsided to 0.6-9 ng/ml within the first wk in all animals implanted either
      thymically or intraperitoneally. Within 2-3 wk, high titers of anti-human growth
      hormone were detected in all animals regardless of the site of implantation. The
      failure of the thymus to offer immune protection for the foreign antigen was
      further confirmed when the animals were subsequently challenged with purified
      human growth hormone. An immediate twofold increase in titer within the first
      week of challenge was detected in animals previously implanted thymically. In
      contrast, animals implanted intraperitoneally but treated with short-term daily
      injection of cyclosporine A (28-41 days) did not mount any significant antibody
      response to human growth hormone throughout the experiment or even when
      challenged subsequently at weeks 8-10 with purified growth hormone. In
      conclusion, implantation of genetically modified fibroblasts in the thymus does
      not lead to tolerization toward soluble novel gene product secreted by these
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634050
TI  - Mechanisms of inherited deficiencies of multiple UDP-glucuronosyltransferase
      isoforms in two patients with Crigler-Najjar syndrome, type I.
AB  - Crigler-Najjar syndrome, type I (CN-I) is a potentially lethal disorder
      characterized by severe unconjugated hyperbilirubinemia resulting from a
      recessively inherited deficiency of hepatic UDP-glucuronosyl-transferase (UGT)
      activity toward bilirubin (B-UGT). Two forms of B-UGT exist in human liver. mRNAs
      for these two forms and that for another isoform with activity toward simple
      phenols (P-UGT) have unique 5' regions, but their 3' regions are identical. The
      three mRNA species are derived from a single locus; the unique 5' regions are
      encoded by single unique exons and the identical 3' regions consist of four
      consecutive exons that are shared by all three isoforms. In this paper, we
      determined genetic lesions in two CN-I patients with deficiency of hepatic B-UGT
      and P-UGT activities. In one patient, there was a C----T substitution in exon 4
      (common region) predicting the substitution of a serine residue with a
      phenylalanine residue; this mutation was present in the identical region of B-UGT
      and P-UGT mRNAs. In the other patient, a C----T substitution in exon 2 (common
      region) of the B-UGT/P-UGT locus resulted in a premature stop codon. This exon
      (132 nt) was absent in heptic B-UGT and P-UGT mRNAs of this patient due to exon
      skipping during pre-mRNA processing. Sequence abnormality of three distinct mRNA
      species explains the abnormality of multiple UGT isoforms in these patients.
      Presence of identical abnormalities in the common regions of the three mRNAs is
      consistent with the finding that the common 3' regions of the two B-UGT mRNAs and
      the P-UGT mRNA are encoded by four shared exons.

PMID- 1634051
TI  - Genetics 50 years ago.

PMID- 1634052
TI  - On the use of color slides.

PMID- 1634053
TI  - Effects of radiation on humans during prolonged spaceflight.

PMID- 1634054
TI  - Oral 5-aminosalicylic acid (Asacol) in the maintenance treatment of Crohn's
      disease. The Italian IBD Study Group.
AB  - A randomized, placebo-controlled multicenter trial was conducted to evaluate the
      efficacy and safety of a delayed-release formulation of 5-aminosalicylic acid (5
      ASA) (Asacol; Giuliani & Bracco, Milan, Italy) for prevention of clinical relapse
      in 125 patients with inactive Crohn's disease. Patients in remission [Crohn's
      Disease Activity Index (CDAI) less than 150] between 3 months and 2 years were
      randomly allocated to receive either 800 mg 5-ASA three times daily (n = 64) or
      placebo (n = 61) for up to 12 months or until relapse of symptoms. Relapse was
      defined by a CDAI greater than 150, with a minimum increase of 100 points over
      the baseline value. The cumulative relapse rates were 12% in the 5-ASA group and
      22% in the placebo group at 3 months [95% confidence interval (CI) for the
      difference, -4 to 24]; 28% and 41%, respectively, at 6 months (95% CI, -4 to 30);
      and 34% and 55%, respectively, at 12 months (95% CI, 3-39; P = 0.02, log rank
      test). Significant decrease in the risk of relapse was found in patients with
      ileitis, in those with previous bowel resection and, in those with prolonged
      prestudy remission. Eight patients (5 on 5-ASA, 3 on placebo) withdrew from the
      study because of adverse reactions, but no major clinical or laboratory adverse
      effect was observed. It is concluded that oral 5-ASA coated with Eudragit S (Rohn
      Pharma GmbH, Wieterstadt, Germany), 2.4 g daily, is safe and seems superior to
      placebo in preventing or delaying clinical relapse in Crohn's disease, especially
      in milder cases and in ileal disease.

PMID- 1634055
TI  - Measurement of gastric emptying by magnetic resonance imaging in humans.
AB  - A new noninvasive radiation-free method to measure gastric emptying in humans was
      developed. The upper abdomen was recorded with a magnetic resonance imager after
      administration of a liquid meal containing Gadolinium tetraazacyclododecane
      tetraacetic acid as a magnetic resonance image (MRI) marker. Meal volumes, total
      gastric volumes, and secretory rates were measured. The MRI technique was
      validated simultaneously by the double indicator method in 5 healthy volunteers
      and in 5 patients with symptoms of disordered gastric emptying applying gamma
      camera scintigraphy and MRI in randomized order. Similar gastric meal emptying
      curves were obtained in volunteers and in patients by MRI and the reference
      methods as assessed by linear (r greater than 0.90; P less than 0.001) and
      intraclass correlation analysis (r greater than 0.905) for T1/2, areas under the
      curve, and percent of gastric meal retained. Furthermore, similar total gastric
      volumes and gastric secretory rates were measured by MRI and the double indicator
      technique. The new MRI method correctly reflected gastric emptying disorders in
      patients. Thus for the first time it is possible to combine these measurements of
      gastric functions in a single method and to relate them to gastric morphology
      visualized by the generation of three-dimensional images.

PMID- 1634056
TI  - The effect of vasoactive intestinal polypeptide on the lower esophageal sphincter
      in achalasia.
AB  - Vasoactive intestinal polypeptide (VIP) is one of the main neurotransmitters
      implicated in the relaxation of the lower esophageal sphincter (LES). The effect
      of exogenous VIP on LES motor activity was determined by esophageal manometry.
      LES pressure (LESP) and LES relaxation were compared in four healthy volunteers
      and in six patients with achalasia. The effects of intravenous doses of 1.5, 3,
      and 5 pmol.kg-1.min-1 of VIP were compared with placebo. Neither placebo nor 3
      and 5 pmol.kg-1.min-1 of VIP produced any effect on esophageal motility in
      healthy volunteers. In achalasia the three doses of VIP caused a dose-dependent
      decrease in LESP with a significant improvement in LES relaxation. A dose of 5
      pmol.kg-1.min-1 produced a maximal decrease of 51% in LESP. A beta-adrenergic
      agonist, isoproterenol, caused a decrease in LESP both in healthy volunteers and
      in patients with achalasia without improving LES relaxation. In summary,
      intravenous VIP improved LES relaxation and caused a decrease in LESP in patients
      with achalasia without affecting LESP in healthy volunteers, indicating that the
      LES muscle in achalasia is supersensitive to VIP. The current study suggests that
      a selective damage in the noncholinergic nonadrenergic innervation of the
      esophagus is in part responsible for the motor alteration seen in these patients.
      The findings and the inability of isoproterenol to improve LES relaxation despite
      decreasing LESP support a role in VIP as a indicator of LES relaxation.

PMID- 1634057
TI  - Cephalic stimulation of gastrointestinal secretory and motor responses in humans.
AB  - The present study was designed (a) to investigate the cephalic phase of
      gastropancreatic secretion, antroduodenal motility, and regulatory peptide
      release in six healthy young men and (b) to assess its regulation by the
      cholinergic system and endogenous cholecystokinin. Sham feeding performed for 15
      minutes induced a concurrent stimulation of gastropancreatic secretion,
      antroduodenal motility, and pancreatic polypeptide release that lasted for 30
      minutes. Reappearance of interdigestive phases III was retarded in the post-sham
      fed state. Atropine abolished secretory, motor, and pancreatic polypeptide
      responses to sham feeding and enhanced gastrin release. The cholecystokinin
      receptor antagonist loxiglumide did not attenuate pancreatic enzyme response but
      diminished antral motor response by 72% (P less than 0.05) and release of
      pancreatic polypeptide by 91% (P less than 0.05); it enhanced gastrin release and
      abolished retardation of reappearance of phase III with sham feeding. It is
      concluded that (a) there is a distinct cephalic phase of gastropancreatic
      secretion, antroduodenal motility, and pancreatic polypeptide release in humans
      that is primarily under cholinergic control and that (b) endogenous
      cholecystokinin is involved in antral motor, gastrin, and pancreatic polypeptide
      responses to sham feeding.

PMID- 1634058
TI  - Crohn's disease in the northeastern and northern Isles of Scotland: an
      epidemiological review.
AB  - An epidemiological study of Crohn's disease has been conducted in northeastern
      Scotland since 1955 and in the Orkney and Shetland Islands since 1966 through the
      end of 1988. There were 856 verified cases on the mainland and 58 in the northern
      isles. There has been no change in the sex ratio on the mainland in recent years,
      with 63% of patients female. Younger men and women living in the city of Aberdeen
      are more liable to develop Crohn's disease than rural inhabitants; the reverse is
      true for men over 60 years of age. The annual incidence of new cases has
      increased; within the city of Aberdeen it was 11.6 per 100,000 during 1985-1987.
      The point prevalence on December 31, 1988, for northeastern Scotland was 147 per
      100,000. Family histories of the disease were noted in 8.3% of cases. The disease
      now affects more distal parts of the intestinal tract. There is no clear
      correlation between these changes and variations in the environment or lifestyle
      of the population. In the Orkney Islands the overall incidence was 6.1 per
      100,000, and there was a male preponderance. In the Shetland Islands the
      incidence was 5.7 per 100,000 during 1966-1988. A family history of Crohn's
      disease was more common in the northern islands than on the mainland.

PMID- 1634059
TI  - Effects of acute normovolemic anemia on gastric mucosal blood flow in rats: role
      of nitric oxide.
AB  - The present study investigates the effects of acute normovolemic anemia induced
      by isovolemic hemodilution on gastric mucosal blood flow (GMBF), measured by
      hydrogen gas clearance, and on the oxygen and hemoglobin content in the gastric
      mucosa, estimated by reflectance spectrophotometry. GMBF significantly increased
      after 3 and 6 mL of isovolemic hemodilution (from 50 +/- 5 to 70 +/- 7 and 77 +/-
      6 mL.min-1.100 g-1, respectively; P less than 0.05) compared with basal values
      (50 +/- 5.mL-1.min-1.100 g-1; P less than 0.05). Oxygen content remained
      unchanged, whereas hemoglobin concentration decreased in parallel with the
      decrease in hematocrit. In a second set of experiments, the role of endogenous
      nitric oxide (NO) as a possible mediator of the gastric vascular changes induced
      by hemodilution was investigated by using the specific inhibitor of NO
      biosynthesis, NG-monomethyl-L-arginine (L-NMMA). The increase in GMBF induced by
      3 mL of isovolemic hemodilution (delta 23 +/- 7 mL.min-1.100 g-1) was attenuated
      in a dose-related manner with L-NMMA, 6.25 mg/kg IV (delta 15 +/- 4 mL.min-1.100
      g-1) or 50 mg/kg IV (delta 5 +/- 2 mL.min-1.100 g-1 g; P less than 0.05). The
      concurrent administration of L-arginine (the precursor of NO biosynthesis)
      abolished the effects of L-NMMA on GMBF changes. The current findings show that
      acute normovolemic anemia causes an increase in GMBF that is dependent on the
      endogenous formation of NO.

PMID- 1634060
TI  - Transient mosaic patterns of morphological and functional differentiation in the
      Caco-2 cell line.
AB  - To gain further insight on the mosaic expression of specific functional
      intestinal markers (such as sucrase-isomaltase) in postconfluent Caco-2 cells, a
      human colon cancer cell line unique in its property to differentiate in vitro
      into a mature enterocyte-like cell type, a comparative study was undertaken to
      examine the morphological and functional differentiation of Caco-2 cells at
      various culture stages. The observations clearly indicate that Caco-2 cells can
      exist only in three different states in culture: homogeneously undifferentiated
      (at subconfluence), heterogeneously polarized and differentiated (between 0 and
      20 days after confluence), and homogeneously polarized and differentiated (after
      30 days). Indeed, in the intermediate state, a strong discrepancy is found among
      adjacent differentiating cells throughout the monolayer relative to sucrase
      isomaltase expression as well as to cell morphology and brush border
      organization. Back-scattered electron imaging analysis showed a lack of
      correlation between these parameters at the cellular level. These observations
      indicate that morphological and functional differentiations of Caco-2 cells
      progress concomitantly according to a transient mosaic pattern, thus providing
      evidence that these two processes are not coupled.

PMID- 1634061
TI  - Ontogeny of procholecystokinin maturation in rat duodenum, jejunum, and ileum.
AB  - Expression and processing of procholecystokinin (proCCK) in rat intestine during
      development were examined using sequence-specific immunoassays, cleavage with
      processing-like enzymes, and chromatography. Fetal proCCK concentrations were
      similar in duodenum, jejunum, and ileum, but the maturation to CCK followed
      different courses: duodenal CCK increased from 14 pmol/g in the fetus to 86
      pmol/g 4 days after birth and then declined to 17 pmol/g in the adult. In
      jejunum, CCK varied from 34 pmol/g in the fetus to 127 pmol/g at day 7, decreased
      to 54 pmol/g at day 21, and increased again to 93 pmol/g in the adult. Ileal CCK
      decreased from 20 pmol/g in the fetus to 10 pmol/g postnatally. Whereas duodenal
      proCCK after birth matured completely to carboxyamidated CCK, jejunoileal proCCK
      matured only partially. Chromatography showed an increase of tyrosine-sulfation
      and proteolytic processing of N-terminal sequences. At day 7 jejunal
      cholecystokinin octapeptide (CCK-8) constituted only a minute fraction of the
      carboxyamidated CCK, of which less than half was sulfated. However, in the adult
      jejunum, CCK-8 constituted a significant fraction, which was completely sulfated.
      It is concluded that the CCK gene is well expressed at propeptide level in the
      fetal small intestine. Postpartum maturation of proCCK, however, is late and
      differs in the three parts of the small intestine. The belated maturation
      supports the hypothesis that factors other than CCK regulate pancreatic growth in
      fetal and neonatal life.

PMID- 1634062
TI  - Surveillance in the routine management of ulcerative colitis: the predictive
      value of low-grade dysplasia.
AB  - Biopsies obtained at colonoscopy from 121 patients with ulcerative colitis (UC)
      for greater than 7 years were reviewed. Dysplasia or neoplasia was found in 27
      patients (22%) after a mean of 16 years; 22 (18%) had dysplasia (all low grade),
      2 had polyps, and 3 had carcinoma without prior dysplasia. Seven had dysplasia
      (or neoplasia) on the next examination, and another 4 after multiple negative
      examinations. Dysplasia preceded carcinoma in 4 (18%) of the 22 patients, and
      carcinoma occurred in 7 (6%) of 121 patients. The average time from the first
      encounter of dysplasia to the finding of carcinoma was 6.3 years, and 3 of 4
      patients with negative second colonoscopies then had unremarkable examinations
      for 2-5 years. Dysplasia without cancer was found later in another 3. Dysplasia
      was found in 12 of 13 colectomy specimens, including the 3 from patients with
      cancer in whom no dysplasia had been found at surveillance colonoscopy. Active
      disease did not eliminate the capability to detect dysplasia or negate the value
      of surveillance for cancer when colonoscopy was conducted for routine clinical
      indications. Most dysplasia was detected in the rectum and sigmoid, supporting
      the value of interim sigmoidoscopies and biopsies during routine management of
      UC. Compliance for surveillance was diminished when the patient was asymptomatic,
      thereby increasing the risk of cancer. Low-grade dysplasia, like high-grade
      dysplasia, is predictive of future carcinoma and warrants careful follow-up. A
      "negative" second examination is no basis for a sense of security or relaxation
      of vigilance.

PMID- 1634063
TI  - Neutrophil autoantibodies in ulcerative colitis: familial aggregation and genetic
      heterogeneity.
AB  - The possibility that the neutrophil autoantibodies associated with ulcerative
      colitis represent a genetic marker of susceptibility was investigated by
      determining their prevalence in unaffected relatives of patients. Neutrophil
      autoantibodies were detected using an enzyme-linked immunosorbent assay, and
      positive values were confirmed by indirect immunofluorescence. An increased
      prevalence of neutrophil antibodies was found not only in the probands (68%,
      26/38) but also in their clinically unaffected family members (15.7%, 17/108)
      compared with controls (2.9%, 1/35) (P less than 0.0001 and P less than 0.05,
      respectively). These results were confirmed with sera from a second center, where
      86.4% (19/22) of probands were positive and 20.9% (9/43) of their relatives were
      positive. The prevalence of neutrophil autoantibodies in the relatives of
      probands who were antibody positive (21.4%) was significantly greater than the
      prevalence in relatives of probands who were antibody negative (7%; P less than
      0.05). The findings are consistent with these antibodies being a potential marker
      of genetic susceptibility to ulcerative colitis and suggest the possibility of
      genetic heterogeneity within this disease.

PMID- 1634064
TI  - Nutrient-independent increases in proglucagon and ornithine decarboxylase
      messenger RNAs after jejunoileal resection.
AB  - To assess potential mediators of adaptive bowel growth, ileal proglucagon
      messenger RNA (mRNA) ornithine decarboxylase (ODC) mRNA, plasma enteroglucagons,
      and plasma glucagonlike peptide I (GLP-I) were analyzed in rats soon after
      jejunoileal resection or control transection. Analyses were performed before and
      after refeeding to establish whether responses are nutrient dependent. The
      elevation of ileal proglucagon and ODC mRNAs within 12 hours after resection and
      before refeeding shows a nutrient-independent component of the adaptive response.
      The onset of adaptive growth of the ileum required luminal nutrient but occurred
      very rapidly, within 4 hours of refeeding. The onset of adaptive growth was
      accompanied by transient elevation of ileal ODC mRNAs. Ileal proglucagon mRNA and
      plasma GLP-I levels were also elevated, and these increases were sustained up to
      8 days after resection. These early and sustained increases in proglucagon mRNA
      and plasma GLP-I indicate that in addition to the enteroglucagons, other
      intestinal proglucagon-derived peptides must be considered as potential mediators
      of adaptive growth after jejunoileal resection.

PMID- 1634065
TI  - High-density lipoprotein 3 retroendocytosis: a new lipoprotein pathway in the
      enterocyte (Caco-2).
AB  - The present study in Caco-2 cells, derived from a human colon carcinoma and
      capable of enterocyte differentiation in culture, describes a retroendocytotic
      pathway for high-density lipoprotein 3 (HDL3). These cells exhibit specific
      binding of apolipoprotein E-free HDL3 which was competed for by HDL3 but not by
      low-density lipoproteins. At 37 degrees C, degradation was negligible and intact
      particles were internalized and resecreted into the medium within 2 hours.
      Electron microscopy showed binding and internalization of gold-labeled HDL3 in
      coated pit regions and transport in endosomes distinct from lysosomes to lipid
      droplets. The fusion of these endosomes with lipid droplets was followed by their
      dissolution and the subsequent extrusion of HDL particles from the cells.
      Fluorescence labeling studies of HDL3 supported cytosolic transport in vesicles.
      Specific binding showed negative feedback regulation by HDL3, was modulated by
      alterations in cellular cholesterol content, and increased with the cellular
      state of differentiation. HDL3 mediated efflux of endogenously labeled
      cholesterol. It is concluded that intact HDL3 is bound specifically by Caco-2
      cells, leading to a subsequent intracellular passage and resecretion through a
      process of retroendocytosis effecting the efflux of cellular cholesterol.

PMID- 1634066
TI  - Spectrum of injury produced in the duodenum by perfusion with luminal acid in the
      rat.
AB  - The dose and time dependence of duodenal mucosal injury by luminal acid perfusion
      was studied. Saline, 0.01, 0.05, 0.15, and 0.3N HCl, were perfused through the
      proximal duodena of rats for 5, 15, or 30 minutes and then harvested for
      histological examination. In a second set of studies, after a 30-minute
      perfusion, duodena were harvested either immediately or 2, 4, 8, or 24 hours
      after the perfusion to study the recovery from injury. Acid disappearance (acid
      delivered minus acid recovered) was measured in all groups. Duodena were examined
      grossly, then fixed, stained, and scored histologically. Whereas no gross mucosal
      injury was noted, there was graded histological injury proportional to acid
      concentration. Injury occurred early in the perfusion and changed little with
      increased perfusion durations. The initial injury lead to an acid disappearance
      rate that was proportional to acid concentration and, therefore, the degree of
      injury. After the initial injury occurred, the rate of acid neutralization was
      unchanged by increased duration of acid perfusion. This acid neutralization
      protected against further injury despite the continued presence of acid. Recovery
      from injury was complete with physiological (0.01 and 0.05N HCl) but not
      pharmacological (0.15 and 0.3N HCl) concentrations of acid. It is concluded that
      acid-induced duodenal injury occurs within 5 minutes of exposure, is proportional
      to the acid concentration, and results in acid neutralization that protects
      against extension of the injury with continued acid exposure.

PMID- 1634067
TI  - A physiological role for cholecystokinin as a regulator of gastrin secretion.
AB  - To explore the role of cholecystokinin (CCK) in regulating gastrin secretion in
      humans, the effect of a CCK antagonist (loxiglumide) on meal-stimulated hormone
      responses was investigated. Subjects received 500 mL of a liquid test meal in the
      presence and absence of loxiglumide (22 mumol.kg-1.h-1). In the control
      experiments, both plasma gastrin and CCK levels increased postprandially. In
      loxiglumide-treated subjects there was a marked elevation in gastrin (area under
      the curve, 11,042 +/- 1493/120 min vs. 2156 +/- 281 pg/120 min) and CCK levels
      compared with the control experiment. These observations were confirmed in
      experiments with modified sham feeding and gastrin-releasing peptide stimulation
      in which loxiglumide pretreatment also caused a significant increase in gastrin
      release compared with saline (P less than 0.05). Further studies with intravenous
      infusion of gastrin, CCK-8, and CCK-33 with and without loxiglumide showed that
      the increases in CCK and gastrin during loxiglumide application cannot be
      explained by alterations in clearance rates. The findings of this study show that
      postprandial gastrin secretion is influenced by CCK and support the concept of a
      negative feedback control of gastrin secretion by CCK.

PMID- 1634068
TI  - Pathophysiology of small intestinal malabsorption in gerbils infected with
      Giardia lamblia.
AB  - Mongolian gerbils were infected with a human pathogenic Giardia lamblia strain
      and compared with sham-treated control animals 6 days after inoculation.
      Infection resulted in crypt hyperplasia associated with an increased enterocyte
      migration rate. Villus height was decreased in the duodenum, unchanged in the
      jejunum, and increased in the ileum of infected animals. Epithelial microvilli
      were markedly shortened, and brush border surface area decreased in the jejunum
      and ileum of infected animals. Thymidine kinase activity was increased in
      isolated duodenal villus enterocytes but did not differ in the jejunum and ileum.
      In vitro and in vivo experiments showed that the infection resulted in decreased
      jejunal glucose-stimulated electrolyte, water, and 3-O-methyl-D-glucose
      absorption, whereas in the ileum in vitro electrolyte and 3-O-methyl-D-glucose
      absorption was similar in infected and control animals. Thus, in the jejunum
      infection causes electrolyte, solute, and fluid malabsorption associated with
      decreased brush border surface area. The results indicate that the diarrhea
      associated with giardiasis is caused by malabsorption rather than active
      secretion.

PMID- 1634069
TI  - Familial aggregation of inflammatory bowel disease in northern Italy: a
      multicenter study. The Gruppo di Studio per le Malattie Infiammatorie Intestinali
      (IBD Study Group).
AB  - To assess the familial aggregation of inflammatory bowel disease (IBD) in Italy,
      the family pedigrees of 411 patients with ulcerative colitis (UC) and 241
      patients with Crohn's disease (CD) seen at 14 participating hospitals were
      studied. Sufficient information was obtained on 97% of 3752 first-degree
      relatives, 80% of 8869 second-degree relatives, and 74% of 5791 cousins. Thirty
      six propositi (5.52%) had a total of 44 affected relatives (16 CD, 28 UC). The
      prevalence of IBD was higher in first- than in second-degree relatives and
      cousins (791, 112, and 163 in 100,000, respectively). A strong intrafamilial
      disease concordance was observed, with 26 cases of UC and 6 of CD among relatives
      of UC patients and 10 cases of CD and 2 of UC among relatives of CD patients. The
      prevalence of UC among first-degree relatives of UC patients and that of CD among
      first-degree relatives of CD patients was 680 and 531 in 100,000, respectively.
      In conclusion, there is a high degree of familial aggregation for IBD in Italy,
      with a strong intrafamilial disease concordance.

PMID- 1634070
TI  - Oral immunization against cholera toxin with a live Yersinia enterocolitica
      carrier in mice.
AB  - The 70-kb pYV plasmid of Yersinia enterocolitica directs the synthesis and
      secretion of several virulence determinants called Yops. These proteins are
      produced during the invasion of the host tissues and induce a strong antibody
      response. The yop genes are transcribed from strong promoters activated by a
      common transcription activator. Recombinant Y. enterocolitica strains expressing
      the B subunit of the cholera toxin were constructed from a yopH-ctxB operon
      fusion. Integration of the gene ctxB in the pYV plasmid itself, by a double
      crossing over, ensured its stability in the infecting bacteria. Oral inoculation
      of recombinant bacteria in mice elicited serum and intestinal antibody responses
      and resulted in protection of the immunized mice against a cholera toxin
      challenge. Secretory immunoglobulin A antibodies against the cholera toxin B
      subunit occurred not only in the intestines but also in the respiratory tract.

PMID- 1634071
TI  - Lysozyme gene expression in inflammatory bowel disease.
AB  - Riboprobe in situ hybridization (rISH) demonstrates active lysozyme synthesis in
      ulcerative colitis and Crohn's disease. Maximal labeling was seen in Paneth
      cells, macrophages, and granulomas. Diffuse infiltration of the mucosa by
      lysozyme-rich polymorphs characterizes ulcerative colitis but obscures reactivity
      in other cell lineages in immunohistochemical studies; lysozyme mRNA is not
      detected in polymorphs, rISH giving a clearer picture than immunohistochemical
      studies of the active synthesis of lysozyme within the gut in inflammatory bowel
      disease. In ulcerative colitis, strong signals localized to Paneth cell
      metaplasia were found in 11 of 20 cases and to a lesser degree in non-Paneth cell
      lineages in regenerative mucosa in 13 of 20 cases. In Crohn's disease, abundant
      labeling was seen in tuberculoid granulomas (5 of 20) and over macrophage
      aggregates in the lamina propria in another 7, characteristic patterns not
      encountered in ulcerative colitis. Low levels of lysozyme messenger RNA were
      found in the ulceration-associated cell lineage ("pseudopyloric metaplasia").
      These results support the view that neutrophils are largely responsible for
      elevated fecal lysozyme levels in ulcerative colitis and macrophages for elevated
      serum lysozyme levels in Crohn's disease.

PMID- 1634073
TI  - Bile composition, microspheroliths, antinucleating activity, and gallstone
      calcification.
AB  - This study examined if abnormalities in bile composition and antinucleating
      activity are associated with gallstone calcification. Nineteen controls without
      gallbladder disease and 42 patients with cholesterol stones were studied. Bile
      was obtained at surgery and analyzed for pH and PCO2, ionized calcium, and total
      calcium. The pH and carbonate concentrations of gallbladder bile were
      significantly higher in patients with calcified stones than in patients with
      noncalcified stones and in controls, resulting in significantly higher levels of
      the ion product in patients with calcified gallstones. Microspheroliths of
      calcium carbonate, seen on microscopic examination of bile, predicted stone
      calcification with a sensitivity of 86%, a specificity of 86%, and a predictive
      value of 86%. Bile from control subjects completely inhibited precipitation of
      calcium carbonate from a supersaturated solution, whereas bile from subjects with
      calcified and noncalcified gallstones did not. It is concluded that gallstone
      calcification is related to elevated bile pH and carbonate concentrations,
      resulting in an elevated ion production of calcium carbonate in gallbladder bile.
      In addition, bile from subjects with calcified and noncalcified gallstones lacks
      antinucleating activity for calcium carbonate.

PMID- 1634072
TI  - Fecal osmotic gap and pH in experimental diarrhea of various causes.
AB  - Although the osmotic gap of fecal fluid is often used to distinguish osmotic
      diarrhea from secretory diarrhea, there has never been a scientific evaluation of
      the validity of this concept. Similarly, although a low fecal fluid pH value is
      used to indicate that diarrhea is mediated by carbohydrate malabsorption, the
      validity of this method is unproven. Therefore, in the present study, diarrhea
      was induced in normal subjects by different mechanisms and fecal fluid osmotic
      gap (using an assumed fecal fluid osmolality of 290 mOsm/kg) and pH were
      measured. In secretory diarrhea caused by phenolphthalein, the osmotic gap was
      always less than 50 mOsm/kg, whereas in osmotic diarrhea caused by polyethylene
      glycol, magnesium hydroxide, lactulose, and sorbitol, the osmotic gap always
      exceeded 50 mOsm/kg. In osmotic diarrhea caused by sodium sulfate, the fecal
      fluid osmotic gap was less than 50 mOsm/kg, but phenolphthalein-induced secretory
      diarrhea could be distinguished from sodium sulfate-induced osmotic diarrhea by
      the fecal chloride concentration. When diarrhea was caused by carbohydrate
      malabsorption (lactulose or sorbitol), the fecal fluid pH was always less than
      5.6 and usually less than 5.3; by contrast, other causes of diarrhea rarely
      caused a fecal pH as low as 5.6 and never caused a pH less than 5.3. It is
      concluded that measurement of fecal fluid osmotic gap and pH can distinguish
      various mechanisms of experimental diarrhea in normal subjects. The concepts on
      which these tests are based are therefore verified experimentally.

PMID- 1634074
TI  - Pancreatic and hepatic abscesses: a late complication in 10 patients with chronic
      pancreatitis.
AB  - In this prospective long-term study of chronic pancreatitis (n = 336) over the
      last 3 decades, 10 patients with advanced calcific pancreatitis developed a
      sepsis associated with intra-abdominal abscesses (6 pancreatic, 4 hepatic). None
      of the known precipitating factors were present (e.g., no pancreatic necrosis or
      recent surgical/endoscopic interventions, no evidence of cholangitis). Nine of 10
      patients had alcoholic chronic pancreatitis. Interestingly a pancreatojejunostomy
      in 9 of 10 patients had been performed up to 12 years previously. Cultures from
      abscess aspirates and/or blood were polymicrobial, mainly a mixed enteric flora
      in 8 patients. All patients recovered after an appropriate antibiotic therapy
      with or without drainage procedures. The pathogenesis of "spontaneous" abscess
      formation in advanced chronic pancreatitis and its relationship to
      pancreatojejunostomy remain to be established.

PMID- 1634075
TI  - The sequence of biliary events preceding the formation of gallstones in humans.
AB  - The aim of the present study was to determine the sequence of events leading to
      formation of gallstones among obese patients predisposed to cholesterol
      gallstones by a very low-calorie diet. Nine obese patients beginning a 520-kcal
      diet had gallbladder bile collected from the duodenum before beginning the diet
      and seven times during the first 56 days of the diet. Biliary cholesterol
      saturation index and levels of arachidonate, prostaglandin E2, and glycoprotein
      increased significantly; nucleation time decreased; and total lipid concentration
      did not change. Decreases in nucleation time preceded the appearance of
      cholesterol crystals. Significant (P less than 0.05) increases in prostaglandin
      E2 level were preceded by significant increases in arachidonate level and
      followed by significant increases in glycoprotein level. These observations
      support the hypotheses that in obese patients predisposed to gallstones by very
      low-calorie diets (a) decreases in nucleation time are necessary before
      cholesterol crystals form in the gallbladder; (b) biliary arachidonate, through
      its conversion to prostaglandins, promotes biliary synthesis and secretion of
      glycoprotein; (c) biliary glycoprotein promotes nucleation; and (d) increases in
      the concentration of gallbladder bile are not necessary for cholesterol
      nucleation to occur in vivo.

PMID- 1634076
TI  - In vivo differences between the turnover rates of leucine and leucine's ketoacid
      in stable cirrhosis.
AB  - Based on urinary nitrogen excretion, previous studies have indicated increased
      protein breakdown rates in cirrhosis. However, studies using [1-13C]-leucine
      infusion methodology have found normal protein breakdown rates. Because abnormal
      partitioning between extracellular and intracellular leucine exists in cirrhosis,
      plasma enrichment of leucine's keto acid (KIC), a marker of intracellular
      leucine, may more accurately reflect protein metabolism than plasma [1
      13C]leucine enrichment. Therefore, protein breakdown and oxidation were
      calculated using both [1-13C]leucine and [1-13C]KIC and compared with urinary
      nitrogen excretion in seven cirrhotics and seven matched controls after an
      overnight fast. The ratio of KIC and leucine plasma enrichment was decreased (P
      less than 0.001) in cirrhosis because of lower KIC enrichment (P less than
      0.006). Cirrhotics had increased rates of protein breakdown (P less than 0.006)
      and protein oxidation (P less than 0.05) based on KIC (P less than 0.006) but not
      leucine enrichment. In controls, protein oxidation calculated from urinary
      nitrogen excretion did not differ from KIC results (0.88 +/- 0.08 vs. 0.83 +/-
      0.06) but was higher than the leucine method (0.88 +/- 0.08 vs. 0.73 +/- 0.05; P
      less than 0.01). However, in cirrhotics protein oxidation based on urinary
      nitrogen was lower than the KIC methodology (P less than 0.01). Therefore,
      cirrhotics have accelerated rates of protein breakdown and oxidation associated
      with increased extrarenal nitrogen loss. Furthermore, these results suggest
      abnormal leucine transport across cell membranes.

PMID- 1634077
TI  - Reversibility of secondary biliary fibrosis by biliodigestive anastomosis in the
      rat.
AB  - Biliary cirrhosis with portal hypertension and hepatocellular failure is a well
      known complication of extrahepatic obstruction. It is unclear to what extent
      these changes are reversible by biliodigestive anastomosis. Therefore a rat model
      of relief of biliary obstruction was developed by performing Roux-en-Y
      choledochojejunostomy in rats after bile duct obstruction. Patency of the
      biliodigestive anastomosis was documented by biliary scintigraphy. Microsomal
      function was assessed in vivo by the aminopyrine breath test and portal
      hypertension by spleen pulp pressure. Microsomal function was markedly impaired
      in obstructed animals but recovered after biliodigestive anastomosis. Microsomal
      cytochrome P450 content paralleled these changes. Similarly, portal hypertension
      was reversed after successful relief of obstruction. Stereologic analysis showed
      that biliodigestive anastomosis partially reversed bile ductular proliferation
      and fibrosis. Studying the time course of recovery showed that restoration of
      microsomal function was achieved after 2 weeks whereas recovery from portal
      hypertension required 4 weeks of biliary drainage. Recovery of microsomal
      function was paralleled by normalization of microsomal lipid composition while
      resolution of portal hypertension occurred parallel to resolution of the
      histologic abnormalities.

PMID- 1634078
TI  - Endogenous opioids accumulate in plasma in a rat model of acute cholestasis.
AB  - To obtain data on the degree to which the opioid system is changed in
      cholestasis, endogenous opioid activity in plasma of rats with acute cholestasis
      was determined 5 days after bile duct resection. Total plasma opioid activity was
      determined using a radioreceptor technique that measured the displacement of the
      opiate receptor ligand [3H]-DAMGO from lysed synaptosomal fractions of normal rat
      brain. Plasma total opioid activity was threefold greater in bile duct-resected
      rats than in sham-operated and unoperated controls (P less than or equal to
      0.05). Plasma levels of the individual endogenous opioid, methionine-enkephalin,
      were determined using a sensitive radioimmunoassay, and the specificity of the
      assay was confirmed using high-performance liquid chromatography. In cholestatic
      rats, plasma methionine-enkephalin levels were more than six-fold greater than in
      sham-operated controls (P less than or equal to 0.001) and more than 17-fold
      greater than in unoperated controls (P less than or equal to 0.001). However,
      plasma methionine-enkephalin levels accounted for less than 5% of total plasma
      opioid activity after bile duct resection. Plasma methionine-enkephalin levels in
      both cholestatic plasma and plasma from sham-operated animals were stable when
      incubated in vitro despite the presence of undiminished activity of the major
      enkephalin-degrading enzymes. Thus, protection of methionine-enkephalin from
      degradation may be a factor contributing to the elevated plasma levels of
      methionine-enkephalin found in cholestasis. The magnitude of the increase in
      plasma endogenous opioid activity in bile duct-resected rats provides support for
      the hypothesis that endogenous opioids contribute to the pathophysiology of
      cholestasis.

PMID- 1634079
TI  - Ileal resection/dysfunction in childhood predisposes to lithogenic bile only
      after puberty.
AB  - Children with ileal resection/dysfunction since infancy have bile that is not
      supersaturated with cholesterol. Five sexually mature subjects (age 16-19 years)
      who had been previously investigated in childhood (age 4-9 years) were studied.
      Gallstones were found in one. Bile rich duodenal aspirates were analyzed for
      lipid content (molar fraction) and the cholesterol saturation index was
      calculated. In the postpubertal subjects, a significantly higher proportion of
      biliary cholesterol (22.0% +/- 4.8% vs. 3.2% +/- 0.6% and 5.7% +/- 0.5%, P less
      than 0.005) and significantly lower bile acids (58.1% +/- 3.9% vs. 79.7% +/- 2.3%
      and 78.2% +/- 1.9%, P less than 0.005) were found compared with the initial
      (prepubertal) samples or in samples from 20 healthy young adults. The cholesterol
      saturation index was significantly higher (3.1 +/- 0.7 vs. 0.6 +/- 0.1 and 1.1 +/
      0.1, P less than 0.005) whereas phospholipid content did not change (19.9% +/-
      1.6% vs. 17.1% +/- 1.8% and 16.6% +/- 1.6%) as compared with themselves before
      puberty and as healthy young adults, respectively. It was concluded that children
      with ileal resection/dysfunction do not appear at risk for cholesterol
      cholelithiasis before puberty; however, the development of biliary cholesterol
      supersaturation after puberty may predispose them to gallstone formation in
      adulthood.

PMID- 1634080
TI  - Pancreatic blood flow in cats with chronic pancreatitis.
AB  - Pancreatic blood flow and its relationship to pancreatic interstitial pressure
      were investigated in a model of chronic pancreatitis in cats using a hydrogen gas
      clearance technique with an intraductal electrode. The intraductal technique
      correlated well with blood flow measurements made using gamma-labeled
      microspheres (r = 0.88, P less than 0.001). In control cats, the basal blood flow
      of 69.1 +/- 9.5 mL.min-1.100 g-1 increased by 25% to 86.2 +/- 11 mL.min-1.100 g-1
      with secretory stimulation (P less than 0.05). Interstitial pressure was -0.02 +/
      0.3 mm Hg and did not change significantly with stimulation. In cats with
      chronic pancreatitis, basal interstitial pressure was 1.8 +/- 0.5 mm Hg and basal
      blood flow 39.9 +/- 4 mL.min-1.100 g-1 (P less than 0.05). Stimulation of the
      chronic pancreatitis gland increased the pressure to 3.0 +/- 0.4 mm Hg (P less
      than 0.01) and reduced flow 15% to 34.2 +/- 4 mL.min-1.100 g-1 (P less than
      0.05). Papaverine increased blood flow in control and chronic pancreatitis cats
      without altering tissue pressure, suggesting that despite the reduced basal blood
      flow, the ability to increase blood flow was preserved in chronic pancreatitis.
      The increased interstitial pressure associated with secretion appeared to limit
      the gland's normal hyperemic response in this model of chronic pancreatitis.

PMID- 1634081
TI  - The effect of diet on feces and jaundice during the first 3 weeks of life.
AB  - This study examined the relationship between fecal output and neonatal jaundice
      in infants exclusively fed either human milk or one of three infant formulas
      (whey predominant, Enfamil; casein predominant, 3305H; and casein hydrolysate,
      Nutramigen; all from Mead Johnson, Evansville, IN). Stool output was quantitated
      during the first 3 weeks of life. Jaundice was assessed by measuring serum
      bilirubin level and transcutaneous jaundice index. In general, after the fourth
      day, breast-fed infants produced lower-weight individual wet and dry stools than
      formula-fed infants. Cumulative wet and dry stool output was also lowest in the
      breast-fed infants during this time. After the first week, breast-fed infants had
      a higher stooling frequency than formula-fed infants. The jaundice indexes of the
      four groups differed significantly on all days after day 3, with highest levels
      in breast-fed infants and lowest levels, for unknown reasons, in those fed casein
      hydrolysate. The jaundice index of those fed casein hydrolysate was significantly
      lower than that of the other formula-fed infants on days 10-18. In the breast-fed
      group the decrease from day 3 to day 21 in both serum bilirubin level and the
      jaundice index was positively correlated with both the 21-day total wet and total
      dry cumulative stool weights. It is concluded that the quantity of stool excreted
      is related to decreases in serum bilirubin levels in infants fed human milk.

PMID- 1634082
TI  - Pyostomatitis vegetans and primary sclerosing cholangitis: markers of
      inflammatory bowel disease.
AB  - The case of a 34-year-old woman with both pyostomatitis vegetans and primary
      sclerosing cholangitis is reported and the literature reviewed. Pyostomatitis
      vegetans is a rare disorder characterized by friable pustules on the buccal
      mucosa and often peripheral blood eosinophilia. In this review, the frequent
      association of pyostomatitis vegetans with inflammatory bowel disease as well as
      the potential for pyostomatitis vegetans to present with sclerosing cholangitis
      and liver disease before any other manifestations of inflammatory bowel disease
      is discussed. Patients with pyostomatitis vegetans may need long-term care for
      gastroenterological disease in addition to treatment for oral lesions.

PMID- 1634083
TI  - Successful treatment of a hepatic cyst by one-shot instillation of minocycline
      chloride.
AB  - Hepatic cysts are not rare but usually are asymptomatic; however, large ones
      sometimes show clinical manifestations. Treatment of a solitary hepatic cyst by
      one-shot instillation of minocycline chloride is reported here; 500 mg of
      minocycline chloride was instilled into the hepatic cyst, 11 cm in diameter,
      through a percutaneous transhepatic cholangiography needle under ultrasound
      guidance. After 5 weeks, the cyst had decreased in size to 5 cm. Five months
      later, the cyst could not be detected by diagnostic imaging. Fifteen months after
      the treatment, no reaccumulated fluid was observed. Ultrasound-guided
      percutaneous one-shot instillation of minocycline chloride seems to be a safe,
      easy, and useful procedure for treating a hepatic cyst.

PMID- 1634084
TI  - Benign cartilaginous tumor (chondroma) of the liver.
AB  - A 44-year-old woman with a large benign cartilaginous tumor (chondroma) of the
      liver is presented. After being followed up by computed tomography for 6 years
      and with imagining evidence for a recent increase in its size, this asymptomatic
      tumor was successfully removed at surgery. The resected tumor proved to be
      chondroma, a benign cartilaginous tumor. A review of the literature showed no
      previous reports of this type of hepatic neoplasm.

PMID- 1634085
TI  - The epidemiology of inflammatory bowel disease: are we learning anything new?

PMID- 1634086
TI  - Oral carrier vaccines: new tricks in an old trade.

PMID- 1634087
TI  - The gastroenterologist's osmotic gap: fact or fiction?

PMID- 1634088
TI  - How does cholecystokinin contract the gallbladder?

PMID- 1634089
TI  - When all the pressure and squeeze backfires.

PMID- 1634090
TI  - Mechanisms of inflammatory diarrhea.

PMID- 1634091
TI  - [A new procedure for continuous measurement of fetal oxygen saturation sub
      partu].
AB  - The principal aim of foetal monitoring during labor is early detection of
      hypoxia. Current methods are unable to accomplish this task. Pulse oximetry
      permits continuous measurement of oxygen saturation and is the best method to
      detect early hypoxia. In this report, an optical scalp electrode is presented,
      which permits continuous monitoring of foetal oxygen saturation during labor.

PMID- 1634092
TI  - [Obstetric pelvimetry using nuclear magnetic resonance tomography (MRI): clinical
      experiences with 150 patients].
AB  - Between Oct. 1987 and Oct. 1991 150 patients of the Frauenklinik Freiburg were
      examined by MR pelvimetry (MRI), 135 of which were "ante partum", i.e. just
      before delivery. The indications were: earlier operative or strongly protracted
      delivery, clinical suspicion of disproportion between head and pelvis, or
      obstetrical "problem pelvis" indicated by manual pelvic examination or ultrasonic
      foetometry. Previous experimental measurements with a phantom and the comparison
      with conventional radiograms by Guthmann and Martius of 10 patients in puerperium
      have shown, that the mean divergence was +/- 2 mm, the maximum divergence 5 mm.
      The MRI method for pelvimetry "ante partum" or in childbed, proved to be a method
      of high accuracy and a very good option to judge the pelvic shape, whilst being
      well accepted by the patients. Furthermore, it allows to determine the foetal BIP
      (biparietal head-diameter), to judge the pelvic soft-tissue, as well as the
      visualisation of the birth canal, all without any exposure to radiation. MR
      pelvimetry is thus part of today's clinical routine. The disadvantages are still
      the high costs as well as the fact, that only few centres have access to MRI
      equipment. Nevertheless, the pelvimetry "post partum" can be safely practised
      radiologically due to the very low radiation exposure.

PMID- 1634093
TI  - [Noninvasive function tests in the evaluation of vascular reactivity in pregnancy
      and pregnancy-induced hypertension].
AB  - At present, there is an increasing discussion regarding the change of the
      prostacyclin/thromboxane ratio as an aetiological factor of pregnancy-induced
      hypertension (PIH). By means of videophotometric capillaroscopy in the
      capillaries of the nailfold, it is possible to visualise the resulting changes in
      the microcirculation. This method employs a special illumination microscope
      (magnification of the optical system x 560). Red blood cell velocity is measured
      under test conditions and microcirculatorical reaction capacity on ischaemic
      stress. Studies were conducted on healthy non-pregnant women and on healthy
      pregnant women as well as on patients suffering from pregnancy-induced
      hypertension. A markedly reduced velocity of red blood cells in patients with
      pregnancy-induced hypertension was seen as a sign of vasoconstriction, namely,
      0.53 mm/sec. versus 0.74 mm/sec. Furthermore, these patients have a higher
      reactivity to ischaemic stress, probably also as a result of the already existing
      vasoconstriction; however, the duration of the hyperaemic phases is reduced in
      pregnancy-induced hypertension. By this method, an insight can be gained into
      microcirculation in pregnancy and in pregnancy-induced hypertension. In addition,
      as preliminary studies have already shown, the influence exercised by different
      medications on microcirculation can be assessed.

PMID- 1634094
TI  - [Placental protein 12 (PP 12) in pregnancy-induced hypertensive diseases].
AB  - Placental protein 12 (PP12) was measured in 30 patients with hypertensive
      disorders of pregnancy, 10 healthy pregnant and 10 healthy nonpregnant controls.
      Differences in PP12-concentrations of healthy nonpregnant (median 2.0
      micrograms/l, range 1.0-5.5 micrograms/l) and healthy pregnant controls (median
      110 micrograms/l, range 29-280 micrograms/l), as well as between healthy
      nonpregnant controls and hypertensive patients (median 125 micrograms/l, range 28
      420 micrograms/l) were both statistically highly significant (p less than 0.001).
      The comparison between healthy pregnant and hypertensive women demonstrated no
      statistically significant differences. In coexistent intrauterine growth
      retardation (median 163 micrograms/l, range 60-400 micrograms/l), higher values
      could be observed in some patients, but this group showed no statistically
      significant difference compared to healthy pregnant controls with adequate fetal
      weight. PP12 does not seem to be a clinically usable parameter in the diagnosis
      of hypertensive disorders of pregnancy and fetal growth retardation, because of
      the widespread range of results.

PMID- 1634095
TI  - [B-streptococci in obstetrics--risks and consequences of maternal colonization
      and neonatal contamination].
AB  - 2,373 mothers and their newborn were studied during two years with respect to B
      streptococci colonisation or contamination. Bacteriological, vaginal and anal
      smears were taken from mothers at the beginning of parturition, as well as the
      amnion and the aspirated stomach contents of the newborn, employing, in each
      case, conventional culture methods and a latex agglutination test as a rapid
      testing method. Smears from the ears were also taken from the newborn for
      bacteriological examination. The vertical transmission and its possible
      influencing variables were examined in 1,328 mother/child pairs of the first
      observation year. Surface contamination of the newborn was confirmed in 10% in at
      least one smear. In the group of mothers with B streptococci colonisation, the
      amnion showed the highest rate of contamination (43%), followed by the aspirated
      stomach contents (26%) and the ear smears (taken from each side separately) with
      28% and 30% respectively. Vertical transmission was decisively influenced by
      vaginal maternal colonisation (50% of the cases resulting in contamination of
      newborn), whereas anal colonisation, if it was the only site of colonisation,
      resulted in contamination of newborn in only 32% of the cases. The rate of
      contamination of newborn dropped significantly from 50% to 20% after intrapartal
      antibiotic prophylaxis, the latter appearing to be meaningful only after at least
      6 hours of exposure. In this group, the surface contamination could be reduced
      from 61% to 8%. A group of newborn suffering from early onset of sepsis (0.4%),
      was compared with a group of 13 newborn at risk of infection (0.9%) with
      established surface contamination and clinical or laboratory chemistry
      confirmation of infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634096
TI  - [Promoting pregnancy following partial zona dissection of the oocyte within the
      scope of in vitro fertilization].
AB  - Partial dissection of the zona pellucida (PZD) is one of several
      micromanipulatory methods for the treatment of male subfertility. PZD involves
      the mechanical introduction of a small hole in the zona pellucida of the oocyte
      prior to insemination. Thus, fusion with the oolemma and fertilization of the
      oocyte is facilitated for spermatozoa with impaired quality that otherwise would
      not be able to penetrate the zona. We have established this technique at our
      clinic and report on the first pregnancy achieved by PZD of the oocyte during our
      IVF programme.

PMID- 1634097
TI  - [Modification of in vitro motility of human sperm by various dioxin congeners in
      super-physiologic concentrations].
AB  - Human ejaculate was fractionated using density gradient centrifugation. Highly
      motile spermatozoa were incubated with "superphysiological" concentrations of
      various dioxin congeners. Over a period of sixty hours, no relevant influence on
      sperm motility in comparison to control media was noted on triplicate testing. It
      therefore appears unlikely, that intravaginally ejaculated spermatozoa would be
      compromised in their motility by naturally occurring levels of dioxins in female
      genital tract secretions. However, this does not preclude the possibility of such
      dioxin levels affecting normal intratesticular spermatogenesis.

PMID- 1634098
TI  - [Endometrial growth in continuous, estrogen substitution monotherapy with
      Estraderm TTS (0.05 mg/die) in 31 postmenopausal females].
AB  - To prevent hyperplasia and carcinoma of the endometrium during Estrogen
      Replacement Therapy (ERT), addition of progestogens once a month is considered
      mandatory. There is, however, no good scientific basis for this assumption. Since
      the addition of progestogens has several disadvantages, it is important to
      minimise the frequency of progestogen addition. Vaginosonography is a rather new
      technique, which has not yet been used for monitoring ERT. This study uses the
      growth of the endometrium, as it was measured by vaginosonography, as a parameter
      for stimulation of the endometrium by estrogens. ERT with Estraderm 50 twice a
      week was started in postmenopausal women. The endometrial thickness at the
      beginning was less than 3 millimeters. During estrogen treatment the endometrial
      thickness was determined every 6 to 10 weeks. As long as there was little or no
      increase during the estrogen treatment, no progestogen was added. Where there was
      a considerable growth, progestogen was added. With the use of vaginosonography,
      it is possible, to distinguish "fast growers" (women whose endometrium responded
      fast) from "slow growers".

PMID- 1634099
TI  - [Epidermal growth factor receptor in human breast cancer: correlation with
      steroid receptors, tumor stage, grading and menopausal status].
AB  - In this study, correlations between the epidermal growth factor receptor (EGF-R),
      steroid receptors, and other prognostic parameters (grading, pTNM-status,
      menopausal status) were analysed in 326 primary breast carcinomas. 19% of the
      tumour samples were EGF-R positive, 63% were estrogen receptor (ER) and 54%
      progesteron receptor (PR) positive. Both steroid receptors were positive in 46%
      of all samples. We found a highly significant inverse correlation between EGF-R
      and steroid receptors. 88% of the ER positive tumours were EGF-R negative (p less
      than 5 x 10(-5)), 90% of the PR positive tumours were EGF-R negative (p less than
      5 x 10(-5)) and 91% of the ER plus PR positive tumours were ERF-R negative (p
      less than 1 x 10(-6)). Grading was available in 170 cases. Six (4%) of the
      carcinomas were highly differentiated (G1), 82 (48%) were classified as G2, and
      another 82 (48%) were poorly differentiated (G3). A combination of negative ER
      and positive EGF-R was found more often in the population of G3 tumours. EGF-R
      was also positively correlated to tumour size. With regard to receptor status, we
      did not find a correlation with lymph node involvement. The ER correlated
      negatively (p less than 1.3 x 10(-5) and the EGF-R positively (p less than 0.042)
      with menopausal status. Thus, EGF-R overexpression seems to be a marker of
      morphological and functional dedifferentiation which is associated with a loss of
      steroid dependency and an increase of an autostimulatory-paracrine growth
      control. These changes seem to be related to poor prognosis.

PMID- 1634100
TI  - [Primary Figo stage III melanoma of the uterine cervix].
AB  - Malignant melanoma of the uterine cervix is a rare neoplasm with poor prognosis.
      Diagnosis is confirmed by immunohistochemical methods and by exclusion of other
      primaries. The common treatment is radical surgery. In advanced stages, primary
      irradiation can be successful. We report on a case of an 83 years old patient,
      suffering from a malignant melanoma of the uterine cervix FIGO III AB, diagnosed
      by histological and immunohistochemical methods. Due to combined irradiation,
      complete remission of the tumour was achieved. Nevertheless, the patient died of
      the malignancy 15 months later.

PMID- 1634101
TI  - [Pregnancy onset without corpus luteum function?].
AB  - Within five years, a patient had five abortions and one biochemical pregnancy
      with two different partners. After the fourth pregnancy, she underwent a
      heterologous immune stimulation. The karyotypes of all three partners were
      normal. On her first visit, a subclinical hypothyroidism was detected and
      substitution with 50 micrograms L-thyroxine was started. Before further
      endocrinological, virological, or anatomical investigation, the patient conceived
      spontaneously for the seventh time. Even though the beta-HCG-levels rose
      adequately and the sonographic development was according to time, serum
      progesterone could not be detected before the eighth week of pregnancy and
      sufficient levels were found from the 15th week onwards. The patient received a
      hormonal substitution therapy with Gravibinon 250 mg i.m. twice a week up to the
      15th week of gestation. She finally delivered a 3800 g healthy boy.

PMID- 1634102
TI  - [Pregnancy and labor in the literature].

PMID- 1634103
TI  - [Pregnancy and short-wave therapy].

PMID- 1634104
TI  - Genetic and environmental effects on blood pressure in a Norwegian sample.
AB  - Systolic (SBP) and diastolic (DBP) blood pressures were measured in a health
      screening of the adult population in Nord-Trondelag, Norway. Correlations were
      computed for 23,936 pairs of spouses, 43,586 pairs of parent and offspring,
      19,151 pairs of siblings, 1,251 pairs of grandparents-grandchildren, 1,146 pairs
      of biological uncles/aunts-nephews/nieces (avuncular), 801 non-biological
      avuncular pairs, 169 pairs of same-sex twins, and smaller groups of other types
      of relationships. Spouse correlations of 0.08 and 0.09 were approximately
      constant or slightly decreasing with marital duration. The correlation values for
      SBP and DBP were approximately 0.16 for parents-offspring, 0.19 to 0.23 for same
      sex siblings with similar values for DZ twins, 0.19 and 0.16 for opposite-sex
      siblings, 0.52 and 0.43 for MZ twins, and close to zero for most of the second
      order relationships. Genetic additive variance was estimated at 0.29 and genetic
      dominance variance at 0.18 with the best model for SBP. The corresponding
      estimates from the best models for DBP were 0.29 or lower and 0.22 or lower, the
      sum not exceeding 0.35. There was evidence of a moderate effect of environmental
      factors shared by same-sex siblings and twins (for DBP), but no cultural
      transmission, and whether or not adult relatives live together does not affect
      familial resemblance for BP. The data did not permit a very precise resolution of
      the relative magnitude of genetic dominance and sibling effects. The correlation
      structure did not show sex-specific genetic effects.

PMID- 1634105
TI  - Two-locus mitochondrial and nuclear gene models for mitochondrial disorders.
AB  - Stimulated by a large pedigree with a cochlear form of deafness, for which we
      considered a two-locus mitochondrial and nuclear gene model, we have extended the
      classic methods of segregation analysis to these classes of two-locus disorders.
      Based on the unique maternal transmission pattern of the mitochondria, we
      demonstrate that utilization of the maternal line pedigree allows us to simplify
      the various two-locus mitochondrial models to "one nuclear locus" models.
      Classifying the nuclear families into different independent groups by the
      mother's phenotypes allows us to estimate the nuclear gene frequency in one group
      and to use this estimate as the expected value to test the fitness of the model
      on the other group. In addition, if we restrict the analysis to specific subsets
      of the mating type(s), we can also test the model on specific groups of nuclear
      families without estimating the gene frequency. Goodness-of-fit tests can be
      performed on pooled sibship data as well as individual sibship data. These
      methods of analysis should assume increasing importance as more disorders with
      features of mitochondrial inheritance are identified.

PMID- 1634106
TI  - Adequacy of single-locus approximations for linkage analyses of oligogenic
      traits.
AB  - When a disease is controlled by two or more mendelian loci acting epistatically,
      it can be modeled in a linkage analysis as a single-locus mendelian disease with
      reduced penetrance. However, the reliability of such an approximation has not yet
      been demonstrated. This study evaluates the adequacy of such single-locus
      approximations, when the disease under investigation is determined by two loci,
      one of which is tightly linked to a genetic marker. A wide range of two-locus
      models were simulated, and analyzed under both the correct two-locus model and
      under a single-locus approximation to that model. In general, the single-locus
      approximations yielded lod scores very close to the correct ones, but estimates
      of theta tended to be upwardly biased. We conclude that a single-locus linkage
      analysis will, in general, provide an excellent approximation to a correct (two
      locus) linkage analysis of epistatic two-locus diseases. This enables researchers
      to continue to use single-locus linkage analyses when two-locus disease
      transmission is a possibility, and it validates linkage findings already obtained
      under single-locus analysis, even if the disease under investigation proves
      ultimately to be governed by two mendelian loci. We also examine alternative
      methods for obtaining parameter estimates for the single-locus approximations,
      and we discuss both generalizations and limitations of our findings.

PMID- 1634107
TI  - Detection of linkage under heterogeneity: comparison of the two-locus vs.
      admixture models.
AB  - Linkage analysis under the two-locus model and the admixture model was compared
      on pedigree data for a common disease stimulated under a model of genetic
      heterogeneity. The ascertainment of families was designed so that the samples had
      a large proportion of families segregating for both disease loci. The two-locus
      linkage analysis model did not demonstrate increased power of detecting linkage
      or more accurate estimates of the recombination fraction, theta than did the
      admixture model linkage analysis. When a sample was purposely chosen so that all
      of the families were segregating for both loci, then the two-locus lod score
      analysis was better. However, the increased power depended on assuming the
      correct gene frequency for the linked locus. It can be concluded that under the
      conditions of genetic heterogeneity examined here, testing for linkage under the
      admixture model is the preferred method of analysis. However, this is not a
      general conclusion that can apply to all two-locus disease models.

PMID- 1634108
TI  - Sensitivity of transmission probabilities to paternity exclusion in segregation
      analysis.
AB  - Paternity exclusions are known to be common in Western countries and are yet
      neglected in segregation analysis because it is almost impossible to check it
      systematically on a large family sample. We had the opportunity of observing the
      sensitivity of segregation analysis parameters to a paternity exclusion in
      analyzing 34 families for a simple Mendelian trait, the acetylator phenotype. We
      found that only one family, with proven paternity exclusion, was responsible for
      a strong rejection of Mendelian transmission probabilities (P much much less than
      0.001).

PMID- 1634109
TI  - Purification and characterization of wheat alpha-gliadin synthesized in the
      yeast, Saccharomyces cerevisiae.
AB  - The development of efficient methods for production and purification of plant
      seed storage proteins in heterologous microbial hosts would facilitate structure
      function studies of these proteins. This report describes such methods applied to
      the production and isolation of wheat alpha-gliadin, a prolamine-type seed
      storage protein, from Saccharomyces cerevisiae. Beginning with the vector, growth
      conditions, and extraction methods of Neill et al. [Gene 55 (1987) 303-317], we
      implemented several improvements to increase the yields of alpha-gliadin per
      volume of yeast cell culture. The CYCl::Gli-A2-Y transcriptional fusion vector,
      pAY31 (Neill et al., 1987), was modified by replacing the ARS1 region of
      replication with that of the 2 mu plasmid of yeast. We formulated a new medium, a
      derivative of synthetic defined (SD) medium supplemented with several nitrogen
      sources, that allows both selection for maintenance of plasmids and growth to
      high cell densities. Stationary phase cultures of cells bearing the modified
      expression vector, and grown in this medium with glycerol and lactate as carbon
      sources, contain significantly higher levels of alpha-gliadin than log-phase
      cultures grown in SD glucose. Sonication in 80% ethanol selectively and
      efficiently extracts the alpha-gliadin from cell pellets of small- or large-scale
      cultures, allowing the purification of several hundred micrograms of the wheat
      protein per liter in just a few high-yield steps. The alpha-gliadin isolated from
      yeast elutes at the same position in HPLC as the A-gliadin fraction purified from
      wheat flour. N-terminal amino acid (aa) sequencing reveals that the signal
      peptide is removed from the gliadin precursor in yeast cells.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1634110
TI  - Expression of a synthetic gene encoding potato carboxypeptidase inhibitor using a
      bacterial secretion vector.
AB  - A synthetic gene encoding the 39-amino-acid (aa) potato carboxypeptidase
      inhibitor IIa (PCI-IIa) has been constructed and expressed using the secretion
      vector, pIN-III-ompA-3, fused in frame to the OmpA signal peptide-encoding
      sequence. Recombinant Escherichia coli secreted a PCI with 10 additional aa at
      the N terminus (rePCI + 10). These extra aa were removed by site-directed
      mutagenesis giving a PCI with no additional aa (rePCI), as shown by fast atom
      bombardment mass spectrometry (M(r) 4295). The two forms of rePCI were found
      almost exclusively in the culture medium, not in the periplasmic space, as would
      be expected from OmpA signal peptide fusions. Both rePCI + 10 and rePCI are
      biologically active and react strongly with serum raised against PCI from potato.
      A method for the purification of rePCI to homogeneity has been developed. The
      purified rePCI shows a Ki for carboxypeptidase A within the range of the natural
      PCI-IIa (1.5-2.7 nM). These results indicate that both rePCI + 10 and rePCI are
      properly folded and that their three disulfide bridges are correctly formed.
      Together with previous reports, our results show that fusion to a secretion
      signal peptide is an effective way of producing small proteins containing
      disulfide bridges in a biologically active form.

PMID- 1634111
TI  - Mapping of a region of dengue virus type-2 glycoprotein required for binding by a
      neutralizing monoclonal antibody.
AB  - Envelope glycoprotein E of flaviviruses is exposed at the surface of the virion,
      and is responsible for eliciting a neutralizing antibody (Ab) response, as well
      as protective immunity in the host. In this report, we describe a method for the
      fine mapping of a linear sequence of the E protein of dengue virus type-2 (DEN
      2), recognized by a type-specific and neutralizing monoclonal Ab (mAb), 3H5.
      First, an Escherichia coli expression vector containing a heat-inducible lambda
      pL promoter was used to synthesize several truncated, and near-full length E
      polypeptides. Reactivities of these polypeptides with polyclonal mouse
      hyperimmune sera, as well as the 3H5 mAb revealed the location of the 3H5-binding
      site to be within a region of 166 amino acids (aa) between aa 255 and 422. For
      fine mapping, a series of targeted deletions were made inframe within this region
      using the polymerase chain reaction (PCR). The hydrophilicity pattern of this
      region was used as a guide to systematically delete the regions encoding the
      various groups of surface aa residues within the context of a near-full-length E
      polypeptide by using PCR. The 3H5-binding site was thus precisely mapped to a
      region encoding 12 aa (between aa 386 and 397). A synthetic peptide containing
      this sequence was able to bind to the 3H5 mAb specifically, as shown by enzyme
      linked immunosorbent assay. In addition, we show that rabbit Abs raised against
      the synthetic peptide of 12 aa were able to bind to the authentic E protein, and
      to neutralize DEN-2 virus in a plaque reduction assay.

PMID- 1634112
TI  - Functional analysis of two long terminal repeats from the HTLV-I retrovirus.
AB  - Human T-cell leukemia virus type I (HTLV-I) is associated with a large spectrum
      of clinical manifestations in man. Viral and host factors are probably involved
      in determining the consequences of infection. Although most of the genome of HTLV
      I appears remarkably stable, considerable variation is observed in the long
      terminal repeat (LTR) which harbors the promoter region. So far, no correlation
      between specific mutations and pathogenesis has been found, and the current
      opinion is that sequence variations reflect the geographical origin of the
      isolate more than the associated pathology. To assess whether the mutations
      observed between two HTLV-I LTRs were functionally significant, two LTRs, which
      differ by ten mutations, were coupled to the highly sensitive eukaryotic
      luciferase-encoding reporter gene, luc, and tested by transfection in a variety
      of cell lines. Marked differences in promoter activity were observed in some of
      the cells tested, whereas in other both LTRs were equally active. This result
      demonstrates that the minor differences observed between two HTLV-I LTRs can
      affect the activity level of the promoter in some cellular environments, a result
      which could point to the LTR as one determinant of HTLV-I cell tropism in vivo.

PMID- 1634113
TI  - Sodium butyrate selectively induces transcription of promoters adjacent to the
      MoMSV viral enhancer.
AB  - The long terminal repeat region of the Moloney murine sarcoma virus (MoMSV) was
      cloned upstream from the Chinese hamster ovary adenine phosphoribosyltransferase
      (APRT)-encoding gene (APRT) in order to enhance synthesis of the APRT protein.
      The replacement of the native promoter with the viral enhancer-promoter increased
      the enzymatic activity of APRT two- to threefold. Addition of sodium butyrate
      (NaBu) to the cell growth medium induced APRT activity ten- to 20-fold above wild
      type levels in both transient and stable transfectants. The introduction of the
      APRT native promoter between the MoMSV enhancer-promoter and structural gene
      reduced the magnitude of the NaBu response. The bacterial cat gene was also
      stimulated by NaBu when linked to the viral enhancer-promoter. No NaBu response
      was found in constructs lacking the MoMSV enhancer region. Northern analysis and
      nuclear run-on experiments indicated that NaBu enhanced transcription of APRT
      mRNA in both transiently and stably transfected cells, but not in cells inhibited
      by cycloheximide. Thus, a butyrate-response element (BRE) is associated with the
      MoMSV enhancer and the action of the MoMSV BRE is promoter-dependent.

PMID- 1634114
TI  - Expression of a gene encoding a scorpion insectotoxin peptide in yeast, bacteria
      and plants.
AB  - The nucleotide sequence encoding the scorpion insectotoxin I5A was chemically
      synthesized and expressed in yeast, bacteria and tobacco. The I5A peptides
      produced in these organisms were purified using an immunoaffinity chromatography
      procedure. I5A produced using the bacterial secretion system was efficiently
      secreted and released into the culture medium. In contrast, only a trace amount
      of I5A was detected in bacterial cytosols when expressed from a direct expression
      vector, suggesting that I5A was unstable in bacterial cells. I5A secreted from
      yeast using an alpha-factor signal sequence was shown to have an N-terminal (Glu
      Ala)2 extension, indicating incomplete processing of the secreted peptide by
      dipeptidyl aminopeptidase A. In tobacco, a nonsecreted form of the protein was
      produced. No measurable insect toxicity was observed when insect larvae were
      assayed, regardless of whether I5A was produced in yeast, bacteria or tobacco.
      The lack of toxicity is almost certainly the result of improper folding due to
      incorrect disulfide bond formation. The inability to produce a biologically
      active peptide must be overcome before scorpion toxins might be used for the
      genetic engineering of plants for insect resistance. The yeast and bacterial
      expression systems described here may be useful for further studies on the
      problem of expressing a biologically active peptide.

PMID- 1634115
TI  - Cloning and mapping of 5' exons from the gene encoding chicken beta nerve growth
      factor.
AB  - An NGF cDNA containing the 5' exons of the nerve growth factor (NGF) messenger
      was obtained from chicken heart mRNA using the anchored polymerase chain reaction
      technique. Alignment of the chicken with the corresponding murine and human
      sequences reveals interspecies similarities. A sequence corresponding to an exon
      found only in the NGF messenger, which is abundant in the submaxillary gland of
      the male mouse, is present in the chicken NGF cDNA. The first non-coding exons of
      the NGF gene are much less conserved between chicken and mouse or human than the
      region of the last exon encoding the mature protein. After the cloning of the
      chicken NGF gene from a cosmid library, the chicken NGF exons have been located
      within 20 kb of DNA. The chicken NGF gene is therefore shorter than its murine
      counterpart which spans more than 43 kb. Furthermore, the organization of the
      chicken and murine NGF genes markedly differs in their 5' portion.

PMID- 1634116
TI  - A transcriptional analysis of the gene encoding mouse U7 small nuclear RNA.
AB  - Expression of the U7 gene, encoding mouse U7 snRNA, following microinjection into
      Xenopus oocytes is both accurate and efficient, giving rise to mature U7 snRNA
      and a precursor with an 8-nucleotide (nt) 3' extension. The mouse U7 gene
      promoter, which is similar to that of the vertebrate major U genes comprising a
      DSE, a PSE and a 3' box, with the same spatial arrangement, is as efficient as
      the Xenopus U2 gene promoter in this assay. A deletion analysis of the mouse U7
      gene identified sequences downstream from the 3' box, within the region (nt +74
      to +196), which seem to have a negative regulatory effect upon the frequency of
      transcription initiation and are also required for accurate 3' end formation.
      Sequences in the nt -1699 to -431 region also seemed to have a negative effect on
      the level of transcription. In addition, sequences upstream from the PSE, within
      the nt -65 to -421 region, are necessary for accurate and efficient synthesis of
      mature U7 snRNA. Finally, the mouse U7 snRNA may not form a functional snRNP in
      Xenopus oocytes due to defective snRNP assembly and/or nuclear import.

PMID- 1634117
TI  - Basal expression of the gene (TIMP) encoding the murine tissue inhibitor of
      metalloproteinases is mediated through AP1- and CCAAT-binding factors.
AB  - In cultured murine fibroblasts, the TIMP gene (encoding tissue inhibitor of
      metalloproteinases) is transcribed constitutively, although at low levels. We
      have used a cell-free system in which nuclear extracts prepared from murine L
      cells support transcription from TIMP DNA templates in vitro. This system was
      used to study the role of cis-acting DNA sequences in the constitutive expression
      of TIMP. Sequences important for expression are located both 5' and 3' (in intron
      1) to the major transcription start point and are required to obtain detectable
      levels of transcription. These regions are specifically recognized by murine
      nuclear factors and contain DNA motifs whose sequences closely resemble binding
      sites for known transcriptional activators. In particular, the data strongly
      suggest a role for CCAAT-binding factor(s) and AP1-binding factors in the basal
      transcription of TIMP.

PMID- 1634118
TI  - Intragenic regulatory elements contribute to transcriptional control of the
      neurofilament light gene.
AB  - To date, no DNA regions involved in the neuron-specific expression of the
      neurofilament light gene (NF-L) have been defined using transfection assays in
      cultured cells. To identify those regulatory regions in the human NF-L gene, we
      generated transgenic mice with a construct containing the basal NF-L promoter (
      292 to +15) fused to the cat gene and with three DNA fragments of 21.5, 7.6 and
      4.9 kb each, including NF-L with different lengths of either 5'- or 3'-flanking
      sequences. We show that the proximal NF-L 5' region (0.3 kb) constitutes a weak
      promoter and that it lacks information to confer neural specificity. However,
      appropriate expression in the nervous system occurred when this minimal promoter
      was combined with either 7.3 or 4.6 kb of NF-L sequences downstream from the
      transcription start point. We conclude that the intragenic NF-L region contains
      cis-acting elements conferring cell-type-specific regulation on the basal
      activity of the NF-L promoter. Interestingly, AP-2 motifs were found within
      homologously placed introns of all three NF genes, as well as in the promoter
      regulatory regions of many neuronal genes. We propose that the acquisition of
      introns by an ancestral intronless IF gene may have contributed to the emergence
      of a lineage of IF genes expressed in the nervous system.

PMID- 1634119
TI  - Gibbon and marmoset c-myc nucleotide sequences.
AB  - The nucleotide sequences of the gibbon and marmoset myc loci have been determined
      by the dideoxy ribomethod. The number of mutations which occurred during
      evolution and the branches affected were deduced according to the principle of
      maximum parsimony, from a comparison with known mammal sequences. As previously
      observed for the human and chimpanzee myc genes, an Alu repeat belonging to
      subclass III was observed in the second intron of the gibbon myc gene. In
      contrast, no such element was found in the marmoset gene. Alignment of the Myc
      amino acid (aa) sequences provided clues for detecting which aa or which protein
      regions have been more heavily mutated. Conversely, some regions remained free of
      mutations and remained unchanged from mouse to human, most probably in connection
      with some important embedded property(ies). An intriguing feature of the human
      Myc protein is duplication of 50 aa out of 439. Strikingly, most of these aa
      remain unchanged in mouse, rat, cat, marmoset, gibbon, chimpanzee and human.

PMID- 1634120
TI  - Structures of cDNAs encoding chum salmon pituitary-specific transcription factor,
      Pit-1/GHF-1.
AB  - Pit-1/GHF-1, a POU family transcription factor, was originally isolated as a
      protein that contributes to the pituitary-specific expression of the mammalian
      growth hormone(GH)-encoding gene. Pit-1/GHF-1 has been recently implicated in the
      development of three types of hormone-producing cells which secrete GH, prolactin
      (PRL) and thyroid-stimulating hormone. A presumed pituitary hormone, somatolactin
      (SL) which belongs to the GH/PRL family, was previously isolated from fish. As
      the first step for determining the possible involvement of the Pit-1 protein in
      the pituitary-specific expression of the SL gene and/or in the development of SL
      producing cells, chum salmon Pit-1 cDNA clones were isolated. Chum salmon Pit-1
      mRNAs were mainly 2 kb and 3 kb in size, and specifically expressed in the
      pituitaries. They encoded a 365-amino acid (aa) protein, which was 74 aa larger
      than that found in mammals. The identity of aa sequences between salmon and rat
      Pit-1 was 69%. These proteins were highly conserved in the region specific for
      the POU family. Salmon Pit-1 had two additional sequences each consisting of
      about 30 aa in the N-terminal region. The sequence involved in transcriptional
      activation is considered to be located in the region including the above
      sequences, and thus, salmon Pit-1 may possibly have novel functions distinct from
      those of rat Pit-1.

PMID- 1634122
TI  - Jimmy Connors: 'geriatric' symbol at 40.

PMID- 1634121
TI  - High-level secretion of the four salivary plasminogen activators from the vampire
      bat Desmodus rotundus by stably transfected baby hamster kidney cells.
AB  - The cDNAs coding for the four Desmodus rotundus salivary plasminogen activators
      (DSPAs) were subcloned into the mammalian expression vector, pMPSV/CMV, which
      carries the myeloproliferative sarcoma virus promoter and the cytomegalovirus
      enhancer. These constructs were transfected, together with plasmids harbouring
      Geneticin (G418)-resistance and puromycin-resistance genes, into baby hamster
      kidney cells. Through the selective pressure of both antibiotics, cell clones
      constitutively overexpressing the DSPA alpha 1, DSPA alpha 2, DSPA beta or DSPA
      gamma cDNAs were obtained. Secretion of active DSPAs was confirmed by zymographic
      analysis and quantified using a fibrin plate assay and ELISA.

PMID- 1634123
TI  - Individualizing the risk/benefit ratio of NSAIDs in older patients.
AB  - Nonsteroidal anti-inflammatory drugs (NSAIDs) have provided safe, effective
      relief of pain and inflammation in millions of elderly patients. Their role in
      the therapy of rheumatic disease, particularly in helping patients to maintain an
      independent lifestyle, is indisputable. Despite this success, recent
      epidemiologic studies have confirmed an increased relative risk for a wide
      variety of significant toxicities. Advanced age has emerged as one of the most
      striking risk factors for all of the commonly associated side effects. However,
      considering the large proportion of the population using these drugs, the
      absolute risk is remarkably low. Recognizing those elderly individuals most
      likely to benefit and least likely to suffer from NSAID use is the key to their
      appropriate use.

PMID- 1634124
TI  - Prescribing physical activity for older patients.
AB  - Regular exercise is an effective nonpharmacologic therapy for stress, sleep
      disorders, depression, and anxiety, as well as such chronic conditions of aging
      as hypertension, obesity, diabetes mellitus, coronary artery disease,
      hyperlipidemia, and constipation. Pre-exercise office assessment of cardiac risk,
      possible limitations, and contraindications is advised. A balanced fitness
      training program includes activities to increase flexibility, strength, and
      cardiovascular endurance. The most effective exercise prescription begins with a
      type of aerobic activity the patient enjoys. A prescribed schedule of stepwise
      increments in frequency, duration, and intensity gradually leads to a maintenance
      level of fitness.

PMID- 1634125
TI  - Deep vein thrombosis and pulmonary embolism: prevention, diagnosis, and
      treatment.
AB  - Pulmonary embolism (PE) is a significant cause of mortality in the elderly. More
      than 90% of pulmonary emboli originate from a thrombus in the deep veins of the
      legs. Proper diagnosis and treatment of deep vein thrombosis (DVT) are thus
      essential to prevent PE. Diagnosis of new or recurrent DVT is based on the
      results of one or more tests, including impedance plethysmography (IPG) or duplex
      venous scan; venography can often be avoided, based on results of initial
      testing. For suspected PE, perfusion lung scanning is the initial test of choice,
      followed by IPG/duplex or venography. Pulmonary angiography is indicated for
      patients with decreased cardiorespiratory reserve. Decisions governing
      prophylaxis of DVT are based on individual relative risk; prophylactic therapies
      include intermittent compression, low-dose heparin, and oral anticoagulants.
      Management of thromboembolism requires IV and oral anticoagulant therapy.

PMID- 1634126
TI  - Age-based rationing of medical care.

PMID- 1634127
TI  - Inadequate analgesia: patients endure pain, fear addiction.

PMID- 1634128
TI  - Ovarian dysgerminoma metastatic to the breast.
AB  - A 16-year-old girl underwent a right salpingo-oophorectomy for a pure
      dysgerminoma limited to the right ovary. One month later, she developed a right
      pelvic mass along with abdominal lymphadenopathies, peritoneal carcinomatosis,
      left breast mass, and left axillary node. Cytology of the breast mass was
      suggestive of a pure dysgerminoma. Breast metastases of epithelial ovarian
      carcinoma are uncommon. In the literature, this is the first case of a breast
      metastasis of an ovarian dysgerminoma.

PMID- 1634129
TI  - Endosalpingiosis in association with ovarian surface papillary tumor of
      borderline malignancy.
AB  - A 40-year-old woman underwent total abdominal hysterectomy, bilateral salpingo
      oophorectomy, pelvic/paraaortic lymphadenectomy, and omentectomy for Stage IA
      ovarian surface papillary tumor of borderline malignancy. Microscopic examination
      revealed endosalpingiosis of ovaries, the peritoneum of uterus, pelvic lymph
      nodes, and omentum. There was no evidence of disseminated peritoneal malignancy.
      The several proposed theories of the pathogenesis of endosalpingiosis are
      reviewed, but that involving metaplasia of the multipotential peritoneal cells is
      presented as the most acceptable.

PMID- 1634130
TI  - Immature teratoma of the ovary--an unusual case.
AB  - A 30-year-old female was found to have a malignant immature teratoma of the ovary
      14 years ago. This was treated with surgery followed by chemotherapy. Two years
      later, hepatic metastasis was discovered and treated with different multiple
      agent chemotherapy, resulting in transformation or evolution into a mature
      teratoma form of disease. Twelve years later, this disease underwent malignant
      degeneration and transformed into a metastatic adenocarcinoma. This case report
      illustrates that malignant ovarian immature teratoma, teratocarcinoma, like its
      testicular counterpart, can evolve or differentiate into an apparently benign
      form of disease, but ultimately leads to death due to subsequent malignant
      transformation into new forms of malignancy arising from any of the three
      primordial germ cell layers.

PMID- 1634131
TI  - Cellular schwannoma of the vagina.
AB  - Schwannomas of the female genital tract are rare, and an example in the vagina
      has not previously been reported. The case of a 37-year-old woman with a cellular
      schwannoma of the vagina is described and is accompanied by a review of
      schwannomas in the female genital tract.

PMID- 1634132
TI  - Recurrent consecutive partial molar pregnancy.
AB  - Gestational trophoblastic disease (GTD) is rare. Recurrent GTD, though occurring
      in only 0.6-2.6% of subsequent pregnancies, has significant clinicopathological
      implications. These include risk of malignant sequelae and subsequent poor
      reproductive performance. The cytogenetics and histopathology of complete and
      partial moles differ, yet there are several clinicopathological similarities.
      Although complete hydatidiform moles are known to recur, very little is known
      about recurrent partial vesicular moles in world literature. We report here on a
      patient with four consecutive recurrent partial hydatidiform moles who is yet to
      achieve a normal pregnancy. Her third molar pregnancy was further complicated by
      severe thyrotoxicosis. The unusual histology and the progressively more
      aggressive clinical course are discussed. The small risk of malignant sequelae
      and the need for close endocrinological monitoring are highlighted, as are her
      chances of yet another recurrent GTD.

PMID- 1634133
TI  - Granulocytic sarcoma of the uterine cervix--literature review of granulocytic
      sarcoma of the female genital tract.
AB  - Granulocytic sarcoma is an extramedullary tumor of malignant granulocytic
      progenitor cells that accompanies, heralds, or signals relapse of acute
      myelogenous leukemia (AML), or indicates blastic transformation of a chronic
      myeloproliferative disorder. We describe a case involving the uterine cervix of a
      51-year-old woman that led to the diagnosis of AML. Granulocytic sarcoma can
      occur in the female genital tract and may be the first clinically significant
      manifestation of a hematologic malignancy. The salient findings in 28 reported
      cases from 12 different countries are reviewed. Awareness of this lesion is
      important for all medical personnel involved in the health care of women.

PMID- 1634134
TI  - Flow-cytometric DNA analysis of stages IB and IIA cervical carcinoma.
AB  - The prognostic significance of flow-cytometric DNA analysis was assessed in 375
      stages IB and IIA squamous cell carcinoma patients treated with radical
      hysterectomy and lymphadenectomy at the Mayo Clinic between 1956 and 1985.
      Paraffin-embedded samples containing at least 20% tumor were dewaxed, rehydrated,
      stained with propidium iodide, and analyzed. Among 344 assessable samples, 136
      (40%) were diploid and 208 (60%) were nondiploid (26 tetraploid, 158 aneuploid,
      and 24 polyploid). Diploid cases were further subclassified: 25 high
      proliferative phase (HPP) (S+G2M greater than 20%) and 111 low proliferative
      phase. No significant correlation was noted between DNA diploid patterns and
      stage, tumor size, grade, or histotype, but HPP diploid tumors had a
      significantly higher risk of nodal metastasis. With a mean follow-up period of
      150 months, 62 patients died of disease. No significant difference was observed
      in survival rates (SR) between diploid and nondiploid tumors, but the subset of
      HPP diploid tumors had a prognosis significantly worse than that of any other
      group (P less than 0.01). Other significant variables included nodal metastases,
      parametrial extension, age, and clinical stage. While ploidy patterns did not
      assign additional risk to node-positive lesions, HPP diploid tumors in node
      negative patients were associated with a significantly lower SR. Multivariate
      analyses in node-negative patients demonstrated that stage, histologic subtype,
      and HPP diploid patterns retained prognostic independence.

PMID- 1634135
TI  - Sigmoid colectomy.

PMID- 1634136
TI  - The combined operative and radiotherapeutic treatment (CORT) of recurrent tumors
      infiltrating the pelvic wall: first experience with 18 patients.
AB  - CORT is a new radiosurgical treatment concept for patients with recurrent
      gynecologic malignancies infiltrating the pelvic wall. The operative part
      consists of (i) staging laparotomy; (ii) maximum debulking of the tumor from the
      pelvic wall and exenteration of infiltrated central pelvic organs; (iii)
      implantation of brachytherapy guiding tubes on the residual tumor/tumor bed at
      the pelvic wall; (iv) pelvic wall plasty with muscle and omentum flaps to create
      a protective distance between the tubes and the pelvic hollow organs and to
      induce therapeutic angiogenesis; and (v) surgical reconstruction of bowel,
      bladder, and vulvoperineovaginal functions. Radiation is given postoperatively as
      fractionated HDR brachytherapy via the implanted tubes. Patients without prior
      pelvic radiation also receive preoperative whole pelvis teletherapy. Eighteen
      patients with recurrent malignancies infiltrating one pelvic wall have been
      treated with CORT in a prospective phase I/II trial at the University of Mainz.
      Fourteen patients had a history of radiation therapy with midpelvic doses of 40
      100 Gy (median, 65 Gy) as primary treatment. Eleven patients (61%) are without
      evidence of disease at 6-32 months (median, 15 months) follow-up. Four patients
      have died from pelvic progression and distant metastases, and two patients are
      alive with disease after 12 months. There was no operative mortality; however,
      one patient succumbed from fatal thromboembolism 6 months after therapy. Three
      patients with prior radiation of greater than 75 Gy had to be treated for
      intestinal fistulas. We conclude that CORT is feasible with encouraging
      preliminary results.

PMID- 1634137
TI  - The prognostic implications of low serum CA 125 levels prior to the second-look
      operation for stage III and IV epithelial ovarian cancer.
AB  - Second-look laparotomy is performed to evaluate response to chemotherapy and to
      determine the need for additional treatment. The relationship between absolute
      levels of serum CA 125 less than 35 u/ml and disease status at second-look
      operation was evaluated in 95 patients with advanced-stage epithelial ovarian
      cancer. Eighty-six patients had Stage III disease and nine patients had Stage IV
      cancer. Residual tumor was documented at second-look laparotomy in 52 (55%) of
      the patients studied. Forty-nine percent of the 82 patients with serum CA 125
      values less than 20 u/ml had residual disease. In contrast, 12 of 13 (92%)
      patients with serum CA 125 values of 20-35 u/ml had residual tumor at second-look
      laparotomy. All patients with serous cystadenocarcinomas and serum CA 125 values
      of 20-35 u/ml had residual tumor, and two-thirds of these cases had grossly
      visible disease. The positive predictive value of a serum CA 125 level of 20-35
      u/ml was 0.92. These data suggest that second-look laparotomy should be deferred
      in patients with advanced-stage ovarian cancer until serum CA 125 values are less
      than 20 u/ml.

PMID- 1634138
TI  - Prospective histopathologic malignancy grading to indicate the degree of
      postoperative treatment in early cervical carcinomas.
AB  - During a 9-year period, 92 women with squamous cell carcinoma of the cervix, FIGO
      stages IA1-IIA, were subjected to primary surgery according to Wertheim Meigs.
      Grading according to a malignancy grading score (MGS) and evaluation of tumor
      size before surgery together with surgical findings of positive nodes or
      insufficient surgical margin at the primary site were used to identify persons
      prospectively at high risk for relapse. Twenty-five women thus received
      postoperative treatment. Results among node-positive patients were good; only 2
      out of 12 patients relapsed. Among 67 node-negative patients in stages IA2-IIA, 4
      relapses occurred. These 4 patients had greater than or equal to 16 risk points
      according to MGS, but small tumors. Instead of tumor size, supplementary risk
      factor is therefore needed. Among the few patients in stage IA1, no high-point
      patients relapsed. These patients would probably have done just as well with less
      extensive surgery.

PMID- 1634139
TI  - The role of appendectomy in surgical procedures for ovarian cancer.
AB  - To assess the role of appendectomy in the surgical procedures for ovarian cancer,
      we evaluated retrospectively the clinical charts of 435 patients who underwent
      surgery after diagnosis of ovarian cancer. The appendix was removed in 160 cases
      and pathological examination revealed 37 with metastatic implants (23%). All the
      patients with appendiceal metastases showed advanced disease (stages III-IV) with
      an incidence of 43%. Ninety-one percent (31/34) of the tumors with appendiceal
      involvement at the staging operation were of the serous cell type and grade II or
      III. No case with early stage, right ovary carcinoma showed appendiceal
      metastatic foci, denying the existence of a preferential lymphatic pathway.
      Microscopic involvement was found only in 4 patients with advanced disease
      (11.7%). No intra- or postoperative complication directly related to the
      appendectomy was recorded. We conclude, with these results, that appendectomy
      should be part of the cytoreductive operation for ovarian cancer.

PMID- 1634140
TI  - ras oncogene product p21 expression and prognosis of human ovarian tumors.
AB  - Monoclonal antibody rp-28 directed against the ras gene product p21 has been
      studied to evaluate ras p21 expression in malignant and benign ovarian tissues.
      Some ovarian carcinomas of serous and mucinous cystadenocarcinomas,
      undifferentiated adenocarcinomas, and clear cell carcinomas demonstrated intense
      staining of ras p21. The frequency and intensity of ras p21 staining were
      observed to increase with the degree of malignancy. There was no significant
      difference in ras p21 expression between early and late stages in ovarian tumors
      arising from the coelomic epithelium. With respect to prognosis, no differences
      between the ras p21-positive and -negative cases in ovarian tumors arising from
      the coelomic epithelium were observed. It is, therefore, possible to say that ras
      p21 expression was not related to clinical staging and prognosis. Expression of
      ras p21 in malignant lesions was higher than that in benign lesions of the ovary,
      and the expression is associated with the degree of malignancy in some types of
      ovarian tumors. Overexpression of ras p21 was observed in epithelial tumors;
      however, increased expression was not observed in germ cell and sex-cord stromal
      tumors. This differential expression of ras p21 is due to the different
      histogenesis of ovarian tumors. This fact may reflect a different carcinogenic
      mechanism for different types of malignancy.

PMID- 1634141
TI  - Papillary serous adenocarcinoma of the endometrium: a clinicopathologic study of
      19 cases.
AB  - Survival in 19 patients with papillary serous adenocarcinoma of the endometrium
      treated at the University of Vermont during the period 1960-1987 was
      significantly worse than that for 360 patients with other types of endometrial
      cancer. Deaths were associated with extrauterine spread and deep myometrial
      invasion detected at the time of surgery. Two patients without myometrial
      invasion and with extrauterine spread who also died may have developed
      synchronous peritoneal serous carcinoma.

PMID- 1634142
TI  - Inexpensive population screening for abnormal cells from the uterine cervix and
      valid results using the vaginal cytopipette.
AB  - Women who have not accepted an invitation by their own general practitioner to
      have a smear test, or for whom voluntary population screening projects are
      unavailable because of lack of public funds, may be at increased risk of
      malignant cervical changes. Such women may be offered self-testing by a
      cytopipette on the basis of the present analysis of abnormal cell counts and cell
      density on the cytological slides. As one link in a prophylactic study using the
      cytopipette, 107 women with abnormal cell findings were reinvited for
      simultaneous sampling by irrigation smear and by ordinary technique. The
      cytological findings indicate that the two methods are equal in recovery of
      abnormal epithelium, provided that the scanned quantity of cells is increased
      fourfold in the irrigation smear method, this quantity being distributed over two
      specimens each with double cell density and giving at least 1800 squamous
      epithelial cells per visual field (125:1) or a total of approximately 10(6)
      epithelial cells in each cytological specimen. Under these conditions the two
      sampling methods have the same predictive value.

PMID- 1634143
TI  - Serum erythropoietin levels in gynecologic cancer patients during cisplatin
      combination chemotherapy.
AB  - To investigate the participation of erythropoietin (Epo) in anemias induced by
      cisplatin combined chemotherapy, serum Epo levels were measured by
      radioimmunoassay on a serial basis in eight patients with gynecologic cancer
      undergoing this chemotherapy. The data demonstrated that serum Epo levels, the
      mean level before chemotherapy being 20.1 +/- 6.6 mU/ml, were significantly
      elevated after the first course of the chemotherapy (52.1 +/- 32.2 mU/ml; P less
      than 0.05) when anemia was not evident. The serum Epo level continued to increase
      as the course of chemotherapy advanced, and furthermore, patients with normocytic
      anemia after a multiple course of this chemotherapy still showed high Epo levels
      (115.2 +/- 53.5 mU/ml) that were appropriate for given degrees of anemia. It is
      suggested that cisplatin combined chemotherapy caused the elevated serum Epo
      levels through an unknown mechanism other than anemia, and that in anemias
      induced by cisplatin, Epo deficiency is not evident.

PMID- 1634144
TI  - Potentiation of cisplatin cytotoxicity in human ovarian carcinoma cell lines by
      trifluoperazine, a calmodulin inhibitor.
AB  - Chemotherapy for ovarian cancer is frequently limited by cisplatin (CDDP)
      resistance. Enhanced DNA repair is one of several mechanisms which may cooperate
      to produce resistance in human ovarian carcinoma cell lines. Published reports
      suggest that calmodulin inhibitors, such as trifluoperazine (TFP), may inhibit
      one or more steps in DNA repair. The effects of TFP alone or in combination with
      CDDP were determined by clonogenic assay of six human ovarian carcinoma cell
      lines, derived from untreated patients (some of which were selected for cisplatin
      resistance in vitro) and from patients clinically refractory to cisplatin-based
      chemotherapy. TFP produced dose-dependent cytotoxicity in all cell lines. In
      addition, TFP (10 microM) produced approximately two-fold enhancement of CDDP
      cytotoxicity in three of the six cell lines (A2780, 2780-CP8, and 2780-C30). TFP
      and CDDP had additive or synergistic cytotoxicity in four of the six cell lines
      by median effects analysis, while clear antagonism was apparent in the remaining
      cell lines. These results suggest that TFP may enhance CDDP cytotoxicity in some,
      but not all, human ovarian carcinoma cell lines. The potential utility of
      trifluoperazine in ovarian cancer, either alone or in combination with cisplatin,
      remains to be defined in xenograft models and in clinical trials.

PMID- 1634145
TI  - The use of ATP bioluminescence assay and flow cytometry in predicting
      radiosensitivity of uterine cancer cell lines: correlation of radiotoxicity and
      cell cycle kinetics.
AB  - Radiotherapy remains an important part of uterine cancer treatment. This study
      was designed to evaluate the potential of the ATP bioluminescence assay and flow
      cytometry for predicting radiosensitivity. Correlation of these two modalities
      revealed important insights into the relationship of radiotoxicity and cell
      kinetic effects. Six human uterine cancer cell lines were used: AE7, ECC1, HEC1A,
      HEC1B, AN3, and SKUT1B. Doses of cobalt 60 were 0, 1, 2, 5, 8, and 10 Gy. The ATP
      bioluminescence assays were performed on Day 7. Cell samples were taken at 0, 24,
      48, 72, 96, and 168 hr for flow cytometry. The linear-quadratic model was used to
      fit survival data and mean inactivation dose D was calculated. Among parameters
      such as D, alpha and beta coefficients, and surviving fraction at 2 Gy (SF2),
      both D and SF2 correlated best with survival data. Radiation effects on the cell
      cycle did not correlate with D and revealed two distinct patterns: either a G1
      accumulation with mild G2 block or a G1 depletion and severe G2 block. The S
      cells consistently demonstrated a biphasic pattern with an initial reduction
      followed by an accumulation. In summary, the ATP assay was shown to have
      potential in the study of radiosensitivity. Radiation-induced cell kinetics
      appeared to vary with intrinsic cellular differences and, thus, could not be used
      to predict radiosensitivity.

PMID- 1634146
TI  - DNA content in juvenile granulosa cell tumors of the ovary: a study of early- and
      advanced-stage disease.
AB  - Paraffin-embedded tissue from 38 patients with early- and advanced-stage juvenile
      granulosa cell tumor (JGCT) of the ovary was analyzed by flow cytometry to
      investigate whether the DNA content is related to the histologic features, stage,
      or clinical outcome. Thirty-three cases were suitable for analysis: twenty-seven
      Stage Ia, two Stage Ic, and four Stage III. Eighteen (55%) tumors were DNA
      diploid and fifteen (45%) tumors were DNA aneuploid with a mean S-phase fraction
      (SPF) of 13.6% and a range of DNA indices from 1.0 to 2.2. Neither the DNA ploidy
      nor the SPF was associated with the stage of the disease. An analysis of the
      relation between DNA content and histopathologic features revealed that
      aneuploidy was associated with high mitotic rates and to a lesser extent with
      high-grade nuclear atypia. DNA aneuploidy was not associated with aggressive
      behavior of Stage Ia JGCTs. However, among the four patients with Stage III
      tumors, the two with diploid, low-SPF tumors were alive and well, whereas the two
      with aneuploid, high-SPF tumors developed recurrences or died. These data suggest
      that further studies on the prognostic significance of flow cytometric analysis
      of DNA content in advanced-stage JGCTs are warranted.

PMID- 1634147
TI  - Marginal fractures of the lateral malleolus in association with other fractures
      in the ankle region.
AB  - Eight cases of avulsion-type fracture of the distal fibula associated with
      fracture of the calcaneus, talus, or ankle region were identified. This avulsion
      fracture can be identified on routine radiographs as well as on CT scans of the
      ankle and is pathognomonic of rupture of the superior peroneal retinaculum with
      or without peroneal tendon displacement. Recognition of this avulsion fracture,
      with subsequent proper management of the underlying peroneal tendon pathology by
      immobilization or surgery, may prevent future tendon dysfunction. It may also
      alter the treatment of other associated injuries.

PMID- 1634148
TI  - Treatment of extensive aseptic defects in old Achilles tendon ruptures: methods
      and case reports.
AB  - Defect bridging is still problematic in the secondary treatment of Achilles
      tendon ruptures. Smaller defects can be treated without problems by the well
      known standardized methods, whereas other methods have to be applied for treating
      larger defects. Free transplants with autogenous or exogenous material should be
      mentioned in this context. Complications are more likely to occur with exogenous
      material, free transplants from the fascia lata require an additional
      intervention to remove the transplant from another localization. These methods
      cannot be applied to achieve reliable restoration of continuity for defects with
      a length of 10 cm. Therefore, in these special cases, we carry out the tendon
      transplantation with a free tendon-muscle graft from the triceps surae muscle. We
      achieved reliable restoration of continuity with complication-free healing of the
      free transplant in, up to now, three cases, in association with the formation of
      a strong, functionally high grade scar plate in the area of the tendon.

PMID- 1634149
TI  - Stabilization of the interphalangeal joint of the big toe: comparison of three
      methods.
AB  - Three methods of stabilizing the IP of the big toe were compared. In group A, 10
      patients underwent tenodesis of the extensor hallucis longus to the extensor
      digitorum brevis tendon. All of them developed a toe-drop; two patients had
      significant symptoms that required IP fusion. In group B, 19 patients underwent
      IP fusion using smooth or threaded intramedullary Kirschner wire fixation. There
      were nine nonunions, three requiring refusion. In group C, 32 patients underwent
      IP fusion using intramedullary screw fixation. There was one nonunion with screw
      failure that required revision. Although none of our patients considered the toe
      drop after extensor hallucis longus tenodesis cosmetically unacceptable, this may
      not be so in other cultures. All complications following IP fusion with screw
      fixation were technical and are avoidable. When stabilization of IP is required,
      we recommend fusion of IP with screw fixation.

PMID- 1634150
TI  - Plantar fasciotomy for intractable plantar fasciitis: clinical results and
      biomechanical evaluation.
AB  - Thirteen consecutive patients underwent plantar fasciotomy in 16 feet for
      intractable plantar fasciitis and had follow-up from 4.5 to 15 years. Plantar
      fasciotomy was successful (good or excellent results) for 71% of the 14 feet
      operated on and for which follow-up data were available. However, time to full
      recovery was prolonged, additional treatment was frequently required, and
      abnormalities of foot function persisted. Flattening of the longitudinal arch
      occurred. Dynamic force-plate studies showed differences in peak vertical, fore
      aft, and lateral-medial forces between patients and matched controls. More rapid
      progression of weightbearing along the longitudinal axis of the foot during
      stance phase in patients indicated avoidance of heel loading.

PMID- 1634151
TI  - Tibial sesamoid shaving for treatment of intractable plantar keratosis.

PMID- 1634152
TI  - The distal course of the sural nerve and its significance for incisions around
      the lateral hindfoot.
AB  - Twenty preserved cadaver limbs were dissected to show the distal course of the
      sural nerve and the number and site of origin of its branches. The mean position
      of the main nerve trunk was calculated at various points related to bony
      landmarks of the fibula and the fifth metatarsal base. Ninety-five percent
      confidence limits for the course of the main nerve trunk could be described. A
      fibula incision may damage the nerve if it extends more than 7 mm inferior to the
      lateral malleolar tip with the foot in equinus. Dorsolateral foot incisions may
      damage both the main trunk and the major anterior branch.

PMID- 1634153
TI  - The retrocalcaneal bursa: anatomy and bursography.
AB  - The retrocalcaneal bursae, located between the posterior angle of the os calcis
      and the Achilles tendon, may become inflamed and hypertrophied. There are few
      objective tests available for the diagnosis of pain syndromes involving the
      hindfoot and it is often difficult to differentiate Achilles tendinitis and
      retrocalcaneal bursitis. Retrocalcaneal bursograms can provide further insight
      into chronic changes in the bursae associated with traumatic and inflammatory
      conditions. This report describes the anatomy of the retrocalcaneal bursa, the
      technique of its opacification, and the application of this technique to the
      diagnosis and treatment of painful hindfoot syndromes. In addition, the anatomy
      of the retrocalcaneal bursa was investigated further using latex casting
      techniques. Twelve cadaver limbs were injected with radiopaque latex casting
      material or renografin into the retrocalcaneal bursae. AP, lateral, and oblique
      radiographs were then obtained on the specimens. The size, capacity, and
      configuration of the postmortem bursae were measured and recorded. Subsequently,
      the cadaver limbs injected with the latex material were cooled and dissection was
      made of the retrocalcaneal bursae. The latex bursal molds were measured,
      graphically recorded, and photographed. Fifteen patients with signs and symptoms
      of retrocalcaneal bursitis and eight asymptomatic patients were selected for this
      study and injected with radiopaque material into the bursae. Anteroposterior,
      lateral, and oblique radiographs were then obtained. The size, capacity, and
      configuration of the retrocalcaneal bursae were measured and recorded. The
      anatomic characteristics noted from the latex bursal molds correlated well with
      the findings on bursography. Bursographic findings in patients with
      retrocalcaneal bursitis can provide insight into the diagnosis and clinical
      management of this disorder.

PMID- 1634154
TI  - Clinical significance of magnetic resonance imaging in preoperative planning for
      reconstruction of posterior tibial tendon ruptures.
AB  - A retrospective study of attenuated/ruptured posterior tibial tendons was
      conducted of all patients who underwent tendon reconstruction over a 4-year
      period. The study comprised 20 feet in 19 patients having an average age of 53.3
      years, with an average follow-up of 2 years. Preoperative magnetic resonance
      images were taken and graded for assignment to one of three magnetic resonance
      imaging (MRI)-based groups. The surgical grade was determined intraoperatively
      based on a previously described classification scheme. No medical or
      rheumatologic conditions predisposing to failure could be identified. Failure was
      defined as postoperative progression of pain and deformity which required
      subsequent triple arthrodesis. There were six failures at an average of 14.7
      months. Surgical evaluation was not correlated to outcome following
      reconstruction. MRI grading, however, was predictive of outcome. The superior
      sensitivity of MRI for detecting intramural degeneration in the posterior tibial
      tendon that was not obvious at surgery may explain why MRI is better than
      intraoperative tendon inspection for predicting the outcome of reconstructive
      surgery. Therefore, it may be helpful to obtain preoperative MRI when this
      particular reconstruction of the posterior tibial tendon is contemplated, since
      this provides the best measure of tendon integrity and appears to be the best
      predictor of clinical success after such surgery.

PMID- 1634155
TI  - Dislocation of the posterior tibial tendon.
AB  - We have treated seven patients with dislocation or recurrent subluxation of the
      posterior tibial tendon. The diagnosis of dislocation was made based on the
      patient's symptoms, physical examination, and magnetic resonance scanning. All
      patients were treated with surgical repair, which was modified according to the
      operative findings. The operative findings included tenosynovitis, a shallow or
      incompetent flexor groove, and tearing or absence of the flexor retinaculum. At
      an average of 28 months following surgery, all patients were markedly improved
      and six returned to their preinjury level of activity.

PMID- 1634156
TI  - A technique for measuring absolute toe pressures: evaluation of pressure
      sensitive film techniques.
AB  - Although a number of pathologies of the forefoot in ballet dancers on pointe have
      been described, pressures and deforming forces have not been adequately measured.
      To evaluate the possible use of pressure-sensitive film (PSF) in measuring the
      pressures on the external soft tissues in such a confined space as the dancer's
      toe shoe, it was tested and calibrated with 20 cadaver toes. Each cadaver toe was
      internally stabilized and loaded longitudinally against PSF on a flat surface.
      The resultant films were analyzed with a video imaging system and the pressures
      and total forces were determined. Results showed that the linearity of the PSF to
      pressure had a regression value of 0.98. By using two sensitivity ranges of
      films, the total force measured by the PSF was found to be within 10% of the
      known applied force on each toe. The PSF, therefore, may very well be a useful
      and accurate method of measuring external soft tissue pressures on the forefoot.

PMID- 1634157
TI  - Repair of concomitant lateral ankle ligament instability and peroneus brevis
      splits through a posteriorly modified Brostrom Gould.

PMID- 1634158
TI  - [Increasing the adhesion of glass ionomer cements in bracket bonding].
AB  - For attaching orthodontic brackets glass ionomer cements are being discussed as
      an alternative material to synthetic glues since they are less aggressive toward
      the tooth enamel. A serious disadvantage consists in a lower degree of adhesion
      to enamel. The adhesion can, however, be increased to some extent by enamel
      preparation. In order to investigate further improvement in this area, 250
      freshly extracted bovine teeth were treated with 22 chemicals and their enamel
      conditioning properties were tested. For the attachment of the brackets the glass
      ionomer cements AqaCem and Ketac-cem are used. Tensile shear tests were carried
      out with a Wolpert universal testing machine. Best results were obtained with the
      aromatic carbonacids benzoic acid and salicylic acid in acetonic solution. The
      mean adhesive power was 9.8 MPa. This means an increase of 38% as compared to
      other pre-conditioning materials such as polyacrylic acid. It can be assumed,
      that aromatic carbonacids as small, very reactive molecules can establish a
      closer contact to the phosphate groups of enamel than can the macromolecular
      polyacrylic acid. Thus, a further step on the way to using glass ionomer cements
      as a bracket bonding material seems to have been taken.

PMID- 1634159
TI  - [The importance of the center of resistance for the biology of tooth movement].
AB  - The tooth movement of loaded premolars was investigated in four two-years-old
      beagle dogs under general anesthesia. Two supragingival registrations were
      performed to calculate the center of rotation in order to estimate the amount of
      tipping. Loads of 5 to 20 N were applied for two to four seconds. The amount of
      tipping was found to be load- and time-dependent. The discrepancy between these
      findings and the models of analytical mechanics were explained by bone bending in
      our experiments. Biology and localization of periodontal remodelling is supposed
      to be dependent on load magnitude, load duration and physical properties of all
      periodontal tissues including bone.

PMID- 1634160
TI  - [The tensile bonding strength of metal plasma-coated bracket bases].
AB  - The tensile bond strength of bracket bases coated with metal plasma were
      examined. The aim was to investigate, whether the conditioning of bracket bases
      by metal plasma is a possible means to increase the tensile bond strength. Two
      typical orthodontic adhesives were used. Three test groups were differentiated:
      1. Metal mesh bracket bases (coated and uncoated with metal plasma), 2. metal
      bracket bases without mesh (coated with metal plasma), 3. ceramic bracket bases
      coated with metal plasma. Metal bracket bases with mesh, coated with metal plasma
      showed superior bond strength in comparison to usual uncoated mesh bracket bases.
      The former were nearly four times stronger than the uncoated bases with reference
      to the first adhesive and two times stronger referring to the second adhesive.
      The primary source of the enhancement of adhesion is due to the enormous increase
      of the retentive active surface created by the metal plasma. This structure
      guarantees an excellent micromechanical interlocking for the adhesive. The mean
      tensile bond strength of titanium coated mesh bases was 20.03 N/mm2 (= 286
      N/bracket). Plasma coated bases without mesh reached average interlocking forces
      comparable to conventional uncoated mesh bases. Ceramic bracket bases were found
      not to be suitable for plasma coating. As a result of these experimental findings
      metal plasma coating of metal bracket bases can be regarded as an excellent means
      to increase the tensile bond strength.

PMID- 1634161
TI  - [The orthodontic treatment of deep bite in adults--a comparison of the straight
      wire appliance and the segmented arch technic].
AB  - The purpose of the study was to analyse and compare deep overbite correction in
      adult patients carried out by a straight wire appliance and the segmented arch
      technique as recommended by Burstone. The sample comprised 50 adult, deep bite
      patients, 25 each treated with straight wire appliance and segmented arch
      technique. Plaster casts and lateral cephalograms made before and immediately
      after finishing treatment were analysed. Both techniques were successful in
      overbite correction; overbite reduction amounted to 3 to 3.5 mm. The straight
      wire appliance group demonstrated predominantly molar extrusion and as a result
      posterior mandibular rotation. A slight intrusion of 1 mm was seen in the lower
      incisor area. The segmented arch technique resulted in an incisor intrusion of
      1.5 mm in the upper and 1.7 mm in the lower jaw. No substantiate extrusion in the
      molar area was found. The advantages of this technique are discussed.

PMID- 1634162
TI  - [The subjective and objective assessment of the long-term follow-up findings an
      average of 17 years after the conclusion of therapy].
AB  - Posttreatment and seven to 28-year postretention records and actual
      questionnaires of 240 orthodontically treated patients were assessed to evaluate
      dental awareness and the patients evaluation of posttreatment changes. 80% have
      regular dental visits and 44% of them have periodontal disease whereas 60% of
      those who responded having irregularly or no dental controls. 38% were aware of
      posttreatment changes, only increased and decreased overjet showed a significance
      in patients evaluation and objective situation.

PMID- 1634163
TI  - [The periodontal changes following orthodontic tooth movement--a retrospective
      histological study in humans. 1].
AB  - The maxilla of a deceased (19 years, female) who was treated with a straight-wire
      appliance could be taken in autopsy. The specimen was prepared histologically in
      the horizontal plane. The type of tooth movement was reconstructed by comparing
      the treatment documents of the beginning (photo of the cast model, radiograph)
      with the photo and radiographs of the specimen. In that manner the histological
      findings could be correlated with the type of tooth movement. RESULTS:
      Localisation and amount of tissue changes at the roots depend on the type of
      tooth movement and the morphology of bone. The histological findings are more
      pronounced than the radiographs show. Histologically verified bony dehiscences in
      the facial or oral cortical plate are not to be diagnosed by macroscopic
      inspection of the specimen.

PMID- 1634164
TI  - [The treatment of open bite using magnets].
AB  - Until recently, surgical correction of the jaws has been widely regarded as the
      most effective treatment of open bites in the permanent dentition. In the
      following case report an open bite was treated non-surgical by intrusion of the
      molars with a magnet appliance. The forces of repelling magnets, fixed opposite
      in the upper and lower jaw were used to intrude the first and second molars. This
      intrusion allowed an autorotation of the mandible upward and forward to close the
      open bite. By reduction of the open bite of about 3 mm a surgical intervention
      could be avoided.

PMID- 1634165
TI  - [Additional therapeutic approaches after coronary thrombolysis].

PMID- 1634166
TI  - [Proctalgia fugax. Differential diagnosis and therapy of fleeting anal cramp].
AB  - Proctalgia fugax--short-lived anal spasm--is a common, extremely unpleasant,
      painful condition that occurs completely unexpectedly, often waking the victim at
      night. Scientific assessment is difficult on account of the functional nature of
      the condition and its multifactorial genesis. Before the patient is labeled "anal
      neurotic", however, he/she should be investigated by a specialist. The results of
      treating the rarely absent pathological organic findings give rise to optimism.

PMID- 1634167
TI  - [Resuscitation in cardiovascular arrest. Part 1: Basic measures, ventilation and
      heart massage].

PMID- 1634168
TI  - [Erythema infectiosum infection can cause intrauterine fetal death. Possibilities
      of diagnosis and treatment].

PMID- 1634169
TI  - [Crataegus in cardiology].
AB  - The fact that the effectiveness of numerous phyto-preparations, so-called, has
      been demonstrated to the satisfaction of traditional medicine has led to
      increasing interest in phytotherapy. This also applies to Crataegus (whitethorn),
      the effects of which have been demonstrated in numerous pharmacological studies.
      These effects, produced mainly by the flavonoids, indicate a simultaneous
      cardiotropic and vasodilatory action, as confirmed clinically in controlled
      double-blind studies. This means that Crataegus can be employed for cardiological
      indications for which digitalis is not (yet) indicated. Prior to use, however, a
      Crataegus preparation must meet certain preconditions with respect to dosage,
      pharmaceutical quality of the preparation, and an accurate definition of the
      later.

PMID- 1634170
TI  - [Andrologic expert assessment. Experiences and results of 40 years].
AB  - On the basis of 300 andrological expertises made over the last 40 years to answer
      the question as to procreative capacity and other andrological problems, a
      position is taken up towards the expertise in general and to a number of
      characteristic data. In more than 95 percent of the cases, there was agreement
      between the conclusions of the expert and the subsequent decision taken by the
      client. It is emphasized that, within the period considered, there has been a
      general decrease in requests for expert opinions on procreative capacity in
      paternity suits, which is traced back to the increasing accuracy of the methods
      of blood group serology. In contrast, expertises in the case of occupational
      accidents, criminal offences and errors in medical treatment are on the increase.

PMID- 1634171
TI  - [Photodynamic laser therapy with antibody-bound dyes. A new procedure in therapy
      of gynecologic malignancies].
AB  - In the present paper, a new therapeutic concept of photodynamic laser therapy
      using antibody-linked dyes for the treatment of gynecological malignancies is
      described. So far, HPD (hematoporphyrin derivative) has been employed in this
      area, but is associated with toxic systemic reactions. We see a solution to this
      problem in the linking of a systemically non-toxic dye--known to induce
      photodynamic reactions while not itself being selectively accumulated within
      tumor cells--to an antibody directed against a selective tumor-associated
      antigen. The results of our study demonstrate the efficacy of this therapeutic
      concept as exemplified by the selective destruction of dye-labeled ovarian
      carcinoma cells by laser light of a defined wavelength (675 nm). The potential of
      this form of photodynamic therapy extends far beyond its use in ovarian
      carcinoma.

PMID- 1634172
TI  - [Resuscitation in cardiovascular arrest. Part 2: Expanded resuscitation
      measures].

PMID- 1634173
TI  - [Local therapy of grade 1 and 2 hemorrhoids. Effectiveness of a combination
      preparation with standardized blood leech extract].
AB  - AIMS: Testing the effectiveness of a topical combination preparation containing
      standardized leech extract, polidocanol and allantoin. STUDY DESIGN: Placebo
      controlled, double-blind study in 80 patients with first and second degree
      hemorrhoids; duration of treatment one week; examinations performed on admission
      and on days 3, 4, 5 and 8. RESULTS: Both the subjective and objective symptoms
      and signs improved during the one week of treatment statistically significantly
      more rapidly under the test preparation as compared with placebo. Histologically
      demonstrable signs of inflammation were more clearly improved in the preparation
      group than in the placebo group. No side effects were observed. CONCLUSIONS: The
      good efficacy and tolerability of a topical therapeutic preparation in first and
      second degree hemorrhoids have been convincingly demonstrated.

PMID- 1634174
TI  - [Anorexia nervosa and bulimia. New research results--success with behavior
      therapy].

PMID- 1634175
TI  - Zenker's diverticulum and reflux.
AB  - The interrelationship between gastroesophageal reflux and Zenker's diverticulum
      remains unclear. The view that cervical diverticula are induced by
      gastroesophageal reflux disease (GER) is apparently supported by epidemiologic
      observations indicating that they occur only in populations with a high incidence
      of GER. However, it is difficult to prove causality on the basis of currently
      available physiological and pathophysiological investigations. The few data
      published to date now end to support a cryptogenic change in upper esophageal
      sphincter (UES) muscle motility characteristics instead of a reflux induced
      lesion to the UES. Clinical experience also shows that GER does not play a major
      role in individual cases of Zenker's diverticula, nor do many surgeons consider
      it a risk following cervical myotomy. This is confirmed by a very low
      complication rate even in large series of patients in whom no attempt was made
      preoperatively to rule out concomitant reflux disease. In conclusion, some facts
      suggest that reflux disease may be a cause of the development of Zenker's
      diverticulum. In the majority of cases, however, autochtonic structural lesions
      to the UES muscle fibers or other, as yet unknown, reasons are more probable.

PMID- 1634176
TI  - Endoscopic treatment of the hypopharyngeal (Zenker's) diverticulum.
AB  - Over the years the techniques for endoscopic treatment of Zenker's diverticulum
      have been improved. Initially, in 1964, we used the electrocoagulation technique
      as described by Dohlman, but currently we prefer to sever the tissue bridge
      between the diverticulum and esophagus with the CO2 laser under microscopic
      control. The results of endoscopic treatment in 507 patients with a diverticulum
      are discussed. It is concluded that endoscopic treatment can readily be performed
      with good results, especially in the case of elderly patients in a poor general
      condition.

PMID- 1634177
TI  - The treatment of pharyngoesophageal diverticulum: the simple and complex.
AB  - Over 900 patients have been treated at the Mayo Clinic for Zenker's diverticulum
      since 1944 using a one-stage transcervical diverticulectomy under general
      anesthesia. Overall results have been very good, but not entirely free of
      morbidity or mortality. An attempt is made to define those circumstances in which
      the procedures used have either been judgmentally or technically difficult or in
      which morbidity or mortality has occurred. These include patients with
      concomitant medical or surgical problems, or complexity related to the
      diverticulum itself. Among the latter are huge or giant sacs, patients with
      severe nutritional and respiratory symptoms related to aspiration, the perforated
      diverticulum, reoperation for recurrent diverticulum and cancer in a
      diverticulum.

PMID- 1634178
TI  - Manometric aspects of Zenker's diverticulum.
AB  - Zenker's diverticulum is thought to result from disordered coordination between
      the pharynx and upper esophageal sphincter. Manometric studies of the upper
      esophagus have been helpful in testing the hypothesis of dysmotility in the
      formation and growth of a Zenker's diverticulum; however, the data have provided
      conflicting evidence. Manometric studies show that resting upper esophageal
      sphincter pressure is normal in some patients with Zenker's diverticulum and
      decreased in others. Abnormal premature relaxation and contraction of the upper
      esophageal sphincter seen in some patients with Zenker's diverticulum may be
      accompanied by pharnygeal contractions against a closed sphincter. This
      abnormality is thought by some investigators to be the cause of Zenker's
      diverticulum, but not by others who have found normal upper sphincter relaxation.
      Future manometric studies will very likely elucidate the pathogenesis of Zenker's
      diverticulum.

PMID- 1634179
TI  - Zenker's diverticulum: is a myotomy of the cricopharyngeus useful? How long
      should it be?
AB  - In a series of 100 consecutive patients surgically treated for Zenker's
      diverticulum (ZD) biopsy specimens were taken at the level of the cricopharyngeal
      muscle in 62 patients and also at the level of the striated muscle wall of the
      cervical esophagus in 10 patients. Contractility, pathological enzymo- and
      immunohistochemical characteristics were studied in comparison with a group of 15
      controls. Obvious pathological findings were noted in 95% of the ZD specimens as
      compared with the control specimens. These pathological changes, although
      somewhat less pronounced, were also documented in the biopsy specimens taken at
      the level of the striated cervical muscle wall. The findings were judged
      important enough to justify a long extramucosal myotomy of the cricopharyngeal
      muscle and cervical esophagus as an essential step in the treatment of ZD. The
      treatment of choice in this series was a diverticulopexy and a four to five
      centimeter long extramucosal myotomy, starting from the cricopharyngeal muscle
      and extending downwards into the striated muscle wall of the cervical esophagus.
      Excellent or very good results were obtained in 96% of the patients with respect
      to diverticulum-related symptoms.

PMID- 1634180
TI  - Surgical management of Zenker's diverticulum.

PMID- 1634181
TI  - The natural history of duodenal ulcer disease.
AB  - With a view to describing the natural history of duodenal ulcer, currently linked
      with powerful and widely used drugs, we retrospectively reviewed all patients
      followed-up at our unit between 1978 and 1989. All DU subjects with at least 5
      years of clinical-endoscopic follow-up were admitted to the study. Concomitant
      gastric ulcer, previous gastrointestinal surgery and treatment other than with H2
      blockers (where necessary) were considered exclusion criteria. Forty-four
      patients (35 males, 9 females, mean age 44.5) proved eligible for this study. At
      monthly intervals in the patients' history of ulcer disease (starting from a
      baseline month 0 when ulcer symptoms first appeared), we compared all cases in
      which the duration of disease coincided, i.e. for each month of the clinical
      course of the ulcer there was a certain number of patients at the same point in
      time; patients' histories coincided variously over a period ranging from 0 to 15
      years. We considered endoscopically-diagnosed relapses (both symptomatic and
      asymptomatic) and hemorrhages as marker events for the activity of DU disease. A
      year-by-year duodenal ulcer activity rate was obtained for both treated and
      untreated subjects, as follows: No. of events/mean No. of patients followed-up
      per month x 100. Fisher's exact test and multivariate analysis (stepwise logistic
      regression) were used to investigate risk factors of poor outcome. We found that
      the years between the 1st and 5th and between the 10th and 15th from the onset of
      duodenal ulcer disease had higher peaks of activity, mostly in untreated
      subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634182
TI  - Hemosuccus pancreaticus from a pseudoaneurysm of the hepatic artery proper in a
      patient with a pancreatic pseudocyst.
AB  - Pseudoaneurysms of the visceral arteries due to pancreatitis, with subsequent
      rupture and hemorrhage into the pancreatic duct are unusual. To date, three cases
      of pseudoaneurysm of the hepatic artery with hemosuccus pancreaticus have been
      reported in the literature. We describe a case of a pseudoaneurysm of the hepatic
      artery proper, which ruptured into a pancreatic pseudocyst communicating with the
      pancreatic duct, and which was the cause of upper gastrointestinal bleeding. This
      case was successfully managed by resection of both the pseudoaneurysm and the
      pancreatic pseudocyst.

PMID- 1634183
TI  - Therapeutic embolization of post-cholecystectomy hepatic artery aneurysm.
AB  - A "sandwich" technique employing steel coils and gelfoam embolization was applied
      in two cases of hepatic artery aneurysms. Immediate cessation of the bleeding was
      evident clinically and the post-embolization angiogram showed occlusion of the
      vascular lesion. Cholecystectomy is one of the most common abdominal operations
      and it is generally well tolerated, particularly in young and middle-aged
      patients. Morbidity rates of 5% to 32% and mortality rates of 0.4% to 2.5% have
      been reported, depending on such factors as age, underlying illness, etc. (1-4).
      The most frequent complications of cholecystectomy are wound infection, abscess,
      ductal injury or ligation, and bleeding. This paper describes two cases of
      hepatic pseudoaneurysm following iatrogenic damage during cholecystectomy which
      was treated with transarterial embolization.

PMID- 1634184
TI  - Serum bile acids and the bile acid tolerance test under oral contraception.
AB  - Oral contraceptives (OC) have lithogenic properties as shown by a rise in biliary
      cholesterol secretion and cholesterol saturation index. Since we noted not only a
      rise in saturation index, but also a reduction in chenodeoxycholate (CDC) pool
      size and an increase in cholate (C) pool size during oral contraception (30
      micrograms ethinylestradiol + 150 micrograms desogestrel), we investigated the
      endogenous bile acid tolerance test as a potential predictor of this effect on
      bile acid pool sizes using a cholecystokinin infusion of 55 min duration (1.2
      U.kg-1.hr-1) as stimulus of the enterohepatic bile acid circulation in 12 healthy
      females before and during oral contraception for 3-5 months. Serum C and CDC
      conjugates were measured at 5-10 min intervals over a period of 150 min and
      analysed by two specific RIA's. Although no significant correlations between the
      serum CDC and C measurements and CDC and C pool sizes were found, a significant
      reduction of nearly 40% for both serum peak levels and the integrated area under
      the serum curve of CDC conjugates during oral contraception, but not of C
      conjugates was found. The reduction in serum levels of CDC conjugates during OC
      using the present model is best explained by both a reduction in CDC pool size
      and more efficient hepatic uptake of CDC conjugates (consisting of considerably
      more taurine conjugates during OC use), as well as by an intestinal effect on
      bile acid absorption under OC.

PMID- 1634185
TI  - Clinical relevance of anorectal function investigations.
AB  - Anorectal function tests are often performed in patients with anorectal
      disorders. The test results have shown considerable overlap between normal
      controls and patients. Therefore, purely clinical indications for the individual
      anorectal function tests are few, and the strength of these tests lies in their
      combination. When the patient is not eligible for surgery or biofeedback, there
      is no indication for these tests.

PMID- 1634186
TI  - Pressure and X-ray recording of reflux into the thoracic stomach.
AB  - Anastomotic leakage, pulmonary aspiration and reflux-esophagitis might be induced
      or aggravated by the increased duodenogastric reflux observed in the thoracic
      stomach. In this study, the effect of respiration on the reflux-promoting
      pressure gradient in the intrathoracally located stomach was assessed. In nine
      patients pressure recording was done in the duodenum and the abdominal and
      thoracic part of the stomach. Intrapleural pressure was determined by recording
      mouth pressure during inspiratory occlusion. In addition, the course of injected
      contrast was examined fluoroscopically. The mean end-expiratory pressure gradient
      in the thoracic part of the stomach was 0.8 cm H2O, increasing up to 6.0 cm H2O
      and 21.3 cm H2O during normal and forced inspiration, respectively. Fluoroscopic
      examination showed reflux of contrast that coincided with the downward movement
      of the diaphragm. From this study, we conclude that reflux into the thoracic
      stomach is promoted by intraluminal pressure fluctuations induced by voluntary
      breathing. Performing a pyloroplasty or -myotomy after intrathoracic
      esophagogastrostomy destroys the integrity of the pyloric sphincter as a barrier
      to reflux, thus promoting duodenogastric reflux.

PMID- 1634187
TI  - Esophageal diverticula.

PMID- 1634188
TI  - Surgical management of esophageal thoracic diverticula.
AB  - Between 1969 and 1989, thirty-three patients were admitted for the treatment of a
      mid- or lower thoracic diverticulum and were investigated. Their mean age was 63
      years. The predominant symptoms were dysphagia and regurgitations of, on average,
      5.8 years' duration. Three patients had associated carcinoma and were excluded
      from the study. Three patients with mild complaints were managed medically and 27
      surgically. Surgical treatment included, prior to 1979, simple diverticulectomy
      in 10 patients since 1970 diverticulectomy and myotomy through a right thoracic
      approach in one patient diverticulectomy, esophageal myotomy and fundoplication
      through a left thoracic approach in 10 patients and simple abdominal esophageal
      myotomy with fundoplication in 4 patients. In 2 patients, an esophagobronchial
      fistula was successfully treated. There were 3 postoperative deaths (2 suture
      line leakages and one massive aspiration pneumonia). Two patients had persistent
      dysphagia: one was reoperated on for a subsequent abdominal esophageal myotomy
      and the other one for severe reflux esophagitis following esophageal dilatations.
      Four patients had reflux esophagitis and two were reoperated on for a total
      duodenal diversion. The importance of the long esophageal myotomy extended on to
      the cardia through a left thoracotomy, and of a good antireflux procedure after
      the myotomy, in the treatment of thoracic esophageal diverticula is emphasized.

PMID- 1634189
TI  - Effects of alloxan-induced diabetes on hemorheology in rabbits.
AB  - Plasma viscosity (PV), apparent whole blood viscosity (WBV), relative blood
      viscosity (RV) and erythrocyte deformability (filterability) (EDF) were
      determined in 13 New Zealand White (NZW) rabbits with alloxan induced-diabetes
      (AID) and 8 normal NZW rabbits, matched for age, sex and weight. AID rabbits were
      divided into two groups depending on the duration of hyperglycemia (long-term,
      greater than 6.0 months (n = 7), and short-term, less than or equal to 3.0 months
      of hyperglycemia, n = 6). Comparing long-term AID rabbits to normal animals, we
      found significant increases in WBV (P less than 0.001, 0.005 for high and low
      rates of shear, respectively), and a marked reduction in EDF (P less than 0.001).
      There was no significant difference in PV between long-term AID and normal
      rabbits. Conversely, PV was significantly increased in rabbits with short-term
      diabetes (P less than 0.01) while there was a concurrent significant increase in
      WBV measured at high and low rates of shear (P less than 0.001, 0.001,
      respectively). No difference was detected in EDF between normal and short-term
      AID rabbits. Furthermore, in long-term AID rabbits there was a strongly positive
      correlation between RV and reduced erythrocyte deformability (r = 0.94, P =
      0.006) while WBV strongly correlated with PV (r = 0.92, P = 0.004) in the short
      term AID subgroup. We conclude from these data: (1) elevated blood viscosity in
      long term AID rabbits is associated with reduced erythrocyte filterability; and
      (2) elevated WBV in short-term AID rabbits is associated with increased PV.

PMID- 1634190
TI  - Increased ketogenesis related to insulin deficiency in isolated hepatocytes from
      NIDDM model rats.
AB  - To investigate the hepatic ketone body metabolism in NIDDM, we studied the ketone
      body production rates in hepatocytes from newly developed non-obese NIDDM model
      rats. NIDDM model rats were prepared by intraperitoneal injection of
      streptozotocin at 2 or 5 days of age (STZ2, STZ5 respectively). After 10-15
      weeks, ketone body production rates in hepatocytes isolated from these rats were
      compared with those from control rats as well as ketotic rats made by intravenous
      injection of streptozotocin into adult rats. Basal ketone body production rates
      from 0.3 mM [U-14C] palmitate in hepatocytes from control, STZ 2, STZ 5 and
      ketotic rats were 11.7 +/- 0.98, 14.9 +/- 0.72, 16.0 +/- 0.45, 22.8 +/- 2.32
      nmole.palmitate/mg.prot/hr, respectively. These rates were stimulated by 1
      microgram/ml of glucagon in control, STZ 2 and STZ 5 rats (14.1 +/- 0.99, 18.6 +/
      1.36, 18.7 +/- 0.69 nmole.palmitate/mg.prot/hr, respectively), but not in
      ketotic rats (22.8 +/- 2.07 nmole.palmitate/mg.prot/hr). The similar effects were
      observed by 1 microgram/ml of epinephrine. The basal ketone body production rates
      were negatively correlated to both hepatic glycogen contents and plasma IRI
      levels. Considering these parameters together, the extent of metabolic
      derangement in STZ 2 and STZ 5 rats was between that in control and ketotic rats.
      These results indicate that the derangements of hepatic ketone body production
      are related to the severity of insulin deficiency and suggest that the enhanced
      hepatic ketogenesis contributes in part to the elevated plasma ketone body levels
      in non-obese NIDDM.

PMID- 1634191
TI  - Effects of dopamine on the release of thyrotropin-releasing hormone from the rat
      retina in vitro.
AB  - The effects of dopamine on the release of thyrotropin-releasing hormone (TRH)
      from the rat retina in vitro were studied. The rat retina was incubated in the
      medium 199 (pH 7.4) with 1.0 mg/ml of bacitracin and 100 micrograms/ml of
      ascorbic acid. The amount of TRH release into the medium was measured by
      radioimmunoassay. The TRH release from the rat retina was inhibited significantly
      in a dose-related manner with the addition of dopamine, but not with pimozide.
      The inhibitory effects of dopamine on TRH release from the rat retina were
      blocked with an addition of pimozide to the medium. The elution profile of
      methanol-extracted rat retina on sephadex G-10 was identical to that of synthetic
      TRH. From these findings it is concluded that the dopaminergic system inhibits
      TRH release from the rat retina in vitro.

PMID- 1634192
TI  - Role of the sympathoadrenal system in the regulation of glycogen metabolism in
      resting and exercising skeletal muscles.
AB  - The purpose of the present study was to characterize the role of catecholamines
      in the regulation of skeletal muscle glycogen metabolism during exercise. Using
      the rat hindlimb perfusion technique we have measured skeletal muscle glycogen
      content, glycogen phosphorylase and synthase activities in sympathectomized
      and/or demedullated rats under epinephrine treatment (10(-7) M) at rest and
      during muscle contraction. When epinephrine and/or norepinephrine deficiency was
      induced, muscle contraction resulted in a decrease in glycogen content (-63%)
      despite a decrease in glycogen phosphorylase activity ratio (0.25 to 0.11; p less
      than 0.001) and an increase in glycogen synthase activity ratio (0.13 to 0.27; p
      less than 0.001). Under these conditions, epinephrine treatment further reduced
      glycogen content while blunting the changes in the activity ratio of the rate
      limiting enzymes. These data indicate that catecholamines do not play a primary
      role in skeletal muscle glycogen breakdown during acute exercise and suggest that
      allosteric regulators may be of prime importance.

PMID- 1634193
TI  - The beta cell function in NIDDM patients with secondary failure: a three year
      follow-up of combined oral hypoglycemic and insulin therapy.
AB  - Eleven Type 2 (non-insulin-dependent) diabetic patients, islet cell
      autoantibodies negative, nonobese with secondary failure to oral hypoglycemic
      agents (OHA) [glyburide (7.5 mg/day) and phenformin (75 mg/day)] and HbA1c 10.2
      +/- 0.6% were studied. Insulin receptors on circulating monocytes, glucose
      utilization at supraphysiological insulin concentrations, and plasma C-peptide
      after i.v. glucagon were evaluated before and after 2 months of combined therapy
      with OHA and insulin (Ultratard HM Novo). A significant improvement was
      demonstrated in HbA1c and glycemia after two months of treatment. Glucose MCR was
      increased after two months of treatment whilst basal C-peptide was decreased as
      well as receptor binding to monocytes. After three years of combined therapy,
      body weight, glycemia and HbA1c did not increase. After three years the C-peptide
      basal values were significantly increased with respect to values found after 2
      months of therapy. These results demonstrate that insulin treatment may restore
      insulin sensitivity in NIDDM patients resistant to OHA treatment and that after
      three years there is no exhaustion of B-cell function.

PMID- 1634194
TI  - Enhanced cholesteryl ester transfer protein activities and abnormalities of high
      density lipoproteins in familial hypercholesterolemia.
AB  - Cholesteryl ester transfer protein may play a role in the cholesteryl ester
      metabolism between high density lipoproteins (HDL) and apolipoprotein B
      containing lipoproteins. To investigate relationship between HDL and cholesteryl
      ester transfer protein (CETP) activity in the development of atherosclerosis, the
      present study has focused on CETP activity in the patients with familial
      hypercholesterolemia (GH). HDL-C and HDL-C/apo A-I mass ratio in heterozygous FH
      were lower than those in normolipidemic controls. There was a 2-fold increase in
      total CETP activity in incubated FH serum compared with normolipidemic controls.
      Assays for CETP activity in the lipoprotein deficient serum (d greater than 1.215
      g/ml) were carried out by measuring the transfer of radioactive cholesteryl ester
      from HDL (1.125 less than d less than 1.21 g/ml) to LDL (1.019 less than d less
      than 1.060 g/ml). CETP activities in heterozygous FH (79 +/- 4 nmol/ml/h) was
      significantly higher than those in normolipidemic controls (54 +/- 6 nmol/ml/h).
      The increased total cholesteryl ester transfer mainly results from increased CETP
      activity in the d greater than 1.215 g/ml, possibly reflecting an increase in
      CETP mass in serum. Increased CETP activity in the d greater than 1.215 g/ml was
      correlated positively with IDL-cholesterol/triglyceride mass ratio (r = 0.496, p
      less than 0.01), and negatively with HDL-cholesterol/apo A-I mass ratio (r = 
      0.334, p less than 0.05). These results indicate that the enhanced CETP
      activities may contribute to increase risk for developing atherosclerosis in FH
      by changing the distribution of cholesteryl ester in serum lipoproteins.

PMID- 1634195
TI  - Effects of probucol on plasma lipids, lipoproteins and parameters of high density
      lipoprotein metabolism.
AB  - Eight patients with primary hypercholesterolemia were treated with probucol for
      17 weeks. Plasma total cholesterol, low density lipoprotein (LDL)-cholesterol,
      and high density lipoprotein (HDL)-cholesterol decreased by 16.6, 15.0 and 25.7%,
      respectively, in response to probucol treatment. Plasma levels of apolipoprotein
      B and apolipoprotein A-I also decreased, while apolipoprotein A-II concentrations
      were unchanged. The decrease in HDL-cholesterol levels was associated with a
      reduction in HDL particle size. No changes in the plasma lecithin:cholesterol
      acyltransferase activity or mass occurred in response to probucol treatment. In
      contrast, a significant 25% increase in plasma cholesteryl ester and triglyceride
      transfer activity occurred following probucol treatment. There was a positive
      correlation (R = 0.94) between cholesterol ester and triglyceride transfer. We
      propose that the increase in lipid transfer activity may in part explain the
      changes in HDL concentration and size, as well as the previously reported effect
      probucol has on reducing atherosclerosis in animal models.

PMID- 1634196
TI  - Effect of growth hormone (GH) on the promotion of body weight gain in the
      spontaneous dwarf rat: a novel experimental model for isolated GH deficiency.

PMID- 1634197
TI  - Microalbuminuria in obese subjects.

PMID- 1634198
TI  - Pseudoangiosarcomatous carcinoma: a clinicopathological study of seven cases.
AB  - Seven cases of carcinoma mimicking angiosarcoma occurring in skin (3 cases),
      breast (3) and lung (1) are described. The cutaneous, pulmonary and one of the
      breast carcinomas were poorly differentiated and squamous in type; the other two
      breast tumours were poorly differentiated ductal carcinomas with focal squamous
      differentiation. Histologically, the pseudoangiosarcomatous pattern was due to
      complex anastomosing channels and spaces lined by neoplastic cells. The spaces
      contained hyaluronic acid. The neoplastic cells exhibited cytokeratin positivity
      but yielded negative results with the endothelial cell markers, factor VIII
      related antigen and CD 34 (QB-END/10). Two breast tumours showed binding of UEA
      1. Ultrastructurally, unequivocal epithelial differentiation was demonstrated in
      six of the cases. Pathogenetically, these tumours appeared to be variants of
      acantholytic squamous cell carcinoma. Recognition of this unusual form of
      carcinoma is important, as an incorrect diagnosis of angiosarcoma may lead to
      inappropriate treatment and prognostication.

PMID- 1634199
TI  - Cellular relationship impairment in maturation arrest of human spermatogenesis:
      an ultrastructural study.
AB  - Ultrastructural examination of testicular biopsies from cases of maturation
      arrest showed that there were characteristic abnormalities of the Sertoli cell
      junctional connections. These abnormalities together with the meiotic failure
      afford an explanation for the severe oligospermia or azoospermia noted in
      patients with maturation arrest. Premature setting up of ectoplasmic
      specializations in front of early spermatids and/or spermatocytes were also
      observed.

PMID- 1634200
TI  - Colloid cysts of the third ventricle: an immunohistochemical study.
AB  - Eleven colloid cysts of the third ventricle were investigated by
      immunohistochemistry using 16 mono- and polyclonal antibodies. Colloid cyst
      epithelium, choroid plexus epithelium and ependyma showed different
      immunohistochemical profiles. In particular, antibodies to different cytokeratins
      and to transthyretin revealed considerable and constant differences of
      immunoreactivity. Therefore, common derivation of the three tissues seems
      unlikely. Our findings are interpreted in favour of the non-neuroepithelial
      origin of third ventricular colloid cysts.

PMID- 1634201
TI  - Desmoplastic supratentorial neuroepithelial tumours of infancy.
AB  - The clinicopathological features of two infants with desmoplastic supratentorial
      neuroepithelial tumours are described. The cases were similar to the 26 cases
      reported previously as desmoplastic infantile ganglioglioma and superficial
      cerebral astrocytoma attached to dura. Neuronal differentiation was absent on
      routine stains, but was immunohistochemically established. We review the
      literature and suggest classifying this clinicopathological entity by using a
      general designation such as desmoplastic supratentorial neuroepithelial tumours
      of infancy, a term which indicates the variability in the amount and lines of
      differentiation.

PMID- 1634202
TI  - Differential expression of the HECA-452 antigen (cutaneous lymphocyte associated
      antigen, CLA) in cutaneous and non-cutaneous T-cell lymphomas.
AB  - The monoclonal antibody HECA-452 identifies an antigen that is primarily
      expressed on high endothelial venules, the preferred site of lymphocyte
      extravasation in lymphoid tissues, and also on a subpopulation of myelomonocytic
      cells and some T-cells. We investigated the expression of the HECA-452 antigen,
      also called the cutaneous lymphocyte associated antigen, in primary cutaneous and
      primary non-cutaneous T-cell non-Hodgkin's lymphomas. The tumour cells of
      cutaneous T-cell non-Hodgkin's lymphomas were positive in 53% of cases, while
      only 5% of the non-cutaneous lymphomas were positive. These differences were also
      present in morphologically identical tumours. Thus, the tumour cells in six out
      of 10 primary cutaneous anaplastic large cell T-cell lymphomas were positive,
      while they were positive in none of 24 primary non-cutaneous anaplastic large
      cell T-cell lymphomas. In general, primary cutaneous and primary nasal T-cell non
      Hodgkin's lymphomas were devoid of HECA-452 positive high endothelial venules,
      whereas most nodal T-cell non-Hodgkin's lymphomas contained HECA-452 positive
      high endothelial venules. These observations suggest that the HECA-452 antigen
      might be related to a skin-associated type of lymphoid tissue and to lymphomas
      originating in the skin. However, the results of HECA-452 expression in secondary
      sites, and the clinical data of the primary cutaneous large cell lymphomas did
      not support the concept that HECA-452 is functionally involved in homing to the
      skin, or that loss of the HECA-452 antigen is related to tumour progression of
      primary cutaneous T-cell lymphomas.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634203
TI  - Thymoma in childhood: a clinicopathological study of five cases.
AB  - The histological and clinical findings in five cases of thymoma arising in
      paediatric patients have been studied. The age range was 11-15 years and no
      patient was affected by myasthenia gravis. All tumours were macroscopically
      encapsulated, but two of them displayed evidence of microscopic capsular
      invasion. Histologically, four cases were of the predominantly cortical type
      (organoid thymoma) with prominent areas of medullary differentiation and
      Hassall's bodies; one case was of the cortical type. All patients are alive and
      disease-free 3 months to 9 years after surgery. These findings suggest that
      thymoma in the paediatric age group may be characterized by fairly uniform
      clinicopathological features, with a low rate of association with myasthenia
      gravis and a favourable prognosis.

PMID- 1634204
TI  - Malignant melanoma occurring in a case of oculocutaneous albinism.

PMID- 1634205
TI  - Pilomatrixoma or calcifying epithelioma of Malherbe invading bone.

PMID- 1634206
TI  - Malignant teratoma of the thyroid: case report and literature review of thyroid
      teratoma in adults.

PMID- 1634207
TI  - KP1 (CD68) staining of granular cell neoplasms: is KP1 a marker for lysosomes
      rather than the histiocytic lineage?

PMID- 1634208
TI  - Epithelioid angiosarcoma arising in an arteriovenous fistula.

PMID- 1634209
TI  - Diversion proctocolitis.

PMID- 1634210
TI  - Angiolymphoid hyperplasia with eosinophilia.

PMID- 1634211
TI  - Silver staining of nucleolar organizer regions in prostatic lesions.

PMID- 1634212
TI  - Data watch. 1990 physician inpatient revenues, admissions.

PMID- 1634213
TI  - New test? Hanlester decision clamps down on MD ventures.
AB  - What's the difference between inducement and encouragement? That's a key question
      in the Hanlester Network case. Attorneys and other experts are carefully sifting
      through the implications of Hanlester, and what its precise--and very important-
      effects may be on joint ventures with physicians.

PMID- 1634214
TI  - Great comebacks: the 1992 turnaround contest winners.
AB  - Turning a hospital around takes hard work, determination, and guts. The winners
      of this year's Hospital Turn-around of the Year Contest, sponsored by Hospitals
      and Coopers & Lybrand, demonstrate that a successful turn-around is about much
      more than money, and that it can't be judged a success based solely on financial
      results. The management team of each winning hospital showed imagination and
      courage in tackling their hospitals' problems. Congratulations to this year's
      winners and finalists for a job well done.

PMID- 1634215
TI  - Is new OIG physician fraud alert precursor to enforcement action?
AB  - A recent fraud alert published by the OIG listing "suspect hospital incentive
      arrangements" in physician recruitment practices is compelling hospital
      executives to review their recruitment strategies. "What is new about this fraud
      alert," says an attorney, "is that the OIG has put them into one document as an
      indication of its enforcement priorities."

PMID- 1634216
TI  - Health care for the homeless: what role should hospitals play?
AB  - A growing number of hospitals across the country are collaborating with others in
      their communities to provide health care to the homeless. "Hospitals should take
      a lead role" in this area, say those already involved.

PMID- 1634218
TI  - The AHA names 1992 award recipients.

PMID- 1634217
TI  - SDR 1992 Vendor Awards of Excellence. How hospital users rate application
      software.
AB  - Information systems budgets for 1992 increased among medium and large hospitals
      and decreased slightly among smaller facilities, according to data gathered by
      Shared Data Research (SDR), Hudson, OH, for its Third Annual Vendor Awards of
      Excellence program.

PMID- 1634219
TI  - High turnover in Congress clouds health issues.

PMID- 1634220
TI  - Coalition develops software to refer uninsured for care.

PMID- 1634221
TI  - 'Unwieldy' claims could bog down automation process.

PMID- 1634222
TI  - MAP (Multidisciplinary Apprentice Program): matching care-givers to patient
      needs.

PMID- 1634223
TI  - Management leadership critical to CQI success.

PMID- 1634225
TI  - Mild dominant osteogenesis imperfecta with intrafamilial variability: the cause
      is a serine for glycine alpha 1(I) 901 substitution in a type-I collagen gene.
AB  - The molecular defect responsible for a case of mild osteogenesis imperfecta (OI)
      with repeated femoral fractures was investigated. The proband and his mother, who
      presented minor OI signs but no bone fractures, were shown to produce normal and
      abnormal type-I procollagen molecules in their dermal fibroblasts. The molecular
      defect was localized in about half of the proband's pro alpha 1(I) mRNA molecules
      by chemical cleavage with piperidine of hydroxylamine-reacted mRNA:cDNA
      heteroduplexes. The corresponding region was reverse-transcribed and amplified by
      polymerase chain reaction (PCR). Cloning and sequencing of the amplified products
      revealed in both subjects a G-to-A transition in the first base of codon 901 of
      the alpha 1(I) triple helical domain, which led to a serine for glycine
      substitution. Allele-specific oligonucleotide hybridization to amplified genomic
      DNA from fibroblasts and leukocytes confirmed the heterozygous nature of both
      patients and proved the absence of mosaicism. The presence of the mutation was
      excluded in other healthy family members, who were reported to have bluish
      selerae. The mild phenotypic outcome of this newly characterized mutation
      contradicts previous findings on glycine substitutions in the C-terminal region
      of collagen triple helix, most of which caused lethal OI.

PMID- 1634224
TI  - Sex determination and sex reversal: genotype, phenotype, dogma and semantics.
AB  - The genetic terminology of sex determination and sex differentiation is examined
      in relation to its underlying biological basis. On the assumption that the
      function of the testis is to produce hormones and spermatozoa, the hypothesis of
      a single Y-chromosomal testis-determining gene with a dominant effect is shown to
      run counter to the following observed facts: a lowering in testosterone levels
      and an increase in the incidence of undescended testes, in addition to sterility,
      in males with multiple X chromosomes; abnormalities of the testes in autosomal
      trisomies; phenotypic abnormalities of XX males apparently increasing with
      decreasing amounts of Y-chromosomal material; the occurrence of patients with
      gonadal dysgenesis and XY males with ambiguous genitalia in the same sibship; the
      occurrence of identical SRY mutations in patients with gonadal dysgenesis and
      fertile males in the same pedigree; and the development of XY female and
      hermaphrodite mice having the same genetic constitution. The role of X
      inactivation in the production of males, females and hermaphrodites in T(X;16)16H
      mice has previously been suggested but not unequivocally demonstrated; moreover,
      X inactivation cannot account for the observed bilateral asymmetry of gonadal
      differentiation in XY hermaphrodites in humans and mice. There is evidence for a
      delay in development of the supporting cells in XY mice with ovarian formation.
      Once testicular differentiation and male hormone secretion have begun, other Y
      chromosomal genes are required to maintain spermatogenesis and to complete
      spermiogenesis, but these genes do not function effectively in the presence of
      more than one X chromosome. The impairment of spermatogenesis by many other
      chromosome abnormalities seems to be more severe than that of oogenesis. It is
      concluded that the notion of a single testis-determining gene being responsible
      for male sex differentiation lacks biological validity, and that the genotype of
      a functional, i.e. fertile, male differs from that of a functional female by the
      presence of multiple Y-chromosomal genes in association with but a single X
      chromosome. Male sex differentiation in XY individuals can be further impaired by
      a euploid, but inappropriate, genetic background. The genes involved in testis
      development may function as growth regulators in the tissues in which they are
      active.

PMID- 1634226
TI  - Microdeletions in interval 6 of the Y chromosome of males with idiopathic
      sterility point to disruption of AZF, a human spermatogenesis gene.
AB  - For males with idiopathic sterility, a molecular screen specific for small
      lesions (microdeletions) in interval 6 of the Y chromosome was set up using 29 Y
      DNA probes. A "de novo" microdeletion in Y interval 6 was detected in 2 out of 19
      "chromosomally normal" sterile males. The first microdeletion includes the Y-DNA
      probes pY6HP35 and 12f3; the second microdeletion includes the Y-DNA probes
      pY6HP52, 49f, FR15-II and the subinterval "C" of probe 50f2. A probe of the pY6H
      sequence family is present in both deletions. Sequences of this family cross
      hybridize to dhMiF1, a DNA sequence of a fertility gene structure on the Y
      chromosome of Drosophila hydei. It was possible to map the position of the Y
      deletion of one patient to the distal part of Yq11.22 or the proximal part of
      Yq11.23, and the deletion of the second patient to the distal part of Yq11.23.
      These microdeletions probably do not overlap. Since AZF, a human spermatogenesis
      gene, has been mapped to Y interval 6, we postulate that the microdeletions
      detected in this chromosome region affect the functional DNA structure of the AZF
      gene. If this holds true, it is possible that the AZF locus, cytogenetically
      mapped to distal Yq11, contains two spermatogenesis genes (AZFa and AZFb) or a
      large gene structure comparable to the Y fertility genes of Drosophila.

PMID- 1634227
TI  - Detection of two missense mutations and characterization of a repeat polymorphism
      in the factor VII gene (F7).
AB  - The 3' portion of the coagulation factor VII gene, containing the activation and
      serine protease domains, was investigated in four subjects with factor VII
      deficiency by temperature gradient gel electrophoresis and sequencing of
      polymerase chain reaction (PCR) products. Molecules displaying an altered melting
      behaviour were detected in three subjects, and direct sequencing showed two
      mutations. A G-to-T transversion causing a missense mutation, Cys-310 to Phe,
      suppresses a disulphide bond conserved in the catalytic domain of all serine
      proteases. This mutation, which in the homozygous form causes a severe reduction
      in protease activity (4%), was found in two patients from different Italian
      regions. A G-to-A transition, which gives rise to a missense mutation, Arg-304 to
      Gln, and is associated with the factor VII padua variant, was found in the
      heterozygous form in a subject also affected by von Willebrand disease. Two
      polymorphic alleles, which differ in one repeat monomer element, were precisely
      mapped in a region spanning the exon-intron 7 border of the factor VII gene and
      studied in families with factor VII or X deficiency.

PMID- 1634228
TI  - Paternal selection favoring mutant alleles of the retinoblastoma susceptibility
      gene.
AB  - Penetrance and segregation rates of mutant Rb-1 alleles were assessed in all 51
      members of eight kindreds with hereditary retinoblastoma by concomitant
      ophthalmologic examination and determination of seven intragenic restriction
      fragment length polymorphisms (RFLPs). Penetrance was in the range reported in
      the literature except for one family in which it was only 42.8%. However, the
      odds of transmitting a mutant Rb-1 allele from one generation to the next were
      25:9 in this population, much above the Mendelian 1:1 ratio (P less than 0.025).
      This preferential transmission was discovered through the use of molecular
      information. Further analysis revealed that this distortion was due to
      preferential inheritance among children of male carriers (18:4, P less than
      0.005). No difference from a 1:1 segregation ratio could be detected among the
      children of female carriers (7:5). These findings were consistent with a review
      of relevant data in the literature.

PMID- 1634229
TI  - Metabolism of GM1 ganglioside in cultured skin fibroblasts: anomalies in
      gangliosidoses, sialidoses, and sphingolipid activator protein (SAP, saposin) 1
      and prosaposin deficient disorders.
AB  - Cultured skin fibroblasts from controls and patients with lysosomal storage
      diseases were loaded with GM1 ganglioside that had been labelled with tritium in
      its ceramide moiety. After a 65-h or 240-h incubation, a large percentage of this
      ganglioside remained undegraded in GM1 gangliosidoses, whereas in the other
      storage diseases studied, one of its metabolites accumulated by 2-4 fold relative
      to controls. Labelled GM2 ganglioside accumulated in 4 variants of GM2
      gangliosidosis, whereas labelled GM3 ganglioside accumulated in sialidosis,
      galactosialidoses and sphingolipid activator protein 1 (SAP-1, saposin B) and
      prosaposin (saposin A, B, C and D) deficient lipidoses. The reduced degradation
      of GM3 ganglioside in the SAP-1 and prosaposin deficiencies was attributed to the
      deficient function of SAP-1. The prosaposin deficient cells also showed a reduced
      re-utilization of radioactive metabolites from GM1 ganglioside (i.e. sphingosine
      and fatty acid) for phospholipid biosynthesis compared with fibroblasts from the
      SAP-1 deficient patient or normal controls. This anomaly was ascribed to the
      previously shown defect in ceramide degradation in prosaposin deficiency.

PMID- 1634230
TI  - A non-alphoid repetitive DNA sequence from human chromosome 21.
AB  - A non-alphoid repetitive DNA from human chromosome 22, consisting of a 48-bp
      motif, shows homology to both G-group chromosomes in the gorilla, thus indicating
      the presence of additional repeat family members on further human chromosomes.
      Therefore, we screened a chromosome-21-specific cosmid library using this
      repetitive sequence from chromosome 22 (D22Z3). Some 40-50 cosmid clones were
      positive in tests for hybridization. One of the clones giving the strongest
      signals was digested with EcoRI/PstI, which we knew to cut frequently within the
      repeats; this resulted in fragments containing repeat units only. The fragments
      were subcloned into plasmid vector pTZ 19. Sequence-analysis of a 500-bp insert
      showed ten copies of a 48-bp repeat similar to D22Z3, with about 15% sequence
      deviation from the chromosome 22 consensus sequence. In situ hybridization of the
      newly isolated recombinant established its chromosome 21 specificity at high
      stringency. Physical mapping by pulsed field gel electrophoresis placed this new
      repeat in close vicinity to the chromosome 21 alphoid repeat. No cross
      hybridization with other mammalian genomes except for those of apes was observed.
      The locus has been designated D21Z2 by the Genome Data Base. A gel mobility shift
      assay indicated that this repetitive motif has protein-binding properties.

PMID- 1634231
TI  - Population cytogenetics of aphidicolin-induced fragile sites.
AB  - Chromosome fragile sites are inducible by aphidicolin in cultured human
      lymphocytes. To assess the frequency and distribution of these common fragile
      sites in the general population, a cytogenetic survey was performed on 126
      subjects, 59 males and 67 females, whose age ranged from 1 day to 72 years.
      Common fragile sites, induced by aphidicolin, were widespread and showed a
      remarkably different sensitivity among individuals; age influenced the overall
      frequency of fragile sites. Moreover, both age and sex seemed to modulate the
      expression of specific fragile sites. In our population, the most common fragile
      sites were: 3p14, 16q23, Xp22, 6q26, 1p31, 4q31, 1p22, 7q22, 2q33, 3q27, 2q31,
      7q32, 14q24, 10q22, 5q31, 2q37, 6p21.

PMID- 1634232
TI  - Characterization of a new mutation (R292G) and a deletion at the human
      uroporphyrinogen decarboxylase locus in two patients with hepatoerythropoietic
      porphyria.
AB  - A deficiency in the activity of uroporphyrinogen decarboxylase (UROD), the fifth
      enzyme of the haem biosynthetic pathway, is found in familial porphyria cutanea
      tarda (F-PCT) and hepatoerythropoietic porphyria (HEP). A new mutation (R292G)
      and a deletion have been found in a pedigree with two HEP patients (two sisters).
      The R292G mutation was not detected in 13 unrelated affected patients with F-PCT,
      so it appears to be uncommon. The possibility that the arginine 292 may
      participate at the active site of the enzyme is discussed. A summary of the 7
      mutations/deletions found in the UROD gene with their frequency is presented.

PMID- 1634233
TI  - Evidence for genetic heterogeneity in hereditary hydronephrosis caused by pelvi
      ureteric junction obstruction, with one locus assigned to chromosome 6p.
AB  - Hereditary hydronephrosis (MIM 143400) is an autosomal dominant trait that causes
      unilateral or bilateral pelvi-ureteric junction (PUJ) obstruction. Linkage
      analysis was undertaken in 5 families with hereditary PUJ obstruction using the
      major histocompatibility complex locus as a test marker. The data as a whole
      supported a hereditary hydronephrosis locus on 6p. Maximal lod scores were 3.090
      at a recombination fraction of 0.1 with full penetrance, and 2.486 at a
      recombination fraction of 0.1 with a penetrance of 90%. However, analysis of two
      point lod scores using the HOMOG program revealed significant evidence for
      genetic heterogeneity with one locus on 6p in 4 of the families, and a different
      locus in one family. After exclusion of this unlinked family, two point analysis
      gave a maximal lod score of 3.9 at a recombination fraction of 0.05 with full
      penetrance, and 4.2 at a recombination fraction of 0.0 with 90% penetrance. These
      data support the assignment of one of the loci for hereditary hydronephrosis to
      chromosome 6p.

PMID- 1634234
TI  - Absence of mutations in the promoter region of the low density lipoprotein
      receptor gene in a large number of familial hypercholesterolaemia patients as
      revealed by denaturing gradient gel electrophoresis.
AB  - Denaturing gradient gel electrophoresis (DGGE) was used in combination with the
      polymerase chain reaction (PCR) to detect sequence variations in the promoter
      region of the low density lipoprotein receptor (LDLR) gene. On the basis of
      calculated predictive melting properties we designed primers to amplify a 447-bp
      fragment of the promoter region from position -512 to -66, containing previously
      identified regulatory sequences. Using a primer with a GC-clamp in combination
      with restriction enzyme digestion, two melting domains could be analysed
      simultaneously. By oligonucleotide-directed mutagenesis artificial mutants were
      generated to optimize the conditions and to test the sensitivity of the method.
      All mutants were readily detected by electrophoresis in a 9% polyacrylamide gel
      containing a 10%-60% linear denaturing gradient. Using this method, we analysed
      DNA samples of 350 heterozygous familial hypercholesterolaemia (FH) patients. No
      mutations were detected, suggesting that mutations in the regulatory elements of
      the promoter sequence do not play a significant role in the etiology of FH.

PMID- 1634235
TI  - The interleukin-7 receptor gene is at 5p13.
AB  - A DNA probe for the interleukin-7 receptor gene was used for in situ
      hybridisation and Southern blot analysis of a series of rodent-human hybrid cell
      lines. The IL-7 receptor gene maps to 5p13.

PMID- 1634236
TI  - Novel promoter and splice junction defects add to the genetic, clinical or
      geographic heterogeneity of beta-thalassaemia in the Portuguese population.
AB  - In order to delineate the spectrum and the relative abundance of beta-globin gene
      defects causing thalassaemia in the Portuguese population, a representative
      sample was analysed including 51 beta-thalassaemia carriers along with 26
      patients representing different clinical phenotypes. Seven mutations were
      identified, four of which [codon 39 (C----T), 39%; intervening sequence (IVS) 1
      nucleotide (nt) 1 (G----A), 26%; IVS 1 nt 110 (G----A), 17%; IVS 1 nt 6 (T----C),
      15%] account for 97% of 93 beta-thalassaemia chromosomes. Two previously
      undescribed mutations, namely a C----T substitution at position--90 in the
      proximal CACCC box, and the deletion of nucleotides 4 and 5 (AG) in IVS2 were
      identified. The uncommon, though ubiquitous, G----T transversion at codon 121 was
      found once upon haplotype V. Direct prenatal diagnosis can be offered to 95% of
      couples at risk of bearing a thalassaemic child.

PMID- 1634237
TI  - A novel mutation in the beta-protein coding region of the amyloid beta-protein
      precursor (APP) gene.
AB  - A novel mutation, a C to T transition at base pair 2124 in exon 17 of the amyloid
      beta-protein precursor (APP) gene, has been identified by direct sequencing of
      amplified DNA from two Alzheimer's disease (AD) patients. A simple
      oligonucleotide-hybridization procedure was developed to allow population studies
      of this DNA variation. The mutation, which is silent at the protein level, was
      present in 2 out of 12 investigated AD patients, in 1 out of 60 non-AD patients
      and in 1 out of 30 healthy individuals. The mutation can be used as a new marker
      for linkage studies involving the APP gene, although more comprehensive
      population studies are required to determine the status of the mutation as a
      possible risk factor for the development of AD.

PMID- 1634238
TI  - A single nucleotide substitution in the phosphoglycerate kinase (PGK)-1 gene
      occurred after the separation of PGK-1 and PGK-2.
AB  - The mammalian genome contains two functional loci for the production of
      phosphoglycerate kinase, PGK-1, an X-linked gene expressed in all somatic cells,
      and PGK-2, an autosomal intron-less gene expressed exclusively in late
      spermatogenesis. A nucleotide substitution from guanine to thymine was recently
      found at position 473 of PGK-1 mRNA in PGK Shizuoka. The mutation was not found
      in the PGK-2 gene and might have occurred after separation of PGK-1 and PGK-2.

PMID- 1634239
TI  - Masking in three-dimensional auditory displays.
AB  - The extent to which simultaneous inputs in a three-dimensional (3D) auditory
      display mask one another was studied in a simulated sonar task. The minimum
      signal-to-noise ratio (SNR) required to detect an amplitude-modulated 500-Hz tone
      in a background of broadband noise was measured using a loudspeaker array in a
      free field. Three aspects of the 3D array were varied: angular separation of the
      sources, degree of correlation of the background noises, and listener head
      movement. Masking was substantially reduced when the sources were uncorrelated.
      The SNR needed for detection decreased with source separation, and the rate of
      decrease was significantly greater with uncorrelated sources than with partially
      or fully correlated sources. Head movement had no effect on the SNR required for
      detection. Implications for the design and application of 3D auditory displays
      are discussed.

PMID- 1634240
TI  - Minimum audible movement angle as a function of the azimuth and elevation of the
      source.
AB  - In the future auditory directional cues may enhance situational awareness in
      cockpits with head-coupled displays. This benefit would depend, however, on the
      pilot's ability to detect the direction of moving sounds at different locations
      in space. The present investigation examined this ability. Auditory motion acuity
      was measured by the minimum audible movement angle (MAMA): the minimum angle of
      travel required for detection of the direction of sound movement. Five
      experienced listeners were instructed to indicate the direction of travel of a
      sound source (broadband noise at 50 dBA) that moved at a velocity of 20 deg/s.
      Nine azimuth positions were tested at 0 deg elevation. Five elevations were then
      tested at 0 deg azimuth. Finally two azimuth positions were tested at an
      elevation of 80 deg. The position of the source did not significantly affect the
      MAMA for azimuth locations between +40 and -40 deg and elevations below 80 deg.
      Within this area the MAMA ranged between 1 and 2 deg. Outside this area the MAMA
      increased to 3 to 10 deg.

PMID- 1634241
TI  - The effect of accommodation on retinal image size.
AB  - The apparent size of an object is diminished when accommodation of the eye moves
      inward to a position closer to the observer than to a viewed object. This
      phenomenon is called accommodation micropsia. Using schematic eyes, we
      investigated change in retinal image size caused by a change in accommodation.
      The use of schematic eyes is also discussed and is justified. The calculated
      magnitude of this diminution for four schematic eyes ranged from unity at
      infinity to a maximum of 0.98 (-2%) at about 12.0 diopters (D). For distances at
      which accommodation micropsia is typically observed (about 2.0 D), retinal
      minification is less than 0.997 (-0.3%). Thus changes in the size of the retinal
      image attributable to accommodation are virtually negligible when compared with
      the observed reduction of 3% to 33%. This suggests that accommodation micropsia
      is mediated almost entirely by processes other than those involving the optics of
      the eye.

PMID- 1634242
TI  - Apparent size and distance in an imaging display.
AB  - The size-distance invariance hypothesis suggests that the perceived size and the
      perceived distance of objects in a field viewed naturally are closely related.
      However, this relationship breaks down when scenes are viewed through high-power
      optical systems. When natural scenes are viewed through an imaging display of
      unity magnification, there is a reduction in their apparent size. This raises the
      question of whether the relationship breaks down when scenes are viewed through a
      low-power imaging display. A single-lens reflex camera was used as an imaging
      display that enabled subjects to vary the size of imaged real-world scenes.
      Judgments of size were found to vary with depth information in scenes and between
      monocular and binocular viewing, consistent with a previous finding, but
      judgments of distance did not vary significantly across either of these
      conditions. The results suggest that judgments of size and judgments of distance
      with imaging displays are not influenced uniformly by environmental and task
      variables.

PMID- 1634243
TI  - Judgments of change and proportion in graphical perception.
AB  - Subjects judged change and proportion when viewing graphs in two experiments.
      Change was judged more quickly and accurately with line and bar graphs than with
      pie charts or tiered bar graphs, and this difference was larger when the rate of
      change was smaller. Without a graduated scale, proportion was judged more quickly
      and accurately with pie charts and divided bar graphs than with line or bar
      graphs. Perception is direct when it requires simpler or fewer mental operations;
      we propose that perception of change is direct with line and bar graphs, whereas
      perception of proportion is direct with pie charts and divided bar graphs. The
      results are also consistent with the proximity compatibility principle.
      Suggestions for improving the design of graphical displays are given.

PMID- 1634244
TI  - Arthritis induced in rats with adjuvant oil is a genetically restricted, alpha
      beta T-cell dependent autoimmune disease.
AB  - Adjuvant arthritis in rats is usually induced by injection of mycobacterium
      tubercle cell walls suspended in various adjuvant oils such as Freund's
      incomplete adjuvant (FIA) or pristane. We have recently shown that injection of
      adjuvant oils without inclusion of mycobacterium tubercle cell walls triggers
      arthritis [oil adjuvant-induced arthritis (OIA)] in the DA rat strain. The OIA is
      a genetically restricted disease since only DA rats are susceptible while Lewis,
      DA-fostered Lewis and F1 (Lew x DA) rats are relatively resistant. Activated
      alpha beta T cells infiltrate the affected joints of adjuvant oil-injected DA
      rats and treatment with monoclonal antibodies to the alpha beta T-cell receptor
      abrogates development of arthritis. These findings show that alpha beta T-cell
      activation is a critical event in the development of OIA.

PMID- 1634245
TI  - Induction of IgE antibodies and T-cell reactivity to ovalbumin in rats colonized
      with Escherichia coli genetically manipulated to produce ovalbumin.
AB  - The immune response to ovalbumin (OA) and the bacterial antigens,
      lipopolysaccharide (LPS) and fimbriae were studied in conventional rats colonized
      from birth with an Escherichia coli strain producing OA. The colonized rats had
      developed IgE antibodies against OA, but not against the fimbrial or the LPS
      antigens from the E. coli at 2 months of age. At this time all rats were primed
      with OA given intracutaneously in Freund's complete adjuvant. Two weeks later the
      colonized rats showed a 35% greater delayed-type hypersensitivity (DTH) reaction
      to OA, measured as ear swelling, than the controls. Thus bacteria carrying
      antigens resembling potential allergens might aggravate, or participate in the
      induction of allergic symptoms. In addition such bacteria could be efficient
      vaccine vectors in protection against parasites. The study illustrates the
      importance of the mode of antigen presentation for the subsequent immune
      response.

PMID- 1634246
TI  - Antibody responses to the blood group antigen D in SCID mice reconstituted with
      human blood mononuclear cells.
AB  - Mice with severe combined immunodeficiency (SCID) were reconstituted with
      peripheral blood mononuclear cells (PBMC) obtained from D-negative individuals
      who had been sensitized to D-positive erythrocytes. Anti-D was spontaneously
      secreted in mice reconstituted with PBMC obtained from donors within 14 days of
      re-immunization with D-positive erythrocytes, but was not detected in murine
      plasma when mice were reconstituted with PBMC obtained from the same donors many
      years after sensitization, even though anti-D was still present in the serum of
      these donors. In the murine plasma the anti-D titres were not related to the
      total human immunoglobulin concentrations. SCID mice reconstituted with PBMC from
      some donors immune to D-positive erythrocytes (but not immunized within 34 days
      of donating the sample) made a recall response to the D antigen, which in some
      cases was maintained for at least 84 days. Depletion of adherent cells from the
      reconstituting PBMC reduced the total concentration of human IgG obtained. These
      results show that SCID mice reconstituted with human PBMC (Hu PBMC-SCID) can make
      a recall response to the D antigen which cannot be attributed to non-specific
      polyclonal B-lymphocyte activation, and that efficient antigen processing and
      presentation of the integral erythrocyte membrane D polypeptide occurs in the Hu
      PBMC-SCID model.

PMID- 1634247
TI  - Cytokine-induced differentiation of IgA B cells: studies using an IgA expressing
      B-cell lymphoma.
AB  - Cytokines such as interleukin-5 (IL-5) and transforming growth factor beta 1 (TGF
      beta 1) increase IgA production by heterogeneous populations of
      lipopolysaccharide (LPS)-activated murine B cells. We have used IgA expressing
      murine B-lymphoma cells CH12.LX.C4.4F10 (4F10) to define the activity of these
      and other cytokines on IgA secretion at the single-cell level, membrane IgA
      expression, IgA polymerization and cell growth. IL-5 as well as LPS significantly
      increases IgA secretion of 4F10 cells, whereas TGF beta 1, a cytokine known to
      stimulate isotype switching to IgA among surface IgM-bearing B cells, inhibits
      IgA secretion. When tested alone, IL-1 beta, IL-2, IL-4, IL-6 and interferon
      gamma (IFN-gamma) do not significantly alter IgA secretion. However, there is a
      synergistic increase in IgA secretion when 4F10 cells are co-stimulated with IL-5
      and IL-4, while IFN-gamma inhibits IL-5-stimulated up-regulation of IgA
      secretion. In parallel with increased IgA secretion after cytokine stimulation,
      4F10 cells display less membrane IgA. Increased J-chain steady-state mRNA levels
      after IL-5 or LPS stimulation are paralleled by increased mRNA levels for
      secreted IgA, but are not accompanied by alterations in the ratio of monomeric to
      polymeric IgA. IL-5 and LPS initially stimulated but later inhibited 4F10 cell
      proliferation suggesting an inverse relationship between proliferation and
      differentiation in this cell line. 4F10 cells are a useful model for the
      characterization of discrete aspects of IgA B-cell differentiation, since the
      secretory and membrane Ig and proliferative responses of this IgA B-cell line to
      cytokines and LPS appear to parallel those of freshly isolated murine B cells.

PMID- 1634248
TI  - Entamoeba histolytica alters arachidonic acid metabolism in macrophages in vitro
      and in vivo.
AB  - Entamoeba histolytica infections are associated with a state of transient
      suppression of cell-mediated immunity. Macrophages, the most important cells in
      host defence and control of invasive amoebiasis, in infected animals have been
      found to be deficient in effector functions and accessory cell potential.
      However, little is known of the cellular mechanisms responsible for the down
      regulation. This study investigated whether macrophage dysfunction in amoebiasis
      is associated with altered macrophage arachidonic acid (AA) metabolism. Resident
      peritoneal macrophages (PMO) from naive gerbils produced enhanced levels of
      prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) in response to live E.
      histolytica trophozoites, to diffusible excretory/secretory products released
      from live amoebae in millicells and to freeze-thawed soluble amoebic proteins
      that were inhibitable by indomethacin (INDO) and nordihydroguaiaretic acid
      (NDGA), respectively. In contrast to PMO from naive gerbils, PMO from animals
      with amoebic liver abscesses at 10, 20 and 30 days post-infection (p.i.) released
      high basal levels of PGE2 and LTC4. In response to zymosan stimulation, PMO from
      infected animals produced two- and fourfold less PGE2 and LTC4, respectively, as
      compared to uninfected controls. AMO showed high constitutive basal release of
      PGE2 and LTC4. In response to amoebic and zymosan stimulation, AMO at 10 days
      p.i. produced significantly higher levels of PGE2 than AMO at 20 days p.i., while
      AMO at 30 days p.i. were refractory to stimulation to produce higher than basal
      levels of PGE2. Early (10 days) and late (20-30 days) AMO were refractory to
      amoebic and zymosan stimulation for enhanced LTC4 release. Pretreatment of AMO
      with AA substrate restored optimal PGE2 and LTC4 biosynthesis, but the cells were
      generally unresponsive to zymosan stimulation to produce augmented levels of
      LTC4. These results strongly suggest that intrinsic or secreted products or both
      from E. histolytica can induce profound alteration of eicosanoid formation in
      cyclooxygenase and lipoxygenase pathways in macrophages from naive and infected
      animals and that AA metabolism by AMO is sequentially modified during the course
      of the disease.

PMID- 1634249
TI  - Tumour necrosis factor-alpha mediates ultraviolet light B-enhanced expression of
      contact hypersensitivity.
AB  - Acute, low-dose ultraviolet B radiation (UVB) impairs the induction of contact
      hypersensitivity (CH) to dinitrochlorobenzene (DNCB) in certain inbred strains of
      mice (termed UVB-susceptible), but not in others (termed UVB-resistant). By
      contrast, exposure of mouse ear skin to an identical regimen of UVB has been
      reported to exaggerate the expression of CH. Recently, tumour necrosis factor
      alpha (TNF-alpha) has been demonstrated to mediate the deleterious effects of UVB
      on CH induction, presumably through local release of TNF-alpha within UVB exposed
      skin. The present studies were conducted to determine whether TNF-alpha also
      mediates the exaggerated expression of CH induced by UVB radiation. It was found
      that TNF-alpha, injected intradermally at the ear challenge site, enhanced the
      expression of CH to DNFB in conventionally sensitized mice. Interestingly, TNF
      alpha was able to amplify the expression of CH in the ears of both UVB
      susceptible strains of mice, and UVB-resistant strains. However, anti-TNF-alpha
      antibodies neutralized UVB-enhanced CH in UVB-susceptible mice, but not in UVB
      resistant mice. These findings support the proposition that TNF-alpha, released
      from UVB-exposed epidermal cells, is a critical mediator of the effects of UVB
      radiation on induction and expression of contact hypersensitivity. The effects of
      UVB radiation, intradermal (ID) TNF-alpha, and/or epicutaneously applied DNFB on
      epidermal Langerhans' cells were also evaluated and compared. Whereas
      epicutaneously applied DNFB alone profoundly depleted the epidermis of
      Langerhans' cells, DNFB painted on UVB-exposed or TNF-alpha-treated skin was much
      less effective at eliminating normal appearing Langerhans' cells. These results
      suggest that one direct effect of TNF-alpha on Langerhans' cells may be to
      immobilize these antigen-presenting cells transiently within the epidermis. It is
      proposed that this immobilization has the paradoxical effect (a) of interfering
      with sensitization, by preventing hapten-bearing Langerhans' cells from migrating
      to the draining lymph node, while at the same time (b) of amplifying CH
      expression by lengthening the interval of hapten retention and presentation with
      the epidermis.

PMID- 1634250
TI  - The effect of cytokines and chemotactic agonists on the migration of T
      lymphocytes into skin.
AB  - The migration of lymphocytes and neutrophils into skin sites stimulated with
      chemotactic agonists or with cytokines known to induce leucocyte-endothelial
      adhesion molecules was examined in sheep. Lymphocytes, collected from efferent
      prefemoral lymph, labelled in vitro with [111In]oxine and reinjected
      intravenously, migrated in large numbers into delayed-type hypersensitivity (DTH)
      reactions elicited by purified protein derivative (PPD) and into sites stimulated
      with tumour necrosis factor-alpha (TNF-alpha) or interferon-gamma (IFN-gamma). In
      contrast, interleukin (IL)-1 alpha, a potent inducer of endothelial leucocyte
      adhesion molecule-1 (ELAM-1), caused moderate accumulation of [111In]lymphocytes
      at concentrations that induced intense accumulation of 111In-labelled
      neutrophils. The chemotactic agonists IL-8 and zymosan-activated plasma (ZAP)
      caused accumulation of very large numbers of neutrophils but only small numbers
      of lymphocytes, whereas platelet-activating factor (PAF) and leukotriene B4
      (LTB4) failed to recruit lymphocytes into skin. IFN-gamma was the only mediator
      to recruit lymphocytes in preference to neutrophils into skin. The results
      suggest that those lymphocyte chemotactic agonists which lack the ability to
      induce adhesion molecules on endothelium play only a minor role in directing
      migration of lymphocytes into skin. Immunohistological examination of skin
      lesions confirmed the findings of studies with 111In-labelled lymphocytes and
      indicated that there was a tendency for CD4+ cells to outnumber CD8+ cells in
      infiltrates induced by all mediators. In contrast to the elevated numbers of T19+
      subset of T-cell receptor (TcR+) gamma delta cells present in DTH reactions, none
      of the mediators induced migration of T19+ cells into skin.

PMID- 1634251
TI  - Natural killer (NK) cell activity in human long-term bone marrow cultures
      (LTBMC): effects of interleukin-2 (IL-2) and granulocyte-macrophage colony
      stimulating factor (GM-CSF) on the progenitor cells.
AB  - Human bone marrow-derived progenitor cells were studied in a long-term bone
      marrow culture system (LTBMC) dependent on an autologous stroma cell layer. The
      establishment of the stromal cell layer was facilitated by using marrow obtained
      from small pieces of sternum, which was cultured for 4 weeks without addition of
      exogenous growth factors. After this period, the response of LTBMC to two
      different cytokines [recombinant human interleukin-2 (rhIL-2) and recombinant
      human granulocyte-macrophage colony-stimulating factor (rhGM-CSF)] was
      investigated. Our results show proliferation in response to both cytokines and
      induction of differentiation of cells able to bind IL-2 and/or GM-CSF again. The
      two cytokines also generate cells responding to rhGM-CSF by colony formation.
      However, a difference with respect to morphology, phenotype and cytotoxic
      function of cells in the LTBMC, was noted between the two cytokines. Cells with
      large granular lymphocyte (LGL) morphology and cytotoxic activity against K562
      and Daudi were generated only in the rhIL-2-supplemented LTBMC. This was
      compatible with a higher frequency of cells expressing the CD56+ phenotype in the
      IL-2-stimulated LTBMC as compared to the GM-CSF supplemented LTBMC. Our results
      also demonstrate the existence of a population of myeloid progenitor cells
      (CD33+) with ability to bind IL-2 in fresh bone marrow (BM).

PMID- 1634253
TI  - Selection of BoCD25 monoclonal antibodies by screening mouse L cells transfected
      with the bovine p55-interleukin-2 (IL-2) receptor gene.
AB  - The bovine interleukin-2 receptor-alpha (IL-2R alpha) gene has been isolated and
      a rabbit antiserum against a fusion protein of the gene has been produced.
      However, the antiserum does not inhibit IL-2-dependent proliferation. Since a
      panel of monoclonal antibodies (mAb) to bovine activation antigens was available,
      we transfected the gene into mouse L fibroblasts, selected stable transfectants
      with the rabbit antiserum, and screened for antibodies that bound the transfected
      cells but not the untransfected cells. Three mAb were selected and all three
      precipitated a molecule of M(r) 55,000 (under reducing conditions) from activated
      cells, as expected from homology with mouse and human IL-2R alpha (CD25, Tac).
      One of the three mAb was a strong inhibitor of IL-2-dependent proliferation of
      bovine lymphocytes. Thus, the availability of transfected cells allowed us to
      establish quickly and unequivocally the antigenic specificity of a number of
      antibodies.

PMID- 1634252
TI  - Modulation of in vitro porcine natural killer cell activity by recombinant
      interleukin-1 alpha, interleukin-2 and interleukin-4.
AB  - In order to understand better how cytokines modulate porcine lymphocyte-mediated
      natural cytotoxicity and to develop a rapid and reliable colorimetric assay to
      study that activity in young pigs, we studied inherent and cytokine induced in
      vitro natural killer (NK) activity. The cytokines we studied were human
      recombinant interleukin-1 alpha (IL-1 alpha), IL-2, IL-4 and interferon-gamma
      (IFN-gamma). Natural killer activity by peripheral blood mononuclear cells
      (PBMC), reported as per cent specific lysis (%SL), was determined by the
      colorimetric measurement of lactate dehydrogenase released from tumour cell
      targets, YAC-1 and K562. Inherent NK activity was low and remained relatively
      unchanged by alterations of assay length or effector cell concentration. Low NK
      activity was also observed in response to IL-4 and IFN-gamma. IL-2 and, to a
      lesser extent, IL-1 alpha induced significant NK activity with trends towards
      increasing %SL with increasing cytokine dose. Optimal IL-1 alpha- and IL-2
      induced NK activity could be observed at 18 hr, with significant activity
      stimulated by IL-2 as early as 4 hr. IL-2-induced NK activity was sensitive to
      effector cell concentration; %SL decreased as the effector to target ratio
      decreased. IL-1 alpha- and IL-2-induced NK activities were decreased in the
      presence of IL-4. These results indicate porcine PBMC are sensitive to in vitro
      modulation by human recombinant IL-1 alpha, IL-2 and IL-4. The ability of IL-1
      alpha and IL-2 to induce swine NK activity and the ability of IL-4 to inhibit
      that activity are similar to the actions of those cytokines in human NK systems.

PMID- 1634255
TI  - Surface expressed heat-shock proteins by stressed or human immunodeficiency virus
      (HIV)-infected lymphoid cells represent the target for antibody-dependent
      cellular cytotoxicity.
AB  - The expression of heat-shock proteins (HSP) of the 72,000 MW family by Daudi and
      H9 lymphoma cells has been investigated by flow cytometry. It has been found that
      both heat-stressed and chronically human immunodeficiency virus (HIV)-infected
      lymphomas show an increased expression of heat-shock proteins (HSP). Moreover,
      murine monoclonal antibody (mAb) against 72,000 MW HSP was able to mediate
      antibody-dependent cellular cytotoxicity (ADCC) using peripheral blood
      lymphocytes (PBL) as effector cells. All target cells used in these experiments
      were efficiently lysed in the presence of anti-HSP antibody suggesting a role of
      membrane HSP in the elimination of stressed or infected cells.

PMID- 1634254
TI  - Identification of immunosuppressive fractions from the rat submandibular salivary
      gland.
AB  - It had previously been suggested that the submandibular gland (SMG) of mice and
      rats may contain in vivo immunosuppressive factor(s). To identify such factor(s),
      we used a multi-step purification procedure of rat SMG extracts. Gel filtration
      chromatography of the SMG crude extract resulted in two pools of fractions with
      significant effects on lymphocyte reactivity in the in vitro concanavalin A (Con
      A) bioassay. Of these two pools, only the one with lower molecular weight
      resulted in the prolongation of murine skin allograft survival, the suppression
      of the delayed-type hypersensitivity (DTH) response to picryl chloride and the
      decrease in number of direct (IgM) plaque-forming cells against sheep red blood
      cells. Fractionation of this low molecular weight (LMW) pool through hydrophobic
      interaction chromatography resulted in three protein fractions designated A, B
      and C. Of these fractions only fraction A produced significant suppression of the
      DTH response. Further purification of fraction A with anion exchange
      chromatography produced two fractions with immunosuppressive activity in the DTH
      response. One fraction demonstrated on SDS-PAGE a single component of 40,000 MW,
      while the other had two components of 30,000 and 40,000 MW respectively.

PMID- 1634256
TI  - Interferon-gamma-dependent immunosuppressive effects of human gingival
      fibroblasts.
AB  - Immunoregulatory functions of human gingival fibroblasts (HGF) were examined. As
      in fibroblasts isolated from other tissues, HGF were activated with interferon
      gamma (IFN-gamma) to express HLA-DR molecules. Despite the fact that the IFN
      gamma-treated HGF showed phenotypical resemblance to so-called antigen-presenting
      cells (APC), the IFN-gamma-treated HGF were ineffective stimulators of
      alloreactive peripheral T cells. Conversely, IFN-gamma-treated HGF dramatically
      inhibited the proliferative responses of allogeneic APC (allo-APC) or
      phytohaemagglutinin (PHA)-stimulated T cells. Immunosuppressive effects of
      culture supernatant (CS) of IFN-gamma-treated HGF were low and were completely
      abrogated by the addition of indomethacin. Moreover, the production of
      prostaglandin E2 (PGE2) by HGF was not affected by IFN-gamma. These results
      suggest that IFN-gamma-dependent immunosuppressive effects of HGF were not due to
      PGE2 produced by HGF. In order to investigate further the mechanism(s) of IFN
      gamma-dependent immunosuppressive effects of HGF, activated T cells and IFN-gamma
      treated HGF were separately cultured in the same well by collagen films which
      were assembled in cylindrical cells and disturbed physical interactions between T
      cells and HGF. The proliferative responses of T cells which directly contacted
      with IFN-gamma-treated HGF were inhibited more significantly than those of T
      cells which did not contact with IFN-gamma-treated HGF. This suggests that IFN
      gamma-dependent immunosuppressive effects of HGF were mediated by direct
      interactions between T cells and activated HGF. The present results suggest that
      IFN-gamma-stimulated HGF would modulate the immune responses of locally
      infiltrated T cells in periodontal lesions.

PMID- 1634257
TI  - A view of the workshop.

PMID- 1634258
TI  - Dutch information policies in the near future.
AB  - The Dutch Ministry of Welfare, Health and Culture played an important part in
      Picture Archiving and Communicating Systems (PACS)-related activities in the
      Netherlands. It subsidized a large Dutch PACS project, which took place in the
      period 1986-1989. Moreover the ministry subsidized this workshop on the
      Technology Assessment of PACS. In this paper, the Director of the Information
      Policy department of the ministry explains the backgrounds of Dutch policy in the
      support of development and evaluation of information technologies applied in the
      health care sector in general and, more specifically, of PACS.

PMID- 1634259
TI  - Workshop aims, outline of the program.
AB  - This workshop on the Technology Assessment of PACS has been organized as a
      rounding off of the Technology Assessment activities which were initiated within
      the Dutch PACS Project (1986-1989). It is made possible by a funding from the
      Dutch Ministry of Health Care (WVC). We hope it will be not only a rounding off,
      but will contribute to more intensive cooperations in this area. In the scope of
      the Dutch PACS project, the software package CAPACITY for cost analyses of PACS
      has been developed, to stimulate the dialogue and exchange of data. During the
      workshop, the data which were collected with CAPACITY are used as a framework for
      discussions. This paper presents the outline of the workshop, its background, its
      aims and the program.

PMID- 1634260
TI  - Overview of CAPACITY data.
AB  - This paper presents an overview of the data from 15 cases collected with the
      CAPACITY software for cost analysis of PACS. The data suggest that both hospital
      wide and partial PACS implementations do not pay back yet. Only Nuclear Medicine
      PACS systems may be introduced cost-neutral in the near future. Because of the
      assumed price drop of hardware components of 5-25% per year, hospital wide and
      partial PACS may allow cost savings within the next 10-20 years. There are major
      differences in viewpoints concerning the required PACS configurations and their
      costs. The experiences with the CAPACITY software suggest the need for the
      establishment of key rules, for designing a PACS configuration and for estimating
      PACS costs.

PMID- 1634261
TI  - Overview of some methodological problems in assessment of PACS.
AB  - The purpose of technology assessment of picture archiving and communications
      systems (PACS) is to establish the need for the technology, provide a measure of
      functionality and to establish the costs and benefits associated with the
      introduction of the system. Given concerns about the clinical acceptability of
      PACS, it is unlikely that radiologists will change from existing film based
      systems until a clear demonstration of costs and benefits has been performed. The
      major need at present is to quantify the benefits which may flow from the
      introduction of PACS system in a standard manner which can be accepted by all
      parties involved.

PMID- 1634262
TI  - Required functionality of PACS from clinical point of view.
AB  - Concerning the required functionality of PACS from a clinical point of view this
      paper describes the functionality during the several phases of the imaging
      process. A list of general requirements is summarized. To get more information a
      period of prototype development and testing is needed. During this period the
      required functionality has to be investigated by questionnaires and automatic
      registration by the work stations.

PMID- 1634263
TI  - Current views on the functionalities of PACS.
AB  - The concept of PACS has evolved from a central storage of medical images to a
      distributed data and image management system. The trend and evolution of the
      definition and design of PACS systems is described in this paper. Special
      emphasis on the concept of distributed and open architecture is given with a
      discussion of the advantages and disadvantages of each approach. A hospital-wide
      PACS system designed based on a distributed architecture integrated with a
      Hospital Information System (HIS) at the University Hospital of Geneva is further
      described.

PMID- 1634264
TI  - The impact of standards.
AB  - The development of standards in the field of PACS is essential. This paper
      explains why and describes the current activities in this field. Special emphasis
      is put on the European activities, i.e. the CEN/TC251 committee. The impact of
      standards is given on the relation between the Information Technology and Medical
      Imaging market.

PMID- 1634265
TI  - Legal aspects of picture archiving and communications systems.
AB  - Legal issues of PACS have so far received little attention. This paper gives an
      overview of this field. It distinguishes three problem areas: Property Law,
      Liability and Fair Information Practices. Current EC developments are described.

PMID- 1634266
TI  - A view from the Nijmegen PACS project.
AB  - A view on PACS is given from a radiology department involved in PACS as part of
      its medical research environment. Special attention is payed to historical
      developments in medical imaging to study the context of actual PACS developments.
      Some directions of future diagnostic developments are indicated. Both image data
      acquisition and presentation techniques are of interest to medical as well as
      industrial applications. It is pointed out how PACS is thought to depend on
      contextual factors.

PMID- 1634267
TI  - Methodology for the evaluation of diagnostic image quality.
AB  - This paper explains the theoretical backgrounds of various methods for the
      evaluation of diagnostic image quality. It introduces the Receiver Operating
      Characteristics (ROC) methodology. The major prerequisites, some important
      features of the experimental set-up and of the data analysis of an ROC study are
      explained. Dedicated software packages to support ROC studies are introduced. A
      possible method on how to relate image quality and cost-effectiveness is
      presented. Finally some current problems of the ROC method and possible
      improvements are discussed.

PMID- 1634268
TI  - The impact of PACS on the information flow.
AB  - It is likely that changes in hospital operational practices made possible by the
      introduction of a whole hospital PACS will require the present information and
      data patterns to be changed significantly. Some of the factors which will affect
      the flow of data and information are considered, and the implications of
      comparing the costs of installing 'whole hospital' PACS systems in different
      institutions are discussed.

PMID- 1634269
TI  - Evaluation of personnel savings through PACS: a modelling approach.
AB  - The ability to improve the efficiency of the use of medical image information is
      often believed to be one of the most important potentials of PACS. The
      organization within hospitals is however complex, which makes it difficult to
      predict the impact of the system. This paper addresses several methods for the
      analysis of the organizational impact and proposes a modelling method.

PMID- 1634270
TI  - Evaluation of PACS-induced organizational change.
AB  - Filmless digital imaging with a PACS will affect health care institutions by
      changing the handling of clinically relevant information, altering needed
      staffing levels, and possibly affecting both the quality and cost of care.
      Economic evaluation of PACS compares the costs and/or benefits of PACS with those
      of all other relevant alternatives. Other evaluations may focus on narrower
      research questions. This paper discusses methodological considerations in
      economic evaluation, methods of time measurement, and the methods and results of
      several applied assessments of PACS effects on the medical imaging department or
      the hospital.

PMID- 1634271
TI  - Quality assurance issues and PACS.
AB  - Quality assessment and assurance is a growing concern in all areas of health
      care. The concern is fueled by a body of evidence that indicates that quality of
      care is not optimal, and in many instances, is unacceptably low. Although
      different standards for quality have been proposed, health outcome is the
      ultimate standard, since improving health is the goal of the health care system.
      The effects of PACS on health outcome are not known. A PAC system has the
      potential to improve quality, especially if it makes the diagnostic process more
      efficient, but evidence that such improvement actually occurs is so far lacking.

PMID- 1634272
TI  - Administrative and organization impact of PACS and its effect on the quality of
      care.
AB  - PACS integrated to RIS and HIS will have a significant impact on the hospital
      operation. This paper describes the current radiological process and indicates at
      what points PACS may prove to be important, in order to guarantee its successful
      implementation with the objective to improve patient care by better management of
      personnel, equipment and information.

PMID- 1634273
TI  - The impact of PACS on research and education.
AB  - Picture Archiving and Communication Systems (PACS) are rapidly evolving and the
      total digital radiology department may be a reality within the next decade. PACS
      can have a major impact on the educational and research responsibilities of a
      medical institution. The possibility of correlating real patient data with
      existing radiological teaching files opens up numerous possibilities. Multi
      institutional research can be strengthened by employing the PACS as the means to
      the end. This paper discusses the representative examples of how teaching and
      research can be enhanced with PACS and the technical requirements to achieve the
      inter-connectivity.

PMID- 1634274
TI  - Influence of health care systems on the market for picture archiving and
      communication systems.
AB  - An analysis is given of the relation between health care systems and the PACS
      market. Two driving forces exist in the market: quality and price. It is argued
      that the quality driven market is mainly independent of the health care system
      and will be the force that drives the introduction of the health care system and
      will be the force that drives the introduction of PACS in the forthcoming years.
      Finally a change of focus is suggested from only archiving and communication to a
      more general concept of image networking, serving more goals than only the goal
      of working filmlessly.

PMID- 1634275
TI  - Experience with an operational nuclear medicine PACS in the Utrecht University
      Hospital.
AB  - At the department of nuclear medicine of the University Hospital Utrecht a single
      modality PACS has been operational since mid 1990. After 1 year of operation the
      functionality, the organizational and economical consequences and the
      acceptability of the PACS are evaluated. The functional aspects reviewed are:
      viewing facilities, patient data management, connectivity, reporting facilities,
      archiving, privacy and security. It is concluded that the improved quality of
      diagnostic viewing and the potential integration with diagnosis, reporting and
      archiving are highly appreciated. The many problems that have occurred during the
      transition period, however, greatly influence the appreciation and acceptability
      of the PACS. Overall, we feel that on the long term there will be a positive
      effect on the quality and efficiency of the work done in our department.

PMID- 1634276
TI  - PACS clinical experience at Georgetown University.
AB  - Georgetown University Hospital has been operating an image management and
      communications system (IMACS or PACS) for 3.5 years. This work was initially
      funded under the Army Medical Research and Development Command Digital Imaging
      Network Systems (DINS) project. The system was taken from a research system
      supporting only radiology tasks to one extended to clinical use, and has been
      used in clinical work for 3 years. This paper will summarize our PACS clinical
      experience and will describe the operational features implemented and those still
      necessary.

PMID- 1634277
TI  - Feasibility of PACS based on 2 years experiences of Hokkaido University PACS.
AB  - Some features of HU-PACS which is now just 2 years old are described with the
      results of clinical assessment on it. It is clear that many advancements in
      technology have made the HU-PACS to be a useful tool of clinical routines. The
      paper describes also problems of the system in future with general comments on
      technology assessment and cost benefit issues.

PMID- 1634278
TI  - PACS experiences in Trieste.
AB  - The installation of a commercial PACS in the Hospitals of Trieste has been the
      start-point for a project of technology assessment, aimed at the evaluation of
      technical, clinical and economic aspects related to the introduction of this new
      and expensive technology in the health care system. During more than two years of
      use of this system in the clinical environment, several research activities have
      been carried out concerning the analysis of the organization of radiology
      departments in Italy, the analysis of work and data volumes, the evaluation of
      technical and clinical performances of PACS versus conventional film-based
      radiology, the integration between PACS and RIS, the experimentation of
      teleradiology applications. An overview of the most important activities and
      related results is given in this paper as well as some indications about future
      developments of the Trieste Project.

PMID- 1634279
TI  - Benefits of coordinated action in PACS evaluation.
AB  - PACS, a health care technology still in its developmental stage, aims to improve
      the management of diagnostic imaging investigations. As the technology has not
      been comprehensively assessed, data and facts to justify its clinical, economic
      and other benefits are to date insufficient. Through internationally coordinated
      action, it is expected to obtain a faster and more comprehensive technology
      assessment of PACS as well as recommendations for optimization of the system and
      guidelines for its rational use in various health care environments.

PMID- 1634280
TI  - Opportunities for cooperation in the domain of informatics and telecommunications
      applied to health.
AB  - The European Community (EC) plays an important part in the stimulation of
      coordinated Research and Development activities in Europe. This paper describes
      features of the EC framework programmes, and gives an overview of the
      opportunities for the support of activities in Technology Assessment of PACS.

PMID- 1634281
TI  - Healthcare informatics and telecommunications: opportunities for international
      coordinated action.
AB  - The interest in international cooperation in the applications of
      telecommunications technologies to healthcare is growing. This paper gives an
      overview of current worldwide activities and suggests opportunities for the
      future.

PMID- 1634282
TI  - Study of the relationships between weather conditions and the marathon race, and
      of meteorotropic effects on distance runners.
AB  - The relationships between the results of Beijing International Marathon Races and
      the corresponding weather conditions are analysed quantitatively. There are
      obvious interrelationships between the marathon results and weather factors such
      as air temperature, wet bulb temperature and human biometeorological indices. For
      example, the correlation coefficient between the average times of the top ten
      finishers and temperature is r = 0.8910. The meteorological conditions are
      classified into three categories, suitable, moderate and unsuitable for running a
      marathon race, and the optimum meteorological index is given. Also the concept of
      a meteorological result, i.e. the part of the actual performances fluctuating
      with the changes in weather conditions, is presented. This plays an important
      role in some kinds of sports such as marathon racing. Finally, the results of
      physiological tests are given, which illustrate the physiological reactions of
      long- and middle-distance runners to the surrounding temperature.

PMID- 1634283
TI  - Environmental profile and critical temperature effects on milk production of
      Holstein cows in desert climate.
AB  - The environmental profile of central Arizona is quantitatively described using
      meteorological data between 1971 and 1986. Utilizing ambient temperature criteria
      of hours per day less than 21 degrees C, between 21 and 27 degrees C, and more
      than 27 degrees C, the environmental profile of central Arizona consists of
      varying levels of thermoneutral and heat stress periods. Milk production data
      from two commercial dairy farms from March 1990 to February 1991 were used to
      evaluate the seasonal effects identified in the environmental profile. Overall,
      milk production is lower during heat stress compared to thermoneutral periods.
      During heat stress, the cool period of hours per day with temperature less than
      21 degrees C provides a margin of safety to reduce the effects of heat stress on
      decreased milk production. Using minimum, mean and maximum ambient temperatures,
      the upper critical temperatures for milk production are 21, 27 and 32 degrees C,
      respectively. Using the temperature-humidity index as the thermal environment
      indicator, the critical values for minimum, mean and maximum THI are 64, 72 and
      76, respectively.

PMID- 1634284
TI  - Effects of running training on in vitro brown adipose tissue thermogenesis in
      rats.
AB  - Brown adipose tissue (BAT) is a major site of nonshivering thermogenesis (NST)
      during cold acclimation for most mammals. Repetitive nonthermal stress such as
      immobilization has been shown to enhance the capacity of NST as cold acclimation.
      In the present study, the effects of running training, another type of nonthermal
      stress, were investigated on in vitro thermogenesis and the cellularity of
      interscapular BAT in rats. The rats were subjected to treadmill running for 30
      min daily at 30m/min under 8 degrees inclination for 4-5 weeks. In vitro
      thermogenesis was then measured in minced tissue blocks incubated in a Krebs
      Ringer phosphate buffer containing glucose and albumin at 37 degrees C, using a
      Clark type oxygen electrode. The trained rats showed less body weight gain during
      the experiment. The weights of BAT and epididymal white adipose tissue were
      smaller in the trained rats. Noradrenaline- and glucagon-stimulated oxygen
      consumption were also significantly smaller in the trained rats. The tissue DNA
      level was greater in the trained rats, but the DNA content per tissue pad did not
      significantly differ. The results indicate that running training reduces BAT
      thermogenesis, possibly as an adaptation to conserve energy substrates for
      physical work.

PMID- 1634286
TI  - Non-psoralen treatment of vitiligo. Part I. Cosmetics, systemic coloring agents,
      and corticosteroids.

PMID- 1634285
TI  - Eosinophilia-myalgia syndrome.

PMID- 1634287
TI  - Signal transduction in normal and psoriatic epidermal cells.

PMID- 1634288
TI  - Les grattinages de papier.

PMID- 1634289
TI  - Donovanosis (granuloma inguinale) still exists.

PMID- 1634290
TI  - Cutis marmorata telangiectatica congenita.
AB  - The authors describe ten cases of cutis marmorata telangiectatica congenita
      (CMTC). All of these cases were sporadic. The incidence of associated anomalies
      was relatively low, and three patients had skin manifestations (cutaneous atrophy
      and nevus telangiectaticus). In two patients, the right leg was shorter and
      thinner. Another two showed neurologic symptoms without lasting neurologic
      damage. New associated anomalies, such as tendinitis stenosans and bowing of the
      lower legs, did not provide additional information regarding the cause of CMTC.
      The authors suggest that Happle's lethal gene hypothesis for Klippel-Trenaunay
      and Sturge-Weber syndromes also could be applied to CMTC.

PMID- 1634291
TI  - Occupational or extrinsic stimulation factors and initial signs of progressive
      systemic sclerosis.
AB  - Forty-eight patients with progressive systemic sclerosis (PSS) (man-woman ratio,
      7:41) were studied, and detailed questionnaires were used to clarify the
      relationship between occupational stresses and the initial signs of PSS. All of
      the patients were right-handed. Raynaud sign was seen in 37 of the 48 patients
      (77.1%) as the predominant initial sign of PSS, and it first was noticed on the
      right index and middle fingers. Three sets of extrinsic aggravating factors,
      vibration stress, fine hand work with mental stress, and exposure to cold, were
      believed to be related closely to the development of the initial signs because
      the initial signs appeared after long-term exposure to the extrinsic factors.

PMID- 1634292
TI  - Cutaneous lupus erythematosus in India: immunofluorescence profile.
AB  - The clinical profile and cutaneous lesions of 65 patients with lupus
      erythematosus (LE) are described. This included 28 discoid LE (13 disseminated,
      15 localized), five subacute cutaneous LE, and 32 systemic LE. The need to
      recognize a pigmented macular form constituting 25% of discoid LE is emphasized.
      Increased incidence of involvement of the lower lip in discoid LE and
      pigmentation in systemic LE is noted. Lupus band test was found to be highly
      sensitive; it was positive for lesional skin of all untreated patients with
      subacute cutaneous LE and systemic LE, it was, however, not useful on nonlesional
      skin.

PMID- 1634293
TI  - Acute cutaneous graft versus host disease: a clinicopathologic and
      immunophenotypic study.
AB  - Acute graft versus host disease (GVHD) is a major complication of bone marrow
      transplantation. This study was undertaken to characterize the histopathologic
      alterations in early lesions of GVHD and to improve our understanding about the
      disease process. Histopathologic and immunoperoxidase studies of skin tissue were
      carried out in 20 patients of GVHD. Sixty percent had grade II histopathologic
      changes in the skin, grade I and III changes were observed in 35% and 5%
      respectively. Follicular involvement could be observed in all cases beyond grade
      I. Immunoperoxidase study revealed OPD4 (+) (T-helper) cells in dermis and OPD4 (
      ) (probably cytotoxic/suppressor) cells in epidermis.

PMID- 1634294
TI  - Extensive macular amyloidosis associated with poikiloderma.

PMID- 1634295
TI  - Cutaneous cryptococcosis mimicking Kaposi's sarcoma as the initial manifestation
      of disseminated disease.

PMID- 1634296
TI  - Xanthoma disseminatum.

PMID- 1634297
TI  - Fatal disseminated Mycobacterium marinum infection.

PMID- 1634298
TI  - Senior medical student clinical and research electives in dermatologic surgery.
AB  - Five senior medical students enrolled in the 4 week clinical elective in
      dermatologic surgery and cutaneous oncology (DSCO); two of these students also
      enrolled in a 4 week research elective in DSCO. During the elective(s) the
      students made significant improvement in the six areas of clinical diagnosis,
      histopathologic diagnosis, clinical management, DSCO procedures, research skills,
      and general information about the subspecialty. Following their elective(s),
      these students submitted a total of six abstracts, one letter, and seven
      manuscripts for presentation or publication.

PMID- 1634299
TI  - Origin of the nevus cell: a retrospective.

PMID- 1634300
TI  - Glandular basement membrane zone immunofluorescence in cicatricial pemphigoid.

PMID- 1634301
TI  - Sweet's syndrome associated with multiple myeloma.

PMID- 1634302
TI  - Eczema herpeticum induced by sun exposure.

PMID- 1634303
TI  - The effect of dietary intake of fruits and vegetables on the odds ratio of lung
      cancer among Yunnan tin miners.
AB  - All newly diagnosed cases of lung cancer (N = 183) among male tin miners of
      Yunnan Province, China and age-sex matched occupational controls (N = 183 aged 45
      79 years) were interviewed within 3 months following cancer diagnosis. The
      questionnaire included information about usual adult diet as well as employment
      and smoking histories. Over 95% of cases and controls were current smokers. The
      27-item food frequency questionnaire included 11 fruits and vegetables rich in
      vitamin A and/or carotenoids. The effect of dietary intake of fruits and
      vegetables on risk of lung cancer was examined with adjustment for exposures to
      radon, arsenic, and smoking as previously documented risk factors for lung
      cancer. Tin miners with reduced intake of yellow and light green vegetables had
      statistically significant increased odds ratios (OR) of lung cancer (OR = 2.26
      and OR = 2.39 for the lowest two quartiles of intake; P value for trend = 0.02)
      among cases compared with controls after multiple logistic regression adjustment
      for covariates; and this relationship was monotonic. Tin miners with reduced
      intake of tomatoes had statistically significant increased adjusted OR of lung
      cancer (OR = 2.64, OR = 3.09, OR = 2.36 for the three lowest quartiles of intake;
      P value for trend = 0.04). This is the first study to demonstrate a protective
      effect of vegetable intake versus the strong effects of smoking and occupational
      exposures on lung cancer risk.

PMID- 1634304
TI  - Influence of migrants on regional variations of stomach and colon cancer
      mortality in the Western United States.
AB  - In order to examine the impact of migrants on regional variations in stomach and
      colon cancer, standardized mortality ratios (SMRs) were calculated for the total,
      nonmigrant (born and dying in same state), and migrant (born out of state) White
      residents of each of the 11 western states in the United States (US). The SMRs
      were derived from the National Center for Health Statistics' Mortality Detail
      Files for 1979-1981 and the 1980 Census Public Use Microdata 5-Percent Sample
      tapes. Migrants in the western US accounted for 79% of all stomach and colon
      cancer deaths. There was no consistent relationship between the SMRs of migrants
      and nonmigrants, with the migrant SMRs being higher in some states and lower in
      others. As a consequence of this differential impact, and their substantial
      numbers, migrants obscured the underlying regional patterns of mortality risk
      observed in the nonmigrants. The states of high or low risk were more contiguous
      in the analysis based on nonmigrants than the total population, and the
      interstate ranges in mortality were greater for nonmigrants. In areas with high
      in-migration, mortality atlases based on the total population may give an
      inaccurate portrayal of regional mortality risks, and spurious correlations may
      arise between the distributions of diseases and environmental characteristics of
      the regions. Regional mortality patterns of nonmigrants may more precisely
      reflect the factors which are influencing these cancers and thus provide a
      greater potential in providing clues to their aetiologies.

PMID- 1634305
TI  - Occupation and hospitalization with ischaemic heart diseases: a new nationwide
      surveillance system based on hospital admissions.
AB  - A cohort of all people in Denmark aged 20-59 years on 1 January 1981 was followed
      up for four years for emigration, death and hospital admission for ischaemic
      heart disease (IHD) as the primary diagnosis. The data set allows tabulation of
      rates of hospitalization by occupation, position and industry. Well-known classic
      associations for IHD have been reproduced. Examples are: male bus drivers had a
      standardized hospitalization ratio (SHR) of 136; for male urban bus drivers SHR =
      143, male taxi drivers SHR = 168, fishermen SHR = 129, men occupied in hotels and
      restaurants SHR = 140, women in hotels and restaurants SHR = 157. The consistency
      with previous findings is an argument that new significant associations should be
      treated as substantiated hypotheses if no selection bias is known. Examples of
      groups at significant excess risk of IHD are those self-employed in the textile
      industry, self-employed hairdressers, foremen in the construction industry,
      bakers, medical and industrial laboratory technicians, telephone assistants and
      unskilled tube and sheet workers in shipyards.

PMID- 1634306
TI  - Risk of mortality and coronary heart disease by marital status in middle-aged men
      in The Netherlands.
AB  - Between 1972 and 1974, a cardiovascular screening survey was conducted in a
      stratified sample of 3365 men aged 45-59 in Rotterdam, the Netherlands. Follow-up
      data collected in 1982 were used to examine the association between marital
      status and mortality and coronary heart disease while adjusting for various
      control variables. Nonmarried men had significantly higher relative risks (RR)
      (95% confidence interval (CI)) of 1.7 (95% CI: 1.2-2.3) and 2.2 (95% CI: 1.2-4.2)
      for all-cause mortality and coronary mortality than the married. Never married
      men showed the most consistent relationships with all-cause and coronary
      mortality, with RR of 2.3 (95% CI: 1.6-3.4) and 2.9 (95% CI: 1.4-6.2)
      respectively. The RR for these endpoints among the widowed and divorced were all
      close to unity, except for the risk of coronary mortality among the widowed,
      which was 2.9 (95% CI: 0.9-10.2). Not being married also increased the risk for
      fatal and total reinfarction, with RR of 3.6 (95% CI: 1.4-9.1) and 2.5 (95% CI:
      1.1-5.6) respectively. The results suggest that in middle-aged Dutch males, the
      health consequences of not being married may differ for the never married,
      divorced, and widowed. Selective mating, differential lifestyles or health
      habits, and lack of social integration were offered as possible explanations.

PMID- 1634307
TI  - Intra-person variability of various physical activity assessments in the Kuopio
      Ischaemic Heart Disease Risk Factor Study.
AB  - We investigated the 12-month intra-person variability of various physical
      activity assessments used in the Kuopio Ischaemic Heart Disease Risk Factor Study
      (KIHD) in 51 men aged 54 years. The methods were a 24-hour total activity
      recording, a 12-month leisure time activity history, a 7-day leisure time
      activity recall and a habitual occupational activity interview. More leisure time
      activity was reported in the retest. Intra-person variability was high for all
      physical activity indices. The proportion of the mean absolute test-retest
      difference out of the test-retest mean was 18% for the 24-hour total activity
      recording, 45% for the 12-month leisure time activity history, 86% for the 7-day
      leisure time activity recall, 70% for kilometres of conditioning activity per
      week (No. = 51) and 22% for the occupational activity interview (No. = 39).
      However, respective intraclass correlations for these indices were 0.43, 0.58,
      0.35, 0.71 and 0.69. The physical activity assessments differ in observed intra
      person variability in accordance with the type of activity, time frame and the
      method of recall. Owing to its representative time frame and relatively small
      intra-person variability the 12-month history may be recommended for a standard
      instrument for population studies concerning leisure time activity.

PMID- 1634308
TI  - Corneal arcus and cardiovascular risk factors in Asians in Singapore.
AB  - This study was a cross-sectional random survey of the whole of Singapore, based
      on 2143 subjects (aged 18-69 years, response rate 60.3%). The presence of corneal
      arcus was determined by a doctor using the naked eye in good light.
      Cardiovascular risk factors were measured by standardized techniques. The
      prevalence rates overall of corneal arcus were: 18-29 years (males 0.5%, females
      0.3%), 30-49 years (males 18.1%, females 13.3%) and 50-69 years (males 70.7%,
      females 55.3%). In the 30-49 age group, people with arcus had higher serum low
      density lipoprotein (LDL) cholesterol concentrations than people without arcus,
      the mean differences being, males 0.31 mmol/l (P = 0.040) and females 0.62 mmol/l
      (P less than 0.001) with an increased likelihood of having values greater than
      5.5.mmol/l of males 1.8 (95% confidence interval (95% CI): 1.0-3.4) and females
      2.6 (95% CI: 1.4-4.8). There were no significant differences for LDL-cholesterol
      in the 50-69 age group. Arcus was weakly associated with fasting plasma glucose
      in the 30-49 age group. Arcus was not associated with serum high density
      lipoprotein (HDL) cholesterol, serum fasting triglyceride, blood pressure and
      cigarette smoking. It is concluded that while corneal arcus is primarily an age
      related change, its formation is accelerated by high serum LDL-cholesterol so
      that in people under 50 years it is a marker for the condition.

PMID- 1634309
TI  - National standards of blood pressure for children and adolescents in Spain:
      international comparisons. The Spanish Group for the Study of Cardiovascular Risk
      Factors in Childhood and Youth.
AB  - This study determined age-specific patterns of blood pressure (BP) in Spanish
      children aged 1-18 years for the purpose of developing BP guidelines for this
      population. Age- and sex-specific BP levels were constructed by pooling data from
      15 studies conducted in Spain. Pooled mean BP levels were then compared with
      those reported by the US Second Task Force on Blood Pressure Control in Children
      and those recently reported from a separate pooled analysis of the relevant
      published surveys collected worldwide. In the Spanish data, the average 1-year
      age increment in Systolic BP (SBP) was uniform for boys and girls until 13 years
      at 2 mmHg; for boys aged 13-18 the increase was 1.3 mmHg/year; in contrast, girls
      reached their maximum values at age 13 and the means remained basically unchanged
      for female adolescents. Fifth-phase diastolic BP (DBP5) values showed a uniform
      increase for both boys and girls from ages 6 to 18 years at 0.9 mmHg/year. In
      most age-sex subgroups, mean SBP values were higher (7-8 mmHg on average) in
      Spain than in the US. However, Spanish values for SBP were in general only
      slightly higher or approximately equal to those for the international data, from
      ages 6 to 18 years. The patterns of change in SBP with age differed somewhat in
      the three data sets. Comparisons for DBP were limited to the age groups for which
      readings of DBP5 were available. For DBP5, only slight differences between the
      Spanish and International pools were observed (ages 6-18 compared), but these
      values were notably higher than those from the US (ages 13-18 compared). These
      findings suggest that the use of any particular age-based standard to evaluate
      readings in children in diverse populations cannot be recommended, at least until
      there is a better understanding of the true differences in BP between
      populations.

PMID- 1634310
TI  - Discrimination of smoking status by thiocyanate and cotinine in serum, and carbon
      monoxide in expired air.
AB  - To develop a procedure for maximizing the discrimination of smoking status, the
      authors analysed parallel samples of thiocyanate and cotinine in serum, and
      carbon monoxide (CO) in expired air in a cohort of 145 male subjects aged 45-65
      years. The sensitivity and specificity were 93% and 82%, 97% and 83%, and 98% and
      100% for thiocyanate, cotinine, and CO respectively. The results were not
      significantly improved when combining two or three methods as compared with CO
      separately. Also, cotinine in urine was analysed in a subgroup of 21 subjects.
      The correlation coefficient between cotinine in serum and urine was 0.92. In a
      subgroup of 44 subjects with extensive information on smoking habits, CO was the
      only indicator significantly related to the quantity of tobacco smoked. We
      conclude that CO seems sufficient for validating smoking status, but as atypical
      smokers who are vulnerable to misclassification may be overrepresented in smoking
      cessation programmes, combining two methods could still be useful. Validating the
      amount of tobacco smoked is of limited use with the current methods.

PMID- 1634311
TI  - Past and present smoking behaviour and its association with health-related habits
      in selected Israeli working populations. The Cordis Study.
AB  - Comprehensive surveys on the characteristics of smokers provide important data
      for the targeting and monitoring of smoking cessation programmes, and making
      international comparisons. Current information on this subject in Israel is very
      limited. During 1985-1987, the prevalence and correlates of cigarette smoking
      were examined in 5281 employees in Israeli industry, screened in the framework of
      the CORDIS study. The prevalence of smoking in men ranged from 44.7% in the age
      group 20-24 years to 28.0% in those aged 55-64. For women the prevalence ranged
      from 23.2% to 15.0% over the same age range. Ethnic differences were most marked
      in younger males with the highest prevalence in those of North African origin.
      Among females, the highest prevalence was among those of Western European origin.
      In most age groups, the highest proportion of exsmokers was found among those of
      Eastern European origin, except for older females where differences were not
      significant. Among males, educational differences were strong, with those of
      lower education smoking the most, whereas among females no significant
      differences were observed. For both sexes, past smokers were more prevalent in
      the highest education category. There was a cohort effect in declining age at
      starting smoking in both sexes and females tended to start smoking about 2 years
      older than males. Exsmokers tended to have been heavier smokers than current
      smokers, suggesting that heavy smokers may be more likely to quit than light
      smokers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634312
TI  - The European Community 'avoidable death indicators' in Sweden 1974-1985.
AB  - Avoidable mortality in Sweden 1974-1985 was analysed using a European Community
      (EC) Working Group list of 'avoidable death indicators." The list includes causes
      of death that in certain age groups were defined as indicators of the outcome of
      medical care intervention or for some conditions, indicators of the national
      health policies. About 10 out of 14 medical health care indicators occurred in
      less than 50 cases per year. Death rates decreased over the 12-year period
      studied for most avoidable death indicators. For women, however, the death rate
      for malignant neoplasms of the trachea, bronchus and lung increased
      significantly. Swedish total mortality for ages 5-64 years was lower than the EC
      standards 1974-1978 and 1980-1984. Most of the avoidable causes of death had a
      relatively low standard mortality rate (SMR) when compared to both the EC
      standard and to the Swedish SMR for total mortality. For asthma, however, the
      Swedish SMR was higher. The development and implementation of the avoidable death
      concept and methodology is discussed.

PMID- 1634314
TI  - Comparison of the incidence of insulin-dependent diabetes mellitus in childhood
      among five Baltic populations during 1983-1988.
AB  - We have carried out a comparison of the incidence of childhood onset insulin
      dependent diabetes mellitus (IDDM) between five populations around the Baltic
      Sea. These were Finland, Estonia, Latvia, Lithuania and Poland. The risk of IDDM
      is highest in the world in Finland and also very high in Sweden, on the western
      and northern side of the Baltic Sea. The risk of IDDM in children on the eastern
      side of the Baltic Sea has not been known before. The data collection period
      covered the years 1983-1988. A marked variation in incidence was seen within this
      relatively small geographical area. Among these five populations, the incidence
      increased with the latitude. Our present results confirmed the very high
      incidence of IDDM in Finland. The average age-standardized yearly incidence of
      IDDM/100,000 was in males under 15 years of age 36.9 in Finland, 10.7 in Estonia,
      6.4 in Latvia, 6.5 in Lithuania and 6.0 in Poland. In females the incidence was
      31.6, 10.0, 6.9, 7.0 and 6.4 in these five populations, respectively. The
      differential in incidence in Estonia as compared with Latvia, Lithuania and
      Poland was statistically significant (P = 0.0002). A slight male excess in
      incidence was found in countries with higher incidence--Finland and Estonia, but
      in lower incidence countries the sex ratio was opposite (P = 0.019 for the
      interaction sex-population). During 1983-1988 the incidence increased
      significantly in Finland but not in other populations although a large year-to
      year variation in incidence was observed in each country, particularly in males.
      We recorded a peak in IDDM incidence in most of these populations around 1986.

PMID- 1634313
TI  - Association of body build with non-insulin-dependent diabetes mellitus and
      hypertension among Chinese adults: a 4-year follow-up study.
AB  - Both cross-sectional and longitudinal studies on the association of body build
      with non-insulin-dependent diabetes mellitus (NIDDM) and hypertension were
      conducted in Taiwan during the period 1986-1990. The cross-sectional study, was
      carried out in 1986 in Ta-An District of Taipei City and five rural areas evenly
      distributed in Taiwan Province. A total of 11,478 randomly selected subjects aged
      40 years or over were surveyed. World Health Organization designations of
      diabetes and hypertension were followed. The longitudinal observation was made in
      1990 for the cohort living in Taipei City who had neither diabetes nor
      hypertension in 1986. Of 2822 subjects, 1873 individuals participated in the
      follow-up study and 52 had died, giving a response rate of 67.6%. In comparison
      with Caucasian or Polynesian populations, Chinese adults have a much lower
      prevalence of obesity (body mass index [BMI] greater than 30 kg/m2). Univariate
      and multivariate analyses revealed both diabetes and hypertension increased as
      body build became heavier. The age-adjusted prevalence ratio and relative risk
      for the fourth quartile of BMI compared to the first quartile were 2.72 and 2.87,
      respectively, for diabetes as well as 2.96 and 2.24, respectively, for
      hypertension. Multiple logistic regression analyses revealed a slightly higher
      increase in prevalence of hypertension than that of diabetes for every 1 kg/m2
      increase in BMI (1.16-fold and 1.12-fold, respectively), while a similar increase
      in BMI resulted in a slightly higher relative risk of diabetes than that of
      hypertension (1.14-fold and 1.11-fold, respectively).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1634315
TI  - Relationship between the degree of individual space-time clustering and age at
      onset of disease among multiple sclerosis patients.
AB  - A previous study of 381 multiple sclerosis (MS) patients from Norway has shown
      significant clustering of residence in adolescence among contemporaneous
      patients. Using a regression model with individual degree of clustering
      determined by Monte Carlo methods, this study utilizes the same data and shows a
      significant correlation (P = 0.002) between the degree of clustering and age at
      clinical onset of disease. A high degree of clustering in adolescence indicated a
      low age at clinical onset. This association was also verified independently of
      the regression model. The finding supports the theory of a common viral agent
      acting epidemically among nonpre-exposed individuals during adolescence, with MS
      developing in individuals with other necessary factors, such as a genetic
      predisposition.

PMID- 1634316
TI  - Estimating the incidence of dementia in the community from prevalence and
      mortality results.
AB  - This paper reports a series of computer simulations of the incidence of dementia,
      and its relationship to age. The simulations use known prevalence and mortality
      data from a single source: Liverpool. Comparison is also made with additional UK,
      European, and international figures to add stability to the estimates. The paper
      concludes that with our present knowledge we can either model prevalence or
      incidence, but not both, and suggests that more information is especially needed
      for the older groups.

PMID- 1634317
TI  - Correlated nondifferential misclassifications of disease and exposure:
      application to a cross-sectional study of the relation between handedness and
      immune disorders.
AB  - In cross-sectional studies, misclassifications of exposure and of health status
      may be related. For instance some subjects may tend to overreport both exposure
      and disease. A misclassification is said to be nondifferential if the sensitivity
      and the specificity which characterize it do not depend on the true status of the
      subjects for the other variables. Nondifferential misclassifications of two
      dichotomic variables may be correlated if the probability of being misclassified
      for one of them depends on the presence of an error of classification for the
      second one. Models are presented to estimate the bias induced by correlated
      nondifferential misclassifications on an odds ratio whose true value is unity.
      For most usual situations, when the great majority of the subjects are healthy
      and nonexposed, the influence of overreporting is shown to be larger than that of
      underreporting. It appears to be relatively easy to find a spurious, but
      significant, relationship. Real data are analysed to show that the potential
      consequences of correlated nondifferential misclassifications are not purely
      theoretical. In a sample of 1676 subjects from the general population we observed
      significant relations between left-hand shift and various aspects of health
      status: reporting a history of eczema, experience of a serious health problem in
      the past, experience of a serious health problem presently, use during the last
      month of analgesics or of drugs for circulatory problems, or digestion,
      consultation with a physiotherapist or hospitalization during the last year.
      These results, as with many similar ones previously reported, are highly
      suggestive of an information bias. They are less easily explained by biological
      hypotheses, e.g. Geschwind's theory of cerebral lateralization, than by
      correlated misclassifications resulting from overreporting of both the use of the
      left hand and the existence of some health problems by healthy right-handers. The
      modelling used in this report supports this hypothesis.

PMID- 1634318
TI  - Seasonality in tropical AIDS: a geographical analysis.
AB  - This paper presents evidence that the growth rate of the AIDS epidemic at the
      district level in Uganda, Central Africa, displays a seasonally recurring
      geographical pattern, with epidemic acceleration in some areas of the country in
      the first 8 months of each year. The spatial and temporal variations in
      acceleration appear to be correlated with the predominant agricultural systems in
      different parts of Uganda. Based upon the frequently hypothesized relationship
      between malnourishment and the progression to clinical AIDS in HIV-infected
      people, it is suggested that the variations in epidemic speed reflect the
      seasonal patterns of nutritional deficiency which occur under some tropical
      agricultural systems. These preliminary findings require further verification
      since they have important implications for directing nutrition-related remedial
      responses to the AIDS epidemic in tropical countries where malnutrition and
      endemic HIV infection coincide.

PMID- 1634319
TI  - Assessment of epidemiological and HIV/AIDS publications in Africa.
AB  - To assess the quantity of epidemiological publications emanating from Africa,
      three international epidemiology journals were examined. In addition, a separate
      MEDLINE search was undertaken for 1987 and 1989-1990 to assess AIDS/HIV
      prevalence and incidence publications. Of 361 general epidemiological articles
      examined for 1974-1975, 49.3% were from the US, 20.5% from the UK, 11.1% from
      Europe, 10.2% from the rest of America, 4.4% from Asia, 3.9% from Australasia and
      0.06% (only two) from Africa. The overall proportion from the USA declined to
      44.0% by 1989-1990; from the UK to 11.1% while from South America and Australasia
      the proportion remained similar. Striking increases occurred in Europe and to a
      lesser extent in Asia. By 1989-1990 African articles contributed 3.6% (31) of the
      total. While over 90% of first authors came from the study region in the US, UK,
      Europe and Australasia; 85.7% in Asia; 70.8% in South America in 1989-1990, in
      Africa only 32.2% were authors from their continent. Of the 220 published
      articles on AIDS/HIV epidemiology 6.8% emanated from Africa in 1987 and 12% of
      606 articles in 1989-1990. African scientists were first authors in 46.7% of
      articles from the continent in 1987 and only 35.5% in 1989 and 1990. In 1987, 60%
      of the articles were co-authored by overseas scientists of various nationalities
      while collaborative publications increased to 78.4% in 1989-1990. Only 15% of
      these articles were published in African Journals. This study stresses the urgent
      need for improving all aspects of epidemiological research and training in Africa
      with particular need with respect to AIDS/HIV research capacity.

PMID- 1634320
TI  - Human immunodeficiency virus infection among intravenous drug addicts in Israel-
      stable low prevalence over 34 months.
AB  - A serological survey of 300 Israeli intravenous drug addicts in 1988-1989, showed
      a 2.3% prevalence of antibodies to human immunodeficiency virus (HIV), very
      similar to the finding of a previous study (2%) performed in the same population
      in 1986. Travel and drug injection abroad continue to be the most significant
      predictors of HIV seropositivity in this group. The relatively uncommon use of
      cocaine and the absence of 'shooting galleries' in Israel, appears to explain
      best the stable low prevalence of HIV infection among parenteral drug addicts in
      this country.

PMID- 1634321
TI  - Various factors associated with the manifestation of influenza-like illness.
AB  - A survey enrolling 814 schoolchildren was conducted immediately after a peak
      epidemic in the 1988-1989 influenza season and then a case-control study for
      influenza-like illness (ILI) was carried out using information concerning illness
      onset and usual lifestyle. Based on the analysis of the correlations among
      symptoms and actions taken due to symptoms, cases were defined as those with
      fever greater than or equal to 38 degrees C and subsequent absenteeism and
      medical consultation during peak epidemic; within this, mild-ILI (MILI) was
      defined as fever greater than or equal to 38 degrees C and less than 39 degrees
      C, and severe-ILI (SILI) as fever greater than or equal to 39 degrees C. Controls
      were defined as those with no symptoms (NS) during that period. Adjusted odds
      ratios (OR) were obtained through an unconditional logistic regression model
      between the MILI (80) or SILI (48) and NS (196) groups from among respondents
      (803). For MILI, increased risks were observed for easily-inflamed tonsils (OR =
      3.0, 95% CI: 1.7-5.4); and larger family size (1.9, 1.1-3.4); with decreased
      risks for higher school grades (0.4, 0.2-0.9); frequent intake of vegetables or
      fruits other than green/yellow vegetables (0.5, 0.3-1.0); and larger room space
      per capita (0.4, 0.2-0.9). For SILI, there were increased risks for easily
      inflamed tonsils (3.8, 1.8-8.1) and history of doctor-diagnosed asthma (2.9, 1.2
      6.7); and decreased risks for higher grades (0.2, 0.1-0.6), frequent intake of
      milk or dairy products (0.3, 0.1-0.6) and vaccination (0.3, 0.1-0.8).

PMID- 1634322
TI  - Subacute sclerosing panencephalitis in The Netherlands--1976-1990.
AB  - Since 1976, when general immunization against measles was introduced in the
      Netherlands, all new cases of subacute sclerosing panencephalitis (SSPE) were
      registered and detailed data about immunization, epidemiology and disease
      progression were collected on them. Up to 1991, 99 new patients have been
      registered of which 81 were born in this country and 18 elsewhere. From 1981
      onwards, the incidence of SSPE among those born in the Netherlands decreased
      gradually from 13 cases per year to one case per year. This decrease is
      attributed to the large scale of immunization against measles. Three SSPE
      patients had been immunized against measles, all of them without a history of
      clinical measles. Epidemiology and risk factors of SSPE did not differ from those
      reported in other countries. An exceptional cluster of four patients in one town,
      who had measles in the same year, is reported. Progression of SSPE appeared to be
      age related. A total of 28 patients was treated with Inosiplex; no significant
      effect on survival in stage 3 of the disease was found.

PMID- 1634323
TI  - Choosing an appropriate measure of diarrhoea occurrence: examples from a
      community-based study in rural Kenya.
AB  - Epidemiological studies which aim to identify protective or risk factors for
      diarrhoea may rely on any of several established measures of disease occurrence,
      including cumulative incidence, (CI), incidence density (ID), and point
      prevalence (P); each with its own strengths and limitations. Comparison of these
      measures was afforded by a community-based study in rural Kenya in which the
      incidence and prevalence of diarrhoea were measured simultaneously but by
      independent means in the same group of children. In a cohort study, CI and ID
      among 138 infants (aged 0-6 months) were 26.1% and 1.41 episodes per 100 infant
      weeks, respectively. Among 111 toddlers (aged 18-29 months) CI and ID were 39.6%
      and 1.96 episodes per 100 toddler-weeks, respectively. In a cross-sectional study
      of these children, the Ps among infants and toddlers were 9.8 and 6.1%,
      respectively. Data on incident cases required more time and resources to obtain
      and evidenced more underreporting of diarrhoea episodes relative to the
      prevalence data. Other community-based studies have reported the ID of diarrhoea
      five times more often than any other measure, but appear to have calculated ID
      incorrectly. The infrequency with which CI and P are reported does not reflect
      their actual utility.

PMID- 1634325
TI  - Estimating prevalence of injecting drug use in an urban population: limitations
      of the three-sample estimation procedure.

PMID- 1634324
TI  - Seroepidemiological characterization of a syphilis epidemic in the Republic of
      the Marshall Islands, formerly a yaws endemic area.
AB  - The annual numbers of reported cases of syphilis in the Republic of the Marshall
      Islands (RMI) increased from none in 1983 to more than 600 in 1989, suggesting a
      large outbreak of syphilis. Much of the increase resulted from expanded
      serological screening. The apparent outbreak of syphilis, therefore, may have
      been partly the result of increased surveillance or, since the RMI was formerly a
      yaws endemic area, possibly due to a resurgence of yaws. To address this problem
      and better characterize the epidemic, we analysed results from a 1989/90 Ministry
      of Health Services mass serological screening on Majuro Atoll, the main
      population centre. Serum specimens from 9160 people (86% of residents aged 15-44
      years) on Majuro were screened with the rapid plasma reagin (RPR) card test; we
      repeated the RPR and performed a confirmatory microhaemagglutination assay for
      Treponema pallidum-specific antibodies (MHA-TP) on a sample of serum specimens.
      To estimate the seroprevalence of syphilis, we also tested a sample of RPR
      nonreactive specimens by MHA-TP. Among people less than 45 years of age, total
      (11.5%) and high-titre (5.2%) seropositivity rates were highest in the 20-24 year
      age group, as was MHA-TP seroprevalence (15.9%). These results suggested that a
      large outbreak of syphilis was responsible for the observed seroreactivity.
      Cumulative incidence modelling and comparisons with the results of a previous
      serosurvey conducted in 1985 suggested that the duration of the syphilis epidemic
      was approximately 10 years and that incidence had not increased appreciably since
      1985.

PMID- 1634326
TI  - Glycoconjugates of opioid peptides. Synthesis and biological activity of
      [Leu5]enkephalin related glycoconjugates with amide type of linkage.
AB  - Three N-glycoconjugates of the general formula H-Tyr-Gly-Gly-Phe-Leu-NH-R (R =
      carbohydrate residue) were synthesized in order to determine the influence of
      some carbohydrate molecules (6-amino-6-deoxy-D-glucopyranose, 2-amino-2-deoxy-D
      glucopyranose, beta-D-glucopyranosylamine) on the biological activity,
      conformation, and stability of the opioid pentapeptide [Leu5]enkephalin. For the
      preparation of this compound different methods of peptide synthesis (active ester
      and mixed anhydride) were investigated. In comparison with [Leu5]enkephalin, all
      three N-glycoconjugates showed higher potency in the guinea pig ileum assay and
      lower potency in the mouse vas deferens assay, indicating a decrease in delta
      opioid receptor selectivity.

PMID- 1634327
TI  - Ionization of tyrosine residues in human serum albumin and in its complexes with
      bilirubin and laurate.
AB  - Spectrophotometric titration of human serum albumin indicates that ionization of
      the 18 tyrosine residues takes place between pH 9 and 12.7. A Hill plot indicates
      that protons dissociate co-operatively from tyrosine residues, in pure albumin
      between pH 11.0 and 11.4 with a Hill coefficient 1.7, and in the bilirubin
      albumin complex between pH 11.2 and 11.7 with a Hill coefficient 1.6. With a
      stopped-flow technique it is shown that about seven of the tyrosines ionize fast,
      with rate constants well above 10(2) s-1, when pH is suddenly changed from near
      neutral to pH 11.76. Further residues ionize slowly, with rate constants around
      10(2) s-1 or less. The N-form of albumin (pH 6) contains one more fast ionizing
      tyrosine than the B-form of albumin (pH 10). Binding of bilirubin or laurate to
      the albumin molecule (molar ratio 1:1) transforms one to three of the fast
      ionizing tyrosines to slowly ionizing.

PMID- 1634328
TI  - Complete structure of eclosion hormone of Manduca sexta. Assignment of disulfide
      bond location.
AB  - The locations of the three disulfide bonds of eclosion hormone (EH) isolated from
      Manduca sexta were assigned by sequence analysis of thermolysin fragments and by
      comparison of a key heterodimeric fragment to regiospecifically synthesized
      parallel and antiparallel isomers. We elucidated the complete structure of
      Manduca EH as a 62-residue peptide which has three disulfide bonds between Cys14
      Cys38, Cys18-Cys34, and Cys21-Cys49.

PMID- 1634329
TI  - Cyclic hexapeptides derived from the human thymopoietin III.
AB  - Six diastereoisomeric cyclic hexapeptides of the partial sequence 39-44 of human
      thymopoietin III in which each residue was replaced with the D-amino acid were
      synthesized. In contrast to expectations, the yields from cyclization were not
      influenced by the location of the D-residue.

PMID- 1634330
TI  - Side reactions in solid phase synthesis of histidine-containing peptides.
      Characterization of two major impurities by sample displacement chromatography
      and FAB-MS.
AB  - The flow-polyamide synthesis of a histidine-containing sequence (Ac-YDNVLDHLTGR)
      produced two major impurities which were isolated through Sample Displacement
      Chromatography and characterized by Fast Atom Bombardment-mass analysis. The
      impurities correspond to the sequence Ac-YDNVLDH, and to a peptide with the Asp
      residue cyclized to a succinimide. The latter side-reaction took place during the
      acetylation procedure, and demands attention where capping procedures are planned
      in the synthesis of Asp-His sequences.

PMID- 1634331
TI  - NMR and molecular modeling characterization of RGD containing peptides.
AB  - The tripeptide sequence arginine-glycine-aspartic acid (RGD) has been shown to be
      the key recognition segment in numerous cell adhesion proteins. The solution
      conformation and dynamics in DMSO-d6 of the cyclic pentapeptides, [formula: see
      text], a potent fibrinogen receptor antagonist, and [formula: see text], a weak
      fibrinogen receptor antagonist, have been characterized by nuclear magnetic
      resonance (NMR) spectroscopy and molecular modeling. 1H-1H distance constraints
      derived from two-dimensional NOE spectroscopy and torsional angle constraints
      obtained from 3JNH-H alpha coupling constants, combined with computer-assisted
      modeling using conformational searching algorithms and energy minimization have
      allowed several low energy conformations of the peptides to be determined. Low
      temperature studies in combination with molecular dynamics simulations suggest
      that each peptide does not exist in a single, well-defined conformation, but as
      an equilibrating mixture of conformers in fast exchange on the NMR timescale. The
      experimental results can be fit by considering pairs of low energy conformers.
      Despite this inherent flexibility, distinct conformational preferences were found
      which may be related to the biological activity of the peptides.

PMID- 1634332
TI  - High level synthesis of biologically active recombinant trichosanthin in
      Escherichia coli.
AB  - Two forms of recombinant trichosanthin (rTCS) were synthesized in high levels in
      Escherichia coli by putting the TCS cDNA under the control of a T7 RNA polymerase
      directed promoter. Purification schemes were developed to isolate the recombinant
      protein from both soluble and insoluble fractions. Form I rTCS possessed the
      mature TCS sequence and had similar biological activities as the natural protein.
      Its IC50 was approximately 0.13 nM in an in vitro rabbit reticulocyte
      translational system and a dose of around 35 micrograms protein per 25 g body
      weight was sufficient to induce complete abortion in mice. Form II rTCS had a
      propeptide of 19 aa at the C-terminus and was five times less active than Form I
      in inhibiting protein synthesis by a rabbit reticulocyte lysate.

PMID- 1634333
TI  - The antineoplastic effect of vitamin D in transgenic mice with retinoblastoma.
AB  - Vitamin D has been shown to inhibit growth of human retinoblastoma in tissue
      culture and nude mouse heterografts. We have described a heritable transgenic
      mouse model of retinoblastoma. The in vivo efficacy of 1,25
      dihydroxycholecalciferol (vitamin D3) was examined by administering this agent to
      transgenic mice with retinoblastoma. Forty-six 8-10-week-old transgene-bearing
      mice were injected intraperitoneally for 5 wk. Experimental animals received 0.05
      microgram (15 animals) or 0.025 microgram (15 animals) of vitamin D. Sixteen
      control animals received only a mineral oil vehicle. Eyes were enucleated at 5 mo
      and were examined histologically by two investigators in a masked fashion. All
      control animals demonstrated bilateral involvement of retinoblastoma. Four eyes
      in the low-dose group and six eyes in the high-dose group had no evidence of
      retinoblastoma. Eyes treated with vitamin D3 showed less extensive involvement of
      the retina by retinoblastoma. Vitamin D-treated animals demonstrated tumors
      confined to the retina, whereas control animals demonstrated larger tumors, more
      often invading the vitreous, anterior chamber, and choroid. Thus, Vitamin D
      inhibited the growth and local extension in a dose-dependent fashion.

PMID- 1634334
TI  - Microsurgery of the retina with a needle-guided 193-nm excimer laser.
AB  - This article presents a method used to guide the beam from an argon fluoride
      excimer laser to make it suitable for microsurgical purposes and confine it to
      areas that can be varied in dimension from 1 micron to tens or hundreds of
      microns. This approach guides the excimer laser beam with an articulated
      mechanical arm and confines it with variable-diameter tapered tubes, possibly
      allowing the use of this laser in in vitro retinal surgery with endolaser
      techniques. Currently, because of the lack of a delivery and focusing system for
      the 193-nm argon fluoride beam and its absorption by biologic liquids, this laser
      is used exclusively in ophthalmology for topical applications, such as corneal
      sculpting. This new method resolves these problems in a unique way with
      impressive results. Specifically, it was shown that, with this needle-guided
      excimer laser, it is possible to remove retinal tissue accurately without
      detectable damage to surrounding cells. Applications of this new technique in
      retinal surgery are discussed.

PMID- 1634335
TI  - Effect of body temperature on threshold for retinal light damage.
AB  - Body temperature is known to influence the threshold for retinal light damage,
      but the magnitude of the effect has varied substantially between previous
      studies. The purpose of the present study was to establish a quantitative
      relation between body temperature in the range of 30-42 degrees C and dose of
      radiation for a just visible change in fundo. Anesthetized pigmented rats were
      exposed to 380 nm radiation for 10 min. Four intensities were simultaneously
      presented. Funduscopic changes were noted 2-3 d after exposure. At 30 degrees C,
      threshold dose was 6 J/cm2; at 42 degrees C, it was about 1 J/cm2. A fair fit to
      the data could be obtained with a linear regression between log threshold dose
      and temperature. The slope was -0.067. In an additional experiment, threshold
      dose at 500 nm and 41 degrees C body temperature was established at 400 J/cm2.
      These results agree with data in monkey and rabbit, but they vary from earlier
      data in rats that show a slope of -0.8. Exposure time, damage criterion, and the
      chromophores involved in retinal light damage are possible factors in the
      discrepancy.

PMID- 1634336
TI  - Sulfated proteoglycans in the human lamina cribrosa.
AB  - The sulfated proteoglycans in the normal human lamina cribrosa were studied by
      electron microscopy after cuprolinic blue dye binding. Within the cores of the
      laminar plates, three types of cuprolinic blue-positive proteoglycan filaments
      with different sizes were associated with collagen fibers. These filaments, which
      were partially sensitive to chondroitinase AC and chondroitinase B, were
      completely removed by chondroitinase ABC and were identified as
      chondroitin/dermatan sulfate proteoglycans. In addition, small punctate and
      filamentous structures that stained with cuprolinic blue were associated with the
      basal laminae of astrocytes and blood vessels. Enzyme chondroitinase ABC had no
      effect, but heparinase digested all of these basement membrane-associated
      structures, indicating that they represented heparan sulfate proteoglycan
      molecules. Keratanase did not affect any of the cuprolinic blue-positive
      materials. This investigation illustrates the ultrastructural distribution and
      morphology of proteoglycans in the human lamina cribrosa and provides baseline
      information for future studies regarding the roles of proteoglycan molecules in
      diseases such as glaucoma.

PMID- 1634337
TI  - Autoregulation of choroidal blood flow in the rabbit.
AB  - Previous studies show that choroidal blood flow is not autoregulated when
      intraocular pressure (IOP) is increased to raise venous pressure and lower the
      perfusion pressure gradient. However, the autoregulatory response to changes in
      mean arterial pressure (MAP) is unclear. In the current study, the perfusion
      pressure gradient (MAP-IOP) was altered by (1) decreasing MAP while IOP was held
      at 5, 15, and 25 mmHg, and (2) increasing the IOP at the prevailing MAP in
      anesthetized rabbits (n = 8). An occluder on the thoracic vena cava was used to
      vary MAP; this was monitored through an ear artery catheter. Two catheters were
      inserted in the vitreous to monitor and control IOP. Choroidal blood flow was
      measured by laser Doppler flowmetry using a slender stainless-steel probe
      positioned next to the retinal surface. The efficacy of autoregulation depended
      on the IOP. When IOP was held constant at 5 mmHg, choroidal blood flow did not
      fall until the perfusion pressure gradient was less than 40 mmHg. The pressure
      flow relationship became progressively more linear (ie, the efficacy of
      autoregulation decreased) when the IOP was held constant at 15 and 25 mmHg. When
      IOP was varied and MAP was held constant, the pressure-flow relationship was
      linear at IOPs greater than 20-25 mmHg. However, choroidal blood flow was
      pressure independent when the IOP was less than 20-25 mmHg. Simultations using a
      myogenic mathematic model of the choroid gave results similar to the experimental
      observations. It was concluded that a myogenic mechanism may be responsible for
      the autoregulation of choroidal blood flow in the rabbit.

PMID- 1634338
TI  - Motion thresholds in retinitis pigmentosa.
AB  - Minimum displacement thresholds, or dmin, were measured in 29 subjects with
      retinitis pigmentosa (RP) and 10 subjects with normal vision. The results showed
      that RP can affect an observer's ability to judge the correct direction of motion
      in a random-dot pattern. The majority of RP subjects had elevated dmin. They
      required a larger displacement to perceive the correct direction of motion. Only
      5 of the 29 RP subjects had thresholds within two standard deviations of the mean
      of the normal-observer distribution. Moreover, three RP subjects were unable to
      detect the correct direction of motion regardless of the displacement magnitude,
      and four RP subjects consistently reported motion in the opposite direction at
      small displacements. The results cannot be explained by abnormal temporal
      processing or a reduction in the effective luminance. There was a statistically
      significant correlation (r = 0.72, P less than 0.001) between log threshold and
      log MAR, consistent with the hypothesis that a reduction in the spatial density
      of the photoreceptors contributes to the motion-threshold elevation. Motion
      thresholds also were measured in subjects with normal vision under conditions of
      simulated "photoreceptor" dropout. The results showed that a random elimination
      of information from over 25% of the image positions significantly elevates motion
      thresholds. These results also support the spatial-density reduction hypothesis.

PMID- 1634339
TI  - The neurophysiologic significance of frontal negativity in pattern-reversal
      visual-evoked potentials.
AB  - To demonstrate that the frontal negative potential (N100) does exist in response
      to pattern-reversal visual stimulation and its independence of the dipole source
      from the major occipital positive potential (P100), modifications of P100 and
      N100 with changes in the check size, contrast, and luminance of the stimulus
      pattern were studied in healthy subjects. Eight different check sizes (10-90 min
      of arc), eight different contrast levels (10-85%), and six different luminance
      levels (11-180 cd/m2) were used. Changing the stimulus conditions modified the
      latencies and amplitudes of P100 and N100 in different ways. P100 latency had a
      band pass spatial tuning function against check size; N100 latency did not. P100
      was sensitive to changes in contrast and luminance; N100 was less dependent on
      these parameters. These findings suggest the existence of different physiologic
      properties for N100. Consequently, frontal negativity is considered to be
      independent of P100.

PMID- 1634340
TI  - Collagen gel contraction by cells associated with proliferative
      vitreoretinopathy.
AB  - The capacities of porcine choroidal fibroblasts, retinal glial cells, and retinal
      pigment epithelial cells to contract collagen gels in vitro were compared.
      Experiments with varied cell numbers indicated that glial cells are the most
      effective, followed by choroidal fibroblasts and retinal pigment epithelial
      cells. Analysis of the secretory products from cultures of these cell types
      revealed that retinal pigment epithelial cells synthesize and secrete peptides
      that promote fibroblast contraction of collagen gels in vitro. The mechanism of
      action of the retinal pigment epithelial cell-secreted contraction promoter was
      compared with that found in serum (type A) and secreted by cultured endothelial
      cells (type B). Like the serum factor, the retinal pigment epithelial cell
      secreted factor was not dependent on active protein synthesis by the target cell
      and must be present continuously to promote contraction.

PMID- 1634341
TI  - Quantitative assessment of growth stimulating activity of the vitreous during
      PVR.
AB  - This report postulates that the activity of cellular proliferation along the
      surface of the retina during proliferative vitreoretinopathy (PVR) is reflected
      in the aggregate effect of proliferation-inducing growth factors in the vitreous.
      A method for quantifying the "net" proliferation-inducing capacity of an
      individual vitreous sample was developed and this assay was used to evaluate the
      vitreous proliferative activity in a model for experimental PVR. Vitreous was
      aspirated sequentially after onset of fibroblast-induced PVR in a rabbit model. A
      simple bioassay for the "aggregate" stimulating activity was developed and each
      sample was assigned a quantitative value in terms of "proliferation units" (PU).
      Experimental eyes demonstrated a wide range of stimulating activity (0-1765 PU),
      but control eyes showed uniformly low levels of activity (0-337 PU). Experimental
      eyes that ultimately developed retinal detachment displayed higher levels of
      proliferative activity than did those eyes destined to remain attached. The
      differences were statistically different by day 3, prior to the onset of clinical
      retinal changes. We conclude that quantification of vitreous proliferation
      stimulating activity is possible and that this method might be useful for
      screening eyes at high risk for the development of recurrent retinal detachment
      from PVR.

PMID- 1634342
TI  - Isolation and cultivation of human iris pigment epithelium.
AB  - There have been very few attempts to isolate and culture human iris pigment
      epithelium (IPE). Earlier efforts that used whole iris explant methods did not
      achieve pure cultures of IPE. We have developed methods for separating the IPE
      from the iris stroma of post-mortem eyes that avoid contamination by other cell
      types. Three different isolation methods were studied: direct dissection, enzyme
      digestion, and enzyme-assisted microdissection. The latter method yielded the
      best results. After treatment with enzyme solution, the IPE was easily separated
      from the stroma under the stereomicroscope and subsequently cultured with
      supplemented F12 medium. With this method, approximately 2.3 x 10(5) cells were
      isolated from each iris with an average viability of 90.2%. IPE cells isolated
      from 19 of 24 eyes grew to confluence in primary culture. The IPE could be
      maintained in pure culture for many generations over several months with up to 20
      population doublings. Cultured IPE demonstrated cytokeratin and S-100 protein by
      immunocytochemistry. Some of these cells also displayed desmin, indicating origin
      from the anterior IPE. Cultured IPE cells retained most of the characteristics of
      IPE in vivo, such as apical/basal polarization, microvilli, and many cell
      junctions. Gradual dilution of pigment occurred in the dividing IPE cells,
      suggesting an inability to produce melanin in vitro. A subpopulation of the IPE
      cells contained myofilaments by electron microscopy, also indicating a anterior
      IPE origin. This method provides a source for large numbers of human IPE cells
      and could be useful in studies of the biology of IPE and the role of IPE in
      pathogenesis of several eye diseases, most notably exfoliation syndrome and its
      associated glaucomas.

PMID- 1634343
TI  - Corneal function after storage in dexsol or optisol.
AB  - Rabbit corneas were stored in Dexsol or Optisol (Chiron, Irvine, CA) for up to 2
      wk at 4 degrees C. The thickness of corneas placed in Dexsol decreased 10 microns
      after they were placed initially in Dexsol, then increased approximately 8
      microns/d for 7 d and 3 microns/d thereafter. Corneas placed in Optisol decreased
      35 microns in thickness initially, then increased 2 microns/d thereafter. Human
      corneas showed similar thickness changes to those of the rabbit when stored in
      these media. After 5.5, 10, and 14 d in storage, rabbit corneas from each medium
      were cultured to assess their net deturgescence ability. Identical groups were
      cultured in media containing 20 microM ouabain to monitor the corneas' passive
      swelling characteristics. Corneas stored in either medium showed similar net
      deturgescence and passive swelling patterns after each storage period.
      Deturgescence rates decreased with increasing storage time, primarily because the
      rates of passive corneal swelling increased with storage time. Knowledge of the
      net deturgescence and passive swelling rates allowed an estimation of the total
      deturgescence activity of corneas after removal from Dexsol or Optisol. The total
      deturgescence activity of corneas stored in Dexsol for 5.5, 10, and 14 d was 85%,
      68%, and 63% of control corneas, which were processed identically but not stored
      before culture. Corneas stored in Optisol exhibited 87%, 71%, and 69% of control
      deturgescence activity, respectively. These experiments show that Optisol was not
      significantly better than Dexsol in retaining poststorage corneal deturgescence
      activity but was superior to Dexsol in preventing corneal swelling during
      storage.

PMID- 1634344
TI  - Myopia and refractive error in dogs.
AB  - The refractive error of 240 phakic dogs of various breeds was measured using
      streak retinoscopy and averaged (-0.27 +/- 1.41 D relative to infinity). Analysis
      by breed showed that the German Shepherd, Rottweiler, and Miniature Schnauzer
      breeds had an increased prevalence of myopia with an average refractive error of 
      0.86 +/- 1.31 D, -1.77 +/- 1.84 D, and -0.66 +/- 1.05 D, respectively. Myopia
      also was found in older dogs with marked nuclear sclerosis of the crystalline
      lens. Fifty-three percent of all German Shepherd dogs in a veterinary clinic
      population (n = 58 eyes) had a myopic refraction of greater than or equal to 
      0.50 D; 64% of all Rottweiler dogs (n = 28 eyes) were myopic. An in-depth
      investigation of German Shepherd dogs, using A-scan ultrasonography,
      photokeratoscopy, and streak retinoscopy, was done at Guide Dogs for the Blind
      (San Rafael, CA). By contrast with the results obtained in the veterinary clinic
      population, the overall average refractive error of guide dog German Shepherd
      dogs (n = 106 eyes) was +0.19 +/- 0.81 D, and only 15% of these dogs were myopic.
      The axial length and corneal curvature of myopic eyes did not differ
      significantly from nonmyopic eyes.

PMID- 1634345
TI  - Calpain in rat cornea.
AB  - This study was conducted to provide a description of calpain proteolytic enzyme
      (EC 3.4.22.17) in normal rat cornea and to document immunohistochemical changes
      in calpain distribution during maturation. Corneal soluble proteins were
      fractionated by diethylaminoethyl chromatography on high-performance liquid
      chromatography. Fractions were analyzed for calpain by enzyme-linked
      immunosorbent assay, immunoblotting, and caseinolytic enzyme activity with
      fluorescein isothiocyanate-labeled casein. Calpain II from the soluble fraction
      of 2-week-old and 3-month-old rat corneas eluted at a similar NaCl concentration
      (220-240 mmol/l) as calpain II from other tissues, was inhibited by E64,
      contained an 80-kilodalton subunit in immunoblots, and was present at specific
      activity of 473 units per gram of protein in 3-month-old rats and 801 units per
      gram of protein in 2-week-old rats. Calpain antigen also was present in the
      ethylenediaminetetraacetic acid and EGTA washed insoluble fraction of cornea.
      Calpain was found (by immunohistochemical analysis) in all layers of the
      epithelium but not in the stroma. Enzyme-linked immunsorbent assay, immunoblots,
      and immunohistochemical analysis showed that calpain in the whole cornea did not
      change with corneal maturation. It was hypothesized that calpain in the cornea
      may be involved in the turnover of epithelial cells during normal maturation.

PMID- 1634346
TI  - Defective processing of motion-defined form in the fellow eye of patients with
      unilateral amblyopia.
AB  - The following three measurements were made on a group of 20 pediatric and 5 adult
      patients with unilateral amblyopia: (1) speed threshold for recognizing motion
      defined dotted letters; (2) recognition acuity for isolated solid letters of 4%
      contrast; and (3) Snellen line acuity for high-contrast letters. Normal limits
      were established with a group of 30 pediatric and 10 adult control subjects. The
      main finding was that, in amblyopic children, a high percentage (83%, 15 of 18)
      of fellow eyes showed a degraded ability to recognize motion-defined letters,
      even though Snellen acuity and 4% letter acuity were normal for age. The fellow
      eyes of all nine patients with strabismic amblyopia showed this pattern of loss,
      as did four of six fellow eyes of patients with anisometropic amblyopia and two
      of three fellow eyes of patients with anisometropic plus strabismic amblyopia.
      Only two clinically unaffected eyes were normal for motion-defined letters. These
      eyes belonged to patients with anisometropic amblyopia. Eighteen of the 19
      previously amblyopic eyes tested were abnormal for motion-defined letters even
      though Snellen acuity was within normal limits for 6 of these eyes. In adults,
      only one of five fellow eyes failed the motion-defined letter test. It was
      concluded that the degradation of form perception associated with amblyopia can
      be different for luminance-defined and motion-defined form and that defective
      processing of motion-defined form is common in the fellow eyes of children with
      unilateral amblyopia.

PMID- 1634347
TI  - Two-dimensional optokinetic nystagmus induced by moving plaids and texture
      boundaries. Evidence for multiple visual pathways.
AB  - Horizontal and vertical components of optokinetic nystagmus (OKN) were measured
      using the magnetic search coil technique in normal human adults during
      presentation of simple and complex moving patterns. Simple patterns were gratings
      moving horizontally and obliquely. Complex moving patterns consisted of plaids
      formed by superimposed oblique motion of two sets of gratings or of illusory
      contours formed by offset discontinuities in gratings. Slow-phase OKN gains (eye
      velocity divided by stimulus velocity) induced by high-contrast type I and type
      II plaids were comparable with those generated by one-dimensional moving
      gratings. The axis of OKN for high-contrast plaids was along the resultant
      direction determined by the intersection-of-constraints rule and not along any
      component. With low-contrast presentations, OKN induced by type I patterns
      remained in the resultant direction, but the OKN direction induced by type II
      patterns was biased toward the components' directions. The OKN generated by
      texture boundaries embedded in real pattern motion was measured for motion of
      illusory contours having systematically varying directions. The gain of OKN
      induced by real motion was independent of the direction of illusory contour
      motion, but the gain to illusory contour motion decreased with increasing contour
      angles. All these results suggest that input signals for driving the optokinetic
      system come from visual areas extracting higher order two-dimensional motion
      information.

PMID- 1634348
TI  - The primary position of the eyes, the resetting saccade, and the transverse
      visual head plane. Head movements around the cervical joints.
AB  - Photographic and video analyses show that the primary position of the eyes is a
      natural constant position in alert normal humans, and the eyes are automatically
      saccadically reset to this position from any displacement of the visual line. The
      primary position is not dependent on fixation, the fusion reflex, gravity, or the
      head position. The primary position is defined anatomically by head and eye
      planes and lines that are localized by photography, magnetic resonance imaging,
      and x-rays of the head and neck. The eyes are in the primary position when the
      principal (horizontal) retinal plane is coplanar with the transverse visual head
      (brain) plane (TVHP), and the equatorial plane of the eye is coplanar with a
      fixed orbital plane (Listing's plane). Evidence is presented to indicate an
      active neurologic basis for the primary position instead of passive mechanical
      forces. A different understanding of the primary position and the conception of
      the TVHP may be valuable in analyzing oculomotor defects.

PMID- 1634349
TI  - Induction of elongation in cultured rat lens epithelial cells by FGF and
      inhibition by selenite.
AB  - The purposes of this experiment were to: (1) test if fibroblast growth factor
      (FGF) induced elongation of cultured rat lens epithelial cells (LEC) and (2)
      determine if selenite affected elongation of LEC. FGF (125-500 ng/ml) reduced the
      number of colonies of LEC, but it did not induce elongation when cells were
      cultured on plastic dishes. One hundred micromolar and, to a lesser extent, 10
      mumol/l selenite also reduced the number of colonies of LEC. Coculture of FGF and
      selenite on plastic caused a synergistic reduction in the number of colonies. FGF
      (125-1000 ng/ml) induced a dramatic morphologic change in LEC. Elongated
      processes radiated from stellate-like cell aggregates when cells were cultured on
      reconstituted basement membrane matrix (Matrigel). Again, 100 mumol/l selenite
      and, to a lesser extent, 10 mumol/l selenite reduced the number of cell
      aggregates with processes on Matrigel. These results indicated that an inhibitory
      effect of selenite on the elongation of LEC may be a factor in the development of
      selenite cortical cataract.

PMID- 1634350
TI  - Decreased photoreceptor count in human eyes with secondary angle-closure
      glaucoma.
AB  - Glaucoma has been known to be associated with a loss of retinal ganglion cells
      and their axons throughout the fundus and a decreased count of photoreceptors and
      retinal pigment epithelial (RPE) cells in the parapapillary region. This study
      investigated whether glaucomatous changes of the deep retinal layer occur outside
      the parapapillary region. The nuclei of the retinal photoreceptors and RPE cells
      were counted in histologic slides of 23 eyes with painful secondary angle-closure
      glaucoma resulting from perforating corneal injuries. Fourteen eyes with
      malignant choroidal melanoma not involving the ciliary body or trabecular
      meshwork served as the control group. No surgical procedure, including laser
      treatment, had been performed posterior to the ora serrata. There were no hints
      of retinal vessel occlusion and localized traumatic retinopathy, historically,
      ophthalmoscopically, or histologically. Photoreceptor count was significantly
      lower (P less than 0.05) in the glaucoma eyes than in the control group. Count of
      RPE cells did not differ between the two groups. This may indicate that glaucoma
      can be associated with a loss of photoreceptors. This could be important for
      psychophysical testing and may point to a more widespread involvement of ocular
      tissues in glaucoma than believed.

PMID- 1634351
TI  - Impact of androgen therapy in Sjogren's syndrome: hormonal influence on
      lymphocyte populations and Ia expression in lacrimal glands of MRL/Mp-lpr/lpr
      mice.
AB  - Recent research has demonstrated that androgen treatment dramatically curtails
      lymphocyte infiltration in the lacrimal glands of a mouse model of Sjogren's
      syndrome. The purpose of the current study was to determine whether this androgen
      action involves the selective suppression of specific lymphocyte populations or
      Ia expression in lacrimal tissue. Autoimmune female MRL/Mp-lpr/lpr mice were
      administered placebo- or testosterone-containing compounds for 0, 17, or 34 d.
      Then lacrimal glands were obtained and processed for immunohistochemical
      evaluation. Results demonstrated that in pretreatment mice, lacrimal lymphoid
      foci were composed predominantly of Thy 1.2+ cells, bearing L3T4 (helper T cell)
      or B220 surface antigens. In contrast, suppressor T cells (Lyt 2+) and surface
      IgM-bearing B cells represented minority populations in the immune infiltrates.
      Class II antigen (Ia) expression was observed on over 40% of the infiltrate
      lymphocytes and occasionally on epithelial cells close to the lymphoid focus.
      During the experimental time course, the extent of lymphocyte infiltration
      increased in glands of placebo-treated mice. This cellular accumulation was
      associated with an elevation in the frequency of B220+ cells, but not that of
      other lymphocyte subclasses. Testosterone administration induced a striking
      diminution in the area encompassed by all immune cell populations. Moreover,
      hormone therapy significantly reduced the frequency of B220+ cells in focal
      infiltrates. Overall, these findings demonstrate that androgen exposure
      stimulates a decrease in the quantity, but not necessarily the entire lymphocyte
      composition, of lymphoid aggregates in lacrimal glands of MRL/lpr mice.

PMID- 1634352
TI  - Extracellular matrix in aged human ciliary body: an immunoelectron microscope
      study.
AB  - Tissue from nine human eyes (ages 52-78 yr) was used to investigate the fine
      structural distribution of collagens I-VI and laminin in the ciliary body using
      the immunogold antibody labeling technique. The anterior segments of the
      specimens were normal, and the eyes were removed in treatment of choroidal
      melanoma. The basement membranes of the ciliary epithelium contained collagens I,
      III, and IV. Laminin was in greater concentration in the outer part of the
      nonpigmented epithelial basement membrane, and the distribution suggested a
      washout effect. The zonular apparatus labeled intensely with laminin. In
      contrast, laminin was not present in the basement membrane of the myocytes in the
      ciliary body. These cells were sheathed in a basement membrane that contained
      types I, III, and IV collagen. Plaque-like structures of slightly different
      morphology (a, filamentous; b, granular; c, amorphous) were found in the
      tendinous insertions, and subtypes a and b were strongly labeled with laminin.
      The basement membranes of the vessels contained types I and IV collagen, but
      laminin labeling was inconclusive. The major finding was that the lamina densa in
      the basement membranes of various sites labeled for collagens I, III, and IV.
      Striated collagen fibrils in the stroma were labeled for types I and III.
      Collagen subtypes V and VI were not identified in significant quantity in any of
      the regions examined.

PMID- 1634353
TI  - Mitochondrial DNA mutation in Leber's hereditary optic neuropathy.
AB  - Leber's hereditary optic neuropathy (LHON) causes acute or subacute central
      visual loss in healthy young males. Recently, it has been thought to be caused by
      a single nucleotide change in the ND4 gene in the mitochondrial genome.
      Mitochondrial DNA (mtDNA) of leukocytes and hair follicle cells from five
      patients in four families with LHON and nine relatives were analyzed by Sfa NI
      and Mae III enzyme digestion and DNA sequencing. Loss of Sfa NI site was found in
      all patients and maternal lineages but not in nonmaternal lineages and normal
      controls. Mae III digested all the mtDNAs that lost the Sfa NI site. The
      restriction fragment pattern of polymerase chain reaction (PCR) products
      exhibited mtDNA heteroplasmy in the hair follicle cells but not in blood cells of
      the proband in one family. Direct sequencing of PCR-amplified mtDNA fragments
      encompassing the ND4 gene of the patients disclosed a transition from guanine to
      adenine at nucleotide position 11778. These results confirm previous reports that
      a G to A point mutation is associated with LHON and that tissue variability and
      heteroplasmy of mtDNA exist in some, but not all, LHON patients.

PMID- 1634354
TI  - Unusually low values of mannitol permeability (PM) of the corneal epithelium and
      endothelium.

PMID- 1634355
TI  - Hb Kanagawa [alpha 40(C5)Lys----Met]: a new alpha chain variant with an increased
      oxygen affinity.
AB  - An abnormal hemoglobin was suspected in a 70-year-old Japanese male with cerebral
      infarction and erythremia with high performance liquid chromatography assay of Hb
      A1c. The hemoglobin variant migrated to the anode more rapidly than Hb A.
      Structure determination studies, including amino acid analysis of the abnormal
      peptide and DNA sequencing of a partially cloned alpha-globin gene, demonstrated
      that it is a new hemoglobin variant which has been named Hb Kanagawa [alpha
      40(C5)Lys----Met]. This variant showed an increased oxygen affinity, decreased
      heme-heme interaction, and a lowered 2,3-diphosphoglycerate effect relative to
      normal.

PMID- 1634356
TI  - Anthropology of the beta S gene-flow from West Africa to north Africa, the
      Mediterranean, and southern Europe.

PMID- 1634357
TI  - A new alpha chain variant, Hb Turriff [alpha 99(G6)Lys----Glu]: the interference
      of abnormal hemoglobins in Hb A1c determination.
AB  - Hb Turriff is a new hemoglobin variant which we have identified in a diabetic
      individual. During the determination of Hb A1c by high performance liquid
      chromatography, an inappropriately elevated result was found to be due to the
      abnormal hemoglobin chromatographing with the Hb A1c fraction. This new
      hemoglobin variant, Hb Turriff [alpha 99(G6)Lys----Glu], is not associated with
      any hematological disturbance, and family investigations indicate that it has
      arisen as a de novo mutation.

PMID- 1634358
TI  - Hb Kaohsiung or New York: a T----A substitution at codon 113 of the beta-globin
      chain creates an Alu I cutting site.

PMID- 1634359
TI  - The unstable Hb Hammersmith or alpha 2 beta 2(42)(CD1)Phe----Ser observed in an
      Indian child; identification by HPLC and by sequence analysis of amplified DNA.
AB  - We have identified the unstable hemoglobin variant present in a Chipewayan Indian
      patient with severe hemolytic anemia as Hb Hammersmith or alpha 2 beta
      2(42)(CD1)Phe----Ser. Her parents were normal. Identification was greatly
      facilitated by the use of reversed phase high performance liquid chromatography
      for the isolation of the beta X chain and its tryptic fragments, and of sequence
      analysis of amplified DNA which readily identified a TTT(Phe)----TCT(Ser)
      mutation at codon 42.

PMID- 1634360
TI  - Hb Rancho Mirage [beta 143(H21)His----Asp]; a variant in the 2,3-DPG binding site
      showing normal oxygen affinity at physiological pH.
AB  - Hb Rancho Mirage was detected in a 17-year-old male in association with a mild
      anemia. Hemoglobin electrophoresis revealed the variant had a mobility between
      Hbs A and J on cellulose acetate (pH 8.6) and a mobility like Hb F on citrate
      agar (pH 6.4). A substitution of His----Asp was found at position 143 in the beta
      chain, a residue that contributes to the anionic 2,3-DPG binding site in Hb. This
      variant exhibited normal oxygen affinity at physiologic pH and reduced affinity
      at alkaline pH. This suggested a subtle shift in the allosteric equilibrium due
      most likely to the introduction of a negative charge that stabilized the 2,3-DPG
      pocket. Both homotrophic (heme-heme) and heterotropic (2,3-DPG and protons)
      effects were reduced; this might be a consequence of an alteration in the
      carboxyl terminal region of the beta-subunits. Although a His----Asp substitution
      would be considered to cause reasonable disruption of the 2,3-DPG and C-terminal
      conformation of the beta- subunits, the properties of Hb Rancho Mirage suggest
      that, in fact, there appear to be no major perturbation of the critical C
      terminal residues.

PMID- 1634361
TI  - The nondeletional types of Hb H disease in Guangxi.
AB  - Three primers were designed, one specific for alpha 1-globin DNA, a second for
      alpha 2-globin DNA, and a third that is common for both alpha 1- and alpha 2
      globin DNA. These three primers can be applied for selective amplification of the
      two globin DNA fragments, which is useful for identification of nondeletional
      types of Hb H disease. Fifty-nine DNA samples of Hb H patients from Guangxi were
      studied by selective amplification, and 27 cases (45.8%) were confirmed as
      nondeletional types. Of these, 22 (81.5%) had the Hb Constant Spring (CS)
      mutation and one had the Hb Quong Sze (QS) mutation; both were identified by
      hybridization with synthesized oligonucleotide probes. Nondeletional Hb H disease
      in Guangxi seems to be more severe than the deletional types. The average
      hemoglobin level of the nondeletional Hb H/CS (--/alpha alpha) is 6.8 g/dl, which
      is lower than that of the deletional types (7.9 g/dl), while the levels of Hb H
      and Hb Bart's were much higher in the patients with Hb H/CS than in those with
      the deletional types.

PMID- 1634362
TI  - Types of thalassemia among patients attending a large university clinic in Kuala
      Lumpur, Malaysia.
AB  - We have identified the beta-thalassemia mutations in 59 patients with thalassemia
      major and 47 patients with Hb E-beta-thalassemia, and the deletional and
      nondeletional alpha-thalassemia determinants in 23 out of 24 patients with Hb H
      disease. All persons were attending the Haematology Clinic at the National
      University of Malaysia in Kuala Lumpur (Malaysia). Most patients (76) were of
      Malay descent, while 52 patients were Chinese, and two came from elsewhere. The
      most frequently occurring beta-thalassemia alleles among the Malay patients were
      IVS-I-5 (G----C) and G----A at codon 26 (Hb E), while a few others were present
      at lower frequencies. The Chinese patients carried the mutation characteristic
      for Chinese [mainly codons 41/42 (-TTCT) and IVS-II-654 (C----T)]; Malay
      mutations were not observed among Chinese and Chinese mutations were virtually
      absent in the Malay patients. The large group of patients with Hb E-beta
      thalassemia and different beta-thalassemia alleles offered the opportunity of
      comparing hematological data; information obtained for patients with Hb E-beta
      thalassemia living in other countries was included in this comparison. Twenty
      three patients with Hb H disease carried the Southeast Asian (SEA) alpha
      thalassemia-1 deletion; 13 had the alpha CS alpha (Constant Spring) nondeletional
      alpha-thalassemia-2 determinant, while the deletional alpha-thalassemia-2 (-3.7
      or -4.2 kb) was present in 10 subjects. The --/alpha CS alpha condition appeared
      to be the most severe with higher Hb H values. Both deletional and nondeletional
      types of alpha-thalassemia-2 were seen among Malay and Chinese patients.

PMID- 1634363
TI  - A new alpha chain variant, Hb Hanamaki or alpha 2(139)(HC1)Lys----Glu beta 2,
      found in a Japanese family.

PMID- 1634364
TI  - Hb Olomouc [alpha 2 beta 2(86)(F2)Ala----Asp] found in a Japanese family.

PMID- 1634365
TI  - Hb Nottingham or alpha 2 beta 2(98)(FG5)Val----Gly observed as a de novo mutation
      in a Canadian child.

PMID- 1634366
TI  - Hb Hope [beta 136(H14) Gly----Asp] and Hb E [beta 26(B8)Glu----Lys]: compound
      heterozygosity in a Thai Mien family.

PMID- 1634367
TI  - Hb Kodaira [beta 146(HC3)His----Gln]: a new beta chain variant with an amino acid
      substitution at the C-terminus.

PMID- 1634368
TI  - Three beta-thalassemia mutations in the Japanese: IVS-II-1 (G----A), IVS-II-848
      (C----G), and codon 90 (GAG----TAG).

PMID- 1634369
TI  - A new case of thalassemia intermedia: interaction of a triplicated alpha-globin
      locus and beta-thalassemia trait.

PMID- 1634370
TI  - Proteoglycan and collagen morphology in superficially scarred rabbit cornea.
AB  - We have examined the changes in collagen and proteoglycan morphology in
      superficial lamellar keratectomy wounds produced in rabbit corneas. The
      ultrastructural location within the tissue of keratan sulphate and chondroitin
      sulphate proteoglycans was demonstrated using the cationic dye Cuprolinic Blue
      under critical electrolyte conditions. Large proteoglycan filaments (up to 500 nm
      long) appeared in the early stages of wound healing; these were most common after
      two weeks' wound healing, after which they decreased both in number and size. At
      these early stages of scar formation, spaces containing proteoglycans were
      present amongst bundles of collagen fibrils. As proteoglycans play an important
      role in controlling corneal hydration, the presence of the large proteoglycan
      filled spaces would result in an abnormally high water content which is found in
      early scar tissue.

PMID- 1634372
TI  - Histochemical analysis of rat testicular glycoconjugates. 2. Beta-galactosyl
      residues in O- and N-linked glycans in seminiferous tubules.
AB  - Rat testes have been examined with a panel of lectins that bind specifically to
      oligosaccharide sequences having terminal or subterminal beta-galactosyl residues
      in O-linked glycans, or in the outer chains of complex N-linked glycans: Arachis
      hypogaea (peanut, AHA), Erythrina cristagalli (coral tree, ECA), Ricinus communis
      (castor bean, RCA120) and Abrus precatorius (jequirity bean, APA) agglutinins.
      Pretreatment of sections with neuraminidase, beta-galactosidase and removal of
      alkali-labile O-linked sequences by beta-elimination allowed the structure of
      these glycans to be further explored. In spermatogonia and spermatocytes there
      was little evidence of glycans terminating in beta-galactosyl residues, although
      these were present at non-reducing terminals as sialylgalactosides. The acrosome
      contained two subsets of O-linked glycans terminating in sialylgalactosides,
      while the nuclear cap showed at least two subsets of N-linked sialylgalactosyl as
      well as O-linked glycans. Spermatozoa exhibited minor changes in the pattern of
      glycosylation, although the overall pattern of beta-galactosyl expression was
      similar. Binding to Sertoli cells showed the presence of some unsubstituted beta
      galactosyl terminals on O-linked glycans but few such N-linked residues, while
      terminal beta-galactosides were scanty in tubular basement membranes.

PMID- 1634371
TI  - Histochemical analysis of rat testicular glycoconjugates. 1. Subsets of N-linked
      saccharides in seminiferous tubules.
AB  - The distribution of N-linked glycans in rat testis has been probed using a panel
      of lectins derived from Galanthus nivalis (snowdrop, GNA), Canavalia ensiformis
      (jack bean, Con A), Lens culinaris (lentil, LCA), Pisum sativum (garden pea, PSA)
      and Phaseolus vulgaris, erythro- and leucoagglutinins (kidney bean, ePHA and
      lPHA). Several classes of N-linked glycan were identified in the spermatogenic
      series, and during differentiation into spermatozoa they altered in both their
      pattern of distribution and relative abundance. A population of tetra-antennary,
      non-bisected, complex glycans, detected by lPHA, was lost during the transition
      from spermatogonia to spermatocytes, while high-mannose structures were acquired;
      these were most abundant in spermatocytes, as were bi- and tri-antennary complex,
      non-bisected glycans, the latter becoming increasingly abundant on acrosomes and
      spermatozoa. Their bisected counterparts were more generally expressed throughout
      spermatogenic cells, although marked localization onto acrosomes and nuclear caps
      was again seen. Transition from spermatocytes to spermatids involved mainly
      changes of the acrosomal granule and nuclear cap, which were carried through to
      the final stages of differentiation. Sertoli cell surfaces and cytoplasmic
      granules showed a high level of N-glycan expression.

PMID- 1634373
TI  - Carbohydrate and protein histochemistry during oogenesis in Halobatrachus
      didactylus (Schneider, 1801) from the Bay of Cadiz (Spain).
AB  - Histological and histochemical characteristics were studied in Halobatrachus
      didactylus (Schneider, 1801) during oogenesis. Three phases could be
      differentiated: previtellogenesis (oogonia and basophilic oocytes),
      vitellogenesis (yolk synthesis) and maturation-spawning. Glycogen, glycoproteins
      and proteins rich in certain amino acids were present in the previtellogenic as
      well as in the vitellogenic cytoplasm oocytes. No acid mucosubstances were
      detected. Three types of yolk (vesicles, vacuoles and granules) contained
      different types of organic reserves; granules were essentially proteic whereas
      globules were lipidic. Carbohydrates and proteins were present in vesicles.

PMID- 1634374
TI  - Changes in lectin binding patterns of Leydig cells during fetal and postnatal
      development in mice.
AB  - Changes in the lectin binding of mouse Leydig cells during fetal and postnatal
      development were examined by light- and electron-microscopy using eight different
      biotinylated lectins (ConA, WGA, RCA-I, UEA-I, GS-I, PNA, SBA and GS-II). At the
      light-microscopic level, ConA, WGA, RCA-I, UEA-I and GS-I showed the same binding
      pattern in which all five lectins bound to the plasma membrane and cytoplasm of
      Leydig cells from the 13th day post coitum (p.c.) to the 8th postnatal week. PNA,
      SBA and GS-II reactions were positive in the plasma membrane and cytoplasm of
      Leydig cells from the 13th day p.c. to 15th day post partum (p.p.) but
      disappeared completely by day 20. At the electron-microscopic level, gold
      particles representing the GS-I or GS-II binding sites were distributed primarily
      along the cell surface membrane, including that of microvilli, as well as in the
      cytoplasm. These results indicate that certain glycoconjugates bearing D
      galactose, N-acetyl-D-galactosamine, and N-acetyl-D-glucosamine residues are
      expressed on the cell surface and in the cytoplasm of Leydig cells during the
      period from the 13th day p.c. to around the 20th day p.p. The results suggest
      that these glycoconjugates might play some role in modulating hormone-receptor
      interaction in the Leydig cells before the 20th day. Furthermore, these results
      may indicate that sugar residues expressed on the cell surface and in the
      cytoplasm of Leydig cells are different from those in the fetal-neonatal and
      adult phases.

PMID- 1634375
TI  - Structural variations of different oral basement membranes revealed by cationic
      dyes and detergent added to aldehyde fixative solution.
AB  - The ultrastructural appearance of different types of basement membrane was
      studied using histochemical methods for visualizing glycosaminoglycans. Samples
      of rat gingiva and mouse molar germ tissue were fixed either with glutaraldehyde,
      glutaraldehyde-ruthenium hexammine trichloride (RHT), glutaraldehyde-Cuprolinic
      Blue (CB) or cetylpyridinium chloride-glutaraldehyde (CPC). Ultrathin sections
      were stained with uranyl acetate and lead citrate. The results showed that the
      conventional trilaminar structure of the basement membrane was observed after
      glutaraldehyde and CB fixation. In contrast, after CPC or RHT fixation, the
      appearance of the basement membrane was homogeneous without any evidence of a
      lamina lucida. Furthermore, after single fixation with CPC, the ultrastructure of
      different basement membranes from oral tissues showed some differences in
      appearance which were related to their localizations, functions, or both.

PMID- 1634377
TI  - [The Romberg head-shake test within the scope of equilibrium diagnosis].
AB  - We review the standard functional tests of static and dynamic equilibrium and
      discuss the value of these tests. The pendular platform test and the tilting
      table test were developed for provocation of the balance system, but are not used
      in clinical investigation because of the complicated apparatus and the
      difficulties of judgement of the curves recorded. A simple modification for
      provocation of the balance system, available in the clinic, the consulting room
      or the doctor's office is recommended, consisting of horizontal head-shaking in
      the Romberg position during posturographic recording. In healthy subjects little
      increase of body sway is found, but in patients with peripheral or central
      vestibular disorders a distinct tendency of disequilibrium is seen.

PMID- 1634376
TI  - Immunocytochemical study of dystrophin in cultured mouse muscle cells by the
      quick-freezing and deep-etching method.
AB  - Dystrophin, the protein product of the Duchenne muscular dystrophy (DMD) gene, is
      deficient in patients with DMD and in mdx mice. It is immunocytochemically
      localized in skeletal muscle sarcolemma. However, little is known about the three
      dimensional ultrastructural localization of dystrophin and its relationship with
      other cytoskeletal proteins. We found that dystrophin is localized irregularly,
      just underneath the plasma membrane in normal cultured mouse myotubes, by using
      the quick-freezing and deep-etching (QF-DE) method; it was found to be closely
      linked to actin-like filaments (8-10 nm in diameter), most of which were
      decorated with myosin subfragment 1, and was attached to the cytoplasmic side of
      the plasma membrane. These results suggest that dystrophin might play an
      important role in the preservation of cell membrane stability by connecting actin
      cytoskeletons with the cytoplasmic side of the plasma membrane.

PMID- 1634378
TI  - [Computer-assisted ENT medical literature search and literature management--a
      report of experiences].
AB  - The increasing number of medical articles calls for a computer-aided system for
      literature database programs, literature retrieval and bibliography systems. We
      report an assessment of a dedicated modem line to DIMDI of Cologne (an institute
      offering a variety of biomedical, psychological and other literature databases),
      Medline on Silverplatter, Current Contents on disk and the Papyrus bibliography
      system. The databases with retrieval software are installed on a IBM-compatible
      PC (386 with an 80MB hard disc) and 4 CD-ROM players. Medline contains
      bibliographic citations and abstracts of biomedical literature; Current Contents
      on disk with its weekly update provides citations of articles published very
      recently; and the Papyrus bibliography system maintains a permanent collection of
      reference citations. When linked to a word processor, Papyrus can automatically
      read the manuscript, create a bibliography and produce a new copy of the
      manuscript in which the citations have been appropriately edited, and the
      references can be printed in any desired format. Although not without drawbacks,
      the configuration described here proved to be a valuable, time-saving tool to
      access citations precisely.

PMID- 1634379
TI  - [The temporal bone].
AB  - Imaging of the temporal bone by high resolution CT scan has become more and more
      accurate in recent years. Coronal slices are particularly important. We present
      the anatomy of four temporal bones embedded in plastic material. Coronal sections
      with a thickness of 2 mm were taken, radiographed and their density measured.
      Particular interest was given to the three-dimensional relations as well as to
      the density of bone of important morphological structures such as the labyrinth,
      middle ear, facial canal, sigmoid sinus, carotid canal and the mastoid. A low
      density of bone corresponds to the colour blue, a high density to black. Because
      of the high resolution of the method it was possible to image small and fine
      structures such as the auditory ossicles, and the perilymphatic and endolymphatic
      ducts. A three-dimensional reconstruction may well be possible in the future, and
      the possibilities of this method are discussed.

PMID- 1634380
TI  - [Marginal cells of the stria vascularis in vitro].
AB  - Explants of stria vascularis and spiral ligament of the guinea pig cochlea were
      cultivated and after 2 days fibroblast-like cells were found growing around the
      explant. Marginal cells advanced at 15 microns/day to the border of the explant,
      and after 2 weeks they proliferated on top of a thin layer of fibroblast-like
      cells outside the explant, replacing several layers of fibroblast-like cells.
      Tight junctions and interdigitations of the lateral membranes were found between
      all neighbouring marginal cells. Their apical surface was covered by microvillus
      like membrane extensions. The basal membrane of the new marginal cells did not
      interdigitate with the underlying membranes of fibroblast-like cells; there was
      always a gap between the two cell types. The results demonstrate that marginal
      cells of the stria vascularis are capable of repairing damage to the epithelium,
      such as may be caused by endolymphatic hydrops, even if the luminal side contains
      perilymph-like fluid. Furthermore, the cell culture allows living, clearly
      identified marginal cells to be studied in vivo.

PMID- 1634381
TI  - [Resection of the semicircular canal system with preserved hearing--an animal
      experiment study].
AB  - In a previous investigation we selectively resected the lateral semicircular
      canal of the rabbit, preserving the hearing in 67% of the animals. We now report
      an attempt to remove all three canals in one step with a microsurgical technique
      using fibrin glue and bone chips. Brain-stem auditory potentials were recorded at
      intervals up to 3 months after operation. Residual hearing could be recorded in
      50% of rabbits. These animals regularly showed a 30-40 dB deterioration of
      hearing.

PMID- 1634382
TI  - [Diagnosis of energy metabolism in ENT tumors--a PET study].
AB  - The metabolism of malignant tumours can be determined in vivo by positron
      emission tomography. Fifty patients with malignant lesions of the head and neck
      were examined before therapy and followed up for 11-18 months. The course of the
      disease was related to the initial fluorodeoxyglucose (FDG) uptake of the tumour.
      There was a relation between FDG uptake and survival: an increased FDG uptake of
      more than 300-400% was related to a reduced survival rate. Patients with an
      uptake less than 300% had a much better prognosis.

PMID- 1634383
TI  - [Indications and surgical treatment of large middle ear abnormality].
AB  - Children with atresia of the external auditory canal should undergo hearing
      assessment and fitting of a bone conduction hearing aid as early as possible to
      allow speech to develop normally. Surgery is done between 5 and 6 years of age,
      guided by high-resolution computed tomography, which provides a more precise
      diagnosis based on the abnormalities seen. The temporomandibular joint lies more
      posteriorly than normal due to aplasia or hypoplasia of the tympanic bone, so
      that the middle ear must be approached through the mastoid, resulting in a less
      favourable coupling to the middle ear structures. In unfavourable cases bone
      anchored hearing aids, creation of a meatus for fitting a hearing aid or a bone
      conduction hearing aid must be considered.

PMID- 1634384
TI  - [Audit of maternal and delivery records].

PMID- 1634385
TI  - [How to diagnose pregnant women with drug abuse problems and which ones need
      support].

PMID- 1634386
TI  - [Description of family social monitoring activities].

PMID- 1634387
TI  - [World Health Organization reinforces the code of ethics on marketing of human
      milk substitutes].

PMID- 1634388
TI  - Lactation characteristics of nine breeds of cattle fed various quantities of
      dietary energy.
AB  - Milk yield data were collected by weigh-suckle-weigh procedures at approximately
      14, 28, 56, 84, 112, 138, 156, 184, and 212 d postpartum for mature Angus,
      Braunvieh, Charolais, Gelbvieh, Hereford, Limousin, Red Poll, Pinzgauer, and
      Simmental cows over a 4-yr period. Individual cows were fed at one of four energy
      intake levels. Parameters characterizing lactation curves for 431 lactations from
      179 cows were estimated by nonlinear regression. Differences due to breed, level
      of energy intake, and the two-factor interaction between breed and level of ME
      allowance for scale and shape parameters of lactation curves and derived
      estimates for time of peak lactation, yield at time of peak lactation, and for
      total yield for a 210-d lactation period were evaluated. Breed and energy intake
      level were significant sources of variation for all traits. Pooled over energy
      levels, daily yields at time of peak lactation of Braunvieh, Gelbvieh, and
      Pinzgauer were greater (P less than .05) than those of Angus, Charolais,
      Hereford, and Limousin. Simmental and Red Poll were intermediate. Total lactation
      yield of the Braunvieh exceeded (P less than .05) that of all other breeds with
      the exception of Gelbvieh. Hereford produced less milk than (P less than .05) the
      other breeds. The response in yields at time of peak lactation as energy
      allowances increased for Braunvieh, Charolis, Gelbvieh, Limousin, and Pinzgauer
      cows were linear and resulted in higher yields at this time. Linear increases in
      total 210-d yield and times of peak lactation were observed for all breeds with
      the exception of Hereford.

PMID- 1634389
TI  - The effect of body condition, live weight, breed, age, calf performance, and
      calving date on reproductive performance of spring-calving beef cows.
AB  - Data from 321 spring-calving cows (mean calving date March 27) were used to
      assess the effects of body condition, live weight, cow age (from 4 to 13 yr), and
      breed (237 Hereford x Friesians and 84 Blue-Greys) and time of calving on the
      proportion of cows that became pregnant, the number of days from the start of
      mating to pregnancy, and calving interval. Mating started at turn-out to pasture
      in mid-May and lasted 9 to 10 wk. Body condition at calving and breed were the
      most significant animal factors affecting reproductive performance. Cows calving
      in higher body condition had shorter (P less than .001) calving intervals (11.2 d
      per unit of body condition at calving). Blue-Grey cows became pregnant in a
      higher proportion (90%) and calving interval was shorter (364 d) than in Hereford
      x Friesians (83%; 374 d). Body condition at the start of mating was less
      important and body condition at the end of mating had no effect. Live weight at
      calving and changes in live weight from calving to the start of mating and during
      the mating period had no significant effect. The proportion of cows becoming
      pregnant decreased significantly with age in Hereford x Friesian cows older than
      7 yr. The variance in calving interval accounted for by calving date, body
      condition at calving, breed, and age was 42%.

PMID- 1634390
TI  - Live animal measurement of carcass traits by ultrasound: assessment and accuracy
      of sonographers.
AB  - The establishment and evaluation of an assessment system to accredit sonographers
      for measuring the carcass traits of subcutaneous fat depths and longissimus
      muscle area (LMA) on potential breeding animals by real-time ultrasound is
      described. Repeatability of operators, variation between the animal's left and
      right sides, and variations in technique were assessed from measurements and
      repeat measurements of 30 cattle by up to eight operators at three testing
      sessions. Accuracy of carcass data was determined by repeatability of
      measurements, variability between measurers, between left and right sides of the
      carcass, and variation due to handling and dressing procedures. Correlations with
      carcass data averaged .92 for rump fat, .90 for rib fat, and .87 for LMA.
      Residual SD averaged .81 mm, .88 mm, and 5.1 cm2. A very experienced sonographer
      can measure LMA only marginally less accurately than it can be measured on the
      carcass. In Session 3, the SE between repeat fat measurements for accredited
      sonographers averaged .43 mm, indicating that fat depths can be measured more
      accurately, but when comparing measurements from different operators, adjustments
      may be required for differences in technique, otherwise overall accuracy will be
      about the same, approximately 1 mm. Scanned rump fat measurements were
      consistently approximately 20% higher than on the chilled, hanging carcass 24 h
      after slaughter; after applying the standard correction factor of 1.17, LMA
      measurements were similar. Scan and carcass rib fat measurements were similar for
      animals with less than or equal to 10 mm of fat cover, above which carcass
      measurements tended to be higher.

PMID- 1634391
TI  - Subclinical mastitis in ewes and its effect on lamb performance.
AB  - Two studies were conducted to 1) assess the effectiveness of the California
      mastitis test (CMT) relative to direct microscopic somatic cell count (DMSCC)
      and(or) somatic cell count (SCC) procedures for detecting subclinical mastitis in
      ewes, 2) determine the incidence of subclinical mastitis based on repeated or
      single sample measures and organisms associated with the inflammation, and 3)
      assess the relationship between milk quality measures and lamb performance. The
      relationship between DMSCC and SCC scores was significant (P less than .01); 90%
      of the variation in DMSCC scores was accounted for by SCC scores. In contrast,
      CMT scores accounted for only 26% of the variation in DMSCC and 30 to 34% of the
      variation in SCC scores. Incidence of inflammation varied from 17 to 50% of ewes
      tested, depending on the study and the method of assessment. Staphylococcus
      species were cultured from 14/41 samples tested, with cultures of Streptococcus
      species (3/41) and Micrococcus species (1/41) also present. The effect of
      subclinical mastitis in ewes on lamb performance was minimal when assessed by
      regressing lamb weights on subclinical mastitis and milk quality scores. In
      conclusion, growth performance of lambs in a management system where they had
      access to supplemental feed was not influenced by the quality of milk produced by
      ewes, or by the degree of subclinical mastitic inflammation present when they
      suckled.

PMID- 1634392
TI  - Influence of yeast culture on feeder calves and lambs.
AB  - Four experiments were conducted to determine the influence of yeast culture on 1)
      the health and performance of feeder calves, 2) the response of calves to an
      infectious bovine rhinotracheitis virus (IBRV) infection, and 3) nutrient
      utilization in lambs fasted for 3 d. In Exp. 1, 108 feeder calves were
      transported from Tennessee to Texas (1,600 km) and fed receiving diets containing
      0 or .75% yeast culture and .35 or .69% P in a 2 x 2 factorial arrangement of
      treatments. In Exp. 2, 101 calves were transported 950 kg from Austin, TX to
      Bushland, TX and fed receiving diets containing 0, .75, 1.125, or 1.5% yeast
      culture. Yeast culture did not significantly affect the health or performance of
      calves in either experiment, although morbid calves fed yeast culture required
      fewer (P less than .05) days of antibiotic therapy in Exp. 2. In Exp. 3, feeder
      steers were fed diets containing 0 or .75% yeast culture and challenged
      intranasally with IBRV. Calves fed yeast culture tended to maintain heavier
      weights and higher DMI during IBRV infection than did steers fed the control
      diet. In Exp. 4, feeder lambs were fasted for 3 d and refed diets containing 0,
      .75, 1.125, or 1.5% yeast culture during a N and mineral balance trial. Lambs fed
      yeast culture had greater (P less than .08) N balance and tended to have greater
      Zn and Fe balance than control lambs. Results of these studies are interpreted to
      suggest that supplementation of morbid calves with yeast culture can have
      beneficial effects (fewer sick days, higher feed intakes) and that these effects
      may be mediated by improved N, Zn, and Fe metabolism.

PMID- 1634393
TI  - Feedlot performance of steers and bulls actively immunized against gonadotropin
      releasing hormone.
AB  - Feedlot performance and testicular and pituitary function were assessed in cattle
      actively immunized against GnRH. In Trial 1, 50 steers were either unimmunized (n
      = 10), actively immunized against keyhole limpet hemocyanin (KLH; n = 10), or
      immunized against a GnRH-KLH conjugate (n = 30). Fifteen of 30 steers immunized
      against GnRH-KLH received a secondary immunization 8 wk after primary
      immunization. Antibodies against GnRH were not evident in unimmunized steers or
      steers actively immunized against KLH. Antibodies against GnRH were noted in all
      immunized animals (n = 30) within 6 wk of primary immunization and anti-GnRH
      antibody concentrations became maximal 20 to 24 wk after immunization. The
      increasing anti-GnRH titer in immunized steers was associated with decreasing
      serum concentrations of LH. Serum concentrations of LH were depressed (P less
      than .05) within 8 wk of primary immunization and reached a nadir by wk 20. The
      patterns of increase in GnRH titer and decrease in serum concentrations of LH did
      not differ (P greater than .05) in animals receiving primary immunization alone
      or primary and secondary immunization. Feedlot performance and carcass quality
      were not affected (P greater than .05) by immunization against KLH or the GnRH
      KLH conjugate. In Trial 2, 60 bull calves (mean weight = 325.2 +/- 2.8 kg) were
      randomly assigned to a 2 x 3 factorial experiment. The two classes (n = 30) were
      1) unimplanted and 2) implanted with Synovex-S. The three treatments (n = 20)
      were 1) intact control, 2) actively immunized against GnRH, and 3)
      castrate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634394
TI  - Effect of zeranol implants in ram and wether lambs on performance traits, carcass
      characteristics, and subprimal cut yields and distribution.
AB  - In two separate 2 x 2 factorial arrangements, 69 male, crossbred lambs were
      allotted randomly to the following treatments: 1) nonimplanted (NI) rams, 2)
      implanted (I) rams, 3) NI wethers, and 4) I wethers. In Trial 1, 36 lambs were
      allotted to treatment groups at birth (n = 9) and I lambs were implanted with 12
      mg of zeranol between 1 and 3 d of age and again at weaning (average age of 62
      d). Lambs were slaughtered at three time-constant end points of 78, 93, and 107 d
      on feed postweaning (average age of 155 d). Rams grew faster postweaning, were
      more efficient in their feed conversion, were heavier at slaughter, and had lower
      numerical yield grades than did wethers (P less than .05). Implanted lambs tended
      (P = .08) to grow faster and were (P less than .05) more efficient in their feed
      conversion than NI lambs. Rams produced heavier (P less than .05) trimmed
      subprimal shoulders, loins, and legs and had (P less than .05) a higher
      percentage of their carcass weight in the subprimal shoulder than did wethers.
      During Trial 2, NI rams (n = 8), I rams (n = 8), NI wethers (n = 8), and I
      wethers (n = 9) were allotted to treatment groups, and I lambs were implanted at
      average ages of 14, 55, and 98 d. After weaning, lambs were weighed every 14 d
      and were slaughtered 7 d after reaching a minimum weight of 50 kg (average age of
      148 d).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634395
TI  - Genotype and treatment biases in estimation of carcass lean of swine.
AB  - Carcasses of 181 barrows, representing five genotypes, 1) H x HD, 2) SYN, 3) HD x
      L[YD], 4) L x YD, and 5) Y x L (H = Hampshire, D = Duroc, SYN = synthetic
      terminal sire line, L = Landrace, and Y = Yorkshire), and two levels of
      ractopamine (RAC) treatment (0 and 20 ppm) were completely dissected and the data
      were used to examine genotype and treatment (RAC) biases in estimation of fat
      standardized lean weight and to evaluate accuracies and precisions realized by
      use of equations based on variables derived from different technologies.
      Independent variables used to establish regression equations represented
      technologies of direct carcass measurements, optical probe data, TOBEC (total
      body electrical conductivity) readings, and dissected (DHMLN) and fat
      standardized (FSHMLN) ham lean. Genotype bias existed when any equation from a
      single technology was used and was minimized by combining FSHMLN with one TOBEC
      reading, carcass length, and the probe measurement of 10th rib fat depth. Large
      RAC biases appeared when equations from direct carcass measurements or optical
      probe data were used and were minimized by an equation using either DHMLN or
      FSHMLN. A practical equation with relatively high R2 value and small genotype and
      RAC biases were developed by combining TOBEC readings with direct carcass
      measurements of 10th rib fat depth and warm carcass weight.

PMID- 1634396
TI  - Growth, development, and carcass composition in five genotypes of swine.
AB  - An experiment with 127 barrows representing five genotypes, 1) H x HD, 2) SYN, 3)
      HD x L[YD], 4) L x YD, and 5) Y x L (H = Hampshire, D = Duroc, SYN = synthetic
      terminal sire line, L = Landrace, and Y = Yorkshire), was conducted to evaluate
      growth and development of swine from 59 to 127 kg live weight. Animals were
      allowed ad libitum access to a pelleted finishing diet containing 18.5% CP, .95%
      lysine, and 10.5% fat, with an energy density of 3,594 kcal of ME/kg. Pigs were
      serially slaughtered at either 59, 100, 114, or 127 kg live BW. After slaughter,
      carcasses were chilled and backfat was measured at four locations. The right side
      of each carcass was fabricated into primal cuts of ham, loin, Boston Butt,
      picnic, and belly. Composition of each primal cut was determined by physical
      dissection into lean, fat, bone, and skin. Estimated allometric growth
      coefficients for carcass length, carcass weight, and longissimus muscle area
      relative to BW; carcass lean, fat, bone, and skin relative to both BW and carcass
      weight; and lean in each of the primal cuts relative to total carcass lean did
      not differ (P greater than .05) among genotypes. Relative to BW, the pooled
      growth coefficient(s) for carcass weight was (were) greater (P less than .001)
      than unity, whereas those for carcass length, longissimus muscle area, and
      backfat at first rib were smaller (P less than .001) than unity. Those for other
      backfat measurements were close to 1.00. Relative to either BW or carcass weight,
      the pooled coefficient(s) for fat was (were) greater (P less than .001) than
      unity, whereas those for lean, bone, and skin were smaller (P less than .001)
      than unity. Growth of lean, backfat, bone, and skin in the carcass were nearly
      linearly associated with increases in BW. The increase in fat weight was
      curvilinear as the pig grew and was accelerated in later growth stages,
      indicating that carcass fat percentage increased with increased BW.

PMID- 1634397
TI  - Reduced animal model with differential genetic grouping for direct and maternal
      effects.
AB  - Mixed-model equations for the reduced animal model with maternal effects and
      different genetic grouping of unknown parents for additive direct and maternal
      effects are derived. The matrices that relate the expected value and the variance
      of the breeding values of non-parents to the parents, as well as the different
      contributions of parental and non-parental breeding values, to the resulting
      mixed-model equations are presented. Mis-specification of additive maternal
      variance and the additive covariance between direct and maternal effects, arising
      from missing information on the dams of known individuals with records, is
      discussed. To avoid an incorrect specification of the variance-covariance matrix
      of the records without having to invert a nondiagonal variance of the residual
      terms, the breeding values of the unknown dams of individuals with records are
      included in the equations. Breeding values of non-parents are back-solved after
      the solutions for genetic groups and breeding values of parents are computed as
      simply as in cases in which maternal effects are absent. A numerical example is
      included to illustrate the derivations.

PMID- 1634398
TI  - Breed effects and heterosis in advanced generations of composite populations on
      actual weight, adjusted weight, hip height, and condition score of beef cows.
AB  - Heterosis effects were evaluated in three composite populations in F1, F2, and F3
      generations separately and combined in 1-yr-old and from 2- through greater than
      or equal to 7-yr-old beef cows. Traits included actual weight, weight adjusted to
      a common condition score, hip height, and condition score. Breed effects were
      evaluated in the nine parental breeds (Red Poll [R], Hereford [H], Angus [A],
      Limousin [L], Braunvieh [B], Pinzgauer [P], Gelbvieh [G], Simmental [S], and
      Charolais [C]) that contributed to the three composite populations (MARC I = 1/4
      B, 1/4 C, 1/4 L, 1/8 H, 1/8 A; MARC II = 1/4 G, 1/4 S, 1/4 H, 1/4 A; and MARC III
      = 1/4 R, 1/4 P, 1/4 H, 1/4 A). Breed group (parental breed and composite) effects
      were significant for all traits analyzed. The effects of heterosis were generally
      important (P less than .05) for all traits in F1, F2, and F3 generations
      separately and combined in the three composite populations. Generally, the
      magnitude of heterosis observed at 1 yr of age did not differ from that observed
      in cows from 2 through greater than or equal to 7 yr old. Adjusting weight to a
      common condition score resulted in an average reduction of heterosis effects on
      actual weight by approximately one-fourth. Thus, approximately one-fourth of the
      effects of heterosis on weight result from heterosis effects on condition score.
      Generally, retained heterosis in the F3 generation of either 1-yr-old or from 2
      through greater than or equal to 7-yr-old cows of the three composite populations
      did not differ (P greater than .05) from expectation based on retained
      heterozygosity for the traits analyzed. These results support the hypothesis that
      heterosis for weight, hip height, and condition score of cows of these age
      classes is the result of dominance effects of genes.

PMID- 1634399
TI  - Estimation of direct and maternal heritability and genetic correlation for
      backfat and growth rate in swine using data from centrally tested Yorkshire
      boars.
AB  - The purpose of this study was to estimate components of variance and covariance
      for backfat and growth rate in swine tested in central test stations in the
      United States. Data were collected from 26 central boar test stations from 1984
      through 1990. The traits analyzed were backfat adjusted to a 104.5-kg basis and
      ADG adjusted to a 36-kg on-test weight. Records from 7,951 purebred Yorkshire
      boars were analyzed. Contemporary groups were defined as boars of a breed that
      were tested and sold as a common group in a test station. Variance components
      were estimated using a pseudo-expectation method with a multiple-trait, sire
      maternal grandsire model. Direct heritabilities for backfat and ADG were
      estimated to be .56 and .24, respectively. Direct maternal effects were
      significant for both backfat and ADG; they accounted for 11 and 23% of the
      variance, respectively. The additive genetic correlation between backfat and ADG
      was approximately zero. Within this population of centrally tested Yorkshire
      boars, heritability seems to be high for backfat and moderate for ADG, with a
      significant maternal effect on each trait.

PMID- 1634400
TI  - A bioeconomic simulation model for a hierarchical swine breeding structure.
AB  - A stochastic computer model was developed to simulate individual pigs in a
      hierarchical breeding system. The bioeconomic model was designed as a tool to
      facilitate the evaluation of selection, culling, and management strategies for a
      three-tiered breeding structure. Events such as mating, farrowing, and selection
      occurred weekly. Variables included number of pigs born alive, survival rate from
      birth to weaning, average daily gain and backfat at 110 kg, number of pigs
      weaned, feed per gain, days from weaning to 110 kg, age at puberty, and growth
      rate and weight of sows and service boars. Also included were probabilities of
      conception, return to estrus by week, survival, involuntary culling, male
      infertility, and unacceptable conformation. Variables important for selection
      were determined by breeding value, individual and maternal heterosis, parity,
      size of birth litter, sex, age of dam, genetic and environmental relationships
      between variables, and common litter, permanent, and random environmental
      effects. Variables derived from selection variables were computed by regression
      using phenotypic relationships between all variables. Also, a random
      environmental effect was added to predicted performance. Means and variances of
      variables differed between genetic lines. Production costs included feed, non
      feed operating, fixed, and replacement stock costs. Income included market
      animals, culls, and replacements sold to lower tiers. Effects of changes in
      backfat on market value and sow maintenance feed costs were not modeled. An
      example is given to illustrate model output.

PMID- 1634401
TI  - Factors affecting dystocia and early calf mortality in Angus cows and heifers.
AB  - Calving performance records (965,417) from purebred American Angus herds
      throughout the United States were used to study dystocia and early calf mortality
      during the period from 1972 to 1985. A sample of 53 (n = 83,467) herds was used
      to establish reasonable limits on the expected frequency of dystocia and
      mortality within and among herds that have good reproductive management programs
      and to verify the frequencies of scores in all other herds (n = 4,130) reporting
      calving performance information. The data were analyzed by logistic regression
      models. Dystocia and perinatal mortality, to a lesser extent, were found to be
      more frequent in heifers than in cows. The odds of unassisted births vs births
      with major difficulty were 11.58 times greater in cows than in heifers. In
      heifers, the odds of an unassisted birth increased with age of dam and decreased
      with birth weight of calf. At a baseline age of 22 mo the odds of an unassisted
      birth for calves weighing 30 and 40 kg were .13 and .02 times lower than the odds
      for calves weighing 20 kg. Alternately, at 29 mo, the odds of an unassisted birth
      for heifers producing a 20-kg calf were 4.53 times greater than at 22 mo.
      Survival of calves to 24 h in heifers was primarily affected by birth weight.
      Heifers producing calves at intermediate weights of 29 kg had higher odds of
      producing live calves at all ages. Considering all heifers calving at 22 to 29 mo
      relative to 20-kg calves, the odds for survival to 24 h were 3.83 times greater
      for 29-kg calves and lower by a factor of .52 for 40-kg calves.

PMID- 1634402
TI  - Luteinizing hormone, testosterone, and behavioral response of male-oriented rams
      to estrous ewes and rams.
AB  - During the breeding season three experiments were conducted to evaluate the LH
      and testosterone (T) response of rams with male sexual orientation (e.g., male
      oriented homosexual rams) to female sheep, to male sheep, and to treatment with
      LHRH. Male-oriented rams were identified through a series of sexual performance
      and sexual preference tests. Treatments included exposure to estrous females and
      to males for 15 min (Exp. 1) and exposure to estrous females and to males for 8 h
      (Exp. 2). Behavioral responses to stimulus animals were recorded. In Exp. 2
      homosexual rams mounted males more than females (P less than .02) and exhibited
      more flehmen (P less than .002) and investigatory sniffs (P less than .01) when
      exposed to males vs females. Acts of aggression (butting the stimulus animals)
      did not differ by gender (P greater than .1). Flehmen and butting were positively
      correlated to LH secretion (P less than .02) of rams exposed to females but not
      to males. In Exp. 1, LH concentration determined every 15 min for 6 h was not
      affected (P greater than .05) by the gender of the stimulus animal. In Exp. 2, LH
      pulse frequency and concentration were similar (P greater than .05) by treatment.
      Lack of an LH response to sexual activity in homosexual rams was not a result of
      pituitary or gonadal insensitivity; within 1 h of a single injection of LHRH both
      LH and T increased (Exp. 3).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634403
TI  - Performance of Bos indicus-influenced bulls in serving capacity tests and
      multiple-sire breeding groups.
AB  - Three experiments were conducted with Santa Gertrudis (SG) or F1 (Gelbvieh x SG
      or Red Angus x SG) bulls to assess factors that influence copulatory activity and
      fertility of Bos indicus-influenced genotypes. In Exp. 1, 3-yr-old SG bulls (n =
      20) with sexual experience and 20-mo-old virgin SG bulls (n = 34) were allotted
      in a split-plot design (age, bull within age group, test day, and heifer
      treatment). Number of mounts (Mt), intromissions (I), and ejaculations (E) were
      measured 14 d apart during two 30-min serving capacity (SC) tests. Estrus was
      either induced via progesterone+estradiol cypionate (PE) injections or
      synchronized with Syncro-Mate B (SMB). There were more (P less than .05) I and E
      on Test d 2 than on Test d 1. Heifers treated with SMB received more (P less than
      .001) Mt, I, and E than did heifers treated with PE. Sixteen 20-mo-old bulls from
      Exp. 1 were allotted to breeding pastures at a bull:heifer ratio of 4:119 +/- 3
      for 50 d in Exp. 2. Breeding pasture treatments either included or excluded low
      SC bulls. Neither pregnancy rate nor least squares mean day of conception
      differed between treatments. Experiment 3 evaluated copulatory activity with a 2
      x 2 factorial arrangement (breed and test day) in 14- to 16-mo-old SG (n = 45)
      and F1 (n = 16) bulls. The F1 bulls had more Mt, I, and E than did the SG bulls
      (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634405
TI  - Increased postnatal growth rates of offspring after antiestrogen treatment of rat
      dams during pregnancy.
AB  - The effects of administration of estradiol antiserum to pregnant rats on birth
      weight, subsequent growth velocity, carcass composition, and reproductive
      performance of their offspring were examined. Treated rats were injected i.p.
      with a potent antiestradiol serum on d 12 of gestation, whereas control rats
      received a similar injection of normal sheep serum. The pups from the treated
      rats were 12.2% heavier at birth than those from control rats (P less than .01)
      and had a greater postnatal growth rate (P less than .05). Chemical analysis of
      body composition at 56 d of age revealed that there was a tendency for female
      offspring from treated rats to exhibit carcass characteristics (such as increased
      percentage of body fat) that were more similar to those of normal male rats than
      to those of normal female rats. Neither onset of puberty nor reproductive
      performance was affected by the treatment. These results indicate that treatment
      of rats during pregnancy with antiestradiol may have potential as a technique for
      increasing postnatal growth rates.

PMID- 1634404
TI  - Characterization of somatotropin binding sites in pig skeletal muscle.
AB  - The present study was conducted to determine whether somatotropin (ST) binding
      sites are present in crude membrane preparations containing sarcolemma of pig
      skeletal muscle. Initial characterization experiments indicated that binding of
      bovine ST (bST) was time- and temperature-dependent and that binding was
      reversible. At 23 degrees C, binding was maximized between 36 and 48 h, whereas
      at 4 degrees C binding had not reached a maximum by 96 h. Somatotropin binding
      was stable between pH 5.5 and 8.5 and increased linearly between 100 and 600
      micrograms of membrane protein. Addition of unlabeled bST decreased specific
      binding of [125I]bST in a dose-dependent manner (ED50: 1 to 1.6 ng/mL). The
      binding sites for bST were specific because porcine prolactin poorly inhibited
      bST binding. Scatchard analysis revealed the presence of a single class of
      binding sites (Ka: 9 to 15 x 10(9)M-1; Bmax: 5 to 6 fmol/mg of protein). In
      summary, the present report is the first to demonstrate that specific ST
      receptors are present in pig skeletal muscle. The role that ST plays in directly
      stimulating muscle growth and(or) muscle synthesis of insulin-like growth factor
      I (IGF-I) in pST-treated pigs as opposed to changes that occur as the result of
      an increase in plasma IGF-I concentration remains to be resolved.

PMID- 1634406
TI  - The effect of live weight gain and live weight loss on body composition of Merino
      wethers: dissected muscle, fat, and bone.
AB  - Sheep were slaughtered after live weight gain (LWG) and live weight loss (LWL) to
      evaluate the effect of different periods of normal and retarded growth on
      dissected carcass components. Thirty-five Merino wether sheep were allowed ad
      libitum access to the experimental diet of 80% alfalfa chaff and 20% cereal grain
      (17.23% CP and 18.10 MJ/kg of GE) to grow from 23.0 to 33.0 kg live weight and
      then fed to lose 10 kg at 133 g/d. Five animals were slaughtered at live weights
      of 23.0, 26.3, 29.6, and 33.0 kg during LWG and 29.6, 26.3, and 23.0 kg during
      LWL. Fleece-free empty BW was similar in both LWG and LWL animals at all common
      slaughter weights because of the lesser and greater weights of the alimentary
      tract contents and the fleece, respectively, in the LWL animals. Carcass weight
      or dissected side weight was greater in LWL animals at each common slaughter
      weight but significantly so (P less than .05) at the 23.0 kg live weight only.
      Total side muscle weight was similar in LWG and LWL animals at each common
      slaughter weight, but the proportion of muscle in the dissected side weight was
      lower (P less than .05) in LWL animals at 23.0 kg live weight. Total side fat,
      subcutaneous fat, intermuscular fat, and kidney and channel fat weights were all
      greater in LWL animals at each common slaughter weight, but significantly so (P
      less than .05) at the 23.0 kg live weight only. Total side bone weight was higher
      at both 26.3 kg (P less than .01) and 23.0 kg (P less than .05) in the LWL
      animals. Weight loss in young sheep mobilized more weight of muscle than fat from
      the carcass, whereas bone weight was constant.

PMID- 1634407
TI  - Yield grade and carcass weight effects on the cutability of lamb carcasses
      fabricated into innovative style subprimals.
AB  - Lamb carcass (n = 100) were selected from USDA yield grades (YG) 2, 3, and 4 and
      carcass weight (CW) groups 20.4 to 24.9, 25.0 to 29.5, and 29.6 to 34.0 kg. Lamb
      carcass were fabricated into semiboneless and boneless subprimals and trimmed to
      three s.c. fat trim levels: .64, .25, and .00 cm of fat remaining. Innovative
      subprimals were fabricated and yields were calculated for the subprimals and
      dissectible components (lean, bone, connective tissue, external fat, and seam
      fat) from each of the various subprimals. Carcass weight as a main effect in a
      two-way analysis of variance did not account for a significant amount of the
      variation in yield among trimmed subprimals or the percentage of the dissectible
      components, but USDA YG was a significant main effect in determining variation in
      yield for many of the subprimals or dissectible components. Muscle seaming of
      shoulders and legs and removal of excessive tails on the loin and rack resulted
      in a majority of the seam fat being removed from these cuts. Dissection data
      clearly showed that seam fat is a major component of rack and shoulder cuts and
      with increasing fatness or higher numerical yield grade there are clearly
      increased amounts of this depot. Increased trimming of external fat magnifies and
      draws more attention to the amount of seam fat remaining. Production of heavy,
      lean lambs would be more useful in an innovative type of program because of the
      larger-sized muscles. Heavy, fat lambs would not be as useful because of their
      decreased yields and excess seam fat located in cuts that cannot be muscled
      seamed because of the loss of retail cut integrity. Seam fat was highly
      correlated to percentage of kidney and pelvic fat and to external fat thickness
      and with USDA yield grade but was not strongly correlated to carcass weight.

PMID- 1634408
TI  - Development of a quantitative quality grading system for mature cow carcasses.
AB  - Data from 400 cow carcasses were used to develop a new quality grading system.
      First principal component (FPC) values were determined for shear force (SHR) and
      palatability attributes of tenderness, connective tissue amount, flavor, and
      juiciness (JUC). Associated eigenvector load values for those traits were -.48,
      .54, .51, .46, and .05, respectively, and FPC values ranged from -3.20 to 2.18.
      Linear regression, using FPC as the independent variate, and SHR and palatability
      attributes (8-point scale, where 8 was highest) as dependent variates explained a
      significant amount of variation (P less than .001) in all traits, except JUC, and
      resulted in R2 values of .71, .89, .80, .66, and .01, respectively. A predictive
      quality-grade equation was developed using FPC as the dependent variate, and
      overall maturity (OM), lean color, marbling score (MS), lean firmness, lean
      texture, fat color (FC), and marbling fineness ([marbling texture + marbling
      distribution]/2; 8-point scale, where 8 was highest) as independent variates. The
      resulting best-fit prediction equation (FPC = -.052-[.0031 x OM] + [.0013 x MS] +
      [.31 x FC]) explained a significant amount (P less than .001) of variation in FPC
      with R2 = .53, Cp = 15.0, and residual standard deviation = .69. A short-cut
      equation was developed from this prediction equation. Simple correlations for OM,
      MS, and FC with FPC were -.56, .39, and .64, respectively. Cow carcasses were
      assigned to one of three quality grades based on FPC values that corresponded
      with predetermined acceptability levels for each palatability trait. Newly
      developed grades were quantitative and less variable than existing grades. Future
      grades for cow carcasses should include fat color to predict palatability.

PMID- 1634409
TI  - 15N-leucine and 15N-isoleucine isotope dilution techniques versus the 15N-isotope
      dilution technique for determining the recovery of endogenous protein and amino
      acids in digesta collected from the distal ileum in pigs.
AB  - Twelve gilts, with an average initial BW of 38 kg, were fitted with simple T
      cannulas at the distal ileum and two catheters in the external jugular veins. The
      animals were fed twice daily (0800 and 2000) 700 g of one of four diets
      containing either soybean meal, canola meal, wheat, or barley as the sole protein
      source. 15N-leucine was infused continuously for 9 d at a rate of 40 mg/kg of BW
      daily via one of the jugular catheters. Blood samples were taken during feeding.
      Ileal digesta samples were collected continuously for 24 h on d 7 and 9 of the
      infusion period. 15N-enrichment excess in leucine and isoleucine in the
      trichloroacetic acid (TCA)-soluble fraction of blood and in digesta were measured
      using single-ion monitoring gas chromatography-mass spectrometry. Assuming that
      the 15N-enrichment excess in leucine and isoleucine in the TCA-soluble fraction
      of the blood is similar to that in endogenous protein secreted into the digestive
      tract and that the amino acid composition of endogenous protein is constant, the
      contribution of endogenous to total protein in ileal digesta was calculated using
      the 15N-isotope dilution technique for leucine and isoleucine, respectively.
      These contributions were much smaller for the 15N-leucine than for the 15N
      isoleucine isotope dilution technique: 7.1 to 11.0 vs 21.8 to 24.9 g of
      protein/kg of DM intake. The values obtained with the 15N-isoleucine isotope
      dilution technique were close to those obtained with the 15N-isotope dilution
      technique as described in a previous publication.

PMID- 1634410
TI  - Methionine requirement of pigs between 5 and 20 kilograms body weight.
AB  - Four nursery experiments were conducted using a methionine (Met)-deficient
      feather meal-corn-soybean meal-dried whey basal diet (20% CP; 3,250 kcal of
      ME/kg, .11% choline, .19% Met, 1.00% cystine) supplemented with lysine,
      tryptophan, and histidine to determine the Met requirement of 5- to 10- and 10-
      to 20-kg pigs. Based on a true Met digestibility value of 81.6% estimated by a
      pig ileal digestibility assay, the Met-deficient basal diet contained .155% of
      digestible Met. A preliminary experiment (Exp. 1) indicated that pigs fed the Met
      deficient basal diet when fortified adequately with Met could produce weight
      gains similar to those of pigs fed a 20% CP practical corn-soybean meal-dried
      whey diet. In Exp. 2 and 3, crossbred pigs weighing 5.8 kg initially were fed
      diets containing graded levels of digestible Met between .195 and .355%. Average
      daily gain increased quadratically (P less than .05) as the level of Met
      increased. When the data of Exp. 2 and 3 were examined together, the digestible
      Met requirement of 5- to 10-kg pigs was estimated to be .255% of the diet. In
      Exp. 4 and 5, crossbred pigs averaging 10 kg were fed digestible Met
      concentrations ranging from .155 to .315%. Average daily gain increased
      quadratically (P less than .05). The digestible Met requirement of 10- to 20-kg
      pigs was estimated at .255% for maximal weight gain, which was similar to that of
      5- to 10-kg pigs. Assuming an 89% digestibility of Met in practical corn-soybean
      meal diets, the total Met level needed in practice would be .29%.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1634411
TI  - Quantitative influence of lysine and energy intake on yield of milk components in
      the primiparous sow.
AB  - A regression approach was used to assess quantitatively the influence of lysine
      and ME intake during lactation on yield of milk components and to determine
      whether this influence was mediated through precursor metabolite concentrations
      in the blood. The influence of lysine and energy intake on sow weight and backfat
      loss also was analyzed by linear regression. Twenty-three primiparous Landrace x
      Yorkshire sows were fed one of nine corn-soybean meal diets to achieve a matrix
      of lysine (15, 30, or 45 g/d) and ME (6.5, 11.5, or 16.5 Mcal/d) intakes. Sow BW
      and backfat losses were found to be predominantly controlled by ME intake (P less
      than .02), with no response to lysine intake (P greater than .92). Lysine and ME
      intake explained a smaller portion of the variability in milk component yield on
      d 8 (R2 less than .34) than on d 22 (R2 = .64 to .78), evidence that dietary
      effects of milk production increased as lactation progressed. Lysine and ME
      intake had an interactive influence (P less than .05) on yield of all milk
      components except lactose, demonstrating that the amount of lysine required to
      maximize milk production increased as ME intake increased. Strong relationships
      between diet and most blood precursor metabolite concentrations (R2 = .5 to .7)
      were detected on d 22. No obvious relationships between precursor metabolite
      concentrations and milk component yield (R2 = .05 to .2) were observed. These
      results describe quantitatively the prominent interactive effects of lysine and
      ME intake on yield of milk components and demonstrate that these effects are not
      directly associated with changes in precursor pool concentrations.

PMID- 1634412
TI  - Interactive effects of dietary levels of tryptophan and protein on voluntary feed
      intake and growth performance in pigs, in relation to plasma free amino acids and
      hypothalamic serotonin.
AB  - The effects of dietary level of tryptophan (TRP) and CP content and composition
      on voluntary feed intake, growth performance, and carcass characteristics in
      finishing pigs were studied in two experiments, with an equal number of females
      and castrated males. In Exp. 1, involving 120 Large White pigs from 44 to 99 kg
      BW with ad libitum access to feed, six treatments were compared according to a 2
      x 3 factorial arrangement: 1) two levels of TRP (.09 and .13%), suboptimal and
      optimal for growth, respectively, 2) three types of CP supply (a 12.5% CP diet
      based on corn-soybean meal, and adequately balanced for essential amino acids
      [EAA] other than TRP; 15.7% CP diet with additional protein from corn gluten
      meal; 16.2% CP diet with additional nonessential amino acids [NEAA, in the form
      of L-glutamic acid.HCl and glycine], and the same levels of EAA as in the 12.5%
      CP diet. In Exp. 2, including four of the six previous factorial combinations
      (.09 and .13% TRP, 12.3 and 15.8% CP with additional protein), 32 pigs of 50-kg
      initial BW were used during 21 d, and further observations on meat quality
      characteristics, plasma free amino acid levels, and serotonin concentrations in
      the posterior hypothalamus were made. The major observed effects were
      interactions of different magnitude according to sex between TRP level and the
      amount and the composition of additional CP. At the suboptimal level of .09% TRP,
      the increase in protein content severely decreased daily feed intake and growth
      compared with the .13% level, especially in females. Conversely, the addition of
      NEAA at both TRP levels had little effect on daily feed intake and growth.
      Deficiency of TRP exerted a significant increase of pH in adductor femoris and
      semimembranosus muscles measured 45 min and 24 h postmortem, but only in females.
      Voluntary feed intake, as affected by dietary TRP and CP levels, was linearly
      related with concomitant changes in TRP to large neutral amino acids (TRP:LNAA)
      ratio both in feed and in plasma, which in turn was directly associated to
      hypothalamic serotonin concentration. It was concluded that an overly low
      concentration of serotonin in the hypothalamus, especially in females, as a
      result of TRP:LNAA imbalance, could be involved in the reduction of voluntary
      feed intake.

PMID- 1634413
TI  - Secretion of ovine lymphocyte suppressor factor from curetted uterine luminal
      cells.
AB  - The secretion of ovine lymphocyte suppressor factor from jugular vein (JV),
      uterine vein (UV), and curetted hemopoietic uterine luminal (UL) mononuclear
      cells was evaluated on d 14 of the cycle, following ovariectomy (OVX) and after
      14 d of progesterone injections (OVX + P4, 1 mg/kg BW). Mononuclear cells
      (predominantly lymphocytes) were harvested by Ficoll-Paque and placed into
      culture (2.5 x 10(6).mL-1.well-1 in RPMI-1640). Cellular supernatants were
      obtained at 72 h and volumes (5 to 50 microL) were tested for suppression of
      phytohemagglutinin (PHA [.08 microgram l)-treated peripheral blood lymphocytes
      (1.0 x 10(5)). In a concurrent experiment, PHA-treated JV, UV, and UL cells (1.0
      x 10(5)) were cultured singly and JV cells (1.0 x 10(5)) were also cocultured
      with each of 1.0 x 10(5), 5.0 x 10(4), and 2.5 x 10(4) UV and UL cells. The
      incorporation of thymidine into DNA was quantified at 60 h. For the cellular
      supernatant experiment, thymidine incorporation was affected by reproductive
      phase (P less than .036), lymphocyte source (P less than .0001), and phase x
      source (P less than .004). For UL cells, the degree of suppressor activity
      follows: d 14 greater than OVX greater than OVX+P4 (P less than .05). The UL
      supernatant from OVX+P4-treated ewes and supernatants of JV and UV cells,
      irrespective of reproductive phase, lacked suppressor activity. Sephacryl S-200
      chromatography revealed that UL supernatant from d-14 ewes contained a greater
      than or equal to 248,000 molecular weight suppressor macromolecule. For the
      cellular coculture experiment, thymidine incorporation was affected by
      reproductive phase (P less than .05) and lymphocyte source (P less than
      .0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634414
TI  - Influence of an agonist of gonadotropin-releasing hormone (buserelin) on estrus
      synchronization and fertility in beef cows.
AB  - The objective of this experiment was to determine the effect of sequential
      treatment with buserelin (a GnRH agonist) and cloprostenol (a prostaglandin F2
      alpha analog) on estrous response and fertility in beef cattle with different
      ovarian conditions. On d 0 (1st d of treatment), the control group (n = 52, 10
      heifers and 42 cows) and the GnRH group (n = 48, 10 heifers and 38 cows) received
      2 mL of saline or 2 mL of Receptal (8 micrograms of buserelin), respectively. On
      d 6, all cows that had not exhibited spontaneous estrus were given i.m. 500
      micrograms of cloprostenol (PGF). Ultrasonography on d 0 and assays of
      progesterone in blood on d -11, 0, and 6 were used to identify follicular and
      luteal status of animals. Cattle were observed for estrus from d 0 to 10. Cows
      showing estrus were bred artificially 12 h after onset of estrus. Over the 10-d
      period, the number of cows detected in estrus and pregnancy and conception rates
      were identical for the two groups. However, between d 0 and 6, the proportion of
      cows exhibiting estrus was lower (P less than .01) in the GnRH group than in the
      control group. Between d 6 and 10, the synchronization rate and precision of
      estrus were greater (P less than .01) in the buserelin-treated group than in the
      control group. Conception rate and interval from PGF injection to onset of estrus
      were not different between the two treatment groups. Presence of a large (greater
      than 10 mm) follicle on d 0 enhanced synchronization rate and precision of
      estrus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634415
TI  - Influence of the embryo on intrauterine migration in sheep.
AB  - Mechanisms of intrauterine migration were examined in 55 ewes. In the first
      experiment, corpora lutea were removed from unilaterally ovariectomized ewes on d
      4 (d 0 = estrus) and pregnancy was maintained by giving exogenous progesterone.
      In Exp. 2, the reproductive tract was altered surgically such that embryos
      initially entered the uterine horn contralateral to the site of ovulation. In
      Exp. 3, ewes received beads of silastic polydimethylsiloxane that released either
      cholesterol or estradiol-17 beta in an attempt to mimic embryonic synthesis of
      estradiol. In the fourth experiment, unilaterally ovariectomized ewes were
      superovulated and spacing of embryos within the uterus was then examined. In all
      experiments, ewes were slaughtered on d 15 and recovery of embryos or beads from
      each uterine horn indicated that migration had occurred. All ewes in Exp. 1 and 2
      that had two conceptuses experienced embryonic migration. Beads impregnated with
      estradiol migrated farther (P less than .01) than cholesterol-containing beads
      (27.6 +/- 4.3 vs 12.5 +/- 1.6 cm, respectively). In Exp. 4, only one conceptus
      had migrated into the contralateral horn in all ewes. These results demonstrated
      that 1) embryonic migration was not affected by local vs systemic exposure to
      progesterone, 2) embryos migrated into the unoccupied horn, regardless of the
      initial horn of entry, 3) estradiol may stimulate embryonic migration, and 4)
      conceptuses were not equally distributed between horns.

PMID- 1634416
TI  - Effects of pregnant mare's serum gonadotropin treatment on follicular populations
      and ovulation rates in prepuberal gilts with two morphologically different
      ovarian types.
AB  - Two experiments were conducted to determine the effects of pregnant mare's serum
      gonadotropin (PMSG) on follicular populations and ovulation rates in prepuberal
      gilts with grape-type (GT) and honeycomb-type (HT) ovaries. The follicular
      populations were determined at 170 d of age (d 0) and 19 d after PMSG (d 19). In
      Exp. 1, the mean number of macroscopic follicles of Classes 2 and 3 was greater
      (P less than .05) in GT (n = 11) than in HT (n = 32) ovaries at d 0, whereas the
      mean number of those of Class 1 was greater (P less than .05) in HT ovaries. At d
      19, no difference was observed between the two ovarian types for any class of
      follicles. The PMSG-induced ovulation rates were comparable between the two
      ovarian types (8.3 vs 7.9, GT vs HT, respectively; P greater than .10). In Exp.
      2, the microscopic follicular populations were determined on right and left
      ovaries removed, respectively, on d 0 and 19. At d 0, GT ovaries (n = 5)
      contained a greater number of Class 5 nonatretic (P less than .01) and atretic (P
      less than .02) follicles than did HT ovaries (n = 5), whereas at d 19 the mean
      number was not statistically different between the two ovarian types (P greater
      than .10). In contrast, gilts with HT ovaries contained a greater (P less than
      .01) number of Class 4 atretic follicles than gilts with GT ovaries at d 0,
      whereas at d 19 the mean number was not statistically different between the two
      ovarian types (P greater than .10).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634417
TI  - Differences in development of bovine oocytes recovered by aspiration or by
      mincing.
AB  - This experiment was performed to clarify relationships between conditions of
      bovine ovaries and developmental capacity of the follicular oocytes recovered
      from them and to compare two methods of oocyte collection, aspiration and
      mincing. Follicular oocytes with surrounding intact, unexpanded cumulus recovered
      by follicular aspiration or by mincing of tissue from 24 pairs of ovaries were
      matured and fertilized in vitro. The number of follicular oocytes recovered from
      pairs of ovaries averaged 32.1 +/- 3.2, but the number recovered varied greatly
      among the 24 pairs of ovaries (range, 7 to 71). The overall rate of development
      to the blastocyst stage was 18% (137/771), and the average number of blastocysts
      produced from a pair of ovaries was 5.7 +/- 1.1 (range, 0 to 17). No
      relationships were found between the presence of corpora lutea or large follicles
      and the proportion of oocytes capable of reaching the blastocyst stage in vitro.
      However, a positive correlation was observed between the number of oocytes
      obtained from each pair of ovaries and subsequent in vitro development; the
      correlation was especially high for oocytes obtained by aspiration. These data
      suggest that the developmental capacity of bovine follicular oocytes after in
      vitro maturation and fertilization is correlated to the number of antral
      follicles aspirated from the pair of ovaries.

PMID- 1634418
TI  - Periodic changes in body composition and in priorities for tissue storage and
      retrieval in mature beef cows.
AB  - Sixty mature (4 to 6 yr), nonpregnant, nonlactating beef cows of two breed types,
      Angus (n = 30) and Simmental (n = 30), were used in a four-period, split-plot
      study (371 d) to determine the seasonal differences in body composition. Periods
      were chosen to represent each of the four seasons in one year that ran
      consecutively from June 14, 1986 to June 20, 1987. Initially, all cows were
      assigned randomly within breed type to one of four feeding levels based on the
      cows' estimated maintenance requirement (75, 87.5, 112.5, and 125% of weight
      maintenance) and were rotated such that all animals were fed at all four feeding
      levels during the course of the study. Body composition was estimated via isotope
      dilution initially and at the end of Periods 1 through 3 and via derived
      regression relationships after Period 4. Body composition differed by breed;
      Simmental cows had greater (P less than .05) amounts of empty body protein (79.4
      vs 55.8 kg, respectively) and less (P less than .05) empty body fat (85.3 vs 93.9
      kg, respectively) than the Angus cows. These differences also were apparent when
      expressed as a percentage of live weight. Season altered components of the empty
      body. On the average, both breeds mobilized (P less than .05) empty body protein
      (-3.6 and -5.4 kg for Angus and Simmental cows, respectively) in the summer while
      simultaneously gaining (P less than .05) empty body fat (15.3 and 30.1 kg for
      Angus and Simmental cows, respectively). Both breeds subsequently tended to gain
      empty body protein in the winter and spring.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634420
TI  - Use and misuse of multiple comparisons in animal experiments.
AB  - The objective of many animal experiments is to detect meaningful relationships
      among treatments and associated responses. Types of comparisons of means include
      pairwise multiple comparisons, planned orthogonal or nonorthogonal contrasts, and
      orthogonal polynomials. Some procedures are appropriate only for specific types
      of treatment designs and specific types of objectives. Pairwise, multiple
      comparisons are appropriate only for comparing unstructured, qualitative
      treatments. Planned comparisons partition the overall set of treatment effects
      into independent or nonindependent subsets, with special application to
      factorials. Orthogonal polynomial (regression) procedures assess relationships
      between quantitative treatments and response when a full range of responses or an
      optimal dose is of interest. Recommendations for appropriate use of each mean
      comparison procedure are illustrated using data from three Journal of Animal
      Science articles. Also mentioned are a number of computer graphics packages that
      provide creative ways to display biological relationships and can be linked to
      statistical packages for input and to word processors or 35-mm cameras for
      output.

PMID- 1634419
TI  - Effects of ruminally degradable and escape protein supplements on steers grazing
      summer native range.
AB  - One experiment was conducted during 1989 to determine whether a deficiency exists
      for either ruminally degradable or escape protein in steers grazing summer native
      range. Increasing levels of ruminally degradable (.15, .27, and .37 kg/d) and
      escape protein (.07, .14, and .21 kg/d) replaced a cornstarch and molasses
      (energy control) supplement. Supplements were isoenergetic and fed individually
      to steers (.88 kg/d). No response to the degradable protein supplement (P = .15)
      was observed; however, a linear gain response (P less than .01) was observed in
      steers fed escape protein in addition to ruminally degradable protein. An in
      vitro study indicated that more (P less than .01) microbial protein was
      synthesized from the energy supplement than from the degradable protein; this
      finding presumably relates to the numerical decrease in weight gains observed for
      steers fed degradable protein supplements. Analyses of esophageal extrusa samples
      indicated that CP was relatively constant for the 1989 growing season compared
      with the 1988 growing season (P less than .05). Escape protein values differed (P
      less than .01) between years and among months within year. Forages that were
      apparently grazed in 1989 were never deficient in degradable protein. Additional
      gain observed from feeding escape protein would indicate that microbial protein
      synthesis may be insufficient to satisfy the metabolizable protein requirement,
      which probably limited gains by steers grazing summer native range.

PMID- 1634421
TI  - Improving social competence.

PMID- 1634422
TI  - An analysis of the effects of multiple setting events on the social behavior of
      preschool children with special needs.
AB  - We examined the effects of four combinations of setting events on the social
      interactions of 7 preschool children with social delays. In Study 1, the status
      of the teacher, activity materials, and peer varied across conditions. In Study
      2, the status of the teacher and materials varied across conditions. Within the
      combinations of setting events, we also examined teacher behavior. Teacher
      presence and absence was varied in both studies. The type and rate of teacher
      prompting were varied in Study 2. The four combinations of setting events
      produced different rates of social behavior by the children with social delays.
      The optimal combination of setting events for promoting peer interaction and
      reducing teacher-child interaction included teacher absence from the activity, a
      limited number and form of materials, and children paired with a socially skilled
      partner.

PMID- 1634423
TI  - Teaching social skills to students with autism to increase peer interactions in
      an integrated first-grade classroom.
AB  - We investigated the use of social skills groups to facilitate increased social
      interactions for students with autism and their nonhandicapped peers in an
      integrated first-grade classroom. Social skills groups consisted of training
      students and peers in initiating, responding, and keeping interactions going;
      greeting others and conversing on a variety of topics; giving and accepting
      compliments; taking turns and sharing; asking for help and helping others; and
      including others in activities. Training occurred during the first 10 min of 20
      min play groups, four times per week. Using a multiple baseline across subjects
      design, results demonstrated increases in the frequency of, time engaged in, and
      duration of social interactions, as well as the responsivity of students and
      peers to each other. Results were maintained when students were monitored and
      given feedback on social performance in play groups and during follow-up.

PMID- 1634424
TI  - Peer-mediated intervention: attending to, commenting on, and acknowledging the
      behavior of preschoolers with autism.
AB  - This study investigated the effects of a peer-mediated intervention on the social
      interaction of five triads comprised of preschoolers with autism and their
      typical peers. Strategies thought to facilitate interaction were selected based
      on analyses of a descriptive data base. Peers were taught to attend to, comment
      on, and acknowledge the behavior of their classmates with disabilities. These are
      behaviors preschoolers typically exhibit frequently, but that do not obligate
      responses to the same extent as questions and requests do. The ABCB reversal
      designs revealed that improved rates of social interaction during play were
      clearly associated with the peer intervention for 4 of the 5 children with
      autism. This intervention offers an alternative peer-intervention package for
      increasing interaction between children with and without disabilities.

PMID- 1634425
TI  - A peer-mediated social network intervention to enhance the social integration of
      persons with moderate and severe disabilities.
AB  - Increasingly, parents, teachers, and students with disabilities are advocating
      for interventions that go beyond skill training to provide support for
      participation in integrated environments and support for friendships. The present
      research demonstrated a social network intervention for youths with moderate and
      severe disabilities. Two groups of nondisabled peers were recruited to
      participate in weekly discussions with an adult integration facilitator to
      increase opportunities for social interaction for 2 students (1 with autism and 1
      who was moderately mentally retarded). The groups met to discuss social
      interactions that had occurred with the students with disabilities and to talk
      about strategies to promote greater inclusion of the students into ongoing social
      interaction. The nondisabled students participated in the design and
      implementation of social skills interventions during transition times and lunch.
      The nondisabled students used self-monitoring data sheets to record the quantity
      and quality of interactions. The frequency of interaction, number of
      opportunities for interaction, and appropriateness of social interactions were
      analyzed with a multiple baseline design. Results indicated that the social
      network intervention was successful in increasing the quantity and quality of
      interactions and that the network strategy promoted the development of
      friendships. The results are discussed in terms of the need for additional
      research showing the relationships between increases in social competence, peer
      mediated intervention, and the development and support of friendship.

PMID- 1634426
TI  - Increasing generalized social interactions in psychotic and mentally retarded
      residents through peer-mediated therapy.
AB  - This study investigated whether withdrawn adults living in a residential center
      for psychotic and mentally handicapped persons could serve as peer therapists to
      increase the social interaction of other withdrawn residents. Two pairs of
      residents served as participants. Treatments were introduced and evaluated within
      a multiple baseline with reversal design. After baseline, the peer therapist was
      instructed to increase the social interactions of a target peer through
      engagement in social interactions. The results demonstrated that the peer
      therapist increased the social interactions of target peers. However, these
      increases did not generalize to other residents until the introduction of a
      multiple peer therapist condition. The percentage of time the peer therapists
      interacted with other nontarget residents also increased throughout the study.
      These results were maintained during a 4-month follow-up condition.

PMID- 1634427
TI  - Improving social skills and disruptive behavior in children with autism through
      self-management.
AB  - The literature suggests that children with autism typically are unresponsive to
      verbal initiations from others in community settings, and that such
      unresponsiveness can lead to problematic social interactions and severely
      disruptive behavior. The present study assessed whether self-management could be
      used as a technique to produce extended improvements in responsiveness to verbal
      initiations from others in community, home, and school settings without the
      presence of a treatment provider. The results showed that children with autism
      who displayed severe deficits in social skills could learn to self-manage
      responsivity to others in multiple community settings, and that such improvements
      were associated with concomitant reductions in disruptive behavior without the
      need for special intervention. The results are discussed in terms of their
      significance for improved development of social skills in children with autism.

PMID- 1634428
TI  - Effects of a videotape feedback package on the peer interactions of children with
      serious behavioral and emotional challenges.
AB  - Peer interactions are among the greatest challenges experienced by children who
      have severe emotional and behavioral problems. This study evaluated an
      intervention package designed to increase the ratio of these children's desirable
      to undesirable interactions. The package included three principal components: (a)
      observation of videotapes following regularly scheduled peer activity sessions;
      (b) self-evaluation of the children's peer interactions observed on the
      videotapes; and (c) delayed feedback and reinforcement for desirable peer
      interactions. Five students from two elementary schools participated. Multiple
      baseline designs and one reversal were used to evaluate the effects of the
      intervention package. The results showed that the intervention produced lower
      levels of undesirable peer interactions and higher ratios of desirable to
      undesirable interactions for all participants. The results are discussed in
      regard to their conceptual and applied implications and in terms of specific
      directions for future research.

PMID- 1634430
TI  - Generalization and maintenance of preschool children's social skills: a critical
      review and analysis.
AB  - This paper summarizes the results of a retrospective review of generalization in
      the context of social skills research with preschool children. A review of
      studies from 22 journals (1976 to 1990) that assessed generalization as part of
      social interaction research provided information concerning the prevalence of
      studies that have assessed generalization, common practices concerning the
      production and assessment of generalization, and the overall success of obtaining
      generalization and maintenance of social behaviors. A comparison of the most and
      least successful studies, with respect to generalization, revealed some
      differences concerning the practices employed by studies within each group.
      Differences differentially related to the production of generalization are
      discussed and recommendations are provided to guide and support future research
      efforts.

PMID- 1634429
TI  - Social validation of component behaviors of following instructions, accepting
      criticism, and negotiating.
AB  - This study evaluated whether behaviors often taught as part of social skills
      training are judged favorably by others. Community judges evaluated the
      performances of people in various situations requiring one of three social
      skills: following instructions, accepting criticism, and negotiating to resolve
      conflicts. These skills were displayed in videotaped scenes by actors with and
      without mental retardation who acted out roles that had different types of
      authority relationships, and when different components or clusters of behavior
      (nonverbal, specific verbal, or general verbal behaviors) were performed well or
      poorly. The highest ratings by judges were of videotaped scenes that depicted
      correct use of all behaviors, regardless of which skill was being examined,
      whether or not the actor had mental retardation, or what the relationship was
      between the two actors. The lowest ratings were of videotaped scenes that
      depicted poor performance of all behaviors, and intermediate ratings were
      obtained when only some of the behaviors were performed poorly. These results, as
      well as the verbal responses of judges to questions, indicated that the different
      behaviors commonly used in teaching the skills of following instructions,
      accepting criticism, and negotiating are relevant to judgment of social
      performance, and are likely to be reinforced and maintained by social
      contingencies.

PMID- 1634431
TI  - On the relationship between self-injurious behavior and self-restraint.
AB  - Many individuals who exhibit self-injurious behavior (SIB) also exhibit self
      restraint. Three hypotheses about the determinants of self-restraint have been
      suggested: (a) Self-restraint is maintained by escape from or avoidance of
      aversive aspects of SIB, (b) self-restraint and SIB are members of the same
      functional class, and (c) self-restraint and SIB are functionally independent.
      This study examined a method by which the relationship between self-restraint and
      SIB may be investigated using functional analysis. Data were collected on the
      self-restraint and SIB exhibited by 5 mentally retarded males, while conditions
      suspected to maintain SIB were manipulated. Results suggested that self
      restraint, like SIB, may be maintained by idiosyncratic contingencies.
      Implications of an understanding of self-restraint for the analysis and treatment
      of SIB are discussed, as are some general possibilities for future research.

PMID- 1634432
TI  - Teaching children with autism appropriate play in unsupervised environments using
      a self-management treatment package.
AB  - The present study used a self-management treatment package to teach 3 children
      with autism, who exhibited inappropriate play behaviors, to play appropriately in
      the absence of a treatment provider. After self-management training,
      generalization and maintenance of the behavior change were assessed. Because of
      the detrimental effects of self-stimulation (arm flapping, spinning toys,
      twirling, etc.) on learning, the relationship between self-stimulatory behaviors
      and appropriate play was measured. Results indicated that the children learned to
      exhibit appropriate play skills in unsupervised settings, appropriate play skills
      generalized to new settings, and 2 of the children maintained their gains at 1
      month follow-up. In addition, self-stimulatory behaviors decreased as appropriate
      play increased. Treatment implications of these findings are discussed.

PMID- 1634433
TI  - Using stimulus equivalence procedures to teach name-face matching to adults with
      brain injuries.
AB  - On pretests, 3 men with brain injuries matched dictated names of three therapists
      to written names, but did not match dictated or written names to photos, produce
      correct names in response to photos, locate offices given written names, or name
      therapists on sight. Match-to-sample training established conditional relations
      between dictated names and photos. Posttests showed the emergence of untrained
      conditional relations involving photos and written names, indicating development
      of three classes of equivalent stimuli (each containing a dictated name, photo,
      and written name). For 1 participant, conditional relations involving photos of
      office nameplates were also examined, but did not emerge pre- or posttraining.
      Two participants produced names orally when given photos and sorted written names
      and faces together after training; the 3rd participant was unavailable for these
      posttests. After training, 1 participant located and named all three therapists
      in their offices.

PMID- 1634434
TI  - Promoting stimulus control with textual prompts and performance feedback for
      persons with mild disabilities.
AB  - We assessed whether written task analyses would serve as textual prompts for
      performing functional tasks by persons with mild disabilities. Several variables
      that could influence the effectiveness of textual prompts to promote stimulus
      control were examined across four groups. A consistent finding was that written
      specific task analyses combined with end-of-trial performance feedback were
      effective for promoting the acquisition and generalization of several tasks.
      Performance transferred immediately to natural discriminative stimuli when the
      written task analyses and feedback were withdrawn for most tasks and
      participants. For 2 participants, transfer of stimulus control was accomplished
      by prompt fading, using individualized written task analyses either with or
      without performance feedback (Group 1). When feedback was not provided, the
      effectiveness of written specific task analyses was inconsistent across groups.
      In contrast to the controlling effects of written specific task analyses, written
      generic task analyses, which specified only major task outcomes, when combined
      with performance feedback (Group 1) did not control responding. Overall, this
      research demonstrated the effectiveness of written specific task analyses and
      performance feedback to promote stimulus control for persons with mild
      disabilities.

PMID- 1634435
TI  - A comparison of two approaches for identifying reinforcers for persons with
      severe and profound disabilities.
AB  - The development of effective training programs for persons with profound mental
      retardation remains one of the greatest challenges for behavior analysts working
      in the field of developmental disabilities. One significant advancement for this
      population has been the reinforcer assessment procedure developed by Pace,
      Ivancic, Edwards, Iwata, and Page (1985), which involves repeatedly presenting a
      variety of stimuli to the client and then measuring approach behaviors to
      differentiate preferred from nonpreferred stimuli. One potential limitation of
      this procedure is that some clients consistently approach most or all of the
      stimuli on each presentation, making it difficult to differentiate among these
      stimuli. In this study, we used a concurrent operants paradigm to compare the
      Pace et al. (1985) procedure with a modified procedure wherein clients were
      presented with two stimuli simultaneously and were given access only to the first
      stimulus approached. The results revealed that this forced-choice stimulus
      preference assessment resulted in greater differentiation among stimuli and
      better predicted which stimuli would result in higher levels of responding when
      presented contingently in a concurrent operants paradigm.

PMID- 1634436
TI  - Fish cell lines as targets for bacterial cytotoxins.

PMID- 1634437
TI  - Heme-containing compounds replace chick embryo extract and enhance
      differentiation in avian muscle cell culture.

PMID- 1634438
TI  - Estrogen-dependent expression of the chicken very low density apolipoprotein II
      gene in serum-free cultures of LMH cells.
AB  - The estrogen-responsive Leghorn strain M chicken hepatoma (LMH) cell line
      provides a model system for studying the estrogen-dependent, liver-specific
      expression of avian genes. Serum-free culture conditions have been established
      that allow expression of apolipoprotein B, very low density apolipoprotein II
      (apoVLDLII), serum albumin, and transferrin at levels detectable by Northern blot
      analysis. Regulation of apoVLDLII mRNA by estrogen occurred in an appropriate
      time- and dose-dependent manner in serum-free cultures of the LMH cells. The
      expression of apoVLDLII mRNA in serum-free culture was at least 100-fold higher
      than that expressed in cultures containing 10% serum. The level of estrogen
      receptors in LMH cells cultured with 10% serum was approximately 2000 receptors
      per cell, and in serum-free culture approximately 1000 receptors per cell. When
      these cells were transfected with estrogen receptor DNA and cultured in serum
      free medium, apoVLDLII mRNA was decreased relative to that expressed in cells
      transfected with a control plasmid. These results indicate that when the LMH
      cells are cultured without serum, estrogen receptors are not the limiting factor
      for the expression of the apoVLDLII gene.

PMID- 1634439
TI  - Development and characterization of breast carcinoma cell lines as in vitro and
      in vivo models for breast cancer diagnosis and therapy.
AB  - To establish a model system for preclinical radioimmunotherapy studies, attempts
      were made to graft 16 different human breast carcinoma cell lines into BALB/c
      nu/nu(nude) mice. Nine produced serially transplantable tumors growing at a
      variable rate, whereas seven failed to do so. Conversely, three new cell lines
      were established in monolayer culture from transplantable human breast tumors in
      nude mice. Twelve selected tumors and their corresponding cell lines were
      characterized for DNA ploidy, % S-phase, and breast epithelial mucin expression
      by immunohistochemistry and flow cytometry. A wide diversity of these cellular
      characteristics were found in that each tumor was unique and distinct from the
      others. DNA ploidy differed among the tumors but was not affected by switching
      between in vitro to in vivo growth. Some tumors expressed similar levels of the
      breast mucin both in vitro and in vivo, whereas most expressed lower levels as
      transplantable tumors. There was a good correlation between immunohistochemical
      and flow cytometric determination of surface and cytoplasmic mucin expression,
      and with both techniques estrogen and progesterone receptor positive tumors had
      significantly higher levels of mucin expression than receptor negative tumors.
      These 12 transplantable breast tumors, with their corresponding cell lines,
      provide an excellent model system for testing radioimmunotherapy and other
      therapeutic reagents because they exhibit diverse phenotypic characteristics that
      represented a mini-population of breast cancer patients' tumors, allowing
      assessment of the effect of therapy when confronted with different breast tumors'
      genotype and phenotype.

PMID- 1634440
TI  - Role of endothelial cells in the proliferative response of cultured pulmonary
      vascular smooth muscle cells to reduced oxygen tension.
AB  - The development of pulmonary hypertension in a wide variety of human disease
      states and experimental animal models characterized by chronic alveolar hypoxia
      is mediated by two pathologic vascular processes, a) vasoconstriction and b)
      vasoconstruction (structural remodeling). The anatomic changes seen within the
      pulmonary circulation include a) increased deposition of collagen and elastin in
      the adventitial layer and b) aberrant pulmonary vascular smooth muscle cell
      proliferation and maturation in the medial segments. Despite the demonstrated
      ability of pharmacologic manipulation in the experimental animal to ameliorate
      both the structural and hemodynamic changes, the actual etiologic mechanisms are
      only beginning to be explored. Using the cell culture technique of co
      cultivation, we have investigated the potential role of bovine pulmonary arterial
      endothelial cell-derived factors in mediating abnormal bovine smooth muscle cell
      growth under conditions of reduced oxygen tension. We have demonstrated that
      these cultured endothelial cells exposed in vitro to reduced levels of
      atmospheric oxygen concentrations of 5.0% and 2.5% O2 for durations of 24 to 72 h
      produce and secrete soluble growth factor(s) which stimulate smooth muscle cell
      proliferation when compared to cells maintained under standard tissue culture
      oxygen conditions of 95% room air. This growth-stimulatory effect required the
      concomitant presence of serum factors (0.5% fetal bovine serum), was inhibited by
      heparin, was distinct from platelet-derived growth factor, and seemed to have a
      molecular weight greater than 14,000 Da. We conclude that reduced levels of
      oxygen tension in vitro can selectively induce pulmonary arterial endothelial
      cells to release mitogen(s) which can stimulate vascular smooth muscle
      replication. Furthermore, we speculate that this in vitro finding may be of
      importance as an etiologic mechanism to explain the accelerated smooth muscle
      cell growth characteristic of hypoxic pulmonary arteriopathy.

PMID- 1634441
TI  - 5,8,11,14-eicosatetraynoic acid-induced destruction of mitochondria in human
      prostate cells (PC-3).
AB  - Culturing human prostate PC-3 cells for 4, 24, or 72 h in the presence of
      5,8,11,14-eicosatetraynoic acid (ETYA), an inhibitor of arachidonic acid
      metabolism and cholesterol biosynthesis, markedly altered the morphology and
      reduced the number of mitochondria in the treated cells. Using quantitative
      electron microscopic morphometry, we documented changes in the number, form,
      area, matrix density, and integrity of the cristae and limiting membranes of
      mitochondria in cells cultured with ETYA. The inhibition of cholesterol synthesis
      or the substitution of ETYA for polyunsaturated fatty acids in the inner membrane
      may participate in the disruption of the mitochondria, which resembles the
      morphologic sequelae of oxidative stress. If sufficiently extensive, these
      changes could contribute to the inhibition of cellular proliferation by ETYA.

PMID- 1634442
TI  - Serum and insulin inhibit cell death induced by cycloheximide in the human breast
      cancer cell line MCF-7.
AB  - Continuous exposure of cells to cycloheximide (CHM) terminates in cell death.
      This may result from CHM's inhibition of protein synthesis. In the present study
      we investigated the effect of serum and insulin on cell death induced by CHM in
      the human breast cancer cell line MCF-7, and correlated this effect to the
      inhibition of protein synthesis. Cell death was evaluated by measuring either
      dead cells by the trypan blue dye exclusion test or by the release of lactic
      dehydrogenase into the culture medium. CHM (0.1 to 50 micrograms/ml) was shown to
      induce cell death in a time- and concentration-dependent manner. Including either
      fetal bovine serum or insulin in the culture medium inhibited this cell death in
      a concentration-dependent manner. Protein synthesis as measured by [3H]leucine
      incorporation was inhibited by the increasing concentration of CHM. However,
      fetal bovine serum and insulin did not alter the protein synthesis inhibition
      rate induced by CHM. These results indicate that inhibition of protein synthesis
      is not enough for cell death to proceed. Insulin or factors present in serum may
      stabilize some crucial cell proteins (key enzymes, cytoskeletal or membrane
      components) which are vital for cell life.

PMID- 1634443
TI  - Transforming growth factor-beta: its effect on phenotype reexpression by
      dedifferentiated chondrocytes in the presence and absence of osteogenin.
AB  - The single and combined actions of transforming growth factor (TGF)-beta and
      osteogenin were evaluated with regard to induction of colony formation and
      reexpression of the differentiated phenotype by dedifferentiated rabbit articular
      chondrocytes in soft agarose under serum-free conditions. TGF-beta alone did not
      promote colony formation and induced accumulation of proteoglycans and type II
      collagen at significantly lower levels than those induced by osteogenin. Although
      synergism between these two growth factors occurred with respect to the induction
      of colony formation, their joint action on reexpression of the differentiated
      phenotype was additive. Complex interactions between the two growth factors may
      explain the latter phenomenon.

PMID- 1634444
TI  - Thymidine kinase-deficient mutants of Aedes albopictus mosquito cells.
AB  - Aedes albopictus mosquito cells resistant to the thymidine analog 5
      bromodeoxyuridine (BrdU) were obtained using a single-step selection procedure.
      The resistant cells were characterized with respect to growth in the presence of
      BrdU, incorporation of [3H]uridine and [3H]thymidine, and thymidine kinase
      activity in crude extracts. The LC50 for TK-6 cells was 95 micrograms BrdU/ml,
      and for TK-8 cells was 45 micrograms/ml. Both clones incorporated [3H]uridine at
      levels corresponding to those in wild-type cells. TK-6 and TK-8 cells did not
      incorporate [3H]thymidine into acid-precipitable material, nor did they contain
      measurable thymidine kinase activity. Thymidine kinase activity in crude extracts
      from wild-type cells had a Km of 2 microM and a Vmax of 10 pmol.min-1.mg-1
      protein.

PMID- 1634445
TI  - Cryopreservative effect of leupeptin on early human bone marrow progenitors.
AB  - Leupeptin, a thiol- and serine-proteinase inhibitor of low molecular weight,
      quickly enters viable cells. This property has been used to protect cells during
      thawing against intracellular proteolytic activities released by injured
      lysosomes. The bone marrow nucleated cells were frozen without rate-controlled
      freezing devices. Concentrations ranging from 0.1 to 1 microM of leupeptin allow
      to recover 87% of the most immature multipotent bone marrow progenitors which can
      develop in vitro into large multilineage colonies, instead of 58% recovery
      without leupeptin. The protective effect of leupeptin is particularly useful to
      freeze cells difficult to cryopreserve or when freezing-control equipment are not
      available.

PMID- 1634446
TI  - Exercise-induced asthma in the Olympic athlete.

PMID- 1634447
TI  - Importance of physical exercise training in asthmatics [see comment].

PMID- 1634448
TI  - Plasma theophylline concentrations and airway function in asthmatic children
      receiving standard and modified RTC therapy.
AB  - The effects of three different dosage schedules for sustained-release
      theophylline (Theolong) were investigated in children with asthma. With regimen
      II (unequal doses at 0800 h and 2000 h), the maximum plasma theophylline
      concentration following the evening dose was significantly higher than that
      following the morning dose, and also was larger than that following the evening
      dose with regimen I (equal doses at 0800 and 2000 h). With regimen III (equal
      doses at 0600 h and 2100 h), the mean theophylline concentration-time curve
      showed a single large peak at 1100 h, whereas with regimen I, there were two
      peaks at 2300 and at 1400 h. Knowledge that a change of the dosage schedule can
      affect the pharmacokinetics of theophylline in this way should aid physicians in
      its safe and effective use.

PMID- 1634449
TI  - Effect of ibudilast: a novel antiasthmatic agent, on airway hypersensitivity in
      bronchial asthma.
AB  - Ibudilast, a unique agent with vasodilating and antiallergic actions, was studied
      in 13 asthmatics for its effect on airway hypersensitivity to histamine
      inhalation. The PC20 values improved significantly from 355.6 to 620.5
      micrograms/ml at 3 months and further to 731.4 micrograms/ml at 6 months
      following the initial treatment with ibudilast (20 mg twice daily orally). In
      addition, the severity of the attacks decreased significantly. Improvements in
      the PC20 and asthmatic symptoms also were observed in the disodium chromoglycate
      group, but these were equal to or lesser than those in the ibudilast group. No
      improvement was observed in the untreated control group. These results suggest
      that ibudilast would be an effective agent for improving nonspecific airway
      hypersensitivity in asthmatics.

PMID- 1634450
TI  - Asthma and the use of CNS depressants: gender differences.
AB  - A retrospective 5-year random sample of 196 charts of patients with asthma was
      obtained from two hospital-based outpatient clinics. The chart reviews showed
      that age- and severity-matched males and females with asthma were prescribed
      antihistamines in similar proportions; however, 16.8% of the females were
      prescribed a tranquilizer or sedative compared with 8.5% of the males. The
      females (8.7%) also were prescribed a combination of these drugs, or two
      tranquilizers; none of the males were prescribed more than one CNS depressant.
      Results showed that, in this study, females were prescribed CNS depressants three
      times as often as males.

PMID- 1634451
TI  - Passive smoking among children with chronic respiratory disease.
AB  - The purpose of this study was to determine the prevalence and source of passive
      smoke exposure among children with chronic respiratory diseases and compare these
      to both a well child and nonrespiratory chronic illness child population. Rates
      and source of passive smoke exposure were compared among four child groups:
      asthma, cystic fibrosis, rheumatoid arthritis, and well children using a
      questionnaire mailed to the parents of the selected children. Twenty percent of
      respondents reported current smoking with a significantly higher rate among the
      cystic fibrosis and rheumatoid arthritis groups. One-third of all children
      surveyed were exposed to passive smoke at home and/or day care on a daily basis.
      Over 80% of the asthma and cystic fibrosis respondents reported a change in
      smoking behavior (i.e., smoking outside the home or smoking fewer cigarettes)
      after the diagnosis of their child's illness as compared with only 40% of the
      nonrespiratory groups. Health care providers need to inquire about potential
      sources of passive smoke exposure in their patients, particularly children with
      chronic respiratory disease.

PMID- 1634452
TI  - Evaluation of a once-a-day theophylline preparation in asthmatic children.
AB  - We conducted a study to evaluate the serum theophylline concentrations and dose
      interval of Theolan preparation in asthmatic children. A series of serum
      theophylline levels were measured both in 10 asthmatic children taking Theolan
      once a day and 9 children twice a day. In the once-a-day group, the peak serum
      theophylline level was greater than 20 micrograms/ml; whereas, in the twice-a-day
      group, it was mostly between 10 and 20 micrograms/ml. The difference of the peak
      to-trough was more fluctuant in the once-a-day group than in the twice-a-day
      group. These results suggest that Theolan given once a day in the evening can be
      useful in the management of nocturnal asthma; however, it was difficult for once
      a-day administration of Theolan to sustain rigid therapeutic serum theophylline
      levels. Because of rapid metabolism in children, they may require a more frequent
      interval than once-a-day dosing to suppress the symptoms of chronic asthma.

PMID- 1634453
TI  - Acquired coagulation factor inhibitors.

PMID- 1634454
TI  - Erythrocytic glucose-6-phosphate dehydrogenase deficiency in the Bania community
      of Punjab.
AB  - Five hundred members belonging to the Bania community of Punjab were screened for
      erythrocytic glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. The incidence
      of enzyme deficiency in males was 2.84 per cent and in females 2.75 per cent,
      with an overall incidence of 2.80 per cent. No correlation between age and G-6-PD
      deficiency was found. The mean values for haemoglobin and haematocrit did not
      differ significantly in the normal and deficient subjects. Study of the
      deficiency pattern amongst family members of the enzyme deficient subjects
      confirmed the X-linked inheritance of G-6-PD deficiency.

PMID- 1634455
TI  - Evaluation of purified protein derivative in the laboratory diagnosis of
      tuberculous meningitis.
AB  - An enzyme-linked immunosorbent assay (ELISA) was standardised for the
      quantitation of IgG antibody in cerebrospinal fluid (CSF) specimens of patients
      with tuberculous meningitis (TBM). Purified protein derivative (PPD1) from H37Ra
      M tuberculosis was used as the antigen in the assay. The sensitivity of the ELISA
      with this antigen was evaluated in the CSF of 10 culture positive and 40 culture
      negative patients with TBM. The specificity of the assay was evaluated in the CSF
      of 50 patients with non-tuberculous neurological diseases (control group). The
      results obtained with this antigen were compared with commercially available
      tuberculin purified protein derivative (PPD2) and BCG antigens. PPD2 gave false
      negative results (50%) in culture positive patients with TBM, and BCG antigen
      gave false positive results in 32% of non-tuberculous subjects. PPD1 gave a
      sensitivity of 60% in culture negative patients with TBM and no false positive
      reactions in the non-tuberculous group. PPD1 antigen, in contrast to other
      mycobacterial antigens, can be very easily prepared in any routine laboratory,
      and this antigen is recommended for use as an aid in the laboratory diagnosis of
      TBM, particularly in culture negative patients with TBM.

PMID- 1634456
TI  - Infections in acute myeloid leukemia. Study of 184 febrile episodes.
AB  - We analysed the case records of 75 patients with acute myeloid leukaemia treated
      at our institute from January 1984 to December 1988 to see the pattern and
      severity of infections and their relationship with granulocytopenia. A total of
      184 febrile episodes (mean 2.45) were recorded; 153 (83.15%) were associated with
      granulocytopenia while 31 (16.84%) were without granulocytopenia. Among
      granulocytopenic patients, infections could be documented microbiologically in
      58.2% and clinically in 30.0% of episodes. In the remaining 41.8% of episodes, no
      clinical, radiological or microbiological evidence could be found out. The
      various sites of infection were: septicaemia 21 (13.72%), disseminated fungal
      infections 4 (2.6%), upper respiratory tract 21 (13.7%), chest 58 (37.9%),
      gastrointestinal tract 8 (5.2%), genitourinary (7.2%), soft tissues 5 (3.2%) and
      skin cellulitis 7 (4.6%). Microbiologically, gram negative organisms (Klebsiella
      pneumoniae, E coli, Pseudomonas aeruginosa) were most common, followed by gram
      positive (Streptococcal faecalis, Staphylococcus aureus, Staph albus, Staph
      epidermidis). Four patients had disseminated fungal infection: candida 2,
      aspergillus *1, mucormycosis *1. Among non neutropenic febrile episodes, the
      sites infected were: septicemia 2 (6.4%), chest 9(29.0%), upper respiratory tract
      1 (3.2%), gastrointestinal 1 (3.2%), soft tissue 1 (3.2%), drug fever 3 (9.6%)
      and fever of unknown origin 14 (45.2%).

PMID- 1634457
TI  - Extrathoracic Castleman's disease.
AB  - Castleman's disease is an uncommon clinical entity. We report two cases of this
      disease with a brief review of literature. Both of them had extrathoracic disease
      which is relatively infrequent. One of them presented with localized hyaline
      vascular type of the disease and the other with the multicentric plasmacytic
      variety. The patient with the latter form of Castleman's disease had
      sclerodactyly, which has not been reported earlier in association with this
      disease.

PMID- 1634458
TI  - Hepatic changes during short-term haemodialysis.
AB  - Twenty five patients with end stage renal disease were studied to find out the
      biochemical and hepatic morphological changes during short term haemodialysis.
      Asymptomatic hepatomegaly was seen in 32% of cases, transaminase elevation in 28%
      and positive Australia antigen in 12% of cases. Histopathological changes were
      observed in all the 12 patients in whom liver biopsy was done. Ten patients (82%)
      exhibited multiple abnormalities. The commonest findings were fatty change (8
      patients); hepatic congestion, focal necrosis, Kupffer cell hyperplasia (6
      patients each); and portal triaditis (5 patients).

PMID- 1634459
TI  - Cutaneous metastasis in lung cancer.

PMID- 1634460
TI  - Basic concepts of clinical pharmacokinetics.
AB  - Clinical pharmacology is now a well established discipline. Unlike the yester
      years when dosage schedules were determined by trial and error, in the present
      day selection of dose, dosage interval and route of administration are based on
      pharmacokinetic and pharmacodynamic principles. The primary utility of
      pharmacokinetics is to study the process of absorption, distribution, metabolism
      and elimination of drugs, fundamental for drug action. Individuals show a wide
      variation in kinetic parameters due to internal and external factors. Sometimes
      change in one variable may be compensated by change in another variable so that
      dose need not be altered e.g. metabolism of some drugs is increased in
      thyrotoxicosis but due to increased protein binding overall dose adjustment may
      not be required. On the other hand sometimes variations in these parameters can
      markedly affect the plasma concentrations of and the pharmacological response to
      drugs e.g. anticonvulsant treatment in oral contraceptive users, phenylbutazone
      addition in warfarin therapy. Drug concentrations can be measured in plasma,
      urine or saliva. Equipped with this knowledge the modern physician will be able
      to make a wiser use of drugs under altered physiological conditions like
      pregnancy, lactation, infancy, old age and pathological states like renal and
      liver failure and shock.

PMID- 1634461
TI  - Infections in acute leukaemia.

PMID- 1634462
TI  - Aortic saddle embolus.

PMID- 1634464
TI  - Factor VII inhibitor.
AB  - Acquired inhibitors of blood coagulation factors occur spontaneously or
      secondarily to various diseases or drug administration. A clinically significant
      factor VII inhibitor is very rare. We report a patient developing factor VII
      inhibitor possibly as a reaction to penicillin administration; it gave rise to
      fatal haemorrhage.

PMID- 1634463
TI  - Treatment of anaemia of progressive renal failure with recombinant human
      erythropoietin. A preliminary report.
AB  - We report response in anaemia and wellbeing of a lady with chronic renal disease
      treated with recombinant human erythropoietin 5000 units thrice weekly. Without
      any blood transfusions, the patient's haematocrit improved (20% to 35%) and a
      subjective improvement in wellbeing and appetite was noted. This drug seems to be
      a breakthrough in the management of anaemia of chronic renal diseases, including
      end stage renal disease, avoiding the risks of repeated blood transfusions.

PMID- 1634465
TI  - Herpes zoster oticus associated with facial, auditory and trigeminal involvement.
AB  - We report a case of herpes zoster oticus with involvement of the mandibular
      division of the trigeminal nerve and loss of taste sensation in the anterior two
      third of the tongue. Infranuclear facial palsy and sensorineural deafness were
      also present.

PMID- 1634466
TI  - Cutaneous anthrax--a report of ten cases.
AB  - The clinical features of ten cases of cutaneous anthrax are reported. Six males
      and four females were affected. Their ages ranged from one and a half year to
      sixty years. The average incubation period was 8 days. Fever and headache were
      common systemic manifestations. Pruritus and ulcer with formation of black eschar
      were typical features. The patients were treated with penicillins and
      chloramphenicol. There was no mortality. Possible human-to-human spread in a
      patient is discussed.

PMID- 1634467
TI  - Thin membrane nephropathy.

PMID- 1634468
TI  - Granulocytic sarcoma of the paranasal sinus.
AB  - We describe a young adult male with granulocytic sarcoma of the paranasal sinuses
      and nose with acute non-lymphoblastic leukaemia. Complete remission was achieved
      after systemic chemotherapy and localised radiation therapy. The patient died
      four months later due to disseminated aspergillosis.

PMID- 1634469
TI  - Right ventricular mural infective endocarditis in a patient with burns.
AB  - An individual who had sustained 43% burns and then developed blood culture
      negative right ventricular infective endocarditis and right basal segmental
      pulmonary infarction is reported. Echocardiography detected vegetations in the
      mid right ventricle. The patient had a central venous catheter in situ during the
      initial stage of management of burns. Following therapy, he recovered
      uneventfully from his extremely toxic and febrile state.

PMID- 1634470
TI  - Progressive dystonia with marked diurnal fluctuation.
AB  - Two cases of dopa-responsive dystonia with marked diurnal fluctuations are
      reported. Of these, one was a 26 year old female who had progressive dystonia of
      more than 20 years' duration with classical diurnal fluctuations exacerbated by
      exercise and relieved with sleep; she also had significant worsening during
      menstruation and the later half of her pregnancy, resulting in a stillbirth. She
      responded remarkably to low doses of L-dopa.

PMID- 1634471
TI  - The puzzle which is pyrexia of undetermined origin.

PMID- 1634472
TI  - Miosis with haloperidol.

PMID- 1634473
TI  - Erythropoietin: a therapeutic tool.

PMID- 1634474
TI  - Male infertility.

PMID- 1634475
TI  - Aetiologic factors in male infertility: clinical, microbiological and hormonal
      evaluation.
AB  - Seventy two infertile men were studied. History of small pox and mumps infection
      was noted in 4 and 3 patients respectively. Seven patients had varicocele (9.2%),
      and small atrophic testes were found in 9 (12.5%). Azoospermia was reported in 41
      (58.3%) and oligospermia in 17 (23.6%), and 14 patients (19.4%) had normal sperm
      counts. Mycoplasma were grown from urethral swabs in 25 (35%) patients. Mean LH
      and FSH were elevated in azoospermics (p less than 0.001), E2-17B in
      oligospermics (p less than 0.001) and FSH in normospermic (p less than 0.01)
      patients. Hypergonadotropism suggestive of primary testicular failure was
      recorded in 43 (59.7%) patients. Hypogonadotropism was noted in 3 (4%) and
      hyperprolactinemia due to pituitary microadenoma induced infertility in only one
      patient. No aetiology could be determined in 11 (16%) patients.

PMID- 1634476
TI  - Platelet aggregation in migraine.
AB  - This study was conducted on forty male patients aged 17-35 years, suffering from
      migraine. Platelet aggregation was evaluated in them twice, once in the aura and
      headache phase of migraine and the other during the period in which patient was
      asymptomatic. We observed significant increase in platelet aggregation during the
      aura and headache phase of the migrainous attack in comparison to the headache
      free interval. Platelet hyperaggregability may be an important factor in the
      pathogenesis of migraine.

PMID- 1634477
TI  - Thyroid morphometry and intrathyroidal 131-I iodine transit kinetics in Kashmiri
      population.
AB  - Morphometric--kinetic parameters of the thyroid gland in the Kashmiri population,
      which is geographically, environmentally, socioculturally, anthropologically and
      ethnically different from that of the main country (Indian republic), have been
      analysed. Morphometrically, the gland in this population has been found to be
      significantly larger (p less than 0.001), while kinetically, the A max which is
      the ordinate-extrapolate of the best-fit RAIU(t) curve, has been found to be
      significantly lower (p less than 0.01). The majority of other structural and
      functional parameters were similar to those of the north Indian population.

PMID- 1634478
TI  - Adenosine deaminase in pleural effusions.
AB  - The serum adenosine deaminase (ADA) level was estimated in 30 patients with
      pleural effusion and 18 healthy controls and was found to be significantly
      elevated in the former (P less than 0.001). The pleural fluid ADA level in
      tubercular pleural effusion was always above 50 U/L and was significantly higher
      than in nontubercular effusions (P less than 0.001). Pleural fluid ADA to serum
      ADA ratio was not helpful in the aetiologic diagnosis of pleural effusions. Thus,
      estimation of pleural fluid ADA is a safe, simple, reliable and non-invasive test
      in distinguishing tubercular and non-tubercular pleural effusions.

PMID- 1634480
TI  - A comparison of the clinical efficacy of ranitidine and sucralfate in reflux
      oesophagitis.
AB  - Forty patients with endoscopically proved reflux oesophagitis were treated in a
      randomised study. Treatment was given for six weeks and consisted of either 1 g
      sucralfate four times a day or 150 mg ranitidine tablet twice daily. Twenty
      patients received each drug. Clinical evaluation was done weekly and endoscopic
      evaluation after six weeks. Eight patients on ranitidine and ten patients on
      sucralfate became asymptomatic at six weeks. Ten patients on ranitidine and
      twelve patients on sucralfate were endoscopically healed. There was no difference
      in the effect of ranitidine and sucralfate treatment (p greater than 0.05).
      Overall tolerance and compliance with the two forms of treatment were good.
      Though ranitidine has a more convenient dose schedule and is more cost-effective,
      sucralfate needs further clinical evaluation.

PMID- 1634479
TI  - Alpha-interferon in hairy cell leukemia: an initial Indian experience.
AB  - In the last decade, 14 patients were diagnosed as having hairy cell leukemia
      (HCL) at our hospital; five of these were treated with the biological response
      modifier, recombinant alpha-interferon (IFN), as their initial treatment. Four of
      these cases showed a complete remission of the disease while one had a good
      partial response after a few months of therapy. One case is in unmaintained
      remission while one has relapsed with a just palpable spleen on stopping the
      drug; two are still on intermittent IFN therapy while one has been lost to follow
      up. Fever and skin rash were the most common side effects observed but did not
      warrant reduction of dose or stoppage of treatment. We conclude that IFN is
      highly effective and well tolerated as initial treatment of HCL in a country like
      India. Splenectomy will continue to be the first line therapy in the majority of
      cases but, in certain selected situations, IFN can be an extremely useful
      alternative.

PMID- 1634481
TI  - Acute Campylobacter jejuni enteritis in 385 hospitalised patients.
AB  - Twenty healthy controls and 385 adult patients suffering from acute enteritis or
      gastroenteritis were enrolled for the study of Campylobacter Jejuni infection
      over a period of 2 years. Thirty five stool samples showed C jejuni on stool
      culture. The isolation rates were at peak in the monsoon season and from watery
      and bloody stool specimens. Pure C jejuni culture was obtained in 18 of 35
      samples; the other 17 samples showed polymicrobial infection or infestation. Nine
      of 35 patients were treated with erythromycin 1 g in divided doses for 7 days.
      Repeat stool cultures did not grow C jejuni. There was no resistance to
      erythromycin therapy. C jejuni are fastidious organisms and require special
      medium and microaerophilic environment for culture.

PMID- 1634482
TI  - Cytokines in rheumatic diseases.

PMID- 1634483
TI  - Chloramphenicol and ciprofloxacin in enteric fever--cost-effectiveness.
AB  - Clinical decision analysis is a technique which is used to deal with
      uncertainities in clinical medicine. We used this technique to compare the cost
      effectiveness of chloramphenicol and ciprofloxacin in the treatment of enteric
      fever. The study shows that the most economical alternative can be predicted if
      the cost of hospital stay and the sensitivity of the organism to chloramphenicol
      are known. Thus if the hospital costs are Rs 50/- per day, chloramphenicol will
      be the drug of choice if more than 52% of the organisms are sensitive to the
      drug. At lower levels of sensitivity to chloramphenicol, ciprofloxacin will be
      the drug of choice.

PMID- 1634484
TI  - Influence of prior information of drug toxicity on patient compliance.
AB  - Sixty patients with pulmonary tuberculosis, who had not received any chemotherapy
      in the past, were divided into two groups. All the patients were put on
      isoniazid, rifampicin and pyrazinamide for 8 weeks followed by isoniazid and
      rifampicin for another 18 weeks. Group A patients were informed of the likely
      occurrence of anorexia and/or vomiting but Group B patients were not. Routine and
      default retrieval home visits were given to ensure maximal drug compliance. Drug
      toxicity related early defaults were significantly less common in Group A
      patients (1 of 30) as compared to Group B (6 of 30).

PMID- 1634485
TI  - Acupuncture--a critical evaluation.
AB  - Acupuncture is a traditional form of Chinese medicine which has been in practice
      for over 3000 years. It was not accepted in the West mainly due to cultural
      barriers. However, research during the last decade has established the
      physiological basis of acupuncture. Although it is mainly used for chronic
      musculoskeletal pain in the West, it also has a place in the treatment of various
      non-painful disorders like bronchial asthma, alcohol and nicotine addiction and
      functional gastrointestinal disorders. Controlled trials published in the
      literature have many methodological flaws, and these can be rectified by
      standardisation of acupuncture technique. Since traditional Chinese medicine and
      Western medicine differ in their concepts of anatomy, physiology and systems of
      diagnosis, it is not possible to reconcile them into a common language. However,
      it is possible for them to co-exist.

PMID- 1634486
TI  - Diarrhoeal diseases in Calcutta.

PMID- 1634487
TI  - Spontaneous left ventricle cavity thrombus in a patient of systemic lupus
      erythematosus.
AB  - A 32 year old female with systemic lupus erythematosus having circulating lupus
      anticoagulant developed a thrombus in the left ventricle cavity, an unusual site.
      She responded to standard anticoagulant regime.

PMID- 1634488
TI  - Giant epithelioid leiomyoblastoma of the stomach--a diagnostic dilemma.
AB  - Epithelioid leiomyoblastoma (ELB) of the stomach is an uncommon slow growing
      smooth muscle tumour, attaining enormous size and presenting with bizzare
      symptoms. We report one such case which posed a diagnostic problem to both the
      clinician and the radiologist; the condition was diagnosed after laparotomy and
      histological examination.

PMID- 1634489
TI  - Visceral larva migrans in an adult.
AB  - Visceral larva migrans is rare in adults. An adult male in whom the diagnosis was
      made by suggestive clinical features and muscle biopsy and who responded to
      thiabendazole is described.

PMID- 1634490
TI  - Primary amoebic lung abscess.

PMID- 1634491
TI  - Herpes zoster associated encephalitis.
AB  - Herpes zoster associated encephalitis is a very rare complication of herpes
      zoster. We are reporting a young healthy man who developed this complication
      along with the usual cutaneous presentation of herpes zoster. He was successfully
      treated with acyclovir.

PMID- 1634492
TI  - Congenital hemihypertrophy with mental retardation.

PMID- 1634493
TI  - Atropine infusion in organophosphorus poisoning.

PMID- 1634494
TI  - Ataxia telangiectasia.

PMID- 1634495
TI  - Renal involvement in leprosy.

PMID- 1634496
TI  - Chloramphenicol-resistant enteric fever.

PMID- 1634497
TI  - Intravenous magnesium in acute myocardial infarction.

PMID- 1634498
TI  - Thrombolysis in myocardial infarction--for whom?

PMID- 1634499
TI  - Viral encephalitis--overdiagnosed, undertreated.

PMID- 1634500
TI  - Genesis of thalassaemia intermedia.

PMID- 1634501
TI  - Pigmentation following cyclophosphamide therapy.

PMID- 1634502
TI  - Global headache in angina pectoris.

PMID- 1634503
TI  - Alpha: the Cinderella subunit of RNA polymerase.

PMID- 1634504
TI  - Fructose transporter in human spermatozoa and small intestine is GLUT5.
AB  - We recently reported that the glucose transporter isoform, GLUT5, is expressed on
      the brush border membrane of human small intestinal enterocytes (Davidson, N. O.,
      Hausman, A. M. L., Ifkovits, C. A., Buse, J. B., Gould, G. W., Burant, C. F., and
      Bell, G. I. (1992) Am. J. Physiol. 262, C795-C800). To define its role in sugar
      transport, human GLUT5 was expressed in Xenopus oocytes and its substrate
      specificity and kinetic properties determined. GLUT5 exhibits selectivity for
      fructose transport, as determined by inhibition studies, with a Km of 6 mM. In
      addition, fructose transport by GLUT5 is not inhibited by cytochalasin B, a
      competitive inhibitor of facilitative glucose transporters. RNA and protein
      blotting studies showed the presence of high levels of GLUT5 mRNA and protein in
      human testis and spermatozoa, and immunocytochemical studies localize GLUT5 to
      the plasma membrane of mature spermatids and spermatozoa. The biochemical
      properties and tissue distribution of GLUT5 are consistent with a physiological
      role for this protein as a fructose transporter.

PMID- 1634505
TI  - Lipopolysaccharide priming of alveolar macrophages for enhanced synthesis of
      prostanoids involves induction of a novel prostaglandin H synthase.
AB  - We report here that lipopolysaccharide (LPS) priming of rabbit alveolar
      macrophages leads to amplified synthesis of prostanoids, at least in part, by
      induction of a novel prostaglandin H synthase (PGH synthase). Rabbit alveolar
      macrophages were cultured with or without added LPS derived from Escherichia coli
      0111:B4 for 4 h and then stimulated with opsonized zymosan (OPZ). LPS priming of
      alveolar macrophages resulted in enhanced release of thromboxane (TX) upon
      stimulation with OPZ, when compared to stimulated non-LPS controls. Addition of
      exogenous arachidonic acid to LPS-primed alveolar macrophages also resulted in
      increased production of TX. The LPS-induced increase in TX formation, in response
      to OPZ or arachidonic acid, was abolished by the addition of actinomycin D or
      cycloheximide during the priming period. Gas chromatography/mass spectrometry
      analysis indicated that levels of prostaglandins D2, E2, and F2 alpha, along with
      TX, were augmented in stimulated LPS-primed alveolar macrophages, implicating PGH
      synthase in the priming process. PGH synthase enzymatic activity, as determined
      by addition of arachidonic acid to macrophage sonicates, was markedly enhanced in
      LPS-primed alveolar macrophages. This correlated with increased PGH synthase
      levels detected by immunoprecipitation of 35S-labeled proteins and by Western
      blot analysis. Finally, Northern blot analysis using a cDNA probe to the recently
      described mitogen-inducible mouse PGH synthase revealed strong induction of
      approximately 4.3-kilobase mRNA in LPS-primed alveolar macrophages. Taken
      together, these results reveal that induction of a novel PGH synthase, probably
      the rabbit homologue of PGH synthase-2, plays a role in the enhanced synthesis of
      prostanoids by LPS-primed alveolar macrophages.

PMID- 1634507
TI  - Synthesis of platelet-activating factor by polymorphonuclear neutrophils
      stimulated with interleukin-8.
AB  - Human interleukin-8 (IL-8) was evaluated for its capability to induce the
      synthesis and release of platelet-activating factor (PAF) from human
      polymorphonuclear neutrophils (PMN). IL-8 promotes in a dose-dependent fashion (1
      100 ng/ml) a rapid synthesis of PAF, which is only partially released. The
      synthesis of PAF is preceded by the activation of acetyl-CoA: 1-alkyl-2-lyso-sn
      glycero-3-phosphocholine acetyl-transferase, suggesting that IL-8 activates the
      "remodeling pathway" of PAF synthesis. By thin layer chromatography and reverse
      phase high pressure liquid chromatography, we demonstrated that PAF synthesized
      by human PMN stimulated with IL-8 is heterogeneous: the 2-acetylated
      phospholipids having the biological and physicochemical characteristics of PAF
      include the 1-O-alkyl form, which is produced in large extent (51%), and the 1
      acyl form (20%). The analysis of the individual molecular species of radyl chain
      indicated nine peaks, 16:0 and 18:0 being the predominant forms. These results
      identify PAF as a direct product of IL-8 stimulation in PMN.

PMID- 1634506
TI  - Serine regulates phosphatidylethanolamine biosynthesis in the hamster heart.
AB  - The role of serine as a precursor and metabolic regulator for
      phosphatidylethanolamine biosynthesis in the hamster heart was investigated.
      Hearts were perfused with 50 microM [1-3H]ethanolamine in the presence or absence
      of serine for up to 60 min. Ethanolamine uptake was attenuated by 0.05-10 mM
      serine in a noncompetitive manner, and the incorporation of labeled ethanolamine
      into phosphatidylethanolamine was also inhibited by serine. Analysis of the
      ethanolamine-containing metabolites in the CDP-ethanolamine pathway revealed that
      the conversion of ethanolamine to phosphoethanolamine was reduced. The reduction
      was a result of an inhibition of ethanolamine kinase activity by an elevated pool
      of intracellular serine. Perfusion of the heart with 1 mM serine caused a 5-fold
      increase in intracellular serine pool. In order to examine the action of serine
      on other phosphatidylethanolamine metabolic pathways, hearts were perfused with
      [1-3H]glycerol in the presence and absence of serine. Serine did not cause any
      enhancement of phosphatidylethanolamine hydrolysis. The base-exchange reaction
      for phosphatidylserine formation or the decarboxylation of phosphatidylserine was
      not affected by serine perfusion. We conclude that circulating serine plays an
      important role in the modulation of phosphatidylethanolamine biosynthesis via the
      CDP-ethanolamine pathway in the hamster heart but does not affect the
      contribution of the decarboxylase pathway for phosphatidylethanolamine formation.

PMID- 1634508
TI  - Functional interactions of stimulatory and inhibitory GDP/GTP exchange proteins
      and their common substrate small GTP-binding protein.
AB  - smg GDS and rho GDI are stimulatory and inhibitory GDP/GTP exchange proteins,
      respectively, for a group of ras p21-related small GTP-binding proteins (G
      proteins). rho p21 is a common substrate small G protein for both GDP/GTP
      exchange proteins. We examined here the functional interactions of these GDP/GTP
      exchange proteins with rho p21 as a substrate. smg GDS and rho GDI interacted
      with the GDP-bound form of rho p21 and thereby stimulated and inhibited,
      respectively, the dissociation of GDP. The inhibitory effect of rho GDI was much
      stronger than the stimulatory effect of smg GDS. The GDP-bound form of rho p21
      formed a complex with rho GDI but not with smg GDS in their simultaneous
      presence. Since the content of smg GDS was generally less than that of rho GDI in
      cells, these results suggest that there is some mechanism to release the
      inhibitory action of rho GDI and to make rho p21 sensitive to the smg GDS action
      during the conversion of rhoA p21 from the GDP-bound inactive form to the GTP
      bound active form in intact cells. On the other hand, rho p21 was previously
      shown to be ADP-ribosylated by bacterial ADP-ribosyltransferases, named C3 and
      EDIN, at Asn41 in the putative effector region of rho p21. This ADP-ribosylation
      was inhibited by rho GDI much more efficiently than by smg GDS. These results
      suggest that rho GDI may mask the putative effector region of rho p21 and thereby
      inhibit its interaction with the target protein even in the presence of smg GDS.
      Thus, both smg GDS and rho GDI are important to regulate the rho p21 activity and
      action in cooperation with each other.

PMID- 1634509
TI  - S(T)PXX motifs promote the interaction between the extended N-terminal tails of
      histone H2B with "linker" DNA.
AB  - The assembly of hybrid core particles onto long chicken DNA with histone H2B in
      the chicken histone octamer replaced with either wheat histone H2B(2) or sea
      urchin sperm histone H2B(1) or H2B(2) is described. All these histone H2B
      variants have N-terminal extensions of between 18 and 20 amino acids, although
      only those from sea urchin sperm have S(T)PXX motifs present. Whereas chicken
      histone octamers protected 167 base pairs (bp) (representing two full turns) of
      DNA against micrococcal nuclease digestion (Lindsey, G. G., Orgeig, S., Thompson,
      P., Davies, N., and Maeder, D. L. (1991) J. Mol. Biol. 218, 805-813), all the
      hybrid histone octamers protected an additional 17-bp DNA against nuclease
      digestion. This protection was more marked in the case of hybrid octamers
      containing sea urchin sperm histone H2B variants and similar to that described
      previously (Lindsey, G. G., Orgeig, S., Thompson, P., Davies, N., and Maeder, D.
      L. (1991) J. Mol. Biol. 218, 805-813) for hybrid histone octamers containing
      wheat histone H2A variants all of which also have S(T)PXX motifs present.
      Continued micrococcal nuclease digestion reduced the length of DNA associated
      with the core particle via 172-, 162-, and 152-bp intermediates until the 146-bp
      core particle was obtained. These DNA lengths were approximately 5 bp or half a
      helical turn longer than those reported previously for stripped chicken chromatin
      and for core particles containing histone octamers reconstituted using "normal"
      length histone H2B variants. This protection pattern was also found in stripped
      sea urchin sperm chromatin, demonstrating that the assembly/digestion methodology
      reflects the in vivo situation. The interaction between the N-terminal histone
      H2B extension and DNA of the "linker" region was confirmed by demonstrating that
      stripped sea urchin sperm chromatin precipitated between 120 and 500 mM NaCl in a
      manner analogous to unstripped chromatin whereas stripped chicken chromatin did
      not. Tryptic digestion to remove all the histone tails abolished this
      precipitation as well as the protection of DNA outside of the 167-bp core
      particle against nuclease digestion.

PMID- 1634510
TI  - Processing of proinsulin by transfected hepatoma (FAO) cells.
AB  - Rat hepatoma (FAO) cells were stably transfected with the gene encoding either
      rat proinsulin II (using the DOL retroviral vector) or human proinsulin (using
      the RSV retroviral vector). Using the DOL vector, production of insulin
      immunoreactive material was stimulated up to 30-fold by dexamethasone (5 x 10(-7)
      M). For both proinsulins, fractional release of immunoreactive material relative
      to cellular content was high, in keeping with the absence of any storage
      compartment for secretory proteins in these cells. Pulse-chase experiments showed
      kinetics of release of newly synthesized products in keeping with release via the
      constitutive pathway. High performance liquid chromatography analysis showed
      immunoreactivity in the medium distributed between three peaks. For rat
      proinsulin II, the first coeluted with intact proinsulin; the second coeluted
      with des-64,65 split proinsulin (the product of endoproteolytic attack between
      the insulin A-chain and C-peptide followed by trimming of C-terminal basic
      residues by carboxypeptidase); the third (and minor peak) coeluted with native
      (fully processed) insulin. For human proinsulin, by contrast, the second peak
      coeluted with des-31,32 split proinsulin (split and trimmed at the B-chain/C
      peptide junction). Analysis of cellular extracts showed intact proinsulin as the
      major product. The generation of the putative conversion intermediates and
      insulin was not due to proteolysis of proinsulin after its release but rather to
      an intracellular event. The data suggest that proinsulin, normally processed in
      secretory granules and released via the regulated pathway, may also be processed,
      albeit less efficiently, by the constitutive pathway conversion machinery. The
      comparison of the sites preferentially cleaved in rat II or human proinsulin
      suggests cleavage by endoprotease(s) with a preference for R/KXR/KR as substrate.

PMID- 1634511
TI  - Choline transport into rat liver mitochondria. Characterization and kinetics of a
      specific transporter.
AB  - Rat liver mitochondria possess a specific choline transporter in the inner
      membrane. The transporter shows saturable kinetics at high membrane potential
      with a Km of 220 microM and a Vmax of 0.4 nmol/mg of protein/min at pH 7.0 and 25
      degrees C. At physiological concentrations of choline, the rate of choline uptake
      by the transporter shows a linear dependence on membrane potential; uptake is
      distinct from the nonspecific cation diffusion process. Hemicholinium-3,
      hemicholinium-15, quinine, and quinidine, all analogues of choline, are high
      affinity competitive inhibitors of choline transport with Ki values of 17, 55,
      15, and 127 microM, respectively. The choline transporter is distinct from other
      known mitochondrial transporters. Rat heart mitochondria do not appear to possess
      a choline transporter. Evidence suggests that the transporter is an
      electrophoretic uniporter. Analogue studies have shown that the hydroxyl and the
      quaternary ammonium groups of choline are necessary for binding to the
      transporter. A comparison of molecular models of choline and the high affinity
      inhibitors has provided evidence for the preferred conformation of choline for
      binding to the transporter. The presence of a choline transporter in the
      mitochondrial inner membrane provides a potential site for control of choline
      oxidation and hence supply of endogenous betaine.

PMID- 1634512
TI  - Relation between the insulin receptor number in cells, autophosphorylation and
      insulin-stimulated Ras.GTP formation.
AB  - We showed previously that upon insulin stimulation of an insulin receptor
      overexpressing cell line, most of the p21ras was rapidly converted into the GTP
      bound state (Burgering, B. M. T., Medema, R. H., Maassen, J. A., Van de Wetering,
      M. L., Van der Eb, A. J., McCormick, F., and Bos, J. L. (1991) EMBO J. 10, 1103
      1109). To determine whether this process also occurs in cells expressing
      physiologically relevant numbers of insulin receptors, insulin stimulated Ras.GTP
      formation was quantitated in Chinese hamster ovary (CHO)-derived cell lines
      expressing varying numbers of insulin receptors. In the parental CHO9 cells,
      expressing only 5.10(3) insulin receptors, insulin stimulation for 3 min
      increased Ras.GTP levels with 10%. Upon increasing the number of insulin
      receptors in these cells, Ras.GTP levels increased almost proportionally until a
      plateau value of 60% is reached at high receptor numbers. These data show that
      receptor overexpression is not a prerequisite for insulin-stimulated Ras.GTP
      formation. The yield of Ras.GTP generated is 0.2-1.0 mol/mol autophosphorylated
      insulin receptor in CHO9- and NIH3T3-derived cell lines, respectively. These
      values argue against signal-amplifying processes between the insulin receptor and
      p21ras. To determine whether receptor autophosphorylation is required for Ras.GTP
      formation, NIH3T3 cells overexpressing insulin receptors were stimulated with a
      monoclonal antibody which activates the receptor and subsequent glucose transport
      without inducing detectable autophosphorylation. Also, CHO cells expressing the
      mutant Ser1200 receptor, which has markedly impaired tyrosyl autophosphorylation
      but is capable of mediating insulin-stimulated metabolic effects in CHO cells,
      were used. In both cases, no Ras.GTP formation was observed. Furthermore, Rat-1
      derived cell lines expressing mutant p21ras, which is permanently in the active
      GTP-bound form, still responded to insulin by increasing the glucose uptake.
      These results support our hypothesis that Ras.GTP formation is activated by the
      tyrosyl-phosphorylated insulin receptor and suggest that an active Ras.GTP
      complex does not mediate metabolic signaling.

PMID- 1634513
TI  - Metabolic pathways of heparan sulfate proteoglycans in a rat parathyroid cell
      line.
AB  - The distribution of heparan sulfate (HS) proteoglycans in clonal rat parathyroid
      cells is regulated by the extracellular Ca2+ concentration, which is a principal
      factor for parathyroid cell function (Takeuchi, Y., Sakaguchi, K., Yanagishita,
      M., Aurbach, G. D., and Hascall, V. C. (1990) J. Biol. Chem. 265, 13661-13668).
      Increasing the concentration of extracellular Ca2+ in the physiological range
      redistributes HS proteoglycans from the cell surface to an intracellular
      compartment. We have now examined effects of the extracellular Ca2+ concentration
      on the metabolism of the HS proteoglycans in detail using [35S]sulfate metabolic
      labeling-chase experiments. Two distinct metabolic pathways were demonstrated:
      (i) the intracellular generation of HS chains from HS proteoglycans in
      prelysosomal compartments followed by their release into the medium (pathway 1),
      and (ii) intracellular generation of HS oligosaccharides from HS chains in
      prelysosomal compartments, which are eventually degraded into free sulfate in
      lysosomes (pathway 2). The HS oligosaccharides were exclusively present within
      the cells, whereas HS chains were found primarily in the medium. The cells do not
      internalize either HS proteoglycans or HS chains from the medium. These
      observations indicate that these two degradation pathways are independent. In
      addition to these pathways, approximately 15% of the HS proteoglycans were
      released into the medium as a proteoglycan form. Treatment of cells with
      chloroquine, a lysosomotropic agent, did not affect generation of HS chains but
      inhibited conversion of HS chains to HS oligosaccharides or to free sulfate and
      resulted in the release of HS chains from the cells. The drug did not affect
      metabolic pathway 1. The extracellular Ca2+ concentration did not alter these
      intracellular degradation pathways for HS proteoglycans in the parathyroid cells.
      Thus, extracellular Ca2+ appears to regulate only the distribution of HS
      proteoglycans between the cell surface and intracellular compartments, and the
      process of cycling between these compartments when extracellular Ca2+ is low.

PMID- 1634514
TI  - Recycling of transferrin receptors and heparan sulfate proteoglycans in a rat
      parathyroid cell line.
AB  - We examined recycling of heparan sulfate (HS) proteoglycans and transferrin
      receptor (Tf-R) in a rat parathyroid cell line. While extracellular Ca2+
      concentration ([Ca2+]e) regulates the recycling of HS proteoglycans in
      parathyroid cells, such that HS proteoglycans only recycle when [Ca2+]e is
      lowered below physiological levels, recycling of Tf-R occurs equally well both in
      0.05 mM (low) and 2 mM (high) [Ca2+]e. Inhibiting endocytosis chemically with
      phenylarsine oxide or at low temperature (4 degrees C) did not abolish the
      effects of changing [Ca2+]e on HS proteoglycans in the recycling compartment even
      though transport of HS proteoglycans from the Golgi complex to the cell surface
      was inhibited in low [Ca2+]e. Microtubules are not involved in the recycling of
      HS proteoglycans or of Tf-R since nocodazole did not affect these processes.
      Inhibiting the increase of intracellular Ca2+ by an intracellular Ca2+ chelator
      sustained recycling of HS proteoglycans even in the presence of high [Ca2+]e.
      These observations show that the exocytosis pathway of HS proteoglycans in the
      recycling compartment is specifically regulated by [Ca2+]e, whereas that for
      constitutive secretion is not. Therefore, the recycling of HS proteoglycans may
      be directly related to some functions of parathyroid cells regulated by [Ca2+]e.
      Although the mechanism by which [Ca2+]e regulates the exocytosis and recycling of
      HS proteoglycans is uncertain, it is suggested that an increase of intracellular
      Ca2+ is necessary, but not necessarily sufficient, for inhibiting their
      exocytosis.

PMID- 1634515
TI  - cis-acting elements that confer lung epithelial cell expression of the CC10 gene.
AB  - To define cis-acting genetic elements responsible for cell-specific
      transcriptional regulation of the CC10 gene, DNA sequences spanning nucleotides 
      2338 to +49 of the rat CC10 gene were linked to a reporter gene coding for
      chloramphenicol acetyltransferase (CAT). In transient expression assays, CC10
      sequences were capable of restricting CAT expression to a human lung
      adenocarcinoma cell line similar to pulmonary Clara cells. Transgenic mice
      harboring the hybrid RtCC10-CAT construct expressed high levels of CAT activity
      specifically within protein extracts of lung and trachea. Transcripts for the CAT
      reporter gene colocalized with those for the endogenous murine CC10 gene within
      the airways of transgenic mice. Functional analysis of deletion mutants
      identified stimulatory, inhibitory, and cell type-specific transcriptional
      regulatory elements. The results of gel retention and DNaseI protection assays
      suggest that a transcriptional stimulatory region located between -320 and -175,
      and a cell type-specific regulatory element located between -175 and +49, result
      from a series of protein-DNA interactions occurring at -220 to -205 and -128 to 
      86, respectively. Lung epithelial specific transcriptional regulatory elements
      described herein will be useful for expression of chimeric genes within
      epithelial cells lining the trachea, bronchi, and bronchioles of mice.

PMID- 1634516
TI  - Minimal essential domains specifying toxicity of the light chains of tetanus
      toxin and botulinum neurotoxin type A.
AB  - To define conserved domains within the light (L) chains of clostridial
      neurotoxins, we determined the sequence of botulinum neurotoxin type B (BoNT/B)
      and aligned it with those of tetanus toxin (TeTx) and BoNT/A, BoNT/C1, BoNT/D,
      and BoNT/E. The L chains of BoNT/B and TeTx share 51.6% identical amino acid
      residues whereas the degree of identity to other clostridial neurotoxins does not
      exceed 36.5%. Each of the L chains contains a conserved motif, HExxHxxH,
      characteristic for metalloproteases. We then generated specific 5'- and 3'
      deletion mutants of the L chain genes of TeTx and BoNT/A and tested the
      biological properties of the gene products by microinjection of the corresponding
      mRNAs into identified presynaptic cholinergic neurons of the buccal ganglia of
      Aplysia californica. Toxicity was determined by measurement of neurotransmitter
      release, as detected by depression of postsynaptic responses to presynaptic
      stimuli (Mochida, S., Poulain, B., Eisel, U., Binz, T., Kurazono, H., Niemann,
      H., and Tauc, L. (1990) Proc. Natl. Acad. Sci. U. S. A. 87, 7844-7848). Our
      studies allow the following conclusions. 1) Residues Cys439 of TeTx and Cys430 of
      BoNT/A, both of which participate in the interchain disulfide bond, play no role
      in the toxification reaction. 2) Derivatives of TeTx that lacked either 8 amino-
      or 65 carboxyl-terminal residues are still toxic, whereas those lacking 10 amino-
      or 68 carboxyl-terminal residues are nontoxic. 3) For BoNT/A, toxicity could be
      demonstrated only in the presence of added nontoxic heavy (H) chain. A deletion
      of 8 amino-terminal or 32 carboxyl-terminal residues from the L chain had no
      effect on toxicity, whereas a removal of 10 amino-terminal or 57 carboxyl
      terminal amino acids abolished toxicity. 4) The synergistic effect mediated by
      the H chain is linked to the carboxyl-terminal portion of the H chain, as
      demonstrated by injection of HC-specific mRNA into neurons containing the L
      chain. This finding suggests that the HC domain of the H chain becomes exposed to
      the cytosol during or after the putative translocation step of the L chain.

PMID- 1634517
TI  - A linoleic acid (8R)-dioxygenase and hydroperoxide isomerase of the fungus
      Gaeumannomyces graminis. Biosynthesis of (8R)-hydroxylinoleic acid and (7S,8S)
      dihydroxylinoleic acid from (8R)-hydroperoxylinoleic acid.
AB  - The fungus Gaeumannomyces graminis metabolized linoleic acid extensively to (8R)
      hydroperoxylinoleic acid, (8R)-hydroxylinoleic acid, and threo-(7S,8S)
      dihydroxylinoleic acid. When G. graminis was incubated with linoleic acid under
      an atmosphere of oxygen-18, the isotope was incorporated into (8R)
      hydroxylinoleic acid and 7,8-dihydroxylinoleic acid. The two hydroxyls of the
      latter contained either two oxygen-18 or two oxygen-16 atoms, whereas a molecular
      species that contained both oxygen isotopes was formed in negligible amounts.
      Glutathione peroxidase inhibited the biosynthesis of 7,8-dihydroxylinoleic acid.
      These findings demonstrated that the diol was formed from (8R)
      hydroperoxylinoleic acid by intramolecular hydroxylation at carbon 7, catalyzed
      by a hydroperoxide isomerase. The (8R)-dioxygenase appeared to metabolize
      substrates with a saturated carboxylic side chain and a 9Z-double bond. G.
      graminis also formed omega 2- and omega 3-hydroxy metabolites of the fatty acids.
      In addition, linoleic acid was converted to small amounts of nearly (65% R)
      racemic 10-hydroxy-8,12-octadecadienoic acid by incorporation of atmospheric
      oxygen. An unstable metabolite, 11-hydroxylinoleic acid, could also be isolated
      as well as (13R,13S)-hydroxy-(9E,9Z), (11E)-octadecadienoic acids and (9R,9S)
      hydroxy-(10E), (12E,12Z)-octadecadienoic acids. In summary, G. graminis contains
      a prominent linoleic acid (8R)-dioxygenase, which differs from the lipoxygenase
      family of dioxygenases by catalyzing the formation of a hydroperoxide without
      affecting the double bonds of the substrate.

PMID- 1634518
TI  - Partially folded state of the disulfide-reduced form of human serum albumin as an
      intermediate for reversible denaturation.
AB  - The conformation of the fully disulfide-reduced state of human serum albumin was
      investigated by tryptophan fluorescence spectrum, CD analyses, and size-exclusion
      chromatography. Both the reduction of the native disulfide-bonded form under
      nondenaturing conditions and the refolding of the urea-denatured disulfide
      reduced form under reduced conditions yielded almost exactly the same disulfide
      reduced state with partially folded unique conformation that was clearly
      distinguished from either the native or fully denatured state. In addition, the
      interconversion between the urea-denatured reduced form and the partially folded
      reduced form was reversible with each other; by reoxidation, the partially folded
      reduced form was converted to the disulfide-bonded form. The conformation of
      disulfide-reduced serum albumin was highly variable depending on pH and ionic
      strength conditions. Thus, we concluded that the disulfide-reduced state with
      partially folded variable conformation is involved in the reversible
      interconversion between the denatured reduced form and the native disulfide
      bonded form of human serum albumin.

PMID- 1634519
TI  - Construction, expression, and characterization of a chimera of factor IX and
      factor X. The role of the second epidermal growth factor domain and serine
      protease domain in factor Va binding.
AB  - The prothrombinase complex, which catalyzes the conversion of prothrombin to
      thrombin, consists of activated Factor X, Factor Va, a membrane surface and Ca2+.
      To examine the structures that support Factor Va binding to Factor X, we used in
      vitro mutagenesis to construct a chimeric molecule that includes regions of
      Factor IX and Factor X. This chimera (IXGla,E1XE2,SP) was prepared from cDNA
      encoding the second epidermal growth factor (EGF) and serine protease domains of
      Factor X linked downstream from the cDNA encoding the signal peptide, propeptide,
      Gla domain, and first EGF domain of Factor IX. The cDNAs encoding the Factor IX/X
      chimera and wild-type Factor X were each expressed in Chinese hamster ovary cells
      and the secreted proteins purified by affinity chromatography using polyclonal
      anti-Factor X antibodies. The chimera migrated as a single major band
      corresponding to a molecular weight of 68,000. By Western blotting, the chimeric
      protein stained with both polyclonal anti-Factor X and anti-Factor IX antibodies.
      gamma-Carboxyglutamic acid analysis demonstrated near complete carboxylation of
      both the wild-type Factor X and the Factor IX/X chimera. Compared with Factor X,
      the rate of zymogen activation of the Factor IX/X chimera was about 50% that of
      Factor X when activated by Factor IXa, Factor VIIIa, phospholipid, and Ca2+. The
      enzyme form of the Factor IX/X chimera, activated Factor IX/X, generated using
      the coagulant protein of Russell's viper venom, expressed full amidolytic
      activity compared with Factor Xa. The activated Factor IX/X chimera had about 14%
      of the activity of Factor Xa when employed in a prothrombinase assay; this
      activity reached 100% with increasing concentrations of Factor Va. A binding
      assay was employed to test the ability of the active site-inactivated Factor
      IX/Xa chimera to inhibit the binding of Factor Xa to the Factor Va-phospholipid
      complex, thus inhibiting the activation of prothrombin to thrombin. In this assay
      the active site-inactivated form of the chimera competed with Factor Xa
      completely but with decreased affinity for the Factor Va-phospholipid complex.
      These data indicate that the second EGF domain and the serine protease domain of
      Factor Xa are sufficient to interact with Factor Va. The Factor IX/X chimera is a
      good substrate for the tenase complex; the defective enzymatic activity of the
      activated Factor IX/X chimera can be accounted for by its decreased affinity for
      Factor Va relative to Factor Xa.

PMID- 1634520
TI  - Structure and function in rhodopsin. Studies of the interaction between the
      rhodopsin cytoplasmic domain and transducin.
AB  - Structural requirements for the activation of transducin by rhodopsin have been
      studied by site-specific mutagenesis of bovine rhodopsin. A variety of single
      amino acid replacements and amino acid insertions and deletions of varying sizes
      were carried out in the two cytoplasmic loops CD (amino acids 134-151) and EF
      (amino acids 231-252). Except for deletion mutant delta 137-150, all the mutants
      bound 11-cis-retinal and displayed normal spectral characteristics. Deletion
      mutant delta 236-239 in loop EF caused a 50% reduction of transducin activation,
      whereas deletion mutant delta 244-249 and the larger deletions in loop EF
      abolished transducin activation. An 8-amino acid deletion in the cytoplasmic loop
      CD as well as a replacement of 13 amino acids with an unrelated sequence showed
      no transducin activation. Several single amino acid substitutions also caused
      significant reduction in transducin activation. The conserved charged pair Glu
      134/Arg-135 in the cytoplasmic loop CD was required for transducin activation;
      its reversal or neutralization abolished transducin activation. Three amino acid
      replacements in loop EF (S240A, T243V, and K248L) resulted in significant
      reduction in transducin activation. We conclude that 1) both the cytoplasmic
      loops CD and EF are required for transducin activation, and 2) effective
      functional interaction between rhodopsin and transducin involves relatively large
      peptide sequences in the cytoplasmic loops.

PMID- 1634521
TI  - Properties of human red cell spectrin heterodimer (side-to-side) assembly and
      identification of an essential nucleation site.
AB  - The antiparallel side-to-side association of spectrin alpha and beta monomers is
      a two-step process which occurs in seconds even at 0 degrees C and at low
      concentrations. Assembly involves initial contact of complementary nucleation
      sites on each subunit, which are located near the actin binding end of the long,
      flexible heterodimer rod. The minimum nucleation sites are comprised of
      approximately four contiguous 106-residue homologous segments or repeats. Three
      repeats in the nucleation site contain an 8-residue insertion and have the
      highest homology to the four spectrin-like repeats in alpha-actinin. The adjacent
      actin binding domain on the beta subunit and the adjacent EF hand motifs on the
      alpha subunit are not required for heterodimer assembly. The nucleation sites
      probably have a specific lock and key structure which defines the unique side-to
      side pairing of the many homologous segments in both subunits. Assembly of
      spectrin heterodimers is probably most analogous to a zipper. After initial
      nucleation site binding, the remainder of the subunits quickly associate along
      their full lengths to reconstitute a normal dimer by supercoiling around each
      other to form a rope-like, flexible rod. Assembly is terminated if either
      polypeptide is interrupted by a protease cleavage. Heterozygotic mutations
      involving either nucleation site are predicted to affect allele incorporation
      into the mature membrane skeleton.

PMID- 1634522
TI  - Metabolic fate of plasma membrane diacylglycerols in NIH 3T3 fibroblasts.
AB  - We have examined the metabolism of three radiolabeled 1,2-diacylglycerols (DGs)
      in NIH 3T3 fibroblasts. Since the lipids used are not appreciably taken up by the
      cells, we used a phosphatidylserine (PS)-based liposome fusion system to rapidly
      associate the lipid species with the plasma membrane. When 1,2-[1-14C]dioleoyl-sn
      3-glycerol ([14C]DOG) is delivered in this way, it is rapidly converted
      predominantly to phosphatidylcholine (PC) and triacylglycerol (TG) and to a
      lesser extent, to monoacylglycerol (MG) and fatty acids (FA), as well as
      phosphatidic acid (PA) and phosphatidylinositol (PI). We present evidence that
      [14C] DOG is largely utilized as an intact molecule rather than being broken down
      to FA and then incorporated to cell lipids. Examination of the metabolism of 1
      stearoyl-2-[1-14C]myristoyl-sn-3-glycerol ([14C]SMG) and 1-stearoyl-2
      arachidonoyl-sn-3-glycerol ([14C]SAG) reveal important differences. Both produce
      substantial labeling of PC but [14C]SMG gives rise to the highest proportion of
      TG and the lowest of PA and PI, whereas [14C]SAG yields the opposite pattern.
      When phosphatidic acid labeled on its glycerol backbone (1,2-dioleoyl-sn-[U-14C]
      glycero-3-phosphate) was supplied to the cells via the liposomes, rapid
      appearance of labeled DG was found which then decreased with concomitant labeling
      of cellular PC and TG. Only small amounts of the glycerol backbone were recovered
      in PI. Our experiments identify three types of processes involved in the
      metabolism of plasma membrane DGs: (i) transferase-catalyzed conversions to PC
      and TG, (ii) lipolytic breakdown to MG and FA, and (iii) phosphorylation to PA
      and then conversion to PI. The relative proportions of each DG species converted
      to these different products are strongly dependent on the fatty acyl composition
      of the particular DG molecular species, even though formation of PC is the major
      event in all cases. Since DGs are important second messengers, our study supports
      the view that conversion to PC and TG can play a key role in DG signal
      attenuation.

PMID- 1634523
TI  - Phytochrome assembly. The structure and biological activity of 2(R),3(E)
      phytochromobilin derived from phycobiliproteins.
AB  - The unicellular rhodophyte, Porphyridium cruentum, and the filamentous
      cyanobacterium, Calothrix sp. PCC 7601, contain phycobiliproteins that have
      covalently bound phycobilin chromophores. Overnight incubation of solvent
      extracted cells at 40 degrees C with methanol liberates free phycobilins that are
      derived from the protein-bound bilins by methanolytic cleavage of the thioether
      linkages between bilin and apoprotein. Two of the free bilins were identified as
      3(E)-phycocyanobilin and 3(E)-phycoerythrombilin by comparative spectrophotometry
      and high pressure liquid chromatography. Methanolysis also yields a third bilin
      free acid whose absorption and 1H NMR spectra support the assignment of the 3(E)
      phytochromobilin structure. This novel bilin is the major pigment isolated from
      cells that are pre-extracted with acetone-containing solvents. Since phytochrome-
      or phytochromobilin-containing proteins are not present in either organism, the
      3(E)-phytochromobilin must arise by oxidation of phycobilin chromophores. This
      pigment is not obtained by similar treatment of a cyanobacterium and a rhodophyte
      that lack phycoerythrin. Therefore, 3(E)-phytochromobilin appears to be derived
      from phycoerythrobilin-containing proteins. Comparative CD spectroscopy of 3(E)
      phytochrombilin and 3(E)-phycocyanobilin suggests that the two bilins share the R
      stereochemistry at the 2-position in the reduced pyrrole ring. Incubation of
      2(R),3(E)-phytochromobilin with recombinant oat apophytochrome yields a covalent
      bilin adduct that is photoactive and spectrally indistinguishable from native oat
      phytochrome isolated from etiolated seedlings. These results establish that the
      phycobiliprotein-derived 2(R),3(E)-phytochromobilin is a biologically active
      phytochrome chromophore precursor.

PMID- 1634524
TI  - Multiple forms of ubiquitin-activating enzyme E1 from wheat. Identification of an
      essential cysteine by in vitro mutagenesis.
AB  - Ubiquitin-activating enzyme, E1, directs the ATP-dependent formation of a thiol
      ester linkage between itself and ubiquitin. The energy in this bond is ultimately
      used to attach ubiquitin to various intracellular proteins. We previously
      reported the isolation of multiple E1s from wheat and the characterization of a
      cDNA encoding this protein (UBA1). We now report the derived amino acid sequence
      of two additional members of this gene family (UBA2 and UBA3). Whereas the amino
      acid sequence of UBA2 is nearly identical to UBA1, the sequence of UBA3 is
      significantly different. Nevertheless, the protein encoded by UBA3 catalyzes the
      ATP-dependent activation of ubiquitin in vitro. Comparison of derived amino acid
      sequences of genes encoding E1 from plant, yeast, and animal tissues revealed 5
      conserved cysteine residues, with one potentially involved in thiol ester bond
      formation. To identify this essential residue, codons corresponding to each of
      the 5 cysteines in UBA1 were individually altered using site-directed
      mutagenesis. The mutagenized enzymes were expressed in Escherichia coli and
      assayed for their ability to activate ubiquitin. Only substitution of the
      cysteine at position 626 abolishes E1 activity, suggesting that this residue
      forms the thiol ester linkage with ubiquitin.

PMID- 1634525
TI  - Characterization of the multisubunit cleavage-polyadenylation specificity factor
      from calf thymus.
AB  - Cleavage-polyadenylation specificity factor (CPSF) is one of five separable
      factors known to be required for 3' cleavage and polyadenylation of mRNA
      precursors in vitro. Previous studies have shown that the cleavage and poly(A)
      addition reactions can be uncoupled in vitro and have suggested that CPSF may be
      the only factor essential for both of these subreactions. Here we report the
      purification of CPSF to near homogeneity from calf thymus and show that the
      purified factor contains three polypeptides of 165, 105, and 70 kDa. These
      polypeptides cosediment precisely with CPSF activity, which has a sedimentation
      coefficient of 11.5 S. Consistent with previous reports from our laboratory,
      purified CPSF does not contain a detectable RNA component, indicating that it is
      a multisubunit protein and not a small nuclear ribonucleoprotein. Extensively
      purified bovine CPSF can function with human poly(A) polymerase to bring about
      AAUAAA-dependent poly(A) addition or with human cleavage factors to catalyze
      accurate 3' cleavage of a pre-mRNA substrate. UV cross-linking and gel retention
      analyses demonstrate that highly purified CPSF interacts with one of these
      cleavage factors, the multisubunit cleavage-stimulation factor, to facilitate
      stable binding of both to an AAUAAA-containing pre-mRNA. Likewise, evidence is
      presented indicating that poly(A) polymerase and CPSF can interact directly.

PMID- 1634526
TI  - Eosinophil-derived neurotoxin and human liver ribonuclease. Identity of structure
      and linkage of neurotoxicity to nuclease activity.
AB  - Eosinophil-derived neurotoxin (EDN) and human liver RNase were found to be
      indistinguishable from each other but distinct from the pancreatic ribonucleases
      in their nucleolytic activity on polynucleotides or small defined substrates.
      Antibodies to EDN and liver RNase showed identical cross-reactivities in assays
      of nuclease inhibition and in a radioimmunoassay. In each instance, EDN and liver
      RNase were easily distinguished from bovine or human pancreatic RNase. When
      injected intrathecally into rabbits, 5-10 micrograms of EDN or liver RNase each
      was neurotoxic as judged by induction of the Gordon phenomenon. Human pancreatic
      RNase was less neurotoxic, and up to 20-fold higher levels of bovine pancreatic
      RNase showed no effect. Treatment of EDN, liver RNase, and eosinophil cationic
      protein with iodoacetic acid at pH 5.5 resulted in inactivation of their RNase
      activity and also destroyed their neurotoxicity. EDN conformation was not greatly
      affected by iodoacetate treatment since interaction of the modified protein with
      antibodies was only slightly altered. We conclude that RNase activity is
      necessary but not sufficient to induce neurotoxic action.

PMID- 1634527
TI  - NAD+ binding site of Clostridium botulinum C3 ADP-ribosyltransferase.
      Identification of peptide in the adenine ring binding domain using 2-azido NAD.
AB  - C3 ADP-ribosyltransferase is an exoenzyme produced by certain strains of
      Clostridium botulinum types C and D, which specifically ADP-ribosylates rho
      proteins in eukaryotic cells. Using the photoaffinity probe [alpha
      32P]nicotinamide-2-azidoadenine dinucleotide, we have identified the adenine ring
      binding domain of the NAD+ binding site. The specificity of labeling was
      demonstrated by saturation effects and protection by the natural compound at
      physiologically relevant concentrations. Saturation of labeling was observed at
      50 microM. Protection experiments indicated an 80% protection of labeling by 100
      microM NAD+ when protein was photolyzed in the presence of 10 microM probe.
      Trypsin or Staphylococcus aureus V8 protease digestion of the photolabeled
      protein, along with boronate affinity chromatography and immobilized metal
      affinity chromatography, was used to specifically isolate the peptide region
      photolabeled with the probe. The peptide corresponded to Phe9-Gly19 near the N
      terminus.

PMID- 1634528
TI  - Cytoplasmic and mitochondrial tRNA nucleotidyltransferase activities are derived
      from the same gene in the yeast Saccharomyces cerevisiae.
AB  - ATP (CTP):tRNA-specific tRNA nucleotidyltransferase is an enzyme required for the
      synthesis of functional tRNAs in eukaryotic cells. Neither the tRNA genes in the
      nucleus nor in organelles encode the CCA end, so it must be added post
      transcriptionally. The gene that codes for the enzyme that adds the CCA end to
      nuclear coded tRNAs in Saccharomyces cerevisiae has been isolated (Aebi, M.,
      Kirchner, G., Chen, J.-Y., Vijayraghavan, U., Jacobson, A., Martin, N. C., and
      Abelson, J. (1990) J. Biol. Chem. 265, 16216-16220). We now demonstrate that
      there is a mitochondrial tRNA nucleotidyltransferase activity in yeast and that
      it is a matrix enzyme. A comparison of purified mitochondrial enzyme with its
      cytoplasmic counterpart revealed no differences. These results suggest that
      proteins responsible for this step in the maturation of tRNAs in the nucleus and
      mitochondria might be identical and coded by the same nuclear gene. Accumulation
      of shortened mitochondrial as well as cytoplasmic tRNAs in a strain with a
      temperature-sensitive tRNA nucleotidyltransferase is consistent with this
      hypothesis. Alteration of the wild type gene such that amino-terminal truncated
      proteins are produced leads to a defect in mitochondrial function and a decrease
      in mitochondrial nucleotidyltransferase activity. This provides a direct
      demonstration that one gene provides this enzyme activity for the biosynthesis of
      tRNAs in both the nuclear/cytoplasmic and mitochondrial compartments in yeast.

PMID- 1634529
TI  - A native RNA secondary structure controls alternative splice-site selection and
      generates two human growth hormone isoforms.
AB  - Consensus sequences at the splice donor, splice acceptor, and lariat branch point
      regions are necessary but insufficient determinants of splice-site selection in
      nuclear precursor mRNAs. Sequences outside of these regions can have a
      significant effect on the utilization of splice sites. Although the mode of
      action of such sequences is undefined in most cases, higher order RNA structures
      have been suggested as a potential contributor to splice-site selection. During a
      detailed analysis of the splicing patterns of the human growth hormone
      transcript, we located 2 bases in the vicinity of the exon 3 major splice
      acceptor site (B) which facilitate the utilization of a competing downstream
      acceptor (B'). The effects of a series of site-specific mutations on the splicing
      pattern demonstrate that these 2 bases function by stabilizing a specific stem
      loop structure in the native transcript. This defined secondary structure
      selectively encompasses the upstream B splice-acceptor site together with its
      lariat branch point region. Increasing the predicted stability of this stem by
      point mutations results in a corresponding shift in splicing towards the
      alternative B' splice-acceptor site. These results indicate that a specific
      secondary structure within the native human growth hormone transcript controls
      the relative utilization of two competing splice-acceptor sites with the
      consequent generation of two functionally distinct hormone isoforms.

PMID- 1634530
TI  - Brefeldin A promotes hydrolysis of sphingomyelin.
AB  - The hydrolysis of sphingomyelin (SM) is a key reaction in the "sphingomyelin
      cycle," which plays a role in the regulation of cell proliferation and
      differentiation (Okazaki, T., Bell, R. M., and Hannun, Y. A. (1989) J. Biol.
      Chem. 264, 19076-19080). SM is produced from endoplasmic reticulum-derived
      ceramide and is delivered to organelle membranes in a regulated manner,
      presumably through the same endomembrane trafficking system used for sorting and
      delivery of proteins. Since brefeldin A (BFA) interferes with this endomembrane
      trafficking system and thus alters normal membrane and organelle distribution, we
      investigated the effect of BFA on SM levels in HL-60 leukemia cells. BFA caused a
      dose-dependent decrease of 20-25% in cellular SM levels, with effects observed at
      concentrations of BFA as low as 0.10 microgram/ml. BFA effects on SM levels were
      noted as early as 5 min and were maximal by 20 min, with no further SM hydrolysis
      observed up to 60 min following treatment with BFA, suggesting the presence of a
      fixed SM-sensitive pool. BFA did not cause SM hydrolysis at 16 degrees C, a
      temperature that inhibits the effects of BFA on endomembrane mixing. The very
      early effects and temperature dependence of BFA-induced SM hydrolysis suggest
      that the mechanism of hydrolysis may be closely related to endomembrane mixing.
      These studies are beginning to define important interrelationships between
      membrane trafficking and topology, SM metabolism, and cell regulation.

PMID- 1634531
TI  - Separation of human neutrophil plasma membrane from intracellular vesicles
      containing alkaline phosphatase and NADPH oxidase activity by free flow
      electrophoresis.
AB  - A putative reservoir of functional plasma membrane proteins, the secretory
      vesicle identified by latent alkaline phosphatase and tetranectin, has previously
      been demonstrated based on indirect evidence (Borregaard, N., Miller, L. J., and
      Springer, T. A. (1987) Science 237, 1204-1206; Borregaard, N., Christensen, L.,
      Bjerrum, O. W., Birgens, H. S., and Clemmesen, I. (1990) J. Clin. Invest. 85, 408
      416). Difficulties in separating plasma membranes from this entity by density
      gradient centrifugation has prohibited discriminative dynamic and quantitative
      studies of secretory vesicles and plasma membranes. By combining density
      centrifugation with free flow electrophoresis we overcame this obstacle. Freshly
      prepared unperturbed human neutrophils were subjected to nitrogen cavitation
      followed by density centrifugation on Percoll gradients. Light membrane fractions
      containing plasma membranes and secretory vesicles were applied to high voltage
      free flow electrophoresis on an Elphor VaP 22. Plasma membrane vesicles,
      identified by HLA class I antigen mixed enzyme-linked immunosorbent assay
      (Bjerrum, O. W., and Borregaard, N. (1990) Scand. J. Immunol. 31, 305-313) and
      125I applied to cells before cavitation, were clearly separated from secretory
      vesicles. Electron microscopy revealed a morphology typical of plasma membranes
      in the former fraction and a population of vesicles with markedly different
      appearance in the latter. Sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis profiles demonstrated distinct differences in protein patterns
      between the two fractions. Superoxide generating capacity induced by sodium
      dodecyl sulfate and cytosol, an entity traditionally ascribed to the plasma
      membrane, was largely confined to fractions containing secretory vesicles. Thus,
      the majority of membrane-bound NADPH oxidase components of light membranes of
      human neutrophils colocalize with secretory vesicles.

PMID- 1634532
TI  - Hexanoate and octanoate inhibit transcription of the malic enzyme and fatty acid
      synthase genes in chick embryo hepatocytes in culture.
AB  - Hexanoate and octanoate inhibit the triiodothyronine (T3)-induced increases in
      the activities of malic enzyme and fatty acid synthase in chick embryo
      hepatocytes in culture. Butanoate was less effective as an inhibitor, and
      palmitate, stearate, and oleate had no effect or small stimulatory effects.
      Hexanoate and octanoate inhibited the lipogenic enzyme activities at a
      transcriptional step, and did so within 30 min of addition. Incubation for 2 h in
      the absence of fatty acid reversed the inhibition of transcription caused by
      hexanoate. The inhibitory effect of hexanoate was selective because DNA content
      and transcription of the glyceraldehyde-3-phosphate dehydrogenase and beta-actin
      genes were not inhibited. Hexanoate-mediated inhibition of transcription rates of
      the lipogenic genes was not correlated with an inhibition of binding of T3 to its
      nuclear receptor. 2-Bromooctanoate and carnitine stimulated the T3-induced
      accumulation of the mRNAs for malic enzyme and fatty acid synthase. The presence
      of hexanoate stimulated by 2- to 3-fold the increase caused by carnitine,
      suggesting that hexanoate and carnitine may regulate lipogenic gene expression by
      a common pathway. Hexanedioate, acetoacetate, beta-hydroxybutyrate, branched
      chain fatty acids, and branched chain keto acids had little or no effect on
      abundance of the lipogenic mRNAs. We suggest that the active inhibitor is a
      metabolite derived from hexanoate or octanoate, possibly an intermediate derived
      from an acyl-CoA derivative.

PMID- 1634533
TI  - Specificity of photolabeling of beta-cell membrane proteins with an 125I-labeled
      glyburide analog.
AB  - The interaction between sulfonylureas and membrane proteins from a hamster
      insulin-secreting tumor (HIT) cell line has been examined. Four HIT cell membrane
      proteins were covalently linked to an 125I-labeled glyburide analog by
      photolabeling. Three photolabeled polypeptides of M(r) 65,000, 55,000, and 30,000
      were identified as low affinity "glyburide receptors." These proteins appear to
      be of similar abundance, when quantitated by photolabeling, with half-maximal
      displacements (Ki values) by glyburide, glipizide, and tolbutamide in the low
      micromolar range. The glyburide analog is more tightly bound to a M(r) 140,000
      protein with dissociation constants, determined by filtration binding assays and
      by photolabeling, of 7 and 9.0 nM, respectively. The labeled analog was displaced
      from the M(r) 140,000 protein by glyburide, glipizide and tolbutamide with Ki
      values of 3.3 nM, 103 nM, and 25 microM, respectively, as estimated by
      photolabeling. Optimal conditions established for visualizing the M(r) 140,000
      band on autoradiograms prepared after UV cross-linking and sodium dodecyl sulfate
      polyacrylamide gel electrophoresis include irradiating the radioligand-receptor
      complex at 1.5 J/cm2 at 312 nm, followed by heating samples in pH 9.0 sodium
      dodecyl sulfate-gel sample buffer. With receptor sites partially occupied (5 nM
      radioligand), approximately 0.75% of the protein is photocoupled to the
      radioligand and visualized by autoradiography. Our results confirm that the M(r)
      140,000 polypeptide contains the beta-cell high affinity glyburide binding site
      and show that the second generation sulfonylurea antidiabetic drugs have a
      selective increase in affinity for this receptor.

PMID- 1634534
TI  - Co-expression of sulfonylurea receptors and KATP channels in hamster insulinoma
      tumor (HIT) cells. Evidence for direct association of the receptor with the
      channel.
AB  - Cell membranes isolated from hamster insulinoma (HIT T15) cells at passages 65-74
      contain high and low affinity receptors for a sulfonylurea derivative, 5
      [125I]iodo,2-hydroxyglyburide (KD values of approximately 7 nM and 16 microM).
      Between passages 75 and 85, the estimated B(max) for the high affinity receptor
      decreases approximately 10-fold from approximately 1.6 to 0.16 pmol/mg membrane
      protein. By contrast, the density of low affinity binding sites, 800-1000
      pmol/mg, is unaltered. The drop in high affinity receptors is paralleled by a
      decrease in the density of KATP channels assessed using patch-clamp and 86Rb(+)
      efflux techniques. These results strongly support the idea that the high affinity
      sulfonylurea receptor is an integral part of the KATP channel.

PMID- 1634535
TI  - Active-site-selective labeling of blood coagulation proteinases with fluorescence
      probes by the use of thioester peptide chloromethyl ketones. I. Specificity of
      thrombin labeling.
AB  - In a new strategy for labeling the active sites of serine proteinases with
      fluorescence probes (Bock, P. E. (1988) Biochemistry 27, 6633-6639), a thioester
      peptide chloromethyl ketone inhibitor is incorporated into the enzyme active
      center and used to produce a unique thiol group which provides a site for
      selective chemical modification with any one of many thiol-reactive fluorescence
      probes. This approach was developed to increase the opportunities for identifying
      fluorescent proteinase derivatives that act as reporters of binding interactions
      by allowing a large number of derivatives, representing a broad range of probe
      spectral properties, to be readily prepared. In the studies described here, the
      specificity of the labeling approach was evaluated quantitatively for the
      labeling of human alpha and beta/gamma-thrombin with the thioester peptide
      chloromethyl ketones, N alpha-[(acetylthio)acetyl]-D-Phe-Pro-Arg-CH2Cl and N
      alpha-[(acetylthio)acetyl]-D-Phe-Phe-Arg-CH2Cl, and the thiol-reactive
      fluorescence probe, 5-(iodoacetamido)fluorescein. Irreversible inactivation of
      thrombin by the inhibitors was accompanied by incorporation of 0.98 +/- 0.06
      mol/mol of the thioester group into the active site, independent of a 470-fold
      difference between the thioester peptide chloromethyl ketones in the bimolecular
      rate constants of alpha-thrombin affinity labeling. Subsequent mild treatment of
      the covalent thrombin-inhibitor complexes with NH2OH in the presence of 5
      (iodoacetamido)fluorescein resulted in generation of the thiol group together
      with its selective modification and incorporation of 0.96 +/- 0.07 mol of
      probe/mol of active sites. The incorporated label was localized to a 9000
      molecular weight region of alpha and beta/gamma-thrombin containing the catalytic
      site histidine residue. Evaluation of competing, side reactions showed that they
      did not significantly compromise the active site specificity of labeling. These
      results demonstrated equivalent, active-site-selective fluorescence probe
      labeling of alpha and beta/gamma-thrombin by use of either of the thioester
      peptide chloromethyl ketones, with a site specificity of greater than or equal to
      94%.

PMID- 1634536
TI  - Active-site-selective labeling of blood coagulation proteinases with fluorescence
      probes by the use of thioester peptide chloromethyl ketones. II. Properties of
      thrombin derivatives as reporters of prothrombin fragment 2 binding and
      specificity of the labeling approach for other proteinases.
AB  - The behavior of an array of fluorescent human alpha-thrombin derivatives in
      reporting binding of the fragment 2 domain of prothrombin was characterized as a
      representative application of the active-site-selective labeling approach to
      studies of blood coagulation proteinase regulatory interactions. An array of 16
      thrombin derivatives was prepared by affinity labeling of the proteinase active
      site with the thioester peptide chloromethyl ketones, N alpha
      [(acetylthio)acetyl]-D-Phe-Pro-Arg-CH2Cl or N alpha-[(acetylthio)acetyl]-D-Phe
      Phe-Arg-CH2Cl, followed by selective modification of the NH2OH-generated thiol
      group on the covalently incorporated inhibitors with each of eight thiol-reactive
      fluorescence probes. The changes in probe fluorescence intensity of the
      derivatives, signaling changes in the environment of the catalytic site
      associated with fragment 2 binding, appeared to be a unique and unpredictable
      function of the structure of the probe and the connecting peptide. These results
      demonstrated the utility of the labeling approach for overcoming the problem of
      not being able to predict which fluorescent label will provide the most useful
      proteinase derivative for investigating an interaction by enabling a greater
      variety of them to be prepared and screened for those with the most desirable
      properties. To determine whether the approach could be extended to other
      proteinases, the specificity of labeling with the fluorescence probe
      iodoacetamide, 5-(iodoacetamido)fluorescein, by use of the two thioester
      inhibitors was evaluated for several other blood coagulation proteinases and
      related trypsin-like enzymes. All of the proteinases were labeled in an active
      site-selective manner. The combined results of quantitating the labeling
      reactions for the proteinase and inhibitor combinations studied thus far showed
      active-site-specific incorporation of 0.98 +/- 0.10 mol of inhibitor/mol of
      active sites and 0.92 +/- 0.11 mol of probe/mol of active sites, representing an
      overall greater than or equal to 93% site-specificity of labeling. These results
      demonstrated the broad applicability of the labeling approach for fluorescence
      studies of proteinases that differ greatly in their catalytic specificities.

PMID- 1634537
TI  - A novel disialoganglioside in rat spleen lymphocytes.
AB  - A novel ganglioside has been identified as the predominant disialoganglioside of
      the lymphocytes prepared from rat spleen. The ganglioside was isolated from rat
      spleen and characterized by compositional analysis, methylation analysis,
      sialidase hydrolysis, proton NMR spectroscopy, and negative ion fast atom
      bombardment mass spectrometry. The structure was determined as follows. [formula:
      see text] This ganglioside is a unique derivative of N-acetyllactosaminyl-GM1.
      The three monosialogangliosides containing N-acetyllactosaminyl-GM1 structure,
      which had been originally isolated from rat spleen (Nohara, K., Suzuki, M.,
      Inagaki, F., Ito, H., and Kaya, K. (1990) J. Biol. Chem. 265, 14335-14339), were
      also found in the lymphocytes and were hardly detected in the spleen remnant
      tissue depleted of single cells. On the other hand, GD1c(NeuGc,NeuGc) (IV3(NeuGc
      alpha 2-8NeuGc)-Gg4Cer), the overwhelmingly predominant ganglioside of rat
      thymocytes (Nohara, K., Suzuki, M., Inagaki, F., and Kaya, K. (1991) J. Biochem.
      (Tokyo) 110, 274-278), was demonstrated to be only a minor component of the
      gangliosides of the spleen lymphocytes. These results suggested that GD1c is
      characteristic for the immature T lineage lymphoid cells and the gangliosides
      having lactosaminyl-GM1 structure are specific for other populations of the
      lymphocytes in rat.

PMID- 1634538
TI  - Purification and characterization of the bacteriophage T7 gene 2.5 protein. A
      single-stranded DNA-binding protein.
AB  - Bacteriophage T7 gene 2.5 protein has been purified to homogeneity from cells
      overexpressing its gene. Native gene 2.5 protein consists of a dimer of two
      identical subunits of molecular weight 25,562. Gene 2.5 protein binds
      specifically to single-stranded DNA with a stoichiometry of approximately 7
      nucleotides bound per monomer of gene 2.5 protein; binding appears to be
      noncooperative. Electron microscopic analysis shows that gene 2.5 protein is able
      to disrupt the secondary structure of single-stranded DNA. The single-stranded
      DNA is extended into a chain of gene 2.5 protein dimers bound along the DNA. In
      fluorescence quenching and nitrocellulose filter binding assays, the binding
      constants of gene 2.5 protein to single-stranded DNA are 1.2 x 10(6) M-1 and 3.8
      x 10(6) M-1, respectively. Escherichia coli single-stranded DNA-binding protein
      and phage T4 gene 32 protein bind to single-stranded DNA more tightly by a factor
      of 25. Fluorescence spectroscopy suggests that tyrosine residue(s), but not
      tryptophan residues, on gene 2.5 protein interacts with single-stranded DNA.

PMID- 1634539
TI  - Interactions of gene 2.5 protein and DNA polymerase of bacteriophage T7.
AB  - Bacteriophage T7 gene 2.5 protein has been shown to interact with T7 DNA
      polymerase (the complex of T7 gene 5 protein and Escherichia coli thioredoxin) by
      affinity chromatography and fluorescence emission anisotropy. T7 DNA polymerase
      binds specifically to a resin coupled to gene 2.5 protein and elutes from the
      resin when the ionic strength of the buffer is raised to 250 mM NaCl. In
      contrast, T7 gene 5 protein alone binds more weakly to gene 2.5 protein, eluting
      when the ionic strength of the buffer is 50 mM NaCl. Thioredoxin does not bind to
      gene 2.5 protein. Steady-state fluorescence emission anisotropy gives a
      dissociation constant of 1.1 +/- 0.2 microM for the complex of gene 2.5 protein
      and T7 DNA polymerase, with a ratio of gene 2.5 protein to T7 DNA polymerase in
      the complex of 1:1. Nanosecond emission anisotropic analysis suggests that the
      complex contains one monomer each of gene 2.5 protein, gene 5 protein, and
      thioredoxin. The ability of T7 gene 2.5 protein to stimulate the activity and
      processivity of T7 DNA polymerase is compared with the ability of three other
      single-stranded DNA-binding proteins: E. coli single-stranded DNA-binding
      protein, T4 gene 32 protein, and E. coli recA protein. All except E. coli recA
      protein stimulate the activity and processivity of T7 DNA polymerase; E. coli
      recA protein inhibits these activities.

PMID- 1634540
TI  - Partial purification, from Xenopus laevis oocytes, of an ATP-dependent activity
      required for nucleosome spacing in vitro.
AB  - A critical feature of chromatin with regard to structure and function is the
      regular spacing of nucleosomes. In vivo, spacing of nucleosomes occurs in at
      least two steps, but the mechanism is not understood. In this report, we have
      mimicked the two-step process in vitro. A novel spacing activity has been
      partially purified from Xenopus laevis ovaries. When this activity is added,
      either at the beginning or at the end of a nucleosomal assembly reaction, it can
      convert a DNA template consisting of irregularly spaced nucleosomes into a
      chromatin structure made up of regularly spaced nucleosomes with a repeat length
      of about 165 base pairs. The reaction requires ATP. Histone H1 is able to
      increase the nucleosomal repeat from 165 to 190 base pairs. This two-step
      increase in nucleosomal repeat length suggests that both the spacing activity and
      histone H1 contribute to generating repeat lengths of greater than 165 base pairs
      and that their contributions may be additive. Alternatively, the critical step in
      the spacing reaction may not be the formation of the 165-base pair repeat but may
      be the sliding of nucleosomes or the reorganization of the octamer structure
      induced by the spacing activity.

PMID- 1634541
TI  - Intracellular transit of a yeast protease is rescued by trans-complementation
      with its prodomain.
AB  - The alkaline extracellular protease (AEP) of the yeast Yarrowia lipolytica is
      synthesized as a preproprotein. The precursor undergoes a complex maturation
      during its intracellular transit, successively involving signal peptide cleavage,
      dipeptidyl aminopeptidase processing, and cleavage at a dibasic site which
      results in the extracellular release of the active enzyme. It was previously
      shown that various deletions within the proregion affect the intracellular
      transit of the protease. Prodeleted precursors are translocated and have their
      signal sequences removed, but they accumulate in the secretion apparatus. We show
      here that the secretion of partially active proteins is restored when the
      prodomain is supplied in trans as an independent peptide. The secretion rescue
      and maturation processing that are reconstituted by the free propeptide do not
      reach wild type efficiency. The results of pulse-chase experiments indicate that
      a rate-limiting step occurs during the intracellular transit of the rescued
      precursors, before Kex2p proteolytic cleavage. This delayed maturation seems to
      be responsible for an overall slower release of the rescued polypeptides.
      Propeptide and AEP were secreted in equimolar amounts by both wild type and trans
      complemented strains, but none could be detected in the supernatant when
      expressed alone. These experiments suggest that the prodomain of AEP initially
      acts as a crucial folding aid for the early secretory transit of the translocated
      precursor. They further suggest that the prodomain is also required for a second
      structural change of the AEP precursor during its activation.

PMID- 1634542
TI  - Negative thyroid hormone control of human growth hormone gene expression is
      mediated by 3'-untranslated/3'-flanking DNA.
AB  - The intact human growth hormone (hGH) gene is negatively regulated by
      triiodothyronine (T3) treatment in transfected rat pituitary tumor cells. We now
      demonstrate that this responsiveness is mediated by a negative thyroid hormone
      response element (nTRE) localized to the proximal 3'-untranslated/3'-flanking
      region (3'-UT/FR). This region binds thyroid hormone receptors specifically and
      with high affinity. nTRE function was promoter-dependent, since it suppressed the
      activity of a positive TRE in the human chorionic somatomammotropin promoter,
      partially repressed activity of the herpes simplex virus TK promoter, but did not
      function with the human actin or Rous sarcoma virus promoters. T3 treatment did
      not alter transcript termination sites nor selectively affect the stability of
      transcripts containing the hGH 3'-UT/FR when transcription was blocked by
      actinomycin D treatment. The function of the nTRE depended on its location in the
      3'-UT/FR; it was inactive when positioned down-stream of the simian virus 40
      (SV40) 3'-UT/FR, and it acted as a positive TRE when placed upstream of the hGH
      promoter. These results demonstrate a novel localization of a TRE with unique
      properties which suggests expanded mechanisms by which thyroid hormone receptors
      can affect gene expression.

PMID- 1634543
TI  - Identification of the catalytically important histidine of 3-hydroxy-3
      methylglutaryl-coenzyme A reductase.
AB  - We identify His381 of Pseudomonas mevalonii 3-hydroxy-3-methylglutaryl-coenzyme A
      (HMG-CoA) reductase as the basic residue functional in catalysis. The catalytic
      domain of 20 HMG-CoA reductases contains a single conserved histidine (His381 of
      the P. mevalonii enzyme). Diethyl pyrocarbonate inactivated the P. mevalonii
      enzyme, and hydroxylamine partially restored activity. We changed His381 to
      alanine, lysine, asparagine, and glutamine. The mutant proteins were
      overexpressed, purified to homogeneity, and characterized. His381 mutant enzymes
      were not inactivated by diethyl pyrocarbonate. All four mutant enzymes exhibited
      wild-type crystal morphology and chromatographed on substrate affinity supports
      like wild-type enzyme. The mutant enzymes had low catalytic activity (Vmax 0.06
      0.5% that of wild-type enzyme), but Km values approximated those for wild-type
      enzyme. For wild-type enzyme and mutant enzymes H381A, H381N, and H381Q, Km
      values at pH 8.1 were 0.45, 0.27, 3.7, and 0.71 mM [(R,S)-mevalonate]; 0.05,
      0.03, 0.20, and 0.11 mM [coenzyme A]; 0.22, 0.14, 0.81, and 0.62 mM [NAD+]. Km
      values at pH 11 for wild-type enzyme and mutant enzyme H381K were 0.32 and 0.75
      mM [(R,S)-mevalonate]; 0.24 and 0.50 mM [coenzyme A]; 0.15 and 1.23 mM [NAD+].
      Both pK values for the enzyme-substrate complex increased relative to wild-type
      enzyme (by 1-2.5 pH units for pK1 and by 0.5-1.3 pH units for pK2). For mutant
      enzyme H381K, the pK1 of 10.2 is consistent with lysine acting as a general base
      at high pH. His381 of P. mevalonii HMG-CoA reductase, and consequently the
      histidine of the consensus Leu-Val-Lys-Ser-His-Met-Xaa-Xaa-Asn-Arg-Ser motif of
      the catalytic domain of eukaryotic HMG-CoA reductases, thus is the general base
      functional in catalysis.

PMID- 1634544
TI  - Myristoylation of flagellar creatine kinase in the sperm phosphocreatine shuttle
      is linked to its membrane association properties.
AB  - TCK, the flagellar creatine kinase (ATP:creatine N-phosphotransferase) of sperm
      from the sea urchin Strongylocentrotus purpuratus is a membrane-associated
      lipophilic protein involved in energy transport. The cDNA derived protein
      sequence contains a consensus site sufficient for the covalent attachment of
      myristate. To examine whether TCK was myristoylated, mouse fibroblast Swiss 3T3
      and baby hamster kidney cell lines were transfected with a cDNA encoding the
      entire TCK protein linked to a metallothionein promotor. TCK expression was
      induced by zinc and paralleled by incorporation of [3H]myristic acid derived
      label into the protein. 3H Label incorporated into TCK was resistant to
      hydroxylamine treatment. The 3H-labeled material released from TCK by acid
      methanolysis eluted from a C18 reverse phase high pressure liquid chromatography
      column at the positions of myristic acid and methylmyristate. Thus, TCK expressed
      in transfected mammalian cell lines contains authentic myristic acid, covalently
      attached through amide linkage. [3H]Myristoyl TCK comigrated on two-dimensional
      gels with the purified lipophilic isoform TCK II from sea urchins. Furthermore,
      like TCK II, [3H]myristoyl TCK associated with phospholipid liposomes, suggesting
      that myristoylation may mediate the observed membrane association of TCK.
      Myristoylation of sea urchin sperm flagellar creatine kinase may play a role in
      confining this enzyme to the flagellum during spermatogenesis.

PMID- 1634545
TI  - Interaction of AP-1-, AP-2-, and Sp1-like proteins with two distinct sites in the
      upstream regulatory region of the plasminogen activator inhibitor-1 gene mediates
      the phorbol 12-myristate 13-acetate response.
AB  - Phorbol 12-myristate 13-acetate induces a 3- and 10-fold induction of
      chloramphenicol acetyltransferase (CAT) activity in HT1080 and HeLa cells,
      respectively, following transient transfection of a 336-base pair plasminogen
      activator inhibitor-1 (PAI-1) promoter fragment linked to a CAT reporter gene.
      Substitution mutations in the regions encompassing nucleotides -78 to -69
      (TGGGTGGGGC) or -61 to -54 (TGAGTTCA), but not in the regions -155 to -149
      (TGCCTCA) or -84 to -76 (AGTGAGTGG) reduced this induction. Gel electrophoresis
      of double-stranded -65 to -50 oligonucleotides of the PAI-1 promoter region and
      nuclear extracts from Hela cells produced a gel shift pattern similar to that
      obtained with a AP-1 consensus oligomer, and excess unlabeled AP-1 oligomer
      reverted binding, suggesting that this region of the PAI-1 promoter is an AP-1
      like binding site. Gel electrophoresis of double-stranded -82 to -65
      oligonucleotides with HeLa nuclear extracts revealed a gel shift pattern of three
      bands; Sp1 consensus oligomer competed with the binding to two of these bands and
      AP-2 consensus sequence oligomer with the binding to the third band. The -82 to 
      65 oligomer also bound to purified AP-2 and Sp1 proteins. Southwestern blotting
      of HeLa nuclear extracts revealed that the labeled oligomer spanning region -82
      to -65 bound to proteins with molecular masses of 52 and 72 kDa. Consensus AP-2
      oligonucleotides competed for binding of the labeled -82 to -65 oligonucleotide
      to the 52-kDa protein, but consensus Sp-1 oligonucleotides did not compete for
      binding to the 72-kDa compound. The 72-kDa component binding to the -82 to -65
      region may represent a new protein involved in transcriptional regulation.

PMID- 1634546
TI  - Folding of human lysozyme in vivo by the formation of an alternative disulfide
      bond.
AB  - The mutant h-lysozyme, W64CC65A, with Trp64 and Cys65 replaced by Cys and Ala,
      respectively, was secreted by yeast and purified. Peptide mapping confirmed that
      W64CC65A contained a nonnative Cys64-Cys81 bond and three native disulfide bonds.
      The mutant had 2% of the lytic activity of the wild-type lysozyme. The midpoint
      concentration of the guanidine hydrochloride denaturation curve, the [D]1/2, was
      2.7 M for W64CC65A at pH 3.0 and 25 degrees C, whereas the [D]1/2 for the wild
      type h-lysozyme was 2.9 M. These results show that the W64CC65A protein is a
      compactly folded molecule. Our previous results, using the mutant C81A, indicate
      that Cys81 is not required for correct folding and activity, whereas Cys65 is
      indispensable (Taniyama, Y., Yamamoto, Y., Kuroki, R., and Kikuchi, M. (1990) J.
      Biol. Chem. 65, 7570-7575). Cys64 substituted for Cys65 in W64CC65A, even though
      the distance between the alpha-carbons at positions 64 and 81 in the wild-type h
      lysozyme is not favorable for forming a disulfide bond. Unlike C81A, the mutant
      W64CC65/81A, which has the additional substitution of Ala for Cys81, did not
      fold. These results suggest that the absence of both the Cys64-Cys81 bond and the
      amino acid residue Trp64 caused the misfolding or destabilization of W64CC65/81A
      in vivo. It is proposed that the formation of the alternative bond, Cys64-Cys81
      is important for the folding of W64CC65A in vivo.

PMID- 1634547
TI  - Use of fetal intestinal isografts from normal and transgenic mice to study the
      programming of positional information along the duodenal-to-colonic axis.
AB  - The four principal cellular constituents of the mouse intestinal epithelium are
      all derived from a multipotent stem cell functionally anchored near the base of
      its crypts. Differentiation of enterocytes, enteroendocrine, and goblet cells
      occurs during an orderly upward migration from monoclonal crypts supplied by a
      single active stem cell to adjacent polyclonal small intestinal villi or to their
      colonic homologs, the surface epithelial cuffs. Paneth cells differentiate as
      they descend to the base of crypts. This epithelium undergoes rapid and perpetual
      renewal yet is able to maintain cephalocaudal (duodenal-to-colonic) differences
      in the differentiation programs of its four cell types from the time of its
      initial cytodifferentiation in late fetal life (embryonic (E) days 16-17). Rat
      liver fatty acid-binding protein/human growth hormone transgenes (Fabpl/hGH) have
      been used as novel phenotypic markers to describe the biological properties of
      gut stem cells and the differentiation programs of their enterocytic and
      enteroendocrine lineages. To determine whether the multipotent stem cell is able
      to retain a "positional" address in the absence of luminal signals, we prepared
      isografts from the proximal small intestine or distal small intestine and colon
      of E15-E16 Fabpl/hGH transgenic mice and their normal littermates and implanted
      them into the subcutaneous tissues of young, adult male CBY/B6 nude mice.
      Immunocytochemical and histochemical studies indicate that appropriate position
      specific differences in the differentiation programs of each of the four
      principal cell lineages are present along the cephalocaudal and crypt-to-villus
      (or crypt-to-epithelial cuff) axes of isografts harvested 4-6 weeks after
      implantation. This suggests that the gut stem cell can be characterized not only
      by its multipotency and enormous capacity for self-renewal but also by its
      ability to be programmed (? imprinted) with positional information. Transgene
      expression is reduced in a number of enteroendocrine subpopulations in small
      intestinal and colonic isografts compared to the intact gut. Moreover, the
      decision to express the Fabpl/hGH transgene appears to be coordinated between
      adjacent crypts as evidenced by (i) the presence of multicrypt patches of wholly
      reporter (hGH)-positive or reporter-negative cells in the intact colon and in
      colonic isografts and (ii) by the presence of coherent bands of reporter-positive
      or -negative cells that emanate from adjacent monophenotypic crypts and extend to
      the apical extrusion zone of distal small intestinal villi.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1634548
TI  - Localization of the C termini of the Rh (rhesus) polypeptides to the cytoplasmic
      face of the human erythrocyte membrane.
AB  - We have raised a rabbit antiserum to a synthetic peptide corresponding to the C
      terminus (residues 400-416) of the Rh30A polypeptide. The rabbit antiserum
      reacted with the Rh30B (D30) polypeptide in addition to the Rh30A (C/c and/or
      E/e) polypeptide(s), indicating that these proteins share homology at their C
      termini. The antiserum did not react with erythrocyte membranes from an
      individual with Rh(null) syndrome. The rabbit antiserum immunoprecipitated Rh
      polypeptides from erythrocyte membranes and alkali-stripped membranes, but not
      from intact erythrocytes. Treatment of intact red cells with carboxypeptidase Y
      did not affect the reactivity of the antiserum, whereas treatment of alkali
      stripped and unsealed erythrocyte ghost membranes resulted in the loss of
      antibody binding. Carboxypeptidase A treatment of intact erythrocytes and alkali
      stripped membranes had no effect on antibody binding, indicating that the C
      terminal domains of the Rh polypeptides contain lysine, arginine, proline, or
      histidine residues. These results show that the C termini of the Rh polypeptides
      are located toward the cytoplasmic face of the erythrocyte membrane. Treatment of
      intact radioiodinated erythrocytes with bromelain followed by immunoprecipitation
      with monoclonal anti-D gave a band of M(r) 24,000-25,000, indicating that the
      Rh30B (D30) polypeptide is cleaved at an extracellular domain close to the N or C
      terminus, with loss of the major radioiodinated domain. Immunoblotting of
      bromelain treated D-positive erythrocyte membranes with the rabbit antiserum to
      the C-terminal peptide revealed a new band of M(r) 6000-6500, indicating that the
      extracellular bromelain cleavage site is located near the C terminus of the
      molecule. The band of M(r) 6000-6500 was not obtained in erythrocyte membranes
      derived from bromelain treated D-negative erythrocytes. Erythrocytes of the rare 
      D- phenotype appear to either totally lack, or have gross alterations in, the
      Cc/Ee polypeptide(s), since the bromelain treatment of these cells resulted in
      the total loss of staining in the M(r) 35,000-37,000 region and the concomitant
      appearance of the new band of M(r) 6000-6500.

PMID- 1634549
TI  - Lipoprotein lipase release from BFC-1 beta adipocytes. Effects of triglyceride
      rich lipoproteins and lipolysis products.
AB  - Lipoprotein lipase (LPL), synthesized by adipocytes and myocytes, must be
      transported to the luminal endothelial cell surface where it then interacts with
      circulating lipoproteins. The first step in this extracellular LPL transport
      pathway is LPL release from the surface of LPL-synthesizing cells. Because
      hydrolysis of triglyceride (TG)-rich lipoproteins releases LPL from the apical
      surface of endothelial cells, we hypothesized that the same substances dissociate
      LPL from adipocytes. 125I-LPL was bound to the surface of brown adipocytes (BFC-1
      beta). LPL binding to the adipocyte surface was greater than to endothelial cell
      surfaces. Using low concentrations of heparin, more LPL was released from
      endothelial cells than BFC-1 beta, suggesting that the affinity of LPL binding to
      the adipocytes was greater than LPL affinity for endothelial cells. Greater than
      3-fold more LPL was released from the cell surface when very low density
      lipoproteins (VLDL) were added to culture medium containing 3% bovine serum
      albumin. LPL remaining on the cell surface decreased with VLDL addition.
      Endogenously produced LPL activity was also released from the cells by VLDL. Low
      and high density lipoproteins did not release 125I-LPL or LPL activity from the
      adipocytes. To assess whether lipolysis was necessary for LPL release, BFC-1 beta
      were incubated with TG-rich lipoproteins from a patient with apoCII deficiency.
      The apoCII-deficient lipoproteins did not release LPL unless an exogenous source
      of apoCII was added. Apolipoproteins E and Cs and high molar ratios of oleic
      acid:bovine serum albumin did not release surface-associated LPL. Lysolecithin
      (25 and 100 microM), but not lecithin, monoglycerides, or diglycerides, released
      adipocyte surface LPL. Because lysolecithin also released LPL during a 4 degrees
      C incubation, cellular metabolic functions are not required for LPL dissociation
      from the cells. Lysolecithin also inhibited LPL binding to endothelial cells;
      however, this effect was abrogated by addition of bovine serum albumin. We
      hypothesize that lipolysis products from TG-rich lipoproteins release adipocyte
      surface LPL, which can then be transported to the luminal endothelial cell
      surface.

PMID- 1634550
TI  - Purification and characterization of multiple components of human lymphoblastoid
      interferon-alpha.
AB  - Twenty-two components of human interferon-alpha (IFN-alpha) derived from Sendai
      virus-induced Namalwa cells were purified by sequential immunoadsorbent affinity
      chromatography using four monoclonal antibody affinity columns followed by
      ultrafiltration and reversed-phase high-performance liquid chromatography. The
      specific activity ranged from 0.2 to 2.6 x 10(8) IU/mg protein on Madin-Darby
      bovine kidney cells, 0.3 to 4.6 x 10(8) IU/mg protein on human WISH cells, and
      10(4) to 7 x 10(5) units/mg protein on mouse L929 cells. The apparent molecular
      weights of the components ranged from 17,500 to 23,300 using nonreducing sodium
      dodecyl polyacrylamide-gel electrophoresis and 17,500 to 27,600 using reducing
      sodium dodecyl polyacrylamide-gel electrophoresis. The amino-terminal amino acid
      sequences were similar among the components as well as to those reported for the
      cloned human IFN-alpha genes (Pestka, S. (1986) Methods Enzymol. 119, 3-14).
      However, four components, f, i, l, and m, have amino-terminal amino acid
      sequences which appear to be unique when compared to those predicted from the
      cDNA clones. One component, pre-a, has a potential N-linked glycosylation site on
      the Asn of residues 2 through 4, Asn-Leu-Ser.

PMID- 1634551
TI  - Heterologous desensitization of platelet-derived growth factor-mediated
      arachidonic acid release and prostaglandin synthesis.
AB  - Prolonged treatment of quiescent Swiss 3T3 cells with vasopressin induced
      heterologous desensitization of specific early signals stimulated by platelet
      derived growth factor (PDGF). PDGF caused a striking dose-dependent release of
      [3H]arachidonic acid (EC50 = 2 ng/ml) and prostaglandin E2 (EC50 = 5 ng/ml).
      These responses are severely attenuated (greater than 85%) by prior exposure to
      vasopressin in a dose-dependent manner (IC50 = 1.5 nM). Maximal loss of
      responsiveness occurred after 40 h of vasopressin treatment with a half-maximal
      desensitization after 11-13 h. The desensitization is dependent upon binding to
      the V1 receptor, since it can be prevented by the antagonist [Pmp1,O-Me
      Tyr2,Arg8]vasopressin. In contrast, stimulation of inositol phosphate
      accumulation and production of diacylglycerol and phosphatidic acid by PDGF are
      unchanged. Thus, the observed heterologous desensitization cannot be attributed
      to an inability to activate phospholipase C. Furthermore, prior exposure to
      vasopressin did not affect the ability of PDGF to evoke tyrosine phosphorylation
      of cellular substrates, demonstrating that vasopressin-induced heterologous
      desensitization causes a block at a point distal to activation of receptor
      tyrosine kinase activity. Other downstream responses including transient
      induction of c-fos expression and stimulation of DNA synthesis were attenuated by
      vasopressin pretreatment. The findings demonstrate a novel mechanism of
      heterologous cellular desensitization namely, persistent occupancy of a guanine
      nucleotide-binding protein-coupled receptor, like the V1 type vasopressin
      receptor, attenuates responsiveness to a polypeptide growth factor like PDGF that
      initiates responses through a tyrosine kinase receptor.

PMID- 1634552
TI  - Coordinate regulation of glycogen metabolism in the yeast Saccharomyces
      cerevisiae. Induction of glycogen branching enzyme.
AB  - The yeast glycogen branching enzyme (EC 2.4.1.18) is shown to be induced in batch
      culture simultaneously with the onset of intracellular glycogen accumulation. The
      branching enzyme structural gene (GLC3) has been cloned. Its predicted amino acid
      sequence is very similar to procaryotic branching enzymes. Northern analysis
      indicates that GLC3 mRNA abundance increases in late exponential growth phase
      coincident with glycogen accumulation. Disruption of the branching enzyme
      structural gene establishes that branching enzyme activity is an absolute
      requirement for maximal glycogen synthesis.

PMID- 1634553
TI  - Identification of the type 2 proinsulin processing endopeptidase as PC2, a member
      of the eukaryote subtilisin family.
AB  - Enzymological studies have implicated two Ca(2+)-dependent endopeptidases in the
      conversion of proinsulin to insulin; a type 1 activity which cleaves on the C
      terminal side of Arg31-Arg32 and a type 2 activity which cleaves C-terminally to
      Lys64-Arg65 in the proinsulin sequence. The possibility that these enzymes are
      related to the recently discovered family of mammalian subtilisin-like gene
      products (furin, PC2, and PC3) and the yeast propheromone-converting enzyme (KEX
      2), was investigated. Degenerate oligonucleotide primers flanking the putative
      catalytic domain within this gene family were used in a polymerase chain reaction
      to amplify related sequences from rat insulinoma cDNA. One major product of 700
      base pairs was obtained which was greater than 99% identical to the corresponding
      rat PC2 sequence. This cDNA was subcloned into the bacterial expression vector
      pGEX-3X to generate a recombinant protein for antibody production. Western blot
      analysis showed the immunoreactivity was prominent in neuroendocrine tissues as a
      65-kDa protein. It was concentrated in secretory granule-enriched fractions of
      insulinoma tissue, where it was present as a readily solubilized monomeric
      protein. Deglycosylation studies using endoglycosidase H and N-glycanase showed
      that the 65-kDa protein was comprised of approximately 9% carbohydrate,
      consistent with the presence of three consensus sequences for N-linked
      glycosylation in rat PC2. The immunoreactivity co-eluted with the type 2
      proinsulin endopeptidase on gel filtration and ion-exchange chromatography and
      the antisera specifically immunoprecipitated type 2 activity from insulin granule
      extracts. N-terminal sequence analysis of the immunoreactive protein gave two
      sequences which corresponded to residues 109-112 and 112-119 of rat PC2. This
      indicated that posttranslational processing of PC2 itself occurs C-terminally to
      basic amino acids to produce the mature enzyme. It is concluded that PC2 is the
      type 2 endopeptidase involved in proinsulin conversion. Localization of PC2
      immunoreactivity to other tissues of the diffuse neuroendocrine system suggests
      that the type 2 endopeptidase also functions in the processing of precursor forms
      of other prohormones and polypeptide neurotransmitters.

PMID- 1634554
TI  - Sphingosine activation of protein kinases in Jurkat T cells. In vitro
      phosphorylation of endogenous protein substrates and specificity of action.
AB  - Sphingosine displays multiple biochemical and biological effects, in particular
      inhibition and activation of protein kinases. To determine the predominant
      interaction of sphingosine with cellular kinases, the effects of sphingosine on
      endogenous protein phosphorylation in Jurkat T lymphoblastic cells were
      investigated in vitro. Sphingosine was found to cause prominent phosphorylation
      of a number of cytosolic proteins ranging in molecular mass from 18 to 165 kDa.
      Phosphorylation was calcium-independent. Phosphorylation of substrates was
      increased in response to concentrations of sphingosine as low as 10 microM and
      peaked at concentrations of 20-200 microM. Multiple lines of evidence suggested
      that sphingosine activated more than one protein kinase: 1) the concentration
      dependence on sphingosine differed from substrate to substrate, 2)
      phosphorylation of one group of substrates required ATP as the phosphate donor,
      whereas a second group showed no preference between ATP and GTP, and 3)
      phosphorylation of some substrates was inhibited by heparin, whereas other
      substrates were resistant. Activation of these kinases demonstrated a very
      specific requirement for D-erythro-sphingoid bases. DL-erythro-dihydrosphingosine
      was partially active, whereas DL-threo-dihydrosphingosine was not. Other related
      molecules such as stearylamine, sphingomyelin, and C2-ceramide were not active.
      Sphingosine-activated kinase(s) were distinct from protein kinase C, cyclic
      nucleotide-activated kinases, and calcium-dependent kinases. These observations
      demonstrate the existence of multiple sphingosine-activated protein kinases with
      high specificity for D-erythro-sphingosine, suggesting physiologic regulation of
      protein phosphorylation by sphingosine.

PMID- 1634555
TI  - A novel human insulinoma-associated cDNA, IA-1, encodes a protein with "zinc
      finger" DNA-binding motifs.
AB  - A subtraction library was constructed from human insulinoma (beta cell tumor) and
      glucagonoma (alpha cell tumor) cDNA phagemid libraries. Differential screening of
      153 clones with end-labeled mRNAs from insulinoma, glucagonoma, and HeLa cells
      resulted in the isolation of a novel cDNA clone designated IA-1. This cDNA clone
      has a 2838-base pair sequence consisting of an open reading frame of 1530
      nucleotides, which translates into a protein of 510 amino acids with a pI value
      of 9.1 and a molecular mass of 52,923 daltons. At the 3'-untranslated region
      there are seven ATTTA sequences between two polyadenylation signals (AATAAA). The
      IA-1 protein can be divided into two domains based upon the features of its amino
      acid sequence. The NH2-terminal domain of the deduced protein sequence (amino
      acids 1-250) has four classical pro-hormone dibasic conversion sites and an
      amidation signal sequence, Pro-Gly-Lys-Arg. The COOH-terminal domain (amino acids
      251-510) contains five putative "zinc-finger" DNA-binding motifs of the form X3
      Cys-X2-4-Cys-X12-His-X3-4-His-X4 which has been described as a consensus sequence
      for members of the Cys2-His2 DNA-binding protein class. Northern blot analysis
      revealed IA-1 mRNA in five of five human insulinoma and three of three murine
      insulinoma cell lines. Expression of this gene was undetectable in normal
      tissues. Additional tissue studies revealed that the message is expressed in
      several tumor cell lines of neuroendocrine origin including pheochromocytoma,
      medullary thyroid carcinoma, insulinoma, pituitary tumor, and small cell lung
      carcinoma. The restricted tissue distribution and unique sequence motifs suggest
      that this novel cDNA clone may encode a protein associated with the
      transformation of neuroendocrine cells.

PMID- 1634556
TI  - Proceedings of the workshop on methodology and protocol of human fertility
      studies under field conditions. June 1991.

PMID- 1634557
TI  - Human fertility studies under field conditions. Introduction.

PMID- 1634558
TI  - The female reproductive axis and its modifications during the post-partum period.

PMID- 1634559
TI  - Aetiological approach of female reproductive physiology in lactational
      amenorrhoea.

PMID- 1634560
TI  - Breast-feeding patterns, maternal milk output and lactational infecundity.

PMID- 1634561
TI  - The assessment of total energy expenditure of female farmers under field
      conditions.
AB  - The paper reviews methods, and their difficulties, in the measurement of the
      daily energy expenditure of rural women under field conditions in developing
      countries. Since all methods need to be validated against a reference method
      which is usually based on indirect calorimetry, examples of the use of this
      technique are given. The energy costs of most agricultural and daily tasks of
      rural women in developing countries have been measured. Large intra- and inter
      individual variations in the cost of a single activity occur, so repeated
      measurements are needed to obtain a valid mean energy cost for a specific
      activity for a homogeneous group of individuals. Much work remains to be done on
      the assessment of the duration and the intensity of the physical activity of the
      rural adolescent and adult female population. Studies indicate that the workload
      of most rural women in developing countries is excessive and frequently
      associated with acute poverty.

PMID- 1634562
TI  - Estimating energy and nutrient intakes in studies of human fertility.
AB  - Two methods of dietary recording, the 24-hr recall and the weighed dietary intake
      methods, are considered appropriate for estimating energy and nutrient intakes in
      studies of human fertility. The former method gives lower estimates than the
      latter, although weighed intakes may underestimate true intakes. Examination of
      food intakes of pregnant, lactating, and non-pregnant, non-lactating New Guinean
      women shows their diet to be less homogeneous than is generally assumed for
      groups in developing countries. As a result direct observations of food intake
      for a limited number of days are not sufficiently accurate for the estimation of
      intake of most of the nutrients examined. Rather the study design should reflect
      the variability of intakes of the nutrients and groups under consideration.

PMID- 1634563
TI  - Estimates of metabolic adaptation in women living in developing countries:
      technical limitations.
AB  - The measurement of food intake has long been used to describe 'adaptation' to low
      energy intakes in certain tropical peoples. However, the methods available to
      quantify food intake are unlikely to reflect accurately real energy intakes in
      free living peoples. Alternatively, estimating energy expenditure shows some
      promise--particularly the measurement of basal metabolic rate (BMR). The BMR may
      be measured effectively in males, but females show wide intra-individual
      variation in BMR during their menstrual cycle, which makes BMR measurements more
      difficult to interpret in the context of adaptation. The use of double-labelled
      water may be the only method suitable to quantify and define 'adaptation' to low
      intakes in women.

PMID- 1634564
TI  - Endemic disease, nutrition and fertility in developing countries.

PMID- 1634565
TI  - Maternal body composition: methods for measuring short-term changes.
AB  - The measurement of short-term changes in maternal body composition during the
      post-partum period under field conditions poses many problems: (1) body
      composition techniques depend on the constancy of the proportions of components
      or their physical properties and are less suitable for measuring changes; (2)
      many of the techniques require expensive, technically sophisticated apparatus
      that is inappropriate to field conditions in many countries; (3) changes in body
      composition affect some areas of the body more than others so regional as well as
      whole body approaches are required. The measurements of body weight, triceps and
      subscapular skinfold thicknesses and upper arm circumference are essential
      measurements. These can be supplemented with further skinfold thicknesses and
      circumferences, and possibly body density and body water measurements. There is
      little to be gained by transforming anthropometric variables into whole body
      composition indices in these circumstances.

PMID- 1634566
TI  - Brief description of WHO protocol for data collection.

PMID- 1634567
TI  - Round table discussion on research design, statistical aspects and data
      collection.

PMID- 1634568
TI  - The ecology of birth seasonality among agriculturalists in central Africa.
AB  - The Lese are subsistence farmers living in the Ituri Forest of north-east Zaire.
      They exhibit significant birth seasonality, with lowest frequencies of conception
      when food production is least, nutritional status is low and ovarian function, as
      measured by salivary steroid hormone levels, is reduced. Efe pygmy foragers, who
      live in the same geographical area but are less dependent on cultivated foods and
      have a more flexible life style, do not exhibit frequent fluctuations in
      nutritional status nor significant birth seasonality. These findings support a
      model of birth seasonality relating climatic variables to variation in fertility
      through a causal chain linking rainfall to food production to energy balance to
      ovarian function to fertility. The model, which emphasises an ecological approach
      to the study of human reproduction, should have broad applicability since
      seasonality of food production and energy balance is widespread geographically
      and across a wide variety of economies and cultures.

PMID- 1634569
TI  - Studies on perceived breast-milk insufficiency: relation to attitude and
      practice.
AB  - Fifty-one mother-infant pairs were followed prospectively by home visits and
      telephone contacts during the first 6 months post-partum. Comparisons between
      mothers who experienced lactation crises because of perceived breast-milk
      insufficiency (crisis group) and those who did not (non-crisis group) revealed
      differences in attitudes to breast-feeding, breast-feeding behaviour and sexual
      life. The crisis group tended to initiate breast-feeding for infant-related
      reasons more frequently than the non-crisis group, which more frequently gave
      mother-related reasons. During the course of breast-feeding attitude changes in a
      negative direction were significantly more common in the crisis group. No
      difference was found between the groups in the resumption of sexual life, but 59%
      of all the women claimed that they experienced less or no desire compared to
      before pregnancy and, of these, a significantly higher proportion belonged to the
      crisis group.

PMID- 1634570
TI  - Fixation with a single screw for slipped capital femoral epiphysis.
AB  - The effectiveness of a single 6.5 or seven-millimeter-diameter screw for the
      promotion of premature physeal closure and the provision of stability of a
      slipped capital femoral epiphysis was investigated. Physeal fusion was
      demonstrated in forty-nine (92 per cent) of fifty-three hips after fixation with
      a single screw. Premature fusion of the involved physis, compared with the
      uninvolved, contralateral physis, was documented (p less than 0.001). Epiphyseal
      stability, as measured by the lateral head-shaft angle, was maintained in all
      except one hip. An analysis of twenty-nine hips for which there was a complete
      set of radiographs, that were in patients who had no endocrine problems, and that
      were the first hips entered into the study when the patient had bilateral
      involvement, revealed an average time to closure of the physeal line of thirteen
      months. A longer time to physeal fusion was correlated with increasingly
      eccentric placement of the screw (r = 0.44, p = 0.016) and increasing severity of
      the slip (r = -0.536, p = 0.003). There was no correlation between the age at the
      time of the operation, race, or sex and the time to physeal fusion. Only one
      patient had penetration by a screw, and no chondrolysis, avascular necrosis, or
      other serious problems developed. Fixation with a single 6.5 or seven-millimeter
      diameter screw provided adequate epiphyseal stability and promoted premature
      physeal fusion in our patients, while decreasing the rate of complications
      compared with that reported to be associated with fixation with multiple screws
      or pins.

PMID- 1634571
TI  - Slipped capital femoral epiphysis. A prospective study of fixation with a single
      screw.
AB  - Forty-four children (fifty-eight hips) who had a slipped capital femoral
      epiphysis were managed by in situ pinning with a single cannulated screw. This
      method of treatment was first used in our institution in 1983. Thirty-one boys
      and thirteen girls were followed for an average of three years (range, two to six
      years). There were eight acute slips and fifty chronic slips. Thirty-four
      patients were black and ten patients were white. The clinical criteria of Heyman
      and Herndon and the radiographic parameters cited by Boyer et al. were used to
      grade the results. Fifty-four hips were rated as either excellent or good.
      Avascular necrosis developed in one patient who had an acute slipped capital
      femoral epiphysis, but chondrolysis did not occur in any patient. The
      complications included a subtrochanteric fracture in one patient and an increase
      in the degree of slippage of the capital femoral epiphysis in two patients.

PMID- 1634572
TI  - Clinical determination of femoral anteversion. A comparison with established
      techniques.
AB  - We evaluated femoral anteversion preoperatively in fifty-nine patients (ninety
      one hips), using a clinical method that we developed, Magilligan radiographs, and
      computed tomographic scans. These measurements were then compared with values for
      anteversion that were obtained intraoperatively. To determine femoral anteversion
      clinically, the patient was placed in the prone position and the maximum lateral
      trochanteric prominence was related to the degree of internal rotation of the
      hip. Compared with computed tomographic scanning and Magilligan radiographic
      determination, the clinically determined anteversion correlated most closely (to
      within 4 degrees) with the amount measured at the time of the operation. The
      clinical method was found to be superior to radiographic techniques for
      determination of the degree of femoral anteversion in children who have not had a
      previous operation about the hip.

PMID- 1634573
TI  - Residual chymopapain activity after chemonucleolysis in normal intervertebral
      discs in dogs.
AB  - Studies were carried out to demonstrate residual chymopapain activity in
      intervertebral discs after chemonucleolysis; protease assay, enzyme-linked
      immunosorbent assay, and immunohistochemical localization of the chymopapain in
      the disc tissue were done. Chymopapain, one milligram per level, was injected
      into the normal lumbar intervertebral discs of adult mongrel dogs and the discs
      were excised after two weeks. Proteolytically active chymopapain was still
      present in the extract of intervertebral disc at this time. The proteolytic
      activity was decreased by sulfhydryl inhibitors but not by inhibitors of
      metalloproteases or serine proteases. Protease and enzyme-linked immunosorbent
      assays showed that 0.60 +/- 0.48 per cent and 0.49 +/- 0.38 per cent of the
      original dose was present two weeks after the injection. Chymopapain was shown by
      immunohistochemical staining to be diffusely located throughout the extracellular
      matrix of the anulus fibrosus and the nucleus pulposus. Some cells, located
      mainly in the inner portion of the anulus, contained vacuoles filled with
      immunoreactive product.

PMID- 1634574
TI  - The effect of femoral stem geometry on interface motion in uncemented porous
      coated total hip prostheses. Comparison of straight-stem and curved-stem designs.
AB  - We compared the magnitudes of motion between the prosthesis and bone during axial
      and torsional loading in seven matched pairs of fresh-frozen femora of cadavera
      in which an uncemented, collarless, isthmus-filling, straight-stem (Harris
      Galante) prosthesis had been placed in one femur and an uncemented, collarless,
      proximal-filling, curved-stem (anatomic) prosthesis had been placed in the other
      femur. The comparison was performed in order to determine the effect of the
      geometry of the stem on the magnitude of motion. Single-limb-stance loads and
      combined axial and torsional loads were applied to the implanted femoral
      prostheses with the use of a jig that simulated acetabular and trochanteric
      loading. Extensometers were used to measure motion at the prosthesis-bone
      interface. The prostheses were then removed and were reinserted, with cement
      applied to the proximal porous coating to simulate ingrowth of bone. The single
      limb-stance and combined axial and torsional loads were reapplied and the
      magnitude of motion was recorded again. No significant differences in the
      magnitudes of the motion were found between the femora in which the straight stem
      had been implanted and the femora in which the curved stem had been implanted,
      during either simulated single-limb-stance or low-intensity torsional loading.
      When large torsional moments (twenty-two newton-meters) were applied,
      significantly less motion occurred at the bone-prosthesis interface, both
      proximally (p = 0.019) and distally (p = 0.0013), in the femora with the curved
      stem implant than in the femora with the straight-stem implant. When cement had
      been applied proximally, proximal and distal motion between the prosthesis and
      the femur was decreased during simulated single-limb-stance and during torsional
      loading in the femora with the straight stem and the femora with the curved stem.

PMID- 1634575
TI  - Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and
      the concept of the effective joint space.
AB  - Thirty-four hips in which there had been prosthetic replacement were selected for
      study because of the presence of linear (diffuse) or lytic (localized) areas of
      periprosthetic bone loss. In all hips, there was careful documentation of the
      anatomical location of the material that had been obtained for histological
      analysis, and the specific purpose of the removal of the tissue was for
      examination to determine the cause of the resorption of bone. Specimens from
      twenty-three hips were retrieved during an operation and from eleven hips, at
      autopsy. The area of bone loss was linear only in sixteen hips, lytic only in
      thirteen, and both linear and lytic in five. In all thirty-four hips,
      intracellular particulate debris was found in the macrophages that were present
      in the area of bone resorption. All thirty-four had intracellular particles of
      polyethylene, many of which were less than one micrometer in size. Thirty-one
      hips had extracellular particles of polyethylene as well. Twenty-two of the
      thirty-four hips had intracellular metallic debris; in ten, metallic debris was
      found extracellularly as well. Ten of the sixteen cemented specimens had
      intracellular and extracellular polymethylmethacrylate debris. In the
      mechanically stable prostheses--cemented and uncemented--polyethylene wear debris
      was identified in areas of bone resorption far from the articular surfaces. The
      number of macrophages in a microscopic field was directly related to the amount
      of particulate polyethylene debris that was visible by light microscopy. Although
      the gross radiographic appearances of linear bone loss and lytic bone loss were
      different, the histological appearance of the regions in which there was active
      bone resorption was similar. Regardless of the radiographic appearance and
      anatomical origin of the specimen, bone resorption was found to occur in
      association with macrophages that were laden with polyethylene debris. In
      general, the number of macrophages present had a direct relationship to the
      degree of bone resorption that was seen. We believe that these findings indicate
      that joint fluid penetrates far more extensively than previously thought, even in
      a well fixed component, along the interface between the prosthesis and bone and
      in the periprosthetic tissues; it is often more extensive than is shown by
      arthrography. We therefore suggest the concept of the effective joint space to
      include all periprosthetic regions that are accessible to joint fluid and thus
      accessible to particulate debris.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1634576
TI  - Osteolysis after total knee arthroplasty without cement.
AB  - The prevalence and characteristics of osteolysis were studied after 174
      consecutive total knee arthroplasties, performed without cement; 16 per cent
      (twenty-seven) of the implants (in twenty-six patients) were identified as being
      associated with osteolysis. The diagnosis was made an average of thirty-five
      months after the operation. Fifteen (56 per cent) of the twenty-seven prostheses
      were revised after an average of forty-five months in situ. The remaining twelve
      implants were still in situ five years or more postoperatively. In the patients
      who were managed with revision, six implants were judged to be stable
      radiographically and intraoperatively. The remaining nine implants were loose.
      The average age of the patients who had osteolysis was sixty-three years, and the
      average weight was seventy-six kilograms (168 pounds). Eighteen of the twenty-six
      patients who had osteolysis were women. The medial aspect of the tibial
      metaphysis was the most common site for resorption of bone (twenty-four knees).
      Sequential radiographs demonstrated progressive extension of the osteolytic
      process around the tibial base-plate of the prosthesis and distally into the
      tibial metaphysis along the screw-bone interface in all patients. Histological
      evaluation of tissue obtained at the revision procedures revealed sheets of
      histiocytes and occasional giant cells. Intracellular particulate polyethylene
      and metal were found; most particles were less than one micrometer in size,
      although particles as large as three micrometers were identified. Mechanical
      failure of the thin, modular, polyethylene tibial insert; excessive abrasion of
      the prominent polyethylene tibial eminence, with secondary wear and impingement
      of the pin on the femoral component; and failure of the metal-backed patellar
      component all contributed to the extensive amount of polyethylene and the
      variable amount of metal debris that were generated. Corrosion between the
      angulated titanium screws and the cobalt-chromium base-plate also contributed
      particulate metal to the osteolytic process locally. This study demonstrated that
      osteolysis occurs in association with cementless total knee replacement.

PMID- 1634577
TI  - Unicompartmental knee replacement: a comparison of constrained and unconstrained
      designs.
AB  - Seventy-six patients who had eighty-seven unicompartmental knee replacements were
      followed for an average of fifty-three months (range, two to twelve years). The
      operation was on the medial side in eighty-two knees and on the lateral side in
      five. Fifty replacements were unconstrained and thirty-seven were constrained. Of
      the fifty knees that had an unconstrained replacement, forty-nine (98 per cent)
      had a good or excellent result, compared with only twenty-six (70 per cent) of
      the knees that had a constrained replacement; the difference is significant (p =
      0.0007). No knee that had an unconstrained replacement had a poor result,
      compared with nine (24 per cent) of the knees that had a constrained replacement
      (p = 0.0009). Four (8 per cent) of the fifty knees that had an unconstrained
      replacement later had a revision total knee arthroplasty, compared with ten (27
      per cent) of the thirty-seven knees that had a constrained replacement; the
      difference is significant (p = 0.04). Noteworthy degenerative changes in the
      opposite compartment occurred in only one of the eighty-seven knees (a knee in
      which an unconstrained prosthesis had been inserted).

PMID- 1634578
TI  - Modular hemiarthroplasty for fractures of the proximal part of the humerus.
AB  - A new biomodular prosthesis was used for the treatment of a displaced fracture of
      the proximal part of the humerus in twenty-two shoulders in twenty-two patients.
      The fractures were classified according to the Neer system; there were thirteen
      four-part, five three-part, and four head-splitting fractures. There were fifteen
      women and seven men, and the mean age was seventy years (range, forty-nine to
      eighty-seven years). The hemiarthroplasty was performed an average of eleven days
      (range, one to forty-five days) after the injury. The deltopectoral interval was
      used in all patients, and the prosthesis was implanted with cement in twenty of
      the shoulders. All of the patients participated in a supervised program of
      rehabilitation. The patients were followed for an average of thirty-six months
      (range, twenty-six to forty-nine months). Twenty of the twenty-two patients had a
      good or excellent result. The active forward elevation averaged 119 degrees;
      external rotation, 40 degrees; and internal rotation, to the twelfth thoracic
      vertebra. All of the patients except for the two who had a poor result had
      satisfactory relief of pain. The two patients who had a poor result had a
      successful revision with a modular prosthesis of the same design. The modular
      head could be removed, enabling the surgeon to gain access to the glenoid and to
      adjust the soft tissues. The over-all scores correlated inversely with the age of
      the patients and the interval from the injury to the operation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1634579
TI  - Treatment of instability of the shoulder with an exercise program.
AB  - One hundred and forty shoulders in 115 patients that had a diagnosis of traumatic
      or atraumatic recurrent anterior, posterior, or multidirectional subluxation were
      treated with a specific set of muscle-strengthening exercises. Only twelve (16
      per cent) of the seventy-four shoulders (sixty-eight patients) that had traumatic
      subluxation had a good or excellent result from the exercises, compared with
      fifty-three (80 per cent) of the sixty-six shoulders that had atraumatic
      subluxation. For this reason, each patient who has instability of the shoulder
      should be thoroughly evaluated if a successful result from conservative treatment
      is to be expected. Every effort must be made to identify the etiology of the
      instability through careful history-taking, physical examination, and
      radiographic evaluation.

PMID- 1634580
TI  - Comparison of orthoroentgenography and computed tomography in the measurement of
      limb-length discrepancy.
AB  - To determine the most accurate roentgenographic technique for the measurement of
      limb-length discrepancy, the twenty lower extremities of ten cadavera were
      measured with use of both orthoroentgenograms and lateral scout computed
      tomographic scanograms. The actual anatomical limb length also was measured, to
      serve as a control. The effects of flexion of the knee joint, use of an external
      fixator, cost and time of the examination, and exposure to radiation also were
      determined. No statistically significant difference in the measurements of the
      length of the femur was found between the two methods at neutral or at 15, 30, or
      45 degrees of flexion of the knee. However, computed tomography was significantly
      more accurate than orthoroentgenography in the measurements of length of the
      tibia and of total length of the limb when the knee was flexed to 30 degrees or
      more (p less than 0.01). The placement of an Ilizarov fixator did not alter the
      results. The cost and time necessary to complete an examination were comparable
      for the two methods. However, computed tomography delivered only 20 per cent of
      the radiation needed for orthoroentgenography. Computed tomography is more
      accurate than orthoroentgenography for the measurement of limb-length discrepancy
      in patients who have a flexion deformity of the knee.

PMID- 1634581
TI  - Arthrodesis of the ankle in patients who have rheumatoid arthritis.
AB  - We reviewed thirty-two arthrodeses of the ankle in twenty-six patients who had
      rheumatoid arthritis. In seventeen patients (eighteen ankles), a compression
      arthrodesis was done and external fixation was used. In eight patients (twelve
      ankles), we used internal fixation with 6.5-millimeter cancellous-bone screws. In
      the remaining patient, an arthrodesis with external fixation was done in one
      ankle and internal fixation was used in the other ankle; data for the appropriate
      ankle are included in each group. The patients were followed for an average of
      thirty-three months. The two groups were comparable with respect to age, sex,
      preoperative medications, and severity of disease. The average time to fusion was
      nineteen weeks in the compression arthrodesis group and seventeen weeks in the
      internal fixation group. Of the nineteen ankles that had a compression
      arthrodesis, four failed to fuse; all of the failures were associated with
      infection. Infection developed in two additional patients, there was malposition
      of the fusion in three patients, and neurapraxia developed in three patients. Of
      the thirteen ankles that had internal fixation, three ankles failed to fuse; one
      of the failures was associated with infection. Infection developed in one
      additional ankle. In two patients, the ankle fused in excessive valgus.
      Comparison of the two groups revealed comparable rates of fusion: fusion occurred
      in fifteen of the nineteen ankles in the group that had compression arthrodesis
      and in ten of the thirteen ankles in the group that had internal fixation. The
      method of arthrodesis did not affect the time to fusion or the rate of
      complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634582
TI  - Reflex sympathetic dystrophy in children. Clinical characteristics and follow-up
      of seventy patients.
AB  - We report on the experience with our first seventy patients who had reflex
      sympathetic dystrophy and were less than eighteen years old (average age, 12.5
      years). In our series, the patients were predominantly girls (male to female
      ratio, 11:59) and the lower extremity was involved most often (sixty-one of the
      seventy patients). The average time from the initial injury to the diagnosis was
      one year, which indicates that the syndrome remains under-recognized in patients
      in this age-group. Conservative treatment with physical therapy, transcutaneous
      electrical nerve stimulation, psychological therapies including cognitive
      behavioral management and relaxation training, and tricyclic anti-depressants was
      effective in improving the average scores for pain and function for forty
      patients. Sympathetic blocks were helpful for twenty-eight of thirty-seven
      patients. Thirty-eight of the seventy patients in the series continued to have
      some degree of residual pain and dysfunction. Reflex sympathetic dystrophy in
      children differs in presentation and clinical course from the syndrome in adults.
      It is best treated in a multidisciplinary fashion.

PMID- 1634583
TI  - The effect of low-frequency electrical fields on osteogenesis.
AB  - An in vivo animal model of disuse osteopenia was used to determine the osteogenic
      potential of specific components of electrical fields. The ability of a complex
      pulsed electrical field to inhibit loss of bone was compared with the remodeling
      response generated by extremely low-power, low-frequency (fifteen, seventy-five,
      and 150-hertz) sinusoidal electrical fields. The left ulnae of thirty adult male
      turkeys were functionally isolated by creation of distal and proximal epiphyseal
      osteotomies and then were exposed, for one hour each day, to an electrical field
      that had been induced exogenously by means of magnetic induction. After a fifty
      six-day protocol, the remodeling response was quantified by a comparison of the
      cross-sectional area of the mid-part of the diaphysis of the functionally
      isolated ulna with that of the intact contralateral ulna. Disuse resulted in a 13
      per cent mean loss of osseous tissue, which was not significantly different than
      the 10 per cent loss that was caused by disuse treated with inactive coils.
      Exposure to the pulsed electrical fields prevented this osteopenia and stimulated
      a 10 per cent mean increase in the bone area. The osteogenic influence of the
      sinusoidal electrical fields was strongly dependent on the frequency; the 150,
      seventy-five, and fifteen-hertz sinusoidal fields, respectively, generated a -3
      per cent, + 5 per cent, and + 20 per cent mean change in the bone area. These
      results suggest a tissue sensitivity that is specific to very low-frequency
      sinusoidal electrical fields, and they imply that the induced electrical fields
      need not have complex waveforms to be osteogenic. Since the frequency and
      intensity range of the sinusoidal fields producing the greatest osteogenic
      response are similar to the levels produced intrinsically by normal functional
      activity, these results support the hypothesis that electricity plays a role in
      the retention of the normal remodeling balance within mature bone.

PMID- 1634584
TI  - Recurrent giant-cell tumor with metaplasia and malignant change, not associated
      with radiotherapy. A case report.

PMID- 1634585
TI  - Pseudotumor of the distal part of the femur in a patient who had
      myelomeningocele. A case report.

PMID- 1634586
TI  - The response to bone allografts.

PMID- 1634587
TI  - Reconstruction of malunited fractures of the lateral malleolus.

PMID- 1634588
TI  - Simple bone cysts of the pelvis in adolescents. A report of four cases.

PMID- 1634589
TI  - Pigmented villonodular synovitis of the knee. The results of total arthroscopic
      synovectomy, partial arthroscopic synovectomy, and arthroscopic local excision.

PMID- 1634590
TI  - Annotation: historical research in child and adolescent psychiatry: scope,
      methods and application.

PMID- 1634591
TI  - The Emanuel Miller Memorial Lecture 1991. Autism and autistic-like conditions:
      subclasses among disorders of empathy.
AB  - Recent autism and autism-related research from Gothenburg is surveyed. In
      indigenous families, typical autism seems no more common now than 10 years ago.
      Genetic factors play a part in causing autism and Asperger syndrome. Certain
      medical syndromes carry a relatively high risk of concomitant autistic symptoms.
      Evidence for non-specific brain dysfunction is often found in autism and autistic
      like conditions. The search for the underlying clue to the riddle of autism may
      be futile. Autism might be best conceptualized as a behavioural syndrome
      reflecting underlying brain dysfunction which shades into other clinical
      syndromes. A new class of disorders of empathy is proposed.

PMID- 1634592
TI  - Unfamiliar face recognition in relatively able autistic children.
AB  - Two experiments were carried out assessing autistic children's recognition,
      discrimination, and fixation of unfamiliar faces and unfamiliar buildings. The
      experiments showed that (i) unfamiliar face recognition is impaired relative to
      normal peers, non-verbal ability matched and verbal ability matched controls.
      Relative to verbal ability matched controls (ii) recognition of buildings is
      normal; (iii) there is an enhanced discrepancy between face discrimination and
      buildings discrimination, in favour of buildings; and (iv) fixation is normal.
      Analysis of the results suggests that impaired face recognition does not result
      from impaired attention or discrimination.

PMID- 1634593
TI  - Do young calendrical calculators improve with age?
AB  - The calendrical calculation performance of two 10-year-old children of the same
      intelligence level (IQ 90) but different calendrical ability, was compared with
      the performance of eight adult idiot-savant calculators. The calculating speeds
      of the two 10-year olds fell within the range of the reaction times of the adult
      savants. No improvement was detectable in a series of successive trials over
      time, either in speed or accuracy. It is concluded that the young calculators
      have already inferred rules about calendrical structure and that their
      performance cannot be accounted for by practice alone, but these savants use
      cognitive strategies to aid their performance.

PMID- 1634594
TI  - The relationship between digit sucking and behaviour problems: a longitudinal
      study over 10 years.
AB  - Data from the Dunedin (New Zealand) Multidisciplinary Health and Development
      Study were used to examine continuity and discontinuity in digit sucking between
      5 and 11 years. The data were also used to examine the relationship between digit
      sucking and behaviour problems at 5, 7, 9, 11 and 15 years. Cross-sectional
      analyses showed a relationship between digit sucking and behaviour problems at
      all ages, except 5 years. Longitudinal analysis by multiple regression showed
      that digit sucking at 5 and 7 years predicted behaviour problems at 7, 9 and 11
      years. This effect was most apparent at 7 years. Children who sucked their digits
      at 11 years were more likely to have overjets of 6mm or more between their upper
      and lower dental arches. The behavioural and dental evidence suggest that it
      would be better for children to stop sucking their digits before they started
      school and acquired their permanent dentition.

PMID- 1634595
TI  - Rates of Obsessive Compulsive Disorder in first degree relatives of patients with
      trichotillomania: a research note.
AB  - To explore a possible relationship between trichotillomania, (TTM) (compulsive
      hair pulling) and Obsessive Compulsive Disorder (OCD), 65 out of 69 (94%) first
      degree relatives of 16 female probands with severe chronic TTM were compared with
      two control groups for OCD and for TTM. Three (19%) of the 16 TTM probands had at
      least one first degree relative with a lifetime history of OCD, and there was an
      age corrected rate of 6.4% of first degree relatives with OCD. No relative in
      control group (A) met criteria for OCD. There was a trend (Fishers exact p = .07,
      two tailed) for a higher rate (age corrected) of OCD in TTM families; these pilot
      data are consistent with the concept of a spectrum of obsessive compulsive
      disorders which includes TTM and other pathological grooming behaviours.

PMID- 1634596
TI  - Patterns of psychiatric disorder in adopted girls: a research note.
AB  - Over a 15-year period adopted children were overrepresented in a psychiatric
      clinic population. The excess was seen in all age groups and there was no rise of
      referrals of adoptees during adolescence. Adopted boys showed the same range of
      disorder as all referred boys. Adopted girls were more likely than other girls to
      have conduct disorders. Those with conduct disorders were more likely than non
      adopted girls with the same disorder to be taken into care and to be given
      inpatient treatment. Differences in family structure and relationships were found
      both between conduct disordered girls of different adoptive status and between
      adopted girls with conduct and other disorders.

PMID- 1634597
TI  - Maternal predictors of behavioral disturbance in preschool children: a research
      note.
AB  - The effects of maternal mental health and familial stress on child behavior were
      evaluated in a community sample of 691 preschoolers. Presence of behavior
      problems was determined using the Behavior Screening Questionnaire (BSQ) at age
      3, and using the Conners Parent Rating Scale at age 4. In multivariate analyses,
      the development of disturbance was predicted by higher BSQ score, maternal role
      competition and maternal hostility assessed at both interviews; persistence was
      predicted by initial BSQ score and initial maternal hostility only. These results
      underscore the complexity of the relationships among maternal, familial and
      childhood variables.

PMID- 1634598
TI  - Detection of pea seedborne mosaic potyvirus by sequence specific enzymatic
      amplification.
AB  - The polymerase chain reaction (PCR) was used to detect pea seedborne mosaic
      potyvirus (PSbMV) pathotype P1 RNA after reverse transcription of total nucleic
      acid preparations from pea (Pisum sativum) tissues. Tissues assayed for PSbMV
      included leaves, roots, petals, seed parts, and pollen. Three oligonucleotide
      primers in appropriate combination yielded two products of the predicted size:
      730 and 1200 bp. The described methodology allows for rapid pathotype-specific
      PSbMV detection with utmost sensitivity and wide applicability.

PMID- 1634599
TI  - Direct sequence analysis of amplified dengue virus genomic RNA from cultured
      cells, mosquitoes and mouse brain.
AB  - A method is described for direct sequence analysis of selected regions of dengue
      virus genomic RNA in infected tissues. Using specific primers, total high
      molecular-weight infected-cell RNA is reverse transcribed to single-stranded (ss)
      complementary DNA, amplified using the polymerase chain reaction (PCR) and
      sequenced using ssDNA obtained after lambda exonuclease digestion of one strand
      of the PCR product (R.G. Higuchi and H. Ochman, Nucleic Acids Research, 17, 5865,
      1989). Sequence data for the envelope protein gene of two dengue-3 virus isolates
      were obtained using RNA from small numbers (10(5)) of cultured mosquito or monkey
      kidney cells, from one mg of infected mouse brain and from 1/300th of an infected
      Toxorhynchites amboinensis mosquito. Independent determinations showed that
      errors occurring during reverse transcription or PCR were not represented to a
      significant degree in the sequence of the amplified DNA. The method does not
      depend on extensive passaging of virus or large-scale growth to generate material
      for sequencing and therefore provides a means of obtaining sequence data for
      unadapted dengue virus isolates.

PMID- 1634600
TI  - Rapid diagnosis of influenza A. Comparison with ELISA immunocapture and culture.
AB  - The Directigen Flu-A is an enzyme immunoassay for detecting in 15 min the
      influenza A nucleoproteinic antigen directly from specimens after passive
      adsorption on a cellulose membrane. The test was assessed using 160 frozen (-20
      degrees C) specimens collected during the 1988-1989 A/H1N1 influenza epidemic and
      the 1989-1990 A/H3N2 epidemic. Compared to the ELISA immunocapture test, the
      sensitivity of the commercial test was 87.8% and the specificity was 97.6%. When
      compared to isolation of viruses on LLCMK2 cells and/or chicken embryo, the
      sensitivity was 84%. No cross-reaction was found with other respiratory disease
      viruses. The feasibility, practicability and rapidity of the test make it a test
      of choice for rapid diagnosis of influenza A.

PMID- 1634601
TI  - Development and application of protein G antibody assay for the detection of
      antibody to hantavirus.
AB  - A new serodiagnostic method designated protein-G antibody assay (PGA) was
      developed for detection of hantavirus infection in various species of animals.
      The assay procedure includes reacting the sera with hantavirus-infected cells on
      glass slides, followed by incubation of biotinylated protein G and amplification
      with the avidin-biotinylated peroxidase complex. Specific antibody in rabbit,
      rat, mouse and Mongolian gerbil serum was detected by this method. The PGA titres
      were similar to those of the neutralization titre. In the sera of Mongolian
      gerbils infected with strain SR-11, antibody was first detected 10 days post
      infection, and the titre increased to 1:256 at 18 days post-infection. PGA was
      evaluated using sera of urban rats (Rattus norvegicus) captured in an endemic
      area of hantavirus infection. The negative (much less than 1:1, 24/62, 38.7%) and
      positive groups (much greater than 1:16, 38/62, 61.3%) were clearly
      distinguished. PGA titres were closely related to IFA titres in the sera. Two of
      10 sera from Clethrionomys rufocanus and one from Apodemus speciosus captured in
      the same endemic area were positive to both PGA and IFA. These data indicate that
      PGA is a simple and useful method for seroepizootiological surveys of hantavirus
      infection, especially in wild rodent reservoirs.

PMID- 1634602
TI  - Transforming growth factor-beta in disease: the dark side of tissue repair.

PMID- 1634603
TI  - Thyroid hormone modulation of the hypothalamic growth hormone (GH)-releasing
      factor-pituitary GH axis in the rat.
AB  - Both thyroid hormone and hypothalamic growth hormone (GH)-releasing factor (GRF)
      facilitate pituitary somatotroph function. However, the pathophysiological role
      of thyroid hormone in GRF secretion is less well understood. Thyrotoxicosis,
      induced by administration of thyroxine (T4) in rats, inhibited both pituitary GH
      levels and immunoreactive GRF secretion from incubated hypothalamus. At the
      highest dose of T4 given for 12 d, GRF secretion and pituitary GH decreased by 50
      and 39%, respectively. Hypothyroidism induced by thyroidectomy (Tx) enhanced GRF
      secretion approximately twofold while depleting pituitary GH by greater than 99%.
      Both of these hypothalamic and pituitary effects were reversed by replacement of
      T4 but not human GH for 7 or 14 d. Human GH was as potent as T4 in restoring
      decreased body weight gains or serum insulin-like growth factor-1 levels in Tx
      rats. These results indicate that at both physiological and pathological
      concentrations in serum, thyroid hormone acts as an inhibitory modulator of GRF
      secretion, probably not involving a feedback mechanism through GH. A biphasic
      effect of thyroid hormone on pituitary GH levels appears to derive from the
      difference in primary target tissues of hyper- and hypothyroidism, the
      hypothalamus and the pituitary, respectively.

PMID- 1634604
TI  - Nuclear expression of the 50- and 65-kD Rel-related subunits of nuclear factor
      kappa B is differentially regulated in human monocytic cells.
AB  - The nuclear factor (NF)-kappa B transcription factor system is composed of at
      least four inducible nucleoprotein adducts termed p50, p55 (NF-kappa B p50), p75
      (NF-kappa B p65), and p85 (c-Rel). These proteins are expressed in the nuclei of
      activated T cells in a distinctly biphasic fashion, with p55 and p75 induction
      occurring within minutes whereas the induction of p50 and p85 occurs after
      several hours. In contrast, p50 and p55 are constitutively expressed in the
      nuclei of U937 and THP-1 monocytic cells. However, cellular activation is
      required for the nuclear expression of p75 in these cells. Additionally,
      activation of monocytic cells does not result in a significant induction of p85.
      Tumor necrosis factor alpha induces the nuclear expression of p55 and p75 in
      these monocytic cells within 20 min, presumably reflecting the liberation of
      these proteins from I kappa B. In contrast, phorbol myristate acetate (PMA)
      induces the expression of these proteins with delayed kinetics, raising the
      possibility that PMA is incapable of mediating the efficient release of p55 and
      p75 from I kappa B in these cells. These findings highlight important differences
      in the regulation of these proteins in monocytic cells versus T cells and suggest
      that the induced expression of NF-kappa B p65 in monocytes may play a central
      role in the activation of HIV-1 gene expression.

PMID- 1634605
TI  - Human enterocyte (Caco-2) migration is modulated in vitro by extracellular matrix
      composition and epidermal growth factor.
AB  - The modulation of enterocyte sheet migration was studied using Caco-2 cells, a
      well-differentiated human colonic cell line. Although Caco-2 cells attached and
      spread equivalently over collagen types I, III, IV, and V and laminin, migration
      over laminin was significantly slower than migration over the collagen types.
      Fibronectin was a poor substrate for attachment, spreading, and migration.
      Epidermal growth factor (EGF) stimulated migration over laminin but did not alter
      Caco-2 migration over collagen or fibronectin. This effect was independent of
      cell proliferation, which was stimulated equivalently on both laminin and
      collagen I. Expression and organization of cell surface receptors for matrix
      (integrins) were studied using antibodies specific for beta and alpha integrin
      subunits. Integrin surface expression was assessed by immunoprecipitation of
      surface 125iodinated control and EGF-treated cells. Beta 1 surface pools did not
      change substantially in any condition studied. Alpha 1 subunit pools were
      decreased after EGF treatment on collagen I but alpha 1 pools increased after EGF
      treatment on laminin. Surface pools of alpha 2 subunits were increased following
      EGF treatment whether cells were cultured on laminin or collagen I. However,
      traditional immunofluorescent and laser confocal imaging demonstrated substantial
      differences in the character of alpha 2 subunit organization between collagen and
      laminin in the migrating cell front. Furthermore, a functional antibody to the
      alpha 2 subunit inhibited EGF stimulation of migration over laminin without
      substantial effects on basal migration over laminin or collagen I. Thus, EGF
      appears to exert a matrix-specific effect on enterocyte migration by modulation
      of integrin expression and organization.

PMID- 1634606
TI  - Identification of a genetic alteration in the code for bilirubin UDP
      glucuronosyltransferase in the UGT1 gene complex of a Crigler-Najjar type I
      patient.
AB  - Patients with Crigler-Najjar syndrome (CN) type I inherit an autosomal recessive
      trait for hyperbilirubinemia, which is characterized by the total absence of
      bilirubin UDP-glucuronosyltransferase (transferase) activity. The recent
      identification of two bilirubin transferase isoforms with identical carboxyl
      termini (Ritter, J. K., J. M. Crawford, and I. S. Owens. 1991. J. Biol. Chem.
      266:1043-1047) led to the discovery of a unique locus, UGT1, which encodes a
      family of UDP-glucuronosyltransferase isozymes, including the two bilirubin forms
      (Ritter, J. K., F. Chen, Y. Y. Sheen, H. M. Tran, S. Kimura, M. T. Yeatman, and
      I. S. Owens. 1992. J. Biol. Chem. 267:3257-3261). The UGT1 locus features a
      complex of six overlapping transcriptional units encoding transferases, each of
      which shares the four most 3' exons (2, 3, 4, and 5) specifying the 3' half of
      the transferase coding regions (condons 289-533) and the entire 3' untranslated
      region of each mRNA. This gene model predicts that a single critical mutation in
      any of these four "common" exons may inactivate the entire family of encoded
      transferases. In agreement with this prediction, we show here that in the first
      CN type I individual analyzed (patient F.B.), a 13-bp deletion has occurred in
      exon 2. Analysis of product generated by the polymerase chain reaction and
      genomic DNA demonstrated that F.B. is homozygous for the defective allele
      (UGT1*FB), and that the consanguineous parents are both heterozygotic at this
      locus. The mutation is predicted to result in the synthesis of severely truncated
      bilirubin transferase isozymes that are lacking a highly conserved sequence in
      the carboxyl-terminus and the characteristic membrane (endoplasmic reticulum)
      anchoring segment of the protein molecule.

PMID- 1634607
TI  - Identification of a common mutation in Finnish patients with nonketotic
      hyperglycinemia.
AB  - Nonketotic hyperglycinemia (NKH) is an autosomal recessive metabolic disorder
      caused by the defects in the glycine cleavage system (GCS; EC 2.1.2.10), a
      multienzyme system that consists of four individual components. NKH is a rare
      disorder in many countries, but with a very high incidence in northern Finland.
      To understand the genetic background of this high incidence, we examined the GCS
      in a typical case of NKH at the molecular level. The activity of P protein, a
      component of the GCS, was not detected in the lymphoblasts of the patient, while
      P protein mRNA of a normal size and level was present in the cells. Structural
      analysis of P protein mRNA from the patient revealed a single nucleotide
      substitution from G to T in the protein coding region, which resulted in an amino
      acid alteration from Ser564 to Ile564. No P protein activity was detected when
      the mutant P protein with this amino acid substitution was expressed in COS 7
      cells. The patient was homozygous for this mutation. Furthermore, this mutation
      was present in 70% (14 of 20) of P protein gene alleles in Finnish patients with
      NKH, whereas it was not found in 20 alleles of non-Finnish patients. The results
      suggest that this mutation is responsible for the high incidence of NKH in
      Finland.

PMID- 1634608
TI  - A T cell-dependent experimental liver injury in mice inducible by concanavalin A.
AB  - Male NMRI or BALB/c mice developed severe liver injury as assessed by
      transaminase release within 8 h when an intravenous dose greater than 1.5 mg/kg
      concanavalin A (Con A) was given. Histopathologically, only the liver was
      affected. Electron micrographs revealed leukocyte sticking to endothelial cells
      and bleb formation of hepatocytes. The hepatotoxicity of the lectin correlated
      neither with its agglutination activity nor with its sugar specificity.
      Administration of 0.5 mg/kg dexamethasone or 50 mg/kg cyclosporine A or 50 mg/kg
      FK 506 (Fujimycin) resulted in protection of the animals whereas indomethacin
      pretreatment failed to protect. Con A hepatitis was accompanied by the release of
      IL-2 into the serum of the animals. Mice with severe combined immunodeficiency
      syndrome lacking B as well as T lymphocytes were resistant against Con A. Athymic
      nude mice with immature T lymphocytes were also resistant. Pretreatment of mice
      with an antibody against T lymphocytes fully protected against Con A as did
      monoclonal anti-mouse CD4. Monoclonal anti-mouse CD8 failed to protect.
      Pretreatment of mice with silica particles, i.e., deletion of macrophages,
      prevented the induction of hepatitis. These findings provide evidence that Con A
      induced liver injury depends on the activation of T lymphocytes by macrophages in
      the presence of Con A. The model might allow the study of the pathophysiology of
      immunologically mediated hepatic disorders such as autoimmune chronic active
      hepatitis.

PMID- 1634609
TI  - The familial hypercholesterolemia (FH)-North Karelia mutation of the low density
      lipoprotein receptor gene deletes seven nucleotides of exon 6 and is a common
      cause of FH in Finland.
AB  - A mutation of the LDL receptor gene very common among Finnish patients with
      heterozygous familial hypercholesterolemia (FH) was identified. This mutation,
      designated as FH-North Karelia, deletes seven nucleotides from exon 6 of the LDL
      receptor gene, causes a translational frameshift, and is predicted to result in a
      truncated receptor protein. Only minute quantities of mRNA corresponding to the
      deleted gene were detected. Functional studies using cultured fibroblasts from
      the patients revealed that the FH-North Karelia gene is associated with a
      receptor-negative (or binding-defective) phenotype of FH. Carriers of the FH
      North Karelia gene showed a typical xanthomatous form of FH, with mean serum
      total and LDL cholesterol levels of 12 and 10 mmol/liter, respectively. This
      mutation was found in 69 (34%) out of 201 nonrelated Finnish FH patients and was
      especially abundant (prevalence 79%) in patients from the eastern Finland. These
      results, combined with our earlier data on another LDL receptor gene deletion (FH
      Helsinki), demonstrate that two "Finnish-type" mutant LDL receptor genes make up
      about two thirds of FH mutations in this country, reflecting a founder gene
      effect. This background provides good possibilities to examine whether genetic
      heterogeneity affects the clinical presentation or responsiveness to therapeutic
      interventions in FH.

PMID- 1634610
TI  - Molecular basis of fibrinogen Naples associated with defective thrombin binding
      and thrombophilia. Homozygous substitution of B beta 68 Ala----Thr.
AB  - In an abnormal fibrinogen (fibrinogen Naples) associated with congenital
      thrombophilia we have identified a single base substitution (G----A) in the B
      beta chain gene that results in an amino acid substitution of alanine by
      threonine at position 68 in the B beta chain of fibrinogen. The propositus and
      two siblings were found to be homozygous for the mutation, whereas the parents
      and another sibling were found to be heterozygous. Individuals homozygous for the
      defect had a severe history of both arterial and venous thrombosis; heterozygous
      individuals had no clinical symptoms. The three homozygotes had a prolonged
      thrombin clotting time in plasma, whereas the heterozygotes had a normal thrombin
      clotting time. Fibrinopeptide A and B (FpA and FpB) release from purified
      fibrinogen by human alpha-thrombin was delayed in both the homozygous propositus
      and a heterozygous family member. Release of FpA from the normal and abnormal
      amino-terminal disulfide knot (NDSK) corresponded to that found with the intact
      fibrinogens, indicating a decreased interaction of thrombin with the NDSK part of
      fibrinogen Naples. Binding studies showed that fibrin from homozygous abnormal
      fibrinogen bound less than 10% of active site inhibited alpha-thrombin as
      compared with normal fibrin, while fibrin formed from heterozygous abnormal
      fibrinogen bound approximately 50% of alpha-thrombin. These results suggest that
      the mutation of B beta Ala 68----Thr affects the binding of alpha-thrombin to
      fibrin, and that defective binding results in a decreased release of FpA and FpB
      in both homozygous and heterozygous abnormal fibrinogens.

PMID- 1634611
TI  - Abnormal sympathetic overactivity evoked by insulin in the skeletal muscle of
      patients with essential hypertension.
AB  - The reason why hyperinsulinemia is associated with essential hypertension is not
      known. To test the hypothesis of a pathophysiologic link mediated by the
      sympathetic nervous system, we measured the changes in forearm norepinephrine
      release, by using the forearm perfusion technique in conjunction with the
      infusion of tritiated NE, in patients with essential hypertension and in normal
      subjects receiving insulin intravenously (1 mU/kg per min) while maintaining
      euglycemia. Hyperinsulinemia (50-60 microU/ml in the deep forearm vein) evoked a
      significant increase in forearm NE release in both groups of subjects. However,
      the response of hypertensives was threefold greater compared to that of
      normotensives (2.28 +/- 45 ng.liter-1.min-1 in hypertensives and 0.80 +/- 0.27
      ng.liter-1 in normals; P less than 0.01). Forearm glucose uptake rose to 5.1 +/-
      .7 mg.liter-1.min-1 in response to insulin in hypertensives and to 7.9 +/- 1.3
      mg.liter-1.min-1 in normotensives (P less than 0.05). To clarify whether insulin
      action was due to a direct effect on muscle NE metabolism, in another set of
      experiments insulin was infused locally into the brachial artery to expose only
      the forearm tissues to the same insulin levels as in the systemic studies. During
      local hyperinsulinemia, forearm NE release remained virtually unchanged both in
      hypertensive and in normal subjects. Furthermore, forearm glucose disposal was
      activated to a similar extent in both groups (5.0 +/- 0.6 and 5.2 +/- 1.1
      mg.liter-1.min-1 in hypertensives and in normals, respectively). These data
      demonstrate that: (a) insulin evokes an abnormal muscle sympathetic overactivity
      in essential hypertension which is mediated by mechanisms involving the central
      nervous system; and (b) insulin resistance associated with hypertension is
      demonstrable in the skeletal muscle tissue only with systemic insulin
      administration which produces muscle sympathetic overactivity. The data fit the
      hypothesis that the sympathetic system mediates the pathophysiologic link between
      hyperinsulinemia and essential hypertension.

PMID- 1634612
TI  - Transplantation of thymic autoimmune microenvironment to severe combined
      immunodeficiency mice. A new model of myasthenia gravis.
AB  - To study the role of the thymus in the cellular pathogenesis of myasthenia gravis
      (MG) we transplanted thymus tissue fragments from MG thymuses beneath the kidney
      capsule of severe combined immunodeficiency (SCID) mice. Immunocytochemical
      studies documented that the human thymus tissues are accepted as long-term grafts
      in the host SCID mice, with human lymphocytes, thymic stroma, and thymic myoid
      cells demonstrable in transplanted thymus for at least 15 weeks after
      transplantation. Human anti-acetylcholine receptor antibodies became detectable 1
      to 2 weeks after transplantation, and in most chimeras the titers increased over
      at least 11 weeks to reach levels typically found in severe human MG. Human Ig
      deposits were detected at skeletal muscle end-plates, demonstrating that the
      human (auto)antibodies bound to murine acetylcholine receptor. In contrast,
      transfers of dissociated thymus cells only lead to a transient increase of anti
      acetylcholine receptor antibodies. Our data prove that myasthenia gravis thymus
      is able to induce and maintain autoantibody production in immunodeprived host
      animals, and that this tissue contains all cellular components required for
      autoantibody production. Transplantation of solid thymus tissue seems to transfer
      an autoimmune microenvironment, which will allow direct studies of the mechanism
      of autosensitization inside the thymus.

PMID- 1634613
TI  - Induction of heme oxygenase is a rapid, protective response in rhabdomyolysis in
      the rat.
AB  - Heme proteins such as myoglobin or hemoglobin, when released into the
      extracellular space, can instigate tissue toxicity. Myoglobin is directly
      implicated in the pathogenesis of renal failure in rhabdomyolysis. In the
      glycerol model of this syndrome, we demonstrate that the kidney responds to such
      inordinate amounts of heme proteins by inducing the heme-degradative enzyme, heme
      oxygenase, as well as increasing the synthesis of ferritin, the major cellular
      repository for iron. Prior recruitment of this response with a single preinfusion
      of hemoglobin prevents kidney failure and drastically reduces mortality (from
      100% to 14%). Conversely, ablating this response with a competitive inhibitor of
      heme oxygenase exacerbates kidney dysfunction. We provide the first in vivo
      evidence that induction of heme oxygenase coupled to ferritin synthesis is a
      rapid, protective antioxidant response. Our findings suggest a therapeutic
      strategy for populations at a high risk for rhabdomyolysis.

PMID- 1634614
TI  - Expression of a missense mutation in the messenger RNA for beta-myosin heavy
      chain in myocardial tissue in hypertrophic cardiomyopathy.
AB  - We have determined that a missense mutation in exon 13 of the beta-myosin heavy
      chain (beta MHC) gene is expressed in the messenger RNA (mRNA) isolated from a
      right ventricular endomyocardial biopsy obtained from the proband of a family
      with hypertrophic cardiomyopathy. The mutation is the result of a substitution of
      an adenine for a guanine residue in one allele of the beta MHC gene and creates a
      second recognition site for the restriction endonuclease Ddel in exon 13. The
      mutation is inherited in a Mendelian fashion and co-segregates with hypertrophic
      cardiomyopathy in this family. Complementary DNAs synthesized from RNA isolated
      from the endomyocardial biopsy were cloned into a plasmid vector and sequenced to
      confirm the expression of both the normal and mutant allele in mRNA of myocardial
      tissue. This is the first report of the transcription of a mutant beta MHC gene
      allele into mRNA of the myocardium.

PMID- 1634615
TI  - Chronic blockade of nitric oxide synthesis in the rat produces systemic
      hypertension and glomerular damage.
AB  - Tonic basal release of nitric oxide (NO) by vascular endothelial cells controls
      blood pressure (BP) in the basal state. In these studies we investigated the
      effects of chronic inhibition of basal NO synthesis in the rat for a 2-mo period.
      Significant systemic hypertension developed in chronically NO-blocked rats
      compared to controls. Marked renal vasoconstriction was also observed with
      elevations in glomerular blood pressure (PGC) and reductions in the glomerular
      capillary ultrafiltration coefficient (Kf). Chronically NO-blocked rats also
      develop proteinuria and glomerular sclerotic injury compared to controls. These
      studies therefore describe a new model of systemic hypertension with glomerular
      capillary hypertension and renal disease due to chronic blockade of endogenous NO
      synthesis. These observations highlight the importance of the endogenous NO
      system in control of normal vascular tone and suggest that hypertensive states
      may result from relative NO deficiency.

PMID- 1634616
TI  - Human hepatic lipocytes synthesize tissue inhibitor of metalloproteinases-1.
      Implications for regulation of matrix degradation in liver.
AB  - Hepatic lipocytes play a central role in the pathogenesis of liver fibrosis, both
      via production of extracellular matrix proteins and through secretion of matrix
      metalloproteinases. In this study, we have characterized lipocyte expression and
      release of tissue inhibitor of metalloproteinases-1 (TIMP-1), an important
      inhibitor of metalloproteinase activity, whose role in liver has not previously
      been examined. TIMP-1 was immunolocalized to human lipocytes, and secretion of
      TIMP-1 was confirmed by ELISA of culture media; (mean +/- SD) 159 +/- 79 ng of
      TIMP-1/10(6) cells per 24 h. Evidence for functional inhibitory activity of
      released TIMP-1 was obtained by (a) reverse zymography that demonstrated a single
      inhibitor band, M(r) 28 kD, that co-migrated with a TIMP-1-positive control
      sample; and (b) unmasking of inhibited gelatinase activity in lipocyte medium by
      separating it from TIMP-1 using gelatin sepharose chromatography; gelatinase
      activity in chromatographed medium increased more than 20-fold, compared with
      unfractionated medium, and could be reinhibited by adding back fractions that
      contained inhibitor. By Northern analysis, freshly isolated human lipocytes
      exhibited low levels of mRNA expression for TIMP-1, but this increased markedly
      relative to beta-actin expression with lipocyte activation during cell culture.
      We conclude that human hepatic lipocytes synthesize TIMP-1, a potent
      metalloproteinase inhibitor, and that TIMP-1 expression increases with lipocyte
      activation. These data indicate that hepatic lipocytes can regulate matrix
      degradation in the liver, and suggest that expression of TIMP-1 by activated
      lipocytes may contribute to the progression of liver fibrosis.

PMID- 1634617
TI  - Adenine nucleotides stimulate migration in wounded cultures of kidney epithelial
      cells.
AB  - Adenine nucleotides speed structural and functional recovery when administered
      after experimental renal injury in the rat and stimulate proliferation of kidney
      epithelial cells. As cell migration is a component of renal regeneration after
      acute tubular necrosis, we have used an in vitro model of wound healing to study
      this process. High density, quiescent monkey kidney epithelial cultures were
      wounded by mechanically scraping away defined regions of the monolayer to
      simulate the effect of cell loss after tubular necrosis and the number of cells
      that migrated into the denuded area was counted. Migration was independent of
      cell proliferation. Provision of adenosine, adenine nucleotides, or cyclic AMP
      increased the number of migrating cells and accelerated repair of the wound.
      Other purine and pyrimidine nucleotides were not effective. Arginine-glycine
      aspartic acid-serine peptide, which blocks the binding of extracellular
      fibronectin to its cell surface receptor, completely inhibited migration in the
      presence or absence of ADP. Very low concentrations of epidermal growth factor
      (K0.5 approximately 0.3 ng/ml) stimulated migration, whereas transforming growth
      factor-beta 2 was inhibitory (Ki approximately 0.2 ng/ml). Thus, adenosine and/or
      adenine nucleotides released from injured or dying renal cells, or administered
      exogenously, may stimulate surviving cells in the wounded nephron to migrate
      along the basement membrane, thereby rapidly restoring tubular structure and
      function.

PMID- 1634618
TI  - Molecular sieving of albumin by the ascending vasa recta wall.
AB  - Molecular sieving of albumin by ascending vasa recta. Evidence exists to support
      the presence of an extravascular pool of albumin in the renal medullary
      interstitium. This study used microperfusion in vivo to measure the transport of
      125I-labeled albumin from descending (DVR) and ascending vasa recta (AVR) to the
      papillary interstitium. Perfusions were performed during furosemide diuresis with
      a buffer containing FITC-labeled dextran (FITC-Dx) 2 x 10(6) mol wt and 125I
      albumin. Perfusate albumin and collection pressure were adjusted to induce either
      zero transcapillary volume flux (Jv) or high volume flux. When Jv was zero, the
      collectate-to-perfusate ratios of FITC-Dx (RDX) and 125I-albumin (Ralb) in the
      DVR and AVR were identical implying that diffusive efflux of albumin was
      immeasurably small. In contrast, when Jv was increased, paired comparison of Ralb
      and RDX in the same AVR revealed a difference, 1.58 +/- 0.06 vs 1.72 +/- 0.08,
      respectively (P less than 0.01). AVR perfusions in hydropenic animals showed
      similar results, Ralb = 1.70 +/- 0.07 and RDX = 2.00 +/- 0.07 (P less than 0.01).
      These data suggest that albumin transport across vasa recta in vivo is likely to
      be governed by solvent drag. The reflection coefficient of the AVR wall to 125I
      albumin is estimated to be 0.78.

PMID- 1634620
TI  - Multiple deletions of mitochondrial DNA in several tissues of a patient with
      severe retarded depression and familial progressive external ophthalmoplegia.
AB  - Multiple deletions of mitochondrial DNA (mtDNA) have recently been reported in
      familial progressive external ophthalmoplegia (PEO), in a case of progressive
      encephalomyopathy, and in inherited recurrent myoglobinuria. The inheritance of
      familial PEO has been autosomal dominant, which indicates that a mutation in an
      unknown nuclear gene results in several mtDNA deletions of different sizes in
      these patients. We report a patient with autosomal dominant PEO, whose major
      clinical symptom, however, was severe retarded depression. The morphological
      analyses of the tissue samples derived from autopsy showed various abnormalities
      in the mitochondria in all the tissues studied. The activities of the respiratory
      chain enzymes encoded by mtDNA were remarkably reduced in the skeletal muscle.
      The mtDNA analyses confirmed that besides myopathy, this patient had a
      multisystem disorder with widespread distribution of multiple deletions of mtDNA.
      The highest percentage of mutated mtDNA was found in the brain, skeletal muscle
      and the heart, the relative quantity of mutated mtDNA correlating to the severity
      of the clinical symptoms.

PMID- 1634619
TI  - Dog mastocytoma cells produce transforming growth factor beta 1.
AB  - Transforming growth factor-beta (TGF beta) promotes deposition of extracellular
      matrix and is associated with fibrotic conditions both in experimental animals
      and in humans. Although a role for mast cells has been suspected in the
      pathogenesis of fibrosis, no potent mediator capable of stimulating fibroblast
      growth or extracellular matrix deposition has been identified in mast cell
      supernatants. We report here the constitutive production of TGF beta 1 by four
      dog mastocytoma cell lines. TGF beta 1 was identified by characteristic biologic
      activity, blockade of biologic effect by specific neutralizing antibody, and by
      recognition of a band with the appropriate migration by western blot. TGF beta 1
      mRNA, but not TGF beta 2 or TGF beta 3 mRNA, was also produced constitutively by
      all four cell lines. Quantitation by bioassay revealed baseline TGF beta
      secretion of approximately 1 ng/10(6) cells over 48 h. Stimulation of mastocytoma
      cells with phorbol ester increased the rate of release of TGF beta 1, most
      markedly in the first 30 min after stimulation, without increasing TGF beta 1
      mRNA. Dog mastocytoma cells produced TGF beta 1 primarily in a latent form,
      inactive until treated with acid. Both pure TGF beta 1 and TGF beta-containing
      mastocytoma cell-conditioned media inhibited mitogenesis and proliferation in dog
      mastocytoma cell lines, suggesting that mast cell tumor lines would not grow
      preferentially based on their ability to produce TGF beta. These studies may make
      possible further investigation of the mechanism by which mast cells contribute to
      the induction of fibrosis.

PMID- 1634621
TI  - Fibrinogen Lima: a homozygous dysfibrinogen with an A alpha-arginine-141 to
      serine substitution associated with extra N-glycosylation at A alpha-asparagine
      139. Impaired fibrin gel formation but normal fibrin-facilitated plasminogen
      activation catalyzed by tissue-type plasminogen activator.
AB  - An A alpha-arginine-141 to serine substitution has been identified in a
      homozygous dysfibrinogen, fibrinogen Lima, associated with impaired fibrin
      polymerization. The point mutation created an asparagine-X-serine-type
      glycosylation sequence, and indeed, extra, mainly disialylated biantennary
      oligosaccharides have been isolated from A alpha asparagine-139 of the patient's
      fibrinogen. This type of glycosylation sequence is unique for human fibrinogen,
      because the sequences shown for normal and abnormal fibrinogens are all
      asparagine-X-threonine types. The terminal sialic acids of the extra
      oligosaccharides seem to have largely contributed to the impaired fibrin gel
      formation, as evidenced by its correction to a near normal level by
      desialylation. Nevertheless, the polymerizing fibrin facilitated tissue-type
      plasminogen activator-catalyzed plasmin formation in a normal fashion, indicating
      that the initial two-stranded fibrin protofibrils had been constructed normally.
      Thus the impaired fibrin gel formation could be attributed to the delay in their
      subsequent lateral association, most probably because of the repulsive forces
      generated by the negative electric charge of the extra sialic acids. The
      substitution of a basic residue arginine to a noncharged residue serine may also
      have contributed to the impaired function in a similar manner or by steric
      hindrance in association with bulky extra oligosaccharide chains.

PMID- 1634622
TI  - The loss of GLUT2 expression by glucose-unresponsive beta cells of db/db mice is
      reversible and is induced by the diabetic environment.
AB  - Glucose-induced insulin secretion by beta cells of diabetic db/db mice was
      studied by a pancreas perfusion technique, and the levels of GLUT2 protein in
      pancreatic islets were assessed by immunofluorescence microscopy and protein blot
      analysis. Beta cells from diabetic mice had a high basal rate of insulin
      secretion; they did not respond to glucose stimulation but displayed a normal
      secretory response to arginine. At the same time, GLUT2 expression by db/db
      islets was lost whereas beta cells from nondiabetic db/+ mice expressed high
      levels of this transporter. GLUT2 levels in liver or kidney of diabetic mice
      were, however, mostly unaltered. Transplanting islets from db/db mice under the
      kidney capsule of db/+ mice restored normal GLUT2 levels. Conversely,
      transplantation of db/+ islets into db/db mice induced the disappearance of GLUT2
      expression. When islets from db/+ mice were transplanted under the kidney capsule
      of streptozocin-diabetic mice, the immunodetection of GLUT2 also disappeared. We
      conclude that: (a) GLUT2 expression is decreased in glucose-unresponsive beta
      cells from db/db mice; (b) the decreased expression of GLUT2 is reversible; (c)
      the loss of GLUT2 expression is induced by the diabetic environment of db/db and
      streptozocin-induced diabetic mice. These observations together with previously
      published data suggest that a factor different from glucose or insulin regulates
      the beta cell expression of GLUT2.

PMID- 1634624
TI  - Radiographic evaluation of early periodontal bone loss in adolescents. An
      overview.
AB  - A number of studies have used radiographs to establish the prevalence of
      periodontal bone loss in adolescents, though widely differing findings have been
      reported. It is likely that such disparity of results can largely be attributed
      to the variety of criteria used to determine the presence of disease, some of
      which are highly subjective. In addition, a number of factors may affect the
      radiographic appearance of commonly chosen reference points. If epidemiological
      studies are to be interpreted correctly, it is important to examine these areas
      and, in particular, to determine the most objective means of recording disease in
      this age group. From a review of the literature, it would seem that assessments
      based on the radiographic distance between the amelo-cemental junction and the
      alveolar crest are the least subjective, yet whether this should be greater than
      2 mm or 3 mm before bone loss is recorded, is still debated.

PMID- 1634623
TI  - Interactions of surfactant protein D with bacterial lipopolysaccharides.
      Surfactant protein D is an Escherichia coli-binding protein in bronchoalveolar
      lavage.
AB  - Surfactant protein D (SP-D) is a collagenous glycoprotein that is secreted into
      the pulmonary airspaces by alveolar type II and nonciliated bronchiolar cells. SP
      D exhibits Ca(++)-dependent carbohydrate binding in vitro and is structurally
      related to the collagenous C-type lectins, including serum conglutinin, serum
      mannose-binding proteins, and surfactant protein A. Preliminary studies showed
      calcium- and saccharide-dependent binding of fluorescein-conjugated or
      radioiodinated SP-D to a variety of microorganisms, including Gram-negative
      bacteria and fungi. A laboratory strain of Escherichia coli (Y1088) was chosen to
      further examine the mechanism(s) of binding. Binding of SP-D to Y1088 was time
      dependent, saturable, and inhibited by cold SP-D or competing saccharides;
      Scatchard analysis gave a Kd of 2 x 10(-11) M. At higher concentrations, SP-D
      also caused Ca(++)-dependent agglutination of Y1088 that was inhibited by alpha
      glucosyl-containing saccharides, antisera to the carbohydrate-binding domain of
      SP-D, or Y1088 LPS. Lectin blots showed specific binding of 125I-SP-D to Y1088
      LPS, as well as LPS from other several strains of enteric Gram-negative bacteria.
      Immunogold studies demonstrated strong and uniform surface labeling of the
      bacteria. Rat and human bronchoalveolar lavage (BAL) caused Ca(++)-dependent
      agglutination of E. coli that was dose dependent and inhibited by competing
      saccharides or anti-SP-D. SP-D was selectively and efficiently adsorbed from rat
      BAL by incubation with E. coli, and incubation of E. coli with radiolabeled rat
      type II cell medium revealed that SP-D is the major E. coli-binding protein
      secreted by freshly isolated cells in culture. We suggest that SP-D plays
      important roles in the lung's defense against Gram-negative bacteria.

PMID- 1634625
TI  - Prevalence of juvenile periodontitis in a circumpubertal population.
AB  - A cross-sectional radiographic screening was performed on bite-wing pairs (BW)
      from 1872 10-12 year old schoolchildren in the Greater Worcester, Massachusetts
      area to assess the prevalence of juvenile periodontitis (JP). The 3-stage
      screening process entailed: (1) visual identification of possible cases based
      upon a visual assessment of BW for interproximal crestal bone levels greater than
      or equal to 2 mm from the cemento-enamel junction (CEJ) on greater than or equal
      to 1 permanent first molar; (2) identification of probable cases based upon BW
      from possible cases measured with a transparent ruler calibrated in millimeters;
      (3) finally, clinical confirmation of JP in consenting probable cases. A total of
      1038 subjects were eligible to be included in the study (greater than or equal to
      3 mesial sites readable). Of the 1038 eligible subjects, 117 possible and 103
      probable cases were identified in stage 1 and stage 2, respectively. A total of
      99 probable cases could be contacted and 43 were examined clinically. Two cases
      of JP were confirmed clinically in stage 3, yielding a prevalence rate of
      4.6/1000. Specifically, this report defines a rate of JP in 10-12 year-old
      schoolchildren for the first time. In addition, these results indicate that BW
      can be used to identify children with JP from large data sets. However, further
      studies including complete clinical and radiographic examinations are necessary
      to determine whether this method is adequate for large epidemiologic studies.

PMID- 1634626
TI  - Guided tissue regeneration combined with osseous grafting in suprabony
      periodontal lesions. An experimental study in the dog.
AB  - The purpose of the present investigation was to evaluate the use of bone grafts
      in combination with the GTR-procedure in reinstituting periodontal support around
      teeth with horizontal bone loss. Orthodontic elastic bands were placed around
      mandibular and maxillary premolars in 3 dogs in order to induce breakdown of the
      periodontal tissues. When the destruction had reached a level corresponding to
      approximately half the root length, the elastic bands were removed and the teeth
      were scaled. After a period with plaque control, mucoperiosteal flaps were
      elevated on the buccal and lingual aspects of the experimental teeth. The exposed
      root surfaces were curetted, and a notch was made at the level of the reduced
      bone crest. In randomly selected test quadrants, Kielbone mixed with fibrin
      sealant (Tisseel) was placed in the interproximal space and in the bifurcations.
      Both the buccal and lingual aspect of the test teeth were then covered by a
      teflon membrane (Zitex) and the raised tissue flaps sutured in a coronally
      displaced position. The contralateral teeth (controls) were treated the same way,
      except that fibrin sealant without Kielbone was applied in the bifurcations and
      the interproximal space prior to the placement of the membranes. The membranes
      were removed by a 2nd operation after 35 days. Clinically, various complications
      were observed during healing. The buccal and lingual flap margins consistently
      failed to join in the interproximal area, and increasing recession of the flap
      margins and exposure of the membranes, resulting in accumulation of bacterial
      deposits and food debris, occurred during the period the membranes were
      maintained.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634628
TI  - High-speed filming of the Periotest measurement.
AB  - Periodontal disease may be diagnosed with the Periotest technique, which involves
      electronically controlled and reproducible percussion of tooth. The movement on
      percussion was investigated with high-speed film and then compared with the
      return of teeth after static deflection for several seconds as has been reported
      previously by Lukas and Scholz. The elastic and viscous properties of the
      periodontium and the surrounding bony tooth socket are to a large extent non
      linear. The 10-20 microns deflection of the healthy tooth represents only a
      fraction of static tooth mobility published by Parfitt or Schulte et al. The
      visco-elastic properties of a healthy tooth enabling the percussion of the
      Periotest tapping head to be decelerated in less than 1 ms are largely lost in
      periodontitis. It is this essential difference which the Periotest method
      utilizes.

PMID- 1634627
TI  - A randomized trial of occlusal adjustment in the treatment of periodontitis
      patients.
AB  - The purpose of the randomized clinical trial was to test; (1) the influence of
      occlusal adjustment (OA) in association with periodontal therapy on attachment
      levels, pocket depth, and tooth mobility, (2) whether OA was of greater
      significance in non-surgically treated periodontal defects, and (3) whether
      initial tooth mobility or disease severity had an affect on post-treatment
      attachment levels following OA. After hygienic-phase therapy, 50 patients
      received OA/No OA according to random assignment; 22 patients received an OA and
      28 were not adjusted. 2 months after OA, either modified Widman flap surgery or
      scaling and root planing by a periodontist were done according to random
      assignment within each patient in a split-mouth design. Following active
      treatment patients were maintained with prophylaxis done every 3 months and
      scored annually. For the analysis of this two-year data, a repeated measures
      analysis of variance was performed using attachment level change and pocket
      depths as outcome indicators. There was significantly greater gain of clinical
      periodontal attachment in patients who received an OA compared to those who did
      not. Both the surgically and non-surgically treated sides of the mouth responded
      similarly to OA. There was no affect of OA on the response in pocket depth, nor
      did initial tooth mobility or initial periodontal disease severity influence the
      response to OA.

PMID- 1634629
TI  - Use of toothpicks for chlorhexidine staining.
AB  - The purpose of this study was to determine if the extrinsic dental staining
      associated with the use of chlorhexidine gluconate (CHX) mouthrinse could be
      prevented or controlled by the patient with the use of toothpicks. 25 subjects
      received a prophylaxis to establish a stain-free baseline and were then randomly
      assigned a control and experimental side of the mouth. The rinsing regimen was
      1/2 oz of 0.12% CHX mouthrinse 2x a day for 3 months. Subjects self-examined
      daily for the appearance of stain. Where stain was visible, a toothpick was used
      to 'rub it away' on the distolabial, labial and mesiolabial surfaces of the
      experimental side only. The rubbing action was similar to the use of an eraser to
      remove a pencil mark from paper. The amount and intensity of stain was
      photographed and graded by a blinded examiner after 2 weeks, 1, 2 and 3 months.
      Subjects kept calendars to encourage and document compliance. When analyzed
      across time, teeth and surfaces, there was a statistically significant difference
      in stain between the control and experimental sides for stain amount, intensity,
      and for a composite of amount/intensity. Clinical differences were slight. The
      study indicates that the use of a simple toothpicking technique can affect
      chlorhexidine stain.

PMID- 1634630
TI  - Subgingival temperature (I). Relation to baseline clinical parameters.
AB  - 44 subjects ranging in age from 14-71 years were measured at 6 sites per tooth
      for gingival redness, plaque accumulation, suppuration, bleeding on probing,
      pocket depth and attachment level. Subgingival temperatures were measured at the
      same 6 sites per tooth using a periodontal temperature probe (Periotemp,
      Abiodent, Danvers, MA). This instrument was also used to measure each subject's
      sublingual temperature in order to compute the differences between sublingual and
      subgingival temperature. Relationships were sought between the baseline clinical
      parameters and the temperature variables in subjects and at sites. The mean and
      standard deviation of the sublingual temperatures for the 44 subjects was 36.6 +/
      0.4 degrees C (range 35.8-37.6 degrees C). The mean of each subject's mean whole
      mouth subgingival temperature was 1.9 degrees C lower, 34.8 +/- 0.6 degrees C
      (range 33.4-36.1 degrees C). The differences of the mean subgingival temperature
      from sublingual ranged from -0.8 to -3.2 degrees C (average -1.9 +/- 0.5 degrees
      C). Mean temperature difference for a subject correlated with % of sites with
      plaque (rs = 0.45), redness (rs = 0.33), bleeding on probing (rs = 0.44), % of
      sites with attachment level greater than 3 mm (rs = 0.44), mean pocket depth (rs
      = 0.44) and mean attachment level (rs = 0.39). There were higher mean
      temperatures at sites exhibiting or not exhibiting plaque (35.0, 34.5 degrees C),
      redness (34.9, 34.6), bleeding on probing (35.1, 34.7) and suppuration (35.4,
      34.8). Sites with pockets less than 4, 4-6 and greater than 6 mm had mean
      temperatures of 34.6, 35.2, 35.8 degrees C, respectively.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1634631
TI  - Subgingival temperature (II). Relation to future periodontal attachment loss.
AB  - The purpose of the present investigation was to determine whether subgingival
      temperature was a risk indicator of periodontal attachment loss (detected in the
      following 2 months) in a subject or at a site. 29 subjects were measured at 6
      sites per tooth for clinical parameters as well as subgingival temperature using
      a periodontal temperature probe (Periotemp, ABIO-DENT, Danvers, MA). The same
      instrument was used to measure sublingual temperature in order to compute
      differences between subgingival and sublingual temperature. Clinical and
      temperature parameters were measured at 2-month intervals. A total of 49 subject
      visits which had both baseline temperature and subsequent attachment level change
      measurements were available for analysis. Attachment level loss greater than 2.5
      mm occurred at 1 or more sites at 16 of 49 subject visits. Elevated mean
      subgingival temperature was related to subsequent attachment loss particularly in
      individuals who exhibited more than 1 progressing site. The odds ratios of a
      subject exhibiting new attachment loss at 1 or more sites or at 2 or more sites
      were 14.5 and 64.0 if the subject's mean subgingival temperature exceeded 35.5
      degrees C. Subjects with high mean subgingival temperatures and widespread
      periodontal destruction appeared to be at greatest risk for new attachment loss.
      Discriminant analysis using % of sites with suppuration, redness and attachment
      level greater than 3 mm and mean site temperature correctly "predicted" disease
      activity with a sensitivity, specificity and overall agreement of 0.75, 0.76 and
      0.82 respectively. Of 7243 sites, 43 (0.59%) and 160 (2.2%) showed attachment
      loss of either 2.5 mm or more or 2 mm or more respectively.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1634632
TI  - Clinical evaluation of a light energy conversion toothbrush.
AB  - A blind, two-way crossover clinical trial was carried out to compare the
      effectiveness of plaque removal between a new, light energy conversion toothbrush
      incorporated with a semiconductor of TiO2 (test) and a similar toothbrush without
      the semiconductor (control). The study was completed by 73 school children aged
      13-15 years. Each toothbrush was used for a period of 3 weeks. The mean
      differences between baseline plaque scores and after subjects used the test and
      control brushes were analyzed by the paired t-test. The Soladey 2 toothbrush
      showed significantly more reduction of plaque on the buccal surfaces of all teeth
      than the control brush. There was no significant difference in the plaque
      removing ability of the two brushes on the lingual aspects of the mandible and on
      the lingual surfaces of the maxillary posterior sextant. As the buccal surfaces
      are more likely to allow light to reach the semiconductor during brushing than
      the lingual areas, it is possible that the reported photocatalytic property of
      the semiconductor may be involved in some way in the observed reduction of
      plaque.

PMID- 1634633
TI  - Periodontal status of older Floridians.

PMID- 1634635
TI  - Thoughts on drug development.

PMID- 1634634
TI  - Prepubertal periodontitis.

PMID- 1634636
TI  - The case conference approach to teaching clinical pharmacology.
AB  - This article analyzes the development of the small group case conference format,
      historically, elsewhere, and at the authors' institution, as a way of introducing
      second-year medical students enrolled in a basic pharmacology course to the
      practicalities, nuances, and challenges of contemporary drug therapy. A number of
      goals and purposes for these conferences have been identified and incorporated
      into the development and execution of a plan carried out over the past 14 years.
      Two examples of the conferences were presented, including an analysis of their
      teaching features. A listing of the general topics of 40 individual conferences
      used by the authors was provided. The authors reviewed evidence based on several
      methods of evaluation that the conferences are enthusiastically accepted by
      second-year medical students as an adjunctive approach to teaching both basic and
      applied clinical pharmacology. In addition, the authors find that the conferences
      subserve a number of other teaching functions such as problem-solving,
      information retrieval and presentation, and peer co-instruction. The conferences
      provide a mechanism for faculty-student interaction and an additional way to
      evaluate student knowledge and performance beyond the more conventional
      examination approaches.

PMID- 1634637
TI  - A nineteen-year-old man with altered mental status.

PMID- 1634638
TI  - The role of ambulatory monitoring of the blood pressure for assessment of
      antihypertensive agents.
AB  - For many decades, the casual blood pressure (BP) has been the standard for
      assessing BP response to antihypertensive agents in clinical trials. Noninvasive
      ambulatory BP technology has improved vastly in the last 15 years and has been
      increasingly used in dose-response studies as well as efficacy trials. Through
      these studies we have learned that casual BP may not be representative of the
      average daily blood pressure, that it may be quite susceptible to observer bias,
      and that it may result in inaccurate calculation of the trough-to-peak ratio of
      an antihypertensive drug. Perhaps more importantly is that a large body of data
      now supports the superiority of average daily BP over that of the casual or
      clinic BP in predicting several indexes of hypertensive target organ damage.
      Thus, use of the ambulatory BP technique in antihypertensive trials yields BP
      data that are far less susceptible to improper diagnosis and are representative
      of the hypertensive burden that causes vascular disease.

PMID- 1634639
TI  - Insulin resistance, hyperinsulinemia, dyslipidemia, hypertension, and accelerated
      atherosclerosis.
AB  - Hypertension is only one component of a multifaceted metabolic-hemodynamic
      complex that also includes obesity, subtle and overt glucose intolerance,
      dyslipidemia, enhanced vascular resistance and accelerated atherosclerosis.
      Results of a number of studies in the past 5 years have shown that even nonobese,
      nondiabetic individuals with hypertension display insulin resistance, which is
      located in peripheral tissues (primarily skeletal muscle), is limited to
      nonoxidative pathways of glucose disposal, and appears to be directly correlated
      with the severity of hypertension. Insulin resistance and associated
      hyperinsulinemia in hypertensive individuals are also associated with increased
      plasma triglyceride levels and decreased high-density lipoprotein concentrations,
      which likely contributes to enhanced atherosclerosis. Hyperinsulinemia may
      directly promote atherosclerosis by enhancing LDL-cholesterol accumulation in
      vessel walls, vascular smooth muscle migration, and proliferation, augmenting
      connective tissue synthesis in the vascular wall, and decreasing the regression
      of lipid plaques. The enhanced peripheral vascular resistance that characterizes
      insulin resistance/hyperinsulinemic states may be related to decreased vascular
      smooth muscle responses to insulin, which normally modulates (attenuates)
      vascular contractile responses to vasoactive agents.

PMID- 1634640
TI  - Cholestyramine-induced hyperchloremic metabolic acidosis.
AB  - Cholestyramine is a nonabsorbable anion exchange resin that is used predominantly
      for the treatment of hypercholesterolemia in adults and the management of acute
      diarrhea in children. The authors report two cases of severe hyperchloremic
      nonanion gap metabolic acidosis associated with the use of cholestyramine
      therapy. The authors recommend that patients taking cholestyramine who have
      concomitant renal insufficiency or who are volume depleted or who are taking
      spironolactone be monitored carefully for the emergence of a hyperchloremic
      metabolic acidosis.

PMID- 1634641
TI  - Lovastatin alters blood rheology in primary hyperlipoproteinemia: dependence on
      lipoprotein(a)?
AB  - As part of a randomized, single-blind, comparative study evaluating the efficacy
      of lovastatin and bezafibrate retard in the treatment of primary
      hypercholesterolemia, hemorheologic parameters (whole blood viscosity,
      hematocrit, plasma viscosity, red blood cell aggregation and deformability, and
      fibrinogen) were studied in 35 patients. Whole blood viscosity and plasma
      viscosity improved significantly after 3 months of treatment with lovastatin,
      whereas other hemorheologic variables remained unchanged. Stratifying 24 patients
      by their lipoprotein Lp(a) levels showed that in those with low Lp(a) (less than
      or equal to 25 mg/dL) high-density lipoprotein cholesterol increased and red
      blood cell aggregation as well as deformability decreased considerably, whereas
      in the group with high Lp(a) levels (greater than 25 mg/dL), the opposite
      behavior was observed. Treatment of primary hypercholesterolemia with lovastatin
      may not only reduce the risk for atherosclerotic complications by its pronounced
      decrease of low-density lipoprotein cholesterol, but also may favorably alter
      blood rheology, and may decrease insudation of plasmatic components into the
      arterial wall and improve tissue perfusion, in particular on the microcirculatory
      level. The possible relevance of Lp(a) levels for the hemorheologic effects of
      lovastatin remains to be elucidated.

PMID- 1634642
TI  - A comparison of tablets with oral suspension formulation of dipyridamole in
      thallium myocardial imaging.
AB  - Dipyridamole stress thallium imaging has been widely employed to diagnose and
      assess the extent of coronary heart disease in patients who cannot exercise. When
      oral dipyridamole administration was used, a wide range of results for
      sensitivity, specificity, hemodynamic response and side effect profile has been
      reported. The authors hypothesized that the formulation used for oral
      administration of dipyridamole plays a major factor in this variability, and that
      the pulverized form of dipyridamole will achieve faster and more consistent
      response than the standard tablet form. The authors studied 13 consecutive
      patients who underwent thallium scintigraphy. Eight patients received
      dipyridamole pulverized and dissolved in a glycol/aqueous base diluent (group A),
      and five patients received the standard form of dipyridamole (group B). In group
      A, mean peak systolic blood pressure decreased from 142 +/- 31 (mean +/- standard
      deviation) to 109 +/- 30 (P = .05), and mean diastolic blood pressure decreased
      from 76 +/- 14 to 51 +/- 5. The mean heart rate changed from 78 +/- 26 to 80 +/-
      10. In group B, baseline systolic blood pressure was 165 +/- 12 and decreased to
      156 +/- 7 at 45 minutes and to 155 +/- 14 at 90 minutes. Heart rate increased
      from baseline of 69 +/- 9 to 75 +/- 8 at 45 minutes and to 76 +/- 11 at 90
      minutes. At 45 minutes, the systolic blood pressure of the 8 group A patients
      dropped by 33 +/- 19 mm Hg, whereas group B's changed by 9 +/- 6 mm Hg (P less
      than .005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634643
TI  - Evaluation of bioavailability and pharmacokinetics of two isosorbide-5
      mononitrate preparations in healthy volunteers.
AB  - The objective of this study was to determine both the pharmacokinetic parameters
      and the bioavailability of two commercial 20-mg isosorbide-5-mononitrate (IS-5
      MN) preparations (test and reference preparation) after single oral
      administration. For this purpose, the test and the reference preparation were
      examined in 24 healthy male volunteers according to a randomized 2-way cross-over
      design, blood samples were withdrawn up to 24 hours postadministration, and
      plasma concentrations of IS-5-MN were quantified by a gas chromatography (GC)
      method. Both preparations led to peak plasma levels of approximately 360 ng/mL IS
      5-MN in the mean 0.76 hour (test) and 0.94 hour (reference preparation) after
      application; the plasma half-lives were about 5.2 hours, and for the areas under
      the curve (AUC(0-infinity)), mean values of 2741 (test preparation) and 2742
      hour.ng/mL (reference preparation) were found. The statistical comparison
      (analysis of variance, confidence intervals) of the pharmacokinetic parameters
      found in the study resulted in bioequivalence of both IS-5-MN preparations. The
      undesired side effects/concomitant symptoms observed are known to occur after IS
      5-MN administration.

PMID- 1634644
TI  - Effect of moricizine on the pharmacokinetics and pharmacodynamics of warfarin in
      healthy volunteers.
AB  - Moricizine HCl, a new orally active antiarrhythmic agent, induces its own hepatic
      metabolism and consequently may interfere with the metabolism of warfarin, a drug
      used commonly by cardiac patients that also is subject to extensive hepatic
      metabolism. Both drugs are also highly protein bound in plasma. To assess the
      possibility of an interaction, single-dose sodium warfarin (25 mg oral Coumadin,
      Du Pont Pharmaceuticals, Wilmington, DE) pharmacokinetics, pharmacodynamics; and
      plasma protein binding were examined in 12 healthy male volunteers 14 days before
      and 14 days after starting chronic oral moricizine HCl administration (250 mg
      every 8 hours). The terminal elimination rate constant of warfarin was increased
      by about 10% when measured in the presence of chronic moricizine administration.
      However, oral plasma clearance, apparent volume of distribution, maximum peak
      plasma concentration, time to reach peak concentration, and protein binding were
      unaffected. More importantly, there was no evidence of a pharmacodynamic
      interaction based on the prothrombin time profile. It was concluded that no
      clinically significant interaction occurs under these conditions.

PMID- 1634645
TI  - Effectiveness of antihypertensive medications in office and ambulatory settings:
      a placebo-controlled comparison of atenolol, metoprolol, chlorthalidone,
      verapamil, and an atenolol-chlorthalidone combination.
AB  - In a double-blind, crossover study, five white men with mild-to-moderate
      hypertension received placebo and fixed doses of atenolol, metoprolol,
      chlorthalidone, verapamil, and the combination of atenolol and chlorthalidone in
      a quasi-random order. Daily dosages were: atenolol, 100 mg; metoprolol, 200 mg;
      chlorthalidone, 50 mg; verapamil, 240 mg; and the same doses of atenolol and
      chlorthalidone in combination. Standard office and daytime ambulatory blood
      pressures were assessed at the end of each month-long trial. Atenolol,
      metoprolol, chlorthalidone, and verapamil controlled office blood pressure with
      similar reductions. Verapamil did not lower ambulatory blood pressure at this
      dose (which is lower than is now commonly used), but reductions in ambulatory
      blood pressure were similar for atenolol, metoprolol, and chlorthalidone. The
      combination of atenolol and chlorthalidone maintained blood pressure control more
      effectively than the single drug treatments in both office and ambulatory
      settings, and the combined hypotensive effects were additive. However, reductions
      in the office due to the combination appeared to overestimate hypotensive
      effectiveness in the ambulatory setting. This study suggests that the
      effectiveness of commonly prescribed antihypertensive regimens varies according
      to setting as well as drug, and that assessment of treatment effectiveness can be
      improved by automated ambulatory blood pressure monitoring.

PMID- 1634646
TI  - Multiple dose pharmacokinetics of four different doses of nisoldipine in
      hypertensive patients.
AB  - This randomized double-blind parallel group study characterized the
      pharmacokinetics of the calcium channel antagonist, nisoldipine (core-coat
      tablets), administered once daily for 7 days in doses of 5 mg (n = 12), 10 mg (n
      = 13), 20 mg (n = 12), and 30 mg (n = 11) to patients with mild to moderate
      hypertension. Serial blood samples were obtained from 0 to 24 hours and from 0 to
      48 hours after nisoldipine administration on days 1 and 7, respectively.
      Nisoldipine plasma concentrations were determined by gas chromatography with
      electron capture detection. No statistically significant difference was found in
      dose-normalized area under the curve between the four groups. Area under the
      curve (standardized to body weight) correlated to dose (r = .74, P less than
      .05). No significant difference existed in oral clearance (L/h/kg) when analyzed
      for equivalence across the four doses: 8.21 +/- 3.47 (5 mg), 11.84 +/- 13.85 (10
      mg), 11.48 +/- 7.49 (20 mg), and 10.36 +/- 5.49 (30 mg). The present
      investigation characterizes the pharmacokinetics of nisoldipine core-coat tablets
      in hypertensive patients and demonstrates the dose proportionality or linearity
      of nisoldipine plasma concentrations and area under the curve, measured over a
      dose range of 5 to 30 mg.

PMID- 1634647
TI  - Comparison of plasma nicotine concentrations after application of nicoderm
      (nicotine transdermal system) to different skin sites.
AB  - Drug absorption through the skin can vary according to the application site. The
      nicotine transdermal system, Nicoderm (Alza Corp., Palo Alto, CA) contains a rate
      controlling membrane designed to regulate delivery of nicotine to the skin and
      thus limit variability in nicotine plasma levels. Plasma nicotine concentrations
      were compared after application of NTS 14 mg/day to three different skin sites
      (upper back, upper outer arm, upper chest) in a randomized, crossover study
      involving 12 healthy male smokers. Plasma nicotine profiles from all three sites
      were similar: nicotine concentrations increased rapidly within 2 to 4 hours,
      reached broad peaks of approximately 11 to 14 ng/mL, and then remained relatively
      constant between 8 and 24 hours after application. The mean nicotine maximum peak
      plasma concentration values for nicotine transdermal system application to the
      arm, back, and chest were equivalent (13.8, 14.6, and 13.2 ng/mL, respectively).
      The mean time to reach peak concentration (tmax) (3 to 6 hours), and area under
      the curve (168, 186, and 183 ng.h/mL) values for the arm, back, and chest,
      respectively, were not significantly different. Thus, bioequivalent plasma
      nicotine concentrations were achieved irrespective of the application site on the
      upper body.

PMID- 1634648
TI  - References to contemporary papers on acoustics.

PMID- 1634649
TI  - The nurse and the firing squad.

PMID- 1634650
TI  - Milestones in Canadian nursing history.

PMID- 1634651
TI  - Changing times--changing nations.

PMID- 1634652
TI  - The future of nursing research in ethics and law.

PMID- 1634653
TI  - Funding of schools of nursing.

PMID- 1634654
TI  - The first 5 years after the dissertation.
AB  - To succeed in academia, nursing faculty members must devote the first 5 years
      following the dissertation to achieving a standard to tenure characteristic of
      the profession. Most institutions in the country adhere to the American
      Association of University Professors' guidelines for tenure. These guidelines
      mandate excellence in teaching, scholarship, and service. A fourth
      characteristic, leadership, is increasingly considered in tenure decisions. The
      expectations of an academic career in nursing serve as the foundation for a
      framework to evaluate the likelihood of success in a particular setting. A
      detailed 5-year plan for achieving tenure is proposed.

PMID- 1634655
TI  - Faculty performance appraisal systems: procedures and criteria.
AB  - This study investigated the consensus among schools of nursing in (1) using the
      eight elements of effective performance appraisal identified in the literature
      and (2) identification of domains, dimensions, and subdimensions of faculty
      performance. Content analysis was done of actual policies, procedures, and forms
      from 86 schools with graduate programs. Performance appraisal systems were found
      to be in an early stage of development. There was substantive agreement on
      teaching, service, and research as domains, with 25% or fewer schools also using
      faculty development, professional practice, and/or administration. There was less
      consensus as to the attributes of domains. Specific dimensions and their
      assignment to domains, as well as recommendations to guide future development,
      are discussed.

PMID- 1634656
TI  - Career commitment in nursing.
AB  - There are different patterns and styles to careers in nursing. The concept of
      career commitment in nursing is explored, and the results of some research are
      discussed for their implications for nursing careers. A longitudinal, repeated
      measures descriptive survey was used to measure career commitment and explore its
      relationship to turnover and work performance in 320 newly employed registered
      nurses at one hospital. Career commitment scores dropped significantly over the
      first year. Although career commitment does correlate with turnover, and there is
      a relationship with job performance, the direct association is weak. Career
      commitment is not a stable phenomenon in the first year in a new job. It appears
      to be susceptible to organizational factors, thus making it possible to provide
      positive benefits for both nurses and hospitals through enhanced career
      commitment.

PMID- 1634657
TI  - Nursing education administrators: level of career development and mentoring.
AB  - The focus of this study was to analyze the influence of mentoring on the level of
      career development of nursing education administrators. Other variables that may
      influence the level of career development of nursing education administrators
      also were examined. These included early life influences, academic preparation,
      supporting factors, constraining factors, and career stage. Relationships among
      these variables are depicted in the conceptual Model of Career Development in
      Academic Administration. Survey research methods were used in this correlational,
      retrospective study. A questionnaire developed by the investigators was mailed to
      a randomly selected national sample of 600 nursing education administrators in
      National League for Nursing-accredited baccalaureate and higher degree programs.
      A response rate of 71 per cent yielded 427 completed questionnaires. Multiple
      regression techniques were used to examine the relationships between dependent
      variables and independent variables in the conceptual model. Nine variables
      explained 59 per cent of the variance in level of career development scores. This
      variance was explained by highest degree earned, number of years since completion
      of the highest degree, number of years as an academic administrator, the
      scholarly difficulty index, the work commitment index, mentoring relationships,
      number of months of nonemployment, number of children, and type of institution
      where highest degree was earned. Mentoring contributed significantly to the
      prediction of level of career development of nursing education administrators and
      therefore should be encouraged and fostered.

PMID- 1634658
TI  - Nursing education: developing specification equations for selection and
      retention.
AB  - Because nursing is a professional area in which costs continue to rise faster
      than in other academic areas, it is imperative to provide quality education that
      is within the financial reach of those students who can benefit from it. This
      study sought to develop a specification equation that could be used to predict
      retention in the academic area and workplace.

PMID- 1634659
TI  - An analysis of the writings of Janet Geister and Mary Roberts regarding the
      problems of private duty nursing.
AB  - Fifty years ago there were two widely circulated nursing journals, each with a
      unique purpose and style. The Trained Nurse and Hospital Review was the privately
      owned older journal, and the American Journal of Nursing was the voice of the
      professional organization. Each journal was edited by a strong nursing leader,
      Janet Geister and Mary Roberts, respectively. Each editor had many years of
      service to the nursing profession in varied capacities. Naturally, each had
      distinctly different interests, visions, and styles of communication. These
      editors witnessed and commented on the change in the sphere of nursing practice
      from a private duty and public health orientation to one that eventually became
      dominated by the hospital. Although their approaches differed, both recognized
      the need for organization, versatility, and creative problem solving. However,
      the legacy of these leaders must be considered in view of the gap that continues
      to exist between practicing nurses and the American Nurses' Association
      leadership.

PMID- 1634660
TI  - Toward conceptualizations in nursing: harbingers from the sciences and
      humanities.
AB  - Conceptualizations of care and caring generated from ethnographic study of Tohono
      O'odham children, Norwegian-Americans, elderly clients in nursing clinics,
      preschoolers, children with cancer, and gender differences is outlined. Where
      research questions came from during life experiences of the author, a journey of
      nursing scholarship viewed from concepts of context development, transformation
      and care, and "Where do we go from here?" serve as the outline for a discussion
      of the generation of conceptualizations. A question for nursing research is
      proposed: What characteristics of care promote human responses for quality human
      experience? Suggestions for nursing research in the future emphasize the
      potential of human responses, variations in conceptualizations of care during the
      life cycles of human beings living in diverse cultural contexts, and changes in
      conceptualizations of care over time.

PMID- 1634661
TI  - Equivalence between adenosine and exercise thallium-201 myocardial tomography: a
      multicenter, prospective, crossover trial.
AB  - OBJECTIVES: The study was designed to compare pharmacologic and exercise stress
      during thallium-201 single-photon tomography in a multicenter prospective
      crossover trial. BACKGROUND: Both exercise and adenosine myocardial perfusion
      imaging have high sensitivity and specificity for detection of coronary artery
      disease. However, few data are available comparing these two stress tests in the
      same patients. METHODS: The study group consisted of 175 subjects: 55 healthy
      volunteers and 120 patients with suspected coronary artery disease. All subjects
      underwent two thallium tomographic tests performed 30 days apart, one during
      intravenous administration of adenosine (140 micrograms/kg per min for 6 min) and
      one during exercise stress. All images were computer quantified and interpreted
      without knowledge of the stress test performed. Interpretation agreement was
      assessed by kappa and Z statistics. RESULTS: Agreement on the presence of normal
      or abnormal tomograms by adenosine and exercise scintigraphy was 82.8% by visual
      analysis with kappa and Z statistics of 0.65 (p less than 0.0001) and 11.1 (p
      less than 0.00001), respectively. The agreement by computer quantification was
      86% with kappa and Z statistics of 0.709 (p less than 0.0001) and 12.2 (p less
      than 0.00001), respectively. Agreement on localization of the perfusion defect to
      a specific coronary vascular territory varied from 82.7% to 91.4% with highly
      significant kappa and Z statistics (p less than 0.0001). There was a good
      correlation between quantified perfusion defect size by adenosine and exercise (r
      = 0.80, p less than 0.0001), but the values for defect size were significantly
      greater by adenosine scintigraphy (p = 0.0073). Adenosine side effects were
      frequent but transient and ceased spontaneously in most subjects within 1 to 2
      min after the infusion was discontinued. CONCLUSIONS: Adenosine thallium-201
      scintigraphy provides diagnostic information similar to that of exercise
      scintigraphy, although values for defect sizes are greater with adenosine.

PMID- 1634662
TI  - Effects of smoking on survival and morbidity in patients randomized to medical or
      surgical therapy in the Coronary Artery Surgery Study (CASS): 10-year follow-up.
      CASS Investigators.
AB  - OBJECTIVES: The goal of this study was to ascertain how continued cigarette
      smoking or smoking cessation related to long-term survival and morbidity in
      patients with established coronary artery disease managed with medical therapy or
      coronary bypass surgery. BACKGROUND: Although the association of cigarette
      smoking with coronary artery disease is well established, the morbidity and
      mortality associated with smoking behavior in patients with such disease
      receiving medical or surgical therapy are less well established. METHODS: The 780
      patients randomized to medical therapy or coronary bypass surgery in the Coronary
      Artery Surgery Study (CASS) were subgrouped according to smoking behavior during
      a mean 11.2-year follow-up interval. Comparisons between smokers and nonsmokers
      were accomplished by univariate and Cox time-dependent multivariate analyses.
      RESULTS: Survival at 10 years after entry into the study was 82% among 468
      patients who reported no smoking during follow-up (nonsmokers) compared with 77%
      among the 312 smokers (p = 0.025). Survival was 80% among those who smoked at
      entry but stopped (quitters) versus 69% among those who continued smoking (p =
      0.025). For patients who smoked at baseline and were randomized to bypass
      surgery, survival at 10 years was 84% among quitters and 68% among nonquitters (p
      = 0.018); the difference in survival between quitters (75%) and nonquitters (71%)
      was less among those randomized to medical therapy (p = NS). Among those who
      smoked at baseline, continued smoking increased the relative risk of death by
      1.73. After 10 years, smokers, in comparison with nonsmokers, were less likely to
      be angina free and more likely to be unemployed and had more activity limitation
      and more hospital admissions (primarily for chest pain, heart attack, cardiac
      catheterization, peripheral vascular surgery and stroke). CONCLUSIONS: Thus,
      among patients with documented coronary artery disease, continued cigarette
      smoking may result in decreased survival--especially among those undergoing
      bypass surgery. Moreover, smokers have more angina, more unemployment, a greater
      limitation of physical activity and more hospital admissions.

PMID- 1634663
TI  - Serial follow-up of adults with repaired tetralogy of Fallot.
AB  - OBJECTIVES AND BACKGROUND: Sudden death has long been considered a major
      contributor to mortality in pediatric patients with corrected tetralogy of
      Fallot. However, this may not apply to the patient with repaired tetralogy of
      Fallot who has survived into adulthood. Consequently we followed up a cohort of
      such adults to establish the clinical outcome and risk factors affecting their
      survival. METHODS: A baseline group of 151 adult patients with repaired tetralogy
      of Fallot were followed up for a mean of 3.2 years. The overall mortality rate
      was low (0.009 death/patient-year). Four patients died during follow-up, but only
      two deaths can be attributed to tetralogy of Fallot repair, and there were no
      sudden cardiac deaths. Clinically 94% of patients have remained in New York Heart
      Association functional class I. A subset of 36 patients were followed up for a
      mean of 6.7 years. This group had three sets of serial testing at 3-year
      intervals consisting of right heart catheterization at the initial study only, 24
      h Holter ambulatory electrocardiographic (ECG) monitoring, exercise ECG and rest
      and exercise radionuclide angiography. RESULTS: Exercise capacity assessed by
      serial exercise stress testing remained stable over the follow-up period, whereas
      the presence of exercise-induced arrhythmias steadily decreased. Most patients
      had no significant arrhythmias and had no significant change in severity of
      arrhythmia with time. Radionuclide angiography showed significant improvement in
      exercise right ventricular ejection fraction over time but a progressive decrease
      in left ventricular ejection fraction at both rest and exercise. However, the
      left ventricular ejection fraction is still within the normal limits for our
      laboratory. CONCLUSIONS: Adults with repaired tetralogy of Fallot have a very
      good prognosis and a low risk of sudden death. However, ventricular function may
      change over time and should be carefully monitored.

PMID- 1634664
TI  - Prevalence and mortality rate of congestive heart failure in the United States.
AB  - OBJECTIVES: The study was designed to determine the prevalence and mortality rate
      of congestive heart failure in noninstitutionalized men and women in the U.S.
      BACKGROUND: Congestive heart failure is a serious condition with significant
      morbidity and mortality. Earlier epidemiologic descriptions of congestive heart
      failure were constructed from small surveys, limited data, hospital records or
      death certificates. No nationally representative data from noninstitutionalized
      persons have been examined. METHODS: Data collected from the National Health and
      Nutrition Examination Survey (NHANES-I, 1971 to 1975) were used to determine the
      prevalence of heart failure on the basis of both self-reporting and a clinical
      definition. Mortality data were derived from the NHANES-I Epidemiologic Follow-up
      Study (1982 to 1986). RESULTS: The prevalence of self-reported congestive heart
      failure approximates 1.1% of the noninstitutionalized U.S. adult population; the
      prevalence of congestive heart failure based on clinical criteria is 2%. These
      estimates suggest that between 1 and 2 million adults are affected. Mortality at
      10 and 15 years for those persons with congestive heart failure increases in
      graded fashion with advancing age, with men more likely to die than women. In the
      group greater than or equal to 55 years old, the 15-year total mortality rate was
      39.1% for women and 71.8% for men. CONCLUSIONS: Congestive heart failure is a
      common problem in the U.S., with significant prevalence and mortality, both of
      which increase with advancing age. As the population of the U.S. becomes older,
      the health care impact of congestive heart failure will probably grow.

PMID- 1634665
TI  - Effects of severity of the residual stenosis of the infarct-related coronary
      artery on left ventricular dilation and function after acute myocardial
      infarction.
AB  - OBJECTIVES: This study was designed to evaluate the relation between the severity
      of the residual stenosis of the infarct-related artery and changes in left
      ventricular volume and function after a first anterior myocardial infarction.
      BACKGROUND: Although thrombolytic therapy improves clinical outcome after acute
      myocardial infarction, the relations between the severity of the residual
      stenosis of the infarct-related artery and postinfarction left ventricular
      remodeling and function are unclear. METHODS: Fifty-eight patients with a first
      anterior myocardial infarction and significant disease only in the left anterior
      descending coronary artery on arteriography performed after 7 to 10 days were
      evaluated. All patients received thrombolytic therapy. Residual stenosis of the
      infarct-related artery was measured with quantitative coronary arteriography.
      Left ventricular volumes and ejection fraction were measured by echocardiography
      and radionuclide angiography, respectively, 7 to 10 days, 6 months and 1 year
      after infarction. End-diastolic and end-systolic left ventricular volumes were
      measured by two-dimensional echocardiography and normalized to body surface area.
      Patients were classified into three groups according to baseline residual
      stenosis severity: total occlusion (Group I), minimal lesion diameter less than
      1.5 mm (Group II) and minimal diameter greater than or equal to 1.5 mm (Group
      III). RESULTS: Group I patients had significantly greater left ventricular end
      diastolic and end-systolic volumes at 6 months and 1 year than did the other
      groups. Group II patients had greater end-diastolic and end-systolic volumes than
      did Group III patients at 1 year. In addition, Group I patients had a lower
      ejection fraction at 1 year than that of the other groups. The minimal lesion
      diameter was significantly correlated with percent change in end-diastolic volume
      at 1 year. CONCLUSIONS: The severity of the baseline residual stenosis of the
      infarct-related artery is an important predictor of change in left ventricular
      volumes in the 1st year after infarction. Total occlusion of the infarct-related
      artery is associated with greater left ventricular dilation and functional
      impairment.

PMID- 1634666
TI  - Coronary angioplasty: a treatment option for left ventricular remodeling after
      myocardial infarction?

PMID- 1634667
TI  - Selection of patients for programmed ventricular stimulation: a clinical decision
      making model based on multivariate analysis of clinical variables.
AB  - OBJECTIVE: This study was conducted to assess the utility of clinical variables
      in predicting the inducibility of sustained ventricular arrhythmias in a
      heterogeneous group of patients undergoing programmed ventricular stimulation.
      METHODS: Variables were considered in a simulated chronologic order to determine
      the incremental information added by the signal-averaged electrocardiogram (ECG)
      and left ventricular ejection fraction. All patients undergoing baseline
      programmed ventricular stimulation for induction of ventricular tachyarrhythmia
      during a 30-month period were included in the study. Fourteen historical, ECG,
      signal-averaged ECG and left ventricular wall motion variables were evaluated for
      their ability in predicting inducibility of a sustained ventricular arrhythmia, a
      "positive" event, at programmed ventricular stimulation. RESULTS: On univariate
      analysis of the clinical variables, comparison between patients with positive or
      negative results showed significant differences in 10 of the 14 clinical
      variables: major cardiac diagnosis, history of ventricular tachycardia,
      myocardial infarction by history or ECG, all five signal-averaged ECG variables,
      left ventricular ejection fraction and presence of left ventricular aneurysm. On
      multivariate analysis, five independent variables were determined to be
      important: history of ventricular tachycardia, historical or ECG evidence of
      myocardial infarction, history of loss of consciousness, filtered QRS duration on
      the signal-averaged ECG and left ventricular ejection fraction. However, with
      sequential multivariate analysis, a model based only on historical and
      conventional ECG data was found to do as well as a model that included signal
      averaged ECG and left ventricular ejection fraction data. CONCLUSIONS: Routinely
      available noninvasive historical, ECG, signal-averaged ECG and left ventricular
      wall motion variables can be used to accurately predict the outcome of programmed
      ventricular stimulation. The majority of the predictive power was obtained with
      the routine model, using only historical and ECG data. The signal-averaged ECG
      and left ventricular wall motion analysis added no significant incremental
      information.

PMID- 1634668
TI  - Angiographic and clinical outcome of intracoronary stenting: immediate and long
      term results from a large single-center experience.
AB  - OBJECTIVES: The purpose of this study was to determine the immediate and long
      term angiographic and clinical results of coronary stenting. BACKGROUND: Although
      preliminary trials of endovascular stenting have demonstrated promising results,
      lack of long-term follow-up has limited the critical evaluation of the role of
      coronary stenting in the treatment of obstructive coronary artery disease.
      METHODS: A total of 250 procedures using the Palmaz-Schatz stent, performed in
      220 patients between June 1988 and July 1991, were examined. Minimal lumen
      diameter of the treated segments was measured on angiograms obtained before,
      after and 6 months after intervention. RESULTS: Stent placement was successful in
      246 (98%) of 250 lesions, reducing diameter stenosis from 77% to -2.5%. There
      were no deaths or Q wave myocardial infarctions. One patient (0.4%) required
      emergency bypass surgery and one (0.4%) developed subacute thrombosis. Femoral
      vascular complications occurred in 36 patients (16%). Six-month angiographic
      follow-up was obtained in 91% of eligible patients. The overall angiographic
      restenosis rate (stenosis greater than or equal to 50%) was 25%. By univariable
      analysis, the rate of restenosis was significantly higher for stents in the left
      anterior descending versus the right coronary artery (44% vs. 12%; p = 0.002); in
      diabetic patients (56% vs. 20%; p = 0.006), and in vessels with post-stent lumen
      diameter less than 3.31 mm (34% vs. 16%; p = 0.05). Stenting of the left anterior
      descending artery was the strongest predictor (p = 0.01) of restenosis in a
      multivariable model. Total survival was 97% and event-free survival (freedom from
      death, myocardial infarction or revascularization) was 70% at 36 months.
      CONCLUSIONS: Palmaz-Schatz stents can be placed successfully with a low incidence
      of major complications. The angiographic restenosis rate was 25%, and 70% of
      patients remained free of cardiovascular events at 3 years. Diabetes, small
      postprocedure lumen diameter and stenting of the left anterior descending artery
      are associated with higher rates of restenosis.

PMID- 1634669
TI  - Obstruction in extracardiac ventriculopulmonary conduits: value of nuclear
      magnetic resonance imaging with velocity mapping and Doppler echocardiography.
AB  - OBJECTIVES: This study was designed to investigate the value of noninvasive
      imaging modalities for the detection of obstruction in extracardiac
      ventriculopulmonary conduits. BACKGROUND: the diagnosis of obstruction in a
      conduit by noninvasive methods can be difficult. Obstruction may be silent and
      its progression unnoticed. Nuclear magnetic resonance imaging (NMR) with velocity
      mapping is a new noninvasive technique that can provide high resolution images
      and has been shown to be a reliable method of measuring blood flow velocity.
      METHODS: Two-dimensional echocardiography, pulsed wave Doppler echocardiography
      and NMR spin echo imaging were used in 52 patients with an extracardiac
      ventriculopulmonary conduit. Continuous wave Doppler echocardiography was used in
      30 of these, Doppler color flow mapping in 26 and NMR velocity mapping in 12.
      Cardiac catheterization data were available in 27 patients and operative or
      autopsy findings in 11. RESULTS: The conduit could be assessed by two-dimensional
      and pulsed wave Doppler echocardiography in only 17% of patients. Doppler color
      flow and continuous wave echocardiography provided technically satisfactory data
      in 19% and 83%, respectively. The anatomy of the conduit was adequately displayed
      by NMR imaging in 90%. A minimal diameter less than 18 mm indicated conduit
      obstruction, although failure to detect calcification resulted in obstruction
      being missed in some patients. Calculated gradients in obstructed conduits
      derived from NMR velocity mapping correlated well with results of continuous wave
      Doppler echocardiography and gave an accurate localization of the site of
      obstruction as well as a measure of its severity. CONCLUSION: NMR imaging with
      velocity mapping is the most effective noninvasive method of assessing
      obstruction in ventriculopulmonary conduits and can obviate the need for invasive
      investigation before an interventional procedure is performed.

PMID- 1634670
TI  - Balloon pulmonary valvuloplasty in infants: a quantitative analysis of pulmonary
      valve-anulus-trunk structure.
AB  - OBJECTIVES: The present study was designed to establish possible predictors of
      unfavorable outcome in infants with pulmonary valve stenosis. BACKGROUND: Balloon
      pulmonary valvuloplasty is the treatment of choice for typical pulmonary valve
      stenosis. Patients with dysplastic valves may be less suitable candidates for
      this procedure because they have morphologic abnormalities of the complex valve
      anulus-trunk that cause the obstructive phenomenon. METHODS: Twenty-five children
      (mean age +/- SD 1.1 +/- 0.7 years) with normal anulus diameter underwent balloon
      pulmonary valvuloplasty using a balloon/anulus ratio of 1.2 +/- 0.11. From the
      lateral view of a right ventricular angiogram, the following variables were
      quantified and scored: A, supravalvular narrowing; B, texture of the valve
      surface; C, diastolic deformity of the Valsalva sinuses; D, trunk/anulus ratio;
      E, systolic valve motion; and F, presence of a contrast jet. Paired t test,
      stepwise multivariate correlation with "dummy" variable methods were applied for
      both hemodynamic and valve-anulus-trunk determinations. RESULTS: The right
      ventricular-pulmonary artery gradient decreased from 66 +/- 21 (range 40 to 120)
      to 24 +/- 11 (range 10 to 50) mm Hg (p less than 0.001), whereas the right
      ventricular systolic pressure decreased from 89 +/- 20 (range 60 to 130) to 48 +/
      15 (range 30 to 80) mm Hg (p less than 0.001). Only variables A, B and D had
      significant influence in a percent reduction in right ventricular pulmonary
      artery gradient (R2 0.94, SEE 5.7; p less than 0.001). A score greater than or
      equal to greater than 4 obtained by adding the values from these three variables
      was correlated with poor outcome. CONCLUSIONS: These data show that there is an
      adequate relation between scores and outcome. We conclude that children less than
      2 years old with pulmonary valve stenosis and a score greater than or equal to 4
      should not be candidates for balloon pulmonary valvuloplasty.

PMID- 1634671
TI  - Coronary artery abnormalities and right ventricular histology in hypoplastic left
      heart syndrome.
AB  - OBJECTIVES: To determine whether right ventricular preservation is compromised in
      any anatomic subgroup of hypoplastic left heart syndrome, we assessed the
      coronary artery anatomy and myocardial histologic features of 151 postmortem
      specimens with hypoplastic left heart syndrome. BACKGROUND: Although previous
      studies have shown that coronary artery abnormalities are more prominent in the
      subgroup of patients who have a patent mitral valve and obstructed aortic valve,
      it has not been established that these abnormalities compromise right ventricular
      perfusion. METHODS: Eighty-nine specimens with a patent mitral valve and aortic
      atresia, 52 with mitral and aortic atresia and 10 with patent mitral and aortic
      valves were examined. Histologic sections of the right ventricle, left ventricle
      and coronary arteries were obtained from 64 study hearts and 5 control hearts.
      RESULTS: Gross coronary anomalies included coronary-cameral communications (n =
      29), single left coronary artery (n = 2), single right coronary artery (n = 1)
      and tortuosity (n = 19). Coronary-cameral communications and tortuosity were
      significantly associated with the subgroup that had mitral hypoplasia and aortic
      atresia. Coronary artery wall thickness relative to lumen diameter was not
      different among the subgroups. No areas of coronary artery stenosis or
      interruption were discovered. Although endocardial fibroelastosis of the left
      ventricle was strongly associated with the mitral hypoplasia and aortic atresia
      group, the right ventricular histologic findings were similar in all subgroups
      and were not differentially affected by older age. CONCLUSIONS: Although the
      incidence of coronary abnormalities is greater in patients with mitral hypoplasia
      and aortic atresia, in this study there was no apparent difference in perfusion
      of the right ventricle among the anatomic subgroups of hearts with hypoplastic
      left heart syndrome.

PMID- 1634672
TI  - Pulmonary circulation in pulmonary atresia associated with the asplenia cardiac
      syndrome.
AB  - OBJECTIVE: The goal of this study was to determine the patterns of the pulmonary
      circulation in patients with pulmonary atresia and asplenia. BACKGROUND: The
      asplenic cardiac syndromes characteristically have complex cardiac anomalies
      including pulmonary stenosis or atresia. Definition of the pulmonary artery
      circulation and pulmonary venous connections is needed for consideration of
      surgical procedures. METHODS: In 35 patients, the sources of pulmonary blood
      flow, anatomic features of pulmonary arteries and pulmonary venous connections
      were determined from angiograms or autopsy specimens. RESULTS: The main pulmonary
      artery was absent or hypoplastic in 91% of patients; most had a ductus
      arteriosus. The right and left pulmonary arteries were confluent in 90% and
      usually of normal size (right 71%, left 63%). Total anomalous pulmonary venous
      connections were present in 38%. CONCLUSIONS: The anatomic features of the
      pulmonary arteries in pulmonary atresia associated with the asplenic cardiac
      syndrome are usually favorable for palliative surgical procedures. Total
      anomalous pulmonary venous connection may exist as a complicating factor.

PMID- 1634673
TI  - Congenital aortic regurgitation: natural history and management.
AB  - OBJECTIVES AND BACKGROUND: Congenital aortic regurgitation is rare as an isolated
      lesion. We describe seven children with no physical features of the Marfan
      syndrome in the patients or their families and no other cardiac lesions who had
      congenital valvular aortic regurgitation. METHODS: From 1954 to the present,
      seven children with auscultatory and physiologic characteristics of aortic
      regurgitation were evaluated for a total of 108 patient-years. We report on their
      natural history, clinical and laboratory findings, management and outcome.
      RESULTS: In five of the seven children congenital aortic regurgitation was
      diagnosed in infancy. In four, progressive severity of the regurgitation led to
      valve replacement at age 3, 10, 15 and 20 years, respectively, and to resection
      of an aneurysm of the ascending aorta in the 10-year old patient. Two patients
      had cystic medial necrosis on aortic biopsy. One of these patients died after
      reoperation for dissecting aneurysm of the thoracic aorta at 22 years of age; the
      other died after dissection and rupture of the ascending aorta at age 25 years.
      After obstructing pannus developed, the 3-year old patient underwent replacement
      of the St. Jude valve at age 10 years. The other three patients were asymptomatic
      at last follow-up at age 8, 10 and 20 years, respectively. CONCLUSIONS:
      Supportive management is recommended until it becomes necessary to intervene
      surgically when regurgitation becomes severe. The need for surgical treatment is
      indicated by the appearance of a diastolic thrill, left ventricular strain on the
      electrocardiogram or other evidence of left ventricular dysfunction on the
      echocardiogram or exercise stress testing by treadmill or radionuclide
      cineangiocardiography. Close follow-up of these patients is important to detect
      progression of aortic regurgitation, especially in the presence of cystic medial
      necrosis.

PMID- 1634674
TI  - Intravascular stent prosthesis for right ventricular outflow obstruction.
AB  - OBJECTIVES: This study was designed to assess the impact of implantation of
      balloon-expandable stents on right ventricular outflow obstruction in children
      with congenital heart disease. BACKGROUND: Intravascular stenting has been
      established as a useful treatment in adults with coronary and peripheral vascular
      disease. Its application in the treatment of infants and children with pulmonary,
      systemic and right ventricular conduit obstruction resistant to balloon
      angioplasty is limited. METHODS: A total of 24 stainless steel stents were
      implanted in 17 patients. Five stents were placed within right ventricular to
      pulmonary artery conduits, 17 in branch pulmonary arteries and 1 in an
      aortopulmonary collateral vessel. Follow-up time has ranged from 1 to 14 months,
      with 6 patients having hemodynamic and angiographic studies greater than 1 year
      after stent placement. The mean age at implantation was 7.4 +/- 5.6 years and the
      mean weight 33 +/- 16 kg. RESULTS: Optimal stent position was obtained in 22 of
      24 implantations. In one patient the stent slipped from the delivery balloon and
      was left positioned in the inferior vena cava. No embolization or thrombotic
      event has been documented. Among patients with right ventricular to pulmonary
      artery conduit obstruction, the gradient was immediately reduced from 85 +/- 30
      mm Hg to 35 +/- 20 mm Hg after stent implantation; however, three patients
      required conduit replacement because of persistent obstruction with elevated
      right ventricular pressures (82 +/- 16 mm Hg). In 10 of 11 patients with
      pulmonary artery stenosis, clinical improvement was noted in association with
      enlargement of vessel diameter by 92% +/- 90% (range 17% to 355%) and the
      gradient reduction of 22 +/- 24 mm Hg to 3 +/- 4 mm Hg. CONCLUSIONS: These data
      support the view that intravascular stenting will become an important adjunct in
      the management of children with congenital heart disease.

PMID- 1634675
TI  - Rapid progression of aortic aneurysms after patch aortoplasty repair of
      coarctation of the aorta.
AB  - OBJECTIVES: This study was undertaken to evaluate the progression of aortic
      aneurysms after patch aortoplasty repair of coarctation of the aorta. BACKGROUND:
      Previous studies demonstrated a 5% to 25% incidence rate of repair site aneurysm
      3 to 18 years after patch aortoplasty repair of coarctation. The natural history
      of aneurysmal progression in this disease entity has not previously been
      examined. METHODS: Twenty-nine patients were identified 5.6 +/- 1 years (mean +/-
      SE) postoperatively and classified into two groups: Group A, aneurysm (n = 7);
      Group B, no aneurysm (n = 22). The presence of an aneurysm was defined
      angiographically as a ratio of the repair site diameter to diaphragmatic aortic
      diameter (aortic ratio) greater than or equal to 1.5. A 23% prevalence (7 of 29)
      of aortic aneurysm was identified. One patient in Group A underwent semiemergency
      aneurysmectomy and two patients in Group B were lost to follow-up. The remaining
      26 patients were reevaluated 3 to 5 years later by clinical examination and chest
      radiography. Aortograms were performed in all patients with suspected aneurysm
      formation or progression. RESULTS: Five of six patients in Group a demonstrated
      progressive aneurysmal dilation documented by an increase in aortic ratio from
      1.64 +/- 0.06 to 2.04 +/- 0.2 (p = 0.03) and an increase in absolute aneurysm
      diameter from 2.5 +/- 0.3 to 3.6 +/- 0.5 cm (p = 0.006). Only 1 of 20 patients in
      Group B had evidence of new aneurysmal dilation (p less than 0.05 vs. Group A).
      Four patients in Group A have undergone elective aneurysmectomy, with equal
      distribution of true and pseudoaneurysms by pathologic examination. CONCLUSIONS:
      Aortic aneurysm formation is common after patch aortoplasty repair of coarctation
      of the aorta. The majority of patients with an aortic ratio greater than or equal
      to 1.5 will show significant progressive aneurysmal dilation within 3 to 5 years.

PMID- 1634676
TI  - Fixed subaortic stenosis in atrioventricular canal defect: a Doppler
      echocardiographic study.
AB  - OBJECTIVES: The objectives of this retrospective study were to describe the
      Doppler and echocardiographic features of fixed subaortic stenosis in the setting
      of atrioventricular (AV) canal defect and to document the de novo occurrence of
      subaortic stenosis and progression of this lesion over time on the basis of
      sequential echocardiographic studies. BACKGROUND: The coexistence of fixed
      subaortic and AV canal defect has been sporadically noted, but no single or
      multicenter experience with this constellation of abnormalities has been
      previously described. METHODS: All patients with a diagnosis of subaortic
      stenosis and complete or partial AV canal defect who had one or more Doppler
      echocardiographic examinations were identified from a computer data bank.
      Retrospective analysis was performed, including review of patients' charts,
      operative notes, recorded videotapes and hard copy recordings when available.
      RESULTS: Twenty-one patients with both subaortic stenosis and AV canal defect
      were identified over a 13-year period. Fifteen were female and the mean age at
      diagnosis of subaortic stenosis was 16 years. Fifteen patients had partial AV
      canal defect with prior repair in 10; 6 patients had complete AV canal defect
      with prior repair in 4. The mean interval from prior repair to recognition of
      subaortic stenosis was 6.8 years. In six patients, serial examinations
      demonstrated the de novo occurrence of subaortic obstruction over a period of 10
      to 87 months. In five patients, progression of known subaortic stenosis was
      documented over a 10- to 59-month period. Surgical resection of subaortic
      stenosis was performed in 16 patients; the echocardiographic diagnosis was
      confirmed in 15 of the 16. CONCLUSIONS: In the largest reported echocardiographic
      series of this lesion complex, it is concluded that subaortic stenosis can occur
      de novo, is often recognized only after repair of the canal defect and is
      progressive. Doppler echocardiography is the method of choice for diagnosis and
      serial follow-up of these patients.

PMID- 1634677
TI  - Steroid-eluting epicardial pacing leads in pediatric patients: encouraging early
      results.
AB  - OBJECTIVES: This study evaluated the pacing and sensing characteristics of a new
      porous-tipped steroid-eluting epicardial lead in a group of pediatric patients.
      BACKGROUND: Pacing in children may be complicated by small patient size, patient
      growth and the prevalence of structural congenital heart disease in children
      requiring pacing. Epicardial pacing has been associated with a high incidence of
      problems with sensing and capture, prompting the use of transvenous endocardial
      pacing when possible. In some children, epicardial pacing may still be desirable
      because of small patient size, potential for caval obstruction, previous cardiac
      surgery limiting transvenous access to the heart, or the need to repair
      congenital heart disease at the time of pacemaker insertion. METHODS: Twelve
      patients aged 3 weeks to 18 years underwent placement of 23 epicardial pacing
      leads (8 atrial, 15 ventricular). Pulse width thresholds, sensing thresholds and
      lead impedance were measured weekly for 6 weeks, then at 3, 6, 12 and 18 months
      after pacemaker implantation. The median duration of follow-up was 12 months.
      RESULTS: Ventricular pulse width thresholds did not change over time, whereas
      atrial pulse width thresholds improved significantly. At 6 months, the mean pulse
      width threshold at 2.5 V for the atrial and ventricular leads was 0.10 +/- 0.03
      and 0.19 +/- 0.09 ms, respectively. The thresholds were slightly lower at 12 and
      18 months. At the most recent follow-up, all atrial leads sensed appropriately at
      2.5 mV and all ventricular leads at 5 mV. CONCLUSIONS: These encouraging early
      results suggest that steroid-eluting epicardial pacing leads may be an attractive
      option for children needing epicardial pacing. Their excellent pacing and sensing
      characteristics may allow reliable dual-chamber pacing in infants who are too
      small for transvenous pacing.

PMID- 1634678
TI  - Simultaneous measurement of coronary flow reserve by left anterior descending
      coronary artery Doppler and great cardiac vein thermodilution methods.
AB  - OBJECTIVES: The objective of this study was to compare left anterior descending
      coronary artery Doppler blood flow velocity and great cardiac vein thermodilution
      blood flow measurements of coronary flow reserve and submaximal coronary
      vasodilation in humans. BACKGROUND: Reported maximal coronary flow reserve values
      obtained with the coronary venous thermodilution method are lower than those
      obtained with other measurement methods. METHODS: Thermodilution measurements of
      great cardiac vein flow in 11 subjects were compared with simultaneous Doppler
      measurements of changes in left anterior descending coronary flow velocity after
      intracoronary administration of papaverine, nitroglycerin, iohexol and
      intravenous administration of dipyridamole. RESULTS: Coronary flow reserve
      (papaverine peak/rest flow ratio) was 3.7 +/- 1.7 (mean +/- SD) by the Doppler
      method and 2.0 +/- 0.7 by the thermodilution technique (p less than 0.001).
      Thermodilution flow changes were also smaller than Doppler-measured changes
      during submaximal vasodilation and during prolonged coronary dilation after
      dipyridamole administration. CONCLUSIONS: Coronary flow reserve and submaximal
      flow increases measured with the thermodilution method were consistently and
      substantially smaller than Doppler-derived measurements. This discrepancy has
      important implications for the comparison of coronary flow reserve measurements
      performed with the use of different techniques.

PMID- 1634679
TI  - Etiology of the Austin Flint murmur.
AB  - OBJECTIVES: The aim of the study was to determine the mechanism of the Austin
      Flint murmur. BACKGROUND: More than 100 years after the initial description of
      the Austin Flint murmur, the etiology of the murmur remains unclear. METHODS: M
      mode and two-dimensional echocardiography, conventional and color flow Doppler
      study, and cine nuclear magnetic resonance (cine NMR) imaging were performed in
      24 patients with clinically moderate or severe aortic regurgitation. Mitral valve
      area was determined by planimetry and pressure half-time measurement. Overlap of
      the aortic regurgitation and mitral inflow jets was graded 0 (no overlap) to 4
      (marked overlap) by Doppler study and cine NMR imaging. The volume of signal loss
      resulting from turbulent blood flow secondary to the aortic regurgitation jet was
      determined on cine NMR images, and the extent of contact with the left
      ventricular endocardium was graded 0 (no contact) to 4 (extensive contact).
      RESULTS: The presence of an Austin Flint murmur did not correlate with mitral
      valve area (2.7 +/- 0.8 cm2 with the murmur vs. 2.5 +/- 0.7 cm2 without), overlap
      of the aortic regurgitation and mitral flow jets (3 +/- 1 vs. 2.3 +/- 1.2),
      diastolic mitral regurgitation (50% vs. 71%) or fluttering of the anterior mitral
      valve leaflet (70% vs. 50%). The presence of an Austin Flint murmur correlated
      best with the volume of signal loss associated with the aortic regurgitation jet
      on cine NMR imaging (65 +/- 16 ml with the murmur. vs. 38 +/- 11 ml without, p
      less than 0.001) and the extent of contact of this signal loss with the left
      ventricular endocardium (2.9 +/- 0.5 vs. 1.5 +/- 0.4, p less than 0.0001).
      CONCLUSIONS: The Austin Flint murmur is caused by the aortic regurgitation jet
      abutting the left ventricular endocardium, resulting in the generation of a low
      pitched diastolic rumbling.

PMID- 1634680
TI  - Nature and time course of generation of isoforms of creatine kinase, MB fraction
      in vivo.
AB  - OBJECTIVES: This study was designed to characterize the nature and time course of
      carboxy-terminal lysine cleavages from the tissue isoform of MB creatine kinase
      (CK) in vivo. BACKGROUND: Rapid conversion of the tissue isoform of MM CK to two
      additional circulating isoforms with one or both carboxy-terminal lysines cleaved
      facilitates early detection of new tissue isoform release after acute myocardial
      infarction and coronary recanalization. Characterization of changes in plasma MB
      CK isoform profiles, potentially enhancing specificity even further, has been
      hindered by difficulties in separating the isoform products and elucidation of
      carboxy-terminal lysine cleavages underlying their formation. METHODS: Isoform
      species with carboxy-terminal lysine present on B-monomers were separated from
      those from which lysine had been cleaved by anion exchange chromatography.
      Carboxy-terminal lysine on M-monomers was assayed with the use of a monospecific
      antibody. RESULTS: MB CK in four pooled plasma samples from among 77 normal
      subjects exhibited carboxy-terminal lysine on 48 +/- 21% (mean +/- SEM) of B
      monomers and 82 +/- 12% of M-monomers. Within the 1st 16 h after the onset of
      acute myocardial infarction, virtually all M- and B-monomers exhibited carboxy
      terminal lysine, indicating release into plasma and the lack of rapid cleavage of
      lysine from the tissue isoform. After 20 to 30 h, 43 +/- 9% (three pools from 19
      patients) of B-monomers and 95 +/- 10% of M-monomers exhibited lysine at the
      carboxyl terminus. After 40 to 50 h, 13 +/- 13% (four pools from 34 patients) of
      B-monomers and 46 +/- 19% of M-monomers still retained carboxy-terminal lysine.
      CONCLUSIONS: In contrast to MM CK, the tissue isoform of MB CK undergoes slow
      cleavage of lysine from both monomers in vivo. Sequential cleavage of lysine
      first from the carboxyl terminus of B-monomers and subsequently from M-monomers
      is consistent with generation of at least two additional isoforms. Development of
      assays capable of resolving all of the isoforms of MB CK that can occur in vivo
      might increase sensitivity for early detection of new tissue isoform release
      associated with acute myocardial infarction and coronary recanalization compared
      with currently available assays that resolve only two species.

PMID- 1634681
TI  - Left ventricular flow propagation during early filling is related to wall
      relaxation: a color M-mode Doppler analysis.
AB  - OBJECTIVES: This study was designed to evaluate the relation between the velocity
      of flow propagation and left ventricular relaxation by using color M-mode Doppler
      echocardiography to analyze flow propagation in the left ventricle. BACKGROUND:
      Noninvasive attempts to identify alterations in left ventricular relaxation have
      been hampered because both the relaxation rate and left atrial filling pressure
      are the determinants of peak early velocity and filling rate. METHODS: Color M
      mode velocity data were transferred to a microcomputer and compared with
      conventional pulsed Doppler data to assess the ability of color M-mode
      echocardiography to analyze velocity field properties. The velocity of flow
      propagation was measured as the slope of the flow wave front during early filling
      in normal subjects (n = 29) and in patients with disease that alters relaxation
      (dilated cardiomyopathy [n = 31], ischemic cardiomyopathy [n = 8], hypertrophic
      cardiomyopathy [n = 5], systemic hypertension [n = 22] and aortic valve disease
      [n = 25]). In nine patients with end-stage dilated cardiomyopathy,
      echocardiographic and left heart catheterization data were obtained at baseline
      and during intracoronary dobutamine infusion. RESULTS: Color M-mode and pulsed
      Doppler echocardiographic data were highly correlated (n = 217, r = 0.94, p less
      than 0.0001, velocity range 0.2 to 1.5 m/s). The velocity of flow propagation was
      lower in patients than in normal subjects (0.46 +/- 0.15 vs. 0.84 +/- 0.11 m/s, p
      less than 0.0001). The decrease was significant in all disease forms with or
      without left ventricular dilation. The velocity of flow propagation was related
      to peak early velocity in normal subjects (p less than 0.001) but not in
      patients. It varied inversely with the isovolumetric relaxation time constant
      during dobutamine infusion and the two variables were highly correlated (p less
      than 0.0001). CONCLUSIONS: The velocity of flow propagation during early filling
      seems to be highly dependent on the left ventricular relaxation rate and could be
      an important tool in studying diastolic function.

PMID- 1634682
TI  - Variability in the quantitation of mitral regurgitation by Doppler color flow
      mapping: comparison of transthoracic and transesophageal studies.
AB  - OBJECTIVES: This study was designed to assess the most accurate and reproducible
      methods to quantitate mitral regurgitation by color flow transthoracic and
      transesophageal echocardiography. BACKGROUND: Quantitative measurements of mitral
      regurgitant jets have resulted in an intraobserver and interobserver variability
      of up to 20%. Few data are available evaluating the various techniques by which
      mitral regurgitant jets are quantitated. METHODS: Forty patients who underwent
      cardiac catheterization and both transesophageal and transthoracic
      echocardiography within 1 week were studied. Two boundaries of the color
      regurgitant jet area were identified and quantitated: 1) the central aliased core
      of the regurgitant jet with the mosaic pattern excluding any swirling low
      velocity flow; and 2) the largest definable area of the regurgitant flow,
      including low velocity flow considered to be part of the regurgitant jet.
      RESULTS: The total regurgitant areas obtained by transthoracic and
      transesophageal studies did not differ (5.7 +/- 4.6 vs. 5.7 +/- 3.7 cm2; p = NS).
      However, the transesophageal mosaics were significantly larger than those
      obtained by transthoracic echocardiography (3.6 +/- 3.1 vs. 2.8 +/- 3.4 cm2; p
      less than 0.01). In transthoracic studies observer variability was higher when
      the mosaic aspect of the regurgitant jet rather than the total regurgitant area
      was measured (24 +/- 20 vs. 16 +/- 11%; p less than 0.05). In contrast, in
      transesophageal studies variability was lower when the mosaic area rather than
      the total regurgitant area was measured (11 +/- 12% vs. 18 +/- 18%; p less than
      0.05). The best correlations with left ventriculography were obtained by using
      the absolute total regurgitant area (r = 0.72) for transthoracic studies and the
      mosaic area of the jets (r = 0.87) for transesophageal studies. CONCLUSIONS:
      Doppler color flow jet areas correlate closely with angiographic results in the
      evaluation of mitral regurgitation. The total regurgitant area (including the
      surrounding swirling flow) in transthoracic studies and the aliased core of the
      regurgitant jet (mosaic) in transesophageal studies appear to be the most
      accurate and reproducible measurements for evaluating mitral regurgitation.

PMID- 1634683
TI  - Quantitation of Doppler color flow recordings: an oxymoron?

PMID- 1634684
TI  - Activation patterns in experimental canine atrial flutter produced by right
      atrial crush injury.
AB  - OBJECTIVES: This study was designed to localize and characterize the atrial
      flutter reentrant circuit and the electrophysiologic effects of right atrial
      crush injury in a new canine model. BACKGROUND: In previous studies sustained
      atrial flutter was induced in the canine heart by rapid atrial pacing after a
      linear crush injury was placed in the right atrial free wall. METHODS: Eight dogs
      (group 1) with three electrode plaques on the right and left atria and Bachmann's
      bundle and seven dogs (group 2) with a single high density electrode plaque on
      the right atrium were studied with use of a 64-channel computerized mapping
      system. RESULTS: At baseline, during sinus rhythm and right and left atrial
      pacing, activation spread uniformly without areas of slow conduction. Crush
      injury produced marked conduction delay or complete block during sinus rhythm,
      increasing the mean difference in activation times across the injury compared
      with control values (group 1, 31 +/- 4 vs. 14 +/- 5 ms, p less than 0.01; group
      2, 28 +/- 10 vs. 7 +/- 2 ms, p less than 0.01). Rapid atrial pacing (S1S1 200 ms)
      above and below the crush injury revealed a line of complete block across which
      adjacent electrodes recorded markedly different activation times (33 +/- 5 and 38
      +/- 12 ms difference, respectively) and around which activation wave fronts
      proceeded, colliding opposite the stimulating electrodes. The mean atrial flutter
      cycle length of 11 episodes induced in group 1 and 14 episodes in group 2 was 157
      +/- 16 and 140 +/- 16 ms, respectively (p = NS). Activation mapping revealed a
      reentrant circuit in the right atrium around the crush injury in all episodes.
      Although the reentrant circuit did not contain a discrete area of slow
      conduction, activation time below was longer than that above the crush injury (92
      +/- 14 vs. 66 +/- 8 ms and 82 +/- 12 vs. 59 +/- 9 ms in groups 1 and 2,
      respectively, p less than 0.01 for both). Rapid atrial pacing or premature
      stimuli produced progressive conduction delay and unidirectional block between
      the crush injury and the tricuspid anulus, inducing atrial flutter directly in 9
      of 25 episodes. In 16 episodes, atrial flutter developed after transient
      induction of atrial fibrillation. CONCLUSIONS: 1) Atrial flutter in this model is
      due to reentry in the right atrium; 2) the crush injury functions as an anatomic
      obstacle around which reentry may occur; and 3) the reentrant circuit does not
      contain a discrete area of slow conduction but, rather, generally slower
      conduction below the crush injury.

PMID- 1634685
TI  - Short-term administration of estrogen and vascular responses of atherosclerotic
      coronary arteries.
AB  - OBJECTIVES: This experiment sought to determine the effect of short-term
      administration of estrogen on endothelium-dependent dilation in the coronary
      arteries of 13 surgically postmenopausal female cynomolgus monkeys. BACKGROUND:
      Long-term estrogen replacement therapy prevents impaired endothelium-dependent
      dilation of atherosclerotic coronary arteries in postmenopausal female monkeys.
      However, it remains unclear whether this action of estrogen is due to long-term
      effects on plasma lipids and atherogenesis or to direct short-term effects on the
      endothelium. METHODS: The monkeys consumed an atherogenic diet for 18 months
      after bilateral ovariectomy. Vascular responses were measured just before
      euthanasia and necropsy. Dextrose in water (control), acetylcholine, 10(-6)M, and
      nitroglycerin were infused for 2.5 min each both before and 20 min after
      intravenous injection of 54 ng ethinyl estradiol. RESULTS: Quantitative coronary
      angiography revealed that the arteries constricted (-17 +/- 3%) in response to
      intracoronary infusion of acetylcholine before estrogen treatment but dilated (+5
      +/- 3%) 20 min after intravenous injection of ethinyl estradiol (p less than
      0.05). Coronary arteries dilated in response to nitroglycerin both before and
      after administration of estrogen (p greater than 0.05). Vascular responses of
      coronary arteries, both before and after administration of estrogen, were not
      associated with variation in plasma lipid concentrations, blood pressure, heart
      rate or plaque size. CONCLUSIONS: Estrogen affects endothelium-dependent coronary
      dilation within 20 min of administration and may have rapid direct effects on the
      vascular endothelium.

PMID- 1634686
TI  - Reversal of acetylcholine effect on atherosclerotic coronary arteries by
      estrogen: pharmacologic phenomenon of clinical importance?

PMID- 1634687
TI  - Coronary intimal proliferation after balloon injury and stenting in swine: an
      animal model of restenosis.
AB  - OBJECTIVES: This study was designed to compare the proliferative response in
      coronary arteries after tantalum stent placement or balloon injury in a
      normolipemic swine model of restenosis. BACKGROUND: Restenosis remains a
      significant complication of percutaneous transluminal coronary angioplasty.
      Efforts to study restenosis have been hampered by the lack of a suitable animal
      model. METHODS: In an attempt to create lesions resembling those of human
      restenosis, normolipemic swine underwent injury of either the left anterior
      descending or the left circumflex coronary artery with either balloon inflation
      or deployment of a tantalum stent. At 4 weeks, they were killed and the injured
      vessels processed for histopathologic analysis. Intimal area, lumen area and
      maximal intimal thickness were measured. The degree of stenosis was expressed as
      residual lumen area (lumen area/intimal area ratio). RESULTS: Vessels injured by
      either method demonstrated significant intimal smooth muscle proliferation
      leading to reduction in lumen area. In the 18 stented vessels residual lumen area
      measured 0.64 +/- 0.18 and maximal intimal thickness measured 0.6 +/- 0.3 mm; in
      the 15 balloon-injured vessels these values were 0.75 +/- 0.18 and 0.4 +/- 0.3
      mm, respectively (p less than 0.05). In addition, most stented vessels had
      reactive inflammatory infiltrates surrounding the stent wires composed of
      lymphocytes, histiocytes and many eosinophils. CONCLUSIONS: These data indicate
      that coronary artery injury in swine with either balloon inflation or stenting
      leads to intimal smooth muscle cell proliferation similar to that seen in human
      restenosis. The degree of intimal proliferation appears to be greater after
      stenting than after balloon injury. Intracoronary stenting in swine is associated
      with a marked inflammatory reaction around the stent wires. These models may be
      helpful in planning systemic and local antirestenosis strategies.

PMID- 1634688
TI  - Electrocardiogram of the humpback whale (Megaptera novaeangliae), with specific
      reference to atrioventricular transmission and ventricular excitation.
AB  - OBJECTIVES: The objective of the study was to record the electrocardiogram (ECG)
      of a large whale to obtain crucial data for comparative electrophysiologic
      analysis. BACKGROUND: The data were needed to establish the mismatch between
      heart size and PR interval and QRS duration in mammals. METHODS: In the waters
      off the coast of Newfoundland, in two humpback whales (Megaptera novaeangliae)
      with an estimated weight of 30,000 kg a 1-lead ECG was recorded, enabling
      reliable assessment of P waves and QRS complexes. RESULTS: It was found that both
      the PR interval (atrioventricular [AV] transmission time) and QRS duration
      (ventricular excitation) are extremely short for animals of this size. These
      findings are difficult, if not impossible, to explain on the basis of currently
      accepted electrophysiologic theories. However, the narrow QRS complex may be due
      to a very dense His-Purkinje network in the ventricular wall of whales.
      Alternative mechanisms that can explain the function of the mammalian AV node
      need to be considered and explored. CONCLUSIONS: The results of the study may be
      of value for the understanding of the ECG in humans.

PMID- 1634689
TI  - Transcoronary chemical ablation of ventricular tachycardia in chronic chagasic
      myocarditis.
AB  - OBJECTIVE: A case of incessant ventricular tachycardia in a patient with Chagas'
      disease that was successfully terminated by chemical ablation is reported.
      BACKGROUND: Chagas' disease is a common medical problem in South America.
      Ventricular tachyarrhythmias, atrioventricular conduction disturbances,
      congestive heart failure and sudden cardiac death are important manifestations of
      this disease. METHODS: Selective catheterization of the coronary artery supplying
      the arrhythmogenic area was performed by using a conventional angioplasty system
      and the arrhythmogenic area was ablated by injection of 96% sterile ethanol.
      RESULTS: Ethanol (96%) injection initially in a lateral branch of the left
      circumflex artery and 2 days later in the proximal segment of the artery resulted
      in termination of ventricular tachycardia. Two weeks after ablation, programmed
      ventricular stimulation failed to induce ventricular tachycardia. CONCLUSION:
      Transcoronary chemical ablation should be considered in selected cases of Chagas'
      disease with incessant ventricular tachycardia.

PMID- 1634690
TI  - Cardiac alternans: diverse mechanisms and clinical manifestations.
AB  - OBJECTIVES: The purpose of this review is to assemble the widely dispersed
      information about cardiac alternans and to categorize the types and mechanisms of
      alternans, their clinical manifestations and possible therapeutic implications.
      BACKGROUND: The phenomena of mechanical and electrical alternans have been of
      continuing interest to both physiologists and clinicians. Recent studies have
      enhanced this interest because of the reported association of alternans with
      experimental myocardial ischemia and cardiac arrhythmias. METHODS: The review
      formulates concepts based on extensive review of published studies and personal
      observations. RESULTS: Cardiac alternans has been subdivided into the following
      four categories: 1) mechanical, 2) electrical, 3) in association with myocardial
      ischemia, and 4) in association with cardiac motion. Mechanical alternans can be
      explained by hemodynamic or inotropic alterations, or both. Mechanical alternans
      in the ventricular muscle is accompanied by alternans of action potential shape.
      In the Purkinje fibers, action potential duration alternates without change in
      shape and is determined by the duration of the preceding diastolic interval.
      However, in ventricular muscle fiber, alternans can occur in the presence of
      constant diastolic intervals. T wave alternans reflects changes in action
      potential duration and is frequently associated with a long QT interval.
      Electrocardiographic manifestations of conduction alternans occur at many
      different sites within the conducting system and myocardium. During myocardial
      ischemia, additional mechanisms of repolarization alternans have been proposed.
      Alternans occurring in the presence of a large pericardial effusion is attributed
      to swinging motion of the heart maintaining two-beat periodicity. CONCLUSIONS:
      Since its origin as "pulsus alternans" described by Traube in 1872, the
      definition of alternans has evolved into a term encompassing multiple physiologic
      and pathologic phenomena that, although united by the term cardiac alternans,
      diverge widely with respect to etiology, mechanism and clinical significance.

PMID- 1634691
TI  - The long QT syndrome: a G or not a G?

PMID- 1634692
TI  - Transesophageal echocardiography. American College of Cardiology position
      statement.

PMID- 1634693
TI  - Marital coital activity in men at the age of 75: relation to somatic,
      psychiatric, and social factors at the age of 70.
AB  - OBJECTIVE: To find somatic, psychiatric, and social variables that predicted
      cessation of coital activity in elderly married men. DESIGN: Prospective,
      longitudinal, observational study SETTING: General survey of a representative
      sample of 70-year-old urban men (born in 1901-02) in Goteborg, Sweden.
      PARTICIPANTS: Forty-one men who were married and had coital activity at age 70
      and who, at the age of 75, were still married when the sample was reinterviewed.
      MAIN OUTCOME MEASURES: Presence (c) or absence (nc) of coital activity at age 75.
      RESULTS: Cessation of coital activity was associated with vasculogenic factors.
      At least one of the following disorders--systemic hypertension, ischemic heart
      disease, congestive heart failure, diabetes mellitus, or hypertriglyceridemia-
      was found in three of the C men and 14 of the NC men, P less than 0.005. Systemic
      hypertension was the most common disorder and was found in one C man and 10 NC
      men, P less than 0.01. Cessation of coital activity was associated with specified
      types of stress between 65 and 70 years of age in the subgroup of men who had
      stopped due to inability; six out of eight reported stress against five out of 20
      in the C group, P less than 0.05. There was no association with any of the
      psychiatric or social factors studied. CONCLUSIONS: Cessation of coital activity
      is predicted by somatic disorders which are associated with vascular damage and
      especially by hypertension. This observation does not allow the conclusion that
      antihypertensive treatment would be effective in postponing the cessation of
      coital activity.

PMID- 1634694
TI  - The relationship of patient's age to the perceptions of the rehabilitation
      environment.
AB  - OBJECTIVE: To compare the perceptions of the rehabilitation environment among
      staff, younger (less than 65), and older patients (greater than 65). DESIGN: The
      Ward Atmosphere Scale (WAS) was administered to 55 patients and 108 staff members
      in a rehabilitation hospital. SETTING: A large university-associated free
      standing rehabilitation hospital. SUBJECTS: Patients and staff primarily
      associated with one of three treatment teams, each on a separate floor. The teams
      were selected to reflect a diversity of treatment styles and patients' diagnoses.
      MAIN OUTCOME MEASURE: The WAS is a 100 true/false questionnaire with 10 subscales
      which combine to form three dimensions: relationship, program orientation, and
      system maintenance. These dimensions represent the principal constructs of the
      instrument. MAIN RESULTS: Multivariate analysis of variance was performed on
      three groups completing the WAS--staff, patients less than 65 years old, and
      patients 65 years and older. This analysis revealed significant differences among
      the three groups on the Relationship (F = 14.3; P less than 0.01) and Program
      Dimensions (F = 36.5; P less than 0.01), and between staff and patients on the
      System Maintenance Dimension (F = 11.4; P less than 0.01). Compared to younger
      patients and staff, older patients had lower perceptions in the combined areas of
      involvement, support, spontaneity, autonomy, practical orientation, personal
      problem orientation, and anger and aggression. Likewise, older patients perceived
      more staff control than staff and younger patients. Younger patients scored
      between older patients and staff. CONCLUSIONS: This study suggests that there may
      be a mismatch between current rehabilitation environments and the needs of
      elderly individuals.

PMID- 1634695
TI  - The Test for Severe Impairment: an instrument for the assessment of patients with
      severe cognitive dysfunction.
AB  - OBJECTIVE: To develop a reliable and valid test of cognitive function suitable
      for patients with severe cognitive impairment. DESIGN: Administration of a test;
      test-retest reliability; comparison to traditional test. SETTING: Chronic long
      term-care facility. PATIENTS OR OTHER PARTICIPANTS: The participants were 40
      elderly residents with severe cognitive impairment. MAIN OUTCOME MEASURES:
      Results of the Test for Severe Impairment (TSI) and its subsections (language,
      memory, executive function, and motor performance); correlation of test and
      retest scores; correlation of TSI with Mini-Mental State Exam. RESULTS: The TSI
      was significantly correlated with the Mini-Mental State Exam (r = 0.83, P less
      than or equal to 0.0001). Test-retest reliability was high (r = 0.96, P less than
      0.0001). The internal reliability of the test was also good (alpha = 0.90).
      Preliminary result of a factor-analysis suggests that factor scores may be
      derived that relate to memory, language production, and knowledge of body parts.
      CONCLUSIONS: The TSI is a valid and reliable test of cognitive function in
      patients with severe cognitive impairment. It is appropriate to use it as a
      unified scale.

PMID- 1634696
TI  - Occult elevation of CK as a manifestation of rhabdomyolysis in the elderly.
AB  - OBJECTIVE: To evaluate the incidence, etiology and clinical course of
      rhabdomyolysis in hospitalized elderly patients. DESIGN: Retrospective case
      series. SETTING: Acute geriatric department of a university-affiliated teaching
      hospital. PATIENTS: Twenty-three patients who fulfilled our criteria of
      rhabdomyolysis. Criteria for inclusion were the finding of elevated serum
      creatine kinase of five-fold or greater above the upper reference limit and
      greater than 97% MM isoenzyme. RESULTS: In a 3-year period 23 patients out of
      2,870 admissions fulfilled the criteria for rhabdomyolysis, an incidence rate of
      0.8%. Diseases or insults associated with rhabdomyolysis were, in order of
      frequency, acute immobilization, infectious disease, cerebrovascular accident,
      hyperosmolar state, hyponatremia, hypernatremia, hypothermia, and a fall. Twenty
      two patients recovered from the acute illness; one patient died from respiratory
      failure. Seventeen patients had renal failure (serum creatinine greater than 180
      mumol/L), none necessitating dialysis. Serum creatinine always declined following
      recovery. CONCLUSION: Elevation of CK with few other clinical features of
      rhabdomyolysis is common in admissions to a geriatric service. It is due to
      complete immobilization resulting from acute illness. Renal failure is mild and
      reversible, and the prognosis for recovery is excellent.

PMID- 1634697
TI  - Measurement of activities of daily living in hospitalized elderly: a comparison
      of self-report and performance-based methods.
AB  - OBJECTIVE: To determine the accuracy of self-reports of physical functioning by
      hospitalized elderly. DESIGN: Comparison of two measures. PATIENTS AND SETTING:
      Two-hundred forty-seven medical inpatients (mean age 78.7 years) hospitalized at
      St. Marys Hospital Medical Center, Madison, WI. MAIN OUTCOME MEASURES: Measures
      of five activities of daily living by self-report and by performance. RESULTS:
      The rate of agreement between self-report and performance ADL measures was the
      lowest in the areas of bathing and dressing where the agreement was 63% and 64%,
      respectively. When patients reported needing no help in these two tasks, they
      were measured lower 32% of the time for dressing and 42% for bathing. When
      patients reported needing help in an activity the agreement rate between patient
      and occupational therapist varied widely, from only 42% for toileting to 78% for
      bathing. The two factors which were statistically associated with poor agreement
      between the two ADL measurements were cognitive impairment (P less than 0.001)
      and a decline from the pre-hospital level of ADL functioning which had occurred
      during hospitalization (P less than 0.001). CONCLUSIONS: These data suggest that
      there may be significant differences between patient assessments and performance
      based measurements of ADL functioning in hospitalized elderly at time of
      discharge. These differences may have implications for the collection of
      functional measurements for discharge planning or for geriatric research in the
      hospital environment.

PMID- 1634698
TI  - The Caretaker Obstreperous-Behavior Rating Assessment (COBRA) Scale.
AB  - OBJECTIVE: To evaluate the usefulness and reliability of the Caretaker
      Obstreperous-Behavior Rating Assessment (COBRA), a new test instrument for
      caretaker assessment of types and severity of "obstreperous behaviors" (OBs) in
      demented patients. DESIGN: COBRA was completed by caretakers of 31 outpatients
      and 36 nursing home inpatients with dementia. Test-retest reliability was
      determined when 25 of the outpatient caretakers re-evaluated their demented
      relative 1 week later; inter-rater reliability was determined on nursing home
      inpatients by comparing the reports of two nurse's aids with equivalent knowledge
      of seven of the patients. SETTING: (1) University medical center Alzheimer's
      Disease and Related Disorders Clinic; (2) community nursing home. PATIENTS:
      Thirty-one sequentially-seen outpatients with dementia; 36 nursing home patients
      with dementia. INTERVENTION: Following instruction in the use of the COBRA Scale,
      caretakers provided scores for their demented patient. The instrument has three
      unique features: (1) it divides OBs into four categories for ease of
      comprehension: Aggressive/Assaultive; Mechanical/Motor; Ideational/Personality;
      and Vegetative; (2) a companion videotape shown to caretakers in advance
      illustrates each behavior to improve reliability of reporting; (3) the
      significance of each OB is estimated with severity and frequency measures. MAIN
      OUTCOME MEASUREMENTS: Frequency and severity of OBs are epitomized in 12 summary
      scores. Test-retest correlations (for outpatients) and inter-rater correlations
      (for inpatients) were analyzed with Pearson Product Moment and Spearman Rank
      Order correlations. RESULTS: Prevalence of OBs and severity was reported for the
      experimental groups. Summary scores revealed test-retest correlations of .95 to
      .73 for 11 of 12 scores (outpatients), and inter-rater correlations of .99 to .73
      for 8 of 12 scores (inpatients). Age, gender, and disease etiology were not
      significantly related to OBs; clinical severity correlated with type and severity
      of OBs. CONCLUSIONS: The COBRA scale provides a convenient, comprehensive, and
      reliable means for caretakers to identify the types and measure the severity of
      OBs in demented outpatients and nursing home inpatients. If additional studies
      confirm these observations, COBRA will be a useful instrument for assessing the
      effects of interventions on OBs in patients with dementia.

PMID- 1634699
TI  - The physician's decision to use tube feedings: the role of the family, the living
      will, and the Cruzan decision.
AB  - OBJECTIVE: To determine the relative importance of factors influencing physicians
      to use tube feedings in patients lacking decision-making capacity. DESIGN:
      Survey. SETTING AND PARTICIPANTS: Four hundred thirty-nine members of the
      Missouri Academy of Family Physicians. MEASUREMENTS: Using a mailed
      questionnaire, physicians were asked for a decision about feeding tube placement
      in an 89-year-old man who was unable to swallow or communicate after a stroke.
      Changing the conditions of the scenario, we then evaluated the influence of
      patient age, duration of disability, a living will, the Cruzan decision, and
      family preferences on the physician's decision. RESULTS: After reading the
      initial case history, 47% of physicians opposed tube feedings. Physicians who
      were told that the patient signed a living will specifically excluding tube
      feedings were more likely to oppose tube feedings than those who were told that
      he signed only a standard living will (53% vs 42%; P = 0.02). Forty-two percent
      of physicians who initially suggested a feeding tube changed their recommendation
      if the family opposed it. Sixty-six percent of physicians who initially opposed a
      feeding tube changed their recommendation if the family "pushed" for it. Thirty
      three percent of physicians who initially opposed tube feedings under the living
      will scenario would favor tube feedings if the patient had not signed a living
      will. Twenty-two percent of physicians who initially opposed tube feedings would
      change to favor them if the issue had arisen before the Cruzan decision.
      CONCLUSIONS: Among this group of physicians, there was no consensus on whether
      tube feedings should be initiated. However, it was found that the family's
      opinion was the most influential factor affecting the physician's recommendation
      about tube feedings. Most physicians endorsed family preferences for tube
      feedings even when this intervention was specifically opposed in the patient's
      living will.

PMID- 1634700
TI  - A clinicopathological study of CT scans in Alzheimer's disease.
AB  - OBJECTIVE: To investigate the accuracy of cranial computerized tomography (CT)
      scans in distinguishing patients with Alzheimer's disease from those with other
      dementing conditions. DESIGN: Retrospective clinicopathological correlation with
      pre-mortem CT scans. SETTING: Urban and rural hospitals and nursing homes in the
      Upper Midwest. PATIENTS: All 507 patients had clinical dementia diagnosed as
      Alzheimer's disease during life and the subsequent referral of their brains to a
      dementia brain bank. Of these, 375 patients had had CT scans as part of the
      diagnostic work-up for dementia. MAIN OUTCOME MEASURES: The presence of
      neuropathological evidence of Alzheimer's disease and the specific findings on CT
      scans. RESULTS: Of the 375 patients evaluated with a CT, 28% were misdiagnosed
      (lacked neuropathological evidence of Alzheimer's disease); of the 132 patients
      evaluated without a CT scan, only 18% were misdiagnosed (P less than 0.05). The
      degree of atrophy and other CT findings were similar in the correctly diagnosed
      and misdiagnosed groups except for increased ventricular size in the correctly
      diagnosed patients (P less than 0.05). CONCLUSION: Although CT scans do not
      usually contribute to the recognition of Alzheimer's disease, the presence of
      ventricular enlargement may help distinguish Alzheimer's disease from other
      dementias.

PMID- 1634701
TI  - Sensitivity and specificity of death certificate diagnoses for dementing
      illnesses, 1988-1990.
AB  - OBJECTIVE: To evaluate the extent to which mortality data, which is often used to
      track secular trends for specific diseases, underestimates the prevalence of
      dementia. DESIGN: Retrospective analysis of existing data. SETTING: Department of
      Mental Health inpatient facilities in South Carolina. SUBJECTS: Inpatients at
      Department of Mental Health facilities who were listed in the South Carolina
      Statewide Alzheimer's Disease and Related Disorders Registry and who died between
      1988 and 1990 (n = 450). MAIN OUTCOME MEASURES: Sensitivity and specificity of
      dementia diagnoses on death certificates compared to medical record diagnoses for
      inpatients with a pre-mortem dementia diagnosis. RESULTS: Twenty-three percent of
      death certificates contained any dementia diagnosis (104/450). The sensitivity of
      death certificates varied by type of dementia (28 percent for Alzheimer's
      disease; 8 percent for multi-infarct dementia) as well as by race, sex, and age.
      CONCLUSIONS: Mortality statistics substantially underestimate the prevalence of
      dementing illnesses and do not fully represent the public health burden of
      dementia.

PMID- 1634702
TI  - The use of targeting criteria in hospitalized HMO patients: results from the
      demonstration phase of the Hospitalized Older Persons Evaluation (HOPE) Study.
AB  - OBJECTIVE: To determine the yield of standardized targeting criteria for
      identifying hospitalized HMO patients who are at high risk for mortality and
      nursing home placement and, therefore, may be appropriate for comprehensive
      geriatric assessment. DESIGN: Prospective cohort study. SETTING: Four HMO
      (Southern California Kaiser-Permanente) hospitals. SUBJECTS: 3,697 patients 65
      years of age or older admitted to any inpatient service from July 1 through
      September 30, 1990. MAIN OUTCOME MEASURES: Screening measures for standardized
      targeting criteria, administered 24-48 hours after admission. RESULTS: Overall,
      35.1% of patients screened met at least one inclusionary criterion, which is
      considerably higher than other published reports. The most commonly met criteria
      were incontinence, impairment in performing activities of daily living,
      malnutrition, and immobility. The percentage of patients meeting at least one
      criterion and meeting each criterion varied considerably among hospitals. The
      vast majority of patients (83%) who were judged appropriate for assessment met at
      least three criteria. CONCLUSIONS: The yield of standardized criteria differs
      when applied to patients in different health care systems and to patients at
      different hospitals within a health care system, which may reflect differences in
      the populations being served and the practice styles of physicians and the
      delivery system. Because no single criterion identified more than approximately
      half of patients who were judged appropriate for assessment, it is likely that a
      battery of criteria will be necessary to identify these patients.

PMID- 1634703
TI  - Anemia and hemoglobin levels in older persons: relationship with age, gender, and
      health status.
AB  - OBJECTIVE: To determine the relationship of hemoglobin levels and anemia with age
      and health status in older adults. DESIGN: Survey. SETTING: Community.
      PARTICIPANTS AND METHODS: Hematologic tests were obtained from 3,946 adults aged
      greater than or equal to 71 years in three communities (East Boston, MA; Iowa and
      Washington counties, IA; and New Haven, CT). RESULTS: Hemoglobin level was
      inversely associated with age, although this was more pronounced in men than in
      women. The proportion anemic was equal for men and women aged 71-74 years (8.6%)
      and increased differentially with age, reaching 41% and 21% for men and women
      aged greater than or equal to 90 years, respectively. Hemoglobin and anemia were
      independently associated with age, race, body-mass index, smoking, cancer,
      hospitalization, renal insufficiency, and hypoalbuminemia. The adjusted relative
      odds of anemia for a 5-year increase in age was 1.5 (95% confidence interval [CI]
      1.3-1.8) for men and 1.2 (95% CI 1.1-1.4) for women. CONCLUSIONS: Age is
      significantly associated with both hemoglobin levels and anemia, with a stronger
      effect in men compared with women, even after simultaneously adjusting for
      demographic characteristics and health status. The decline of hemoglobin and
      concomitant increased anemia with age is not necessarily a result of "normal
      aging" so the detection of anemia in an older person should prompt appropriate
      clinical attention.

PMID- 1634704
TI  - Glucose tolerance in women: the effects of age, body composition, and sex
      hormones.
AB  - OBJECTIVE: To determine the separate and interactive effects of age, phase of the
      menstrual cycle, menopausal hormone status, body fat mass, and regional fat
      distribution on glucose tolerance in healthy women. DESIGN: Retrospective study.
      SETTING: The Baltimore Longitudinal Study of Aging. PATIENTS: Two hundred sixty
      healthy women aged 22-89 years. MEASUREMENTS: Plasma levels of estradiol and
      progesterone, body mass index (BMI), waist-to-hip ratio (WHR), and plasma glucose
      values in the fasting state (FPG) as well as 120 minutes after 40 gm/m2 of oral
      glucose (G120) were measured for each participant. RESULTS: We found a
      progressive decline in oral glucose tolerance of 0.4 mM (6.7 mg/dL)/decade at
      G120) in women from early to late adult years, with no relationship to phase of
      the menstrual cycle and no abrupt change associated with the menopause. Multiple
      regression analysis revealed significant, independent effects of BMI and WHR on
      FPG and G120. The influence of age (P less than 0.01) on G120 was stronger than
      that of the BMI or WHR (P less than 0.05). There was no significant relationship
      between the levels of endogenous sex hormones and glucose tolerance after
      adjustments for age, BMI, and WHR. However, women taking oral contraceptives, but
      not those receiving postmenopausal replacement therapy, did exhibit mildly
      elevated G120 values. CONCLUSIONS: Age per se, and to a lesser extent BMI and
      WHR, but not levels of endogenous sex steroids, contribute to the physiological
      decline in glucose tolerance in older women.

PMID- 1634705
TI  - Milacemide: a placebo-controlled study in senile dementia of the Alzheimer type.
AB  - OBJECTIVE: Milacemide, a MAO-B inhibitor that is also a prodrug for glycine, was
      tested as a treatment for senile dementia of the Alzheimer type (SDAT) because of
      its potential for enhancing cognition in animal models of impaired learning and
      memory. DESIGN: Double-blind, placebo-controlled, randomized clinical trial.
      SETTING: Sixteen study sites, both university-affiliated and private. PATIENTS: A
      total of 228 outpatients (116 men and 112 women) with SDAT, ranging in age from
      49-93 years. INTERVENTION: 1200 mg/day milacemide treatment for 1 month (113
      patients received milacemide, and 115 patients received placebo). MAIN OUTCOME
      MEASURES: Alzheimer's Disease Assessment Scale and the Mini-Mental State
      Examination. RESULTS: Milacemide-treated SDAT patients did not show significant
      improvement in any of the outcome measures used. Significant elevations in liver
      enzymes in four subjects were of sufficient magnitude to necessitate withdrawal
      from the study. CONCLUSIONS: Milacemide does not appear to be an effective
      treatment in enhancing cognition in SDAT patients.

PMID- 1634706
TI  - Complete heart block presenting as intermittent delirium: case report and review
      of the literature on cardiac disease in the elderly.

PMID- 1634707
TI  - Alternative management of cutaneous squamous cell carcinoma in an elderly man:
      report of a case and review of the literature.

PMID- 1634708
TI  - Tetanus-diphtheria vaccinations in a veterans nursing home.

PMID- 1634709
TI  - Progress in gerontology: polymyalgia rheumatica and temporal arteritis.

PMID- 1634710
TI  - Multidimensional risk assessment versus age as criterion for retirement of
      airline pilots.
AB  - OBJECTIVE: To determine whether airline pilots over the age of 60 pose a hazard
      to aviation safety and whether risk assessment could replace age-based
      retirement. DATA SOURCES: A computer-assisted literature search (MEDLINE), expert
      consultation, and government reports. STUDY SELECTION: Original studies on flight
      performance and pilot age; sudden incapacitation, neuropsychological testing,
      and/or medication use in pilots; and/or non-invasive testing for predicting
      sudden death or stroke in asymptomatic subjects. DATA EXTRACTION: Pertinent
      results and methods data were abstracted from the 49 included studies. DATA
      SYNTHESIS: No study on aircraft accidents or pilot performance has shown an
      increased accident risk for over-60-year-old pilots. Normal age-related cognitive
      changes probably have minimal impact on aviation safety up to age 70, given above
      average health, education, and experience in airline pilots. Cognitive tests have
      not been validated for predicting flight performance safety, but they can detect
      early stages of cognitive disease. Cardiovascular incapacitation risk increases
      with age, but risk factor profiles and non-invasive tests could identify pilots
      with non-acceptable risk. CONCLUSIONS: An improved medical certification test
      could identify those pathologic conditions that might occur more frequently in
      older subjects. If pilots also underwent adequate performance testing, a gradual
      increase of the retirement age to approximately age 70 would seem justified. In
      the future, a longitudinal database should be established to validate medical
      tests for their ability to predict a pilot's accident risk. Using individual
      pilots as their own controls might be more sensitive than using population-based
      norm values. Progress in this field would advance medical assessment for other
      groups such as air traffic controllers or automobile drivers.

PMID- 1634711
TI  - The family's will or the living will: patient self-determination in doubt.

PMID- 1634712
TI  - Gobbledygook geriatrica.

PMID- 1634713
TI  - Health style.

PMID- 1634715
TI  - Tracking dementia by the IMC and the MMSE.

PMID- 1634714
TI  - Low weight and nutritional deficiency.

PMID- 1634716
TI  - Isolated systolic hypertension.

PMID- 1634717
TI  - A prospective study of pressure sore risk among institutionalized elderly.
AB  - OBJECTIVE: To determine if dietary intake, nutritional status, and other physical
      markers are risk factors for the development of pressure sores in the elderly.
      DESIGN: Cohort study. SETTING: 250-bed skilled nursing facility with 90 extended
      care beds in which the average length of stay is 28 days. PATIENTS: Two hundred
      newly admitted residents (70% female, 95% Caucasian) who were over age 65,
      estimated to stay greater than 10 days, at risk for pressure sore development
      (Braden Scale score less than or equal to 17) but free of existing pressure sores
      were studied for 12 weeks or until discharge. MEASURES: Skin assessment, Braden
      Scale score, blood pressure, body temperature, anthropometrics, and dietary
      intake were studied weekly. CBC, serum albumin, serum total protein, serum iron,
      iron binding capacity, serum zinc and copper, and serum vitamin C were studied
      weekly for 4 weeks and biweekly for 8 weeks. MAIN OUTCOME MEASURES:
      Presence/absence and stage of pressure sores. MAIN RESULTS: Stage I pressure
      sores developed in 70 (35%) and Stage 2 or worse in 77 (38.5%) residents.
      Subjects who developed pressure sores were older (P less than 0.001) and had
      lower systolic and diastolic blood pressure (P less than 0.001) and higher body
      temperature (P less than 0.001) than those without pressure sores. Dietary intake
      of all nutrients was lower among subjects who developed pressure sores. Using
      logistic regression, the best predictors or pressure sore development were the
      Braden Scale score, diastolic blood pressure, temperature, dietary protein
      intake, and age. CONCLUSIONS: Risk assessment is recommended upon admission to a
      nursing home and weekly for the first month. Risk status can be effectively
      predicted by using the Braden Scale in combination with knowledge of age, blood
      pressure, temperature, and dietary protein intake.

PMID- 1634718
TI  - Post-operative delirium: predictors and prognosis in elderly orthopedic patients.
AB  - OBJECTIVE: To compare the effect of post-operative analgesia using epidural
      versus intravenous infusions on the incidence of delirium after bilateral knee
      replacement surgery in elderly patients. Additional risk factors and impact on
      post-operative recovery were also assessed. DESIGN: Prospective randomized
      controlled trial. SETTING: Urban referral hospital specializing in elective
      orthopedic surgery. PATIENTS: 60 consecutive patients undergoing bilateral knee
      replacement surgery with epidural anesthesia were approached; 51 patients were
      eligible and consented. The mean age was 68, 55% were women, and there was a high
      prevalence of comorbid medical disease. No patient was demented pre-operatively.
      INTERVENTION: Random allocation to either continuous epidural infusion of
      bupivacaine and fentanyl or continuous intravenous infusion of fentanyl.
      Infusions were initiated at the first complaint of pain and continued through the
      36- to 48-hour stay in the recovery room. MAIN OUTCOME MEASURE: Acute post
      operative delirium defined using an algorithm based on DSM III criteria. RESULTS:
      The overall incidence of acute delirium was 41%, with no difference between types
      of post-operative analgesia. Predictors of delirium were age, gender, and pre
      operative alcohol use. All cases resolved within 1 week, and length of stay and
      achievement of physical therapy goals were the same for delirious and non
      delirious patients. CONCLUSIONS: There is a high incidence of post-operative
      delirium in elderly non-demented patients following bilateral knee replacement,
      regardless of whether post-operative analgesia is administered by the epidural or
      intravenous route.

PMID- 1634719
TI  - Delusions and behavioral disturbances in cognitively impaired elderly persons.
AB  - OBJECTIVE: To compare cognitive function and the prevalence of selected
      behavioral problems in delusional and non-delusional dementia patients. DESIGN:
      Retrospective medical record review. SETTING: An outpatient geriatric assessment
      center. PARTICIPANTS: 114 consecutive patients with dementia. MAIN OUTCOME
      MEASURES: Delusions as recorded in a consultation report. RESULTS: Delusions were
      described in 25.5% of patients. A variety of behavioral disturbances were more
      common in delusional than non-delusional patients, including agitation, angry or
      hostile outbursts, urinary incontinence, wandering or pacing, and insomnia. While
      cognitive function as measured by the MMSE was similar in delusional and non
      delusional patients (18.9 +/- 3.8 and 19.2 +/- 5.9, respectively), there was a
      statistically borderline tendency for delusions to occur more often in patients
      in the mid-range of cognitive impairment (17 less than or equal to MMSE less than
      or equal to 23) compared with patients with greater or lesser degrees of
      cognitive impairment (32% vs 17% respectively). CONCLUSION: Delusions in dementia
      are associated with a variety of behavioral problems. Further studies are needed
      to clarify the role of delusions in the development of disruptive behaviors in
      dementing illness.

PMID- 1634720
TI  - The risk factors of age and family history and their relationship to screening
      mammography utilization.
AB  - OBJECTIVE: To study the association of two well known risk factors for breast
      cancer and the association of knowledge of those risk factors with mammography
      utilization. DESIGN: Cross sectional: two independent random telephone surveys.
      SETTING: Two Northeastern metropolitan communities surveyed in 1987 and in 1989.
      PARTICIPANTS: Women without breast cancer who spoke English and who were between
      45 and 75 years of age. MAIN OUTCOME MEASURES: The two risk factors measured were
      a family history of breast cancer and being 65 or older. Participants were
      surveyed about their knowledge of risk factors, presence of risk factors,
      selected beliefs, attitudes, reinforcing factors and mammography use. Results
      were analyzed for women 50-75. RESULTS: There was a substantial increase in
      mammography use over the 2-year period. Having a positive family history or being
      older is not associated with increased mammography utilization. Knowledge that
      family history and/or age are risks is associated with increased utilization.
      However, knowledge of risk factors is not associated with having those risks.
      Older women have lower utilization than younger women regardless of their
      knowledge of age as a risk. Increased physician recommendation is associated with
      increased utilization. CONCLUSION: Since knowing that a factor is a risk and
      having a physician recommend mammography are each associated with increased use,
      we conclude that the primary care physicians' role in increasing mammography
      utilization is critical.

PMID- 1634721
TI  - Napping and 24-hour sleep/wake patterns in healthy elderly and young adults.
AB  - OBJECTIVE: To examine differences between healthy elderly and young adults in
      daytime napping, nocturnal sleep, and 24-hour sleep/wake patterns. A second
      objective was to determine whether elderly subjects with more and less frequent
      naps differed in their clinical features or nocturnal sleep. DESIGN: Survey by
      sleep/wake logs and polysomnography. Comparison by age. SETTING: Sleep/wake logs
      were completed in the subjects' homes. Polysomnographic studies were conducted on
      an outpatient basis in a sleep and chronobiology research laboratory. SUBJECTS:
      Convenience samples of forty-five healthy subjects over 78 years of age (21M,
      24F) and 33 healthy adults between 20 and 30 years of age (20M, 13F). MAIN
      OUTCOME MEASURES: Using self-reports, we estimated the frequency and timing of
      daytime naps; timing, duration, and quality of nocturnal sleep; and 24-hour
      patterns of sleep and wakefulness. Also polysomnographic sleep measures. RESULTS:
      Compared to young adults, elderly subjects reported a greater mean number of
      daytime naps (P = .004), shorter nocturnal sleep with more wakefulness and
      earlier sleep hours (P less than .003 for each), and a trend for a shorter 24
      hour sleep fraction. Among the elderly, more-frequent and less-frequent nappers
      did not differ in clinical ratings, self-report sleep measures, or
      polysomnographic measures. There was a trend for more sleep-disordered breathing
      and periodic limb movements in more frequent nappers. CONCLUSIONS: These findings
      are consistent with an age-related decrease in amplitude of the circadian sleep
      propensity rhythm, or with the expression of a semi-circadian (12-hour)
      sleepiness rhythm. However, we cannot exclude the additional possibility that
      napping results from lifestyle factors and nocturnal sleep pathologies in a
      subset of the elderly.

PMID- 1634722
TI  - Hypnotics, sleep, and mortality in elderly people.
AB  - OBJECTIVE: To re-assess relationships between mortality, hypnotic use, subjective
      insomnia, and sleep duration. DESIGN: A prospective study examining 5-year
      mortality among hypnotic drug users and respondents with subjective insomnia
      identified in a longitudinal study of health, activity, and lifestyle (Nottingham
      Longitudinal Study of Activity and Ageing). SETTING: General community.
      PARTICIPANTS: 1042 survey respondents, aged over 65 years, randomly selected from
      the community and stratified at age 75 years. MAIN OUTCOME MEASURE: Recorded
      mortality. RESULTS: During the 5-year period, 352 respondents died. The mortality
      rate was significantly greater among those taking some form of medication for
      sleep (n = 208) than for those not taking sleep medication (n = 812; chi-square =
      4.91, df = 1, P = 0.027). When sleep medication users were categorized as either
      "hypnotic users" (ie, users of medication with recognized hypnotic or sedative
      actions) or "other users" (including analgesics and other over-the-counter
      medicines), only "other users" showed significant excess mortality (chi-square =
      7.27, df = 1, P = 0.007). Logistic regression showed that "other users" were 2.5
      times more likely to die than "non-users" even when gender, health risk, and
      usual sleep duration were controlled. There were no significant relationships
      between mortality and subjective insomnia or reported duration of sleep.
      CONCLUSIONS: Earlier reported relationships between excess mortality and use of
      medication for sleep are replicated in this study. Among elderly people, however,
      this relationship does not derive from the pharmacological characteristics of
      prescription hypnotics. Rather, it appears that reported self-medication to
      promote sleep, using a variety of non-sedative products, provides an
      epidemiological "marker" for a group within which levels of morbidity and
      mortality are particularly high. Excess mortality associated with very short or
      long sleep duration was not replicated in this study. Overall, these findings
      provide little epidemiological support for a wide-spread interaction between
      benzodiazepine hypnotic use and sleep disordered breathing in old age.

PMID- 1634723
TI  - Risk factors for early hospital readmission in a select population of geriatric
      rehabilitation patients: the significance of nutritional status.
AB  - OBJECTIVE: To test the strength of the evidence in favor of the hypothesis that
      protein-energy undernutrition is an independent risk factor for non-elective
      hospital readmission within 3 months of discharge in a population of elderly
      hospitalized patients. DESIGN: Retrospective analysis of data from prospective
      observational study. METHODS: All 110 elderly patients admitted to a geriatric
      recuperative care and rehabilitation unit during a 6-month period completed a
      comprehensive in-patient evaluation. Ninety-eight of these patients were
      subsequently discharged alive and followed prospectively for 3 months. All
      hospital readmissions during the observation period were identified by patient
      interview and, within the VA hospital system, computer tracking of admissions.
      Based on the discharge assessment, the strongest predictors of non-elective
      readmission were identified using univariate and multivariate statistical
      procedures. RESULTS: Twenty-eight of the 98 patients discharged alive and
      completing the 3-month follow-up (29%) had at least one non-elective readmission.
      The patients discharged home were non-electively readmitted more frequently than
      were the patients discharged to a nursing home (32% vs 11%, P = 0.05). Of the 109
      discharge assessment variables analyzed, the best predictor of which patients
      would have at least one non-elective hospital readmission was the discharge serum
      albumin, followed by a diagnosis of dementia, discharge gamma globulin, the
      subscapular skinfold thickness, home ownership, and the discharge Katz Index of
      ADL score. Discharge serum albumin concentration, subscapular skinfold thickness,
      and discharge serum gamma globulin concentration were all negatively correlated
      with risk of non-elective readmission. The presence of functional debilitation or
      dementia was associated with a lower likelihood of non-elective readmission
      compared with the absence of these conditions. CONCLUSIONS: Protein-energy
      undernutrition appears to be a strong independent risk factor for non-elective
      hospital readmission especially among the highest risk patients, those who are
      functionally independent and cognitively intact.

PMID- 1634724
TI  - The relations among caregiver stress, "sundowning" symptoms, and cognitive
      decline in Alzheimer's disease.
AB  - OBJECTIVE: To investigate the relations among the initial perceived stress of
      Alzheimer patients' caregivers, the rate of change of perceived stress, patients'
      sundowning behaviors, and patients' rate of cognitive decline. DESIGN: A
      longitudinal cohort study in which Alzheimer patients and their caregivers were
      assessed at 6-month intervals. SETTING: Hospital out-patient clinic. Patients and
      caregivers lived at home. SUBJECTS: Subjects were 35 patients (50-79 years) with
      Alzheimer's disease and their primary caregivers (24 males and 11 females); all
      caregivers were spouses. METHODS: At time of entry into the study, caregivers
      indicated which of seven behaviors indicative of sundowning were exhibited by the
      patient. Patients were evaluated successively using the Mini-Mental State
      Examination, whereas caregivers completed the Perceived Stress Scale, provided an
      index of social support utilization, and completed the Beck Depression Inventory.
      MAIN OUTCOME MEASURES: Caregivers' initial perceived stress and the rate of
      change of perceived stress, patients' sundowning behavior, and rate of cognitive
      decline. RESULTS: The pattern of correlations indicated that both rate of
      cognitive decline and initial sundowning behavior were significantly correlated
      with initial perceived caregiver stress. The average rate of increase of
      caregivers' perceived stress was positively correlated with the initial incidence
      of sundowning behaviors, even when controlling for the effects of caregiver
      depression and social support utilization. CONCLUSION: Sundowning behavior of
      Alzheimer patients is associated with an increased rate of change of caregivers'
      perceived stress. This association may be specific to sundowning behavior because
      there was no relation between the rate of change of perceived stress and morning
      agitation. The findings suggest that future caregiver intervention programs could
      profitably focus on sundowning behavior rather than general agitation.

PMID- 1634725
TI  - Urinary tract infections and estrogen use in older women.
AB  - OBJECTIVE: To examine the relationship between exogenous estrogen use and risk of
      clinically diagnosed urinary tract infection (UTI) in older women. DESIGN: A case
      control study. SETTING: Two hundred seventy-six general practices. PATIENTS:
      Cases (n = 3,616) were women, age 50-69 years, with a first recorded UTI in the
      calendar years 1989 or 1990. Controls (n = 19,162) were matched for age and
      practice. MAIN OUTCOME MEASURE: Clinical diagnosis of UTI. RESULTS: Women using
      estrogens for greater than or equal to 1 year had an increased risk of being
      diagnosed with a UTI compared to non-users, crude odds ratio (OR) 1.9 (95% CI 1.5
      2.2). All of this excess risk was observed in women with intact uteri, OR 2.1 (CI
      1.7-2.7). Hysterectomized women had no increased risk, OR 1.1 (CI 0.8-1.5).
      Controlling for diabetes, neurologic deficit, atrophic vaginitis, incontinence,
      and age did not affect the observed associations. CONCLUSION: Estrogen use is
      associated with an increased risk of UTI in older women with intact uteri but not
      in hysterectomized women. This observed differential effect on women with or
      without uteri may be explained by prescribing biases between these two groups of
      women, but we lack any evidence to support this conclusion over several
      alternative possibilities.

PMID- 1634726
TI  - Group A streptococcal bacteremia associated with gastrostomy feeding tube
      infections in a long-term care facility.

PMID- 1634727
TI  - Classic hemophilia in elderly patients.

PMID- 1634728
TI  - The "fractured Foley": an unusual complication of chronic indwelling urinary
      catheterization.

PMID- 1634729
TI  - Delirium in older patients.

PMID- 1634730
TI  - (-)Deprenyl-medication: a strategy to modulate the age-related decline of the
      striatal dopaminergic system.
AB  - (-)Deprenyl (Selegiline, Jumex, Eldepryl, Movergan), a close structural relative
      to phenylethylamine (PEA), is a drug with a unique pharmacological spectrum. (1)
      It is a highly potent and selective, irreversible inhibitor of B-type monoamine
      oxidase (MAO), a predominantly glial enzyme in the brain. The activity of this
      enzyme significantly increases with age. (-)Deprenyl, the first selective
      inhibitor of MAO-B described in literature, has become the universally used
      research tool for selectively blocking B-type MAO. It is the only MAO-B inhibitor
      in clinical use. (2) (-)Deprenyl interferes with the uptake of catecholamines and
      indirectly acting sympathomimetics because it is handled by the catecholaminergic
      neuron in a way similar to the physiological substances transported through the
      axonal end organ and vesicular membrane. The unique behavior of (-)deprenyl is
      that, in striking contrast to PEA and its relatives, it does not displace the
      transmitter from storage, ie, it is not a releaser. The net result is that (
      )deprenyl inhibits the releasing effect of tyramine, and, at present, is the only
      safe MAO inhibitor that can be administered without dietary precautions. (3)
      Maintenance on (-)deprenyl selectively enhances superoxide dismutase (SOD) and
      catalase activity in the striatum. This effect is unrelated to its effect on MAO
      B and the inhibitory effects of the drug on neurotransmitter uptake. (4)
      Maintenance on (-)deprenyl facilitates the activity of the nigrostriatal
      dopaminergic neurons with remarkable selectivity, and this effect, too, is
      unrelated to either its effects on MAO or on neurotransmitter uptake. (5)
      Maintenance on (-)deprenyl prevents the characteristic age-related morphological
      changes in the neuromelanin granules of the neurocytes in the substantia nigra.
      All in all, (-)deprenyl increases the activity of the nigrostriatal dopaminergic
      system and slows its age-related decline. Maintenance of male rats on (-)deprenyl
      delays the loss of the capacity to ejaculate, slows the decline of learning and
      memory, and significantly lengthens the life-span as compared with saline-treated
      rats. Parkinson's disease patients on levodopa plus (-)deprenyl (10 mg daily)
      live significantly longer than those on levodopa alone. (-)Deprenyl is the first
      drug that retards the progress of Parkinson's disease. Newly diagnosed
      Parkinson's disease patients maintained on (-)deprenyl need levodopa
      significantly later than their placebo-treated peers. Maintenance on (-)deprenyl
      improves significantly the performance of patients with Alzheimer's disease. It
      is concluded that Parkinson's disease and Alzheimer's disease patients need to be
      treated daily with 10 mg (-)deprenyl from diagnosis until death, irrespective of
      other medication.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1634732
TI  - Advance directives on restraints.

PMID- 1634731
TI  - Delusions, delirium, and cognitive impairment: the challenge of clinical
      heterogeneity.

PMID- 1634733
TI  - At least routine laboratory assessment...

PMID- 1634734
TI  - Teaching about urinary incontinence.

PMID- 1634735
TI  - Quality graduates mean power to the profession.

PMID- 1634736
TI  - Standards of care.

PMID- 1634737
TI  - Premises liability.

PMID- 1634738
TI  - The unification of European optometry.

PMID- 1634739
TI  - Evaluating the laws defining blindness.
AB  - The law defining legal blindness was written in 1935, and has not been updated
      since. A historical view of the background in the development of this law and a
      comparison to laws used in other countries helps to point out some problems with
      the current definition. As the population gets older, the prevalence of visual
      impairment will be increasing. To administer programs, distribute funding, and
      ensure adequate care, the problems inherent in the definition of legal blindness
      must be addressed, and the law must be revised.

PMID- 1634740
TI  - Vascular implications of optic atrophy.
AB  - Optic atrophy can often be a result of arterial blood flow insufficiency
      associated with systemic vascular disease (cardiovascular disease, hypertension,
      or diabetes mellitus). The lack of adequate blood perfusion pressure can create
      conditions leading to anoxia and death of the nerve fiber layer with a resultant
      visual field defect. A case of a 63-year-old white male is presented with optic
      atrophy resulting from anterior ischemic optic neuropathy 5 years earlier. A
      review of the literature concerning the more common causes of ocular vascular
      insufficiency (i.e., anterior ischemic optic neuropathy, internal carotid
      disease, central retinal artery occlusion, and branch retinal artery occlusion)
      as well as diagnostic testing and therapeutic management is discussed.

PMID- 1634741
TI  - Norrie's disease vs. PHPV: one family's dilemma.
AB  - This paper presents the numerous similarities between Norrie's disease and
      bilateral persistent hyperplastic primary vitreous. A description of each disease
      is given, as well as a case report which demonstrates the difficulty in
      distinguishing the two disease processes when there is a negative family history
      of blindness. A discussion section focuses on the need for a better differential
      protocol for Norrie's disease, which would aid the clinician when a family
      history of blindness is absent.

PMID- 1634742
TI  - Duane's retraction syndrome.
AB  - The clinical findings for 29 patients with Duane's retraction syndrome (DRS) are
      reported. Similar to other studies, a preponderance of females, left eye
      involvement, and type I DRS occurred. The incidence of both anisometropia and
      amblyopia was somewhat higher than for the normal population. Unexpectedly,
      complaints of diplopia existed for seven patients.

PMID- 1634743
TI  - Retention of patient records.
AB  - Patient records are essential to provide patients with appropriate health care
      and to preserve patients' rights. Patient records are also vital to help
      practitioners defend lawsuits. Therefore, practitioners must maintain patient
      records in good order for as long as possible. This paper discusses the clinical
      and legal issues involved in record retention, including the relevant state
      regulations and record requirements in other health care fields, to provide
      guidelines for retention of optometric patient records. Based on the statutes of
      limitations, common practice and sound medical and legal advice, optometric
      patient records should be retained for a minimum of 10 years after the patient
      was last seen. Ideally, patient records should be retained forever.

PMID- 1634744
TI  - Peer review of expert medical-legal testimony: a proposal for child neurology.

PMID- 1634745
TI  - Medulloblastoma: II. A pathobiologic overview.
AB  - The pathobiology of medulloblastoma is reviewed in light of emerging data
      regarding its immunocytochemical and cytobiologic, as well as molecular biologic,
      characteristics. The nature of the lesion, particularly its nosologic relation to
      primitive neuroectodermal tumor, is discussed, as is its place in the World
      Health Organization classification of tumors of the central nervous system.

PMID- 1634746
TI  - Nervous system dysfunction in children with paraneoplastic syndromes.
AB  - Paraneoplastic syndromes are complexes of symptoms and signs that occur in
      association with cancer and that are unexplained by the known anatomic and
      physiologic characteristics of the tumor. Many of these syndromes are neurologic
      in nature or have consequences for the central or peripheral nervous system.
      These syndromes have been well characterized in adults. With the exception of
      opsoclonus-myoclonus, little has been written about the occurrence of such
      syndromes in children. This review looks at published reports of paraneoplastic
      syndromes in children and concludes that paraneoplastic syndromes in childhood
      differ from those seen in adulthood because of differences in both the host and
      the kinds of neoplasms most prevalent in each age group. Paraneoplastic syndromes
      may be underreported in childhood because of the difficulty in eliciting specific
      neurologic complaints from children and because a thorough neurologic examination
      is often not undertaken as a matter of routine.

PMID- 1634747
TI  - Spontaneous intracerebral hemorrhage: a very late delayed effect of radiation
      therapy.
AB  - Cerebral necrosis is a well-known delayed sequela of radiation to the central
      nervous system. Delayed intracerebral hemorrhage occurring several years after
      radiation is rare; however, with increased survival, this complication will
      become more common. We report a child who developed a brain-stem hemorrhage 4.5
      years following radiation therapy for brainstem tumor. The possible pathogenesis
      for the spontaneous hemorrhage is discussed. The onset of the neurologic symptoms
      in this setting occurs later than the usual symptoms of radiation necrosis. It is
      important to recognize this entity as a late delayed complication of radiation
      therapy and not to mistake it for tumor recurrence.

PMID- 1634748
TI  - Follow-up study of muscle function in children of mothers with myasthenia gravis
      during pregnancy.
AB  - Most infants whose mothers have myasthenia gravis are healthy at birth, but 10%
      to 15% have a transient neonatal form of myasthenia gravis. In this study, the
      muscular function and neuromuscular transmission were examined in 31 children,
      aged 3 months to 31 years (median, 10 years), of 15 myasthenic mothers. Eleven of
      these children had had the neonatal form of myasthenia gravis. The children were
      examined clinically and with neurophysiologic methods. Blood samples were taken
      for HLA typing, creatine kinase levels, and myoglobin and acetylcholine receptor
      antibody studies. Twenty-nine of the 31 children had no signs of neuromuscular
      disease. Two children (who had had neonatal myasthenia gravis) had a moderate
      stationary myopathy, probably unrelated to the myasthenia gravis of their mother.
      Creatine kinase levels were normal for all subjects. Acetylcholine receptor
      antibody levels were similar to those of a control population. The HLA type B8
      antigen was not significantly more prevalent in the children who had had neonatal
      myasthenia gravis than in the healthy children. Neonatal myasthenia gravis in a
      previous sibling was the only factor in the material that predicted the
      occurrence of myasthenic symptoms in the neonatal period.

PMID- 1634749
TI  - Cartoons of famous neurologists by Milt Gross.

PMID- 1634750
TI  - Angelman syndrome: clinical profile.
AB  - To further delineate the clinical and developmental features of Angelman
      syndrome, we collected data through three sources of information: (1) physical
      examinations; (2) laboratory data and family questionnaire data of affected
      individuals; and (3) literature review. The questionnaire data describes a
      generally normal prenatal and birth history. Feeding difficulties, developmental
      delay, or seizures were the presenting problems in all infants. The diagnosis of
      Angelman syndrome, however, was not made in any infant prior to 1 year of age.
      Except for seizures, no medical or surgical complication was common, although a
      variety of visual complaints or findings were common. Sixty percent of Angelman
      syndrome children had a cytogenetically demonstrated deletion of chromosome 15q11
      q13. The individuals with and without a deletion could not be differentiated
      clinically. Diagnosis in early childhood is therefore difficult, and a high index
      of suspicion is recommended.

PMID- 1634751
TI  - Improved neuropsychological outcome in children with brain tumors diagnosed
      during infancy and treated without cranial irradiation.
AB  - Neuropsychological outcome of 28 patients with brain tumors diagnosed before the
      age of 36 months (mean, 19 months) was assessed using a comprehensive battery of
      tests. Elapsed time between diagnosis and testing averaged 6.2 years. Half the
      patients had received cranial radiation therapy and surgery, with and without
      chemotherapy, whereas the rest had received only surgery, with or without
      chemotherapy. Groups were comparable with respect to tumor diagnosis and
      location, age at diagnosis, race, and sex. Intellectual functioning was
      significantly lower in children whose treatment included cranial irradiation than
      in those treated without cranial irradiation, and this effect was more pronounced
      in nonverbal than in verbal intellectual abilities. Mean scores for the radiation
      group were lower than for the no-radiation group in all areas assessed and were
      significantly below age-based normative means in five of the eight cognitive
      areas: intellectual, memory, attention, motor, and visual-spatial skills. Mean
      scores for children in the no-radiation group were generally within the average
      range in all cognitive areas except visual-spatial skills, which were
      significantly below age-based normative means. Endocrine deficiencies and growth
      retardation were much more prevalent in patients treated with cranial
      irradiation. Because the immature brain is susceptible to treatment-related
      pathologic changes, infants are at greater risk than older children for
      significant, long-term neuropsychological, endocrine, and growth sequelae. In
      children treated without cranial irradiation, morbidity was minimized without an
      increased rate of mortality.

PMID- 1634752
TI  - Cerebral tumors in children presenting with epilepsy.
AB  - The records of 20 children with seizures who had cerebral tumor confirmed
      histologically between 1979 and 1989 have been reviewed. These patients
      represented 2.9% of all children presenting with seizures. Forty percent were
      aged 15 months or younger, all of whom presented with partial seizures. Initial
      misdiagnosis of seizures occurred in 25% of these infants. Examination was normal
      in 75% of the study group. Behavior disturbance was present in 50%, with
      deterioration occurring in 60% of these. Electroencephalograms revealed focal
      abnormalities in 62% and generalized abnormalities in 25% when performed. Cranial
      ultrasound was performed in two cases, with false-negative results. Computed
      tomographic scan findings were not diagnostic of tumor in 40%. Magnetic resonance
      imaging confirmed the presence of tumor in all children in whom it was performed.
      Tumors most frequently involved the temporal lobes (55%) and the frontal lobes
      (40%). Surgical intervention resulted in considerable improvement in seizure
      control in 75%. Surgery is useful in the control of tumor-related seizures and
      should be considered early in the treatment of this disorder. Suspicion of tumor
      should increase when seizures are partial or refractory, particularly if
      intelligence and physical examination are normal or if there is progressive
      deterioration in behavior. The most appropriate type of brain imaging is magnetic
      resonance imaging scan.

PMID- 1634753
TI  - Etiology of lateral rectus palsy in infancy and childhood.
AB  - The etiologies of lateral rectus palsy in 132 infants and children seen over a
      period of 22 years in a university medical center were retrospectively reviewed
      and compared with similar reports in the literature. Unlike most reports, which
      lump children with adults, this study focuses on childhood etiologies of lateral
      rectus palsy. In contrast to the only two studies in the literature on childhood
      lateral rectus palsy, which reflect a purely ophthalmologic perspective, this
      study reflects experiences of pediatric neurology and pediatric neurosurgery, as
      well as ophthalmology. Most lateral rectus palsies were unilateral, almost
      equally distributed between right and left sides. Trauma, tumor, and congenital
      etiologies were the most prevalent. The relative frequency of each of these
      etiologies varies by service (neurology, neurosurgery, ophthalmology). In 10.6%
      of patients, etiology could not be determined. The majority of patients had an
      isolated lateral rectus palsy. Association of lateral rectus palsy with other
      cranial nerve palsies and/or long tract signs characterized trauma and tumor. The
      majority of tumors were primary and infratentorial. A small number of patients
      had benign recurrent lateral rectus palsy.

PMID- 1634754
TI  - Trichothiodystrophy: report of a new case with severe nervous system impairment.

PMID- 1634755
TI  - Plantar responses in infants.

PMID- 1634756
TI  - The future of child neurology.

PMID- 1634757
TI  - The matter of madness: perspectives on the history of psychiatry.

PMID- 1634758
TI  - Myelosuppressive effects in vivo of purified recombinant murine macrophage
      inflammatory protein-1 alpha.
AB  - Purified recombinant murine macrophage inflammatory protein-1 alpha (rmuMIP-1
      alpha), a cytokine with myelopoietic activity in vitro, was assessed in vivo by
      injection into C3H/HeJ mice for effects on proliferation (percentage of cells in
      S phase DNA synthesis of the cell cycle) and absolute numbers of granulocyte
      macrophage, erythroid, and multipotential progenitor cells in the femur and
      spleen, and on nucleated cellularity in the bone marrow, spleen, and blood.
      rmuMIP-1 alpha rapidly decreased cycling rates (at 2 to 10 micrograms/mouse i.v.)
      and absolute numbers (at 5 to 10 micrograms/mouse i.v.) of myeloid progenitor
      cells in the marrow and spleen. These effects were dose- and time-dependent and
      reversible. Suppressive effects were noted within 3 to 24 h for cell cycling and
      absolute numbers of progenitor cells in the marrow and spleen, and by 48 h for
      circulating neutrophils. A study comparing the effects of i.v. injection of
      rmuMIP-1 alpha versus rmuMIP-1 beta, a biochemically similar molecule but with no
      myelosuppressive effects in vitro, demonstrated myelosuppression in vivo by
      rmuMIP-1 alpha, but not by rmuMIP-1 beta. The results suggest that rmuMIP-1 alpha
      has myelosuppressive activity in vivo and offers the possibility that it may be a
      useful adjunct to treatments involving cytotoxic drugs because of its reversible
      suppressive effects on normal progenitor cell cycling.

PMID- 1634759
TI  - An immunosuppressive retrovirus-derived hexapeptide interferes with intracellular
      signaling in monocytes and granulocytes through N-formylpeptide receptors.
AB  - We have previously found that the retroviral p15E-derived hexapeptide LDLLFL is a
      potent inhibitor of the FMLP-induced polarization response that is an early event
      in chemotaxis of monocytes and granulocytes. We investigated the mechanism of
      action of LDLLFL. LDLLFL inhibited the changes in [Ca2+]i in response to FMLP,
      but not to C5a or leukotriene B4. The reverse peptide LFLLDL was not inhibitory.
      In the presence of LDLLFL, the FMLP dose-response curve shifted to higher
      concentrations, indicating that LDLLFL interfered with binding of FMLP to its
      receptor. Indeed, binding of [3H]FMLP to neutrophilic granulocytes was inhibited
      in the presence of LDLLFL. Furthermore, immunosuppressive LDLLFL homologs also
      inhibited binding of FMLP to granulocytes, whereas noninhibitory LDLLFL homologs
      did not. Our results suggest that retroviral p15E and p15E-like factors, which
      can be found in serum of patients with cancer or chronic upper airway infections,
      may interfere with the interaction of N-formylpeptides derived from
      (opportunistic) bacteria, with monocytes and granulocytes. This receptor
      interference may impair monocyte and granulocyte reactivity toward these agents.

PMID- 1634760
TI  - Priming of the respiratory burst of bone marrow-derived macrophages is associated
      with an increase in protein kinase C content.
AB  - The biochemical mechanism(s) underlying the priming of the macrophage for an
      enhanced PMA-induced respiratory burst is not understood. Because the cellular
      receptor for PMA is thought to be protein kinase C (PKC), we have investigated
      the effects of priming agents on cellular PKC levels. Sonicates from unprimed
      bone marrow-derived macrophages (BMM) were found to contain PKC activity (309 +/-
      51 pmol 32P-incorporated/mg/min; mean +/- SE, n = 17) as measured by the
      phospholipid-, diacylglycerol-, and calcium-dependent phosphorylation of histone.
      Exposure of BMM to priming agents such as TNF-alpha, LPS, and
      granulocyte/macrophage-CSF resulted in a significant increase in both histone
      phosphorylating activity and levels of immunoreactive PKC protein in these cells.
      A minimum of 6-h exposure, with an increasing effect up to 48 h, was required for
      a detectable increase in PKC level. The activity from primed BMM, like that of
      the untreated cells, was predominantly cytosolic. The kinetics and concentration
      dependence of the priming agent-induced increase in the PKC content of BMM
      closely paralleled the enhancing effects of these agents on the PMA-stimulated
      respiratory burst. Furthermore, CSF-1, a cytokine that does not prime BMM, failed
      to increase PKC activity. We propose that the exposure of BMM to priming agents
      leads to an increase in the expression of a stimulatory isozyme(s) of PKC,
      resulting in an enhanced ability to mount a respiratory burst in response to
      stimulation with PMA.

PMID- 1634761
TI  - Collagen-induced arthritis in rats. Examination of the epitope specificities of
      circulating and cartilage-bound antibodies produced by outbred and inbred rats
      using cyanogen bromide-derived peptides purified from heterologous and homologous
      type II collagens.
AB  - To determine the number and location of antibody binding epitopes on type II
      collagen, outbred and inbred rats were immunized with chick, bovine, human, and
      rat type II collagen (CII, BII, HII, and RII); all sera were assayed for reaction
      with a panel of CB peptides purified and renatured from the immunizing collagen
      and from RII. Antibody reaction patterns (profiles) varied among individual
      outbred rats but were essentially constant over time and changed little after
      boosting. The strongest antibody reactions were to CB11, CB9-7, and CB12 followed
      by CB8, CB10, and CB6. Antibody profiles varied depending on the species of
      collagen used for immunization and the strain of rat immunized. Except for CB10,
      where antibodies were largely specific for heterologous collagens, antibodies
      reactive with all other CB peptides cross-reacted strongly with renatured rat CB
      peptides. Sera from inbred BB rats immunized with BII, CII, or HII reacted best
      with CB11, unlike antisera to RII that reacted strongly with CB9-7. Inbred LEW,
      COP, WKY, F344, and BUF rats immunized with BII reacted strongest with CB9-7 and
      variably with CB11 and CB12. BBxLEW F1 hybrid rats reacted almost equally with
      CB11 and CB9-7 producing an antibody profile intermediate to those elicited in
      the parent strains. Finally, antibodies reactive with rat CB11, CB9-7, and CB12
      could be eluted from normal rat cartilage incubated in anti-BII serum; antibody
      eluate profiles generally paralleled the profile produced by the sera applied to
      cartilage. Taken together, these findings indicate that multiple antibody
      reactive epitopes on type II collagen may be instrumental in the initiation of
      collagen-induced arthritis in rats, particularly shared or cross-reactive
      epitopes located within CB11, CB9-7, CB12, and CB8.

PMID- 1634762
TI  - Anticardiolipin antibodies in NZW x BXSB F1 mice. A model of antiphospholipid
      syndrome.
AB  - NZW x BXSB F1 (W/B F1) male mice develop systemic lupus-like disease, and several
      autoantibodies, circulating immune complexes, and lupus nephritis become
      apparent. The abnormally high incidence of degenerative coronary vascular disease
      with myocardial infarction and thrombocytopenia due to the presence of both
      platelet-associated antibodies and circulating antiplatelet antibodies in this
      animal has been reported. We found that W/B F1 male mice produced autoantibodies
      against cardiolipin (aCL) and that the titer of aCL increases with age. aCL from
      W/B F1 male mice were mainly IgG and binding activity to cardiolipin was aCL
      cofactor (beta 2-glycoprotein I (beta 2-GPI)) dependent. We developed monoclonal
      aCL from these animals and examined specificity of the autoantibodies. All the
      mAb used reacted with the negatively charged phospholipids, cardiolipin,
      phosphatidylserine, and phosphatidylinositol, and some reacted with platelets and
      DNA. The addition of human or mouse beta 2-GPI enhanced the titer for monoclonal
      aCL from the W/B F1 mice. From the results of competitive inhibition enzyme
      immunoassay with monoclonal aCL and purified beta 2-GPI, aCL from the W/B F1 mice
      recognized the complex of CL and beta 2-GPI. The W/B F1 male mouse may be an
      appropriate model for use in studies on the pathologic significance of aCL in
      patients with antiphospholipid syndrome.

PMID- 1634763
TI  - Circumvention of the induction of resistance in murine experimental autoimmune
      thyroiditis by recombinant IL-1 beta.
AB  - Murine experimental autoimmune thyroiditis (EAT) is induced in genetically
      susceptible mice by immunization with mouse thyroglobulin (MTg). We have
      previously shown that raising the level of circulatory MTg for greater than or
      equal to 2 to 3 days, by the i.v. injection of soluble MTg or the infusion of
      thyroid-stimulating hormone, rendered these mice resistant to subsequent EAT
      induction. The Ag-specific resistance was mediated by CD4+ Ts cells, and the
      induction of unresponsiveness could be interfered with by injecting the T cell
      adjuvant poly(A).poly(U) 3 h after MTg pretreatment. To dissect further the
      cytokine signals involved in circumventing the induction of resistance, the
      effect of human rIL-1 beta was examined. As with poly(A).poly(U), mice given 4000
      or 10,000 U or rIL-1 beta 3 h after deaggregated MTg (dMTg) were not resistant to
      EAT induced with MTg and adjuvant. Moreover, mice given 90,000 U or rIL-1 beta
      after dMTg and then immunized displayed very severe thyroiditis, strong in vitro
      proliferative response, and high antibody titers, compared with immunized
      controls, indicating a dose-dependent effect of rIL-1 beta. The intermediate dose
      of 10,000 U or rIL-1 beta was selected to determine the importance of time
      interval between dMTg and rIL-1 beta administration. Interference with the
      induction of suppression was more efficacious when rIL-1 beta was given at 3 h
      than at 24 h, but at 24 h it was no more effective than 4000 U given at this
      interval. In contrast, mice given 10,000 U of rIL-1 beta 3 h before dMTg and then
      challenged developed MTg antibodies but little thyroiditis, demonstrating that
      the interference with suppression of autoantibody responses can occur without
      altering the induction of suppression of thyroiditis. The injection of rIL-1 beta
      also led to a sharp but transient rise in serum IL-6. The short t1/2 of IL-6
      suggests that any role played by IL-6 would require critical timing. Murine rIL-2
      given at 1 and 2 days after dMTg had a minimal effect on induced resistance.
      Lastly, immunization of dMTg-pretreated mice with MTg and rIL-1 beta did not
      induce EAT, demonstrating that rIL-1 beta could not interfere with established
      suppression. Thus, the intervention by rIL-1 beta in MTg-induced suppression
      occurs at a critical time, early after the injection of dMTg but before the
      establishment of resistance.

PMID- 1634764
TI  - Novel human autoantibodies reactive with 5'-terminal trimethylguanosine cap
      structures of U small nuclear RNA.
AB  - A class of RNA-containing particles, U small nuclear/nucleolar ribonucleoprotein
      particles (U snRNP), are well known to be targets for sera from patients with
      various autoimmune diseases. In the most cases the protein components carry the
      antigenic determinants. We have identified serum autoantibodies from three
      patients with systemic sclerosis that were directed against U1-U5 snRNA by
      immunoprecipitation of deproteinized 32PO4 labeled HeLa cell total RNA. By
      competitive radioimmunoprecipitation assays, an experimentally induced anti-2,2,7
      trimethylguanosine (TMG) cap structure mAb inhibited the reaction of these
      antisera. In addition, IgG isolated from the antisera inhibited the anti-TMG mAb
      reaction to the U snRNA. Furthermore, a structural analog, 7-methylguanosine
      triphosphate, competitively inhibited the reaction of the antisera to the U
      snRNA. Thus we concluded that the TMG cap structure of the U snRNA could be a
      target for serum autoantibodies.

PMID- 1634765
TI  - Selective breeding of miniature swine leads to an increased rate of acceptance of
      MHC-identical, but not of class I-disparate, renal allografts.
AB  - Previous work from this laboratory demonstrated that tolerance to MHC-identical
      or class I-disparate renal allografts develops in approximately one third of
      miniature swine without exogenous immunosuppression. A back-cross study indicated
      that rejection of MHC-identical transplants due to minor Ag was controlled by one
      or possibly two non-MHC-linked, autosomal dominant Ir genes. According to this
      hypothesis, and assuming complete penetrance, graft acceptors would be homozygous
      recessive at the relevant Ir loci, as would their offspring. Alternatively, if
      the gene(s) were incompletely penetrant, then two acceptors could give rise to a
      rejector. However, a high rate of MHC-identical graft acceptance would still be
      expected in the offspring of acceptors even if the Ir gene(s) were incompletely
      penetrant. To test this hypothesis and to obtain a higher frequency of acceptor
      animals for studies of tolerance, a program of selective breeding of renal
      allograft acceptors was begun. In the present paper, we assess the effect of
      selective breeding on renal graft acceptance. The analysis indicates a marked
      increase in the rate of MHC-identical graft acceptance, from 27.3% (n = 24) for
      the earliest of the four chronologic subgroups assessed to 64.5% (n = 33) for the
      most recent subgroup (p less than 0.0001). Calculations of kinship revealed that
      the increased acceptance of MHC-identical grafts was not the result of
      differences between acceptors and rejectors in donor/recipient consanguinity.
      Class I-disparate grafts (n = 128) were similarly stratified chronologically and
      compared. Unlike MHC-identical grafts, the rate of acceptance of class I
      disparate grafts has not changed over time. We conclude that rejector/acceptor
      status with respect to class I MHC incompatibility is determined by genetic
      factors in addition to those that control responses to minor antigen
      incompatibilities only.

PMID- 1634766
TI  - Shedding of the CD44 adhesion molecule from leukocytes induced by anti-CD44
      monoclonal antibody simulating the effect of a natural receptor ligand.
AB  - The CD44 adhesion molecule, playing an important role in leukocyte extravasation,
      was down-regulated by PMA and ionomycin on granulocytes and by an immobilized or
      soluble anti-CD44 mAb both on granulocytes and lymphocytes. Soluble labeled CD44
      molecules of lower apparent molecular mass as compared to their membrane
      counterparts were isolated from culture supernatants of stimulated surface
      iodinated cells. Shedding rather than internalization is the mechanism found to
      be responsible for the loss of CD44 from the cell surface. The size of the
      soluble CD44 shed from the cells stimulated in vitro corresponds to soluble CD44
      isolated from human serum. These data suggest that shedding, induced by anti-CD44
      antibody simulating the effect of a natural CD44 ligand, is an important
      regulatory mechanism controlling surface CD44 expression on leukocytes in vivo.

PMID- 1634767
TI  - MHC class II deletion mutant expresses normal levels of transgene encoded class
      II molecules that have abnormal conformation and impaired antigen presentation
      ability.
AB  - Successive transfers of HLA-DR alpha and beta genes restored expression of HLA-DR
      antigens to human B-lymphoblastoid cell line, LCL .174, from which all known
      expressible class II genes are deleted. While transferent cells displayed large
      amounts of DR on their surfaces, transgene-encoded DR3 molecules lacked a
      conformation-dependent epitope. DR1-restricted CTL lysis of DR1-expressing
      transferents pulsed with native influenza virus proteins was greatly reduced; the
      same cells were efficiently lysed in the presence of CTL-recognized influenza
      peptides. The properties of DR-expressing transferents of .174 suggest they are
      defective in producing peptides from exogenous proteins or in forming DR/peptide
      complexes. Comparison with other DR-expressing deletion mutants indicates that at
      least one gene in an approximately 230 kb DNA segment between the DQ1 and Ring 7
      loci is needed for normal DR-mediated processing and presentation. Production of
      DR3 molecules having the conformation-dependent 16.23 epitope and efficient DR1
      restricted presentation of influenza viral epitopes occurred in a B cell line
      that has a mutation specifically eliminating expression of the TAP1 transporter
      gene, which is in the approximately 230 kb interval and is needed for production
      of HLA class I/peptide complexes.

PMID- 1634768
TI  - Dual mechanisms of potentiation of murine antigen-specific IgE production by
      cyclosporin A in vitro.
AB  - Concomitant administration of cyclosporin A (CsA) with Ag has been shown to
      augment the production of Ag-specific IgE in vivo. We demonstrate that addition
      of CsA also markedly potentiated Ag-specific IgE in vitro. Low doses of CsA (3
      and 10 ng/ml) added at the time of culture initiation selectively enhanced Ag
      specific IgE but not IgA or IgG1 production, whereas higher doses (30 ng/ml)
      suppressed production of all the isotypes. Augmented IgE production was found to
      correlate with enhanced production of IL-4 and diminished production of IFN
      gamma. Delayed addition (after 2 days) of low doses of CsA to Ag-stimulated
      cultures did not potentiate IgE production, even though CsA differentially
      affected levels of IL-4 and IFN-gamma. CsA enhanced Ag-mediated cognate T/B
      interaction was not affected by neutralizing doses of anti-IL-4, suggesting Ag
      mediated lymphocytic "synapses" may be inaccessible to anti-IL-4. The effect of
      CsA on Ag presentation was determined by pulsing peritoneal exudate cells, spleen
      cells, or primed B cells with Ag and low doses of CsA before incubation with
      primed splenocytes. Enhanced Ag-specific IgE responses were detected with no
      effect on IL-4 or IFN-gamma levels. Thus, our study indicates that CsA
      potentiation of Ag-specific IgE response is due to cumulative action of CsA on
      two independent pathways: first, CsA differentially modulates IL-4 and IFN-gamma
      levels during the early phase of cognate Th2/B cell interaction; and second, CsA
      directly affects APC and IgE isotype-specific amplifying cellular components
      without apparently affecting the secretory levels of IL-4 and IFN-gamma. Dual
      mechanisms of CsA-potentiated IgE production are consistent with the hypothesis
      of two-tiered T cell regulation of Ag-specific IgE responses.

PMID- 1634769
TI  - Selective functional depletion of HIV gp120 peptides complexed with MHC from
      antigen-presenting cells engaged with specific T lymphocytes.
AB  - Human T cell lines specific for different peptides of HIV envelope glycoprotein
      gp120 have been used as probes to identify the availability of functional MHC
      peptide complexes on APC. MHC-peptide complexes recognized by T cells specific
      for peptide 24 (amino acids 225-240) are no longer available on the surface of
      APC after interaction with irradiated (binding nonproliferating) T cells with the
      same fine specificity. On the contrary, MHC-peptide complexes recognized by T
      cells specific for peptide 30 (amino acids 285-300) were functionally available
      and could stimulate T cells with such a specificity. The reciprocal experiment
      yielded similar results. The same data were also reproduced with another pair of
      gp120 peptides. These data demonstrate that upon clustering of peptide-specific T
      cells with presenting cells presentation of the same peptide to a second cohort
      of T cells with identical specificity is abolished, suggesting that a selective
      functional depletion of the MHC-peptide complexes engaged with specific T cells
      occurs at the surface of the presenting cells. The depletion does not affect
      other MHC molecules complexed with unrelated peptides.

PMID- 1634770
TI  - Surface Ig receptor-induced nuclear AP-1-dependent gene expression in B
      lymphocytes.
AB  - The relationship between signals generated via the sIgR complex of B lymphocytes
      and subsequent changes in gene expression is poorly understood at the molecular
      level. To illuminate mechanisms that may couple these events, we examined the
      expression and function of tetradecanoyl phorbol acetate-response element (TRE)
      binding proteins (i.e., activator protein 1, (AP-1)) in the murine B lymphoma
      cell line BAL-17.7.1 (BAL-17), which models primary B lymphocyte responses in a
      number of respects. Cross-linking of sIgR led to substantial induction of nuclear
      AP-1, in BAL-17 B cells, that bound the TRE, as detected by electrophoretic
      mobility shift assay. The sIgR-induced TRE-binding activity consisted of both Jun
      and Fos proteins, on the basis of immunoreactivity of nucleoprotein complexes
      with specific antisera. In addition, immunoprecipitation with specific antisera
      showed that de novo synthesis of Jun-B and c-Jun proteins, accompanied by c-Fos,
      was stimulated after cross-linking of sIgR on BAL-17 B cells. Transient
      transfection of BAL-17 B cells with reporter gene constructs showed that B cell
      AP-1 failed to trans-activate the TRE-containing human collagenase gene promoter,
      for which activity is dependent upon functional expression of cellular c-Jun. In
      contrast, sIg-induced AP-1 trans-activated a HSV-tk promoter that contained three
      TRE; this pattern of gene expression is consistent with the presence of
      functional Jun-B-containing AP-1 in B lymphocytes. These results are the first to
      attribute a functional role to sIgR-mediated AP-1 in B lymphoid cells and suggest
      that AP-1 functions to couple the sIgR complex to changes in nuclear gene
      expression.

PMID- 1634771
TI  - Transcription and recombination of the murine RS element.
AB  - The deletion of C kappa is a frequent event in lambda-producing B cells in both
      mice and humans. Deletions of the murine C kappa gene are mediated by
      recombination events that involve the RS (recombining segment) element located
      downstream of the C kappa gene. RS recombinations appear to be mediated by the
      same mechanisms involved in Ig and TCR gene rearrangement. It has been suggested
      that RS recombinations might activate a factor that is involved in the initiation
      of lambda gene rearrangement in maturing pre-B cells. We have identified a unique
      RNA transcript derived from the recombined RS element present in some pre-B cell
      lines. However, gene transfer studies indicate that this RS transcript is not
      sufficient to induce lambda gene recombination in pre-B cell lines. We also find
      that recombination of the RS element in pre-B cell lines is closely correlated
      with changes in chromatin structure and transcriptional activation. Thus,
      recombination of the RS element in pre-B cells appears to be regulated in a
      manner similar to the regulation of antibody gene VDJ joining.

PMID- 1634772
TI  - Structure and expression of class II alpha genes in miniature swine.
AB  - Two overlapping genomic clones corresponding to the swine DRA class II gene were
      isolated and characterized. Restriction mapping and partial sequence data of the
      exon-containing fragments allowed identification and orientation of the five
      exons encoding the alpha chain. Two full length cDNA clones corresponding to the
      transcribed DRA gene from two different haplotypes of the swine MHC were
      sequenced. Nucleotide sequence alignments revealed that the two swine DRA cDNA
      were very similar and closely related to the human DRA equivalent. An additional
      glycosylation site, compared with those of human DRA, was found in the second
      external domain of the protein. Northern analyses showed that porcine DRA and DQA
      genes were the only two class II alpha genes expressed in the spleen, despite the
      presence of DPA and DZA genes in the genome. In addition to transfected cells
      expressing homologous pairs of alpha and beta chains from SLA-DR, stable
      transfectants expressing nonhomologous pairs of alpha and beta chains from DR and
      DQ loci were obtained, suggesting that such associations may contribute to the
      functional heterogeneity of class II products.

PMID- 1634773
TI  - Human leukocyte activation antigen M6, a member of the Ig superfamily, is the
      species homologue of rat OX-47, mouse basigin, and chicken HT7 molecule.
AB  - Peripheral granulocytes from rheumatoid arthritis and reactive arthritis patients
      were recently found to express higher levels of a newly defined Ag, termed M6, in
      comparison to granulocytes from healthy subjects. We present here the molecular
      characterization of M6 Ag and show that it is a novel human leukocyte activation
      associated cell surface glycoprotein. Peripheral lymphocytes do not significantly
      express M6 Ag, however, it appears upon 3-day PHA-activated T blasts. On
      monocytes, which constitutively express M6 Ag, it is down-regulated on day 1 but
      re-induced on day 3 of granulocyte-macrophage CSF stimulation. SDS-PAGE analysis
      of M6 immunoprecipitates shows a single band of 54 kDa under nonreducing
      conditions that shifts to 65 kDa under reducing conditions. Endoglycosidase F
      treatment of M6 immunoprecipitate reveals that 50% of the M6 molecule is composed
      of N-linked carbohydrates. By modifying the COS cell cloning strategy, we have
      isolated cDNA clones encoding M6 Ag. M6 cDNA hybridizes with a single mRNA
      transcript of approximately 1.7 kb in Northern blotting. Comparison analysis of
      the M6 sequence indicates that M6 Ag is a member of the Ig superfamily and the
      species homologue of rat OX-47 Ag, mouse basigin (gp42), and chicken HT7
      molecule. The highly conserved remarkable transmembrane domain suggests that the
      M6 Ag may be a component of a multichain complex in the plasma membrane.

PMID- 1634774
TI  - Chicken IgA H chains. Implications concerning the evolution of H chain genes.
AB  - A cDNA clone (A1) encoding for a novel chicken Ig H chain isotype was isolated.
      In sequence comparison to mammalian H chains, A1 C region was most closely
      related to the alpha isotype. For example, identities of 35%, 32%, and 31% at the
      amino acid level to rabbit C alpha, C mu, and C gamma were observed,
      respectively. Distribution of the glucosamine acceptor sites (Asn-X-Ser/Thr) in
      A1 C region was typical of alpha H chains. Moreover, A1 C region probe hybridized
      to a 2.2-kb RNA species expressed in the epithelial lymphoid tissues. Thus, A1
      was identified as the avian homologue for mammalian alpha H chains.
      Interestingly, the chicken C alpha was structurally consistent with four complete
      CH domains, whereas only three domains are present in the mammalian C alpha
      genes. In addition, interdomain sequence alignments suggested that the homologue
      for the chicken C alpha 2 domain is missing from the mammalian alpha H chains.
      Thus, the present data suggest evolution of the IgA isotype before the
      segregation of avian and mammalian species. Also, the first C alpha gene may have
      consisted of four CH domains, whereas reorganization of the C alpha 2 region led
      to the generation of hinge region in the mammalian alpha H chains.

PMID- 1634775
TI  - The rat mast cell antigen AD1 (homologue to human CD63 or melanoma antigen ME491)
      is expressed in other cells in culture.
AB  - Previously we reported that the mAb AD1 recognized a heavily glycosylated 50- to
      60-kDa protein (AD1 Ag) sterically close to the high-affinity IgE receptor on rat
      basophilic leukemia (RBL-2H3) cells. The N-terminal amino acid sequence of the
      AD1 Ag was nearly identical to that of human CD63 (melanoma-associated Ag ME491).
      In this study we cloned the cDNA of AD1 Ag from a rat basophilic leukemia 2H3
      cDNA library. An open reading frame of 238 amino acids was identified that
      contained the N-terminal 43 amino acid sequence. No evidence of a signal peptide
      was found. However, four predominantly hydrophobic stretches of sequence were
      predicted to form membrane-spanning helices, and three putative N-glycosylation
      sites were identified. The AD1 Ag and CD63 were highly conserved between rat and
      human, suggesting that the sequence of this protein is important for its
      function. By immunostaining various rat tissues, the AD1 Ag was found localized
      to mast cells. However, it was located to lysosomes, secretory granules and the
      plasma membrane of RBL-2H3 cells and to lysosomes and plasma membrane of many
      other cultured cell lines. The AD1 Ag could be induced by placing cells in
      culture. Fibroblasts and hepatocytes freshly isolated from rat embryos stained
      very weakly for AD1 Ag; however, after 24 to 48 h in culture they were strongly
      positive. This increase in the expression of the AD1 Ag was accompanied by an
      increase in detectable RNA message. Therefore, AD1/ME491/CD63 Ag is a mast cell
      marker in tissue, but is also associated with other cells in culture.

PMID- 1634776
TI  - A novel DNA binding activity is elevated in thymocytes expressing high levels of
      H-2Dd after radiation leukemia virus infection.
AB  - Resistance to radiation leukemia virus-induced leukemia is mediated by gene(s) in
      the H-2D region of the MHC; a clear correlation exists between disease resistance
      and increased H-2Dd expression on the thymocyte surface. We have investigated the
      molecular basis for this stimulation of H-2Dd class I expression. Elevated H-2
      mRNA and H-2 transcription are demonstrated in the infected thymocytes as
      compared to normal thymocytes indicating that the elevation of H-2 surface
      expression is the result of transcriptional activation. Gel mobility assays
      performed with nuclear extracts of normal and infected thymocytes and sequences
      5' of the H-2Dd gene show that specific binding occurs with both extracts; the
      binding differs both quantitatively and qualitatively, however. DNase I
      protection analysis detects a protein binding site that is protected only by
      extracts from infected cells. The protected region contains a sequence similar to
      the AP-1 consensus sequence. Gel shift competition assays and UV photo-cross
      linking to an oligonucleotide containing this sequence demonstrate that specific
      binding of an H-2 binding factor 1 occurs and that this factor is not the AP-1
      binding complex. This novel binding factor, activated in vivo, might also be
      involved in the normal regulation of H-2 gene expression by recognizing the
      highly conserved binding sequence (TGACGCG) found in the 5' flanking region of
      many MHC class I genes. This is the first demonstration of the parallel
      stimulation of a DNA binding activity and increased transcription occurring in
      thymocytes after infection with a leukemogenic retrovirus.

PMID- 1634777
TI  - Extensive polymorphism in the extracellular domain of the mouse B cell
      differentiation antigen Lyb-2/CD72.
AB  - Lyb-2/CD72 is a 45-kDa mouse B cell surface protein that binds CD5 and has been
      shown to play a role in B cell proliferation and differentiation. Using the
      polymerase chain reaction we have isolated and sequenced cDNA clones encoding the
      serologically defined mouse Lyb-2a, Lyb-2b, and Lyb-2c alleles. We confirmed that
      our full length cDNA clones encode the Lyb-2a, -2b, and -2c alleles,
      respectively, by transfecting the isolated Lyb-2/CD72 cDNA clones into L cells
      and demonstrating that the transfectants bind only the appropriate allele
      specific anti-Lyb-2/CD72 antibodies. Sequence comparisons demonstrate that the
      Lyb-2/CD72 allels are highly conserved in their cytoplasmic and transmembrane
      domains but exhibit a high degree of polymorphism in their extracellular domains.
      This polymorphism in the extracellular region involves amino acid substitutions
      at a minimum of 20 residues and is concentrated primarily in the membrane distal
      region. cDNA sequence comparisons also demonstrate two distinct seven amino acid
      insertion/deletions among these allelic variants. A form of Lyb-2b cDNA lacking
      the sequence encoding the transmembrane region was isolated from a C57B1/6 mouse
      and a CH12.LX subline. The Lyb-2/CD72 PCR products from mRNA of mice expressing
      Lyb-2a and Lyb-2c contain a DNA fragment that corresponds in size to the
      transmembraneless form, suggesting that these mouse strains also express this
      mRNA.

PMID- 1634778
TI  - Naturally acquired CD8+ cytotoxic T lymphocytes against the Plasmodium falciparum
      circumsporozoite protein.
AB  - In rodent malaria model systems, protective immunity induced by immunization with
      irradiated sporozoites is eliminated by in vivo depletion of CD8+ T cells, and
      adoptive transfer of CTL clones against the circumsporozoite protein protects
      against malaria. We recently demonstrated that volunteers immunized with
      irradiated Plasmodium falciparum sporozoites produce CTL against peptide 368-390
      of the P. falciparum circumsporozoite protein. To determine whether natural
      exposure to malaria induced similar CTL, we studied 11 adult, male, life-long
      residents of a highly malarious area of Kenya, who were selected because their
      lymphocytes had been shown to proliferate after stimulation with peptides 361
      380, 371-390, or 368-390 and because nine had been resistant to malaria in
      previous studies. In four of the 11 individuals there was peptide-specific,
      genetically restricted, CTL activity. In all four individuals, this activity was
      unaffected by depletion of CD4+ T cells. In three volunteers the activity was
      eliminated or reduced by depletion of CD8+ T cells; in the fourth volunteer the
      CD8+ T cell depletion was uninterpretable. This first demonstration of CD8+ T
      cell, genetically restricted, Ag-specific CTL against a malaria protein among
      individuals exposed to endemic malaria provides a foundation for studying the
      relationship between circulating CTL and resistance to malaria infection.

PMID- 1634779
TI  - Discrepancy between in vitro measurable and in vivo virus neutralizing cytotoxic
      T cell reactivities. Low T cell receptor specificity and avidity sufficient for
      in vitro proliferation or cytotoxicity to peptide-coated target cells but not for
      in vivo protection.
AB  - The TCR-alpha beta of CTL recognize peptide Ag in association with MHC class I
      molecules. TCR binding should be highly specific to guarantee pathogen
      specificity and to avoid self-reactivity. Therefore, the in vivo relevance of T
      cells exhibiting cross-reactivities in vitro and the respective role of the TCR
      affinities involved are not clear. To analyze high and low avidity T cell
      activities both in vitro and in vivo, we investigated primary and clonal CTL
      responses specific for the lymphocytic choriomeningitis virus nucleoprotein 118
      126 epitope in association with the two closely related H-2Ld or H-2Lq molecules.
      As expected, we found highly specific class I-allele-restricted CTL responses
      when antiviral protection or immunopathology in vivo and lysis of virus infected
      target cells in vitro were analyzed. In contrast, the CTL were MHC crossreactive
      and thus considerably less discriminatory against targets expressing high MHC
      peptide densities and in proliferation assays. The data show that relatively high
      TCR avidities are required for virus neutralization in vivo, in contrast to in
      vitro analyses of peptide-coated target cells or proliferative T cell responses
      that may engage TCR of low avidity and broad specificity and therefore may not
      reflect biologically relevant TCR avidities.

PMID- 1634780
TI  - Cross-protection against influenza virus infection afforded by trivalent
      inactivated vaccines inoculated intranasally with cholera toxin B subunit.
AB  - Cross-protection against influenza virus infection was examined in mice,
      immunized intranasally with a nasal site-restricted volume of inactivated
      vaccines together with cholera toxin B subunit (CTB) as an adjuvant. The mice
      were challenged with either a small or a large volume of mouse-adapted virus
      suspension, each of which gave virgin mice either a predominant upper or lower
      respiratory tract infection. A single dose of a monovalent influenza A H3N2 virus
      vaccine with CTB provided complete cross-protection against the small-volume
      challenge with a drift virus within the same subtype, but a slight cross
      protection against the large-volume challenge. A second dose of another drift
      virus vaccine increased the efficacy of cross-protection against the large-volume
      challenge. Similar cross-protection against H1N1, H3N2, or B type drift virus
      challenge was provided in the mice having received a primary dose of a mixture of
      H1N1, H3N2, and B virus vaccines with CTB and a second dose of another trivalent
      vaccine. The degree of cross-protection against the small- and the large-volume
      infection paralleled mainly the amount of cross-reacting IgA antibodies to
      challenge virus hemagglutinin in the nasal wash and that of cross-reacting IgG
      antibodies in the bronchoalveolar wash, respectively. On the other hand, in mice
      immunized subcutaneously with the trivalent vaccines having no cross-reacting IgA
      antibodies, the efficacy of cross-protection was not so high as that of nasal
      vaccination. These results suggest that the nasal inoculation of trivalent
      vaccines with CTB provides cross-protection against a broader range of viruses
      than does the current parenteral vaccination.

PMID- 1634781
TI  - Surgery in rheumatoid arthritis.

PMID- 1634782
TI  - Blindness in India.

PMID- 1634783
TI  - Bladder rehabilitation in spinal cord injury patients.
AB  - The relative efficacy of intermittent catheterisation, self or assisted, over
      indwelling catheterisation was studied on 44 patients of different extent of
      spinal cord lesions. All the surviving cases (9) of incomplete cord lesion became
      catheter free irrespective of the method of catheterisation. In these patients
      urine was also found to be infection free by the 5th week of admission. Twenty
      seven cases of complete cord lesion (out of a total of 35) became catheter free,
      of whom 18 patients were on intermittent catheterisation (out of a total of 20)
      and 9 patients were on indwelling catheter (out of a total of 15 cases). In the
      later group incidence of urine infection was higher. Other complications like
      urethral trauma were comparable between patients with indwelling catheter and
      patients with intermittent, self or assisted, catheterisation.

PMID- 1634784
TI  - Low dose ketamine: an ideal supplementary anaesthesia for spinal block.
AB  - In a double blind clinical trial 100 adult patients were randomly divided into 2
      groups. In group I after spinal block slow injection of diazepam (0.1 mg/kg) was
      followed by placebo (0.5 mg/kg as bolus and 0.5 mg/kg/hour in infusion). In group
      II patients, after spinal block slow injection of diazepam (0.1 mg/kg) was
      followed by injection of ketamine (0.5 mg/kg as bolus and 0.5 mg/kg/hour as
      infusion). Low dose of ketamine in combination with diazepam significantly
      improves quality of anaesthesia, gives better cardiovascular stability without
      significant increase in complication rate and significantly improves patients'
      acceptance for the technique.

PMID- 1634785
TI  - Epidemiology of rheumatic and congenital heart diseases in school children.
AB  - A stratified random sample of 10,263 school-going children in the age group of 6
      16 years from government and private schools were screened for the prevalence of
      rheumatic fever, rheumatic heart diseases and congenital heart diseases. Fourteen
      children were found to have rheumatic heart disease with valvular lesions either
      single or in combination eg, pure mitral stenosis (6 cases), mitral regurgitation
      (4 cases), combined mitral stenosis and mitral regurgitation (3 cases) and aortic
      and mitral regurgitation (one case). Eight children had congenital heart diseases
      in the form of ventricular septal defect (3 cases), atrial septal defect (2
      cases), patent ductus arteriosus (2 cases) and congenital bicuspid aortic valve
      (one case) while none had active rheumatic fever.

PMID- 1634786
TI  - Anti-amoebic antibody levels in gastro-intestinal disorders.
AB  - Serum anti-amoebic antibody levels were studied in 91 cases having clinical
      presentation of bowel disorders and 31 cases of control. Anti-amoebic antibody
      was positive in significant dilutions in 38 cases (31.15%) in total comprising 9
      cases out of 22 cases showing presence of Ent histolytica cyst in stool, 13 cases
      who were positive for ova, parasite and cysts other than Ent histolytica in stool
      and 16 cases out of 70 cases with negative stool findings. It was positive in 5
      cases out of 9 diagnosed cases of amoebic liver abscess. Assessment of
      immunoglobulin levels in amoebic liver abscess cases revealed high levels of
      immunoglobulin G and immunoglobulin M.

PMID- 1634787
TI  - Gastric cancer: a critical analysis of surgical treatment and long term survival.
AB  - Results of consecutive study of 120 cases of carcinoma stomach treated by one
      surgical team over a period of 10 years (1980-89) are presented. Maximum cases
      were in the sixth and seventh decades with male to female sex ratio of 2.5:1. The
      lesion in most cases were in the gastric antrum. Distal tumours were more of
      poorly differentiated histology compared to proximal tumours. Eighty-three out of
      120 (69%) patients underwent surgical resection. In 50 patients it was in the
      form of a subtotal and distal gastrectomy. Only 5 patients underwent a total
      gastrectomy. In 70 cases the resection which involved en bloc removal of involved
      part of stomach including adequate proximal and distal free margins, omenta and
      perigastric lymph nodes and considered absolutely curative in 8 cases being no
      disease. The overall 5-year-survival figure was 18%. However, taking only the
      resected cases into account, the 5-year survival rate was 27%. The low survival
      figure can be attributed to a very small number of early cases encountered.

PMID- 1634788
TI  - Effect of clinicobiochemical bias on the sensitivity of nuclear imaging in
      detecting hepatic malignancies.
AB  - A retrospective analysis of the sensitivity of nuclear imaging in detecting
      hepatic malignancies has been done. Effects of clinical and liver function test
      bias have been studied on the ascribed sensitivity. The clinicobiochemical bias
      raises the detection sensitivity from 66.7% to 90.7% (p less than 0.001) but
      decreases the specificity of nuclear imaging significantly (p less than 0.05).

PMID- 1634789
TI  - Postcaesarean wound infection: a review of risk factors.
AB  - In a prospective study of 431 cases delivered by caesarean section, wound
      infection developed in 54 (12.52%) cases. In 2.55% cases, infection was deep with
      drainage of purulent material. The factors associated with a high risk of wound
      infection were anaemia, multiple pelvic examinations, prolonged rupture of
      membranes and handling by dai. General ward cases had a significantly higher
      wound infection rate than the private ward cases.

PMID- 1634790
TI  - Primary multicentric carcinomas of kidney.

PMID- 1634791
TI  - Ellis-van Creveld syndrome.

PMID- 1634792
TI  - Alveolar soft part sarcoma.

PMID- 1634793
TI  - Hospital administration in Calcutta. 1933.

PMID- 1634794
TI  - Epilepsy and pregnancy.

PMID- 1634795
TI  - Immunisation certificate.

PMID- 1634796
TI  - Q fever.

PMID- 1634797
TI  - Sports medicine.

PMID- 1634798
TI  - Helmets and head injuries.

PMID- 1634799
TI  - Association of gastric hypoacidity with opportunistic enteric infections in
      patients with AIDS.
AB  - To determine the relation and possible significance of gastric hypoaciditity to
      chronic diarrhea in AIDS, patients with and without chronic (greater than 1
      month) diarrhea underwent fasting gastric juice pH measurement and microbiologic
      study and upper and lower endoscopy with biopsy. All 8 patients with diarrhea and
      high gastric pH (greater than 3; mean, 6.1 +/- 1.0) had gastric bacterial
      overgrowth (greater than 10(4) bacteria/mL) along with opportunistic
      enteropathogens in the duodenum or rectosigmoid, but only 1 of 6 patients with
      diarrhea and gastric pH in the normal range (less than or equal to 3; mean, 1.9
      +/- 0.7) had overgrowth or an opportunistic enteropathogen. By contrast, all but
      1 of 9 controls (AIDS patients without diarrhea) had normal fasting gastric pH
      (mean, 2.9 +/- 1.5). Overall, the presence of gastric hypoacidity was associated
      with identification of opportunistic enteropathogens (P = .035). Thus, gastric
      hypoacidity is associated with quantitative bacterial overgrowth and
      opportunistic enteric infections and may be etiologically important in the
      pathophysiology of the chronic diarrhea seen in some AIDS patients.

PMID- 1634800
TI  - Effect of cyclosporin A and zidovudine on immune abnormalities observed in the
      murine acquired immunodeficiency syndrome.
AB  - Two therapeutic modalities, zidovudine (targeting retroviral replication) and
      cyclosporin A (targeting immunopathologic consequences of retroviral expression)
      were evaluated in a murine model of AIDS. In previous studies, cyclosporin A
      treatment (40 or 60 mg/kg/day) before and after infection with LP-BM5 murine
      leukemia viruses protected against the development of immunodeficiency disease.
      The present study extends these findings. First, a low dose of cyclosporin A (20
      mg/kg/day) was ineffective, and treatment initiated 5 days after infection did
      not protect against virus-induced lymphoproliferation and hypergammaglobulinemia.
      Second, zidovudine added to drinking water (0.1 mg initiated 5 days after
      infection and continued for 8 weeks) was more effective than 0.2 mg/mL given day
      5-12 after infection. This treatment reduced lymph node size, disease severity as
      determined histologically, retrovirus-induced gp70 expression, and IgE (but not
      IgM and IgG) levels. Third, combined treatment had an additive, protective effect
      on lymphocyte proliferative capacity. This successful dual therapeutic strategy
      in a mouse model has potential applicability for similar approaches in treating
      human immunodeficiency virus infection.

PMID- 1634801
TI  - Epidemiologic and historical relationships among 87 rabies virus isolates as
      determined by limited sequence analysis.
AB  - Nucleotide sequence analysis of a 200-bp region of the nucleoprotein (N) gene of
      rabies virus differentiated unique genetic groups of rabies virus from samples
      collected in areas where dog rabies is enzootic in Asia, Africa, Europe, and the
      Americas. Patterns of nucleotide sequence identified for an outbreak area were
      conserved in samples collected over three decades. Epidemiologic relationships
      among isolates were determined by patterns of conserved nucleotide sequence, and
      the degree of sequence divergence between samples from separate outbreak areas
      were measured. This approach suggested that a historical reconstruction of events
      leading to the introduction of rabies into an area would be possible. In this
      broader view of rabies epidemiology, the cultural legacy of European exploration
      and colonization may have also included zoonotic disease.

PMID- 1634802
TI  - Translocation of Campylobacter jejuni across human polarized epithelial cell
      monolayer cultures.
AB  - The ability of Campylobacter jejuni isolates to translocate across an epithelial
      cell barrier was investigated by using polarized Caco-2 cell monolayers grown on
      microporous membrane filters. The 4 C. jejuni isolates tested all traversed the
      Caco-2 cell monolayers and displayed similar translocation kinetics. The number
      of bacteria crossing the polarized cell monolayers continued to increase with
      time until 4 h after inoculation, at which time a maximum rate of translocation
      was observed. Transmission electron microscopy revealed that C. jejuni
      translocated across polarized Caco-2 cell monolayers by passing both through and
      between cells. Chloramphenicol, an inhibitor of bacterial protein synthesis,
      reduced the translocation of C. jejuni. Bacterial attachment, internalization,
      and translocation were inhibited at low temperature. These data indicate that
      adherence, penetration, and translocation of C. jejuni require active bacterial
      and target cell processes and further suggest a role for cellular translocation
      in the pathogenesis of C. jejuni-mediated enteritis.

PMID- 1634803
TI  - Trimethoprim-resistant Escherichia coli in households of children attending day
      care centers.
AB  - Children in day care centers are frequently colonized with trimethoprim-resistant
      Escherichia coli. The frequency of transmission to family members was studied.
      Colonization with trimethoprim-resistant E. coli was detected in 13 (57%) of 23
      day care center children. Among the 50 (98%) of 51 household members tested,
      colonization was detected in 13 (26%), representing 12 (52%) of 23 households
      tested. Households of colonized center children had significantly more colonized
      members than did households of noncolonized children (odds ratio, 13.3; 95%
      confidence interval, 1.3-172.6; P = .01). There was a trend toward higher
      prevalence of colonization in mothers (35%) and siblings (30%) than in fathers
      (12%). The same plasmid profiles of trimethoprim-resistant E. coli from center
      children were found among 8 (67%) of 12 colonized households. There was no
      association between antibiotic use and fecal colonization with trimethoprim
      resistant E. coli. Thus, transmission of trimethoprim-resistant E. coli among
      children within day care centers and from center children to household members is
      common.

PMID- 1634804
TI  - Role of interferon-gamma in experimental gram-negative sepsis.
AB  - To study the role of interferon-gamma (IFN-gamma) in gram-negative shock,
      mortality was compared in mice receiving either a monoclonal antibody to IFN
      gamma (H22) or an irrelevant monoclonal antibody (L2-3D9) before or after an LD90
      dose of Escherichia coli O111:B4. H22 given either 1 h before or 0.5 h after
      bacterial challenge protected mice from death (mortality at 48 h, 28% vs. 83%, P
      less than .001). Serum tumor necrosis factor-alpha (TNF alpha) levels and
      bacterial counts in blood and organs (liver, spleen, heart, and brain) were
      similar in H22-treated animals and controls. The peak serum TNF alpha levels were
      95.7 +/- 16.4 ng/mL and 80.7 +/- 14.9 ng/mL in the H22 and control groups,
      respectively. These results indicate that IFN-gamma plays a significant role in
      the pathogenesis of gram-negative sepsis.

PMID- 1634805
TI  - Affinity constants of naturally acquired and vaccine-induced anti-Pseudomonas
      aeruginosa antibodies in healthy adults and cystic fibrosis patients.
AB  - Naturally acquired anti-Pseudomonas aeruginosa antibody fails to afford
      protection against repeated P. aeruginosa bronchopulmonary exacerbations in
      cystic fibrosis (CF) patients. In an effort to explain this phenomenon, the titer
      and affinity constants of serum anti-lipopolysaccharide (LPS) IgG were determined
      in five study groups: healthy adults before and after immunization with a
      polyvalent LPS-based vaccine, healthy noncolonized CF patients before and after
      immunization, nonimmunized CF patients with significantly elevated anti-LPS
      antibody titers without documented colonization, recently colonized CF patients
      before and after immunization, and nonimmunized CF patients chronically colonized
      with P. aeruginosa. Immunization elicited a significant rise in total anti-LPS
      immunoglobulin levels and affinity constants in both healthy adults and CF
      patients. Although chronically colonized patients had elevated levels of total
      anti-LPS antibody, these antibodies possessed affinities at least 100-fold less
      than those of vaccine-induced antibodies.

PMID- 1634806
TI  - Blood-brain barrier damage in patients with bacterial meningitis: association
      with tumor necrosis factor-alpha but not interleukin-1 beta.
AB  - Brain damage after meningeal infection could result from impairment of cerebral
      endothelial cell functions and disruption of blood-brain barriers. Tumor necrosis
      factor-alpha (TNF alpha) and interleukin-1 beta (IL-1 beta) produce many of their
      effects by acting on endothelial cells. This study correlates levels of TNF alpha
      and IL-1 beta in paired cerebrospinal fluid (CSF) and serum samples with the
      degree of blood-brain barrier damage, as manifested by CSF to serum albumin
      quotient, in 48 patients with bacterial meningitis and 66 controls. CSF levels of
      TNF alpha and IL-1 beta in bacterial meningitis were significantly higher than in
      controls. Intrathecal levels of TNF alpha, but not IL-1 beta, correlated with
      albumin quotient (P less than .001), with degree of blood-brain barrier
      disruption (P less than .001), and with disease severity and indices of meningeal
      inflammation. Sequential CSF samples demonstrated that IL-1 beta and TNF alpha
      disappear from the CSF within 24 h of antibiotic treatment. Data presented here
      suggest that TNF alpha is related to blood-brain barrier damage in bacterial
      meningitis and that its effect could be dissociated from that of IL-1 beta.

PMID- 1634807
TI  - Epidemic meningococcal disease in Nairobi, Kenya, 1989. The Kenya/Centers for
      Disease Control (CDC) Meningitis Study Group.
AB  - An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989,
      outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred
      between April and November (250/100,000 population). The case-fatality rate was
      9.4% among hospitalized patients. Areas that included Nairobi's largest slums had
      particularly high attack rates. The epidemic displayed an unusual age
      distribution, with high attack rates among those 20-29 years old. A vaccination
      campaign was conducted. By early January, the weekly case count had fallen to 25
      from a high of 272 (in September). A case-control study estimated the vaccine
      efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the
      vaccination campaign reduced the number of cases by at least 20%. Multilocus
      enzyme electrophoretic typing demonstrated that the strain responsible for this
      large epidemic is closely related to strains that caused other recent epidemics,
      documenting further spread of what may be a particularly virulent clonal complex
      of group A Neisseria meningitidis.

PMID- 1634808
TI  - Broad and persistent effects of benzathine penicillin G in the prevention of
      febrile, acute respiratory disease.
AB  - After an outbreak of acute rheumatic fever at a US Army training installation, a
      benzathine penicillin G prophylaxis program was instituted. Surveillance data
      were analyzed to measure rates of febrile, acute respiratory disease (ARD) among
      trainees before and after prophylaxis was begun. Annual admissions for ARD
      decreased from 1927 to 690 (-64.2%) after benzathine penicillin G prophylaxis was
      begun. Admissions with throat cultures positive for Streptococcus pyogenes fell
      from 595 to 63 (-89.4%), a reduction that accounted only for a minority (43%) of
      the total 1237 "prevented" admissions. Temporal changes in disease rates at other
      installations where drug was not administered were also analyzed. Only a small
      decrease in the number of annual ARD admissions (-6.3%) was observed at other
      training installations. These findings support a hypothesis that benzathine
      penicillin G has a broad effect in the prevention of ARD that extends beyond the
      simple elimination of group A streptococcal infection.

PMID- 1634809
TI  - Epidemiologic analysis of group A streptococcal serotypes associated with severe
      systemic infections, rheumatic fever, or uncomplicated pharyngitis.
AB  - More than 1100 group A streptococcal isolates collected in the United States
      (1988-1990) were examined to document an association of individual serotypes with
      specific clinical infections during the recent resurgence of group A infections
      and their sequelae. The most commonly isolated strains from patients with only
      uncomplicated streptococcal pharyngitis ("control" strains) were M serotypes 1,
      2, 4, and 12. M1, M3, and M18 were statistically significantly more frequently
      isolated from patients with serious invasive infections and M3 and M18 from
      patients with rheumatic fever compared with the distribution of serotypes from
      the 866 control strains. An unexpected and important finding indicated that
      isolation rates of M1 streptococci varied geographically within the United States
      by year. The propensity for M1 streptococci to be statistically associated with
      severe systemic infections appeared unrelated to the M1 isolation rates from
      patients with only uncomplicated pharyngitis, thus offering additional support
      for the concept of strain-associated virulence rather than virulence broadly
      related to a given serotype.

PMID- 1634810
TI  - Comparison of the major outer membrane protein variant sequence regions of B/Ba
      isolates: a molecular epidemiologic approach to Chlamydia trachomatis infections.
AB  - The molecular evaluation of the chlamydial major outer membrane protein (MOMP)
      gene (omp1) can facilitate epidemiologic investigations of this pathogen.
      Genotyping of omp1 provides a more precise characterization of Chlamydia
      trachomatis than do current immunotyping techniques. Genetic omp1 variants of
      serovars that are responsible for ocular disease in Tunisia were identified.
      Archival conjunctival samples collected during 1972 and 1975 from trachoma
      patients in Douz were sequenced by automation along with additional B and Ba
      trachoma and genital isolates. Over 90% of the nucleotide changes resulted in an
      amino acid substitution. Different amino acid sequence changes in variable
      segments 1, 2, and 4 were found in the specimens collected in 1975 from those
      collected in 1972. Determination of omp1 genotypes responsible for trachoma will
      be useful for prospective, epidemiologic studies to identify chlamydial
      reservoirs within the host, evaluate transmission patterns, and determine the
      antigenic variation of MOMP for rational vaccine development.

PMID- 1634811
TI  - Low-inoculum model of surgical wound infection.
AB  - A model of surgical wound infection that uses low inocula of bacteria and closely
      simulates clinical infection involved inoculating suspensions of Staphylococcus
      aureus and dextran microbeads into intermuscular sites on the dorsum of guinea
      pigs, harvesting lesions at 72-96 h, identifying as a positive end point lesions
      yielding staphylococci on subculture, and using logistic regression for data
      analysis. Prophylaxis was placebo, ampicillin, or cefazolin, and three
      representative strains of S. aureus were used. A highly significant correlation
      (P less than .001) was observed between inoculum sizes and infection rates.
      Without antimicrobial prophylaxis, ID50 for each strain was less than 10
      organisms; with antimicrobials, ID50 was significantly higher. Differences in the
      virulence of strains and in the efficacy of the antimicrobial regimens also were
      observed. The model should prove useful for understanding mechanisms of virulence
      among pathogenic bacteria and for elucidating subtle but important differences in
      efficacy among antibiotics used in prophylaxis.

PMID- 1634812
TI  - Comparison of in vitro adherence of methicillin-sensitive and methicillin
      resistant Staphylococcus aureus to human nasal epithelial cells.
AB  - Reported nasal carriage rates of personnel caring for patients with methicillin
      resistant Staphylococcus aureus (MRSA) range from 1% to 6% in contrast to nasal
      carriage rates of 45%-65% for methicillin-sensitive S. aureus (MSSA) in health
      care personnel under nonepidemic conditions. One proposed explanation for these
      conflicting observations was examined, namely that MSSA and MRSA differ in their
      ability to adhere to nasal epithelial cells. The adherence of 6 genotypically
      distinct strains of MSSA and MRSA to nasal epithelial cells from 5 healthy donors
      was compared using a radioisotope assay system (coefficient of variation, 26%).
      The effect of pretreating epithelial cells with S. aureus-derived ribitol
      teichoic acid, a known adhesin of S. aureus for epithelial cells, was also
      examined. The mean (+/- SE) adherence of MRSA compared with MSSA in 108 assays
      was 125 +/- 11.9 versus 129 +/- 8.3 viable bacteria per cell (P = .67). Dose
      dependent competitive inhibition by ribitol teichoic acid was linear and
      equivalent for MRSA and MSSA (r, .949, P less than .001). As these in vitro
      results correlate to adherence in vivo, it would be anticipated that MRSA and
      MSSA would have an equal likelihood of nasal carriage. A critical review of
      published epidemiologic studies comparing MRSA and MSSA carriage rates also
      supports this hypothesis.

PMID- 1634813
TI  - Intestinal parasite infection in the Kampuchean refugee population 6 years after
      resettlement in Canada.
AB  - A follow-up prevalence study was done in 1989 of the same Kampuchean refugee
      population (247 subjects) that had been screened and treated for intestinal
      parasite infection 6 years earlier. A control group (102 subjects) included
      Kampuchean refugees who had arrived in Montreal at about the same time. These
      groups did not differ in age, sex, family size, or number of months spent in
      refugee camps. Statistically significant prevalence differences were observed in
      the rescreened group between 1982-1983 (63.7%) and 1989 (21.9%) and between the
      rescreened group and the control group (39.2%). These differences are largely
      attributable to the elimination of Ascaris infection and decreases in Giardia and
      hookworm infections. However, Strongyloides infection decreased only slightly
      (from 15% to 11%) in the rescreened group, while 12% of the control group was
      infected. Despite an early screening and treatment program, there remain
      important health risks in this immigrant population due to long-lived potentially
      pathogenic parasites.

PMID- 1634814
TI  - Degree and length of viremia in adults with measles.
AB  - Measles viremia is thought to peak at onset of rash and diminish rapidly over the
      subsequent 2-3 days. The length of viremia and the proportion of peripheral blood
      mononuclear cells (PBMC) infected during measles were investigated in 8 adults.
      Blood was obtained from 7 patients between days 2 and 4 of rash. Five patients
      had repeat specimens obtained on day 6 or 7, and 1 patient had samples taken on
      days 6 and 10. Limiting dilutions of PBMC were cultivated with cord blood PBMC
      and stimulated with phytohemagglutinin. Virus was identified by syncytia
      formation and confirmed by immunofluorescent staining. Virus was isolated from
      all 8 patients. Four of 6 patients were still viremic at day 6 or 7 of rash.
      Titers ranged from 3 to 5623 TCID50/10(5) PBMC. Adults with measles may have
      prolonged viremia, and a large proportion of PBMC may be infected.

PMID- 1634815
TI  - High concentrations of intrathecal interleukin-6 in human bacterial and
      nonbacterial meningitis.
AB  - Interleukin-6 (IL-6) is multipotent cytokine that acts in a network of factors
      directing the inflammatory reaction of purulent bacterial meningitis (PBM).
      However, little is known about the role of IL-6 in aseptic or "viral" meningitis
      (AM). IL-6 was assayed by RIA in cerebrospinal fluid (CSF) and serum samples
      obtained from patients with AM (n = 65), PBM (n = 8), and lymphocytic bacterial
      meningitis (LBM, n = 11). Of patients with AM, 89% had detectable IL-6 in CSF,
      with high IL-6 titers (median, 2160 pg/mL; 95% confidence interval [CI], 1320
      2540 pg/mL) compared with 100% in patients with PBM (median, 6575 pg/mL; 95% CI,
      450-32,000 pg/mL) and 90.9% in patients with LBM (median, 875 pg/mL; 95% CI, 150
      2180 pg/mL). There was a highly symmetrical correlation between IL-6 and the
      percentage of polymorphonuclear cells in CSF of patients with PBM (r = .97, P =
      .01) and AM (r = .49, P = .002). In conclusion, this study shows evidence that IL
      6 is released into the meningeal space in aseptic meningitis and is correlated
      with the local acute inflammatory response.

PMID- 1634816
TI  - Fibroblasts protect the Lyme disease spirochete, Borrelia burgdorferi, from
      ceftriaxone in vitro.
AB  - The Lyme disease spirochete, Borrelia burgdorferi, can be recovered long after
      initial infection, even from antibiotic-treated patients, indicating that it
      resists eradication by host defense mechanisms and antibiotics. Since B.
      burgdorferi first infects skin, the possible protective effect of skin
      fibroblasts from an antibiotic commonly used to treat Lyme disease, ceftriaxone,
      was examined. Human foreskin fibroblasts protected B. burgdorferi from the lethal
      action of a 2-day exposure to ceftriaxone at 1 microgram/mL, 10-20 x MBC. In the
      absence of fibroblasts, organisms did not survive. Spirochetes were not protected
      from ceftriaxone by glutaraldehyde-fixed fibroblasts or fibroblast lysate,
      suggesting that a living cell was required. The ability of the organism to
      survive in the presence of fibroblasts was not related to its infectivity.
      Fibroblasts protected B. burgdorferi for at least 14 days of exposure to
      ceftriaxone. Mouse keratinocytes, HEp-2 cells, and Vero cells but not Caco-2
      cells showed the same protective effect. Thus, several eukaryotic cell types
      provide the Lyme disease spirochete with a protective environment contributing to
      its long-term survival.

PMID- 1634817
TI  - Serum tumor necrosis factor in acute and fulminant hepatitis B.

PMID- 1634818
TI  - Safety and immunogenicity of Salmonella typhi Ty21a liquid formulation vaccine in
      4- to 6-year-old Thai children.

PMID- 1634819
TI  - Serum interleukin-6 levels and adverse reactions to diethylcarbamazine in
      lymphatic filariasis.

PMID- 1634820
TI  - Clinical significance of tumor necrosis factor in patients with bronchogenic
      carcinoma and benign lung diseases: a comparative study.
AB  - Tumor Necrosis Factor (TNF) was determined in the serum of 72 lung carcinoma
      patients. Twenty-four healthy subjects younger than 50 years and 10 healthy
      subjects older than 70 years were considered as control group. TNF was also
      measured in 20 patients with stage I sarcoidosis and in 15 patients with
      pulmonary fibrosis. The marker was detected in 32% of cases in the neoplastic
      group, in 37.5% of disease confined to the chest and in 25% of advanced disease
      cases. A large proportion of TNF-positive samples was found in sarcoidosis (30%),
      and even larger in pulmonary fibrosis (66.6%). TNF was also present in healthy
      subjects older than 70 (40%). We conclude that TNF is not specific of malignancy,
      being demonstrable in other benign pulmonary diseases and even in the course of
      physiological aging.

PMID- 1634821
TI  - HER-2/neu gene in primary and local metastatic axillary lymph nodes in human
      breast tumors.
AB  - In order to verify whether the HER-2/neu gene is involved in the initial phases
      of neoplastic disease or in its progression, we evaluated the amplification and
      overexpression of this gene in the primary tumor and in synchronous metastatic
      axillary lymph nodes of 26 women with operable breast cancer. HER-2/neu was
      amplified in 35% and overexpressed in 33% of the primary sites; similar
      percentages were found in lymph nodes. The clear correlation between the two
      disease sites regarding gene, mRNA and protein levels, supports the hypothesis
      that this gene is involved in the initial and invasive phases of neoplasia. Its
      actual role with respect to other biological tumor characteristics during the
      metastatic process should be investigated further.

PMID- 1634822
TI  - Preliminary evaluation of HER-2/neu oncogene and epidermal growth factor receptor
      expression in normal and neoplastic human ovaries.
AB  - The HER-2/neu oncogene (a member of the Erb-like oncogene family) is distinct
      from but closely related to the c-erb B gene which encodes the epidermal growth
      factor receptor (EGFr). HER-2/neu gene amplification was found in a large number
      of mammary carcinomas and there was a strong correlation between this phenomenon
      and poor prognosis. In our study HER-2/neu oncogene expression was determined in
      16 malignant ovarian tumors, 2 ovarian lymphomas and 5 normal ovaries. The HER
      2/neu gene was found both in normal ovaries and malignant tumors, without any
      apparent difference among the various histological types. In all the specimens
      examined, HER-2/neu expression did not seem to be related to EGF binding
      capacity.

PMID- 1634823
TI  - Half-life of carcinoembryonic antigen following curative resection of
      adenocarcinoma of the lung.

PMID- 1634824
TI  - Total lactate dehydrogenase and tumor necrosis factor alpha levels in cyst fluid
      of women with gross cystic breast disease.

PMID- 1634825
TI  - CAM26 and CAM29 cytosol levels in breast tumors classified according to estrogen
      receptor status. First results.

PMID- 1634826
TI  - Plasma monomeric calcitonin as a marker of disease activity in multiple myeloma
      patients with osteolysis.
AB  - Circulating monomeric human calcitonin (hCT-M), parathyroid hormone, osteocalcin,
      alkaline phosphatase, urinary hydroxyproline, corrected serum calcium and
      inorganic phosphate were measured in 49 multiple myeloma patients and 49 matched
      controls. In patients with Durie-Salmon stage III disease hCT-M levels (16.9 +/-
      5.8 ng/l, mean +/- SD) were significantly higher than controls and stage I
      patients (P less than 0.01), and correlated directly with corrected serum calcium
      (r = 0.74; P less than 0.001). In the same subgroup 14 of 15 patients had plasma
      hCT-M concentrations higher than the mean + 2SD of the controls. The calcium
      infusion test induced an increase of hCT-M in normocalcemic patients which was
      significantly greater in patients with advanced disease than in either controls
      or stage I patients. These findings suggest that hCT-M may be a biochemical index
      of bone resorption and disease activity in myeloma patients with osteolysis. In
      fact, its plasma concentrations were elevated in a large proportion (93%) of
      patients with severe bone involvement, and correlated directly with serum
      calcium. Moreover, our findings suggest the presence of a calcitonin-dependent
      calcium homeostatic mechanism, that protects against hypercalcemia due to tumor
      osteolysis.

PMID- 1634827
TI  - Growth fraction of colorectal carcinoma (Ki67): a comparative study.
AB  - We studied the growth fraction of 55 resected colorectal adenocarcinomas by means
      of a three-step immunoperoxidase technique (avidin-biotin-peroxidase) using the
      monoclonal antibody Ki67 directed against a cell proliferation-associated nuclear
      antigen. The percentage of Ki67-positive cells was evaluated independently by two
      observers, and a Ki67 score was obtained for each case. No correlation was
      observed between Ki67 staining and patient's age and sex, tumor size and
      localization or grading and staging according to Dukes' method (modified by
      Astler-Coller and Turnbull). The growth fraction showed extreme heterogeneity in
      the cases examined, within each grade of differentiation.

PMID- 1634828
TI  - [Right aortic arch with mirror-image branching and coarctation of the aorta--a
      case report].
AB  - The right aortic arch with coarctation of the aorta was reported. A 56-year-old
      woman admitted to the hospital because of headache and hypertension. Cardiac
      catheterization revealed the right aortic arch with coarctation of the aorta and
      80 mmHg pressure gradient across the coarctation. The bypass operation with a 14
      mm Dacron graft between the ascending to descending aorta was performed. There
      was no peak systolic pressure gradient between the ascending and descending aorta
      after bypass operation. This patient is the fourth case report with both mirror
      image type right aortic arch and coarctation of the aorta.

PMID- 1634829
TI  - [Recurrent thromboses of the Bjork-Shiley valve in a patient with gout].
AB  - A 56-year-old male, who had mitral stenosis and gout, underwent mitral valve
      replacement with the Bjork-Shiley valve prosthesis. Four years after the surgery,
      the patient suddenly became dyspneic on exercise due to malfunctioning valve.
      Thrombosis was found on the prosthesis, which was replaced again by Bjork-Shiley
      valve. Thrombotest value had been satisfactorily controlled at 12.8 +/- 4.2% with
      warfarin since the first surgery. Dilazep chlorate also had been prescribed.
      Hyperuricemia had been controlled with allopurinol. In spite of these combined
      medical therapy, thrombosed valve recurred. Clotted prosthesis was superseded by
      Carpentier-Edwards Bioprosthesis. Enhancement of platelet function of the
      patients with gout and hyperuricemia has been reported. Gout in this case might
      have influence on the recurrent episodes of thrombosis. Monitoring of platelet
      function would be necessary in follow-up of a patients with gout and valve
      replacement.

PMID- 1634830
TI  - [A case of a primary neurofibroma of the left ventricle].
AB  - A neurogenic tumor of the heart is extremely rare, and previously only 8 cases of
      malignant schwannoma and 3 cases of neurilemmoma have been reported. The patient
      of this case was a seven year old boy and referred to our hospital by his school
      doctor for investigation of IRBBB on screening ECG. The chest-X-ray showed a
      bulging contour on left ventricular apex. Echocardiography and angiography showed
      a 4 x 4 cm solid mass in the anterior-lateral wall of the left ventricle near the
      apex. Thoracotomy was performed and during cardiopulmonary bypass the tumor was
      successfully removed without involvement of the endocardium. It was not
      encapsulated. The pathohistological findings of the specimen were compatible with
      neurofibroma, and S-100 protein was demonstrated immunohistochemically.

PMID- 1634831
TI  - [Surgical treatment of Candida endocarditis involving mitral valve--a case
      report].
AB  - A 53-year-old male with a low pulmonary function (FEV1.0 500 ml) and cachexia was
      admitted for a remittent fever. Blood culture along with echocardiography
      indicating vegetation on the anterior mitral leaflet confirmed Candida
      endocarditis involving mitral valve. Following anti-fungal drug therapy, mitral
      valve replacement was performed. Surgical specimen of mitral valve showed
      vegetation on the anterior mitral leaflet with Candida albicans. The post
      operative course was uneventful, through the anti-fungal drug therapy was
      compelled to be discontinued owing to drug allergy. He was discharged on the 67th
      postoperative day. There was no evidence of recurrence without medication for 9
      months after his discharge.

PMID- 1634832
TI  - [Biventricular repair for right isomerism associated with transposition of great
      arteries and common atrioventricular canal].
AB  - A 5-years old boy, whose thoracic situs was right isomerism, was diagnosed as
      transposition of great arteries, common atrioventricular canal (intermediate
      type), severe tricuspid valve regurgitation, pulmonary valve stenosis, bilateral
      superior vena cava and left sided inferior vena cava. The preoperative RVEDV was
      95% and LVEDV 160%, and LV/RV pressure ratio was 0.54. Atrial rerouting using
      pericardial patch, replacement of tricuspid valve and pulmonary valvotomy were
      performed. Postoperative course was uneventful. This was a rare case of right
      isomerism who received biventricular repair.

PMID- 1634833
TI  - [A case report of surgical repair of aneurysm involving the distal arch and the
      descending aorta through median sternotomy].
AB  - A 46-year-old male patient with aneurysm involving the distal arch and the
      descending aorta was operated on successfully. Graft replacement of aneurysm with
      inclusion method was performed through median sternotomy with left pleurotomy.
      One month after operation, CT scan showed thrombus occupied between the graft and
      the aneurysm, and two years postoperatively, the aneurysm shrunk almost to normal
      size of the aorta. Therefore, our surgical procedure was considered to be proper.

PMID- 1634834
TI  - [Spontaneous intercostal lung hernia].
AB  - A 70-year-old man admitted our clinic because of a painful bulge in the left
      chest wall that had appeared following a bout of coughing. CT confirmed the
      presence of lung herniation at the left eight interspace. At surgery a 3 x 16 cm
      anterolateral defect in the site was confirmed. A patch of Gore-Tex (expanded
      polytetrafluoroethylene) was fashioned and sewn into the defect with interrupted
      3-0 Ethibond sutures. Spontaneous intercostal lung hernia is a rare lesion of
      thoracic wall and have not been reported in Japan. We describe a case with some
      reviewing.

PMID- 1634836
TI  - [Cell kinetics in two cases of meningioma with ultra-late pulmonary metastases].
AB  - In order to elucidate the influence of surgical intervention on cell kinetics, we
      investigated the DNA ploidy pattern and mitotic index in two patients with
      metastatic pulmonary meningioma more than 10 years after the first operation for
      primary brain lesions. The first patient, with hemangiopericytomatous meningioma,
      showed a diploid pattern in all resected specimens and intrathoracic metastases
      obtained at autopsy, and also showed a constant mitotic indices throughout the
      clinical course. The second patient, with meningothelial meningioma, also showed
      a diploid pattern and constant mitotic indices throughout the clinical course.
      There was no difference in the two parameters between this second patient and 5
      non-metastatic control cases. In conclusion, there was no positive correlation
      between these two parameters and the acceleration of tumor growth detected at
      every surgical intervention.

PMID- 1634835
TI  - [Experimental and clinical study of cardiopulmonary hemodynamics under one-lung
      ventilation during transthoracic esophagectomy].
AB  - Cardiopulmonary hemodynamics in pre- and postoperative period after transthoracic
      esophagectomy under one-lung ventilation (OLV) was investigated in experimental
      and clinical studies. In experimental study, 30 mongrel dogs were assigned to one
      of the groups: Group 1 (n = 10): 2 hour right thoracotomy alone under one (n = 5)
      or two-lung ventilation (TLV) (n = 5), Group 2 (n = 10): thoracotomy +
      esophagectomy, Group 3 (n = 10): esophagectomy + right thoracic vagotomy. For
      further evaluation of the effect of vagotomy on increase of extravascular lung
      water (EVLW) on 3rd POD, the following 2 groups were designed as Group 4-1) (n =
      5): thoracotomy + right thoracic vagotomy and Group 4-3) (n = 5): esophagectomy +
      left thoracic vagotomy. In clinical study, 30 patients underwent transthoracic
      esophagectomy were randomly divided into either OLV or TLV group. Cardiopulmonary
      hemodynamics and postoperative complications were investigated in pre- and up to
      3 POD. 1. Cardiopulmonary parameters and EVLW except PaO2 and shunt ratio were
      not different between OLV and TLW groups in experimental study. PaO2 of OLV group
      dropped from the pre-thoracotomy value of 577 +/- 75 mmHg to 98 +/- 47 mmHg. This
      decrease was significant in comparison with TLV (582 +/- 85 mmHg to 215 +/- 132
      mmHg) (p less than 0.05). Shunt ratio increased in the OLV group from 10 +/- 11%
      to 37 +/- 13%. This increase was also significant in comparison with TLV (24 +/-
      10% from 9 +/- 9%) (p less than 0.05). However, both PaO2 and shunt ratio
      returned to the pre-thoracotomy value after stopping of OLV and showed no
      difference compared with TLV. 2. EVLW per kg was not different between 5 groups.
      Values of right to left lung ratio of EVLW in Group 3 and Group 4-3), 1.77 +/-
      0.26 and 1.82 +/- 0.26, were greater than that in Group 1, 1.39 +/- 0.17 (p less
      than 0.05). This difference seems to be caused by increase of permeability of
      pulmonary capillaries. 3. Cardiopulmonary parameters and postoperative
      complications were not different between OLV and TLV groups in clinical study. In
      conclusion, OLV is a desirable procedure, not only for good exposure of the
      operative filed, but also for its safety regarding the cardiopulmonary
      hemodynamics. Transthoracic esophagectomy plus vagal branch denervation, which is
      necessary for aggressive lymphadenectomy around the trachea, increases EVLW and
      subsequent pulmonary edema compared with thoracotomy alone.

PMID- 1634837
TI  - [Modified technique for chronic tricuspid regurgitation in rabbits and evaluation
      of intestinal malabsorption in the chronic stage of this model].
AB  - One of pathophysiological processes in cardiac cachexia with severe congestive
      cardiac failure is malabsorption in the intestine. This malabsorption might be
      caused by high venous pressure in the intestine, following congestive liver due
      to congestive cardiac failure. However, this has not been proved experimentally
      yet. In this experiment, rabbits were utilized because their body weights are
      relatively equal and their life cycle is shorter than that of dogs, for which
      experimental procedure has been established. Our purpose was first, to establish
      the technique which can produce tricuspid regurgitation (TR) in rabbits, and
      secondly, to examine the degree of malabsorption in these animals in the chronic
      stage of TR. SURGICAL TECHNIQUE: The TR rabbits (n = 4) were provided by means of
      division of the chordae of the tricuspid valve through the 4th intercostal space
      in the right thoracotomy. Division of the chordae was performed through the right
      atrial incision under direct vision while employing total temporary inflow
      occlusion. The duration of inflow occlusion varied from one to two minutes.
      RESULT: The mean of the peak right atrial pressure before the procedure was 6.5
      mmHg, that just after the procedure was 16.1 mmHg, and that two to four months
      after the procedure was 17.0 mmHg. The peak right atrial pressure just after the
      procedure were higher than those before the procedure, and the peak right atrial
      pressure two to four months after the procedure were also higher than those
      before the procedure in all rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634838
TI  - [Hematologic and endocrinologic effects of pulsatile cardiopulmonary bypass using
      a centrifugal pump].
AB  - The effects of pulsatile and nonpulsatile flow during cardiopulmonary bypass
      (CPB) with of centrifugal pump (Sarns) and membrane oxygenator, on blood cells,
      hemodynamics, and hormonal response were studied. In the pulsatile group (group
      P) in which pulsatile flow was generated by centrifugal pump and a 20 Fr arterial
      cannula was used, hemolysis and reduction of platelet count during CPB were more
      marked than in the nonpulsatile group (group NP), in which the same type of
      circuit was used. When the 20 Fr arterial cannula was replaced with a 24 Fr
      cannula (group Pc), the rate of hemolysis during CPB was significantly reduced
      compared with that in group P (p less than 0.05). The rate of rise in plasma free
      hemoglobin from 10 to 70 minutes CPB in group Pc was 15.0 mg/dl/hr, this value
      did not exceed that in either group NP or in group Pr, in which a roller pump
      rather than centrifugal pump was used to generate pulsatile flow. These findings
      show that pulsatile CPB with a centrifugal pump produces no deleterious
      hematologic effect in clinical use. The rise in the level of angiotensin II in
      group P was significantly smaller than that in group NP (p less than 0.05), and
      the rise in plasma renin activity and levels of angiotensin I, adrenalin and
      noradrenaline were smaller than those in group NP, although these differences
      were no significance. These findings indicate that the centrifugal pump generates
      pulsatile flow effectively, although not so effectively as to prevent the rise in
      peripheral vascular resistance. During CPB, there was no change in levels of
      thyroid hormones, including free T3, free T4 and reverse T3, in either pulsatile
      groups P and Pc or nonpulsatile group. TSH level in group Pc was significantly
      elevated in contrast with that in the nonpulsatile group (p less than 0.05), in
      which no change in TSH level was seen. It is suggested that pulsatile perfusion
      using a centrifugal pump might maintain sufficient hypothalamic-pituitary
      function to permit secretion of TSH in response to various stimuli.

PMID- 1634839
TI  - [Preservation of the heart with University of Wisconsin solution--hemodynamic and
      morphological evaluation in a canine heterotopically transplanted heart].
AB  - University of Wisconsin (UW) solution has been reported to extend the safe cold
      ischemic time in the preservation of the liver, kidney and pancreas. However,
      there have been few reports of safe cold ischemic time in heart preservation with
      UW solution. The purpose of this study was to find whether UW solution can extend
      the safe cold ischemic time in cardiac transplantation in dogs. Heterotopic
      cardiac transplantation was performed in mongrel dogs after cold ischemic
      preservation of the hearts with UW solution, ischemic time 8, 16 and 24 hours
      (Gr.UW8, Gr.UW16 and Gr.UW24, respectively) and with GIK solution, ischemic time
      4 hours (Gr.G4) which is considered the safe cold ischemic time in clinical
      cardiac transplantation. The following was studied: 1) Emax of the LV, myocardial
      contraction, by pressure-volume curve with the volume measured conductance
      catheter method, 2) myocardial tissue blood flow of the LV (MTBF), with laser
      doppler tissue flow meter, 3) serum CPK and electron microscopical evaluation.
      Emax and MTBF were measured before transplantation and after reperfusion. Their
      results were expressed as percentage of the values before transplantation. As
      results, after 120 minutes from reperfusion, Emax was recovered to 94 +/- 13% in
      Gr.G4, 104 +/- 11% in Gr.UW8, 67 +/- 22% in Gr.UW16 and 66 +/- 16% in Gr.UW24.
      Emax in Gr.G4 and Gr.UW8 were significantly (p less than 0.01) higher than that
      in Gr.UW16 and Gr.UW24. After 120 minutes from reperfusion, MTBF was recovered to
      90 +/- 19% in Gr.G4, 98 +/- 9% in Gr.UW8, 63 +/- 19% in Gr.UW16 and 61 +/- 6% in
      Gr.UW24.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634840
TI  - [Simple hypothermic retrograde cerebral perfusion for brain protection during
      aortic arch surgery].
AB  - We have recently found that retrograde cerebral perfusion can be performed by
      simply elevating central venous pressure to 15 mmHg in the Trendelenburg position
      when the aortic arch is open during aortic arch surgery. During deep hypothermic
      (15 degrees C) perfusion of the lower half of the body with the descending aorta
      occluded, and with single cannulation of the right atrium for drainage, oxygen
      saturated venous blood perfuses the brain retrogradely, supplying it with oxygen.
      This method renders clamping of the aortic arch and the arch vessels unnecessary.
      Eleven cases of aortic arch aneurysm (9 males, 2 females; 5 true aneurysms, 5
      dissecting aneurysms, one combined aneurysm; mean age, 63 years) were operated
      using this technique, whose clinical significance was then evaluated. Median
      sternotomy was performed in 4 cases, left thoracotomy in 7. Patch replacement was
      performed in 2 cases and graft replacement in 9 cases (the proximal arch in 2,
      the whole arch in 2, the distal arch in 5). In two cases coronary artery bypass
      surgery using the internal thoracic artery was performed simultaneously via
      lateral thoracotomy. Operation time was 517 +/- 139 min, pump time was 211 +/- 34
      min, cardiac arrest time was 84 +/- 34 min and the lowest rectal temperature was
      15.7 +/- 1.1 degrees C. In the venous return, PO2 was 188 +/- 136 mmHg, and SO2
      97.5 +/- 2.9%, the respective values in the retrogradely perfused blood in the
      aortic arch being 46 +/- 12 mmHg and 68.8 +/- 18.8%.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1634841
TI  - [Surgical treatment of lung cancer with mediastinoscopic positive lymph nodes].
AB  - There are no definite criteria for the indication of surgery in lung cancer with
      mediastinal lymph node involvement. During the past 20 years, 100 patients (76
      patients with adenocarcinoma and 24 patients with squamous cell carcinoma) have
      undergone thoracotomy for lung cancer with mediastinoscopic positive lymph nodes
      at our hospital. Of these, relatively curative resection was performed on 13
      patients. The 5-year survival rate in these 13 patients was 28%, which was
      significantly higher than the 0% in 42 patients with relatively non-curative
      resection and the 0% in 26 patients with absolutely non-curative resection. The 5
      year survival rate was 9% in both T1 (n = 14) patients and T2 (n = 37) patients.
      No T3 (n = 21) and T4 (n = 9) patients survived 3 years. The 5 year survival rate
      in patients with squamous cell carcinoma was 12% and that in patients with
      adenocarcinoma was 0%, but there was no significant difference. The survival
      rates of T1 and T2 patients were significantly higher than that of T3 patients (p
      less than 0.02 and p less than 0.005) respectively. Contralateral mediastinal
      lymph node metastasis (N3) was observed significantly more frequently in patients
      with adenocarcinoma (38%) than in those with squamous cell carcinoma (13%), but
      there was no significant difference in the survival rate. In N2 patients, the
      survival rate was compared between those with mediastinal nodal involvement of an
      early stage (N2-1) and those with lymph node metastasis of more advanced stage
      (N2-2) according to the lobe bearing the primary cancer.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1634842
TI  - [Endoscopic ultrasonography for preoperative diagnosis of the hilar and
      mediastinal lymph node metastases in lung cancer].
AB  - Fifty patients with lung cancer underwent transesophageal endoscopic
      ultrasonography (EUS) for preoperative detection of metastases to the hilar and
      mediastinal lymph nodes. An electronic ultrasonic fiberscope with a linear array
      (EPB-503-FS, Machida-Toshiba) was used. Later, in surgery, a total of 513 nodes
      that could have been detected by EUS were removed. Of these, 54 nodes were found
      to be metastatic histologically, and 459 were non-metastatic. The rate of
      detection by EUS was 65% (35/54) for the metastatic nodes; the rate was 41%
      (186/459) for the non-metastatic nodes (p less than 0.01). Metastatic nodes were
      detected at high rates in every lymph node site. Non-metastatic nodes were
      detected at low rates in sites 1, 2, and 4, and at the highest rate in site 7.
      Metastatic nodes had characteristic internal echoes, affected by the extent of
      tumor and necrosis present in a node, and were detected more easily than non
      metastatic nodes. For larger or rounder nodes, metastasis was more common (p less
      than 0.01). Lymph nodes that could be detected were classified into six types by
      their internal echo patterns; three of these types were rarely metastatic, and
      were called 'negative'; the other three were often metastatic, and were called
      'positive'. In histological examinations, of the 'negative' nodes found in fact
      to be metastatic histologically, invasion by the tumor tended to be diffuse and
      necrosis was minute. The 'positive' nodes that were in fact metastatic tended to
      have one of two internal echo patterns (depending on the amount of necrosis) when
      invasion was diffuse, and a third pattern when invasion was localized.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1634843
TI  - [Effect of aortic valve replacement on left ventricular function in adult
      patients with aortic stenosis].
AB  - Echocardiographic and hemodynamic studies were obtained in 16 consecutive adult
      patients who underwent aortic valve replacement (AVR) with St. Jude Medical valve
      for aortic stenosis (AS). Three cases of congenital AS was included and two of
      them had undergone aortic valvotomy in childhood. One of 16 patients died due to
      late cardiac tamponade six weeks after AVR. Postoperative studies showed improved
      left ventricular (LV) functions. LV end diastolic and end systolic diameter (LVDs
      and LVDs) fell from 50.3 and 38.2 to 44.6 and 31.6 mm respectively (p less than
      0.05). Fractional shortening (%FS) rose from 26.5 to 32.2% (p less than 0.05).
      End systolic wall stress (ESWS) fell from 126.2 to 69.6 k dynes/cm2 (p less than
      0.01). Cardiac index and pulmonary arterial wedge pressure improved from 3.4 and
      14.4 to 3.6 l/min/m2 and 10.5 mmHg respectively (ns). Preoperatively, six were
      functional class II, eight were class III and one was class IV (New York Heart
      Association classification). Postoperative improvement was as follows, eight:
      class I, seven: class II. In four cases, preoperative echocardiography revealed
      most depressed LV function in %FS (smaller than 21%) and ESWS (greater than 140).
      Postoperatively they improved from 18.3 and 164 to 26.0% and 72.8 k dynes/cm2
      respectively. These results suggested that depressed LV function in the patients
      with longstanding AS was largely related to limited preload reserve due to LV
      enlargement and mechanical unloading of LV (correction of afterload mismatch)
      resulted in improvement of LV function. In conclusion, LV dysfunction owing to AS
      alone is reversible and AVR results in great clinical improvement.

PMID- 1634844
TI  - [The effects of osmolarity in reperfusion solution upon myocardial protection].
AB  - The effects of several different osmolarity in reperfusion solution were studied.
      Experimental time course was as follows: 20 min working perfusion, 3 min
      cardioplegic infusion with St. Thomas Cardioplegic Solution (STS) followed by
      global ischemia for 33 min at 37.5 degrees C, 15 min early Langendorff
      reperfusion with different osmolarity by adding sucrose and 5 min late
      reperfusion with Krebs Henseleit bicarbonate buffer, followed by 20 min working
      perfusion. Percent recoveries of aortic flow showed that 290 mOsm/L in
      reperfusion solution possessed optimal protective properties with bell shaped
      dose response characteristics.

PMID- 1634845
TI  - [Intralobal sequestration in children--a new concept from the form of bronchial
      tree in sequestrated lung].
AB  - Twenty cases of the intralobal sequestration of the lung in children have been
      experienced. The age of the patients were from eleven days to fifteen years.
      Intralobal sequestration was classified into two groups, (central type and
      peripheral type) by the way of reconstruction of the bronchial tree in the
      sequestrated lung. In 8 cases of central type, the site of lesion was variable.
      The bronchial trees of the sequestrated lung were running toward the hilus of the
      normal lung but the bronchi of the affected area in the normal lung were absent.
      The aberrant arteries were muscular in histology, and the drainage veins were
      pulmonary vein. In 12 cases of peripheral type, the lesion was in segment 10 area
      in every cases. The bronchial trees of the sequestrated lung were running toward
      the pulmonary ligament where an aberrant artery came from, and B10 of the normal
      lung were patent. The aberrant arteries were elastic in histology, and the
      drainage veins were pulmonary and/or azygos vein. It is conceivable that the
      peripheral type is the real intralobal sequestration and the central type is the
      mixture of some other diseases.

PMID- 1634846
TI  - [A useful method for the surgical treatment of active infective endocarditis--a
      case report using the Teflon felt reinforcing method].
AB  - In the surgical treatment for active infective endocarditis (IE), perivalvular
      leakage is the most severe complication. We had a 42-year-old man who had active
      IE and a giant vegetation in the aortic valve, and a small mycotic aneurysm in
      the left ventricular outflow tract. Other operative observations included slight
      redness and a decrease in the reflex of the annular endocardium. We made a patch
      closure of the mycotic aneurysm, and aortic valve replacement using the Teflon
      felt reinforcing method. In the postoperative course, he had a pacemaker
      implantation with complete AV block. Postoperative pathological examination
      revealed inflammatory cells and plasma infiltration, and edematous change of the
      interstitial tissue around the cusp surface and annular side of the resected
      valve. These pathological changes could explain the redness and the decrease in
      the reflex of the annular endocardium. The edematous changes of the annular
      tissue might be the cause of postoperative perivalvular leakage. Reinforcement of
      the prosthetic valve with Teflon felt might be a useful method to prevent
      perivalvular leakage. There is, however, the possibility of acceleration or
      elongation of infective endocarditis. In our experiences of the surgical
      treatment for active IE, we performed valve replacement using Teflon felt in 6
      patients, and not using in 27 patients. The mean period until CRP had been
      normalized was no significant difference between both groups (mean days using
      Teflon felt were 63.5 days, and not using were 75 days).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1634847
TI  - [A case of a small thymoma associated with myasthenia gravis in which the tumor
      was reduced by corticosteroid therapy].
AB  - The case in this study was a 34-year-old male with a small thymoma associated
      with myasthenia gravis. The patient had been treated with corticosteroids for 10
      months against myasthenia gravis. During the course of the treatment a chest CT
      revealed that the tumor had reduced. Thereafter the extended thymectomy was
      performed. A close examination of the excised thymus revealed the presence of a
      flat cystic tumor measuring 1.5 x 0.8 x 0.5 cm at the site corresponding to the
      CT image. This tumor was histologically ascertained to be a thymoma. The thymoma
      is sensitive to corticosteroids, which can effectively reduce it. As conclusion,
      it is necessary to check thoroughly on the presence of thymoma prior to the
      initiation of corticosteroid therapy to treat myasthenia gravis.

PMID- 1634848
TI  - [A case report of so-called solitary fibrous tumor of the mediastinum].
AB  - A 52-year-old house wife was admitted to our hospital with the diagnosis of a
      impending rupture of the aneurysm of the ascending aorta. Chest X-ray showed an
      anterosuperior mediastinal mass which extended into right hemithorax and space
      between ascending aorta and superior vena cava on CT and MRI. Median sternotomy
      showed a large mass, arising from the left lobe of the thymus covered with
      mediastinal pleura and projecting into the right pleural cavity with no
      dissemination. The tumor was excised with the thymic glands together with the
      involved ascending aorta and pericardium. It was encapsulated tumor, 10 x 9 x 8
      cm in size, 420 g in weight, and revealed central necrosis with bleeding on the
      cut surface. The pathological findings showed spindle cell tumor with high
      mitotic activity, immunoreactivity for vimentin, but not for keratin, and no
      ultrastructural evidence of micro villi. So far as the Japanese literature about
      the so-called solitary fibrous tumor of the mediastinum is concerned, this is
      considered to be the first case in our country.

PMID- 1634849
TI  - [A modified technique in total cavopulmonary connection].
AB  - We have used an alternative technique in Total Cavopulmonary Connection without
      using any prosthetic material. The technique is a modification of Senning
      operation in which a flap of right atrial wall is used to create a tunnel between
      inferior vena cava and superior vena cava. We used this modified technique in two
      cases, and they showed excellent postoperative convalescence.

PMID- 1634850
TI  - [A case of infective endocarditis of the tricuspid valve repaired by vegetectomy
      and annuloplasty].
AB  - A successful repair of infective endocarditis of the tricuspid valve in a drug
      abuser is reported. A 25-year-old woman with a history of drug addiction was
      referred to our hospital complaining of high fever despite antibiotic therapy.
      Blood cultures showed staphylococcal septicemia, and echocardiography revealed
      large vegetations attached to the tricuspid annulus and massive regurgitation of
      the tricuspid valve. Blood studies showed renal failure and hematological
      abnormalities due to septicemia and right ventricular failure. Excision of the
      vegetation and the posterior leaflet was performed along with annuloplasty (Kay's
      procedure). The patient's postoperative course was uneventful and subsequent
      echocardiographic examination disclosed no evidence of recurrence, and
      insignificant tricuspid valvular regurgitation. Local excision of vegetation and
      leaflet repair by annuloplasty may be performed in cases with well-circumscribed
      vegetation and minor leaflet damage.

PMID- 1634851
TI  - [The pulmonary venous obstruction following repair with absorbable sutures in
      total anomalous pulmonary venous drainage--a case report].
AB  - A 4-month-old boy with infracardiac type of total anomalous pulmonary venous
      drainage (TAPVD) who underwent anastomosis between left atrium and common
      pulmonary vein at age of one month with absorbable suture of polydioxanone (PDS),
      was suffered from pulmonary venous obstruction (PVO). The ostia of pulmonary
      veins were stenosed severely. The histological findings showed that there were
      inflammatory changes and fibrosis around PDS suture. These findings suggested
      that PDS would cause inflammatory change of tissues around, which might be
      occurred following repair of TAPVD.

PMID- 1634852
TI  - [An unusual case of annular constrictive pericarditis--a "framed heart"].
AB  - We presented a 62-year-old female with constrictive pericarditis of an unusual
      anatomy. A calcified constrictive band, 2-3 cm wide, ran parallel to the frontal
      plane, coursing circularly along the anterior aspect of the great arteries, right
      atrium, diaphragmatic surface of the right ventricle, posterolateral aspect of
      the left ventricle and back to the great arteries. The course of the constrictive
      band was circular but completely different from that of typical annular
      constrictive pericarditis in which a constrictive band runs along the
      atrioventricular groove. Hemodynamic consequences of our patient was rather non
      specific impairment of ventricular filling than functional valvular stenoses due
      to external compression characteristic for the typical annular constrictive
      pericarditis. Effective surgical relief of the constriction was accomplished
      under cardiopulmonary bypass and cardioplegic cardiac arrest.

PMID- 1634853
TI  - Evaluation of quality of lateral full spine radiographs: a statistical study.
AB  - OBJECTIVE: This study examines the effects of filtration on X-ray quality in 287
      lateral full spine radiographs of human subjects. The impact of the subject's sex
      and age on the effects of filtration was also examined. DESIGN: X rays obtained
      with and without filtration were selected at random from various chiropractic
      clinics in North America. Five college instructors from various clinical
      backgrounds classified each film as adequate film quality, or as over- or
      underexposed in each of the cervical, thoracic, lumbar and sacral spinal regions.
      RESULTS: Log linear analyses showed that the use of filtration produced the best
      overall film quality, and that film quality decreased as age increased in all
      spinal regions, regardless of filtration usage. A higher percentage of films of
      subjects less than 54 yr of age were judged to be of adequate quality when
      filtration was used. Films of male subjects had better quality in the lower
      spinal regions; films of females were better in the upper regions. CONCLUSIONS:
      By the evidence supported by the statistical analyses, it is suggested that
      lateral full spine films may only be used as a means for postural screenings if
      filtration is always used, and to take the sex and age of the patient into
      account in deciding whether to change technique exposure factors or to use
      sectional views, which would increase the probability of better quality films.

PMID- 1634854
TI  - Who's interested in chiropractic history?
AB  - OBJECTIVE: To determine the extent of interest in chiropractic history among
      chiropractors in various nations, states and provinces. DATA SOURCES: The
      worldwide chiropractor population distribution was determined by noting the
      circulation of the biweekly magazine, Dynamic Chiropractic. Interest in
      chiropractic history among chiropractors was implied by inclusion in the
      Membership Directory of the Association for the History of Chiropractic (AHC).
      DATA EXTRACTION: An interest index was derived by expressing the number of
      members of the AHC as a percentage of the chiropractor population in each region.
      DATA SYNTHESIS: Worldwide membership in the AHC involves less than 1% of the
      total estimated chiropractor population; Canadian chiropractors demonstrated
      twice as much interest proportionately compared to all other members of the
      profession. CONCLUSIONS: Reasons for the minimal interest in chiropractic history
      are considered, and recommendations for increasing historical interest and
      scholarship are provided.

PMID- 1634855
TI  - Scapholunate failure: a long term clinical follow-up.
AB  - Rotary subluxation of the carpal scaphoid is a rare condition that may lead to
      collapse of the wrist. The subluxation is the result of disruption of the
      scapholunate interosseous ligament, often secondary to scaphoid fracture or
      significant trauma. The characteristic clinical and radiographic findings are
      discussed. Controversy exists regarding treatment, but lack of treatment
      predisposes the wrist to degenerative changes. A case report is discussed which
      illustrates the salient features of this condition.

PMID- 1634856
TI  - The fixed response objective structured clinical examinations: a useful adjunct
      for assessing competence in diagnostic decision making?

PMID- 1634857
TI  - Assessment of cervical vertigo.

PMID- 1634858
TI  - The superior intracapsular ligament of the sacroiliac joint: presumptive evidence
      for confirmation of Illi's ligament.

PMID- 1634859
TI  - Influence of substrate on retraction of neurites following electrical activity of
      leech Retzius cells in culture.
AB  - 1. The aim of these experiments was to determine how electrical stimulation of
      identified neurones in culture influences their growth on defined substrates.
      Single Retzius cells isolated from the central nervous system (CNS) of the leech
      were plated in culture dishes coated with the plant lectin Concanavalin A or with
      extracellular matrix extract containing leech laminin to promote neurite
      outgrowth. Stimuli were applied by a fine tungsten microelectrode placed close to
      the cell surface. The efficacy of electrical stimulation was checked occasionally
      by recording intracellularly with a microelectrode. 2. After the period of
      stimulation had ended, there was a short delay before neurones plated on leech
      laminin retracted their neurites. Of 112 neurones, only 11 failed to respond to
      stimulation. Neurite retraction in each cell was non-uniform, some processes
      retracting while others did not. After having retracted, most neurites
      subsequently showed clear regrowth. The degree of retraction depended on the
      duration of the stimulus train: whereas a few minutes was sufficient to produce
      observable effects, prolonged periods of stimulation caused more extensive
      retraction. Trains of impulses at 4 s-1 were equally effective when they were
      delivered in intermittent bursts or continuously. 3. The time in relation to
      growth at which stimuli were applied was of critical importance. Neurones
      stimulated during the phase of rapid outgrowth on leech laminin did not retract
      their neurites, which continued to elongate during and after stimulation.
      Neurones that had not retracted during the early phase were stimulated again
      later, when extension and outgrowth of neurites had ceased or slowed. At this
      stage stimulation was followed by retraction and subsequent regrowth. 4. Retzius
      cells plated on a substrate of Concanavalin A instead of leech laminin failed to
      show any retraction after stimulation. 5. To investigate the possible role of
      Ca2+, cells were grown with raised concentrations of Mg2+ in the bathing fluid.
      Raised [Mg2+] did not influence the rate or the extent of neurite outgrowth. It
      reduced, but did not block, the effects of electrical stimulation. Earlier
      experiments have shown that growth on Concanavalin A occurs without obvious Ca2+
      entry following stimulation. Together with the present experiments, the results
      suggest that Ca2+ entry following impulses in cells grown on laminin is
      responsible for the massive retraction.

PMID- 1634860
TI  - Degenerative changes in the structure of neuromuscular junctions of Manduca sexta
      during metamorphosis.
AB  - During the degenerative processes that precede and accompany metamorphosis of the
      larval mesothoracic dorsal longitudinal muscles of Manduca sexta, the motor
      nerves and neuromuscular junctions undergo a variety of structural changes that
      are largely secondary to the changing morphologies of their respective glia. In
      the central region of the main motor nerve, the multiple layers of glial
      processes surrounding each of the large axons withdraw, leaving them apposed. In
      the peripheral region of the main motor nerve and in the secondary and tertiary
      nerve branches supplying the muscle, the outer glial processes of the nerve
      sheath and those that loosely wrap accompanying small neurosecretory axons all
      swell. Phagocytic cells and cells of unknown function invade the outer region of
      the nerve. In the neuromuscular junctions, the glial cells withdraw their
      processes from a complicated interdigitation with processes from the muscle fiber
      and from their relationship with the nerve terminal. As degeneration proceeds,
      this allows a greater area of contact between each nerve terminal and the muscle
      fiber. Within each junction there is a mixture of both functional and non
      functional regions and active zones, as determined by both thin-section and
      freeze-fracture observations. No correlation was found between the degree of
      degeneration of a neuromuscular junction and its association with a particular
      muscle fiber or its position on the fiber relative to the origin or insertion.

PMID- 1634861
TI  - Gas exchange, metabolite status and excess post-exercise oxygen consumption after
      repetitive bouts of exhaustive exercise in juvenile rainbow trout.
AB  - Juvenile rainbow trout (approximately 6 g) were exercised to exhaustion in two 5
      min bouts given 6 h apart. Resting levels of whole-body lactate and glycogen were
      restored prior to the second bout. The rate of O2 consumption increased about
      threefold 5 min after each bout of exercise, while recovery time decreased from 4
      h after the first bout to 2-3 h after the second. The excess post-exercise oxygen
      consumption, i.e. 'oxygen debt', was significantly reduced by 40% after the
      second exercise bout, despite almost identical rates of lactate clearance and
      glycogen resynthesis. The rates of CO2 and ammonia excretion increased sixfold
      and threefold, and recovery times decreased from 4-6 h to 3 h and from 3 h to 1.5
      h, respectively. After the first bout, whole-body lactate levels peaked at 5 min
      post-exercise at about 8.5 times pre-exercise levels. After the second bout,
      lactate levels peaked at 0 min post-exercise and fell more rapidly during
      recovery. Whole-body glycogen levels decreased by 70% and 80% and ATP levels
      decreased by 75% and 65% after the first and second bouts, respectively, while
      glucose levels increased about 1.5-fold immediately after both bouts. Creatine
      phosphate levels decreased by 70% and 80% after the first and second bouts,
      respectively. After 6 h of recovery, creatine phosphate levels were higher after
      the second bout than after the first. These findings suggest that exhaustive
      exercise may cause a 'non-specific' increase in metabolic rate not directly
      related to the processing of metabolites, which is reduced upon a subsequent
      exercise bout. This is in contrast with the classical 'oxygen debt hypothesis',
      which states that the oxygen debt and lactate clearance are linked. Furthermore,
      it appears that two sequential exercise bouts are sufficient to induce a
      'training effect', i.e. improved rates of metabolic recovery.

PMID- 1634862
TI  - The influence of cerebellar lesions on the swimming performance of the trout.
AB  - The influence of partial cerebellar ablation on the performance of rainbow trout,
      Oncorhynchus mykiss, swimming in a water tunnel was studied. Before surgery, all
      fish maintained a steady position in the water tunnel at all speeds tested. A
      linear relationship was found between the specific velocity (body length s-1) and
      the tail-beat frequency. After partial cerebellectomy, the fish swam well in the
      tunnel at low speeds, retaining the relationship between tail-beat frequency and
      specific velocity, but they were unable to maintain a steady position at water
      speeds requiring tail-beat frequencies above 3.5 s-1 and were swept backwards.
      Two sham-operated fish swam at all water speeds tested. Post mortem histological
      investigation showed that the lesions were restricted to the cerebellar corpus.
      We conclude that the cerebellum plays no role in the generation of motor
      programmes but may be essential for their selection and implementation.

PMID- 1634863
TI  - Cardiovascular responses of the red-blooded antarctic fishes Pagothenia
      bernacchii and P. borchgrevinki.
AB  - The aim of this study was to investigate cardiac performance and cardiovascular
      control in two red-blooded nototheniid species of antarctic fishes, Pagothenia
      bernacchii (a benthic fish) and P. borchgrevinki (a cryopelagic fish), and to
      make comparisons with existing information on haemoglobin-free antarctic
      teleosts. In quiescent P. bernacchii at 0 degrees C ventral aortic pressure (PVA)
      was 3.09 kPa and cardiac output (Q) was 17.6 ml min-1 kg-1, with a heart rate
      (fH) of 10.5 beats min-1 and stroke volume of 1.56 ml kg-1. Following atropine
      treatment, Q was maintained but heart rate increased and stroke volume decreased.
      Resting heart rate resulted from an inhibitory cholinergic tone of 80.4% and an
      excitatory adrenergic tone of 27.5%. The intrinsic heart rate was 21.7 beats min
      1 at 0 degrees C. In quiescent P. borchgrevinki at 0 degrees C, PVA was 3.6 kPa,
      Q was 29.6 ml min-1 kg-1 and stroke volume was 2.16 ml kg-1. The resting heart
      rate in P. borchgrevinki of 11.3 beats min-1 resulted from an inhibitory
      cholinergic tone of 54.5% and an excitatory adrenergic tone of 3.2%. The
      intrinsic heart rate was 23.3 beats min-1. P. bernacchii maintained Q during a
      progressive decrease in water oxygen tension from 20 to 6.7 kPa, but fH was
      increased significantly. Thus, although there is cholinergic control of the
      heart, no hypoxic bradycardia was observed. Recovery from hypoxia was associated
      with increases in Q and fH; stroke volume returned to control values. PVA
      declined in recovery as total vascular resistance decreased. Hypoxic exposure
      following atropine treatment resulted in progressive increases in PVA, Q and
      stroke volume; fH decreased during the recovery period. Hypoxic exposure in P.
      borchgrevinki produced similar cardiovascular responses to those observed in P.
      bernacchii. During an acute increase in water temperature from 0 to 5 degrees C,
      P. bernacchii regulated Q and total vascular resistance. Stroke volume decreased
      as fH increased. The intrinsic heart rate had a Q10 of 1.96 over this temperature
      range. P. bernacchii maintained chronotropic inhibition up to a temperature of
      2.5-3.0 degrees C. However, by 5 degrees C this chronotropic inhibition of the
      heart rate was lost. Infusion of adrenaline into the ventral aorta of P.
      bernacchii resulted in significant increases in Q, fH, PVA and total vascular
      resistance. Infusion of adrenaline after atropine treatment caused similar
      cardiovascular changes without the change in fH. P. borchgrevinki could sustain
      swimming in a water tunnel at approximately 1 body length per second for 6-10
      min.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1634864
TI  - Responses to freezing exposure of hatchling turtles Trachemys scripta elegans:
      factors influencing the development of freeze tolerance by reptiles.
AB  - Hatchling red-eared turtles Trachemys (= Pseudemys) scripta elegans (Wied) from a
      Louisiana population display a significant ability to withstand the freezing of
      extracellular body fluids. All animals survived at least 2 h of freezing at -2.5
      or -4 degrees C. At -2.5 degrees C, survival declined to 50% after 6 h of
      freezing and no animals recovered after 24 h or longer, when mean ice content
      reached 54.7 +/- 1.4% of total body water. At -4 degrees C, all turtles recovered
      from 4 h of freezing exposure with a mean ice content of 49.6 +/- 2.4%, but
      survival dropped sharply thereafter with no animals recovering after 8 h, when
      ice content had reached 64.5 +/- 0.7%. Survival times were substantially shorter
      and percentage ice values greater than comparable values for hatchling painted
      turtles (Chrysemys picta (Schneider)) from northern populations subjected to
      identical freezing exposures. The ability to synthesize cryoprotectants in
      response to freezing was poorly developed in T. s. elegans; maximal accumulation
      of glucose was only 3.2 mumol g-1 wet mass in liver. Lactate content increased
      two- to threefold in oxygen-sensitive organs (heart and brain) during freezing,
      but levels of lactate and other putative cryoprotectants were unchanged in other
      organs. Total free amino acid content rose significantly in liver, muscle and
      blood during freezing; increased taurine concentration was primarily responsible
      for the changes in liver and blood. The capacity for freezing survival by T. s.
      elegans hatchlings from southern populations would be of limited use for
      hibernation in a cold climate, but the metabolic responses to freezing displayed
      by these animals might be enhanced by northern populations to increase their
      freeze tolerance.

PMID- 1634865
TI  - Calcium transients in identified leech glial cells in situ evoked by high
      potassium concentrations and 5-hydroxytryptamine.
AB  - We have recorded the fluorescence of Fura-2-loaded, identified glial cells in the
      neuropile of the central nervous system of the leech Hirudo medicinalis using the
      ratio of emission at 350 nm excitation to that at 380 nm excitation as an
      indicator of intracellular Ca2+ concentration ([Ca2+]i). The neuropile glial
      cells were exposed by mechanically removing the overlying ganglionic capsule and
      the neuronal cell bodies and were then impaled using a microelectrode under
      visual control to inject Fura-2 ionophoretically. The resting Ca2+ level was
      measured using digitonin or Triton to permeabilize the cell membrane at different
      external concentrations of Ca2+; it was found to vary between 5 and 79 nmol l-1
      and averaged 32 +/- 23 nmol l-1 (+/- S.D., N = 7). Raising the external K+
      concentration from 4 to 20 mmol l-1 or adding 50 mumol l-1 5-hydroxytryptamine (5
      HT) produced a rapid, reversible rise in [Ca2+]i. During prolonged exposure to
      high [K+] or 5-HT, [Ca2+]i remained high. Upon restoring normal external [K+] or
      removing 5-HT, [Ca2+]i returned to its initial resting value within 1-2 min. The
      responses of [Ca2+]i to high [K+] and 5-HT were greatly reduced in nominally
      Ca(2+)-free saline, suggesting that the [Ca2+]i transients required an influx of
      Ca2+ into the cells. In the presence of 5-HT, the rise in [Ca2+]i was accompanied
      by a decrease in the resistance and an increase in the responsiveness to K+ of
      the glial cell membrane, indicating the existence of a Ca(2+)-dependent K+
      conductance elicited by 5-HT.

PMID- 1634866
TI  - The influence of temperature on ryanodine sensitivity and the force-frequency
      relationship in the myocardium of rainbow trout.
AB  - The relationship between stimulation frequency and contraction was established
      for ventricular strips from rainbow trout heart at 5, 15 and 25 degrees C.
      Compared to mammalian species, changes in temperature had little impact on force
      development in trout ventricle at physiologically relevant stimulation
      frequencies. However, the force-frequency relationship was changed from a
      biphasic response with a minimum around 0.2 Hz at 5 and 15 degrees C to a
      monophasic decline in force with increasing frequency at 25 degrees C. Ryanodine
      reversed the negative force-frequency relationship at 25 degrees C. Potentiation
      of twitch force after a 5 min rest period was increased from 121 +/- 4% at 15
      degrees C to 209 +/- 12% at 25 degrees C. A similar augmentation was seen for the
      maximal rate of force development. Rest potentiation of both force and maximal
      rate of force development (dF/dT) was abolished by ryanodine at both 15 and 25
      degrees C. The ryanodine concentration causing a half-maximal reduction in rest
      potentiation of force was 51 nmol l-1 at 25 degrees C and 483 nmol l-1 at 15
      degrees C. Rest potentiation was maximally reduced by 10 mumol l-1 ryanodine to
      50 and 79% of the value in the absence of ryanodine at 25 and 15 degrees C,
      respectively. At 5 degrees C, rest potentiation was similar to that at 15 degrees
      C. At 5 degrees C, there was no rest potentiation of dF/dT and ryanodine did not
      reduce rest potentiation of force. Instead, rest potentiation was correlated with
      a potentiation of time to peak tension (TPT) at 5 degrees C. Thus, in trout
      ventricle, force correlates with TPT at 5 degrees C and seems to be regulated by
      a ryanodine-insensitive mechanism, while at 25 degrees C force is correlated with
      the maximal rate of force development and the sarcoplasmic reticulum appears to
      contribute significantly to excitation-contraction coupling.

PMID- 1634867
TI  - Degenerative changes in the muscle fibers of Manduca sexta during metamorphosis.
AB  - The ultrastructural changes associated with the early stages of degeneration of
      the larval mesothoracic muscle fibers of Manduca sexta were examined during the
      prepupal period and on the first day after ecdysis. Over this 5 day period, the
      muscle fibers decrease in cross-sectional area but increase in apparent surface
      area compared to the dimensions of early fifth-instar fibers. Large numbers of
      electron-dense granules or droplets are formed and extruded from the muscle
      cytoplasm into the hemolymph; this process may account for some of the decrease
      in muscle fiber mass and may represent a developmental mechanism for recycling
      nutrients. As the fibers shrink, the thick basal lamina is thrown into folds.
      Phagocytic hemocytes (granulocytes) congregate in clusters over the surface of
      the degenerating fibers and appear to remove specifically the basal lamina. The
      timely removal of the thick larval basal lamina may be essential for subsequent
      fusion of myoblasts to the residual larval myofibers. The contractile elements
      within the degenerating muscle fibers become disorganized but are not
      dysfunctional at the end of the first 12 h after the pupal ecdysis. Tracheoles
      withdraw from intimate contact with each muscle fiber in its clefts and T-tubules
      and associate in groups adjacent to it. Mitochondria appear to be degenerating.
      These structural changes are concurrent with a previously observed decline in
      resting potential and suggest that a significant change in the electrical
      properties of the muscle fibers should be expected as well.

PMID- 1634868
TI  - Nucleocapsid gene sequence of a North American isolate of viral haemorrhagic
      septicaemia virus, a fish rhabdovirus.
AB  - Viral haemorrhagic septicaemia is the most important viral disease of trout in
      Europe. The causative agent, viral haemorrhagic septicaemia virus (VHSV), a
      member of the lyssavirus genus of the rhabdoviridae family, was formerly believed
      to be confined to portions of the European continent; however in 1988, VHSV was
      isolated from adult chinook (Oncorhynchus tshawytscha) and coho (O. kisutch)
      salmon returning to two hatcheries in the northwestern part of the State of
      Washington, U.S.A. Initial fears were that the virus had been imported into North
      America, perhaps by aquaculture activities. The nucleotide and deduced amino acid
      sequences of the nucleocapsid (N) gene of one of the North American (Makah)
      isolates of VHSV were determined and compared with published sequences of a
      European reference strain of VHSV (07-71) and the Round Butte strain of
      infectious haematopoietic necrosis virus (IHNV), another salmonid fish
      rhabdovirus that is enzootic in western North America. The N gene of the Makah
      isolate of VHSV shared a similarity of 88.433% at the nucleotide level and
      94.802% at the amino acid level with the N gene of the European strain of VHSV,
      and 62.121% amino acid similarity with the N protein of IHNV. Like the European
      reference isolate, the North American isolate of VHSV showed three domains in the
      N protein, the central one being the most conserved and the likely site of
      interaction with genomic RNA. This was also the region of highest similarity with
      the amino acid sequence of IHNV. The sequence data suggested that the Makah and
      07-71 isolates were of independent origin.

PMID- 1634869
TI  - Characterization of a new picorna-like virus, himetobi P virus, in planthoppers.
AB  - Picorna-like virus particles, 29 nm in diameter, were purified from apparently
      healthy Laodelphax striatellus Fallen. The virus particles had a buoyant density
      of 1.352 g/ml in CsCl and a sedimentation coefficient of 161 s. The virus capsid
      proteins consisted of three major polypeptides of M(r)s 36,500, 33,000 and
      28,000, and three minor polypeptides. The virus contained a major ssRNA of M(r)
      2.8 x 10(6) and was also frequently associated with a minor dsRNA of M(r) 4 x
      10(6). The 3' end of the ssRNA had a poly(A) tract of about 60 adenine residues.
      The virus has been provisionally named himetobi P virus.

PMID- 1634870
TI  - Baculovirus structural proteins.

PMID- 1634871
TI  - Electrotransfection of protoplasts from tomato, wild tomato, barley and
      chrysanthemum with tobacco mosaic virus RNA.
AB  - Protoplasts isolated from tomato, wild tomato, barley and chrysanthemum were
      electrotransfected with tobacco mosaic virus (TMV) RNA under almost the same
      optimum electric conditions: five square DC pulses of 50 microseconds duration at
      500 to 800 V/cm, with the protoplasts suspended at 2 x 10(5)/ml in 0.5 M-mannitol
      containing 100 microM-MgCl2 and 10 to 20 micrograms/ml TMV RNA. ELISAs of these
      transfected protoplasts showed that the yields and the growth curves of the virus
      were quite similar, indicating a lack of host specificity in the initially
      infected cells of these plants.

PMID- 1634872
TI  - Analysis of the dsRNAs of apple chlorotic leaf spot virus.
AB  - Double-stranded RNAs were isolated from plants infected with five different
      isolates of apple chlorotic leaf spot virus (ACLSV). Analysis by PAGE and by
      Northern blot hybridization showed that six major species of viral dsRNA of
      approximately 7.5, 6.4, 5.4, 2.2, 1.1 and 1.0 kbp can be detected in infected
      plants, irrespective of the ACLSV isolate used. In addition to the dsRNA of 7.5
      kbp corresponding to the full-length genome, the size and position on the genome
      of the 2.2 and 1.1 kbp species indicate that these are very probably double
      stranded forms of subgenomic RNAs allowing the expression of the internal open
      reading frames coding respectively for the ACLSV 50K and coat proteins. The
      subgenomic messenger for the coat protein was indeed detected in total RNA
      preparations from infected plants. Surprisingly, the two most abundant dsRNA
      species, of 6.4 and 5.4 kbp, were found to be 5'-coterminal with the genomic RNA.
      A model for the expression of the genome of ACLSV and for the production of the
      molecules 5'-coterminal with the genomic RNA is presented.

PMID- 1634873
TI  - Autocatalytic activity of the tobacco etch virus NIa proteinase in viral and
      foreign protein sequences.
AB  - The small nuclear inclusion (NIa) protein of the tobacco etch virus (TEV) is
      synthesized initially as part of a genome-derived high M(r) precursor. The NIa
      protein releases itself from this genome-derived precursor by self-cleavage, or
      an autocatalytic processing event. Cleavage between specific glutamine-glycine
      dipeptides at the N and C termini generates the 430 amino acid or 49,000 M(r)
      (49K) NIa protein. The requirements of this autocatalytic release, or cis
      cleavage, were examined by constructing gene cassettes encoding the TEV NIa
      protein which could be ligated into particular locations in cDNA of the TEV
      genome and also into foreign gene DNA sequences. Using cell-free transcription
      and translation systems, polyproteins containing TEV NIa sequences were
      synthesized and assayed for (i) autocatalysis and (ii) the ability of a
      functional NIa proteinase, purified from plant tissue, to cleave in bimolecular
      or trans reactions various artificial polyproteins which contained an inactive
      form of the NIa proteinase. The NIa self-cleavage events required an active
      proteinase sequence and a consensus TEV cleavage site sequence at the N and C
      termini. These results were consistent for NIa protein sequences placed at a
      foreign TEV cleavage site or in unrelated proteins. Differences were noted in the
      trans cleavage of these sites.

PMID- 1634874
TI  - Conserved terminal sequences of rice ragged stunt virus genomic RNA.
AB  - The 5'- and 3'-terminal nucleotide sequences of the dsRNA genome segments of rice
      ragged stunt virus (RRSV), a member of the plant Reoviridae, were determined and
      compared with those published for other viruses in this family. The 5'- and 3'
      terminal regions of the RRSV plus strand RNA from all genome segments were found
      to have the same conserved hexanucleotide (5' GAUAAA---) and tetranucleotide (--
      GUGC 3') sequences, respectively. These conserved terminal sequences were
      different from those found in viruses in the Phytoreovirus and Fijivirus genera.
      This result confirms that, as already suggested, RRSV should be placed in a third
      genus.

PMID- 1634875
TI  - Secretion of fowl plague virus haemagglutinin from insect cells requires
      elimination of both hydrophobic domains.
AB  - In the present study we have investigated the role of the hydrophobic domains of
      the fowl plague virus (FPV) haemagglutinin (HA) on its intracellular transport
      and maturation in insect cells. To this end processing of full-length HA (A+) has
      been compared to that of two truncated forms lacking either the cytoplasmic
      domain and the transmembrane domain (A-) or lacking the entire HA2 subunit, i.e.
      the transmembrane domain and the fusion peptide (HA2-). All glycosylation sites
      present on A- and HA2- were glycosylated, indicating that both truncated forms
      were completely translocated in the endoplasmic reticulum. Unlike A+, A- and HA2-
      did not form trimers as indicated by cross-linking, gradient centrifugation and
      studies employing conformation-specific antibodies. Whereas HA2- was efficiently
      secreted, A- was retained in the cells in an apparently membrane-bound form. The
      data show that the carboxy-terminal transmembrane region is essential for the
      formation and stability of the trimers of the FPV HA. These observations also
      indicate that, under certain conditions, the fusion peptide of the FPV HA can
      serve as a membrane anchor.

PMID- 1634876
TI  - Oligomerization and post-translational processing of glycoprotein G of human
      respiratory syncytial virus: altered O-glycosylation in the presence of brefeldin
      A.
AB  - The post-translational maturation of the attachment G glycoprotein of human
      respiratory syncytial virus (RSV) was investigated. The G protein formed homo
      oligomers which sedimented in sucrose gradients at the same rate as the fusion F
      protein tetramer. Oligomerization of the G protein was insensitive to
      carbonylcyanide m-chlorophenylhydrazine, showing that this step occurs in the
      endoplasmic reticulum prior to O-glycosylation which initiated in the trans-Golgi
      compartment. The sedimentation of the G protein oligomer was essentially
      unchanged by the subsequent addition of O-linked sugars. This indicated that
      their contribution to the M(r) of the G protein is less than that estimated by
      electrophoretic mobility. It also suggested that O-glycosylation is not an
      important determinant of G protein oligomerization and, by implication, of
      polypeptide folding. The G protein is palmitylated. In short labelling pulses,
      the G protein accumulated as two species of 48K and 50K which contained only N
      linked sugars, whose difference in M(r) was due solely to an N-linked sugar,
      which both assembled into oligomers, but which differed in the rate of subsequent
      O-glycosylation. The G protein was not detectably O-glycosylated in the presence
      of monensin, confirming previous work. In the presence of brefeldin A (BFA), it
      accumulated as a partially O-glycosylated species (BFA-G) of 68K to 78K. But
      further analysis by chase incubations following BFA-washout, by lectin-binding,
      and by glycosidase treatment suggested that BFA-G was not a fully authentic
      processing intermediate. In particular, some of the O-linked side-chains of the
      BFA-G protein were found to be sialylated. Rather than being a normal step in
      processing, this sialylation probably was due to altered distribution or activity
      of sialyltransferases during BFA treatment and may have resulted in the premature
      termination of elongation of some of the O-linked side-chains. Thus, these
      studies (i) indicate that O-glycosylation of the G protein begins in the trans
      Golgi compartment and (ii) suggest that O-glycosylation is completed in as a
      subsequent compartment, but this latter suggestion is complicated by the evidence
      that the BFA-G protein is not a fully authentic intermediate.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1634877
TI  - Sequence analysis of the genes encoding the nucleocapsid protein and
      phosphoprotein (P) of phocid distemper virus, and editing of the P gene
      transcript.
AB  - The nucleotide and deduced amino acid sequences of two genes of phocid distemper
      virus (PDV) were determined by cDNA cloning and sequencing. The long open reading
      frame of the gene encoding the nucleocapsid (N) protein is presented. As with
      other morbilliviruses, the phosphoprotein (P) gene of PDV was found to be located
      after the 5' end of the N gene and before the 3' end of the matrix protein gene.
      The P gene was shown to have the capacity to encode three distinct proteins, P, V
      and C, in analogy to other morbilliviruses. The results presented provide
      evidence for editing of the PDV P mRNA transcript by insertion of G residues.
      When the nucleotide and deduced amino acid sequences of the N, P, V and C genes
      were aligned with corresponding sequences of other established members of the
      morbillivirus genus, compelling homology was found between PDV and canine
      distemper virus (CDV), whereas there was markedly less similarity between PDV and
      measles virus or rinderpest virus. On the basis of the alignments presented, the
      estimated amino acid sequence similarity between the N and P genes of PDV and CDV
      was 84% and 76%, respectively. These differences at the genomic level indicate
      that the viruses are two separate entities.

PMID- 1634878
TI  - Basis of neurovirulence of avirulent rabies virus variant Av01 with stereotaxic
      brain inoculation in mice.
AB  - Av01 is a variant of the challenge virus standard strain of fixed rabies virus
      that was selected with a neutralizing anti-glycoprotein monoclonal antibody, and
      has a single amino acid change in the glycoprotein. It is avirulent after both
      intracerebral and peripheral routes of inoculation in adult mice. In this study,
      Av01 was found to be neurovirulent with stereotaxic brain inoculation in either
      the striatum or cerebellum of adult mice. Mice that had been inoculated
      simultaneously with Av01 by the intracerebral and intrastriatal routes recovered.
      More infectious virus was present in the brains of mice inoculated
      intrastriatally than intracerebrally, and more neurons contained rabies virus
      antigen. However, the topographical distribution of infected neurons was similar
      with both routes. Serum neutralizing antibodies against rabies virus were
      produced later and in smaller quantities after intrastriatal inoculation. Av01 is
      probably neurovirulent after stereotaxic brain inoculation because this route
      produces both a direct site of viral entry into the central nervous system and a
      low level of immune stimulation.

PMID- 1634879
TI  - Lack of human immunodeficiency virus type 1 (HIV-1) replication and accumulation
      of viral DNA in HIV-1-infected T cells blocked in cell replication.
AB  - Human immunodeficiency virus type 1 (HIV-1) infection of the CD4+ SupT and CEM
      cell lines, blocked in cell replication by the polymerase alpha inhibitor
      aphidicolin (APC), was studied. The APC-treated cells showed a lack of viral
      production, but the presence of single cell killing. High levels of unintegrated
      viral DNA forms were found in the infected APC-treated cells as compared with
      untreated cells. Moreover, an increased rate of viral replication occurred in the
      remaining viable cells following removal of APC. The results indicate that HIV-1
      entry and reverse transcription can take place in cells blocked in the S phase of
      the cell cycle. Replication of infectious progeny virions appears to require de
      novo cell division. Finally, accumulation of viral DNA in cells during APC
      treatment can result in cytopathological effects and subsequent enhancement of
      virus production.

PMID- 1634880
TI  - Recombinant interleukin 4 stimulates human immunodeficiency virus production by
      infected monocytes and macrophages.
AB  - Recombinant interleukin 4 (IL-4) stimulated extracellular (EC) and intracellular
      (IC) production of human immunodeficiency virus (HIV) from infected human blood
      derived monocytes and macrophages when incubated with the cells after but not
      before virus inoculation. Significant stimulation was observed in 20 of 27
      experiments with monocytes (inoculated with HIV immediately after adherence) and
      10 of 13 experiments with macrophages (inoculated after 5 days adherence) using a
      total of 30 normal donors of monocytes and macrophages, and 11 recent isolates of
      monocytotropic HIV strains (after one passage in mononuclear cells). Marked
      increases in EC and IC HIV antigen were observed in some experiments, which were
      comparable with the maximal stimulatory effects of other cytokines such as IL-2.
      IL-4 also had similar effects on infectious HIV concentration as measured by
      reverse transcriptase and TCID50 assays. Antibody to IL-4 prevented the
      stimulatory effect of the cytokine. The proportion of monocytes and macrophages
      infected by HIV, as determined by in situ hybridization, also increased after
      incubation with IL-4 for 7 days. The most marked effects were observed with HIV
      infected macrophages, for which the proportion of unstimulated infected cells was
      lower (35 to 45% increasing to 66 to 70% with IL-4 treatment). There was also an
      increased proportion of cells with high granule concentrations, suggesting that
      IL-4 increases the intracellular concentration of viral nucleic acids. This was
      supported by semi-quantitative hybridization experiments showing that total HIV
      RNA increased in IL-4-stimulated monocytes 48 to 96 h after HIV inoculation. A
      marked increase in aggregates was observed on day 7 in HIV-infected monocytes
      treated with IL-4, compared to that in HIV-infected cells alone or IL-4-treated
      uninfected monocytes. These findings suggest that IL-4 stimulates HIV replication
      in the early phases of infection and may also facilitate virus transmission by
      aggregate formation.

PMID- 1634881
TI  - Low pH deforms the influenza virus envelope.
AB  - Influenza virus membrane fusion is induced by low pH, which triggers an
      irreversible conformational change in the viral haemagglutinin (HA). The result
      of this change is the extrusion of the HA fusion peptide, after which it may act
      in the fusion of virus and endosomal membranes. Here we describe electron
      microscopic observations on low pH-treated virus after negative staining or cryo
      electron microscopy of virus in the frozen hydrated state. The results indicate a
      destabilization of the virus membrane at low pH that can be reversed by returning
      the pH to neutral.

PMID- 1634882
TI  - Bovine respiratory syncytial virus nucleocapsid protein: mRNA sequence analysis
      and expression from recombinant vaccinia virus vectors.
AB  - The nucleotide sequence of the mRNA encoding the nucleocapsid (N) protein of
      bovine respiratory syncytial (BRS) virus, strain 391-2, was determined.
      Recombinant vectors containing a cDNA of the complete N gene were constructed,
      and expression of the N protein in eukaryotic cells was demonstrated using two
      different vector systems. The BRS virus N mRNA was 1197 nucleotides in length,
      exclusive of poly(A), and had a single major open reading frame that encoded a
      polypeptide of 391 amino acids with a calculated M(r) of 42.6K. The nucleotide
      and amino acid sequences of the BRS virus N gene were compared to those of human
      respiratory syncytial (HRS) virus strains A2 and 18537, and to BRS virus strain
      A51908. The level of nucleic acid identity between the N mRNA of BRS virus 391-2
      and both HRS virus subtypes was 80 to 81%, whereas the identity between the two
      BRS virus strains was 97%. A 93 to 94% level of identity was observed between the
      deduced amino acid sequences of the N protein of BRS virus 391-2 and the
      corresponding sequences of the two HRS virus strains. The two BRS virus N
      proteins differed in amino acid sequence at only three positions. Recombinant BRS
      virus N protein was expressed using two different vector systems: in cells from a
      plasmid using the vaccinia virus/T7 polymerase expression system or from a
      recombinant vaccinia virus. N proteins synthesized by the two vector systems
      migrated with an electrophoretic mobility identical to that of authentic BRS
      virus N protein, and were precipitated by anti-BRS virus antibodies.

PMID- 1634883
TI  - Castration and antisteroid treatment impair vocal learning in male zebra finches.
AB  - Both song behavior and its neural substrate are hormone sensitive: castrated
      adult male zebra finches need replacement of gonadal steroids in order to restore
      normal levels of song production, and sex steroids are necessary to establish
      male-typical neural song-control circuits during early development. This pattern
      of results suggests that hormones may be required for normal development of
      learned song behavior, but evidence that steroids are necessary for normal neural
      and behavioral development during song learning has been lacking. We addressed
      this question by attempting to eliminate the effects of gonadal steroids in
      juvenile male zebra finches between the time of initial song production and
      adulthood. Males were castrated at 20 days of age and received systemic implants
      of either an antiandrogen (flutamide), an antiestrogen (tamoxifen), or both
      drugs. The songs of both flutamide- and tamoxifen-treated birds were extremely
      disrupted relative to normal controls in terms of the stereotypy and acoustic
      quality of individual note production, as well as stereotypy of the temporal
      structure of the song phrase. We did not discern any differences in the pattern
      of behavioral disruption between birds that were treated with either flutamide,
      tamoxifen, or a combination of both drugs. Flutamide treatment resulted in a
      reduced size of two forebrain nuclei that are known to play some role unique to
      early phases of song learning [lateral magnocellular nucleus of the anterior
      neostriatum (IMAN) and area X (X)], but did not affect the size of two song
      control nuclei that are necessary for normal song production in adult birds
      [caudal nucleus of the ventral hyperstriatum (HVc) and robust nucleus of the
      archistriatum (RA)]. In contrast, treatment with tamoxifen did not result in any
      changes in the size of song-control nuclei relative to normal controls, and it
      blocked the effects of flutamide on the neural song-control system in birds that
      were treated with both drugs. Castration and antisteroid treatment exerted no
      deleterious effects on the quality of song behavior in adult birds, indicating
      that gonadal hormones are necessary for the development of normal song behavior
      during a sensitive period.

PMID- 1634885
TI  - Demonstration of motoneuron-12 sparing in cultured Manduca sexta ventral nerve
      cords.
AB  - The emergence of the adult Manduca sexta moth is accompanied by the death of half
      of the neurons present in the pupal abdominal nervous system (Truman, 1983). This
      developmental neuronal death is highly selective, so that the same neurons die at
      the same time relative to emergence in every moth. In the case of the MN-12
      motoneurons, this cell death is regulated both by hemolymph concentrations of a
      steroid hormone, 20-hydroxyecdysone, and by actions exerted by adjacent ganglia
      (Truman and Schwartz, 1984; Fahrbach and Truman, 1987). This latter effect, which
      has been previously described in isolated abdomens and in moths with transected
      ventral nerve cords, has now been reproduced under controlled culture conditions
      in which the selectivity and extent of postemergence neuronal death is comparable
      to that seen in vivo. With respect to the MN-12 neurons found in the most
      anterior unfused abdominal ganglion, A3, the pterothoracic ganglion appears to be
      the source of a factor that permits these neurons to die according to their usual
      developmental schedule.

PMID- 1634884
TI  - Directional control of neurite outgrowth from cultured hippocampal neurons is
      modulated by the lectin concanavalin A.
AB  - Cell surface carbohydrates play an important role in the regulation of neurite
      outgrowth during neuronal development. We have investigated the actions of the
      plant lectin concanavalin A (Con A), a carbohydrate-binding protein, on neurite
      outgrowth from hippocampal pyramidal neurons in primary cell culture. Neurons
      plated in culture medium containing nanomolar concentrations of Con A have a
      larger number of primary neurites arising directly from the cell soma than do
      neurons plated in culture medium alone. Furthermore, Con A causes
      counterclockwise turning of neurites in over 70% of the cultured neurons. Both of
      these effects of Con A are blocked by the hapten sugar alpha-methyl-D
      mannopyranoside, suggesting that they result from the interaction of Con A with a
      cell surface carbohydrate. Another lectin with a different sugar specificity,
      wheat germ agglutinin, does not modulate neurite outgrowth. Analysis of neurite
      outgrowth using video-enhanced microscopy reveals that the counterclockwise
      turning is accompanied by directionally biased extension of filopodia from the
      growth cones of growing neurites. Treatment of the neurons with cytochalasin,
      which disrupts actin polymerization, eliminates the neurite turning induced by
      Con A, suggesting that actin microfilaments are involved in directional control
      of neurite outgrowth.

PMID- 1634886
TI  - Modifications of motoneuron development following transplantation of thoracic
      spinal cord to the lumbar region in the chick embryo: evidence for target-derived
      signals that regulate differentiation.
AB  - In order to examine the role of target cells in the development of spinal
      motoneurons, the neural tube from thoracic segments was transplanted to the
      lumbar region on embryonic day (E) 2, and allowed to innervate hindlimb muscles
      in the chick embryo. When examined at later stages of development, the proportion
      of white and gray matter in the thoracic transplant was altered to resemble
      normal lumbar cord. Many thoracic motoneurons were able to survive up to
      posthatching stages following transplantation. The branching and arborization of
      dendrites of thoracic motoneurons innervating hindlimb muscles, as well as
      motoneuron (soma) size, were also increased to an extent approximating that seen
      in normal lumbar motoneurons. In support of previous studies using a similar
      transplant model, we have also found that the peripheral (intramuscular)
      branching pattern of thoracic motoneuron axons innervating hindlimb muscles was
      similar to that of normal lumbar motoneurons. Axon size and the degree of
      myelination of transplanted thoracic motoneuron axons were also increased so that
      these parameters more closely resembled axons of normal lumbar than normal
      thoracic spinal motoneurons. Virtually all of the changes in motoneuron
      properties noted above were observed irrespective of whether or not the
      transplanted spinal cord had developed in anatomical continuity with the host
      rostral cord. Accordingly, it is unlikely that the changes in the development of
      transplanted thoracic motoneurons reported here are induced either entirely, or
      in part, by signals derived from the host central nervous system. Rather, these
      changes appear to be mediated by interactions between the transplanted
      motoneurons and the hindlimb. We favor the notion that retrograde trophic signals
      derived from the hindlimb act to modulate the development of innervating
      motoneurons. Whether this signal involves a diffusible trophic agent released
      from target cells, or acts by some other mechanism is presently unknown.

PMID- 1634887
TI  - High vocal center growth and its relation to neurogenesis, neuronal replacement
      and song acquisition in juvenile canaries.
AB  - It is generally thought that most circuits of the adult central nervous system
      (CNS) are sculpted, in part at least, by selective elimination of some of the
      neurons present in an initial overabundant set. In this scenario, the birth of
      neurons precedes the period when brain functions, such as learning, first occur.
      In contrast to this form of brain assembly, we describe here the delayed
      development of the high vocal center (HVC) and one of its efferent pathways in
      canaries. The retrograde tracer Fluoro-Gold (FG) was injected into one of HVC's
      two efferent targets, the nucleus robustus archistriatalis (RA), to define the
      boundaries of HVC. The HVC grows markedly between 1 and 4 months, invading
      neighboring territories of the caudal telencephalon. During this same period,
      0.43%-0.64% of the HVC neurons present at 1 year of age are labeled per day of
      [3H]-thymidine injection. [3H]-Thymidine labeling is a marker of cell birth, and
      during the first 4 months HVC neuron number increases, probably accounting for
      part of the HVC growth observed. Thereafter, the number of HVC neurons remains
      constant, but neuronal birth persists. We infer from this that neuronal
      replacement starts as early as 4 months after hatching and perhaps before then.
      About half of the neurons born after posthatching day 10 grow an axon to RA to
      form the main efferent pathway exiting from HVC. HVC growth, neurogenesis,
      axogenesis, and the observed replacement of neurons happen during the period of
      juvenile vocal learning. However, the recruitment of neurons that are still
      present at 1 year shows no particular inflections corresponding to the various
      stages in song learning, and continues at essentially the same rate after the
      more stereotyped adult song has been acquired. We suggest that a combination of
      neurogenesis and neuronal replacement provides unique advantages for learning.

PMID- 1634888
TI  - Transient neonatal denervation alters the proliferative capacity of myosatellite
      cells in dystrophic (129ReJdy/dy) muscle.
AB  - It has been previously shown that transiently denervated, neonatal dystrophic
      muscle fails to undergo the degeneration-regeneration cycle characteristic of
      murine dystrophy (Moschella and Ontell, 1987). Thus, the myosatellite cells
      (myogenic stem cells) in these muscles have been spared the mitotic challenge to
      which dystrophic myosatellite cells are normally subjected early in the time
      course of the disease. By in vitro evaluation of the proliferative capacity of
      myosatellite cells derived from extensor digitorum longus (EDL) muscles of 100
      day-old genetically normal (+/+) and genetically dystrophic [dy/dy (129ReJdy/dy)]
      mice and from muscles of age-matched mice that had been neonatally denervated (by
      sciaticotomy) and allowed to reinnervate, it has been possible to directly
      determine whether the cessation of spontaneous regeneration in older dy/dy
      muscles in vivo, is due to an innate defect in the proliferative capacity of the
      myosatellite cells or exhaustion of the myosatellite cells' mitotic activity
      during the regenerative phase of the disease. This study demonstrates that
      transient neonatal denervation of dystrophic muscle (Den.dy/dy) increases the
      number of muscle colony-forming cells (MCFs) per milligram of wet weight muscle
      tissue, increases the plating efficiency, and significantly increases the in
      vitro mitotic activity of dystrophic myosatellite cells toward normal values. The
      increased mitotic capability of myosatellite cells derived from Den.dy/dy muscle
      as compared to unoperated dy/dy muscle suggests that there is no innate defect in
      the proliferative capacity of the myosatellite cells of dy/dy muscles and that
      the cessation of spontaneous regeneration in the dy/dy muscles is related to the
      exhaustion of their myosatellite cells' mitotic capability.

PMID- 1634889
TI  - Development of coordinated movement in chicks: II. Temporal analysis of hindlimb
      muscle synergies at embryonic day 10 in embryos with spinal gap transections.
AB  - Spinal neural circuits can recruit muscles to produce organized patterns of
      activity early in embryonic development. In a previous study, using multichannel
      electromyographic (EMG) recordings, we characterized burst parameters for these
      patterns in the legs of chick embryos during spontaneous motility in ovo at
      embryonic days (E) 9 and E10 (Bradley and Bekoff, 1990). Results of the study
      suggested both neural and biomechanical factors play an important role in the
      development of coordinated limb movements. In this study, to explore the
      contribution of descending neural inputs to the control of leg movements during
      motility, we applied similar methods to characterize motor patterns produced by
      the spinal cord in the absence of descending inputs. Thoracic spinal gap
      transections were performed at E2 and EMG patterns were recorded at E10. Several
      EMG features for chronic spinal embryos were similar to those for normal embryos
      and demonstrate that lumbar spinal circuits can be correctly assembled to control
      limb movements in the absence of connectivity with more rostral neural structures
      during early differentiation processes. However, certain aspects of the EMG
      patterns in chronic spinal embryos were different from patterns in normal embryos
      and provide support for conclusions drawn earlier by Oppenheim (1975).
      Specifically, our data support the view that propriospinal and/or supraspinal
      inputs function to regulate the timing of cyclic limb movements controlled by
      spinal neural circuits. Finally, we consider the possible long-term effects of
      chronic spinal gap transections as compared to acute spinal transections on the
      development of motility.

PMID- 1634890
TI  - S100 is present in developing chicken neurons and Schwann cells and promotes
      motor neuron survival in vivo.
AB  - We used polyclonal antisera recognizing S100, a small acidic protein highly
      enriched in nervous tissue, to stain sections of embryonic chicken lumbosacral
      spinal cord and hindlimb. S100 immunoreactivity was detected in developing
      sensory neurons of the dorsal root ganglia (DRG) and motor neurons of the ventral
      spinal cord as early as embryonic day (E) 5, and staining persisted through
      hatching. In contrast, expression of S100 first became apparent in Schwann cells
      at E13, just before myelination, and was not detected in developing skin or
      muscle. Since S100 beta was present in motor and sensory neurons and is known to
      promote neuronal survival and neurite extension in vitro (Winningham-Major,
      Staecker, Barger, Coats, and Van Eldik, 1989), we tested the ability of S100 to
      promote neuron survival in an in ovo survival assay. Addition of S100 to chick
      embryos in ovo during the period of naturally occurring motor neuron cell death
      resulted in a significant increase in motor neuron survival, but had no effect on
      the in vivo survival of sensory neurons in the DRG. The findings that S100 is
      present in spinal motor neurons and that the addition of S100 enhances the
      survival of these cells in vivo are consistent with the possibility that S100 may
      act as a naturally occurring neuron survival factor during development.

PMID- 1634891
TI  - Mossbauer effect studies on some bioinorganic complexes of europium.
AB  - The bioinorganic complexes of europium with N-acetyl-DL-alanine, N-acetyl-DL
      valine, and DL-alanyl-DL-alanine have been synthesized and the Mossbauer spectra
      at room temperature have been measured for these solid state complexes. The
      Mossbauer parameters indicate that the water molecules in these complexes are not
      directly linked to the central europium ion and are outside the coordination
      sphere of europium and biological ligands, and that the chemical bond between the
      europium ion and the ligands may be predominantly ionic in character, with the
      possibility of partial covalent contribution.

PMID- 1634892
TI  - On the use of iron octa-alkylporphyrins as models for protoporphyrin IX
      containing heme systems in studies employing magnetic circular dichroism
      spectroscopy.
AB  - The magnetic circular dichroism (MCD) properties of numerous oxidation and
      ligation state derivatives of myoglobin and horseradish peroxidase reconstituted
      with an iron octa-alkylporphyrin (mesoheme IX) have been investigated in order to
      establish the utility of such porphyrins as models for protoporphyrin IX
      containing systems. The MCD spectra of the mesoheme-reconstituted proteins are
      blue-shifted (4-12 nm) and are somewhat more intense (1.5-2.5 fold) when compared
      to the spectra of analogous derivatives of native myoglobin and horseradish
      peroxidase. However, the spectral band patterns of the mesoheme-reconstituted
      proteins closely resemble those of the native proteins in essentially all cases.
      These data demonstrate that octa-alkylporphyrins can be productively used as
      models for protoporphyrin IX in studies of heme proteins with MCD spectroscopy.

PMID- 1634893
TI  - Synthesis, characterization, and antitumor activity of new chloroethylamine
      platinum complexes.
AB  - A series of cis-bis-(2-chloroethylamine)platinum(II) and platinum(IV) complexes
      were synthesized and characterized by elemental analysis, IR, and 1H and 195Pt
      NMR spectroscopic techniques. Complexes were tested in vitro against murine L1210
      leukemia and human ovarian A2780 cell lines and in vivo against the L1210
      leukemia model. Some of these complexes showed excellent antitumor activity in
      both systems. However, all were inactive against cisplatin-resistant A2780/CP
      cells.

PMID- 1634894
TI  - Vascular dementia: neuropathologic alterations and metabolic brain changes.
AB  - After reviewing the concepts of dementia, in general, and vascular dementia, in
      particular, this review discusses potential future approaches that may contribute
      to an improved definition of the clinical syndrome and the neuropathological
      features of vascular dementia. Specific brain alterations in high-energy
      phosphate compounds, as measured by nuclear magnetic resonance, may contribute to
      the separation between dementias with neurodegenerative diseases and those with
      ischemic (vascular or hemodynamic) disorders.

PMID- 1634895
TI  - Transient myoclonic state with asterixis in elderly patients: a new syndrome?
AB  - We report 7 patients who developed acute co-occurrences of fragmentary
      generalized myoclonus and asterixis. All patients were elderly and had other
      chronic diseases. This condition appeared acutely, progressed over several hours
      and then disappeared in 2-3 days with diazepam administration. No sequelae were
      noted, although most cases developed recurrences. The myoclonus occurred
      spontaneously and was slightly enhanced by action. The myoclonus was widely
      distributed but predominated in the neck, shoulder girdle, and upper extremities.
      Opsoclonus was not noted. Clinically apparent myoclonus was not evoked by sensory
      stimuli. Asterixis was observed in the upper extremities in all cases. Asterixis
      like movements of the protruded tongue were also observed. Neurological findings
      other than the myoclonus and asterixis were unremarkable. Neither metabolic nor
      organic abnormalities clearly responsible for this condition were identified.
      Cerebral potentials preceding the myoclonic jerks recorded in one case suggested
      that the myoclonus may have been a spontaneous cortical myoclonus. We named this
      condition a transient myoclonic state with asterixis (TMA). Awareness of this
      syndrome is clinically important because of its benign nature, although it can
      recur.

PMID- 1634896
TI  - Delayed wallerian degeneration in the central nervous system of Ola mice: an
      ultrastructural study.
AB  - The ultrastructural features of wallerian degeneration in the optic nerves of the
      mutant mouse, C57BL/Ola, was compared with that occurring in age matched control
      mice, to determine whether the previously described defect in the peripheral
      nervous system was present in the central nervous system as well. On
      ultrastructural examination, marked delay in the rate of degeneration was seen in
      the Ola mice nerves seen most clearly at all stages up to 4 weeks post
      enucleation, following which differences progressively became undetectable. Once
      degeneration began, however, the pattern and mechanisms were similar to those
      seen in control animals, with macrophages, oligodendrocytes, and astrocytes
      apparently behaving similarly. In both the experimental animals and the controls,
      the rate of degeneration was slower than that seen in the peripheral nervous
      system. This study confirms a previous electrophysiological study that the defect
      in this mutant affects axons in both the peripheral and the central nervous
      systems.

PMID- 1634897
TI  - Contralateral early blink reflex in patients with facial nerve palsy: indication
      for synaptic reorganization in the facial nucleus during regeneration.
AB  - Fifty patients with Bell's palsy and 30 patients with etiologically different
      symptomatic peripheral facial nerve palsy were studied by means of electrically
      evoked blink reflexes 1-23 days after onset of paresis. Their results were
      compared with a normal control group of 30 healthy subjects. In a significant
      number of patients (64% in Bell's palsy and 53% in symptomatic facial nerve
      palsy) a contralateral early blink reflex response (R1) could be elicited upon
      stimulation of the normal side as compared to 13% in the control group. It is
      suggested that this result may be explained by synaptic reorganization of the
      facial nucleus leading to functional unmasking of pre-existing crossed trigemino
      facial reflex pathways during regeneration. This view is in line with previous
      experimental data in animals on the time course of structural changes in the
      facial nucleus after lesioning of the ipsilateral facial nerve.

PMID- 1634898
TI  - Effects of astrocytes, insulin and insulin-like growth factor I on the survival
      of motoneurons in vitro.
AB  - We isolated motoneurons from E15 dissociated mouse spinal cord by density
      centrifugation and planted them onto poly-ornithine-coated coverslips in a growth
      medium (DMEM/F12) supplemented with progesterone, transferrin, selenium, horse
      serum and muscle extract. Under these conditions only 28% of the motoneurons
      survived for 8 days. When living astrocytes on a separate coverslip were
      introduced into dishes containing motoneurons, there was a two-fold increase in
      neuronal survival. The addition of insulin and insulin-like growth factor I (IGF
      I) to such cultures alone or together, still further increased motoneuron
      survival, but this did not happen in the absence of astrocytes. We conclude that
      (a) astrocytes exert a trophic role in the survival of spinal motoneurons, (b)
      the effect does not require physical contact of the cells, and (c) insulin and
      IGF-1 have neurotrophic activity for motoneurons, an effect possibly mediated by
      living astrocytes.

PMID- 1634899
TI  - Myasthenia gravis: T and B cell reactivities to the beta-bungarotoxin binding
      protein presynaptic membrane receptor.
AB  - Antibodies against acetylcholine receptor (AChR) can be detected in most patients
      with myasthenia gravis (MG) and are considered to be involved in the
      immunopathogenesis of this disease. AChR are isolated from crude receptor
      preparations by binding to alpha-bungarotoxin (alpha-BuTx). Patients with MG have
      also antibodies against a second protein tentatively named presynaptic membrane
      receptor (PsmR), which has been isolated from crude receptor utilizing beta
      bungarotoxin (beta-BuTx). PsmR could represent another antigen besides AChR
      relevant for the development of MG. We have now evaluated the T cell reactivity
      to PsmR in MG and controls by analysing the frequencies of cells which in
      response to PsmR in short-term cultures secreted interferon-gamma (IFN-gamma).
      The B cell response to PsmR was analysed in parallel by counting cells secreting
      anti-PsmR antibodies. Most patients with MG had PsmR reactive T cell in blood
      with a median number of about 1 per 44,000 mononuclear cells. Cells secreting
      anti-PsmR antibodies belonging to the IgG and IgA isotypes, less frequently of
      the IgM isotype were detected in most MG patients. A positive correlation was
      found between T cells reactive with PsmR and anti-PsmR IgG antibody secreting
      cells. PsmR reactive T and B cells were also detected in control patients, but at
      much lower numbers. Our results indicate that MG is accompanied by T as well as B
      cell responses to PsmR, in addition to the previously recognized responses to
      AChR. It remains to be shown whether these PsmR reactivities are of pathogenetic
      importance in MG.

PMID- 1634900
TI  - Myasthenogenicity in the main immunogenic region of acetylcholine receptor as
      modified by conformational design: an approach to antigenic synthetic peptides.
AB  - Myasthenogenic regions in the acetylcholine receptor (AChR) alpha-subunit were
      studied in view of the conformation-dependent B-cell epitope expected at beta
      turn and the MHC class II-restricted T-cell epitope expected at alpha-helix.
      Torpedo AChR alpha 67-76 and alpha 107-116 were synthesized as the main
      immunogenic region and the site specific for T-cell epitope in Lewis rat,
      respectively. Model peptides, synthesized by combining these natural sequence
      segments or by intervening the segment aligned as Asn-Pro-Gly-Gly (NPGG) in
      natural sequence segments, were tested in terms of antigenic conformation. The
      model peptide, alpha 107-116.alpha 67-76.alpha 107-116, was immunogenic in the
      induction of the animal model of myasthenia, accompanied by the anti-peptide
      antibody cross-reactive with the native AChR. High antigenicity in antibody
      assays for various peptide- and native AChR-immunized rats was found when the
      model peptides, alpha 107-116.alpha 67-76 and/or alpha 107-116.NPGG.alpha 67-76
      were used for measurement as antigens. Antigenic conformation for the induction
      of the disease may thus be different from that for the reactivity to antibody.

PMID- 1634901
TI  - 31P-NMR spectroscopy of skeletal muscle in Becker dystrophy and DMD/BMD carriers.
      Altered rate of phosphate transport.
AB  - Muscle energy metabolism was studied by phosphorus nuclear magnetic resonance
      spectroscopy (31P-NMR) in 6 patients with Becker dystrophy, and in 24 female
      DMD/BMD carriers (n = 18) and non-carriers (n = 6). At rest all patients showed a
      high Pi/PCr ratio due to low PCr and high Pi contents, and a high intracellular
      IpH. 31P-NMR of carriers and non-carriers did not differ from controls. In
      patients and carriers in-magnet exercise revealed a reduced ability to perform
      work and Pi/PCr ratios higher than controls for comparable relative levels of
      steady-state work. Post-exercise Pi recovery was found abnormal in patients and
      in carriers. The 31P-NMR abnormalities found in the working muscle of both BMD
      patients and female DMD/BMD carriers indicate a defect of phosphate metabolism
      that, be it primary or secondary, reflects a deficit of energy metabolism.

PMID- 1634902
TI  - Development of HTLV-I-associated myelopathy after blood transfusion in a patient
      with aplastic anemia and a recipient of a renal transplant.
AB  - We report the development of rapid progressive HTLV-I-associated myelopathy (HAM)
      after blood transfusion in two immunosuppressed patients, one of whom had
      aplastic anemia and the other was the recipient of a renal transplant receiving
      immunosuppressive chemotherapy. Spastic paraparesis developed 11 or 16 months
      after transfusion and rapidly progressed to a wheelchair-bound state. The present
      2 cases suggest that the coexistent immunosuppression may play an important role
      in the rapid development of HAM in transfusion-acquired cases.

PMID- 1634903
TI  - Guillain-Barre syndrome associated with high titers of anti-GM1 antibodies.
AB  - We found high titers of anti-GM1 antibodies (1/1280 or more) in 3 of 14
      consecutive patients (21%) with Guillain-Barre syndrome (GBS) and in 2 additional
      patients who developed GBS, 10-11 days after starting parenteral treatment with
      gangliosides. Antibodies were IgG in 4 patients and IgM in one, and they all
      bound to asialo-GM1, and, in 3, to GD1b as well. Although the clinical features
      in all the patients with high anti-GM1 titers fulfilled the criteria for the
      diagnosis of GBS and in 4 of them, proteins but not cells were elevated in
      cerebrospinal fluid, electrodiagnostic studies in 3 patients showed prominent
      signs of axonal degeneration, that in one case were confirmed by morphological
      studies on sural nerve biopsy. No recent antecedent infection was reported by
      these patients, but in 3, including patients treated with gangliosides, anti
      Campylobacter jejuni antibodies were elevated. In 3 patients a consistent
      decrease in anti-GM1 levels was observed after the acute phase of the disease
      suggesting that the frequent occurrence of these antibodies in patients with GBS
      and their frequent association with a prominent axonal impairment may have
      pathogenetic relevance.

PMID- 1634904
TI  - Effects of exogenous monounsaturated fatty acids on fatty acid metabolism in
      cultured skin fibroblasts from adrenoleukodystrophy patients.
AB  - The conversion of [1-14C]16:0 to very-long-chain saturated fatty acids (VLCSFA)
      was greater in fibroblasts from adrenoleukodystrophy (ALD) patients than
      fibroblasts from normal subjects. Added 23:1(n-9) decreased the formation of
      VLCSFA from [1-14C]16:0 in ALD fibroblasts to the value found in normal
      fibroblasts. Chain-elongation as well as extensive chain-shortening of added
      20:1(n-9), 22:1(n-9), 23:1(n-9) and 24:1(n-9) occurred in both normal and ALD
      fibroblasts, with chain-shortening being less in ALD than in normal fibroblasts.
      Added 18:1(n-9) together with 22:1(n-9) reduced the levels of both VLCSFA and
      total n-6 and n-3 polyunsaturated fatty acids (PUFA) in normal and ALD
      fibroblasts. The levels of total (n-6) and (n-3) PUFA but not the levels of
      VLCSFA were readily restored by culturing the cells in the presence of 18:1(n-9),
      22:1(n-9), 18:2(n-6) and 18:3(n-3). The results are consistent with added
      monounsaturated fatty acids reducing levels of VLCSFA in ALD fibroblasts by
      depressing their biosynthesis from 16:0. They also support the use of oils rich
      in long chain monoenes as a dietary therapy for ALD patients but caution that the
      PUFA status of ALD patients should be monitored with a view to dietary
      supplementation, if necessary, with PUFA.

PMID- 1634905
TI  - Dopaminergic insufficiency reflecting cerebral ageing: value of a dopaminergic
      agonist, piribedil.
AB  - Amongst the various disturbances of neurotransmission accompanying cerebral
      ageing, dopaminergic insufficiency is undoubtedly the most constant, the earliest
      and the most severe. It affects the three ascending dopaminergic systems and may
      explain many of the motor, emotional, affective and cognitive disorders
      associated with cerebral ageing. In particular, the psychobehavioural syndrome of
      cerebral ageing is marked by disorders affecting the capacities for abstraction,
      conceptualization, reasoning, elaboration of strategies and problem-solving and
      therefore analogous to those of frontal symptomatology. They probably reflect
      disafferentation of the frontal lobe, deprived of effective dopaminergic
      innervation. This hypothesis is supported by the beneficial effects of the
      dopaminergic agonist piribedil on symptoms of cerebral ageing, particularly on
      the psycho-behavioural changes.

PMID- 1634906
TI  - Retinal dopaminergic receptor affinity and ocular pharmacokinetic profile of
      piribedil.
AB  - Binding studies on retinal dopamine receptors have revealed the existence of both
      D1 and D2 receptors. Human retina micro-autoradiographs confirm the distribution
      of dopaminergic receptors in the plexiform layers. Piribedil, a dopaminergic
      agonist, is able to bind to D2 receptors, while its metabolite (S584)
      preferentially displaces D1-specific radioligands. These results demonstrate that
      piribedil has a dopamine-like pharmacological profile including direct
      interaction with receptors. When instilled into the rabbit eye, piribedil
      penetrates rapidly and accumulates in the pigmented epithelia--the iris ciliary
      body and chorioretina--before being rapidly cleared. Macro-autoradiographs
      confirm this distribution and show the levels to be compatible with the affinity
      of piribedil for retinal dopaminergic receptors.

PMID- 1634907
TI  - Parkinson's disease: pathological mechanisms and actions of piribedil.
AB  - The cause of the degeneration of dopamine-containing cells in the zona compacta
      of the substantia nigra in Parkinson's disease remains unknown. The ability of
      the selective nigral toxin 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP)
      (via its metabolite MPP+) to destroy nigral dopamine cells selectively by
      inhibiting complex I of the mitochondrial energy chain may provide a clue.
      Indeed, recent studies of post-mortem brain tissue have suggested the presence of
      an on-going toxic process in the substantia nigra in Parkinson's disease leading
      to excess lipid peroxidation. This appears also to involve a disruption of
      mitochondrial function since mitochondrial superoxide dismutase activity is
      increased and there is impairment of complex I. These changes may in turn relate
      to a selective increase in the total iron content of substantia nigra coupled to
      a generalised decrease in brain ferritin content. Piribedil is used in the
      symptomatic treatment of Parkinson's disease and is particularly effective
      against tremor. Piribedil (and its metabolites) acts as a dopamine D-2 receptor
      agonist. However, in our studies in contrast to other dopamine agonists, in vivo
      piribedil interacts with dopamine receptors in the substantia nigra and nucleus
      accumbens but not those in the striatum. In patients with Parkinson's disease the
      beneficial effects of piribedil may be limited by nausea and drowsiness. Indeed,
      in MPTP-treated primates piribedil reverses motor deficits but marked side
      effects occur. However, pre-treatment with the peripheral dopamine receptor
      antagonist domperidone prevents the unwanted effects and piribedil produces a
      profound and longer-lasting reversal of all components of the motor
      syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634908
TI  - Effect of a dopaminergic agonist, piribedil (Trivastal 50 mg LP), on visual and
      spatial integration in elderly subjects.
AB  - Dopamine acts as a neuromodulator in the retina. Dopaminergic deficiency of any
      origin, as observed in elderly subjects, is associated with altered visual
      performances, and more specifically with altered perception of contrasts. The
      goal of this study was to compare contrast vision in elderly subjects and young
      subjects (first phase, n = 20), then to compare this function in elderly subjects
      before and after 3 months of treatment with a dopaminergic agonist, piribedil
      (Trivastal 50 mg LP), administered once daily (second phase, n = 20). The
      perception of contrast was analysed using a test measuring sensitivity to colour
      contrast yielding threshold values for sensitivity to contrast in eight spatial
      frequencies and three colours (red, green, blue) and in two directions
      (horizontal and vertical). The results of the first phase of the study
      demonstrated that elderly subjects showed a decrease in contrast perception in
      comparison with young subjects, primarily in the high frequency range, and over
      the full range of stimulation for direction and colour. In the second phase,
      elderly subjects, in comparison with young subjects, showed altered visual
      contrast, again in the high frequency range, but also in the low frequency range
      for horizontal simulation with red and blue. After 3 months of treatment with
      piribedil the mean contrast sensitivity threshold, over the entire frequency
      range, had significantly increased (P less than 0.05) for all stimulations, apart
      for red in the vertical direction. These results underline the value of treatment
      with a dopaminergic agonist, piribedil in visual disturbances in patients with
      dopaminergic deficiency (Parkinson patients or elderly subjects).

PMID- 1634909
TI  - Activity and acceptability of piribedil in Parkinson's disease: a multicentre
      study.
AB  - Several controlled trials have shown that the dopamine agonist, Trivastal
      (piribedil), is active in the treatment of Parkinson's disease, particularly with
      regard to tremor. To determine its efficacy as monotherapy in patients previously
      untreated with levodopa, a 3-month multicentre study was conducted with Trivastal
      50 mg LP in 113 patients with idiopathic Parkinson's disease. The study
      population consisted of 66 men and 47 women, aged 63.1, SD 0.6 (43-79) years with
      a 2.1, SD 0.2 (1-15) year history of Parkinson's disease. Mean disease stage was
      1.82 (1-4) by the Hoehn and Yahr classification. Tremor was the predominant
      clinical feature in 42 patients; the remaining 71 patients displayed the full
      parkinsonian syndrom. Trivastal 50 mg LP was prescribed stepwise up to doses of
      150-250 (207, SD 6.4) mg/day at the end of 3 months. No concomitant anti
      parkinsonian medication was given. Patients were clinically assessed at 1, 2 and
      3 months on the Webster scale, a specific tremor scale and the HARD depression
      scale. Mean results were as follows in the 90 patients completing the study. On
      the Webster scale, tremor fell from 1.7 to 1 (-41%, P less than 0.001),
      bradykinesia from 1.5 to 0.8 (-47%, P less than 0.001) and rigidity from 1.3 to
      0.9 (-31%, P less than 0.001); on the specific scale, rest tremor decreased in
      daily duration and amplitude from 3.9 to 2.4 (-39%, P less than 0.001) and from
      2.9 to 2.1 (-35%, P less than 0.001), respectively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1634910
TI  - Deterioration of dopaminergic pathways and alterations in cognition and motor
      functions.
AB  - Degeneration of central dopaminergic neurons is the most characteristic
      pathological feature of Parkinson's disease. It remains to be established to what
      extent these lesions explain the motor, cognitive and affective disorders
      observed in patients, but there are now some interesting clues to a possible
      solution.

PMID- 1634911
TI  - Predictive testing for inherited mutations in cancer-susceptibility genes.

PMID- 1634912
TI  - Combined modality therapy of rectal cancer: decreased acute toxicity with the
      preoperative approach.
AB  - PURPOSE: We compared the combined radiation therapy (RT) plus chemotherapy
      segments of two separate parallel phase I trials to determine if combined pelvic
      RT, fluorouracil (5-FU), and high-dose leucovorin (LV) had less acute toxicity
      when delivered preoperatively versus postoperatively in patients with rectal
      cancer. PATIENTS AND METHODS: Patients with unresectable disease received
      preoperative RT plus LV and 5-FU followed by surgery and postoperative LV and 5
      FU. Patients with resectable disease received identical doses, techniques, and
      schedules of RT and LV and 5-FU except all therapy was delivered postoperatively.
      On day 1, patients received LV and 5-FU times one cycle. RT began on day 8. A
      second cycle of LV and 5-FU was given concurrently with the fourth week of RT.
      RESULTS: Although more patients (75% v 32%; P = .02) received the higher dose
      level of 5-FU (250 mg/m2), significantly fewer experienced acute grade 3 to 4
      toxicity with preoperative versus postoperative therapy (13% v 48%; P = .045).
      There was no grade 3 to 4 myelosuppression in either group. The two grade 3
      toxicities in the preoperative group were gastrointestinal. The grade 3
      toxicities in the postoperative group included seven gastrointestinal and two
      genitourinary; four patients had a grade 4 toxicity. CONCLUSION: Given the high
      incidence of grade 3 to 4 toxicity also reported in the postoperative combined
      modality adjuvant randomized trials, future adjuvant trials should explore the
      preoperative approach.

PMID- 1634913
TI  - Randomized comparison of cisplatin plus fluorouracil and carboplatin plus
      fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head
      and neck: a Southwest Oncology Group study.
AB  - PURPOSE: The Southwest Oncology Group (SWOG) conducted a randomized comparison of
      cisplatin plus fluorouracil (5-FU) and carboplatin plus 5-FU versus single-agent
      methotrexate (MTX) in patients with recurrent and metastatic squamous-cell
      carcinoma (SCC) of the head and neck. The primary objective was to compare
      separately the response rates of each combination regimen to standard weekly MTX.
      PATIENTS AND METHODS: Two hundred seventy-seven patients diagnosed with SCC of
      the head and neck were randomized to one of three treatments: (1) cisplatin 100
      mg/m2 intravenously (IV) on day 1 and 5-FU 1,000 mg/m2 per day for a 96-hour
      continuous infusion repeated every 21 days; (2) carboplatin 300 mg/m2 IV on day 1
      and 5-FU 1,000 mg/m2 per day for a 96-hour continuous infusion repeated every 28
      days; and (3) MTX 40 mg/m2 IV given weekly. RESULTS: All three treatment regimens
      were well tolerated. However, both hematologic and nonhematologic toxicities were
      significantly greater with cisplatin plus 5-FU compared with MTX (P = .001).
      Toxicity from carboplatin plus 5-FU was intermediate compared with the other
      regimens. The complete and partial response rates were 32% for cisplatin plus 5
      FU, 21% for carboplatin plus 5-FU, and 10% for MTX. The comparison of cisplatin
      plus 5-FU to MTX was statistically significant (P less than .001), and the
      comparison of carboplatin plus 5-FU to MTX was of borderline statistical
      significance (P = .05). Median response durations and median survival times were
      similar for all three treatment groups. Logistic regression models showed that
      only treatment assigned was associated significantly with response (P = .001).
      Cox proportional hazards models indicated that only performance status was
      associated significantly with survival (P less than .01). CONCLUSIONS: We
      conclude that combination chemotherapy resulted in improved response rates but
      was associated with an increased toxicity and no improvement in overall survival.
      Therefore, new treatments that may alter the course of disease in recurrent head
      and neck cancer patients still need to be identified.

PMID- 1634914
TI  - LOPP alternating with EVAP is superior to LOPP alone in the initial treatment of
      advanced Hodgkin's disease: results of a British National Lymphoma Investigation
      trial.
AB  - PURPOSE: The purpose of this randomized trial was to compare the efficacy of
      eight cycles of chlorambucil, vincristine, procarbazine, and prednisone (LOPP)
      with four cycles of LOPP that alternate with four cycles of etoposide,
      vinblastine, Adriamycin (doxorubicin; Familitalia Carlo Erba, Ltd, UK), and
      prednisone (EVAP) in patients with advanced Hodgkin's disease. PATIENTS AND
      METHODS: Between June 1983 and December 1989, 594 patients were entered onto the
      study. Of the 594, 295 patients were allocated to receive LOPP, and 299 were
      allocated to receive LOPP/EVAP. RESULTS: The complete remission (CR) rates were
      57% and 64%, respectively, after initial chemotherapy (difference not significant
      [NS]), and 65% and 75%, respectively, after the subsequent administration of
      radiotherapy to residual masses (P less than .01). The procedure associated
      mortality in the LOPP and LOPP/EVAP arms was 1% and 3%, respectively. The
      actuarial CR relapse-free survival was significantly greater in the LOPP/EVAP arm
      (P less than .001) as was the overall survival (P less than .05). The CR relapse
      free rate, disease-free survival (DFS) rate, and overall survival rate at 5 years
      were 52%, 32%, and 66%, respectively, in the LOPP arm, compared with 72%, 47%,
      and 75% in the LOPP/EVAP arm, respectively. CONCLUSION: These results indicate
      that LOPP and EVAP is superior to LOPP alone as initial treatment for advanced
      Hodgkin's disease.

PMID- 1634915
TI  - Diffuse small cleaved-cell lymphoma: a heterogeneous disease with distinct
      immunobiologic subsets.
AB  - PURPOSE AND METHODS: Diffuse small cleaved-cell lymphoma (DSCL) is a relatively
      uncommon non-hodgkin's lymphoma (NHL) in the United States and has not been the
      subject of recent in-depth study of factors predictive of outcome. It is unique
      among the NHL of intermediate grade because there is no evidence of a curable
      subset of patients. To investigate whether any laboratory data might predict
      outcome, we studied 33 cases collected during a 12-year period and correlated
      morphology, immunohistochemistry, and serum lactate dehydrogenase (LDH) with
      clinical data and outcome. RESULTS: We found that proliferative rate (Ki-67),
      cell lineage (T v B cell), and serum LDH were associated with significant
      differences in survival. A Ki-67 value greater than or equal to 20% was
      associated with a median survival of 20 months compared with 80 months for lower
      values (P = .0002); patients with tumors of T-cell lineage had a median survival
      of 20 months compared with 40 months for those with B-cell neoplasms (P = .0143);
      and a serum LDH greater than 225 IU/L was associated with a median survival of 8
      months compared with 40 months for lower LDH levels (P = .0004). Blastoid
      morphology was also linked to a trend toward poor outcome (P = .08). Neither a
      history of low-grade lymphoma nor the presence of residual immunologically
      detectable follicles influenced outcome (P = .93 and .97, respectively).
      CONCLUSION: We conclude that high Ki-67, high LDH, and T-cell lineage each
      identify DSCL patients with poor outcome.

PMID- 1634916
TI  - Abrogating chemotherapy-induced myelosuppression by recombinant granulocyte
      macrophage colony-stimulating factor in patients with sarcoma: protection at the
      progenitor cell level.
AB  - PURPOSE: The purpose of this study was to optimize the dose, schedule, and timing
      of recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF)
      administration that would best abrogate myelosuppression in patients with
      sarcoma. PATIENTS AND METHODS: Sarcoma patients who had experienced severe
      myelosuppression after chemotherapy with Cytoxan (cyclophosphamide; Bristol-Myers
      Squibb Co, Evansville, IN), Adriamycin (doxorubicin; Adria Laboratories,
      Columbus, OH), and dacarbazine ([CyADIC], cycle 1) were eligible. GM-CSF was
      administered during a 14-day period until 1 week before cycle 2 of CyADIC and was
      resumed 2 days after cycle 2 completion. The schedule subsequently was modified
      to allow the earlier administration of GM-CSF in which CyADIC was compressed from
      5 days to 3 days, and GM-CSF was administered immediately after the
      discontinuation of CyADIC in cycle 2. To understand better the impact of GM-CSF
      on bone marrow stem cells, the proliferative status of bone marrow progenitors
      was examined during treatment. To evaluate the effects of GM-CSF on effector
      cells, select functions of mature myeloid cells were also examined. RESULTS: In
      the seven patients who were treated on the initial schedule, GM-CSF enhanced the
      rate of neutrophil recovery; however, severe neutropenia was not abrogated, By
      using the modified schedule in 17 patients, GM-CSF significantly reduced both the
      degree and the duration of neutropenia and myeloid (neutrophils, eosinophils, and
      monocytes) leukopenia. The mean neutrophil and mature myeloid nadir counts were
      100/mm3 and 280/mm3 in cycle 1 and 290/mm3 and 1,540/mm3 in cycle 2 (P less than
      .01 and P less than .001). The duration of severe neutropenia (neutrophil count
      less than 500/mm3) and myeloid leukopenia (myeloid leukocyte count less than
      1,000/mm3) were reduced from 6.2 and 6.8 days in cycle 1 to 2.8 and 1.4 days in
      cycle 2 (P less than .001). While 16 of 17 patients experienced severe myeloid
      leukopenia (less than 500/mm3) in cycle 1, only two of 17 experienced severe
      myeloid leukopenia in cycle 2 (P less than .001). Overall, severe neutropenia was
      abrogated in seven patients, which made them eligible for dose-escalation of
      Adriamycin. The fraction of cycling progenitors increased threefold on GM-CSF and
      decreased dramatically below the baseline within 1 day of GM-CSF discontinuation.
      CONCLUSIONS: The modified schedule improved the beneficial effects of GM-CSF by
      enhancing myeloprotection and permitting dose-intensification of chemotherapy.
      The increased myeloid mass and quiescent progenitors at the initiation of
      chemotherapy suggest that GM-CSF might allow further chemotherapy dose-rate
      intensification by shortening the interval between courses.

PMID- 1634917
TI  - Effective initial therapy of advanced breast cancer with fluorouracil and high
      dose, continuous infusion calcium leucovorin.
AB  - PURPOSE: The use of leucovorin (LV) to modulate fluorouracil (FU)-mediated
      inhibition of thymidylate synthase has been shown both in vitro and in vivo to
      improve the antitumor activity of this drug. Based on our previous demonstration
      that this combination was active in heavily pretreated patients with prior FU
      exposure, we performed a phase II study of FU and high-dose intravenous calcium
      LV in patients with advanced breast cancer who had been exposed to no more than
      one prior chemotherapy regimen. PATIENTS AND METHODS: Fifty-one female patients
      with metastatic breast cancer were entered onto this trial. Patients with
      metastatic disease limited to soft tissue, lymph nodes, skin, and pulmonary
      nodules were allowed no prior chemotherapy for advanced disease. Those with
      metastases in the liver or a lymphangitic pattern on chest x-ray were allowed
      either a single prior regimen for advanced disease or no therapy for metastatic
      disease if less than 1 year had elapsed since the completion of adjuvant
      chemotherapy. FU was given daily for 5 days at 400 mg/m2/d with calcium LV, 500
      mg/m2/d, beginning 24 hours before and continuing 12 hours after the first and
      last FU doses, respectively. RESULTS: The overall objective response rate among
      45 eligible patients was 36% (95% confidence interval, 22% to 51%). Fourteen of
      31 patients in the soft tissue category responded (45%), and two of 14 in the
      visceral category experienced an objective response (14%). The median response
      duration was 5 months. Toxicities were moderate leukopenia and mucositis.
      CONCLUSIONS: FU plus LV is an active first-line regimen with antitumor efficacy
      comparable to that of the anthracyclines, which warrants further exploration in
      combination with other agents active in advanced breast cancer. FU plus LV in
      this schedule is also an excellent alternative for patients with medical
      contraindications to more intensive combination chemotherapy regimens.

PMID- 1634918
TI  - Prognostic significance of progesterone receptor levels in estrogen receptor
      positive patients with metastatic breast cancer treated with tamoxifen: results
      of a prospective Southwest Oncology Group study.
AB  - PURPOSE: Southwest Oncology Group (SWOG) protocol 8228 is a prospective trial
      designed to investigate the prognostic significance of progesterone receptor
      (PgR) levels in estrogen receptor (ER)-positive breast cancer patients who were
      treated with tamoxifen. This study was undertaken because the value of PgR
      measurements in advanced breast cancer had been assessed previously only in
      studies that were small, retrospective, or included heterogeneously treated
      patients. METHODS: Receptor assays were performed only in the laboratories that
      met strict quality control guidelines. Of the 398 patients entered, 342 patients
      were eligible and assessable for the study end points of objective clinical
      response, time to treatment failure, and overall survival. RESULTS: Multivariate
      analysis shows that elevated PgR levels significantly and independently
      correlated with increased probability of response to tamoxifen, longer time to
      treatment failure, and longer overall survival. Overall response rate (defined as
      complete response [CR], partial response [PR], or stable disease [SD] for greater
      than 6 months) in this trial was 54%. Response rates to tamoxifen were 43%, 53%,
      and 61% in subsets of patients with less than 10, 10 to 99, and more than 100
      fmol/mg PgR, respectively. Exploratory subset analysis using PgR and other
      prognostic variables identified ER-positive patient subsets with response rates
      to tamoxifen ranging from 24% (premenopausal patients) to 86% (postmenopausal
      patients with ER greater than 38 and PgR greater than 329 fmol/mg). No groups of
      ER-positive patients were identified who had such a low response rate as to
      absolutely preclude considering the use of tamoxifen. Multivariate analysis
      showed the independent, statistically significant predictors were: for response
      to tamoxifen, menopausal status, PgR, and ER; for time to treatment failure,
      menopausal status, disease-free interval (DFI), PgR, and ER; and for overall
      survival DFI, PgR, ER, site of disease, and history of adjuvant therapy.
      CONCLUSION: We conclude that knowledge of PgR levels together with other clinical
      information can improve the pretreatment assessment of ER-positive breast cancer
      patients with metastatic disease.

PMID- 1634919
TI  - Effects of mastectomy versus lumpectomy on emotional adjustment to breast cancer:
      a prospective study of the first year postsurgery.
AB  - PURPOSE: Procedure (mastectomy v lumpectomy) and choice of procedure were
      examined as predictors of adjustment to breast cancer in a prospective study of
      the experiences of the first year after surgery. PATIENTS AND METHODS: Breast
      cancer patients were interviewed the day before surgery, 10 days after surgery,
      and at the 3-month, 6-month, and 12-month follow-ups. Patients included 24 women
      who received mastectomy on strong recommendation, 24 who chose mastectomy for
      other reasons, and 15 who chose lumpectomy. Subjective well-being was assessed in
      terms of mood disturbance, perceived quality of life, life satisfaction, marital
      satisfaction, perceptions of social support, and self-rated adjustment. RESULTS:
      Surgical groups differed in well-being in only one respect: lumpectomy patients
      reported a higher-quality sex life at 6 and 12 months postsurgery than mastectomy
      patients. Choice of surgical procedure predicted higher levels of life
      satisfaction at 3 months. CONCLUSION: The lack of difference between surgical
      groups in areas other than sexual adjustment replicates previous findings, but
      extends them by (1) using a fully prospective design, (2) providing data on the
      period surrounding the surgery (as well as later periods), and (3) examining a
      broader range of indices of well-being than usual.

PMID- 1634920
TI  - Infants with neuroblastoma and regional lymph node metastases have a favorable
      outlook after limited postoperative chemotherapy: a Pediatric Oncology Group
      study.
AB  - PURPOSE: Infants less than or equal to 1 year of age with neuroblastoma (NB) have
      a favorable outlook with minimal to moderate therapy. Patients with complete or
      partial removal of the primary tumor but positive intracavitary lymph nodes
      (Pediatric Oncology Group [POG] stage C) have a higher risk for recurrent
      disease. To determine the importance of distinguishing infants with POG stage C
      NB from those with POG stage B disease and to assess the efficacy and toxicity of
      treating POG stage C infants with limited, postoperative chemotherapy, a study
      was conducted by the POG. PATIENTS AND METHODS: Forty-four eligible POG stage C
      infants received cyclophosphamide 150 mg/m2 orally on days 1 to 7 and Adriamycin
      (doxorubicin; Adria Laboratories, Columbus, OH) 35 mg/m2 intravenously (IV) on
      day 8 (CYC/ADR), every 3 weeks for five courses followed by second-look surgery.
      No continuation therapy was given if surgical and pathologic complete response
      (CR) was achieved. Secondary therapy with five courses of cisplatin 90 mg/m2 on
      day 1 followed by teniposide (VM-26) 100 mg/m2 on day 3 (CDP/VM) was given to
      infants with gross residual tumor after CYC/ADR and second-look surgery. RESULTS:
      Thirty-four infants achieved CR after CYC/ADR alone, three after CYC/ADR and
      second-look surgery, two after CYC/ADR, surgery, and maintenance therapy, and two
      after alternative treatment with CDP/VM (total CR rate, 42 of 44). The 3-year
      survival and disease-free survival are both 93%. Toxicity was nominal.
      CONCLUSIONS: Infants with POG stage C NB have a favorable outlook, which is
      similar to infants with POG stage B NB; the surgical staging procedure for
      distinguishing these infant subsets may not be necessary. Future studies should
      focus on the reduction of treatment toxicity and efficacy maintenance, and
      address methods to identify infants at risk for failure.

PMID- 1634921
TI  - Phase II study of liposomal muramyl tripeptide in osteosarcoma: the cytokine
      cascade and monocyte activation following administration.
AB  - PURPOSE: A phase II trial that uses liposome-encapsulated muramyl tripeptide
      phosphatidylethanolamine (L-MTP-PE) in patients with relapsed osteosarcoma is
      underway. To determine if in vivo cytokine induction plays a role in the
      mechanism of action of L-MTP-PE, we investigated the circulating cytokine levels
      of 16 patients who were undergoing therapy. PATIENTS AND METHODS: Patients had
      histologically proven osteosarcoma and pulmonary metastases that developed either
      during adjuvant chemotherapy or that were present at diagnosis and persisted
      despite chemotherapy. Patients were rendered disease-free by surgery. The major
      goal of the study was to improve the disease-free interval in this high-risk
      group. L-MTP-PE 2 mg/m2 was infused during a 1-hour period twice a week for 12
      weeks, then once a week for 12 weeks. Serial blood samples were collected after L
      MTP-PE administration and were assayed for cytokine levels (tumor necrosis factor
      alpha [TNF alpha] interleukin-1 alpha [IL-1 alpha], IL-1 beta, IL-6, interferon
      gamma [IFN-gamma], neopterin, C-reactive protein). RESULTS: After the infusion of
      L-MTP-PE, there was rapid induction of circulating TNF alpha and IL-6. TNF alpha
      levels peaked 1 to 2 hours after infusion in 10 of 16 patients, whereas peak IL-6
      levels were detected at 2 to 3 hours in all patients. Induction of circulating
      TNF alpha and IL-6 was evident only after the first dose of L-MTP-PE. Neither IL
      1 alpha nor IL-1 beta was detected in the plasma. Neopterin levels increased at
      24 hours postinfusion, which indicated macrophage activation, and were not
      related to the induction of circulating IFN-gamma. C-reactive protein was
      elevated in all patients at 24 hours and decreased by 72 hours. Unlike
      circulating TNF alpha and IL-6, elevations in C-reactive protein and neopterin
      could be detected throughout the treatment course. CONCLUSION: It is concluded
      that L-MTP-PE has specific biologic effects in patients with osteosarcoma that
      may be important to the drug's immunostimulatory capacity and its effectiveness
      as an antitumor agent.

PMID- 1634922
TI  - Refinement of clinicopathologic staging for localized soft tissue sarcoma of the
      extremity: a study of 423 adults.
AB  - PURPOSE: The prognostic value of factors used in clinicopathologic staging of
      localized soft tissue sarcoma (STS) of the extremity were analyzed
      comprehensively. PATIENTS AND METHODS: Four hundred twenty-three patients with
      STS that was confined to the extremity were admitted to Memorial Sloan-Kettering
      Cancer Center from 1968 to 1978. Cox models for the hazards rates of tumor
      mortality, development of a distant metastasis, strictly local recurrence, and
      postmetastasis survival were developed. Tests of changes in the prognostic value
      of the important variables over time were performed, as well as an analysis of
      the effect of a local recurrence on the hazard rate of distant metastasis.
      RESULTS: Three unfavorable characteristics contained independent prognostic value
      for the rates of distant metastasis and tumor mortality: high grade (P less than
      .00001), deep location (P less than .0002), and size greater than or equal to 5
      cm (P less than .007). Their Cox model coefficients did not differ significantly
      (P greater than or equal to .65); thus, a staging scheme based on the risk of
      ever developing a distant metastasis would assign equal prognostic weights to
      grade, depth, and size. The tumor grade effect during the initial 18 months was
      much larger in magnitude than those for depth and size, and its effect
      disappeared beyond that time (P = .0003). Thus, a staging scheme based on the
      risk of early metastatic spread would assign a distinctly larger prognostic
      weight to grade and lesser but equal weights to depth and size. There was no
      local recurrence effect on the rate of distant metastasis in the high-risk group
      (high grade, deep, and greater than or equal to 5 cm; P = .75), but there was a
      significant association among the remaining groups combined (P = .0039). The
      magnitude of this association actually increased according to the number of
      favorable characteristics presented (P = .0024). CONCLUSIONS: The refinement of
      clinicopathologic staging may depend on the choice of outcome variable: ultimate
      prognosis versus early metastatic spread. Additionally, the observed local
      recurrence effect may be explained by a tendency for some patients to acquire one
      or more unfavorable risk factors at the time of local recurrence.

PMID- 1634923
TI  - Role of technetium 99m-labeled monoclonal antibody in the management of melanoma
      patients.
AB  - PURPOSE: A study was performed to assess the usefulness of a radiolabeled
      monoclonal antibody (MoAb; technetium 99m NR-ML-05 Fab) as a detecting agent, as
      well as to evaluate its role in the overall decision-making process in the
      management of cutaneous malignant melanoma. PATIENTS AND METHODS: Twelve patients
      with histologically confirmed primary cutaneous melanoma and palpable regional
      nodes were injected with MoAb NR-ML-05 Fab, radiolabeled with 20 to 30 mCi of
      99mTc. Whole-body anterior and posterior images were obtained. Left and right
      lateral views of the head and anterior and posterior views of the chest, abdomen,
      pelvis, and extremities were obtained, as were selected single-photon emission
      computed tomographic (SPECT) views of regional lymph nodes and areas of known or
      suspected lesions. RESULTS: In nine of 12 patients, clinical and/or MoAb
      evolution identified 30 discrete sites of suspected melanoma. The remaining three
      patients showed no positive sites, and there was no evidence of metastatic
      melanoma. All 30 sites were examined microscopically, and melanoma was confirmed
      histologically in 23. The remaining seven were negative. MoAb imaging detected 21
      (true-positive) but failed to detect two (false-negative) lesions. Sensitivity
      was 91% (21 of 23); positive predictive value was 95% (21 to 22). CONCLUSIONS:
      MoAb imaging seems to provide an excellent way to obtain information with regard
      to the metastatic status of melanoma patients. Immunocytochemistry showed that
      MoAb (NR-ML-05) is as sensitive as the S-100 antibody and probably more sensitive
      than the commercially available antimelanoma antibody HMB-45.

PMID- 1634925
TI  - Interferon-alpha, zidovudine, and granulocyte-macrophage colony-stimulating
      factor: a phase I AIDS Clinical Trials Group study in patients with Kaposi's
      sarcoma associated with AIDS.
AB  - PURPOSE: To increase the hematologic tolerance of interferon-alpha (IFN alpha)
      and zidovudine combination therapy by the addition of granulocyte-macrophage
      colony-stimulating factor (GM-CSF), and to evaluate the safety, tolerance, and
      potential efficacy of the combination in patients with Kaposi's sarcoma and AIDS.
      PATIENTS AND METHODS: Seventeen patients with Kaposi's sarcoma associated with
      AIDS received zidovudine 200 mg orally every 4 hours and GM-CSF 5 micrograms/kg/d
      subcutaneously. Successive cohorts received IFN-alpha 2b at a daily subcutaneous
      dose of 5, 10, or 20 million units. The dose of GM-CSF was titrated to maintain
      the neutrophil count between 1 and 5 x 10(9) cells/L. Doses of all three drugs
      were reduced, as required, for nonhematologic toxicities. RESULTS: GM-CSF induced
      leukocytosis in all patients. On average, a dose of 1.25 micrograms/kg/d was
      sufficient to maintain the neutrophil count within the desired range. The
      combination of 20 million units of IFN-alpha with zidovudine and GM-CSF induced
      dose-limiting toxicity in four of six patients. The major side effects were
      constitutional symptoms, which included malaise, anorexia, fatigue, fever, and
      were dose-limiting in three patients. Severe anemia and/or thrombocytopenia
      developed in three patients. Seven patients (41%; 95% confidence interval [CI],
      18% to 64%) showed objective tumor regression that persisted for a median of 51
      weeks. A rapid decrease in free-serum p24 antigen levels was observed in seven
      patients who had measurable levels at baseline; the mean time required to isolate
      human immunodeficiency virus (HIV-1) from peripheral-blood cells was increased by
      7 days. The number and percentage of CD4-positive lymphocytes showed no
      significant change. CONCLUSIONS: GM-CSF prevents neutropenia induced by the IFN
      alpha and zidovudine combination and induced no adverse effects on immune
      function or HIV activity. However, nonhematologic toxicity precluded a major
      increase in the maximum-tolerated doses of IFN-alpha and zidovudine.

PMID- 1634924
TI  - Sequential chemoimmunotherapy in the treatment of metastatic melanoma.
AB  - PURPOSE: A phase II study that alternates the sequence of chemotherapy
      (carmustine [BCNU], cisplatin [CDDP], and dacarbazine [DTIC]) and biologic
      therapy (interleukin-2 [IL-2] and interferon alfa-2 alpha [alpha IFN]) was
      performed to establish a safe and efficacious way to sequence these forms of
      treatment for metastatic melanoma. PATIENTS AND METHODS: Patients who had
      measurable metastatic melanoma, a Karnofsky performance status of greater than or
      equal to 70, and no clinically significant cardiac or pulmonary dysfunction were
      eligible for entry onto this trial. Responses to treatment were assessed after a
      treatment cycle by two tumor evaluations at least 4 weeks apart. RESULTS: Forty
      two consecutive patients with metastatic melanoma were treated with this
      sequential chemoimmunotherapy. Transient thrombocytopenia and neutropenia were
      observed frequently, but neither hemorrhage nor infection occurred in any of the
      patients. Of the 42 patients, 10 achieved a complete response (24%), 14 achieved
      a partial response (33%), two achieved a minor response (5%), eight had stable
      disease (19%), and eight (19%) had progressive disease. The median time to
      disease progression for all patients was 7 months. The median survival for all
      patients entered onto the trial was 11.5 months. A vitiligo-like depigmentation
      was induced in many patients by this treatment. CONCLUSIONS: Cytotoxic
      chemotherapy can be administered safely immediately before or immediately after
      IL-2 and alpha IFN. Sequential chemoimmunotherapy administered as previously
      described yields a response rate of more than 55%. The overall survival curve
      suggests that a proportion of patients may achieve a long-term benefit from this
      treatment. Also, cutaneous depigmentation induced by this treatment suggests that
      immune modulation may contribute to the antimelanoma effect of this treatment.

PMID- 1634926
TI  - Phase I trial of thiotepa in combination with recombinant human granulocyte
      macrophage colony-stimulating factor.
AB  - PURPOSE: The ability of growth factors to stimulate marrow recovery suggests
      their potential for use in dose intensification of cytotoxic drugs. We performed
      a phase I study of the alkylating agent thiotepa in combination with granulocyte
      macrophage colony-stimulating factor (GM-CSF), with the goal of dose-escalation
      of thiotepa. Thiotepa was selected based on its capacity for dose escalation to
      more than 1 g/m2 in the marrow transplantation setting. PATIENTS AND METHODS: The
      starting dose of thiotepa (75 mg/m2) was the highest dose evaluated in our
      previous phase I trial. Thirteen patients received 22 courses of thiotepa and GM
      CSF. The dose of GM-CSF was 10 micrograms/kg subcutaneously daily in six patients
      and 5 micrograms/kg in seven patients. RESULTS: Three patients (23%) developed
      grade 3 to 4 neutropenia on the first course, with a recovery to more than
      1000/mm3 in 4.7 days (mean). Recovery was as rapid with the 5 micrograms/kg as it
      was with the 10 micrograms/kg GM-CSF dose. Thrombocytopenia grade 3 to 4 affected
      seven of 13 (54%) patients in the first course; counts recovered to more than
      50,000/mm3 in a median of 15 days. GM-CSF at either dose did not influence
      markedly the severity or duration of thrombocytopenia, and did not permit dose
      escalation of thiotepa. Among the seven patients who received a second cycle of
      treatment, six of seven experienced grade 3 or 4 thrombocytopenia that lasted a
      median of 15.5 days. Five had thrombocytopenia that lasted more than 35 days
      after one to three cycles of treatment. Plasma concentrations of thiotepa and
      tepa were measured by gas chromatography in eight patients. The plasma
      elimination of thiotepa fit a two-compartment open model with a harmonic mean
      terminal half-life of 2.44 hours. The mean total body clearance was 217.9
      mL/min/m2, and the mean steady-state volume of distribution (Vdss) was 36.8 L/m2.
      The half-life of tepa was 7.98 hours, and the ratio of the area under the plasma
      concentration versus time curve (AUC) of tepa to that of thiotepa was 0.79.
      CONCLUSIONS: These data were consistent with our previous observations at this
      dose, and indicated that the severity of toxicity in these patients was not
      explained by aberrant pharmacokinetic indices. We conclude that, independent of
      effects on neutropenia, severe and cumulative platelet toxicity precludes further
      escalation of thiotepa dose despite the use of GM-CSF.

PMID- 1634927
TI  - Methotrexate pharmacokinetics following administration of recombinant
      carboxypeptidase-G2 in rhesus monkeys.
AB  - PURPOSE: Carboxypeptidase-G2 (CPDG2) is a bacterial enzyme that rapidly
      hydrolyzes methotrexate (MTX) into inactive metabolites. As an alternative form
      of rescue after high-dose MTX (HDMTX), CPDG2 has more potential advantages than
      standard leucovorin (LV) rescue. In this study, the plasma pharmacokinetics of
      MTX with and without CPDG2 were evaluated in adult rhesus monkeys. MATERIALS AND
      METHODS: The plasma pharmacokinetics of MTX were determined in groups of animals
      that had received a 300-mg/m2 loading dose of MTX followed by a 60-mg/m2/h
      infusion during an 18-hour period. One group received CPDG2 at the end of the
      infusion, and the other group served as a control. Two additional animals with
      high titers of anti-CPDG2 antibody also were studied. RESULTS: During infusion,
      the steady-state MTX plasma concentration was 11.3 +/- 4.8 mumol/L. Without
      CPDG2, the postinfusion plasma MTX concentration remained above 0.1 mumol/L for
      more than 6 hours. After the administration of 50 U/kg of CPDG2, plasma MTX
      concentrations decreased to nontoxic levels (less than 0.05 mumol/L) within 30
      minutes. The initial half-life (t1/2 alpha) of MTX decreased from 5.8 +/- 2.1
      minutes to 0.7 +/- 0.02 minutes after enzyme administration. The postinfusion
      area under the plasma concentration time curve of MTX was 301 +/- 171 mumol/L/min
      without CPDG2 compared with 19.6 +/- 6.1 mumol/L/min with CPDG2. The
      immunogenicity studies performed indicated that although animals developed anti
      CPDG2 antibodies, none of them manifested allergic symptoms. The effectiveness of
      CPDG2 was diminished but not eliminated in animals with high titers of anti-CPDG2
      antibody. CONCLUSIONS: CPDG2 is capable of rapidly decreasing plasma MTX
      concentrations to nontoxic levels. The administration of CPDG2 seems safe, well
      tolerated, and it may be useful as an alternative to LV rescue.

PMID- 1634928
TI  - Cisplatin in gynecologic carcinosarcoma.

PMID- 1634929
TI  - Interleukin-2 therapy with or without lymphokine-activated killer-cell infusions
      for low-grade non-Hodgkin's lymphomas?

PMID- 1634930
TI  - Radiation therapy is better than chemotherapy in early-stage Hodgkin's disease?
      Not so fast.

PMID- 1634931
TI  - Interpretation of nonsignificant results.

PMID- 1634932
TI  - Annual meeting highlights: molecules with messages.

PMID- 1634933
TI  - Strontium-89 and low-dose infusion cisplatin for patients with hormone refractory
      prostate carcinoma metastatic to bone: a preliminary report.
AB  - Strontium-89 has been used for the treatment of painful bony metastases in
      patients suffering from disseminated adenocarcinoma of the prostate, with a
      variable proportion of patients obtaining clinically significant reductions in
      analgesic requirements. Based on data revealing enhancement of continuous low
      dose rate irradiation by low-dose cisplatin in murine models, a protocol using
      148 MBq (4 mCi) of 89Sr and 35 mg/m2 of cisplatin infused over 2 days, 1 and 4 wk
      after administration of the radioisotope was undertaken. Preliminary data suggest
      good pain relief with 55% of 18 patients entered thus far obtaining at least a
      50% reduction in analgesic requirements. Improvements in total alkaline
      phosphatase and serum lactate dehydrogenase have consistently been seen, with
      some patients exhibiting improvements in hemoglobin, tumor markers and bone
      scans. Toxicity appears to be mild, with no life-threatening complications. In
      particular, myelosuppression after one course of treatment was modest, but
      retreatments in two patients has resulted in grade 3 hematologic toxicity. Two
      patients developed a "pain flare" after administration of cisplatin. Further
      accrual to this study will allow more accurate determination of pain response
      rate, and improved evaluation of parameters of objective response.

PMID- 1634934
TI  - Scintigraphic assessment of MIBG uptake in globally denervated human and canine
      hearts--implications for clinical studies.
AB  - To further characterize the behavior of metaiodobenzylguanidine (MIBG) in the
      myocardium and to test the hypothesis that the denervated heart would show normal
      early uptake on MIBG due to non-neuronal localization, we examined the early and
      late distribution of 123I-labeled MIBG in normal and globally denervated canine
      and human hearts. Canine hearts were denervated by intravenous injections of 6
      hydroxydopamine, while patients were studied a mean of 4.3 mo following cardiac
      transplantation. Results in denervated hearts were compared to normal controls.
      Normal hearts showed prominent MIBG uptake on initial 5-min and 3-hr delayed
      images. Globally denervated canine hearts showed prominent uptake on initial
      images and absence of localization on delayed images, indicating complete washout
      of non-neuronally bound radionuclide. The transplanted human hearts showed no
      localization of MIBG on either early or delayed images. These results suggest
      that the non-neuronal uptake mechanism (uptake 2) is not significant in human
      myocardium. This finding has significant implications for interpreting the
      myocardial behavior of MIBG in various pathologic situations such as dilated
      cardiomyopathy.

PMID- 1634935
TI  - Evaluation of a neural-network classifier for PET scans of normal and Alzheimer's
      disease subjects.
AB  - The value of PET as an objective diagnostic tool for dementia may depend on the
      degree to which abnormal metabolic patterns can be detected by quantitative
      classification methods. In these studies, a neural-network classifier based on
      coarse region of interest analyses was used to classify normal and abnormal FDG
      PET scans. The performance of neural networks and of an expert reader were
      evaluated by cross-validation testing. When the "abnormal" class was represented
      by subjects with clinical diagnoses of "Probable Alzheimer's," the areas under
      the relative-operating-characteristic (ROC) curves were 0.85 and 0.89 for the
      neural network and the expert reader, respectively. When testing with abnormal
      subjects represented by "Possible AD" cases, ROC areas for both the network and
      the expert were 0.81. The neural network out-performed discriminant analysis. It
      is concluded that PET has potential for the detection of abnormal brain function
      in dementing diseases, and that the combination of neural networks and PET is a
      useful diagnostic tool. Despite the low-resolution "view" afforded the neural
      network, its performance was nearly equivalent to that of an expert reader.

PMID- 1634936
TI  - Reproducibility of plasma and extracellular fluid volume measurements in
      critically ill patients.
AB  - Plasma and extracellular fluid (ECF) volume measurements may provide valuable
      complementary data to the hemodynamic measurements currently used to compare
      fluid infusions in critically ill patients. To assess the reproducibility of
      plasma and extracellular fluid volume measurements in critically ill patients, we
      injected 131I-labeled albumin (10 microCi) and 35S-sodium sulfate (50 microCi),
      respectively, into 15 stable patients on two occasions 150 min apart. Plasma was
      sampled at 20, 30, and 40 min after each injection and the volume of distribution
      of each radioisotope was calculated from the extrapolated zero time counts. We
      found that plasma and ECF volume did not differ significantly between the first
      (42.4 +/- 4.7 ml/kg and 186 +/- 39 ml/kg) and second (42.8 +/- 5.5 ml/kg and 193
      +/- 48 ml/kg) measurements. Specifically, the mean difference between the two
      measurements was 0.4 +/- 3.2 ml/kg and 7 +/- 17 ml/kg respectively. We conclude
      that measurements of plasma and ECF volume are reproducible over 150 min in
      stable critically ill patients.

PMID- 1634937
TI  - The effects of carbidopa administration on 6-[18F]fluoro-L-dopa kinetics in
      positron emission tomography.
AB  - Carbidopa (L-alpha-hydrazino-alpha-methyl-b-(3,4-dihydroxyphenyl) propionic acid
      is a known inhibitor of aromatic amino acid decarboxylase. In both humans and
      monkeys, we studied the effects of carbidopa on plasma and brain kinetics of 6
      [18F]fluoro-L-DOPA (FDOPA), an analog of L-DOPA used for PET studies of the
      central dopaminergic system. Pretreatment with carbidopa resulted in increases in
      the plasma levels of FDOPA and 3-O-methyl-6-[18F]fluoro-L-DOPA (3-OMFD). Total
      striatal and cerebellar activities measured with PET were also increased.
      Furthermore, increases observed in the specific striatal activity (striatum minus
      cerebellum total activity) were correlated with increases in the plasma FDOPA
      curve. Carbidopa pretreatment did not affect the influx rate constant (K) for
      FDOPA from plasma to striatum in humans as determined by Patlak graphical
      analysis. Thus, an increase in measured striatal tomographic activity was
      secondary to the increase in plasma FDOPA levels rather than as a result of
      changes in the FDOPA influx rate constant.

PMID- 1634938
TI  - Clinical meaning of circulating antithyroglobulin antibodies in differentiated
      thyroid cancer: a prospective study.
AB  - In recent studies of patients with differentiated thyroid cancer (DTC), an
      association between the persistence of tumor and the presence of circulating anti
      thyroglobulin antibodies (TgAbs) have been described. The aim of the present
      study was to evaluate TgAb variations before and after total thyroid ablation and
      to correlate TgAb levels to the outcome of disease. Forty-three patients with DTC
      were studied (35 female, 8 male; 33 patients had papillary cancer and 10
      follicular cancer). Tumor was intrathyroid in 20 cases, had spread to the lymph
      nodes in 19 and to the lungs in 4. All patients underwent total thyroidectomy and
      131I therapy, and were then treated by suppressive doses of L-thyroxine. After a
      mean follow-up of 3.55 yr, TgAbs became undetectable in 24 patients (all were
      considered tumor-free), whereas TgAbs remained elevated in 19 cases. In 5 of
      these 19 patients, disease progression or persistence was documented (to the
      lymph nodes in three and to the lungs in two). TgAb levels were higher in
      patients with persistent disease in comparison with those tumor-free. Serum
      thyroglobulin (S-Tg) results were only elevated in the two patients with
      persistent disease in the lungs. Our data suggest that TgAbs determination may
      give some additional information to the follow-up of patients with DTC: the
      disappearance of TgAbs after therapy seems to represent a favorable prognostic
      factor, while the persistence of circulating TgAbs, particularly at high levels
      and in the absence of detectable S-Tg, may be representative of disease.

PMID- 1634939
TI  - Leukocyte scintigraphy in the diagnosis of mycotic aneurysm.
AB  - Early diagnosis of a mycotic aneurysm is critical, but often unsuspected, due to
      the insidious onset of symptoms related to occult infection. This study was
      undertaken to assess the role of leukocyte scintigraphy in establishing the
      diagnosis of mycotic aneurysm. The records of all patients with possible mycotic
      aneurysm between 1985 and 1991 were reviewed. Seven patients had leukocyte
      scintigraphy and computed tomography (CT), three also had magnetic resonance
      imaging (MRI) and three had angiography as part of the diagnostic workup. CT and
      MRI detected aneurysms in five of the seven patients, but CT scans were
      misinterpreted in two patients as indicative of abscess only. In six patients,
      infection could not be differentiated from thrombosis, seroma or hemorrhage by CT
      or MRI. Leukocyte scintigraphy was positive in all four patients with infected
      aneurysms; it was negative in two of the three noninfected aneurysms and
      equivocal in the third. Leukocyte scintigraphy provided a useful early survey
      that demonstrated evidence of infected aneurysms in four patients and identified
      other sites of infection in two patients. Leukocyte uptake complemented CT, MRI
      and angiographic findings distinguishing between seroma/hematoma and adjacent
      infection to establish a preoperative diagnosis of infected aneurysms.

PMID- 1634940
TI  - Detection of cardiovascular infections with radiolabeled leukocytes.

PMID- 1634941
TI  - Rapid gastric emptying of an oral glucose solution in type 2 diabetic patients.
AB  - Gastric emptying of a liquid glucose meal was measured with scintigraphic
      techniques in nine recently diagnosed Type 2 diabetic patients and nine sex- and
      age-matched nondiabetic control subjects. Seven of the nine Type 2 diabetic
      patients were receiving oral hypoglycemic therapy which was discontinued the
      evening prior to the study. The other two diabetic patients were taking no
      medication. The average gastric half-emptying time was 33.6 min (s.e.m. = 3.2)
      for the diabetic patients and 64.6 min (s.e.m. = 4.2) for the nondiabetic
      controls (p = 0.0005). These measurements indicate rapid gastric emptying in Type
      2 diabetic patients which may contribute to worsening of glucose control in these
      patients.

PMID- 1634942
TI  - Time course of myocardial infarction evaluated by indium-111-antimyosin
      monoclonal antibody scintigraphy: clinical implications and prognostic value.
AB  - To investigate the clinical implications of 111In-antimyosin antibody
      scintigraphy in the chronic stage of myocardial infarction, 34 studies were
      performed in 26 patients with 36 infarcts of various infarct ages. The infarcts
      were divided into three groups according to time from onset of chest pain to
      scintigraphy. Positive antimyosin images were obtained in 93% of Group I patients
      (3 days to 1 mo), 71% of Group II patients (1.5 mo to 1 yr) and none were
      obtained from Group III patients (1.5-6 yr). A negative correlation was observed
      between antimyosin uptake and the time after myocardial infarction. In Group II,
      patients with coronary artery patency and patients showing redistribution on
      exercise 201TI scintigraphy were more likely to have positive antimyosin images
      compared to patients without these features. Recurrent angina may also relate to
      chronic antimyosin uptake. Indium-111-antimyosin antibody scintigraphy may be a
      useful method in assessing the course of myocardial infarction and for the
      patient follow-up.

PMID- 1634943
TI  - Quantitative stress-redistribution thallium-201 SPECT using prone imaging:
      methodologic development and validation.
AB  - Prone 201Tl myocardial perfusion SPECT has been shown to improve left ventricular
      inferior wall counts compared to supine imaging, thus minimizing diaphragmatic
      attenuation. Prone SPECT quantitative normal limits were developed and
      prospectively applied to 36 patients who had coronary angiography. The prone
      imaging table used had a cut-out under cardiac area which increased the average
      myocardial counts by 10.7% compared to prone SPECT through the standard table.
      Overall specificity and sensitivity were 80% and 93%, respectively. For the
      right, left circumflex and left anterior descending coronary arteries, the
      specificities were 94%, 71%, and 94%; and sensitivities were 88%, 89% and 78%,
      respectively. The normalcy rate in 55 normal patients was 89%. Incidence and the
      severity of patients motion in 200 prone SPECT studies were compared to 200
      supine SPECT studies. Mild and severe motion occurred in 12% and 4% of the supine
      studies and in only 3.5% and none of the prone studies, respectively. When
      compared to supine SPECT, prone SPECT had higher (p less than 0.01) regional
      counts/pixel in the inferior wall and septum, but required an average increase of
      2.9 +/- 1.0 cm in camera to chest wall distance and resulted in a reduction of
      total myocardial counts. Prone SPECT provides an alternative approach for
      patients who cannot tolerate supine imaging. It should be considered when
      inferior wall defects on supine imaging pose a diagnostic dilemma and when motion
      on supine imaging necessitates repeat acquisition.

PMID- 1634944
TI  - Subcellular distribution and analysis of technetium-99m-MIBI in isolated perfused
      rat hearts.
AB  - To address the apparent discrepancy between cultured cells and whole heart
      preparations, Langendorff-perfused rat hearts loaded with hexakis (2
      methoxyisobutyl isonitrile) technetium (I) (99mTc-MIBI) were fractionated by a
      standard differential centrifugation method and fractional contents of 99mTc-MIBI
      were correlated with the mitochondrial marker, malate dehydrogenase (MDH), and
      mitochondrial substrates. The "cytosolic" fraction nominally contained 89% +/- 3%
      of total 99mTc-MIBI, but also contained 91% +/- 1% of total MDH activity by this
      method. Chromatographic analysis of activity in the "cytosolic" fraction
      demonstrated greater than 95% of the agent was present as the original free
      cationic complex; binding to a small molecular weight cytosolic protein was not
      involved in localization. Addition of the mitochondrial uncoupler CCCP (5 microM)
      to both "mitochondrial" and "cell fragment" pellets released up to 84% +/- 8% of
      99mTc-MIBI content and addition of the mitochondrial substrate succinate (10
      microM) in the presence of rotenone (1 microM) enhanced 99mTc-MIBI content by up
      to 139% +/- 52% over the control. These correlative data from rat hearts indicate
      that approximately 90% of 99mTc-MIBI activity in vivo is associated with
      mitochondria in an energy-dependent manner as a free cationic complex, but
      migrates during fractionation/centrifugation.

PMID- 1634945
TI  - Time course of skeletal muscle glucose uptake during euglycemic hyperinsulinemia
      in the anesthetized rabbit: a fluorine-18-2-deoxy-2-fluoro-D-glucose study.
AB  - Since skeletal muscle has been implicated as the major site of insulin
      resistance, the purpose of this study was to examine in detail the time course of
      muscle glucose uptake during the onset and maintenance of euglycemic
      hyperinsulinemia. Uptake of 18F-2-deoxy-2-fluoro-D-glucose (FDG) by the thigh
      muscle of an anesthetized rabbit was monitored by a single pair of coincidence
      photon detectors. Graphical analysis of tissue and plasma radioactivity
      concentrations was performed to derive fractional rates of FDG phosphorylation
      continuously. FDG phosphorylation rates were determined during rest (glucose 7
      mM, insulin 5-10 microU/ml) and subsequent 5-min intervals under conditions of
      euglycemic hyperinsulinemia (glucose 6-8 mM; insulin 350-400 microU/ml plasma).
      FDG phosphorylation did not increase above resting control levels until 5.5 +/-
      1.5 min after intravenous insulin administration. After 20-30 min of
      hyperinsulinemia, FDG phosphorylation and calculated glucose metabolic rates were
      increased by 50%. At 35-40 min of the clamp in place, there was a second increase
      in tracer phosphorylation which plateaued at 200% of control (p less than 0.01)
      and remained at this level for the remainder of the experiment. In conclusion, we
      have described a method for making rapid, serial estimates of insulin-mediated
      skeletal muscle glucose uptake. We suggest that appraisal of the time course of
      glucose uptake with FDG will aid in the understanding of normal and
      pathophysiologic states of insulin action in vivo.

PMID- 1634946
TI  - 5-Iododeoxyuridine increases the efficacy of the radioimmunotherapy of human
      tumors growing in nude mice.
AB  - Recently, there has been much interest in the use of radionuclide conjugated
      monoclonal antibodies for the treatment of human malignancies. One way to
      potentially maximize the therapeutic effectiveness of radioimmunotherapy would be
      to sensitize tumor cells to the radiation dose delivered by the antibody. Since
      radioimmunotherapy can potentially treat disseminated disease, including
      micrometastasis, we chose to study a halogenated pyrimidine radiosensitizer, a
      class of compounds that affect nonhypoxic cells. 5-Iododeoxyuridine, administered
      with pyrimidine metabolism modulators, increased the therapeutic effectiveness of
      radioimmunotherapy, resulting in individual cures of human tumors growing in
      BALB/c nu/nu (nude) mice. 5-Iododeoxyuridine was administered with N
      (phosphonacetyl)-L-aspartic acid and 5-fluoro-deoxycytidine plus
      tetrahydrouridine. This drug treatment was combined with radioimmunotherapy using
      131I conjugated to a monoclonal antibody, Mc5. Mc5 binds to a mucin component of
      the human milk fat globule. This antigen is expressed on the surface of MX-1
      cells, the transplantable human tumor used in this study. Tumor-bearing mice
      treated with both the drug protocol and 131I-Mc5 (540 microCi, 10
      microCi/micrograms) showed a regression in average tumor volume. The average
      tumor volume was reduced below the initial size at treatment for 50 days; two of
      five cures were obtained. Neither cures nor regressions were observed with either
      the drug or antibody treatments alone. Our results indicate the potential for
      increasing the therapeutic effectiveness of radioimmunotherapy of human solid
      tumors with halogenated pyrimidines.

PMID- 1634947
TI  - Fluorine-18-labeled monoclonal antibody fragments: a potential approach for
      combining radioimmunoscintigraphy and positron emission tomography.
AB  - Monoclonal antibody fragments labeled with 18F could be useful for PET if
      selective tumor uptake could be achieved within a few half-lives of this nuclide.
      To evaluate this possibility, the F(ab')2 fragment of Mel-14, an antibody
      reactive with gliomas and other tumors, was labeled by reaction with N
      succinimidyl-4-[18F]fluorobenzoate. The in-vitro binding properties of 18F
      labeled Mel-14 F(ab')2 were nearly identical to those observed when this F(ab')2
      was labeled by reaction with N-succinimidyl-4-[125I]iodobenzoate (18F, affinity
      constant = (6.7 +/- 1.1) x 10(8) M-1; 125I, affinity constant = (8.8 +/- 0.6) x
      10(8) M-1). The tissue distribution of the two labeled fragments was compared in
      paired-label studies performed in athymic mice with subcutaneous D-54 MG human
      glioma xenografts. Uptake of both nuclides in tumor was rapid with levels as high
      as 18.7% +/- 1.1% injected dose/g for 18F and 19.4% +/- 1.0% injected dose/g for
      125I observed by 4 hr after injection. Tumor-to-normal tissue ratios for 18F
      labeled Mel-14 F(ab')2 at 4 hr ranged between 0.8:1 for kidneys to 40:1 for
      brain. These results suggest that it may be feasible to use 18F-labeled antibody
      fragments for imaging tumors with PET.

PMID- 1634948
TI  - Relationship between quantitative tumor scintigraphy and time to metastasis in
      dogs with osteosarcoma.
AB  - Parameters that predict tumor aggressiveness or response to therapy are
      potentially useful in selecting the most appropriate treatment. In theory, the
      biologic aggressiveness of an untreated bone tumor may be reflected in bone scan
      parameters. The purpose of this study was to assess the usefulness of bone
      scintigraphy as a predictive indicator of subsequent metastasis in 25 dogs with
      primary osteosarcoma. Dogs received radiotherapy and/or intra-arterial cisplatin
      prior to limb-sparing surgery. Quantitative bone scintigraphy of the tumor was
      performed prior to treatment (25 dogs) and following treatment but prior to limb
      sparing surgery (22 dogs). All dogs developed metastasis at a median time of 202
      days (range, 41-444 days) after initiation of treatment. A statistically
      significant relationship was identified between time to metastasis and: (1) the
      radiographic tumor area, (2) the pretreatment ratio of mean counts per pixel in
      tumor-to-adjacent nontumor bone (T/NTT), and (3) the pre:post-treatment T/NTT.
      Larger tumor area and high pretreatment tumor activity were associated with
      earlier metastasis. Tumors characterized by greater decreases in scintigraphic
      uptake after treatment were associated with earlier metastasis. These data
      suggest that osteosarcomas with high pretreatment mean counts per pixel signify
      aggressive tumors subject to early metastasis.

PMID- 1634949
TI  - Diagnosis of bleeding mycotic iliac aneurysm on technetium-99m renal scan.
AB  - Since abdominal aneurysms are common in the elderly, it is not unusual to see
      incidental aneurysms on renal scintigraphy performed for other reasons. However,
      the initial discovery of a bleeding aneurysm on a renal scan in a patient with
      salmonella septicemia who has no other obvious focus of infection should be
      considered suspicious for mycotic aneurysm. A prompt diagnosis is crucial to
      avoid catastrophic outcome associated with delayed surgical intervention.

PMID- 1634950
TI  - Scintigraphic aspect of Rotor's disease with technetium-99m-mebrofenin.
AB  - A 28-yr-old male with Rotor's disease was studied with 99mTc-mebrofenin. The
      scintigraphic pattern was that of a slow liver uptake with unimpaired excretion
      and persistent visualization of the cardiac blood pool, kidneys and urinary tract
      up to 6 hr. The gallbladder was visualized at 55 min postinjection.

PMID- 1634951
TI  - Hepatic clearance of technetium-99m-iminodiacetic acid derivatives in
      hyperbilirubinemic states.

PMID- 1634952
TI  - Indium-111 imaging of an inflammatory abdominal aortic aneurysm.
AB  - Indium-111-labeled leukocyte scanning has been shown to be a highly sensitive and
      specific imaging modality in the detection of abscess formation. Leukocyte
      infiltration occurs in a variety of inflammatory states as well as some
      noninflammatory states, leading to false-positive results. We report a case of an
      inflammatory abdominal aortic aneurysm imaged by 111In. It is not clear whether
      the activity noted is due to the inflammatory nature of the aneurysm or to
      hemorrhage present within the wall of the aneurysm.

PMID- 1634953
TI  - Reversible thallium-201 perfusion defects of the septal and inferoapical segments
      in a patient with incomplete right bundle branch block and normal coronary
      angiogram.
AB  - Possible causes of reversible perfusion defect in exercise-rest 201Tl myocardial
      images in a patient with a normal coronary artery angiogram include left bundle
      branch block, coronary spasm, myocardial bridges, hypertrophic cardiomyopathy,
      mitral valve prolapse, aortic valve disease and anomalous origin of the left
      coronary artery arising from the pulmonary artery. This case is a report of a 34
      yr-old man with incomplete right bundle branch block and angiographically normal
      coronary arteries who was found to have reversible defects involving septal and
      inferoapical walls on stress-rest 201Tl-chloride myocardial imaging.

PMID- 1634954
TI  - Acute onset of cardiogenic shock associated with normal coronary arteries,
      diffuse myocardial necrosis, and rapid clinical recovery.

PMID- 1634955
TI  - Effect of patient motion on tomographic myocardial perfusion imaging.
AB  - We evaluated the effect of patient motion on inducing false-positive tomographic
      201Tl myocardial perfusion studies. The effects of the angle of camera rotation
      at which movement occurs, the direction of movement and the distance of movement
      were studied. Movement was stimulated by shifting the raw data from normal motion
      free 201Tl tomographic myocardial perfusion studies. The visual detectability of
      motion artifact was evaluated with receiver-operating characteristic curve
      analysis. The clinical importance of patient movement was determined by measuring
      the incidence of quantitative bull's-eye abnormalities induced by motion. Visual
      artifacts were more detectable and quantitative abnormalities more frequent as
      the distance of movement increased. Artifacts from 3.25 mm of movement were not
      visually detectable. Artifacts from 6.5 mm of movement were visually detectable,
      but were infrequently clinically important. Movement of 13 mm or greater
      frequently caused quantitative abnormalities. Quantitative abnormalities from
      axial movement were more frequent than artifacts from lateral movement.
      Quantitative abnormalities were more frequent when the movement occurred at the
      beginning or end. We conclude that when patients move during 201Tl tomographic
      myocardial perfusion imaging, the incidence and character of false-positive
      results depend on the angle of camera rotation at which the movement occurs, the
      direction of the movement and distance of the movement.

PMID- 1634956
TI  - Sensitivity of SPECT thallium-201 myocardial perfusion imaging to patient motion.

PMID- 1634957
TI  - Attenuation correction of thallium SPECT using differential attenuation of
      thallium photons.
AB  - The greatest limitation of 201Tl for the diagnosis of coronary artery disease
      remains the high soft-tissue attenuation of its low energy photons. However,
      thallium also emits a smaller number of higher energy photons. Since photons of
      higher energy undergo less attenuation, it was postulated that the amount of
      attenuation could be ascertained from the ratio of the low-to-high energy photon
      counts. A planar phantom was used to derive a regression equation relating
      attenuation to the count ratio of the low and high energy peaks. A three
      dimensional heart phantom was constructed and SPECT images were obtained in air
      and water. Application of the attenuation correction algorithm to the SPECT
      images of the phantom in water produced images quantitatively similar to that
      obtained in air. We conclude that by using differential photon attenuation,
      correction of 201Tl SPECT using a single order post-processing technique is
      feasible. This technique may allow for more accurate analysis of thallium
      myocardial perfusion scintigraphy.

PMID- 1634958
TI  - Of theoretical derivations and empirical evidence.

PMID- 1634959
TI  - An automated method for rotational correction and centering of three-dimensional
      functional brain images.
AB  - The display and analysis of functional brain images often benefit from head
      rotational correction and centering. An automated method was developed to align
      brain PET images into a standard three-dimensional orientation. The algorithm
      performs transverse and coronal rotational correction as well as centering of a
      brain image set. Optimal rotational correction and centering are determined by
      maximizing a bilateral hemispheric similarity index, the stochastic sign change
      criterion. Testing of this algorithm on simulated symmetrical brain image sets
      showed errors less than 1.0 degree and 0.5 pixels for rotational correction and
      centering, respectively. With actual PET data, the algorithm results correlated
      well with those obtained by visual inspection. Testing on asymmetrical brain
      image sets with simulated lesions indicated that performance of the algorithm is
      not sensitive to focal asymmetries. This automated method provides objective,
      reproducible image alignment into a standard orientation and facilitates
      subsequent data analysis techniques for functional brain images.

PMID- 1634960
TI  - Does PET offer little additional value when compared with SPECT?

PMID- 1634961
TI  - Science behind clinical PET.

PMID- 1634962
TI  - The role of gallium scanning in staging lymphoma.

PMID- 1634963
TI  - The case for calcium antagonists as first-line treatment of hypertension.
AB  - OBJECTIVES: The evidence in favour of using calcium antagonists as first-line
      treatment for hypertension was reviewed. Without performing a comprehensive meta
      analysis, an evaluation was made of the favourable effects of these agents on
      cardiovascular risk factors other than the reduction in blood pressure.
      BACKGROUND: Hypertension is a disease of the elderly, in whom calcium antagonists
      are particularly effective. These agents do not have the adverse effects on
      lipids or insulin resistance seen with thiazides or beta-blockers. MODE OF
      ACTION: Promising new data show that the development of atherosclerosis can be
      slowed by interference with endothelial and platelet mechanisms, inhibition of
      vascular smooth muscle proliferation, binding of lipoproteins and hydrolysis of
      cholesterol esters in liposomes. CONCLUSIONS: On the grounds of superior efficacy
      in the target patient population, together with favourable effects on other
      important factors in the genesis of atherosclerosis, calcium antagonists are the
      drugs of choice for first-line therapy and are also readily combined with the
      other major classes of antihypertensive drugs.

PMID- 1634964
TI  - Psychophysical derivation of the impulse response through generation of
      ultrabrief responses: complex inverse estimation without minimum-phase
      assumptions.
AB  - A new technique is presented for the psychophysical measurement of the response
      phase that requires no assumptions of the relation between the phase and
      amplitude components of the frequency response. The amplitude attenuation is
      measured by a standard threshold paradigm and is then compensated for by
      increasing harmonic strength in proportion to the visual attenuation. Then the
      phase of each frequency component is adjusted to maximize the internal response
      amplitude. The amplitude and phase values may be converted by inverse Fourier
      transformation into the estimated visual impulse response in any stable set of
      stimulus conditions and are insensitive to a wide variety of response
      nonlinearities. A key aspect of the phase measurement technique is the generation
      of a stimulus to obtain the minimum time spread of the internal response,
      creating a briefer response than for any other stimulus.

PMID- 1634965
TI  - Blind deconvolution of quantum-limited incoherent imagery: maximum-likelihood
      approach.
AB  - Previous research presented by the author and others into maximum-likelihood
      image restoration for incoherent imagery is extended to consider problems of
      blind deconvolution in which the impulse response of the system is assumed to be
      unknown. Potential applications that motivate this study are wide-field and
      confocal fluorescence microscopy, although applications in astronomy and infrared
      imaging are foreseen as well. The methodology incorporates the iterative
      expectation-maximization algorithm. Although the precise impulse response is
      assumed to be unknown, some prior knowledge about characteristics of the impulse
      response is used. In preliminary simulation studies that are presented, the
      circular symmetry and the band-limited nature of the impulse response are used as
      such. These simulations demonstrate the potential utility and present limitations
      of these methods.

PMID- 1634966
TI  - Motion recovery in light-attenuating media from image-shading variations.
AB  - One of the requirements for providing some autonomy in the operation of robotic
      vehicles is an accurate knowledge of position, orientation, and motion relative
      to nearby objects and the environment. Passive-vision sensing provides a useful
      tool for extracting such information from the images of the scene. Some
      applications, including the operation of undersea vehicles, involve working under
      artificial lighting in an attenuating medium. The extraction of motion, position,
      and orientation information requires models of image brightness that incorporate
      the effects that are due to the illumination attenuation and the illumination
      variation resulting from the motion of the light source. We investigate the
      problem of motion recovery from image-shading variations for a configuration
      common in many undersea applications. On the basis of the image model developed
      earlier [J. Opt. Soc. Am. A 8, 217 (1991)], we show that the motion of a vehicle
      can be determined in closed form by using three Lambertian planar surfaces as
      optical beacons.

PMID- 1634967
TI  - Keeping up with the PAC.

PMID- 1634968
TI  - Classification and treatment of zygomatic fractures: a review of 1,025 cases.
AB  - The treatment of zygomatic fractures varies among surgeons, and the cosmetic and
      functional results are frequently less than optimal. A treatment guideline based
      on a simple classification of zygomatic fractures is presented. The emphasis is
      placed on the indications for closed and open reduction, consistent methods of
      three-dimensional alignment and fixation, and the management of concomitant
      infraorbital rim and orbital floor fractures. Postoperative results with regard
      to infraorbital nerve and maxillary sinus dysfunction, malar asymmetry, and
      orbital complications in the treatment of 1,025 consecutive zygomatic fractures
      are presented.

PMID- 1634969
TI  - The effects of zygomatic complex fracture on masseteric muscle force.
AB  - The masseter muscle often has been implicated as a primary cause of postreduction
      displacement of the fractured zygomatic complex. However, this contention has
      never been proved. This study compared masseter muscle force in 10 male controls
      with that in 10 male patients who had sustained unilateral zygomaticomaxillary
      complex (ZMC) fractures. Calculation of muscle force was based on measured bite
      force, electromyogram, and radiographic determination of muscle vectors. It was
      found that the masseter muscle in patients with ZMC fractures developed
      significantly less force than masseter muscle in controls. Following fracture,
      the masseter force slowly increased, but at 4 weeks following surgery the
      majority of patients were still well below control levels. The results of this
      study cast uncertainty on the role of the masseter muscle in postreduction
      displacement of the fractured ZMC.

PMID- 1634970
TI  - Current concepts in the surgical management of traumatic auricular hematoma.
AB  - There has been considerable confusion in the literature regarding the proper
      treatment of auricular hematoma. This has stemmed from an inadequate
      understanding of the mechanisms involved in the formation and propagation of this
      condition. This article reviews the literature and give suggestions as to the
      proper surgical management of this problem.

PMID- 1634971
TI  - Donor site morbidity of greater auricular nerve graft harvesting.
AB  - To better understand the risks of obtaining greater auricular nerve (GAN) grafts,
      a retrospective analysis of 29 patients who underwent GAN graft procurement
      between 1985 and 1990 was conducted. No short-term morbidity was noted. Thirteen
      patients developed symptomatic nerve injuries, of which 6 reported spontaneous
      resolution in an average of 4.6 months. Three patients developed neuromas and 1
      formed a hypertrophic scar. Persistent nerve injury symptoms were well tolerated
      in all but one patient, who developed sympathetic-mediated pain.

PMID- 1634972
TI  - Maxillofacial esthetics: anthropometrics of the maxillofacial region.
AB  - Many artists, orthodontists, and surgeons have proposed guidelines for esthetic
      facial evaluation, but few have shown a scientific basis for their criteria.
      Farkas, however, made a substantial contribution to anthropometric facial
      measurements of adult whites. His raw data were used to develop a comprehensive
      set of ratios to define the esthetic face. A systematic maxillofacial evaluation
      derived from Farkas's data is presented, along with a brief description of its
      clinical application.

PMID- 1634973
TI  - Pseudocysts of the mandibular condyle.
AB  - The panoramic radiographs of 507 consecutive patients receiving comprehensive
      dental treatment were evaluated for the presence of radiolucencies in the
      mandibular condyles. Nine patients met the study criteria. Five patients had
      bilateral and four patients had unilateral circumscribed radiolucencies in the
      anterior aspect of the condyle. Computerized tomography confirmed that these
      radiolucencies were age-related anatomic variants that were accentuated and
      distorted during panoramic radiography.

PMID- 1634974
TI  - Incidence of temporomandibular joint symptoms following whiplash injury.
AB  - Recently there has been considerable litigation involving the development of
      temporomandibular joint (TMJ) pain and dysfunction following cervical
      musculoskeletal injury (whiplash). The purpose of this investigation was to
      interview, examine, and follow up patients with a diagnosis of whiplash injury to
      determine the incidence of associated temporomandibular disorders. Patients were
      divided into two categories: those with and those without radiologic evidence of
      cervical skeletal injury. In the 63 patients with radiographic evidence of
      cervical skeletal injury (group 1), none had clicking at the time of initial
      examination. In the 92 patients without positive radiographs (group 2), only one
      had clicking. At 1 month follow-up by telephone, 2 of 51 available patients in
      group 1 had developed clicking, but no new TMJ symptoms were reported by the 78
      patients in group 2 contacted by phone. Seventy percent of the initial follow-up
      group (44 patients) with radiographic evidence of injury were contacted by
      telephone at 1 year and none reported new symptoms of TMJ pain or clicking. Sixty
      five percent of the initial follow-up group without radiographic evidence of
      injury (60 patients) were interviewed and also reported no new TMJ symptoms.
      These data indicate that the incidence of TMJ pain and clicking following
      whiplash injury is extremely low, and that patients who do not have clicking on
      resolution of their initial pain/dysfunction subsequently do not develop this
      problem.

PMID- 1634975
TI  - Role of osteopromotion in experimental bone grafting to the skull: a study in
      adult rats using a membrane technique.
AB  - This study explores the effect of an osteopromotive membrane technique in a
      mature animal model on the survival of membranous and endochondral bone inlays in
      mandibular defects and membranous bone onlays on the calvarial roof. Twenty-eight
      adult male rats received fibular or mandibular inlay bone grafts to trephine
      defects in the mandibular angle, as well as mandibular disc onlay grafts to the
      parietal and frontal bone regions. The results were assessed by gross inspection
      and light microscopy after 12 weeks. Membrane use markedly promoted bone
      deposition in the defects. The membranous bone inlays showed complete
      incorporation to the margins of the defect, whereas the endochondral grafts at
      all times were covered by a thin fibrous capsule and failed to incorporate. Onlay
      grafts generally resorbed substantially, but the grafts covered by a membrane
      seemed more active, developed an increased cancellous component, and showed less
      pronounced volumetric loss. The findings confirm the fact that a biological
      difference exists between membranous and endochondral bone. They also confirm the
      osteopromotive effect of the membrane technique, and suggest that the amount of
      bone needed for transplantation can be reduced using this method.

PMID- 1634976
TI  - Effect of ibuprofen on the healing and remodeling of bone and articular cartilage
      in the rabbit temporomandibular joint.
AB  - The purpose of this study was to determine the effect of ibuprofen on the healing
      and remodeling of bone and cartilage in the temporomandibular joint of the
      rabbit. Forty-two rabbits were operated on to create a groove and a hole in the
      articular surface of both the right and left mandibular condyles. Following
      surgery, the animals were divided into three groups. Group A (12 rabbits) was
      used as a control and the animals did not receive any medication. Group B (15
      rabbits) was given a daily dose of 17 mg/kg of ibuprofen. Group C (15 rabbits)
      was given a daily dose of 34 mg/kg of ibuprofen. All animals were killed after 4
      weeks. The 84 condyles were examined clinically and histologically. Statistical
      analysis showed a highly significant difference in the healing of bone and
      cartilage between groups A and C (P less than .01) and a significant difference
      between groups A and B (P less than .05). The results of this study indicate that
      ibuprofen has an adverse effect on the healing of bone and cartilage in the
      temporomandibular joint of the rabbit.

PMID- 1634977
TI  - Growth of a costochondral graft in the rat temporomandibular joint.
AB  - The aim of this study was to examine the growth and adaptation of costochondral
      grafts in the temporomandibular joint (TMJ). An autogenous rib section with
      either a short, intermediate, or long cartilaginous end was transplanted to
      replace the right mandibular condyle in 20-day-old rats. At 40 days, the
      mandibular halves with the short cartilage transplants were shorter than the
      contralateral halves, whereas the two sides did not differ in length in the rats
      with the intermediate transplant. The mandibular halves with the longest
      cartilaginous transplants initially were longer than the contralateral ones. The
      glenoid fossa was located more laterally as compared with the unoperated side.
      The results provide evidence that costochondral transplants do not adapt to the
      functional conditions of the TMJ and that the amount of cartilage in the graft
      has some bearing on its growth capacity.

PMID- 1634978
TI  - Creation of disc displacement in human temporomandibular joint autopsy specimens.
AB  - The purpose of this study was to investigate the possibility of iatrogenically
      creating disc displacement in the human temporomandibular joint (TMJ). Fourteen
      fresh TMJ autopsy specimens with superior disc position were selected for the
      study. The upper and lower joint spaces were exposed via a preauricular incision
      and two to three superficial mediolateral incisions were made in the inferior
      surface of the posterior disc attachment (ie, retrodiscal tissue). After these
      incisions were made it was possible to manually displace the disc anteriorly. To
      maintain the disc in the anterior position the condyle was positioned against the
      posterior disc attachment in a manner corresponding to the closed mouth position.
      The joints were then fixed in this relationship and magnetic resonance imaging
      (MRI) was repeated using the same scanning plane and scanning parameters as
      before intervention. After imaging, the joints were cryosectioned to show the
      degree of disc displacement. Histologic analysis was made of the posterior disc
      attachment. Postoperative MR images and cryosections showed the disc to be
      displaced anteriorly in 12 of the 14 joints. Displacement of the disc was
      complete in eight joints (the entire mediolateral dimension of the joint) and
      partial (only in the lateral part of the joint) in four joints. The disc remained
      in a superior position in two joints. Cryosections and histologic analysis showed
      the incisions in the inferior aspect of the posterior disc attachment to be
      superficial. The results of this study suggest that the integrity of the inferior
      aspect of the posterior attachment of the disc to the condyle is essential for
      keeping the disc in its position superior to the condyle.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1634979
TI  - The prevention and treatment of aspiration of vomitus during pharmacosedation and
      general anesthesia.
AB  - The aspiration of gastric contents can occur in patients with a depressed level
      of consciousness. Pulmonary aspiration is a serious potential complication of
      pharmacosedation and general anesthesia. Sequelae associated with aspiration
      include pulmonary obstruction, chemical pneumonitis, secondary infection, and
      possibly death. Morbidity following aspiration is enhanced with an increased
      volume of aspirate, a more acidic pH, a high particle content, and bacterial
      contamination. Treatment of aspiration is dependent on the nature of the
      aspirate. Identifying aspiration-susceptible patients, employing preventive
      measures, and using careful anesthetic technique can effectively reduce the risk
      of aspiration.

PMID- 1634980
TI  - Keeping one in the air: iconography of the newly extracted tooth.
AB  - Tooth extraction remains a universally identifiable symbol of dentistry.
      Descriptions of the procedure in art and literature suggest three attributes of
      the dentist in the act of removing teeth: skill, power, and healing. Elements of
      the dentist's cultural identity are examined in light of the abundant imagery of
      dental extractions.

PMID- 1634981
TI  - Osteochondroma of the mandibular condyle: case report and review of the
      literature.

PMID- 1634982
TI  - Use of silicone drains in the management of cervicofacial infections.

PMID- 1634983
TI  - Difference of opinion or motivation?

PMID- 1634984
TI  - Bigger isn't always better.

PMID- 1634985
TI  - Bruce N. Epker to receive William J. Gies Award.

PMID- 1634986
TI  - AAOMS (American Association of Oral and Maxillofacial Surgeons) 74th annual
      meeting and scientific sessions. Honolulu, September 14-19, 1992. Abstracts.

PMID- 1634987
TI  - [Effects of inner ear immune responses on auditory function in guinea pigs].
AB  - Following direct challenge with KLH antigen primary or secondary (after systemic
      immunization) to the ES (endolymphatic sac) in guinea pigs, ECoG
      (electrocochleograms) were recorded from the round window induced by click and
      tone pips. The recordings were carried out on the 2nd, 7th and 21st days after
      local antigen challenge. There were no abnormal findings in the ECoG of the
      primary antigen challenged animals. On the other hand, prolongation of latencies,
      decrease in amplitudes of APs (compound action potentials) and increases in SP/AP
      ratios were observed in the 2nd day recordings of the secondary antigen
      challenged animals. However, all parameters of ECoG in the 7th day recordings
      were normal. Decreases in AP amplitudes were again found in the 21st day
      recordings. The ECoG findings with click and tone pip stimulation showed similar
      results. From these findings, in conjunction with morphological observations, it
      is speculated that these ECoG findings are caused by immuno-injury to the ES and
      cochlea, as well as the resultant endolymphatic hydrops which develops acutely
      and gradually subsides after secondary challenge.

PMID- 1634988
TI  - [Image analysis of the inner ear with CT and MR imaging: pre-operative assessment
      for cochlear implant surgery].
AB  - Recent progress in magnetic resonance imaging (MRI) has made it possible to
      obtain detailed images of the inner ear by delineating the lymphatic fluid within
      the labyrinth. We analyzed CT scans and MR images in 70 ears manifesting profound
      deafness owing to inner ear lesions and compared their detective ability for
      inner ear lesions. The following results were obtained. 1) CT scan examination
      showed slight to extensive ossification of the labyrinth in six ears (9%),
      whereas MRI examination revealed low to absent signal intensity of the inner ear
      in nine ears (13%). Therefore, it was concluded that MRI is more sensitive in
      detecting abnormalities of the inner ear than CT scan. 2) MRI provided useful
      information as to whether the cochlear turn is filled with lymphatic fluid or
      obstructed. This point was one of the greatest advantages of MRI over CT scan. 3)
      Abnormal findings in either or both the CT scan and the MRI were detected in
      suppurative labyrinthitis occurring secondary to chronic otitis media, bacterial
      meningitis and in inner ear trauma. However, such abnormal findings were not
      detected in patients with idiopathic progressive sensorineural hearing loss,
      ototoxicity or sudden deafness. These findings should be taken into consideration
      in pre-operative assessment of cochlear implant candidates.

PMID- 1634989
TI  - [Histological study of human lingual tonsil, especially changes with aging].
AB  - The lingual tonsils, in company with the pharyngeal and palatine tonsils,
      constitute Waldyer's tonsillar ring and function as an immunological organ.
      However, fewer reports have been published on the lingual tonsil than on the
      other tonsils. It can hardly be said that changes is the lingual tonsil related
      to age have been studied in detail. The author reported a qualitative study on
      both gross and histological findings of the lingual tonsil, focusing on its
      changes with aging, in 204 autopsied cases (124 males and 60 females). The
      results of the qualitative observations obtained were as follows: 1. The lingual
      tonsils were classified into three shapes based on gross findings; flat,
      prominent and hypertrophic. Most of the hypertrophic tonsils were seen in the
      group in the 2nd decade and in those aged between the 4th and 6th decade of life.
      2. Lymphatic tissues were classified into three types; isolated diffuse, adhesive
      converged and independent converged types. It was presumed that reconstruction of
      the lymphatic tissue should occur independently of proliferation of the
      connective tissue since the lymphatic tissues of the three were not related to
      aging. 3. Hyperplasia of the connective tissue, which separated the lymphatic
      tissues, started in the 2nd decade and rapidly increased after the 6th decade.
      Hyperplasia of the elastic fiber in the capsula also started in the 2nd decade
      and increased with aging. The results of quantitative observation were as
      follows: 1. Total area of the lingual tonsil and lymphatic tissues in each slice
      of the specimen showed two peaks in size in the 2nd and 5th decades. 2. Total sum
      of the lymphfolliculus had changed with aging in the same manner as mentioned
      above in "1". The ratios of the lymphfolliculus to the parenchymal tissue and to
      the lymphepithelial symbiosis had also altered with aging. However, the number of
      lymphfolliculi per unit was almost constant. A significant difference between the
      sexes was detected below the 4th decade, when hormonal sexual difference were
      manifest. 3. Total sum of the area of the crypt increased from the 4th decade
      onward. From these findings, it is concluded that the lingual tonsil transiently
      responds to aging from the first to the 2nd decade, when the pharyngeal and
      palatine tonsils have dominant functions, and becomes active from the 4th to 5th
      decades, followed by a decrease in function after the 6th decade though its
      activity persists in elderly individuals.

PMID- 1634990
TI  - [CT rim effects in various head and neck lesions].
AB  - The authors evaluated various head and neck lesions seen from April 1988 through
      March 1990 both by plain and enhanced CT, examined the incidence of rim effect
      (or rim enhancement), classified these effects, and discussed underlying
      mechanisms. Materials consisted of 177 cases including primary tumors (28 benign
      and 49 malignant cases) and lymphadenopathy associated with malignancy (9 cases,
      metastatic nodes and malignant lymphomas), inflammatory lesions (20 cases),
      cystic lesions (12 cases), other lesions (7 cases, jugular thrombosis, carotid
      atheroma and aural lesions), and 22 cases without abnormal findings. Among the
      177 cases, rim effects were observed in 22 cases (12%). These effects were
      analyzed and classified. The incidences of rim effect according lesion type are
      as follows; cervical lymphadenopathy associated with malignancy 5/9 (56%),
      primary tumors 8/77 (10%), inflammatory lesions none, cystic lesions 7/12 (58%),
      and others 3/7 (43%). The highest incidence was seen with cystic lesions
      including mucoceles of the paranasal sinuses and cervical cysts. Rim effects were
      classified as follows; Type 1: cystic pattern, Type 2: parenchymatous pattern,
      Type 3: vascular pattern and Type 4: others. Type 1 was seen in 15 cases (68%),
      Type 2 in 3 cases (14%), Type 3 in 3 cases (14%), and Type 4 in 1 case (5%). Type
      1 included 6 cystic lesions, 3 malignant lymphadenopathies, 3 benign tumors and
      others. Type 2 included 2 malignant lymphadenopathies and 1 benign tumor, and
      Type 3, 2 jugular thromboses and 1 carotid atheroma. There was only one Type 4, a
      cystic lesion. Of interest is the mode of incidences among cervical
      lymphadenopathies associated with malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634991
TI  - [Respiratory function in patients with perennial nasal allergy and pollinosis].
AB  - There are many patients with allergic rhinitis who have no lower airway symptoms.
      The question arises as to whether or not the lower airway is involved in such
      cases, but the results of investigations in this field remain controversial. To
      answer this question, I performed various respiratory function tests in patients
      with perennial nasal allergy or pollinosis with or without a history of bronchial
      asthma. In addition, physiological changes in lower airway lesions were evaluated
      after challenge with antigen and histamine in these patients. In the present
      study, respiratory function was examined by autospirometry and the following
      results were obtained. 1. The group with perennial nasal allergy and a history of
      bronchial asthma showed significantly lower FEV1.0%, PER, %VC, V75, V50, and V25
      values than the group with perennial nasal allergy without history of bronchial
      asthma, indicating an obstructive lesion in the lower airway. The group with
      perennial nasal allergy alone showed lower V75, V50, and V25 values than the
      control group, suggesting small airway obstruction. 2. The group with perennial
      nasal allergy and a history of bronchial asthma showed marked hypersensitivity in
      the lower airway after histamine inhalation. The group with perennial nasal
      allergy alone showed marked changes in V75, V50, and V25: the degree was between
      that of the control group and that in the group with a history of asthma. 3. In
      patients with pollinosis, various respiratory function tests showed no
      abnormalities during the in-season of pollinosis and the out-seasons. However,
      inhalation of antigen or histamine decreased various parameters, significantly
      V50 and V25, during the symptomatic season.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1634992
TI  - [A temporal bone study of the jugular fossa].
AB  - This study was performed to elucidate the anatomic variations of the jugular
      fossa (JF) on the basis of examination of 120 human temporal bones. Observations
      were made of temporal bones sectioned along a plane including the cochlea, the
      JF, and long axis of the internal auditory canal. The position of the upper
      margin of the JF was classified according to its relation to the tympanic cavity,
      the cochlea, and the internal auditory canal. The height of the upper margin of
      the JF was classified as follows. Low type; inferior to the level of the external
      auditory canal. Middle type; between the level of the external auditory canal and
      the cochlea. High type; superior to the level of the cochlea. The results
      revealed that 58 ears were of low type, 46 middle type, and 16 high type. Middle
      and high type comprised 62 ears, thus in 52% of ears the upper margin of the JF
      was situated superior to the external auditory canal. The relation between the JF
      and the cochlea was classified as follows. Medial type; medial to the medial
      margin of the cochlea. Lateral type; lateral to the medial margin of the cochlea.
      The results showed that 74 ears were of medial type, and 46 lateral type.
      Therefore, in 62% of ears the upper margin of the JF was situated medial to the
      medial margin of the cochlea. Forty-seven ears of medial type were of middle or
      high type. Ears of lateral type included none of high type. The jugular bulb
      diverticulum was observed in 32 ears, which consisted of 3 of low type, 13 middle
      type, 16 high type. When the upper margin of the JF was positioned higher, the JF
      was in a more medial position. However, no defect of the bony labyrinth was
      observed. In conclusion, it is considered that protrusion of the jugular bulb
      into the tympanic cavity was not caused by the abnormally high position of the
      JF, but by its lateral displacement. Distances from the JF to the surrounding
      structures were as follows; to the tympanic membrane 5.58 +/- 2.43mm (mean +/-
      S.D.), to the tympanic cavity 2.94 +/- 1.92mm, to the cochlea 4.93 +/- 2.20mm,
      and the internal auditory canal 5.82 +/- 2.38mm.

PMID- 1634993
TI  - [A case of transfusion-associated GVHD after total laryngectomy].
AB  - We report a case of fatal transfusion-associated graft versus host disease (GVHD)
      that developed in a patient with laryngeal cancer. After a 39.6Gy irradiation
      dose, total laryngectomy with right radical neck dissection was performed. The
      postoperative course was uneventful. However, seven days after blood transfusion,
      high fever (38.5 degrees C) suddenly appeared. On the ninth day, watery diarrhea
      and facial erythema were observed. On the 12th day, liver disturbance and
      pancytopenia developed. The patient died on the 16th day because of overwhelming
      sepsis. Transfusion-associated GVHD has a mortality rate of more than 90%.
      Therefore, the most important procedure for preventing GVHD is the use of
      irradiated blood products. Furthermore unnecessary blood transfusion should be
      avoided.

PMID- 1634994
TI  - [Nasal airflow resistance before and after adenoidectomy].
AB  - Nasal airflow resistance was measured in order to study physiological changes in
      the upper airway before and after adenoidectomy. The posterior method was better
      for measuring the state of the posterior portion of the nasal cavity, as compared
      with the anterior method. The posterior method was modified by improving the
      pressure piece, the size of which had been inadequate for insertion into a
      child's mouth. A positive correlation was found between the adenoidal
      nasopharyngeal ratio examined on X-ray film and the nasal airflow resistance both
      before and after surgery. Also there was a positive correlation between the
      weight of the resected adenoids and nasal airflow resistance preoperatively.
      Nasal airflow resistance was found to be significantly higher in patients who
      snored, breathed by mouth or had nocturnal breathing disorders than in those
      without these symptoms.

PMID- 1634995
TI  - The analysis of new short-period circadian rhythm mutants suggests features of D.
      melanogaster period gene function.
AB  - A number of new period gene (per) mutants were generated by in vitro mutagenesis
      and germ line transformation. Missense mutations were made at amino acid 589,
      which is altered in the 19 h short-period (per(s)) mutant, and insertion
      mutations were generated with peptides commonly used for epitope tagging. Most of
      these new per mutants had short behavioral rhythms. Flies with heteroallelic
      combinations of these new mutant per genes were found to have "hybrid" periods,
      i.e., they had values that were usually in between those of the individual
      alleles. These findings suggest that short-period per mutants are not unusual
      gain-of-function mutants but rather more traditional loss-of-function mutants
      that are unable to influence the circadian pacemaker in a proper manner. The data
      also suggest that the per protein may engage in important intermolecular
      interactions.

PMID- 1634996
TI  - Additive gene actions on the fiber number in the anterior optic tract of
      Drosophila melanogaster.
AB  - The influence of mutations in seven neurological genes on the number of fibers in
      the anterior optic tract (AOT) of Drosophila melanogaster has been investigated.
      It is shown that the number of fibers in the AOT can be drastically reduced in
      single and especially in multiple mutants. However, no evidence for synergistic
      interactions between the sample of mutations used in the sine oculis (so),
      reduced optic lobes (rol), minibrain (mnb), and small optic lobes (sol) genes was
      obtained at the level of the AOT. The rolKS222 and so mutations eliminate similar
      fiber sets in the AOT, which are distinctly different from those eliminated by
      solKS58 and mnb1.

PMID- 1634997
TI  - Mutants with delayed cell death of the ptilinal head muscles in Drosophila.
AB  - The emergence of adult Drosophila melanogaster from the puparium is followed by
      the programmed degeneration of a number of muscle groups. We have isolated two X
      linked mutants that delay the programmed death of at least some of these muscles.
      During eclosion, the fly makes use of a membranous sac, the ptilinum, which is
      later retracted into the head capsule. Six of the eight sets of muscles involved
      in the retraction then undergo degeneration. The muscle fibers initially show a
      gradual atrophy and then degenerate rapidly through fragmentation followed by
      absorption. In wild-type flies, this degeneration is obvious by 12 h after
      eclosion due to the loss of the birefringence of the muscles. Through mutagenesis
      with ethyl methanesulfonate, we isolated four mutants whose birefringence of the
      doomed muscles was retained even at 12 h. Mutants were genetically classified
      into two complementation groups; mcd-1 and mcd-2 (mcd: muscle cell death). The
      muscles of the mcd-1 mutants degenerate more slowly than that of the wild-type
      flies; the fibers enter the fragmentation step but are then not rapidly absorbed.
      In the mcd-2 mutants, the fibers atrophy more slowly than that in the wild-type
      flies and fail to undergo fragmentation. The difference in the process of the
      muscle death between the mcd-1 and the mcd-2 mutants suggests that at least two
      genes act on different steps in the process of muscle cell death.

PMID- 1634998
TI  - Genetic and age related models of neurodegeneration in mice: dystrophic axons.
AB  - Dystrophic axons (DA) are non-specific lesions that occur in a wide variety of
      human and animal diseases. In this paper we describe the distribution of these
      lesions in three newly discovered mouse neurological mutants. The distribution of
      DA in these mutants is defined by their names, lumbosacral neuroaxonal dystrophy
      (lnd), located on Chromosome 7, generalized neuroaxonal dystrophy (gnd) and
      vestibulomotor degeneration (vmd). The last mutant, which has degeneration as
      well as DA in lateral vestibular nucleus and vestibulo-spinal tracts, dies in the
      first weeks of life; the first two live for approximately one year. A previously
      described mutation, dystonia musculorum (dt), was found to produce generalized DA
      like gnd, but dt/dt mutants die at an early age. DA were also found to occur in
      the nuclei gracilis and cuneatus, in the area of Clark's column and in lumbo
      sacral spinal cord in aging normal mice either fed ad libitum or at a level of
      40% dietary restriction. The dietary regimen had little effect on the numbers of
      DA observed in susceptible areas of the neuroaxis. The mutant models of
      neuroaxonal dystrophy may prove useful in studies of the pathophysiology of DA in
      general and of specific inherited diseases of man, such as infantile neuroaxonal
      dystrophy and Hallervordin-Spatz disease.

PMID- 1634999
TI  - Mutations on the second chromosome affecting the Drosophila eye.
AB  - In the developing eye of Drosophila, cell interactions appear to be responsible
      for organising undifferentiated cells into unit eyes, or ommatidia. Extensive
      mutagenesis has been used to search for mutations affecting the development and
      differentiation of ommatidia. These mutations have been characterized using
      sections of adults and immunocytochemistry of imaginal discs. Fourteen loci on
      the second chromosome are described that affect the spacing of the preclusters,
      the differentiation of ommatidial cells, orientation of the ommatidia, or
      architecture of the adult retina, that cause retinal degeneration in larval or
      pupal eye discs, or that cause homeotic transformation of part of the head.

PMID- 1635000
TI  - Pathology in the undergraduate medical curriculum.

PMID- 1635001
TI  - Immunocytochemical demonstration of IGF-II immunoreactivity in human
      phaeochromocytoma and extra-adrenal abdominal paraganglioma.
AB  - Insulin-like growth factor (IGF)-II immunoreactivity was demonstrated in 14
      adrenal glands, six retroperitoneal paraganglia, 18 phaeochromocytomas, and six
      extra-adrenal abdominal paragangliomas through the use of a monoclonal antibody
      against rat IGF-II which cross-reacts with human IGF-II. A subpopulation of
      parenchymal cells in normal adrenal medulla and in retroperitoneal paraganglia
      was positively immunolabelled. Eighteen cases with phaeochromocytoma including
      two malignant and four multiple endocrine neoplasias all contained numerous IGF
      II-immunoreactive tumour cells. All six extra-adrenal abdominal paragangliomas
      contained numerous immunoreactive tumour cells. Almost all the other normal human
      adult tissues examined failed to immunolabel. These results indicate that IGF-II
      like immunoreactivity is widely expressed in normal and neoplastic human
      paraganglionic tissues, although its biological significance in these tissues has
      not been determined.

PMID- 1635002
TI  - Diagnosis of the acute ischaemic heart by ion elution from myocardium.
AB  - The post-mortem diagnosis of acute myocardial ischaemia may be difficult to
      establish in the absence of morphological changes in the myocardium or recent
      coronary thrombosis. Ischaemic cell injury leads to potassium (K) efflux and
      sodium (Na) influx and, if the blood is still circulating, the K:Na ratio of the
      tissue falls. In this study, the K:Na ratio was measured by eluting the ions from
      samples of myocardium and assaying the eluate. The method yields similar results
      to those obtained by a previous method, in which myocardial samples were
      homogenized. The K:Na ratios on samples of horizontal slices through the heart
      were plotted on maps of the slices. A low K:Na ratio corresponded to, but
      extended beyond, areas where there was morphological evidence of ischaemia. The
      method is simple and may be of use in routine practice.

PMID- 1635003
TI  - Renal cell carcinoma: comparison of morphological and flow cytometric parameters
      of primary tumour and invasive tumour lying within the renal vein.
AB  - Histological assessment and DNA flow cytometry have been performed on 15 kidneys
      containing primary adenocarcinomas which had invaded the renal vein. Comparison
      of morphological variables showed that samples of the intravenous tumour were
      more commonly composed of granular cells (53 per cent) than were samples from the
      main tumour mass (16 per cent), and were also of higher nuclear grade. In 7 of 14
      kidneys, DNA studies showed either a higher S-phase fraction (five cases) or DNA
      aneuploidy (two cases) in tumour cells lying within the renal vein. The mean S
      phase fraction was also shown to increase in higher nuclear grades. Thus, both
      morphological and biological differences exist between invasive tumour cells
      lying within the renal vein and those in the main tumour. This is a useful model
      for the investigation of venous invasion and may give a better prediction of the
      metastatic potential of renal cell carcinoma.

PMID- 1635004
TI  - Myoendothelial contacts in arteriolosclerosis.
AB  - Human renal biopsies were examined electron microscopically to investigate close
      contacts between endothelial and smooth muscle cells in small arterioles. These
      myoendothelial contacts were seen in the form of cytoplasmic projections passing
      through fenestrae in the basal lamina. Most of these cell processes seem to arise
      from the endothelial cells. In the control vessels, the separation between the
      endothelial cells and smooth muscle cells of the tunica media is 0.09-0.27
      microns. With arteriolosclerosis there is an increasing separation between the
      elements of the intima and the media, from 1.0 to 2.42 microns. In spite of this
      increasing separation, myoendothelial contacts maintain an intercellular space of
      10-15 nm, as observed in the control vessels. At 2.42 microns of separation, the
      amount of extracellular material accumulated is such that the cells can no longer
      keep in contact. Break up of the myoendothelial contacts may be responsible for
      impairment of communication between the tunica intima and media in the vessel
      wall in arteriolosclerosis.

PMID- 1635005
TI  - Total parenteral nutrition for a terminally ill patient?

PMID- 1635006
TI  - Grief: re-forming life's story.

PMID- 1635007
TI  - Active metabolites of morphine.

PMID- 1635008
TI  - Use of the rectal, buccal, and sublingual narcotics in the management of cancer
      pain.

PMID- 1635009
TI  - Morphine intoxication during acute reversible renal insufficiency.

PMID- 1635010
TI  - Properties and function of the ocular melanin--a photobiophysical view.
AB  - This paper reviews the biosynthesis and physicochemical properties of the ocular
      melanin. Age-related changes of melanin granules and the corresponding formation
      of lipofuscin pigments in the retinal pigment epithelium (RPE) are also
      described. Adverse photoreactions of the eye and, in particular, light-induced
      damage to the RPE-retina are reviewed in relation to the ocular pigmentation. A
      hypothesis on the photoprotective role of the RPE melanin is presented that is
      based on the ability of the cellular melanin to bind redoxactive metal ions.
      Since bound-to-melanin metal ions are expected to be less damaging to the pigment
      cells, it is proposed that sequestration of heavy metal ions by the RPE melanin
      is an efficient detoxifying mechanism. It is postulated that oxidative
      degradation of RPE melanin may lower its metal-binding capability and decrease
      its anti-oxidant efficiency. Cellular and environmental factors that may
      contribute to possible oxidative damage of the RPE melanin are discussed in
      connection with the etiology of age-related macular degeneration.

PMID- 1635011
TI  - 212.8 nm laser photolysis of aromatic and aliphatic amino acids and related
      peptides.
AB  - The comparison of the photochemical properties of three aromatic and five
      aliphatic amino acids and three dipeptides was carried out using 212.8 nm laser
      irradiation and high performance liquid chromatography. The photochemical
      sensitivity, photolysis quantum yield and quantum yield of peptide bond scission
      were determined. Two-photon absorption coefficients of solvent (liquid water) and
      cell windows material (fused silica) at lambda = 212.8 nm were established.

PMID- 1635012
TI  - Intracellular localization of meso-tetraphenylporphine tetrasulphonate probed by
      time-resolved and microscopic fluorescence spectroscopy.
AB  - The effects of solvent pH on spectral properties and fluorescence decay kinetics
      were investigated in order to characterize the microenvironment of meso
      tetraphenylporphine tetrasulphonate (TPPS4) taken up by cells. Steady-state
      absorption and fluorescence spectra of TPPS4 in buffer solutions of different pH
      were used to identify a ring protonated species at pH less than or equal to 4.
      This dictation could also be distinguished from the unprotonated form by its
      altered fluorescence decay time (3.5 vs. 11.4 ns). In addition, time-resolved
      spectroscopy gave some evidence of a monocationic species existing at pH 6-9.
      This was concluded from the occurrence of another component with a decay time of
      5 ns. Measurements of the spectral and kinetic properties of the fluorescence
      emission of single epithelial cells (RR1022) incubated with TPPS4 indicated that
      the sensitizer was mainly localized in a microenvironment with a pH of 5, a value
      which occurs intracellularly only within lysosomes. Cells kept in the dark
      exhibited the characteristic spectra of both the dication and the neutral form.
      The fluorescence decay showed two components with decay times of 2.6 ns and 10.6
      ns. Irradiation of the cells changed the decay times to 4.6 ns and 13.4 ns and
      the dication fluorescence emission peak vanished, which is in accordance with the
      results obtained from buffer solutions at pH greater than or equal to 6.
      Therefore, we deduce that the photodynamic action leads to a rupture of the
      lysosomes and that the sensitizer is released into the surrounding cytoplasm.

PMID- 1635013
TI  - Phage T7 in biological UV dose measurement.
AB  - An experimental method complete with theoretical considerations is presented for
      the measurement of different biological UV doses. The method is based on the high
      sensitivity of phage T7 activity to UV light. A precisely determined T7
      inactivation action spectrum is presented over a wide optical range (240-514 nm).
      Using the T7 spectral sensitivity in relation to the minimal erythema dose (MED)
      and the effective spectral irradiance from solar radiation for the MED, an
      example is given to determine the MED value based on the measurement of T7
      inactivation for a given case. The advantages and applicability of the method are
      discussed.

PMID- 1635014
TI  - Photophysical processes in the NADH-alcohol dehydrogenase complex.
AB  - Fluorescent analysis showed the high sensitivity of the NADH-alcohol
      dehydrogenase complex to UV irradiation. The complex reacts to UV illumination
      with "photoresponse," a rapid decrease in NADH fluorescence intensity to some
      stationary level. No such decrease was found in the NADH solution without the
      protein. The maximum rate of photoresponse was observed at pH 8.0, i.e, the
      biochemical optimum for the enzyme. It is suggested that the main reason for the
      photoresponse is desorption of NADH from the protein due to vibrational and
      conformational relaxation after photoexcitation. The data obtained point to the
      possibility of controlling "dark" enzymatic processes with light.

PMID- 1635015
TI  - Proposal of modified mechanisms for photodynamic therapy.

PMID- 1635016
TI  - Coevolution: a history of the macroevolutionary approach to studying host
      parasite associations.
AB  - The year 1991 marked 100 yr of coevolution research. I have reviewed the first 90
      yr of this history. Three chronological phases are apparent: recognition of
      predictable associations among hosts and their parasites; search for patterns of
      association and their underlying causes, emphasizing either correlated
      biogeographic patterns or correlated phylogenies; and development of objective
      and repeatable methodologies for reconstructing and interpreting these patterns
      of association. Von Ihering, an outspoken anti-Darwinian, was undoubtedly the
      first to recognize and make use of predictable host-parasite associations.
      Kellogg and Fahrenholz, however, had more profound influence on subsequent
      generations, but in different directions. Kellogg attempted to meld natural
      selection with speciation by isolation. He also considered host specificity a
      component of coevolution, important but variable. His work laid the foundation
      for future research concentrated on biogeographic interpretations of host
      parasite relationships. This emphasis and Metcalf's failed attempts to provide
      adequate mechanisms for reconstructing phylogenies reduced the biogeographic
      approach to an empirical research program in the hands of Manter. Fahrenholz, on
      the other hand, exposed to a strong anti-Darwinian sentiment, emphasized the
      importance of strict host specificity. This led to Eichler's formulation of the
      first 3 coevolutionary rules and the conclusion that host specificity was not a
      component but the cause of coevolution and ultimately the tautology inherent in
      the phylogenetic approach. All had to rely on 1 assumption, that host and
      parasite phylogenies were reflected in the taxonomic hierarchy. Hennig criticized
      this assumption and provided a method whereby phylogenies are reconstructed
      independently. Brooks melded this new phylogenetic method (cladistics) with an
      equally new biogeographic method (vicariance biogeography), providing the
      foundations for the modern macroevolutionary approach to studying host-parasite
      associations.

PMID- 1635017
TI  - Origins, diversification, and historical structure of the helminth fauna
      inhabiting neotropical freshwater stingrays (Potamotrygonidae).
AB  - Members of the freshwater stingray family Potamotrygonidae occur throughout the
      major river systems of eastern South America that empty into the Atlantic Ocean.
      Ichthyologists have tended to assume that the ancestor of the potamotrygonids was
      an Atlantic marine or euryhaline stingray that dispersed into freshwater,
      presumably during the last marine ingression 3-5 million years ago. The helminth
      parasites that inhabit potamotrygonids suggest an alternative perspective on
      their origin. Phylogenetic and biogeographic analysis of the helminths inhabiting
      potamotrygonids suggest that the hosts are derived from an ancestral Pacific
      urolophid stingray that was trapped in freshwater by the uplifting of the Andes
      beginning perhaps as early as the early Cretaceous period and ending by the mid
      Miocene epoch, changing the course of the Amazon River, which previously had
      flowed into the Pacific Ocean.

PMID- 1635018
TI  - Parasites as probes for biodiversity.
AB  - Cestodes of the genus Linstowia, parasitic in marsupials, show patterns of
      coevolution and ancient historical-ecological connections. Correlated with the
      breakup of the austral landmasses (Gondwanaland) of the Neotropical and
      Australian regions from the Antarctic continent, the age of this host-parasite
      community is estimated to be between 60 and 70 million years old. Based on the
      data from the survey of parasites of mammals from throughout Bolivia and from the
      phylogenetic analysis of the cestodes, we urge the planners of biodiversity
      preserves in the neotropics to consider the Yungas of Bolivia as a region that
      supports an ancient ecological community worthy of consideration as a
      biopreserve.

PMID- 1635019
TI  - Congruent and synchronic patterns in biogeography and speciation among seabirds,
      pinnipeds, and cestodes.
AB  - Congruence in biogeographic patterns among diverse assemblages of taxa indicates
      uniformity in the historical determinants of biotic distributions. Comparisons of
      host and parasite phylogenies and the elucidation of distributional area
      relationships are requisite components of analyses in historical biogeography.
      Host-parasite associations with broad geographic ranges are often archaic and
      have been structured largely by coevolutionary processes. In contrast, the
      origins and radiation of the primary cestode faunas of some seabirds (Alcataenia
      spp./Alcidae) and pinnipeds (Anophryocephalus spp./Phocidae and Otariidae) are
      associated with colonization. These young colonizing faunas, in the Holarctic
      Region, were influenced by a common history during the late Pliocene and
      Pleistocene epochs. Periodic range contraction, with isolation in refugial
      centers, and subsequent expansion into postglacial habitats for hosts and
      parasites coincided with the cyclic pattern of stadials and interstadials. During
      the past 2-3 million years following colonization, these dramatic climatic
      fluctuations strongly influenced the continuity of ecological associations in
      marine habitats and appear to have been the determinants of congruent and
      synchronic patterns of speciation among these disparate taxa of marine
      homeotherms and eucestodes.

PMID- 1635020
TI  - A phylogenetic and biogeographic analysis of the genera of Spirorchinae (Digenea:
      Spirorchidae) parasitic in freshwater turtles.
AB  - Cladistic analysis of the freshwater genera of Spirorchinae (Schistosomatoidea:
      Spirorchidae sensu Yamaguti, 1971) plus Haematotrema Stunkard, 1923, and
      Aphanospirorchis Platt, 1990, was completed. The Spirorchinae were considered
      monophyletic based on synapomorphies of the esophagus. Three lineages,
      Spirhapalum (Europe/Asia), Plasmiorchis+Hemiorchis (India), and Spirorchis +
      Henotosoma + Haematotrema + Aphanospirorchis (North America), were identified.
      Nelsen consensus analysis was used as the basis for recognizing 3 valid
      monophyletic genera: Spirhapalum, Plasmiorchis, and Spirorchis. Hapalotrematinae
      sensu Smith, 1972 (e.g., Hapalorhynchus/Coeuritrema), is considered the most
      plesiomorphic group of spirorchids. Freshwater representatives of the
      hapalotrematines have been reported from 7 of 12 extant turtle families,
      including the relatively primitive Pelomedusidae (Pleurodira) and exhibit a
      worldwide distribution. It is hypothesized that this group arose in the early
      Triassic period, prior to the breakup of Pangea. Thus, it represents a primitive
      lineage that was present during the diversification of turtle lineages in the mid
      Mesozoic era. Spirorchinae arose later (late Cretaceous period) as a Laurasian
      component parasitic in the more recent pond turtles (Emydidae + Bataguridae).
      Species of Spirhapalum retained a relatively plesiomorphic distribution, and they
      are found in emydids (Europe) and batagurids (Asia). Species of Spirorchis arose
      and diversified with North America emydids following the separation of North
      America and Europe in the late Cretaceous or early Tertiary periods. Species of
      Plasmiorchis are hypothesized to be derived from Asian ancestors that accompanied
      the colonization of India by Asian batagurids during the early Tertiary period.
      The presence of Spirorchis species in snapping turtles (Chelydridae/North
      America) and of Plasmiorchis species in Indian soft-shelled turtle (Trionychidae)
      are considered independent colonization events.

PMID- 1635021
TI  - The roles of ecological and evolutionary influences in providing structure to
      parasite species assemblages.
AB  - Parasite species assemblages currently are thought to range from isolationist to
      interactive, their dynamic properties being related to the number of species and
      types of hosts involved. The literature contains few experimental tests of this
      concept, however, and many of the host/parasite systems studied to date are not
      amenable to experimental manipulation. In this review, the presence of a parasite
      species, in a sample of host individuals, is considered to be an evolutionary
      phenomenon, but the parasite's population structure is considered to be an
      ecological one. Studies that allow evaluation of these 2 influences are
      comparative in nature and include data from a series of homogeneous samples of
      host populations. A lottery model is presented, in which hosts acquire their
      assemblages of parasites by Monte Carlo type sampling from multiple kind arrays;
      the major structuring influence is the relative probability of becoming infected
      by various parasite species. Claims of parasite species interaction need to be
      supported by studies showing departures from the predictions of this model. The
      species density and infraassemblage diversity index distributions are recommended
      as quantitative tools useful in such work.

PMID- 1635022
TI  - Allozyme analysis of Trichinella isolates from various host species and
      geographical regions.
AB  - Allozyme analysis was carried out on 152 Trichinella isolates from synanthropic
      and wild animals and from humans; the isolates were collected from 5 continents.
      The analysis, involving 27 enzymes, revealed the presence of 8 distinct gene
      pools, termed T1-T8. Four of the genetic groups represent the 4 previously
      proposed species: Trichinella spiralis sensu stricto (T1), Trichinella nativa
      (T2), Trichinella nelsoni (T7), and Trichinella pseudospiralis (T4). The other 4,
      T3, T5, T6, and T8 are distinct from previously described species. The absence of
      allozymic hybrid patterns among even sympatric groups indicates a lack of gene
      flow among the groups. Principal component analysis and the unweighted pair group
      method of analysis were used to assemble allozyme patterns of the 152 isolates
      into discrete groups and to show their relative relationships. Both analyses
      indicated the presence of 8 primary clusters that correlated with the gene pools
      revealed by direct allozyme profile analysis. The absence of evidence of gene
      flow among the gene pools and the high level of allozymic differentiation between
      the cluster groups support the concept that the genus Trichinella is composed of
      several sibling species.

PMID- 1635023
TI  - Biological characterization of Trichinella isolates from various host species and
      geographical regions.
AB  - Forty isolates of Trichinella collected from 5 continents were compared for 7
      biological characters: newborn larvae produced per female worm cultured in vitro
      at the seventh, eighth, and ninth day postinfection, host muscle nurse cell
      development time, reproductive capacity index in rats and chickens, and
      resistance of muscle larvae to freezing. The isolates also were compared by
      analyses of an environmental character of the location from which they were
      isolated: the isotherms for January and July. By factorial analysis of
      correspondence of the biological and environmental data, the 40 isolates were
      grouped into 8 gene pools (T1-T8). The environmental temperature-related
      distribution was more evident for the sylvatic isolates (T2, T3, T5, T6, T7, T8),
      than for T1, which was isolated from domestic pigs, and for T4, a bird-adapted,
      nonencapsulating genetic type. The 8 biological groups correlated closely with
      the 8 gene pools previously identified on the basis of allozyme analysis. These
      results support the concept that the genus Trichinella is composed of at least 5
      distinct gene pools or sibling species: Trichinella spiralis sensu stricto (T1),
      Trichinella nativa (T2), Trichinella sp. (T3), Trichinella pseudospiralis (T4),
      and Trichinella nelsoni (T7), and 3 other groups of uncertain taxonomic status
      (i.e., T5, T6, and T8).

PMID- 1635024
TI  - Taxonomic revision of the genus Trichinella.
AB  - The analysis of genetic, biochemical, and biological data on about 300
      Trichinella isolates, reported in the literature, allows a taxonomic revision of
      this genus. We propose the recognition of 5 sibling species, Trichinella spiralis
      (Owen, 1835) sensu stricto; Trichinella nativa Britov and Boev, 1972; Trichinella
      pseudospiralis Garkavi, 1972; Trichinella nelsoni Britov and Boev, 1972 sensu
      stricto; and Trichinella britovi n. sp., on the basis of biochemical and
      biological characteristics. Trichinella britovi n. sp. is characterized by
      distribution in the Palaearctic Region; newborn larvae (NBL) production in vitro
      of 35-55 NBL/72 hr; nurse cell development time (NC d.t.) between 24 and 42 days
      postinfection (d.p.i.); low reproductive capacity index (RCI) in mice, rats, and
      pigs; low resistance to freezing; 1 unique marker allozyme; and moderate
      pathogenicity for humans. The new species is most similar to Trichinella nativa
      but differs from it in 4 allozymes, in having less resistance to freezing, in
      having a different pattern of major ribosomal DNA fragments after endonuclease
      digestion, and in distribution area. Trichinella nativa is characterized by a
      holarctic distribution; hosts that are sylvatic mammals; NBL production in vitro
      28-54/72 hr; NC d.t. between 20 and 30 d.p.i.; low RCI in mice, rats, and pigs;
      high resistance to freezing; 2 unique marker allozymes; and moderate to severe
      pathogenicity for humans. Trichinella spiralis sensu stricto is characterized by
      a cosmopolitan distribution in domestic pigs, associated wildlife, and humans;
      high NBL production in vitro (greater than 90 NBL/72 hr); NC d.t. between 16 and
      37 d.p.i.; high RCI in mice, rats, and pigs; no resistance to freezing; 6 unique
      marker allozymes; and high pathogenicity for humans.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1635025
TI  - Cyclophilin of Schistosoma japonicum.
AB  - A 623-bp cDNA molecule encoding cyclophilin, a specific cyclosporin A-binding
      protein, has been isolated from Schistosoma japonicum using a heterologous cDNA
      probe from Echinococcus granulosus. The nucleotide sequence of this molecule has
      been determined, and the deduced amino acid sequence has revealed extensive
      homology with homologues of other species. Southern blot analysis suggests that
      S. japonicum cyclophilin is the product of a single-copy gene. The cloning of
      this cDNA will allow an investigation of cyclophilin as a possible target of the
      antischistosome effects of cyclosporin A.

PMID- 1635026
TI  - Separation and characterization of adult worm proteins and glycoproteins from the
      liver fluke Opisthorchis viverrini.
AB  - Detailed studies of liver fluke proteins and antigens are necessary to facilitate
      further investigation of the human immune responses to these parasites.
      Accordingly, Opisthorchis viverrini antigens were analyzed by sodium dodecyl
      sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. We
      initially encountered excessive background smearing, vertical streaking, and
      indistinct bands that were similar to problems previously described by
      investigators studying this and other trematodes including Schistosoma mansoni.
      These problems were especially evident with silver staining of proteins and
      occurred despite the extensive use of protease inhibitors. They were minimized by
      using mini (vs. large) SDS-PAGE and Coomassie blue protein staining. With the
      latter 2 techniques, adult worm somatic proteins and excretory-secretory products
      were separated and characterized. Immunoblots using rabbit anti-adult worm sera
      demonstrated that some of these proteins were antigens common to both the adult
      and metacercarial stages. Several of these antigens also corresponded (according
      to molecular weight) to glycoproteins, detected by concanavalin A blotting. These
      findings form a base for subsequent studies of the human immune response to liver
      fluke infection.

PMID- 1635027
TI  - Detection of Schistosoma mansoni circulating cathodic antigen for evaluation of
      resistance induced by irradiated cercariae.
AB  - The appearance of serum levels of circulating cathodic antigen (CCA) detectable
      by a monoclonal antibody (mAb) (5H11) antigen-capture sandwich enzyme-linked
      immunosorbent assay (ELISA) system was evaluated during acute Schistosoma mansoni
      infections in female CF1 mice exposed to either 100 or 25 cercariae. Measurable
      CCA levels occurred in these groups at 5 and 7 wk after infection, respectively.
      The kinetics of appearance of CCA were thus related to the intensity of
      infection. The level of resistance developed by female C57BL/6 mice upon
      immunization with irradiated cercariae, as expressed by both worm burden and CCA
      levels after cercarial challenge was evaluated. Immunization conferred 44%
      protection against the challenge infection, and the level of CCA detected in the
      sera of the control group was significantly (P less than 0.02) higher than that
      found in the sera of the immunized group, 6 wk after challenge. These results
      demonstrate that CCA detection by the 5H11 mAb antigen-capture sandwich ELISA can
      reflect vaccine-induced resistance against S. mansoni. Localization studies
      showed that 5H11 reacts with a CCA epitope in the adult worm gut and to a lesser
      extent with the male tegument. Adaptations of this and other antigen detection
      systems may prove useful in monitoring the efficacy of developmental vaccines, an
      ability that may be essential for the extension of such studies to humans.

PMID- 1635028
TI  - Changes in humoral responses to Trypanosoma cruzi during the course of infection
      in mice held at elevated temperature.
AB  - A parasite-specific, enzyme-linked immunosorbent assay and immunoblot analysis
      were used to examine the development of humoral immunity in Trypanosoma cruzi
      infected C3H mice that survive acute infection when held at elevated
      environmental temperature. Both parasite-specific antibody levels and numbers of
      antigens identified increased during infection in mice held at 36 C, with the
      greatest reactivity measured in sera from mice that had resolved parasitemias.
      Heat shock of culture forms of T. cruzi resulted in production of different
      antigens, but there was no strong difference in the antigens recognized by sera
      from mice held at room temperature and those recognized by sera from mice held at
      36 C. Immunoblot analysis using blood-form trypomastigote antigens identified a
      band of approximately 61 kDa produced by trypomastigotes in mice held at 36 C
      that was strongly detected by sera from mice held at 36 C. Little if any
      reactivity to this antigen was observed using sera from mice held at room
      temperature.

PMID- 1635030
TI  - Investigation of transplacental transmission of Caryospora bigenetica
      (Apicomplexa: Eimeriidae) in mice.
AB  - Five pairs of female Swiss-Webster mice were caged with 5 males (2 females/1
      male). Eight females were inoculated orally with 2.6 x 10(5) Caryospora
      bigenetica oocysts either 3 days before mating, 3 days after mating (PMD), 9 PMD,
      or 16 PMD. The remaining 2 females were inoculated orally with Hanks' balanced
      salt solution and served as controls. One female from each cage delivered
      naturally at full term and the second female delivered by cesarean section on
      postmating day 18. The number of offspring per litter ranged from 7 to 12. One
      female produced a litter of 3 stillborn and 5 liveborn offspring. Seven of 8
      female mice exhibited swollen muzzles and footpads 8 days after inoculation.
      Caryospora bigenetica was identified in tissues of muzzle, tongue, footpad,
      uterus, and placenta at necropsy. This is the first report of C. bigenetica in
      uterus and placenta. Clinical signs and tissue infections were not observed in
      control mice or in any offspring of the 10 female mice. This study presents
      evidence that C. bigenetica is not transmitted transplacentally.

PMID- 1635029
TI  - Binding of complement to trypomastigotes of a Brazil strain of Trypanosoma cruzi:
      evidence for heterogeneity within the strain.
AB  - Binding of the complement components C3 and C5 to epimastigote and trypomastigote
      stages of the Brazil strain of Trypanosoma cruzi was examined using radioligand
      binding and flow cytometric assays. Fibroblast-derived trypomastigotes bound
      approximately 40% fewer molecules of [125I]C3 per parasite than did
      epimastigotes. The predominant molecular species of C3 deposited on fibroblast
      derived trypomastigotes was the inactive form iC3b. Addition of parasite-specific
      antisera failed to enhance the number of molecules of [125I]C3 per parasite or
      the proportion of active to inactive C3b. Flow cytometric studies revealed that
      only 50% of trypomastigotes (fibroblast-derived or blood-form) bound C3. In
      contrast to results of the [125I]C3 binding studies, flow cytometric analysis
      showed that the percentage of trypomastigotes binding C3 actually increased upon
      incubation with parasite-specific antisera. C5 was found also to bind to only a
      percentage of trypomastigotes.

PMID- 1635031
TI  - A comparative study of the host-parasite relationship of Pomphorhynchus
      patagonicus (Acanthocephala) in two species of fish from Lake Rosario (Chubut,
      Argentina).
AB  - Some aspects of the host-parasite relationships of Pomphorhynchus patagonicus
      (Acanthocephala) in 2 fish species from Lake Rosario (Chubut, Argentina) were
      studied. The fish species Patagonina hatcheri (Atherinidae) is autochthonous, and
      Oncorhynchus mykiss (Salmonidae) is introduced. The host species appears to
      influence attachment, size, sexual maturity, and distribution of parasites along
      the digestive tract. In P. hatcheri, an effective major host, parasites are
      attached firmly to the wall of the gut, well developed, attain a greater size,
      and a large proportion of females is gravid with ripe eggs. In O. mykiss, an
      unsuccessful host, there were many unattached parasites that were small and not
      well developed; gravid females were rare and never had ripe eggs.

PMID- 1635032
TI  - Population dynamics of Plasmodium falciparum sporogony in laboratory-infected
      Anopheles gambiae.
AB  - The population dynamics of cultured Plasmodium falciparum parasites was examined
      during their sporogonic development in Anopheles gambiae mosquitoes. Estimates of
      absolute densities were determined for each life stage, and life tables were
      constructed for each of 38 experimental infections. Macrogametocyte and ookinete
      mortalities contributed equally to the overall mortality. On average, there was a
      40-fold decrease in parasite numbers in the transition from the macrogametocyte
      to the ookinete stage, a 69-fold decrease in the transition from ookinete to
      oocyst stages, and a total net decrease in parasite numbers from macrogametocyte
      to oocyst stage of 2,754-fold (i.e., multiplicative). There was no relationship
      between macrogametocyte and ookinete densities due to the inherent variability in
      fertility among different gametocyte cultures. There was a curvilinear
      relationship (r2 = 0.66) between ookinete and oocyst densities. Above a threshold
      of about 30 ookinetes/mosquito, the oocyst yield per ookinete became increasingly
      greater with increasing ookinete density. There was a linear relationship (r2 =
      0.73) between oocyst and sporozoite densities, with an average of 663 salivary
      gland sporozoites produced per oocyst. Sporozoite production per oocyst was not
      affected by oocyst density and virtually all oocyst infections resulted in
      sporozoite infections of the salivery glands. This quantitative study indicates
      that the sporogony of cultured P. falciparum in laboratory-infected A. gambiae is
      an inefficient process and that the ookinete is the key transitional stage
      affecting the probability of vector infectivity.

PMID- 1635033
TI  - Histochemistry and ultrastructure of the metacercarial cyst of Bolbogonotylus
      corkumi (Trematoda: Cryptogonimidae).
AB  - Histochemical and ultrastructural studies were conducted on the metacercarial
      cyst of the cryptogonimid trematode Bolbogonotylus corkumi from the muscle tissue
      of fantail darters Etheostoma flabellare. The metacercarial cyst consisted of an
      outer host capsule and an inner parasite cyst. The host capsule was composed of
      an outer region of fibroblasts, collagen, macrophages, and unidentified cells,
      and an inner region containing degenerating cells. The parasite cyst was thin,
      homogenous, and noncellular in nature. The host capsule stained strongly for
      connective tissue and proteins and moderately for lipids, nucleic acids,
      nonspecific esterase activity, and acid and alkaline phosphatase activities. The
      parasite cyst stained intensely for acid mucopolysaccharides and moderately for
      acid phosphatase activity. A thick glycocalyx occurred between the parasite cyst
      and metacercarial tegument.

PMID- 1635034
TI  - Occurrence of the acanthocephalan Eocollis arcanus in Georgia.
AB  - The geographical range of the acanthocephalan Eocollis arcanus Van Cleave, 1947,
      is extended to Atlantic drainages in Georgia where it occurs in a previously
      unreported host, the centrarchid Centrarchus macropterus.

PMID- 1635035
TI  - Influence of a menhaden oil diet on cercarial penetration of Schistosoma mansoni.
AB  - The ability of a menhaden oil (MO) diet to influence cercarial penetration into
      mouse tail skin was evaluated. Male CD-1 mice 4-6 wk old (15.2 g average weight)
      were fed a 0, 10%, or 20% MO-supplemented diet for 2 wk. After this time mice
      were infected with either 65 +/- 3 or 145 +/- 3 [35S]methionine/cysteine-labeled
      cercariae for 1 hr by tail immersion. Twenty-four hours and 7 days later groups
      of mice were killed and their tail skin removed and autoradiographed. At 24 hr
      postinfection, mice fed a 20% MO diet had significantly higher cercarial
      penetration than controls and 10% MO diets (56% +/- 5.2 vs. 44% +/- 2.9, P =
      0.02, 1-tailed t-test). After 7 days mice fed a 20% MO diet retained more
      radioactive foci than controls or 10% MO diets (21% +/- 2.0 vs. 15% +/- 1.3, P =
      0.01, 1-tailed t-test).

PMID- 1635036
TI  - Serologic response of the opossum Didelphis virginiana to a temperature-sensitive
      mutant (ts-4) of Toxoplasma gondii.
AB  - A study was designed to measure the Toxoplasma gondii-specific IgM and IgG
      antibody responses of opossums inoculated with tachyzoites of the temperature
      sensitive mutant of T. gondii, ts-4, and to examine its persistence in the
      tissues. Four young opossums seronegative for anti-Toxoplasma gondii IgM and IgG
      antibodies immediately after capture and 4 wk later were injected subcutaneously
      with 1.8 x 10(6) ts-4 tachyzoites; a fifth opossum (also seronegative) received
      an injection of saline only. Serum was collected weekly and titered by modified
      direct agglutination for anti-Toxoplasma gondii IgM and IgG. IgM titers were
      detectable from week 1 to week 6 postinoculation (PI). IgG was measurable by week
      3 and remained high for 30 wk PI when the opossums were killed and examined. The
      control opossum did not develop a specific antibody response. At necropsy major
      lesions were not found. No anti-Toxoplasma gondii IgG was detected in serum
      collected from mice injected with tissues prepared from the opossums at necropsy,
      and no T. gondii was found on impression smears made at necropsy from these mice.
      Modified direct agglutination performed with or without 0.2 M 2-mercaptoethanol
      worked well for measuring specific IgM and IgG antibodies in experimentally
      infected opossums.

PMID- 1635037
TI  - In vitro oxygen consumption and motility of Cryptobia salmositica, Cryptobia
      bullocki, and Cryptobia catostomi (Sarcomastigophora: Kinetoplastida).
AB  - Cryptobia salmositica (pathogenic and vaccine strains), Cryptobia bullocki
      (pathogenic), and Cryptobia catostomi (nonpathogenic) have similar oxygen
      consumption rates (0.17 +/- 0.01 nm O2/10(6) parasites). Incubation with sodium
      azide (5 microliters of a 1-M solution to 1 ml of parasite suspension, i.e., a 5
      mM final concentration) reduced the oxygen consumption by approximately 4.5-fold.
      Motility of the parasites was also greatly reduced in sodium azide. The oxygen
      consumption and motility of the parasites returned to preazide treatment levels
      when the azide was removed even after 24 hr of incubation in sodium azide. The
      activities of hexokinase, pyruvate kinase, and cytochrome C oxidase were not
      detected in the 3 species of Cryptobia.

PMID- 1635038
TI  - Theileria sergenti proliferates in SCID mice with bovine erythrocyte transfusion.
AB  - The unavailability of in vitro or in vivo experimental systems has been the major
      factor hampering the progress of research studies on Theileria sergenti,
      causative agent of theileriosis, a major disease of cattle in Japan. We report
      the first successful propagation of T. sergenti in SCID mice into which
      uninfected bovine erythrocytes (Bo-RBC) were supplied periodically. The
      infectivity of T. sergenti proliferated in an SCID mouse was ascertained by
      successful transfer of infection into another SCID mouse into which uninfected Bo
      RBC were supplied periodically.

PMID- 1635039
TI  - An introduction to the five-factor model and its applications.
AB  - The five-factor model of personality is a hierarchical organization of
      personality traits in terms of five basic dimensions: Extraversion,
      Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience.
      Research using both natural language adjectives and theoretically based
      personality questionnaires supports the comprehensiveness of the model and its
      applicability across observers and cultures. This article summarizes the history
      of the model and its supporting evidence; discusses conceptions of the nature of
      the factors; and outlines an agenda for theorizing about the origins and
      operation of the factors. We argue that the model should prove useful both for
      individual assessment and for the elucidation of a number of topics of interest
      to personality psychologists.

PMID- 1635040
TI  - The five-factor model: issues and applications.

PMID- 1635041
TI  - Editor's introduction to Tupes and Christal.

PMID- 1635042
TI  - Author's note on "Recurrent personality factors based on trait ratings".

PMID- 1635043
TI  - Recurrent personality factors based on trait ratings.
AB  - Intercorrelations among ratings on 35 personality traits, selected as
      representative of the personality domain, were obtained for eight samples. These
      samples differed in length of acquaintanceship from 3 days to more than a year;
      in kind of acquaintanceship from assessment programs in a military training
      course to a fraternity house situation; in type of subject from airmen with only
      a high-school education to male and female undergraduate students to first-year
      graduate students; and in type of rater from very naive persons to clinical
      psychologists and psychiatrists with years of experience in the evaluation of
      personality. Centroid or multiple-group factors were extracted and rotated
      orthogonally to simple structure. For one study, an independent solution was
      obtained in which analytic rotations were accomplished on an IBM 650 computer
      using Kaiser's normal varimax criterion. Five fairly strong and recurrent factors
      emerged from each analysis, labeled as (a) Surgency, (b) Agreeableness, (c)
      Dependability, (d) Emotional Stability, and (e) Culture.

PMID- 1635044
TI  - Assessing the five-factor model of personality description.
AB  - Several approaches to assessing the dimensions of the five-factor model are
      reviewed and evaluated. The items in the assessment instrument may be adjectives
      or phrases, and the instrument itself may have been developed specifically to
      measure the five factors or may have been reinterpreted in terms of the five
      factor model. Data are presented comparing an adjective-based measure of the
      model (Goldberg, 1990) with two phrase-based measures (Costa & McCrae, 1985;
      Hogan, 1986), and recommendations are made for the choice of an instrument in
      different research contexts. Allport's (1937) distinctions between the structure
      of the trait lexicon and the structure of personality in individuals are
      reiterated.

PMID- 1635045
TI  - Implicit personality theory and the five-factor model.
AB  - The Big Five have not only been identified in ratings of knowledgeable
      informants, but also in ratings of strangers, in co-occurrence likelihood ratings
      of traits, in semantic similarity ratings of trait pairs, and in prototypicality
      ratings of acts for traits. This article describes the shared and distinctive
      characteristics of correlations among trait ratings and implicit personality
      theory and reviews studies that compare the structure of memory-based ratings and
      of on-line behavior counts. Three hypotheses suggested in the literature to
      account for these correlations are delineated and discussed: an accurate
      reflection hypothesis, a distortion hypothesis, and an overlap hypothesis. It is
      concluded that the distortion hypothesis, has been discredited and that an
      overlap model best accounts for the available evidence. This implies that traits
      are real and accurately perceived, provided that the judges have the necessary
      information.

PMID- 1635046
TI  - The five-factor model in personality: a critical appraisal.
AB  - This critical appraisal aims to position the five-factor model within the
      multifaceted field of personality psychology by highlighting six important
      limitations of the model. These are the model's (a) inability to address core
      constructs of personality functioning beyond the level of traits; (b) limitations
      with respect to the prediction of specific behavior and the adequate description
      of persons' lives; (c) failure to provide compelling causal explanations for
      human behavior and experience; (d) disregard of the contextual and conditional
      nature of human experience; (e) failure to offer an attractive program for
      studying personality organization and integration; and (f) reliance on simple,
      noncontingent, and implicitly comparative statements about persons. The five
      factor model is essentially a "psychology of the stranger," providing information
      about persons that one would need to know when one knows nothing else about them.
      It is argued that because of inherent limitations, the Big Five may be viewed as
      one important model in personality studies but not the integrative model of
      personality.

PMID- 1635047
TI  - Personality and psychopathology: an application of the five-factor model.
AB  - Our review is concerned with the relationship of the five-factor model of
      personality to psychopathology, focusing in particular on Axis II personality
      disorders and depression. The five factors provide a particularly compelling
      model for interpreting the Axis II personality disorders as maladaptive variants
      of normal personality traits. However, we also discuss methodological and
      conceptual limitations of this application. There has been little research on the
      relationship of Openness, Agreeableness, and Conscientiousness to Axis I mental
      disorders, but considerable attention has been given to Neuroticism and
      Extraversion. We focus in particular on the difficulty in distinguishing between
      the various ways in which personality can relate to depression, either as a
      predisposition to, a complication of, a pathoplastic effect upon, or a spectrum
      variant of the mental disorder. We conclude with recommendations for future
      research.

PMID- 1635048
TI  - Personality and health: advantages and limitations of the five-factor model.
AB  - Interest in the association between personality characteristics and physical
      health has been renewed in recent years. Theory and research in this area has
      also been complicated by conceptual and methodological limitations. The present
      article briefly reviews this literature and discusses the advantages and
      limitations of the five-factor model of personality as an integrating framework
      for studies of personality and health. The model has already been fruitfully
      applied in several contexts, and more possibilities exist. Although it has some
      potential limitations, the application of the five-factor model--as well as other
      aspects of current personality theory and research--is likely to facilitate
      progress in the study of how personality influences health.

PMID- 1635049
TI  - Probing the big five in adolescence: personality and adjustment during a
      developmental transition.
AB  - The present study probed the links among Big Five personality differences, self
      reported personality differences, and adjustment to school among young
      adolescents. We used a multimethod converging analysis, with three sources of
      data: (a) adolescent self-report on standardized personality inventories; (b)
      classroom teacher trait ratings and evaluations of adjustment; and (c) school
      guidance counselor evaluations of adjustment. Evaluations of adolescent
      adjustment were systematically related to Big Five personality differences, as
      assessed by both classroom teachers' and school counselors' ratings. For
      classroom teachers, adjustment was closely related to evaluations on the Big Five
      dimension of Conscientiousness. Adolescent self-report on several standardized
      measures was not related to adult evaluation of school adjustment. We suggest
      that the five-factor model may be a useful tool for probing adjustment during the
      transition to adolescence.

PMID- 1635050
TI  - On traits and temperament: general and specific factors of emotional experience
      and their relation to the five-factor model.
AB  - In this article we investigate relations between general and specific measures of
      self-rated affect and markers of Neuroticism, Extraversion, Openness to
      Experience, Agreeableness, and Conscientiousness. Replicating previous research,
      we found strong and pervasive associations between Neuroticism, its facets, and
      the various negative affects; and between Extraversion, its facets, and the
      positive affects. Conscientiousness also had a significant, independent relation
      with general positive affect, but this effect was entirely due to the specific
      affect of attentiveness, which was more strongly related to Conscientiousness
      than Extraversion. Conversely, only the achievement facet of Conscientiousness
      correlated broadly with the positive affects. Finally, hostility had a strong
      independent association with (low) Agreeableness. The results for Neuroticism and
      Extraversion further clarify the temperamental basis of these higher order trait
      dimensions; whereas those obtained for Agreeableness and Conscientiousness
      illustrate the importance of examining personality-affect relations at the lower
      order level.

PMID- 1635051
TI  - Manipulation in close relationships: five personality factors in interactional
      context.
AB  - This research had three basic goals: (a) to identify manipulation tactics used in
      close relationships; (b) to document empirically the degree of generality and
      specificity of tactical deployment across relationship types (mates, friends,
      parents); and (c) to identify links between five major personality dimensions and
      the usage of manipulation tactics. Twelve manipulation tactics were identified
      through separate factor analyses of two instruments based on different data
      sources: Charm, Reason, Coercion, Silent Treatment, Debasement, and Regression
      (replicating Buss et al., 1987), and Responsibility Invocation, Reciprocity,
      Monetary Reward, Pleasure Induction, Social Comparison, and Hardball (an amalgam
      of threats, lies, and violence). The Big Five personality factors were assessed
      through three separate data sources: self-report, spouse report, and two
      independent interviewers. Personality factors showed coherent links with tactics,
      including Surgency (Coercion, Responsibility, Invocation), Desurgency
      (Debasement), Agreeableness (Pleasure Induction), Disagreeableness (Coercion),
      Conscientiousness (Reason), Emotional Instability (Regression), and Intellect
      Openness (Reason). Discussion focuses on the consequences of the five personality
      factors for social interaction in close relationships.

PMID- 1635052
TI  - Personality and personal projects: linking big five and PAC units of analysis.
AB  - This article examines the relationships between classical trait units as
      represented by the five-factor model (e.g., Digman, 1990) and personal action
      construct (PAC) units as measured by Personal Projects Analysis (Little, 1983).
      One hundred and forty-seven students were administered the NEO Personality
      Inventory (Costa & McCrae, 1985) and two components of Personal Projects
      methodology during their first term in university. Neuroticism and
      Conscientiousness were related to problematic and positive project systems,
      respectively, with these effects generalizing across the academic and
      interpersonal project domains. Extraversion and Agreeableness were also
      associated with positive evaluations of personal projects, particularly in the
      interpersonal domain. Openness was distinctively linked with project initiation
      and value congruency. We suggest theoretical and applied implications of using
      PAC methods to expand and refine the classical trait research agenda.

PMID- 1635053
TI  - 5-lipoxygenase: properties, pharmacology, and the quinolinyl(bridged)aryl class
      of inhibitors.
AB  - In conclusion, an effective modulator of the AA cascade for the treatment of
      asthma and other inflammatory diseases may require 5-LO inhibitory activity as
      well as LTD4 antagonism in order to limit the effects of LTB4, LTD4, and 5-HPETE.
      The unknown role of LTC4 with respect to bronchoconstriction and mucus production
      could mask the efficacy of a pure LTD4 antagonist in man, whereas the chemotactic
      property of LTB4 for eosinophils can contribute to lung inflammation. Indeed, it
      is observed that the blood of patients with bronchial asthma has increased
      numbers of hypodense eosinophils. In addition, the formation of lipid-derived
      peroxide radicals, such as 5-HPETE, are believed to be responsible for various
      types of cellular injuries associated with the inflammatory disease process.
      Because inhibition of the CO pathway is thought to explain the therapeutic
      effects of nonsteroidal antiinflammatory agents in rheumatic diseases, a 5-LO
      inhibitor with CO inhibitory activity may also be desirable profile for an
      antiasthma agent. The validation of the LT hypothesis of disease had to wait for
      the demonstration of a clinical effect by either a LTD4 receptor antagonist or a
      LT synthesis inhibitor (5-LO inhibitor). Only very recently has this evidence
      become available and it is now apparent that compounds that antagonize LTD4
      receptors or inhibit LT synthesis have shown clinical efficacy in a wide range of
      diseases. Due to the breakthrough nature of this approach, certain of these
      compounds are being considered for expedited development. The absence of side
      effects seen in the clinical trials of selective 5-LO inhibitors is gratifying
      and argues that LTs are not important in homeostasis. Only time will tell whether
      5-LO inhibitors will take their place in the therapeutic armamentarium; however,
      the recent demonstration of clinical efficacy by a number of these compounds is a
      significant step in this direction.

PMID- 1635054
TI  - A series of potent HIV-1 protease inhibitors containing a hydroxyethyl secondary
      amine transition state isostere: synthesis, enzyme inhibition, and antiviral
      activity.
AB  - A series of HIV-1 protease inhibitors containing a novel hydroxyethyl secondary
      amine transition state isostere has been synthesized. The compounds exhibit a
      strong preference for the (R) stereochemistry at the transition state hydroxyl
      group. Molecular modeling studies with the prototype compound 11 have provided
      important insights into the structural requirements for good inhibitor-active
      site binding interaction. N-Terminal extension of 11 into the P2-P3 region led to
      the discovery of 19, the most potent enzyme inhibitor in the series (IC50 = 5.4
      nM). 19 was shown to have potent antiviral activity in cultured MT-4 human T
      lymphoid cells. Comparison of analogs of 19 with analogs of 1 (Ro31-8959)
      demonstrates that considerably different structure-activity relationships exist
      between these two subclasses of hydroxyethylamine HIV-protease inhibitors.

PMID- 1635055
TI  - Synthesis and X-ray crystallographic analysis of quinazolinone
      cholecystokinin/gastrin receptor ligands.
AB  - Compounds exemplified by 2-[2-(5-bromo-1H-indol-3-yl)ethyl]-3-[3-(1-
      methylethoxy)phenyl]-4(3H)-quinazolinone (3, IC50 = 0.0093 microM using mouse
      brain membranes) represent a structurally novel series of non-peptide
      cholecystokinin B receptor ligands. Since asperlicin, a selective CCK-A receptor
      antagonist, may be regarded as a conformationally constrained 2-substituted-3
      phenyl-4(3H)-quinazolinone, the progenitor of compound 3 (compound 2, 2-[2-(1H
      indol-3-yl)ethyl]-3-phenyl-4(3H)- quinazolinone) might therefore represent a
      conformationally flexible pharmacophore of the natural product. To probe possible
      conformational preferences for this class of receptor ligands, in particular the
      spatial relationship between the indole and quinazolinone rings, we prepared a
      series of analogues with methyl substituents on the ethylene bridge as well as
      congeners with different linkers. The X-ray crystal structure conformation for
      compound 22 (2-[2-(1H-indol-3-yl)ethyl]-3-]-3-(1-methylethoxy) phenyl]-4(3H)
      quinazolinone, IC50 = 0.026 microM) is extended with the two heteroaromatic rings
      adopting an antiperiplanar arrangement around the central sigma bond of the
      ethane linker, whereas the solid-state conformation for a less active analogue 19
      (2-[2-(1H-indol-3-yl)-1-methylethyl]-3-[3-(1- methylethoxy)phenyl]-4(3H)
      quinazolinone, IC50 = 9.1 microM) is folded with the two heteroaromatic systems
      adopting a synclinal orientation. However, MM2 force field calculations
      (MacroModel, v 3.0) suggest that the energy difference between the folded and
      extended conformation is small. Thus, other factors such as unfavorable steric
      interactions may account for the difference in receptor affinity. For derivatives
      with one to three methylene units separating the indole and quinazolinone rings,
      maximal receptor binding activity was found when the distance separating the two
      heteroaromatic systems is defined by an ethyl group. Introducing unsaturation
      into the ethylene bridge of compound 3 limited the conformational flexibility of
      the molecule and decreased its receptor affinity greater than 2 orders of
      magnitude.

PMID- 1635056
TI  - Comparative molecular field analysis of anticoccidial triazines.
AB  - Comparative molecular field analysis (CoMFA) of 2-(substituted phenyl)-1,2,4
      triazine-3,5(2H,4H)-diones (triazines henceforth) resulted in an excellent
      correlation of their anticoccidial potencies with their physical properties. Two
      items about this work are notable: (i) the biological data are from a whole
      animal infectious disease model; and (ii) for the best results CoMFA required
      columns of measured "lipophilicity" and "acidity" data in addition to the
      calculated data in the steric field and electrostatic field columns. CoMFA
      resulted in a quantitative description of the major steric and electrostatic
      field effects, and gave significant new insights to factors governing potency.
      The model was used to "predict" the potencies of diverse triazines not used in
      making the model itself.

PMID- 1635057
TI  - Structure-activity relationships of a series of 2-amino-4-thiazole-containing
      renin inhibitors.
AB  - A series of renin inhibitors was synthesized that contained a 2-amino-4-thiazolyl
      moiety at the P2 position. These derivatives are potent inhibitors of monkey
      renin in vitro and are selective in that they only weakly inhibit the closely
      related aspartic proteinase, bovine cathepsin D. Four compounds exhibited oral
      blood pressure lowering activity in high-renin normotensive monkeys. One of these
      compounds, 22 (PD 134672), was selected for further evaluation in renal
      hypertensive monkeys, on the basis of its superior efficacy and duration of
      action in the in vitro assays and the normotensive primate model.

PMID- 1635058
TI  - Rationally designed "dipeptoid" analogues of CCK. Acid mimics of the potent and
      selective non-peptide CCK-B receptor antagonist CI-988.
AB  - This paper outlines the synthesis of selected acid mimics of the non-peptide CCK
      B selective antagonist CI-988, 1. CCK-B and CCK-A binding affinities of these
      analogues are described and their CCK-B affinity and selectivity rationalized by
      consideration of the pK(a) values, charge distribution, and geometry of the
      respective acid mimics. Several of the compounds have CCK-B binding affinities
      similar to the parent carboxylic acid 1 (CCK-B, IC50 = 1.7 nM; pK(a) = 5.6) and
      span a pK(a) range of less than 1 (sulfonic acid 27) to greater than 9.5 (5-thio
      1,2,4-triazole 24). Among the more active compounds synthesized are
      tricyclo[3.3.1.1(3,7)]dec-2-yl [R-(R*,R*)]-[2-[[2-[[(3-hydroxy-5
      isoxazolyl)acetyl]-amino]-2- phenylethyl]amino]-1-(1H-indol-3-ylmethyl)-1-methyl
      2-oxoethyl+ ++]carbamate (15), tricyclo[3.3.1.1(3,7)]dec-2-yl [R-(R*,R*)]-[1-(1H
      indol-3-ylmethyl)-1-methyl-2-oxo-2-[[2-[(1-oxo- 3-sulfopropyl)amino]-2
      phenylethyl]amino]-ethyl]carbamate, monosodium salt (27), and
      tricyclo[3.3.1.1(3,7)]dec-2-yl [R-(R*,R*)]-[1-(1H-indol-3-ylmethyl)-1- methyl-2
      oxo-2-[[2-[[(1H-1,2,4-triazol-5-ylsulfinyl)acetyl]a mino]-2
      phenylethyl]amino]ethyl]carbamic acid (34) which have CCK-B binding affinities of
      IC50 = 2.6, 1.3, and 1.7 nM, CCK-A/-B ratios of 650, 780, and 550 and pK(a)
      values of 6.5, less than 1, and 7.0, respectively.

PMID- 1635059
TI  - Benzazepinone calcium channel blockers. 5. Effects on antihypertensive activity
      associated with N1 and aromatic substituents.
AB  - We have shown that the pyrrolidinylmethyl substituent on the lactam nitrogen (N1)
      of benzazepinone and benzothiazepinone calcium channel blocking agents is
      resistant to metabolic deamination and generally increases the duration and
      potency of antihypertensive activity in spontaneously hypertensive rats (SHR)
      relative to (N,N-dimethylamino)ethyl analogs. Additionally, compounds possessing
      a substituent on the fused aromatic ring are more resistant to metabolic
      deacylation of the C3 hydroxy function, which may explain why aromatic
      substituents also frequently increase the potency and/or duration of
      antihypertensive activity. Our data also indicate the increased antihypertensive
      activity associated with these structural modifications is independent of any
      effects of potency in vitro. Overall, we interpret these results to indicate that
      these structural modifications improve antihypertensive activity as a result of
      increased metabolic stability and, consequently, oral bioavailability.

PMID- 1635060
TI  - Studies on antidiabetic agents. 11. Novel thiazolidinedione derivatives as potent
      hypoglycemic and hypolipidemic agents.
AB  - In the course of further chemical modification of the novel antidiabetic
      pioglitazone (AD-4833, U-72,107), a series of 5-[4-(2- or 4-azolylalkoxy)benzyl-
      or -benzylidene]-2,4-thiazolidinediones was prepared and evaluated for
      hypoglycemic and hypolipidemic activities in insulin-resistant, genetically
      obese, and diabetic KKA(y) mice. Replacement of the 2-pyridyl moiety of
      pioglitazone by a 2- or 4-oxazolyl or a 2- or 4-thiazolyl moiety greatly enhanced
      in vivo potency. The corresponding 5-benzylidene-type compounds, in which a
      methine was used as a linker between the benzene ring and the thiazolidinedione
      ring, also had potent biological activity. Among the compounds synthesized, 5-[4
      [2-(5-methyl-2-phenyl-4-oxazolyl)ethoxy]benzyl]-2,4- thiazolidinedione (18)
      exhibited the most potent activity, more than 100 times that of pioglitazone. The
      synthesis and structure-activity relationships for this novel series of
      derivatives are detailed.

PMID- 1635061
TI  - N-[4-[[(3,4-dihydro-4-oxo-1,2,3-benzotriazin-6- yl)methyl]amino]benzoyl]-L
      glutamic acid, a novel A-ring analogue of 2-desamino-5,8-dideazafolic acid.
AB  - N-[4-[[(3,4-Dihydro-4-oxo-1,2,3-benzotriazin-6- yl)methyl]amino]benzoyl]-L
      glutamic acid ("2-aza-2-desamino-5,8- dideazafolic acid", ADDF) was synthesized
      from 2-amino-5-methylbenzamide via a four-step sequence consisting of
      diazotization, benzylic bromination, condensation with dimethyl N-(4
      aminobenzoyl)-L-glutamate, and ester hydrolysis. ADDF was an inhibitor of
      recombinant mouse thymidylate synthase; inhibition was competitive with 5,10
      methylenetetrahydrofolate as variable substrate (Ki = 2.3 microM). It was a
      substrate for murine folylpolyglutamate synthetase with kinetic characteristics
      (Km = 28 microM) comparable to those of aminopterin, and it inhibited the growth
      of L1210 cells in culture (IC50 = 0.52 microM). The structural modification of
      the A-ring embodied in ADDF appears to offer a novel, heretofore unexplored
      approach to the design of TS inhibitors.

PMID- 1635062
TI  - Synthesis and structure-activity relationships of cephalosporins with C-3'
      catechol-containing residues.
AB  - Cephalosporins with new catechol substituents at C-3' have been synthesized,
      including novel compounds with C-3' carbon-carbon bonds. Many of these compounds
      have high potency against Gram-negative bacteria, in particular against resistant
      strains like Pseudomonas aeruginosa. Structure-activity relationships are
      discussed in terms of their dependence on the pKa of the C-3' catechol and also
      in terms of steric and conformational factors of the C-3' substituent. The best
      overall properties were found in compounds with a bulky and/or conformationally
      restricted acidic C-3' catechol.

PMID- 1635063
TI  - Pharmacokinetics of catechol cephalosporins. The effect of incorporating
      substituents into the catechol moiety on pharmacokinetics in a marmoset model.
AB  - Two series of cephalosporins A and B have been synthesized, bearing at C-3'
      catechols substituted with various electron withdrawing groups (Y) and differing
      links (X), and were evaluated for their in vitro antibacterial activity and their
      pharmacokinetics in marmosets. Compounds in series A, bearing an isobutyric oxime
      substituent, proved to be highly active against Gram-negative organisms and were
      especially noteworthy for showing long elimination phase (beta) half-lives in
      marmosets. It was established that introduction of electron withdrawing
      substituents greatly increased the beta half-lives of compounds (5, X = NHCO, Y =
      H, t1/2 = 1.25 h, AUC = 27 mg/h per L; 11, X = NHCO, Y = 5-Cl, t1/2 = 4.5 h, AUC
      = 638 mg/h per L) and that the nature of the link also influenced t1/2, the
      highest values being obtained when X = NHCO and OCO. Acidities (pKa values) of
      the substituted catechols were measured, and relationships between the acidities
      and half-lives were evaluated. Thus it was established that the more acidic
      catechols gave the longest half-lives (12, X = NHCO, Y = 2,5-Cl2, t1/2 = 8.2 h,
      AUC = 461 mg/h per L). Further elaboration of the catechol to bicyclic systems
      maintained good pharmacokinetics when the pKa was sufficiently acidic.

PMID- 1635064
TI  - Nonpeptide angiotensin II receptor antagonists: synthetic and computational
      chemistry of N-[[4-[2-(2H-tetrazol-5-yl)-1-cycloalken-1-
      yl]phenyl]methyl]imidazole derivatives and their in vitro activity.
AB  - A series of nonpeptide angiotensin II receptor antagonists was synthesized and
      tested in vitro to investigate requirements for recognition by and binding to AT1
      receptors. Compared to a known series of N-(biphenylylmethyl)imidazoles,
      including losartan (DuP 753), which has a more rigid conformation in the 2'
      tetrazolylbiphenyl moiety, the new series replaces the terminal phenyl with
      cycloalkenyls. Compounds were made with five- to seven-membered rings and with
      either a hydroxymethyl (3) or carboxyl (4) group at the 5 position on the
      imidazole ring. The effects of the lipophilicity and steric bulk of the terminal
      ring system, the amount of pi-electron density in the terminal ring, and the
      relative spatial proximity of the tetrazolyl and the middle phenyl are explored
      in terms of binding affinity to AT1 receptors in rat adrenal glomerulosa and
      rabbit aorta. The physicochemical variables of the new compounds were quantitated
      by computational chemistry and compared to those of losartan and its carboxyl
      metabolite. Potency at the AT1 receptors is maximized when the terminal ring is
      six-membered; an aromatic ring binds better than a cycloalkenyl ring. The 5
      carboxyimidazole compounds show higher affinity than the 5-hydroxymethyl series.

PMID- 1635065
TI  - Metabolism of 5-hydroxytryptamine by brain synaptosomes and microsomes in the
      presence of cysteine and glutathione.
AB  - Incubation of 5-hydroxytryptamine (1) with L-cysteine and pig or bovine brain
      microsomes and an NADPH-generating system or with synaptosomes results in the
      rapid formation of the (2R,4R)- and (2S,4R)-epimers of 2-[(5-hydroxy-1H-indol-3
      yl)methyl]thiazolidine. Incubation of 1 and glutathione under the same
      experimental conditions yields the (2R,4R)- and (2S,4R)-epimers of alpha-amino-4
      [[(carboxymethyl)amino]carbonyl]-2-[(5-hydroxy-1H- indol-3-yl)methyl]-delta-oxo-3
      thiazolidinepentanoic acid. These various thiazolidine derivatives are formed by
      nucleophilic addition of the thiol residues of cysteine or glutathione to the
      aldehyde group of 5-hydroxyindole-3-acetaldehyde (2), the primary product of the
      monoamine oxidase-mediated oxidative deamination of 1. The facile reaction of
      cysteine and glutathione with 2 might represent a mechanism designed to scavenge
      the biogenic aldehyde and therefore to prevent its alkylation of key
      intraneuronal protein nucleophiles.

PMID- 1635066
TI  - Acetazolamide-like carbonic anhydrase inhibitors with topical ocular hypotensive
      activity.
AB  - New carbonic anhydrase (EC 4.2.1.1) inhibitors were synthesized as potential
      drugs for the topical treatment of glaucoma. They were obtained by substituting
      the acetyl group of acetazolamide and methazolamide with bicarboxylic acids of
      different chain length (C4-C6). The terminal carboxyl was either kept free or
      esterified with alcohols of different size (C1-C12). A gamma-aminovaleric
      derivative was also prepared. All compounds proved active as carbonic anhydrase
      inhibitors in vitro, with an average IC50 of about 0.5 microM. Some proved also
      to be topically active in vivo in lowering the artificially elevated intraocular
      pressure in rabbits. The most active compound, carrying a succinic acid side
      chain, is the most soluble in aqueous buffers. Its duration of action is about 8
      h and it is under evaluation as a topical antiglaucoma drug. It is hypothesized
      that the duration of action could be longer in compounds having both the same
      high water solubility and partition coefficient.

PMID- 1635068
TI  - 1-(5'-Fluoro-6'-hydroxy-5',6'-dihydrouracil-5'-yl)-5-fluorouracil, a novel N(1)
      C(5)-linked dimer that releases 5-fluorouracil by radiation activation under
      hypoxic conditions.

PMID- 1635067
TI  - Synthesis of the acridone alkaloids glyfoline and congeners. Structure-activity
      relationship studies of cytotoxic acridones.
AB  - Glyfoline (4, 1,6-dihydroxy-10-methyl-2,3,4,5-tetramethoxyacridin-9-one) and its
      congeners were synthesized for evaluation of their cytotoxicity. A detailed
      structure-activity relationships (SAR) of these acridone derivatives were also
      studied. To study the SAR of glyfoline analogues, substituent(s) at C-1 and C-6
      and at the heterocyclic nitrogen of glyfoline nucleus were modified. Nitro- and
      amino-substituted glyfoline analogues were also synthesized to study the effects
      of substituent(s) (electron-withdrawing vs electron-donating) on their
      cytotoxicity. These compounds were synthesized via the Ullmann condensation of
      anthranilic acids with iodobenzenes or 2-chlorobenzoic acids with aniline
      derivatives. The SAR studies showed that 1-hydroxy-9-acridones were more active
      than their 1-OMe derivatives against cell growth of human leukemic HL-60 cells in
      culture. Replacement of NMe of glyfoline with NH or N(CH2)2NEt2 resulted in
      either total loss or dramatic reduction of cytotoxicity. Glyfoline congeners with
      nitro function at the A-ring were inactive, while compounds with amino
      substituent were shown to be cytotoxic in vitro.

PMID- 1635069
TI  - Praesomal nerves in Leptorhynchoides thecatus (Acanthocephala:
      Rhadinorhynchidae).
AB  - Investigated by light microscopy, the nerve pathways are described for the first
      time in the praesoma of a species of Rhadinorhynchidae. The pathways are
      described for 18 nerves, eight paired and two single, which originate from the
      cerebral ganglion and a post-ganglionic cell and terminate in the body wall
      musculature and the proboscis. The location of three commissures formed by these
      nerves is also described.

PMID- 1635070
TI  - Internal reproductive system in adult males of the genus Camponotus (Hymenoptera:
      Formicidae: Formicinae).
AB  - Descriptions are provided of the histology and ultrastructure of the male
      internal reproductive tracts from three species of Camponotus, representing three
      subgenera. This study is the first to provide ultrastructural information on the
      testes (including spermatogenesis and spermiogenesis), seminal vesicles, and
      accessory glands in ants. Testes contain about ten follicles each, and each
      follicle is capable of producing hundreds of cysts in which spermatozoa develop.
      Structural evidence of meiosis in late pupal testes includes cytoplasmic bridges
      between spermatocytes, centriole elimination, and fusion of mitochondria.
      Developing spermatids are in close contact with cyst cells in the region of the
      acrosome. Mature spermatozoa are similar in ultrastructure to those described
      previously for two other subfamilies of ants (Myrmicinae and Dolichoderinae). The
      ultrastructure of the seminal vesicle suggests that it is not merely a passive
      organ for sperm storage. Large numbers of both mitochondria and membranous whorls
      suggest a pH-regulating and/or hormonal function. The accessory gland is made up
      of secretory cells that contain a diversity of secretory granules. SDS-PAGE
      reveals several proteins found in the accessory glands but absent in the adjacent
      genitalia. Preliminary analyses indicate that carbohydrate is an important
      component of accessory gland secretions.

PMID- 1635071
TI  - Effects of hypothermia and rewarming on phospholipase C-evoked glycerol output in
      rat myocardial cells.
AB  - The combined action of phosphatidylcholine preferring phospholipase C (PC-PLC)
      and intracellular lipases has recently been shown to cause glycerol output in
      energy deprived rat cardiomyocytes. In the present study we examined the effect
      of hypothermia and rewarming on PC-PLC evoked glycerol output in freshly
      isolated, calcium-tolerant myocytes. The cells were preincubated for 60 min at
      hypothermic (5 degrees C) or normothermic (37 degrees C) conditions in Krebs
      Henseleit bicarbonate buffer (pH 7.4) supplemented with 1 mM DL-carnitine, 1%
      B.S.A. and 5 mM glucose. Addition of PC-PLC resulted in a significantly higher (P
      less than 0.05) output of glycerol in myocytes undergoing rewarming than in
      myocytes kept constantly at 5 degrees C or 37 degrees C. The values obtained for
      PC-PLC induced glycerol output (difference in glycerol output between incubations
      with and without PC-PLC) were 6.77 +/- 2.6 (37 degrees C), 4.54 +/- 1.7 (5
      degrees C) and 22.85 +/- 5.9 (5-37 degrees C) nmol/10(6) cells.h. Rewarming in
      addition caused a significantly higher (P less than 0.05) leakage of lactate
      dehydrogenase (LDH) from the rewarmed cells as compared to cells at constant
      temperatures (5 degrees C or 37 degrees C). However, there was no additional
      effect of PC-PLC on LDH leakage. The elevated PC-PLC induced glycerol output in
      rewarmed myocytes was not related to a fall in the percentage of rod-shaped cells
      or a reduced cellular content of ATP, since no differences could be detected
      between the various myocyte preparations with respect to these
      parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635072
TI  - Reduced adenylyl cyclase inhibition by carbachol and GTP during acute myocardial
      ischaemia.
AB  - Acute myocardial ischaemia frequently is complicated by ventricular
      tachyarrhythmias. These arrhythmias are in part due to an increased
      susceptibility of myocardial cells to adenylyl cyclase stimulation by
      catecholamines [1]. As adenylyl cyclase underlies an endogenous dual regulation
      by stimulatory and inhibitory receptor systems, adenylyl cyclase stimulation can
      be counteracted by the activation of receptors like the muscarinic M2 receptor
      [2]. Therefore, the effect of myocardial ischaemia on muscarinic receptor and
      "inhibitory" guanine nucleotide binding proteins (G(i)) mediated inhibition of
      adenylyl cyclase was studied. During 5 min of myocardial ischaemia, carbachol
      mediated inhibition of forskolin and isoproterenol stimulated adenylyl cyclase
      was reduced by 30% and 50%, respectively. Hormone independent inhibition of
      adenylyl cyclase by the nonhydrolyzable GTP-analogue guanosine 5'-[beta gamma
      imido]triphosphate (Gpp(NH)p) was reduced by 46%. In contrast, the amount of
      G(i), as determined by pertussis toxin catalyzed ADP-ribosylation, remained
      constant during 15 min of ischaemia. The impaired function of muscarinic receptor
      linked signal transduction during early myocardial ischaemia could contribute to
      the occurrence of ischaemia induced tachyarrhythmias by a reduced ability to
      counteract adenylyl cyclase activation.

PMID- 1635073
TI  - Neutrophils contribute to TNF induced myocardial tolerance to ischaemia.
AB  - Sublethal endotoxin (ETX) pretreatment of rats induces protection from cardiac
      ischaemia-reperfusion injury. This protective state is associated with increased
      endogenous myocardial catalase activity. Since tumour necrosis factor (TNF) is
      one mediator of ETX effects, we hypothesized that (TNF) pretreatment of the rat
      (30 micrograms/kg ip) 36 h prior to cardiac ischaemia-reperfusion could induce
      myocardial protection. We found that TNF administration increased both myocardial
      tolerance to ischaemia reperfusion injury (modified Langendorff, buffer
      perfusion, global, normothermic ischaemia) and myocardial catalase activity at 36
      h. Moreover, we found that 6 h after TNF administration, myocardial hydrogen
      peroxide (H2O2, assessed by aminotriazole-H2O2 inactivation of catalase) and
      myocardial neutrophil accumulation (assessed by histology) were both increased.
      When neutrophil function was inhibited either by neutrophil depletion
      (vinblastine) or by ibuprofen treatments of the rat before TNF, the protection
      previously apparent at 36 h was blocked. We conclude that TNF can induce
      myocardial resistance to ischaemia reperfusion injury. This protection is related
      to prior tissue neutrophil accumulation and concomitant increases in H2O2 levels.

PMID- 1635074
TI  - Effect of amiodarone therapy on the time course of myocardial phospholipid
      hydrolysis during in vitro total ischaemia in cat hearts.
AB  - The effects of chronic amiodarone therapy on myocardial phospholipid hydrolysis
      induced by total in vitro ischaemia were investigated in cat hearts. Chronic
      treatment of cats with amiodarone (30 mg/kg/day, orally) for 6 weeks resulted in
      a sufficient uptake of the drug reaching tissue levels of 83 +/- 13 & 122 +/- 22
      microM (n = 12) for amiodarone and its principle metabolite, desethylamiodarone,
      respectively. This was accompanied by a significant increase (37%, P less than
      0.001) in total phospholipid content of heart in treated as compared to untreated
      animals. Upon in vitro total ischaemia, these endogenous drug levels were
      sufficient to attenuate significantly hydrolysis of membrane phospholipid. The
      degree of attenuation was dependent upon the duration of ischaemic insult. In
      this regard, protection against phospholipid losses by amiodarone treatment was
      significantly more in the later irreversible phase of ischaemic injury whether
      studied in an in vitro total ischaemia model or in an isolated perfused heart
      preparation. Similar trend was observed in the relative accumulation of
      lysophospholipid and non-esterified fatty acid levels during ischaemia, i.e. both
      were significantly attenuated by amiodarone treatment. However, in contrast to
      the fatty acid data, the net changes in lysophospholipids per gram tissue wet
      weight were similar in treated and untreated animals, suggesting that the
      protective effects of amiodarone may have involved other enzymes including
      phospholipase C and D. Also, during the entire time course studied, all the
      phospholipid classes appeared to be affected to more or less a similar degree,
      indicating that the effects of the drug may have manifested in other subcellular
      compartments besides lysosomes. However, at all time periods studied, the net
      release of eicosatetraenoic and docosahexaenoic acid (fatty acids occupying
      primarily sn-2 position of phospholipids) was different, release of the former
      fatty acid being inhibited more than the latter, suggesting specific interaction
      of amiodarone with the molecular species of phospholipid. The data suggest that
      amiodarone attenuates ischaemia-induced membrane lipid abnormalities in part
      through modulation of phospholipid metabolism, and that this effect may be one of
      the key determinants which contribute to its antiarrhythmic properties during
      acute ischaemia.

PMID- 1635075
TI  - Mechanism of the membrane depolarization induced by oxidative stress in guinea
      pig ventricular cells.
AB  - Mechanism of the membrane depolarization induced by oxidative stress was examined
      using ion-selective microelectrode and patch clamp techniques. In guinea-pig
      papillary muscles stimulated at 0.5 Hz, cumene hydroperoxide (CH) at a
      concentration of 300 microM decreased the resting membrane potential and
      shortened the action potential, concomitantly with muscle contracture. The
      membrane depolarization was not associated with a significant decrease in
      intracellular potassium ion activity, indicating that the depolarization is not
      due to a decrease in potassium equilibrium potential resulting from leak of
      intracellular K+. In isolated guinea-pig ventricular cells. CH (10-30 microM)
      consistently decreased the inward rectifier potassium current and slightly
      decreased the calcium current. In cell-attached patches CH inhibited the opening
      of the inward rectifier K+ channel without affecting the unit amplitude of the
      single channel current. Thus, the depolarization of the resting membrane induced
      by oxidative stress is, at least in part, due to the inhibition of the inward
      rectifier K+ channel activity, and may play an important role in the genesis of
      reperfusion-induced arrhythmias.

PMID- 1635076
TI  - Reductive activation of mitomycin C: a delicate balance.

PMID- 1635077
TI  - Ken Olden has clear vision as NIEHS director.

PMID- 1635078
TI  - Second round of NCI funds goes to other institutes.

PMID- 1635079
TI  - Drug firms, countries hope to cash in on natural products.

PMID- 1635080
TI  - Biodiversity treaty still unsigned by U.S.

PMID- 1635081
TI  - Top July stories are "5 a day," new cancer risks.

PMID- 1635082
TI  - ACS focusing on breast cancer detection.

PMID- 1635083
TI  - Cancer pain in the elderly needs special attention.

PMID- 1635084
TI  - Recommendations on predictive testing for germ line p53 mutations among cancer
      prone individuals.

PMID- 1635085
TI  - Relationship between mammographic and histological risk factors for breast
      cancer.
AB  - BACKGROUND: Information on breast cancer risk can be obtained both from the
      histological appearance of the breast epithelium in biopsy specimens and from the
      pattern of parenchymal densities in the breast revealed by mammography. It is not
      understood, however, how parenchymal densities influence breast cancer risk or
      whether these densities are associated with histological risk factors. PURPOSE:
      We have estimated, in a large cohort of women, the relative risk of detecting
      carcinoma in situ, atypical hyperplasia, hyperplasia without atypia, or
      nonproliferative disease in biopsy specimens from women with different extents of
      mammographic density. We also examined the association between these histological
      classifications and radiological features present specifically at the biopsy
      site. METHODS: The source of study material was a population of women aged 40-49
      years who were enrolled in the Canadian National Breast Screening Study (NBSS).
      Mammograms from women who had undergone a biopsy (n = 441) and from a comparison
      group of women (n = 501) randomly selected from the mammography arm of the NBSS
      were classified according to the extent of mammographic density. The
      corresponding histological slides were independently classified by a review
      pathologist. RESULTS: Compared with women showing no mammographic densities,
      women with the most extensive densities (i.e., occupying greater than 75% of the
      breast volume) had a 9.7 times greater risk of developing carcinoma in situ or
      atypical hyperplasia (95% confidence interval [CI] = 1.75-53.97), a 12.2 times
      greater risk of developing hyperplasia without atypia (95% CI = 2.97-50.14), and
      a 3.1 times greater risk of developing non-proliferative disease (95% CI = 1.20
      8.11). The gradients in risk were not monotonic across the five classifications
      of mammographic density. The association could not be explained by the presence
      of mammographic densities at the biopsy site, but calcification at the biopsy
      site was strongly associated with high-risk histological changes (relative risk =
      24; 95% CI = 5.0-156.0). CONCLUSIONS: These results suggest that the radiological
      patterns referred to as mammographic dysplasia may influence breast cancer risk
      by virtue of their association with high-risk histological changes in the breast
      epithelium. IMPLICATIONS: Identification of the factors responsible for high-risk
      histological changes may offer new insights into the etiology of breast cancer
      and potentially lead to the development of methods for its prevention.

PMID- 1635086
TI  - Bioactivation of mitomycin C by xanthine dehydrogenase from EMT6 mouse mammary
      carcinoma tumors.
AB  - BACKGROUND: Mitomycin C is an antineoplastic antibiotic requiring bioactivation
      to an alkylating species or to an intermediate capable of generating oxygen
      radicals for its toxic effect. The enzymes responsible for the in vivo activation
      of mitomycin C have been proposed to include NADPH-cytochrome-c reductase, DT
      diaphorase, and xanthine oxidase. PURPOSE: In this study, xanthine dehydrogenase,
      an enzyme structurally similar to xanthine oxidase, was assessed for its ability
      to activate mitomycin C. Partially purified xanthine dehydrogenase, from EMT6
      mouse mammary tumors, was investigated for its ability to bioactivate mitomycin C
      under both aerobic and hypoxic conditions. METHODS: We conducted this analysis by
      measuring mitomycin C-induced oxygen consumption, alkylating potential, and
      mitomycin C consumption and metabolite formation as determined by high-pressure
      liquid chromatography analysis. RESULTS: Bioactivation of mitomycin C by xanthine
      dehydrogenase under both aerobic and hypoxic conditions gave rise to the
      formation of a metabolite, 2,7-diaminomitosene. Formation of this metabolite and
      alkylating ability were greater under hypoxic than under aerobic conditions and
      were increased when the pH was decreased from 7.4 to 6.0. Mitomycin C consumption
      was the same under both aerobic and hypoxic conditions and was independent of pH.
      Oxygen consumption studies showed that xanthine dehydrogenase-activated mitomycin
      C consumed oxygen at a much lower rate than xanthine oxidase-activated mitomycin
      C. CONCLUSIONS: Xanthine dehydrogenase-activated mitomycin C appears to be a good
      alkylating species but a relatively poor generator of reactive oxygen when
      compared with xanthine oxidase activation under aerobic conditions. IMPLICATION:
      Xanthine dehydrogenase may play an important role in the bioactivation of
      mitomycin C to an alkylating species under both aerobic and hypoxic conditions.

PMID- 1635087
TI  - l-folinic acid versus d,l-folinic acid in rescue of high-dose methotrexate
      therapy in children.
AB  - BACKGROUND: At this time, folinic acid (FA) is commercially available as the
      racemic mixture d,l-FA, whose biological activity is supported by natural l-FA.
      The administration of d,l-FA results in the accumulation of d-FA in plasma
      relative to the active l-FA form; in vitro studies have shown that d-FA can
      compete with the polyglutamation of methotrexate (MTX). PURPOSE: Our purpose was
      to compare, on a pharmacokinetic, biological, and clinical basis, the racemic
      mixture d,l-FA with the pure l-FA in rescue of high-dose MTX therapy (5 g/m2) in
      children with acute lymphocytic leukemia (ALL). METHODS: Eighteen children with
      ALL were entered in this trial, which was planned with a crossover design. Four
      cycles of MTX were administered to each patient, and rescue was achieved orally
      every 6 hours at a dose of 12 mg/m2 for d,l-FA and 6 mg/m2 for pure l-FA. The d,l
      FA and l-FA rescues were alternated from one cycle to the next. d-FA, l-FA, and
      the active metabolite 5-methyltetrahydrofolate (5-MTHF) were measured in plasma
      using a stereospecific high-performance liquid chromatography assay. RESULTS:
      Considering total active folate levels (l-FA + 5-MTHF), mean residual
      concentrations were similar for rescue by d,l-FA and l-FA, after two and six
      intakes, respectively: 92 and 186 nM for d,l-FA rescue versus 100 and 184 nM for
      l-FA rescue. Intra-individual comparison of total active folates (l-FA + 5-MTHF)
      did not show any significant difference between d,l-FA rescue and l-FA rescue.
      After administration of d,l-FA, the accumulation of d-FA in plasma was confirmed.
      For both types of FA rescue, MTX terminal half-lives were identical (average
      value, 13.9 hours). Considering each type of toxic effect (hematologic, hepatic,
      renal, and digestive), there was no significant difference in the proportion of
      toxic cycles following l-FA rescue or d,l-FA rescue. CONCLUSION: The
      administration of the pure l-FA, compared with the administration of the racemic
      mixture, results in comparable blood profiles of active folates and MTX, leads to
      equivalent treatment tolerance, and avoids the plasma accumulation of d-FA.

PMID- 1635088
TI  - Hematopoietic growth-promoting effects of natural killer cells in mice in
      response to in vivo administration of human interleukin-2.
AB  - BACKGROUND: Interleukin-2 (IL-2) is currently being evaluated as an anti
      neoplastic agent because of its stimulatory effects on the immune system.
      However, little is known about the effects of systemic IL-2 administration on
      hematopoietic parameters. PURPOSE: Recombinant human IL-2 (rHuIL-2) was
      administered to mice to evaluate its in vivo hematopoietic effects. The mechanism
      underlying the effects of rHuIL-2 administration was also determined. METHODS:
      Mice were given 5 x 10(4) IU of rHuIL-2 for 5 days, and their hematopoietic
      progenitor cell status was determined as measured by growth in soft agar.
      Antiserum to natural killer (NK) cell-specific markers was used to ascertain if
      NK cells were responsible for the hematopoietic effects of rHuIL-2. NK cells were
      purified and cultured in vitro with rHuIL-2 and then adoptively transferred into
      syngeneic mice to determine the effects on hematopoiesis. RESULTS: Treatment of
      mice with rHuIL-2 resulted in a significant increase in bone marrow and splenic
      hematopoietic progenitor cell content. Mice with severe combined immune
      deficiency (SCID), which lack T cells and B cells yet have NK cells, also
      responded to the myelostimulatory effects of rHuIL-2. However, removal of NK
      cells from the SCID mice with antiserum to NK cell-specific markers abrogated the
      myelostimulatory properties of rHuIL-2. Adoptive transfer of NK cells that were
      propagated in vitro with rHuIL-2 into mice also resulted in an increase in
      splenic hematopoietic progenitor cells. CONCLUSIONS: rHuIL-2 exerts significant
      myelostimulatory effects after in vivo administration, and NK cells are
      responsible for at least some of these effects. IMPLICATIONS: These results
      suggest that NK cells and rHuIL-2 may be of use clinically to promote
      hematopoiesis after bone marrow transplantation or in the face of other
      myelotoxic therapy in the treatment of cancer.

PMID- 1635089
TI  - Intrathecal dacarbazine treatment of leptomeningeal malignant melanoma.

PMID- 1635090
TI  - Diuretic use and risk factors for cancer: results of animal studies.

PMID- 1635091
TI  - Indole-3-carbinol.

PMID- 1635092
TI  - Men, women, and murder: gender-specific differences in rates of fatal violence
      and victimization.
AB  - To study the potential differences that distinguish homicides involving women as
      victims or offenders from those involving men, we analyzed Federal Bureau of
      Investigation Uniform Crime Reports data on homicides that occurred in the United
      States between 1976 and 1987. Only cases that involved victims aged 15 years or
      older were included. Persons killed during law enforcement activity and cases in
      which the victim's gender was not recorded were excluded. A total of 215,273
      homicides were studied, 77% of which involved male victims and 23% female
      victims. Although the overall risk of homicide for women was substantially lower
      than that of men (rate ratio [RR] = 0.27), their risk of being killed by a spouse
      or intimate acquaintance was higher (RR = 1.23). In contrast to men, the killing
      of a woman by a stranger was rare (RR = 0.18). More than twice as many women were
      shot and killed by their husband or intimate acquaintance than were murdered by
      strangers using guns, knives, or any other means. Although women comprise more
      than half the U.S. population, they committed only 14.7% of the homicides noted
      during the study interval. In contrast to men, who killed nonintimate
      acquaintances, strangers, or victims of undetermined relationship in 80% of
      cases, women killed their spouse, an intimate acquaintance, or a family member in
      60% of cases. When men killed with a gun, they most commonly shot a stranger or a
      non-family acquaintance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635093
TI  - Laparoscopy in the evaluation of the intrathoracic abdomen after penetrating
      injury.
AB  - Penetrating trauma to the intrathoracic abdomen is a difficult clinical problem,
      especially with reference to the detection of diaphragmatic injuries. A
      retrospective analysis of 657 laparotomies for penetrating abdominal trauma at
      our institution revealed 78 laparotomies with negative results. The majority
      (44.8%) were for wounds in the lower chest and upper abdomen. The role of
      laparoscopy in evaluating these difficult areas was studied in 40 (34 stab wounds
      and 6 gunshot injuries) patients. Fifteen stab wounds and five gunshot wounds
      were nonpenetrating. Laparoscopy revealed eight clinically unsuspected
      diaphragmatic lacerations in seven patients. Twenty patients had hemoperitoneum.
      Five patients with omental bleeding and abdominal wall bleeding and four with
      nonbleeding liver lacerations underwent nontherapeutic laparotomies. One patient
      with a nonbleeding liver laceration was observed successfully without laparotomy.
      Ten of the 20 patients with hemoperitoneum had therapeutic laparotomies. The
      incidence of diaphragmatic lesions discovered by laparoscopy in this series was
      comparable with that reported after a mandatory laparotomy for thoracoabdominal
      wounds. It is concluded that laparoscopy is an excellent modality for the
      evaluation of the intrathoracic abdomen and the diaphragm.

PMID- 1635094
TI  - Mild head injury: a plea for routine early CT scanning.
AB  - We reviewed the records of 1538 mild head injury patients admitted during a 4 1/2
      year period to the Southern New Jersey Regional Trauma Center. All patients had
      experienced brief loss of consciousness or amnesia, but had a normal or near
      normal neurologic examination on admission, with Glasgow Coma Scale (GCS) scores
      of 13-15 and no focal neurologic deficit. Routine urgent cranial CT scans were
      obtained on all patients, and correlations between skull fractures and
      intracranial lesions investigated. Two hundred sixty-five patients (17.2%)
      harbored 340 lesions on CT scans, of which 131 were fractures and 209 were
      intracranial abnormalities. Fifty-eight patients needed surgery for their
      intracranial lesions; 23 of them had no skull fractures. None of the 1339
      patients without CT evidence of intracranial lesions deteriorated under
      observation. We conclude that clinical observation with or without skull x-ray
      films is inadequate to rule out potentially dangerous intracranial lesions in
      apparently mild head injuries. If there is a history of loss of consciousness or
      amnesia, an immediate CT scan is indicated. If the results of the CT scan are
      normal and there are no other indications for admission, these patients may be
      safely discharged.

PMID- 1635095
TI  - Antibiotic-primed fibrin gel improves outcome in contaminated splenic injury.
AB  - Fibrin gel (FG) has recently been shown to be bactericidal in the management of
      contaminated hepatic injury; antibiotic loading of fibrin gel (AFG) may augment
      this effect. We evaluated the antimicrobial properties of FG and AFG in a rat
      model of contaminated splenic injury. Fibrin gel was made from centrifuged plasma
      of separate donor rats and bovine thrombin. Antibiotic fibrin gel was similarly
      produced following intravenous injection of 70 mg/kg ticarcillin. Male Holtzman
      rats (250-300 g) were anesthetized and a laparotomy done. The abdomen was
      contaminated with 1 x 10(7) Bacteroides fragilis and the spleen transected in the
      midportion. Treatment consisted of splenorrhaphy (S) (n = 7), FG application (n =
      7), or AFG (n = 7). The animals were autopsied at 1 week to evaluate abscess
      formation and abdominal adhesions (grade I = none, grade II = mild, grade III =
      severe). Antibiotic/fibrin gel significantly decreased abscess formation
      following splenic injury when compared with S (2 of 7 vs. 7 of 7; p less than
      0.05 by ANOVA) without an increase in adhesions. Fibrin gel also decreased
      abscess formation but not significantly (4 of 7 vs. 7 of 7). Histologic analysis
      confirmed the beneficial effect of FG and AFG on wound healing. The bactericidal
      effect of FG is improved by antibiotic loading in contaminated intraabdominal
      injury.

PMID- 1635096
TI  - Packing and re-exploration for patients with nonhepatic injuries.
AB  - We retrospectively reviewed the clinical records of 11 patients admitted to the
      trauma service at Kings County Hospital who underwent packing and temporary
      closure for severe nonhepatic injuries. The mean ISS was 37 and the mean
      Abdominal Trauma Index value was 48. Operative findings included 17 major
      vascular injuries. Although the mean blood pressure was 105 mm Hg during the
      procedure, the patients required an average of 17 units of blood and all were
      acidotic, hypothermic, and coagulopathic. Acidosis persisted in all patients and
      the mean base excess was -13 at closure. A conscious decision was made to
      terminate the procedure when surgical bleeding was controlled. Patients were
      resuscitated and warmed in the ICU and returned to the operating room within 48
      hours. Seven of the 11 patients survived. Of the eight patients who survived to
      return to the operating room, all required gastrointestinal procedures at re
      exploration. This preliminary experience supports packing to control
      coagulopathic bleeding, use of temporary abdominal closure, and further ICU
      resuscitation with a planned second laparotomy for definitive management of
      gastrointestinal injuries in patients with severe nonhepatic injuries.

PMID- 1635097
TI  - A pediatric trauma center without a pediatric surgeon: a four-year outcome
      analysis.
AB  - Approximately 25% of all injury victims are in the pediatric age group, and one
      in four injured children will require a pediatric trauma center. According to the
      American College of Surgeons as well as many state guidelines, a level I
      pediatric trauma team should be directed by a pediatric surgeon. In 1986, the
      pediatric surgeon left our pediatric trauma center, but the center remained open
      under a cooperative effort by the adult trauma surgeons and pediatric
      intensivists. We have retrospectively reviewed the charts of all pediatric trauma
      patients (age less than or equal to 15 years) for the subsequent 4 years to
      determine the outcome of treatment without a pediatric surgeon. During this
      period, we treated 303 pediatric patients with multiple or serious single-system
      injuries. The mean age was 6.9 +/- 0.3 (SEM) years and 66% were boys. Falls were
      the cause of injury in 31% of the patients, with pedestrian/bicycle, motor
      vehicle crashes, and penetrating injuries resulting in 26%, 19%, and 3% of the
      injuries, respectively. The mean ISS was 15.6 +/- 0.8, and 73% of the patients
      had at least one AIS greater than or equal to 3. Surgical procedures were
      required in 48% of the patients. There were 27 deaths in this group, most
      commonly related to head injury (89%). The mean Pediatric Trauma Score of the
      patients who died was 1.6 +/- 0.8 and no patient with a Pediatric Trauma Score
      greater than 7 died.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635098
TI  - The reaction of copper and other projectile metals in body tissues.
AB  - To determine the effect of copper in tissue, copper specimens, along with other
      metals commonly used in firearm projectiles, were implanted into rats. Copper
      consistently produced a necrotic, abscesslike reaction in all tissues tested.
      Nickel produced a similar reaction, although of lesser magnitude. Aluminum, zinc,
      and lead produced no significant tissue reaction.

PMID- 1635099
TI  - A new method of diagnosing diaphragmatic injury using intraperitoneal technetium:
      case report.
AB  - The diagnosis of diaphragmatic laceration following blunt or penetrating trauma
      is often difficult to establish. Delay in recognition of this injury can be life
      threatening, resulting in herniation of abdominal viscera with possible
      strangulation or respiratory embarrassment. Previous animal studies from our
      institution have documented that intra-abdominal instillation of technetium
      sulfur colloid is a sensitive method to diagnose diaphragmatic disruption. We now
      present a case of diaphragmatic injury where the preoperative diagnosis was
      accurately made using this method when other imaging studies were inconclusive.

PMID- 1635101
TI  - Predictors of blinding or serious eye injury in blunt trauma.
AB  - Multivariate analysis was used to identify factors predicting injury and visual
      outcome in 94 blunt trauma patients evaluated for eye injuries among 6700
      admissions to a level I trauma center over a 29-month period. Patients with
      penetrating eye injuries were excluded from this review. Eye injury was detected
      in 93% or 87 of the patients evaluated. Seven percent of eye injuries resulted in
      blindness, 22% were serious (visual acuity between 20/40 and 20/200 or eye injury
      requiring surgery), and 71% were temporary (final visual acuity of 20/40 or
      better). The presence of an afferent pupillary defect or a nonreactive pupil was
      the most important factor in predicting the severity of eye injury (p = 0.0023),
      followed by facial fractures (p = 0.0084), and no eye opening or eye opening to
      pain within the Glasgow Coma Scale (p = 0.02). Eye injury is an infrequent
      complication of blunt trauma. Appropriate consultation for evaluation of this
      problem can be obtained based on findings from the initial history and screening
      physical examination.

PMID- 1635100
TI  - Salmonella typhi splenic abscess in an intravenous drug abuser following
      splenorrhaphy: case report.
AB  - A recent case of posttraumatic splenic abscess in an HIV-positive intravenous
      drug abuser following a splenic salvage procedure is reported. With the recent
      trend toward splenic preservation and the ever-increasing population of HIV
      positive, immune-compromised patients, the complication of splenic abscess may
      become more common.

PMID- 1635102
TI  - Experimental cardiac tamponade with a myocardial wound: the effect of rapid
      intravenous infusion of saline.
AB  - In order to demonstrate that the evolution of cardiac tamponade from a
      ventricular wound is different from that without myocardial wounding, the effects
      of a rapid infusion of saline solution on hemodynamic behavior and pericardial
      pressure (PP) were evaluated in dogs with cardiac tamponade caused by ventricular
      perforation (group C), animals without cardiac tamponade (group A), and animals
      with cardiac tamponade induced by infusion of saline into the pericardium (group
      B). We found that blood pressure (BP) increased from 107.5 +/- 15.5 mm Hg to 126
      +/- 4 mm Hg in group A; increased from 64.5 +/- 17.9 mm Hg to 117.5 +/- 22.17 mm
      Hg in group B; and increased from 60.75 +/- 46.5 mm Hg to 76 +/- 14.4 mm Hg in
      group C. Central venous pressure (CVP) increased from 3.75 +/- 0.96 cm H2O to 9.5
      +/- 3.3 cm H2O in group A; increased from 8 +/- 2.4 cm H2O to 16.25 +/- 3.1 cm
      H2O in group B; and rose from 7.75 +/- 2.6 cm H2O to 20.66 +/- 5.03 cm H2O in
      group C. Cardiac output (CO) increased from 3.9 +/- 1.2 L/min to 18.93 +/- 3.96
      L/min in group A; increased from 1.23 +/- 0.3 L/min to 5.4 +/- 1.7 L/min in group
      B; and increased from 1.8 +/- 0.66 L/min to 3.53 +/- 1.31 L/min in group
      C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635103
TI  - Multivariate population-based analysis of the association of county trauma
      centers with per capita county trauma death rates.
AB  - The purpose of this study was to utilize a large population-based data base to
      determine the association of trauma centers with per capita county trauma death
      rates. METHODS: Per capita county trauma death rate, the dependent variable in
      the model, was obtained from a well-validated state Medical Examiner's data base.
      Over 200 county demographic, prehospital, and hospital trauma care resource
      variables were obtained from a variety of sources for multivariate modeling.
      Bivariate analysis identified candidate variables for multivariate modeling,
      excluding highly correlated independent variables to avoid problems of
      collinearity. Multivariate linear regression, logistic regression, and stepwise
      discriminant analysis were used to determine the relative association of the
      candidate variables with per capita county trauma death rates. RESULTS: Bivariate
      analysis identified multiple factors associated with per capita county trauma
      death rates. These included, among others: county rurality, percentage of
      unemployment, percentage nonwhite, 911 access, and ALS certified EMS. Per capita
      trauma death rates were significantly lower in counties with trauma centers
      compared with counties without trauma centers (4.0 +/- 0.5 and 5.0 +/- 1.1 deaths
      per 10,000 population, p = 0.0001, respectively). Multivariate analysis
      demonstrated that the presence of a trauma center in the county and ALS were the
      best medical system factors predicting decreased per capita county trauma death
      rates. CONCLUSIONS: This study is unique in utilizing a regional population-based
      data base of all trauma deaths in a large state to analyze the association of
      trauma centers and trauma death rates. Multivariate modeling controlling for
      other county variables demonstrated that the presence of a trauma center and
      Advanced Life Support training were the best predictors of per capita county
      trauma death rates. These findings are consistent with the hypothesis that trauma
      centers decrease trauma death rates.

PMID- 1635104
TI  - Sonography in blunt abdominal trauma: a preliminary progress report.
AB  - Evaluation of blunt abdominal trauma is clinically challenging. Diagnostic
      peritoneal lavage (DPL) and computed tomographic (CT) scanning have become
      primary diagnostic modalities. We examined the efficacy and role of
      ultrasonographic (US) studies in the initial abdominal evaluation of blunt trauma
      patients. Over an 8-month period, patients whose abdominal work-up indicated the
      need for DPL or CT were evaluated sonographically within the first hour after
      admission by trauma fellows (PGY-6) with at least 1 hour of theoretical training
      and 1 hour of practical training. Sonograms considered positive were those
      showing free peritoneal fluid or organ disruption. Hard copies of the sonograms
      were evaluated by a staff radiologist without knowledge of the fellows'
      interpretations or of DPL or CT results. Based on the fellows' interpretation of
      the real-time sonograms, among the first 163 patients studied were 11 true
      positive, 146 true-negative, one false-positive, and five false-negative results.
      Sixteen patients had intra-abdominal injury documented by DPL, CT, or laparotomy.
      Ultrasonography was 91% sensitive in detecting the presence of hemoperitoneum.
      Overall, ultrasonography was 69% sensitive, 99% specific, and 96% accurate in
      diagnosing abdominal injury. We conclude that emergency sonography on admission
      can serve as a valuable adjunct to the physical diagnosis of clinically
      significant hemoperitoneum. It is noninvasive, portable, and accurate in
      determining the need for further diagnostic/surgical intervention.

PMID- 1635105
TI  - Effect of increased intra-abdominal pressure on mesenteric arterial and
      intestinal mucosal blood flow.
AB  - The effects of increased intra-abdominal pressure (IAP) on intestinal blood flow
      were studied in eight anesthetized pigs. Mesenteric artery blood flow (MABF),
      intestinal mucosal blood flow (IMBP), tonometric intramucosal pH (pHi), mean BP
      (MAP), cardiac output (CO), and pulmonary artery wedge pressure (PAWP) were
      measured as IAP was raised to 10, 20, 30, and 40 mm Hg by infusing lactated
      Ringer's solution (LR) into the peritoneal cavity. The MAP was kept constant with
      IV LR. Cardiac output fell slightly from 5.4 +/- 1.1 at baseline to 4.0 +/- 1.2
      L/min at an IAP of 40 mm Hg (p less than 0.05). An IAP of 20 mm Hg caused
      significant decreases in MABF (73% +/- 22% of baseline) (p less than 0.05) and
      IMBF (61% + 12% of baseline) (p less than 0.05). These changes became
      progressively greater as the IAP was increased to 40 mm Hg. The pHi fell to 6.98
      +/- 0.14 at 40 mm Hg IAP (p less than 0.01), indicating severe mucosal ischemia.
      Thus increased IAP can cause severe intestinal ischemia, which may be more
      important than the cardiac, pulmonary, and renal changes usually described.

PMID- 1635106
TI  - The effect of burn wound size on hemostasis: a correlation of the hemostatic
      changes to the clinical state.
AB  - The effect of burn wound size on the activation of fibrinolysis, coagulation, and
      contact factors was analyzed in 60 thermal injury patients. Blood samples from 47
      male patients and 13 female patients, (average age 37 years; range 1.5-70 years)
      were collected within the first 36 hours and at 5-7 days following injury. The
      patient population was categorized by percentage of burn (second degree and/or
      third degree): less than 20%, n = 22; 20%-40%, n = 18; greater than 40%, n = 20.
      The average percentage of burn was 32% (range, 4%-95%). The mechanism of injury
      was by flame (25), explosion and flame (19), scald (12), electric (3), or
      chemicals (1). An associated inhalation injury was present in 12 patients. The
      overall mortality rate was 13% (8). Sepsis or serious infection occurred in 23%
      (14) of the patients. On admission, 83% of the patients had normal prothrombin
      times (PT) and activated partial thromboplastin times (APTT). However, specific
      hemostatic variables showed marked changes. Admission hemostatic markers that
      correlated with the severity of injury were: tissue-plasminogen activator (tPA),
      plasminogen activator inhibitor (PAI), D-dimer (D-di), plasminogen (Plg),
      proteins C and S (PrC and PrS), antithrombin III (ATIII), thrombin-antithrombin
      complex (TAT), kallikrein (Kal:c), kinin (Kin), C1 esterase inhibitor (C1Inh),
      and factor VII clotting and antigen (FVII:c, FVII:ag). These data suggest that
      during the early course following burn injury, thrombogenicity is increased (TAT
      increases) because of a decrease in ATIII, PrC, and PrS; and fibrinolysis
      activation (D-di increases) occurs via an increase in tPA with a p value increase
      in PAI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635107
TI  - "Scoop and run" or stabilize hemorrhagic shock with normal saline or small-volume
      hypertonic saline?
AB  - The controversy over a policy of "scoop and run" or stabilizing hemorrhagic shock
      when evacuation time is short has not yet been settled. Small volumes of
      hypertonic saline have been suggested as effective therapy when the scoop-and-run
      policy is adopted. In the present study small-volume hypertonic saline treatment
      and normal saline treatment of "uncontrolled" hemorrhagic shock (UCHS) in rats
      were compared with no treatment, which best simulates the scoop-and-run policy.
      The rats were randomly assigned to three groups. Uncontrolled hemorrhagic shock
      was induced by 12% resection of the terminal portion of the rats' tails. In group
      I (n = 13) the animals were untreated. In group II (n = 6) UCHS was treated by
      administering 41.5 mL/kg 0.9% NaCl (NS). In group III (n = 6) UCHS was treated by
      administering 5 mL/kg 7.5% NaCl (HTS). Resection of the rats' tails in group I
      was followed by bleeding of 3.3 +/- 0.3 mL in 15 minutes with a fall in mean
      arterial pressure (MAP) from 100.9 +/- 7 to 63.5 +/- 5 mm Hg (p less than 0.001).
      The early bleeding and hemodynamic responses were similar in all three groups.
      Further blood loss in the first hour in group I was 0.5 +/- 0.2 mL, and MAP rose
      spontaneously to 73.2 +/- 6 mm Hg (p less than 0.05). The NS infusion in group II
      was followed by further bleeding of 4.1 +/- 0.9 mL (p less than 0.01) and a
      further fall in MAP to 53.8 +/- 7 mm Hg (p less than 0.01) after 60
      minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635108
TI  - The clinical significance of myocardial contusion.
AB  - In an attempt to identify a group of blunt trauma victims with asymptomatic
      myocardial contusion (MC) who do not benefit from intensive cardiac monitoring,
      we prospectively divided 336 patients admitted to the SICU with possible MC
      following blunt trauma in the 6 years prior to January 1990 into three groups:
      Group 1 (n = 155, age 30.5 +/- 9 years) consisted of those patients admitted for
      mechanism of injury, J-point elevation, with or without minor chest injury. None
      developed arrhythmias. Their SICU length of stay (LOS) was 2.41 +/- 0.77 days.
      Group 2 (n = 43, age 31.5 +/- 10 years) patients had the same admission criteria
      as the patients in group 1 plus an abnormal emergency department ECG, i.e.,
      arrhythmia, heart block, ischemia. None had cardiac complications. Their SICU LOS
      was 2.47 +/- 0.94 days. Group 3 (n = 138, age 40 +/- 20 years) patients had four
      or more rib fxs, a pulmonary contusion, a flail chest, or extra-thoracic injuries
      or were greater than 60 years of age. All required SICU admission for their non
      cardiac injuries. Nineteen patients had cardiac complications requiring
      treatment. None had a cardiac death. Their SICU LOS was 10 +/- 22 days. We
      conclude that young patients with minor blunt thoracic trauma and a normal or
      minimally abnormal ECG do not benefit from cardiac monitoring.

PMID- 1635110
TI  - Focal brain injury results in severe cerebral ischemia despite maintenance of
      cerebral perfusion pressure.
AB  - Severe head injury often causes an increase in intracranial pressure (ICP) and
      decreases in cerebral blood flow (CBF) and cerebral oxygen delivery (CO2del). To
      determine if this reduction in CBF and CO2del would produce cerebral ischemia and
      if this reduction would be abrogated by maintaining global cerebral perfusion
      pressure (CPP), we studied CPP, ICP, CBF, CO2del, cerebral oxygen extraction
      ratio (CO2ER), and cortical water content (CWC) in a porcine model of focal
      cryogenic brain injury. Fifteen mature swine were randomized to two groups. The
      experimental group (n = 7) had a brain lesion and was studied for 24 hours. The
      control group (n = 8) was instrumented only. Cryogenic injury significantly
      increased ICP and decreased CBF and CO2del compared with controls. There were no
      significant differences in CPP between the groups for the entire experiment, and
      the CPP was well above the ischemic threshold. The CO2ER significantly increased
      in the first three hours after brain injury. However, CO2ER in experimental
      animals tended to decrease 12 hours after brain injury and was not significantly
      different from that in controls. Cryogenic injury significantly increased the CWC
      in the lesioned hemisphere. These data indicate that focal brain injury results
      in persistent ischemia despite the normalization of CPP, suggesting that a
      significant increase in cerebral vascular resistance (CVR) occurs after brain
      injury. We conclude that in addition to maintenance of CPP, intervention to
      reduce CVR may be important in the management of brain injury.

PMID- 1635109
TI  - Local production of interleukin-8 is associated with nosocomial pneumonia.
AB  - One hundred five (70%) of 151 patients hospitalized in the intensive care unit
      and undergoing mechanical ventilation had bronchial secretions that tested
      positive for interleukin-8 within 36 hours of admission. Arterial blood, mixed
      venous blood, and urine collected simultaneously all tested negative, except for
      11 patients admitted with intra-abdominal septic foci. The presence of
      interleukin-8 in the pulmonary air space early in the course of hospitalization
      was significantly associated with patients with multiple injuries, the need for
      greater ventilatory support, the occurrence of pulmonary dysfunction, and a 66%
      incidence of nosocomial bacterial pneumonia. We conclude that the early local
      production of interleukin-8 in the lungs is an early marker of pulmonary injury
      and may be involved in the pathogenesis of nosocomial bacterial pneumonia.

PMID- 1635111
TI  - The effect of in-line microwave energy on blood: a potential modality for blood
      warming.
AB  - The treatment of hypothermia associated with hemorrhage, exposure, or
      intraoperative intervention continues to represent a challenge for trauma care
      teams. An innovative technique for combining microwave heating with continuous
      temperature monitoring into a feedback-controlled system for blood warming has
      been developed. The effect of microwave warming on the structure and function of
      blood was compared with that in nonheated controls. Erythrocyte structural
      integrity (hemolysis) was evaluated by comparing levels of lactate dehydrogenase
      (LDH), potassium (K+), and plasma hemoglobin (PHGB), and hematocrit (HCT) in
      heated and nonheated (control) samples of banked red blood cells. Hemoglobin
      function was evaluated in fresh blood by comparing the P50 and hemoglobin
      electrophoresis of experimental and control samples. Prewarming temperatures were
      3 degrees or 23 degrees C; temperatures after warming were 35 degrees, 37
      degrees, or 39 degrees C. The results reflect the percentage of changes for 84
      heated and 24 unheated blood samples. There were no statistical differences in
      any of the biochemical variables measured. The P50 for three heated and three
      unheated samples was 30.7 +/- 1.2 and 30.5 +/- 0.9 mm Hg (p greater than 0.05).
      There were no changes in the hemoglobin electrophoretic patterns in experimental
      or control samples. This system is designed to deliver microwave energy in a
      uniform and controlled manner, overcoming the limitations of conventional
      microwave ovens that in the past caused local overheating and subsequent
      hemolysis when used for blood warming. The structural and functional integrity of
      erythrocytes after microwave warming indicate the safety and effectiveness of
      this technique.

PMID- 1635112
TI  - Early criteria predictive of prolonged mechanical ventilation.
AB  - This study was performed to determine if prolonged mechanical ventilation (MV)
      could be predicted by objective clinical variables present at 48 hours after MV
      was instituted. During a 3-month period, 49 (54%) of 91 mechanically ventilated
      surgical intensive care unit patients required MV for 2 or more days. Twelve
      (24%) of these patients died. Patients requiring 2-13 days of MV had
      significantly lower alveolar-arterial oxygen gradients (PAO2 - PAO2), PEEP, and
      FIO2 on MV day 2 compared with patients with MV greater than or equal to 14 days.
      PAO2 - PAO2 greater than or equal to 175 mm Hg on day 2 in patients without
      chronic obstructive pulmonary disease (COPD) was 60% sensitive and 91% specific
      for MV greater than or equal to 14 days. In survivors, a day-2 PAO2 - PAO2
      greater than or equal to 175 mm Hg (without COPD) or a GCS score less than or
      equal to 9 had a 91% positive predictive value and a 96% negative predictive
      value for MV greater than or equal to 14 days. We conclude that mechanical
      ventilation for 14 or more days can be accurately predicted at 48 hours after the
      institution of ventilatory support by these objective criteria.

PMID- 1635113
TI  - Radiographic evaluation of adult patients with blunt renal trauma.
AB  - Recent reports in the literature suggest that radiographic evaluation of the
      normotensive blunt trauma patient with microscopic hematuria is no longer
      necessary. Several facilities, however, including ours, continue to perform
      excretory urography (IVP) routinely in this setting. To evaluate further whether
      this practice is indicated, we retrospectively reviewed the records of 317 adults
      who presented to our facility between May 1986 and December 1989 after blunt
      trauma with resultant microscopic hematuria but no shock. All patients were
      radiographically assessed with an IVP. Of the 317 studies 29 (9%) had an abnormal
      result, including 28 with renal contusion and 1 with a nonfunctioning kidney (in
      which case further evaluation revealed a congenitally absent kidney). No
      significant urological injury was identified. Thus, no injury would have been
      missed if a policy of observation had been followed in these patients. Our data
      support other reports in the literature that radiographic staging is not
      necessary in the adult blunt trauma patient with microscopic hematuria but no
      shock.

PMID- 1635114
TI  - Angiographic embolization of renal stab wounds.
AB  - Nonoperative management of renal stab wounds following complete radiographic
      assessment has become an accepted if not preferred therapeutic option. Selected
      injuries, however, including renal artery branch injuries, often require surgical
      intervention and result in partial or total nephrectomy. We report our experience
      with 16 renal branch arterial injuries secondary to street stabbing during the
      last 10 years that were managed with angiography and embolization techniques.
      Angiography with embolization was the initial treatment in 11 patients, while 5
      had undergone emergency surgical intervention initially because of hemodynamic
      instability. Subsequently, gross hematuria recurred in the latter 5 patients and
      they were managed angiographically. Overall, 14 of 16 patients had prompt
      hemostasis documented either on the post-embolization angiogram or by clinical
      assessment. In 2 patients bleeding was increased but partial nephrectomy
      ultimately was required. Complications included nontarget embolization in 2
      patients: 1 subsequently had hypertension and 1 had no untoward effect as a
      result of this complication. We conclude that angiography with transcatheter
      embolization techniques provides a safe and effective means of managing renal
      artery branch injuries secondary to stab wounds.

PMID- 1635115
TI  - Microscopic venous infiltration as predictor of relapse in renal cell carcinoma.
AB  - In a retrospective analysis at a single institution we evaluated the significance
      of various pathological phenomena on the disease-free survival of patients with
      radically resected renal cell carcinoma. Parameters considered were tumor
      extension (pT stage) according to the International Union Against Cancer, tumor
      invasion into the renal vein or vena cava (V stage), standard histological
      grading (G stage), nuclear grading (F stage) and microscopic venous infiltration.
      The pT stage had a significant impact on disease-free survival (p = 0.0004) of
      patients with radically resected tumors, as did G stage (p = 0.0001) and F stage
      (p = 0.002). In contrast to some previously reported results tumor extension to
      the renal vein and vena cava showed no influence on disease-free survival (p =
      0.077). On the other hand, microscopic venous infiltration, defined as local
      tumor infiltration through all vessel structures including the endothelial layer
      leading to a free tumor extension into the vessel, had a significant impact on
      disease-free survival (p less than 0.0001). When stratifying either tumor size or
      nuclear differentiation against microscopic venous infiltration, the latter
      retained a superior influence on disease-free survival (p = 0.01 and p = 0.0079,
      respectively). We conclude that microscopic venous infiltration is the most
      important predictor of relapse in renal cell carcinoma.

PMID- 1635116
TI  - Ureteroscopic treatment of urothelial carcinoma of the ureter and renal pelvis.
AB  - From June 1987 to September 1990, 12 patients were evaluated for ureteroscopic
      treatment of upper urinary tract neoplasms. Four patients were not considered
      candidates because of technical reasons. Each of these patients was treated by
      nephroureterectomy. A total of 8 patients underwent ureteroscopic therapy with a
      neodymium:YAG laser 1 to 11 times (median 2) for the treatment of 3 proximal
      ureteral or pelvic lesions and 7 distal ureteral lesions. One patient had local
      progression and 1 failed subsequent laser treatment for technical reasons. Both
      of these individuals were salvaged with an operation. Three patients were without
      recurrence for 15, 21 and 36 months. Two patients had multiple superficial local
      recurrences and continue to be managed endoscopically without local progression
      for 12 and 32 months. One patient was asymptomatic 16 months after treatment but
      he has refused followup evaluation. Of 7 patients with ureteral tumors who were
      believed to be candidates for endoscopic therapy 5 have had the tumors controlled
      by this method of treatment. Only 1 renal pelvic tumor has been successfully
      treated. Most patients with tumors in the renal pelvis are not candidates for
      rigid endoscopic therapy because of the tumor size and location. In selected
      individuals ureteroscopic laser treatment of upper urinary tract transitional
      cell carcinoma can achieve local control with renal preservation.

PMID- 1635117
TI  - The double-J ureteral stent: in vivo and in vitro flow studies.
AB  - Although most ureters can now be stented, the rate of ureteral obstruction from
      extrinsic compression remains relatively high. To illuminate the mechanisms of
      obstruction in these patients we performed 20 in vivo pressure-flow
      investigations in 14 patients with indwelling ureteral Double-J stents. All
      patients had a percutaneous nephrostomy tube in place. Our investigations
      revealed proper drainage to the bladder in 17 of the 20 studies at an average
      renal pelvic pressure of 19.9 cm. water. Vesicorenal reflux was noted at an
      average bladder pressure of 20 cm. water in 17 studies. Three stents appeared to
      be obstructed. They showed no drainage to the bladder but also no reflux. To
      evaluate the in vivo results we then performed an in vitro study of pressure-flow
      characteristics under conditions simulating ureteral obstruction. At
      physiological flow rates different ureteral stents showed no major differences in
      pressure-flow characteristics. With compression and kinking, flow resistance in
      softer stents was notably greater than in hard stents. Therefore, we believe that
      in patients with suspected extrinsic compression of the ureter hard Double-J
      stents should be used. Vesicorenal reflux appears to be a reliable predictor of
      stent function.

PMID- 1635118
TI  - Metallic Wallstents: a new therapy for extrinsic ureteral obstruction.
AB  - Self-expanding metallic stents, frequently used in interventional radiology, were
      implanted into 15 obstructed ureters in 12 patients. The cause of obstruction was
      lymph node metastases of different malignant tumors or direct tumor compression
      of the ureter. Followup in 12 patients was 3 to 31 weeks. Immediately after
      implantation all stents drained well. During the initial 4 weeks slight
      obstruction occurred due to hyperplasia of regenerating urothelium. The stents
      were fully incorporated into the ureteral wall 8 weeks after implantation, they
      were covered by smooth epithelium and the hyperplasia had disappeared.
      Complications were hemorrhagia in 1 patient and incrustation in 2. No infection
      was observed. Complications due to the tumor were obstruction distal to the stent
      in the presence of a widely open catheter in 3 patients. Early results are
      presented. Late results are not yet available. The method seems to be minimally
      invasive and easy to perform.

PMID- 1635119
TI  - Balloon cystoscopy with neodymium:YAG laser.
AB  - We performed balloon cystoscopy for the diagnosis of gross hematuria as well as
      for the treatment of bladder tumor using the neodymium:YAG laser. Animal
      experiments were done to evaluate the efficacy of laser irradiation through the
      balloon, which proved to have the same effect as conventional laser irradiation.
      A total of 40 patients with bladder diseases was observed and treated by balloon
      cystoscopy, and the results were examined comparatively. Even with gross
      hematuria the structure of the mucosa and the tumor could be observed in detail
      without irrigating the inside of the bladder. Most bladder tumors were
      successfully treated with laser irradiation through the balloon through the optic
      lens system. Therefore, balloon cystoscopy appears to be a useful endoscopic
      modality in neodymium:YAG laser surgery for the treatment of bladder tumor.

PMID- 1635120
TI  - Home screening for hematuria: results of a multiclinic study.
AB  - The majority of urinary tract tumors cause bleeding in the urine. A program
      designed to detect hematuria before it is grossly apparent may contribute to
      earlier detection and more successful treatment of these malignancies. To test
      this hypothesis a hematuria home screening study was conducted. A total of 1,340
      healthy men 50 years old or older used chemical reagent strips for 14 consecutive
      days to test the urine. Of the men 283 (21.1%) had at least 1 episode of
      hematuria. Of the 192 hematuria positive men who received a complete urological
      evaluation 16 (8.3%) had urological cancers and 47 (24.5%) had other hematuria
      causing diseases that required immediate treatment. The quantity and frequency of
      hematuria were not related to disease severity. A hematuria home screening
      regimen is feasible and economical, and may promote the early detection of
      urinary tract cancers and other diseases in men more than 50 years old.

PMID- 1635121
TI  - The predictive value of flow cytometry and urinary cytology in the followup of
      patients with transitional cell carcinoma of the bladder.
AB  - To determine the predictive value of flow cytometric deoxyribonucleic acid (DNA)
      ploidy and urine cytology in patients with superficial transitional cell
      carcinoma of the bladder, a retrospective analysis was performed on 181 patients
      who presented for evaluation of presumed superficial transitional cell carcinoma
      of the bladder. Of the patients 91 were confirmed to have superficial
      transitional cell carcinoma and were systematically followed with cystoscopy,
      flow cytometry and urine cytology from 1984 until 1989. They underwent 637
      evaluations (mean 7 evaluations per patient). At initial evaluation, flow
      cytometry had 81% sensitivity and 57% specificity, while urine cytology was 75%
      sensitive and 94% specific. During the followup flow cytometry was 76% sensitive
      and 36% specific. Urine cytology was less sensitive (40%) but more specific (81%)
      than flow cytometry in followup evaluation. These results were similar whether
      intravesical chemotherapy or bacillus Calmette-Guerin was administered. To
      ascertain whether false positive flow cytometry represented early detection of
      recurrent transitional cell carcinoma not apparent at cystoscopy, patients with
      positive flow cytometry and urine cytology were followed longitudinally. False
      positive flow cytometry and urine cytology were equally predictive of recurrent
      transitional cell carcinoma progressively with time. However, for any given
      examination flow cytometry was more likely to detect and predict recurrent
      transitional cell carcinoma. At 4 years the bladder transitional cell carcinoma
      incidence for false positive flow cytometry and urine cytology was 87% and 84%,
      respectively.

PMID- 1635122
TI  - Adjuvant chemotherapy of recurrent superficial transitional cell carcinoma:
      results of a European organization for research on treatment of cancer randomized
      trial comparing intravesical instillation of thiotepa, doxorubicin and cisplatin.
      The European Organization for Research on Treatment of Cancer Genitourinary
      Group.
AB  - A total of 356 patients with recurrent superficial transitional cell carcinoma of
      the bladder was entered in a randomized clinical trial to compare intravesical
      thiotepa, doxorubicin and cisplatin with respect to the recurrence rate and
      disease-free interval. After complete transurethral resection of all visible
      lesions, the drugs were administered weekly for 4 weeks and monthly for 11
      months. The recurrence rates per year were 0.50 for thiotepa, 0.54 for
      doxorubicin and 0.58 for cisplatin. Of 266 patients (mean followup 41 months) 35
      reported an increase in T category and 19 of them had distant metastases. No
      association between treatment and progression was noted. Thus, there is no
      difference among treatments with respect to efficacy. However, severe
      anaphylactic reactions were observed in the cisplatin arm and chemical cystitis
      was more frequently reported in patients who received doxorubicin.

PMID- 1635123
TI  - Advanced bladder cancer (stages pT3b, pT4a, pN1 and pN2): improved survival after
      radical cystectomy and 3 adjuvant cycles of chemotherapy. Results of a controlled
      prospective study.
AB  - A total of 49 bladder cancer patients with tumor stages pT3b, pT4a and/or pelvic
      lymph node involvement without microscopic or macroscopic evidence of residual
      tumor was randomized into 2 comparative groups: the chemotherapy group was to
      receive 3 adjuvant cycles of methotrexate, vinblastine and cisplatin plus
      doxorubicin (M-VAC) or epirubicin (M-VEC) after radical cystectomy. The control
      group received no additional treatment. The protocol was activated in May 1987.
      Patient recruitment was concluded in December 1990 because an interim analysis of
      the 49 randomized patients revealed a significant prognostic advantage in favor
      of 26 patients randomized to the chemotherapy group compared to 23 in the control
      group (p = 0.0015, log rank test for relapse-free survival curves). Of the 26
      patients randomized for adjuvant chemotherapy 18 were treated with M-VAC or M-VEC
      (3 cycles in 16 patients and 2 cycles in 2). Of the remaining 8 patients 7
      refused chemotherapy before or during cycle 1 and 1 received chemotherapy without
      cisplatin because of impaired renal function. An update of the patients in August
      1991 revealed a further increase in the prognostic difference between the 2 trial
      arms (p = 0.0012). Of 18 patients who received treatment with M-VAC or M-VEC only
      3 have had tumor progression to date compared to 18 of 23 patients in the control
      group. Further statistical analysis of the data was performed on the basis of
      Cox's regression model, incorporating various criteria as explanatory variables,
      including patient sex and age, pT stage and number of involved lymph nodes. This
      multivariate analysis revealed a significant decrease in the risk of tumor
      recurrence (p = 0.0007, 2-sided) after adjuvant chemotherapy. The number of lymph
      nodes involved was also of prognostic significance (p = 0.0028, 1-sided). The
      results indicate that the survival time after radical cystectomy can be prolonged
      considerably by adjuvant polychemotherapy in cases of locally advanced bladder
      carcinoma. Fortunately, all of these conclusions are not affected by switching
      from an intent-to-treat analysis to an analysis of the therapy actually
      performed. The p values obtained from the latter are 0.0005 (log rank test) and
      0.0001 (Cox model with the same set of additional regressors).

PMID- 1635124
TI  - Treatment of recurrent urethral stricture by internal urethrotomy and
      intermittent self-catheterization: a controlled study of a new therapy.
AB  - A controlled study of the effect of treatment of recurrent urethral stricture by
      internal urethrotomy followed by clean intermittent self-catheterization for 3
      months is reported. There were 28 men (median age 70 years, range 18 to 75)
      allocated to internal urethrotomy and clean intermittent self-catheterization for
      3 months (treatment group) and 33 (median age 76 years, range 36 to 87) were
      randomized to undergo internal urethrotomy only (observation group). The groups
      were comparable in terms of patient age, etiology of the primary stricture,
      number of recurrences, length and site of the actual stricture, and preoperative
      maximum flow rate (p less than 0.01). After termination of the treatment all
      patients from both groups were evaluated by uroflowmetry 2, 4, 6 and 12 months
      later, and a new recurrence was defined as a maximum flow rate of less than 10
      ml. per second (micturition volume greater than 100 ml.) and a characteristic
      flow curve. From the treatment group 23 patients could be assessed: 2 had
      discontinued clean intermittent self-catheterization due to urethral hemorrhage,
      2 died during the observation period and 1 was lost to followup. From the
      observation group 28 patients were assessable: 3 died during the observation
      period and 1 was lost to followup. Treatment results were not significantly
      different (p less than 0.01). Of the patients in the treatment and observation
      groups 78% and 82%, respectively, had a new stricture. The median interval for
      this to occur was 4 months for both groups. Since no patient had clinical signs
      of stricture during clean intermittent self-catheterization, we conclude that for
      the treatment of recurrent urethral stricture clean intermittent self
      catheterization following internal urethrotomy should be continued for a long
      duration, possibly permanently.

PMID- 1635125
TI  - The change of urinary 11-dehydro-thromboxane B2 and 2,3-dinor-6-keto
      prostaglandin F1 alpha in arteriogenic impotence.
AB  - Thromboxane A2 is a potent vasoconstrictor and a stimulus of platelet
      aggregation, which may contribute to hypercoagulability. The prostacyclin,
      prostaglandin I2, has exactly the opposite effect. Measurement of the major
      urinary metabolites, 11-dehydro-thromboxane B2 and 2,3-dinor-6-keto-prostaglandin
      F1 alpha (prostaglandin F1 alpha) by radioimmunoassay can accurately reflect in
      vivo the biosynthesis of thromboxane A2 and prostaglandin I2, respectively. Group
      1 consisted of 60 patients less than 50 years old. The mean urinary 11-dehydro
      thromboxane B2 level of 3 patients with arteriogenic impotence was significantly
      greater than that of the 57 control volunteers: 2.66 +/- 0.65 versus 1.74 +/-
      0.56 (plus or minus standard deviation) ng./mg. creatinine (p = 0.008). The
      prostaglandin F1 alpha levels for the patients and controls were 32.74 +/- 8.45
      and 37.58 +/- 16.55 ng./mg. creatinine, respectively, which was not significantly
      different (p greater than 0.05). Group 2 consisted of 96 patients 50 years old or
      older. The 11-dehydro-thromboxane B2 concentration in the urine was 1.83 +/-
      0.58, 2.54 +/- 1.12 and 1.91 +/- 0.73 ng./mg. creatinine in the 47 normal control
      volunteers, 20 patients with arteriogenic impotence and 29 with arteriogenic
      impotence plus intracavernous injection of 20 micrograms prostaglandin E1,
      respectively. The arteriogenic impotence group showed the significantly highest
      level among the 3 groups (p = 0.0025). Also, the urinary prostaglandin F1 alpha
      levels in these patients were 45.71 +/- 36.3, 57.71 +/- 35.53 and 59.30 +/- 45.08
      ng./mg. creatinine, respectively, which was not significantly different (p
      greater than 0.05). For the 13 patients with arteriogenic impotence (group 3) we
      compared the urinary 11-dehydro-thromboxane B2 and prostaglandin F1 alpha levels
      before and after intracavernous injection of prostaglandin E1 by using a paired t
      test. The results showed that the change in 11-dehydro-thromboxane B2 levels was
      2.78 +/- 1.09 versus 1.99 +/- 0.75 ng./mg. creatinine, which was significantly
      different (p = 0.005), whereas that for prostaglandin F1 alpha was 62.30 +/-
      40.41 versus 58.86 +/- 44.26 ng./mg. creatinine, with no significant difference
      (p greater than 0.05). Our findings suggest that urinary 11-dehydro-thromboxane
      B2 may have an important role in the diagnosis and treatment of arteriogenic
      impotence.

PMID- 1635126
TI  - The value of increased end diastolic velocity during penile duplex sonography in
      relation to pathological venous leakage in erectile dysfunction.
AB  - In 58 patients 23 to 71 years old (mean age 49.5 years) with suspected
      vasculogenic erectile dysfunction diagnosed on the basis of repeated negative
      reactions to intracavernous pharmacological stimulation (rigidity less than 60%
      when measured with the RigiScan* device) pharmacocavernosometry and duplex
      Doppler measurements were performed. The end diastolic velocity in the 24
      patients without venous leakage ranged from 0 to 21 cm. per second (mean 7.5 +/-
      6.3, standard deviation). The end diastolic velocity in the 34 patients with
      venous leakage ranged from 0 to 26 cm. per second (mean 9.0 +/- 6.7). In 23 of
      the 58 patients a peak systolic velocity of less than 25 cm. per second was
      found, which is an indication of arterial disease. Of 35 patients with a normal
      peak systolic velocity 15 were in the group without and 20 were in the group with
      leakage. In the group with a normal peak systolic velocity no statistically
      significant difference was found in end diastolic velocity between patients with
      and without leakage. We conclude that the end diastolic velocity during color
      Doppler analysis of patients with negative reactions on intracavernous
      pharmacological stimulation does not provide a good indication of potential
      pathological venous leakage.

PMID- 1635127
TI  - The value of dynamic color duplex scanning in the diagnosis of venogenic
      impotence.
AB  - To determine the value of color duplex scanning in the diagnosis of venogenic
      impotence we examined 53 patients. The control population consisted of 26
      psychogenically impotent men and 8 normal potent men who all had a firm erection
      after pharmacological stimulation. There was no significant difference in the
      values of duplex parameters between these 2 groups. The venous leak population
      was characterized by a bad erectile response to pharmacological stimulation
      despite a good arterial compliance and by a persistent diastolic flow as shown by
      duplex scanning. There was a significant difference with the control population
      for the parameters of resistance index after 10 minutes (p = 0.001), minimal
      resistance index (p = 0.016) and corporeal volume increase (p = 0.010). There was
      a good correlation between the results of duplex scanning and those of
      pharmacocavernosography-pharmacocavernosometry (93%). We conclude that dynamic
      color duplex scanning can be used as a screening procedure to diagnose
      significant venous leakage in an objective manner with the resistance index.

PMID- 1635128
TI  - Current urological practice: routine urological examination and early detection
      of carcinoma of the prostate.
AB  - With the increasing incidence of carcinoma of the prostate, the interest in early
      diagnosis through screening has dramatically increased. Several organizations,
      including the American Urological Association (AUA) and the American Cancer
      Society, have promulgated recommendations on suggested early detection methods.
      To determine the current practice patterns of United States urologists, a survey
      was sent to a random sample of 10% of all urologist members of the AUA. The
      survey was designed to determine what are current recommendations for an annual
      urological checkup for older men, what tests should be included in screening for
      carcinoma of the prostate and what age groups of men should undergo prostate
      cancer screening. A total of 562 surveys was returned, constituting a 4.7% sample
      of all urologist members of the AUA. The use of digital rectal examination was
      unanimously recommended for the urological examination as well as for prostate
      cancer detection. Prostate specific antigen was recommended by a majority of
      respondents for both situations. Screening was recommended for men ages 50 to 80
      years. Demographic factors had a significant role in clinical recommendations by
      urologists.

PMID- 1635129
TI  - Frequency and location of extracapsular extension and positive surgical margins
      in radical prostatectomy specimens.
AB  - Positive surgical margins have been reported with disturbing frequency in radical
      prostatectomy specimens and may portend an increased risk of eventual treatment
      failure. We determined the location of any cancer, extracapsular extension and
      positive surgical margins in 144 consecutive step-sectioned radical prostatectomy
      specimens. Of the 46 stage A cancer patients 98% had residual cancer in the
      prostate after transurethral resection and in 76% cancer was found posteriorly in
      the gland. Extracapsular extension was identified in 10 patients (22%):
      anteriorly in 5, posterolaterally in 5 and on the most apical transverse section
      in 4. Positive margins were found in 10 patients (22%) and half of these occurred
      posterolaterally. Of the 98 stage B cancer patients tumor was located posteriorly
      in 97%. Extracapsular extension was found in 62 patients (63%) and in 87% of
      these it was located posterolaterally. Positive margins were found in 23%, most
      commonly in the posterolateral and rectal areas (57% and 26%, respectively), and
      in more than half of these the positive margin resulted from incision into the
      capsule. In 18 of the 144 patients (13%) a single positive surgical margin was
      the only pathological indicator of treatment failure and half of these occurred
      in the area of the neurovascular bundle. Some of these patients with
      extraprostatic tumor might have been cured if wide excision of the neurovascular
      bundle had been performed. Overemphasis on preservation of potency during radical
      prostatectomy may leave some patients with persistent local disease.

PMID- 1635130
TI  - Ultrasound for detecting Schistosoma haematobium urinary tract complications:
      comparison with radiographic procedures.
AB  - Chronic infection with Schistosoma haematobium primarily causes urinary tract
      complications. These lesions are often silent or ignored and not detected until
      irreversible changes have occurred. However, early chemotherapy can prevent
      progression and usually reverse all but the more severe abnormalities. Recently,
      abdominal ultrasound has been shown to be an inexpensive, portable and safe means
      of detecting schistosomal morbidity. A prospective study was performed on 40
      patients comparing abdominal radiography, excretory urography (IVP), cystoscopy
      and ultrasound to detect urinary tract morbidity due to S. haematobium infection.
      Ultrasound was as sensitive as an IVP in detecting bladder masses, hydronephrosis
      and renal stones. It detected hydroureter less frequently (sensitivity 62.5%)
      than an IVP but visualized this lesion and hydronephrosis in some patients with
      nonfunctioning kidneys. Ultrasound demonstrated bladder stones as well as an x
      ray but it detected bladder wall calcification with less sensitivity (65%) and
      was much less sensitive (12.5%) for detecting ureteral stones.

PMID- 1635131
TI  - Stepladder incision technique for lengthening of bowel mesentery.
AB  - A tension-free bowel anastomosis is essential when bowel segments are used in
      reconstructive urological procedures. A safe and effective technique is described
      to lengthen the mesenteric vascular pedicle. Serial incisions are made in the
      mesenteric peritoneum horizontally, perpendicular to the vascular plane on both
      sides of the mesentery. This technique has provided up to 3 cm. of additional
      length without complication in 3 cases.

PMID- 1635132
TI  - A modified surgical retractor blade for radical retropubic prostatectomy and
      retropubic surgery.

PMID- 1635133
TI  - A simple test for the detection of intraoperative rectal injury in major
      urological pelvic surgery.
AB  - We describe our experience with a simple inexpensive test with 2 practical uses:
      1) to detect unrecognized intraoperative rectal injury and 2) to assess the
      adequacy of repair of rectal injuries.

PMID- 1635134
TI  - Detrusor function in suprasacral spinal cord injuries.
AB  - A total of 21 patients with chronic, stable suprasacral spinal cord injuries
      underwent a comprehensive neurological evaluation. A second lumbosacral lesion
      was excluded. The urodynamic findings were relatively constant as 95% of the
      patients showed detrusor hyperreflexia with elevated pressures, sphincteric
      dyssynergia and a competent bladder neck during the filling phase. The urodynamic
      findings of unexpected detrusor function in high spinal cord injury, for example
      areflexia and hypocontractility, should raise the clinician's suspicion that
      there is a lesion or dysfunction involving the sacral cord.

PMID- 1635135
TI  - Results of the renewed extravesical reimplant for surgical correction of
      vesicoureteral reflux.
AB  - In 1987 Firlit et al described their results using Hodgson's technique of the
      modified extravesical Gregoir-Lich procedure. They coined the term detrusorrhaphy
      or extravesical ureteral advancement to describe this technique. During the last
      4 years we performed this reimplantation on 211 ureters in 132 patients. Of the
      patients 79 had unilateral and 53 had bilateral procedures. Included were 6
      megaureters requiring ureteral tailoring and 9 uncomplicated duplications. All
      but 1 patient were cured of reflux. No postoperative obstruction was encountered.
      Our results indicate that this is an excellent procedure to repair vesicoureteral
      reflux with minimal morbidity and short hospital stay.

PMID- 1635136
TI  - Urodynamic dysfunction in walking myelodysplastic children.
AB  - We evaluated urodynamically and radiologically 54 children with myelodysplasia
      and neurological deficits at or below the S1 level. Baseline urodynamic testing
      was normal in 13 patients (24%), while 12 (22%) had an upper motor neuron and 13
      (24%) had a lower motor neuron type of dysfunction. A total of 7 patients (13%)
      had a mixed upper and lower motor neuron type, and 9 (17%) had only lower motor
      neuron dysfunction of the urethral sphincter with a normally contractile bladder.
      Followup studies varying in time from 1 month to 10 years showed a changing
      neurourological lesion in 29 patients (54%): 25 deteriorated while 4 improved. Of
      the 54 children 20 had hydronephrosis and/or vesicoureteral reflux. Incontinence
      was the major problem in 41 patients (75%), and was managed initially with
      pharmacological agents and/or clean intermittent catheterization, with 9 of the
      41 eventually requiring surgery. Urodynamic assessment reveals a variable picture
      that does not correlate well with the apparent neurological examination. Despite
      the low level of the neurological deficit, many children may be at risk for
      urinary tract deterioration. These findings emphasize the importance of
      continuous surveillance and appropriate management in this group of
      myelodysplastic children who have the greatest potential for a normal life.

PMID- 1635137
TI  - The management of the neuropathic bladder in adolescents with imperforate anus.
AB  - The management of 58 patients born with an imperforate anus who presented to the
      urology service and who are currently 18 years old or older is discussed. Of the
      44 patients with a high imperforate anus 43 were treated by a rectal pull-through
      and 1 by an anal cut back procedure, while an anal cut back procedure was used in
      all 14 children with a low imperforate anus. A total of 32 children (55%) had a
      neuropathic bladder (hyperreflexic in 29 and atonic in 3). A spinal deformity was
      present in 72% of the hyperreflexic group but not in the atonic group.
      Vesicoureteral reflux occurred in 41% of the patients, two-thirds of whom had a
      neuropathic bladder. A total of 30 children had an associated genital anomaly and
      27 had an upper tract anomaly. Nineteen children underwent an operation for the
      neuropathic bladder, with modern reconstructive methods involving substitution or
      augmentation cystoplasty, supplemented with self-catheterization, being superior
      to older methods with regard to continence. The incidence of a neuropathic
      bladder in these children is high in both operative groups but it is usually
      associated with a spinal deformity and unlikely to be iatrogenic in nature unless
      proved to be of lower motor neuron origin. Early operative management is advised
      to achieve continence and minimize renal impairment.

PMID- 1635138
TI  - Perforation of the gastric segment of an augmented bladder secondary to peptic
      ulcer disease.
AB  - Gastrocystoplasty consists of bladder augmentation using part of the gastric
      body. We describe a child in whom peptic ulcer disease developed in the gastric
      portion of the bladder, with subsequent perforation of the ulcer. Chronic renal
      failure, hypercalcemia and oliguria are potential ulcerogenic conditions commonly
      present in patients with gastrocystoplasty. Perforation of the ulcer is a
      potentially fatal complication. Periodic cystoscopy and prophylactic treatment
      with hydrogen blockers and alkalization of the urine should be considered in
      patients with those risk factors.

PMID- 1635139
TI  - Ileal nipple for continence in cloacal exstrophy.
AB  - Since 1985, 7 children 2 to 17 years old with urinary incontinence from cloacal
      exstrophy underwent bladder augmentation and creation of a small bowel nipple at
      the bladder outlet. There were 3 genetic female and 4 genetic male patients being
      reared in the female role. In 3 early cases augmentation was done with small
      bowel, while gastric augmentation was used in 3 later cases and 1 had both types.
      Six patients became completely dry and they empty by intermittent self
      catheterization. In the youngest patient the operation failed because the nipple
      became infarcted and disappeared. Reoperation will be performed after at least 1
      year has passed. In cloacal exstrophy if there is insufficient local tissue to
      create a bladder neck and urethra, a reversed, catheterizable bowel nipple may be
      an option to consider.

PMID- 1635140
TI  - Traumatic priapism in a child: evaluation with color flow Doppler sonography.
AB  - We report a case of nonischemic priapism in an 11-year-old boy that occurred
      after blunt perineal trauma. Color flow Doppler sonography ruled out ischemic
      priapism and proved itself valuable as part of the emergency diagnostic
      evaluation of priapism in childhood.

PMID- 1635141
TI  - Posttraumatic arterial priapism in a 7-year-old boy: successful management by
      percutaneous transcatheter embolization.
AB  - Priapism may be classified as the classical veno-occlusive form or the more
      recently described high flow, arterial type. We report a case of posttraumatic
      arterial priapism in a 7-year-old boy. The successful management with
      percutaneous transcatheter embolization of the internal pudendal artery is
      described.

PMID- 1635142
TI  - Unilateral hydroureteronephrosis caused by abdominoscrotal hydrocele.
AB  - Abdominoscrotal hydrocele is extremely rare in children. A case is presented of
      an unusually large abdominoscrotal hydrocele in a child, with secondary right
      hydroureteronephrosis due to contiguous pressure and right cryptorchidism. This
      entity, although unusual, should be considered in the differential diagnosis of a
      lower abdominal mass in children, as well as a cause of hydroureteronephrosis.
      Diagnosis is made with ultrasound, computerized tomography and occasionally
      excretory urography. Complete surgical excision through a groin incision is
      recommended, but optional inguinoabdominal or abdominal incisions have been
      reported. After surgical removal, healing is usually complete, including
      regression of the hydroureteronephrosis.

PMID- 1635143
TI  - Repair of an autotransplant renal artery aneurysm: case report and literature
      review.
AB  - We report the successful repair of a renal artery aneurysm involving the
      autotransplanted kidney of a 25-year-old hypertensive woman. The risk factors for
      renal artery aneurysm rupture, and the relationships between hypertension and
      renal artery aneurysms are presented.

PMID- 1635144
TI  - Late onset renal allograft anastomotic pseudoaneurysm with absent Doppler signal.
AB  - A large extrarenal pseudoaneurysm, originating from the arterial anastomosis of a
      renal allograft, occurred spontaneously 7 years after transplantation in a 29
      year-old diabetic patient. Although the scintigraphic examination was diagnostic
      of a pseudoaneurysm, pulsed Doppler and color coded Doppler ultrasound failed to
      demonstrate a Doppler signal, suggesting erroneously a nonvascular fluid
      collection. The role of scintigraphy combined with duplex ultrasound in this rare
      but potentially fatal complication of renal transplantation is discussed.

PMID- 1635145
TI  - Late development of renal carcinoma in allograft kidney.
AB  - The Cincinnati Transplant Tumor Registry recorded 169 cases of renal carcinoma
      developing in transplant recipients. The great majority of these cases were of
      primary renal cell carcinoma developing in the recipient native kidneys. Renal
      carcinoma developing de novo in the renal allograft occurred 17 times, with a
      maximal interval to clinical development of 85 months after transplantation. The
      development of multicentric renal cell carcinoma in an allograft 156 months after
      transplantation is described. The 24-year-old white male recipient with Alport's
      syndrome received a cadaver renal allograft from a healthy 27-year-old black man
      who had died of a cerebral hemorrhage in 1977. At 13 years after transplantation
      the recipient had upper abdominal pain. Ultrasound revealed 2 incidental renal
      masses and a renal cyst in the allograft. Partial nephrectomy confirmed the
      presence of multicentric renal carcinoma. The graft was left in situ and
      immunosuppression was maintained. The recipient continued to do well with no
      evidence of disease 1 year postoperatively. Deoxyribonucleic acid banding
      demonstrated that the tumor and recipient blood were of different patterns.

PMID- 1635146
TI  - Transitional cell carcinoma of the kidney with vena caval involvement: report of
      3 cases and a review of the literature.
AB  - Vena caval tumor thrombus in association with transitional cell carcinoma of the
      kidney is uncommon, with only 9 cases having been reported to our knowledge. We
      report 3 additional cases and review this subject with particular attention to
      symptoms, radiographic evaluation and the importance of early diagnosis.

PMID- 1635147
TI  - A late manifestation of testicular seminoma in the bladder in a renal transplant
      recipient: a case report.
AB  - An unusual case is presented of a renal transplant recipient on immunosuppressive
      medication who underwent orchiectomy for a testicular seminoma. Since the
      surgical resection plane showed seminoma cells, radiotherapy was applied to the
      para-aortic and inguinal regions. Tumor recurred in the bladder 3 years later as
      demonstrated by urine cytology and later by bladder biopsies. After chemotherapy,
      repeated bladder biopsies were normal and a complete remission was achieved. The
      possible metastatic pathways are discussed.

PMID- 1635148
TI  - Trifurcation of the urethra: a case report.
AB  - Trifurcation of the anterior urethra is an uncommon anomaly. We present a case of
      trifurcation of the anterior urethra with pelvic ectopia of the right kidney and
      complete left ureteral duplication.

PMID- 1635150
TI  - Total prostatoseminal vesiculectomy in the treatment of debilitating perineal
      pain.
AB  - Persistent perineal pain, unresponsive to antibiotics and analgesia, sufficient
      to produce an inability to function in any work or social environment is
      occasionally encountered. A total of 5 such patients underwent total
      prostatoseminal vesiculectomy: 3 experienced complete relief of the pain and 1
      experienced symptomatic relief to the extent that he ranks the residual
      discomfort as 1 on a scale of 1 to 10. The remaining patient had complete absence
      of pain for approximately 4 months but thereafter mild, intermittent proximal
      urethral discomfort developed during voiding. Total prostatoseminal vesiculectomy
      may be occasionally applicable in the patient disabled by chronic perineal pain.
      We believe that psychiatric evaluation and concurrence should be a preoperative
      prerequisite.

PMID- 1635149
TI  - Actinomycosis associated with pilonidal sinus of the penis.
AB  - We report a case of actinomycosis associated with a penile pilonidal sinus. This
      association does not appear to have been described previously. We recommend the
      submission of biopsies of unusual lumps in the genital region (fresh biopsies for
      bacteriological examination and fixed biopsies for histomorphological
      assessment).

PMID- 1635151
TI  - Re: The no-scalpel vasectomy.

PMID- 1635152
TI  - Radioimmunodetection of human bladder tumor xenografts in nude mice with
      radiolabeled monoclonal antibodies.
AB  - The tumor targeting potential of two monoclonal antibodies (mAbs) reacting with
      growth-regulated surface glycoproteins of human bladder cancer was investigated.
      The mAb T16 reacts more intensely with stationary cells while the mAb T43 is
      preferentially reactive with exponentially growing cells. The test target was T24
      human bladder cancer cells grown subcutaneously in 30 nude mice. Controls for
      tumor specificity were human lung cancer cells grown on the contralateral side.
      Purified mAb's T16 and T43, and Om5, a non-reactive control, were radiolabeled
      with 131-Iodine and injected intravenously in doses ranging from 50 to 300
      microCi in tumor-bearing animals. Consistent images of the bladder cancer
      xenografts were obtained at 48 and 72 hours with tumors as small as 0.1 gm. High
      resolution tumor images were obtained only with the reactive antibodies and
      according to their in vitro specificity. These results demonstrate that the two
      mAbs T16 and T43 can specifically and sensitively localize human bladder cancer
      cells in vivo.

PMID- 1635153
TI  - Epidermal growth factor: receptor binding and effects on the sex accessory organs
      of sexually mature male mice.
AB  - The role of epidermal growth factor (EGF) in maintaining the integrity of the
      male sex accessory glands was investigated in the mouse. In the sexually mature
      male C3H mouse, EGF levels were highest in the submandibular gland, followed by
      the seminal vesicles and the prostate. Twenty eight days after sialoadenectomy
      (Sx), EGF fell below detectable limits in the serum and in the seminal vesicles.
      However, the prostate still retained 22% of its immunoreactive EGF. There was a
      seven-fold increase in serum testosterone after sialoadenectomy. Despite this
      drastic rise in testosterone, both prostatic and seminal vesicular weights were
      reduced, serum levels of LH were suppressed only by 37% and FSH levels were not
      altered. All these changes were abolished by the simultaneous administration of
      exogenous EGF at 100 micrograms./kg./day for 28 days. Both prostatic and seminal
      vesicular membranes contained binding sites for 125I-EGF. Binding was maximal
      after one hour of incubation at room temperature. Two classes of binding sites
      were shown for either organ (Kd = 1.2 nM, n = 56 fmol/mg. and Kd = 74 nM, n = 540
      fmol/mg. for prostate; Kd = 0.9 nM, n = 29 fmol/mg. and Kd = 93 nM, n = 150
      fmol/mg. for seminal vesicle). The binding of 125I-EGF was displaced by excess
      EGF and TGF-alpha but not by insulin, ILGF-2 and PDGF. These data suggest that
      EGF may have an important role in maintaining the integrity of the seminal
      vesicle and the prostate in the mouse. While the seminal vesicle appears to
      acquire EGF by uptake from the environment, the prostate may have the ability to
      synthesize EGF locally.

PMID- 1635154
TI  - Evidence for a non-androgenic role of testis and epididymis in androgen-supported
      growth of the rat ventral prostate.
AB  - A widely held view is that the role of testis in prostatic growth is through its
      ability to secrete androgen. Our earlier observation suggested a non-androgenic
      role for the testis, and perhaps the epididymis, in promoting growth of the
      ventral prostate in rats. The present study was conducted to evaluate the
      separate role of the testis and the epididymis in this phenomenon. In the first
      study, increasing quantities of silastic tubing filled with crystalline
      testosterone were implanted into adult Sprague-Dawley rats at the time of
      bilateral epididymo-orchiectomy or sham-operation. Twenty-eight days later,
      growth of the ventral prostate, as determined by fresh weight, DNA, and protein
      content, was significantly greater in sham-operated rats than in those receiving
      combined epididymo-orchiectomy, confirming our previous observation using
      dihydrotestosterone. In the second and third studies, rats were subjected to
      selective surgical procedures to evaluate the independent role of the testis and
      the epididymis. At the same time, 12 cm silastic tubing filled with testosterone
      or dihydrotestosterone were implanted subcutaneously into each of these animals
      for 28 days. Results indicated that the ventral prostate was significantly
      smaller in rats receiving the combined epididymo-orchiectomy than that of sham
      operated controls. Simple orchiectomy or simple epididymectomy resulted in an
      increased weight of the ventral prostate between the two values obtained from the
      above two groups. Ligation of either the efferent duct or the vas deferens
      yielded ventral prostatic weights comparable to the androgen-treated, sham
      operated controls. These results indicated that in order to achieve a maximal
      effect on androgen-supported growth of the ventral prostate, the presence of both
      the testis and the epididymis is required.

PMID- 1635155
TI  - Effect of intracavernous simultaneous injection of acetylcholine and vasoactive
      intestinal polypeptide on canine penile erection.
AB  - We investigated the effects of intracavernous injection of a combination of
      acetylcholine (ACh) and vasoactive intestinal polypeptide (VIP) on the erectile
      response in eleven adult male dogs. The minimum dose of ACh which increased the
      intracavernous pressure in eight dogs varied from 0.2 to 40 micrograms, and the
      minimum dose of VIP varied from 0.2 to 5 micrograms. When the minimum doses of
      ACh and VIP were injected simultaneously, a strong increase of intracavernous
      pressure (the mean increase was 102 cm. H2O from the baseline level) and a
      sustained erection (mean 5 min.) were observed in all eight dogs. The effect of
      simultaneous injection of both drugs was not additive but synergistic.
      Pretreatment with VIP-antibody and atropine intracavernously suppressed the
      erectile response induced by cavernous nerve stimulation. VIP may increase the
      affinity of muscarinic receptors for ACh in canine corpus cavernosum because
      pretreatment with atropine alone before the simultaneous injection of ACh and VIP
      completely abolished the effect of the combination. We conclude that ACh and VIP
      may play a cooperative role in canine penile erection.

PMID- 1635156
TI  - Mechanism of ammonium transport by intestinal segments following urinary
      diversion: evidence for ionized NH4+ transport via K(+)-pathways.
AB  - Using a previously reported in vivo intestinal perfusion model in the rat, we
      have shown that net total ammonium absorption accounts for the majority of the
      acid load resulting from urinary intestinal diversion. In the present study, by
      varying perfusate pH and therefore NH3 concentrations, we demonstrated that the
      net flux of total ammonium did not correlate with non-ionized NH3 concentrations
      (r = .039). This indicates that the basic mechanism of total ammonium flux is via
      ionized NH4+ movement. To more precisely define the transport processes involved,
      we manipulated this system with the following chemical and pharmacologic probes
      of electrolyte transport: amiloride (0.5 mM/l.), furosemide (1 mM/l.), 2,4,6
      triaminopyrimidine (TAP) (15 mM/l.), methylprednisolone (3 mg./100 gm./B.W.) S.Q.
      x 3 days followed by perfusion, and barium (Ba2+) (15 mM/l.). Net solute flux was
      not significantly altered by the mucosal addition of amiloride or TAP.
      Methylprednisolone treated rats exhibited significantly diminished Na+ secretion
      (p less than .01) and increased Cl- absorption (p less than .05) without
      affecting net total ammonium flux providing evidence for the inducibility of Na+
      conductance channels and against significant NH4+ movement via this pathway. The
      mucosal addition of furosemide resulted in significantly decreased net absorption
      of both total ammonium (p less than .001) and K+ (p less than .05). The addition
      of Ba2+ resulted in a three-fold reduction of ammonium absorption (p less than
      .001) and a greater than ten-fold reduction in K+ absorption (p less than .001).
      The observation of significant inhibition of ammonium absorption by furosemide
      and barium suggests that K+ transport pathways play a significant role in the
      intestinal transport of NH4+.

PMID- 1635157
TI  - Inhibition of rat bladder tumor (RBT323) growth by tumor necrosis factor alpha
      and interferon-gamma in vivo.
AB  - The antiproliferative activities of recombinant rat gamma-interferon and
      recombinant human tumor necrosis factor alpha were evaluated in a new rat bladder
      tumor model, RBT323. The RBT323 is a spontaneously arisen, serially
      transplantable, bladder tumor in ACI rats. Histologically and ultrastructurally
      this tumor is a grade 2-3 transitional tumor without squamous cells. The RBT323
      appears to be non-immunogenic in tumor excision and rechallenge experiments. The
      tumor was transplanted subcutaneously and the drugs were administered
      peritumorally. Gamma-interferon and tumor necrosis factor monotherapy starting
      two days after tumor implantation showed dose-dependent growth inhibiting effects
      in the dose range tested. Combination treatment with gamma-interferon and the
      highest dose of tumor necrosis factor resulted in synergistic antiproliferative
      effects. After cessation of the combination treatment all tumors resumed growth,
      initially with a low doubling time, but finally with their original growth rate.
      Gamma-interferon treatment initiated at a tumor volume of 0.2 to 0.5 cm.3 had no
      antitumor effects, whereas treatment with 100 micrograms. tumor necrosis factor
      per rat inhibited tumor growth significantly. Different combinations of the
      cytokines had synergistic effects against established tumors. These studies
      demonstrate antitumor effects of gamma-interferon and tumor necrosis factor in a
      rat bladder tumor model system. Combination therapy has synergistic effects and
      prolongs the time to tumor recurrence.

PMID- 1635158
TI  - Morphological changes and alterations in regional intrarenal blood flow induced
      by graded renal ischemia.
AB  - A model of renal ischemia was used to study morphological changes and alterations
      in intrarenal blood flow. Renal artery blood flow was reduced from 120 to 20
      ml./minute (normal 172 +/- 14) for 3 weeks. Morphological changes were assessed
      histologically, and by electronmicroscopy. Intrarenal blood flow was determined
      using microspheres. Flow rates less than 80 ml./minute resulted in a progressive
      loss of renal volume with arterial thrombosis and renal infarction at 20
      ml./minute. Histological changes included loss of glomerular volume, tubular
      dilatation (60 ml./minute), tubular cast formation (50 ml./minute) tubular
      atrophy, interstitial fibrosis, arteriolar thickening (40 ml./minute) and
      glomerular hyalinization (30 ml./minute). Electronmicroscopy changes at 60
      ml./minute (loss of glomerular microvasculature, unfolding of glomerular vascular
      tuft, appearance of blind ending vessels) progressed to disruption of glomerular
      architecture noted at 30 ml./minute. Narrowing of medullary blood vessels (60
      ml./minute) and neovascularisation (40 ml./minute) was observed. Progressive
      ischemia decreased medullary, inner cortical and outer cortical blood flow (5.9
      to 2.1 ml./minute/gm.) p less than 0.01, with a compensatory increase to the
      opposite kidney.

PMID- 1635159
TI  - Collagen alterations in the corpus cavernosum of men with sexual dysfunction.
AB  - Previous studies have noted the abundance of collagen in human erectile tissues
      and the association of altered collagen content with erectile dysfunction. We
      investigated these notions by studying the collagen characteristics of biopsies
      from the corpus cavernosum of men who required surgical correction of their
      sexual dysfunction. Histologic analysis revealed abundant collagen within the
      erectile tissues. With the exception of patients with Peyronie's disease and
      priapism, only mild alterations in collagen architecture were noted in the
      remainder of the patients. Biochemical quantitation confirmed the histologic
      study. The mean collagen content represented 47% of total protein in most
      patients. The proportion rose to 68% and 73% in the patients with Peyronie's
      disease and priapism, respectively. No statistical difference in collagen content
      was noted in all the patients studied. Immunohistochemistry revealed collagen
      types I and IV to predominate in the corpus cavernosum, with type III making up
      the minority. There were no qualitative changes in collagen ratios with age and
      disease. We conclude that though collagen is a major component of the penis,
      there are no changes in its histologic characteristics that can be correlated to
      senescence or to the etiology of erectile dysfunction.

PMID- 1635160
TI  - [Analysis of the GPIIb and GPIIIa genes in patients with Glanzmann's
      thrombasthenia].
AB  - Glanzmann's thrombasthenia (GT) is an autosomal recessive bleeding disorder due
      to a deficiency or abnormality of glycoproteins (GPs) IIb and IIIa, but its
      genetic basis remains to be determined. We analyzed the genes for GPIIb and
      3'GPIIIa in 3 patients with GT and in 7 control subjects by Southern blot. No
      large deletions or insertions were detected in these genes in any patient with
      GT. Furthermore, the GPIIb and GPIIIa mRNAs derived from the platelets of
      patients with GT could be amplified using the reverse transcriptase-polymerase
      chain reaction (RT-PCR). This finding indicates that the mRNAs of the patients
      with GT are considered to be normally transcribed. The molecular defects of the
      GPIIb.

PMID- 1635161
TI  - [Multicenter clinical evaluation of red cell concentrates stored up to 6 weeks in
      MAP, a new additive solution].
AB  - The clinical safety and efficacy of transfusion of red cell concentrates stored
      in MAP solution (MAP-CRC) containing mannitol, adenine, glucose, phosphate and
      citrate, into 39 anemic patients were evaluated. In 23 patients, infusion of MAP
      CRC was alternated with infusion of ordinary CRC as a control. The MAP-CRC and
      CRC used in this study were stored at 4 degrees C for an average of 38.2 +/- 2.6
      days (n = 52) and 18.1 +/- 2.2 days (n = 26), respectively. Red cell recovery was
      77.5% for MAP-CRC and 82.5% for CRC, based on calculation of the increase in
      hemoglobin level one day after transfusion. There were no differences between
      patients transfused with MAP-CRC and those transfused with CRC in clinical
      findings or biochemical data. No major side-effects other than pyrexia associated
      with the underlying infections were seen in patients transfused with MAP-CRC. MAP
      CRC stored up to 42 days is apparently as safe and effective as stored CRC. This
      new additive solution may therefore be useful for the future expansion of the
      indications for autologous blood transfusion by facilitating the collection and
      storage of more blood in the liquid state for a longer period, and may also be
      useful in obtaining more plasma from whole blood as source plasma.

PMID- 1635162
TI  - [Clinical evaluation of traditional Chinese medicine for chronic idiopathic
      thrombocytopenic purpura].
AB  - The efficacy of traditional Chinese medicine (Kampo medicine) was examined in 40
      patients with steroid-unresponsive idiopathic thrombocytopenic purpura (ITP). All
      patients were, at first, given Hochuekihi-to, and when they were refractory,
      therapy was switched to Sairei-to, Ninjinyoei-to, and Kamikihi-to. The efficacy
      rate was 20.0% by Hochuekihi-to, 20.7% by Sairei-to, 5.5% by Ninjinyoei-to and
      6.7% by Kamikihi-to, respectively. Thus, overall responders were 12 in 40
      patients with an effective rate of 30.0%. The mechanism of action of traditional
      Chinese medicine is discussed in relation to the production of various kinds of
      cytokines.

PMID- 1635163
TI  - [Abnormalities of beta spectrin with hereditary elliptocytosis in mother and
      child].
AB  - It is generally considered that abnormality of the erythrocyte membrane skeleton
      co elliptocytes. There are, however, few reports of beta spectrin variants. We
      found a new variant of beta spectrin in a child and her mother. This report is
      the first case of abnormality of beta spectrin in Japan. The propositus was an 8
      month-old girl who was first examined by us in 1988. On laboratory findings, she
      showed anemia, increased reticulocyte count and decreased haptoglobin
      concentration. Both peripheral blood smears of patient and her mother showed
      typical elliptocytosis and they were diagnosed as hereditary elliptocytosis. SDS
      PAGE patterns of the red cell membranes of the propositus and her mother were
      characterized by the presence of an abnormal component migrating immediately
      below the spectrin chains. We confirmed that the abnormal spectrin appeared
      clearly at the expense of normal beta chain. The abnormal spectrin (M.W.
      216,000d) makes up 16% of the total beta chain. The inheritance of our case was
      autosomal dominant. The present case is considered as a new spectrin variant.

PMID- 1635164
TI  - [Hematopoietic failure of a healthy child with human parvovirus B19 infection-
      studies on the hematopoiesis].
AB  - An 8 year-old boy, who had been healthy since his birth, presented fever,
      ecchymosis and nasal bleeding. His peripheral blood picture showed pancytopenia
      and bone marrow showed erythroblastopenia, but these findings recovered
      spontaneously in two weeks. The diagnosis of human parvovirus B19 (HPVB19)
      infection was made by the presence of anti HPVB19 IgM antibodies in the sera. In
      order to investigate the mechanisms of erythroblastopenia and pancytopenia, we
      performed in vitro hematopoietic cell culture in both acute phase and the
      convalescent phase (3 months after the onset). In the acute phase, the formation
      of CFU-E colony was inhibited but that of BFU-E, CFU-G, GEMM colony was not
      inhibited. Unexpectedly, HPVB19 DNA was detected in CFU-GEMM colony cells with
      the PCR technique. It is suggested that HPVB19 infected not only to erythroid
      progenitor cells but also to other progenitors.

PMID- 1635165
TI  - [Familial occurrence of myelodysplastic syndrome concomitant with monoclonal
      gammapathy].
AB  - Myelodysplastic syndrome (MDS) combined with monoclonal gammopathy or multiple
      myeloma has rarely been reported. In this article, two siblings, a brother and
      his sister who showed simultaneous occurrence of MDS and monoclonal gammopathy
      are reported. The first case, a 73-year-old male, was admitted to our hospital in
      November, 1987. Analysis of peripheral blood revealed pancytopenia without blast
      cells. Bone marrow was hypocellular with 14.9% of myeloblasts and 2.8% of plasma
      cells characterized by 2 to 4 nuclei. Serum IgA level was 635 mg/dl and serum
      immunoelectrophoresis revealed a monoclonal IgA lambda band. The second case, a
      70-year-old female, younger sister of the first case, was admitted to our
      hospital in January, 1988. Bone marrow was normocellular with 23% of peroxidase
      negative myeloblasts and 12.8% of atypical plasma cells. Serum IgG level was
      1,901 mg/dl with monoclonal IgG kappa band. Hematological findings have remained
      unchanged for 12 months. The first case was regarded as hypoplastic MDS with
      monoclonal gammopathy and the second case was MDS with smoldering myeloma. These
      cases were very similar with in respect to age, time of onset, clinical course,
      hematological findings and especially, association with M-protein. There are no
      reports concerning the familial incidence of MDS with M-protein. These findings
      supported the hypothesis that an initial event selects a clone of stem cells
      which retain the capability to differentiate into mature myeloid and lymphoid
      cells, in these cases B-cells.

PMID- 1635166
TI  - [Myelodysplastic syndromes in two young brothers].
AB  - Myelodysplastic syndromes that occurred in two young brothers are reported. A 19
      year-old man was admitted to Kobe City General Hospital in May 1990 because of
      fever and nasal bleeding. On admission his hemoglobin was 5.5 g/dl, platelet
      count 1.5 x 10(4)/microliters and white cell count 1,700/microliters with 18%
      neutrophils and 80% lymphocytes. Bone marrow aspirate showed dysplastic features
      of trilineage blood cells with 4.8% myeloblasts. A diagnosis of refractory anemia
      was made. His younger brother, a 17-year-old man was examined in May 1990 because
      of increasing fatigability of 2 years' duration. His hemoglobin was 8.7 g/dl,
      platelet count 2.1 x 10(4)/microliters and white cell count 2,800/microliters.
      Bone marrow aspirate revealed morphological abnormalities in three lineages with
      5.2% myeloblasts. He was diagnosed as having refractory anemia with excess of
      blasts. Their parent are consanguineous. The onset at a young age, reduced CD4
      lymphocytes and similarity of dyshematopoietic findings suggests the presence of
      common genetic disorder in the pluripotent hematopoietic stem cells.

PMID- 1635167
TI  - [Myelodysplastic syndrome associated with marked eosinophilia and basophilia].
AB  - Myelodysplastic syndrome (refractory anemia with excess of blasts; RAEB) with
      marked basophilia and eosinophilia is described. An 82-year-old male was admitted
      to our hospital because of severe normocytic normochromic anemia (Hb 5.6 g/dl).
      The white cell count was 9,200/microliters with marked basophilia (34.5%) and
      eosinophilia (19.5%). The bone marrow aspiration also revealed both basophilia
      and eosinophilia, with blast contents of 9%. Diagnosis of RAEB was established.
      Although the treatment with red cell transfusion and ubenimex (Bastatin) was
      started, anemia was not improved. A karyotype of the bone marrow cells from this
      patient showed 47, XY, +8, i (17q), which has been observed as additional
      chromosomal abnormalities in blastic crisis of chronic myelogenous leukemia. The
      diagnosis of CML was not compatible with this case, because Ph1 chromosome and
      bcr gene rearrangement were negative. It is concluded that eosinophilia and
      basophilia might be derived from clonal abnormalities associated with MDS.

PMID- 1635168
TI  - [Erythroleukemia in pregnancy with successful outcome of delivery].
AB  - A 37-year-old woman was admitted to our hospital because of anemia in the 33rd
      week of pregnancy. On admission, the hemoglobin was 7.6 g/dl, platelets
      508,000/microliters and WBC 8,300/microliters with 4% blast cells. Bone marrow
      aspirate demonstrated 50% erythroblasts of nucleated cells, which had prominent
      megaloid and polynucleic changes, and 20% myeloblast cells. We diagnosed her as
      having erythroleukemia. Receiving packed-red-cell transfusions, she had a
      cesarean section, and gave birth to a female infant (BW 2,175 g) in the 34th week
      of pregnancy. At the same time, she had a total hysterectomy with left
      adnexectomy. The postoperative course was favorable. She had a combination
      chemotherapy of BHAC-DMP, resulting in a partial remission. After the second
      induction chemotherapy with subcutaneous use of G-CSF and BHAC-DMP, complete
      remission was obtained, which lasted for almost 17 months. The child is growing
      well without any hematological disorder.

PMID- 1635169
TI  - [B-cell chronic lymphocytic leukemia complicated by autoimmune thrombocytopenic
      purpura].
AB  - A 74-year-old Japanese male was admitted because of anemia. Hepatosplenomegaly,
      lymphoadenopathy, and purpura were not found. The laboratory data on admission
      revealed that the white-cell count was 9,400/microliters, the hemoglobin 11.1
      g/dl, and the platelet count 17,000/microliters. Platelet-associated IgG was
      794.2 ng/10(7) cells. The patient was diagnosed as having autoimmune
      thrombocytopenic purpura (ATP) at this time. He was treated with prednisolone,
      but his thrombocytopenia not improve. In addition to prednisolone, azathioprine
      was given to him. During the course of treatment, leukocytosis gradually appeared
      and the white-cell count reached more than 30,000/microliters with over 70%
      lymphocytes. A bone marrow aspiration revealed 70% of small lymphocytes, and
      surface marker analysis showed that CD19 and HLA-DR were positive on these
      lymphocytes. Southern blotting analysis demonstrated rearrangements of JH and JK.
      He was finally diagnosed as B-CLL complicated by ATP. One month after the
      azathioprine administration, the platelet count increased more than
      30,000/microliters and the white-cell count decreased less than
      10,000/microliters. About 2% of patients with CLL are known to be complicated by
      ATP. To our knowledge, the present case is the first case of B-CLL complicated by
      ATP in Japan.

PMID- 1635170
TI  - [Lymphokine-activated killer (LAK) cells and interleukin-2 (IL-2) therapy that
      improved lymphadenopathy in a patient with B cell non-Hodgkin's lymphoma].
AB  - A 70-year-old man was admitted to our hospital on March 9, 1989 because of fever,
      superficial generalized lymphadenopathy, upper abdominal mass and right pleural
      effusion. The diagnosis of non-Hodgkin's lymphoma (follicular medium sized cell
      type, B cell) was made by a biopsy of the neck lymph node. Peripheral blood
      mononuclear cells were obtained from the patient by cytopheresis. The cells were
      cultured for 8 days with interleukin-2 (IL-2) to generate Lymphokine-activated
      killer (LAK) cells. The patient received a total of 7.7 x 10(9) LAK cells
      intravenously over a period of 3 weeks. He also received continuous intravenous
      infusion of IL-2 for 17 days, starting 2 days before the first infusion of LAK
      cells. After this therapy, although his superficial generalized lymphadenopathy
      disappeared or decreased in size, the size of the upper abdominal mass did not
      decrease. Therefore, it is suggested that adoptive immunotherapy is a beneficial
      treatments for B cell lymphoma. However, LAK cells should be generated in much
      larger quantities for a more successful therapeutic result.

PMID- 1635171
TI  - [Hodgkin's disease associated with Behcet's disease].
AB  - This paper reports a rare case of Hodgkin's disease with Sjogren syndrome in the
      course of Behcet's disease. A 43-year-old man developed arthralgia of bilateral
      knees, ankles, elbows and wrists in May, 1988. He had hazy vision and was
      diagnosed as having iridocyclitis and chorioretinitis in February, 1989. Gingival
      ulcer, penile ulcer, erythema nodosum on the right lower leg and superficial
      thrombophlebitis on the bilateral arms appeared in June, 1989. Therefore, he was
      diagnosed as Behcet's disease. He responded well to prednisolone. In November,
      1989, he developed fever with positive CRP and elevated alkaline phosphatase.
      Multiple mass lesions in the liver and spleen with retrocrural lymphadenopathy
      were noticed on the abdominal CT and echogram. A cervical lymph node biopsy
      revealed Hodgkin's disease of the mixed cellularity type. At the same time, the
      patient had dry eyes and a dry mouth. Salivary gland biopsy revealed chronic
      sialoadenitis with lymphocytic infiltration compatible with Sjogren syndrome. The
      patient responded well to ABVD regimen. He is still free of disease as of May,
      1991.

PMID- 1635172
TI  - [Hairy cell leukemia successfully treated with 2'-deoxycoformycin following
      refractoriness to splenectomy and alpha-interferon therapy].
AB  - A 34-year-old man was admitted in May, 1989 because of severe left upper
      abdominal pain, which was caused by advanced splenomegaly. On initial
      examinations, peripheral blood showed leukocytosis (13,400/ml) including 60%
      hairy cell which also infiltrated in bone marrow (64%). The patient was diagnosed
      as having hairy cell leukemia (Japanese type) of B-cell lineage. Splenectomy was
      performed as an initial treatment. The effect of splenectomy was only palliative
      and transient leukocytosis progressed thereafter. alpha-interferon and
      bestrabucil (KM 2210) were then adopted for 4 months respectively. The effects
      were, however, unsatisfactory. Subsequently the patient was treated successfully
      with 2'-deoxycoformycin (DCF). Complete remission was attained following 12
      injections of 7.5 mg/body of DCF during 5 months and durable remission persists
      for more than 6 months without maintenance therapy. The side effect was minimum.

PMID- 1635173
TI  - [Idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia
      with elevated level of serum interleukin-6].
AB  - A 38-year-old male was admitted in January 1984 due to lymphadenopathies with
      hyperimmunoglobulinemia with a serum IgG level of 2,872 mg/dl. Following this, he
      was observed as an outpatient in regard to lymphadenopathies of unknown origin.
      In 1989, after the fourth lymph node biopsy he was diagnosed as having idiopathic
      plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia. At that time
      his serum IgG level was 8,090 mg/dl. The elevated serum interleukin-6 (IL-6)
      level, up to 21.1 pg/ml, was particularly interesting, because IL-6 is involved
      in the oncogenesis of plasmacytoma/myeloma. The patient also had thrombocytosis,
      hematuria, and a serum increased level of C reactive protein which seemed to be
      related to the effects of IL-6 i.e. thrombopoiesis, induction of the
      proliferation of mesenchymal cells, and induction of the production of acute
      phase proteins by hepatocytes, respectively. Even though he displayed no outward
      symptoms before and after treatment with prednisolone and melphalan, elevated
      immunoglobulin levels were still present.

PMID- 1635174
TI  - [Natural interferon-alpha induced cytogenetic complete remission in a patient
      with chronic myelocytic leukemia, diagnosed in early chronic phase with
      basophilia and normal blood cell counts].
AB  - A 57-year-old woman visited to our hospital complaining of paresthesia in the
      right leg. She had no abnormal physical findings. However, the peripheral blood
      examination demonstrated 7% basophilia with 8000/microliters WBC count and
      decreased neutrophil alkaline phosphatase activity (score 37, rate 19%). She was
      diagnosed as Ph1 chromosome positive CML in early phase by the chromosomal
      analysis of bone marrow cells. She received subcutaneous injection of natural
      interferon-alpha at a dosage of 600 x 10(4) IU daily from March 10, 1987. The
      dosage and administration interval were gradually reduced and prolonged. Since
      November 1988, weekly injections of 300 x 10(4) IU has been administered as
      maintenance therapy. Cytogenetic improvement was seen at 4 months after the start
      of IFN. Disappearance of Ph1 chromosome positive cells was observed on December
      11, 1987. It was suggested that the administration of IFN from the early chronic
      phase played an important role in the control of the disease.

PMID- 1635175
TI  - [alpha-Interferon in the treatment of essential thrombocythemia].
AB  - Two patients with essential thrombocythemia were successfully treated by
      administering native alpha-interferon (alpha-IFN). One patient was a 38-year-old
      man in whom thrombocytosis was found accidentally. His platelet count on
      admission was 880,000/microliters and megakaryocytes increased. Three million
      units of alpha-IFN was administered subcutaneously everyday, and the platelet
      count decreased gradually to about 500,000/microliters within 2 weeks. The other
      patient was a 66-year-old woman who visited our hospital complaining of
      tenderness and swelling of the fingertips. Her platelet count was
      1,610,000/microliters, and megakaryocytes increased and showed abnormal
      morphology. Six million units of alpha-IFN was administered subcutaneously every
      other day. The tenderness and swelling of the fingertips disappeared soon after
      the beginning of alpha-IFN administration. The platelet count decreased to about
      500,000/microliters within 10 days, but she developed itching of the skin over
      the entire body. Therefore, alpha-IFN treatment was discontinued. It was
      suggested that alpha-IFN suppresses not only the maturation and proliferation of
      the progenitors of megakaryocytes but also the production of platelets from
      megakaryocytes. Administration of alpha-IFN should be considered in treating
      patients with essential thrombocythemia, because effects appear soon and alpha
      IFN does not induce a second malignancy.

PMID- 1635176
TI  - [Alveolar rhabdomyosarcoma with massive bone marrow involvement and 2;13
      chromosome translocation].
AB  - We report a 9-year-old girl who had massive bone marrow infiltration of tumor
      cells at the onset of alveolar rhabdomyosarcoma. She was admitted to a surgical
      hospital because of abdominal pain and tumor in the buttock. Computerized
      tomographic scans of the pelvis revealed an abnormal mass. She was referred to
      our department. Hematological examination showed pancytopenia. Blood chemistry
      revealed hypercalcemia and hyperuricemia. Bone marrow was occupied with 100%
      tumor cells. Chromosome analysis of tumor cells in bone marrow revealed a
      specific translocation, t(2;13) (q37;q14). This finding enabled the diagnosis of
      a disseminated alveolar rhabdomyosarcoma to be established. She was treated with
      vincristine, cyclophosphamide and epirubicin, achieved a complete remission, but
      died of relapse 3 months after diagnosis.

PMID- 1635177
TI  - [All-trans retinoic acid induced a complete remission in a case of refractory
      relapsed acute promyelocytic leukemia].
AB  - Forty five year old male suffering from relapsed acute promyelocytic leukemia
      (APL) was treated with all-trans retinoic acid (ATRA) and attained second
      complete remission (CR) without bone marrow hypoplasia. He was diagnosed as
      having APL in September 1989. The DCMP-85 regimen first induced CR in October,
      however the disease relapsed in September 1990. The DCMP-85 and and the MEC (MIT,
      ETOP, Ara-C) regimens were applied for re-induction without success. Then, 45
      mg/m2/day ATRA was given orally from December 28, 1990. Laboratory data before
      ATRA treatment were as follows; 35.4% leukemic cells in the bone marrow, Hb 11.0
      g/dl, Plt 130,000/microliters, WBC 5,100/microliters without leukemic cells, and
      no DIC was detected. During the treatment, his bone marrow was examined
      frequently. The bone marrow series showed no hypoplasia at any time and gradual
      reduction of leukemic cells with proliferation of mature granulocytes. CR was
      attained on January 21, 1991. DIC did not develop. Cytogenetic anomalies
      including t(14;17;15) (q24;q11.2;q22) reduced from 29/30 cells at relapse to 4/30
      cells at the time of CR. Dryness of mouth and lips, irritation around eyes and
      the elevations of GOT, GPT and triglyceride level were seen as the side effects
      of ATRA, however they were tolerable.

PMID- 1635178
TI  - [Differentiation therapy of acute promyelocytic leukemia: two successful cases of
      remission induction by all-trans retinoic acid].
AB  - We described two pediatric patients with acute promyelocytic leukemia (APL) who
      were successfully induced into complete remission with all-trans retinoic acid
      (ATRA, 45 mg/m2 per day) after failing on conventional chemotherapy. Initial
      response was observed as correction of DIC within a week of treatment.
      Hematologically, initial increase of maturing leukocytes reached a peak
      peripheral WBC count on the 16th and 20th day, respectively. However, these
      seemingly differentiated leukocytes retained Auer body and dysplastic features
      and there was no concomitant recovery of erythroid and megakaryocytic lineages at
      this point. A sudden drop of leukocyte counts after this peak made a brief period
      of leukopenia before the complete remission was finally attained morphologically
      in 4-5 weeks. Thus, remission of APL by ATRA therapy consisted of a two-phase
      course. In one patient, we observed an increase of histiocytes phagocytizing
      leukocytes in the marrow during the recovery from leukopenia. It is, therefore,
      postulated that the two-phase course of recovery may reflect the differentiation
      of leukemic cells by ATRA and subsequent clearance of senescent cells by the
      reticuloendothelial system followed by regeneration and differentiation of
      residual normal hematopoietic stem cells.

PMID- 1635179
TI  - [Improvement of bone marrow hematopoiesis in idiopathic myelofibrosis with
      prednisolone].
AB  - A 64 year-old female patient of idiopathic myelofibrosis (IMF), who had had
      rapidly progressing massive splenomegaly and severe pancytopenia refractory to
      blood transfusion, was treated with PSL 0.6 mg/kg/day for a month, being
      significantly improved not only symptomatically and hematologically but also in
      bone marrow hematopoiesis. Although the effectiveness of PSL to restoration of
      bone marrow hematopoiesis has been almost unknown, long term oral PSL should be
      tried for a certain phase of IMF.

PMID- 1635180
TI  - [Pharmacology and action mechanism of calcium and magnesium as regulators of
      blood pressure].

PMID- 1635181
TI  - [Pharmacology and action mechanism of endothelium-derived relaxing factor].

PMID- 1635182
TI  - [Neural network of circulatory control system].

PMID- 1635183
TI  - [Roles of cytokines on blood pressure regulation].

PMID- 1635184
TI  - [Insulin--pharmacological aspects].

PMID- 1635185
TI  - [Definition of high blood pressure].

PMID- 1635186
TI  - [Comparison of various methods of measuring blood pressure].

PMID- 1635187
TI  - [A clinical significance and limitation of home blood pressure measurements].

PMID- 1635188
TI  - [Ambulatory blood pressure monitoring in hypertensive patients].

PMID- 1635189
TI  - [Classification and severity of hypertension].

PMID- 1635190
TI  - [Hypertension detection and follow-up program(HDFP)].

PMID- 1635191
TI  - [An epidemiology of hypertension in Japanese].

PMID- 1635192
TI  - [The changing pattern of hypertension and incidence of cardiovascular diseases in
      a long-term follow-up survey of a Japanese community: the Hisayama Study].

PMID- 1635193
TI  - [Long-term trends in blood pressure observed in rural and urban populations].

PMID- 1635194
TI  - [Long-term follow-up of hypertension in work site population].

PMID- 1635196
TI  - [Genetic background of hypertension].

PMID- 1635195
TI  - [An epidemiological analysis of cardiovascular diseases in the subtropical
      islands of Okinawa].

PMID- 1635197
TI  - [The background of racial difference in hypertension].

PMID- 1635198
TI  - [Simulation of cardiovascular control system].

PMID- 1635199
TI  - [Characteristics in prehypertensive stage of essential hypertension].

PMID- 1635200
TI  - [Pathogenesis of essential hypertension--a perspective].

PMID- 1635201
TI  - [Autonomic nervous system in essential hypertension].

PMID- 1635202
TI  - [Role of sodium and potassium in the pathogenesis of essential hypertension].

PMID- 1635203
TI  - [Arterial factors in essential hypertension].

PMID- 1635204
TI  - [Etiological and physiopathological significance of catecholamine activity in
      hypertension].

PMID- 1635205
TI  - [Etiological and physiopathological significance of serotonin activity in
      essential hypertension].

PMID- 1635206
TI  - [Etiological significance of the renin-angiotensin system in essential
      hypertension].

PMID- 1635207
TI  - [Etiological and physiopathological significance of vasopressin activity in
      essential hypertension].

PMID- 1635208
TI  - [Etiological significance of prostaglandins and related substances in
      hypertension].

PMID- 1635209
TI  - [Diurnal variation of blood pressure].

PMID- 1635210
TI  - [The kallikrein-kinin system and blood pressure regulation in essential
      hypertension].

PMID- 1635211
TI  - [Etiological significance of calcium and magnesium activity in essential
      hypertension].

PMID- 1635212
TI  - [Etiological significance of calcium regulating hormones in hypertension].

PMID- 1635213
TI  - [Etiological and physiopathological significance of endothelin activity in
      essential hypertension].

PMID- 1635214
TI  - [Etiological and physiopathological significance of cytokine activity in
      hypertension].

PMID- 1635215
TI  - [Etiological and physiopathological significance of growth factor activity in
      hypertension].

PMID- 1635216
TI  - [Insulin--its role in the pathogenesis of hypertension].

PMID- 1635217
TI  - [Etiological and physiopathological significance of steroid hormones in
      hypertension].

PMID- 1635218
TI  - [Etiological and physiopathological significance of taurine in hypertension].

PMID- 1635219
TI  - [Miscellaneous factors on mechanisms of blood pressure regulation].

PMID- 1635220
TI  - [Molecular biology in renin angiotensin system].

PMID- 1635221
TI  - [Essential hypertension and cerebral blood flow].

PMID- 1635222
TI  - [Renal hemodynamics in essential hypertension].

PMID- 1635223
TI  - [Peripheral vascular hemodynamics in essential hypertension].

PMID- 1635224
TI  - [Disorders of renal sodium excretion in essential hypertension].

PMID- 1635225
TI  - [Electrolyte transport in the blood cell membrane and essential hypertension].

PMID- 1635226
TI  - [Changes in platelet function in essential hypertension].

PMID- 1635227
TI  - [Hypertension and microvascular rheology].

PMID- 1635228
TI  - [Diurnal rhythm of blood pressure in normotensive subjects and patients with
      essential hypertension].

PMID- 1635230
TI  - [Circadian changes in blood pressure before and after admission].

PMID- 1635229
TI  - [Mechanisms and sources of circadian variations in blood pressure].

PMID- 1635231
TI  - [A clinical significance of nocturnal blood pressure].

PMID- 1635232
TI  - [Sodium, potassium and calcium intake and hypertension].

PMID- 1635233
TI  - [Alcohol and hypertension].

PMID- 1635235
TI  - [Effects of alcohol on circadian blood pressure pattern].

PMID- 1635234
TI  - [Possible mechanisms of alcohol-induced hypertension].

PMID- 1635236
TI  - [Smoking as a factor altering blood pressure: acute and chronic effects].

PMID- 1635237
TI  - [Cold stimulation and essential hypertension].

PMID- 1635238
TI  - [Psychological stress and blood pressure].

PMID- 1635239
TI  - [Exercise and essential hypertension].

PMID- 1635240
TI  - [Blood pressure during sleep].

PMID- 1635241
TI  - [Biosynthetic pathway of endothelin].

PMID- 1635242
TI  - [Seasonal differences in blood pressure].

PMID- 1635243
TI  - [Disturbance of cerebral circulation in hypertension--introduction].

PMID- 1635244
TI  - [Pathogenic mechanisms of hypertensive cerebrovascular lesions--importance of
      regional nutrition].

PMID- 1635245
TI  - [Echocardiographic findings in hypertensive heart disease--evaluation of cardiac
      structure and function].

PMID- 1635246
TI  - [The relationship between hypertension and hypertrophic cardiomyopathy].

PMID- 1635247
TI  - [Renal disorder (nephrosclerosis) in hypertension].

PMID- 1635248
TI  - [Arteriosclerosis associated with hypertension].

PMID- 1635249
TI  - [Ocular fundus changes in essential hypertension].

PMID- 1635250
TI  - [Sleep apnea syndrome and hypertension].

PMID- 1635251
TI  - [Pressure-regulating factors--pharmacology and action mechanisms.
      Catecholamines].

PMID- 1635252
TI  - [Hypertension and sudden death].

PMID- 1635253
TI  - [Classification of antihypertensive agents].

PMID- 1635254
TI  - [Thiazides and thiazide-like diuretics].

PMID- 1635255
TI  - [Loop diuretics].

PMID- 1635256
TI  - [Potassium-sparing diuretics].

PMID- 1635257
TI  - [Centrally acting sympathetic inhibitors].

PMID- 1635258
TI  - [Presynaptic adrenergic neuron blocking drugs].

PMID- 1635259
TI  - [Regional flows in conscious hypertensive rats].

PMID- 1635261
TI  - [Relaxants of arterial and arterio-venous smooth muscles].

PMID- 1635260
TI  - [Blood pressure regulating factors--pharmacology and action mechanisms.
      Serotonin].

PMID- 1635262
TI  - [Ca antagonists].

PMID- 1635263
TI  - [Nonpeptide angiotensin II antagonists].

PMID- 1635264
TI  - [Renin inhibitors].

PMID- 1635265
TI  - [Renin angiotensin system as a regulator of blood pressure--pharmacological
      actions and its mechanisms].

PMID- 1635266
TI  - [Serotonergic antagonist].

PMID- 1635267
TI  - [Pharmacology and action mechanism of vasopressin as a regulator factor of blood
      pressure].

PMID- 1635268
TI  - [Pharmacology and action mechanism of prostaglandins and related substances as
      regulators of blood pressure].

PMID- 1635269
TI  - [Pharmacology and action mechanism of kallikrein-kinin system as a regulator of
      blood pressure].

PMID- 1635270
TI  - [Development of a scale for workers' coping behavior: its reliability and
      validity].
AB  - The purpose of this study is to develop a scale for measuring coping with job
      stressors. Stress process and coping function provide the theoretical framework.
      Coping is conceptualized as situation-specific behavior. We measure episodic
      coping, that is, the strategies that individuals actually use in coping with a
      particular situation. First, a preliminary scale, was prepared. It contained 39
      coping behaviors with job stressor which were based on an open-ended pilot study.
      Next, factor analysis was conducted in order to identify the structure of the
      scale. Subjects of this study were 649 male employees and 91 female employees of
      a in manufacturing firm and research and development institute. By occupation
      they were comprised of 383 professionals, 99 technicians, 96 clerks, 104
      miscellaneous workers and 58 of unknown occupation. Seven items in the
      preliminary scale were omitted because of their psychometrical properties.
      Finally, factor analysis showed three factors in the scale: positive action and
      cognition (11 items), avoidant action and cognition (10 items), and symptom
      management (11 items). The coping scale showed high conceptual validity and
      reliability.

PMID- 1635271
TI  - [Person-centered approach in occupational mental health: theory, research and
      practice].
AB  - The objective of this study was to articulate the person-centered approach (PCAp)
      in theory and in the research and practice of occupational mental health. First,
      Carl Rogers' person-centered theory was reviewed. Secondly, a study on 1,661
      workers was presented in which psychological variables such as fatigue (FG),
      depression (DP) and anxiety (AX) were found to be negatively correlated with
      relationship scales concerning the workers' perception of the person-centered
      attitudes (PCA) of their superiors, the democratic leadership of their superiors
      (DEM) and the overall activation (ACT) of their worksites. Significant
      differences in FG, DP and AX were found among workers who perceived of their
      superiors as having either high or low PCA. Workers who reported that their
      superiors had high PCA had significantly less FG, DP and AX than those who
      perceived of their superiors as having low PCA. Similar results were also
      obtained when high DEM/low DEM and high ACT/low ACT were compared in terms of
      workers' FG, DP and AX. Thus, the PCA of job superiors was considered to be
      positively related to the mental health of workers. Thirdly, PCA training in
      industry was introduced and evaluated. A total of 137 trainees (managers)
      conducted active listening, a basic skill in the PCAp, and filled out a
      relationship inventory immediately afterwards, evaluating themselves as listeners
      and their partners as listeners. A comparison of scores between the first and
      last sessions of training showed significant increases in empathy, congruence and
      unconditional positive regard at the last session in both the speakers' version
      and the listeners' version of the relationship inventory. Cases showing changes
      in human relations at work as a consequence of PCA training, reported by the
      trainees and confirmed by an occupational health nurse, were presented. This
      study showed that PCA, which is positively related to workers' mental health, can
      increase as a result of training. The implications of these studies are discussed
      and various possibilities for further research using the concepts of PCAp are
      presented. The authors hope that such a viewpoint in occupational mental health
      may lead to fruitful research and practice in the field of occupational medicine.

PMID- 1635272
TI  - [Excretion of p-chloroaniline metabolites into urine. Excretion of 2,4
      dichloroaniline and p-chloroformanilide].
AB  - Previously, we identified by gas chromatography/mass spectrometry (GC/MS) urinary
      metabolites of p-chloroaniline (p-CA) in a patient with acute p-CA poisoning.
      Among these metabolites there is a possibility that 2,4-dichloroaniline (2,4-DCA)
      and p-chloroformanilide (p-CFA) are produced through some unknown metabolic
      pathways in human. In order to clarify whether 2,4-DCA and p-CFA were produced
      within the human body or not, an attempt was made to detect these metabolites in
      the patient's urine samples prepared by various pretreatments, using both GC/MS
      and high performance liquid chromatograph. In addition, the detection of these
      metabolites in non-exposed person's urine samples spiked with p-CA and 2-amino-5
      chlorophenol was attempted by GC/MS using same the procedures in order to examine
      whether p-CA and 2-amino-5-chlorophenol excreted as metabolites were further
      changed to 2,4-DCA or p-CFA in the urine or not. 2,4-DCA was found abundantly in
      the ethereal extracts from the patient's urine samples hydrolyzed with
      hydrochloric, sulfuric and nitric acids, but only small amounts from intact urine
      samples by GC/MS. No 2,4-DCA was detected in the urine samples to which were
      added p-CA and 2-amino-5-chlorophenol. p-CFA was found in the ethereal samples
      which were extracted at acidic conditions from the patient's urine samples by
      GC/MS at the injection port temperature of 250 degrees C of the gas
      chromatograph, but the p-CFA peak disappeared at the injection port temperature
      of 150 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635273
TI  - [Assessment of occupational exposures to industrial hazardous substances. V. A
      proposed method for evaluating employee's exposure averages (8-h TWAs) using a
      single day measurement].
AB  - Daily exposure averages (8-h TWAs) to hazardous substances may vary considerably
      day to day, even though a worker is engaged in the same job. Previously we
      proposed a method to evaluate a long-term exposure condition with interday
      fluctuation using some exposure measurements. As it is assumed that 8-h TWAs are
      log-normally distributed, geometric standard deviation (sigma g) representing
      true interday fluctuation of 8-h TWAs should be estimated. If a single day's 8-h
      TWA of a worker is measured, sigma g of his own distribution of 8-h TWAs cannot
      be estimated. Therefore, to evaluate a long-term condition using a single day's 8
      h TWA, representative sigma g in all industrial workplaces must be determined
      beforehand. To investigate sigma g observed in many industrial workplaces, two
      days' 8-h TWAs of each worker were measured in a week on 260 workers exposed to
      19 hazardous substances. Sg2 (geometric standard deviation estimated by two
      samples) ranged from 1.00 to 8.22 with a median of 1.47 and a 90% upper limit of
      2.47. Transforming Sg2 into sigma g, median and 90% upper limit of sigma g were
      1.75 and 2.47, respectively. According to a classification scheme in the proposed
      method, exposure levels (I to III) were calculated using sigma g of 1.75 and
      2.47. A long-term exposure condition to hazardous substances can be evaluated by
      comparing a single day's 8-h TWA with the exposure levels.

PMID- 1635274
TI  - [Questionnaire survey for the fitness of protective equipment used by workers].

PMID- 1635275
TI  - [A method for storage of urine samples in the biological monitoring of organic
      solvents].

PMID- 1635276
TI  - [Carpal tunnel syndrome in three public school lunch cooks].

PMID- 1635277
TI  - Renal basolateral membrane SO4/HCO3 transporter characterized by fluorescent
      acridine orange.
AB  - Acridine orange (AO), a pH-sensitive fluorescent indicator, was used to study the
      characteristics of SO4/HCO3 transport in basolateral membrane vesicles (BLMV)
      isolated from rabbit renal cortex. The BLMV preparation containing a low buffer
      concentration and preloaded with 25 mM HCO3 was mixed with buffer containing AO
      and SO4 in the absence of an initial pH gradient. SO4 influx tended to drive HCO3
      efflux, causing intravesicular accumulation of AO and fluorescence quenching.
      There was no AO quenching in the absence of HCO3 with or without an external SO4
      gradient. 100 microM 4,4'-dibenzamido-2,2'-disulfonic stilbene (DBDS) inhibited
      the fluorescence quenching completely. 25 and 100 mM external Cl did not cause AO
      quenching. There was no effect of pH (6.5-8.0) on SO4/HCO3 transport. The Kd for
      SO4 was 8.2 mM. A positive inwardly directed diffusion potential (K(in) = 5 mM,
      K(out) = 100 mM with valinomycin) did not exert any effect on the SO4/HCO3
      transport, indicating that the transport process is insensitive to voltage. The
      Ki for DBDS inhibition of SO4/HCO3 transport was 2.3 microM.

PMID- 1635279
TI  - Characterization of G-proteins in rat glomeruli.
AB  - G-proteins in rat glomeruli were examined using bacterial toxin-catalyzed ADP
      ribosylation and specific immunoblots. ADP-ribosylation catalyzed by cholera and
      pertussis toxin demonstrated the existence of Gs and Gi proteins in the
      glomerular membranes. Immunoblots further revealed two types of Gs alpha (45 and
      52 kDa), Gi alpha 1 and/or Gi alpha 2 (40-41 kDa), Gi alpha 3 (40 kDa) and G beta
      (35-36 kDa) but not Go alpha in the membranes of the glomeruli. The predominant
      subspecies of Gs alpha was a 52 kDa protein. However, detectable amounts of G
      proteins did not exist in cytosolic extracts of the glomeruli. We conclude that
      several subspecies of Gs and Gi proteins are present in rat glomerular membranes.

PMID- 1635278
TI  - Arginine vasopressin increases intracellular calcium ion concentration in
      isolated mouse collecting tubule cells: distinct mechanism of action through V2
      receptor, but independent of adenylate cyclase activation.
AB  - The effects of arginine vasopressin (AVP*2) and its V2 receptor agonist, 1
      deamino-8-D-AVP (dDAVP), on the intracellular calcium ion concentration ([Ca2+]i)
      in isolated collecting tubular cells of mouse kidney were examined using
      fluorescent indicator fura-2 and a superfusion system. Both AVP and dDAVP evoked
      a rapid, transient increase followed by a sustained elevation of [Ca2+]i in CCT,
      OMCT, and IMCT in a dose-dependent manner. In CCT, the increments in [Ca2+]i by
      dDAVP were lower than those induced by AVP at all concentrations (10(-10)-10(-6)
      M) of the agonists tested, while in OMCT and IMCT, the increments were
      comparable. The initial peak of the rise in [Ca2+]i induced by AVP and dDAVP in
      these collecting tubule segments was partially attenuated by about 40% and the
      second sustained elevation was largely abolished in the absence of Ca2+ in the
      superfusate. Further, the increments [Ca2+]i induced by AVP were not affected by
      the addition of nicardipine to the superfusate. The increases in [Ca2+]i evoked
      by AVP and dDAVP were not mimicked by cAMP or forskolin. Moreover, they were not
      affected by alpha-adrenergic stimulation with epinephrine, in the presence and
      absence of prazosin, conditions which inhibit AVP-dependent cAMP production.
      These results indicate that AVP increases [Ca2+]i in CCT, OMCT, and IMCT,
      probably through V2 receptors, but via a mechanism which is independent of
      adenylate cyclase activation. In addition, the rise in [Ca2+]i is due to both
      Ca2+ release from the intracellular stores and increased Ca2+ influx through Ca2+
      channels insensitive to nicardipine.

PMID- 1635280
TI  - Specificity of IgA antibodies in sera from patients with IgA nephropathy.
AB  - A study was undertaken on the specificity of circulating IgA antibodies in
      patients with IgA nephropathy detected by immunofluorescence using avidin-biotin
      complexes. Renal biopsy specimens and serum samples were obtained from 33
      patients with IgA nephropathy, 14 other glomerular diseases and 3 normal renal
      tissues. These renal specimens were treated with citrate buffer (pH 3.2), and
      then incubated with serum samples obtained from the same and other patients with
      IgA nephropathy, other glomerular diseases or healthy adults at 37 degrees C for
      30 min. The specimens were incubated with biotin conjugated gout F(ab')2 anti
      human IgA antiserum at 37 degrees C for 30 min, and then with fluorescein-labeled
      avidin at 37 degrees C for 30 min. It was found that IgA antibodies in the sera
      from patients with IgA nephropathy specifically combined with the autologous
      glomerular mesangial areas, but only 25.7% of them combined with allogeneic renal
      tissues of IgA nephropathy patients. Confirmatory findings were obtained using an
      automatic image analyzer. However, these IgA antibodies did not combine with the
      renal tissues from patients with other glomerular diseases or normal renal
      tissues. In parallel studies, in order to distinguish IgA nephropathy from other
      glomerular diseases before renal biopsy, the renal specimens from patients with
      IgA nephropathy were also incubated with serum samples obtained from 42 patients
      with proteinuria and/or hematuria before renal biopsy. It was demonstrated that
      the incidence of IgA binding in IgA nephropathy was significantly higher than
      that in other glomerular diseases prior to renal biopsy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1635281
TI  - Study on anti-IgA antibody in patients with IgA nephropathy.
AB  - Serum IgG antibodies to polyclonal IgA, IgA1 and IgA2 were evaluated by enzyme
      linked immunosorbent assay in 50 patients with IgA nephropathy and 30 healthy
      controls to elucidate the relationship between IgA and IgG in IgA nephropathy.
      Anti-IgA antibody was considered positive if the titer exceeded the mean value in
      normal controls by greater than 2 SD. In patients with IgA nephropathy, 18 cases
      (36%) demonstrated anti-IgA antibody, 19 cases (38%) anti-IgA1 antibody and 7
      cases (14%) anti-IgA2 antibody. Western blots confirmed the existence of anti-IgA
      antibody in these patients. There were no significant differences in serum IgA
      concentration, serum creatinine concentration, degree of hematuria, amount of
      urinary protein, and rate of glomerular IgG deposition between the "positive"
      group and "negative" group. Although the mechanism of production and the role of
      this antibody remain unknown, it may represent one of the diverse immune
      abnormalities of IgA nephropathy and may be involved in the pathogenesis of IgA
      nephropathy.

PMID- 1635282
TI  - Clinical significance of anti-neutrophil cytoplasmic antibodies (ANCA) in
      collagen diseases associated with vasculitic syndrome in Japan.
AB  - The present study was undertaken to determine the anti-neutrophil cytoplasmic
      antibody (ANCA) levels in 96 patients with various collagen diseases associated
      with renal vasculitis and vasculitic syndrome in Japan. The results indicated
      that cytoplasmic(C)-ANCA is an autoantibody highly specific to Wegener's
      granulomatosis (WG) and that it is also active in renal injury. The relationships
      between ANCA and focal segmental necrotizing GN, i.e., renal vasculitis as
      proposed by Balow, were investigated. Perinuclear(P)-ANCA was detected with high
      sensitivity and specificity in renal vasculitis without WG, and the severity of
      necrotizing and crescentic nephritis in WG was correlated especially well with
      the C-ANCA titer. Detection of ANCA is considered clinically useful for the
      etiological differentiation of renal vasculitis, suggesting the possibility that
      C-ANCA may be involved in the onset of vasculitis of the glomerular capillary
      vessels in WG. The presence of C-ANCA and cytokines (IL-1 beta and TNF-alpha) is
      important in the pathogenesis of vasculitis and GN in WG.

PMID- 1635283
TI  - High resolution three-dimensional meshwork structure of the glomerular basement
      membrane.
AB  - To investigate the ultrastructure of the glomerular basement membrane (GBM), rat
      GBM was treated with sodium dodecyl sulfate and 2-mercaptoethanol and observed
      under an electron microscope employing ultrathin sectioning and rotary shadowing
      methods. Further, thick sections of the treated GBM were examined by high voltage
      transmission electron microscopy. A fine three-dimensional meshwork structure was
      clearly observed through the entire thickness of the GBM treated with sodium
      dodecyl sulfate and 2-mercaptoethanol by conventional transmission electron
      microscopy and high voltage transmission electron microscopy. The diameter of the
      fibrils forming the meshwork structure was about 3 nm and the dimensions of the
      pores present in the meshwork were 3 to 4 nm. The rotary shadowing technique
      revealed fine fibrils disentangled from the GBM that were bound together, and
      corresponded morphologically type IV collagen molecules. The present findings
      suggested that the GBM has a fine three-dimensional meshwork structure through
      its entire thickness which is composed mainly of type IV collagen and may
      function as a size barrier in the renal glomerulus.

PMID- 1635284
TI  - Effects of pravastatin on serum lipids and apolipoproteins in hyperlipidemia of
      the nephrotic syndrome.
AB  - The nephrotic syndrome is often accompanied by hyperlipidemia associated with an
      increased risk of accelerated atherosclerosis. The present study was undertaken
      to evaluate the effects of pravastatin, a novel competitive inhibitor of 3
      hydroxy-3-methylglutaryl coenzyme A reductase, on the serum lipids and
      apolipoproteins in patients with this syndrome and marked hyperlipidemia. Eleven
      adult patients received 10 mg of pravastatin twice daily for 4 to 8 weeks. The
      total serum cholesterol decreased from 426 +/- 44 to 309 +/- 18 mg/dl (-27.4%,
      mean +/- S.E.; p less than 0.01) following administration of pravastatin. The
      serum triglyceride decreased from 332 +/- 122 to 229 +/- 50 mg/dl (-30.9%),
      although this change was not significant. Despite the fact that the HDL
      cholesterol level was barely changed (51 +/- 7 to 51 +/- 6 mg/dl), the LDL
      cholesterol fell from 313 +/- 30 to 211 +/- 16 mg/dl (-32.5%; p less than 0.005),
      and the LDL to HDL cholesterol ratio fell from 7.57 +/- 1.59 to 4.94 +/- 0.88 (
      34.8%; p less than 0.05). These changes caused the atherogenic index to decline
      from 9.6 +/- 2.4 to 6.1 +/- 1.2 (-36.5%; p less than 0.05). No significant
      alterations could be found among apolipoproteins A-1, A-2, B, C-2, C-3, and E.
      During the present study period, pravastatin was well tolerated and did not
      affect the serum protein, albumin, serum urea nitrogen, creatinine levels, or
      urine protein excretion. Also, there were no serious adverse effects. Pravastatin
      appears to be effective for treating patients with hyperlipidemia of the
      nephrotic syndrome.

PMID- 1635286
TI  - Anti-proteinuric and anti-coagulatory effects of camostat mesilate in azotemic
      diabetics.
AB  - The present study was conducted on 8 patients with advanced diabetic nephropathy
      who showed a significant reduction of proteinuria through ACE inhibition.
      Camostat mesilate, one of the most potent protease inhibitors developed for oral
      use, was administered to these patients at a daily dose of 600 mg starting after
      4 weeks of ACE inhibitor administration. Laboratory data were obtained 1) just
      before the ACE inhibition, 2) after 4 weeks of the ACE inhibitor single
      treatment, and 3) after another 4 weeks of the additional treatment with camostat
      mesilate. The urinary protein excretion decreased from 1) 10.1 +/- 1.3 to 2) 7.3
      +/- 1.1, and 3) 4.6 +/- 0.9 g/day [mean +/- SEM; significance of difference 1)
      2), p less than 0.05; 2)-3), p less than 0.01], and the serum total protein
      values increased from 1) 5.0 +/- 0.3 to 2) 5.2 +/- 0.2, and 3) 5.4 +/- 0.3 g/dl
      [1)-3), p less than 0.05]. The plasma levels of fibrinogen, and of E fragment and
      D-dimer of FDP changed from 1) 476 +/- 43 to 2) 477 +/- 41, and 3) 374 +/- 33
      mg/dl [2)-3), p less than 0.01], from 1) 125 +/- 19 to 2) 147 +/- 27, and 3) 104
      +/- 30 ng/ml [2)-3), p less than 0.05], and from 1) 261 +/- 60 to 2) 272 +/- 86,
      and 3) 185 +/- 56 ng/ml [2)-3), p less than 0.05], respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1635287
TI  - Study of factors related to hypotension in hemodialysis patients.
AB  - The factors related to hypotension in hemodialysis patients were evaluated. The
      subjects consisted of 120 hemodialysis patients (61 males and 59 females), whose
      ages ranged between 28 and 82 years, and who had undergone hemodialysis treatment
      for a period ranging between 3 and 201 months. They were divided into three
      groups: Group A, 53 normotensive patients; Group B, 52 patients with hypotension
      during hemodialysis; and Group C, 15 patients with constant hypotension. The
      evaluated factors were age, sex, etiology of renal failure, hemodialysis term,
      ultrafiltered volume, responsiveness to vasopressor drugs, Cr, Na, Ht, TP,
      cardiothoracic ratio, presence or absence of heart disease, and microvibration
      pattern. Statistical analysis was performed using multivariate analysis
      (Quantification II and IV methods). The results of the Quantification IV method
      indicated that Groups A and B were similar but Group C was quite different from
      the other two groups. The results of the Quantification II method indicated that
      the most important factor which characterized the difference between Group A and
      Group C was the responsiveness to vasopressor drugs, and the most important
      factor in the difference between Group B and Group C was the microvibration
      pattern. Group B was characterized by abnormal microvibration patterns and Group
      C was characterized by a low responsiveness of the peripheral vessels to
      vasopressor drugs. We conclude that the hypotension during hemodialysis was
      caused predominantly by dysfunction of the autonomic nervous system, while the
      constant hypotension was caused predominantly by a deterioration of constriction
      of the peripheral vessels.

PMID- 1635285
TI  - Comparison of converting enzyme inhibitor and calcium channel blocker in SHR with
      nephrotoxic serum nephritis.
AB  - In order to compare the protective effects of angiotensin converting enzyme
      inhibitors (ACEI) and calcium channel blockers (CCB) on the renal function in
      experimental nephritis, nephrotoxic serum nephritis was induced in male
      spontaneously hypertensive rats (SHR). The above drugs were then chronically
      administered to different groups, as follows: the ACEI-treated group (n = 7)
      received captopril (150 mg/kg/day), and the CCB-treated group (n = 6) was given
      both nifedipine (40 mg/kg/day) and nisoldipine (20 mg/kg/day). The control group
      (n = 8) received a placebo. Although the control group developed marked
      hypertension and proteinuria, the rats treated with either ACEI or CCB
      demonstrated a significant and equivalent decrease in mean arterial pressure and
      urinary protein excretion. At 15 weeks after the injection of nephrotoxic serum,
      all rats were anesthetized with Inactin, and the glomerular filtration rate (GFR)
      and renal plasma flow (RPF) were measured. In the control group, GFR and RPF were
      markedly attenuated. However, both were preserved at much higher levels in the
      ACEI-treated group, and GFR was also maintained to a similar degree in the CCB
      treated group. Histological studies were carried out after the clearance studies.
      As a result, it was found that the ACEI treatment significantly limited the
      development of glomerulosclerosis, whereas CCB modestly ameliorated the
      glomerular structural lesions. Moreover, ACEI significantly reduced the serum
      cholesterol, while CCB did not exert such an effect. These results suggest that
      both ACEI and CCB have a therapeutic effect in experimental glomerulonephritis
      models which are accompanied by hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635288
TI  - A case of IgA nephritis showing diffuse podocytic detachment from the glomerular
      basement membrane.
AB  - We report the case of a 15-year-old Japanese female with severe mesangial
      proliferative IgA glomerulonephritis who showed a dramatic response to cocktail
      therapy for nephrotic syndrome. She had suddenly developed massive proteinuria
      and microscopic hematuria. The first renal biopsy at one month after onset
      revealed severe mesangial hypercellularity and podocytic detachment from the
      glomerular basement membrane (GBM). The cocktail therapy resulted in a decrease
      of proteinuria clinically, and a second biopsy demonstrated repair of the
      podocytic detachment. We suggest that the massive proteinuria in this case was
      due to destruction of the size barrier by detachment of podocytes from the GBM,
      and the repair of the podocytic covering on the GBM was accelerated by the
      cocktail therapy.

PMID- 1635289
TI  - Timolol movement across isolated iris-ciliary body of albino rabbit.
AB  - The outward (from the aqueous to the stromal side) and the inward (from the
      stromal to the aqueous side) movement of [14C]timolol across the isolated iris
      ciliary body of the albino rabbit were studied using Ussing's chamber under short
      circuit conditions and timolol concentrations of 0.025-60 microM. The tissue
      permeability in both directions decreased gradually as the timolol concentration
      was increased, while at higher concentrations tissue permeability was almost
      constant. This finding indicated that the timolol movement in both directions
      consists of passive diffusion and a possibly active mechanism, with the former
      contributing mainly at higher concentrations. The tissue permeability for passive
      diffusion was calculated as 7.2 x 10(-6) cm/second. The outward timolol movement
      by a possibly active mechanism was saturated against the concentrations tested.
      In addition, the outward timolol movement was significantly reduced by ouabain,
      2,4-dinitrophenol and low temperature. These results suggested that the non
      passive component of the outward timolol movement was carrier-mediated active
      transport, and Lineweaver-Burk plots gave the half-saturation concentration (Km)
      value of 0.098 microM. On the other hand, the inward timolol movement by a
      possible active mechanism was not saturated. Neither ouabain nor 2,4
      dinitrophenol inhibited it. Thus the non-passive component of the inward timolol
      movement was thought to be different from that of the outward movement.

PMID- 1635290
TI  - Molecular mimicry: uveitis induced in Macaca fascicularis by microbial protein
      having sequence homology with retinal S-antigen.
AB  - S-antigen (S-Ag), a well characterized 45-kDa protein in the photoreceptor cells,
      induces predominantly T-cell-mediated autoimmune uveitis when injected into
      experimental animals. Recently, we have shown that native histone H3 protein
      derived from yeast (Saccharomyces cerevisiae), or a synthetic peptide that is
      homologous with S-Ag peptide M in having six consecutive amino acids, induces
      experimental autoimmune uveitis (EAU) similar to that induced by native S-Ag in
      the Lewis rat. In this study, monkeys (Macaca fascicularis) immunized with
      histone H3 peptide developed a strong cellular immune response to this peptide as
      well as to peptide M. However, no significant inflammation or
      hypervascularization was observed in the retina or the iris during the
      experimental period, when they were examined clinically with an inverted
      ophthalmoscope. Histopathological examination showed that all monkeys injected
      with histone H3 peptide or with native histone H3 lost a large number of
      photoreceptor rod cells and developed neovascularization in the outer nuclear
      cell layer of the retina. These histopathological findings in the monkey retina
      closely resemble those seen in human patients with some types of uveitis. The
      possible involvement of microbial proteins having sequence homology with normal
      retinal proteins in the pathogenicity of human uveitis is discussed.

PMID- 1635291
TI  - Study of suppressive effect of intravenous fluconazole on endogenous Candida
      endophthalmitis in rabbits.
AB  - The effect of intravenous fluconazole on endogenous Candida endophthalmitis in
      rabbits was investigated. Preventive and therapeutic experiments were carried
      out. In the preventive series, rabbits were injected intravenously with 5 mg/kg
      of fluconazole at 30 minutes, 1 day and 2 days after intravenous inoculation with
      Candida albicans spores. The control group received no medication. No treated
      rabbits developed ocular lesions and no Candida spores were isolated from the
      treated eyes. On the other hand, all control rabbits developed bilateral
      chorioretinitis and C. albicans was isolated invariably from the control eyes. In
      the therapeutic series, intravenous fluconazole (5 mg/kg body weight) was
      administered from 3 to 6 days after inoculation. All rabbits developed
      chorioretinitis and Candida spores were isolated from all eyes. Therefore, the
      results of this study prove that intravenous fluconazole is more effective in
      preventive use than in therapeutic use against endogenous Candida endophthalmitis
      in rabbits.

PMID- 1635292
TI  - Expression of human ornithine aminotransferase (OAT) in OAT-deficient Chinese
      hamster ovary cells and fibroblasts of gyrate atrophy patient.
AB  - Gyrate atrophy is a hereditary chorioretinal degenerative disease caused by a
      deficiency of the mitochondrial enzyme, ornithine aminotransferase (OAT). Recent
      investigations have demonstrated the molecular genetic defects of OAT in gyrate
      atrophy patients. We constructed a eukaryotic expression vector (pcDHOAT) which
      contains the SV40 promoter and human OAT cDNA. We used OAT(-) Chinese hamster
      ovary (CHO) cells, which have negligible OAT activity, and fibroblasts from a
      gyrate atrophy patient (GA35 cell), which have negligible OAT mRNA and enzyme.
      Incorporation of pcDHOAT and synthesis of human OAT mRNAs and active enzyme were
      demonstrated in both cell types. The level of expression of human OAT was low in
      the GA35 cells in comparison to the CHO cells. Despite the limited success, the
      ability to express active OAT in these OAT-deficient cells using an expression
      vector offers possibilities of replacement gene therapy for gyrate atrophy.

PMID- 1635293
TI  - Linkage disequilibrium between glucose-6-phosphate dehydrogenase deficiency and
      congenital color blindness in Turkish population.
AB  - No erythrocyte glucose-6-phosphate dehydrogenase (G6PD)-deficient person was
      detected among 90 male patients with congenital color blindness (CCB) diagnosed
      at the Ophthalmology Clinic of our Hospital. Eighteen complete G6PD-deficient
      subjects had normal color vision. These results suggest that there is a linkage
      disequilibrium between CCB and G6PD genes.

PMID- 1635294
TI  - Characterization of T-cell subsets, soluble interleukin-2 receptors and
      interleukin-6 in Vogt-Koyanagi-Harada disease.
AB  - The lymphocyte subunits and subsets of 12 patients with Vogt-Koyanagi-Harada
      disease (VKH disease) were characterized using two-color flow cytometry
      techniques, both in cerebrospinal fluid (CSF) and in peripheral blood (PB).
      Soluble interleukin-2 receptor (sIL-2R) levels and interleukin-6 (IL-6) levels
      were also measured. The percentage of T cells was significantly higher in CSF
      than in PB (P less than 0.01), but the percentage of B cells was decreased in CSF
      (P less than 0.05). As for T-cell subsets, the percentage of helper T cells was
      especially high in CSF (P less than 0.01). Also, the ratio of helper T
      cells/suppressor T cells was significantly larger in CSF than in PB. These data
      suggest that helper T cells play an important role in the early stages of VKH
      disease. sIL-2R and IL-6 levels were not elevated in CSF of patients with VKH
      disease. The level of sIL-2R in serum also was not elevated.

PMID- 1635295
TI  - Photocoagulation with continuous wave ND:YAG laser for neovascular maculopathy.
AB  - Twenty-two eyes in 22 cases of neovascular maculopathy were treated with
      continuous wave (CW) Nd:YAG laser and followed up for 6 to 24 months. The effect
      of the treatment was evaluated by repeated visual acuity testing, fundus
      photography, fluorescein angiography and automated static perimetry. In 91% of
      the patients visual acuity remained unchanged or improved. Fluorescein
      angiography revealed that the neovascularization disappeared in 91% of the
      patients. In 40% of the patients the central visual field showed improvement by
      automated static perimetry. These results indicate that CW Nd:YAG laser
      photocoagulation is useful for the treatment of neovascular maculopathy.

PMID- 1635296
TI  - High frequency of mitochondrial ND4 gene mutation in Japanese pedigrees with
      Leber hereditary optic neuropathy.
AB  - The association of the ND4 gene mutation (mutation) at nucleotide position 11778
      of mitochondrial DNA (mtDNA) was investigated in 14 definitive Japanese pedigrees
      with Leber hereditary optic neuropathy (LHON). The mutation was detected by SfaNI
      and MaeIII restriction fragment length polymorphisms of mtDNA amplified by
      polymerase chain reaction. All 14 LHON pedigrees exhibited the mutation, whereas
      10 controls did not. The association of this mutation with LHON was revealed to
      be significantly higher in Japanese (91.7%) than in 27 reported Caucasian (51.9%)
      LHON pedigrees, implying genetic heterogeneity. In the tested 14 pedigrees, 28
      cases with the mutation comprised 19 affected (17 male and 2 female) and 9
      asymptomatic (all female except for one) individuals. Such a predominance of
      males in the incidence of LHON suggested probable participation of additional
      pathogenetic factor(s) in the development of optic atrophy in LHON patients.

PMID- 1635297
TI  - Cell death in rat retina after pressure-induced ischaemia-reperfusion insult:
      electron microscopic study. II. Outer nuclear layer.
AB  - Pressure-induced ischaemia-reperfusion insult of sufficient duration leads to
      significant retinal damage in rats. In this report we describe the morphology of
      degenerating cells in the outer nuclear layer at several time points after the
      insult, as observed by electron microscopy. Only one death pattern was observed.
      It was characterized by asynchronous involvement of individual cells, progressive
      densification and shrinkage of nuclear and cytoplasmic components, and a final
      phase of disaggregation and heterophagic elimination by Muller cells. This
      pattern of cell death combined features of an apoptosis-like mechanism and
      secondary necrosis.

PMID- 1635298
TI  - Clinical features of Japanese family with autosomal dominant retinitis pigmentosa
      caused by point mutation in codon 347 of rhodopsin gene.
AB  - Four members in a Japanese family had autosomal dominant retinitis pigmentosa
      caused by a single point mutation in codon 347 of the rhodopsin gene. The
      youngest, an 11-year-old girl, had an abnormal electroretinographic response,
      although her fundus appeared normal. The other affected family members noticed
      night blindness in the second decade. Their fundi showed diffuse pigmentation
      with concentric visual field loss, and there was no recordable
      electroretinographic response. Cataract developed in the fourth decade in the
      older patients. Good visual acuity was retained however, even in the fifth
      decade, after cataract extraction. These clinical features were similar to those
      of American patients (European family origin) with the same mutation of the
      rhodopsin gene reported previously.

PMID- 1635299
TI  - Uric acid as biochemical marker for retinal and optic nerve damage after
      occlusion and reperfusion of common carotid and vertebral arteries in rat.
AB  - Transient retinal and optic nerve ischemia lasting for 20 minutes was produced in
      Wistar rats by clipping bilateral common carotid arteries and coagulating both
      vertebral arteries by heat. The uric acid level in the retina and optic nerve
      were determined by high performance liquid chromatography with electrochemical
      detection just before induction of ischemia, 20 minutes after induction of
      ischemia, and after resolution of ischemia. Uric acid content in the optic nerve
      (28.0 +/- 4.5 ng/mg protein) was about 5 times higher than that in the retina
      (5.7 +/- 0.8 ng/mg protein) in the control experiment. Ischemia lasting for 20
      minutes caused a 2.7-fold increase of uric acid in the optic nerve and a 1.8-fold
      increase in the retina. Following reperfusion of the blood flow by unclipping of
      the common carotid arteries, the uric acid level decreased to the control level
      in both the retina and optic nerve 30 minutes after unclipping, which was
      followed by 3.1- and 1.6-fold increases in uric acid in the retina and the optic
      nerve, respectively, at 60 minutes after unclipping. Although ischemia alone
      causes tissue damage, there is some clinical evidence that greater injury can
      occur after oxygen is reintroduced to ischemic tissue. Our results indicate that
      the retina is more likely to be damaged by reperfusion than the optic nerve.

PMID- 1635300
TI  - Increased lysosomal enzyme activity of keratocytes after endocytosis of foreign
      particles.
AB  - It has been reported that keratocytes endocytose foreign particles both in vitro
      and in vivo, suggesting the active participation of keratocytes in corneal wound
      healing and host defense mechanism. To understand the cellular response and the
      fate of engulfed foreign particles, we investigated the changes in the lysosomal
      enzyme activities after keratocytes endocytosed latex beads or glutaraldehyde
      fixed Staphylococcus aureus. Acid phosphatase activity in the cells endocytosing
      either latex beads or fixed bacteria increased significantly as compared with
      that in the control over the period of 12 hours. Changes in acid phosphatase
      activity depended on both the incubation periods and the amount of latex beads or
      bacteria added. The activity reached a plateau after 6 hours of incubation. When
      keratocytes endocytosed latex beads, the activity of N-acetyl-beta-D
      glucosaminidase in the cells showed an increase similar to that of acid
      phosphatase. However, the N-acetyl-glucosaminidase activity in the cells
      endocytosing fixed bacteria did not increase significantly. These findings
      suggest that endocytosing keratocytes increase degrading enzyme activities in the
      cells to break down engulfed foreign particles. It is also suggested that the
      intracellular response is varied according to the character of the engulfed
      materials.

PMID- 1635301
TI  - Batten disease--deteriorating course of ocular findings.
AB  - For over two years, we monitored the visual functions and ocular findings of two
      siblings with Batten disease. At the initial visit, the older patient was in the
      advanced stage of the disease, manifesting symptoms similar to those previously
      reported by many authors. The younger patient, on the other hand, was in the
      early stage of the disease at the time of the first visit. In the next 8 months,
      however, the visual acuity of the younger patient decreased rapidly, from 1.0 to
      below 0.1. Although the electroretinogram (ERG) showed a normal a-wave and a
      reduced b-wave when visual acuity was normal, repeated recordings of the ERG at
      each visit revealed rapid reduction of the b-wave. This finding seems to confirm
      the animal data, indicating that the primary lesion of the retina was in the
      inner layers. To our knowledge, this is the first report on these phenomena which
      may be unique to the deteriorating visual system in Batten disease and may
      facilitate early diagnosis.

PMID- 1635302
TI  - Bilateral retinal detachment with large breaks of pars plicata associated with
      coloboma lentis and ocular hypertension.
AB  - A 39-year-old man developed bilateral, insidiously progressing detachment of the
      retina and nonpigmented epithelium of the ciliary body because of a large break
      in the pars plicata. The anterior segments had multiple malformations including
      ectopia of the lens associated with coloboma of the lens and hypoplastic ciliary
      processes. The pars plicata breaks were present in areas corresponding to the
      anomalies of the lens-zonule-ciliary body complex and caused progressive, shallow
      rhegmatogenous retinal detachments with anterior chamber cells and elevation of
      intraocular pressure. Surgeries with scleral buckling procedure combined with
      vitrectomy and lensectomy brought about reattachment of the retina. This case
      indicates that subtle anomalies in the lens-zonule-ciliary body complex might be
      an indication of a break in the nonpigmented epithelium of the ciliary body which
      could lead to rhegmatogenous retinal detachment. The mode of inheritance of the
      clinical syndrome remained undefined because of negative family history.

PMID- 1635303
TI  - A case of testicular feminization syndrome with bulimia nervosa.
AB  - A 19-year-old patient with a female appearance visited our department for
      treatment of bulimia nervosa. The patient had primary amenorrhea. Chromosomal
      studies revealed a 46XY karyotype, and the plasma testosterone level was in the
      range of normal adult males. The patient was diagnosed as having testicular
      feminization syndrome. The psychological background, such as severe anxieties
      concerning her body, was behind the eating disorders. Examinations revealed
      intraabdominal testes. A bilateral gonadectomy was performed, and no androgen
      receptors were detected in the suprapubic skin. After the gonadectomy, the
      patient's mental status became much more stable, and the ability to control her
      eating pattern was restored. Testicular feminization with bulimia nervosa is rare
      in Japan. The importance of mental support and a careful follow-up to people with
      testicular feminization is being discussed.

PMID- 1635304
TI  - Reduction of cerebral blood flow in chronic schizophrenia: relation to age.
AB  - The effect of age on resting-state cerebral blood flow (CBF) was studied in 40
      medicated patients with chronic schizophrenia aged 20 to 57 and 32 age- and sex
      matched normal controls, using the regional CBF with the xenon-133 inhalation
      technique. Global CBF (average of 16 cerebral regions) and the left prefrontal
      flow ratio (left prefrontal/global CBF) were significantly lower in
      schizophrenics aged 20-29 than in age-matched controls. Both global CBF and the
      left prefrontal flow ratio correlated with age in controls, but neither of such
      correlations was found in schizophrenics. Therefore, the CBF deficits in chronic
      schizophrenia appear to be unaffected by the aging process.

PMID- 1635305
TI  - Linkage study of schizophrenia with markers on chromosome 11 in two Japanese
      pedigrees.
AB  - We examined the linkage between schizophrenia and DNA markers on chromosome 11 in
      two Japanese pedigrees. Thirty individuals from the two pedigrees were genotyped
      at the eleven polymorphisms (eight loci) studied. Data were analyzed according to
      three models, representing a range of single gene models from near dominant to an
      intermediate model. For all markers, except those at the D11S35 locus, there is
      no evidence for the linkage. Positive LOD scores between 1 and 1.5 are obtained
      for some genetic models with the polymorphism at D11S35. Two point scores for the
      broad diagnostic model and for the intermediate parameter set peak at 1.49.

PMID- 1635306
TI  - 5HT2 receptor-mediated function in depressed patients: investigation by measuring
      5HT-induced shape change of blood platelets.
AB  - The 5HT-induced shape change (5HT-SC) of blood platelets, which had been
      suggested to reflect the 5HT2 receptor-mediated function of the central nervous
      system (CNS), was examined in patients with depression before or after
      antidepressant therapy. The degree of 5HT-SC did not differ between patients
      before treatment (n = 17) and healthy controls (n = 26). In patients after
      treatment (n = 12), in whom depression had been improved but drug therapy was
      continued, 5HT-SC in a concentration of 10(-5) M 5HT was observed more potently
      than that in healthy controls or untreated patients (p less than 0.05 and p less
      than 0.05, respectively). In 4 patients in whom 5HT-SC was measured before and
      after mianserin treatment, 5HT-SC increased after the treatment. These results
      suggest that the 5HT2 receptor-mediated function in the CNS may not be damaged in
      patients with depression, and that the 5HT2 receptor-mediated function in the CNS
      may be enhanced by antidepressants.

PMID- 1635307
TI  - Serial changes of SPECT in periodic synchronous discharges in a case with
      Creutzfeldt-Jakob disease.
AB  - We conducted serial EEG and SPECT studies on one female with Creutzfeldt-Jakob
      disease (CJD). In an analysis of EEG, a periodic synchronous discharge (PSD) was
      observed in the middle of the third stage (terminal stage) of Bernoulli's
      classification. The frequency of PSD was the highest at the beginning of the
      third stage, followed by a gradual decrease and disappeared at the end of the
      third stage. In the middle of the third stage, SPECT disclosed blood flow
      differences between the cerebrum and other regions (the cerebellum and the
      brainstem), while no such difference was observed by SPECT at the end of the
      third stage. It was suggested that the appearance of PSD requires the presence of
      a pathological change in the cerebrum precedent to other regions.

PMID- 1635308
TI  - Voiding dysfunction in Parkinson's disease.
AB  - A micturitional history of unselected 110 patients with Parkinson's disease
      revealed that 66 (60%) had urinary symptoms such as irritative in 28%,
      obstructive in 11%, and both symptoms in 21%. The frequency of urinary symptoms
      statistically correlated with severity of the disease, but not with the duration
      of illness and no sexual difference was noted. A urodynamic study was conducted
      in 39 patients and 7 had residual urine of 30 ml or more, 19 had detrusor
      hyperreflexia, 19 had a small bladder capacity and only 1 had detrusor-sphincter
      dyssynergia. The results indicate that the disturbed urine storage is more
      frequent and to a severer degree than that of urine evacuation in Parkinson's
      disease.

PMID- 1635309
TI  - Proceedings of the 6th Workshop for the Clinical Research on Chronobiology.
      October 16-17, 1991, Nagoya.

PMID- 1635310
TI  - Sleep rhythm disturbances in school refusers.

PMID- 1635311
TI  - Circadian sleep-waking rhythm disturbance in blind adolescence.

PMID- 1635312
TI  - Free-running melatonin, sleep propensity, cortisol and temperature rhythms in a
      totally blind person.

PMID- 1635313
TI  - Three cases with sleep-wake rhythm disorders, showing remarkable improvements in
      daily cycle under the influence of several psycho-social conditions.

PMID- 1635314
TI  - Seasonal affective disorder (SAD) with non-24-hour sleep-wake rhythm during
      depressive phase.

PMID- 1635315
TI  - Study on sleep-wake rhythm disorders in two outpatient clinics.

PMID- 1635316
TI  - A polysomnographic study on patients with delayed sleep phase syndrome (DSPS).

PMID- 1635317
TI  - Effect of vitamin B12 (mecobalamin) on the free-running period of rat circadian
      behavioral rhythm.

PMID- 1635318
TI  - Effects of vitamin B12 on the period of free-running rhythm in rats.

PMID- 1635319
TI  - Effect of methylcobalamin (VB12) injection on sleep-wake rhythm in demented
      patients.

PMID- 1635320
TI  - A multicenter study of the effects of vitamin B12 on sleep-waking rhythm
      disorders: in Shizuoka Prefecture.

PMID- 1635321
TI  - Collaborative multicenter field trial of the Draft of ICD-10 in Japan-
      interdiagnostician reliability and disagreement: a report from the WHO project on
      "field trials of ICD-10, Chapter V".
AB  - The Draft of "ICD-10, Chapter V, Clinical Descriptions and Diagnostic Guidelines"
      was tested in a multicenter field trial in Japan. We have previously reported
      good results in suitability, confidence and ease of diagnosis, and adequacy of
      descriptions of the Draft. In this paper, the interdiagnostician reliability of
      the Draft is reported. Among the two-character categories, "Schizophrenia,
      Schizotypal States and Delusional Disorders (F2)" (ICC = .80) and "Mood Disorders
      (F3)" (ICC = .80) proved reliable. "Neurotic, Stress-Related, and Somatoform
      Disorders (F4)" was less reliable (ICC = .65). The ICCs of the 17 major
      categories (three-character code) and the 21 subcategories (four-character code)
      were also calculated. The finding that in Japan subtyping schizophrenia with ICD
      10 was more reliable than that made using DSM-III Diagnostic Criteria supports
      the need to use a descriptive version of ICD-10 as the basis for several versions
      serving different purposes. The nature of disagreements with unreliable
      categories was also investigated. The results are discussed with special
      reference to the changes in the final Draft of Chapter V, which contained a
      feedback of the results from field trials from all over the world.

PMID- 1635322
TI  - A multicenter study on sleep-wake rhythm disorders in Japan: a preliminary
      results.

PMID- 1635323
TI  - The factors in influencing the adjustment to shift work.

PMID- 1635324
TI  - Diurnal rhythm in body temperature in different phases of the menstrual cycle.

PMID- 1635325
TI  - Ultradian rhythms in task performance and EEG activities during prolonged
      continuous work.

PMID- 1635326
TI  - Effects of phototherapy on circadian rhythms of body temperature in affective
      disorders.

PMID- 1635327
TI  - Circadian temperature and sleep-wake rhythms in depression.

PMID- 1635328
TI  - Fifty young women's seasonal changes in mood and behavior in Tokyo.

PMID- 1635329
TI  - Prevalence of seasonal mood changes in low latitude area: Seasonal Pattern
      Assessment Questionnaire score of Quezon City workers.

PMID- 1635330
TI  - A case of reversed seasonal affective disorder.

PMID- 1635331
TI  - Seasonal variations of the circadian rhythms in seasonal affective disorder (2).

PMID- 1635332
TI  - A nationwide survey of seasonal affective disorders in outpatient university
      clinics in Japan--a preliminary report.

PMID- 1635333
TI  - Four clinical types of panic disorders.
AB  - The authors attempted to classify panic disorders into four types according to a
      clinical course and accompanying neurotic or depressive symptoms. The
      characteristics of each type are as follows; type I: a single panic attack is the
      only symptom, type II: only panic attacks occur frequently without any
      accompanying neurotic or depressive symptoms, type III: a recurrence of panic
      attacks and the gradual development of neurotic symptoms, such as anticipatory
      anxiety, generalized anxiety, agoraphobia, or hypochondriasis, type IV:
      depressive symptoms develop in the course of recurring panic attacks. Type IV is
      further divided into three subtypes. Type IV-1: depressive symptoms develop
      secondary to panic attacks and major depression later coexists with panic
      disorder. Type IV-2: panic disorder continuously changed into major depression.
      Type IV-3: panic attacks and depressive symptoms are seen independently. The most
      common types are type III and type IV-1, and seem to be a core group of the panic
      disorder. Typical cases of each type are presented and underlying psychopathology
      is discussed.

PMID- 1635334
TI  - Current views on panic disorder and its management in Japan: a national survey.
AB  - In a national random-sample survey, the views of 1,069 practicing clinicians,
      including internists, surgeons and psychiatrists, on panic disorder were surveyed
      by using a series of questionnaires. In spite of a high rate of clinical
      experience and agreements on the symptoms among clinicians, the nature of this
      disorder, such as a common descriptive diagnosis, and the preferred treatment
      have not been agreed upon by the Japanese medical community. Furthermore,
      respondents were questioned as to the preferred treatment for panic disorder, but
      no treatment was regarded as critical by a majority of clinicians. It is
      concluded that because of the high potential patient population with panic
      disorder, clinical research that will provide more adequate diagnosis and
      treatment for this disorder is necessary in Japan.

PMID- 1635335
TI  - Outcome at discharge for clients in a psychiatric day care program.
AB  - The effectiveness of a psychiatric day care program was assessed in terms of the
      outcome at discharge for 79 clients. One-third of the clients were employed,
      either full-time or part-time (in case of students, at school), during the
      postprogram period of three months or more. Another one-third left the program
      prematurely with or without exacerbation of psychotic symptoms. Clients having
      premature termination were significantly less adherent to outpatient clinic
      visits and/or psychotropic medication. Family's understanding of and cooperation
      in the program were significantly less favorable in clients with early
      termination. The possible strategies for reducing the dropouts were discussed.

PMID- 1635336
TI  - Klinefelter's syndrome and epileptic psychosis: a case report.
AB  - We present here a case of Klinefelter's syndrome with epileptic psychosis. The
      patient was a 30-year-old male, who suffered from epilepsy for 23 years. He
      showed auditory hallucination, delusion of reference and delusion of grandeur. At
      present there are some cases of Klinefelter's syndrome with various psychiatric
      symptoms, but there are few cases of Klinefelter's syndrome with epileptic
      psychosis. These various neuropsychiatric symptoms of the present case are
      thought to be associated with a specific effect of chromosomal abnormality
      through the cerebral dysfunction.

PMID- 1635337
TI  - On the psychophysiology of dreaming: a sensory image--free association hypothesis
      of the dream process.
AB  - A psychophysiological hypothesis of the dream process during REM sleep called "a
      sensory image-free association hypothesis" is proposed. It is assumed that a
      state with a sustained EEG pattern of drowsiness (non-REM stage-1) and muscle
      atonia produces a stream of disorganized and vague thinking as a background
      mentation during the REM sleep. The phasic excitation of the brain occurring
      concurrently with the burst of rapid eye movements (REMs) activates the
      hippocampal-neocortical memory system and draws out sensory images from the
      memory reservoir of the brain. The dreamer makes a freely organized association
      about the successive sensory images and makes up a dream story. This hypothesis
      is compatible not only with the recent neurophysiological findings but also with
      traditional psychological interpretation of the dream content.

PMID- 1635338
TI  - A computerized tomographic study in patients with delusional and non-delusional
      depression.
AB  - This is a description of a computerized tomographic study of 45 non-delusional
      depressed, 29 delusional depressed patients and 77 neurotic control subjects. The
      cerebral atrophy ratio (CAR) on the three different slices and the ventricular
      ratio (VBR) of the anterior horn and the body of the lateral ventricles were
      calculated, analyzed and compared using Student's t test. Compared to the control
      subjects, the non-delusional depressive patients had greater CAR values than the
      controls but there were no significant differences of VBR values between the two
      groups. The patients with delusional depression had significantly larger CAR and
      VBR values than the non-delusional depressives and control subjects. The
      delusional depressives had greater brain atrophy than the non-delusionals and it
      was suggested that organic cerebral factors may have etiological significance in
      the depressions, especially the delusional depressives.

PMID- 1635339
TI  - The peritoneal equilibration test in children.
AB  - The peritoneal equilibration test (PET) has been recommended in adults as a
      standardized means of estimating solute transport. Based on results of the PET,
      adult peritoneal permeability has been classified as high, high average, low
      average, and low. We performed a PET on 32 children aged 0.8 to 17.8 years (mean
      9.3) using a dwell volume of 32 +/- 5 ml/kg of 2.5% dialysate. Dialysate to
      plasma (D/P) ratios for creatinine, urea, and sodium were calculated at two and
      four hours as were the ratios of dialysate glucose at two and four hours to the
      dialysate glucose at time 0 (D/Do). Stepwise logistic regression identified only
      the patients' age and D/Do glucose values at two hours as significant predictors
      of ultrafiltration. Net ultrafiltration after a four hour dwell could be
      predicted for 75% of children above 9.3 years, or whose D/Do glucose value at two
      hours was greater than 0.45. The mean and standard deviation values for D/Do
      glucose and D/P creatinine at four hours were 0.31 +/- 0.17 and 0.71 +/- 0.12,
      respectively. When children are characterized according to adult standards, at
      least 70% fall into the high or high average permeability categories.

PMID- 1635340
TI  - Glomerular hemodynamics and eicosanoid synthesis in a rat model of IgA
      nephropathy.
AB  - We sought to study glomerular pathophysiology in a model of IgA nephropathy
      (IgAN). Preliminary experiments with oral immunization indicated that Lewis rats
      had higher IgA levels and IgA/IgG ratios than Wistar, Fischer or Sprague-Dawley
      rats. Six groups of Lewis rats were studied: four continuously orally immunized
      for eight weeks with bovine gamma globulin (BGG) in the drinking water, the other
      two non-immunized controls. Groups of immunized rats were treated with a
      thromboxane receptor antagonist (SQ 29,485) and/or a thromboxane synthase
      inhibitor (UK 38,485). After systemic challenge, microscopic hematuria was
      present in 84% of immunized rats not given anti-thromboxane drugs versus 18% of
      non-immunized rats (P less than 0.01). Immunized rats showed predominantly IgA
      glomerular deposits with lesser IgG and C3, and produced more glomerular
      thromboxane than controls, but no significant increase in prostaglandin E2.
      Immunized rats also had reduced GFR and RPF, but not a reduced filtration
      fraction, compared to controls. Thromboxane synthase inhibitor diminished
      glomerular thromboxane and increased prostaglandin E2 in immunized rats. Anti
      thromboxane therapy reduced hematuria and apparently re-established the RPF but
      not the GFR in immunized rats, yielding a reduced filtration fraction. We propose
      that increased thromboxane, in concert with mesangial contraction that is
      unaffected by anti-thromboxane drugs, contributes to the pathophysiology in this
      model of IgAN.

PMID- 1635341
TI  - Distribution of the alpha 1 and alpha 2 chains of collagen IV and of collagens V
      and VI in Alport syndrome.
AB  - We compared the distribution of the alpha 1 and alpha 2 chains of collagen IV and
      of collagens V and VI in glomeruli of males with Alport syndrome to their
      distribution in normal glomeruli and glomeruli from patients with non-Alport
      renal diseases. alpha 1(IV), alpha 2(IV), collagen V and collagen VI are normally
      restricted to the mesangium and the subendothelial aspect of the glomerular
      basement membrane (GBM). In contrast, these proteins were present throughout the
      entire width of the GBM in Alport glomeruli. These alterations were apparent in
      "early" Alport glomeruli, that is, those exhibiting minimal abnormalities by
      light microscopy, and they were further accentuated in sclerosing Alport
      glomeruli. Obsolescent Alport glomeruli, in which the capillary tuft had
      collapsed and few remaining cell nuclei were present, exhibited nearly complete
      loss of alpha 1(IV) and alpha 2(IV), like obsolescent glomeruli in non-Alport
      diseased kidneys. However, the matrix of obsolescent Alport glomeruli stained
      intensely for collagen V and collagen VI, while these collagen types were not
      prominent in obsolescent glomeruli of non-Alport diseases kidneys. These
      observations suggest that the process of glomerulosclerosis in Alport kidneys has
      attributes unique to this disease. It would also appear that mutations affecting
      the Alport gene product have secondary effects on the distribution of other GBM
      constituents.

PMID- 1635342
TI  - Glomerulonephritis in chronic lymphocytic leukemia and related B-cell lymphomas.
AB  - We retrospectively analyzed clinical presentation, immunopathological data and
      renal outcome in 13 patients with glomerulonephritis (GN) and chronic lymphocytic
      leukemia (CLL) or related diffuse well-differentiated lymphocytic lymphoma (WDLL)
      of B-cell lineage. B-cell proliferation and glomerulopathy were simultaneously
      diagnosed in seven of the 13 patients. Nephrotic syndrome was observed in nine
      patients. Serum creatinine was elevated (greater than 120 mumol/liter) in 10
      patients and exceeded 400 mumol/liter in three patients. A clear cut relationship
      between GN and hematologic disease could be established in nine cases: five
      patients had MPGN caused by type I or type II cryoglobulinemia; two had MPGN or
      mesangial hypertrophy with circulating and deposited noncryoprecipitating
      monoclonal IgG K and IgM K, respectively; in the two remaining patients,
      monotypic IgG K glomerular deposits exhibiting fibrillary organization were
      observed in association with MGN or MPGN, despite the absence of circulating M
      component by immunofixation. The pathophysiologic link between glomerular lesions
      and B-cell proliferation was further evidenced by effectiveness of specific
      treatment of the malignancy by chlorambucil. This drug, used in the absence of
      steroids, induced complete remission of nephrotic syndrome in the five patients
      to whom it was given. Moreover, in the five patients with creatininemia greater
      than 200 mumol/liter who received chemotherapy, substantial improvement in renal
      function was observed. These overall data demonstrate that the occurrence of GN
      in B-CLL and related lymphoma is not fortuitous, and testify to the
      paraneoplastic nature of glomerular involvement mediated by deposition and
      possibly processing of cryoprecipitating or noncryoprecipitating M-components.

PMID- 1635343
TI  - Glomerular damage after uninephrectomy in young rats. I. Hypertrophy and
      distortion of capillary architecture.
AB  - Uninephrectomy (UNX) results in a higher incidence of focal glomerular sclerosis
      (FGS) in young rats than it does in adults. The reason for this higher
      susceptibility in young animals is not fully understood, but this does suggest
      that UNX in young rats may represent a particularly promising model in which to
      study the development of FGS. In the present study 10-day-old rats were subjected
      to UNX. After 4, 12 and 24 weeks, glomerular hypertrophy, structural lesions and
      function were analyzed in comparison with sham-operated controls. Up to the
      twelfth week, remnant kidney growth and glomerular growth proceeded in parallel;
      thereafter, kidney growth ceased, whereas glomerular growth continued
      undiminished. Twenty-four weeks after UNX, glomerular tuft volume in experimental
      animals exceeded that in controls by 80%. Twelve weeks after surgery, total GFR
      in UNX rats was approximately 80% of that in controls, a value maintained until
      the end of the observation period. Twenty-four weeks after surgery, heavy
      proteinuria was present in UNX animals. Structural abnormalities in glomeruli of
      UNX animals were already encountered 12 weeks after surgery; they were present to
      a much lesser extent in controls. In UNX animals these proceeded to the FGS stage
      by the end of the observation period. Three major groups of glomerular lesions
      were observed: (1) changes in the width and shape of glomerular capillaries. (2)
      changes in podocyte structure, and (3) tuft adhesions to Bowman's capsule with or
      without segmental sclerosis. The structural changes are analyzed in this and an
      accompanying paper [1]. The present paper deals with the widespread formation of
      irregular, giant capillary loops. They occur predominantly at the tuft periphery
      with a clear predilection for the vascular pole region. They are not a result of
      compensatory growth, but rather an expansion of single capillaries due to failure
      of the mesangium. Local disconnection of the mesangium from its anchoring points
      at the GBM leads to bulging and "coalescence" of capillary loops, resulting in
      abnormally-shaped vascular channels. This process is associated with a
      rearrangement of the corresponding mesangium. In our view, the appearance of
      dilated capillaries represents a local event pivotal to the development of more
      severe lesions, such as tuft adhesions and FGS.

PMID- 1635344
TI  - Glomerular damage after uninephrectomy in young rats. II. Mechanical stress on
      podocytes as a pathway to sclerosis.
AB  - In a preceding study [1], we showed that within six months after UNX in young
      rats, glomeruli in the remnant kidney undergo a sequence of serious changes which
      finally lead to focal segmental glomerulosclerosis (FGS). The formation of
      abnormally-shaped capillary channels was shown to result from local mesangial
      failure and is considered to be a nidus for the development of more severe
      lesions. In the present paper, the development of characteristic lesions in
      podocyte structure is described and analyzed. Concomitant with overall glomerular
      growth after UNX, a pronounced hypertrophy of podocytes was observed, while the
      mean number of podocytes per glomerulus did not change. It appears that podocytes
      cannot sustain the same degree of growth as the tuft as a whole; podocyte
      hypertrophy is soon followed by maladaptive changes which eventually lead to cell
      destruction. The following sequence of pathologic changes can be suggested: cell
      bodies enlarge in volume and area associated with a dramatic attenuation to
      cytoplasmic sheets. Primary processes are thinned out and frequently extend to
      remote capillaries. As a whole, the capillary area served by a single podocyte is
      dramatically enlarged. Furthermore, the expanding cytoplasmic sheets (derived
      from podocyte cell bodies) cover an increasingly large proportion of the outer
      capillary surface, that is, of the filtration area. Consequently, an increasing
      amount of filtrate is delivered into the subcellbody space. Obstruction of the
      efflux of this filtrate into the urinary space causes bulging of the overlying
      cytoplasmic sheets into pseudocysts. Podocytes overlying abnormally-shaped and
      dilated capillary channels are generally the most seriously affected. Tuft
      hypertrophy, pseudocyst formation and local capillary expansion cause wide-spread
      apposition of podocytes to Bowman's capsule. Appositions are a prerequisite for
      the development of tuft adhesion. Local detachment of a podocyte from the GBM in
      those areas allows access of parietal cells to the GBM. In early adhesions the
      connection of the tuft to Bowman's capsule is established by single parietal
      cells which attach to both the GBM and the basement membrane of Bowman's capsule.
      An adhesion is considered as a nidus for segmental sclerosis; as the adhesion
      progresses, the related tuft regions turn into sclerosis. In the present model
      FGS develops exclusively in areas of tuft adhesion.

PMID- 1635345
TI  - Dialysis disequilibrium syndrome (DDS) in the rat: role of the "reverse urea
      effect".
AB  - DDS is characterized by neurologic deterioration and cerebral edema which occurs
      after hemodialysis. To investigate the pathogenesis of DDDS, we studied the
      effects of rapid hemodialysis on plasma and brain electrolytes, urea, and
      osmolality in the rat. Forty-two hours after bilateral nephrectomy, nine uremic
      rats were hemodialyzed for 90 minutes against dialysate without urea (model of
      DDS), yielding a decrease in plasma urea from 72 +/- 2 mM to 34 +/- 2 mM (P less
      than 0.01) and an 8% (29 mOsm/kg) decrease in plasma osmolality. This group was
      compared to three control groups: 11 uremic animals dialyzed against a bath with
      urea added so that no fall in plasma urea occurred, and 15 uremic and 12
      nonuremic animals that were not dialyzed. In animals dialyzed without urea,
      compared to uremic non-dialyzed animals, there was a 6% increase in brain water
      (3.89 +/- 0.04 liter/kg dry wt vs. 3.67 +/- 0.03, P less than 0.01) and an
      increase in the brain to plasma (urea) ratio (1.30 +/- 0.06 vs. 0.79 +/- 0.05, P
      less than 0.01). Comparison of these parameters in animals dialyzed without urea
      versus other control groups yielded similar results. In animals dialyzed without
      urea, the 53% decrease in plasma urea was associated with only a 13% decrease in
      brain urea content. Brain content of sodium and potassium was not significantly
      different among groups. Retention of brain urea despite the large decrease in
      plasma urea was able to account for the increased brain water observed in animals
      dialyzed without urea.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635346
TI  - Effect of insulin therapy on renal hemodynamic response to amino acids and renal
      hypertrophy in non-insulin-dependent diabetes.
AB  - Since renal hemodynamic disturbances are important in renal injury and are
      exacerbated by elevated plasma amino acid concentrations in insulin-dependent
      diabetes, we measured glomerular filtration rate (GFR) and renal plasma flow
      (RPF) after an overnight fast and during amino acid infusion in 12 patients with
      NIDDM and nine normal subjects. In the diabetic patients (plasma glucose 12.4 +/-
      0.6 mmol/liter), the fasting GFR (113 +/- 6 vs. 98 +/- 7 ml/min.1.73 m2 in normal
      subjects, P = 0.056) and RPF (635 +/- 37 vs. 540 +/- 20 ml/min.1.73 m2 in normal
      subjects, P less than 0.05) were increased. After amino acid infusion, the
      increase in GFR (159 +/- 7 vs. 121 +/- 6 ml/min.1.73 m2 in normal subjects, P
      less than 0.05) and RPF (970 +/- 51 vs. 700 +/- 18 ml/min.1.73 m2 in normal
      subjects, P less than 0.05) were augmented. Insulin infusion for 36 hours did not
      change these responses. After three weeks of insulin therapy (plasma glucose 5.9
      +/- 0.2 mmol/liter), the amino acid-stimulated GFR (143 +/- 5 ml/min.1.73 m2) and
      RPF (836 +/- 30 ml/min.1.73 m2) declined (P less than 0.05), while the fasting
      values remained unchanged. The right kidney volume was measured by
      ultrasonography and found to decrease after three weeks of insulin therapy from
      188 +/- 12 to 165 +/- 9 ml/1.73 m2 (P less than 0.05). However, both values were
      greater than that in the normal subjects, 124 +/- 13 ml/1.73 m2 (P less than
      0.01). Glomerular hyperfiltration and hyperperfusion became augmented during
      hyperaminoacidemia in our NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635347
TI  - Measurement of glomerular filtration rate in ICU patients using 99mTc-DTPA and
      inulin.
AB  - Improved and reliable methods for assessing glomerular filtration rate (GFR) in
      intensive care patients are needed in light of known deficiencies using
      creatinine clearance. We compared simultaneous two-hour clearances of inulin
      (CIn), creatinine (CCr), and 99mTc-diethylenetriaminepentaacetic acid (CDTPA) in
      18 medical or surgical intensive care patients (range, 49 to 92 years old) with
      blood urea nitrogen (BUN) levels greater than 17.9 mmol/liter (0.5 mg/ml), serum
      creatinine levels greater than 150 mumol/liter (0.02 mg/ml), or estimated
      Cockcroft clearance less than 60 ml/min. Patients had severe renal dysfunction
      with average GFR of 35 ml/min (range, 2 to 69 ml/min). CDTPA and CCr correlated
      significantly with CIn, although CDTPA tended to provide a closer approximation.
      Cockcroft clearance (32 +/- 4 ml/min) was grossly similar to CDTPA and CIn and
      correlated significantly, especially when weight was calculated using actual as
      opposed to ideal body weight. In a subset of 13 patients with CIn less than 30
      ml/min, only CDTPA was significantly correlated with CIn. In patients in the
      intensive care unit, CDTPA provides a rapid, accurate, and inexpensive clinical
      assessment of GFR, even at very low GFRs.

PMID- 1635348
TI  - The pathogenesis of Alport syndrome involves type IV collagen molecules
      containing the alpha 3(IV) chain: evidence from anti-GBM nephritis after renal
      transplantation.
AB  - Mutations in the COL4A5 collagen gene have been implicated as the primary defect
      in Alport syndrome, a heritable disorder characterized by sensorineural deafness
      and glomerulonephritis that progresses to end-stage renal failure. In the present
      study, the molecular nature of the defect in Alport glomerular basement membrane
      (GBM) was explored using anti-GBM alloantibodies (tissue-bound and circulating)
      produced in three Alport patients subsequent to renal transplantation. The
      alloantibodies bound to the alpha 3(IV)NC1 domain of type IV collagen and not to
      any other basement membrane component. In tissue sections, the alloantibodies
      bound specifically to peripheral GBM in normal kidney and the affected renal
      transplant but not to that of Alport kidney. These results establish that: the
      alpha 3 chain in type IV collagen molecules, the Goodpasture autoantigen, is the
      target alloantigen in post-transplant anti-GBM nephritis in patients with Alport
      syndrome, and that a molecular commonality exists in the pathogenesis of anti-GBM
      nephritis causing loss of renal allografts in patients with Alport syndrome and
      renal failure in patients with Goodpasture syndrome. These findings implicate:
      (1) defective assembly of type IV collagen molecules containing the alpha 3(IV)
      chain in Alport GBM; and (2) the existence of a mechanism linking the assembly of
      molecules containing the alpha 3(IV) chain with those containing the alpha 5(IV)
      chain.

PMID- 1635350
TI  - 23rd Meeting of the Spanish Society of Nephrology. Madrid, Spain, October 1,
      1991. Abstracts.

PMID- 1635349
TI  - Stimulating growth in uremic children.

PMID- 1635351
TI  - Society of Nephrology. Geneva, Switzerland, October 17-18, 1991. Abstracts.

PMID- 1635352
TI  - Immunocytochemical study of glomerular permeability to anionic, neutral and
      cationic albumins.
AB  - The renal handling of albumin of various isoelectric points (pI) was studied in
      mice by high resolution quantitative immunocytochemistry. Bovine serum albumin
      (BSA) was tagged with dinitrophenol (DNP) and cationized to pI 6.5 to 7.5 and to
      pI over 8.5. These tracers, including the anionic BSA-DNP (pI 4.8) were injected
      in the iliac vein of mice and the post-embedding protein A-gold technique was
      used with antibodies against DNP to localize the different tracers in renal
      tissue. Morphometric analysis of the labeling over the glomerular wall has
      demonstrated variations in its distribution according to the pI of the markers.
      Anionic and neutral BSA molecules were detected on the endothelial side of the
      basement membrane, while labeling for cationic BSA was present mainly in the
      laminae rarae interna and externa known to display fixed polyanionic sites.
      Neutral and cationic BSA-DNP reached the urinary space and were detected within
      the endocytotic apparatus of the proximal tubule epithelium. Neutralization of
      the anionic sites of the basement membrane with cationic BSA resulted in an
      increase in the permeability towards anionic BSA-DNP. In addition to the
      demonstration of glomerular permeability properties towards various probes, the
      present study has demonstrated that dinitrophenylated albumin represents an
      excellent versatile tool for the quantitative morphological investigation of
      glomerular permeability.

PMID- 1635353
TI  - Regulation of inositol transport by glucose and protein kinase C in mesangial
      cells.
AB  - Since inositol (Ins) depletion appears to be an important mechanism of cell
      injury in diabetic glomerulopathy, we studied Ins transport in cultured rat
      mesangial cells during hyperglycemia. High glucose stimulated [3H]-Ins uptake by
      50 to 90% within 24 hours in a dose dependent manner. This effect was
      characterized by an increase in the Vmax of a Na(+)-dependent Ins transporter
      (10.3 +/- 0.2 vs. 16.4 +/- 0.4 pmol/mg/min, P less than 0.005). Since high
      glucose also induced activation of protein kinase C (PKC) in permeabilized
      mesangial cells, we examined the potential role of this enzyme in the stimulation
      of Ins transport by glucose. Both PKC inhibition with H7 and staurosporine, and
      down regulation of PKC by prolonged PMA (1.6 microM) treatment inhibited the
      stimulatory effect of glucose on Ins transport. In conclusion, high glucose
      stimulates Na(+)-dependent Ins transport in mesangial cells by a mechanism
      mediated by PKC. This process may represent an important adaptive response of
      mesangial cells to hyperglycemia.

PMID- 1635354
TI  - Blood pressure-independent effect of angiotensin inhibition on vascular lesions
      of chronic renal failure.
AB  - Previous studies in experimental models of progressive renal failure have shown
      that the capacity of antihypertensive drugs to protect glomeruli from sclerosis
      is often unpredictable from their effect on systemic blood pressure. The present
      study was undertaken to ascertain whether this systemic blood pressure
      independent structure-preserving effect of antihypertensives, particularly
      angiotensin II converting enzyme inhibitors (ACEI), is confined to the glomerulus
      or not, as well as whether this effect is mediated via angiotensin II (Ang II).
      The following experimental drug regimens were used in the rat model of subtotal
      nephrectomy (sNPX): so-called triple therapy [TRX; a combination of reserpine 5
      mg/liter drinking water (DW), hydralazine 80 mg/liter DW and hydrochlorothiazide
      25 mg/liter DW], or ACEI (either captopril, CPL, 600 mg/liter DW, enalapril, ENL,
      400 mg/liter DW or lisinopril, LSL, 200 mg/liter DW), or a novel Ang II receptor
      antagonist (Ang IIR, L-158,809, 20 mg/liter DW). These dosages were identified in
      pilot studies to be the minimum required to control systemic blood pressure in
      the early phase up to 12 weeks. In addition, a separate group was treated with a
      higher dose of L-158,809 (80 mg/liter DW) with equipotent systemic pressor
      effect. Treatment was initiated eight weeks after subtotal nephrectomy following
      renal biopsy, and animals were sacrificed at 16 weeks. In ACEI treated rats,
      carotid arterial wall thickening (WT), defined as ratio of media thickening to
      radius of outer vessel wall, was similar to normal age-matched control (0.073 in
      all ACEI treated rats, vs. 0.074 in normal control) and significantly less than
      with TRX (ratio 0.118) or untreated sNPX (0.130). Even more remarkably, coronary
      arteriole WT in ACEI-treated rats averaged 0.139, a value less than one half and
      one third of TRX (0.298) and untreated sNPX control (0.388), respectively.
      Similar results were obtained for mesenteric artery WT. These findings were
      closely paralleled by changes of glomerular sclerosis. In untreated sNPX control
      rats, glomerular sclerosis increased from biopsy to autopsy specimens by an
      average of 458%. Although TRX dampened the degree of increase in sclerosis to on
      average 212%, this protective effect was far less than that achieved by ACEI. In
      the latter, sclerosis increased on average only 65% from biopsy to autopsy.
      Although all ACEIs were more effective than TRX, captopril and lisinopril groups
      showed greatest benefit at these doses. Ang IIR also protected renal and
      extrarenal structures with 34% increase of sclerosis index in low dose and WT
      0.088, 0.117 and 0.112, respectively in carotid, mesenteric and coronary
      arteries.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1635355
TI  - Permeability of dialyzer membranes to TNF alpha-inducing substances derived from
      water bacteria.
AB  - Pro-inflammatory cytokine-inducing substances derived from cultured E. coli have
      previously been shown to pass across low-flux regenerated cellulosic dialyzer
      membranes. In the present study, a sterile filtrate of Pseudomonas maltophilia
      grown from standard bicarbonate dialysis fluid was used to test the permeability
      of various dialyzer membranes (regenerated cellulose, cellulose triacetate,
      polyacrylonitrile, polysulfone and polyamide) to TNF alpha-inducing bacterial
      substances. Pyrogen-free tissue culture medium (MEM) was recirculated for 60
      minutes in the dialysate compartment of a closed-loop dialysis system, then P.
      maltophilia filtrate was added and recirculation was continued for a further
      hour. Samples from the dialysate (MEM) and the blood side (containing 10% human
      plasma in MEM) were incubated with donor mononuclear cells (MNC) for 18 hours and
      TNF alpha release was measured in MNC supernatants by radioimmunoassay. Five
      minutes after the addition of P. maltophilia filtrate, mean TNF alpha-inducing
      activity in the dialysate increased from (mean +/- SEM) 0.10 +/- 0.02 to 18.2 +2-
      1.5 (ng/2.5 x 10(6) MNC/18 hr). TNF alpha-inducing activity in the blood side
      increased with regenerated cellulose from 0.10 +/- 0.01 to 4.57 +/- 1.55 (N = 8;
      P less than 0.001); with cellulose triacetate from 0.20 +/- 0.05 to 0.44 +/- 0.10
      (N = 5; P less than 0.05), and with polyacrylonitrile from 0.10 +/- 0.02 to 1.16
      +/- 0.45 (N = 5; P less than 0.03). No increased TNF alpha-inducing activity was
      observed in the blood side of polysulfone (N = 5) or polyamide dialyzers (N =
      5).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635356
TI  - Increased oxygen radical and eicosanoid formation in immune-mediated mesangial
      cell injury.
AB  - To evaluate whether monocytes/macrophages derived from glomeruli could be a
      source of increased eicosanoid and free oxygen radical formation in glomerular
      disease, monocytes/macrophage (M/M) were isolated from nephritic glomeruli and
      their in vitro generation of eicosanoids and superoxides were measured.
      Glomerular immune injury was induced by i.v. injection of a rabbit-anti-rat
      thymocyte antiserum (ATS). Kidneys were removed two, five, and 24 hours, and
      three and eight days after ATS. Adhesive glomerular macrophages were obtained by
      isolation of glomeruli, enzymatic digestion and incubation of the single cell
      suspensions in culture dishes. O2-production was evaluated by superoxide
      dismutase (SOD)-inhibitable reduction of ferricytochrome C; PGE2 and TxB2 release
      was assessed by direct RIA. Glomerular macrophage infiltration was maximal 24
      hours after intravenous antibody (35.9 +/- 5.1 M/M per glomerulus). In vitro
      production of superoxide was significantly enhanced (P less than 0.001) five
      hours after ATS administration (51.6 +/- 4.4 nmol O2/10(6) MM/hr), when compared
      with M/M from controls (30.4 +/- 2.0 nmol O2/10(6) MM/hr). TxB2 formation of
      glomerular M/M was increased (P less than 0.001) two hours and five hours after
      ATS administration (1056 +/- 75 and 1182 +/- 112 pg TxB2/10(6) MM/hr) compared
      with controls (390 +/- 34 pg TxB2/10(6) MM/hr). PGE2 synthesis, however, was
      decreased (P less than 0.01) at five hours after ATS (629 +/- 43 pg PGE2/10(6)
      MM/hr) compared with controls (950 +/- 125 pg PGE2/10(6) MM/hr). Furthermore,
      there was release of leukotriene B4 (LTB4) in monocytes of nephritic glomeruli
      five hours after ATS administration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635357
TI  - Different mutations in the COL4A5 collagen gene in two patients with different
      features of Alport syndrome.
AB  - Alport syndrome is a hereditary renal disease in which progressive renal failure
      is often accompanied by sensorineural deafness and ocular abnormalities.
      Recently, mutations were detected in the type IV collagen alpha 5 chain gene in
      Alport syndrome patients. We searched for mutations in this gene in 18 unrelated
      patients, and in two patients abnormalities were detected. In the gene of patient
      BB we identified a complex deletion, which included the exons encoding the non
      collagenous domain and part of the collagenous region. This patient showed early
      onset nephritis (end-stage renal disease at 17 years) with deafness. Within a
      year after receiving a kidney from an unrelated donor, he developed an
      antiglomerular basement membrane nephritis. In patient WJ a point-mutation was
      detected, changing a tryptophane into a serine in the non-collagenous domain. His
      clinical features are milder (renal failure at 33 years, no hearing loss), and a
      recent renal allograft did not provoke antiglomerular basement membrane disease.
      These initial data suggest that differences in the extent of disruption of the
      non-collagenous domain may correlate with the severity and/or heterogeneity of
      Alport syndrome and with the development of nephritis in renal allografts.

PMID- 1635358
TI  - Ureteral obstruction decreases renal prepro-epidermal growth factor and Tamm
      Horsfall expression.
AB  - Northern and dot-blot analysis of polyadenylated RNAs of kidney cortical and
      outer medullary tissue was performed in male Sprague-Dawley rats at varying times
      up to 24 hours after bilateral ureteral obstruction (BUO), after 24 hours of
      unilateral obstruction (UUO) and at varying periods after release of BUO or UUO.
      Pre-proEGF (preproEGF) and Tamm-Horsfall (TH) mRNA declined by four hours of BUO
      to virtually undetectable levels at 24 hours of ureteral obstruction. Upon
      release of BUO or UUO, preproEGF and TH mRNA returned slowly toward normal but
      remained below control levels up to four days after release of ureteral
      obstruction. Urinary EGF excretion paralleled these changes in renal preproEGF
      mRNA. Although these changes are similar to those observed during nephrotoxic and
      ischemic renal failure, where the expression of the immediate early genes
      precedes the fall in preproEGF and TH expression, no such increase in the
      expression of these genes occurred after bilateral ureteral obstruction. These
      changes in preproEGF and TH expression could also be dissociated from uremia and
      high rates of DNA synthesis, suggesting that ureteral obstruction itself is a
      sufficient cause of the reduced expression. The increase in ureteral pressure and
      its functional and humoral effects may each play a role in reduced preproEGF and
      TH expression during ureteral obstruction.

PMID- 1635360
TI  - [Evaluation of the levels of selected immunoglobulins in peripheral blood of
      patients with recurrent anterior uveitis].
AB  - The antigen of the tissular congruity HLA-B 27 appears more frequently in
      patients with anterior uveitis than in healthy people. The presence of this
      antigen in a patient may have a substantial influence on the changes seen in the
      peripheral blood and on the clinical picture of the condition. Coming from that
      assumption the authors undertook a trial of revealing the interdependence between
      the concentration of some immunoglobulins in the blood serum and the appearance
      of the above-mentioned antigen in patients with recurrent iridocyclitis. In the
      group of patients with the antigen of tissular congruity HLA-B 27 they found a
      statistically significant higher concentration of the A and G immunoglobulins
      than in the control group.

PMID- 1635359
TI  - [Effect of various light sources on visual functions in the age aspect. I.
      Conscious reaction time and the manual spatial visual localization].
AB  - The authors present the results of investigations performed in 28 right-handed,
      normally seeing persons divided into 2 groups: 15 of them were in productive age
      and 13 in older age. The authors compared the dynamics of the behaviour of the
      visual functions in dependence on the age of the subjects and the stay in the
      glow and sodium light. No adverse influence of the sodium light on the hand
      localization could be detected, instead it seems that it negatively influenced
      the selective reaction in older productive persons in the sense of an increased
      number of faults.

PMID- 1635361
TI  - [Evaluation of the effectiveness of prostacyclin in the treatment of thrombosis
      of the central retinal vein using a double-blind method].
AB  - The patients were divided by chance into 2 groups: the first one (15 persons) was
      given a natrium salt of prostacyclin (Epoprostenol Wellcome or Chinoin) in a dose
      of 5 mg/kg/min. intravenously by an infusion pump in 5 infusions; the control
      group (15 persons) received instead of prostacyclin a placebo (0.1 M glycine
      buffer of pH 10.5). Besides all the patients were given Doxium or Calcium
      dobesilate, Rutinoscorbin, Vitamin C, and Polopyrin S (Soluble Aspirin).
      Immediately after the completion of the treatment the authors did not find any
      essential differences between the examined groups. In prolonged observations
      however one demonstrated a significantly smaller frequency of the development of
      neovascularization in the eyes of persons treated by prostacyclin in comparison
      with the control group.

PMID- 1635362
TI  - [Evaluation of the effect of advanced pathological changes on the course of the
      treatment of patients with primary open-angle glaucoma].
AB  - One hundred seventy two persons (300 eyes) with various degree of advancement of
      glaucomatous changes of the optic nerve were examined at the start of the
      treatment and after 1, 5 and 10 years. It was detected that in the eyes with a
      nearly full cupping of the optic disc the deterioration of the visual acuity and
      the advancement of field changes occurred much more frequently than in eyes with
      a small lesion of the nerve, as well in the eyes treated conservatively as in
      those treated surgically.

PMID- 1635363
TI  - [Personal experiences with conservative treatment of central retinal
      degeneration].
AB  - 21 patients (40 eyes) aged 27-84 years (15 women and 6 men) were treated orally
      with cavinton 3 x 5 mg, sadamine++ 3 X 75 mg, cinnarizine++ 3 X 40 mg, vit. A+E 3
      X 1 caps. daily. Intramuscularly++ were given vit. B1 25 mg, vit. B12 1000
      micrograms, geriocaine++ 100 mg, and not in all sadamine++ 300 mg daily.
      Improvement of visual acuity for distance was observed in 31 eyes (77.5%) and for
      near vision in 17 eyes (42.5%). Within 34 eyes with visual field abnormalities in
      9 the central or pericentral scotomas were observed. After medical treatment the
      central scotomas were diminished in 6 eyes (66.6%) and the enlargement of
      peripheral visual border from 10 to 30 degree in 10 eyes (40%) were observed.

PMID- 1635364
TI  - [Soft contact lens as an obturator in children with amblyopia].
AB  - The authors present the results of application of a soft contact lens in 16
      children. The lens has been used for obturation of the master-eye in the
      treatment of amblyopia. Particular attention was committed to the improvement of
      the visual acuity, retinal fixation and position of the eyes.

PMID- 1635365
TI  - [Immunologic response of the anterior chamber in the light of observation of the
      presence of bee sting].
AB  - The authors present a case of a bee sting sticking for 3 days in the anterior
      chamber. It did not provoke any inflammatory changes except of a sector hyperemia
      of the iris and aqueous flare. After a surgical removal of the sting these
      symptoms receded. The lack of reaction to the bee poison is considered in the
      light of a humoral reaction and of the phenomenon of Anterior Chamber Associated
      Immune Deviation (ACAID) the essence of which is based on the suppression of the
      late type of sensitivity.

PMID- 1635366
TI  - [Atypical clinical picture of uveal melanoma].
AB  - Presented is a case of uveal melanoma in the posterior segment of the eye. It has
      been accompanied by an inflammatory reaction of the anterior segment which made
      impossible the visual evaluation of the fundus.

PMID- 1635367
TI  - [Early changes in the visual system in subacute sclerosing panencephalitis].
AB  - This paper presents our observations of changes in the visual system in the early
      period of SSPE in the group of 23 children at the age of 3 to 17 years (18 boys
      and 5 girls). The most frequent changes were papillary stasis (9 patients).
      Decreased visual acuity with no changes in the optic fundus or with
      chorioretinitis and simple atrophy of the optic nerve were observed in 8
      children. Convergent squint, visual hallucinations and visual agnosia were
      additional symptoms in single cases. Changes in the visual system which appeared
      in early period of the disease as single clinical symptom usually create serious
      diagnostic problems. The greatest problem appeared when papillary stasis
      coexisted with other symptoms of increased intracranial pressure.
      Neuroradiological examinations were decisive in these cases. Diagnosis of SSPE
      was confirmed by further course of the disease and others additional and typical
      results.

PMID- 1635368
TI  - [Critical evaluation of the treatment of diabetic retinopathy based on personal
      experience].
AB  - The authors present the results of analysis of the treatment of 184 patients (360
      eyes) with diabetic retinopathy; it comprises as well the out-patients as the in
      patients divided into 4 groups in dependence on the changes and the treatment
      applied (laser focused photocoagulation, panretinal photocoagulation, cryopexy)
      the majority of patients reported to the hospital with an advanced proliferative
      diabetic retinopathy and this allowed only the performance of a panretinal
      photocoagulation and in a part of cases only cryopexy. The attention is called to
      the necessity of an early detection of pathological changes and of an early
      treatment.

PMID- 1635369
TI  - [Value of different serological tests in the diagnosis of various forms of active
      ocular toxoplasmosis].
AB  - The analysis of results of indirect immunofluorescence and direct agglutination
      reaction in patients with various forms of ocular toxoplasmosis showed that these
      reactions have a limited value in diagnostics of this condition. One can define a
      sure diagnosis of active ocular toxoplasmosis when the titre of these reactions
      are higher than 512. The ELISA IgM reaction is specific for the active form of
      this disease. The sensitivity of this reaction amounts 43-50%. In cases of
      iridocyclitis the results of the serological tests were similar to those of the
      control group; this confirms the hypothesis that the inflammation is evoked by an
      allergic reaction.

PMID- 1635370
TI  - [Stickler's syndrome].
AB  - Stickler's syndrome or congenital, progressive arthro-ophthalmopathy refers to
      disturbances of the connective tissue of the organism but mainly the
      osteoarticular and visual systems. In the visual system one discovers a
      congenital high myopia, pathological changes in the vitreous in the form of
      membranes and proliferative bands as well as retinal detachment. A metabolic
      defect concerning the hyaluronic acid and the collagen of the 2-d type is assumed
      to be the cause of this syndrome.

PMID- 1635371
TI  - [Radial keratotomy and the factors determining its effectiveness].
AB  - The authors present a short history of the development of the idea and technique
      of the radial keratotomy. They discuss the individual factors as well topical
      (corneal curvature, intraocular pressure) as general (age, sex) and also surgical
      parameters influencing the final effect of operation and its stability. Presented
      are: the indications and contraindications for the procedure, the preoperative
      approach, surgical technique and the postoperative treatment.

PMID- 1635372
TI  - [Failures, complications and side effects of radial keratotomy].
AB  - The authors present the 10-years results of radial keratotomy in the light of the
      world literature. The refractive and functional efficacy of this procedure as
      well as intraoperative and postoperative complications are discussed. The problem
      of the influence of the radial keratotomy on the endothelium is presented in the
      light of clinical and experimental investigations. The daily fluctuation of the
      refraction has been discussed in the aspect of diurnal variations of the
      intraocular pressure and the changes in corneal thickness resulting from its
      hydratation. The problem of binocular vision in conditions of postoperative
      anisometropia is also presented.

PMID- 1635373
TI  - [Effect of various light sources on visual functions in the age aspect. II.
      Visual acuity, the range of accommodation and fusion and the visual field].
AB  - The authors performed examinations in 15 middle aged persons and in 13 persons of
      older productive age in conditions of equivalent illumination, first the glow
      one, then the sodium one of 600 lx value at the stand of examination. They
      observed the dynamics of selected visual functions as the time went by in the
      forenoon hours. The group of older persons tolerated worse the sodium light and
      in both age groups one could observe the receding of the visual near point. The
      authors analyze the remaining visual functions in both conditions of
      illumination.

PMID- 1635374
TI  - Regulation of hematopoietic cell function by protein tyrosine kinase-encoding
      oncogenes, a review.
AB  - Tyrosine phosphorylation of proteins by protein tyrosine kinases (PTKs) is an
      important mechanism in the regulation of various cellular processes such as
      proliferation, differentiation, and transformation. Accumulating data implicate
      PTKs as essential intermediates in the transduction of extracellular signals to
      the interior of the cell. This review summarizes the mechanism of action of PTKs
      from the major subclasses and the involvement of PTK-encoding oncogenes in the
      regulation of hematopoietic cell function.

PMID- 1635376
TI  - Increased serum interleukin 6 levels in patients with myelodysplastic syndromes.
AB  - Serum concentration of interleukin 6 (IL-6) was measured in 45 patients with
      myelodysplastic syndromes (MDS). A commercially available enzyme-linked
      immunosorbent assay (ELISA) with a sensitivity of 3 pg/ml was used. While IL-6
      was undetectable in healthy volunteers, 32 of the patients with MDS showed IL-6
      concentrations higher than 3 pg/ml. In MDS we found serum concentrations of IL-6
      between 0 and 150 pg/ml with a median of 9 pg/ml, mean and standard deviation
      (SD) were 15 and 26 pg/ml respectively. In refractory anemia with excess of
      blasts in transformation (RAEB-t) the serum IL-6 concentrations were
      significantly higher than in refractory anemia (RA; p = 0.0025), in refractory
      anemia with excess of blasts (RAEB; p = 0.0050) and in chronic myelomonocytic
      leukemia (CMML; 0.0449). No significant difference was detected between RA and
      RAEB or between CMML and the other types of MDS, while s significant negative
      correlation was found between the concentrations of IL-6 and hemoglobin (p =
      0.0228).

PMID- 1635375
TI  - Intensive sequential post-induction therapy for adults with acute myelogenous
      leukemia in first remission: long-term follow-up and results.
AB  - We designed a post-induction therapy including intensive sequential therapy with
      non-cross-resistant drugs in an effort to prolong disease-free survival (DFS) for
      adults with acute myelogenous leukemia. Forty-five patients entered this study
      and 33 of 35 patients entering complete remission received the post-induction
      therapy. With a median follow-up for survivors of 3.5 years from complete
      remission, the actuarial 5-year DFS was 46% +/- 19% (95% confidence interval).
      The five-year DFS for patients over 45 years of age was comparable to that for
      patients under 45 years of age (50% +/- 26% vs 47% +/- 28%). Furthermore, the
      actuarial 5-year DFS for patients who required two courses of induction therapy
      was comparable to that for patients who required only one course of induction
      therapy (45% +/- 29% vs 50% +/- 25%). The toxicity of post-induction therapy was
      tolerable and no patients died during complete remission.

PMID- 1635377
TI  - Binding of monoclonal anti-interleukin 2 antibody to nucleoli in acute leukemia
      blast cells.
AB  - Neutralizing anti-IL-2, anti-IL-3, and anti-IL-6 monoclonal antibodies (MAbs)
      were used for the immunoenzymatic detection of the respective cytokines in blast
      cells of 38 patients with acute myeloid (AML) and lymphoid (ALL) leukemias by the
      APAAP-technique. In 20/24 AML-cases (83%) blast cells showed intranuclear
      staining with MAb anti-IL-2 (DMS-1). In 17 cases reaction was restricted to the
      nucleoli, in 4 cases additional cytoplasmic staining was observed. Only 2/13
      (15%) of the ALL cases showed anti-IL-2 staining. In contrast to IL-2, neither IL
      3, IL-6 nor IL-2R alpha-chains were detected in any of the acute leukemias
      tested. The anti-IL-2 staining of nucleoli in AML cells is distinct from the
      cytoplasmic staining which is observed in PHA-activated normal lymphocytes and in
      a minority of AML cells.

PMID- 1635378
TI  - High constitutive expression of heat shock protein 90 alpha in human acute
      leukemia cells.
AB  - The constitutive expression of the genes for four heat shock proteins (hsps) was
      studied in leukemia cell lines, cells obtained from patients with acute leukemia,
      and normal blood cells by means of Northern-blot analysis. Western-blot analysis
      with hsp90 antibody showed that the leukemia cells contained larger amounts of
      hsp90 than the normal peripheral mononuclear cells. The expression of the hsp90
      alpha gene was enhanced in the leukemia cell lines and the acute leukemia cells
      from patients as compared with the normal blood cells. In contrast, the
      expression of the hsp90 beta gene could hardly be recognized in either the acute
      leukemia cells or the normal blood cells. An increased expression of hsp70 gene
      was observed in only one patient. The expression of the hsp27 gene was enhanced
      in one-half the patients with common acute lymphoblastic leukemia. Thus,
      exclusively the hsp90 alpha gene was expressed highly in the leukemia cells,
      indicating its association with cellular proliferation.

PMID- 1635379
TI  - The effect of high-dose methylprednisolone treatment on GM-CSF level in children
      with acute leukemia: a pilot study.
AB  - High-dose methylprednisolone therapy (HDMP) induces acceleration of leukocyte
      recovery in acute lymphoblastic leukemia (ALL) and the differentiation of
      myeloblasts to mature granulocytes in acute myeloblastic leukemia (AML). These
      effects of corticosteroids have been shown to be due to the enhanced colony
      stimulating activity (CSA) and responses to corticosteroids in some patients with
      aplastic anemia and myelodysplastic syndromes (MDS) have been related to
      increased CSA activity. We measured the serum (granulocyte-macrophage colony
      stimulating factor (GM-CSF) levels by a sandwich linked immunoabsorbent assay
      (ELISA) in patients with ALL and AML at presentation and following high-dose
      methylprednisolone (HDMP) therapy. Serum GM-CSF levels at presentation in the ten
      cases studied ranged between 160 and 700 pg/ml (mean 418.5 +/- 252.5). One week
      following HDMP therapy GM-CSF levels increased to between 260 and 950 pg/ml
      (733.5 +/- 203.2). Four weeks after therapy the GM-CSF levels increased to
      between 470 and 1350 pg/ml (911 +/- 278.7). GM-CSF levels were markedly elevated
      one week after HDMP in the patients with ALL, suggesting that in addition to the
      lymphotoxic effects on leukemic blasts, the acceleration in neutrophil recovery
      may be due to release of GM-CSF induced by HDMP and its effects on myeloid
      progenitors.

PMID- 1635380
TI  - Is cigarette smoking a risk factor for non-Hodgkin's lymphoma or multiple
      myeloma? Results from the Lutheran Brotherhood Cohort Study.
AB  - Among 17,633 U.S. white male insurance policy holders whose use of tobacco was
      characterized in a 1966 self-administered questionnaire, there were 49 deaths
      from non-Hodgkin's lymphoma (NHL) and 21 from multiple myeloma (MM) during a 20
      year follow-up. Men who had ever smoked cigarettes had an elevated mortality from
      NHL (RR = 2.1; CI = 0.9-4.9), with risk almost four-fold greater among the
      heaviest smokers (RR = 3.8; CI = 1.4-10.1) compared with those who used no
      tobacco. In contrast, risk of MM was only slightly elevated among those who had
      ever smoked cigarettes (RR = 1.3; CI = 0.4-3.9) and without evidence of a dose
      response trend. Since this is the first cohort study suggesting a link between
      cigarette smoking and NHL and findings from case-control studies have been
      inconsistent, additional clarification should be sought from larger incidence
      based cohort investigations.

PMID- 1635381
TI  - The cytotoxic effects of 5-OH-1,4-naphthoquinone and 5,8-diOH-1,4-naphthoquinone
      on doxorubicin-resistant human leukemia cells (HL-60).
AB  - The effect of 5-OH-1,4-naphthoquinone and 5,8-diOH-1,4-naphthoquinone, two
      quinones highly reactive with oxygen, was studied on HL-60 and HL-60R cells. The
      multidrug resistance developed by the doxorubicin-resistant HL-60 cell line did
      not prevent the cytotoxic effect of these compounds, at clinically relevant
      concentrations. An increase in cellular defenses against oxygen radicals seemed
      to be one of the features developed by HL-60R, since the homogenate from this
      cell line had only 65% of the ability of the original cell line to form oxygen
      radicals during doxorubicin reduction. This result may be explained in part by
      the slight increase in superoxide dismutase and DT-diaphorase enzymatic
      activities.

PMID- 1635384
TI  - Effects of a fibroblast-derived inhibitor on the growth of normal marrow and
      leukemic clonogenic cells.
AB  - Blood cells develop in the bone marrow, controlled by a network of regulatory
      factors, some of which originate in the stroma. Previously, we found that most
      fibroblastoid (FB) cells growing in primary cultures of rat marrow bear surface
      antigens different from those found on FB of certain other tissues. As determined
      by two monoclonal antibodies ("ST3" and "ST4"), the "marrow type" is ST3+/ST4-
      and releases predominantly a colony-stimulating activity (CSA) into its culture
      media (CM), whereas the "peripheral type" (e.g. lung) is predominantly ST3-/ST4+
      and produces inhibitory activity in excess of CSA. The studies described here
      show that this inhibitor also is active on rat leukemic myeloblasts (the BNML
      cell line), but not on eight other cell lines derived from rat tumors of various
      origins or on the human-derived leukemic cell lines tested. It was produced
      without exogenous stimulation, was labile to heat and acid, was not neutralized
      by antisera to transforming growth factor-beta, beta-interferon, or ferritin, and
      had an apparent mol wt in the range of 100-120 kD (peak of activity by gel
      filtration). From the results obtained at this time, we are not able to ascribe
      this fibroblast-derived activity to any known inhibitor molecule.

PMID- 1635383
TI  - Intranuclear concentration measurements of doxorubicin in living leucocytes from
      patients treated for a lympho-proliferative disorder.
AB  - The accumulation of doxorubicin (DOX) in white blood cells of treated patients
      has been studied by quantitative microspectrofluorometry. From blood samples of
      treated patients, leucocyte subpopulations were separated by the gradient method.
      Emission fluorescence spectra from a microvolume of a single living cell nucleus
      were analysed in terms of spectral shape and fluorescence yield between free and
      DNA-bound doxorubicin. With this non-destructive analysis technique, intranuclear
      doxorubicin concentrations were determined within +/- 10%. Doxorubicin
      concentrations were measured in patients treated with bolus injection. After an
      accumulation of DOX in leucocytes during the first 30 min, intranuclear
      doxorubicin concentration did not vary significantly for 24 h, whereas its
      concentration in plasma decreased. Despite large differences between patients,
      monocytes accumulated significantly more doxorubicin than granulocytes or
      lymphocytes did.

PMID- 1635382
TI  - Flow cytochemical analysis of peripheral lymphocytes in chronic B-lymphocytic
      leukemia. Prognostic role of the blast count determined by the H*1 system and its
      correlation with morphologic features.
AB  - Peripheral blood samples from 148 previously untreated patients with chronic B
      lymphocytic leukemia (B-CLL) were analyzed with the Technicon H*1 flow cytometer.
      The absolute number and the percentage values of both LUCs (large unstained
      cells) and blasts were correlated with survival, as well as with well-known
      prognostic factors including morphological subtypes of lymphoid cells. Results
      showed that patients at the most advanced clinical stages (Rai: III and IV;
      Binet: C) had the highest percentage and count of both LUCs and blasts.
      Furthermore, the proportion of LUC positively correlated with the following
      prognostic factors: peripheral lymphocytosis (greater than 50 x 10(9)/l); marked
      splenomegaly (greater than 10 cm UCM); % of circulating prolymphocytes, %
      immunoblasts, and % LGL. Our data analysis further revealed that chemotherapy
      produced a greater reduction of both the LUCs and of the blast count than of that
      of small lymphocytes. An increase in LUC count was found to coincide with
      deterioration of clinical status (progressive changes in the clinical stages,
      occurrence of prolymphocytoid transformation). A rapid increase in blast count
      was found to occur in concomitance with the development of Richter's syndrome,
      and correlated positively with the number of peripheral immunoblasts determined
      by light microscopy. Moreover, a blast percentage higher than 7% had the
      strongest predictive relation to survival rate when compared with other
      hematological parameters (lymphocytosis greater than 50 x 10(9)/l, % of LUCs
      greater than 12%, LUC to lymphocyte ratio greater than 16%, LUCs count greater
      than 2.2 x 10(9)/l). In the light of these findings, it may be suggested that the
      presence both of larger proportions of LUCs and of blasts measured with the flow
      cytometry may be considered unfavorable prognostic factors in B-CLL. However,
      based on morphological and multivariate statistical analyses, the blast count
      proved to be the most important prognostic parameter determined by the H*1 system
      in B-CLL.

PMID- 1635385
TI  - A patient with monosomy 7 and polyuria.
AB  - Diabetes insipidus (DI) is a rare complication of leukaemia. An association
      between monosomy 7 and DI in leukaemias has been proposed. We present a case of
      Ph1-positive CML who developed polyuria at the time of lymphoid blast
      transformation associated with loss of chromosome 7. Biochemical results were not
      diagnostic of DI and a therapeutic trial of DDAVP was unsuccessful. Post-mortem
      showed a peripituitary and renal leukaemic infiltrate and although DI is a
      possibility, the cause of his polyuria remains unresolved.

PMID- 1635386
TI  - 5th International Workshop on Chronic Lymphocytic Leukemia.
AB  - In the past few years important advances have been made in our understanding of
      the biology and natural history of CLL; also, new strategies and agents offer
      promise in the treatment of this form of leukemia. Now, patients can be treated
      on a more rationale basis and with real prospects for a sustained control of
      their disease, and improved quality of life. Hopefully, progresses in CLL will
      continue to accumulate in the coming years.

PMID- 1635387
TI  - Enhanced NK activity during blast crisis in chronic myelogenous leukemia (CML)

PMID- 1635388
TI  - Macrophage colony-stimulating factor production in leukemic cell lines compared
      to normal T cells.

PMID- 1635390
TI  - Isochromosome 11q in acute erythroblastic leukemia.

PMID- 1635389
TI  - Can dipyridamole or verapamil slow regrowth of leukaemia cells?

PMID- 1635391
TI  - [Seroprevalence of human immunodeficiency virus infection at an emergency service
      of an urban area].
AB  - BACKGROUND: Objectification of the seroprevalence of infection by the human
      immunodeficiency virus (HIV) among patients consulting in a hospital emergency
      ward of an urban area is presented. Detection of unknown carriers of HIV is also
      reported as well as an evaluation of the reasons for consultation by these
      patients in emergency wards. METHODS: A prospective study was carried out in the
      emergency ward of internal medicine with the random selection of 500 patients. In
      each case the following were evaluated: previous epidemiology of HIV, reason for
      consultation and clinical suspicion of HIV infection. The determination of HIV
      antibodies was carried out in all patients by ELISA with a further ELISA and
      Western blot being performed for seropositivity. RESULTS: 8.4% of the patients
      included were previously known carriers of HIV. In addition, 1.1% presented
      positive serology vs previously unknown HIV. The most frequent reason for
      consultation was a febrile syndrome followed by digestive and respiratory
      symptomatology. CONCLUSIONS: There is a high seroprevalence of HIV carriers among
      patients consulting in emergency wards with an unnegligible percentage of unknown
      carriers. The profile of previously unknown HIV carriers is that of male between
      25-35 years of age consulting for a febrile syndrome of no apparent focus who
      pertains or has previously pertained to a risk group.

PMID- 1635392
TI  - [Nephropathy in human immunodeficiency virus infection].
AB  - BACKGROUND: Patients with the human immunodeficiency virus (HIV) infection may
      present different types of nephropathy with focal segmentary glomerulosclerosis
      (FSGS) being the most specific lesion associated to HIV (HIVN). The prevalence of
      this entity varies between 1 to 23%. These differences have been attributed to
      ethnic factors and/or intravenous drug addiction (IVDA). The renal alterations
      presented in these patients with HIV infection were analyzed. METHODS: Two groups
      of patients were studied: Group I with 300 consecutive patients with advanced HIV
      infection (complex related with AIDS) treated with zidovudine without initial
      kidney infection followed for a mean of 19 +/- 11 months (99% caucasian, 65%
      IVDA, 66% AIDS); and group II with 11 patients with HIV infection remitted for
      kidney involvement (4 on hemodialysis). RESULTS: Group I: 26 cases (9%) presented
      acute reversible kidney failure (12 prerenal, 9 nephrotoxicity and 5 mixed). No
      patient presented HIVN criteria. Group II: one black patient developed HIVN and
      had no known risk factors. The remaining patients presented glomerular changes
      different from those of HIVN. CONCLUSIONS: The scarce prevalence of human
      immunodeficiency virus nephropathy in the present series is of note despite the
      high number of intravenous drug addicts included suggesting that ethnic factors
      determine the differences observed in different series. The most frequent kidney
      disturbances seen are those related with infectious complications associated to
      the acquired immunodeficiency syndrome and the treatment of the same.

PMID- 1635393
TI  - [Prevalence of human immunodeficiency virus infection, hepatitis B virus and
      syphilis in full term pregnancy].
AB  - BACKGROUND: The estimation of the frequency of infection by HIV, hepatitis B
      virus and syphilis in unselected populations of full-term pregnancy is useful for
      epidemiologic surveillance of these diseases and for decision marking in prenatal
      detection. METHODS: A transversal study of 3,193 women who gave birth in the
      Hospital General de Elche between March 1989 and February 1990 was carried out. A
      blind survey was developed to avoid ethic problems and bias derived from the
      undertaking of HIV test without patient consent. RESULTS: The prevalence of HIV
      was 0.5/1,000 women (CI 95%, 0-1.5); HBV 8.9/1,000 (CI 95%, 4.6-13.2) and
      syphilis 1.5/1,000 (CI 95%, 0.9-2.1). CONCLUSIONS: The diffusion of the AIDS
      epidemic in Spain to the general population does not at present seems important
      although studies should be performed in the future to monitor the trend. The
      prevalence of syphilis in Spain is low in this study in comparison with the
      results of other Spanish studies which may be explained by greater quality of
      care in to pregnancy. The prevalence of HBV suggests the need for detection and
      vaccination of newborns.

PMID- 1635395
TI  - [Aids: where we are and where we are heading].

PMID- 1635394
TI  - [Multicenter study of the prevalence of type 2 human immunodeficiency virus
      infection in Spain (1990)].
AB  - BACKGROUND: HIV-2 is a new retrovirus which may produce AIDS and has been mainly
      described in individuals from West Africa. More than 400 cases have been reported
      in France and Portugal while in Spain very few cases of HIV-2 infection have been
      reported with few studies having been made concerning the prevalence of the
      disease. This multicentric study analyzes the prevalence of HIV-2 infection in
      subjects of different risk groups in Spain and evaluates the diagnostic efficacy
      of different methodologies. METHODS: The presence of HIV-2 antibodies was
      analyzed in 902 serum samples of high risk individuals collected in 1990 from:
      386 drug addicts, 246 not drug addict prostitutes, 184 West Africans and 86
      homo/bisexual individuals. These samples were from Barcelona, Sevilla, and
      Malaga. The detection of antibodies was carried out by enzymatic immunoanalysis
      (EIA), Western blot (WB) and an enzymoimmuno-dot (EID) designed with synthetic
      peptides. RESULTS: Positive serology only for HIV-2 was detected in 7 samples
      from African immigrants. Two drug addicts presented double reactivity HIV-1/HIV-2
      in all the tests suggesting double infection. No prostitutes or homo/bisexual
      males were identified with positive serology for HIV-2. Cross-reactivity between
      HIV-1 and HIV-2 was more frequently detected in WB than in EID. Greater
      discordance was found in the results obtained by EIA, WB, and EID in the West
      Africans than in the analysis of the samples of native subjects. CONCLUSIONS:
      This study demonstrates that, for the time being, HIV-2 infection in Spain is
      rare although from among immigrants from endemic areas subjects with behavior to
      risk of transmission to the autochthonous population have been identified. The
      use of techniques designed with synthetic peptides may be of use to discriminate
      HIV-1 and HIV-2 infection in positive samples by enzymatic immunoanalysis (EIA)
      and Western blot which use a viral lysate as antigenic material.

PMID- 1635396
TI  - [Human immunodeficiency virus infection in seronegative subjects: myth or
      reality?].

PMID- 1635397
TI  - [Cell cultures: usefulness in biomedical research].

PMID- 1635399
TI  - [Supraclavicular silicoanthracotic adenopathy].

PMID- 1635398
TI  - [Cavitated pulmonary mass in a 19-year-old male].

PMID- 1635400
TI  - [Cerebello-extrapyramidal syndrome as the only manifestation of poisoning with
      tricyclic antidepressives].

PMID- 1635401
TI  - [A proposal of a deontologic decalogue].

PMID- 1635402
TI  - [Regional differences in amiodarone consumption].

PMID- 1635403
TI  - [Role of conservative surgery in the multidisciplinary treatment of Ewing's
      sarcoma in childhood].
AB  - BACKGROUND: In order to cure Ewing's sarcoma it is necessary to have an approach
      which considers the radical local control on the sites of macroscopic disease,
      along with the systemic control of micrometastases. On the present study the
      experience of the authors in analyzed, remarking the role of cytoreduction
      surgery on curability. METHODS: From January 1982 to August 1991, 24 patients
      with the mean age 13 years, 14 boys and 10 girls, previously untreated and with a
      pathology proven diagnosis have been treated by the authors. The treatment
      protocol included: alternating chemotherapy with cyclophosphamide, adriamycin,
      methotrexate, bleomycin, actinomycin D and vincristine; administered
      simultaneously with preoperative external radiation with a volume that completely
      included the affected bone and surrounding soft tissues for a total dose of 45
      Gy/4.5 weeks. After a resting period of 4 weeks, resection of the involved bone
      and adjacent healthy bone was performed, followed by a single dose of 10-15 Gy of
      intraoperative radiotherapy to the tumor bed. Subsequently a custom prostheses or
      allograft was implanted. RESULTS: Twenty patients had localized disease and 4 had
      metastatic disease at diagnosis. In 16 cases the tumor was in extremities, 5
      axial, and 3 extraskeletical. In 15 patients surgery with limb sparing techniques
      was performed, 8 had en block resection and one amputation (calcaneous location).
      At the time of this report 21 patient are alive (87%). Four had disease
      progression, of this 3 had died (12%). The actuarial disease free survival rate
      is 80% +/- 9% with a follow-up of 104 months, being the mean survival time of
      85.5 months. CONCLUSIONS: The cytoreduction surgery included into a
      multidisciplinary approach permits to achieve a high rate of cure in Ewing's
      sarcoma. The toxicity of the program can be considered acceptable.

PMID- 1635404
TI  - [Influence of chronic renal failure and of its treatment on serum
      erythropoietin].
AB  - BACKGROUND: In order to know the influence of dialysis treatment in
      erythropoietin production, serum erythropoietin (Ep) has been studied in patients
      with anemia due to chronic renal failure (CRF). METHODS: Thirty six of them in
      hemodialysis (HD), 10 in continuous ambulatory peritoneal dialysis (CAPD) and 18
      in predialysis stage (PD) and their results were compared to two control groups,
      including 72 healthy controls (HC) and the second one 89 iron deficiency anemia
      patients (ID). RESULTS: Patients had lower Hb and Ep levels than the other
      groups. Although Ep was higher in CAPD and PD. Ep levels were similar to HC
      values, and lower than ID levels. It could be demonstrated any correlation
      between Hb and Ep in CRF patients, however a negative exponential correlation was
      demonstrated in ID patients between Hb and Ep (r = -0.83; p less than 0.00001).
      In summary, Ep is higher in CAPD and in PD than in HD, but the levels are lower
      than they should be expected. CONCLUSIONS: These data confirm an Ep production
      failure in most of IRC patients and it seems likely that Ep treatment could be
      effective to treat the anemia of CRF.

PMID- 1635405
TI  - [Primary cerebral lymphoma in 10 patients with AIDS. Comparative clinico
      radiologic study with cerebral toxoplasmosis, cerebral tuberculoma and primary
      cerebral lymphoma in non-immunodepressed patients].
AB  - BACKGROUND: Primary central nervous system lymphoma (PCNSL) is the second cause
      of cerebral masses in patients with the acquired immunodeficiency syndrome
      (AIDS). The present study evaluated the possible presence of clinical or
      radiologic signs permitting differentiation of AIDS patients and PCNSL from those
      with cerebral masses of other etiologies. METHODS: Clinical history and cranial
      computerized tomography (CT) of patients with PCNSL and AIDS from the Hospital
      Clinic i Provincial in Barcelona were reviewed. Results were compared with those
      of patients with PCNSL without evidence of immunosuppression and with those with
      AIDS and cerebral toxoplasmosis or tuberculoma diagnosed during the same period.
      RESULTS: Of 685 patients with AIDS, 10 were identified with PCNSL. The clinical
      picture was not different to that observed in patients with AIDS and cerebral
      toxoplasmosis or tuberculomas. In contrast to PCNSL in non immunodepressed
      patients, the cerebral CT in patients with PCNSL and AIDS demonstrated hyperdense
      lesions in only 44% and contrast enhancement was not homogeneous in any case.
      These characteristics were similar to those observed in the CT of patients with
      cerebral toxoplasmosis or tuberculoma with the exception that only 8% of the
      lesions by toxoplasmosis were spontaneously hyperdense. CONCLUSIONS: The clinical
      radiological data of primary central nervous system lymphoma in patients with the
      acquired immunodeficiency syndrome are similar to those observed in other
      etiologies. However, the presence of a sole spontaneously hyperdense region in
      cranial computerized tomography is more suggestive of primary central nervous
      system lymphoma than cerebral toxoplasmosis.

PMID- 1635407
TI  - [Molecular epidemiology].

PMID- 1635406
TI  - [Familial study for the early diagnosis of insulin-dependent diabetes mellitus].
AB  - BACKGROUND: Diabetes is more frequently found than expected in families of first
      grade with children with diabetes type I. METHODS: With the aim of identifying
      the potential candidates prone to develop diabetes type I, genetic and metabolic
      analysis was carried out on the members of 11 families with a diabetic type I
      child. They were distributed into three groups: 11 diabetic patients (IDDM); 22
      progenitors and 13 unaffected siblings. The HLA haplotype was determined, the
      spectrum of autoantibodies and the intravenous glucose tolerance test (IVTT) were
      performed. RESULTS: In two progenitors postprandial glycemia values corresponding
      to intolerance to carbon hydrates were obtained. Moreover, in one the IVTT was
      found to be low in the normal values. Of a total of 12 non diabetic descendents
      studied, 4 shared identical HLA haplotypes as the diabetic, 5 were haploidentical
      and 3 unidentical. The DR 3 antigen was detected in 90% of the diabetics; in 68%
      of the progenitor group and in 50% of the non diabetic descendents. Sixty-two
      percent of the children inherited the DR 4 antigen of the father (p less than
      0.05), while 37% do so from the mother. Of the siblings with a haplotype
      identical to that of the diabetic, 2 were also ICA positive; asymptomatic at the
      moment of the study but in one the diabetes type I became manifest after 2 years
      of evolution. CONCLUSIONS: Subjects at high risk of becoming type I diabetics may
      be identified at a preclinical phase by means of HLA typing and the detection of
      immunologic and metabolic markers associated with the disease.

PMID- 1635408
TI  - [Contribution of continuous ambulatory monitoring of arterial pressure to the
      diagnosis and treatment of arterial hypertension].

PMID- 1635409
TI  - [Pulmonary infection caused by Rhodococcus equi in a renal transplant recipient].
AB  - Rhodococcus equi is a primarily pathogen in animals and it has only rarely been
      seen in immunocompromised humans. We describe our experience with an HIV-negative
      patient with a functioning renal graft under cyclosporin-azathioprine-prednisone
      therapy. The patient died after a two months recurrent multifocal pneumonia. The
      cultures from sputum and blood were negatives but R. equi was isolated from lungs
      in the necropsy. Most of the 41 cases we had found in the literature had AIDS or
      HIV infection. Six cases had a kidney graft under azathioprine-prednisone
      therapy. Rhodococcus equi infection may be missed in some instances due to
      incomplete or improper identification of the organism, that grows well in aerobic
      media but is usually regarded as a component of normal flora or as a contaminant.
      The ability of R. equi to persist in and eventually to destroy macrophages is the
      basis of its pathogenicity. It also explains the clinical resistance to
      antibiotics without intracellular activity. Rhodococcus equi infection must be
      suspected in immunocompromised patients with recurrent pneumonia. Correct
      identification and combined therapy with lipophilic antibiotics that penetrate
      the macrophages are necessary to prevent the high mortality of this infection.

PMID- 1635410
TI  - [Chronic myeloid leukemia after chemotherapy treatment for non-Hodgkin's
      lymphoma].
AB  - A 52 year old male presenting chronic myeloid leukemia (CML) Philadelphia
      chromosome positive (Ph) four years after the diagnosis of a non Hodgkin's
      lymphoma is described. The patient had received high total doses of alkylating
      drugs (cyclophosphamide and chlorambucil) as part of chemotherapy treatment for a
      diffuse mixed lymphoma. At four years of diagnosis of the lymphoma the appearance
      of hepatosplenomegaly, leukocytosis with myeloma and basophilia and
      thrombocytosis were observed. These alterations augmented progressively until a
      cytogenetic study of the bone marrow two years late established the diagnosis of
      CML upon demonstrating the presence of the Ph chromosome with no other karyotypic
      anomalies being observed. The explorations carried out at that time confirmed
      that the lymphoma continued to be in remission. The CML initially responded to
      treatment with busulphan. However, following a year and a half the disease
      evolved to a phase of acceleration and the patient died a few weeks later due to
      pneumonia with no signs indicative of lymphoma activity having been detected
      since the diagnosis of the CML.

PMID- 1635411
TI  - [Direct methods for the detection of the human immunodeficiency virus].

PMID- 1635412
TI  - [The day that I did not kill Mikado].

PMID- 1635413
TI  - [Severity indexes and prognosis in intensive care. Their application in diabetic
      hyperosmolar coma].

PMID- 1635414
TI  - [Prognostic factors in bladder carcinoma].

PMID- 1635415
TI  - [Anatomopathologic diagnosis of Alzheimer's disease].

PMID- 1635416
TI  - [Spontaneous bacterial peritonitis and pneumoperitoneum].

PMID- 1635417
TI  - [Miliary tuberculosis secondary to intravesical instillation of Calmette-Guerin
      bacilli].

PMID- 1635418
TI  - Interaction of antidepressants with 4-aminopyridine.
AB  - Systemic administration of 4-Aminopyridine at a dose of 4 mg/kg (4-AP) induces
      hypothermia in mice. Scopolamine (ED50 = 0.26 mg/kg) and two tricyclic
      antidepressants, desipramine (ED50 = 1.82 mg/kg) and IM/P/3/4 (ED50 = 8.95 mg/kg)
      completely antagonize 4-AP-induced hypothermia, whereas minaprine (0.1-0.25
      mg/kg), a non-tricyclic antidepressant, reverts only 45% of the maximal effect of
      4-AP. Oxotremorine at a dose of 0.05 mg/kg (OXO) induces a hypothermic effect
      comparable to that of 4-AP. Scopolamine (ED50 = 0.011 mg/kg) completely reverts
      OXO-induced hypothermia whereas desipramine and IM/P/3/4 never produce more than
      60% of antagonism over a wide range of doses. Minaprine does not affect OXO
      induced hypothermia. These results suggest that the interaction of
      antidepressants with cholinergic function occurs mainly at the pre-synaptic
      level.

PMID- 1635419
TI  - Effects of (S)-alpha -fluoromethylhistidine and metoprine on locomotor activity
      and brain histamine content in mice.
AB  - We examined the effects of (S)-alpha -fluoromethylhistidine (FMH), an inhibitor
      of histidine decarboxylase, and metoprine, an inhibitor of histamine N
      methyltransferase, on the locomotor activity and the brain histamine content of
      ICR mice. The brain histamine content was decreased by FMH (12.5 or 50 mg/kg,
      i.p.) and increased by metoprine (4 mg/kg, i.p.). Under these conditions, the
      locomotor activity and the number of rearing were significantly decreased and
      increased by FMH and metoprine, respectively. The higher the brain histamine
      content, the greater the locomotor activity and vice versa. In a previous paper
      [Sakai et al., Life Sciences, 48, 2397-2404 (1991)], we showed that thioperamide,
      a histamine H3 antagonist, which enhances the release of histamine from
      histaminergic neurons, in doses of 12.5 and 25 mg/kg, i.p. increases the
      locomotor activity, whereas it decreases the brain histamine content. Taken
      together, these results support the hypothesis that central histaminergic neurons
      may be involved in the control of state of locomotion and rearing.

PMID- 1635420
TI  - Rapid and simple gas chromatographic measurement of lactic acid in red blood
      cells, plasma, and tumor cells after hyperthermia.
AB  - The content of lactic acid in red blood cells, plasma, and Ehrlich ascites tumor
      cells were measured by a gas-liquid chromatography using a column with a
      terephtalic acid support coated with polyethylene glycol-6000. The lactic acid
      contents were directly determined in aqueous samples, because they were converted
      to a volatile derivative in the column. The method was rapid and simple, compared
      with previous methods which need time-consuming conversion of lactic acid to
      volatile derivatives. Our measurements showed the increase in the contents of
      intra- and extracellular lactic acid after hyperthermia.

PMID- 1635421
TI  - A new test for measuring diapause in the pink bollworm Pectinophora gossypiella
      Sunders.
AB  - An ELISA test was developed to assay for the presence of a protein,
      pectinophorin, that is expressed only in diapausing last instar larvae of the
      pink bollworm, Pectinophora gossypiella Saunders. Use of the test provides a good
      estimation of the percent of diapause larvae in populations of pink bollworm in
      cotton fields in California and Arizona. All plow down dates are chosen before
      the majority of larvae enter diapause so as to eliminate as many overwintering
      survivors as possible. These dates may now be determined more precisely for any
      given field by use of the new ELISA procedure.

PMID- 1635423
TI  - Estimation of unbound concentrations of morphine from microdialysate
      concentrations by use of nonlinear regression analysis in vivo and in vitro
      during steady state conditions.
AB  - The unbound concentration of morphine in striatum of rats was estimated during a
      constant rate infusion of morphine 14 mumol/h*kg, by use of the microdialysis
      technique and nonlinear regression analysis. The concentrations in plasma of
      morphine and its metabolite, morphine-3-glucuronide, were 4.2 +/- 1.4 microM and
      7.7 +/- 4.0 microM, respectively, during the constant rate infusion. The
      corresponding estimated unbound concentrations of morphine in striatum varied
      between 0.06 and 0.11 microM. No morphine-3-glucuronide was detected in the brain
      dialysates. The unbound concentration in striatum was lower than expected based
      on unbound plasma concentrations and could be an indication of active transport
      from the brain. Five different equations were tested to find the best empirical
      description of the relationship between microdialysate concentration and
      perfusion rate by nonlinear regression analysis. The equations were validated by
      a serum in vitro study, where three unbound concentrations of morphine estimated
      from microdialyis were compared to estimates obtained from equilibrium dialysis.
      The precision of the parameter estimates obtained from the five equations was
      tested by Monte Carlo simulations. One of the equations (Eq. 4) was selected in
      preference to the others, because of the good agreement with the estimated
      unbound concentration obtained by equilibrium dialysis in vitro, and good
      precision of the parameter estimates. The method described in this paper is
      valuable when estimating the unbound concentration of drug from microdialysate
      concentrations during steady state conditions. Furthermore, the method is easily
      accessible when working in the pharmacokinetic and pharmacodynamic field.

PMID- 1635422
TI  - Protein kinase C activity during sphinganine potentiation of retinoic acid
      induced differentiation in a human leukemia cell line (HL-60).
AB  - The differentiation of HL-60 promyelocytic cells toward mature granulocytic cells
      induced by retinoic acid (RA) was accompanied by a decrease in protein kinase C
      (PKC) activity. The enhancement of RA-induced differentiation and the
      potentiation of the decrease of PKC activity by sphinganine (SP) seemed to
      correlate with each other. Kinetically, PKC activity during RA-induced
      differentiation without SP decreased to its lowest (75% of the control) after
      48h; about 50% of the reduction was observed at 24h. In the presence of SP, PKC
      activity decreased more rapidly to its lowest (60% of the control) within 24h of
      incubation of RA. SP, added 24h before or concomitantly with the addition of RA,
      could potentiate the RA-induced differentiation and the reduction of PKC
      activity. Our results indicate that the effect of SP and the role of PKC during
      RA-induced differentiation may be critical at the early stages of induction of
      differentiation (within 24h of RA exposure).

PMID- 1635424
TI  - Powerless? Not if we don't want to be.

PMID- 1635425
TI  - UNICEF launches the Baby-Friendly Hospital Initiative.

PMID- 1635426
TI  - Clarifying HIB schedules.

PMID- 1635427
TI  - ICEA position statement on maternal substance abuse.

PMID- 1635428
TI  - Don't forget to play!

PMID- 1635429
TI  - Neonatal and pediatric PEG tubes.

PMID- 1635430
TI  - Nursing alert: vertical transmission of HIV and HBV.

PMID- 1635431
TI  - Parental prerogatives: Newmark v. Williams.

PMID- 1635432
TI  - Maternal drug abuse and its effects on young children.

PMID- 1635433
TI  - Bridging the cultural gap with Southeast Asians.

PMID- 1635434
TI  - Alcohol and other drug education videos.

PMID- 1635435
TI  - Biases in meta-analysis and how to compensate.

PMID- 1635436
TI  - Thyrotoxic periodic paralysis in the United States. Report of 7 cases and review
      of the literature.
AB  - Although hypokalemic periodic paralysis is a common complication of
      hyperthyroidism among Asian populations, it is an uncommon problem in the United
      States. The recent experience in an American medical center with 7 patients with
      thyrotoxic periodic paralysis (TPP) is reviewed. Compared to most descriptions of
      this disorder, which tend to reflect the international experience with this
      disease, patients with TPP in the United States reflect the ethnic makeup of the
      local population: the predisposition of patients of Asian origin is very evident,
      but whites are more frequently affected than most previous reports have
      recognized. Hispanics and American Indians also appear to be at increased risk,
      and blacks have also been affected. Except for the fact that hyperthyroidism is
      an absolute requirement for expression of the disease, TPP is identical to
      familial periodic paralysis (FPP) in its clinical presentation. TPP affects
      predominantly males (to an even greater degree than FPP), is rarely associated
      with a positive family history, and has a later onset of presentation than FPP
      (reflecting the need for hyperthyroidism to occur before the disorder can be
      expressed). Graves disease is the most common cause of hyperthyroidism in
      affected patients, but any cause of thyrotoxicosis (including administration of
      excessive amounts of exogenous thyroid hormone) can trigger attacks of TPP in
      susceptible subjects. Clinical features of thyroid disease may be very subtle or
      virtually nonexistent; as a result, thyroid function tests should be routinely
      monitored in patients with features of hypokalemic paralysis. The pathophysiology
      of the disorder is not well understood. Definitive treatment of hyperthyroidism
      leads to cessation of periodic hypokalemic paralysis, but symptoms can return
      with recurrence of the hyperthyroid condition. Potassium administration during an
      acute attack will shorten the duration of the episode, and treatment with
      propranolol, potassium supplementation, or spironolactone may prevent attacks in
      some patients.

PMID- 1635437
TI  - Gastrointestinal manifestations of epidermolysis bullosa. A study of 101
      patients.
AB  - One hundred one patients with EB were evaluated by a combination of prospective
      and retrospective review, and analyzed regarding the nature, incidence, and
      prevalence of their gastrointestinal (GI) manifestations. Involvement of the GI
      tract is a well-known extracutaneous manifestation of dystrophic EB, but it also
      occurred in more than one-half and one-third, respectively, of those with
      junctional and simplex EB. Most of the serious consequences, such as esophageal
      strictures and microstomia, occurred in recessive dystrophic EB but were also
      seen, although infrequently, in the junctional and simplex forms. The majority of
      patients with dysphagia had an esophageal stricture, and the cervical esophagus
      was the most common location. The onset of dysphagia generally occurred in the
      first decade of life, in patients much younger than previously recognized.
      Diagnostic endoscopy did not reveal lesions which could not have been detected
      radiographically. Lower GI complaints were common, especially constipation and
      perianal blistering, and affected all types of EB. These complaints contributed
      substantially to management problems but they did not correlate with colonic
      pathology and appeared to reflect anal or perianal disease.

PMID- 1635438
TI  - Nocardiosis in patients with human immunodeficiency virus infection. Report of 2
      cases and review of the literature.
AB  - Nocardia infection is a rarely reported opportunistic infection in HIV-infected
      patients. Nocardiosis typically occurs in HIV-infected patients with advanced
      immunodeficiency (89% of cases), often as the initial serious opportunistic
      infection (42% of cases). In most HIV-infected patients, nocardia infection is
      disseminated at the time of diagnosis and is characterized by an indolent course
      that may be difficult to differentiate from other systemic infections. Invasive
      procedures to obtain tissue of fluid for culture are frequently necessary to make
      the diagnosis, although a Gram or modified acid-fast stain of sputum or other
      infected material may suggest the etiologic agent. Although trimethoprim
      sulfamethoxazole is the most commonly used initial therapy, it was discontinued
      in 50% of cases because of adverse reactions. Even though the optimal treatment
      has not been defined, nocardiosis in HIV-infected patients can be treated
      successfully with or without sulfa-containing antimicrobial regimens, along with
      surgical drainage when necessary. Recurrence is noted after short duration of
      treatment, and consideration should be given to lifelong maintenance therapy.

PMID- 1635439
TI  - Wilson disease.
AB  - Wilson disease is an inherited disorder of copper metabolism. Progress has been
      made in establishing the location of the gene on the long arm of chromosome 13,
      and in finding nearby probes that can be used to identify affected sibs of newly
      diagnosed patients. However, the gene has not been cloned, and the molecular
      nature of the defect remains unknown. The cause of the disease is a failure to
      excrete unneeded and excessive copper in the bile for loss in the stool. This may
      be due to a failure to excrete copper packaged in ceruloplasmin into the bile.
      Clinically, patients usually present during the second to fourth decades of life
      with liver, neurologic, or psychiatric disease, but the diagnosis is often missed
      or delayed. Once a diagnosis of Wilson disease is considered, reliable studies of
      copper variables can be carried out. After diagnosis, patients must receive
      anticopper treatment for the rest of their lives, to reduce copper levels and
      prevent copper reaccumulation. For life-long maintenance therapy, we recommend
      zinc acetate because of its complete efficacy and lack of toxicity; it acts by
      blocking copper absorption. For initial therapy of the acutely ill patient, no
      currently available therapy has proven to be ideal. A chelator-type drug, either
      penicillamine or trien, can be used for the initial therapy of patients who
      present with liver disease; transition to zinc acetate can then be made after a
      few months. For the initial therapy of acutely ill patients who present with
      neurologic disease, chelation should be avoided because neurologic worsening
      frequently occurs, probably due to redistribution of copper which temporarily
      raises the levels of copper in the brain. For initial treatment, zinc therapy is
      also not ideal because it is relatively slow-acting. A new experimental drug,
      tetrathiomolybdate, shows promise in the initial treatment of patients with
      Wilson disease. The major challenges ahead include closing the remaining
      therapeutic hiatuses, cloning and expressing the gene to understand its function,
      and improving clinical diagnosis so that therapy can be instituted as quickly as
      possible.

PMID- 1635440
TI  - Pneumocystis carinii infection. 1973.

PMID- 1635441
TI  - [Objective evaluation of respiratory ventilation at work by measuring peak
      expiratory flow rate (PEFR)].
AB  - Eleven patients suffering from baker's asthma, 27 patients with bronchitis and 2
      patients with suspected bronchial asthma resulting from occupational exposure to
      formaldehyde were subjected to a single blinded 3-day observation. Clinical
      symptoms' analysis and PEFR were performed to diagnose asthmatic symptoms at the
      workplaces. In all the patients with barker's asthma bronchoconstriction was
      observed as a result of exposure to formaldehyde on both "no drug" and "placebo"
      days. No bronchoconstriction on the "bronchodilator" day was observed. Reactions
      to other asthmatic and bronchitic patients differed significantly. The proposed
      model seems to be useful as a routine diagnostic procedure in occupational
      asthma.

PMID- 1635442
TI  - [Psychological evaluation of the effects of chronic occupational exposure of
      paint shop workers to the mixture of organic solvents].
AB  - The aim of the study was to evaluate the psychological effects of chronic
      occupational exposure to the mixture of organic solvents containing xylene,
      toluene, n-butanol, butyl acetate, n-butyl acetate, ethyl acetate and
      cyclohexanone defined by MAC values. Thirty-four paint shop workers and 34
      controls, matched according to sex, age, education and the type of work
      performed, were examined. The Neurobehavioral Core Test Battery (NCTB) was used
      in the study. In the exposed workers, a longer simple reaction time was observed,
      as well as reduced manual skills and impaired precision of the hand movements.

PMID- 1635443
TI  - [Peripheral vision in copper mine workers].
AB  - Eighty-two copper mine workers were subjected to an examination performed twice a
      day. Field of vision and eye's resolving power were examined in all subjects.
      Preliminary examination was performed above ground before the miners started
      their work and later, after five hour's work under ground. During the follow-up
      examination the limitation of the field of vision was found in 64% of face
      foremen and in 13.6% of off-face miners. This limitation was observed in the
      lower temporal quadrants. The limitation is probably of central origin and is
      connected with the effects of occupational agents, eg. noise. The eye's resolving
      power assessed under ground was statistically remarkably lower than above ground.
      However, taking into consideration the inadequate lighting, one might expect more
      serious changes of this characteristic.

PMID- 1635444
TI  - [Acetylcholinesterase activity in erythrocytes of workers engaged in the
      production of iron-manganese alloys].
AB  - The activity of acetylcholinesterase in the red blood cells of metallurgy workers
      producing iron-manganese alloys was statistically less significant than the
      activity of this enzyme in the control group. Work tenure and smoking intensity,
      measured using the smoking index method did not significantly affect the
      acetylcholinesterase activity in the worker's red blood cells (smoking index =
      number of packs of cigarettes smoked per day x years of smoking; one pack = 20
      cigarettes). The results may point to malfunctions of the erythrocytes membranes
      caused by harmful substances in iron works producing iron-manganese alloys.

PMID- 1635446
TI  - [Biological markers--a new trend in evaluating the effects of the environment on
      the body].
AB  - Deepening changes in the environment, resulting from the industrialization
      process, have a negative effect upon human health. They increase specific health
      effects and bring about higher incidence of common diseases. Biomarkers make it
      possible to evaluate the organism's reaction toward the hazardous effects of
      exposure to noxious chemicals of the environmental origin. Biomarkers reflect the
      changes in the exposed organisms and make it possible to assess exposure, its
      health effects and susceptibility to toxic agents. At the moment, research is
      under was aimed at finding biomarkers for the neoplastic process and determining
      the neurotoxic effects, changes in the reproductive system, immunotoxic effects
      as well as toxic changes in such organs as liver, kidneys and lungs.

PMID- 1635445
TI  - [International control of the quality of microscopic-numerical analysis of the
      levels of man-made mineral fibers (MMMF) in the air of the work area].
AB  - In the years 1986-1990 the Institute of Occupational Medicine in Lodz (Department
      of Aerosols) participated in seven exchanges of preparations within the WHO/Euro
      MMMF Reference Scheme programme. The number of persons analysing the preparations
      increased from three, during the first exchange, to seven in the sixth. Markings
      in the 1st and 3rd exchange constituted two thirds of the reference markings. In
      the 2nd, 5th and 7th exchange the markings were similar, and in the 6th exchange
      they were lower than in the reference markings. According to the accepted system,
      the markings of the standardized density in four exchanges (2nd, 5th, 6th and
      7th) were determined as class I (0.70-1.40), and in the remaining exchanges (1st,
      3rd and 4th) of class II (0.50-2.00).

PMID- 1635447
TI  - [Risk of neoplasms among workers in the paper-cellulose industry].
AB  - The results of various epidemiological research indicate that workers in the pulp
      and paper industry have an increased risk of developing and dying of malignant
      cancer with a specific location. The paper discusses recent studies in the area.
      The findings point to an increased risk of stomach cancer in workers
      occupationally exposed to pulp produced in the sulfite process. Workers making
      paper and cardboard are especially at risk for lung cancer. Some researchers
      signal a higher risk of lymphatic system cancer and stoma cancer. On the basis of
      existing data on exposure in the pulp and paper industry, it is impossible to
      determine the exact effects of exposure to a given compound or chemical.
      Assessment of exposure at particular work areas and analysis of data using the
      job exposure matrix is necessary. This should provide more information about
      cancerogenic compounds in the pulp and paper industry.

PMID- 1635449
TI  - Prediction of the carcinogenic potential of chemicals.

PMID- 1635448
TI  - [Principles of establishing the registries of chemical substances in the United
      States and Europe].
AB  - The paper presents the principles of building up the inventories of chemical
      substances in the USA, the countries belonging to European Economic Community
      (EEC) and Austria. In all countries, the appropriate legal regulations putting
      the manufacturers and importers of chemicals under obligation to provide some
      strictly determined information underlie the decision to build up these
      inventories. The data provided usually inform of: manufacturer's name and
      address, chemical substance identity, production volume and ways of distribution.
      The paper presents also the criteria of selection of substances to be placed in
      the inventory, organizational scheme of building up the inventory and the ways of
      exacting the respective regulations. The inventories of chemical substances
      issued in the USA and Austria may serve as banks of information on the place,
      kind and quantity of chemical substances on the territory of the whole country.
      Based on these data a map of chemical hazards zones may be prepared which may
      adversely affect either human health or environment. The inventory of EEC
      countries may serve only as lists of chemicals occurring in the common market.

PMID- 1635450
TI  - Sensitivity of Salmonella typhimurium TA97a to the type of agar used for
      preparation of Vogel-Bonner plates.
AB  - Recent problems with the supply of Difco bacto agar have forced some laboratories
      to evaluate alternative agars for use in the Salmonella/microsome assay. This led
      to the independent observation in two laboratories (Boots and Glaxo) that
      Salmonella typhimurium TA97a is sensitive to certain types of agar that may be
      used to prepare Vogel-Bonner minimal medium plates. A programme of work was,
      therefore, undertaken to investigate this phenomenon; 9-aminoacridine
      hydrochloride (at Boots) and 4-nitro-o-phenylenediamine (at Glaxo) were tested
      against TA1537 and TA97a using Vogel-Bonner plates prepared with a number of
      different agars. Three agars (Lab M, Difco Bi-tek and Beckton Dickinson
      granulated) were identified which, although supporting normal growth of TA1537
      revertant colonies, gave much reduced control counts and responses to the
      mutagens with TA97a. One agar, Becton Dickinson grade A, gave poor responses with
      TA1537 but produced satisfactory results with TA97a. In contrast to the Vogel
      Bonner plates, varying the type of agar used in the top agar overlays had little
      effect on the responses obtained. On the basis of these comparisons, Becton
      Dickinson purified agar was selected as a suitable alternative to Difco bacto and
      it was concluded that laboratories using agars other than these, or purchasing
      pre-poured plates without specifying the type of agar, should be made aware of
      potential problems with TA97a.

PMID- 1635451
TI  - Formation of thymidine adducts and cross-linking potential of 2-bromoacrolein, a
      reactive metabolite of tris(2,3-dibromopropyl)phosphate.
AB  - DNA-adduct formation by the mutagen 2-bromoacrolein (2BA) with DNA was studied.
      [3-3H]2BA was reacted with single-stranded (ss) DNA or double-stranded (ds) DNA
      and subsequently incubated with methoxylamine to convert an unstable
      2BA:thymidine adduct (Meerman et al., Cancer Res., 49, 6174-6179, 1989) to a
      stable product. This product was identified in the study as 3-(2"-hydroxy-3"
      methoximpropyl)thymidine (HYMETH) by LC-MS. After extensive purification and
      enzymatic hydrolysis of modified ssDNA and dsDNA, approximately 5% of the
      covalently bound activity coeluted with added HYMETH standard in a reverse phase
      HPLC system. Because the unstable 2BA:thymidine adduct may have the potential to
      form cross-links, we investigated the reaction of this adduct with various
      nucleophiles in vitro. A reaction occurred between the adduct and cysteine, but
      not with lysine or deoxynucleosides. Reaction of 2BA with ssDNA in the presence
      of [3H]glutathione also resulted in the binding of radiolabelled GSH to DNA.
      These results indicate that the reactive aldehyde group of the adduct can react
      with thiol groups in proteins to form protein-DNA cross-links. Further, the
      possibility that tris- and bis-(2,3-dibromopropyl)phosphate (Tris-BP and Bis-BP)
      form such cross-links was examined in vivo in Drosophila. The results indicate
      that Tris-BP is a cross-linking agent, whereas Bis-BP is not. Inasmuch as Tris-BP
      is known to be metabolized rapidly to 2BA and Bis-BP, whereas Bis-BP forms 2BA
      only very slowly, suggests that in Drosophila DNA adducts are formed that cross
      link proteins.

PMID- 1635452
TI  - Use of batch and fed-batch fermentation for studies on the variation of
      glutathione content and its influence on the genotoxicity of methyl-nitro
      nitrosoguanidine in yeast.
AB  - We have applied fermenter techniques to analyse the variations of glutathione
      (GSH) content in cultures of the diploid strain D7 of Saccharomyces cerevisiae.
      Choosing various experimental conditions of controlled batch and fed-batch
      fermentation we give evidence that the GSH levels of the yeast cultures depend on
      growth phase, the carbon source supply and the carbon source metabolism in an
      unexpectedly complex manner. Additionally, we analysed yeast cells with low GSH
      levels which were obtained either by depleting GSH with chloroacetophenone (CN)
      chemically or by using a GSH-deficient diploid strain (gsh1/gsh1). In order to
      study the relevance of the factors influencing the GSH concentration for
      genotoxicity testing in yeast we have used N-methyl-N'-nitro-N-nitrosoguanidine
      (MNNG) which is activated by GSH. We show that in cells which are GSH proficient
      the extent of genotoxicity of MNNG correlates well with the GSH levels in the
      cells. Conditions of high GSH content (stationary phase of growth) corresponds
      with high genotoxic activity of MNNG, whereas conditions of low GSH content as
      logarithmic growth, glucose repression, GSH deficiency caused by the gsh1
      mutation and GSH depletion by CN treatment correspond with a very moderate
      genotoxic effect of MNNG. These findings emphasize the necessity to use
      metabolically highly standardized cells for genotoxicity testing, since the
      carbon source catabolism, the concentration of glucose, growth rate and possibly
      other parameters influence the metabolization of xenobiotic agents in yeast.

PMID- 1635453
TI  - Bacterial mutagenic evaluation of a series of 4' substituted derivatives of 3
      benzylidenamino-5H-1,2,3-triazin[5,4b]indol-4-one.
AB  - The mutagenicity of ten triazinoindole derivatives was studied in bacteria. The
      compounds form part of a 3-(4'-substituted-benzylidenamino)-5H-1,2,3-triazin[5,4
      b]in dol-4-one series and differ in the physicochemical properties of the
      substituent at the 4' position of the benzylidenamino group: -H, -OH, -COOH, 
      OCH3, -COOCH3, -NHCOCH3, -C1, -NO2, -C6H5, and -OC6H5. They were tested in the
      TA97, TA98, TA100, and TA102 strains of Salmonella typhimurium, both with and
      without metabolic activation, using the preincubation procedure. Only the
      derivatives with phenyl and phenoxy substituents were non-mutagenic. The
      remaining compounds significantly increased the number of His+ revertants and
      showed three patterns of activity based upon their mutagenic potency and their
      response to metabolic activation. Size and hydrophobicity of the 4'-substituents
      are the physicochemical characteristics that most differentiate the mutagenic
      triazinoindole derivatives from the nonmutagenic ones.

PMID- 1635454
TI  - Influence of the triazine ring on the mutagenicity of triazinoindoles and some
      congeners.
AB  - Three compounds, which could be considered as precursors or derivatives of the 3
      (4'-substituted-benzylidenamino)5H- 1,2,3-triazin[5,4b]indol-4-one series, were
      selected from the study of their mutagenic activity. Ames tests were performed
      study of their mutagenic activity. Ames tests were performed using the Salmonella
      typhimurium strains TA97, TA98, TA100, and TA102, according to the preincubation
      procedure, both with and without metabolic activation. The 3-amino-5H-1,2,3
      triazin[5,4b]indol-4-one has been shown to be a strong S9-independent mutagen,
      which reverts frameshift and substitution mutations. Nevertheless its potency
      increases with the addition of microsomal fraction. In contrast, the 2-benzyliden
      1-(3-aminoindol)-2-carbohydrazide and the 3-aminoindol-2-carbohydrazide congeners
      were not mutagenic. These results suggest that the 1,2,3-triazine ring is the
      principle substructure responsible for the mutagenicity of the triazinoindole
      congeners studied.

PMID- 1635455
TI  - Induction of ribonucleoside diphosphate reductase gene transcription by chemicals
      in Escherichia coli.
AB  - A fusion between the promoter of the nrdA gene of Escherichia coli and the lacZ
      gene has been constructed, and the induction of nrdA gene expression by 20
      organic and 20 inorganic chemicals has been studied. The inducing compounds of
      the SOS genes, such as bleomycin, captan, ciprofloxacin, enoxacin, hydroxyurea, N
      methyl-N'-nitro-N-nitrosoguanidine, mitomycin C, nalidixic acid, ofloxacin and
      hexavalent chromium compounds also trigger the expression of the nrdA gene. Other
      chemicals such as aluminium, manganese and zinc salts, reported as negative in
      the SOS Chromotest, are also inducers of the nrdA gene. These results suggest
      that ribonucleoside diphosphate reductase transcription is increased by chemicals
      able to either block DNA synthesis or to alter the enzymes participating in the
      DNA replication. Induction of nrdA gene is an effect to be further considered in
      the study of alterations produced by physical or chemical treatments which act
      upon DNA metabolism.

PMID- 1635456
TI  - Effect of arsenite on the DNA repair of UV-irradiated Chinese hamster ovary
      cells.
AB  - Arsenite, an ubiquitous human carcinogen, has been shown to enhance the
      cytotoxicity, mutagenicity and clastogenicity of UV light in mammalian cells.
      Arsenite may exert its co-genotoxic effects by inhibiting DNA repair. Results
      from alkaline sucrose gradient sedimentation show that arsenite did not
      accumulate UV-induced DNA strand breaks in Chinese hamster ovary (CHO) K1 cells
      as aphidicolin plus hydroxyurea (HU) did. These data indicate that arsenite did
      not inhibit the activity of DNA polymerase alpha in UV repair. Treatment with
      arsenite before UV irradiation slightly reduced the DNA strand breaks accumulated
      by cytosine beta-D-arabinofuranoside (AraC) plus HU. This effect implies that
      arsenite only slightly inhibited the incision of UV-induced DNA adducts. The low
      molecular weight DNA accumulated by post-UV incubation with AraC plus HU shifted
      to high molecular weight upon the incubation of cells in drug-free medium, but
      this shifting was prohibited by the presence of arsenite. This suggests that
      arsenite inhibited the rejoining of DNA strand breaks. When a pulse-chase
      labelling procedure was applied on UV-irradiated cells, the chain elongation of
      nascent DNA was strongly inhibited by post-incubation with arsenite. These data
      show that arsenite inhibited post-replication repair in UV-irradiated cells.
      Therefore, the steps inhibited by arsenite in UV-induced DNA repair in CHO K1
      cells are different from human fibroblasts in which the inhibition of excision of
      pyrimidine dimers by arsenite was reported to be the major target.

PMID- 1635457
TI  - Micronuclei induced by 2-chlorobenzylidene malonitrile contain single chromosomes
      as demonstrated by the combined use of flow cytometry and immunofluorescent
      staining with anti-kinetochore antibodies.
AB  - The effects of the tear gas 2-chlorobenzylidene malonitrile (CS) on micronucleus
      induction and cell cycle kinetics were studied in Chinese hamster and Ehrlich
      ascites tumour cells using flow cytometric analysis of micronuclei and nuclei in
      suspension, and indirect immunofluorescent staining of kinetochores in
      micronuclei. In both cell lines CS induced a concentration-dependent inhibition
      of the fraction of cells in mitosis as observed by simultaneous flow cytometric
      measurements of DNA content and side scatter intensities of cell nuclei.
      Micronucleus frequency increased during the delayed division of cells accumulated
      by CS in mitosis and reached a plateau when most of these cells have divided. The
      height of this plateau depended on the CS concentration. Results obtained by flow
      cytometric analysis of the frequency of CS-induced micronuclei did not agree
      quantitatively with results obtained by microscopic analysis due to cells showing
      CS-induced fragmented nuclei. Nearly all CS-induced micronuclei exhibited
      kinetochores, the majority of which (60-70%) showed one kinetochore per
      micronucleus implying the presence of a single metaphase chromosome in these
      micronuclei. DNA distributions of micronuclei measured by flow cytometry showed
      pronounced peaks corresponding to the DNA distribution of chromosomes measured by
      flow karyotyping. Even micronuclei containing two of the large chromosomes could
      be observed as distinct peaks in the distributions. The combined results of flow
      cytometric analysis of micronucleus distributions and immunofluorescence staining
      of kinetochores in micronuclei suggest that CS induces micronuclei mainly by
      damaging the spindle fibres of single chromosomes during mitosis, thus possibly
      leading to aneuploidy and polyploidy.

PMID- 1635458
TI  - Aneuploidy induction in mouse spermatocytes.
AB  - Assays for aneuploidy are being developed within a coordinated research program
      sponsored by the Commission of the European Communities. The 10 known and suspect
      spindle poisons colchicine (COL), econazole (EZ), chloral hydrate (CH),
      hydroquinone (HQ), diazepam (DZ), thiabendazole (TB), cadmium chloride (CD),
      pyrimethamine (PY), thimerosal (TM) and vinblastine (VBL) were tested for
      aneuploidy induction in male germ cells. Two different criteria were used for the
      evaluation of slides from testicular material of (102/El x C3H/El)F1 mice at
      different times (6, 14 and 22 h) after treatment with different doses of each of
      the test chemicals. Secondary spermatocytes of mice were evaluated by chromosome
      counting to determine the induction of hyperploidy. The proportions of
      spermatogonial mitoses, first and second meiotic metaphases were determined in
      order to recognize an effect of the test chemicals on testicular cell
      proliferation. COL, EZ, CH, HQ and VBL clearly increased the frequencies of
      hyperploid secondary spermatocytes which indicated non-disjunction induction
      during the first meiotic division. DZ and CD were less effective but
      significantly positive (P less than 0.05). Concomitantly, COL, EZ, CH, HQ, DZ, CD
      and VBL induced meiotic delay in primary and/or secondary spermatocytes. It is
      concluded that meiotic delay may be indicative for aneuploidy induction and the
      evaluation of changes in testicular cell proliferation described here could serve
      as a prescreen and partially substitute the time-consuming counting of metaphase
      chromosomes in secondary spermatocytes.

PMID- 1635459
TI  - Study on the mutagenicity of brandy with the Ara test.
AB  - The forward mutation assay to L-arabinose resistance (Ara test) in Salmonella
      typhimurium was used to demonstrate that evaporated residues of brandy had direct
      acting mutagenic activity. The mutagenicity covered a 100-fold range, from 13482
      to 127 AraR induced mutants/ml brandy equivalent. Rat liver S9 mix suppressed the
      mutagenic activity of brandy in the Ara test. The inactivating capacity was
      independent of microsomal monoxygenase enzymes and appeared to be mediated
      through a heat stable component of the S9 fraction. Catalase was identified as
      the putative S9 component responsible for its inactivating capacity. The
      implication of reactive oxygen species in the direct-acting mutagenicity of
      brandy was supported by the higher sensitivity of Escherichia coli bacterial
      strains deficient in two major cellular antioxidant defense (glutathione and/or
      catalase) compared to their parental wild-type. Phenolic compounds of a polar
      nature could be responsible for the mutagenicity through the production of
      reactive oxygen intermediates. Non-matured beverages (gin and non-matured rum)
      were non-mutagenic. It is conceivable that mutagenic phenolics might be extracted
      from the wood during maturation in the barrel. Autoxidation of phenolic compounds
      could be a common mechanism in the mutagenicity of complex mixtures of plant
      origin.

PMID- 1635461
TI  - Industrial Genetic Toxicology Discussion Group. Report of the meeting on
      'Practical Experiences with Regulatory Mutagenicity Guidelines'.

PMID- 1635460
TI  - Chromosomal localization of human O6-methylguanine-DNA methyltransferase (MGMT)
      gene by in situ hybridization.
AB  - Recombinant lambda phage DNA containing segments of human O6-methylguanine-DNA
      transferase gene was employed to localize this gene among the human chromosomes
      using non-radioactive in situ hybridization technique. This gene was found to be
      present at the telomeric end, 26q, of the long arm of the chromosome 10.

PMID- 1635462
TI  - Toward normative expert systems: Part II. Probability-based representations for
      efficient knowledge acquisition and inference.
AB  - We address practical issues concerning the construction and use of decision
      theoretic or normative expert systems for diagnosis. In particular, we examine
      Pathfinder, a normative expert system that assists surgical pathologists with the
      diagnosis of lymph-node diseases, and discuss the representation of dependencies
      among pieces of evidence within this system. We describe the belief network, a
      graphical representation of probabilistic dependencies. We see how Pathfinder
      uses a belief network to construct differential diagnosis efficiently, even when
      there are dependencies among pieces of evidence. In addition, we introduce an
      extension of the belief-network representation called a similarity network, a
      tool for constructing large and complex belief networks. The representation
      allows a user to construct independent belief networks for subsets of a given
      domain. A valid belief network for the entire domain can then be constructed from
      the individual belief networks. We also introduce the partition, a graphical
      representation that facilitates the assessment of probabilities associated with a
      belief network. We show that the similarity-network and partition representations
      made practical the construction of Pathfinder.

PMID- 1635463
TI  - Natural language processing and semantical representation of medical texts.
AB  - For medical records, the challenge for the present decade is Natural Language
      Processing (NLP) of texts, and the construction of an adequate Knowledge
      Representation. This article describes the components of an NLP system, which is
      currently being developed in the Geneva Hospital, and within the European
      Community's AIM programme. They are: a Natural Language Analyser, a Conceptual
      Graphs Builder, a Data Base Storage component, a Query Processor, a Natural
      Language Generator and, in addition, a Translator, a Diagnosis Encoding System
      and a Literature Indexing System. Taking advantage of a closed domain of
      knowledge, defined around a medical specialty, a method called proximity
      processing has been developed. In this situation no parser of the initial text is
      needed, and the system is based on semantical information of near words in
      sentences. The benefits are: easy implementation, portability between languages,
      robustness towards badly-formed sentences, and a sound representation using
      conceptual graphs.

PMID- 1635464
TI  - Possibilities of software phantoms for quality control of KBS in nuclear
      medicine.
AB  - The assessment of the results of a "knowledge-based system" (KBS) for quality
      control is a basic requirement for clinical application: Large numbers of test
      studies are necessary in order to cover as widely as possible the spectrum of
      cases to be analyzed by the KBS. The use of original patient data as test data is
      one possibility, but real data are provided unevenly. This is due to the set of
      characteristics which are relevant to the analysis. Data are available in a
      limited quantity only. This implies a remaining set of unvalidated cases which
      are not represented in the data pool. The software phantom is an approach towards
      systematically guided validation. It permits the generation of test data adjusted
      to the demands of the validation.

PMID- 1635465
TI  - Data modeling for immunological and clinical data of leukemia and myasthenia
      patients.
AB  - In this study it was investigated whether and to what extent semantic data models
      and their methods for data modeling are useful for adequate representation and
      integration of immunological and clinical data. To that end the special research
      program in leukemia research and immunogenetics (SFB 120) of the University of
      Tubingen was taken as an example. Based on the semantic data model RM/T we
      propose the design of a database system, report on its realization, and discuss
      this approach. Using a semantic data model, the quality of data increased
      considerably. This means, for instance, that the integration of the molecular
      biological knowledge allows a better control of the person-related results.
      Hence, the decisions based of these data may have greater validity and the
      treatment on leukemia patients can be improved. Furthermore, the elucidation of
      immune mechanisms concerning auto-immune diseases could be improved.

PMID- 1635466
TI  - Eurosentinel: development of an international sentinel network of general
      practitioners.
AB  - The Eurosentinel project was a European concerted action. It started in June 1988
      and ended in June 1991. Its purpose was to coordinate activities in the field of
      sentinel practices with GPs and the ultimate goal was to establish a real
      European network of sentinel practices. This paper deals with the purposes of the
      project, the studies carried out in the frame of the project, and an evaluation
      of three years Eurosentinel.

PMID- 1635467
TI  - Use of two online services as drug information sources for health professionals.
AB  - The utility of the online computer services BRS Colleague and Dialog Medical
      Connection, when used primarily as drug information sources by physicians,
      nurses, and pharmacists and attitudes toward their use, are described. Study
      sites included office-based medical practices, a university clinic family
      medicine group, and a university clinical pharmacy department. Participants had
      access to either of the computer services during two 9 1/2-month periods. All
      searches were automatically recorded and analyzed. A total of 1,112 search
      sessions were conducted (78% by pharmacists, 16% by nurses, 6% by physicians) by
      38 of 65 participants. Information which completely answered questions was found
      for slightly less than one-third of searches. Errors occurred in about 81% of
      searches which retrieved incomplete information. Lack of time was a major factor
      which limited use of the services, and infrequent users felt that the services
      did not fit in well with their daily work routine.

PMID- 1635468
TI  - A new paradigm of medical informatics.

PMID- 1635469
TI  - Expert system design in hematology diagnosis.
AB  - A two-part study was designed to test the hypothesis that sufficient information
      is available from a modern hematology analyzer (the Coulter STKS) to reach a
      reliable intermediate conclusion which can be used as input to the next decision
      making level in the design of a high-performance expert system for hematology
      diagnosis. In phase one, we analyzed the performance of three probabilistic
      systems (using Bayes' rule) which interpret STKS data: a control system which
      took the traditional approach of classifying cases into specific diagnoses, and
      two test systems which were designed to reach only an intermediate conclusion but
      not a final diagnosis. One of the test systems classified cases into "textbook
      categories" of disease and the other utilized defined diagnostic patterns. The
      systems were tested with 150 cases. The pattern approach ranked the correct
      choice first in 141 of 150 cases (94%). In phase two, we abandoned Bayes' rule,
      reformulated the pattern approach into a heuristic classification system, and
      tested its reliability on 820 cases. The algorithm of the reformulated system was
      able to classify all 820 cases into the same predominant pattern as a panel of
      three experienced laboratory hematologists.

PMID- 1635470
TI  - Toward normative expert systems: Part I. The Pathfinder project.
AB  - Pathfinder is an expert system that assists surgical pathologists with the
      diagnosis of lymph-node diseases. The program is one of a growing number of
      normative expert systems that use probability and decision theory to acquire,
      represent, manipulate, and explain uncertain medical knowledge. In this article,
      we describe Pathfinder and our research in uncertain-reasoning paradigms that was
      stimulated by the development of the program. We discuss limitations with early
      decision-theoretic methods for reasoning under uncertainty and our initial
      attempts to use non-decision-theoretic methods. Then, we describe experimental
      and theoretical results that directed us to return to reasoning methods based in
      probability and decision theory.

PMID- 1635471
TI  - Anti-oxidant therapy improves microvascular ultrastructure and perfusion in
      postischemic myocardium.
AB  - To determine the contribution of oxygen-derived free radicals to the changes in
      microvascular structure and function which follow reperfusion of ischemic
      myocardium, isolated perfused rat hearts were subjected to 15 or 45 min of global
      ischemia followed by 5 min of oxygenated reperfusion. Hearts were then fixed by
      perfusion with glutaraldehyde and perfused with nuclear track photographic
      emulsion to identify competent capillaries in scanning and transmission electron
      micrographs. Reperfusion after 15 min caused a significant reduction in the
      density of competent capillaries in the subendocardial third of the left
      ventricle, but this reduction was lessened but not eliminated by the addition of
      0.61 mmole/liter desferrioxamine, but not by 60,000 U/liter superoxide dismutase
      plus 60,000 U/liter catalase, to the perfusate. After 45 min of ischemia both
      interventions prevented the myocyte swelling, endothelial cell changes, bleb
      formation, and reduction in microvascular lumina characteristic of unprotected
      reperfusion, but only desferrioxamine significantly improved microvascular
      competence. This suggests that the hydroxyl radical rather than superoxide and/or
      hydrogen peroxide has a pathogenic role, although desferrioxamine may have other
      effects as nonspecific chelator. Postischemic reductions in capillary function
      also occur in reversibly injured myocardium in the absence of structural
      abnormality. Preventing postischemic microvascular incompetence has the potential
      to minimize ischemic cell injury and to enhance repair following myocardial
      infarction, but it also may increase the risk of hemorrhage from venules.

PMID- 1635472
TI  - An evaluation of skin capillary blood flow determinations in neonates using a
      computerized videophotometric method.
AB  - Dynamic capillaroscopy has been shown to give valid measurements of skin
      capillary blood flow in adults. The aim of this investigation is to evaluate the
      accuracy of the method when applied to studies in newborn infants. A computerized
      videophotometric technique was used to measure the skin capillary blood cell
      velocity (CBV) and the capillary erythrocyte column diameter at 64 standardized
      locations in 16 nailfold capillaries in five subjects. To estimate the method's
      reliability, we calculated the coefficient of variation (CV = 1 SD/mean x 100%)
      for repeated measurements at each location. The CV for CBV determinations was
      found to be 3.4% (0.9-13%) and the corresponding value for capillary diameter
      measurements was 6.7% (0.5-12%) (median and range). Although the CBV and diameter
      values were found to vary along the course of the capillary, the volume flow of
      blood cells was assumed to be the same in simultaneously studied but different
      sections of the capillary. The paired CBV and diameter observations were
      therefore used to calculate blood cell flow values at an average of four
      different intracapillary locations. To estimate the method's validity, the CV for
      these repeated flow calculations was determined and found to be 7.5% (3.2-26%).
      We conclude that the age-specific characteristics in neonates, mainly a high
      hematocrit and short, irregular skin capillary loops, do not limit the
      feasibility and accuracy of videophotometric microscopy for dynamic
      microcirculatory studies in neonates.

PMID- 1635473
TI  - Repeated measurement variation and precision of laser Doppler flowmetry
      measurements.
AB  - The repeated measurement variation of laser Doppler flowmetry (LDF) recordings is
      essential for the precision level of the method in the assessment of tissue
      perfusion. The objective of this paper was to discuss the practical consequences
      of this problem by presenting a statistical method which can be used to estimate
      the number of replicates needed to reach a certain precision standard. By a
      repeated measures analysis of variance with a single-factor design, the mean
      variation of repeated measurements and its standard deviation were estimated.
      This estimate was used for simulation of a 95% confidence interval with length
      defined as a percentage of the mean of repeated measurements. The analyses were
      made in LDF samples performed in skin, gastric mucosa, and pig kidney in order to
      exemplify the use of the method. Paired values gave an unacceptable precision
      estimate in all tissues, but by increasing the number of replicates, the
      estimated precision was greatly enhanced. A preliminary recommendation for the
      practical use of LDF in the assessment of tissue perfusion is to perform at least
      four to six repeated measurements. Further studies are needed in order to
      establish methodological standards. The presented statistical considerations
      could also be relevant for other procedures used in microvascular research.

PMID- 1635474
TI  - Coronary microvascular response to exogenously administered and endogenously
      released acetylcholine.
AB  - The objectives of the present study were first, to determine the coronary
      microvascular response to vagal stimulation and to compare it to exogenously
      administered acetylcholine, and second, to determine the microvascular response
      to larger doses of acetylcholine which preferentially increase subendocardial
      blood flow. In anesthetized cats and dogs, the left ventricular epicardial
      vasculature was visualized in mid-diastole with stroboscopic epi-illumination.
      Myocardial perfusion was measured with the radioactive microsphere technique. In
      cats microvascular diameters were measured at control and following bilateral
      vagal nerve stimulation (5-30 Hz) or left atrial infusion of acetylcholine (0.4
      1.0 micrograms/kg/min). Aortic pressure and heart rate (A-V-sequential pacing)
      were maintained constant. Vagal stimulation (n = 13) increased myocardial
      perfusion by 25 +/- 9% (control: 161 +/- 17 ml/min x 100 g). Acetylcholine (n =
      13) produced a similar increase in myocardial flow (control: 185 +/- 16 ml/min x
      100 g, 30 +/- 9%). Both vagal stimulation and acetylcholine dilated all size
      arteries and arterioles (51-410 microns; 5 +/- 1% and 11 +/- 2%, respectively).
      In dogs intracoronary administration of acetylcholine (10 micrograms/min) that
      increased myocardial flow twofold (control: 129 +/- 7 ml/min x 100 g; 10
      micrograms/min: 263 +/- 26 ml/min x 100 g) and increased the endo/epi flow ratio
      also dilated all vessel sizes. In conclusion, vagal stimulation and exogenously
      administered acetylcholine produce similar effects on the coronary
      microcirculation and dilate all size classes of arteries and arterioles in a
      similar manner. Intracoronary infusion of acetylcholine which preferentially
      increases subendocardial blood flow also dilates all size classes of
      microvessels. Thus, the ability of acetylcholine to preferentially increase
      subendocardial blood flow cannot be explained by a selective dilation of a
      particular size class of arterioles. These data suggest that neurally released
      acetylcholine can diffuse to the endothelial layer to release vasodilator
      substances in vivo.

PMID- 1635475
TI  - Modeling transient exchange in mesentery.
AB  - In this paper, a mathematical model of interstitial transport and microvascular
      exchange within a rigid mesenteric tissue segment is employed to simulate the
      transient exchange of fluid and plasma proteins following two systemic
      disturbances: hypoproteinemia and venous congestion. In each case, the model
      system behavior is studied as a function of interstitial plasma protein transport
      mechanisms and mesothelial transport properties. Plasma protein washout was
      generally predicted in cases of hypoproteinemia. However, following venous
      congestion, the transient change in interstitial plasma protein content also
      depended on the relative sieving properties of the filtering and draining
      boundaries. When these boundaries display similar sieving characteristics, the
      interstitial plasma protein content increases following the disturbance. Such
      behavior may have some bearing on transient exchange in the hepatic
      microcirculation during venous congestion.

PMID- 1635476
TI  - Use of fluorescently labeled erythrocytes and digital cross-correlation for the
      measurement of flow velocity in the cerebral microcirculation.

PMID- 1635477
TI  - Fiber matrix model reanalysis: matrix exclusion limits define effective pore
      radius describing capillary and glomerular permselectivity.

PMID- 1635478
TI  - Perfusate composition modulates in vitro renal microvascular pressure
      responsiveness in a segment-specific manner.

PMID- 1635479
TI  - An extension of the fiber matrix model of vascular permeability.

PMID- 1635480
TI  - Capillary as a communicating medium in the microvasculature.

PMID- 1635481
TI  - [The use of pulsed field electrophoresis using diversely directed electrical
      fields for establishing the degree of similarity of three Pseudomonas cultures].
AB  - It has been shown that from the group of three restriction endonucleases (XbaI,
      Uba 78I, DraI) only XbaI digests the native Pseudomonas genomic DNA into the
      number of fragments, sufficient for their comparative analysis. Optimal
      electrophoresis conditions were adjusted for the better DNA restricts separation.
      Each Pseudomonas culture gives unique patterns of DNA restriction. The
      calculation of the conservative fragments fraction content in the samples led us
      to the conclusion that P. fluorescens differs equally from both P. fluorescens 80
      and P. alcaligenes. The P. fluorescens 80 DNA contains a relatively larger number
      of fragments equal in size with those of P. alcaligenes DNA, than DNA of P.
      fluorescens. We have concluded that the systematics of the Pseudomonas genus is
      still imperfect and that the analysis of DNA restriction patterns is necessary
      for the estimation of the similarity level of cultures studied.

PMID- 1635482
TI  - [The nature of stability of yeast cells to drying].
AB  - The residual water and dry matter condition in the lyophilized biomass of the
      yeast Saccharomyces cerevisiae was studied by NMR-relaxation technique. It was
      shown that the slow component of the transverse magnetization NMR signal spectrum
      corresponding to the so-called "isolated mobile water" was caused in fact by the
      interaction of the disaccharide trehalose with the cell biopolymers. The big
      amount of hydrogen bonds formed by trehalose and their three-dimensional
      orientation closed to the orientation in water clusters assure the valuable
      functioning of this disaccharide during the process of removing water out of
      cells. When stationary phase yeast biomass containing a lot of trehalose was
      dried the cell organelles condition remained practically unchanged what led to
      the high resistance of such cells to dehydration.

PMID- 1635483
TI  - Anaesthesia in obstetrics--how safe?

PMID- 1635484
TI  - Frozen embryos: another population explosion?

PMID- 1635485
TI  - Azoospermia.

PMID- 1635486
TI  - Rural mental health.

PMID- 1635487
TI  - Antenatal care of low risk obstetric patients by midwives. A randomised
      controlled trial.
AB  - OBJECTIVES: To assess the practicality, acceptability to patients and salary
      costs of the antenatal care of low risk obstetric patients by midwives. DESIGN: A
      randomised controlled trial. SETTING: The antenatal clinic at Westmead Hospital,
      a teaching hospital of the University of Sydney in western Sydney. PATIENTS: From
      January 1989 until November 1990, 89 women booking for full antenatal care at
      Westmead Hospital and classified as low risk were randomly allocated to one of
      two groups. Group 1 (43 patients) had their antenatal care provided by registered
      midwives. Group 2 (46 patients) had their antenatal care provided by an
      obstetrician (either Visiting Medical Officer or Staff Specialist) in a routine
      hospital antenatal clinic. INTERVENTIONS: Patients in the midwives' clinic were
      seen by an obstetrician at their first visit to the antenatal clinic and again at
      30 weeks and at 40 weeks. MAIN OUTCOME MEASURES: These were the salary costs of
      each clinic and the patients' levels of satisfaction. Maternal and neonatal
      indicators, delivery details and analgesic requirements were also considered.
      These indicators were planned before data collection commenced. RESULTS: The
      major differences found were a 28% to 68% salary cost saving and that patients
      cared for by midwives showed appreciation of the continuity of care and
      information given at the midwives' clinic. CONCLUSIONS: The care of low risk
      obstetric patients by midwives in a midwives' clinic showed salary cost savings
      and high patient acceptance.

PMID- 1635488
TI  - Comparative study of mammography and mammary serum antigen estimation for breast
      cancer screening.
AB  - OBJECTIVE: To compare mammary serum antigen (MSA) levels with mammography as a
      screening test for breast cancer. To determine the value of MSA testing to
      decrease the need for women to undergo mammography. DESIGN: A blind prospective
      comparison of MSA levels and mammography to detect breast cancer. SETTING: Royal
      Women's Hospital Breast Cancer Screening Clinic. Women were mainly self-referred.
      RESULTS: MSA levels had a wide range in normal women and women with mammography
      detected breast cancer. Mean MSA levels in women with breast cancer reflected
      tumour volume, but a wide range was again seen. At 60% specificity, the
      sensitivity of an elevated MSA level for breast cancer was 63% for invasive
      cancer and zero for in-situ disease. MSA levels were modestly but significantly
      elevated in smokers over non-smokers. CONCLUSION: The MSA level is an
      insufficiently sensitive or specific marker to have a role in screening for
      breast cancer.

PMID- 1635489
TI  - In-vitro fertilisation and neonatal ventilator use in a tertiary perinatal
      centre.
AB  - OBJECTIVE: To determine the contribution of livebirths resulting from in-vitro
      fertilisation and related technologies (IVF) to the use of neonatal ventilator
      beds. DESIGN: A retrospective review of records of all livebirths from our
      hospital's IVF program and all IVF infants receiving mechanical ventilation in
      our neonatal intensive care unit for the period 1985-1989. We also reviewed
      records of labour ward deliveries, neonatal intensive care unit admissions and
      transfer requests in order to obtain comparative data for livebirths of non-IVF
      infants whose mothers had been booked to deliver in our hospital. SETTING: A
      tertiary perinatal centre with a large IVF program and a Level 3 neonatal
      intensive care unit. RESULTS: IVF livebirths accounted for 5.1% of total
      ventilator bed days. Compared with non-IVF booked livebirths, IVF babies were
      more likely to require ventilation (odds ratio, 7.41; P less than 0.0001) and
      used more ventilator bed days per 100 livebirths (rate ratio, 9.63; P less than
      0.0001), largely due to preterm delivery of multiple pregnancies; 42.3% of IVF
      babies who required ventilation were from triplet births and 38.5% from twin
      births. Nevertheless, even IVF singletons used more ventilator bed days per 100
      livebirths than non-IVF booked livebirths (rate ratio, 2.78; P less than 0.0001).
      IVF livebirths accounted for 9.9% of the 78% increase in ventilator bed days used
      in 1989 compared with 1985. CONCLUSIONS: IVF livebirths accounted for only a
      small percentage of the overall use of neonatal ventilator beds, but consumed
      relatively more of such resources per livebirth than did non-IVF livebirths. The
      degree of risk of requiring ventilation is directly related to the number of
      infants in a multiple pregnancy, but even IVF singletons are at a relatively high
      risk of requiring ventilation.

PMID- 1635490
TI  - Increased risk of postnatal depression after emergency caesarean section.
AB  - OBJECTIVE: To examine whether women having an emergency caesarean section are at
      increased risk of developing postnatal depression at one, three and six months
      postpartum. DESIGN: Participants were part of a larger study examining the
      relationship between personality dysfunction and postnatal depression. All women
      were recruited at an antenatal clinic in the first trimester of their pregnancy.
      These women were followed up at one, three and six months postpartum to identify
      cases of postnatal depression, defined by the Edinburgh Postnatal Depression
      Scale (EPDS). RESULTS: Data were collected from 188 women, who were divided into
      three groups by method of delivery: 21 women had an emergency caesarean section,
      49 had a forceps delivery and 118 had a spontaneous vaginal delivery. Comparison
      of the groups indicated a significant difference at three months postpartum only.
      Women having an emergency caesarean section had significantly higher EPDS scores
      than women who had forceps or spontaneous vaginal delivery (9.15 +/- 6.18 v. 5.05
      +/- 3.81 v. 5.79 +/- 4.47; F(2,143) = 4.2, P less than 0.02). Analysis of
      postnatal depression at three months indicated that women in the emergency
      caesarean section group had a relative risk of 6.82 (95% confidence interval,
      2.85-16.15) compared with women in the other groups. CONCLUSIONS: When compared
      with women having spontaneous vaginal or forceps deliveries, women having an
      emergency caesarean section had more than six times the risk of developing
      postnatal depression three months postpartum. Special attention to this group
      appears warranted.

PMID- 1635491
TI  - Oestrogen and the breast. 1. Myths about oestrogen and breast cancer.

PMID- 1635492
TI  - A graduate diploma in family medicine by distance education.

PMID- 1635493
TI  - A master's degree in family medicine.

PMID- 1635494
TI  - Health status and lifestyle in elderly Hawaii Japanese and Australian men.
      Exploring known differences in longevity.
AB  - OBJECTIVE: To contrast health status and lifestyle in two elderly populations
      with differing longevity. DESIGN: Comparison of two cross-sectional data sets.
      SETTING: Non-institutionalised subjects. SUBJECTS: Men aged 60-81 years resident
      in Dubbo, New South Wales (n = 1183, 1988-1989) and Japanese men of the same ages
      resident in Hawaii (n = 1376, 1980-1982). MAIN OUTCOME MEASURES: Cardiovascular
      and non-cardiovascular disease prevalence, risk factors, social and health
      status. RESULTS: A history of heart attack, angina and stroke was twice as
      prevalent in Dubbo men as in Hawaii Japanese. Other diseases were many times more
      prevalent in Dubbo--liver disease sixfold, prostate and renal disease twofold,
      and arthritis 1.5-fold. Hypercholesterolaemia and untreated hypertension were
      more prevalent in Dubbo (threefold and 1.5-fold respectively). Current smoking
      was similar in both groups, while diabetes was twice as prevalent in the Hawaii
      Japanese. More Dubbo men were widowed or lived alone, and fewer remained in paid
      employment. Dubbo men had more limited physical mobility. CONCLUSIONS: Elderly
      Dubbo men have an excess of cardiovascular disease and associated risk factors,
      as well as an excess of non-cardiovascular disease, compared with Hawaii
      Japanese. This may account, in part, for a higher total mortality rate in elderly
      Australians compared with Japanese. Some of this disease burden may be amenable
      to risk factor intervention.

PMID- 1635495
TI  - Acute adrenal insufficiency secondary to heparin-induced thrombocytopenia
      thrombosis syndrome.
AB  - OBJECTIVE: To present a case of acute adrenal insufficiency secondary to heparin
      induced thrombocytopenia-thrombosis syndrome (HITTS), an important though rare
      complication of heparin therapy. CLINICAL FEATURES: A 69-year-old woman developed
      HITTS secondary to low dose heparin administered subcutaneously as prophylaxis
      against deep venous thrombosis. This followed a revision of a knee replacement.
      The first manifestation of HITTS was the development of pulmonary emboli in the
      setting of a falling platelet count. Bilateral adrenal haemorrhages complicated
      her course resulting in acute adrenal insufficiency. Non-specific symptoms
      dominated the clinical picture, with fever, nausea, abdominal pain and vomiting.
      Symptomatic postural hypotension was noted later in the course of her illness.
      INTERVENTION AND OUTCOME: The diagnosis of adrenal insufficiency was confirmed by
      short Synacthen test plus computed tomographic scanning which demonstrated
      bilateral adrenal haemorrhages. Steroid replacement resulted in rapid clinical
      improvement. CONCLUSIONS: This case demonstrates one of the life threatening
      complications that may occur with heparin even in prophylactic doses. Regular
      platelet counts are essential to detect heparin-induced thrombocytopenia at an
      early stage.

PMID- 1635496
TI  - Whiplash in Australia: illness or injury?
AB  - OBJECTIVE: To provide a perspective on "whiplash" injury in Australia by
      examining conflicting evidence, which suggests on the one hand that the disorder
      is a culturally conditioned and legally sanctioned illness and on the other, that
      it is an occult injury which can cause chronic pain. DATA SOURCES: The published
      English language literature derived from MEDLINE covering epidemiological,
      pathogenetic and psychological aspects of "whiplash" injury, post-traumatic
      stress disorder, abnormal illness behaviour and iatrogenicity; the Australian
      legal literature; the printed news media; the Transport Accident Commission of
      Victoria and the State Government Insurance Commission of South Australia. DATA
      SYNTHESIS AND CONCLUSIONS: Comparative studies suggest that "whiplash" is an
      illness reinforced by legal and social sanction. Evidence from Victoria indicates
      that the reported incidence of "whiplash" can be reduced by minor legislative
      change. Occult injury to cervical intervertebral discs, vertebral end plates and
      cervical zygapophysial joints may be responsible for "whiplash" symptoms in some
      who are involved in motor vehicle accidents. This is likely to be confined to a
      small number of those involved in unexpected rear-end collisions.

PMID- 1635497
TI  - The evolution of computer viruses. Part 1: A compelling analogy with biological
      virus.

PMID- 1635498
TI  - Immunosuppression in transplantation.

PMID- 1635500
TI  - Community attitudes to smoking in restaurants.

PMID- 1635499
TI  - The effect of oestrogen on the female cardiovascular system.
AB  - OBJECTIVE: To review the present state of knowledge regarding the effect of
      oestrogen on the female cardiovascular system (e.g. atherosclerosis, myocardial
      infarction, hypertension and thrombosis). DATA SOURCES: Over 100 articles (most
      published over the last 10 years) were reviewed. They included epidemiological,
      biochemical, physiological, animal and clinical studies which related to the
      effect oestrogens have on the cardiovascular system of postmenopausal women.
      These data contained a wide cross-section of results and outcomes and each study
      was summarised to provide the most relevant information. Where a particular study
      provided an opinion or result at variance with the majority opinion, that study
      has been discussed in greater detail. STUDY SELECTION: All published papers which
      appeared to be relevant to an understanding of the clinical implications of
      oestrogen replacement therapy and its impact on the female cardiovascular system
      were included in this analysis. Some papers which appeared to repeat data and
      results previously published were not included. DATA SYNTHESIS: The overwhelming
      eight of evidence from this literature review supports the concept that oestrogen
      reduces the risk of atherosclerosis and myocardial infarction. It also confirms
      that postmenopausal "natural" oestrogen is a vasodilating agent which will lead
      to a fall in blood pressure and an improvement in blood flow and the pulsatility
      index. Although oral oestrogen did appear to increase thrombogenic activity,
      there was no clinical evidence that "natural" oestrogen taken after the menopause
      increased the risk of venous thrombosis. CONCLUSIONS: The consensus of the
      published data is that oestrogen conveys a highly protective effect on the
      cardiovascular system of postmenopausal women. There will be a reduction of up to
      50% in myocardial infarction and stroke, a reduction in the incidence of
      hypertension and an improvement in blood flow. Some of the data suggest that even
      for women who have suffered from an infarct, their long-term survival is enhanced
      by oestrogen therapy. The medical myth that oestrogen has a deleterious effect on
      the cardiovascular system of women is finally laid to rest.

PMID- 1635501
TI  - Melioidosis in Sydney.

PMID- 1635502
TI  - Lead toxicity in cats.

PMID- 1635503
TI  - HIV testing of homosexual and bisexual men.

PMID- 1635504
TI  - RSI, whiplash and cervicobrachial pain.

PMID- 1635505
TI  - Medical aspects of euthanasia.

PMID- 1635506
TI  - Male homosexuality.

PMID- 1635507
TI  - Cultural variations in mental health.

PMID- 1635508
TI  - Cultural variations in mental health.

PMID- 1635509
TI  - Gonococcal arthritis: a Bangkok connection.

PMID- 1635510
TI  - Testing after vasectomy.

PMID- 1635511
TI  - Adolescent use of sun-protection measures.

PMID- 1635512
TI  - The New World screw-worm and other exotic myiases in Australia.

PMID- 1635513
TI  - Child abuse: does prosecution serve any useful purpose?

PMID- 1635514
TI  - The Privy Council and the professional foul.

PMID- 1635515
TI  - Environmental radiation risks near Sellafield judged trivial--the Merlin case.

PMID- 1635516
TI  - The legal consequences of shock. 1933.

PMID- 1635517
TI  - [Endoscopic sub-fascial perforant vein dissection in the treatment concept of
      primary varicose veins].
AB  - Subfascial dividing of insufficient perforating veins is considered the most
      effective therapeutic principle in the treatment of primary varicosis and
      postthrombotic changes or varicosis-related trophic disturbances of the skin. A
      new endoscopic technique allows these veins to be sectioned under direct vision,
      with little trauma. Between November, 1986 and August 1991, 74 patients underwent
      endoscopic sectioning of perforating veins in a total of 106 legs. In 100 legs,
      the procedure was combined with a conventional stripping operation. The
      perforating veins divided most frequently involved the Cockett group (223), the
      24 cm perforating vein (86) and the Boyd group (83). In three legs (2.8%) showing
      trophic skin changes in the lower leg area impaired wound healing was seen
      postoperatively. Follow-up examination carried out 27 months after the procedure
      revealed insufficient perforating veins in two of the legs treated. New varices
      were seen in nine legs. In terms of staging of chronic venous insufficiency,
      either a more favourable stage or complete healing can be achieved in 90 of the
      cases.

PMID- 1635518
TI  - [Image analysis of DNA cytometry in tumors of the upper gastrointestinal tract].
AB  - The prognostic influence on the DNA content was investigated in 189 patients
      (esophagus carcinoma n = 45, gastric cancer n = 103, pancreatic cancer n = 41)
      who underwent a curative resection. In a multivariate analysis the DNA content
      had a strong as well as an independent influence on the prognosis in esophagus
      cancer and in pancreatic carcinoma. In gastric cancer, the DNA content had no
      influence on the prognosis. These results show that the DNA content of the tumor
      cells, as a measurement of the numerous chromosomal aberrations, well reflects
      the aggressiveness of the tumor growth in esophagus- and pancreatic cancer. In
      these tumors it represents the decisive criteria for the prognostic judgement.

PMID- 1635519
TI  - [Morbidity and fatality of surgery for stomach cancer. Results of a prospective
      study on the importance of various risk factors].
AB  - A total of 172 patients with cancer of the stomach presenting between 1986 and
      1990 were entered into a prospective study. Total gastrectomy including extended
      lymph node dissection and splenectomy was done in 84 patients, simply gastrectomy
      in 28, resection in 29, and other operative procedures with no resection in 31
      patients. Postoperative morbidity rates were 38%, 21%, 17% and 26%, respectively,
      with 16% surgical and 24% nonsurgical complications, mainly pulmonary. Important
      parameters proved to be extensive resections such as extended total gastrectomy,
      intraoperative blood loss and general physical condition (ASA I/II 24%, ASA III
      34%). Total gastrectomy can be performed even in geriatric patients (greater than
      70 years), although these patients had a clearly higher morbidity rate (48% vs.
      35%) after extended procedures, the mortality rate not being increased. The
      overall mortality rate was 3.5%.

PMID- 1635520
TI  - [Perianal infections in Crohn disease. Results of local surgical treatment in
      comparison with non-Crohn patients].
AB  - In a prospective study the results of local surgery in perianal infections in
      patients with and without Crohn's disease were compared. In patients with Crohn's
      disease (CD) the abscesses and fistulas were more extensive and complicated than
      in patients without Crohn's disease (NCD). The source of infection was
      cryptoglandular in 81% (CD) resp. 100% (NCD). The wound healing in CD-patients
      was four weeks longer than in NCD patients. Abscesses or fistulas recurred in
      6/18 (CD) resp. 1/25 (NCD). Partial incontinence occurred in 6/18 CD and 5/25
      NCD. It is concluded that perianal infections can be treated successful in most
      of patients with Crohn's disease.

PMID- 1635521
TI  - [Recommendations for ambulatory diagnosis of sleep apnea].

PMID- 1635522
TI  - [Cumulative manifestations of acute intermittent porphyria].

PMID- 1635523
TI  - [Step-wise diagnosis in gastroenterology. Liver, bile, pancreas].

PMID- 1635524
TI  - [Successful fibrinolytic therapy of early diagnosed coumarin necrosis].

PMID- 1635525
TI  - [Recent findings in the field of pediatric ophthalmology].

PMID- 1635526
TI  - [The long-term prognosis of anorexia nervosa: the evaluation of hospital
      treatment].
AB  - The present study is the continuation of a previous programme performed by a mail
      or phone questionnaire. In this study 18 subjects with anorexia nervosa were
      submitted to a clinical semi-structured interview, and underwent a medical
      examination regarding eating habits and Rorschach tests. Clinical results seemed
      to be quite satisfactory (none died and 84% were greatly improved or had
      recovered clinically) whereas the psychopathologic aspects were less positive.
      The authors conclude that complete clinical evaluation can be considered the only
      safe approach for the understanding of the clinical course.

PMID- 1635527
TI  - [A sampling epidemiological study of infant health in relation to the type of
      feeding].
AB  - An epidemiological study has been carried out an the scholastic population of
      L'Aquila (Abruzzo). This study had the aim of verifying possible correlations
      between feeding procedures and the outbreak of illnesses whose causes are
      unknown. The information was registered with the collaboration of the Medical
      Scholastic Service, in the period of May-June in 1988-1989, interviewing four
      hundred and seventy-seven mothers of students, the information regards the
      temporary period of 1973-1985. The results of their elaboration are as follows:
      75.9% of babies took breast milk at birth and in following months breast feeding
      was the most frequent (34.8%). The procedure breast feeding-bottle feeding was
      carried out in 30.4% of cases and exclusively bottle feeding in 22.4%. The study
      has permitted to discover thirteen cases of illnesses whose cause are unknown
      among which a case of SIDS (sudden infant death syndrome) in a newborn baby fed
      till eighteen weeks with breast milk and through twenty days before dying with
      undiluted cows milk. These illnesses happened in 13.4% of babies fed by bottle
      milk and diluted with running water; in 7.7% by cow's milk diluted with running
      water and in 4.3% by undiluted cow milk. Some Authors have suspected a
      relationship between bacterial endotoxin introduced by diet and baby illnesses
      whose causes are unknown. For this a quantitative determination of such
      substances is necessary in baby diets.

PMID- 1635528
TI  - [The activities of a pediatric emergency department. The emergency problems].
AB  - The authors reviewed records of admission at the Fist Ais-Emergency Service of
      "G. Gaslini" Children's Hospital, data referring both to in and outpatients.
      First of all we took into account epidemiological data analysing occurrence and
      types of diseases; at the same time a demographic study, which aimed to show a
      decrease in the child population in Genova, was performed. Secondly we compared
      these data with the real number of admitted patients: collected data showed that
      this service has been used excessively.

PMID- 1635529
TI  - [Weight gain in the first 2 months of life in neonates with a birth weight less
      than or equal to 1500 g. A comparison between parenteral nutrition and orogastric
      feeding].
AB  - This study was designed to verify the effectiveness of parenteral nutrition (NP)
      and continuous nasogastric feeding (AOG) in providing a good caloric intake and a
      good growth in the very low birth weight infants during the first 60 days of
      life. The study included 108 preterm babies with birth weight less than or equal
      to 1500 g: 26 received parenteral nutrition, 82 nasogastric feeding. Infants in
      NP showed a smaller postnatal weight loss and regained birth weight earlier than
      the AOG group. Caloric intake greater than 120 kcal/kg/die was achieved in 10.2
      days of life in the NP group and in 14.1 days in the AOG group. Full enteral
      feeding was achieved later in the NP than in the AOG group (25.7 days vs 20.7
      days). Weight gain at 60 days of life was better in the NP group (23.2 g/die vs
      18.2 g/die), while there was no difference in the head circumference gain. The
      study shows the efficacy of NP in providing a good caloric intake in the very low
      birth weight infants in the first weeks of life.

PMID- 1635530
TI  - [Nutritional studies in a commune of Lazio. Anthropometric data and food
      consumption in childhood].
AB  - The present study concerns with anthropometric and nutritional data collected in
      the school population of a small rural town in Lazio. We studied 368 school
      children of both sexes, belonging to the following age groups: from 7 to 8 years,
      9 to 10 years, 11 to 12 years, 13 to 14 years. The technique of evaluation of
      obesity used in this paper is: weight 20% higher than the height-adjusted figure
      according to NCHS's curves and triceps skinfold higher than 90 degrees centile
      according to Tanner's curves. Dietary intake was assessed by a "24 hour-recall"
      on three consecutive days one of which of holiday. The prevalence of obesity is
      17.7%. In all the age groups daily caloric intake is adjusted to that recommended
      by Italian 1987 Larn. On the other hand the single nutrient's assumption shows
      important differences from Larn. Particularly in all the age groups daily protein
      intake is high (14.6%-15.8% of the energy in a day), with an increased animal
      vegetable protein ratio (1.5-2.1). Dietary lipids are higher than 35.9% of day's
      energy (35.9%-39.5%); the polyunsaturated/saturated fatty acids ratio is low (0.3
      0.5). Cholesterol in the diet (231-347 mg/day) exceeds the level recommended. The
      daily intake of total carbohydrates (45.3%-48.5%) is low. Crude fiber intake
      increases with age from 2.8 g to 4.5 g/day. There is no statistical difference
      between obese and not obese subjects for what concerns energy intake or single
      nutrient's assumption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635531
TI  - [A rare case of idiopathic staghorn urolithiasis in childhood. Imaging
      diagnosis].
AB  - The authors describe one case of kidney staghorn lithiasis in a little patient 1
      1/2 years old, as complication of a megacalycosis with associated pyelo-ureteral
      junction dysplasia. They underline the value of ultrasound both as a first
      examination and, particularly, in the follow up because of the non invasivity of
      the technique and the correct information about the persistence of calculi and
      dilatation.

PMID- 1635532
TI  - [Cardiac rhabdomyoma in tuberous sclerosis. A report of five cases and review of
      the literature].
AB  - Five children with tuberous sclerosis (TS), a polysystemic disease, had cardiac
      tumors detected by B-mode echocardiography. In a fetus, sonography performed at
      the eighth month showed the presence of a cardiac mass and of polycystic kidneys:
      the diagnosis of TS was confirmed postnatally because of the presence of
      calcified cerebral nodules. A newborn dichorial twin had paroxysmal tachycardia
      at ten days. B-mode echocardiography showed the presence of seven intracardiac
      tumors, and cerebral CT the presence of multifocal periventricular
      calcifications. An absence in a nine month old baby prompted an electrocardiogram
      that proved abnormal; a B-mode echocardiography showed large apical cardiac
      tumor; again cerebral CT showed periventricular calcified nodules. Two girls, 9
      and 10 y.o. respectively, affected by TS, with normal electrocardiograms, both
      presented a small, asymptomatic, intracardiac mass demonstrated sonographically.
      In recent years, prenatal sonography and B-mode echocardiography in patients with
      TS demonstrated with increasing frequency the association of cardiac tumors
      (rhabdomyomas) with TS. Tumor detection often precedes the appearance of the
      cutaneous and neurological signs typical of the disease. This paper emphasizes
      the role of echocardiography in detecting cardiac tumors, as an early sign for
      the diagnosis of tuberous sclerosis, and to depict the natural history of cardiac
      rhabdomyoma with its variable clinical presentation and prognosis.

PMID- 1635533
TI  - [The Fanconi-Bickel syndrome: one more case].
AB  - The association of de Toni-Debre-Fanconi syndrome with alteration of galactose
      metabolism and glycogen hepatic storage, before further clarification, is defined
      as Fanconi-Bickel syndrome. The Authors present a case in which the alterations
      in galactose metabolism typically do not affect the enzymes responsible for
      galactosemia. In such patients a recognised enzymatic defect glycogenosis is not
      involved and glycogen storage in the liver can be a secondary phenomenon, which
      can increase, differing according to each subject. Liver biopsy to detect storage
      can be avoided when all the other diagnostic criteria are observed.

PMID- 1635534
TI  - [The effects of lactitol in the treatment of intestinal stasis in childhood].
AB  - Thirty-nine children (18 males, 21 females) suffering from intestinal stasis were
      treated with lactitol or a reference drug (lactulose in crystalline form),
      according to a balanced randomization, for 15 days. The first group of children
      included 19 subjects treated with lactitol, the second group included 20 subjects
      treated with lactulose. The dosages of lactitol and lactulose were, respectively,
      of 150-350 mg/kg and of 150-300 mg/kg daily per os with a single administration
      in the morning. During the trial, the children did not take any concomitant drug.
      For each patient the tested parameters were: number of intestinal evacuations,
      consistency of stool and adverse reactions (abdominal swelling, abdominal pain,
      nausea, vomiting, meteorism) daily; routine laboratory tests at the beginning and
      at the end of the trials. The results showed that the subjects treated with
      lactitol have manifested, besides a proved therapeutic efficacy, a better
      tolerability and compliance than the subjects treated with lactulose.

PMID- 1635535
TI  - [The exercise test in cystic fibrosis: the usefulness and applicability of
      various methods].

PMID- 1635536
TI  - Neurotoxicity of phenytoin administered to newborn mice on developing cerebellum.
AB  - To examine the neurotoxic effects of phenytoin (PHT) on cerebellar development,
      we administered 50 mg/kg PHT suspended in sesame oil orally to newborn Jcl:ICR
      mice once a day during postnatal days 2-14 and determined plasma PHT
      concentrations at designated intervals during the administration period. In the
      treated group, walking reflex and negative geotaxis were poorly developed on
      postnatal day 14. Pyknotic cells in the external granular layer (EGL)
      significantly increased and were prominent in the vermis area compared with
      controls on postnatal day 14. Plasma PHT levels were 34-36 micrograms/ml on the
      3rd day of PHT treatment and approached a steady-state situation. Total brain
      weight, size of the cerebellum, and cerebellar weight were significantly reduced
      in the treated group on postnatal day 56. Accordingly, oral administration of PHT
      in the neonatal period induced neurotoxic damage on the developing cerebellum.

PMID- 1635537
TI  - The use of dose equivalency as a risk assessment index in behavioral
      neurotoxicology.
AB  - This article reports changes with graduated dosage of alcohol on a standardized
      set of cognitive and psychomotor performance tests and refers to the approach as
      dose equivalency. Subjects (N = 20) were tested until their performance was
      stable on 10 tests from a microcomputer test battery. After administration of
      sufficient alcohol to achieve .15 blood alcohol level (BAL), using breath as the
      independent variable, the descending branch of the BAL curve was followed by
      measuring performance at set levels of alcohol. A dose-response relationship was
      confirmed in all performance tests (p less than .01), and multiple regression was
      used to select performance subtests that maximally predicted alcohol level. Four
      subtests were combined into a linear composite that related well to alcohol
      levels above 0.05 BAL (shrunken R = .75), which was used in a power function to
      approximate the roughly linear relation above 0.05, as well as the clearly
      nonlinear function between 0.05 and zero. It is suggested that alcohol, a
      powerful central nervous system depressant, can be a useful metric in
      communicating risk in neurotoxicological research.

PMID- 1635538
TI  - Neurodevelopmental effect of aluminum in mice: fostering studies.
AB  - In order to determine sensitive periods for induction of neurodevelopmental
      effects of aluminum (Al), mice were fed either 25 (control) or 1000 (high Al)
      micrograms Al/g diet (as Al lactate) from conception through lactation and
      litters were fostered either within or between groups at birth. Birth parameters
      were not influenced by Al intake. Food intake and body weight were 10%-12% lower
      during lactation in dams fed the high Al diets. Both gestation and lactation high
      Al exposure led to growth retardation in offspring beginning on day 10 postnatal;
      combined gestation and lactation exposure led to the biggest weight differential
      at weaning (23%). For neurobehavioral measures obtained at weaning, forelimb
      grasp strength was influenced by gestation high Al exposure, whereas negative
      geotaxis was influenced by lactation exposure, and hindlimb grasp and temperature
      sensitivity were influenced by both gestation and lactation exposure. Pup liver
      and brain manganese (Mn) and liver iron (Fe) concentrations at weaning were lower
      after high Al lactation exposure than in controls. Pup brain and liver Al
      concentrations were similar among the groups. These data show that mice are
      susceptible to neurodevelopmental effects of high maternal dietary Al intake
      during both gestation and lactation, and that high maternal intake can result in
      altered essential trace element metabolism in the offspring.

PMID- 1635539
TI  - Effects of prenatal cocaine on behavioral responses to a cocaine challenge on
      postnatal day 11.
AB  - The purpose of this study was to investigate the effects of prenatal cocaine
      treatment on behavioral responsivity to a cocaine challenge on postnatal day (PD)
      11. Timed-pregnant Sprague-Dawley rats were injected s.c. with 40 mg/kg/day of
      cocaine (20 mg/kg twice daily) from gestational day 11 to 20. Saline-control
      females received saline injections and were pair-fed to the cocaine-treated
      females, whereas untreated-control females were undisturbed and were fed ad lib.
      Litters were culled to eight pups on PD1 and fostered to normal lactating dams.
      On PD 11, subjects were given either saline or cocaine (1.25, 2.5, or 5.0 mg/kg
      s.c.) and then tested 15 min later for isolation-induced ultrasonic vocalizations
      and other behaviors. Prenatal cocaine-treated pups showed a reduced sensitivity
      to the stimulating effect of postnatal cocaine on wall climbing, which may
      reflect an underlying alteration in central dopaminergic and/or noradrenergic
      systems. Most of the other behaviors studied, including ultrasonic vocalizations,
      were unaffected by prenatal cocaine administration. However, one other notable
      finding was an increase in postnatal mortality among the cocaine-exposed pups. We
      hypothesize that prenatal cocaine treatment may alter pup behavior so as to
      produce abnormal maternal-offspring interactions and impaired development in some
      individuals.

PMID- 1635540
TI  - Development of neurons and synapses in ochratoxin A-induced microcephalic mice: a
      quantitative assessment of somatosensory cortex.
AB  - Ochratoxin A (a mycotoxin) is known to cause cell death in the developing brain
      of embryos 1-2 days after treatment. Microcephaly was observed with high
      frequency in mice by prenatal treatment with ochratoxin A. Using a stereological
      method, the numerical densities of neurons and synapses were investigated in the
      somatosensory cortex of 6-week-old microcephalic mice. The numerical density of
      neurons in ochratoxin A-treated mice represented a 39% increase compared to the
      control mice, but there was no difference in the numerical density of synapses.
      The somatosensory cortices of control mice had about 13,000 synapses per neuron,
      whereas ochratoxin A-treated mice had about 9,400 synapses per neuron. The
      deficits in synapse-to-neuron ratios seen in ochratoxin A-induced microcephalic
      brain seemed to result from a reduced dendritic growth.

PMID- 1635541
TI  - The use of repeated measures analyses in developmental toxicology studies.
AB  - In many toxicology studies, it is common to take the same measurements on an
      individual animal at several time points (e.g., body weight across days or weeks,
      activity levels either within a single test session or across days). Such
      repeated measures for both maternal and offspring endpoints routinely are
      incorporated into developmental toxicology studies to allow characterization of
      the profile of treatment-related effects over time. To permit a valid statistical
      analysis, repeated measures studies are characterized by: random assignment of
      treatment to experimental units, measurement of the variable(s) of interest at
      the same time points for all animals, and avoidance of systematic overlaying of
      treatment and potential response gradients. Assumptions for and advantages of the
      use of a repeated measures analysis of variance versus single-factor analyses at
      each time point are illustrated in two data sets from a rat perinatal and
      postnatal study. The variance-covariance structure of repeated measures designs
      dictates that adjustments are necessary to provide protection against inflated
      Type 1 error rates. Communication between statisticians and toxicologists which
      allow the implementation of such analyses can improve the interpretation of data
      resulting from repeated measures study designs.

PMID- 1635542
TI  - Principles and pitfalls in the analysis of prenatal treatment effects in
      multiparous species.
AB  - Developmental studies often assess the effect of treatment of the pregnant mother
      on offspring. The use of multiparous species such as rats and mice in such
      studies creates a special set of design and analysis problems. These arise for
      two reasons. First, the availability of many offspring per litter tempts the
      experimenter to inflate sample size by treating scores from several pups per
      litter as independent observations. Second, large litter size seldom makes it
      practical to measure exposure effects in all offspring of an exposed dam. Such
      studies commonly involve two-stage sampling: Drawing a random sample of dams for
      treatment, then drawing a second sample of pups per dam for neurobehavioral
      measurements. In this article, such sampling was modeled by two different
      simulations. The first, a standard Monte-Carlo approach, sampled from random
      normal distributions for litter mean and within-litter variability. The second
      simulation sampled without replacement from actual data on weight of all pups in
      a series of 39 nontreated rat litters. These mutually-supportive approaches
      demonstrate that litter effects, even over as few as three litters, are generally
      large and statistically meaningful. Consequently, statistical significance tests
      are sensitive to litter effects. Inflation of sample size by treating as few as 2
      pups per litter as independent measurements can almost triple the nominal 0.05
      alpha level. Furthermore, two-stage sampling increases the within-treatment error
      term and correspondingly reduces statistical power relative to one-stage
      sampling.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635543
TI  - The teaming leader in nursing--trendsetter for the 1990s.

PMID- 1635544
TI  - Certification is formal recognition for RN's demonstrated competence.

PMID- 1635545
TI  - Trends in ischemic heart disease mortality--United States, 1980-1988.
AB  - In 1989, approximately 500,000 persons died from ischemic heart disease (IHD),
      the leading cause of death in the United States (1). This report summarizes an
      analysis by CDC to characterize trends in IHD mortality in the United States from
      1980 through 1988 (the latest year for which data are available), and emphasizes
      comparisons by race and sex, region, and state.

PMID- 1635546
TI  - Pregnancy risks determined from birth certificate data--United States, 1989.
AB  - The 1989 revision of the "U.S. Standard Certificate of Live Birth" includes new
      items of information about medical and lifestyle risk factors related to
      pregnancy, birth, and method of delivery (1,2). This report presents data about
      three of these new items: maternal weight gain during pregnancy, smoking during
      pregnancy, and method of delivery. For this analysis, to allow for more in-depth
      comparisons, data were limited to the two largest racial groups (black and white)
      in the United States.

PMID- 1635547
TI  - Homicide surveillance--United States, 1979-1988.
AB  - From 1979 through 1988, 217,578 homicides occurred in the United States, an
      average of greater than 21,000 per year. Homicide rates during this 10-year
      period were about 1.5 times higher than the rates during the 1950s. The national
      homicide rate of 10.7/100,000 in 1980 was the highest ever recorded. Homicide
      occurs disproportionately among young adults. Among the 15- to 34-year age group,
      homicide is the fourth most common cause of death among white females, the third
      most common cause among white males, and the most common cause among both black
      females and black males. In 1988, nearly two-thirds (61%) of homicide victims
      were killed with a firearm, 75% of these with a handgun. More than half (52%) of
      homicide victims were killed by a family member or acquaintance, and about one
      third (35%) of homicides stemmed from a conflict not associated with another
      felony. The homicide mortality rate among young black males 15-24 years of age
      has risen 54% since 1985. Ninety-nine percent of the increase was accounted for
      by homicides in which the victim was killed with a firearm. The surveillance data
      summarized in this report should assist public health practitioners, researchers,
      and policymakers in addressing this important public health problem.

PMID- 1635548
TI  - Influenza--United States, 1989-90 and 1990-91 seasons.
AB  - During the 1989-90 influenza season, 98% of all influenza viruses isolated in the
      United States and reported to CDC were influenza A. Almost all those that were
      antigenically characterized were similar to influenza A/Shanghai/11/87(H3N2), a
      component of the 1989-90 influenza vaccine. Regional and widespread influenza
      activity began to be reported in late December 1989, peaked in mid-January 1990,
      and declined rapidly through early April 1990. Most of the outbreaks reported to
      CDC were among nursing-home residents. Considerable influenza-associated
      mortality was reflected in the percentage of deaths due to pneumonia and
      influenza (P&I) reported through the CDC 121 Cities Surveillance System from
      early January through early April. More than 80% of all reported P&I deaths were
      among persons greater than or equal to 65 years. In contrast to the predominance
      of influenza A during 1989-90, during the 1990-91 influenza season 86% of all
      influenza virus isolations reported were influenza B. Widespread influenza
      activity was reported from mid-January through April 1991, with regional activity
      extending into May. Outbreaks were reported primarily among schoolchildren, and
      no evidence of excess influenza-associated mortality was found. Almost all the
      influenza B isolates tested were related to influenza B/Yamagata/16/88, a
      component of the 1990-91 influenza vaccine, but were antigenically closer to
      B/Panama/45/90, a minor variant.

PMID- 1635549
TI  - Chancroid in the United States, 1981-1990: evidence for underreporting of cases.
AB  - Chancroid, a bacterial sexually transmitted disease (STD) characterized by
      genital ulceration, has reemerged in the United States during the last decade.
      From 1950 to 1980, cases were infrequently reported. After an epidemic in
      California in 1981, however, the numbers of cases increased, peaking in 1987 at
      5,035. Despite a subsequent decline in numbers of reported cases to 4,223 in
      1990, new areas continue to report outbreaks. Interpreting chancroid surveillance
      data is difficult because confirmatory culture media are not commercially
      available. In addition, states may not require that unconfirmed or even confirmed
      cases be reported. To determine if chancroid is more widely distributed than
      surveillance figures indicate, CDC contacted STD clinics in 115 health
      departments, located in 32 states, the District of Columbia, and Puerto Rico-
      areas chosen because they had reported five or more cases of chancroid in any
      single year during 1986-1990--to determine if cases might be occurring but not
      reported. Only 16 of the 115 clinics had culture media available for Haemophilus
      ducreyi, and only nine had laboratory facilities complete enough to definitively
      diagnose chancroid, syphilis, or genital herpes, the most common STDs
      characterized by genital ulcers. Five or more clinically likely cases occurring
      in 1990 were identified in 24 states, seven more than surveillance figures
      indicated. Surveillance can be improved if a) states utilize the definitions for
      chancroid cases adopted for use in 1990 and b) microbiology laboratories utilize
      enhanced diagnostic methods.

PMID- 1635550
TI  - Chemical modification and irreversible inhibition of striatal A2a adenosine
      receptors.
AB  - The ligand recognition site of A2a-adenosine receptors in rabbit striatal
      membranes was probed using non-site-directed labeling reagents and specific
      affinity labels. Exposure of membranes to diethylpyrocarbonate at a concentration
      of 2.5 mM, followed by washing, was found to inhibit the binding of [3H]CGS 21680
      and [3H]xanthine amine congener to A2a receptors, by 86 and 30%, respectively.
      Protection from diethylpyrocarbonate inactivation by an adenosine receptor
      agonist, 5'-N-ethylcarboxamidoadenosine, and an antagonist, theophylline,
      suggested the presence of two histidyl residues on the receptor, one associated
      with agonist binding and the other with antagonist binding. Binding of [3H]CGS
      21680 or [3H]xanthine amine congener was partially restored after incubation with
      250 mM hydroxylamine, further supporting histidine as the modification site.
      Preincubation with disulfide-reactive reagents, dithiothreitol or sodium
      dithionite, at greater than 5 mM inhibited radioligand binding, indicating the
      presence of essential disulfide bridges in A2a receptors, whereas the
      concentration of mercaptoethanol required to inhibit binding was greater than 50
      mM. A number of isothiocyanate-bearing affinity labels derived from the A2a
      selective agonist 2-[(2-aminoethylamino) carbonylethylphenylethylamino]-5'-N-
      ethylcarboxamidoadenosine (APEC) were synthesized and found to inhibit A2a
      receptor binding in rabbit and bovine striatal membranes. Binding to rabbit A1
      receptors was not inhibited. Preincubation with the affinity label 4
      isothiocyanatophenylaminothiocarbonyl-APEC (100 nM) diminished the Bmax for
      [3H]CGS 21680 binding by 71%, and the Kd was unaffected, suggesting a direct
      modification of the ligand binding site. Reversal of 4
      isothiocyanatophenylaminothiocarbonyl-APEC inhibition of [3H]CGS 21680 binding
      with hydroxylamine suggested that the site of modification by the isothiocyanate
      is a cysteine residue. A bromoacetyl derivative of APEC was ineffective as an
      affinity label at submicromolar concentrations.

PMID- 1635551
TI  - Tunicamycin increases desensitization of junctional and extrajunctional
      acetylcholine receptors expressed in Xenopus oocytes by a mechanism independent
      of N-glycosylation blocking.
AB  - Extrajunctional and junctional mouse muscle acetylcholine receptors (AChRs)
      expressed in Xenopus oocytes in the presence of tunicamycin desensitized more
      rapidly than the corresponding AChRs synthesized in the absence of tunicamycin.
      The two types of AChR expressed in non-tunicamycin-treated oocytes could be
      distinguished by their different rates of desensitization, but tunicamycin
      diminished this difference. The effect of tunicamycin on the AChR desensitization
      appeared to be reversible, and coapplication of tunicamycin with acetylcholine
      (ACh) also caused a similar effect on desensitization of these AChRs suggesting
      that the effect of tunicamycin was mediated by a mechanism independent of N
      glycosylation blocking. In addition, tunicamycin increased the amplitude of
      membrane current elicited by application of lower doses of ACh and accelerated
      the rate of desensitization, which suggests that tunicamycin favors an open
      channel state and, therefore, accelerates transition towards a desensitized
      state. Tunicamycin also increased the membrane current decay elicited by ACh in
      oocytes expressing incomplete AChRs, missing the beta, gamma, epsilon, or delta
      subunits.

PMID- 1635552
TI  - Staurosporine-induced neurite outgrowth in PC12 cells is independent of protein
      kinase C inhibition.
AB  - The protein kinase C (PKC) inhibitor staurosporine, a member of the K252a family
      of fungal alkaloids that are known as protein kinase inhibitors, induces neurite
      outgrowth in pheochromocytoma PC12 cells. The progressive staurosporine-induced
      neurotropic effect (EC50 = 50 nM) has the following characteristics: it is
      evident after 4 hr of incubation, requires the continuous presence of
      staurosporine, occurs at 37 degrees but not at 4 degrees, and is not blocked by
      K252a derivatives. Scanning electron micrographs showed long neurites, ruffling,
      and dense networks in nerve growth factor (NGF)-treated cells and short neurites,
      flattening, and smooth cell surface in staurosporine-treated cells.
      [3H]Staurosporine binding, which was time, temperature, and dose dependent,
      saturated at 5-10 nM. Other kinase inhibitors were poor competitors. The
      [3H]staurosporine bound over 20 hr at 37 degrees was poorly dissociated by acetic
      acid wash or unlabeled staurosporine. These results suggest an uptake process
      occurring at 37 degrees that is required for the neurotropic effect of
      staurosporine. NGF did not interfere with staurosporine binding, and
      staurosporine did not affect NGF receptor binding. At neurotropic concentrations
      of staurosporine, PKC in PC12 cells was completely inhibited. When PKC activity
      was down-regulated by prolonged exposure to phorbol myristate acetate, PC12 cells
      responded to staurosporine with neurite outgrowth similar to that of untreated
      cells. Although the target and mechanism of the neurotropic effects of
      staurosporine remain to be determined, the observed effects on PKC-deficient
      cells indicate that PKC may not be required for the neurotropic effect of this
      compound in PC12 cells. These results suggest that caution should be taken in the
      interpretation of staurosporine action in vivo, and they provide a
      pharmacological tool for the development of potential neurotropic drugs.

PMID- 1635553
TI  - Molecular neurotoxicology of trimethyltin: identification of stannin, a novel
      protein expressed in trimethyltin-sensitive cells.
AB  - The molecular basis of selective vulnerability of specific neuronal populations
      to neurotoxicants remains a key focus in neurotoxicology. Trimethyltin (TMT)
      selectively damages neurons in rodent and human central nervous system after a
      single exposure. By coupling subtractive hybridization with molecular cloning
      techniques, we isolated a cDNA specifically localized in TMT-sensitive cells.
      This 2.9-kilobase cDNA encodes a putative 10-kDa peptide of 88 amino acids,
      termed "stannin." In immunocytochemical experiments, antisera raised against the
      amino terminus of stannin exhibited strong immunoreactivity in TMT-sensitive
      neurons in the hippocampus and entorhinal cortex, areas previously identified by
      in situ hybridization. Northern blot and in situ hybridization experiments
      detected a 3.0-kilobase stannin mRNA in brain, spleen, and kidney; expression
      occurred as early as embryonic day 15 in rat brain and thymus. In situ
      hybridization in human hippocampus demonstrated a stannin mRNA in pyramidal and
      dentate gyrus neurons. High stringency Southern blot analysis of genomic DNA
      identified stannin homologs in rabbit, Drosophila, and human. These findings
      indicate that stannin is present in TMT-sensitive cells and may play a role in
      the selective toxicity of organotin compounds.

PMID- 1635554
TI  - Gender-related expression of rat microsomal epoxide hydrolase during maturation:
      post-transcriptional regulation.
AB  - Expression of microsomal epoxide hydrolase (mEH), levels of mEH mRNA, and the
      rate of mEH mRNA transcription were examined in hepatic and renal tissues at 4,
      24, 44, and 56 weeks of age in male and 4, 14, 24, 34, and 44 weeks of age in
      female Sprague-Dawley rats. Immunoblot analyses revealed that hepatic mEH levels
      in males increased in an age-dependent manner, with a maximal increase
      (approximately 3-fold) being noted at 44 weeks of age, whereas the expression of
      hepatic mEH in females decreased significantly at 14 weeks of age or older, by
      approximately 70%s, compared with that of 4-week-old rats. Microsomes from kidney
      tissue failed to exhibit an age-dependent change in either sex. mEH mRNA levels
      were measured in total and poly(A)+ RNA isolated from hepatic and renal tissues.
      RNA blot hybridization analyses, probed with a 1.3-kilobase mEH cDNA, revealed
      that the levels of hepatic mEH mRNA in total RNA isolated from males were
      elevated approximately 1.5-, 2.8-, and 2.3-fold at 24, 44, and 56 weeks of age,
      respectively, relative to those at 4 weeks of age, whereas the levels of hepatic
      mEH mRNA in poly(A)+ RNA from males failed to change in an age-dependent manner.
      In contrast, the levels of hepatic mEH mRNA in either total or poly(A)+ RNA from
      female animals were dramatically decreased from 4 to 14 weeks of age, by
      approximately 90%. The suppressed levels of mEH mRNA in females were maintained
      at 24, 34, and 44 weeks of age (approximately 80%). However, the levels of renal
      mEH mRNA failed to change in an age-dependent manner in either sex, which was
      consistent with there being no change in the levels of mEH protein in kidney. In
      order to examine whether the gender-related maturational changes in hepatic mEH
      mRNA levels could result from transcriptional regulation, nuclear run-on assays
      were performed. The rate of hepatic mEH gene transcription failed to change in
      either males or females at the ages that exhibited significant changes in both
      mRNA levels and protein expression, suggesting that transcriptional regulation is
      not associated with the gender-dependent modulation of mEH mRNA levels during
      maturation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1635555
TI  - Affinity alkylation of hamster hepatic arylamine N-acetyltransferases: isolation
      of a modified cysteine residue.
AB  - N-Acetyltransferases (NATs) play key roles in the detoxification and/or
      bioactivation of arylamines, arylhydroxylamines, arylhydroxamic acids, and
      hydrazines in mammalian tissues. In the present study, two hamster hepatic NATs
      (NAT I and NAT II) were separated, and each was purified greater than 2000-fold
      by sequential ammonium sulfate fractionation, DEAE anion exchange chromatography,
      Sephadex G-75 gel filtration chromatography, aminoazobenzene-coupled affinity
      chromatography, and DEAE anion exchange high performance liquid chromatography.
      Both NAT I and NAT II were purified to near-homogeneity. The molecular masses of
      NAT I and NAT II were estimated to be 30.5 kDa and 32.6 kDa, respectively. 2
      (Bromoacetylamino)fluorene (Br-AAF) and bromoacetanilide were synthesized and
      evaluated as affinity labels for NAT I and NAT II. Whereas Br-AAF was a highly
      selective inactivator of NAT II, bromoacetanilide inactivated both NAT I and NAT
      II in a similar fashion. Inactivation of NAT II by both Br-AAF and
      bromoacetanilide, and inactivation of NAT I by bromoacetanilide, followed pseudo
      first-order kinetics. Relative rate constants (k(obs)/[I]) for the two compounds
      indicate that Br-AAF is approximately 25 times more potent than bromoacetanilide
      as an inactivator of NAT II. Both acetylcoenzyme A (CoASAc) and 2
      acetylaminofluorene protected NAT II from inactivation by Br-AAF, and CoASAc
      provided protection of both NAT I and NAT II activities from inactivation by
      bromoacetanilide, indicating that the inactivation by both bromoacetanilide and
      Br-AAF is active site directed. The irreversibility of the inactivation of NATs
      by Br-AAF and bromoacetanilide was demonstrated by the failure to recover
      transacetylase activities after gel filtration of enzyme preparations that had
      been preincubated with Br-AAF or bromoacetanilide. Preincubation of NAT II with
      CoASAc significantly reduced the incorporation of [14C]Br-AAF into the enzyme,
      providing further evidence that the labeling is active site directed. In
      addition, pretreatment of NAT II with N-ethylmaleimide completely prevented the
      labeling of NAT II with [14C]Br-AAF, which suggests that a cysteine thiol is the
      target nucleophile of Br-AAF. High performance liquid chromatography analysis of
      the hydrochloric acid hydrolysate of [14C]Br-AAF-labeled NAT II revealed that 70%
      of total radioactivity is associated with S-carboxymethyl-L-cysteine, indicating
      that Br-AAF reacts primarily with a cysteine residue at the active site. These
      studies provide direct evidence that hamster hepatic NAT II contains an essential
      cysteine residue at the active site, and they establish the potential utility of
      Br-AAF for determining amino acid sequences in the active site of hamster hepatic
      NAT II.

PMID- 1635556
TI  - Identification of amino acid residues of 5-lipoxygenase-activating protein
      essential for the binding of leukotriene biosynthesis inhibitors.
AB  - 5-Lipoxygenase-activating protein (FLAP) is specifically labeled by [125I]L
      669,083 and [125I]L-691,678, photoaffinity analogues of two classes of potent
      leukotriene biosynthesis inhibitors. Because human FLAP contains only a single
      tryptophan residue at position 72 and two internal methionine residues at
      positions 89 and 125, we have used reagents that specifically cleave at these
      residues, in conjunction with antipeptide antisera, to localize the site of
      attachment of the photoaffinity ligands. Immunoprecipitation of specifically
      labeled peptide fragments after digestion of photoaffinity-labeled FLAP by
      iodosobenzoic acid at 72Trp demonstrates that the inhibitors bind to FLAP amino
      terminal to this residue. This finding is consistent with similar
      immunoprecipitation studies after digestion at methionine residues using cyanogen
      bromide. These findings localize the site of attachment of the inhibitors to a
      region of FLAP that includes the hydrophilic loop between the proposed first and
      second transmembrane regions. Based on these findings, site-directed mutagenesis
      of human FLAP was performed to define key amino acids involved in inhibitor
      binding. Using a radioligand binding assay, analysis of mutants of human FLAP
      expressed in COS-7 cells demonstrates that a number of residues in the amino
      terminal half of the first hydrophilic loop of the protein can be deleted without
      significantly affecting inhibitor binding. In contrast, no inhibitor binding was
      detectable with mutants in which amino acid residues in the carboxyl-terminal
      half of this loop were deleted. Furthermore, a point mutation of 62Asp to
      asparagine results in a mutant with dramatically reduced affinity for inhibitors.
      This loss of affinity was not displayed by a mutant in which 62Asp was mutated to
      a glutamate residue, suggesting that a negative charge associated with residue 62
      may be critical for inhibitor binding. The roles that amino acid residues in the
      carboxyl-terminal half of the first hydrophilic loop of FLAP may play in the
      binding of leukotriene biosynthesis inhibitors are currently under investigation.

PMID- 1635557
TI  - A shuttle vector system for the investigation of immunoglobulin gene
      hypermutation: absence of enhanced mutability in intermediate B cell lines.
AB  - Somatic hypermutation focused to the rearranged V(D)J segment of the
      immunoglobulin (Ig) loci contributes substantially to antibody gene
      diversification. However, neither the precise B cell subset subject to
      hypermutation nor the molecular mechanism(s) involved is known. One model
      proposes that Ig segments may be uniquely susceptible to DNA nicking and
      subsequent error-prone repair during a specific B cell developmental stage. We
      describe an SV40-based shuttle vector system for testing such a model. Plasmids
      containing two distinct Ig segments juxtaposed to the supF marker gene have been
      passaged through cell lines representing intermediate stages of B cell
      development, rescued and screened for marker gene mutations. To date we have not
      demonstrated enhanced supF mutation in any cell line examined, irrespective of
      the adjacent Ig segment. Thus, these cell lines exhibit normal DNA repair
      mechanisms and no evidence of increased endonuclease activity on the Ig segments
      tested. The feasibility of this system will allow similar experiments using other
      Ig target sequences exposed to a broader range of B cells.

PMID- 1635558
TI  - Sequences of variable regions of a monoclonal antibody specific to the thyroid
      hormone, triiodo-L-thyronine.
AB  - We have determined the nucleotide sequences of the variable regions of H and L
      chains of a monoclonal antibody 98QQ that interacts with the thyroid hormone
      triiodo-L- thyronine with high affinity. Analysis of the nucleotide sequence of
      the light chain V region of 98QQ revealed that the VL sequence is 99% identical
      to Balb/c germline Vk 21-E sequence. That is an interesting finding with this
      high affinity anti-T3 antibody, since occurence of predominantly germline
      variable region sequences is observed in some autoantibodies to self antigens but
      not usually in high affinity IgG antibodies. The sequence analysis also revealed
      that the heavy chain variable region sequence of 98QQ is similar to a V region of
      an anti-DNA antibody (MRL DNA 22). Thus the sequence analysis of our anti-T3 mAb
      98QQ has revealed some features of autoantibodies to self antigens.

PMID- 1635559
TI  - Synthesis and secretion of a functional antibody in a vaccinia virus expression
      system.
AB  - A humanized rat monoclonal antibody (Campath 1H) has been expressed in HeLa cells
      using recombinant vaccinia viruses. Heavy and light chain recombinant viruses
      were constructed separately and when grown independently produced proteins of the
      expected molecular weights. Expressed heavy chain was entirely intracellular but
      light chain was mainly excreted and processed. When cells were infected at high
      multiplicity with both heavy and light chain recombinants a proportion of the
      heavy chain was then found in the extracellular medium. This secreted heavy chain
      was shown to be associated with light chain as judged by co-electrophoresis in
      non-reducing SDS polyacrylamide gels and by co-purification on protein-A
      sepharose. The secreted heavy and light chain complexes were functionally active
      as an antibody, with activity comparable to authentic Campath 1H antibody as
      assessed by ELISA, T-cell binding and antigen binding assays. Production of
      antibody in this system was achieved in the absence of serum, which is an
      important consideration in the production of monoclonal antibodies (MAbs). The
      amount of antibody produced was 0.2-0.4 micrograms/10(6) cells without
      optimization of expression levels. The wide host cell range of vaccinia virus
      together with the recently developed methods for increasing expression levels
      make this an attractive candidate as a flexible general vehicle for producing
      MAbs.

PMID- 1635560
TI  - Isolation and sequence of a cDNA coding for the immunoglobulin mu chain of the
      sheep.
AB  - A sheep cDNA library was screened with a human C mu probe, and the complete
      nucleotide sequence of a 1923 nt cDNA was determined. It contains sequences
      corresponding to all the exons (VH, DH, JH, CH1, CH2, CH3 and CH4) characteristic
      of the immunoglobulin mu heavy chain regions. The deduced amino acid sequence
      shows a percentage of identical residues in the range 65-45% when compared with
      the mu chains of various species. The VH region of this clone is clearly related
      to a group of genes that includes mouse VH36-60 and VHQ52, human VH2, VH4 and VH6
      gene families and Xenopus VHII gene families. The constant region shows an
      unusual repartition of cystein and proline residues at the beginning of the CH2
      domain, that may result in a molecule with enhanced stability and reduced
      flexibility.

PMID- 1635561
TI  - Characterization of soman-binding antibodies raised against soman analogs.
AB  - The production of antibodies against the highly toxic organophosphorus compound
      soman (GD) has been undertaken. Monoclonal antibodies were raised against two
      structural analogs of soman which served as haptens for immunization. In these
      soman analogs the chemically active P-F bond of the soman molecule was
      substituted by a P-OH group (which is ionized to P-O- under physiological
      conditions) or a P-H bond, creating compounds which we have named GDOH and GDH,
      respectively. These soman analogs were linked to carrier proteins through a short
      linker extending from the pinacolyl group. Monoclonal antibodies were selected
      according to their ability to bind to the immunizing hapten, and their
      specificities were determined by competitive inhibition assays. Out of total of
      103 anti-GDOH antibodies 22 bound soman, whereas no binding was achieved with 62
      anti-GDH antibodies. The two groups of monoclonal antibodies differed also in
      their structural specificity as demonstrated by different reactivities against a
      variety of soman analogs and substituted derivatives. These studies indicate that
      in order to achieve further improvement in anti-soman reactivity with protective
      potential, other groups (which resemble the OH group) have to be substituted for
      the F atom in the soman molecule.

PMID- 1635562
TI  - Mitogen-induced human T cell proliferation is associated with increased
      expression of selected PKC genes.
AB  - The induction of T cell proliferation and differentiation into mature effector
      cells is dependent on two principal exogenous signals that are provided by the
      antigen or mitogen and IL2. The enzyme protein kinase C (PKC) has a major role in
      the antigen-receptor signalling pathway in T cells, but appears not to be
      involved in signalling via the IL2-receptor (IL2-R). Since both pathways trigger
      a series of sequentially coordinated transcriptional events in which numerous
      genes are activated, we tested whether a T cell mitogen acting via the TCR/CD3
      complex, and IL2, affect the expression of the conventional, Ca(2+)-dependent,
      PKC genes (alpha, beta and gamma) in T cells. Stimulation of human peripheral
      blood lymphocytes or an enriched population of human T cells with
      phytohemagglutinin resulted in augmented mRNA levels of PKC alpha and PKC beta,
      but not PKC gamma-gene. The response peaked at 24-48 hr when a 3-5-fold increase
      was observed. Stimulation of IL2-R alpha-expressing T cells with human
      recombinant IL2 induced cell proliferation and transcription of the IL2-R alpha
      gene (greater than 100-fold), but did not change mRNA levels of PKC alpha or PKC
      beta genes. The results suggest that stimulation of human T cells with mitogens
      acting via the TCR/CD3 complex, that involve activation of PKC, is accompanied
      also by a late activation of selected PKC genes. By contrast, agonists such as
      IL2, that operate via a different signalling pathway, do not modify the
      expression of any of the known conventional PKC genes.

PMID- 1635563
TI  - Interaction of aglycosyl immunoglobulins with the IgG Fc transport receptor from
      neonatal rat gut: comparison of deglycosylation by tunicamycin treatment and
      genetic engineering.
AB  - The role of carbohydrate in the structure and function of immuno-globulin Fc
      regions has been studied using the interaction of a monoclonal mouse IgG2b anti
      NIP antibody with the IgG Fc transport receptor from neonatal rat gut. An
      aglycosyl variant of this immunoglobulin, in which site-directed mutagenesis had
      been used to eliminate the carbohydrate attachment site in the CH2 domain by
      changing Asn297 to Ala, was compared in this system to aglycosyl immunoglobulin
      prepared from immunoglobulin-secreting cells treated with tunicamycin to inhibit
      N-linked glycosylation. Loss of carbohydrate from the heavy chain was confirmed
      for both methods by Western blotting of the separated chains with Concanavalin A,
      and no significant differences in circular dichroism spectra were found between
      glycosylated and non-glycosylated mutants. Removal of carbohydrate by site
      directed mutagenesis had no effect on binding of the immunoglobulin to the Fc
      transport receptor (FcTR) in vitro or transport from the gut to blood in vivo.
      Short-term clearance from circulation and degradation by gut contents in vitro
      were similarly unaffected. Mutation of Glu235 to Leu, an alteration that allows
      binding to human monocyte Fc gamma RI, did not alter the interaction with FcTR.
      However, treatment of wild-type or aglycosyl mutant cells with tunicamycin
      resulted in immunoglobulin which was less stable, cleared more rapidly and was
      transported slightly less efficiently. These findings indicate that the binding
      site for the FcTR may be unique among Fc-binding ligands, and that tunicamycin
      treatment may cause alterations in the immunoglobulin molecule in addition to
      loss of N-linked carbohydrate.

PMID- 1635564
TI  - The immunochemistry of sandwich ELISAs--V. The capture antibody performance of
      polyclonal antibody-enriched fractions prepared by various methods.
AB  - Studies compare the performance of antibody-enriched serum fractions prepared by
      various methods, when adsorbed on polystyrene microtiter wells as capture
      antibodies (CAbs) and tested against multivalent antigens. The criteria of
      performance in the RIA used included antigen capture capacity (AgCC) and the nmol
      of functional capture sites per microtiter well (CAbt). Affinity purified
      polyclonal (pAb) and monoclonal antibodies (mAb) were employed as reference CAbs.
      AgCC was highest for enriched fractions prepared using caprylic acid and a high
      pressure SpG affinity column. The performance of capture antibodies is expressed
      by an equation which was empirically derived and experimentally tested; CAbt x
      AgCC/ng adsorbed IgG. In terms of this parameter, CAb-enriched fractions prepared
      with caprylic acid performed best. The data reported also provide insight into
      solid-phase ligand immunochemistry. Adsorbed polyclonal CAb performed with
      remarkable homogeneity in percent bound and in Scatchard plots. Values obtained
      for CAbt from Steward-Petty plots were directly correlated with the length of the
      LBR of log-log percent bound plots but indicated that less than 10% of the
      potential capture sites of polyclonal CAbs remained functional after adsorption;
      mAb showed a more serious loss of activity. The loss of CAbt was a general
      phenomenon for all preparations tested although relative to their antibody
      content, certain antibody-enriched fractions retained a higher proportion of CAbt
      than their affinity-purified counterparts. Comparative studies in which the
      activity of adsorbed mAb and pAb was compared to the same antibodies immobilized
      by a non-adsorptive procedure, indicated that adsorbed CAbs also express lower
      affinity. The studies we report offer a single parameter criterium for
      comparatively evaluating CAb performance while simultaneously revealing the need
      to develop immobilization procedures that can preserve CAbt and antibody affinity
      so that immunoassays with wide dynamic ranges and high AgCC can be developed
      without waste of antibody.

PMID- 1635565
TI  - Gastric-outlet obstruction induced by prostaglandin therapy in neonates.
AB  - BACKGROUND: An infusion of prostaglandin E1 is widely used to maintain patency of
      the ductus arteriosus in neonates with congenital heart disease. After gastric
      outlet obstruction was recognized in several infants who received prostaglandin
      E1, we studied the association between the drug and this complication. METHODS:
      We evaluated all neonates who received prostaglandin E1 in our hospital between
      October 1, 1989, and September 30, 1991, for clinical, radiologic, or
      pathological evidence of acute gastric-outlet obstruction. RESULTS: Of the 74
      neonates evaluated, 65 had no signs of gastric obstruction and were considered
      normal; 5 had clinical and radiologic or pathological evidence of gastric
      obstruction consistent with the presence of antral mucosal hyperplasia. The
      remaining four neonates had clinical signs of gastric obstruction, but no
      radiologic or pathological examinations were performed. The 5 neonates with
      antral hyperplasia had received prostaglandin E1 for longer periods (mean [+/-
      SD] duration, 569 +/- 341 hours) than the 65 normal neonates (54 +/- 58 hours, P
      less than 0.001) or the 4 neonates with clinical signs of gastric obstruction
      (119 +/- 60 hours, P less than 0.05). The cumulative dose of prostaglandin E1 was
      higher in the neonates with antral hyperplasia (2982 +/- 1392 micrograms per
      kilogram of body weight) than in the normal neonates (279 +/- 270 micrograms per
      kilogram, P less than 0.001) or the neonates with signs of gastric obstruction
      (528 +/- 306 micrograms per kilogram, P less than 0.01). In two neonates with
      antral hyperplasia, the cessation of therapy lessened the gastric-outlet
      obstruction. CONCLUSIONS: The administration of prostaglandin E1 to neonates can
      cause gastric-outlet obstruction due to antral hyperplasia. Neonates who receive
      prostaglandin E1 at recommended doses for more than 120 hours should be closely
      monitored for evidence of antral hyperplasia.

PMID- 1635566
TI  - Treatment of metastatic malignant melanoma with dacarbazine plus tamoxifen.
AB  - BACKGROUND: Endocrine factors may affect the clinical course of malignant
      melanoma and the response to the treatment of this disease. The presence of
      estrogen receptors in melanomas has been suggested, and occasional responses to
      antiestrogen therapy have been reported. METHODS AND RESULTS: We randomly
      assigned 117 patients with metastatic malignant melanoma to treatment with
      dacarbazine alone or dacarbazine in combination with tamoxifen. The overall rate
      of response, measured objectively, was higher (28 percent vs. 12 percent, P =
      0.03) and survival was longer (median, 48 vs. 29 weeks, P = 0.02) among the
      patients who received dacarbazine plus tamoxifen than among those who received
      dacarbazine alone. Among women, both the response rate (38 percent vs. 10
      percent, P = 0.04) and the median survival (69 vs. 30 weeks, P = 0.008) were
      better with dacarbazine plus tamoxifen than with dacarbazine alone, whereas among
      men the differences were smaller and not statistically significant. Among the
      patients given dacarbazine alone, there were no significant differences between
      women and men in response rate (10 percent vs. 13 percent) or survival (30 vs. 27
      weeks), whereas among those given dacarbazine plus tamoxifen, women had better
      outcomes, as indicated by both response rate (38 percent vs. 19 percent, P =
      0.15) and survival (69 vs. 31 weeks, P = 0.02). When we analyzed the Quetelet
      body-mass index (the weight in kilograms divided by the square of the height in
      meters) as an indirect indicator of the levels of endogenous estrogens in
      postmenopausal women and in men, survival was not affected by the body-mass index
      in the group given dacarbazine alone, whereas in the group given dacarbazine plus
      tamoxifen, survival was longer among patients whose Quetelet index was above the
      median value than among those with a Quetelet index lower than the median value
      (60 vs. 26 weeks, P less than 0.001). CONCLUSIONS: In the treatment of metastatic
      malignant melanoma, dacarbazine plus tamoxifen is more effective than dacarbazine
      alone, as indicated by both the response rate and the median survival; the
      difference in efficacy is among women.

PMID- 1635568
TI  - The vector of the Lyme disease spirochete.

PMID- 1635567
TI  - Brief report: primary immunodeficiency caused by mutations in the gene encoding
      the CD3-gamma subunit of the T-lymphocyte receptor.

PMID- 1635569
TI  - Refractory hypertension.

PMID- 1635570
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 34-1992. A 19-year-old man with progressive proximal muscle
      weakness, contractures, and cardiac abnormalities.

PMID- 1635571
TI  - Gastric-outlet obstruction in children.

PMID- 1635572
TI  - Disseminated melanoma--is there a new standard therapy?

PMID- 1635573
TI  - Is a tick's bark worse than its bite? Formulating an answer with decision
      analysis.

PMID- 1635574
TI  - HIV-1 from a seronegative transplant donor.

PMID- 1635575
TI  - Suppressive therapy for cryptococcal meningitis.

PMID- 1635576
TI  - Suppressive therapy for cryptococcal meningitis.

PMID- 1635577
TI  - Suppressive therapy for cryptococcal meningitis.

PMID- 1635578
TI  - Surgical management of spastic diplegia.

PMID- 1635579
TI  - Intracranial hemorrhage in blacks as compared with whites.

PMID- 1635580
TI  - Intracranial hemorrhage in blacks as compared with whites.

PMID- 1635581
TI  - Changing blood types.

PMID- 1635582
TI  - Rhabdomyolysis with acute tubular necrosis--a nonglomerular cause of dysmorphic
      hematuria.

PMID- 1635583
TI  - Aerosolized recombinant human deoxyribonuclease I in the treatment of cystic
      fibrosis.

PMID- 1635584
TI  - An economic evaluation of asthma in the United States.

PMID- 1635585
TI  - Vaginal inflammation in Africa.

PMID- 1635586
TI  - A muscarinic receptor different from the M1, M2, M3 and M4 subtypes mediates the
      contraction of the rabbit iris sphincter.
AB  - In order to analyse the subtype of muscarinic receptors involved in the
      methacholine-induced contraction of the rabbit iris sphincter we have determined
      equilibrium dissociation constants (KB) of various antagonists in the sphincter
      muscle. The values were compared with those observed at M1 (rabbit vas deferens),
      M2 (heteroreceptors in rat iris) and M3 receptors (guinea-pig ileum), or at the
      muscarinic receptors in the guinea-pig uterus. The methacholine-induced
      contraction of the uterus from immature guinea-pigs was competitively antagonized
      by pirenzepine (6.64, -log KB), 4-DAMP (8.39), hexahydrodifenidol (HHD; 7.00 for
      the (R)- and 5.40 for the (S)-enantiomer), p-fluoro-hexahydrosiladifenidol (p-F
      HHSiD; 6.25) and valethamate bromide (8.04). The affinity of the antagonists is
      consistent with the presence of an M2 receptor. The -log KB values of the
      antagonists in the rabbit iris sphincter (6.43, p-F-HHSiD; 6.22, AQ-RA 741; 7.23
      and 5.34, (R)- and (S)-trihexyphenidyl) were lower than, or within the lowest
      range of, estimates in the other experimental models, irrespective of the subtype
      selectivity of the antagonist. This excludes the presence of an M1, M2, M3 or M4
      receptor in this smooth muscle. The affinity of UH-AH 37 in the iris was
      intermediate between that for M1 or M3, and M2 receptors. The low affinity of AQ
      RA 741 and the low enantiomeric ratio of trihexyphenidyl (THP) in the iris (77.6)
      would be compatible with a presumed M5 receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635587
TI  - Presynaptic muscarinic receptor subtypes involved in the inhibition of
      acetylcholine and noradrenaline release in bovine cerebral arteries.
AB  - Experiments were performed in bovine cerebral arteries preincubated with [3H]
      choline or [3H]-noradrenaline to analyze the presynaptic muscarinic receptors
      involved in inhibition of acetylcholine and noradrenaline release induced by
      electrical stimulation (4 Hz, 200 mA, 0.3 ms, 1 min). For this purpose, the
      actions of several muscarinic receptor antagonists on the 3H overflow and on the
      carbachol-induced inhibition of this overflow were assessed. The evoked [3H]
      acetylcholine release and [3H]-noradrenaline release were markedly reduced by the
      presence of tetrodotoxin, Ca(2+)-free medium, and the inhibitor of both choline
      transport and choline acetyltransferase, AF64A. Chemical sympathetic denervation
      with 6-hydroxydopamine (6-OHDA) decreased the uptake of [3H]-noradrenaline, and
      AF64A reduced mainly the uptake of [3H]-choline, but also of [3H]-noradrenaline.
      Carbachol reduced the evoked [3H]-noradrenaline and [3H]-acetylcholine release;
      the IC50 values were 0.37 and 0.43 mumol/l, respectively. Atropine and 4-DAMP,
      but not AF-DX 116, methoctramine or pirenzepine, increased the evoked [3H]
      acetylcholine release. However, these muscarinic antagonists failed to modify the
      evoked [3H]-noradrenaline release. Carbachol inhibited the release of both
      acetylcholine and noradrenaline. The inhibition was blocked by the antagonists.
      The rank orders of potency (based on plC50 values) were, in the case of [3H]
      acetylcholine release, atropine greater than 4-DAMP greater than AF-DX 116
      greater than or equal to pirenzepine greater than or equal to methoctramine, and,
      in the case of [3H]-noradrenaline release, atropine greater than 4-DAMP greater
      than AF-DX 116 greater than or equal to methoctramine greater than or equal to
      pirenzepine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635588
TI  - Chronopharmacology of isoprenaline: the effects on rat plasma concentrations of
      large neutral amino acids depend on time of day for administration.
AB  - This investigation was undertaken in order to test our hypothesis, that the
      endogenous circadian rhythms in large neutral amino acids (LNAAs) in plasma are
      partly regulated by beta-adrenergic mechanisms. The beta-adrenoceptor agonist
      isoprenaline, which is known to decrease the concentrations of rat plasma LNAAs,
      was given at several time-points over a full 24-h period intraperitoneally to
      rats, which were killed 1 h later. Isoprenaline, administered in the evening,
      decreased the plasma amino acid concentrations more than it did in the same doses
      given in the morning. Also the potency of isoprenaline was in this respect higher
      in the evening than in the morning. This finding, of a time-of-day dependent
      relationship between the effects of a beta-adrenoceptor agonist and plasma LNAA
      concentrations, supports our hypothesis, that beta-adrenergic mechanisms are
      involved in the endogenous regulation of the plasma LNAA rhythms. We suggest that
      the known endogenous circadian variation in sympathetic activity, which gives
      rise to a reciprocal rhythm in beta-adrenoceptor responsiveness, could be one
      factor explaining that part of the circadian rhythm in plasma LNAA
      concentrations, which is not due to variations in food intake.

PMID- 1635589
TI  - Characterization of extracellular GABA in the substantia nigra reticulata by
      means of brain microdialysis.
AB  - Brain microdialysis was used to characterize extracellular gamma-aminobutyric
      acid (GABA) in the substantia nigra reticulata (SNR) of freely moving rats. The
      extracellular GABA in the SNR was characterized using acutely implanted probes (4
      8 h after surgery; day 1) and chronically implanted probes (24 h after surgery;
      day 2). 3-Mercaptopropionic acid, a glutamic acid decarboxylase inhibitor, was
      used to identify GABA. This drug induced an immediate decrease in the
      extracellular GABA levels to 40% of basal values, suggesting that the detected
      GABA is, at least in part, newly synthesized. The basal levels of extracellular
      GABA measured either on day 1 or day 2 were not affected by infusion of
      micromolar amounts of tetrodotoxin. Therefore, a direct coupling between GABA
      dialysate concentrations and nerve-impulse flow does not seem to exist. Infusion
      of the GABA uptake inhibitor nipecotic acid (0.5 mmol/l) resulted in a 4-fold
      increase in the dialysate levels of GABA lasting at least for 3 h on both days.
      K+ stimulation (60 mmol/l) increased extracellular GABA levels in the SNR to 450%
      of basal values. This effect again did not differ significantly on day 1 and day
      2. The origin of the extracellular GABA in the SNR, as recorded by microdialysis
      under the two experimental conditions, is discussed.

PMID- 1635590
TI  - Dopamine releasing effect of phenylbiguanide in rat striatal slices.
AB  - The present study explored the mechanisms underlying the dopamine releasing
      effect of phenylbiguanide, a compound commonly used as a 5-HT3 receptor agonist.
      Phenylbiguanide, and also serotonin and 2-methyl-serotonin, enhanced the outflow
      of radioactivity from superfused rat striatal slices preloaded with [3H]dopamine.
      The presence of the dopamine uptake blocker nomifensin prevented the increase in
      outflow. The effect of phenylbiguanide was not antagonized by 5-HT3 receptor
      antagonists, did not require the presence of Ca2+ in the superfusion buffer, and
      also occurred in reserpinized preparations with depleted dopamine stores.
      Phenylbiguanide caused a greater shift in the distribution of superfusate
      radioactivity from DOPAC to dopamine than did nomifensin. All these results are
      in agreement with an exchange mechanism by which phenylbiguanide promotes the
      efflux of dopamine by operation of the uptake carrier in the reversed direction.
      In consonance, phenylbiguanide, and also serotonin and 2-methyl-serotonin,
      inhibited the binding of [3H]CFT to dopamine uptake sites, although the rank
      order for promoting outflow, serotonin greater than phenylbiguanide greater than
      2-methyl-serotonin, differed from that for inhibiting [3H]CFT binding to dopamine
      uptake sites, 2-methylserotonin approximately serotonin greater than
      phenylbiguanide. The present results raised the possibility that phenylbiguanide
      has an additional activity in releasing vesicular dopamine into the cytoplasmic
      pool.

PMID- 1635592
TI  - [Food as cause of atopic eczema in children].

PMID- 1635591
TI  - Antihypertensive activity of the non-peptide angiotensin II receptor antagonist,
      SK&F 108566, in rats and dogs.
AB  - The antihypertensive activity of the nonpeptide angiotensin II receptor
      antagonist, SK&F 108566 (E)-alpha-[[2-butyl-1-[(4-carboxyphenyl)methyl]-1H
      imidazol-5- yl]methylene]-2-thiophene propanoic acid), was examined in rats and
      dogs. SK&F 108566 produced dose-dependent decreases in blood pressure in renin
      dependent hypertensive rats. At 10 mg/kg intraduodenally, mean arterial blood
      pressure fell from between 150-160 mm Hg to approximately 124 mm Hg. A sustained
      infusion of SK&F 108566 at 25 micrograms/min intraduodenally normalized blood
      pressure during 3 days of infusion and for 18 h following cessation of the
      infusion. Evaluation of the systemic hemodynamic effects of SK&F 108566 in
      chronically instrumented renin-dependent hypertensive rats demonstrated that the
      antihypertensive effects of SK&F 108566 were accompanied by a significant
      increase in cardiac output with little change in stroke volume. In dogs made
      acutely hypertensive by an intravenous infusion of angiotensin I, SK&F 108566
      resulted in dose-dependent decreases in blood pressure. The antihypertensive
      activity of SK&F 108566 at 10 mg/kg p.o. was maintained for between 13-15 h, a
      similar duration of action as observed with enalapril (1 mg/kg, p.o.).
      Administration of DuP 753 (losartan) intravenously caused a small and short-lived
      fall in blood pressure in the angiotensin I-infused hypertensive dog. However,
      the active metabolite of losartan, EXP 3174, resulted in a response of longer
      duration. In dogs made hypertensive by placement of an ameroid constrictor on the
      left renal artery, SK&F 108566 (10 mg/kg, p.o.) or enalapril (1 mg/kg, p.o.)
      resulted in antihypertensive responses of at least 12 h duration. The data
      indicate that SK&F 108566 is a long-acting antihypertensive agent in the rat and
      dog.

PMID- 1635593
TI  - [Discontinuation of anonymity of donors in artificial insemination; a moral
      assessment of counter-arguments].

PMID- 1635594
TI  - [AIDS, a problem without boundaries].

PMID- 1635595
TI  - [Estrogen substitution following the menopause and the risk of breast cancer; the
      importance of endogenous risk factors].

PMID- 1635596
TI  - [Epiphysiolysis of the femoral head].

PMID- 1635597
TI  - [Current possibilities in the treatment of severe stenosis of the large airways].

PMID- 1635598
TI  - [Immunologically mediated contact urticaria caused by foods in young children
      with constitutional eczema].
AB  - Fifty-two children with atopic dermatitis were investigated with the mixed-food
      radio-allergosorbent test (RAST) and the skin provocation test 'Skin Application
      Food Test' (SAFT). The mixed-food RAST is a commercially available test with
      multiple allergens on one disk. The disk contains 6 common food allergens: cow's
      milk, egg, peanut, soy, codfish and wheat. The SAFT is a system with which foods
      are applied to the skin in the state in which they are consumed. This test system
      is routinely used in our subdivision of Paediatric Dermatology in Sophia
      Children's Hospital. In some children, atopic dermatitis grew worse after a
      positive SAFT reaction. In 50% of the 38 children with food allergy a correlation
      was found between exacerbation/induction of atopic dermatitis and consumption or
      direct skin contact of foods to which the child was allergic. Due to direct skin
      contact of foods, atopic dermatitis can grow worse with sudden attacks of
      pruritus, especially on the hands and in the face. The SAFT imitates the
      naturally occurring symptoms, is child friendly and easy to perform. The mixed
      food RAST can be used as a screening test to identify the children with atopic
      dermatitis and an atopic immune response to foods, so possibly food allergy.
      Further investigations of the sensitivity of the target organ (in atopic
      dermatitis: the skin) and the usefulness of the SAFT are then indicated.

PMID- 1635599
TI  - [Prevalence of putative food hypersensitivity in young children].
AB  - Prevalence, symptoms and family prevalence of food hypersensitivity and other
      hypersensitivities were investigated in a group of 5-6-year old children (n =
      1039) in a rural area of the Netherlands using a questionnaire for the parents.
      Subsequently parents were asked about their actions once they suspected their
      child of food hypersensitivity. According to 23.1% of the parents their child was
      hypersensitive, and mostly food hypersensitive (11.4%). In particular,
      gastrointestinal symptoms, crying spells in infancy and behaviour problems were
      reported. These symptoms were usually caused by cows' milk, food additives and
      chocolate. Most of the food hypersensitive children experienced their first
      problems before their first birthday. Although only 39% of these children were
      examined, 91.5% of the parents of the so-called food hypersensitive children
      restricted the food intake of their children. CONCLUSION: Many parents consider
      their children to be food hypersensitive and they restrict the food intake
      without any examination.

PMID- 1635600
TI  - [Routine screening for syphilis in neurology is not useful].
AB  - In a retrospective study the results of the screening for syphilis in one of the
      neurological wards of the Academic Medical Centre in Amsterdam were analysed. The
      Venereal Disease Research Laboratory test (VDRL) and the Treponema Pallidum
      Haemagglutination Assay (TPHA) in serum were used for screening. The data for
      analysis were obtained via the hospital computer data base and via the medical
      files of the department of neurology. During the 5-year study period (1986-1990)
      2378 adult patients were admitted and 1247 (52.4%) of them were screened. In
      seven (0.56%) patients both tests were positive. Three of them had been treated
      for syphilis in the past and showed no symptoms of active syphilis. Four (0.32%)
      patients suffered from active neurosyphilis. In three of these four patients
      syphilis was suspected on admission and confirmed by the tests. In one patient
      the diagnosis of syphilis was not considered. The positive test results became
      available shortly before she died of pneumonia and were without consequences.
      None of the 32 (2.6%) patients with a positive TPHA and a negative VDRL was
      diagnosed as having (neuro-)syphilis. Two (0.16%) patients had a false-positive
      VDRL. We conclude that routine serological examination for syphilis of every
      patient admitted to a neurological ward is not useful. We advise a limited
      screening of patients who belong to a group with high risk for syphilis and
      patients with symptoms and signs that can be caused by syphilis, such as dementia
      or ischaemic strokes at a relatively young age.

PMID- 1635601
TI  - [Tungiasis].
AB  - Tungiasis is an inflammation of the skin caused by infestation of a fertilised
      female sand flea, Tunga penetrans. Two patients who contracted this skin disease
      in the tropics (Surinam and Kenya-Uganda) are described. Because of the increase
      of international travelling, import diseases are seen more often. If the disease
      is known, it is easy to diagnose and to treat tungiasis.

PMID- 1635603
TI  - [Medical activities under adverse conditions. Study Group Medical Development
      Cooperation].

PMID- 1635602
TI  - [Serious psychological side effect in children taking high doses of deptropine].
AB  - Since 1986 the Netherlands Centre for Monitoring of Adverse Reactions to Drugs
      has received 16 reports concerning psychic effects attributed to the use of
      deptropine citrate (Brontine) in children ranging from one to ten years of age.
      Within 1 to 3 days after starting treatment with a daily dose of 0.6-3 mg,
      hallucinations appeared in 7 children, aggressive behaviour and/or agitation in 6
      children, ataxia in 2 children, and anxiety in 1 child. In none of these cases
      could another cause be found. In one patient symptoms persisted during the whole
      15-month period of treatment. All patients recovered rapidly after
      discontinuation of deptropine citrate. As it probably concerns a dose-dependent
      effect and because most patients had been prescribed a daily dose of 0.06 mg/kg
      body weight, it is strongly advised to exceed the recommended daily dose of 0.03
      mg/kg body weight as little as possible.

PMID- 1635604
TI  - [The acute stage of cerebrovascular accident (CVA); characteristics and
      management].

PMID- 1635605
TI  - [The value of proton spin resonance tomography in the diagnosis of intra
      articular pathological symptoms of the knee].

PMID- 1635606
TI  - [Of what benefit is a research internship in the tropics for Dutch medical
      students?].

PMID- 1635607
TI  - [Minor symptoms in family practice; keratitis due to ultraviolet rays].

PMID- 1635608
TI  - The impact of caring on politics.

PMID- 1635609
TI  - A student's perspective.

PMID- 1635610
TI  - In response to April 8th release of Louis Harris poll on the public's attitudes
      about health care.

PMID- 1635611
TI  - Human animal interaction: basis fo pet-therapy.

PMID- 1635612
TI  - Workplace advocacy survey.

PMID- 1635613
TI  - [Diagnosis and therapy of meningosis neoplastica].
AB  - Metastatic leptomeningeal disease occurs in 5-30% of patients with breast or lung
      cancer, malignant melanoma, non-Hodgkin's lymphoma, leukemia and primary
      malignant brain tumors. Intrathecal chemotherapy with methotrexate, cytarabine,
      or thiotepa combined with irradiation of the site of major involvement increases
      overall median survival from 1-2 months to 2-7 months. Clinical outcome is
      limited by progression of systemic or CNS disease and by the neurotoxic side
      effects of therapy, i.e. leukoencephalopathy. New immunotherapeutic strategies of
      intrathecal treatment may be effective and less toxic, but are not yet
      sufficiently defined and available. This review covers the current diagnostic and
      therapeutic features of metastatic leptomeningeal disease. Pragmatic therapeutic
      recommendations, based on available clinical knowledge are given with special
      consideration of the side effects of therapy.

PMID- 1635614
TI  - [Examination of the visual system with transcranial magnetic stimulation].
AB  - The influence of transcranially applied magnetic stimuli on the function of the
      afferent (sensory) and efferent (motor) parts of the visual system have been
      discussed. Excitatory (positive) phenomena are subjective photic sensations
      (phosphenes) which can be elicited by transcranial magnetic stimulation over
      occipital parts of the skull. The phosphenes appear on the left or right side of
      the visual field depending upon the direction of the coil currents, which
      determines whether the visual cortex of the right or the left hemisphere is
      activated. The configuration of the phosphene fields hints at an excitation of
      the primary visual cortex (Brodmann's area 17). However, magnetic brain
      stimulation also produces inhibitory (negative) phenomena. When strong magnetic
      field pulses are applied over the primary visual cortex, foveally presented
      visual stimuli cannot be identified even when no phosphenes are perceived at the
      same time. Depending on the position of the stimulation coil, this suppression of
      perception can be restricted to visual stimuli presented on the right, or left
      of, above or below the fixation point. No generation or disturbance of eye
      movements by transcranial magnetic stimulation has been reported before, except
      for a delay of saccades within a reaction time paradigm.

PMID- 1635615
TI  - [Fibromuscular dysplasia as a cause of cerebral infarct].
AB  - Fibromuscular dysplasia (FMD) is a non-atheromatous, non-inflammatory, segmental
      arteriopathy of unknown etiology. Fibroplasia of the tunica media is most common.
      After the renal arteries, the carotid arteries are most frequently affected.
      Angiographically beaded and tubular stenoses are seen. Complete occlusions and
      spontaneous dissection of the carotid arteries occur. The angiopathy causes
      general symptoms such as headache and vertigo, but also recurrent TIA and
      ischemic cerebral infarction. We examined 15 patients (12 female) suffering from
      FMD and stroke. The diagnosis of FMD was based on angiographic findings in all
      cases. 13 patients made a good recovery and seven of them could be discharged
      from hospital without any neurological deficit. Apart from conservative
      treatment, primary percutaneous or operative angioplasty may be necessary in some
      cases in spite of the mostly benign outcome of the disease. Acetylsalicylic acid
      should be given in all cases.

PMID- 1635616
TI  - [Vertebrobasilar ischemia. Value of Doppler ultrasound in the acute phase].
AB  - We prospectively studied patients with acute vertebrobasilar ischaemia to assess
      the value of Doppler ultrasound compared to cerebral angiography during initial
      evaluation. Doppler ultrasound was diagnostic in 11 of 14 patients (79%).
      Transcranial ultrasonic examination yielded important information in addition to
      extracranial findings in 8 of 11 patients. Depending on the underlying vascular
      pathology, Doppler ultrasound proved to be a useful screening instrument to
      support acute management of vertebrobasilar ischaemia. With regard to clinical
      symptoms and ultrasonic findings, practical consequences for diagnostic
      evaluation are proposed.

PMID- 1635617
TI  - [Transcranial Doppler ultrasound in carotid endarterectomy].

PMID- 1635618
TI  - [Neuro-Behcet's syndrome: encephalitis and cerebral venous thrombosis--clinical
      aspects and neuroradiology of 5 cases].
AB  - The value of brain CT-scan, magnetic resonance imaging (MRI) and angiography for
      diagnosis, differential diagnosis and follow up in Neuro-Behcet-Syndrome is
      assessed in 5 cases. Three of the patients presented with clinical signs of
      encephalitis. Further investigations led to the diagnosis of Behcet-Syndrome. CT
      scan was negative in two of these cases, but MRI showed multiple, predominantly
      periventricular lesions with high signal intensity on T2-weighted spin-echo
      images in all three. Clinical symptoms improved with steroid and chlorambucil
      therapy in all three cases. In two patients the MRI-lesions resolved at least
      partially after 1.5 and 3 years of treatment respectively. In one patient the
      initial MRI-findings were still present after 7 months of treatment. The other
      two patients presented with headache, papilledema and increased CSF-pressure. The
      cause was superior sagittal sinus thrombosis, confirmed by angiography in both
      cases. Additional symptoms appeared later and led to the diagnosis of Behcet
      syndrome. One patient died of pulmonary aneurysms 28 months after the diagnosis
      had been established. The course of disease of the remaining patient is so far
      favorable.

PMID- 1635619
TI  - [Spontaneous regression of significant stenoses and occlusions of the internal
      carotid artery].
AB  - 19 patients with severe stenoses or occlusions of the internal carotid artery
      showed spontaneous recanalization at follow-up. The cause of the stenotic process
      was spontaneous or traumatic dissection, fibromuscular dysplasia, ergotism or
      arteriosclerotic disease. Total recanalization occurred in carotid artery
      dissections coinciding with the best clinical outcome. In fibromuscular dysplasia
      and arteriosclerotic process, recanalization was seldom found, incomplete, and
      the clinical course was less favourable.

PMID- 1635620
TI  - [Lack of specificity of single photon emission computerized tomography in
      dementia--results of a case of progressive paralysis].
AB  - In a 53-year old male suffering from paretic neurosyphilis, SPECT-investigations
      were performed before and after treatment with high doses of Penicillin G. The
      patient was admitted for disturbances of speech and concentration, memory
      disorder and tonic-clonic seizures. Mental examination showed a mild dysphoria
      and irritability in mood, but no disturbance of orientation, no euphoria or
      expansive delusions, and no paranoia. Mini-Mental-State examination was within
      the normal range (28 points); no abnormalities were found on neurologic
      examination, and CT and MRI investigations showed normal findings. The diagnosis
      was verified by CSF-examination (pleocytosis, elevated protein, positive Lues
      reactions). SPECT investigation with Tc 99m HMPAO (20 mCi, single-head rotating
      camera) revealed a pronounced bilateral parieto-temporal uptake deficiency as
      observed in patients with dementia of Alzheimer's type. After 18 months the
      clinical symptoms had remitted, and laboratory findings were improved. On the
      other hand, the bilateral parieto-temporal uptake deficiency in SPECT remained
      unchanged. Possible causes of these findings are discussed in relation to
      neuropathologic findings. It can be concluded that bilateral parieto-temporal
      uptake deficiency in SPECT is a nonspecific finding and that there is no
      correlation between clinical improvement and SPECT pattern in paretic
      neurosyphilis.

PMID- 1635621
TI  - [Hemodynamic monitoring during a migraine attack with aura. A case report].

PMID- 1635622
TI  - [Communicating syringomyelia and syringobulbia after surgery of a spinal epidural
      tuberculoma].
AB  - In a 46 year old patient a syringomyelia and syringobulbia were diagnosed
      clinically 18 years after a transverse lesion of the cord and removal of an
      epidural spinal tuberculoma. Post-myelographic CT and NMR scans showed a
      communicating syringomyelia and syringobulbia. A flavectomy was performed and a
      syringopleural shunt implanted. The operation was successful by neuroradiological
      criteria. Clinically there was a worsening of the spastic gait during one-year
      follow up. Neuroradiological findings and etiology of the syrinx are discussed,
      and a causal relationship to the tuberculoma is proposed.

PMID- 1635623
TI  - CT-stereotactic fibrinolysis of spontaneous intracerebral hematomas.
AB  - CT-stereotactic fibrinolysis is an effective alternative to surgical and
      conservative therapies for intracerebral hematoma. The method consists of
      stereotactically puncturing and partially evacuating the hematoma. After
      fibrinolysis using urokinase, the residual hematoma is completely evacuated
      through a catheter inserted in the cavity of the hematoma. The operation is
      usually performed under local anesthesia. Stereotactic methods are safer and less
      invasive than other methods. Since October 1985, a total of 85 patients have been
      treated with this method in the Department of Stereotaxy and Neuronuclear
      Medicine at the University of Freiburg Medical School. Although 25 patients died
      (29.4%) during the mean follow-up period of 20 months, only 16 (18.8%) died in
      the acute postoperative phase or within the first 60 days after evacuation.
      Eighteen patients (21.2%) had died six months after the operation. The quality of
      life of the 60 surviving patients, as measured on the Karnofsky Scale at follow
      up, was very good to good in 70% and moderate in 23.3%. Only 6.7% of the patients
      were so disabled that they required special care and assistance or had to be
      placed in a nursing home. The long-term results are thus very encouraging.

PMID- 1635624
TI  - Clinical and cerebral blood flow studies in patients with intracranial hemorrhage
      and amyloid angiopathy typical of Alzheimer's disease.
AB  - Spontaneous intracerebral hemorrhages can occur in patients with severe amyloid
      angiopathy and other morphological signs of Alzheimer's disease (AD). We observed
      15 patients in whom histological examination of brain tissue specimens obtained
      at surgery revealed characteristic congophilic amyloid deposits in subcortical
      arteries and/or nerve cells. Clinical follow-up examinations were carried out up
      to 9 years after diagnosis. In addition, three survivors from the operated group
      were investigated by neuropsychological testing and single photon emission
      computer tomography (SPECT) using Tc-99m-HMPAO for determination of regional
      cerebral blood flow (rCBF). SPECT could not differentiate between the "typical
      Alzheimer disease pattern" of bilateral temporo-parietal rCBF reduction and flow
      deficits resulting from previous hemorrhage. Intellectual functioning was found
      to be impaired to various degrees ranging from normal function to severe dementia
      (MMS test scores varied between 15 and 26 points); again, it was difficult to
      differentiate clinically between the nosologic entities mentioned above. On the
      basis of our present experience we cannot distinguish between brain dysfunction
      due to Alzheimer's disease and intracranial hemorrhage from amyloid angiopathy.
      This supports the idea that intracranial hemorrhage may only be one clinical
      manifestation of amyloid deposits, another one being "Alzheimer's disease" with
      varying preponderance.

PMID- 1635625
TI  - Non-acoustic tumors of the cerebellopontine angle.
AB  - 52 patients with non-acoustic neurinoma tumors of the cerebellopontine angle
      undergoing surgery over a 16 year period (1974-1989) are analyzed with regard to
      epidemiologic factors, presenting symptoms, neurological findings, diagnostic
      procedures, surgical approaches, recurrences, and longterm survival rates.
      Meningiomas (20 cases) and epidermoid tumors (16 cases) outnumber the rare tumors
      which exhibit wide histological variation. Trigeminal neuralgia was found as a
      significantly frequent sign of epidermoids. Total removal was possible in nine
      meningiomas (45%), fourteen epidermoid tumors (87.5%) and 11 (69%) mostly
      malignant rare tumors. There were many longterm survivors in meningioma and
      epidermoid groups with a median follow-up period of 4.1 years. The results are
      compared to those reported in the literature and a brief review of reported rare
      tumors of the angle is presented.

PMID- 1635626
TI  - Intracranial cavernous angioma.
AB  - We report 14 cases of intracranial cavernous angioma, analyzing the clinical
      features, with special reference to the risk of bleeding, radiological images and
      treatment in these and in 153 published cases, 167 in all. Cerebral hemorrhage
      occurred in 44%: typical (intraparenchymal or subarachnoid) in 24.6%, and masked
      by epilepsy, headache or neurological deficits in 19.2%. In patients with the
      typical hemorrhagic pattern posthemorrhagic mortality was 12.2%. Of the patients
      who had a hemorrhage 42.5% were left with more or less disabling neurological
      deficits, and 16.4% had a rebleed. In discussing treatment we consider four
      groups of intracranial cavernous angioma: A) symptomatic in a zone of low
      surgical risk; B) asymptomatic with low surgical risk; C) symptomatic with high
      surgical risk; D) asymptomatic with high surgical risk. The treatment is
      surgical, except in the high risk asymptomatic variety, best followed initially
      with sequential CT scan and MRI and then considered for surgery if the lesion
      becomes symptomatic, increases in size or presents neuroradiological signs of
      bleeding.

PMID- 1635627
TI  - Intramedullary metastasis of unknown origin: a case report.
AB  - We report a case of cervicothoracic intramedullary metastasis with long survival.
      The patient is in satisfactory neurological condition 18 months after operation
      and has resumed her normal lifestyle. Despite meticulous examinations, the
      primary lesion could not be identified. We discuss the relevant published work.

PMID- 1635629
TI  - Achondroplasia: unusual bone abnormalities of the cervical spine.
AB  - We report the case of an achondroplastic child in whom severe morphological and
      postural abnormalities of the cervical vertebrae were coupled with only mild and
      stable neurological deficits. The pathogenesis of the abnormalities is discussed.

PMID- 1635628
TI  - A case of Foster Kennedy syndrome without frontal lobe or anterior cranial fossa
      involvement.
AB  - Foster Kennedy syndrome is a very rare syndrome which includes ipsilateral optic
      atrophy and central scotoma, anosmia, contralateral papilledema, and,
      occasionally, ipsilateral proptosis. A large frontal lobe, olfactory groove, or
      medial third sphenoidal wing tumor, usually a meningioma, creates this syndrome.
      In this report, the author presents a case of metastatic cerebral tumor with
      Foster Kennedy syndrome but without frontal lobe or anterior cranial fossa
      involvement.

PMID- 1635630
TI  - Meningioma of the fourth ventricle: a case report.
AB  - A rare case of fourth ventricle meningioma with a combined intraventricular
      intracerebellar localization, successfully removed by surgical treatment, is
      reported. The features of this type of meningioma as compared to the purely intra
      ventricular variety are discussed.

PMID- 1635631
TI  - Management and prognosis of intracranial giant aneurysms. A report on 58 cases.
AB  - Between 1975 and 1989, 58 patients, 32 females and 26 males, mean age 50 years,
      with intracranial giant aneurysms with a diameter more than 2.5 cm were treated
      at our clinic. 48% of the patients presented with subarachnoidal hemorrhage. The
      most of the other 30 patients presented with cranial nerve dysfunctions. The most
      common site of the aneurysm was the internal carotid artery (25 cases, 43%),
      followed by the anterior cerebral artery (14%), and the vertebro-basilar region
      (11 cases, 19%). In 14 patients direct surgery was not performed because of the
      poor general condition of the patient, the high risks, or non-consent. In seven
      patients (12%) the aneurysm had been misdiagnosed as meningeoma, pituitary
      adenoma, craniopharyngeoma or glioblastoma. 47% of all patients were discharged
      as "independent" and 19% died. Patients without SAH had better chance of
      survival: 7% of patients without SAH died and 29% of patients with hemorrhage.
      50% of patients without hemorrhage were discharged as "independent" but only 18%
      of patients with SAH. Because of the high incidence of hemorrhage and the better
      prognosis for patients without hemorrhage, we recommend routine surgical
      treatment of patients with giant aneurysms.

PMID- 1635632
TI  - [From praxis to the concept of monitoring in anesthesia and intensive care].

PMID- 1635634
TI  - [Temperature monitoring and sites of measurement of body temperature].
AB  - The authors report an investigation of 331 consecutive patients submitted to
      major surgery to evaluate the reliability of temperature monitoring in different
      body sites in relation to central temperature. After having considered the
      minimal temperature changes and the difficulties due to the different techniques
      used, it is concluded that the measurement at the middle 3rd of the oesophagus is
      the most reasonable measurements site.

PMID- 1635633
TI  - [Clinical evaluation of pre-surgical anxiety: changes in plasma levels of the
      anxiety peptide (diazepam binding inhibitor)].
AB  - The score scale of anxiety (STAI, Y, 1-2) and haematic levels of DBI (diazepam
      binding inhibitor) were used in 48 surgical patients for clinical evaluation of
      preoperative anxiety, before and after drugs for preoperative medication. After
      randomization, were clinically and statistically compared 6 groups according to
      premedicant drugs (diazepam 0.3 mg/kg; flunitrazepam 0.03 mg/kg; saline;
      prometazine 0.7 mg/kg); before and after preoperative medication were evaluated
      the anxiety relief with the score scale, haematic levels of DBI and haemodynamics
      (systolic and diastolic AP and HR). The results show that DBI can objectively
      measure the anxiety relief, that not are correlate haematic levels of DBI and
      score scale, that the best benzodiazepines are diazepam (0.3) and flunitrazepam
      (0.015) and that the prometazine might give anxiety relief for 5-HT antagonist
      action. Even if there are limits to study (scanty cases, are missing the range
      and the brain values of DBI and blood test of DBI is slow method) may be useful
      the use of score scale and haematic levels of DBI in clinical evaluation of
      preoperative anxiety relief.

PMID- 1635635
TI  - [The effects of succinylcholine on heart rate and rhythm in infants].
AB  - The authors examined the possible variations of cardiac activity in 91 infants
      aged between a few days and six months in order to study the changes following
      administration of succinylcholine during general anaesthesia. No variations in
      rhythm and/or heart rate occurred, not even in those children to whom atropine
      had not been injected intravenously before succinylcholine.

PMID- 1635636
TI  - [Loco-regional anesthesia vs general anesthesia in carotid endarterectomy.
      Response to the surgical stress].
AB  - The advantages of performing carotid endarterectomy in the awake patient,
      perioperative analgesia, circulatory parameters, plasma cortisol and PRL response
      to surgery have been evaluated. Ten patients were submitted to general
      anaesthesia and ten patients to superficial and deep cervical block. The Authors
      conclude that, although the number of patients studied is limited, there are no
      significant differences between the two groups for intraoperative analgesia,
      hemodynamic imbalance and plasma cortisol and PRL. This result support the belief
      that carotid endarterectomy in awake patients can be safely performed on patients
      with chronic obstructive pulmonary disease.

PMID- 1635637
TI  - [The propofol-fentanyl-pancuronium combination in aorto-coronary bypass.
      Experience and personal caseload].
AB  - The authors report the use of a total intravenous anaesthesia in CABG. An
      association of propofol-fentanyl-pancuronium with a bolus at induction, then with
      continuous perfusion was used. Hemodynamic and oxymetric data obtained from the
      right heart and radial artery samples show good hemodynamic stability during
      surgery. It is underlined that, in order to reduce possible hemodynamic changes
      it is very important to use, during the surgical procedure, the lowest drug
      concentration.

PMID- 1635638
TI  - [Endocrine-metabolic response to 2 different techniques in surgery of the
      abdominal aorta].
AB  - Plasma cortisol and PRL were measured in two groups of patients undergoing
      reconstructive aortic surgery under either general anaesthesia and continuous
      epidural analgesia with supplemental general anaesthesia. The results confirmed
      that epidural analgesia with light general anaesthesia is much able than general
      anaesthesia to suppress the metabolic response associated with aortic surgery
      procedures.

PMID- 1635639
TI  - [Plasma levels of mepivacaine in the double block of the sciatic and the femoral
      nerve].
AB  - The large use of double block of sciatic and femoral nerves (bibloc) with high
      mepivacaine 2% doses (10 mg/kg) has pointed out some cases of toxicity. We found
      a relationship between shiver and mepivacaine arterious plasma levels higher than
      6 micrograms/ml. These symptoms were self-limited and statistically not
      significant.

PMID- 1635640
TI  - [A new ventilation method: the laryngeal mask].
AB  - A size 3 laryngeal mask was used in 20 patients who underwent elective general
      surgery. It consists of a silicon tube attached to mask which must be inserted
      into the hypopharynx and then inflated. No curarisation nor laryngoscopy is
      needed. Operations were performed in assisted or spontaneous ventilation, with
      good airway patency and absence of coughing, secretions and sore throat. In 2
      cases introduction of the mask failed. Technique, advantages and problems related
      to its use are described.

PMID- 1635641
TI  - [The use of Opticath in the correct measurement of the pulmonary capillary wedge
      pressure].
AB  - The Authors assess the utility of the on-line monitoring of SvO2 during 156
      measurements of pulmonary capillary wedge pressure (PCWP) done on 52 Intensive
      Care Unit patients. The measurement was always right when the SvO2 increased more
      than 90%. The Authors found a good correlation between the SvO2 monitored during
      the measurement of the PCWP and the saturation of pulmonary capillary blood
      measured by cooximeter. These data suggest that the complex procedure to confirm
      the reliability of the measurement recommended by Gardner can be simplified by
      the observation of the trend of SvO2 on the monitor oximetrix. This allows to
      obtain saving time for the staff, saving blood for the patients, reduction of
      risk for the transmission of infective diseases due to the handling of blood and
      guarantees a further routinary control of reliability on the measure of PCWP.

PMID- 1635642
TI  - [Circulation effects of noradrenaline in hyperdynamic septic shock].
AB  - The authors report on a group of 8 patients in septic shock, treated with NA in
      association with dopamine and/or dobutamine, according to a personal therapeutic
      protocol. The use of NA in septic shock with low SVR showed an improvement in
      hemodynamic condition and a higher survival rate in the treated patients. During
      the study many clinical, laboratory and microbiologic data were also recorded.

PMID- 1635643
TI  - [Efficacy and safety of amrinone in the treatment of heart insufficiency in
      intensive care].
AB  - The authors describe the results obtained treating with amrinone for 48 hours 11
      patients with acute heart failure. The patients (4 males and 7 females), age
      range between 50 and 82 years) received an initial bolus of 0.75 mg/kg followed
      by and infusion which on average was of 5.82 +/- 1.06 (SD) micrograms/kg/min.
      Besides a subjective and objective clinical improvement they could observe a
      quick and remarkable improvement of the main hemodynamic parameters (cardiac
      index, cardiac output, pulmonary capillary wedge pressure, mean pulmonary
      pressure). The tolerability of the drug was good, except for a decrease in
      platelet, already described in literature. In conclusion, the Authors consider
      amrinone a very interesting drug for its positive inotropic and vasodilating
      activity and because it does not cause an increase of the myocardial oxygen
      consumption.

PMID- 1635644
TI  - [Role of oxygen venous saturation monitoring and CAVH in the multiple organ
      failure syndrome. Description of a clinical case].
AB  - A 42 year old man was admitted to the intensive Care Unit with signs and symptoms
      of septic shock, associated with adult respiratory distress syndrome (ARDS),
      jaundice and acute renal failure. In order to support different organs failures
      mechanical ventilation (IPPV, PSV, CPAP), continuous arteriovenous hemofiltration
      were affected, and continuous intravenous infusion of dopamine and dobutamine was
      started. After and during application of these therapeutic measures, continuous
      monitoring of mixed venous blood oxygen saturation (SvO2) was applied by Swan
      Ganz fiber optic catheter in the pulmonary artery. Monitoring of SvO2 represented
      a useful means to guide inotropic therapy and to assess the hemodynamic effects
      of CAVH and mechanical ventilation. The case reported emphasized the role of
      continuous venous oximetry in multiple organ failure syndrome.

PMID- 1635645
TI  - [Usefulness of monitoring the mixed venous blood saturation (SvO2) in the
      diagnosis of heart rupture. A clinical case].
AB  - We describe a case report of acute left ventricular free wall rupture during
      acute myocardial infarction in a sedated and curarised patient. Continuous
      monitoring of SvO2 was very useful on early diagnosis.

PMID- 1635646
TI  - [Propofol and fentanyl in Sanfilippo disease. Surgical intervention with
      adenotonsillectomy].
AB  - An intravenous anesthesia with propofol and fentanyl was used for
      adenotonsillectomy in a child affected by mucopolysaccharidosis. This technique
      proved to be safe and convenient without peri- and postoperative complications.

PMID- 1635647
TI  - [New aspects concerning the corpus luteum].
AB  - We have summed up current knowledge about the formation and lysis of corpus
      luteum with the co-ordinate intervention of luteotrophic and luteolytic factors.
      Then we re-examined the function of the corpus luteum in the physiologic
      menstrual cycle and in the first period of pregnancy, with special attention to
      luteal insufficiency as a cause of endocrine miscarriage.

PMID- 1635648
TI  - [Colpo-cyto-histological correlations in intraepithelial lesions of the uterine
      cervix].
AB  - The aim of this study was to assess the clinical efficiency of colposcopic
      findings as diagnostic tests for intraepithelial lesion using the analysis of
      colpo-cyto-histological correlations. The results of 3340 colposcopic tests
      performed in the Colposcopy Unit of the Second Clinic of Obstetrics and
      Gynecology between March 1990 and May 1991 were analysed, taking into account 326
      (9.7%) cases of Abnormal Transformation Zone (ANTZ). The colpo-histological
      correlation in ANTZ 1 cases (52 cases of white epithelium, 92 standard mosaic, 42
      standard dotted and 61 mixed cases) was 65.2% (52.3%) for HPV; 12.9% for CIN).
      The colpo-histological correlation in ANTZ 2 cases (30 cases of thickened white
      epithelium, 5 irregular mosaic, 4 irregular dotted, 2 atypical vessels, 4
      thickened gland outlets and 6 mixed cases) was 70.5% (43.3% for HPV; 27.2% for
      CIN an and Ca). In this retrospective study colposcopy showed a diagnostic
      accuracy of 64.6% in the cases examined and played a decisive role in the
      diagnosis of intraepithelial lesions of the uterine cervix.

PMID- 1635649
TI  - [Clinical aspects of breast cancer in the aged woman].
AB  - In Italy breast cancer mortality is constantly increasing in women over 70 years
      of age. The retrospective analysis of the cases observed at the "Senology Center"
      of the II Institute of Obstetrics and Gynecology (University "La Sapienza" of
      Rome) shows when compared to the group of women under age of 40 a higher number
      of advanced cases. This delayed diagnosis needs a most radical treatment and
      adjuvant therapies (i.e. chemotherapy) that cannot often be carried out because
      of general problems. Therefore, elderly women should be sensibilized to undergo
      periodical and regular sanitary inspection.

PMID- 1635650
TI  - [Laser CO2: results of treatment of HPV lesions in male the partner].
AB  - Hundred-fifty-seven male partners of patients affected by Human Papillomavirus
      (HPV) lesions, underwent CO2 Laser vaporization between January 1989 and January
      1990. The age ranged between 18 and 45 (median 28.2). The vaporization was
      performed with a Coherent System 451 CO2 Laser equipment, at a power of 16 watt
      in continuous mode, depth of 2 mm and a free margin of 2 mm. First Laser
      treatment proved successful in 129 patients (82.1%); 17 out of 28 patients with
      persistent or relapsed pathology underwent a second CO2 Laser vaporization with a
      total cure percentage equal to 92.9%. Laser-surgery is the method of choice in
      the treatment of HPV genital lesions.

PMID- 1635651
TI  - [Transcervical vs. transabdominal amniocentesis in the bacterial evaluation of
      the amniotic fluid].
AB  - The authors compare the results of bacteriological research on amniotic fluid by
      transcervical and trans-abdominal amniocentesis. Eighty women at term of their
      pregnancy, scheduled for cesarean section, underwent a bacteriological vaginal
      test and a trans-cervical amniocentesis before and a trans-abdominal
      amniocentesis during cesarean section. The results obtained from both specimens
      of the amniotic fluid were the same in 90% of the cases. A negative
      bacteriological result of trans-cervical amniocentesis excluded a positive result
      of trans-abdominal amniocentesis. Instead, when a positive bacteriological result
      was obtained in trans-cervical amniocentesis, trans-abdominal amniocentesis gave
      a positive result in only 60% of the cases. We conclude that trans-cervical
      amniocentesis, besides being less dangerous, easy to perform and easily repeated,
      is sufficiently secure and reliable in bacteriological results as compared with
      trans-abdominal amniocentesis.

PMID- 1635652
TI  - [Estrogen receptors (ER) and progesterone receptors (PgR) in ovarian cancer].
AB  - The paper reviews recent advances regarding interactions between cells and
      steroid hormones together with the latest data on receptor content in normal and
      malignant ovarian tissue and their importance in tumoral biology. Three recently
      published studies confirm that there is an 84% concentration of PgR and 35% of ER
      in the normal ovary. The incidence of steroid receptors in benign tumours is
      virtually the same as that found in normal tissue, except for a slight increase
      in PgR, whereas in malignant ovarian cancer ER and PgR receptors show marked
      changes. PgR levels fall dramatically from 94% to 42%, while there is a slight
      rise in ER levels. It has also been demonstrated that low receptor status tumours
      were more aggressive than those with high receptor positivity in all patients
      with a follow-up of two or more years. In terms of clinical management, the
      tumour differences led to the use of synchronised chemohormonal treatment.
      Preliminary data are encouraging but further research is required to identify the
      optimal combination. With reference to receptor expression in relation to
      prognosis it appears clear that receptor-positive tumours have a better prognosis
      than receptor-negative ones.

PMID- 1635653
TI  - [Cervix cerclage. A 20-year case load].
AB  - Uterine cervical incompetence is the most common cause of habitual abortion in
      the second trimester of pregnancy and premature delivery; cervical cerclage still
      represents the only surgical treatment for cervical incompetence. In the last 20
      years (1971-1990) we performed 272 Mac Donald cervical cerclages in patients
      between the 8th and the 34th week of pregnancy. In 16 cases the outcome of
      pregnancy is unknown; 198 women (73.3%) subsequentely delivered healthy infants
      later than 37 weeks' gestation or weighing more than 2500 g.

PMID- 1635654
TI  - [Local anesthesia in cervix biopsy].
AB  - The Authors evaluated the perception of pain in a group of 35 patients undergoing
      cervical biopsy and the efficacy of using 40 mg of lydocaine (xylocaina spray) in
      24 patients compared to a control group. Pain perception was evaluated using
      Scott-Huskissons's visual analogous scale. It was observed that this diagnostic
      method was painful and that premedication using topical anesthesia was an
      efficacious method of significantly reducing painful symptoms.

PMID- 1635655
TI  - [Cytological study of an inflammatory type Pap-test].
AB  - The paper reports the results of the study of 900 s of which 630 were of an
      inflammatory type (70%). The age group most severely affected by phlogosis was
      that between 35-45 years old with the highest frequency in the group aged between
      35-39 years old. Associated pathologies were found in 191 cases (21.2%), with
      bacterial infections in 101 cases (11.2%), candida in 43 cases (4.8%), T.V. in 17
      cases (1.9%), viral infections in 10 cases (1.1%), CIN in 14 cases (1.5%) and
      malignant tumours in 2 cases (0.22%).

PMID- 1635656
TI  - [Dermoid cyst associated with planocellular carcinoma].
AB  - The case of an ovarian mature cystic teratoma with an associated squamous cell
      carcinoma is described. The patient, in advanced stage, died a few months after
      surgery, during the treatment by chemo and radiotherapy.

PMID- 1635657
TI  - [Crohn disease in pregnancy. Considerations on and discussion of a clinical
      case].
AB  - Crohn's disease with acute abdomen in pregnancy is described. The Authors
      evaluate Crohn's disease together with the diagnostic, prognostic and therapeutic
      problems and relationships between this disease and pregnancy. They conclude as
      underlining the rarity of Crohn's disease beginning in pregnancy and so the
      importance of symptoms related to this disease in fertile age woman to make
      diagnosis and therapy before pregnancy.

PMID- 1635658
TI  - [A case of myomectomy in the course of cesarean section].

PMID- 1635659
TI  - Clozapine decreases enkephalin mRNA in rat striatum.
AB  - Typical antipsychotic drugs (i.e. haloperidol) induce extrapyramidal movement
      disorders while 'atypical' antipsychotics (i.e. clozapine) do not. In situ
      hybridization histochemistry followed by film autoradiography showed that
      clozapine treatment (20 mg/kg i.p. daily for 28 days) decreased the level of
      labelling for preproenkephalin mRNA in the striatum of the rat while haloperidol
      treatment (1 mg/kg i.p. daily for 28 days) resulted in no change compared with
      controls. The results suggest that these typical and atypical antipsychotic drugs
      exert differential effects on the enkephalin-containing striatal projection to
      the globus pallidus, a pathway critical for the expression of extrapyramidal
      movement disorders.

PMID- 1635660
TI  - Differential membrane properties and dopamine effects in the shell and core of
      the rat nucleus accumbens studied in vitro.
AB  - Electrophysiological differences between the shell and core of the rat nucleus
      accumbens were investigated by intracellular recordings from an in vitro slice
      preparation. The average input resistance of neurons recorded in the shell was
      larger than in the core. Neurons in the core were characterized by a more
      negative resting membrane potential than neurons in the shell. Furthermore, bath
      applied dopamine attenuated synaptic responses recorded in the shell, but not in
      the core. Thus, the two main subregions of the nucleus accumbens differ both in
      basal membrane properties and in dopaminergic modulation of synaptic
      transmission.

PMID- 1635661
TI  - Serotonin may have neurotoxic properties.
AB  - Serotonin (5HT), a major platelet secretory product, has been shown to suppress
      CNS function in vivo. As part of an ongoing project to study interactions between
      neuron and platelet, we used organotypic explant cultures of rat spinal cord to
      study if 5HT had a morphologically demonstrable neurotoxic effect. The results
      suggest that serotonin may be neurotoxic, and that this effect may be prevented
      by ketanserin, a specific 5HT2 antagonist. Related experiments, using
      acetylcholinesterase (AChE) enzyme activity as a biochemical parameter, indicate
      that 5HT hastens the decline of enzyme activity. The concentrations of 5HT at
      which neurotoxicity was demonstrated were comparable to the calculated 5HT
      concentration potentially present in the vicinity of an acute cerebral thrombus.
      These findings could provide new insight into the mechanism of ischemic neuronal
      injury.

PMID- 1635662
TI  - Effects of estradiol treatment on responses of rat preoptic warm sensitive
      neurons to progesterone in vitro.
AB  - Single unit activity was recorded extracellularly in preoptic slice preparations
      from ovariectomized female rats. The rats were pretreated daily with (1)
      estradiol benzoate (20 micrograms/0.1 ml sesame oil) for 3 consecutive days just
      prior to the experiment (OVX+E72h), (2) sesame oil (OVX+Oil), or (3) untreated
      (OVX). In the preparations from OVX rats, 12 (50%) of 24 warm-sensitive neurons
      were inhibited and 2 (8%) were excited by the application of progesterone (P) in
      perfusion medium (30 ng/ml). In OVX+Oil preparations, 4 (40%) of 10 warm
      sensitive neurons were inhibited and none was excited by P. In OVX+E72h
      preparations, however, only 4 (10%) were inhibited by P and 16 (38%) of 42 warm
      sensitive neurons were excited. When Ru38486, a P-receptor antagonist, was
      applied together with P, no excitation was observed in warm-sensitive neurons in
      OVX+E72h preparations. These findings suggest that the P-induced excitation of
      preoptic warm sensitive neurons is mediated through the estrogen-induced P
      receptors.

PMID- 1635663
TI  - Quantitative differences in the deposition of beta A4 protein in the sulci and
      gyri of frontal and temporal isocortex in Alzheimer's disease.
AB  - The distribution of beta-amyloid protein (beta A4) in the frontal and temporal
      isocortex of 14 Alzheimer's disease brains was examined using a combination of
      immunohistochemistry and computer image analysis. The area of cortex covered by
      beta A4 deposits was determined and expressed as a percentage of the total
      cortical grey matter area in each field of interest. Significantly more beta A4
      was found in the grey matter of the sulci as compared to that of the gyral crests
      in both the frontal and the temporal lobes (P less than 0.05). Furthermore, in
      each case, greater quantities of beta A4 were observed in the frontal rather than
      the temporal lobes. This apparent differential vulnerability is likely to reflect
      underlying anatomical connections or perhaps differences in cell packing density
      and appears to strengthen the case for an anatomical basis for the spread of the
      disease pathology.

PMID- 1635664
TI  - Absence of c-fos induction in neonatal rat brain after seizures.
AB  - Induction of the proto-oncogene c-fos is often considered to be a marker of
      increased neuronal activity. We have used in situ hybridization to study the
      pattern of c-fos expression in limbic structures following kainic acid-induced
      seizures during the postnatal period in the rat. Prior to postnatal day 13 (P13),
      seizure activity did not result in c-fos induction in any limbic structure.
      Between P13 and P25, a gradual increase in c-fos expression was observed in
      hippocampus and cortical structures. These results were corroborated by nuclear
      run-off transcription assay. Thus, alterations in c-fos transcription that may
      facilitate stimulus-transcription coupling occur during postnatal development.
      The possible relationship between the postnatal maturation of c-fos expression
      and the increase in susceptibility of specific neuronal populations to seizure
      induced cell damage is discussed.

PMID- 1635665
TI  - Inhibitory effect of neuropeptide Y (NPY) on the in vitro activity of dopamine
      beta-hydroxylase.
AB  - Neuropeptide Y (NPY) is found to be costored with norepinephrine (NE) in vesicles
      of the nerve terminals. An endogenous inhibitor of dopamine-beta-hydroxylase
      (DBH), the synthetic enzyme of NE, has been mentioned. In an attempt to clarify
      the effect of NPY on DBH activities, an in vitro assay is carried out using
      chromatographic analysis of NE formation from dopamine. NPY (20-80 pmol/ml)
      produced a dose-dependent depression of NE formation catalysed by the purified
      bovine adrenal DBH. Lineweaver-Burke plots (Km = 1.1 mM, Vmax = 10 pmol/min/mg
      protein) showed a non-competitive inhibition in NPY (30 pmol/ml, IC50)-treated
      samples. Moreover, failure of denatured NPY even at maximum concentration to
      influence the DBH activities suggested the essential of natural form of NPY.
      Participation of sulfhydryl compound seems also negligible, because N
      ethylmaleimide did not overcome the effect of NPY. These results indicate that
      NPY has the ability to inhibit the catalytic action of DBH.

PMID- 1635666
TI  - Antidromic and synaptic activation of Deiters' neurons induced by stimulation of
      red nucleus in the cat.
AB  - Antidromic and orthodromic action potentials of neurons located in the lateral
      vestibular nucleus of Deiters' evoked by stimulation of red nucleus were studied
      in anaesthetized cats. Vestibulospinal neurons were identified by stimulation of
      the lateral vestibulospinal tract. The 'second-order' vestibular neurons were
      revealed by mean of stimulation of the ipsilateral VIIIth nerve. Stimulation of
      the red nucleus is shown to lead mainly to antidromic, as well as mono-, oligo-
      and polysynaptic activation of Deiters' neurons. Not any inhibitory reaction was
      observed in vestibular neurons in response to stimulation of the red nucleus.
      Ascending axon collaterals of the vestibulospinal neurons to this brainstem
      structure were revealed. The peculiarities and functional significance of the
      effects mentioned are discussed.

PMID- 1635667
TI  - The role of local contrast in the visual deficits of humans with naturally
      occurring amblyopia.
AB  - We measured the positional acuity of amblyopic observers and their sensitivity to
      the local contrast information which provides the cue for the position judgement.
      Our results suggest that there exist fundamental differences in the neural losses
      in humans with strabismic and anisometropic amblyopia. The losses in positional
      acuity of anisometropic amblyopes may be accounted for on the basis of the
      reduced contrast sensitivity and increased neural pooling of the underlying
      visual filters; whereas strabismic amblyopes, like the normal periphery, show an
      extra loss, which may be accounted for on the basis of scrambling, or jitter in
      the topographic mapping of information from retina to cortex. Since neurons in
      the striate cortex of monkeys show precise positional coding, it would be of
      particular interest to examine the positional acuity and local contrast
      sensitivity in cortical neurons of monkeys with experimental amblyopia using the
      same stimuli to measure both.

PMID- 1635668
TI  - Expression of GAD mRNA in GABA interneurons of the rat medial frontal cortex.
AB  - The distribution of glutamic acid decarboxylase (GAD) mRNA containing cells was
      studied in the rat medial frontal cortex (MFC). The neurons labelled by the 35S
      labelled cDNA probe were distributed uniformly throughout all the layers and
      represented 16% of the total neuronal population. It was possible to distinguish
      two cell populations expressing high and low levels of GAD mRNA corresponding to
      63% and 27% of labelled cells, respectively. Concerning the laminar distribution
      of these two populations of GAD mRNA containing neurons, no marked difference was
      observed between the various areas of the MFC.

PMID- 1635669
TI  - Relationships between electrically induced slow negative potentials and changes
      in extracellular potassium concentrations in cerebral cortex of the cat.
AB  - Experiments were carried out on cats under deep nembutal anaesthesia. Local
      cortical stimulation evoked both a slow negative potential (SNP) and an increase
      in extracellular potassium ([K+]o) which were maximal in the upper cortical
      layers. The decline in the K(+)-potential in deeper layers was slower than in the
      upper ones so that with time [K+]o became equal in upper and deeper layers. No
      SNP was recorded at that time, perhaps explaining why K(+)-potential decay is of
      longer duration than the SNP. Transcallosal stimulation also evoked an SNP but
      gave a lesser difference in delta [K+]o in upper and deeper layers. The lower
      amplitude of the SNP evoked by transcallosal stimulation may be due to these
      circumstances. These data could clarify the mechanism of correlation disturbance
      between SNPs and K(+)-potentials in the cerebral cortex.

PMID- 1635670
TI  - Alzheimer's amyloid precursor protein accumulates within axonal swellings in
      human brain lesions.
AB  - By using a monoclonal antibody and polyclonal antibodies to human beta amyloid
      precursor protein (APP), we immunohistochemically examined axonal swellings
      (spheroids). The immunoreactivity of APP was observed in numerous spheroids,
      which were found around the areas of old cerebral infarctions, in the globus
      pallidus with Hallervorden-Spatz disease as well as in or around brain abscesses.
      The axonal swellings were not immunolabeled with beta protein. These results
      implied that APP accumulated in spheroids regardless of beta protein depositions.

PMID- 1635671
TI  - Gpp(NH)p stimulates [3H]raclopride binding to homogenates from human putamen and
      accumbens.
AB  - The effects of the stable GTP analogue Gpp(NH)p (5'-guanylyl imido diphosphate)
      were examined on in vitro [3H]raclopride binding to dopamine D2 receptors in
      preparations from post mortem human brains. The estimated number of receptors in
      the brain was 29% and 38% higher in putamen and accumbens, respectively, when
      determined in the presence of Gpp(NH)p as compared to its absence. The
      interaction of agonists was biphasic confirming the two affinity state model of
      the receptor--G-protein complex. The addition of Gpp(NH)p to the assay abolished
      the two site competition of apomorphine with [3H]raclopride binding in both
      regions studied. The non-specific binding at high concentrations of apomorphine
      was not significantly affected by the addition of Gpp(NH)p, indicating that only
      the specific binding of [3H]raclopride to the dopamine D2 receptor is increased.

PMID- 1635672
TI  - Deficient corpus callosum in hybrids between ddN and three other abnormal mouse
      strains.
AB  - The mouse strain ddN from Japan was crossed with three other inbred strains prone
      to absence of the corpus callosum (BALB/cWah1, I/LnJ and 129/ReJ), and at least
      one brain with abnormally small corpus callosum was observed in offspring from
      each F1 hybrid cross. Data for several polymorphic protein markers revealed that
      the four strains are not closely related genetically. Nevertheless, they share
      common genetic causes of an absent corpus callosum, which helps to understand why
      anatomical studies of ddN and BALB/c have yielded similar results. The
      hippocampal commissure is abnormally small in I/LnJ mice and the anterior
      commissure is often malformed in BALB/c mice, but both commissures in hybrids
      were normal, which suggests a different genetic basis for these defects and the
      absent corpus callosum.

PMID- 1635673
TI  - PT requirements for physician office laboratories.
AB  - The Clinical Laboratory Improvement Amendments of 1988 (CLIA-88) regulations will
      require physician office laboratories (POLs) to participate in proficiency
      testing (PT) for all nonwaivered tests performed in private offices. PT will
      enhance the quality of the testing performed in a POL.

PMID- 1635674
TI  - Personnel recordkeeping requirements for CLIA-88.
AB  - Documented personnel files will be a requirement of the Clinical Laboratory
      Improvement Amendments of 1988 (CLIA-88) regulations. This documentation will
      help reduce laboratory errors and liability by clearly and completely defining
      the employee's duties and responsibilities.

PMID- 1635675
TI  - Evaluation of prothrombin time and partial thromboplastin time.
AB  - Prothrombin time (PT) and partial thromboplastin time (PTT) tests are commonly
      ordered for hospitalized patients. A significant reduction in laboratory workload
      and expense can be achieved if these tests are ordered appropriately. The
      likelihood that the patient will benefit from these tests is small.

PMID- 1635676
TI  - Why bother the New Jersey State Department of Health?
AB  - The reporting of communicable diseases is a legal and professional
      responsibility. Individual case reports can be an important piece in a medical
      puzzle, allowing public health officials to describe new diseases and modes of
      transmission so preventive measures can be developed and implemented.

PMID- 1635677
TI  - Phagocytosis of Candida parapsilosis by polymorphonuclear leukocytes.
AB  - The authors present a brief case report on an unusual entity. This rare
      phenomenon observed in a peripheral smear is worth noting. Neutrophils and rare
      eosinophils show intracellular fungal cells; the size, shape, and budding are
      consistent with Candida parapsilosis.

PMID- 1635678
TI  - Medium chain acyl-coenzyme A dehydrogenase deficiency and SIDS.
AB  - Medium chain acyl-coenzyme A dehydrogenase deficiency (MCADD) is a potentially
      fatal genetic defect in fatty acid metabolism and may account for a proportion of
      all deaths initially attributed to sudden infant death syndrome (SIDS). Effective
      therapy and prevention are available.

PMID- 1635679
TI  - The diagnosis and management of depression: an overview.
AB  - The authors present an overview of the diagnosis, treatment, and management of
      depressed patients. They discuss current psychotherapeutic techniques, the
      psychopharmacologic management of depression, and guidelines for referral of
      depressed patients to mental health professionals.

PMID- 1635681
TI  - How do we look?

PMID- 1635680
TI  - Federal PRO program undergoing fundamental transformation.
AB  - The PRO of New Jersey, Inc. is committed to the ideal of a localized peer review
      process--one that is based on the belief that New Jersey physicians are best
      suited to assess the work of their peers. The concept of a local peer review
      remains absolutely essential.

PMID- 1635682
TI  - Reform in workplace key to claim.

PMID- 1635683
TI  - Banking on breast milk.

PMID- 1635684
TI  - Competition in health: fear is the key.

PMID- 1635685
TI  - Teaching cultural safety.

PMID- 1635686
TI  - The making of a TV commercial.

PMID- 1635687
TI  - Four honoured for rescue role.

PMID- 1635688
TI  - Comments on the "exception...".

PMID- 1635689
TI  - Auxiliary personnel can increase productivity.

PMID- 1635690
TI  - Head nurse and CNS: teaming up.

PMID- 1635691
TI  - International exchange programs and recruitment.

PMID- 1635692
TI  - Ambulatory surgery: integrating the preadmission program.

PMID- 1635693
TI  - A computerized CIS enhances bedside intensive care.

PMID- 1635694
TI  - Protecting children: a public duty to report.

PMID- 1635695
TI  - On writing a column on ethics.

PMID- 1635696
TI  - LTC: there's no place like home.

PMID- 1635697
TI  - What nursing leaders are saying about technology.

PMID- 1635698
TI  - Building careers: AONE's new center. American Organization of Nurse Executives.

PMID- 1635699
TI  - Informatics: managing clinical operations data.

PMID- 1635700
TI  - Charting: the impact of bedside computers.

PMID- 1635701
TI  - Automated patient care systems: the ethical impact.

PMID- 1635702
TI  - Nursing practice: promoting computer literacy.

PMID- 1635703
TI  - Males in nursing.

PMID- 1635704
TI  - A new perspective on scheduling: freedom and cost control.

PMID- 1635705
TI  - Nurse managers and clinical nursing research.

PMID- 1635706
TI  - MBFT--management by follow-through.

PMID- 1635707
TI  - Signs of things to come.

PMID- 1635708
TI  - Evaluation instruments to measure professional nursing practice.

PMID- 1635709
TI  - Patient advocacy: the role of nursing leadership.

PMID- 1635710
TI  - 1992 software guide.

PMID- 1635711
TI  - Manufacturers disappoint.

PMID- 1635712
TI  - On guard.

PMID- 1635713
TI  - 100 percent dentists.

PMID- 1635714
TI  - Where past and future intersect.

PMID- 1635715
TI  - Forces of change.

PMID- 1635716
TI  - Meeting the curriculum challenge.

PMID- 1635717
TI  - New horizons in periodontics. The challenge for diagnosis.
AB  - Contemporary periodontics offers successful treatment for most cases of
      periodontitis. The data analyzed in this paper suggest, however, that a large
      percentage of the population in our region suffers from established, overt
      periodontitis and does not receive periodontal therapy. Guidelines and the
      sensitivity and specificity of detection, using present-day clinical procedures
      of periodontal pocket probing and radiograph analysis, are described for the
      detection of patients with established, overt periodontitis.

PMID- 1635718
TI  - Buffalo School of Dental Medicine. The way it was.

PMID- 1635719
TI  - Adhesion of direct restorative materials.
AB  - The development of adhesive restorative systems has been a major focus in
      dentistry. Materials that can attach to tooth structure make it possible to take
      a far more conservative approach to restorative dentistry.

PMID- 1635721
TI  - AIDS patients need dental care.

PMID- 1635720
TI  - HHC to study oral aspects of AIDS.

PMID- 1635722
TI  - Celebrating the U.B. centennial.

PMID- 1635723
TI  - Second opinion.

PMID- 1635724
TI  - The role of selection bias in comparing cesarean birth rates between physician
      and midwifery management.
AB  - OBJECTIVE: The midwifery service at our hospital has been observed to have a 2%
      cesarean birth rate consistently over a 10-year period. There are substantial
      differences in labor management style between the midwives and physicians. We
      sought to test the hypothesis that the low cesarean birth rate on the midwifery
      service was the result of patient selection bias. METHODS: A randomized blinded
      clinical trial was conducted in which 492 low-risk patients were assigned to
      either physician or midwifery management. The provider responsible for labor
      management was unable to determine group assignment. Patients in the midwifery
      group were managed by previously established protocols, and outcome was
      attributed to the midwives even if the patients subsequently required transfer to
      physician management. Route of delivery was the primary outcome measurement.
      Continuous variables were analyzed using Student t test and discrete variables
      using chi 2. RESULTS: There were no demographic differences between the groups,
      and the admission pelvic examinations were the same. The patients assigned to the
      midwifery group had a 2.1% cesarean birth rate, whereas those assigned to
      physician management had a 0.4% rate. The higher rate of operative vaginal
      deliveries in the physician group was statistically significant. There were no
      differences in neonatal outcomes. The physician-managed group had significantly
      more episiotomies and third- and fourth-degree extensions. CONCLUSIONS: The 2%
      cesarean birth rate observed on the midwifery service appeared to be the result
      of patient selection bias. A low cesarean birth rate can be achieved by either
      physician or midwifery management in a selected low-risk population.

PMID- 1635725
TI  - Unfavorable outcome in penultimate pregnancy and premature rupture of membranes
      in successive pregnancy.
AB  - OBJECTIVES: Previous adverse obstetric events are known to influence the outcome
      of the succeeding pregnancy. We tested the hypothesis that preterm premature
      rupture of membranes (PROM), full-term PROM, and preterm delivery without PROM
      relate independently to the outcome of the immediately preceding pregnancy.
      METHODS: In a case-control study, 345 women 15-45 years old with preterm PROM,
      full-term PROM, or preterm delivery without PROM were singly matched by age,
      race, and parity to women having full-term delivery. Information about the
      penultimate pregnancy, household smoking, and sociodemographic variables were
      obtained during face-to-face interviews. Obstetric history, infections during
      pregnancy, and pregnancy complications abstracted from medical records were cross
      checked with patient interview data. Penultimate pregnancy outcomes included full
      term delivery, premature delivery, fetal loss or miscarriage, and planned
      abortion. RESULTS: Women having preterm PROM or preterm delivery without PROM in
      the index pregnancy were, respectively, 6.34 and 21.28 times more likely than
      controls to have had preterm delivery in the preceding pregnancy. A preceding
      fetal loss or miscarriage also increased 4.39-fold the risk for preterm PROM.
      Exposure to cigarette smoke, urinary tract infections, and vaginal bleeding
      during the index pregnancy independently increased the risk for preterm PROM.
      Women with full-term PROM did not differ significantly from controls in the
      outcomes of the penultimate pregnancy. CONCLUSION: Preterm delivery in the
      preceding pregnancy is associated with an increased risk for preterm delivery
      with or without PROM.

PMID- 1635726
TI  - Bacterial vaginosis in early pregnancy and pregnancy outcome.
AB  - OBJECTIVE: We assessed the association between bacterial vaginosis in early
      pregnancy and adverse pregnancy outcome. METHODS: Vaginal swabs for bacterial
      culture, Gram stain, and Papanicolaou stain were taken at the first prenatal
      visit between 8-17 weeks' gestation in 790 healthy nulliparous women. RESULTS:
      Culture-proven bacterial vaginosis was detected in 169 of 790 women (21.4%), 167
      (98.8%) of whom could also be identified by Gram stain. Papanicolaou smears were
      available from 299 women, among whom 101 had bacterial vaginosis on culture; of
      these 101, 78 (77.2%) could be detected by Papanicolaou stain. Of the 751 women
      whose clinical follow-up was completed, 42 had been treated for preterm uterine
      contractions (preterm labor), but only 17 delivered between 20-36 weeks'
      gestation (preterm birth). Premature rupture of membranes (PROM) occurred more
      than 6 hours before delivery in 80 cases (nine preterm and 71 term). Bacterial
      vaginosis in early pregnancy predicted preterm labor, preterm birth, or preterm
      PROM with a sensitivity of 41-67%, specificity of 79%, and negative predictive
      value of 96-99%, but the positive predictive value was low at 4-11%. However,
      bacterial vaginosis was associated with a 2.6-fold risk (95% confidence interval
      [CI] 1.3-4.9) for preterm labor, a 6.9-fold risk (95% CI 2.5-18.8) for preterm
      birth, and a 7.3-fold risk (95% CI 1.8-29.4) for preterm PROM. CONCLUSIONS:
      Bacterial vaginosis in early pregnancy can be detected reliably by Gram stain
      and, in most cases, by Papanicolaou smear. Although bacterial vaginosis is
      associated with preterm labor, preterm birth, and preterm PROM, the clinical
      usefulness of its assessment is limited because of the high rate of false
      positive findings.

PMID- 1635727
TI  - Myasthenia gravis in pregnancy.
AB  - OBJECTIVE: Our purpose was to review our experience with nine cases of myasthenia
      gravis complicating pregnancy. METHODS: We reviewed the records of all patients
      discharged from the Vancouver Salvation Army Grace Hospital from January 1979 to
      January 1989 with an admission diagnosis of myasthenia gravis in pregnancy.
      RESULTS: Nine patients delivered 11 infants. Four suffered antepartum
      exacerbations. The most severe of these, respiratory failure, occurred in a
      thymectomized patient. Labor was rapid and uncomplicated except for a single case
      of cephalopelvic disproportion delivered abdominally. We noted no puerperal
      exacerbations. Our solitary case of neonatal myasthenia gravis was managed in the
      special care nursery with intramuscular neostigmine given over a 16-day period.
      CONCLUSION: There are no predictive factors that identify the mother at risk for
      peripartum exacerbation of myasthenia gravis or the infant at risk for neonatal
      myasthenia gravis. Optimal care for the parturient is achieved through a team
      approach involving the obstetrician, neurologist, and pediatrician.

PMID- 1635728
TI  - Pharmacokinetics of salbutamol in the pregnant woman after subcutaneous
      administration with a portable pump.
AB  - OBJECTIVE: We sought to determine whether subcutaneous administration of
      salbutamol resulted in plasma levels comparable to those achieved after
      intravenous or oral administration. METHODS: Twenty-nine women with preterm labor
      received subcutaneous infusion of salbutamol through a portable pump. We used
      three different rates of continuous infusion: a low rate of 3.33
      micrograms/minute (20 subjects), an intermediate rate of 6.66 micrograms/minute
      (four subjects), and a high rate of 9.99 micrograms/minute (five subjects).
      Plasma salbutamol concentrations were assayed by high-performance liquid
      chromatography after 48 hours of continuous infusion in the subcutaneous tissue
      and after bolus injections (184 micrograms in the low-rate group and 368
      micrograms in the intermediate- and high-rate groups). RESULTS: Plasma salbutamol
      concentrations after 48 hours of subcutaneous infusion increased almost linearly
      with the rate of infusion: 6.29 +/- 1.58, 15.5 +/- 1.0, and 21.7 +/- 4.26 ng/mL
      in the low-, intermediate-, and high-rate groups, respectively (P less than .001
      between the three groups). After bolus injection, maximum plasma concentrations
      were significantly different between the three groups (P less than .001) and from
      their respective baseline values (P less than .001): 8.33 +/- 1.9, 18.85 +/- 2.0,
      and 25.86 +/- 4.8 ng/mL in the low-, intermediate-, and high-rate groups,
      respectively. CONCLUSION: Subcutaneous tocolysis can provide plasma salbutamol
      levels similar to the levels obtained orally or intravenously.

PMID- 1635729
TI  - Sound levels in the human uterus.
AB  - OBJECTIVE: We sought to determine the degree to which noises and voices are
      attenuated or enhanced as they pass into the uterus. METHODS: In eight
      parturients, a hydrophone in the uterus was used to measure sound pressure levels
      for externally generated one-third-octave band noises, male and female voices,
      and the subject's voice. RESULTS: Low-frequency sounds (0.125 kHz) generated
      outside the mother were enhanced by an average of 3.7 dB. There was a gradual
      increase in attenuation for increasing frequencies, with a maximum attenuation of
      10.0 dB at 4.0 kHz. Sound attenuation was slightly less if the insonation was
      from in front of the woman rather than behind. Intrauterine sound levels of the
      mother's voice were enhanced by an average of 5.2 dB, whereas external male and
      female voices were attenuated by 2.1 and 3.2 dB, respectively. The effect of
      frequency on attenuation, the differences between front and back insonation, and
      the differences between speakers in attenuation were all statistically
      significant. CONCLUSIONS: The intrauterine environment is rich with externally
      generated sounds. This may imply fetal risk from maternal noise exposure and may
      aid in understanding fetal imprinting from prenatal exposure to voices.

PMID- 1635730
TI  - High rates of atypical cervical cytology: occurrence and clinical significance.
AB  - The current literature suggests that atypical (benign atypia or class II)
      Papanicolaou smears occur at a frequency of 1.6-5.4% and are associated with a
      substantial rate of underlying cervical dysplasia. However, we noted that our
      rate of atypia exceeded these figures, particularly in our clinic population. To
      quantify this observation, 1107 consecutive Papanicolaou smears from the clinic
      population were audited prospectively and compared with 262 consecutive
      Papanicolaou smears performed contemporaneously in private patients served by the
      same laboratory. The rate of histologic dysplasia underlying this diagnosis was
      assessed by analyzing the results of 101 consecutive colposcopic examinations
      performed subsequently on clinic patients evaluated for persistently atypical
      cytology (atypical index smear followed by repeat cytology scheduled 2-4 months
      later). The prevalence of atypia in the clinic population was 321 of 1107 (29%;
      95% confidence interval [CI] 26-32%), a rate 2.3 times that of the private
      patients (33 of 262, 13%) (P less than .001). Eighteen of 101 clinic patients
      with persistent atypia had dysplasia (18%; 95% CI 11-25%), and 25 of 101 (25%;
      95% CI 17-33%) had human papillomavirus infection, both documented by the
      histology of directed cervical biopsies. Cervical intraepithelial neoplasia grade
      II or higher was present in three of these 18 women (17%; 95% CI 6-39%). We
      conclude that some populations have atypical cervical cytology at a frequency
      much greater than that reported previously. Furthermore, the pathology underlying
      this diagnosis is considerable and warrants evaluation. The optimal management of
      atypical cervical cytology in such populations is problematic.

PMID- 1635731
TI  - The significance of peritoneal cytology in stage IB cervical cancer.
AB  - OBJECTIVE: The purpose of this study was to determine the incidence of positive
      peritoneal cytology and to evaluate its usefulness in the management of patients
      with early-stage cervical cancer. METHODS: Peritoneal cytology was studied in 273
      women undergoing primary surgical exploration for International Federation of
      Gynecology and Obstetrics stage IB cancer of the cervix. Charts were reviewed
      retrospectively for clinicopathologic data concerning tumor size, cell type,
      lymph node status, and outcome. RESULTS: Cytology was positive in four women,
      three of whom had enlarged pelvic or para-aortic lymph nodes or intraperitoneal
      disease. There was no association between tumor histology or tumor size and
      peritoneal cytology. CONCLUSION: The incidence of positive peritoneal cytology in
      early-stage cervical cancer is low, and the prognostic significance of positive
      cytology is overshadowed by other risk factors more obvious at surgery. The
      routine collection of cytologic specimens at laparotomy should be abandoned in
      this setting.

PMID- 1635732
TI  - Invasive cervical cancer complicating intrauterine pregnancy: treatment with
      radical hysterectomy.
AB  - OBJECTIVE: Radical hysterectomy and bilateral pelvic lymph node dissection have
      become the mainstay of treatment for early-stage cervical cancer because of both
      a high success rate and acceptable morbidity. However, those cervical lesions
      that occur concomitant with an intrauterine pregnancy have historically been
      treated with irradiation. We report the morbidity and results of radical
      hysterectomy and bilateral pelvic lymph node dissection for the treatment of
      early-stage cervical cancer complicating intrauterine pregnancy. METHODS: Between
      1955-1991, 13 patients were treated with radical hysterectomy and bilateral
      pelvic lymph node dissection with the fetus in situ, and eight others with
      cesarean delivery followed by radical hysterectomy and bilateral pelvic lymph
      node dissection. Charts were reviewed retrospectively. RESULTS: Mean operative
      time was 281 minutes. The mean blood loss was 777 mL with radical hysterectomy
      and bilateral pelvic lymph node dissection alone, and 1750 mL with cesarean
      delivery, radical hysterectomy, and bilateral pelvic lymph node dissection (P
      less than .01). Intraoperative morbidity included a single accidental cystotomy
      that was complicated in the postoperative period by a vesicovaginal fistula.
      Fever was the most common postoperative cause of morbidity (29%), while two
      patients (10%) had wound seromas and a single patient (5%) each had a pulmonary
      embolism, cystitis, and transfusion-related hepatitis. No perioperative deaths
      occurred. After documentation of maturity, seven healthy infants were delivered
      with no major morbidity. Twenty patients (95%) are alive and free of disease with
      a mean follow-up of 40 months. CONCLUSION: Radical surgery offers immediate
      treatment for early-stage cervical cancer during intrauterine pregnancy, with low
      associated morbidity, acceptable survival, and preservation of ovarian function.

PMID- 1635733
TI  - The value of exploratory laparotomy in patients with endometrial carcinoma
      according to the new International Federation of Gynecology and Obstetrics
      staging.
AB  - OBJECTIVE: We conducted a retrospective review of 169 consecutive patients
      diagnosed with endometrial carcinoma to evaluate the advantage of exploratory
      laparotomy according to the new International Federation of Gynecology and
      Obstetrics (FIGO) classification as compared with clinical staging. METHODS: All
      169 patients were admitted to the Department of Gynecologic Oncology from August
      1980 through June 1988 and underwent exploratory laparotomy, which included total
      abdominal hysterectomy, bilateral salpingo-oophorectomy, and peritoneal washings.
      We performed complete lymph node dissection of the pelvic and the para-aortic
      areas on 87 patients with clinical stages I and II. Eighteen more patients were
      upgraded to stage III or IV during exploratory laparotomy with lymph node biopsy.
      Forty-nine patients did not have lymph node dissection because of age and medical
      contraindications. In 15 patients with clinical stage III or IV, lymph node
      dissection was performed as part of debulking surgery. Clinical staging showed
      135 patients (80%) with stage I, 19 (11%) with stage II, three (2%) with stage
      III, and 12 (7%) with stage IV carcinoma. RESULTS: Surgical restaging according
      to the new FIGO classification resulted in 117 patients (69%) with stage I, seven
      (4%) with stage II, 23 (14%) with stage III, and 22 (13%) with stage IV
      carcinoma. Thirty patients (19%) of 154 with clinical stage I or II had
      extrauterine spread. Thirty-three of 169 patients (19.5%) had their clinical
      staging upgraded and six (3.5%) were downgraded. The 5-year actuarial survival
      rates for clinical stages I, II, and IV were 83, 64, and 8%, respectively. The
      actuarial survival rates for surgical stages I, II, III, and IV were 89, 100, 58,
      and 24%, respectively. Cases surgically staged as I with high-risk variables (eg,
      poor differentiation, unfavorable histologic types, and deep myometrial invasion)
      or stage II received 5000 cGy to the whole pelvis using a box technique. Patients
      with surgical stage III or IV received adjuvant intravenous chemotherapy (eg,
      doxorubicin, hydrochloride, Cytoxan, and cisplatin) consecutively for ten to 12
      courses. Megestrol acetate was added for 2 years. CONCLUSIONS: Surgical staging
      after exploratory laparotomy defined the true extent of disease and identified
      20% of the cases that may escape effective treatment.

PMID- 1635734
TI  - Uterine leiomyomas: cytogenetic and histologic profile.
AB  - OBJECTIVE: The main purpose of this study was to determine whether there is any
      correlation between the cytogenetic abnormalities and histology in uterine
      leiomyomas. METHODS: A total of 93 benign uterine leiomyomas were included in the
      study. The majority (88 of 93) were classified as typical benign leiomyomas, four
      as cellular, and one as atypical symplastic. RESULTS: A normal chromosome
      complement (46,XX) was observed in approximately 50% of the cases (41 of 93).
      Seventeen leiomyomas did not grow sufficiently in culture to yield cells for
      chromosome analyses. Of the 35 cases with clonal abnormalities, 28 could be
      divided into four major subgroups, each representing one of the most common
      abnormalities observed, such as those of chromosomes 1, 7, and 13, and t(12;14).
      CONCLUSIONS: Our findings indicate that approximately 50% of leiomyomas show
      clonal abnormalities, which can be subdivided into four different major
      categories; four of five (80%) of the atypical leiomyomas showed clonal
      chromosome abnormalities, which in one case were complex. The results indicate
      that different specific chromosome abnormalities may characterize the same tumor
      type.

PMID- 1635736
TI  - The possible role of endothelial cells in hypertensive disorders during
      pregnancy.
AB  - OBJECTIVE: To clarify the role of endothelial cells in pregnancy-related
      hypertensive disorders, we studied the cytotoxic effect of sera from normal
      pregnant women and from gravidas with various hypertensive complications of
      pregnancy. METHODS: We obtained serum samples from 84 Japanese women: 17 with
      preeclampsia, ten with gestational hypertension, six with chronic hypertension,
      five with chronic hypertension with superimposed preeclampsia, 21 normal
      gravidas, and 25 healthy nonpregnant women. Endothelial cell injury was measured
      by the release of radiolabeled chromium from the cells into the culture medium.
      RESULTS: The mean (+/- standard error of the mean) values of chromium 51 release
      in preeclampsia, gestational hypertension, chronic hypertension, chronic
      hypertension with superimposed preeclampsia, normal pregnancy, and healthy
      nonpregnant women were: 21.9 +/- 2.1, 10.0 +/- 2.0, 9.2 +/- 2.3, 12.9 +/- 0.8,
      8.4 +/- 1.4, and 7.3 +/- 1.6%, respectively. Normal pregnant and nonpregnant
      subjects did not differ with respect to endothelial cell injury. Sera from women
      with preeclampsia demonstrated significantly greater endothelial cell injury than
      did sera from normal gravidas. Subjects with the three other categories of
      hypertensive disorders did not differ significantly from normal gravidas.
      CONCLUSION: Preeclampsia is characterized by the presence of a serum factor
      cytotoxic to endothelial cells. Therefore, the mechanism responsible for the
      increase in blood pressure differs between women with preeclampsia and those with
      other hypertensive disorders in pregnancy.

PMID- 1635735
TI  - Changes in serum electrolytes after transcervical resection of endometrium and
      submucous fibroids with use of glycine 1.5% for uterine irrigation.
AB  - OBJECTIVE: We evaluated the postoperative changes in serum electrolytes in
      relation to the amount of irrigating fluid absorption and the occurrence of
      nausea and vomiting after transcervical resection of endometrium and submucous
      fibroids. METHODS: From May 1989 to October 1991, 101 consecutive patients were
      operated on for menometrorrhagia with transcervical resection of endometrium and
      submucous fibroids using glycine 1.5% for uterine irrigation. The deficit of
      glycine was assessed during and at the end of the operation. During the
      postoperative course, attention was paid to the occurrence of cerebral confusion,
      nausea (defined by at least one incident of vomiting), and dyspnea. The serum
      levels of sodium, potassium, and chloride were assessed before the operation, at
      the end of the procedure, and after 4, 8, and 12 hours. RESULTS: No marked water
      intoxication or signs of volume overload were seen, but 33% of the patients had
      nausea and vomiting in the postoperative period. These patients showed a more
      pronounced postoperative decrease in serum sodium (P = .0001) and a larger
      glycine deficit (P = .004) than did patients without nausea. The postoperative
      decrease in serum sodium correlated significantly to the glycine deficit (R2 =
      0.83, P less than .001). CONCLUSION: Postoperative hyponatremia after
      transcervical resection of the endometrium correlated with the deficit of
      irrigant fluid but not with the operation time or the total amount of irrigant
      fluid used. We recommend that serum sodium be controlled and corrected if
      necessary postoperatively in patients with nausea and vomiting.

PMID- 1635737
TI  - A randomized clinical trial comparing the Cytobrush and cotton swab for
      Papanicolaou smears.
AB  - OBJECTIVE: We sought to determine whether use of the Cytobrush/spatula or the
      cotton swab/spatula is better in obtaining satisfactory Papanicolaou smears as
      defined by the Bethesda System. METHODS: This 1-year randomized trial was
      performed at the Los Angeles County + University of Southern California Women's
      Hospital colposcopy clinic. Participants were all nonpregnant patients referred
      to the colposcopy clinic for abnormal Papanicolaou smears. The main outcome
      measurement was the effectiveness in obtaining satisfactory Papanicolaou smears
      as defined by the Bethesda System. Data were analyzed using the Pearson chi 2
      test. RESULTS: The sampling methods had similar abilities to obtain a
      satisfactory smear (Cytobrush/spatula 63%, cotton swab/spatula 57%; P = .23).
      Less-than-optimal smears accounted for 28% of the Cytobrush group and 38% of the
      cotton-swab group. The Cytobrush was superior in its ability to obtain
      endocervical cells (Cytobrush 80%, cotton swab 60%; P less than .01). Both
      sampling methods had similar rates of correlation with histologic diagnosis. No
      complications were associated with either technique. CONCLUSIONS: The
      Cytobrush/spatula is superior to the cotton swab/spatula in obtaining
      endocervical cells. There appears to be no difference in each method's ability to
      obtain satisfactory smears. Application of the Bethesda System results in a
      significant number of less-than-optimal smears using either technique.

PMID- 1635738
TI  - Ilioinguinal nerve entrapment during needle suspension for stress incontinence.
AB  - The anatomy of the ilioinguinal nerve makes it vulnerable to entrapment near its
      exit from the superficial inguinal ring, where it lies almost directly superior
      to the pubic tubercle. During a 27-month period (December 1986 to March 1989), we
      encountered seven cases of ilioinguinal nerve entrapment following needle
      suspension procedures. In each case the diagnosis was made because of
      characteristic pain localized to the medial groin, mons, labia majora, and inner
      thigh. The intensity and character of the pain varied considerably, presumably
      depending on the time and degree of nerve compression. This paper discusses the
      resulting pain complex, diagnosis, pathophysiology, and options for prevention
      and treatment of this uncommon complication.

PMID- 1635739
TI  - Abnormal findings on hysterosalpingography: effects on fecundity in a donor
      insemination program using frozen semen.
AB  - OBJECTIVE: We sought to evaluate the effect of abnormal baseline
      hysterosalpingography (HSG) on subsequent fecundity during the first six cycles
      of treatment. METHODS: Hysterosalpingography was performed on 208 asymptomatic
      ovulatory women with no history of pelvic disease who were referred for donor
      insemination. The findings were categorized into five groups: 1) normal study, 2)
      uterine anomaly or filling defect with bilateral tubal patency, 3) normal uterine
      anatomy with unilateral tubal patency, 4) normal uterine anatomy with bilateral
      tubal blockage, and 5) normal uterine anatomy with hydrosalpinx. Subjects in
      groups 4 and 5 received inseminations only if patency of at least one fallopian
      tube was demonstrated with laparoscopy. Life-table analysis was performed to
      calculate the average monthly fecundity and cumulative conception rates for each
      group. The Mantel-Haenszel test was used to compare group fecundities. RESULTS: A
      total of 1460 donor insemination cycles were performed. The number of cycles in
      each group were as follows: group 1, 1173 (80%); group 2, 153 (10%); group 3, 90
      (6.2%); group 4, 16 (1.1%); and group 5, 28 (1.9%). None of the patients in group
      4 or 5 conceived. The cumulative conception rates in the first three groups were
      46, 34, and 40%, respectively, and were not significantly different from one
      another (P greater than .05). Although a high incidence of uterine filling
      defects and unilateral tubal blockage was observed (19.2%), the incidence of an
      abnormal HSG finding that significantly decreased fecundity was only 2.8%.
      CONCLUSION: In women with no history of tubal or uterine disease, routine HSG
      before initiation of donor insemination is of limited value for identifying
      decreased treatment fecundity.

PMID- 1635740
TI  - Frequency, distribution, and theoretical mechanisms of hematologic and weight
      discordance in monochorionic twins.
AB  - OBJECTIVE: The purpose of this study was to determine the frequency,
      distribution, and most likely etiology of hematologic and weight discordance in
      pathologically proven monochorionic twins, and to use this information to
      reevaluate the neonatally derived definition of the twin-twin transfusion
      syndrome. METHODS: We reviewed our experience with 97 pathologically proven
      monochorionic twin pregnancies. The frequency and distribution of weight and
      hemoglobin-hematocrit (hb-hct) discordance were determined for all twin pairs.
      Factors that may have contributed to the discordance were identified, and
      theoretical mechanisms were proposed. RESULTS: All combinations of weight and hb
      hct discordance were observed. Thirty-four twin pairs (35%) were discordant for
      weight. In half of these (17 of 34), the hb and hct were concordant. In 18% (six
      of 34), the smaller twin had the higher hb-hct, and in 32% (11 of 34), the
      smaller twin had the lower hb-hct. Twenty-three of 63 size-concordant pairs (36%)
      were discordant for hb-hct. Ten infants were infected at birth, eight had
      malformations, and 25 likely suffered an acute transfusion event. CONCLUSIONS:
      Any combination of weight and hb-hct discordance can occur in monochorionic
      twins. Acute and chronic twin-twin transfusion, uteroplacental insufficiency,
      infection, malformations, or other factors may have accounted for the discordance
      observed. Thorough antenatal evaluation with invasive testing and marker studies
      (to identify a physiologically unbalanced placental anastomosis) may be necessary
      to establish an accurate diagnosis. We conclude that weight and/or hb-hct
      discordance is relatively common in monochorionic twins and in itself is not
      sufficient to diagnose twin-twin transfusion.

PMID- 1635741
TI  - The relationships among psychosocial profile, maternal size, and smoking in
      predicting fetal growth retardation.
AB  - OBJECTIVE: We explored the relationships among measures of psychosocial well
      being, maternal size, and smoking in predicting infant size at birth. METHODS:
      Participants in this population-based cohort study were drawn from public health
      prenatal clinics in Jefferson County, Alabama during 1985-1988. Para 1 and 2
      women were screened for 11 risk factors for low birth weight, including small
      stature, a previous low birth weight infant, and smoking. RESULTS: Poor scores on
      five of six psychosocial scales, as well as on a combined profile, were
      associated with a significantly higher relative risk of fetal growth retardation
      (FGR) only in thinner women, defined as having a body mass index less than the
      median (relative risk [RR] 2.11, 95% confidence interval [CI] 1.47, 3.04). A
      significant association between the psychosocial profile and birth weight was
      demonstrated for thin women in a multivariate analysis adjusting for gestational
      age, race, infant sex, and smoking (P = .0003). The relationship remained
      significant when hypertension, alcohol and drug use, and weight gain were added
      to the model (P = .003). In women with a body mass index above the median, a poor
      psychosocial profile showed little association with FGR (RR 1.20, 95% CI 0.73,
      1.98) and did not have a significant association with birth weight. A poor
      profile had a greater association with FGR in non-smokers (RR 2.04, 95% CI 1.29,
      3.22) than in smokers (RR 1.4, 95% CI 0.95, 2.06). CONCLUSIONS: Greater pre
      pregnancy weight for height appears to protect against the adverse effects of a
      poor psychosocial profile in a population of poor, primarily black women. In
      thinner women, both smoking and a poor psychosocial profile were associated with
      a substantially increased rate of FGR, indicating a subgroup of women who may
      receive greater benefits from intervention programs.

PMID- 1635742
TI  - Subcutaneous tissue thickness cannot be used to distinguish abnormalities of
      fetal growth.
AB  - Two hundred forty-four women with normal pregnancies between 15-42 weeks'
      gestation served as a control group to determine subcutaneous tissue thickness at
      three different fetal locations: mid-calf, mid-thigh, and abdomen at the level of
      the abdominal circumference. The values at the three locations were comparable,
      varying between 1 mm at 15 weeks' gestation and approximately 5.5 mm at term.
      Similar measurements were obtained in two study groups consisting of 13 growth
      retarded and 38 large for gestational age fetuses. The degree of overlap in
      subcutaneous tissue thicknesses between the normal group and the two groups with
      disturbances in fetal growth was such that neither growth retardation nor
      macrosomia could be reliably predicted with these sonographic measurements.

PMID- 1635743
TI  - Doppler velocimetry in concordant and discordant twin gestations.
AB  - Doppler blood flow studies in 63 pairs of concordant and 17 pairs of discordant
      twins were compared with those of 277 appropriate for gestational age singleton
      fetuses. Discordancy was defined as a more than 20% intra-pair actual birth
      weight difference. The data were divided into five groups: singletons and large
      and small concordant and discordant twins. Statistical comparisons of the
      regression lines for the large concordant and discordant twins and the singletons
      showed no significant differences among the three lines, either in slopes (P =
      .1) or intercepts (P = .08). Comparisons of the regression lines for small
      concordant and discordant twins and the singletons indicated a significant
      interaction among the three lines (P = .01). Additional analysis leads us to
      conclude that the systolic-diastolic ratio (S/D) decreases with advancing
      gestational age for all groups except small discordant twins. The S/D of small
      discordant twins differed significantly from that of singletons and tended to
      differ from that of small concordant twins.

PMID- 1635744
TI  - Systolic or diastolic notch in uterine artery blood flow velocity waveforms in
      hypertensive pregnant patients: relationship to outcome.
AB  - To identify the relationship between a systolic or diastolic notch in uterine
      artery flow velocity waveforms and pregnancy outcome, we studied 140 hypertensive
      pregnant women with transvaginal, image-directed pulsed Doppler ultrasound. The
      subjects were classified according to the presence or absence of a systolic or
      diastolic notch. In 14 with a systolic and 25 with a diastolic notch, the
      resistance indexes in the uterine arteries on both sides of the uterus were
      significantly higher than in 101 subjects without a notch. Those with notches had
      significantly higher rates of fetal growth retardation and cesarean delivery
      because of fetal distress. Significantly more infants born to women with a notch
      spent longer than 48 hours in the neonatal intensive care unit. Subjects with a
      systolic notch also had significantly higher rates of abnormal fetal heart rate
      patterns during labor and low Apgar scores at 5 minutes. Fifty-one women with
      elevated resistances indexes in both uterine arteries were divided into two
      groups according to the resistance index in the umbilical artery. Each group was
      subdivided according to the presence or absence of a systolic or diastolic notch
      in the uterine artery flow velocity waveforms. In the group with a normal
      resistance index in the umbilical artery, five women had growth-retarded fetuses
      when a notch was present (N = 8), compared with none in women without a notch (N
      = 11) (P less than .005). The respective figures for the group with abnormal
      umbilical artery resistance indexes were 14 of 19 (73.7%) and two of 13 (15.4%)
      (P less than .002).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635745
TI  - Oxygen measurements in endometrial and trophoblastic tissues during early
      pregnancy.
AB  - Placental and endometrial partial pressures of oxygen (PO2) were measured using a
      polarographic oxygen electrode during the first trimester of pregnancy. Between 8
      10 weeks' gestation, placental PO2 levels were significantly lower (P less than
      .001) than endometrial levels. A significant (P less than .001) increase was
      observed for placental PO2 values measured at 12-13 weeks compared with those
      obtained at 8-10 weeks. We suggest that the increase of placental PO2 at the end
      of the first trimester is related to the establishment of continuous maternal
      blood flow in the intervillous space.

PMID- 1635746
TI  - Intravascular transfusion of fetuses with rhesus incompatibility: prediction of
      fetal outcome by changes in umbilical venous pressure.
AB  - OBJECTIVE: We examined whether abnormal elevations in umbilical venous pressure
      during intravascular transfusion predict post-transfusion mortality. METHODS:
      Umbilical venous pressures were measured during intravascular transfusion of
      human fetuses with Rhesus incompatibility. Five fetuses died within 24 hours
      after transfusion and nine fetuses survived the procedure. RESULTS: Survivors and
      non-survivors were similar in demographic and clinical data, as well as in
      transfusion characteristics. The only difference between the groups was the
      change in umbilical venous pressure during the transfusion: 5.0 +/- 6.3 mmHg for
      survivors versus 18.1 +/- 10.4 mmHg for non-survivors (P = .01). An increase in
      the umbilical venous pressure of 10 mmHg or more predicted fetal death with a
      sensitivity of 80% and specificity of 89%. CONCLUSION: Based on these results, we
      have modified our transfusion technique. If the change in umbilical venous
      pressure during intravascular transfusion approaches 10 mmHg, we discontinue the
      procedure. If the change in pressure exceeds 10 mmHg during transfusion, we
      remove blood and replace it with an equal volume of saline.

PMID- 1635747
TI  - Effects of norethisterone on pressor response to angiotensin II in men.
AB  - OBJECTIVE: We examined the effects of norethisterone and/or mestranol on the
      pressor response to angiotensin II in 20 healthy men. METHODS: Four study
      protocols were used: I) mestranol 0.08 mg/day for 6 days followed by mestranol
      plus norethisterone 20 mg/day for 6 days, II) mestranol 0.16 mg/day for 6 days
      followed by norethisterone alone 10 mg/day for 6 days, III) mestranol 0.24 mg/day
      followed by norethisterone 20 mg/day for 6 days, and IV) norethisterone 20 mg/day
      for 6 days. The angiotensin II dose to elicit a 20-mmHg rise in diastolic blood
      pressure was considered the effective pressor dose. This was determined before
      each protocol, at the end of the mestranol-alone portion, and at the end of the
      norethisterone portion. Subjects in study III also underwent measurement of
      plasma prostanoid levels, plasma renin activity and concentration, and estradiol
      and progesterone just before each angiotensin II infusion. Subjects in studies I
      and III underwent measurement of mean platelet volume, complete blood counts,
      liver function tests, and coagulation factors before each angiotensin II
      infusion. RESULTS: Whereas mestranol had no apparent effect on angiotensin II
      pressor response, norethisterone at a dose of 20 mg/day (with or without
      concurrent mestranol administration) caused a significant decrease in pressor
      responsiveness to angiotensin II. No changes in plasma prostanoids or renin could
      be found that would account for the change in pressor response. CONCLUSION: These
      findings indicate that the refractoriness to angiotensin II induced by
      norethisterone was related to its progestogenic properties.

PMID- 1635748
TI  - Fetal intracardiac potassium chloride injection to avoid the hopeless
      resuscitation of an abnormal abortus: I. Clinical issues.
AB  - OBJECTIVE: With the intention of preventing the attendant medical, ethical, and
      legal problems arising from the birth of live-born, anomalous fetuses, we
      initiated a program offering fetal intracardiac potassium chloride injection as
      an adjunctive measure in the setting of genetically indicated second-trimester
      abortion. METHODS: A lethal fetal injection was offered to patients carrying
      chromosomally or structurally abnormal fetuses at 19-24 weeks' gestation who
      desired abortion. When the patient elected this procedure, real-time ultrasound
      guidance was used to inject 3-5 mL of potassium chloride (2 mEq/mL) directly into
      the fetal cardiac chambers, followed by observation of fetal heart activity to
      ascertain cessation. Labor was subsequently induced with uterotonic
      prostaglandins. RESULTS: The procedure caused immediate cessation of fetal heart
      motion in 20 of 21 cases. There were no maternal complications. No fetuses were
      live-born. CONCLUSIONS: Direct fetal intracardiac potassium chloride injection
      effectively causes immediate fetal cardiac arrest. This approach may be adopted
      in cases of abortion by labor-induction methods at advanced gestations to ensure
      that the abortus is stillborn.

PMID- 1635749
TI  - The lesser tragedy.

PMID- 1635750
TI  - Prevention of neonatal group B streptococcal infections: advances in maternal
      vaccine development.
AB  - OBJECTIVE: We describe the current state of prevention of neonatal group B
      streptococcal infections and present recent advances toward the development of a
      maternal vaccine for prevention of this disease. DATA SOURCES: We used a MEDLINE
      search of the Index Medicus from 1976-1992 for articles regarding group B
      streptococcus classification and immunology. Group B streptococcus was also cross
      referenced with bacterial antigens, antibodies, and vaccines. Relevant textbooks
      were reviewed. METHODS OF STUDY SELECTION: Fifty-seven articles were selected as
      providing important background and new findings pertinent to this topic. DATA
      EXTRACTION AND SYNTHESIS: The literature supports prophylactic use of intrapartum
      antibiotics in mothers who are known carriers of group B streptococcus but
      highlights the need for more sensitive rapid screening techniques to identify
      this high-risk population. The promise of intravenous immunoglobulin for neonatal
      prophylaxis has not been borne out, although hyperimmune and monoclonal
      preparations offer renewed hope for prophylaxis and adjuvant therapy. Native
      bacterial polysaccharides, conjugated oligosaccharides and polysaccharides, and C
      proteins have been investigated as antigens for candidate vaccines. Antibodies
      elicited in human and animal studies provide protection against bacterial strains
      possessing these determinants. The theoretical existence of a "universal antigen"
      is significant because polysaccharide and C protein formulations are required to
      be polyvalent. CONCLUSIONS: The development of a vaccine for prevention of
      neonatal group B streptococcal sepsis is an attainable goal. Further study of the
      immunogenic properties of bacterial-cell-wall polysaccharides and their
      conjugates, C proteins, and the potential universal antigen is required.

PMID- 1635751
TI  - Fetal intracardiac potassium chloride injection to avoid the hopeless
      resuscitation of an abnormal abortus: II. Ethical issues.
AB  - Following the diagnosis of a genetic anomaly, some couples choose to have a legal
      abortion. However, following later abortions at greater than 20 weeks, the rare
      but catastrophic occurrence of live births can lead to fractious controversy over
      neonatal management. To avoid this situation, we have added fetal intracardiac
      potassium chloride injection to cause fetal cardiac arrest before induction of
      labor. The ethical issues surrounding such a practice are complex. We support
      this practice for three reasons: 1) The women's decision for abortion is
      protected because this practice assures her right for non-interference; 2)
      potential psychological harm to the patient and other family members is avoided;
      and 3) the potential for coercive intervention by other health care personnel is
      eliminated. At least three objections can be raised: 1) All abortions are unjust;
      2) newborns and second-trimester fetuses at similar weights with identical
      defects should be managed in like fashion; and 3) the patient is not entitled to
      death of the fetus, only to evacuation of the uterine contents. On balance, we
      believe that our approach is justifiable ethically as it reduces the burden of
      conflict between the wishes of the patient and those of the neonatal care givers.
      It should be introduced only in situations in which the likelihood of civil or
      criminal liability or unwarranted medical intervention is high.

PMID- 1635752
TI  - Closed liability claims analysis and the medical record.
AB  - An analysis of 353 closed claims involving obstetrician-gynecologists revealed
      that the 40 highest-paid claims (11.3%) accounted for 88.7% of the total dollars
      spent. Newborn obstetrics, maternal obstetrics, and delayed-diagnosis claims
      represented 80%. Five doctors represented in the top 13 claims had another one or
      two claims among the highest 40. Only one of these physicians is still in good
      standing with the insurance company. Twelve claims (30%) were judged to be
      nonmeritorious, resulting in indemnity in five cases. Most of these claims
      illustrated either deficits with the medical record or system failures. A number
      of these problems could be prevented by avoiding system failures and by regarding
      the medical record as a legal document. Lawsuits occasionally resulted in an
      unfair distribution of dollars to injured parties and led to justifiable
      restriction of few physicians. It is critical that there be a record of why
      something was done. If the record is silent, there is no defense. An erroneous
      decision may be defensible if the reasons leading to it are recorded in the
      chart.

PMID- 1635753
TI  - Clues to enhancing the identification of human immunodeficiency virus-infected
      women.
AB  - Although ACOG recommends human immunodeficiency virus (HIV) testing of pregnant
      women who are "at increased risk" of HIV infection, more explicit recommendations
      do not exist. We suggest three stages of collecting clinical clues that may
      enhance the identification of HIV-infected women. The first considers traditional
      HIV-risk behaviors. The second incorporates the answers to specific questions in
      the clinical history, and the third considers the results of standard blood tests
      obtained during routine obstetric-gynecologic visits.

PMID- 1635754
TI  - Glenn A. Fry Award Lecture 1991: perceptual manifestations of imperfect optics in
      the human eye: attempts to correct for ocular chromatic aberration.
AB  - The profession of optometry has been very successful in providing optical
      corrections for spherocylindrical refractive errors. In this paper, I examine one
      attempt to improve retinal image quality beyond that afforded by a standard
      refractive correction. Ocular chromatic aberration is one of the factors that
      prevent retinal image quality from reaching the upper limit set by the wave
      nature of light. It can be subdivided into three primary aberrations (wavelength
      dependent differences in imaging plane, image position, and image size). We have
      been able to measure all three of these using psychophysical techniques. Although
      attempts to provide an optical correction for wavelength-dependent refractive
      errors have been optically successful, they have failed to improve vision.
      Several possible explanations are given for this failure.

PMID- 1635755
TI  - Cortical potentials evoked by short wavelength patterned light.
AB  - Pattern-evoked cortical potentials (PECPs) were recorded in response to the onset
      of blue and black, square wave gratings superimposed on a bright orange
      background. Several lines of evidence, including spectral sensitivity and the
      absence of response in a tritanopic subject, indicate that the measured cortical
      potentials reflect input from S cones. Spatial and temporal tuning of this
      response are comparable to psychophysical measures of the S-pathway. In agreement
      with previous studies of achromatic and chromatic spatial processing, a
      comparison of the response to patterns of different complexity indicates that
      spatial processing in the S-pathway can be described by linear systems analysis.
      An oblique effect for the S-pathway is demonstrated. Additional findings which
      bear on the nature of postreceptoral processing in the S-pathway are considered.
      Included are measurements from a patient with diabetic retinopathy. This study
      underscores the potential importance of the S-pathway for spatial information
      processing.

PMID- 1635757
TI  - Vergence errors: some hitherto unreported aspects of fixation disparity.
AB  - Measurement of the monocular components of fixation disparity indicated a higher
      prevalence of asymmetric contributions to the total deviation than previously
      reported. Furthermore, the exact proportion varied from moment to moment. Two of
      six subjects showed significant changes in fixation disparity over a period of 1
      week. For all six subjects the changes in fixation deviation of one eye were
      virtually independent of those changes occurring in the other eye. In other
      words, these monocular variances were uncorrelated. Settings of the monocular
      components of binocular fixation disparity were accomplished at an accuracy close
      to that achieved by using a monocular vernier technique. The remaining
      differences appeared to be due to occasional instabilities during binocular
      viewing. The usual method of clinical measurement in which only one element is
      moved is not always equivalent to that determined by summing the two monocular
      components. The principal process measured by subjective fixation disparity
      appears to be either oculomotor or localized directional shifts of a monocular
      nature.

PMID- 1635756
TI  - Comparison of two glare measurement methods through light scattering modeling.
AB  - Two methods used for evaluation of glare in patients with opacities of the ocular
      media are compared. One is a low contrast letter test and the other is a direct
      light scattering meter. Theoretical expressions for the measures obtained from
      the two different glare tests are derived in terms of the point spread function.
      Measurements on healthy test persons wearing diffusive glasses with known light
      scattering properties were in good agreement with the theory. Data from 26
      cataractous eyes are presented and discussed in light of the theory.

PMID- 1635758
TI  - Multimeridional apparent frontoparallel plane: relation between stimulus
      orientation angle and compensating tilt angle.
AB  - The classical apparent frontoparallel plane (AFPP) setting is typically obtained
      by having the subject move a series of parallel rods farther or closer until they
      line up in a plane perceived to be parallel to the face plane. If there is a size
      difference between the two ocular images, the AFPP setting defined by the rods
      will exhibit a tilt from the objective frontoparallel plane, about an axis
      parallel to the rods. The multimeridional apparent frontoparallel plane (MAFPP)
      is an extension of this procedure to rod orientations other than the vertical
      meridian. In previous studies, it was found that oblique tilt angle settings
      corresponding to rod orientations of 45 degrees and 135 degrees are equal to
      square root 2 times the tilt angle for the vertical rod orientation for the same
      interocular magnification difference along the meridian perpendicular to the
      rods. In this study, we measured the tilt angles produced by a series of oblique
      rod orientations between 15 degrees and 165 degrees, inclusive. Throughout the
      150 degrees range tested, the tilt angles were found to be consistently
      proportional to the cosecant of the rod orientation angle, the factor square root
      2 previously used being a specific example of this relation. Within this range,
      neither empirical cues nor the induced effect cause the cosecant relation to
      break down. It is suggested that the MAFPP procedure can be applied more
      extensively than previously anticipated.

PMID- 1635759
TI  - Monocular vernier acuity in normally binocular, monocular, and amblyopic
      subjects.
AB  - Previous experiments that have compared monocular vernier acuity in amblyopic,
      monocularly blind, and normal binocular subjects have been confined to the center
      of the retina. Based on brain changes that accompany the early disruption of form
      vision in one eye, monocularly blind subjects (that is, those who have completely
      lost the ability to process form vision in one eye) and amblyopic subjects are
      expected to have better vernier acuity in their normally functioning eye than
      subjects with normal binocular vision. Results from such studies have been
      ambiguous. This experiment was set up to study monocular vernier acuity in the
      central and peripheral retina of the three groups of subjects mentioned above.
      The results show that, at the center, monocularly blind subjects have the best
      vernier acuity followed by the amblyopic subjects and, finally, the normal
      binocular subjects have the worst acuity. In the peripheral retina, no
      significant differences were found between the three groups. A possible
      explanation has been provided for this finding.

PMID- 1635760
TI  - Accommodation on downward gaze.
AB  - A study was conducted with the purpose of examining the possible effects of
      vertical and horizontal eye movements upon accommodation. A special Badal
      stimulator was made which was vertically rotatable around the center of an eye.
      The stimulator was attached to the Three-Dimensional Optometer III (TDOIII),
      which could measure accommodation, eye movement, and pupil diameter
      simultaneously. The reliability of the TDOIII measurements of accommodation was
      checked by comparing with a stigmatoscope measurement. Three young males served
      as subjects. A small but definite near accommodation was measured dynamically in
      association with vertical eye movement. We believe this to be the first report of
      this finding. The amount of near accommodation with downgaze showed a tendency to
      decrease when the target was brought near.

PMID- 1635761
TI  - Normative data for hertel exophthalmometry in a normal adult black population.
AB  - Ocular protrusion data were obtained on 309 black adults using a Hertel
      exophthalmometer. The mean protrusion value for black men and women was 18.20 and
      17.46 mm, respectively. The upper limit of normal was 24.14 and 22.74 mm for
      males and females, respectively. The differences between base measurement and
      mean protrusion values of black men and women were significantly different (p
      less than 0.015). These data are compared with those of adult white subjects and
      show that blacks have a higher range of normal than whites. The data indicate
      that the published upper limit of normal (21 mm) for exophthalmos is not
      appropriate for adult black patients.

PMID- 1635762
TI  - Acute ptosis secondary to contact lens wear.
AB  - Ocular ptosis secondary to the wearing of rigid contact lenses has been reported.
      Generally this ptosis is not of the classical variety, and appears to be an
      edematous or inflammatory response of the lid to the presence of the lens. We
      report a case of acute ptosis secondary to rigid lens wear in a patient who had
      undergone cataract surgery. The patient had been a contact lens wearer before
      surgery, and developed the relative ptosis postsurgically in the nonoperated eye.
      The ptosis resolved without any form of intervention other than ceasing to wear
      the contact lens. We feel that in cases where rigid lens wear is discontinued
      unilaterally for any reason, and a relative ptosis is noted, it should be given
      time to resolve before any therapeutic regimen is considered.

PMID- 1635763
TI  - Central retinal vein occlusion in a middle-aged adult with HIV infection.
AB  - Recently central retinal vein occlusion (CRVO) has been described as a possible
      AIDS-related phenomenon. We have seen another case of CRVO in a middle-aged male
      with HIV infection. Extensive laboratory testing failed to reveal any other
      systemic abnormality which might be contributory. The potential role of HIV
      infection in the pathogenesis of CRVO is discussed.

PMID- 1635764
TI  - Electronic submission of abstracts for the annual meeting of the American Academy
      of Optometry.
AB  - Recently the American Academy of Optometry conducted a 2-year trial in which
      abstracts submitted for presentation at the Annual Meeting could be transmitted
      to the Academy in electronic form. Electronic submission has many advantages for
      the author as well as for the Academy and therefore has now been endorsed as the
      preferred method of submission for future meetings. Step-by-step procedures for
      electronic submission are described.

PMID- 1635766
TI  - Future optometric educators.

PMID- 1635765
TI  - Low vision section.

PMID- 1635767
TI  - Measuring the effects of glare.

PMID- 1635768
TI  - [Combined coronary artery and heart valve surgery at the Clinic for
      Cardiovascular Surgery (1979-1990)].
AB  - As a result of increasing mean age of patient undergoing open heart surgery more
      and more combined valve and coronary surgery cases are performed. The operative
      risk of combined procedure is higher than that of valve replacement or coronary
      bypass grafting alone. In case of aortic valve disease the operation reduces the
      workload of the left ventricle thus decreasing the oxygen demand of the
      myocardium. In pure mitral valve stenosis as a consequence of valve replacement
      the left ventricular preload increases and coexisting coronary artery disease is
      of greater importance than in the other case. Since 1979 until the end of 1990
      there were 146 combined operations performed in the Cardiovascular Surgical
      Clinic of Semmelweis Medical University of Budapest. The operative results and
      theoretical considerations are discussed.

PMID- 1635769
TI  - [Surgical cerclage in the treatment of cervical incompetence during pregnancy
      (determining the legitimacy of the procedure)].
AB  - The authors studied the effectiveness of the cervical cerclage operation in the
      therapy of cervical insufficiency during the pregnancy. Two Hundred sixteen
      pregnant women took part in this trial in whose pregnancy the necessity of
      cerclage operation was not unequivocal. It means, that the therapeutical cerclage
      operation was not necessary, but the necessity of prophylactic cerclage operation
      was doubtful as well. From the randomized 216 cases they performed cerclage
      operation in 108 pregnancies and in 108 cases they did not perform it. In the
      respect of pregnancy care they did not make any difference between the two
      groups. The authors from their trial draw the conclusion, that in doubtful cases
      where the necessity of cervical cerclage operation is not unequivocal--e.g. at
      serious gestational case history--it is advisable to perform the operation. The
      danger of premature birth can be diminished in this way.

PMID- 1635770
TI  - [Reconstruction of the mandible using a vascularized graft from the iliac bone].
AB  - Twelve vascularized iliac crest free-tissue transfers were used for oromandibular
      reconstruction, 2 as osteocutaneous and 10 as osseous flaps. Two patients had
      preoperative radiotherapy. Nine of the 12 reconstruction were carried out
      primarily, following radical surgery for oral cancer. One graft was lost by
      venous thrombosis. Evidence of bone union was noted in 11 patients, and no
      pseudoarthrosis was observed. The main advantage of this method is the
      availability of a large bloc of living composite tissue and both the functional
      and cosmetic results should be improved in patients undergoing resection of the
      anterior part of the mandible.

PMID- 1635771
TI  - [Activities of the Hungarian Medical Student Association].

PMID- 1635772
TI  - [Reasec poisoning in childhood].

PMID- 1635774
TI  - [Clinical significance of serological markers of Helicobacter pylori].
AB  - Helicobacter pylori (H. pylori) is a Gram-negative, curved bacillus known since
      1983. It is supposed to play role in the pathogenesis of certain gastroduodenic
      diseases, e.g. non-ulcer dyspepsia (NUD), chronic inflammation, ulcers, etc.
      Serum samples of 70 patients who were examined for stomach complaints with
      gastroscopy and those of 22 healthy persons were analysed. The purpose of the
      study was to evaluate anti-H. pylori IgG, IgM and IgA antibodies using ELISA
      method. Whether the antibodies can be detected or not, 8 possible variations
      exist, each of them denoting certain state of infection. These states are not
      always going parallel with the macroscopic pictures revealed by gastroscopy, but
      there are some obvious congruences. Results show that serologic examination
      cannot replace gastroscopy but on the other hand in follow-up tests and
      examinations as well as in understanding the aetiology of different
      gastroduodenal diseases it can play an important role.

PMID- 1635775
TI  - [Clinical significance of intrauterine growth retardation].
AB  - The authors have examined the measure of the influence of the proportional and
      disproportional retardation on the results of the pre- and subnatal observation
      of the fetus and on the frequency of perinatal mortality and newborns' morbidity,
      premature birth and newborns born with low birth weight. The authors have stated
      the two types of retardation leads to a higher global perinatal mortality mainly
      by causing a more frequent intrauterine mortality. Comparing the results of the
      retarded newborns to those of the somatically normally developed neonates they
      prove it from several aspects that the proportional retardation means a much
      higher risk for the newborn than the disproportional retardation which is also a
      risk factor. The new NDN classification system elaborated and used by the authors
      is suitable for differing the two types of retarded newborns.

PMID- 1635773
TI  - [Genetic traits in the area of Bodrogkoz].
AB  - In 1984 a late malaria endemic area, called Bodrogkoz was studied. This was a
      reexamination of the population genetic work performed by Walter, Nemeskeri. In
      six villages of Bodrogkoz 328 persons were tested for AB0, Rh blood groups,
      haptoglobins, haemoglobin concentration, haematocrit, erythrocyte amount, the
      MCV, the MCH and the G-6-PD were analyzed. The quantitative determination of HbF
      and HbA2, red cell osmotic resistance and thalassemia were measured as well.
      Thalassemia heterozygote carriers and an increased level of HbF were revealed.
      The frequency of G-6-PD deficiency was 0.39%. In Bodrogkoz the frequencies of
      AB0, Rh and haptoglobin types were similar in the present and all previous
      studies. The background of this similarity might be the genetic similarity
      between two following generations. On the basis of these facts, the Hb0 Arab and
      partially DNA work we suggested an alternative hypothesis that these mutant genes
      got into Bodrogkoz by the rather later migration than with ancient Hungarian
      people during the period of conquest of Hungary.

PMID- 1635776
TI  - [Successful surgical correction of persistent truncus arteriosus by an aortic
      homograft].
AB  - After palliative procedure a 2 years old girl with congenital heart disease was
      corrected with aortic homograft. Truncus arteriosus is a rare congenital heart
      disease and this is the first successfully corrected case in our country. Using
      homograft in this age group improves the early and late result of this type of
      corrective surgery.

PMID- 1635777
TI  - [Doege-Potter syndrome. Fibrous mesothelioma of multicentric localization,
      causing hypoglycemia].
AB  - The authors present a case of a 73 year old female patient. She had a left side
      pleural mesothelioma and had been operated thrice. At the third operation an
      abdominal propagation joined to the thoracic mesothelioma. Starting from this
      third surgery severe hypoglycemic episodes illustrated the clinical pictures. The
      electronmicroscopy of the resected tumor mass documented the presence of
      neurosecretory granules. This strongly suggests that tumor mass produced a
      substance which could have been responsible for the hypoglycemic episodes. Due to
      the fact the insulin levels measured during severe hypoglycemias were always on a
      low level, we suppose that an insulin like material (IGF--II) was responsible for
      the above mentioned symptoms. The authors briefly review the literature.

PMID- 1635778
TI  - [Activities of the Medical Section of the Transylvanian Museum Association].

PMID- 1635780
TI  - [The non-ulcer dyspepsia syndrome].

PMID- 1635779
TI  - [Jozsef Sadler, physician-botanist in the first half of the 19th century].

PMID- 1635781
TI  - The Prescription Accountability and Patient Care Improvement Act: issues of
      concern for oncology nurses.

PMID- 1635782
TI  - [The Nutrition Committee of the Austrian Society of Pediatrics and Adolescent
      Medicine. Comment on nutrition with solid foods in infancy and early childhood].
AB  - The Nutrition Committee of the Austrian Pediatric Society recommends that weaning
      foods should be introduced between 4 and 6 months of age, which agrees with the
      recommendations in the EC and the U.S. Opinion against early introduction of
      solid foods have focused on concerns about renal solute load, obesity, coeliac
      disease, and food allergy. On the other hand, when weaning was postponed after 6
      months of age, growth faltering in some breastfed infants and iron-deficiency
      anemia in infants fed non-fortified formulas or cow's milk were observed. Two
      broad categories--"baby foods" and "cereal-based weaning foods"--are on the
      market in Austria. "Baby foods" include complete meals sold in jars, soups,
      desserts and puddings, fruit juices, nectars, and vegetable juices. "Cereal-based
      weaning foods" are composed of one or more cereals either alone, or with the
      addition of vegetables, fruits, milk and milk products, egg, or other
      ingredients. Weaning food labelling should include information if sugars, salt,
      iron, vitamins minerals and trace elements have been added and if the product is
      free from gluten, cow's milk and egg protein, and lactose.

PMID- 1635783
TI  - Epidemiological aspects of childhood diabetes mellitus.
AB  - Descriptive epidemiological studies concerning childhood IDDM have demonstrated
      geographic differences and an increase in incidence rates. While sex and age
      distribution have been found remarkably similar.

PMID- 1635784
TI  - IDDM in Hungarian children: population-based clinical characteristic and their
      possible implication for diabetic health care. Hungarian Childhood Diabetes
      Epidemiology Study Group.
AB  - Following our 10-year retrospective study, prospective registration of all newly
      diagnosed children has started in 1989. Data of the primary source (hospital
      records) were validated using the central pharmacy register for insulin.
      Ascertainment rate was 96%. Clinical characteristics are analysed on the basis of
      data of 324 children diagnosed in 1989-1990. There were some regional differences
      in incidence with no relationship between incidence and the degree of
      urbanization. The duration of clinical symptoms before diagnosis was less than
      two months in 81% of the cases, two to four months in 17% of the children, and no
      symptoms were recorded in 2% of the cases. The mean reported weight loss was 3.3
      kg (range 0 to 16 kg), blood glucose at diagnosis ranged between 8.5 and 80.0
      mmol/l (mean 25.4 mmol/l). Ketosis was noted in 86%, and 40% received infusion
      therapy at onset. There was no correlation between age, initial, blood glucose,
      ketosis, severity of the clinical condition and duration of symptoms. IDDM was
      reported in 4.7% of first degree relatives. Birth order was a significant risk
      factor, firstborn children were less at risk than subsequent siblings (P less
      than 0.05); the number of children in diabetic families was similar to those in
      the general population (2.1 vs. 1.8). The high mean blood glucose and ketosis
      indicate a relatively severe metabolic decompensation at the time of diagnosis
      and call for further improvement in the diagnostic acumen of the pediatric
      community.

PMID- 1635785
TI  - [Incidence of pediatric diabetes mellitus in Austria--results of a prospective
      study 1989-1990].
AB  - The mean annual incidence of childhood diabetes mellitus (0-14 years of age) in
      Austria was 7,713 cases per 100,000 during 1989-1990. The manifestation rate in
      boys was insignificantly higher than in girls and the age distribution showed an
      increase up to an incidence peak around puberty. Typical seasonal variation with
      the highest incidence in autumn and winter could be demonstrated and the
      incidence in eastern parts of Austria seemed to be higher than in Vorarlberg.

PMID- 1635786
TI  - Risk factors for cardiovascular disease in chronic spinal cord injury patients.
AB  - To establish whether the reported increased cardiovascular (CV) morbidity in
      spinal cord injury (SCI) patients is due to increased levels of established CV
      risk factors, we assessed overall CV risk in 102 consecutive patients aged 25-64
      by calculation of a 'risk factor score' (RFS) derived from the MRFIT study (age,
      diastolic blood pressure (DBP), total cholesterol (TC) level, cigarettes/day,
      sex), obtaining a percentile position amongst an age and sex matched peer group
      from the 1983 Australian Risk Factor Prevalence Study. Chronic SCI patients had a
      very low overall percentile position of risk of 26.03 + 15.06 (mean +/- S.D.) and
      those patients with SCI for greater than 10 years had only a slightly higher risk
      position of 33.16 +/- 29.66. The low relative risk in SCI patients was due mainly
      to significantly lower DBP levels (67 +/- 13 mm hg), as TC levels (5.38 +/- 1.60
      mmol/L) and cigarette consumption (31% smokers, mode 11-20/day) were similar to
      the control population (83 +/- 12 mmHg, 5.68 +/- 1.2 mmol/L, 28% smokers, mode 11
      20/day, respectively). As other known risk factors such as lipoprotein
      cholesterol fractions were not included in the RFS index, these were measured in
      327 consecutive SCI patients. HDL cholesterol levels, which are negatively
      correlated with CV risk, were significantly lower in SCI patients (1.12 +/- 0.30
      mmol/L) compared to controls (1.35 +/- 0.35 mmol/L) and those patients more than
      10 years post SCI had still lower levels (1.02 +/- 0.40). These data suggest that
      the reported increased incidence of CV disease in SCI patients is unexplained by
      increases in BP, TC or smoking. However, low HDL levels may contribute to CV risk
      and the role of other risk factors such as increased vascular reactivity remain
      to be established.

PMID- 1635787
TI  - The role of the diaphragm in trunk extension in tetraplegia.
AB  - Interest has been focused on the diaphragm as the all important respiratory
      muscle in tetraplegia for decades but its unique role as a trunk extension muscle
      has not been considered. This study set out to establish the relationship, if
      any, between the roles of the diaphragm during arm exercise and trunk flexion.
      Eight male complete cervical cord injuries (CCI) patients, sitting in their
      wheelchairs, were studied during rest, trunk flexion and start of arm cranking.
      The average flow, volume, oesophageal and gastric pressures (Poes and Pga) and
      the myoelectric activity of the diaphragm (EMGdi) were recorded. The EMGdi
      pattern changed from phasic activity at rest to continuous or almost continuous
      activity during trunk flexion. Patients were then either spontaneously holding
      their breath or breathing irregularly with rapid or shallow breaths. Also, the
      normalised EMGdi signal strength increased by an average of 150% and the mean Pga
      by about 3 kPa, while mean Poes decreased by about 0.5 kPa. At the start of
      exercise, patients with poor triceps function, less than MRC grade 3, exhibited
      similar ventilatory and EMGdi changes as had been seen in trunk flexion. In
      patients with better triceps function, only minor changes in these variables were
      observed. The findings suggest that the diaphragm acts both as a trunk extensor
      muscle and a respiratory muscle. During posture imbalance, the postural needs
      temporarily override the respiratory needs.

PMID- 1635788
TI  - The neurosensory musculocutaneous tensor fasciae latae flap: long term results.
AB  - In 1971 we started covering pressure sores and unstable scars with transposition
      rotation-muscle and musculocutaneous flaps. In 1980 we published the first
      results with 6 neurosensory musculocutaneous tensor fasciae latae flaps. Until
      April 1989, 31 tensor fasciae latae flaps (TFL) were used, and we review a
      consecutive series of 19 neurosensory TFL-flaps. Questions such as whether to
      delay the procedure; early and late complications; evolution of the sensation;
      and indications are outlined under the aspects of long term follow up studies.
      The conclusion is that if the neurological pattern permits a neurosensory flap,
      such flaps should be done because no local recurrence occurred. In extended
      neurosensory TFL-flaps sensation of the filling status of the rectum is improved,
      and sitting control and perception of the 'body scheme' are also improved.

PMID- 1635789
TI  - Changes in thyroid hormones, thyroid stimulating hormone and cortisol in acute
      spinal cord injury.
AB  - To determine the hormonal response to acute spinal cord injury, serial serum
      samples were collected from 18 patients with acute spinal cord injury and from 14
      control patients with spinal fractures without cord injury. The first sample was
      taken within 24 hours of injury, the second at 24-48 hours; and the third at 7
      days for determination of thyroxine (T4), free T4 (FT4), triiodothyronine (T3),
      reverse T3 (rT3), T3 uptake (T3U), thyroid stimulating hormone (TSH), thyroxine
      binding globulin (TBG), growth hormone (GH), cortisol, and insulin. Significant
      increases were observed in rT3 levels and transient changes were observed in the
      T4 and T3 levels in the spinal cord injured group but not in the group with
      spinal fractures alone. The changes in the spinal cord injured patients are
      consistent with the 'low T3 syndrome'. However, the persisting rise of rT3 at 7
      days was an unexpected finding. In addition to the cord injury, these changes may
      also be related to dexamthasone administration and nutritional factors.

PMID- 1635790
TI  - The effects of sauna on tetraplegic and paraplegic subjects.
AB  - Six tetraplegic (T) and 4 paraplegic (P) subjects underwent a 20-minute pre sauna
      phase (30 degrees C DB; 65% RH), and an up to 15-minute sauna (85 degrees C DB;
      less than 10% RH), followed by a 15 minute post sauna phase (30 degrees C DB; 65%
      RH). During all phases subjects wore a bathing suit and remained supine on a
      hospital trolley. Heart rate (HR) and blood pressure (BP) were recorded during
      all phases. Rectal temperature (Trec) was measured by a probe (AD590) inserted
      approximately 14 cm into the rectum. Oral temperature (Toral) also utilising
      (AD590) circuitry was recorded simultaneously with Trec. Skin temperature (Tsk)
      (AD590) was measured on the head, chest, right thigh and right calf. Forehead
      sweat rate (SR) was determined from dew point temperature (Tdp). A catheter was
      inserted into a dorsal hand or foot vein and venous blood was withdrawn at
      selected times and analysed for haemoglobin (Hb) and haematocrit (Hct), and the
      separated plasma was analysed for glucose (Glu), sodium (Na+), potassium (K+) and
      chloride (C1-). Venous blood sampled just prior to entering and just prior to
      leaving the sauna, was analysed for adrenalin (A) and noradrenalin (NA) using
      high performance liquid chromatography. For both groups HR rose significantly
      during the sauna with a significant decline in HR for the P group during the post
      sauna phase. There were no significant changes in systolic BP for either group. A
      significant decline in diastolic BP was found for the T group during the post
      sauna phase. There were no episodes of syncope.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635791
TI  - Vocational decision making by sixty spinal cord injury patients.
AB  - Sixty persons with spinal cord injury completed the My Vocational Situation (MVS)
      questionnaire developed by Holland, Daiger and Power. The MVS was designed to
      identify problems related to vocational decision making, ie lack of vocational
      identity, lack of occupational information, and the presence of environmental or
      personal barriers to a chosen occupational goal. As expected, more problems were
      reported by unemployed persons than by employed persons, and by those who
      reported lower levels of psychological well being. MVS scores were not mediated
      by age, time since injury or severity of injury.

PMID- 1635792
TI  - Psychological approach to the rehabilitation of the spinal cord injured: the
      contribution of relaxation techniques.
AB  - We analyse the benefit of learning relaxation techniques as an essential coping
      strategy in the behavioural medicine field. This has proved useful as a part of
      the newly spinal cord injured rehabilitation treatment or concerning later
      problems if there is readmission. We report the changes we have made in the
      relaxation standard methods to be used in spinal cord injured patients as well as
      the timing in the rehabilitation process when these techniques were applied.

PMID- 1635793
TI  - Aerobic power of competitive paraplegic road racers.
AB  - The purpose of this study was to determine peak aerobic power and associated
      physiological responses in highly competitive spinal cord injured (SCI)
      paraplegic road racers. Seven (6 male and one female) active paraplegic (lesions
      T4-T12) road racers and 9 healthy untrained able-bodied males performed
      continuous graded arm crank ergometer tests to exhaustion for determinations of
      peak power output (PO), oxygen uptake (VO2), pulmonary ventilation (VE), heart
      rate (HR), and respiratory exchange ratio (RER). Compared to able-bodied
      subjects, male paraplegic road racers elicited significantly (p less than or
      equal to .05) higher mean (+/- SD) peak levels of PO (141.6 +/- 8.8 vs 111.4 +/-
      27.7 W), absolute VO2 (2.72 +/- .52 vs 2.22 +/- .381/min), and VO2 per unit of
      body weight (43.06 +/- 7.4 vs 30.33 +/- 4.3 ml/kg/min). Although peak HR (180.3
      +/- 9.5 vs 173.2 +/- 8.5 bpm) and VE (92.8 +/- 17.2 vs 74.6 +/- 20.3 l/min)
      tended to be higher for male paraplegic road racers than able-bodied subjects,
      the differences were not statistically significant. The female paraplegic road
      racer achieved the highest peak levels of PO (119 W) and VO2 (1.99 l/min; 38.0
      ml/kg/min) reported to date for wheelchair-dependent women. These data suggest
      that intense physical training via wheelchair propulsion can markedly enhance
      upper body cardiovascular fitness in SCI paraplegics. However, the correlational
      analysis between 10 km time and peak VO2 was nonsignificant (p greater than .05)
      indicating that factors other than peak upper body aerobic power may influence
      wheelchair road racing performance.

PMID- 1635794
TI  - The value of urodynamics and bladder management in predicting upper urinary tract
      complications in male spinal cord injury patients.
AB  - A review of 160 male patients admitted to the Shepherd Spinal Center was
      completed to determine the influence of urodynamic findings and choice of bladder
      management program on the risk of developing upper urinary tract distress
      following acute spinal injury. Within the context of this investigation, upper
      urinary tract distress was defined as presence of hydronephrosis, febrile urinary
      tract infection, urolithasis or vesicoureteral reflux. Three groups were
      identified according to the urodynamic findings and the bladder management
      program. Thirty-four subjects with preservation of detrusor function managed
      their bladders by spontaneous voiding. Seventy patients with detrusor areflexia
      managed their bladders via intermittent catheterization; and 56 males who had
      detrusor hyperreflexia on urodynamics were managed by a reflex voiding program
      with condom drainage. None of the subjects with preservation of spontaneous
      voiding function experienced upper tract distress. Seven percent of those on
      intermittent catheterization and 32% of those managed by a reflex voiding program
      experienced upper tract distress. The presence of detrusor hyperreflexia with or
      without vesicosphincter dyssynergia influenced the likelihood that subjects would
      experience upper urinary tract distress following spinal injury. While
      traditional urodynamics failed to distinguish patients managed by a reflex
      voiding program who experienced upper tract distress from those who did not,
      calculation of a new urodynamic variable, the urethral pressure gradient, was
      found to assist in this prediction.

PMID- 1635795
TI  - Spinal cord lesion after penicillin gluteal injection.
AB  - Penicillin gluteal injection may cause sudden and irreversible paraplegia. In the
      literature 6 cases have been reported, and spinal infarction was conjectured, the
      mechanism being obscure. The actual incidence of such a complication is not
      known. We observed 2 more cases, 6 and 16 years respectively following such an
      injection. The clinical features suggested that spinal infarction had occurred,
      and an MRI study in the most severely impaired patient showed marked spinal
      atrophy, giving further support to the spinal infarction hypothesis. These
      findings and the pathophysiological considerations suggest that the mechanism
      might be the accidental injection into the superior gluteal artery, causing its
      distal spasm and the upstream ascent of the penicillin with ensuing embolic
      and/or spastic occlusion of the arterior spinal artery.

PMID- 1635796
TI  - Acute paraplegia resulting from haemorrhage into a spinal neurofibroma.
AB  - Acute paraplegia due to the intratumour haemorrhage of spinal neurofibroma is a
      rare condition. We describe 2 patients with this unusual presentation. Surgical
      treatment was successful in both patients. These 2 cases are reported, and the
      literature is reviewed.

PMID- 1635797
TI  - Esophageal perforation: a delayed complication following traumatic spinal cord
      injury. Case report.
AB  - Esophageal perforation is an uncommon but serious complication of penetrating
      injuries to the neck and chest. A case of delayed esophageal perforation in a
      patient with traumatic spinal cord injury is presented. The pathophysiology,
      diagnosis, and treatment of this potentially fatal complication are discussed.

PMID- 1635799
TI  - Pediatric neurology.

PMID- 1635798
TI  - Neurocutaneous syndromes.
AB  - Many of the neurocutaneous disorders are more common than once suspected, in part
      because patients with milder forms of the disorders are now more likely to be
      recognized. Improved diagnostic studies and increasingly specific medical and
      surgical therapy allow some previously untreatable complications to be
      successfully managed. Genetic linkage analysis has localized the abnormal gene
      for some of the hereditary neurocutaneous disorders onto specific chromosomes,
      and newly developed clinical diagnostic criteria have improved our ability to
      establish a definite diagnosis in less obvious patients. Thus, the outlook for
      these patients is no longer uniformly pessimistic.

PMID- 1635800
TI  - Perinatal cerebrovascular disease in the neonate. Parenchymal ischemic lesions in
      term and preterm infants.
AB  - Acute cerebrovascular injury in term and preterm infants is a cause of
      significant morbidity. Treatment efforts in the past have focused on attempts to
      prevent such injury by interceding during labor in term infants and improving
      neonatal care in preterm infants. Epidemiologic studies suggest that these
      strategies have had little impact. A new strategy--drug treatment of acute
      ischemic brain injury--is on the horizon. The recognition and prognostication in
      ischemic neonatal brain injury takes on a new importance in this light.

PMID- 1635801
TI  - Bacterial meningitis in children. Selected aspects.
AB  - Accumulating clinical experience has gradually outlined the epidemiology of acute
      bacterial meningitis, including the epidemic and the sporadic forms, the
      customary clinical signs related to different age groups and causative organisms,
      and methods of rapid diagnosis by laboratory examinations. Effective treatment,
      which continues to evolve, emerged in the 1940s with the development of
      antibacterial antimicrobials, first with the sulfonamides and then with the
      penicillins. The literature relative to these aspects of the disease has been
      abundant in the past few years. This article is directed to a variety of topics
      that have direct bearing on the disorder but are less often addressed to those
      who deal with infants and children.

PMID- 1635802
TI  - Acquired immunodeficiency syndrome and the child's central nervous system.
AB  - Human immunodeficiency virus-1 (HIV-1) associated central nervous system disease
      may complicate the course of HIV-1 infection in infants and children. Neurologic
      dysfunction in these young patients adds significantly to the morbidity of the
      disease and is often a devastating complication. It is apparent that HIV-1
      infection in infants and young children is complicated by numerous developmental
      parameters. The developmental stage of the nervous and immune systems when
      exposed to the virus is likely to interact in complex ways with HIV-1 variables.
      In order to care for these children and to design rational approaches for
      treatment and prevention, it is now critical to develop a better understanding of
      how HIV-1 affects the developing nervous system.

PMID- 1635803
TI  - Nonepileptic paroxysmal events in childhood.
AB  - Seizures are the most commonly occurring paroxysmal events of childhood. There
      are a large number of other disorders, however, that present with discrete
      attacks separated by symptom-free intervals. The differentiation of these
      conditions from seizures depends on a willingness to consider alternate diagnoses
      and a thorough review of the history of the events. Laboratory tests, and
      especially the electroencephalogram, are aids to diagnosis, but reliance on
      laboratory data has many pitfalls. The clinical features of the important
      nonepileptic paroxysmal disorders of childhood are reviewed.

PMID- 1635804
TI  - Movement disorders of children.
AB  - Abnormal movements occur in many of the neurologic disorders affecting children
      and in certain conditions are the presenting major manifestations. In children
      abnormal movements may be transient and benign and do not necessarily indicate a
      progressive degeneration of the central nervous system. Clinical observations and
      appropriate laboratory investigation will frequently lead to a neurologic
      diagnosis that in many instances will respond to specific pharmacologic
      treatment.

PMID- 1635805
TI  - Imaging of the central nervous system in pediatrics and adolescence.
AB  - Magnetic resonance imaging (MRI) has taken its place beside computed tomography
      (CT) and ultrasonography in effective imaging of the central nervous system in
      infants and children. The major initial impact of MRI in pediatric neuroradiology
      has been the displacement or replacement of the more expensive and invasive
      procedures such as angiography, myelography, cisternography, and
      ventriculography. Ultrasonography remains the screening procedure for fetal and
      infant central nervous system abnormalities, whereas CT continues to be an
      effective brain screening technique after loss of the ultrasonography windows
      with growth of the child. The better the clinical information transmitted to the
      radiologist in advance of imaging of the patient, the more likely the clinician
      will receive valuable information in return.

PMID- 1635806
TI  - Functional brain imaging in pediatrics.
AB  - With the development of noninvasive tomographic imaging techniques, it is now
      possible to measure local chemical and physiologic functions in various body
      organs. Studies of local cerebral glucose metabolism in infants and children
      using positron emission tomography (PET) have provided important information on
      human brain functional development and plasticity. The clinical application of
      functional neuroimaging techniques in the management of pediatric neurologic
      disorders has yielded encouraging results. In children with intractable epilepsy
      being considered for surgical intervention, PET is highly sensitive in localizing
      focal areas of cortical dysplasia, heterotopias, and other migrational defects
      corresponding to surface electrographic localization of epileptogenic regions.
      Expanding PET technology provides a new approach that holds great promise in the
      diagnosis and management of brain disorders in children.

PMID- 1635807
TI  - Detection of inherited neurometabolic disorders. A practical clinical approach.
AB  - The most common neurometabolic disorders to be considered are organic acidurias
      and amino acid apathies followed by urea cycle disorders, congenital lactic
      acidosis, peroxisomal disorders, and, less frequently, sphingolipidoses,
      mucopolysaccharidoses, glycoprotein degradation disorders, fatty acid oxidation
      disorders, and neuronal ceroid lipofuscinoses.

PMID- 1635808
TI  - Rhabdomyolysis in childhood. A primer on normal muscle function and selected
      metabolic myopathies characterized by disordered energy production.
AB  - Patients with rhabdomyolysis present an important clinical problem. In acute
      episodes immediate treatment may be necessary to prevent significant morbidity
      and mortality. Evaluation of affected patients necessitates an understanding of
      basic muscle pathophysiology and of the variety of disturbances that can
      interfere with muscle energy metabolism. The physician must then pursue a
      systematic stepwise evaluation (Table 6) that includes obtaining relevant history
      and laboratory studies, as well as arranging for appropriate provocative testing
      and muscle biopsy. Once the diagnosis is established, patient and family
      counseling is necessary, particularly in genetic disorders. Unfortunately,
      specific therapies have not proven entirely successful, and treatment generally
      has been directed at reducing the severity of rhabdomyolytic episodes.

PMID- 1635809
TI  - Changes in the approach to central nervous system tumors in childhood.
AB  - Current approaches to children with brain tumors are in a state of evolution.
      Currently, 50% of children with all types of brain tumors may be expected to
      survive 5 years. Therefore, the goals of neuro-oncology have broadened to include
      improved survival and improved quality of life. This article reviews changes in
      therapy that have altered survival as well as changes in therapy as a consequence
      of increasing recognition of complications and toxicity of treatment.

PMID- 1635810
TI  - Current status of Duchenne muscular dystrophy.
AB  - Duchenne muscular dystrophy is the second most common lethal genetic disorder in
      humans. With the advent of molecular genetic technology, the definition of this
      disease has been modified to include an abnormality of dystrophin in muscle--a
      dystrophinopathy. Accurate genetic counseling is possible using methods of
      deletion detection and linkage analysis. Treatment of this type of muscular
      dystrophy may soon mean the routine use of steroids and later include direct
      injection of an artificial gene for dystrophin.

PMID- 1635811
TI  - A practical approach to children failing in school.
AB  - The most likely causes of failure in school in otherwise capable children who
      come from homes in which they are loved and cared for are learning disabilities,
      affective illness, primary disorder of vigilance and, on occasion, narcolepsy.
      The various learning disabilities are often accompanied by problems of attention,
      concentration, organization, mood and feelings, and social interaction. These
      latter problems are reflections of biochemical disorders that respond effectively
      to judicious pharmacologic intervention. When this type of medical management is
      combined with constructive counseling and suitable curriculum adjustments, the
      child can attain his or her maximum education potential and become a productive
      and contributing adult member of society.

PMID- 1635812
TI  - Evaluation of the child with idiopathic mental retardation.
AB  - A review of the advances in diagnostic techniques for evaluation of children with
      idiopathic mental retardation is presented. The current status of the use of
      clinical genetics, cytogenetics, molecular genetics, and neuroimaging in
      evaluating children with mental retardation is emphasized. Special attention is
      given to the evaluation of children with mental retardation and "autism" or
      "cerebral palsy."

PMID- 1635813
TI  - Metabolism of 3,5,3'-triiodothyronine sulfate by tissues of the fetal rat: a
      consideration of the role of desulfation of 3,5,3'-triiodothyronine sulfate as a
      source of T3.
AB  - We have recently demonstrated that serum concentration of 3,5,3'-triiodothyronine
      sulfate (T3S) is markedly elevated in the human newborn at a time when serum
      3,5,3'-triiodothyronine (T3) is very low. The present study explores the ability
      of maternal (19-21 d pregnant) and near-term fetal Sprague-Dawley rat tissues to
      1) monodeiodinate T3S and T3 in both the outer and the inner ring and 2)
      desulfate T3S to T3. Maternal liver microsomes metabolized T3S exceedingly
      efficiently (compare fetus p less than 0.05). Eighty percent or more of T3S was
      consumed during its incubation with 360 micrograms/mL microsomes for 2 h. The
      majority of the consumption of T3S by adult liver microsomes occurred by its 5'
      monodeiodination to I-; little inner-ring monodeiodination to 3,3'
      diiodothyronine was demonstrable. In fetal liver microsomes, however, over 75% of
      the substrate T3S remained unchanged after a 2-h incubation. T3 was metabolized
      similarly moderately by fetal and maternal liver microsomes. Brain microsomes
      metabolized T3S poorly in both the mother and the fetus. Over 90% of substrate
      T3S remained unchanged after a 2-h incubation in each case. Interestingly, brain
      microsomes metabolized T3 more rapidly than T3S (p less than 0.05). In the fetus,
      desulfation of T3S to T3 was clearly evident only in microsomes from the liver
      and the brain; in the adult, it was plentiful in many tissues. Fetal liver and
      brain tissues metabolize T3S poorly, and both actively desulfate T3S to T3. These
      data and those indicating high serum T3S in the fetus suggest that T3S is a local
      source of T3 in critical tissues in the fetus and possibly in adults with the low
      T3 syndrome.

PMID- 1635814
TI  - Urinary medium-chain acylcarnitines in medium-chain acyl-CoA dehydrogenase
      deficiency, medium-chain triglyceride feeding and valproic acid therapy:
      sensitivity and specificity of the radioisotopic exchange/high performance liquid
      chromatography method.
AB  - To determine the sensitivity and specificity of detecting urinary medium-chain
      acylcarnitines for the diagnosis of MCAD deficiency, 114 urine specimens from 75
      children with metabolic diseases and controls were analyzed in a blinded fashion
      using a radioisotopic exchange/HPLC method. All 47 patients with MCAD deficiency
      were correctly diagnosed using the criterion hexanoylcarnitine or
      octanoylcarnitine peak areas larger than those of other medium-chain
      acylcarnitines. The majority of them were tested during the asymptomatic state
      without L-carnitine loading. Four patients with other defects of fatty acid
      oxidation and three patients receiving valproic acid had a similar acylcarnitine
      excretion pattern. To further examine the specificity of the method, eight
      infants receiving a diet enriched with medium-chain triglycerides and 13
      additional patients receiving valproic acid were studied. Most of these also
      tested positive for MCAD deficiency by the above criterion. Analysis by a new gas
      chromatographic-mass spectrometric procedure revealed that octanoylcarnitine, not
      valproylcarnitine, was the most abundant medium-chain carnitine ester excreted by
      a patient treated with valproic acid. Quantitation of urinary hexanoylcarnitine
      and octanoylcarnitine showed considerable overlap among patients with MCAD
      deficiency and those receiving valproic acid or a medium-chain triglyceride
      enriched diet. MCAD deficiency can be reliably detected in urine specimens by
      this method without the need for prior carnitine loading. However, other defects
      in fatty acid oxidation must be differentiated from MCAD deficiency, and a
      history of medium-chain triglyceride or valproic acid administration must be
      considered if the diagnosis of MCAD deficiency is sought through analysis of
      urinary acylcarnitines.

PMID- 1635815
TI  - Short-chain acyl-coenzyme A dehydrogenase activity, antigen, and biosynthesis are
      absent in the BALB/cByJ mouse.
AB  - BALB/cByJ (J) mice have short-chain acyl-CoA dehydrogenase (SCAD) deficiency and
      an organic aciduria similar to that of human SCAD deficiency. [9,10(n)-3H]- and
      [15,16(n)-3H]palmitate oxidations in J mouse fibroblasts were 96 and 35% of
      control, respectively, consistent with an isolated SCAD defect. Acyl-CoA
      dehydrogenase activities were assayed in muscle and fibroblast mitochondria from
      BALB/cBy controls (Y) and SCAD-deficient J mice. Medium-chain acyl-CoA
      dehydrogenase (MCAD) activities were comparable in both J and Y mice from all
      tissues. In the presence of MCAD antiserum, SCAD activities in J mice were
      undetectable in both tissues. Apparent Km and Vmax values in liver mitochondria
      suggested a somewhat increased affinity of MCAD for butyryl-CoA in J mice, as
      compared with MCAD from other species. Immunoblot studies using mitochondria
      revealed identical apparent SCAD molecular weight in liver, muscle, and
      fibroblasts from Y mice and no detectable SCAD antigen in J mice; MCAD antigen
      was detected in comparable amounts from both Y and J mice. Radiolabeling and
      immunoprecipitation studies in J mouse fibroblasts revealed no SCAD synthesis,
      but normal MCAD synthesis. These data argue against the existence of tissue
      specific SCAD isoforms in the mouse and confirm that this mouse strain is a model
      for the human organic aciduria resulting from this beta-oxidation defect.

PMID- 1635816
TI  - Deletion in blood mitochondrial DNA in Kearns-Sayre syndrome.
AB  - Mitochondrial DNA deletions have been described in the Kearns-Sayre syndrome
      (KSS) and the Pearson's marrow-pancreas syndrome. In some cases, the same 4,977
      bp deletion has been identified in these two very different diseases. Therefore,
      it is not currently possible to predict the clinical phenotype from the size or
      location of the deletion. Instead, differential tissue distribution of the
      deletion has been implicated as one possible determinant of phenotype. In
      particular, in KSS the deletions have not been detected by Southern blotting in
      the blood, whereas in Pearson's syndrome they are easily detectable. We describe
      here an 11-y-old boy with clinically characteristic KSS and a 7.4-kb
      mitochondrial DNA deletion between nucleotides 7,194 and 14,595. Southern
      blotting reveals that 75% of the mitochondrial DNA molecules from his peripheral
      blood have this deletion. This case blurs further the molecular distinction
      between the KSS and Pearson's marrow-pancreas syndrome, questioning whether
      tissue distribution is a sufficient explanation for the very different phenotypes
      of these disorders.

PMID- 1635817
TI  - Separation of noncutaneous epithelia in a fetus diagnosed in utero with
      junctional epidermolysis bullosa.
AB  - This study was undertaken to identify the extent of involvement of cutaneous and
      noncutaneous epithelia during expression in utero of junctional epidermolysis
      bullosa. Skin and other organs from a 19-wk estimated gestational age fetus
      affected with junctional epidermolysis bullosa and from age-matched controls were
      examined by light and transmission electron microscopy. In the affected fetus,
      skin samples from different body regions including trunk, leg, arm, and finger
      all showed some separation at the dermal-epidermal junction in the plane of the
      lamina lucida. Hemidesmosomes were absent or hypoplastic, whereas anchoring
      fibrils appeared normal in structure and number. Interfollicular epidermis
      appeared to have separated easily, whereas some follicles remained anchored in
      the dermis. Areas of epithelium in the trachea and bronchi had separated, but
      within the lung parenchyma the epithelium of smaller bronchioles and alveoli
      remained attached to supporting connective tissue. The transitional epithelium of
      the urinary bladder showed small areas of separation compared with the gall
      bladder epithelium, which showed extensive separation. Gall bladder epithelium in
      several control fetuses also was consistently separated. In the affected fetus as
      well as in controls, gall bladder had multiple layers of basal lamina, a
      previously unrecognized structural feature of human fetal gall bladder. Epithelia
      that remained intact included the linings of the stomach and small and large
      intestines and endothelium of large and small vessels in all organs. Kidney,
      spleen, liver, and lymph nodes appeared normal in all aspects. In control
      samples, neither skin nor most of the noncutaneous epithelia had separated from
      the underlying connective tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635818
TI  - The expression of surface tissue factor apoprotein by blood monocytes in the
      course of infections in early infancy.
AB  - The expression of surface tissue factor procoagulant activity and its shedding by
      blood monocytes can be induced by several stimuli. Few of these defined
      situations, other than the presence of bacteria and their toxins, are commonly
      present in the young human infant. In this study, measurements were made of the
      percentage of monocytes expressing surface tissue factor apoprotein (TFA) in
      blood taken from babies in the early weeks of life. Mononuclear cells were
      separated from blood in an environment free of detectable endotoxin. After
      exposure to a polyclonal rabbit antibody raised to purified brain TFA and
      subsequent exposure to a fluorescin-labeled murine anti-rabbit IgG, the cell
      fluorescent activity was analyzed by flow cytometry. The percentage of monocytes
      showing strong fluorescence was determined. In every instance when systemic
      bacterial infection was present, more than 60% of the monocytes examined showed
      fluorescence indicative of the presence of surface TFA. In a single case of
      fungal Candida septicemia, none of the monocytes was positive. More than 60% of
      cells were found to be positive in certain instances where infection was highly
      probable but not proven. Positive cells were found in three cases of isoimmune
      hemolytic disease of the newborn, as had been anticipated from previous studies,
      whereas less than 25% of monocytes derived from babies in the absence of
      discernible infection or isoimmune hemolytic disease expressed surface TFA (p
      less than 0.001). These findings provide insight into a possible mechanism of
      coagulation activation in sepsis and may prove to be a useful predictor of the
      presence of infection or endotoxemia in young infants.

PMID- 1635819
TI  - Capillary versus arterial plasma catecholamines as markers for sympatho-adrenal
      activity in infants.
AB  - In this study, we investigated whether capillary plasma catecholamines can be
      used as a suitable substitute for arterial catecholamines. Analysis was done
      radioenzymatically. Catecholamine concentrations were not different in arterial
      and simultaneously collected "arterialized" (warmed foot) capillary plasma
      obtained by heel-prick from 18 neonatal intensive care patients as assessed by
      linear regression analysis (correlation coefficient: 0.966 for noradrenaline;
      0.894 for adrenaline; p less than 0.05) and by a Wilcoxon test [noradrenaline:
      2.13 (0.61-10.47) versus 2.41 (1.05-10.23); adrenaline: 0.75 (0.16-1.70) versus
      0.72 (0.10-1.37) nmol/L, median (range)]. However, "arterialization" of capillary
      blood is important; when blood was obtained in nine neonates without warming
      their feet, capillary concentrations of noradrenaline were higher than arterial
      values (p less than 0.03) and those of adrenaline were not different from
      arterial values. Catecholamine concentrations in arterialized capillary plasma
      collected in healthy full-term infants at 1 h [n = 9; noradrenaline: 6.85 (3.09
      8.88) nmol/L; adrenaline: 1.34 (0.86-2.85) nmol/L] and 5 d after birth [n = 27;
      noradrenaline: 1.58 (0.89-3.16) nmol/L; adrenaline: 0.59 (0.25-1.64) nmol/L]
      reflect the well-known fall (p less than 0.01) in catecholamine levels after
      delivery. With a highly sensitive analytical technique, catecholamine
      concentrations can reliably be assessed in minute samples (100-200 microL) of
      arterialized capillary blood, even when concentrations have dropped to low
      "resting" basal levels. Moreover, the capillary sampling procedure is simple and
      safe, can easily be applied to healthy infants, and does not have the practical
      and ethical limitations of arterial blood sampling.

PMID- 1635820
TI  - Bone mineralization outcomes in human milk-fed preterm infants.
AB  - We evaluated bone mineralization by single photon absorptiometry at 2 y in a
      cohort of preterm infants studied since birth. Infants were fed human milk
      fortified with Ca [to achieve 80 mg/dL (19.96 mmol/L)] and P [40 mg/dL (12.91
      mmol/L)] from wk 2 through 8 after birth. After hospital discharge, infants were
      divided into two groups (HM and F) determined by the timing of the introduction
      of cow milk-based formula. Mid-radius bone mineral content (BMC) was assessed in
      10 infants who were breast-fed (HM) for a minimum of 2 mo after hospital
      discharge and 11 who were bottle-fed (F). The mean duration of human milk-feeding
      differed by design between HM and F groups (31 +/- 15 versus 11 +/- 3 wk,
      respectively). Although we had observed previously that group F had significantly
      greater BMC values at 16, 25, and 52 wk compared with values in group HM, we
      found similarities in BMC values (180 +/- 30 mg/cm) between groups at 2 y. The 2
      y cohort comprised healthy infants and the groups had similar birth weights,
      lengths of gestation, and values for weight (10.8 +/- 1.1 kg), length (82 +/- 2
      cm), and bone width (7.8 +/- 1.1 mm). Follow-up outcomes at 2 y in preterm
      infants fed fortified human milk in hospital suggest that if they continue to
      receive human milk after hospital discharge, radius BMC will "catch-up" to that
      of similar infants given formula in the posthospitalization period.

PMID- 1635821
TI  - Responses of gastrointestinal peptides and motor activity to milk and water
      feedings in preterm and term infants.
AB  - Because duodenal motor activity differs between preterm and term infants during
      fasting, this study evaluated the responses of motor activity and peptide release
      in response to feeding. In the first study, fasting concentrations of gastrin,
      gastric inhibitory peptide, neurotensin, and peptide YY (PYY) were determined in
      53 preterm and 20 term infants. Plasma concentrations of gastrin and neurotensin
      were significantly lower in preterm infants than in healthy adults reported
      previously by our lab (p less than 0.01). Plasma concentration of gastric
      inhibitory peptide and PYY were higher than in healthy adults (p less than 0.01).
      Gastrin concentrations in preterm and term infants varied directly with
      gestational age (p less than 0.005); PYY varied inversely with gestational age (p
      less than 0.005). In a secondary study, intestinal manometry was recorded and
      serial peptide concentrations were determined in 43 preterm babies who were given
      their first enteral feeding intraduodenally with formula or sterile water.
      Although none of the four peptide plasma concentrations changed in response to
      feeding with water, plasma concentrations of gastric inhibitory peptide,
      neurotensin, and PYY significantly increased with formula feedings (p less than
      0.05 or less). In addition, plasma gastrin increased significantly in seven
      infants fed milk compared with eight fed water by orogastric tube (p less than
      0.01). In contrast to the peptide response to feeding, motor activity changed in
      response to feeding with either water or milk; motility indices increased and
      periods of motor quiescence decreased significantly during feeding as compared
      with fasting (p less than 0.02). Responses of both motor activity and peptides to
      feeding were time related.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635822
TI  - Effects of pentoxifylline on the cardiovascular manifestations of group B
      streptococcal sepsis in the piglet.
AB  - Pentoxifylline (PTXF) is a methylxanthine that modifies leukocyte function and
      inhibits cytokine release. To evaluate its effects on the cardiovascular
      manifestations of sepsis secondary to group B streptococci, 14 anesthetized,
      mechanically ventilated piglets were studied over a 240-min period. Animals were
      randomly assigned to a treatment group that received a PTXF bolus (20 mg/kg)
      followed by a continuous infusion of 5 mg/kg/h before and during group B
      streptococci (1 x 10(8) colony forming units/kg/min) administration and a control
      group that received saline as a placebo. Comparison of the hemodynamic
      measurements and arterial blood gases during the first 90 min of PTXF treatment
      with those of the control group resulted in the following 90 min values: systemic
      arterial blood pressure was significantly higher in the PTXF group (89 +/- 10
      versus 56 +/- 30 mm Hg; p less than 0.005) as was cardiac output (0.18 +/- 0.04
      versus 0.10 +/- 0.07 L/kg/min; p less than 0.005). Pulmonary vascular resistance
      remained lower in the PTXF-treated animals (135 +/- 117 versus 248 +/- 119 mm
      Hg/L/min/kg; p less than 0.001), and these animals were less acidotic as measured
      by pH (7.07 +/- 0.2 versus 7.31 +/- 0.1; p less than 0.05) and base deficit (-15
      +/- 9 versus -5 +/- 2 mmol/L; p less than 0.05). Median survival time was
      significantly longer in the PTXF group (210 versus 90 min; p less than 0.002).
      These data demonstrate that PTXF can ameliorate some of the deleterious
      hemodynamic manifestations of group B streptococci sepsis and result in improved
      survival in a young animal model.

PMID- 1635823
TI  - Dynamic analysis of cardiac R-R intervals in normal infants and in infants who
      subsequently succumbed to the sudden infant death syndrome.
AB  - Infants who subsequently succumb to the sudden infant death syndrome (SIDS) have
      higher heart rates and reduced heart rate variation compared with other infants.
      We examined dynamic changes in cardiac interbeat intervals to explore these
      differences in cardiac control. Recordings of electrocardiographic activity and
      respiratory movement were acquired from 13 SIDS victims before their deaths.
      Moment-to-moment changes in R-R intervals during quiet sleep, rapid eye movement
      sleep, and waking were compared with values of 13 matched control infants. For
      each sleep-waking state, every R-R interval was plotted against the previous
      interval (Poincare plots), and each change in interbeat interval was plotted
      against the previous change. Dispersion of interbeat intervals at different heart
      rates was reduced in SIDS victims, resulting in Poincare plots markedly different
      from those of controls. The dispersion, sampled at the 10th and 90th percentiles
      of heart rates, was reduced across all sleep-waking states in SIDS victims. At
      high heart rates, the difference between groups disappeared after correcting for
      basal rate; however, the reduced range at low heart rates was independent of
      basal rate. SIDS victims also showed smaller beat-to-beat changes in heart rate
      and fewer sustained runs of consistent heart rate changes during waking relative
      to controls. The differences in cardiac rate dynamics suggest altered autonomic
      control in infants who succumb to SIDS. We speculate that the autonomic
      disturbance may lead to cardiac instability or may indicate CNS alterations with
      the potential to affect other vital functions.

PMID- 1635824
TI  - The effects of respiratory training with inspiratory flow resistive loads in
      premature infants.
AB  - Respiratory training of premature infants was performed to determine whether
      improved respiratory muscle strength and/or endurance would result. Twenty-two
      premature infants were randomized into control and training groups for 2 wk,
      using inspiratory flow-resistive loads for training (75 cm H2O.L-1.s in wk 1 and
      90 cm H2O.L-1.s in wk 2). Respiratory endurance was assessed by the time interval
      required for the development of a 5-torr rise in transcutaneous CO2 tension
      during the hypoventilation induced by loaded breathing, using a moderately severe
      resistive load (250 cm H2O.L-1.s at 1 L.min-1). Respiratory strength was assessed
      by the maximum negative airway pressure generated during occluded breaths, a
      pressure-time integral, and an effort index. Results revealed that respiratory
      muscle endurance, which was not initially different between control and trained
      groups, increased significantly after 2 wk in the trained group by 137% (median
      value, p less than 0.05), whereas it remained unchanged in the control group (
      24%). The trained group of infants also showed a significant decrease in baseline
      breathing frequency between the initial and final measurements taken 2 wk apart
      when compared with controls (p less than 0.05) and a lesser increase in
      inspiratory time with loading in the final measurement as compared with the
      initial value (p less than 0.05). There was no significant difference between the
      control and trained groups in initial or subsequent measures of respiratory
      muscle strength. Inspiratory flow-resistive load training appears to improve the
      respiratory endurance of premature infants in whom respiratory muscle fatigue has
      been described to play a role in the development of respiratory failure.

PMID- 1635825
TI  - The relationship between rhythmic swallowing and breathing during suckle feeding
      in term neonates.
AB  - Little is known of the development of efficient coordination between suckle
      feeding and breathing in human infants. To establish baseline data, we recorded
      breathing and swallowing activity during bottle feeds in 23 infants at 14-48 h
      postnatal age. Most swallows (overall mean 68%) were organized into runs, with
      intervals starting at 0.6-0.8 s and slowing to 1-1.3 s after 30-40 s. The
      proportion of run swallows to total swallows increased significantly with age.
      Swallow intervals were regular (coefficient of variation = 18-38%) compared with
      breathing (coefficient of variation = 50%). Both breathing rate and tidal volume
      were significantly reduced by the onset of suckle feeding, and the pattern of
      respiratory airflow became markedly irregular. Mild transient desaturation was
      common, but was not accompanied by changes in heart rate. Swallows could occur in
      all phases of breathing. Overall, equal numbers of swallows were preceded by
      expiration and inspiration, but twice as many were followed by expiration
      compared with inspiration. Swallows were classified by the respiratory phases
      both preceding and following the swallow. Swallows occurred in all possible
      classifications in each of the infants studied. The incidence of the most
      frequent classification (inspiration-swallow-expiration), was 24% overall
      (individual range 5-50%). The phase relation between swallows and breaths changed
      frequently but showed occasional short periods of stability during which the
      breathing became regular and tidal volume increased. We conclude that at less
      than 48 h the normal infant has little coordination between swallowing and
      breathing rhythms and maintains rhythmic swallowing at the expense of eupnea.

PMID- 1635826
TI  - Surfactant lavage in a piglet model of meconium aspiration syndrome.
AB  - Meconium aspiration continues to be a major cause of morbidity and mortality in
      newborn infants and is one of the most common indications for extracorporeal
      membrane oxygenation. Lab studies have suggested that meconium inactivates
      surfactant and displaces surfactant from the alveolar surface. A recent report
      has suggested a clinical role for surfactant therapy in human infants with
      meconium aspiration. We evaluated the effect of surfactant (Survanta) lavage on a
      piglet model of meconium aspiration. Meconium pneumonitis was created by
      administration of 4 mL/kg of a 20% slurry of human meconium via endotracheal
      tube. Twenty-four newborn piglets were then randomly assigned to one of three
      groups: 1) suction only (n = 7), 2) saline lavage (n = 5), or 3) surfactant
      lavage (n = 7). Five piglets were excluded from analysis due to death from
      pneumothorax during meconium administration (n = 3), death from pneumothorax
      during saline lavage (n = 1), and death from pneumothorax during surfactant
      lavage (n = 1). The surfactant group had a statistically significant (p less than
      0.05) improvement in arterial to alveolar oxygen ratio gradient versus both
      control groups for the first 3 h. The oxygenation index was statistically
      significant versus the suction only group at 1, 3, and 4 h. Surfactant lavage of
      meconium aspiration in piglets results in short-term improvement of oxygenation
      and warrants further study.

PMID- 1635827
TI  - Effects of maternal protein-calorie malnutrition on the phospholipid composition
      of surfactant isolated from fetal and neonatal rat lungs. Compensation by
      inositol and lipid supplementation.
AB  - The effects of a maternal protein-calorie malnutrition during gestation and
      lactation were analyzed on fetal and postnatal lung growth and maturation,
      including a surfactant fraction isolated from lung tissue. There was a
      considerable reduction in body weight and in wet and dry lung weights of
      malnourished pups. Lung protein and DNA concentrations were similar in both
      groups except in late gestation (lung hyperplasia) and 2 and 15 d after delivery
      (hypocellularity). Lung glycogen breakdown was slowed down in malnourished
      newborns. Surfactant material was decreased the most perinatally and the
      reduction was more marked than for the nonsurfactant fraction of the lung.
      Disaturated phosphatidylcholine, the major surface active surfactant component,
      was decreased the most at birth (1.70 +/- 0.31 nmol/mg wet wt versus 3.68 +/-
      0.17 nmol/mg in controls, n = 8) and on d 2 (5.04 +/- 0.53 nmol/mg versus 7.67 +/
      0.44 nmol/mg in controls, n = 8). There was an apparent recovery in the
      composition of surfactant in malnourished rats 5 d after delivery, due in fact to
      a decrease in controls, and an actual return to normal levels 15 to 20 d after
      birth. Postnatal lipid supplementation with Intralipid led to partial recovery on
      d 10. Inositol supplementation totally reverted the effects of malnutrition on
      surfactant phospholipids (8.36 +/- 0.94 nmol disaturated phosphatidylcholine/mg
      wet wt on d 2 versus 7.67 +/- 0.44 nmol/mg in controls and 5.55 +/- 0.62 nmol/mg
      in untreated malnourished rats, n = 10; 2.43 +/- 0.32 nmol disaturated
      phosphatidylcholine/mg wet wt on d 10 versus 3.26 +/- 0.32 nmol/mg in controls
      and 1.18 +/- 0.27 nmol/mg in untreated malnourished rats, n = 8).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1635828
TI  - Effects of pancuronium bromide on cerebral blood flow changes during seizures in
      newborn pigs.
AB  - We investigated the effects of pancuronium bromide pretreatment on cerebral blood
      flow (CBF) during bicuculline-induced seizures in anesthetized piglets. Arterial
      blood pressure, gases, pH, cerebral electrocortical activity, and CBF
      (radioactive microsphere) were monitored at baseline, 10 min after administration
      of pancuronium (0.3 mg/kg i.v.; n = 9) or vehicle (normal saline; n = 8), and
      again at 5, 15, and 60 min after bicuculline (3 mg/kg i.v.). No change in CBF
      from baseline was observed at 10 min after either saline or pancuronium
      treatment, before induction of seizures. In the saline group, CBF was 36 +/- 3
      mL.min-1.100 g-1 before bicuculline and increased to 166 +/- 24 and 205 +/- 35
      mL.min-1.100 g-1 at 5 and 15 min, respectively, after bicuculline, returning
      toward baseline by 60 min. In the pancuronium group at 5 min after bicuculline,
      CBF increased from 45 +/- 7 to 169 +/- 26 mL.min-1.100 g-1, but fell to 88 +/- 17
      mL.min-1.100 g-1 at 15 min in contrast to saline-treated piglets. Also, at 15 min
      of seizures, differences between groups were observed in arterial blood pressure,
      gases, and pH. Although these variables were in the normal range with pancuronium
      treatment, the saline-treated animals had increased arterial blood pressure (81
      +/- 6 mm Hg) and PCO2 (6 +/- 0.4 kPa) and decreased PO2 (7 +/- 0.5 kPa) and pH
      (6.91 +/- 0.06). Electrocortical activity was abnormal during seizures in both
      groups. At 60 min, reversal to normal activity was observed in six of nine
      pancuronium-treated animals versus two of eight saline-treated animals. These
      data suggest that pancuronium limits cerebral hyperemia during prolonged seizures
      by attenuating increases in blood pressure as a result of elimination of skeletal
      muscle activity. This leads to minimal alteration of arterial PCO2, PO2, and pH
      during seizures.

PMID- 1635829
TI  - Oxygen free radicals and the cerebral arteriolar response to group B
      streptococci.
AB  - We used a cranial window preparation to observe the effects of direct application
      of group B streptococci to the surface of the brain in the adult rat. Continuous
      exposure to group B streptococci at concentrations of 10(3) and 10(5)
      organisms/mL caused progressive dilation of surface (pial) cerebral arterioles
      that became statistically significant (p less than 0.05) after 2.5 h. These
      results were reproduced with heat-killed organisms at the same concentration, but
      not with a bacteria-free filtrate of the growth medium. In separate studies, we
      found that infusion of alkaline cerebrospinal fluid (pH = 7.8) into the window
      did not reverse vasodilation, suggesting that it was not due to progressive
      cerebrospinal fluid acidosis. A solution of nitroblue tetrazolium infused into
      the window at the end of a 3-h exposure to the organism was promptly reduced,
      suggesting the presence of oxygen free radicals. Treatment with i.v. polyethylene
      glycol-superoxide dismutase and polyethylene glycol-catalase in doses of 10,000
      and 20,000 U/kg, respectively, was itself without effect on pial arterioles, but
      treatment with these compounds before exposure to group B streptococci eliminated
      the vasodilation. These data support a role for oxygen free radicals in the
      pathogenesis of pial arteriolar dysfunction induced by exposure to group B
      streptococci.

PMID- 1635830
TI  - Cerebral responses to acute maternal alcohol intoxication in immature fetal
      sheep.
AB  - Previous studies in mature fetal sheep have shown that alcohol depresses cerebral
      blood flow (CBF), cerebral O2 consumption (CMRO2), and cerebral glucose
      consumption (CMRglu). This effect earlier in gestation might contribute to the
      pathogenesis of fetal alcohol syndrome. Physiologic studies of immature fetal
      sheep have demonstrated lower CBF, CMRO2, and CMRglu as well as a blunted
      vasodilatory response to hypoxia compared with mature fetal sheep. The purpose of
      this study was to determine whether immature fetal responses to alcohol are
      blunted compared with near-term fetal responses. We studied seven immature fetal
      sheep in utero at 92 +/- 1 d gestation (term = 147 d) 2 d after placement of
      vascular catheters. Pure ethanol (1 g/kg) was infused i.v. to the mother over 1
      h. We measured CBF and myocardial blood flow by radioactive microspheres and
      calculated CMRO2 and CMRglu using arterial and sagittal sinus O2 and glucose
      concentrations. At a fetal ethanol concentration of 33 + 8 mmol/L (150 +/- 37
      mg/dL), there were no significant changes in CBF, CMRO2, or CMRglu. There was
      mild hypoglycemia (glucose concentration = 1.05 +/- 0.2 versus 1.33 +/- 0.2 mM
      baseline) and lactic acidemia (lactate concentration = 1.29 +/- 0.3 versus 1.07
      +/- 0.2 mM baseline). Cardiovascular variables were unchanged as was myocardial
      blood flow. The immature fetal sheep brain shows no significant cerebrovascular
      and metabolic response to acute alcohol intoxication compared with mature fetal
      sheep. Mild hypoglycemia and lactic acidemia did develop. The reason for the
      developmental differences in response to alcohol and their relationship to fetal
      alcohol syndrome remain to be elucidated.

PMID- 1635831
TI  - Perinatal assessment of cerebral flow velocity wave forms in the human fetus and
      neonate.
AB  - The temporal relationship between changes in cerebral Doppler flow velocity wave
      forms, ductal patency, blood gases, and blood pressure during the transition from
      intrauterine to newborn life was assessed longitudinally in 16 healthy term
      fetuses and newborns. Doppler flow velocity wave forms were obtained from fetal
      cerebral arteries (anterior cerebral, internal carotid, and basilar) before
      birth, within 8 h after birth, and again at 24 and 48 h after birth. The
      resistance index was used as a measure of vascular resistance. The resistance
      index of the cerebral arteries studied increased significantly between the
      antenatal and 8-h study periods. This was followed by a significant decrease
      below fetal levels by the 24-h study period, with little change thereafter. We
      conclude that in the newborn human, as in the newborn lamb, the transition from
      fetal to immediate newborn life is associated with an increase in cerebral
      vascular resistance and thus a decrease in cerebral blood flow in response to the
      increase in arterial oxygenation. The subsequent decrease in the cerebral
      resistance index between 8 and 24 h of life cannot be explained by a loss of
      ductal shunting nor by associated changes in newborn blood gases or blood
      pressure, but may rather reflect a remodeling of the circulation due to impedance
      matching.

PMID- 1635832
TI  - Five-year plan for nutrition research and training: executive summary. National
      Institute of Child Health and Human Development.

PMID- 1635833
TI  - Pediatric cardiology research in 1990: a review of abstracts submitted to the
      Society for Pediatric Research, American Academy of Pediatrics, and American
      Heart Association Scientific Sessions.
AB  - We assessed pediatric cardiology research by reviewing pediatric cardiology
      abstracts submitted in 1990 to the Society of Pediatric Research, American
      Academy of Pediatrics, and American Heart Association national meetings. Included
      were accepted and rejected studies. Abstracts were reviewed for disease being
      studied, methodology used to answer the research question, study design, and
      acceptance/rejection. Abstracts were analyzed from 123 institutions, 81 American
      and 42 foreign. Out of 423 abstracts, 307 (72.6%) were clinical and the remainder
      were basic science investigations. Slightly more than half of the clinical
      submissions were related to congenital heart disease. Coronary artery disease and
      inflammatory diseases accounted for 12% of clinical submissions.
      Echocardiography, clinical outcome measures, and electrophysiology were the most
      common research methodologies. Almost 80% of basic science research was performed
      in normal tissues; animal physiology, fetal physiology, and cellular/biochemical
      studies were the most common methodologies. With regard to study design, half of
      the clinical studies were retrospective and only 6% were either prospective
      epidemiologic or prospective controlled intervention trials. For basic sciences,
      38% of abstracts were descriptions of phenomena and 62% were hypothesis testing,
      with developmental hypotheses being most common. Acceptance rates favored higher
      quality study design. However, areas of greatest interest to cardiologists,
      congenital heart disease, cardiomyopathy, and electrophysiology, had poorer
      quality study design than did other areas. We have shown broad interest in
      pediatric cardiology research. However, clinical studies frequently were
      retrospective or had uncontrolled study designs. Basic science research was
      performed at a small number of institutions and emphasized either description of
      phenomena or developmental biology of normal tissues.

PMID- 1635834
TI  - Brain vasoactive effects of phenobarbital during hypertension and hypoxia in
      newborn pigs.
AB  - Phenobarbital in anticonvulsant concentrations has been shown to lower cerebral
      blood flow (CBF) during hypertension and to reduce the incidence of
      intraventricular hemorrhage in newborn beagles after hypertensive insult. We
      proposed that hypoxic dilatation of brain blood vessels might alter the effect of
      phenobarbital (PBS) on blood flow during hypertension. Thus, in 14 control and
      nine PBS-treated 1- to 2-d-old newborn piglets, the radio-active microsphere
      technique was used to determine CBF during 1) steady state (SS), 2) hypertension
      (HT), and 3) HT plus hypoxia of 5 min duration. In seven controls and in four PBS
      treated piglets, CBF was also determined during recovery from hypoxia. PBS was
      infused after SS in a 20-mg/kg dose, and serum levels were obtained 30 min later.
      Blood pressures were not significantly different between groups when compared
      during SS, HT, hypoxia, and recovery. Similarly, pH, PO2, and PCO2 were not
      significantly different between groups when compared during normoxia and hypoxia,
      and hematocrits were maintained by transfusions after reference sample
      withdrawals. CBF in control animals increased significantly during HT and
      remained significantly higher than SS values throughout the 5 min of hypoxia and
      into the recovery period. In PBS-treated piglets, however, there was no
      significant increase in CBF during HT. Blood flows also stayed at SS levels
      during HT plus 5 min hypoxia and recovery from hypoxia. Thus, in newborn piglets,
      PBS lowered CBF during HT. Furthermore, this blood flow lowering effect persisted
      during hypoxia, preventing compensatory increases in CBF that might have
      otherwise occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635835
TI  - Hypoxemia and reoxygenation with 21% or 100% oxygen in newborn pigs: changes in
      blood pressure, base deficit, and hypoxanthine and brain morphology.
AB  - To study whether room air is as effective as 100% O2 in resuscitation after
      hypoxia, hypoxemia (PaO2 2.3-4.3 kPa) was induced in newborn pigs (2-5 d old) by
      ventilation with 8% O2 in nitrogen. When systolic blood pressure had fallen to 20
      mm Hg, animals were randomly reoxygenated with either 21% O2 (group 1, n = 9) or
      100% O2 (group 2, n = 11) for 20 min followed by 21% O2 in both groups. Controls
      (group 3, n = 5) were ventilated with 21% O2 throughout the experiment. Base
      deficit peaked at 31 +/- 5 mmol/L (mean +/- SD) for both hypoxic groups at 5 min
      of reoxygenation and then normalized over the following 3 h. There were no
      statistically significant differences between the two groups during reoxygenation
      concerning blood pressure, heart rate, base deficit, or plasma hypoxanthine.
      Hypoxanthine peaked at 165 +/- 40 and 143 +/- 42 mumol/L in group 1 and 2 (NS),
      respectively, and was eliminated monoexponentially in both groups with an initial
      half-life for excess hypoxanthine of 48 +/- 21 and 51 +/- 27 min (NS),
      respectively. Blinded pathologic examination of cerebral cortex, cerebellum, and
      hippocampus after 4 d showed no statistically significant differences with regard
      to brain damage. We conclude that 21% O2 is as effective as 100% O2 for
      normalizing blood pressure, heart rate, base deficit, and plasma hypoxanthine
      after severe neonatal hypoxemia in piglets and that the extent of the hypoxic
      brain damage is similar in the two groups.

PMID- 1635836
TI  - Alterations in cerebrovascular reactivity after positive pressure ventilation.
AB  - Pressure ventilation of the newborn can adversely affect the cardiovascular
      system. Increasing airway pressure increases cerebral venous pressure, thus
      stressing brain vasculature. To test the hypothesis that cerebral venous
      distension caused by mechanical ventilation alters cerebral microvascular
      responses, we studied cerebrovascular responses before, during, and after
      positive pressure ventilation. Anesthetized newborn pigs were ventilated with a
      standard time-cycled, pressure-limited infant respirator. Pial arterioles were
      measured in response to hypercapnia, topical isoproterenol, and topical
      norepinephrine during control [mean airway pressure (Paw) = 0.9 +/- 0.05 kPa (4.8
      +/- 0.3 cm H2O)] conditions, during 40-60 min of increased Paw [2.5 +/- 0.2 kPa
      (13.9 +/- 1.3 cm H2O)], and when the Paw was lowered again. Pial arteriolar
      dilation in response to hypercapnia was not changed by increasing Paw. Similarly,
      responses to isoproterenol and norepinephrine were unaltered during raised Paw.
      However, a significant decrease in responses to topical isoproterenol and
      norepinephrine was observed after increased Paw. These experiments show that
      specific prostanoid-independent cerebrovascular responses are altered subsequent
      to pressure ventilation, whereas prostanoid-dependent dilation to hypercapnia was
      not affected. These changes suggest that the newborn cerebral vasculature is
      affected by positive pressure ventilation, further raising the possibility that
      ventilation-induced alterations in microvascular responses could make the brain
      more vulnerable to added stresses after pressure ventilation.

PMID- 1635837
TI  - Taurine and osmoregulation. IV. Cerebral taurine transport is increased in rats
      with hypernatremic dehydration.
AB  - Taurine is an organic osmolyte in brain cells. We studied whether cerebral
      taurine transport is enhanced as part of the cell volume regulatory adaptation to
      hypernatremia. Hypernatremic dehydration was induced for 48 h. Synaptosomes,
      metabolically active nerve terminal vesicles, were isolated by homogenization of
      brain and purification on a discontinuous Ficoll gradient. Taurine transport was
      evaluated in vitro using a rapid filtration assay. After 48 h of hypernatremia,
      there was a 22.4% increment in Na(+)-specific taurine transport from 2.99 +/-
      0.16 to 3.66 +/- 0.13 mumol/mg protein/30 min (p less than 0.001). Dehydration
      for 48 h without hypertonic saline loading had no effect on taurine uptake.
      Glycine transport was unaltered by hypernatremia. The adaptation in taurine
      uptake resulted from an enhanced Vmax of the high affinity-low capacity transport
      system [265 +/- 17, control versus 337 +/- 19 nmol/min/mg protein, experimental
      (p less than 0.03)] without a change in the Km (approximately 60 microM). Under
      both control and hypernatremic conditions, Na+ and Cl- were required for maximal
      total Na(+)-mediated taurine uptake. Oubain (1 mM) decreased taurine uptake by
      25%, whereas addition of beta-alanine or hypotaurine (500 microM) to the external
      media reduced taurine transport by 45-65% in both control and experimental
      conditions (p less than 0.01). Synaptosomal taurine uptake in hypernatremic rats
      was inhibited by 15-20% (p less than 0.01) after addition of 4-acetamido-4'
      isothiocyanostilbene-2,2'-disulfonic acid (0.1 mM) or 4,4'-diisothiocyanostilbene
      2,2'-disulfonic acid (0.1 mM) or 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid
      (0.1 mM) to the external medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635838
TI  - The frequency of revertants in mdx mouse genetic models for Duchenne muscular
      dystrophy.
AB  - The mdx mouse has been used for the development of cellular and gene therapies
      for Duchenne muscular dystrophy. The relatively frequent occurrence of dystrophin
      positive muscle cells called revertants has hampered these efforts by interfering
      with data interpretation. The mdx4cv and mdx5cv dystrophin mouse mutants have
      approximately 10-fold fewer revertants than the mdx mutant at both 2 and 6 mo.
      The mdx3cv dystrophin mouse mutant may be a useful model for some types of human
      dystrophin deficiencies in which the levels of dystrophin are low but not
      completely absent.

PMID- 1635839
TI  - Vaccine-induced human antibody responses to the Haemophilus influenzae b
      polysaccharide in severe combined immunodeficient mice engrafted with human
      leukocytes.
AB  - We examined the ability of severe combined immunodeficient (SCID) mice-human
      peripheral blood leukocyte (PBL) chimeras to respond to immunization with
      Haemophilus influenzae b polysaccharide (Hib PS) vaccines. Two to 3 wk after PBL
      engraftment, human-PBL-SCID mice, prepared with PBL from one of five adult
      donors, were immunized with free or protein-conjugated Hib PS. Antibody to Hib PS
      was quantitated in preimmunization and postimmunization sera. Before
      immunization, anti-Hib PS antibody was detectable (greater than 10 ng/mL) in
      three of 40 mice. Of the 37 human-PBL-SCID mice not having detectable serum
      antibody before immunization, 31 produced greater than or equal to 20 ng/mL
      (greater than or equal to 2-fold increase) anti-Hib PS antibody 2 to 3 wk after
      immunization. Both free and protein-conjugated forms of Hib PS were immunogenic.
      Geometric mean anti-Hib PS antibody levels ranged from 50 to 139 ng/mL. Vaccine
      induced anti-Hib PS antibodies frequently expressed HibId-1, a cross-reactive
      idiotype that predominates the in vivo human antibody response to Hib PS.
      However, among mice engrafted with PBL from a single donor, the HibId-1
      distribution was highly skewed, suggesting that clonally distinct B cells were
      being stimulated in individual mice. These findings indicate that human PBL
      transplanted into SCID mice are functionally responsive to Hib PS antigenic
      challenge. This system may serve as a useful model for studying the regulation
      and cellular requirements for human polysaccharide immunity.

PMID- 1635840
TI  - Mitochondrial myopathy studies on permeabilized muscle fibers.
AB  - Respiratory parameters of skeletal muscle were determined in permeabilized muscle
      fibers by adapting a technique described by Veksler et al. for cardiac fibers
      (Biochim Biophys Acta, 892:191-196, 1987). This method consists of the
      permeabilization of muscle fibers by saponin by allowing respiratory substrates
      and inhibitors to reach the mitochondria. In this way, the mitochondria may be
      studied inside the fibers as if they were isolated. We have verified, using
      various techniques, that the mitochondria remain intact during this procedure.
      This method has been applied to the study of six newborn infants for whom a
      diagnosis of a mitochondrial defect was suspected. In all cases, the defect was
      to be found on the permeabilized fibers, and this was confirmed by an enzymatic
      study. The advantage of this new method, associated with the measurement of the
      enzymatic activities on a crude homogenate, is to enable a simple and rapid
      diagnosis on a small amount of sample without damaging the mitochondria during
      the isolation procedure.

PMID- 1635841
TI  - Cardiac teratogenicity of dichloroethylene in a chick model.
AB  - Trichloroethylene (TCE) and dichloroethylene (DCE) are related halogenated
      aliphatic hydrocarbon industrial solvents that are frequently found as drinking
      water contaminants. TCE has been implicated as a cardiac teratogen in an
      epidemiologic study and in a chick model. The purpose of this study was to
      determine whether DCE was also a cardiac teratogen in the chick embryo.
      Fertilized White Leghorn chick eggs (n = 418) were inoculated just above the
      embryo with 30 microL of a test solution on d 3 of incubation. Two control groups
      were studied: normal saline (n = 96) and the diluent for the DCE, mineral oil (n
      = 108). DCE was studied at three doses: 5, 20, and 25 microM (n = 76, 62, and 76,
      respectively). Eggs were coded with a seven-digit number to mask identity. Chicks
      were terminated on d 18 of incubation, and, after external inspection, hearts and
      great vessels were dissected macroscopically according to a detailed protocol.
      Abnormal hearts were reviewed and the diagnosis was agreed upon by three
      investigators before decoding the seven-digit number and photographing the
      abnormality. Some embryo death and subsequent tissue autolysis occurred in all
      groups, but, compared to controls, it was not significantly greater in the
      treatment group. However, combining all controls and all experimentals,
      significantly more (p = 0.02) embryonic death occurred in the experimental group.
      Noncardiac anomalies occurred in 17 embryos and were highest in the saline
      (four), 5 microM (four), and 20 microM (seven) DCE groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1635842
TI  - Myocardial carbohydrate, ketone, and fatty acid uptake in conscious lambs with
      aortopulmonary shunts.
AB  - A left to right shunt increases myocardial work and is often accompanied by
      increased catecholamine levels. Because both increased myocardial work and
      increased catecholamine levels may induce increased fatty acid utilization, which
      could increase resting myocardial oxygen consumption and therefore unfavorably
      affect coronary reserve, we studied myocardial uptake of glucose, pyruvate,
      lactate, beta-OH-butyrate, acetoacetate, FFA, and triglycerides in 12 7-wk-old
      lambs with aortopulmonary left to right shunts (58 +/- 2% of left ventricular
      output, mean +/- SEM) and in 10 control lambs 2 wk after surgery. Despite the
      shunt, systemic blood flow in the shunt lambs was maintained at the same level as
      in the control lambs. This was accomplished by an increased heart rate and stroke
      volume. Furthermore, the shunt was accompanied by an increased myocardial oxygen
      consumption in the shunt lambs (834 +/- 70 versus 528 +/- 43 mumol O2.min-1 x 100
      g-1; p less than 0.05). There were no significant differences in arterial
      substrate concentrations between the two groups. The same was true for
      arteriovenous differences across the myocardium, with the exception of lactate,
      which was substantially higher in shunt than in control lambs (72 +/- 25 versus
      18 +/- 23 mumol/L; p less than 0.05). As a consequence, myocardial lactate uptake
      in the shunt lambs was increased 15-fold (18 +/- 6 versus 1 +/- 2 mumol.min-1 x
      100 g-1; p less than 0.02), whereas uptake of the other substrates merely
      paralleled the increased myocardial blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635843
TI  - A study of galactose intolerance in human and rat liver in vivo by 31P magnetic
      resonance spectroscopy.
AB  - An oral load of 20 mg/kg galactose produces significant changes in the 31P
      magnetic resonance spectrum of the liver of a galactosemic patient. The peak at
      5.2 ppm (which includes inorganic phosphate and galactose-1-phosphate) increased
      on two occasions to about twice its original size 60 min after galactose
      administration. An oral load of 10 mg/kg galactose given to a second patient
      produced no discernible changes at 30 min. We have also used an animal model of
      galactose intolerance, in which galactose metabolism in rats was blocked by the
      acute administration of ethanol. Studies in vivo and in vitro showed that the
      increase in the peak at 5.2 ppm was largely due to galactose-1-phosphate. We have
      shown in this preliminary study that small amounts of galactose can produce
      significant elevation of hepatic galactose-1-phosphate, which can be detected by
      31P magnetic resonance spectroscopy.

PMID- 1635844
TI  - Starch digestion in young children with cystic fibrosis measured using a 13C
      breath test.
AB  - The study was designed to evaluate a non-invasive breath test using naturally 13C
      rich corn (maize) as substrate to provide quantitative information about the
      digestion of starch by children in health and disease. The variability of
      background 13C:12C of young British children was investigated by collecting
      breath samples over 6 h from 17 healthy children, 6-35 mo old, and from seven
      children with cystic fibrosis, 25-48 mo old, in their homes. Background 13C
      enrichment was -26.6 and -25.4 delta per mil in the healthy and cystic fibrosis
      groups, respectively (p less than 0.01), and varied little during the day (SD =
      0.4 delta per mil). Eight healthy children and five with cystic fibrosis were
      given a test breakfast of corn starch cooked in milk with sugar. The cystic
      fibrosis group repeated the test with the addition of an enzyme supplement
      containing alpha-amylase. Subjects accepted variable amounts of starch (range 0.2
      2.8 g/kg body wt). The percentage of ingested 13C recovered during the 6 h after
      the meal increased with age in the healthy children (range 15-53%). Three
      children with cystic fibrosis had negligible 13C recoveries, and the other two
      had lower recoveries than expected for their age. The addition of enzymes did not
      consistently improve 13C recovery. We conclude that the 13C breath test based on
      corn has potential for investigating starch digestion in young children. Initial
      results suggest that starch digestion is impaired in some children with cystic
      fibrosis and that enzyme supplements do not improve digestion consistently or
      completely.

PMID- 1635845
TI  - Development of the neonatal rat small intestinal barrier to nonspecific
      macromolecular absorption. II. Role of dietary corticosterone.
AB  - The role of oral corticosterone (C) in the maturation of the neonatal rat jejunal
      barrier to the absorption of nonspecific macromolecules was evaluated. This was
      done by adding C to the diet of rat pups weaned at an early age, 17 d, from
      maternal milk (MM) to either a protein hydrolysate (PH) or soy (S) artificial
      formula. Both PH and S are known to cause a delay in small intestinal closure to
      the absorption of a 40-kD glycoprotein tracer, horseradish peroxidase (HRP), on d
      21 of age. C was added to PH and S formulas from d 17 to 21 at 0.26 mumol/L (10
      micrograms/dL), a level found in the MM of lactating rat dams, or at 10.29
      mumol/L (400 micrograms/dL) (PH + 10C, PH + 400C) (S + 10C, S + 400C). Controls
      consisted of rat pups fed PH or S without C and animals remaining with the dam on
      MM. The delay in jejunal closure to HRP on d 21 in both PH- and S-fed pups was
      prevented by C supplementation at both the higher and lower concentrations.
      Geometric mean (95% confidence intervals) jejunal HRP absorption in PH + 10C pups
      was 74 (32,167) IU HRP/mL x cm x min, less than in pups fed PH without C [353
      (200,615); p less than 0.05] and indistinguishable from HRP absorption in MM-fed
      animals [111 (79,154)]. HRP absorption in PH + 400C pups [52 (23,115)] was also
      less than that in animals fed PH without C (p less than 0.01) and
      indistinguishable from those fed MM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635846
TI  - Polyamine concentration in rat milk and food, human milk, and infant formulas.
AB  - The polyamine concentration in rat milk and food, human milk, and infant formulas
      was estimated by HPLC. In rat milk, the concentration of putrescine and spermine
      was low (generally under 2.5 nmol.mL-1 for putrescine and under 1 nmol.mL-1 for
      spermine). The spermidine concentration was higher and seemed to increase during
      lactation. The rat food was richer in polyamines than the rat milk (about 150
      times for putrescine and spermine, about 30 times for spermidine). We already
      proved that ingestion of spermine or spermidine can induce precocious maturation
      of the rat intestine. The present observations suggest that polyamines contained
      in rat food could play an important role in postnatal maturation of the rat
      intestine. The polyamine concentration of human milk was measured from 60
      different mothers during a period extending from the 1st wk to the 6th mo of
      lactation. Great variation was observed. During the 1st mo of lactation, the
      general pattern was as follows: putrescine concentration generally varied little
      (from 1 to 3 nmol.mL-1), spermine and spermidine concentrations showed a similar
      pattern (the highest values appeared at the end of the 1st wk of suckling). After
      the 4th mo of lactation, putrescine concentration increased slightly, whereas
      spermine and spermidine concentration stayed almost stable. The concentrations of
      polyamines in 18 powdered milks for babies were estimated. Spermine and
      spermidine contents were lower than those in human milk. A protective effect of
      spermine or spermidine against alimentary allergies is suggested.

PMID- 1635847
TI  - Serum growth hormone-binding proteins in the human fetus and infant.
AB  - Growth hormone-binding protein (GH-BP) levels were studied in cord serum of 69
      human infants born after 24 to 41 wk of gestation and in serum of 14 infants aged
      1 to 3 mo. GH-BP levels were measured by HPLC-gel filtration of serum incubated
      overnight with 125I-hGH. The radioactive elution profile revealed two small 125I
      hGH peaks of high molecular weight and a large peak, corresponding to monomeric
      125I-hGH. The first peak of high molecular weight was variable, showed some of
      the characteristics (high molecular weight, displaceability by a large excess of
      unlabeled hGH) of the described low affinity, high capacity GH-BP, and did not
      correlate with gestational age or birth weight (peak I-BP). The second peak was
      identified as 125I-hGH bound to the high affinity, low capacity GH-BP (peak II
      BP). Mean +/- SD specific binding of 125I-hGH to this peak was significantly (p
      less than 0.0001) different between preterm infants (3.1 +/- 1.1%; n = 51), term
      infants at birth (4.2 +/ 1.1%; n = 18), and 1- to 3-mo-old infants (8.5 +/- 1.6%;
      n = 14). To evaluate the effect of intrauterine nutritional state, the ponderal
      index (weight/lengths) was calculated. Peak II-BP levels were lower (p less than
      0.05) in infants with the ponderal index less than 2.35 (2.8 +/- 1.0%; n = 20)
      than in those with the ponderal index between 2.35 and 2.65 (3.4 +/- 1.2%; n =
      29) or greater than 2.65 (3.8 +/- 1.2%; n = 20).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635848
TI  - Clinical usefulness of urinary growth hormone measurements in normal and short
      children according to different expressions of urinary growth hormone data.
AB  - To assess the clinical usefulness of urinary growth hormone (UGH) measurements, a
      UGH determination technique, including dialysis, ultrafiltration, and measurement
      by polyclonal-coated tube RIA, was established. Sixty-three short children were
      studied: 56 idiopathic growth retarded (37 prepubertal and 19 pubertal) and seven
      prepubertal with classic GH (growth hormone) deficiency. Forty-two healthy
      children (32 prepubertal and 10 pubertal) served as controls. Two groups of
      adults were studied: eight with active acromegaly and 11 healthy controls. UGH
      was measured in 24-h urine samples from all patients and controls. Mean +/- SD
      UGH excretion expressed as ng/24 h was significantly lower in the GH-deficient
      group compared with prepubertal growth-retarded and control children (p less than
      0.01). No differences were found between UGH excreted by controls and by the
      growth-retarded groups. Pubertal children excreted significantly higher amounts
      of GH when UGH was expressed as ng/24 h (p less than 0.02 and p less than 0.03,
      respectively), but this difference disappeared when UGH was expressed as ng/g
      creatinine. UGH was significantly higher in acromegalic patients compared with
      adult controls (p less than 0.001). Differences between day, night, and 24-h UGH
      were studied in 23 children. UGH in night urine was significantly lower whether
      expressed as the total amount or as ng/g creatinine. The effect of recombinant
      hGH administration on UGH was studied in 13 children after 6 and 12 mo of
      treatment. UGH increased significantly under recombinant hGH treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1635849
TI  - Dual energy x-ray absorptiometry measurement of bone mineral content in newborns:
      validation of the technique.
AB  - To evaluate the applicability of dual energy x-ray bone absorptiometry in
      newborns, precision and accuracy of the method was tested for very small
      quantities of mineral ranging from less than 0.5 g to about 4 g of hydroxyapatite
      using a Hologic QDR 1000 instrument. For six femurs excised from preterm
      stillborns, the mean precision for bone mineral content (BMC) and bone mineral
      density (BMD) was 1.2 and 0.8%, respectively. Accuracy based on ash weight
      indicated a mean overestimation of about 7%. In vivo, the precision was assessed
      by measuring lumbar spine BMC and BMD (L1 to L5) two or three times in 10
      newborns (gestational age, 33 to 40 wk). The mean coefficients of variation were
      2.40 and 1.55% for BMC and BMD, respectively. Lumbar spine BMC and BMD were also
      measured once in 30 full-term infants. Values ranged from 1.17 to 3.90 g for BMC
      and from 0.192 to 0.356 g/cm2 for BMD. The present study shows that dual energy x
      ray absorptiometry provides a valuable new tool for the assessment and management
      of BMC in low birth weight infants and neonates in general.

PMID- 1635850
TI  - Prostaglandin E2 attenuates hyperoxia-induced injury in cultured rabbit tracheal
      epithelial cells.
AB  - We assessed the kinetics of hyperoxia-induced prostaglandin E2 (PGE2) production
      by cultured rabbit tracheal epithelial (TE) cells with different inherent
      capacities to generate PGE2 and the role of endogenous PGE2 production in
      protecting these cells from hyperoxic injury. Rabbit TE cells grown to confluence
      with or without lipid supplements [0.1% Excyte III (Miles-Pentex) and 1 microM
      arachidonic acid] were exposed for 2 h to control (5% CO2/air) or hyperoxic (5%
      CO2/90% O2) atmospheres at a gas-fluid interface. Serial cell culture effluents
      collected during exposure were analyzed for PGE2 by enzyme-linked immunoassay.
      Basal PGE2 production by lipid-supplemented cells was approximately 3-fold
      greater than that by unsupplemented cultures (p less than 0.01). In lipid
      supplemented cells, PGE2 production doubled after 15 min of hyperoxic exposure (p
      less than 0.05) and then declined to approximately 50% of initial levels, whereas
      exposure to 5% CO2/air did not significantly change PGE2 production. In
      unsupplemented cells, neither control nor hyperoxic exposure altered PGE2
      production. Hyperoxia-exposed TE cells had decreased ability to convert 10 microM
      exogenous arachidonic acid to PGE2, suggesting hyperoxia-induced inhibition of
      the enzymes involved in PGE2 synthesis. Lipid-supplemented cells were less
      susceptible to hyperoxic injury than unsupplemented monolayers, as evidenced by
      increased viability (trypan blue exclusion) and decreased generation of lipid
      peroxides (thiobarbituric acid reactive substances). Addition of exogenous PGE2
      to unsupplemented cultures at concentrations that were produced by lipid
      supplemented cells (2 ng/mL every 15 min) during hyperoxic exposure eliminated
      these differences in hyperoxia-induced lipid peroxidation and
      cytotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635851
TI  - Mechanical fragility of erythrocyte membrane in neonates and adults.
AB  - The shortened life span of neonatal red blood cells (RBC) is associated with
      accelerated membrane loss. The present study was designed to measure the critical
      shear force that causes membrane failure and the rate of membrane failure for
      neonatal and adult RBC. A micropipette technique was used to determine the
      membrane extensional (shear) elastic modulus (i.e. resistance of the membrane to
      extensional elastic deformation), the rate of extensional membrane deformation
      (i.e. surface viscosity), and the tension for local membrane fragmentation. A
      flow channel system was used to determine the critical shear force of plastic
      membrane deformation (i.e. beginning of membrane tether formation), the rate of
      plastic deformation, and the plastic shear viscosity coefficient. The extensional
      elastic modulus of neonatal RBC was 18% smaller and the rate of elastic
      deformation was 25% longer compared with adult cells (p less than 0.05). Membrane
      surface viscosity was similar for both cell types. The tension for local membrane
      fragmentation in the micropipette was 23% lower in neonates than in adults.
      However, the strain (i.e. extent of membrane deformation calculated as ratio of
      the stress resultant and the elastic modulus) at which membrane rupture in the
      micropipette occurred was similar for neonatal and adult RBC. This indicates that
      the smaller critical tension for neonatal RBC membrane failure was due to
      increased membrane elastic deformability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635852
TI  - Blood viscosity and optimal hematocrit in preterm and full-term neonates in 50-
      to 500-micrometer tubes.
AB  - Blood viscosity is an important determinant of blood flow resistance. Because a
      substantial part of flow resistance arises in small arteries and arterioles with
      diameters of 100 microns and less, rheologic properties of blood from preterm
      infants (24 to 36 wk of gestation), full-term neonates, and adults were measured
      in glass tubes with diameters of 50, 100, and 500 microns for a wide range of
      adjusted feed hematocrits (0.15-0.70). At each of the feed hematocrits, blood
      viscosity decreased when going from a 500-microns tube to a 50-microns tube. The
      viscosity reduction increased with increasing hematocrit. Moreover, the viscosity
      reduction was more pronounced in the neonates than in the adults. At a hematocrit
      of 0.70, the viscosity reduction averaged 56% in preterm infants, 50% in full
      term neonates, and 39% in adults (p less than 0.005). However, the viscosity
      reductions at a hematocrit of 0.30 were only 35, 29, and 19%, respectively (p
      less than 0.05). In all four groups, blood viscosity increased exponentially with
      increasing hematocrit. The steepness of the hematocrit-viscosity curves decreased
      with decreasing tube diameter and with decreasing maturity of the infants.
      Erythrocyte transport efficiency (hematocrit/blood viscosity) was calculated to
      estimate the optimal hematocrit (i.e. hematocrit with maximum erythrocyte
      transport). In 500-microns tubes, the optimal hematocrit was about 0.40 in all of
      the groups. In 100-microns tubes, the optimal hematocrit was 0.44 +/- 0.05 in the
      adults and 0.52 +/- 0.04 in the neonates (p less than 0.05). In 50-microns tubes,
      the optimal hematocrit was 0.51 +/- 0.04 in adults and 0.60 +/- 0.05 in the
      neonates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635853
TI  - Primacy of dimensions in vibrotactile perception: an evaluation of early holistic
      models.
AB  - Early holistic models of perception presume that stimuli composed of interacting
      dimensions can be experienced initially as undifferentiated. This view,
      formalized through recourse to a Euclidean geometry of perceptual space, predicts
      that the orientation of axes used to create stimulus sets is unimportant to
      performance in speeded classification. We tested this idea by using the
      interacting vibrotactile dimensions of pitch and loudness. Despite perceivers'
      relatively poor experience with these dimensions, we showed that the orientation
      corresponding to pitch and loudness was unique in vibrotactile perceptual space;
      subjects classified stimuli more efficiently at this orientation than at other
      orientations. Certain holistic models also claim that when stimulus differences
      are small, perceivers can recognize change without distinguishing the kind of
      change. We tested this idea by using a signal detection analysis of unspeeded
      same-different decisions. We found that subjects' ability to notice the kind of
      change equaled their ability to notice the change alone. In view of these
      results, which indicate that pitch and loudness are primary in vibrotactile
      perception, we detail a new conception of dimensional interaction.

PMID- 1635854
TI  - In defense of the right and left audiograms: a reply to Coren (1989) and Coren
      and Hakstian (1990)
AB  - Coren (1989) noticed that the various air-conduction pure-tone thresholds
      obtained from one ear of an individual in quiet tend to display a high
      correlation. In addition, Coren and Hakstian (1990) reported a consistently high
      correlation between pure-tone thresholds in the two ears of the same individual.
      On the basis of these observations, these authors proposed that pure-tone
      thresholds measured at audiometric frequencies in one ear, and those measured in
      both ears of an individual, be collapsed into a single average threshold value.
      The present paper disputes the usefulness and the appropriateness of such a
      proposal.

PMID- 1635855
TI  - On the perception of shape from shading.
AB  - The extraction of three-dimensional shape from shading is one of the most
      perceptually compelling, yet poorly understood, aspects of visual perception. In
      this paper, we report several new experiments on the manner in which the
      perception of shape from shading interacts with other visual processes such as
      perceptual grouping, preattentive search ("pop-out"), and motion perception. Our
      specific findings are as follows: (1) The extraction of shape from shading
      information incorporates at least two "assumptions" or constraints--first, that
      there is a single light source illuminating the whole scene, and second, that the
      light is shining from "above" in relation to retinal coordinates. (2) Tokens
      defined by shading can serve as a basis for perceptual grouping and segregation.
      (3) Reaction time for detecting a single convex shape does not increase with the
      number of items in the display. This "pop-out" effect must be based on shading
      rather than on differences in luminance polarity, since neither left-right
      differences nor step changes in luminance resulted in pop-out. (4) When the
      subjects were experienced, there were no search asymmetries for convex as opposed
      to concave tokens, but when the subjects were naive, cavities were much easier to
      detect than convex shapes. (5) The extraction of shape from shading can also
      provide an input to motion perception. And finally, (6) the assumption of
      "overhead illumination" that leads to perceptual grouping depends primarily on
      retinal rather than on "phenomenal" or gravitational coordinates. Taken
      collectively, these findings imply that the extraction of shape from shading is
      an "early" visual process that occurs prior to perceptual grouping, motion
      perception, and vestibular (as well as "cognitive") correction for head tilt.
      Hence, there may be neural elements very early in visual processing that are
      specialized for the extraction of shape from shading.

PMID- 1635857
TI  - Amplitude discrimination of sinusoids and narrow-band noise with Rayleigh
      properties.
AB  - The ability of human observers to discriminate differences in the amplitude of
      sinusoids and narrow-band noises was measured by the rating method of detection
      theory. Although each sinusoid (always 1000 Hz) was presented at a fixed
      amplitude, its amplitude on any trial was drawn from one of two Rayleigh
      probability distributions that differed in mean amplitude: a signal distribution
      and a noise distribution. Similarly, the amplitudes of the narrow-band noises
      were distributed as the Rayleigh distribution by virtue of the reciprocal
      relation between their bandwidth (100 Hz centered on 1000 Hz) and duration (10
      msec). The obtained psychometric functions showing the area under the ROC as a
      function of signal-to-noise ratio were similar for both kinds of signals and were
      displaced, on average, about 4 dB from an ideal observer's function. The slopes
      of the obtained functions were similar to those of an ideal observer using 1
      degree of freedom--half the number available in Rayleigh noise.

PMID- 1635856
TI  - Characterizing the influence of native language experience on adult speech
      perception.
AB  - Previous cross-language research has indicated that some speech contrasts present
      greater perceptual difficulty for adult non-native listeners than others do. It
      has been hypothesized that phonemic, phonetic, and acoustic factors contribute to
      this variability. Two experiments were conducted to evaluate systematically the
      role of phonemic status and phonetic familiarity in the perception of non-native
      speech contrasts and to test predictions derived from a model proposed by Best,
      McRoberts, and Sithole (1988). Experiment 1 showed that perception of an
      unfamiliar phonetic contrast was not less difficult for subjects who had
      experience with an analogous phonemic distinction in their native language than
      for subjects without such analogous experience. These results suggest that
      substantive phonetic experience influences the perception of non-native
      contrasts, and thus should contribute to a conceptualization of native language
      processing skills. In Experiment 2, English listeners' perception of two related
      nonphonemic place contrasts was not consistently different as had been expected
      on the basis of phonetic familiarity. A clear order effect in the perceptual data
      suggests that interactions between different perceptual assimilation patterns or
      acoustic properties of the two contrasts, or interactions involving both of these
      factors, underlie the perception of the two contrasts in this experiment. It was
      concluded that both phonetic familiarity and acoustic factors are potentially
      important to the explanation of variability in perception of nonphonemic
      contrasts. The explanation of how linguistic experience shapes speech perception
      will require characterizing the relative contribution of these factors, as well
      as other factors, including individual differences and variables that influence a
      listener's orientation to speech stimuli.

PMID- 1635858
TI  - Visual search for direction of shading is influenced by apparent depth.
AB  - Recent reports of rapid visual search for some feature conjunctions suggested
      that preattentive vision might be sensitive to scene-based as well as to image
      based features (Enns & Rensink, 1990a, 1990b). This study examined visual search
      for targets defined by the direction of a luminance gradient, a conjunction of
      luminance and relative location that often corresponds to object curvature and
      direction of lighting in naturalistic scenes. Experiment 1 showed that such
      search is influenced by several factors, including the type of gradient, the
      shape of the contour enclosing the gradient, and the background luminance. These
      factors were varied systematically in Experiment 2 in a three-dimensionality
      rating task and in a visual-search task. The factors combined interactively in
      the rating task, supporting the presence of an emergent property of three
      dimensionality. In contrast, each factor contributed only additively to the speed
      of the visual-search task. This is inconsistent with the view that search is
      guided by specialized detectors for surface curvature or direction of lighting.
      Rather, it is in keeping with the view that search is governed by a number of
      "quick and dirty" processes that are implemented rapidly and in parallel across
      the visual field.

PMID- 1635860
TI  - Strength of visual interpolation depends on the ratio of physically specified to
      total edge length.
AB  - We report four experiments in which the strength of edge interpolation in
      illusory figure displays was tested. In Experiment 1, we investigated the
      relative contributions of the lengths of luminance-specified edges and the gaps
      between them to perceived boundary clarity as measured by using a magnitude
      estimation procedure. The contributions of these variables were found to be best
      characterized by a ratio of the length of luminance-specified contour to the
      length of the entire edge (specified plus interpolated edge). Experiment 2 showed
      that this ratio predicts boundary clarity for a wide range of ratio values and
      display sizes. There was no evidence that illusory figure boundaries are clearer
      in displays with small gaps than they are in displays with larger gaps and
      equivalent ratios. In Experiment 3, using a more sensitive pairwise comparison
      paradigm, we again found no such effect. Implications for boundary interpolation
      in general, including perception of partially occluded objects, are discussed.
      The dependence of interpolation on the ratio of physically specified edges to
      total edge length has the desirable ecological consequence that unit formation
      will not change with variations in viewing distance.

PMID- 1635859
TI  - Determinants of the perception of sagittal motion.
AB  - This study examines the change in the perceived distance of an object in three
      dimensional space when the object and/or the observer's head is moved along the
      line of sight (sagittal motion) as a function of the perceived absolute
      (egocentric) distance of the object and the perceived motion of the head. To
      analyze the processes involved, two situations, labeled A and B, were used in
      four experiments. In Situation A, the observer was stationary and the perceived
      motion of the object was measured as the object was moved toward and away from
      the observer. In Situation B, the same visual information regarding the changing
      perceived egocentric distance between the observer and object was provided as in
      Situation A, but part or all of the change in visual egocentric distance was
      produced by the sagittal motion of the observer's head. A comparison of the
      perceived motion of the object in the two situations was used to measure the
      compensation in the perception of the motion of the object as a result of the
      head motion. Compensation was often clearly incomplete, and errors were often
      made in the perception of the motion of the stimulus object. A theory is
      proposed, which identifies the relation between the changes in the perceived
      egocentric distance of the object and the tandem motion of the object resulting
      from the perceived motion of the head to be the significant factor in the
      perception of the sagittal motion of the stimulus object in Situation B.

PMID- 1635861
TI  - Heartbeat--the rhythm of health.

PMID- 1635863
TI  - Human lactation and breast feeding management.

PMID- 1635864
TI  - Acknowledging the forgotten priority.

PMID- 1635862
TI  - Self directed learning: the development of a learning plan.

PMID- 1635865
TI  - American Cancer Society announces 1992 Lane W. Adams Award recipients.

PMID- 1635866
TI  - The challenge of caring in oncology nursing.

PMID- 1635867
TI  - Music therapy: a gift beyond measure.

PMID- 1635868
TI  - Families: an essential element in the care of the patient with cancer.

PMID- 1635869
TI  - The process of maintaining hope in adults undergoing bone marrow transplantation
      for leukemia.
AB  - The purpose of this qualitative study was to explore the processes of hoping in
      adults undergoing bone marrow transplantation (BMT) for leukemia. Grounded theory
      methodology was used to elicit the experience of hoping in 10 men and 10 women,
      ages 20-58, who had undergone BMT. The central process described by participants
      was that of maintaining hope. The core categories used to describe this process
      were Dealing With It and Keeping It in Its Place. Dealing With It is defined as
      the process of confronting the negative possibilities inherent in the illness
      experience and allowing the full range of thoughts, behaviors, and emotions
      resulting from this confrontation. Keeping It in Its Place is defined as the
      process of managing the impact of the illness by controlling or limiting one's
      response to the disease and therapy. The relationship between these two
      contradictory core categories is explained by The Dialectic of Maintaining Hope.
      This dialectic is defined as the synthesis of the antithetical strategies of
      Dealing With It and Keeping It in Its Place in which people are able to transcend
      each strategy and sustain hope. The findings provide a nascent, explanatory model
      and information for nurses regarding an important adaptive process.

PMID- 1635870
TI  - The oncology nurse's role in patient advance directives.
AB  - In December 1991, Patient Self-Determination Amendment (PSDA) legislation was
      implemented. The PSDA requires facilities funded by Medicare/Medicaid to inform
      patients of their decision-making rights regarding medical care. An advance
      directive (AD), a living will, or a durable power of attorney for health care
      contains statements made by competent people directing their medical care if they
      should become incompetent. Oncology nurses are in an advantageous position to
      educate and advocate for their patients with respect to end-of-life decisions.
      They are qualified to facilitate the AD process by virtue of their ability to
      relate to patients and families their extensive experience with the terminally
      ill and their expertise as liasons between patients, families, and the
      multidisciplinary team. A clear understanding of the patient's wishes regarding
      life-sustaining treatments enables the oncology nurse to advocate more
      effectively on the patient's behalf. This article highlights definitions of ADs,
      advantages and disadvantages of each, and recommendations for the oncology
      nurse's practice.

PMID- 1635871
TI  - Patients who have undergone bone marrow transplantation: their quest for meaning.
AB  - This study investigates the processes of "meaning-making" and life interpretation
      as experienced by a group of patients who underwent bone marrow transplantation.
      Six adult male patients were followed until the 100th day after their
      transplantation or until their deaths. A hermeneutic study of their experiences
      revealed that they manipulated the meanings of their lives and sought meaning in
      their lives in two different ways: (1) they renegotiated their social position in
      a new situation, and (2) they tried to reach an understanding of their
      experiences as a whole.

PMID- 1635872
TI  - Early and late radiation-induced skin alterations. Part II: Nursing care of
      irradiated skin.
AB  - Teaching patients how to care for irradiated skin during and after a course of
      radiation therapy is a major concern of oncology nurses. Part I of this two-part
      article (ONF 19(5):801-807) focused on the mechanisms of skin injury. Many
      topical preparations are available for skin care. When these substances are
      applied, both the active ingredient and the vehicle must be appropriate for the
      condition being treated. Preparations may be applied to the skin as liquids
      (e.g., lotions, solutions, tinctures used in wet dressings, soaks, baths) or
      solids (e.g., powders, creams, ointments). As skin reaction progresses during a
      course of radiation therapy, recommendations for skin care will change. Healing
      of injury occurs in three stages: inflammation, proliferation, and maturation.
      Wound healing proceeds more rapidly in a moist environment, and a variety of
      occlusive dressings can be used with moist desquamation.

PMID- 1635873
TI  - Oncology nursing society position paper on cancer and aging: the mandate for
      oncology nursing.

PMID- 1635874
TI  - Better education results in less stomatitis.

PMID- 1635875
TI  - Peridex decreases oral mucositis.

PMID- 1635877
TI  - Assessment promotes proper oral care.

PMID- 1635876
TI  - Alternatives to unwaxed floss and peroxide rinses recommended.

PMID- 1635878
TI  - Ongoing assessment of patient teaching remains important.

PMID- 1635879
TI  - Oral care of patients receiving radiation therapy to head and neck.

PMID- 1635880
TI  - Educational guide improves management of xerostomia.

PMID- 1635882
TI  - Fumes from the spleen.

PMID- 1635881
TI  - Mantel-Haenszel techniques and logistic regression: always examine one's data
      first and don't overlook the simpler techniques.
AB  - The authors point out that, in addition to logistic regression, there are other,
      simpler techniques available for making an adjusted estimate of association
      between an outcome and a risk factor. Also, the consequence of mismodelling with
      regression, i.e. of missing the real relationship between an outcome and a risk
      factor, is illustrated with an example. The need to 'examine one's data' prior to
      performing multivariable techniques is emphasised.

PMID- 1635883
TI  - Risk factors in limb reduction defects.
AB  - Risk factors were studied in 123 children with limb reduction defects (LRD) from
      118,265 consecutive births of known outcome during the period from 1979 to 1987
      in the area which is covered by our registry of congenital malformations. For
      each case a control was studied. The LRD was localised and classified according
      to the EUROCAT guide for the description and classification of limb defects. The
      prevalence of LRD was 1.04 per thousand: 82.9% of the babies were liveborn, 13.0%
      were late spontaneous abortion or stillborn and termination was performed in 4.0%
      of the cases. The proportion of males was 0.55. The most common malformations in
      the 51.2% of children who had at least one other anomaly than LRD were associated
      cardiac, digestive and renal anomalies. The pregnancy with limb anomalies was
      more often complicated by oligohydramnios, polyhydramnios and threatened abortion
      but there were no differences in parental characteristics. However, 9.7% of
      marriages were consanguineous (P less than 0.01) and the incidence of LRD in
      first-degree relatives of the children with LRD was high. First-degree relatives
      also had more non-limb malformations than did those of controls.

PMID- 1635884
TI  - The California Cerebral Palsy Project.
AB  - The California Cerebral Palsy Project (CACP) is a population-based study of 192
      children with moderate or severe congenital cerebral palsy who were born between
      1983 and 1985 in four San Francisco Bay area counties and who were alive and
      residing in California at age 3 years. Initial ascertainment of cases was based
      on records of two agencies known to enrol virtually all CACP-eligible children.
      Final case status was established by standardised clinical examination in 67% of
      cases and extensive record review in 33%. The 192 cases gave a prevalence at age
      3 of 1.23/1000 survivors. Twins were 10% of the cases with a prevalence of
      6.7/1000. Overall, 53% of the cases had birthweight greater than or equal to 2500
      g and 28% had birthweight less than 1500 g. There was no association between
      birthweight and severity of functional impairment and no consistent association
      between birthweight and the presence of associated disabilities. The CACP
      prevalence is lower than that reported in other studies and is believed to be due
      to the more stringent case inclusion criteria employed for this research data
      base.

PMID- 1635885
TI  - Prenatal events and the risk of subependymal/intraventricular haemorrhage in very
      low birthweight neonates.
AB  - The effects of prenatal factors on the risk of subependymal and/or
      intraventricular brain haemorrhage in very low birthweight (VLBW) neonates were
      studied. Data were collected on 201 consecutively born VLBW neonates without
      major congenital anomalies, who were born at a regional obstetric referral
      centre. Brain haemorrhage was identified by cranial ultrasound examinations. The
      reliability of these examinations (concordance among readers' interpretations)
      was assessed and found to be moderate (kappa = 0.47 for the finding of
      subependymal haemorrhage (SEH); kappa = 0.50 for the finding of intraventricular
      haemorrhage (IVH)). Prenatal factors were more strongly associated with IVH than
      with SEH. In univariable analyses, maternal pre-eclampsia, multiple gestation and
      maternal treatment with betamethasone were associated most strongly with a
      decreased risk of haemorrhage whereas labour and vaginal delivery were associated
      most strongly with an increased risk. These associations remained in a
      multivariable analysis which included prenatal events (maternal illnesses, fetal
      presentation and obstetrical interventions), as well as gestational age,
      birthweight, gender, treatment with assisted ventilation, and the occurrence of
      pneumothorax. Further aetiological study of the effects of prenatal factors could
      provide information useful in preventing SEH/IVH.

PMID- 1635887
TI  - Seasonality of births in Turkey.

PMID- 1635886
TI  - 'Errors' in perinatal medicine: an epidemiological perspective.

PMID- 1635888
TI  - Cohort reconstruction.

PMID- 1635889
TI  - Cryopreserved human tissue in pharmacological research.
AB  - Despite the relevance of human isolated tissue in human pharmacology, its use is
      still very much the exception rather than the rule. The major reason for this is
      that the supply of fresh human material is both irregular and unpredictable. This
      article considers the usefulness of cryopreservation to store human isolated
      tissues for subsequent pharmacological studies. Despite certain problems, such as
      some reduction in contractile force and endothelial function, the main
      biochemical properties and affinities of most agonists and antagonists have been
      shown to be well preserved. Hence, this technique offers clear potential for
      ensuring the supply of both vascular and non-vascular human material for
      pharmacological studies.

PMID- 1635890
TI  - Control of salt intake by steroids and cerebral peptides.
AB  - Steroids (aldosterone and testosterone) and peptides of cerebral origin
      (angiotensin II and the tachykinins) control the salt intake of the rat. They
      arouse or suppress the behaviour and produce life-long enhancements of NaCl
      intake. Need-induced salt intake (salt appetite or salt hunger), which is the
      consequence of sodium deficiency, is aroused by a synergy within the brain of
      cerebral angiotensin II and aldosterone. And prior episodes of sodium depletion
      produce enhancements of subsequent salt appetites, but only if the prior
      depletions were accompanied by angiotensin II and aldosterone action. Need-free
      salt intake, which occurs daily when the rat is in positive sodium balance, is
      inherently high in the rat and is organized in the perinatal period by aromatized
      testosterone which suppresses the intake of the male. It is also enhanced by
      prior activations of angiotensin II and aldosterone. Both need-induced and need
      free salt intake are suppressed by intracranial tachykinins. Non-mammalian
      tachykinins (eledoisin, physalaemin, kassinin) are both antidipsogenic and
      antinatriorexigenic, but amino-senktide, an analogue of the mammalian tachykinin
      substance P with selective affinity for the NK 3 receptor, appears to be a
      selective antinatriorexigenic agent, and could provide a rational therapy for
      chronic overconsumption of salt.

PMID- 1635891
TI  - Effects of S9977 and dihydroergotamine in an animal experimental model for
      migraine.
AB  - The present study concerns the effects of S9977, a trimethylxanthine derivative
      with potential antimigraine characteristics, on the distribution of carotid blood
      flow in the anaesthetized pig. Furthermore, the effects of dihydroergotamine have
      been analysed for comparison. Dihydroergotamine (3, 10, 30 and 100 micrograms/kg,
      i.v.) elicited dose-dependent pressor and bradycardic responses which were
      probably mediated by its partial agonist action on alpha-adrenoceptors and
      dopamine2 receptors. In contrast, S9977 (0.3, 1, 3 and 10 mg/kg, i.v.) caused a
      moderate hypotension and bradycardia. The carotid haemodynamic effects of
      dihydroergotamine (3, 10, 30 and 100 micrograms/kg, i.v.) consisted of a dose
      dependent reduction of arteriovenous anastomotic blood flow and conductance and
      an increase in nutrient (tissue) blood flow and conductance. As a consequence,
      jugular venous PO2 decreased. These findings, demonstrating an active
      constriction of arteriovenous anastomoses, are in agreement with earlier findings
      in cats. Though S9977 (0.3, 1, 3 and 10 mg/kg, i.v.) decreased carotid (two
      highest doses) and arteriovenous anastomotic (highest dose) blood flow, there was
      no concomitant decrease in the vascular conductances. Therefore, the effects of
      S9977 seem to be related to a decrease in arterial blood pressure and not to an
      active vasoconstriction of arteriovenous anastomoses. These results are discussed
      in terms of the potential therapeutical usefulness of S9977 in the treatment of
      migraine.

PMID- 1635892
TI  - Pharmacokinetics of heptastigmine in rats.
AB  - Heptastigmine is a new long acting cholinesterase inhibitor that affects
      behaviour in a number of cognitive tests in animals. We have studied its
      pharmacokinetics in rats: plasma kinetics were evaluated after single intravenous
      dose (2 mg/kg), intramuscular (4 mg/kg) and oral (4 and 8 mg/kg) administration.
      Tissue distribution (heart, liver, kidney and brain) was studied after single
      intramuscular (4 mg/kg) and oral (8 mg/kg) administration. Plasma and tissue
      kinetics were also investigated after repeated oral doses (8 mg/kg b.i.d. for 7
      days). Heptastigmine levels in plasma and tissues were determined using an HPLC
      method with an electrochemical detector. After a single dose, heptastigmine
      remained for a long time in plasma (the terminal half-life was about 12 h),
      distributed widely in tissues (the volume of distribution was about 61) and brain
      concentrations were very high (4-22 times those found in plasma). After repeated
      oral doses, the drug levels increased in plasma and, to a lesser extent, in liver
      and kidney.

PMID- 1635893
TI  - Effect of the flavanolignans of Silybum marianum L. on lipid peroxidation in rat
      liver microsomes and freshly isolated hepatocytes.
AB  - The effect of several flavanolignans (silicristin, silidianin, silybin and
      isosilybin) present in silymarin, the extract of Silybum marianum fruits, was
      tested on lipid peroxidation in rat liver microsomes and freshly isolated
      hepatocytes. In microsomes lipid peroxidation was generated by ADP/Fe2+ and
      NADPH. All flavanolignans inhibited peroxidation in a concentration dependent
      manner. In hepatocytes lipid peroxidation was induced by ADP/Fe3+ complex and
      cell damage was evaluated as LDH activity released in the medium. The inhibition
      of the peroxidative process by flavanolignans was also evident in this model,
      even if with a potency order different from that found in microsomes. In
      contrast, the effect on LDH release was significant only for silybin and
      isosilybin, the other compounds being inactive on this parameter.

PMID- 1635894
TI  - Effect of BN 52256 and other mediator antagonists on ouabain-induced cardiac
      arrhythmia in a model of anaphylaxis in guinea-pigs.
AB  - Different mediators released by anaphylaxis seem to be involved in different
      pathophysiological conditions, including cardiac arrhythmia. Histamine, 5-HT and
      platelet-activating factor (PAF) could participate in the enhanced
      arrhythmogenicity during anaphylaxis in guinea-pigs. The threshold dose of
      ouabain-induced arrhythmia is decreased in actively sensitized guinea-pigs by
      i.p. administration of ovalbumin. The purpose of the present paper was to
      investigate the effect of different mediator antagonists. Antagonists of PAF (WEB
      2170), histamine (clemastine) and 5-HT (cyproheptadine) in doses of 5.0 mg/kg,
      5.0 mg/kg and 0.5 mg/kg, respectively, can increase the threshold dose of ouabain
      induced arrhythmias signalling an antiarrhythmic effect. A combination of WEB
      2170 and clemastine, each of them in inactive doses (2.0 mg/kg and 1.0 mg/kg,
      respectively) showed a statistically significant antiarrhythmic effect. A
      combination of the same dose of WEB 2170 and cyproheptadine (0.1 mg/kg) under the
      same conditions induced an antiarrhythmic effect, too. BN 52256 is a new
      antiallergic drug synthesized on the basis of a novel concept of combining
      inhibitory activity against various inflammatory mediators in one molecule. BN
      52256 in doses of 20-80 micrograms/kg exhibited a statistically significant
      antiarrhythmic effect. BN 52256 needed a 12.5-125 fold lower dose to induce the
      same antiarrhythmic effect compared to the antagonists of PAF, histamine or 5-HT
      investigated in this study. Depending on the pathophysiological conditions,
      different mediators seem to be involved in the occurrence of cardiac arrhythmia.
      A complex inhibition of these mediators could induce a more specific influence on
      such kinds of cardiac arrhythmias.

PMID- 1635895
TI  - Effects of soman on norepinephrine uptake and electrically stimulated release
      from human uterine arteries.
AB  - The effects of soman on the uptake and electrically induced release of
      norepinephrine (noradrenaline) from isolated human uterine artery have been
      investigated. Soman did not alter the uptake of norepinephrine by human uterine
      artery, but reduced the electrically induced release of norepinephrine from the
      artery. This reduced norepinephrine release may augment the fall in blood
      pressure induced by accumulated acetylcholine stimulating muscarinic receptors
      following cholinesterase inhibition.

PMID- 1635896
TI  - Catecholamine and serotonin depletion from rat spinal cord: effects on morphine
      and footshock induced analgesia.
AB  - Using a methodology that causes a selective degeneration of spinal cord
      catecholaminergic or serotoninergic pathways but not those of the brain, it has
      been possible to study more precisely the role played by the spinal cord
      monoaminergic systems that underly the mechanism through which morphine and
      endogenous opioids modulate nociceptive inputs. Both noradrenaline (NA) and
      serotonin (5-HT) appear to be involved: first, the noradrenergic and only
      subsequently, with higher doses of the opiate, the serotoninergic pathways.

PMID- 1635897
TI  - Effects of prostaglandins and PAF on the contractility of the bovine ciliary
      muscle.
AB  - The present study has investigated the effect of prostaglandins and PAF on the
      contractility of the bovine ciliary muscle, a tissue involved in the control of
      aqueous outflow. The results show that the prostaglandins tested (PGI2, its
      stable analogue Iloprost, PGE2, PGE1, and PGF2 alpha) as well as PAF, were able
      to contract the ciliary muscle, although with different potencies and efficacies.
      PGI2 and Iloprost displayed parallel dose-effect curves with upper plateaus that
      did not differ significantly; however, PGI2 was slightly more potent than
      Iloprost. This is at variance with what is observed at the level of the platelet
      prostacyclin receptor. PGF2 alpha was equipotent with the PGEs tested, with a
      maximal effect not different from either PGI2 or PGEs. PAF was the most
      efficacious of the compounds tested.

PMID- 1635898
TI  - Homelessness: a rural perspective.

PMID- 1635899
TI  - Sounding a political call to arms.

PMID- 1635900
TI  - ANA position statement on nursing and the Patient Self-Determination Act.

PMID- 1635901
TI  - Nurses in advanced practice: a new prescription for a healthy America.

PMID- 1635902
TI  - Fetal alcohol syndrome and its implications for the day care provider.

PMID- 1635903
TI  - Discharge planning.

PMID- 1635904
TI  - [Integrated individual psychotherapy of adolescent and young adult enuretic
      patients--psychodiagnostic and psychosomatic aspects].
AB  - The subject of this paper are fundamental positions, concerning the contents, and
      empirical results of 15 years time, concerning the dynamic-orientated single
      psychotherapy for youth and young adult enuretics. It is supported by analyses of
      15 years time in the medical-psychological practice. From a sample of, all in
      all, 250 patients, the results of a group of 55 patients at the age of 15-21
      years are shown, who were treated with dynamic-orientated single-psychotherapy,
      and are discussed with an emphasis on the integrative, biopsychosocial character
      of this illness. Enuresis nocturna is being regarded consequently as a special
      psychomatic complex phenomenon, and the empiric results are being interpreted
      with orientation to theory. There have been applied several test-methods for the
      purpose of inter-groupal pre-post-analyses, before and after the treatment with a
      duration of katamnese of 6 months. Statements concerning the efficiency, as well
      as essential changes of parameters in the course of the psychotherapy are special
      subject of result-related discussions. The results certify, that contential
      specific, age-differentiated emotional and social aspects of personality and
      reflexion are getting very significantly changed in the course of the successful
      or partly successful therapy, while in the cases of the non-successfully treated
      patients no changes in such manner could be obtained.

PMID- 1635906
TI  - [Sex differences in dreams. Content analysis of oknophile and philobatic dream
      images in the dreams of children and adolescents].
AB  - Until now it had been observed that in their dreams girls concern themselves more
      with inter-human relationships, whereas boys concern themselves stronger with the
      outside world and aggressive striving. In this survey manifest dreams, as
      reported in psychotherapies, spontaneously remembered and taken down by the
      children and young people themselves, were examined with an index in which
      Balint's theories about oknophilia and philobatism were used. The question
      whether there are any differences of sex was checked there. One important result
      of this survey was that girls in fact dream more oknophile subjects, whereas boys
      dream more philobatic ones. As the philobatic attitude might be put down to an
      earlier trauma than the oknophile one, this result here above all corresponds
      with the hypothesis of the feminist psychoanalytics (Chodorow, Olivier), that
      boys axe dismissed from the symbiosis with their mothers too early. With that
      they get into a premature independence they are not up to. Girls on the other
      hand are rather overcharged narcissistically and their mothers hold on to them
      for too long.

PMID- 1635905
TI  - ["Men only make dirt!"--A study of single mothers in a mother-child program].
AB  - This paper deals with social case work of single-parent mothers participating in
      a 'mother and child' programme in Ulm. The social workers realized that these
      mothers frequently leave the childrens' fathers immediately after the birth of
      the baby or soon after. The relationships of the mothers with their partners and
      their families of origin were studied by questionnaires. The authors find that
      those women who broke the relationships to the childrens' fathers judge their
      families of origin as significantly more dysfunctional as those mothers who have
      been relating to their partners. It is assumed that the single parent mothers
      suffer from insufficient internalizations with their own fathers in regard to
      attachment behaviour. Tragically these women repeat the instability of their
      parents' marriages in their own partnerships.

PMID- 1635908
TI  - Current topic: water volume of the ovine conceptus; point of view.
AB  - The sheep is the only species for which there is sufficient information to
      justify an overview of maternofetal water transfer. Current information points to
      the following conclusions: (1) the site of water exchange between mother and
      conceptus is mainly the placenta; (2) the pressure that initiates transfer to the
      fetus is the osmotic pressure of solutes that are present in higher
      concentrations in fetal plasma than in maternal plasma, such as urea, fructose,
      amino acids, bicarbonate and lactate; (3) maternal ultrafiltrate thus attracted
      into the conceptus arrives there mostly denuded of electrolytes and is strongly
      hypotonic; thus it is the transfer of electrolyte that restrains the transfer of
      water; (4) maternofetal transfer of water is strongly facilitated by angiotensin
      I in the fetal circulation by a sequence of events that has not yet been
      elucidated; (5) the net combined osmotic and hydrostatic pressure that drives
      water across the placenta is of the order of only 20 to 80 mm Hg; (6) it is
      necessary to make a sharp distinction between transfer from mother to conceptus
      and transfer from one compartment to another compartment within the conceptus.
      Finally, the review lists certain precautions to be taken in the further study of
      water exchange between mother and conceptus.

PMID- 1635907
TI  - [Dangerous comics--only a fantasy?].
AB  - Both superhero comics and fairy tales are equally popular with children: they
      create fantasy worlds full of violence and dangers which the hero must overcome.
      The question is raised whether the criticism of prevailing violence and a lack of
      realism can be rejected not only when considering fairy tales but also in the
      case of comics. The comparison of the two genres leads to the following results:
      Comics with their regressive pull and their independent superhuman heroes
      represent the archaic world of narcissism unconscious, unwilling to develop and
      conservative. Violence serves to maintain the original state or regain a
      harmonious "paradise". However, the rich world of symbols is also the creative
      source of our existence to which we keep returning--whether in dreams or in other
      fields of imagination. As works of literature, fairy tales seem to be more
      progressive and concerned with solutions. In the main, they support the
      development of the self. Violence is used to overthrow the old order and usher in
      the new. The aggression results in overcoming the unconscious. The image of the
      fairy tale hero corresponds to the child's view of the world. He does not seek
      narcissistic solitude and greatness but the companionship of prince or princess.
      A progressive and optimistic view of the future as well as a more conservative
      and retrospective tendency are part of human nature. For children, however,
      problems of development take precedence. Thus superhero comics are only dangerous
      for severely disturbed children, but fairy tales are certainly more beneficial.

PMID- 1635909
TI  - Effects of diacylglycerol and gonadotropin-releasing hormone on human chorionic
      gonadotropin release by cultured trophoblast cells.
AB  - The effect of activation of calcium- and phospholipid-dependent protein kinase
      (protein kinase C) on human chorionic gonadotropin (hCG) release by cultured
      trophoblast cells was studied and a role of protein kinase C in the GnRH-mediated
      hCG release was also evaluated. Both GnRH and 1-oleoyl-2-acetylglycerol (OAG), a
      protein kinase C activator, stimulated hCG release after 3 h incubation in a dose
      dependent manner with ED50 of 55 nmol/l and 4.0 nmol/l, respectively. A tumor
      promoting phorbol ester, 12-O-tetradecanoylphorbol-13-acetate (TPA) also
      stimulated hCG release while two non-tumor-promoting compounds, phorbol and 4
      alpha-phorbol, failed to stimulate hCG release. hCG release by maximal effective
      dose of GnRH (10 mumol/l) or OAG (1 mumol/l) was further stimulated when cells
      were incubated with same concentrations of GnRH and OAG. OAG-stimulated hCG
      release was completely inhibited by a protein kinase C inhibitor, H-7, with ID50
      of 23 nmol/l while H-7 did not affect GnRH-mediated hCG release. These results
      indicate that GnRH-stimulated hCG release is not mediated by protein kinase C
      pathway, however, the secretion of hCG is also regulated by the mechanism that
      involves protein kinase C activation.

PMID- 1635910
TI  - Placental localization of 15-hydroxy-prostaglandin dehydrogenase in early and
      term human pregnancy.
AB  - The human placenta possesses a large capacity for inactivation of prostanoids.
      This is due to the presence of large quantities of the NAD(+)-linked 15-hydroxy
      prostaglandin dehydrogenase (PGDH type I; EC 1.1.1.141). In order to investigate
      whether a specific localization of PGDH is at the origin of the increasing
      placental PGDH activity during early pregnancy, PGDH activity was localized
      histochemically in placental tissue obtained in early pregnancy and at term.
      Intracellular PGDH activity was present in three distinct compartments in the
      placenta. First, the syncytiotrophoblast and second, the underlying
      cytotrophoblast layer of placental terminal villi contained PGDH. Third,
      scattered throughout the sections, we found chorion-like cells which showed
      strong staining for PGDH activity. The intensity of staining in samples before 12
      weeks of gestation was much less than in samples after 12 weeks of gestation,
      which were comparable to those at term. Thus, the fetal cell layers at the
      boundary between the fetal tissues and the maternal blood have a great potential
      to inactivate prostanoids suggesting that the fetus protects itself against
      prostanoids of maternal origin.

PMID- 1635911
TI  - Effect of maternal hypokalaemia on unidirectional maternofetal and net potassium
      fluxes across the placenta of the anaesthetized rat.
AB  - Potassium (K+) fluxes across the placenta of rats, at 21 days gestation, fed a
      low K+ diet or a control diet were studied. The rats on the low K+ diet had a
      significantly (P less than 0.001) lower arterial plasma K+ concentration compared
      to those on the control diet (1.95 +/- 0.12 and 2.93 +/- 0.06 mmol/l
      respectively; mean +/- s.e., n = 17). Fetal umbilical arterial plasma K+
      concentration was unaltered in maternal hypokalaemia and was significantly (P
      less than 0.001) higher than that of maternal plasma (4.58 +/- 0.15 and 4.66 +/-
      0.12 mmol/l in low K+ and control groups respectively). Net K+ flux across the
      placentas (as measured by fetal accretion between days 20 and 21 of gestation) of
      hypokalaemic mothers (0.106 +/- 0.02 mumol/min/g placenta, n = 6) was not
      different to that in controls (0.104 +/- 0.01 mumol/min/g placenta, n = 8).
      Unidirectional maternofetal flux (Jmf) across the placentas, measured as the
      accumulation of 42K in the fetuses after injection of the radioisotope into
      maternal blood, was also not significantly different between the hypokalaemic and
      control mothers (0.5 +/- 0.08 mumol/min/g placenta, n = 8 versus 0.63 +/- 0.06
      mumol/min/g placenta, n = 7, respectively). However, measurement of Jmf by
      perfusion of the placentas through their fetal circulations yielded a higher
      value than the accumulation method and in this analysis was significantly (P less
      than 0.02) lower in the low K+ than in the control group (0.75 +/- 0.10
      mumol/min/g placenta, n = 11, and 1.27 +/- 0.14 mumol/min/g placenta, n = 9,
      respectively). These results show that net placental K+ fluxes are unaltered
      during maternal hypokalaemia but suggest that unidirectional maternofetal fluxes
      may be reduced.

PMID- 1635912
TI  - Plasma levels of eosinophil granule major basic protein in pregnant cynomolgus
      monkeys.
AB  - The sera of all pregnant women contain increased amounts of a protein
      biochemically and immunologically similar to the eosinophil granule major basic
      protein (MBP). Immunofluorescence shows that the pregnancy-associated MBP is
      localized to placental trophoblastic cells. This information raises important
      questions about the function of pregnancy-associated MBP because of the potential
      biological functions attributed to its eosinophil counterpart (namely, its potent
      toxic and cytostimulatory activities). Previous studies demonstrated the presence
      of an immunologically cross-reactive protein in the placentae and plasma of
      pregnant non-human primates. Here, plasma MBP levels were measured throughout
      gestation in cynomolgus monkeys. In early pregnancy, only modest increases in MBP
      were found in contrast to the sharp rise observed in the first 20 weeks of human
      pregnancy. During the final one-third of gestation, striking increases in plasma
      MBP occurred in the monkeys. This parallels the late rise in MBP seen in humans
      in the third trimester. Thus, the cynomolgus monkey may serve as a model to
      clarify the role of the MBP in the biochemical events that culminate in
      parturition.

PMID- 1635913
TI  - Enhanced glutathione S-transferase (GST) activity in pregnant rats treated with
      benzo(a)pyrene.
AB  - Administration of Benzo(a)pyrene (BP, 50 mg/kg/d) to pregnant rats significantly
      increased Glutathione S-transferase (GST) activity in placental tissue-extract
      (Vmax = 40 nmol/min/mg protein and 69 nmol/min/mg protein in controls versus
      treated animals respectively; P less than 0.01) and total fetal tissue-extract
      (Vmax = 51 nmol/min/mg protein and 82 nmol/min/mg protein in controls versus
      treated animals respectively; P less than 0.01) indicating an induction effect of
      BP on the GST system. An increase in the Km values was also observed: 1.61 x 10(
      3) M and 2.84 x 10(-3) M in control versus treated placentae; 1.38 x 10(-3) M and
      2.05 x 10(-3) M in control versus treated fetuses. A competitive effect on the
      enzyme by the BP present in the sample may also be involved. The glutathione
      content in both tissues did not show any changes after the treatment with BP.
      This increase in the GST system was not sufficient to protect the fetus. BP
      affected the reproductive performance of pregnant rats by significantly
      increasing the number of resorptions and fetal wastage, and, also, by decreasing
      the fetal weight.

PMID- 1635914
TI  - Endotoxin induced intraplacental thrombotic tendency and decreased vascular
      ADPase in the pregnant rat.
AB  - The mechanism underlying increased sensitivity for endotoxin in pregnancy, as
      reflected by intravascular thrombus formation in various organs i.e. the
      placenta, is unknown. We studied the influence of endotoxin infusion at day 14
      upon the vascular antithrombotic ADPase present in the labyrinth of the rat
      placenta just before term (day 21). Pregnant Wistar rats were infused with either
      endotoxin (1 microgram/kg body weight) or saline through permanent vena jugularis
      catheters and their placenta and kidneys were examined at day 21 using light
      electron microscopy and enzyme cytochemistry at the ultrastructural level. Also,
      placenta perfusion ex vivo was done using platelets and ADP to test the
      thrombotic tendency of placental vessels in endotoxin treated and control rats.
      The results show in both maternal as well as the fetal vessels of the placental
      labyrinth vascular occlusions and decreased membrane ADPase activity exclusively
      in endotoxin treated and not in saline infused pregnant animals. Alternate
      placenta and kidney perfusion ex vivo resulted in intraplacental and
      intraglomerular platelet aggregation again exclusively in endotoxin-treated rats.
      It is concluded that vascular ADPase may be affected by endotoxin due to the
      pregnant condition, resulting in a functional defect in antithrombotic potention
      which may promote intravascular formation of microthrombi in situ.

PMID- 1635915
TI  - The route of maternal IgM transport to the rabbit fetus.
AB  - The route of IgM transport to the rabbit fetus was investigated by comparing its
      localization with that of IgG in the yolk sac splanchnopleure and uterine tissues
      using direct immunofluorescence and immunodiffusion analysis. IgM was first
      detected in fetal serum at 20 days of gestation but was present in uterine fluid
      at 18 days, the earliest stage tissues and fluids were examined. IgM was co
      localized with IgG in the yolk sac endoderm basement membrane and in the vascular
      mesenchyme of the yolk sac splanchnopleure providing evidence of its transport to
      fetal blood; it was also present in vesicles in the yolk sac endoderm. IgM could
      not be detected in uterine fluid of nonpregnant uterine horns of rabbits
      unilaterally pregnant. Human IgM injected into the maternal circulation was
      readily transported to the uterine fluid and across the yolk sac splanchnopleure
      to fetal blood indicating that IgM secreting plasma cells, found to be present in
      the uterine stroma, contributed little towards IgM in the uterine fluid.
      Degenerating paraplacental decidual tissue, a feature of rabbit pregnancy, is
      suggested to be a major route for maternal immunoglobulin transport to the
      uterine fluid.

PMID- 1635916
TI  - Microdetermination of vitamin D2 (ergocalciferol) using N-bromosuccinimide.
AB  - A novel method for the microdetermination of vitamin D2 in its pure state and
      pharmaceutical preparations using N-bromosuccinimide (NBS) is reported. The new
      method is easy, simple, and accurate.

PMID- 1635917
TI  - [Relationships between manufacturing parameters and pharmaceutical-technological
      requirements of biodegradable microparticles. 2. Preparation of injectable
      microparticles in biodegradable polyester].
AB  - Local anesthetics containing biodegradable polyester microparticles are prepared
      using a modified solvent-evaporation process and a spray drying technique. The
      preparation methods are compared critically. The modified solvent-evaporation
      process is preferred for the preparation of microparticles. Yields of 90% and
      microparticle size distributions can be influenced in a reproducible manner.
      Using the spray drying technique yields are only 60%. The product is
      characterized by a high portion of microparticles under 10 microns, which are
      responsible for the rapid release of cinchocain in 168 h as well.

PMID- 1635918
TI  - Timolol in lipospheres.
AB  - Lipospheres carrying timolol (1) were obtained from microemulsions. They had
      lecithin, palmitic and decanoic acids as the main constituents. The sizes were
      between 300 and 400 nm and the amount of 1 incorporated varied from 2.7 to 4.8%
      according to the microemulsion used. Compound 1 was present in the lipospheres
      mainly as ion pairs in order to increase its lipophilicity. The difference found
      in the incorporation was principally due to the different lipophilicity of the
      ion pairs of 1.

PMID- 1635919
TI  - [The use of bead cellulose for controlled drug liberation. 5. Binding of
      benzocaine as a model drug to dialdehyde-bead cellulose and its in vitro
      liberation].
AB  - In the case of ionic binding of drugs to bead cellulose and its derivatives there
      was no pronounced retardation obvious. Because of this lack benzocaine as a model
      drug was covalent bound to dialdehyde bead cellulose by an azomethine bond in
      analogy with enzyme immobilisation methods. The rate of liberation in phosphate
      buffer was low and incomplete compared with the dissolution rate of pure
      benzocaine under the same conditions. A further decrease of liberation rate was
      obtained by reduction of the azomethine to the amine bond. Retardation of drug
      liberation strictly speaking was not achieved. The main amount of liberated drug
      was liberated during the first 20 min, but after 6 h the rate was still under 50%
      of the drug available. The physical properties of the beads like spherical shape
      and porosity are not significantly influenced by oxidation of cellulose and by
      loading with drug.

PMID- 1635920
TI  - Regulation of the tetracycline hydrochloride release from polyacrylate
      microspheres. Part 1.
AB  - Due to the precipitation of free bases sparingly soluble in water, it is not
      possible to achieve a uniform release in the gastrointestinal tract of delayed
      action drugs containing salts of weak bases, e.g. tetracycline hydrochloride, at
      pH-values surpassing their pKa values. The problem of drug release control can be
      solved by adding Eudragit L to the polymetacrylate (Eudragit RS) microspheres. It
      has been established that 30% Eudragit L ensures a gradual uniform release of
      tetracycline hydrochloride (KOr = 11%/h) irrespective of variations in the pH of
      the gastrointestinal tract.

PMID- 1635921
TI  - Some factors affecting properties and dissolution behavior of tableted furosemide
      microspheres.
AB  - Furosemide (1) microspheres prepared by using Eudragit RS (1:4 and 1:2
      drug:polymer ratios) were tableted. Microspheres were compressed with or without
      excipients (lactose, Avicel PH 101 or Emcompress). The thickness and crushing
      strength of tablets containing excipients were also found to be affected by the
      type of excipients. Dissolution characteristics of furosemide from tableted
      microspheres with or without excipients depended on the applied compression force
      but showed a controlled release behavior. Compression slowed down the release of
      1. Addition of excipients to the formulation increased drug dissolution. The
      release from tablets followed Higuchi matrix model kinetics.

PMID- 1635922
TI  - Studies on dressing for dental surgery use. Part 2. Influence of Kunitz' protease
      inhibitor on properties of dental gelatinous dressings.
AB  - To increase resistance of gelatinous dressings to the etching action of trypsin
      in vitro, the Kunitz' protease inhibitor has been added. It has been found that
      the etching rate of the dressings was reduced in proportion to the inhibitor
      added. Addition of plasticizers in the presence of an inhibitor reduces the
      etching rate of the dressings and the effect depends on the type and
      concentration of the plasticizer added. Thermally sterilized dressings have an
      average of 10% less resistance to the etching action of trypsin. The liberation
      of the inhibitor from the dressings follows first order kinetics, whereas its
      liberation rate depends upon the type of the plasticizer used.

PMID- 1635923
TI  - Effect of AWD 52-39 on vasoconstriction induced by noradrenaline and 5
      hydroxytryptamine in vitro and in vivo in rats.
AB  - The vascular effect of the potential nootropic AWD 52-39 (1; N,N-diacetoxyethyl
      9,10-dihydrolysergic acid amide) as well as its influence on noradrenaline- or 5
      HT-induced vasoconstriction were studied in the isolated rat aorta and in
      anesthetized normotensive and pithed rats. Vasoconstriction was determined by
      measuring the increase in mean arterial pressure (MAP). Both in vitro and in
      pithed rats, 1 caused a slight vasoconstriction, whereas a dose-dependent short
      lasting decrease in mean arterial pressure was found in normotensive rats. In
      vitro and in pithed rats, 1 exerted no influence on the noradrenaline-induced
      vasoconstriction, while the 5-HT-induced contractile response was significantly
      inhibited. These findings characterize 1 as a competitive antagonist at vascular
      5-HT2 receptors without any alpha-adrenolytic effect.

PMID- 1635924
TI  - Immunological and antitumor effects of coumarin and some derivatives.
AB  - Coumarin and its 4-OH and 7-OH derivatives, as well as o-, m- and p-coumaric acid
      were tested against P-815 and P-388 tumor cells in vitro. In addition, the
      compounds were investigated in various in vitro immunological test systems and
      genuine coumarin was tested furthermore against the Sarcoma-180 in CD1 mice. In
      vivo, coumarin showed only a moderate antitumor effect against the allogeneic
      Sarcoma-180 at concentrations of 10 and 40 mg/kg, with inhibition rates of 49 and
      60%, respectively. However, both concentrations were markedly toxic. In vitro all
      compounds were more or less cytotoxic against P-815 and P-388 tumor cell lines
      starting at a concentration of 100 micrograms/ml. At subtoxic concentrations
      (less than or equal to 10 micrograms/ml) the samples showed no mitogenic activity
      against murine spleen lymphocytes and PHA costimulated human peripheral blood
      lymphocytes. Furthermore, with the coumarin derivatives neither cytotoxic
      macrophages could be induced against P-815 tumor cells nor an increased release
      of Il-2 and TNF-alpha could be observed. Only 7-OH coumarin, in concentrations of
      2 and 20 micrograms/ml, caused a strong increase in phagocytosis of 124 and 84%
      in both, human peripheral blood granulocytes and murine peritoneal macrophages,
      respectively.

PMID- 1635925
TI  - [Sex as a factor in drug consumption].
AB  - Based upon the hypothesis on the diverse dependency of drug consumption on the
      sex of population as its influencing factor, this relationship was closely
      studied. The dynamics of the dependency of large urban population has been
      analysed for a period of 4 years. Important differences in the dependency on sex
      and age have been found. The fine structure of this dependency including the
      analysis of its stability have been determined. The experiment was based on
      mathematical analysis methods.

PMID- 1635926
TI  - Stability of meclofenoxate hydrochloride in artificial gastric and intestinal
      media.

PMID- 1635927
TI  - [Calmus as a drug: advantage or risk?].

PMID- 1635928
TI  - Synthesis and in vitro study of platelet antiaggregant activity of some 4
      quinazolinone derivatives.
AB  - Some new 4-quinazolinones were prepared. Their antiplatelet activity was
      evaluated in vitro with respect to aggregation induced by ADP, collagen,
      arachidonic acid and the platelet serotonin release reaction. Most molecules
      showed an inhibiting power similar to that of acetylsalicylic acid under the same
      conditions, and even greater when aggregation was induced by ADP. Reduction of
      the 4-quinazolinone derivatives to their 1,2,3,4-tetrahydroquinazoline homologues
      produced an increase in platelet inhibitory action except when ADP is the
      inductor.

PMID- 1635930
TI  - Mechanism of the polarographic reduction of a new 5-nitrofuran derivative with
      antibacterial activity.
AB  - The reduction at mercury electrodes of a new 5-nitrofuran derivative with
      antibacterial activity, N2-(5-nitrofurfurylidene)formohydrazide-4-(3,5
      dicyanophenyl)-6-ethoxy-2- pyridyl)imide, was studied by conventional, normal
      pulse, reverse normal pulse and differential pulse polarography in water
      dimethylformamide (30%) buffered media. The waves observed, whose number depended
      on pH, are attributed to the reduction of the nitro group (6 electrons) and the
      azomethinic unit (4 electrons). The basic mechanisms of the electrode reactions
      have been deduced from the characteristics of the waves. Conditions for
      determining the formal potential of the nitroderivative/radical-anion system, a
      parameter related to pharmacological activity, are also reported.

PMID- 1635929
TI  - Study of local anaesthetics. Part 98(3): Preparation and local anaesthetic
      activity of 4-alkylpiperazinoethyl esters of o-heptyloxyphenylcarbamic acid.
AB  - During the course of study of variations in the basic moiety of heptacainium
      chloride 10 derivatives of 4-alkylpiperazinoethyl esters of o
      heptyloxyphenylcarbamic acid were prepared. Pharmacological investigation
      indicated that practically all the new compounds were several times more active
      than standards (cocaine and procaine). The most effective compound was 1-[2-(o
      heptyloxyphenylcarbamoyloxy)ethyl]-4-butyl-piperazinium dichloride, which was 142
      times more active than cocaine and 266 times more active than procaine.

PMID- 1635931
TI  - Proof of efficacy of nootropics for the indication "dementia" (phase III)-
      recommendations.

PMID- 1635932
TI  - TSH responses to TRH as a function of basal serum TSH: relevance for unipolar
      depression in females--a multivariate study.
AB  - Baseline thyroid-secreting-hormone (TSH)-assessed by means of ultrasensitive
      assays (IRMA)-and free-thyroid-hormone (FT4) levels were determined in 84
      depressed females, and the TSH responses to 200 micrograms thyrotropin-releasing
      hormone (TRH) (IV) measured. It was found that TRH-induced TSH responses were
      linearly and positively related to basal TSH-IRMA; lower TRH-stimulated TSH
      secretion in melancholic patients was attributable to lowered basal TSH-IRMA
      values. A progression was found-within the euthyroid range-of basal TSH-IRMA
      values towards lower levels along the diagnostic spectrum: the highest basal TSH
      IRMA levels were witnessed in minor depressives and the lowest in melancholics,
      while simple major-depressed females occupied an intermediate position. This
      shift appears to be indicative of severity of illness. Basal TSH-IRMA data can
      roughly be used as a clinical tool separating melancholia from minor depression:
      at a threshold value of less than or equal to 1 microUI/ml, sensitivity was 56%
      and specificity 92%. It is concluded that basal TSH-IRMA provides a more accurate
      representation of melancholia than peak TSH responses, which appear to constitute
      little more than a magnified, but biased signal of basal TSH-IRMA. In future, the
      assay of basal TSH-IRMA could replace TRH testing.

PMID- 1635933
TI  - A comparison of carbamazepine Divitabs and a normal carbamazepine preparation in
      psychiatric and oligophrenic patients.
AB  - Twenty patients who had become accustomed to a stable oral carbamazepine dose
      participated in an open, randomized, two-centre, cross-over study, in which
      ordinary tablets and Divitabs (a new sustained release preparation) were
      compared. Pharmacokinetic parameters, seizure control, effects on the behavioral
      state, and tolerability were considered. A smaller Area Under the Curve (AUC)
      during the Divitabs period was the only pharmacokinetic parameter with a
      significant difference (p less than 0.05). However, all patients with peak/trough
      carbamazepine serum level ratios of at least 1.30 after the intake of the normal
      tablet-form (n = 9) showed a smaller peak/trough ratio during the Divitabs
      period. No remarkable differences were found between the normal carbamazepine
      preparation and Divitabs regarding seizure frequency and tolerability. The
      behavioral state improved in four patients during the Divitabs period, whereas no
      enhancement was noticed during the normal-tablet period in any of the subjects.
      Although this study produced no evidence that carbamazepine Divitabs were at all
      advantageous for the trial population in general, some of the pharmacokinetic
      results suggest that a subgroup of the patients would benefit from changing from
      the normal tablet-form to Divitabs. However, even in this subgroup, the usage of
      Divitabs was not shown to result in obvious clinical benefits.

PMID- 1635934
TI  - Monitoring of laboratory parameters during carbamazepine therapy in psychiatric
      patients.
AB  - In recent years, carbamazepine has increasingly also been used in psychiatric
      indications. However, the manifold action of this drug also manifests itself in a
      number of adverse effects. In a prospective study including 46 patients, who were
      given carbamazepine for psychiatric indications and most of whom were also
      treated with one or several other psychotropic drugs, the following laboratory
      parameters were determined at two-weekly intervals: red and white blood count,
      platelets, SGOT, SGPT, gamma GT, alkaline phosphatase, serum calcium, serum
      sodium, IgA, IgG, IgM. Statistically significant changes were found in
      erythrocytes, leucocytes, platelets (decrease), Gamma GT (increase), serum
      calcium (decrease), IgA, IgM (decrease). The clinical relevance of these changes
      is discussed.

PMID- 1635935
TI  - The antidepressant effect of carbamazepine in callosal agenesis: a case report.
AB  - A dramatic resolution of severe depressive symptoms following carbamazepine
      administration in a patient with callosal agenesis is reported. Maintenance
      treatment with carbamazepine resulted in the alleviation of concomitant organic
      symptoms and in a marked improvement in quality of vital functions.

PMID- 1635936
TI  - Effect of pyritinol on EEG and SSEP in comatose patients in the acute phase of
      intensive care therapy.
AB  - The extent and duration of acute disturbances of consciousness depend on the
      severity and localization of the underlying cerebral dysfunction. The Glasgow
      Coma Scale (GCS) permits a relevant statement to be made on the course and
      recovery tendency of functional damage patterns in cerebral, mesencephalic, and
      brain stem structures. Therapy is directed at exerting a beneficial effect on the
      disturbed cerebral metabolism by administration of centrally active substances
      and at utilizing the available reserve plasticity of the brain for any possible
      recovery of mental performance. The bioavailability and profile of action of
      pyritinol have been well documented in animal experiments. We have studied the
      question as to the extent to which the substance influences the depth of coma in
      patients receiving acute intensive care therapy, and how this can be objectified
      electrophysiologically in the form of a specific central effect on basal brain
      structures. In a phase-II pilot study over five days the acute effect of
      intravenous 60-min. administration of 1,000 mg pyritinol on the depth of coma,
      the central conduction time (CCT) and the primary complex amplitude (N20/P25) of
      the SSEP, and on vigilance behavior (spectral edge frequencies and power) was
      investigated for 90 minutes in each case under intensive-medical steady-state
      conditions in 10 comatose patients. Because of the differences in the underlying
      brain damage, the primary depth of coma, age (30-89 years), sex (two female,
      eight male), as well as previous treatment (surgery, conservative), the
      significance of the results could not be evaluated by confirmatory statistical
      analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1635937
TI  - Efficacy of low vs. high doses of levosulpiride on negative symptoms of
      schizophrenia.

PMID- 1635939
TI  - Believe it or not!

PMID- 1635938
TI  - Negative attitudes towards clinical trials: problem or promotion?

PMID- 1635940
TI  - Differences in developmental movement patterns used by active versus sedentary
      middle-aged adults coming from a supine position to erect stance.
AB  - The purpose of this study was twofold: (1) to further validate categories for the
      movement pattern of supine to standing in adults and (2) to evaluate the
      influence physical activity might have on the movement patterns used for rising.
      Seventy-two adults, between 30 and 39 years of age (mean = 34.1, SD = 2.8),
      performed the rising task while being videotaped. Subjects were divided into
      three groups by self-reports of level of physical activity (daily to rarely).
      Individual videotaped trials were classified using the previously described
      categories. Comparisons among the activity-level groups revealed that more active
      subjects demonstrated more developmentally advanced movement patterns in the
      righting task, consistent with earlier research on older adults. Results suggest
      that lifestyle patterns of regular, moderate physical activity may influence how
      a person performs the basic righting task of coming from a supine to a standing
      position. This investigation also provided additional support for the use of
      developmental sequences for the movement pattern of supine to standing.

PMID- 1635941
TI  - Direct access use by experienced therapists in states with direct access.
AB  - Direct access use among experienced therapists practicing in states with 3 years'
      experience with direct access was studied, as were differences between therapists
      who had and had not practiced through direct access. A questionnaire was mailed
      to 250 members of the North Carolina, Nevada, and Utah chapters of the American
      Physical Therapy Association. Almost half (44.5%) of the respondents had
      practiced through direct access; an estimated 10.3% of their caseload was seen
      through direct access. Reasons for not practicing through direct access were that
      the employer does not permit direct access practice (49.1%), insurance does not
      reimburse for direct access practice (43.6%), no patients have been seen without
      referral (25.5%), and personal preference to treat by referral only (23.6%).
      Therapists who had treated patients through direct access were significantly more
      likely to believe that direct access had benefited them professionally and
      benefited their patients than were therapists who had not practiced through
      direct access.

PMID- 1635942
TI  - Influence of sensory inputs on standing balance in community-dwelling elders with
      a recent history of falling.
AB  - Vision and/or ankle somatosensory inputs often do not correlate with the position
      of the center of gravity. In this case, visual or somatosensory information may
      be in conflict with other sensory systems that convey a true sense of body
      orientation. The purpose of this study was to determine how conflicting visual
      and ankle somatosensory inputs influenced standing balance in elders with a
      history of falls. Forty-seven community-dwelling elders (8 male, 39 female),
      between 65 and 96 years of age (mean = 80.5, SD = 9.0), participated in this
      project. Subjects with two or more falls in the 6 months prior to study were
      assigned to a fall group (n = 16), whereas those with no history of falling
      during the same time interval were assigned to a no-fall group (n = 31). In order
      to remove any bias in the testing procedure, the tester was not aware of group
      assignments. Subjects were evaluated using a sensory organization test (SOT) for
      standing balance and a "Get Up and Go" test (GUGT) for general mobility. Analysis
      of covariance was used to evaluate the SOT scores (by group, vision, and surface
      condition) and the GUGT scores. Body sway is known to increase with the normal
      aging process, and for this reason, age was selected as a covariate. The
      association between the SOT total score and the GUGT score was evaluated using
      Spearman rank-order correlation coefficients. The results showed a significant
      interaction between group and surface conditions, which indicated a decreased
      stance duration for fallers on a compliant surface compared with the stance
      duration for nonfallers (adjusted mean faller stance duration = 53 seconds, SD =
      42; mean nonfaller stance duration = 67 seconds, SD = 32). Subjects in the fall
      group also had significantly higher GUGT scores (which indicated poor mobility
      function) than did subjects in the nonfall group (adjusted mean faller GUGT score
      = 2.65, SD = 1.48; mean nonfaller GUGT score = 1.47, SD = 0.77). The Spearman
      correlation between total SOT scores and the GUGT scores was greater for fallers
      (r = -.67) than for nonfallers (r = -.44). Orientation input from the ankle
      appears to have greater importance for preventing falls compared with a visual
      reference. The SOT and GUGT may be useful in the field to establish criteria for
      screening elders in a fall-prevention program.

PMID- 1635943
TI  - A new method for the determination of the characteristic shape of an isokinetic
      quadriceps femoris muscle torque curve.
AB  - It has been suggested that visual analysis of isokinetic quadriceps femoris
      muscle torque curve (TC) shapes may have potential use in the diagnosis and
      prognosis of knee pathologies. The primary purpose of this pilot study was to
      develop a method for analyzing the shape of an isokinetic TC. Our method
      normalizes and averages the TC, and then uses curvilinear analysis of the TC
      shape to aid in diagnosis and prognosis. For demonstration, the method was
      applied to isokinetic quadriceps femoris muscle TC data collected using a LIDO
      digital dynamometer from 25 healthy volunteer subjects and retrospectively
      acquired from the uninvolved limbs of 37 patients with unilateral knee
      pathologies. The preliminary results revealed (1) that a common quadriceps
      femoris muscle TC shape existed for the volunteer group at 60 degrees and 180
      degrees/s; (2) that the uninvolved limbs of the patient group exhibited the same
      shape at 60 degrees/s, but not at 180 degrees/s; and (3) that the quadriceps
      femoris muscle TC shape demonstrated no significant differences with respect to
      limb dominance or gender for either group. Further testing of this quantitative
      method on a larger sample is needed to determine its usefulness in the analysis
      and implications of TC shape concerning pathology and diagnosis.

PMID- 1635944
TI  - Physical therapy assessment and treatment protocol for nursing home residents.
AB  - This article describes a standard protocol for assessing physical function in
      elderly nursing home residents. Major physical dimensions that are measured with
      the protocol include range of motion, muscle force, muscle reflex activity,
      sensation, soft tissue status, balance/coordination, and posture. A practical,
      functionally prioritized treatment model based on the assessment is also
      presented. The standardized assessment and treatment plan may be useful to the
      physical therapist in (1) planning and prioritizing treatment, (2) identifying
      when goals have been met, (3) recognizing when there is a need for treatment plan
      modification, and (4) educating physical therapy students in applying problem
      solving skills in their treatment sessions.

PMID- 1635945
TI  - In support of student research.

PMID- 1635946
TI  - More support for student research.

PMID- 1635947
TI  - Physical therapy evaluation is crucial.

PMID- 1635948
TI  - Reliable ultrasound transmission.

PMID- 1635949
TI  - [Individualized psycho-educational therapy concept in inpatient treatment of
      schizophrenic patients--models and personal experiences].
AB  - A brief review of literature concerning educative methods of therapy of
      schizophrenics and their relatives will be used to discuss the similarities of
      these strategies, which differ in conception and intensity but are comparable
      considering their efficiency. A self-developed (eclectical) model of educative
      therapy and first experiences will be introduced. In view of the recessing
      character resp. the tendency towards chronicity in many cases of schizophrenia it
      seems, that the improvement of coping-abilities of the patients and their
      relatives dealing with the disease is a more promising goal concerning the long
      term prognosis than focussing on "healing" or suppression of actual symptoms. In
      addition to information about the disease the individualized proceeding
      corresponding with the person's own experiences will be stressed. Only as far as
      the concept of disease is close to the one the patient has, it can become
      relevant for deeds.

PMID- 1635950
TI  - [A psycho-educational family group for reducing stress and preventing recurrence
      for families of schizophrenic patients. Catamnestic results of the Tubingen
      family project].
AB  - Providing information about the disease and the way of coping with it has a
      central position in therapeutic interventions with families. By giving basic
      knowledge about schizophrenia to relatives we developed the practical conception
      of the psychoeducative relatives' group (information-group), a structured
      program, which is oriented toward concrete problem-solving and supportive
      behavior to cope with stress in the family. The effects of this group were
      investigated on the knowledge and subjective distress of 35 relatives related to
      the course of schizophrenia in comparison to a communication group. The
      participants of the information-group retained their knowledge after 9 months and
      their distress was decreased significantly. The relapse rate was reduced to 25%.
      The subjective distress correlated up to .41 with relapse after 9 months. A
      survey of the patients showed 70% improvements of the symptoms, 75% felt
      themselves better accepted by relatives. With the development of the relatives'
      distress scale a suitable instrument to measure distress is available.

PMID- 1635951
TI  - [Practical importance of the expressed emotion concept for rehabilitation].

PMID- 1635952
TI  - [Treatment of schizophrenia in the family].
AB  - The Bonn project "Treatment of schizophrenia in Family" is in the tradition of
      behavioristic and psychoeducative family intervention studies in England and USA.
      Information about psychosis and its neuroleptical treatment, communication and
      problem solving training are provided to schizophrenic patients and to their
      relatives at home. Important results and experiences of the 2-year-study are
      presented.

PMID- 1635953
TI  - [Travel as a stabilizing factor in folie a deux?].
AB  - Case report on a folie a deux (double insanity) in a relatively young, married
      couple who decompensated psychologically subsequent to the failure of different
      compensation mechanisms after premorbid strange behaviour and jointly developed
      delusions of ugliness and of injury. The history of the disease pattern of "folie
      a deux", or double insanity, is described, as well as the present-day
      definitions, and the case report is set against this background.

PMID- 1635954
TI  - [A nose in the face].

PMID- 1635955
TI  - Guidelines for reducing the risk of disease transmission in the psychophysiology
      laboratory. SPR Ad Hoc Committee on the Prevention of Disease Transmission.
AB  - The acquired immunodeficiency syndrome (AIDS) pandemic has highlighted the need
      for safeguards against the inadvertent transmission of infectious disease in the
      psychophysiology laboratory. These Guidelines identify factors contributing to
      the risk of bloodborne disease transmission to subjects or technicians, and
      recommend procedures to minimize such risk, given current knowledge and
      techniques. The lowest risk is associated with the application of devices, such
      as surface electrodes, to nonabraded, intact skin. Such devices should be clean,
      but do not require disinfection. The potential risk of infection is higher when
      surface electrodes are applied to non-intact skin. Abrasion, or other breaks in
      the skin, can allow seepage of blood products carrying such pathogens as
      hepatitis B virus and the human immunodeficiency virus that causes AIDS. Thus
      electrodes require high-level disinfection before reuse on non-intact skin. In
      addition, technicians should wear gloves during skin preparation and should
      abrade the skin no more than necessary, using only sterile, preferably non-sharp
      materials. The highest risk is that associated with items that enter sterile
      tissue, such as subdermal electrodes and the needles and lancets sometimes used
      in skin preparation. Such items must be sterile at the time of use and must be
      handled with extreme caution.

PMID- 1635956
TI  - Autonomic correlates of illness imagery.
AB  - Psychophysiological responses to imagery of self-relevant illness threats were
      examined for high and low extreme groups of hypervigilants and health care
      utilizers. Heart rate, skin conductance, and respiration were the physiological
      measures recorded; self-reports of perceived illness vulnerability, negative
      affect, image clarity, and image realness were the psychological measures
      obtained. Responses to neutral, exercise, and illness threat scenes were
      compared. Hypervigilants showed an increased heart rate response to imagery of
      illness scenes, whereas all other groups returned more quickly to baseline
      levels. The results are similar to those reported by Lang for snake phobics. They
      also lend some support to Horowitz's theory of intrusive imagery, in which self
      relevant, anxiety-provoking events tend to continuously intrude upon one's
      thoughts, and this intrusive imagery was reflected cardiovascularly. There could
      be several possible underlying mechanisms for these findings.

PMID- 1635957
TI  - Modulation of slow cortical potentials by instrumentally learned blood pressure
      responses.
AB  - We assessed whether instrumentally-learned pressor responses inhibit
      electrocortical activity, as predicted by learning theories of idiopathic
      hypertension. Subjects received beat-by-beat feedback for increases and decreases
      in mean arterial pressure measured from the finger (Penaz method). Slow
      potentials were recorded from the midsagittal line during the final training
      session. Also recorded at this time were heart rate, eye movements, respiration,
      and post-session verbal reports of the subject's control strategies. Thirteen of
      14 subjects differentiated blood pressure increases and decreases at p less than
      .05 or better during the final session (within-subject discriminative operant
      procedure). Slow potentials were less negative on blood pressure increase
      compared to decrease trials at all midsagittal sites (p less than .02),
      indicating relative cortical inhibition by pressor responses. This effect
      occurred even though subjects reported tensing of muscles on increase trials (p
      less than .01), a behavioral activity previously associated with augmented rather
      than diminished cortical negativity. On increase trials slow potentials shifted
      toward positivity just prior to heart rate deceleration (the latter effect
      confirming activation of the baroreceptors).

PMID- 1635958
TI  - PRES: the controlled noninvasive stimulation of the carotid baroreceptors in
      humans.
AB  - To study physiological and psychological effects of baroreceptor activity, the
      cervical neck cuff technique has been frequently used to stimulate the carotid
      baroreceptors mechanically. Using this technique, no satisfying control
      conditions to date have been available. Because the carotid stretch receptors are
      sensitive not only to the pressure level, but also to the rate of change, it is
      possible to manipulate the receptor firing through changes in carotid pulse
      amplitude. The device described here relies on the application of short changes
      in cuff pressure tied to different phases within the cardiac cycle (phase related
      external suction (PRES)). A brief external suction during systole has potent
      stimulatory effects on baroreceptors whereas the application of the very same
      pressure pulse during diastole inhibits the firing burst associated with the
      pulse wave. To allow an ongoing period of stimulation, a sequence of alternating
      negative/positive pressure pulses is applied. In the stimulation condition, the R
      wave of the electrocardiogram triggers a negative pulse which is followed by a
      positive one during diastole. In the control condition this relationship is
      reversed. Two experiments are reported confirming different baroreceptor effects
      of the two conditions. PRES allows for blind or double-blind experiments to
      investigate effects of baroreceptor activity on physiology and behavior.

PMID- 1635959
TI  - The relationship between cardiovascular and catecholamine reactions to laboratory
      and real-life stress.
AB  - Studies on the predictive value of stress testing in the laboratory for the
      reaction to real-life stress have shown equivocal results. The variety of
      laboratory tasks differ for unknown reasons in their predictive power, and the
      results vary unsystematically among the physiological parameters measured. Most
      studies have focused on the prediction of ambulatory levels of blood pressure.
      Many other influences, besides stress, however, influence ambulatory levels.
      Therefore, a better operationalization of real-life stress is to measure a person
      in a resting position during a period of well defined real-life stress. The
      present study investigates whether the difference in ability of laboratory stress
      tasks to predict real-life stress values is due to the different type of
      physiological response they induce. Hence, in the present study a more detailed
      measurement of the stress response was performed. A second question was whether
      stress testing would add to the prediction of the real-life stress reactions
      above the prediction based on resting levels. This question was answered for both
      cardiovascular and catecholamine reactions to laboratory tasks. Two active coping
      tasks, one inducing a mainly cardiac-sympathetic reaction and the other a
      relatively more vascular response, and a cold pressor test were administered to
      33 healthy young males. Real-life stress consisted of the anticipation of the
      public defence of the PhD thesis. Tasks indeed differed in predictive power, but
      this was not a function of the type of response they induced.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1635960
TI  - Dimensional analysis of no-task human EEG using the Grassberger-Procaccia method.
AB  - A method developed by Grassberger and Procaccia allows estimation of the
      dimensional complexity of the state-space attractor of a time series. Saturation
      of dimensional-complexity estimates with increasing values of embedding dimension
      is considered a strong indication that the time series is governed by
      deterministic chaos. The present investigation employed the Grassberger-Procaccia
      method to estimate EEG dimensional complexity in a multi-subject, factorial
      experiment. Twelve subjects were tested under two no-task conditions (eyes closed
      and open), with the block of two conditions being repeated four times. EEG was
      recorded from the nineteen 10-20 loci. Dimensional complexity declined across
      Blocks 1-3 and then leveled off, and was higher in the eyes-open than in the eyes
      closed condition. Condition also interacted with locus in that the increase in
      dimensional complexity associated with opening the eyes was greater over
      occipital loci. Comparison with the results of Fourier analysis indicated that a
      similar but not identical pattern of effects was obtained for alpha (8-12 Hz)
      power. Further, across the entire data set, if alpha power exceeded a value of
      about 70 microV2, dimensional complexity was uniformly low, a finding in concert
      with previous results indicating that the eyes-closed, occipital alpha rhythm
      possibly represents deterministic chaos of relatively low dimension.

PMID- 1635961
TI  - Effects of eating on vection-induced motion sickness, cardiac vagal tone, and
      gastric myoelectric activity.
AB  - This study investigated the effect of food ingestion on motion sickness severity
      and its physiological mechanisms. Forty-six fasted subjects were assigned either
      to a meal group or to a no-meal group. Electrogastrographic (EGG) indices (normal
      3 cpm activity and abnormal 4-9 cpm tachyarrhythmia) and respiratory sinus
      arrhythmia (RSA) were measured before and after a meal and during a subsequent
      exposure to a rotating drum in which illusory self-motion was induced. The
      results indicated that food intake enhanced cardiac parasympathetic tone (RSA)
      and increased gastric 3 cpm activity. Postprandial effects on motion sickness
      severity remain equivocal due to group differences in RSA baseline levels. During
      drum rotation, dysrhythmic activity of the stomach (tachyarrhythmia) and vagal
      withdrawal were observed. Furthermore, high levels of vagal tone prior to drum
      rotation predicted a low incidence of motion sickness symptoms, and were
      associated positively with gastric 3 cpm activity and negatively with
      tachyarrhythmia. These data suggest that enhanced levels of parasympathetic
      activity can alleviate motion sickness symptoms by suppressing, in part, its
      dysrhythmic gastric underpinnings.

PMID- 1635962
TI  - Event-related potentials elicited by deviant endings to melodies.
AB  - Event-related potentials were recorded from scalp electrodes while subjects
      listened to well-known melodies. The melodies ended either with the expected note
      or with a different note. This design was a nonlinguistic analogue of the design
      used by Kutas and Hillyard (1980b), who first reported that anomalous terminal
      words in sentences elicited N400 potentials. However, Besson and Macar (1987)
      reported that deviant terminal notes in melodies did not elicit N400 potentials.
      In the present study, additional time was allowed for expectations to develop for
      the terminal note. Deviant terminal notes did not elicit N400s. In both studies,
      however, the deviant notes elicited P300-like waves. This outcome raised the
      possibility that N400 might have been masked by the positive potential. In a
      second condition in which P300 amplitude was minimized, N400s were again not
      evident. These results thus illustrate two additional situations in which
      nonlinguistic stimuli that deviated from a sequential pattern failed to elicit
      N400 potentials.

PMID- 1635963
TI  - Electrodermal lability: individual differences affecting perceptual speed and
      vigilance performance in 9 to 16 year-old children.
AB  - Studies on adults have suggested that a deterioration in performance (within
      session vigilance decrement) on a continuous performance task may be related to
      individual differences in baseline levels of electrodermal activity
      (electrodermal lability). This study investigated this relationship in 153
      children, aged 9-16 years. A significant vigilance decrement was observed, as
      indicated by average decreases in perceptual sensitivity (d') over an 11.5-min
      time period. Although electrodermal labiles were overall more perceptually
      sensitive than electrodermal stabiles, results did not support the premise that
      the performance of stabiles decreases over time more than that of labiles.
      Performance on other cognitive tasks, involving tests of perceptual speed
      ability, did not appear to be highly related to vigilance performance. However
      labiles were not only better able to sustain their attention, but also performed
      better and faster on these cognitive tasks.

PMID- 1635964
TI  - A comparison between two methods for assessing heartbeat perception.
AB  - In this study two methods assessing heartbeat perception ability were compared.
      Subjects (N = 64) completed Schandry's (1981) mental tracking task and Stormer's
      (1988) heartbeat discrimination procedure (based on Whitehead, Drescher, Heiman,
      & Blackwell, 1977). In addition, subjects were tested on their ability to
      estimate the duration of time intervals. A high degree of correspondence was
      found between the two heartbeat perception tasks for the extreme groups of very
      good and very poor perceivers, but a low degree of correspondence emerged for the
      middle range of performance (overall r = .59, p less than .001). Time estimation
      did not correlate significantly with either heartbeat detection procedure. Blood
      pressure measurements taken after the Schandry task and between Stormer test
      blocks showed that blood pressure amplitude was elevated among good perceivers on
      both heartbeat detection tasks.

PMID- 1635965
TI  - Beat-by-beat cardiac responses in normals and schizophrenics to events varying in
      conditional probability.
AB  - Anticipatory cardiac deceleration and poststimulus acceleration were studied in
      schizophrenic inpatients and controls during performance of a counting task.
      Reduced cardiac responding has been reported for schizophrenic patients for
      paradigms using relatively long intertrial intervals. During a relatively fast
      rate of stimulus presentation (3-s interstimulus interval), changes in cardiac
      interbeat interval were measured in 20 inpatient male chronic schizophrenics and
      18 control volunteers. Subjects counted an infrequent tone which was always
      followed by at least one frequent tone. Control subjects showed significant
      anticipatory cardiac deceleration preceding the unpredictable tones, whereas
      patients did not show a differential cardiac deceleration. Control subjects
      showed poststimulus acceleration that was inversely proportional to the
      conditional probability of events, whereas patients exhibited greatly reduced
      poststimulus acceleration; patterns for both groups resembled findings previously
      observed for event-related potential and pupillary dilation data. Analysis of
      cardiac cycle time indicated significant variation in primary bradycardia
      associated with the delay between stimuli and immediately preceding R-waves in
      controls (replicating Lacey & Lacey, 1980), with only an immediate bradycardia at
      stimulus reception for patients regardless of cardiac cycle time. The data
      reinforce the notion that the manner in which information is used by
      schizophrenics, as reflected by cardiac responsivity, differs both quantitatively
      and qualitatively from that of controls.

PMID- 1635966
TI  - Pregnancy alters blood pressure responses to psychological and physical
      challenge.
AB  - The purpose of the study was to evaluate the effect of the substantial changes in
      female reproductive hormones that occur during normal pregnancy on cardiovascular
      responses to psychological and physical challenges. Twenty-one healthy
      normotensive women performed serial subtraction, mirror image tracing, and
      isometric handgrip exercise tasks prior to pregnancy and again during the second
      trimester of pregnancy. A control group of 34 healthy women who did not intend to
      become pregnant and were nonpregnant were also tested in the same protocol twice,
      6-10 months apart. Results showed that the pregnant women exhibited a reduced
      diastolic blood pressure response to all three tasks, relative to their pre
      pregnancy levels, whereas nonpregnant controls did not change in their diastolic
      blood pressure response across time. These results are consistent with the
      hypothesis that elevations in female reproductive hormones diminish blood
      pressure responses during challenge because of dampened sympathetic nervous
      system activity.

PMID- 1635967
TI  - A major effect of recording site on measurement of electrodermal activity.
AB  - Although the medial phalanx has been recommended as the preferred site for
      recording skin conductance activity, a review of articles published in
      Psychophysiology indicates that a large minority (34%) of studies employ the
      distal phalanx. Informal observations also suggest that the distal site may be
      more reactive than the medial site. This study formally tests this observation by
      recording skin conductance from both medial and distal phalanges. Twenty-four
      right-handed subjects (12 male, 12 female) were exposed to a series of 10
      orienting and defensive stimuli. Electrodes were placed on the fore and middle
      fingers of each hand, with distal sites used on one hand and medial sites on the
      other for each subject. Skin conductance amplitudes were 3.5 times larger at
      distal than medial sites (p less than .002), while skin conductance levels were
      2.08 times larger at distal sites (p less than .0005). A significant Site X
      Stimulus interaction (p less than .025) indicated that the distal site was more
      sensitive to habituation over trials and to increases in skin conductance
      amplitudes with increasing stimulus intensity than the medial site. On the basis
      of these findings it is recommended that distal sites be used in preference to
      medial sites in the recording of skin conductance activity.

PMID- 1635968
TI  - Dengue activity in Puerto Rico, 1990.
AB  - Reported dengue activity in Puerto Rico (PR) increased in 1990 for the fourth
      consecutive year. The Community Hygiene Division of the PR Health Department
      received 9,540 reports of suspected dengue cases. Of the blood samples obtained
      from 7,660 patients, 1,911 were confirmed as dengue infection by laboratory tests
      at the Dengue Branch, San Juan Laboratories, Centers for Disease Control. Dengue
      2 (DEN-2) continued to be the most frequently isolated serotype among all
      confirmed cases, hospitalized patients, and the confirmed cases with hemorrhagic
      manifestations. Disease was reported throughout the island and during all months,
      but activity, as in previous years, was lowest from April through July, and
      highest from September to November. The highest rates of laboratory-confirmed
      illness occurred in towns on the south coast and in the central mountains, with
      only one or two circulating virus serotypes (DEN-2 in the south; DEN-2 and DEN-4
      in the central mountains). Although cases were confirmed in infants and
      octogenarians, the majority of laboratory-confirmed cases (1,293, 68%), and the
      highest attack rates (0.70/1000), were reported in persons younger than 30. Of
      patients with confirmed cases, 289 (15%) were hospitalized, and 438 (23%)
      reported at least one hemorrhagic manifestation. One presumptive dengue case with
      fatal outcome was reported in 1990 in a 17-year-old woman in whom a febrile
      illness, seizures, and coma developed; she died after cardiorespiratory arrest.
      Recent dengue infection in this individual was serologically documented, but no
      virus was isolated.

PMID- 1635969
TI  - Glycation of blood proteins during pregnancy and lactation in the rat.
AB  - Non-enzymatic glycation of blood proteins is a time and concentration dependent
      process and has been used clinically to monitor carbohydrate metabolism during
      human pregnancy. Since gestation in rats is of much shorter duration than in
      humans (3 weeks vs 9 mos) the question was raised whether similar differences in
      glycated proteins could be observed. Therefore, levels of glucose, glycated
      hemoglobin and fructosamine were measured during normal pregnancy and lactation
      in rats. Glucose levels during late pregnancy were significantly lower than in
      non pregnant and early pregnant rats. During lactation glucose levels return to
      normal. Glycated hemoglobin paralleled glucose decrease during late pregnancy and
      increased during lactation. Fructosamine followed a similar pattern. Therefore
      glycated hemoglobin and fructosamine appear to be reliable indicators of glucose
      status during gestation and lactation similar to humans and may have value as
      predictors of gestational diabetes mellitus once a suitable rat model is
      developed.

PMID- 1635970
TI  - Prelude activities in the synthesis of tissue-specific secretory protein
      products.
AB  - In studying the process of protein synthesis of a silk-producing organism we have
      found that several macromolecules must be synthesized in order for the process to
      occur. Through time course studies, we have found that small RNAs may play a
      paramount role in directing the finely orchestrated process. Alanine tRNA, U1
      snRNA, and 5S RNA have been identified through Northern blotting as molecules
      timely and tissue-specific synthesized and upgraded as a prelude activity for the
      silk being produced.

PMID- 1635971
TI  - Extraction and purification of a catalase from Candida albicans.
AB  - Candida albicans yeast cells H317 were grown to mid-log phase, mechanically
      disrupted and the resulting crude extract clarified by centrifugation. This
      catalase rich fraction (1.26 x 10(-4) units/ml) was fractionated by liquid phase
      isoelectric focusing in a pH gradient ranging from 3 to 10 using the Rotofor
      Isoelectric Focusing Preparative Cell. After isoelectric separation, fractions
      containing catalase activity were focused between pH 6.7 and 9.3. Active
      fractions were pooled and re-focused. After the second fractionation, catalase
      activity increased to 1.52 x 10(-2) units/ml and was restricted to fractions
      ranging from pH 7.6 to 8.8. To this point a 121 fold purification was achieved.
      Native polyacrylamide gel electrophoresis analysis of active fractions revealed a
      band migrating between 272,000 and 132,000 daltons which showed catalase
      activity. Purification of C. albicans catalase will allow us to evaluate its
      potential role in protecting this opportunistic pathogen from products of the
      oxidative burst. Antibodies generated against the catalase provide means for the
      evaluation of neutralizing fungal defenses against products of the oxidative
      burst during phagocytosis.

PMID- 1635972
TI  - [HIV infection and AIDS: neuropsychiatric and neuropsychological aspects].
AB  - The progressive confirmation of the neurotropic character of HIV, in
      juxtaposition to the recognition of AIDS dementia complex as an important central
      nervous system clinical manifestation, have engendered a greater interest in this
      phenomena. Consequently, a more precise description of the behavioral and mental
      aspects of this infection have evolved. This article has two purposes, to discuss
      the AIDS dementia complex concept and secondly, to review the neuropsychiatric
      and neuropsychological aspects of infection by HIV and AIDS, as it pertains to
      adult patients.

PMID- 1635973
TI  - Faculty and dental auxiliaries exchange program between the University of Granada
      and the University of Puerto Rico dental schools.

PMID- 1635974
TI  - [Medical Center of Puerto rico. Problems and solutions].

PMID- 1635975
TI  - [Considerations on interdisciplinarity: theory and practice].
AB  - The curricular content of undergraduate programs in the health sciences should
      integrate, in a logical and coherent manner, competencies in general education as
      well as professional and interdisciplinary competencies. Among the principal
      obstacles for integration discussed are inflexibility of administrative and
      accreditation policies and lack of an interdisciplinary vision in curriculum
      development. This article examines the need to prepare a graduate with
      competencies to attend patient/client as a holistic human being, thus requiring
      to make use of psychological, ethical, legal & philosophical knowledge as well as
      concepts, skill and attitudes of the profession. The program of Bachelor in
      Health Sciences of the College of Health Related Professions is presented as one
      of an interdisciplinary nature, in which 23 percent of the total credits are
      general education courses, 49 percent are professional courses, 17 percent are
      interdisciplinary courses and 11 percent are elective courses.

PMID- 1635976
TI  - The evolution of delayed dispersal in cooperative breeders.
AB  - Why do the young of cooperative breeders--species in which more than two
      individuals help raise offspring at a single nest--delay dispersal and live in
      groups? Answering this deceptively simple question involves examining the costs
      and benefits of three alternative strategies: (1) dispersal and attempting to
      breed, (2) dispersal and floating, and (3) delayed dispersal and helping. If, all
      other things being equal, the fitness of individuals that delay dispersal is
      greater than the fitness of individuals that disperse and breed on their own,
      intrinsic benefits are paramount to the current maintenance of delayed dispersal.
      Intrinsic benefits are directly due to living with others and may include
      enhanced foraging efficiency and reduced susceptibility to predation. However, if
      individuals that disperse and attempt to breed in high-quality habitat achieve
      the highest fitness, extrinsic constraints on the ability of offspring to obtain
      such high-quality breeding opportunities force offspring to either delay
      dispersal or float. The relevant constraint to independent reproduction has
      frequently been termed habitat saturation. This concept, of itself, fails to
      explain the evolution of delayed dispersal. Instead, we propose the delayed
      dispersal threshold model as a guide for organizing and evaluating the ecological
      factors potentially responsible for this phenomenon. We identify five parameters
      critical to the probability of delayed dispersal: relative population density,
      the fitness differential between early dispersal/breeding and delayed dispersal,
      the observed or hypothetical fitness of floaters, the distribution of territory
      quality, and spatiotemporal environmental variability. A key conclusion from the
      model is that no one factor by itself causes delayed dispersal and cooperative
      breeding. However, a difference in the dispersal patterns between two closely
      related species or populations (or between individuals in the same population in
      different years) may be attributable to one or a small set of factors. Much
      remains to be done to pinpoint the relative importance of different ecological
      factors in promoting delayed dispersal. This is underscored by our current
      inability to explain satisfactorily several patterns including the relative
      significance of floating, geographic biases in the incidence of cooperative
      breeding, sexual asymmetries in delayed dispersal, the relationship between
      delayed dispersal leading to helping behavior and cooperative polygamy, and the
      rarity of the co-occurrence of helpers and floaters within the same population.
      Advances in this field remain to be made along several fronts.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1635977
TI  - Is there teaching in nonhuman animals?
AB  - We derive a simple operational definition of teaching that distinguishes it from
      other forms of social learning where there is no active participation of
      instructors, and then discuss the constituent parts of the definition in detail.
      From a functional perspective, it is argued that the instructor's sensitivity to
      the pupil's changing skills or knowledge, and the instructor's ability to
      attribute mental states to others, are not necessary conditions of teaching in
      nonhuman animals, as assumed by previous work, because guided instruction without
      these prerequisites could still be favored by natural selection. A number of
      cases of social interaction in several orders of mammals and birds that have been
      interpreted as evidence of teaching are then reviewed. These cases fall into two
      categories: situations where offspring are provided with opportunities to
      practice skills ("opportunity teaching"), and instances where the behavior of
      young is either encouraged or punished by adults ("coaching"). Although certain
      taxonomic orders appear to use one form of teaching more often than the other,
      this may have more to do with the quality of the current data set than with
      inherent species-specific constraints. We suggest several directions for future
      research on teaching in nonhuman animals that will lead to a more thorough
      understanding of this poorly documented phenomenon. We argue throughout that
      adherence to conventional, narrow definitions of teaching, generally derived from
      observations of human adult-infant interactions, has caused many related but
      simpler phenomena in other species to go unstudied or unrecorded, and severely
      limits further exploration of this topic.

PMID- 1635978
TI  - Haldane's Causes of Evolution after 60 years.

PMID- 1635979
TI  - [Imaging of the liver segments by ultrasound. A practical approach].
AB  - Segmentation of the liver according to Couinaud is the anatomical basis for
      hepatic surgery. Based upon the dichotomic branching of the portal vein and its
      ramifications the liver is divided into lobes (right, left and caudate): 4 double
      segments (DS) (right lobe: anterior and posterior DS; left lobe: medial and
      lateral DS); and 8 segments (S): caudate lobe (S I); lateral DS (S II and S III);
      medial DS (S IV); anterior DS (S VIII and S V); posterior DS (S VII and S VI).
      This three-dimensional concept can also be used in US using hepatic veins, the
      portal vein and its branches, hepatic fissures and ligaments as landmarks. The
      localization and extent of a tumor and its relationship to the vasculature of the
      liver can thus be determined and the surgical management of such patients can be
      improved. The exact definition of each segment of the liver by US is shown and
      the preoperative localizations in several cases of surgically confirmed liver
      tumors are presented.

PMID- 1635980
TI  - [Sonography of focal liver changes. Practical indications for differential
      diagnosis].
AB  - This article reviews the sonomorphologic features of malignant and benign focal
      liver lesions. Common methodological sources of diagnostic errors, features which
      benign and malignant findings have in common as well as the limitations of the
      method and further diagnostic procedures are described.

PMID- 1635981
TI  - [Portal computed tomography. Methodology and indications].
AB  - CT arterioportography (CTAP) requires intra-arterial contrast material via the
      superior mesenteric (splenic) artery. Malignant hepatic tumors are characterized
      by arterial vascularization and only minimal portal blood supply. Portal contrast
      therefore reveals small tumors with a high sensitivity of 68-87%. Sensitivity is
      higher in metastatic tumors than in hepatocellular carcinomas. CTAP is the method
      of choice for evaluation of the number, size and location of hepatic tumors prior
      to surgical intervention. If the findings are unclear, additional magnetic
      resonance imaging and sonography during the operation are useful.

PMID- 1635982
TI  - [Status and development of new clinical contrast media for MR diagnosis of liver
      diseases].
AB  - MR contrast agents are developed for pharmaceutical manipulation of tissue signal
      intensities. Today it is widely recognized that MR contrast agents will play an
      increasingly important role in MR imaging of the liver. Contrast-enhanced MR
      imaging allows to obtain simultaneously dynamic physiologic information and high
      anatomic detail. Up to now three major classes of MR contrast agents are
      available for clinical MR-imaging of the liver. These include paramagnetic
      perfusion agents, hepatobiliary agents, and super-paramagnetic RES-specific iron
      oxide particles. A fourth class of contrast agents now in use for animal
      experiments includes ultra-small super-paramagnetic particles which can be
      targeted to extra-reticuloendothelial structures such as asialoglycoprotein
      receptors of hepatocytes. In this article, we review recent advances in the
      development of MR contrast media and the clinical status of contrast-enhanced MR
      imaging of the liver.

PMID- 1635983
TI  - [The value of magnetic resonance tomography in the detection and differential
      diagnosis of focal liver lesions].
AB  - Magnetic resonance imaging (MRI) of the liver has made considerable progress due
      to improvements in the examination technique. Sensitivity for the detection of
      focal liver lesions is higher for MRI than for CT. In the differential diagnosis
      of liver tumors MRI is remarkably accurate. This is particularly true for
      hemangiomas, liver cell carcinomas and focal nodular hyperplasias. From a
      clinical view point differentiation between hemangiomas and metastases is of
      utmost importance. Future improvements in MR diagnosis of liver diseases are
      expected due to fast imaging techniques and liver-specific contrast agents.

PMID- 1635984
TI  - [Radiologic diagnosis before and after liver transplantation].
AB  - The main function of imaging procedures before liver transplantation is the
      exclusion of factors that may either constitute contraindications to surgery or
      necessitate a modification of the operation technique. Ultrasound and MRI are the
      modalities best suited for this purpose. After transplantation, imaging
      procedures are required mainly for diagnosis of and differentiation, in
      particular, between vascular and biliary complications, rejection, and infection,
      since these postoperative complications very often cannot be reliably
      differentiated on the basis of clinical and laboratory parameters alone. As
      vascular disturbances can vary widely in their presentation and can mimic other
      complications, duplex Doppler sonography plays a dominant role in clarification
      of the perfusion status of the graft. If infection is suspected, ultrasound
      generally has to be supplemented by other imaging procedures such as CT or MRI;
      if these techniques reveal suggestive lesions, a fine-needle aspiration is
      mandatory in most cases. Invasive procedures such as angiography or PTC are now
      applied only in selected cases, especially if an intervention is contemplated.
      Rejection cannot be reliably diagnosed by any of the imaging techniques and still
      requires biopsy.

PMID- 1635985
TI  - [MRT of the hand and wrist of sport climbers. Imaging of injuries and
      consequences of stress overload].
AB  - The hands and wrists of 20 top-level rock climbers with sports injuries and
      overstress abnormalities were compared with the hands and wrists of 10 normal
      volunteers. They were all studied with MR imaging at 1.5 T. The imaging protocol
      included spin-echo and gradient-echo sequences with 1- to 5-mm-thick contiguous
      slices in the axial, coronal and/or sagittal planes, depending on the location
      and nature of the suspected injury. Typical hand and wrist lesions depicted with
      MRI in climbers consisted of anular ligament tears, lesions of the flexor
      tendons, tenosynovitis, ganglion cysts, joint effusion and functional carpal
      tunnel syndrome. The MRI findings on these abnormalities were compared to normal
      findings and those with ultrasound and plain films. In addition, hypertrophic
      changes in the muscles, tendons, ligaments, and bones of top-level rock climbers
      were assessed morphometrically. MRI proved to be the superior imaging modality in
      the diagnosis of sports injuries and overstress abnormalities of the hand and
      wrist in rock-climbing athletes.

PMID- 1635986
TI  - [Product of the month: a bibliographic database with optional formatting
      capability].
AB  - The function and usage of the software package "Endnote Plus" for the Apple
      Macintosh are described. Its advantages in fulfilling different requirements for
      the citation style and the sort order of reference lists are emphasized.

PMID- 1635987
TI  - [Acute abdominal pain with a massively dilated intestinal segment. Cecal
      volvulus].

PMID- 1635988
TI  - [Magician and apprentice: the confrontation between Karl Kraus and Sigmund
      Freud].

PMID- 1635989
TI  - [Identity and the self. The importance of recent developmental research for the
      psychoanalytic theory of the self].
AB  - Recent findings from research on human development have implications for the
      psychoanalytic concepts of self and identity. The emerging feeling of selfhood
      appears to be the precipitate of finely tuned interactive regulations involving
      mother and child. Similarly, early mirroring processes are shown to have a
      fundamental significance for the experimental structure of self and identity. The
      author discusses the new meanings acquired by the identity concept as a result of
      these investigations. He describes the elementary psychic structures of identity
      as well as the subordinate regulatory function of the sense of identity.

PMID- 1635990
TI  - [Debit and credit. Menopause between illusion and reality].
AB  - Middle-aged women in patriarchial societies are still widely considered as
      deficient and damaged and therefore can easily become objects of medical
      attention. The authors seek the reasons for this in fact that the different
      changes of male and female potency in the 45 to 55 age-group provoke defense
      mechanisms. These are meant to ensure the intactness of the male--who then is
      supposedly in his 'best age'--for the sake of both men and women. Apart from
      this, psychoanalytical theories--like the one of the "depressive position", held
      by Melanie Klein--confirm the prejudice that a woman going through the change of
      life is damaged, and thus has to mourn the "desease" of menopause.

PMID- 1635991
TI  - [Interpretation between determinism and hermeneutics. A new approach].
AB  - There are two traditional views of psychoanalytic interpretation. One takes its
      bearings from Freud and regards the present condition of the subject as
      determined by his/her real past. The objective is then to uncover the "real"
      history. The other may be termed hermeneutic/creative and has its origins in
      authors such as C.G. Jung and Paul Ricoeur. It looks upon interpretation as a
      process of conferring subsequent significance on a fragmentary past devoid of
      meaning. In an attempt to break away from this rigid dualism, the author
      describes interpretation in the analysis context as a method of deconstruction
      with the aim of creating scope for new constructions that are the work of the
      person undergoing analysis. In the light of this approach interpretation reveals
      itself as an expression of the unity of constraint (determinism) and freedom
      (hermeneutics).

PMID- 1635992
TI  - [The working alliance is St. Stephan's cathedral. Epistemological considerations
      of the Heinrich Deserno lecture, "Analysis and the working alliance" (1990)].
AB  - With the term "working alliance", as it was discussed by R.R. Greenson in noted
      publications, an understanding of work was introduced that corresponds with the
      dominant contemporary idea of work as a purely instrumental and technical process
      which is alien to the original "spirit" of Freudian Analysis. The author shows
      that psychological work, which in analysis is carried out cooperatively by
      analyst and analysand, needs transference to be successful, a transference with
      the help of which the analysand is able to discuss and specify his unconscious
      psychological conflicts. In Greenson's understanding the working alliance-
      supposedly neurosis-free--appeals to the rational part of the ego and introduces
      a normative understanding of reality. The transference relationship, by contrast,
      gives room to those psychic forces which refuse to obey the authority of the ego
      and its tendencies to conventionalize and suppress unconscious material.

PMID- 1635993
TI  - [The working alliance and psychoanalysis in theory and practice].
AB  - The author points out a remarkable discrepancy between the concept of work in the
      practice of psychoanalysis, especially in the concept of the working alliance
      (Greenson), and the concept of work included in the dreamwork.

PMID- 1635994
TI  - ["The very wise Heloise". On dependency and resistance of the female in relation
      to actual male dominance and the magic power of its representation].
AB  - Psychoanalytical theory of femininity starts from the assumption that specific
      patterns of identification can be traced back historically to ancient traditions
      which frequently remain unconscious to those concerned. In the 12th century, the
      abbess Heloise advocated ideals which on the one hand questioned the medieval
      image of woman, while on the other hand she sought to be in accordance with the
      socially domineering male (Abaelard) who represented the intellectual life. The
      correspondence between Heloise and Abaelard reveals paradigmatically Heloise's
      conflict between rebellion and resignation, between the striving for autonomy and
      regression, which is resolved in some form of female narcissism.

PMID- 1635995
TI  - [The interpersonal alliance as the principle of psychoanalytic therapy].
AB  - The classical opinion encountered in psychoanalytic psychotherapy is that the
      main curative agent is language, i.e. the information proffered by the analysand
      and the interpretations of the analyst. Over and against this view the author
      draws attention to the non-verbal structures in the twosome relationship between
      analysand and therapist. Essential elements of this working alliance, he
      suggests, operate via non-verbal behaviour. Hence this behaviour needs to be
      systematically observed and evaluated. His conclusion is that it requires the
      consideration of non-verbalized fantasies and affects for the therapeutic
      relationship to develop into a "good relationship".

PMID- 1635997
TI  - [The self and its fate. A "archeological" study of psychoanalytic avant garde
      (II)].

PMID- 1635996
TI  - [Insight in psychotic disorders].

PMID- 1635998
TI  - [A body of one's own. Sexual development and physical female development in the
      mother-child relationship].
AB  - Prevalent psychoanalytic opinion has it that (sexually) femaleness is marked by a
      severe deficiency. Accordingly it is widely held that the acknowledgement of
      female sexuality is primarily a matter for fathers rather than mothers. The
      author takes a different stance, insisting on the opportunities inherent in the
      mother-daughter relationship to the extent that it both permits and encourages
      pleasurable self-examination and acceptance of the body on the part of the
      growing girl. In the therapeutic connection, the author calls for a form of
      remedial socialisation to fill the specific lacunae that have developed around
      female sexuality.

PMID- 1635999
TI  - [From the sense organ of the skin to the imaginary envelope of the self. On
      Didier Anzieu's "The skin self"].

PMID- 1636000
TI  - [Was Freud's confrontation with psychiatry only an episode or experience, which
      formed his further scientific development?].

PMID- 1636001
TI  - The Women's Policy Unit moves into its second year: women on the agenda.

PMID- 1636002
TI  - Aged care funding.

PMID- 1636003
TI  - Brisbane Youth Service: an innovative health programme.

PMID- 1636004
TI  - Caring for the aged--but who cares for the carers?

PMID- 1636005
TI  - Remote area nursing--needs must be recognised.

PMID- 1636006
TI  - Lexical mediation between sight and sound in speechreading.
AB  - In two experiments, we investigated whether simultaneous speech reading can
      influence the detection of speech in envelope-matched noise. Subjects attempted
      to detect the presence of a disyllabic utterance in noise while watching a
      speaker articulate a matching or a non-matching utterance. Speech detection was
      not facilitated by an audio-visual match, which suggests that listeners relied on
      low-level auditory cues whose perception was immune to cross-modal top-down
      influences. However, when the stimuli were words (Experiment 1), there was a
      (predicted) relative shift in bias, suggesting that the masking noise itself was
      perceived as more speechlike when its envelope corresponded to the visual
      information. This bias shift was absent, however, with non-word materials
      (Experiment 2). These results, which resemble earlier findings obtained with
      orthographic visual input, indicate that the mapping from sight to sound is
      lexically mediated even when, as in the case of the articulatory-phonetic
      correspondence, the cross-modal relationship is non-arbitrary.

PMID- 1636007
TI  - Do abrupt-onset peripheral cues attract attention automatically?
AB  - The proportion of peripheral cues that predicted at which of two locations a
      discrimination target would occur was manipulated in three experiments. Near cues
      occurred adjacent to the target and far cues occurred adjacent to the other
      location. In Experiment 1, near and far cues were presented in separate blocks so
      each predicted target location. Both types of cue produced benefit relative to a
      neutral baseline. In Experiment 2 expectancy for near versus far cues was
      manipulated. In one group, 80% of the peripheral cues were near; in another, only
      20% were near; in a third, near and far cues occurred randomly. Near cures always
      produced benefit. Far cues produced benefit when they were expected, had no
      effect in the random group, and sometimes produced cost when they were
      unexpected. Experiment 3 repeated the near-expected and far-expected conditions,
      but target duration was shortened to 50 msec. A similar pattern emerged, except
      that near cues produced less benefit at longer SOAs when they were unexpected.
      The data suggest that peripheral, abrupt-onset cues may produce benefit via an
      automatic process, but that such a process is more like location priming than the
      capture of attention. Expectancy determines whether and where attentional
      resources will be allocated in response to the cue.

PMID- 1636008
TI  - Pragmatic schemas and the selection task: to reason or not to reason.
AB  - Cheng and Holyoak (1985) have proposed that people possess classes of
      linguistically based schemas that have an internal structure that is determined
      by pragmatic considerations. They found that when permission schemas ("If you
      want to do P, then you must do Q") are used in the selection task, the success
      rate is much superior to what is usually observed. According to Cheng and
      Holyoak, this is due to the fact that the permission schema is defined by a set
      of production rules that give the same answers to problems of conditional
      inference as those of formal logic. In order to test this hypothesis
      specifically, 160 university students were given one of two tests. The first
      contained two sets of inferential reasoning tasks, one using a permission schema,
      the second using a relation of multiple causality. The second test employed the
      same two conditional relations, but in an appropriate context. The results
      indicated that subjects did better on the reasoning task with the schema of
      multiple causality when presented in context, but, as predicted, their
      performance was much worse on the inferential reasoning task with the permission
      schema, which generated a higher proportion of logically incorrect responses.
      These results suggest that contrary to what has been affirmed, permission schemas
      might not have a logical structure that is equivalent to conditional logic. A
      second experiment examined selection task performance using the same two
      relations in context. Performance on the permission schema was superior to that
      found with the relation of multiple causality. This confirmed previous results
      indicating that permission schemas do improve selection task performance, but
      also suggests that this effect is not related to understanding of conditional
      reasoning.

PMID- 1636009
TI  - Mobilization of cognitive resources and the generation effect.
AB  - The generation effect refers to the memory advantage of words that have been
      generated rather than read. Such a read-generate comparison confounds qualitative
      task differences and raises methodological problems. A revised methodology is
      proposed circumventing these problems in that the encoding task is held constant
      and all stimuli have to be generated, but the degree of generativeness (i.e. the
      amount of cueing) is varied. In Experiment 1, 1, the (refined version of the)
      generation effect is demonstrated in a within-subjects design; with increasing
      generation activity left to the subject, free recall performance increases. No
      effect is obtained for degree of target masking. The same finding is replicated
      and shown to be independent of self-paced study time when generative activity is
      manipulated between subjects (Experiment 2) or within subjects (Experiment 3). As
      all learning trials involve generation, encoding time is controlled
      statistically, and free recall is used as a measure of memory, this refined
      generation effect cannot be explained as an artifact of selective attention or
      elaboration. Rather, generative activity seems to increase the mobilization of
      cognitive resources. This motivational account is supported by Experiment 4
      showing an enhanced generation effect for positive mood.

PMID- 1636010
TI  - Phonology, working memory, and foreign-language learning.
AB  - Three tasks were used to predict English learning by Finnish children over a
      three-year period. In the pseudoword repetition task the pupils had to repeat
      aloud tape-recorded pseudowords sounding like Finnish or English. In the
      pseudoword copying task the pupils saw strings of letters resembling Finnish or
      English words and copied them when they had disappeared from view. When comparing
      syntactic-semantic structures, the pupils had to find the syntactically matching
      pairs from two sets of Finnish sentences. Repetition and copying accuracy and the
      ability to compare syntactic-semantic structures predicted English learning.
      Intercorrelations between test scores and English and mathematics grades suggest
      that repetition and copying accuracy were specifically related to language
      learning. It is concluded that the ability to represent unfamiliar phonological
      material in working memory underlies the acquisition of new vocabulary items in
      foreign-language learning.

PMID- 1636011
TI  - Incidentalomas: problems of diagnostic assessment.

PMID- 1636012
TI  - Adrenal glands: metastases, lymphomas, infections and cysts.

PMID- 1636013
TI  - Unusual and coincidental presentation of metastatic pheochromocytoma. Report of
      three cases.

PMID- 1636014
TI  - Diagnostic imaging of adrenal diseases.

PMID- 1636015
TI  - Radiologic imaging of hyperadrenocorticism syndromes.

PMID- 1636016
TI  - Adrenocortical scintigraphy.

PMID- 1636017
TI  - Radiocholesterol scintigraphy in Cushing's syndrome.

PMID- 1636018
TI  - Primary aldosteronism and hyperandrogenism.

PMID- 1636019
TI  - Diagnostic imaging of neuroblastoma.

PMID- 1636020
TI  - Effect of interaction between gentamicin and pyridoxal-5-phosphate on functional
      and metabolic parameters in kidneys of female Sprague-Dawley rats.
AB  - Daily intraperitoneal (i.p.) injection of genatmicin at a dose of 70 mg/kg for 11
      days produced nephrotoxicity in female Sprague-Dawley rats as evidenced by
      increased excretion of urinary protein and trypsin inhibitory activity as well as
      rise in renal individual class and total phospholipid. The observed proteinuria
      was associated with a significant twofold fall in creatinine clearance and
      histopathological changes, including the presence of hyaline casts and flattened
      epithelial cells within the lumen of proximal convoluted tubules. Although
      pyridoxal-5-phosphate (50 mg/kg) administered i.p. did not significantly alter
      creatinine clearance, histopathology, proteinuria, and urinary trypsin inhibitory
      activity, an increase in individual class and total phospholipid was noted in
      kidney. In rats simultaneously administered gentamicin and pyridoxal-5-phosphate,
      the observed fall in renal gentamicin content was associated with a return of
      individual class and total phospholipid to control values. However, the decline
      in creatinine clearance, enhanced proteinuria, and increase in urinary trypsin
      inhibitory activity in the simultaneous-treated group was similar or greater than
      that seen in the gentamicin-only injected rats. Morphological examination of
      simultaneous-treated rats revealed extensive alterations in proximal tubules
      including numerous mitotic figures, large vesicular nucleii, and prominent
      nucleoli in epithelial cells as well as hyaline casts within the lumen. Our data
      combined with results of previous studies suggest that sex and type of rat strain
      are important factors in aminoglycoside-induced nephrotoxicity. It is evident
      that a specific concentration of pyridoxal-5-phosphate may be necessary to
      provide protection against all manifestations of aminoglycoside-induced renal
      damage.

PMID- 1636021
TI  - Effect of captopril on urinary excretion of renin and angiotensinogen in
      aminonucleoside nephrosis.
AB  - Puromycin aminonucleoside (PAN)-nephrotic rats show high plasma renin, low plasma
      angiotensinogen (Angt), and increased urinary excretion of renin and Angt. In
      this work, we studied the effect of captopril on urinary excretion of total
      protein, renin, and Angt for 25 days after PAN injection. Captopril had no effect
      on total protein urinary excretion; however, captopril did enhance the urinary
      excretion of renin and did decrease the urinary excretion of Angt. This seems to
      be due to the fact that captopril magnifies the increase in renin and the
      decrease in Angt in the plasma of PAN-nephrotic rats.

PMID- 1636022
TI  - Clinical profile and factors affecting mortality in acute renal failure.
AB  - The records of 110 patients with acute renal failure (ARF) admitted to the
      Department of Medicine of the Philippine General Hospital during a 5-year period
      (1983-1988) were reviewed. The objectives were to evaluate the clinical profile
      of ARF patients and to determine what factors influenced mortality. Infection
      significantly influenced the causation and prognosis of ARF. Fifteen patients
      died, for an overall mortality rate of 14%. Forty-six clinical variables were
      analyzed in order to identify factors correlated with mortality. Four variables
      significantly increased the risk of death from ARF: older age, hyperkalemia,
      oliguria, and presence of sepsis on admission. These characteristics define a
      subset of patients for whom more aggressive treatment of ARF is warranted.

PMID- 1636023
TI  - Glomerulotubular function in patients undergoing moderate surgical stress.
AB  - Glomerular function and renal tubular function assessed by measurements of
      creatinine clearance rates (CCR), lithium clearance rates (CLi, and N-acetyl-beta
      D-glucosaminidase (NAG) enzymuria were measured immediately prior to and within
      24 h of operation (average operative time 150 min) in 16 patients undergoing a
      moderate surgical stress. Although serum creatinine concentrations and CCR were
      similar pre- and postsurgery at 105 +/- 21 and 108 +/- 21 mumol/L and 108 +/- 67
      and 110 +/- 59 mL/min/100 kg body weight (mean +/- SD), respectively, both CLi
      and NAG were significantly increased following the surgical insult. CLi was
      increased from 19.7 +/- 6.1 to 31.7 +/- 16.7 mL/min/100 kg (p less than 0.01) and
      NAG from 71 +/- 58 to 164 +/- 10 U/mmol urinary creatinine (p less than 0.001).
      In addition, the absolute distal tubular reabsorption of sodium and water
      increased from 18.3 +/- 5.9 and 15.8 +/- 9.7 to 30.6 +/- 16.4 and 27.6 +/- 12.2
      mL/min/100 kg body weight (both p less than 0.05), respectively. These results
      indicate early postoperative renal tubular dysfunction following a moderate
      surgical stress, undetected by conventional screening.

PMID- 1636024
TI  - Cyclosporin A abolishes renal reserve capacity.
AB  - Renal functional reserve (RFR) was investigated in a group of renal transplant
      recipients taking cyclosporin A (CyA) immunosuppressive therapy. Nine patients
      received a 93 g oral protein load containing 5983 mg of glycine. GFR and ERPF
      were measured using isotope infusions of 51Cr EDTA and 125I OIH, respectively,
      before and for 3 h after the meal. Patients studied demonstrated a wide range of
      baseline GFRs (20.9-89.5 mL/min, mean 50.09 mL/min). However, few patients
      demonstrated an individual RFR, regardless of original level of function.
      Overall, no significant change in either GFR or ERPF was demonstrated after the
      protein stimulus. CyA is known to alter intrarenal prostanoid synthesis in favor
      of vasoconstriction and RFR is thought to be mediated by prostanoids. Therefore a
      mechanism for the absence of RFR in patients receiving CyA therapy is suggested.

PMID- 1636025
TI  - Management of acute renal failure in the critically ill with continuous
      venovenous hemodiafiltration.
AB  - Continuous venovenous hemodiafiltration (CVVHD) has been increasingly utilized
      for renal replacement therapy in the critically ill. We report details of a
      prospective study of CVVHD in 12 critically ill patients (7 males, 5 females;
      mean age 60 years, range 30-72 years; Apache II score mean 27.4, range 21-35)
      with oligoanuric acute renal failure supported on CVVHD. Vascular access was
      obtained via double lumen subclavian or femoral cannulae. The mean pretreatment
      urea was 35.9 mM/L and the mean pretreatment creatinine was 559 microM/L. After
      24 h of treatment on CVVHD these fell to a urea mean of 20.3 mM/L and a
      creatinine mean of 298 microM/L and remained stable at these values for the
      duration of CVVHD. The mean net ultrafiltrate volume was 551 mL/h, with a urea
      clearance mean of 26.6 mL/min and a creatinine clearance mean of 23.7 mL/min.
      There were no complications related to use of the blood pump module or
      extracorporeal circuit. Excellent hemodynamic stability, control of fluid and
      electrolyte balance, and azotaemia control were maintained while on CVVHD.
      Technique survival was 100%. Patient survival was 42%. We conclude that CVVHD is
      a safe, effective, and durable therapy for the treatment of acute renal failure
      in the critically ill and that it offers outstanding metabolic control and
      cardiovascular stability.

PMID- 1636026
TI  - Effects of suprofen on the isolated perfused rat kidney.
AB  - Although suprofen has been associated with the development of acute renal failure
      in greater than 100 subjects, the mechanism of damage remains unclear. The direct
      nephrotoxic effects of a single dose of 15 mg of suprofen were compared in the
      recirculating isolated rat kidney perfused with cell-free buffer with or without
      the addition of 5 mg/dL of uric acid. There were no significant differences in
      renal sodium excretion, oxygen consumption, or urinary flow rates in kidneys
      perfused with suprofen compared with the drug-free control groups. In contrast, a
      significant decline in glomerular filtration rate was found after the
      introduction of suprofen to the kidney perfused with uric acid; no changes were
      found with suprofen in the absence of uric acid. A significant decrease in the
      baseline excretion rate of uric acid was found in rats given suprofen, compared
      with drug-free controls. However, the fractional excretion of uric acid was
      unchanged between the groups over the experimental period. In summary, suprofen
      causes acute declines in renal function, most likely by directly altering the
      intrarenal distribution of uric acid.

PMID- 1636027
TI  - The diagnostic value of CT scan in acute renal cortical necrosis.
AB  - We report the characteristic CT scan findings of renal cortical necrosis in a
      patient of acute renal failure, which was confirmed on renal biopsy. CT scan is a
      useful, noninvasive investigative modality for an early diagnosis of renal
      cortical necrosis.

PMID- 1636028
TI  - Bladder involvement in systemic amyloidosis causing massive hemorrhage in
      hemodialysis.
AB  - We report a chronic hemodialyzed patient with bladder involvement of a secondary
      amyloidosis that presented as isolated hematuria evolving quickly to a massive
      hemorrhage and vesical rupture. We believe that this is the first report of
      bladder amyloidosis involvement in the course of hemodialysis. This knowledge may
      help in managing dialysis patients with hematuria.

PMID- 1636029
TI  - Technical advances in transjugular intrahepatic portosystemic shunts.
AB  - A transjugular intrahepatic portosystemic shunt (TIPS) can be created
      percutaneously with the Palmaz balloon-expandable stent. This article describes a
      transjugular-only approach with a 16-gauge needle. A functional and efficacious
      shunt can be achieved in most cases with stent diameters of 8-10 mm.
      Occasionally, a 12-mm-diameter shunt is necessary for effective variceal
      decompression. The procedure is considered successful when the portosystemic
      gradient is lowered to 12 mm Hg or less after stent placement. Hepatic vein
      stenosis in the shunt outflow can develop after the TIPs procedure. This
      complication has been treated successfully with additional stent placement. TIPS
      can undoubtedly be performed successfully and safely with a transjugular-only
      approach; however, the full impact of TIPS on the treatment of portal
      hypertension remains to be determined.

PMID- 1636030
TI  - Stridor and upper airway obstruction in infants and children.
AB  - Upper airway obstruction in infants and children is a common and distressing
      problem because of the relatively narrow diameter of the airway in early life.
      Although ultrasound, computed tomography, and magnetic resonance imaging have
      become increasingly popular modalities for use in many pediatric diseases, plain
      radiography and fluoroscopy, with attention to technique, collimation, and
      patient position, continue to be the mainstays for the evaluation of stridor in
      children. An understanding of normal airway anatomy and air flow dynamics is
      necessary for this evaluation. This article presents the diagnostic features of
      conditions a radiologist may encounter in an infant or child with upper airway
      obstruction. Plain radiographic and fluoroscopic findings from over 100 cases of
      infants and children with this condition were reviewed to determine how
      frequently the specific diagnosis was confirmed with these studies. In the vast
      majority of cases, plain radiography and fluoroscopy suffice.

PMID- 1636031
TI  - Diseases of the trachea and main-stem bronchi: correlation of CT with pathologic
      findings.
AB  - This article presents the computed tomographic (CT) features of the most common
      abnormalities of the trachea and main-stem bronchi and correlates CT and
      pathologic findings. The abnormalities are classified into focal and diffuse.
      Focal disease tends to produce a decreased airway diameter, whereas diffuse
      diseases are divided into those that increase the airway diameter and those that
      decrease it. Conventional CT with 10-mm collimation was performed in 36 patients
      to assess their condition. Additional dynamic incremental thin-section (1.5-5.0
      mm collimation) CT was performed in patients with focal abnormalities. Findings
      from conventional CT correlated closely with those from pathologic analysis of
      specimens from patients with diffuse disease, but dynamic thin-section scans are
      necessary for optimal assessment of focal abnormalities. CT demonstrates the
      location and extent of disease; helps characterize abnormal tissues; helps
      evaluate the thickness of the tracheal and bronchial walls; and helps determine
      the extent of extraluminal disease, including the presence of mediastinal
      extension and lymphadenopathy.

PMID- 1636032
TI  - Cardiac valve reconstruction and replacement: a brief review.
AB  - Surgical methods for improving the function of diseased cardiac valves are valve
      reconstruction (valvuloplasty) and valve replacement with mechanical prostheses,
      biologic prostheses, or homograft (donor) valves. Reconstruction is used
      primarily for incompetent mitral and tricuspid valves and addresses each part of
      the valve apparatus individually. Annuloplasty rings are often used to restore
      the size and shape of the valve orifice. Long-term anticoagulation therapy is not
      necessary. The designs of mechanical prostheses have evolved since the early
      caged-ball prostheses. Current models are noted for their durability. Patients
      who undergo implantation of these prostheses must also undergo long-term
      anticoagulation therapy. Biologic prostheses made from porcine valves or bovine
      pericardium are not as durable as their mechanical counterparts, but they do not
      require long-term anticoagulation therapy. Homografts are used in relatively few
      centers. They have good hemodynamics and do not necessitate long-term
      anticoagulation therapy. Radiologists should be familiar with the radiographic
      appearance of the various valve prostheses and annuloplasty rings and with the
      advantages and disadvantages of their use in cardiac valvular surgery.

PMID- 1636033
TI  - Cystic masses of the pancreas.
AB  - Although the pseudocyst is the most common cystic mass of the pancreas found at
      imaging studies, radiologists should be aware of the multiple disease processes
      that can manifest in a similar manner. This article reviews these other entities
      by category of the origin of the mass, including congenital, inflammatory, and
      neoplastic. Computed tomography, ultrasound, and magnetic resonance imaging
      studies are presented, and, although the considerable overlap of imaging features
      makes it generally impossible to render a specific diagnosis, combining the
      findings from these modalities is helpful in formulating a differential
      diagnosis. Because a cystic mass of the pancreas is not always a pseudocyst,
      percutaneous drainage should be followed by cytologic analysis of the aspirate. A
      biopsy of the wall of the cystic mass may also be necessary.

PMID- 1636035
TI  - Diagnosis of colon disease in the 1990s: radiologists should take a stand.

PMID- 1636034
TI  - Chondrosarcoma: MR imaging with pathologic correlation.
AB  - Magnetic resonance (MR) images of 21 surgically confirmed chondrosarcomas were
      retrospectively reviewed in conjunction with plain radiographs and computed
      tomographic scans and correlated with pathologic findings. The tumors appeared
      lobulated, and signal intensity, as analyzed visually (intermediate on T1
      weighted, high on T2-weighted images), was similar for all lesions, regardless of
      pathologic type. Size of lesion was not an indicator of grade. The appearances of
      mesenchymal and dedifferentiated chondrosarcomas mimicked that of conventional
      chondrosarcoma. Extraskeletal chondrosarcoma was visualized as a lobulated soft
      tissue mass. In all cases, MR imaging accurately depicted intraosseous and soft
      tissue extent of tumor noted at surgery and pathologic examination. Histologic
      type or grade of chondrosarcoma generally cannot be characterized on the basis of
      visual analysis of signal intensity noted on routine MR images. However, MR
      imaging is excellent for exact delineation of tumor extent.

PMID- 1636036
TI  - Diagnostic uses of nuclear medicine in AIDS.
AB  - Radionuclide imaging, if applied with an organ system approach, is useful in the
      diagnosis of the AIDS (acquired immunodeficiency syndrome)-related complex.
      Specific pathologic processes can be suspected on the basis of uptake patterns.
      The intensity and pattern of pulmonary uptake and concomitant nonpulmonary uptake
      of gallium provide guidelines for distinguishing among various opportunistic
      pulmonary pathogens. Gastrointestinal and extra-gastrointestinal tract uptake of
      gallium aids distinction among fungal, mycobacterial, and viral infections and
      neoplasms. Patterns of spleen uptake of technetium-99m sulfur colloid and gallium
      allow differentiation between neoplasm (Kaposi sarcoma) and infection (with
      mycobacteria). Skeletal and soft-tissue abnormalities can be characterized and
      differentiated on the basis of bone scan and other radionuclide scan findings.
      Thallium uptake in brain tumors (and not in areas of infection) allows brain
      lesion discrimination. In the proper clinical setting, AIDS nephropathy has a
      characteristic gallium uptake pattern. Cardiac abnormalities (including
      functional) can also be assessed with scintigraphy. With knowledge of these organ
      specific patterns and with correlative imaging studies, the manifestations of
      AIDS can be differentiated and appropriate treatment instituted.

PMID- 1636037
TI  - Radiographic detail and variation of the nominal focal spot size: the "focal
      effect".
AB  - It is not generally appreciated that there is a gradation of the focal spot size
      from the anode to cathode end of an x-ray field that can dramatically affect
      radiographic detail from one end of a radiograph to the other. The authors name
      this gradation the "focal effect." Gradations in radiation intensity and focal
      spot size were measured from anode end to cathode end of a 14 x 17-inch field and
      were visually demonstrated with lymphangiograms and line-pair patterns. The
      degradation in spatial resolution along the anode-cathode axis was found to be as
      much as 75%, depending on the orientation of the patient with respect to the x
      ray tube. Radiographic detail is, therefore, significantly improved (even when
      the large focal spot is used) by exploiting the focal effect and placing the body
      part requiring the best radiographic detail at the anode end of the table.

PMID- 1636038
TI  - Performance characteristics and image fidelity of gray-scale monitors.
AB  - Gray-scale monitors are an essential element of electronic radiology, and their
      ability to provide images that are perceived to be identical to those available
      on conventional or laser-printed film is crucial to success of electronic
      radiology. Image fidelity is measured in physical characteristics (luminance,
      dynamic range, distortion, resolution, and noise) and with psychophysical
      techniques, including receiver operator characteristics analysis with clinical
      images and testing with contrast-detail patterns to determine threshold contrast.
      Currently, laser-printed images facilitate greater information transfer than does
      a gray-scale monitor because of their higher absolute luminance (500 ft-L vs 60
      ft-L), greater perceived dynamic range, and better spatial resolution. In the
      near future, the developments of gray-scale monitors with 150-200 ft-L luminance,
      a display standard based on just noticeable differences, and algorithms to
      improve similarities between gray-scale display images and laser-printed images
      will help increase the acceptability of monitors as a means to make primary
      diagnoses.

PMID- 1636039
TI  - Electronic imaging workstations: ergonomic issues and the user interface.
AB  - The electronic imaging workstation serves as the interface between an electronic
      system and a user. Although the performance aspects of electronic displays are
      crucial considerations in workstation design, experience suggests that human
      factors in mechanical operation, software accessibility, and workstation
      environment are also important. Generally, workstations should have monitors
      arranged horizontally, and the work environment should be designed to minimize
      glare from lighting fixtures and to accommodate requirements for low luminance.
      Devices that control the workstation (eg, key pads, track balls) should be
      designed so that the user can operate primary and auxiliary controls with
      efficiency of hand and eye movements. Although many innovations in software (eg,
      graphical user interfaces) have allowed current workstations to be operated by
      users who have no knowledge of computer operations, further improvements in
      interactive software are necessary if such systems are to be accepted by
      radiologists.

PMID- 1636040
TI  - Systems integration: requirements for a fully functioning electronic radiology
      department.
AB  - Disparate computer-based information systems such as hospital information systems
      (HIS), radiology information systems (RIS), and picture archiving and
      communication systems (PACS) have been introduced into radiology departments at
      various times to meet specific operational objectives. Typically, these systems
      are implemented without an integration strategy. Systems integration, which
      optimizes integrity of data and labor savings, can be achieved by two general
      approaches. The first links the HIS to the PACS; the second involves interlinking
      of the HIS, RIS, and PACS, with the RIS as the central controlling system.
      Standardization in hardware, operating systems, and data base formats--which will
      allow true integration--is being addressed nationally and worldwide. Operational
      issues to resolve include ways to increase network capacity, control of data
      flow, and strategies for dealing with downtime. In the future, systems
      integration will enable prefetching, two-way interfaces, interfaces with digital
      dictation systems, and improved linkages with external digital input devices.

PMID- 1636041
TI  - Langerhans cell histiocytosis of bone.
AB  - Langerhans cell histiocytosis (LCH), previously called histiocytosis X, refers to
      a spectrum of disease characterized by idiopathic proliferation of histiocytes
      producing focal or systemic manifestations. Causes and pathogenesis remain
      unclear. However, recent studies suggest abnormal immune regulation as an
      important factor. The three classic syndromes may have considerable clinical
      overlap: eosinophilic granuloma, in which the disease is limited to bone in
      patients usually 5-15 years old; Hand-Schuller-Christian disease, characterized
      by multifocal bone lesions and extraskeletal involvement of the
      reticuloendothelial system (RES) usually seen in children 1-5 years old; and
      Letterer-Siwe disease, in which there is disseminated involvement of the RES with
      a fulminant clinical course in children less than 2 years old. Osseous
      involvement is typically in the flat bones, with lesions of the skull, pelvis,
      and ribs accounting for more than half of all lesions. About 30% of lesions are
      in long bones. Radiographic appearance of osseous LCH depends on site of
      involvement and phase of the disease. Early lesions appear aggressive with poorly
      defined margins and lamellated periosteal reaction. Late lesions appear well
      defined and may show sclerotic margins and expanded remodeled appearance.

PMID- 1636042
TI  - Characteristics and control of contrast in CT.
AB  - Understanding how contrast is produced and controlled in computed tomography (CT)
      is essential to proper application of this modality. In the typical CT scanner, a
      narrow x-ray beam in the section thickness direction and an air gap in the
      section plane are used to reduce scatter and improve contrast. High- and low
      contrast detectability of a CT scanner are important performance parameters
      contributing to optimal image quality. The limits of detectability of high
      contrast objects (ie, spatial resolution) are affected by detector aperture size,
      pixel size of the image, algorithm used to reconstruct the image, and section
      thickness. Visibility of low-contrast objects is limited by image noise and the
      algorithm. Contrast in CT images can be controlled by the window level and window
      width settings used to display the image. These settings dictate how the actual
      measurements of tissue attenuation are translated into a gray-scale image. Wide
      window widths can be used to provide an accurate representation of bone, and
      narrow widths are more useful for visualizing soft tissues.

PMID- 1636043
TI  - Ultrasound case of the day. Budd-Chiari syndrome.

PMID- 1636044
TI  - Pediatric case of the day. Pulmonary mesenchymal cystic hamartoma.

PMID- 1636045
TI  - General case of the day. Fibrovascular polyp of the esophagus.

PMID- 1636046
TI  - [Motor diagnosis in children: the correlation among three instruments].

PMID- 1636047
TI  - [Kinemetric and dynamometric analysis of the motor behavior of cerebral palsy
      children and its changes after intensive sports and exercise therapy].
AB  - Walking is one of those major everyday functions therapeutic efforts in disabled
      persons are aimed at, in order to maintain, or improve, their mobility. A six
      months intensive sports and movement therapy programme for cerebral palsied
      children serves to set out the potential of comprehensive gait analysis in
      assessing treatment effectiveness, and to present pertinent parameters for
      assessment. Following therapy, positive modifications of the gait pattern were
      found using a variety of kinematic and dynamic indicators. Moreover discussed and
      dealt with in some depth are the gait analysis requirements in view of assessing
      treatment programme effectiveness as well as comprehensive documentation of
      individual gait patterns. Along with the kinemetric procedures, it is in
      particular the dynamometric measuring methods which are outstanding in these
      respects, as they demonstrate very great exactness of measurement and register
      numerous parameters at the same time, with the data being available relatively
      rapidly.

PMID- 1636048
TI  - ["Indicators of Reha-Status (IRES)"--a patient questionnaire for assessing need
      and success of rehabilitation].
AB  - A basic instrument is presented which enables essential parameters of
      rehabilitation patients' somatic, functional and psychosocial status to be
      brought out and data collected at a "middle level of detail" in a standardized
      manner, i.e. a patient questionnaire which can be used to complement medical
      assessment or, for example in follow-up, as a stand-alone tool. Development and
      testing of the instrument has been supported over the past three years by the LVA
      Wurttemberg pension insurance fund, both financially and conceptually. In the
      present article, questionnaire contents and structure are described, and
      validation findings reported, standardization on a representative sample of the
      resident population (n = 1848) is set out. The validation studies performed
      showed the instrument to be reliable, valid and sensitive, and meeting with good
      acceptance on the part of patients. Finally, a specifically designed computer
      programme is set out which facilitates questionnaire data input and basic
      analyses. Potential applications for the IRES questionnaire are for example seen
      in describing rehabilitation course and outcome, in documenting the effectiveness
      of rehabilitation measures (quality control), or in the framework of
      rehabilitation diagnosis, in particular relative to functional and psychosocial
      dimensions.

PMID- 1636049
TI  - [Coping and compensation strategies of patients with disseminated
      encephalomyelitis and of patients with schizophrenic psychoses].
AB  - In ten patients with schizophrenic psychosis and ten patients with multiple
      sclerosis, the coping and compensation strategies were examined by means of
      semistructured interviewing. The following categories were considered: 1.
      avoidance; 2. habituation and/or adaptation to the disease; 3. efforts to
      compensate the deficits by will-power; 4. efforts to train certain types of
      behaviour; 5. self-treatment; 6. disease awareness and insight. Examples for
      these categories are given for both groups of patients. There is a surprising
      similarity in the statements made by the schizophrenic patients and those with
      multiple sclerosis. All of the patients with multiple sclerosis had developed
      coping strategies against psychological symptoms. It is suggested that the
      neuropsychological deficits in multiple sclerosis resemble the symptoms of
      reduced energetic potential observed in schizophrenia. In both groups efforts
      should be made to activate the compensation strategies by adequate training
      procedures.

PMID- 1636050
TI  - Encainide-induced diabetes: analysis of islet cell function.
AB  - OBJECTIVE: The purpose of this study was to gain insight into the mechanisms
      responsible for encainide-induced diabetes. Specifically, we sought to determine
      if absolute insulinopenia was present or whether encainide-induced diabetes was
      metabolically more like type II than type I diabetes. RESEARCH DESIGN AND
      METHODS: Islet function was assessed in a 65 year old white male with encainide
      induced diabetes. After 6 months of encainide treatment and 2 months duration of
      diabetes, C-peptide, glucagon, and glucose levels were measured at baseline and
      at 30 minute intervals for 120 minutes following an oral mixed meal. These
      measurements allowed assessment of islet beta and alpha cell function in
      comparison to control data from our laboratory. RESULTS: In this patient with
      encainide-induced diabetes, basal and peak C-peptide concentrations were similar
      to controls although peak C-peptide occurred substantially later than in
      controls. At peak glucose, the patient's C-peptide/glucose ratio was low
      indicating relative (but not absolute) insulinopenia. At baseline, glucagon was
      relatively depressed. Following Sustacal, there was an increase in glucagon of
      100% over baseline compared to a mean glucagon rise in controls of only 8%. There
      was no serological evidence for autoimmune diabetes as islet cell autoantibodies
      were absent. CONCLUSIONS: Similar to other forms of diabetes, encainide-induced
      diabetes is a bihormonal disorder. The metabolic pattern was more like type II
      than type I diabetes with C-peptide secretion in the normal range, yet persistent
      hyperglycemia that suggests relative insulinopenia and concurrent insulin
      resistance.

PMID- 1636051
TI  - Transient postnatal elevation of norepinephrine content and turnover in brain
      regions of rats exposed to terbutaline prenatally: evidence for autoregulation of
      noradrenergic development?
AB  - Terbutaline, a beta-adrenergic agonist used to arrest premature labor, crosses
      the placenta to affect fetal nervous system development. In the current study,
      pregnant rats were given 10 mg/kg of terbutaline on gestational days 17, 18 and
      19 and the development of noradrenergic neuronal activity was assessed in brain
      regions of the offspring by measuring norepinephrine content and turnover. For
      the latter measure, animals of different ages were given a single injection of
      alpha-methyl-p-tyrosine, an inhibitor of norepinephrine biosynthesis, and the
      decline in transmitter levels evaluated in the ensuing 2.5 hr period. Body and
      brain region weights were unaffected by prenatal terbutaline exposure, and
      norepinephrine content was unaltered during the period of drug administration.
      Nevertheless, the terbutaline-treated animals showed a transient elevation of
      both norepinephrine content and turnover in the immediate postnatal period. On
      postnatal day 2, turnover was increased by 50% throughout the brain, whereas
      effects on content were much smaller; this disparity suggests that terbutaline
      primarily alters nerve impulse activity (which would affect turnover more than
      content) rather than accelerating synaptogenesis (which would increase content
      equivalently to, or more than turnover). Values returned to normal by postnatal
      day 4 and remained so through the end of the period of synaptogenesis (day 21).
      The transient effects of terbutaline stand in contrast to the prolonged, and
      ultimately adverse effects of other drugs used in prematurity, notably
      glucocorticoids, and are likely to reflect a naturally-occurring, positive
      trophic influence of beta-adrenergic stimulation on noradrenergic development.

PMID- 1636052
TI  - Membrane-associated phospholipase A2 detected by a radioimmunoassay is a
      sensitive marker of inflammation in rheumatoid arthritis.
AB  - To investigate the clinical significance of membrane-associated phospholipase A2
      (M-PLA2) measured by a radioimmunoassay(RIA) in rheumatoid arthritis, we examined
      serum M-PLA2 concentrations in 16 patients with rheumatoid arthritis. All showed
      elevated levels of serum M-PLA2. On the other hand, serum concentrations of C
      reactive protein (CRP) and IL-6 were increased in 13 (81.3%) and 14 (87.5%) of 16
      patients, respectively. The serum concentrations of M-PLA2 were significantly
      correlated with those of CRP. These results indicate that M-PLA2 is an acute
      phase reactant and a sensitive and useful marker of inflammation in rheumatoid
      arthritis.

PMID- 1636053
TI  - IRFI-016, a new radical scavenger, limits ischemic damage following coronary
      artery occlusion in rats.
AB  - The effects of IRFI-016 [2(2,3 Dihydro-5-Acetoxy 4,6,7-Trimethyl-Benzofuranyl)
      acetic acid] a new radical scavenger were studied following six hours of
      myocardial ischemia, induced by left coronary artery occlusion in male rats. The
      loss of myocardial Creatinine Phosphokinase activity (CPK), myocardial
      Myeloperoxidase Activity (MPO), ECG, survival rate, and Pressure Rate Index (PRI)
      were evaluated in SHAM, control (vehicle i.p. injection) and IRFI-016 (200 mg/kg
      i.p., 30 minutes before occlusion) treated animals. CPK was significantly reduced
      and MPO significantly enhanced in the ischemic areas of the hearts obtained from
      vehicle treated rats when compared to SHAM operated ones. Pretreatment with IRFI
      016 significantly attenuated (52%) loss of CPK activity in ischemic hearts and
      the increase in MPO activity, but did not increase PRI, thus indicating that this
      substance reduces the myocardial ischemic demand for oxygen. Occlusion of the
      coronary artery, furthermore, was associated with an immediate rise in the ST
      segment of the ECG, which was significantly attenuated by IRFI-016. These
      findings further support the important role of free radicals in the pathogenesis
      of acute myocardial ischemia and suggest that IRFI-016 may be a useful agent in
      the treatment of myocardial occlusion injury.

PMID- 1636054
TI  - Characteristics of covalent gossypol binding to microsomal proteins.
AB  - Gossypol is a potent antifertility agent contained in seeds and other parts of
      cotton plants. The limit set in 1974 by the FDA for this C30H30O8 compound in
      consumer products is 450 ppm. The binding characteristics and the nature of the
      microsomal protein adducts of radiolabeled gossypol were studied using
      centrifugation, extraction, reverse phase HPLC and filter assay approaches.
      Results showed a significant amount of radiolabeled gossypol to be associated
      with the precipitated proteins after aqueous, ethanol, acetone and ether
      extractions. The nature of binding of these protein adducts involved covalent,
      covalent but reversible (e.g., Schiff bases), and tightly-bound and trapped
      noncovalent residues. Non-acid labile binding adducts constituted 40% of the
      precipitated microsomal proteins. Eight percent of the adducts were covalent,
      reversible and reducible by NaBH4. A gradient HPLC separation of the acetone
      extracts resulted in non-gossypolone hydrophilic protein adducts with a mean
      retention time of 2.3 minutes. Gossypol can bind tightly to hepatic microsomal
      proteins with a ratio of 80 nmoles/mg protein under physiological conditions.
      Significant portions of these bindings are not due to simple acid labile Schiff
      base formation. Purer membrane preparation provided results showing predominant
      binding of gossypol to endoplasmic reticulum (ER) and mitochondria, followed to a
      lesser extent by peroxisomes and plasma membranes. Difference spectra of the
      gossypol-bound rat hepatic microsomal preparations and controls demonstrated a 3
      nm shift from 413 to 410 nm caused by gossypol covalent-binding. Results of this
      study indicate that gossypol binds covalently to microsomal proteins. Its binding
      to membrane proteins may affect metabolism of sterols, steroids, or fatty acids.

PMID- 1636055
TI  - Monoisoamyl meso-2,3-dimercaptosuccinate: interaction with metallothionein-bound
      cadmium in vitro and evidence of active transport into renal and hepatic cells in
      vivo.
AB  - Monoisoamyl meso-2,3-dimercaptosuccinate (Mi-ADMS) and the unesterified 2,3
      dimercaptosuccinic acid (DMSA) were evaluated for relative reactivities against
      metallothionein (MT)-bound cadmium (Cd) in vitro by elution of the reaction
      products through Sephadex G-75 gel. After 3 hr of incubation, Mi-ADMS removed
      about 70% of the Cd from Cd-MT, and a new peak emerged which corresponded to that
      obtained by elution of a 2:1 molar mixture of Mi-ADMS and Cd. Only about 15% of
      the Cd was removed from Cd-MT by DMSA. After 24 hr of incubation with Mi-ADMS, no
      evidence remained of the presence of Cd-MT; all of the Cd was recovered in a very
      high molecular weight fraction and in a fraction corresponding to Cd ion. In
      contrast, after 24 hr of incubation with DMSA, 25% of the Cd was still present as
      Cd-MT, while the remainder eluted in a fraction corresponding to a 2:1 molar
      complex of DMSA and Cd. When Mi-ADMS was administered to Cd-bearing mice which
      had received an inhibitor of organic anion transport, probenecid (PBC) or
      sulfinpyrazone (SPZ), prior to administration of the monoester, there was a
      marked attenuation of the Cd mobilizing actions of Mi-ADMS as reflected in whole
      body Cd levels. Analysis of organ Cd concentrations revealed that PBC blocked
      primarily the mobilization of renal Cd by Mi-ADMS, while the principal action of
      SPZ in antagonizing the action of Mi-ADMS was on hepatic Cd mobilization. It was
      concluded that Mi-ADMS has a higher affinity for Cd in Cd-MT than does DMSA, and
      that the access of Mi-ADMS to intracellular Cd is, at least in part, mediated by
      the organic anion transport system.

PMID- 1636056
TI  - In vivo studies on halogen compound interactions. III. Effect of carbon
      tetrachloride plus 1,2-dichloroethane on liver necrosis and fatty accumulation.
AB  - The effect of a single dose of carbon tetrachloride (CT), 1,2-dichloroethane
      (DCE) and the mixture on liver toxicity was investigated. The co-presence of both
      toxins exerts a more than additive effect on liver necrosis and on TBA-reactive
      substances produced by liver homogenates incubated at 37 degrees C. Both these
      effects are prevented in animals treated with vitamin E. The liver GSH is not
      involved in the synergistic action. The liver triglyceride levels of rats treated
      with the mixture are lower than in those treated with CT alone. This finding
      cannot be explained either by an improvement in the lipoprotein secretion or by
      the fact that the liver receives less NEFA. It is thus likely that the apparent
      protection against liver steatosis is the sign of more severe damage to the liver
      cell that partially blocks triglyceride synthesis. The mixture composed of CT+DCE
      exerts a potentiating action on liver toxicity with CT+DCE having the same
      characteristics as those, as previously reported, exerted by the co-presence of
      CT+DBE.

PMID- 1636057
TI  - In vivo studies on halogen compound interactions. IV. Interaction among different
      halogen derivatives with and without synergistic action on liver toxicity.
AB  - The liver toxicity of several halogen compound mixtures have been tested. The
      compounds were selected on the basis of their metabolic pathways: carbon
      tetrachloride (CT) and trichlorobromomethane (TCBM) undergo a dehalogenation via
      P450-dependent enzyme system, 1,2-dichloroethane (DCE) and 1,2-dibromoethane
      (DBE) are mainly conjugated with the cytosolic glutathione (GSH) by means of the
      GSH-S-transferase. The mixture TCBM+DBE shows a more than additive action on
      lipid peroxidation and liver necrosis. TCBM, like CT, reduces the hepatic level
      of GSH-S-transferase, increasing the amount of DBE available for cytochrome P450
      dependent metabolism, with the production of toxic metabolites. Thus, the
      behavior of the mixture TCBM+DBE is very similar to that of the mixture CT+DBE,
      previously reported. Mixtures composed of CT+TCBM and DCE+DBE do not show any
      synergistic effect on liver toxicity. The results allow one to conclude that the
      toxicity of mixtures of halogen compounds can be partly predicted on the basis of
      their metabolic pathways. When the metabolism is quite different, a synergistic
      toxicity can occur if one pathway interferes with a detoxification mechanism of
      the other compound. If the two metabolisms are very similar they produce, at
      most, an additive toxicity.

PMID- 1636058
TI  - Antioxidant effect of calmodulin antagonists in rat brain homogenate.
AB  - Several calmodulin antagonists, W-7, amitriptyline, trifluoperazine,
      chlorpromazine, dibucaine, prenylamine, calmidazolium, and compound 48/80,
      inhibited lipid peroxidation induced non-enzymatically in rat brain homogenate by
      ascorbate and Fe2+. Suggestions of involvement of calmodulin in various oxidative
      cellular responses, based on experiments using calmodulin antagonists, may need
      to be re-evaluated.

PMID- 1636059
TI  - Serotonin release in nucleus of the solitary tract and its modulation by
      antitussive drugs.
AB  - The effects of antitussive drugs on the release of [3H]5-hydroxytryptamine ([3H]5
      HT) were investigated in slices prepared from rat nucleus of the solitary tract
      (NTS) and depolarized with 30 mM KCl under superfusion conditions. Dihydrocodeine
      and dextromethorphan, both central acting antitussive drugs, significantly
      increased the release of [3H]5-HT from slices of the rat NTS. Furthermore, these
      antitussive drugs significantly increased the rate of turnover of the 5-HT in the
      brainstem. These results suggest that the effect of central acting antitussive
      drugs were mediated by increase of 5-HT release in the brainstem, particularly in
      the NTS.

PMID- 1636060
TI  - Conversion of mitochondrial redox state toward oxidation by prostacyclin in 70%
      hepatectomized rats.
AB  - Arterial blood ketone body ratio (KBR) and hepatic mitochondrial phosphorylation
      rate (PR) were investigated in partially (70%) hepatectomized rats treated with
      100 micrograms/kg body weight prostacyclin (PGI2) analogue i.p. after operation
      and every 12 h thereafter up to 72 h. Sampling was performed at 12, 24, 48, and
      72 h after operation. In sham-operated rats, KBR significantly increased from the
      preoperative values of 0.34 +/- 0.03 and 0.38 +/- 0.03, to 0.55 +/- 0.03 and 0.58
      +/- 0.02 at 12 h in the groups with and without PGI2 treatment, respectively (P
      less than 0.001). KBR returned to the preoperative levels after 24 h in the PGI2
      treated group, while it tended to be in the lower normal range in the untreated
      group. In the hepatectomized rats, KBR significantly decreased in the untreated
      group compared with the preoperative values and the values in the sham-operated
      group. It returned to the preoperative range within 72 h. In the PGI2-treated
      group, KBR increased significantly, to values above 0.54, after a 24-h delay and
      was maintained at those levels for 72 h. Concentrations of total ketone bodies
      (TKB) in the untreated groups remained in the upper range of preoperative values
      (above 200 nmol/ml) in the sham-operated rats and decreased significantly in the
      hepatectomized group (234 to 126 nmol/ml). TKB in the treated groups tended to
      decrease only in the sham-operated group (205 to 166 nmol/ml), and was massively
      reduced in the hepatectomized group (167 to 81 nmol/ml).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1636061
TI  - Experimental selective myocardial infarction in the dog without open-chest
      surgery.
AB  - In 16 dogs, a selective myocardial infarction (MI) was experimentally provoked
      without open-chest-surgery by means of microspheres (MS) injected into a Judkins
      catheter positioned into the left anterior descending coronary (LAD) under
      fluoroscopy. This was shown by ECG-abnormalities, increase of the serum-enzymes
      of myocardial necrosis, decrease of left ventricular end diastolic pressure
      (LVEDP), wedge pressure, and cardiac output. After 5 weeks, thoracotomy showed a
      myocardial infarction limited to the anterior wall of the heart, which was of
      subendocardial location and consisted of multiple zones of microinfarction.
      Histological examination of the corresponding area showed necrosis of myocardial
      muscle fibres.

PMID- 1636062
TI  - Histopathology of experimental spinal cord trauma. Comparison of treatment with
      TRH, naloxone, and dexamethasone.
AB  - The results of treatment with thyrotropin-releasing hormone (TRH), naloxone and
      dexamethasone treatments albino rats with experimental spinal cord injury were
      compared. All the animals were made paraplegic by the application clip method of
      Rivlin and Tator. Treatment was administered i.p. as bolus injections in two
      doses, at 45 and 120 min after the injury. Animals were allocated randomly to
      four experimental groups: (1) TRH (0.6 mg per dose), (2) naloxone (0.8 mg per
      dose), (3) dexamethasone (0.6 mg per dose), and (4) control (saline). TRH-treated
      rats showed significantly better histopathological scores than either naloxone or
      dexamethasone-treated ones (Kruskal Wallis: 24.058 P less than 0.001).

PMID- 1636063
TI  - Photosensitization of human bladder carcinoma cells by pyrene-dodecanoic acid:
      quantitative analysis of the cytotoxicity.
AB  - The effects of photochemotherapy with the fluorescent fatty acid pyrenedodecanoic
      acid (P12) and long-wavelength ultraviolet (UVA) light on cells derived from
      human bladder carcinoma were studied. Exposure of these anchorage-dependent cells
      to P12 either in monolayers of adherent cells or in suspension resulted in a time
      related uptake of P12 and its incorporation into the cells' neutral and
      phospholipids. The uptake and localization of P12 was visualized with
      fluorescence microscopy and the distribution of the cell population with respect
      to P12 uptake was analyzed by flow cytometry. Irradiation of P12-containing
      monolayers of bladder carcinoma cells with UVA light resulted in cell killing.
      But, on microscopic examination no apparent cell lysis was detected, and since
      digestion with trypsin did not result in the dispersion of the monolayers it was
      impossible to assess toxicity by cell count. Alternative procedures were
      therefore used, and the following cell parameters were determined: (a) cellular
      uptake or release of chromate; (b) ability of cells to re-adhere to the
      substratum; and (c) the long-range proliferation potential. The combined
      inhibitory effect of photoirradiation on cell adherence and on their
      proliferative potential was utilized for determining reductions of up to 7 log in
      cell viability. The results obtained with five independently established in vitro
      bladder carcinoma cell lines indicated that these cells are susceptible to P12
      induced photosensitization, suggesting that bladder malignancies might be
      potential candidates for pyrene-induced photochemotherapy.

PMID- 1636064
TI  - Reduced clearance of leukocytes from lungs in septic rats.
AB  - Leukocytes have previously been shown to sequestrate in the lungs and liver in
      association with traumatic and septic shock. In a rat model of gram-negative
      sepsis of intra-abdominal origin, a previously described in vivo technique was
      used for dynamic studies of leukocyte sequestration in different organs using
      white blood cells labeled with 111-indium-oxine. One group of rats was either
      studied immediately after induction of sepsis or for 6 h under a scintillation
      camera for continuous registration of the activity distribution (i.e., presence
      of leukocytes). Another group was studied 12 h after induction of sepsis for 60
      min. The activity increased immediately over the lungs, indicating sequestration
      of the leukocytes during the first 6 h, but there was no significant difference
      in this respect between septic and control animals. It does not seem possible to
      study leukocyte sequestration dynamically in this way. When the labeled
      leukocytes were administered 12 h after induction of sepsis, however, the
      activity of septic animals' lungs was seen to remain elevated over the time
      period studied compared with control rats, in which the activity slowly
      decreased. In the liver and spleen, the activity increased in both groups, but
      significantly more so in control animals, which may be explained by disturbed
      leukocyte margination and cell turnover in the septic animals. This study has
      indicated that leukocyte distribution in different organs is affected by sepsis
      and this reaction can be studied using radiolabeled leukocytes.

PMID- 1636065
TI  - Effect of age and gender on in vivo ethanol elimination, hepatic alcohol
      dehydrogenase activity, and NAD+ availability in F344 rats.
AB  - It has been reported that aging strikingly decreases in vivo ethanol metabolism
      in F344 rats without major effects on hepatic alcohol dehydrogenase (ADH)
      activity. Because hepatic ADH activity is not always rate limiting in the
      oxidation of ethanol, we measured in vivo ethanol elimination rate (EER), hepatic
      ADH activity, and the hepatic-cytoplasmic and mitochondrial redox states after
      acute ethanol application in 2- and 12-month-old F344 rats of both sexes. In
      male, but not in female, animals EER decreased with age significantly, by 28% (P
      less than 0.01). The body-to-liver weight ratio was significantly increased in
      male (39.4 +/- 1.5 vs 46.5 +/- 2.0; P less than 0.05), but not in female, animals
      with age. Specific activity of ADH was not significantly changed by age, while
      the activity was significantly reduced with age in male, but not female, rats
      when related to body weight (5.1 +/- 0.4 vs 3.9 +/- 0.3 mumoles/100 g b.wt./min;
      P less than 0.05). The cytoplasmic, but not the mitochondrial (NAD+) to (NADH),
      ratio was significantly decreased with age in male livers (317 +/- 48 vs 793 +/-
      128, P less than 0.05), while this was not the case in female livers. In summary,
      the data show a sex dependence of the effect of age on ethanol metabolism. The
      observed reduction in in vivo EER with age in male animals is due at least in
      part to an increased body-to-liver weight ratio, decreased hepatic ADH activity,
      and reduced availability of NAD+, the cofactor of the ADH reaction. The cause of
      this may be decreased transport of reducing equivalents through the mitochondrial
      membrane due to a lack of shuttle systems or a change in the physicochemical
      properties of the mitochondrial membrane, or decreased reutilization of NADH as
      NADPH resulting from a reduction of microsomal ethanol oxidation with age.

PMID- 1636067
TI  - Bladder cancer in the spinal cord-injured patient with long-term catheterization:
      a casual relationship?

PMID- 1636066
TI  - Preventive effect of beta-alanyl-L-histidinato zinc on bone metabolism in rats
      fed on low-calcium and vitamin D-deficient diets.
AB  - The effect of beta-alanyl-L-histidinato zinc (AHZ) on bone metabolism in the
      femoral diaphysis of rats fed on low-calcium and vitamin D-deficient diets was
      investigated. Rats were orally administered AHZ (10, 30, and 100 mg/kg per day)
      for 14 days and were killed on the 15th day. Feeding with low-calcium and vitamin
      D-deficient diets caused a significant decrease in serum 25-hydroxy-vitamin D3,
      calcium, and inorganic phosphorus concentrations. These decreases were not
      prevented by AHZ administration. Meanwhile, the femoral-diaphyseal calcium and
      phosphorus contents were significantly reduced by feeding with the deficient
      diets. Decrease in bone calcium content was significantly prevented by the doses
      of 30 and 100 mg AHZ/kg. Furthermore, the dose of 100 mg AHZ/kg produced a
      significant increase in bone deoxyribonucleic acid (DNA) content and alkaline
      phosphatase activity in rats fed on the deficient diets. Bone zinc content in the
      deficient rats was significantly increased by the doses of AHZ (30 and 100
      mg/kg). The present results suggest that oral administration of AHZ has a
      preventive effect in the development of deteriorating bone metabolism in rats fed
      on low-calcium and vitamin D-deficient diets.

PMID- 1636068
TI  - Extracorporeal shock wave lithotripsy in neurologically impaired patients.

PMID- 1636069
TI  - The occurrence of urologic injuries in patients with gunshot wounds to the spine.

PMID- 1636070
TI  - Complications from long-term indwelling Foley catheters in female patients with
      neurogenic bladders.

PMID- 1636071
TI  - Continent diversion and bladder augmentation in spinal cord-injured patients.

PMID- 1636072
TI  - Neurourology of spinal cord-injured patients.
AB  - To simply perform a rectal examination is not adequate. The interpretation is of
      paramount importance. Often in cauda equina lesions, tone found in the
      sphincteric site will be misinterpreted to mean somatic reflex tone. The tone
      found in these low lesions with areflexic bladders is caused by the fact that the
      internal anal sphincters are innervated by the sympathetic fibers, which are
      still intact in these patients. One may often have to rule out physical tone--an
      intrinsic property of tissue. When performing the dermatome examination for
      sensation, it is important that the examiner orders the patient to close his
      eyes. Then the examiner hits the air only while asking the patient. "Do you feel
      anything now?" It is surprising how many patients will respond by saying, "I feel
      it!" These patients do a great deal of wishful thinking or have paresthesias or
      dysesthesias. If these two factors are not ruled out, the examiner can be misled.
      The examiner should not stimulate two sites simultaneously (eg, leaning with the
      elbow on the thigh of the patient while testing the anogenital dermatomes,
      particularly if sensation is present in the thigh). This error in technique can
      produce a false-positive response while pinning the anogenital sites, which may
      be anesthetic. It is unsatisfactory for the examiner to state that the patient
      has sensation without specifically stating whether it is pinprick, light touch,
      or even hypalgesic, especially when referring to the sacral segments.
      Additionally, the examiner must state whether the sensation is unilateral or
      bilateral. To examine only the perianal dermatomes is insufficient; the penile
      and scrotal dermatomes must also be examined.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636073
TI  - The evaluation of autonomic dysreflexia.

PMID- 1636074
TI  - [From obesity to diabetes or the natural history of abnormalities in the
      secretion and action of insulin].

PMID- 1636075
TI  - [Conservative treatment of breast cancer in the early stage: factors predictive
      of local recurrence].

PMID- 1636076
TI  - [Etiopathogenesis of paraneoplastic hypercalcemia].

PMID- 1636077
TI  - [Malignant hypercalcemia: treatment].

PMID- 1636078
TI  - Containing the costs of the EMF problem.

PMID- 1636079
TI  - Cell-transplant results under fire.

PMID- 1636080
TI  - NIH strategic plan nears its final form.

PMID- 1636081
TI  - Monkey-human viral hybrid is new weapon in AIDS fight.

PMID- 1636082
TI  - Scientists search for "the disappeared" in Guatemala.

PMID- 1636083
TI  - New genes may shed light on cell growth control.

PMID- 1636084
TI  - Origins and extinctions: paleontology in Chicago.

PMID- 1636085
TI  - Three-dimensional structure of an angiotensin II-Fab complex at 3 A: hormone
      recognition by an anti-idiotypic antibody.
AB  - The elucidation of bioactive conformations of small peptide hormones remains an
      elusive goal to structural chemists because of the inherent flexibility of these
      molecules. Angiotensin II (AII), the major effector of the renin-angiotensin
      system, is an octapeptide hormone for which no clear structural models exist.
      Peptide hormones such as AII share the property that they bind to their receptors
      with high affinities, in spite of the fact that they must overcome an extremely
      large conformational entropy barrier to bind in one conformation. A "surrogate
      system" that consists of a high-affinity monoclonal antibody (MAb) and AII has
      been used to study a bound conformation of AII. The crystallographic structure of
      the complex reveals a structure of AII that is compatible with predicted
      bioactive conformations of AII derived from structure-activity studies and
      theoretical calculations. In the complex, the deeply bound hormone is folded into
      a compact structure in which two turns bring the amino and carboxyl termini close
      together. The antibody of this complex (MAb 131) has the unusual property that it
      was not generated against AII, but rather against an anti-idiotypic antibody
      reactive with a MAb to AII, which renders this antibody an anti-anti-idiotypic
      antibody. The high affinity for AII of the original MAb to AII was passed on to
      MAb 131 through a structural determinant on the anti-idiotypic antibody.
      Strikingly, the conformation of AII in this complex is highly similar to
      complementarity determining region loops of antibodies, possibly indicating that
      a true molecular mimic of bound AII was present on the anti-idiotypic antibody
      against which MAb 131 was elicited.

PMID- 1636086
TI  - Magnetoferritin: in vitro synthesis of a novel magnetic protein.
AB  - The iron storage protein ferritin consists of a spherical polypeptide shell
      (apoferritin) surrounding a 6-nanometer inorganic core of the hydrated iron oxide
      ferrihydrite (5Fe2O3.9H2O). Previous studies have shown that the in vitro
      reconstitution of apoferritin yields mineral cores essentially identical to those
      of the native proteins. A magnetic mineral was synthesized within the
      nanodimensional cavity of horse spleen ferritin by the use of controlled
      reconstitution conditions. Transmission electron microscopy and electron
      diffraction analysis indicate that the entrapped mineral particles are discrete 6
      nanometer spherical single crystals of the ferrimagnetic iron oxide magnetite
      (Fe3O4). The resulting magnetic protein, "magnetoferritin," could have uses in
      biomedical imaging, cell labeling, and separation procedures.

PMID- 1636087
TI  - Recognition of angiotensin II: antibodies at different levels of an idiotypic
      network are superimposable.
AB  - Genetic and sequence information are reported for an angiotensin II-reactive
      antibody (Ab1, MAb 110) and an anti--anti-idiotypic antibody (Ab3, MAb 131) that
      have identical antigen binding properties and that are related by an anti
      idiotypic antibody (Ab2-beta) that satisfies accepted biochemical criteria for an
      internal image-bearing antibody. The sequences of the variable regions of the Ab3
      and of the Ab1 are nearly identical, even though the Ab1 is an antibody to a
      peptide and the Ab3 is an antibody to a globular protein. Significantly, amino
      acid residues that make critical contacts with antigen in the crystal structure
      of the Ab3-antigen complex are highly conserved in Ab1, suggesting that the
      epitopes of the Ab2-beta recognized by the Ab3 do indeed resemble the bound
      structure of the antigen.

PMID- 1636088
TI  - Identification of envelope V3 loop as the major determinant of CD4 neutralization
      sensitivity of HIV-1.
AB  - Laboratory isolates of human immunodeficiency virus type-1 (HIV-1) such as HTLV
      IIIB are generally T cell line-tropic and highly sensitive to neutralization by
      soluble CD4 (sCD4), a potential antiviral agent that is undergoing clinical
      trial. However, many primary HIV-1 isolates are macrophage-tropic and sCD4
      resistant. Envelope V3 loop sequences derived from primary HIV-1 isolates were
      sufficient to confer on HTLV-IIIB not only the tissue tropism but also the degree
      of sCD4 neutralization resistance characteristic of their HIV-1 strains of
      origin. Single amino acid changes in the V3 loop enhanced sCD4 resistance by up
      to tenfold. These observations suggest that the tissue tropism and sCD4
      neutralization sensitivity of HIV-1 isolates are regulated by similar mechanisms.

PMID- 1636089
TI  - Stress-induced facilitation of classical conditioning.
AB  - Stress has been shown to impair subsequent learning. To determine whether stress
      would impair classical conditioning, rats were exposed to inescapable, low
      intensity tail shock and subsequently classically conditioned under freely moving
      conditions with a brief periorbital shock unconditioned stimulus and a white
      noise conditioned stimulus. Unexpectedly stressed rats exhibited significantly
      more conditioned eyeblink responses and the magnitude of their individual
      responses was also enhanced. These results stand in contrast to the learning
      deficits typically observed and suggest that stress can enhance the acquisition
      of discrete conditioned responses.

PMID- 1636090
TI  - Establishment of stable, cell-mediated immunity that makes "susceptible" mice
      resistant to Leishmania major.
AB  - Cell-mediated, but not antibody-mediated, immune responses protect humans against
      certain pathogens that produce chronic diseases such as leishmaniasis. Effective
      vaccination against such pathogens must therefore produce an immunological
      "imprint" so that stable, cell-mediated immunity is induced in all individuals
      after natural infection. BALB/c mice "innately susceptible" to Leishmania major
      produce antibodies after substantial infection. In the present study,
      "susceptible" mice injected with a small number of parasites mounted a cell
      mediated response and acquired resistance to a larger, normally pathogenic,
      challenge. This vaccination strategy may be applicable in diseases in which
      protection is dependent on cell-mediated immunity.

PMID- 1636091
TI  - Planar induction of anteroposterior pattern in the developing central nervous
      system of Xenopus laevis.
AB  - It has long been thought that anteroposterior (A-P) pattern in the vertebrate
      central nervous system is induced in the embryo's dorsal ectoderm exclusively by
      signals passing vertically from underlying, patterned dorsal mesoderm. Explants
      from early gastrulae of the frog Xenopus laevis were prepared in which vertical
      contact between dorsal ectoderm and mesoderm was prevented but planar contact was
      maintained. In these, four position-specific neural markers (engrailed-2, Krox
      20, XlHbox 1, and XlHbox 6) were expressed in the ectoderm in the same A-P order
      as in the embryo. Thus, planar signals alone, following a path available in the
      normal embryo, can induce A-P neural pattern.

PMID- 1636092
TI  - Transforming growth factor-beta in leishmanial infection: a parasite escape
      mechanism.
AB  - The course of infection with the protozoan parasite Leishmania is determined in
      part by their early replication in macrophages, the exclusive host cells for
      these organisms. Although factors contributing to the survival of Leishmania are
      not well understood, cytokines influence the course of infection. Transforming
      growth factor-beta (TGF-beta) is a multipotential cytokine with diverse effects
      on cells of the immune system, including down-regulation of certain macrophage
      functions. Leishmanial infection induced the production of active TGF-beta, both
      in vitro and in vivo. TGF-beta was important for determining in vivo
      susceptibility to experimental leishmanial infection.

PMID- 1636093
TI  - An eosinophil-dependent mechanism for the antitumor effect of interleukin-4.
AB  - Murine interleukin-4 (IL-4) exhibits potent antitumor activity when present at
      the site of tumor cell challenge. Associated with tumor cell death is the
      appearance of an inflammatory infiltrate comprised predominantly of eosinophils
      and macrophages, but with few lymphocytes. Antibodies that specifically block the
      accumulation of granulocytes at the site of inflammation were injected in vivo to
      define the cell type responsible for the antitumor action of IL-4. These studies
      implicate eosinophils in IL-4-mediated tumor cytotoxicity. The lymphoid
      independent nature of IL-4 action is supported by the analysis of mutant mouse
      strains with defined lymphocyte immunodeficiencies. The observed regression of
      established tumor masses by localized IL-4 action provides a rationale for
      exploring IL-4-mediated tumor killing as a potential therapy for human malignant
      disorders.

PMID- 1636094
TI  - Visually evoked oscillations of membrane potential in cells of cat visual cortex.
AB  - In response to visual stimulation, cells of the cat visual cortex fire
      rhythmically at frequencies between 30 and 60 hertz. This rhythmic firing can be
      synchronized among cells in widespread areas of the visual cortex. The visual
      stimulus conditions under which this process occurs suggest that the
      synchronization may contribute to the integration of information across broadly
      displaced parts of the visual field. An intricate mechanism must control the
      regularity of firing and its synchronization. In vivo whole-cell patch recordings
      from cells in area 17 have now shown that robust oscillations of membrane
      potential underlie the regularity of firing seen extracellularly. In the cells
      studied, the characteristics of the oscillations of membrane potential suggest
      that such oscillations are produced by rhythmic activity in synaptic inputs.
      These rhythmic synaptic inputs form the most likely mechanism for the
      synchronization of activity in neighboring cortical cells.

PMID- 1636095
TI  - [Anatomic characteristics of the pelvic girdle].
AB  - The most recent methods of investigation (CT osteoabsorptiometry) were applied in
      an attempt to reconstruct from their morphological structure the way in which
      connections between the bones of the pelvic girdle undergo stress. Thus, both
      sacroiliac articulation and symphysis pubis show characteristic distribution of
      the subchondral bone density and layout of the tensile collagen fibrous material
      as expression of a strongly varying qualitative pattern of stress during walking.
      In the region of sacroiliac articulation are the highest subchondral densities,
      both at the cranial and caudal edges, whereas the central part of the two
      auricular surfaces is less heavily mineralized. This distribution matches the
      thickness of the hyaline cartilage of the joint. There are striking sexual
      differences in the distribution of the subchondral bone density at the bordering
      surfaces of the symphysis pubis. During walking, all components of sacroiliac
      articulation and the symphysis pubis are apparently subjected to sudden changes
      in stress. Independent of this, the os sacrum is constantly exposed to torque on
      account of the weight of the upper body, and this is balanced out by the
      sacrospinal and sacrotuberal ligaments.

PMID- 1636096
TI  - [The role of CT in diagnosis and therapy of fractures of the pelvic girdle].
AB  - The conventional pelvic overview and special projections of the pelvic ring are
      often not conclusive for the diagnosis of pelvic ring fractures. The
      superimposition of multiple bony and soft tissue structures interfere with
      correct three-dimensional orientation of the bony lesions in spite of special
      projections. CT offers the possibility of identifying pelvic fractures that are
      not visible in conventional radiographs. Dislocated fractures can especially be
      appreciated. With CT, it was possible for the first time to classify lesions of
      the sacroiliac joint: (I) distortion (vacuum phenomena), (II) rupture of the
      ventral sacroiliac ligaments (open book), (III) lesions of the ventral and dorsal
      sacroiliac ligaments, and (IV) luxation of the os sacrum. Lesions of the sacrum
      can also be classified into four groups: (I) diastasis of the sacroiliac joint,
      (II) sacral lip fractures, (III) vertical fractures and compression fractures,
      (IV) comminuted fractures. Above all, the CT scan facilitates an accurate
      examination of the dorsal pelvic ring. Furthermore, better appreciation of
      intrapelvic soft tissue lesions is possible. In a retrospective study on 53
      patients, in 88.7% we had quite helpful and extremely helpful CT examinations,
      and 90% higher precision in comparison to conventional radiographs.

PMID- 1636097
TI  - [Pelvic girdle fractures--must they be stabilized?].
AB  - Osteosynthesis can only be successful in the pelvis if one has a biomechanical
      understanding of the physiological flux of force from the neck of the femur via
      the acetabular fossa to the sacroiliac joint. The sacroiliac ligaments have a
      particularly important support function here. For assessing stability and
      classifying the traumatic patterns it is helpful to use Pennal's classification,
      which takes the direction of the action of force into account. Three basic forms
      can be distinguished: anteroposterior compression, lateral compression and
      vertical avulsion. Depending on the extent of the traumatic pattern one can
      distinguish three subtypes. Type 1 is treated conservatively while types 2 and 3
      require surgical treatment. The traumatic patterns and treatment techniques
      applied are described clearly and with good illustrations.

PMID- 1636098
TI  - [Timing of osteosynthesis in pelvic girdle injuries. Advantages and disadvantages
      of early surgical management].
AB  - Eighty-five percent of the patients with pelvic injuries have multiple injuries;
      the mortality averages 40%. The frequency of laparotomy is about 35%,
      predominantly because of rupture of the spleen and liver and less often because
      of rupture of the bladder. New osteosynthesis techniques were developed in an
      attempt to find better means of local tamponade. After acute cheilotomy, a simple
      means of ventral internal fixation should always be used. Dorsal stabilization
      techniques, if required, should seldom be done in the acute setting. Slatis-type
      external fixation as an isolated mode of stabilization is insufficient in
      unstable injuries.

PMID- 1636099
TI  - [Anesthesiologic problems and specifics in the management of severe pelvic
      injuries].
AB  - There is a close relationship between trauma of the pelvis, hemorrhagic shock,
      microcirculation disturbances and multiple organ failure. Of primary importance
      are the treatment of pain, early intubation, artificial ventilation, protection
      against heat loss and replacement of massive blood loss. Contrary to conventional
      volume replacement by electrolyte solutions, the author favors the administration
      of colloids, especially the new concept of "small volume resuscitation," i.e.,
      the rapid infusion of a mixture of hypertonic saline solution and hyperoncotic
      dextran. Although there are limitations, the central venous and pulmonary
      arterial pressure reflect the volume balance of the circulation. The oxygen
      partial pressure of mixed venous blood, more or less reflecting the global oxygen
      supply state of the organism, can be measured only by means of a pulmonary artery
      catheter. The outcome depends greatly on optimization of the oxygen supply to a
      patient in shock whose oxygen needs are remarkably increased. Therapy should be
      aimed at keeping the arterial oxygen tension above 150 mmHg, increasing the
      cardiac index to 50% above normal, and stabilizing the hemoglobin concentration
      at an individually optimized value.

PMID- 1636100
TI  - [Classification and management of complex pelvic trauma].
AB  - Complex pelvic traumas are pelvic fractures accompanied by pelvic soft tissue
      injuries. Mortality in major pelvic fractures with associated soft tissue
      injuries is high, and these injuries can pose a more complex range of therapeutic
      problems. Uncontrolled bleeding and septic complications are the main causes of
      death. There has been extensive work on grading pelvic ring fractures, but less
      attention has been paid to grading the accompanying soft tissue damage.
      Therefore, a grading system for pelvic injuries was developed that takes the soft
      tissue damage into account more than the fracture classification did when used
      alone. It is a point system that considers the fracture itself, the soft tissue
      injuries, including lesions in the pelvic organs, vessels and nerves, and the
      general concomitant injuries. From 1972 to 1990 the clinical course and outcome
      of 132 patients with complex pelvic traumas were reviewed. The mortality was
      34.8%. Eighty-three of the patients (62.9%) underwent immediate laparotomy and in
      68 patients (51.7%) open reduction and internal fixation of the unstable pelvic
      ring were performed. For better primary treatment of patients with complex pelvic
      injuries, a trauma algorithm is introduced. It leads to important therapeutic
      steps after brief clinical, ultrasonic and radiological assessments. The major
      questions in the flow chart take the pelvic ring and hemodynamic instability into
      account. Immediate laparotomy, surgical control of hemorrhage, and open reduction
      and internal fixation of an unstable pelvic ring represent the most important
      requirements for successful treatment.

PMID- 1636101
TI  - [Determining indications and osteosynthesis techniques for the pelvic girdle].
AB  - 1566 patients with fractures of the pelvis were treated at the Department of
      Traumatology of the Hannover Medical School between 1972 and 1990: 1350 patients
      had fractures of the pelvic ring, 216 isolated acetabulum fractures, 398
      combinations of pelvic ring fractures and acetabular involvement; 718 of these
      patients were admitted with severe polytrauma. For 1254 patients a complete file
      was available for clinical and radiological evaluation of fracture distribution,
      classification (Tile and anatomical location) and concomitant injuries. During
      the observation period, significant increase in the severity of the trauma, the
      severity of the pelvic fractures and the rate of internal stabilization,
      especially of the posterior pelvic ring was observed. The overall mortality after
      pelvic fractures was 18.1%. This mortality depended significantly on the Hannover
      Polytrauma Score (PTS) and the associated pelvic and extrapelvic blunt trauma.
      Internal fixation of pelvic fractures was performed in 195 patients. This
      experience has now led to standardized procedures for the different fracture
      locations. With the task of minimizing soft tissue trauma and reducing the
      implant size, more differentiated treatment of sacral fractures is now applied.
      Adapted small fragment implants ("local osteosyntheses") can be applied, with an
      unilateral longitudinal dorsal incision providing an excellent overview over the
      fracture line. For internal fixation of sacral fractures, involvement
      (penetration by screws, transfixation) of the sacroiliac joint is avoided
      whenever possible. In our experience early open reduction and internal fixation
      of pelvic fractures facilitates the management of these severely injured
      patients.

PMID- 1636102
TI  - [Complications in surgical management of pelvic fractures].
AB  - In the care of pelvic injuries complications arise because of organizational and
      technical factors, some of which are described here. The following measures are
      important: autotransfusion, emptying the bladder and catheterization, checking
      and protection of the colon, correct management of the operation table, and
      prophylactic measures to avoid thrombosis. From an operational/technical point of
      view, it is most important that a larger with good exposure route be chosen that
      takes the anatomical structures into account. Of 123 cases, 20% were not ideally
      reduced. Twice massive bleeding occurred from the A. glutea superior, once the
      sacral dura was opened without any adverse effects, infection occurred 8 times
      and 10 times peroneal paralysis was observed.

PMID- 1636103
TI  - [Initial results with the ball joint fixator].
AB  - The ball-joint fixator is a one-plane external fixator system that allows
      correction of the reduction postoperatively. Dynamic axial loading is made
      possible by a telescoping device. Between January 1987 and June 1991, 312
      external fixators were applied in the Department of Trauma of the Surgical
      University Clinic in Freiburg/Breisgau. In 25 of these cases the ball-joint
      fixator (Unifix) was used. The study includes 16 open and 8 closed tibial
      fractures and 1 open femoral fracture. The pin-tract infection rate was 14%. In
      16 patients a cast was necessary for a short time after the fixator had been
      removed, and 3 other patients needed intramedullary nailing. The long-term
      complications observed were osteitis pseudarthrosis and refracture (in 1 case
      each). The ball-joint fixator is a device that can be applied very easily and
      quickly. It can be used to advantage in the treatment of multiple trauma patients
      with open tibial fractures. Because of the fixed distance between the pin clamps
      there is no advantage over the original AO fixator in fractures where the
      telescoping mechanism cannot be used.

PMID- 1636104
TI  - [Effect of pin-point surface osteosynthesis plates in comparison with
      conventional osteosynthesis plate surfaces on the sub-implant bone tissue.
      Preliminary communication].
AB  - Treatment of bone fractures with compression plates requires contact surfaces
      between the implant and bone. Because of this, there is a major nutritional
      disturbance in bone as a result of surgery. In an animal study of minipigs, this
      investigation proved that the reduced contact surfaces of periosteal bone
      vitality and that contact aids in the prevention of osteoporosis. Our work
      substantiates the conclusion that the osteoporosis underneath the smooth surface
      plates in the vicinity of implants is a result of cortical remodeling. This
      effect is believed to be induced by necrosis rather than by unloading effects.

PMID- 1636105
TI  - [What is the effect of para-articular fractures on hyaline joint cartilage?
      Experimental electron optic studies of the rabbit on post-traumatic subchondral
      vascularization disorders].
AB  - Joint fractures can interrupt the arterial and venous blood supply to the hyaline
      cartilage. Previous studies revealed effects of venous engorgement and
      hypertension in the cartilage. In this study the influence of interruption of the
      blood supply on the development of osteoarthritis was analysed. In a prospective,
      experimental study in 40 rabbits all vessels in the patella were ligated and the
      cartilage was investigated after 2, 6, 12, and 24 weeks by transmission electron
      microscopy. After 2 weeks no degenerative signs were determined. After 6 weeks
      there were distinct signs of cartilage injury. The degeneration of the hyaline
      cartilage increased with time. The endpoint of injury was the destruction of the
      cartilage and necrosis of the chondrocytes, determined after an ischaemic period
      of 24 weeks. The stages of cartilage degeneration in our trial correspond to the
      changes that are well known to occur in osteoarthritis. In conclusion,
      interruption of the blood supply of the patella results in degenerative changes
      to the joint cartilage. This effects is related to the duration of ischaemia. On
      the basis of results we recommend early and watertight repositioning of fractured
      joints not only for biomechanical reasons but also to avoid irrevocable effects
      of interrupted blood supply on hyaline joint cartilage.

PMID- 1636106
TI  - [Craniocerebral trauma and aseptic osteonecrosis. Steroid-induced sequelae after
      therapy of brain edema].
AB  - In this publication we present three cases of avascular osteonecrosis (AON) of
      the femoral head and the talus in adolescent and young adult patients following
      short-term, high-dose steroid therapy for cerebral trauma. All patients were
      proven to be free of other risk factors for AON. The latency period between the
      steroid therapy and the occurrence of AON ranged from 12 to 60 months; steroid
      therapy lasted for 12 to 16 days with a total dosage equivalent to 2370-7180 mg
      prednisolone. Our case reports are added to a review of the literature with 14
      similar cases reported receiving short-term, high-dose steroid therapy; 2 of them
      were also after brain trauma. To the best of our knowledge, 1 of our cases shows
      the longest latency period ever described after such therapy, and all our cases
      had a shorter therapy time than reported by other authors who have mentioned
      brain trauma patients. Additionally, bilateral necrosis of the talus due to short
      term, high-dose steroid therapy has also not previously been described. Whereas
      AON is quite common after long-term steroid therapy (e.g., for immunosuppression
      and rheumatic disorders), our cases prove that serious complications can occur
      even after a short period of emergency steroid therapy in cerebral trauma, a
      possibility that is generally unknown. The minimal dosage and the maximum time
      steroids can be applied to exclude the risk of AON has not yet been determined,
      although we do recognize that steroids are useful for the prevention of brain
      edema.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636108
TI  - [A modified procedure for repositioning shoulder dislocation].
AB  - A new method is presented for the reduction of shoulder dislocations and
      dislocation fractures, together with the follow-up results. This procedure is a
      modification of a method for reduction of the hip. Examination of our patients 1
      3 years after the accident showed no sign of nerve lesions and little residual
      discomfort.

PMID- 1636107
TI  - [Radiologic diagnosis of cervical spine injuries].
AB  - This investigation was designed to evaluate the radiological methods used for
      diagnosis of cervical spine injuries. In the time from 1977 to 1990, a total of
      102 patients with 113 fractures or fracture-dislocations of several segments of
      the cervical spine were diagnosed and treated in the University Surgical Clinic
      in Graz; 36 of these patients had lesions of the upper cervical spine and 66,
      lesions of the lower cervical spine. All trauma patients with disturbances of
      consciousness or neck discomfort reported on questioning or elicited by palpation
      underwent three-view radiographic screening for cervical spine injuries (lateral,
      AP and open-mouth views). This led us to suspect cervical spine injuries in all
      102 patients. Computerized tomography was performed in 76 cases, which yielded
      additional information in 55 cases about the middle and posterior column and the
      adjacent vertebral bodies. In 13 cases conventional tomograms were important to
      confirm the diagnosis of dens fracture. Except for the diagnosis of hanged-man
      and dens fractures, computerized tomography is accepted as the second step for
      the evaluation of cervical spine injuries. We performed 8 investigations with
      magnetic resonance imaging in 7 patients, and noted spinal cord lesions of low
      signal intensity in 3 of these cases.

PMID- 1636109
TI  - [Distraction of the first metacarpal bone for thumb reconstruction].
AB  - After amputation of the thumb good functional results can be achieved by
      lengthening the first metacarpal bone, if a suitable technique is used. Since
      1987 we have treated six patients in this way. In all of our patients the thumb
      was mechanically stable and sensitive after lengthening, thus improving the
      patients' ability to use their hands for grasping. Other advantages include the
      relative simplicity of the method, the fact that no experience of microsurgery is
      necessary and that the surgery does not result in soft tissue damage. In most
      cases treatment is on an outpatient basis. Between the various operations the
      patient can be reintegrated into his professional and social life. The period of
      absence from work (about 12 weeks) is relatively short when the severity of the
      injury is taken into consideration. Distraction of the first metacarpal bone
      cannot be considered an alternative to replantation but represents a
      complementary procedure in accordance with the modern management of severe hand
      injuries.

PMID- 1636110
TI  - [Post-traumatic recurrent hip joint dislocation].
AB  - Recurrent post-traumatic dislocation of the hip joint without an accompanying
      fracture is very rare. Delayed reduction and a too short immobilization periods
      seems to favor redislocation. One case is presented together with a discussion of
      the operative therapy and the intraoperative pathological-anatomical findings
      with respect to the literature.

PMID- 1636111
TI  - [Computerized tomography follow-up of the ante-torsion angle after femoral shaft
      fractures in the adult].
AB  - Rotational deformities are common complications following fractures of the
      femoral shaft. Computed tomography for determination of the anteversion angle of
      the femoral neck has proved to be the most suitable way of quantifying rotational
      faults. Out of our inpatient collective, 45 patients who had undergone
      interlocking intramedullary nailing of the femur and 10 in whom dynamic
      compression plating had been performed were examined by clinical investigation
      and computed tomography. Patients impression and clinical findings proved to be
      less reliable. Computerized determination of the anteversion angle showed
      rotational deviations of more than 10 degrees in 18 patients with interlocking
      nails and in 3 with dynamic compression plates. According to our investigations,
      rotational deviations less than 20 degrees will not usually handicap the patient.
      Therefore, we suggest that use of the term "rotational fault" be restricted to
      deviations exceeding 20 degrees compared with the uninjured side.

PMID- 1636112
TI  - [Mechanical properties of PDS-augmented patellar tendon transplants in
      reconstruction of the anterior cruciate ligament].
AB  - In 25 sheep the anterior cruciate ligament (ACL) was reconstructed after
      resection. Twelve modified "Jones procedures" were performed (transplantation of
      the central third of the patellar tendon with an initial load of 50 N) and 13
      polydioxanone (PDS) augmentations. In 15 cases the ACL was resected from the
      right knee. Twenty-one sheep survived for 1 year and were then evaluated. Loss of
      the ACL leads to instable joints in this experiment. Within the first 6 months
      anterior translation occurs; after 1 year subluxations can be seen on the X-ray
      films. Macroscopical signs of extensive arthrosis were seen in the femorotibial
      and femoropatellar joints; the menisci were totally destroyed. Macroscopically
      strong ligaments were seen 1 year after PDS-augmented reconstruction as well as
      after transplantation of the patellar tendon with an initial load of 50 N. There
      was no difference between the two groups. The mechanical strength reached 54% of
      the maximum load of a control group in the Jones reconstructions and 61% after
      additional augmentation with a 2-mm biodegradable PDS cord. There was no
      statistically significant difference. Both methods are suitable for
      reconstruction of the ACL; the patellar tendon replaces the ACL very well.

PMID- 1636114
TI  - AIDS: A review for the hepatologist.

PMID- 1636113
TI  - [Bilateral subcutaneous rupture of the quadriceps tendon caused by minor trauma.
      A case report].
AB  - A case of bilateral simultaneous rupture of the quadriceps tendons resulting from
      minor trauma is reported. The etiology, diagnosis and therapy are discussed.

PMID- 1636115
TI  - Structure and function of the human immunodeficiency virus type 1.

PMID- 1636116
TI  - Epidemiology of human immunodeficiency virus infection and the acquired
      immunodeficiency syndrome.

PMID- 1636117
TI  - Neoplasms of the gastrointestinal tract and hepatobiliary system in acquired
      immunodeficiency syndrome.

PMID- 1636118
TI  - Diagnostic considerations in the human immunodeficiency virus-infected patients
      with gastrointestinal or abdominal symptoms.

PMID- 1636119
TI  - Enteric immunologic abnormalities in human immunodeficiency virus infection.
AB  - The intestinal mucosa is an important portal of entry of HIV, and HIV-infected
      mononuclear cells are found in the intestinal lamina propria of 30 to 50% of HIV
      infected patients even at early stages of the disease. HIV infection of
      epithelial cells has not consistently been detected and is still controversial.
      Intestinal T cells are phenotypically and functionally distinct from circulating
      T cells, especially in their state of activation and differentiation, which both
      affect the replication and cytopathicity of HIV. An increase in CD8+ cells and
      variable decreases in CD4+ cells have been found in the intestinal lamina propria
      by immunohistologic studies, resulting in a decreased CD4 to CD8 ratio; in
      addition, CD25 expression is reduced. Changes in intraepithelial lymphocytes are
      unclear. B-cell differentiation seems to be disturbed because IgA plasma cells
      and IgA2 secretion are reduced. Depletion or functional impairment of activated
      mucosal lamina propria lymphocytes by HIV infection could explain the breakdown
      of the mucosal immune barrier leading to opportunistic diseases; in addition, due
      to the interrelationship between mucosal immune system and epithelium, these
      changes might be responsible for the partial bowel atrophy and maturational
      defects in enterocytes of HIV-infected patients.

PMID- 1636121
TI  - Human immunodeficiency virus infection of the liver.

PMID- 1636120
TI  - Wasting in the acquired immunodeficiency syndrome.

PMID- 1636122
TI  - Hepatic histopathology in the acquired immunodeficiency syndrome.
AB  - Involvement of the liver with the same opportunistic organisms and neoplasms
      affecting other organs has been recognized since the beginning of the AIDS
      epidemic. In this overview of hepatic histopathologic features in AIDS, we review
      the range of opportunistic infections and neoplasms accompanying HIV infection.
      Hepatic disease may result from viral, bacterial, protozoal, or fungal infection,
      or secondary to drugs and neoplasms. Liver involvement in AIDS usually reflects
      disseminated rather than primary disease. CMV and mycobacteria are the most
      common organisms in liver identified in biopsy and autopsy studies. A variety of
      nonspecific features, including steatosis, granulomas, and sinusoidal
      abnormalities may also be seen. HIV-1 itself was recently identified in the
      liver. Speculation regarding the significance of this finding has been discussed
      in this review. Hepatitis B, C, and D may also complicate the course of disease
      in patients with AIDS. Hepatitis B behaves differently in the population with
      AIDS than in immunocompetent patients. We concluded our review with a discussion
      of the present recommendations regarding the use of liver biopsies in these
      patients. This topic continues to be widely debated in the literature.

PMID- 1636123
TI  - Human immunodeficiency virus-associated biliary tract disease.

PMID- 1636124
TI  - A 29-year-old man with the acquired immunodeficiency syndrome and liver
      dysfunction.

PMID- 1636125
TI  - Neural transplantation: an approach to cellular plasticity in the developing
      central nervous system.

PMID- 1636126
TI  - Surfactant protein regulation and diabetic pregnancy.

PMID- 1636127
TI  - Cellular timing of fetal lung development.

PMID- 1636128
TI  - Hypoxic responses of the neonatal endothelium.

PMID- 1636129
TI  - Matrix receptors and development.

PMID- 1636130
TI  - Ontogeny of nonimmune defense mechanisms.

PMID- 1636131
TI  - Salmonella infections of the abdominal aorta.
AB  - Salmonella accounts for up to one-third of all primary abdominal aortic
      infections. During the past ten years, we have treated three patients with this
      disease and have reviewed an additional 61 instances found in the English
      literature. The overall survival rate was 46 percent. Fever and back or abdominal
      pain were present in more than 90 percent of the patients, while a pulsatile mass
      was present in only 42 percent of those reported. Blood cultures were positive in
      73 percent of patients. Computed tomography and angiography were helpful in
      delineating the presence of aneurysms and defining the extent. Twenty-two
      patients were treated without undergoing aortic resection; there were no
      survivors. One patient had an aortic resection without reconstruction and
      survived. Twenty-eight patients were treated with aortic resection and anatomic
      reconstruction. Six patients in this group died of graft sepsis and an additional
      six patients required graft removal for persistent infection. In contrast, 18 of
      19 patients treated with extra-anatomic grafting and aneurysm resection survived,
      with only one death from aortic stump sepsis. No patient has required graft
      removal for sepsis. These results suggest that aneurysm resection and extra
      anatomic bypass is the treatment of choice in patients with Salmonella infections
      involving the infrarenal aorta.

PMID- 1636132
TI  - A comparison of outcome after resection for squamous cell carcinomas and
      adenocarcinomas of the esophagus and cardia.
AB  - Among 625 patients with squamous cell carcinoma and 134 patients with
      adenocarcinoma of the esophagus and cardia, a one stage resection was performed
      upon 375 patients of the squamous carcinoma group (excluding
      pharyngolaryngoesophagectomy) and 92 patients in the adenocarcinoma group. The
      patients formed the basis of the current analysis. Male to female ratio was 7:1
      for those with squamous carcinoma compared with 3.6:1.0 for those with
      adenocarcinoma (p = 0.037). Most squamous carcinomas were located in the middle
      one-third (56.3 percent) and lower one-third (33.0 percent) of the esophagus.
      Adenocarcinomas were predominantly found at the cardia (91.3 percent) and lower
      one-third (6.5 percent). Postoperatively, respiratory complications occurred in
      34.4 percent of patients in the group with squamous carcinoma and in 19.6 percent
      of patients in the group with adenocarcinoma (p = 0.01). Cardiac complications
      occurred in 28.3 percent of patients in the group with squamous carcinoma and in
      16.3 percent of patients in the group with adenocarcinoma (p = 0.03). Anastomotic
      leaks were uncommon for both groups (4.3 and 5.4 percent, respectively).
      Anastomotic recurrence occurred in 6.1 and 7.6 percent of patients, respectively.
      Respiratory complications, malignant cachexia and sepsis accounted for most of
      the deaths in the hospital. The 30 day mortality rates for patients with squamous
      carcinoma and adenocarcinoma were comparable (4.8 and 6.5 percent, respectively)
      (p = 0.33). After 30 days, mortality rates differed significantly (11.7 and 3.3
      percent, respectively) (p = 0.026). The overall hospital mortality rates,
      however, were comparable (16.5 and 9.8 percent, respectively) (p = 0.14). The
      overall five year survival rate for both groups was 15 percent. For patients with
      squamous carcinomas, the five year survival rate after curative resection was 31
      percent compared with 5 percent for palliative resection. For patients with
      adenocarcinomas, the respective five year survival rates were 35 and zero
      percent. It was concluded that the two types of tumor differ significantly in the
      incidence of postoperative morbidity, but mortality and the long term survival
      rates were similar.

PMID- 1636133
TI  - A prospective randomized double blind study of perioperative antibiotic use in
      the grafting of ulcers of the lower extremity.
AB  - We conducted a prospective, randomized, double blind study of the use of a
      perioperative antibiotic in the skin grafting of arterial and venous ulcers of
      the lower extremity. Ninety-four patients were randomized and 90 were available
      for analysis. There was no statistically significant difference in graft "take"
      or incidence of recipient site infection in the antibiotic versus the no
      antibiotic group.

PMID- 1636134
TI  - Treatment of calculi of the common bile duct.
AB  - Endoscopic sphincterotomy (EST) is regarded as an alternative therapeutic
      approach to the surgical treatment of choledocholithiasis. To clarify the
      indication for each of these two methods, a prospective study has been performed
      comparing patients with calculi of the common bile duct who had undergone
      endoscopic or surgical treatment. Mortality, morbidity and stone clearance were
      used as criteria for the evaluation of the dependence of age on results achieved
      by the two modalities. Of 306 patients with choledocholithiasis, 199 underwent
      surgical exploration of the duct and 107 underwent endoscopic sphincterotomy.
      Patients who were more than 60 years of age and had previously undergone
      cholecystectomy underwent endoscopic sphincterotomy. All other patients had
      surgical treatment. There were no significant differences among the two groups
      with regard to mortality rates. The incidence of relevant complications as well
      as the incidence of surgical revisions related to postoperative complications in
      the operation group was, however, significantly higher (p less than 0.05). In
      contrast with this, the incidence of retained stones was significantly lower (p
      less than 0.01) in the group that underwent surgical treatment (2.5 percent) than
      in the group that had endoscopy (11.2 percent). When assessing the results in
      terms of stone clearance, complications and mortality rates, findings seem to
      indicate that a safe limit for the application of surgical treatment would be 60
      years of age, whereas older patients should be primarily considered as candidates
      for EST.

PMID- 1636135
TI  - Reflux esophagitis and carcinoma.
AB  - Early detection of a malignancy in reflux esophagitis should permit an effective
      surgical action if a causal time relation between reflux, esophagitis and
      carcinoma exists. In the medical literature on tumors of the esophagus associated
      with reflux esophagitis, it has been reported that they are adenocarcinomas in
      most instances. Squamous carcinomas are seldom mentioned. In a population of
      patients with five squamous carcinomas and 13 adenocarcinomas associated with
      reflux, three squamous carcinomas had developed on stage III or on a stenotic
      esophagitis and two squamous carcinomas were at the upper limit of a Barrett's
      esophagus. The 13 adenocarcinomas were associated with a Barrett's esophagus. No
      carcinoma was found to be associated with a low grade esophagitis. During the
      same time period, 224 patients were operated upon for a serious documented
      esophagitis (stage III, stenotic, Barrett's esophagus), including the 18 patients
      with carcinoma. Five hundred and thirty-four patients were operated upon for a
      lower grade esophagitis, with no associated carcinoma and 592 patients were
      operated upon for carcinoma of the esophagus. The five squamous carcinomas
      associated with reflux were resected and classified T1 N0. The 13 adenocarcinomas
      associated with reflux were resected and classified T1 N0 M0 (two patients), T2
      N0 M0 (two), T3 N0 M0 (five), T3 N1 M0 (one patient), T3 N2 M0 (one) and T3 N3 M0
      (two patients). Four patients with squamous carcinomas were alive after two, six,
      nine and 15 years. Eight patients with adenocarcinomas were alive after two years
      (one patient), three years (two patients), four years (three), five years (one
      patient) and seven years (one). Three carcinomas were diagnosed by routine
      endoscopy. The mean age of the patients with carcinoma associated with reflux was
      older than in the general carcinoma series, the relative number of females was
      higher and the use of alcohol and tobacco was not as frequent, but the
      differences were not significant. In squamous and columnar carcinomas, a long
      history was significant (p less than 0.001); in Barrett's esophagus, loss of
      weight (p less than 0.01), intestinal epithelium (p less than 0.001) and
      dysplasia (p less than 0.01) were also significant. In one patient, carcinoma was
      discovered during the follow-up evaluation of an antireflux procedure for
      Barrett's esophagus.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1636136
TI  - Total exenteration, two or one ostomy.
AB  - Total exenterations require fecal and urinary diversions, necessitating ostomies
      in the anterior abdominal wall. This article was done to explore the possibility
      of extremely low anastomoses of the intestine to the anal stump, to reduce the
      number of ostomies to only one for the urinary diversion. Although technically
      feasible, the long term follow-up evaluation of these patients resulted in us
      having reservations concerning function.

PMID- 1636137
TI  - Patient characteristics, methods of diagnosis and treatment of melanoma in the
      United States.
AB  - The American College of Surgeons performed a patient care and evaluation study of
      melanoma for 1981 and 1987 to determine the presenting symptoms, methods of
      evaluation, clinical management and resulting outcome. Melanomas of the skin,
      eye, mucous membrane, metastases with unknown primary site and miscellaneous
      sites were included. Details concerning 5,004 patients from 681 hospitals in the
      study in 1981 and 6,900 patients from 844 hospitals in the study in 1987 were
      obtained--most melanomas were located in the skin; a decline in symptoms occurred
      at initial diagnosis; an increase in age at first diagnosis was reported; most
      melanomas were in Caucasian patients; slightly more melanomas occurred in men
      than women; more melanomas occurred in men on the head and neck and trunk, and
      more in the lower extremity in women; most tumors were not large in diameter; a
      significant shift was reported to lower levels of Clark's invasion, and a
      significant amount of unknowns existed in the Breslow's thickness of invasion.
      The large number of unknowns makes analysis difficult, but there seems to be some
      shift toward thinner levels of Breslow's in tumors in which it was known, from
      1981 to 1987. Only a small proportion of patients in the current series was known
      to have node involvement or known distant metastases. An overall decline in
      diagnostic studies occurred between 1981 and 1987.

PMID- 1636138
TI  - The course of severe foot infection in patients with diabetes.
AB  - Infection of the foot is a limb threatening condition for patients with diabetes
      mellitus. Identification of patients with diabetes and severe infection of the
      foot most likely to benefit from early revascularization or major amputation
      would improve the results of a treatment policy to prevent limb loss and avoid
      futile delays in amputation. During a nine year period, 79 diabetic patients
      underwent emergency procedures for severe infection of the foot during the
      initial hospitalization period. None of the patients underwent arterial
      reconstruction. Eventually, 21 of the patients required a major amputation, eight
      during the initial hospitalization and 13 on a subsequent admission. Stepwise
      discriminant analysis of clinical independent variables revealed that the
      patients most likely to require a major amputation during the initial
      hospitalization were those with an absent dorsalis pedis pulse and a
      polymicrobial infection (p = 0.018). The overall amputation rate (immediate or
      subsequent amputation) was higher for patients of either sex with nonpalpable
      pedal pulses when compared with those with at least one palpable pulse (p less
      than 0.05). Males who were not dependent on insulin had the highest risk of
      overall limb loss (p = 0.01). Patients undergoing delayed amputation required a
      significantly higher number (p = 0.01) of readmissions to the hospital for
      recurrent infection of the foot than those who did not undergo amputation. Data
      in the current study suggest that early major amputation in a subset of patients
      would prevent delay in the rehabilitation process of the amputee, decrease long
      term morbidity and reduce health care cost. An aggressive policy of early
      revascularization in patients with a pulse deficit may reduce the amputation rate
      in those with diabetes with severe infection of the foot.

PMID- 1636139
TI  - Achieving local control for inflammatory carcinoma of the breast.
AB  - A single institution, retrospective study of 28 patients with inflammatory
      carcinoma of the breast treated from 1984 to 1990 was performed. Patients
      received two to four cycles of cyclophosphamide, doxorubicin and 5-fluorouracil
      (CDF) and were then evaluated for mastectomy. Mastectomy was accomplished in 26
      patients after CDF. In 21 patients, the breast was resectable after the initial
      doses of chemotherapy and modified radical mastectomy was done. Radiation therapy
      was given to 16 of the 21 patients after six to nine cycles of postoperative
      chemotherapy. The remaining five of 26 patients had a marginal response to CDF
      and underwent preoperative radiation therapy. Local recurrence occurred in four
      of five patients receiving preoperative radiation, in three of 16 receiving
      postoperative radiation and in one of five receiving mastectomy without radiation
      therapy. The overall observed five year survival rate was 18 percent, with a
      median of 34 months. Neither dermal lymphatic invasion nor estrogen receptor
      status were statistically significant variables when analyzing patients for local
      recurrence or survival. Despite poor long term survival results, the combination
      of induction CDF, mastectomy and postoperative radiation achieved local control
      in 81 percent of patients.

PMID- 1636140
TI  - Postprandial peptide YY release is mediated by cholecystokinin.
AB  - Peptide YY (PYY), a 36 amino acid peptide, is a member of the structurally and
      functionally related pancreatic polypeptide (PP) family of gastrointestinal and
      neurally active peptides. Peptide YY is released postprandially from the distal
      small intestine and colon and has been shown to inhibit many physiologic actions
      of cholecystokinin (CCK), an integral foregut hormonal stimulant of pancreatic
      and gastric secretion. The specific signals for the release of PYY have not been
      ascertained, although foregut signals, both neural and hormonal, are likely. In
      this study, we evaluated the possible role for CCK in postprandial PYY release in
      eight conscious dogs. Conscious dogs were given a fat meal or a one hour
      intravenous infusion of CCK-8. On separate days, the dogs were pretreated with
      the specific CCK receptor antagonist L-364,718. Peripheral blood samples were
      collected for radioimmunoassay for PYY, PP and neuropeptide Y. The fat meal and
      exogenous CCK stimulated PYY and PP release, effects that were abolished by
      pretreatment with the CCK receptor antagonist. The results provide support for a
      physiologic role of CCK in the mediation of postprandial PYY and PP release.
      Furthermore, an inhibitory feedback loop is suggested between the hindgut (PYY)
      and the foregut (CCK).

PMID- 1636141
TI  - Carcinoma arising in Barrett's esophagus.
AB  - During the period 1971 and 1990, 500 patients underwent resection for carcinoma
      of the esophagus, 51 of whom had an associated Barrett's esophagus. Of these, 49
      had adenocarcinoma and two had squamous cell carcinoma. Barrett's carcinoma
      accounted for 23.7 percent of the surgically treated adenocarcinomas during this
      period. Reflux symptoms were present in 13 patients preoperatively. Tumors
      developed in four patients who had undergone previous antireflux operation and in
      two patients on the surveillance program. By postresection staging, 18 patients
      had stage II tumors and 33 patients had stages III and IV tumors. Stage and
      length of the tumor were the only prognostic determinants. The overall 90 day
      hospital mortality rate was 17.6 percent. The hospital mortality rate before 1986
      was 22.9 percent, but decreased to 6.3 percent in the last five years. The one,
      two and five year survival rates were 45.9, 25.0 and 13.6 percent, respectively.
      The five year survival rate was significantly greater for patients with stage II
      (25 percent) than for patients with stages III and IV (4.5 percent) (p less than
      0.05) and for tumor length less than 6 centimeters (21 percent) than for tumors
      greater than 6 centimeters (zero percent; p less than 0.001).

PMID- 1636142
TI  - Modified suburethral sling procedure for treatment of recurrent or severe stress
      urinary incontinence.
AB  - The most suitable material used to perform suburethral sling procedures for
      recurrent or severe stress urinary incontinence remains controversial. A
      comparison was made between two commonly used materials, synthetic Gore-Tex
      (expanded reinforced polytetrafluoroethylene) and autologous fascia lata. Both
      groups showed improved urethral pressure profiles postoperatively, but there was
      no difference in the magnitude of change between groups. The objective cure rate
      at six months for the Gore-Tex group was 100.0 versus 87.5 percent for the fascia
      lata group (p = 0.155). While there was no statistical difference between the
      incidence of de novo detrusor instability or length of postoperative bladder
      drainage (p = 0.104 and p = 0.978, respectively), there was a trend toward more
      postoperative complications of urinary obstruction in the Gore-Tex group.

PMID- 1636143
TI  - A new double-turn one-hand knot.
AB  - The technique of making a one-hand double or triple turn thrust of a suture is
      described. The advantage of the technique is the low risk of gliding of the first
      thrust and the decreased need of assistance.

PMID- 1636144
TI  - Total hepatic mesh wrap for hemostasis.
AB  - To improve hemostasis and avoid the complications of perihepatic packing, a
      technique of hepatic tamponade using total mesh wrap is reported. The method is
      geometrically, technically and mechanically feasible and appears to be effective
      in controlling severe parenchymatous bleeding.

PMID- 1636145
TI  - A new technique to correct vascular steal secondary to hemodialysis grafts.
AB  - Three patients are described who developed symptomatic steal distal to
      hemodialysis grafts, documented by angiodynography. Intraoperatively, the graft
      was plicated to increasing depths while using angiodynography over the radial and
      ulnar artery. When the flow became antegrade, the plication was stopped,
      resulting in salvageable grafts. Using the technique, all three patients had long
      use of the graft after the steal was corrected.

PMID- 1636146
TI  - Immunologic associations of keloids.
AB  - The mechanisms underlying the pathogenesis of keloids have not been fully
      characterized despite extensive past and present research. Results of past and
      present studies have shown that the immune system is actively involved in the
      development of these lesions. Future investigations into the biochemistry and
      immunologic factors of keloids are anticipated and expected to produce additional
      insight. The inability to identify cellular (fibroblast) abnormalities has led
      most investigators to focus on the humoral regulators of wound healing, that is,
      biochemical substances, immunologic mediators and growth factors. Future studies
      are needed to confirm or refute the presence of AFA. AFA, if they exist, may
      prove to be useful as immunologic markers of keloids and may help distinguish
      keloids from hypertrophic scar in the early stages of wound healing. The
      influence of immunologic mediators may be more impressive early in the
      development of scars. "Young" or "early" is defined as less than two years of
      age, whereas "old" or "late" keloids are more than two years of age. We suggest
      that future studies stratify keloids into early versus late and also measure the
      rates of collagen synthesis of fibroblasts derived from the normal and abnormal
      specimens from the same patient. Analysis of the leukocyte factors will clarify
      the role the immune system has in the regulation of collagen synthesis.
      Preliminary investigations have shown that immunotherapy may be of value in the
      treatment of keloids. The role of fibroblast heterogeneity needs to be
      investigated. It is not known which aspects of fibroblast heterogeneity are
      responsible for the localized and accelerated rates of collagen synthesis of
      keloid fibroblasts.

PMID- 1636147
TI  - Exigent postinjury thoracotomy analysis of blunt versus penetrating trauma.
AB  - We reviewed the recent experience with urgent thoracotomy performed in the
      operating room (OR) to compare the relative indications and injury pattern after
      blunt versus penetrating trauma. Among 2,316 patients admitted with acute trauma
      of the chest, excluding 319 undergoing thoracotomy at the emergency department,
      83 required urgent OR thoracotomy; 27 patients (3 percent) sustained blunt
      trauma, 32 (4 percent) had stab wounds (SW) and 24 (7 percent) had gunshot wounds
      (GSW). The indications for operation after blunt trauma were shock (48 percent)
      and angiographically defined great vessel injuries (48 percent). For SW,
      thoracotomy was done for tamponade (50 percent), excessive chest tube output (28
      percent) or shock (15 percent), and for GSW, thoracostomy output (50 percent),
      shock (25 percent) or tamponade (12.5 percent). Descending thoracic aorta (DTA)
      or other arch vessel tears were confirmed in 48 percent of patients with blunt
      trauma requiring thoracotomy; the remaining had pulmonary (31 percent) or cardiac
      wounds (7 percent). The most frequently encountered injuries in patients with SW
      were cardiac (46 percent) and pulmonary (37 percent), while the patients with GSW
      had predominantly pulmonary (72 percent) and cardiac (14 percent) injuries. The
      surgical management of blunt versus penetrating chest trauma differs with respect
      to the indications for urgent thoracotomy as well as the underlying injury
      pattern. The most common indication for urgent thoracotomy after penetrating
      injuries was excessive chest tube output (37.5 percent). Excluding torn DTA, only
      14 of 822 patients (1.7 percent) admitted with blunt chest trauma required urgent
      thoracotomy and 13 of these patients (93 percent) presented in a state of
      refractory shock because of active thoracic hemorrhage. Thus, in contrast with
      penetrating wounds, urgent thoracotomy for blunt trauma is rarely justified on
      the basis of chest tube output alone.

PMID- 1636148
TI  - Muscarinic M2-selective ligands also recognize M4 receptors in the rat brain:
      evidence from combined in situ hybridization and receptor autoradiography.
AB  - We have used autoradiographic techniques to examine the characteristics and
      distribution of the binding of reported selective M2 muscarinic ligands and
      compared them with the distribution of cells expressing mRNAs for the different
      subtypes of muscarinic receptors. Our results suggest that the M2 ligands used in
      the present study ([3H]OXO-M, ([3H]OXO-M,[3H]AF-DX384,AF-DX116, methoctramine)
      also recognize M4 receptors present in regions such as the striatum and olfactory
      tubercle. This is supported by 1) relative abundances of the different
      transcripts, with m2 mRNA being very scarce and m4 mRNA very abundant in these
      regions; 2) comparison of the pharmacological characteristics of M2-ligand
      binding sites in brain areas selected by their exclusive expression of M2
      receptors versus areas enriched in M4 receptors. An important conclusion of these
      studies is that none of the muscarinic radioligands available at the present time
      appears to label specifically a single muscarinic receptor subtype population.
      Areas are suggested where autoradiographic techniques can be helpful in
      elucidating the subtype selectivity of existing and new ligands.

PMID- 1636150
TI  - Evidence for GABAergic interneurons in the red nucleus of the painted turtle.
AB  - Immunocytochemical and electrophysiological evidence supporting the presence of
      GABAergic interneurons in the turtle red nucleus is presented. Injections of HRP
      into the spinal cord produced labeling of large neurons in the contralateral red
      nucleus. The peroxidase-antiperoxidase (PAP) method revealed smaller cells
      immunoreactive to an antibody against glutamate decarboxylase (GAD), the
      synthetic enzyme for the inhibitory neurotransmitter GABA, that were interspersed
      among larger immunonegative neurons. Similar small neurons were densely
      immunostained by antibodies to GABA-glutaraldehyde conjugates obtained from
      different sources and applied according to pre-embedding and postembedding
      protocols. Rubrospinal neurons retrogradely labeled with HRP measured 16 and 27
      microns in mean minor and major cell body diameters, while GABA-like
      immunopositive neurons situated within the red nucleus measured 7 and 13 microns.
      There was very little overlap in soma size between the two cell populations.
      Therefore, we suggest that the GAD- and GABA-positive neurons may be local
      inhibitory interneurons. This notion is further supported by observations of pre
      embedding immunostaining for GAD and postembedding immunostaining for GABA
      showing that the turtle red nucleus is amply innervated by immunoreactive axon
      terminals. These puncta are closely apposed to cell bodies and dendrites of both
      immunonegative large neurons and immunopositive small neurons. Moreover,
      immunogold staining at the electron microscopic level demonstrated that GABA-like
      immunoreactive axon terminals with pleomorphic synaptic vesicles formed symmetric
      synapses with cell bodies and dendrites of the two types of red nucleus cells.
      These ultrastructural features are commonly assumed to indicate inhibitory
      synapses. A moderately labeled bouton with round vesicles and asymmetric synapses
      was also observed. In addition, the two types of red nucleus neurons received
      asymmetric axosomatic and axodendritic synapses with GABA-negative boutons
      provided with round vesicles, features usually associated with excitatory
      functions. To obtain electrophysiological evidence for inhibition, intracellular
      recordings from red nucleus neurons were conducted using an in vitro brainstem
      cerebellum preparation from the turtle. Small, spontaneous IPSPs were recorded
      from 7 out of 14 red nucleus cells studied. These morphological and physiological
      results provide strong support for concluding that the turtle red nucleus, like
      its mammalian counterpart, contains GABAergic inhibitory interneurons. While we
      have not identified the main source of input to these interneurons, in view of
      the scarce development of the reptilian cerebral cortex, this input is unlikely
      to come from the motor cortex as it does in mammals.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1636149
TI  - Long-term frontal brain metabolic changes in cocaine abusers.
AB  - Neurological complications from cocaine use are well recognized. We propose that
      chronic cocaine use can also cause clinically silent brain dysfunction. We
      investigated brain glucose metabolism with positron emission tomography (PET) and
      2-deoxy-2[18F] fluoro-D-glucose (FDG) in 21 neurologically intact chronic cocaine
      abusers (C) and 18 normal controls (N). The cocaine abusers were tested 1-6 weeks
      after the last use of cocaine and seven were retested after a 3 month drug-free
      period. Global cerebral glucose metabolism was not significantly different
      between controls and cocaine abusers (N = 38.4 +/- 3, C = 36.5 +/- 5 mumol/100 g
      of tissue, min). However, cocaine abusers had significantly (P less than 0.05)
      lower metabolic activity in 16 of the 21 left frontal regions and 8 of the 21
      right frontal regions. These decreases persisted after 3-4 months of
      detoxification and were correlated with the dose (P less than or equal to 0.01)
      and the years of cocaine use (P less than or equal to 0.05). This study shows
      reduced rates of frontal metabolism in neurologically intact cocaine abusers that
      persist even after 3-4 months of detoxification.

PMID- 1636151
TI  - ATP-sensitive K+ channels mediate an IPSP in dorsal horn neurones elicited by
      sensory stimulation.
AB  - Nociceptive dorsal horn neurones, which are involved in the processing of pain
      related information, are inhibited by input from vibration-sensitive, large
      diameter primary sensory fibres (Wall and Cronly-Dillon, 1960; Salter and Henry,
      1990a,b). We have reported previously that the inhibition of spinal nociceptive
      neurones by vibration is mediated by adenosine acting through P1-purinergic
      receptors (Salter and Henry, 1987). In a number of different types of cell,
      adenosine is known to activate K+ currents (Gerber et al., 1989; Greene and Haas,
      1985; Proctor and Dunwiddie, 1987; Segal, 1982; Trussell and Jackson, 1987) and
      we have recently found that the adenosine-mediated inhibition of nociceptive
      neurones by vibration is the result of an inhibitory postsynaptic potential
      (IPSP), which is, indeed, caused by a K+ conductance (De Koninck and Henry, 1988,
      1992). It has been reported that adenosine-activated K+ channels in cardiac
      muscle cells are the ATP-sensitive K+ channels (Kirsch et al., 1990). Therefore,
      we questioned whether these channels might mediate the purinergic IPSP we have
      observed in nociceptive dorsal horn neurones. We report here that glibenclamide,
      a blocker of ATP-sensitive K+ channels (Ashcroft, 1988; Schmid Antomarchi et al.,
      1987a,b), blocks the inhibition of nociceptive neurones by vibratory stimulation
      when this compound is administered locally by iontophoresis or systemically by
      intravenous injection. In addition, direct intracellular injection of ATP was
      found to block the IPSP evoked by vibratory stimulation. These data indicate that
      the purinergic IPSP in nociceptive spinal neurones is mediated via ATP-sensitive
      K+ channels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636152
TI  - Oscillation of interspike interval length in substantia nigra dopamine neurons:
      effects of nicotine and the dopaminergic D2 agonist LY 163502 on
      electrophysiological activity.
AB  - The rates and patterns of discharge activity exhibited by 16 spontaneously active
      substantia nigra pars compacta dopamine neurons were studied in halothane
      anesthetized rats using three types of quantitative measures: 1) mean discharge
      rates, 2) population characteristics of interspike interval samples, and 3)
      interspike interval time-series measures which were used to examine patterns in
      the ordering of interspike intervals. The mean discharge rate of these 16 cells
      was 2.9 +/- 0.3 spikes/sec, and each cell was classified as bursting (25% of the
      cells) or non-bursting (75%). The distribution of interspike intervals of non
      bursting neurons were more normally distributed. Time-series analyses (raw time
      series plots, return maps, and phase portraits) revealed a substantial
      oscillatory tendency in the magnitudes of consecutive interspike intervals in
      these neurons under baseline conditions: Successive interspike intervals tended
      to alternate between short and long durations, although short bursts often
      occurred. Under baseline conditions, these cells exhibited both multispike bursts
      and consecutive long intervals less frequently than would have been predicted by
      chance ordering of the interspike intervals. These results imply that there are
      mechanisms acting to reduce the probability of these types of events. Locally
      infused nicotine enhanced discharge rates in these neurons. Burst firing
      increased in four neurons, while five neurons did not show any change in burst
      firing. LY 163502 induced significant decreases in both discharge rate and
      bursting activity in all cells tested. The variation coefficient, skew, and
      kurtosis of the interspike interval distributions were not consistently altered
      by either drug. The local infusion of either nicotine or LY 163502 decreased the
      oscillatory phenomenon seen in the baseline condition. Neither the nicotine or LY
      163502 time-series data exhibited a larger proportion of long-short and short
      long pairs (relative to the median interval) than would be expected by chance. It
      is hypothesized that these neurons have intrinsic mechanisms, made manifest under
      anesthesia, which induce oscillations in interspike interval length. The
      oscillatory effect of these mechanisms can be overridden by tonic increases in
      either excitatory or inhibitory tone.

PMID- 1636153
TI  - Ounce of care worth tons of cash.

PMID- 1636154
TI  - Leadership ... requires tow E's.

PMID- 1636155
TI  - [Quality control in thoracic roentgen images].

PMID- 1636156
TI  - [Lung radiology].
AB  - Specific clinical problems of the lung ask for evaluation by specific imaging
      methods. Chest radiography, although still fundamental, is used more carefully,
      whereas computed tomography, nuclear medicine methods, MRI and angiography all
      contribute to answer specific questions.

PMID- 1636157
TI  - [Imaging methods in musculoskeletal radiology].
AB  - Musculoskeletal disorders can be examined by conventional radiography, nuclear
      bone scan, computerized tomography, ultrasound and magnetic resonance imaging.
      The potentials and limitations of each method determine the individual
      application, depending whether the etiology, the extension or the follow-up of a
      bony lesion is evaluated.

PMID- 1636158
TI  - [Ultrasound diagnosis of the abdomen].
AB  - Ultrasonography is the method of first choice for the rational work-up of
      abdominal pathologies. The results and limitations of this method for diagnosis
      of diseases of the gallbladder, bile ducts, liver, pancreas, spleen, kidney and
      urinary tract, adrenal glands, vessels and lymph nodes, female pelvis and
      gastrointestinal tract are presented in a short overview. Particular reference is
      made to a critical approach, emphasizing relevant further investigations.

PMID- 1636159
TI  - [Radiation protection in diagnostic radiology].
AB  - For every diagnostical X-ray radiation exposure the applied dose has to be
      limited to the smallest possible value. Within the scope of a general Swiss
      survey it has been found that in the various medical practices and hospitals the
      applied doses varied quite strongly. The main reasons leading to an overdose were
      the operating conditions of the X-ray and film processing equipment, the film and
      foil materials and improper filming techniques. The applied single dose served as
      a measure for the radiation protection assessment of diagnostical X-ray
      exposures. To prevent this in the future, individual patients who are exposed to
      unnecessary radiation loads should be regularly checked in quality-ensuring
      tests.

PMID- 1636160
TI  - Safety of virus inactivated antithrombin III concentrate antithrombin III immuno
      (AT III).
AB  - In a prospective clinical trial the risk of infection after application of virus
      inactivated antithrombin III concentrate ANTITHROMBIN III IMMUNO (AT III) was
      investigated in patients undergoing cardiovascular surgery. The study was
      conducted according to the recommendations of the International Committee on
      Thrombosis and Hemostasis (ICTH), with the exception that most patients required
      additional blood products as well as AT III. Twenty-seven patients were eligible
      to test for the risk of acquiring hepatitis B. Twenty-six patients could be
      evaluated in terms of hepatitis NANB transmission considering ALT-levels whereas
      20 patients could be tested for anti-HCV one year after surgery. Samples from 78
      patients could be monitored for anti-HIV-1. None of these patients showed any
      signs of infection. AT III IMMUNO seems to be an antithrombin III concentrate
      with low or absent infectivity.

PMID- 1636161
TI  - Effects of 9, 12, 15-octadecatrien-6-ynoic acid on the metabolism of arachidonic
      acid in platelets and on platelet aggregation.
AB  - An acetylenic fatty acid: 9,12,15-octadecatrien-6-ynoic acid (dicranin) was
      extracted from Dicranum Scoparium and preincubated with platelets which were then
      stimulated by exogenous arachidonic acid (20:4 n-6). This molecule at 10(-4) M
      weakly inhibited the cyclooxygenase activity as assessed by measurement of 12
      hydroxy-heptadecatrienoic acid (HHT) In contrast, the 12-hydroxy-eicosatetraenoic
      acid (12-HETE) synthesized by the 12-lipoxygenase was strongly increased by about
      650%. The same effects were observed with 10(-5) M and with 10(-6) M of dicranin
      but to a lesser extent. Platelet hydroxylated dicranin metabolites were also
      found and the structure of the main compound determined by GC-MS was a 13-hydroxy
      derivative. Its origin has not yet been elucidated. Platelet aggregation induced
      by 1 microgram/ml of U46619, a structural PGH2 analogue was completely abolished
      in the presence of dicranin. Platelet aggregation induced either by thrombin or
      by arachidonic acid was inhibited by 10(-4) M of dicranin only after
      preincubation. This observation indicates that the formation of metabolites of
      dicranin are necessary to effect this inhibition. Dicranin is thus a new
      inhibitor of platelet aggregation and may prove to be useful for elucidating the
      effects of 12-HETE in biological systems.

PMID- 1636162
TI  - Pharmacokinetics of two pasteurized factor VIII concentrates by different and
      multicenter assays of factor VIII activity.
AB  - We assessed the pharmacokinetic characteristics of a new high-purity pasteurized
      FVIII concentrate in comparison with an intermediate purity pasteurized
      concentrate, produced by the same manufacturer. The study was designed as a cross
      over single-dose pharmacokinetic investigation in 8 non-bleeding patients with
      severe hemophilia A. All patients were given 25 IU/kg of each of the two
      concentrates, with an interval of at least one week between the two
      administrations. Decay curves were assessed by collecting 10 serial blood samples
      over 36 hours following the end of infusion. The concentration of Factor VIII in
      blood samples was determined in triplicate in three different laboratories using
      each of the following assay methods: a one-stage clotting assay, a two-stage
      clotting assay, and a two-stage chromogenic-peptide substrate assay. All
      pharmacokinetic parameters were calculated by model-independent methods. The two
      products were found to differ significantly both in the clearance, which was on
      average 13.8% lower for Haemate P, and in the in-vivo recovery, which was 11.7%
      lower for Factor VIII:C P on the average. In comparison with previous
      pharmacokinetic data obtained from other heated Factor VIII concentrates, the
      clearance of Haemate P was found to be significantly slower, while the half-life
      of both products was longer. No differences were observed in the Vd-area. These
      findings indicate that the purification procedures to which both products are
      subjected do not increase the in-vivo rate of plasma disappearance of Factor
      VIII.

PMID- 1636163
TI  - Possible role of plasminogen activator inhibitor 2 in the prevention of the
      metastasis of gastric cancer tissues.
AB  - The concentrations of urinary type plasminogen activator (u-PA), plasminogen
      activator inhibitor 1 (PAI-1), and PAI-2 were measured in gastric cancer tissues
      and adjacent healthy mucosal tissues. Levels of u-PA, PAI-1 and PAI-2 were higher
      in cancer than in control tissues. PAI-1 levels were higher together with the
      progression of cancer however there were no differences in u-PA or PAI-2 levels.
      Tumors with higher PAI-1 and lower PAI-2 levels tend to metastasize to remote
      lymph nodes. When the numbers of involved lymph nodes were analyzed, tumors with
      the large number of metastatic lymph nodes showed higher PAI-1 and lower PAI-2
      level. No difference was shown in u-PA levels among these groups. These
      tendencies were more significant in patients with progressed gastric cancer.
      These results suggest that tumor with higher PAI-2 levels tend to localize or
      have less tendency to metastasize to lymph nodes. On the other hand PAI-1 was
      generally higher in tumor with invasion into nearby tissue or with nodal
      metastasis.

PMID- 1636164
TI  - Influence of oxygen radicals generating agents on eicosanoid metabolism of human
      endothelial cells.
AB  - Human umbilical venous endothelial cells were incubated with increasing
      concentrations (0.001-10 mmol/l) of H202 or cumene hydroperoxide. PGI2 was
      released within the first five minutes, whereas a significant increase in TXA2
      release was not observed before 10 minutes after stimulation. Furthermore the
      content of intracellular ATP and the level of cytosolic free Ca2+ were measured.
      Doses of 0.01 mmol/l H202 or cumene hydroperoxide increased the intracellular ATP
      level. Doses higher than 0.1 mmol/l led to a decrease of ATP. The cytosolic free
      calcium (Ca2+) increased on stimulating the cells with 0.1 mmol/l cumene
      hydroperoxide between 120 and 240 seconds after stimulation, whereas 0.1 mmol/l
      H202 had no effects. These data give strong evidence, that eicosanoid-synthesis
      is directly started by oxygen radicals, followed by an elevation of intracellular
      free Ca2+.

PMID- 1636165
TI  - LPS-induced, but not interferon-gamma-induced procoagulant activity of suspended
      human macrophages is followed by a refractory state of low procoagulant
      expression.
AB  - Monocyte-derived macrophages cultured under a variety of conditions were assessed
      for expression of procoagulant activity (PCA) upon induction by various triggers,
      using a semiautomated turbidimetric recalcification time assay in a kinetic ELISA
      reader. Macrophages cultured in a nonadherent (teflon) culture system and seeded
      in microtiter plates responded with PCA expression to lipopolysaccharide (LPS),
      to toxic shock-syndrom toxin-1 (TSST-1) and to surface-bound IgG, but not to
      surface-bound albumin, nor to interferon-gamma (IFN-gamma). In contrast,
      macrophages stimulated in teflon containers by IFN-gamma showed a strong PCA
      response peaking around 24 hr after stimulation, but they failed to secrete
      tumour necrosis factor (TNF). Suspended IFN-gamma-stimulated cells showed a
      similar response upon 2nd stimulation by LPS or IgG after adherence to microtiter
      plates as did nonprimed counterparts. In contrast, cells primed in suspension,
      then cultured in adherence secreted dramatically enhanced amounts of TNF when
      compared with nonprimed cells. Macrophages stimulated in suspension with LPS
      showed a PCA response of similar magnitude, which was accompanied by TNF
      secretion. PCA of both IFN-gamma-primed and LPS-exposed suspension culture cells
      was largely due to the surface expression of tissue factor, and to a lesser
      extent of a prothrombinase-like activity, as evidenced by PCA testing with factor
      X-deficient plasma. The kinetics of LPS-induced PCA differed from IFN-gamma
      induced PCA, in that PCA peaked at 6 hr and fell to insignificant levels after 24
      hr. When transferred to microtiter plates at this time, they could be
      restimulated neither with LPS, nor with surface-adherent IgG nor with IFN-gamma.
      Evidence was obtained that the failure to express PCA was due to a refractory
      state of the cells rather than to the generation of cell-bound or secreted
      inhibitors of coagulation. The loss of PCA expression could be prevented by pre
      exposure to IFN-gamma. Thus, PCA expression may be dissociated from other
      functional and/or activation parameters (e.g. TNF secretion). For the first time,
      a state in which cells are completely unresponsive to PCA induction has been
      identified. Should lower LPS concentrations also be found to induce such a
      refractory state, our results may be of pathophysiological significance.

PMID- 1636166
TI  - Determination of soluble fibrin: a comparison of four different methods.
AB  - The determination of soluble fibrin (SF) in plasma was compared using four
      different methods. The SF-ELISA immunologically measures the concentration of
      desAA- and desAABB-fibrin while the SF-tPA-test is based on activation of
      plasminogen by tissue plasminogen activator (tPA) in the presence of fibrin; the
      SF-PS-turbidimetry assay relies on the protamine sulphate (PS) -induced
      aggregation of fibrin in plasma whereas the SF-erythrocyte-agglutination-test (SF
      EAT) detects soluble fibrin by its aggregation with fibrin monomers attached to
      test erythrocytes. Soluble fibrin was generated in vitro by addition of thrombin
      or ancrod to plasma. In these experiments the soluble fibrin values of the four
      methods correlated well with each other and with the fibrinopeptide A release,
      especially in ancrod-induced fibrinogen turnover (r greater than 0.93). This high
      correlation is remarkable, considering the fact that the methods are based on
      different principles. Detection of thrombin-induced soluble fibrin was more
      sensitive; differences between ancrod and thrombin action were observed as well,
      probably due to different forms of soluble fibrin. A delayed increase of SF-PS
      turbidimetry values in particular during the thrombin action can be attributed to
      a lack of detectable aggregation of soluble fibrin at low concentrations due to
      its solubility in plasma. Subsequently, soluble fibrin was measured in samples
      from patients. The SF-ELISA and SF-tPA-test were highly sensitive and correlated
      better than the other methods with each other, but all correlations were less
      satisfactory compared with the in vitro studies. These weaker correlations might
      be explained by the heterogeneity of soluble fibrin determined by inter- and
      intraindividually varying concentrations of fibrinogen and its different
      derivatives in plasma samples from patients. All methods provided reliable
      results with differences in sensitivity, specificity and practicality. The SF-tPA
      test, SF-PS-turbidimetry, and SF-EAT are practical methods for routine use
      whereas the SF-ELISA is a highly reliable and by far the most sensitive and
      specific method thus offering new insights into pathogenesis of fibrinaemia and
      related diseases.

PMID- 1636167
TI  - Diagnostic efficacy of the D-dimer assay in disseminated intravascular
      coagulation (DIC).
AB  - The D-Dimer (D-D) assay for measuring cross-linked fibrin degradation products is
      now available for the clinical laboratory. We combined this assay with other
      tests to assess patients with diagnosed or suspected DIC. Also, a small group of
      patients (20) with deep venous thrombosis (DVT) were studied. The D-D test,
      antithrombin-III assay, FDP titer, fibrinopeptide-A level, protamine sulfate
      test, fibrinogen, prothrombin time, and activated partial thromboplastin time
      were used. The D-D test was abnormal in 93.7%, the AT-III level was abnormal in
      87.5%, the fibrinopeptide-A level was abnormal in 89.5%, and the FDP titer was
      elevated in 83.7% of patients with DIC. When assessing patients found not to have
      confirmed DIC the D-D assay was abnormal in 20%, the AT-III level was abnormal in
      6%, and the fibrinopeptide-A level was elevated in 13%. We conclude the D-Dimer
      assay to be a useful molecular marker of hemostasis in diagnosing DIC and this
      test will often discriminate between those patients with or without DIC,
      especially when used with the AT-III and fibrinopeptide-A assays. Of the battery
      of tests used in this study, the most useful, in descending order of efficacy,
      appear to be the D-dimer assay (93.7% abnormal), the fibrinopeptide-A titer
      (89.5% abnormal), the AT-III level (87.5% abnormal), and the FDP titer (83.7%
      abnormal). Of the global tests, the diagnostic efficacy of the prothrombin time
      activated partial thromboplastin time, and protamine sulfate test were no greater
      than chance and appear to be of little use in aiding in a diagnosis of DIC. Also,
      the D-Dimer assay is similar in cost to the FDP titer and is cost effective for
      the routine clinical laboratory.

PMID- 1636168
TI  - Factor XIIIA2/XIIIB2 ratio in severely traumatized patients with soft tissue
      trauma.

PMID- 1636169
TI  - Purification of bovine histidine-rich glycoprotein.

PMID- 1636170
TI  - "Rebleeding" the reversal of shear stress activation of platelets--a possible
      clue to thrombogenesis.

PMID- 1636171
TI  - Spatial and temporal regulations in helicoidal extracellular matrices: comparison
      between plant and animal systems.
AB  - This paper proposes an overview of the last few years' investigations regarding
      the helicoid formation in extracellular matrices (ECMs). Despite the
      architectural polymorphism displayed among the layered ECM throughout the living
      kingdom, helicoidal structures are often described in ECMs and appear as an
      optimal mechanical device. Helicoids correspond to complex two-phases composites,
      formation and regulation of which are still a source of debate. Taking the time
      event into consideration, it is clear that helicoid in ECMs are regulable
      structures. On the other hand, analogies with helicoidal formations in
      cholesteric liquid crystals strongly support the hypothesis of involvement of
      self-assembly processes. Therefore the balance between self-assemblies and cell
      regulation is questioned. By gathering animal and plant data on the topic and by
      analysing the characteristics of these helicoids in ECMs, it is clear that cells
      have the necessary machinery to interfere with the self-assembly processes in
      response to physiological or mechanical mechanisms. They are able to modify the
      physicochemical conditions outside the plasma membrane, therefore acting on the
      pattern of self-assembly. Several mechanisms are proposed to explain sudden
      variations occurring in the helicoidal formation with time.

PMID- 1636172
TI  - The interphase microtubule cytoskeleton of five different phenotypes of
      microvessel endothelial cell cultures derived from bovine corpus luteum.
AB  - The interphase microtubule cytoskeleton of five different microvessel endothelial
      cell cultures, recently established from bovine corpus luteum, was analysed using
      anti-tubulin immunofluorescence. An antibody against acetylated microtubules
      detected four cell types each of which possessed a single cilia. The length of
      the cilia were up to 10 microns for cell types 1 and 2. Ciliary stubs had a
      length of up to 0.37 microns in cell types 4 and 5. Cilia were missing in cell
      type 3. Long and short cilia were located in the perinuclear region from where
      cytoplasmic microtubules radiated. Cell type 3 displayed straight microtubules
      rather than the wavy path seen in the other cell types. The amount of tyrosinated
      microtubules visualized by a specific antibody was consistently higher than that
      of posttranslationally acetylated microtubules. The latter were more apparent in
      cell types 4 and 5 than in the other cell types. We conclude: Differences in the
      cytoplasmic microtubule inventory of each microvessel endothelial cell type
      points at individual functions maintained in culture.

PMID- 1636174
TI  - Carotid endarterectomy: a continuing cause for concern. Background.

PMID- 1636173
TI  - Production of neutrophil-specific lipid chemoattractant activity by cultured
      endothelial cells: heterogeneity dependent on species, ligand, or endothelial
      cell site of origin.
AB  - Previous studies have demonstrated that the interaction of cultured bovine aortic
      and pulmonary arterial endothelial cells and the proinflammatory vasoactive
      amines histamine, serotonin, and angiotensin II, causes production of three novel
      lipid neutrophil-specific chemoattractants that are distinct from other
      phospholipid or lipid neutrophil chemoattractants. In this study, we investigated
      the species and site specificity of this inflammatory response by incubating
      human aortic and pulmonary arterial endothelial cells with histamine, serotonin,
      and angiotensin II and assaying the supernatants for their effect on neutrophil
      migration. Each of these vasoactive amines caused production of neutrophil
      chemoattractant activity in a concentration dependent manner in both cell types.
      For each amine, production was blocked by a specific antagonist: cimetidine for
      histamine, methiothepin for serotonin-stimulated aortas, ketanserin for serotonin
      stimulated pulmonary arteries, and saralasin for angiotensin II. In each case,
      all chemoattractant activity partitioned into the organic phase and resolution by
      HPLC yielded two chemotactic lipids. As with the lipid chemoattractants produced
      by bovine endothelial cells, these lipids did not coelute with PAF, LTB4, 5-HETE,
      or 15-HETE, nor did they increase lymphocyte or monocyte migration. The pattern
      of chemotactic activity following resolution by HPLC was similar in both human
      aortic and pulmonary arterial endothelial cells, but was different from that of
      bovine aortic and pulmonary arterial endothelial cells in that only two
      chemoattractant lipids appeared; the third chemotactic lipid was never produced.
      These studies demonstrate that human endothelial cells may actively participate
      in neutrophil enriched local inflammatory responses by production of neutrophil
      specific chemotactic factors. They also suggest this response may be dissimilar
      depending on the site and species from which the endothelial cells originate.

PMID- 1636175
TI  - Symptomatic carotid artery stenosis: a solvable problem. North American
      Symptomatic carotid Endarterectomy Trial.

PMID- 1636176
TI  - Nearing the finish line? The asymptomatic Carotid Atherosclerosis Study.

PMID- 1636177
TI  - Aortogenic embolic stroke: a transesophageal echocardiographic approach.
AB  - BACKGROUND AND PURPOSE: We studied the frequency and grade of atherosclerotic
      changes in the thoracic aorta and their significance as embologenic lesions in
      patients with stroke. METHODS: Using transesophageal echocardiography, we
      evaluated complicated lesions in the thoracic aortas of 62 patients who met our
      clinical criteria for embolic stroke. A complicated lesion was defined as a
      raised lesion with an irregular surface or acoustic shadow based on a comparative
      study of echocardiographic and histopathologic findings. The results were
      compared with plain radiographic findings and in some cases with computed
      tomographic or aortographic findings. RESULTS: Twenty-six patients (42%) showed
      complicated aortic arch lesions on echocardiogram. Transesophageal
      echocardiography brought us more abundant information than other techniques.
      Aortic knob calcification by plain radiography correlated well with the presence
      of echocardiographically complicated lesions, suggesting its utility for rough
      screening of atherosclerotic changes. Fifty-two patients had other potential
      embolic sources in the heart or cervical arteries. Among the remaining 10
      patients without extra-aortic embolic sources, three showed complicated lesions
      and were diagnosed as having aortogenic embolic stroke. CONCLUSIONS: Aortic
      atherosclerosis should be recognized as an embolic source of stroke and the
      advantage of transesophageal echocardiography recognized in its evaluation.

PMID- 1636178
TI  - Reproducibility of noninvasive ultrasonic measurement of carotid atherosclerosis.
      The Asymptomatic Carotid Artery Plaque Study.
AB  - BACKGROUND AND PURPOSE: To determine the effect of a lipid-lowering agent and/or
      a low-dose antithrombotic agent on the progression of early-stage carotid
      atherosclerosis, noninvasive B-mode ultrasound was used to measure intimal-medial
      thickness in asymptomatic individuals with moderately elevated lipids as part of
      the ongoing multicenter Asymptomatic Carotid Artery Plaque Study. METHODS:
      Uniform ultrasonic scanning and reading protocols were implemented to obtain
      maximum intimal-medial thickness measurements in 12 standard segments in patients
      having a small to moderate wall thickness (1.5-3.5 mm) in at least one of the
      carotid arteries. Paired B-mode image recordings on 858 patients, performed 1
      month apart and read at a core laboratory (each pair by the same reader),
      determined both within-sonographer (W, n = 405) and between-sonographer (B, n =
      453) reproducibility. RESULTS: The primary end point (mean +/- SD), defined in
      each individual as the mean value of the 12 maximum intimal-medial thickness
      measurements, was 1.31 +/- 0.21 mm (W) and 1.32 +/- 0.22 (B) at the time of the
      second examination. The mean difference in the primary end point (exam 2-exam 1)
      was -0.01 +/- 0.13 mm (W) and 0.00 +/- 0.15 mm (B). The Pearson correlation
      coefficients were 0.79 (W) and 0.75 (B). In 90% of the patients, the absolute
      difference in the primary end point was less than 0.22 mm (W) and less than 0.24
      mm (B). Variability of the secondary end point, defined as the single largest
      intimal-medial thickness measurement in a patient, was between three and four
      times larger than the variability for the primary end point. Differences in
      sonographer performance between clinical centers were very small. CONCLUSIONS:
      The results demonstrate that standardized noninvasive ultrasonic techniques yield
      highly reproducible measures of carotid intimal-medial thickness, which can serve
      as a measure of carotid atherosclerosis in clinical trials that monitor small
      rates of lesion progression.

PMID- 1636179
TI  - Short-term prognosis of stroke due to occlusion of internal carotid artery based
      on transcranial Doppler ultrasonography.
AB  - BACKGROUND AND PURPOSE: The clinical course of stroke due to occlusion of the
      internal carotid artery is influenced by amount of collateral flow. We measured
      mean frequency shifts in the middle cerebral artery by transcranial Doppler
      ultrasonography to determine its prognostic value. METHODS: Patients with proven
      extracranial occlusion of the internal carotid artery and ipsilateral hemispheral
      stroke were enrolled in our study. We performed transcranial Doppler
      ultrasonography on 31 patients within 48 hours after the stroke onset and
      followed up 25 patients in 28 days. At the same time, neurological examination
      with quantification of neurological deficit was done. We correlated values of
      flow frequency shifts on the side of stroke with degree of neurological deficit
      at the onset and at 28 days as well as the degree of clinical improvement and the
      value of frequency shifts. RESULTS: We found a negative correlation between blood
      flow frequency shifts in the middle cerebral artery and degree of neurological
      deficit at the onset (Spearman rank correlation coefficient, -0.567; p less than
      0.001). We also found a positive correlation between the change of the
      neurological deficit during follow-up and frequency shifts at the onset (Spearman
      rank coefficient, 0.548; p less than 0.05). CONCLUSIONS: Diminished blood flow
      velocity (mean frequency shift) in the area of stroke is a negative prognostic
      factor for the degree of neurological deficit at the onset and a negative
      prognostic factor for possible improvement. Knowledge of hemodynamic conditions
      in the stroke area may help to improve therapeutic decisions.

PMID- 1636180
TI  - Transcranial Doppler correlation with cerebral angiography in sickle cell
      disease.
AB  - BACKGROUND AND PURPOSE: Cerebral infarction in sickle cell disease is associated
      with arterial narrowing or occlusions of intracranial arteries. Primary stroke
      prevention would be feasible if a noninvasive screening test could be developed
      to detect intracranial disease in patients before symptoms develop. METHODS: To
      determine the sensitivity and specificity of transcranial Doppler in detecting
      significant (greater than or equal to 50% lumen diameter reduction) intracranial
      arterial lesions, we compared transcranial Doppler and cerebral angiography in a
      primarily young, symptomatic group of 33 patients (18 males and 15 females) with
      sickle cell disease. RESULTS: From a total of 34 examinations, transcranial
      Doppler detected significant abnormalities in 26 of 29 (sensitivity 90%,
      specificity 100%). Five were normal by both techniques. The transorbital
      examination detected abnormalities in two patients whose studies were otherwise
      unremarkable. CONCLUSIONS: Transcranial Doppler is sensitive and specific for the
      detection of arterial vasculopathy of sickle cell disease. Screening should
      include a transorbital examination of the distal internal carotid artery as well
      as examination using the transtemporal approach.

PMID- 1636181
TI  - Serum autoantibodies in patients with Alzheimer's disease and vascular dementia
      and in nondemented control subjects.
AB  - BACKGROUND AND PURPOSE: In this study we sought to evaluate the clinical
      significance of serum autoantibodies to dementing processes. METHODS: We assessed
      40 age-matched subjects: 10 patients with probable Alzheimer's disease, 10 with
      possible Alzheimer's disease with cerebrovascular disease, 10 with vascular
      dementia, and 10 nondemented control subjects. Serum from each subject was tested
      for the presence of antithyroglobulin antibody, thyroid antimicrosomal antibody,
      gastric anti-parietal cell antibody, anti-smooth muscle antibody, antinuclear
      antibody, rheumatoid factor, antineuronal antibody, and anticardiolipin antibody.
      In addition, we investigated the sera of these patients for the presence of an
      antivascular antibody directed against the vascular basement membrane
      proteoglycan antigen and for circulating immune complexes. RESULTS:
      Autoantibodies were present in 100% of the patients with possible Alzheimer's
      disease with cerebrovascular disease, 80% of those with vascular dementia, 40% of
      those with probable Alzheimer's disease, and 30% of the nondemented control
      subjects. The highest number of autoantibodies was observed in patients with
      vascular dementia and possible Alzheimer's disease with cerebrovascular disease.
      Antinuclear antibody was present in 60% of vascular dementia patients and
      antineuronal antibody in 50% of these patients. However, no individual
      autoantibody could differentiate Alzheimer's disease from cerebrovascular
      disorders. Immune complexes were detected in the serum of 20-30% of each patient
      group. Neither the patient nor the control sera was found to contain
      antiendothelial antibody. CONCLUSIONS: Despite the relatively small number of
      individuals examined in each category, the elevated number of autoantibodies
      associated with possible Alzheimer's disease with cerebrovascular disease and
      vascular dementia indicates a possible link between the presence of
      autoantibodies and cerebrovascular disorders in dementia.

PMID- 1636182
TI  - Measurement of motor recovery after stroke. Outcome assessment and sample size
      requirements.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to analyze recovery of
      motor function in a cohort of patients presenting with an acute occlusion in the
      carotid distribution. Analysis of recovery patterns is important for estimating
      patient care needs, establishing therapeutic plans, and estimating sample sizes
      for clinical intervention trials. METHODS: We prospectively measured the motor
      deficits of 104 stroke patients over a 6-month period to identify earliest
      measures that would predict subsequent motor recovery. Motor function was
      measured with the Fugl-Meyer Assessment. Fifty-four patients were randomly
      assigned to a training set for model development; 50 patients were assigned to a
      test set for model validation. In a second analysis, patients were stratified on
      basis of time and stroke severity. The sample size required to detect a 50%
      improvement in residual motor function was calculated for each level of
      impairment and at three points in time. RESULTS: At baseline the initial Fugl
      Meyer motor scores accounted for only half the variance in 6-month motor function
      (r2 = 0.53, p less than 0.001). After 5 days, both the 5-day motor and sensory
      scores explained 74% of the variance (p less than 0.001). After 30 days, the 30
      day motor score explained 86% of the variance (p less than 0.001). Application of
      these best models to the test set confirmed the results obtained with the
      training set. Sample-size calculations revealed that as severity and time since
      stroke increased, sample sizes required to detect a 50% improvement in residual
      motor deficits decreased. CONCLUSIONS: Most of the variability in motor recovery
      can be explained by 30 days after stroke. These findings have important
      implications for clinical practice and research.

PMID- 1636183
TI  - Platelet-activating factor acetylhydrolase in plasma lipoproteins from patients
      with ischemic stroke.
AB  - BACKGROUND AND PURPOSE: Platelet-activating factor is a potent bioactive
      phospholipid and may play an important role in occlusive vascular diseases. To
      assess the inactivation of this autacoid in plasma, we measured platelet
      activating factor acetylhydrolase activity in plasma low density and high density
      lipoproteins from patients with ischemic stroke. METHODS: Low density and high
      density lipoproteins were separated by ultracentrifugation from plasma of 33
      patients with cerebral thrombosis and 31 age-matched healthy control subjects,
      and platelet-activating factor acetylhydrolase activity in each fraction was
      assayed. RESULTS: The average values of platelet-activating factor
      acetylhydrolase activity in low density lipoprotein from patients and control
      subjects were 41 +/- 18 and 29 +/- 17 nmol/ml per minute, respectively, and the
      difference was statistically significant (p less than 0.01 U test). There was no
      difference in activity in high density lipoprotein between the two groups (16 +/-
      11 versus 14 +/- 9 nmol/ml per minute, respectively). CONCLUSIONS: The increased
      plasma platelet-activating factor acetylhydrolase activity in stroke patients is
      primarily attributable to the increased binding to low density lipoprotein, and
      this increase may be an adaptation to the augmented generation of platelet
      activating factor in ischemic stroke.

PMID- 1636184
TI  - Stroke risk from alcohol consumption using different control groups.
AB  - BACKGROUND AND PURPOSE: Our aim in this study was to investigate the relation
      between chronic alcohol consumption and stroke. METHODS: A case-control study was
      carried out using two hospital-based control groups and the results of a
      community-based survey of alcohol consumption. Hospital-based control subjects
      were chosen either from "general" medical admissions or a subset of "select"
      admissions that excluded possible alcohol-related admissions. Cases were selected
      from hospital inpatients. RESULTS: The relative risk for stroke associated with
      alcohol consumption greater than 300 grams per week for general control subjects
      was 0.73 (95% confidence interval [CI], 0.54-3.49) compared with 1.30 (95% CI,
      0.42-4.05) for select control subjects. The odds ratio was further increased to
      1.93 (95% CI, 0.87-4.28) using data from the community-based survey. None of
      these estimates were statistically significant. CONCLUSIONS: These results
      illustrate how the risk associated with alcohol consumption varies depending on
      the choice of control groups and may explain the contradictory results from
      previous case-control studies. Because of different biases associated with
      control selection, we believe that the results of this study are consistent with
      those of other studies that demonstrate a modest increased risk for stroke
      associated with alcohol consumption.

PMID- 1636185
TI  - Effects of cerebral angiomas on perifocal and remote tissue: a multivariate
      positron emission tomography study.
AB  - BACKGROUND AND PURPOSE: Using multitracer positron emission tomography, I
      investigated regional hemodynamic and metabolic changes in both perifocal and
      remote tissues of cerebral angiomas, with special reference to steal phenomena.
      METHODS: In 22 patients (14 with arteriovenous malformations and eight with
      cavernomas) cerebral blood flow, cerebral blood volume, mean vascular transit
      time, cerebral metabolic rate for oxygen, oxygen extraction fraction, cerebral
      metabolic rate for glucose, and glucose extraction fraction were measured using
      standard positron emission tomographic methods. Twelve patients also had their
      cerebral glucose metabolism assessed during psychophysical activation. Regions of
      interest representing the angioma, perifocal and remote tissues, contralateral
      mirror regions, and standard brain regions were analyzed. RESULTS: There were no
      significant changes in hemodynamic variables or oxygen metabolism in the
      ipsilateral cerebral hemisphere, but ipsilateral glucose metabolism was reduced
      both at rest (p less than 0.01) and during activation (p less than 0.05). Glucose
      (p less than 0.001) and oxygen (p less than 0.001) metabolism in regions of
      perifocal tissue with low blood flow were decreased, with substrate extraction
      fractions showing no increase to compensate for insufficient blood flow.
      Functional recruitment of the cortex overlying the angioma beyond its periphery
      and supplied by the same arterial branches was subnormal (p less than 0.05)
      despite relatively unchanged hemodynamics in this tissue compartment.
      CONCLUSIONS: These data suggest that dysfunction of the cortex supplied by
      arterial branches also feeding the vascular malformation is related to neuronal
      deafferentation, while the proportionate decrease in blood flow and metabolism of
      perifocal tissue may be ascribed to neuronal loss in chronically hypoperfused
      areas, rather than to persistent hemodynamic steal effects.

PMID- 1636186
TI  - Combined magnetic resonance imaging and proton magnetic resonance spectroscopy of
      patients with acute stroke.
AB  - BACKGROUND AND PURPOSE: The prospect for a therapeutic window for treatment of
      ischemic stroke encourages the noninvasive investigation of metabolic changes in
      acute ischemia. Recently, localized proton spectroscopy became available at 1.5-T
      magnetic resonance systems. In this study we evaluated the usefulness of combined
      magnetic resonance imaging and spectroscopy on the diagnosis of acute and chronic
      infarctions. METHODS: Combined magnetic resonance imaging and spectroscopy
      investigations were carried out with a 1.5-T system in 16 volunteers, eight
      patients with chronic infarction (greater than 8 months), and 10 patients with
      acute ischemic stroke (less than 8 hours). We used a stimulated echo sequence to
      acquire localized spectra from image-guided volumes of interest (16-27 ml).
      RESULTS: There were no significant interindividual differences of choline,
      creatine, phosphocreatine, and N-acetyl aspartate resonances in the spectra from
      volunteers. In chronic infarctions, N-acetyl aspartate was decreased in relation
      to choline. Acute ischemic infarctions were characterized by decreased N-acetyl
      aspartate resonances and elevation of lactate. CONCLUSIONS: The study
      demonstrates the feasibility of proton spectroscopy in stroke patients. Metabolic
      alterations in ischemic tissue can be monitored and can distinguish acute from
      chronic lesions.

PMID- 1636187
TI  - Impairment of endothelium-dependent relaxation in human basilar artery after
      subarachnoid hemorrhage.
AB  - BACKGROUND AND PURPOSE: The goal of this study was to determine the alterations
      in vascular reactivity of human basilar artery after subarachnoid hemorrhage.
      METHODS: Human basilar arteries were obtained from subjects who died within 1 day
      after subarachnoid hemorrhage and control subjects who died from causes other
      than brain involvement. Basilar artery strips were suspended for isometric
      tension recording in Krebs-Ringer solution. Morphometric study was also carried
      out on paraffin-embedded sections stained with van Gieson's elastica stain of
      preselected sites from the basilar arteries. The intimal and medial area and the
      intimal index ([intimal area/area circumscribed by internal elastic lamina] x
      100) were evaluated. RESULTS: Contractile responses to KCl, norepinephrine, and 5
      hydroxytryptamine did not differ between subarachnoid hemorrhage and control
      groups. The endothelium-dependent relaxation responses to thrombin, bradykinin,
      and calcium ionophore A23187 were less for the subarachnoid hemorrhage group than
      for the control group. However, the endothelium-independent response to sodium
      nitroprusside of the subarachnoid hemorrhage group did not differ from that of
      the control group. Morphometric measurements were comparable between the two
      groups. CONCLUSIONS: These results suggest that the decreased relaxation
      responses to thrombin and bradykinin occur at the level of endothelial cells and
      not smooth muscle cells and that decreased relaxation may be involved in delayed
      vasospasm after subarachnoid hemorrhage. Although the decreased relaxation was
      observed within 1 day after subarachnoid hemorrhage, a period in which delayed
      spasm does not occur, this time difference may be dependent on the severity of
      bleeding after rupture of an aneurysm.

PMID- 1636188
TI  - Indomethacin promotes germinal matrix microvessel maturation in the newborn
      beagle pup.
AB  - BACKGROUND AND PURPOSE: Although indomethacin has been demonstrated to prevent
      germinal matrix and intraventricular hemorrhage in clinical and animal studies,
      the mechanism of action of this agent to prevent hemorrhage remains unclear.
      Previous studies have demonstrated both that the microvessels in the germinal
      matrix of newborn beagle pups undergo basement membrane maturation during the
      first 4 postnatal days and that indomethacin may promote laminin deposition in
      tumor cell culture systems. METHODS: We employed the newborn beagle pup model to
      test the hypothesis that indomethacin may stimulate laminin deposition in
      germinal matrix microvessels. Newborn pups were randomized to receive either 0.1
      mg/kg/dose i.p. indomethacin or an equal volume of saline diluent. Pups received
      doses of study medication once a day for 1, 2, or 3 days and were studied on
      postnatal days 1, 2, 3, or 4. Pups were anesthetized and systemically perfused
      with buffered formalin; the brains were removed and prepared for
      immunohistochemical study. RESULTS: Sections stained with Bandeiraea lectin
      demonstrated that there was no difference in germinal matrix vessel density among
      the postnatal ages studied; similarly, there were no differences in vessel
      density between saline- and indomethacin-treated animals at any postnatal age.
      Quantification of germinal matrix stained intensity by confocal microscopy
      demonstrated significant increases in indomethacin-treated pups for both laminin
      staining at postnatal days 2 (p = 0.05) and 3 (p = 0.0009) and type V collagen
      staining at postnatal day 2 (p = 0.011). Although staining for beta 1 integrins
      increased across postnatal ages, there were no differences between saline- and
      indomethacin-treated animals. CONCLUSIONS: These data suggest that indomethacin
      may stimulate basement membrane deposition in the germinal matrix microvessels of
      newborn beagle pups to prevent germinal matrix and/or intraventricular
      hemorrhage.

PMID- 1636189
TI  - Time course of cerebral blood flow and histological outcome after focal cerebral
      ischemia in rats.
AB  - BACKGROUND AND PURPOSE: The relation between time-dependent changes in cerebral
      blood flow and the appearance of infarction after focal cerebral ischemia is
      still a matter for debate. The aim of this study was to measure perfusion after
      simultaneous occlusions of the left middle cerebral artery and ipsilateral common
      carotid artery in rats and correlate it with the timing and distribution of
      histological changes. METHODS: We studied histological and cerebral blood flow
      changes 5 minutes and 4, 24, and 48 hours after the onset of focal ischemia.
      Blood flow was determined autoradiographically using [14C]iodoantipyrine. A
      coronal template subdivided into regions of interest was applied to the
      autoradiographs and the histological data. RESULTS: In some regions of the
      nonoccluded hemisphere, cerebral blood flow 5 minutes after occlusion fell below
      50% of normal. Many ischemic structures showed stable blood flow for 48 hours
      after occlusion, confirming that in this model reperfusion is minimal. Infarction
      occurred eventually in all areas in which blood flow at 5 minutes fell below 10%
      of that in control rats, but infarction appeared earlier in regions in which
      blood flow at 5 minutes was below 5% of that in control rats. When blood flow at
      5 minutes rose above 12% of that in control rats, the occurrence of infarction
      became unpredictable. CONCLUSIONS: Despite the general dependence of infarction
      on perfusion levels, blood flow was not a reliable indicator of those regions
      committed to infarction.

PMID- 1636190
TI  - Facilitating postischemic reduction of cerebral lactate in rats.
AB  - BACKGROUND AND PURPOSE: Dichloroacetate facilitates a decrease in brain lactate
      during reperfusion after incomplete ischemia. This study examined the possible
      activation of pyruvate dehydrogenase enzyme by dichloroacetate to explain this
      effect. Because the duration of ischemia and hyperglycemia exacerbate ischemic
      brain damage, the effect of both of these factors on lactate reduction with and
      without dichloroacetate treatment after ischemia also was explored. METHODS: The
      two-vessel occlusion and controlled blood loss model of stroke was applied to
      anesthetized rats. Samples of cerebral cortex were analyzed for lactate by enzyme
      fluorometry and for pyruvate dehydrogenase activity by radioassay. RESULTS:
      Treatment with dichloroacetate produced no significant stimulation of pyruvate
      dehydrogenase after ischemia. When the duration of ischemia was increased or 50%
      glucose was infused before ischemia, brain lactate was significantly higher (p
      less than 0.01, Duncan's test). After 30 minutes of ischemia, treatment with a
      low dose of dichloroacetate (25 mg/kg) improved the reduction in lactate (p less
      than 0.01, Duncan's test). CONCLUSIONS: These results indicate that although
      dichloroacetate reduces brain lactate after cerebral ischemia, the mechanism of
      action does not involve dichloroacetate's known ability to stimulate pyruvate
      dehydrogenase. However, these data support the use of dichloroacetate to lower
      cerebral lactate, especially in cases where ischemia is greater than or equal to
      30 minutes in duration. They also suggest that early restoration and maintenance
      of perfusion after ischemia and discontinuing the use of 50% glucose before
      impending ischemia likewise would facilitate reduction of postischemic brain
      lactate.

PMID- 1636191
TI  - Early changes in rabbit cerebral artery reactivity after subarachnoid hemorrhage.
AB  - BACKGROUND AND PURPOSE: Subarachnoid hemorrhage frequently leads to long-term
      cerebral artery narrowing called vasospasm. Very early changes in cerebral
      arteries have not been studied extensively and may be critical for the later
      pathological developments. We therefore determined what changes in the reactivity
      of cerebral arteries could be observed after 10 minutes' or 24 hours' contact
      with subarachnoid blood. METHODS: Ten minutes or 24 hours after the injection of
      blood or physiological solution (sham hemorrhage) into the cisterna magna of
      anesthetized rabbits or no injection (control rabbits), segments of the middle
      cerebral, basilar, and vertebral arteries were removed for conventional in vitro
      tension measurements. Concentration-response curves to four endogenous
      constrictors likely to be released after hemorrhage were obtained, and the
      maximum relaxation to acetylcholine was determined. RESULTS: There were no
      significant differences between the sham hemorrhage and control groups. Compared
      with control rabbits, treated animals showed increased reactivity to uridine
      triphosphate in the basilar and vertebral arteries at 10 minutes but not at 24
      hours, whereas reactivity was increased in the middle cerebral artery only at 24
      hours. Reactivity to serotonin was greatly increased in all arteries at both
      latencies (up to 2.7 times). Reactivity to noradrenaline was unchanged in the
      basilar and vertebral arteries at 10 minutes; reactivity in both the basilar and
      middle cerebral arteries was increased at 24 hours, which is compatible with
      denervation supersensitivity. There were only minor changes in the reactivity to
      histamine, and only at 10 minutes. Relaxation to acetylcholine was increased for
      the middle cerebral artery at 10 minutes but otherwise was not significantly
      changed. CONCLUSIONS: Reactivity to uridine triphosphate, serotonin, and
      noradrenaline greatly increases by 10 minutes to 24 hours after subarachnoid
      hemorrhage, and this increase is not owing to the mechanical effects of
      intracranial hypertension, nor is it related to impaired endothelium-dependent
      relaxation. It is suggested that these and other spasmogens cause excessive
      muscular calcium loading with a very rapid onset after subarachnoid hemorrhage.

PMID- 1636192
TI  - A phospholipase C inhibitor ameliorates postischemic neuronal damage in rats.
AB  - BACKGROUND AND PURPOSE: The hypothesis of calcium-induced neuronal damage has
      been proposed regarding brain ischemia. Phospholipase C is an enzyme that
      catalyzes the phosphodiesteratic cleavage of phosphatidylinositol. The cleavage
      of phosphatidylinositol 4,5-bisphosphate by phospholipase C yields 1,4,5-inositol
      triphosphate, which mediates intracellular release of calcium, and 1,2
      diacylglycerol, which is an activator of protein kinase C. We examined the effect
      of phenylmethylsulfonyl fluoride, a phospholipase C inhibitor, on delayed
      neuronal damage after transient forebrain ischemia in the hippocampal CA1
      subfield in rats to assess the role of phospholipase C in postischemic neuronal
      damage. METHODS: Twenty-minute forebrain ischemia was induced using the method of
      Pulsinelli and Brierley. We measured the neuronal density of the hippocampal CA1
      subfield 7 days after reperfusion. The effect of phenylmethylsulfonyl fluoride
      was tested in both pretreatment and posttreatment groups. RESULTS: In the vehicle
      treatment group (n = 13), neuronal density was 51 +/- 42/mm (mean +/- SD). The
      neuronal densities in the 50-mg/kg (n = 12) and 100-mg/kg (n = 14)
      phenylmethylsulfonyl fluoride pretreatment groups and the 100-mg/kg (n = 10)
      phenylmethylsulfonyl fluoride posttreatment group were 99 +/- 50, 150 +/- 55, and
      143 +/- 63/mm, respectively. These values were significantly higher than that of
      the vehicle treatment group (p less than 0.05, p less than 0.01, and p less than
      0.01, respectively). CONCLUSIONS: It is suggested that the activation of
      phospholipase C has an important role in postischemic delayed neuronal damage.

PMID- 1636193
TI  - Reduction of infarct volume and mortality by thrombolysis in a rat embolic stroke
      model.
AB  - BACKGROUND AND PURPOSE: Thrombolytic therapy with recombinant tissue plasminogen
      activator was tested in a rat embolic stroke model. METHODS: The rat carotid
      territory was embolized with arterial-like microthrombi formed under pressure.
      Hemispheric cerebral blood flow before and after embolization was measured by the
      intraarterial Xenon-133 injection method. Fifteen minutes after embolization, 24
      rats were treated with 3 mg/kg or 10 mg/kg tissue plasminogen activator, and 27
      were treated with saline. Carotid angiography displayed the rate of occlusion of
      the cerebral arterial supply before and after treatment. Brains were fixed and
      evaluated neuropathologically and infarct volume was measured. RESULTS: Cerebral
      blood flow was reduced 70-86% after embolization. The comparison of pretreatment
      and posttreatment angiography showed significant (p = 0.0005) reperfusion in the
      treated rats. Thrombolytic therapy significantly reduced the infarct volume from
      55.1% to 24.4% of embolized hemisphere volume (p = 0.007) and increased the
      survival rate from 0.48 to 0.96 (p = 0.0004). Fifty-three percent of the
      embolized rats recanalized completely after thrombolytic treatment and developed
      almost no infarction (median volume 2.8%), and all survived. No hemorrhagic
      complications were observed. CONCLUSIONS: Early thrombolytic therapy induced
      recanalization and reduced mortality and infarct volume after embolic stroke in
      this model.

PMID- 1636194
TI  - Fatal basilar vasculopathy complicating bacterial meningitis.
AB  - BACKGROUND: Bacterial meningitis complicated by thrombosis, vasculitis, and
      aneurysm formation affecting both small and distal branches of cerebral vessels
      has been well described. Involvement of major cerebral vessels is rare and has
      only been documented late in the course of disease. CASE DESCRIPTION: We describe
      the clinical and pathological findings in a young man who presented with pontine
      infarction as an early manifestation of bacterial meningitis. Streptococcus
      milleri, an unusual organism in this setting, was cultured. Despite improvement
      with antibiotic therapy, the patient experienced fatal subarachnoid hemorrhage. A
      ruptured inflammatory aneurysm of the basilar artery, evidence of residual
      meningitis and vasculitis, and basilar thrombosis associated with pontine
      infarction were found. CONCLUSIONS: Bacterial meningitis, which may be associated
      with severe vasculopathy of the basilar artery and lead to cerebral infarction,
      aneurysm formation, and subarachnoid hemorrhage, should be considered in the
      differential diagnosis of these conditions. The role of S. milleri in meningitis
      and its vascular complications merits further study.

PMID- 1636195
TI  - Loss of vision induced by the color white: a sign of carotid occlusive disease.

PMID- 1636196
TI  - Technology used to assess vasomotor reactivity affects results.

PMID- 1636197
TI  - Neurocysticercosis as a cause of stroke.

PMID- 1636198
TI  - Thrombin activity in cerebrospinal fluid after subarachnoid hemorrhage.

PMID- 1636199
TI  - Sneddon's syndrome and antiphospholipid antibodies: clarification of a
      controversy by skin biopsy?

PMID- 1636200
TI  - Special issue: AIDS.

PMID- 1636201
TI  - The OSHA bloodborne pathogens standard.
AB  - 1. The OSHA Standard is intended to reduce the risks to health-care workers of
      exposure to bloodborne pathogens. Because the patient's HIV or HBV status is
      often unknown, the Standard focuses on reducing the risks of exposure to blood
      and those body fluids to which universal precautions apply. 2. Engineering and
      work practice controls to reduce the risk of exposure include techniques for
      handling, cleaning, and decontaminating instruments with minimal hand contact;
      using containers to pass surgical instruments; wearing puncture-resistant gloves;
      and using forceps or clamps to remove scalpel blades from knife handles. 3.
      Employers must provide personal protective equipment at no cost. This equipment
      must prevent blood or other potentially hazardous materials from passing through
      or reaching employee's work or street clothes, skin, eyes, mouth, or other mucous
      membranes during normal conditions for the duration of time used.

PMID- 1636202
TI  - Intervention in early HIV infection.
AB  - 1. The primary goals of early intervention in HIV infection are to prevent or
      delay disease progression and to interrupt HIV transmission. 2. After assessing
      the stage of a patient's infection, the next goal of early intervention is to
      minimize the risk of progression. The initial assessment of an HIV-infected
      individual should include a comprehensive evaluation of all previous disease
      exposures that might become problematic with immune system compromise. 3. Two
      antiviral agents are licensed to treat HIV infection: zidovudine and didanosine.
      Only zidovudine is approved for treatment of early HIV infection and is
      recommended for all HIV-positive adults with or without symptoms of disease
      progression who have absolute CD4 helper cell counts less than 500.

PMID- 1636203
TI  - Women and the AIDS epidemic: no longer hidden.
AB  - 1. Women acquire HIV infection along one of three routes: parenteral, sexual, or
      vertical (perinatal). The HIV/AIDS epidemic among women in the US is growing
      primarily through parenteral and heterosexual exposures, which are tightly linked
      to social issues of substance abuse. 2. The majority of AIDS clinical trial
      participants have been white men. Differences in male and female physiology,
      hormonal influences on drug pharmacokinetics, and the social context of disease
      may render protocols ineffective or even harmful for women. 3. To respond
      effectively to the AIDS epidemic among women in the US, major public health
      issues, such as access to care, availability of family planning and drug
      treatment services, and racial discrimination, must be addressed.

PMID- 1636204
TI  - The child with HIV infection.
AB  - 1. Although incurable, HIV infection is treatable. Advances in antiretroviral
      therapy, prophylaxis to prevent opportunistic infections, treatment of
      opportunistic infections, and aggressive nutritional intervention allow for
      prolonged survival with a reasonable quality of life for many infected children.
      2. HIV-infected children tolerate the majority of surgical procedures well; HIV
      infection alone is not a contraindication to surgery. Because of the multiple
      laboratory abnormalities that occur in children with HIV, nurses must assess that
      the appropriate laboratory testing has been completed and that the results have
      been reviewed. 3. Symptoms in children with HIV result from multiple causes and
      present in a variety of ways. As the lives of children are extended with better
      supportive and antiviral treatment, additional manifestations of HIV are being
      noted.

PMID- 1636205
TI  - Update on AIDS: the second decade.

PMID- 1636206
TI  - AIDS: an equalizer among the races.

PMID- 1636208
TI  - Package simplifies compliance with federal regulations.

PMID- 1636207
TI  - Consumer advisory on AIDS available to patients.

PMID- 1636209
TI  - HIV insurance plan for health-care workers provides lifestyle coverage.

PMID- 1636210
TI  - Blood exposure and puncture risks for OR personnel.
AB  - 1. Although all health-care workers are at risk for exposure to bloodborne
      organisms, OR personnel are the most intensively exposed to blood. Exposures to
      blood were noted in up to half of the procedures observed. 2. Risk-reduction
      strategies include using two pairs of puncture-resistant gloves and face
      protection for all procedures; wearing impermeable gowns during procedures with
      heavy blood loss; using surgical instruments and techniques that reduce the
      chance of percutaneous contacts; and adopting protocols for handling sharps,
      counting sponges, and cleaning the operating room. 3. Better and more comfortable
      personal protective equipment is needed. Manufacturers should develop risk
      protective and cost-effective barriers that reduce risks for patients of surgical
      wound infections while reducing the risks for health-care workers of exposures to
      blood and bloodborne pathogens.

PMID- 1636211
TI  - [Changes in the form and ultrastructure of the smooth-muscle cells in the human
      aorta in prenatal ontogeny].
AB  - The shape of smooth muscle cells (SMC) was analysed using the phase contrast
      microscopy of cell suspensions obtained by alcohol-alkali dissociation, as well
      as the semithin sections prepared in perpendicular planes. The phenotype of SMC
      was analysed using transmission electron microscopy. The shape of SMC changes
      from preferentially round to preferentially spindle-like and stellate one during
      development. The differentiation of SMC is accompanied with the increase in the
      contractile apparatus content and in the decrease in the content of synthetic
      organelles.

PMID- 1636212
TI  - [The intracellular pH and cell proliferation of the LS cell line and its
      derivative LSM adapted to monolayer growth].
AB  - The dynamics of intracellular pH (pHi) during proliferation of cells of LS line
      in bicarbonate-containing media and of its derivative LSM line adapted to grow in
      a monolayer has been studied. The contact of LS cells with a solid substrate was
      not accompanied by their spreading and by an increase in pHi. The pHi values of
      growing and resting LS cells were practically equal (7.03 and 6.97,
      respectively). The adhesion and spreading of LSM cells were accompanied by an
      increase in pHi. The proliferation of LSM cells occurred at different pHi values:
      at 7.32 on solid substrate with serum, at 7.18 on substrate without serum, at
      7.13 in a serum-containing suspension, at 6.97 in a suspension without serum. The
      highest growth rate was observed at the increased pHi value. Cell proliferation
      on the substrate stopped at pHi values within 7.10 and 7.13 which were equal to
      or exceeded the pHi of growing cells in suspension. No difference was observed
      between LS and LSM cells in the activities of Na+/H+ exchange and transport of Cl
      into cells that are involved in pHi regulation. Transport of HCO3- into the
      cytoplasm of LSM cells was more active than that of LS cells. The role of pHi in
      the anchorage dependence of cell proliferation is discussed.

PMID- 1636213
TI  - [The effect of the synthetic leu-enkephalin analog dalargin on the proliferative
      activity of glioma C6 cells and on the intensity of their DNA synthesis].
AB  - Effect of dalargin, an opioid peptide (a synthetic analogue of Leu-enkephalin),
      on proliferation and intensity of DNA synthesis of C6 glioma cells was studied.
      Specific conditions of cultivation were selected, with a low control value of
      proliferation, which permitted to assess growth-stimulating effect of the
      peptide. Growth curves were plotted to assess peptide activity, which
      demonstrated that reaction was a many-phase process: a significant increase in
      cell number under peptide effect was observed only at the beginning of the
      logarithm phase and at the beginning of the prestationary phase of the growth
      curve. Cell number increased on average by 25-27% in the presence of dalargin as
      compared to control. Reaction of glioma DNA synthesis to dalargin also
      demonstrates complexity of the process: the peptide changes DNA synthesis, but as
      a rule, this process has a three-phase character and is not directly associated
      with the duration of cultivation in the presence of dalargin. Effect of naloxone,
      an opiate receptor blocker, was analysed to assess the receptor mechanism. It was
      found that reaction for naloxone and for combined effect of naloxone and dalargin
      was not the same.

PMID- 1636214
TI  - [The effect of the functional electrostimulation of rat fast and slow muscles on
      the structural state of actin in the thin filaments of a ghost muscle fiber].
AB  - The effect of electrostimulation of fast (EDL) and slow (SOL) rat muscles on the
      orientation and mobility of fluorescent probes rhodamine-phalloidine and 1.5
      IAEDANS (N-iodoacetyl-N'-(5-sulpho-1-naphtyl)-ethylenediamine), located in
      various parts of actin molecule, has been studied by polarized microfluorimetry
      techniques. Muscles were stimulated at 20 Hz with the pulse width of 0.3 msec,
      some muscles were treated for 6 h during the first day, the other muscles for 6 h
      a day during the next 4 days before glycerinization. Then muscle fibres freed by
      the extraction of myosin, tropomyosin and troponin (ghost fibres) were used. It
      was shown that the binding of myosin subfragment 1 (S1) to actin induced the
      changes in polarized fluorescence of the fibres. The analysis of the obtained
      data showed that the formation of actomyosin complex in stimulated muscles
      resulted in increasing the angle between the thin filaments and the emission
      dipole of rhodamine-phalloidine, as well as in decreasing the mobility of this
      dye. In the experiments with the 1.5-IAEDANS label, the angle of the emission
      dipole decreased, while the label mobility increased. It was suggested that the
      orientation of domains in actomyosin complex changes following the
      electrostimulation to affect both the conformational state of F-actin in thin
      filaments of ghost fibres and actin-myosin interaction.

PMID- 1636215
TI  - [The expression of hetero-organic antigens of kidney origin on the surfaces of
      cultured rat hepatocytes under the influence of the narrow-band fractions of non
      histone chromosomal proteins].
AB  - Narrow fractions of nonhistone chromosomal proteins (NHCP) eluted with 0.4-0.5 M
      NaCl from the phosphocellulose column stimulate expression of hetero-organic
      antigens of kidney origin on the membrane of intact hepatocytes cultured in
      suspension. These fractions of NHCP were isolated from the intact rats kidney,
      from cells of hepatoma 27 and Zajdela hepatoma, and from the carcinogenic liver
      after a single diethylnirozamine injection. The membrane hetero-organic antigens
      were identified by means of indirect immunofluorescence using specific immune
      serum.

PMID- 1636216
TI  - [The morphology of cell lines suitable for vaccine production studied by scanning
      electron microscopy].
AB  - Five nontumorogenic cell lines suitable for vaccine production were studied by
      SEM. It was shown that diploid cell line 41 originated from sheep embryo kidney
      and also two heteroploid cell lines, line 4921 originated from embryo skin and
      muscles of the African green young monkey and line 4647 from kidney of the adult
      monkey, maintained normal cell morphology and normal growth pattern in early and
      in later passages in cultures. Some alterations in epithelial dense monolayer
      formation were revealed in the heteroploid cell lines: in line 455 originated
      from spleen of the adult African green monkey, and in line 4184 originated from
      line 41. The revealed alterations can be considered as the early morphological
      signs of the transformation of epithelial cells in culture. These cell lines also
      retained the stability of their morphological characteristics at the earlier and
      later passages. All the studied cell lines were free of contaminating agents.

PMID- 1636217
TI  - [Fascicular and sub-fascicular architecture of the cruciate ligament].
AB  - The details of the collagen fascicle morphology and the vascularization of the
      anterior and the posterior cruciate ligament were examined by the combined use of
      histology, transmission- and scanning electron microscopy, morphometry and
      immunohistochemistry. The diameters of the collagenous fibrils in the anterior
      cruciate ligament ranged between 20 and 155 nm (x = 74 nm, s = 18.8 nm) and in
      the posterior cruciate ligament between 20 and 175 nm (x = 82 nm, s = 25.4 nm).
      Type III and VI collagen were found distributed throughout the matrix but
      concentrated in the attachment regions of the ligaments. The content of type IV
      collagen in the anterior cruciate ligament was low. The amount of arterioles
      revealed a typical pattern (anterior cruciate ligament: less than 30 years =
      2.94/mm2, greater than 90 years = 2.02/mm2, proximal = 3.15/mm2, distal =
      2.18/mm2; posterior cruciate ligament: less than 30 years = 4.69/mm2, greater
      than 90 years = 3.87/mm2, proximal = 4.08/mm2, distal = 3.98/mm2).

PMID- 1636218
TI  - [Clinical relevance of whole body skeletal scintigraphy in multiple injury and
      polytrauma patients].
AB  - The provision of care to polytraumatised patients is a particular diagnostic and
      therapeutic challenge. The examination data of 162 polytraumatised patients were
      retrospectively investigated to determine the diagnostic gain provided by
      skeletal scintigraphy with 99mTc-HMDP. It was found that every fresh fracture
      (with the exception of fractures to the skull) led to a scintigraphically clearly
      demonstrable remodelling reaction within ten to 14 days. The timing of the
      examination was of decisive importance for the information yield. Not until about
      the tenth to 12th day did also those fractures that showed a delayed uptake show
      adequately signal-intensive areas of uptake in the scintigram. Typical examples
      were additional fractures of the spine and pelvis in patients immobilised by
      fractures of the limbs. At this time, with the aim of skeletal scintigraphy, an
      additional fracture was found in half of all patients, and was subsequently
      verified radiologically. Additional diagnostic information is independent of the
      ability of the patient to cooperate. This was of particular importance in the
      case of the very severely injured and old patients. Skeletal scintigraphy can be
      employed with equal efficacy to reliably exclude bone injuries. Thus, skeletal
      scintigraphy if of particular significance in the determination of the extent of
      bone injury in polytraumatised patients. This applies in particular to the
      preparation of an expertise. Thus, as in the case of staging of malignomas, the
      additional performance of bone scanning twelve to 14 days after traumatisation
      should form part of routine care offered to polytraumatised patients.

PMID- 1636219
TI  - [Fat pad signs and supinator fat line in cubital trauma].
AB  - The fat pad sign and the supinator fat line (SFL) are valuable diagnostic aids in
      the evaluation of bony cubital injuries. A total of 377 lateral X-rays of the
      elbow joint-including 121 fractures--were investigated. The supinator fat line
      exhibited bar-like and bird-like configurations in 55.9% and 41.8% of healthy
      test subjects, respectively. In the presence of a fracture, a wavy configuration,
      directed downwards from, or running parallel to, the upper edge of the radius,
      was seen in 95% of the cases. If in the event of an injury to the elbow a wavy
      configuration is seen in association with a positive anterior and/or posterior
      fat pad sign, bony involvement of the joint-forming elements may justifiably be
      suspected.

PMID- 1636220
TI  - [Traumatic lesions of the proximal tibial epiphysis].
AB  - 36 fractures of the tibia involving the proximal tibial epiphyseal cartilage were
      treated in 35 patients at the Accident Hospital Lorenz Bohler, Vienna over a ten
      year period from 1980 to 1989. The average age at injury was 13.2 years. Most
      common concomitant injuries were ruptures of the ACL and/or MCL associated with
      meniscal lesions in type III- and IV-fractures and fractures of the fibula in
      type II injuries. We saw two associated aggravating problems as defined by a
      compartment-syndrome of the lower leg with one immediate peroneal-nerve palsy,
      but lesion or disruption of the popliteal artery was not observed. 26 patients
      were treated conservatively and nine patients had to be operated on. Long-term
      follow-up (means 6.4 years) was available in 28 cases. Premature epiphyseal
      closure was seen in three cases and one of them developed an axis angulation in
      the sense of genu recurvatum but operative correction was not necessary.
      Unsatisfactory results were stated in four cases due to their knee instability or
      posttraumatic painful arthrosis. There was no case of growth disturbance with
      axis deformation or angulation requiring surgical revision.

PMID- 1636221
TI  - [Post-traumatic length discrepancy and muscular atrophy after femoral fractures
      in childhood].
AB  - The results of a clinical follow-up study of 107 children treated in the
      University Hospital Hamburg-Eppendorf because of femoral shaft fractures are
      shown. Most of the fractures healed with lengthening of the fractured bone and
      showed a muscles atrophy of the concerned limb as well. This study demonstrates
      the connections between these alterations.

PMID- 1636222
TI  - [Treatment procedure in humeral shaft fractures with primary or secondary radial
      nerve damage].
AB  - We give an account of 28 patients with fractured humerus diaphysis, suffering
      from primary and seven patients suffering from secondary lesion of the radialis
      nerve, all treated by operation. In each case the radialis nerve was exposed and
      the fracture was treated by fixation with compression plates. In case of primary
      lesions of the radialis nerve, we found intraoperative damages by traction (six
      times), contusions (seven times), intraneural hamatomas (six times) and for one
      time perforation of the nerve by bones. The rest of this group (eight times) did
      not show any pathological finding. Those patients with secondary lesion of the
      radialis nerve showed damages by traction (three times) and in two cases the
      nerve was walled up by callus or connective tissue. Two times we could not find
      any pathological alteration of the nerve. 23 (six) out of 28 (seven) patients
      with primary (secondary) lesion of the radialis nerve could be followed up. On
      this occasion we stated complete neurological restitution 20 times (four times)
      and incomplete restitution three times (two times). The great number of
      pathological findings, which necessitate operative treatment, the short duration
      of remission and the high rate of restitution confirm us to leave the way of
      conservative treatment in cases of primary or secondary lesion of the radialis
      nerve and the indication of acute operation is given.

PMID- 1636223
TI  - [The effectiveness of physical therapy techniques. Possibilities of
      electromyography evaluation].
AB  - The purpose of this study is to verify the efficiency of selected
      physiotherapeutic techniques. EMG analysis with surface electrodes was performed
      in order to obtain sufficient data about the process of local strain.
      Furthermore, the local strain of the muscles surrounding a healthy knee is
      compared with the local strain of muscles after a knee injury (ACL-rupture) with
      resultant atrophy. The results prove modifications of progress and amplitudes of
      local strain and of coordination affected by atrophy/non-atrophy. On account of
      the first results additional research is recommended to investigate the specific
      aims of the different techniques.

PMID- 1636224
TI  - [Improved interpretation of intra-operative myelography in dorsal spinal
      instrumentation].
AB  - Intraoperative assessment of the spinal canal during dorsal instrumentation for
      vertebral fractures which narrow the canal is facilitated by myelography.
      However, the flow of contrast medium around a displaced fragment may result in an
      erroneous interpretation of canal patency. By performing myelography prior to
      instrumentation and reduction of the fracture, a chance in myelography-findings
      after reduction can clearly be caused only by successful repositioning of the
      displaced fragment. The possibility of an incorrect interpretation of the
      investigation can thus be reduced.

PMID- 1636225
TI  - [Heart arrest as a sequela of clavicular fracture].
AB  - After a fracture of the medial part of the clavicle cardiac arrest occurred. This
      complication can be explained by vagus irritation because of fracture haematoma.
      The patient survived and was, six months later, of best health.

PMID- 1636226
TI  - Superficial bladder cancer.

PMID- 1636227
TI  - Epidemiology and etiology of bladder cancer.
AB  - Urinary bladder cancer has long been associated with specific etiologic factors,
      and our knowledge of these factors has increased during this century. The most
      important factor, even in industrialized societies, is cigarette smoking.
      Specific chemicals have also been identified as causing bladder cancer, as have a
      variety of occupational exposures to less well-defined specific agents. In other
      parts of the world, the association of bladder cancer with Balkan nephropathy,
      endemic blackfoot disease, and schistosomiasis provides additional leads for
      investigating, and potentially preventing, the process of carcinogenesis in
      humans. Many of the critical observations in our understanding of bladder cancer
      have been made by practicing physicians, and this is likely to continue. It is
      essential that physicians dealing with bladder cancer patients be attuned to
      potential etiologic factors, including cigarette smoking, various industrial
      exposures, or drug exposures to further our understanding of this issue. Bladder
      cancer is a potentially preventable disease and an important one, as indicated by
      the total number of cases and the extent of morbidity and death attributable to
      it around the world.

PMID- 1636228
TI  - Natural history of superficial bladder cancer. Prognostic features and long-term
      disease course.
AB  - Superficial bladder cancer or, more accurately, stages Ta, T1, and Tis encompass
      a spectrum that ranges from innocuous to life-threatening lesions. There is
      growing evidence that Ta grade 1 tumors rarely become invasive; although when
      there is associated carcinoma in situ or severe dysplasia, the risk of
      invasiveness increases. Carcinoma in situ is treacherous, with unpredictable
      behavior. Predictors of recurrence and progression are beginning to be identified
      for the various superficial tumors.

PMID- 1636229
TI  - Cytologic and histologic features of superficial bladder cancer.
AB  - Despite technologic advances in diagnostic skills, cytologic and histologic
      evaluation is still the standard for the identification of bladder cancer, and
      these two techniques are critical in therapy selection and post-treatment
      surveillance. The key to the proper interpretation of cytologic specimens lies in
      appropriate collection and handling of the sample. Because treatment differs
      according to the histologic type of a tumor, when a mixture of types is found,
      all should be listed with their relative proportions. Both pathologists and
      urologists must be aware of the importance of the muscularis mucosae; a
      transitional-cell carcinoma may invade this layer without extending into the true
      muscle.

PMID- 1636230
TI  - Diagnosis and staging of bladder cancer.
AB  - The need for prompt diagnosis and accurate staging of bladder cancer cannot be
      over-emphasized, as delays in diagnosing the tumor are clearly associated with a
      poor prognosis. Accurate staging using the American Joint Committee system is
      essential if clinicians are to compare the results of different therapies.

PMID- 1636231
TI  - Surgical techniques for endoscopic resection of bladder cancer.
AB  - Accompanying the advances in surgical techniques and new intravesical and
      systemic therapeutic agents for the treatment of individuals with bladder cancer
      has been the development of greatly improved instrumentation for viewing the
      interior of the urinary tract and removing neoplasms. Fiberoptic lenses can now
      be combined with a video system, which enables the urologist to examine the lower
      urinary tract, not only more easily but with greater magnification. Training is
      obviously accelerated with the use of video endoscopy. The system also provides
      the opportunity for documentation and transmittal of the operative findings using
      either still or motion photography. The endoscopic procedure should be carried
      out in an orderly fashion. Sufficient lenses and cautery loops must be available
      to visualize the entire lower urinary tract and to biopsy or resect any
      abnormality and ensure hemostasis. The urologist should work closely with the
      pathologist to obtain sufficient cytologic and pathologic material to be
      confident of the presence or absence of tumor.

PMID- 1636232
TI  - Laser surgery for transitional-cell carcinoma. Technique, advantages, and
      limitations.
AB  - Lasers generate a unique form of energy with specific tissue effects different
      from those of either unipolar or bipolar electrocautery. A noncontact coagulation
      necrosis of superficial transitional-cell carcinoma of the bladder can be
      achieved. There are insufficient data to support the contention that the
      recurrence rate of transitional-cell carcinoma is decreased by laser therapy.
      However, there is abundant evidence that laser treatment of superficial bladder
      cancer is effective in eradicating grossly visible tumors. Bleeding does not
      occur during laser application, a clear advantage over electrocautery resection.
      Additionally, the treatment can sometimes be performed without anesthesia, and
      the energy can be transmitted via flexible fibers, facilitating the use of
      flexible cystoscopes. Bladder perforation is unlikely, obturator nerve
      stimulation does not occur, and postoperative Foley catheter drainage of the
      bladder is unnecessary. Tumors within bladder diverticula can be treated
      endoscopically with lasers, and stenosis of the ureteral orifice is rare. There
      is experimental evidence that laser treatment does not increase the absorption of
      intravesical chemotherapy, possibly allowing earlier adjuvant use of intravesical
      treatment postoperatively. On the other hand, there are limitations of laser
      treatment. Lasers are less familiar to both surgeons and operating room
      personnel. Appropriate eye protection during treatment is mandatory. Tumor
      staging is suboptimal, because tissue from the base of the lesion is not
      routinely available for histologic examination. Accordingly, appropriate patient
      selection is a paramount consideration. Finally, bowel injury without bladder
      perforation is a unique, though rare, complication of laser surgery. Simultaneous
      laparoscopy may be of benefit in some patients but is not indicated routinely.
      Although laser treatment has not revolutionized the management of superficial
      bladder cancer, it has an established and enduring role. Future changes in
      surgical instruments seem likely to increase the usefulness of lasers in managing
      patients with transitional-cell carcinoma of the bladder.

PMID- 1636233
TI  - Recurrent or aggressive bladder cancer. Indications for adjuvant intravesical
      therapy.
AB  - Advances in understanding of the variables that adversely affect the prognosis of
      patients with superficial bladder cancer allow more accurate predictions of the
      aggressive biologic potential of tumors. Intravesical therapy appears to be an
      effective and essential adjuvant in those patients with high-risk tumor
      variables. Multiple risk factors related to the tumor, individual patient
      characteristics, and treatment modality must be evaluated. Assignment of the
      relative importance of these risk factors will differ from patient to patient.
      Factors useful for predicting tumor aggressiveness in order to decide the
      appropriateness of adjuvant intravesical therapy include tumor size,
      configuration, and grade; ploidy status; Tis and T1 categories; multifocality;
      postoperative cytologic analysis; the failure of prior intravesical therapy; and
      prostatic urethral involvement. The integration of this information with
      formulation of a treatment plan represents both the art and the science of
      urologic oncologic practice. Research efforts need to be directed at the
      development of better tumor markers for superficial bladder cancer.

PMID- 1636234
TI  - Carcinoma in situ.
AB  - Carcinoma in situ is a high-grade and aggressive manifestation of transitional
      cell carcinoma of the bladder that has a highly variable course. The treatment of
      CIS has undergone dramatic changes since this malignancy was first recognized.
      While cystectomy was once recommended as the initial treatment of choice,
      recognition of the highly variable prognosis and the uniformly high response rate
      to intravesical BCG has prompted a more conservative approach to management.
      While it is recommended that patients be offered the option of radical
      cystectomy, data do not currently exist to confirm that cystectomy provides a
      superior survival or quality of life compared with an initial trial of BCG
      immunotherapy followed by salvage cystectomy if needed. With current optimal BCG
      immunotherapy regimens, which consist of a 6-week course of BCG followed by three
      weekly instillations at 3 months, 6 months, and every 6 months for 3 years, the
      complete response rate is 82%; and it is estimated that more than 75% of patients
      having a complete response will remain continuously disease free for 5 or more
      years. Patients who fail BCG immunotherapy without evidence of progression may
      yet be candidates for intravesical chemotherapy, photodynamic therapy, or
      alternative immunotherapies such as alpha-2b interferon, bropirimine, or keyhole
      limpet hemocyanin.

PMID- 1636235
TI  - Principles of intravesical chemotherapy and immunotherapy.
AB  - By tailoring the use and selection of an intravesical agent to the individual
      patient, it should be possible to reduce toxicity and avoid overtreatment.
      Similarly, patients with more alarming disease processes can be treated sooner if
      the need for that more aggressive or toxic therapy is recognized early. Finally,
      it is important to recognize that patients who fail initial therapy with BCG have
      a good probability of responding to additional BCG and that there are promising
      investigational immunotherapies available for those who fail adequate courses of
      BCG.

PMID- 1636236
TI  - Intravesical chemotherapy. Treatment selection, techniques, and results.
AB  - A variety of chemotherapeutic agents are available for the patient with rapidly
      recurring superficial bladder cancer. Management should have two therapeutic
      goals--ablation of existing tumors and prevention of tumor recurrence. Stage,
      grade, and multicentricity are all important factors in the decision for
      therapeutic intervention. Intravesical instillation of chemotherapeutic agents
      can reduce the rate of recurrence of superficial tumors but has not yet been
      proved to lower the incidence of later muscle-invasive tumors. Different dosage
      schedules and methods require further study. Empiric dose schedules may not
      provide optimal therapeutic effects. The question of timing of instillation of
      agents after definitive resection needs clarification as well. Questions that
      remain can be answered only through appropriately designed studies encompassing
      large numbers of patients with treatments assigned in a randomized fashion.

PMID- 1636237
TI  - Complications of intravesical chemotherapy.
AB  - A variety of intravesical chemotherapeutic agents are now available for the
      treatment of superficial transitional-cell carcinoma of the bladder. The
      toxicities associated with these agents may make one more appealing than another
      in the face of similar efficacies. Intravesical instillations of thiotepa have
      resulted in incidences of leukopenia of 8% to 54%, of thrombocytopenia of 3% to
      31%, and of irritative voiding symptoms of 12% to 69%. Close monitoring of blood
      counts prior to weekly instillations remains vital in preventing myelosuppressive
      complications. The complications associated with the intravesical use of
      mitomycin C are mainly chemical cystitis and contact dermatitis. Additionally,
      allergic reactions have been documented. Most of these complications respond to
      cessation of therapy with application of topical steroids as needed.
      Complications of reduced bladder capacity, bladder-wall calcifications, and
      myelosuppression are uncommon. Toxicities associated with the use of doxorubicin,
      epirubicin, and ethoglucid are almost exclusively local and usually described as
      mild to moderate dysuria, frequency, or urgency. Case reports of systemic
      reactions to doxorubicin are notable in that the patients responded well to
      diphenhydramine and, in one severe case, epinephrine. Other adverse effects such
      as reduced bladder capacity, fever, and nausea and vomiting are very uncommon.
      New agents, such as mitoxantrone, are undergoing phase I and phase II studies.
      The ideal agent, which would be highly effective and minimally toxic, remains to
      be developed.

PMID- 1636238
TI  - Immunology of the bladder.
AB  - Immunobiology techniques that once were the domain of research are increasingly
      being applied in the clinic. Transitional epithelium of the bladder undergoes
      some recognized immunologic changes as it becomes malignant, and their detection
      may have prognostic value. Examples of such changes are deletion of the ABO(H)
      blood group antigens, inappropriate expression of Lewis antigens, loss of beta-2
      microglobulin and the MHC class 1 heavy chain, and alterations in the production
      of cellular adhesion molecules and integrins. Other possibly useful markers are
      ras oncogene products, Thomsen-Friedenreich antigen, epidermal growth factor
      receptor, and perhaps antigens unique to transitional-cell carcinoma.

PMID- 1636239
TI  - Bacillus Calmette-Guerin immunotherapy. Techniques and results.
AB  - Intravesical instillation of bacillus Calmette-Guerin (BCG) has become an
      important adjunct in the management of patients with stages Ta and T1
      transitional-cell carcinoma of the bladder and carcinoma in situ (CIS). For BCG
      to be effective, patients should be assigned to the appropriate protocol. With
      proper treatment, tumor recurrences can be prevented in as many as 80% of
      patients, residual tumor eradicated in 60%, and CIS eliminated in 70% of
      appropriately selected patients.

PMID- 1636240
TI  - Complications of bacillus Calmette-Guerin immunotherapy.
AB  - Knowing when to give and when to withhold BCG will prevent most complications,
      but even when all precautions are taken, some complications will occur. The
      initial step in the treatment of infectious complications is the use of
      isoniazid. Routine prophylactic isoniazid should not be given, as animal studies
      have confirmed that immune stimulation, and presumably antitumor activity, can be
      inhibited by isoniazid prophylaxis. However, when cystitis persists more than 2
      days or is so severe that it does not respond to symptomatic treatment, isoniazid
      300 mg daily is used to control the symptoms, prevent progressive infection, and
      avoid the overgrowth of BCG, which can result in excessive organisms and
      suppression of the immune response. If symptoms progress despite isoniazid
      treatment or do not begin to abate within 1 to 2 weeks, rifampicin 600 mg daily
      is added. Rifampicin is given from the beginning in patients with potentially
      severe extravesical BCG infection such as pneumonitis, hepatitis, or nephritis.
      In patients with symptoms such as fever, malaise, or bladder irritation that
      respond within a few days, it generally is necessary to continue antitubercular
      antibiotics for only 2 weeks. Those with extravesical infection and those who do
      not respond promptly to treatment are treated for 3 months, and those with severe
      or deep-seated infection are treated for 6 months. The current recommendation for
      the treatment of sepsis after BCG administration, based on limited clinical
      experience and controlled animal experimentation, is to use isoniazid and
      rifampicin plus prednisolone 40 mg daily.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636241
TI  - Long-term results of intravesical therapy for superficial bladder cancer.
AB  - Intravesical chemotherapy will cause complete regression of existing papillary
      tumor in one third to one half of patients. Controlled clinical trials have
      demonstrated that chemotherapy reduces the short-term incidence of tumor
      recurrence by 15% to 18%, but by 5 years, the number of patients suffering tumor
      recurrence is equal to that in patients treated with surgery alone. Tumor
      progression cannot occur in the absence of tumor recurrence, but existing studies
      of intravesical chemotherapy have failed to demonstrate significant reduction in
      disease progression or mortality rate with treatment. Immunotherapy has the
      advantage of a mechanism of action different from that of cytotoxic chemotherapy.
      Immunotherapy with BCG has resulted in complete tumor regression in one half or
      more of treated patients with papillary tumors and in more than 70% of those with
      CIS. Controlled studies similarly demonstrate a significant reduction in tumor
      recurrence, and protection from tumor recurrence has been observed to persist for
      5 years or more. At the present time, data remain limited, but three controlled
      studies have found statistically significant reductions in the rate of disease
      progression, and one has found a significant reduction in the mortality rate,
      with BCG immunotherapy. These observations provide convincing evidence that
      immunotherapy is the treatment of choice for patients with aggressive superficial
      tumors and suggest that the development of immunotherapeutic alternatives to BCG
      is likely to be rewarding.

PMID- 1636242
TI  - When intravesical measures fail. Indications for cystectomy in superficial
      disease.
AB  - The indications for intravesical therapy for superficial bladder cancer include
      multifocal or recurrent tumors, lamina propria invasion, CIS, and superficial
      involvement of the prostatic urethra. Tumor-free success rates approach 70% in
      most series. Intravesical therapy is usually administered as a 6-week course with
      a re-evaluation of the bladder at the 3-month interval. If disease persists, a
      second 6-week course of therapy is administered. If tumor recurs or persists at
      the 6-month evaluation, treatment is considered to have failed, and another form
      of therapy is instituted (Fig. 1). In the 30% of patients failing an adequate
      course of intravesical therapy, cystectomy may be indicated for uncontrollable
      superficial disease not amenable to transurethral resection, persistent grade III
      lesions, lamina propria invasion, persistent CIS, persistent involvement of the
      prostatic urethra, and persistence of tumor in a nonfunctioning bladder. Rarely,
      cystectomy may be indicated because of severe adverse effects related to
      intravesical therapy.

PMID- 1636243
TI  - Continent urinary diversion using an ileal servomechanism sphincter.
AB  - A continent, catheterizable, physiologically responsive urinary sphincter
      servomechanism can be created from a short segment of ileum for use in a
      continent urinary diversion. Because it is easily constructed and provides
      dynamic continence control, this new sphincter appears to have applications in
      reconstructive urologic surgery.

PMID- 1636244
TI  - Autologous rib perichondrial grafts in experimentally induced osteochondral
      lesions in the sheep-knee joint: morphological results.
AB  - The purpose of the present study was to examine the fate of autologous
      perichondrial grafts after transplantation into cartilage lesions in weight
      bearing joints. Osteochondral lesions were made in the articular surface of knee
      joints in 36 sheep. The defects were filled with autologous rib perichondrial
      grafts which were secured by either collagen sponges (12 animals) or fibrin glue
      (12 animals). Defects without perichondrial grafts served as controls (12
      animals). Following 1 week of immobilization of the operated leg, the plaster was
      removed and the animals were allowed to move freely. Animals were sacrificed
      after 4, 8, 12 and 16 weeks. The grafts were removed and investigated
      histologically. In contrast to weight-bearing areas and control defects, hyaline
      like cartilage formation was seen in non-weight-bearing areas after 4 weeks. This
      newly formed cartilage revealed strong metachromasia following staining with
      acidic toluidine blue and reacted positively with periodic acid-Schiff,
      indicating de novo synthesis of proteoglycans and glycoproteins. Scanning
      electron microscopy and examinations with polarized light confirmed a hyaline
      cartilage-like architecture for the surface area as well as for the fibre
      orientation of the whole graft. Enzyme histochemistry for alkaline and acid
      phosphatase activity showed positive reactivity only at the base of the
      transplants.

PMID- 1636245
TI  - Adrenal tumours in Chinese.
AB  - Patients with adrenal tumours were identified (n = 412). Among them, 43% (176
      patients) had primary and 57% (236 patients) had secondary tumours. Of the
      primary tumours, 71% were adenomas, but adrenal cortical carcinoma 6.8% (12
      cases), phaeochromocytoma 9.7% (17 cases), neuroblastoma 6.2% (11 cases),
      ganglioneuroma 1.1% (2 cases) and myelolipoma 4% (7 cases) were also seen. Rare
      tumours like lipoma and haemangioma were also found. Most of the metastatic
      tumours were carcinomas (88.2%), mainly from lung (33.2%), stomach (15.9%) and
      oesophagus (17.3%).

PMID- 1636246
TI  - Differentiated thyroid carcinomas: the relevance of various pathological features
      for tumour classification and prediction of tumour progress.
AB  - In this series of 263 surgically treated cases of thyroid cancer, 12% were
      finally classified as benign lesions after histopathological review. Difficulty
      in the assessment of tumour capsule invasion in follicular neoplasms was the most
      frequent cause of diagnostic error. Squamous metaplasia, clusters of ground glass
      nuclei and psammoma bodies were found to be the most specific discriminators
      between papillary and follicular carcinomas. Among papillary carcinomas, tumour
      diameter above 30 mm, thyroid capsular invasion and regional lymph node
      metastases were found to be significant prognostic factors according to survival
      analyses. Of additional practical importance, our results indicate that tumour
      infiltration in the thyroid capsule should be reported as a marker of early extra
      thyroidal extension.

PMID- 1636247
TI  - Macrophages in normal human bone marrow and in chronic myeloproliferative
      disorders: an immunohistochemical and morphometric study by a new monoclonal
      antibody (PG-M1) on trephine biopsies.
AB  - An immunohistochemical and morphometric study was performed on routinely
      processed trephine biopsies of the bone marrow in 30 normal individuals and in 90
      patients with various subtypes of chronic myeloproliferative disorder. Using a
      new monoclonal antibody (PG-M1) directed against a formalin-resistant epitope on
      macrophages and by employment of the Prussian blue reaction, quantitation of this
      cell population was feasible. Morphometric analysis revealed that the number of
      iron-laden macrophages represented only a fraction of the total number of
      histiocytic reticular cells. As could be expected, in polycythaemia rubra vera,
      no haemosiderin deposits were detectable, but the content of macrophages slightly
      exceeded that of the normal bone marrow. In chronic myeloid leukaemia 9 of 30
      patients showed a significant increase in PG-M1-positive reticular cell elements.
      These were consistent with pseudo-Gaucher cells, sea-blue histiocytes and
      intermediate cell types. Primary (idiopathic) myelofibrosis-osteomyelosclerosis
      was characterized by a significant increase in macrophages (25 of 30 patients).
      Involvement of macrophages in the complex mechanisms generating bone marrow
      fibrosis and angiogenesis and in bone remodelling (osteosclerosis) may be
      responsible for this finding.

PMID- 1636248
TI  - Microscopic features of the regeneration of white pulp in autotransplanted
      spleens in rats.
AB  - The process of regeneration of white pulp in autotransplanted splenic tissue,
      implanted into a pocket made by the greater omentum in rats, was investigated
      histologically and immunohistochemically. Three days after transplantation,
      almost all implants were necrotic. At day 7, viable splenic tissue had gradually
      regenerated at the periphery of the implants. At day 10, lymphocytes accumulated
      around the arterioles. The accumulations resembled the periarteriolar lymphoid
      sheath of normal spleens in structure, but consisted mainly of B-lymphocytes,
      with a few scattered T-lymphocytes. However, by week 2, the localization peculiar
      to T- and B-lymphocytes became definite, and follicular dendritic cells were
      simultaneously observed in the lymph follicles. This regeneration of the white
      pulp in the autotransplanted spleens differed from the formation of the white
      pulp during ontogeny and during recovery after spleen irradiation.

PMID- 1636249
TI  - Chromosome analyses in patients with myelodysplastic syndromes: correlation with
      bone marrow histopathology and prognostic significance.
AB  - Chromosome analyses of bone marrow and peripheral blood cells were performed in a
      total of 51 patients with myelodysplastic syndromes (MDS) simultaneously with
      histopathological examination of resin-embedded bone marrow biopsies. Diagnosis
      of MDS was established by histopathology according to the French-American-British
      (FAB) classification, and reassessed by haematological data and clinical course.
      Clonal karyotypic changes were found in 30 of the 51 patients (59%): in 15 of 19
      (79%) patients with refractory anaemia, 7 of 11 (64%) with refractory anaemia and
      excess of blasts (RAEB), 6 of 10 (60%) with RAEB in transformation, and 2 of 11
      (18%) with chronic myelomonocytic leukaemia. The following three features of the
      histopathology revealed positive correlations with karyotype abnormalities: all
      cases of myelofibrosis in MDS (7/51) were accompanied by chromosome aberrations,
      microforms of megakaryocytes with reduced nuclear lobulation were observed in 18
      of 30 cases with karyotype changes, and hypocellularity of haematopoiesis was
      associated with aberrations of chromosome 7 in 2 of 4 cases. No positive
      correlations were revealed between abnormal karyotypes and the transformation to
      acute leukaemia. The survival times were significantly decreased in patients with
      complex (3 and more) karyotype changes, when compared with patients with single
      (1-2) chromosome aberrations or normal karyotype, independently of the FAB
      classification.

PMID- 1636250
TI  - Vascular and myofibrillar lesions in acute myoglobinuria associated with
      carnitine-palmityl-transferase deficiency.
AB  - A case of severe exercise-induced myoglobinuria in a 14-year-old boy suffering
      from a carnitine-palmityl-transferase (CPT) defect is reported. Biopsies of the
      forearm muscle were examined using light and electron microscopy in the acute and
      recovery phases of the illness. The first biopsy showed the presence of scattered
      foci of necrosis where necrotic fibres with occasional disruptions of the basal
      lamina were seen around injured capillaries. Various degrees of damage and
      different stages of evolution were found in these foci, which also contained
      regenerating muscle fibres. In the second biopsy, performed 2 weeks later, most
      of the fibres displayed a normal structure. Necrosis was no longer present.
      However, in some areas perivascular fibrosis was prominent, the fibres were small
      and irregularly shaped, and their nuclei often centrally located. These data
      strongly suggest that circulatory disorders and ischaemia, brought about by
      premature acute metabolic imbalance, could be involved in the development of
      exercise-induced myolysis observed in CPT deficiency. The risk of fibrous
      cardiomyopathy in these patients is pointed out.

PMID- 1636251
TI  - The features of glomerulitis in the acute stage of panarteritis nodosa.
      Developmental process of glomerulitis and correlation between glomerular and
      vascular lesions.
AB  - In order to determine the morphological characteristics of certain vascular and
      glomerular lesions and the correlation between them, we attempted three
      dimensional observation using serial sections of an autopsy kidney, from a
      patient with panarteritis nodosa in the acute phase. Fibrinoid necrotizing
      vasculitis spread from arcuate arteries to arterioles in a segmental, eccentric
      pattern, especially occurring at bifurcations. Segmental arteriolitis often
      originated in extraglomerular capsular arteriole and spread into the
      intraglomerular capsular arteriole and glomerular capillaries, directly leading
      to necrotizing glomerulitis. Some of the glomerulitis connected directly with
      extracapsular arteriolitis was segmental and eccentric in distribution. Most of
      the glomerulitis had a tendency to originate in the hilar arteriole, which was
      near bifurcations between the arteriole and glomerular capillaries. Segmental
      glomerulitis was found to consist of four elements: glomerular tuft necrosis with
      fibrin exudation, crescents, rupture or dissolution of Bowman's capsule, and
      pericapsulitis. It is suggested that the segmental inflammatory attacks, repeated
      more than twice, give rise to widespread and almost global necrotizing
      glomerulitis.

PMID- 1636252
TI  - Vimentin expression by Reed-Sternberg cells in Hodgkin's disease.
AB  - The expression of vimentin in Reed-Sternberg cells in 61 samples of Hodgkin's
      disease (HD) was examined using an avidin-biotin-peroxidase complex technique.
      Forty biopsies (66%) expressed vimentin, and expression was seen in all subtypes
      of HD. No immunophenotypic differences between vimentin-positive and vimentin
      negative cases were noted. The significance of such expression is unclear, but
      may be related to the alterations in growth and differentiation that are typical
      of neoplastic cells.

PMID- 1636253
TI  - Health Care Access Task Force report. Non-financial barriers to care.

PMID- 1636254
TI  - Practice alert! Immunization initiative.

PMID- 1636256
TI  - Making research work for you.

PMID- 1636255
TI  - Doing something about domestic violence.

PMID- 1636257
TI  - [The long-term behavior of homologous bone transplants in reconstruction of
      single chamber calcaneus cysts. Conventional and computerized tomography
      results].
AB  - Treatment of four unicameral calcaneal bone cysts by operative packing with
      homologous trabecular bone grafts was evaluated by conventional radiography and
      CT after a mean follow-up time of 51 months (range 48-57 months). Data on graft
      incorporation and remodelling are presented. In all cases trabecular bone showing
      an orderly arrangement was found to have developed in the cyst space. Homogeneous
      areas were present in 2 instances. These coincided with the neutral triangle,
      i.e. a zone in which stresses are physiologically low. Graft incorporation and
      remodelling followed Wolff's laws of bone transformation and can be regarded as
      complete before month 27. The final bone pattern is definitely established before
      month 50. Conventional radiography is sufficient for routinely evaluating the
      healing pattern. CT should be reserved for research purposes. Impaction of
      trabecular bone chips may be dispensable. Tight packing without impaction would
      at least help to save bone graft material. The use of homologous trabecular bone
      subjected to special pretreatment was found to be unproblematic. It minimizes
      surgery-related stresses and reduces the operating time.

PMID- 1636258
TI  - [Intravenous peripheral digital subtraction angiography after stabilization of
      medial femoral neck fractures. Results and value].
AB  - In patients with medial femoral neck fractures the condition of the blood vessels
      is the decisive factor as to whether or not femoral capital necrosis will
      develop. Therefore, conventional angiography has been used both preoperatively
      for the diagnostic work-up and for selecting the best mode of management and
      postoperatively for prognostic purposes. Its routine use has, however, been
      limited by the long examination time, the complexity of the technique and the
      potential complications. Peripheral intravenous digital subtraction angiography
      (DSA) for imaging peripheral vessels is a far less demanding procedure. Its
      usefulness was studied postoperatively in 7 patients. The vascular information
      obtained was inferior to that of conventional angiography because of the
      inherently poorer vessel imaging qualities. Moreover, since its applicability is
      limited to patients with a completely intact cardiovascular system and normal
      cardiac output, it is not suitable for most geriatric patients. It is, therefore,
      concluded that peripheral intravenous DSA cannot (yet) be recommended as a
      routine procedure. It remains to be seen whether technical improvements in system
      features will improve the diagnostic performance.

PMID- 1636259
TI  - [Spinal internal fixator--analysis of problems in 28 cases].
AB  - Problems encountered in the management of thoracolumbar and lumbar spinal
      fractures with the "fixateur interne" are reviewed. 28 patients were treated
      between 1986 and 1988. Retrospective analysis identified the following problems:
      a. Loosening of nuts at the longitudinal rod and/or clamp ends--b. Major
      corrosion defects of Schanz screws and clamps--c. Large implant volume--d. Non
      availability of intermediate rod lengths. Earlier problems, i.e. the absence of
      an effective press-fit (transverse stabilizer) between the 2 longitudinal rods
      and the non-availability of a cutter for trimming the Schanz screws, have
      meanwhile been resolved. Loosening of the nuts at the clamp end may cause
      substantial loss of reduction and jeopardize the outcome of treatment. The
      problem of how to identify loosening, which is usually recognizable within 27
      days, is discussed at length. Since loosening occurs irrespective of fracture
      type and site, instrumentation length, ancillary surgical procedures, type of
      postoperative care, preoperative neurological status and operating surgeon, it
      appears to be inherent in the system. Alterations in neighbouring vertebral
      segments attributable to rebundant rod lengths cannot altogether be excluded. The
      potential occurrence of corrosion defects should prompt implant removal after
      radiologically confirmed fracture healing.

PMID- 1636260
TI  - [Comparison of manual and mechanical anastomosis technique in operations on the
      large intestine].

PMID- 1636261
TI  - [The human chorionic gonadotropin (hCG) receptor: a new class within the family
      of GTP protein coupled receptors. Epitope mapping of receptor-bound agonistic and
      antagonistic forms of hCG].
AB  - Human chorionic gonadotropin (hCG) is a member of the glycoprotein hormone
      family. It is composed of an alpha and a beta subunit, the latter being closely
      homologous to that of human luteinizing hormone (hLH). HCG and hLH bind to the
      same receptor. The molecular mass of hCG is 38 kD, up to 30% of which is
      contributed by the carbohydrate moieties linked to each of the two subunits.
      Structure-function relationship studies have indicated that both subunits
      interact with the receptor and that altogether four different peptide domains
      (two on each subunit) are responsible for high-affinity receptor binding. The
      carbohydrate units are responsible for expression of agonist activity:
      deglycosylated hCG (degly-hCG) is unable to induce a biological response (cAMP
      increase), despite high-affinity binding. We have previously mapped the antigenic
      surface of hCG and described 14 different epitopes that can be recognized by
      specific monoclonal antibodies (MCA), i.e. five epitopes on the alpha subunit,
      five on the beta subunit and four epitopes which are formed through association
      of the two subunits (conformational or alpha beta epitopes). The number and
      topography of epitopes was found to be the same on degly-hCG. This framework of
      immunological coordinates was then applied to probe the orientation of hCG, as
      well as that of the competitive antagonist degly-hCG in their receptor-bound
      states. With a receptor-hormone-125I-MCA sandwich approach we found that while
      hCG still presented two of the 14 epitopes, i.e. beta 3 and beta 5, no epitope
      was accessible on receptor-bound degly-hCG. This differential pattern thus
      correlates with the signal transduction-competence of the respective ligand.
      Overall, these data indicate that most of the surface of hCG is masked by
      moieties of the receptor. Accordingly, that moiety must itself be folded in a way
      that it provides a large contact surface. No portion other than the 341-residue
      long extracellular domain would seem capable of doing that. Computer-assisted
      secondary structure predictions support this view. This domain is the novel
      feature that distinguishes glycoprotein-hormone receptors from the other members
      of the G protein-coupled receptor superfamily.

PMID- 1636262
TI  - [Importance of locus of control in the disease adjustment process in women with
      genital cancer].
AB  - This study deals with psychological aspects of coping observed in gynecological
      cancer patients--on the one hand with behavioral, emotional and cognitive
      reactions to the disease and on the other hand with the efficiency value of these
      mechanisms in handling the disease. As one important aspect, the attitude towards
      control of the disease should be correlated with the coping process. Accordingly,
      the results demonstrate a correlation between high self-responsibility and
      positive appraisal of the disease: Women who believe they are in control of the
      disease try harder to fight the disease and interpret their own situation more
      positively than women with a fatalistic attitude and this enables them to make
      more sense of the disease; they experience more positive changes in their own
      lifestyle due to the disease. Furthermore, women who ascribe responsibility for
      the course of the disease to other interpret their situation in a more positive
      light. They actively search for social support and obviously experience this
      trust in the power of other people as a helpful measure. A fatalistic attitude to
      the disease is combined with rumination and social withdrawal.

PMID- 1636263
TI  - [Precancerous stages of cervix cancer (CIN)--attitude and coping with the
      disease].
AB  - The subjective reactions and the mental state of 50 patients with a diagnosis CIN
      I, II and III were studied. The data were gathered after gynaecological follow-up
      examinations in semistructured interviews and with a list of complaints (B-L)
      according to Zerssen (1975). Patients with CIN I or II were examined and
      interviewed 3 months after diagnosis, patients with persistent CIN I or II were
      studied after 6 months, and patients with CIN III before conization. Patients
      with CIN reacted to the diagnosis in a similar manner to patients confronted with
      the diagnosis of cancer. Effective coping with the disease depended on adequate
      medical information being received by the women. The patients who were satisfied
      with the medical information had a more positive approach to the course of the
      disease and found it less life-threatening than those patients who were
      dissatisfied with the information received. The results of this study indicate
      that subjective experience of the disease is largely independent of its objective
      severity.

PMID- 1636265
TI  - [Thrombophlebitis and ulcus cruris caused by primary varicose veins of the lower
      extremity. Diagnostic and therapeutic consequences for the general practitioner].

PMID- 1636264
TI  - [Clinical aspects and epidemiology of hepatitis B].

PMID- 1636266
TI  - [Still's disease in adulthood].

PMID- 1636267
TI  - [Medical promotion practices in the 1st half of the 18th century exemplified by
      Halle].

PMID- 1636268
TI  - [Saxony medical development reflected by the royal calendar and state records
      (1728-1934)].

PMID- 1636269
TI  - [Correlation between acinar cell fat accumulation and secretory capacity of the
      rat pancreas in the early stage of alcohol-induced pancreatopathy].
AB  - In patients exhibiting chronic alcohol abuse, the accumulation of fat droplets in
      pancreatic acinar cells, as well as changes in pancreatic secretion, can be
      interpreted as early signs of pancreatic damage. Using rats, (the animals were
      fed for 9 +/- 1 months with a solution of 20% v/v ethanol, combined with either a
      normal or a fat enhanced diet) we tested whether or not these symptoms are
      related both to each other and to morphological lesions of the tissue. Based on
      six separate histological criteria, the lesions were classified into five stages
      of severity. In order to characterize the secretory capacity of the pancreas, we
      measured the outputs of lipase, alpha-amylase, trypsin, chymotrypsin,
      carboxypeptidase A, elastase, and phospholipase A. Compared with the control
      group, we found that the alcohol-fed animals exhibited a significantly higher
      degree of morphological damage to the pancreas, as well as an increased frequency
      of fat accumulation in the acinar cells, and, with the exception of alpha
      amylase, a rise in the level of enzyme secretion. In the animals exhibiting the
      highest degree of tissue damage, however, both fat accumulation and
      hypersecretion appeared to be diminished. This diminution could possibly be
      interpreted as the first sign of chronic pancreatitis. Increased consumption of
      fat did not change either the level of fat accumulation in the acinar cells, or
      the level of pancreatic secretion. Within the group of alcohol-fed rats, the most
      pronounced levels of hypersection were found in animals exhibiting cellular fat
      accumulation. However, the secretion levels of the alcohol-fed animals exhibiting
      no such fat accumulation did not differ significantly from that of the control
      group. Therefore, a relationship appears to exist in rats between fat
      accumulation in acinar cells and the level of pancreatic secretion.

PMID- 1636270
TI  - [The diagnostic value of the amino acid absorption test in detection of a
      disorder of exocrine pancreatic function].
AB  - The amino acid consumption test (AACT) during exogenous stimulation with secretin
      and CCK was proposed as a sensitive and highly specific test for detection of
      exocrine pancreatic insufficiency. To further investigate the diagnostic value of
      this test we measured the AACT in comparison with the pancreolauryl serum test
      (PLT) in patients with chronic pancreatitis and in patients with gastrointestinal
      diseases but without pancreatic disease. A total of 48 patients, 23 patients with
      chronic pancreatitis (CP) and 25 patients with gastrointestinal diseases, were
      included in the study. Diagnosis of chronic pancreatitis was established by
      standardized morphological criteria in ultrasound, ERCP, CT, and was confirmed by
      surgery in 11 cases. The PLT was abnormal in 83% of patients with chronic
      pancreatitis and normal in 92% of the control subjects (diagnostic accuracy 88%).
      Basal amino acid concentration was comparable in patients with chronic
      pancreatitis and in control subjects (300 +/- 12 [symbol: see text] 325 +/- 16
      mumol/l). The peak decrease of amino acids occurred after 30 min during combined
      stimulation with secretin and ceruletide and was not different between the two
      groups (CP: 11.2 +/- 1.7%, controls: 13.9 +/- 1.9% below basal values). With a
      12% decrease of amino acids as cutoff, sensitivity was 74% and specificity 52%
      (diagnostic accuracy 63%). Integrated amino acid decrease did not show any
      significant differences between CP and controls (CP: 228 +/- 63% min, controls:
      397 +/- 80% min). Determination of the individual amino acids serine, valine,
      histidine, and isoleucine could also not discriminate between patients with
      chronic pancreatitis and other gastrointestinal diseases.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1636271
TI  - [An increased incidence of bacterial endocarditis in chronic inflammatory bowel
      diseases].
AB  - Of 92 consecutive patients treated for proven native valve endocarditis three had
      ulcerative colitis and 2 Crohn's disease. All 5 patients developed severe
      complications; three had to undergo emergency valve replacement. With a
      prevalence of 64.1/10(5) cases of inflammatory bowel disease the calculated
      incidence (5/92) revealed a significant over-representation of inflammatory bowel
      disease among patients with proven endocarditis (p less than 5.08 x 10(-9)).
      Possible explanations may be the suppression of cellular immune defense by
      therapeutic interventions, high frequency of bacteremia caused by increased
      permeability of the damaged mucosa for bacteria and a higher incidence of
      diagnostic and therapeutic interventions in this patient population. Therefore,
      prophylaxis for bacterial endocarditis should be carefully considered before
      expected bacteremias in patients with highly active inflammatory bowel disease
      even in the absence of cardiac factors predisposing to bacterial endocarditis.

PMID- 1636272
TI  - [Experimental damage of the epithelial layer of the ileum by dietary fats:
      transmission electron microscopy findings and their comparison with cell
      pathology in Crohn disease].
AB  - Regarding the unknown pathogenesis of Crohn's disease repeatedly the importance
      of diet has been accentuated. Epidemiological, biochemical and animal
      experimental results have focused on a possible relationship between the
      consumption of chemically processed, partial hydrogenated fats and the
      development of regional enteritis. In this context an experimental animal model
      in pigs was designed to analyze, whether transmission electron microscopic
      alterations of ileal mucosa could be induced by forage of chemically processed
      fats. By creation of a retroperistaltic ileal segment the contact time between
      chyme and intestinal mucosa was prolonged. Our underlying question was to what
      extent disorders of the intestinal barrier function could be compared to Crohn's
      disease. Present study concentrates on the epithelial-cell-layer. It was shown
      that in comparison to the control animals the lamina epithelialis mucosae of all
      animals after fat-feeding was characterized by: sublethal lesion of the
      enterocytes/crypt-epithelial cells (shortening and alteration of the microvilli,
      degeneration of mitochondria, formation of autophagocytic vacuoles); goblet cell
      hyperplasia and increased production of mucus; focal appearance of
      intraepithelial lymphocytes as well as presence of polymorphonuclear granulocytes
      in the epithelium; widening of the intercellular-space locally up to total loss
      of the functional structure of the epithelial-cell-layer. In total the picture
      can be evaluated as an inflammatory process of the ileal mucosa. It can be
      concluded, that chemically processed fats as used in the described experimental
      conditions could induce this process. The feature of mucosal damage shows obvious
      similarities to ultrastructural findings in Crohn's disease if compared.

PMID- 1636273
TI  - Superficial esophageal carcinoma in achalasia, detected by endoscopic
      surveillance.
AB  - A 42 year old woman had undergone a Heller myotomy for achalasia of the cardia at
      age 28. Thereafter, she had become asymptomatic but reported for endoscopic
      follow-up examinations at three-yearly intervals. Fourteen years after surgery,
      endoscopy and biopsy revealed "carcinoma in situ" in the proximal esophagus and
      surgery was recommended. In the resected specimen, a circumscribed area of cancer
      was demonstrated that invaded the lamina propria but was confined to the mucosa.
      With the exception of mild and transient postoperative dysphagia, she had an
      uneventful postoperative course and remains well 16 months following surgery.
      This case demonstrates that endoscopic surveillance may detect early malignant
      changes in the achalasic esophagus and may possibly lead to an improvement in
      survival.

PMID- 1636274
TI  - [An interesting case--endoscopic hemostasis of an actively bleeding sigmoid
      diverticulum--a case report].
AB  - A pulsating arterial bleeding from a diverticulum, situated in the colon
      sigmoideum, was identified and stopped during video-documentation in a 70 year
      old man. After injection with a solution of suprarenin, the diverticulum was
      turned out like a balloon into the colon and didn't show any signs of further
      bleeding until the patient was prepared for a semi-elective resection of the
      sigmoid. This case demonstrates that emergency endoscopy is an effective method
      for diagnosis and even therapy of massive lower intestinal bleeding which
      eventually has to be supplemented by radiological techniques like scintigraphy
      and arteriography.

PMID- 1636276
TI  - [Esophageal perforation in attempted ERCP].
AB  - In this report we refer to a 88-years old female patient who was admitted to our
      hospital under the diagnosis of cholecysto- and choledocholithiasis. Due to
      clinical symptoms, general performance status and sonographically proven dilated
      bile ducts emergency-ERCP was performed by an experienced endoscopist.
      Unfortunately esophageal perforation occurred due to subsequently diagnosed
      hiatus hernia. Potential pitfalls during examination as well as a concept of
      problem management during endoscopies with side-view optics will be discussed.

PMID- 1636275
TI  - [Side effects of laxatives].
AB  - The side effects of anthraquinones, diphenylmethane derivatives (e.g. bisacodyl,
      sodium picosulphate), saline laxatives, lactulose, and cisapride are discussed.
      When taken in recommended doses, no relevant side effects have been observed,
      except for hypermagnesemia following magnesium containing cathartics in renal
      insufficiency. This holds also true for the time of pregnancy and lactation.
      (Pseudo-)melanosis coli is characterized by pigment loaded macrophages without
      apparent functional consequences. It occurs mainly after anthraquinones, but to a
      lesser degree also after diphenylmethane derivatives. Clinically relevant side
      effects of the above laxatives have been published exclusively after excessive
      dosing. They consist in electrolyte disturbances (mainly hypokalemia), metabolic
      alkalosis, renal tubular dysfunction, and other less frequent side effects. Cases
      of "cathartic colon" have not been published during the last decades. It was
      probably due to laxatives which are no longer used.

PMID- 1636277
TI  - [Pancreatic transplantation: success and problems].
AB  - The results of pancreatic transplantation could be improved markedly since using
      the bladder drainage technique. The best function rates can be achieved when
      transplanting simultaneously a kidney from the same donor. In our own series of
      50 combined pancreas-/kidney transplantations (CPKT) the 1-year-graft function
      rate for both organs reaches 88%. The drainage of the exocrine pancreatic
      secretions into the urinary tract leads, however, to a high incidence of
      recurrent urinary tract infections. Diagnosis of rejections after combined
      pancreas-/kidney transplantation is mainly based on the function of the
      simultaneously transplanted kidney and the exocrine secretion of the pancreatic
      graft. In spite of triple drug therapy (prednisolone, azathioprine, cyclosporine
      A) and ATG (antithymocyte globulin) prophylaxis the incidence of acute rejection
      episodes is initially high. For rejection therapy monoclonal antibodies, such as
      OKT3, are most effective. Glucose metabolism is almost completely normalized
      after successful pancreatic transplantation. Considering late diabetic
      complications, however, only positive effects on diabetic neuropathy are
      confirmed. This is probably due to the very late onset of therapy by pancreatic
      transplantation. A significant improvement in other late diabetic complications
      can only be expected in long term follow up studies. The positive effect on
      physical and psychological rehabilitation, however, improves the quality of life
      in most of the patients after CPKT substantially. Even though the results of
      isolated pancreatic transplantation reaches 1-year-graft function rates of
      approximately 60% in single centers, the indication to this treatment should
      consider the disadvantages of long term immunosuppression and the uncertain
      results considering secondary complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636278
TI  - [Detection of mutated ras-oncogene in pancreatic cancers: improved diagnostic
      possibilities using molecular biology techniques?].
AB  - C-Ki-ras oncogenes have been detected by polymerase chain reaction in the
      majority of pancreatic carcinomas. The biological role of ras oncogenes in
      pancreatic carcinogenesis is unknown. This review summarizes the current
      knowledge of ras oncogenes in pancreatic carcinomas, the different techniques for
      oncogenes and their possible diagnostic value.

PMID- 1636279
TI  - [Acute pancreatitis: bad prognosis for obese patients?].

PMID- 1636280
TI  - [Antibodies to neutrophilic granulocytes (p-ANCA): a further indication for a
      common origin of ulcerative colitis and primary sclerosing cholangitis?].

PMID- 1636281
TI  - [Use of endoscopy in gastritis and duodenitis].

PMID- 1636282
TI  - [Ombudsman Kristina remains administrator of Radiumhemmet. Interview by Carina
      Roxstrom].

PMID- 1636283
TI  - [Acute care department--successful example with blemishes].

PMID- 1636284
TI  - [You can lose money when you get sick during the course].

PMID- 1636285
TI  - [Documentation unsatisfactory--many cannot write a record. Interview by Jan
      Thomasson].

PMID- 1636286
TI  - [South African nurses persecuted for professional membership].

PMID- 1636287
TI  - [A market economic grasp of health care].

PMID- 1636288
TI  - [Models nobody understands].

PMID- 1636289
TI  - [District Department Stockholm: one needs competence for models].

PMID- 1636291
TI  - [SHSTF acts against racism and hostility toward strangers].

PMID- 1636290
TI  - [We must be prepared to risk meeting death. Interview by Maria Ejd].

PMID- 1636292
TI  - [Education in medical technology increases safety in nursing].

PMID- 1636294
TI  - [Health care education in the background].

PMID- 1636293
TI  - [Counseling is a success--Ann-Christine starts a course on the climacteric now.
      Interview by Eva Aldstedt].

PMID- 1636295
TI  - [After half a year in Lebanon--Gunborg and Lotta feel at home in their
      Palestinian camp. Interview by Kristina Aberg].

PMID- 1636296
TI  - [Wage negotiations in the EEC. Can the Swedish model survive?].

PMID- 1636297
TI  - [Cornea bank: an increase in the number of transplantations is possible].

PMID- 1636298
TI  - [Eye foreign bodies. Patients should be sent to the eye clinic for treatment].

PMID- 1636299
TI  - [Eye infections--a red eye can indicate infection].

PMID- 1636300
TI  - [Eye prostheses--their production with a more than 100-year old technique].

PMID- 1636301
TI  - [Retinal detachment--with microsurgery even severe cases can be cured].

PMID- 1636302
TI  - [Testing of hearing aids--the perfect apparatus cannot be found].

PMID- 1636303
TI  - [Acoustic trauma--preventive use of hearing protectors].

PMID- 1636304
TI  - [Ear infections--how to treat children with ear infections].

PMID- 1636305
TI  - [European exchange among permanent laboratory assistants].

PMID- 1636306
TI  - [Victims of dislike for foreigners].

PMID- 1636307
TI  - [Members in Vasterbotten are disappointed by employers: "Why do we have the
      lowest salary in the country?"].

PMID- 1636309
TI  - [Kitson's model shows the way].

PMID- 1636308
TI  - [We manage our own tests with Miran. Interview by Carina Roxstrom].

PMID- 1636310
TI  - [Karlskrona helps Klaipeda. A ship comes to Lithuania loaded with health care].

PMID- 1636311
TI  - [Eva and Sivan bake cakes for the socially handicapped children].

PMID- 1636312
TI  - [Nurses are key persons in child health services].

PMID- 1636313
TI  - [Acquitted from indictment of causing death].

PMID- 1636314
TI  - [Data system will provide better care and higher wages].

PMID- 1636315
TI  - [Madelein goes to Barcelona. Interview by Jan Thomasson].

PMID- 1636316
TI  - [A just pension system].

PMID- 1636317
TI  - [Now the community takes over primary health care in Ale].

PMID- 1636319
TI  - [Treatment of patients the general subject. Interview by Carina Roxstrom].

PMID- 1636318
TI  - [Margareta Hallberg (correction of Hallman), nursing instructor and researcher:
      male dominance is not always oppression].

PMID- 1636320
TI  - Molecular biology in diagnostic microbiology. PCR on Mycobacterium leprae.
AB  - The polymerase chain reaction (PCR) has already produced several hundreds of
      papers. Alternative procedures for diagnostic purposes based on nucleic acid
      detection do exist but have until now found less application. Problems with the
      PCR are discussed. It is proposed that the diagnostic microbiology laboratory has
      a section devoted to PCR for the diagnosis of diseases whose etiologic agent can
      "almost not" be cultured such as (for Flanders) Mycoplasma pneumoniae, Chlamydia
      pneumoniae, Toxoplasma gondii, EB virus and some other agents in particular
      specimens. In this setting the PCR would only be performed on selected,
      clinically justified samples, in close collaboration between clinician and
      microbiologist. PCR will evidently play an important role in research.
      Illustration is given of PCR applied for the detection Mycobacterium leprae.

PMID- 1636321
TI  - [The inventors of the obstetric forceps and the obstetric lever].
AB  - A multiple lineage is proposed for the invention of the obstetric forceps. Having
      been conceived by a member of the Chamberlen family in fifteenth- or seventeenth
      century England, the instrument seems to have been reinvented in Flanders by Jan
      Palfyn and in Holland by Rogier Roonhuyse. Later, Roonhuyse invented a more
      effective instrument for coping with the impacted head: the obstetric lever.
      Palfyn's "Iron Hands" inspired Dusse to produce the "French" forceps which bears
      his name.

PMID- 1636322
TI  - New perspectives for the chemotherapy and chemoprophylaxis of AIDS (acquired
      immune deficiency syndrome).
AB  - Various new classes of compounds have been recently identified as potent and
      selective inhibitors of acute HIV infection in vitro. As a rule, these compounds
      inhibit HIV replication at a concentration of 0.1-1 micrograms/ml, while not
      being toxic to the host cells at concentrations up to 500 micrograms/ml or
      higher. Some of the compounds even inhibit HIV replication at a concentration of
      a few nanograms per ml, thus achieving selectivity indexes up to 100,000, which
      makes them particularly promising drug candidates for the chemotherapy and 
      prophylaxis of HIV infections in vitro. These new candidate drugs for the
      treatment of AIDS fall into the following categories: (i) polyanions
      (polysulfates, polysulfonates, polycarboxylates and polyoxometalates), which
      interfere with virus attachment to the cell membrane; (ii) some plant lectins and
      modified (i.e. succinylated) albumins, which may directly interact with the
      fusion of the viral envelope with the cell membrane; (iii) bicyclam derivatives,
      which seem to be targeted at the uncoating (disassembly of the viral proteins
      from the viral RNA genome); and (iv) reverse transcriptase (RT) inhibitors which
      fall into two subcategories. The phosphonylmethoxyalkyl derivatives PMEA and
      FPMPA interact, as chain terminators, with the RT substrate binding site, as do
      azidothymidine (AZT) and the other dideoxynucleoside analogues. The TIBO
      derivatives and their congeners interact with a non-substrate binding site at the
      HIV-1 RT, and thus behave as allosteric inhibitors of the enzyme. The TIBO
      congeners have proved to be highly specific inhibitors of HIV-1 replication.

PMID- 1636323
TI  - [Clinical pharmacology: current status and perspectives].
AB  - In view of the ever increasing complexity of individualized pharmacotherapy, the
      study of new and potent drugs in man and the misuse and abuse of drugs, WHO-Study
      Group reports and a recent enquiry in Belgium, France and W. Germany stress that
      the development of clinical pharmacology is an absolute necessity for patients,
      physicians, health authorities, the pharmaceutical industry and society at large.
      It seems this development could be optimally achieved by setting up, within
      Services of General Medicine or Internal Medicine of University Hospitals and
      large Public Hospitals, autonomous Units of Clinical Pharmacology with the
      responsibility to take an active part: a) at the service level: 1) in patient
      care, either directly in general medical services or drug problem oriented
      consultations, or indirectly through consultative functions and
      pharmacotherapeutic conferences; 2) in drug monitoring services, management of
      cases of overdose, drug information, drug utilization surveys, pharmaco
      epidemiology, ethical committees, formulary committees, drug regulatory agencies
      and studies of Phase I, II and III; b) at the teaching level: 1) in courses of
      clinical pharmacology sui generis, to undergraduates, in close collaboration with
      the University Department of Pharmacology; 2) at the postgraduate level, as a
      specialty in se, and as part of the training in medical specialties and at the
      level of continuing education of general practitioners and specialists; c) at the
      research level: 1) in clinical pharmacokinetic studies, with special attention to
      interindividual variability and genetic factors, to drug concentration/effect
      studies, to drug interactions, and in pharmacodynamic studies, in view of the
      development of new approaches in the study of drug-receptor interactions; 2) in
      the design, realization and evaluation of Phase I, II and III studies, clinical
      trials and multicenter drug studies.

PMID- 1636324
TI  - Better outcome of patients with traumatic hematomas of the posterior fossa?
AB  - Within 10 years nearly 500 intracranial hematomas were operated, only 44
      concerned the posterior fossa - and only 26 were of traumatic origin.
      Retrospective observations show that the suspected poor prognosis does not exist
      as is believed. Factors predicting the outcome are described.

PMID- 1636325
TI  - [Conservative or surgical treatment for foreign body injuries of the brain].
AB  - Presenting our patients with cerebral foreign body injuries since 1954 we find
      that surgical management is not absolutely indispensable. Criteria for
      conservative management are presented with illustrative cases.

PMID- 1636326
TI  - Chronic extradural haematoma--report of 33 cases.
AB  - During 35 years (1955-1989) 236 extradural haematomas were operated on in the
      National Institute of Neurosurgery, Budapest. 33 of them were operated on after
      the 4th day following trauma. These cases were termed as chronic ones. There was
      no mortality and only two patients had permanent neurological signs. The much
      more favourable outcome of the chronic extradural haematoma could be explained
      with the slow development of the haematoma. It is remarkable that the trauma
      itself was not recognised in several cases.

PMID- 1636327
TI  - [Psychological counseling of the family of patients with craniocerebral injuries
      (psychological family counseling of severely ill patients)].
AB  - Relatives of 235 brain-injured (BI) patients were observed by trained
      (psychiatric) staff for psychological coping. This was practiced since 1984 in a
      BI-rehabilitation ward at a regional psychiatric hospital with 450 beds, serving
      a catchment area of 330,000. In semi-structured observations patterns of
      emotional behaviour were registered, which resemble those presented by Kubler
      Ross for relatives of the dying. Nevertheless important differences were noted:
      1. Unrealistic expectations on the relatives' side: caused by insufficient
      information on differences of physical and cerebral rehabilitation and unfounded
      belief, transfer from the intensive care section itself signifies the patient's
      restitution. 2. Unrealistic evaluations: individual consequences of BI may be
      underrated by relatives, more so if no additional injuries illustrate the
      patient's severe condition. 2.1. Coma--interpreted as "pseudosleep". Frequently
      the next of kin are uninformed on the aetiopathology or consequences of coma.
      Restitution of cerebral functions in various stages of impairment cause
      confusion, anxiety, resignation even rejection on the side of the relatives. 3.
      Personality changes: disruptions of personal traits or characteristics as outcome
      of severe BI are widely known and regarded as formidable consequence. 4. Fear of
      reintegration; therefore this fear is not infrequent in the next of kin.
      Additional factors caused by personal history or psychopathology may complicate
      the issue. Attitudes to rehabilitation are determined by psychological reactions
      of relatives and may be crucial for the outcome. Recognition of pathological
      traits and management of psychological attitudes ensures optimal effect of
      rehabilitation. We noticed several phases in the relatives' psychological
      changes: acute, initial, protracted and final stage.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1636328
TI  - [Introduction of the Valduna-Reha Scale].
AB  - We present a rating scale for the progress in rehabilitation which has been
      developed and tested in the course of several years. It is of special suitability
      for the documentation of rehabilitation in cases of dysfunction of the central
      nervous system due to various syndromes arising from vascular, post-traumatic and
      post-operative causes. It comprises the essential somatic as well as
      psychological data and differentiates between specific (e.g. localised) symptoms
      and their effects on the individual's global functioning, especially within his
      (her) social sphere. Under this aspect our scale appears to be of optimal use,
      especially with regard to the requirement: "as simple as possible and as
      comprehensive as necessary". It modifies the criteria of the WHO regarding the
      threefold differentiation between impairment, disability and handicap, by the use
      of two levels of documentation, thereby gaining in validity.

PMID- 1636329
TI  - [Early rehabilitation of coma patients on the neurosurgical intensive care
      station. On the philosophy and practice of interdisciplinary cooperation].
AB  - The concept of early rehabilitation is an important task of humanity for
      neurosurgical intensive care patients emerging from coma. In Germany only little
      experience in this field has been reported, although the concept of early
      rehabilitation is well known in the other western European countries and the USA.
      In connection with the author's teaching activities at the pedagogical and
      psychological departments of the University of Oldenburg, an interdisciplinary
      concept of communicative "cooperative dialogues" was established for early
      rehabilitation, beginning in the earliest phases of coma at the neurosurgical
      intensive care unit. Although the results could not be evaluated statistically
      yet, the clinical course and outcome of emergence from primary or postoperative
      coma have improved rapidly by single patients, based on mobilization of neuronal
      plasticity and self-organized processes. Because of a significant lack of
      possibilities of early rehabilitation in the northwestern part of Germany,
      especially for young head injured adults, our efforts will continue. The
      philosophy and practice of early rehabilitation propose a new interpretation of
      neurosurgical patients emerging from coma, i.e. a dynamic process of a "second
      human creation". Early rehabilitation is an important task for the
      neurosurgically working doctor. Also for the neurosurgical profession the concept
      of early rehabilitation has to be integrated interdisciplinary to medical
      teaching at university level as soon as possible.

PMID- 1636330
TI  - [Fluctuat nec mergitur: professional liability of the surgeon in our current
      judicial system].

PMID- 1636331
TI  - [Medical professional liability insurance: its role, extent, limitations].

PMID- 1636332
TI  - [The physics of laser technology].

PMID- 1636333
TI  - [Clinical application and risks of surgical lasers].

PMID- 1636334
TI  - Reevaluation of quality assurance in the cytology laboratory.

PMID- 1636335
TI  - "Collagen balls" in peritoneal washings. Prevalence, morphology, origin and
      significance.
AB  - Peritoneal washings obtained at laparotomy from women undergoing surgery for
      neoplasms of the genital tract may contain "collagen balls," consisting of tissue
      fragments composed of collagen covered with mesothelial cells. Collagen balls
      were found in 19 (4.5%) of 418 peritoneal washings and were more prevalent in
      specimens labeled pelvic washings (17 of 294, or 5.8%) than in those labeled
      peritoneal washings (2 of 124, or 1.6%). In 15 of the 19 cases in which we found
      collagen balls, at least one ovary was available for microscopic examination. In
      14 of the 15 cases minute nodular papillary stromal projections covered with
      mesothelium were found on the surface of the ovaries. We conclude that collagen
      balls, a nonspecific entity, most probably originate on the surface of the
      ovaries. Their significance lies in their being mistaken for mucin-distended
      cells exfoliated from a neoplasm or from detached fragments of a papillary
      ovarian neoplasm.

PMID- 1636336
TI  - Fine needle aspiration of metastatic and hematologic malignancies clinically
      mimicking pancreatic carcinoma.
AB  - The fine needle aspiration (FNA) cytology findings in 19 cases of hematopoietic
      and metastatic neoplasms that radiographically mimicked primary pancreatic
      carcinoma are reported. These cases represented 11% of 176 malignant diagnoses in
      a series of 304 pancreatic FNAs. The cytologic diagnoses included 7 non-Hodgkin's
      lymphomas, 2 Hodgkin's lymphomas, 6 small cell carcinomas (4 lung, 1 gallbladder,
      1 skin), 3 squamous cell carcinomas (2 cervix, 1 esophagus) and 1 hepatocellular
      carcinoma. In six cases the pancreatic lesion was the initial presentation of
      malignant disease. These included five lymphomas, which probably involved
      peripancreatic lymph nodes, and a metastatic small cell carcinoma of pulmonary
      origin. Recognition of unusual morphologic features of pancreatic carcinoma
      raised the possibility of extrapancreatic malignancies. Electron microscopy and
      immunocytochemistry performed on FNA specimens were helpful in selected cases.
      The FNA diagnosis of hematopoietic and metastatic neoplasms that clinically mimic
      pancreatic carcinoma prompts appropriate clinical studies and treatment and
      eliminates the need for open pancreatic biopsy and/or resection.

PMID- 1636337
TI  - Role of esophageal brushing cytology in monitoring patients treated with
      sclerotherapy for esophageal varices.
AB  - Recent reports claim that there might be a relationship between sclerotherapy for
      esophageal varices and cancer of the esophagus. The discovery of a squamous cell
      cancer of the lower esophagus in a patient treated three years previously with
      sclerotherapy led us to set up a follow-up protocol. In order to assess this
      relationship and to monitor the evolution of such lesions, 68 patients treated
      with sclerotherapy with polidocanol because of esophageal varices were examined
      endoscopically at six-month intervals, and brushing samples were taken. The ages
      of the patients ranged between 35 and 81 years, and all had portal hypertension
      due to cirrhosis; 10 patients with the same disease but without bleeding varices
      were also examined. The interval between sclerotherapy and the first cytologic
      follow-up examination averaged 34 months, while the interval to the last follow
      up examination averaged 40 months. One patient was examined four times (1.4%), 10
      three times (14.7%), 39 twice (57.4%) and 18 only once (26.5%). Two cases were
      interpreted as nuclear hyperplasia associated with inflammation and were found to
      have regressed at a subsequent examination; all the other cases were reported as
      negative although sometimes associated with inflammation. None of the controls
      showed any abnormalities. While the occurrence of esophageal cancer after
      sclerotherapy might be associated with other risk factors, such as alcohol intake
      and smoking, esophageal brushing cytology can successfully monitor these patients
      and detect early stages of neoplasia.

PMID- 1636338
TI  - Fine needle aspiration cytology of orbital and adnexal masses.
AB  - Fine needle aspiration (FNA) biopsy was performed on 35 patients with orbital and
      adnexal masses. Histopathologic study was performed on 15 of the cases. Examples
      of benign and malignant primary orbital neoplasms, as well as inflammatory
      lesions diagnosed this way, are described. The diagnostic accuracy of the
      technique in evaluating orbital masses was 97.1%; there was one false-negative
      case. The study indicated that this simple technique has considerable diagnostic
      value in palpable orbital masses.

PMID- 1636339
TI  - Cytology of allergic conjunctivitis. Presence of airborne, nonhuman elements.
AB  - Two groups of patients suffering from allergic conjunctivitis (32 atopic, 33
      nonatopic) were studied. Their conjunctival secretions were subjected to
      cytologic examination involving morphologic and semiquantitative evaluation.
      Account was taken of noncellular and nonhuman elements in the smears; they
      included mucus, Charcot-Layden crystals, pollen grains, vegetal fragments and
      fungi. In 12 cases scanning electron microscopy was used in conjunction with x
      ray microanalysis to identify material of noncellular origin. Similar quantities
      of inflammatory cells were present in both groups, while epithelial cells,
      particularly goblet cells, were more numerous in the atopic than in the nonatopic
      group (21.8% versus 6%). Pollen grains, vegetal fragments and fungi were present
      in 18%, 55% and 12% of cases, respectively. Exfoliative cytology emerges as a
      valuable tool for the diagnosis of allergic conjunctivitis, while the presence of
      noncellular elements is of particular diagnostic significance.

PMID- 1636340
TI  - A new look at cervical cytology. ThinPrep multicenter trial results.
AB  - The objective of this study was to compare the sensitivity of a new test method
      with the smear method for detection of neoplasia of the uterine cervix. The new
      procedure, the ThinPrep process, is an automated, fluid-based technique for the
      collection and preparation of exfoliated and aspirated cytologic specimens. A
      single sample from each patient was split and prepared both with the smear and
      test methods. The diagnostic results from the two slides were compared in this
      blind study. Among a total of 2,655 patients, diagnoses concurred in 92% of cases
      and were within one diagnostic level of each other 98% of the time. The ThinPrep
      method facilitated the detection of more low-grade lesions (P less than .001,
      McNemar's test). In addition, the test method decreased the number of ambiguous
      interpretations. The ThinPrep method appears to improve the cervical cytologic
      smear quality by the harvest of a random and reproducible sample, with a
      reduction in artifacts. The new method improves the sensitivity of the cervical
      cytologic screening test.

PMID- 1636341
TI  - Filarial infection of the breast. Report of a case with diagnosis by fine needle
      aspiration cytology.
AB  - The breast is not a frequent site of filarial infection. We report a case of fine
      needle aspiration cytologic diagnosis of filariasis of the breast, not previously
      reported.

PMID- 1636342
TI  - Secretory carcinoma of the breast. Report of a case with diagnosis by fine needle
      aspiration.
AB  - We report a case of secretory carcinoma of the breast in a 63-year-old woman
      studied by fine needle aspiration (FNA). The cytologic features included solid
      nests, cohesive sheets and isolated tumor cells with intracytoplasmic
      vacuolization and signet-ring-like forms. Although secretory carcinoma is an
      unusual breast tumor, especially in adults, the cellular morphology was
      distinctive on FNA. This could permit the preoperative diagnosis of secretory
      carcinoma and the planning of optimal surgical therapy prior to an intervention.

PMID- 1636343
TI  - Neurilemoma of the breast in a man. A case report.
AB  - A case of neurilemoma of the left breast in an 83-year-old man is presented,
      including the fine needle aspiration and biopsy diagnosis. A review of the
      literature did not reveal the existence of such a tumor in a man's breast. The
      aspirate yielded a cellular smear composed of clusters of spindle-shaped cells
      showing minimal atypia and Verocay bodies. The final diagnosis was established on
      the excised mass through histopathologic study.

PMID- 1636344
TI  - Needle aspiration biopsy of vulvar endometriosis. A case report.
AB  - Vulvar involvement by endometriosis is extremely rare. A patient presented with a
      vulvar tumor and was diagnosed on needle aspiration biopsy and subsequently on
      histopathology as having endometriosis of the vulva. The treatment offered was
      conservative, local excision of the tumor. The patient was well and free of
      complaints when last seen in the Outpatient Department, at six months of follow
      up. Needle aspiration biopsy as a diagnostic tool in vulvar tumors and the
      histogenesis of the endometriosis are discussed.

PMID- 1636345
TI  - Fine needle aspiration cytology diagnosis of tuberculous thyroiditis. A report of
      eight cases.
AB  - Among 1,283 cases of thyroid lesions subjected to fine needle aspiration cytology
      (FNAC) over a period of two years, 8 cases (0.6%) were found to be having
      cytologic features consistent with tuberculous thyroiditis. The ages of the
      patients ranged from 14 to 65 years, with a median of 30. The male:female ratio
      was 4:4. Six cases clinically presented with solitary nodules of the thyroid and
      two cases as abscesses in the thyroid region. Three patients had concomitant
      cervical lymphadenopathy, and only two patients were known cases of tuberculosis
      on treatment. Ultrasonography, done in seven cases, confirmed solitary nodules in
      four; in one case the differentiation between an extrathyroid nodule and cystic
      isthmic nodule was difficult, and in the remaining two cases the lesions were
      found to be extrathyroid. Fine needle aspirates from thyroid swellings showed
      epithelioid granuloma with necrosis in five cases and necrosis without
      epithelioid granuloma in three cases. The number of cases positive for acid-fast
      bacilli in these two groups were two and three, respectively. Lymph node
      aspiration, done in three cases, revealed necrotic material in two; both were
      positive for acid-fast bacilli, and the third case showed epithelioid granuloma
      without necrosis.

PMID- 1636346
TI  - Cytologic features of poorly differentiated "insular" carcinoma of the thyroid. A
      case report.
AB  - A case of poorly differentiated "insular" carcinoma of the thyroid is presented.
      Fine needle aspiration cytology suggested the differential diagnosis of poorly
      differentiated carcinoma versus anaplastic carcinoma. Histologic examination of
      the resected specimen confirmed the diagnosis of insular carcinoma. The cytologic
      features of this uncommon primary thyroid malignancy are described and discussed
      with reference to the literature.

PMID- 1636347
TI  - Disseminated histoplasmosis diagnosed by percutaneous needle biopsy of a
      retroperitoneal lymph node. A case report.
AB  - A case of disseminated histoplasmosis diagnosed by percutaneous needle biopsy
      cytology is reported. The patient presented with fever and pancytopenia. Computed
      tomography (CT) revealed retroperitoneal lymphadenopathy. Cytology smears
      prepared from a CT-guided screw needle biopsy of one of the lymph nodes showed
      numerous histiocytes with intracytoplasmic yeast forms consistent with
      Histoplasma capsulatum. Fungal cultures prepared from additional needle biopsy
      material confirmed the diagnosis. This case illustrates the utility of needle
      biopsy in the evaluation of radiographically detected retroperitoneal
      lymphadenopathy and in the rapid diagnosis of infectious disease in certain
      clinical settings.

PMID- 1636348
TI  - Fine needle aspiration cytology of silicone lymphadenopathy in a patient with an
      artificial joint. A case report.
AB  - Three years after replacement of the left first metatarsophalangeal joint with a
      silicone prosthesis, a patient noted enlargement of a left femoral lymph node.
      Fine needle aspiration of the node revealed a foreign body giant cell reaction to
      particulates morphologically compatible with silicone elastomer. This finding
      suggests the potential utility of fine needle aspiration in the evaluation of
      patients' responses to a variety of foreign materials used in prosthetic devices
      and as pharmaceuticals.

PMID- 1636349
TI  - Primary cecal lymphoma. Report of a case with preoperative diagnosis by fine
      needle aspiration and immunocytochemistry.
AB  - Fine needle aspiration of a cecal mass was performed on a patient with a cecal
      tumor and iron-deficiency anemia. Cytologic studies of the air-dried smears
      showed large cell lymphoma. The diagnosis of large cell lymphoma of the B-cell
      type was affirmed by immunocytochemical studies and at laparotomy and resection
      of the tumor. Even under unusual circumstances, the diagnosis of such a rare
      abdominal lesion as primary cecal lymphoma can be made with certainty by
      cytologic and immunologic studies of fine needle aspirates.

PMID- 1636350
TI  - Ameloblastic fibroma. Report of a case with fine needle aspiration cytologic
      findings.
AB  - A case of ameloblastic fibroma of the jaw in an 18-year-old patient is presented.
      Fine needle aspiration cytologic smears showed two different types of cellular
      elements: a glandlike epithelial component, arranged in bidimensional, well
      outlined clusters of basaloid cells with palisading of the columnar cells at the
      borders of those clusters, and a mesenchymal component that consisted of loosely
      arranged fusiform cells. These cytologic features appear to be sufficiently
      characteristic to suggest a diagnosis of ameloblastic fibroma by fine needle
      aspiration.

PMID- 1636351
TI  - Endoscopic brushing cytology of primary gastric choriocarcinoma. A case report.
AB  - A rare primary choriocarcinoma of the stomach developed in a 71-year-old woman
      admitted with epigastric pain and weight loss. Brushing smears revealed highly
      atypical malignant cells with bizarre nuclei and prominent nucleoli. Multiple
      histologic sections revealed pure choriocarcinoma. Human chorionic gonadotropin
      and keratin were demonstrated in malignant cells by immunohistochemistry.

PMID- 1636352
TI  - Osteitis fibrosa cystica (brown tumor) in a patient with renal transplantation.
      Report of a case with aspiration cytodiagnosis.
AB  - The cytologic findings from fine needle aspiration of a left shoulder mass are
      described for a woman who had undergone renal transplantation and on whom an
      orthopedic consultation suggested the clinical possibility of a soft tissue
      sarcoma. The aspirate samples from multiple sites in the mass showed several
      multinucleate, osteoclast-type giant cells, spindly or fibrillary cells with
      ovoid nuclei and a significant amount of granular calcium. The needle aspiration
      cytodiagnosis was of critical importance since it saved the patient from invasive
      surgical intervention. This case emphasizes the role of needle aspiration
      cytology in providing a rapid cytodiagnosis of osteitis fibrosa cystica with a
      minimally invasive method.

PMID- 1636353
TI  - Elastofibroma dorsi. Cytologic, histologic, immunohistochemical and
      ultrastructural studies.
AB  - Cytologic, light and electron microscopic, and immunohistochemical studies were
      conducted on a case of elastofibroma. Aspiration cytology showed a characteristic
      "braidlike" or "fern leaf-like" structure. Immunohistochemically the accumulate
      was shown to be elastin. Transmission electron microscopy indicated electron
      dense, granular aggregates surrounded by microfilaments and collagen, while
      scanning electron microscopy revealed balls with a ball-of-yarn-like structure
      consisting of small fibrils, probably of elastin. These structures are unique to
      this disease and useful for diagnosis.

PMID- 1636355
TI  - 40th annual scientific meeting of the American Society of Cytology. Quebec City,
      Canada, September 29-October 4, 1992. Abstracts.

PMID- 1636354
TI  - Fine needle aspiration cytology in malignant Sertoli cell tumor of the testis. A
      case report.
AB  - A rare case of malignant Sertoli cell tumor of the testis occurred in which the
      diagnosis was initially suggested on fine needle aspiration cytology. Smears of
      the testicular, inguinal and cervical lymph node aspirates showed cells
      resembling normal Sertoli cells arranged in nests and tubules. Histopathology of
      the orchidectomy specimen confirmed the diagnosis. The literature is briefly
      reviewed.

PMID- 1636356
TI  - Polypoid carcinoma of the esophagus on brush cytology.

PMID- 1636357
TI  - Clinical evaluation of the ThinPrep method for the preparation of nongynecologic
      material.

PMID- 1636358
TI  - Avoiding unreadably thick Cytospin preparations.

PMID- 1636359
TI  - Diagnosis of occult ovarian carcinoma in endometrial smears.

PMID- 1636360
TI  - Noninvasive measuring methods for the investigation of irritant patch test
      reactions. A study of patients with hand eczema, atopic dermatitis and controls.
AB  - The aim of the study was to assess the susceptibility of clinically normal skin
      to a standard irritant trauma under varying physiological and patophysiological
      conditions. Evaluation of skin responses to patch tests with sodium lauryl
      sulphate (SLS) was used for assessment of skin susceptibility. The following
      noninvasive measuring methods were used for evaluation of the skin before and
      after exposure to irritants: measurement of transepidermal water loss by an
      evaporimeter, measurement of electrical conductance by a hydrometer, measurement
      of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a
      colorimeter and measurement of skin thickness by ultrasound A-scan. The studies
      were carried out on healthy volunteers and patients with eczema. In the first
      studies the standard irritant patch test for assessment of skin susceptibility
      was characterized and validated. SLS was chosen among other irritants because of
      its ability to penetrate and impair the skin barrier. The implications of use of
      different qualities of SLS was investigated. The applied noninvasive measuring
      methods were evaluated, and for quantification of SLS-induced skin damage
      measurement of TEWL was found to be the most sensitive method. Application of the
      standard test on clinically normal skin under varying physiological and
      patophysiological conditions lead to the following main results: Seasonal
      variation in skin susceptibility to SLS was found, with increased susceptibility
      in winter, when the hydration state of the stratum corneum was also found to be
      decreased. A variation in skin reactivity to SLS during the menstrual cycle was
      demonstrated, with an increased skin response at day 1 as compared to days 9-11
      in the menstrual cycle. The presence of active eczema distant from the test site
      increased skin susceptibility to SLS, indicating a generalized hyperreactivity of
      the skin. Taking these sources of variation into account healthy volunteers and
      patients with hand eczema and atopic dermatits were studied and compared. In
      healthy volunteers increased baseline TEWL and increased light reflection from
      the skin, interpreted as "fair" skin, was found to be associated with increased
      susceptibility to SLS. Hand eczema patients were found to have fairer and thinner
      skin than matched controls. Increased susceptibility to SLS was found only in
      patients with acute eczema. Patients with atopic dermatitis had increased
      baseline TEWL as well as increased skin susceptibility as compared to controls.
      Skin susceptibility is thus influenced by individual- as well as environment
      related factors. Knowledge of determinants of skin susceptibility may be useful
      for the identification of high-risk subjects for development of irritant contact
      dermatitis, and may help to prevent the formation of the disease.

PMID- 1636361
TI  - Mechanisms of skin adherence, penetration and tissue necrosis production by
      Haemophilus ducreyi, the causative agent of chancroid.
AB  - Haemophilus ducreyi (H. ducreyi) strains, representing both reference strains and
      low-passage isolates, were investigated in terms of surface structures and
      enzymatic equipment. The interaction of these factors with host tissue was
      analysed using new in vitro- and in vivo-models. By electron microscopy studies
      there was no evidence of an extracellular capsule or surface appendages such as
      pili or flagella. Interaction of all isolates tested with the lectin Phaseolus
      vulgaris suggests N-acetyl-D-glucosamine units as common structural features of
      H. ducreyi cell envelope polysaccharide. In attachment to epithelial cells more
      than one hemagglutinin might be implicated as different haemagglutination
      patterns could be observed whereby the activity was not heat-labile, but was
      abolished by formaldehyde. Hydrophobic interactions might be of importance as
      well as strains showed a wide range of reactions from hydrophobic to hydrophilic,
      low hydrophobicity being more marked with the older strains. No elaboration of
      degradative enzymes based on the measurement of enzymatic activity using
      insoluble dye-protein complexes could be detected in case of H. ducreyi, using
      Azocoll and Remazol Brilliantblue hide powder for detection of proteolytic
      activity and elastinorcein for detection of elastase activity. In vitro studies
      using human keratinocytes and Vero cells did not show any morphological changes
      when incubated with H. ducreyi culture filtrates. In vivo studies with a new
      mouse model for H. ducreyi infection could confirm the results of the in vitro
      studies. Mere contact to undamaged skin both of whole cell organisms, live or
      heat-killed, and of culture filtrates did not lead to any reaction or even damage
      of mouse skin. However, when the outer epidermal layer was overcome by
      intradermal injection of shaved mice ulcers developed. Tissue necrosis production
      was not bound to live organisms as dead ones showed the same effect. There is
      great evidence that this tissue necrosis is associated with H. ducreyi
      lipopolysaccharide (LPS) because intradermal injection of purified H. ducreyi LPS
      lead to the same reaction pattern. For the first time a cell mediated immune
      response could be demonstrated in case of H. ducreyi infection as different
      antigen preparations of H. ducreyi isolates induced proliferation of lymphocytes
      isolated from healthy unexposed individuals and from a chancroid-sensitized male.
      In the latter case measured cell responses were much stronger. The dose-dependent
      phenomenon was associated with interleukin-2 production. In summary, H. ducreyi
      isolates do not exhibit cytotoxic effects on the epithelial cells of the
      skin.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1636363
TI  - Career advancement for nurses--what is it? A joint venture of three Calgary
      hospitals.

PMID- 1636362
TI  - The economics and politics of health care system ailments.

PMID- 1636364
TI  - Spirituality: implications for nursing care.

PMID- 1636365
TI  - Community action research teams in population focused nursing a post diploma
      learning experience.

PMID- 1636366
TI  - The Florence Nightingale lamp.

PMID- 1636367
TI  - Screen test update, program activity, and cancer detection rates.

PMID- 1636368
TI  - The promotion of the image of nurses.

PMID- 1636369
TI  - Politically--taking action.

PMID- 1636370
TI  - [Lacunar syndromes due to intracerebral hemorrhage].
AB  - Nine cases (seven men and two women, mean age 64.5 years) of classical lacunar
      syndromes due to intracerebral hemorrhage are reported. Three patients presented
      with pure motor hemiparesis (two putaminal hematomas with proportional weakness
      and one cortical hemorrhage with brachio-crural hemiparesis). Four patients
      presented with sensorimotor stroke due to thalamo-capsular hemorrhage. The last
      two patients had thalamic hemorrhage causing ataxic hemiparesis or dysarthria
      clumsy hand syndrome. Four subjects had arterial hypertension, one was diabetic,
      and two were treated with anti-vitamin K. Abrupt onset was noted in all
      instances. Only one patient experienced moderate inaugural headaches. Good
      recovery occurred in all cases. Lacunar syndromes are a very uncommon
      presentation of intracerebral bleeding. Hemorrhages are yet the second etiology
      of such syndromes. Distinguishing hemorrhage from infarction is not clinically
      possible and needs early unenhanced CT scan.

PMID- 1636371
TI  - Muscle cramp as a feature of neuromuscular disease. Five neuromuscular disorders,
      accompanied by frequent muscle cramps.
AB  - Five case reports of neuromuscular disorders, presenting with frequent muscle
      cramps are discussed. Clinical diagnosis and pathophysiologic concepts are
      highlighted.

PMID- 1636372
TI  - Movement disorders due to cerebral Toxoplasma gondii infection in patients with
      the acquired immunodeficiency syndrome (AIDS).
AB  - Hemichorea and parkinsonism are unusual manifestations of cerebral toxoplasmosis
      in patients with AIDS. We here describe two such cases and we reviewed
      extensively the literature (through computer searches using MEDLINE) for other
      reported instances. In our patients, unlike the other neurological symptoms, the
      response of the movement disorders to anti-toxoplasmosis therapy was delayed and
      only partial. We demonstrate that tetrabenazine is a valuable additional
      symptomatic treatment for choreic movements in one of our patients. We emphasize
      that, among patients suffering from AIDS, particularly in countries with high
      prevalence of toxoplasmosis, the occurrence of movement disorders should first
      suggest the diagnosis of cerebral toxoplasmosis.

PMID- 1636373
TI  - Inefficiency of metal chelators to promote recovery of methylmercury inhibited
      CNS succinic dehydrogenase.
AB  - This paper deals with the level of succinic dehydrogenase (SDH) in various
      locations of the central nervous system (CNS) of rat, treated with methylmercury
      chloride (MMC) and later with antagonists. None of the CNS areas reveals any
      effect after 2 days of MMC application, but further treatment causes a linear
      inhibition of the enzyme with increasing duration of MMC exposure. Maximal
      inhibition in all regions is exhibited after 15 days of treatment. In absolute
      terms, the maximal inhibition is observed in the olfactory bulbs and the minimal
      effect is seen in the spinal cord after 15 days with low and high doses of MMC
      respectively.

PMID- 1636374
TI  - Human glial fibrillary acidic protein (GFAP): molecular cloning of the complete
      cDNA sequence and chromosomal localization (chromosome 17) of the GFAP gene.
AB  - We isolated three glial fibrillary acidic protein (GFAP) cDNA clones from a
      glioma cell line, U-251 MG. One clone isolated from a U-251 MG cDNA library was
      long, but lacked both ends. Using poly(A)+ RNA and primers synthesized according
      to the sequence of this clone, we used the polymerase chain reaction-assisted
      rapid amplification of cDNA ends (PCR-RACE) method, which is a strategy to
      isolate cDNA ends, and obtained cDNA clones for the 5' and 3' ends. From the
      sequences of these overlapping clones, the complete nucleotide sequence of human
      GFAP cDNA was established. The start (ATG) and the stop (TGA) signals were seen
      at nucleotide positions 15 and 1311, respectively, and divided the entire
      sequence of 3027 bp into 14 bp of 5' non-coding, 1296 bp of coding and 1717 bp of
      3' non-coding regions. Using cDNA probes made from both the coding and the 3' non
      coding regions, Northern blot hybridization was performed with two different
      stringencies on RNAs from human and rodent brains and human GFAP-positive and 
      negative cells. It was shown that the 3' non-coding region probe was more
      specific for human GFAP than the coding region probe which was specific only
      under higher stringency conditions. This was also suggested by homology analysis
      of the sequence with those of various intermediate filament proteins. Based on
      these findings, we performed spot blot hybridization of sorted human chromosomes
      and Southern blot hybridization of PCR-amplified DNAs of a panel of hamster-human
      somatic cell hybrids and localized the human GFAP gene to chromosome 17.

PMID- 1636375
TI  - Basophilic inclusions in sporadic juvenile amyotrophic lateral sclerosis: an
      immunocytochemical and ultrastructural study.
AB  - This report concerns immunocytochemical and ultrastructural studies on the
      basophilic inclusions in two cases of sporadic juvenile amyotrophic lateral
      sclerosis (ALS). The inclusion had a globular, irregular-shaped, or sometimes
      fragmented appearance. Ultra-structurally, the inclusions consisted mainly of
      thick filamentous structures associated with granules. Focal neurofilamentous
      accumulations were occasionally observed among the granulofilamentous structures.
      The basophilic inclusions occasionally showed granular reaction product deposits
      with an antibody to ubiquitin. The inclusions did not react with antibodies to
      phosphorylated neurofilament and to tau protein.

PMID- 1636376
TI  - Comparison of behavior in muscle fiber regeneration after bupivacaine
      hydrochloride- and acid anhydride-induced myonecrosis.
AB  - We compared the morphologic characteristics of muscle fiber necrosis and
      subsequent regeneration after injury induced by intramuscular injections of
      bupivacaine hydrochloride (BPVC) and a variety of solutions at acid and alkaline
      pH (acetic anhydride, citric acid buffer, and sodium carbonate buffer). After
      BPVC injection the necrotic muscle fibers were rapidly invaded by phagocytic
      cells, followed by active regeneration and very little fibrous scar formation.
      The regenerating muscle fibers increased rapidly in size and attained complete
      fiber type differentiation and regained their initial fiber diameter within 1
      month. Both alkaline and acid solutions induced muscle fiber necrosis followed by
      regeneration. Fiber necrosis induced by alkaline buffers and acetic anhydride
      solutions above pH 5.0 produced changes quite similar to that induced by BPVC.
      However, injection with 0.1 M acetic anhydride at pH below 4.0 resulted in
      coagulative necrosis of the injured muscle with very little phagocytic
      infiltration with poor regenerative activity and dense fibrous tissue scarring.
      Thus, pH 4.0 appears to be the critical pH determining the type of muscle injury
      and subsequent poor phagocytic and regenerative activities. This model of acidic
      acetic anhydride injury may lead to the identification of factors which interfere
      with regeneration and cause fibrous tissue scarring in human muscular dystrophy.

PMID- 1636377
TI  - Immunophenotypic analysis of infiltrating leukocytes and microglia in an
      experimental rat glioma.
AB  - The appearance and cellular distribution of major histocompatibility complex
      (MHC), as well as lymphocytic and macrophage antigens has been studied in a fully
      developed experimental rat forebrain glioma. Activated microglial cells and
      microglia-derived macrophages expressing CR3 complement receptor molecules and
      MHC class II (Ia) antigen were found throughout the tumor, and with increased
      density along the tumor's periphery. MHC class I antigen expression was entirely
      absent from tumor cells, and found only occasionally on microglia. The expression
      of leukocyte common antigen, and CD4 and CD8 antigens was conspicuous throughout
      the tumor, and associated with lymphocytes, perivascular cells, and microglia.
      Cells expressing the ED2 macrophage epitope were almost exclusively of the
      perivascular type and revealed a distribution dissimilar to that of cells
      positive for Ia antigen. The ED2 epitope was found sporadically on ramified
      microglial cells. The results show that despite heavy infiltration with blood
      mononuclear and CNS microglial cells, the tumor showed no evidence of destruction
      caused by inflammatory cells. Possible mechanisms of tumor immunosuppressive
      activity preventing the full immunological activation of microglia and blood
      mononuclear cells are discussed.

PMID- 1636378
TI  - Colloid cysts of the third ventricle: ultrastructural features are compatible
      with endodermal derivation.
AB  - The histogenesis of colloid cyst of the third ventricle remains unsettled.
      Ultrastructural and immunohistochemical analyses have suggested the following
      possible origins: (a) neuroepithelium, including paraphysis, ependyma, choroid
      plexus and tela chorioidea; and (b) endoderm, including respiratory and enteric
      epithelium. This report describes the ultrastructural features of the lining
      epithelium in four cases of colloid cyst. Six distinct cell types were
      recognized: (1) ciliated cells with occasional abnormal cilia; (2) non-ciliated
      cells with microvilli coated with granulofibrillary material; (3) goblet cells
      showing discharge of secretory granules; (4) basal cells with prominent
      tonofilaments and desmosomes; (5) basal-located cells with elongated electron
      lucent cytoplasm and scattered membrane-bound dense-core granules (150-350 nm);
      and (6) small undifferentiated cells with scanty organelles. Junctional complexes
      were present in the former four cell types but absent in the latter two. The
      types of epithelial cells and their topographic distribution within the
      epithelium are both very similar to those of normal respiratory epithelium and to
      the lining epithelium of intraspinal bronchogenic cyst. The observations made in
      the present study are compatible with the hypothesis that colloid cysts of the
      third ventricle originate from the endoderm, most likely the respiratory
      epithelium.

PMID- 1636379
TI  - Metabolically dependent blood-brain barrier breakdown in chronic relapsing
      experimental allergic encephalomyelitis.
AB  - We have studied chronic relapsing experimental allergic encephalomyelitis
      (CREAE), a model of immune-mediated demyelination, using gadolinium (Gd)-enhanced
      magnetic resonance imaging in vivo and the blood-brain barrier (BBB) markers,
      lanthanum nitrate and Gd nitrate, histologically. In regions of the spinal cord
      showing Gd enhancement, there was evidence for vesicular transport as a mechanism
      of BBB breakdown in CREAE, shown by an increased number of endothelial vesicles
      containing lanthanide (lanthanum or Gd, whichever had been perfused) and
      deposition of tracer in the perivascular space; tight interendothelial junctions
      remained intact. Prior perfusion with 2,4-dinitrophenol, a metabolic inhibitor,
      suppressed the appearance of endothelial vesicles containing lanthanide and
      tracer in the perivascular space. We conclude that an important contribution to
      BBB breakdown in CREAE is mediated by a metabolic change in the endothelial cells
      associated with increased vesicular transport.

PMID- 1636380
TI  - Abnormal local-circuit neurons in epilepsia partialis continua associated with
      focal cortical dysplasia.
AB  - A limited cortical resection including the rolandic fissure and the pre- and
      postcentral cortical regions was carried out in a patient suffering from
      epilepsia partialis continua resistant to antiepileptic drugs. The histological
      examination revealed several foci of very large neurons distributed with no
      laminar organization in the depth of the rolandic fissure and in the crown of the
      primary motor and primary somatosensory areas; these lesions were consistent with
      focal cortical dysplasia. In addition, decreased numbers of neurons, astrocytosis
      and proliferation of capillaries, compatible with chronic tissue necrosis, were
      found in the inferior regions of the banks of the rolandic fissure.
      Subpopulations of local-circuit neurons were examined with parvalbumin, calbindin
      D-28k and somatostatin immunocytochemistry. Focal areas of cortical dysplasia
      contained abnormal immunoreactive neurons. Huge parvalbumin-immunoreactive cells
      were distributed at random and resembled axo-axonic (chandelier) and basket
      neurons. Abnormal calbindin D-28k-immunoreactive cells were reminiscent of double
      bouquet neurons and multipolar cells. Very large somatostatin-immunoreactive
      cells were seldom observed in the dysplastic foci. On the other hand, areas of
      tissue necrosis displayed massive reduction of immunoreactive cells and fibers.
      Abnormalities in the morphology and distribution of local-circuit (inhibitory)
      neurons observed here for the first time in focal cortical dysplasia may have a
      pivotal role in the appearance and prolongation of electrical discharges and
      continuous motor signs in human focal epilepsy.

PMID- 1636381
TI  - Tubuloreticular structures in microglial cells, pericytes and endothelial cells
      in Alzheimer's disease.
AB  - In two of six brain biopsies of patients with Alzheimer's disease (AD),
      tubuloreticular structures (TRS) were observed in the distended endoplasmic
      reticulum of microglial cells, endothelial cells of vessels, and pericytes. In
      the microglial cells that produce amyloid fibrils, TRS were found in the
      cytoplasmic channels, which were filled with newly formed amyloid fibrils. Co
      localization of TRS and newly formed amyloid fibrils in the same cellular
      compartment strengthens the hypothesis that amyloid fibrils are formed in the
      endoplasmic reticulum of microglial cells. Formation of TRS in microglial cells,
      pericytes, and endothelial cells of vessels probably reflects local or systemic
      alpha-interferon production. In some cells, this pathological process coexists
      with the second type of pathological changes: formation of amyloid fibrils.

PMID- 1636382
TI  - Cystic brain stem necrosis in a premature infant after prolonged bradycardia.
AB  - A case is described of symmetrical cavitating brain stem necrosis produced by
      cardiac arrest in a premature infant. Two months after birth this 25-week
      gestational age infant suffered a prolonged episode of bradycardia. She was
      resuscitated and then died 3 weeks later. The autopsy revealed striking bilateral
      cavitation of the brain stem tegmentum extending in a columnar fashion from the
      upper portion of the spinal cord to the hypothalamus. The findings in this case
      are identical to the brain stem injury experimentally produced by complete
      cardiac arrest in the rhesus monkey.

PMID- 1636383
TI  - An unusual demyelinating neuropathy in a patient with Waardenburg's syndrome.
AB  - We present clinical and laboratory data from a patient with Waardenburg's
      syndrome type II comprising iris heterochromia and deafness, complicated by
      Hirschsprung's disease--a known association--and an unusual demyelinating
      peripheral neuropathy--a unique association. The neuropathy is characterised by
      excessive focal folding of myelin sheaths. It is our view that, although both
      disorders could represent the consequences of neural crest embryopathy, it is
      more likely that they are associated by chance.

PMID- 1636384
TI  - Angelman's syndrome: a neuropathological study.
AB  - We report the neuropathological findings of a 3-year-old boy with Angelman's
      syndrome. The main abnormalities were macroscopic consisting of small temporal
      and frontal lobes which also showed disorganised and irregular gyri. The
      occipital lobes appeared flattened but were otherwise normal as were the parietal
      lobes. The brain stem and cerebellum appeared normal externally. Microscopically
      there was irregular distribution of neurons in layer 3 and in the cerebral white
      matter a few subcortical ectopic neurons were present in the temporal and frontal
      lobes. A single "Purkinje" cell heterotopia was seen but otherwise the cerebellum
      appeared normal.

PMID- 1636385
TI  - Conjunctival malignant melanoma in Sweden 1969-91.
AB  - Clinical information, follow-up and histopathological parameters of the primary
      lesions were assessed for all (45) individuals with conjunctival malignant
      melanomas in Sweden presenting during a 22.5 year period (1969 to mid 1991). The
      annual incidence of conjunctival malignant melanoma in Sweden was 0.0240 per
      100,000. On average, two new cases were diagnosed each year (population 8.6
      million in 1991). Sixty-two per cent of the lesions recurred, but re-growth in
      itself was not correlated to reduced survival. The actuarial 10-year survival
      proportion using life-table analysis was 70%. A significantly reduced survival
      due to tumour-related death was noted in patients with tumours with high mitotic
      indices, many epithelioid cells and in lesions exceeding 10 mm in diameter. Other
      factors that may influence survival are presented in the context of previous
      reports. The present policy in Sweden for treating patients with malignant
      melanoma of the conjunctiva is outlined and discussed.

PMID- 1636386
TI  - In vitro ingrowth of choroidal cells on Bruch's membrane.
AB  - Full thickness eyewall explants were made from human eyes, the retina and retinal
      pigment epithelium were removed, and the explants were maintained in vitro in
      Ham's F-10 medium with 20% foetal bovine serum. Cultured explants were examined
      by scanning and transmission electronmicroscopy after varying lengths of time.
      When in vitro, choroidal cells migrated across the cut edge of the explant onto
      the denuded Bruch's membrane where they subsequently showed production of
      extracellular matrix. In the human eye, ingrowth of choroidal cells on Bruch's
      membrane is found in macular degenerations, inflammatory chorioretinal disorders
      and subsequent to trauma. The in vitro model system presented in our study could
      facilitate evaluation of the dynamics underlying such ingrowth and also of
      factors affecting the course of this process.

PMID- 1636387
TI  - The influence of argon laser panretinal photocoagulation on the rabbit ERG c
      wave.
AB  - We observed the influence of panretinal photocoagulation on the ERG c-wave in
      rabbit eyes. DC-registered ERGs were recorded from rabbit eyes before and after
      photocoagulation, and compared with those of the fellow eyes. The rabbits were
      subdivided into 3 groups according to application numbers: 500, 1000, and 1500
      spots. The ERG c-waves were found to have totally disappeared in all rabbits 3
      days after panretinal photocoagulation, then reappeared with various intervals.
      In the 500 spot group, the c-wave reappeared after one week, and almost reached
      control levels in one and a half months. In the 1000 spot group, a 10 day delay
      was noted, and 90% of control levels were regained after 6 months. In the 1500
      spot group, the c-wave didn't reappear until 2 weeks later, and regained 70% (of
      the control level) after 6 months. The recovery rates were related to the number
      of laser applications. These results indicate that the ultimate degree of
      recovery in c-wave amplitude and the time required for the reestablishment of
      retinal pigment epithelium function both depend on the size of the coagulated
      area.

PMID- 1636388
TI  - The prevalence and type of glaucoma in geriatric patients.
AB  - A group of 100 institutionalized geriatric patients aged 69-94 years (mean 81.2
      years) was studied at Koskela Helsinki Municipal Hospital. The selection of the
      patients was randomized by taking 100 patients having a birth-date divisible by
      five. Glaucoma occurred in 15% of the patients (14 women and one man). Six
      patients had bilateral primary open-angle glaucoma. One patient had capsular
      glaucoma in one eye and secondary glaucoma in the other eye. Eight patients had
      glaucoma only in one eye; three narrow-angle glaucoma, three primary open-angle
      glaucoma and two secondary glaucoma. Exfoliation occurred in 21 patients (26%,
      21/80). Ten patients had bilateral exfoliation and 11 exfoliation only in one
      eye. IOP was measured in 75 patients, 150 eyes, with applanation tonometry,
      averaging 12.5 mmHg (SD 5.0), and in 22 patients, 44 eyes, with Schiotz
      tonometry, averaging 16.3 mmHg (SD 5.6). Visual acuity for long distance and also
      the reading acuity were greater than 0.3 in 66% (54/82).

PMID- 1636389
TI  - Long-term post trabeculectomy intraocular pressures.
AB  - Eighty-one eyes which had had trabeculectomy with a mean follow-up period of 9.2
      years (range 7 to 10 years) were studied retrospectively for their subsequent
      pattern of intraocular pressure. Of 43 chronic open-angle glaucoma eyes, 29 (67%)
      had their pressures maintained below 21 mmHg by trabeculectomy alone over a 7-10
      year period. On the other hand, 25 of 38 (65%) eyes with other types of glaucoma
      required an average of 1.5 different antiglaucoma medications post-op for the
      control of their intraocular pressures. Fifteen of 69 (22%) phakic eyes required
      cataract extraction at a mean of 5.1 years post-op. Two of 43 (5%) chronic open
      angle glaucoma eyes suffered blinding complications attributable to the
      procedure. Seventeen percent: of eyes gained visual field at a mean of 7% of the
      pre-op field per year following trabeculectomy. Fifty percent lost field at a
      mean rate of 2.3% per year.

PMID- 1636390
TI  - Myopia among medical students in Norway.
AB  - In this study the prevalence of myopia and age at onset among medical students
      were determined. Of the 140 senior medical students at The Faculty of Medicine,
      University of Trondheim, Norway, 133 (75 females, 58 males) were examined. Visual
      acuity was tested and the refractive error was measured using automated
      refraction and clinical refractive technique. The prevalence of myopia was found
      to be 50.3% in the right eye (n = 67) without significant difference between
      female and male students. The refractive state was unrelated to body height.
      Among the myopic students, the mean equivalent sphere was -2.34 +/- 2.01 D in the
      right eye (range -9.25 D to -0.25 D). A clear relationship was detected between
      the current amount of myopia and the age at which corrective lenses were first
      prescribed. However, as much as 43.3% of the myopic students wearing corrective
      lenses first received these at the age of about 20 years, indicating a relatively
      high prevalence rate of adult-onset myopia.

PMID- 1636391
TI  - Effect of number of test points and size of test field in automated perimetry.
AB  - Sensitivity variation in normal subjects was studied, by changing the number of
      test locations and the size of test fields on automated perimetry. Using the
      Sargon program, four different programs that differed in the number of test
      points or in the size of test field were made. Mean sensitivity and short-term
      fluctuation were calculated from the same test points of each program. The
      program with the fewest points and the smallest size produced the greatest
      sensitivity and the least fluctuation. Our results showed that the number of test
      points and the size of test field affected the sensitivity and its
      reproducibility in automated perimetry.

PMID- 1636392
TI  - Repeatability, reproducibility and intersession variability of the Allergan
      Humphrey ultrasonic biometer.
AB  - We evaluated repeatability and reproducibility of the Allergan Humphrey model 820
      ultrasonic biometer. Sixty eyes (30 subjects) free from ophthalmological
      abnormality were examined on two separate occasions by two experimenters, one
      experienced and one inexperienced. The 95% confidence limits for repeatability
      lie between +0.12/-0.13 mm and reproducibility between +0.15/-0.14 mm for AC
      depth, between +0.11/-0.13 mm and +0.12/-0.16 mm for lens thickness, between
      +0.17/-0.19 mm and +0.19/-0.18 mm for right axial length and between +0.26/-0.40
      mm and +0.22/-0.25 mm for left axial length. The 40% gain used to measure left
      axial lengths produced poor retinal echospikes, which may account for reduced
      accuracy compared to the right eyes using 60% gain. Ten subjects (20 eyes)
      returned for 3 further visits and the variability over 5 sessions was examined
      using a two-factor ANOVA with repeated measures on one factor. There were no
      significant experimenter or session effects and no interaction effect. This
      biometer gives clinically repeatable and reproducible results and is convenient
      to use.

PMID- 1636393
TI  - Conjunctival eosinophilia in atopic and non-atopic external eye symptoms.
AB  - We studied the occurrence in an ophthalmological office practice of conjunctival
      eosinophilia in 333 normal subjects (mean age 26 years) and in 152 atopic and 484
      non-atopic patients (mean age 40 years) with various external eye symptoms.
      Eosinophils were present in 131/636 patients (21%) and in 22/333 asymptomatic
      normal subjects (7%). In those patients with conjunctival eosinophilia, a history
      of some kind of atopic condition was obtained only in 53/131 (40%). When the
      patients were characterized according to the presence of both eosinophilia and
      atopy, eosinophilia without signs of atopy was observed in 7-15% in different
      diagnostic groups. Patients with conjunctivitis or blepharoconjunctivitis had a
      fourfold risk for eosinophilia compared to normal subjects (odds ratios 4.52 and
      4.09, confidence intervals 2.02, 10.12 and 2.40, 6.99), when atopy, sex, age,
      time of the examination and presence of bacteria were included as potential
      confounders in the regression model. We conclude that a considerable portion of
      patients with external eye symptoms, and especially with various forms of
      conjunctivitis, show eosinophilic inflammation without any evidence of atopic
      background. They can be labelled as having 'intrinsic' eosinophilic
      conjunctivitis analogously to the classification used in patients with intrinsic
      rhinitis and asthma. The etiology of this common nonatopic syndrome remains to be
      established.

PMID- 1636394
TI  - The effect of sodium cromoglycate eyedrops compared to the effect of terfenadine
      on acute symptoms of seasonal allergic conjunctivitis.
AB  - A multicentre, group comparative open study was carried out on 68 patients to
      compare the effects of 2% sodium cromoglycate eyedrops and an oral antihistamine,
      terfenadine, on acute symptoms of seasonal allergic conjunctivitis. The study was
      continued for one week after the onset of acute symptoms. Both medications were
      equally efficient in reducing symptoms during the first hour of observation.
      During the one-week follow-up both medications reduced symptoms to a low level,
      and both medications were equally effective for allergic symptoms, except that
      terfenadine was more effective in reducing the watering of eyes.

PMID- 1636395
TI  - Tear film profile in Graves' ophthalmopathy.
AB  - Tear film profile was studied in 30 patients with Graves' ophthalmopathy. Tear
      film pH, fluorescein staining, marginal tear strip and Schimer test values in
      patients with Graves' ophthalmopathy were comparable with controls, indicating
      normal tear secretion. Tear film break-up-time (BUT) in late Graves'
      ophthalmopathy was significantly low suggesting unstable tear film. Rose bengal
      as well as lissamine green staining intensity scores were significantly high,
      indicating presence of drying epithelial cells in early as well as late Graves'
      ophthalmopathy patients.

PMID- 1636396
TI  - Changes with age in Schiotz and Goldmann readings.
AB  - Three thousand one hundred and fifteen paired Schiotz and Goldmann readings in
      persons aged 10-79 years were re-examined. There was first a drop and then a rise
      in IOP with increasing age. The two methods gave very similar results up to age
      50. After the age of 50 Goldmann pressures rose faster than Schiotz pressures.
      Changes in Schiotz readings do not reliably reflect true changes in IOP over time
      within the same eye or between different age groups within the same population.

PMID- 1636397
TI  - Diffuse type alteration of the ocular wall in different eye diseases.
AB  - The ocular wall dimensions (thickness and volume) were measured by means of
      ultrasonography in 61 eyes of 61 patients with different eye diseases and 31 eyes
      of 31 healthy subjects with or without refractive error. The results confirmed,
      that in spite of the great variance in the ocular wall thickness, depending on
      the axial eye length, the volume of the ocular coats is constant in healthy eyes
      (ca. 1.65 cm3). In patients with ocular hypotony (eyes after intraocular surgery
      or trauma, and eyes with uveitis or with phthisis bulbi) and in patients with
      exophthalmus, the ocular wall was thicker and larger in volume than in the
      healthy control groups. In contrast, the ocular wall dimensions (thickness and
      volume) were smaller in patients with glaucoma. The results of the study showed
      that an alteration in the volume of the ocular wall implies a pathological
      condition of the eye, and thus ultrasound examination of the ocular wall
      dimensions might play a role in the diagnosis and in the follow-up of the
      patient.

PMID- 1636398
TI  - A classification for dry eyes following comparison of tear thinning time with
      Schirmer tear test.
AB  - In a double-blind study a non-invasive method of examining the stability of the
      precorneal tear film was used to record tear thinning time on a population of 34
      independently diagnosed dry eye patients. The results were compared with those
      for tear output, as inferred from the standard Schirmer tear test, and a
      correlation coefficient of 0.20 determined. The mean tear thinning time and
      Schirmer results for the population sample were 6.87 +/- 2.97 sec, and 5.62 +/-
      5.69 mm wetting in 5 min, respectively. From a plot of tear thinning time against
      Schirmer a simple classification for dry eyes can be made. A Type A with normal
      tear stability and low output accounting for 14.70% of the dry eyes. A Type B
      with low tear stability and normal output, also accounting for 14.70% of the dry
      eyes. A Type C with low stability (less than 9.84 sec), and low output (less than
      11.31 mm wetting in 5 min) accounting for 70.60% of the dry eyes.

PMID- 1636399
TI  - Corneal epithelial healing under contact lenses. Quantitative analysis in the
      rabbit.
AB  - The rate of corneal epithelial healing was determined as a function of the oxygen
      level present at the tear-cornea interface. Oxygen levels of 1.77, 2.3, 5.3,
      8.55, 10.12, and 16.45% were created over the rabbit cornea with tarsorrhaphy and
      various contact lenses. Full depth epithelial defects of 4.5 mm diameter were
      created in 6 animals for each test condition with the fellow eye serving as a
      control and healing in air (21.09% oxygen). The defect (radius) was measured at
      24-h intervals until healing occurred. Statistically significant (p less than
      0.05, paired Student t-test) delays in healing were found with oxygen levels of
      8.55% and below. These delays were most profound over the initial 24 h. The
      healing rate with tarsorrhaphy, at the 1.77% oxygen level, over the first 24 h
      was 5.2 microns/h radius, only 15.2% of the paired control, 34.0 microns/h
      radius, healing in air (21.09% oxygen). Healing rates over the initial 24 h under
      contact lenses allowing 2.3, 5.3, 8.55, 10.12, and 16.45% oxygen were 6.1, 23.5,
      26.5, 43.0, and 45.0 microns/h in radius, respectively.

PMID- 1636400
TI  - Reactive production of extracellular matrix (ECM) by corneal endothelial cells.
AB  - Results of experimental and histopathological studies of reactive production of
      extracellular matrix by corneal endothelial cells are summarized and evaluated.
      In anterior synechiae, epithelial ingrowth and a chronic corneal ulcer
      extracellular matrix was produced not only toward Descemet's membrane but also on
      the normally free endothelial cell surface. In some cases of anterior synechiae
      and cystic epithelial ingrowth, after partial separation of the new layer of
      extracellular matrix, recovery and regeneration of endothelial cells was
      possible. In diffuse epithelial invasion, extracellular matrix facilitated at the
      beginning the progression of epithelium over endothelium, putatively serving as a
      substrate; however, in longer-standing invasions endothelial cells degenerated
      and died. Reactive production of extracellular matrix may represent a defensive
      mechanism of endothelium threatened by foreign cells, tissues or materials.

PMID- 1636401
TI  - Amino acid incorporation in cell cultures from eyes with pseudo-exfoliation
      material.
AB  - Conjunctival tissue was removed from eyes with and without pseudo-exfoliation
      material during cataract surgery. Cells derived from these samples were
      maintained in vitro. Confluent cultures were examined by transmission electron
      microscopy, and non-confluent as well as confluent cultures were examined for
      their ability to incorporate 3H-leucine and 3H-proline into TCA-precipitated
      material. Cells derived from both types of samples showed deposition of
      extracellular matrix, and a similar incorporation of the two amino acids. It is
      concluded that in vitro studies allow examination of basic metabolic patterns
      under varying conditions, and also a search for possible differences in such
      functions between tissues with and without production of pseudo-exfoliation
      material.

PMID- 1636402
TI  - Indirect spectral transmission ratio measurements of the aging crystalline lens
      nucleus.
AB  - A new objective approach to characterize color and opalescence in the lens
      nucleus, using wavelength indexed transmission ratios (TR) is described.
      Transmission ratios, i.e. the transmissivity per unit lens thickness, for the
      whole visible spectral range (390-720 nm) were calculated using fast scanning
      spectral colorimetry (FSSC). The lowest transmission ratios values were obtained
      in the blue part of the spectrum in general and at 450 nm in particular. They
      inversely followed the subjectively determined LOCS II color grading. The
      difference between transmission ratios at the absorbed part of the spectrum (less
      than 500 nm) and the non-absorbed part (greater than 550 nm) also reflects the
      LOCS II color grading. The overall mean transmission ratios for all wavelengths
      in the spectrum gives an index that closely followed the nuclear opalescence
      grading of the LOCS II system. The transmission ratios are theoretically
      independent of the spectral characteristics of the incident light as long as it
      contains suprathreshold energies in the whole measured spectral range.

PMID- 1636403
TI  - Light scatter in aging and cataractous human lens.
AB  - We measured back light scattering of the human lens with the Lens Opacity Meter
      701 in order to determine whether it can be used for objective assessment of lens
      opacities in various types of cataracts. One-hundred and twenty-seven eyes of 127
      individuals were examined including 43 healthy volunteers in various age groups
      and 84 patients with cortical, nuclear, posterior subcapsular or mixed lens
      opacities. Almost 90% of the total variation in the light scatter values was
      accounted for by age in non-cataractous eyes. Mean scatter value of every
      cataract group was statistically significantly higher than that of age matched
      healthy controls (p less than 0.0001). Highest scatter values were measured in
      cortical cataracts while the mean values of other types of cataract were not
      statistically significantly different from each other. The regression between
      light scatter and visual acuity was statistically significant for each cataract
      group. However, large variation of visual acuity was found with scatter values
      below 60. The results indicate that the Interzeag Lens Opacity Meter is able to
      identify cataractous and non-cataractous eyes and discern at least advanced
      cortical cataracts from other types of lens opacities.

PMID- 1636404
TI  - Efficacy of cryotherapy for retinopathy of prematurity.
AB  - This is a retrospective study of the benefit of transconjunctival cryotherapy for
      retinopathy of prematurity (ROP) in 43 eyes of 22 infants (birth weight 716-1675
      g) from July 1985 to January 1988. Nine eyes were treated at ROP stage 4A
      (early), 14 eyes at stage 3 plus disease, and 20 eyes at stage 3. Cryotherapy was
      applied to the retinal avascular zone. In 13 eyes the ridge of extraretinal
      fibrovascular proliferation was also treated. Two eyes with peripheral exudative
      retinal detachment in two quadrants had additional treatment of the area of
      elevated retina. Reexamination was performed at the age of 26 to 52 months
      (average 38 months). Regression of the ROP was found in all eyes. Seven eyes
      showed a lateral traction of the temporal vascular arcades, six of these eyes had
      a slight macular ectopia. None of the eyes progressed to stage 4B or 5. Visual
      acuity was 6/60 or better. Twelve children (60%) achieved 6/18 or better and 5
      (25%) 6/9 or more. Our data indicate that cryotherapy for ROP grade 3 and early
      stage 4A prevents the progression to advanced stages. The results also imply a
      functional benefit of cryotreatment in infants with progressive severe ROP.

PMID- 1636405
TI  - Trends in cataract surgery in Milan (Italy) from 1956 to 1987. Relationship to
      age and visual acuity.
AB  - In order to test whether the mean age at cataract surgery has changed over the
      course of the last 30 years, a hospital series of 5443 patients undergoing
      cataract extraction between 1956 and 1987 is reviewed. All cases attended the
      same University Eye Clinic of Milan and most were resident in the same
      geographical area. Cases with macular or optic nerve diseases were excluded.
      Results show that mean age at cataract surgery progressively increased from 67.5
      to 71.5 years (slope = +0.096 years of age per year, p = 0.0001) as did visual
      acuity at surgery (patients with visual acuity levels greater than or equal to
      1/10 at time of cataract surgery rose from 3.2% to 47.9%). These results can be
      interpreted in terms of a change in age composition of the Italian population,
      improved access to health services for the elderly, and an improvement in
      surgical and rehabilitation techniques.

PMID- 1636406
TI  - Results and evaluation of high volume intracapsular cataract surgery in Nepal.
AB  - One thousand intracapsular cataract extractions were performed by two
      ophthalmologists over a 57-day period at Lahan Eye Hospital in Nepal. Ninety-nine
      per cent of eyes had a visual acuity of less than 3/60 at surgery. Ninety-eight
      per cent of eyes achieved a visual acuity of 3/60 or better with aphakic
      spherical correction at discharge, of which 69% had a visual acuity of 6/36 or
      better. In 314 eyes seen at 1-month follow-up, 88% achieved 6/18 or better with
      full aphakic correction. The surgical time averaged less than 10 min and the cost
      of disposables less than pounds 1 per operation.

PMID- 1636407
TI  - Acceptability of aphakic correction. Results from Karnali eye camps in Nepal.
AB  - Of 235 aphakic patients followed for 1-10 years in Karnali, Nepal, 23% were
      wearing aphakic spectacles in good condition, 25% had lost or broken their
      spectacles, 31% were wearing scratched or repaired spectacles, 5% never received
      spectacles and 16% were dissatisfied, of which 84% still had good phakic vision
      in the fellow eye. Of 303 aphakic eyes, 89% had a visual acuity of 6/60 or better
      with +10 spherical correction and 7.3% (22 eyes) were blind (V/A less than 3/60);
      of which the major causes were pre-existing posterior segment disease unrelated
      to the cataract operation.

PMID- 1636408
TI  - Conjunctivo-cytologic changes in response to intense physical activity.
AB  - Possible cytological changes of the conjunctival fluid in association with
      physical activity were studied in a series of 39 subjects practising aerobics, 22
      football players, and 29 marathon runners by means of the quantitative pipette
      method and the qualitative stix method of Norn. The first group was only examined
      after exercise, the two latter both before and after. No significant changes were
      detected in the cytologic composition of the conjunctival fluid in association
      with exercise.

PMID- 1636409
TI  - Is beta-lactamase-producing bacteria of major importance for unfavourable
      development of acute otitis media?

PMID- 1636410
TI  - Ear deformities in mandibulofacial dysostosis.
AB  - Bilateral conductive deafness is common in mandibulofacial dysostosis with or
      without atresia of the external auditory meatus. This deafness is due to a wide
      range of deformities of the ossicular chain associated with a characteristic
      reduction in the size of the middle ear cavity. The inner ear is only
      occasionally affected. This study describes findings of experimentally induced
      malformations of the ears in laboratory animals which are compared to the
      clinical, radiological and surgical findings from 14 patients with
      mandibulofacial dysostosis (Treacher-Collins syndrome).

PMID- 1636411
TI  - Extended middle ear drug delivery. A new concept; a new device.
AB  - The authors present the development of a new device that consists of a
      biodegradable support matrix incorporating a therapeutically releasable amount of
      ampicillin. This device is in an insertable shape that allows easy placement into
      the middle ear. Once in the middle ear cavity it expands, contacts the walls, and
      provides extended sustained release of ampicillin. In vitro studies over three
      months documented the consistent release of therapeutically effective levels of
      ampicillin. In vivo efficacy was demonstrated in the cat otitis media induced by
      eustachian tube obstruction. Cultures of normal cat middle ear cavities prior to
      obstruction revealed no microflora. Cultures after obstruction of the middle ears
      of animals treated with this device had no growth of bacteria as early as one
      week after obstruction (10 out of 12 cats). The contralateral untreated ears
      became culture negative at two weeks post obstruction, suggesting that the effect
      of the device is not limited to the treated ear. Histopathological studies showed
      the effect of the device as early as one week post obstruction in treated ears
      and after two weeks in the contralateral ear. Both ears became normal at three
      months, while obstructed untreated animals (controls) developed chronic
      irreversible otitis media changes. In addition, histopathological findings
      documented a lack of inflammatory reaction from the device itself, and its
      capacity of being biodegradable. Topical extended middle ear drug delivery can
      become a significant form of treatment for middle ear disease and has the
      potential of being useful as a source for inner ear drug delivery.

PMID- 1636412
TI  - Changes of the middle ear mucosa induced by untreated and penicillin V treated
      experimental pneumococcal otitis media.

PMID- 1636413
TI  - Lymphocyte-mucosal interaction of the middle ear mucosa.
AB  - The middle ear mucosa possesses immunologic features similar to those of the
      peripheral mucosa sites in the common mucosal immune system and after mucosal
      immunization, antigenspecific IgA-forming cells appear in the inflamed mucosa of
      the tympanic cavity. Recent investigations suggest that lymphocyte migration to
      lymphoid tissues is regulated by lymphocyte-high endothelial venules (HEV)
      interaction. However, the lymphocyte migration mechanism to the middle ear mucosa
      is still unclear. We investigated whether or not organ-specific determinants
      which lymphocytes bind with are present on the middle ear mucosa by in vivo and
      in vitro lymphocyte adherence assays by using fluorescein-labeled lymphocytes
      from various lymphoid tissues. Many lymphocytes from Peyer's patches and hilar
      lymphnodes adhered on the inflamed middle ear mucosa with or without mucosal
      immunization, while these cells were not found on the normal tympanic mucosa. The
      number of the cells was smaller than that in the gastrointestinal mucosa.
      Lymphocyte adherence to the middle ear mucosa was not suppressed by anti-T cell
      antibody. These findings suggest that the middle ear mucosa possesses organ
      specific mucosal determinants which B-lymphocytes selectively bind with, and that
      those determinants which regulate lymphocyte migration to the middle ear mucosa
      differ from those of other mucosae in the gastrointestinal tract.

PMID- 1636414
TI  - Genetically induced inner ear degeneration. A structural and functional study.
AB  - The jerker mouse mutant has an autosomal recessive mutation, which in homozygotes
      results in early postnatal degeneration of the sensory epithelia in both the
      cochlea and vestibulum. An age-related consecutive functional and morphological
      analysis of the cochlea has been performed in homozygote (je/je) and heterozygote
      (je/+) jerker mice. Cochlear function was determined with auditory brainstem
      response (ABR) technique. Heterozygotes were regularly tested to a final age of
      12 months. With increasing age they displayed ABR threshold shifts which were of
      about the same magnitude in the whole frequency range tested (2-31.5 kHz) but
      extremely variable in individual animals. From homozygote jerker mice no ABR
      could be elicited. There was a similar morphologic pattern of cochlear
      degeneration in both homozygote and heterozygote jerker mice affecting primarily
      the stereocilia and cuticular plate in both outer and inner hair cells. In
      homozygotes these changes were found in very young animals but in heterozygotes
      they did not become evident until later in life. All parts of the cochlea became
      simultaneously affected, that means there was no topographical gradient in the
      pathological course. The ABR thresholds in 12 months old heterozygotes were
      correlated semiquantitatively to hair cell pathology in the cochlea. The
      functional and morphological changes in heterozygotes probably reflect a random
      influence of the jerker gene vis-a-vis the wild type of gene.

PMID- 1636415
TI  - T cell subsets in round window membrane after middle ear immunostimulation.
AB  - In secondary middle ear immune response, kinetics of immunocytes, especially T
      cell subsets, was examined in the round window membrane (RWM) using
      immunohistochemical methods. Healthy BALB/c mice and keyhole limpet hemocyanin
      (KLH) antigen were employed in this study. The inflammatory responses of the RWM
      and middle ear were investigated after antigen challenge into the middle ear
      bulla. We used antibodies against murine macrophages and granulocytes (anti-Mac
      1), murine helper/inducer T cells (anti-Lyt-1 and -L3T4), murine
      suppressor/cytotoxic T cells (anti-Lyt-2), murine interleukin-2 receptor (7D4),
      murine immunoglobulins (anti-IgG, -IgM and -IgA) and KLH. In the RWM and middle
      ear mucosa, inflammatory cells were observed at 6 hours, peaking on days 3-7,
      whereas these cells were rarely seen in the scala tympani of the basal turn.
      Luminal effusion with an enormous infiltration of inflammatory cells, which
      consisted mainly of Mac-1 cells, IgG cells and IgM cells, was observed in the
      middle ear cavity on days 1-7 post antigen challenge. In the inflamed RWM, Mac-1
      cells were the predominant cell type followed by helper T cells, interleukin 2
      receptor positive cells and IgG positive cells, though IgM, IgA and Lyt-2
      positive cells were rarely observed after antigen challenge. Our results suggest
      that RWM has the ability to protect inner ear by cellular immune response through
      activated helper T cells and Mac-1 cells.

PMID- 1636416
TI  - The microwave oven in temporal bone research.
AB  - The microwave oven has recently been introduced in morphological research. It can
      be used for virtually all procedures in histological processing; fixation,
      dehydration, embedding, staining, immunotechniques, and the techniques used for
      electron microscopy. Here we report that the microwave oven histoprocedures also
      have several advantages in temporal bone research on animals. The microwave oven
      has been tested for (i) fixation, (ii) decalcification, (ii) staining of semithin
      plastic sections. The microwave oven procedures are time-saving and results in an
      excellent preservation of the tissues. The microwave histoprocessing should also
      be applicable to temporal bone research in human.

PMID- 1636417
TI  - The role of type I allergy in secretory otitis media and mast cells in the middle
      ear mucosa.
AB  - To clarify the role of type I allergy in the etiology and pathogenesis of
      secretory otitis media (SOM), clinical and experimental studies were done. The
      distribution of mast cells in the tubotympanum of normal and developing guinea
      pigs was also investigated. Our clinical study revealed that the ratio of
      complications of nasal allergy (NA) in 222 SOM-young children is 42%, while that
      of SOM in 259 NA-young children is 35%. These ratios were significantly higher
      than those seen in control group which consists of 104-children randomly selected
      from a kindergarten and elementary school. Findings of our animal experiment
      showed that the eustachian tube is involved, both functionally and
      morphologically, in type I allergic reactions of the nose. The tubal dysfunction
      evoked by nasal allergic reactions was transient, not culminating in middle ear
      effusion (MEE). However, this dysfunction interferes with the clearance of MEE.
      Our studies suggest that type I allergic reactions of upper respiratory tracts
      are factors indicative of a chronic state of disease, rather than a cause of SOM.
      In adult guinea pigs, the density of mast cells was highest in the pharyngeal
      orifice of the eustachian tube. The density was higher in the adult than in
      developing guinea pigs. Mast cells in the middle ear mucosa appeared in areas
      covered by ciliated epithelia or areas richly vasculized. The results of our
      investigation suggest that mast cells distribute in the tubotympanum responding
      to continuous stimuli to the tubotympanic cavity.

PMID- 1636418
TI  - Permeability of arachidonic acid metabolites through the round window membrane in
      chinchillas.
AB  - Our previous studies showed that samples of middle ear effusion contain high
      concentrations of arachidonic acid metabolites (AAMs); both prostaglandins (PGs)
      and leukotrienes (LTs). Since abnormal levels of AAMs in the perilymph seem to be
      associated with salicylate ototoxicity and the round window membrane (RWM) is the
      most likely route of entry from the middle ear to the inner ear, it would be
      important to know the permeability of AAMs through the RWM. Permeability of AAMs
      was determined by applying labeled and standard representatives AAMs on the RWM
      and counting radioactivity or measuring concentrations of AAMs in perilymph at
      different time intervals. Using chinchillas as experimental animals, samples of
      perilymph were obtained through a fenestration made at the helicotrema of the
      cochlea after 0.5, 1, 2, and 4, hours from placing tritiated or standard PGE2, 6
      keto-PGF1 alpha, LTB4, LTC4 and 15-hydroxyeicosatetraenoic acid (HETE) over RWMs.
      Radioactivity in the perilymph was determined by a scintillation counter and
      concentrations of AAMs were measured by reverse phase high performance liquid
      chromatography (RP-HPLC) and radioimmunoassay. AAMs, which are twenty carbon
      fatty acids, were found to cross the RWM readily. Radioactivity and
      concentrations of AAMs in perilymph were detected in 30 minutes and peaked by one
      hour from the application of AAMs on the RWM. The results of this study suggest
      that AAMs such as PGs and LTs present in the middle ear fluid can cross the RWM
      readily and enter into the perilymphatic space of the cochlea. Sensorineural
      hearing loss observed in chronic otitis media could be mediated by PGs and LTs in
      the middle ear effusion crossing over to the inner ear through the RWM.

PMID- 1636419
TI  - Effect of exogenous arachidonic acid metabolites applied on round window membrane
      on hearing and their levels in the perilymph.
AB  - Our previous studies revealed that treatment with sodium salicylate or
      indomethacin caused hearing loss, a decrease in prostaglandin (PG) levels, and an
      increase in leukotriene (LT) levels of the arachidonic acid (AA) cascade in the
      perilymph. We suspected that decreased PG-levels and/or elevated LT-levels in the
      inner ear may be responsible for the salicylate ototoxicity. In order to test
      this hypothesis, effects of exogenous treatments with PGs, PG-analog, LTs, and
      other lipoxygenase products on hearing and levels of AA metabolites in the
      perilymph were studied in chinchillas. Cyclooxygenase products, PGI2, 6-keto-PGF1
      alpha, Iloprost (PGI2 analog), PGE2, and LTB4, LTC4, and 15
      hydroxyeicosatetraenoic acid (15-HETE) in the lipoxygenase products in the dose
      of 150 ng were applied on the round window membrane (RWM); cochlear function
      tested by auditory brainstem response (ABR) and samples of perilymph were
      collected at 0.5, 1, 2, and 4 hours after the application. Samples of perilymph
      were assayed for all spectra of AA metabolites by high performance liquid
      chromatography (HPLC) and radioimmunoassay (RIA). PG-treated animals developed
      minimal or no hearing loss. LT-treated animals exhibited hearing loss of 20 to 40
      dB, peaking at one hour after the treatment. Elevated levels of arachidonic acid
      metabolites were measured in the perilymph of the ears treated with respective AA
      metabolites, with peak levels at one hour from the application. The findings of
      this study indicate that hearing loss can be induced by altered levels of PGs or
      LTs in the perilymph. This is another strong evidence that salicylate induced
      ototoxicity can be mediated by abnormal arachidonic acid metabolism in the inner
      ear.

PMID- 1636420
TI  - Laminin in the endolymphatic sac and vestibular endorgans of developing chick
      embryos.
AB  - The expression of laminin was analyzed in the vestibular endorgans of chick
      embryos using immunohistochemical methods. The basement membrane of the otocyst
      in the 5-day-old chick embryo was positive for laminin. In the 9-day-old chick
      embryo, the basement membrane of the macula of the saccule and utricle was
      positive, but the crista ampullaris showed a very weak positive reaction. The
      basement membrane of the endolymphatic sac in the 11-day-old chick embryo was
      strongly positive. These results suggest that laminin may be an essential
      substance with regard to the pathology of the vestibular endorgans. Moreover, the
      uneven distribution of laminin suggests that the basement membrane plays a role
      whose importance is yet to be determined in the physiology of the inner ear.

PMID- 1636421
TI  - The levels of IL-1 beta in human middle ear effusions.
AB  - Inflammatory mediators retained in middle ear effusion (MEE) during otitis media
      are important in influencing the clinical outcome of this disease. Interleukins,
      important immunomodulatory proteins, undoubtedly influence this inflammatory
      response. In our present study we analyzed 74 human middle ear effusion samples
      for interleukin-1 beta (IL-1 beta). Those effusions classified as purulent (POM)
      contained the highest levels, while those classified as serous (SOM) had the
      lowest. A statistically significant correlation between age and level of IL-1
      beta was observed, namely, the younger group had higher levels of IL-1 beta than
      the older group in MOM and POM samples. The results of this study show that IL-1
      beta is present in human middle ear effusion of otitis media and suggest that IL
      1 beta may be an important mediator involved in the disease processes of otitis
      media.

PMID- 1636422
TI  - The round window membrane under normal and pathological conditions.
AB  - Current research and an overall review of round window membrane studies is
      presented and the concepts that have evolved from these studies are described.
      Ultrastructural studies of the round window membrane of rodents, felines, and
      primates disclosed three basic layers: an outer epithelium lining the middle ear,
      a middle core of connective tissue, and an inner epithelium bordering the inner
      ear. Morphological evidence suggests that the membrane participates in: (a) the
      release of mechanical energy supplied by the ossicular chain to the labyrinthine
      fluids; (b) an alternative route for sound energy to enter the cochlea; (c)
      secretion into and absorption from perilymph; and (d) the defense system of the
      middle and inner ears. Permeability of the round window is considered an accident
      and not a function of the membrane. The complications of permeability (potential
      ototoxicity) and its potential usefulness (drug delivery) are discussed.

PMID- 1636423
TI  - Round window membrane rupture and inner ear damage due to barotrauma.
AB  - We investigated inner ear barotrauma in humans and in guinea pigs. The shapes of
      audiograms in patients with inner ear barotrauma were varied, such as high-tone
      hearing loss, profound loss, low-tone hearing loss, dip type, etc. In inner ear
      barotrauma in guinea pigs, damage to the organ of Corti was observed in various
      parts of the cochlear turns in varying severity. Some animals showed rupture of
      the round window membrane and/or reduction of endocochlear potential following
      the barotrauma but the rupture healed and EP recovered spontaneously within one
      week. We consider that irreversible hearing loss in patients with inner ear
      barotrauma depends on the extent of damage to the organ of Corti.

PMID- 1636424
TI  - Cochlear effects of hyaluronan applied on ruptured round window membrane.
AB  - The purpose of the present experimental study was to determine whether hyaluronan
      (hyaluronic acid, HYA) exerts any functional or morphologic ototoxic effects on
      the cochlea when in contact with a ruptured round window membrane (RWM). HYA in
      1% solution was applied in the round window (RW) niche of rats (n = 6) prior to
      perforating the RWM. In a control group (n = 6) the RWM was perforated alone.
      Cochlear functioning and structure were monitored by recording auditory brainstem
      responses (ABRs) at 2-31.5 kHz and by scanning electron microscopy. Perforation
      of the RWM alone resulted in immediate loss of ABR thresholds between 6 and 31.5
      kHz in 2 of 6 animals. Similar results were obtained after application of HYA
      into the RW niche and subsequent RWM perforation. In both treatment groups the
      mean ABR thresholds and mean latencies for wave II at the ABR threshold returned
      to the pre-surgical (normal) range after 2 months. Also with respect to the
      cochlear morphology the results in both treatment groups were alike including
      minor structural changes in hair cell stereociliae but no loss of hair cells. It
      is concluded that HYA, when instilled into the middle ear with the inner ear
      opened, is free from cochlear ototoxic effects. Our present findings enhance the
      potential usefulness of HYA in otosurgery, even in cases when the inner ear has
      been opened and/or when one wishes to protect the inner ear.

PMID- 1636425
TI  - Pseudomonas aeruginosa exotoxin A and Haemophilus influenzae type b endotoxin.
      Effect on the inner ear and passage through the round window membrane of the
      chinchilla.
AB  - Pseudomonas aeruginosa exotoxin A was applied to the round window membrane of the
      chinchilla in concentrations ranging from 1 microgram/ml to 1 mg/ml. Haemophilus
      influenzae type b endotoxin (45,000 endotoxin units/ml) was applied in the same
      way. Five animals were also subjected to blocking of the Eustachian tube, 3 to 8
      months earlier, resulting in serous otitis media and exotoxin A (1 mg/ml) was
      applied into the round window niche of these animals. Effects on the inner ear
      was recorded with quantitative morphology (hair cell counting) and
      electrophysiologically (action potential threshold measurements) 4 weeks after
      application of exotoxin A. Concentrations of exotoxin A in perilymph was measured
      with ELISA and concentration of endotoxin in perilymph was measured with Limulus
      Amoebocyte Lysate and Quantitative Chromogenic Limulus Amebocyte Lysate. Four
      weeks after application of exotoxin A at a concentration of 10 micrograms/ml
      severe inner ear damage could be demonstrated. No inner ear damage was
      demonstrated when lower concentrations were used. Passage into the inner ear
      could only be demonstrated after exposure of the round window membrane to an
      exotoxin A concentration of 1 mg/ml. Round window membranes affected by chronic
      inflammation were shown to be less permeable to exotoxin A, thus indicating that
      thickening of the round window membrane may have a protective effect on the inner
      ear. A low passage rate into the inner ear was demonstrated after endotoxin
      exposure. It may be concluded that small amounts of exotoxin A passing through
      the round window membrane may cause inner ear damage. The passage rates, however,
      for both exotoxin A and endotoxins are low.

PMID- 1636426
TI  - Undecalcified temporal bone morphology: a methodology useful for gross to fine
      observation and three-dimensional reconstruction.
AB  - Using a novel method of cutting undecalcified temporal bone specimens,
      quantitative structural analysis in the human and the Japanese monkey was
      undertaken. One millimeter thick serial slices made from unembedded temporal
      bones retained fine structure. Therefore, gross to fine observation could be
      performed systematically at the macroscopic, light, scanning, and transmission
      electron microscopic levels. The entire temporal bone three-dimensional
      reconstruction was completed from embedded sections; consequently, the volume of
      the tubotympanum and air cell system could be calculated. Available methods by
      embedding, tungsten carbide sectioning, grinding, and microwave irradiation for
      decalcification were also examined. These morphologic studies suggest that these
      novel methods offer timesaving advantages over any presently available
      techniques, and allow for elucidation of temporal bone morphology with only a few
      specimens.

PMID- 1636427
TI  - Repeated measurements of compound action potential: evaluation of the ototoxicity
      of otic drops.
AB  - Consecutive CAP threshold shifts were studied in chinchillas following round
      window application of Cortisporin Otic Suspension for 10 minutes. A marked
      deterioration in CAP threshold was observed at 24 hours following otic
      application but these threshold shifts were reversible at lower frequencies. The
      shifts were progressive at higher frequencies at the 4 week measurement. The
      progressive high frequency loss with recruitment and with normal EP levels
      implies some hair cell dysfunction due directly to Cortisporin Otic Suspension
      ototoxicity and/or secondarily to middle ear inflammatory reactions to the otic.
      Short-term studies of ototopical drugs may result in misleading assessments as to
      the pattern and degree of ototoxicity. Long-term (i.e., one month or longer)
      studies are recommended for accurate ototoxicity assessment.

PMID- 1636428
TI  - Effect of round window membrane application of salicylate and indomethacin on
      hearing and levels of arachidonic acid metabolites in perilymph.
AB  - Our previous studies revealed that systemic salicylate-induced ototoxicity is
      associated with altered levels of arachidonic acid metabolites (AAMs) in the
      perilymph. In order to eliminate the possibility of systemic toxic effects of
      salicylate when it is given parenterally, an animal model of salicylate-induced
      ototoxicity was developed by applying it on the round window membrane (RWM).
      Using chinchillas as experimental animals, sodium salicylate (150 micrograms) or
      another nonsteroidal anti-inflammatory drug (NSAID), indomethacin (20 micrograms)
      was applied on the RWM, cochlear function was determined by auditory brainstem
      response (ABR) and perilymph assayed for AAMs both prostaglandins (PGs) and
      leukotrienes (LTs) by high performance liquid chromatography (HPLC) and
      radioimmunoassay (RIA) at different time intervals. When salicylate or
      indomethacin was applied on the RWM, dose-dependent ABR threshold losses of 20 to
      50 dB was observed in 1 to 2 hours associated with decreased concentrations of 6
      keto-PGF1 alpha and elevated levels of LTs. The hearing loss recovered to normal
      threshold over a period of 8 hours. The control group showed no hearing loss or
      any change in PG or LT-levels in the prilymph. The results of this study suggest
      that the method of inducing ototoxicity by applying salicylate or indomethacin on
      the RWM seems to be a reliable method for avoiding systemic toxicity of the
      parenteral treatment method and that ototoxicity induced by salicylate or
      indomethacin may be mediated by decreased PGs and elevated LTs.

PMID- 1636429
TI  - Are glucocorticoids in ear drops ototoxic?
AB  - Ototopical drugs such as antiseptics, antibiotics and solvents can have an
      ototoxic potential. These substances are often combined with an anti-inflammatory
      steroid of which hydrocortisone is one of the most commonly used. Little is known
      of possible adverse effects on the inner ear of hydrocortisone. From animal
      experiments it has been shown that this drug applied in the round window niche
      will impair the ABR thresholds in the high frequency range. The ototoxic
      potential of glucocorticoids will be discussed and questioned.

PMID- 1636430
TI  - Middle ear problems in childhood.
AB  - No single factor is as yet known which could be used to predict the possible
      development of rAOM in infants and children. However, some circumstantial
      evidence can be seen. Thus, an AOM debut before the age of six months in a child
      with a family history of recurrent otitis indicates a clear risk of multiple
      recurrent episodes. Other 'intrinsic factors' speaking in favour of rAOM are low
      concentrations of specific IgG antibodies against pneumococcus type 6A in cord
      serum and a presence of the hereditary HLA-antigen A2 on the surfaces of white
      blood cells. Extrinsic factors' such as type of day-care, passive exposure to
      smoking at home and poor housing seem to increase the risk but do probably not
      constitute the definite cause of rAOM.

PMID- 1636431
TI  - Secretory otitis media and high-frequency hearing loss.
AB  - 31 children (mean age 13 years; range 8.5-17.2) who had been tympanostomy treated
      for SOM during the years 1977-1980 were invited for follow-up examination. 29
      normal age peers were enrolled as controls. The test battery included clinical
      pneumotoscopical examination and conventional pure-tone audiometry as well as air
      conduction and electric bone-conduction high-frequency audiometry. High-frequency
      hearing losses (6-18 kHz) were found as sequels of SOM. The median threshold
      difference between the SOM group and the controls varied from 0 to 10 dB
      depending on the frequency. The hearing losses were considered to be of the
      conductive type, and probably related to changes in the tympanic membrane and the
      middle ear caused by SOM. On the other hand, we found also sensorineural hearing
      losses suggesting lesion at the cochlear level.

PMID- 1636432
TI  - Oncocytic neoplasms of the thyroid gland.
AB  - Among well differentiated thyroid tumors, oncocytic neoplasms feature a
      distinctive set of clinical, morphologic and biologic characteristics, some of
      which have been a matter of controversy. The world literature on this subject has
      been reviewed to show that: 1) Morphology accurately predicts the behavior of
      Hurthle cell tumors assuming that the specimen has been adequately sampled; 2)
      Capsular and/or vascular invasion is the sine qua non condition for a diagnosis
      of malignancy; 3) "Indeterminate" or "possibly malignant" categories are useless
      because in the absence of invasion these neoplasms almost invariably behave in a
      benign fashion; 4) Among cases histologically classified as malignant, a
      clinically aggressive behavior is to be expected in a high percentage of cases;
      5) Size alone cannot be used as a criterion of malignancy; 6) Less than total
      thyroidectomy provides an adequate treatment for histologically benign tumors;
      aggressive surgical procedures (i.e. total thyroidectomy) do not diminish the
      incidence of metastasis; 7) Analysis of DNA content may be helpful in defining
      subsets of patients with Hurthle cell carcinomas having a particularly poor
      prognosis; 8) Mitochondrial and/or nuclear DNA abnormalities probably play an
      important role in the cellular alterations which characterize the phenotype of
      oncocytes.

PMID- 1636433
TI  - Pathological effects of maternal hypoglycemia on fetal development in cats.
AB  - The pathogenesis of fetal brain damage caused by acute maternal hypoglycemia was
      investigated experimentally in cats: profound hypoglycemia (blood glucose
      concentration: less than 30 mg/dl) was induced in 12 pregnant cats at various
      stages of gestation by intravenous bolus injections of insulin. Maximal
      hypoglycemia was attained within 2-3 h, although the grade and duration in
      individual cats varied. The EEGs of all of seven maternal cats examined showed an
      increased frequency of slow high-voltage waves as hypoglycemia progressed,
      eventually becoming flat in 3 for a maximum period of 20 min. Some fetuses showed
      severe neuropathological changes, such as infarction or intrauterine death.
      Subventricular softening, cortical hemorrhage and ischemic neuronal changes also
      occurred, being distributed symmetrically in the parasagittal areas of the
      cerebrum, basal ganglia, thalamus and tegmentum of the brainstem. In general,
      these pathological changes were more marked in fetuses and neonates than in the
      maternal cats, in which only ischemic neuronal changes were present, and may have
      been due to fetal systemic hypotension and cerebral ischemia induced by
      hypoglycemia. In maternal cats, the distribution of neurons showing ischemic
      changes was widest in the cerebral cortex, and some were also present in the
      dentate gyri of the hippocampus. Moreover, ultrastructural examination of the
      ischemic neurons in maternal cats, unlike those of the fetuses, showed no
      mitochondrial swelling. Therefore, the distribution and ultrastructural nature of
      the ischemic neurons found in the maternal cats were considered to be
      characteristic of hypoglycemia, as proposed by Agardh et al. (1980).

PMID- 1636434
TI  - Glomerulonephritis induced by murine chronic graft-versus-host reaction.
AB  - Severe glomerulonephritis was induced successfully in (B10 x DBA/2)F1 (BDF1) mice
      by injection of parental DBA/2 lymphoid cells. The mice manifested typical
      nephrotic syndrome dying around 10 weeks post injection. Electron microscopical
      examination demonstrated electron dense deposits first in the mesangial matrix,
      then in the subepithelium compatible with immune complex glomerulonephritis.
      Subendothelial deposits were not observed. Immunofluorescent study revealed IgG
      deposition in the capillary wall and IgM in the mesangium early in the process.
      As the lesion progressed, both IgG and IgM were present in the mesangial area and
      along the capillary wall. Some glomeruli showed segmental mesangiolysis,
      suggesting that altered mesangial cells have a role in the development of
      glomerular change, which together with rise in serum anti-DNA antibody titer
      suggest that autoantibodies promote the glomerular lesions in this model system.

PMID- 1636435
TI  - Malignant lymphomas of the nasal cavity and paranasal sinuses. A
      clinicopathologic and immunohistochemical study.
AB  - The clinicopathologic and immunohistological features of 20 Japanese patients
      with non-Hodgkin's lymphomas (NHLs) limited to the sinonasal area were studied
      using a broad panel of T- and B-cell markers on paraffin-embedded and fresh
      frozen tissue. All cases showed a diffuse growth pattern. Nine cases were B-cell
      lymphomas (immunoblastic n = 4, centroblastic n = 3, immunocytoma n = 1,
      centrocytic n = 1), and nine were T-cell lymphomas (pleomorphic medium and large
      cell n = 8, angioimmunoblastic n = 1). In two cases, the cell lineage could not
      be determined. No morphologic features of angiocentric/angiodestructive
      lymphoproliferative lesions or lymphoepithelial lesions in ductal or glandular
      epithelium were seen in our series. Eight (89%) of the nine T-cell tumors and
      four (44%) of the nine B-cell neoplasms involved both the nasal cavity and
      paranasal sinuses. Six of the nine T-cell neoplasms showed a clinical
      presentation of rhinitis, whereas all of the B-cell neoplasms showed tumor masses
      in the nasal cavity and/or paranasal sinuses. The two-year survival rate for T
      cell lymphomas was poorer than that for B-cell lymphomas. The five-year survival
      of patients with NHLs involving both the nasal cavity and paranasal sinuses was
      also poorer than that of patients in whom NHLs were limited to the nasal cavity.

PMID- 1636436
TI  - Distribution of antigens detected with MB1, MB2 and MB3 on non-hematopoietic
      human organs and various tumors.
AB  - We have examined the distribution of antigens detected by MB1, MB2 and MB3 on non
      hematopoietic normal human tissues and various types of benign and malignant
      tumors. MB1 and MB2 reacted with various organs, such as the epithelium of
      various glands, smooth muscle cells, vascular endothelial cells, and peripheral
      nerve tissue. The distributions of these two antibodies were essentially
      identical. Reactivity with MB3 was confined to the ductal epithelium of salivary
      glands, the pancreas, and sweat glands, and the cortex of the adrenal gland.
      Immunoblotting analysis demonstrated that MB1 and MB2 reacted with a few bands of
      an extract of myometrial cytoskeletal fraction and salivary gland cytosol
      fraction, whereas MB3 failed to show any bands on these materials. The
      reactivities of MB1 and MB2 with various neoplasms were similar to those in
      normal organs, with slight variations of staining pattern and preponderance in
      well differentiated tumors. Exceptionally, carcinoid tumor and small round cell
      tumors, such as small cell carcinoma or neuroblastoma, were not reactive with MB1
      and MB2. MB3 reacted with several cases of well differentiated benign and
      malignant epithelial tumors in various organs, and exceptional cases of malignant
      schwannoma and glioma. These results indicate that the antigens detected by MB1
      and MB2 are distributed broadly on non-hematopoietic normal organs, whereas those
      detected by MB3 are confined to exceptional cases of epithelial and non
      epithelial tumors. Thus, although the use of MB1, MB2 and MB3 is of little value
      for differential diagnosis of various tumors, these three antibodies may be
      useful for determining of the origin of some tumor types.

PMID- 1636437
TI  - Meningeal hamartoma of the scalp. A variant of primary cutaneous meningioma.
AB  - A case of meningeal hamartoma of the scalp is reported. A 15-year-old girl was
      admitted complaining of scalp nodules in the midline occipital region. A midline
      skull defect was found under the nodular lesions. Histologically, the mass had a
      fibrocollagenous tract extending to the dura and showed an admixture of mature
      adipose tissue, small vessels, strands of fibrocollagenous tissue, and scattered
      foci of meningocytes. Immunohistochemically, the meningocytes desmosomes,
      interdigitating processes, and intermediate filaments. The patient's brother also
      had the meningeal hamartoma of the scalp. Meningeal hamartoma as a variant of
      primary cutaneous meningioma is extremely rare, and this is the first report of
      such a case in Japan.

PMID- 1636438
TI  - Primary mesenchymal chondrosarcoma of the lung. A case report with
      immunohistochemical and ultrastructural studies.
AB  - A case of primary pulmonary mesenchymal chondrosarcoma is reported. The tumor
      occurred first in the lower lobe of the right lung of a Japanese female aged 45.
      Three years after the first operation it metastasized to the upper lobe of the
      left lung. The tumors were highly cellular and composed of undifferentiated
      mesenchymal cells and interspersed islands of well-differentiated cartilaginous
      tissue. Immunohistochemistry failed to detect S-100 and vimentin in the
      undifferentiated cells. In contrast, Leu-7 and blood coagulation factor XIIIa
      were positive in these cells. Electron microscopically, undifferentiated
      mesenchymal cells had narrow cytoplasm with sparsity of organelles, but no
      intermediate-sized filaments were detected. In the transitional areas between
      undifferentiated cells and cartilaginous components, thin intracytoplasmic
      filaments were sometimes observed in the tumor cells. The differentiation toward
      cartilaginous cells of undifferentiated mesenchymal cells was suggested by
      immunohistochemistry and electron microscopy. This is the first case of
      mesenchymal chondrosarcoma occurring in the lung with long-term follow-up.

PMID- 1636439
TI  - Inflammatory pseudotumor of the spleen. Report of a case with an
      immunohistochemical study.
AB  - A 81-year-old Japanese man with a splenic inflammatory pseudotumor is described.
      The pseudotumor was unchanged in size after one year of observation.
      Macroscopically, the lesion was a firm well-circumscribed 5.5 x 5 x 5 cm mass
      showing a yellowish-white cut surface. Histologically, it was composed of
      abundant mixed inflammatory infiltrates, predominantly UCHL-1(+) T and L26(+) B
      lymphocytes, plasma cells containing various immunoglobulin subtypes, and S-100
      protein(+), and lysozyme and NCA(+) histiocytes, with a sclerotic stroma. Small
      numbers of eosinophils, neutrophils and foamy macrophages were admixed. The
      patient has remained disease-free for 14 months after splenectomy. Only ten
      splenic inflammatory pseudotumors have been reported in the literature. This
      paper adds an additional case, together with details of immunohistochemical
      polyclonality of each inflammatory cell population, confirming that this disease
      is a nonspecific inflammatory change.

PMID- 1636440
TI  - Rhabdomyosarcoma with focal cartilaginous differentiation (malignant
      mesenchymoma) of the inferior vena cava.
AB  - A sarcoma arising from the inferior vena cava occupied the entire lumen of the
      inferior vena cava, right atrium, hepatic veins and common iliac veins. Its
      histological appearance was non-specific sarcoma, except for the presence of a
      few rhabdomyoblasts and some immature cartilaginous tissue.
      Immunohistochemically, some tumor cells were positive for myoglobin, desmin, HHF
      35, and vimentin. Electron microscopy revealed that some tumor cells contained
      myofilaments and Z bands in the cytoplasm, which are characteristics of
      rhabdomyosarcoma. The tumor was diagnosed as rhabdomyosarcoma with focal
      cartilaginous differentiation (malignant mesenchymoma) of the inferior vena cava.

PMID- 1636441
TI  - The influence of high salt intake and/or chronic blood volume expansion on renin
      angiotensin system in Brattleboro rats.
AB  - The influence of chronic saline drinking and/or DOCA-salt treatment on plasma
      renin activity and renal renin concentration was studied in vasopressin-deficient
      homozygous (DI) Brattleboro rats and their vasopressin-secreting heterozygous
      (non-DI) littermates. The activity of renin-angiotensin system (RAS) can be
      suppressed even in the absence of vasopressin under the conditions of a
      sufficiently high salt intake that is achieved in DI rats by consumption of 0.6%
      saline instead of water. An almost complete RAS suppression in both plasma and
      kidney was observed in young animals in which high salt intake induced not only
      blood volume expansion but also blood pressure elevation, i.e. in mildly
      hypertensive unilaterally nephrectomized saline drinking DI rats as well as in
      moderately hypertensive DOCA-salt treated DI rats and in non-DI rats with a
      severe DOCA-salt hypertension. Our results indicate that intravascular expansion
      and blood pressure changes are important factors for the modulation of plasma and
      renal renin activity even in the absence of vasopressin.

PMID- 1636442
TI  - Is the mean power frequency shift of the EMG a selective indicator of fatigue of
      the fast twitch motor units?
AB  - During repeated maximum isokinetic contractions parallel decreases in output and
      the mean power frequency (MPF) of the electromyogram (EMG) occur, followed by
      stable levels (the endurance level). This study aimed to investigate if hypoxia
      of the plantar flexors will result in a shift in MPF during the endurance level.
      Mechanical performance and simultaneous surface EMG activity of three plantar
      flexors (m. soleus, m. gastrocnemius medialis and m. gastrocnemius lateralis)
      were recorded during repeated isokinetic plantar flexions at 1.05 rad s-1 in 10
      healthy women. The study consisted of two tests with 14 days in between: (1) a
      maximum test consisting of 125 maximum plantar flexions. After 100 contractions,
      using a tourniquet, a relative ischaemia (hypoxia) was induced. (2) a submaximum
      test performed at the level established between contractions 70-100 of the
      maximum test, consisting of 125 plantar flexions. During the maximum test
      mechanical performance output, the signal amplitude (RMS) of the EMG and the MPF
      decreased in parallel during the initial 50 contractions followed by stable
      levels during the subsequent 50 contractions. When hypoxia was induced decreases
      in mechanical performance and RMS appeared without significant decreases in MPF.
      The present study indicates that the MPF shift is mainly sensitive to biochemical
      changes in the type 2 fibres. Hypoxia mainly located to the type 1 fibres will
      not be detected using the MPF variable.

PMID- 1636443
TI  - Splanchnic and renal vasoconstrictor and metabolic responses to neuropeptide Y in
      resting and exercising man.
AB  - The local clearance of neuropeptide Y (NPY) and whether NPY influences splanchnic
      and renal metabolism in man have not been investigated previously. The influence
      of NPY on splanchnic and renal blood flows at physiologically elevated levels has
      also not been investigated. The effects of a 40-min constant NPY infusion (3 pmol
      kg-1 min-1) at rest and during 130 min of exercise (50% of VO2max) were studied
      in six healthy subjects and compared with resting and exercising subjects
      receiving no NPY. Blood samples were drawn from arterial, hepatic and renal vein
      catheters for the determination of blood flows (indicators: cardiogreen and para
      aminohippuric acid [PAH]), NPY, catecholamines, glucose, lactate and glycerol.
      NPY infusion was accompanied by: (1) significant fractional extraction of NPY
      like immunoreactivity (NPY-Li) by splanchnic tissues at rest (58 +/- 5%) and
      during exercise (53 +/- 6%), while no arterial-venous differences could be
      detected across the kidney; (2) a reduction in splanchnic and renal blood flows
      of up to 18 and 13% respectively (P less than 0.01-0.001) at rest without any
      additional changes during exercise; and (3) metabolic changes as reflected in:
      (a) a more marked fall in arterial glucose during exercise compared to the
      reference group (P less than 0.05); (b) a 35% lower splanchnic glucose release (P
      less than 0.01) during exercise due to diminished glycogenolysis (P less than
      0.01); and (c) a lower arterial lactate level (18% P less than 0.05) together
      with unchanged splanchnic lactate uptake during exercise, suggesting reduced
      lactate production by extrahepatic tissues. The disappearance of plasma NPY-Li
      after the infusions was biphasic with two similar half-lives at rest (4 and 39
      min) and during exercise (3 and 43 min).

PMID- 1636444
TI  - Pro-oxidant effects of normobaric hyperoxia in rat tissues.
AB  - Rats were exposed to 100% O2 atmosphere for 12, 36 or 48 h, and their lungs,
      brain, liver and kidneys were studied for signs of oxidative damage. Oxidative
      damage at molecular level was estimated by: (1) the appearance of conjugated
      diene double bonds and (2) the amount of fluorescent chromolipids in lipids
      extracted from tissues. As important intracellular regulators of oxidative
      stress, the response of enzymes detoxifying reactive oxygen species was also
      studied. Macroscopically, the brain and the lungs were most susceptible to oxygen
      induced effects. As an indication of oxidative tissue damage, hyperoxia caused
      accumulation of fluorescent chromolipids in brain and lung tissues, whereas diene
      conjugation did not reveal any signs of lipid peroxidation. Accumulation of
      fluorescent chromolipids was most prominent in the brain, where 99 and 138%
      increases over the control were detected after 36 and 48 h hyperoxia,
      respectively. Fluorescent chromolipids appeared in urine already before their
      concentrations were elevated in tissues. The activity of superoxide dismutase in
      the brain was initially decreased, followed then by a slight induction of
      activity at the later time-points. Pulmonary and hepatic catalase activities were
      markedly decreased after prolonged (36 and 48 h) hyperoxia. In conclusion,
      fluorescent chromolipid formation seems to be a sensitive indicator of hyperoxia
      induced oxidative damage in rat tissues. The lipid peroxidation-derived
      fluorescent chromolipids are eliminated from the body via urinary excretion.
      Moreover, impaired detoxication of reactive oxygen may be implicated in tissue
      damage due to hyperoxia.

PMID- 1636445
TI  - Differential responses in post- and pre-ganglionic adrenal sympathetic nerve
      activity and renal sympathetic nerve activity after injection of 2-deoxy-D
      glucose and insulin in rats.
AB  - The aim of the study was to compare pre-ganglionic adrenal nerve activity (pre
      aSNA) to post-ganglionic adrenal nerve activity (post-aSNA) in rats after
      administration of 2-deoxy-D-glucose (2-DG, 500 mg kg-1, i.v.), which mimicks a
      central hypoglycaemia or to the response in pre-aSNA and post-aSNA to
      hypoglycaemia after injection of insulin (5U). Renal postganglionic sympathetic
      nerve recordings (rSNA) in a separate group was used as a reference. Adrenal or
      renal multifibre nerve activity was recorded in chloralose-anaesthetized Wistar
      rats. Trimethaphan, a short-lasting ganglionic blocker, was administered i.v. (10
      mg kg-1) in order to test for pre- or post-aSNA in the adrenal nerves. The
      adrenal nerves was considered to contain predominantly post or preganglionic
      fibres, respectively if the nerve activity in the adrenal nerve decreased (post
      aSNA) or increased (pre-aSNA). In contrast, all renal nerves showed almost a pure
      postganglionic activity. Post-aSNA responded with a tendency to increase after
      the 2-DG injection. The highest value (percentage change from control) 5 min
      after injection was 12 +/- 9%. The pre-aSNA increased with values of 99 +/- 52%
      at 3 min and 86 +/- 31% at 5 min (percentage change from control). The activity
      in the rSNA was only slightly decreased after the injection of 2-DG when compared
      to pre-drug control activity. There was a significant difference between the pre
      aSNA vs. post-aSNA at 1 min (P less than 0.05), 3 min (P less than 0.01) and 5
      min (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636446
TI  - Increased resistance to haemorrhage induced by intracerebroventricular infusion
      of hypertonic NaCl in conscious sheep.
AB  - The effect of elevated cerebrospinal fluid Na+ concentration (CSF [Na+]) on the
      tolerance of blood loss, and concomitant cardiovascular and humoral responses
      were studied in conscious sheep. A slow (0.7 ml kg-1 min-1) venous haemorrhage
      was continued until the mean systemic arterial pressure suddenly decreased to
      less than 50 mmHg, or in the absence of hypotension, until a total blood loss of
      25 ml kg-1. Significantly more blood had to be removed to induce hypotension in
      animals receiving an intracerebroventricular (i.c.v.) infusion (0.02 ml min-1) of
      0.5 M NaCl (starting 30 min before haemorrhage and continued throughout the
      experiment) compared to control haemorrhages without concomitant i.c.v. infusion
      (22.7 +/- 1.2 ml vs 16.9 +/- 0.9 ml kg-1). In one animal, subjected to 0.5 M NaCl
      infusion, the blood pressure was still maintained at 25 ml kg-1 of haemorrhage.
      In spite of a larger blood loss, animals receiving i.c.v. infusion of hypertonic
      NaCl had an improved recovery of the blood pressure after haemorrhage, due to a
      better maintained cardiac output rather than to a reinforced increase of the
      vascular resistance. The improved cardiovascular responses to haemorrhage during
      elevated CSF [Na+] are not readily explained by the effects on the plasma
      concentrations of vasopressin, angiotensin II or noradrenaline, although the
      latter was augmented. The plasma protein concentration decreased already during
      the 30 min of hypertonic NaCl infusion preceding haemorrhage, and the
      haemodilution caused by the subsequent blood removal was aggravated, which
      indicates that this treatment also causes transfer of fluid to the plasma
      compartment. We conclude that elevated CSF [Na+] increases tolerance to
      haemorrhage and improves cardiovascular function after blood loss in sheep. Since
      the haemodynamic responses in many respects were similar to those reported in
      response to the systemic administration of a small volume of hypertonic NaCl
      solution in haemorrhagic shock, part of the effect of that treatment may be
      mediated via cerebral effects of increased Na+ concentration.

PMID- 1636447
TI  - Atropinization decreases oxytocin secretion in dairy cows.

PMID- 1636448
TI  - Low birth weight is associated with elevated adult blood pressure in the
      chronically catheterized guinea-pig.

PMID- 1636449
TI  - Calciuresis elicited by spontaneous rehydration in dehydrated sheep.

PMID- 1636450
TI  - [Controversies in the diagnosis and treatment of cancer of the prostate. Meeting
      of the Uro-oncologic Group of the Spanish Association of Urology. Vigo].

PMID- 1636451
TI  - [Vascular complications in 237 recipients of renal transplant from cadaver].
AB  - Between July 1976 and June 1990, 244 transplantations were performed. Of the 237
      patients monitored, 13 (5.4%) had vascular complications: 10 (77%) renal artery
      stenosis, 1 (7.7%) primitive iliac artery stenosis, 1(7.7%) renal artery
      thrombosis, 1 (7.7%) renal vein thrombosis. Six patients underwent surgery
      (Angioplasty was performed in three patients, re-anastomosis to the common iliac
      artery in one, by-pass of saphenous vein in another one, while in the last one it
      was tried a release of the vascular pediculus). Management with drugs was
      possible in one case. At present, 11 of the 13 patients are still alive and three
      of the grafts remain functional after a mean follow-up time of 83 months.
      According to a univariate study, the influential factors in the development of
      vascular complications are, the identity of Locus A, the type of extraction in
      Locus B, the length of cold ischaemia, the type of vascular anastomosis and the
      number of previous rejections. The factors with maximal influence in the
      development of complications are the type of vascular suture (with or without
      patch) and the number of previous rejections (according to a study of log
      regression models). The study demonstrates the significant influence vascular
      complications have on the graft's durability (p = 0.005).

PMID- 1636452
TI  - [Renal fungal infection: presentation forms and therapeutic advances].
AB  - Fluconazole is a broad spectrum anti-fungal agent which combines good tolerance,
      efficacy and low toxicity, and offers useful advantages in the treatment of
      certain forms of mycosis. Three cases of renal fungal disease treated with
      surgery (nephrectomy in two cases and pyelolitectomy plus partial nephrectomy in
      the third one) and fluconazole or amphotericin B are presented. In all three
      cases there was at least one predisposing factor (diabetes, urolithiasis, urinary
      catheter, previous therapy with antibiotics, or AIDS), and the causing pathogens
      were Candida and Mucor. Administration of fluconazole 100 mg b.i.d. for 4 weeks
      in the two candida infected patients accomplished a complete cure of the disease.
      Incidence, etiopathology, presentation forms and diagnostic techniques of urinary
      mycosis are analyzed together with the current therapeutical options, making
      special reference to fluconazole.

PMID- 1636453
TI  - [Abdominal echography to determine the weight of the prostate].
AB  - The relationship of post-operatively determined prostatic gland weight and that
      calculated prior the procedure, by means of abdominal ultrasound techniques using
      the "ellipsoid method", has been studied in 88 patients undergoing retropubic
      adenectomy. The regression line was nearly optimal, Y = 0.946 X + 2.295, and the
      correlation coefficient between both weight measures was r = 0.915. Abdominal
      ultrasound examinations are a simple, quick and safe means to evaluate prostate
      weight, prior to deciding the type of surgery (open adenectomy or transurethral
      resection) for prostate adenoma.

PMID- 1636454
TI  - [Complete androgenic blockade: myth or reality. Study and follow-up of 35
      patients with advanced carcinoma of the prostate].
AB  - Retrospective evaluation of the efficacy of complete androgenic blockade started
      by Labrie et al. using therapy with leuprolide acetate in monthly dosage of 7.5
      mg i.m. associated to flutamide at the usual dosage in 35 patients with prostate
      adenocarcinoma in C-D1-D2 stages, who had not been given prior anti-neoplastic
      therapy. Clinical and analytical control studies were carried out during therapy
      follow-up for a maximum time of 36 months. The objective response of adverse
      events that can be superimposed to previous studies carried out with analogs on
      daily administration was assessed. Castration levels achieved were maintained for
      the length of the study below 50 ng/dl. Correlation between tissue type, rated
      according to the Mostofi classification, evolution or degree of response obtained
      and preserved increase of tumour markers (PSA, PAP, LDH, Prolactin) was
      evaluated; the evolution observed in patients who maintained high values of
      markers was worse with the referred treatment.

PMID- 1636455
TI  - [Incidence and characteristics of multiple neoplasms in urologic patients].
AB  - The incidence and features of malignant primary multiple (MPM) neoplasias found
      in clinical urological patients have been analyzed so as to determine the actual
      magnitude of the problem and to obtain a better knowledge of this disease. For
      this reason, case histories of patients with MPMN, where at least one of the
      involved neoplasia was urological, were retrospectively studied. The study
      included a 9-year follow-up period and followed the Warren and Gates inclusion
      criteria. The number of MPMN patients was 23, representing an incidence of 6.1%
      among patients with urological neoplasias. Mean age at the time of discovery of
      the second tumour was 77.1 years. In the 15 patients with metachronic tumours,
      the time interval between the first and second tumours ranged between 1 to 25
      years (average 5.4 years). The most frequently observed tumour association was
      bladder transitional carcinoma and prostate adenocarcinoma. The cause of death
      was always the second neoplasia.

PMID- 1636456
TI  - [Prognostic value of local vascular infiltration in infiltrating transitional
      carcinoma of the bladder].
AB  - The present retrospective study analyzes the evolution and survival of 79
      patients with bladder infiltrant transitional carcinoma (T2-T3), which were
      treated with radical cystectomy and bilateral ilio-obturating lymphadenectomy.
      Pre-operative radiotherapy (57/79) and neo-adjuvant chemotherapy (24/79) was used
      as supplementary therapy. The univariate analysis showed the relationship between
      tumour vascular infiltration (TVI) and presence of nodes micrometastasis (p =
      0.002). The variables with greater forecast power in the multivariate analysis
      for survival were a decline in the post-radio and/or neo-adjuvant chemotherapy
      tumoral stage (p = 0.000) and TVI (p = 0.001). Survival decreased significantly
      in patients with TVI (p = 0.008), this finding denoting a worse prognosis than
      the presence of nodular micrometastasis (p = 0.01).

PMID- 1636457
TI  - [Triple ureter in crossed renal ectopy: an embryologic rarity].
AB  - Presentation of one case of CRE (crossed renale ectopia) with triplicity
      (trifidity) of the ortho and ectopic collector systems, due to the existence in
      both cases of pyelourethral bifidity and a third cranial blind ureter. This case
      represents a casual finding during a routine study of a female patient with
      orthostatic and exertion urinary incontinence (EUI). The case idiosyncrasies,
      which initially elicited the possibility of urethral ectopia, are analyzed.
      Incidence and variants of this unusual congenital anomaly are commented upon.

PMID- 1636458
TI  - [Solitary adrenal gland hydatid cyst].
AB  - Presentation of one case of solitary suprarenal hydatid cyst. Clinical diagnosis
      was made from a right lumbar pain, achieving identification of the parasitic
      disease by radiological and biological means. Treatment combined mebendazole and
      surgery. Both therapeutical options are discussed.

PMID- 1636459
TI  - [Distal tubular renal acidosis with nephrocalcinosis].
AB  - Nephrocalcinosis and distal tubular acidosis are two infrequent processes caused
      by several etiologies which can present in association. This paper describes a
      clinical case of tubular acidosis and explains the differential diagnosis of both
      entities.

PMID- 1636460
TI  - [Spontaneous renocolic fistula secondary to pyonephrosis of lithiasic etiology].
AB  - Description of one case of spontaneous fistulization between a renal calix and a
      descending colon, secondary to lithiasic pyonephrosis. Diagnosis was carried out
      by means of ascending pyelography without it being clinically suspected.
      Treatment is surgical, combining nephrectomy, fistula resection and closure of
      the colic gap. Etiology, favouring factors, diagnosis and treatment are
      explained.

PMID- 1636461
TI  - [Paratesticular rhabdomyosarcoma].
AB  - Presentation of one case of embryonic paratesticular rhabdomyosarcoma in a 19
      year old male. Following high inguinal radical orchiectomy, he required
      hemiscrotectomy, and it was found to be a foreign body granuloma. Prior to
      staging lymphadenectomy, therapy was complemented with radiotherapy and
      polychemotherapy according to a VAC protocol. The patient shows clinical
      remission at two and a half years after being diagnosed and one and a half years
      after completion of treatment.

PMID- 1636462
TI  - [Bacteremia caused by Clostridium perfringens as a complication of
      ureterosigmoidostomy].
AB  - A 63 year old male underwent cystectomy and ureterosigmoidostomy after diffuse
      carcinoma "in situ" of the bladder was discovered, and thereafter, various
      episodes of pyelonephritis and metabolic imbalance, in one of them, a left pneumo
      ureter and a positive blood culture for Clostridium Perfringens and enterococci
      was detected. Empiric therapy with Aztreonam was started, and changed after to
      high-dose intravenous amoxicillin. Two months later the ureterosigmoidostomy was
      converted to an ileal conduit. The patient has remained asymptomatic on
      subsequent controls.

PMID- 1636463
TI  - [Inverted papilloma of the renal pelvis: presentation of a case].
AB  - Contribution of a new case of urothelial inverted papilloma of rare location. Its
      invariably benign character and resolution with conservative surgery, forces to
      bear in mind this possibility when encountering pelvic repletion defects which
      can be mistaken, even after exfoliative cytologies, for low-degree transitional
      carcinomas, there being necessary to exhaust all procedures within our grasp in
      order to establish a diagnosis prior to definite surgery.

PMID- 1636464
TI  - [Double renal tumor: histogenetic implications].
AB  - Presentation of a new case of synchronic concurrence of renal adenocarcinoma and
      papillar carcinoma of renal pelvis on the same kidney. The origin of this double
      malignant renal tumour remains unknown, although several hypothesis have been
      raised. We believe that coexistence of both tumours is more than casual and we
      would underscore the morphogenetic interpretation of such coincidence.

PMID- 1636465
TI  - [Renal hemangiomas: a clinical case and review of the literature].
AB  - Renal haemangiomas, an unusual cause of renal haematuria, are benign vascular
      dysplasias of uncertain etiology. Usually asymptomatic, their clinical
      manifestation is a unilateral renal haematuria associated or not to obstructive
      urological disease through accumulation of clots in the urinary tract and
      arterial hypertension when associated to a major arteriovenous shunt.
      Arteriographic diagnosis is based on the size of the vascular malformation but
      the absence of findings in the arteriography does not eliminate the presence of
      small-sized haemangiomas or microhaemangiomas responsible for the renal chronic
      haematuria, also labelled as "essential haematuria", which sometimes can be
      diagnosed through endoscopic examination of the renal cavities. This report
      presents one case of renal haemangioma which appeared as a massive, sudden
      haematuria and prompted haemodynamic instability requiring haemotherapy.
      Following arteriographic diagnosis, selective transarterial embolization was
      undertaken with three modified Gianturco's metal helicoids, to which the patient
      responded favourably. The report includes a review of the clinical, pathological,
      diagnostic and therapeutical features of renal haemangiomas.

PMID- 1636466
TI  - Personal and parental problem drinking: effects on problem-solving performance
      and self-appraisal.
AB  - This study examined the problem-solving performances and self-appraisals of
      problem-solving ability of college-age subjects with and without parental history
      of problem drinking. Contrary to our predictions, children of problem drinkers
      (COPDs) were rated as somewhat more effective in their problem-solving skills
      than non-COPDs, undermining prevailing assumptions about offspring from alcoholic
      households. While this difference was not large and was qualified by other
      variables, subjects' own alcohol abuse did exert a detrimental effect on problem
      solving performance, regardless of parental history of problem drinking. However,
      a different pattern was evident for problem-solving self-appraisals. Alcohol
      abusing non-COPDs saw themselves as effective problem-solvers while alcohol
      abusing COPDs appraised themselves as poor problem-solvers. In addition, the self
      appraisals of alcohol-abusing COPDs were consistent with objective ratings of
      solution effectiveness (i.e., they were both negative) while alcohol-abusing non
      COPDs were overly positive in their appraisals, opposing the judgments of trained
      raters. This finding suggests that the relationship between personal alcohol
      abuse and self-appraised problem-solving abilities may differ as a function of
      parental history of problem drinking. Limitations on the generalizability of
      findings are addressed.

PMID- 1636467
TI  - Compliance to nicotine gum recommendations in a multicomponent group smoking
      cessation program: an exploratory study.
AB  - This is an exploratory study of compliance to nicotine chewing gum in a
      multicomponent group smoking cessation program where usage was optional. Two
      thirds (24 out of 36) of the participants across three group sessions complied
      with the recommendation to use nicotine chewing gum. All subjects received
      standard instructions. Demographic characteristics (age, sex, site of employment)
      and smoking variables (number of years smoked, pretreatment number of cigarettes
      smoked per day, and nicotine dependence) failed to predict compliance, but
      complaint participants reported significantly greater confidence at their ability
      to not smoke in various challenging situations as measured by the Smoking Self
      Efficacy Questionnaire. Those who did comply mostly failed to chew the gum in the
      way instructed. Reduced craving was cited as the most positive feature of gum
      use.

PMID- 1636468
TI  - Reactivity to alcohol-relevant beverage and imaginal cues in alcoholics.
AB  - This study was designed to explore three primary facets of reactivity to alcohol
      relevant stimuli among alcoholics: (a) comparison of exposure to an alcohol
      containing beverage vs. an appropriate, standardized control beverage; (b)
      efficacy of imaginally presented cues to elicit reactivity, alone and in
      combination with beverage cues; and (c) examination of the recovery process.
      Forty-eight male veterans attending an inpatient alcohol treatment program served
      as participants and were randomly assigned to one of four groups in a 2 (Alcohol
      vs. Lemonade Beverage) X 2 (High-Risk vs. Low-Risk Imagery) design. Heart rate
      reactivity to Beverage cues was consistent with previous research. An interaction
      of Beverage and Imagery manipulations during recovery revealed both experimental
      manipulations influenced heart rate, although the Alcohol/High-Risk Imagery
      exposure group did not demonstrate enhanced effects. Both manipulations also had
      an impact on ratings of desire to consume alcohol. These findings provide further
      support for the reliability of cue reactivity effects, and suggest the utility of
      imaginal exposure procedures as a component of a comprehensive cue reactivity
      assessment.

PMID- 1636469
TI  - Do weight concerns hinder smoking cessation efforts?
AB  - This study examined the hypothesis that weight concerns interfere with smoking
      cessation efforts. Four hundred fifty-nine women screened for participation in a
      smoking cessation treatment program completed Stunkard's Three Factor Eating
      Questionnaire (1981), measures of smoking-specific weight gain concern, and
      smoking history measures. Success in current cessation efforts was assessed 6
      months following treatment. The restraint subscale of the TFEQ was associated
      with lower baseline level of nicotine dependence, a history of smoking fewer
      cigarettes, and longer prior periods of successful smoking abstinence. Baseline
      level of nicotine dependence and treatment group were significant predictors of
      smoking cessation at 6 months posttreatment. Restraint score was marginally
      predictive of higher rates of abstinence from smoking at 6 months when baseline
      level of nicotine dependence and treatment group were controlled. These results
      do not support the hypothesis that weight concerns interfere with smoking
      cessation attempts.

PMID- 1636470
TI  - Incarcerated adolescents' attributions for drug and alcohol use.
AB  - Incarcerated adolescents' attributions for drug use were investigated. A new 50
      item questionnaire, the Inventory of Drug Taking Situations (IDTS), was used to
      assess reasons for use. The IDTS yields eight subscales corresponding to risky
      situations identified by Marlatt and others. On the IDTS, subjects indicate how
      frequently they used their drug of choice when confronted with each risky
      situation. The IDTS scales had good internal consistency and higher scores were
      significantly associated with self-reports of drug use frequency. Furthermore,
      IDTS scores were most valid for the type of drug the measure was filled out
      about. Adolescents reported that they tended to use more frequently in response
      to positive and/or interpersonal experiences, as opposed to negative and/or
      internal ones. Positive, negative, interpersonal, and internal reasons for use
      were all equally correlated with frequency of use. In the most heavily drug
      involved adolescents, however, negative reasons were more highly correlated with
      frequency of use than positive reasons. Treatment implications are discussed.

PMID- 1636471
TI  - Relationship between two ways of measuring alcohol dependence.
AB  - One of the main difficulties hampering research with the concept of the alcohol
      dependence syndrome is the lack of a set of agreed-upon operational definitions
      of each element composing the syndrome. To illustrate the possible impact of
      these different operationalizations of alcohol dependence on research results,
      this article shows the correlation between two different sets of items used to
      operationalize DSM-III-R alcohol dependence in a clinical sample. Results show
      that the correlations between the various sets of items are low. About 60% of the
      correlations are in between .21 and .40. These results suggest that different
      operationalizations of dependence may not be measuring the same phenomena, and
      should not be seen as interchangeable.

PMID- 1636472
TI  - Treatment response in obese binge eaters: preliminary results using a very low
      calorie diet (VLCD) and behavior therapy.
AB  - The present study compared the treatment response of male and female obese binge
      eaters and nonbinge eaters attending a university-based weight reduction program
      employing a very low calorie diet (VLCD) and concurrent behavior therapy. Twenty
      nine percent of female patients (n = 19) and 22% of male patients (n = 6) were
      characterized as binge eaters based on their scores on the Binge Eating Scale. No
      significant differences were found between binge and nonbinge groups on measures
      of weight loss, adherence to the diet, or drop-out rate, although a trend towards
      greater attrition in the binge group (32%) relative to the nonbinge group (17%)
      was noted. However, binge eaters had significantly higher pretreatment levels of
      trait anxiety, state anxiety, and depression as well as higher within treatment
      levels of anxiety and depression despite significant reductions in depression
      over the course of treatment. Further examination revealed a binge status X sex
      interaction effect on state anxiety. Binge-eating females had significantly
      higher anxiety levels pretreatment and throughout the 10 weeks of the study. No
      differences between binge and nonbinge males on levels of anxiety were found.
      These preliminary results tentatively suggest that a VLCD in conjunction with
      behavior therapy may be an effective method of weight loss for this segment of
      the obese population, but that elevated levels of anxiety persist in female
      patients. Future studies must address the long-term maintenance of weight loss in
      this population as well as other treatment strategies.

PMID- 1636473
TI  - Smoking as a weight-control strategy and its relationship to smoking status.
AB  - This investigation assessed the use of cigarettes for weight control and the
      relative impact of weight-control smoking and dietary restraint on current
      smoking status and future intent to quit smoking in 221 smokers and ex-smokers.
      We found that weight-control smokers were more likely to gain weight in previous
      quit attempts, had less formal education, scored higher on dietary restraint, and
      reported higher weight among biologic parents. Females who gained weight in
      previous cessation attempts were also more likely to be weight-control smokers.
      Current smoking was predicted by decreasing age, weight-control issues, lower
      dietary restraint, less education, more cigarettes smoked per day, less obesity
      in parents, and more cessation attempts. Females with higher relative weights
      were more likely to be smokers than males with less relative weight. The results
      indicated that the number of fewer prior quit attempts, higher levels of weight
      control smoking, and increasing age predicted plans not to quit smoking. These
      results have important implications for those subjects at risk for continued
      smoking.

PMID- 1636474
TI  - Restraint, food choice, and cognitions.
AB  - Restrained eaters were hypothesized to prefer high kilocalorie (KCAL) food when
      given a choice of both high and low KCAL foods after consuming a high KCAL
      preload. Study 1 found no differences between restrained and unrestrained eaters
      in food choice in either preload condition. Study 2 found that preloaded subjects
      preferred lower KCAL foods than subjects in the no preload condition. Both
      restrained and unrestrained eaters ate less food after consuming a high KCAL
      preload than after no preload. Preloaded restrained eaters expressed a greater
      number of control-related thoughts regarding food than any other group; however,
      these thoughts did not mediate disinhibited eating. Implications for restraint
      theory are discussed.

PMID- 1636475
TI  - Validity of the Mizes Anorectic Cognitions scale: a comparison between
      anorectics, bulimics, and psychiatric controls.
AB  - The Mizes Anorectic Cognition scale (MAC) was developed to assess cognitions
      relevant to anorexia and bulimia nervosa. It assesses three areas: rigid weight
      regulation, weight and approval, and excessive self-control as a component of
      self-esteem. Previous research has supported the validity and reliability of the
      scale. The purpose of the present study was to extend previous work to include
      anorectic patients, examine the specificity of the scale by making comparisons to
      a psychiatric (rather than normal) control group, and secondarily, to conduct a
      preliminary comparison of bulimics and anorectics. Results showed that for the
      total MAC score and the subscales, bulimics and anorectics scored higher than
      psychiatric controls, though they did not differ from each other.

PMID- 1636476
TI  - Stability of salivary cotinine sent through the U.S. mail for verification of
      smoking status.
AB  - Until now mass media smoking cessation studies have relied almost exclusively on
      self-reports of smoking cessation because biochemical confirmation has not seemed
      practical. This study investigated the reliability of mailed salivary cotinine
      specimens for the determination of smoking status. Two simultaneous saliva
      specimens were obtained from 10 smokers and 10 nonsmokers. One of each pair was
      frozen immediately. The other was sent through the local U.S. mail and then
      subjected to additional physical agitation and heat before being frozen. All
      specimens were subsequently analyzed for cotinine. No cotinine was detectable in
      any of the nonsmokers' specimens. There was excellent correlation between the
      paired smokers' specimens. These results show that the mailing of saliva
      specimens for cotinine analysis is practical and provides accurate data on
      smoking status. It is an approach which could easily be used in mass media
      smoking cessation studies to biochemically confirm smoking behavior.

PMID- 1636477
TI  - Artificial neural networks in bioprocess state estimation.
AB  - The application of artificial neural networks to the estimation and prediction of
      bioprocess variables is presented in this paper. A neural network methodology is
      discussed, which uses environmental and physiological information available from
      on-line sensors, to estimate concentration of species in the bioreactor. Two case
      studies are presented, both based on the ethanol production by Zymomonas mobilis.
      An efficient optimization algorithm which reduces the number of iterations
      required for convergence is proposed. Results are presented for different
      training sets and different training methodologies. It is shown that the neural
      network estimator provides good on-line bioprocess state estimations.

PMID- 1636478
TI  - A human genome analysis system (HUGA-I) developed in Japan.
AB  - A part of the Japanese human genome project has resulted in the development of a
      world original human genome analysis system. Circumstances of the project,
      objective, design concept, and constitution of the system are described in the
      paper.

PMID- 1636479
TI  - Use and engineering aspects of immobilized cells in biotechnology.
AB  - A short review of the research in the past two years (1990-1991) on immobilized
      whole cells, such as microbial, plant, and animal cells, is presented including a
      discussion from an engineering point of view. Recent works concerning the
      intraparticle mass transfer effect on immobilized microbial cells by the authors
      and their co-workers are also introduced. Finally, future prospects of the
      immobilized cell system will be discussed.

PMID- 1636480
TI  - Modelling the growth of filamentous fungi.
AB  - Despite the considerable industrial importance of filamentous fungi there have
      been very few attempts to model the complex growth process of these
      microorganisms. With a new generation of high performance, computerized
      bioreactors and new analytical techniques it is possible to obtain the necessary
      experimental data for setting up reliable structured models describing the growth
      process of filamentous fungi. It is therefore interesting to review the
      mathematical models described previously in the literature and the experimental
      data on which these models are built. Only structured models are considered due
      to the complex metabolism of filamentous fungi and to the natural cellular
      structuring of the biomass, i.e. the biomass can be divided into different cell
      types. In order to set up good structured models it is strictly necessary to have
      a detailed knowledge of the mechanisms underlying the growth process. This
      involves both biochemical insight and understanding of the interactions between
      different macromolecules and cytological organelles.

PMID- 1636481
TI  - An overview of the biotechnology research activities in the European Community.
AB  - The research in Biotechnology is an important element for the competitive
      environment of European bioindustrial activities. In this article the evolution
      of the Biotechnology programmes in the European Community is presented.

PMID- 1636483
TI  - Immunochemically based assays for process control.
AB  - Immunoanalysis for process control is reviewed. The development of non
      equilibrium immunoassays from a manually operated flow injection system to a
      completely computerized system for sample analysis as well as calibration and
      data evaluation is discussed. Several other approaches in using immunochemistry
      in biosensors for process control are discussed. The fact that reuse of
      antibodies raises specific demands on their properties is discussed. Even if the
      area is young, much progress has been achieved and one can foresee an interesting
      future development of the area.

PMID- 1636482
TI  - Use of regulated secretion in protein production from animal cells: an overview.
AB  - Traditional industrial cell culture processes require extensive downstream
      product refining due to low product titer and purity in the spent growth medium.
      A controlled secretion process incorporating cells derived from endocrine or
      exocrine organs could potentially alleviate this processing burden by dynamically
      decoupling product recovery from cell growth and product biosynthesis. In
      addition, such specialized secretory cells may be uniquely capable of performing
      desirable post-translational processing of the secretory product. We briefly
      review the biology of regulated protein secretion as well as the biology and
      biochemistry of the signal transduction mechanisms by which regulated systems
      respond to environmental stimuli. Drawing on these and other basic principles
      from cell biology and bioengineering, we describe the important features of a
      controlled secretion process. Among other issues we discuss the choice of cell
      lines, expression systems, cell culture methods, and bioreactor configurations.
      We extensively analyze the kinetics of regulated secretion in the context of a
      controlled secretion process. This discussion is illustrated with experimental
      results from two model cell lines, recombinant AtT-20 and beta TC3, expressing
      recombinant human endocrine hormones or native murine insulin respectively.

PMID- 1636484
TI  - The induction of cellular group II phospholipase A2 by cytokines and its
      prevention by dexamethasone.
AB  - Treatment of rat glomerular mesangial cells with interleukin-1 beta, tumor
      necrosis factor or forskolin resulted in the secretion of phospholipase A2
      activity into the culture medium. Essentially all of this secreted phospholipase
      A2 activity was recognized by monoclonal antibodies elicited against rat liver
      mitochondrial 14 kDa group II phospholipase A2. Immunoblot analysis and gel
      filtration confirmed the presence of only 14 kDa phospholipase A2 in the culture
      supernatant. This enzyme could hardly be detected in unstimulated mesangial cells
      and after a lag period of 6 to 8 hours becomes detectable in both cells and
      culture medium. The results indicate that the increased phospholipase A2 activity
      upon treatment of the cells with cytokines is not due to activation of an
      existing cellular pool of enzyme but is caused by induced synthesis of group II
      phospholipase A2. Pretreatment of the cells with dexamethasone, a known inhibitor
      of prostaglandin synthesis, dose-dependently inhibits cytokine-induced
      phospholipase A2 activity. Western immunoblot analysis of cells and culture
      medium demonstrates that this is not due to inhibition of existing phospholipase
      A2 but because dexamethasone prevents the cytokine-induced synthesis of
      phospholipase A2 protein.

PMID- 1636485
TI  - Brain phospholipases and their role in signal transduction.

PMID- 1636486
TI  - Modulation of arachidonic acid metabolism in cultured rat astroglial cells by
      long-chain N-3 fatty acids.

PMID- 1636487
TI  - Aplysia californica contains a novel 12-lipoxygenase which generates biologically
      active products from arachidonic acid.
AB  - Physiologic stimulation of identified neurons in ganglia of the marine mollusk,
      Aplysia californica, leads to the generation of arachidonic acid metabolites.
      Using various preparations of Aplysia nervous tissue, we have identified 12
      lipoxygenase products including the inactive 12-hydroxyeicosatetraenoic acid (12
      HETE) and the biologically active 12-ketoeicosatetraenoic acid (12-KETE) and 8
      hydroxy-11(12)-epoxyeicosatrienoic acid (8-HEpETE). Each of these metabolites can
      be derived from the intermediate 12-hydroperoxyeicosatetraenoic acid (12-HPETE),
      which can itself activate several identified neurons in Aplysia. In spite of
      conflicting results in studies of mammalian brain 12-lipoxygenase, Aplysia
      nervous tissue clearly contains an enzymatic activity which generates
      stereochemically pure 12(S)-HETE. This activity is destroyed by boiling and is
      sensitive to nonspecific lipoxygenase inhibitors but not to agents specific for
      other lipoxygenases or the cyclooxygenase enzyme. The Aplysia 12-lipoxygenase is
      highly enriched in neural tissue and is almost completely absent in the neural
      sheath, which is composed primarily of connective tissue and muscle. Preliminary
      purification has shown that, in contrast to the previously characterized 12
      lipoxygenases, the Aplysia enzyme is associated with membrane fractions and is
      not found in the cytosol. Further studies are in progress to determine the
      kinetic properties and to define the cellular and subcellular distribution of
      this novel lipoxygenase.

PMID- 1636489
TI  - Phospholipid metabolism and second messenger system after brain ischemia.
AB  - To evaluate possible involvement of phospholipid metabolism and related second
      messenger systems in the selective neuronal damage after ischemia, we measured
      changes of polyphosphoinositides (PPIs) and free fatty acids (FFAs) in a model of
      5-min or 10-min ischemia and reperfusion in gerbils. The binding activity of 3H
      phorbol 12,13-dibutyrate (PDBu) for protein kinase C (PKC) and 3H-inositol 1,4,5
      triphosphate (IP3) for IP3 receptors was demonstrated autoradiographically.
      Induction of 70 KDa heat shock protein (HSP70) mRNA and amyloid precursor protein
      (APP) mRNA was also examined using Northern blot analysis. In the parietal cortex
      (an area resistant to transient ischemia), PPIs decreased during ischemia and
      recovered rapidly after reperfusion. However, recovery did not occur in the
      hippocampal CA1 area (an area more vulnerable to transient ischemia). In the
      cortex, arachidonic acid (AA) increased during ischemia and returned to baseline
      by 7 days after reperfusion; in the CA1 area, the AA level remained elevated even
      after 7 days of reperfusion. PDBu binding decreased in CA1 cells after 2 days of
      reperfusion. IP3 binding began to decrease at 5 hr of reperfusion, which is far
      earlier than either the onset of decreased PDBu binding or the observation of
      neuronal damage by light microscopy. The induction of HSP70 mRNA occurred, but
      the induction of APP mRNA did not. Regional differences in the induction of HSP70
      mRNA were found; CA1 cells produced less HSP70 mRNA than cortical cells 8 hr
      after transient ischemia. These results suggest that CA1 cell membranes may not
      recover after transient ischemic attack, and that the membranes of the
      endoplasmic reticulum, which have IP3 receptors, may undergo alterations earlier
      than cytoplasmic membranes. The variable induction of HSP70 mRNA may be related
      to regional differences in vulnerability in cortical and hippocampal CA1 cells
      after transient ischemia. Involvement of excitatory neurotransmission in the
      induction of HSP70 has been suggested. The combined data may support a role for
      inositol phospholipid metabolism, changes in related second messenger systems,
      and induction of HSP70 in the excitotoxic mechanism of hippocampal CA1 neuronal
      damage, death, and repair.

PMID- 1636488
TI  - Essential fatty acid deficiency in cultured SK-N-SH human neuroblastoma cells.
AB  - SK-N-SH neuroblastoma cells grown under standard culture conditions contain
      significant amounts of Mead acid (20:3 omega 9) in phospholipids, indicating
      essential fatty acid (EFA) deficiency. The amount of esterified 20:3 omega 9 was
      augmented by growth in a chemically defined EFA-free medium, whereas its presence
      could be virtually eliminated by supplementation of the culture medium with
      either arachidonic (20:4 omega 6; AA), eicosapentaenoic (20:5 omega 3; EPA), or
      linolenic (18:3 omega 3) acids. Substitution of Mead acid for omega 6 fatty
      acids, particularly evident in phosphatidylinositol (PI), indicates a
      compensatory replacement of omega 9 for omega 6 fatty acids during EFA
      deficiency. Studies evaluating [3H]scopolamine binding to the M3 muscarinic
      acetylcholine receptors (mAChRs) present in these neurotumor cells as well as
      effects of carbachol on phosphoinositide turnover and intracellular Ca2+
      mobilization, indicate that the biosubstitution of 20:4 omega 6 with 20:3 omega 9
      does not detectably impair these measures of signal transduction. Stimulation of
      mAChRs with carbachol increased the cellular mass of diacylglycerol (DAG)
      approximately 60%. On the basis of distinctive fatty acid "signatures" of each of
      the phospholipid classes, it is concluded that the DAG initially released
      following muscarinic stimulation is derived from phosphoinositide breakdown.
      After several minutes, however, a significant amount of DAG comes from
      phosphatidylcholine (PC) as well. In contrast to DAG, the composition of
      phosphatidate (PA) following receptor stimulation closely resembles that of the
      phosphoinositides, even at the later time points examined. These results support
      a selective phosphorylation of DAG arising from the stimulated breakdown of
      phosphoinositides, favoring the conservation of the 1-stearoyl, 2-arachidonoyl
      (or 20:3 omega 9) moiety.

PMID- 1636490
TI  - Impact of dietary fatty acid balance on membrane structure and function of
      neuronal tissues.
AB  - Neural tissue has generally been viewed as resistant to structural changes
      induced by exogenous factors. Research has shown that the brain responds to
      changes in diet by altering neurotransmitter synthesis, and by shifting
      neuroendocrine controls over a variety of physiological events. Animal model
      research also indicates that fatty acid constituents and synthesis of brain
      structural lipid in membranes undergoing turnover can be altered by changing the
      composition of dietary fat. In growing animals, the balance between dietary omega
      6 and omega 3 fatty acids influences brain phospholipid fatty acid composition,
      phosphatidylethanolamine methyltransferase activity, and rate of
      phosphatidylcholine biosynthesis via the CDP-choline pathway. It is concluded
      that biosynthetic control mechanisms regulating synthesis of brain structural
      lipid, in particular phosphatidylcholine, respond to exogenous factors and
      represent a normal physiological response by the brain. This response may provide
      a mechanism for therapeutic treatment of disorders involving degeneration of
      brain structural lipid.

PMID- 1636491
TI  - Structural and functional importance of dietary polyunsaturated fatty acids in
      the nervous system.
AB  - The nervous system is the organ with the second greatest concentration of lipids.
      These lipids participate directly in membrane functioning. Brain development is
      genetically programmed. It is therefore necessary to ensure that nerve cells
      receive an adequate supply of nutrients, especially of lipids, during their
      differentiation and multiplication, and throughout their lives. The effects of
      polyunsaturated fatty acid deficiency have been extensively studied; prolonged
      deficiency leads to death in animals. Linoleic acid is now universally recognized
      to be an essential nutrient. Until recently, however, alpha-linolenic acid was
      considered non-essential. Feeding animals with oils that have a low alpha
      linolenic content results in all brain cells and organelles and various organs
      having reduced amounts of 22:6n-3, which is compensated for by an increase in
      22:5n-6. The speed of recuperation from these anomalies is extremely slow for
      brain cells, organelles, and microvessels, in contrast to other organs. A
      decrease in alpha-linolenic series acids in the membranes results in a 40%
      reduction in the Na(+)-K(+)-ATPase of nerve terminals and a 20% reduction in 5'
      nucleotidase. Some other enzymatic activities are not affected, although membrane
      fluidity is altered. A diet low in alpha-linolenic acid induces alterations in
      the electroretinogram which disappear with age; motor function and activity are
      little affected, but learning behavior is markedly altered. The presence of alpha
      linolenic acid in the diet confers a greater resistance to certain neurotoxic
      agents (triethyl-lead). During the period of cerebral development, there is a
      linear relationship between brain content of n-3 acids and the n-3 content of the
      diet up to the point where alpha-linolenic levels reach 200 mg for 100 g of food
      intake. Beyond that level there is a plateau. For other organs, such as the
      liver, the relationship is also linear up to 200 mg/100 g, but then there is
      merely an abrupt change in slope and not a plateau. When dietary 18:2n-6 content
      was varied, it was noted that 20:4n-6 optimum values were obtained at 150 mg/100
      g for all nerve structures, 300 mg for testicle and muscle, 800 mg for kidney,
      and 1200 mg for liver, lung and heart. A deficiency in alpha-linolenic acid and
      an excess of linoleic acid have the same main effect: an increase in 22:5n-6
      levels.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1636492
TI  - Long and very long polyunsaturated fatty acids of retina and spermatozoa: the
      whole complement of polyenoic fatty acid series.

PMID- 1636493
TI  - Phospholipid metabolism in rat intestinal mucosa after oral administration of
      lysophospholipids.
AB  - The present results indicate that PS, a phospholipid contained in small amounts
      in the human diet and not included in plasma lipoproteins, may be used to
      influence phospholipid metabolism in intestinal mucosal cells. Since PS influx
      into absorptive cells occurs after its hydrolysis to lysoPS, this metabolite may
      be used to increase the absorption of this phospholipid. These data show that
      lysoPS, after diffusion into intestinal cells, is sequentially converted into PS
      and PE (which make up a minor fraction of the lipids present in lipoproteins). As
      expected, lysoPS given together with radiolabeled unsaturated fatty acids was
      unable to promote their transfer into plasma lipoproteins. In this respect lysoPS
      differed from lysoPC, the latter increasing the appearance of dietary fatty acids
      in plasma. When given together, lysoPS decreased the lysoPC-induced transfer of
      unsaturated fatty acids into plasma. This effect required addition of
      triglycerides to the lipid mixture. In attempting to explain this triacylglycerol
      dependent inhibition by lysoPS, we found that this phospholipid increased the
      incorporation of glycerol into mucosal cell PC. In contrast, lysoPC was
      inhibitory. Furthermore, in the presence of labeled inositol, lysoPC (but not
      lysoPS) promoted the appearance of labeled phosphatidylinositol. The data thus
      suggest that the two lysophospholipids differ in promoting the two main pathways
      of PC synthesis in the intestinal cells. While lysoPC favors PC synthesis by
      reacylation, lysoPS enhances the CDP-choline pathway of PC synthesis.

PMID- 1636494
TI  - Carbachol-stimulated release of arachidonic acid and eicosanoids from brain
      cortex synaptoneurosome lipids of adult and aged rats.
AB  - Synaptoneurosomes from the brain cortex of adult rats (4 months old) and aged
      rats (27 months old), prelabeled with [14C]arachidonic acid (AA), were used as
      the source of enzyme(s) and substrates to study the effect of a cholinergic
      agonist on the release of AA and eicosanoids. In synaptoneurosomes from adult
      brains, carbachol, the nonhydrolyzable analog of acetylcholine, increased AA
      release by 16% in the presence of 2 mM calcium. This agonist-mediated AA release
      occurred specifically from phosphatidylinositol (PI). Concomitantly, carbachol in
      the presence of 2 mM Ca2+ significantly activated the formation of 15-HETE and
      PGF2 alpha. This effect of carbachol on the level of eicosanoids was also
      observed in the presence of endogenous calcium. In synaptoneurosomes from aged
      brains, carbachol had no effect on the release of AA and eicosanoids. The results
      of studies involving inhibitors of phospholipase A2 (PLA2) and phospholipase C
      (PLC) suggested that PLA2 is almost completely responsible for the Ca(2+)
      dependent, carbachol-mediated AA liberation. The distribution of labeled AA in
      the lipids after incubation of synaptoneurosomes in the presence of 2 Mm Ca2+ and
      carbachol indicated that in aged synaptoneurosomes, the muscarinic receptor
      mediated degradation of phosphoinositides through phospholipase C is preserved,
      but the turnover of the phosphoinositide cycle is probably suppressed. These
      results indicate that aging significantly affects the population of cholinergic
      muscarinic receptors coupled to PLA2.

PMID- 1636495
TI  - Carbachol-induced stimulation of inositol phosphates, arachidonic acid and
      prostaglandin F2 alpha in rabbit retina.

PMID- 1636496
TI  - Induced and spontaneous seizures in man produce increases in regional brain lipid
      detected by in vivo proton magnetic resonance spectroscopy.
AB  - Elevations of brain concentrations of arachidonic acid and other free fatty acids
      (FFAs) by seizures induced in animals were demonstrated some years ago.
      Similarly, large shifts of potassium (K+) from intra- to extracellular space
      during seizure activity have been documented in numerous studies. More recent
      studies of cell membrane function demonstrated a direct effect of FFAs on
      membrane K+ conductance, suggesting that FFAs may play a primary role in seizure
      evolution in brain tissue. Using electroconvulsive therapy (ECT), in which
      generalized seizures are induced in patients by passage of electrical current, as
      a controlled human model of seizures, we studied the in vivo biochemical effects
      of single generalized seizures with localized proton magnetic resonance
      spectroscopy (1H MRS). We found that ECT reliably induces an elevation in the
      lipid signal that resonates at approximately 1.2 ppm. We observed a similar
      increase in brain lipids in a patient with temporal lobe epilepsy temporarily off
      medication; the signal disappeared after re-medication. Similar observations were
      noted for a subject with focal gliosis bordering a resected brain tumor. Finally,
      acute alcohol effects seem also to induce observable lipid changes. The 1H MRS
      technique does not yet permit direct identification of the specific lipids
      involved but analysis of cerebrospinal fluid obtained by lumbar puncture before
      and immediately after ECT may permit more precise characterization of the
      observed lipid increases. Theoretical and clinical implications of these results
      for the study of brain FFAs and epilepsy will be discussed.

PMID- 1636497
TI  - Characteristics and possible functions of mast cell phospholipases A2.
AB  - Phospholipase A2 activity in lysates of mast cells and their related cells [mouse
      bone marrow-derived IL-3 dependent mast cells (BMMC), rat connective tissue mast
      cells (CTMC), and rat mastocytoma RBL-2H3 cells] was measured using
      phosphatidylethanolamine (PE), phosphatidylserine (PS), and phosphatidylcholine
      (PC) as exogenous substrates. Both BMMC and RBL cells showed rather high
      phospholipase A2 activity, whereas CTMC showed only weak activity. These cells
      contained at least three types of phospholipase A2. Type 1 enzyme showed no
      appreciable affinity to heparin, and preferentially hydrolyzed either PC or PE,
      both of which have an arachidonic acid at the sn-2 position. The activity was
      absorbed by monoclonal antibody against rabbit platelet cytosolic 85-kDa
      phospholipase A2. Type 2 enzyme had an affinity to heparin, and was completely
      inhibited by anti-rat platelet 14-kDa secretory phospholipase A2. This enzyme
      could be expressed as an "ecto-type" enzyme on the cell surface and might be
      secreted from cells when mast cells are activated. Type 3 enzyme also had an
      affinity to heparin, but was separated from type 2 enzyme on reverse-phase HPLC.
      This enzyme did not interact with anti-14-kDa secretory enzyme antibody. Purified
      type 3 enzyme (30-kDa) specifically hydrolyzed PS. p-Bromophenacylbromide
      inhibited all types of phospholipase A2, whereas mepacrine inhibited type 2 and
      type 3 enzymes, but not type 1 enzyme. Type 2 enzyme was also inhibited by the
      specific antibody, complement degradation product, and a small-molecular-weight
      inhibitor. Histamine release was inhibited by all these inhibitors, whereas PGD2
      production was inhibited only by p-bromophenacylbromide. Possible roles for these
      phospholipases A2 in mast cell function are proposed.

PMID- 1636498
TI  - Network of signal transduction pathways involving lipids: protein kinase C
      dependent and -independent pathways.

PMID- 1636499
TI  - Essential fatty acids and neurodevelopmental disorder.

PMID- 1636500
TI  - Regulation of arachidonic acid metabolism in the perinatal brain during
      development and under ischemic stress.
AB  - Oxygen deprivation following cessation of blood flow to vital organs such as
      brain, heart, and kidney is a ubiquitous human disease, invariably leading to
      devastating consequences. Studies in experimental models support the contention
      that membrane permeability is altered, ion fluxes impaired, and energy stores
      depleted under these circumstances. Certain lipids such as diglycerides (DG) and
      arachidonic acid (AA), both of which are important cellular second messengers,
      appear to increase during ischemia. At this point, the contribution of these and
      other lipids to cell deregulation, loss of function, and ultimate death has not
      been clarified because no precise link between lipid alterations as detected in
      ischemia and subsequent cellular processes has been made. In this report we
      examine the origin of lipid-derived second messengers in fetal rat brain
      prelabeled with [3H]AA and study the fate of various lipids upon obstruction of
      the fetal-maternal circulation. The data support the possibility of a
      phospholipase A2-mediated deacylation of poly-phosphoinositides (poly-PI) to form
      free AA and a phospholipase C-mediated hydrolysis of PC to form DG during
      ischemia.

PMID- 1636501
TI  - Interactions of phospholipids and free fatty acids with antidepressant
      recognition binding sites in rat brain.
AB  - The lipid microenvironment of cell membranes has been shown to regulate both
      neurotransmitter and hormone receptors. Preincubation of cortical synaptosomal
      membranes of rat brain with phospholipase A2 (PLA2) increases the number of
      [3H]imipramine ([3H]IMI) high affinity binding sites without altering Kd (Bmax
      control: 2.53 +/- 0.28 pmol/mg protein vs Bmax PLA2: 3.66 +/- 0.26 pmol/mg
      protein). The displacement curves of [3H]IMI binding in synaptosomal membranes
      with other tricyclic antidepressants are not affected by the presence of PLA2.
      The effect of PLA2 was prevented by incubation with EGTA (2 x 10(-3)) or bovine
      serum albumin (BSA; 1:1). In addition, end products of catalytic activity of PLA2
      such as unsaturated fatty acids (arachidonic or oleic acids) mimicked the effect
      of PLA2. These effects were entirely prevented by preincubation with BSA. The in
      vitro addition of the acidic phospholipid phosphatidylserine isolated from bovine
      brain (BC-PS) produced a similar increase in Bmax. This action was also blocked
      by addition of BSA. On the other hand, palmitic acid, a saturated fatty acid, and
      lysophosphatidylserine (lysoPS) or lysophosphatidylethanolamine (lysoPE) failed
      to modify [3H]IMI binding sites. The chronic administration of tricyclic
      antidepressant (AD) resulted in a 25% decrease in [3H]IMI binding sites in
      synaptosomal membranes. Preincubation of these AD-treated membranes with PLA2 did
      not alter [3H]IMI binding, whereas the addition of unsaturated free fatty acids
      (FFA) produced a greater increase in the density of [3H]IMI binding sites in
      comparison with control membranes. Taken together, these findings suggest that
      unsaturated free fatty acids could play an important role in the regulation of
      the number of [3H]IMI high affinity binding sites in the mammalian brain.

PMID- 1636502
TI  - Severe changes in polyunsaturated fatty acids in the brain, liver, kidney, and
      retina in patients with peroxisomal disorders.

PMID- 1636503
TI  - Extracellular phospholipase A2.

PMID- 1636504
TI  - Degradation of phospholipids and protein kinase C activation for the control of
      neuronal functions.

PMID- 1636505
TI  - Disposition kinetics of phospholipid liposomes.
AB  - This article reviews the disposition of intravenously injected phospholipid
      liposomes and discusses the problems related to its kinetic modeling. The
      processes responsible for the plasma clearance of liposomes are examined in
      detail and it is shown that mechanisms other than reversible distribution to the
      extravascular space are, as a rule, responsible for the biphasic plasma clearance
      patterns that are typically observed following bolus intravenous injection of
      liposomes. Accordingly, a one-compartment open model is generally sufficient to
      describe the disposition kinetics of phospholipid vesicles. Two factors may be
      responsible for the observation of a biphasic decline of plasma liposome
      concentration. The first factor is the presence of different liposomal species
      with different kinetic behaviors. Kinetically distinct vesicles are present in
      preparations of liposomes that are heterogeneous in size, since the larger
      vesicles are cleared at a faster rate than the smaller ones. Different liposomal
      species may also originate in the plasma as a result of: i) fusion between
      phospholipid vesicles with generation of larger liposomal structures; and ii)
      interaction with high-density lipoproteins (HDL) with consequent production of
      either liposomes that have acquired apoproteins or lipoprotein particles enriched
      in phospholipids. Both these species are cleared by specific mechanisms at rates
      different from that of the original vesicle. The second factor is a time
      dependent decrease in clearance due to progressive saturation of the retention
      capacity of the cells that take up liposomes. A convex concentration-time decay
      curve has also been reported. This decay pattern is consistent with a
      concentration (dose)-dependent elimination. As this observation relates to only
      one type of liposome (small unilamellar vesicles composed of sphingomyelin and
      cholesterol), its relevance to the disposition of liposomes of different size and
      composition remains to be established.

PMID- 1636506
TI  - Ischemic brain damage: focus on lipids and lipid mediators.
AB  - The last two decades of research have produced detailed information not only on
      how ischemia causes degradation of phospholipids and accumulation of potentially
      cytotoxic breakdown products of such lipids, but also on reactions elicited by
      the subsequent conversion of these products into a series of lipids, mediating an
      array of cellular and intercellular reactions. It now seems clear that PAF, as
      well as several of the cyclooxygenase and lipoxygenase products of arachidonic
      acid, can induce changes, particularly in the microvasculature, which jeopardize
      cell survival in reperfused tissue. It is equally clear that, at least following
      long periods of ischemia, free radicals generated in reactions that are
      interacting with those producing eicosanoids and PAF play a similar role. A
      somewhat more speculative mechanism links sustained activation and membrane
      translocation of PKC to delayed neuronal death following transient ischemia. All
      of these interactions underscore the importance of lipolytic events for cell
      damage in ischemia and other conditions with a compromised cellular energy
      metabolism.

PMID- 1636507
TI  - Diacylglycerol composition and metabolism in peripheral nerve.
AB  - The content and molecular species composition of 1,2-diacylglycerol (DAG) in rat
      sciatic nerve was determined and compared with the molecular species profiles for
      glycerophospholipid classes in order to gain information concerning the metabolic
      pathways of DAG formation. The level of DAG in freshly dissected epineurium-free
      nerve (44 +/- 2 pmol/mg wet weight) was 10-40% of that in other tissues and
      cultured cells. The predominant DAG molecular species were 18:0/20:4 (30%) and
      16:0/18:1 (17%). In comparison with phospholipid molecular species patterns, DAG
      was characterized by a substantial but lower proportion of the 18:0/20:4 species
      than was found in phosphoinositides, and a significant fraction of saturated
      species such as those found in phosphatidylcholine. In nerve from diabetic rats,
      both the content and arachidonoyl-containing molecular species of DAG were
      reduced. These species were also decreased in individual glycerophospholipids,
      except for phosphatidylinositol. The distribution of molecular species in
      phosphatidic acid (PA) did not resemble that of any other phospholipid. A large
      rise in DAG content occurred when nerve was incubated in vitro. Molecular species
      analysis indicated that phosphoinositides were the main source, especially during
      the initial period. This process was virtually abolished in a Ca(2+)-free medium
      and probably reflects a response to tissue injury. Evidence was obtained for the
      isomerization of DAG to 1,3-diacylglycerol during incubation. PA content and
      molecular species composition of incubated nerve did not change. However,
      inclusion of propranolol, a PA phosphatase inhibitor, caused a 40% accumulation
      of PA within 10 min, suggesting that formation of this phospholipid is
      continuous. These findings support the conclusion that DAG is principally derived
      from phosphoinositides by phospholipase C hydrolysis, but a minor fraction could
      be derived from phosphatidylcholine either by the action of phospholipase C or
      via phospholipase D and PA phosphatase. The metabolic origins of PA appear to be
      diverse.

PMID- 1636508
TI  - Physiology of osmotolerance in fungi.

PMID- 1636509
TI  - Yeast flocculation: a new perspective.

PMID- 1636510
TI  - Crystalline bacterial cell-surface layers.

PMID- 1636511
TI  - Bacterial motility and chemotaxis.

PMID- 1636512
TI  - Secretory pathway function in Saccharomyces cerevisiae.
AB  - A genetic analysis of secretory pathway function in yeast was initiated some 12
      years ago in the laboratory of Randy Schekman. These mutants held great promise
      in terms of providing an experimental system with which molecular participants of
      secretory pathway function could be investigated. This early promise has not
      failed. For the last five years, analysis of yeast secretory pathway function has
      been at the cutting edge of our understanding of the mechanisms by which proteins
      travel between intracellular compartments. In some cases, Sacch. cerevisiae has
      provided a valuable in vivo corroboration of the concepts derived from
      biochemical studies of mammalian intercompartmental protein transport in vitro.
      In other cases, studies conducted in the yeast system have defined previously
      unanticipated involvements for known catalytic activities in the secretory
      process. It is clear that yeast will continue to play a major role in setting the
      pace of research directed towards a detailed molecular understanding of protein
      secretion. Since it is now apparent that the basic strategies that underlie
      secretory pathway function have been conserved among eukaryotes, further
      exploitation of the powerful and complementary yeast and mammalian experimental
      systems guarantees that the next decade will see even greater progress towards
      our understanding of protein secretion in eukaryotic cells than did the first.

PMID- 1636513
TI  - MR imaging in radiation myelopathy.
AB  - PURPOSE: Using MR imaging, we assessed the signal, size, and enhancing
      characteristics of the cervical cord in patients in whom radiation myelopathy
      developed after radiotherapy for nasopharyngeal carcinoma. PATIENTS AND METHODS:
      Ten patients, 3 men and 7 women, aged from 32 to 77 years, were included. MR
      imaging was performed 1 to 53 months after clinical manifestations of myelopathy.
      RESULTS: Two cases showed atrophy of the cervical cord without abnormal signal
      intensity; in the others, a long segment of the cervical cord demonstrated low
      signal intensity on T1-weighted images and high signal intensity on T2- or T2*
      weighted images. Some of these cases also showed swelling of the cord. Focal
      enhancement at C1-C2 area after intravenous administration of Gd-DTPA was seen in
      four cases. CONCLUSIONS: There is a correlation between the time of MR imaging
      after onset of symptoms and MR findings. When MR scans were obtained more than 3
      years after onset of symptoms, atrophy of the cervical cord was noted without
      abnormal signal intensity. When MR was performed less than 8 months after onset
      of symptoms, a long segment of the cervical cord demonstrated abnormal signal
      intensity with or without associated swelling of the cord and focal enhancement.

PMID- 1636514
TI  - Ossification of the posterior longitudinal ligament: MR evaluation.
AB  - PURPOSE: To investigate the MR appearance of ossification of the posterior
      longitudinal ligament (OPLL) of the cervical spine. MATERIALS AND METHODS: A
      retrospective review of MR images and conventional tomograms in 147 patients.
      RESULTS: In the sagittal plane, proton-density images identified the ossified
      lesions more clearly than did T1- and T2-weighted images. All axial sequences
      identified the lesions much frequently. T1-weighted images often showed areas of
      increased intensity within the lesions of the continuous and mixed type,
      especially within the thick lesions. Fat images by Dixon technique demonstrated
      same areas of increased intensity, which strongly suggested fatty marrow
      formation. On conventional tomograms, configurations of radiolucent areas within
      the lesions corresponded to areas of increased intensity on T1-weighted images.
      CONCLUSION: Proton-density sagittal and axial images are important in
      establishing the diagnosis of OPLL. The areas of increased intensity on T1
      weighted images and radiolucent areas suggest marrow formation.

PMID- 1636515
TI  - Spinal MR findings in neurofibromatosis types 1 and 2.
AB  - PURPOSE: To evaluate the frequency and nature of spinal pathology, the frequency
      of clinically silent lesions, and the potential benefit of screening spinal MR in
      neurofibromatosis patients. PATIENTS AND METHODS: 28 neurofibromatosis type-1 (NF
      1) patients and nine neurofibromatosis type-2 (NF-2) patients were studied with
      postcontrast spinal MR imaging. RESULTS: NF-1: One patient had a biopsy-proven
      low-grade glioma; five patients, intradural, extramedullary masses (N = 23); one
      patient, extradural masses (N = 2) (neurofibromas); 16 patients had bony
      abnormalities; and three patients thecal sac abnormalities. NF-2: Five patients
      demonstrated intramedullary masses (five/eight ependymomas); nine patients,
      intradural, extramedullary masses (meningiomas, schwannomas); and four patients,
      bony abnormalities. Eight/10 NF-1 and four/nine NF-2 patients had asymptomatic
      masses. CONCLUSION: Intradural disease is common, often asymptomatic, and often
      presents at a young age in NF-1 and NF-2 patients. Because of the propensity to
      develop significant asymptomatic as well as symptomatic intradural disease,
      screening of the entire spine with MR is recommended in both NF-1 and NF-2
      patients.

PMID- 1636516
TI  - Radiologic screening in the neurocutaneous syndromes: strategies and
      controversies.

PMID- 1636517
TI  - Meningocele manque: radiologic findings with clinical correlation.
AB  - PURPOSE: To determine whether meningocele manque can be detected by neuroimaging
      techniques in dysraphic patients. METHODS: We reviewed the records and imaging
      studies of 16 patients with surgically proved meningocele manque seen at our
      institution between 1989 and 1990. Both CT and MR imaging techniques were used.
      CT of the spine was performed immediately following contrast myelography.
      RESULTS: Nine of 16 patients (CT, four; and MR, five) showed evidence of
      meningocele manque which corresponded to intraoperative findings. Fourteen of 16
      patients were found to have diastematomyelia, eight with medium septum and six
      without a septum. Associated findings included syrinx (six), lipoma (five),
      dermoid cyst (one), and neuroenteric cyst (one). After completing this review, we
      were able to prospectively diagnose dorsal bands in two new patients; these bands
      were confirmed at surgery. CONCLUSION: Dorsal bands can be detected in dysraphic
      patients with CT or MR using operative findings as a road map.

PMID- 1636518
TI  - Aneurysm hemodynamics: an experimental study.
AB  - PURPOSE: To study the flow of blood in aneurysms. METHODS: A canine model was
      used to study the hemodynamics of lateral, bifurcation, and terminal aneurysms
      with angiography and color Doppler techniques. FINDINGS: Flow within experimental
      aneurysms, although not laminar, is seldom if ever turbulent, but rather is
      highly predictable, varying primarily according to the relationship of the
      aneurysm to its parent artery. CONCLUSIONS: These studies support earlier in
      vitro work and provide further evidence that not all aneurysms share similar
      stresses. A more complete understanding of these hemodynamic features will be
      useful in the establishment of criteria that allow recognition of those aneurysms
      that are more or less likely to rupture, to grow, or to thrombose.

PMID- 1636519
TI  - MR diffusion imaging of cerebral infarction in humans.
AB  - PURPOSE: MR diffusion imaging was performed to investigate changes in water
      diffusion in patients with cerebral infarction. METHODS: Diffusion maps of the
      apparent diffusion coefficient (ADC) were created to show local water mobility in
      the brain tissue in 15 patients. These ADC maps were compared with conventional
      T2-weighted images. RESULTS: Distinct subregions with different water diffusions
      were detected, even when the infarcted area appeared homogeneous on a T2-weighted
      image. The results also show that stroke lesions of the same age can have very
      different water diffusions. A trend towards an increasing diffusion coefficient
      in a lesion during the first several days following an acute event was observed
      in a group of patients imaged at multiple timepoints. CONCLUSION: The measurement
      of diffusion coefficients in vivo now offers an opportunity for greater
      understanding of the biophysical changes that occur during the evolution of
      infarction in humans.

PMID- 1636520
TI  - Stereotaxic angiography in gamma knife radiosurgery of intracranial arteriovenous
      malformations.
AB  - Gamma knife radiosurgery is an effective alternative to embolization or
      microsurgical removal of small arteriovenous malformations, particularly in
      eloquent areas of brain tissue. Stereotaxic angiography is a useful diagnostic
      and targeting adjunct to gamma knife radiosurgery, and the authors present their
      experience (1,100 patients) with methods and technique, and show how the nidus of
      the arteriovenous malformation can be defined angiographically. Dose planning
      employing digitization of the subtraction image enables determination of the
      spatial coordinates of the lesion by means of an interactive computer program.

PMID- 1636521
TI  - Cerebral aneurysms: detection and delineation using 3-D-CT angiography.
AB  - PURPOSE: We compared three-dimensional image (3-D-CT) angiography with
      conventional angiography to determine the clinical usefulness of this technique.
      MATERIALS AND METHODS: We studied 15 patients with cerebral aneurysms using
      dynamic CT with intravenous injection of contrast material and reconstructed 3-D
      CT angiography. RESULTS: 3-D-CT angiography could be performed in conjunction
      with standard axial high-resolution CT without any additional scanning time and
      within 10-30 minutes for the overall study. All aneurysms were clearly visualized
      by 3-D-CT angiography. 3-D-reconstruction was very helpful in demonstrating the
      neck, shape, and direction of aneurysms, and adjacent vascular and bony
      structures. One small aneurysm that was difficult to detect on axial images was
      clearly visualized on 3-D-reconstruction. CONCLUSION: 3-D-CT angiography of
      cerebral aneurysms could be performed routinely and was helpful in demonstrating
      the complex anatomy of cerebral aneurysms and surrounding structures. This
      technique will be of value in surgical planning.

PMID- 1636522
TI  - Raeder syndrome: MR appearance.
AB  - A 40-year-old woman presented with symptoms compatible with Raeder syndrome. MR
      demonstrated narrowing of the left cavernous carotid artery. The high cervical
      portion of the left internal carotid artery was not identified. Angiography
      confirmed the narrowing of the cavernous carotid artery and showed marked and
      irregular stenosis of the distal cervical internal carotid artery. Involvement of
      the left sympathetic plexus and of ipsilateral cavernous sinus arteries is
      believed to have been the cause of the Raeder syndrome in this patient.

PMID- 1636523
TI  - Noninvasive preoperative cortical localization by magnetic source imaging.
AB  - The authors successfully used magnetoencephalography and MR data to localize the
      sensorimotor cortex in two patients prior to neurosurgery; preoperative
      localization influenced surgical management.

PMID- 1636524
TI  - Three-dimensional time-of-flight MR angiography in the evaluation of intracranial
      aneurysms treated by endovascular balloon occlusion.
AB  - The authors share their experience with MRA in the assessment of cerebral
      aneurysms. Despite its limitations--spatial resolution, insensitivity to slow
      flow states, subacute thrombus artifacts--they believe the technique shows
      potential.

PMID- 1636525
TI  - Acute thrombosis of the intracranial dural sinus: direct thrombolytic treatment.
AB  - Acute intracranial dural sinus thrombosis may have severe morbidity or fatal
      complications without appropriate treatment. Direct dural sinus venography can be
      performed safely with a soft Tracker catheter to document the fresh thrombus as
      an adjunct to CT or MR. We are reporting our experience with successful direct
      urokinase thrombolytic therapy in three cases of superior sagittal sinus and two
      cases of transverse and sigmoid sinus thrombosis. All five patients have
      recovered completely without any residual clinical deficit.

PMID- 1636526
TI  - Professor Giovanni Di Chiro, Director of Neuroradiology at the National
      Institutes of Health in Bethesda, Maryland, was the recipient of the "Ottorini
      Rossi Award".

PMID- 1636527
TI  - Endovascular treatment of a giant fusiform aneurysm of the entire basilar artery.
AB  - The authors describe a case of fusiform basilar artery aneurysm not amenable to
      surgical clipping or balloon occlusion with preservation of the parent artery.
      The aneurysm was treated by balloon occlusion (proximal basilar artery) after
      test occlusion was well-tolerated; 7-year follow-up showed good results.

PMID- 1636528
TI  - Internal carotid balloon test occlusion does require quantitative CBF.

PMID- 1636529
TI  - Asymmetric appearance of intracranial vessels on routine spin-echo MR images: a
      pulse sequence-dependent phenomenon.
AB  - PURPOSE: To determine the cause of right to left signal intensity differences
      arising from intracranial vessels during routine spin-echo axial MR imaging of
      the head. METHODS AND RESULTS: Using a normal imaging sequence in which the
      default directions of the frequency and phase axes were horizontal and vertical,
      respectively, differences in signal intensity arising from the vertebral arteries
      were observed in a healthy subject. With the exchange of the frequency and phase
      axes relative to the normal sequence, no signal intensity differences between the
      vertebral arteries were recognized. Other pulse sequence modifications, ie, the
      use of motion-compensating gradients and the reversed polarity of the frequency
      encoding gradient, also resulted in variable appearances of the vertebral
      arteries, indicating that the right-to-left signal asymmetry of the vertebral
      arteries observed on the normal spin-echo image results from a pulse sequence
      dependent phenomenon. CONCLUSIONS: Frequency-encoding and slice-selection
      gradients both produce motion-induced phase shifts. These phase shifts depend on
      the angle between the direction of flow and that of the effective vector sum of
      these gradients. The asymmetric appearance of the vertebral arteries during
      normal spin-echo imaging was found to result from the angle dependence of motion
      induced phase shifts. Awareness of this artifactual phenomenon is important to
      avoid confusing it with conditions such as stenosis/occlusion, dissection, or
      slow flow.

PMID- 1636530
TI  - Endoscopic paranasal sinus surgery: radiographic evaluation of severe
      complications.
AB  - PURPOSE: To report our experience with the radiographic evaluation of severe
      complications resulting from the functional endoscopic sinus surgery (FESS)
      procedure. PATIENTS: Ten major complications were reviewed retrospectively.
      FINDINGS: Ten major complications occurred. Eight of 10 had injury to the floor
      of the anterior cranial fossa, fovea ethmoidalis (roof of the ethmoid sinus), or
      roof of the sphenoid sinus. Six patients presented with meningitis or rhinorrhea,
      two presented with headache and massive pneumocephalus; one patient who presented
      with meningitis had a large nasal frontal encephalocele. Noncontrast brain CT
      that included the paranasal sinuses adequately evaluated the source of
      pneumocephalus. Thin-section coronal CT accurately predicted the site of leak in
      five patients. Both coronal sinus CT and MR imaging were useful to confirm the
      nasal encephalocele. Two of 10 had vascular injury secondary to FESS. One patient
      presented with subarachnoid hemorrhage seen on noncontrast CT and cerebral
      angiography demonstrated an aneurysm of the anterior cerebral artery. The second
      patient suffered severe intraoperative hemorrhage. Emergency angiography revealed
      a pseudoaneurysm of the cavernous carotid artery, and balloon occlusion of the
      artery was performed. No deaths occurred in this series. CONCLUSION: Radiologists
      should be familiar with the rare, but potential complications of this commonly
      performed procedure in order to help direct the work-up in an efficacious manner.

PMID- 1636531
TI  - Rapid MR imaging of the pediatric brain using the fast spin-echo technique.
AB  - PURPOSE: To evaluate diagnostic reliability and to establish optimal scanning
      techniques of a recently developed Fast Spin-echo MR pulse sequence that allows
      rapid proton density-weighted and T2-weighted imaging. METHODS: We compared
      lesion conspicuity and signal intensity measurements on Fast Spin-echo and
      conventional spin-echo sequences in 81 patients ranging from 1 week to 25 years
      in age on a 1.5-T MR unit. A total of 28 Fast Spin-echo dual-echo images (14
      slice locations) were obtained in 2:08 minutes with a 256 x 128 matrix or in 3:12
      minutes with a 256 x 192 matrix at a TR of 2000 msec and two excitations.
      RESULTS: Lesion conspicuity and characterization on Fast Spin-echo images
      compared favorably with conventional spin-echo images in our series when pseudo
      TEs of 15 and 90 msec were employed for proton density-weighted and T2-weighted
      images, respectively. Fast Spin-echo images yielded diagnostic information in
      four nonsedated patients whose conventional spin-echo images were either degraded
      by motion or unobtainable. Fat signal remained bright on T2-weighted Fast Spin
      echo images. Magnetic-susceptibility effects were slightly reduced with Fast Spin
      echo but did not pose any diagnostic problem in our series. CONCLUSION:
      Diagnostically reliable rapid dual-echo brain images can be obtained with Fast
      Spin-echo sequences.

PMID- 1636532
TI  - Bilateral neonatal Sturge-Weber-Dimitri disease: CT and MR findings.
AB  - The CT and MR features of cortical calcification and meningeal angiomatosis are
      typical of Sturge-Weber-Dimitri disease but are unusual in children less than 1
      year of age. This case describes a child presenting with both of these features
      bilaterally in the neonatal period and represents an unusual presentation of this
      disorder.

PMID- 1636533
TI  - High signal from the otic labyrinth on unenhanced magnetic resonance imaging.
AB  - High signal from the otic labyrinth was observed on precontrast MR scan of two
      patients who presented with sudden hearing loss and vertigo. The authors suggest
      the possibility that the high signal was caused by hemorrhage but that clinical
      significance and therapeutic implications of this finding need further study.

PMID- 1636534
TI  - MR appearance of intracanalicular eighth nerve lipoma.
AB  - The authors present the MR appearance of an intracanalicular eighth nerve lipoma
      in a 30-year-old woman, describe the clinical manifestations, and discuss the
      possible etiology; biopsy findings were conclusive. Precontrast T1-weighted
      images should be obtained.

PMID- 1636535
TI  - CT and ultrasound imaging of retropharyngeal abscesses in children.
AB  - PURPOSE: To show the role of ultrasound (US) in distinguishing retropharyngeal
      abscess from adenitis in children. METHODS: Eleven infants and children had
      clinical symptoms suggestive of retropharyngeal infection. Radiographic
      evaluation included, lateral neck radiography (11/11), contrast-enhanced neck CT
      (10/11), contrast-enhanced neck MR (1/11), and real time US (11/11) patients. US
      was used to characterize masses as solid (adenitis) or complex (abscess) and for
      guiding intraoperative aspiration and drainage. RESULTS: Contrast CT and MR
      showed findings suspicious for abscess in all 11 cases. Only three children had
      surgically drainable abscesses. CT numbers within inflammatory masses did not
      distinguish adenitis from abscess. US was able to correctly diagnose abscess or
      adenitis in each case. CONCLUSION: Lateral neck radiography and contrast CT
      identify and localize retropharyngeal inflammatory masses in children. US, but
      not CT, distinguishes between adenitis and abscess and aids in intraoperative
      aspiration and drainage.

PMID- 1636536
TI  - MR imaging in patients with primary thyroid lymphoma.
AB  - The authors describe two patients with thyroid lymphoma and Hashimoto
      thyroiditis; T1- and T2-weighted MR sequences were used. In one patient, the
      region of lymphoma showed a different signal intensity on T2 images; in the other
      patient, the signal level was identical to the Hashimoto disease. In sum, the
      processes could not be significantly differentiated using MR.

PMID- 1636537
TI  - Administration of gadopentetate dimeglumine in MR imaging of intracranial tumors:
      dosage and field strength.
AB  - PURPOSE: To investigate the efficacy of 0.025, 0.05 and 0.1 mmol/kg gadopentetate
      dimeglumine in MR imaging of patients with intracranial tumors at mid and high
      field strength. METHODS: In 88 patients, an open-label phase III multicenter dose
      finding study was performed at 0.5, 1.0, and 1.5 T MR units. Before and after (5,
      15, 25 minutes) intravenous administration of gadopentetate dimeglumine, imaging
      was performed with T1-weighted spin-echo sequences. RESULTS: With 0.1 mmol/kg
      yielding the highest values, tumor enhancement and numerical tumor/brain contrast
      showed dose-dependent 5-minute postcontrast values (P less than 0.05). Compared
      to 5-minute postcontrast values, there was no significant change at 15 and 25
      minutes. Although the lowest values of enhancement were found at 0.5 T,
      differences in enhancement among the field strengths were not statistically
      significant. The numerical data were confirmed by visual assessment of
      tumor/brain contrast. Eighty to 90% of cases had diagnostically valuable
      enhancement at 0.1 mmol/kg, 50% at 0.05 mmol/kg, and 10% at 0.025 mmol/kg (P less
      than 0.05). There were no adverse events. CONCLUSION: Our results confirm that
      0.1 mmol/kg gadopentetate dimeglumine is more effective at enhancing intracranial
      tumors than lower doses at mid and high field MR units.

PMID- 1636538
TI  - MR of primary CNS lymphoma in immunologically normal patients.
AB  - PURPOSE: To describe the MR findings of primary CNS lymphoma. METHODS: MR scans
      of 20 patients with histologically proved primary CNS lymphoma were reviewed. We
      evaluated the size, multiplicity, signal intensities, and enhancement
      characteristics of the lesions. We divided the lesions into an enhancing area
      referred to as Zone 1 and abnormal signal surrounding this, referred to as Zone
      2. RESULTS: Primary CNS lymphoma presented as solitary enhancing lesions in 40%
      of the patients and multiple lesions in 40%. Thirty-three separate lesions were
      visible: 58% abutted the ventricular system, 76% showed a homogenous enhancement
      pattern, and 79% showed marked enhancement. In 64% of the lesions, Zone 1 and
      Zone 2 showed different signal intensities on T1-weighted images. CONCLUSIONS:
      Primary CNS lymphoma usually presents as solitary or multiple dense homogenous
      enhancing lesions that abut an ependymal surface. These lesions can be divided
      into an enhancing area and an area of surrounding abnormal signal. These two
      areas often have different signal intensities on unenhanced T2-weighted images.
      These findings are sufficiently suggestive of the diagnosis of primary CNS
      lymphoma that a needle biopsy be performed based on these findings and
      appropriate therapy can then be instituted.

PMID- 1636539
TI  - Neuromas and meningiomas: evaluation of early enhancement with dynamic MR
      imaging.
AB  - PURPOSE: To investigate the role of dynamic MR imaging in the differentiation of
      neuromas and meningiomas. METHODS: Eleven patients with neuromas and 15 patients
      with meningiomas underwent dynamic contrast-enhanced MR imaging using a short TE
      FLASH sequence and a bolus injection of Gd-DTPA. RESULTS: There was no
      significant difference between these tumors in the signal-enhancement increment
      at the late phase, which corresponds to the signal-enhancement increment between
      pre- and postcontrast images in conventional spin-echo imaging. However, the
      signal enhancement at the vascular phase, ie, the phase where the first passage
      of Gd-DTPA was recognized both in the arteries and veins, was approximately four
      times as high in meningiomas as in neuromas. The difference was statistically
      significant. Furthermore, meningiomas had a wider range of early signal
      enhancement than did neuromas, reflecting the histologic varieties: two
      angioblastic meningiomas had the highest values, and three fibroblastic the
      lowest values comparable with those of neuromas, while meningiomas with other
      subtypes had intermediate values. CONCLUSIONS: The results of this study indicate
      that the evaluation of early enhancement with dynamic MR imaging is helpful in
      the differentiation of neuromas and meningiomas, and possibly in the crude
      prediction of pathologic subtypes of meningiomas.

PMID- 1636541
TI  - Bilateral thalamic glioma: review of eight cases with personality change and
      mental deterioration.
AB  - PURPOSE: To describe the clinical, radiographic, and neuropathologic features of
      bilateral thalamic glioma. METHODS: We searched our hospital records (1963 to
      present) to identify patients diagnosed as having the disease. RESULTS: Our
      search revealed eight patients, ranging in age from 8-63 years, with bithalamic
      tumor diagnosed by angiography, CT, and/or MR. All patients displayed personality
      changes and/or mental deterioration, including memory loss, inattention,
      confusion, hallucination, hyperphagia, or slow mentation. Unilateral motor
      weakness was also noted in six cases. The tumor always involved the medial aspect
      of the left and right thalami, but was often more extensive. The pathology was
      determined to be grades I-IV astrocytoma, confirmed by stereotactic biopsy or
      autopsy in six. Mild to moderate hydrocephaly occurred in some cases and was
      considered to be a contributing factor to mental deterioration. No correlation
      was found between age and type of tumor. CONCLUSIONS: Bilateral glioma of the
      dorsomedial and intralaminar nuclei of the thalamus can be a primary cause of
      dementia that has not been well-recognized in the past. CT and particularly MR
      should be considered for patients presenting with personality change or dementia,
      because of the possible presence of this unusual but devastating disease.

PMID- 1636540
TI  - MR imaging of metastatic GI adenocarcinoma in brain.
AB  - PURPOSE: To investigate an observed preferential T2-shortening effect seen in
      patients with intracerebral metastases from adenocarcinoma of the GI tract.
      METHODS: Ten patients with intracerebral metastases from adenocarcinoma of the GI
      tract were evaluated with MR imaging with CT and histopathologic correlation.
      RESULTS: Nine of 10 patients demonstrated intracranial masses with decreased
      signal intensity on T2-weighted images. T1-weighted images showed decreased or
      isointense signal in all cases. Special histologic staining was performed in four
      of 10 cases, all of which were positive for increased protein (mucin) with no
      evidence of blood products or calcium. CONCLUSION: We propose that the observed
      preferential T2-shortening effect is secondary to slowing of rotational and
      translational proton motion caused by increased protein concentration in the form
      of mucin.

PMID- 1636542
TI  - Prospective cerebral MR study of HIV seropositive and seronegative men:
      correlation of MR findings with neurologic, neuropsychologic, and cerebrospinal
      fluid analysis.
AB  - PURPOSE: As part of a longitudinal study of human immunodeficiency virus type 1
      (HIV) infection, we attempted to identify early cerebral MR findings that might
      correlate to clinical evidence of central nervous system involvement. METHODS: We
      studied 65 seropositive and 40 seronegative homosexual males using cranial MR,
      neurologic, immunologic, and neuropsychologic examinations. RESULTS: The
      incidence of mildly enlarged ventricles, sulci, and punctate areas of abnormal
      signal in both groups was similar in both groups. Diffuse, poorly defined areas
      of abnormal white matter signal were difficult to consistently identify in
      seropositives. Enlarged adenoidal lymphoid tissue was found in 30 (46%) of
      seropositives and 2 (5%) of seronegatives (P = .0001). The incidence of sinus
      inflammatory change was similar in the two groups. CONCLUSION: MR of intracranial
      contents is substantially normal in a non-AIDS HIV(+) population.

PMID- 1636543
TI  - MR findings in acute and chronic coccidioidomycosis meningitis.
AB  - PURPOSE: To characterize MR findings in acute and chronic coccidioidomycosis
      meningitis and relate the imaging features to the clinical course. METHODS: We
      reviewed MR scans and clinical findings of 12 patients with coccidioidal
      meningitis. RESULTS: Patients with active or untreated disease were found to have
      hydrocephalus and intense enhancement of the cervical subarachnoid space,
      basilar, sylvian, and interhemispheric cisterns on postcontrast MR scans. Focal
      parenchymal signal abnormalities suggesting ischemia or infarction were common.
      Abnormal MR enhancement decreases during therapy, although patients develop
      cortical and/or brain stem atrophy. CONCLUSIONS: Widespread cisternal and
      cervical subarachnoid meningeal involvement is common in coccidioidal meningitis.
      Serial contrast MR imaging reflects the effects of therapy in patients with
      coccidioidal meningitis.

PMID- 1636544
TI  - MR imaging of intraventricular cysticercosis.
AB  - Intraventricular cysticercosis cysts can migrate through the ventricular system
      and produce hydrocephalus. MR is more sensitive than CT in the detection of these
      cysts.

PMID- 1636545
TI  - Simultaneous neurofibroma and schwannoma of the sciatic nerve.
AB  - The authors report a case of simultaneously occurring neurofibroma and schwannoma
      of the sciatic nerve and discuss the complementary aspects of MR and US. The
      schwannoma was well-defined and showed distal enhancement on sonographic
      evaluation, whereas the neurofibroma was ill-defined; both tumors were
      hypoechoic. T1- and T2-weighted MR images revealed similar signal characteristics
      of the two tumors, but intense enhancement following administration of gadolinium
      DTPA distinguished the schwannoma from the neurofibroma.

PMID- 1636546
TI  - Orbital mesenchymal chondrosarcoma.

PMID- 1636547
TI  - Gadopentetate dimeglumine enhancement of multiple sclerosis lesions on long TR
      spin-echo images at 0.6 T.
AB  - The authors sought to determine if Gd-DTPA enhancement of multiple sclerosis (MS)
      hampers lesion detection on long TR spin-echo images (TE 60 msec) at 0.6 T. They
      measured the signal intensity (SI) of 41 lesions (10 patients) and normal
      appearing gray (NAGM) and white matter (NAWM) before and after administration of
      contrast. The change in SI of nonenhancing lesions and NAGM and NAWM was small
      (less than or equal to 1.5%), and of enhancing lesions (5.3%) moderate. The
      contrast of nonenhancing lesions to NAGM and NAWM changed insignificantly, but
      the contrast of enhancing lesions to NAGM and NAWM increased significantly. The
      authors conclude that long TR images can be obtained after Gd-DTPA without
      hampering lesion conspicuity in research MR protocols in multiple sclerosis.

PMID- 1636548
TI  - Chondromyxoid fibroma of the frontal bone.
AB  - Chondromyxoid fibroma of frontal bone is a rare lesion. Plain skull films showed
      a round radiolucent mass with a sclerotic margin. It was dense on plain CT scan
      and showed no convincing contrast enhancement. MR imaging showed low signal
      intensity relative to gray matter on T1-weighted image (500/20), isointensity on
      proton-density image (2000/30), high intensity on T2-weighted image, and marked
      peripheral enhancement on postcontrast (gadopentetate dimeglumine) study.

PMID- 1636550
TI  - Contrast-enhanced CT of acute isodense subdural hematoma.

PMID- 1636549
TI  - Postoperative dissemination of fat particles in the subarachnoid pathways.
AB  - A case of postoperative dissemination of fat particles into the cerebrospinal
      fluid pathways is reported. Following removal of a foramen magnum meningioma, a
      postoperative MR scan showed fat droplets in the basal cisterns and in the
      frontal horns of the lateral ventricles. The patient was asymptomatic and a
      repeat MR scan 7 months later was normal, with resolution and clearing of the
      previously noted cerebrospinal fluid fat.

PMID- 1636551
TI  - Unusual MR and CT appearance of an epidermoid tumor.

PMID- 1636552
TI  - The spectrum of radiologic abnormalities in the neonatal CNS.

PMID- 1636553
TI  - Physician integrity and the bureaucracy.

PMID- 1636554
TI  - Sticker shock.

PMID- 1636555
TI  - Exemption from seat belt use.

PMID- 1636556
TI  - Syndrome of 'iatrogenic' polydipsia.

PMID- 1636557
TI  - Preterm birth prevention: cognition over technology?

PMID- 1636558
TI  - Family physicians and social responsibility.

PMID- 1636559
TI  - Diary from a week in practice.

PMID- 1636560
TI  - Preventing the complications of preterm birth.
AB  - Preterm birth is a major cause of infant morbidity and mortality. Although
      studies have been complicated by problems of definition and methodology, certain
      strategies have the potential to reduce both the incidence and the impact of
      preterm birth. These strategies include accurate assessment of gestational age,
      education about the signs and symptoms of early labor, recommendations for
      smoking cessation, and screening for asymptomatic bacteriuria in all prenatal
      patients. In addition, specific interventions such as cervical cerclage may be
      indicated in certain patients. The role of home uterine monitoring is not yet
      established. If preterm labor does occur, tocolysis should be used to delay
      delivery, and in appropriate cases the patient should be transferred to a medical
      center with a neonatal intensive care unit. Antenatal administration of
      corticosteroids in preterm labor appears to significantly reduce fetal morbidity.

PMID- 1636561
TI  - Traumatic rupture of the diaphragm and herniation of the liver.
AB  - Injuries that result in a sudden increase in intra-abdominal pressure may cause a
      diaphragmatic tear and visceral herniation. Right-sided tears are significantly
      less likely than left-sided tears because of the protective effect of the liver.
      When diaphragmatic elevation persists in a post-trauma patient, or if unexplained
      acidosis or hypoxemia develops, herniation of abdominal contents should be
      suspected. This is particularly true when other signs of severe trauma are
      present, such as multiple rib fractures, laceration of the liver or spleen, or a
      history of deceleration injury.

PMID- 1636562
TI  - Intraoral examination in pyogenic facial lesions.
AB  - Pyogenic cutaneous lesions of the cervicofacial region may be due to a variety of
      causes. One possibility that should be considered is an odontogenic infection
      secondary to untreated dental caries, periodontal disease or previous
      maxillofacial trauma. An intraoral examination is mandatory to evaluate the oral
      cavity for signs of pathology that may be manifested as a purulent cutaneous
      lesion. Patients with odontogenic infection should be referred to a dentist for
      definitive treatment, which may consist of either endodontic therapy or
      extraction of the involved tooth and curettage of any abscesses or fistulous
      tracts.

PMID- 1636563
TI  - Acute pain management in infants, children and adolescents: operative and medical
      procedures. Agency for Health Care Policy and Research.

PMID- 1636564
TI  - Trichloroethylene: environmental and occupational exposure.
AB  - Trichloroethylene is used in paint strippers, rug cleaners, spot removers,
      typewriter correction fluid and industrial cleaners. It is a common environmental
      contaminant, detected in over one-third of hazardous waste sites and in 10
      percent of groundwater sources. Acute workplace exposure above acceptable levels
      can cause neurologic, respiratory and hepatic problems. The health effects of
      prolonged occupational and environmental low-level exposure are probably minimal,
      but whether such exposure poses a risk remains controversial. Although
      trichloroethylene has been shown to cause cancer in some animals, it has not been
      proven to be a human carcinogen. Trichloroethylene has been involved in several
      well-publicized cases of contamination of community water supplies, and family
      physicians are likely to receive questions about this chemical.

PMID- 1636565
TI  - Loop electrosurgical excision procedure for CIN.
AB  - The loop electrosurgical excision procedure, also referred to as large loop
      excision of the transformation zone, is gaining acceptance in the United States
      as a method for treating cervical intraepithelial neoplasia. Loop excision of
      cervical tissue is accomplished using a high-frequency alternating current
      (radiofrequency) and thin wire loop electrodes. Loop excision may be in the form
      of simple excision of the transformation zone or electrosurgical loop conization.
      The specimens obtained using this technique are suitable for histologic
      evaluation. Loop excision, which is usually performed under local anesthesia, is
      associated with minimal short-term and long-term morbidity. Patient acceptance is
      high. Family physicians who perform colposcopy should consider using loop
      electrosurgical excision to treat cervical intraepithelial neoplasia in the
      outpatient setting.

PMID- 1636567
TI  - Concurrent HIV and HCV infections hasten liver failure.

PMID- 1636568
TI  - ACOG (American College of Obstetricians and Gynecologists) issues report on HIV
      infection in women.

PMID- 1636566
TI  - Jimson weed toxicity: management of anticholinergic plant ingestion.
AB  - Jimson weed is a hallucinogenic plant that is common in rural areas. Consumption
      of any part of the plant can result in severe anticholinergic toxicity. The
      clinical presentation of jimson weed toxicity is similar to that seen in cases of
      atropine poisoning. Treatment is aimed at removing plant material from the
      gastrointestinal tract, keeping the patient safe and reversing severe
      anticholinergic sequelae.

PMID- 1636569
TI  - FDA approval of rapid HIV test.

PMID- 1636570
TI  - Approval of ddC for AIDS patients.

PMID- 1636571
TI  - Left ventricular function under stress before and after myocardial
      revascularization.
AB  - To compare left ventricular responses to stress during exercise-induced
      myocardial ischemia and after myocardial revascularization, 35 patients (mean age
      55 +/- 7 years, class III angina) with three-vessel coronary artery disease
      underwent a rest and exercise initial-transit radionuclide angiocardiography
      before aortocoronary bypass grafting. Left ventricular ejection fraction
      decreased during exercise (p less than 0.01), but cardiac output was augmented
      with an increased heart rate (p less than 0.0001) and left ventricular end
      diastolic volume (p less than 0.001). Group A (n = 15) underwent six serial
      resting studies at different volume loads during the first 24 hours after
      operation while heart rate and blood pressure were held constant. These data
      revealed no significant change in left ventricular ejection fraction, but preload
      varied in all patients because of bleeding and fluid administration, with a mean
      end-diastolic volume change of 115 to 176 ml. This range of end-diastolic volume
      was similar to that defined with rest and exercise testing before operation.
      Group B (n = 20) underwent a repeat rest and exercise test 3 months after
      operation that demonstrated no change in resting function. However, exercise
      ejection fraction and peak systolic pressure/end-systolic volume ratio increased
      (p less than 0.001 and p less than 0.05, respectively) while end-diastolic volume
      decreased (p less than 0.05) compared with the values before operation. These
      data indicate that patients with coronary artery disease have chronically adapted
      cardiac function that makes use of both rapid heart rate and a wide range in
      preload to augment cardiac function under stress.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1636572
TI  - Detection of acute myocardial infarction with digital image processing of two
      dimensional echocardiograms.
AB  - We have previously described the ability of a computer-based image digitizing
      system to assess early textural changes in acute canine myocardial infarction. To
      determine whether this technique could be applied to human beings, we studied 12
      patients with a first acute transmural myocardial infarction and five normal
      subjects. Two-dimensional echocardiograms were performed on days 1 and 8 in
      normal subjects and on days 1 (day of admission), 2, 3, 5, and 14 in the patient
      population. All recording parameters on the echocardiography machine were kept
      identical for serial studies. The mean period between hospitalization and first
      echocardiogram was 11.1 hours (range 4 to 20 hours). End-diastolic frames from
      the two-dimensional echocardiographic images were digitized and displayed on a
      monitor. The mean pixel intensity (MPI) (+/- SD) in the region of asynergy (area
      of myocardial infarction) and a normal area were determined. In normal
      volunteers, no significant change in MPI was noted between anteroseptal and
      lateral areas on two separate two-dimensional echocardiographic studies, which
      were performed 7 days apart (anteroseptal: MPI, 21.6 +/- 1.1 vs 21.8 +/- 0.4, p =
      not significant) and (lateral: MPI, 21.5 +/- 1.2 vs 21.4 +/- 1.4, p = not
      significant). In patients with myocardial infarction, a significant increase in
      MPI was noted on the first day of myocardial infarction between normal and
      infarcted myocardium (20.4 +/- 2.0 vs 24.3 +/- 2.3, p less than 0.05) and
      progressively increased thereafter until day 14 (20.5 +/- 1.7 vs 31.9 +/- 3.7, p
      less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636573
TI  - Quantitative planar imaging of glucose metabolic activity in myocardial segments
      with exercise thallium-201 perfusion defects in patients with myocardial
      infarction: comparison with late (24-hour) redistribution thallium imaging for
      detection of reversible ischemia.
AB  - Exercise thallium-201 24-hour redistribution imaging and myocardial glucose
      metabolism with F-18-deoxyglucose were used to identify reversible ischemia in 30
      patients with previous myocardial infarction. Metabolic images were obtained
      using a planar gamma camera fitted with a rotating tungsten collimator. Of 184
      exercise thallium perfusion defects, late redistribution occurred in 88.
      Metabolic evidence for reversibility (metabolism-perfusion mismatch) was
      identified in 91% of these 24-hour reversible segments. However, 72% of the
      segments with fixed perfusion defects also had residual ischemia by F-18
      deoxyglucose. Out of 26 fixed severe thallium defects, 69% had F-18-deoxyglucose
      evidence for residual ischemia. A subset of 14 patients underwent serial exercise
      thallium scintigraphy or gated equilibrium radionuclide angiography after
      revascularization or medical therapy. Out of 46 fixed thallium defects in these
      patients, 30 demonstrated serial scintigraphic improvement. F-18-deoxyglucose
      thallium mismatch was present in 81% of these segments, but was absent in the
      majority of the unimproved segments. Thus quantitative planar imaging of
      myocardial glucose metabolism with F-18-deoxyglucose using a well-collimated
      gamma camera can detect clinically important reversible ischemia in segments with
      fixed thallium defects at late redistribution imaging.

PMID- 1636574
TI  - Lack of influence of pretreatment antistreptokinase antibody on efficacy in a
      multicenter patency comparison of intravenous streptokinase and anistreplase in
      acute myocardial infarction.
AB  - Antistreptokinase antibodies present in patients as a result of previous
      streptococcal infections might theoretically influence the thrombolytic response
      to streptokinase or anistreplase. The potential influence of antibody, measured
      as antigen binding to immunoglobulin G, was investigated in a randomized, double
      blind, multicenter patency comparison of intravenous streptokinase (1.5 million
      units/60 minutes) and intravenous anistreplase (30 units/2 to 5 minutes) in
      patients with acute myocardial infarction. Antibody results were evaluated in 333
      patients (from a total study population of 370 patients) less than 76 years of
      age with ECG evidence of ST segment elevation who could be treated within 4 hours
      of the onset of symptoms. Variations in pretreatment circulating levels of
      antibody did not influence angiographically defined early coronary patency rates
      (Thrombolysis in Myocardial Infarction grade 2 or 3 perfusion, measured at a mean
      of 140 minutes after therapy was begun) for either streptokinase or anistreplase.
      Similarly the lytic response represented by systemic plasminogen activation and
      measured as changes in plasma plasminogen and fibrinogen levels after dosing (at
      mean times of 90 minutes and 24 hours) was not correlated with baseline antibody
      levels. Furthermore, pretreatment antibody was not a risk factor for poor outcome
      in response to streptokinase or anistreplase (reocclusion within 24 hours, in
      hospital death, or stroke) and did not correlate with hypotension or allergic
      type reactions recorded as adverse events. In conclusion, within the population
      limits defined by the inclusion and exclusion criteria of the study (patients
      were excluded if they had received streptokinase or anistreplase within the
      previous 6 months), pretreatment antistreptokinase immunoglobulin G is not a
      significant determinant of the efficacy response to streptokinase or
      anistreplase.

PMID- 1636575
TI  - Plasma plasminogen activator inhibitor activity and tissue plasminogen activator
      levels in patients with unstable angina and those with coronary spastic angina.
AB  - Plasminogen activator inhibitor (PAI) activity and tissue plasminogen activator
      (TPA) antigen were measured in venous samples in 14 patients with unstable angina
      consisting of eight patients with organic stenosed coronary arteries and six
      patients with coronary spastic angina (unstable angina group); in 14 patients
      with stable exertional angina (stable exertional angina group); and in 14
      patients with chest pain syndrome (chest pain syndrome group). The plasma levels
      of PAI activity were higher (p less than 0.01) in the unstable angina group than
      in the stable exertional angina group and the chest pain syndrome group (12.3 +/-
      1.0 versus 5.1 +/- 0.7 and 4.8 +/- 0.6 IU/ml). The plasma levels of TPA antigen
      were also higher (p less than 0.05) in the unstable angina group than in the
      stable exertional angina group and the chest pain syndrome group (10.2 +/- 1.3
      versus 6.5 +/- 0.8 and 6.0 +/- 0.7 ng/ml). There were no significant differences
      in PAI activity and TPA antigen levels between the stable exertional angina group
      and the chest pain syndrome group. Furthermore, both PAI activity and TPA antigen
      levels in the unstable angina group decreased to the levels in the stable
      exertional angina group and the chest pain syndrome group after treatment (p less
      than 0.01). In conclusion, the increased plasma PAI activity in patients with
      unstable angina and in those with coronary spastic angina indicates that the
      fibrinolytic system is impaired in these patients.

PMID- 1636577
TI  - Intracoronary electrocardiogram during coronary angioplasty.
AB  - This prospective study examines the data derived from the intracoronary
      electrocardiogram (ECG) (derived from the coronary guide wire) compared with that
      from four standard surface leads (I, II, III, and V2) in documenting myocardial
      ischemia during coronary angioplasty. Intracoronary and surface ECGs were
      simultaneously recorded in 300 consecutive patients (mean age 59 +/- 10; range 33
      to 80 years; 246 males [82%] during coronary angioplasty in 368 lesions (167 left
      anterior descending [46%], 85 left circumflex [23%], 107 right coronary arteries
      [29%], and nine bypass grafts [2%]), before balloon inflation, at 1 minute of
      inflation, and at the end of the procedure. ST segment changes (greater than 0.1
      mV) were observed in the intracoronary ECG in 306 lesions (83%) (151 left
      anterior descending [88%], 75 left circumflex [89%], and 80 right coronary
      arteries [73%]) versus in 245 lesions (67%) in the surface ECG (126 left anterior
      descending [73%], 43 left circumflex [47%], and 76 right coronary arteries [70%];
      [p less than 0.0001]). The mean ST segment shift was 0.5 +/- 0.4 mV in
      intracoronary and 0.1 +/- 0.2 mV in standard leads (p less than 0.0001). ST
      elevation was seen in 97% of cases with intracoronary ECG changes versus in 83%
      with surface ECG changes. The remainder had ST depression. A total of 48 lesions
      (13%) did not produce ECG changes and 62 (16%) had silent ischemia. In 75 lesions
      (21%), ECG changes were seen only in the intracoronary ECG, compared with 14
      lesions (4%) with changes only in the surface ECG (p less than 0.001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1636576
TI  - Abnormal nondefect zone myocardial thallium washout ratio in patients with
      reversible thallium defects and normal coronary arteriograms.
AB  - Thallium myocardial defects in patients with no angiographic coronary artery
      stenosis have been attributed to attenuation effects and other artifacts. Of 323
      patients having thallium myocardial imaging following dipyridamole infusion, 10
      of 159 patients with a segmental perfusion abnormality were found to have no
      luminal diameter stenosis greater than 20% on coronary angiography and no
      electrocardiographic (ECG) evidence of myocardial infarction or left bundle
      branch block. A time-standardized regional thallium washout ratio was calculated
      as thallium myocardial counts with dipyridamole to counts without dipyridamole.
      In comparison to 10 age-matched control patients with no evidence of cardiac
      disease and no myocardial thallium defect, study patients had a lower regional
      myocardial thallium washout ratio from both the defect and nondefect (1.57 +/-
      0.40 versus 2.27 +/- 0.92, p = 0.041) zones. Nine of the 10 study patients had
      independent evidence of noncoronary heart disease, including echocardiographic or
      ECG evidence of left ventricular hypertrophy in six patients. In patients with
      thallium defects and normal coronary arteriograms, a time-standardized regional
      thallium myocardial washout ratio for the nondefect zone may aid in the
      differentiation of patients with noncoronary heart disease from those with soft
      tissue artifacts.

PMID- 1636578
TI  - Efficacy of directional coronary atherectomy in cases unsuitable for percutaneous
      transluminal coronary angioplasty (PTCA) and after unsuccessful PTCA.
AB  - Directional coronary atherectomy (DCA) was used in 10 female and 50 male patients
      with an average age of 58 years. They were categorized into three different
      groups depending on the indications for atherectomy. Group 1 included all
      patients who had atherectomy as their primary intervention (n = 20) because they
      were assumed to be unsuitable for percutaneous transluminal coronary angioplasty
      (PTCA). Group 2 consisted of patients in whom DCA was used after failed balloon
      dilatation with unsuccessful but uneventful treatment (n = 17). Group 3 (n = 23)
      included patients in whom DCA was performed as a "rescue" or "bailout" procedure
      after unsuccessful PTCA resulting in critical ischemia (ECG changes, chest pain,
      hypotension, and shock). The target lesions were located in the left main artery
      in two, left anterior descending artery in 43, right coronary artery in 15, and
      aortocoronary venous bypass in five. The mean length of the lesions was 8 mm (2
      to 25 mm). The overall success rate for 65 lesions was 92%. The mean stenosis was
      reduced from 87 +/- 12% to 19 +/- 17% in patients with primary success. Presently
      available follow-up angiograms (30) showed six restenoses. Major complications
      occurred in seven patients (myocardial infarction in two and coronary artery
      bypass graft surgery within 24 hours in five); there were no deaths. Our results
      show that DCA is a safe and effective technique that can extend the use of
      percutaneous procedures and provide a promising nonsurgical option in cases of
      unsuccessful PTCA.

PMID- 1636579
TI  - Catheter ablation of accessory atrioventricular pathways in 114 symptomatic
      patients with Wolff-Parkinson-White syndrome--a comparative study of direct
      current and radiofrequency ablation.
AB  - To evaluate and compare the safety and efficacy of catheter-mediated direct
      current and radiofrequency ablation in patients with Wolff-Parkinson-White
      syndrome, 114 patients with accessory pathway-mediated tachyarrhythmias underwent
      catheter ablation. Electrophysiologic parameters were similar in patients
      undergoing direct-current (group 1, 52 patients with 53 accessory pathways) and
      radiofrequency (group 2, 62 patients with 75 accessory pathways) ablation.
      Immediately after ablation, 50 of 53 accessory pathways (94%) were ablated
      successfully with direct current, but 2 of the 50 accessory pathways had early
      return of conduction and required a second ablation; 72 of 75 accessory pathways
      (96%) were ablated successfully with radiofrequency current. In the three
      accessory pathways in which radiofrequency ablation was unsuccessful, a later
      direct-current ablation was successful. During follow-up (group 1, 14 to 27
      months; group 2, 8 to 13 months), none of the patients with successful ablation
      had a recurrence of tachycardia. Complications in direct-current ablation
      included transient hypotension (two patients), accidental atrioventricular block
      (one patient), and pulmonary air trapping (two patients); complications in
      radiofrequency ablation included cardiac tamponade (one patient) and suspicious
      aortic dissection (one patient). Myocardial injury and proarrhythmic effects were
      more severe in direct-current ablation. The length of the procedure and the
      radiation exposure time were significantly shorter in direct-current (3.5 +/- 0.2
      hours, 30 +/- 4 minutes) than in radiofrequency (4.1 +/- 0.4 hours, 46 +/- 9
      minutes) ablation. Findings in this study confirm the impression that
      radiofrequency ablation is associated with fewer complications than direct
      current ablation and radiofrequency ablation with a large-tipped electrode
      catheter is an effective and relatively safe nonsurgical method for treatment of
      Wolff-Parkinson-White syndrome.

PMID- 1636580
TI  - A comparison of standard and high-dose regimens for the initiation of amiodarone
      therapy.
AB  - The effects of two regimens for the initiation of amiodarone therapy were
      compared in 92 patients with inducible sustained ventricular tachycardia (VT) at
      baseline electrophysiologic testing. Two groups of 46 patients each received a
      total of 16.8 gm of oral amiodarone before follow-up electrophysiologic testing.
      Group A (standard dose) received 1200 mg/day for 14 days, and group B (high dose)
      received 2400 mg/day for 7 days. Amiodarone suppressed the induction of sustained
      VT in six subjects (13%) in group A versus 10 (22%) in group B (p = NS). In
      subjects who continued to have inducible VT after amiodarone loading, the mean
      increase in cycle length of induced VT was similar in group A (delta = 85 +/- 73
      msec) and group B (delta = 78 +/- 59 msec). The mean increase in sinus cycle
      length, AH and HV intervals, paced QRS duration, and ventricular refractory
      periods was also not significantly different between the two groups. Side effects
      developed in 10 (22%) patients in group B but were serious only in one, and one
      patient required a reduction in dosage. Thus compared to the 14-day standard-dose
      regimen, the 7-day high-dose regimen was well tolerated and had similar effects
      on VT inducibility and electrophysiologic variables. Its use may significantly
      shorten the duration of hospitalization in patients with life-threatening
      inducible VT who are undergoing loading with amiodarone on an inpatient basis.

PMID- 1636581
TI  - Washout of long-term treatment with flecainide and propafenone in patients with
      complex ventricular arrhythmias and cardiac disease. Antiarrhythmic Drug
      Evaluation Group.
AB  - To assess the spontaneous variability of ventricular arrhythmias after withdrawal
      of apparently successful antiarrhythmic therapy, we enrolled in a washout
      protocol 40 patients who had completed a randomized controlled 2-year study of
      antiarrhythmic drugs (the Antiarrhythmic Drug Evaluation Group [ADEG] study). All
      of them had heart disease and were first seen with high-grade ventricular
      arrhythmias (Lown class 4a and 4b) at enrollment. After 2 years all of them had
      responded to propafenone or flecainide; patients who completed the study on a
      regimen of amiodarone were not considered for the washout study. A total of 27
      patients discontinued flecainide and 13 propafenone. Seven days after withdrawal
      they underwent 24- or 48-hour ECG testing and were classified as true responders
      (TR) if the arrhythmias were present at the same level as 2 years previously and
      false responders (FR) if they were below the ADEG responsiveness level. TR
      patients had a third 24-hour ECG 7 days later, after rechallenge with the same
      treatment, and FR patients had a third ECG without drugs. Adherence to the
      protocol was ascertained by measuring drug plasma concentrations at every 24-hour
      ECG recording. No differences were found in distribution of heart disease and
      grade of ventricular arrhythmias between patients in the washout study and the
      remaining group of the ADEG trial. Twenty-four of 40 patients (60%) were true
      responders. In 4 of the 17 patients who had a third 24 hour ECG, the
      responsiveness to the same drug was not confirmed.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1636582
TI  - Correlation of symptoms with occurrence of paroxysmal supraventricular
      tachycardia or atrial fibrillation: a transtelephonic monitoring study. The
      Flecainide Supraventricular Tachycardia Study Group.
AB  - The purpose of this study was to determine whether symptoms recorded at the time
      of transtelephonic ECG monitoring (TTEM) correlate with attacks of paroxysmal
      supraventricular tachycardia (PSVT) or paroxysmal atrial fibrillation (PAF). We
      studied 113 patients with these arrhythmias who made a total of 3319 TTEM calls
      during their participation in double-blind, placebo-controlled, crossover,
      multicenter trials of flecainide therapy. Among 49 patients with PSVT, 62.7% of
      symptomatic calls were associated with ECG-documented PSVT as compared with 6.8%
      of asymptomatic calls (p less than 0.001). Similarly, among 69 patients with PAF,
      69% of symptomatic calls were associated with ECG-documented PAF compared with
      10.6% of asymptomatic calls (p less than 0.001). Both in patients with PSVT and
      PAF, an attack of PSVT or PAF could be documented by ECG in more than 70% of the
      calls when patients complained of tachycardia, increased sweating, or dyspnea.
      The sensitivity of a symptomatic call was 91% for PSVT and 89% for PAF, and it
      was not influenced by flecainide therapy. However, flecainide therapy was
      associated with a decrease in the positive predictive value of symptomatic TTEM
      calls and an increase in false positive TTEM transmissions. We conclude that in
      patients with symptomatic PSVT or PAF, there is a temporal relationship between
      symptoms and the occurrence of ECG-documented attacks of PSVT or PAF. However,
      sole reliance should not be placed on the presence or absence of symptoms as a
      measure of drug failure or efficacy, and it is important to document the cardiac
      rhythm by TTEM at the time symptoms are recorded.

PMID- 1636583
TI  - Arterial blood nicotine concentration and coronary vasoconstrictive effect of low
      nicotine cigarette smoking.
AB  - Low-nicotine cigarettes have been advertised to the public as less harmful to the
      cardiovascular system. We studied the effects of smoking two low-nicotine
      cigarettes on arterial and venous blood nicotine levels, hemodynamics, and
      coronary vascular tone in 12 patients referred for diagnostic coronary
      arteriography. All were chronic smokers as evidenced by their elevated baseline
      arterial and venous cotinine blood levels (139 +/- 30 ng/ml and 155 +/- 34 ng/ml,
      respectively). High-resolution coronary angiograms were evaluated "blindly"
      before and after smoking. An electronic caliper was used to measure the diameter
      of disease-free coronary segments of the left anterior descending and circumflex
      arteries. Arterial nicotine levels rose from 5 +/- 1 ng/ml at baseline to 37 +/-
      7 ng/ml (p less than 0.01) after the first cigarette was smoked and to 45 +/- 8
      ng/ml (p less than 0.01) after the second cigarette. Venous nicotine levels rose
      from 8 +/- 2 ng at baseline to 15 +/- 3 ng/ml (p less than 0.05) after the first
      cigarette and to 20 +/- 3 ng/ml (p less than 0.01) after the second cigarette.
      After the first cigarette heart rate increased 8 +/- 2 beats/min (p less than
      0.003) and double product 1229 +/- 400 beats/min x mm Hg (p less than 0.02).
      Compared to baseline values, after the second cigarette heart rate increased 9 +/
      1 beats/min (p less than 0.001) and double product 1767 +/- 486 beats/min x mm
      Hg (p less than 0.01). Systolic, diastolic, and mean blood pressure did not
      change significantly after either the first or second cigarette.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1636584
TI  - Discordance between responses of contrast echo intensity to increased flow rate
      in human coronary circulation and in vitro.
AB  - According to the Stewart-Hamilton equation flow is inversely related to the area
      under the time-concentration curve produced by the transit of a detectable
      indicator. To verify the applicability of this principle for contrast
      echocardiography, we bolus injected a saccharide echo contrast agent (0.8 ml)
      into an in vitro circulatory model at variable flow rates. Two-dimensional echo
      images were digitized, and curves demonstrating the ratio of videointensity over
      time were derived. As expected, flow was inversely related to the area under the
      curves (r = 0.93). To apply this principle to human coronary circulation, we
      bolus injected sonicated iopamidol (4 ml) into the normal left coronary artery of
      six patients at baseline and after intravenous administration of dipyridamole
      (0.84 mg/kg in 10 minutes). Echo images were digitized, and myocardial time
      intensity curves were derived. The area under the curve after dipyridamole
      administration (210 +/- 128 gray level.sec) did not appear significantly
      different from that at baseline (177 +/- 80 gray level.sec). Thus a mismatch
      exists between contrast echo data obtained in vitro and in human coronary
      circulation.

PMID- 1636585
TI  - Pregnancy in patients with prosthetic heart valves: the effects of
      anticoagulation on mother, fetus, and neonate.
AB  - Maternal and fetal complications in a consecutive series of 60 pregnancies in 49
      patients with prosthetic heart valves were prospectively evaluated. Group 1
      consisted of 40 pregnancies in 31 patients who were taking oral anticoagulants.
      No oral anticoagulation was used in 20 pregnancies in 19 patients (group 2). In
      group 1 there were three instances of acute valvular thrombosis during the 35
      pregnancies in patients with mechanical prostheses, with two maternal deaths.
      There were two episodes of cerebral embolism, one in group 1 and one in group 2.
      Patients with isolated aortic valve replacement had fewer maternal complications
      (2 of 13) than patients with isolated mitral valve replacement (15 of 42) without
      statistical significance. Severe bioprosthesis dysfunction occurred in 4 of 25
      pregnancies (one rupture and three stenosis) with two maternal deaths, one in the
      puerperium and the other in the postoperative period of cardiac surgery during
      pregnancy. When analyzing obstetric events we observed seven spontaneous
      abortions and one hydatidiform mole. All spontaneous abortions occurred in group
      1. The incidences of prematurity and low birth weight were significantly higher
      in group 1 than in group 2 (46.6% vs 10.5%, p less than 0.05, and 50% vs 10.5%, p
      less than 0.05, respectively). Moreover, there was a significant association
      between prematurity and the mother's New York Heart Association functional class
      (61.5% in classes III and IV vs 22.2% in classes I and II, p less than 0.05).
      There were five neonatal deaths, all in group 1 (p = NS vs group 2). Three
      infants had warfarin-related congenital defects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636586
TI  - Heredity and hypertension: impact on metabolic characteristics.
AB  - This study was performed to evaluate the possible role of heredity in the
      clinical characteristics of hypertension. Metabolic, endocrine, and renal
      measurements were compared in subjects with normal blood pressure who had a
      family history of hypertension (n = 60) with those of subjects with normal blood
      pressure who did not have a family history of hypertension (n = 48). The groups
      were matched for age (mean, 44 +/- 2 years and 45 +/- 2 years) and blood pressure
      (127 +/- 1/77 +/- 1 mm Hg and 127 +/- 2/77 +/- 1 mm Hg). The following parameters
      were higher in the patients with a family history of hypertension than in those
      without. Plasma insulin concentrations (14.1 +/- 1.1 vs 10.8 +/- 1.0 microU/ml; p
      less than 0.05), insulin-glucose ratio (0.15 +/- 0.01 vs 0.11 +/- 0.010; p less
      than 0.05), norepinephrine concentrations (315 +/- 24 pg/ml vs 208 +/- 20 pg/ml;
      p less than 0.01), plasma renin activity (2.1 +/- 0.2 ng Angl/ml/hr vs 1.6 +/-
      0.2 ng Angl/ml/hr; p less than 0.02), total cholesterol levels (217 +/- 8 mg/dl
      vs 197 +/- 0.3 mg/dl; p less than 0.05), creatinine clearance (125 +/- 9 ml/min
      vs 96 +/- 8 ml/min; p less than 0.01), and albumin excretion rate (3.2 +/- 0.3
      micrograms/min vs 2.6 +/- 0.3 micrograms/min; p = 0.1). Moreover, patients with a
      family history of hypertension had smaller increases in systolic blood pressure
      during treadmill exercise (55 +/- 3 mm Hg vs 64 +/- 3 mm Hg; p less than 0.03).
      There were no differences in echocardiographic left ventricular mass index
      between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636587
TI  - Assessment of reperfusion after thrombolytic therapy for myocardial infarction.
AB  - The benefits of thrombolytic therapy in reducing the mortality associated with
      acute myocardial infarction are well documented. Presumably, this is on the basis
      of a patent IRA, although other mechanisms may be involved. Because there is a
      25% to 30% failure rate for thrombolytic therapy that is associated with a
      significantly worse prognosis, it is crucial to document reperfusion in a timely
      fashion. In cases of failure to reperfuse, the patient could be considered a
      candidate for secondary mechanical intervention. While coronary arteriography is
      presently the "gold standard" to document reperfusion, this is an invasive
      procedure associated with small but defined risks for the patient. A noninvasive
      marker that is readily available and highly accurate is most desirable. There are
      a number of methods currently used to document coronary reperfusion
      noninvasively. This review discusses the advantages and disadvantages of each
      method, and the need for continued evaluation and refinement in noninvasive
      modalities to identify patients who are candidates for further intervention.

PMID- 1636588
TI  - Advantages and limitations of methods to detect, localize, and quantitate
      intracardiac left-to-right shunting.

PMID- 1636589
TI  - Electrocardiography of myocarditis revisited: clinical and prognostic
      significance of electrocardiographic changes.
AB  - To clarify the clinical and prognostic value of the ECG, an ECG review was
      undertaken in 45 consecutive patients with a histologic diagnosis of active
      myocarditis (29 men and boys and 16 women and girls; age, 36.8 +/- 15 years;
      idiopathic myocarditis, 39 cases). In patients (21) with symptoms of recent onset
      (less than or equal to 1 month) AV block and repolarization abnormalities were
      the prevailing ECG features at the time of admission, and a pseudoinfarction
      pattern (Q waves plus ST-segment elevation) frequently heralded a rapidly fatal
      course ("fulminant myocarditis"). Left atrial enlargement and atrial
      fibrillation, left ventricular hypertrophy and LBBB, which prevailed in patients
      who had symptoms for longer periods, corresponded to the most severe degree of
      left ventricular dysfunction during the initial hemodynamic and echocardiographic
      evaluation. The overall mortality rate after 58 +/- 24 months from the time of
      diagnosis was 29%. Abnormal QRS complexes and LBBB were markers of poor survival,
      independently of initial indexes of left and right ventricular function, both of
      which indicate an increased propensity for sudden cardiac death.

PMID- 1636590
TI  - New developments in pharmacologic stress imaging.
AB  - The clinical usefulness of cardiac imaging modalities that rely upon the
      detection of perfusion defects and wall motion disturbances requires conditions
      that provoke a heterogeneity of coronary flow and a myocardial oxygen imbalance,
      respectively. Traditionally, this has been achieved by exercise stress testing.
      Many patients cannot perform dynamic exercise sufficiently for various reasons.
      Pharmacologic stress has been proven to be an attractive alternative for physical
      exercise. Currently, several stressing agents are used in conjunction with
      thallium-201 scintigraphy, 2-D echocardiography and, recently, MRI. The most
      employed agents include vasodilators, such as dipyridamole and adenosine, and
      catecholamines, such as dobutamine (Table VI). The predominant rationale of
      thallium-201 perfusion scintigraphy is based on the creation of a flow
      maldistribution between territories supplied by normal arteries and those
      supplied by stenotic arteries that does not necessarily require ischemia.
      Dipyridamole and adenosine, as rather selective coronary vasodilators, are well
      suited to provoke such a condition and may be classified as the ideal markers of
      myocardial perfusion. 2-D echocardiography and MRI have the potential to provide
      noninvasively derived information of cardiac dynamics and regional myocardial
      function. To assess the functional significance of coronary artery disease,
      detection of wall motion abnormalities and alterations in ejection fraction
      require the presence of myocardial ischemia. Dobutamine, as a widely applied
      inotropic agent in the management of severely depressed left ventricular
      contractile function, seems to be an appropriate pharmacologic stressor when
      heart failure is absent. By increasing contractility, heart rate, and systolic
      arterial pressure, it is capable of inducing an imbalance between myocardial
      oxygen demand and supply, leading to ischemia in patients with coronary artery
      disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636591
TI  - The pathologic changes in the conduction system beyond the age of ninety.
AB  - The conduction systems of two women who were 92 and 91 years of age,
      respectively, were examined by serial section. The first patient had sick sinus
      syndrome for more than 20 years, and the second patient had intermittent complete
      AV block that alternated with normal sinus rhythm for 12 years before her death.
      Both patients had severe coronary artery disease and had pacemakers and were
      doing well. The conduction systems in both revealed fatty metamorphosis in the
      approaches to the SA and AV nodes, the SA node, the AV node, and the atria with
      fibrotic changes in the ventricular septum, the AV bundle, and the bundle
      branches. Patient 1 had normal SA nodal artery and patient 2 had extensive
      vascularization of the AV node. As the heart ages, fatty replacement of the atria
      affect the SA and AV nodes, and fibrotic changes of the ventricular septum affect
      the AV bundle and the bundle branches. Adequate collateral anastomosis to the
      conduction system may prevent the development of permanent complete AV block in
      the elderly.

PMID- 1636592
TI  - Biventricular apical rupture and formation of pseudoaneurysm: unique flow
      patterns by Doppler and color flow imaging.

PMID- 1636593
TI  - Unsuspected third coronary artery in a candidate for coronary bypass surgery.

PMID- 1636594
TI  - Ventricular tachycardia in a patient with congenital coronary arteriovenous
      fistula.

PMID- 1636595
TI  - Vasospastic angina in Crow-Fukase syndrome.

PMID- 1636596
TI  - Myocardial infarction associated with anabolic steroid use in a previously
      healthy 37-year-old weight lifter.

PMID- 1636597
TI  - Acute arteritis after coronary angioplasty.

PMID- 1636598
TI  - Fibrinolytic therapy for superior vena cava and right atrial thrombosis:
      diagnosis and follow-up with biplane transesophageal echocardiography.

PMID- 1636599
TI  - Transesophageal echocardiographic evaluation of intracardiac lymphoma.

PMID- 1636600
TI  - Myocardial entrapment by lymphoma: a cause of reversible segmental left
      ventricular dysfunction.

PMID- 1636601
TI  - Spontaneous contrast echoes in pericardial effusion: sign of gas-producing
      infection.

PMID- 1636602
TI  - Posterior mediastinal masses: rare causes of cardiac compression.

PMID- 1636603
TI  - Variation in Doppler-derived stenotic aortic valve area during ejection.

PMID- 1636604
TI  - Heart transplant in Ebstein's anomaly with endocardial fibroelastosis.

PMID- 1636605
TI  - Verapamil-induced gingival hyperplasia in children.

PMID- 1636606
TI  - Aortic dissection following intraaortic balloon insertion: recognition by
      transesophageal echocardiography.

PMID- 1636607
TI  - The diagnostic value of imaging techniques for aortic dissection.
AB  - Previous studies conducted in high-risk populations have reported high predictive
      values and accuracies for diagnostic imaging techniques for aortic dissection. To
      see how these techniques perform in low-risk populations, we used Bayes' theorem
      to calculate predictive values and accuracies for angiography, CT, MRI, and TEE.
      In high-risk populations (disease prevalence = 50%), positive predictive values
      were all greater than 85%. In intermediate risk populations (disease prevalence =
      10%), positive predictive values were greater than or equal to 90% for CT, MRI,
      and TEE, but were 65% for angiography. In low-risk populations (disease
      prevalence = 1%), positive predictive values were 100% for MRI and less than or
      equal to 50% for angiography, CT, and TEE. In all three populations, negative
      predictive values and accuracies were greater than or equal to 85%. From these
      results we conclude that diagnostic imaging techniques for aortic dissection do
      not perform as well in low-risk populations as they do in high-risk populations.

PMID- 1636608
TI  - Magnesium deficiency and sudden death.
AB  - A link between Mg deficiency and sudden death is suggested by a substantial
      number of studies published over the past three decades. Data come from
      epidemiologic, autopsy, clinical, and animal studies. They suggest that: (1)
      Sudden death is common in areas where community water supplies are Mg-deficient.
      (2) Myocardial Mg content is low in people who die of sudden death. (3) Cardiac
      arrhythmias and coronary artery vasospasm can be caused by Mg deficiency and (4)
      Intravenous Mg reduces the risk of arrhythmia and death immediately after acute
      myocardial infarction. Because of these data, Mg supplementation has been
      proposed as a possible method of reducing the risk of sudden death. Suggested
      ways of supplementing Mg include public education to change dietary habits,
      addition of Mg to community water supplies, fortification of foods, and oral
      supplementation. Despite the substantial number of studies linking Mg deficiency
      with sudden death, no prospective studies have yet investigated whether large
      scale Mg supplementation is useful for the primary prevention of sudden death.

PMID- 1636609
TI  - Regional changes in body composition by time of year in healthy postmenopausal
      women.
AB  - We examined regional changes in fat, lean, and bone tissue for greater than 1 y
      in 125 postmenopausal women. Duplicate whole-body scans were performed at 6-mo
      intervals. Period 1 was June or July to December or January and period 2 was
      December or January to the following June or July. Lean and bone tissue mass in
      the arms, legs, trunk, and whole body increased in period 1 and decreased in
      period 2 [eg, lean tissue in legs increased 1.84 +/- 0.41% (mean +/- SE) in
      period 1 and decreased 2.84 +/- 0.39% in period 2, P less than 0.001]. In each
      region except the arms, fat tissue decreased in period 1 and increased in period
      2. Quadriceps muscle strength was correlated with lean tissue mass of the legs
      [rp (controlled for height) = 0.24, P V 0.02] and physical activity was
      correlated with quadriceps strength. Overall, body weight did not change
      significantly (0.17 +/- 0.41% increase, P greater than 0.20); however, there was
      a net loss of 1.08 +/- 0.39% (P less than 0.01) in lean tissue in the legs and a
      net increase of 3.43 +/- 1.12% (P less than 0.01) in fat tissue in the trunk.

PMID- 1636610
TI  - Effects of dietary protein deficiency on mineral metabolism and bone mineral
      density.
AB  - The effects of dietary protein restriction on mineral and bone metabolism are
      uncharacterized. We studied growing rats fed a diet low in protein (5%) for 4, 6,
      and 8 wks (n = 10 animals/group) and compared them with animals pair-fed with a
      protein-replete (18%) diet. The low-protein diet rapidly induced a profound
      hypocalciuria that persisted for greater than or equal to 8 wk. Serum calcium and
      phosphorus concentrations were not affected but serum total and free 25
      dihydroxyvitamin D concentrations as well as gastrointestinal calcium absorption
      were lower in the low-protein animals. Skeletal dimensions were reduced in the
      protein-deprived rats but there were no significant differences in bone mineral
      content between control and low-protein animals at 4, 6, and 8 wks. Hence,
      dietary protein deprivation resulted in slower growth but bone mineral density
      was maintained when there was a marked reduction in urinary calcium excretion.

PMID- 1636611
TI  - Impact of diabetic status, dietary intake, physical activity, and smoking status
      on body mass index in NHANES II.
AB  - Individuals with non-insulin-dependent diabetes mellitus (NIDDM) have a higher
      body mass index (BMI) than nondiabetic individuals and it has been reported that
      individuals with NIDDM have more difficulty losing excess weight. To assess an
      independent effect of NIDDM on weight status, analyses were conducted to predict
      BMI with variables previously associated with weight status. Subjects from the
      Second National Health and Nutrition Examination Survey were categorized into
      three groups: individuals with NIDDM and on oral medication, individuals with
      diet-controlled NIDDM, and nondiabetic adults. Additionally, planned orthogonal
      comparisons between these groups were conducted after other predictors were
      controlled for; 9.18% of the variability was explained for men (P less than
      0.001) whereas 12.11% was explained for women (P less than 0.0001), with several
      variables significantly related in each model. An independent effect for diabetes
      status was found in both sexes and there were no differences in BMI between NIDDM
      groups in either sex.

PMID- 1636612
TI  - Total energy expenditure of healthy Swedish women during pregnancy and lactation.
AB  - Total energy expenditure (TEE) was estimated in healthy Swedish women by the
      doubly labeled water method in a longitudinal study during pregnancy and
      lactation. Measurements were made before pregnancy (A); in gestational weeks 16
      18 (B), 30 (C), and 36 (D); as well as 2 (F) and 6 (G) mo after delivery. When
      the results were interpreted, earlier published data regarding resting metabolic
      rate (RMR), energy intake, and energy in breast milk were also considered. TEE
      (MJ/d) and TEE/RMR were 10.5 +/- 2.2 (mean +/- SD) and 1.87 +/- 0.42 (n = 28),
      9.6 +/- 2.8 and 1.65 +/- 0.67 (n = 22), 12.5 +/- 3.4 and 1.82 +/- 0.45 (n = 22),
      12.2 +/- 4.1 and 1.66 +/- 0.52 (n = 19), 10.6 +/- 2.0 and 1.82 +/- 0.41 (n = 23),
      and 10.8 +/- 2.7 and 1.79 +/- 0.42 (n = 23) at A, B, C, D, F, and G,
      respectively. The results indicated that physical activity tended to be decreased
      during early pregnancy. Taking changes in body energy stores into consideration,
      it was estimated that subjects recorded 86% and 77% of their energy intakes at A
      and F respectively.

PMID- 1636613
TI  - Daily energy expenditure in free-living children: comparison of heart-rate
      monitoring with the doubly labeled water (2H2(18)O) method.
AB  - Total energy expenditure (TEE) was measured simultaneously in 36 free-living
      children aged 7, 9, 12, and 15 y over 10-15 d by the doubly labeled water (DLW)
      method and for 2-3 separate days by heart-rate (HR) monitoring. The 95%
      confidence limits of agreement (mean difference +/- 2SD) were -1.99 to +1.44
      MJ/d. HR TEE discrepancies ranged from -16.7% to +18.8% with 23 values lying
      within +/- 10% of DLW TEE estimates. Boys and girls spent 462 +/- 108 and 318 +/-
      120 min/d, respectively, in total physical activity (P less than 0.01). Time
      spent in moderate and vigorous physical activity (MVPA) was 68 +/- 37 min/d by
      younger children (7-9 y) and 34 +/- 24 min/d by older children (12-15 y) (P less
      than 0.001). Younger boys engaged in MVPA (91 +/- 33 min/d) and vigorous physical
      activity (VPA) (35 +/- 15 min/d) significantly longer than younger girls (MVPA,
      39 +/- 16 min/d, P less than 0.001; VPA, 10 +/- 4 min/d, P less than 0.01) as did
      older boys (MVPA, 52 +/- 21 min/d; VPA, 30 +/- 18 min/d) compared with older
      girls (MVPA, 15 +/- 10 min/d; VPA, 8 +/- 5 min/d). HR monitoring provides a close
      estimation of the TEE of population groups and objective assessment of associated
      patterns of physical activity.

PMID- 1636614
TI  - The interactive effects of dietary quality on the growth and attained size of
      young Mexican children.
AB  - Predictors of attained size at 30 mo and growth rate between 18 and 30 mo (eg,
      diet, maternal size, morbidity, age at weaning, and selected environmental
      factors) were investigated by using longitudinal data from 67 Mexican children
      aged 18-30 mo. These children were small because of growth stunting in early
      infancy. Between 18 and 30 mo they grew on average at the 50th percentile of
      National Center for Health Statistics references values for weight, and the 25th
      for length. Size at 30 mo and growth rates were unrelated to energy or protein
      intakes during the previous year, but positively related to consumption of animal
      origin foods. Maternal weight predicted size and growth only for children with
      larger intakes of animal products. Individual rates of weight and length growth
      were uncorrelated on average, correlated negatively when animal-product intake
      was low, and positively only when more animal products were consumed. Integrated
      weight and length growth, and the influence of maternal size on growth, may be
      disrupted by poor dietary quality. Different children would be identified as
      malnourished depending on whether weight or length growth was measured.

PMID- 1636615
TI  - Maternal serum folate and zinc concentrations and their relationships to
      pregnancy outcome.
AB  - To evaluate the relationship between folate and zinc, and its effect on pregnancy
      outcome, maternal serum folate and zinc concentrations were determined at 18 and
      30 wk gestation in a defined population of 285 pregnant women as part of a large
      scale study to identify risk factors for fetal growth retardation (FGR). These
      results were correlated with birth weight and Apgar scores of newborn infants and
      with maternal infections during the perinatal period. A weak linear relationship
      was observed between maternal serum folate and zinc concentrations at 30 wk
      gestation. Folic acid supplementation had favorable effects on birth weight and
      Apgar scores of newborns, and reduced prevalence of FGR and maternal infections.
      No significant correlation was found between serum zinc concentration and birth
      weight of infants. The concept that folic acid supplementation has an adverse
      effect on maternal zinc nutriture and pregnancy outcome was not supported.

PMID- 1636616
TI  - Polyamines in human and rat milk and in infant formulas.
AB  - Polyamines are ubiquitous compounds known to be involved in cell proliferation
      and differentiation in many tissues. Enteral administration of these compounds
      has been shown to produce effects in suckling and adult animals. Using HPLC
      techniques, we verified the presence of putrescine, spermidine, and spermine in
      human milk and quantitated their concentration in samples collected from the
      first week up to 4 mo of lactation. Mean values of these compounds ranged (per
      liter) from 0 to 615 nmol putrescine, from 73 to 3512 nmol spermidine, and from
      722 to 4458 nmol spermine. Polyamine concentrations in infant formulas were
      dependent on the protein source, the particular polyamine, and the protein
      concentration of the formula. Concentrations of these three compounds in rat milk
      over the first 3 wk of lactation were higher than in human milk, with spermidine
      being the polyamine most elevated compared with human milk (almost 20-fold
      higher). An artificial formula used for the rearing of suckling rats contained
      trace to immeasurable amounts of polyamines. Our study identifies milk as one
      vehicle for polyamine delivery to the intestinal mucosa of suckling animals.

PMID- 1636617
TI  - Effects of diets rich in monounsaturated fatty acids on plasma lipoproteins--the
      Jerusalem Nutrition Study. II. Monounsaturated fatty acids vs carbohydrates.
AB  - Seventeen male Yeshiva students were randomly allocated to a crossover study with
      two 12-wk dietary periods of monounsaturated fatty acids (MUFAs) vs a
      carbohydrate (CHO)-rich diet while concentrations of saturated (SFAs) and
      polyunsaturated (PUFAs) fatty acids were kept similar. Total plasma cholesterol
      (TC) decreased significantly by approximately 7.7% and low-density-lipoprotein
      cholesterol (LDL-C) by 14.4% on the MUFA diet, whereas on the CHO diet no
      significant change in cholesterol concentrations occurred, in contrast to that
      predicted by the equations of Keys and Hegsted. Concentrations of high-density
      lipoprotein cholesterol (HDL-C) did not change significantly on either diet. On
      the MUFA diet there was a significantly lower proneness to peroxidation of plasma
      and LDL lipids and less extensive metabolism of conditioned LDL by peritoneal
      macrophages. We conclude that dietary MUFAs lower TC and LDL-C concentrations,
      independently of other dietary fatty acids and in addition may reduce the
      susceptibility of LDL to oxidative stress.

PMID- 1636618
TI  - Lipoprotein-containing apolipoprotein A-I: sex-related quantitative and
      qualitative changes in this lipoprotein subspecies after ingestion of fat.
AB  - We investigated the postprandial changes of two species of lipoproteins
      containing apolipoprotein (apo)A-I: lipoprotein containing apo A-I but no apo A
      II (LpA-I), and lipoprotein containing apo A-I and apo A-II (LpA-I/A-II). These
      lipoproteins were isolated from 10 men and 11 women at 0, 4, and 6 h after they
      had eaten butter. In LpA-I, the concentrations of all lipids except triglyceride
      were increased at 4 and 6 h in the women. In the men all lipids were increased
      only at 4 h. The increase of apo A-I concentration was found at 6 h only in the
      women. In LpA-I/A-II, the concentrations of all lipids were increased at 4 h and
      only phospholipid (PL) was increased at 6 h in the women. In the men, free
      cholesterol and PL were increased at 4 and 6 h. The increases of apo A-I and apo
      A-II concentrations were found at 4 and 6 h only in the men. These results
      suggest that the postprandial changes are sex-related and may relate to the
      different incidence of atherosclerotic cardiovascular disorders.

PMID- 1636619
TI  - Gastroileal nitrogen and electrolyte movements after bovine milk ingestion in
      humans.
AB  - Gastric emptying and flow rates of nitrogen and electrolytes (Na+, K+, Cl-, Mg2+,
      Ca2+) were studied in humans after bovine milk ingestion. With water as the
      control, intestinal effluents were collected after meal ingestion at the
      beginning of the jejunum or in the distal ileum. The flow rate of the effluent
      peaked in the first 40-min period after meal ingestion and returned to the
      initial amount within 100 min. After water ingestion the quantity of nitrogen
      recovered in the digesta remained unchanged both in the jejunum and in the ileum
      during the test period. After milk ingestion the nitrogen concentration in the
      jejunal digesta peaked in the first 20 min. Forty-two percent of milk nitrogen
      was absorbed before the jejunum and 93% was absorbed before the end of the ileum.
      These results showed that for the completion of the absorption of dietary
      proteins such as milk proteins, the lower part of the intestine is necessary.

PMID- 1636620
TI  - A method for determining concentrations of retinol, tocopherol, and five
      carotenoids in human plasma and tissue samples.
AB  - To explore the relation between plasma and tissue concentrations of seven fat
      soluble micronutrients (retinol, alpha-tocopherol, lutein, cryptoxanthin,
      lycopene, alpha-carotene, and beta-carotene), we developed methods for clarifying
      plasma and tissue samples and quantitating these seven analytes simultaneously by
      using HPLC with ultraviolet detection. Clarification of tissue samples was
      performed by using enzymatic digestion followed by mechanical homogenization;
      saponification was avoided and tocopherol nicotinate was used as an internal
      standard. Precision and sensitivity for small samples of plasma and solid tissues
      were determined. Accuracy for plasma samples was assessed by comparing results
      obtained by using this method with those obtained by using older, standardized
      methods. Results from application of this method to patient samples of plasma and
      various tissues are presented. This method will be of interest to investigators
      seeking to quantitate these seven micronutrients in solid tissue samples, but
      desiring to avoid the usual saponification step required in most other reported
      techniques.

PMID- 1636621
TI  - Distribution of biotin in human plasma: most of the biotin is not bound to
      protein.
AB  - Estimates of the plasma concentration of biotin differ considerably. Variation in
      detectability of biotin bound covalently to protein is one potential source of
      disagreement. In this study we determined the amount of biotin covalently bound
      to plasma protein. First, greater than 99% of free and reversibly bound biotin
      was removed by dialysis; then greater than 90% of covalently bound biotin was
      released by acid hydrolysis. For plasma samples from 11 normal adults, the ratio
      of covalently bound biotin to free biotin was 0.15 +/- 0.09 (mean +/- SD). Taking
      into account the additional biotin that is reversibly bound to protein, this
      study provides evidence that approximately 12% of total biotin in plasma is
      covalently bound, 7% is reversibly bound, and 81% is free. We conclude that
      covalently bound biotin cannot account for the reported sixfold increase in
      biotin detected after acid hydrolysis. We speculate that the reported increase
      was an artifact caused by substances produced during acid hydrolysis of plasma.

PMID- 1636622
TI  - Metabolism of carotenoid analogs in humans.
AB  - Single oral doses (100 mumol) in peanut oil of 4,4'-dimethoxy-beta-carotene,
      ethyl beta-apo-8'-carotenoate, and beta-apo-8'-carotenal were administered to
      healthy adult male subjects (n = 4-6). Blood samples were taken frequently
      thereafter, and serum carotenoids and retinoids were analyzed by HPLC. The
      metabolism of the three analogs was very different; 4,4'-dimethoxy-beta-carotene
      was oxidized at the 4 and 4' positions but apparently not cleaved, whereas ethyl
      beta-apo-8'-carotenoate was not detectably metabolized, and beta-apo-8'-carotenal
      was extensively converted to its corresponding acid, alcohol, and fatty acyl
      ester and detectably converted to retinyl ester and possibly to two shorter beta
      apocarotenals. Serum concentrations of endogenous retinoids and carotenoids,
      except as noted above, were not affected in any case. Kinetically, the maximum
      serum concentrations, areas under the curve, and mean sojourn times for the three
      analogs differed by 50-, 270-, and 5-fold, respectively. For any given analog,
      however, the fractional standard deviations for these parameters were only 0.2
      0.5.

PMID- 1636623
TI  - Serum copper and zinc in random samples of the population of Northern Ireland.
AB  - Serum copper and zinc concentrations (mumol/L) were measured in nonfasting
      subjects aged 25-64 y participating in two independent population surveys in
      Northern Ireland. In 1983-84, copper in 1144 males was 17.2 +/- 3.1 (mean +/- SD)
      and zinc was 12.1 +/- 1.7 (SD). Copper in 1055 females, neither pregnant nor
      taking estrogens or progestogens, was 19.0 +/- 3.9 and zinc was 11.6 +/- 1.4. In
      1986-87 copper in 1142 males was 17.9 +/- 3.3 and zinc was 13.2 +/- 2.1. Copper
      in 1034 females was 20.1 +/- 3.9 and zinc was 12.7 +/- 2.0. Zinc but not copper
      concentrations decreased from early morning to late afternoon; both were
      unaffected by reported postprandial time. There was a positive relationship
      between copper and age for both sexes but zinc showed only a slight upward trend
      with age. A positive relationship between copper and the aggregation of classical
      risk factors for coronary heart disease was demonstrated.

PMID- 1636624
TI  - Effect of glyburide and omega 3 fatty acid dietary supplements on glucose and
      lipid metabolism in patients with non-insulin-dependent diabetes mellitus.
AB  - Using a random crossover design, we examined the effects of glyburide for 4 wk on
      glucose, insulin, lipid, and lipoprotein metabolism in 10 men with non-insulin
      dependent diabetes (NIDDM) receiving dietary fish-oil concentrates containing
      omega 3 (n-3) fatty acids (8 g/d). Compared with glyburide alone, fasting plasma
      glucose concentrations increased with fish oil. Although glyburide with fish oil
      decreased fasting glucose concentrations, they did not return to baseline. Basal
      insulin concentrations were unaltered by fish oil without or with glyburide;
      however, postprandial insulin concentrations were decreased by fish oil. Although
      total cholesterol and triglyceride concentrations were unchanged, very-low
      density-lipoprotein cholesterol concentrations decreased and low-density
      lipoprotein cholesterol rose and apolipoprotein B concentrations trended higher.
      Thus, glyburide only partially rectified the impaired fuel homeostasis associated
      with fish-oil supplements in patients with NIDDM. Therefore, we do not recommend
      intake of fish oil concentrates containing n-3 fatty acids in patients with
      NIDDM.

PMID- 1636625
TI  - Fat mass in predicting resting metabolic rate.

PMID- 1636626
TI  - Previously undescribed disk-capsule innervation: some speculative thoughts for
      TMD clinicians.

PMID- 1636627
TI  - The holodent system, a new technique for measurement and storage of dental casts.
AB  - A system for producing holograms and for three-dimensional measuring on holograms
      is described. The precision of the system was evaluated when three-dimensional
      measurements were made on (1) a holographic image superimposed on the
      corresponding object and (2) two superimposed holographic images of the same
      object. When a metal test object with sharp well-defined contours, easy to
      reorientate was used, the precision was 0.02 to 0.11 mm for x, y, and z
      coordinates (transverse, longitudinal, and vertical planes). When dental casts
      that have less distinct contours were used, precision was reduced to 0.03 to 0.43
      mm. Precision was high for the x and y coordinates and satisfactory for the z
      coordinate. The system has a precision that is equal to that of previously
      reported methods and may be well-suited for studies of dental positional changes
      in longitudinal materials of study models. Holograms of dental casts may solve
      storage problems by replacing space consuming plaster models.

PMID- 1636628
TI  - Load-deflection characteristics of nickel-titanium alloy wires after clinical
      recycling and dry heat sterilization.
AB  - The desirable mechanical properties of nickel-titanium alloy wires and their
      relatively high cost has prompted many clinicians to recycle these wires.
      Clinical recycling exposes the wires to several weeks or months of mechanical
      stresses and elements of the oral environment, as well as sterilization between
      uses. In a previous study it was noted that clinical recycling combined with cold
      sterilization alters the load-deflection characteristics and surface topography
      of nickel-titanium wires. Whether similar changes in mechanical properties occur
      in wires subjected to repeated clinical use and dry heat sterilization is not yet
      clear. The purpose of this investigation was to determine the effects of in vivo
      recycling interposed by dry heat sterilization (together referred to as clinical
      recycling, CR) on the load-deflection characteristics of nickel-titanium alloy
      wires. To differentiate the effects of dry heat sterilization (DHS) from those of
      CR on the behavior of these wires, a series of wires were also subjected to DHS
      only. Two types of nickel-titanium wires, namely Nitinol and NiTi were subjected
      to a three-point bending test in an as-received condition (T0), after one cycle
      (T1), and two cycles (T2) of DHS or CR. Ten wires comprised each subsample.
      Statistical analyses were done by one-factor repeated measures analysis of
      variance and Scheffe F test. Both DHS alone, as well as CR, produced significant
      changes in the loading and unloading characteristics of Nitinol and NiTi wires.
      However, the changes in the load-deflection characteristics of these wires after
      DHS only were relatively small, and the clinical significance of these changes is
      open to question.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636629
TI  - Force degradation of closed coil springs: an in vitro evaluation.
AB  - This in vitro study was designed to determine the force degradation of closed
      coil springs made of stainless steel (SS), cobalt-chromium-nickel (Co-Cr-Ni) and
      nickel-titanium (Niti) alloys, when they were extended to generate an initial
      force value in the range of 150 to 160 gm. The specimens were divided into two
      groups. Group I included SS, Co-Cr-Ni, and two nickel-titanium spring types (Niti
      1 and Niti 2), 0.010 x 0.030 inch with an initial length of 12 mm. Group II was
      comprised of SS, Co-Cr-Ni, and Niti 3 0.010 x 0.036-inch springs, with an initial
      length of 6 mm. A universal testing machine was used to measure force. A pilot
      study determined the extension required for each spring type, so that the initial
      force was in the range of 150 to 160 gm. Initial force was recorded, and then the
      springs were extended to the respective distances at 4 hours, 24 hours, 3 days, 7
      days, 14 days, 21 days, and 28 days resulting in a total of eight time periods.
      Between the time intervals, all springs were extended to the same initial
      extension on specially designed racks and stored in a salivary substitute at 37
      degrees C. Means and standard deviations of force values, percent force loss, and
      mean extension were statistically analyzed. All springs showed a force loss over
      time. Of the total, the major force loss for most springs was found to occur in
      the first 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636630
TI  - Mandibular remodeling measured on cephalograms. 1. Osseous changes relative to
      superimposition on metallic implants.
AB  - We report the results of a study aimed at quantifying remodeling of mandibular
      surfaces in a sample of growing children who represent those usually treated by
      orthodontists in the mixed and early adult dentition. The sample, 31 patients
      with metallic implants of the Bjork-type, was monitored at annual intervals
      between 8 1/2 and 15 1/2 years of age. (Maxillary remodeling changes for the
      sample have been reported earlier.) The present article reports findings
      concerning changes at condyle, gonion, menton, pogonion, and point B as
      identified on lateral cephalograms. Data are reported in the Frankfort plane
      frame of reference with the cephalograms from different time points superimposed
      on the metallic implants. Mean displacement at condyle was larger than that at
      any other landmark and was similar in magnitude and direction to the observations
      of Bjork when the difference in orientation of the vertical axis in the two
      studies is taken into account. The mean displacement of gonion was in an upward
      and backward direction at an angle of approximately 45 degrees to the Frankfort
      plane. Mean displacements at menton and pogonion were in a downward and backward
      direction but were very small. Mean displacement at point B was somewhat greater
      than that of menton and gonion, oriented in an upward and backward direction.
      Individual variation for most of the parameters measured was sufficiently large
      to warrant the inference that caution should be used when mean values are applied
      to the analysis of individual cases.

PMID- 1636631
TI  - The study of the maxillary sinus areas in different orthodontic malocclusions.
AB  - In the present study, the maxillary sinus areas have been investigated on
      orthopantomographs of 103 male and 86 female subjects either with ideal
      occlusions or with malocclusions. It has been found that malocclusions and sex
      factors have no effect on the size of the maxillary sinuses, and that sex is a
      significant factor only in Angle Class II malocclusions. The female subjects with
      Angle Class II malocclusions have larger maxillary sinuses than the male subjects
      and the other groups of female subjects.

PMID- 1636632
TI  - Mandibular growth estimated by four cephalometric measurements.
AB  - Mandibular growth was estimated by four cephalometric measurements on three
      lateral cephalograms of 21 subjects. The estimates made by three standard
      cephalometric approaches were compared with that made by a "scientific" method.
      The scientific method was based on the change in position of the cephalometric
      landmark condylion on cephalograms orientated on two metal implants inserted in
      the mandible. The other three investigated "standard" cephalometric methods were
      each based on estimating the difference in length between two cephalometric
      landmarks: (1) pogonion-condylion, (2) pogonion-articulare, and (3) maximum
      mandibular length. In general, the individual estimates of the amount of
      mandibular growth by the scientific method and that estimated by each of the
      standard cephalometric methods were not proportional. Some factors affected the
      estimates of mandibular growth. For example, (1) the growth direction of the
      condyle, (2) the change in position of pogonion on the mandible during the
      growth, and (3) the apposition of bone on the chin in some cases. The amount of
      mandibular growth, which is estimated by the standard cephalometric methods, and
      growth velocity curves, which is based on such estimates, are therefore not
      valid. Accordingly, conventional cephalometric analyses are not as reliable at
      traditionally envisaged.

PMID- 1636633
TI  - The effect of clinical use and sterilization on selected orthodontic arch wires.
AB  - The effect of clinical use and various sterilization/disinfection protocols on
      three types of nickel-titanium, and one type each of beta-titanium and stainless
      steel arch wire was evaluated. The sterilization/disinfection procedures included
      disinfection alone or in concert with steam autoclave, dry heat, or cold solution
      sterilization. No clinically significant differences were found between new and
      used arch wires. The direction of load application to the arch wire and the
      particular segment of arch wire tested was found to cause substantial differences
      in generated loads for certain arch wire types.

PMID- 1636634
TI  - Anterior crossbite correction in the early deciduous dentition.

PMID- 1636635
TI  - Chaos theory and fractals.

PMID- 1636636
TI  - Facial height index.
AB  - The ratio of posterior facial height to anterior facial height, called the facial
      height index, is described. The clinical uses of the facial height index are
      discussed. One of its uses is illustrated in the accompanying case report.

PMID- 1636637
TI  - Reconditioning and reuse of orthodontic devices.

PMID- 1636638
TI  - Wilbur J. Prezzano receives Albert H. Ketcham Memorial Award.

PMID- 1636639
TI  - Walter C. Buchsieb and James P. Kerrigan receive AAO Distinguished Service
      Awards.

PMID- 1636640
TI  - Four recipients of the 1991 B.F. and Helen Dewel Award.

PMID- 1636641
TI  - J. Douglas Ware receives Shepard Award.

PMID- 1636642
TI  - Dr. Goldstein receives the Medal of Achievement.

PMID- 1636643
TI  - The biomechanical effects of a sagittal split ramus osteotomy on the relationship
      of the mandible, the hyoid bone, and the cervical spine.
AB  - The effects of a sagittal split ramus osteotomy in correcting mandibular
      retrognathism and prognathism were studied cephalometrically in a group of 25
      patients. The patients were divided into two groups, 18 patients with
      retrognathic mandibles and 7 patients with prognathic mandibles to be corrected
      by means of a sagittal split ramus osteotomy according to Obwegeser Dal Pont. The
      major complications of this type of surgical intervention have been documented in
      literature and are known as (1) a certain degree of relapse, i.e., mandibular
      instability and (2) the development of a permanently disturbed head balance. The
      displacement of the dental, skeletal, and neuromuscular components within the
      craniomandibular complex requires a large adaptive capacity and suggests that the
      patient will develop a forward head posture (anteroposition of the head) after
      both types of surgical intervention. In mandibular advancement, however, the
      initiating mechanism to develop a forward head posture starts in the
      cervicothoracic transition (C6-C7-T1-T2). In mandibular set-back, the discussed
      mechanism will start in the upper cervical area (C0-C1-C2-C3). The different
      pattern of movement of C2 and C3 in mandibular advancement and mandibular set
      back, respectively, confirmed the conclusion that the initiating mechanisms, may
      be found in the cervicothoracic transition and the upper cervical region,
      respectively.

PMID- 1636644
TI  - Oral water intoxication.

PMID- 1636645
TI  - Congenital hypocalcemia: transient or persistent?

PMID- 1636646
TI  - Hemorrhagic shock and encephalopathy syndrome.

PMID- 1636647
TI  - The brass standard.

PMID- 1636648
TI  - Hyperinsulinemic, hypertrophic cardiomyopathy in infancy.

PMID- 1636649
TI  - The effect of pediatric psychologic consultations on the management of adolescent
      suicide attempts in the pediatric service of a general hospital.

PMID- 1636650
TI  - The pediatrician's role in treating gay patients.

PMID- 1636651
TI  - Growing up: health care for adolescents and young adults with chronic conditions.

PMID- 1636652
TI  - Children of prisoners.

PMID- 1636653
TI  - Sudden infant death syndrome in neonates.

PMID- 1636654
TI  - Kindergarten screening tests accurately predict performance in kindergarten.

PMID- 1636655
TI  - Enhancing pediatric resident development through retreats.

PMID- 1636656
TI  - The escalating problem of antimicrobial resistance in Streptococcus pneumoniae.

PMID- 1636657
TI  - Antibiotic-resistant pneumococcal disease in South African children.
AB  - OBJECTIVE: To determine the incidence of antibiotic-resistant pneumococcal
      disease and to compare the presentation and outcome of penicillin-resistant
      infections with penicillin-susceptible infections. DESIGN: Patient series.
      SETTING: General community hospital. PATIENTS: Eighty-three children with
      penicillin-resistant pneumococcal bacteremia or meningitis and 124 children with
      penicillin-susceptible pneumococcal bacteremia or meningitis. SELECTION
      PROCEDURES: Consecutive patients admitted between 1989 and 1991. INTERVENTIONS:
      None. MEASUREMENTS AND RESULTS: Forty percent of community-acquired isolates and
      95% of hospital-acquired isolates were resistant to penicillin. Eighty-three
      (82%) of 101 penicillin-resistant infections were community acquired. Resistance
      to chloramphenicol, tetracycline, and erythromycin occurred in 9%, 12%, and 4% of
      all isolates, respectively. The proportion of penicillin-resistant pneumococci
      with cefotaxime minimum inhibitory concentrations greater than or equal to 0.5
      micrograms/mL increased from 0% in a 1986 study to 21.5% in this study. The sites
      of infection, underlying diseases, and mortality of patients with penicillin
      resistant infections outside the central nervous system did not differ
      significantly from those of penicillin-susceptible infections. CONCLUSIONS: The
      resistance of Streptococcus pneumoniae to beta-lactam antibiotics has increased
      alarmingly in South Africa. Penicillin-resistant and penicillin-susceptible
      pneumococcal infections cause a similar spectrum of illness.

PMID- 1636658
TI  - Patterns of infection after pediatric liver transplantation.
AB  - OBJECTIVE: To characterize the patterns of infection that occur after orthotopic
      liver transplantation in children. DESIGN: Inception cohort, retrospective.
      SETTING: Referral center for liver transplantation, university hospital.
      PATIENTS: Thirty-six consecutive children who underwent orthotopic liver
      transplantation and who survived for at least 48 hours after transplantation.
      INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Twenty-six (72%) of the children
      had at least one infection, and infection caused four deaths. More infections
      occurred when prophylactic antilymphocyte antibodies were given than when they
      were not given (2.9 vs 1.0 infections per transplant). The risk of infection was
      greatest during the first 2 weeks after orthotopic liver transplantation. Most
      infections were caused by bacteria (52 cases), followed by viruses (16 cases) and
      fungi (11 cases). Bacteria were the most common pathogens during all periods,
      except the third and fourth weeks, when viruses predominated. The most common
      primary sites of bacterial infection were abdomen (15 cases), bloodstream (15
      cases), and surgical wound (10 cases); the most frequent isolates were aerobic
      gram-negative bacilli (48% of isolates) and enterococci (19%). Cytomegalovirus
      was the most common viral pathogen (seven cases), and Candida albicans caused all
      fungal infections. Fungal infections were significantly associated with systemic
      antibiotic therapy and abdominal complications. CONCLUSIONS: Characteristic
      patterns of infection occur after pediatric orthotopic liver transplantation, and
      knowledge of these patterns is likely to result in improved care for transplant
      recipients.

PMID- 1636659
TI  - Mumps-associated acute cerebellar ataxia.
AB  - During a mumps outbreak between 1987 and 1988, six children presented with
      symptoms of acute cerebellar involvement as the sole neurologic complication. The
      neurologic symptoms followed parotitis and lasted for up to 3 weeks. Serologic
      evidence was suggestive of recent mumps infection. Symptoms spontaneously
      resolved in all patients without any residual signs or symptoms during 2- to 2.5
      year follow-up.

PMID- 1636660
TI  - A survey of the structure and function of pediatric continuity clinics.
AB  - Continuity clinic is a mandated part of all accredited pediatric residency
      programs, yet there are minimal guidelines regarding structure and function. In
      1988, we surveyed 101 residency programs, asking them to describe their
      continuity clinic experience. Eighty-seven residency programs (86%) responded to
      the 40-item questionnaire. The results showed clinics to be similar in many
      aspects, with consistent emphasis on developmental issues and anticipatory
      guidance. Areas of concern included lack of monitoring of the patient panel (31%
      did not monitor), excess care for chronic diseases or handicapping conditions
      (mean, 22% of patients), and lack of training in telephone advice (43% provided
      no such training).

PMID- 1636661
TI  - Unrecognized exercise-induced bronchospasm in adolescent athletes.
AB  - OBJECTIVE--As part of their preparticipation physical examinations, 1241 middle
      and high school student athletes completed a questionnaire and were interviewed
      to elicit risk factors for unrecognized exercise-induced bronchospasm (EIB).
      Spirometry was then performed when the students were at rest. RESEARCH DESIGN-
      All participants completed a questionnaire, were interviewed, and underwent
      baseline testing to determine forced expiratory volume in 1 second (FEV1).
      SETTING--All testing was performed in a school setting. SELECTION PROCEDURES-
      Athletes known to have EIB who were receiving appropriate treatment (46 athletes
      [4%]) and athletes with no risk factors based on medical history and normal
      results of spirometry (847 athletes [68%]) were eliminated from further
      evaluation. Students with medical histories indicating risk of unrecognized EIB
      and students with abnormal results of spirometry were eligible for exercise
      challenge by standard treadmill protocol. MEASUREMENTS AND RESULTS--Of the 348
      eligible students, 230 (66%) completed the exercise challenge. Sixty-six of the
      230 students had greater than 15% reduction in FEV1, and 50 of the 66 students
      had greater than 20% reduction, representing a 29% occurrence of previously
      undiagnosed EIB in a population of students identified with screening to be at
      risk of unrecognized EIB. Of the 179 students identified to be at risk based on
      medical history only, 28% had EIB. Of 33 students with positive results of
      spirometry but no medical history that put them at risk, 15% had EIB. Of the 18
      students with medical histories that put them at risk and positive results of
      spirometry, 61% had EIB. Including the subpopulation with reduction in FEV1 of
      greater than 15%, students shown to be at risk after screening, and students
      previously identified as having EIB, 145 students were identified as having EIB
      (12%). CONCLUSIONS--These data are in accord with results of previously reported
      studies of college and Olympic athletes. The data may have implications for more
      extensive screening in the adolescent population.

PMID- 1636662
TI  - Radiological case of the month. Hydrocolpos in virilizing congenital adrenal
      hyperplasia.

PMID- 1636663
TI  - Radiological case of the month. Patent urachal duct.

PMID- 1636664
TI  - Picture of the month. Cutaneous vascular lesions.

PMID- 1636665
TI  - Synthetic surfactant replacement therapy decreases estimated pulmonary artery
      pressure in respiratory distress syndrome.
AB  - OBJECTIVE: To evaluate the effects of surfactant replacement therapy on the
      pulmonary artery pressure in infants with respiratory distress syndrome. DESIGN:
      Nonrandomized, "before-after" trial. SETTING: Neonatal intensive care unit at a
      referral center. PARTICIPANTS: Ten preterm infants with respiratory distress
      syndrome. INTERVENTIONS: Administration of two or four doses of an exogenous
      synthetic surfactant at 12-hour intervals. MEASUREMENTS AND RESULTS: Systolic
      pulmonary artery pressure was estimated by measuring tricuspid regurgitant flow
      velocity with the Doppler method before and, on average, 45 minutes after
      administration of synthetic surfactant. Measurable recordings were technically
      obtainable on 18 of 23 occasions. Surfactant instillation decreased pulmonary
      artery pressure significantly on 17 of 18 occasions, but did not change the
      systemic blood pressure. Twelve hours after surfactant treatment, pulmonary
      artery pressure measured on nine occasions returned to the pretreatment level. No
      change in the velocity or magnitude of the ductal left-to-right shunting due to
      exogenous surfactant was found. CONCLUSIONS: Synthetic surfactant replacement
      therapy in infants with respiratory distress syndrome induces a significant, but
      transient decrease in systolic pulmonary artery pressure with no effect on the
      ductal shunt.

PMID- 1636666
TI  - Agnogenic myeloid metaplasia in children.
AB  - Agnogenic myeloid metaplasia is a chronic myeloproliferative disorder
      characterized by splenomegaly, leukoerythroblastosis, extramedullary
      hematopoiesis, teardrop-shaped red blood cells, and fibrosis of the bone marrow.
      It is a disease of adults, with only one case report in the pediatric literature.
      The symptoms of the patient in this case clearly fit the diagnostic criteria of
      this disease. Myelofibrosis in children is usually of the acute type, presenting
      in infancy and running a fulminant, fatal course with minimal or mild
      splenomegaly. Red blood cells are usually normal on morphologic examination.
      Three infants, including two siblings, presented at ages 9, 10, and 16 months
      with clinical and laboratory findings consistent with agnogenic myeloid
      metaplasia. The occurrence of the disease in these siblings is suggestive of an
      autosomal recessive mode of inheritance.

PMID- 1636667
TI  - Infant deaths due to unintentional injury. An 11-year autopsy review.
AB  - OBJECTIVE: The number and causes of unintentional infant deaths were determined
      to identify common, preventable infant deaths. DESIGN: Retrospective autopsy
      review. SUBJECTS: Infants aged 1 day to 1 year undergoing complete autopsies.
      SETTING: Autopsies performed by the Louisville Office of the Kentucky Medical
      Examiner's Program from 1979 through 1989. METHOD: The manner of death was
      designated as an "accident" based on review of autopsy findings, scene
      investigation, and investigation by law enforcement officials. The cases were
      divided into groups based on the nature of the unintentional injury. RESULTS:
      Causes of death included asphyxia in mechanically unsafe sleeping environments,
      overlying, drowning, scald burns, plastic bag suffocation, house fires, motor
      vehicle collisions, aspiration of foreign bodies, hypothermia, blunt head trauma,
      and alcohol toxicity. The largest group of deaths in this series resulted from
      mechanically unsafe sleeping environments. CONCLUSIONS: The majority of deaths in
      this series could have been prevented by minor changes in the household
      environment. The causes of fatal unintentional injury to infants are different
      from those in older children. Pediatricians should be aware of hazards unique to
      this age group.

PMID- 1636668
TI  - The maturation of morphine clearance and metabolism.
AB  - OBJECTIVE: To determine how early in childhood the clearance of morphine sulfate
      reaches that in adults. DESIGN: Patient series. SETTING: Children's Hospital and
      Medical Center, Seattle, Wash. PARTICIPANTS: Forty-nine children aged 1 day to
      2.5 years with normal renal and hepatic function. All children were receiving a
      constant rate intravenous infusion of morphine for postoperative analgesia for
      greater than 24 hours. INTERVENTIONS: Blood and urine samples were collected
      during infusion and immediately after discontinuation of the morphine infusion.
      MEASUREMENTS: Morphine concentrations were determined and clearance was
      calculated using the infusion data. Half-life and volume of distribution were
      calculated using the postinfusion data. The formation of metabolites was
      evaluated using the urine data. Morphine clearance increased with age, median
      clearances ranging from 5 mL/kg per minute in neonates aged 1 to 7 days to 21
      mL/kg per minute in infants aged 6 months and older. This change in clearance
      correlated with age. The formation clearance of morphine glucuronide was
      correlated with age, whereas the formation clearance of morphine sulfate and the
      renal clearance of morphine were independent of age. CONCLUSIONS: Morphine
      clearance reaches adult values by age 6 months to 2.5 years. In contrast to
      previous reports on the maturation of sulfate conjugation, it does not appear
      that morphine sulfate clearance is enhanced relative to glucuronidation in early
      infancy.

PMID- 1636669
TI  - The importance of spirometry in the assessment of childhood asthma.
AB  - OBJECTIVE: To assess the pulmonary function of children with asthma at the time
      of a routine follow-up visit when they were judged to be clinically well. DESIGN:
      Pulmonary function tests were performed on children with a previous diagnosis of
      asthma. None had had any symptoms for at least 6 weeks. All had normal Wright
      peak flow rates and normal findings at physical examination. SETTING: General
      pediatric and pediatric pulmonary clinic at a municipal hospital in the Bronx,
      NY. PATIENTS: Sixty-five children with asthma who fit the above criteria. All
      were able to perform spirometry adequately. Their mean (+/- SD) age was 11 +/- 3
      years, and their median age was 10 years. SELECTION PROCEDURES: All clinic
      patients were screened as possible participants. The 65 patients were deemed
      eligible, and were willing and able to perform spirometry. INTERVENTIONS: None.
      MEASUREMENTS AND RESULTS: The group's mean (+/- SD) forced expiratory volume in 1
      second/forced vital capacity ratio was 80% +/- 8%, and their mean mid-maximal
      expiratory flow was 66% +/- 23% of the predicted value. Of the 65 patients, 11
      (17%) had forced expiratory volume in 1 second/forced vital capacity ratios of
      less than 72%, and 35 (54%) had a mid-maximal expiratory flow of less than 65% of
      the predicted value. CONCLUSION: Failure to perform spirometry in children with
      asthma results in underdiagnosis of airflow obstruction. This may result in
      obstruction persisting into adulthood and/or progression to hyperinflation.

PMID- 1636670
TI  - National trends in pediatric resident recruitment.
AB  - Primary care residency programs throughout the nation are having increasing
      difficulty recruiting sufficient residents. Only 65% of pediatric residency
      positions are filled with medical graduates from the United States. We sent a
      questionnaire to pediatric residency program directors throughout the country to
      assess what changes pediatric programs had implemented in response to matching
      concerns. Forty-one percent had recruited non-house officer professionals to
      perform resident-type work. Such professionals included osteopathic and/or
      foreign-trained physicians (55%) and moonlighters (49%). House staff work hours
      had been reduced in 35% of programs and on-call frequency in 33%. Sixty-one
      percent had made significant changes in their recruiting practices in the past 5
      years that are described herein. Annual recruiting budgets varied from nothing to
      over $75,000. This survey reveals widespread reduction in resident work load and
      increased intensity in the recruiting process throughout the country.

PMID- 1636671
TI  - Inflammatory cytokines within the central nervous system: sources, function, and
      mechanism of action.
AB  - In recent years, there has been increasing evidence that soluble mediators such
      as cytokines from activated T lymphocytes and macrophages are able to modulate
      the growth and function of cells found within the central nervous system (CNS),
      specifically macroglia and microglia cells. Furthermore, glial cells, upon
      activation, can secrete immunoregulatory factors that influence
      lymphoid/mononuclear cells as well as the glial cells themselves. Thus the
      potential exists for bidirectional communication between lymphoid cells and glial
      cells within the CNS, which in part is mediated via cytokines. This review
      describes various neurological disease states in which both immune and glial
      cells may contribute to inflammation and immunologic events occurring in the CNS.
      The mechanisms by which glial cells both respond to and synthesize a variety of
      cytokines within the CNS and the capacity of glial cells to acquire major
      histocompatibility complex antigens and function as antigen-presenting cells
      within the CNS are described in detail. The implications of these functions,
      cytokine secretion and antigen presentation, by glial cells are discussed with
      respect to neurological diseases associated with autoimmunity and/or
      inflammation.

PMID- 1636672
TI  - Protein kinase C affects microfilaments, bone resorption, and [Ca2+]o sensing in
      cultured osteoclasts.
AB  - The effects of protein kinase C (PKC) in the control of osteoclast activity are
      still unknown. We investigated the role of the enzyme in the control of
      microfilament organization, podosome assembly, bone resorption, and extracellular
      Ca2+ sensing in chicken and rabbit osteoclasts treated with agents known to
      affect PKC activity. Cells were treated for 20 min with a PKC activator [phorbol
      12-myristate 13-acetate (PMA)], a PKC inhibitor (staurosporine), a protein kinase
      A (PKA) inhibitor (H-9), a guanosine 3',5'-cyclic monophosphate-dependent protein
      kinase-PKA-PKC inhibitor (H-7), or with the inactive phorbol, 4 alpha-phorbol, to
      examine microfilaments by decoration with rhodamine-phalloidin. In PMA-treated
      osteoclasts, the number of microfilament-containing adhesion structures
      (podosomes) per cell decreased. However, enlarged microfilamentous cores in
      podosomes and stress fiber-like filaments, otherwise absent in controls,
      appeared. Whereas H-7 induced increase of the number of podosomes, staurosporine,
      H-9, and 4 alpha-phorbol failed to change microfilament organization. Chicken
      osteoclasts received also long-term treatment with the agents in the presence of
      [3H]proline-prelabeled chicken or rat bone particles to measure bone resorption.
      PMA, as well as staurosporine and H-7, stimulated the resorbing activity, whereas
      cells were insensitive to H-9 and 4 alpha-phorbol. Measurement of cytosolic free
      calcium concentration in PMA-treated fura-2-loaded single osteoclasts
      demonstrated a synergistic effect of PKC activation on the inhibitory
      extracellular calcium concentration-sensing mechanism, which was, by contrast,
      blocked by H-7, staurosporine, and H-9 and was insensitive to 4 alpha-phorbol.
      These results indicate that PKC regulates osteoclast activity inducing both
      morphological and functional modifications.

PMID- 1636673
TI  - Protein kinase C does not participate in carbachol's secretory action in T84
      cells.
AB  - We investigated the role of protein kinase C (PKC) in mediating carbachol's
      stimulation of transepithelial Cl- secretion in T84 cells. Direct PKC activation
      with phorbol 12-myristate 13-acetate (PMA) stimulated transepithelial Cl-
      transport (measured as the short-circuit current), demonstrating that PKC could
      interact with the secretory apparatus. Carbachol stimulated PKC activity,
      suggesting that the enzyme might participate in the hormone's action.
      Diacylglycerol metabolism inhibitors (DMIs), known to augment hormone-stimulated
      increases in diacylglycerol levels, potentiated the short-circuit current
      response to carbachol. The effect of DMIs was not due to amplification of
      carbachol-induced increases in PKC activity, however; PKC activity during
      carbachol stimulation was no higher in the presence of DMIs than in their
      absence. Augmentation of carbachol's action by DMIs appeared to be due to the
      direct activation of PKC which, like PMA, stimulated the Cl- conductance of the
      apical membrane (GCl). The effects of DMIs and carbachol on GCl were additive.
      Carbachol itself stimulated GCl but not by activating PKC; staurosporine did not
      blunt the effect of carbachol on GCl. Nor did staurosporine reduce the effect of
      carbachol on transepithelial Cl- secretion. These observations demonstrate that
      PKC does not participate in the secretory action of carbachol in T84 cells and
      suggest that direct PKC activation with DMIs and PMA stimulates an apical pool of
      PKC that is not accessible to carbachol applied to the basolateral membrane.

PMID- 1636674
TI  - Characteristics of membrane currents evoked by photoreleased inositol
      trisphosphate in Xenopus oocytes.
AB  - Photorelease of inositol 1,4,5-trisphosphate (InsP3) from a caged precursor was
      used to study characteristics of Ca(2+)-activated Cl- currents activated in
      Xenopus oocytes by the InsP3-Ca2+ signaling pathway. Photolysis flashes shorter
      than a threshold duration evoked no response, but the current amplitude then grew
      about linearly as the flash duration was further lengthened. Currents directly
      evoked by photorelease of Ca2+ from a caged precursor grew linearly with
      increasing flash duration and showed a small threshold before they were
      activated. However, the major part of the threshold of InsP3-evoked responses
      appears to arise because a certain concentration of InsP3 (estimated to be
      approximately 60 nM) is required to evoke Ca2+ liberation. Subthreshold
      conditioning flashes potentiated responses to subsequent flashes, and the
      potentiation increased linearly with increasing conditioning flash duration
      before abruptly declining. The potentiation decayed exponentially with a time
      constant of approximately 17 s with increasing interflash interval. Currents
      evoked by photoreleased InsP3 began after a latency that shortened from 10 s or
      longer to 100 ms as the photolysis intensity was increased. This dose dependence
      of the latency could be quantitatively explained by the time required for the
      InsP3 concentration to rise above threshold. Intracellular injection of heparin
      (a competitive antagonist at the InsP3 receptor) increased the threshold for
      InsP3 action, as did increased temperature. We conclude that several
      characteristics of InsP3-evoked responses, including their dose dependence,
      latency, and facilitation with paired stimuli, arise because a distinct threshold
      level of InsP3 is required to evoke release of Ca2+ from intracellular stores.

PMID- 1636675
TI  - Effect of forskolin on conductive anion pathways of toad skin.
AB  - The effect of the diterpene, forskolin, on pathways for conductive Cl- transport
      was analyzed using isolated skins of Bufo viridis. Forskolin did not stimulate
      the voltage-activated Cl- movement from mucosa to serosa; the Lorentzian
      component in the power density spectrum, which was present at serosa positive
      clamp potentials under control conditions, decreased significantly. The
      observation that stimulation of cytosolic adenosine 3'-5'-cyclic monophosphate
      (cAMP) by forskolin has no effect on the voltage-activated Cl- transport argues
      against control of this pathway by cAMP. Our data further demonstrate that the
      forskolin-activated Cl- conductive pathway is also permeable for NO3-. This
      pathway was studied in absence of mucosal Cl-, which eliminates Cl- movement
      through the voltage-activated pathway. With SO4(2-) and Cl- on the mucosal and
      serosal sides, respectively, this forskolin-induced pathway displayed a linear
      current-voltage relationship. The associated Lorentzians increased at serosa
      negative clamp potentials. Transepithelial current and plateau value of the
      Lorentzian were related by a quadratic function, which suggests voltage
      independence of number and open-close probability of these conductance sites.
      Morphological sites for voltage-activated and forskolin-induced conductive Cl-
      transport remain to be identified.

PMID- 1636676
TI  - Metabolic substrates can alter postischemic recovery in preconditioned ischemic
      heart.
AB  - The mechanisms that contribute to myocardial cell injury are not well understood.
      Furthermore, the ability of reperfusion conditions to modify ischemic injury is
      unclear. Recent studies have indicated that glucose utilization may improve ionic
      homeostasis. Because considerable derangement of ion concentrations occurs during
      ischemia, glucose utilization may be beneficial when stimulated during the
      reperfusion period. The effects of glycolytic vs. mitochondrial substrates on
      postischemic contractile function, high-energy phosphates and ion balance
      (intracellular Ca2+ and pH) were determined. Reperfusion conditions were compared
      in the "preconditioned ischemic" heart where baseline contractile recovery during
      reperfusion with glucose as the sole exogenous substrate was 74 +/- 5% (n = 10).
      Contractile recovery was determined for reperfusion with pyruvate (14 +/- 2%, n =
      10), pyruvate+glucose (23 +/- 4%, n = 10), deoxyglucose+acetate (25 +/- 4%, n =
      10), and lactate+glucose (60 +/- 11%, n = 10). Contractile dysfunction could not
      be attributed to differences in high-energy phosphate contents. Elevated levels
      of intracellular Ca2+ during reperfusion were, however, correlated with poor
      contractile function. After 20 min of reperfusion, the mean time-averaged
      intracellular Ca2+ values, measured with 19F-nuclear magnetic resonance of 5
      fluoro-1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-loaded hearts,
      were 994 +/- 110 nM (glucose, n = 5), 2,270 +/- 494 nM (pyruvate, n = 5), 2,671
      +/- 419 nM (pyruvate+glucose, n = 5), 2,382 +/- 480 nM (deoxyglucose+acetate, n =
      5), and 1,019 +/- 33 nM (lactate+glucose, n = 5). These results are consistent
      with a beneficial role for glucose utilization during reperfusion, where enhanced
      recovery of contractile function and ionic homeostasis were observed.

PMID- 1636677
TI  - Regulated expression of monocyte chemoattractant protein-1 in normal human
      osteoblastic cells.
AB  - An influx of monocytes is observed in many different physiological and
      pathophysiological states, including bone remodeling and injury. These cells
      appear at early stages of bone formation and repair and persist throughout the
      later stages. In experiments described here, unstimulated normal human
      osteoblastic cells did not produce detectable levels of monocyte chemotactic
      activity. However, interleukin-1 (IL-1)-stimulated normal human osteoblastic
      cells produced a chemoattractant that is similar to monocyte chemoattractant
      protein-1 (MCP-1) at the levels of mRNA expression, protein production, and
      chemotactic activity. Northern blot analysis indicates that IL-1 elicits a dose
      dependent increase in MCP-1 mRNA in normal human osteoblastic cells. Two proteins
      of M(r) 9,000 and M(r) 13,000 were specifically immunoprecipitated with MCP-1
      antiserum from IL-1-stimulated normal human osteoblastic cells. Monocyte
      chemotactic activity from IL-1-treated cells was blocked by MCP-1 antiserum.
      These studies establish that normal human osteoblastic cells can be induced to
      produce monocyte chemoattractants and that this is accounted for by the induced
      expression of MCP-1.

PMID- 1636678
TI  - Citrate transport in proximal cell line.
AB  - Citrate uptake into kidney proximal tubules occurs via an apical dicarboxylate
      transporter and a poorly characterized process in the basolateral membrane. We
      used OK cells, a cell line derived from opossum kidney, to study citrate
      transport in proximal tubule-like cells. Citrate uptake into cell monolayers was
      studied using [14C]citrate with [3H]mannitol as a volume marker. Citrate uptake
      into these cells was sodium dependent and saturable with increasing
      concentrations of citrate. In contrast to previous models, citrate transport was
      altered minimally by changes in pH from 6.2 to 7.0 and increased at pH 7.4 to
      7.8. A variety of di- and tricarboxylates were tested for interaction with
      citrate transport. The dicarboxylates succinate, malate, and oxaloacetate at 1 mM
      concentration inhibited citrate uptake minimally (uptake at least 80% of
      control); one dicarboxylate, alpha-ketoglutarate, did inhibit citrate uptake
      significantly. In contrast, the tricarboxylates isocitrate and tricarballylate
      inhibited citrate uptake significantly, indicating probable competitive
      inhibition with the transport process. These characteristics are distinctly
      different from those of the apical membrane dicarboxylate transporter. 1,2,3
      Benzenetricarboxylic acid, an inhibitor of the mitochondrial tricarboxylate
      transporter, did not alter citrate uptake. In conclusion, the OK proximal cell
      line exhibits a novel citrate transport process compared with the apical
      transport of citrate described in most proximal systems. This transport process
      probably involves the trivalent species of citrate in contrast to the usual
      predominant transport of divalent citrate. This transport process may represent a
      process similar to that in the basolateral membrane of the proximal tubule.

PMID- 1636679
TI  - Participation of fast-activating, voltage-dependent K currents in electrical slow
      waves of colonic circular muscle.
AB  - The plateau phase of electrical slow waves in phasic gastrointestinal muscles is
      critical for excitation-contraction coupling. The plateau appears to depend upon
      a balance between inward Ca2+ current and outward K+ currents that is sustained
      for several seconds. Voltage-dependent, non-Ca(2+)-dependent K currents were
      studied in canine colonic circular muscle cells using the whole cell patch-clamp
      technique. At room temperature, depolarization activated a slow outward current
      that showed little inactivation during 500 ms. Increasing the temperature to 37
      degrees C significantly increased the rate of activation of voltage-dependent
      outward current. The onset of the outward current overlapped the transient inward
      Ca2+ current, suggesting that this K current may act as a brake on the upstroke
      depolarization of electrical slow waves in intact muscles. Voltage-dependent
      outward current was sustained for the duration of test pulses. This current
      balanced the sustained inward current that was also activated at physiological
      test potentials. The outward current evoked by test pulses positive to -20 mV
      inactivated by at least 50% within 500 ms. Half inactivation occurred at -36 mV.
      Voltage-dependent K current was reduced by 4-aminopyridine (4-AP; 1-5 mM), but
      difference currents obtained by subtracting currents elicited from holding
      potentials of -45 mV from currents obtained from holding potentials of -100 mV
      were not affected by 4-AP (1 mM). Studies were also performed on intact muscles
      to test the effects of 4-AP on electrical slow waves. 4-AP increased the
      amplitude and rate of rise of the upstroke potential and increased the amplitude
      and prolonged the plateau phase of slow waves. These data suggest that a rapidly
      activating, inactivating, voltage-dependent K current participates in electrical
      slow waves of colonic circular smooth muscles.

PMID- 1636680
TI  - Interferon-gamma is an inducer of plasminogen activator inhibitor type 1 in human
      orbital fibroblasts.
AB  - Expression of plasminogen activator inhibitor type 1 (PAI-1), an important
      determinant of the pericellular proteolytic environment, was assessed in cultured
      human orbital and dermal fibroblasts. Bidimensional electrophoretic separation of
      total cellular [35S]methionine-labeled proteins revealed multiple isoforms of the
      50-kDa PAI-1 protein (isoelectric point range 5.6-6.3) expressed in dermal
      strains but not in orbital cultures. The addition of human recombinant interferon
      gamma (100 U/ml) to the media for 48 h resulted in a marked induction of PAI-1 in
      the orbital cultures (greater than 50-fold above baseline), whereas the
      expression in dermal cultures was either attenuated or induced modestly (5-fold).
      The identity of the 50-kDa PAI-1 was verified by immunoprecipitation of secreted
      proteins. Indirect immunofluorescence localized PAI-1 to aggregates at the
      ventral undersurface of the monolayer. Interferon-gamma induced several other
      proteins in cultured cells. The observation that untreated orbital fibroblasts do
      not express detectable cell-associated PAI-1 suggests that the pericellular
      proteolytic environment of these cells is regulated ordinarily by other factors.
      The economy of the extracellular matrix of orbital connective tissue may be
      particularly susceptible to the influence of inflammatory cytokines such as
      interferon-gamma.

PMID- 1636681
TI  - Diverse prostaglandin receptors activate distinct signal transduction pathways in
      rat myometrium.
AB  - Attempts were made to identify prostaglandin (PG) receptors in rat myometrium,
      according to the differential rank order of potencies displayed by the natural
      PGs and their analogues, both at the level of second messenger generation and
      contraction. In estrogen-treated rat myometrium, PGs [iloprost = PGI2 greater
      than PGE2 much greater than 16,16-dimethyl (DM)-PGE2; sulprostone = misoprostol =
      0] induced adenosine 3',5'-cyclic monophosphate generation, indicating the
      contribution of a PGI2 receptor. The generation of inositol phosphates was
      stimulated by PGs (PGF2 alpha greater than PGD2 much greater than PGE2 = DM-PGE2
      much greater than iloprost greater than sulprostone = misoprostol = 0),
      reflecting a PGF2 alpha-receptor-mediated process, which was insensitive to
      pertussis toxin (PTX). Contractions caused by PGF2 alpha were closely correlated
      to PGF2 alpha-receptor activation associated with the phospholipase C pathway. By
      contrast, contractions evoked by PGE2, equally mimicked by sulprostone and
      misoprostol, were abolished by PTX and were independent of phospholipase C
      activation. In the pregnant myometrium (day 21), the latter PGE-receptor-mediated
      mechanism also contributed to contractions caused by PGE2 (less than microM
      concn). Phospholipase C activation was coupled not only to PGF2 alpha but also to
      PGE receptors and could be correlated with contractions induced by PGF2 alpha and
      PGE2 greater than microM concn). All PGs tested were coupled to inhibitory G
      protein-mediated adenylate cyclase inhibition, displaying an equipotency that did
      not allow characterization of the inhibitory PG receptors.

PMID- 1636682
TI  - Heat shock increases cytosolic free Ca2+ concentration via Na(+)-Ca2+ exchange in
      human epidermoid A 431 cells.
AB  - This study characterized cytosolic free Ca2+ concentration ([Ca2+]i) in normal
      and thermally injured human epidermoid A 431 cells. The resting [Ca2+]i in normal
      cells at 37 degrees C was 87 +/- 5 nM (n = 105). When cells were subjected to
      hyperthermia (40-50 degrees C), [Ca2+]i increased in a temperature- and time
      dependent manner. The maximal increase in cells exposed to 45 degrees C was
      observed at 20 min; [Ca2+]i returned to normal within 1 h. The heat-induced
      [Ca2+]i increase depended on the presence of external Ca2+. La3+ and Cd2+ but not
      Co2+, verapamil, or nifedipine attenuated the heat-induced [Ca2+]i increase. TMB
      8 partially blocked the increase in [Ca2+]i but pertussis toxin and cholera toxin
      pretreatment did not. The magnitude of the heat-induced [Ca2+]i increase or
      45Ca2+ uptake depended on the presence of extracellular Na+. Heat treatment
      reduced the apparent Michaelis constant for external Ca2+ from 490 +/- 91 to 210
      +/- 60 microM, whereas the maximal velocity remained the same. The intracellular
      Na+ concentration decreased 62.5% after heating. The heat-induced [Ca2+]i
      increase was completely blocked by amiloride (5 microM) and 5'-(N,N-dimethyl)
      amiloride (1 microM). These results suggest heat activates the Na(+)-Ca2+
      exchange system so as to increase [Ca2+]i and reduce [Na+]i.

PMID- 1636683
TI  - Ammoniagenesis in LLC-PK1 cultures: role of transamination.
AB  - The LLC-PK1 renal epithelial cell line has been used as a model system to study
      renal ammoniagenesis and its regulation by metabolic acidosis in vitro.
      Experiments were performed on confluent LLC-PK1 epithelia grown for 10-14 days in
      conventional monolayer technique. After the medium pH was changed from 7.6 to 7.0
      for 24-72 h by lowering the bicarbonate concentration in culture medium, LLC-PK1
      cells responded with an adaptive increase in glutamine consumption and ammonia
      production. The rates of glutamine uptake and ammonia generation displayed a
      ratio of 1:1, i.e., 1 mol ammonia was produced per mole of glutamine consumed.
      Glutamine consumption and ammonia formation were paralleled by an equimolar
      production of L-alanine, indicating that transamination appears to be the main
      ammoniagenic pathway in LLC-PK1 cells. Analysis of the key enzymes of renal
      ammoniagenesis, phosphate-dependent glutaminase (PDG) and glutamate dehydrogenase
      (GDH), revealed no changes in enzyme activities up to 72 h of adaptation. Alanine
      aminotransferase (ALT) activity in LLC-PK1 cells also remained unchanged during
      the adaptation period. Because transamination seems to play a crucial role in
      channeling the metabolic flux in LLC-PK1 ammoniagenesis, experiments were
      performed in which transamination was inhibited by (aminooxy)acetate (AOA). After
      incubation of control and pH 7.0-adapted LLC-PK1 cultures for 24-72 h in 0.2 mM
      AOA, no alanine production was found, but 2 mol of ammonia were formed per mole
      of glutamine consumed, again, without adaptive changes in PDG and GDH
      activities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636684
TI  - Activation of permeabilized neutrophils: role of anions.
AB  - Activation of neutrophils was recently reported to be accompanied by large
      changes in their Cl- content [J. B. Myers, H. F. Cantiello, J. H. Schwartz, and
      A. I. Tauber. Am. J. Physiol. 259 (Cell Physiol. 28): C531-C540, 1990]. The
      significance of these ionic changes to the immune response has not been studied.
      To evaluate the role of intracellular [Cl-], the anionic composition of the
      cytosol was varied in human neutrophils permeabilized by electroporation or by
      treatment with streptolysin O. In Cl(-)-rich media, permeabilized but otherwise
      untreated cells remained quiescent, resembling unstimulated intact cells. In
      contrast, suspension of permeabilized cells in Cl(-)-depleted media elicited
      protein phosphorylation, actin polymerization, secretion of lysozyme, and a
      respiratory burst. The latter was demonstrated by several criteria to be mediated
      by the NADPH oxidase. The responses observed in Cl(-)-depleted media were
      insensitive to pretreatment of the cells with pertussis toxin but were inhibited
      by addition of GDP or by omission of ATP. The data suggest that an early event in
      signal transduction, common to several effectors, is sensitive to the ionic
      composition of the cytosol. This component, possibly a GTP-binding protein, may
      be affected by the anion concentration changes reported to occur during
      physiological stimulation of neutrophils.

PMID- 1636685
TI  - Glucose utilization and insulin action in adult rats submitted to prolonged food
      restriction.
AB  - Glucose tolerance and insulin effects on glucose production and utilization by
      various tissues were studied in 70-day-old anesthetized rats submitted to food
      restriction from the fetal stage. Basal and glucose-induced plasma insulin levels
      were reduced in food-restricted rats without alterations in glucose tolerance.
      Insulin action was quantified by using the euglycemic-hyperinsulinemic clamp
      technique. Glucose turnover rates were measured by using D-[6-3H]glucose.
      Exogenous insulin failed to decrease glucose production in food-restricted rats.
      Weight-related whole body glucose utilization was higher in restricted rats than
      in controls both in the basal (21.9 +/- 0.7 vs. 9.4 +/- 0.6 mg.min-1.kg-1) and
      hyperinsulinemic states (37.5 +/- 1.1 vs. 14.0 +/- 1.2 mg.min-1.kg-1). Local
      glucose utilization by peripheral tissues was estimated by a 2-deoxy-D-[1
      3H]glucose technique. In both basal and hyperinsulinemic conditions glucose
      utilization was increased in various adipose and muscle tissues of the food
      restricted rats as compared with the controls. Thus we conclude that food
      restriction leads to an increase in the insulin-mediated glucose uptake by
      various peripheral tissues and to insulin resistance in the liver.

PMID- 1636686
TI  - Developmental expression of insulin-regulatable glucose transporter GLUT-4.
AB  - The insulin-regulatable glucose transporter (GLUT-4) is expressed in adipose
      tissue and in cardiac and skeletal muscle (D. E. James, R. Brown, J. Navarro, and
      P. F. Pilch. Nature Lond. 333: 183-185, 1988). We examined GLUT-4 development
      between postnatal days 1 and 41 (P1-P41) in male and female rats in these tissues
      by quantitative immunoblotting. GLUT-4 was detectable in each tissue at
      comparable levels at P1. However, the subsequent patterns of GLUT-4 development
      were distinctive. GLUT-4 increased in the diaphragm after P7, peaked at P20, and
      then declined. GLUT-4 expression in the heart increased rapidly after P7 to
      plateau on P41 at levels four times greater than the diaphragm. In sharp
      contrast, adipose tissue expression was highest between P3 and P5 but declined to
      a nadir at P20 before rebounding at P34. These patterns were observed for both
      sexes within each tissue, but female GLUT-4 expression was higher in diaphragm
      and heart and lower in adipose tissue. The expression of GLUT-4 appears to be
      regulated in a tissue-specific manner by a developmental program that may
      coordinate the expression of other proteins of metabolic importance.

PMID- 1636687
TI  - Osteocalcin and its message: relationship to bone histology in magnesium-deprived
      rats.
AB  - These studies examine effects of brief Mg deprivation on bone histomorphometry
      and on secretion and synthesis of the specific osteoblast product, osteocalcin.
      Osteocalcin mRNA was determined in calvaria-derived cells and was correlated to
      circulating concentrations of the protein after 8 days of Mg deprivation.
      Circulating osteocalcin was decreased in Mg-deprived rats when compared with pair
      fed normal rats after 8 days of Mg deprivation, with no significant changes in
      calcium or 1,25-dihydroxyvitamin D [1,25(OH)2D]. Serial sampling demonstrated a
      difference in osteocalcin levels by 2 days of Mg deprivation, before any changes
      in circulating calcium or parathyroid hormone were present. Although circulating
      osteocalcin is decreased in Mg-deprived animals, levels can be stimulated with
      1,25(OH)2D3. Osteocalcin mRNA is reduced after Mg deprivation, suggesting that
      low circulating levels are due, at least in part, to reduced osteocalcin
      synthesis. Mg-deprived rats had diminished bone volume and abnormal histological
      features consistent with disorganized and chaotic bone remodeling. These findings
      indicate that low-Mg intake during growth can alter the quality and quantity of
      bone and suggest that Mg deprivation may contribute to the development of
      osteoporosis.

PMID- 1636688
TI  - Decreased T4-to-T3 conversion in brown adipose tissue of Zucker fa/fa pups before
      the onset of obesity.
AB  - To determine whether the capacity of thyroxine (T4)-to-3,5,3'-triiodothyronine
      (T3) conversion was altered in Zucker fa/fa pups, we measured thyroxine 5'
      monodeiodinase (T(4)5'D) activity in brown adipose tissue (BAT) and liver of
      suckling and weaned fa/fa and Fa/fa littermates. In suckling fa/fa compared with
      Fa/fa rats, T(4)5'D was reduced by 30-55% in BAT and slightly increased in liver,
      while serum free T3 was significantly decreased (-30%). Altered T(4)5'D activity
      in BAT of fa/fa pups could be corrected by adrenergic stimulation. After weaning,
      in fa/fa rats, the capacity for T4-to-T3 conversion was totally restored in BAT
      while it was dramatically reduced in liver. The concentration of serum free T3
      remained lower in fa/fa than in Fa/fa rats (-40%). These data confirm that BAT is
      a very early site of fa gene expression and are consistent with the hypothesis
      that a defect in the autonomic nervous system may be a primary cause of this
      genetic obesity. It is also suggested that, during suckling, BAT plays an
      important role in systemic production of T3.

PMID- 1636689
TI  - Relationship between aerobic fitness level and daily energy expenditure in weight
      stable humans.
AB  - The relationship between exercise and energy expenditure is unclear, with some
      suggestions that exercise leads to increased energy expenditure over and beyond
      the increase due to the exercise itself. In this cross-sectional study, we
      examined the relationships among aerobic fitness level, body composition, and
      total daily energy expenditure in 78 subjects. Daily energy expenditure
      (determined in a whole room calorimeter) was significantly correlated with both
      fat-free mass (FFM) and aerobic fitness (estimated from maximum aerobic capacity
      or VO2max). However, multiple-regression analysis demonstrated that, after
      accounting for FFM, VO2max did not explain a significant amount of the remaining
      variation in energy expenditure. In addition, the relationship between resting
      metabolic rate and both FFM and VO2max was evaluated using data from 214 weight
      stable subjects analyzed retrospectively. The results were identical with the
      results obtained from the 78 subjects in that VO2max did not have effects
      independent of FFM on energy expenditure. We conclude that aerobic fitness does
      not have a direct effect on energy expenditure. However, it may have effects that
      are mediated through body composition, since in both populations studied here,
      VO2max was positively correlated with FFM and negatively correlated with
      adiposity.

PMID- 1636690
TI  - Thermogenic and hormonal responses to amino acid infusion in septic humans.
AB  - Metabolic effects of a commercially available amino acid infusate were
      investigated in five preoperative patients with abdominal sepsis and five healthy
      subjects. Oxygen consumption (VO2) was measured continuously during the 3-h
      study, and blood samples were taken regularly for hormone and metabolite
      analyses. During 1 h of preinfusion measurements, VO2 was 15% higher (P less than
      0.05) in the septic patients. Preinfusion plasma cortisol, glucagon, and
      catecholamines were also significantly elevated in the septic group. The amino
      acid solution (9 g nitrogen; 950 kJ; 227 kcal) was infused into each subject
      through their central venous catheter during the 2nd and 3rd h of the study. VO2
      increased similarly in both groups by approximately 21% during the infusion (P
      less than 0.05), whereas respiratory quotient increased significantly in only the
      controls (P less than 0.05). Plasma insulin and glucagon concentrations rose
      significantly in both groups during the infusion, despite little change in
      glucose levels. Plasma norepinephrine increased in both groups, although the
      response was significant in only the control subjects. In summary, the amino acid
      infusate stimulated metabolic rate similarly in the septic and nonseptic
      subjects.

PMID- 1636691
TI  - Prednisone-induced osteopenia in beagles: variable effects mediated by
      differential suppression of bone formation.
AB  - To examine the mechanism of glucocorticoid-induced osteopenia and the basis for
      variable bone loss after glucocorticoid administration, we gave prednisone (1.3
      mg.kg-1.day-1) to normal male dogs (n = 15) for 29 wk to attempt induction of
      osteopenia. Compared with age-matched control dogs (n = 14), prednisone treatment
      rapidly decreased spinal bone density by 4.3%, as assessed by quantitative
      digital radiography, and reduced trabecular bone volume by 14.6%, as measured by
      quantitative histomorphology of iliac crest bone specimens. Bone loss was
      attenuated in prednisone-treated dogs after prolonged treatment (greater than 12
      wk). Prednisone treatment resulted in diminished bone formation rates (15 +/- 3.4
      vs. 47 +/- 4.5 microns/yr) and activation frequency (0.4 +/- 0.1 vs. 1.3 +/-
      0.2/day). These findings indicate that suppression of osteoblastic function and
      recruitment is the primary histological abnormality mediating glucocorticoid
      induced osteopenia in beagles. In contrast, prednisone administration had no
      effect on bone resorption or serum concentrations of parathyroid hormone and 1,25
      dihydroxyvitamin D, which suggests that these factors are not essential for
      prednisone-induced bone loss. Moreover, 33% of beagles were totally resistant to
      glucocorticoid-induced osteopenia. Such heterogeneity of bone loss was associated
      with variable suppressive effects of prednisone on osteoblastic function, as
      evidenced by greater bone formation rates and activation frequency in prednisone
      resistant animals. Collectively, these observations suggest that glucocorticoid
      induced bone loss results from a dynamic interplay between steroid-mediated
      suppression of osteoblastic function and recruitment and undefined compensatory
      factors that ameliorate the effects of glucocorticoids on osteoblastic
      precursors.

PMID- 1636692
TI  - Epidermal growth factor prohormone is secreted in human urine.
AB  - Examination of adult human urine by immunoblot analysis with antiserum specific
      to human recombinant 6-kDa epidermal growth factor (EGF) reveals the presence of
      an immunoreactive protein with a molecular mass of 165 kDa. This protein is
      consistently found in the morning (first) but not in day urine of adult males and
      females. Day urine contains variable proportions of four other high-molecular
      weight EGFs with approximate molecular masses of 97, 66, 50, and 42 kDa. The 165
      kDa EGF immunoreactive protein reacts with mouse amino-terminal EGF prohormone
      (proEGF) antiserum and comigrates with mouse urinary proEGF, suggesting that the
      protein is the human EGF prohormone. The 165-kDa human proEGF exhibits strong
      binding affinity to concanavalin A, indicating that it is glycosylated.
      Immunoblotting of urine in infants and children of various age groups
      demonstrates the presence of proEGF in all age groups, but its concentration is
      highest in children 2-4 yr of age. These findings, taken together with secretion
      of proEGF of similar molecular mass in mouse and rat urine, suggest that renal
      proEGF secretion is an evolutionarily conserved phenomenon and may have an
      important function or functions distal to the site of its synthesis.

PMID- 1636693
TI  - Erectile and copulatory dysfunction in chronically diabetic BB/WOR rats.
AB  - The pituitary-testicular axis, penile reflexes, and copulatory behavior were
      studied in male BB diabetic rats from 10 to 40 wk of diabetes. Serum testosterone
      was diminished from 18 to 28 wk of diabetes, and the responses to human chorionic
      gonadotropin stimulation were blunted. Serum luteinizing hormone (LH) in diabetic
      rats did not differ from that of the control rats before or after LH-releasing
      hormone stimulation. Serum follicle-stimulating hormone and prolactin levels were
      also similar to controls. After 26 wk of diabetes, androgen-sensitive
      reproductive accessory organs were significantly reduced in size. This also was
      true for the androgen-sensitive bulbocavernosus and ischiocavernosus muscles.
      Penile reflexes in these animals from 20 to 32 wk of diabetes were consistently
      reduced in number and demonstrated prolonged latency. Copulatory behavior was
      evaluated in these animals at 25 and 28 wk of diabetes and revealed a reduced
      number of BB diabetic rats showing normal behavior at 25 wk of diabetes. At 28 wk
      of diabetes, mount latency, intromission latency, ejaculatory latency, and the
      postejaculatory interval were all prolonged compared with controls. In addition,
      the number of diabetic animals showing normal behavior was reduced compared with
      controls. These studies demonstrate that chronically BB diabetic rats develop
      diminished testosterone and erectile dysfunction that precedes ejaculatory
      dysfunction in a similar fashion as impotence in diabetic men. We suggest that
      further studies in this animal model may be critical to the better understanding
      and treatment of impotence in diabetic men.

PMID- 1636694
TI  - Role of GH in regulating nocturnal rates of lipolysis and plasma mevalonate
      levels in normal and diabetic humans.
AB  - To define the role that nocturnal increments in growth hormone (GH) play in
      maintaining lipolysis, glycerol turnover was measured in six patients with GH
      deficiency and six normal subjects during sleep. Glycerol production initially
      decreased in both groups but then increased to 1.44 +/- 0.20 mumol.kg-1.min-1 by
      0800 h in normal subjects, whereas GH deficiency was associated with a continuous
      fall to 0.77 +/- 0.10 mumol.kg-1.min-1, P less than 0.02. Nonesterified fatty
      acid levels paralleled these changes. Six GH-deficient patients received basal GH
      replacement including a pulse during sleep, which resulted in normal fasting
      fatty acid levels (P less than 0.05, replaced vs. chronic deficiency). To assess
      a possible link between the normal nocturnal increase in plasma mevalonate (the
      product of the rate-limiting step in cholesterol synthesis) and sleep-associated
      GH release, 11 GH-deficient patients and 11 normal subjects were studied. Peak
      nocturnal and fasting mevalonate concentrations were not correlated with GH
      level. We conclude that nocturnal growth hormone secretion is essential for
      maintaining lipolysis but that it is not related to normal increments in
      mevalonate and, by inference, to cholesterol synthesis during sleep.

PMID- 1636695
TI  - Use of [3-3H]glucose and [6-14C]glucose to measure glucose turnover and glucose
      metabolism in humans.
AB  - [3-3H]glucose is frequently used to measure glucose turnover in humans. If
      fructose 6-phosphate-fructose 1,6-diphosphate cycling (Fpc) is negligible in both
      liver and muscle, then [3-3H]- and [6-14C]glucose (corrected for Cori cycle
      activity) should provide equivalent measures of glucose turnover. In addition, if
      glycogenolysis is fully suppressed, then [14C]lactate specific activity should
      equal that of [6-14C]glucose from which it was derived, and oxidation of [6
      14C]glucose, as measured by rate of generation of 14CO2, should equal total
      glucose oxidation (i.e., that derived from intra- and extracellular pools) as
      measured by indirect calorimetry. To address these questions, glucose turnover
      was measured simultaneously with [3-3H]- and [6-14C]glucose in the basal state
      and in presence of low (approximately 200 pM) and high (approximately 750 pM)
      insulin concentrations. Glucose turnover rates measured with [3-3H]- and [6
      14C]glucose were equivalent at all insulin concentrations, indicating that Fpc
      had no detectable effect on measurement of glucose appearance. [14C]lactate
      specific activity was lower (P less than 0.01) than that of [6-14C]glucose in the
      basal state but not during either low- or high-dose insulin infusion, implying
      that all lactate was derived from extracellular glucose. On the other hand,
      glucose oxidation as measured by rate of generation of 14CO2 was lower (P less
      than 0.05) than glucose oxidation as measured by indirect calorimetry during both
      insulin infusions, implying either that suppression of glycogenolysis was not
      complete in all tissues or that one or both of these techniques do not accurately
      measure glucose oxidation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636696
TI  - Plasma leucine kinetics and urinary nitrogen excretion in intensively treated
      diabetes mellitus.
AB  - It is well known that inadequate insulin therapy stimulates body protein loss in
      insulin-dependent diabetes mellitus (IDDM). It is less well known, however, that
      accelerated body protein loss (as indicated by increased leucine oxidation)
      occurs in IDDM even during conventional glycemic control. It is not known whether
      intensified insulin therapy fully normalizes protein oxidation or, more
      importantly, whether such therapy is sufficient to allow the adaptive decrease of
      protein oxidation that normally occurs when protein intake is restricted below
      the customary surfeit level. We used two measures of protein oxidation [daily
      urinary nitrogen (N) excretion over several days of intensive insulin therapy and
      plasma [1-13C]leucine oxidation during short-term strict euglycemia] to assess
      the response of 7 men with IDDM and 12 normal men after adaptation first to a
      control diet providing maintenance energy and conventional (surfeit) protein then
      to an isoenergetic protein-free diet. After adaptation to the protein-free diet
      and during short-term strict euglycemia achieved using intravenous insulin,
      leucine turnover and oxidation decreased equivalently in normal and diabetic
      subjects. However, daily urinary obligatory N excretion, which indicated the
      effect of the low-protein diet and intensive subcutaneous insulin therapy over
      several days, was increased by 18% in the diabetic group (P less than 0.05). Even
      mildly elevated average blood glucose values well within the guidelines for
      intensive therapy were strongly correlated with high rates of urinary N excretion
      (r = 0.97, P = 0.0002). Thus insulin therapy of IDDM that imposes strict
      euglycemia is compatible with a normal ability to diminish body protein oxidation
      in response to protein restriction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636697
TI  - Free and sulfoconjugated catecholamine responses at birth in newborn sheep.
AB  - There have been little data on catecholamine sulfoconjugation in developing
      animals or humans. We studied the differences in free and sulfoconjugated
      catecholamines at birth in newborn sheep. Baseline concentrations of
      sulfoconjugated norepinephrine and epinephrine were the predominant form of
      circulating catecholamine, representing 77 +/- 4 and 65 +/- 12% of total
      circulating catecholamines, respectively. At birth the free epinephrine
      concentration increased 10-fold (49 +/- 27 to 653 +/- 21 pg/ml, respectively),
      and plasma free norepinephrine concentration rose 4-fold (307 +/- 92 to 1,178 +/-
      389 pg/ml). In contrast, there was only a transient twofold increase in the
      sulfoconjugated epinephrine. There was no increase in the sulfoconjugated form of
      norepinephrine. These data demonstrate that, while the near-term newborn sheep
      has a well-developed mechanism for sulfoconjugation of circulating
      catecholamines, this does not occur rapidly. During the logarithmic increases of
      circulating catecholamines at birth, there are not commensurate increases in the
      concentration of sulfoconjugated norepinephrine or epinephrine. Thus
      sulfoconjugation does not appear to represent a significant mechanism for
      inactivation of the high circulating levels of catecholamines seen at birth.

PMID- 1636698
TI  - Dose-response characteristics of human proinsulin and insulin in non-insulin
      dependent diabetic humans.
AB  - We compared the actions of human proinsulin and insulin on glucose turnover and
      on intermediary carbohydrate and lipid metabolism in non-insulin-dependent
      diabetes mellitus (NIDDM). Six diet-controlled weight-matched (25.4 +/- 1.0
      kg/m2) NIDDM subjects underwent six separate isoglycemic clamps. Glucose turnover
      was measured using a primed continuous infusion of [6',6'-2H2]glucose. Each
      subject received three low-dose intravenous infusions of both insulin and
      proinsulin. Blood glucose was maintained at 6.7 +/- 0.3 mM during proinsulin and
      insulin infusion. Insulin (I) infusions gave steady-state levels of 0.12 +/-
      0.001 (I1), 0.18 +/- 0.01 (I2), and 0.33 +/- 0.01 nM (I3). Steady-state
      proinsulin (P) levels were 2.5 +/- 0.1 (P1), 4.3 +/- 0.2 (P2), and 8.8 +/- 0.9 nM
      (P3). Hepatic glucose production was suppressed equally by proinsulin and insulin
      at all doses. The metabolic clearance rate of glucose was significantly increased
      during the insulin infusion compared with proinsulin. The use of [6',6'
      2H2]glucose resulted in a mean underestimation of the glucose infusion rate of
      10.0 +/- 4.0 and 6.0 +/- 2.5% during the two highest insulin and proinsulin
      doses, respectively. Proinsulin had a significantly weaker effect than insulin,
      at the lowest infusion dose, in percent suppression of plasma nonesterified fatty
      acids, blood glycerol, and beta-hydroxybutyrate levels (all P less than 0.05).
      Blood lactate levels were lower during the P1 (628 +/- 43 microM) and P2 (657 +/-
      93 microM) infusions compared with I1 (776 +/- 60 microM) and I2 (878 +/- 44
      microM; P less than 0.05, P less than 0.02), respectively.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1636699
TI  - Mechanism of delayed hepatic glycogen synthesis after an oral galactose load vs.
      an oral glucose load in adult rats.
AB  - We have compared the effects of administration of oral galactose or glucose (1
      g/kg) to 24-h fasted rats to examine the mechanism by which galactose regulates
      its own incorporation into liver glycogen in vivo. Liver glycogen increased to a
      maximum more slowly after galactose than after glucose administration (0.14 vs.
      0.29 mumol.g liver-1.min-1). Glycogen accumulation after the galactose load was
      70% of that after the glucose load (149 vs. 214 mumol), and the net increase in
      liver glycogen represented the same proportion (24 vs. 22%) of added carbohydrate
      after urinary loss of galactose was accounted for. Slower glycogen accumulation
      after galactose vs. glucose loading could not be explained by galactosuria, by
      differences in the active forms of synthase or phosphorylase, by end product
      (glycogen) inhibition of synthase phosphatase, or by different concentrations of
      the known allosteric effectors of synthase R plus I and phosphorylase a. Similar
      increases in glucose 6-phosphate were observed after both hexoses. AMP and ADP
      increased only transiently after galactose administration, and ATP, UTP, and Pi
      concentrations were unchanged. The UDP-glucose concentration decreased, whereas
      the UDP-galactose concentration increased two- to threefold after galactose but
      not glucose administration. The UDP-glucose pyrophosphorylase reaction is
      inhibited competitively by UDP-galactose. This could explain the decreased UDP
      glucose concentration and the reduced rate of glycogen synthesis after galactose
      was given.

PMID- 1636700
TI  - Comparison of indirect calorimetry and a new breath 13C/12C ratio method during
      strenuous exercise.
AB  - A new stable isotope method for the determination of substrate oxidation rates in
      vivo is described and compared with indirect calorimetry at rest and during high
      intensity exercise (30 min at 80-85% maximal O2 uptake capacity) in six well
      trained cyclists. This method uses the absolute ratios of 13C/12C in expired air,
      endogenous glucose, fat, and protein in addition to O2 consumption and is
      independent of CO2 production (VCO2). Carbohydrate and fat oxidation rates at
      rest, calculated by both methods, were not significantly different. During
      exercise the breath 13C/12C ratio increased and reached a steady state after 15
      20 min. Carbohydrate oxidation rates during exercise were 39.4 +/- 5.2 and 41.7
      +/- 5.7 mg.kg-1.min-1 [not significant (NS)], and fat oxidation rates were 7.3 +/
      1.3 and 6.9 +/- 1.2 mg.kg-1.min-1 (NS), using indirect calorimetry, and the
      breath ratio method, respectively. We conclude that the breath 13C/12C ratio
      method can be used to calculate substrate oxidation under different conditions,
      such as the basal state and exercise. In addition, the results obtained by this
      new method support the validity of the underlying assumption that indirect
      calorimetry regards VCO2 as a reflection of tissue CO2 production, during
      exercise in trained subjects, even up to 80-85% maximal O2 uptake.

PMID- 1636701
TI  - Effect of insulin on oxidative and nonoxidative pathways of free fatty acid
      metabolism in human obesity.
AB  - The dose-response relationship between the plasma insulin concentration and
      oxidative and nonoxidative pathways of free fatty acid (FFA) metabolism was
      examined in 11 obese and 7 lean subjects using a stepwise insulin clamp technique
      in combination with indirect calorimetry and infusion of [1-14C]palmitate. The
      fasting plasma FFA concentration was elevated in obese subjects (793 +/- 43 vs.
      642 +/- 39 mumol/l; P less than 0.01) and was associated with an increased basal
      rate of plasma FFA turnover, FFA oxidation, and nonoxidative FFA disposal, i.e.,
      reesterification (all P less than 0.01). Suppression of plasma FFA turnover by
      physiological increments in plasma insulin was impaired in obese compared with
      lean subjects. However, plasma FFA turnover expressed per kilogram fat mass was
      normally suppressed by insulin in obese subjects. Although insulin suppressed
      plasma FFA oxidation to the same extent in lean and obese subjects, inhibition of
      total lipid oxidation by insulin was impaired in the obese group. Obese subjects
      had an enhanced basal rate of nonoxidative FFA disposal, which was suppressed
      less by physiological increments in plasma insulin compared with lean controls.
      Therefore, we conclude that 1) lipolysis in uncomplicated obesity is normally
      sensitive to insulin; the enhanced FFA flux is simply a consequence of the
      increased fat mass. 2) Nonoxidative FFA disposal expressed per lean body mass is
      enhanced in obese subjects and correlates with the increase in plasma FFA
      concentration and fat mass. 3) Enhanced oxidation of intracellular lipids
      contributes to the enhanced rate of total lipid oxidation in obese subjects.

PMID- 1636702
TI  - Multiple cold air exposures change oral triiodothyronine kinetics in normal men.
AB  - The influence of cold exposure on triiodothyronine (T3) kinetics was studied in
      16 men before, during (biweekly), and after 80 (10/wk) cold (4 degrees C) air
      exposures. We used serum values before and up to 24 h after a pharmacological
      oral (o) dose of T3 [76.8 nmol (50 micrograms)] to calculate noncompartmental
      kinetic parameters. To assess the role of thyroxine (T4) and thyrotropin (TSH),
      we administered a replacement dose of T3 [46.0 nmol/day (30 micrograms)] to eight
      men (+T3 group) and placebo to eight others (-T3 group) for the 2-mo study. There
      was no group effect of T3 treatment (+T3) on oral total volume of distribution
      (TVdo), metabolic clearance rate (MCRo), or disposal rate (DRo). TVdo was not
      changed over the study. Cold increased MCRo by 5.4 +/- 2.0 l.day-1.m-2. DRo
      increased with cold by 10.2 +/- 4.4 nmol.day-1.m-2. Although serum TSH, total T4,
      and free T4 decreased by approximately 50% in the +T3 group, the changes in MCRo
      and DRo with cold were not different from those in -T3. We describe that human T3
      kinetics are changed with brief repeated exposures to cold air and that these
      increases in MCRo and DRo do not appear to be dependent on TSH or T4.

PMID- 1636703
TI  - Effects of fish and safflower oil feeding on subcellular glucose transporter
      distributions in rat adipocytes.
AB  - Effects of fish oil feeding on glucose transport systems and cell size in rat
      adipocytes were examined and compared with those of safflower oil or carbohydrate
      feeding under isoenergy intake conditions. Glucose transport activity was
      assessed by measuring 3-O-methyl-D-glucose transport. The concentration of
      erythrocyte type glucose transporter (GLUT-1) and muscle/fat type transporter
      (GLUT-4) was measured by immunoblotting. The amount of each transporter in intact
      cells was estimated by the amount of transporter and protein of each membrane
      fraction and by the recovery of marker enzymes. In cells from safflower-fed rats
      compared with those from carbohydrate-fed rats, insulin-stimulated glucose
      transport activity per cell decreased to 51% after a 1-wk feeding, and cell size
      increase became larger with these effects and continued for at least 4 wk. At 1
      wk of feeding, GLUT-1 and GLUT-4 per cell in plasma membrane from insulin-treated
      cells decreased to 62 and 35%, respectively, with concomitant transporter
      decreases in the low-density microsome fraction. In cells from high-fish oil-fed
      rats in which two-thirds of safflower oil was replaced by fish oil, when compared
      with those from safflower oil-fed rats, insulin-stimulated glucose transport
      activity increased 1.7-fold after 1 wk of feeding with concomitant cellular GLUT
      1 and GLUT-4 increases, but its effect declined thereafter. Parallel with this
      time course, cell size increase was smaller after 1 wk, but this effect also
      declined thereafter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636704
TI  - Duodenal intramural nerves in control of pyloric motility and gastric emptying.
AB  - We have investigated the role of ascending duodenal intramural nerves in the
      control of isolated pyloric pressure waves (IPPW) and liquid gastric emptying. In
      six pigs, the proximal duodenum was transected to interrupt intramural nerves. A
      further six pigs had a sham operation. Four weeks after operation, motility of
      the antrum, pylorus, and duodenum was recorded by side holes and a sleeve sensor.
      Gastric emptying of a 1,000-ml test meal was significantly more rapid in duodenum
      transected animals (P less than 0.0001) during intraduodenal infusion of each of
      isosmolar dextrose (424 ml emptied), fatty acid (335 ml), and amino acids (396
      ml) than in duodenum-intact animals (dextrose: 128 ml; fatty acid: 57 ml; amino
      acids: 192 ml). Associated with this, in duodenum-transected animals infusion of
      each of isosmolar dextrose, fatty acid, amino acids, and hyperosmolar saline
      failed to produce the stimulation of IPPW seen in duodenum-intact animals. In
      both duodenum-intact and -transected animals, supramaximal stimulation by
      intraduodenal infusion of 25% dextrose slowed gastric emptying and stimulated
      IPPW. Ascending duodenal intramural nerves are a major physiological pathway for
      nutrient- and osmolar-stimulated feedback control of pyloric motility and gastric
      emptying.

PMID- 1636705
TI  - Cholecystokinin at physiological levels evokes pancreatic enzyme secretion via a
      cholinergic pathway.
AB  - The mechanism by which physiological concentrations of cholecystokinin (CCK)
      evoke pancreatic exocrine secretion in humans was investigated. CCK octapeptide
      (CCK-8) dose dependently increased trypsin and lipase output in healthy humans.
      Atropine inhibited CCK-8 (10 ng.kg-1.h-1)-stimulated trypsin output by 84.0 +/-
      7.7% and lipase output by 78.6 +/- 9.2%. The inhibition with atropine was much
      less with a CCK-8 dose of 40 ng.kg-1.h-1 (41.8 +/- 6.6% for trypsin and 46.3 +/-
      7.3% for lipase). CCK-8 at 10 ng.kg-1.h-1 produced plasma CCK levels similar to
      postprandial levels (6.0 +/- 1.3 vs. 6.9 +/- 0.8 pM), whereas the 40-ng.kg-1.h-1
      dose produced supraphysiological levels (18.4 +/- 3.1 pM). To evaluate if CCK
      might act via stimulation of cholinergic nerves, in vitro studies were performed
      using rat pancreas. CCK-8 (10 nM-10 microM) stimulated [3H]acetylcholine release
      from pancreatic lobules that was blocked by tetrodotoxin, a calcium-free medium,
      and the CCK antagonist L364,718. In conclusion, CCK-stimulated pancreatic enzyme
      secretion is dependent on cholinergic neural and noncholinergic pathways. In
      humans, CCK infusions, which produce plasma CCK levels similar to those seen
      postprandially, stimulate the pancreas predominantly via a pathway dependent on
      cholinergic innervation. Correlative in vitro experiments suggest that CCK may
      act by stimulation of neural acetylcholine release. In contrast,
      supraphysiological CCK infusions act in part via noncholinergic pathways.

PMID- 1636706
TI  - Stimulation of intramural secretory reflex by luminal distension pressure in rat
      distal colon.
AB  - The effects of distension on epithelial transport were examined by increasing
      intraluminal pressure in the rat distal colon in vitro. Two kinds of preparation,
      one with the musculature intact (intact preparation) and the other with the
      musculature and the myenteric neurons detached (mucosa-submucosa preparation),
      were used and the transmural potential difference (PD) changes were measured. In
      the intact preparation, distension with a luminal pressure of 15 cmH2O for 15 s
      caused a transient increase in PD (the lumen being more negative) of 3.7 +/- 0.6
      mV. The distension-induced increase in PD was largely sustained when the pressure
      was applied for 10 min. Distension caused by intraluminal pressure, if it is of a
      similar degree to that caused by fecal pellets, is enough to elicit a PD
      increase. The distension-induced PD increase was largely abolished by the removal
      of Cl- from the bathing solution, or by the addition of furosemide or bumetanide.
      In the mucosa-submucosa preparation, distension with a luminal pressure of 15
      cmH2O for 15 s caused an increase in PD of 5.8 +/- 0.6 mV. The distension-induced
      increase in PD was partially inhibited by atropine and was further decreased in
      the presence of tetrodotoxin both in the intact and mucosa-submucosa preparation.
      Indomethacin reduced the distension-induced PD increase in both preparations.
      These results suggest that distension by increased intraluminal pressure elicits
      the activation of Cl- secretion, which is mediated by submucosal plexus neurons.
      In addition, this distension-induced reflex is likely to be activated by normal
      fecal pellets.

PMID- 1636707
TI  - Role of chloride ions in lower esophageal sphincter tone and relaxation.
AB  - Studies were performed in strips of opossum lower esophageal sphincter (LES)
      muscle in vitro. External Cl(-)-free Krebs solution (0[Cl-]o) inhibited resting
      tone. Treatment with the Cl- channel blocker diphenylamine-2-carboxylate (DPC,
      0.3-100 microM) caused a concentration-dependent relaxation of LES muscle, as did
      treatment with 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS, 1 microM
      3 mM), a Cl(-)-HCO3- exchange blocker, and bumetanide (0.3-100 microM), a blocker
      of the Na(+)-K(+)-2Cl- cotransport. DIDS and bumetanide are also known to cause
      Cl- channel block. The calculated pD2 and Emax values for DPC, DIDS, and
      bumetanide were 5.24 +/- 0.28 (n = 5), 3.38 +/- 0.16 (n = 5), and 4.49 +/- 0.23 M
      (n = 5), and 78.80 +/- 5.38, 74.80 +/- 6.54, and 83.70 +/- 10.20%, respectively.
      The neuronal Cl- channel activators gamma-aminobutyric acid and glycine had no
      effect on the resting tone. DPC, DIDS, and bumetanide appear to have acted
      directly on smooth muscle rather than indirectly through the release of
      inhibitory neurotransmitters because LES relaxation by these agents was not
      influenced by tetrodotoxin (10 microM), which blocks action potentials in nerves,
      or by omega-conotoxin (1 microM), which inhibits the release of neurotransmitters
      from nerve terminals. LES muscle relaxed by exposure to 0[Cl-]o, DPC, DIDS, and
      bumetanide contracted with the addition of carbachol (30 microM); muscle so
      treated was resistant to the inhibitory neurotransmitter-mediated relaxation
      ordinarily induced by electrical field stimulation (EFS, 0.12-32 Hz). This effect
      was not nonselective, as the EFS-resistant muscle relaxed fully with
      isoproterenol (0.1-100 microM). HCO(3-)-free Krebs in the nominal absence of CO2
      did not affect the resting tone and its relaxation. The Ca2+ channel blocker
      nifedipine decreased resting tone but did not antagonize the relaxation of
      carbachol-contracted muscle induced by either EFS or isoproterenol. These studies
      suggest that Cl- may play an important role in LES tone and relaxation due to
      inhibitory neurotransmitter released from intramural nerves.

PMID- 1636708
TI  - Neurohormonal mechanism of pancreatic exocrine secretion stimulated by sodium
      oleate and L-tryptophan in dogs.
AB  - In the present investigation, we have studied the effect of atropine on the
      pancreatic secretion stimulated by intraduodenal administration of either sodium
      oleate or exogenous cholecystokinin (CCK). In four dogs prepared with gastric and
      Thomas duodenal cannulas, pancreatic juice was collected for measurement of
      volume, bicarbonate, and protein output, and peripheral venous blood samples were
      obtained for radioimmunoassay of both secretin and CCK. Volume, bicarbonate, and
      protein output of the pancreatic juice increased significantly in response to
      sodium oleate (1-4 mmol/h) in a dose-dependent manner. The increase in pancreatic
      secretion paralleled the increments in both plasma CCK and secretin. Atropine
      given intravenously suppressed completely both pancreatic secretion and release
      of CCK stimulated by sodium oleate, whereas the release of secretin was not
      affected. Pancreatic secretion was significantly increased in a dose-dependent
      manner by exogenous CCK octapeptide (CCK-8) at 16, 32, and 64 micrograms (14, 28,
      and 56 pmol).kg-1.h-1. Atropine inhibited protein output only partially, but it
      did not influence bicarbonate output. In five additional dogs, the effect of
      atropine on L-tryptophan-stimulated pancreatic secretion was studied.
      Interestingly, atropine failed to influence the CCK release and pancreatic
      secretion of volume and bicarbonate, except for protein secretion, which was
      significantly inhibited. It was shown previously that atropine inhibited
      significantly the pancreatic secretion of bicarbonate stimulated by secretin in
      physiological doses. Thus we conclude that the inhibition by atropine of the
      pancreatic exocrine secretion stimulated by sodium oleate is mediated by both
      suppression of CCK release and inhibition of action of secretin on the exocrine
      pancreas.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636709
TI  - Pregnancy- and lactation-induced changes in active intestinal calcium transport
      in rats.
AB  - A time course study of active Ca transport in the duodenum and the terminal ileum
      was conducted using the everted gut sac technique during the last week of
      pregnancy and throughout lactation. A triphasic pattern was revealed in the
      proximal duodenum: a marked rise between 18 and 20 days of pregnancy, a plateau
      maintained during the last 3 days of pregnancy and the first 2-3 days of
      lactation, and a fall by day 4 of lactation. The late-pregnancy rise was
      significant also when expressed as milligrams Ca transported relative to tissue
      weight, indicating that intestinal hypertrophy was not the cause of the increase.
      The ratio of serosal to mucosal Ca concentration remained low until approximately
      day 11 of lactation, when it rose toward a new peak. There was no active Ca
      transport in the ileum until the third week of lactation. Serum prolactin levels
      increased 10-fold between 18 and 20 days of pregnancy and remained high until at
      least day 7 of lactation, but did not correlate significantly with duodenal Ca
      transport. Injected rat prolactin did not result in a precocious rise in Ca
      transport in pregnant rats. The fluctuations in duodenal Ca transport during
      lactation were reflected by a small, but statistically significant, decrease in
      net fractional Ca absorption at 6-9 days compared with either 2-4 days or 13-16
      days. We suggest that duodenal active Ca transport plays only a small role in
      total intestinal Ca absorption in the lactating rat except when dietary Ca is
      greatly restricted.

PMID- 1636710
TI  - Chloride-mediated inhibitory junction potentials in opossum esophageal circular
      smooth muscle.

PMID- 1636711
TI  - Evidence for Kupffer cell migration along liver sinusoids, from high-resolution
      in vivo microscopy.
AB  - Kupffer cells are generally considered fixed tissue macrophages of the liver.
      However, we have evidence that this opinion is incorrect. High-resolution in vivo
      video microscopy shows that Kupffer cells have the ability to migrate along
      sinusoidal walls. Images recorded from anesthetized mice show active locomotion
      of cells with or against the direction of blood flow or in the absence of flow.
      The size, changing morphology, and uptake of carbon or microspheres strongly
      suggest that these are Kupffer cells. Quantitative measurements were made on 29
      migrating Kupffer cells. The mean speed of migration was 4.6 +/- 2.6 (SD)
      microns/min and was not significantly different whether migration occurred with
      or against the flow. When fluorescent microspheres were given in vivo as a
      phagocytic challenge, Kupffer cells containing few microspheres migrated more
      slowly (0.9 +/- 0.9 microns/min, n = 10), whereas those containing many
      microspheres were never seen to migrate. Individual Kupffer cells were able to
      move independently, i.e., in directions different from those of neighboring
      Kupffer cells. These findings may have major implications for the role of Kupffer
      cells in scavenging foreign particles and as antigen-presenting cells.

PMID- 1636712
TI  - Effect of erythromycin on gastric myoelectrical activity in normal human
      subjects.
AB  - While a great deal of attention has been paid to the effect of erythromycin (Ery)
      on gastric contractility, its effect on gastric myoelectrical activity, which
      controls gastric motility, remains unknown. In this study, Ery (6 mg/kg) was
      infused intravenously in 14 normal human subjects (placebo controlled). Gastric
      myoelectrical activity was recorded using the surface electrogastrographic
      method. The electrogastrogram (EGG) recordings were analyzed using spectral
      analysis methods. It was found that the presence of the 2-4 cycles/min activity
      (normal slow wave frequency range) in the EGG was 51 +/- 19% in the first hour of
      the intravenous Ery infusion, which was significantly smaller (P less than 0.001,
      t test) than that (72 +/- 20%) during the corresponding control period
      (intravenous saline). This difference was, however, not quite significant (P =
      0.067, t test) in the second hour after the infusions. The average score for
      nausea during Ery was 4.5 (0 for no nausea, 10 for the most severe nausea). We
      conclude that 1) intravenous Ery induces irregularities in the cutaneous EGG in
      normal human subjects; and 2) the noninvasive cutaneous EGG is an attractive
      method both for the investigation of the effects of pharmacological and
      prokinetic agents such as Ery on gastric myoelectrical activity in humans and for
      correlating clinical responses to changes in the EGG.

PMID- 1636713
TI  - Peptidergic nerves mediate post-nerve stimulation hyperemia in rat gut.
AB  - Cessation of perivascular nerve stimulation (NS) elicits a transient increase in
      intestinal blood flow above the prestimulatory value. This enhancement of blood
      flow constitutes the phenomenon of post-nerve stimulation hyperemia (PSH). We
      investigated the involvement of peptidergic sensory nerves in intestinal PSH. In
      anesthetized rats the velocity of blood flowing through the anterior mesenteric
      artery (VBF) was measured with a pulsed Doppler velocimeter. PSH was induced by 4
      min of postganglionic electrical NS (5 Hz). PSH was abolished by distal
      periarterial application of tetrodotoxin and intra-arterial lidocaine, which
      suggests a peripheral sensory nervous mechanism for PSH. The increase in
      conductance at peak PSH was blocked by pretreatment with the selective, primary
      afferent neurotoxin capsaicin administered as 1) subcutaneous injection in
      neonatal life, 2) topical application to periarterial nerves, or 3) injection
      into the jejunal lumen. In rats pretreated with reserpine, NS evoked a hyperemic
      response, which was blocked by capsaicin. Treatment with adenosine deaminase
      inhibited PSH considerably less than capsaicin, suggesting a lesser role for
      adenosine in PSH. Our findings support the hypothesis that postganglionic NS
      activates both adrenergic and peptidergic nerves and that the latter release
      vasodilator peptides in the gut during PSH.

PMID- 1636714
TI  - Differential alterations in microvascular perfusion in various organs during
      early and late sepsis.
AB  - Although cellular dysfunction occurs very early in sepsis, it remains
      controversial whether this is solely due to a decrease in tissue perfusion.
      Recent studies have indicated that while active hepatocellular function was
      depressed, hepatic surface microvascular blood flow (MBF) increased in early
      sepsis but decreased in late sepsis as produced by cecal ligation and puncture
      (CLP). However, it is not known whether microvascular hyperperfusion in early
      sepsis and microvascular hypoperfusion in late sepsis are common events in other
      organs under such conditions. To study this, rats were subjected to sepsis by
      CLP, after which these and the corresponding shams received 3 ml/100 g body wt
      normal saline. Microvascular perfusion and MBF in various tissues were assessed
      by colloidal carbon infusion and laser-Doppler flowmetry, respectively, at 5 h
      (i.e., early sepsis) or 20 h (late sepsis) after CLP or sham operation. Carbon
      perfused areas were quantitated by an Optomax image analyzer. The results
      indicate that the carbon-perfused areas and MBF in the liver, renal cortex,
      spleen, and small intestinal serosa (only MBF) increased significantly 5 h after
      CLP. In late sepsis, however, the carbon-perfused areas and MBF were found to be
      significantly decreased. A highly linear relationship was observed between the
      changes of carbon-perfused areas and MBF during sepsis in the tested organs. Thus
      the microvascular responses in the fluid-resuscitated sepsis model are
      characterized by hyperperfusion in the early stage and hypoperfusion in the late
      stage of sepsis in the tested tissues. The cellular dysfunctions observed during
      the early stage of sepsis are, therefore, not due to any reduction in tissue
      perfusion.

PMID- 1636715
TI  - ATP induces two cholecystokinin binding affinity states in permeabilized rat
      pancreatic acini.
AB  - The influence of adenine and guanine nucleotides on cholecystokinin (CCK)
      receptor binding was examined in streptolysin O-permeabilized rat pancreatic
      acini. Specific binding of tracer to intact acini was 12.1 +/- 0.4% per milligram
      protein, while permeabilized acini bound 34.6 +/- 2.9% (n = 7). The increase in
      binding was also seen when normalized to DNA. Binding to permeabilized acini was
      reduced by the presence of 1 mM ATP to 23.0 +/- 1.3%. Analysis of competitive
      inhibition of tracer binding by unlabeled CCK-8 was consistent with binding to
      two affinity states on intact acini, with the equilibrium dissociation constants
      for the high (KdH)- and low (KdL)-affinity states equal to 41 +/- 5 pM and 5.2 +/
      0.4 nM, respectively; permeabilized acini displayed a single binding site with
      Kd = 598 +/- 40 pM. In the presence of 1 mM ATP, two states were seen on
      permeabilized acini with KdH = 85 +/- 11 pM and KdL = 2.7 +/- 0.6 nM. ATP, ATP
      gamma S, GTP, and GTP gamma S all inhibited binding, with half-maximal inhibition
      occurring at greater than 1 mM, 21 microM, 5 microM, and 0.4 microM,
      respectively. GTP gamma S (1 microM) also induced two affinity states with KdH =
      112 +/- 7 pM and KdL = 1.5 +/- 0.2 nM (n = 3). Binding of CCK to pancreatic
      membranes was also decreased by ATP, and a similar regeneration of two binding
      affinity states was observed. ATP also decreased binding of [125I-Tyr4]bombesin
      to permeabilized acini, but in contrast did not generate two measurable binding
      affinity states.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636717
TI  - Enhanced sinusoidal glutathione efflux during endotoxin-induced oxidant stress in
      vivo.
AB  - Hepatic release of reduced glutathione (GSH) and its oxidation [glutathione
      disulfide (GSSG) formation] were investigated in male Fischer rats in vivo after
      administration of various doses (1-15 mg/kg) of endotoxin (Salmonella
      enteritidis). Endotoxin dose dependently enhanced basal plasma glutathione (9.64
      +/- 0.80 microM) and GSSG (1.08 +/- 0.23 microM GSH equivalents) levels by up to
      450 and 1,300%, respectively, 60 min after administration of the highest dose.
      Determination of arteriovenous differences of plasma glutathione and portal vein
      blood flow demonstrated an increase of basal sinusoidal glutathione efflux (18
      nmol.min-1.g liver wt-1) by 300% 15 min after 5 mg/kg endotoxin. Activation of
      Kupffer cells by retinol enhanced endotoxin-induced release of GSH and its
      oxidation severalfold. Endotoxin enhanced plasma levels of catecholamines;
      however, only an epinephrine-induced not the endotoxin-induced stimulation of
      hepatic GSH efflux was inhibited by adrenergic blockers. Depletion of serum
      complement by cobra venom factor pretreatment completely abolished the endotoxin
      induced increase of GSH release and enhanced GSSG formation. Zymosan-activated
      serum (source of C5a) increased GSSG formation and GSH release. It is concluded
      that endotoxin triggered an extracellular oxidant stress and an increased release
      of hepatic GSH indirectly through complement activation. Increased sinusoidal
      efflux of GSH and its extracellular oxidation may act as a local defense
      mechanism against the potentially deleterious effects of reactive oxygen
      generated by Kupffer cells during their physiological functions.

PMID- 1636716
TI  - Increased lymphatic flux of hyaluronan from cat intestine during fat absorption.
AB  - During fat absorption, chylomicrons with sizes up to 5,000-10,000 A must traverse
      an interstitium that has estimated pore sizes of 120-200 A to reach the lacteals.
      The present experiments were performed to study the behavior of the interstitial
      matrix component hyaluronan during fat absorption from the intestine. Ileal
      segments were isolated and autoperfused in pentobarbital-anesthetized cats. A
      postnodal lymphatic was cannulated, and lymph flow, protein, and hyaluronan
      concentration in lymph were determined. In group 1, a mixture of oleic acid and
      taurocholate was infused into the ileal lumen, while in group 2 the animals were
      fed cream overnight. In group 1, control lymph flow and hyaluronan concentration
      averaged 53.3 +/- 16.0 (SD) microliters.min-1.100 g intestine-1 and 21.4 +/- 16.0
      micrograms/ml, respectively. Administration of taurocholate and oleic acid
      increased lymph flow and lymph hyaluronan concentration by 100 and 50%,
      respectively, resulting in a nearly three-fold increase in hyaluronan flux.
      Subsequent increases in venous pressure increased lymph flow and reduced
      hyaluronan concentration in lymph to less than 3 micrograms/ml. Hyaluronan flux
      remained approximately 2 micrograms.min-1.100 g intestine-1 independent of lymph
      flow. In group 2, no lymph sample was available before administration of fat.
      Hyaluronan concentration at control venous pressure was 19.3 +/- 6.7
      micrograms/ml and fell to 10 micrograms/ml at the highest lymph flow. Hyaluronan
      flux was approximately 10 micrograms.min-1.100 g intestine-1 at the highest lymph
      flow and venous pressure (P less than 0.05 compared with the same lymph flow in
      group 1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636718
TI  - Gallbladder mucosal function: studies in absorption and secretion in humans and
      in dog gallbladder epithelium.
AB  - The gallbladder is conventionally regarded as an absorptive organ such that
      dilute hepatic bile is both stored and concentrated. We studied 35 patients who
      had recovered from a percutaneous transhepatic gallbladder drainage performed for
      acute cholecystitis. After an overnight fast, gallbladder bile was dark brown in
      color and had a wide scatter in the lipid composition. Two hours after a meal,
      the gallbladder bile was opalescent white in color and had the composition of an
      extracellular fluid. This phenomenon was uniformly observed in all 35 patients
      and was also consistently reproducible when five patients were repeatedly
      studied. We used normal dog gallbladder epithelial cell monolayers grown in
      culture and examined sodium flux. Control gallbladder cells absorbed sodium. When
      secretin (0.5-2.5 x 10(-7) M) was added, there was a prompt reversal of sodium
      flux, resulting in net secretion. We conclude that secretion is a physiological
      function of the gallbladder mucosa. After feeding, the neural and humoral factors
      divert stored and newly secreted bile into the duodenum and induce active de novo
      secretion thus producing a gallbladder bile that is opalescent white with no
      lipids. Our results also have important implications on the origin of the
      pathological "white bile," the pathogenesis and treatment of gallbladder sludge,
      as well as the kinetic analysis of compounds undergoing enterohepatic
      recirculation.

PMID- 1636719
TI  - Renal failure increases gastric mucosal blood flow and acid secretion in rats:
      role of endothelium-derived nitric oxide.
AB  - Because of the contradictory findings in clinical studies, and the complete lack
      of animal studies, the purpose of this investigation was to characterize the
      changes in gastric mucosal blood flow (GMBF) and acid secretion in an animal
      model of chronic renal failure. Rats with chronic renal failure induced by
      partial kidney infarction had a significantly higher basal GMBF and lower gastric
      vascular resistance than control rats. The gastric acid secretory and mucosal
      hyperemic response to pentagastrin were markedly enhanced in renal failure rats.
      Because endothelial-derived nitric oxide (NO) is an endogenous vasodilator that
      regulates gastric vascular tone, we hypothesized that NO mediates the gastric
      hyperemia of renal failure rats. The administration of N omega-nitro-L-arginine
      methyl ester (L-NAME), a specific inhibitor of NO formation, produced a
      significantly greater decrease in GMBF in renal failure rats than in control
      rats, including a low dose inhibiting the basal hyperemia in renal failure rats
      but having no effect in control rats. It also attenuated pentagastrin-stimulated
      GMBF in both groups. In contrast, L-NAME produced a similar decrease in basal
      skeletal muscle blood flow in both renal failure and control rats. We conclude
      that in the renal failure rat 1) there is an increased basal GMBF and
      pentagastrin-stimulated acid output and GMBF, and 2) this gastric mucosal
      hyperemia is mediated by NO.

PMID- 1636720
TI  - Uptake of biotin by isolated rat liver mitochondria.
AB  - This study examined the mechanism of biotin uptake by liver mitochondria.
      Mitochondria were isolated from rat liver by an established procedure and
      demonstrated normal respiratory control ratios. Uptake of biotin with time at
      incubation buffer pH 6.1 was rapid and linear and occurred with a distinct
      "overshoot" phenomenon that peaked at approximately 1 min of incubation. At
      incubation buffer pH 7.4, however, uptake of biotin with time was significantly
      slower and no overshoot was observed. Gradual lowering of incubation buffer pH
      from 7.9 to 6.1 caused a similar pattern of increase in uptake of low (0.024
      microM) and high (8 and 30 microM) concentrations of biotin. At incubation buffer
      pH 6.1 and 7.4, uptake of biotin as a function of concentration (0.012-30 microM)
      was linear and occurred at rates of 3.62 and 1.90 pmol.mg protein-1.5 s-1,
      respectively. Addition to the incubation medium of high concentrations of
      unlabeled biotin, its related compounds (biocytin, desthiobiotin, biotin methyl
      ester, thioctic acid, and thioctic amide), or substrates of known mitochondrial
      transporters (succinate, pyruvate, glutamate, malate, and phosphate) failed to
      cause any significant inhibition in uptake of [3H]biotin by mitochondria
      incubated in buffer pH 6.1 and 7.4. Furthermore, preloading mitochondria with
      unlabeled biotin, biocytin, malate, or aspartate failed to cause any significant
      stimulation in biotin uptake. At incubation buffer pH 6.1, treatment of
      mitochondria with the protonophore FCCP caused significant inhibition in pH
      dependent overshoot of biotin uptake. However, treatment of mitochondria with the
      potassium ionophore valinomycin caused significant stimulation in the pH
      dependent overshoot of biotin uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636721
TI  - Submucosal reflexes: distension-evoked ion transport in the guinea pig distal
      colon.
AB  - Muscle-stripped segments of distal colon from guinea pigs were mounted in
      modified flux chambers to determine the effect of distension on mucosal
      secretion. Ion secretion was monitored as changes in short-circuit current (Isc).
      Distending forces were pressure gradients established by controlled reduction in
      liquid volume of the submucosal compartment of the chamber. Volume removal for 10
      s or 5 min evoked a monophasic or biphasic increase in Isc, which returned to
      baseline within 5-20 min. The amplitude of the response correlated with the
      volume removed and was reduced by bumetanide and Cl-free solutions but not by
      tetraethylammonium or amiloride. Tetrodotoxin and atropine also suppressed the
      response. Neither the nicotinic receptor antagonist mecamylamine, the 5
      hydroxytryptamine3 (5-HT3) receptor antagonist ICS 205-930, or the prostaglandin
      synthesis inhibitor piroxicam altered the response. Addition of prostaglandin D2
      to the submucosal bath significantly enhanced the response. The results suggest
      that distension of the colon evokes anion secretion by activation of reflex
      circuits with cholinergic neurons and muscarinic synapses. Prostaglandins and 5
      hydroxytryptamine acting at 5-HT3 receptors appear not to be signal substances in
      the reflex pathway, which evokes the secretory response to distension.

PMID- 1636722
TI  - Interleukin-1 alpha and -beta augment pulmonary artery transendothelial albumin
      flux in vitro.
AB  - Human recombinant interleukin-1 alpha (rIL-1 alpha) and -beta were studied to
      determine whether either could alter the permeability of bovine pulmonary artery
      endothelial cell monolayers. Endothelial cells were grown to confluence on
      filters mounted in chemotaxis chambers placed in wells. Barrier function of the
      monolayers was assessed by placing 14C-labeled bovine serum albumin ([14C]BSA) in
      the upper chamber and sampling the lower well for [14C]BSA. rIL-1 alpha induced a
      significant (P less than 0.01) dose- and time-dependent increase in
      transendothelial [14C]BSA flux. rIL-1 alpha exposures as brief as 30 min
      increased permeability, but the increased albumin transfer could not be
      demonstrated before 4 h after exposure. Exposures up to 6 h were reversible at 24
      h. rIL-1 alpha induced significantly (P less than 0.01) greater increments in
      [14C]BSA flux than did equivalent exposures to rIL-1 beta. No important
      differences between bovine and human rIL-1 beta were demonstrated. Increased
      transendothelial flux could not be ascribed to either endothelial cytotoxicity or
      growth inhibition. There was no additive or synergistic relationship between rIL
      1 alpha and human recombinant tumor necrosis factor-alpha. Our studies suggest
      that IL-1 alpha and -beta may play a role in the pathogenesis of pulmonary
      vascular leak.

PMID- 1636723
TI  - Bioassay of a tracheal smooth muscle-constricting factor released by respiratory
      epithelial cells.
AB  - Epithelium-derived factors of unknown identity have been proposed to modulate
      airway smooth muscle tone. We developed a novel sensitive bioassay system that
      allows serial perfusion of cultured respiratory epithelial cells and guinea pig
      trachea (GPT). GPT responses were assessed as diameter changes by computerized
      video microscopy (resolution, 15 microns). A permanent hamster lung epithelial
      cell line was grown on microcarrier beads and perfused in a cell column. When the
      outflow tubing from the epithelial cell column was connected to the inflow
      cannula, the detector GPT contracted, reaching 28 +/- 6% of the maximum
      methacholine (100 microM)-induced contraction (n = 12, P less than 0.001).
      Perfusion of the cell column with diclofenac (10 microM) or lysin-mono
      acetylsalicylic acid (100 microM) abolished the GPT contraction, whereas
      selective perfusion of the detector GPT with either agent did not block the
      contraction. Analysis of the effluent of the epithelial cell column demonstrated
      a significant basal release of prostaglandins F2 alpha and E2 (PGF2 alpha and
      PGE2) and 6-ketoprostaglandin F1 alpha, whereas only marginal amounts of
      thromboxane B2 were detected. When given exogenously, PGF2 alpha, PGE2, PGI2, and
      U-46619 all contracted the GPT. It is concluded that lung epithelial cells can
      contract GPT by releasing a transferable factor. This factor is likely to be a
      constrictor cyclooxygenase product that is not produced in epithelium-denuded
      GPT.

PMID- 1636724
TI  - Direct measurement of acetylcholine release in guinea pig trachea.
AB  - In this study, we applied high-performance liquid chromatography with
      electrochemical detection (HPLC-EC) to the measurement of acetylcholine (ACh)
      release from nerve endings in guinea pig tracheal smooth muscle. We also tested
      for muscarinic inhibitory regulation of ACh release in this species, which is
      widely used for studies of airway neural control. Clip-connected segments of the
      posterior membrane of the guinea pig trachea were mounted in organ baths between
      stimulating electrodes and incubated in Krebs-Henseleit buffer containing (in
      microM) 10 indomethacin, 1 neostigmine, 1 phentolamine, and 1 propranolol. To
      measure ACh, the bath was emptied and aliquots of buffer were injected directly
      into the HPLC-EC; the lower limit of detection was 1 pmol/200 microliters sample.
      Electrical field stimulation (EFS) at 5 Hz for 10 or 30 min increased ACh release
      from 1.8 +/- 1.4 (SE) to 6.2 +/- 1.3 pmol.mg protein-1.min-1 (n = 15). The effect
      of atropine was examined by comparing amounts of ACh released by EFS before and
      after exposure to either atropine (0.3 microM) or vehicle. Before atropine
      treatment, EFS-evoked ACh release was 4.9 +/- 0.6 pmol.mg protein-1.min-1; after
      atropine exposure, EFS-evoked release of ACh increased significantly to 15.0 +/-
      2.2 pmol.mg protein-1.min-1 (n = 11; P less than 0.05). Corresponding values
      before and during exposure to vehicle were 9.3 +/- 4.4 and 10.7 +/- 4.7 pmol.mg
      protein-1.min-1, respectively. The ratios of the changes in EFS-evoked ACh
      release were 3.1 +/- 0.3 and 1.3 +/- 0.1 in atropine-treated and vehicle-treated
      groups, respectively (P less than 0.05). We conclude that HPLC-EC is a reliable
      and sensitive technique for the detection of EFS-evoked release of ACh from clip
      connected segments of guinea pig tracheal smooth muscle.

PMID- 1636725
TI  - In vitro responses of ovine intrapulmonary arteries and veins to endothelin-1.
AB  - We determined responses of third-generation intrapulmonary arteries and veins of
      fetal, newborn, and adult sheep to endothelin-1 (ET) and the role of endothelium
      and cyclooxygenase metabolites in ET effects in adult sheep lung vessels.
      Presence of endothelium in vessel rings was confirmed by response to endothelium
      dependent vasodilators, acetylcholine or bradykinin. Vessel tension induced by ET
      was expressed as a percentage of tension induced by 100 mM KCl. We found that
      arteries and veins contracted to 10(-9) to 10(-6) M ET in a dose-dependent
      manner. Veins exhibited greater sensitivity to ET than arteries in all age
      groups. Arteries and veins of adult sheep lungs were more sensitive to ET than
      those of fetal and newborn lambs. In adult sheep lung vessels, pretreatment with
      indomethacin (5 x 10(-6) M) and SQ 29548, a thromboxane A2-prostaglandin H2
      receptor antagonist (10(-5) M), significantly attenuated venous contraction to
      ET; arterial contraction was unaffected. Denuding vessels of endothelium did not
      affect responses to ET. We conclude that, in ovine lungs, veins are more
      sensitive to ET than arteries and that developmental differences in pulmonary
      vascular responses to ET exist.

PMID- 1636726
TI  - IL-6 enhances TNF-alpha- and IL-1-induced increase of Mn superoxide dismutase
      mRNA and O2 tolerance.
AB  - Tumor necrosis factor-alpha (TNF-alpha), interleukin-1 alpha (IL-1), and
      interleukin-6 (IL-6) are multifunctional cytokines produced by a number of cells
      in response to endotoxin. We have previously demonstrated (M.-F. Tsan, J. E.
      White, T. A. Santana, and C. Y. Lee. J. Appl. Physiol. 68: 1211-1219, 1990, and
      M.-F. Tsan, C. Y. Lee, and J. E. White. J. Appl. Physiol. 71: 688-697, 1991) that
      tracheal insufflation of 5 micrograms of TNF-alpha or 1 microgram of IL-1
      markedly protects rats against O2 toxicity and enhances pulmonary Mn superoxide
      dismutase (Mn SOD) activity. We now report that TNF-alpha and IL-1 at
      subprotective doses, e.g., 1 and 0.2 micrograms, respectively, act
      synergistically in protecting rats against O2 toxicity. Likewise, TNF-alpha and
      IL-1 at 0.005 microgram/ml each act synergistically in enhancing endothelial cell
      Mn SOD, but not Cu,Zn SOD mRNA levels. IL-6 at 5 or 10 micrograms provides no
      protective effect in rats against O2 toxicity and at up to 0.5 microgram/ml has
      no apparent effect on endothelial cell Mn or Cu,Zn SOD mRNA levels. However, IL-6
      markedly enhances TNF-alpha- and IL-1-induced increases in Mn SOD mRNA levels and
      O2 tolerance. These results support an important role of Mn SOD in the protection
      against O2 toxicity.

PMID- 1636727
TI  - Restricted diffusion of macromolecules by endothelial monolayers and small-pore
      filters.
AB  - We studied the size-selective permeability and restricted diffusion (Rd)
      properties of macromolecules across bovine pulmonary artery endothelial cell
      (BPAEC) or epithelial (LLC-PK1) monolayers grown on polycarbonate (PC) filter
      supports using fluorescein isothiocyanate-hydroxyethyl starch (FITC-HES, 16 A
      less than ae less than 180 A). Most BPAEC seeded at subconfluent density and
      grown for 3-6 days produced barriers with marked Rd. This characteristic was
      similar to that measured across PC filters with pore radii (rp) of 150 and 250 A
      without cells. Rd of LLC-PK1 monolayers was consistent with a transport pathway
      rp of much less than 75A. BPAEC monolayers prepared by supraconfluent seeding
      showed convective solute transport due to a significant number of incompletely
      formed intracellular junctions. Most monolayers grown to confluence, or a thin
      layer of collagen type I prevented this effect, Rd was enhanced when BPAEC
      monolalyers were grown on this collagen network. These data suggest that the
      subendothelial layers, which includes basal lamina, pericyte, and interstitial
      collagen, may act as series resistors with the endothelium to provide the Rd
      observed in the microvascular wall in vivo. This may explain why BPAEC monolayers
      grown to confluence without subendothelial layers in vitro showed Rd consistent
      with large (150-250 A) rp that was significantly greater than those modeled as
      the small (approximately 50 A) "pore" or 6-A fiber matrix of the in vivo
      capillary wall.

PMID- 1636728
TI  - Formation of alveoli in rats: postnatal effect of prenatal dexamethasone.
AB  - We administered a glucocorticosteroid (dexamethasone) or its diluent to pregnant
      rats on gestation days 17, 18, and 19. In male offspring we determined the lung's
      gas exchange surface area (S(a)), the average volume (v) of gas exchange saccules
      at age 2 days and alveoli at age 14 days, and their number (N) on these days.
      S(a), v, and N at 2 days and v at 14 days were not affected by the prenatal
      administration of dexamethasone. However, S(a) and N were lower in 14-day-old
      pups from dexamethasone-treated dams than in pups from diluent-treated dams. In
      separate experiments we found the responsiveness to prenatal dexamethasone, as a
      depressor of the postnatal increase in S(a), appeared earlier in female than male
      fetuses; it was present in female but not in male fetuses on days 16-18 and was
      found in male fetuses on days 17-19. We conclude 1) prenatal administration of
      dexamethasone diminishes the postnatal increase in S(a), 2) responsiveness to
      this action of dexamethasone occurs earlier in gestation in female than in male
      fetuses, and 3) prenatal dexamethasone does not effect the postnatal volume of an
      average alveolus but diminishes their number in male pups.

PMID- 1636729
TI  - Stimulation of phosphatidylcholine hydrolysis in type II alveolar epithelial
      cells.
AB  - The effects of phorbol 12-myristate 13-acetate (TPA) or ATP on
      phosphatidylcholine (PC) hydrolysis were investigated in cultured type II
      pneumocytes prelabeled with [3H]choline or 1-O-[3H]octadecyl-sn-glycero-3
      phosphocholine ([3H]lyso-PAF). In cells prelabeled with [3H]choline, TPA or ATP
      stimulated an increase in [3H]choline, [3H]phosphocholine, and
      [3H]glycerophosphocholine. The formation of these choline metabolites was
      associated with a concomitant loss of [3H]PC but not from disaturated PC or
      phosphatidylinositol. In cells prelabeled with [3H]lyso-PAF, the formation of
      [3H]phosphatidic acid (PA) and then [3H]1,2-DG was stimulated by TPA or ATP and
      was associated with a loss of 3H from PC but not from disaturated PC or
      phosphatidylinositol. There was a concentration-dependent formation of [3H]1,2-DG
      and [3H]PA in response to ATP. Downregulation of protein kinase C with TPA
      abolished the stimulation of PC hydrolysis. In addition to the generation of
      metabolites indicative of phospholipase C and/or D activity, [3H]lyso-PC, a
      product of phospholipase A2, was also generated in response to TPA. These
      findings suggest an important role for PC breakdown in signal transduction in
      type II pneumocytes.

PMID- 1636730
TI  - Surfactant protein D: subcellular localization in nonciliated bronchiolar
      epithelial cells.
AB  - Surfactant protein D (SP-D, CP4) is a collagenous surfactant-associated
      carbohydrate binding protein that was initially characterized as a biosynthetic
      product of type II pneumocytes. Immunoperoxidase studies of formaldehyde solution
      fixed and paraffin-embedded rat lung demonstrated staining for SP-D in the
      cytoplasm of a subpopulation of bronchiolar epithelial cells as well as type II
      cells. Accordingly, immunogold-labeling techniques were used to further examine
      the cellular distribution and subcellular localization of SP-D in the small
      airways. Lung tissues were fixed with 0.5% glutaraldehyde-3% paraformaldehyde and
      embedded in LR White resin. Sections were reacted with affinity purified
      polyclonal antibodies to SP-D, and sites of antibody binding were demonstrated
      using a biotinylated secondary antibody-streptavidin-gold detection system. Anti
      SP-D selectively decorated secretory compartments of nonciliated bronchiolar
      cells (Clara cells) with strong and specific labeling of apical electron-dense
      secretory granules. Almost all of the granules in nonciliated columnar cells were
      labeled; however, labeling was typically nonuniform, with preferential decoration
      of the periphery of the granule. The largest numbers of immunoreactive epithelial
      cells were observed in the distal membranous bronchioles, with progressively
      smaller numbers of cells in more proximal bronchioles. There was no detectable
      labeling of cells lining the large cartilagenous airways or trachea. These
      studies provide evidence that SP-D is a secretory product of nonciliated
      bronchiolar cells. We suggest that Clara cell-derived SP-D is a component of
      bronchiolar lining material, consistent with our hypothesis that SP-D contributes
      to surfactant metabolism and/or host defense within small airways.

PMID- 1636731
TI  - Tobacco smoke releases performed mediators from canine mast cells and modulates
      prostaglandin production.
AB  - The role of an extract of tobacco smoke in activating mast cells was studied.
      With the use of isolated, canine mast cells as a model, we found that cigarette
      smoke solution (CSS) induced the release of the performed mediators histamine and
      tryptase from these cells in an energy- and temperature-dependent, non-cytotoxic
      manner. There was no requirement for extracellular calcium. Nicotine tartrate did
      not reproduce the effect of CSS. Interestingly, mast cells produced little
      prostaglandin D2 (PGD2) in response to the CSS, and there was a concentration
      related inhibition of calcium ionophore A23187-induced PGD2 synthesis. This
      suggests at least two mechanisms acting on the mast cell: tobacco smoke can
      directly activate mast cells to release performed mediators and can
      simultaneously inhibit prostaglandin production. These observations suggest a
      mechanism by which mast cells may participate in the bronchospastic and
      proinflammatory changes seen in the lungs and airways of smokers.

PMID- 1636732
TI  - Processing of surfactant protein B proprotein by a cathepsin D-like protease.
AB  - Surfactant protein B (SP-B) is a hydrophobic peptide of relative molecular weight
      (M(r)) = 8,000 that is associated with pulmonary surfactant phospholipids. SP-B
      is synthesized by the alveolar type II epithelial cell as a proprotein of M(r) =
      42,000 which requires at least two proteolytic cleavages to generate the 79
      residue mature SP-B peptide. We have previously reported that cleavage of the NH2
      terminal propeptide, to generate a processing intermediate of M(r) = 25,000,
      occurs in close temporal approximation to secretion. In the present study we
      demonstrate that SP-B proprotein, isolated from stably transfected Chinese
      hamster ovary cells, is processed to M(r) = 25,000 by a crude type II cell
      membrane fraction but not by intact type II cells or type II cell conditioned
      media. In vitro processing of the proprotein by the type II cell membrane
      preparation resulted in release of a single peptide of M(r) = 16,000-17,000,
      which was detected by antiserum directed against antigenic epitopes in propeptide
      of the precursor. SP-B processing activity was extracted by Na2CO3 lysis of the
      type II cell membrane preparation, had a pH optimum of 5.0-6.0, and was inhibited
      by 10(-7) M pepstatin A, suggesting that the NH2-terminal peptide of the
      precursor is cleaved by an aspartyl protease. Consistent with this hypothesis,
      processing of SP-B by a crude type II cell membrane preparation was blocked by
      antiserum directed against the aspartyl protease cathepsin D; further, purified
      cathepsin D efficiently processed the SP-B precursor to M(r) = 25,000.
      Collectively these results suggest that cleavage of the NH2-terminal propeptide
      of the SP-B precursor is mediated by cathepsin D or a cathepsin D-like protease
      localized within the secretory pathway of the type II epithelial cell.

PMID- 1636733
TI  - Cloning and expression of an airway epithelial 12-lipoxygenase.

PMID- 1636734
TI  - Effects of endothelin on renal hemodynamics and tubuloglomerular feedback.
AB  - The effect of endothelin (ET)-1 infusion on renal hemodynamics and the
      tubuloglomerular feedback (TGF) mechanism was examined in rats. ET-1 reduced
      early proximal flow rate (EPFR) measured in the absence of distal flow from 28 +/
      1 to 23 +/- 1 nl/min at a subpressor dose (100 pmol.100 g body wt-1.h-1 iv) and
      from 27 +/- 2 to 19 +/- 2 nl/min at a pressor dose (200 pmol.100 g body wt-1.h
      1). Reductions of EPFR induced by loop perfusion at 40 nl/min were 11 +/- 1 and
      12 +/- 1 nl/min at the subpressor and pressor doses and were not different from
      controls. The stop-flow pressure response to loop perfusion was not altered by
      the pressor dose of ET-1. The subpressor dose of ET-1 increased renal vascular
      resistance (RVR) by 40% but left glomerular filtration rate (GFR) and urinary
      excretion of sodium (UNaV) unaltered. The pressor dose of ET-1 not only increased
      RVR by 140% and decreased GFR and renal plasma flow by 37 and 52%, but it
      increased UNaV proportional to the rise in blood pressure (r = 0.724, P less than
      0.01). ET-1 is a potent renal vasoconstrictor and induces pressure natriuresis.
      ET-1 increases both pre- and postglomerular resistances but does not affect TGF
      response.

PMID- 1636735
TI  - Oligopeptides: mechanism of renal clearance depends on molecular structure.
AB  - We have investigated the relative contribution of hydrolysis, intact transport
      and urinary excretion to the renal clearance of Gly-Sar, Gly-Sar-Sar, and Gly-Gly
      Sar in fed and starved rats. The results obtained from isolated kidney perfusion
      studies are summarized as follows: 1) clearance was fastest for Gly-Gly-Sar and
      slowest for Gly-Sar-Sar, 2) urinary excretion of Gly-Sar-Sar exceeded that of Gly
      Gly-Sar or Gly-Sar, 3) there was accumulation of products of hydrolysis of Gly
      Gly-Sar in the perfusate but not of Gly-Sar or Gly-Sar-Sar, 4) isolated brush
      border and basolateral membranes of renal tubular cells lacked hydrolytic
      activity against Gly-Sar and Gly-Sar-Sar but possessed hydrolytic activity
      against Gly-Gly-Sar, 5) an excess amount of Gly-Sar-Sar reduced the rate of
      clearance of Gly-Gly-Sar by approximately 40% and significantly increased urinary
      excretion of this peptide, 6) the nonfiltering kidney cleared Gly-Gly-Sar at a
      rate which was 50% of that of the filtering kidney but did not clear Gly-Sar, and
      7) starvation for 96 h was without a significant effect on the renal clearance of
      either Gly-Sar or Gly-Sar-Sar but significantly reduced the renal clearance of
      Gly-Gly-Sar and the brush-border membrane hydrolase activity against this
      peptide. We conclude that the molecular structure determines the affinity of
      oligopeptides for the membrane transport and hydrolytic systems, which, in turn,
      determines their efficiency for clearance by the kidney.

PMID- 1636736
TI  - Eicosanoids modulate apical Ca(2+)-dependent K+ channels in cultured rabbit
      principal cells.
AB  - Patch clamp technology was utilized to study the effects of apical phospholipase
      A2 (PLA2) metabolites on "maxi K" channels in the principal cell apical membrane
      of rabbit cortical collecting tubule (CCT) primary cultures (B. N. Ling, C. F.
      Hinton, and D. C. Eaton. Kidney Int. 40: 441-452, 1991). At resting membrane
      potential, this channel is quiescent in the cell-attached configuration. Apical
      application of the PLA2 agonist melittin (1 microgram/ml) for 10 min increased
      single-channel open probability (Po) from 0.0004 +/- 0.0010 to 0.11 +/- 0.05.
      Similarly, apical exposure to 50 microM arachidonic acid (AA) or 0.5 microM
      prostaglandin (PG) E2, but not 0.5 microM PGF2 alpha, also increased channel
      activity. Conversely, 10 microM of the PLA2 antagonist quinacrine applied
      apically decreased Po. Removal of apical bath Ca2+ did not prevent melittin-, AA
      , or PGE2-induced channel activation. We then examined the role of maxi K
      channels and eicosanoids in principal cell volume regulation. Within seconds of
      reducing basolateral bath tonicity (285 to 214 mosmol/kgH2O), NPo (i.e., no. of
      channels x Po) initially increased approximately 200%, followed by a delayed but
      prolonged activation phase that was attenuated by removal of apical bath Ca2+.
      Pretreatment with 10 microM quinacrine, 100 microM indomethacin (cyclooxygenase
      inhibitor), or 0.25 microM thapsigargin (to deplete intracellular Ca2+ stores)
      abolished the initial phase of swelling-induced channel activation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1636737
TI  - Regulation of S6 kinase activity in renal proximal tubule.
AB  - The proximal tubule undergoes hypertrophy in response to loss of functioning
      renal mass and hyperplasia following injury by ischemia or nephrotoxins. Both
      hypertrophic growth and cell proliferation are characterized by increases in the
      rate of protein synthesis. To investigate regulation of protein synthesis in
      mammalian proximal tubule cells, potential peptide mediators of proximal tubule
      growth, epidermal growth factor (EGF) and angiotensin II, were studied in
      cultured rabbit proximal tubule cells. Although only EGF stimulated DNA
      synthesis, both agonists stimulated protein synthesis. One potential regulatory
      mechanism of eukaryotic protein synthesis involves phosphorylation of ribosomal
      protein S6 by activation of a specific serine/threonine kinase (S6 kinase). Both
      EGF and angiotensin II stimulated S6 kinase activity and S6 phosphorylation.
      Phorbol 12-myristate 13-acetate was also found to activate S6 kinase, and 24 h of
      pretreatment to deplete protein kinase C inhibited subsequent S6 kinase
      activation by a high concentration (10(-6) M) of angiotensin II. To determine
      whether S6 kinase was also activated in the kidney in vivo, S6 kinase activity
      was examined after ablation of renal mass. Within 1 h after contralateral
      nephrectomy, S6 kinase activity increased in rat renal cortex. In summary, both
      EGF and angiotensin II stimulated protein synthesis and S6 kinase activity in
      cultured proximal tubule cells, and S6 kinase activity also increased in renal
      cortex after contralateral nephrectomy.

PMID- 1636738
TI  - Hormonal regulation of rat renal proximal tubule brush-border membrane ionic
      permeability.
AB  - The effects on ionic permeability of toxins and hormones that activate or
      deactivate the guanine nucleotide regulatory (G) proteins that govern adenylate
      cyclase activity were examined in rat renal proximal tubule cell brush-border
      membranes. These studies demonstrate that activation of stimulatory G (Gs)
      proteins by cholera toxin or parathyroid hormone and deactivation of inhibitory
      (G (Gi) proteins by pertussis toxin result in a selective increase in Cl-
      permeability relative to that of K+ as determined with the potential-sensitive
      fluorescent probe 3,3'-dipropylthiadicarbocyanine iodide [diS-C3-(5)]. In
      contrast, activation of Gi by angiotensin II significantly decreases relative Cl-
      permeability. The selective increase in relative Cl- permeability induced by
      parathyroid hormone results in an inside-negative potential in membrane vesicles
      exposed to an inward NaCl gradient that is of sufficient magnitude to stimulate
      electrogenic, Na(+)-dependent glucose transport. These data suggest that the
      relative ionic permeabilities of brush-border membranes are tonically regulated
      by the opposing effects of hormones that act via Gs or Gi proteins. Changes in
      membrane potential resulting from this regulation may play an important role in
      modifying transport in the proximal tubule.

PMID- 1636739
TI  - Bidirectional peritoneal transport of immunoglobulin in rats: tissue
      concentration profiles.
AB  - Protein transport occurs between the blood and the peritoneal cavity during
      clinical procedures, but events within the surrounding tissue space are poorly
      understood. We used quantitative autoradiography to examine the tissue
      concentration profiles of immunoglobulin G (IgG) in regions surrounding the
      peritoneal cavity. We have varied the route of administration (intravenous or
      intraperitoneal), the osmolality of the dialysis solution (isotonic or
      hypertonic), and the time of analysis (20 or 200 min). After intravenous
      injection, IgG profiles were relatively flat in most tissues and were not
      affected by time or osmolality. Concentrations corresponded to the capillary
      density in specific tissues. After intraperitoneal administration, the IgG tissue
      profiles were significantly steeper than after intravenous administration. The
      tissue concentrations increased with time but decreased when a hypertonic
      solution was substituted for an isotonic solution. Hypertonic dialysis causes a
      water flux into the cavity, which dilutes the contents but does not prevent
      penetration of protein into the surrounding tissue. Based on IgG movement in
      tissue during hypertonic dialysis, the peritoneum appears to function as a
      heterogeneous structure, which allows osmotically induced water transport into
      the cavity in some regions with simultaneous transport of hydrostatic pressure
      driven water and solute flow from the cavity into the tissue in other regions.

PMID- 1636740
TI  - Increased functional differentiation of rabbit proximal tubule cells cultured in
      glucose-free media.
AB  - We have determined the influence of glucose (Glc)-free medium on the growth and
      differentiation of rabbit kidney proximal tubule cells (PTC) in primary cultures.
      The specific growth rates and the protein-to-volume ratios are shown to be
      independent of the culture conditions. In contrast, the functional expression of
      four brush-border membrane enzyme markers was found to decline steadily and in
      the same way from day 3 in culture up to late confluence in Glc-containing
      medium, and different evolution patterns and high expression levels were observed
      up to confluence in a Glc-free glutamine (Gln)-supplemented medium. Electron
      microscopy clearly showed, however, that the functional and morphological
      differentiation of the brush-border membrane is not correlated. Finally, by use
      of an indirect immunofluorescent technique in combination with flow cytometry, it
      is demonstrated that confluent cells grown in Glc and Gln media form homogeneous
      cell populations of PTC. It is thus concluded that the functional differentiation
      of rabbit kidney PTC in primary cultures is strongly dependent upon the energy
      source present in the culture medium.

PMID- 1636741
TI  - Sites of antinatriuretic action of insulin along rat nephron.
AB  - This study was aimed at identifying the renal sites of the antinatriuretic action
      of insulin by evaluating whether this hormone may alter the function of Na-K
      ATPase in specific nephron segments. For this purpose, possible actions of
      insulin on the rate of 86Rb uptake were evaluated in vitro on single segments of
      proximal convoluted tubule (PCT), thick ascending limb, and collecting tubule
      microdissected from collagenase-treated kidneys of normal rats. Results indicate
      that physiological concentrations of insulin inhibited by 44% the initial rate of
      ouabain-sensitive 86Rb uptake in the medullary and cortical thick ascending limb,
      whereas it increased it by 40% in proximal tubules and by 60% in both cortical
      and medullary collecting tubules. The kinetics and dose dependence of insulin
      actions were different in the thick ascending limb, the PCT, and the collecting
      tubule, with the latter less sensitive but displaying an earlier response to
      insulin than the PCT and the thick ascending limb.

PMID- 1636742
TI  - Effects of glucagon on glomerular filtration rate and urea and water excretion.
AB  - Clearance experiments were performed in anesthetized male Wistar rats to
      reevaluate the renal effects of glucagon (Gluc) on glomerular filtration rate
      (GFR) and solute and water excretion. After an 80-min control period, these
      effects were evaluated in the last 80 min of a 2-h intravenous Gluc infusion.
      Gluc induced significant increases in GFR (+20%), urine flow rate (+150%), free
      water reabsorption (+50%), urea synthesis and urea excretion (+66%), and nonurea
      solute excretion (+67%). In addition, fractional urea excretion (FEurea)
      increased by 43% (P less than 0.01). Additional experiments showed that increases
      in either urea excretion or urine flow rate (induced by appropriate infusion of
      urea or half-dilute saline), similar to those seen after Gluc, could not account
      for the increased FEurea. All significant effects of Gluc were also observed
      during infusion of antidiuretic hormone or during water diuresis. The tubular
      effects of Gluc could be explained by a reduction in proximal reabsorption. The
      dose of Gluc required to induce all the effects described above was 12 ng.min
      1.100 g body wt-1, a dose producing an approximately 10-fold supraphysiological
      peripheral plasma concentration but a "physiological" level for the liver.
      Infusion of 1.2 ng induced almost no change in renal function, and infusion of
      120 ng induced no greater effects than 12 ng. These results suggest 1) that Gluc,
      a hormone liberated after protein ingestion, exerts coordinated effects on liver
      and kidney to increase simultaneously urea synthesis and excretion and to promote
      water conservation and 2) that these effects could, at least in part, be indirect
      and depend on the Gluc-induced stimulation of hepatocyte metabolism.

PMID- 1636743
TI  - Effects of formate and oxalate on volume absorption in rat proximal tubule.
AB  - We examined the effects of formate and oxalate on the rate of fluid absorption
      (Jv) in the rat proximal convoluted tubule in situ. Proximal tubules were
      microperfused with a high-Cl-, low-HCO3- Ringer solution (pH 6.7), and the
      peritubular capillaries were perfused with a standard Ringer solution (pH 7.4),
      simulating conditions in the late proximal tubule. Jv, a measure of transtubular
      NaCl absorption under these conditions, was calculated from the change in luminal
      [3H]inulin. Addition of formate in the physiological range (500 microM) to the
      luminal perfusate increased Jv by 45%; addition of 500 microM formate to both
      luminal and capillary perfusates increased Jv by 57%. Similarly, addition of
      oxalate in the physiological range (5 microM) to the luminal perfusate increased
      Jv by 37%; addition of 5 microM oxalate to both luminal and capillary perfusates
      increased Jv by 57%. The stimulatory effects of formate and oxalate perfused in
      the lumen and capillaries were not additive. Addition of 4,4'
      diisothiocyanostilbene-2,2'-disulfonate (DIDS, 0.1 mM) to the luminal perfusate
      had no effect on baseline Jv measured in the absence of added formate and oxalate
      but completely abolished the increment in Jv induced by formate and oxalate.
      Addition of the Cl(-)-channel blocker diphenylamine-2-carboxylate (DPC, 0.2 mM)
      to the capillary perfusate had no effect on baseline Jv but completely abolished
      the increment in Jv induced by formate and oxalate.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1636744
TI  - Effect of selenium-deficient diet in experimental glomerular disease.
AB  - We examined the effect of a selenium-deficient diet on two experimental models of
      glomerular disease, the puromycin aminonucleoside (PAN)-induced nephrotic
      syndrome, a model of minimal change disease, and passive Heymann nephritis, a
      complement-dependent and neutrophil-independent model that resembles membranous
      nephropathy. The specific activity of selenium-dependent glutathione peroxidase
      was markedly reduced in the liver, the kidney cortex, and in glomeruli in
      weanling male Sprague-Dawley rats placed on a selenium-deficient diet for 6 wk
      compared with rats fed a selenium-replete diet, with no significant differences
      in the specific activities of superoxide dismutase or catalase. PAN-injected
      selenium-deficient rats had a marked and significantly greater proteinuria
      throughout the course of the experiment compared with PAN-injected selenium
      replete rats with no significant histological differences. In the passive Heymann
      nephritis model induced by injecting anti-Fx1A immunoglobulin G, rats fed a
      selenium-deficient diet had significantly higher urinary protein (day 5: 91 +/-
      16 mg/24 h, n = 10) compared with rats fed a selenium-replete diet (52 +/- 5
      mg/24 h, n = 11) with no differences in the amount of antibody deposited in the
      kidney. The most likely explanation for the effect of a selenium-deficient diet
      is that selenium deficiency resulted in a marked reduction of glutathione
      peroxidase, thus indicating an important role of glutathione peroxidase in these
      models of glomerular injury.

PMID- 1636745
TI  - Functional and structural characterization of endosomes from toad bladder
      epithelial cells.
AB  - Previous functional studies of toad bladder endosomes have been complicated by
      the presence of multiple endosome subpopulations each possessing different
      permeability characteristics. To identify and characterize both water channel
      containing vesicles (WCV) and other endosome subpopulations, we combined flow
      cytometry, electron microscopy, stop-flow fluorometry, and sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. Flow cytometry of endosomes identified
      distinct populations of fluorescein-labeled endosomes in bladders after removal
      of antidiuretic hormone (ADH) stimulation (ADH withdrawal). Centrifugation
      separated the larger fluorescein-labeled vesicles, sedimenting at lower speed
      (intermediate pellet, IP), from the smaller fluorescein-labeled vesicles,
      sedimenting at high speed (high-speed pellet, HSP). Permeability and structural
      studies of these subpopulations revealed the following. 1) IP endosomes labeled
      10 min after ADH withdrawal (ADH IP) represented a highly purified population of
      WCV with high water permeability (Pf) that exhibited a low-activation energy and
      sensitivity to organic mercurials. 2) IP endosomes from unstimulated bladders did
      not contain functional water channels. 3) HSP from either ADH withdrawal or
      unstimulated bladders exhibited low Pf and acidified after addition of
      extravesicular ATP; moreover, protein compositions of purified HSP were distinct
      from those of purified IP. These results suggest that HSPs represent constitutive
      and not ADH-sensitive endosomes. 4) High permeability to protons (PH+) was seen
      in ADH IP endosomes but not the other fractions, providing strong evidence that
      the ADH water channel conducts protons. 5) Multivesicular bodies (MVB) exhibited
      low Pf and PH+, indicating that they do not possess functional water
      channels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636746
TI  - Renal kinin antagonism does not impair pressure-induced natriuresis.
AB  - We studied the contribution of the renal kallikrein-kinin system to short-term
      electrolyte and water balance during baseline and during acutely elevated renal
      perfusion pressure (RPP) in the anesthetized dog. Renal blood flow, glomerular
      filtration rate, urine flow rate, renin secretion rate, and urinary excretion of
      sodium, potassium, prostaglandin E2 (PGE2), and kinins were measured at baseline
      RPP during intrarenal infusion of 0.9% saline or the competitive bradykinin
      analogue [D-Arg0,Hyp3,Thi5,D-Phe7,Thi8]bradykinin (50 micrograms/min), which
      blocks vascular and interstitial kinin receptors. RPP was then raised above
      baseline (control group 25%; kinin analogue group 22%) by ligating the celiac
      artery, the superior mesenteric artery, and the aorta distal to the renal
      arteries. Renal parameters were again measured during infusion of saline or the
      kinin analogue. The analogue had no effect on renal hemodynamic or excretory
      parameters at baseline perfusion pressures. Increasing RPP significantly
      increased urine flow rates and urinary sodium excretion rates (control group, 43
      mumol/min; kinin analogue group, 55 mumol/min) in both groups of animals.
      Increasing pressure also tended to decrease renin secretion rate in both groups
      of animals; however, neither increased pressure nor infusion of the analogue
      affected urinary excretion of PGE2 or kinins. The results suggest that intrarenal
      kinins are not powerful short-term regulators of electrolyte and water balance
      and that an intact kallikrein-kinin system is not necessary to induce pressure
      diuresis and natriuresis.

PMID- 1636747
TI  - Regulation of mesangial cell cyclooxygenase synthesis by cytokines and
      glucocorticoids.
AB  - The cytokines, interleukin-1 (IL-1) and tumor necrosis factor (TNF), potently
      induce prostaglandin formation in glomerular mesangial cells. Mechanisms by which
      these cytokines stimulate prostaglandin formation vary among cell types. We
      investigated whether alterations in phospholipase A2 (PLA2) or cyclooxygenase
      (COX) mass and activity contribute to the changes in mesangial cell prostaglandin
      production. These cytokines induced COX activity and mass in a time-dependent
      manner, which paralleled prostaglandin production. IL-1 increased COX mass
      approximately threefold by 24 h. TNF had a much smaller effect, although it
      appeared to be additive with IL-1. IL-1-induced COX mass was maintained at an
      increased level for at least 48 h. The glucocorticoid dexamethasone (DEX)
      virtually abolished prostaglandin production and blocked cytokine induction of
      COX activity and mass. DEX did not reduce COX activity or mass below the basal,
      serum-fed levels, however. By utilizing stable isotope methods, we could
      demonstrate that IL-1 increased free arachidonate levels, implying new PLA2
      synthesis over a time course that was maximal at 6 h and was cycloheximide and
      actinomycin D sensitive. These data demonstrate that the cytokines IL-1 and TNF
      enhance synthesis of COX and PLA2, contributing to increased prostaglandin
      production. Cytokine-stimulated prostaglandin production ceases when cells are
      also treated with DEX, although control levels of COX activity and mass remain.
      This occurs because DEX inhibits the IL-1-induced enhanced arachidonate release.

PMID- 1636748
TI  - Intracellular recording and dye transfer in arterioles during blood flow control.
AB  - We tested for dye coupling between arteriolar smooth muscle cells (SMC) and
      endothelial cells (EC) and investigated the correspondence of vasomotor activity
      with changes in the membrane potential (Vm) of EC and SMC during blood flow
      control. Female golden hamsters (n = 8, 90-170 g) were anesthetized
      (pentobarbital sodium, 60 mg/kg ip). A cheek pouch was spread over an optical
      pedestal, transilluminated, and irrigated with physiological saline solution (37
      degrees C, pH 7.4). Glass microelectrodes were filled with 3 M KCl or with
      Lucifer yellow dye (LY, mol wt 470; 106 mM). SMC or EC of arterioles (ID, 20-50
      microns) containing blood flow were impaled under a stereomicroscope. Vm was
      similar [-48 +/- 3 and -52 +/- 4 mV (means +/- SE)] with KCl (n = 6) or LY (n =
      13) microelectrodes, respectively. Acetylcholine (5 x 10(-6) M) increased Vm from
      -47 +/- 3 to -67 +/- 4 mV (n = 5; P less than 0.01) concomitant with
      vasodilation. Spontaneous slow waves in Vm (2/min, 15-30 mV) were observed in
      arterioles with vasomotion. In cells identified with LY microinjection, resting
      Vm was -52 +/- 8 and -44 +/- 2 mV for EC (n = 3) and SMC (n = 3), respectively.
      SMC injected with LY did not show evidence of dye transfer to other SMC or to EC.
      When an EC was injected, the dye spread to many contiguous EC but not to
      SMC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636750
TI  - Effect of changing afterload and inotropic states on inner and outer ventricular
      wall thickening.
AB  - Effect of changing afterload and inotropic states on inner and outer ventricular
      wall thickening. Am. J. Physiol. 263 (Heart Circ. Physiol. 32): H109-H116, 1992.-
      To study the differing behaviors of the inner (IH) and outer halves (OH) of the
      left ventricular (LV) free wall during an increasing afterload and changing
      inotropic states, we determined the LV pressure (LVP) and transmural (TM) and OH
      wall thickness (WTTM and WTOH) by sonomicrometry in 11 anesthetized dogs. The
      percent systolic wall thickening (% delta WT) and the fractional contribution
      (FC) were calculated. At rest, % delta WT of TM, IH, and OH were 22 +/- 1 (mean
      +/- SE), 33 +/- 3, and 13 +/- 2 (P less than 0.01 vs. IH), respectively. The FC
      of IH and OH were 74 +/- 5 and 29 +/- 4% (P less than 0.01 vs. IH), respectively.
      During increasing afterload by aortic constriction (AC) without drugs, % delta WT
      in IH was reduced to 22 +/- 2%, associated with unchanged % delta WT in OH (12 +/
      3%), whereas the FC of IH and OH were not altered from resting values. During AC
      with dobutamine infusion (3 micrograms.kg-1.min-1), the % delta WT and FC in each
      layer were not reduced from resting values. On the other hand, during AC with
      propranolol (2 mg bolus iv), the reduction of % delta WT in IH was greater (from
      29 +/- 4 to 15 +/- 6%, P less than 0.01) than that in OH (from 11 +/- 2 to 10 +/-
      3%; P less than 0.01 vs. IH). The FC in the IH was decreased (56 +/- 16%) by AC
      with propranolol, so that the difference in FC between IH and OH became
      insignificant (FCOH 40 +/- 13%, P greater than 0.1 vs. FCIH).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1636749
TI  - Modulation of NO and endothelin by chronic increases in blood flow in canine
      femoral arteries.
AB  - Experiments were designed to determine whether chronic increases in arterial
      blood flow alter production of or response to nitric oxide and endothelin. Canine
      femoral arteries proximal to an arteriovenous fistula- and from the contralateral
      sham-operated blood vessels were removed, cut into rings, and suspended for
      measurement of isometric force in organ chambers. The remainder of the artery was
      homogenized for measurement of endothelin content by radioimmunoassay. NG
      monomethyl-L-arginine (10(-4) M) caused concentration-dependent increases in
      tension only in fistula-operated arteries. Endothelium-dependent relaxations to
      acetylcholine and BHT-920 were greater in fistula- compared with sham-operated
      arteries. These differences were reduced by the arginine analogue. Pertussis
      toxin (100 ng/ml) inhibited relaxations to acetylcholine only in fistula-operated
      arteries and to BHT-920 only in sham-operated arteries. Contractions to
      endothelin-1 were greater in fistula- compared with sham-operated arteries. These
      results suggest that chronic increases in blood flow enhance the tonic and
      receptor-stimulated production of nitric oxide and its release by receptors
      coupled to pertussis toxin-sensitive guanine nucleotide regulatory proteins.
      Furthermore, chronic increases in blood flow may either inhibit the production of
      endothelin or promote its depletion from endothelial cells while simultaneously
      increasing the sensitivity of the smooth muscle to its contractile effects.

PMID- 1636751
TI  - Long-term coronary stenosis in rats: cardiac performance, myocardial morphology,
      and contractile protein enzyme activity.
AB  - To determine the effects of chronic nonocclusive coronary constriction on cardiac
      hemodynamics, myocardial structure, and contractile protein enzyme activity, the
      left coronary artery was narrowed in rats, and measurements of ventricular pump
      function, extent and localization of tissue damage, and myofibrillar Mg2+ and
      Ca2+ myosin adenosinetriphosphatase (ATPase) activities were measured 3 mo later.
      In the presence of coronary artery stenosis averaging 56%, two different degrees
      of depression in global cardiac performance were identified, and the animals were
      divided in two groups. In the first group, left ventricular end-diastolic
      pressure (LVEDP) was increased and LV+ and/or--the first derivative of LV
      pressure (dP/dt) were decreased, whereas in the second group end-diastolic and
      peak systolic LV pressures, LV+ and -dP/dt and right ventricular dynamics were
      all impaired. Thus left ventricular dysfunction and failure occurred with
      coronary narrowing. Structurally, multiple foci of replacement fibrosis were
      found across the left ventricular wall, but the number of these lesion profiles
      was 2.6-fold larger in failing animals than in rats with cardiac dysfunction.
      Biochemically, Mg(2+)-ATPase activity in myofibrils and Ca2+ myosin ATPase were
      not altered biventricularly. On the other hand, a shift from V1 to V3 myosin
      isoenzymic content occurred in the failing left ventricle. In conclusion, the
      late impairment in ventricular pump function associated with prolonged coronary
      artery stenosis appears to be sustained more by the magnitude of myocardial
      damage than by defects in contractile protein enzyme activity.

PMID- 1636752
TI  - Influence of pericardial constraint on atrioventricular interactions.
AB  - The effects of the pericardial constraint in control, tamponade, and absent
      pericardium conditions was studied in 18 anesthetized open-chest dogs. Atrial
      pressures and systolic and diastolic inflow volumes per beat in the superior
      (SVC), inferior vena cavae (IVC), and pulmonary vein (PV) were measured. With
      increasing tamponade, 1) the systolic-diastolic distribution of venous flow
      became almost exclusively systolic in the SVC (P less than 0.001) and IVC (P less
      than 0.05), as the gamma-descent disappeared; 2) similar but lesser left-sided
      changes occurred in PV flows (P less than 0.001) and pressure; and 3) the
      systolic-diastolic distribution of venous flow was modulated by heart rate. The
      results imply that during tamponade 1) increased pericardial liquid pressure
      associated with an increased pericardial constraint couples reciprocal atrial and
      ventricular volume changes; 2) the atria fill during ventricular ejection
      (atrioventricular interaction); 3) total heart volume must have been relatively
      constant throughout a cardiac cycle; and 4) differences in right and left heart
      compliances may explain persistent diastolic PV flow. Pericardiotomy produced a
      small increase in the ratio of diastolic to systolic venous inflow volumes (P
      less than 0.025), suggesting that normally the pericardium has a minor influence
      on atrioventricular interaction, the volume changes in the atria and ventricles
      being relatively uncoupled. With severe tamponade, a homogeneous pericardial
      fluid column tightly couples atrial and ventricular volume changes and accounts
      for the characteristic changes in atrial pressure waveforms and patterns of
      venous flow.

PMID- 1636753
TI  - Regional contractile performance during acute ischemia in porcine right
      ventricle.
AB  - Studies of regional ischemia in the canine left ventricle (LV) have shown
      augmented systolic segmental shortening in nonischemic regions. To characterize
      these responses in the right ventricle (RV), acute occlusions of the right
      coronary artery (RCAO) were produced in anesthetized pigs. Orthogonal pairs of
      ultrasonic segment-length crystals were implanted in the mid-RV free wall
      (ischemic region) and in the outflow tract (nonischemic region). RV pressure-area
      work loops were generated during inferior vena caval occlusions, and both slope
      (M) of the preload recruitable stroke work relationship and elastance (Ees) of
      the end-systolic pressure-area relationship were determined by linear regression.
      Under control conditions, there was no significant difference in M or Ees of the
      two regions. After RCAO, fractional area shortening decreased by 84% in the
      ischemic region but increased by 21% in the nonischemic region. Although RV end
      diastolic pressure and areas in both regions increased, M was significantly
      reduced by 78% only in the ischemic region. There was no change in contractile
      function in the nonischemic region as described by M and Ees despite the increase
      in systolic fractional area shortening. Therefore the nonischemic region of the
      porcine RV exhibits an apparent compensatory hyperkinesis in response to regional
      ischemia similar to that shown for the canine LV, consistent with the Frank
      Starling mechanism.

PMID- 1636754
TI  - Removal of sarcolemmal sialic acid residues results in a loss of sarcolemmal
      functioning and integrity.
AB  - Treatment of neonatal rat heart cells with neuraminidase results in a large
      increase of cellular-associated Ca2+. The study described below was designed to
      test the hypothesis that neuraminidase produces its effects by increasing the
      transient Ca2+ channel current, as proposed by Yee et al. (24). This ICa,T can be
      inactivated by dodecylsulfate (DDS) (17). The experimental data show that 1) the
      increase in cellular Ca2+ during neuraminidase treatment cannot be explained by
      an increased ICa,T; 2) neuraminidase treatment has a much more profound effect on
      sarcolemmal permeability than has been recognized previously; and 3) the effect
      of neuraminidase treatment can be prevented by 50 microM DDS. The study indicates
      that glycocalyx-lipid bilayer interactions are important in maintenance of
      selective permeability of the sarcolemma. The protective effect of 50 microM DDS
      is probably mediated by insertion of the negatively charged amphiphilic molecule
      in the sarcolemma, although the exact mechanism remains to be elucidated.

PMID- 1636756
TI  - Sodium and left ventricular mass in untreated hypertensive and normotensive
      subjects.
AB  - To determine whether urinary sodium excretion (a rather rough estimate of sodium
      intake) can influence left ventricular mass independently of arterial pressure,
      91 untreated subjects with essential hypertension and 50 normotensive subjects of
      similar age were studied. Left ventricular mass index (M-mode echocardiography)
      was positively correlated with urinary sodium excretion in hypertensive (r =
      0.22, P less than 0.01) as well as normotensive subjects (r = 0.22, P less than
      0.05), and systolic arterial pressure was correlated only in hypertensive
      subjects (r = 0.23, P less than 0.01). When hypertensive subjects were divided
      into groups with appropriate or inappropriate left ventricular mass by reference
      to a theoretical optimal left ventricular mass for each subject's level of
      systolic arterial pressure, left ventricular mass was appropriate in 68% and
      inappropriate in 32% of subjects. Urinary sodium excretion was higher in subjects
      with inappropriate left ventricular mass compared with those with appropriate
      left ventricular mass. In conclusion, sodium excretion may be an important
      modulator of the influence of arterial pressure on the left ventricle in
      normotensive subjects and subjects with essential hypertension.

PMID- 1636755
TI  - Chemoreceptor responsiveness in fetal sheep.
AB  - Fetal peripheral chemoreceptor responses to arterial O2 saturation and changes in
      PCO2 have not yet been quantitated. In 24 late-term chronically instrumented
      fetal sheep, we measured the heart rate response to acute hypoxemia induced by
      uterine arterial occlusion at various resting O2 saturations (25-86%) and at
      induced reductions and increases in baseline O2 saturation. As an index of fetal
      chemoreceptor responsiveness we calculated the fall in heart rate divided by the
      fall in arterial O2 saturation (delta HR/delta sat). delta HR/delta sat was
      inversely related to resting O2 saturation at levels less than 65%, but greater
      than 65% this relationship was no longer present. However, an induced increase in
      baseline O2 saturation from 66 +/- 12 to 76 +/- 10% decreased delta HR/delta sat
      from 2.6 +/- 1.6 to 1.8 +/- 1.0, indicating that when resting O2 saturation is
      greater than 65% there may be adaptation of peripheral chemoreceptors. Below 65%,
      an induced decrease in baseline O2 saturation increased delta HR/delta sat (to
      3.8 +/- 1.8), suggesting a lack of adaptation to lower O2 saturations.
      Concomitant changes in PCO2, or differences in baseline PCO2, did not affect
      delta HR/delta sat during uterine arterial occlusion, which suggests that there
      is no interdependence between O2 and CO2 as a stimulus for the fetal peripheral
      chemoreceptor. However, acute hypercapnia (n = 24 in 8 fetal sheep) induced
      bradycardia. Furthermore, this bradycardia was related to the increase in fetal
      arterial PCO2. We conclude that the fetal peripheral chemoreceptor is sensitive
      to hypoxemia and hypercapnia and that the hypoxemia response is accentuated with
      decreases in initial O2 saturation.

PMID- 1636757
TI  - Comparable sensitivity of flow contraction and relaxation to Na reduction may
      reflect flow-sensor characteristics.
AB  - Physiological salt solution infused through the lumen of a resistance branch of
      the rabbit central ear artery mounted in an isometric myograph causes both
      contraction and relaxation. The effect of reductions in extracellular Na up to 26
      mM (20% of the NaCl content of the physiological saline solution) on these flow
      induced changes in wall force and on the contraction to norepinephrine (10(-6) M)
      and relaxation to acetylcholine (10(-8) to 3 x 10(-6) M) and papaverine (10(-6)
      to 3 x 10(-5) M) has been studied. Na in the physiological saline solution was
      reduced by substitution of NaCl with sucrose or N-methyl-D-glucamine. The effect
      of either of these substitutions was to reduce both responses, contraction and
      relaxation, to the same extent. This sensitivity is such that physiological
      changes in blood Na concentration would be expected to influence flow-induced
      changes in wall tone. Responses to norepinephrine, acetylcholine, and papaverine
      were not significantly changed by these alterations in Na. It is argued that
      since reduction of extracellular Na diminished both contraction and relaxation to
      a similar extent, leading to relaxation and contraction respectively, that this
      effect probably occurs at a site common to both flow responses. Because both flow
      effects occur after endothelium removal and the extracellular matrix binds a
      large proportion of the Na in the blood vessel wall, this may represent the
      location of a flow-sensitive mechanism.

PMID- 1636758
TI  - Uterine prostaglandin production in ovine pregnancy: effects of angiotensin II
      and indomethacin.
AB  - The ovine and human uteroplacental vascular beds are more refractory to
      angiotensin II (ANG II)-induced vasoconstriction than the systemic vasculature.
      ANG II increases in vitro prostacyclin (PGI2) production by uterine but not
      omental arteries from pregnant sheep. Thus vasodilator prostaglandins may account
      for this difference in vascular responsiveness. We measured uterine and systemic
      eicosanoid production and hemodynamic responses in pregnant sheep before and
      during intravenous ANG II (1.15 and 11.5 micrograms/min). ANG II caused dose
      related increases in arterial pressure and systemic and uterine vascular
      resistance (P less than 0.05). PGI2 metabolite (6-keto-PGF1 alpha) in the uterine
      vein rose from 166 +/- 70 (SE) to 223 +/- 114 and 631 +/- 323 pg/ml, respectively
      (P less than 0.05), and arterial levels increased from 67 +/- 24 to 145 +/- 78
      and 312 +/- 173 pg/ml, respectively (P less than 0.05). Basal uterine
      venoarterial differences of 6-keto-PGF1 alpha were 99 +/- 43 pg/ml and increased
      during 11.5 micrograms ANG II/min to 295 +/- 181 pg/ml (P less than 0.05) but not
      during 1.15 micrograms/min (64 +/- 30 pg/ml). Responses were similar in gravid
      and nongravid uterine horns. Unilateral uterine prostaglandin inhibition with
      indomethacin did not alter basal uterine blood flow or systemic responses to ANG
      II (0.573-11.5 micrograms/min); however, ipsilateral uterine prostaglandin
      production fell and uterine vasoconstrictor responses increased (P less than
      0.05). During ovine pregnancy ANG II increases uterine PGI2 production. PGI2
      appears in part to attenuate ANG II-induced uterine vasoconstriction.

PMID- 1636759
TI  - An animal model of chronic coronary stenosis resulting in hibernating myocardium.
AB  - An experimental animal model of hibernating myocardium is presented. Sixteen
      animals were initially prepared of which seven were selected for final review.
      Hearts were instrumented in two separate surgical procedures such that maximum
      phasic flow velocity in the left anterior descending (LAD) coronary artery was
      reduced by 50% and followed over 1 wk. Regional shortening declined at 1 wk to
      62% of aerobic values (P less than 0.048) and did not improve over 2 h
      reperfusion. Metabolic determinations, obtained after 1 wk of coronary stenosis
      and immediately sampled before and after release of the LAD flow constrictor,
      showed no evidence of acidosis, hypercarbia, or an inability to extract oxygen at
      the tissue level. Thereafter, during the 2-h reperfusion period, hearts were able
      to respond to dobutamine (10 micrograms/kg infusion over 1 min) challenge with an
      appropriate shift in an end-systolic length estimate of contractility.
      Mitochondrial respiration at the conclusion of the studies in the reperfused bed
      demonstrated near normal recovery compared with aerobic values. None of the seven
      hearts showed gross evidence of infarction and only one heart was noted to have a
      few microfocal changes of healing infarction. Thus a new model of coronary
      stenosis is presented, which affected substantial reductions in mechanical
      function consistent with the concepts of hibernating myocardium. These mechanical
      events were not associated with marked metabolic abnormalities, reflecting
      advanced ischemia or mitochondrial dysfunction and could be transiently improved
      with inotropic stimuli. This model may prove beneficial as a tool in
      understanding mechanistic events underlying the hibernating heart.

PMID- 1636760
TI  - Oxygen transport during anemic hypoxia in pigs: effects of digoxin on metabolism.
AB  - We tested whether digoxin would limit tissue hypoxia during severe anemia by
      improving peripheral O2 distribution or decreasing O2 demands. Hematocrit (Hct)
      was reduced in eight control and eight digoxin-treated pigs from 27-28% to 17-18,
      11-12, and 7-8%. Whole body and hindlimb blood flow, O2 transport, O2 extraction,
      and O2 consumption and serum catecholamines (epinephrine and norepinephrine) were
      determined at each Hct. Arterial and femoral venous lactate and O2 deficit were
      obtained to reflect tissue hypoxia. Cardiac output was significantly greater (P
      less than 0.05) with digoxin, as expected, but there were no differences in
      hindlimb blood flow. Also, whole body and hindlimb O2 extractions were equal in
      both groups for similar levels of O2 transport, suggesting that digoxin did not
      alter the relationship of O2 flow to metabolism in regional circulations. As
      whole body O2 consumption fell, controls accumulated more (P less than 0.05) O2
      deficit and arterial lactate than the digoxin group. Furthermore, the slope
      demonstrating the linear increase of lactate with respect to O2 deficit was much
      steeper in controls (y = 1.11 + 0.06x) than in digoxin (y = 1.36 + 0.02x),
      suggesting that there were differences in the degree of tissue hypoxia for
      comparable O2 deficit. This may be attributed to the marked differences in
      catecholamine response: epinephrine was higher in controls at Hct of 7-8% and
      norepinephrine was higher at Hcts of 11-12 and 7-8%. Digoxin may have inhibited
      the release of catecholamine or reduced the stimulus for catecholamine secretion
      during anemia. We speculate that digoxin markedly improved the balance between
      peripheral O2 supply and demand during anemia by inhibiting catecholamine
      thermogenesis, thereby decreasing O2 demands. This may explain some of the
      salutary effects of glycosides in high-output cardiac failure with normal
      ventricular function.

PMID- 1636761
TI  - Contribution of adenosine to isoproterenol-stimulated prostacyclin production in
      rabbit heart.
AB  - This study investigated adenosine's contribution to isoproterenol-stimulated
      prostacyclin production, measured as 6-ketoprostaglandin F1 alpha (6-keto-PGF1
      alpha) output, and mechanical function in the isolated rabbit heart perfused with
      Krebs-Henseleit buffer. The isoproterenol-induced increase in 6-keto-PGF1 alpha
      was diminished by adenosine (10 microM), the A1 receptor antagonist 1,3-dipropyl,
      8-cyclopentylxanthine (DPCPX 0.06 microM), and the A2 receptor agonist CGS-21680
      (0.6 microM); CGS-21680 did not decrease heart rate (HR) or myocardial
      contractility (dP/dt(max)). The isoproterenol-induced increase in 6-keto-PGF1
      alpha was potentiated by the A1 receptor agonist 1-deaza,2-chloro,N6
      cyclopentyladenosine (DCCA, 0.6 microM) and the A2 receptor antagonist 3,7
      dimethyl,1-propargylxanthine (DMPX, 6 microM). The isoproterenol-induced increase
      in dP/dt(max) and HR was diminished by adenosine, DCCA, and DMPX. DPCPX enhanced
      dP/dt(max) and HR and prevented the decrease by adenosine and DCCA of the
      isoproterenol-induced increase in HR and dP/dt(max); the increase by DCCA but not
      the decrease by adenosine in 6-keto-PGF1 alpha output was abolished. DMPX
      abolished the effect of adenosine and CGS-21680 to reduce isoproterenol
      stimulated 6-keto-PGF1 alpha. These data suggest that adenosine generated in
      response to isoproterenol attenuates its effect on HR and dP/dt(max) through A1
      receptors and on prostacyclin synthesis via A2 receptors.

PMID- 1636762
TI  - Angiotensin II receptor antagonism in ovine heart failure: acute hemodynamic,
      hormonal, and renal effects.
AB  - The hemodynamic, hormonal, and renal effects of angiotensin II-type 1 receptor
      antagonism (AT1A) have not been documented previously in heart failure (HF) or
      compared with angiotensin-converting-enzyme inhibition (ACEI). Accordingly, we
      investigated the acute (2-h) response to losartan (1 and 10 mg/kg iv) or vehicle
      (N saline) followed by captopril (12.5 mg) on separate days in an ovine model of
      HF induced by 7 days of rapid ventricular pacing. Losartan induced a significant
      rise in plasma renin activity (PRA) and plasma angiotensin II levels (P less than
      0.01 and P less than 0.001, respectively), in association with a fall in the
      plasma aldosterone-to-PRA ratio (P less than 0.001) and plasma atrial natriuretic
      peptide (P less than 0.05). Mean arterial and left atrial pressure both fell
      significantly after losartan (P less than 0.001), whereas the rise in cardiac
      output was not sustained. The response to captopril was similar except for plasma
      angiotensin II, which declined (P less than 0.001). Glomerular filtration and
      urine sodium excretion were maintained despite a fall in renal perfusion
      pressure. In conclusion, the vasodilatation and renal effects of AT1A were
      similar to ACEI. Thus AT1A may be a useful therapeutic alternative to ACEI in HF.

PMID- 1636763
TI  - Regulation of spontaneous EDRF release in diabetic rat aorta by oxygen free
      radicals.
AB  - The interaction of endothelium-derived relaxing factor (EDRF) and oxygen-derived
      free radicals may potentially play an important role in the pathophysiology of
      complications associated with diabetes. In the present study, we investigated
      spontaneous EDRF release in diabetic rat aorta that is unmasked by the addition
      of superoxide dismutase (SOD). SOD produced a significantly greater relaxation in
      diabetic aorta compared with control aorta using both aortic ring and bioassay
      preparations. This relaxation was unaltered by pretreatment with catalase or
      indomethacin. Removal of the endothelium or pretreatment with either NG
      monomethyl-L-arginine or methylene blue eliminated SOD-induced relaxation in both
      control and diabetic rings. Measurement of antioxidant enzymes revealed an
      elevation in catalase in diabetic aorta, with no difference in the SOD or
      glutathione peroxidase activity. The increase in catalase activity suggests
      increased exposure of diabetic aorta to hydrogen peroxide. Pretreatment of rings
      with the catalase inhibitor, 3-amino-1,2,4-triazole, attenuated the SOD-induced
      relaxation in diabetic aortic rings but had no effect in control aortic rings. In
      summary, our observations suggest that the diabetic rat aorta releases more
      spontaneous EDRF than control aorta; however, the activity of EDRF on vascular
      smooth muscle tone is masked by increased destruction by oxygen-derived free
      radicals.

PMID- 1636764
TI  - Left ventricular shape changes during the course of evolving heart failure.
AB  - The temporal relationship between left ventricular (LV) shape changes and the
      development of LV dysfunction, dilation, and sympathoadrenergic hyperactivity was
      examined in 10 dogs with chronic heart failure produced by multiple sequential
      intracoronary microembolizations. LV shape was quantitated from serial
      ventriculograms based on the ratio of the major to minor axis at end systole and
      end diastole. Measurements were made at baseline (before embolizations) and were
      repeated at 2, 8, and 16 wk after the last embolization. A significant increase
      of LV sphericity was present at 2 wk, with only minimal changes occurring
      thereafter. Despite the tendency for LV shape changes to plateau between 2 and 16
      wk, LV ejection fraction continued to decline (31 +/- 1 vs. 20 +/- 2%; P less
      than 0.001), and LV end-diastolic volume continued to increase (86 +/- 6 vs. 103
      +/- 9 ml; P less than 0.01) as did plasma norepinephrine concentration (456 +/-
      30 vs. 868 +/- 172 pg/ml; P less than 0.02). These data indicate that in the
      course of evolving heart failure, LV shape abnormalities precede the development
      of profound LV dysfunction, dilation, and overt activation of the sympathetic
      nervous system.

PMID- 1636765
TI  - Cytosolic pH measurements in single cardiac myocytes using carboxy
      seminaphthorhodafluor-1.
AB  - This study examines the use of carboxy-seminaphthorhodafluor-1 (C-SNARF-1) as an
      indicator of cytosolic pH in isolated rat cardiac myocytes. The emission spectrum
      of C-SNARF-1 when excited at 530 nm contains two well-separated peaks at
      approximately 590 and 640 nm, corresponding to the acidic and basic forms of the
      indicator. This spectral feature allows the indicator to be used in the single
      excitation, dual emission ratio mode. When C-SNARF-1 is loaded into rat cardiac
      myocytes as the membrane permeant ester derivative, C-SNARF-1/AM, the indicator
      localizes within the cytosol with virtually no partitioning into the
      mitochondria. C-SNARF-1 does not load into isolated mitochondria in suspension.
      There was no evidence for the presence of non-deesterified C-SNARF-1 within the
      cells. C-SNARF-1 can be calibrated in situ using a technique that abolishes all
      transsarcolemmal pH gradients. A 0.7-unit shift in the apparent pK (pKapp = pK
      log10) between the in vitro calibration and the in situ calibration is consistent
      with a change in beta (I640 to pH 9/I640 at pH 5) in the cytosolic environment
      (beta in situ/beta in vitro = 0.21) and not a change in the true pK of the
      indicator. The contribution of cellular autofluorescence to the total signal can
      be made negligible. There is no effect of C-SNARF-1 on the contractile properties
      of rat cardiac myocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636766
TI  - Laser-Doppler flowmetry in monitoring regulation of rapid microcirculatory
      changes in spinal cord.
AB  - We established a rabbit model for continuous on-line monitoring of spinal cord
      microcirculation using laser-Doppler flowmetry (LDF). We tested the suitability
      of this model for studying rapid, nonequilibrium microcirculatory blood flow (BF)
      states induced by pharmacological treatments, hemorrhage, and asphyxia. Effective
      BF regulation was observed at systemic arterial pressure levels of 50 mmHg.
      Autoregulatory vasodilation began 1 min after the onset of severe hypotension,
      whereas more immediate vasodilation took place after asphyxia (hypercarbia).
      Pathological situations were studied in a simple model of spinal cord (SC)
      ischemia-reperfusion after 10 (n = 7) and 25 min (n = 7) of ischemia and 2 h of
      reperfusion. After 25 min of ischemia, delayed hypoperfusion (BF -35 +/- 7%, P
      less than 0.01) took place in association with tissue edema. LDF offered
      sensitive, stable, and reproducible estimates of microcirculation with high
      temporal resolution, thus permitting on-line evaluation of rapid, nonequilibrium
      BF responses and delayed states of spinal cord BF dysregulation.

PMID- 1636767
TI  - A method to reconstruct myocardial sarcomere lengths and orientations at
      transmural sites in beating canine hearts.
AB  - The ability to measure cyclic changes in myocardial sarcomere lengths and
      orientations during cardiac ejection and filling would improve our understanding
      of how the cellular processes of contraction relate to the pumping of the whole
      heart. Previously, only postmortem sarcomere measurements were possible after
      arresting the heart in one state and fixing it for histology. By combining such
      histological measurements with direct observations of the deformation experienced
      by the same myocardial region while the heart was beating, we have developed a
      method to reconstruct sarcomere lengths and orientations throughout the cardiac
      cycle and at several transmural layers. A set of small (1 mm) radiopaque beads
      was implanted in approximately 1 cm3 of the left ventricular free wall. Using
      biplane cineradiography, we tracked the motion of these markers through various
      cardiac cycles. To quantify local myocardial deformation (as revealed by the
      relative motion of the markers), we calculated the local deformation gradient
      tensors. As the heart deforms, these describe how any short vectorial line
      segment alters its length and orientation relative to a reference state.
      Specifically, by choosing the reference state to be the arrested and fixed heart
      and by measuring the sarcomere vector in that state, we could then use the
      deformation gradient tensors to reconstruct the sarcomere vector that would exist
      in the beating heart. As ventricular chamber volume varied over its normal range
      of operation, the range of reconstructed sarcomere lengths (approximately 1.7-2.4
      microns) was comparable to other histological studies and to measurements of
      sarcomere length in excised papillary muscles or trabeculae. The pattern of
      sarcomere length changes was markedly different, however, during ejection vs.
      filling.

PMID- 1636768
TI  - Isometric biaxial tension of smooth muscle in isolated cylindrical segments of
      rabbit arteries.
AB  - Biaxial tension developed in the common carotid and femoral arteries of rabbits
      by the activation of smooth muscle was determined in vitro using cylindrical
      segments. While the smooth muscle was stimulated with 10(-5) M norepinephrine,
      the intraluminal pressure and axial force were measured under isometric
      conditions, i.e., keeping the diameter and length constant. The development of
      the active tension in the axial direction was roughly proportional to that in the
      circumferential direction. The ratio of the axial stress response to the
      circumferential one was positively correlated to the ratio of the axial stretch
      to the circumferential one. The axial response was larger than expected from the
      histological observation that the smooth muscle cells align almost
      circumferentially. This means that although smooth muscle cells are oriented
      almost circumferentially, the extracellular matrix transmitted the smooth muscle
      constriction force not only in the circumferential direction, but also in the
      longitudinal direction under isometric conditions.

PMID- 1636769
TI  - How to encode arterial pressure into carotid sinus nerve to invoke natural
      baroreflex.
AB  - The purpose of this study was to develop an artificial baroreceptor that was
      capable of invoking the "natural" baroreflex by electrically stimulating the
      afferent nerve. In six anesthetized, vagotomized dogs, we first identified, using
      the white-noise method, the transfer function from carotid sinus pressure to
      aortic pressure (HCSP.AoP) and that from the electrical carotid sinus nerve
      stimulation to aortic pressure (HCSN.AoP). We then backcalculated the transfer
      function required for the artificial baroreceptor (HCSP.CSN) as the ratio of
      HCSP.AoP to HCSN.AoP. To activate the artificial baroreceptor, we electrically
      stimulated the carotid sinus nerve with the frequency-modulated pulse train
      obtained in real time by convolving the impulse response of HCSP.CSN with
      instantaneous aortic pressure. We tested performance of the artificial
      baroreceptor by imposing random changes in blood volume. The pressure-stabilizing
      effects of the artificial baroreceptor were indistinguishable from those of the
      native one. We conclude that the artificial baroreceptor can invoke the natural
      baroreflex. The proposed framework generally would be applicable to interface
      artificial devices with the central nervous system.

PMID- 1636770
TI  - Oxygen diffusion in hamster striated muscle: comparison of in vitro and near in
      vivo conditions.
AB  - To investigate the suggestion of A. S. Popel, R. N. Pittman, and M. L. Ellsworth
      [Am. J. Physiol. 256 (Heart Circ. Physiol. 25): H921-H924, 1989] that Krogh's
      diffusion coefficient for O2 in vivo might be an order of magnitude higher than
      in vitro, O2 diffusion coefficient (DO2) and resting O2 consumption were measured
      on hamster retractor muscle in vitro and under near in vivo conditions where the
      muscle remained attached to the animal but the arterial inflow was occluded just
      before measurement. Experiments were performed on two groups of animals,
      differing in weight and age. We found that DO2 determined in vitro (extrapolated
      to 37 degrees C) was 1.81 +/- 0.12 x 10(-5) cm2/s for group I (smaller and
      younger), which was not significantly different from the value (2.00 +/- 0.08 x
      10(-5) cm2/s) determined in group II. In both groups, DO2 under near in vivo
      conditions tended to be 10-15% larger than the value in vitro, although this
      trend did not reach statistical significance. It is unlikely that this trend is
      large enough to reconcile the inconsistency between theoretical and experimental
      determinations of O2 diffusion from the arteriolar network of this tissue.

PMID- 1636771
TI  - Quantitation of specific binding of orosomucoid to cultured microvascular
      endothelium: role in capillary permeability.
AB  - Orosomucoid (also known as alpha 1-acid glycoprotein) is a highly sialylated,
      polyanionic serum glycoprotein. Its presence in vascular perfusates alters
      microvascular permeability, presumably by binding to the endothelial glycocalyx,
      but the rest of its functions remains unknown. In this study, we assess the
      binding of bovine serum orosomucoid (BSO) to the surface of bovine pulmonary
      microvascular endothelial cells (BLMVEC) in culture at 4 degrees C. The binding
      of radioiodinated BSO (125I-BSO) reached equilibrium after 10 min of incubation,
      was not calcium dependent, and was reversible by greater than 80% in 30 min. The
      binding of 125I-BSO was competed with unlabeled BSO but not by transferrin,
      immunoglobulin, gelatin, ovalbumin, mannan, fucoidan, mucin, or asialomucin. In
      addition, binding was not affected by the presence of galactose, glucose, fucose,
      mannose, N-acetyl-D-galactosamine, or N-acetyl-D-glucosamine. This binding
      behavior is not consistent with carbohydrate recognition by lectin-like molecules
      such as the asialoglycoprotein receptor. Scatchard analysis of the BSO binding to
      BLMVEC produced a concave-upward shaped curve, which revealed a higher affinity
      binding component with an apparent equilibrium affinity constant (Kd) of 8.6 nM
      and a maximum receptor number of 40,000/cell and revealed a moderate affinity
      component with a Kd of 9.1 microM with a maximum binding of 10(7) binding sites
      per cell. Other blood vessel-associated cells clearly bound less BSO with a lower
      binding affinity than the BLMVEC monolayers. From the binding data, we estimated
      the total increase in the negative charge of the glycocalyx with orosomucoid
      binding to be approximately 17 meq/l.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636772
TI  - Comparison of norepinephrine and isoproterenol clearance in congestive heart
      failure.
AB  - Congestive heart failure (CHF) is accompanied by increased sympathetic nervous
      activity. Previous studies have demonstrated that plasma norepinephrine (NE), a
      marker of sympathetic nervous activity, is elevated in CHF due to increased NE
      spillover into the circulation and decreased NE clearance. In this study we
      compared the clearance of NE and isoproterenol (ISO) in eight CHF subjects
      (plasma NE 601 +/- 133 pg/ml), and in nine controls (plasma NE 285 +/- 53 pg/ml)
      by using steady-state infusions of tritiated NE ([3H]NE) and tritiated ISO
      ([3H]ISO). Because ISO is not a substrate of neuronal reuptake but is removed
      from the circulation in a way that is similar to NE after neuronal reuptake
      blockade with desipramine, ISO clearance may permit a gross estimation of non
      neuronal uptake of circulating NE. The NE clearance was lower in CHF than in the
      control group (CHF 1.25 +/- 0.13, controls 2.04 +/- 0.22 l.min-1.m-2; P = 0.009).
      The ISO clearance was reduced similarly in CHF (CHF 0.90 +/- 0.09, controls 1.59
      +/- 0.12 l.min-1.m-2; P less than 0.001). Because the ratio of ISO to NE
      clearance was similar in both groups, our findings suggest that a low cardiac
      output in CHF decreases the availability of circulating catecholamines to tissue
      elimination sites.

PMID- 1636773
TI  - Altered agonist-induced Ca2+ mobilization in aortic smooth muscle cells from
      cardiomyopathic hamsters.
AB  - We compared the responses to the Ca(2+)-mobilizing effects of norepinephrine
      (NE), endothelin-1 (ET), and arginine vasopressin (AVP) of primary cultures of
      vascular smooth muscle cells (VSMCs) from aortas of young (30-40 days old)
      cardiomyopathic (Bio 14.6 strain) and age-matched control hamsters. In Bio 14.6
      VSMCs, saturating concentrations of NE and ET elicited increases in the
      intracellular Ca2+ concentration ([Ca2+]i), which reached approximately 50 and
      62% of those in control VSMCs. AVP elicited a significant increase in [Ca2+]i
      only in Bio 14.6 VSMCs. In contrast, 10 microM ionomycin induced similar Ca2+
      responses in both types of cells in the absence of extracellular Ca2+. Ligand
      binding assay revealed that maximal binding values for alpha 1-adrenergic
      antagonists and ET in Bio 14.6 VSMCs were 59-64 and 85% of those in control
      VSMCs. Thus VSMCs from aortas of Bio 14.6 hamsters had reduced reactivity to NE
      and ET but increased response to AVP. The reduced Ca2+ response of Bio 14.6 VSMCs
      to NE appeared to be due mainly to a decrease in the receptor number.

PMID- 1636774
TI  - Role of endothelium-derived nitric oxide in myocardial reactive hyperemia.
AB  - In pentobarbital sodium-anesthetized dogs we investigated the role of the
      endothelium-derived nitric oxide and adenosine in the regulation of the coronary
      blood flow during myocardial reactive hyperemia. Repayments of flow debt after 10
      , 20- and 60-s occlusion of the left circumflex coronary artery (LCX) were
      measured before and after infusion of NG-monomethyl-L-arginine (L-NMMA; n = 15),
      8-phenyltheophylline (8-PT; n = 5), and both L-NMMA and 8-PT (n = 5) into the
      LCX. Infusion of L-NMMA (2 mumol/min, for 20 min) reduced repayments of flow debt
      after 10-, 20-, and 60-s LCX occlusion by 30 +/- 4 (P less than 0.01), 34 +/- 3
      (P less than 0.01), and 14 +/- 3% (P less than 0.01), respectively. Infusion of 8
      PT (0.75 mumol/min for 15 min) also reduced these repayments of flow debt by 31
      +/- 7 (P less than 0.01), 30 +/- 7 (P less than 0.01), and 34 +/- 6% (P less than
      0.01), respectively. Simultaneous infusion of L-NMMA and 8-PT significantly
      attenuated the peak reactive flow rate and reduced repayment of flow debt after
      20-s LCX occlusion by 57 +/- 1% (P less than 0.001), and this reduction in
      repayment of flow debt was significantly greater than each of those by the
      individual administration of L-NMMA and 8-PT (both P less than 0.01). The
      suppressive effect of L-NMMA on repayment of flow debt after 20-s LCX occlusion
      was quickly reversed by the infusion of L-arginine (3 mg/min for 10 min; n =
      5).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636775
TI  - Catecholamines in cerebrospinal fluid are increased by behavioral arousal and
      myocardial ischemia.
AB  - To study the central neural mechanisms involved in malignant ventricular
      arrhythmia, concentrations of norepinephrine in the cerebrospinal fluid were
      measured during behavioral stimulation and during coronary artery occlusion. Pigs
      were instrumented via thoracotomy with catheters to measure mean arterial
      pressure and plasma catecholamines and with silk snares around the left anterior
      descending coronary artery for occlusion after recovery from surgery. Cannulas
      were placed in the lateral ventricle of the brain to sample cerebrospinal fluid.
      Behavioral arousal was induced by lifting the pig in a canvas sling for 5 min.
      Mean arterial pressure, heart rate, and both plasma and cerebrospinal fluid
      norepinephrine concentrations increased significantly after lifting stimulation.
      In a separate experiment, 5 min after coronary artery occlusion, both plasma
      catecholamines and norepinephrine in cerebrospinal fluid were significantly
      elevated. Furthermore, pigs in which ventricular fibrillation occurred after
      occlusion had significantly higher concentrations of norepinephrine in
      cerebrospinal fluid before coronary artery occlusion.

PMID- 1636776
TI  - Effects of mechanical vibration on left ventricular diastolic properties during
      global ischemia.
AB  - To examine the effect of mechanical vibration on ventricular relaxation and
      diastolic chamber stiffness under global ischemia, we studied eight coronary
      perfused, isolated, isovolumic canine left ventricles (LV). To produce varying
      degrees of impaired relaxation, graded coronary flow reduction and paced
      tachycardia were imposed. A mechanical 50-Hz, 2-mm-amplitude vibration was
      applied during diastole and was turned off during systole. Without diastolic
      vibration, the relaxation time constant of LV pressure (tau) increased with the
      severity of ischemia. The chamber stiffness index (K) from the diastolic pressure
      volume relationship showed a slight increase during ischemia; tau decreased with
      diastolic vibration. The change in tau with vibration increased with ischemia and
      was dependent on vibration amplitude but not heart rate. The ratio of tau to the
      diastolic interval (DI, the time from peak negative rate of LV pressure change to
      end diastole) always decreased with vibration and was linearly correlated with K
      (r = 0.93; P less than 0.01). K decreased with vibration when tau/DI was greater
      than 0.3. We conclude that diastolic vibration improves impaired relaxation and
      chamber stiffness under myocardial ischemia.

PMID- 1636777
TI  - Suppression of baroreceptor discharge by endothelin at high carotid sinus
      pressure.
AB  - Endothelin is a potent vasoconstrictor peptide released from endothelial cells
      capable of producing marked and prolonged increases in arterial pressure. The
      purpose of this study was to determine whether endothelin alters the sensitivity
      of arterial baroreceptors. Multifiber baroreceptor activity was recorded from the
      vascularly isolated, endothelium-denuded carotid sinus in dogs anesthetized with
      alpha-chloralose. Local exposure of baroreceptors to endothelin at a
      concentration of 10(-8) M produced vasoconstriction of the carotid sinus as
      measured with sonomicrometer crystals but did not alter baroreceptor discharge
      significantly. A higher concentration of endothelin (10(-7) M) markedly
      suppressed baroreceptor activity, particularly at pressures greater than 100 mmHg
      (n = 7, P less than 0.05). The magnitude of the decrease in activity was
      dependent on the duration of exposure to endothelin. Baroreceptor activity
      measured at carotid pressures of 60, 100, and 200 mmHg averaged 23 +/- 4, 65 +/-
      6, and 100 +/- 0% of maximum during control; 38 +/- 12, 61 +/- 9, and 74 +/- 15%
      after exposure to endothelin (10(-7) M) for 2 min; and 27 +/- 8, 53 +/- 12, and
      56 +/- 19% after 12 min, respectively. The suppression of nerve activity with the
      high dose of endothelin was not accompanied by additional vasoconstriction,
      suggesting a direct effect of endothelin on nerve endings. We speculate that
      endothelin released from endothelial cells may act in a paracrine manner to
      suppress activity of baroreceptors, particularly at high levels of arterial
      pressure. Such an action would interfere with the buffering capacity of the
      baroreflex and promote hypertension.

PMID- 1636778
TI  - Anticipatory activity and entrainment of circadian rhythms in Syrian hamsters
      exposed to restricted palatable diets.
AB  - Activity rhythms were recorded from hamsters in three conditions: during timed
      feedings of an attractive diet with free access to regular food, during
      restriction to 70% of normal food consumption, and during moderate food
      deprivation with limited temporal access to an attractive diet. An attractive
      diet given to intact animals did not induce anticipatory activity or entrainment,
      but damage to the suprachiasmatic nuclei (SCN) led to the development of
      anticipatory activity. Food restriction to 70% of normal intake led to
      anticipatory components in some intact animals, without entraining the dominant
      circadian pacemaker. The combination of a palatable diet and food restriction led
      to anticipatory activity before the daily feeding times and entrainment of a
      previously free-running circadian rhythm in some animals. Ablation of the SCN did
      not eliminate anticipatory activity in experimental animals, but did eliminate
      the free-running component of the rhythms. These results indicate that hamsters
      have a mechanism separate from the SCN that can anticipate daily feeding times,
      as rats do, and that they may show entrainment of the SCN-based pacemaker to such
      feeding schedules.

PMID- 1636779
TI  - Behavioral effects of A71623, a highly selective CCK-A agonist tetrapeptide.
AB  - We studied the behavioral effects of a novel cholecystokinin tetrapeptide (CCK-4)
      analogue, A71623, with full agonist activity and high affinity and selectivity
      for the CCK-A receptor subtype relative to the CCK-B receptor. In tests for
      anorectic activity, A71623 was found to suppress 60-min intakes of a liquid diet
      in both deprived and sated rats, and the effects were blocked by a selective CCK
      A antagonist, A70104. Compared with CCK-8, A71623 was found to have improved
      potency and duration of action; the most potent route of administration was
      intraperitoneal. A71623 also suppressed the intake of a liquid diet and a 0.2 M
      sucrose solution in lean and obese Zucker rats. In daily injection studies, the
      anorectic activity of CCK-8 diminished rapidly, whereas the suppressant effects
      of A71623 on food intakes and body weight gains persisted throughout the 11-day
      treatment period. Finally, A71623 reduced the spontaneous locomotor activity of
      rats at doses above those required to suppress intakes. These studies are the
      first to describe the behavioral effects of a potent and highly selective CCK-A
      receptor agonist.

PMID- 1636780
TI  - Fractal properties in fetal breathing dynamics.
AB  - The dynamic pattern of fetal breathing was studied in 17 fetal lambs with
      chronically implanted electromyographic electrodes in the diaphragm. The
      instantaneous breathing rate time series appeared similar on different time
      scales, with clusters of faster breathing rates interspersed with periods of
      relative quiescience, suggesting self-similarity. Distribution histograms of the
      interbreath intervals (IBIs) showed log-normal distribution for IBIs less than 1
      s and inverse power-law distribution for IBIs greater than 1 s. The ratio of log
      normal distribution to power-law distribution varied from approximately 2 at 102
      days to approximately 30 by 130 days of gestation. Fast Fourier transform of the
      breathing rate time series revealed 1/f beta power spectra for all animals, with
      beta increasing linearly from 0.43 to 0.88 between 102 and 139 days. Studies in
      the newborn lamb showed further maturation in both the distribution
      characteristics of the IBIs, as well as in the 1/f power spectra, with beta
      approaching 1.0 at 2 days after birth. The inverse power-law relationship in the
      distribution of the IBIs, together with the 1/f beta power spectra, indicate
      scale invariance and suggest that fractal mechanisms are involved in the
      regulation of fetal breathing.

PMID- 1636781
TI  - Hyperosmolality impairs ammonia-mediated inflammation: implications for the renal
      medulla.
AB  - Although ammonia modifies the third component of complement (C3) and activates
      the alternative pathway, inflammation is not seen in the renal medulla where
      ammonia concentrations are normally elevated. We examined the effect of the
      unique hyperosmolar milieu of the renal medulla on the interaction of ammonia
      with C3 and the capacity of ammonia-modified C3 (NH3.C3) to induce cytolytic
      injury and stimulate neutrophils (PMN). Incubation of purified human C3 with
      ammonia in concentrations found in urine results in significant disruption of the
      C3 thiolester bond compared with ammonia-free controls. Coincubation with urinary
      osmolytes and hyperosmolar NaCl and urea does not impair thiolester disruption
      over a range of ammonia concentrations. However, hyperosmolar NaCl and urea
      virtually abolish cytolytic injury mediated by the alternative pathway.
      Coincubation with the organic osmolytes betaine, sorbitol, and inositol fails to
      reverse this inhibitory effect of hyperosmolar NaCl and urea. Hyperosmolar NaCl
      and urea also suppress lytic injury mediated by ammonia and complement in MDCK, a
      cell line derived from canine distal tubular epithelium. Both PMN degranulation
      and respiratory burst responses to NH3.C3 are significantly blunted in the
      presence of hyperosmolar NaCl and urea. Hyperosmolality also impairs PMN
      responses to the formyl peptide N-formyl-Met-Leu-Phe and phorbol 12-myristate 13
      acetate (PMA). Therefore, in an in vitro setting of hyperosmolar NaCl and urea,
      amidation of C3 occurs, but subsequent membrane-directed and receptor-mediated
      functions of NH3.C3 are markedly impaired.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636782
TI  - Healing of intestinal anastomoses in adrenalectomized rats given corticosterone.
AB  - To determine the effect of physiological variations in glucocorticoid levels on
      wound healing, adrenalectomized rats, implanted with corticosterone pellets of
      varying concentrations, and sham-operated rats were subjected to ileal
      transection followed by end-to-end anastomosis. Adrenalectomized animals with
      plasma corticosterone levels less than 2.5 micrograms/dl suffered 25% mortality.
      In rats surviving 1 wk, bursting pressure of the anastomotic site was measured as
      an index of wound healing. At plasma corticosterone levels of 3.9-7.4
      micrograms/dl, which approximate normal physiological levels, bursting pressure
      was not significantly different from that in sham-adrenalectomized animals. In
      adrenalectomized rats with lower or higher corticosterone levels, bursting
      pressure was significantly reduced. Thus a narrow range of plasma corticosterone
      is required for optimal wound healing in this model; higher values tend to impair
      healing, as do subnormal values, perhaps because of slower protein turnover; low
      values also lead to high mortality.

PMID- 1636783
TI  - Salt taste discrimination after bilateral section of the chorda tympani or
      glossopharyngeal nerves.
AB  - Gustatory deafferentation of the anterior tongue by bilateral section of the
      chorda tympani nerve, which removes only 15% of the total taste buds in the rat,
      severely impaired the rat's ability to discriminate NaCl from KCl. The
      discrimination deficit was selective. Denervated rats were able to discriminate
      sucrose from quinine. Despite eliminating four times as many taste buds by
      bilateral section of the glossopharyngeal nerve, posterior lingual
      deafferentation had no effect on NaCl vs. KCl discrimination performance.
      Collectively, these data suggest that afferents in the chorda tympani nerve
      provide the highest degree of disparity between the peripheral signals
      representing NaCl and KCl. Electrophysiological findings of others implicate the
      sodium-specific afferents that appear to exclusively exist in the chorda tympani
      nerve as the critical elements subserving the NaCl vs. KCl discrimination.

PMID- 1636784
TI  - Temperature dependence of electrophysiological properties of guinea pig and
      ground squirrel myocytes.
AB  - The effects of changing temperature on the electrophysiology of isolated cardiac
      myocytes of the guinea pig and Richardson's ground squirrel were studied by patch
      clamp techniques. In cells from both species, the resting membrane potential
      declined on cooling from 36 to 12 degrees C by approximately 6 mV. The duration
      of the plateau of the action potential in guinea pig cells increased
      monotonically on cooling. In contrast, the action potential of ground squirrel
      cells showed a biphasic response, increasing in duration from 36 to 24 degrees C
      and then decreasing on cooling from 24 to 12 degrees C. From voltage-clamp
      studies, the properties of L-type calcium currents (ICa) on cooling were compared
      in the two species and were found to be similar: In both cases, ICa decreased in
      amplitude from approximately 2 nA peak current at 36 degrees C to less than 400
      pA at 12 degrees C. The Q10 of both the maximum amplitude and time to peak for
      ICa in both species was approximately 1.8. The time for half inactivation had a
      greater Q10 of 2.5-3. It is concluded that, surprisingly, factors affecting the
      resting membrane potential and properties of L-type calcium channels are not
      major contributors to cardiac dysfunction on cooling. Rather, it is sarcoplasmic
      reticulum calcium release and reuptake that are likely to be the most important
      cold-sensitive processes.

PMID- 1636785
TI  - Cryomicroscopic analysis of freezing in liver of the freeze-tolerant wood frog.
AB  - The technique of directional solidification coupled with low-temperature scanning
      electron microscopy was applied to analyze the freezing of liver slices from the
      freeze-tolerant frog Rana sylvatica. Micrographs of liver slices from 5 degrees C
      acclimated frogs frozen on the directional stage to -7 degrees C showed
      continuous ice formed along an expanded vasculature with hepatocytes that were
      shrunken and virtually dehydrated. However, when frogs were given a survivable
      freezing exposure at -4 degrees C for 24 h, liver slices subsequently frozen in
      vitro at -7 degrees C were much less shrunken and the presence of intracellular
      ice crystals (formed when samples were plunged into liquid N2 before microscopy)
      demonstrated that ample free water remained in these hepatocytes at -7 degrees C.
      This reduced level of cell dehydration was correlated with the buildup of 280 +/-
      61 mumol/g wet wt glucose as a cryoprotectant in liver during the -4 degrees C
      exposure in vivo. The study provides the first direct cytological analysis of the
      freezing process in an organ of a freeze-tolerant vertebrate and the first
      confirmation of the relationship between maintenance of a critical minimum cell
      volume and freezing survival by these animals.

PMID- 1636786
TI  - Sepsis produces early depression of gut absorptive capacity: restoration with
      diltiazem treatment.
AB  - Although gut permeability increases and bacterial translocation occurs under
      certain pathological conditions, it remains unknown whether gut absorptive
      capacity (GAC) is altered early after the onset of sepsis. The aim of the present
      study was to investigate this and also to determine whether diltiazem has any
      effect on GAC in early sepsis. Rats were lightly anesthetized and cecal ligation
      and puncture (CLP) was performed. A nasogastric tube was inserted, cannulation of
      various blood vessels was carried out, and the animals were allowed to recover
      from anesthesia. One hour after CLP, one group of animals received a 1-ml bolus
      of normal saline intravenously, and another group received diltiazem, 400
      micrograms/kg body wt. Sham animals had no CLP performed. GAC was determined by
      the D-xylose absorption test at 2 and 4 h after CLP. One hour after the
      administration of D-xylose via the nasogastric tube, its concentration in portal
      blood was determined colorimetrically. Results show that GAC is significantly
      depressed at 2 and 4 h after CLP despite the maintenance of normal blood
      pressure, central venous pressure, and portal pressure. Administration of
      diltiazem restored GAC to normal levels at 4 h after CLP. Thus diltiazem is a
      useful adjuvant in the treatment of sepsis because it restores gut absorptive
      capacity to normal and allows for early enteral nutrition.

PMID- 1636787
TI  - Strong conservation of the expression of cystatin C gene in choroid plexus.
AB  - The expression of the cystatin C gene was studied by Northern analysis of RNA
      isolated from the choroid plexus, other brain tissues, and liver from 11
      mammalian and 4 avian species. The probe used for hybridization was cystatin C
      cDNA isolated previously from a rat choroid plexus cDNA library. Strong
      conservation of the expression of the cystatin C gene in choroid plexus was
      suggested by the observation of substantial levels of cystatin C mRNA in choroid
      plexus RNA from all mammalian and avian species studied. In contrast, levels of
      cystatin C mRNA in total liver RNA varied widely for mammalian as well as for
      avian species. It was concluded that the synthesis of cystatin C in choroid
      plexus has probably been conserved since the stage of the stem reptiles, the
      common ancestors of mammals and birds. The cystatin C gene was also found to be
      expressed early in ontogeny, as indicated by the observation of similar cystatin
      C mRNA levels in choroid plexus RNA from newly hatched and adult chickens.

PMID- 1636788
TI  - Composition and mechanics of mesenteric resistance arteries from pregnant rats.
AB  - We tested the hypothesis that the systemic resistance vasculature of the rat is
      remodeled during pregnancy as evidenced by significant alterations in the passive
      mechanical properties and extracellular matrix proteins in mesenteric arteries.
      Mechanical characteristics were determined for arteries from 20-day pregnant rats
      (n = 6) and age-matched controls (n = 5). Lumen diameter and wall thickness were
      measured in pressurized arteries (250-microns diameter) using a dimension
      analyzing system. Distensibility (the relative change in diameter per unit change
      in pressure) was less in the arteries from the pregnant rats (P less than 0.01).
      The calculated stress-strain relationships and elastic moduli indicated that the
      arteries were less stiff by late gestation (P less than 0.05). Ultramicro amino
      acid analysis and radioimmunoassay were used to measure hydroxyproline,
      desmosine, and leucine as indicators of collagen, elastin, and total protein,
      respectively, in similar-sized arteries. Hydroxyproline/leucine (index of
      collagen) and desmosine/leucine (elastin concentration) decreased 19 and 15% by
      late gestation (P less than 0.05). The significant alterations in passive
      mechanics and in extracellular protein content support the concept that arterial
      wall remodeling in the peripheral vasculature may be one component of the
      cardiovascular adaptations during pregnancy.

PMID- 1636789
TI  - Effects of hydration state on exercise thermoregulation in goats.
AB  - In this study we asked how exercise affects sweating and panting and how
      dehydration affects exercise thermoregulation in goats. Six goats exercised (4.8
      km/h, +10% slope) for 45 min at an ambient temperature of 35 degrees C when
      hydrated and after 48 h without drinking water. Hematocrit (Hct), plasma protein
      concentration (PP), and plasma osmolality were elevated by dehydration (P less
      than or equal to 0.05). Hct and plasma osmolality increased further during
      exercise in hydrated and dehydrated animals (P less than or equal to 0.05), but
      PP rose only in hydrated goats (P less than or equal to 0.05). The increase in
      central blood temperature (Tbl) during exercise was greater in dehydrated than in
      hydrated animals (P less than or equal to 0.001). Evaporation by panting (Eresp)
      and sweating were linearly related to Tbl during exercise. The relationship
      between Eresp and Tbl was not affected by dehydration, but dehydrated animals
      showed an increased Tbl threshold for sweating. We postulate that the elevation
      in threshold for sweating may be due primarily to increased body fluid
      osmolality, and that hypovolemia may not play a significant role in the
      thermoregulatory adjustments to exercise in dehydrated goats.

PMID- 1636790
TI  - Comparing responses when each response is a curve.
AB  - We describe, generalize, and demonstrate the application of a method (W. H.
      Lawton, A. Sylvestre, and M. S. Maggio, Technometrics 14: 513-532, 1972) that can
      be used to partially analyze population data. The data from each subject consist
      of a series of responses observed at distinct values of a predictor variable. The
      method assumes that all subjects' data originate from a common process but differ
      because the "units" of predictor and response variables differ among subjects.
      For example, if the predictor variable is time, time can be "faster" or "slower"
      from subject to subject. We deal with two different problems. In the first one
      the response at x for the ith subject is of the form beta 1i + beta 2iG[(x - beta
      3i)/beta 4i] + epsilon, where G(x) is a mathematical "shape" function (of the
      predictor variable x) representing the process and epsilon is observation error.
      The units of observed and predictor variable are then defined by the values of
      beta 1i, beta 2i and beta 3i, beta 4i, respectively. In particular beta 1i and
      beta 3i express shifts and beta 2i, beta 4i express scales of the observed and
      predictor variables, respectively. In the second problem the response at x for
      the ith subject is of the form beta 1i + beta 2i integral of x0 G[(s - beta
      3i)/beta 4i].Hi(x - s) ds + epsilon, where Hi(x) is a known function. In both
      problems, the method estimates the common "shape" function G(x) nonparametrically
      and the parameters beta 1i, beta 2i, beta 3i, and beta 4i for each
      subject.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636791
TI  - Reproducibility of human vagal carotid baroreceptor-cardiac reflex responses.
AB  - Published information on the reproducibility of human baroreflex responses in the
      absence of interventions is limited. Therefore, we analyzed retrospectively
      vagally mediated carotid baroreceptor-cardiac reflex responses of 34 healthy
      young adult volunteers whom we studied twice, 7-10 days apart (all 34 subjects)
      or 10 wk apart (8 subjects). We delivered a sequence of neck pressure changes
      during held expiration: A computer-driven bellows initially raised pressure to
      approximately 40 mmHg for five heart beats, and then reduced pressure in a
      stepwise series of R-wave-triggered 15-mmHg decrements to about -65 mmHg. R-R
      interval changes were plotted as functions of the carotid distending (systolic
      less neck) pressure occurring within each interval. Each experimental session
      yielded one stimulus-response relation, which comprised the average of seven
      separate trials. Six measures were derived from these relations: minimum,
      maximum, and range of R-R intervals; maximum slope; and operational point [(R-R
      interval shortening/R-R interval range) x 100%]. Linear regression correlation
      coefficients for measurements made on two occasions were all highly significant
      (range: 0.64-0.99). Our results indicate that human vagally mediated carotid
      baroreceptor-cardiac reflex responses, studied serially under exacting
      experimental conditions, are highly reproducible.

PMID- 1636792
TI  - Midbrain central gray: influence on medullary sympathoexcitatory neurons and the
      baroreflex in rats.
AB  - The influence of the central gray (CG) of the midbrain on the activity of 19
      barosensitive sympathoexcitatory neurons of the rostral ventrolateral medulla
      (RVLM) and on the sympathetic vasomotor baroreflex was studied in halothane
      anesthetized rats. Eighteen RVLM barosensitive units were readily activated by
      train stimulation of the CG, although twin-pulse stimulation was less effective
      (10 of 19 neurons responded). Inhibition of neurons within the RVLM by bilateral
      microinjection of the GABA-mimetic drug muscimol abolished the pressor responses
      to CG stimulation, while the accompanying lumbar nerve sympathoexcitation was
      converted to sympathoinhibition. In baroreceptor-denervated vagotomized animals,
      unilateral microinjection of muscimol into the RVLM ipsilateral or contralateral
      to the site of CG stimulation resulted in approximately equal attenuation of the
      CG sympathoexcitatory and pressor responses. In contrast, the sympathoexcitatory
      response to electrical stimulation of the sciatic nerve was reduced more
      effectively by inhibition of the RVLM contralateral to the site of stimulation.
      Electrical stimulation of the CG lateral and ventrolateral to the aqueduct
      produced sympathoexcitation [increased discharge of the greater splanchnic and
      lumbar sympathetic nerves (SSN and LSN)] with an increase in mean arterial blood
      pressure. Activation of the SSN by CG stimulation was greater than that observed
      for the LSN (n = 5 rats). This differential influence of the CG on the
      sympathetic outflow was not a result of a differential influence of the
      baroreflex. Electrical stimulation of the CG produced elevations of the gain and
      the cut-off pressure of the baroreflex for both the SSN and LSN.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1636793
TI  - Endothelium-derived relaxing factor in pulmonary and renal circulations during
      hypoxia.
AB  - The pulmonary and renal vasculatures, in contrast to the systemic vasculature,
      constrict during hypoxia. The endothelium has been implicated in mediating these
      vascular responses to acute hypoxia via the production of endothelium-derived
      vasoactive factors. The present study, performed in anesthetized dogs, was
      designed to investigate the role of endothelium-derived relaxing factor (EDRF) to
      attenuate the vasoconstrictor response of the pulmonary and renal circulations
      during acute hypoxia. In response to hypoxia, pulmonary (2.2 +/- 0.3 to 4.5 +/-
      0.6 mmHg.l-1.min) and renal (0.60 +/- 0.07 to 0.90 +/- 0.14 mmHg.ml-1.min)
      vascular resistances increased. Inhibition of endogenous EDRF with NG-monomethyl
      L-arginine resulted in similar increases in pulmonary (3.0 +/- 0.1 to 4.8 +/- 0.4
      mmHg.l-1.min) and renal (0.67 +/- 0.07 to 0.90 +/- 0.09 mmHg.ml-1.min) vascular
      resistances as in hypoxia. However, in the presence of both hypoxia and EDRF
      inhibition, an exaggerated pulmonary vascular response was observed (2.2 +/- 0.2
      to 7.4 +/- 0.9 mmHg.l-1.min), in contrast to the renal vascular response to EDRF
      inhibition during hypoxia (0.61 +/- 0.05 to 0.95 +/- 0.10 mmHg.ml-1.min), which
      was not different from hypoxia or EDRF inhibition individually. The endothelium
      derived contracting factor endothelin, which modestly increased during hypoxia
      (11.7 +/- 1.9 to 15.6 +/- 2.4 pg/ml), may also contribute to this
      vasoconstrictive response to hypoxia. This study suggests in the intact animal
      that EDRF serves to oppose the pulmonary vasoconstrictor response to hypoxia and
      further characterizes the role of endothelium-derived factors in the regulation
      of vascular function during hypoxia.

PMID- 1636794
TI  - Isoperiodic neuronal activity in suprachiasmatic nucleus of the rat.
AB  - A subpopulation of neurons in the suprachiasmatic nucleus (SCN) is shown here to
      exhibit isoperiodic bursting activity. The period of discharge in these cells may
      be lengthened or the periodicity may be transiently disrupted by photic
      stimulation. It is suggested that many, if not all, of these cells are vasoactive
      intestinal polypeptide (VIP) neurons. It is shown that the ultradian periodicity
      of these cells, estimates of the VIP neuron population size in the SCN, effects
      of partial lesions on tau (period), and estimates of the phase stability of SCN
      driven circadian rhythms are consistent with a strongly coupled, multioscillator
      model of circadian rhythmicity, in which the oscillator population constitutes a
      restricted subset of the SCN neuronal population.

PMID- 1636795
TI  - Differences in brown adipose tissue thermogenic responses between Long-Evans and
      Sprague-Dawley rats.
AB  - Temperature experiments of 4- and 21 degrees C-acclimated conscious and
      anesthetized Sprague-Dawley (SD) and Long-Evans (LE) rats revealed that the LE
      groups or SD rats acclimated to 4 degrees C had significant increases in
      intracapsular brown adipose tissue (IBAT) temperature above core after
      ventromedial hypothalamic nucleus (VMH) electrical stimulation or after
      norepinephrine (NE) infusion (50 micrograms/kg total dose), whereas IBAT
      temperatures of SD rats (acclimated to 21 degrees C) rose only after intravenous
      NE. Another study of 21- or 4 degrees C-acclimated SD rats revealed that only the
      4 degrees C-acclimated group showed graded increases in IBAT temperature after
      VMH electrical stimulation as current amplitude or total current duration (not
      pulse frequency) of the electrical stimulus was increased. In vitro analysis of
      isolated IBAT tissues of age-matched anesthetized LE or SD rats acclimated to 21
      degrees C showed that many indicators of thermogenic capacity including
      mitochondrial uncoupling protein were significantly lower in the SD group. The
      results demonstrate that lean male SD rats acclimated to 21 degrees C have
      suppressed IBAT temperature responses to VMH electrical stimulation compared with
      lean LE rats due to a reduced thermogenic capacity of that tissue.

PMID- 1636796
TI  - Diverse effects of calcium channel blockers on skeletal muscle glucose transport.
AB  - Verapamil, a calcium channel blocker, inhibited the insulin-stimulated glucose
      transport rate in isolated rat epitrochlearis muscle in a dose-dependent manner
      (1-200 microM) without affecting basal glucose transport rate. Verapamil's
      inhibition was rapid in onset and disappearance; changes in glucose transport
      rate were detectable when verapamil was added to or removed from the incubation
      medium 15 min prior to measurement of glucose transport. Verapamil also inhibited
      the stimulation of muscle glucose transport caused by hypoxia, indicating that
      the effect was not limited to insulin action. Although the optical isomers of
      verapamil vary considerably in their potency as Ca2+ channel blockers, they were
      equally effective inhibitors of insulin-stimulated glucose transport rate.
      Nifedipine (10-200 microM), a more potent blocker of skeletal muscle Ca2+
      channels than verapamil, was less effective as an inhibitor of insulin-stimulated
      glucose transport. Furthermore, nifedipine (10 microM) did not inhibit hypoxia
      stimulated glucose transport. Diltiazem (200 microM), another Ca2+ channel
      blocker, did not reduce insulin-stimulated glucose transport.

PMID- 1636797
TI  - Differential baroreceptor reflex modulation by centrally infused angiotensin
      peptides.
AB  - The present study was designed to investigate the effect of
      intracerebroventricular (icv) and intravenous (iv) infusion of angiotensin (ANG)
      (1-7), ANG III, and ANG II on the baroreceptor control of heart rate (BHR) in
      conscious rats. Reflex changes in HR were elicited by bolus iv injection of
      either phenylephrine or sodium nitroprusside before and within 1 and 3 h of icv
      infusion of ANG II (n = 10), ANG III (n = 9), ANG-(1-7) (n = 9), or saline (n =
      9) at a rate of 3 nmol.7.5 microliter-1.h-1. In another group of animals (n =
      23), iv infusion of the same amount of ANG peptides was carried out at a rate of
      0.7 ml/h. The average ratio of changes in HR in beats per minute and changes in
      mean arterial pressure (MAP, mmHg) was used as an index of BHR sensitivity. ANG
      II and ANG III produced a significant increase in the basal levels of MAP, but
      only during the first hour of infusion (iv or icv). No significant changes in
      baseline HR were observed. ANG-(1-7) and saline infusion did not change basal
      levels of HR or MAP (iv or icv). ANG II (iv and icv) and ANG III (icv) caused a
      significant decrease in the BHR sensitivity for reflex bradycardia. In contrast,
      icv infusion of ANG-(1-7) induced a significant increase in BHR sensitivity for
      reflex bradycardia (-3.0 +/- 0.3, 1 h, and -2.8 +/- 0.1 beats.min-1.mmHg-1, 3 h
      vs. -2.1 +/- 0.2 beats.min-1.mmHg-1, before infusion).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1636798
TI  - Hypertonic NaCl inhibits gastric motility and food intake in rats with lesions in
      the rostral AV3V region.
AB  - Several diverse treatments that stimulate pituitary secretion of oxytocin (OT) in
      rats produce a parallel inhibition of gastric motility and food intake. The
      present experiments demonstrate that injection of hypertonic saline (HS) is
      another such treatment. Systemic administration of large doses of OT had no
      effect on gastric motility. Lesions within the region anteroventral to the third
      ventricle (AV3V region) severely impaired the drinking response to HS without
      affecting its inhibition of either gastric motility or food intake. These and
      other results suggest that despite the close association of pituitary secretion
      of OT with inhibition of both gastric motility and food intake in intact animals
      after HS administration, these effects may be dissociated by lesions within the
      AV3V region. Consequently, osmosensitive cells located within the periventricular
      tissue of the rostral AV3V region, which are critical for the stimulation of
      thirst and pituitary OT secretion after systemic injection of HS, do not appear
      to be essential for the parallel inhibition of gastric motility and food intake
      produced by this treatment in rats.

PMID- 1636799
TI  - Circulatory dynamics during periodic intracranial hypertension in fetal sheep.
AB  - The human fetal head is periodically compressed during labor. The resulting
      increase in intracranial pressure (ICP) may exceed the hydrostatic increase in
      mean arterial pressure (MAP), thereby decreasing cerebral perfusion pressure
      (CPP). We determined whether the cardiovascular system of near-term fetal sheep
      is capable of rapidly increasing MAP during periodic increases in ICP. In 12
      chronically instrumented fetuses, we produced sinusoidal oscillations in ICP with
      a maximum of 52 +/- 1 mmHg (baseline MAP) and a minimum of 4 +/- 1 mmHg at a 3
      min periodicity by ventricular fluid infusion and withdrawal. Phasic increases in
      MAP and decreases in electromagnetically determined renal blood flow tracked
      behind ICP by 0.3-0.5 min. By the sixth cycle, tonic peripheral vasoconstriction
      that occurred attenuated by the reduction in CPP during subsequent ICP
      oscillations. By the 10th cycle, plasma catecholamines and vasopressin increased
      20-fold. To more closely simulate the pattern during labor, we produced an ICP
      triangular pulse train with 5-min periodicity and pulse duration of 1.5 min in
      six other fetuses. The MAP response was nearly out of phase with this more rapid
      rise of ICP. Thus the phasic component of the fetal pressor response is
      inadequate for maintaining CPP when ICP is increased to baseline MAP in less than
      0.75 min. However, when the ICP pulse duration and frequency are sufficiently
      high, a tonic pressor response that may be humorally mediated acts to minimize
      transient cerebral ischemia.

PMID- 1636800
TI  - The psychotherapist as witness for the prosecution: the criminalization of
      Tarasoff.
AB  - The "duty to protect" doctrine heralded by the Tarasoff decision seeks to prevent
      physical harm to third parties by psychiatric patients. Recent court cases have
      mandated the testimony of a criminal defendant's psychotherapist both about the
      Tarasoff warning itself and about confidential treatment information that was
      associated with the warning. One court further ruled that some clinical sessions
      were not psychotherapy and therefore were not afforded the protection of
      psychotherapist-patient privilege. The continuing erosion of confidentiality has
      resulted in psychiatrists and other mental health professionals becoming
      prosecution witnesses at the criminal trials of their own patients.

PMID- 1636801
TI  - Decreased brain metabolism in neurologically intact healthy alcoholics.
AB  - OBJECTIVE: The extent to which cerebral dysfunction in alcoholics is related to
      the direct effects of alcohol in the brain rather than to indirect mechanisms
      and/or alcohol withdrawal remains unclear. The purpose of this study was to
      evaluate whether healthy alcoholics with no evidence of alcohol-associated
      complications showed changes in brain glucose metabolism. METHOD: Positron
      emission tomography and [18F]-fluorodeoxyglucose were used to measure regional
      brain metabolism. The study group consisted of 22 normal, healthy, right-handed
      volunteers and 22 neurologically intact, healthy, right-handed alcoholics tested
      6 to 32 days after alcohol discontinuation. RESULTS: Alcoholics showed
      significantly lower whole brain metabolism than normal control subjects.
      Normalization of regional metabolic values to the whole brain metabolic rate
      revealed that the left parietal and right frontal cortices were the most affected
      regions. Although the whole brain metabolic rate was correlated with the amount
      of time since alcohol discontinuation, the "normalized" decreases in left
      parietal and right frontal glucose metabolism were not. CONCLUSIONS: These
      findings support the contribution of the direct effect of alcohol as well as
      alcohol withdrawal on the changes in regional brain metabolism seen in
      alcoholics. They also provide evidence of cerebral changes in neurologically
      intact healthy alcoholics.

PMID- 1636802
TI  - Hypothalamic-pituitary-adrenal axis hyperactivity and psychosis: recovery during
      an 8-year follow-up.
AB  - OBJECTIVE: An earlier study showed that the results of dexamethasone suppression
      test (DST) predicted outcome among patients with a functional psychosis followed
      to 1 year. The present study was undertaken to replicate these findings with a
      different patient group and a longer follow-up. METHOD: Ninety-two inpatients
      with nonorganic, nonmanic psychoses had DSTs during their hospitalizations.
      Raters who were blind to DST results, and to baseline chart or research
      diagnoses, conducted personal interviews with 71 of the patients 8 years later.
      RESULTS: Patients who had been nonsuppressors on the DST were five times more
      likely than those who had been suppressors to be free of psychotic features and
      to exhibit insight at the follow-up interview (42% versus 8%). Prognostic
      differences between these groups were clear within the first year of follow-up.
      Baseline diagnoses also strongly predicted outcome, even among DST
      nonsuppressors, and DST results had no prognostic significance among patients
      with a baseline diagnosis of schizophrenia. Later ages at onset and short episode
      durations at intake also predicted recovery, but baseline DST suppressor status
      remained important after control for these factors. CONCLUSIONS: The findings of
      this study and those of the earlier follow-up suggest that among patients with a
      functional psychosis, nonsuppression on the DST is prognostically important,
      particularly after the exclusion of those who meet narrow criteria for
      schizophrenia.

PMID- 1636803
TI  - The dexamethasone suppression test in adolescent outpatients with major
      depressive disorder.
AB  - OBJECTIVE: The purpose of the study was to determine whether the dexamethasone
      suppression test (DST) would discriminate between outpatient adolescents with
      major depressive disorder and normal adolescent comparison subjects. METHOD:
      Depressed patients were accepted into the study only if they fulfilled the
      Research Diagnostic Criteria for major depressive disorder. The depressed
      subjects (N = 44) and the normal subjects (N = 38) were studied in the same
      environment and under the same conditions. The subjects received 1 mg of
      dexamethasone at 11:00 p.m. The next day, blood for determining plasma cortisol
      concentrations was drawn through an indwelling catheter every 60 minutes from
      8:00 a.m. until 11 p.m. RESULTS: After dexamethasone, the cortisol levels of the
      adolescents with major depressive disorder and the normal subjects were not
      significantly different. Only six (14%) of the depressed subjects and one (3%) of
      the normal subjects showed evidence of nonsuppression (cortisol value greater
      than 5 micrograms/dl). Analyses of subgroups of the depressed patients based on
      suicidal tendencies and endogenous subtype also failed to reveal significant
      differences in cortisol values. Estimates of the severity of depression showed
      significant negative correlations with cortisol values among the depressed
      patients. CONCLUSIONS: In contrast with previous studies of adolescent
      inpatients, the DST did not discriminate between the adolescent outpatients with
      major depressive disorder and the normal comparison subjects in this study.
      Possible reasons for the discrepancies, such as severity of the depression and
      inpatient status, are discussed.

PMID- 1636804
TI  - Relapse after cognitive behavior therapy of depression: potential implications
      for longer courses of treatment.
AB  - OBJECTIVE: The authors studied the risk of relapse among depressed patients after
      cognitive behavior therapy in order to document the need and potential
      indications for longer-term models of treatment. METHOD: Forty-eight patients
      with major depression who responded during a 16-week course of cognitive behavior
      therapy entered a 1-year prospective follow-up study, as did two patients who
      received 20 weeks of therapy. Standardized, independent clinical assessments were
      completed 1, 3, 6, 9, and 12 months after treatment. Relapse was defined as, at
      minimum, a 2-week period in which the subject met the DSM-III-R criteria for
      major depression and had a Hamilton depression scale score of 15 or more.
      RESULTS: Sixteen patients (32%) relapsed during the 1-year follow-up. Correlates
      of relapse included a history of depressive episodes, higher levels of depressive
      symptoms and dysfunctional attitudes, slower response to therapy, and being
      unmarried. Patients who fully recovered during therapy (Hamilton depression score
      of 6 or less for 8 weeks or more) were at significantly lower risk for relapse
      than those who partially recovered (9% and 52%, respectively). Slower response to
      therapy, unmarried status, and high residual scores on the Dysfunctional
      Attitudes Scale were independently and additively related to increased risk of
      relapse. CONCLUSIONS: These findings provide further evidence of a relation
      between residual symptoms and relapse after cessation of active treatment. The
      authors strongly recommend that models of longer-term psychotherapy be developed
      for depressed patients who do not recover fully during time-limited cognitive
      behavior therapy.

PMID- 1636805
TI  - Protective effects of imipramine maintenance treatment in panic disorder with
      agoraphobia.
AB  - OBJECTIVE: This study was designed to assess and compare the differential relapse
      rates of patients with panic disorder and agoraphobia after discontinuation of
      acute treatment (6 months) or acute plus maintenance treatment (18 months) with
      imipramine. METHOD: Sixteen patients with panic disorder and agoraphobia who had
      shown marked and stable response to 6 months of acute imipramine treatment and a
      comparable group of 14 patients who had been in remission during an additional
      year of half-dose imipramine maintenance treatment entered a 3-month, double
      blind discontinuation study followed by a 3-month drug-free period. Assessments
      of the patients were made according to operationalized response/relapse criteria,
      and plasma drug concentrations were monitored. RESULTS: Survival analysis
      revealed significantly different cumulative probabilities of continued response 6
      months after discontinuation of imipramine treatment between the patients who had
      received only acute treatment and those who had received acute and maintenance
      treatment. CONCLUSIONS: The results support the hypothesis that successful
      imipramine maintenance treatment of patients with panic and agoraphobia can have
      protective effects against relapse, at least in the first 6 months after the
      maintenance treatment period.

PMID- 1636806
TI  - The latent structure of anxiety symptoms in anxiety disorders.
AB  - OBJECTIVE: Research in the psychopathology of panic and anxiety disorders,
      particularly agoraphobia, suggests that fear of fear may be the basis of these
      conditions. However, there is little empirical research on the definition and
      validity of the concept of fear of fear in a clinical study group. The authors'
      aims are 1) to determine empirically if particular associations between symptoms
      and beliefs exist in a group of patients with anxiety disorders and what
      underlying dimensions of perceived threat they represent and 2) to assess the
      relative importance of these associations in agoraphobia with panic attacks,
      panic disorder, social phobia, and generalized anxiety disorder. METHOD: In an
      anxiety disorders treatment unit, 390 outpatients with anxiety disorders
      diagnosed according to DSM-III criteria completed the Anxiety Symptoms and
      Beliefs Scale. RESULTS: A principal components analysis of the patients' ratings
      on the Anxiety Symptoms and Beliefs Scale produced a four-factor solution in
      which specific sets of anxiety symptoms loaded with specific beliefs. These four
      factors were interpreted as respiratory symptoms, vestibular symptoms, autonomic
      arousal, and psychological threat. Respiratory and vestibular symptoms were more
      associated with panic disorder diagnoses than with social phobia and generalized
      anxiety disorder diagnoses. CONCLUSIONS: These findings support a conception of
      fear of fear in anxiety disorders as fearful beliefs concerning the experience of
      anxiety symptoms. Associations between symptoms and fear of fear are present
      across anxiety disorders but are most pronounced in agoraphobia with panic
      attacks.

PMID- 1636807
TI  - Are males more likely than females to develop schizophrenia?
AB  - OBJECTIVE: This study was undertaken to determine whether the incidence of
      schizophrenia is equivalent for males and females. METHOD: An attempt was made to
      identify every first-episode case of psychosis in a large Canadian city over a
      period of 2 1/2 years. A comprehensive referral network was established that
      included hospital and community settings where psychotic persons might appear.
      More than 300 potential subjects were identified, 175 of whom underwent a
      structured psychiatric interview and were assigned diagnoses according to five
      different diagnostic systems. RESULTS: The incidence of schizophrenia was two to
      three times higher among males than among females. Even though the use of
      different diagnostic systems yielded slightly different risk rates, the elevated
      risk for males remained consistent. There were no differences between the sexes
      in the incidence of affective psychosis. In comparison with schizophrenia, the
      incidence rates for mood disorders with psychotic features were sometimes lower
      and sometimes higher, depending on the diagnostic system used. CONCLUSIONS: The
      findings, coupled with reports in the past 10 years from other investigators,
      challenge the conventional belief that the incidence of schizophrenia is the same
      for the two sexes.

PMID- 1636808
TI  - A monozygotic mirror-image twin pair with discordant psychiatric illnesses: a
      neuropsychiatric and neurodevelopmental evaluation.
AB  - One piece of genetic evidence for the biological distinctness of schizophrenia
      and bipolar illness is the rarity of monozygotic twin pairs in which one twin
      suffers from schizophrenia and the other from bipolar disorder. The authors
      describe a pair of monozygotic mirror-image twins with discordant diagnoses,
      schizophrenia in one twin and bipolar or schizoaffective disorder in the other.

PMID- 1636809
TI  - Interictal psychiatric morbidity and focus of epilepsy in treatment-refractory
      patients admitted to an epilepsy unit.
AB  - Of 71 consecutive patients admitted to an epilepsy unit of a general hospital, 32
      (45%) were classified as having psychiatric disorders by using the General Health
      Questionnaire. No differences were evident to support a specific relationship
      between the type or focus of epilepsy and psychopathology.

PMID- 1636810
TI  - Neurobehavioral functioning in a nonconfounded group of asymptomatic HIV
      seropositive homosexual men.
AB  - Neurobehavioral functioning was tested in 34 asymptomatic HIV-seropositive and 43
      HIV-seronegative male homosexual subjects without substance abuse and CNS
      disorders. The HIV-positive subjects exhibited mild motor slowing compared to the
      seronegative subjects. These differences remained after controlling for potential
      cofactors. Early neurobehavioral impairment in HIV infection seems limited to
      subclinical motor deficits and attributable to HIV rather than possible
      confounding factors.

PMID- 1636811
TI  - Sudden self-harm while taking fluoxetine.

PMID- 1636812
TI  - Fluoxetine-induced anorexia in a bulimic patient.

PMID- 1636813
TI  - Lyell syndrome and lethal catatonia: a case for ECT.

PMID- 1636814
TI  - Schizophrenia and chromosomal fragile sites.

PMID- 1636815
TI  - Serotonin syndrome.

PMID- 1636816
TI  - The (Ab)use of computers.

PMID- 1636817
TI  - Alcohol and addictions.

PMID- 1636818
TI  - Alcohol and addictions.

PMID- 1636819
TI  - Kleptomania and shoplifting.

PMID- 1636820
TI  - Clozapine concentrations and clinical response in schizophrenic patients.

PMID- 1636821
TI  - Identification of mood variance in depression.

PMID- 1636822
TI  - Twins and eating disorders.

PMID- 1636823
TI  - Regarding the use and accuracy of the family history method.

PMID- 1636824
TI  - Credibility of patients in psychiatric research.

PMID- 1636825
TI  - Recovery and shorter duration of hospitalization.

PMID- 1636826
TI  - Socioeconomic differences in mortality in Britain and the United States.

PMID- 1636827
TI  - National mortality rates: the impact of inequality?
AB  - Although health is closely associated with income differences within each country
      there is, at best, only a weak link between national mortality rates and average
      income among the developed countries. On the other hand, there is evidence of a
      strong relationship between national mortality rates and the scale of income
      differences within each society. These three elements are coherent if health is
      affected less by changes in absolute material standards across affluent
      populations than it is by relative income or the scale of income differences and
      the resulting sense of disadvantage within each society. Rather than
      socioeconomic mortality differentials representing a distribution around given
      national average mortality rates, it is likely that the degree of income
      inequality indicates the burden of relative deprivation on national mortality
      rates.

PMID- 1636828
TI  - The Roseto effect: a 50-year comparison of mortality rates.
AB  - OBJECTIVES: Earlier studies found striking differences in mortality from
      myocardial infarction between Roseto, a homogeneous Italian-American community in
      Pennsylvania, and other nearby towns between 1955 and 1965. These differences
      disappeared as Roseto became more "Americanized" in the 1960s. The present study
      extended the comparison over a longer period of time to test the hypothesis that
      the findings from this period were not due to random fluctuations in small
      communities. METHODS: We examined death certificates for Roseto and Bangor from
      1935 to 1985. Age-standardized death rates and mortality ratios were computed for
      each decade. RESULTS: Rosetans had a lower mortality rate from myocardial
      infarction over the course of the first 30 years, but it rose to the level of
      Bangor's following a period of erosion of traditionally cohesive family and
      community relationships. This mortality-rate increase involved mainly younger
      Rosetan men and elderly women. CONCLUSIONS: The data confirmed the existence of
      consistent mortality differences between Roseto and Bangor during a time when
      there were many indicators of greater social solidarity and homogeneity in
      Roseto.

PMID- 1636830
TI  - Car size or car mass: which has greater influence on fatality risk?
AB  - OBJECTIVES: Proposed increases in corporate average fuel economy standards would
      probably lead to lighter cars. Well-established relationships between occupant
      risk and car mass predict consequent additional casualties. However, if size, not
      mass, is the causative factor in these relationships, then decreasing car mass
      need not increase risk. This study examines whether mass or size is the causative
      factor. METHODS: Data from the Fatal Accident Reporting System are used to
      explore relationships between car mass, car size (as represented by wheelbase),
      and driver fatality risk in two-car crashes. RESULTS: When cars of identical (or
      similar) wheelbase but different mass crash into each other, driver fatality risk
      depends strongly on mass; the relationship is quantitatively similar to that
      found in studies that ignore wheelbase. On the other hand, when cars of similar
      mass but different wheelbase crash into each other, the data reveal no dependence
      of driver fatality risk on wheelbase. CONCLUSIONS: Mass is the dominant causative
      factor in relationships between driver risk and car size in two-car crashes, with
      size, as such, playing at most a secondary role. Reducing car mass increases
      occupant risk.

PMID- 1636829
TI  - HMO membership, treatment, and mortality risk among prostatic cancer patients.
AB  - OBJECTIVES: Treatment and mortality risk were compared between prostate cancer
      patients receiving care in fee-for-service settings and those receiving care in a
      health maintenance organization (HMO). METHODS: Two samples were obtained from a
      population-based tumor registry. Patients in the first sample (n = 201) were
      interviewed shortly after diagnosis to obtain data on income, education, overall
      health status, and expenditures for health status, and expenditures for health
      care. These data were combined with information from the tumor registry on cancer
      stage, age, treatment, place of residence, and source of care. Only tumor
      registry data were obtained for most patients in the second sample (n = 962). For
      both samples, survival time was monitored for up to 80 months. RESULTS:
      Multivariate analysis of data from the interviewed sample indicated that HMO
      patients were less likely to receive surgery but more likely to receive radiation
      therapy than were those in fee-for-service settings. Mortality risk was lower for
      the HMO patients than for those in fee-for-service plans. Findings based on the
      second sample were nearly identical. CONCLUSIONS: This study suggests that HMOs
      may offer important advantages to lower-income patients at risk for specific life
      threatening diseases.

PMID- 1636831
TI  - The development of registries for surveillance of adult lead exposure, 1981 to
      1992.
AB  - OBJECTIVES: Since 1981, 15 states have established registries for surveillance of
      adult lead absorption, primarily based on reports of elevated blood lead levels
      from clinical laboratories. I review the status of the registries and recommend
      steps for further development. METHODS: Companies reported to the New York
      registry are compared with those cited by the Occupational Safety and Health
      Administration (OSHA). I present data on US workers and plants with potential
      lead exposures and blood tests, as well as review registries' reporting
      requirements. RESULTS: Registries identify many companies not cited by the
      Occupational Safety and Health Administration, but underreporting occurs because
      (1) reporting is usually not required from laboratories outside the state, (2)
      most registries use a blood lead reporting level of 1.21 mumol/L, which excludes
      many exposed workers, and (3) many companies with potential exposures do not have
      routine monitoring programs. CONCLUSIONS: Registries' reporting requirements and
      procedures should be standardized, including a blood lead reporting level of 0.72
      mumol/L. Elevated blood lead levels should be a reportable condition nationwide,
      and a comprehensive national surveillance system should be established: clinical
      laboratories should be required to report cases to those states with lead
      registries or directly to the national adult lead registry.

PMID- 1636832
TI  - Lower respiratory illness in infants and low socioeconomic status.
AB  - OBJECTIVES: Infants from families of low socioeconomic status are said to suffer
      higher rates of lower respiratory illness, but this assertion has not been
      carefully examined. METHODS: We studied the frequency and determinants of lower
      respiratory illness in infants of different socioeconomic status (n = 393) by
      analyzing data from a community-based cohort study of respiratory illness during
      the first year of life in central North Carolina. RESULTS: The incidence of lower
      respiratory illness was 1.41 in the low socioeconomic group, 1.26 in the middle
      group, and 0.67 in the high group. The prevalence of persistent respiratory
      symptoms was 39% in infants in the low socioeconomic group, 24% in infants in the
      middle group, and 14% in infants in the high group. The odds of persistent
      respiratory symptoms in infants of low and middle socioeconomic status were
      reduced after controlling for environmental risk factors for lower respiratory
      illness. Enrollment in day care was associated with an increased risk of
      persistent symptoms among infants of high but not low socioeconomic status.
      CONCLUSIONS: Infants of low socioeconomic status are at increased risk of
      persistent respiratory symptoms. This risk can be partly attributed to
      environmental exposures, most of which could be changed.

PMID- 1636833
TI  - Imported leprosy in the United States, 1978 through 1988: an epidemic without
      secondary transmission.
AB  - OBJECTIVES: Leprosy remains a major health problem in many regions of the world.
      In the United States, although leprosy continues to be reported, approximately
      90% of cases are imported (i.e., occur among immigrants and refugees). An
      increase in imported cases began in 1978. This study was conducted to analyze
      this trend and to characterize the contributing cases. METHODS: Centers for
      Disease Control leprosy surveillance data from 1971 through 1988 were analyzed.
      RESULTS: The number of imported cases reported annually was relatively constant
      from 1971 through 1977 (mean = 119 per year), increased to 307 in 1985, and then
      decreased to 102 in 1988. Of the 957 excess cases reported from 1978 through
      1988, 73.4% were among persons from Southeast Asia, including 51.3% from Vietnam,
      Cambodia, and Laos (Indochina). There was no coincident increase in indigenous
      cases of leprosy; the mean annual number of such cases was 17.7 (range = 10 to
      29). Leprosy remains endemic in Texas, Hawaii, Louisiana, and possibly
      California. CONCLUSIONS: An epidemic of imported leprosy began in the United
      States in 1978, peaked in 1985, and ended by 1988. This increase was primarily
      due to cases among refugees from Indochina and was limited by a decrease in the
      influx of Indochinese refugees in the mid-1980s. There is no evidence that these
      cases resulted in transmission in the United States.

PMID- 1636834
TI  - Socioeconomic status and childhood mortality in North Carolina.
AB  - Children in families eligible to receive Aid to Families with Dependent Children
      (AFDC) were found to have substantially higher mortality rates than non-AFDC
      children. The disparity seems to be greater for Whites than for non-Whites. These
      results suggest the presence of social class differentials in access to and use
      of health care and related services and facilities, in exposure to environmental
      risks, and in knowledge of injury control measures.

PMID- 1636835
TI  - Does equal socioeconomic status in black and white men mean equal risk of
      mortality?
AB  - Although concerns have been expressed that mortality from coronary disease and
      all other causes is greater among Blacks than Whites, we hypothesized that, when
      socioeconomic status is adequately considered, mortality inequalities between
      Blacks and Whites are insignificant. The study population was a random sampling
      of Black and White men who were 35 years of age or older when recruited into the
      Charleston Heart Study in 1960. Education level and occupational status at
      baseline were used to compare mortality over the ensuing 28 years between Black
      and White men, who were classified as low or high socioeconomic status. In no
      instance were Black-White differences in all-cause or coronary disease mortality
      rates significantly different when socioeconomic status was controlled. We
      conclude that socioeconomic status is an important predictor of mortality and
      that, when socioeconomic status is considered, differences in Black-White
      mortality rates may be small.

PMID- 1636836
TI  - Job strain and mortality in elderly men: social network, support, and influence
      as buffers.
AB  - The aim was to investigate whether job strain affects mortality in a
      representative population of elderly men, and whether social network and social
      support outside the workplace can buffer the negative health effects of job
      strain. A higher relative mortality risk (RR) was found among men exposed to job
      strain (RR = 1.7). The combination of exposure to job strain and seven different
      measures of weak social network and social support was associated with a further
      increased RR ranging from 2.1 to 4.6.

PMID- 1636837
TI  - Mortality and the attribution of health problems to aging among older adults.
AB  - This study examined the association between mortality and attributing health
      problems to aging among 1391 respondents from the Longitudinal Study of Aging who
      indicated difficulty with activities of daily living. Of this number, 72 persons
      attributed impairment primarily to "old age." Logistic regression controlling for
      demographics, physical health problems, self-rated health, and social
      involvements showed an association with mortality (adjusted odds ratio = 1.78, CI
      = 1.05, 3.00). Attributing health problems to aging may carry a risk of adverse
      health events.

PMID- 1636838
TI  - Use of cardiovascular disease medications and mortality in people with older
      onset diabetes.
AB  - Mortality follow-up for a cohort defined in 1980 with diabetes diagnosed at 30
      years of age or older has been completed through 1988. History of medication use
      was obtained during the initial evaluation. There were 605 (44.2%) confirmed
      deaths; heart disease was the underlying cause in 49.9% of the deaths. Use of
      loop diuretics was associated with an odds ratio of death of 1.8 (95% CI = 1.4,
      2.2). Although a causal relationship cannot be inferred, it is reasonable to
      suggest that blood chemistries be monitored regularly in persons on these drugs
      since electrolyte imbalance may be related to death.

PMID- 1636839
TI  - The accuracy of the National Death Index when personal identifiers other than
      Social Security number are used.
AB  - This study analyzed the accuracy of the National Death Index when personal
      identifiers were used that included or excluded Social Security number.
      Computerized records of the Department of Veterans Affairs were used for
      comparison. Different combinations of identifiers other than Social Security
      number correctly identified from 83 to 92 percent of dead and 92 to 99 percent of
      living persons. These results should prove useful in ascertaining the mortality
      status of patient populations without information on Social Security numbers.

PMID- 1636840
TI  - Race and sex differences in mortality following fracture of the hip.
AB  - This paper describes the all-cause mortality experience, following a fracture of
      the hip, of 712,027 persons covered by the Medicare program from 1984 through
      1987. White women experienced the lowest mortality rate (17.2 per 1000 person
      months), followed by Black women (22.9 per 1000 person-months), Black men (33.5
      per 1000 person-months), and White men (33.7 per 1000 person-months). The
      observed race-sex differences in survival were found at all ages and regardless
      of the number of comorbid conditions listed with the discharge diagnosis. While
      these data demonstrate marked race-sex differences in survival following hip
      fracture, the cause of these differences is not immediately apparent and demands
      further investigation.

PMID- 1636841
TI  - Seroprevalence of HIV-1 and hepatitis B and C in prostitutes in Albuquerque, New
      Mexico.
AB  - A survey of persons soliciting sex in an area known to be frequented by
      prostitutes in Albuquerque, NM, included 43 females and 66 males. Seroprevalence
      rates found in this population-based study were as follows: human
      immunodeficiency virus type 1 (HIV-1), 3%; hepatitis B, 39%; hepatitis C, 45%.
      Increased age, intravenous drug use, and condom use were independent risk factors
      for hepatitis B. Female gender and intravenous drug use were independent risk
      factors for hepatitis C. Neither sharing injection equipment nor engaging in
      receptive anal intercourse was independently associated with hepatitis B or C.

PMID- 1636842
TI  - Decreased access to medical care for girls in Punjab, India: the roles of age,
      religion, and distance.
AB  - Risk factors that increase the likelihood of discrimination against girls in
      India have not been well studied. In this study of hospitalized children in
      Punjab, India, girls were less likely to be in the newborn or infant age groups,
      to be of the Sikh religion, or to come from far away than were boys. These
      differences suggest that these factors are significant risk factors for denied
      access to medical care for girls living in Punjab, India.

PMID- 1636843
TI  - Biotechnology products in the field: bringing regulation closer to home.

PMID- 1636844
TI  - Project Together: serving substance-abusing mothers and their children in Des
      Moines.

PMID- 1636845
TI  - Mortality among minority populations in the United States.

PMID- 1636846
TI  - Ethnic differences in nicotine exposure.

PMID- 1636847
TI  - Estimation of small area population denominators.

PMID- 1636848
TI  - Suicide by the elderly.

PMID- 1636849
TI  - Firefighters and heart disease.

PMID- 1636850
TI  - Dissimilarities between Tuskegee Study and HIV/AIDS programs emphasized.

PMID- 1636851
TI  - Handedness, traffic crashes, and defensive reflexes.

PMID- 1636852
TI  - The GORE-TEX anterior cruciate ligament prosthesis. A long-term followup.
AB  - The GORE-TEX anterior cruciate ligament prosthesis has been implanted in 268
      patients at our institution since April of 1984. Follow-up for this study was
      available on 70% of these patients (188). Eighty-one percent (152) of these had
      the ligament for chronic injuries, 14% (26) for acute, and 5% (10) for subacute
      injuries. The patient population had an average age of 27.6 years (SD = 8.4) and
      a Tegner activity score of 6.05 (SD = 1.53). Prior procedures had been performed
      on 56% (105) of the patients. Concomitant procedures were performed in 73% (137)
      and included iliotibial band tenodesis, partial meniscectomy, posterior oblique
      ligament advancement, or meniscal repair. Followup averaged 48 months (range, 24
      to 68). Evaluation included a questionnaire, physical examination, radiographs,
      KT-1000 arthrometer testing, and an activity score. Results were graded as
      excellent, good, fair, and poor. Acceptable results (good and excellent) were
      obtained in 83 patients (44%). Fifty-eight patients (32%) were rated excellent
      and 25 (13%) were rated good. Unacceptable results (fair and poor) were obtained
      in 105 patients (56%). Twenty-five patients (13%) were rated fair and 80 (42%)
      were rated poor. Subjective improvement was indicated by 166 patients (88%).
      Activity levels postoperatively as rated by the Tegner Scale improved in 2 (1%),
      remained the same in 167 (89%), and decreased in 19 patients (10%). Effusions
      occurred in 63 patients (34%) and caused an unacceptable result in 22 (12%).
      Rupture occurred in 23 patients (12%). Loosening greater than 3 mm occurred in 64
      patients (34%) and led to unacceptable results in 37 (20%). Infection occurred in
      5 patients (2.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636853
TI  - Arthroscopic staple capsulorrhaphy for anterior shoulder instability.
AB  - We reviewed the results of the arthroscopic staple capsulorrhaphy on 47 patients
      with a followup of 4 years. Thirty-four of the 47 shoulders had a history of
      traumatic dislocation, while the remaining 13 had a history of subluxation. The
      recurrence rate was 25%, with 8 shoulders developing recurrent frank dislocation
      and 4 developing subluxation. Only 21 of the 47 patients were able to resume
      normal sporting activities after surgical repair. We had no cases of staple
      loosening within the joint, but we did have 3 patients whose staples were removed
      because of persistent pain in the shoulder.

PMID- 1636854
TI  - The effect of external ankle support in chronic lateral ankle joint instability.
      An electromyographic study.
AB  - We examined the effect of ankle taping on ankle joint stability by measuring
      mechanical stability using standardized stress radiographs. Anterior talar
      translation and talar tilt, both with and without ankle tape, were examined. The
      reduction of anterior talar translation and talar tilt with tape as compared to
      without tape was insignificant. The reaction time of the peroneus muscles was
      measured by electromyographic signal after a simulated ankle sprain on a tilting
      trapdoor. The reaction time was significantly slower in the unstable ankles of 20
      athletes with unilateral ankle instability than in the stable contralateral
      ankles. With tape, the reaction time was significantly shortened, although not
      back to normal. The greatest improvement in reaction time was achieved in ankles
      with the highest degree of mechanical instability. Thus, the mechanism behind the
      function of ankle tape may be to restrict the extremes of ankle motion and to
      help shorten the reaction time of the peroneus muscles by affecting the
      proprioceptive function of the ankle.

PMID- 1636855
TI  - The effects of anabolic steroids on collagen synthesis in rat skeletal muscle and
      tendon. A preliminary report.
AB  - We measured the activities of prolyl 4-hydroxylase and galactosylhydroxylysyl
      glucosyltransferase (both enzymes of collagen biosynthesis) and the concentration
      of hydroxyproline in male rat soleus muscle and Achilles tendon during anabolic
      steroid treatment at 1 and 3 weeks. The rats were treated using a therapeutic
      dosage or a dosage that was five times the therapeutic level. After 1 week, the
      activity of prolyl 4-hydroxylase decreased significantly (P less than 0.01) in
      both treated groups in the soleus muscle, but the activity of
      galactosylhydroxylsyl glucosyltransferase decreased significantly (P less than
      0.05) only in the group given a therapeutic dose. After 3 weeks, the activities
      were at the control level. In the Achilles tendon, the activity of prolyl 4
      hydroxylase and the hydroxyproline concentration decreased significantly (P less
      than 0.05) in the group given high doses at 3 weeks. Anabolic steroid treatment
      seems to have at least a transitory effect on collagen biosynthesis in male rat
      muscle and tendon; in tendon this effect is seen only with high doses.

PMID- 1636856
TI  - A profile of the musculoskeletal characteristics of elite professional ballet
      dancers.
AB  - Twenty-eight principal dancers and soloists from America's two most famous ballet
      companies were examined for anthropometric measurements, including flexibility,
      muscle strength, and joint range of motion. Both male and female dancers were
      flexible, but not hypermobile, and did not differ significantly from each other.
      Marked differences were found between the range of motion of the hip and ankle in
      the dancers and the norms for the general population. The increased external
      rotation of the hip in women was accompanied by a loss in internal rotation,
      resulting in an increased range of motion with an externally rotated orientation.
      The men, however, lost more internal rotation than they gained in external
      rotation. These data raise the possibility of a torsional component to the turned
      out hip position in elite female professional ballet dancers. In addition,
      significant anatomic differences separate elite dancers of both sexes from the
      normal population.

PMID- 1636857
TI  - Long-term functional results in patients with anterolateral rotatory instability
      treated by iliotibial band transfer.
AB  - The purpose of this paper is to define the use of the extraarticular, lateral
      reconstruction in the spectrum of patients with cruciate deficiency. A review was
      conducted of 112 consecutive patients with a MacIntosh-type iliotibial band
      transfer done between 1972 and 1986. Fifty-six of the patients had a partial or
      complete meniscectomy, and 24% had failed a previous extraarticular procedure.
      Eighty-one percent were men, with a mean age of 23. Twenty-five percent of the
      patients had radiographic degenerative changes at the knee at the outset. Ninety
      eight percent had an anterior drawer of 1+ or greater; 97% had a pivot shift
      greater than trace. All patients had symptomatic knee instability. Seventy-seven
      of the 112 patients (69%) were available for followup (range, 24 months to 15.5
      years; median, 7.6). Twenty-three patients (21%) returned for examination, KT
      1000 and Cybex testing, and radiographs. An additional 54 patients (48%) were
      seen by their local physicians or returned a detailed questionnaire that included
      the Cincinnati knee rating scale. At final followup, 38% complained of some knee
      instability, 36% had recurrent effusions, 61% had intermittent pain, 79% had
      radiographic gonarthrosis, and 25% had undergone additional surgery. Forty-two
      percent had a positive Lachman after surgery, and only 15% had a pivot shift. The
      mean knee score was 81.1. Previous extraarticular anterior cruciate ligament
      reconstruction, meniscectomy, and generalized ligamentous laxity were associated
      with a significant decrement in the knee rating (P = 0.05). Ligamentous laxity
      strongly correlated with symptoms of giving way.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636858
TI  - Anterior cruciate ligament-medial collateral ligament injury: nonoperative
      management of medial collateral ligament tears with anterior cruciate ligament
      reconstruction. A preliminary report.
AB  - We present the results of a series of patients who had nonoperative management of
      the medial collateral ligament with anterior cruciate ligament reconstruction.
      From February 1983 through December 1989, 84 of 90 consecutive patients were
      available for followup (minimum, 1 year; mean, 3.1 years) with a combined
      anterior cruciate ligament-medial collateral ligament injury (anterior cruciate
      ligament rupture and medial collateral ligament tear) received surgical
      management by the same physician. The last 68 of these 84 patients who met the
      inclusion criteria underwent patellar tendon graft for anterior cruciate ligament
      reconstruction, with concomitant nonoperative management of medial collateral
      ligament tears. Follow-up evaluation consisted of physical examination for medial
      laxity, range of motion, and isokinetic and KT-1000 testing. Brace use and
      postoperative level of competition were also recorded. In addition, the patients
      completed a subjective assessment questionnaire rating pain, swelling, and
      stability. They also rated overall activity level, and any changes in their
      ability to do the activities tested: walk, climb stairs, run, jump, or twist. Our
      results indicate that proper reconstruction of the anterior cruciate ligament, in
      conjunction with nonoperative management of tears of the medial collateral
      ligament in combined anterior cruciate ligament-medial collateral ligament
      injuries, can given excellent stability and good to excellent functional outcome
      in patients with combined anterior cruciate ligament-medial collateral ligament
      injuries.

PMID- 1636859
TI  - Evaluation of ultrasonography as a diagnostic technique in the assessment of
      rotator cuff tendon tears.
AB  - In this study we assessed the clinical usefulness of ultrasonography as a
      modality in the diagnosis of rotator cuff tears. One hundred twenty patients with
      preoperative ultrasonography were analyzed by diagnostic arthroscopy to evaluate
      rotator cuff integrity. Two groups, 61 patients with a positive ultrasonogram and
      59 patients with a negative ultrasonogram, were analyzed. The 61 patients with a
      positive ultrasonogram preoperatively were found to have 42 full-thickness tears
      and 19 partial-thickness tears. Diagnostic arthroscopy confirmed a sensitivity of
      95% for the full-thickness tears and 41% for the partial-thickness tears. In the
      59 patients with negative ultrasonography, the specificity for full-thickness
      tears was 93% and in the 19 partial-thickness tears it was 91%. Our conclusion is
      that ultrasonography is an effective modality for the assessment of full
      thickness tears, but not partial-thickness tears.

PMID- 1636860
TI  - Stress changes of the distal radial growth plate. A radiographic survey and
      review of the literature.
AB  - We conducted a radiographic survey to determine skeletal age and the nature and
      prevalence of stress-related changes affecting the distal radial growth plate in
      60 young competitive gymnasts (39 females, 21 males). Comparison of results for
      chronological and skeletal age revealed a significant delay in maturation for
      girls (P less than 0.001). Radiographic evaluation revealed 5 gymnasts (4 girls
      and 1 boy) with stress-related changes of the left wrist, and four of these were
      considered to be minimal. These results, in conjunction with our previous
      findings and the review of related literature, reveal three important
      observations. First, the widening and irregularities of the distal radial physis
      that we described previously appear to be the first in a spectrum of abnormal
      changes secondary to overuse and probably represent a stress fracture of the
      distal radial growth plate. The radiographic changes associated with this injury
      are not the normal adaptive changes seen in young, competitive gymnasts.
      Secondly, more serious long-term abnormality may result even though the injury
      may initially resemble a Salter-Harris type I or II stress fracture. Long-term
      complications may include symmetrical or asymmetrical retardation or halted
      growth at the affected site, positive ulnar variance, and associated
      pathoanatomic sequelae. Thirdly, the incidence of distal radial growth plate
      stress injury remains unclear; we recommend a further, large-scale prospective
      epidemiologic study involving both male and female gymnasts. We urge that
      physicians and other health professionals associated with gymnastics clubs
      educate coaches about the possibility of significant injury to the distal radial
      physis, risk factors, and suggested preventive measures.

PMID- 1636861
TI  - Anterior-posterior and rotational displacement of the tibia elicited by
      quadriceps contraction.
AB  - The anterior-posterior displacement and rotation of the tibia elicited by
      isolated loading of the quadriceps muscle was determined as a function of joint
      angle and muscle load using a computerized radiographic technique. Data collected
      from 12 fresh-frozen cadaveric knees demonstrated that quadriceps contraction can
      result in significant (less than 7 mm) anterior displacement of the tibia in the
      range of 0 degrees to 80 degrees of flexion, and a mild (less than 2 mm)
      posterior displacement in the range of 80 degrees to 120 degrees of flexion. Peak
      anterior displacement of 6.3 mm was observed at 30 degrees of flexion under a 12
      kg load in the quadriceps, while a constant 1.5 mm posterior displacement was
      observed throughout flexion angles exceeding 80 degrees. It was further shown
      that the magnitude of the anterior displacement increased nonlinearly as the
      quadriceps force increased. Loading of the quadriceps also resulted in internal
      rotation of the tibia in the range of 0 degrees to 90 degrees of flexion, and in
      external rotation of the tibia in the range of 90 degrees to 120 degrees. Peak
      internal rotation of 7 degrees was observed at 15 degrees of flexion and a peak
      external rotation of 1 degrees was detected at 120 degrees of flexion. Larger
      quadriceps load resulted in larger rotation. We concluded that quadriceps
      contraction during knee extension has direct impact on anterior displacement and
      rotation of the tibia and therefore on anterior cruciate ligament stress,
      increasing it as the muscle's force is increased during knee extension.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1636862
TI  - An electromyographic analysis of the elbow in normal and injured pitchers with
      medial collateral ligament insufficiency.
AB  - Electromyography and high-speed film were used to examine the muscle activity in
      the elbows of pitchers with medial collateral ligament insufficiency compared to
      the activity in uninjured elbows. Ten competitive baseball pitchers with medial
      collateral insufficiency and 30 uninjured competitive pitchers were tested while
      throwing the fastball and the curveball. The extensor carpi radialis brevis and
      longus in the injured pitchers showed greater activity than in the uninjured
      pitchers for both pitches. The triceps, flexor carpi radialis, and pronator teres
      all showed less activity in the injured pitchers during the fastball, but only
      the triceps had less activity during the curveball. The differences were seen
      during the late cocking and acceleration phases, which place the greatest stress
      on the medial collateral ligament. If the flexor carpi radialis and pronator
      teres were substituting for the deficient medial collateral ligament and
      functioning as dynamic stabilizers, one would expect enhanced muscle activity.
      However, the opposite was found. This pattern of asynchronous muscle action with
      medial collateral ligament injury may predispose the joint to further injury. The
      muscular differences seen are critical to the understanding of the pathomechanics
      of patients with medial collateral ligament deficiency, and provide a basis for
      rehabilitation.

PMID- 1636863
TI  - European soccer injuries. A prospective epidemiologic and socioeconomic study.
AB  - In 1 year, 715 patients with soccer injuries were registered and treated in the
      emergency department of Randers City Hospital. We did a prospective study of
      these patients using a questionnaire to determine the most common locations,
      types, mechanisms, and treatments of injury. Financial costs for society and the
      individual were also examined. Forty-nine percent of the injuries were to the
      joints; sprains and contusions were the most common types of injury, accounting
      for 46% and 25%, respectively. The majority of patients (64% of the men and 58%
      of the women) were injured during physical contact with another player. Most
      (63%) of the patients were treated in the emergency department and then released.
      Thirty-one percent had to be absent from work, but only 8% of the patients had a
      loss of income because of their injury. The average amount of work time lost was
      5 days.

PMID- 1636864
TI  - Shoulder torque changes in the swimming athlete.
AB  - Torque production was assessed in the shoulders of competitive men and women
      swimmers for the motions of abduction, adduction, and external and internal
      rotation. Testing was performed on the Cybex II dynamometer and the results were
      compared to controls. In addition, the ratios of torque development for
      adduction:abduction and external rotation:internal rotation were evaluated. The
      results demonstrated a statistically significant increase in torque production in
      swimmers for most motions tested. Statistically significant ratio shifts were
      also noted. The ratio of adduction:abduction increased and that for external
      rotation:internal rotation decreased. We think these shifts in the torque ratios
      in swimmers' shoulders resulted from sport-specific repetitive activity that
      emphasizes adduction and internal rotation.

PMID- 1636865
TI  - Strength testing after third-degree acromioclavicular dislocations.
AB  - Twenty male patients with a grade III acromioclavicular joint dislocation were
      evaluated more than 2 years after their injury; the average followup was 4.5
      years. Strength testing was performed with a Cybex II dynamometer in three planes
      evaluating flexion, extension, internal rotation, external rotation, abduction,
      and adduction at 60 and 120 deg/sec. Subjective complaints were minor and neither
      daily activities nor athletic participation were impaired. Objectively, only one
      patient had tenderness over the acromioclavicular joint. All patients had full
      motion and negative impingement signs. Strength testing with the Cybex II
      dynamometer showed no significant difference (P less than 0.05) between the
      injured and uninjured shoulder for strength in internal rotation, external
      rotation, abduction, adduction, extension, or flexion at speeds of 60 and 120
      deg/sec. This study shows that the strength of the shoulder is not significantly
      affected by conservative treatment of grade III acromioclavicular dislocations.
      Conservative treatment results in minimal or no functional deficit. The authors
      recommend that grade III acromioclavicular dislocations be treated
      nonoperatively.

PMID- 1636866
TI  - Magnetic resonance imaging evaluation of the patellar tendon after use of its
      central one-third for anterior cruciate ligament reconstruction.
AB  - Magnetic resonance imaging was used to evaluate the remaining patellar tendon
      after its central one-third had been harvested for anterior cruciate ligament
      reconstruction. Twenty patients were studied at either 6 weeks, 4, 6, 9, or 18
      months postoperatively. The average thickness, width, cross-sectional area, and
      signal intensity of the operated and contralateral non-operated tendons were
      calculated and compared for each magnetic resonance imaging scan. A significant
      increase in the thickness was noted at all periods of followup, but no change in
      width occurred despite the defect being closed at the time of surgery. High
      signal intensity was present in the early periods, which signified edema and scar
      tissue. Signal intensity decreased at subsequent follow-up periods until at 18
      months the operated tendon appeared normal. These findings indicate that the
      patellar tendon has the potential to regenerate and remodel in the postoperative
      period.

PMID- 1636867
TI  - Allograft anterior cruciate ligament reconstruction in a sheep model. The effect
      of synthetic augmentation.
AB  - The purpose of this study was to assess the effect of synthetic augmentation of a
      bone-patellar tendon-bone allograft on the basis of biomechanical, morphologic,
      and histologic evaluation. The anterior cruciate ligament was reconstructed in
      the left knee of 66 adult sheep. Half the knees received bone-patellar tendon
      bone grafts alone, while the other half were augmented. All of the knees,
      including the contralateral controls, had gross and histologic examination,
      hydroxyproline assay for collagen content, and biomechanical testing in groups at
      0, 4, 16, and 52 weeks postoperatively. Biomechanical testing included
      anteroposterior translation, ultimate tensile strength, energy to failure,
      stiffness, and mode of failure. Eight fresh bone-patellar tendon-bone allografts
      were compared to eight cryopreserved bone-patellar tendon-bone allografts for
      baseline data on the effects of the cryopreservation. Cryopreservation did not
      have any effect on graft characteristics. Gross and histologic examination did
      not reveal any significant difference between the augmented and nonaugmented
      groups at any of the time periods. In addition, hydroxyproline content of the
      allograft was not altered by augmentation throughout the study period.
      Biomechanical laboratory evaluation demonstrated the augmented group had
      significantly reduced anteroposterior translation (P less than 0.05) at 52 weeks
      compared to the nonaugmented group. The ultimate tensile strength was
      significantly higher (P less than 0.05) in the augmented group at 4 weeks, but at
      52 weeks both groups had attained only 50% of the normal anterior cruciate
      ligament strength. Stiffness and energy to failure were similar in both groups at
      all time periods. From the results of this study, synthetic augmentation appears
      to improve initial strength and prevent late allograft laxity while allowing
      normal remodeling processes to occur in the bone-patellar tendon-bone allograft
      anterior cruciate ligament reconstruction.

PMID- 1636868
TI  - Avulsion fracture of the medial epicondyle caused by arm wrestling.
AB  - Fractures occurring in teenagers during arm wrestling usually involve the distal
      humerus and appear as a fracture of the medial epicondyle. We studied eight male
      patients, aged 13 to 15 years, with such fractures. All fractures involved the
      right hand and occurred while the patients were in the final stages of winning a
      match in a formal competition. Three fractures occurred during an official
      competition and the other five occurred during a match between friends. One
      patient suffered from ulnar nerve paresis that eventually recovered
      spontaneously. All of the patients were immobilized for 10 to 21 days, and
      progressed gradually to motion of the elbow. At 1-year followup, clinical and
      functional results were satisfying. Therefore, we recommend conservative
      management for fractures of the medial epicondyle sustained during arm wrestling.

PMID- 1636869
TI  - Measurements of length and tension patterns during reconstruction of the
      posterior cruciate ligament.
AB  - The twofold purpose of this study was to develop an intraoperative technique to
      assess isometric positioning of posterior cruciate ligament grafts and to
      demonstrate the rationale for postoperative immobilization of the knee in full
      extension after a posterior cruciate ligament reconstruction. Multiple femoral
      fixation sites were selected on the medial intercondylar notch and the posterior
      cruciate ligament substitute was assessed for changes in length and tension at
      each of these sites during knee flexion from 0 degree to 120 degrees. The most
      isometric and isotonic femoral fixation site was localized over a small area
      slightly distal to the center of the medial intercondylar notch surface. This
      isometric point can be identified intraoperatively using recognizable surface
      markers within the knee. When a posterior stress was applied to the proximal
      tibia, the posterior cruciate ligament substitute showed the least increase in
      tension and length when the knee was locked in full extension for all of the
      potential femoral attachment sites assessed. This suggests that postoperative
      immobilization should be maintained in full extension to limit the stress placed
      on the posterior cruciate ligament reconstruction.

PMID- 1636870
TI  - Isolated musculocutaneous nerve injury complicating closed fracture of the
      clavicle. A case report.

PMID- 1636871
TI  - Scapular fractures in professional football players.

PMID- 1636872
TI  - Avulsion of the pectoralis major tendon.

PMID- 1636873
TI  - The efficacy of halofantrine in the treatment of acute malaria in nonimmune
      travelers.
AB  - A multicenter prospective trial was performed to investigate the efficacy and the
      tolerability of halofantrine in nonimmune patients with malaria imported from
      areas with drug-resistant falciparum parasites (mainly Africa). Forty-five of the
      74 subjects were treated with a one-day regimen (3 x 500 mg) of halofantrine, and
      the other 29 received the same regimen with an additional treatment on day 7. In
      the second group, a 100% efficacy rate was demonstrated, but in the group
      receiving the one-day regimen, four recrudescences were observed in patients with
      falciparum malaria. Only five mild adverse reactions were seen, which disappeared
      spontaneously after the end of the treatment. We conclude that halofantrine is
      highly effective in curing malaria in nonimmune subjects. The treatment scheme
      for such persons should include an additional treatment on day 7 for nonimmune
      individuals. This drug was well tolerated in our patients, indicating that
      halofantrine will be useful in the treatment of multidrug-resistant malaria in
      nonimmune persons.

PMID- 1636874
TI  - Intestinal capillariasis (Capillaria philippinensis) acquired in Indonesia: a
      case report.
AB  - We report a case of intestinal capillariasis in a 32-year-old Italian man. After
      he made a trip to Indonesia that lasted approximately one month, he developed
      heartburn, abdominal pain, irregular bowel movements, headache, fatigue, weight
      loss, low-grade fever, and severe itching. The diagnosis was provided by the
      recovery of Capillaria philippinensis eggs in the stool. Treatment with oral
      albendazole, 200 mg twice a day for 21 days, resulted in clinical and
      parasitologic cure. This is the first report of C. philippinensis infection
      acquired in Indonesia.

PMID- 1636875
TI  - Parasite-specific IgE and IgG levels in the serum and pleural effusion of
      paragonimiasis westermani patients.
AB  - In seven patients with paragonimiasis westermani, parasite-specific IgE and IgG
      levels in sera and pleural effusion were determined by an enzyme-linked
      immunosorbent assay (ELISA). The sensitivity to adult excretory-secretory (E-S)
      antigen was compared with the sensitivity to whole worm extract antigen, and the
      former was more sensitive in both an IgE-ELISA and IgG-ELISA. Both parasite
      specific IgE and IgG could be detected by ELISA at levels much higher than those
      in control subjects using E-S antigen. When specific IgE and IgG levels in sera
      and pleural effusion of individual patients were compared, the latter had higher
      values. The difference between levels of specific IgE in pleural effusion and
      serum did not correlate with that of specific IgG. These results indicate that
      specific IgE and IgG antibodies form locally, i.e., in the lung, and that pleural
      effusions from patients with paragonimiasis are more suitable than serum for
      immunodiagnosis.

PMID- 1636876
TI  - Quinine with tetracycline for the treatment of drug-resistant falciparum malaria
      in Thailand.
AB  - Reports of deteriorating quinine efficacy prompted us to investigate the ability
      of quinine-tetracycline to clear parasites and fever from patients with multiple
      drug-resistant Plasmodium falciparum infections. Past and present treatment
      results were compared at two study sites along the Thai-Cambodian border. In
      northeastern Thailand, quinine-tetracycline cleared parasites more quickly in
      1990 than in 1987 (mean 3.4 and 4.0 days, respectively; P = 0.006). In
      southeastern Thailand, there were no significant differences between 1990 (n =
      26) and 1981-1983 (n = 42) in the time taken to clear either parasites (median 96
      and 93 hr, respectively; P = 0.35) or fever (mean 74 and 66 hr, respectively; P =
      0.30). In vitro drug sensitivity testing revealed a two-fold decrease in
      susceptibility to quinine between 1983 and 1990 in isolates from the southeastern
      Thai-Cambodian border (mean inhibitory concentration 166 ng/ml and 320 ng/ml,
      respectively; P less than 0.001). We conclude that oral quinine-tetracycline
      continues to reliably clear parasites and fever from falciparum malaria patients
      infected in eastern Thailand. Periodic re-evaluations are warranted, however,
      since the decrease in vitro susceptibility to quinine may be followed by an in
      vivo decay in the treatment response.

PMID- 1636877
TI  - Emergence of multidrug-resistant Plasmodium falciparum in Thailand: in vitro
      tracking.
AB  - Mefloquine was introduced into Thailand in 1985 for the treatment of Plasmodium
      falciparum infection. Recently, clinical failure of mefloquine was observed in
      southeastern Thailand, where an epidemic of falciparum malaria occurred.
      Beginning in 1984 and continuing until 1989, in vitro monitoring of P. falciparum
      isolates from Borai, a border district in the southeastern part of the country,
      showed a progressive decrease in mefloquine sensitivity until 1989; in 1990, the
      degree and prevalence of resistance accelerated. A similar pattern of resistance
      was observed for halofantrine, an antimalarial drug not yet commercially
      available in Thailand. In vitro sensitivity patterns of mefloquine and
      halofantrine elsewhere in the country remained relatively unchanged. These
      observations suggest a serious deterioration in available drugs for the treatment
      of falciparum malaria in southeastern Thailand that is predicted to spread
      throughout the country and Southeast Asia.

PMID- 1636878
TI  - Epidemiology of giardiasis in Wisconsin: increasing incidence of reported cases
      and unexplained seasonal trends.
AB  - Giardia lamblia is the most commonly reported enteric pathogen in Wisconsin.
      Since giardiasis became a notifiable disease, the annual number of cases reported
      to the Wisconsin Division of Health has increased more than 20-fold, from 2.2
      cases per 100,000 population in 1981 to 49.1 cases per 100,000 population in
      1988. To better understand the nature of this increasing trend, we reviewed
      records of G. lamblia infections reported to the Wisconsin Division of Health
      from 1981 to 1988. Although the increase in reported cases was a general
      phenomenon that was not limited to a few high-risk groups, the highest annual
      incidence and greatest increase occurred in children 1-4 years old; 34% of the
      cases in this age group occurred in children who attended day care centers. A
      remarkably consistent late summer (August) increase was observed across all
      demographic and risk groups, suggesting that G. lamblia may be more common in the
      environment during late summer, or that risk factors for transmission may differ
      during these months. Additional studies are needed to further explain the
      increasing incidence and seasonal nature of reported giardiasis and to identify
      opportunities for prevention.

PMID- 1636879
TI  - Vectorial transmission of Trypanosoma cruzi: an experimental field study with
      susceptible and immunized hosts.
AB  - The dynamics of vectorial transmission of Trypanosoma cruzi and the level of host
      (guinea pigs) protection after immunization with attenuated parasites (TCC
      strain) was studied under natural climatic conditions in an endemic region of
      northern Argentina. The experimental design included two guinea pig corrals
      isolated by mosquito netting. One (controls) had 17 healthy and susceptible adult
      guinea pigs. The other had 19 guinea pigs immunized with attenuated T. cruzi TCC
      strain. Each corral was colonized in April 1988 with equal-sized populations of
      Triatoma infestans naturally infected by T. cruzi. To evaluate relevant variables
      in the natural transmission of Chagas' disease, corrals were sampled in both
      winter and late spring to assess vector populations, and to carry out
      parasitologic studies on both vertebrate and invertebrate hosts. In both corrals,
      vector density decreased in winter and reached a maximum in the hot season. The
      vector infection rate was very high (greater than 50%) throughout the experiment.
      Vector infectivity increased with temperature and vector age, but did not differ
      between the experimental and control corrals. The vector-host contact rate showed
      a close relationship with temperature, although a very high vector density
      decreased this rate, even with high ambient temperatures. Initial infections by
      T. cruzi occurred among guinea pigs only during the hot season. Vectorial
      transmission risk was estimated from the total number of bug bites per day, the
      proportion of infected bugs, and the daily incidence in the guinea pig
      population. During the hot season, this risk was 6.84 x 10(-4) in the control
      group and 1.82 x 10(-4) in the immunized group.

PMID- 1636880
TI  - Lymphocytic choriomeningitis virus infection and house mouse (Mus musculus)
      distribution in urban Baltimore.
AB  - Four hundred eighty house mice (Mus musculus) were trapped primarily from urban
      sites in Baltimore, Maryland from 1984 to 1989 and tested for antibody to
      lymphocytic choriomeningitis virus (LCMV). The majority of mice (95%) were
      trapped in residences at two city locations (n = 260), or in an urban park (n =
      196); five additional sites were sampled. Overall, 9.0% of the mice were LCMV
      antibody positive and infected animals were obtained from six of eight sites,
      including all three of the primary city sites, where the prevalence varied
      significantly (3.9-13.4%). The location with the highest prevalence was an inner
      city residential site where positive mice were found significantly clustered
      within blocks and households. In this location, LCMV antibody prevalence was also
      significantly correlated with estimates of mouse density within individual
      blocks. The focal nature of LCMV infection in house mice may result from contact
      or vertical transmission of virus in conjunction with the highly structured
      social system of mice, which promotes inbreeding and limited dispersal.

PMID- 1636881
TI  - A cluster of Coxiella burnetii infections associated with exposure to vaccinated
      goats and their unpasteurized dairy products.
AB  - An outbreak of Q fever occurred among patients and staff of a psychiatric
      institution in southern France. Some of the patients and staff left the
      institution daily to work on a farm where goats were raised for raw milk and
      cheese production. The goats had all been vaccinated annually with a commercial
      vaccine containing phase II Coxiella burnetii antigen. A serologic survey
      revealed that 40 (66%) of the 61 patients and staff had elevated titers to C.
      burnetii. Seropositive persons were more likely to report an acute illness (P =
      0.001), fever (P = 0.04), weakness (P = 0.04), arthralgia (P = 0.04), and
      headaches (P = 0.06) in the preceding year than were seronegative persons.
      Seropositivity rates were significantly higher among persons who worked on the
      farm and consumed unpasteurized milk products (69% [22 of 32]; P = 0.007), those
      who only had worked on the farm (75% [9 of 12]; P = 0.009), and those who only
      had consumed unpasteurized milk products (75% [9 of 12]; P = 0.009), compared
      with those who had not worked with the goats or consumed unpasteurized milk
      products (0 of 5). Despite vaccination against Q fever, no antibodies to C.
      burnetii were detectable in 17 (59%) of 29 goats. All 12 seropositive goats had
      antibodies to both phase I and phase II antigens, indicating that they were
      naturally infected, and two of three goats examined were shedding C. burnetii in
      their milk. Vaccination of this herd did not prevent the outbreak and might have
      increased shedding of C. burnetii in the dairy products.

PMID- 1636882
TI  - Ookinete rates in Afrotropical anopheline mosquitoes as a measure of human
      malaria infectiousness.
AB  - Anopheles gambiae s.1. and An. funestus were sampled for Plasmodium spp.
      ookinetes in two P. falciparum-endemic sites in western Kenya. Since the ookinete
      is a transitional stage of short duration, occurring after fertilization and
      before oocyst development, only females in the half-gravid and gravid stages of
      blood digestion were examined. Preparations of homogenized midguts were spotted
      onto microslides and examined microscopically after staining with Giemsa.
      Overall, ookinetes were detected in 4.4% of 1,079 anophelines examined over an
      eight-month period. Anopheles funestus had higher ookinete rates than An. gambiae
      s.1., and ookinete rates were higher in half-gravid than in gravid An. gambiae
      s.1. Geometric mean numbers of ookinetes per infected female were less than five
      for each species at the two sites, and the maximum number observed was only 12.
      The low frequencies and numbers of ookinetes were sufficient to produce
      sporozoite rates of 4-18% in the vector populations. The intense transmission of
      P. falciparum in these two sites is maintained by anthropophilic vectors where
      only one in 23 blood meals initiates an infection of generally less than five
      ookinetes. Relationships between human malaria infectiousness and vector
      infectivity are dependent upon the high efficiency of the developmental
      transition from the ookinete to the subsequent oocyst and sporozoite stages.

PMID- 1636883
TI  - Epidemiologic investigation of an outbreak of cutaneous leishmaniasis in a
      defined geographic focus of transmission.
AB  - An outbreak of cutaneous leishmaniasis occurred in a unit of 608 Puerto Rican
      national guardsmen conducting jungle warfare training in the Panama Canal Area in
      July 1984. An epidemiologic investigation of reported nonhealing, ulcerating skin
      lesions was conducted among 540 (89%) unit members in November and December 1984.
      Fifteen (88%) of 17 individuals with chronic, ulcerating skin lesions were
      confirmed as cases of cutaneous leishmaniasis by culture or histopathology.
      Twelve cases yielded positive Leishmania cultures, identified as L. braziliensis
      panamensis by cellulose acetate electrophoresis. Evaluation of different
      diagnostic techniques revealed that direct examination of tissues by Giemsa
      stained histological examination was the most sensitive test (87% sensitivity),
      with an indirect immunofluorescent antibody test being rather insensitive (67%).
      All but one of the confirmed cases operated in small units that trained and slept
      overnight at a mortar firing site for a period of three days, yielding a site
      specific attack rate of 22% (14 of 64). This contrasted with a much lower attack
      rate of 0.2% (1 of 476), experienced by unit members who trained at other
      locations during the same time frame (P less than 0.001). The median incubation
      period calculated from day of arrival at the mortar firing site was 17 days
      (range 2-78) for the 15 confirmed cases. Available personal protection methods,
      such as the use of insect repellents, were not appropriately implemented by unit
      personnel and thus, were not found to effectively protect against Leishmania
      infection. This is the largest reported outbreak of cutaneous leishmaniasis in
      military personnel associated with a single geographic focus of infection and
      contrasts with the usual sporadic disease experience in Panama.

PMID- 1636884
TI  - Clustering of host-seeking nymphal deer ticks (Ixodes dammini) infected by Lyme
      disease spirochetes (Borrelia burgdorferi).
AB  - In areas where the agent of Lyme disease is intensely enzootic, the mouse
      reservoirs may be universally infected. Because a large proportion of the vector
      tick population appears to feed upon these hosts, the prevalence of infection in
      the vectors should approach 100%. However, infection in host-seeking nymphal
      ticks in nature rarely exceeds 40%. To help reconcile this apparent paradox, we
      examined whether estimates of prevalence might differ if we did not assume that
      infected ticks are randomly or uniformly distributed within a site. Nymphal
      Ixodes dammini were collected by dragging a series of 10-meter replicates within
      an intensely enzootic site. Estimates of the prevalence of spirochetal infection,
      based upon the monthly means of individual 10-meter collections, were then
      compared with estimates derived by pooling all samples. Host-seeking ticks tended
      to cluster. The Lyme disease spirochete was present in 15.6% of 469 pooled ticks.
      When the prevalence estimate was based solely on ticks in clusters that contained
      one or more infected ticks, however, at least 50% of the ticks were infected. We
      conclude that nymphal deer ticks infected by Lyme disease spirochetes tend to
      aggregate spatially in nature, and that prevalence estimates based upon a mean
      value for pools may be misleading.

PMID- 1636885
TI  - Schistosomiasis and the Dogon country (Mali)
AB  - A previously unknown area of schistosomiasis transmission is reported based on
      findings from a travelers' clinic in Barcelona. Three species of Schistosoma (S.
      haematobium, S. mansoni, and S. intercalatum) were diagnosed in a cluster of 43
      patients who had been swimming in the Bandiagara and Bankas districts of Mali,
      where the Dogon people live. Three villages in the Bankas district appear to
      harbor these three species. The transmission potential of such a focus in this
      area is outlined. The travelers involved had little or no information on the
      risks of contracting schistosomiasis in that area. Obtaining a traveler's
      history, including accurate geographic data, is shown to be a crucial asset for
      improving epidemiologic research.

PMID- 1636886
TI  - Characterization of the heat-shock response of Trichomonas vaginalis.
AB  - The heat-shock response induced in Trichomonas vaginalis by exposure to various
      incubation temperatures was traced by metabolic labeling and monitored by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis and fluorography. Increasing
      the incubation temperature from 37 degrees C to 43 degrees C depressed normal
      protein production and enhanced synthesis of heat-shock proteins (hsp). Smaller
      increases in incubation temperature resulted in little change in protein
      synthesis, whereas larger temperature increases inhibited protein synthesis. The
      hsp produced by T. vaginalis included molecules with approximate molecular masses
      of 85, 78, 66, 61, 35-31, 20-15, and 12 kD. Trichomonas vaginalis switched to hsp
      synthesis gradually. Full conversion to hsp production occurred within 60-90 min
      after the initiation of the 43 degrees C stress. The period of synthesis was
      different for individual hsp, suggesting independent regulation of hsp
      production. Four strains of freshly reinitiated and culture-adapted (extended in
      vitro culture) T. vaginalis synthesized the 85-, 78-, and 66-kD hsp, but varied
      in the synthesis of the 61-, 35-, 34-, 32-, and 31-kD molecules. Culture
      adaptation affected the heat-shock response of two of the four strains tested.

PMID- 1636887
TI  - Nucleoside transporters in Leishmania major: diversity in adenosine transporter
      expression or function in different strains.
AB  - Cytotoxic nucleoside derivatives may become useful in the treatment of parasitic
      infections. As part of our drug development studies, the effect of a number of
      nucleosides (100 microM) on the cellular transport of 3H-adenosine and 3H-inosine
      (each at 1 microM) in promastigotes from four Leishmania major strains was
      investigated. When 3H-inosine was used as permeant, all strains exhibited
      essentially the same inhibition profile, with unlabeled inosine, guanosine,
      formycin B, and 3'-deoxyinosine being strongly inhibitory, and adenosine-related
      compounds such as 2'-deoxyadenosine and tubercidin being inactive. However, when
      3H-adenosine was used as permeant, considerable differences in the inhibition
      profiles were noted among strains. Thus, both inosine transporter-selective
      nucleosides such as inosine and guanosine and adenosine transporter-selective
      nucleosides such as 2'-deoxyadenosine and tubercidin showed variable activity as
      inhibitors of 3H-adenosine transport in different strains. These observations
      indicated that an adenosine transporter was variably expressed in different
      strains, and that inhibition profiles for adenosine transport indicated cellular
      entry via both the inosine and adenosine transporters. The existence of different
      types of adenosine transporters as an alternative explanation could not be ruled
      out. The apparent uniform expression of an inosine transporter among different
      species and strains of Leishmania suggests that inosine derivatives may be useful
      as anti-leishmanial drugs.

PMID- 1636889
TI  - Percutaneous endoscopic gastrostomy or jejunostomy and the incidence of
      aspiration in 79 patients.
AB  - Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic jejunostomy
      (PEJ) are well-accepted procedures for long-term enteral alimentation. PEG has
      replaced surgical gastrostomy at many institutions because of its safety and
      ease. This study was undertaken to evaluate the indications for PEG and PEJ, as
      well as their success rates, complications with special attention to aspiration,
      and long-term follow-up. We were specifically interested in reviewing the problem
      of aspiration in patients with PEG and PEJ. A retrospective review of 79 patients
      at Brooke Army Medical Center over a 3-year period was done. PEG or PEJ was
      successful in 79 of 81 patients (97%). The most common indications were
      neurologic disorders in 46 patients (58%) and cancer in 20 (25.3%). Complications
      other than aspiration occurred in 11 patients (14%). Aspiration occurred in nine
      patients after PEG or PEJ (11.4%); six patients had experienced aspiration prior
      to PEG or PEJ. Six patients had a jejunostomy tube placed through the PEG for
      prevention of aspiration, and three died of continued aspiration. We conclude
      that aspiration is not prevented by PEJ, continues to be a major problem after
      PEJ, and becomes manifest for the first time after PEG.

PMID- 1636888
TI  - Clinical utility of open lung biopsy for undiagnosed pulmonary infiltrates.
AB  - Open lung biopsy (OLB) is often performed as the definitive diagnostic procedure
      in patients with undiagnosed pulmonary infiltrates, but controversy exists as to
      the clinical utility of this practice. A retrospective review of 50 consecutive
      patients who underwent OLB for undiagnosed pulmonary infiltrates was done to
      assess the diagnostic value as well as the frequency with which these results
      affected therapy and mortality. Histologic tissue diagnoses were obtained in all
      patients. Specific pathologic diagnoses were obtained in 56% of patients,
      nonspecific in 44%. Lobar or lateralized infiltrates were more likely to yield a
      specific diagnosis (87%) than diffuse, bilateral infiltrates (42%). Thirty-four
      patients (68%) had previously had a nondiagnostic transbronchial biopsy; 58% of
      these patients had a specific diagnosis established by OLB. Twelve patients (24%)
      were in acute respiratory failure at the time of OLB; this group had a 50%
      mortality rate as compared with only 2.6% for patients not in acute respiratory
      failure (p less than 0.01). Therapy was altered (new specific or nonspecific
      treatment initiated or therapy withdrawn) in 78% of patients undergoing OLB.
      Thirty-day in-hospital survival was significantly higher in patients for whom
      either specific or nonspecific therapy was indicated and initiated versus those
      in whom no therapy was initiated or all therapy was withdrawn (mortality: 5.5%
      versus 35.7%; p = 0.01). Mortality was not related to the presence of
      immunosuppression or to the finding of a specific diagnosis. The overall
      mortality rate of 14% in this series compares favorably with mortality rates
      found in similar series, reflecting differences in patient populations and
      possibly the timing of intervention. OLB remains a clinically valuable diagnostic
      tool in selected patients.

PMID- 1636890
TI  - Simulation of blood flow in microgravity.
AB  - Knowledge of venous, capillary, and arterial blood flow in microgravity is
      required to modify hemostatic techniques for control of bleeding in traumatic
      injuries or surgical procedures in space. To simulate human arterial, venous, and
      capillary bleeding, fresh whole bovine blood was injected by two operators at
      calculated flow rates (3.5, 7, and 14 mL for venous and 14 and 28 mL for
      arterial) in 10 seconds with empirical controls in a lucent glove box during zero
      gravity parabolic flight on NASA's KC-135 aircraft. A pig's foot was used to
      mimic capillary bleeding. Hemostasis with sponges and laerdal suction was
      evaluated by video and still photography. Evaluations of the arterial and venous
      bleeding were conducted at 3 rates x 3 parabolas, and capillary bleeding was
      evaluated with 5 parabolas x 2 methods (pig's foot and sponge). Influenced by
      surface tension, the slow venous bleeding coated syringe surfaces and formed a
      dome over the skin laceration bleeding site. Arterial and venous bleeders broke
      into uniform spheres with low-velocity spheres bouncing off an absorbent pad and
      suction tip. Conventional dabbing with gauze fragmented blood into small spheres.
      Capillary oozing was better controlled by "wicking" up blood with gauze. Repeated
      arterial bleeding opacified the glove box wall. This stimulation demonstrated
      unique characteristics of extracorporeal blood flow and inadequacies of common
      methods of hemostasis in microgravity.

PMID- 1636891
TI  - Biliary reconstruction in benign postoperative stricture with transhepatic tubes.
AB  - This study reports our experience with 31 patients who underwent biliary
      reconstructions due to iatrogenic lesions of the main biliary tract. The
      technique of Hepp and Couinaud, associated with the use of transhepatic Silastic
      tubes, was utilized in 90% of the patients, and the mucosal graft was employed in
      only three patients. The recommended time for keeping the transhepatic tube in
      place was 6 months. In order to prevent subphrenic fluid collection between the
      tube exit orifice in the hepatic parenchyma and the abdominal wall, the tubes
      were protected with a Penrose drain over the course of their use. This tactic
      appeared effective. The immediate postoperative mortality was 9%, and the long
      term results, with a mean follow-up period of 44 months, were considered good in
      92% of the patients who survived surgery.

PMID- 1636892
TI  - Polytetrafluoroethylene in above-knee arterial bypass surgery for critical
      ischemia.
AB  - Seventy-one consecutive above-knee polytetrafluoroethylene (PTFE) femoropopliteal
      arterial bypasses performed between 1981 and 1989 for critical ischemia were
      followed prospectively to determine graft patency and limb salvage. Cumulative
      graft patency and limb salvage rates were calculated by life table analysis.
      Graft patency was 80%, 68%, 55%, 39%, and 39%, and limb salvage 97%, 87%, 84%,
      77%, and 77% at 1, 2, 3, 4, and 5 years, respectively. Twenty-nine grafts have
      occluded with re-emergence of critical ischemia in 14, treated by 5 amputations
      and 9 reconstructions using autogenous saphenous vein (ASV) in 6 and PTFE in 3.
      These favorable results are not as good in terms of primary patency as those
      reported with ASV, but good limb salvage, good early patency, ease of use, and
      preservation of the saphenous vein for use later have encouraged us toward
      primary use of PTFE in selected patients. This experience strongly questions the
      wisdom of an "all autogenous" policy for reconstruction at this level.

PMID- 1636894
TI  - Molecular biology: an overview.
AB  - An overview of molecular biology is presented for the practicing surgeon.
      Definitions of the constructs and activity of DNA, RNA, and protein synthesis are
      defined. These principles are illustrated in their use in recombinant DNA
      technologies. A glossary is provided for the terms utilized.

PMID- 1636893
TI  - 31P-NMR evaluation of postischemia renal ATP and pH levels after ATP-MgCl2
      treatment in rabbits.
AB  - Phosphorus-31 (31P) nuclear magnetic resonance (NMR) spectroscopy was used to
      measure adenosine triphosphate (ATP) concentration and pH in vivo in rabbits
      subjected to a 40-minute period of unilateral renal ischemia to determine the
      effect of infusing ATP-magnesium chloride (MgCl2, 100 mumol/kg) versus saline at
      the initiation of reperfusion. Data were compared initially by analysis of
      variance and then analyzed further using a general linear model with covariate
      adjustment. ATP-MgCl2-treated animals did not have higher ATP levels during
      recovery but did have significantly higher renal blood flow (p less than 0.05), a
      significantly decreased rate of recovery from acidosis (p less than 0.05), and
      significantly higher urinary output (p less than 0.01) than saline-treated
      animals during the recovery period. Therefore, treatment with ATP-MgCl2 improves
      postischemic functional parameters in this model of moderate injury without
      functioning as a direct source of ATP or its precursors. These data add support
      to the emerging concept that intracellular acidosis protects cells from
      reperfusion injury.

PMID- 1636895
TI  - An update on incision for ilioinguinal lymph node dissection.
AB  - The wound morbidity after ilioinguinal lymph node dissections can be
      significantly reduced by precise planning of both the incision and the extent of
      flap elevation. Flap elevation extends no farther than the edges of the
      quadrilateral block of Anson, and exposure is best obtained with a bipedicle
      incision with broad-based pedicles. The broad bases ensure the greatest
      possibility for the sustentation of the flaps by the remaining microcirculation.
      All suction drains are placed far laterally, not through the base of any flaps,
      to avoid the high bacterial count on the skin of the groin, genitals, perineum,
      and anus. Closure is undertaken with a running suture, which allows for a seal
      that will facilitate suction. Suction continues until drainage is less than 25
      mL/d.

PMID- 1636896
TI  - Direct septum transversum incision to replace circumferential diaphragmatic
      incision in operations on the cardia.
AB  - Application of a simple anatomic approach to lesions of the cardia, both benign
      and malignant, in consecutive patients has demonstrated an excellent exposure
      with the same flexibility as the standard, circumferential, diaphragmatic, and
      abdominal incision used for the past 50 years. The technical details of the
      procedure and its application are described, along with the pertinent embryology,
      anatomy, and physiology that led to this approach.

PMID- 1636897
TI  - A technique for rapid closure of traumatic small intestine perforations without
      resection.
AB  - Small bowel perforation after blunt trauma is frequently associated with other
      intra-abdominal injuries. Typically, large luminal defects are encountered after
      blunt trauma that cannot be closed primarily without subsequent luminal
      compromise, necessitating formal resection with primary anastomosis. We describe
      a safe, rapid, and effective method by which traumatic small bowel perforations
      may be closed without resection using readily available gastrointestinal stapling
      devices. The speed of the closure allows for expedient management of associated
      injuries without fear of continued enteric spillage. No mesenteric resection or
      closure is needed, obviating the possibility of internal hernias.

PMID- 1636898
TI  - Nasopharyngeal brachytherapy with access via a transpalatal flap.
AB  - We used a posteriorly based transpalatal flap for interstitial nasopharyngeal
      brachytherapy in five patients with nasopharyngeal carcinoma. All of these
      implants were done with iodine 125 seeds. The disease in three of five patients
      has been controlled locally for 27, 30, and 40 months, respectively. Two patients
      experienced local failure and died. There have been no palatal healing problems
      despite high doses of previous radiation in all of our patients. No palatal
      incompetence has been seen. This technique appears safe and should be considered
      for discrete lesions of the high posterior or superior nasopharynx that cannot be
      approached by less invasive methods.

PMID- 1636899
TI  - Absence of colorectal cancer metastasis to the cirrhotic liver.
AB  - Hepatic metastasis of colorectal cancer was found in 40 (16%) of 250 patients
      with colorectal cancer treated in our department during the past 5 years. Liver
      cirrhosis was not found among the 40 patients with metastases (16%) but was
      present in 46 (21.9%) of the 210 nonmetastatic patients, with a significant
      difference between the two groups (p less than 0.001). The rate of patients who
      were positive for hepatitis B surface antibody was 10% in the metastatic group
      and 34.3% in the nonmetastatic group, with a significant difference (p less than
      0.01). These findings suggest that colorectal cancer does not metastasize to the
      injured liver, especially the cirrhotic liver.

PMID- 1636900
TI  - Drug therapy for inflammatory bowel disease: Part II.
AB  - Part II of this two-part article (See The American Journal of Surgery 1992; 164:
      85-9) reviews the current definition of the role of immunosuppressive therapy in
      inflammatory bowel disease (IBD) and the use of antibiotics in IBD, as well as
      summarizes the uses of the new agents on the horizon for the treatment of IBD.
      Azathioprine and 6-mercaptopurine have steroid-sparing effects in patients with
      refractory Crohn's disease and ulcerative colitis, treat Crohn's disease
      associated fistulas, and are the first agents to demonstrate efficacy in the
      prophylaxis of Crohn's disease. Their low risk for the development of
      lymphoreticular malignancy remains a factor in decisions regarding their long
      term use. Cyclosporine is steroid sparing in active chronic Crohn's disease and,
      given intravenously, may help treat severe, refractory ulcerative colitis.
      Antibiotics have expanding roles: metronidazole is effective for the primary
      treatment of Crohn's disease, fistulas, abscess, bacterial overgrowth, and
      pouchitis (after ileoanal anastomosis). Other potential agents show promise in
      pilot studies but await controlled trials.

PMID- 1636901
TI  - Vascular lesions of the intestines.

PMID- 1636902
TI  - Contributions of the Zollinger-Ellison syndrome.

PMID- 1636903
TI  - Relative risks of complications in giant and nongiant gastric ulcers.
AB  - There are two divergent views regarding giant gastric ulcers. Traditionally, they
      have been regarded as a virulent disease prone to massive hemorrhage,
      intractability, and perforation. Recently, an entirely opposing viewpoint has
      developed that considers them no different from ordinary gastric ulcers. In this
      study between 1984 and 1989, 62 patients with giant ulcers (greater than or equal
      to 3 cm) were compared with 476 benign gastric ulcer patients to evaluate their
      relative risks of ulcer complications. The results showed that giant ulcers are
      more prone to severe hemorrhage (44% versus 27%; chi 2 test: p less than 0.009)
      but not more prone to free perforation. Penetration into contiguous organs
      occurred more frequently with giant gastric ulcers (45% versus 10%; chi 2 test: p
      less than 0.0001). The risk of the presence of microscopic malignancy in the
      macroscopically benign-looking giant ulcer is significantly greater than in the
      nongiant type (13% versus 3%; Fisher's exact test: p = 0.0013). The data showed
      that patients with giant gastric ulcers are more at risk for the development of
      life-threatening complications and, hence, more likely to require surgery.

PMID- 1636905
TI  - [Antibiotics in laryngectomized patients: prophylactic use in the postoperative
      period].
AB  - Study of the follow-up of 43 laryngectomees during a 20 months term done at the
      Hospital de San Vicente de Paul, Medellin, Colombia. Twenty patients received
      prophylactically 1 gr of sodium cefoperazone each 12 hours for 3 doses; the other
      23 were treated with penicillin/gentamycin after surgery, for 10 days. Sodium
      cefoperazone group showed an infection index of 16 percent compared with 65
      percent of the penicillin-gentamycin group. Factors such surgical time, previous
      tracheotomy, cancer staging, radical neck dissection and radiotherapy were not
      related to the infection. Index 16 percent still is high and possible responsible
      causes are analyzed in the paper.

PMID- 1636904
TI  - Avoiding laparotomy in nonsurgical pneumoperitoneum.
AB  - Patients with free intraperitoneal air collections usually undergo emergency
      surgery, and the majority will have a gastrointestinal tract perforation.
      However, there is a subset of patients in whom no identifiable perforation is
      found at surgery. This entity of noniatrogenic, nonsurgical spontaneous
      pneumoperitoneum is being diagnosed more frequently at present and is commonly
      associated with other disease processes that, together, may suggest a benign
      process. Therefore, a diagnostic algorithm that would preclude operative
      intervention in this cohort of patients would be of paramount clinical
      importance. In this report, we present representative cases of the most common
      types of nonsurgical pneumoperitoneum, review the pathogenesis of this disorder,
      and discuss its relationship with pneumatosis cystoides intestinalis, pulmonary
      disorders, scleroderma, and gynecologic processes. Finally, we outline a
      diagnostic algorithm that may identify patients who can safely be observed,
      thereby reducing the incidence of negative laparotomies and, secondarily, the
      aggregate cost of health care.

PMID- 1636906
TI  - [Post-tonsillectomy peritonsillar abscess].
AB  - Quinsy cases following tonsillectomy are very rare indeed, as proved by the
      scarce publications related to the subject. And all of them presented after a
      long term of years elapsed. From the perusal of the bibliography done by the AA.
      none of the cases presented close to the operation. The chance to see and treat
      one case starting from the fourth postoperative day compelled the AA. to report
      it.

PMID- 1636907
TI  - [Olfactory esthesioneuroblastoma (presentation of 4 cases from the authors'
      practice)].
AB  - This is a new case of Esthesioneuroblastoma to joint the other 3 of our Archives.
      The opportunity is profited in order to make a revision on the subject.

PMID- 1636908
TI  - [Ototoxicity of deferoxamine].
AB  - Deferoxamine or desferrioxamine (DFO) is a chelating agent, largely used in
      patients with chronic renal failure, although it has many side effects, being
      ototoxicity one of them. In this paper we studied the eventually adverse otologic
      effects of DFO in 20 patients receiving haemodialysis. A complete audiological
      evaluation, including pure-tone audiometry, brainstem auditory evoked potentials
      and high-frequency audiometry, was performed. The results showed a sensorineural
      hearing loss of retrocochlear origin in 3/20 cases (15%). We can accept that
      ototoxic effects of DFO are minimal, but no inexistent. Because of these we
      considered highly recommendable an accurate control of hearing in patients with
      renal disease receiving DFO.

PMID- 1636909
TI  - [Anterior reconstructive glottecomy].
AB  - Shallow lesions of the glottis spreading to both sides of the middle line (T1b)
      have special characteristics under the viewpoint of its resection, because of the
      neighbourhood of the anterior commissure. Frontal and frontolateral techniques
      require a reconstructive step in order to avoid synechiae. The AA. report 35
      cases with glottis reconstruction following several procedures: skin pedicled
      flap or epiglottoplasty. As the results almost the totality of the laryngectomees
      were "cured" after 5 years follow-up, and a high percentage of them free of
      tracheostomy tube.

PMID- 1636911
TI  - [Surgical treatment of locally advanced cancer of the tongue by total glosso
      pharyngo-laryngectomy].
AB  - Seven patients with advanced carcinoma of the tongue (T4) were treated with total
      glossectomy and laryngectomy, neck dissection (radical-functional or radical
      traditional) and reconstruction with the pectoralis major myocutaneous flap. The
      AA. comment the surgical technique, the pros and the cons of the indications, the
      justification, the objectives and the consequences.

PMID- 1636910
TI  - [Olfactory esthesioneuroblastoma].
AB  - The AA. present 2 cases of olfactory Neuroblastoma in different stages of
      histologic differentiation, which are compared. Bibliographic survey of the
      entity.

PMID- 1636912
TI  - [Laryngocele and pyolaryngocele].
AB  - Report of one case of laryngocele and an other one of pyolaryngocele, in two
      children with laryngeal papillomatosis. Review of the treatment and the origin of
      the process as well. The AA. point out that with regard to the cause there is an
      interrelation between a congenital predisposition, represented by a large
      ventricular appendix, and other postnatal acquired factors, for instance, the
      papillomatosis present in the two patients, which justify the paper.

PMID- 1636913
TI  - [The reliability of proximal and distal gas samples in the capnometry of
      infants].
AB  - To compare the accuracy of end-tidal pCO2 measurement derived from the connector
      (petCO2 proximal) and from the tip of the endotracheal tube (petCO2 distal), we
      measured paCO2, petCO2-proximal and distal in 42 infants (weight: 2500-9500 g)
      manually ventilated with an Ayre's t-piece breathing circuit (Kuhn modification).
      For distal gas sampling we used a commercially available "uncuffed tracheal tube
      with monitoring lumen" Mallinckrodt, Hennef, with a separate monitoring lumen
      leading to the distal tip of the endotracheal tube. Compared with paCO2 (26.2 +/-
      5.3 mmHg), proximal gas sampling resulted in a significantly lower petCO2 (17.3
      +/- 6.0; P less than 0.001) and a large arterial-end-tidal pCO2 difference (pa
      etCO2 9.0 +/- 6.8 mmHg). The correlation between paCO2 and petCO2 was poor (r =
      0.29; n.s.). In infants weighing less than 5000 g the arterial-end-tidal pCO2
      difference was found to be especially high (12.1 +/- 5.1 mmHg); it was slightly
      smaller in infants with more than 5000 g (5.6 +/- 7.0 mmHg). Distal petCO2 values
      approximated arterial pCO2 much better (petCO2 26.0 +/- 5.8 mmHg; diff pa-etCO2
      0.4 +/- 3.0 mmHg, r = 0.86) even in very small children. In 12 children (weight:
      2500-8000 g) ventilated with a circuit (Drager-Kreissystem) accurate petCO2
      measurements were obtained from both the proximal and the distal sampling site.
      CONCLUSIONS: When an Ayre's t-piece is used for ventilation of children weighing
      less than 10 kg, distal gas sampling for petCO2 measurement should be preferred.
      Proximal gas sampling does not allow correct capnometry except in a circuit with
      one-way valves.

PMID- 1636914
TI  - [The incidence of hypoxia in the immediate postoperative period].
AB  - Arterial oxygen saturation (SaO2) was continuously measured using a pulse
      oximeter in 214 spontaneously breathing adult patients in a recovery room.
      Hypoxaemia was defined as an SaO2 of 90% or below. The patients were divided into
      three groups: in group I (n = 83) monitoring was started immediately after
      arrival in the recovery room, just before oxygen therapy was begun. The patients
      in group II (n = 106) were observed during and after oxygen therapy. Patients in
      group III (n = 25), most of whom had regional anaesthesia, were not treated with
      oxygen in the recovery room. RESULTS. Clinically unexpected hypoxaemia occurred
      in all three groups: hypoxaemia was observed in 32.6% of patients before oxygen
      administration (group I). Under oxygen therapy SaO2 was normal in 99.4% of the
      patients; however, in 30.2% of patients hypoxaemia recurred after oxygen had been
      discontinued (group II). Hypoxaemic periods were seen in 24% of patients in group
      III. CONCLUSION. The results indicate the necessity of oxygen administration
      during transport and in the early postoperative period to all patients. Even
      during and after regional anaesthesia or brief general anaesthesia, oxygen
      administration appears to be indicated. Monitoring of SaO2 with a pulse oximeter
      has become an increasingly standard procedure in modern anaesthesia and should be
      mandatory.

PMID- 1636915
TI  - [The addition of ethyl alcohol to the irrigating fluid. Monitoring fluid
      absorption during transurethral resection of the prostate].
AB  - The absorption of irrigation solution during transurethral prostatic resection
      may lead to the life-threatening condition of the so-called TUR syndrome. For a
      long time no early recognition procedure was easily and routinely available. This
      study was set up to investigate the effectiveness of ethanol as an early
      indicator of beginning absorption, as described by Hulten. Ethanol was therefore
      added to the irrigating fluid as a marker, and alcohol concentrations were
      measured in the exhaled breath. METHODS. For measurement of alcohol an Alcotest
      monitor 7110, Dragerwerk (Lubeck, FRG) was used. In preliminary experiments with
      13 healthy volunteers the lowest amount of measurable i.v.-administered 2% Ringer
      ethanol solution was found to be about 200 ml. The irrigating fluid used was a 2%
      ethanol-mannitol/sorbitol solution. RESULTS. The control of breath and blood
      alcohol levels in 10 patients undergoing transurethral bladder surgery showed
      that there was no absorption of alcohol across the internal bladder lining. Of 52
      patients, who had to undergo transurethral prostatic resection, 23 had positive
      breath alcohol values of up to 0.81/1000. In 6 patients the blood alcohol levels
      only were elevated (max. 0.18/1000). In 23 other patients no increased blood or
      breath alcohol levels were detectable. The negative breath alcohol levels in 6
      patients were most probably attributable to low breath volumes due to lack of
      cooperation caused by pre- and/or intraoperative sedation. There were no
      significant changes in central venous pressure, mean arterial pressure or heart
      rate even at the time of maximal alcohol levels, compared with initial values.
      These parameters thus cannot be used for the early recognition of beginning
      absorption. Simultaneous monitoring of serum sodium concentrations revealed
      significant decreases at the time of maximal breath alcohol levels. Yet, the
      first indication of beginning absorption was always a positive alcohol level.
      Serum sodium changes followed later with increasing alcohol levels. Sodium
      concentration did not drop before a positive alcohol level was measured in any of
      these cases. CONCLUSION. It was thus proven that the addition of ethanol to the
      irrigating fluid and monitoring of the patient's exhaled breath with the Alco
      testmonitor is a simple, non-invasive system that can be routinely used for early
      detection of absorption during transurethral prostatic resection. Adequate
      adjustment of the further course of the operation was possible. The dreaded TUR
      syndrome did not develop in any of the patients monitored in this way.

PMID- 1636916
TI  - [Monitoring patients in the anesthesia recovery room. Continuous transcutaneous
      O2 and CO2 measurements].
AB  - To establish whether continuous transcutaneous O2 and CO2 measurement in the
      recovery room is suitable for non-invasive monitoring of spontaneous respiration
      in patients newly operated upon, comparative transcutaneous and arterial pO2 and
      pCO2 investigations were carried out on 35 adults. There was a correlation
      coefficient of 0.66 between paO2 and tcpO2. The transcutaneous pO2 values
      measured were 45.3 mm Hg under the arterial values. When the transcutaneous CO2
      values were compared with the arterial values, the correlation coefficient was
      0.906. The mean transcutaneous pCO2 values measured lay around 0.7 mm Hg above
      the arterial values. On the basis of this slight deviation in CO2 values, the
      method appears to be suitable for continuous non-invasive determination of pCO2.
      The very large deviations in the O2 values indicate that transcutaneous
      measurement of oxygen partial pressure in this specific examination situation is
      not sufficiently reliable, which makes questionable the practice of using one
      piece of equipment for both measurements. In the clinical setting presented,
      transcutaneous O2 monitoring does not represent an alternative to close clinical
      observation and pulse oximetry.

PMID- 1636917
TI  - [Propofol versus midazolam. Long-term sedation in the intensive care unit].
AB  - Sedative-analgesic treatment of patients on long-term artificial ventilation aims
      at protection from stress related to their disease or therapy. By stabilising
      both the patient's vital functions and psychological state this treatment may
      contribute to therapeutic success. The choice of drugs depends primarily on the
      nature and course of the underlying disease. Midazolam and propofol are available
      as hypnotics for short-term sedation during the post-operative period. The
      purpose of this study was to evaluate the effects of both agents on
      cardiovascular function, cortisol production, lipometabolism, and the recovery
      period following 24-h sedation. METHODS. Twenty female patients (mean body
      weight: 72 kg, mean age: 60 years) were randomly assigned to receive either
      midazolam or propofol over 24 h following major abdominal surgery. Balanced
      anaesthesia (halothane/O2/N2O/fentanyl) was administered for the surgical
      procedure. Assisted ventilation was used in all patients during the post
      operative sedation period. Sedation depth was maintained at III-IV on the Ramsey
      scale. On arrival in the intensive care unit (ICU), an initial i.v. bolus of
      midazolam 0.1 mg/kg or propofol 1 mg/kg was followed by a continuous infusion
      (midazolam: 0.1 mg/kg.h; propofol: 2 mg/kg.h). Supplementary boluses of one-half
      the initial dose were given if required. Post-operative analgesia was achieved
      with 3 mg intravenous piritramide at 2-h intervals. A 7F Swan-Ganz catheter was
      inserted in the pulmonary artery and haemodynamic and biochemical parameters were
      monitored at 4-h intervals over 24 h starting 2 h after arrival in the ICU.
      Catecholamines were measured by high-pressure lipid chromatography (HPLC),
      cortisol by radioimmunoassay, midazolam by HPLC and ultraviolet detection, and
      propofol by HPLC and fluorescence detection. Data were calculated as means. The
      statistical analysis was performed according to the Mann-Whitney test, and
      significance was accepted for P less than 0.05. RESULTS. On administration of the
      propofol bolus at the onset of sedation, a decrease in blood pressure was
      particularly observed in patients with masked hypovolaemia, however, this
      decrease was easily controlled by volume administration. Independent of the type
      of sedation, the haemodynamic parameters remained unchanged throughout the
      observation period. At all times of measurement the mean heart rate was lower in
      the propofol group (90/min) when compared with the midazolam group (100/min),
      however, this difference did not reach significance. There were also no
      significant differences in cardiac index at all times of measurement, although it
      increased in both groups within the first 12 h by 0.6 l/min.min2. In both groups
      this increase was associated with a reduction in peripheral resistance and an
      increase in rectal temperature. To achieve the desired sedation depth, midazolam
      was administered at a mean dosage of 0.11 mg/kg.h and propofol at 1.9 mg/kg.h.
      Catecholamine levels decreased in both groups within the first 8 h: after 8 h of
      sedation the plasma levels of noradrenaline and adrenaline were 525 and 65 pg/ml,
      respectively, in the midazolam group and 327 and 51 pg/ml in the propofol group.
      (ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1636918
TI  - [Computer-assisted mechanical ventilation of newborn infants].
AB  - Mechanical ventilation of mature or premature newborns is supposed to provide
      pulmonary gas exchange while causing minimal side effects to the respiratory
      system and circulation of the infants. A certain degree of alveolar ventilation,
      for example, can be achieved by different ventilator settings with different
      airway pressures (Fig. 1), and thus the corresponding effects on lung mechanics,
      barotrauma, and circulation differ. Parameters indicating optimal ventilator
      settings cannot be measured often enough in routine daily care and sometimes are
      difficult to interpret because of complex interactivity factors. The aim of the
      computer program "RespCalc" is to shorten the empirical steps of adapting
      respirator settings to the status of the ventilated patient by calculating the
      necessary data and drawing patient-specific nomograms. The computer program
      "RespCalc" makes use of the mathematical relationships characterizing the
      determinants of lung mechanics. The following data are necessary for use of the
      program: patient identification, weight, alveolar ventilation, recent paCO2,
      compliance, and resistance. By using the time-constant tau, the minimal
      inspiratory time as well as a maximal possible respirator rate are displayed
      without inducing inadvertent PEEP at a ratio of 1:1. Afterward, the planned
      figures of the different respirator rates and corresponding inspiration times
      must be typed in. The program simultaneously checks whether the previously
      calculated minimal figures for in- and exhalation time are maintained. If the
      above-mentioned figures and the typed-in ones differ, an optical and acoustical
      error message appears, and thus the user is forced to correct the
      problem.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1636919
TI  - [An infected fistula following a peridural catheter].
AB  - An infected fistula was observed in a woman (Age: 69 years, weight: 60 kg,
      height: 159 cm) 14 days after insertion and 8 days after removal of a peridural
      catheter inserted preoperatively for postoperative analgesia after nephrectomy
      (carcinoma). Due to haemodynamic problems in the early postoperative period no
      analgetic or local anaesthetic medication was applied via the peridural catheter.
      After unsuccessful antibiotic and surgical treatment the women was transferred to
      the Neurosurgical department five weeks after nephrectomy. Magnetic resonance
      imaging of the lumbar region showed a fistula (Segment L2/L3) reaching the
      epidural space but no epidural spreading or epidural abscess. Partial laminectomy
      L2/L3 was performed and the fistula excised under continuous antibiotic treatment
      with ofloxacin. Up until 21 months after the operation no recidivation occurred.
      Exact details of catheter insertion and catheter treatment in the postoperative
      period are not available; the fact, that no bactericide [9] local anaesthetic
      agents were applied, might have favoured the occurrence of this infection.
      Infectious complications have to be taken into consideration for the indication
      of peridural catheters in the perioperative period.

PMID- 1636920
TI  - [The emergency telephone number--the essential weak link in an emergency system.
      Prospective studies involving cardiac arrests observed by bystanders].
AB  - The first link in the "chain of survival" concept is the activation of the
      emergency medical system (EMS) by a bystander after recognition of cardiac arrest
      (CA) or its immediate prodrome. Our ongoing study is aimed at evaluating the
      current effectiveness of bystander EMS activation for all cases of CA in the city
      and area of Mainz. Methods. Starting February 1991, we began to prospectively
      examine collapse-intervention intervals in all cases of CA treated by our
      physician-manned ambulance. Precision voice recorders carried by the ambulance
      crews are activated and linked to the EMS dispatcher to time the arrival of the
      ambulance vehicle. Time intervals starting from the time of collapse are then
      reconstructed from the dispatcher's time and the tapes. The emergency phone
      number dialled initially by the bystander and the time of collapse in witnessed
      cardiac arrests are identified. RESULTS. Sixty-six CAs were witnessed and
      included in this study. In 20% of those cases, the number dialled initially by
      the bystander was 19222 (EMS dispatcher), in 38% 110 (police), and in 42% other
      numbers (family practitioners or their on-call service, fire department). The
      time interval, as median (25th percentile; 75th percentile), between collapse and
      receipt call by the emergency dispatchers was 4 min (2; 8) for all patients (n =
      66), and 6.5 min (3; 12) whenever numbers other than emergency phone numbers were
      dialled. All following time intervals (start of BLS or ACLS procedures) showed
      differences (P less than 0.05) between the 110 or 19222 group [BLS: 8.5 min (4.8;
      13.1) or 10 min (7.35; 12.1); ACLS: 11.3 min (9.1; 13.45) or 12.9 min (10.6;
      21.5)] vs the group, in which other phone numbers were initially dialled [BLS:
      15.25 min (9.25; 19.4); ACLS: 20.11 min (12.6; 28.3)]. The first ECG rhythm
      showed VF in 56% and 54% in case 110 and 19222 were dialled, but only in 32% in
      the other group. CONCLUSION. Even one single weak link in the "chain of survival"
      can lower overall survival rates. An indispensable, but apparently underrated
      component of an effective EMS includes an informed citizenry able to call swiftly
      for help. Lack of an unequivocal emergency number, well known and accepted by the
      citizens, produces confusion and delays. In our systems, the correct medical
      emergency phone number (19222) was dialled in 20% of the cases only, thus
      demonstrating clearly the lack of public awareness of this 5-digit number. In a
      higher percentage, the three-digit police number (110) was dialled. In cases
      where numbers other than emergency numbers were dialled (42%), the longest time
      intervals between collapse and receipt of call by the dispatchers occurred,
      associated with the longest time intervals until initiation of CPR and the lowest
      percentage of patients found in ventricular fibrillation. We conclude that
      establishment of a simple three-digit EMS phone number, preferentially Europe
      wide, in combination with an intensification of public awareness, could be a
      vital step not only to reduce time intervals between collapse and CPR in our EMS
      system but also to improve survival.

PMID- 1636921
TI  - [A comparison of a tramadol/metamizole infusion with the combination tramadol
      infusion plus ibuprofen suppositories for postoperative pain management following
      hysterectomy].
AB  - Postoperative pain management is still a grossly neglected field. In most cases,
      antipyretic analgesics alone are insufficient during the early postoperative
      period. Powerful narcotics are often avoided or underdosed because they are
      associated with the risk of respiratory depression. Some authors recommend
      combined infusion of tramadol and metamizole, which is assumed to provide
      sufficient pain relief without the risk of respiratory depression. However, this
      regimen has not yet been investigated in a study that meets currently accepted
      scientific standards. METHODS. Sixty patients who underwent vaginal hysterectomy
      were included in a randomised, prospective double-blind study. Thirty women
      received two placebo suppositories immediately after induction of anaesthesia and
      a postoperative infusion of tramadol and metamizole (400 mg tramadol plus 5 g [=
      10 ml] metamizole in 500 ml electrolyte solution). The 30 women of the control
      group received two ibuprofen suppositories (585.2 mg) preoperatively and a post
      operative tramadol infusion (400 mg tramadol plus 10 ml placebo [NaCl 0.9%] in
      500 mg electrolyte solution). The patients of both groups received 125 ml of the
      appropriate infusion solution as a loading dose over 10 min (corresponding to
      1.25 mg metamizole and 100 mg tramadol in the metamizole/tramadol group or 100 mg
      tramadol in the ibuprofen/tramadol group) 10 min after awakening. The remaining
      solution was administered at an infusion rate of 12.5-25 ml/h (corresponding to
      125-250 mg metamizole and 10-20 mg tramadol/h or 10-20 mg tramadol/h). On request
      or when complaining of stronger pain, the patients received an additional bolus
      infusion of 125 ml over 10 min. In case of insufficient pain reduction despite
      repeated infusion of 125-ml boli or consumption of the entire infusion solution,
      the patients discontinued the study and received demand-adapted intravenous
      titration of piritramide. Postoperative pain was evaluated on the visual analogue
      scale (VAS) and the 101-point numerical rating scale immediately before the start
      of the infusion. Pain evaluation was repeated 20, 30, 40, 60, 100, 120, and 240
      min after awakening accompanied by registration of heart rate, respiratory rate,
      systolic and diastolic blood pressure, and side effects. RESULTS. About 60% of
      the entire infusion solution was administered within 60 min in both groups.
      Significant postoperative pain reduction in both groups and on both the 101-point
      scale and the VAS was observed only at 100, 120, and 240 min after awakening. In
      the tramadol/metamizole group, nausea occurred in 7 cases and vomiting in 1. Nine
      patients in this group additionally required intravenous piritramide because of
      insufficient pain relief. In the tramadol/ibuprofen group, 8 patients complained
      about nausea and 4 patients vomited. Six patients additionally received
      intravenous piritramide because of insufficient pain reduction. CONCLUSIONS.
      Satisfactory pain reduction occurred rather late despite high doses of both the
      tramadol/metamizole and the tramadol/ibuprofen. Both analgesic combination must
      be regarded as insufficient after inhalational anaesthesia because of the very
      slow onset of action and the high failure rate.

PMID- 1636922
TI  - [A fatal intraoperative cerebral ischemia following kinking of the internal
      carotid artery?].
AB  - Postoperative neurological deficit may result from ischaemic or hypoxic
      hypoxaemia. Postural cerebral hypoperfusion may ensue when a pre-existing
      asymptomatic vascular anomaly in combination with rotation of the head for
      surgical positioning compromises cerebral blood flow. CASE REPORT. A 30-year-old
      man was referred for recraniotomy for glioblastoma. Following uneventful
      induction of anaesthesia, increased diuresis and progressive hypothermia were
      observed. The postoperative period was complicated by a seizure, followed by
      apnoea requiring reintubation of the trachea. A CAT scan revealed global cerebral
      oedema with subtotal compression of the third ventricle. Intracranial pressure
      was 60 mm Hg as measured by an epidural probe. On the 1st postoperative day
      clinical and electroneurophysical signs of brain death were observed; the patient
      underwent organ explantation the next day. PATHOLOGY. Pathological examination
      revealed pronounced global hypoxaemic lesions and an S-shaped internal carotid
      artery with intimal proliferation (Fig. 1). The diagnostic conclusion was
      cerebral ischaemia following carotid occlusion caused by carotid kinking and
      completed by surgical positioning (rotation of the head). CONCLUSION. Carotid
      kinking is a rare abnormality, and patients at risk may not be identified
      preoperatively. Though it is questionable whether this disaster could have been
      prevented at all, electroneurophysiological monitoring would have been the only
      early monitoring system capable of detecting diminishing cerebral blood flow.
      Although a request for routine intraoperative neurophysiological monitoring seems
      unrealistic at present, it has to be acknowledged that only such monitoring could
      have provided the information needed to save this patient.

PMID- 1636923
TI  - [Comments on the article by J. Schuttler et al. Optimized dosage strategies for
      total intravenous anesthesia with propofol and ketamine].

PMID- 1636924
TI  - [Comments on the article by B.W. Bottiger et al. Non-surgical removal of a
      knotted Swan-Ganz catheter].

PMID- 1636925
TI  - [The results in chronic ischemia of the lower limbs. The Granada-90 Geriatric
      Angiology Study (2)].
AB  - Results of a study about the chronic ischaemia of the lower limbs and its
      correlation with age, sex and previous diagnosis, are presented. Also, a
      comparison between previous diagnosis and results following the methodology
      exposed, was made. Study group included 433 older patients, randomizadely
      selected and permanent residents of some geriatric centers of the Oriental
      Andalucy.

PMID- 1636926
TI  - [Embolism of the humeral artery originating in a thrombosed axillo-femoral
      bypass].
AB  - A case of a patient, with acute arterial ischemia at the upper limb is reported.
      On this case, ischemia was caused by humeral arterial embolism. The embolic
      origin was focused on the proximal end of a thrombosed axillofemoral bypass.
      After a rude manipulation during surgical procedure, part of the thrombus,
      following the sanguineous current, occluded the humeral artery. Patient underwent
      an emergent surgery. Posterior course was good. Histology showed a re
      epithelialized, ancient thrombus. Cardiologic studies and angiography showed no
      others embolic focuses.

PMID- 1636927
TI  - [A spontaneous pseudoaneurysm of the superficial femoral artery. Apropos a case].
AB  - A case of pseudoaneurysm of the superficial femoral artery is reported. No
      relation with traumatisms, septic, agents or others could be proved. Literature
      was reviewed, looking for the different etiologies of pseudoaneurysms. The
      extremely rare incidence of the case reported is noted.

PMID- 1636928
TI  - [The clinical and socioeconomic aspects of cerebrovascular diseases in Europe (a
      study in Turin on patients during 12 years of hospitalization)].
AB  - During the period 1976-1987, 295,718 patients affected by vascular diseases have
      been admitted into all the public and private hospitals of Piemonte (Italy):
      172,483 patients were affected by arteriopathies. 95,231 (55.2%) have been
      admitted because of cerebrovascular diseases: 73,511 (42.6%) were affected by
      diffuse form (T), 18,258 (26.5%) by TIA and 3,462 (2%) by precerebral stenosis
      and occlusions. (TSA). These data have been compared to the incidence of
      cerebrovascular disease in Europe and risk factors, sex, age, department of
      hospitalizations, kind of therapy and results have been investigated. In Piemonte
      cerebrovascular diseases show not only the highest incidence among all the
      vascular diseases, but they seem to be the highest cause of morbidity among all
      the patients admitted into the hospitals.

PMID- 1636929
TI  - [The seeding of porcine endothelial cells on a polytetrafluoroethylene (PTFE)
      substrate. An experimental study].
AB  - The endotely of the vascular wall represents a natural antithrombogenic layer in
      intimal contact with the bloody flow. The waited success of the artificial
      prosthesis as replacers of minor vessels was not reached. Basically, its poor
      results were caused by the lake of endothelialization on the prothesical
      material. A cellular lap on the prosthesis, previously to the implant, could be a
      good resolution to this problem. If we studied the possibility to obtain a
      stable, endothelial monolayer "in vitro" before to the "in vivo" implant of the
      vascular prosthesis. We studied the role of fibronectin as a mediator between the
      substract and the endothelial cell. Changes on fibronectin when it is added on
      the culture medium were also analyzed. Although fibronectin has some positive
      effects as a biologic "glue" previously to the implant to the prosthesis, our
      results show that after the implant, fibronectin could cause a toxic effect on
      the adherence and survival of the endothelial cells.

PMID- 1636930
TI  - Blood culture: comparison of outcomes between switch-needle and no-switch
      techniques.
AB  - BACKGROUND: Because blood culture is a common test at our institution, we hoped
      to save money and reduce the risk of needlestick injury by modifying our current
      technique for the preparation of culture specimens without increasing the risk of
      contamination. METHODS:  OBJECTIVE: To compare the contamination rates of blood
      culture specimens obtained by the conventional method of switching to another
      sterile needle before inoculation with those of specimens obtained by a method
      without switching. DESIGN: Cross-over study. SETTING: Department of Medicine of
      university hospital. PARTICIPANTS: Nursing personnel working in seven acute care
      medical wards in Siriraj Hospital, Bangkok, Thailand. INTERVENTIONS: From March
      to June 1991, participating nurses prepared blood culture specimens by means of
      both switch-needle and no-switch techniques in a cross-over study. All blood
      culture specimens were submitted to microbiology laboratory to determine the
      growth of microorganisms. MEASUREMENT: Growth in a culture was considered to be
      "true positive" or "contamination" by predetermined criteria. RESULTS: Total
      number of blood culture specimens was 1619; of these, 813 were prepared by switch
      needle technique and 806 were prepared by no-switch technique. The contamination
      rates were 7.6% and 8.3% for switch-needle and no-switch techniques, respectively
      (p = 0.61). CONCLUSIONS: The switch-needle technique may not be necessary for
      obtaining blood culture specimens unless the needle is obviously contaminated.
      The no-switch technique for the preparation of blood culture specimens is more
      convenient and less expensive; it also poses less risk of needlestick injury.

PMID- 1636931
TI  - Potential for local and systemic bacterial infection in some occupational groups
      in Benin City, Nigeria.
AB  - BACKGROUND: Many Third World countries may not have adequate facilities for rapid
      sensitivity testing of antibiotics as an aid to diagnosis and chemotherapy. It
      may therefore be valuable to relate bacterial carriage on the skin to type of
      work a person does. METHODS: Given areas of skin in workers from 10 occupational
      groups were sampled. The bacteria obtained were analyzed after growth on
      appropriate media. The sensitivity profiles of potential pathogens isolated from
      these groups, as well as of those (Staphylococcus aureus only) isolated from
      patients with certified infections, were carried out and the results were
      analyzed. RESULTS: Staphylococcus aureus constituted the most widely and
      frequently isolated potential pathogen. Proteus mirabilis, Escherichia coli, and
      Klebsiella species were also frequent colonizers of skin. There was a statistical
      relationship between work type and overall prevalence of bacteria on skin (p less
      than 0.01). Most isolates of the work groups were highly sensitive to gentamicin
      and cefuroxine but not to penicillin G, ampicillin, and trimethoprim plus
      sulfamethoxazole; isolates from infected persons were generally more resistant
      than were the community-acquired ones. CONCLUSIONS: A relationship may exist
      between the types of bacteria carried on the skin and the type of work in which a
      person is engaged.

PMID- 1636932
TI  - Position paper: immunizations. The Association for Practitioners in Infection
      Control, Inc.

PMID- 1636933
TI  - Needlestick injury: blood, mononuclear cells, and acquired immunodeficiency
      syndrome.
AB  - INTRODUCTION: Because transmission of HIV to health care workers after
      needlestick injury has occurred mainly a result of deep insertion of large gauge
      needles, blood and viable mononuclear cells transferred after needlestick injury
      were measured. METHODS: Needles of 20 to 27 gauge were filled with HIV-1
      seropositive blood and inserted through extracorporeal human skin or parafilm
      covering physiologic saline solution modified Drabkin's solution, or culture
      medium, or inserted directly into one of these fluids, to a depth of one third of
      the needle length (0.5 inch) for 1 second. Volume of blood transferred was
      measured by both modified Drabkin's method and by chromium 51 labeling of red
      blood cells. Transfer of viable mononuclear cells was measured by growth in
      culture medium containing autologous feeder cells. RESULTS: The volume of blood
      transferred from a needle passed through skin varied from 312 +/- 69 nl from a 20
      gauge needle to 14 +/- 4 nl from a 27-gauge needle, as measured by modified
      Drabkin's technique, and from 404 +/- 80 nl to 12 +/- 3.1 nl, as measured by
      chromium 51 labeling of red blood cells. The volume of blood transferred from a
      needle passed through parafilm was twice that transferred through skin. The
      volume of blood transferred through skin was 40% that transferred directly into
      fluid not covered by any barrier; blood transferred through parafilm was 80% of
      that transferred directly. When needles containing blood were inserted into
      culture medium for 1 second in the absence of a barrier, at least one viable
      mononuclear cell was almost always transferred to fluid from all gauges of needle
      tested. Insertion of needles through skin prevented transfer of all viable
      mononuclear cells from only 3% to 5% of 20- to 23-gauge needles, and from 12% to
      32% of 26- and 27-gauge needles. Parafilm was an even less effective barrier than
      skin. Insertion of needles through parafilm completely prevented transfer of
      viable mononuclear cells from no 20- to 23-gauge needles and from only 5% to 10%
      of 26- and 27-gauge needles. CONCLUSION: The volume of blood transferred after
      needle insertion through skin for 1 second varied with the gauge of the needle
      and was 30-fold higher from a 20-gauge than from a 27-gauge needle. Variable
      mononuclear cells were transmitted after insertion through skin from more than
      95% of 20- to 23-gauge needles and from 68% to 88% of 26- and 27-gauge needles.
      Parafilm was less effective than skin in reducing transmission of blood and
      viable mononuclear cells.

PMID- 1636934
TI  - The efficacy of mupirocin ointment and chlorhexidine body scrubs in the
      eradication of nasal carriage of Staphylococcus aureus among patients undergoing
      long-term hemodialysis.
AB  - BACKGROUND: Patients undergoing long-term hemodialysis have a high prevalence of
      Staphylococcus aureus nasal carriage, which may lead to serious infections.
      Mupirocin ointment has been used intranasally to eradicate S. aureus carriage in
      health human volunteers and health care workers. Chlorhexidine, an antiseptic
      with excellent antistaphylococcal activity, is widely used for handwashing and
      skin cleansing. METHODS: Anterior nares cultures were obtained from patients
      older than 18 years who were undergoing long-term hemodialysis. Patients with S.
      aureus nasal carriage were enrolled in the study. Axillae and groins were
      cultured. Patients were given mupirocin ointment intranasally twice per day for 7
      days and chlorhexidine body scrubs daily for the first 3 days. Follow-up cultures
      were obtained from anterior nares, axillae, and groins at 1 day, and 1, 4, 8 and
      12 weeks after treatment. RESULTS: One day after completion of treatment nasal
      carriage was eradicated in 83% of patients (15/18). After 12 weeks, 69% of
      patients (11/16) were free of nasal carriage. CONCLUSIONS: Success rates of
      eradication were excellent compared with those in other published reports. This
      simple and effective regimen had no major side effects.

PMID- 1636935
TI  - Streptococcus pyogenes outbreak in a long-term care facility.
AB  - BACKGROUND: Although outbreaks involving Streptococcus pyogenes have been
      uncommon among the elderly population, recent reports suggest that this organism
      is an important nosocomial pathogen among institutionalized older patients and
      carries significant morbidity and mortality. An outbreak of S. pyogenes, type
      M12, T12, occurred in a large long-term care institution serving the ill and
      chronically disabled. The outbreak involved 14 residents of the intermediate care
      facility and lasted for 4 months. METHODS: A prospective epidemiologic
      investigation was initiated at the onset of the outbreak. Pertinent clinical and
      demographic information regarding both residents and personnel was obtained by
      interview, review of medical and surveillance records, and examination of
      patients for lesions. Cultures were obtained within 24 hours of symptom onset
      from those with characteristic clinical symptoms. Unpaired convalescent sera were
      tested for group A streptococcal extracellular antigens by a rapid
      hemagglutination slide test. Control measures included active surveillance of
      residents and staff for suspicious clinical syndromes, transfer of high-risk
      patients, elimination of a common seating area, and improved handwashing and
      hygiene measures. RESULTS: The attack rate was 7.5%, with 64.3% of these patients
      residing on one unit. S. pyogenes was isolated from eight residents, 5 residents
      had a characteristic syndrome and an elevated streptozyme hemagglutination titer
      of 400, and 1 resident died within hours of having cellulitis of the groin.
      Clinical syndromes included cellulitis, pharyngitis, bronchitis, pneumonia, and
      septicemia. Seven residents required acute care; two residents died within 3
      weeks of the onset, yielding a case fatality rate of 14.3%. CONCLUSIONS: The
      major means of transmission appeared to be direct contact between residents,
      although transmission from an infected staff member may have accounted for some
      cases. The hypothesis of long-term colonization was supported by the extended
      times between infections. The severity of illness and the apparent transmission
      through direct contact between residents warrants (1) early detection of infected
      lesions, (2) recognition of invasive illness, (3) prompt effective treatment, and
      (4) surveillance for S. pyogenes infections among residents and personnel.

PMID- 1636936
TI  - Surveillance of nosocomial infection in private psychiatric hospitals: an
      exploratory study.
AB  - BACKGROUND: The vast majority of work published about infection control programs,
      procedures, and practices addresses general acute care facilities. Consequently,
      infection-control coordinators at psychiatric hospitals have few established
      norms or models to use in adapting available standards to the unique needs of
      psychiatric hospitals and their patients. This descriptive study explored
      practices for the surveillance of nosocomial infections in private psychiatric
      hospitals. METHODS: A survey was mailed to the infection control coordinator of
      the 284 hospitals belonging to the National Association of Private Psychiatric
      Hospitals. Questionnaire data were collected anonymously. Surveys were returned
      by 103 (36%) of the hospitals. RESULTS: The most frequent criteria used to define
      the presence of nosocomial infections were the Center for Disease Control
      guidelines and clinical judgment, used by 38% and 39% of the respondents,
      respectively. Most (64%) of the respondents indicated that they did calculate a
      nosocomial infection rate. The most frequent method used to calculate infection
      rates was based on patient discharges. Sixty-five hospitals (63%) reported their
      most recent yearly infection rate, which ranged from 0.00 to 0.35, with a median
      rate of 0.05 (mean, 0.06; SD, 0.07). CONCLUSIONS: Overall, the findings reflected
      much variability in respondents' practices in defining nosocomial infections and
      calculating infection rates. We therefore suggest that both the method used to
      calculate the rate and facilities' definitions of nosocomial infection be
      considered when comparing infection rates across facilities.

PMID- 1636937
TI  - Tuberculosis in patients infected with human immunodeficiency virus: a problem
      solving approach.

PMID- 1636938
TI  - A universal precautions monitoring system adaptable to any health care
      department.
AB  - The Occupational Safety and Health Administration has proposed monitoring
      employee compliance with universal precautions, as recommended by the Centers for
      Disease Control. Our respiratory care department, following a four-step system
      development plan, has developed and implemented a universal precautions
      monitoring system that is easy to adapt to any health care department. The
      results from monitoring can be used for educational planning, quality assurance
      purposes, and employee performance reviews.

PMID- 1636940
TI  - [A preliminary evaluation of the PACS project].

PMID- 1636939
TI  - U.K. experience with indwelling urethral catheters.

PMID- 1636941
TI  - [The laboratory in basic pediatrics].
AB  - We realize a review of laboratory in Basic Pediatry, this is a method of
      etiological and pathogenical diagnosis, and also is good for the following and
      evolution in the treatment of the patient. We talk of the results in three
      levels: hematological, biochemical and microbiological, and in contrast with the
      needs of every pediatrics age.

PMID- 1636942
TI  - [Marginalization and health. Introduction].

PMID- 1636943
TI  - [The types, causes and consequence of marginalization in Latin America].

PMID- 1636944
TI  - [The causes, effects and consequences of marginalization].

PMID- 1636945
TI  - [Marginality, ethnic groups and health].
AB  - Main marginated ethnic groups in Span are to be found among gypsies and 3rd world
      immigrants. The first group include about 250,000 persons and the second group
      more tan half a million people. Their origins and their being past of the less
      fortunate social layers made them a group of health risk. Pediatric pathologies
      are those favored by socio-economic shortcomings as well as hygienic-sanitary
      deficiencies. Imported pediatric pathologies have a small incident.

PMID- 1636947
TI  - [Marginalization and AIDS in pediatrics].
AB  - This study realizes a view of the patient, his disease and his environment,
      divided in newborn, kindergarten and schoolers, and into other group,
      adolescents. The themes are neurology clinic, familiar, social and economic
      environment, problems of the chronic disease, scholarships, hospitalization ahd
      assistance, adoption and legal rules in relation with the pediatrics patients
      with AIDS or positives antibodies.

PMID- 1636946
TI  - [Morbidity, physical growth and psychopathology in marginal populations in
      suburban areas].
AB  - A comparative study between two distinctive groups of children documenting
      morbidity, physical growth and psychopathology was completed. 186 children
      belonging to a marginal and deprived suburban community from Valencia was defined
      as a experimental group (EG). 100 randomly selected children attending the
      emergency room of La Fe Children's Hospital was defined as control group (CG).
      Significant statistical differences were found between the two groups in: type
      and quality of prenatal care, vaccinations, low stature, depressive
      symptomatology and bizarre personality and behaviour. No significant statistical
      differences were found between the two groups in: breast feeding patterns,
      incidence of respiratory and gastrointestinal illnesses, weight, prematurity, low
      birth weight, caries and anxiety.

PMID- 1636948
TI  - [New antiviral agents].

PMID- 1636949
TI  - [Advances in antimicrobial therapy].
AB  - The recent developments in the field of antimicrobials are discussed. Amongst
      those discussed are the new beta lactamase inhibitors the third generation
      cephalosporins, the carbapenems, the quinolones, and the new macrolides.

PMID- 1636950
TI  - [The prevalent pathology in the low-birth-weight newborn infant].

PMID- 1636951
TI  - [Hypoxic-ischemic encephalopathy in the newborn infant].

PMID- 1636952
TI  - [Growth: the problems].

PMID- 1636953
TI  - [Accidents in childhood and adolescence. Their magnitude and prevention].

PMID- 1636954
TI  - [The frequency, causes and mortality due to accidents in Latin America].
AB  - Children's accidents, or injuries, is a relevant health problem in Latin America
      (L.A.). There are big differences among the rates of mortality of different
      countries for each age group. Mortality caused by motor vehicles is outstanding
      but not always related to mortality by all the causes of accident. In a high
      number of L.A. countries rates of death by accidents from O to 14 years are
      higher than in U. S. A. The strategies and resources oriented to prevention have
      not relationship with their importance as cause of morbidity, mortality and
      disabling. Actions must be epidemiologically based in morbi-mortality for each
      country by causes, regions and the socio-economical status of the population.

PMID- 1636955
TI  - [Mortality due to accidents in pediatrics. Their causes and frequency].
AB  - The aim of the study was to ascertain the magnitude, causes and frequency of
      fatal accidents in Spain in children aged O to 14 years. The information was
      provided by the Instituto Nacional de Estadistica. The latest data published for
      the five years 1982 to 1986 inclusive are studied and the causes of death by
      accident evaluated.

PMID- 1636956
TI  - [The toxic accident in childhood].

PMID- 1636957
TI  - [Preventive measures in accidents in childhood].

PMID- 1636958
TI  - [New findings and the potential use of the growth hormone].
AB  - Use and potential use of human growth hormone (GH). The benefit of GH in
      classical growth hormone deficiency is well known. For the past six years, the
      availability of biosynthetic human growth hormone has permitted the investigation
      of the effect of GH in a variety of growth disorders. GH has been shown to be
      helpful in children with idiopathic short stature, Turner's syndrome,
      neuroendocrine deficiency, and chronic renal insufficiency. Although the
      experience is limited, GH would appear helpful in short children with
      intrauterine growth retardation and Noonan's and Prader-Willi syndromes. GH
      increases muscle mass and strength and decreases fat mass in young adults with
      GHD and treatment is under consideration. One of the areas of present interest
      and potentially of great benefit is the use of growth hormone in catabolic
      conditions (burns, surgical operations, patients with a prolonged stay in
      intensive care units, malnourished patients and patients with chronic obstructive
      pulmonary disease). In catabolic conditions, GH is effective in decreasing
      nitrogen loss, in maintaining nitrogen balance, even with hypocaloric diets, and
      in increasing protein synthesis and skeletal muscle mass when combined with
      adequate nutrition. GH has proven helpful in inducing ovulation and improving
      fertility in patients with GHD and in patients with ovarian resistance to
      gonadotropins. The field of growth hormone therapy is expanding and potentially
      GH could be of benefit to many children and adults with a variety of disorders.

PMID- 1636959
TI  - [Growth hormone-releasing factor (GRF) in the treatment of the child with a
      growth hormone (GH) deficiency].

PMID- 1636960
TI  - [Neurosecretory dysfunction].

PMID- 1636961
TI  - [The effect of the growth hormone on low familial and constitutional body
      heights].

PMID- 1636962
TI  - [Other indications for growth hormone treatment: chronic kidney failure and
      Turner's syndrome].
AB  - Recently, it has been demonstrated that treatment with growth hormone (GH) can
      accelerate height velocity in children with chronic renal insufficiency (CRI),
      after kidney transplantation and in Turner syndrome. The pathogenesis of growth
      retardation in CRI is complex. Possibly the most important factor involved is the
      presence of peripheral resistance to insulin-like growth factors. The
      administration of GH in high doses may restore catch-up growth, both in children
      with CRI and in kidney post-transplant patients. After 12 months of treatment
      height velocity increased from 4.3 to 6.6 cm/year in 4 children with CRI, and
      from 2.5 to 7.4 cm/year in 3 patients with kidney transplant. GH therapy alone,
      but even more in combination with oxandrolone increases the growth rate in Turner
      syndrome and may increase the final height, but the long-term results of this
      treatment are awaited. No undesirable collateral effects have been reported.

PMID- 1636963
TI  - [Vaccinations].

PMID- 1636964
TI  - [New viruses in perinatology (HBV and HIV). Can we prevent their vertical
      transmission?].

PMID- 1636965
TI  - New developments in vaccinology.

PMID- 1636967
TI  - [The vaccinal calendar in Latin America].

PMID- 1636966
TI  - [Adverse reactions to vaccines].
AB  - The adverse reactions to vaccines are still a questioned subject because of the
      diversity of criteria they have been assessed with. We review the different
      etiopathogenic mechanisms that may be involved in their production, so as their
      local and general clinical features. We finally suggest that in despite of
      presentation of the adverse reactions that can be really attributed to vaccines,
      in order to known their real incidence it is necessary to develop a control
      system all over the vaccinated population.

PMID- 1636968
TI  - [Vaccinations in Latin America. "The incidence and costs of avoidable diseases"].

PMID- 1636969
TI  - [The schedule of systematic vaccinations in Catalonia].

PMID- 1636970
TI  - [Acute bronchopulmonary infections. Introduction].

PMID- 1636971
TI  - [Pneumonia in children in Latin America: morbidity, predisposing causes,
      mortality and costs].
AB  - The paper refers to pneumonia in children under five years of age in Latin
      America, and covers the following toplos: morbidity, predisposing and risk
      factors, mortality and costs. It emphasizes the magnitude, tendency and advances
      in the control of the problem. High pneumonia morbidity and mortality rates are
      observed, with slow tendency to decrease in the majority of the countries of the
      Region, with some exceptions. The paper points out the importance of the National
      Programs of Control of Acute Respiratory Infections (ARI), specifically of
      pneumonia, following the guide lines of the PAHO/WHO. Special mention is made of
      the diagnosis, ambulatory standardized treatment and cost-effectiveness under the
      strategy of the Primary Health Care. The preventive measures are important,
      including the health education of parents and the training of the community
      health workers. The principal goal is to obtain a decrease of one third in the
      mortality of pneumonia in children, within the present.

PMID- 1636972
TI  - [The epidemiology, predisposing causes and costs for Spain].

PMID- 1636973
TI  - [Tissue damage and immunological responses in acute bronchopulmonary infections].
AB  - The appearance of a clinical infectious disease in the lung is determined by the
      success or failure of pulmonary defense mechanisms. This review highlights
      several components of the normal respiratory host defenses: the mechanical
      barriers, the immunoglobulins IgG and IgA, and the interaction of the alveolar
      macrophages and lymphocytes. For optimal clearance, not only must effectors
      cells, responder cells, and mediators be present, but their action must be
      integrated.

PMID- 1636974
TI  - [The etiological treatment of acute infections of the lower respiratory tract:
      bronchitis and pneumonias].

PMID- 1636975
TI  - [An epidemiological study of allergic pathology in the general pediatric
      population. Mortality and costs].

PMID- 1636976
TI  - [The etiopathogenetic bases for the prevention of allergic diseases].

PMID- 1636977
TI  - [Prevention in food allergy].

PMID- 1636978
TI  - [Prevention in respiratory allergic pathology].

PMID- 1636979
TI  - [The child and his ecosystem. Introduction].

PMID- 1636980
TI  - [The family and the child].

PMID- 1636981
TI  - [The influence of school].

PMID- 1636982
TI  - [Leisure in childhood].

PMID- 1636983
TI  - [The influence of the communications media].
AB  - Media is very important in promoting health education. Television is the most
      important as children spend great part of their time in front of it. This time
      consuming might compromise the development of children as they would be unable
      for other essential activities during TV watching.

PMID- 1636984
TI  - [Nutrition in the sick child. Introduction].

PMID- 1636985
TI  - [The nutritional status of children with a chronic disease].

PMID- 1636986
TI  - [The indicators of nutritional status].

PMID- 1636987
TI  - [The nutrition of the child in a critical state].

PMID- 1636988
TI  - [Enteral nutrition].

PMID- 1636989
TI  - [Gastroesophageal reflux. Introduction].

PMID- 1636990
TI  - [The etiopathogenesis of gastroesophageal reflux].

PMID- 1636991
TI  - [Advances in the diagnosis of gastroesophageal reflux].

PMID- 1636992
TI  - [Medical treatment].

PMID- 1636993
TI  - [The surgical treatment of gastroesophageal reflux (GER)].
AB  - From 1960 to 1990, a total of 2,476 instances of cardio-hiatal abnormalities were
      treated. The cause of the abnormality was achalasia (cardio-esophageal
      dilatation) in 2.244 instances, sliding hernias in 167 and hiatal hernias in 65.
      Only 213 patients underwent operations, 8,%. Gastroesophageal reflux in children
      has characteristics different from those of gastroesophageal reflux in adults.
      Knowledge of the forces that influence the closing mechanisms of the lower
      esophageal sphincter (LES) is the cornerstone for rational and logical
      intervention. The philosophy in pediatrics is that a child is a being in
      evolution and that the anomaly in children originates from a displaced healthy
      LES that has not had the opportunity to demonstrate its function because it is
      not in its proper place. An operation that helps to provide essential anatomic
      conditions immediately leads the LES to normal physiology. The A.A. discussed and
      presented in which cases the surgical procedure has to be taken.

PMID- 1636994
TI  - [The ethics code project in pediatrics. Introduction].

PMID- 1636995
TI  - [The ethical aspects in pediatric therapeutics].

PMID- 1636996
TI  - [Noninvasive research].

PMID- 1636997
TI  - [The ethical problems in neonatology].

PMID- 1636998
TI  - [The future of viral pathology].

PMID- 1637000
TI  - [Basic ideas on a pediatric ethics code].

PMID- 1636999
TI  - [The formulation of an ethics code in pediatrics].

PMID- 1637001
TI  - [The hospital discharge project. A multicenter study for the computerization of
      the hospital discharge report and for the definition of the basic minimum
      collection of data on pediatric hospitalization].

PMID- 1637002
TI  - [Informtoxic. A multimedia toxicological database].

PMID- 1637003
TI  - [Target. Integrated auxological calculation].

PMID- 1637004
TI  - [Computer-assisted medical teaching: the simulation of clinical cases in neonatal
      pathology].

PMID- 1637005
TI  - [Informatics and the teaching of medicine].

PMID- 1637006
TI  - [Brasilia: a city for children].

PMID- 1637007
TI  - [Emotional factors and their effect on growth and immunology].

PMID- 1637008
TI  - [The prevention of chronic kidney failure].

PMID- 1637009
TI  - [Low weight at birth in children born at term and their final height].

PMID- 1637010
TI  - [Diet, cholesterol and the late consequences].

PMID- 1637011
TI  - [The sociopolitical-economic implications of genetic engineering].

PMID- 1637012
TI  - [The promotion of maternal-child health for the next decade. Introduction].

PMID- 1637013
TI  - [The causes of mortality and pathologies prevalent in infancy in Latin America].

PMID- 1637014
TI  - [The causes of mortality and prevalent pathology in children in Portugal--their
      evolution and an analysis of the current situation].
AB  - The author analyses the infant mortality rate amongst different age groups in
      Portugal, considering not only the regional variations but also its prenatal,
      neonatal, post neonatal, and children between 1-4 and 5-9 years components. The
      author takes in consideration other factors which enable one to attribute the
      principal causes of morbidity to each particular age group.

PMID- 1637015
TI  - [The causes of mortality and prevalent pathology in newborns in Spain].

PMID- 1637016
TI  - [Prevalent pathology and the causes of mortality in the Spanish pediatric
      population from 0 to 14 years of age].

PMID- 1637017
TI  - [The priority objectives and recommendations for the next decade in Spain].

PMID- 1637018
TI  - [The priority objectives and recommendations for the next decade in Latin
      America].

PMID- 1637019
TI  - [pediatric diagnosis today].

PMID- 1637020
TI  - [New applications of echography: Doppler ultrasonography].
AB  - The Doppler effect, the different types of Doppler echography its functions and
      the parameters to evaluate the blood flow are defined. The clinical applications
      of Doppler in paediatrics are analyzed which are grouped in four great chapters:
      1) cerebral blood flow. 2) renal flood flow: a.-native kidney, b.-transplanted
      kidney. 3) hepatic blood flow: a.-native liver, b.-transplanted liver. 4)
      characterization of mass, tissue and structures. Exploration technique of
      different organs are described and findings in different clinical sectors are
      referred to, emphasizing normal patterns.

PMID- 1637022
TI  - Lyme disease associated with fibromyalgia.
AB  - OBJECTIVE: To describe the clinical and laboratory findings as well as results of
      treatment in patients with Lyme disease associated with fibromyalgia. DESIGN:
      Observational cohort study. The mean duration of observation was 2.5 years
      (range, 1 to 4 years). SETTING: Diagnostic Lyme disease clinic in a university
      hospital. PATIENTS: Of 287 patients seen with Lyme disease during a 3.5-year
      period, 22 (8%) had fibromyalgia associated with this illness, and 15 (5%)
      participated in the observational study. MEASUREMENTS: Symptoms and signs of
      fibromyalgia, immunodiagnostic tests for Lyme disease, and tests of neurologic
      function. RESULTS: Of the 15 patients, 9 developed widespread musculoskeletal
      pain, tender points, dysesthesias, memory difficulties, and debilitating fatigue
      a mean duration of 1.7 months after early Lyme disease; the remaining six
      patients developed those symptoms during the course of Lyme arthritis. At the
      time of our evaluation, late in the course of their illness, 11 patients had
      positive immunoglobulin (Ig) G antibody responses to Borrelia burgdorferi by
      enzyme-linked immunosorbent assay (ELISA), one had a positive Western blot, and
      the three seronegative patients had positive cellular immune responses to
      borrelial antigens. Four patients had abnormal cerebrospinal fluid analyses that
      showed an elevated protein level, a slight pleocytosis, or intrathecal antibody
      production to the spirochete. The signs of Lyme disease resolved with antibiotic
      therapy, usually intravenous ceftriaxone, 2 g/d for 2 to 4 weeks, except in one
      patient with persistent knee swelling. However, 14 of the 15 patients continued
      to have symptoms of fibromyalgia. Currently, only one patient is completely
      asymptomatic. CONCLUSIONS: Lyme disease may trigger fibromyalgia, but antibiotics
      do not seem to be effective in the treatment of the fibromyalgia.

PMID- 1637021
TI  - Comparison of cefuroxime axetil and doxycycline in the treatment of early Lyme
      disease.
AB  - OBJECTIVE: To compare the efficacy of cefuroxime axetil and doxycycline in the
      treatment of patients with Lyme disease associated with erythema migrans. DESIGN:
      Randomized, multicenter, investigator-blinded clinical trial with clinical
      evaluations during treatment (8 to 12 days) and at 1 to 5 days and 1, 3, 6, 9,
      and 12 months post-treatment. SETTING: Three university referral centers and one
      private practice. PATIENTS: A total of 123 patients with physician-documented
      erythema migrans. INTERVENTION: Patients were treated orally for 20 days with
      either cefuroxime axetil, 500 mg twice daily (63 patients), or doxycycline, 100
      mg three times daily (60 patients). MEASUREMENTS: Resolution of erythema migrans
      and of signs and symptoms related to early Lyme disease as well as prevention of
      late Lyme disease. RESULTS: A satisfactory clinical outcome (success or
      improvement) was achieved in 51 of 55 (93%) evaluable patients treated with
      cefuroxime axetil and in 45 of 51 (88%) patients treated with doxycycline
      (difference, 5%, 95% Cl, -5% to 14%). The only complication at 1 month post
      treatment was Lyme arthritis in one patient who received doxycycline. Of the
      patients with satisfactory outcomes at 1 month post-treatment who were evaluable
      at 1 year post-treatment, a satisfactory outcome was achieved in 43 of 48 (90%)
      and in 35 of 38 (92%) patients treated with cefuroxime axetil and doxycycline,
      respectively (difference, -2%; Cl, -12% to 7%). Lyme arthritis did not develop in
      any patient after 1 month post-treatment, whereas peripheral neuropathy was
      suspected in one patient treated with cefuroxime axetil. Thirty percent of
      patients treated with cefuroxime axetil and 32% of those treated with doxycycline
      had one or more drug-related adverse events. Doxycycline was associated with more
      photo-sensitivity reactions (15% compared with 0%; P = 0.001) and cefuroxime
      axetil with more diarrhea (21% compared with 7%; P = 0.035) and Jarisch
      Herxheimer reactions (29% compared with 8%; P = 0.005). CONCLUSIONS: Cefuroxime
      axetil is well tolerated and appears to be equally as effective as doxycycline in
      the treating of early Lyme disease and in preventing the subsequent development
      of late Lyme disease.

PMID- 1637023
TI  - Long-term bone loss in men: effects of genetic and environmental factors.
AB  - OBJECTIVE: To identify environmental factors associated with bone loss in adult
      male twins and to determine the extent to which shared environmental
      characteristics affect estimates of the genetic influence on bone loss. DESIGN: A
      16-year cohort study. SETTING: A midwestern university hospital. PARTICIPANTS:
      One hundred and eleven male veterans of World War II or the Korean conflict, born
      between 1916 and 1927. All were twins, with the sample comprising 48 pairs and 15
      persons whose twin brothers were deceased or seriously ill. MEASUREMENTS: Bone
      mass and environmental characteristics (cigarette smoking, alcohol consumption,
      physical activity, dietary calcium intake, use of thiazide diuretics) measured at
      baseline and 16 years later. RESULTS: Rates of radial bone loss averaged 0.45%
      per year. Those who both smoked and used alcohol at levels greater than the
      median for the population had a rate of bone loss (10% in 16 years) twice the
      rate of those who were below the median level for both variables (5% bone loss, P
      = 0.003). Rates of bone loss were correlated within twin pairs, and these
      correlations were diminished 25% to 35% by adjustments for environmental
      influences on bone loss. However, statistically significant within-pair
      correlations remained (r = 0.4), which did not differ between monozygotic and
      dizygotic twin pairs after adjustments for smoking, alcohol use, dietary calcium
      intake, and exercise. CONCLUSIONS: Bone loss in men during mid-life is
      determined, at least in part, by environmental factors, including smoking,
      alcohol intake, and, possibly, physical activity. Rates of bone loss were similar
      within twin pairs, apparently because of a shared environment.

PMID- 1637024
TI  - The "retinoic acid syndrome" in acute promyelocytic leukemia.
AB  - OBJECTIVE: To describe a novel complication of therapy with all-trans retinoic
      acid in patients with acute promyelocytic leukemia. DESIGN: Case series. SETTING:
      Comprehensive cancer center. PATIENTS: Consecutive patients with a morphologic
      diagnosis of acute promyelocytic leukemia who underwent remission induction
      treatment with all-trans retinoic acid, 45 mg/m2 body surface area per day.
      MEASUREMENTS AND RESULTS: Nine of 35 patients (26%; 95% CI, 9% to 52%) with acute
      promyelocytic leukemia who were treated with all-trans retinoic acid developed a
      syndrome consisting primarily of fever and respiratory distress. Additional
      prominent signs and symptoms included weight gain, lower-extremity edema, pleural
      or pericardial effusions, and episodic hypotension. The onset of this symptom
      complex occurred from 2 to 21 days after starting treatment. Three deaths
      occurred; post-mortem examinations in two patients showed pulmonary interstitial
      infiltration with maturing myeloid cells. Six other patients survived, each
      achieving complete remission (five patients with all-trans retinoic acid only; 1
      patient with chemotherapy). In six of the nine cases, the onset of the syndrome
      was preceded by an increase in peripheral blood leukocytes to a level of at least
      20 x 10(9) cells/L. Certain therapeutic interventions, including leukapheresis,
      temporary cessation of therapy with all-trans retinoic acid, and cytotoxic
      chemotherapy in moderate doses were not useful after respiratory distress was
      established. However, the administration of high-dose corticosteroid therapy
      (dexamethasone, 10 mg IV intravenously every 12 hours for 3 or more days) early
      in the course of the syndrome resulted in prompt symptomatic improvement and full
      recovery in three of four patients. CONCLUSIONS: The use of all-trans retinoic
      acid to induce hematologic remission in patients with acute promyelocytic
      leukemia is associated in some patients with the development of a potentially
      lethal syndrome that is not uniformly accompanied by peripheral blood
      leukocytosis. Early recognition of the symptom complex of fever and dyspnea,
      combined with prompt corticosteroid treatment, may decrease morbidity and
      mortality associated with this syndrome.

PMID- 1637025
TI  - Antiphospholipid thrombosis: clinical course after the first thrombotic event in
      70 patients.
AB  - OBJECTIVE: To determine the clinical course and influence of antithrombotic
      therapy in patients with lupus anticoagulant or anticardiolipin antibodies, or
      both, after the first thromboembolic event. DESIGN: Retrospective survey of
      consecutive patients treated according to their physician's best judgment.
      SETTING: Secondary and tertiary referral practice. PATIENTS: Seventy patients (48
      women [69%]) with a mean age (+/- SD) of 45.5 +/- 17.3 years. The
      antiphospholipid syndrome was primary in 51 patients (73%) and secondary to
      systemic lupus erythematosus in 14 patients (20%) and to chronic idiopathic
      thrombocytopenic purpura in 5 patients (7%). MEASUREMENTS: Site of initial and
      recurrent thrombotic events (venous or arterial), as well as kind (aspiring,
      heparin, or warfarin) and intensity of anticoagulation. RESULTS: Total follow-up
      after the first thrombotic event was 361.0 patient-years (mean [+/- SD], 5.2 +/-
      5.6 years per patient). Thirty-seven patients (53%) had 54 recurrent events, with
      2 patients experiencing fatal events. Arterial events were followed by arterial
      events, and venous events by venous events, in 49 of 54 instances (91%).
      Recurrence rates during "no treatment;" aspirin therapy; or low-, intermediate-,
      or high-intensity warfarin therapy (international normalized ratios [INRs] less
      than or equal to 1.9, 2.0 to 2.9, and greater than or equal to 3.0, respectively,
      or rabbit brain thromboplastin prothrombin time ratios of approximately less than
      1.3, 1.3 to 1.5, and greater than 1.5, respectively) were 0.19, 0.32, 0.57, 0.07
      (P = 0.12), and 0.00 (P less than 0.001) per patient-year. The follow-up periods
      for the five types of therapy were 161.2, 37.8, 11.3, 40.9, and 110.2 patient
      years, respectively. The highest INR coincident with thrombosis was 2.6. Five
      warfarin-treated patients had five significant bleeding events (0.031 per patient
      year). CONCLUSIONS: Recurrent thrombosis is a potentially serious problem for
      patients with lupus anticoagulant or anticardiolipin antibodies or both. The site
      of the first event (arterial or venous) tended to predict the site of subsequent
      events. Intermediate- to high-intensity warfarin therapy may confer better
      antithrombotic protection than low- to intermediate-intensity warfarin therapy or
      aspirin therapy. Further studies are needed to define more precisely the
      rethrombosis rate and optimal type, intensity, and duration of antithrombotic
      therapy.

PMID- 1637026
TI  - Increased incidence of Hodgkin disease in homosexual men with HIV infection.
AB  - OBJECTIVE: To evaluate the incidence of Hodgkin disease and non-Hodgkin lymphoma
      among homosexual men infected with human immunodeficiency virus (HIV). DESIGN:
      Cohort study with computer-matched identification of participants with the
      Northern California Cancer Center registry. Population rate comparisons were made
      with data from the Surveillance, Epidemiology, and End Results (SEER) cancer
      registry. PARTICIPANTS: The 6704 homosexual men in the San Francisco City Clinic
      Cohort study. MEASUREMENTS: Incidence of Hodgkin disease, non-Hodgkin lymphoma,
      HIV infection, and the acquired immunodeficiency syndrome (AIDS); calculation of
      sex and age-adjusted standardized morbidity ratios and attributable risk.
      RESULTS: Eight cases of Hodgkin disease and 90 cases of non-Hodgkin lymphoma were
      identified through computer matching among cohort members residing in the San
      Francisco Bay area from 1978 through 1989. Among the HIV-infected men, the age
      adjusted standardized morbidity ratio was 5.0 (95% CI, 2.0 to 10.3) for Hodgkin
      disease and 37.7 (CI, 30.3 to 46.7) for non-Hodgkin lymphoma. The excess risk
      attributable to HIV infection was 19.3 cases of Hodgkin disease per 100,000
      person-years and 224.9 cases of non-Hodgkin lymphoma per 100,000 person-years.
      CONCLUSION: An excess incidence of Hodgkin disease was found in HIV-infected
      homosexual men. Additional well-designed epidemiologic studies are needed to
      determine whether Hodgkin disease should be considered an HIV-related malignancy.

PMID- 1637027
TI  - An outbreak of tuberculosis among hospital personnel caring for a patient with a
      skin ulcer.

PMID- 1637028
TI  - Pneumococcal disease during HIV infection. Epidemiologic, clinical, and
      immunologic perspectives.
AB  - OBJECTIVE: To characterize the epidemiology, clinical manifestations, and
      immunologic risk factors for infections with Streptococcus pneumoniae among
      persons infected with human immunodeficiency virus (HIV); and to delineate a
      practical approach for diagnosis, treatment, and prevention of these infections.
      DATA SOURCES: English-language articles from Index Medicus and their references
      as well as abstracts from conference proceedings that compared rates as well as
      clinical and microbiologic features of S. pneumoniae infections in HIV-infected
      patients. STUDY SELECTION: All human studies that included denominators,
      appropriate control groups, or sufficient clinical descriptions and animal
      studies with key immunologic observations were cited. DATA EXTRACTION: We
      compared epidemiologic and clinical responses to pneumococcal disease in HIV
      infected patients and control subjects and correlated clinical and experimental
      data on immunologic defects associated with HIV infection with those on
      regulation of pneumococcal infections. DATA SYNTHESIS: Among patients with HIV
      infection, the incidence of invasive pneumococcal disease is high, bacteremia is
      a common complication of pneumonia, and relapses occur frequently. However, the
      clinical presentation, response to therapy, and serotypes isolated are similar to
      those in persons without HIV infection, and mortality is similar or lower.
      Specific local and systemic defects in host defense, particularly humoral
      immunity, may contribute to the high incidence of invasive pneumococcal disease.
      CONCLUSIONS: Streptococcus pneumoniae is the leading cause of invasive bacterial
      respiratory disease in adults and children with HIV infection. Prompt diagnosis
      and antimicrobial therapy are associated with a favorable clinical outcome.
      Characterizing the specific immunologic defects associated with invasive
      pneumococcal disease in HIV-infected patients may facilitate development of
      successful, cost-effective strategies for prophylaxis.

PMID- 1637029
TI  - Variable mortality rates among dialysis treatment centers.
AB  - OBJECTIVE: To examine the variation in the risk for mortality among patients
      treated at renal dialysis facilities within a defined geographic area. SETTING:
      All free-standing and hospital-based dialysis facilities in a single southeastern
      state reported to the registry. DESIGN: Cohort of dialysis patients followed for
      1 year by an end-stage renal disease registry. PATIENTS: Patients (n = 3612) aged
      20 years and older receiving treatment at the dialysis facilities reporting to
      the registry during 1987. MEASUREMENTS: Demographic, comorbid, and severity of
      illness indicators were abstracted from patient records. Facility-specific risk
      estimates were derived from a Cox proportional hazards model. RESULTS: Facility
      specific mortality rates ranged between 2.0 and 10.5 deaths per 10,000 patient
      days. Mortality rates were higher among older persons; whites; those with a
      history of diabetic nephropathy, angina, or congestive heart failure; and
      patients with either nutritional or functional status impairment. Facility
      specific prevalence of each mortality risk factor varied widely. The unadjusted
      risk for death in a facility at the 75th percentile of risk was 1.3 times that of
      a facility at the median, whereas at the 25th percentile, it was 0.68 times as
      likely--a twofold range of risk. Controlling for differences in the prevalence of
      patient characteristics did not change the interquartile range in risks, and a
      facility's adjusted risk estimate showed a strong correlation with its unadjusted
      estimate (R2, 0.566; P less than 0.0001). CONCLUSIONS: Patient attributes
      associated with increased risk for mortality vary widely among dialysis
      facilities. Adjustment for these differences did not, however, substantially
      change either the degree of variation in mortality risks or the relative ranking
      of a facility's mortality.

PMID- 1637030
TI  - Retinoid therapy for acute promyelocytic leukemia: a coming of age for the
      differentiation therapy of malignancy.

PMID- 1637031
TI  - A new commission report on medical education.

PMID- 1637032
TI  - The chronic fatigue syndrome controversy.

PMID- 1637033
TI  - Yogurt for candidal vaginitis.

PMID- 1637034
TI  - Diagnostic workup of AIDS-associated diarrhea.

PMID- 1637036
TI  - AIDS in Africa.

PMID- 1637035
TI  - Diagnostic workup of AIDS-associated diarrhea.

PMID- 1637038
TI  - AIDS in Belle Glade.

PMID- 1637037
TI  - The ethos of doctors and corporations.

PMID- 1637039
TI  - Theories of neurodegeneration.

PMID- 1637040
TI  - Genetic causes of neuronal cell death.

PMID- 1637041
TI  - Ovarian steroid and neurotoxin models of brain aging in rodents.

PMID- 1637042
TI  - Modulation of NMDA excitotoxicity by redox reagents.

PMID- 1637043
TI  - beta-Methylamino-L-alanine (BMAA) and amyotrophic lateral sclerosis-parkinsonism
      dementia of the western Pacific.

PMID- 1637044
TI  - Ca2+ and cell death.

PMID- 1637045
TI  - The etiology of Alzheimer's disease: the pathogenesis of dementia. The role of
      neurotoxins.

PMID- 1637046
TI  - Overview of Parkinson's disease.

PMID- 1637047
TI  - Role of astrocytes in MPTP metabolism and toxicity.

PMID- 1637048
TI  - Characteristics of dopaminergic neurotoxicity produced by MPTP and
      methamphetamine.

PMID- 1637049
TI  - MPP+ redox cycling: a new mechanism involving hydride transfer.

PMID- 1637050
TI  - Creation of transgenic mice that overexpress monoamine oxidase-B neuronally.

PMID- 1637051
TI  - Cytopathologic features indicative of 5-hydroxytryptamine axon degeneration are
      observed in rat brain after administration of d- and l-methylenedioxyamphetamine.

PMID- 1637052
TI  - Biochemical basis of structural electivity of MPTP-like neurotoxicity.

PMID- 1637053
TI  - Indole-N-methylation of beta-carbolines: the brain's bioactivation route to
      toxins in Parkinson's disease?

PMID- 1637054
TI  - Manganese as possible ecoetiologic factor in Parkinson's disease.

PMID- 1637055
TI  - Similar inhibition of mitochondrial respiration by 1-methyl-4-phenyl-pyridinium
      (MPP+) and by a unique N-methylated beta-carboline analogue, 2,9-dimethyl
      norharman (2,9Me2NH).

PMID- 1637056
TI  - Degeneration of rat locus coeruleus neurons is not accompanied by an irreversible
      loss of ascending projections. Evidence for reestablishment of forebrain
      innervation by surviving neurons.

PMID- 1637057
TI  - Mitochondrial mechanisms of neurotoxicity.

PMID- 1637058
TI  - Effects of prolonged chronic dietary treatment with AlCl3 on selected metabolisms
      and memory in rats.

PMID- 1637059
TI  - ATP deficits and neuronal degeneration induced by 3-nitropropionic acid.

PMID- 1637060
TI  - MPTP-induced ATP loss in mouse brain.

PMID- 1637061
TI  - MK-801 prevents methamphetamine-induced striatal dopamine damage and reduces
      extracellular dopamine overflow.

PMID- 1637062
TI  - Generic inhibition of mitochondrial electron transport by MPP+ and other charge
      shielded lipophilic cations.

PMID- 1637063
TI  - Characterization of [3H]MK-801 binding in LA-N-2 neuroblastoma cells.

PMID- 1637064
TI  - Patterns of Fos expression suggest similar mechanisms of action for the
      excitotoxins domoic and kainic acid.

PMID- 1637065
TI  - Analysis of the protective effects of 21-aminosteroids in MPP(+)-induced
      neurotoxicity to dopaminergic neurons in mesencephalic cultures.

PMID- 1637067
TI  - L-dopa potentiates the neurotoxicity of some amphetamine analogues.

PMID- 1637066
TI  - Age and dietary factors in hippocampal sensitivity to trimethyltin.

PMID- 1637068
TI  - The platelet plasma membrane serotonin transporter catalyzes exchange between
      neurotoxic amphetamines and serotonin.

PMID- 1637069
TI  - Brain-derived neurotrophic factor protects dopaminergic cells from 6
      hydroxydopamine toxicity.

PMID- 1637070
TI  - Evidence for a common mechanism of serotonin release induced by substituted
      amphetamines in vitro.

PMID- 1637071
TI  - In vivo and in vitro pharmacologic profile of two new irreversible MAO-B
      inhibitors: MDL 72,974A and fluorodeprenyl.

PMID- 1637072
TI  - Antioxidative therapeutic strategies for Parkinson's disease.

PMID- 1637073
TI  - Cholinergic toxins and Alzheimer's disease.

PMID- 1637074
TI  - Neurochemical responses to 6-hydroxydopamine and L-dopa therapy: implications for
      Parkinson's disease.

PMID- 1637075
TI  - Comparison of MPTP and amphetamines as dopaminergic neurotoxins.

PMID- 1637077
TI  - Calcitonin gene-related peptide: a neuropeptide generated as a consequence of
      tissue-specific, developmentally regulated alternative RNA processing events.

PMID- 1637076
TI  - Features of the dopaminergic neurotoxin MPTP.

PMID- 1637078
TI  - The calcitonin family of peptides.

PMID- 1637079
TI  - Calcitonin gene-related peptide in the brain, spinal cord, and some peripheral
      systems.

PMID- 1637080
TI  - Localization of calcitonin gene-related peptide in the rat and human pituitary
      gland using immunocytochemistry and in situ hybridization. CGRP expression during
      ontogeny and after endocrine manipulations.

PMID- 1637081
TI  - Structure-activity analysis of CGRP's neurobehavioral effects.

PMID- 1637082
TI  - Calcitonin gene-related peptide in the brain. Neurochemical and behavioral
      investigations.
AB  - CGRP in the amygdala is concentrated in an area close to the central nucleus.
      High potassium releases CGRP, and this release, as well as the tissue
      concentration of CGRP in the amygdala, can be influenced by neuroleptic drugs.
      Both molecular forms, alpha- and beta-CGRP, are present in the amygdala in a
      ratio of approximately 3:1. CGRP influences social behavior in chicken.
      Therefore, CGRP may have a prominent role in psycho-behavioral function and may
      be a target for action and/or side effects of antipsychotic drugs.

PMID- 1637083
TI  - Enteric and visceral afferent CGRP neurons. Targets of innervation and
      differential expression patterns.

PMID- 1637084
TI  - Release of calcitonin gene-related peptide from sensory neurons.
AB  - CGRP is released from capsaicin-sensitive sensory neurons in a Ca(2+)-dependent
      manner in a variety of peripheral organs as well as from central terminals. The
      mechanisms for CGRP release by low concentrations of capsaicin, electrical
      antidromic nerve stimulation, and bradykinin have several similar characteristics
      regarding sensitivity to TTX, CTX, and alpha 2-adrenoceptor activation. High
      capsaicin concentration and nicotine evoke CGRP release via other mechanisms. The
      effects of capsaicin, resiniferatoxin, and SO2 are blocked by RR, which probably
      inhibits ion fluxes associated with capsaicin receptor activation. CGRP released
      upon irritation of peripheral branches of primary afferents may evoke a variety
      of cardiovascular actions and influence motility in the gastrointestinal and
      urogenital tracts.

PMID- 1637085
TI  - Calcitonin gene-related peptide in the regulation of cardiac function.

PMID- 1637086
TI  - Membrane actions of calcitonin gene-related peptide in cardiac and smooth muscle
      myocytes.
AB  - Calcitonin gene-related peptide is a 37-amino acid neuropeptide acting as a
      transmitter of nonadrenergic, noncholinergic nerves in the heart. Binding sites
      of high affinity have been reported in coronary arteries, in atria, and, of minor
      density, in ventricular myocardium. These sites are likely linked to G-proteins
      mediating modifications of ion channel opening probability and duration and to
      stimulation of adenylate cyclase activity and cAMP-mediated alterations of ion
      channel activities. In isolated and perfused guinea pig hearts, low
      concentrations of CGRP (1-3 nM) exerted no chronotropic effect, but increased
      coronary flow slightly. Atrioventricular conduction duration and effective
      refractory period of atrioventricular conduction were prolonged by 3 nM of CGRP.
      The higher concentration of 10 nM increased the sinus rate, and the effects on
      the atrioventricular node were counterbalanced. HV and QRS duration of the ECG
      remained essentially unchanged, but persistent ventricular fibrillation was
      inducible by burst stimulation in all CGRP-treated hearts. Results in human
      myometrial myocytes indicate that CGRP exerted direct G protein-mediated
      activation of potassium channels, leading to hyperpolarization and smooth muscle
      relaxation. Activation of potassium channels, most prominent in smooth muscle
      relaxation, is likely an additional factor in the cardiostimulatory profile of
      CGRP.

PMID- 1637087
TI  - Role of calcitonin gene-related peptide in gastrointestinal blood flow.

PMID- 1637088
TI  - Inhibition of gastric acid secretion and ulcers by calcitonin [correction of
      calciton] gene-related peptide.
AB  - A central action of CGRP to inhibit gastric acid secretion, demonstrated in rats
      and dogs, is mediated at least in rats through modulation of parasympathetic
      outflow to the stomach. The centrally mediated protective effects of CGRP against
      ethanol-induced lesions is unique to this peptide and not shared by other
      centrally acting inhibitors of gastric function. It may be related to the
      increase in gastric mucosal blood flow induced by central CGRP. The presence of
      CGRP-like immunoreactivity and receptors in medullary nuclei receiving visceral
      information and influencing vagal outflow suggests a possible role of the peptide
      in the central regulation of gastric function. Peripheral injection of CGRP is
      well established to inhibit acid secretion in rats, dogs, rabbits, and humans.
      Its antisecretory effect is unlikely to be related to a direct action on the
      parietal cells. It involves specific and marked release of gastric somatostatin
      through an interaction with CGRP receptors characterized on D cells and coupled
      with cAMP. In addition, CGRP induces a decrease in acetylcholine transmission in
      the enteric nervous system, which may contribute to the inhibition of acid. The
      rich innervation of the stomach with CGRP-like immunoreactivity, which forms the
      major component of gastric sensory fibers, along with peptide release by sensory
      stimulation and potent actions on gastric secretions suggests a role of the
      peptide in the regulation of gastric function.

PMID- 1637089
TI  - The physiology of calcitonin gene-related peptide in the islet compared with that
      of islet amyloid polypeptide (amylin).
AB  - Following the discovery of a second gene containing a CGRP-like sequence, we
      demonstrated that "beta-CGRP" was indeed translated as a 37-amino acid peptide in
      vivo and was the predominant form of CGRP produced by the enteric nervous system.
      The presence of CGRP in the islet has been reported by several groups. We now
      show that beta-CGRP is again the major form. Another 37-amino acid peptide was
      recently isolated from islet amyloid deposits and found to have approximately 50%
      amino acid sequence homology with CGRP. Islet amyloid polypeptide, or amylin, is
      co-localized with insulin to the beta-cell secretory granule and is synthesized
      and released in parallel with insulin in response to a range of physiological and
      pharmacological stimuli. IAPP was subsequently shown, like CGRP, to inhibit the
      release of insulin pharmacologically. Interestingly, it was also shown to
      decrease the uptake of glucose by striated muscle, though it was considerably
      less potent than CGRP. This led to the suggestion that IAPP might be a
      circulating hormone regulating peripheral insulin sensitivity. Infusion of IAPP
      in human volunteers to produce plasma concentrations more than 100-fold higher
      than those seen physiologically, however, failed to alter peripheral glucose
      disposal. We conclude that beta-CGRP and IAPP are likely to play a role in local
      paracrine control of the islet.

PMID- 1637090
TI  - Calcitonin gene-related peptides: influence on intestinal ion transport.

PMID- 1637091
TI  - Calcitonin gene-related peptide in inflammatory bowel disease and experimentally
      induced colitis.
AB  - Pronounced changes in gut neuropeptide content have been observed in colonic
      tissues from animals with acute experimental colitis and in some patients with
      inflammatory bowel disease. The early decrease of CGRP in the colon during
      colitis in the animal studies suggest that CGRP is released during the
      inflammatory process. No data are available showing the biological action of
      released CGRP during inflammation. The sensory neurotoxin capsaicin was used in
      animal studies to examine the effect of sensory nerves on inflammation and
      healing in experimental animal models. The severity of colitis was enhanced after
      capsaicin pretreatment in acute and chronic animal models of colitis. These data
      support the hypothesis that sensory nerves exert a protective and healing
      promoting function in the gut. CGRP is a good candidate for this action of
      sensory nerves because it is a major component in sensory nerve fibers. How CGRP
      exerts its protective function in the intestine is unknown. Data from gastric
      ulcer models support the hypothesis that a main action of CGRP is regulation of
      mesenteric and mucosal blood flow resulting in enhanced protection and tissue
      healing. Other effector roles of CGRP afferent nerve endings could also be
      considered.

PMID- 1637092
TI  - Calcitonin gene-related peptide in the regulation of urinary tract motility.

PMID- 1637094
TI  - Molecular mechanisms of cell-specific and regulated expression of the
      calcitonin/alpha-CGRP and beta-CGRP genes.
AB  - The calcitonin/CGRP gene family utilizes several fundamental mechanisms for
      regulation of gene expression. The structural diversity of the family depends
      both on tissue-specific RNA processing and the presence of multiple,
      independently regulated genes. Our laboratory has been studying the structure and
      expression of the rat calcitonin/alpha-CGRP and beta-CGRP genes. We have studied
      the processing of transcripts from these genes by introducing a variety of
      mutated and hybrid genes into several cell lines to identify sequences critical
      for processing regulation. These mutant genes have ranged from point mutations to
      exchanges of entire splice sites, as well as chimeric constructs between the
      calcitonin/alpha-CGRP and beta-CGRP genes. The beta-CGRP gene provides a unique
      insight into the role of cis-acting sequences in tissue-specific splicing events.
      The rat beta-CGRP gene has an overall structure similar to that of the
      calcitonin/alpha-CGRP gene, but the former lacks an exon encoding a calcitonin
      like hormone. Although the beta-CGRP gene contains splice junction sequences
      analogous to those utilized for alternative splicing in the calcitonin/alpha-CGRP
      gene, alternatively spliced products from regions within the beta-CGRP gene are
      not observed. Substitution of specific domains from the calcitonin/alpha-CGRP
      gene into the beta-gene can reconstitute some, but not all, aspects of
      alternative RNA processing. The results of transfection studies suggest that
      multiple regions within these genes contribute to alternative RNA splicing.

PMID- 1637093
TI  - Calcitonin gene-related peptide and peripheral nerve regeneration.

PMID- 1637095
TI  - Calcitonin gene-related peptide is chemotactic for human T lymphocytes.
AB  - Certain neuropeptides, such as CGRP, are associated with C-type nerve fibers in
      the skin and are known to be proinflammatory mediators. Because of their probable
      role in various cutaneous diseases, we investigated the effect of alpha- and beta
      CGRP on human leukocyte migration in a 48-well microchemotaxis chamber using a 5
      microns-pore filter. Elutriated peripheral blood leukocytes (enriched 80-90% for
      CD3+ and 10-20% for CD20+ lymphocytes) were added to the upper wells, and CGRP to
      the lower ones in a dose range of 10(-19)-10(-5) M; both were diluted in RPMI
      medium containing 0.05% fetal calf serum. The chamber was incubated at 37 degrees
      C for 2.5 hours, and the filter was washed and stained. The mean number of cells
      migrating through the filter was calculated for quadruplicate wells in each
      treatment group. Chemotactic activity was expressed as a migration index (MI =
      number of cells responding to CGRP/media control). Both alpha- and beta-CGRP were
      optimally chemotactic for leukocytes at approximately 50 pM, with a mean
      migration index of 11.5 for filter-adherent cells (n = 13 experiments); migration
      due to chemokinesis was minimal, as measured by checkerboard analysis. Almost all
      leukocytes that responded to CGRP were T cells (TCs), and the CD4 to CD8 ratio
      was similar to that of the input population; B cells were not observed. CGRP
      induced migration appears to be a specific receptor-mediated event, as
      pretreating the cells with CGRP resulted in significant down-regulation of their
      chemotactic response to CGRP, but not to interleukin-1 alpha. Our data suggest
      that the release of CGRP from free nerve endings near the dermal-epidermal
      junction could influence cutaneous TC trafficking. As neuropeptides exacerbate
      (possibly initiate) the inflammatory process, they are likely to be important
      pharmacological targets in dermatological disorders.

PMID- 1637096
TI  - Eosinophil chemotactic peptide sequences in rat alpha-CGRP. Activation of a novel
      trophic action by neutral endopeptidase 24.11.
AB  - Rat alpha- and alpha-CGRP are substrates for endopeptidase 24.11 in vitro.
      Cleavage of both peptides occurs at several points, including an unusual
      substrate recognition site to the amino side of ala36. In alpha-CGRP this
      resulted in the early formation of val32-gly-ser-glu35, a sequence previously
      reported to be a component of the eosinophil chemotactic factor of anaphylaxis
      (ECF-A). The biological activity of this peptide fragment was confirmed by
      bioassay. Chemotactic activity in other hydrolysis fragments of both alpha- and
      beta-CGRP was observed. Both alpha- and beta-CGRP could thus serve as precursors
      to different eosinophil chemotactic peptide fragments. A novel function of
      endopeptidase 24.11 may be to modify rather than to terminate the biological
      activity of CGRP peptides.

PMID- 1637098
TI  - Distribution of calcitonin gene-related peptide in the central nervous system of
      the rat by immunocytochemistry and in situ hybridization histochemistry.

PMID- 1637097
TI  - Evidence that calcitonin gene-related peptide contributes to inflammation in the
      skin and joint.
AB  - Calcitonin gene-related peptide produces dose-related vasodilatation after
      intradermal injection in several species. In the present study, CGRP increased
      blood flow in rabbit skin but had no direct effect on edema formation in rat or
      rabbit skin or in the rat knee joint. However, CGRP produced significant
      potentiation of edema formation when co-injected with histamine, a potent
      mediator of increased vascular permeability. Therefore, release of CGRP from
      stimulated C-fiber nerves may contribute to the vascular changes that are an
      integral part of the inflammatory process. The activity of the putative CGRP
      antagonist CGRP8-37 (300 pmol) against CGRP was also investigated in rabbit and
      rat skin. Whereas it was found to selectively antagonize the effects of CGRP in
      rabbit skin, the antagonist produced edema in rat skin at the same dose. Thus,
      CGRP8-37 may be used in the rabbit to study the effects of endogenously released
      CGRP, but caution is required when this antagonist is used in the rat.

PMID- 1637099
TI  - CGRP in brain stem motoneurons. Dependent on target innervated?

PMID- 1637100
TI  - CGRP as a marker of the climbing fibers during the development of the cerebellum
      in the rat.
AB  - Olivary fibers express CGRP-LI until the nest phase of their development and
      never in the next postnatal steps, that is, the "capuchon" stage. Together with
      other results presented in this volume regarding the postnatal development of
      CGRP binding sites in the cerebellar cortex, these immunohistologic findings
      suggest a role for CGRP in reshaping connectivity and in synapse stabilization of
      cerebellar circuitry during postnatal development.

PMID- 1637101
TI  - Immunohistochemical localization of calcitonin gene-related peptide in the rat
      eye. Response to capsaicin pretreatment.

PMID- 1637102
TI  - Calcitonin gene-related peptide is released from cholinergic synapses.

PMID- 1637103
TI  - Is there a synaptic innervation of pelvic neurons by CGRP-immunoreactive sensory
      nerves?

PMID- 1637104
TI  - Pharmacological effects of capsaicin treatment on innervation of the rat kidney
      with calcitonin gene-related peptide.

PMID- 1637105
TI  - CGRP-like immunoreactive nerve endings in the rat knee joint.

PMID- 1637106
TI  - CGRP immunoreactivity in the mammalian pancreas.

PMID- 1637107
TI  - Long-term increase in CGRP levels in rat spinal dorsal horn following skin
      ultraviolet irradiation. A mechanism of sunburn pain?

PMID- 1637108
TI  - Production of CGRP in three continuous cell lines from human medullary thyroid
      carcinomas.

PMID- 1637109
TI  - An assessment of the anabolic skeletal actions of the common-region peptides
      derived from the CGRP and calcitonin prohormones.

PMID- 1637110
TI  - Ibuprofen, indomethacin, and high-dose aspirin, but not low-dose aspirin or
      imidazole, inhibit CGRP elevations in plasma during endotoxicosis.

PMID- 1637111
TI  - Characteristics of CGRP-induced relaxation in rabbit ophthalmic artery.

PMID- 1637112
TI  - Increased sympathetic outflow to the gut by cerebral CGRP inhibits duodenal,
      pancreatic, small intestinal, and biliary functions.

PMID- 1637113
TI  - Preparation of a monoclonal antibody to rat alpha-CGRP for in vivo
      immunoneutralization of peptides.

PMID- 1637114
TI  - Stimulation of rat antral CGRP release by intraluminal peptone.

PMID- 1637115
TI  - Sialoadenectomy selectively increases rat gastric CGRP. Interaction with
      capsaicin-sensitive afferents.

PMID- 1637116
TI  - Multiple mechanisms in the action of alpha-CGRP in rat stomach.

PMID- 1637117
TI  - Calcitonin gene-related peptide mediates the gastric hyperemic response to acid
      back-diffusion.

PMID- 1637118
TI  - Antagonism of the motor effects of CGRP and of capsaicin on the guinea pig ileum
      by human CGRP8-37.

PMID- 1637119
TI  - Calcitonin gene-related peptide as modulator of cholecystokinin-induced
      contraction of guinea pig gall bladder strips in vitro.

PMID- 1637120
TI  - Effect of calcitonin gene-related peptide on passive avoidance behavior in rats.
      Role of transmitters.

PMID- 1637121
TI  - Neurochemical effects of CGRP.

PMID- 1637122
TI  - Inhibition of insulin-stimulated glycogen synthesis in skeletal muscle by
      resiniferatoxin is probably due to a mechanism involving CGRP.

PMID- 1637123
TI  - Identification and partial characterization of the salmon calcitonin/CGRP gene by
      polymerase chain reaction.
AB  - The polymerase chain reaction was used to amplify sequences encoding calcitonin
      and CGRP in the genomic DNA of salmon. Amplification products of the expected
      length were cloned and sequenced. In this way a new CGRP-coding sequence was
      identified. The new sequence and the known salmon calcitonin-coding sequence were
      shown to be part of one gene, implying that alternative gene expression takes
      place in fish.

PMID- 1637124
TI  - A method of surgical correction of myopia by fashioning a new optically active
      epithelial surface: keratoepitheliomileusis.
AB  - A new form of refractive keratoplasty for the correction of myopia was developed
      using a new approach to the problem. The midperipheral annular area of the
      recipient cornea was deepithelialized, and Bowman's layer was removed using a
      special bore coated with diamond crumbs. A cryolathed annular graft was placed on
      this prepared midperipheral area of the recipient cornea concentrically with its
      center. As a result of subsequent reepithelialization inside the transplanted
      ring, a regular optically active surface was formed. The refractive effect
      gradually appeared eight to ten weeks after surgery This new optically active
      surface acted as a lens, consisting of epithelial cells on top of the host
      cornea. The method required neither cutting of the stroma nor any manipulation in
      the optical zone of the cornea. A new term "keratoepitheliomileusis" was coined
      for this new procedure. Eleven patients (12 eyes) with high myopia ranging from
      7.5 to 22.0D underwent keratoepitheliomileusis. The refractive and visual results
      found after four to 16 months of follow-up are presented. Emmetropic refraction
      occurred in three patients. In the other nine eyes, the deviation from emmetropia
      ranged from 0.75 to 2.5D. In all patients, uncorrected visual acuity was improved
      considerably (up to 0.3 to 1.OD) without loss in their best-corrected vision.

PMID- 1637125
TI  - Multifocal choroiditis with evidence of Lyme disease.
AB  - A 32-year-old man had multifocal choroiditis without vitreous involvement. The
      diagnosis of Lyme disease was suggested by serial enzyme-linked immunosorbent
      assays of his serum and a cerebrospinal fluid specimen. The ocular findings
      resembled those seen in patients with acute posterior multifocal placoid pigment
      epitheliopathy (APMPPE). The active lesions resolved after administration of a
      two-week course of intravenous ceftriaxone. This case suggests that some cases of
      APMPPE actually may be Lyme disease.

PMID- 1637126
TI  - Presumed exudative retinal detachment after cryotherapy in retinopathy of
      prematurity.
AB  - Cryotherapy of the peripheral avascular retina in selected cases of retinopathy
      of prematurity has been shown to reduce the incidence of posterior retinal
      detachment, retinal fold involving the macula, and retrolental tissue. Although
      exudative retinal detachments have been described after cryotherapy during
      scleral buckling procedures, to our knowledge, this observation has not been
      reported after cryotherapy in retinopathy of prematurity. We describe such a
      case.

PMID- 1637127
TI  - Nondetectable electroretinogram in combined methylmalonic aciduria and
      homocystinuria.
AB  - We present the case of a patient with congenital methylmalonic aciduria with
      homocystinuria and a nondetectable electroretinogram. To our knowledge, this is a
      new entity to be considered in the differential diagnosis of nondetectable
      electroretinography in infancy.

PMID- 1637128
TI  - Choroidal vascular aneurysm with massive choroidal hemorrhage.
AB  - A rare case of a choroidal vascular aneurysm arising from the short posterior
      ciliary artery is reported in a 40-year-old woman. The aneurysm was detected by
      fluorescein angiography. It caused recurrent choroidal hemorrhage with blindness
      as the outcome. The diagnosis of aneurysm would have been missed without
      fluorescein angiography. A search should be made for choroidal vascular aneurysm
      in cases of spontaneous choroidal and vitreous hemorrhage both clinically (using
      fluorescein angiography) and histopathologically (in the event of enucleation of
      the eyeball).

PMID- 1637129
TI  - Presenting signs and symptoms of choroidal melanoma: what do they mean?
AB  - Presenting signs and symptoms of 193 patients with choroidal melanomas (followed
      for up to 152 months) were recorded using retrospective chart review. Eighty
      patients (41%) had no symptoms (the melanoma was found during routine
      ophthalmologic examination in 65 patients and during treatment for other eye
      problem in 15 patients). We found 113 patients (59%) had symptoms (visual acuity
      or visual field defects, 77 patients; flashes or floaters, 30 patients; pain, 5
      patients, and metastatic disease, 1 patient). The tumor size was related to the
      presence or absence of symptoms (chi-square, 10.6; P = .005). More tumors that
      presented with symptoms were medium sized (64%) than large (27%). Men had
      significantly more symptoms (chi-square, 4.1; P = .04). The right eye was more
      likely to be involved in patients with symptoms (chi-square, 7.3; P = .007).
      Kaplan-Meier survival analysis for age, sex, presence of tumor or retinal
      detachment in the macula, tumor location, presence of symptoms, laterality, and
      tumor size showed that only tumor size was related to a difference in incidence
      of metastasis (log-rank chi-square, 12.9; P = .002). With increased tumor height,
      the probability of developing metastasis was greater.

PMID- 1637130
TI  - Spastic entropion after cataract surgery.
AB  - Spastic entropion is an acute eyelid condition seen in patients with acute
      inflammatory ocular conditions. It has been reported after cataract surgery. We
      describe three cases of spastic entropion after cataract surgery that did not
      resolve after the ocular irritation subsided. All were associated with eyelid
      and/or cul-de-sac injection of antibiotics and corticosteroids or anesthetic
      solution. All had dehiscence of the capsulopalpebral fascia. Spastic entropion is
      an evolving stage toward permanent entropion.

PMID- 1637131
TI  - Proton magnetic resonance spectroscopic imaging for metabolic characterization of
      demyelinating plaques.
AB  - We used proton magnetic resonance (MR) spectroscopic imaging to determine the
      serial changes in MR signals from choline, creatine, lactate, and N
      acetylaspartate in and around a large demyelinating lesion followed over a period
      of 8 months. Elevated lactate and choline signals were observed at the first
      examination 3 days after the onset of symptoms. Reduced N-acetylaspartate signals
      were observed a few days afterward. The abnormal metabolite signals varied in
      different regions of the lesion and extended beyond the borders of abnormal
      signal intensity seen on conventional MR imaging (MRI). On the last examination
      at 8 months when the lesion appeared much smaller on MRI, choline signals from
      the center of the lesion were still high, but were falling. Choline signals
      outside the lesion on MRI had returned to normal as had lactate signals
      everywhere. Importantly, there was no recovery of N-acetylaspartate signals in or
      adjacent to the lesion on MRI. This serial study demonstrates the potential of MR
      spectroscopic imaging for characterizing the chemical pathological evolution of
      demyelinating lesions in ways that conventional MRI cannot. We propose that
      abnormal signals from choline can indicate recent regional demyelination, while
      persistent abnormal signals from N-acetylaspartate can provide an index of
      irreversible damage in the nervous system.

PMID- 1637132
TI  - Mild senile dementia of the Alzheimer type. 4. Evaluation of intervention.
AB  - The design of trials of interventions intended to slow or arrest the progression
      of senile dementia of the Alzheimer type must be based on analysis of the natural
      history of the disease. Using a random coefficients statistical model, we
      analyzed the natural history of senile dementia of the Alzheimer type in
      carefully defined subjects with mild disease (n = 68) for periods of up to 10
      years. Subject performance was assessed longitudinally on batteries of clinical
      and psychometric measures. The characteristics of these measures were analyzed
      relevant to their utility as outcome measures for long-term trials in patients
      with senile dementia of the Alzheimer type. Estimates were made of sample sizes
      required to show arrest, and 50% or 25% slowing in the progression of mild
      disease. We suggest that a clinically relevant global measure, such as the Sum of
      Boxes of the Clinical Dementia Rating scale, and a performance-based clinical
      scale or psychometric measure would be appropriate in a 12- or 24-month trial
      enrolling subjects with mild senile dementia of the Alzheimer type.

PMID- 1637133
TI  - Localization of extratemporal epileptic foci during ictal single photon emission
      computed tomography.
AB  - We obtained single photon emission computed tomography (SPECT) scans with
      technetium-99M-hexamethyl-propylene-amine-oxime in 11 patients during 12
      extratemporal partial seizures (9 simple partial, 3 complex partial). Ten ictal
      SPECT studies in 9 patients showed a focal region of hyperperfusion, which agreed
      with electrical seizure onset in 5 and with clinical seizure localization in 4 in
      whom ictal electroencephalography was not localized. Contralateral cerebellar and
      ipsilateral basal ganglia hyperperfusion was seen in 3 patients with a frontal
      lobe seizure focus. Ictal hyperperfusion was well circumscribed, unlike the
      diffuse hyperperfusion changes reported during temporal lobe seizures. This
      observation may indicate a different degree of seizure spread in temporal as
      opposed to extratemporal epilepsy. Because electroencephalographic localization
      is often elusive in extratemporal seizures, ictal SPECT may be very helpful for
      the localization of extratemporal foci.

PMID- 1637134
TI  - Multifocal inflammatory leukoencephalopathy with 5-fluorouracil and levamisole.
AB  - A cerebral demyelinating disease developed in 3 patients during adjuvant therapy
      with 5-fluorouracil and levamisole for adenocarcinoma of the colon. None of the
      patients had evidence of metastatic disease or prior neurological disease. The
      duration of chemotherapy before onset of neurological symptoms ranged from 15 to
      19 weeks. The total dose of 5-fluorouracil was 9.7 to 15.7 gm. The total dose of
      levamisole was 2.7 to 3.75 gm. Two patients presented with a subacute (2-3 weeks)
      progressive decline in mental status and ataxia. The third patient had two
      unexplained episodes of loss of consciousness. In each, magnetic resonance
      imaging with gadolinium demonstrated prominent multifocal enhancing white matter
      lesions. Cerebral biopsy was performed stereotaxically in 2 patients. The
      morphological features were those of active demyelinating disease. The myelin
      loss was associated with numerous dispersed as well as vasocentric macrophages,
      sparing of axons, and perivascular lymphocytic inflammation. Electron microscopy
      confirmed the light microscopic findings. All 3 patients improved after cessation
      of chemotherapy and a short course of corticosteroid therapy. Our patients
      represent the first reported examples of an inflammatory leukoencephalopathy
      associated with the administration of 5-fluorouracil and levamisole. This
      syndrome may represent the pathological basis for 5-fluorouracil neurotoxicity,
      although we cannot completely exclude the role of levamisole.

PMID- 1637135
TI  - The spectrum of neurological disease in patients with systemic cancer.
AB  - To ascertain the range of neurological problems in patients with systemic cancer,
      we prospectively evaluated neurological symptoms, neurological diagnoses, and
      primary tumors in all patients with a history of systemic cancer examined by the
      Department of Neurology at the Memorial Sloan-Kettering Cancer Center, from Jul
      1, 1990, to Dec 31, 1990. Of the 815 patients seen for neurological symptoms,
      less than half (45.2%) had metastatic involvement of the nervous system. The
      three most common symptoms were back pain (18.2%), altered mental status (17.1%),
      and headache (15.4%). The most common neurological diagnosis was brain metastasis
      (15.9%), followed by metabolic encephalopathy (10.2%), pain associated with bone
      metastases only (9.9%), and epidural extension or metastasis of tumor (8.4%). Of
      133 patients with undiagnosed back or neck pain, 44 (33%) had epidural extension
      or metastases from tumor and 40 (30%) had pain associated with vertebral
      metastases only. In 15 (11%) the cause for the back pain was unrelated to
      metastatic disease. Of 132 patients seen on initial consultation for altered
      mental status, metabolic encephalopathy was the major neurological diagnosis (80;
      61%); 20 (15%) had intracranial metastases. Of 97 patients with undiagnosed
      headache, 59 (61%) had a nonstructural cause. Fifty-three of these patients had
      either migraine, tension headache, or headache related to systemic illness (e.g.,
      fever, sepsis). These results indicate that even in patients with systemic
      cancer, a group particularly prone to developing neurological disease that can be
      diagnosed radiologically, the role of clinicians remains important in helping
      distinguish noncancer-related and nonmetastatic neurological problems.

PMID- 1637136
TI  - Selective accumulation of aluminum and iron in the neurofibrillary tangles of
      Alzheimer's disease: a laser microprobe (LAMMA) study.
AB  - We report the results of an examination of the elemental content of
      neurofibrillary tangle-bearing and neurofibrillary tangle-free neurons identified
      within the hippocampus of 10 subjects with Alzheimer's disease and 4
      neuropathologically intact age-matched control subjects. The study employed laser
      microprobe mass analysis (LAMMA), a technique that provides extremely sensitive
      multielement detection in plastic-embedded, semithin-sectioned tissues. Evidence
      for the selective accumulation of aluminum within the neurofibrillary tangle
      bearing neurons was obtained in all 10 subjects with Alzheimer's disease. The
      site of aluminum deposition within these cells was the neurofibrillary tangle
      itself, and not the "nuclear region," as we previously reported. Iron
      accumulation was also detected within neurofibrillary tangles. Evaluation for the
      accumulation of other elements within the tangle-bearing neurons failed to reveal
      any other metallic element as being consistently present. In addition, probe
      sites directed to neurons identified in snap-frozen cryostat sections from 2
      subjects with Alzheimer's disease revealed similar spectra with prominent
      aluminum-related peaks, confirming that our findings are not related to exogenous
      contamination through fixation, embedding, or other procedures prior to analysis.
      This study further confirms the association of aluminum and neurofibrillary
      tangle formation in Alzheimer's disease.

PMID- 1637137
TI  - Cortically evoked motor responses in patients with Xp22.3-linked Kallmann's
      syndrome and in female gene carriers.
AB  - Patients with Kallmann's syndrome show hypothalamic hypogonadism, hyposmia, and
      congenital mirror movements. As a correlate, a defect of gonadotropic neuron
      migration into the brain was recently detected. Considering abnormal outgrowth of
      neurons also as a possible substrate underlying mirror movements, we studied 3
      patients and 2 asymptomatic female gene carriers from a kindred with proven
      linkage to Xp22.3, using focal transcranial magnetic stimulation of motor cortex
      hand areas with a figure-eight coil. In all 3 affected brothers, bilateral
      responses could be evoked almost simultaneously in their thenar muscles (slight
      latency differences were statistically insignificant). In contrast, the mother
      and the maternal aunt showed only unilateral, normal thenar responses, even with
      maximum tolerable stimulator output and high signal amplification.
      Correspondingly, mirror movements were present in the patients, but not in the
      gene carriers. Bilaterality of cortically evoked hand muscle responses and mirror
      movements, therefore, behaved as X-chromosomal recessive traits. A likely cause
      might be a disorder of neuronal outgrowth in the motor system, particularly of
      inhibitory callosal fibers. For normal anatomical development of the motor
      system, one intact Xp22.3 gene seems necessary.

PMID- 1637138
TI  - Collagen cross-linking of skin in patients with amyotrophic lateral sclerosis.
AB  - Collagen cross-links of skin tissue (left upper arm) from 11 patients with
      amyotrophic lateral sclerosis (ALS) and 9 age-matched control subjects were
      quantified. It was found that patients with ALS had a significant reduction in
      the content of an age-related, stable cross-link,
      histidinohydroxylysinonorleucine, that was negatively correlated with the
      duration of illness. The contents of sodium borohydride-reducible labile cross
      links, dehydro-hydroxylysinonorleucine and dehydro-histidinohydroxymerodesmosine,
      were significantly increased and were positively associated with the duration of
      illness (r = 0.703, p less than 0.05 and r = 0.684, p less than 0.05,
      respectively). The results clearly indicate that during the course of ALS, the
      cross-linking pathway of skin collagen runs counter to its normal aging,
      resulting in a "rejuvenation" phenomenon of skin collagen. Thus, cross-linking of
      skin collagen is affected in ALS.

PMID- 1637139
TI  - In vivo imaging of glucose consumption and lactate concentration in human
      gliomas.
AB  - Twenty patients with histologically confirmed gliomas were studied with positron
      emission tomography (PET) and proton magnetic resonance spectroscopy (1H-MRS).
      PET with 18F-2-fluoro-2-deoxy-D-glucose (FDG) provided tomograms of the metabolic
      rate of glucose. MRS images were obtained by combining volume-selective
      excitation with phase-encoded acquisition. With 32 x 32 gradient phase-encoding
      steps, an in-plane resolution of 7 x 7 mm was achieved. From this set of spectra,
      lactate maps were created and compared with PET maps of glucose metabolism.
      Maximum glucose metabolic rates within tumors (relative to metabolic rates of
      glucose in contralateral regions of the brain) were correlated significantly with
      maximum lactate concentrations (relative to N-acetyl aspartate peaks in the
      contralateral part of the brain). In 8 tumors, no lactate was detected, and in 7
      of these the maximum glucose metabolic rate was below the median value. The tumor
      with the highest lactate concentration also had the highest glucose metabolic
      rate. The topographic relation between glucose metabolic rate and lactate
      concentration could be analyzed in 9 patients by three-dimensional alignment of
      the PET and MRS images. In that analysis, maximum lactate concentrations were
      often not found in the same location as maximum glucose metabolism, but lactate
      tended to accumulate in tumor cysts, necrotic areas, and the vicinity of the
      lateral ventricles. The combination of FDG PET and 1H-MRS imaging demonstrates
      details of the spatial relation between the two poles of nonoxidative glycolysis,
      glucose uptake and lactate deposition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637140
TI  - Revised estimate of the prevalence of multiple sclerosis in the United States.
AB  - Using three adjustments, we have revised a 1976 prevalence count for multiple
      sclerosis in the United States. The adjustments were made to data from a US
      national survey; they used 1990 population projections from the US Bureau of the
      Census, and results of investigations conducted in Weld and Larimer Countries,
      Colorado, and Olmsted County, Minnesota. It is estimated that approximately
      250,000 to 350,000 persons in the United States in 1990 had physician-diagnosed
      multiple sclerosis.

PMID- 1637141
TI  - Congenital hypomyelination neuropathy with arthrogryposis multiplex congenita.
AB  - A term male infant is described with an isolated disorder of peripheral
      myelination. At necropsy, the great majority of medium-to-large axons were
      unmyelinated. Electron microscopy showed normal axons and redundant lamination of
      basement membrane, suggestive of early onion bulb pathology. Immunohistochemistry
      of peripheral nerve showed deficiency of the myelin proteins P2 and P0, myelin
      basic protein, and myelin-associated glycoprotein. Arrest of peripheral
      myelination at the promyelin stage appears to be the origin of myelin deficiency.

PMID- 1637142
TI  - Familial amyloidotic polyneuropathy: report of patients heterozygous for the
      transthyretin Gly42 gene.
AB  - We studied 2 patients from a Japanese family with familial amyloidotic
      polyneuropathy (FAP). Their clinical features are similar to type 1 FAP, and the
      proband's rectal tissue contained amyloid that stained with antihuman
      transthyretin (TTR) antiserum. Direct DNA sequencing of the proband's TTR gene
      revealed a guanine-for-adenine substitution in the second base of codon 42,
      producing a glycine for glutamate substitution in the plasma protein.

PMID- 1637143
TI  - [The interpretation of morphometric data of 10- to 13-year-old school children
      from the survey year 1978 of the Braunschweig Longitudinal Study].
AB  - The paper represents a cross-sectional study from a sample of 1800 out of 3000
      school-children from the Braunschweiger Langsschnitt. In this methodical approach
      we first eliminate approximately the influence of age and stature on the raw data
      from all body measurements with regression equations. The transformed data were
      attached to three "types" named 'below normal', 'normal', and 'above normal', in
      course of which 'normal' means all cases in the range of the standard deviation,
      whereas the two other "types" are corresponding to the adjacent ranges of values.
      Subsequently each transformation on the mean of age and stature a discriminant
      analysis has been performed grouping the cases by the "types" of the width of
      pelvis, resp. shoulders. There were found great influences of the stature on the
      chosen measures of width in our investigated class of age. They could be made
      clear alone by using allometrical methods. Only before correction of the body
      height the given grouping is supported by other variables, at which different
      sets of variables dominate the discriminant functions for boys and girls. Out of
      this new aspects and considerations result for the understanding of the physique
      and the physique typologies, which would be significant in our opinion for
      acceleration phenomenon as well as for the comparative examinations on
      populations.

PMID- 1637144
TI  - [The early bronze age graveyards of Franzhausen I, lower Austria. 2. Demographic
      analysis].
AB  - In a recent study of 714 graves of the Early Bronze Age cemetery, Franzhausen I,
      658 individuals were demographically analysed. The masculinity rate and the
      mortality rate in the age groups were of similar order compared with estimates
      derived from other series of this period. On the base of a stationary population
      model, life tables were calculated showing life expectancy at birth to be 25.8
      years and at the age of 20, 17.7 years. Also computed were: the crude death rate
      (Z = 38.8); and the population size (P = 31 or 65). The lack of infants were
      estimated by regressions (5q0 = 58%) and the results are discussed.

PMID- 1637145
TI  - Dermatoglyphics of the Efe pygmies.
AB  - This paper deals with the dermatoglyphics in a group of Efe Pygmies, especially
      with the quantitative traits of fingers, as well as with palmar dermatoglyphics.
      This material was collected by P. Schebesta in Zaire and was partially published
      already by J.A. Valsik in 1938.

PMID- 1637146
TI  - [Position on the publication of S. Ehrhardt (1990): Setukesen. A population group
      between Estonians and Russians in southeast Estonia. Homo 40, 159-175.
      Reflections on responsibility in anthropological works].
AB  - The uncommented publication of data on Setukesen people (SE Estonia), which were
      collected in 1942, by the scientific journal Homo (40, 159-175, 1990) is
      remarkably unreceptive to discussions within the scientific community at large.
      Therefore some basic considerations on scientific ethics in anthropology are
      outlined. Unfortunately Homo has refused to publish this statement which was
      written on appointment of the advisory board of the German Society of
      Anthropology and Human Genetics.

PMID- 1637147
TI  - [The early bronze age graveyard of Franzhausen I, lower Austria. 3. Study of
      epigenetic characteristics].
AB  - The epigenetic variants of 635 early Bronze Age individuals from Franzhausen I,
      Lower Austria, were studied. The main interest of this examination, besides
      getting data, was the calculation of frequencies and testing the variants for sex
      and age dependence. Additionally, intertraits and side-to-side correlation were
      discussed. The results showed that as much data as possible should be included
      for calculation. Even subadult individuals could be adopted in the analysis if
      facts of growth and formative years are considered. Sex and intertrait
      correlation are less important for population comparison, but they have
      considerable consequences for intrapopulation calculation.

PMID- 1637148
TI  - [Sexual dimorphism of tooth crown diameters. A contribution to the determination
      of the sex of subadult individuals from the early bronze age graveyard of
      Franzhausen I, lower Austria].
AB  - In this paper, the sexual differences between mesio-distal and bucco-lingual
      diameters of deciduous and permanent teeth of an Early Bronze Age population from
      Franzhausen are presented. Data from a total of 172 (85 male and 87 female)
      subadult individuals was collected. The presumptive sex determination needed for
      this investigation could be achieved because of specific burial rites that
      characterize the Unterwolbling culture south of the Danube. The averages of both
      the deciduous and permanent teeth show that female individuals possess altogether
      teeth of smaller dimensions. The differences are, for a few permanent teeth,
      statistically highly significant. Using these to calculate discriminant analyses
      based on differing variable sets, a correct sex assignment was achieved in 81% to
      75% of all cases. For the purposes of sexual diagnosis, a function combining only
      three measurements (MD and BL diameters of upper canine and BL diameter of the
      first upper molar) was 80% successful.

PMID- 1637149
TI  - Food habits and dental disease in an iron-age population.
AB  - Tooth diseases and wear record valuable information on diet and methods of food
      preparation in past human populations. In this paper the teeth of an Iron-Age
      population (Monte Bibele, Bologna) are analyzed to reconstruct their nutritional
      situation. The analysis of caries frequency and distribution indicates a level of
      carbohydrate consumption which is consistent with an agricultural way of life.
      The presence of calculus indicates that proteins were present in the diet of the
      Monte Bibele population. The frequency of antemortem tooth loss and of dental
      abscesses is in harmony with the results of the analysis of caries and calculus.
      The examination of dental wear suggests the presence of a substantial vegetable
      component in the diet. From the analysis of the dental characteristics one can
      conclude that the population of Monte Bibele had a prevalent agricultural
      economy. The presence of some diachronic variations in the distribution of the
      examined characters suggest changes in the diet in the course of time.

PMID- 1637150
TI  - [The color and structure of the human iris. 1. Morphological studies].
AB  - The material basis of this investigation consists of empirical findings and
      colour photographs of the irises of 200 pairs of twins and 100 control pairs. For
      the morphological investigation first-born twins and control persons are combined
      to constitute a comparative group of 400 non-related testees. Research by means
      of the iris microscope and the evaluation of standardized iris photographs led to
      the development of a catalogue of features which describes 10 iris
      characteristics for the iris colour and 20 for the iris structure. For each
      feature different degrees of markedness are defined and their frequency is
      determined. Similarly, intraindividual right/left and sex differences as well as
      age-dependencies and the relation between the features are examined. The setting
      up of features includes outlining an iris-colour class system in order to render
      a better and more practicable determination of eye colour possible. As a
      substitute for Martin/Schulz's table of eye-colour, which describes only eye
      colour phenomena, 4 iris-colour classes are set up whose main criterion of
      classification is the quantity of pigment. When we consider the testees of all
      age classes, sex differences have no statistical relevance as for iris colour.
      Only in the case of male testees may an intensive decrease of blue and brown iris
      colour in favour of combination colours (yellow pigment colours in particular) be
      observed during the phase of puberty. Therefore, the brightening postulated in
      the relevant literature can be confirmed. With regard to female testees, in
      contrast, pigment shifting is of no statistical relevance. After a slight
      brightening the irises numerically re-darken at the adult-stage to the initial
      child level, i.e. they become "dark again" rather than just become "darker".
      Within the iris structure only the characteristics of the anterior stroma leaf
      show sex differences. They are, however, only weakly marked and can be described
      merely as a trend. Over the whole range of the age classes, there are no
      outstanding structural differences. The different iris characteristics concerning
      iris colour stand in a significant relation to each other. When we consider the
      statistically relevant relations between structural features, it becomes clear
      that particularly reduced and particularly intact iris characteristics correlate.
      Thus, we can distinguish between an intact type of iris and a reduced one. Three
      quarters of the testees, however, combine reduced and intact properties with
      medium degrees of markedness.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1637151
TI  - Ethanol production from cellobiose, amorphous cellulose, and crystalline
      cellulose by recombinant Klebsiella oxytoca containing chromosomally integrated
      Zymomonas mobilis genes for ethanol production and plasmids expressing
      thermostable cellulase genes from Clostridium thermocellum.
AB  - The Zymomonas mobilis genes for ethanol production have been integrated into the
      chromosome of Klebsiella oxytoca M5A1. The best of these constructs, strain P2,
      produced ethanol efficiently from cellobiose in addition to monomeric sugars.
      Utilization of cellobiose and cellotriose by this strain eliminated the
      requirement for external beta-glucosidase and reduced the amount of commercial
      cellulase needed to ferment Solka Floc SW40 (primarily crystalline cellulose).
      The addition of plasmids encoding endoglucanases from Clostridium thermocellum
      resulted in the intracellular accumulation of thermostable enzymes as coproducts
      with ethanol during fermentation. The best of these, strain P2(pCT603T)
      containing celD, was used to hydrolyze amorphous cellulose to cellobiose and
      produce ethanol in a two-stage process. Strain P2(pCT603T) was also tested in
      combination with commercial cellulases. Pretreatment of Solka Floc SW40 at 60
      degrees C with endoglucanase D substantially reduced the amount of commercial
      cellulase required to ferment Solka Floc. The stimulatory effect of the
      endoglucanase D pretreatment may result from the hydrolysis of amorphous regions,
      exposing additional sites for attack by fungal cellulases. Since endoglucanase D
      functions as part of a complex in C. thermocellum, it is possible that this
      enzyme may complex with fungal enzymes or bind cellulose to produce a more open
      structure for hydrolysis.

PMID- 1637152
TI  - Microbial oxidation of oleic acid.
AB  - Resting cells of Saccharomyces cerevisiae (baker's yeast, type II; Sigma) were
      used to convert oleic acid into 10-hydroxyoctadecanoic acid with a 45% yield.
      Nocardia aurantia (ATCC 12674), Nocardia sp. (NRRL 5646), and Mycobacterium
      fortuitum (UI 53378) all converted oleic acid into 10-oxo-octadecanoic acid with
      65, 55, and 80% yields, respectively. Structures of all metabolites were
      suggested by 1H and 13C nuclear magnetic resonance and by infrared and mass
      spectrometry. Structures of isomeric hydroxystearate and oxostearate derivatives
      and the stereochemical purity of hydroxystearates are difficult to prove
      unambiguously unless authentic standard compounds are available for spectral
      comparison. We describe the use of the chemical Baeyer-Villiger oxidation
      technique with 10-oxo-octadecanoic acid followed by mass spectral analysis of
      neutral extracts as a simple method to confirm the position of oxo-functional
      groups in the structures of fatty acid ketones. We further introduce a simple
      method based on 1H nuclear magnetic resonance analysis of diastereomeric S-(+)-O
      acetylmandelate esters of hydroxystearates as a means of ascertaining
      stereochemical purities of hydroxy fatty acids.

PMID- 1637153
TI  - Limited degradation of chlorophenols by anaerobic sludge granules.
AB  - To better understand the fate of chlorophenols treated in upflow anaerobic sludge
      bed reactors, we examined the ability of sludge granules from such bioreactors to
      degrade two trichlorophenols and one dichlorophenol in batch incubations under
      controlled conditions. Biodegradation was primarily limited to two distinct
      activities, reductive dehalogenation of ortho- and of meta-chlorine substituents.
      Both 3- and 4-monochlorophenol were persistent degradation products, while 2
      monochlorophenol was further degraded. We also examined factors potentially
      affecting the rate and extent of 2,3,6-trichlorophenol degradation. An initial
      concentration of up to 1.75 mM (346 mg/liter) was dehalogenated. At that
      concentration, dehalogenation was partially inhibited but methanogenesis from
      formate was not. The initial concentration affected both the extent of
      dehalogenation and which products were detected. The maximum dechlorination rate
      observed was 1.4 mumol of Cl- h-1 g of volatile suspended solids-1.
      Dechlorination had a temperature optimum of 50 degrees C, was inhibited by added
      electron acceptors, and was not appreciably affected by added electron donors.
      The availability of electron acceptors and electron donors did not affect the
      extent of chlorophenol degradation. These particular sludge granules do not
      appear to be capable of mineralizing phenols with meta- or para-chlorine
      substituents.

PMID- 1637154
TI  - Purification and characterization of two serine carboxypeptidases from
      Aspergillus niger and their use in C-terminal sequencing of proteins and peptide
      synthesis.
AB  - A procedure was developed to prepare in large amounts two carboxypeptidases, CPD
      I and CPD-II, from Aspergillus niger. They were each shown to be serine proteases
      and single-chain monomers with molecular masses of ca. 81 kDa and containing 22%
      carbohydrates. Amino acid analysis, carbohydrate determination, and N-terminal
      sequencing (20 to 25 residues) were performed on each enzyme. CPD-I showed
      sequence homologies with malt carboxypeptidase II, while the N terminus of CPD-II
      was different from that of any known serine carboxypeptidase. Like
      carboxypeptidase Y from Saccharomyces cerevisiae and carboxypeptidase III from
      malt, CPD-II contained a free sulfhydryl group that could play a role in
      catalysis. Both A. niger enzymes had pH optima of about 4 and were unstable above
      pH 7. Their specificities for substrate positions P1 and P'1 were characterized
      by use of, as substrates, a series of N-blocked amino acid esters and dipeptides.
      Both enzymes were specific for Arg, Lys, and Phe in P1. CPD-I preferred
      hydrophobic residues in P'1, while CPD-II was highly specific for Arg and Lys in
      this position. Each displayed an original specificity when P1 and P'1 were
      considered together. The specificities were also studied by analyzing the time
      course of the release of amino acids from eight different peptides of various
      lengths. CPD-I and CPD-II appeared to be quite suitable for C-terminal sequence
      studies as well as for the synthesis of peptide bonds. The latter was studied
      with two peptide esters as aminolysis substrates and a series of amino acid
      amides as nucleophiles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637155
TI  - Structure, organization, and transcription of a cellobiohydrolase gene cluster
      from Phanerochaete chrysosporium.
AB  - Restriction mapping and sequence analysis of cosmid clones revealed a cluster of
      three cellobiohydrolase genes in Phanerochaete chrysosporium. P. chrysosporium
      cbh1-1 and cbh1-2 are separated by only 750 bp and are located approximately 14
      kb upstream from a cellulase gene previously cloned from P. chrysosporium (P.
      Sims, C. James, and P. Broda, Gene 74:411-422, 1988). Within a well-conserved
      region, the deduced amino acid sequences of P. chrysosporium cbh1-1 and cbh1-2
      are, respectively, 80 and 69% homologous to that of the Trichoderma reesei
      cellobiohydrolase I gene. The conserved cellulose-binding domain typical of
      microbial cellulases is absent from cbh1-1. Transcript levels of the three P.
      chrysosporium genes varied substantially, depending on culture conditions. cbh1-1
      and cbh1-2 were not induced in the presence of cellulose, nor did they appear to
      be subject to glucose repression. Therefore, aspects of the chromosomal
      organization, structure, and transcription of these genes are unlike those of any
      previously described cellulase genes.

PMID- 1637156
TI  - Use of repetitive (repetitive extragenic palindromic and enterobacterial
      repetitive intergeneric consensus) sequences and the polymerase chain reaction to
      fingerprint the genomes of Rhizobium meliloti isolates and other soil bacteria.
AB  - The distribution of dispersed repetitive DNA (repetitive extragenic palindromic
      [REP] and enterobacterial repetitive intergenic consensus [ERIC]) sequences in
      the genomes of a number of gram-negative soil bacteria was examined by using
      conserved primers corresponding to REP and ERIC sequences and the polymerase
      chain reaction (PCR). The patterns of the resulting PCR products were analyzed on
      agarose gels and found to be highly specific for each strain. The REP and ERIC
      PCR patterns of a series of Rhizobium meliloti isolates, previously ordered in a
      phylogenetic tree based on allelic variations at 14 enzyme loci (B. D. Eardly, L.
      A. Materon, N. H. Smith, D. A. Johnson, M. D. Rumbaugh, and R. K. Selander, Appl.
      Environ. Microbiol. 56:187-194), were determined. Isolates which had been
      postulated to be closely related by multilocus enzyme electrophoresis also
      revealed similar REP and ERIC PCR patterns, suggesting that the REP and ERIC PCR
      method is useful for the identification and classification of bacterial strains.

PMID- 1637157
TI  - Influence of ecosystematic factors on survival of Escherichia coli after large
      scale release into lake water mesocosms.
AB  - Mass cultures of an Escherichia coli K-12 strain were released into exposed
      mesocosms in a eutrophic lake. The release was performed with and without
      additional input of the E. coli culture medium to stimulate the scenario of
      leakage of a production fermenter on one hand and to compare the influence of the
      added organic nutrients with that of the added strain on the other hand. The
      survival of the introduced strain and the influence on ecological processes in
      the mesocosms were monitored for 10 weeks after release. For comparison, survival
      of the strain in microcosms with sterile lake water was also monitored. Survival
      of the strain was determined by means of immunofluorescence and growth on
      selective agar medium. In lake mesocosms, E. coli showed a rapid and constant
      dieback during the first week. After 4 days, cells were mostly restricted to
      particles, which seemed to provide niches for survival. From the second week
      onward, survival was improved in mesocosms with culture medium added. In
      microcosms with sterile lake water, plate counts of E. coli showed a strong
      decrease within 2 weeks, while total cell numbers remained approximately the
      same. The rapid elimination of E. coli from the free-water phase of the mesocosms
      was probably due to the combined effect of the inability to grow in lake water
      and grazing. The better survival of E. coli (mainly on particles) in mesocosms
      with added medium was attributed to the medium-induced enhancement of primary
      production, which was the source of a large quantity of particles. These
      particles, in turn, may have functioned as niches for prolonged survival as well
      as transport vehicles for sedimentation of the E. coli cells.

PMID- 1637158
TI  - Biosorption of dichlorodiphenyltrichloroethane and hexachlorobenzene in
      groundwater and its implications for facilitated transport.
AB  - The potential for enhanced mobility of hydrophobic pollutants by cotransport with
      bacteria in saturated soils was evaluated from measurements of biosorption of 14C
      labeled hexachlorobenzene and dichlorodiphenyltrichloroethane (DDT) to five
      strains of soil and sewage bacteria. The sorption process could be described by a
      linear partition equation and appeared to be reversible, but desorption kinetics
      were slow and/or partly irreversible. The DDT partition coefficients varied with
      equilibration time, possibly reflecting DDT-induced changes in the physiology of
      the bacteria. The partition coefficients, normalized to the masses of the
      bacteria, ranged from 250 to 14,000 for live cells, but the largest coefficients
      were associated with autoclaved cells of a Pseudomonas sp. The sorptive capacity
      of the bacterial biomass was greater for DDT than for hexachlorobenzene but was
      not correlated to overall bacterial hydrophobicity, measured by hydrophobic
      interaction chromatography. In a column study, 1.2 x 10(9) cells of a Bacillus
      sp. strain per ml enhanced DDT transport about 8-fold, whereas an advective
      dispersive-sorptive equilibrium model for two mobile phases, water and free
      living bacteria, suggested a 14-fold enhancement, based on the DDT partition
      coefficient. The disagreement was in part due to a retarded nonequilibrium
      movement of the bacteria. Model calculations based on literature data covering a
      wide range of organisms and compounds suggested that 10(6) cells ml-1 would
      increase the mobility of very hydrophobic compounds (log octanol-water partition
      coefficient [K(ow) of greater than or equal to 6), whereas higher densities of
      bacteria (10(8) cells ml-1) would have a significant impact on compounds with a
      log K(ow) of greater than or equal to 4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637159
TI  - Biodegradation of polycyclic aromatic hydrocarbons by new isolates of white rot
      fungi.
AB  - Eight rapid Poly R-478 dye-decolorizing isolates from The Netherlands were
      screened in this study for the biodegradation of polycyclic aromatic hydrocarbons
      (PAH) supplied at 10 mg liter(-1). Several well-known ligninolytic culture
      collection strains, Phanerochaete chrysosporium BKM-F-1767, Trametes versicolor
      Paprican 52, and Bjerkandera adusta CBS 595.78 were tested in parallel. All of
      the strains significantly removed anthracene, and nine of the strains
      significantly removed benzo(a)pyrene beyond the limited losses observed in
      sterile liquid and HgCl2-poisoned fungus controls. One of the new isolates,
      Bjerkandera sp. strain Bos 55, was the best degrader of both anthracene and
      benzo(a)pyrene, removing 99.2 and 83.1% of these compounds after 28 days,
      respectively. Half of the strains, exemplified by strains of the genera
      Bjerkandera and Phanerochaete, converted anthracene to anthraquinone, which was
      found to be a dead-end metabolite, in high yields. The extracellular fluids of
      selected strains were shown to be implicated in this conversion. In contrast,
      four Trametes strains removed anthracene without significant accumulation of the
      quinone. The ability of Trametes strains to degrade anthraquinone was confirmed
      in this study. None of the strains accumulated PAH quinones during benzo(a)pyrene
      degradation. Biodegradation of PAH by the various strains was highly correlated
      to the rate by which they decolorized Poly R-478 dye, demonstrating that
      ligninolytic indicators are useful in screening for promising PAH-degrading white
      rot fungal strains.

PMID- 1637160
TI  - Applications of a colorimetric plate assay for soluble methane monooxygenase
      activity.
AB  - A straightforward method is described for screening methanotrophic colonies for
      soluble methane monooxygenase (sMMO) activity on solid media. Such activity
      results in the development of a colored complex between 1-naphthol, which is
      formed when sMMO reacts with naphthalene, and o-dianisidine (tetrazotized).
      Methanotrophic colonies expressing sMMO turned deep purple when exposed
      successively to naphthalene and o-dianisidine. The method was evaluated within
      the contexts of two potential applications. The first was for the enumeration of
      Methylosinus trichosporium OB3b in a methane-amended, unsaturated soil column
      dedicated to vinyl chloride treatment. The second application was for the
      isolation and enumeration of sMMO-bearing methanotrophs from sanitary landfill
      soils. The technique was effective in both applications.

PMID- 1637161
TI  - Biodegradation of mixtures of substituted benzenes by Pseudomonas sp. strain
      JS150.
AB  - Pseudomonas sp. strain JS150 was isolated as a nonencapsulated variant of
      Pseudomonas sp. strain JS1 that contains the genes for the degradative pathways
      of a wide range of substituted aromatic compounds. Pseudomonas sp. strain JS150
      grew on phenol, ethylbenzene, toluene, benzene, naphthalene, benzoate, p
      hydroxybenzoate, salicylate, chlorobenzene, and several 1,4-dihalogenated
      benzenes. We designed experiments to determine the conditions required for
      induction of the individual pathways and to determine whether multiple substrates
      could be biodegraded simultaneously. Oxygen consumption studies with whole cells
      and enzyme assays with cell extracts showed that the enzymes of the meta, ortho,
      and modified ortho cleavage pathways can be induced in strain JS150. Strain JS150
      contains a nonspecific toluene dioxygenase with a substrate range similar to that
      found in strains of Pseudomonas putida. The presence of the dioxygenase along
      with multiple pathways for metabolism of substituted catechols allows facile
      extension of the growth range by spontaneous mutation and degradation of mixtures
      of substituted benzenes and phenols. Chlorobenzene-grown cells of strain JS150
      degraded mixtures of chlorobenzene, benzene, toluene, naphthalene,
      trichloroethylene, and 1,2- and 1,4-dichlorobenzenes in continuous culture. Under
      similar conditions, phenol-grown cells degraded a mixture of phenol, 2-chloro-, 3
      chloro, and 2,5-dichlorophenol and 2-methyl- and 3-methylphenol. These results
      indicate that induction of appropriate biodegradative pathways in strain JS150
      permits the biodegradation of complex mixtures of aromatic compounds.

PMID- 1637162
TI  - Numerical taxonomy of gram-negative, nonmotile, nonfermentative bacteria isolated
      during chilled storage of lamb carcasses.
AB  - A numerical taxonomic study using 75 characters was performed with 132 strains of
      gram-negative, nonmotile, nonfermentative bacteria selected on the basis of lack
      of motility and Gram reaction among 1,200 cultures isolated during aerobic
      storage of lamb carcasses. At the 80% similarity level (SSM), eight clusters were
      formed. Strains in clusters 1 to 6 could be identified as members of the family
      Moraxellaceae and, more specifically, as members of the Psychrobacter-[Moraxella]
      phenylpyruvica subgroup. Of these strains, clusters 1 and 2 (88 strains) were
      identified as [Moraxella] phenylpyruvica and cluster 3 (15 strains) was
      identified as Psychrobacter immobilis. Clusters 4, 5, and 6 were not identifiable
      with any species. Clusters 7 and 8 consisted of 14 strains considered nonmotile
      variants of Pseudomonas fragi. The highest separation indices corresponded to
      acid production from certain carbohydrates (melibiose, L-arabinose, and
      cellobiose). Although strains of Psychrobacter-Moraxella clusters were relatively
      frequently identified at the completion of slaughter, very few cultures were
      detected on spoiled carcasses. It appears, therefore, that this group of
      organisms has only low spoilage potential.

PMID- 1637163
TI  - Depletion of proton motive force by nisin in Listeria monocytogenes cells.
AB  - The basal proton motive force (PMF) levels and the influence of the bacteriocin
      nisin on the PMF were determined in Listeria monocytogenes Scott A. In the
      absence of nisin, the interconversion of the pH gradient (Z delta pH) and the
      membrane potential (delta psi) led to the maintenance of a fairly constant PMF at
      -160 mV over the external pH range 5.5 to 7.0. The addition of nisin at
      concentrations of greater than or equal to 5 micrograms/ml completely dissipated
      PMF in cells at external pH values of 5.5 and 7.0. With 1 microgram of nisin per
      ml, delta pH was completely dissipated but delta psi decreased only slightly. The
      action of nisin on PMF in L. monocytogenes Scott A was both time and
      concentration dependent. Valinomycin depleted only delta pH, whereas nigericin
      and carbonyl cyanide m-chlorophenylhydrazone depleted only delta psi, under
      conditions in which nisin depleted both. Four other L. monocytogenes strains had
      basal PMF parameters similar to those of strain Scott A. Nisin (2.5
      micrograms/ml) also completely dissipated PMF in these strains.

PMID- 1637164
TI  - Determination of plasmid DNA concentration maintained by nonculturable
      Escherichia coli in marine microcosms.
AB  - The concentration of plasmid pBR322 DNA in nonculturable Escherichia coli JM83
      was measured to determine whether the plasmid concentration changed during
      survival of E. coli in marine and estuarine water. E. coli JM83 containing the
      plasmid pBR322 was placed in both sterile seawater and sterile estuarine water
      and analyzed for survival (i.e., culturability) and plasmid maintenance. The
      concentration of pBR322 DNA remained stable in E. coli JM83 for 28 days in an
      artificial seawater microcosm, even though nonculturability was achieved within 7
      days. E. coli JM83 incubated in sterile natural seawater or sterile estuarine
      water did not reach nonculturability within 30 days. Under all three conditions,
      plasmid pBR322 DNA was maintained at approximately the initial concentration.
      Cloning of DNA into the plasmid pUC8 did not alter the ability of E. coli to
      maintain vector plasmid DNA, even when the culture was in the nonculturable
      state, but the concentration of plasmid DNA decreased with time in the microcosm.
      We conclude that E. coli is able to maintain plasmid DNA while in the
      nonculturable state and that the concentration at which the plasmid is maintained
      appears to be dependent upon the copy number of the plasmid and/or the presence
      of foreign DNA.

PMID- 1637165
TI  - Reductive dechlorination of chlorophenols by a pentachlorophenol- acclimated
      methanogenic consortium.
AB  - Anaerobic digester sludge fed 5,300 mg of acetate per liter, 3.4 microM
      pentachlorophenol, and nutrients for 10 days biotransformed pentachlorophenol by
      sequential ortho dechlorinations to produce 2,3,4,5-tetrachlorophenol and 3,4,5
      trichlorophenol. Upon acclimation to 3.4 microM pentachlorophenol for 6 months,
      the methanogenic consortium removed chlorines from the ortho, meta, and para
      positions of pentachlorophenol and its reductive dechlorination products.
      Pentachlorophenol was degraded to produce 2,3,4,5-tetrachlorophenol, 2,3,4,6
      tetrachlorophenol, and 2,3,5,6-tetrachlorophenol. Dechlorination of 2,3,4,5
      tetrachlorophenol produced 3,4,5-trichlorophenol, which was subsequently degraded
      to produce 3,4-dichlorophenol and 3,5-dichlorophenol. 2,3,4,6-Tetrachlorophenol
      was dechlorinated at the ortho and meta positions to produce 2,4,6
      trichlorophenol and 2,4,5-trichlorophenol. 2,3,5,6-Tetrachlorophenol yielded
      2,3,5-trichlorophenol, followed by production of 3,5-dichlorophenol. 2,4,6
      Trichlorophenol was degraded to form 2,4-dichlorophenol, and 2,4,5
      trichlorophenol was dechlorinated at two positions to form 2,4-dichlorophenol and
      3,4-dichlorophenol. Of the three dichlorophenols produced (2,4-dichlorophenol,
      3,4-dichlorophenol, and 3,5-dichlorophenol), only 2,4-dichlorophenol was degraded
      significantly within 3 weeks, to produce 4-chlorophenol.

PMID- 1637166
TI  - Combined subtraction hybridization and polymerase chain reaction amplification
      procedure for isolation of strain-specific Rhizobium DNA sequences.
AB  - A novel subtraction hybridization procedure, incorporating a combination of four
      separation strategies, was developed to isolate unique DNA sequences from a
      strain of Rhizobium leguminosarum bv. trifolii. Sau3A-digested DNA from this
      strain, i.e., the probe strain, was ligated to a linker and hybridized in
      solution with an excess of pooled subtracter DNA from seven other strains of the
      same biovar which had been restricted, ligated to a different, biotinylated,
      subtracter-specific linker, and amplified by polymerase chain reaction to
      incorporate dUTP. Subtracter DNA and subtracter-probe hybrids were removed by
      phenol-chloroform extraction of a streptavidin-biotin-DNA complex. NENSORB
      chromatography of the sequences remaining in the aqueous layer captured
      biotinylated subtracter DNA which may have escaped removal by phenol-chloroform
      treatment. Any traces of contaminating subtracter DNA were removed by digestion
      with uracil DNA glycosylase. Finally, remaining sequences were amplified by
      polymerase chain reaction with a probe strain-specific primer, labelled with 32P,
      and tested for specificity in dot blot hybridizations against total genomic
      target DNA from each strain in the subtracter pool. Two rounds of subtraction
      amplification were sufficient to remove cross-hybridizing sequences and to give a
      probe which hybridized only with homologous target DNA. The method is applicable
      to the isolation of DNA and RNA sequences from both procaryotic and eucaryotic
      cells.

PMID- 1637167
TI  - Monoclonal antibody-colony immunoblot method specific for isolation of
      Pediococcus acidilactici from foods and correlation with pediocin (bacteriocin)
      production.
AB  - BALB/c mice were immunized with broken, heat-killed cells of Pediococcus
      acidilactici H. After murine cell fusions, one monoclonal antibody (MAb), Ped
      2B2, was selected on the basis of its positive reaction with seven of seven
      strains tested in an enzyme-linked immunosorbent assay with whole cells of P.
      acidilactici. The MAb Ped-2B2 did not show any cross-reactions with other lactic
      acid bacteria or other gram-positive or gram-negative organisms. Sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis and Western blot (immunoblot) analysis
      of surface proteins of P. acidilactici indicated that Ped-2B2 reacted with a
      protein of 116 kDa. MAb Ped-2B2 was used as a probe to isolate Pediococcus
      species from fermented-meat products by colony immunoblotting. A total of 18 Ped
      2B2-reactive Pediococcus spp. isolates were isolated from eight food samples and
      assayed for bacteriocin production. All of the isolates produced bacteriocins
      which were heat stable, proteinaceous, and inhibitory to Lactobacillus plantarum
      NCDO 955. Biochemical characterization of these isolates indicated that they were
      all P. acidilactici.

PMID- 1637168
TI  - Immunogold and fluorescein immunolabelling of Legionella pneumophila within an
      aquatic biofilm visualized by using episcopic differential interference contrast
      microscopy.
AB  - Biofilms containing diverse microflora were developed in tap water on glass and
      polybutylene surfaces. Legionella pneumophila within the biofilms was labelled
      with monoclonal antibodies and visualized with immunogold or fluorescein
      isothiocyanate conjugates. Development of a differential interference contrast
      technique in an episcopic mode enabled simultaneous visualization of the total
      biofilm flora and gold-labelled legionellae. The legionellae occurred in
      microcolonies within the biofilm in the absence of amoebae, suggesting that the
      bacterial consortium was supplying sufficient nutrients to enable legionellae to
      grow extracellularly within the biofilm.

PMID- 1637169
TI  - Vitamin B12-dependent propionate production by the ruminal bacterium Prevotella
      ruminicola 23.
AB  - When Prevotella ruminicola 23 was grown in a defined medium containing a vitamin
      mixture, significant amounts of propionate were formed. Succinate and acetate
      were the major fermentation acids produced when vitamins were omitted, and
      further experiments demonstrated that propionate formation was dependent on
      vitamin B12. When the organism was grown in continuous culture at dilution rates
      of less than 0.20 h-1, propionate and acetate were the predominant fermentation
      products and little succinate was formed when vitamin B12 was present. However,
      at higher dilution rates, propionate formation declined and succinate
      accumulated. Since cell protein yields were reduced 15 to 25% in the absence of
      vitamin B12, the pathway for propionate formation may contain an energy
      conserving step.

PMID- 1637170
TI  - Roles of arginine in growth of Clostridium botulinum Okra B.
AB  - Group I strains of Clostridium botulinum are known to degrade arginine by the
      arginine deiminase pathway. We have found that C. botulinum Okra B consumed a
      level of arginine (20 g/liter) higher than the basal requirement for growth (3
      g/liter). Arginine was probably the preferred source of nitrogen for biosynthesis
      but did not serve as a major source of energy. Citrulline and proline were
      produced as major fermentation products in media containing high levels of
      arginine, but in media with basal amounts of arginine these products were
      produced in lower quantities during growth and were later reassimilated. The
      results indicate that C. botulinum Okra B changes its metabolism during
      consumption of surplus arginine, and this change is associated with toxin
      repression, formation of citrulline and proline as end products, and possibly
      resistance to environmental stresses such as increased acidity and osmolarity.

PMID- 1637171
TI  - Changes in fatty acid branching and unsaturation of Streptomyces griseus and
      Brevibacterium fermentans as a response to growth temperature.
AB  - Streptomyces griseus showed three different modes of changing fatty acids in
      response to temperature change. In Brevibacterium fermentans, two such responses
      were found. The responses involved changes in fatty acid branching, unsaturation,
      or chain length, depending on growth temperature range. Changes in unsaturation
      of branched-chain acids were characteristic at low growth temperatures.

PMID- 1637172
TI  - Altered proteoglycan synthesis via the false acceptor pathway can be dissociated
      from beta-D-xyloside inhibition of proliferation.
AB  - beta-D-Xylosides have been used to perturb proteoglycan (PG) synthesis to
      elucidate the function of PGs in a number of cellular processes, including
      proliferation, migration, and differentiation. This study was designed to examine
      whether specific xylosides affect the proliferation of several different cell
      types and, if so, whether this effect is dependent on altered PG synthesis via
      the false acceptor pathway. Both methylumbelliferyl beta-D-xylopyranoside and p
      nitrophenyl beta-D-xylopyranoside (PNP beta-xyloside) inhibit cell proliferation
      and modulate PG synthesis; however, the alpha form of PNP xyloside which does not
      perturb PG synthesis inhibits the proliferation of cultured cells on a molar
      basis equally as well as the beta form. Conversely, beta-methyl xylopyranoside
      stimulates the synthesis of free glycosaminoglycan chains equally as well as PNP
      beta-xyloside and yet has no measurable effect on cell proliferation at
      comparable doses, indicating that cells can grow normally while experiencing
      disruption of their proteoglycan metabolism. At doses ranging from 0.5 to 5 mM,
      PNP beta-xyloside arrests cells in the G1 phase of the cell cycle at the same
      time point as serum starvation. It also delays the exist of cycling cells from
      the S phase. This treatment is not cytotoxic and is rapidly reversed by the
      replacement of PNP beta-xyloside containing medium with control medium. Dimethyl
      sulfoxide, the most commonly used solvent for beta-xyloside in proteoglycan
      studies, potentiates the inhibitory effect of PNP beta-xyloside on cell
      proliferation. These results indicate that the perturbation of PG synthesis via
      the false acceptor pathway can be uncoupled from control of cell proliferation.

PMID- 1637173
TI  - Mitochondrial damage and its role in causing hepatocyte injury during stimulation
      of lipid peroxidation by iron nitriloacetate.
AB  - Incubation of isolated rat hepatocytes with 0.1 mM iron nitrilotriacetic acid
      (FeNTA) caused a rapid rise in lipid peroxidation followed by a substantial
      increase in trypan blue staining and lactate dehydrogenase release, but did not
      affect the protein and non-protein thiol content of the cells. Hepatocyte death
      was preceded by the decline of mitochondrial membrane potential, as assayed by
      rhodamine 123 uptake, and by the depletion of cellular ATP. Chelation of
      extracellular Ca2+ by ethylene glycol bis(beta-aminoethyl ether) N,N'-tetraacetic
      acid or inhibition of Ca2+ cycling within the mitochondria by LaCl3 or
      cyclosporin A did not prevent the decline of rhodamine 123 uptake. On the other
      hand, a dramatic increase in the conjugated diene content was observed in
      mitochondria isolated from FeNTA-treated hepatocytes. Oxidative damage of
      mitochondria was accompanied by the leakage of matrix enzymes glutamic oxalacetic
      aminotransferase (GOT) and glutamate dehydrogenase (GLDH). The addition of the
      antioxidant N,N'-diphenylphenylene diamine (DPPD) completely prevented GOT and
      GLDH leakage, inhibition of rhodamine 123 uptake, and ATP depletion induced by
      FeNTA, indicating that Ca(2+)-independent alterations of mitochondrial membrane
      permeability consequent to lipid peroxidation were responsible for the loss of
      mitochondrial membrane potential. DPPD addition also protected against hepatocyte
      death. Similarly hepatocytes prepared from fed rats were found to be more
      resistant than those obtained from starved rats toward ATP depletion and cell
      death caused by FeNTA, in spite of undergoing a comparable mitochondrial injury.
      A similar protection was also observed following fructose supplementation of
      hepatocytes isolated from starved rats, indicating that the decline of ATP was
      critical for the development of FeNTA toxicity. From these results it was
      concluded that FeNTA-induced peroxidation of mitochondrial membranes impaired the
      electrochemical potential of these organelles and led to ATP depletion which was
      critical for the development of irreversible cell injury.

PMID- 1637174
TI  - Inhibition of glutathione transferase pi from human placenta by 1-chloro-2,4
      dinitrobenzene occurs because of covalent reaction with cysteine 47.
AB  - Human placenta glutathione transferase pi is irreversibly inhibited when
      incubated with 1-chloro-2,4-dinitrobenzene (CDNB) in the absence of the
      cosubstrate glutathione. The enzyme is protected against CDNB inactivation by the
      presence of S-methylglutathione and glutathione. The kinetics of inactivation is
      pseudo-first-order with k(obs) = 0.04 min-1 when 44 microM enzyme is incubated in
      presence of 1 mM CDNB at pH 6.5. The inhibition is saturable with respect to the
      CDNB concentration and the enzyme-CDNB complex shows a K(i) = 2.7 mM. Concomitant
      to the inhibition process is formation of an absorption band at 340 nm. After
      trypsin digestion and HPLC analysis, the CDNB-reacted enzyme gives a single
      peptide absorbing at 340 nm. Automated Edman degradation of this peptide
      indicates cysteine 47 to be the residue alkylated by CDNB.

PMID- 1637175
TI  - Plant sterol biosynthesis: novel potent and selective inhibitors of cytochrome
      P450-dependent obtusifoliol 14 alpha-methyl demethylase.
AB  - The R-(-) isomer of methyl 1-(2,2-dimethylindan-1-yl)imidazole-5-carboxylate (CGA
      214372; 2) strongly inhibited P450-dependent obtusifoliol 14 alpha-demethylase
      (P450OBT.14DM) (I50 = 8 x 10(-9) M, I50/Km = 5 x 10(-5) in a maize (Zea mays)
      microsomal preparation. Kinetic studies indicated uncompetitive inhibition with
      respect to obtusifoliol. The corresponding S-(+) isomer was a 20-fold weaker
      inhibitor for P450OBT.14DM. The molecular features of a variety of analogues of 2
      were related to their potency as inhibitors of P450OBT.14DM in vitro, allowing
      delineation of the key structural requirements governing inhibition of the
      demethylase. CGA 214372 proved to have a high degree of selectivity for
      P450OBT.14DM. This allowed easy distinction of this activity from other P450
      dependent activities present in the maize microsomal preparation and gave strong
      evidence that P450OBT.14DM is a herbicidal target. Microsomal maize P450OBT.14DM
      and yeast P450LAN.14DM, the only known examples of P450-dependent enzymes
      carrying out an identical metabolic function in different eukaryotes, showed
      distinct inhibition patterns with CGA 214372 and ketoconazole, a substituted
      imidazole anti-mycotic.

PMID- 1637176
TI  - Enantioselective inhibition of human leukocyte elastase.
AB  - (RS)-Diethyl-2-benzyl-succinate was resolved using alpha-chymotrypsin. The two
      enantiomers were then elaborated to yield (S)-(+) and (R)-(-)-3-benzyl-N-[(methyl
      sulfonyl)oxy]succinimide and the inhibitory activity of the two enantiomers
      toward human leukocyte elastase was subsequently determined. The k2/KI values for
      the R and S isomers were found to be 330 and 1500 M-1 s-1, respectively.

PMID- 1637177
TI  - Lipid peroxidation and its inhibition in low density lipoproteins: quenching of
      cis-parinaric acid fluorescence.
AB  - The fluorescent polyunsaturated parinaric acid incorporated in LDL particles is
      highly sensitive to the concentration of peroxyl radicals in the aqueous medium,
      undergoing rapidly oxidative degradation, as detected by a quenching of
      fluorescence, without delay after radical generation in solution. Ascorbate,
      cysteine, and urate suppress the parinaric acid fluorescence decay promoted by
      peroxyl radicals generated at a constant rate (thermal decomposition of 2,2'-azo
      bis(2-amidino-propane hydrochloride)) in a concentration-dependent manner. The
      chain-breaking efficiencies of these antioxidants are evaluated from the time
      interval (inhibition period) of parinaric acid protection from oxidative
      degradation. The results correlate with the inhibition periods of LDL oxidation
      as monitored by O2 consumption. Therefore, the sensitive and simple parinaric
      acid assay can be used as a semiquantitative screening test for the detection of
      potentially important water-soluble chain-breaking antioxidants. Conversely to O2
      consumption, the absence of any initial lag phase of probe degradation attests to
      the sensitivity of the assay. An improved methodology based on second-derivative
      spectroscopy to follow the formation of conjugated diene isomers directly in the
      preparation without the need for lipid extraction also confirms the sensitivity
      of this assay. To assess the usefulness of parinaric acid assay, strong chain
      breaking activities of caffeic and chlorogenic acids are reported.

PMID- 1637178
TI  - The heparin binding site of human extracellular-superoxide dismutase.
AB  - Extracellular-superoxide dismutase (EC-SOD) is a secretory glycoprotein that is
      major SOD isozyme in extracellular fluids. We revealed the possible structure of
      the carbohydrate chain of serum EC-SOD with the serial lectin affinity technique.
      The structure is a biantennary complex type with an internal fucose residue
      attached to asparagine-linked N-acetyl-D-glucosamine and with terminal sialic
      acid linked to N-acetyllactosamine. EC-SOD in plasma is heterogeneous with regard
      to heparin affinity and can be divided into three fractions: A, without affinity;
      B, with intermediate affinity; and C, with high affinity. It appeared that this
      heterogeneity is not dependent on the carbohydrate structure upon comparison of
      EC-SOD A, B, and C. No effect of the glycopeptidase F treatment of EC-SOD C on
      its heparin affinity supported the results. A previous report showed that both
      lysine and arginine residues probably at the C-terminal end, contribute to
      heparin binding. Recombinant EC-SOD C treated with trypsin or endoproteinase Lys
      C, which lost three lysine residues (Lys-211, Lys-212, and Lys-220) or one lysine
      residue (Lys-220) at the C-terminal end, had no or weak affinity for the heparin
      HPLC column, respectively. The proteinase-treated r-EC-SOD C also lost triple
      arginine residues which are adjacent to double lysine residues. These results
      suggest that the heparin-binding site may occur on a "cluster" of basic amino
      acids at the C-terminal end of EC-SOD C. EC-SOD is speculated to be primarily
      synthesized as type C, and types A and B are probably the result of secondary
      modifications. It appeared that the proteolytic cleavage of the exteriorized
      lysine- and arginine-rich C-terminal end in vivo is a more important contributory
      factor to the formation of EC-SOD B and/or EC-SOD A.

PMID- 1637179
TI  - The activity of pyruvate carrier in a reconstituted system: substrate specificity
      and inhibitor sensitivity.
AB  - The pyruvate carrier, of molecular mass 34 kDa, was purified from mitochondria
      isolated from rat liver, rat brain, and bovine heart, by affinity chromatography
      on immobilized 2-cyano-4-hydroxycinnamate. Its activity after reconstitution in
      phosphatidylcholine vesicles was measured either as uptake of [1-14C]pyruvate or
      as exchange with different 2-oxoacids. All preparations exhibited similar
      apparent Km values for pyruvate, but somewhat different V(max) values. The
      ability to exchange different anions of physiological significance, including
      branched-chain 2-oxoacids, confirmed the known substrate specificity described
      for the pyruvate carrier in mitochondria. The sensitivity of pyruvate transport
      toward phenylglyoxal suggested an important role of arginyl residues in the
      transport activity, while a role of lysyl and histidyl residues was not
      confirmed.

PMID- 1637180
TI  - beta-Carotene and alpha-tocopherol are synergistic antioxidants.
AB  - The possibility of a cooperative interaction between fat-soluble antioxidants is
      examined in a membrane model. A combination of beta-carotene and alpha-tocopherol
      results in an inhibition of lipid peroxidation significantly greater than the sum
      of the individual inhibitions. Our data provide the first evidence that beta
      carotene can act synergistically with alpha-tocopherol as an effective radical
      trapping antioxidant in membranes.

PMID- 1637181
TI  - Modulation of calmodulin levels, calmodulin methylation, and calmodulin binding
      proteins during carrot cell growth and embryogenesis.
AB  - Carrot cell cultures were used to study the dynamics of calmodulin protein
      levels, calmodulin methylation, and calmodulin-binding proteins during plant
      growth and development. Comparisons of proliferating and nonproliferating wild
      carrot cells show that, while calmodulin protein levels does not vary
      significantly, substantial variation in post-translational methylation of
      calmodulin on lysine-115 is observed. Calmodulin methylation is low during the
      lag and early exponential stages, but increases substantially as exponential
      growth proceeds and becomes maximal in the postexponential phase. Unmethylated
      calmodulin quickly reappears within 12 h of reinoculation of cells into fresh
      media, suggesting that the process is regulated according to the cell growth
      state. Calmodulin and calmodulin-binding proteins were also analyzed during the
      formation and germination of domestic carrot embryos in culture. Neither
      calmodulin methylation nor calmodulin protein levels varied significantly during
      somatic embryogenesis. However, upon germination of embryos, the level of
      calmodulin protein doubled. By calmodulin overlay analysis, we have detected a
      major 54,000 M(r) calmodulin-binding protein that also increased during embryo
      germination. This protein was purified from carrot embryo extracts by calmodulin
      Sepharose chromatography. Overall, the data suggest that calmodulin methylation
      is regulated depending upon the state of cell growth and that calmodulin and its
      target proteins are modulated during early plant development.

PMID- 1637182
TI  - Modification of acidic residues normalizes sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis of caldesmon and other proteins that migrate anomalously.
AB  - Caldesmon migrates as a 140-kDa protein during polyacrylamide gel electrophoresis
      in the presence of sodium dodecyl sulfate (SDS), although its true molecular mass
      is close to 90 kDa. Since caldesmon's high acidic residue content may be
      responsible for this anomaly, it was reasoned that modification of these
      residues, with a loss of negative charge, might restore normal electrophoretic
      migration. Therefore caldesmon was reacted with 1-ethyl-3-(3
      dimethylaminopropyl)carbodiimide in the presence of excess ethanolamine, which
      results in negatively charged carboxylates being converted to neutral amides
      without protein cross-linking. The absence of cross-linking was shown by rotary
      shadow electron microscopy. In accord with expectations, modified caldesmon
      migrated as a 94-kDa protein when compared to standards, which were much less
      affected by modification. The anomalous migration of caldesmon might be due to
      the repulsion of negatively charged SDS by caldesmon's acidic residues. Low
      binding of SDS to caldesmon is consistent with the fact that SDS, up to 1%, had
      little or no effect on the secondary structure of caldesmon, as monitored by
      circular dichroism. However, other mechanisms can also explain these
      observations. The abnormal migration of tropomyosin and calsequestrin, both of
      which have a high percentage of acidic amino acids, was also "normalized" by this
      treatment. Thus this method might have general application for the
      electrophoresis of proteins which have a high acidic residue content and migrate
      anomalously.

PMID- 1637183
TI  - Variability in the G3 domain content of bovine aggrecan from cartilage extracts
      and chondrocyte cultures.
AB  - The content of the globular domains G1, G2 and G3 on the core protein of high
      density (A1D1) aggrecan isolated from newborn and mature bovine cartilage and
      from cultures of bovine chondrocytes was examined. Quantitation based on the 220
      nm absorbance of tryptic marker peptides from each domain isolated by reversed
      phase HPLC showed that while the content of G1 and G2 was essentially the same
      for all samples, the content of G3 varied markedly. The molar yield of G3 and G1
      marker peptides indicated that approximately 55% of the G1-bearing aggrecan from
      immature cartilage carried the G3 domain, while for mature cartilage this figure
      was markedly reduced, at about 35%. Aggrecan prepared from the cell layer matrix
      of calf chondrocyte cultures had an apparent G3 content similar to newborn
      cartilage (55%), whereas aggrecan prepared from the medium of these cultures had
      a markedly higher G3 content, at about 80%. The high content of G3 in cell medium
      samples compared to cartilage extracts was supported by electron microscopic
      analysis of A1D1 preparations. The G3 content of the two subpopulations of
      aggrecan present in mature cartilage and separable by flat bed agarose gel
      electrophoresis was also determined at about 45% (Band I) and 20% (Band II)
      respectively. These results are discussed in terms of the likely origin of the
      marked variability in the G3 domain content of aggrecan.

PMID- 1637184
TI  - Baculovirus expression and characterization of catalytically active horseradish
      peroxidase.
AB  - Studies of horseradish peroxidase (HRP), a prototypical enzyme, have provided
      much of the information that is available on the mechanisms and functions of
      hemoprotein peroxidases. HRP itself is widely used in biotechnological
      applications. Further progress in defining the structure and function of the
      enzyme, however, requires its expression in a heterologous system. We report here
      baculovirus-mediated, high yield expression of a synthetic gene for HRP in
      Spodoptera frugiperda cell culture. Expression of the soluble, glycosylated
      protein requires the 5'-leader sequence of the native gene. Recombinant
      horseradish peroxidase reacts with H2O2 to give compound I, II, and III spectra
      and a guaiacol oxidation activity, identical to those of the native enzyme. The
      integrity of the recombinant active site is confirmed by NMR spectroscopy and by
      catalytic reaction with ethylhydrazine to give a stabilized isoporphyrin that
      decays exclusively to delta-meso-ethylheme. Furthermore, thioanisoles are
      oxidized by recombinant and native HRP with the same enantiomeric specificity.
      HRP expressed in a baculovirus system, despite probable differences in
      glycosylation, is essentially identical to the native enzyme.

PMID- 1637185
TI  - Site-directed mutagenesis of glutathione S-transferase YaYa: functional studies
      of histidine, cysteine, and tryptophan mutants.
AB  - The rat cytosolic glutathione S-transferase Ya subunit contains three histidine
      residues (at positions 8, 143, and 159), two cysteine residues (at positions 18
      and 112), and a single tryptophan residue (at position 21). Histidine, cysteine,
      and tryptophan have been proposed to be present either near or at the active site
      of other glutathione S-transferase subunits. The functional role of these amino
      acids at each of the positions was evaluated by site-directed mutagenesis in
      which valine or asparagine, alanine, and phenylalanine were substituted for
      histidine, cysteine, and tryptophan, respectively. Mutant enzymes H8V, H143V,
      H159N, C112A, and W21F retained either full or better catalytic efficiencies
      (k(cat)/Km) toward 1-chloro-2,4-dinitrobenzene and glutathione. Lower but
      significant k(cat)/Km values were observed for H159V and C18A toward 1-chloro-2,4
      dinitrobenzene. Some mutants displayed different thermal stabilities and
      intrinsic fluorescence intensities, but all retained the ability to bind heme.
      These results indicate that histidine, cysteine, and tryptophan in the
      glutathione S-transferase Ya subunit are not essential for catalysis nor are they
      involved in the binding of heme to the YaYa homodimer.

PMID- 1637186
TI  - The purification and physicochemical characterization of maize (Zea mays L.)
      isocitrate lyase.
AB  - A purification scheme is described for the glyoxylate cycle enzyme isocitrate
      lyase from maize scutella. Purification involves an acetone precipitation and a
      heat denaturation step, followed by ammonium sulfate precipitation and
      chromatography on DEAE-cellulose and on blue-Sepharose. The latter step results
      in the removal of the remaining malate dehydrogenase activity, and of a high
      molecular mass (62 kDa) but inactive degradation product of isocitrate lyase.
      Catalase can be completely removed by performing the DEAE-cellulose
      chromatography in the presence of Triton X-100. Pure isocitrate lyase can be
      stored without appreciable loss of activity at -70 degrees C in 5 mM
      triethanolamine buffer containing 6 mM MgCl2, 7 mM 2-mercaptoethanol, and 50%
      (v/v) glycerol, pH 7.6. Maize isocitrate lyase is a tetrameric protein with a
      subunit molecular mass of 64 kDa. Purity of the enzyme preparation was
      demonstrated by polyacrylamide gel electrophoresis in the presence of
      dodecylsulfate, in acid (pH 3.2) urea and by isoelectric focusing (pI = 5.1).
      Maize isocitrate lyase is devoid of covalently linked sugar residues. From
      circular dichroism measurements we estimate that its structure comprises 30%
      alpha-helical and 15% beta-pleated sheet segments. The enzyme requires Mg2+ ions
      for activity, and only Mn2+ apparently is able to replace this cation to a
      certain extent. The kinetics of the isocitrate lyase-catalyzed cleavage reaction
      were investigated, and the amino acid composition of the maize enzyme was
      determined. Finally the occurrence of an association between maize isocitrate
      lyase and catalase was observed. Such a multienzyme complex may be postulated to
      play a protective role in vivo.

PMID- 1637187
TI  - The influence of endogenous acyl-acyl carrier protein concentrations on fatty
      acid compositions of chloroplast glycerolipids.
AB  - The concentrations of long-chain acyl-acyl carrier proteins (acyl-ACP) occurring
      during fatty acid synthesis from [1-14C]acetate within chloroplasts isolated from
      spinach, pea, and amaranthus leaves were manipulated by making minor changes to a
      basal incubation medium containing sn-glycerol 3-phosphate (G3P). Pools of oleoyl
      , stearoyl-, and palmitoyl-ACP were compared with those of the corresponding 1
      acyl glycerol 3-phosphates to determine how endogenous acyl-ACP concentrations
      affected the fatty acid compositions of chloroplast glycerolipids. The 1-acyl G3P
      synthesized by isolated chloroplasts contained more palmitate than would be
      expected for the precursor of thylakoid phosphatidylglycerol in the different
      plant species. However, treatments which increased ratios of oleoyl- to palmitoyl
      ACP by about 50% increased synthesis of sn-1-oleoyl G3P to the extent anticipated
      from known fatty acid compositions of the different phosphatidylglycerols. Since
      stearate constituted 70-73% of the acyl-ACP and 48-51% of the 1-acyl-G3P pool of
      spinach and pea chloroplasts incubated in the presence of cyanide, it is
      transferred to G3P much more efficiently in situ than would be predicted from
      competition studies using mixtures of acyl donors and purified acyltransferases.
      Increasing concentrations of G3P in incubation media from 0.1 to 2 mM had
      relatively little effect on the amounts and proportions of acyl-ACPs but forced
      the synthesis of palmitoyl-G3P and, ultimately, disaturated glycerolipid. It is
      concluded that the chloroplast G3P acyltransferases are primarily responsible for
      determining the fatty acid compositions of procaryotic glycerolipids in plants,
      but that acyl-ACP concentrations may play a more important role than would be
      anticipated from the kinetics of the purified enzyme. However, those kinetics may
      be quite complex; allosteric effectors may influence the affinities of the enzyme
      for oleoyl-ACP and for G3P.

PMID- 1637188
TI  - Endrin-induced increases in hepatic lipid peroxidation, membrane microviscosity,
      and DNA damage in rats.
AB  - Endrin is a polyhalogenated cyclic hydrocarbon pesticide which produces hepatic
      and neurologic toxicity. Previous studies have indicated that endrin induces
      hepatic lipid peroxidation. In order to further assess the possible role of lipid
      peroxidation in the toxicity of endrin, the dose- and time-dependent effects of
      endrin on hepatic lipid peroxidation, membrane microviscosity and DNA damage in
      rats were examined. Rats were treated with 0, 3.0, 4.5, or 6.0 mg endrin/kg as a
      single oral dose in corn oil, and the animals were killed 0, 12, 24, 48, or 72 h
      post-treatment. Dose-dependent increases in hepatic mitochondrial and microsomal
      lipid peroxidation and microviscosity as well as nuclear DNA single strand breaks
      were observed as early as 12 h post-treatment. Maximum increases in these three
      parameters occurred 24 h after endrin administration at all three doses. While
      the incidence in DNA damage decreased with time after 24 h, the incidence of
      lipid peroxidation and microviscosity of microsomal and mitochondrial membranes
      remained relatively constant. Dose- and time-dependent increases in liver and
      spleen weight/body weight ratios with decreases in thymus weight/body weight
      ratios were observed. The data indicate that endrin administration induces
      hepatic lipid peroxidation which may be responsible for the increased membrane
      microviscosity as a result of membrane damage as well as enhanced DNA damage.

PMID- 1637189
TI  - Trace element distribution in growing feathers: additional excretion in feather
      sheaths.
AB  - The use of feathers is a non-invasive and repeatable method for biomonitoring
      trace element levels in birds and their ecosystems. Trace element levels were
      examined in different parts of growing flight feathers from young common terns
      (Sterna hirundo) to determine distribution of heavy metals and selenium,
      potential bias from using partially grown feathers, and whether additional heavy
      metals and selenium are excreted in feather sheaths that are sloughed before
      feathers are usually sampled. Lead and mercury levels were significantly higher
      in the distal fully formed portion of the growing feather (with no residual blood
      supply) compared to the proximal, growing portion of the feather with a residual
      blood supply, but no significant differences were evident for cadmium and
      selenium. These results suggest that using partially grown feathers
      underestimates the amount of lead and mercury in fully formed feathers and that
      higher levels of lead and mercury are sequestered in feathers than are present in
      the blood at any one time. Significantly higher concentrations of lead and
      cadmium, and significantly lower levels of mercury were in the sheath compared to
      the whole feather blade. These data suggest that birds excrete more lead and
      cadmium during molt than previously thought.

PMID- 1637190
TI  - Cadmium and mercury in emergent mayflies (Hexagenia bilineata) from the upper
      Mississippi River.
AB  - Burrowing mayflies (Hexagenia bilineata) were analyzed to assess longitudinal
      patterns in their cadmium and mercury content along the upper Mississippi River.
      Emergent mayflies (subimagoes and imagoes) were collected in 1988 at 34 sites (25
      navigation pools), extending 1260 km from Little Falls, Minnesota, downstream to
      St. Louis, Missouri. Cadmium concentrations in composite samples of whole
      mayflies ranged from 7 to 219 ng/g dry weight in females and from less than 7 to
      265 ng/g in males. Cadmium concentrations were highest (greater than or equal to
      150 ng/g) in samples from Pools 2 and 3 (downstream from the Twin Cities
      metropolitan area), 15 (near the Quad Cities metropolitan area), and 27 (near the
      St. Louis metropolitan area). Cadmium concentrations in female mayflies decreased
      significantly with distance downstream from Pool 2 at river mile 825 to Pool 9 at
      river mile 648, paralleling spatial trends in the cadmium contamination of
      sediments in the reach downstream from the Twin Cities metropolitan area,
      reported in earlier studies; cadmium burdens in mayflies followed a similar
      spatial trend. Concentrations of mercury were much less variable, ranging from 44
      to 102 ng/g dry weight in female mayflies and from 60 to 177 ng/g in males;
      concentrations and burdens were highest in mayflies collected at Pools 2, 20, 22,
      25, and 27. Mercury concentrations in females decreased significantly with
      distance downstream from Pool 2 at river mile 825 to Pool 5A at river mile 728.5.
      Concentrations of mercury and cadmium in composite samples of female mayflies
      were not correlated, indicating dissimilar longitudinal patterns in
      concentrations of the two metals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637191
TI  - Chronic renal effects in three studies of men and women occupationally exposed to
      cadmium.
AB  - We measured sensitive indicators of renal damage in three different populations
      occupationally exposed to cadmium, and examined the degree of variation in damage
      and the relative sensitivity of different types of indicators. The three studies
      included (1) men exposed in a cadmium recovery plant, (2) men exposed in a
      nickel/cadmium battery plant, and (3) women exposed in the latter plant. The
      indicators of renal damage were urinary proteins in three categories: (1) the
      high molecular weight enzymes alanine aminopeptidase (AAP) and N-acetyl-beta-D
      glucosaminidase (NAG), (2) the intermediate molecular weight protein albumin
      (ALB), and (3) the low molecular weight proteins retinol-binding protein (RBP)
      and beta 2-microglobulin (B2M). These tests indicate that exposed groups with
      higher urine cadmium levels had varying degrees of renal damage. All exposed
      groups showed evidence of renal damage when compared with their respective
      control groups. A higher percentage of elevated protein levels was noted in the
      exposed group of Study 1 than in the exposed groups of Studies 2 and 3. In Study
      1, the means of all five protein levels and ALB, RBP, and B2M fractional
      clearances were significantly elevated in the group with higher urine cadmium
      concentrations when compared with the groups with lower urine cadmium
      concentrations. Highly significant dose-response relationships for all of the
      urinary protein tests, including fractional clearances, were found. All of the
      tests were more sensitive in detecting evidence of subclinical renal damage than
      serum creatinine, a commonly used indicator of renal function. The order of test
      sensitivity in men was determined by considering three factors: (1) the magnitude
      of the correlation coefficient between the test and the urine cadmium
      concentration in the study with the most advanced damage, (2) the relative
      cadmium level predicted by the dose-response model at which there is a 10% chance
      of observing an elevated test value, and (3) the ability of the tests to detect
      renal effects in the population with less advanced damage. The tests in order of
      decreasing sensitivity in men are ALB, AAP, NAG, RBP approximately B2M. The women
      with higher urine cadmium levels in Study 3 had a higher percentage of elevated
      AAP and NAG values when compared with the control group.

PMID- 1637192
TI  - Mitotic toxicity, sister chromatid exchange, and rec assay of pesticides.
AB  - Genotoxicity of 10 pesticides (chlornitrofen, chlomethoxyfen, molinate,
      thiobencarb, simazine, simetryn, diazinon, iprofenfos, piperofos and oxadiazone)
      was studied by mitotic toxicity, sister chromatid exchange, and rec assay. The
      pesticides are detected frequently at high levels in the Yodo River water in
      Osaka, Japan, which is used for drinking water by thirteen million people.
      Mitotic toxicity was evaluated by mitotic index (MI) and second mitosis index
      (SI), using a Chinese hamster cell line V79. SI is the rate of twice divided
      metaphases in chromosome preparation for sister chromatid exchange. All the
      pesticides decreased the two indices dose-dependently. MI50 and SI50, the
      concentrations of pesticides which lowered the indices to 50% of the solvent
      control, was determined. The MI50 and SI50 of each pesticide were very similar,
      and the pesticides did not hinder cell division specifically. None of the
      pesticides induced more sister chromatid exchanges than 1.5 times the solvent
      control. Chlomethoxyfen and simazine induced sister chromatid exchanges
      significantly in V79 cells, but the dose dependencies were poor. Simetryn had rec
      effect and was concluded to have DNA damaging activity.

PMID- 1637193
TI  - A method for the trace analysis of naptalam (N-1-naphthylphthalamic acid) in
      water.
AB  - A method for the trace analysis of naptalam, N-1-naphthylphthalamic acid, in
      water is presented. Naptalam, a pre-emergent, broad-leaf, and grassy herbicide,
      is used with soybean, peanut, and vine crops. Tap and well water samples are
      extracted on a cyclohexyl solid phase extraction cartridge, eluted from the
      cartridge with methanol, and evaporated to dryness. The sample is esterified with
      diazoethane, evaporated to dryness, reconstituted with methanol, and converted to
      the stable N-1-naphthyl phthalimide in the gas chromatograph (GC) injector port
      for detection and quantitation using a nitrogen-phosphorus detector. Sample
      injection technique and injector port temperature are critical to high
      derivatization yields. Confirmation of conversion to N-1-naphthyl phthalimide was
      made by gas chromatograph/mass spectrometer (GC/MS). Spiking tests at levels of 3
      to 100 micrograms/L showed good recovery.

PMID- 1637194
TI  - An outbreak of a food-related illness resembling boric acid poisoning.
AB  - An outbreak of an illness suggestive of boric acid poisoning occurred among 51
      persons who had eaten lunch at the cafeteria of the United States Agency for
      International Development in Islamabad, Pakistan, on February 11, 1990. Affected
      patients had headache and severe myalgias 2 to 4 hours after eating lunch. Fever,
      nausea and vomiting, red eyes, and photophobia were also reported. Among 25
      patients (49%), a sunburn-like inflammation of the skin of the face developed,
      which subsequently desquamated. One patient required hospitalization for 1 day
      because of dehydration. Among all patients, the only symptoms remaining 72 hours
      after the meal were mild headache, fatigue, and peeling skin. Those persons who
      became ill were more likely to have eaten one particular food item (minestrone
      soup) for lunch than were those who did not become ill. A similar illness has
      been described following ingestion of boric acid. However, the results of an
      analysis of serum samples collected 3 days after the lunch from 24 patients did
      not show boron above normal background levels. Because of boron's short half
      life, however, these data do not rule out the possibility that patients may have
      had higher boron levels at the onset of the illness.

PMID- 1637195
TI  - Bioassay-directed chemical characterization of genotoxic agents in the dissolved
      and particulate water phases of the Besos and Llobregat Rivers (Barcelona,
      Spain).
AB  - Particulate (greater than 0.22 microns) and dissolved phases of water
      concentrates (600 mL) of Llobregat and Besos Rivers (Barcelona, Spain), were
      tested in the Salmonella/microsome assay, tester strains TA98 and TA100. Most of
      them showed significant mutagenic activity. However, independently of the
      application of exogenous metabolic activation, the dimethylsulfoxide extracts of
      the particulate matter exhibited a stronger mutagenic activity than the dissolved
      phase. This indicated that both rivers are chronically polluted by frameshift and
      base-pair substitution mutagens and promutagens. In order to investigate their
      identity, a bioassay-directed column chromatography fractionation of the base
      neutrals isolated from the dissolved and particulate phases of Besos river water
      (7 L) was carried out. The mutagenic activity (TA98) was higher in presence of S9
      and was recovered in the more polar fractions, where several mutagenic agents
      were identified by capillary GC-MS in the negative ion chemical ionization mode
      (NICI). Among them, o-tolidine, nitroquinoline, nitroaniline, dichlorobenzidine
      and several aromatic quinones were candidates for fraction mutagenicity.

PMID- 1637196
TI  - Characteristic trend of persistent organochlorine contamination in wildlife from
      a tropical agricultural watershed, south India.
AB  - The residue levels of persistent organochlorines, such as HCH (BHC: 1,2,3,4,5,6
      hexachlorocyclohexane) isomers, DDT [1,1,1-trichloro-2,2-bis (p-chlorophenyl)
      ethane] compounds, PCBs (polychlorobiphenyls) and HCB (hexachlorobenzene), were
      measured in wildlife. The wildlife were sampled from terrestrial and aquatic
      habitats in and around the agricultural watershed of Parangipettai, South India.
      On the basis of overall concentrations sigma HCH ranked first followed by sigma
      DDT, sigma PCB and HCB, reflecting the increasing usage of HCH in recent years in
      India. The residue levels of organochlorines in birds varied according to their
      feeding habits and showed the following pattern: inland piscivores and scavengers
      greater than coastal piscivores greater than insectivores greater than omnivores
      greater than granivores. High levels of HCH and DDT residues were recorded in
      Pond heron and Cattle egret which feed in the agricultural fields. Comparison of
      HCH concentrations in fish and birds in the study area to other locations was
      made to further understand the dynamics of contaminant accumulation in tropical
      wildlife. Regarding birds, a wide variation in residue levels could be seen among
      various countries, with tropical regions registering high levels. In contrast,
      the variation is not prominent in the case of fish. The residue levels in fish
      measured in the present study were generally comparable to values reported from
      other locations. This suggests that the bioavailability of contaminants to the
      aquatic fauna is less due to the smaller flux and shorter residence time of these
      chemicals in the tropics.

PMID- 1637197
TI  - A mass spectroscopic method for analysis of AHH-inducing and other
      polychlorinated biphenyl congeners and selected pesticides in fish.
AB  - The 209 polychlorinated biphenyl (PCB) congeners exhibit a wide range in toxicity
      to fish, birds, and mammals. This paper discusses the use of gas
      chromatography/mass spectrometry negative chemical ionization (GC/MS-NCI) to
      quantify congeners of highly suspected toxicity such as IUPAC #77 (3,3',4,4'
      tetrachlorobiphenyl) and #126 (3,3',4,4',5-pentachlorobiphenyl). GC/MS analysis
      time needed to produce the necessary resolution was reduced to 1 h per sample or
      standard, allowing an autosampler to inject 12 samples in 24 hours, plus 12
      standards/QC samples. Identification and quantification of some 60+ congeners and
      several selected pesticides and estimation of total PCBs are also possible within
      the 1 h analysis. For congeners of high chlorination (penta through octa), the
      method exhibited excellent sensitivity, such that we could not locate a fish
      which exhibited PCB levels below our calibrated quantitation range. NCI was not
      as sensitive for mono through tri and for some tetrachlorinated PCB congeners, an
      exception being PCB #77, for which sensitivity was of the same order as for the
      more highly chlorinated biphenyls. Long term stability was excellent. Over a 6-mo
      period, results of replicate analyses for PCB congeners and pesticides in a
      composited sample of lake trout (Salvelinus namaycush) from Lake Michigan had a
      relative standard deviation of 12% of the mean. Over the same time period, mean
      recoveries for samples spiked at concentrations similar to those in Lake Michigan
      lake trout were 90-102%. Response was linear over a wide range of concentrations
      for each of the analyzed compounds. This method is now being used for routine
      analysis of PCB congeners and selected pesticides in our laboratory.

PMID- 1637198
TI  - Variability in organochlorine analysis in fish: an interlaboratory study and its
      implications for environmental monitoring and regulatory standards.
AB  - Samples of muscle, from four types of fish, that had been spiked at 0.25 and 1.0
      mg/kg with hexachlorobenzene (HCB), gamma BHC (lindane), technical chlordane,
      p,p'-DDT, p,p'-DDE and p,p'-DDD were analyzed by eight laboratories. Some
      laboratories could not reliably detect organochlorine compounds even though they
      were registered as national testing laboratories. The analytical accuracies of
      laboratories that were able to reliably detect the spiked compounds were very
      variable and exceeded acceptable limits. Within-laboratory precision was
      generally acceptable. There was significant interlaboratory variability among the
      estimates of percent lipid for each fish type. This variability negated the use
      of percent lipid for standardization of organochlorine concentrations for
      comparison between studies. The results highlight the need for standard
      analytical protocols that are regularly tested by interlaboratory studies. They
      also indicate that interchangeability of data between studies is limited due to
      low analytical accuracy. Therefore, comparison of analytical data to absolute
      environmental and regulatory standards is difficult. The use of "latitudinal
      confidence ranges" when setting regulatory standards is recommended.

PMID- 1637199
TI  - Differential sensitivity of Dugesia dorotocephala and Cheumatopsyche pettiti to
      water acidification: ecological implication for predator-prey interactions.
AB  - The initial hypothesis that predation pressure should decrease with decreasing pH
      in aquatic macrobenthic communities if predatory invertebrates are more sensitive
      to water acidification than prey invertebrates is tested. Short-term toxicity
      bioassays were conducted in soft water (average value of total hardness 38.0 mg
      CaCO3/L) to determine the differential sensitivity of the predator, Dugesia
      dorotocephala (Turbellaria, Tricladida), and the prey, larvae of Cheumatopsyche
      pettiti (Insecta, Trichoptera), to low pH. Test pH solutions were prepared with
      sulfuric acid (H2SO4). Test species were also exposed to high concentrations of
      sulfate ion (95 mg SO4 =/L for D. dorotocephala and 340 mg SO4 =/L for C.
      pettiti) as sulfate toxicity controls, using potassium sulfate (K2SO4). No
      mortality was observed during these toxicity controls, indicating that toxic
      effects generated by low pH were fundamentally due to H+ ions. The 72 and 96-h
      LC50s (as pH values) and their 95% confidence limits were 4.88 (4.72-5.05) and
      5.04 (4.89-5.21) for D. dorotocephala, and 3.25 (3.00-3.51) and 3.48 (3.24-3.73)
      for C. pettiti. Net-spinning caddis-fly larvae migrated from their retreat nets
      and protruded their anal papillae before dying. After short-term bioassays,
      predation-pressure laboratory experiments were performed for 6 days. The
      cumulative mortality of C. pettiti by predation of D. dorotocephala decreased
      with decreasing sublethal pH values. The average predation rates at mean pH
      values of 7.7, 7.7, 6.6, 6.5, 6.2 and 6.0 were 2.5, 2.0, 1.33, 1.17, 0.67 and
      0.33 larvae/day, respectively. The major biotic factor affecting predation
      pressure appears to be the reduction in the physiological activity of triclads at
      low pH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637200
TI  - Inhibition of binding of thyroxin to transthyretin by outdoor and indoor airborne
      particulate matter and effects on thyroid hormone and vitamin A metabolism in
      rats.
AB  - Previous studies have indicated that chemicals, e.g., hydroxylated
      polychlorinated biphenyls (PCBs) decrease plasma thyroxin levels through
      interaction with transthyretin. As a consequence, plasma vitamin A and thyroxin
      are depleted. Both thyroxin and vitamin A are important regulators of normal
      epithelial differentiation and proliferation and might act in the promotion phase
      of carcinogenesis. In the present report, extracts of indoor and outdoor airborne
      particulate matter (APM), originating from different pollution sources, were
      tested for a possible interaction in vitro and in vivo with thyroxin and vitamin
      A. Results indicated that all APM extracts significantly interfered with thyroxin
      binding to transthyretin. In all cases, the more polluted samples inhibited
      binding more than the corresponding control samples. Exposure of rats to a
      cigarette smoke extract induced clear changes in plasma thyroxin and
      triiodothyronin hormone levels. Triiodothyronin levels were reduced most. Effects
      on plasma vitamin A levels were also found, but these were less clear. In
      addition a decrease in lung vitamin A levels was found, but this decrease was not
      statistically significant. Exposure of rats to an outdoor APM extract induced
      significant changes in plasma triiodothyronin levels. Effects on thyroxin levels
      were not significant, although the same trend was seen as for the cigarette smoke
      APM extract. No changes in plasma or liver vitamin A concentrations were induced
      by the outdoor APM extract. Lung vitamin A levels were decreased, but again this
      decrease was not statistically significant. Taken together, the present report
      shows that APM extracts have the potency to interfere with thyroid hormone
      metabolism both in vitro and in vivo and probably with vitamin A metabolism as
      well.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637201
TI  - The effect of environmental pH on sodium balance in the red-spotted newt,
      Notophthalmus viridescens.
AB  - Sodium influx and efflux of the red-spotted newt, Notophthalmus viridescens, at
      two pHs were investigated in efts and adults in water and on land. The sodium
      efflux rate constant was not affected by pH. Efflux was generally greater under
      aquatic than terrestrial conditions, and for efts than for adults. In an aquatic
      setting, both adults and efts were able to maintain sodium balance at pH 5, but
      exhibited net sodium loss at pH 3. Sodium influx was greater in efts at pH 5 than
      in any other group. Adults in all treatments lost mass during the experiment,
      while efts in all treatments were able to maintain body mass. In their normal
      terrestrial environment, red efts probably avoid substantial sodium fluxes by
      maintaining a hydrophobic skin, which decreases contact with soil solutions.

PMID- 1637202
TI  - Laundering as decontamination of apparel fabrics: residues of pesticides from six
      chemical classes.
AB  - Research on reducing the level of pesticide residue on a textile substrate has
      examined many variables under many different conditions. This study controlled
      fiber type and the use of prewash product in an examination of residue levels for
      a number of pesticides in different pesticide classes. For all pesticides
      examined, the use of prewash lowered pesticide residues regardless of fiber type.
      Differences in pesticide residue level attributable to fiber type were not
      consistent.

PMID- 1637203
TI  - Acute toxicity, percutaneous absorption and effects on hepatic mixed function
      oxidase activities of 2,4,4'-trichloro-2'-hydroxydiphenyl ether (Irgasan DP300)
      and its chlorinated derivatives.
AB  - Acute toxicity of 2,4,4'-trichloro-2'-hydroxydiphenyl ether (Irgasan DP300) (I)
      and its three chlorinated derivatives, 2',3,4,4'-tetrachloro-2-hydroxydiphenyl
      ether (II), 2',4,4',5-tetrachloro-2-hydroxydiphenyl ether (III) and 2',3,4,4',5
      pentachloro-2-hydroxydiphenyl ether (IV), in mice were examined by
      intraperitoneal injection. The LD50 values of Irgasan DP300, II, III and IV were
      1,090, 710, 650 and 430 mg/kg, respectively. The percutaneous absorptions of
      these tritiated compounds were also examined by the application on the backs of
      mice. The radioactivities in most tissues reached to the maximal levels at 12 h
      or 18 h after dosing, which corresponded to 11-76% of the maximal levels given by
      the oral administration (Kanetoshi et al. 1988a). These results show the high
      percutaneous absorbability of Irgasan DP300 and its chlorinated derivatives. The
      intraperitoneal administrations of III and IV to rats induced hepatic microsomal
      aminopyrine N-demethylase and aniline 4-hydroxylase activities similarly to
      phenobarbital. These chlorinated derivatives also increased cytochrome P-450
      content, and the activities of aminopyrine N-demethylase and N-methylaniline N
      demethylase in hepatic microsomes from mice. The extents of the increases were
      similar to those by phenobarbital and 3-methylcholanthrene.

PMID- 1637204
TI  - Serum esterase inhibition in birds: a nondestructive biomarker to assess
      organophosphorus and carbamate contamination.
AB  - With the aim of proposing a nondestructive biomarker for monitoring the
      toxicological risk to birds of exposure to the organophosphorus insecticide
      azamethiphos and the carbamate insecticide methomyl, laboratory studies were
      performed on serum "B" esterases in Japanese quail (Coturnix coturnix japonica).
      The birds received two single dose treatments of each compound (azamethiphos and
      methomyl), i.e., 50 mg/kg and 250 mg/kg respectively. In the first treatment,
      serum butyrylcholinesterase (BChE) and carboxylesterase (CbE) were drastically
      inhibited in the azamethiphos-treated group, 24 h after the dose. No inhibition
      was detected for BChE and CbE activities in the methomyl-treated group, 24 h
      after the dose. In the second treatment, the birds died or were sacrificed 3 h
      after the dose. Serum BChE and brain acetylcholinesterase (AChE) were strongly
      inhibited after treatment with both insecticides. Serum CbE, hepatic microsomal
      CbE and 7-ethoxyresorufin dealkylation activities were also inhibited. A
      statistically significant correlation between serum BChE and brain AChE was found
      at lethal and sublethal doses of these xenobiotics. The experimental results
      indicate that the nondestructive biomarker BChE can give an early qualitative and
      semi-quantitative warning of the toxic effects of organophosphate and carbamate
      insecticides in birds.

PMID- 1637205
TI  - Herbert Sloan Lecture. The international cardiothoracic surgeon.

PMID- 1637206
TI  - Barrett's esophagus with high-grade dysplasia: an indication for esophagectomy?
AB  - Between 1982 and 1991, 19 patients (17 men and 2 women) with Barrett's esophagus,
      10 of whom were in a surveillance program, were found to have high-grade
      dysplasia without evidence of invasive carcinoma. Median age was 66 years (range,
      30 to 79 years). Heartburn was the most common presenting symptom. Esophagoscopy
      at the time of high-grade dysplasia diagnosis demonstrated normal Barrett's
      mucosa in 10 patients (53%), shallow ulcers in 3, slight mucosal irregularities
      in 2, small mucosal nodules in 2, stricture in 1, and shallow ulcer with
      stricture in 1. Eighteen patients underwent esophagectomy. There were no
      operative deaths. Nine patients (50%) had invasive carcinoma. Postsurgical stage
      was stage 0 in 9 patients, stage I in 6, stage IIA in 2, and stage IIB in 1.
      Median follow-up was 34 months (range, 2 to 116 months). Recurrent cancer
      developed in 2 patients. Overall 5-year survival was 66.7%; 5-year survival for
      patients with stage 0 disease was 100% and for stage I and II disease, 35.7%. We
      conclude that high-grade dysplasia in an indication for esophageal resection
      because of the high rate of associated early invasive carcinoma and that
      resection can be done safely with the expectation of excellent long-term
      survival. Because of these findings, we continue to recommend endoscopic
      surveillance in all patients with Barrett's esophagus.

PMID- 1637207
TI  - Treatment of AIDS-related bronchopleural fistula by pleurectomy.
AB  - Spontaneous pneumothorax in patients with acquired immunodeficiency syndrome
      (AIDS) may require prolonged therapy for treatment of a persistent bronchopleural
      fistula, and treatment by standard methods often fails. This pilot study was done
      to test the effectiveness of aggressive surgical therapy for definitive treatment
      of persistent bronchopleural fistula in patients with AIDS. Between March 1989
      and September 1991, 44 patients with AIDS were treated for spontaneous
      pneumothorax with closed tube thoracostomy; 14 of these patients had development
      of persistent bronchopleural fistula for more than 10 days, and 2 patients had
      subsequent bronchopleural fistula on the opposite side. Operative therapy in 14
      patients included 15 thoracotomies and one sternotomy. The bronchopleural fistula
      was closed directly with suture or staples in 15 procedures and resected by
      lobectomy in 1 patient. All 14 patients received adjuvant parietal pleurectomy.
      Operative mortality was 7% (1 of 14 patients). The fistula was closed in all
      survivors and 13 patients were discharged between 7 and 28 days postoperatively.
      Pathologic examination confirmed Pneumocystis carinii in 13 patients with a high
      incidence of diffuse involvement and subpleural necrosis, further demonstrating
      the need for pleurectomy. These data suggest that in selected patients
      bronchopleural fistulas associated with AIDS can be effectively controlled by
      surgical closure combined with pleurectomy.

PMID- 1637208
TI  - Pediatric lung transplantation for pulmonary hypertension and congenital heart
      disease.
AB  - Five children underwent lung transplantation for end-stage pulmonary hypertension
      and respiratory insufficiency associated with congenital heart disease. One (17
      mo) had pulmonary hypertension with a patent ductus arteriosus and required two
      periods of preoperative extracorporeal membrane oxygenation before successful
      bilateral sequential lung transplantation. One (21 mo) required bilateral lung
      transplantation for pulmonary hypertension and bronchopulmonary dysplasia
      associated with iatrogenic injury to the left pulmonary artery. This child also
      had patent ductus arteriosus ligation and preoperative catheter closure of an
      atrial septal defect. Extracorporeal membrane oxygenation was required for early
      postoperative pulmonary support. One child underwent right single-lung
      transplantation and closure of an atrial septal defect for pulmonary
      hypertension. Two patients had single-lung transplantation for Eisenmenger's
      syndrome: 1 with muscular inlet ventricular septal defect closure, atrial septal
      defect closure, and right single-lung transplantation; 1 with ventricular septal
      defect closure, patent ductus arteriosus ligation, right ventricular outflow
      tract patch repair, and single-lung transplantation. All patients survived
      operation, with one late death (lymphoproliferative disease). The 4 survivors are
      all ambulatory without oxygen and have evidence of normal pulmonary artery
      pressure 9 to 12 months after transplantation.

PMID- 1637209
TI  - Primary bony and cartilaginous sarcomas of chest wall: results of therapy.
AB  - Primary bony and cartilaginous sarcomas of the chest wall are uncommon, and data
      concerning treatment and results are sparse. To assess the results of therapy, we
      reviewed our 40-year experience. Records of 38 patients with osteosarcoma and 88
      with chondrosarcoma arising in chest wall admitted to Memorial Sloan-Kettering
      Cancer Center from 1949 to 1989 were reviewed. The 88 patients with
      chondrosarcoma ranged in age from 5 to 86 years (median age, 49 years); the
      male/female ratio was 1.3:1. Presenting complaint was mass, pain, or both in 93%.
      Primary therapy was resection (n = 84), radiation therapy (n = 3), or
      chemotherapy (n = 1). Overall 5-year survival was 64%. Significant adverse
      prognostic factors included metastases at initial presentation (n = 9),
      metastases at any time during the course of disease (n = 23), age greater than 50
      years (n = 42), incomplete or no resection (n = 13), and local recurrence (n =
      24). Sex, grade, and tumor size were not prognostic factors. The 38 patients with
      osteosarcoma ranged in age from 11 to 78 years (median age, 42 years); the
      male/female ratio was 1.5:1. Presenting complaint was mass, pain, or both in 95%.
      Primary therapy included resection (n = 31; alone in 13, with radiation therapy
      in 3, with chemotherapy in 15), radiation therapy (n = 3), radiation therapy and
      chemotherapy (n = 2), chemotherapy (n = 1), or no treatment (n = 1). Overall 5
      year survival was 15%. Significant adverse prognostic factors included presence
      of synchronous metastases (n = 13) and metastases at any time during the course
      of disease (n = 26).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637210
TI  - Prolonged open sternotomy and delayed sternal closure after cardiac operations.
AB  - Maintenance of an open sternotomy (OS) after a complicated cardiac operation is
      an adjunct in the treatment of the severely impaired heart. We hypothesized that
      predictors of the timing, morbidity, and prognosis of delayed sternal closure
      (DSC) could be determined by intensive case review. Prolonged OS was used in 107
      of 6,030 adult open heart patients (1.8%) between 1987 and 1991. Indications for
      OS were hemodynamic instability (40), myocardial edema (18), intractable bleeding
      (23), relentless arrhythmias (9), and ventricular assist devices (17). Delayed
      sternal closure was carried out in 75 of 107 patients at a mean of 3.4 +/- 0.3
      days after OS. Fifty of these 75 (67%) survived and were discharged an average of
      43 +/- 6 days after closure. Fifty-seven patients died: 32 before DSC at 3.7 +/-
      0.8 days after OS and 25 after DSC at 27 +/- 4 days after OS. Baseline cardiac
      index (1.7 +/- 0.1 L.min-1.m-2) improved an average of 1.0 +/- 0.1 L.min-1.m-2
      after OS (p less than or equal to 0.001) and remained stable through DSC (2.5 +/-
      0.3 L.min-1.m-2) and late (9 +/- 0.7 days) follow-up (2.8 +/- 0.1 L.min-1.m-2).
      Delayed sternal closure in patients without ventricular assist devices was
      significantly more likely to be successful (45/63 versus 9/27; p less than 0.002)
      when carried out after the onset of a negative daily fluid balance. Sternal
      infection occurred in 4 of 75 (5%) patients after DSC and was associated with
      bleeding as an indication for OS (3/15 versus 1/60; p less than 0.02).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1637211
TI  - A staged expanding pulmonary artery band.
AB  - Pulmonary artery banding is indicated in numerous congenital cardiac defects not
      amenable to a total repair. One complication of pulmonary artery banding,
      especially in neonates who require early banding, is progressive cyanosis during
      the rapid growth phase requiring earlier than anticipated total correction, which
      may produce a less than optimal result. A simple pulmonary artery band that
      enlarges as the patient grows would avoid this early complication. We report a
      technique of pulmonary artery banding in an animal model using different
      absorbable sutures. The band enlarges in a prescribed staged fashion without any
      further intervention, hopefully allowing growth of neonates and infants with
      complex congenital heart disease.

PMID- 1637212
TI  - Long-term survival after resection of pulmonary metastases from carcinoma of the
      breast.
AB  - Resection of isolated pulmonary metastases may yield improved survival in select
      patients. Between 1981 and 1991, 44 women (median age, 55 years) with a history
      of breast cancer underwent 47 thoracotomies with no operative deaths and only
      three minor postoperative complications (3/47, 6.4%). Confirmation of the
      metastatic origin of the lung lesion was made by direct histological comparison
      with the primary. Three patients had benign nodules and were excluded, and 4
      patients had less than complete resection at thoracotomy. The median survival
      after thoracotomy of the remaining 37 patients with completely resected
      metastases was 47 +/- 5.5 months, and their actuarial 5-year survival was 49.5%.
      Patients with a disease-free interval of longer than 12 months had a longer
      survival (median survival, 82 +/- 6 months; 5-year survival, 57%) than patients
      with a disease-free interval of 12 months or less (median survival, 15 +/- 3.6
      months; 5-year survival, 0%) (p = 0.004). Patients with estrogen receptor
      positive status (n = 14) tended to have longer survival after resection than
      patients with estrogen receptor-negative status (n = 15) (median survival, 81 +/-
      9 months versus 23 +/- 6 months, respectively; p = 0.098). Other clinical
      variables analyzed did not predict survival after thoracotomy. We conclude that
      resection of pulmonary metastases in patients with breast cancer can be done
      safely and may result in long-term survival for a substantial number of patients.
      Patients with a disease-free interval of longer than 12 months have an excellent
      prognosis after complete resection.

PMID- 1637213
TI  - Thallium imaging in preoperative evaluation of the pulmonary resection candidate.
AB  - The major determinants of morbidity and mortality after pulmonary resection are
      the physiologic status of the cardiac and pulmonary systems. The role of thallium
      201 imaging was reviewed in 151 consecutive patients to determine its
      significance in physiologic assessment. 10.3% of patients were found to have
      serious asymptomatic coronary artery disease, and thallium imaging made a
      difference in the management of 50% of these patients. When used appropriately,
      thallium imaging is an important modality in physiologic assessment of the
      pulmonary resection candidate.

PMID- 1637214
TI  - Hypothermic thoracic and thoracoabdominal aneurysm operation: a central
      cannulation technique.
AB  - Surgical resection of the descending thoracic and thoracoabdominal aorta is
      associated with the risk of spinal cord ischemic injury, particularly in patients
      with aortic dissection. Hypothermic total cardiopulmonary bypass with periods of
      circulatory arrest has been advocated for spinal cord protection with encouraging
      early results. However, techniques for this procedure are relatively complex. An
      alternative cannulation technique with venous return from the right atrium
      through the internal jugular vein and arterial return to the aortic arch is
      described. This has been used in 6 patients for replacement of the descending
      thoracic or thoracoabdominal aorta. Despite profound hypothermia and preservation
      of the principal spinal radicular artery, 1 patient suffered early paraparesis
      with some recovery but eventually died of multisystem failure. A second elderly
      patient with severe obstructive airways disease died of respiratory failure 11
      days postoperatively. Four patients made a good recovery including 1 with a
      ruptured thoracoabdominal aneurysm who subsequently required gut resection for
      ischemic necrosis present preoperatively. This cannulation technique together
      with profound hypothermia has greatly improved the operating conditions for
      extensive aneurysms of the thoracoabdominal aorta. Paraparesis occurring despite
      hypothermic protection and attempted preservation of the spinal cord arterial
      supply suggests that unfavorable vascular anatomy still predominates in the risk
      factors for ischemic injury.

PMID- 1637215
TI  - Glucose and insulin supply before cardiopulmonary bypass in cardiac surgery: a
      double-blind study.
AB  - A double-blind study versus placebo was carried out to evaluate the effects of a
      500-mL infusion of 30% glucose containing 300 units of ordinary insulin and 5 g
      of potassium chloride administered at a rate of 1.66 mL.kg-1.h-1 for 1 hour
      before cardiopulmonary bypass. The hemodynamic parameters measured before and
      after administration of the solution, after cardiopulmonary bypass, after
      administration of protamine, and 3 hours after leaving the operating room showed
      the beneficial effect of the glucose-insulin-potassium infusion on cardiac index
      (+23.6% after protamine infusion) and left (+16.3% 3 hours postoperatively) and
      right (+47.3% after cardiopulmonary bypass) ventricular workload index with a
      decrease in systemic vascular resistance. For patients with a cardiac index of
      less than 2.5 L.min-1.m-2 before administration of the glucose-insulin-potassium
      solution, the beneficial effect on the cardiac index was further increased 3
      hours postoperatively (+33%). During the postoperative period, the requirements
      in inotropic drugs and disturbances of rhythm were not significantly different
      between the two groups, although they were twofold lower in patients receiving
      glucose-insulin-potassium. Laboratory tests showed that postoperative
      hypoglycemia was more common in the glucose-insulin-potassium group but had no
      detrimental effects; it no longer occurs since we began administering the glucose
      infusion at 15 g/h over 8 hours. The data reflect the beneficial effect
      associated with the action of glucose-insulin-potassium on myocardial protection
      during heart operations and were confirmed by the hemodynamic results. This
      argues in favor of the routine use of this technique, especially in patients with
      poor ventricular function.

PMID- 1637216
TI  - Morphology of the posterior junctional area in atrioventricular septal defects.
AB  - The location and size of the coronary sinus in hearts with atrioventricular
      septal defect were investigated in relation to the known disposition of the
      atrioventricular conduction axis. We examined the morphology in 40 hearts and
      supplemented this series with two other hearts that had been serially sectioned
      previously. The coronary sinus received drainage from a persistent left superior
      caval vein in 5 hearts. Six cases of 40 had malalignment of the septal structures
      relative to the crux of the heart. In these, the conduction axis was anticipated
      to course in the position where the inlet ventricular septum met the
      atrioventricular junction. The coronary sinus terminated in the left atrium in 4
      hearts: 2 in the morphological series and 2 that were sectioned for histological
      studies. The sectioned hearts showed the atrioventricular conduction axis in the
      usual position for the defect, unrelated to the coronary sinus. The principle
      that the node and penetrating bundle are located at the intersection of the
      ventricular septum with the atrioventricular junction holds good despite the
      variability of the coronary sinus.

PMID- 1637217
TI  - Long-term follow-up results after reconstruction of the mitral valve by leaflet
      advancement.
AB  - In this study, we discuss the clinical results of mitral leaflet advancement
      performed on 29 patients over the past 10 years and attempt to determine the
      indication. Preoperative diagnosis of mitral valve lesion consisted of mitral
      regurgitation in 21 patients and mitral stenosis in 8 patients. Mitral valve
      repair was applied to the anterior mitral leaflet in 2, the posterior mitral
      leaflet in 25, and bilateral leaflets in 2 patients. Reoperation was performed on
      13 patients, and 1 patient died of renal failure immediately after reoperation.
      No reoperation was needed for 96.6% of the patients at 1 year, 89.5% at 5 years,
      75.0% at 8 years, 63.8% at 10 years, and 52.6% at 15 years postoperatively. At
      reoperation, the repaired mitral leaflet was found to be calcified in 3 patients
      more than 9 years after the initial operation. Of the 12 survivors without
      reoperation, mitral stenosis associated with regurgitation was obvious in 6
      patients. Of the 21 patients with preoperative mitral regurgitation, 90.0% showed
      no deterioration at 5 years, 79.7% at 8 years, and 69.1% at 10 years. On the
      other hand, for the 8 patients with mitral stenosis, the rates were 87.5% at 1
      year, 62.5% at 5 years, 50.0% at 8 years, and 25% at 10 years. Our results
      suggest that mitral leaflet advancement shows satisfactory results in patients
      with mitral regurgitation but is not successful for patients with mitral stenosis
      in the long term because the repaired valve tends to be stenotic in the late
      postoperative period.

PMID- 1637218
TI  - Successful treatment of postoperative chylothorax using an external
      pleuroperitoneal shunt.
AB  - We report 3 patients with chylothorax who were successfully managed as
      outpatients using external pleuroperitoneal shunts. This external shunt has the
      advantage over subcutaneously placed shunts of pumping large volumes of fluid
      with each compression of the pumping chamber, of not causing the discomfort
      associated with pumping a subcutaneous chamber, of not becoming difficult to find
      in the subcutaneous space, and of being constructed of larger components which do
      not kink or become easily clogged with fibrinous debris.

PMID- 1637219
TI  - Thoracic aortic operations in patients aged 70 years or older.
AB  - Thirty-one patients over the age of 70 years (group A) and 72 patients less than
      69 years (group B) underwent a variety of thoracic aortic surgical procedures.
      Early and long-term results and cerebral function were compared between the two
      groups. Preoperative and postoperative cerebral function was evaluated using mini
      mental state-Himeji and Wechsler adult intelligence scale tests. The operative
      mortality of groups A and B was 12.9% and 11.1%, respectively (not significant).
      There were no significant differences in postoperative complications between the
      two groups. The late mortality rates of groups A and B were 11.1% and 9.3%,
      respectively (not significant). There were no significant differences between the
      two groups in the mini mental state-Himeji test, digit symbol, vocabulary, and
      total Wechsler adult intelligence scale scores before and after operation. We
      conclude that thoracic aortic surgical procedures in patients over 70 years of
      age can be performed with acceptable mortality and morbidity risks. Most patients
      showed symptomatic improvement.

PMID- 1637220
TI  - Long-term results of the Ivalon baffle mitral valve repair.
AB  - In the evolution of mitral valve surgery, Ivalon sponge was sutured to the
      posterior leaflet of the mitral valve to obtain competency. Between August 1959
      and October 1962, 18 patients had this procedure. All patients were discharged
      home. Three patients were lost to follow-up 5 to 10 years after operation. Valve
      replacement was necessary in 7 patients 10.4 +/- 8.5 years after repair.
      Bacterial endocarditis causing late death occurred in 5 patients within 4 years.
      Five embolic episodes occurred. The estimated probability of survival and need
      for valve replacement at 28 years were 29.2% +/- 12.3% and 12.4% +/- 6.7%,
      respectively.

PMID- 1637221
TI  - Pulmonary torsion: a questionnaire survey and a survey of the literature.
AB  - Pulmonary torsion is a rare but life-threatening complication of thoracic
      operations and trauma. A questionnaire was sent to 140 thoracic surgeons in the
      United Kingdom to examine its incidence, particularly torsion of the middle lobe
      after right upper lobectomy. The answers from 117 thoracic surgeons (84%) were
      collected and analyzed. Thirty-five responders (30%) had seen one or more cases
      of pulmonary torsion. The majority of cases occurred after pulmonary resection,
      and most of these instances involved middle lobe torsion after right upper
      lobectomy. In total, 39 cases were reported; 1 (3%) occurred spontaneously in an
      azygos lobe, 2 (5%) were seen after trauma, 28 (72%) were seen after pulmonary
      resections and 8 (21%), after other procedures. In this group of responders, 27
      (77%) routinely fix the middle lobe to the remaining lobe after right upper or
      lower lobectomy, upper lobe fixation being required only if the transverse
      fissure is well developed. Of the 82 responders who had never seen instances of
      pulmonary torsion, only 47 (57%) routinely do this fixation.

PMID- 1637222
TI  - Concomitant cardiac and pulmonary operation: the role of cardiopulmonary bypass.
AB  - To assess the safety and efficacy of concomitant pulmonary resection and cardiac
      operation requiring cardiopulmonary bypass, the records of 19 patients were
      reviewed. Eighteen patients (94.7%) presented with cardiac symptoms and were
      found to have pulmonary pathology of indeterminate etiology. Pulmonary resections
      were performed through a median sternotomy in all but 1 patient, who underwent
      posterolateral thoracotomy and right middle lobectomy after repositioning because
      dense adhesions prevented adequate dissection through the initial incision. A
      total of 24 resections were performed. Sixteen (66.7%) were performed on
      cardiopulmonary bypass. Six wedge resections (25.0%) were performed before
      bypass. Two lobectomies (8.3%) were performed after infusion of protamine
      sulfate. Nine patients (47.4%) had benign pathology, 7 (36.8%) had primary
      carcinoma, and 3 (15.8%) had metastatic disease. Bleeding complications occurred
      in 15.8% of patients (3/19). There was 1 perioperative death (5.3%), which was
      due to adult respiratory distress syndrome after intraoperative hemorrhage
      followed lobectomy for bullous disease. Another patient required lateral
      extension of the sternotomy during an episode of exsanguinating intraparenchymal
      pulmonary hemorrhage, which resulted in lobectomy, as well as costochondral and
      sternal osteomyelitis. A third patient required exploration for bleeding at the
      staple line. Postoperative complications occurred in 7 patients (36.8%) and were
      predominantly respiratory (5/7, 71.4%) (p = 0.006). The median postoperative
      hospitalization was 15 days. Although comparison of patients who underwent
      pulmonary resection during bypass with those who had resection either before
      heparinization or after protamine infusion showed no significant difference with
      respect to age, incidence of malignancy, operation performed, complications,
      postoperative hospitalization, or survival, this was probably due to the small
      number of patients in the study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637223
TI  - Open lung biopsy for diffuse infiltrative lung disease.
AB  - The purpose of this study was to determine the most appropriate site of biopsy in
      patients with diffuse infiltrative lung disease (DILD). Twenty patients were
      evaluated. During open lung biopsy, a representative region (inflamed and least
      fibrotic) of the radiographically most involved lobe was identified and a biopsy
      done. A second biopsy specimen was obtained from an adjacent accessible lobe. The
      biopsy specimen from each lobe was processed separately, and a descriptive
      histologic report was generated for each of the two lobes. Tissue was cultured
      for bacteria, fungi, and mycobacteria. In 17 patients, the second biopsy site had
      fewer roentgenographic abnormalities than the radiographically most involved
      lobe. In 3 patients, the number of radiographic abnormalities was equal in all
      lobes. The same pathologic diagnosis was reached by histologic examination of the
      two biopsy specimens in 8 of 10 patients with acute DILD and in 10 of 10 patients
      with chronic DILD. In 2 patients, the biopsy specimen from the radiographically
      most involved lobe showed pathologic features not seen in the other specimen.
      Cultures from both biopsy specimens were grown separately in 6 patients. Fungi (n
      = 2) and bacteria (n = 1) were isolated from the radiographically most involved
      lobe (n = 2) or from the lobe of initial lung infiltration (n = 1) in 3 patients.
      When biopsy specimens are obtained from a representative region of the
      radiographically most involved lobe in patients with DILD, biopsy of other lobes
      is unnecessary.

PMID- 1637224
TI  - Acute severe postischemic myocardial depression reversed by triiodothyronine.
AB  - The purpose of this study was to determine the effects of triiodothyronine (T3)
      on postischemic left ventricular performance and high-energy phosphate content in
      a severe injury model. Isolated working rat hearts (n = 63) received 20 mL of
      hyperkalemic NIH No. 1 cardioplegia and were subjected to 20 minutes of ischemia
      at 37 degrees C. Treated hearts were reperfused with T3-supplemented modified
      Krebs-Henseleit buffer. Control hearts did not receive T3 supplementation. All
      treated hearts (n = 44) performed work after ischemia, whereas 26% (5/19) of the
      control hearts were not able to perform any left ventricular work after ischemia.
      Comparisons with preischemic values demonstrated significant progressive
      hemodynamic recovery with increasing concentrations of T3 (0, 0.06, 0.15, and
      0.60 ng/mL) with concomitant recovery of left ventricular stroke work index (63%,
      72%, 89% [p less than 0.05], and 99% [p less than 0.05], respectively). There
      were corresponding increases in recovery of aortic flow, systolic pressure,
      cardiac index, and stroke volume index (p less than 0.05). There were no
      significant changes in coronary sinus flow or heart rate in any group compared
      with preischemic values. Comparisons of postischemic high-energy phosphate
      concentrations also demonstrated no change between treated and untreated groups
      (p greater than 0.05). We conclude that administration of T3 in a severe left
      ventricular injury model significantly augments rapid ventricular recovery with
      no change in postischemic high-energy phosphate concentrations.

PMID- 1637225
TI  - Accessory atrioventricular node and bundle: a cause of antidromic reentry
      tachycardia.
AB  - Two patients are described with antidromic reentry tachycardia successfully
      treated by interruption of an anterior septal accessory atrioventricular node and
      bundle. This anomalous connection resembles an atrioventricular conduction sling
      seen in complex congenital heart malformations. It has atrioventricular node-like
      properties, is located in the anterior septal area, will only conduct antegrade,
      and has an insulated connection to the right bundle branch. Rather than
      nodoventricular, nodofascicular, atriofascicular, or Mahaim, a more appropriate
      label for the connection is accessory atrioventricular node and bundle.

PMID- 1637226
TI  - Adjuvant radiotherapy after complete resection of thymoma.
AB  - Seventy patients were studied after undergoing complete resection of thymoma to
      determine the effect of postoperative adjuvant mediastinal radiotherapy on
      prognosis, with regard to clinical stage, histological type, and pleural factor.
      Pleural factor was defined as follows: p0, no adhesion to the mediastinal pleura;
      p1, fibrous adhesion to the mediastinal pleura without microscopic invasion; and
      p2, microscopic invasion of the mediastinal pleura. Recurrence of thymoma after
      complete resection was observed in 13 patients, 12 (92%) with pleural
      dissemination, 6 (46%) with local recurrence, and 2 (15%) with distant metastasis
      (types of recurrence are overlapping). In stage I and stage II p0 patients, no
      recurrence was observed, regardless of mediastinal radiotherapy. Whereas
      mediastinal irradiation completely prevented recurrence in stage II p1 patients,
      4 (36.4%) nonirradiated stage II p1 patients experienced recurrence. In stage II
      p2 patients, 75% had pleural dissemination even after radiotherapy. A high
      incidence of recurrence was also observed in stage III, nonirradiated (25%) and
      irradiated (30%) patients. The results suggest that mediastinal irradiation for
      stage I and II p0 patients is not always necessary, and that therapy for stage II
      p1 is essential and also expected to decrease the recurrence rate. On the other
      hand, in stage II p2 and stage III thymomas, mediastinal irradiation is not
      sufficient to prevent pleural recurrence even after complete resection. Our
      classification based on pleural factor is useful for better selection of
      appropriate postoperative treatment for thymoma patients.

PMID- 1637227
TI  - Skeletal muscle ventricles as left atrial-aortic pumps: short-term studies.
AB  - In 5 dogs, skeletal muscle ventricles (SMVs) were constructed from the latissimus
      dorsi muscle and placed in the left hemithorax. After a 3-week vascular delay
      period, SMVs were electrically preconditioned with 2-Hz stimulation for 6 weeks.
      At a second operation, SMVs were connected between the left atrium and thoracic
      aorta by afferent and efferent aortic root homografts, and stimulated to contract
      in a 1:2 diastolic mode. At a mean left atrial pressure of 12.4 +/- 1.3 mm Hg and
      a burst stimulation frequency of 33 Hz, SMV stroke volume was initially 43% of
      that of the native left ventricle, achieving a flow equivalent to 21% of cardiac
      output (194 +/- 38 versus 902 +/- 85 mL/min). At 50-Hz stimulation, this figure
      rose to 27% (246 +/- 41 mL/min; p less than 0.05). Skeletal muscle ventricle
      power output (the product of stroke work and contraction rate) at 33 Hz was 0.016
      +/- 0.003 W, increasing to 0.024 +/- 0.004 W at 50 Hz (p less than 0.05),
      corresponding to 14% and 22%, respectively, of left ventricular power output
      (0.11 +/- 0.012 W). After 4 hours of continuous pumping, four of the SMVs were
      still generating flows of more than 70% of starting values and more than 60% of
      initial power output. This study demonstrates that SMVs can function in the
      systemic circulation at physiologic left atrial preloads.

PMID- 1637228
TI  - Isolated extracardiac unruptured sinus of Valsalva aneurysms.
AB  - Reports concerning unruptured, isolated aneurysms of one sinus of Valsalva are
      rare. These aneurysms usually protrude inside the heart and are very rarely
      extracardiac. We report 4 cases of isolated, unruptured extracardiac aneurysms of
      the noncoronary sinus of Valsalva. Clinical symptoms were nonspecific. Operation
      was performed by patch reconstruction of the dilated aortic sinus without
      replacement of the ascending aorta. Microscopic examination of the diseased
      aortic wall revealed absence of medial elastic fibers. Late follow-up in all 4
      cases revealed a normal ascending aorta with no dilatation of the aortic root and
      no aortic regurgitation.

PMID- 1637229
TI  - Heterotopic heart transplantation and recipient heart operation in ischemic heart
      disease.
AB  - The role of heterotopic heart transplantation in coronary heart disease has not
      been defined. Between 1983 and 1988, 28 patients with end-stage ischemic heart
      disease were managed by heterotopic heart transplantation and adjunctive
      operation on the recipient heart: coronary artery bypass grafts and
      aneurysmectomy, 20; coronary artery bypass grafts, 5; and aneurysmectomy, 3.
      Indications were feasibility of operative procedures to the recipient heart and
      small donor size (61% of the donors were less than 15 years). The 1-year and 5
      year actuarial survival was 79% and 63%. Of the 22 patients who survived to 2
      year follow-up, all of whom had been severely limited (New York Heart Association
      grade III/IV) preoperatively, 20 were in grades I or II at 2-year follow-up (p
      less than 0.001). In 14 of 22 patients (64%), the recipient heart augmented the
      donor cardiac output substantially, and in 4 the recipient heart supported the
      patient when the donor heart failed to eject. In conclusion, this series
      demonstrates the efficacy of heterotopic transplantation combined with operation
      to the recipient heart in the management of patients with end-stage ischemic
      heart disease.

PMID- 1637230
TI  - Surgical treatment for ectopic atrial tachycardia.
AB  - Atrial tachycardia is an infrequent but potentially dangerous arrhythmia which
      often determines cardiac enlargement. Surgical ablation of the arrhythmia is
      effective and safe, provided a careful atrial mapping is performed and the
      surgical technique is tailored to the individual focus location. Eight patients
      underwent surgical ablation of ectopic atrial tachycardia between 1977 and 1990.
      Different techniques were adopted for each patient according to the anatomical
      location of the focus and possibly associated arrhythmias. Whenever possible, a
      closed heart procedure was chosen. In 1 patient a double focal origin was found
      and treated by separate procedures. In 1 patient with ostium secundum atrial
      septal defect and atrial flutter, surgical isolation of the right appendage and
      the ectopic focus was performed. In all patients ectopic atrial tachycardia was
      ablated with maintenance of the sinoatrial and atrioventricular nodal function as
      well as internodal conduction. In follow-up up to December 1991, no recurrency
      was recorded.

PMID- 1637231
TI  - Optimal level of hypothermia for prolonged myocardial protection assessed by 31P
      nuclear magnetic resonance.
AB  - The optimal level of hypothermia during myocardial preservation for cardiac
      transplantation is not known. Phosphorus 31 nuclear magnetic resonance
      spectroscopy was used to assess the effect of different preservation temperatures
      (15 degrees C in group 1, 4 degrees C in group 2) on the myocardial high-energy
      phosphate profiles during prolonged global ischemia and subsequent reperfusion of
      isolated rat hearts. Adenosine triphosphate depletion during ischemia was more
      gradual in group 2, leading to significant differences in myocardial adenosine
      triphosphate concentrations between the two groups after 3 hours of ischemia. The
      fall in intracellular pH during ischemia was significantly less pronounced in
      hearts preserved at 4 degrees C as compared with those at 15 degrees C. The
      postischemic recovery of both the left ventricular peak systolic pressure and the
      maximum rate of increase of left ventricular pressure was enhanced in group 2,
      although the ischemic period was 3 hours longer than in group 1. Hypothermia at 4
      degrees C as compared with 15 degrees C appears to prolong myocardial protection
      with respect to adenosine triphosphate preservation, prevention of the fall in
      intracellular pH, and the enhancement of postischemic hemodynamic recovery.

PMID- 1637232
TI  - Tricuspid valve obstruction caused by plasmacytoma metastasis.
AB  - A patient undergoing resection of a solid, right-sided intracardiac plasmacytoma
      metastasis causing severe dyspnea and tricuspid valve obstruction is reported. A
      review of the literature verified the rarity of this clinical finding.

PMID- 1637233
TI  - Bilateral adrenal hemorrhage after an open heart operation.
AB  - Bilateral adrenal hemorrhage and acute adrenal insufficiency were diagnosed after
      coronary bypass grafting in a 65-year-old man. The symptoms were nonspecific and
      easily mistaken for other postoperative complications. Diagnosis was based on
      finding of adrenal hemorrhage on computed tomogram and confirmed biochemically
      with an adrenal stimulation test. Corticosteroid therapy was curative.

PMID- 1637234
TI  - Combined maze procedure and septal myectomy in a septuagenarian.
AB  - A 75-year-old woman with refractory paroxysmal atrial fibrillation and
      hypertrophic obstructive cardiomyopathy underwent a successful combined maze
      procedure and septal myectomy. Postoperative episodes of atrial fibrillation and
      flutter occurred only during periods of bradyarrhythmia and did not recur with
      atrial inhibited pacing.

PMID- 1637235
TI  - Tracheoesophageal fistula after chemotherapy for lymphoma.
AB  - We present a case of tracheoesophageal fistula that occurred after chemotherapy
      for stage IV B Hodgkin's lymphoma. We outline our surgical management of the case
      and advocate the use of a single-stage repair in selected cases.

PMID- 1637236
TI  - Congenital aortic stenosis and patent ductus arteriosus in the adult.
AB  - Concurrent aortic stenosis and patent ductus arteriosus are not infrequent in
      children but are rare in adults. An adult case is described with diagnosis by
      cardiac catheterization and magnetic resonance imaging and with management by
      combined aortic valve replacement and patent ductus ligation. Review of the
      English-language literature produced only 8 such cases in adults, 2 of which were
      managed by a single-stage operation. Successful diagnosis in the adult requires
      careful observation at cardiac catheterization, and simultaneous valve
      replacement and ductus ligation may be a useful option in patient management.

PMID- 1637237
TI  - Extracardiac total cavopulmonary connection.
AB  - We report the case of a 6-year-old child who underwent definitive conversion to
      the Fontan circulation using a newly conceived operative technique. This new
      procedure allows the operation to be performed as a totally extracardiac
      operation and is based on the hydrodynamic principles of the total cavopulmonary
      connection.

PMID- 1637239
TI  - Approach for insertion of aortic composite valve grafts.
AB  - The usual methods for the reattachment of the coronary ostia to the ascending
      aortic conduit have several disadvantages and potential complications. A novel,
      straight-forward technique is described that allows for tension-free anastomoses
      to be constructed with minimal risk of blood loss and a reduced risk of
      reoperation for false aneurysms at the anastomoses.

PMID- 1637238
TI  - Safe intraaortic balloon pump placement through the ascending aorta using
      transesophageal ultrasound.
AB  - Intraaortic balloon pumping salvages a substantial number of patients who fail to
      be weaned from cardiopulmonary bypass after an open heart operation. Patients
      with severe peripheral vascular disease may require ascending aortic balloon pump
      insertion. We describe a simple method of direct aortic puncture for intraaortic
      balloon pump placement using transesophageal ultrasound as a means of avoiding
      complications during insertion and documenting correct balloon position.

PMID- 1637240
TI  - Method of single-lung transplantation in the absence of a left atrial cuff.
AB  - A method used clinically for anastomosing the pulmonary veins to the left atrium,
      in the absence of a left atrial cuff, during single-lung transplantation by
      reconstructing the atrium with pericardium is described. Postoperative
      ventilation/perfusion scans show normal pulmonary blood flow.

PMID- 1637241
TI  - Right internal mammary artery extended with an inferior epigastric artery for
      circumflex and right coronary bypass.
AB  - The right in situ internal mammary artery extended end to end with a free
      inferior epigastric artery was used through the transverse sinus for sequential
      grafting to one marginal branch of the circumflex artery and one or both distal
      branches of the right coronary artery. This procedure was applied in 5 patients
      with three-vessel disease who received in addition a left in situ internal
      mammary artery as a sequential graft to the left anterior descending coronary
      artery and one of its diagonal branches. The postoperative course was uneventful
      in all cases. A postoperative coronary angiogram obtained on day 10 in 4 patients
      showed all the grafts and anastomoses patent.

PMID- 1637242
TI  - Cervical esophago-esophageal anastomosis.
AB  - We describe our results with cervical esophagoesophageal anastomosis. This
      approach has been used with success in 4 patients. It has the advantage of
      avoiding esophagectomy in patients with benign disease and allows restoration of
      esophageal continuity in patients having limited options for esophageal
      replacement.

PMID- 1637243
TI  - Current morbidity, mortality, and survival after bronchoplastic procedures for
      malignancy.
AB  - The number of patients reported to have undergone bronchoplastic procedures has
      increased nearly fourfold in the past decade. These techniques represent
      excellent surgical therapy for patients with benign endobronchial lesions,
      traumatic airway disruptions, or tumors of low-grade malignant potential, and for
      select patients with surgically resectable lung cancer. Eighty-nine percent of
      bronchoplastic procedures are performed for malignancy. We reviewed 1,915
      bronchoplastic procedures for carcinoma reported over the past 12 years to
      determine the incidence of complications and survival. Complications included
      local recurrence (10.3%), 30-day mortality (7.5%), pneumonia (6.7%), atelectasis
      (5.4%), benign stricture or stenosis (5.0%), bronchopleural fistulas (3.5%),
      empyema (2.8%), bronchovascular fistulas (2.6%), and pulmonary embolism (1.9%).
      Results were further stratified into sleeve lobectomy and sleeve pneumonectomy
      groups. Five-year survivals for stage I, II, and III carcinoma were 63%, 37%, and
      21%, respectively. Sleeve lobectomy for carcinoma extends surgical therapy to
      select patients with complication rates comparable to pneumonectomy and long-term
      survival similar to that for conventional resections.

PMID- 1637244
TI  - 1985: Fluorocarbons: a potential treatment of cerebral air embolism in open-heart
      surgery. 1992 update.

PMID- 1637245
TI  - Retrograde disc escape in a Harken mitral valve prosthesis.

PMID- 1637246
TI  - Coronary bypass graft aneurysm.

PMID- 1637247
TI  - Role of the bronchial arteries in lung function.

PMID- 1637248
TI  - Surgical stabilization of the flail chest.

PMID- 1637249
TI  - Bronchial stump closure.

PMID- 1637250
TI  - Types of alcoholics, I. Evidence for an empirically derived typology based on
      indicators of vulnerability and severity.
AB  - An empirical clustering technique was applied to data obtained from 321 male and
      female alcoholics to identify homogeneous subtypes having discriminative and
      predictive validity. The clustering solution identified two "types" of alcoholics
      who differed consistently across 17 defining characteristics in the male and
      female samples. One group, designated type A alcoholics, is characterized by
      later onset, fewer childhood risk factors, less severe dependence, fewer alcohol
      related problems, and less psychopathological dysfunction. The other group,
      termed type B alcoholics, is characterized by childhood risk factors, familial
      alcoholism, early onset of alcohol-related problems, greater severity of
      dependence, polydrug use, a more chronic treatment history (despite their younger
      age), greater psychopathological dysfunction, and more life stress. The two types
      also differed with respect to treatment outcome assessed prospectively at 12 and
      36 months. The results are consistent with historical and contemporary
      typological theories that have postulated similar subgroups of alcoholics. The
      findings suggest that an empirically derived, multivariate typology of alcoholism
      has theoretical implications for explaining the heterogeneity among alcoholics
      and may provide a useful basis for predicting course and estimating treatment
      response.

PMID- 1637251
TI  - The Comprehensive Assessment of Symptoms and History (CASH). An instrument for
      assessing diagnosis and psychopathology.
AB  - The Comprehensive Assessment of Symptoms and History was developed for research
      studies of schizophrenia spectrum conditions and affective spectrum conditions.
      It is designed to provide a comprehensive information base concerning current and
      past signs and symptoms, premorbid functioning, cognitive functioning,
      sociodemographic status, treatment, and course of illness. Because the
      information base is broad, it is not wedded to a specific diagnostic system but
      rather permits clinicians and investigators to make diagnoses using a wide range
      of systems, including Research Diagnostic Criteria, DSM-III, DSM-III-R, and the
      International Classification of Diseases. Given the fact that disorders in
      psychiatry are not defined at the etiological or pathophysiological level,
      diagnostic criteria are prone to ongoing revision as our knowledge base changes.
      Research strategies suggest that investigators should maintain a flexible
      database to permit them to adapt to changes in diagnostic systems, to do
      comparative nosological studies, and, ultimately, to develop new diagnostic
      systems based on knowledge concerning the underlying neurobiological nature of
      disorders. Because it provides a comprehensive information base, the
      Comprehensive Assessment of Symptoms and History facilitates research of this
      type. Extensive developmental work has been done with the Comprehensive
      Assessment of Symptoms and History, including interrater and test-retest
      reliability studies, validity studies, training programs, and data entry
      programs.

PMID- 1637252
TI  - The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale,
      and description.
AB  - The history, rationale, and development of the Structured Clinical Interview for
      DSM-III-R (SCID) is described. The SCID is a semistructured interview for making
      the major Axis I DSM-III-R diagnoses. It is administered by a clinician and
      includes an introductory overview followed by nine modules, seven of which
      represent the major axis I diagnostic classes. Because of its modular
      construction, it can be adapted for use in studies in which particular diagnoses
      are not of interest. Using a decision tree approach, the SCID guides the
      clinician in testing diagnostic hypotheses as the interview is conducted. The
      output of the SCID is a record of the presence or absence of each of the
      disorders being considered, for current episode (past month) and for lifetime
      occurrence.

PMID- 1637253
TI  - The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest
      reliability.
AB  - A test-retest reliability study of the Structured Clinical Interview for DSM-III
      R was conducted on 592 subjects in four patient and two nonpatient sites in this
      country as well as one patient site in Germany. For most of the major categories,
      kappa s for current and lifetime diagnoses in the patient samples were above .60,
      with an overall weighted kappa of .61 for current and .68 for lifetime diagnoses.
      For the nonpatients, however, agreement was considerably lower, with a mean kappa
      of .37 for current and .51 for lifetime diagnoses. These values for the patient
      and nonpatient samples are roughly comparable to those obtained with other
      structured diagnostic instruments. Sources of diagnostic disagreement, such as
      inadequate training of interviewers, information variance, and low base rates for
      many disorders, are discussed.

PMID- 1637254
TI  - Sleep in schizophrenic patients on and off haloperidol therapy. Clinically stable
      vs relapsed patients.
AB  - We examined the state-dependent contribution of neuroleptic withdrawal and
      psychotic relapse in influencing sleep measures. Eighteen clinically stable male
      schizophrenic patients taking haloperidol were studied with 3 nights of
      polysomnography for baseline measures and again after neuroleptic withdrawal.
      Sleep measures were also obtained at the point of relapse (n = 9) or after a 6
      week drug-free period if the patient remained clinically stable (n = 9).
      Neuroleptic withdrawal led to a global deterioration of rapid eye movement and
      non-rapid eye movement sleep and a reduction of rapid eye movement latency in
      both groups. Relapsers differed from nonrelapsers in that they had a larger
      decrease in total sleep time, sleep efficiency, total non-rapid eye movement
      sleep, and stage 2 sleep. The level of psychosis was inversely correlated with
      sleep efficiency, total sleep time, and stage 4 sleep in the drug-free patients.
      Our data suggest that clinical state needs to be identified in sleep studies of
      drug-free patients.

PMID- 1637255
TI  - Oral heparin normalizes blood pressure and elevated cytosolic calcium in
      hypertensive rats.
AB  - Increased calcium uptake in vascular tissue, leading to elevated cytosolic free
      calcium has been implicated in the pathophysiology of hypertension. This study
      examined the effect of oral heparin on systolic blood pressure, platelet
      cytosolic free calcium and aortic calcium uptake in spontaneously hypertensive
      and normotensive Wistar-Kyoto rats. Starting at age 12 weeks, each strain of rats
      were divided into 2 groups (6 animals in each group); the control group was
      placed on H2O (100%) and the experimental group was placed on H2O with heparin
      (0.5 mg sodium heparin/ml H2O) for a period of nine weeks. At 21 weeks, systolic
      blood pressure, platelet cytosolic free calcium and aortic calcium uptake were
      significantly higher in spontaneously hypertensive rats on water compared with
      spontaneously hypertensive rats on heparin and Wistar-Kyoto rats on water and on
      heparin. Oral heparin treatment normalized the elevated platelet cytosolic free
      calcium, aortic calcium uptake and systolic blood pressure in spontaneously
      hypertensive rats but had no effect on Wistar-Kyoto rats. Heparin also prevented
      onset of adverse renal vascular changes observed in spontaneously hypertensive
      rats. Oral heparin treatment did not cause abnormal hematological, biochemical or
      pathological changes in rats.

PMID- 1637256
TI  - Post-marketing surveillance of probucol (Sinlestal) in Japan.
AB  - We surveyed the efficacy and safety of probucol (Sinlestal) in 6,002 patients
      with hyperlipidemia during the past six years between Oct., 1984 and Sep., 1990.
      Probucol was usually administered for more than 8 weeks at a dose of 500 mg per
      day and effects on serum lipids and adverse drug events (ADEs) were investigated.
      Total cholesterol (TC), triglycerides (TG) and HDL cholesterol (HDL)
      significantly decreased by 16-20%, 6-9% and 15-20% respectively. Further, LDL
      cholesterol (LDL) decreased by 15-19%. ADEs were reported in 2.7% (161/6,002
      subjects), but severity was mild or moderate. In addition to survey in 6,002
      patients, the effect on regression of xanthomas and safety in long-term
      administration of over one year was investigated in 44 and 142 patients,
      respectively. Regression of xanthoma was observed in 63.6% (28/44 subjects).
      Probucol was well tolerated in long-term administration. These PMS results showed
      probucol to possess good therapeutic efficacy and safety.

PMID- 1637258
TI  - Analysis of stress-strain curves at fast and slow velocities of loading in vitro
      in the transverse section of the rat incisor periodontal ligament following the
      administration of beta-aminopropionitrile.
AB  - The in vitro mechanical properties of this ligament were examined by analysing
      the stress-strain curve obtained from a transverse section of the mandible.
      Mechanical measures were compared between normal rats and lathyritic rats given
      drinking water containing 0.2% of beta-aminopropionitrile (BAPN) for 20 days, and
      between the velocity of loading at 10(4) and 1 mm/24 h. The daily dose of BAPN
      decreased gradually because the body weight increased gradually. At the velocity
      of 10(4) mm/24 h, the maximum shear stress, elastic stiffness and failure strain
      energy density in the experimental subgroup fell to 43-50% of the control values,
      and at 1 mm/24 h to 71-80%. The maximum strains were not significantly different
      between the control and experimental subgroups either at 10(4) or at 1 mm/24 h.
      In the control subgroups, the maximum shear stress, elastic stiffness and failure
      strain energy density at 1 mm/24 h fell to 0.04-0.30% of those at 10(4) mm/24 h,
      and in the experimental subgroups to 0.08-0.43%. The maximum strains at 1 mm/24 h
      were 1.7-1.8 times greater than those at 10(4) mm/24 h in both the control and
      experimental subgroups. It is assumed that changes in the mechanical properties
      of the periodontal ligament were caused by inhibition of maturation of the
      periodontal collagen fibres. Assuming that the periodontal ligament is
      viscoelastic in nature, it is suggested that the main component reacting at 10(4)
      mm/24 h was an elastic one and that both components, with emphasis on the viscous
      one, interact at 1 mm/24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637257
TI  - Effects of probucol on low-density lipoprotein catabolism in guinea pigs.
AB  - We studied the effects of administering probucol on the catabolism of low density
      lipoprotein (LDL) in guinea pigs. Probucol administration significantly lowered
      the levels of total and LDL-cholesterol in animals given either normal chow or
      the high cholesterol (1% W/W) diet. High-density lipoprotein cholesterol was
      decreased significantly in the animals fed cholesterol, but not normal chow diet.
      Triglyceride levels were unaffected in both groups. No significant changes were
      observed in the LDL receptor-dependent and LDL receptor-independent catabolism of
      native LDL and LDL obtained from a probucol-treated patient. However, when the
      LDL isolated from a probucol-treated patient was injected, the fractional
      catabolic rate was significantly lower than that of injected native LDL. This
      study indicates that probucol lowered the plasma LDL cholesterol level neither by
      an increased catabolism of LDL via an LDL receptor nor an LDL receptor
      independent pathway.

PMID- 1637260
TI  - Short electromyographic bursts in the rabbit digastric muscle during the jaw
      closing phase.
AB  - Masseter and digastric muscle activities and jaw movement trajectories were
      recorded in freely moving rabbits during eating. The patterns in these
      trajectories and activities were similar to those described in previous studies
      on restrained animals. Although the duration of masticatory sequences, which
      started with food intake followed by grinding movements and ended by swallowing,
      varied, the total number of chewing cycles in a chain of masticatory sequences
      was consistent (1043 +/- 51, mean +/- SD; n = 5, for chow pellets) among the
      animals tested. When animals ate hard foods, extra bursts in the digastric
      electromyograms occurred frequently in the jaw-closing phase. The digastric
      activities were rather short (6.1 +/- 1.0 ms; n = 100) and the amplitude of these
      digastric short bursts (DSBs) was much larger (1.69 +/- 0.81 mV; n = 100) than in
      the opening phase (0.56 +/- 0.33 mV; n = 100), which actually depressed the jaw.
      When a soft food (bread) was tested, this activity was not observed. The
      proportion of occurrences of the DSB in a chewing cycle was high at the slow
      closing phase, indicating that the DSBs were due to tooth contacts during food
      crushing. Of 1035 chewing cycles examined in the five animals, 124 were
      associated with a DSB and 415 cycles with a masseter inhibitory period (MIP). The
      proportion of the occurrences of the MIP was significantly larger than that of
      the DSBs. Of 124 DSBs, 85 (68.5 per cent) coincided with an MIP. Four were not
      associated with clear MIPs, although there was masseter activity at the time of
      the DSBs. The other 35 DSBs were out of phase with the masseter bursts, although
      still in a closing phase. The durations of the MIPs accompanied by a DSB were
      significantly longer than those not so associated. The DSB may be a reflex
      response mediated by periodontal mechanoreceptors when the upper and lower teeth
      come together while chewing hard food. The reflex arc for the DSB may be
      independent of that for the MIP, and the threshold for the DSB may be higher.

PMID- 1637259
TI  - Mast cell heterogeneity in various oral mucosal sites in the rat.
AB  - Two distinct types of mast cells are recognized in the rat: connective tissue
      mast cells (CTMCs), found in the peritoneal cavity, skin, tongue, etc. and
      mucosal mast cells (MMCs), found in the intestinal mucosa. The two subsets differ
      functionally and can be defined by histochemical methods. The aim here was to
      characterize the mast cell population in various oral mucosal sites. Biopsies
      were taken from the tongue, buccal mucosa, gingival mucosa and intestine
      (jejunum) of 20 rats. For optimal preservation of the MMCs, a fixative with low
      aldehyde concentration and low pH was used. The biopsies were embedded in
      paraffin. The first of three consecutive sections (5 microns) was stained with
      toluidine blue for 30 s, the second with toluidine blue for 7 days and the third
      with astra blue/safranine. Cells positive with toluidine blue after 30 s were
      classified as CTMCs, and those positive after 7 days but not after 30 s as MMCs.
      Cells positive to safranine in the astra blue/safranine staining sequence were
      classified as CTMCs and those positive to astra blue as MMCs. The total number of
      mast cells was similar in the superficial layers of all oral tissues studied.
      There were more mast cells in the deeper than in the superficial portions of the
      tongue. Mast cells with staining characteristics and size similar to those
      observed in the intestinal mucosa (MMCs) were found together with 'classical'
      connective tissue mast cells (CTMCs). The results suggest that the mast cell
      population of oral mucosal tissues of the rat contains both CTMC- and MMC-like
      cells.

PMID- 1637261
TI  - Fluoride binding by matrix proteins in rat mineralizing tissue.
AB  - Chronic fluoride exposure in vivo results in alterations in the formation of
      mineralizing tissues. One possible mechanism for the formation of fluorosed tooth
      enamel and bone is a binding of fluoride to matrix proteins, resulting in an
      alteration in their structure and function. Studies were designed to investigate
      fluoride binding to matrix proteins in vivo and their possible role in fluorosis.
      Rats were given either 0 or 100 parts/10(6) fluoride in drinking water for 6
      weeks to allow the formation of fluorotic mineralizing tissues. The animals were
      killed by CO2 inhalation, and the enamel and bone were analysed for fluoride and
      calcium. Matrix binding by fluoride in enamel was determined after extraction of
      proteins from undemineralized matrix. In bone, the matrix was demineralized and
      F, Ca and P were determined in both ashed and unashed samples. The studies showed
      ionic binding of fluoride to the matrix in both enamel and bone, possibly
      associated with calcium binding by the matrix. There was no difference in the
      amount of matrix-bound fluoride in control as compared to fluorosed bone or
      maturation-stage enamel. This indicates that although matrix proteins can bind
      fluoride, it is not likely that this mechanism is important in the formation of
      fluorosed mineralizing tissues.

PMID- 1637262
TI  - Effects of transforming growth factor-beta 1 on cultured dental follicle cells
      from rat mandibular molars.
AB  - Analysis of the total proteins secreted by cultured dental follicle cells
      revealed that transforming growth factor-beta 1 (TGF-beta 1) stimulated them to
      secrete more extracellular matrix proteins into a serum-free medium than did
      follicle cells not exposed to the growth factor. Electrophoresis and scanning
      densitometry showed that secretion of all the major proteins was increased by
      exposure to the growth factor but the amounts ranged from a 66% increase for one
      of the procollagen chains to a 7% increase for fibronectin. Immunofluorescence
      using anti-type I collagen and anti-fibronectin showed that the intracellular
      concentration and intracellular localization of the antibodies was not changed by
      incubating the cells with the growth factor. The growth factor did not cause an
      increase in cell number but did modify the association of the cells in the
      culture, causing them to aggregate into clusters whereas the control cells formed
      a confluent monolayer. These results suggest that TGF-beta 1 may signal the
      fibroblasts of the dental follicle to secrete the extracellular matrix needed for
      its development into a periodontal ligament.

PMID- 1637263
TI  - Ultrastructural quantification of collagen fibrils in the central region of the
      articular disc of the temporomandibular joint of the cat and the guinea pig.
AB  - This quantitative ultrastructural analysis was made on articular discs from four
      guinea pigs and four cats. Mean diameters of collagen fibrils were small
      (approximately 45 nm) and showed unimodal distributions. These features are
      consistent for connective tissues subjected to compressional forces. The
      relatively high percentage volume of the extracellular matrix occupied by
      collagen in the articular disc of the guinea pig (approximately 60 per cent) and
      the presence of crimping is, however, more typical of a connective tissue
      subjected to tension. Two differences were discernible between the collagen in
      the articular discs of the guinea pig and cat. First, the percentage volume
      occupied by collagen for the guinea pig disc was significantly higher than for
      the cat. Second, the frequency distribution of collagen fibril diameters for the
      cat, although unimodal, was skewed. These differences possibly reflect the
      different types of movement at the temporomandibular joints in the two species.

PMID- 1637264
TI  - Flow cytometric evaluation of phagocytosis by peripheral blood polymorphonuclear
      leucocytes in human periodontal diseases.
AB  - The complement-dependent phagocytic functions of polymorphonuclear leucocytes
      (PMNL) in peripheral blood from 15 patients with localized juvenile periodontitis
      (LJP), 13 with generalized juvenile periodontitis (GJP) and 52 with adult
      periodontitis (AP), and from 30 normal subjects as controls were measured by flow
      cytometry. Heparinized blood was collected and incubated with fluorescent
      microspheres, and erythrocytes were removed. By means of single-cell analysis the
      percentage of phagocytosing cells (% phagocytosis) and the mean number of
      microspheres phagocytosed by one PMNL (degree of phagocytosis; d-phagocytosis)
      were measured. Some but not all patients with LJP (53%) and GJP (46%) showed
      consistently low % phagocytosis and d-phagocytosis. On the other hand, only 6% of
      AP patients and no healthy subjects showed a reduction of PMNL phagocytosis.
      Phagocytosis was unchanged after initial periodontal treatment in all subjects,
      suggesting the depression of PMNL phagocytosis may not be a transient phenomenon
      associated with periodontal status. Furthermore, PMNLs from the LJP patients that
      showed depressed phagocytic function exhibited depressed phagocytic responses
      with either autologous or normal plasma, while control PMNLs with either normal
      or the patients' plasma showed normal responses. These results suggested that the
      depressed phagocytic responses in LJP patients could be due to cell-associated
      defect(s) on the PMNL.

PMID- 1637265
TI  - Immunohistochemical detection of androgen receptors in human oral mucosa.
AB  - Oral mucosal biopsies from 11 healthy volunteers, 7 women and 4 men, were
      analysed for the localization of androgen, oestrogen and progesterone receptors.
      The samples were dissected as quickly as possible and immediately frozen in
      liquid nitrogen to be stored at -70 degrees C. Only androgen receptors could be
      detected by the methods used. These were mainly located in the nuclei of basal
      epithelial cells, and to some extent in the nuclei of fibroblasts and endothelial
      cells. Failure in the localization of oestrogen and progesterone receptors might
      have been due either to low numbers of receptors or to the insensitivity of
      antibodies used. The method is thus suitable only for detecting androgen
      receptors.

PMID- 1637266
TI  - Chondroitin sulfate-induced generation of epiretinal membranes.
AB  - Previous investigations have examined the role of serum and retinal pigment
      epithelium-derived factors in the elaboration of epiretinal membranes.
      Alternatively, the contribution of the insoluble interphotoreceptor matrix, known
      to contain chondroitin-sulfate-containing proteoglycans, in the generation of
      epiretinal membranes, has not been evaluated, to our knowledge. To investigate
      the potential role of chondroitin sulfates in eliciting epiretinal membranes,
      chondroitin sulfate glycosaminoglycans were injected into the vitreous cavity of
      rabbits. Examination demonstrated epiretinal membranes in 86% of eyes receiving
      chondroitin-6-sulfate. Temporal development of chondroitin sulfate
      glycosaminoglycan-induced epiretinal membranes was categorized into three
      distinct stages: a preretinal cell stage 1 to 3 weeks following injection, a
      glial "tuft" stage at 3 to 6 weeks, and a "mature" complex membrane stage at 6
      weeks or later. Our results suggest that intravitreal administration of
      chondroitin sulfate glycosaminoglycan, components of insoluble interphotoreceptor
      matrix proteoglycans, may elicit the generation of epiretinal membranes, even in
      the absence of retinal disruption.

PMID- 1637267
TI  - Loiasis in Maryland.

PMID- 1637268
TI  - A surgical procedure to minimize lower-eyelid retraction with inferior rectus
      recession.
AB  - Advancement of the capsulopalpebral head at the time of inferior rectus recession
      has been described as a technique to minimize postoperative lower-eyelid
      retraction. In a prospective randomized masked clinical trial, this technique
      combined with inferior rectus recession was compared with inferior rectus
      recession alone, with respect to post-operative lower-eyelid retraction. The mean
      (+/- SD) postoperative lower-eyelid retraction was 0.7 +/- .82 mm for patients in
      whom the capsulopalpebral head was advanced, as opposed to 1.3 +/- .85 mm for the
      control group. This difference was statistically significant (Student's t =
      2.787; P = .006).

PMID- 1637269
TI  - Infectious endophthalmitis following sutureless cataract surgery.

PMID- 1637270
TI  - Infectious endophthalmitis following sutureless cataract surgery.

PMID- 1637271
TI  - Infectious endophthalmitis following sutureless cataract surgery.

PMID- 1637272
TI  - Infectious endophthalmitis following sutureless cataract surgery.

PMID- 1637273
TI  - Infectious endophthalmitis following sutureless cataract surgery.

PMID- 1637274
TI  - Intraocular cilia after penetrating eye injury.

PMID- 1637275
TI  - Iris nodule and intralenticular abscess associated with Propionibacterium acnes
      endophthalmitis.

PMID- 1637276
TI  - Recommendations for better Medicare performance.

PMID- 1637277
TI  - Dyslexia at The New York Times: (mis)understanding of parallel visual processing.

PMID- 1637278
TI  - Excimer laser photorefractive keratectomy in high myopia. A multicenter study.
AB  - Excimer photorefractive keratectomy was performed at three centers on 16 highly
      myopic eyes (8 diopters [D] or more) and followed up for 6 months. Ablation
      depths ranged from 137 to 230 microns. The preoperative spherical equivalent of
      myopia ranged from -8.62 D to -14.50 D (mean +/- SD, -11.57 +/- 1.62 D). Six
      months after surgery, the mean refraction (spherical equivalent) was -0.90 +/-
      2.13 D. Eleven of 16 eyes achieved refractions within 2 D of that attempted. All
      eight patients at one site were treated with a maximum-beam diameter of 6.0 mm
      and were corrected to within 2 D of that attempted, and all were 20/40 or better
      uncorrected. Three of eight eyes at the other two sites were treated with a 5.5-
      or 5.6-mm maximum-beam diameter, which achieved corrections within 2 D of that
      attempted. The epithelium healed within 3 to 4 days, and there were no erosions.
      Mild subepithelial reticular haze, similar to that seen with excimer
      photorefractive keratectomy for lower myopia, was seen in all patients, with two
      patients experiencing more significant corneal haze. This peaked at 3 to 6 weeks
      and then gradually diminished. All but two patients had a return of their best
      corrected preoperative visual acuity to within one Snellen line at 6 months. This
      preliminary study shows excimer photorefractive keratectomy to be a promising
      surgical treatment for patients with higher myopia.

PMID- 1637280
TI  - Contrast sensitivity in patients with nuclear cataracts.
AB  - Spatial contrast sensitivity and lens density were measured in 30 subjects (18
      patients with pure nuclear cataracts and 12 age-matched controls). Contrast
      sensitivity was assessed using two techniques: a conventional monitor method in
      which gratings were viewed through the cataract (overall spatial contrast
      sensitivity) and a laser interferometer method in which gratings were formed
      directly on the retina (interferometric spatial contrast sensitivity), thus
      reducing the effect of an opaque lens on grating contrast. The degree of lens
      nuclear opacity was measured by assessing the density of Zeiss Scheimpflug slit
      lamp video camera images. A contrast sensitivity loss was found by using both
      methods; this reduction reached statistical significance only when monitor
      stimuli were used. There was a significant correlation between lens nuclear
      density and sensitivity loss at spatial frequencies from 4 to 16 cycles/degree (r
      = .56 to .79 and P less than .05 to less than .001). A correlation coefficient of
      .82 (P less than .001) characterized the relationship between visual acuity (log
      of the minimal angle of resolution) and lens density. Nuclear lens opacity
      significantly affects contrast sensitivity; pure nuclear cataracts produce
      spatial visual losses at intermediate and high spatial frequencies.

PMID- 1637279
TI  - The effect of topical corticosteroids on refractive outcome and corneal haze
      after photorefractive keratectomy. A prospective, randomized, double-blind trial.
AB  - In this study, we report the results of a prospective, double-blind trial to
      determine whether high-dose topical corticosteroids have an effect on refractive
      outcome or anterior stromal haze after photorefractive keratectomy. A total of
      113 patients were allocated randomly to either placebo- or steroid-treated groups
      (0.1% dexamethasone metasulphobenzoate for 3 months) and underwent either -3.00
      diopter (D) or -6.00-D procedures. At 6 weeks, the mean change in refraction was
      significantly greater in the steroid-treated group than in the placebo-treated
      group (-3.00-D group, P = .0015; -6.00-D group, P = .0011). However, when
      corticosteroids were discontinued at 3 months, this difference became
      statistically insignificant. There was no statistically significant effect on
      anterior stromal haze at any stage. Since long-term use of corticosteroids to
      maintain the initial beneficial effect on refraction would be unacceptable, we
      conclude that these agents should not be used after photorefractive keratectomy.

PMID- 1637281
TI  - Rotation of posterior chamber intraocular lenses for management of lens
      associated recurring hyphemas.
AB  - Management of recurring hyphemas associated with posterior chamber intraocular
      lenses may include a combination of medical, laser, and surgical modalities.
      Miotic and laser therapies have often failed, and surgical treatment has
      primarily relied on removal of the offending lens. We describe herein a method
      for rotation of the intraocular lens that provides an effective means of
      preventing one form of recurrent intraocular hemorrhage.

PMID- 1637282
TI  - Complications of glaucoma surgery. Ocular decompression retinopathy.
AB  - In seven eyes of four patients, retinal hemorrhages were observed following
      trabeculectomy under both local and general anesthesia. The hemorrhages were
      diffuse, both deep and superficial, and many had white centers when first
      observed. Two patients were young healthy male myopes undergoing primary
      trabeculectomy. The third patient was a young man with chronic uveitis. The
      fourth patient was an elderly man with primary open angle glaucoma who had an
      acute rise in intraocular pressure following cataract extraction. Intraocular
      pressure and visual results appeared unaffected by the hemorrhages. Retinal
      hemorrhages associated with ocular decompression appear to be relatively benign.

PMID- 1637283
TI  - Fine-needle aspiration biopsy of the iris.
AB  - Fine-needle aspiration biopsy (FNAB) specimens obtained from nine consecutive
      iris lesions were examined. The lesions included primary malignant melanoma (four
      cases), metastatic melanoma, metastatic adenocarcinoma, leukemic infiltrate,
      lymphocytic infiltrate, and epithelial ingrowth. Subsequent histopathologic
      correlation was performed in all cases. Patient treatment influenced by the
      results of the FNABs included enucleation (three cases), clinical observation
      (two cases), external beam irradiation (two cases), resection, and radioactive
      plaque application. No complications occurred from the FNABs. Fine-needle
      aspiration biopsy of the iris can be performed with local anesthesia at the slit
      lamp as an outpatient procedure. In general, FNAB is a safe, effective method of
      obtaining diagnostic material from primary neoplastic, secondary neoplastic, and
      degenerative processes involving the iris. Limitations of the procedure include
      discrepancies in interpretation of the cytologic study and inadequate specimen.

PMID- 1637284
TI  - Unsuccessful excimer laser phototherapeutic keratectomy. Clinicopathologic
      correlation.
AB  - A 46-year-old man underwent phototherapeutic keratectomy with a 193-nm excimer
      laser in an attempt to remove a superficial corneal scar that had been present
      for 36 years. The scar proved to be resistant to ablation with the laser, while
      relatively normal stroma was easily ablated. Histopathologic examination of the
      corneal button removed 3 months after excimer laser surgery revealed absence of
      Bowman's membrane in the area of ablation, superficial stromal disorganization
      and scarring, raised nodules of collagenous tissue extending into the epithelium,
      and no calcification within the lesion. Ultrastructural examination was
      remarkable for irregularly oriented collagen fibers within the scar. The
      resistance of this lesion to excimer laser ablation appears to have been the
      consequence of marked differences in rates of ablation between normal stroma and
      the very long-standing scar.

PMID- 1637285
TI  - What is actually stained by rose bengal?
AB  - It has been believed that 1% rose bengal does not stain normal, healthy cells but
      rather stains degenerated or dead cells and mucous strands. In contrast to this
      conventional knowledge, we discovered that both commercial additive-containing
      and additive-free rose bengal solutions stained four different types of healthy
      cultured cells, including rabbit corneal epithelial cells. Rose bengal staining
      was rapid, dose dependent, predominantly nuclear, and detectable with the naked
      eye at concentrations as low as 0.05% and 0.025% for the commercial additive
      containing or additive-free solutions, respectively, and with the fluorescence
      microscope at a concentration of 0.001%. It is surprising to discover that rose
      bengal is not a vital dye; after staining, cells actually lost vitality, as
      evidenced by instant morphologic changes, subsequent loss of cellular motility,
      cell detachment, and cell death. Such an intrinsic toxic effect was augmented by
      light exposure. The rose bengal staining of live as well as detergent-treated
      (Triton X-100) cells could be blocked by such tear components as mucin and
      albumin, suggesting that normally negative rose bengal staining is due to the
      protective function of the preocular tear film, ie, staining is not dictated by
      lack of cell vitality. These data indicate that rose bengal staining ensues
      whenever there is poor protection of surface epithelium by the preocular tear
      film; this represents a new interpretation for rose bengal stains seen in various
      ocular surface disorders.

PMID- 1637286
TI  - Multifocal corneal topographic changes with excimer laser photorefractive
      keratectomy.
AB  - Excimer laser photorefractive keratectomy can flatten the central cornea, thereby
      eliminating myopic refractive errors; in older patients, however, presbyopia
      limits satisfaction. Computer-assisted topographic analysis of corneas after
      refractive surgery indicates that a minority of patients achieve a multifocal
      lens effect, such that they maintain reasonable acuity over a range of defocus.
      We have purposefully attempted to create a multifocal refractive effect and have
      analyzed the subsequent topographies quantitatively to determine if multifocality
      was achieved. In corneas not operated on and plastic hemispheres, a fairly small
      range of corneal powers is observed; the range of powers is increased after a
      monofocal ablation. After multifocal ablations, a greater spread of surface
      powers is observed, often with a bimodal distribution, indicative of an apparent
      multifocal effect. These observations suggest that in some patients undergoing
      photorefractive keratectomy for myopia, it may be possible to reduce symptoms of
      presbyopia, although a decrease in image contrast or monocular diplopia may
      complicate this approach.

PMID- 1637287
TI  - Isolation, by affinity chromatography and gel filtration in 8 M-urea, of an
      active subunit from the anti-(blood-group A+N)-specific lectin of Moluccella
      laevis.
AB  - The lectin from Moluccella laevis seeds agglutinates specifically blood-type-A
      and -N erythrocytes, and both activities are inhibited by micromolar
      concentrations of N-acetyl-D-galactosamine. The lectin consists of three
      subunits: a 67 kDa heterodimer, made up of two S-S-linked polypeptides of 28 and
      46 kDa, and two non-covalently linked moieties of 26 and 42 kDa, the latter
      migrating after reduction with an apparent molecular mass of 46 kDa. Here we
      demonstrate that affinity chromatography of a crude protein fraction from M.
      laevis seeds on immobilized D-galactose in the presence of 8 M-urea affords a
      fully active lectin practically devoid of the 42 kDa subunit. We also present
      data showing that the 26 kDa subunit is devoid of cysteine residues, that the 28
      kDa subunit contains two cysteine residues engaged in S-S bonds with the 46 kDa
      subunit, and that the latter has, in addition, two intramolecular cystine
      residues. Gel filtration on Sephadex G-150 in 8 M-urea/0.2 M-D-galactose of the
      lectin, affinity-purified in the presence of urea, afforded a pure 26 kDa subunit
      which exhibited both anti-A and anti-N activity, as well as high specificity for
      N-acetyl-D-galactosamine. In addition to demonstrating that the lectin is
      unusually stable and retains its carbohydrate-binding activity in 8 M-urea, our
      findings also show that the activity for different blood groups resides in the
      same subunit.

PMID- 1637288
TI  - Lipid utilization by human lymphocytes is correlated with high-density
      lipoprotein binding site activity.
AB  - The nature and physiological importance of high-density lipoprotein (HDL) binding
      sites on unstimulated (resting) and mitogen-activated (blast) human peripheral
      blood lymphocytes were investigated. Specific HDL binding on resting and blast T
      lymphocytes was saturable at 50 micrograms of 125I-HDL/ml and of high affinity,
      with Kd values of 8.1 x 10(-8) M and 6.5 x 10(-8) M, respectively, and Bmax.
      values of 79 ng and 180 ng/mg of cell protein respectively at 4 degrees C.
      Binding of HDL double-labelled with fluorescent dioctadecylindocarbocyanine (Dil)
      and isotope (125I) as well as of single fluorescence- or isotope-labelled HDL was
      inhibited competitively by HDL apoproteins. Studies of the cholesterol flux
      between the cells and HDL showed that HDL, low-density lipoprotein (LDL) or BSA
      at a concentration of 100 micrograms/ml in the tissue culture medium did not
      result in a significant difference in exogenous [3H]cholesterol efflux from the
      cell membrane at 37 degrees C. Proliferating T-blasts incorporated more
      cholesterol from HDL or LDL than did resting lymphocytes. When the cells were
      pulsed with 125I-HDL and chased in fresh lipid-free medium, up to 80% of the
      radioactivity released was not precipitable with trichloroacetic acid. This
      percentage decreased in a competitive manner when unlabelled HDL was present in
      the chase incubation medium. Finally, cultivation of lymphocytes with conditioned
      medium from macrophages increased Dil-HDL binding/uptake, while it was decreased
      by mevinolin-induced inhibition of hydroxymethylglutaryl-coA reductase. In
      conclusion, human lymphocytes possess a HDL binding site (receptor) responsible
      for lipid binding/uptake and concomitant internalization and degradation of
      apoproteins from HDL, but not for reverse cell membrane cholesterol transport.
      The activity of the binding site is up-regulated during cell proliferation and
      down-regulated during cell growth suppression.

PMID- 1637289
TI  - Long-chain acyl-CoA ester intermediates of beta-oxidation of mono- and di
      carboxylic fatty acids by extracts of Corynebacterium sp. strain 7E1C.
AB  - beta-Oxidation of palmitate and tetradecanedioic acid was studied in cell-free
      extracts of the Gram-positive bacterium Corynebacterium sp. strain 7E1C, and the
      acyl-CoA ester intermediates formed were analysed by h.p.l.c. beta-Oxidation
      assays displayed a lag phase before a constant rate of NAD+ reduction was
      obtained. The length of the lag phase was inversely proportional to the number of
      units of activity added to assays. This is a characteristic feature of a system
      of consecutive reactions proceeding via free intermediates. During beta-oxidation
      of palmitate all the saturated acyl-CoAs from C16 to C8 were detected together
      with trace amounts of unsaturated and 3-hydroxy-intermediates. The time-course of
      intermediate formation again indicated a precursor-product relationship
      indicative of free intermediates being formed. When 3-hydroxyacyl-CoA
      dehydrogenase was inhibited by completely removing NAD+ from assays, the major
      acyl-CoAs, detected during palmitate beta-oxidation were palmitoyl-CoA, hexadeca
      2-enoyl-CoA and 3-hydroxypalmitoyl-CoA. These compounds also displayed a
      precursor-product relationship. Under normal assay conditions the acyl-CoA
      dehydrogenase(s) are the probable rate-limiting enzyme(s) of the beta-oxidation
      spiral. These results indicate that in cell-free extracts of Corynebacterium sp.
      strain 7E1C, beta-oxidation proceeds via free acyl-CoA intermediates and is at
      variance with the concept of substrate channelling or of a 'leaky hose pipe'
      model as proposed for mitochondrial beta-oxidation in eukaryotic cells. The
      significant accumulation of chain-shortened acyl-CoA esters is similar to the
      situation observed for mammalian peroxisomal beta-oxidation.

PMID- 1637290
TI  - Regulation of Na+/Ca2+ exchange in the rat pancreatic B cell.
AB  - Na+/Ca2+ exchange in the B cell was recently characterized by measuring
      intracellular-Na(+)-dependent 45Ca2+ uptake in isolated rat pancreatic islet
      cells. The aim of the present study was to investigate the regulation of this
      process. Extracellular pH (pHo) and intracellular pH (pHi) markedly affected
      Na+/Ca2+ exchange. A fall of 0.04 unit in pHi decreased the exchange by 45%,
      whereas a rise of 0.13 unit increased the uptake by 70%. Mitochondrial poisons
      (oligomycin, antimycin A and 2,4-dinitrophenol) inhibited reverse Na+/Ca2+
      exchange by about 25-50%. The exchanger displayed a low Q10 (temperature
      coefficient), indicating that it is only indirectly dependent on metabolic
      energy. The phorbol ester phorbol 12-myristate 13-acetate did not affect Na+/Ca2+
      exchange. Likewise, lowering the extracellular K+ concentration did not inhibit
      45Ca2+ uptake. In conclusion, the pHi and the metabolic state of the cell may
      represent important modulatory signals by which insulin secretagogues such as
      glucose could regulate reverse Na+/Ca2+ exchange in the B cell. The process does
      not appear to co-transport K+ nor to be influenced by protein kinase C.

PMID- 1637291
TI  - Processing of human pro-lactase-phlorizin hydrolase at reduced temperatures:
      cleavage is preceded by complex glycosylation.
AB  - Intracellular processing of human intestinal lactase-phlorizin hydrolase (LPH)
      includes an essential proteolytic cleavage step that generates the mature brush
      border enzyme from the single-chain polypeptide precursor (pro-LPH). Previous
      work in organ culture of small intestinal biopsy samples [Naim, Sterchi & Lentze
      (1987) Biochem. J. 241, 427-434] has demonstrated that this cleavage occurs
      intracellularly. Since no intermediate forms of pro-LPH (trimmed or complex
      glycosylated) could be discerned in pulse-chase analyses it was suggested that
      the cleavage process occurs at a fast rate. To identify intermediate forms of pro
      LPH prior to cleavage, I studied the biosynthesis of LPH by employing a pulse
      chase protocol in mucosa explants (or biopsies) at reduced temperatures (22
      degrees C). Here, I could identify by immunoprecipitation with monoclonal anti
      LPH antibodies four LPH forms that exhibited a product-precursor
      relationship:mannose-rich precursor (pro-LPHh), trimmed pro-LPH (LPHt), complex
      glycosylated pro-LPH (pro-LPHc) and cleaved, mature LPH (LPHm). The results
      clearly indicate that the generation of mature LPH is preceded by complex
      glycosylation of the precursor form. The fact that this was not previously
      observed in the same experimental system under normal biosynthetic labelling
      conditions (37 degrees C) demonstrates that the cleavage process of pro-LPH
      occurs at a fast rate in the human small intestine.

PMID- 1637292
TI  - Dissociation between phytohaemagglutinin-stimulated generation of inositol
      phosphates and Ca2+ increase in human mononuclear leucocytes.
AB  - We have tested whether phytohaemagglutinin (PHA)-stimulated generation of
      inositol phosphates (IP) and increases in intracellular Ca2+ can be dissociated
      in human mononuclear leucocytes. Lowering the incubation temperature from 37
      degrees to 25 degrees C decreased PHA-stimulated IP generation by more than 80%,
      but only marginally affected PHA-stimulated Ca2+ increases. In the absence of
      extracellular Ca2+, PHA did not stimulate IP generation or Ca2+ increases,
      although PHA binding to its acceptor sites was not impaired. Increasing
      extracellular Ca2+ up to 0.15 mM enhanced PHA-stimulated PHA generation but this
      increase was attenuated by further increasing extracellular Ca2+ to 2.6 mM.
      Increasing extracellular Ca2+ to 0.3 mM also enhanced PHA-stimulated Ca2+
      increases, and further increasing extracellular Ca2+ did not affect it. Co
      treatment with 100 microM-prostaglandin E2 completely abolished PHA-stimulated IP
      generation, but inhibited Ca2+ increases by only 20-30%. These results could be
      explained by IP-generation-independent Ca2+ increases or by non-linear coupling
      of IP generation to Ca2+ increases. Since the PHA concentrations required to
      increase Ca2+ were greater than those required for IP generation, the latter
      hypothesis can be excluded. Furthermore, the Ca2+ ionophore ionomycin increased
      intracellular Ca2+ and weakly stimulated IP generation, but with very similar
      concentration-response relationships. Our data suggest that PHA-stimulated IP
      generation and Ca2+ increases in human mononuclear leucocytes mainly occur
      independently of one another rather than sequentially.

PMID- 1637293
TI  - Large inhibitor of metalloproteinases (LIMP) contains tissue inhibitor of
      metalloproteinases (TIMP)-2 bound to 72,000-M(r) progelatinase.
AB  - Connective-tissue cells in culture produce a family of metalloproteinases which,
      once activated, can degrade all the components of the extracellular matrix. These
      potent enzymes are all inhibited by the tissue inhibitor of metalloproteinases
      (TIMP), and it was thought that this inhibitor was solely responsible for the
      inhibition of these enzymes within connective tissue. However, other inhibitors
      have recently been described, including large inhibitor of metalloproteinases
      (LIMP) present in the culture medium of human foetal lung fibroblasts. Here we
      show that a large proportion of the inhibitory activity of LIMP consists of
      72,000-M(r)-progelatinase bound to TIMP-2, a recently discovered low-M(r)
      metalloproteinase inhibitor closely related to TIMP. The physiological
      implications of the secretion of a complex of 72,000-M(r) progelatinase and TIMP
      2 are discussed, and the separation of the complex in 6 M-urea is described.

PMID- 1637294
TI  - Quantification of apolipoprotein B-48 and B-100 in rat liver endoplasmic
      reticulum and Golgi fractions.
AB  - We have developed a method for measurement of apolipoprotein (apo) B-48 and apo B
      100 in blood and subcellular fractions of rat liver based on SDS/PAGE followed by
      quantitative immunoblotting using 125I-Protein A. Standard curves were prepared
      in each assay using apo B prepared from total rat lipoproteins by extraction with
      tetramethylurea. Subcellular fractions (rough and smooth endoplasmic reticulum
      and Golgi fractions) were prepared from rat liver and separated into membrane and
      cisternal-content fractions. For quantification, membrane fractions were
      solubilized in Triton X-100, and the apo B was immunoprecipitated before
      separation by SDS/PAGE and immunoblotting. Content fractions were concentrated by
      ultrafiltration and separated by SDS/PAGE without immunoprecipitation.
      Quantification of apo B in subcellular fractions and detection of apo B by
      immunoblotting yielded consistent results. In all fractions apo B-48 was the
      major form, accounting for approximately three-quarters of the total apo B. By
      using marker enzymes as internal standards, it was calculated that all of the apo
      B was recovered in the endoplasmic reticulum and Golgi fractions, with
      approximately 80% of each form of apo B in the endoplasmic reticulum. More than
      90% of the apo B of the rough- and smooth-endoplasmic-reticulum fractions was
      membrane-bound, whereas approx. 33 and 15% of the apo B of the cis-enriched Golgi
      fractions and trans-enriched Golgi fractions respectively were membrane-bound.

PMID- 1637295
TI  - Effects of clofibric acid on the activity and activity state of the hepatic
      branched-chain 2-oxo acid dehydrogenase complex.
AB  - Feeding clofibric acid to rats caused little or no change in total activity of
      the liver branched-chain 2-oxo acid dehydrogenase complex (BCODC). No change in
      mass of liver BCODC was detected by immunoblot analysis in response to dietary
      clofibric acid. No changes in abundance of mRNAs for the BCODC E1 alpha, E1 beta
      and E2 subunits were detected by Northern-blot analysis. Likewise, dietary
      clofibric acid had no effect on the activity state of liver BCODC (percentage of
      enzyme in the dephosphorylated, active, form) of rats fed on a chow diet.
      However, dietary clofibric acid greatly increased the activity state of liver
      BCODC of rats fed on a diet deficient in protein. No stable change in liver BCODC
      kinase activity was found in response to clofibric acid in either chow-fed or low
      protein-fed rats. Clofibric acid had a biphasic effect on flux through BCODC in
      hepatocytes prepared from low-protein-fed rats. Stimulation of BCODC flux at low
      concentrations was due to clofibric acid inhibition of BCODC kinase, which in
      turn allowed activation of BCODC by BCODC phosphatase. Inhibition of BCODC flux
      at high concentrations was due to direct inhibition of BCODC by clofibric acid.
      The results suggest that the effects of clofibric acid in vivo on branched-chain
      amino acid metabolism can be explained by the inhibitory effects of this drug on
      BCODC kinase.

PMID- 1637296
TI  - Amino acid sequence of band-3 protein from rainbow trout erythrocytes derived
      from cDNA.
AB  - In this report we present the first complete band-3 cDNA sequence of a
      poikilothermic lower vertebrate. The primary structure of the anion-exchange
      protein band 3 (AE1) from rainbow trout erythrocytes was determined by nucleotide
      sequencing of cDNA clones. The overlapping clones have a total length of 3827 bp
      with a 5'-terminal untranslated region of 150 bp, a 2754 bp open reading frame
      and a 3'-untranslated region of 924 bp. Band-3 protein from trout erythrocytes
      consists of 918 amino acid residues with a calculated molecular mass of 101 827
      Da. Comparison of its amino acid sequence revealed a 60-65% identity within the
      transmembrane spanning sequence of band-3 proteins published so far. An
      additional insertion of 24 amino acid residues within the membrane-associated
      domain of trout band-3 protein was identified, which until now was thought to be
      a general feature only of mammalian band-3-related proteins.

PMID- 1637298
TI  - Direct electrochemical studies of hydrogenase and CO dehydrogenase.
AB  - The reduction potentials of two relatively high-molecular-mass enzymes were
      determined directly at an edge pyrolytic graphite electrode by using square-wave
      voltammetry. The equilibrium reduction potential versus standard hydrogen
      electrode was determined for Clostridium pasteurianum hydrogenase I (E'0 = -377
      +/- 10 mV; molecular mass 60 kDa) and Rhodospirillum rubrum carbon monoxide
      dehydrogenase (E'0 = -418 +/- 7 mV; molecular mass 62 kDa). The reduction
      potential of each enzyme was pH-independent, and one electron was transferred per
      redox centre. The reduction potential was determined to be identical for the CO
      dehydrogenase, semi-apo-(CO dehydrogenase), and CO dehydrogenase with carbonyl
      sulphide (COS) or cyanide bound. The electron-transferring efficiency of CO
      dehydrogenase was affected by two inhibitors, COS and cyanide, as indicated by a
      diminished analytic current.

PMID- 1637297
TI  - Molecular cloning and heterologous expression of a cDNA encoding a mouse
      glutathione S-transferase Yc subunit possessing high catalytic activity for
      aflatoxin B1-8,9-epoxide.
AB  - Resistance to the carcinogenic effects of aflatoxin B1 (AFB1) in the mouse is due
      to the constitutive expression of an Alpha-class glutathione S-transferase (GST),
      YcYc, with high detoxification activity towards AFB1-8,9-epoxide. A cDNA clone
      (pmusGST Yc) for a murine GST Yc polypeptide has been isolated. Sequencing has
      shown the cDNA insert of pmusGST Yc to be 922 bp in length, with an open reading
      frame of 663 bp that encodes a polypeptide of M(r) 25358. The primary structure
      of the murine GST Yc subunit predicted by pmusGST Yc is in complete agreement
      with the partial amino acid sequence of the aflatoxin-metabolizing mouse liver
      GST described previously [McLellan, Kerr, Cronshaw & Hayes (1991) Biochem. J.
      276, 461-469]. A plasmid, termed pKK-musGST Yc, which permits the expression of
      the murine Yc subunit in Escherichia coli, has been constructed. The murine GST
      expressed in E. coli was purified and found to be catalytically active towards
      several GST substrates, including AFB1-8,9-epoxide. This enzyme was also found to
      possess electrophoretic and immunochemical properties closely similar to those of
      the GST Yc subunit from mouse liver. However, the GST synthesized in E. coli and
      the constitutive mouse liver Alpha-class GST exhibited small differences in their
      chromatographic behaviour during reverse-phase h.p.l.c. Automated Edman
      degradation revealed alanine to be the N-terminal amino acid in the GST Yc
      subunit expressed in E. coli, whereas the enzyme in mouse liver possesses a
      blocked N-terminus. Although sequencing showed that the purified Yc subunit from
      E. coli lacked the initiator methionine, the amino acid sequence obtained over
      the first eleven N-terminal residues agreed with that predicted from the cDNA
      clone, pmusGST Yc. Comparison of the deduced amino acid sequence of the mouse Yc
      polypeptide with the primary structures of the rat Alpha-class GST enzymes
      revealed that it is more closely related to the ethoxyquin-induced rat liver Yc2
      subunit than to the constitutively expressed rat liver Yc1 subunit. The
      significance of the fact that both mouse Yc and rat Yc2 exhibit high catalytic
      activity towards AFB1-8,9-epoxide, whereas rat Yc1 possesses little activity
      towards this compound, is discussed in terms of structure/function.

PMID- 1637299
TI  - Tyr-143 facilitates interdomain electron transfer in flavocytochrome b2.
AB  - The role of Tyr-143 in the catalytic cycle of flavocytochrome b2 (L
      lactate:cytochrome c oxidoreductase) has been examined by replacement of this
      residue with phenylalanine. The electron-transfer steps in wild-type and mutant
      flavocytochromes b2 have been investigated by using steady-state and stopped-flow
      kinetic methods. The most significant effect of the Tyr-143----Phe mutation is a
      change in the rate-determining step in the reduction of the enzyme. For wild-type
      enzyme the main rate-determining step is proton abstraction at the C-2 position
      of lactate, as shown by the 2H kinetic-isotope effect. However, for the mutant
      enzyme it is clear that the slowest step is interdomain electron transfer between
      the FMN and haem prosthetic groups. In fact, the rate of haem reduction by
      lactate, as determined by the stopped-flow method, is decreased by more than 20
      fold, from 445 +/- 50 s-1 (25 degrees C, pH 7.5) in the wild-type enzyme to 21 +/
      2 s-1 in the mutant enzyme. Decreases in kinetic-isotope effects seen with [2
      2H]lactate for mutant enzyme compared with wild-type, both for flavin reduction
      (from 8.1 +/- 1.4 to 4.3 +/- 0.8) and for haem reduction (from 6.3 +/- 1.2 to 1.6
      +/- 0.5) also provide support for a change in the nature of the rate-determining
      step. Other kinetic parameters determined by stopped-flow methods and with two
      external electron acceptors (cytochrome c and ferricyanide) under steady-state
      conditions are all consistent with this mutation having a dramatic effect on
      interdomain electron transfer. We conclude that Tyr-143, an active-site residue
      which lies between the flavodehydrogenase and cytochrome domains of
      flavocytochrome b2, plays a key role in facilitating electron transfer between
      FMN and haem groups.

PMID- 1637300
TI  - A recombinant human 'mini'-hexokinase is catalytically active and regulated by
      hexose 6-phosphates.
AB  - Mammalian hexokinase type I is a 100 kDa enzyme that has been considered to be
      evolved from an ancestral 50 kDa yeast-type hexokinase, insensitive to product
      inhibition, by gene duplication and fusion. According to this model, and based on
      many experimental data, the catalytic site is associated with the C-terminal half
      of the enzyme, although an allosteric site for the binding of glucose 6-phosphate
      could be present on the N-terminal half of the molecule. We have isolated a cDNA
      clone of hexokinase from a lambda gt11 human placenta library comprising 2658 bp,
      containing a single open reading frame of 1893 nucleotides, which encodes a
      truncate form of hexokinase starting from asparagine-287 to the terminal serine
      917. This clone was further digested with restriction enzyme NcoI to obtain
      almost only the C-terminal half of human hexokinase starting from methionine-455
      to the terminal amino acid and was overexpressed in active form in Escherichia
      coli and purified by ion-exchange h.p.l.c. The overexpressed 'mini'-hexokinase
      was found not only to catalyse glucose phosphorylation, but also to be inhibited
      by glucose 6-phosphate and other mono- and bis-phosphate sugars exactly like the
      complete mammalian enzyme. These results suggest that the C-terminal half of
      human hexokinase, in addition to the catalytic site, also contains the regulatory
      site and that the evolutionary relationship between the hexokinases should be
      reconsidered by including the appearance of a regulatory site before the gene
      duplication.

PMID- 1637301
TI  - Chemical heterogeneity as a result of hydroxylamine cleavage of a fusion protein
      of human insulin-like growth factor I.
AB  - Recombinant DNA techniques were used to biosynthesize human insulin-like growth
      factor I (hIGF-I) as a fusion protein wherein the fusion polypeptide is an IgG
      binding moiety derived from staphylococcal protein A. This fusion protein is
      produced in Escherichia coli and secreted into the fermentation broth. In order
      to release mature recombinant-derived hIGF-I (rhIGF-I), the fusion protein is
      treated with hydroxylamine, which cleaves a susceptible Asn-Gly bond that has
      been engineered into the fusion protein gene. Reversed-phase h.p.l.c. was used to
      estimate the purity of the rhIGF-I preparations, especially for the
      quantification of the methionine sulphoxide-containing variant. It was determined
      that hydroxylamine cleavage of the fusion protein produced, as a side reaction,
      hydroxamates of the asparagine and glutamine residues in rhIGF-I. Although
      isoelectric focusing was effective in detecting, and reversed-phase h.p.l.c. for
      producing enriched fractions of the hydroxamate variants, ion-exchange
      chromatography was a more definitive procedure, as it allowed quantification and
      facile removal of these variants. The identity of the variants as hydroxamates
      was established by Staphylococcus aureus V8 proteinase digestion, followed by
      m.s., as the modification was transparent to amino acid and N-terminal sequence
      analyses. The biological activity of rhIGF-I was established by its ability to
      incorporate [3H]thymidine into the DNA of BALB/c373 cells and by a radioreceptor
      assay utilizing human placental membranes. Both assays demonstrate that the
      native, recombinant and methionine sulphoxide and hydroxamate IGF-I variants are
      essentially equipotent.

PMID- 1637302
TI  - Effect of cell-cell and cell-matrix interactions on the response of fibroblasts
      to epidermal growth factor in vitro. Expression of collagen type I, collagenase,
      stromelysin and tissue inhibitor of metalloproteinases.
AB  - Investigations of the effect of epidermal growth factor (EGF) on the expression
      of four genes involved in the turnover of the extracellular matrix, collagen type
      I, collagenase, stromelysin and tissue inhibitor of metalloproteinases (TIMP)
      were performed on four strains of skin fibroblasts in vitro. Addition of EGF to
      subconfluent cultures for increasing periods of time up to 5 days induced an
      inhibition of procollagen alpha 1(I) mRNA and a strong stimulation of collagenase
      (100-fold) and stromelysin (1000-fold) mRNAs, whereas the mRNA of TIMP was
      increased to a lesser extent (5-fold). After a 40 h pulse with EGF, these effects
      persisted for 24-48 h after withdrawal of the growth factor and slowly diminished
      thereafter to attain control values after several days. By culturing fibroblasts
      for increasing periods of time, different levels of confluence were obtained
      allowing for the deposition of an extracellular biomatrix. The steady-state level
      of collagenase and stromelysin mRNAs were profoundly depressed in confluent as
      against non-confluent cultures, whereas no major change for TIMP and procollagen
      alpha 1(I) mRNAs was observed. Upon treatment of these cultures with EGF for 48h,
      the steady-state level of collagenase, stromelysin and TIMP increased, whereas
      procollagen alpha 1(I) mRNA was slightly reduced. These modifications were, at
      least in part, dependent upon a regulation of the transcription rate, as
      suggested from run-off experiments. Similar states of confluence were obtained by
      seeding cells at increasing densities in short-term cultures in which cell-cell
      contact predominated. In such culture conditions, the collagenase and stromelysin
      mRNAs were enhanced in high as compared to low density cultures. The response to
      EGF was progressively decreased for collagenase, stromelysin and, to a lesser
      extent, TIMP mRNAs at most densities and a complete lack of response to EGF at
      the highest cell density was observed. Under all culture conditions the
      modulation of collagenase mRNA was paralleled by similar modifications of enzyme
      activity. These results emphasize the importance of the cell-cell contacts and
      cell-matrix interactions in the expression of the genes coding for
      metalloproteinases or their inhibitor and their modulation by growth factors.

PMID- 1637303
TI  - Phosphorylation of the adipose/muscle-type glucose transporter (GLUT4) and its
      relationship to glucose transport activity.
AB  - The effects of protein phosphorylation and dephosphorylation on glucose transport
      activity reconstituted from adipocyte membrane fractions and its relationship to
      the phosphorylation state of the adipose/muscle-type glucose transporter (GLUT4)
      were studied. In vitro phosphorylation of membranes in the presence of ATP and
      protein kinase A produced a stimulation of the reconstituted glucose transport
      activity in plasma membranes and low-density microsomes (51% and 65% stimulation
      respectively), provided that the cells had been treated with insulin prior to
      isolation of the membranes. Conversely, treatment of membrane fractions with
      alkaline phosphatase produced an inhibition of reconstituted transport activity.
      However, in vitro phosphorylation catalysed by protein kinase C failed to alter
      reconstituted glucose transport activity in membrane fractions from both basal
      and insulin-treated cells. In experiments run under identical conditions, the
      phosphorylation state of GLUT4 was investigated by immunoprecipitation of glucose
      transporters from membrane fractions incubated with [32P]ATP and protein kinases
      A and C. Protein kinase C stimulated a marked phosphate incorporation into GLUT4
      in both plasma membranes and low-density microsomes. Protein kinase A, in
      contrast to its effect on reconstituted glucose transport activity, produced a
      much smaller phosphorylation of the GLUT4 in plasma membranes than in low-density
      microsomes. The present data suggest that glucose transport activity can be
      modified by protein phosphorylation via an insulin-dependent mechanism. However,
      the phosphorylation of the GLUT4 itself was not correlated with changes in its
      reconstituted transport activity.

PMID- 1637304
TI  - Differential effects of platelet-derived growth factor, serum and bombesin on
      phospholipase D-mediated hydrolysis of phosphatidylethanolamine in NIH 3T3
      fibroblasts.
AB  - In previous studies, activators of protein kinase C, sphingosine, ATP and various
      oncogenes were each found to enhance phospholipase D-mediated hydrolysis of
      phosphatidylethanolamine (PtdEtn) in NIH 3T3 fibroblasts. Here I examined
      possible stimulation of PtdEtn hydrolysis by various growth-stimulatory agents,
      including serum, bombesin, platelet-derived growth factor (PDGF), fibroblast
      growth factor (FGF) and insulin. Treatment of NIH 3T3 fibroblasts, prelabelled
      with [14C]Etn or [32P]PtdEtn, with PDGF-BB resulted in enhanced formation of
      [14C]Etn or [32P]phosphatidic acid from the respective labelled cellular pools of
      PtdEtn. A maximal effect (approximately 3-fold stimulation) on PtdEtn hydrolysis
      was obtained with 50 ng of PDGF/ml after 5 min of treatment. Phosphatidylcholine
      (PtdCho) was also hydrolysed, although less extensively than PtdEtn, in PDGF
      stimulated cells. PDGF-stimulate hydrolysis of both PtdEtn and PtdCho was
      prevented by prolonged (30 h) treatment of cells with 400 nM-phorbol 12-myristate
      13-acetate (PMA). Similar to PDGF, fetal calf serum (1-10%) also stimulated
      PtdEtn hydrolysis. However, in contrast to PDGF, the effect of serum on PtdEtn
      hydrolysis (i) was not diminished by pretreatment with PMA, and (ii) was
      synergistic with that of PMA after a 1 h incubation. Compared with PDGF and
      serum, bombesin had less effect on PtdEtn hydrolysis, while FGF and insulin had
      no effects at all. In contrast to PDGF or serum, bombesin inhibited the effect of
      PMA on PtdEtn hydrolysis.

PMID- 1637305
TI  - The biologically active phospholipid, lysophosphatidic acid, induces
      phosphatidylcholine breakdown in fibroblasts via activation of phospholipase D.
      Comparison with the response to endothelin.
AB  - Lysophosphatidic acid (LPA) is a simple phospholipid that possesses hormone- and
      growth-factor-like properties. LPA initiates its action by inducing GTP-dependent
      phosphoinositide hydrolysis and inhibiting adenylate cyclase [van Corven,
      Groenink, Jalink, Eichholtz & Moolenaar (1989) Cell 59, 45-54]. Here we show that
      LPA stimulates rapid breakdown of phosphatidylcholine (PC) in Rat-1 fibroblasts.
      LPA-induced PC breakdown occurs through activation of phospholipase D (PLD), as
      measured by the formation of free choline and phosphatidic acid and by
      transphosphatidylation in the presence of butan-1-ol. LPA also stimulates
      generation of diacylglycerol, but there is no detectable formation of
      phosphocholine, suggesting that a PC-specific phospholipase C (PLC) is not
      involved. The response to LPA was compared with that to endothelin, a potent
      inducer of phospholipid hydrolysis but a poor mitogen for Rat-1 cells. Our
      results indicate that: (1) LPA is less efficient than endothelin in inducing
      phosphoinositide and PC breakdown; (2) LPA-induced PLD activation is short-lived,
      levelling off after 2 min, whereas the endothelin-stimulated increase in PLD
      activity persists for at least 1 h; (3) the effect of LPA on PLD, like that of
      endothelin, is blocked by long-term pretreatment of the cells with phorbol ester,
      suggesting that PLD activation occurs through a protein kinase C-dependent
      mechanism. Furthermore, our results support the notion that there is no simple
      causal relationship between the degree of agonist-induced phospholipid hydrolysis
      and the magnitude of the mitogenic response.

PMID- 1637306
TI  - Dissociation and unfolding of Pi-class glutathione transferase. Evidence for a
      monomeric inactive intermediate.
AB  - The dissociation and unfolding of the homodimeric glutathione transferase (GST)
      Pi from human placenta, using different physicochemical denaturants, have been
      investigated at equilibrium. The protein transitions were followed by monitoring
      loss of activity, intrinsic fluorescence, tyrosine exposure, far-u.v. c.d. and
      gel-filtration retention time of the protein. At low denaturant concentration
      (less than 1 M for guanidinium chloride and less than 4.5 M for urea), a
      reversible dissociation step leading to inactivation of the enzyme was observed.
      At higher denaturant concentrations the monomer unfolds completely. The same
      unfolding behaviour was also observed with high hydrostatic pressure as
      denaturant. Our results indicate that the denaturation of GST Pi is a multistep
      process, i.e. dissociation of the active dimer into structured inactive monomers
      followed by unfolding.

PMID- 1637307
TI  - Epidermal growth factor increases sn-1,2-diacylglycerol levels and activates
      phospholipase D-catalysed phosphatidylcholine breakdown in Swiss 3T3 cells in the
      absence of inositol-lipid hydrolysis.
AB  - Addition of epidermal growth factor (EGF) to quiescent Swiss 3T3 cells resulted
      in a sustained increase in cellular diacylglycerol (DG) content in the absence of
      inositol-lipid hydrolysis. In the presence of non-cytotoxic concentrations of
      butan-1-ol, EGF stimulated the formation of phosphatidylbutanol, indicating that
      the EGF receptor was able to couple to the activation of phospholipase D (PLD).
      EGF-stimulated release of choline from Swiss 3T3 cells suggested that the major
      substrate for this PLD was phosphatidylcholine. Unlike bombesin-stimulated PLD
      activity, the response to EGF was not inhibited by a selective protein kinase C
      (PKC) inhibitor (Ro-31-8220), suggesting that it was not dependent on PKC
      activation. Pre-treatment of Swiss 3T3 cells with the EGF-receptor tyrosine
      kinase inhibitor AG18 selectively inhibited EGF-stimulated PLD activity; bombesin
      stimulated PLD activity was unaffected. Butan-1-ol inhibited phorbol ester- and
      bombesin-stimulated DG formation suggesting a role for a coupled
      PLD/phosphatidate phosphohydrolase pathway; in contrast, EGF-stimulated DG
      formation was unaffected.

PMID- 1637308
TI  - Plasma-membrane-intercalated heparan sulphate proteoglycans in an osteogenic cell
      line (UMR 106-01 BSP).
AB  - The heparan sulphate (HS) proteoglycans associated with the cell layer of a rat
      osteosarcoma cell line [UMR 106-01 (BSP)] were compared with similar cell
      associated proteoglycans from other cells, and their interaction with the plasma
      membrane was studied. HS proteoglycans were metabolically labelled by incubation
      of cell cultures with [3H]glucosamine or [3H]leucine and [35S]sulphate. HS
      proteoglycan core protein preparation generated by heparitinase digestion of the
      major species from UMR 106-01 (BSP) cells co-migrated on PAGE with identical
      preparations from ovarian granulosa cells and parathyroid cells (at approximately
      70 kDa). The hydrophobic nature of the major HS proteoglycans from these diverse
      cell lines, based on elution position from octyl-Sepharose, were also comparable.
      Linkages of the HS proteoglycan to the cell membrane were investigated by
      labelling plasma-membrane preparations with a lipid soluble photoactivatable
      reagent, 3-(trifluoromethyl)-3- (m-[125I]iodophenyl)diazirine (TID), which
      selectively labels plasma-membrane-spanning peptide domains. Purified HS
      proteoglycan from UMR 106-01 (BSP) cells was shown to be accessible to the
      [125I]TID, and the core protein portion of the molecule was labelled, confirming
      its close association with the plasma membrane. Approx. 36% of 35S-labelled HS
      proteoglycans were released from the cell surface by phospholipase C (Bacillus
      thuringiensis), which specifically cleaves phosphatidylinositol-linked proteins.
      In the presence of insulin, the metabolism of the phospholipase C-sensitive
      population was unaltered; however, release of the phospholipase C-insensitive
      population into the medium was increased. These data indicate that a
      subpopulation of HS proteoglycans are covalently bound to the plasma membrane by
      a glycosylphosphatidylinositol structure, with the remainder representing those
      species directly inserted into the plasma membrane via a hydrophobic peptide
      domain. These observations are similar to those reported for ovarian granulosa
      cells [Yanagishita & McQuillan (1989) J. Biol. Chem. 264 17551-17558], and thus
      may represent a general phenomenon for many cell types.

PMID- 1637309
TI  - Cloning, sequencing and expression in Escherichia coli of the rubredoxin gene
      from Clostridium pasteurianum.
AB  - A 3.9 kb BglII-HindIII DNA fragment containing the rubredoxin gene from
      Clostridium pasteurianum has been cloned using oligonucleotide probes designed
      from the protein sequence. The 2675 bp SspI-HindIII portion of this fragment has
      been sequenced and found to contain three open reading frames in addition to the
      rubredoxin gene. The putative product of one of these open reading frames is
      similar to various thioredoxin reductases. The rubredoxin gene translates into a
      sequence that differs from the previously published protein sequence in three
      positions, D-14, D-22 and E-48 being replaced by the corresponding amides. These
      changes have been confirmed by partial resequencing of the protein. Promoter-like
      sequences and a transcription termination signal have been found near the
      sequence of the rubredoxin gene, which may therefore constitute an independent
      transcriptional unit. Expression of C. pasteurianum rubredoxin in Escherichia
      coli strain JM109 has been optimized by subcloning a 476 bp SspI-SspI fragment
      encompassing the rubredoxin gene. Under these conditions, the latter gene was
      partly under the control of the lac promoter of pUC18, and the level of
      rubredoxin production could be increased twofold on addition of a lactose
      analogue, thus reaching 2-3 mg of pure protein/l of culture. Recombinant
      rubredoxin was produced in E. coli cells as the holoprotein, and displayed a u.v.
      visible-absorption spectrum identical with that of the rubredoxin purified from
      C. pasteurianum. M.s. and N-terminal sequencing showed that C. pasteurianum
      rubredoxin expressed in E. coli differs from its native counterpart by having an
      unblocked N-terminal methionine.

PMID- 1637310
TI  - Neutron and X-ray solution-scattering studies of the ternary complex between
      proteoglycan-binding region, link protein and hyaluronan.
AB  - Proteoglycan aggregates of cartilage are stabilized by the formation of a ternary
      complex between the G1 domain at the N-terminus of the proteoglycan monomer
      (aggrecan), link protein and hyaluronan polysaccharide. Both the G1 domain and
      link protein contain similar three-domain structures formed from an
      immunoglobulin fold and two proteoglycan tandem repeats, the arrangement of which
      had been investigated by neutron and synchrotron X-ray scattering [Perkins,
      Nealis, Dunham, Hardingham & Muir (1991) Biochemistry 30, 10708-10716]. Here,
      solution scattering was used to investigate the ternary complexes formed between
      a proteolytic fragment of proteoglycan monomer containing G1 (termed binding
      region), link protein and hyaluronan oligosaccharides containing either 34 or 450
      saccharide units (HA34 and HA450). The ternary complex with HA34 had a neutron
      radius of gyration, RG, at infinite contrast not exceeding 5.5 nm. The ternary
      complex with HA34 had an X-ray cross-sectional radius of gyration Rxs of 2.4 nm
      and a neutron Rxs at infinite contrast of 2.00 nm. Since both were similar or
      larger than the Rxs for binding region (X-rays, 2.04 nm; neutrons, 1.84 nm) and
      link protein (neutrons, 0.8 nm), analyses showed that the cross-sectional mean
      width of the ternary complex is greater than those in each of the free proteins,
      i.e. the two proteins associated side-by-side. Similar results were obtained with
      HA450 complexed with binding region and with both binding region and link
      protein. This structural model was verified by hydrodynamic simulations of the
      experimental sedimentation coefficient of 5.5 S, which showed that a compact
      ternary-complex structure was formed. Although scattering curve simulations using
      small spheres were limited for the ternary complex with HA34 because of its
      approximate RG value, the scattering data were compatible with the formation of a
      compact complex formed by side-by-side contacts between G1 and link protein.

PMID- 1637311
TI  - Effects of insulin-like growth factor I on the rates of glucose transport and
      utilization in rat skeletal muscle in vitro.
AB  - 1. The effects of insulin-like growth factor I (IGF-I) on the rates of glucose
      transport and utilization and its interaction with insulin were investigated in
      rat soleus muscle in vitro. IGF-I increased the rates of glucose transport,
      lactate formation, glycogen synthesis and the flux of glucose to hexose
      monophosphate, but it had no effect on the rate of glucose oxidation or
      glycogenolysis. 2. In the absence of insulin, low levels of IGF-I (0-30 ng/ml)
      increased the rate of glycolysis and the content of fructose 2,6-bisphosphate,
      but the content of glucose 6-phosphate remained unaltered; at higher levels of
      IGF-I (300-3000 ng/ml) the rate of glycolysis and the content of fructose 2,6
      bisphosphate showed a further modest increase, but the content of glucose 6
      phosphate doubled. Similar changes were seen when the level of insulin was
      increased from basal (0-0.4 ng/ml) to maximal (40 ng/ml). 3. Neither IGF-I nor
      insulin affected the contents of ATP, ADP, AMP, phosphocreatine or citrate. 4.
      Maximal concentrations of IGF-I increased the rate of lactate formation to a
      greater extent than did maximal concentrations of insulin. 5. In the presence of
      IGF-I, the rate of glucose utilization was less responsive to insulin. 6. The
      results suggest that, in rat skeletal muscle: (a) IGF-I increases the rates of
      glucose transport and utilization independently of insulin, and has a
      preferential effect on the rate of lactate formation; (b) the effects of IGF-I
      and insulin are not additive; (c) in addition to its effects on glucose
      transport, IGF-I increases the rate of glycogen synthesis and may stimulate
      glycolysis at the level of 6-phosphofructokinase; (d) changes in the content of
      fructose 2,6-bisphosphate may be part of the mechanism to regulate glycolytic
      flux in skeletal muscle in response to either IGF-I or insulin.

PMID- 1637312
TI  - Separation and characterization of the two Asn-linked glycosylation sites of
      chicken serum riboflavin-binding protein. Glycosylation differences despite
      similarity of primary structure.
AB  - Serum riboflavin-binding protein, a phosphoglycoprotein from the blood of laying
      hens, contains two Asn-Xaa-(Thr)Ser sequons in very similar but well-separated
      regions of amino acid sequence. In order to evaluate the effect of local amino
      acid sequence on the structure of the attached oligosaccharides, serum riboflavin
      binding protein was purified to homogeneity, reduced and alkylated, digested with
      trypsin, and the two glycopeptides were separated by reversed-phase
      chromatography. After digestion with peptide-N-glycosidase F the released
      oligosaccharides were separated by high-pH anion-exchange chromatography and the
      oligosaccharide profiles of the two glycopeptides were compared. Although the two
      asparagine residues that are glycosylated are contained in pentapeptide segments
      in which four out of five amino acids are identical, the array of
      oligosaccharides present at each site show differences in both type and
      distribution. This suggests that local secondary or tertiary structure, or the
      order of glycosylation, influences the oligosaccharide structure more than does
      the primary structure flanking the attachment site.

PMID- 1637313
TI  - A serine proteinase of an archaebacterium, Halobacterium mediterranei. A
      homologue of eubacterial subtilisins.
AB  - A homogeneous serine proteinase secreted by the extreme halophilic bacterium
      Halobacterium mediterranei 1538 was isolated by affinity chromatography on
      bacitracin-Sepharose with a yield of 48% (260-fold purification). The enzyme
      reveals an optimum for pyroglutamyl-Ala-Ala-Leu p-nitroanilide hydrolysis at pH
      8.0-8.5 (Km 0.14 mM; k(cat). 36.9 s-1). Its activity increases linearly with NaCl
      concentration over the range 2-5 M. The substrate specificity of the enzyme is
      comparable with that of secretory subtilisins, the extent of protein degradation
      approaching that attained with proteinase K. The enzyme has a molecular mass of
      41 kDa and a pI of 7.5. The N-terminal sequence of H. mediterranei serine
      proteinase reveals a 50% identity with that of Thermoactinomyces vulgaris serine
      proteinases, indicating that the enzyme belongs to the subtilisin family. Hence
      the serine proteinase secreted by the halophilic bacterium should be considered
      as a functional analogue, and a structural homologue, of eubacterial serine
      proteinases (subtilisins).

PMID- 1637314
TI  - Structural analysis of the regulatory elements of the type-II procollagen gene.
      Conservation of promoter and first intron sequences between human and mouse.
AB  - Transcription of the type-II procollagen gene (COL2A1) is very specifically
      restricted to a limited number of tissues, particularly cartilages. In order to
      identify transcription-control motifs we have sequenced the promoter region and
      the first intron of the human and mouse COL2A1 genes. With the assumption that
      these motifs should be well conserved during evolution, we have searched for
      potential elements important for the tissue-specific transcription of the COL2A1
      gene by aligning the two sequences with each other and with the available rat
      type-II procollagen sequence for the promoter. With this approach we could
      identify specific evolutionarily well-conserved motifs in the promoter area. On
      the other hand, several suggested regulatory elements in the promoter region did
      not show evolutionary conservation. In the middle of the first intron we found a
      cluster of well-conserved transcription-control elements and we conclude that
      these conserved motifs most probably possess a significant function in the
      control of the tissue-specific transcription of the COL2A1 gene. We also describe
      locations of additional, highly conserved nucleotide stretches, which are good
      candidate regions in the search for binding sites of yet-uncharacterized
      cartilage-specific transcription regulators of the COL2A1 gene.

PMID- 1637315
TI  - Iron release and membrane damage in erythrocytes exposed to oxidizing agents,
      phenylhydrazine, divicine and isouramil.
AB  - Mouse erythrocytes were incubated with oxidizing agents, phenylhydrazine,
      divicine and isouramil. With all the oxidants a rapid release of iron in a
      desferrioxamine (DFO)-chelatable form was seen and it was accompanied by
      methaemoglobin formation. If the erythrocytes were depleted of GSH by a short
      preincubation with diethyl maleate, the release of iron was accompanied by lipid
      peroxidation and, subsequently, haemolysis. GSH depletion by itself did not
      induce iron release, methaemoglobin formation, lipid peroxidation or haemolysis.
      Rather, the fate of the cell in which iron is released depended on the
      intracellular availability of GSH. In addition, iron release was higher in
      depleted cells than in native ones, suggesting a role for GSH in preventing iron
      release when oxidative stress is imposed by the oxidants. Iron release preceded
      lipid peroxidation. The latter was prevented when the erythrocytes were preloaded
      with DFO in such a way (preincubation with 10 mM-DFO) that the intracellular
      concentration was equivalent to that of the released iron, but not when the
      intracellular DFO was lower (preincubation with 0.1 mM-DFO). Extracellular DFO
      did not affect lipid peroxidation and haemolysis, suggesting again that the
      observed events occur intracellularly (intracellular chelation of released iron).
      The relevance of iron release from iron complexes in the mechanisms of cellular
      damage induced by oxidative stress is discussed.

PMID- 1637316
TI  - Modification of catalytically important carboxy residues in endoglucanase D from
      Clostridium thermocellum.
AB  - Endoglucanase D (EC 3.2.1.4; EGD) from Clostridium thermocellum is rapidly (k =
      216 M-1.min-1) and almost completely (greater than 95%) inactivated with
      Woodward's reagent K (N-ethyl-5-phenylisoxazolium-3'-sulphonate).
      Spectrophotometric analysis at 340 nm reveals that eight carboxy residues react,
      whereas specific ligands protect one residue against modification. The enzyme
      retains it full activity under the latter conditions. The kinetics and pH
      dependence of inactivation point towards the involvement of one or more essential
      carboxy groups with a pKa of 5.7-5.8. Samples modified in the absence or presence
      of ligand were analysed by reversed-phase liquid chromatography after proteolysis
      with subtilisin. Dual-wavelength monitoring at 214 and 340 nm during this
      fractionation leads to the identification of a putatively active-site peptide
      (Gly-508-Ala-562) which was further characterized by amino acid and partial N
      terminal sequence analyses. Asp-546 and Glu-555 are postulated as possible active
      site residues. This follows from alignments using ten endoglucanase sequences
      belonging to the same family. Strong local conservation suggests that this C
      terminal sequence is structurally and/or functionally important.

PMID- 1637317
TI  - Phosphorylation of the spliced variant forms of the recombinant stimulatory
      guanine-nucleotide-binding regulatory protein (Gs alpha) by protein kinase C.
AB  - Recombinant forms of Gs alpha-1 and Gs alpha-4 were shown to act as substrates
      for a purified preparation of brain protein kinase C. Both forms of Gs alpha were
      thermally denatured during the incubation such that phosphorylation was virtually
      complete (greater than 90%) after 30 min. The quantity of phosphate incorporated
      into approximately equivalent starting amounts of the two forms of Gs alpha (4.8
      pmol of Gs alpha-1 and 5.5 pmol of Gs alpha-4) at maximal phosphorylation were
      0.23 +/- 0.08 pmol for Gs alpha-1 and 0.56 +/- 0.12 pmol for Gs alpha-4. Since
      both forms of Gs alpha were thermally denatured to the same extent after 30 min,
      the increased phosphorylation state of Gs alpha-4 provides evidence that Gs alpha
      4 contains an additional phosphorylation site. Bray and co-workers [Bray, Carter,
      Simmons, Guo, Puckett, Kamhollz, Spiegel & Nirenberg (1986) Proc. Natl. Acad.
      Sci. U.S.A. 83, 8893-8897] proposed that an additional phosphorylation site may
      exist at the splice junction in Gs alpha-4. The guanine-nucleotide-free form of
      Gs alpha appears to be the preferred substrate for phosphorylation. This
      interpretation is based upon the following observations. (i) Guanosine 5'-[beta
      thio]diphosphate at micromolar concentrations inhibits the susceptibility of Gs
      alpha to phosphorylation; (ii) beta gamma-subunits, which inhibit GDP release
      from Gs alpha-GDP at millimolar Mg2+ concentrations, also inhibit the
      susceptibility of Gs alpha to phosphorylation; and (iii) guanosine 5'[beta gamma
      imido]triphosphate inhibits the susceptibility of Gs alpha to act as a substrate
      for phosphorylation. These studies suggest that there is potential for cross-talk
      between receptors which trigger PtdIns(4,5)P2 hydrolysis and subsequently protein
      kinase C activation, and receptors which stimulate adenylate cyclase via Gs.

PMID- 1637318
TI  - Glutamine transport and metabolism in mammalian skeletal muscle.

PMID- 1637319
TI  - Some evidence for the existence of substrate cycles and their utility in vivo.

PMID- 1637320
TI  - Agonist-evoked Ca2+ entry in human platelets.

PMID- 1637321
TI  - Molecular cloning and expression of a new rat liver cell-CAM105 isoform.
      Differential phosphorylation of isoforms.
AB  - An hepatocyte cell-adhesion molecule (cell-CAM105) was recently shown to be
      identical with the liver plasma-membrane ecto-ATPase. This protein has structural
      features of the immunoglobulin superfamily and is homologous with
      carcinoembryonic antigen proteins. We have cloned a cDNA encoding a new form of
      the cell-CAM105 which is a variant of the previously isolated clone. In addition
      to having a shorter cytoplasmic domain, the new isoform also has substitutions
      clustered in the first 130 amino acids of the extracellular domain. Both of these
      isoforms are expressed on the surface of hepatocytes with the shorter variant
      being the predominant form. The previously isolated cell-CAM105 (long form) has
      more potential phosphorylation sites than does the new isoform (short form). Both
      isoforms are found to be phosphorylated after incubation with [32P]phosphate in
      vitro, with the long form being phosphorylated to a significantly higher extent.
      This observed differential phosphorylation could be one of the mechanisms for the
      regulation of isoform functions. Using antipeptide antibodies specific for the
      long form and antibodies that are reactive with both isoforms, we have shown that
      both isoforms are localized in the canalicular domain of hepatocytes. The
      sequence differences between these two isoforms suggest that they are probably
      derived from different genes rather than from alternative splicing.

PMID- 1637322
TI  - Localization of intestinal trefoil-factor mRNA in rat stomach and intestine by
      hybridization in situ.
AB  - A cDNA encoding rat intestinal trefoil factor (rITF) was prepared by reverse
      transcription and PCR amplification. The sequence obtained was well conserved
      with that of other trefoil peptides. An antisense riboprobe produced from the
      clone was used to localize the sites of ITF expression in the rat
      gastrointestinal tract using hybridization in situ. We found rITF mRNA in goblet
      cells in the small intestine and colon; a gradient of signal strength greatest
      near the crypt base was sometimes present. We found no evidence for rITF
      expression in Brunner's glands, the pancreas, or most regions of the gastric
      mucosa. Surprisingly, strong signals for rITF mRNA were detected in a region of
      stomach at the junction of the squamous fore-stomach with the glandular gastric
      mucosa. This region, which may correspond to the cardiac region, formed part of a
      larger area of cells staining positive for acid mucins. We hypothesize that
      concerted expression occurs of particular trefoil peptides with specific mucins,
      and that this organization reflects a functional relationship between mucins and
      trefoil peptides.

PMID- 1637323
TI  - A simple, fast, one-step method for the purification of the skeletal-muscle
      ryanodine receptor.
AB  - In this paper we describe a simple, fast, one-step method for the purification of
      the skeletal-muscle ryanodine receptor. The ryanodine receptor from CHAPS
      solubilized junctional sarcoplasmic-reticulum membranes was adsorbed to a
      spermine-agarose column and eluted by 2 mM-spermine. The purified receptor,
      consisting predominantly of a 450 kDa polypeptide on SDS/PAGE, binds
      [3H]ryanodine with a specific activity of approximately 300 pmol/mg of protein
      and with a high affinity (KD = 4.7 +/- 2 nM). The purified receptor appears to
      retain the pharmacological properties of the receptor in the original membranes.
      The purification resulted in over 80% recovery of the initial ryanodine-binding
      sites and about 30-96-fold purification. This simple and fast method is highly
      reproducible and suitable for purification of small as well as large quantities
      of ryanodine receptor.

PMID- 1637324
TI  - A choice between glycogen and delta-crystallin accumulation is made in glial
      cells and not influenced by overlying neurons.
AB  - Chick-embryo neuroretinal cells convert extensively into lens under low-glucose
      conditions, but this transdifferentiation process is blocked by high-glucose
      media. We have previously observed an inverse relationship between the levels of
      glycogen (a marker of normal retinoglial differentiation) and of delta-crystallin
      (a lens marker) in such cultures. However, most of the glycogen accumulated under
      high-glucose conditions is apparently localized in those glial (G) cells
      underlying clusters of neurons (N cells). We here show that glial-enriched
      cultures (largely depleted of N cells) both accumulate glycogen and fail to
      transdifferentiate in high-glucose media. Moreover, glycogen localization in
      groups of glial cells is unaffected by the absence of N cells. Thus the choice
      between normal and foreign differentiation pathways is made autonomously within
      the retinoglial-cell population and is not influenced significantly by the
      presence or absence of N cells.

PMID- 1637325
TI  - Surface topography of histidine residues of tetanus toxin probed by immobilized
      metal-ion affinity chromatography.
AB  - Tetanus toxin contains 14 histidine residues: six of them are localized in the
      light chain (L), one is present in the N-terminal half of the heavy chain (HN)
      and the remaining seven histidines are localized in the C-terminal half of the
      heavy chain (Hc). Using immobilized-metal-ion affinity chromatography with
      Chelating Superose-Zn(II), we show that histidines of Hc are exposed to the
      protein surface and are responsible for the binding of tetanus toxin and of Hc to
      the immobilized metal. The histidines of the L chain are not available for co
      ordination of matrix-bound Zn2+; however, two of them and three of the histidines
      of fragment Hc are accessible to diethyl pyrocarbonate. Chromatography on
      Superose-Zn(II) is also shown to be a simple and efficient method for the rapid
      isolation of tetanus toxin and of its Hc fragment, which can be extended to the
      botulinum neurotoxins.

PMID- 1637326
TI  - Instability of the protoplast membrane of facultative alkaliphilic Bacillus sp. C
      125 at alkaline pH values below the pH optimum for growth.
AB  - Cell walls of facultative alkaliphilic Bacillus sp. C-125 consist of three
      polymers (peptidoglycan, teichuronopeptide and teichuronic acid). Protoplasts
      prepared from the strain with egg-white lysozyme regenerated cell walls at
      neutral pH, but not at pH above 8.5. The protoplasts were susceptible to lysis at
      alkaline pH. The protoplasts exposed to alkaline pH rapidly burst and lost
      ability to regenerate their cell walls. The alkali-instability was similar to
      that of protoplasts from neutrophilic Bacillus subtilis 168. The membrane
      vesicles were also labile at alkaline pH. The acidic wall components of strain C
      125 may contribute to stabilization of the cytoplasmic membrane of cells growing
      at alkaline pH, probably by shielding the membrane from direct exposure to an
      alkaline environment.

PMID- 1637328
TI  - Reverse vesicles as a new system for studying enzymes in organic solvents.
AB  - A new approach to the study of enzyme activity in organic solvents has been
      developed by using optically transparent reverse vesicles. Polyphenol oxidase was
      incorporated in an active form into the above ternary system formed by the non
      ionic surfactant tetra(ethylene glycol) dodecyl ether/n-dodecane/water. The
      enzyme in this microenvironment, surprisingly, showed an apparent positive co
      operativity which has never before been described either in aqueous solution or
      in reverse micelles. In addition, the Vmax. expressed was similar to that in
      water and twice that displayed in reverse micelles.

PMID- 1637329
TI  - Contribution of five amino acid residues in the glutathione-binding site to the
      function of human glutathione transferase P1-1.
AB  - Five amino acids in proximity to GSH bound in the active-site cavity of human
      Class Pi glutathione transferase (GST) P1-1 were mutated by oligonucleotide
      directed site-specific mutagenesis. The following mutations gave catalytically
      active mutant proteins with the proper dimeric structure: Arg14----Ala, Lys45---
      Ala, Gln52----Ala, Gln65----His and Asp99----Asn. The mutation Gln65----Ala was
      also made, but the protein was not characterized because of its poor catalytic
      activity. Residues Arg14, Lys45, Gln52 and Gln65 all contribute to binding of
      glutathione, and the substitutions caused an approx. 10-fold decrease in
      affinity, corresponding to 5 kJ/mol, except for Arg14, for which the effect was
      larger. In addition, Arg14 appears to have an important structure role, since the
      Arg14----Ala mutant demonstrated a significantly lower stability as compared with
      the wild-type and the other mutant enzymes. Asp99 primarily contributes to
      catalysis rather than to binding. The kcat./Km-versus-pH profile for the Asp99---
      Asn mutant is shifted by 0.5 pH unit in the alkaline direction, and it is
      proposed that Asp99 may participate in proton transfer in the catalytic
      mechanism. The possibility of redesigning the substrate specificity for GSTs was
      shown by the fact that the mutant Lys45----Ala displayed a higher catalytic
      efficiency with GSH monoethyl ester than with its natural substrate, GSH.

PMID- 1637330
TI  - Reconstitution in vitro of a membrane-fusion event involved in constitutive
      exocytosis. A role for cytosolic proteins and a GTP-binding protein, but not for
      Ca2+.
AB  - The fusion of post-Golgi transport vesicles with the plasma membrane is perhaps
      the least well understood step in the network of intracellular membrane traffic.
      We have used an 'in vitro' system to study this membrane-fusion event. We show
      here that fusion requires the presence of cytosolic proteins, but not Ca2+, and
      is inhibited by the non-hydrolysable GTP analogue guanosine 5'-[gamma
      thio]triphosphate, which indicates the involvement of a GTP-binding protein.

PMID- 1637327
TI  - 5'-Nucleotidase: molecular structure and functional aspects.

PMID- 1637331
TI  - Structure determination of a novel cyclic phosphocompound isolated from
      Desulfovibrio desulfuricans.
AB  - The structure of a novel diphosphodiester compound recently detected in
      Desulfovibrio desulfuricans cells [Santos, Fareleira, Pedregal, LeGall & Xavier
      (1991) Eur. J. Biochem. 201, 283-287] was fully elucidated using a combination of
      n.m.r. techniques in aqueous and in methanolic solutions. The novel metabolite
      was identified as 3-methyl-1,2,3,4-tetrahydroxybutane-1,3-cyclic bisphosphate,
      and the minimum energy conformation is presented. The two chiral centres have the
      relative configuration RS.

PMID- 1637332
TI  - A member of the eukaryotic subtilisin family (PC3) has the enzymic properties of
      the type 1 proinsulin-converting endopeptidase.
AB  - PC3, a mammalian homologue of the yeast subtilisin-like proteinase Kex2, was
      expressed in Xenopus oocytes and its activity was characterized. PC3 cleaved
      human proinsulin at one of the two dibasic sites (KTRR32 but not LQKR65). The
      specificity, inhibitor profile, pH optimum (5.5) and Ca(2+)-dependence (K0.5 =
      2.5-3 mM) paralleled those of the insulin-granule type 1 endopeptidase activity,
      suggesting a role for PC3 in the conversion of prohormones.

PMID- 1637333
TI  - Activation of phospholipase D by alpha-thrombin or epidermal growth factor
      contributes to the formation of phosphatidic acid, but not to observed increases
      in 1,2-diacylglycerol.
AB  - The receptor-mediated activation of a phosphatidylcholine-hydrolysing
      phospholipase D (PLD) has recently been described. We investigated the effect of
      alpha-thrombin and epidermal growth factor (EGF) on cellular PLD activity in
      order to determine the role of this enzyme in mitogen-induced increases in
      phosphatidic acid and sn-1,2-diacylglycerol. In the presence of ethanol,
      stimulation of [3H]myristic acid-labelled quiescent IIC9 cells with alpha
      thrombin or EGF resulted in a rapid increase in radiolabelled phosphatidyl
      ethanol which reached a plateau at 1 min, indicating the rapid and transient
      activation of PLD. We observed a concomitant decrease in the mitogen-stimulated
      increase of radiolabelled phosphatidic acid. In contrast, ethanol did not
      significantly effect the elevation of sn-1,2-diacylglycerol levels stimulated by
      alpha-thrombin or EGF as determined by measurement of sn-1,2-diacylglycerol mass
      or the appearance of [3H]1,2-diacylglycerol. A novel lipid, detected by two
      dimensional t.l.c. analysis, was generated in [3H]myristic acid-labelled cells
      stimulated with alpha-thrombin, but not EGF, in the presence of ethanol.
      Treatment in vitro of cellular lipids isolated from [3H]myristic acid-labelled
      cultures with PLD in the presence of ethanol also resulted in the generation of
      this novel lipid species, supporting the role of this enzyme in its production.
      These data indicate that in quiescent IIC9 cells: (a) alpha-thrombin or EGF
      rapidly and transiently activates a PLD; (b) although this activation is
      responsible for part of the mitogen-induced increases in phosphatidic acid, it
      does not contribute to induced increases in sn-1,2-diacylglycerol; and (c)
      activation of this enzyme appears to be involved in the formation of a novel
      lipid generated in response to alpha-thrombin, but not EGF, in IIC9 fibroblasts.

PMID- 1637334
TI  - Relationship between glutathione content in liver and glutathione conjugation
      rate in the rat in vivo. Effect of buthionine sulphoximine pretreatment on
      conjugation of the two 2-bromoisovalerylurea enantiomers during intravenous
      infusion.
AB  - The relationship between hepatic glutathione content and hepatic glutathione
      conjugation rate in the rat in vivo was investigated. As substrate for
      glutathione conjugation, racemic (R,S)-2-bromoisovalerylurea (BIU) was used which
      gives rise to the biliary excretion of two diastereoisomeric glutathione
      conjugates and the urinary excretion of two diastereoisomeric mercapturates. The
      excretion rate of the glutathione conjugate in bile reflects hepatic conjugation
      exclusively. An intravenous infusion of BIU was given and the excretion rates of
      the metabolites in bile and urine were determined. The glutathione concentration
      in the liver was followed by taking biopsies every hour. Glutathione was depleted
      by the infused substrate; in rats that were pretreated with the inhibitor of
      glutathione biosynthesis, buthionine sulphoximine (BSO), the depletion of the
      glutathione content was more rapid. The rate of excretion of the glutathione
      conjugate in bile was plotted against hepatic glutathione content. These results
      indicate that the 'organ Km' for glutathione in the liver is approximately 0.5
      mumol/g of liver, so that the hepatic glutathione conjugation rate is decreased
      only at severe glutathione depletion.

PMID- 1637335
TI  - Human tumour cathepsin B. Comparison with normal liver cathepsin B.
AB  - Cathepsin B was purified from normal human liver and several human tumour tissues
      and partially characterized. Three forms of cathepsin B, with molecular masses of
      25 kDa, 26 kDa (the two appearing as a doublet) and 30 kDa, were detected in
      SDS/polyacrylamide gels. The 25-26 kDa doublet was associated with the fractions
      from tumours and normal liver containing the highest cathepsin B activity.
      Cathepsin B from both sources showed similar pH optima. Both normal liver and
      tumour cathepsin B exhibited similar kinetics against selected synthetic
      substrates. At neutral pH and 24 degrees C, cathepsin B from both normal liver
      and tumour exhibited a lower Km and a higher kcat./Km than at pH 6.0. Their
      inhibitory profiles against synthetic inhibitors were also similar. Immunological
      studies with a monospecific antibody against the mature double-chain form of
      human liver cathepsin B and an antibody against a cathepsin B-derived synthetic
      peptide established the immunological similarity of liver and tumour enzymes. The
      N-terminal sequences of the 25 kDa and 26 kDa forms were identical with that of
      the heavy chain of the mature double-chain form of human cathepsin B, whereas the
      N-terminal sequence of the 30 kDa species was identical with that of the single
      chain form of human cathepsin B. Treatment of the double-chain form of cathepsin
      B from normal liver and tumours with the endoglycosidase peptide-N4-(N-acetyl
      beta-glucosaminyl)asparagine amidase converted the 26 kDa form into 25 kDa in
      SDS/polyacrylamide gels, suggesting that cathepsin B may exist as both
      glycosylated and unglycosylated forms. Our results, in contrast with those
      reported earlier for mouse cathepsin B, indicate that human liver and tumour
      cathepsin B are similar.

PMID- 1637336
TI  - Regulation of pyruvate dehydrogenase by insulin and polyamines within
      electropermeabilized fat-cells and isolated mitochondria.
AB  - 1. Regulation of the mammalian pyruvate dehydrogenase (PDH) complex by insulin
      and polyamines has been examined by using electropermeabilized rat epididymal fat
      cells and isolated mitochondria. The complex could be regulated within the
      permeabilized cells not only by insulin, but also by certain low-M(r) species,
      including Ca2+ and the polyamine spermidine. 2. Both spermine and spermidine
      increased the level of active dephosphorylated PDH (PDHa) in isolated adipose
      tissue mitochondria 2-3-fold, with half-maximal effects at 0.9 mM and 1.7 mM
      respectively. By contrast, PDH activity in rat heart mitochondria was essentially
      insensitive to the effects of these polyamines. 3. The effects on PDH activity of
      incubation of adipose-tissue mitochondria with spermine persisted through re
      isolation and re-incubation of the mitochondria in the absence of the polyamine.
      4. No evidence was found of any increase in the concentration of spermine
      associated with purified mitochondrial fractions prepared from insulin-treated
      tissue. 5. Overall, the data provide further evidence against a role for
      polyamines in the rapid stimulation of PDH by insulin, but suggest that
      polyamines may be important in mediating longer-term changes in the activity of
      the complex.

PMID- 1637337
TI  - Evidence for G proteins in rat parotid plasma membranes and secretory granule
      membranes.
AB  - G proteins were identified in rat parotid plasma membrane-enriched fractions and
      in two populations of isolated secretory granule membrane fractions. Both
      [32P]ADP-ribosylation analysis with bacterial toxins and immunoblot analysis with
      crude and affinity-purified antisera specific for alpha subunits of G proteins
      were utilized. Pertussis toxin catalysed the ADP-ribosylation of a 41 kDa
      substrate in the plasma membrane fraction and both secretory granule membrane
      fractions. Cholera toxin catalysed the ADP-ribosylation of two substrates with
      molecular masses of 44 kDa and 48 kDa in the plasma membrane fraction but not in
      the secretory granule fractions. However, these substrates were detected in the
      secretory granule fractions when recombinant ADP-ribosylating factor was present
      in the assay medium. Immunoblot analysis of rat parotid membrane fractions using
      both affinity-purified and crude antisera revealed strong immunoreactivity of
      these membranes with anti-Gs alpha, -Gi alpha 1/alpha 2 and -Gi alpha 3 sera. In
      contrast Gs alpha was the major substrate found in both of the secretory granule
      fractions. Granule membrane fractions also reacted moderately with anti-Gi alpha
      3 antiserum, and weakly with anti-Gi alpha 1/alpha 2 and -G(o) alpha sera. The
      results demonstrate that the parotid gland membranes express a number of G
      proteins. The presence of G proteins in secretory granule membranes suggests that
      they may play a direct role in regulating exocytosis in exocrine glands.

PMID- 1637338
TI  - A potentiometric titration study of the interaction of heparin with metal
      cations.
AB  - Potentiometric titrations, at ionic strengths (I) ranging from 0.0057 to 0.336,
      suggest that Ca2+, Cu2+, Li+ and Na+ bind to heparin in a manner that depends on
      cation identity. These interactions were less affected by the value of I than
      those of heparin with Mg2+, which binds weakly below I0.050 and with K+, which
      binds weakly at I0.0057. Of the interactions studied, that of heparin with Cu2+
      was the least readily reversible.

PMID- 1637339
TI  - Additional biochemical findings in a patient and fetal sibling with a genetic
      defect in the sphingolipid activator protein (SAP) precursor, prosaposin.
      Evidence for a deficiency in SAP-1 and for a normal lysosomal neuraminidase.
AB  - It has been shown that sphingolipid activator proteins (SAPs) 1 and 2 are encoded
      on the same gene along with two other putative activator proteins [Furst,
      Machleidt & Sandhoff (1988) Biol. Chem. Hoppe-Seyler 369, 317-328 and O'Brien,
      Kretz, Dewji, Wenger, Esch & Fluharty (1988) Science 241, 1098-1101]. We have
      undertaken further biochemical investigations on a patient and fetal sibling, who
      were previously shown to have a unique sphingolipid storage disorder associated
      with an SAP-2 deficiency [Harzer, Paton, Poulos, Kustermann-Kuhn, Roggendorf,
      Grisar & Popp (1989) Eur. J. Pediatr. 149, 31-39]. The severity of their disorder
      suggested that other products of the SAP precursor or prosaposin gene may also be
      deficient. The turnover of cerebroside sulphate and globotriaosylceramide were
      investigated and were both impaired in fibroblasts from the patient and fetus.
      However, the activities of cerebroside sulphate sulphatase and
      globotriaosylceramide alpha-galactosidase in vitro were normal in cells from the
      fetus and patient respectively. In addition, there was an increase in cerebroside
      sulphate concentration in the kidney of the affected fetus. These results
      indicate that, in addition to the SAP-2 deficiency, there was a defect in SAP-1
      function in this disorder. Additional increases in the concentration of
      monohexosyl- and dihexosyl-ceramide in the fetal kidney probably reflect the
      deficiency of SAP-2 in the case of monohexosylceramides, and the combined
      activator deficiency in the case of dihexosylceramides. Lactosylceramide-loading
      studies confirmed that there was a defect in the turnover of this lipid in
      fibroblasts from the affected patient and fetus but not from a patient with an
      isolated SAP-1 deficiency, or from patients with Krabbe disease, GM1
      gangliosidosis or galactosialidosis. It has been suggested [Potier, Lamontagne,
      Michaud & Tranchemontagne (1990) Biochem. Biophys. Res. Commun. 173, 449-456]
      that the prosaposin gene also codes for lysosomal neuroaminidase. However, we
      found normal neuraminidase activity in fibroblasts from our patient, using assay
      conditions which are diagnostic for sialidosis patients. The role of prosaposin
      gene products in sphingolipid metabolism is discussed in view of our biochemical
      findings in this genetic disorder.

PMID- 1637340
TI  - Active-site characterization of S1 nuclease. I. Affinity purification and
      influence of amino-group modification.
AB  - A simple procedure, involving heat-treatment, DEAE-Sephadex, AMP-Sepharose and
      Bio-Gel P-60 chromatography, was developed for the purification of S1 nuclease to
      homogeneity from commercially available Takadiastase powder. Chemical
      modification of the amino groups of purified S1 nuclease revealed that lysine is
      essential for single-stranded DNAase, RNAase and phosphomonoesterase activities
      associated with the enzyme. The kinetics of inactivation suggested the
      involvement of a single lysine residue in the active site of the enzyme.
      Additionally, lysine modification was accompanied by a concomitant loss of all
      the activities of the enzyme, indicating the presence of a common catalytic site
      responsible for the hydrolysis of single-stranded DNA, RNA and 3'-AMP. Substrate
      protection and inhibitor-binding studies on enzyme modified with 2,4,6
      trinitrobenzenesulphonic acid showed that lysine may be involved in the substrate
      binding.

PMID- 1637341
TI  - Inhibition of cysteine proteinases in lysosomes and whole cells.
AB  - Inhibitors of cysteine proteinases have been used extensively to dissect the
      roles of these proteinases in cells. Surprisingly though, little work has been
      performed to demonstrate unequivocally that the inhibitors reach and inactivate
      their target proteinases in cell culture or in vivo. In the present study, the
      permeability of lysosomes and whole cells has been studied. Benzyloxycarbonyl (Z)
      [125I]iodo-Tyr-Ala-diazomethane (CHN2), an inhibitor of cathepsins L and B, has
      been shown to label active forms of these enzymes in lysosomes and whole cells.
      The ability of other cysteine proteinase inhibitors to block this labelling has
      been used to indicate the permeation of these compounds. All the inhibitors were
      able to block labelling by Z-[125I]iodo-Tyr-Ala-CHN2 in lysosomal extracts. In
      intact lysosomes or cells, however, only N-[N-(L-3-trans-ethoxycarbonyloxirane-2
      carbonyl)-L-leucyl]-3- methylbutylamine ('E-64d') Z-Tyr-Ala-CHN2, Z-Phe-Ala-CHN2
      and Z-Phe-Phe-CHN2 were able to block labelling by Z-[125I]iodo-Tyr-Ala-CHN2. N
      [N-(L-3-trans-Carboxyoxirane-2-carbonyl)-L-leucyl]amino-4-gua nidinobutane (E-64)
      and leupeptin were unable to block labelling by Z-[125I]iodo-Tyr-Ala-CHN2 in
      lysosomes or in cells. The ability to block labelling in lysosomes is an
      indication of the ability of the inhibitor to diffuse across membranes. Thus E-64
      and leupeptin do not readily permeate membranes and therefore their uptake into
      cells probably only occurs via pinocytosis.

PMID- 1637342
TI  - Use of rosy mutant strains of Drosophila melanogaster to probe the structure and
      function of xanthine dehydrogenase.
AB  - The usefulness in structure/function studies of molybdenum-containing
      hydroxylases in work with rosy mutant strains of Drosophila melanogaster has been
      investigated. At least 23 such strains are available, each corresponding to a
      single known amino acid change in the xanthine dehydrogenase sequence. Sequence
      comparisons permit identification, with some certainty, of regions associated
      with the iron-sulphur centres and the pterin molybdenum cofactor of the enzyme.
      Procedures have been developed and rigorously tested for the assay in gel
      filtered extracts of the flies, of different catalytic activities of xanthine
      dehydrogenase by the use of various oxidizing and reducing substrates. These
      methods have been applied to 11 different rosy mutant strains that map to
      different regions of the sequence. All the mutations studied cause characteristic
      activity changes in the enzyme. In general these are consistent with the accepted
      assignment of the cofactors to the different domains and with the known
      reactivities of the molybdenum, flavin and iron-sulphur centres. Most results are
      interpretable in terms of the mutation affecting electron transfer to or from one
      redox centre only. The activity data provide evidence that FAD and the NAD+/NADH
      binding sites are retained in mutants mapping to the flavin domain. Therefore,
      despite some indications from sequence comparisons, it is concluded that the
      structure of this domain of xanthine dehydrogenase cannot be directly related to
      that of other flavoproteins for which structural data are available. The data
      also indicate that the artificial electron acceptor phenazine methosulphate acts
      at the iron-sulphur centres and suggest that these centres may not be essential
      for electron transfer between molybdenum and flavin. The work emphasizes the
      importance of combined genetic and biochemical study of rosy mutant xanthine
      dehydrogenase variants in probing the structure and function of enzymes of this
      class.

PMID- 1637343
TI  - Participation of the phenolic hydroxyl group of Tyr-8 in the catalytic mechanism
      of human glutathione transferase P1-1.
AB  - The coding region of cDNA corresponding to human class Pi glutathione transferase
      P1-1 was amplified by the PCR, subcloned into an expression vector, pKHP1,
      expressed in Escherichia coli, and characterized. The physicochemical and
      catalytic properties of recombinant glutathione transferase P1-1 were
      indistinguishable from those of the enzyme previously isolated from human
      placenta. The active-site residue Tyr-8 of the wild-type enzyme was converted
      into Phe by means of oligonucleotide-directed mutagenesis. The mutant enzyme Y8F
      displayed a 300-fold decrease in specific activity, ascribable mainly to a
      lowered k(cat.) (or V) value. Kinetic parameters reflecting binding affinity,
      S0.5 (substrate concn. giving 1/2V) and I50 (concn. of inhibitor giving 50%
      remaining activity), were only moderately elevated in the mutant enzyme. These
      results indicate that Tyr-8 contributes primarily to catalysis as such, rather
      than to binding of the substrates. The dependence of k(cat.)/Km on pH shows an
      optimum at pH 7.0, defined by acidic and basic ionic dissociation constants with
      pKa1 = 6.7 and pKa2 = 7.3 respectively. The mutant enzyme Y8F does not display
      the basic limb of the k(cat.)/Km versus pH profile, but shows a monotonic
      increase of k(cat.)/Km with an apparent pKa1 of 7.1. The results indicate that
      the phenolic hydroxyl group of Tyr-8 in un-ionized form, but not the phenolate of
      Tyr-8, contributes to catalysis by glutathione transferase P1-1.

PMID- 1637344
TI  - Evidence for phosphatidylinositol hydrolysis in pancreatic islets stimulated with
      carbamoylcholine. Kinetic analysis of inositol polyphosphate metabolism.
AB  - Anion-exchange h.p.l.c. was used initially to analyse the products formed after
      addition of either [3H]Ins(1,3,4,5)P4 or [3H]Ins(1,4,5)P3 to homogenates of
      pancreatic islets. Metabolic routes similar to those of other tissues were
      established: dephosphorylation of Ins(1,4,5)P3 to Ins(1,4)P2 and then Ins4P; and
      sequential degradation of Ins(1,3,4,5)P4 to Ins(1,3,4)P3, Ins(3,4)P2 and Ins(3 or
      1)P. In addition, there was a limited conversion of Ins(1,3,4)P3 into Ins(1,3)P2.
      After stimulation of [3H]inositol-prelabelled islets with the muscarinic-receptor
      agonist carbamoylcholine (carbachol), there was a rapid (10 s) increase in
      Ins(1,4,5)P3, Ins(1,3,4)P3, Ins(1,4)P2 and Ins4P. In the presence of 10 mM-LiCl,
      Ins1P was also significantly increased (P less than 0.05) by 5 s, before any
      increase in Ins4P (10 s), Ins(1,3)P2 (60 s) or Ins(3,4)P2. When carbachol was
      displaced with atropine, after 1 h pre-stimulation, the maximal decreases in
      Ins(1,4,5)P3 and Ins1P from the stimulated steady state (5 s) clearly preceded
      those of the other metabolites. These declines were used to calculate the
      turnover times and rate of metabolic flux through the various inositol
      phosphates. These experiments confirmed the relatively minor importance of the
      Ins(1,3)P2 pathway (less than 10% of the total flux) and demonstrated that
      Ins(1,4,5)P3 removal was evenly distributed through the Ins(1,4)P2 and
      Ins(1,3,4,5)P4 routes. They also established that flux through Ins1P was 8-fold
      greater than that through Ins(1,4,5)P3, indicating that the former could not have
      been derived from PtdInsP2 hydrolysis. Similarly, in islets pretreated with
      neomycin, which binds to PtdInsP2 with greater affinity than to PtdIns, the
      increase in Ins1P caused by 1 min stimulation with carbachol was not affected,
      despite virtual abolition of the increase in Ins4P, and an overall inhibition of
      PtdInsP2 hydrolysis by 67%. The results indicate that, in addition to PtdInsP2
      breakdown, carbachol also promotes a rapid PtdIns hydrolysis which becomes
      increasingly predominant with prolonged stimulation.

PMID- 1637345
TI  - Kinetic studies of the polygalacturonase enzyme from Colletotrichum
      lindemuthianum.
AB  - The intrinsic protein fluorescence of the polygalacturonase from Colletotrichium
      lindemuthianum was exploited in stopped-flow experiments aimed at elucidating the
      kinetic mechanism for this enzyme. Binding of the polymeric substrate
      polygalacturonic acid (PGA) essentially produced a triphasic fluorescence
      profile. There was an initial rapid quench in fluorescence, consistent with the
      rapid formation of the enzyme-substrate complex, with an equilibrium constant of
      about 8 x 10(-4)% (w/v) PGA (about 0.27 microM). There then followed a near
      constant fluorescence phase, attributable to turnover of the enzyme-substrate
      complex as a steady-state intermediate. As the concentration of the steady-state
      intermediate became depleted, towards the end of the reaction, there was a
      partial return of the fluorescence intensity. This phase is attributed to a
      final, single turnover of the enzyme at the end of the reaction. The fluorescence
      intensity does not return to its original level due to product remaining bound at
      the end of the reaction.

PMID- 1637346
TI  - Inhibition of steroid 5 alpha-reductase by specific aliphatic unsaturated fatty
      acids.
AB  - Human or rat microsomal 5 alpha-reductase activity, as measured by enzymic
      conversion of testosterone into 5 alpha-dihydrotestosterone or by binding of a
      competitive inhibitor, [3H]17 beta-NN-diethulcarbamoyl-4-methyl-4-aza-5 alpha
      androstan-3-one ([3H]4-MA) to the reductase, is inhibited by low concentrations
      (less than 10 microM) of certain polyunsaturated fatty acids. The relative
      inhibitory potencies of unsaturated fatty acids are, in decreasing order: gamma
      linolenic acid greater than cis-4,7,10,13,16,19-docosahexaenoic acid = cis
      6,9,12,15-octatetraenoic acid = arachidonic acid = alpha-linolenic acid greater
      than linoleic acid greater than palmitoleic acid greater than oleic acid greater
      than myristoleic acid. Other unsaturated fatty acids such as undecylenic acid,
      erucic acid and nervonic acid, are inactive. The methyl esters and alcohol
      analogues of these compounds, glycerols, phospholipids, saturated fatty acids,
      retinoids and carotenes were inactive even at 0.2 mM. The results of the binding
      assay and the enzymic assay correlated well except for elaidic acid and
      linolelaidic acid, the trans isomers of oleic acid and linoleic acid
      respectively, which were much less active than their cis isomers in the binding
      assay but were as potent in the enzymic assay. gamma-Linolenic acid had no effect
      on the activities of two other rat liver microsomal enzymes: NADH:menadione
      reductase and glucuronosyl transferase. gamma-Linolenic acid, the most potent
      inhibitor tested, decreased the Vmax. and increased Km values of substrates,
      NADPH and testosterone, and promoted dissociation of [3H]4-MA from the microsomal
      reductase. gamma-Linolenic acid, but not the corresponding saturated fatty acid
      (stearic acid), inhibited the 5 alpha-reductase activity, but not the 17 beta
      dehydrogenase activity, of human prostate cancer cells in culture. These results
      suggest that unsaturated fatty acids may play an important role in regulating
      androgen action in target cells.

PMID- 1637347
TI  - An e.x.a.f.s. study of the manganese O2-evolving complex in purified Photosystem
      II membrane fractions. The S1 and S2 states.
AB  - Manganese K-edge X-ray spectra have been obtained for Photosystem II samples
      isolated using Triton X-100 detergent and samples further purified by n-heptyl
      beta-D-thioglucoside detergent treatment to remove light-harvesting polypeptides
      and low-affinity calcium. The structure of the manganese complex is very similar
      for the two detergent preparations used. Analysis of the e.x.a.f.s. spectra for
      samples in the S1 and S2 states indicate changes in bond lengths for the shells
      of oxygen/nitrogen atoms. For the S1 state, oxygen shells at 0.181 and 0.193 nm
      (1.81 and 1.93 A) were observed and one manganese shell at 0.270 nm (2.70A). In
      the S2 state the oxygen bond lengths are longer at 0.184 and 0.200 nm (1.84 and
      2.00 A). Additionally a shell of scatterers at 0.37 nm (3.7 A) was observed in
      both states which could be fitted to models with calcium scatterers at this
      distance.

PMID- 1637348
TI  - Effects of detergent on the sulphation of chondroitin by cell-free preparations
      from chick-embryo epiphyseal cartilage.
AB  - The effects of the non-ionic detergent Triton X-100 on 6-sulphation of two
      species of endogenous nascent proteochondroitin by a chick-embryo cartilage
      microsomal system was examined. Sulphation of the larger (Type I) species with
      adenosine 3'-phosphate 5'-phosphosulphate was slightly diminished when Triton X
      100 was present, whereas sulphation of the smaller (Type II) species was slightly
      enhanced. An ordered rather than random pattern of sulphation was obtained for
      the smaller proteoglycan, but with a considerably lower degree of sulphation than
      that of the larger proteochondroitin. These differences were consistent with
      other differences between these two species as described previously. Sulphation
      of exogenous [14C]chondroitin and exogenous proteo[3H]chondroitin by the
      microsomal system with Triton X-100 present produced ordered rather than random
      sulphation patterns. When a 100,000 g supernatant fraction was utilized for
      sulphation of [14C]chondroitin or proteo[3H]chondroitin, Triton X-100 was not
      needed, and ordered sulphation was still obtained. When hexasaccharide was used,
      sulphation of multiple N-acetylgalactosamine residues of the individual
      hexasaccharides resulted. This was relatively independent of Triton X-100 or the
      concentration of the hexasaccharide acceptors. With soluble enzyme, sulphation of
      multiple N-acetylgalactosamine residues on the individual hexasaccharide
      molecules was even greater, so that tri-sulphated products were found. This
      suggests that ordered rather than random sulphation of chondroitin with these
      enzyme preparations is due to enzyme-substrate interaction rather than to
      membrane organization.

PMID- 1637350
TI  - Regulation of carboxypeptidase E. Effect of pH, temperature and Co2+ on kinetic
      parameters of substrate hydrolysis.
AB  - Carboxypeptidase E is a member of the carboxypeptidase A and B gene family, with
      many of the putative active-site and substrate-binding residues conserved between
      these enzymes. However, the pH optimum of carboxypeptidase E is substantially
      lower than that of carboxypeptidases A and B. To evaluate whether the difference
      in the pH optima of these carboxypeptidases reflects fundamental differences in
      the ionization behaviour of active-site residues, the influence of pH on
      carboxypeptidase E activity was examined. The V(max) for hydrolysis of dansyl-Phe
      Ala-Arg is pH-independent between 5 and 7, but decreases at pH values below 5.
      The pKa for the group the protonation of which leads to the loss of activity is
      approximately 4.8, and the slope of the V(max.)/pH profile suggests that only a
      single ionizable group is involved. In contrast, Km and V(max.)/Km are
      dramatically influenced by pH over the range 5-7, with multiple ionizable groups
      detected in this pH range. The pKa of the group the protonation of which
      decreases the V(max.) of substrate hydrolysis is lower (4.5) for carboxypeptidase
      E which had been reconstituted with Co2+. The enthalpy of ionization of the group
      observed in the V(max.) profile for carboxypeptidase E is approx. 28.9 kJ/mol.
      These results are compatible with the active-site model of the homologous
      carboxypeptidase A: in this model the ionization of a metal-bound water molecule
      is responsible for the observed decrease in V(max.).

PMID- 1637349
TI  - Ecto-phosphorylation on aortic endothelial cells. Exquisite sensitivity to
      staurosporine.
AB  - One- and two-dimensional gel electrophoresis of proteins from bovine aortic
      endothelial cells (BAEC) incubated with [gamma-32P]ATP revealed the preferential
      labelling of a cell-associated 21 kDa substrate. The labelling of this band was
      detectable within 30 s, increased up to 30 min and was stable for at least 3 h
      following the wash-out of the ATP. This protein was also labelled after
      incubation of the cells with [gamma-35S]ATP. Incorporation of radioactivity into
      the 21 kDa band did not occur if the endothelial cells were treated with low
      concentrations of trypsin (0.01%) before or after the labelling period. The
      pattern of BAEC protein phosphorylation by [gamma-32P]ATP was completely
      different from that of the fetal calf serum used for the cell culture. The
      presence of serum during the incubation of BAEC with [gamma-32P]ATP did not
      modify qualitatively the labelling pattern and, in particular, did not enhance
      the phosphorylation of the 21 kDa substrate; this suggests that neither the
      kinase nor the 21 kDa substrate are adsorbed serum proteins. Staurosporine, a
      protein kinase inhibitor with low specificity, decreased the labelling of the 21
      kDa protein with an IC50 of 2 nM. In contrast, at 100 nM, staurosporine did not
      decrease the accumulation of inositol phosphates induced by ATP via the
      activation of P2y receptors. These data indicate the presence of aortic
      endothelial cells of an ecto-kinase which uses extracellular ATP to produce the
      selective and long-lived phosphorylation of a 21 kDa endothelial substrate. Ecto
      phosphorylation of this protein might play a role in the modulation of
      endothelial cell functions by ATP, in addition to the P2y receptors [Boeynaems &
      Pearson (1990) Trends Pharmacol. Sci. 11, 34-37]. The exquisite sensitivity of
      ecto-phosphorylation to inhibition by staurosporine and its specific inhibition
      by some isoquinolinesulphonamide compounds provide potential pharmacological
      tools to investigate this hypothesis.

PMID- 1637351
TI  - Ceramide glycanase from the earthworm, Lumbricus terrestris.
AB  - Ceramide glycanase (CGase) is an enzyme that cleaves the linkage between the
      sugar chain and the ceramide. To make this enzyme readily available, we have
      developed a simple method for preparing it from the earthworm, Lumbricus
      terrestris. The method involves Bio-Gel A-0.5m, octyl-Sepharose and p
      aminophenylthiogalactoside-agarose column chromatography. By gel filtration, the
      molecular mass of earthworm CGase was found to be 43.7 kDa. With ganglioside GM1
      as substrate, the optimal pH of this enzyme was found to be between pH 3.5 and
      4.0. Earthworm CGase hydrolyses glycolipids only in the presence of a detergent.
      Among various bile salts tested, sodium cholate was found to be the most
      effective in stimulating the hydrolysis of GM1 by this enzyme. Earthworm CGase
      released intact glycan chains from various glycosphingolipids in which the glycan
      chain is linked to the ceramide through a beta-glucosyl linkage. It also detached
      glycan chains from lactosyldialkylglycerol and alkyl-beta-lactosides.

PMID- 1637352
TI  - Increasing the thermostability of the neutral proteinase of Bacillus
      stearothermophilus by improvement of internal hydrogen-bonding.
AB  - In an attempt to increase the thermostability of the neutral proteinase of
      Bacillus stearothermophilus the buried Ala-170 was replaced by serine. Molecular
      dynamics simulations showed that Ser-170 stabilizes the enzyme by formation of an
      internal hydrogen bond. In addition, the hydroxy group of Ser-170 could
      contribute to stability by filling an internal cavity. After the introduction of
      the mutation, using site-directed-mutagenesis techniques, an increase in
      stability of 0.7 +/- 0.1 degrees C was obtained.

PMID- 1637353
TI  - Involvement of GTP in cell-free activation of neutrophil NADPH oxidase. Studies
      with GTP analogues.
AB  - Activation of superoxide-producing NADPH oxidase of neutrophils requires the
      presence of cell membranes, cytosolic components and arachidonate and is markedly
      enhanced by non-hydrolysable analogues of guanine nucleotides, i.e. guanosine 5'
      [gamma-thio]triphosphate and guanosine 5'[beta gamma-imido]triphosphate
      (p[NH]ppG). Gel filtration and ultrafiltration of the cytosol decreased the basal
      activity of NADPH oxidase. Activity could be restored by GTP, suggesting
      participation of the nucleotide in basal activation. Preincubation of neutrophil
      cytosol with periodate-oxidized p[NH]ppG (ox-p[NH]ppG) followed by gel filtration
      resulted in a time-dependent enhancement of basal oxidase activity. The presence
      of GDP or GTP, but not ATP, during the incubation with ox-p[NH]ppG abolished this
      enhancement. These data are consistent with a stable association of ox-p[NH]ppG
      with an oxidase-linked cytosolic protein. SDS/PAGE of neutrophil cytosol
      preincubated with [3H]ox-p[NH]ppG revealed radioactivity in bands migrating as
      100, 70, 47, 34 and 22 kDa proteins. Evidence for covalent labelling of the
      cytosolic protein p47-phox with [3H]ox-p[NH]ppG is presented. Heterogeneity of
      cytosolic GTP-binding sites and possible participation of protein p47-phox in
      functional interaction with GTP analogues during cell-free activation are
      suggested.

PMID- 1637354
TI  - A study of the chylomicron metabolism in WHHL rabbits after fat loading.
      Discrepancy between results based on measurement of apoprotein B-48 or retinyl
      palmitate.
AB  - We studied the metabolism of chylomicrons in homozygous Watanabe heritable
      hyperlipidaemic (WHHL) rabbits and in cholesterol-fed or normally fed New Zealand
      White (NZW) rabbits by measuring the concentrations of apoprotein B-48 and of
      retinyl palmitate in their serum after feeding fat plus this vitamin according to
      two different protocols. Compared with NZW controls, retinyl palmitate
      accumulated in both hyperlipidaemic groups under study, not only in the d less
      than 1.019 fraction but also in the low-density lipoprotein (LDL) fraction. A
      strong correlation was found between the retinyl palmitate concentration in
      either the d less than 1.019 fraction or the LDL fraction of the WHHL rabbits and
      the concentrations of cholesterol and triacylglycerols in these fractions. This
      suggests that retinyl palmitate is exchanged rapidly between exogenous and
      endogenous lipoproteins. This is supported by the lack of a correlation between
      the retinyl palmitate concentrations and the intensity of the apoprotein B-48
      band in the respective d less than 1.019 fractions or LDL fractions; in most
      fractions, in which large amounts of retinyl palmitate were present, the
      intensity of the apoprotein B-48 band was not increased compared with the fasting
      concentrations. Assuming that retinyl palmitate is a marker for the transfer of
      exogenous lipids, the results of our experiments indicate that the removal of
      exogenous lipids is delayed by complexing to endogenously synthesized
      lipoproteins. However, the clearance of apoprotein B-48 is normal and thus
      independent of the LDL-receptor activity.

PMID- 1637355
TI  - Metabolism of R- and S-1,3-butanediol in perfused livers from meal-fed and
      starved rats.
AB  - The metabolism of millimolar concentrations of R- or S-1,3-butanediol has been
      studied in perfused livers from fed and starved rats. Protocols were designed to
      measure in the same experiment (i) uptake of the diol, (ii) the contribution of
      the diol to ketogenesis, (iii) the contribution of the diol to total fatty acid
      plus sterol synthesis, and (iv) conversion of S-1,3-butanediol into S-3
      hydroxybutyrate. Our data show that R- and S-1,3-butanediol are taken up by the
      liver at the same rate. Most of the metabolism of R-1,3-butanediol is accounted
      for by conversion to the physiological ketone bodies R-3-hydroxybutyrate and
      acetoacetate. Only 29-38% of S-1,3-butanediol uptake is accounted for by
      conversion into physiological ketone bodies. The balance of S-1,3-butanediol
      metabolism is conversion to S-3-hydroxybutyrate, lipids and CO2.

PMID- 1637356
TI  - Triacylglycerol accumulation and secretion in hepatocyte cultures. Effects of
      insulin, albumin and Triton WR 1339.
AB  - We have investigated the possibility that the apparent inhibition of very-low
      density lipoprotein (VLDL)-triacylglycerol secretion by the addition of insulin
      to rat hepatocyte cultures may result from insulin-mediated enhancement of
      hepatic lipase secretion and, consequently, of extracellular triacylglycerol
      hydrolysis. We have, therefore, studied the effects of the inhibitor of lipase
      activity, Triton WR 1339, on the secretion of triacylglycerol by cultured rat
      hepatocytes. Incubation of hepatocyte cultures with increasing concentrations of
      Triton WR 1339 increased the accumulation of acylglycerol in the medium,
      suggesting that, in normal incubations, a substantial rate of degradation of
      secreted triacylglycerol does occur and that it results in an under-estimation of
      the rate of triacylglycerol secretion. However, Triton did not counteract the
      inhibitory effects of insulin, suggesting that the observed increased activity of
      hepatic lipase induced by the hormone cannot account for the inhibition of
      acylglycerol accumulation in the medium that occurred in the presence of insulin.
      BSA increased the accumulation of triacylglycerol in culture media by about 2
      fold and also decreased the activity of hepatic lipase by 80%. A causative
      relationship between these two effects was supported by the further observation
      that Triton abolished the effects of BSA on triacylglycerol accumulation in the
      medium. The implications of these data for the validity of the use of Triton for
      the study of hepatic rates of triacylglycerol production in vivo and of secretion
      by hepatocytes in vitro are discussed.

PMID- 1637357
TI  - Expression of Pseudomonas aeruginosa nitrite reductase in Pseudomonas putida and
      characterization of the recombinant protein.
AB  - Nitrite reductase from Pseudomonas aeruginosa has been successfully expressed in
      Pseudomonas putida. The purified recombinant enzyme contains haem c but no haem
      d1. Nonetheless, like the holoenzyme from Ps. aeruginosa, it is a stable dimer
      (molecular mass 120 kDa), and electron transfer to oxidized azurin is biphasic
      and follows bimolecular kinetics (k1 = 1.5 x 10(5) and k2 = 2.2 x 10(4) M-1.s-1).
      Unlike the chemically produced apoenzyme, recombinant nitrite reductase
      containing only haem c is water-soluble, stable at neutral pH and can be
      quantitatively reconstituted with haem d1, yielding a holoenzyme with the same
      properties as that expressed by Ps. aeruginosa (namely optical and c.d. spectra,
      molecular mass, cytochrome c551 oxidase activity and CO-binding kinetics).

PMID- 1637358
TI  - Selective oxidation of histidine residues in proteins or peptides through the
      copper(II)-catalysed autoxidation of glucosone.
AB  - Glucosone has been identified as the main intermediate sugar moiety product of
      the copper(II)-catalysed autoxidation of the Amadori compound [Kawakishi,
      Tsunehiro & Uchida (1991) Carbohydr. Res. 211, 167-171]. Oxidative fragmentation
      of the model protein, especially selective degradation of the histidine residue
      in protein or peptides mediated by the copper(II)-catalysed autoxidation of
      glucosone, is discussed in this paper. The oxidative damage to protein could be
      retarded by catalase (EC 1.11.1.16) and EDTA, while superoxide dismutase (EC
      1.15.1.1) and hydroxyradical scavengers showed little effect. Through the process
      of the oxidative degradation of N-benzoylhistidine and other histidine-containing
      peptides, the oxidation of the imidazole ring in histidine caused by the
      glucosone-copper(II) system was the same as that by the ascorbate-copper(II)
      system. These facts suggest that the copper-catalysed autoxidation of glucosone
      could generate some active-oxygen species causing oxidative damage to protein
      similar to that caused by the ascorbate-copper(II) system.

PMID- 1637359
TI  - Dual role for protein kinase C alpha as a regulator of ion secretion in the
      HT29cl.19A human colonic cell line.
AB  - The involvement of protein kinase C (PKC) in the regulation of intestinal ion
      secretion was studied in polarized monolayers of the HT29cl.19A human colon
      carcinoma cell line. Carbachol, phorbol esters [PMA (phorbol 12-myristate 13
      acetate) and PDB (phorbol 12,13-dibutyrate)] and 8-bromo cyclic AMP (8-Br-cAMP)
      induced Cl secretion, as measured by a rise in the short-circuit current (ISC).
      The electrical response to carbachol coincided with a transient translocation of
      PKC alpha from the soluble to the particulate fraction. The carbachol-, PDB- and
      8-Br-cAMP-induced ISC responses were inhibited by pretreatment of the cells with
      PMA (0.5 microM) for 2 h, a time period in which PKC alpha, beta 1 and gamma
      levels were not changed. As shown by 86Rb+ and 125I- efflux studies, the main
      targets for this inhibition were basolateral K+ transporters rather than apical
      Cl- channels. Prolonged exposure to PMA (24 h) led to a 60% recovery of the 8-Br
      cAMP response, but not of the carbachol- or PDB-provoked secretion. As shown by
      immunoblotting with PKC-isoenzyme-specific antisera, the recovery of the 8-Br
      cAMP response coincided with the down-regulation of PKC alpha, whereas the levels
      of PKC beta 1 and gamma were unmodified. These results suggest that PKC alpha,
      but not PKC beta 1 or gamma, is involved in both acute stimulation and chronic
      inhibition of ion secretion in the HT29cl.19A colonic cell line.

PMID- 1637360
TI  - DNA precursor asymmetries, replication fidelity, and variable genome evolution.
AB  - Balanced pools of deoxyribonucleoside triphosphates (dNTPs) are essential for DNA
      replication to occur with maximum fidelity. Conditions that create biased dNTP
      pools stimulate mutagenesis, as well as other phenomena, such as recombination or
      cell death. In this essay we consider the effective dNTP concentrations at
      replication sites under normal conditions, and we ask how maintenance of these
      levels contributes toward the natural fidelity of DNA replication. We focus upon
      two questions. (1) In prokaryotic systems, evidence suggests that replication is
      driven by small, localized, rapidly replenished dNTP pools that do not
      equilibrate with the bulk dNTP pools in the cell. Since these pools cannot be
      analyzed directly, what indirect approaches can illuminate the nature of these
      replication-active pools? (2) In eukaryotic cells, the normal dNTP pools are
      highly asymmetric, with dGTP being the least abundant nucleotide. Moreover, the
      composition of the dNTP pools changes as cells progress through the cell cycle.
      To what extent might these natural asymmetries contribute toward a recently
      described phenomenon, the differential rate of evolution of different genes in
      the same genome?

PMID- 1637361
TI  - Biological asymmetries and the fidelity of eukaryotic DNA replication.
AB  - A diploid human genome contains approximately six billion nucleotides. This
      enormous amount of genetic information can be replicated with great accuracy in
      only a few hours. However, because DNA strands are oriented antiparallel while
      DNA polymerization only occurs in the 5'----3' direction, semi-conservative
      replication of double-stranded DNA is an asymmetric process, i.e., there is a
      leading and a lagging strand. This provides a considerable opportunity for non
      random error rates, because the architecture of the two strands as well as the
      DNA polymerases that replicate them may be different. In addition, the proteins
      that start or finish chains may well be different from those that perform the
      bulk of chain elongation. Furthermore, while replication fidelity depends on the
      absolute and relative concentrations of the four deoxyribonucleotide precursors,
      these are not equal in vivo, not constant throughout the cell cycle, and not
      necessarily equivalent in all cell types. Finally, the fidelity of DNA synthesis
      is sequence-dependent and the eukaryotic nuclear genome is a heterogeneous
      substrate. It contains repetitive and non-repetitive sequences and can actually
      be considered as two subgenomes that differ in nucleotide composition and gene
      content and that replicate at different times. The effects that each of these
      asymmetries may have on error rates during replication of the eukaryotic genome
      are discussed.

PMID- 1637362
TI  - From cell fates to morphology: developmental genetics of the Caenorhabditis
      elegans male tail.
AB  - The C. elegans male tail is being studied as a model to understand how genes
      specify the form of multicellular animals. Morphogenesis of the specialized male
      copulatory organ takes place in the last larval stages during male development.
      Genetic analysis is facilitated because the structure is not necessary for male
      viability or for strain propagation. Analysis of developmental mutants, isolated
      in several functional and morphological screens, has begun to reveal how fates of
      cells are determined in the cell lineages, and how the specification of cell
      fates affects the morphology of the structure. Cytological studies in wild type
      and in mutants have been used to study the mechanism of pattern formation in the
      tail peripheral nervous system. The ultimate goal is to define the entire pathway
      leading to the male copulatory organ.

PMID- 1637363
TI  - Cutting, splicing, reordering, and elimination of DNA sequences in hypotrichous
      ciliates.
AB  - Hypotrichous ciliates extensively process genomic DNA during their life cycle.
      Processing occurs after cell mating, beginning with multiple rounds of DNA
      replication to form polytene chromosomes. Thousands of transposonlike elements
      are then excised from the chromosomes and destroyed, and thousands of short,
      internal eliminated sequences (IESs) are excised from coding and noncoding parts
      of genes and destroyed. IES removal from a gene is accompanied by splicing of the
      remaining chromosomal DNA segments to form a transcriptionally competent gene.
      For some genes these DNA segments are in a scrambled order and are ligated into a
      genetically correct order at the time of IES removal. Next the polytene
      chromosomes are cut up band-by-band and all genes are excised from the
      chromosomes as short, linear molecules averaging 2.2 kbp (in Oxytricha nova).
      Gene excision is accompanied by destruction of all nongenic DNA, which, together
      with the transposonlike elements and IESs, accounts for approximately 95% of the
      total sequence complexity of the genome in O. nova. Telomeric sequences are added
      to the excised gene-sized DNA molecules. Finally, the gene-sized molecules are
      replicated several times to form the macronucleus of the organism.

PMID- 1637364
TI  - Cancer predisposition in Bloom's syndrome.
AB  - This article focuses upon defining those factors which may contribute to the
      pathogenesis of cancer. The molecular basis of tumour etiology is discussed with
      reference to cancer predisposing syndromes, and in particular to the human
      inherited disease, Bloom's syndrome. In Bloom's syndrome, patients are
      predisposed to a wide variety of malignant disease. We propose a model in which
      overexpression of the ubiquitous c-myc proto-oncogene contributes to this
      process.

PMID- 1637365
TI  - RNA-binding proteins: masking proteins revealed.

PMID- 1637366
TI  - Induction mechanism of a single gene molecule: stochastic or deterministic?
AB  - A new field of gene expression regulation research is emerging that has
      previously been overlooked. This new area is concerned with distinguishing the
      expression of a single gene from the averaged expression of many gene copies
      within the cell population. This paper reviews research focused on individual
      genes in inducible gene expression systems. The main experimental strategy is to
      measure the gene expression level of a single cell containing a single reporter
      gene molecule. In contrast to the commonly held belief, gene induction is found
      to be stochastic under certain conditions. The possible mechanisms and
      implications are discussed.

PMID- 1637367
TI  - Prognostic significance of extent of nodal involvement in stage D1 prostate
      cancer treated with radiotherapy.
AB  - The records of 107 patients with newly diagnosed adenocarcinoma of the prostate
      irradiated with curative intent at Duke University Medical Center from 1970
      through 1983 were reviewed. Forty patients (37%) underwent standard bilateral
      pelvic lymph node dissection (PLND) prior to beginning irradiation. Twenty-four
      patients (22%) were found to have pelvic nodal metastases (Stage D1). Those found
      to have a single microscopically positive node at PLND may be curable with
      irradiation. In contrast, those with more extensive nodal metastases appear to be
      incurable with radiotherapy. Additional studies are needed to confirm or refute
      these findings.

PMID- 1637368
TI  - Psychoactive drug use in an institution for intellectually handicapped persons.

PMID- 1637369
TI  - The opioid system and the placebo response.

PMID- 1637370
TI  - Age associated memory impairment.

PMID- 1637371
TI  - Mortality in meningococcal disease.

PMID- 1637372
TI  - Income distribution and life expectancy.

PMID- 1637373
TI  - Variant-specific monoclonal and group-specific polyclonal human immunodeficiency
      virus type 1 neutralizing antibodies raised with synthetic peptides from the
      gp120 third variable domain.
AB  - The third variable (V3) domain of the human immunodeficiency virus type 1 (HIV-1)
      external membrane glycoprotein gp120 is of crucial importance in eliciting
      neutralizing antibodies in infected persons. Polyclonal (PAb) and monoclonal
      (MAb) antibodies directed against selected epitopes in the V3 domain are valuable
      tools for analysis of the involvement of such sequences in neutralization and for
      definition of the relation between amino acid variability and immunological cross
      reactions. The aim of this study was to obtain such site-specific antibodies. By
      using synthetic peptides derived from the V3 domain, a group-specific
      neutralizing PAb, two high-affinity HIV-1 IIIB neutralizing MAb, and two
      nonneutralizing MAb were raised. A 15-amino-acid peptide overlapping the tip of
      the V3 domain of HIV-1 MN was used to produce a rabbit PAb (W0/07). This PAb
      inhibited syncytium formation induced by HIV-1 IIIB and four field isolates. A
      similar IIIB-derived peptide was used to generate two murine immunoglobulin G1
      (IgG1) MAb (IIIB-V3-13 and IIIB-V3-34). Pepscan analysis mapped the binding site
      of IIIB-V3-34 to the sequence IRIQRGPGR. The Kds of IIIB-V3-13 and IIIB-V3-34 for
      gp120 were 6.8 x 10(-11) and 1.6 x 10(-10) M, respectively. These MAb neutralized
      IIIB but not MN and inhibited syncytium formation induced by IIIB. They are
      applicable in enzyme-linked immunosorbent assays, immunocytochemistry, and flow
      cytometry. A peptide covering the left base of the V3 domain was used to generate
      two murine IgG1 MAb (IIIB-V3-21 and IIIB-V3-26). The binding site of IIIB-V3-21
      was mapped to the sequence INCTRPN. These MAb did not neutralize HIV-1 and did
      not inhibit syncytium formation. This study supports the notion that HIV-1
      neutralizing antibodies suitable for multiassay performance can be obtained with
      synthetic peptides and that high-affinity MAb can be generated. Such site
      specific antibodies are useful reagents in the analysis of HIV-1 neutralization.
      In addition, the cross-neutralization of different viral strains by PAb generated
      through single-peptide immunization is directly relevant to vaccine development.

PMID- 1637374
TI  - The signal for Golgi retention of bovine beta 1,4-galactosyltransferase is in the
      transmembrane domain.
AB  - The expression and localization of bovine beta 1,4-galactosyltransferase (Gal T)
      has been studied in mammalian cells transfected with Gal T cDNA constructs, and
      the role of the amino-terminal domains of Gal T in Golgi localization examined.
      Here we demonstrate that the transmembrane (signal/anchor) domain of bovine Gal T
      contains a positive Golgi retention signal. Bovine Gal T was characterized in
      transfected cells with anti-bovine Gal T antibodies, affinity-purified from a
      rabbit antiserum using a bacterial recombinant fusion protein. These affinity
      purified antibodies recognized native bovine Gal T and showed minimum cross
      reactivity with Gal T from non-bovine sources. Bovine Gal T cDNA was expressed,
      as active enzyme, transiently in COS-1 cells and stably in murine L cells, and
      the product was shown to be localized to the Golgi complex by immunofluorescence
      using the polypeptide-specific antibodies. A low level of surface bovine Gal T
      was also detected in the transfected L cells by flow cytometry. The removal of 18
      of the 24 amino acids from the cytoplasmic domain of bovine Gal T did not alter
      the Golgi localization of the product transiently expressed in COS-1 cells or
      stably expressed in L cells. Both the full-length bovine Gal T and the
      cytoplasmic domain deletion mutant were N-glycosylated in the transfected L
      cells, indicating both proteins have the correct N(in)/C(out) membrane
      orientation. Deletion of both the cytoplasmic and signal/anchor domains of bovine
      Gal T and incorporation of a cleavable signal sequence resulted in a truncated
      soluble bovine Gal T that was rapidly secreted (within 1 h) from transfected COS
      1 cells. Replacement of the signal/anchor domain of bovine Gal T with the
      signal/anchor domain of the human transferrin receptor resulted in the transport
      of the hybrid molecule to the cell surface of transfected COS-1 cells.
      Furthermore, a hybrid construct containing the signal/anchor domain of Gal T with
      ovalbumin was efficiently retained in the Golgi complex, whereas ovalbumin
      anchored to the membrane by the transferrin receptor signal/anchor was expressed
      at the cell surface of transfected COS-1 cells. Overall, these studies show that
      the hydrophobic, signal/anchor domain of Gal T is both necessary and sufficient
      for Golgi localization.

PMID- 1637375
TI  - Involuntary interventions: does the benefit exceed the cost?

PMID- 1637376
TI  - The duty to attend upon the sick.

PMID- 1637377
TI  - "It takes more than knowledge: it takes assertiveness".

PMID- 1637378
TI  - Biopesticides and resistance.

PMID- 1637379
TI  - Underreporting of pedestrian road accidents.

PMID- 1637380
TI  - Side of origin of epithelial ovarian cancer.

PMID- 1637381
TI  - Effect of anoxia on intracellular ATP, Na+i, Ca2+i, Mg2+i, and cytotoxicity in
      rat hepatocytes.
AB  - The effects of anoxia were studied in freshly isolated rat hepatocytes maintained
      in agarose gel threads and perfused with Krebs-Henseleit bicarbonate buffer
      (KHB). Cytosolic free calcium (Ca2+i) was measured with aequorin, intracellular
      sodium (Na+i) with SBFI, intracellular pH (pHi) with BCECF, lactic dehydrogenase
      (LDH) by the increase in NADH absorbance during lactate oxidation to pyruvate,
      ATP by 31P NMR spectroscopy in real time, and intracellular free Mg2+ (Mg2+i)
      from the chemical shift of beta-ATP relative to alpha-ATP in the NMR spectra.
      Anoxia was induced by perfusing the cells with KHB saturated with 95% N2, 5% CO2.
      After 1 h of anoxia, beta-ATP fell 66%, and 85% after 2 h, while the Pi/ATP ratio
      increased 10-fold from 2.75 to 28.3. Under control conditions, the resting
      cytosolic free calcium was 127 +/- 6 nM. Anoxia increased Ca2+i in two distinct
      phases: a first rise occurred within 15 min and reached a mean value of 389 +/-
      35 nM (p less than 0.001). A second peak reached a maximum value of 1.45 +/- 0.12
      microM (p less than 0.001) after 1 h. During the first hour of anoxia, Na+i
      increased from 15.9 +/- 2.4 mM to 32.2 +/- 1.2 mM (p less than 0.001), Mg2+i
      doubled from 0.51 +/- 0.05 to 1.12 +/- 0.01 mM (p less than 0.001), and pHi
      decreased from 7.41 +/- 0.03 to 7.06 +/- 0.1 (p less than 0.001). LDH release
      doubled during the first hour and increased 6-fold during the second hour of
      anoxia. Upon reoxygenation, ATP, Ca2+i, Mg2+i, Na+i, and LDH returned near the
      control levels within 45 min. To determine whether the increased LDH release was
      related to the rise in Ca2+i, and whether the increased Ca2+i was caused by Ca2+
      influx, the cells were perfused with Ca(2+)-free KHB (+ 0.1 mM EGTA) during the
      anoxic period. After 2 h of anoxia in Ca(2+)-free medium, beta-ATP again fell
      90%, but Ca2+i, after the first initial peak, fell below control levels, and LDH
      release increased only 2.7-fold. During reoxygenation, Ca2+i, ATP, Na+i, and LDH
      returned near the control levels within 45 min. These results suggest that the
      rise in Ca2+i induced by anoxia is caused by an influx of Ca2+ from the
      extracellular fluid, and that LDH release and cell injury may be related to the
      resulting rise in Ca2+i.

PMID- 1637382
TI  - Acrofacial dysostosis syndromes.

PMID- 1637383
TI  - A question of outcomes.

PMID- 1637384
TI  - The surgical management of vaginal vault prolapse.

PMID- 1637386
TI  - CPR in hospitalized patients.

PMID- 1637385
TI  - Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis.

PMID- 1637387
TI  - Insurance helpline.

PMID- 1637388
TI  - Sorry, I don't see nursing home patients.

PMID- 1637389
TI  - Time-cycled inverse ratio ventilation.

PMID- 1637390
TI  - Health care quality assurance: tracer analyses in quality assessment of
      ambulatory care provided by two outpatient teaching clinics.

PMID- 1637391
TI  - NANP responds to critics.

PMID- 1637392
TI  - Laryngeal mask airway for emergency cases.

PMID- 1637393
TI  - In obstetrics: there is an alternative to water.

PMID- 1637394
TI  - Unnecessary CT scans in stroke patients.

PMID- 1637395
TI  - Psychiatric diagnosis in a group of astronaut applications.

PMID- 1637396
TI  - Newer treatments beyond reach of Third World.

PMID- 1637397
TI  - Does increased lipase activity in serum imply damage to the pancreas?

PMID- 1637398
TI  - Changes in stimulating and blocking TSH receptor antibodies in a patient
      undergoing three cycles of transition from hypo to hyper-thyroidism and back to
      hypothyroidism.
AB  - We report a patient who underwent, over a mere 3-year period, three successive
      cycles of oscillation from hypo to hyper-thyroidism and back to hypothyroidism.
      This unusual sequence of events originated in a rare passage of primary
      hypothyroidism to hyper-thyroidism. The hyperthyroidism seemed typical of the
      autoimmune subgroup of toxic multinodular goitre. Stimulating and blocking TSH
      receptor antibody activities were measured (by cAMP functional bioassays using
      cultured human thyrocytes) during the course of the fluctuating phases of hypo
      and hyper-thyroidism. Measurement of such antibody activities revealed the
      coexistence of both stimulatory and blocking types of antibody in several serum
      samples from the patient. Throughout the whole course of alterations in thyroid
      function, thyroid stimulating antibodies were present. This was not the case with
      thyrotrophin receptor antibodies exhibiting TSH antagonist activity which seemed
      to appear and disappear. Monitoring such activity indicated that the emergence of
      blocking antibody seems to herald the onset of hypothyroidism.

PMID- 1637399
TI  - Cardioplegia with fluorescein for visualization of coronary arteries.

PMID- 1637400
TI  - The cholesterol controversy.

PMID- 1637401
TI  - Thrombosis and pulmonary embolism.

PMID- 1637402
TI  - Organ donation from intensive care units.

PMID- 1637403
TI  - Prescribing at the hospital-general practice interface.

PMID- 1637404
TI  - More on high-dose busulfan and seizure prophylaxis.

PMID- 1637405
TI  - Aluminum and Alzheimer's disease.

PMID- 1637406
TI  - Dipyridamole thallium-201 scintigraphy as a preoperative screening test.

PMID- 1637407
TI  - Countering cardiac counterpulsation.

PMID- 1637408
TI  - Melanomas that defy clinical recognition.

PMID- 1637409
TI  - Rhabdoid tumor of the central nervous system.

PMID- 1637410
TI  - Bone marrow transplant retinopathy.

PMID- 1637411
TI  - Factors associated with chronic lung disease in preterm infants.

PMID- 1637412
TI  - In response to position paper by National Council Against Health Fraud.

PMID- 1637413
TI  - Smoking and ischemic heart disease.

PMID- 1637414
TI  - Re: "Prenatal exposure to parents' smoking and childhood cancer".

PMID- 1637415
TI  - Therapeutic pulmonary artery catheterization.

PMID- 1637416
TI  - Appropriate in vivo expression of a muscle-specific promoter by using avian
      retroviral vectors for gene transfer [corrected].
AB  - The promoter regions of the chicken skeletal muscle alpha-actin (alpha sk-actin)
      and the cytoplasmic beta-actin genes were linked to the bacterial chloramphenicol
      acetyltransferase (CAT) gene. Replication-competent retroviral vectors were used
      to introduce these two actin/CAT cassettes into the chicken genome. Chickens
      infected with retroviruses containing the alpha sk-actin promoter expressed high
      levels of CAT activity in striated muscle (skeletal muscle and heart); much lower
      levels of CAT activity were produced in the other nonmuscle tissues. In contrast,
      chickens infected with retroviruses containing the beta-actin promoter linked to
      the CAT gene expressed low levels of CAT activity in many different tissue types
      and with no discernible tissue specificity. Data are presented to demonstrate
      that the high levels of CAT activity that were detected in the skeletal muscle of
      chickens infected with the retrovirus containing the alpha sk-actin promoter/CAT
      cassette were not due to preferential infectivity, integration, or replication of
      the retrovirus vector in the striated muscles of these animals.

PMID- 1637417
TI  - Drug targeting with monoclonal antibodies. A review.
AB  - Monoclonal antibodies have been widely used in attempts to target anti-neoplastic
      agents selectively to tumours. Problems associated with the use of monoclonal
      antibodies as the targeting moiety include lack of complete tumour selectivity,
      antigenic heterogeneity, tumour access and immunogenicity. Considerable effort in
      the targeting field is being expended in an attempt to reduce or overcome these
      problems. Attachment of monoclonal antibodies to low molecular weight cytotoxic
      drugs, protein toxins, radionuclides or enzymes capable of conversion of inactive
      prodrugs to cytotoxic drugs, has, despite these problems, resulted in conjugates
      which do have selective anti-tumour effects in animal models. The advantages and
      limitations of these different approaches are reviewed. It remains to be
      established in man if any of these approaches will result in significant
      therapeutic benefit in major solid tumours.

PMID- 1637418
TI  - Expression of the murine homologue of the cell cycle control protein p34cdc2 in T
      lymphocytes.
AB  - The mammalian homologue of the cdc2 gene of the fission yeast Schizosaccharomyces
      pombe encodes a p34cdc2 cyclin-dependent kinase that regulates the cell cycle of
      a wide variety of cell types. Resting murine T lymphocytes contained no
      detectable p34cdc2 protein, histone kinase activity, or specific mRNA for the
      cdc2 gene. Activation of the T cells by immobilized anti-CD3 resulted in the
      expression of specific mRNA late in the G1 phase of the cell cycle, and p34cdc2
      protein was detectable at or near G1/S. At this point in the cell cycle, the
      protein was phosphorylated at tyrosine and displayed no H1 histone kinase
      activity. As the cells progressed through the cycle, the amount of specific mRNA
      and p34cdc2 increased, and H1 histone kinase activity was detectable when the
      cells were blocked at G2/M by nocodazole. The activation of T cells by phorbol
      dibutyrate induced the expression of IL-2R but failed to induce the synthesis of
      IL-2 or the expression of cdc2-specific mRNA. Under these conditions, the
      activated cells failed to enter the S phase of the cell cycle. Because the
      presence of IL-2 added exogenously during activation by phorbol dibutyrate
      resulted in the expression of cdc2-specific mRNA and progression through the cell
      cycle, either IL-2 or the interaction with IL-2R may be involved in the
      expression of cdc2 and regulation of the G1/S transition.

PMID- 1637419
TI  - [Relapse prevention in liver transplant patients treated for liver involvement
      due to hepatitis B virus].
AB  - Controversy surrounds the indication of liver transplantation in patients with
      hepatitis B virus infection. The major problem is the very high risk of infection
      of the graft. Some investigators have suggested that the presence of HBsAg is a
      contraindication to liver transplantation. Between February 1975 and December
      1990, 178 HBs positive patients were transplanted at Paul Brousse Hospital in
      Professor H. Bismuth's Department, 137 for post hepatitis cirrhosis and 41 for
      fulminant hepatitis. Since April 1984 we have decided long term
      immunoprophylactic therapy for all patients with HBs infection. But only from
      August 1987 our supply of purified anti HBs immunoglobulin has been adequate to
      treat all our patients according to the following protocol: 10.000 IU during the
      peroperative phase, 10.000 IU immediately after intervention, 10.000 IU every day
      for the first 6 days, 10.000 IU when the anti HBs levels were under 150 IU/l. One
      hundred thirty-nine patients were treated by this method. 110 cleared HBs antigen
      from their sera and their liver were biologically and histologically free of B
      virus infection. 29 patients showed reappearance of HBs antigen in their sera and
      nearly all of them developed objective, histologically confirmed, graft lesions.
      These lesions are those of classical infection: acute hepatitis, active chronic
      hepatitis and cirrhosis. So 79% of patients were successfully treated with a
      follow up of 45 months to 6 months. We also studied the prognostic factors under
      treatment. The study shows: in the case of fulminant hepatitis, 93% success
      versus 77% in post hepatitis cirrhosis; in the case of Delta superinfection, 94%
      success versus 66% with pure B infection; in the absence of HBVDNA in the
      patient's sera before transplantation, 92% success versus 20% in the presence of
      HBVDNA. For a better understanding of the overall results, the two following
      parameters have to be considered: some patients relapsed after stopping their
      treatment, some other patients, despite repositivation of HBs antigen in their
      sera showed a paradoxal good evolution. These considerations enable us to obtain
      HBVDNA positive patients: 10% success, HBVDNA negative patients: Fulminant
      hepatitis: 100% success B Delta post hepatitis cirrhosis: 100% success B post
      hepatitis cirrhosis: 92% success.

PMID- 1637420
TI  - [Transfusion security and morbidity in France].

PMID- 1637421
TI  - [DNA polymorphism in a Brazilian population: relationship to allele frequencies
      in France].
AB  - The allele frequency distribution of two highly polymorphic DNA sequences was
      determined in a population from the metropolitan area of Fortaleza (Northeast
      Brazil). DNAs from 234 individuals were digested with Pvull and successively
      hybridized to each probe: alpha-Globin 3'HVR and Mucin HVR. The resulting allele
      frequencies were compared to those observed in a French population. There is no
      statistically significant difference between these populations in the 3'HVR
      system. On the contrary, the distribution is statistically different in the Mucin
      HVR/Pvull system.

PMID- 1637422
TI  - [Removal of plasma lipids by selective filtration].
AB  - We herein describe a new depth filter media which exhibits selective adsorption
      properties for lipids of plasma on Zeta Plus Del I (Cuno Europe). Lipids plug
      chromatographic columns and filter during plasma fractionnation and cause
      solution instability for the final product. Several parameters which could affect
      the lipid removal efficiency on Zeta Plus Del I have been investigated:
      prefiltration, contact time, ionic strength, pH, and temperature. The maximum
      percentage of total lipids eliminated, in the better operating conditions was
      68%. This method has proven to be efficient for the treatment of plasmatic lipids
      and can be easily incorporated in an industrial process.

PMID- 1637423
TI  - Arthroscopic subacromial decompression: a clinical review.
AB  - Arthroscopic subacromial decompression has become a popular technique supplanting
      the open Neer acromioplasty in many instances of chronic rotator cuff disease. A
      review of 61 consecutive decompressions with a minimum follow-up of 12 months was
      undertaken to evaluate preoperative criteria and surgical outcomes. Of the 61
      patients, 53 patients with an average follow-up of 23 months were available for
      review. Thirty-four men and 19 women with an average age of 47 years comprised
      the study group. Eleven (21%) had full-thickness tears, 35 (66%) had partial
      thickness injuries, and 7 (13%) had normal-appearing rotator cuffs at the time of
      arthroscopy. The UCLA shoulder rating system was used to evaluate outcome. Eighty
      one percent of the patients had an excellent (32%) or good (49%) result whereas
      19% (15% fair and 4% poor) were considered unsatisfactory. Those with early
      impingement findings and partial rotator cuff tears were likely to experience a
      satisfactory outcome. Patients with full-thickness rotator cuff tears were less
      likely to experience a successful result (55%). Workmen's compensation cases had
      a satisfactory outcome in 74%, with a predominance of good over excellent
      results. Excluding those with full-thickness tears and work-related injuries, a
      satisfactory outcome was achieved in 90%. Arthroscopic subacromial decompression
      for mechanical impingement of the rotator cuff is a technically demanding
      procedure requiring appropriate skills as well as careful preoperative treatment
      and evaluation. For individuals in whom conservative measures fail and who meet
      stringent criteria, namely, a largely intact rotator cuff and a non-work-related
      injury, a highly reliable and satisfying outcome can be anticipated by both
      patient and surgeon.

PMID- 1637424
TI  - Use of an electrocautery loop probe for arthroscopic meniscectomy: a five-year
      experience with results, indications, and complications.
AB  - Between 1984 and 1990, 952 patients had arthroscopic meniscectomies with a
      specially designed electrocautery loop probe. In all but 250 patients, 1.5%
      glycine was used as the nonconductive irrigating solution. Ninety-five patients
      had repeat arthroscopic procedures at a minimum of 6 months after their original
      procedure. Biopsies of the meniscal remnants were obtained in 21 patients. In all
      21, there was no evidence of thermal damage in the area of the previous
      arthroscopic meniscal electrosurgery. In less than 4% of the patients, articular
      surface injuries occurred at the time of the original meniscectomy. Careful
      records were kept outlining the areas of contact damage with the exposed wire of
      the electrocautery loop probe. At repeat arthroscopies in 17 patients 9 months to
      4 years after the initial procedure, there was no apparent evidence of
      significant permanent damage to the articular surface in the area of the original
      thermal injury. The electrocautery loop probe was effective for efficient
      resection of simple and complex tears of the medial or lateral meniscus.

PMID- 1637425
TI  - Arthroscopic evaluation of allograft anterior cruciate ligament reconstruction.
AB  - In a previous study, we evaluated the findings of arthroscopic second looks at
      open anterior cruciate ligament reconstructions using autogenous tissue. We were
      disappointed at the variable quality of the ligaments and the presence of
      articular cartilage lesions. These findings led us to change our treatment
      protocol. Since 1983, we have used freeze-dried allografts for arthroscopic
      intraarticular ACL reconstructions. We have started protected motion in a brace
      immediately postoperatively and delayed weightbearing for 12-16 weeks. A total of
      54 patients with at least a 2-year follow-up were evaluated subjectively (Lysholm
      scale) and objectively (KT 1000). Some 78% were rated good or excellent, and 87%
      were satisfied with their surgery. Of these 54 patients, 28 underwent subsequent
      surgery for hardware removal, manipulation, or removal of adhesions. All 28 had
      an arthroscopy, and an evaluation of ligamentous tissue and articular cartilage
      at the time of the second surgery. The graft resembled a normal anterior cruciate
      ligament in 18 patients. The graft was slightly lax in two of these patients, but
      their clinical examination revealed normal stability. In six patients, the
      intercondylar notch was covered by a sheath of dense, fibrous tissue, but the
      knees were stable. In two cases, there was slight fraying of the lateral aspect
      of the graft from impingement on the lateral femoral condyle. In two cases the
      graft failed. The condition of the articular cartilage was documented and
      compared with the condition of the articular cartilage at the time of cruciate
      reconstruction. In 19 cases, the articular cartilage had been normal and remained
      normal at the time of reevaluation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637426
TI  - Augmentation of the accuracy of percutaneous electrode implantation by using a
      modified arthroscope to guide insertion.
AB  - Using a clear polyvinyl fluoride sheath over an arthroscope, inserted through a 1
      cm stab incision, we have demonstrated the feasibility of visualizing the sciatic
      nerve and its branches in the feline model. The purpose of this technique is to
      allow visual control, without a large surgical incision, of the exact site of
      implantation of electrodes used for functional neuromuscular stimulation.
      Currently, we determine the optimum site for percutaneous electrode implantation
      by stimulating the target nerve or muscle with a 26-gauge probe needle until
      maximal response is obtained. This method lacks accuracy because there is no
      direct visualization of the location of the tip of the probe or the electrode.
      With the new technique, we identified nerves by their distinctive vascular
      markings and we followed the nerves with minimal disruption of the soft tissues.
      In this way, individual branches were identified and targeted for
      instrumentation, allowing selective stimulation of specific muscle groups.

PMID- 1637427
TI  - The intra-articular pressure of the shoulder: an experimental study on the role
      of the glenoid labrum in stabilizing the joint.
AB  - It was shown on human corpses that the glenohumeral joint may be compared to a
      piston surrounded by a valve. The glenoid labrum, then, should work like the
      valve block, sealing the joint from atmospheric pressure. In order to test this
      hypothesis, 18 human shoulder preparations were studied. The mean stabilizing
      force obtained by atmospheric pressure was 146 N. Additionally, 15 patients
      without any sign of instability and 17 patients with an anterior instability of
      the shoulder were tested under general anesthesia. In stable shoulder joints,
      traction at the arm caused negative intra-articular pressure that could be
      correlated to the amount of force exerted. In contrast, unstable shoulder joints
      with a tear of the glenoid labrum (Bankart lesion) did not exhibit this
      phenomenon. For unstable shoulder joints, the piston-and-valve model is no longer
      valid. This enlarges the current concept of shoulder joint stability in two ways:
      (a) the absence of negative intra-articular pressure disturbs joint mechanics and
      (b) altered pressure receptors might disturb motor coordination that dynamically
      protects the shoulder from dislocating forces.

PMID- 1637428
TI  - Subacromial impingement: open versus arthroscopic decompression.
AB  - An analysis of the follow-up results of 53 patients treated by an arthroscopic
      decompression (AD) and 53 patients treated by an open decompression (OD) is
      presented. Patients were evaluated pre- and postoperatively with the UCLA
      Shoulder Rating Scale, which includes an assessment of pain, function, range of
      motion, strength, and patient satisfaction. After an average of 20.1 months for
      the AD group and 27.3 months for the OD group, good or excellent results were
      found in 83.1% in the AD group and in 81.1% in the OD group. Patient satisfaction
      was 88.3% (AD) compared with 94.3% (OD). Results of decompression in both groups
      were not influenced by associated pathologies (acromioclavicular degeneration,
      frozen shoulder, calcified tendinitis, rotator cuff lesions).

PMID- 1637429
TI  - Comparison of initial pull-out strength of arthroscopic suture and staple Bankart
      repair techniques.
AB  - This study was performed to investigate the initial failure strength of
      arthroscopic suture and staple techniques use to treat recurrent anterior
      shoulder instability. Eight canine shoulder complexes were fashioned so that four
      1-cm wide strips of capsule remained attached to the glenoid in each specimen
      (total of 32 test specimens) these specimens were tested to tensile failure on an
      Instron model 1331 testing machine either intact (n = 5), or after the capsule
      was sharply dissected off the bone and repaired with an arthroscopic staple (n =
      11) or arthroscopic suture technique (n = 12). The control group failed at 17.75
      +/- 7.14 kg, the suture repair at 11.0 +/- 2.56 kg, and the staple repair at 4.77
      +/- 2.32 kg. These failure strengths were all statistically different from each
      other (p less than 0.0001). All failures occurred at the capsular bone interface.
      The authors do not advance one technique over the other but do advise surgeons to
      be mindful of the results when instituting early shoulder motion after
      arthroscopic Bankart procedures.

PMID- 1637430
TI  - Arthroscopic treatment of calcific tendinitis of the shoulder.
AB  - The results of arthroscopic treatment of chronic resistant calcific tendinitis of
      the shoulder in twenty-three patients were evaluated. Each patient had greater
      than 1 year of unsuccessful nonoperative management prior to arthroscopic
      surgery. The average age was 49 years (range 33-60) and average follow up was 26
      months (range 12-47). Subacromial bursectomy was performed in all patients. Based
      on follow-up radiographs, thirteen patients had partial calcium removal while
      nine had complete removal of calcium. Results were graded as good in eleven
      patients (50%) with full motion and complete pain relief, satisfactory in nine
      (41%) patients with full motion and occasional episodes of pain, and
      unsatisfactory in two (9%) patients with persistent pain. Arthroscopic calcium
      removal and subacromial bursectomy are reasonable alternatives in the treatment
      of chronic calcific tendinitis resistant to conservative treatment.

PMID- 1637431
TI  - Extension-supination sign in prearthroscopic elbow distension.
AB  - A clinical sign of extension and supination of the elbow is described after
      prearthroscopic distension with fluid. When elicited, intra-articular fluid
      placement is indicated, assisting correct location of the arthroscope within the
      joint.

PMID- 1637433
TI  - Wrist arthroscopy: indications and results.
AB  - The results of 84 wrist arthroscopies in 74 patients (performed by the same
      surgeon) were reviewed retrospectively. Arthroscopies were categorized as
      "diagnostic"--to identify unknown pathology, "staging"--to assess the severity of
      known pathology, and "operative"--to treat known pathology. Ninety-eight percent
      of diagnostic arthroscopies accurately established details of the pathology in
      question. Ninety-six percent of staging arthroscopies helped guide future
      clinical management. Of the patients in the operative category, 35% improved
      after treatment with arthroscopy alone, requiring no further surgical
      intervention. This study shows that wrist arthroscopy is a powerful diagnostic
      and staging tool and suggests that it may also develop into a valuable treatment
      modality.

PMID- 1637432
TI  - Evaluation of the triangular fibrocartilage complex tears by arthroscopy,
      arthrography, and magnetic resonance imaging.
AB  - Arthroscopic findings in 11 patients with chronic ulnar painful wrist were
      compared both with arthrographic and magnetic resonance (MR) imaging results to
      evaluate the accuracy of the former procedure in the detection of triangular
      fibrocartilage complex (TFCC) lesions. MR imaging and arthrography investigations
      appeared to be sensitive modalities when compared with arthroscopic findings in
      TFCC lesions (specificity 100%; sensitivity 82 and 80%). MR imaging can be
      advantageously employed in the screening of patients suspected of having a TFCC
      tear, eliminating the necessity of an arthrographic examination. However, MR
      imaging could not define the exact site of the tear within the degenerate TFCC or
      detect lesions of the articular cartilage. Arthroscopy offers sure evidence of
      the site of TFCC lesion and more information about the intraarticular associated
      causes of chronic ulnar wrist pain such as chondromalacia and synovitis. An added
      benefit is that many of the pathologies seen can be treated using arthroscopic
      surgical techniques.

PMID- 1637434
TI  - Anatomic and biomechanical analysis of the arthroscopic wafer procedure.
AB  - The ulnar impaction syndrome is a common clinical entity that is most often
      associated with positive ulnar variance and is characterized by triangular
      fibrocartilage complex (TFCC), lunate, and/or distal ulnar pathology. Traditional
      treatment for symptomatic ulnar impaction syndrome has been conservative;
      however, in cases refractory to nonoperative management, formal ulnar shortening
      has been successful in long-term clinical series. Recently, arthroscopic ulnar
      shortening, the "arthroscopic wafer procedure" (AWP) (debridement of the
      perforated TFCC margins and limited ulnar head resection using a motorized burr)
      has become an option to treat this clinical syndrome. In an attempt to evaluate
      the biomechanical efficacy of the AWP, an experimental study was undertaken using
      nine ulnar positive cadaver forearms. Each specimen was evaluated biomechanically
      using axial load cells and pressure-sensitive film to evaluate the effect of
      serial resection of the TFCC and distal ulna on axial load and ulnar carpal
      pressures. The results of this experimental study revealed a statistically
      significant unloading of the ulnar aspect of the wrist after excision of the
      centrum of the TFCC and resection of the radial two-thirds width of the ulnar
      head, to a depth of subchondral bone resection. Furthermore, additional bony
      resection tended to correlate favorably with the stage of TFCC pathology noted,
      i.e., the more advanced the stage, the more resection necessary to unload the
      ulnar aspect of the wrist. Based on this biomechanical study, a limited clinical
      series has been initiated with early favorable results. The AWP biomechanically
      unloads the ulnar carpal complex, and therefore has a theoretical potential of
      relieving the symptoms of the ulnar impaction syndrome.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1637435
TI  - Septic arthritis following arthroscopy: clinical syndromes and analysis of risk
      factors.
AB  - During a 4-year study of 4,256 knee arthroscopies, eighteen patients became
      infected (infection rate 0.42%). Occurrence of infection was strongly associated
      with use of long-acting intraarticular intraoperative corticosteroids. Infection
      was more common among patients with longer surgery operating times, increased
      numbers of procedures during surgery, prior procedures, and performance of
      chondroplasty or soft tissue debridement. Subsequent to the study, the infection
      rate fell to 0.1%. Twenty-four infections were studied (our eighteen plus six
      other concurrent community cases); twelve were due to Staphylococcus aureus,
      eleven to coagulase-negative staphylococci, and one to Enterobacter cloacae.
      Seventy percent of the patients had onset of symptoms within 3 days of surgery.
      Most patients with coagulase-negative staphylococcal infections had fevers less
      than 38.3 degrees C (101 degrees F), negative Gram stains on synovial fluid,
      normal peripheral leukocyte counts, and somewhat indolent, mild clinical
      syndromes, while most patients with S. aureus infections had higher fevers,
      positive synovial Gram stains, peripheral leukocytosis, and more acute and severe
      clinical syndromes. Knee pain, swelling, and warmth always occurred, but erythema
      was noted in only 30% of patients. Treatment with 2 weeks of intravenous
      antibiotics was successful in all but one patient. Long-term results were
      excellent in sixteen of twenty-two patients.

PMID- 1637436
TI  - Complications associated with the use of an infusion pump during knee
      arthroscopy.
AB  - This is a report of four complications from the use of an automated arthroscopy
      pump in 283 patients undergoing knee arthroscopy. The first patient had
      extravasation of fluid into the thigh, requiring discontinuation of the
      procedure. The second patient developed a compartment syndrome of the leg,
      necessitating a four-compartment fasciotomy of the leg. The third patient
      developed severe fluid extravasation into the anterior thigh compartment. A
      limited fasciotomy of the anterior thigh compartment was performed. The fourth
      patient developed moderate extravasation into the anterior part of the thigh and
      groin, necessitating discontinuation of pump irrigation and conversion to gravity
      irrigation to complete a partial medial meniscectomy. During a 15-month period, a
      complication rate of 1.4% from fluid extravasation during knee arthroscopy was
      noted. This review represents our initial experience with the infusion pump. No
      cases of fluid extravasation have occurred subsequently during a 12-month period.

PMID- 1637437
TI  - Anterior cruciate ligament tears in skeletally immature patients: meniscal
      pathology at presentation and after attempted conservative treatment.
AB  - We evaluated 12 skeletally immature patients with acute, intrasubstance tears of
      the anterior cruciate ligament (ACL) and open physes for meniscal pathology.
      Arthrograms were completed in 10 of 12 patients, and subsequent arthroscopy
      confirmed 8 meniscal tears (4 medial, 4 lateral) in 6 patients. Four patients
      with repairable menisci underwent arthroscopic meniscal repair and stabilization.
      Eight patients received quadriceps and hamstrings rehabilitation and returned to
      sports with a brace. After return to sports, all braced patients developed
      instability with multiple episodes of "giving way." Average time from initial
      injury to first episode of instability was 7 months. Seven patients sustained
      further meniscal damage an average of 15 months (range 7-27 months) after initial
      injury. We conclude that meniscal pathology is commonly associated with ACL tears
      in skeletally immature patients and we recommend arthrography or arthroscopy to
      evaluate patients with suspected ACL tears. Brace management did not prevent
      instability or new meniscal tears.

PMID- 1637438
TI  - A new femoral drill guide for arthroscopically assisted anterior cruciate
      ligament replacement.
AB  - There are an increasing number of drill guides and methods of selecting the most
      isometric femoral attachment site for reconstruction of the anterior cruciate
      ligament (ACL); some of these are complex and time-consuming. The senior author
      (R.P.) has developed a simple "inside-out" arthroscopic femoral drill guide,
      which is designed to reliably locate the optimal femoral attachment site. The
      accuracy and reliability of this guide was assessed in 10 cadaver knees. The
      isometry of semitendinosus tendon (ST), then patellar bone-tendon-bone (BTB)
      grafts was assessed in each knee. In no instance, for either reconstruction, was
      there greater than 3 mm graft movement through a full range of knee motion. Based
      on this study, we therefore conclude that this very simple drill guide is a
      useful tool in arthroscopic ACL reconstruction to quickly, easily, and reliably
      select the optimal femoral attachment site. It also negates the need for a
      lateral incision when using a BTB graft, thus reducing morbidity and improving
      cosmesis.

PMID- 1637439
TI  - Knee arthroscopy using local anesthesia.
AB  - This study confirms the feasibility of performing arthroscopy and arthroscopic
      surgery with patients under local anesthesia. Seventy patients underwent
      arthroscopy under local anesthesia using mepivacaine with adrenaline. In 49
      patients, arthroscopic surgery was performed. It is important to wait at least 20
      min after the injection of the anesthetic before surgery to anesthetize the
      medial part of the joint. There were few complications. Diagnostic and surgical
      arthroscopy can be successfully performed in the majority of patients with local
      anesthesia.

PMID- 1637440
TI  - Roentgenographic changes after arthroscopic meniscectomy: five-year follow-up in
      patients more than 45 years old.
AB  - Fifty knees with a mean follow-up time of greater than 5 years after arthroscopic
      meniscectomy were evaluated clinically and roentgenographically. Clinically,
      patients did well, with 98% patient satisfaction and 90% good or excellent
      results based on a modified Lysholm score. Although postoperative roentgenography
      showed some progression of Fairbank's changes in 61% with significant progression
      in 15% of knees, when changes in the nonoperative knee were considered, only 40%
      of operative knees showed progression, with only 4% of these knees showing
      significant progression. Normal results on preoperative anteroposterior
      roentgenography with the patient weight bearing and an anatomic tibiofemoral axis
      of greater than or equal to 4 degrees of valgus correlated with better long-term
      roentgenographic results.

PMID- 1637441
TI  - Arthroscopic meniscal repair: a posterior cannulated technique.
AB  - A modified inside-to-outside technique of meniscal repair is presented. The
      technique employs a 14 gauge needle that acts as the receiving conduit for a
      standard 10 in meniscal repair needle. The repair needle is placed into the joint
      through a repair cannula in a routine manner. Twenty-four meniscal repairs with
      an average follow-up of 26 months are presented with a clinical success rate of
      92% and no complications. The technique provides a particularly effective and
      safe approach to the placement of meniscal repair sutures at the posterior
      extremes of medial and lateral meniscal tears.

PMID- 1637442
TI  - The diagnostic potential of synovial effusion in meniscal pathology.
AB  - During a 20-month period, 382 arthroscopies were performed and the type of
      washout fluid obtained was noted. When a torn meniscus was found, the fluid was
      macroscopically abnormal in 97.4% of cases. A crystal clear washout was
      associated with no demonstrable pathology in over half the cases, the remainder
      having mainly patellofemoral joint pathology and other articular lesions. Only
      6.3% of those with a clear fluid washout had meniscal pathology. Of those with
      abnormal fluid, 68% had meniscal pathology, with a normal arthroscopic
      examination being found in only 8.5%. In addition, when the fluid from traumatic
      effusions was examined microscopically, a typical droplet containing lipid
      crystals was found to be present and to account for an oily macroscopic
      appearance. These data support the use of fluid irrigation of the knee as a
      screening test for intraarticular pathology, especially of the menisci, that may
      allow a reduction in the number of negative arthroscopies.

PMID- 1637443
TI  - Localized chondrocalcinosis of the lateral tibial condyle presenting as a loose
      body in a young athlete.
AB  - Chondrocalcinosis, although very rare in young adults, can occur in some young
      patients. Although its presenting clinical history or radiographic findings may
      resemble those of an intraarticular loose body, chondrocalcinosis can occur in
      young athletes, possibly after repetitive microtrauma, and should be included in
      the differential diagnosis of calcified intraarticular lesions in the young
      athlete.

PMID- 1637444
TI  - Arthroscopic-assisted glenohumeral arthrodesis.
AB  - A case of successful glenohumeral arthrodesis performed under arthroscopic
      control is presented. Clinical and radiographic fusion occurred by 6 weeks after
      the procedure. Salient features of the procedure include arthroscopic debridement
      of all hyaline cartilage and subchondral bone on both sides of the joint,
      reduction in a functional position, and internal fixation with percutaneously
      placed screws.

PMID- 1637445
TI  - Resection of bucket-handle meniscus tears: a simple technique using a Beaver
      blade.
AB  - This article describes a simple technique for the use of a #66 Beaver blade to
      assist in the resection of bucket-handle meniscus tears. This is a standard
      ophthalmologic blade and should be readily available in most operating rooms. The
      technique described is a simple, inexpensive means of resecting bucket-handle
      tears without changing portals during the procedure.

PMID- 1637446
TI  - The surgical approach to lateral meniscal repair.
AB  - Peripheral lateral meniscal tears are amenable to meniscal repair. Rasp abrasion
      and fibrin clot deposition along with vascular access channels are advances that,
      one hopes will increase healing rates of meniscal repairs. A basic principle that
      is not emphasized in the literature is how to perform the surgical approach to
      the lateral meniscus for safe placement of a meniscal repair retractor. This
      article reviews the anatomical planes of which the surgeon must be cognizant to
      facilitate retractor placement.

PMID- 1637447
TI  - [Value of MRT in diagnosis of tumors in the area of the temporal bone,
      nasopharynx, nose, paranasal sinuses and cranial aspects of the parapharyngeal
      space].
AB  - Magnetic resonance imaging (MRI) is now an established technique which is
      becoming increasingly important in the diagnosis, treatment planning and follow
      up of ENT tumours. It offers numerous advantages over other diagnostic
      procedures, especially computed tomography (CT). The soft tissue contrast enabled
      by MRI is superior to that obtained with CT scanning. MRI also enables multiplane
      imaging, which facilitates evaluation of the complex anatomy of the head. Apart
      from spin echo sequences, the most commonly employed technique, gradient echo
      sequences are becoming ever more important. This technique is flow-sensitive,
      reduces the investigation time and permits 3D imaging.

PMID- 1637448
TI  - [Olfactory sensitivity in adenoid hyperplasia].
AB  - Olfactory sensitivity was assessed in 37 children aged between 5 and 12 years
      before and after adenectomy. Olfactory detection thresholds for 2-phenylethanol
      and dimethyldisulphide, as well as the ability to distinguish 8 other odours,
      were measured using a squeeze bottle test. The results suggest that preoperative
      olfactory detection thresholds in subjects with severe nasal obstruction
      attributable to adenoid hypertrophy are higher than in those with less severe
      nasal obstruction. The olfactory detection thresholds improved after adenectomy
      in cases with high preoperative nasal obstruction indices. The olfactory
      detection threshold remained relatively unchanged in cases with less severe
      adenoid hyperplasia. In contrast, improvement in olfactory discrimination was
      observed in all children, irrespective of the degree of preoperative nasal
      obstruction.

PMID- 1637449
TI  - [Allergic rhinopathy: Magic Lite SQ Allergy Screen Inhalant and CAP-FEIA SX1-
      comparison of two allergen-specific screening tests in serum].
AB  - Although total IgE determination in the diagnosis of allergic rhinitis has been
      proposed for screening, specific tests seem to be more efficient. In this study,
      Magic Lite SQ Allergy Screen Inhalant (ML) and CAP-FEIA Phadiatop (CF) were
      compared in serum in a group of 101 patients with allergic rhinitis (41 women, 60
      men, mean age 31.4 years, range 7-69) and 37 controls (17 women, 20 men, mean age
      38.3 years, range 6-68). All patients were suffering from nasal disease. The
      diagnosis based on case history, skin prick test, total and specific IgE
      determination and nasal challenge tests. ML was found to have a sensitivity of
      96% and a specificity of 83.8% while CF achieved a sensitivity of 94.1% and a
      specificity of 94.6%. Efficiency was 92.8% for ML and 94.2% for CF. A positive
      predictive value of 94.2% for ML and of 97.9% for CF was calculated while the
      negative predictive value was 88.6% for ML and 85.4% for CF. It is concluded,
      that both ML and CF are suitable allergy screening tests able to give a 100%
      diagnostic security in combination with further examinations, especially
      regarding the case history.

PMID- 1637450
TI  - [Ozena and allergic rhinitis in ichthyosis vulgaris].
AB  - The clinical course of an ozaena in a patient with an autosomal dominant
      ichthyosis vulgaris was complicated by the skin disease related atopic
      disposition with allergic rhinitis. Electron microscopic studies of the
      pathologically keratinized mucosa of the nasopharynx revealed a similar defect of
      the mucosal keratohyalin caused by the absence of the protein filaggrin.

PMID- 1637451
TI  - [Biopsy of the temporal artery in polymyalgia rheumatica].
AB  - Biopsy of the temporal artery is still the most important component in the
      diagnosis of polymyalgia rheumatica and giant cell arteritis. Although this is a
      minor surgical intervention, certain vascular complications must be considered.
      Therefore, preoperative Doppler sonography should be performed. Finally, to
      prevent false-negative results, the temporal artery should be excised bilaterally
      and not shorter than 4 cm.

PMID- 1637452
TI  - [Esthetic aspects of excision of basaliomas of the area of the head and neck].
AB  - Eighty-four patients with basal cell carcinoma of the head and neck were
      submitted to surgery. In 75%, infiltration of the reticular dermis or the
      subcutis was documented. Primary closure of the wound was achieved in only one
      third of these patients. In the remaining cases, the defects were closed by local
      flaps, regional flaps or a microvascular forearm flap. In 86% of the cases, good
      to-excellent results were achieved.

PMID- 1637453
TI  - [A recommendation for calibration and choice of masking noises used in speech
      audiometry].
AB  - Tests to evaluate speech recognition ability against background noise have still
      not been adequately standardized. This is due in part to the lack of a
      calibration procedure for the various noises used in testing. In the present
      study, a psychoacoustic method for the calibration of fluctuating background
      noises was evaluated. Three types of noise were used: babble noise, stationary
      noise and fluctuating speech simulating noise in accordance with (CCITT Rec. G
      227). Following calibration, the masking effect of each type of noise was
      evaluated. Results indicated that stationary and fluctuating speech simulating
      noise had similar effect on speech understanding ability. The steepness of the
      intensity-intelligibility function was significantly greater using babble noise
      as compared with stationary or fluctuating speech simulating noise. Babble noise
      was well accepted by our subjects. However, since its measurement can be
      calibrated, stationary speech simulating noise may also be used in speech
      audiometry.

PMID- 1637454
TI  - [Evoked otoacoustic emissions in diagnosis of cochlear hearing disorders].
AB  - The authors consider the possibility of routine use of evoked otoacoustic
      emissions (EOE) in diagnosis of sensory hearing loss by comparison of EOE curves
      with relative curves obtained by pure tone audiometry. 180 ears with sensory
      hearing loss of different aetiologies were examined. EOE were obtained by
      application of Bray and Kemp's Evoked Otoacustic Measurement Package (ILO88). The
      results obtained show a close correlation between presence of EOE and real
      hearing losses of different frequencies obtained by pure tone audiometric
      evaluation. We could detect no EOE with hearing losses over 50 dB HL at 500 Hz,
      40 dB HL at 1000 Hz, 50 dB HL at 2000 Hz and 85 dB HL at 4000 Hz. With a rate of
      middle hearing loss over 45 dB HL we also did not find EOE for the whole
      frequency range. On the base of this study, the authors conclude that EOE explore
      the functional integrity of those parts of the cochlea that correspond to the
      middle frequencies of hearing range. If EOE are not detectable, statements on the
      nature and extent of hearing loss on the base of this examination are not valid.

PMID- 1637455
TI  - [The temporal course of nystagmus reactions after rotational stimulation
      (modified Veits long rotational method). Part II. Recommendations for the
      simplification of nystagmus evaluation in the rotational test].
AB  - In this study, on the basis of the graphics showing the time course of the
      nystagmus reactions following rotatory stimuli (Part I), some practical proposals
      are made on how the nystagmus responses following the rotatory test can be
      routinely analysed more quickly. The recommendations are oriented to the
      requirement that the selection of defined 30-second-intervals during the per- and
      postrotatory phase for the nystagmus analysis should reflect the total reaction
      in healthy subjects as well as in patients with acute vestibular lesions in a
      representative manner. It is also shown that reducing the analysis intervals to
      only 15 seconds or selecting unfavourable segments, can lead to an unacceptable
      falsification of the results.

PMID- 1637456
TI  - [Provocable tumor of the cheek as a manifestation of so-called "infiltrating
      lipoma" of the masseter muscle].
AB  - We report on a 29-year-old male patient, who presented at our outpatient clinic
      with a 6-year history of progressive swelling of the right cheek. Contraction of
      the masseter muscle increased the swelling. MR-Imaging revealed a tumor measuring
      2 x 3 cm, which was located within the masseter muscle. The histological
      diagnosis was infiltrating lipoma, which to our knowledge has not been described
      in this area before. This particular type of lipoma is extremely rare in the head
      and neck. The diagnostic and therapeutic management of infiltrating lipoma is
      discussed, and guidelines for adequate follow-up suggested. In addition, the
      authors review other sites of this tumor and describe its histological
      characteristics and differential diagnosis.

PMID- 1637457
TI  - [Paralysis of the hypoglossal nerve after bilateral tonsillectomy].

PMID- 1637458
TI  - [Prevention of gagging in pharyngeal inspection].

PMID- 1637459
TI  - Nurses and doctors ... and patients.
AB  - A Forum discussion group hosted by Dr Eilif Liisberg was formed from a few of the
      participants at a WHO nursing conference in Geneva. Subjects discussed were the
      status of nursing and changing attitudes to patients.

PMID- 1637460
TI  - "PolioPlus", a booster shot.

PMID- 1637461
TI  - Immunization: full coverage the aim.

PMID- 1637462
TI  - Postage stamps with WHO messages.

PMID- 1637463
TI  - Multilingual health education tapes project.

PMID- 1637464
TI  - Smaller health areas for a better service.
AB  - An analysis of Sudan's health system revealed a lack of sound leadership for
      village-level providers. The district-based peripheral health system was failing
      to meet an increased demand for leadership and management support. Some of the
      principal factors explaining this state of affairs were population growth,
      increased numbers of health units, long distances and transport difficulties.
      With a view to solving these problems, the country was divided into smaller
      health areas around rural hospitals and similar physician-led facilities. A
      decentralized system based on the principles of primary care was established in
      these areas under health area management teams. Setbacks encountered in giving
      effect to the policy have led to proposals for a new implementation strategy.

PMID- 1637465
TI  - Health systems in flux as East meets West.
AB  - The characteristics of health systems in eastern and western Europe and North
      America are outlined with special reference to financial control and
      accountability. The advantages and drawbacks of the various systems are examined
      and the prospects for new departures and improved services are considered.

PMID- 1637467
TI  - Homo sapiens--a suicidal species?

PMID- 1637466
TI  - Homo sapiens--a suicidal species?

PMID- 1637468
TI  - Health messages on postage stamps.

PMID- 1637469
TI  - Nursing education in Indonesia.

PMID- 1637470
TI  - Acupuncture and moxibustion in primary health care in rural China.

PMID- 1637471
TI  - Ancillary health workers, a resource worth cultivating.

PMID- 1637472
TI  - Health promotion on board ships.

PMID- 1637473
TI  - Schoolchildren as conveyors of health information for family members.

PMID- 1637474
TI  - Education: the key to preventing vesicovaginal fistula in Nigeria.

PMID- 1637475
TI  - Amnesty International is also concerned about health.

PMID- 1637476
TI  - Pharmacy education and drug abuse in Pakistan.

PMID- 1637477
TI  - Safe childbirth needs more than medical services.
AB  - This article reviews nonmedical factors contributing to maternal mortality in
      Indonesia, the Philippines, and Thailand. In general, countries or regions should
      define their own priorities for intervention strategies designed to diminish the
      influence of such factors.

PMID- 1637478
TI  - Birth kits for safe motherhood in Bangladesh.
AB  - Tetanus infection remains the leading cause of high neonatal mortality in
      Bangladesh. Birth kits which instruct and assist in a clean, safe birth are seen
      as a key measure in reducing the high incidence of neonatal deaths. A
      multisectoral programme has developed a simple kit and tested its potential for
      distribution to pregnant women. Initial results are positive and development is
      continuing.

PMID- 1637479
TI  - Prices for a leaner dairy industry.
AB  - For several decades, the basic policies of the dairy industries in developed
      countries, especially Canada and the Member States of the European Community,
      have encouraged the production of fat and have tended to neglect that of protein
      and minerals. This not only opposes the general well-being and the best interests
      of consumers but also distorts world trade. Much could be done by health
      professionals to persuade the milk producers, consumers and governments that
      support for dairy farming should be modified so that less fat and more protein
      are produced and consumed.

PMID- 1637480
TI  - Safer sex in tourist resorts.
AB  - A survey in Torbay, England, indicated substantial sexual interaction of an
      unsafe kind between young residents and tourists. A pilot programme is described
      which sought to promote safer sexual behaviour: the attention of both tourists
      and local people who frequented nightclubs was engaged by peer groups who
      conveyed educational messages.

PMID- 1637481
TI  - What choices in care for the incontinent?
AB  - Urinary and faecal incontinence affect many millions of people yet much remains
      to be done before they can all be properly cared for and the incidence of the
      conditions can be significantly diminished. The author discusses the situation in
      the light of a comparison of nursing initiatives in Denmark and the United
      Kingdom.

PMID- 1637482
TI  - New AIDS strategy aimed more at women.

PMID- 1637483
TI  - Global AIDS update.

PMID- 1637484
TI  - Children's vaccine initiative.

PMID- 1637485
TI  - [Atopic dermatitis. Epidemiology].
AB  - It was in 1923 that Coca and Cooke made a distinctive entity of a group of
      diseases of allergy, including asthma, and hay fever. They remarked that these
      affections were frequently associated and/or preceded by eczema localised to
      certain regions (flexor folds), sometimes generalised, perhaps appearing
      suddenly, from the third month in infants. In effect, the majority of
      constitutional eczema is in infants of 6 months, 75% of the cases are in one-year
      old children. There is recovery in 5 years following the start of the affection
      in 90% of cases. Only 5% of cases persist to adulthood.

PMID- 1637486
TI  - [Clinical diagnosis of atopic dermatitis].
AB  - Atopic eczema is a pruriginous dermatosis that most often starts before one year,
      but which may show for the first time after 50 years. The diagnosis is
      essentially clinical, with signs of banal eczema (especially acute in young
      infants, more chronic later) but of which the topography develops
      characteristically as a function of age and in the context of atopy. The
      development of is chronic, dotted with inflamed eruptions and may be complicated
      by an alteration of general state with bacterial (very frequent) or viral
      superinfections. The appearance of asthma is frequent when the dermatosis is
      extended. It usually disappears before adult age. Differential diagnosis is
      needed especially when there is an atypical form or association with another
      pruriginous dermatosis. Questioning must cover the environment, food habits and
      search for signs that may show the responsibility of an allergen.

PMID- 1637487
TI  - [Etiologies of atopic dermatitis].
AB  - Atopic dermatitis is no longer a constitutional illness that cannot be
      influenced. The discovery of IgE fixed to the cells of Langerhans changes the
      physiopathological concept of this illness. There must be a minutely careful
      search for all the possible etiologies before advising therapy or long-term
      treatment. Attention must be given to the role of foods, discovery of causal
      pneumoallergens and a systematic search for a contact allergen must be made. This
      systematic and scrupulous search also gives confidence to a patient who is
      discouraged by the development of the condition.

PMID- 1637488
TI  - [Complementary examinations in atopic dermatitis].
AB  - The complementary assessment of atopic eczema involved a biological assessment:
      one part in vitro (total IgE, specific IgE, T4/T8 immunoregulator index); one
      part in vivo (skin tests: skin reaction intradermal reaction, patch test).

PMID- 1637489
TI  - [Treatments for atopic dermatitis].

PMID- 1637490
TI  - Anxiety and family needs of the relatives of cardiac medical-surgical ICU
      patients.
AB  - The purpose of this study was to seek information on the perceived needs of
      family members visiting a patient in a critical care unit (ICU) of two hospitals
      located in Sudbury, Ontario. The sample included fifty-one family members
      visiting cardiovascular surgical patients (CVS) and forty-four family members
      visiting cardiovascular medicine patients (CVM). The study was part of a larger
      project conducted on a convenience sample of 166 subjects visiting an ICU
      patient. Data was gathered using a self-report questionnaire, the Critical Care
      Family Needs Inventory (CCFNI) (Molter and Leske, 1983), and Spielberger's (1983)
      State Trait Anxiety Inventory (STAI). Information was also collected about
      worries, knowledge, spiritual needs and the distance of subjects' residence from
      the site of hospitalization. The sample for both groups was predominantly female.
      The State Anxiety Scale of the STAI yielded mean scores for both groups which
      were significantly higher than those obtained by Spielberger (1983) (CVS: z = 
      3.28, p less than .0001; CVM: z = -3.41, p less than .0001).

PMID- 1637491
TI  - Delay in seeking appropriate medical help by individuals experiencing the
      symptoms of heart attack.

PMID- 1637492
TI  - Policy, practice and research.

PMID- 1637493
TI  - A community survey of cardiac emergency skills: symptom recognition and CPR.
AB  - This descriptive study assessed recognition of symptoms of myocardial infarction
      (MI) by community members and their ability to respond to emergency situations
      with cardiopulmonary resuscitation (CPR) skills. One thousand questionnaires were
      randomly mailed to residents with a response rate of 48.1%. Results indicated
      that residents have limited awareness of symptoms of MI other than demonstrated
      chest pain and that 20.6% of the respondents had taken a CPR course. CPR courses
      were taken by 9.6% of respondents who had one or more relatives diagnosed with
      heart disease. The lack of awareness of symptoms of MI and limited ability to
      perform CPR skills in emergency situations by community residents may contribute
      to the high mortality rates due to heart disease. Results of the study suggest
      that educational campaigns be instituted in the community under study to promote
      recognition of and response to cardiac emergencies.

PMID- 1637494
TI  - The effect of prenatal ethanol exposure on scentmarking in the C57BL/6J and
      C3H/He mouse strains.
AB  - In utero exposure to ethanol has been shown to alter sexually dimorphic behaviors
      in rats. However, it is not clear whether this phenomenon is robust in other
      species, such as the mouse, which is sensitive to ethanol-induced birth defects.
      Further, it is not known whether significant differences exist across murine
      strains. If similar to the classic teratogenic effects of ethanol, it would be
      expected that strain differences in sensitivity should be evident, with some
      strains demonstrating an alteration in sexually dimorphic behavior and other
      strains demonstrating little or no effect. As a first attempt to address these
      issues, we have examined two mouse strains widely used in prenatal alcohol
      research, the inbred C3H/He and C57BL/6J strains. Scentmarking was selected as
      the behavior of interest. It is robustly sexually dimorphic in the rat and mouse,
      with males marking more than females and preliminary reports have demonstrated
      that in utero ethanol exposure reduces this behavior in the male rat. In the
      mouse strains selected for study, pregnant females were provided with either a
      liquid diet consisting of 25% ethanol-derived calories or pair-fed an isocaloric
      liquid diet from gestation days 6-18. An additional control group was included
      which was fed laboratory chow ad lib throughout gestation. Male and female
      offspring of each strain were tested for scentmarking at 65-75 days of age. As
      expected, results showed that the effect of prenatal ethanol exposure on
      scentmarking varied with both strain and sex. In the C3H/He strain, scentmarking
      was reduced significantly in male ethanol-exposed offspring (i.e., the males were
      feminized).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637495
TI  - Rat synaptic membrane fluidity parameters after intermittent exposures to ethanol
      in vivo.
AB  - Differentiated membrane alterations correlate with the development of functional
      tolerance or dependence during chronic alcohol intoxication in humans as well as
      in animals. In animal studies, a single period of continuous exposure was
      generally used. In humans, the consumption can be more episodic with heavier
      weekend drinking. How a heavy but intermittent alcohol exposure over 4 weeks
      affects the synaptic membrane fluidity and sensitivity was examined in male and
      female adult rats. No differences were seen between membranes from males and
      females. Alterations were found in the negative polar membrane region probed by
      TMA-DPH and the sensitivity to acute ethanol was significantly reduced in the DPH
      (lipid core) and TMA-DPH probed membrane regions. Tolerance to the hypothermic
      effect of ethanol has developed and could be correlated with the resistance of
      the membrane lipid core to ethanol. Intermittent exposures to ethanol, as
      continuous ones, can result in development of functional and membrane tolerance
      and in specific alterations in the fluidity of the polar part of the membrane,
      probably in relation with dependence.

PMID- 1637496
TI  - Cardiorespiratory reflex due to pulmonary J receptors stimulation by acetaldehyde
      in rats.
AB  - Acetaldehyde (AcH) administered intravenously or into the right ventricle induces
      reflex bradycardia, hypotension, and apnea in the rat. The efferent pathway for
      this reflex is vagal and probably secondary to pulmonary J receptors stimulation.
      Located between the alveoli and the pulmonary capillary, J receptors are
      accessible through the pulmonary circulation and the airways. For this reason, a
      method for indirect nebulization (IN) of AcH into the airways, that provides a
      continuous record of respiration without changes in intrapulmonary pressure, was
      developed. IN of AcH (n = 14) induced bradycardia (64 +/- 3.1%), hypotension (34
      +/- 4.2%), and apnea (79%), which were blocked by vagotomy (n = 9). The latencies
      (s) for bradycardia (0.34 +/- 0.06), hypotension (0.68 +/- 0.11), and apnea (0.25
      +/- 0.11) were significantly shorter than those obtained by the intravenous
      route. Three rats that did not develop apnea had an equivalent response, where
      both tidal volume and minute ventilation decreased about 40% and these effects
      were also blocked by vagotomy. Indirect nebulization of AcH allowed us to
      demonstrate that pulmonary J receptors are responsible for this reflex response.

PMID- 1637498
TI  - A role for behavioral sensitization in uncontrolled ethanol intake.
AB  - The processes that underlie the transition from controlled to uncontrolled
      consumption of ethanol are unknown. Behavioral sensitization is proposed as one
      of these processes and occurs with repeated administration of psychomotor
      stimulants whereby both behavioral and neurochemical responses to the drugs are
      progressively enhanced. Because ethanol shares some actions in common with these
      drugs, chronic exposure to ethanol may intensify its reinforcing properties. The
      effect of ethanol on several behavioral models suggests that behavioral
      sensitization may develop especially in the presence of environmental cues. Thus,
      a research opportunity exists to study factors that contribute to an increasing
      probability of progressively higher ethanol consumption. Knowledge of these
      factors will lead to a better understanding of why some people drink
      uncontrollably.

PMID- 1637497
TI  - Ceramide composition of whole brain synaptosomal gangliosides from mice
      genetically bred for divergent ethanol sensitivities.
AB  - A comparison of the two major ceramide molecular species (d18:1-C18:0 and d20:1
      C18:0) of synaptosomal gangliosides GM1, GD1a+GT1a, GD1b, GT1b, revealed a
      difference between the ceramide composition of ethanol-sensitive LS and ethanol
      insensitive SS whole brain synaptosomal gangliosides. In all comparisons, the
      ratio of the two major molecular species, (d18:1-C18:0/d20:1-C18:0) was less for
      LS than for SS mice.

PMID- 1637499
TI  - Effect of chronic consumption of ethanol and vitamin E on fatty acid composition
      and lipid peroxidation in rat heart tissue.
AB  - Lipid peroxidation products and the fatty acid composition of phospholipids were
      studied in the hearts of rats chronically consuming ethanol supplemented with
      large amounts of vitamin E. Ethanol representing 36% of the total calories was
      ingested for 7 weeks in a modified Lieber-DeCarli liquid diet that contained
      vitamin E at 30 IU/L in the control or 172 IU/L in the supplemental dietary
      group. Ethanol and/or vitamin E did not change the absolute content (micrograms
      per mg of phospholipids) of the main fatty acids (C18:0, C18:2, and C20:4) of
      heart phospholipids but increased the amount of the minor C20-C22 fatty acids.
      Cardiac phospholipid levels increased in rats chronically consuming excess
      vitamin E and/or alcohol. Chronic ethanol consumption caused elevations of the
      relative content (percent of total fatty acids) of tri-, tetra-, and hexaenoic
      acids and peroxidizability index (PI) of the cardiac phospholipids.
      Supplementation with vitamin E blocked this ethanol-induced shift in the fatty
      acid profile toward unsaturation and decreased the PI. Ethanol enhanced
      accumulation of vitamin E in heart tissue by 30% irrespective of the vitamin E
      content in the diet. Enrichment of the diet with vitamin E coincided with the low
      levels of fluorescent products in heart lipids. A positive correlation (r = 0.36;
      p = 2%) was found between vitamin E and diene conjugates in the heart cells.
      Thus, vitamin E has a stabilizing effect on heart phospholipids by preventing
      changes in their fatty acid composition and peroxidative deterioration.

PMID- 1637500
TI  - Delayed onset of puberty and subtle alterations in GnRH neuronal morphology in
      female rats exposed prenatally to ethanol.
AB  - Fetal alcohol exposed (FAE) animals exhibit physiological and behavioral deficits
      associated with reproduction including alterations in LH secretion and decreased
      sex behavior. Such deficits led us to examine the morphological characteristics
      and number of GnRH neurons in female rats prenatally exposed to ethanol. Sprague
      Dawley dams (Harlan, Indianapolis, IN) were administered a fortified liquid diet
      (Sustacal) containing 35% ethanol derived calories from day 7 through
      parturition. Controls were pair-fed a similar isocaloric diet containing no
      ethanol during this period or allowed access to dry food pellets ad lib. Compared
      to both control groups, puberty was found to be significantly delayed in females
      that were exposed prenatally to ethanol. The median age of vaginal opening for
      chow-fed and pair-fed controls was 34-35 days compared to 38-39 days for FAE
      animals. A subgroup of these females was selected at 44 days of age on the basis
      of delayed onset of puberty and compared with pair-fed controls for the number
      and morphology of GnRH-immunoreactive staining (ir) neurons in the medial
      preoptic area (MPOA) and the diagonal band of Broca (DBB), regions which contain
      the majority of GnRH-IR cells in the rat brain. In both areas, light microscopic
      study revealed no differences in GnRH-IR cell number, nor were differences
      detected among the groups in the number of bipolar versus unipolar cells.
      However, a significant increase was observed in FAE brains compared to controls
      in the ratio of GnRH-IR neurons with irregular processes compared to smooth cell
      contours.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637501
TI  - Activated conformations of the ras-gene-encoded p21 protein. 1. An energy-refined
      structure for the normal p21 protein complexed with GDP.
AB  - A complete three-dimensional structure for the ras-gene-encoded p21 protein with
      Gly 12 and Gln 61, bound to GDP, has been constructed in four stages using the
      available alpha-carbon coordinates as deposited in the Brookhaven National
      Laboratories Protein Data Bank. No all-atom structure has been made available
      despite the fact that the first crystallographic structure for the p21 protein
      was reported almost four years ago. In the p21 protein, if amino acid
      substitutions are made at any one of a number of different positions in the amino
      acid sequence, the protein becomes permanently activated and causes malignant
      transformation of normal cells or, in some cell lines, differentiation and
      maturation. For example, all amino acids except Gly and Pro at position 12 result
      in an oncogenic protein; all amino acids except Gln, Glu and Pro at position 61
      likewise cause malignant transformation of cells. We have constructed our all
      atom structure of the non-oncogenic protein from the x-ray structure in order to
      determine how oncogenic amino acid substitutions affect the three-dimensional
      structure of this protein. In Stage 1 we generated a poly-alanine backbone
      (except at Gly and Pro residues) through the alpha-carbon structure, requiring
      the individual Ala, Pro or Gly residues to conform to standard amino acid
      geometry and to form trans-planar peptide bonds. Since no alpha-carbon
      coordinates for residues 60-65 have been determined, these residues were modeled
      by generating them in the extended conformation and then subjecting them to
      molecular dynamics using the computer application DISCOVER and energy
      minimization using DISCOVER and the ECEPP (Empirical Conformational Energies for
      Peptides Program). In Stage 2, the positions of residues that are homologous to
      corresponding residues of bacterial elongation factor Tu (EF-Tu) to which p21
      bears an overall 40% sequence homology, were determined from their corresponding
      positions in a high-resolution structure of EF-Tu. Non-homologous loops were
      taken from the structure generated in Stage 1 and were placed between the
      appropriate homologous segments so as to connect them. In Stage 3, all bad
      contacts that occurred in this resulting structure were removed, and the
      coordinates of the alpha-carbon atoms were forced to superimpose as closely as
      possible on the corresponding atoms of the reference (x-ray) structure. Then the
      side chain positions of residues of the non-homologous loop regions were modeled
      using a combination of molecular dynamics and energy minimization using DISCOVER
      and ECEPP respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1637502
TI  - Molecular dynamics simulation in vacuo and in solution of [Aib5,6-D-Ala8]
      cyclolinopeptide A: a conformational and comparative study.
AB  - The conformation of a Cyclolinopeptide A analogue, c-(Pro-Pro-Phe-Phe-Aib-Aib-Ile
      D-Ala-Val), has been investigated by means of molecular dynamics simulations, in
      various molecular environments. The molecular dynamics results are compared with
      that obtained for Cyclolinopeptide A and a detailed analysis of the different
      behaviour for the two compounds is reported. A complete analysis of hydrogen
      bonds is presented.

PMID- 1637503
TI  - The structures of bacteriorhodopsin with different retinal-Schiff base
      orientations--computer modeling and energy minimization studies.
AB  - Bacteriorhodopsin has been the subject of intense study in order to understand
      its photochemical function. The recent atomic model proposed by Henderson and
      coworkers based on electron cryo-microscopic studies has helped in understanding
      many of the structural and functional aspects of bacteriorhodopsin. However, the
      accuracy of the positions of the side chains is not very high since the model is
      based on low-resolution data. In this study, we have minimized the energy of this
      structure of bacteriorhodopsin and analyzed various types of interactions such as
      -intrahelical and interhelical hydrogen bonds and retinal environment. In order
      to understand the photochemical action, it is necessary to obtain information on
      the structures adopted at the intermediate states. In this direction, we have
      generated some intermediate structures taking into account certain experimental
      data, by computer modeling studies. Various isomers of retinal with 13-cis and/or
      15-cis conformations and all possible staggered orientations of Lys-216 side
      chain were generated. The resultant structures were examined for the distance
      between Lys-216-schiff base nitrogen and the carboxylate oxygen atoms of Asp-96-
      a residue which is known to reprotonate the schiff base at later stages of
      photocycle. Some of the structures were selected on the basis of suitable retinal
      orientation and the stability of these structures were tested by energy
      minimization studies. Further, the minimized structures are analyzed for the
      hydrogen bond interactions and retinal environment and the results are compared
      with those of the minimized rest state structure. The importance of functional
      groups in stabilizing the structure of bacteriorhodopsin and in participating
      dynamically during the photocycle have been discussed.

PMID- 1637504
TI  - Nucleic acids packaging processes: effects of adenine tracts and sequence
      dependent curvature.
AB  - The effects of short runs of adenines (A-tracts) upon nucleic acids packaging
      processes and the properties of the resulting condensates were investigated by
      using random DNA sequences isolated from natural sources, as well as synthetic
      segments obtained by an extensive ligation of specific oligomers. Reiteration of
      short A-tracts (A(N) where N less than 3) within the DNA molecules is found to be
      compatible with a long-range chiral organization of the strands in the nucleic
      acid condensed phases. This chiral order, whose occurrence necessitates a high
      degree of flexibility, is shown, however, to differ from that exhibited by packed
      species originating from random AT-rich fragments; the altered patterns are
      interpreted in terms of a reduced overall flexibility of the DNA strands.
      Repetition of longer A-tracts (where N greater than 3), in which the distinct
      structural features that characterize this motif are fully expressed, results in
      a complete suppression of any chiral order in the packed particles, assigned to a
      significantly enhanced rigidity. DNA fragments where A-tracts are reiterated in
      phase, leading to a stable macroscopic curvature, are found to undergo
      condensation through altered pathways and to form toroidal shapes of unusually
      small dimensions. The results point towards the intriguing possibility that A
      tracts and, in particular, the global, intrinsic curvature associated with such
      motifs, might be involved in the determination of nucleic acids packaging
      pathways, and underline the usefulness of defined sequences in the study of DNA
      condensation processes.

PMID- 1637505
TI  - Preferred positions of AA and TT dinucleotides in aligned nucleosomal DNA
      sequences.
AB  - Multiple alignment of 118 nucleosomal DNA sequences by maximizing simultaneously
      match of AA dinucleotides and match of TT dinucleotides results in a pattern of
      the dinucleotide distributions which is characteristic of the nucleosomal DNA
      sequences. The AA dinucleotides are found to be distributed symmetrically
      relative to the TT dinucleotide distribution, around the middle point of the
      nucleosomal DNA sequence. The distances between major peaks of the distributions
      are multiples of about 10.4 bases. The peaks of the TT distribution are shifted
      by 6 bases downstream from the peaks of the AA distribution.

PMID- 1637506
TI  - Molecular modeling to predict the structural and biological effects of mutations
      in a highly conserved histone mRNA loop sequence.
AB  - The 3'-end of histone mRNAs contains a highly conserved sequence motif which is
      believed to form a 6 base pair stem and a 4 base loop. These sequences are
      involved in both the efficiency of 3'-end formation and stability of the mature
      histone mRNA. We have modeled four stem basepairs and the loop portion of this
      structure using the wildtype sequences and several mutant sequences. A structure
      for the wildtype stem-loop is proposed that is based on energy minimization using
      a representative wildtype sequence and comparison with structures obtained using
      naturally occurring mutations which do not alter loop function. A wildtype
      structure is proposed in which the top basepair of the stem is broken, forming a
      six base loop. Mutant sequences with altered bases in the loop and in the stem
      were also modeled. The effect of these mutations on the proposed wildtype
      structure is discussed and possible biological consequences considered.

PMID- 1637507
TI  - Base sequence criteria and Cartesian coordinates for stable B/Z and B/Z/B
      junctions in relaxed DNA.
AB  - It seems increasingly evident that if the Z form of DNA exists in the genome it
      must exist as short sections of alternating pyrimidine-purine sequences in the
      midst of very long sections of B-form DNA. We have determined the minimum length
      of a string of alternating CG base pairs that can go into the Z form in the
      middle of a long B form. Self-complimentary oligomers of the form T(M)(CG)(N)A(M)
      were synthesized. The conformation of the resulting duplex was determined in 6M
      aqueous NaCl solution by Raman scattering. We have found that 12 alternating CG
      base pairs is the minimum length required to form a stable Z form of DNA inside
      of a long B form section. Only the 4 center CG base pairs go into the Z form.
      These 4 CG base pairs in the Z form are flanked on each side by 4 CG base pairs
      in a non-Z (probably B) form as well as the ..TT.. ..AA.. sequences in the B
      form. We propose a model of the B/Z junction in which the double helix flips
      directly from the B form to the Z form so that there are no base pairs in the
      junction. In this model the B form is nucleated in the AT base pairs on each end
      and is propagated into the CG base pairs in the center. This model is supported
      by isotopic H/D exchange experiments that shows that the H/D exchange of the non
      Z form CG base pairs is highly retarded and indicates that they remain in the B
      form. A Thermodynamic analysis of the concentration dependence of the melting
      point of the duplexes in both low and high salt, supports our model and rules out
      the possibility of hairpin formation. The enthalpy for the formation of a B/Z
      junction is determined to be about +16 kcal/junction. A comparison of these
      results with recent results on B/Z junctions in super-coiled DNA is given.
      Molecular modeling calculations permit us to obtain values for the coordinates
      and torsional angles of the oligomers showing both B/Z and B/Z/B junctions. The
      Cartesian coordinates for these oligomers as well as stereo figures of these
      models in color are available from the authors.

PMID- 1637508
TI  - A reduced set of coordinates for modeling DNA structures: (I). A B-to-A
      transition pathway driven by pseudorotational angle.
AB  - The A-DNA and the B-DNA are two well characterized polymorphous forms of DNA
      duplex. By using Metropolis Monte Carlo Simulations in a reduced coordinate
      space, we have shown that the B in equilibrium with A transitions can be induced
      by forcing pseudorotational angle (W) to change between C3'-endo and C2'-endo
      puckerings. The energy barrier for the transition pathway is less than 10
      Kcal.mol-1. Base-pair parameters x-displacement (Dx) and roll (rho), which have
      the largest differences between the two forms of structures, cannot drive the
      transition. Our results support the view that the bistable states of the DNA
      duplex are due to the bistable structures of the sugar ring.

PMID- 1637509
TI  - Sequence effects on the propeller twist of base pairs in DNA helices.
AB  - Molecular mechanics calculations are performed on all the ten base pair steps
      (duplex dimers) and also a number of trimer and tetramer duplexes comprising
      them, in an attempt to systematically examine the possible base sequence effects
      on the magnitudes of propeller twists of base pairs at a given step. The analysis
      reveals that though propeller twist is a base pair property, it behaves very much
      like other base step parameters such as slide, roll, twist etc., Hence, it may be
      necessary to monitor the nature and variation of magnitudes of pt at a step.
      Calculations performed on 45 out of the 136 unique tetramer combinations
      involving all the ten unique base steps show that the difference in magnitudes of
      propeller twists of the base pairs of a given step has been found to be either
      steep or moderate depending on base pairs that flank the base step. These
      observations compare very well with the available experimental data. Tetramer
      sequences, wherein a base pair of a base step repeats in the same direction,
      exhibit a relatively steep difference in propeller twist at the step. Tetramers
      other than these exhibit moderate difference in propeller twist. Such sequences
      are broadly classified as type-I and type-II respectively. Practically all the
      tetrads considered in the study, excepting those with GT step and a few involving
      CG and GC steps, conform to the above classification.

PMID- 1637510
TI  - DNA sequences at and between the GC and TATA boxes: potential DNA looping and
      spatial juxtapositioning of the protein factors.
AB  - Regulation of gene expression in eukaryotes involves a complex assembly of DNA
      recognition sequence elements and their respective protein factors. The upstream
      promoter/enhancer sequences are position and orientation independent. Despite
      their variable distances from the TATA box and transcription start site,
      interaction between the protein activators and TATA general transcription factors
      takes place, enabling induced levels of transcription initiation. Here the
      intervening sequences between the GC and TATA boxes are examined as functions of
      their lengths. Regardless of the substantial differences in the spacer sizes,
      similar mono and dinucleotide distributions are noted. Purine-purine base pair
      steps, except for AA, are more frequent at and near the GC box in the 5' ends of
      the loops than in their 3' ends. Pyrimidine-pyrimidine base pair steps, except
      for TT behave similarly. AT and TA (as well as AA and TT) are more frequent in
      the 3' ends of the loops near the TATA. Examination of these distributions, as
      well as of the sequences composing the GC and TATA boxes indicates that the DNA
      in the upstream part of the loop is more rigid, whereas the downstream regions
      are far more flexible. The flexibility of the general TATA region may afford
      correct spatial juxtapositioning of the proteins with respect to each other,
      enabling interactions between the activators and the general transcription
      factors.

PMID- 1637511
TI  - A Monte Carlo simulation of hydration of xanthine-derivatives and their stacked
      forms.
AB  - Results on a Monte Carlo simulation of the hydration of monomer and possible
      stacked dimer forms of a purine alkaloid series in 200- and 400-water molecule
      clusters are presented. Investigation of different purine stacked dimers in a 200
      water molecule cluster reveals that for caffeine there exists one, for
      theophylline two and for theobromine four dimers are energetically favorable. For
      caffeine, the same energetically favored stacked dimer form is observed in both
      the 200- and 400-water molecule cluster. The main factor stabilizing the
      preferred dimer stacks is the change in the interaction between water molecules
      of the monomer cluster and those water molecules in the dimer cluster.

PMID- 1637512
TI  - The conformational behaviour of complexes of alpha-cyclodextrin with p
      chlorophenol and p-hydroxybenzoic acid in water as studied by molecular dynamics
      simulations.
AB  - Molecular dynamics simulations were performed to obtain information about the
      conformational behaviour and stabilization of alpha-cyclodextrin (alpha CD)
      complexes in water. Simulations of p-chlorophenol and p-hydroxybenzoic acid in
      alpha CD showed that the complex is a very flexible system. The guest compound
      rotates inside the cavity and partly moves in and out. alpha CD continuously
      adapts its conformation to the orientation of the guest compound (or vice versa):
      the hexagon of the glycosidic oxygen atoms is stretched parallel to the plane of
      the aromatic ring of the guest compound during 80% of the simulation. This
      suggests that Van der Waals interactions play an important role in the
      stabilization of the complex. Each intramolecular hydrogen bond between
      neighbouring glucose units is formed during 30-80% of the simulation. Hydrogen
      bonds between alpha CD and the guest compound, on the other hand, are rarely
      formed. Thus, intermolecular hydrogen bonding seems to play a minor role in the
      stabilization of alpha CD complexes.

PMID- 1637513
TI  - Effect of enalapril on the progression of chronic renal failure. A randomized
      controlled trial.
AB  - In order to study the influence of angiotensin converting enzyme (ACE) inhibition
      on the progression of chronic nephropathy, 70 patients with a median glomerular
      filtration rate (GFR) of 15 (range, 6 to 54) mL/min/1.73 m2 were randomized in an
      open study to basic treatment with enalapril or conventional antihypertensive
      treatment. The patients were followed for at least 2 years or until they needed
      dialysis. The groups were comparable with respect to age and sex distribution,
      etiology of renal diseases, initial levels of renal function and arterial blood
      pressure (BP), and protein intake. The therapeutic goal was a BP of 120 to 140/80
      to 90 mm Hg. The GFR, estimated by the plasma clearance of 51Cr-EDTA, was
      measured every third month, and the individual rate of progression was calculated
      as the slope of the GFR v time plot. In the enalapril group, the median decline
      in GFR was -0.20 (range, +0.18 to -7.11) mL/min/1.73 m2/month and in the control
      group it was -0.31 (+0.01 to -1.97) mL/min/1.73 m2/month (P less than .05). There
      was no significant difference in blood pressure or plasma lipid levels between
      the groups. Thus, the progression of moderate to severe chronic nephropathy was
      slower on a basic treatment with enalapril as compared to conventional
      antihypertensive therapy.

PMID- 1637514
TI  - Renal resistive index after captopril test by echo-Doppler in essential
      hypertension.
AB  - In 45 patients with essential hypertension and 15 age-matched normotensive
      control subjects, the renal resistive index, as an expression of arterial
      impedance, was determined using Doppler ultrasound. In both kidneys the resistive
      index was assessed at baseline and after captopril test (50 mg orally). In the
      moderate and severe hypertensives, compared to mild hypertensives and control
      subjects, the baseline resistive index was significantly higher (P less than
      .05). Following captopril, the resistive index increased only in normotensives (P
      less than .05) and in mild hypertensives (P less than .05). Univariate and
      multivariate analyses show that the duration and severity of hypertension
      correlated with an increase of the resistive index both in basal and in dynamic
      conditions. Thus, the use of the resistive index, as determined by echo-Doppler,
      could provide useful information for the assessment of renal vascular impedance
      in essential hypertensive patients. This would help us detect the evolution of
      hypertensive disease to the higher degrees of severity that are correlated to
      renal arteriolar damage.

PMID- 1637515
TI  - Beneficial effect of nifedipine and moxonidine on glomerulosclerosis in
      spontaneously hypertensive rats. A micromorphometric study.
AB  - The effect of calcium channel blockers on the development of glomerulosclerosis
      and progression of renal failure in different models of renal injury is still
      controversial. We compared the effects of blood pressure lowering with high doses
      of nifedipine (27 mg/kg body weight/day) and with the sympatholytic agent
      moxonidine (8 mg/kg body weight/day) in 6-month-old male spontaneously
      hypertensive rats (SHRsp). As controls we studied untreated hypertensive SHRsp
      and normotensive Wisfar-Kyoto rats (WKY). After 3 months of treatment, left
      ventricular (LV) weight and systolic blood pressure (tail plethysmography) were
      lower in both treated groups (144 +/- 21.4 mm Hg and 144 +/- 13.5 mm Hg v 193 +/-
      38.6 mm Hg in untreated SHRsp), but remained higher than in WKY (116 +/- 16.0 mm
      Hg). Stereological analysis of perfusion fixed kidneys showed an unchanged total
      volume of cortex and medulla, but a higher mean glomerular volume in nifedipine
      treated SHRsp. The glomerulosclerosis index was similarly reduced by both
      antihypertensive agents (92.8 +/- 68.1 in untreated SHRsp v 27.2 +/- 12.9 and
      18.2 +/- 9.8 in the two treatment groups, respectively). This was accompanied by
      a similar reduction of total cortical arterial wall volume (from 36.3 +/- 16.5
      mm3 to 18.9 +/- 2.53 and 15.3 +/- 2.53 mm3, respectively) and by reduction of
      tubular atrophy or interstitial fibrosis, respectively. In this model nifedipine
      lowered blood pressure and inhibited development of glomerulosclerosis to the
      same extent as a sympatholytic agent. This was accompanied by increased
      glomerular volume and filtration area in nifedipine treated animals.

PMID- 1637516
TI  - Insulin resistance and abnormal electrocardiograms in patients with high blood
      pressure.
AB  - Plasma glucose and insulin responses to an oral glucose challenge and fasting
      plasma lipid and lipoprotein concentration were compared in 25 normal individuals
      and 53 patients with high blood pressure. Patients with hypertension were further
      subdivided into two groups--normal electrocardiogram (EKG) (n = 24) or abnormal
      EKG (n = 29)--using the Minnesota code criteria. Patients with hypertension and
      an abnormal EKG had significantly higher plasma glucose and insulin
      concentrations following oral glucose than did the control population.
      Furthermore, plasma triglyceride (TG) concentration was higher and high density
      lipoprotein cholesterol concentration lower then normal in hypertensive patients
      with an abnormal EKG, and the ratio of total to HDL cholesterol was higher in
      this subgroup. Values for patients with high blood pressure and a normal EKG were
      intermediate. Insulin-mediated glucose uptake was also measured in a subset of
      patients with hypertension and either a normal (n = 18) or abnormal (n = 17) EKG.
      When these two subgroups were compared, those with high blood pressure and an
      abnormal EKG were significantly more insulin resistant than patients with
      hypertension and a normal EKG. In addition, they also had higher plasma glucose
      and insulin responses to oral glucose, higher fasting plasma triglyceride and
      cholesterol concentrations, and an increase in the ratio of total to HDL
      cholesterol. Thus, patients with high blood pressure have abnormalities of
      glucose, insulin, and lipid metabolism when compared to a nonhypertensive control
      group, and the magnitude of these metabolic defects is significantly greater in
      patients with high blood pressure who have EKG evidence of coronary heart
      disease.

PMID- 1637517
TI  - Components of blood pressure variability in the elderly and effects on sample
      size calculations for clinical trials.
AB  - This study investigated components of blood pressure variability in the elderly
      using both ambulatory blood pressure monitoring (ABPM) and casual clinic blood
      pressure measurement. These were then used to determine sample size requirements
      for clinical trials of different design scenarios in the elderly. Twenty-six
      elderly subjects not receiving antihypertensive medication were recruited from
      general practices and seen on four occasions at weekly intervals. On each
      occasion of blood pressure was measured in the clinic using a standard mercury
      sphygmomanometer and then for 24 h using a noninvasive ambulatory monitoring
      device. The between subject and between subject/within occasion components of
      blood pressure variability were determined by analysis of variance and used to
      calculate to sample size requirements for parallel and crossover trials
      respectively. The between subject variance of mean blood pressure was 1/3 greater
      with clinic readings, except within a subgroup of subjects who had isolated
      systolic hypertension (ISH). Increasing the number of readings or occasions on
      which measurement was performed in a parallel group trial only reduced the
      variability substantially when the number of subjects involved was small. With
      crossover designs, the between subject component of variance is eliminated
      resulting in substantial reduction in sample size. Whereas 60 subjects with ISH
      would be required to detect a 10 mm Hg difference in systolic blood pressure
      between two treatments in a parallel design using casual readings, only 18 are
      required with a crossover trial. If ABPM is used the number of subjects required
      are 54 and 14, respectively. Reducing variability with ABPM involves a trade-off
      between the increased number of readings available with the technique against the
      highly uniform and standardized conditions used to determine clinic blood
      pressures. ABPM appears most useful as a strategy for reducing sample size in
      parallel group trials involving small numbers of subjects measured on one
      occasion.

PMID- 1637518
TI  - Cytosolic calcium and insulin resistance in elderly patients with essential
      hypertension.
AB  - We evaluated insulin sensitivity in normotensive (blood pressure, BP, less than
      135/85 mm Hg) and hypertensive (BP greater than 160/90 mm Hg) elderly subjects
      over 65 years old who were stratified as normal weight (body mass index, BMI,
      less than 27) and obese (BMI greater than 27). Obese hypertensive individuals
      demonstrated marked hyperinsulinemia (P less than .01) and significantly reduced
      (P less than .05) submaximally stimulated adipocyte 2-deoxyglucose (2-DOG) uptake
      (abdominal wall fat biopsy). Normal weight hypertensive subjects also
      demonstrated higher levels of insulinemia and lower insulin-stimulated 2-DOG
      uptake than nonobese controls. Adipocyte [Ca2+]i levels were elevated in all
      elderly subjects compared to young individuals (P less than .01). Basal and
      maximally stimulated 2-DOG uptake were similar in all groups. One month of
      therapy with a calcium channel blocker, 10 mg nitrendipine twice daily, reduced
      blood pressure in the hypertensive subjects, reduced plasma insulin to control
      values during an oral glucose tolerance test in obese hypertensive individuals (P
      less than .01), and restored adipocyte 2-DOG uptake at submaximally effective
      insulin concentration to control values in normal weight and obese hypertensive
      subjects. In summary, older hypertensive, and particularly older obese
      hypertensive, patients manifest significant insulin resistance accompanied by
      elevated levels of [Ca2+]i in their adipocytes.

PMID- 1637519
TI  - Diagnostic accuracy of exercise thallium-201 scintigraphy in men with
      asymptomatic essential hypertension.
AB  - Coronary artery disease is responsible for much of the morbidity and mortality in
      patients with essential hypertension, and these complications have proven to be
      relatively resistant to antihypertensive therapy. However, the diagnosis of
      coronary disease in the hypertensive population has been considered problematic.
      In the present study, 30 asymptomatic patients with mild to moderate hypertension
      with positive exercise electrocardiograms (ECG) or stress thallium-201
      scintigrams underwent coronary angiography to determine the accuracy of these
      tests for coronary artery disease. The exercise ECG was positive in 25 subjects,
      of whom 15 had significant coronary lesions and 10 did not. Thallium-201
      scintigraphy proved more accurate: 17 of 18 patients with reversible
      abnormalities had significant obstructive coronary disease anatomically
      corresponding to the defect, one patient with a fixed defect had normal coronary
      arteries and was found to have an idiopathic cardiomyopathy, and 9 of 11 without
      defects had no significant lesions. The results were similar in populations with
      and without echocardiographic criteria for left ventricular hypertrophy. These
      findings indicate that despite previous suggestions to the contrary, thallium-201
      scintigraphy can accurately diagnose coronary artery disease in most patients
      with asymptomatic essential hypertension, and that most asymptomatic hypertensive
      patients with physiologic evidence of myocardial ischemia have associated
      coronary artery disease.

PMID- 1637520
TI  - Effects of dietary fish oil on Rb+ efflux from aorta of stroke prone
      spontaneously hypertensive rats.
AB  - The effect of fish oil on potassium efflux and basal tension in aortas from
      stroke prone spontaneously hypertensive rats (SHRSP) was evaluated. Four-week-old
      male Wistar-Kyoto rats (WKY) and SHRSP were divided into two groups: one received
      a 5% corn oil diet; the other a 5% menhaden oil diet. After 15 weeks, mean
      systolic blood pressure (mm Hg) was reduced in SHRSP-fish (202 +/- 5) compared to
      SHRSP-corn (227 +/- 4). Systolic pressure of WKY-fish (146 +/- 3) was not
      different from WKY-corn (151 +/- 4). Potassium efflux was evaluated with the
      isotope 86Rb. Basal 86Rb efflux from aorta of SHRSP-corn was evaluated compared
      to WKY-corn. Diltiazem or sodium nitroprusside decreased 86Rb efflux and basal
      tension in SHRSP. Basal 86Rb efflux, tension, and the magnitude of this diltiazem
      or nitroprusside-induced inhibition were decreased in SHRSP-fish. At maximal
      diltiazem or nitroprusside concentration, 86Rb efflux from both SHRSP dietary
      groups was similar but still greater than control aorta. The IC50 values for
      diltiazem or nitroprusside effects on 86Rb efflux and tension were not altered by
      diet in SHRSP. Qualitatively similar changes in basal 86Rb efflux and tension
      were noted in WKY-fish compared to WKY-corn. These experiments demonstrate that
      dietary fish oil supplementation decreased calcium-sensitive 86Rb efflux and
      basal tension in vascular smooth muscle and suggest that these changes may
      contribute to the concomitant antihypertensive effect of dietary fish oil in
      SHRSP.

PMID- 1637521
TI  - Effects of enalapril on heart failure in hypertensive patients with diastolic
      dysfunction.
AB  - Ten hypertensive patients with symptoms of heart failure and normal systolic
      function but with diastolic dysfunction were treated with 10 mg enalapril twice a
      day for 9 +/- 3 months to evaluate the effects of this agent alone on heart
      failure induced by diastolic dysfunction. After therapy, all patients improved
      and echocardiographic parameters of diastolic dysfunction became normalized. It
      is concluded that enalapril appears to be useful in the treatment of heart
      failure in hypertensive patients with normal systolic function and diastolic
      dysfunction.

PMID- 1637522
TI  - Comments on "Renal resistive index after captopril test by echo-Doppler in
      essential hypertension" by Veglio et al.

PMID- 1637523
TI  - Continuous monitoring of analyte concentrations.
AB  - We have investigated the application of a modified, heterogeneous, competitive
      enzyme immunoassay for the continuous measurement of small analytes in a medium
      stream. The analytical system contains two antibodies that are immobilized on
      spatially separated areas, one binding the analyte (Ab1) and the other binding
      the enzyme (Ab2). An analyte-enzyme conjugate serves as signal generator. The
      analyte-enzyme conjugate functions as a heterobifunctional shuttle that can bind
      to either antibody. A semipermeable membrane retains the enzyme shuttle in the
      internal volume of the sensor but permits the passage of small analytes from the
      medium stream. The amount of enzyme bound to Ab1 is inversely proportional and
      the amount of enzyme bound to Ab2 is directly proportional to the analyte
      concentration. We have demonstrated that this analytical system (1) can provide a
      larger total signal; (2) has a sensitivity comparable with conventional
      competitive immunoassays; (3) does not require the separation of bound from free
      antigens; and (4) is therefore suitable for the continuous measurement of
      analytes in a medium stream. With a model system, an increase from 0 ng ml-1 to
      20 ng ml-1 of the steroid hormone progesterone and the subsequent fall to 0 ng ml
      1 could be monitored.

PMID- 1637525
TI  - On-line determination of glucose and lactate concentrations in animal cell
      culture based on fibre optic detection of oxygen in flow-injection analysis.
AB  - A flow-injection analysis (FIA) system based on fibre optic detection of oxygen
      consumption using immobilized glucose oxidase (GOD) and lactate oxidase (LOD) is
      described for the on-line monitoring of glucose and lactate concentrations in
      animal cell cultures. The consumption of oxygen was determined via dynamic
      quenching by molecular oxygen of the fluorescence of an indicator. GOD and LOD
      were immobilized on controlled pore glass (CPG) in enzyme reactors which were
      directly linked to a specially designed fibre optic flow-through cell covering
      the oxygen optrode. The system is linear for 0-30 mM glucose, with an r.s.d. of
      5% at 30 mM (five measurements) and for 0-30 mM lactate, with an r.s.d. of 5% at
      30 mM (five measurements). The enzyme reactors used were stable for more than 4
      weeks in continuous operation, and it was possible to analyse up to 20 samples
      per hour. The system has been successfully applied to the on-line monitoring of
      glucose and lactate concentrations of an animal cell culture designed for the
      production of recombinant human antithrombine III (AT-III). Results of the on
      line measurement obtained by the FIA system were compared with the off-line
      results obtained by a glucose and lactate analyser from Yellow Springs Instrument
      Company (YSI).

PMID- 1637524
TI  - Laccase-based biosensor for determination of polyphenols: determination of
      catechols in tea.
AB  - A new method of amperometric determination of phenolic compounds using an enzyme
      electrode is proposed. The latter represents the combination of the oxygen
      electrode and immobilized laccase. Analytical systems of flow injection and batch
      types were considered. A method of immobilization was developed that provided an
      increase in the stability of the enzyme. Optimal conditions for biosensor
      operation were found. The time needed for analysis in the flow injection mode was
      below 100 s. A column with immobilized enzyme could be used for up to 500
      determinations of phenolic compounds without decrease of the enzyme activity. The
      practical validity of the method was demonstrated by tannin analysis in tea of
      different brands.

PMID- 1637526
TI  - A single mode fibre-optic evanescent wave biosensor.
AB  - This paper reports experimental developments in the construction and operation of
      a single-mode fibre-optic evanescent wave biosensor using an exposed core silica
      single-mode fibre embedded in a silica block. The device was able to monitor the
      concentration of a blue dye, Procion Blue MX-G, in overlayers of various
      refractive indices. The practicality of such a biosensor has been demonstrated
      with a colorimetric enzyme assay system. Penicillin G in the 0-0.4 mM
      concentration range was monitored at 633 nm by the decoloration of the starch
      iodine reagent when Bacillus cereus penicillinase was immobilized over the
      exposed core of the monomode fibre.

PMID- 1637527
TI  - A new membrane electrode for the detection of antibody.
AB  - A new membrane electrode sensitive to specific antibody is described which
      incorporates dinitrophenyl antigen in polyvinyl chloride matrix membrane on to
      the surface of a solid-state graphite-loaded epoxy-resin electrode. The
      sensitivity of the electrode is based on the ionophoric property of the
      dinitrophenyl antigen. Response curves for the potassium ion and its specific
      antibody are reported.

PMID- 1637528
TI  - Effects of temperature and analyte application technique on neuron-based chemical
      sensing.
AB  - Results are presented which enhance the field of neuron-based sensing by
      providing insight on the effects of operating temperature and analyte application
      technique (pulse versus back-mixed) on sensing properties. In these studies,
      serotonin sensing attributes of giant visceral neurons VV1 and VV2 from the pond
      snail Lymnea stagnalis were measured. Experiments using a rapid fluid-exchange
      system reveal a concentration-dependent increase in maximum firing frequency
      similar to that reported earlier for a slow well-mixed application. With a rapid
      application, however, the maximum firing frequency is reached more quickly, and
      there is less cell-to-cell variability in both the maximum response and
      sensitivity. Given an application technique, an increase in temperature causes an
      increase in sensitivity and maximum firing frequency, as well as a decrease in
      the time required for the response to return to baseline following removal of the
      analyte. To provide insights on the kinetics of the serotonin-induced response,
      the effects of temperature and concentration on the rates of activation, recovery
      and desensitization were examined in detail. In general, it was found that an
      increase in temperature increases the rates of activation and desensitization,
      while the effects on recovery were not apparent. In addition, both the rates of
      activation and desensitization have a direct dependence on concentration while
      the rate of recovery has an inverse dependence.

PMID- 1637529
TI  - Silent violence.

PMID- 1637530
TI  - Time to take back our streets--and our homes.

PMID- 1637531
TI  - A public health solution to violent crime.

PMID- 1637532
TI  - A journalist's eye view of the trauma physician's dilemma.

PMID- 1637533
TI  - A commentary on violence.

PMID- 1637534
TI  - Violence and the ear and temporal bone.

PMID- 1637535
TI  - Physical abuse of children. A retrospective review and an otolaryngology
      perspective.
AB  - Child abuse is a common problem seen by practicing physicians. To further define
      the incidence and the type of head and neck injury in children referred for
      evaluation of child abuse, a 5-year retrospective study of 4340 patients was
      undertaken. Of these patients, 2950 (68%) were victims of sexual abuse, while
      1390 (32%) were victims of physical abuse. Forty-nine percent of patients abused
      physically had evidence of injury to the head and neck region, while only 1% of
      the sexually abused children had injuries in the head and neck area. The age of
      the patients ranged from 1 day to 17 years, with a mean of 5.6 years. More than
      150 of these children were under the age of 1 year; 180 patients were admitted.
      The average age of the admitted patients was 2.1 years. The alleged perpetrator,
      mechanism of injury, and location of injury were tabulated. There were 11 deaths
      in the series (1.6%). Child abuse has been defined in our institution as any
      injury inflicted on a child. Identification and reporting of suspected child
      abuse is required by law and essential for the well-being of the abused child.
      Recommendations are made concerning the evaluation of these children, their
      management, and the physician's legal responsibility to report suspected cases of
      child abuse.

PMID- 1637536
TI  - Gunshot wounds to the head and neck.
AB  - Gunshot wounds to the head and neck contribute to substantial medical, economic,
      and social problems in the United States today. The treatment of these patients
      requires the contemporary head and neck surgeon to be precisely informed in
      anatomy, wound ballistics, resuscitation, and surgical decision making. Ninety
      recent cases at the University of Texas Health Science Center affiliated
      hospitals in Houston were reviewed and are reported. Data show substantial trends
      in patient demographics and corroborate other reports in the trauma literature.
      Controversies in patient management continue, but current evidence favors a
      protocol of selective surgical exploration.

PMID- 1637537
TI  - The acute management of external laryngeal trauma. A 27-year experience.
AB  - The acute care of 139 consecutive patients with external laryngeal trauma over a
      27-year period is reported. This article represents an effort to periodically
      reevaluate our care of this relatively infrequent injury and to share our changes
      and refinements in treatment. This series provides the means to test and
      establish basic principles in the acute care of external laryngeal trauma because
      (1) the number of years encompassed by the article, (2) most patients were
      managed by one physician, (3) the relative consistency of management principles
      throughout the series, and (4) the delivery of trauma care in Dallas County,
      Texas, reflects a broad sampling of this injury within the geographic area.

PMID- 1637538
TI  - Management of combined frontonaso-orbital/skull base fractures and telecanthus in
      355 cases.
AB  - In regard to the multiple problems of reconstruction concerning this fracture
      pattern, we developed various methods to achieve optimal results. As various
      vital regions, apart from the nasoethmoidal fractures and aesthetics, are
      involved, the proposed classification has direct implication for the surgical
      procedure. Even in intracranial fragment dislocations, cerebral contusion, and
      elevated intracranial pressure, the subcranial approach, in contrast with the
      transfrontal access, enables early definitive management of the skull base and
      the external facial frame in a one-stage procedure. Another method, the
      symmetrical centripetal compression of the canthal ligaments and naso-orbital
      bone fragments, enables correct reduction of the telecanthus. The significant
      reduction of morbidity and complication rate to a minimum confirms the efficiency
      of our treatment modalities.

PMID- 1637539
TI  - Complications of endoscopic sinus surgery.
AB  - Endoscopic sinus surgery has become popular during recent years. We report the
      complications of endoscopic sinus surgery in 593 patients in whom 1235 sides were
      operated on. Forty-five patients had complications, in three of whom they were
      systemic. The remaining 42 patients had complications on 52 (4.2%) sides; these
      complications were mostly minor. In 0.3% of the sides operated on, potentially
      serious complications, such as orbital hematoma or cerebrospinal fluid leak, were
      seen. None of these patients developed loss of vision or meningitis. Absence of
      the middle turbinate is a risk factor for developing complications. We conclude
      that endoscopic sinus surgery is a safe procedure in experienced hands.

PMID- 1637540
TI  - Otolaryngologic manifestations of child abuse.
AB  - Currently, awareness is growing of child abuse in the medical and lay
      communities. To familiarize otolaryngologists with the head and neck findings in
      abused children, we retrospectively analyzed 85 patients admitted to an inner
      city hospital with the diagnosis of abuse or neglect. Forty-eight children (56%)
      had abnormalities within the head and neck region. Excluding coincidental
      findings, 31 children (36%) had findings that could be directly linked to
      physical abuse or neglect. The face was the region with the most abnormal
      findings in our study (25 children [30%]). Soft-tissue findings were the most
      numerous (27 children [32%]). The literature is reviewed on the subject of
      otolaryngologic manifestations of abuse.

PMID- 1637541
TI  - Auricular injury as a presentation of child abuse.
AB  - Child abuse causes serious physical and emotional injury. Those abused, however,
      are usually unable or unwilling to gain access to agencies that might help them.
      The otolaryngologist, while usually not the patient's primary physician, may be
      in the position to detect child abuse. We describe a 3-year-old boy who sustained
      auricular trauma as the result of child abuse. The importance of physician
      recognition of an abuse case and the institution of appropriate measures are
      discussed.

PMID- 1637542
TI  - Endotracheal tube safety during electrodissection tonsillectomy.
AB  - A case report of an endotracheal tube fire occurring during electrodissection
      tonsillectomy is presented. The authors believe that this incident occurred
      because a retrograde leak of ventilating gases around an uncuffed endotracheal
      tube during positive-pressure ventilation produced a high oxygen concentration in
      the mouth, allowing indirect ignition of the tube. In vitro testing supported
      this hypothesis. Ignition tests on polyvinylchloride endotracheal tubes using
      electrocautery in various oxygen concentrations were performed. As oxygen
      concentration increased, the endotracheal tube could be moved further from the
      cautery and still allow ignition of the tube. At 52% oxygen, with the cautery set
      at 25-W coagulation current, the endotracheal tube could not be ignited.
      Recommendations to prevent a recurrence of this incident are included.

PMID- 1637543
TI  - Conservative endoscopic surgery in inverted papilloma. Preliminary report.
AB  - Inverted papilloma is noted for recurrence and occasional association with
      malignancy, leading most authors to recommend lateral rhinotomy as the initial
      surgical approach in all cases; however, conservative surgery has been reported
      to be effective in selective cases. Endoscopic control was used in the surgical
      treatment of three cases of inverted papilloma. In all three cases, the lesions
      were unilateral and localized, with limited extension into the sinonasal region,
      and they were not associated with malignancy or recurrent (as proved by
      endoscopy, computed tomography, and histopathologic examination). Total removal
      of the mass was achieved through a conservative intranasal approach. Endoscopic
      follow-up for periods ranging between 12 and 39 months, with an average of 23
      months, failed to identify any recurrence. These findings point to the
      feasibility of applying this conservative endoscopic approach for total excision
      of limited lesions of inverted papilloma.

PMID- 1637544
TI  - Acquired flaccid larynx. A case report supporting the neurologic theory of
      laryngomalacia.
AB  - Congenital flaccid larynx, also known as laryngomalacia, is a common clinical
      entity accounting for approximately 60% of laryngeal problems in the newborn. It
      is a benign and relatively asymptomatic condition that patients often outgrow by
      12 to 18 months of age. A variety of mechanisms have been proposed to explain
      laryngomalacia including cartilage immaturity and poor neuromuscular control
      secondary to hypomaturity or dysfunction. This entity has only recently been
      described as an acquired disorder. A case of an 11-year-old boy who presented
      with basilar artery thrombosis and a midpontine infarction is described.
      Inability to extubate despite spontaneous respirations prompted flexible
      laryngoscopy, which revealed complete supraglottic collapse with airway
      obstruction. The patient was successfully treated with an epiglottoplasty. This
      case supports the neuromuscular dysfunction theory as a cause of laryngomalacia.

PMID- 1637545
TI  - Stomal seeding by percutaneous endoscopic gastrostomy in patients with head and
      neck cancer.
AB  - Presented is the first known case of squamous cell carcinoma that developed at
      the site of a "pull" type percutaneous endoscopic gastrostomy stoma. The patient
      had advanced squamous cell carcinoma of the pharynx when the percutaneous
      endoscopic gastrostomy tube was placed. This article should serve as a warning of
      this potential complication. Alternate techniques and other precautionary methods
      are described.

PMID- 1637547
TI  - A foresight: the burned oil wells in Kuwait.

PMID- 1637546
TI  - Kyoshiro Yamakawa, MD, and temporal bone histopathology of Meniere's patient
      reported in 1938. Commemoration of the centennial of his birth.

PMID- 1637548
TI  - Controlled exposures of volunteers to respirable carbon and sulfuric acid
      aerosols.
AB  - Respirable carbon or fly ash particles are suspected to increase the respiratory
      toxicity of coexisting acidic air pollutants, by concentrating acid on their
      surfaces and so delivering it efficiently to the lower respiratory tract. To
      investigate this issue, we exposed 15 healthy and 15 asthmatic volunteers in a
      controlled-environment chamber (21 degrees C, 50 percent relative humidity) to
      four test atmospheres: (i) clean air; (ii) 0.5-microns H2SO4 aerosol at
      approximately 100 micrograms/m3, generated from water solution; (iii) 0.5-microns
      carbon aerosol at approximately 250 micrograms/m3, generated from highly pure
      carbon black with specific surface area comparable to ambient pollution
      particles; and (iv) carbon as in (iii) plus approximately 100 micrograms/m3 of
      ultrafine H2SO4 aerosol generated from fuming sulfuric acid. Electron microscopy
      showed that nearly all acid in (iv) became attached to carbon particle surfaces,
      and that most particles remained in the sub-micron size range. Exposures were
      performed double-blind, 1 week apart. They lasted 1 hr each, with alternate 10
      min periods of heavy exercise (ventilation approximately 50 L/min) and rest.
      Subjects gargled citrus juice before exposure to suppress airway ammonia. Lung
      function and symptoms were measured pre-exposure, after initial exercise, and at
      end-exposure. Bronchial reactivity to methacholine was measured after exposure.
      Statistical analyses tested for effects of H2SO4 or carbon, separate or
      interactive, on health measures. Group data showed no more than small equivocal
      effects of any exposure on any health measure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637549
TI  - Negative regulation of gene expression by TGF-beta.
AB  - Stromelysin gene expression is transcriptionally activated by a number of growth
      factors (e.g., EGF and PDGF), tumor promoters (e.g., TPA), and oncogenes (e.g.,
      ras, src) through an AP-1-dependent mechanism. TGF-beta repression of stromelysin
      induction is mediated at the level of transcription by an element located at
      position -709 in the rat stromelysin promoter referred to as the TGF-beta
      inhibitory element (TIE). A TIE-binding protein complex is induced by treatment
      of rat fibroblasts with TGF-beta. This protein complex contains the protooncogene
      c-fos, and induction of c-fos by TGF-beta is required for the repressive effects
      of TGF-beta on stromelysin gene expression. Interestingly, c-fos induction is
      also required for stimulation of stromelysin expression by EGF in rat
      fibroblasts. Preliminary studies suggest that differential regulation of members
      of the jun family of early-response genes may explain this apparent paradox and
      determine whether stromelysin is induced or repressed by growth factors. TGF-beta
      stimulation therefore initiates a cascade of events that results in a specific
      pattern of gene expression: the direct stimulation of early-response genes can
      lead to subsequent induction or repression of other genes. Growth factor
      regulation of matrix metalloproteinases appears to play a role in embryonic
      development in the morphogenesis of the murine lung. Treatment of embryonic lungs
      in organ culture with the growth factors EGF or TGF-alpha results in stimulation
      of growth and inhibition of branching morphogenesis. A similar inhibition of
      branching was observed when these lung rudiments were treated with the matrix
      metalloproteinase collagenase. Most interestingly, the effects of EGF and TGF
      alpha can be completely reversed by the tissue inhibitor of metalloproteinases,
      TIMP. TGF-beta has the opposite effect on growth of murine lung rudiments--growth
      is inhibited in a dose-dependent manner. This example illustrates a potential
      role for growth factor regulation of matrix-degrading metalloproteinases in
      complex developmental processes.

PMID- 1637550
TI  - Modulation of vascular cell behavior by transforming growth factors beta.
AB  - The vascular cell responses to the type 1, 2, and 3 isoforms of transforming
      growth factor-beta (TGF-beta 1, TGF-beta 2, TGF-beta 3) were studied using bovine
      aortic endothelial (BAECs) and smooth muscle cells (BASMC3) as well as rat
      epididymal fat pad microvascular endothelia (RFCs). Three distinct bioassays
      indicated that TGF-beta elicits results that do not differ significantly from
      those of the TGF-beta 1 isoform in all three cell populations. These assays are:
      inhibition of proliferation, cell migration, and neovascularization. By contrast
      the cellular responses to TGF-beta 1 and TGF-beta 3 differed from those to TGF
      beta 2. Three distinct receptor assays revealed the presence of type I and type
      II TGF-beta 1 cell surface binding proteins on BAECs, BASMCs, and RFCs.
      Experimentation to decipher cell surface binding by the different isoforms
      revealed that iodinated TGF-beta 1 bound to the surface of all three vascular
      cell types can be competed off in similar fashion by either TGF-beta 1 or TGF
      beta 3; however, competition with TGF-beta 2 produced unique binding profiles
      dependent on the cell type examined. The ratios of type I to type II TGF-beta
      receptors in these three vascular cell types vary from 1:1 in BAECs to 1.5:1 in
      RFCs to 3:1 in BASMCs and can be correlated with the differences noted in
      cellular responses to TGF-beta 1 and TGF-beta 2 in proliferation, migration, and
      in vitro angiogenic assays.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637551
TI  - The role of TGF-beta s in mammalian development and neoplasia.
AB  - To date, three mammalian TGF-beta isoforms have been identified, each encoded by
      different genetic loci. Through each is very similar in primary amino acid
      structure, there are clear differences both in the mature bioactive peptide
      region and in the latency-associated peptide, which could potentially confer
      differential biological specificity. As one route to investigate differential
      biological function in vivo we have used gene specific probes for in situ
      hybridization studies to examine the distribution of RNA transcripts during
      mammalian embryogenesis. Mouse embryos from 6 to 14.5 gestational age and human
      embryos from 32 to 57 days post-fertilization have been probed. A general
      conclusion from these studies is that each TGF-beta gene has a distinct, through
      overlapping, pattern of transcript distribution and that this pattern, in most
      cases, is conserved between mouse and man. We have focused on the biological
      function the TGF-betas play in certain epithelia and in cardiogenesis, which will
      be discussed in this presentation.

PMID- 1637552
TI  - Regulation of mammary growth and function by TGF-beta.
AB  - We have previously shown that TGF-beta 1 rapidly and reversibly inhibits ductal
      growth in vivo when administered by miniature slow-release plastic implants. A
      possible role for endogenous TGF-beta 1 was suggested by the observation that the
      normal gland displayed substantial, developmentally regulated levels of TGF-beta
      1 transcripts and protein. These studies have now been extended to include the
      other two mammalian TGF-beta isoforms. When tested with slow-release plastic
      implants, TGF-beta 2 and TGF-beta 3 also caused disappearance of the
      proliferating mammary stem cell layer, with rapid involution of ductal end buds
      and cessation of glandular growth. None of the isoforms was active in inhibiting
      alveolar morphogenesis. We conclude that under the conditions of these tests, the
      three mammalian isoforms are functionally equivalent. However, striking
      differences in patterns of gene expression and in the distribution of
      immunoreactive peptides suggest that TGF-beta 2 was expressed only at low levels,
      and mainly during pregnancy. TGF-beta 3 was expressed in ductal stroma and
      epithelium, and was the only isoform detected in myoepithelial cells. Developing
      alveolar tissue and its associated ducts displayed striking TGF-beta 3 gene
      expression and immunostaining, which were greatly reduced during lactation. We
      are now investigating the possibility that the observed high levels of TGF-beta
      expression in pregnancy, particularly of TGF-beta 3, and the absence of
      substantial expression of any isoform during lactation, may indicate a role for
      the TGF-beta in regulating functional differentiation or the onset of milk
      secretion.

PMID- 1637553
TI  - TGF-beta 3-mediated tissue interaction during embryonic heart development.
AB  - A critical process during early heart development is the formation of mesenchymal
      cells which will contribute to valves and septa of the mature heart. These cells
      arise by an epithelial-mesenchymal transformation of endothelial cells in the
      atrioventricular (AV) canal and outflow tract areas of the heart. Adjacent
      endothelial cells in the atrium and ventricle remain epithelial. A three
      dimensional collagen gel culture system has been exploited to examine the
      interactions that mediate this transformation. The AV canal myocardium produces a
      stimulus that is transmitted through an intervening extracellular matrix to the
      AV canal endothelium. This interaction is regionally specific, such that
      ventricular myocardium does not provide an adequate stimulus and ventricular
      endothelium does not respond to the AV canal myocardial stimulus. Exogenous TGF
      beta 1 (or TGF-beta 2) can complement ventricular myocardium to produce
      transformation by AV canal endothelium. A blocking antibody, effective against
      several TGF-beta, prevents cell transformation. To identify the specific member
      of the TGF-beta family that functions in situ, antisense oligonucleotides for
      each of the numbered TGF-beta were topically added to AV canal explant cultures.
      Only the oligonucleotide targeted to TGF-beta 3 was an effective inhibitor of
      mesenchymal cell formation. Studies have been undertaken to localize specific
      mRNas by in situ hybridization and RNase protection assays. These assays have
      concentrated on the regional and temporal appearance of TGF-beta 2 and 3.
      Surprisingly, RNase protection assays with a TGF-beta 3 sense probe showed the
      presence of a transcript complementary to TGF-beta 3.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1637554
TI  - The bone morphogenetic protein family and osteogenesis.
AB  - The BMPs (bone morphogenetic proteins) are a group of related proteins originally
      identified by their presence in bone-inductive extracts of demineralized bone. By
      molecular cloning, at least six related members of this family have been
      identified and are called BMP-2 through BMP-7. These molecules are part of the
      TGF-beta superfamily, based on primary amino acid sequence homology, including
      the absolute conservation of seven cysteine residues between the TGF-betas and
      the BMPs. The BMPs can be divided into subgroups with BMP-2 and BMP-4 being 92%
      identical, and BMP-5, BMP-6, and BMP-7 being an average of about 90% identical.
      To examine the individual activities of these molecules, we are producing each
      BMP in a mammalian expression system. In this system, each BMP is synthesized as
      a precursor peptide, which is glycosylated, processed to the mature peptide, and
      secreted as a homodimer. These reagents have been used to demonstrate that single
      molecules, such as BMP-2, are capable of inducing the formation of new cartilage
      and bone when implanted ectopically in a rodent assay system. Whether each of the
      BMPs possesses the same inductive activities in an animal is the subject of
      ongoing research. Based on the chondrogenic and osteogenic abilities of the BMPs
      in the adult animal, the expression of the mRNAs for the BMPs has been examined
      in the development of the embryonic skeleton by in situ hybridization. These
      studies demonstrate that the BMP mRNAs are spatially and temporally expressed
      appropriately for the proteins involved in the induction and development of
      cartilage and bone in the embryonic limb bud.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637555
TI  - Mullerian inhibiting substance in reproduction and cancer.
AB  - During embryogenesis normal male phenotypic development requires the action of
      Mullerian Inhibiting Substance (MIS) which is secreted by Sertoli cells of the
      fetal testis. As testes differentiate in genetic (XY) males, they produce MIS
      which causes regression of the Mullerian ducts, the anlagen of the female
      reproductive tract. Soon thereafter, testicular androgens stimulate the Wolffian
      ducts. In females, on the other hand, MIS is not produced by grandulosa cells
      until after birth, before which, estrogens induce Mullerian duct development,
      while the Wolffian ducts passively atrophy in the absence of androgenic
      stimulation. High serum MIS levels in males are maintained until puberty,
      whereupon they fall to baseline levels. In females MIS is undetectable in serum
      until the peripubertal period when values approach the baseline levels of males.
      This distinct pattern of sexual and ontogenic expression presupposes and requires
      tight regulation. MIS may play a role in gonadal function and development. Our
      laboratory has shown that an important role for ovarian MIS is to inhibit oocyte
      meiosis, perhaps providing maximal oocyte maturation prior to selection for
      ovulation and subsequent fertilization. Furthermore, Vigier et al. (Development
      100:43-55) have recently obtained evidence that MIS may influence testicular
      differentiation, coincident with inhibition of aromatase activity. Current
      structure-function studies demonstrate that MIS, like other growth regulators in
      its protein family, requires proteolytic cleavage to exhibit full biological
      activity. MIS can be inhibited by epidermal growth factor. This antagonism, which
      is common to all MIS functions so far investigated, is associated with inhibition
      of EGF receptor autophosphorylation. We have provided evidence that bovine MIS
      can inhibit female reproductive tract tumors arising in adults.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1637556
TI  - TGF-beta regulation of epithelial cell proliferation.
AB  - The predominant effect of TGF-beta 1 on cell proliferation is inhibition. Earlier
      studies demonstrated that TGF-beta 1 inhibition of skin keratinocyte
      proliferation involves suppression of c-myc transcription and indirect evidence
      suggested that the protein product of the retinoblastoma gene (pRB) may be
      involved in this process. Skin keratinocytes transformed by SV40 and human
      papilloma virus-16 (HPV-16) or HPV-18 resisted growth inhibition and suppression
      of c-myc mRNA by TGF-beta. Transient expression of HPV-16 E7 gene, adenovirus
      E1A, and SV40 large T antigen (TAg) blocked the TGF-beta 1 suppression of c-myc
      transcription. Studies with transformation-defective mutants of E1A and TAg
      suggested that a cellular protein(s) that interacts with a conserved domain of
      the DNA tumor virus oncoproteins mediates TGF-beta 1 suppression of c-myc
      transcription and keratinocyte growth. Transient expression of pRB in skin
      keratinocytes repressed human c-myc promoter/CAT transcription as effectively as
      TGF-beta 1. The same c-myc promoter region, termed the TGF-beta Control Element
      (TCE), was required for regulation by both TGF-beta 1 and pRB. TCE bound a
      cellular protein of approximately 106 kDa and this binding was decreased by TGF
      beta 1 treatment. Our data indicate that pRB can inhibit c-myc transcription and
      suggest the involvement of cellular factor(s) in addition to pRB in the TGF-beta
      1 pathway for the suppression of c-myc transcription and growth
      inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637557
TI  - Differential expression of the TGF-beta isoforms in embryogenesis suggests
      specific roles in developing and adult tissues.
AB  - The TGF-beta's are multifunctional, pleiotropic molecules with major effects in
      control of cellular migration, cellular proliferation, and elaboration of
      extracellular matrix. Thus far, five distinct isoforms of TGF-beta have been
      described, each approximately 65-85% homologous and containing the characteristic
      9 positionally conserved cysteine residues. Although the actions of the activated
      mature forms of the different isoforms on cells are qualitatively similar in most
      cases, there are a few examples of distinct activities. For example, TGF-beta's 1
      and 3, but not TGF-beta 2, inhibit the growth of large vessel endothelial cells,
      and TGF-beta's 2 and 3, but not TGF-beta 1, inhibit the survival of cultured
      embryonic chick ciliary ganglionic neurons. In addition, selective targeting of
      the latent forms of the TGF-beta's is suggested by the observation that latent
      TGF-beta 2 is the prominent isoform found in body fluids such as amniotic fluid,
      breast milk, and the aqueous and vitreous humor of the eye; it is noteworthy in
      this regard that TGF-beta 2 is unique among various isoforms in that it lacks a
      RGD integrin-binding sequence in its precursor. The most dramatic differences in
      the TGF-beta isoforms are seen at the level of expression, where there is now a
      wealth of data demonstrating both spatially and temporally distinct expression of
      both the mRNAs and proteins in developing tissues, regenerating tissues, and in
      pathologic responses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637558
TI  - Effect of occlusion on in vitro percutaneous absorption of two compounds with
      different physicochemical properties.
AB  - It is a general rule that percutaneous absorption is increased when the site of
      application is occluded. In this study we compared the in vitro permeation
      profiles of two molecules with different physicochemical properties under
      occluded versus unoccluded conditions. Human abdominal skin samples were mounted
      on Dianorm Teflon macro 1 cells and Franz diffusion cells which represented
      occluded or unoccluded conditions, respectively. Our data show that occlusion
      increased the permeation of citropten (lipophilic compound) 1.6 times whereas
      that of caffeine (amphiphilic compound) remained unchanged. This lack of
      penetration enhancement under occluded conditions has also been observed by other
      authors, especially concerning hydrophilic and slightly lipophilic molecules. Our
      results support the view that occlusion does not necessarily increase the
      percutaneous absorption of a chemical.

PMID- 1637559
TI  - Interaction of minoxidil with pigment in cells of the hair follicle: an example
      of binding without apparent biological effects.
AB  - To identify minoxidil target cells in hair follicles we followed the uptake of
      radiolabeled drug in mouse vibrissae follicles both in vitro and in vivo.
      Autoradiography showed that both 3H-minoxidil and 3H-minoxidil sulfate
      accumulated in the differentiating epithelial matrix cells superior to the dermal
      papilla, a distribution similar to that of pigment. Minoxidil localized in
      melanocytes, melanocyte processes, and areas of greater melanin concentrations
      within the epithelial cells. Although uptake of minoxidil was significantly less
      in unpigmented follicles, the drug stimulated proliferation and differentiation
      of both pigmented and unpigmented follicles. Labeled minoxidil bound to Sepia
      melanin and was displaced with unlabeled minoxidil and other electron donor
      drugs. This interaction with melanin acts as a targeting mechanism of minoxidil
      to pigmented hair follicles but has no apparent functional significance in hair
      growth. This work illustrates how measurement of drugs in hair may be biased by
      pigmentation.

PMID- 1637560
TI  - Assay of erythromycin in tape strips of human stratum corneum and some
      preliminary results in man.
AB  - The antibiotic erythromycin is used topically in the treatment of acne vulgaris.
      In order to evaluate the in vivo cutaneous absorption behavior of erythromycin in
      man, an analytical procedure for erythromycin in stratum corneum tape strips was
      developed. Erythromycin was extracted from tape strips using solid-phase
      extraction, followed by alkaline diethyl ether extraction. Reconstituted extracts
      were analyzed by RP-HPLC with electrochemical detection. This procedure proved to
      be adequate in a pilot experiment in man, topical erythromycin appearing to be
      distributed over the stratum corneum, its upper layers displaying an inward
      decreasing gradient.

PMID- 1637561
TI  - The local side effects of transdermally absorbed nicotine.
AB  - Percutaneous nicotine administration induces predominant sudorific and rubiform
      responses in the skin which may be accompanied by subtle piloerection,
      hyperalgesia and pruritus (although these signs are not overtly manifest). These
      dermal responses are complex and mechanisms have been proposed for the direct
      nicotine-stimulation of sweat glands, piloerection and vasoconstriction. These
      reactions are accompanied by secondary activation and release of vasodilator
      peptides which produce a predominating vasodilator tone following topical
      administration, this response masking the direct axon reflex-mediated
      vasoconstriction.

PMID- 1637562
TI  - Comparative atrophogenicity potential of medium and highly potent topical
      glucocorticoids in cream and ointment according to ultrasound analysis.
AB  - 24 healthy volunteers with no history of skin disease were entered in a 6-week
      double-blind randomized study to compare the atrophogenicity potentials of both
      cream and ointment forms of triamcinolone acetonide and clobetasol propionate.
      The atrophogenicity potential of cream preparations turned out to be greater than
      that of ointment preparations containing identical amounts of the same
      glucocorticoid. This result proves both the reproducibility of the assay and the
      general character of the phenomenon in view of the limited previous evidence.

PMID- 1637563
TI  - Comparison of infrared and helium-neon lasers in the measurement of blood flow in
      human skin by the laser-Doppler technique.
AB  - Histamine-induced changes in blood flow in normal human skin were assessed by
      laser-Doppler velocimetry using 2 lasers of different wavelengths: 780 nm
      infrared and 633 nm helium-neon. The visible flare response in skin was also
      measured by planimetry. Laser-Doppler velocimetry was shown to detect both the
      magnitude of the change in blood flow caused by histamine and also the extent of
      the changes in the skin. Both parameters were related to the dose of histamine,
      which ranged between 25 and 750 pmol/site. There was good correlation between the
      magnitude of the histamine-induced blood flow change and the extent of the
      response. The flare induced by histamine and measured by planimetry was similar
      in extent to the blood flow change recorded by laser-Doppler velocimetry. No
      difference in either the magnitude or the extent of blood flow changes in
      response to histamine, as measured by laser-Doppler velocimetry, were found when
      lasers of different wavelengths were used.

PMID- 1637564
TI  - Effects of calcipotriol (MC 903) and calcitriol after topical application on the
      skin of hairless rats. Much lower effect of calcipotriol on systemic calcium
      homeostasis.
AB  - Topical application of calcitriol or its analogs is a new approach for treating
      psoriasis, but may be limited by systemic calcitropic effects. Calcipotriol (MC
      903) is a novel calcitriol analog with low calcitropic potency after systemic
      application. To compare the topical potency of calcitriol and calcipotriol we
      applied the two drugs on the right flanks of hairless rats for 10 days. In
      concentrations of 0.001-0.01 g/100 ml (ethanol) the two drugs are equally
      effective in inducing changes in the horny layer of the skin (increase in the
      amount of horny material that is able to be desquamated). This can be interpreted
      as a stimulation of terminal keratinocyte differentiation. However, only
      calcitriol caused a significant rise in the serum calcium concentration. In
      conclusion, calcitriol and calcipotriol seem to be equally effective after
      topical application on the skin of hairless rats, but calcipotriol has a much
      lower systemic calcium liability.

PMID- 1637565
TI  - Role of transepidermal and transfollicular routes in percutaneous absorption of
      hydrocortisone and testosterone: in vivo study in the hairless rat.
AB  - The importance of the transappendageal route on percutaneous absorption was
      assessed in the hairless rat. Skin permeation of two steroids, hydrocortisone and
      testosterone, was evaluated in vivo on normal and artificially damaged skin in
      which follicles and sebaceous glands disappeared during healing. The test
      compounds were applied for periods of 0.5, 2 and 6 h. Thereafter, the stratum
      corneum reservoir function, the epidermal and dermal distribution profiles, and
      systemic absorption were determined for both molecules. The results presented
      here show that the reservoir function of the stratum corneum of appendage-free
      (scar) skin is more pronounced than that of normal skin, whereas the
      concentration appearing in the epidermis and dermis was greater in normal skin.
      Moreover, sebaceous glands probably contribute to the penetration of
      hydrocortisone and testosterone. We show that the relative importance of the skin
      appendages depends on the intrinsic physical properties of the molecules tested,
      and the time of application.

PMID- 1637566
TI  - Combined inter-observer and inter-method variation in bone histomorphometry.
AB  - Manual methods for the measurement of bone biopsies have largely been superseded
      by semi-automatic computerised techniques. Histomorphometrists often use control
      data obtained by other observers using different methods, thus combining inter
      observer and inter-method variation. We have examined the combined effect of
      inter-method and inter-observer variation on measurements of bone area, osteoid
      perimeter, and osteoid width in iliac crest biopsies from healthy subjects, one
      observer using the manual grid system and the other using a semi-automated
      technique. Inter-observer and inter-method variation were independently
      determined, and the proportion of each expressed as a percentage of combined
      error. Our results indicate that the combination of inter-method and inter
      observer variation causes significant differences in the values obtained for
      osteoid perimeter, whereas inter-method variation is mainly responsible for
      differences in osteoid width values; differences in bone area are largely due to
      inherent sampling variation. These variations indicate that caution is required
      when comparison is made with control data from other sources, especially if
      different techniques are employed.

PMID- 1637567
TI  - Calcium in osteoblast-enriched bone cells.
AB  - The exchangeability, location, and amount of the total calcium in bone cells were
      studied in relation to their osteoblastic activity. Cells were isolated from
      neonatal rat calvariae by sequential collagenase digestion and incubated with
      45Ca2+ before or after various treatments. 45Ca2+, 40Ca2+, and DNA were
      determined on each cell sample. Long-term experiments were performed on cultured
      cells. The cells closest to the forming bone had the highest alkaline phosphatase
      activity and the highest Ca2+ content (i.e., 17 mm Ca2+/l cell water, as compared
      to soft tissue cells, which have 2-3 mm Ca2+/l (Borle 1981). About 50% of this
      Ca2+ exchanges readily with 45Ca2+ and appears to be located almost entirely in
      the cell membrane. Thirty-five percent exchanges only slowly with a t1/2 of 27
      hours, and is located within the cell, principally in the mitochondria as seen in
      pyroantimonate fixed cells (Neuman et al. 1985). In spite of its slow exchange
      ability, this Ca2+ fraction can be mobilized or augmented rapidly when Ca2+
      supply is reduced or increased in vitro or in vivo. 1,25(OH)2D3 given in vivo
      increased this intracellular Ca2+ when the Ca2+ supply was low and released it
      when the Ca2+ supply was high. About 15% of the Ca2+ in these cells was
      nonexchangeable. These results suggest that osteoblasts do process more Ca2+ when
      closer to the mineralization site. Whether this Ca2+ is en route from blood to
      bone or from bone to blood will require further study.

PMID- 1637568
TI  - Bone mass status in different degrees of chronic renal failure.
AB  - Bone mineral density (BMD) was evaluated in 69 patients with chronic renal
      failure (CRF) and in healthy controls matched for age, sex, and, for women,
      menopausal status. Both appendicular (predominantly cortical) and axial
      (predominantly trabecular) bone mass were measured. Appendicular BMD was measured
      by single photon absorptiometry on the distal forearm and axial BMD was measured
      by dual photon absorptiometry on the lumbar spine. Patients were divided into
      three groups on the basis of creatinine clearance: group 1, 58 to 36 ml/min;
      group 2, 30 to 18 ml/min; group 3, 15 to 9 ml/min. Both appendicular and axial
      BMD decreased with the worsening of renal failure. Parathyroid hormone levels
      were inversely correlated with the values of appendicular BMD. BMD values were
      significantly lower in postmenopausal than in premenopausal women. Months of
      menopause were inversely correlated with axial BMD values. Appendicular BMD was
      lower in CRF patients than in controls, and both appendicular and axial BMD were
      significantly lower in postmenopausal uremic women than in postmenopausal healthy
      women.

PMID- 1637569
TI  - Increased bone volume and reduced bone turnover in vitamin D-replete rabbits by
      the administration of 24R,25-dihydroxyvitamin D3.
AB  - To study the effect of a large dose of 24R,25(OH)2D3 on bone metabolism, we
      treated vitamin D-replete rabbits with the agent for eight weeks. Fifteen rabbits
      20 weeks of age were divided into three groups of five animals each. Group I
      received only the vehicle; groups II and III were given the agent at doses of 10
      micrograms/kg/d, and 100 micrograms/kg/d, respectively. Through the dosing
      period, serum calcium, phosphorus, alkaline phosphatase, and creatinine levels
      were not altered. By the end of the experiment, serum 1,25(OH)2D or serum 25(OH)D
      levels did not change, nor did the PTH level. Serum 24,25(OH)2D levels for groups
      I, II, and III were 5.25 +/- 3.40, 76.16 +/- 19.90 (p less than .01), and 199.0
      +/- 30.90 (p less than .01) ng/ml, respectively. The bone mineral content (BMC)
      significantly increased in group III. The percentages of BMC increase in group
      III over group I were 14.5% on the femur, 34.1% (p less than .01) on the sixth
      lumbar vertebra, and 23.3% (p less than .05) on the seventh lumbar vertebra. A
      marked increase of bone mineral densities in the cancellous bone-rich regions was
      seen in group III. Bone histomorphometry on the seventh lumbar vertebra
      demonstrated that both the eroded surface and the osteoclast number were reduced
      and the surfaces indicating bone formation such as the osteoid surface and the
      tetracycline double labeled surface were also reduced. However, both the osteoid
      thickness and the mineral apposition rate increased and the mineral formation
      rate at the tissue level remained approximately equal to that in the
      control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637570
TI  - Relationships between quantitative histological measurements and noninvasive
      assessments of bone mass.
AB  - We performed a comprehensive analysis of the relationships between histologic
      indices in the iliac crest (cancellous bone volume, trabecular structural
      indices, cortical width, and core width) and bone density in the spine, hip, and
      wrist in 81 patients with various metabolic bone diseases including osteoporosis,
      osteomalacia, hyperparathyroidism, and Paget's disease. In the whole group, all
      of the histologic indices correlated significantly with bone mineral density
      (BMD) of the spine and the three regions of the hip (r = 0.28-0.73), with the
      exception of cortical width which correlated with the hip but not the spine (r =
      0.21). There was no relationship between the histologic variables and either the
      distal or proximal radius. When the osteoporotic subgroup was considered
      separately, the relationships between BMD and both cancellous bone volume and the
      structural indices (trabecular number, separation, and thickness) were lost. In
      contrast, cortical width correlated more strongly with both spine and hip BMD.
      The relationship between core width and the spine was lost but persisted in the
      hip region. In female osteoporotic patients alone, only cortical width remained
      significantly correlated with spine or hip BMD. We conclude that the
      relationships between bone densities in the axial and peripheral regions and
      histomorphometric variables in iliac crest are not constant. In addition,
      cancellous bone volume and the trabecular structural indices relate well to
      noninvasive axial BMD measurements only in a heterogenous group with a large
      variance in both parameters. In the more homogeneous group with osteoporosis,
      cortical width appears to be a more powerful predictor of BMD at the important
      sites of osteoporotic fracture.

PMID- 1637571
TI  - A method for estimating the uncertainty of future bone mass.
AB  - The development of statistical models for estimating fracture probability is a
      promising method for quantitating and optimizing the clinical utility of bone
      mass measurements. Earlier models have assumed that future bone mass could be
      predicted exactly and were, therefore, limited to analyses that assume the loss
      rate is known in advance. Since bone loss rates may vary over time and cannot be
      predicted accurately, we have developed a new model, based on empirical data,
      that estimates the degree of uncertainty associated with predicted bone mass.
      Without a bone mass measurement, the population mean must be assumed for an
      individual. For the calcaneus, the standard deviation of the population
      distribution is about 60 mg/cm2. By measuring bone mass, one can determine how
      close or far from the mean an individual's true bone mass is, with a standard
      deviation (SD) of about 3 mg/cm2. Without a subsequent bone mass measurement, our
      model predicts that the uncertainty (standard deviation) in calcaneal bone mass
      will increase approximately sixfold (relative to the reproducibility at the
      initial measurement) over a period of five years for women under age 60, from 3
      mg/cm2 to 19 mg/cm2. The five-year increase in uncertainty is approximately
      fourfold for women over age 60, from 3 to 13 mg/cm2. However, the uncertainty in
      bone mass for an individual five years after the initial measurement is still
      only one third to one fifth that of the entire population, and can be reduced to
      the initial level by obtaining another measurement. Furthermore, the predicted
      (or measured) values are usually much better estimates of an individual's true
      bone mass than simply assuming the population average.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1637572
TI  - Effects of bisphosphonates and inorganic pyrophosphate on osteogenesis in vitro.
AB  - The bisphosphonates, which are chemically related to pyrophosphate, have been
      studied extensively both in vivo and in vitro to elucidate their effects on bone
      tissues and cells. However, because these agents have important effects on bone
      resorption, the majority of investigations have focused on this area. Few studies
      regarding direct bisphosphonate effects on bone formation have been carried out
      in the past and, thus, we chose to use the chick periosteal osteogenesis (CPO) in
      vitro model system to test the direct effects of pyrophosphate and the
      bisphosphonates ethane-1-hydroxy-1,1-diphosphate (HEBP) and disodium-1-hydroxy-1
      amino-propylidine (APD) on various parameters of osteogenesis in vitro. The data
      show that the bisphosphonate HEBP inhibits bone mineralization reversibly while
      APD, at low doses, may actually enhance mineralization of bone. Similarly,
      pyrophosphate (PPi) will prevent mineralization in CPO cultures. However, CPO
      cultures can circumvent PPi-mediated blockage of mineralization with longer-term,
      continuous (10-day) incubation, whereas this does not occur if cultures are
      incubated continuously with bisphosphonates. Both drugs appear to be able to
      reverse beta-glycerophosphate-induced changes in alkaline phosphatase activity,
      but do not appear on their own to regulate the activity of this enzyme. The
      findings show that in addition to their well-known effects on resorption,
      bisphosphonates have significant and direct effects on mineralization in bone
      forming cultures. Their direct effects on osteoblastic activity and
      differentiation remain to be determined.

PMID- 1637573
TI  - Immunological screening of SPARC/Osteonectin in nonmineralized tissues.
AB  - SPARC/Osteonectin is a major bone-related protein that is also present in
      nonmineralized tissues and in platelets. As compared to bone SPARC/Osteonectin,
      SPARC/Osteonectin from platelets presents a slightly lower electrophoretic
      mobility in SDS-PAGE and a 100-fold decreased affinity for a unique monoclonal
      antibody, Mab2 (Malaval et al. 1991). To check the tissular diversity of
      SPARC/Osteonectin, protein extracts from bovine bone, nonmineralized tissues, and
      platelets were screened by immunoblotting and immunoradiometric assay, with Mab2
      and three other monoclonal antibodies recognizing distinct epitopes. The
      SPARC/Osteonectin secreted by a human osteosarcoma cell line (MG63) was also
      tested. In all the nonmineralized tissues tested (gut, bone marrow, tendon,
      mesentery, artera, lens, skin, liver, and cornea), SPARC/Osteonectin presents the
      same immunoreactivity and electrophoretic mobility as in bone. The heavier
      molecular weight and Mab2-negative form present in platelets seems to be unique
      to this cell type. Osteosarcoma cell extracts and conditioned media give the same
      results as bone extracts, indicating that the low molecular weight and Mab2
      positive form of SPARC/Osteonectin present in most tissues does not result from
      proteolytic cleavage in the matrix, but is secreted as such. Bone and platelet
      SPARC/Osteonectin present different patterns of sensitivity to glycosidases,
      suggestive of a difference in N-glycosylation. However, these treatments do not
      affect the decreased affinity of Mab2 for platelet SPARC/Osteonectin, which is
      not likely to be related to difference in N-glycosylation.

PMID- 1637574
TI  - Comparison of low-dose intramuscular and intravenous salcatonin in the treatment
      of primary hyperparathyroidism.
AB  - The treatment of hypercalcaemia with low-dose salcatonin (100 U/d), administered
      either as a single intramuscular bolus or as a continuous intravenous infusion
      for five days, was examined in two groups of 10 patients with primary
      hyperparathyroidism, in a randomized open parallel study. Both the peak (0.31 +/-
      0.035 mmol/L v 0.13 +/- 0.034 mmol/L) and overall (0.073 +/- 0.016 mmol/L v 0.018
      +/- 0.016 mmol/L) hypocalcaemic responses were greater in the infusion group. The
      peak reduction in serum calcium occurred on day 2 of treatment after which there
      was a progressive attenuation of response. All the differences between the two
      methods of administration wer due to renal rather than bony effects of
      salcatonin. Possible causes of progressive resistance to treatment included
      reductions in sodium excretion and serum phosphate. It is concluded that low-dose
      salcatonin administered as a continuous infusion was more effective than the same
      dose given as a bolus. The kidney played a pivotal role both in the cause of the
      hypercalcaemia and in the response to treatment, including the rapid development
      of resistance which limits the use of salmon calcitonin in primary
      hyperparathyroidism to short-term reduction of serum calcium.

PMID- 1637575
TI  - [Salary in order to fight?. Interview by Kjell Arne Bakke].

PMID- 1637576
TI  - [Cosmetic changes of important principles?].

PMID- 1637578
TI  - [Safety can mean imprisonment].

PMID- 1637577
TI  - [Home care nursing: a bottomless pit].

PMID- 1637579
TI  - [Hamar hospital gives responsibility to nurses. Interview by Siv Barstad].

PMID- 1637580
TI  - [4-year university education in Iceland: power and prestige but the same salary].

PMID- 1637581
TI  - [4-year university education in Iceland: the salary problem is distracting].

PMID- 1637582
TI  - [A society president says thanks for the hospitality. Interview by Bjorn Arild
      Ostby].

PMID- 1637583
TI  - [Gene technology--problem-creating progress].

PMID- 1637584
TI  - [A bank for good ideas].

PMID- 1637586
TI  - [Montebello Center: "soft light and gentle warmth"].

PMID- 1637585
TI  - [Tough treatment--successful results. Interview by Liv Sandvand Hergum].

PMID- 1637587
TI  - [Health care nurse based on the Oppland model].

PMID- 1637588
TI  - [We care for children jointly].

PMID- 1637589
TI  - [No thanks to psychiatric nurses].

PMID- 1637590
TI  - [Psychiatric health services: granted responsibility, lacking plans].

PMID- 1637591
TI  - [Go and lay down, Gunnar].

PMID- 1637592
TI  - Pre-emptive analgesia.

PMID- 1637593
TI  - Transoesophageal pulsed wave Doppler measurement of cardiac output during major
      vascular surgery: comparison with the thermodilution technique.
AB  - We measured cardiac output in 12 patients undergoing elective abdominal vascular
      surgery at specific times during the procedure with simultaneous thermodilution
      and transoesophageal pulsed Doppler echocardiographic techniques. No patient had
      clinical evidence of valvular heart disease before surgery. Five patients had
      echocardiographic evidence of mitral regurgitation on colour-coded Doppler. Using
      Bland and Altman analysis to compare the cardiac output measurement by the two
      techniques, the Doppler method overestimated the cardiac output (bias = 0.86
      litre min-1) compared with the thermodilution technique and there were wide
      limits of agreement between the two techniques (+2.4 to -4.1 litre min-1).
      However, in the seven patients with no evidence of mitral regurgitation, closer
      agreement (bias 0.14 litre min-1) and narrower limits (+1.6 to -1.3 litre min-1)
      were observed. We conclude that, in patients with competent mitral valves,
      transoesophageal echocardiograph may provide accurate determination of cardiac
      output.

PMID- 1637594
TI  - Continuous collection of pulse oximetry data: a new, inexpensive, portable
      computerized method.
AB  - The availability of reliable pulse oximetry equipment has led to interest in
      identifying patterns of hypoxaemia in the postoperative period. Methods for the
      computerized collection and analysis of pulse oximetry data have been described,
      but these require continuous use of a relatively powerful computer system
      throughout both the monitoring (data collection) and analysis periods. We have
      designed a technique which uses a small, portable and relatively inexpensive
      computer unit for data collection, after which the data may be transferred to a
      more powerful computer for analysis. Appropriate programming and choice of
      software have produced a relatively "user friendly" system which can be operated
      successfully even with minimal computing experience. The unit has the potential
      to be modified to form the basis of a "medical advice system" which could be used
      for the "intelligent" monitoring of high risk patients.

PMID- 1637595
TI  - The United Kingdom as seen by a Japanese anaesthetist.

PMID- 1637596
TI  - Aspirin, extradural anaesthesia and the MRC Collaborative Low-dose Aspirin Study
      in Pregnancy (CLASP)

PMID- 1637597
TI  - Repeated resistance to non-depolarizing neuromuscular blocking drugs in a patient
      with multiple myeloma.

PMID- 1637598
TI  - Movements of the vocal cords on induction of anaesthesia with thiopentone or
      propofol.
AB  - Using a fibreoptic laryngoscope, we have recorded on video tape the movements of
      the vocal cords after induction of anaesthesia with either propofol or
      thiopentone. The angle formed by the vocal cords decreased after induction of
      anaesthesia in both groups. This reduction in angle was significantly greater in
      the thiopentone group. The vocal cords closed completely in four patients in the
      thiopentone group and one patient in the propofol group. This difference may be
      explained by greater depression of laryngeal reflexes by propofol and this may
      account for the lower incidence of laryngospasm after induction of anaesthesia
      with propofol in comparison with thiopentone.

PMID- 1637599
TI  - Factors affecting magnitude and time course of neuromuscular block produced by
      suxamethonium.
AB  - This study was designed to identify factors that significantly alter the
      magnitude and duration of suxamethonium-induced neuromuscular block in patients
      with an apparently normal genotype for pseudocholinesterase. One hundred and
      fifty-six adults (ages 18-65 yr) were allocated to 13 subgroups. Patients in each
      subgroup received suxamethonium 50-2000 micrograms kg-1. The mechanographic
      response of the adductor pollicis brevis muscle to ulnar nerve stimulation was
      recorded. The ED50 was found to be 167 micrograms kg-1, ED90 was 316 micrograms
      kg-1 and ED95 was 392 micrograms kg-1. The duration of action (delta t) was in
      agreement with earlier published results. The magnitude of block was dose-related
      and decreased with increasing onset time (ton) and pseudocholinesterase activity
      (PChA). Neither age nor gender affected the degree of suxamethonium-induced
      block. Delta t was dose-related, decreased with increasing PChA, and was shorter
      for women. Age and ton had no effect on delta t.

PMID- 1637600
TI  - Haemodynamic effects of isoflurane during propofol anaesthesia.
AB  - We have studied haemodynamic responses to 0, 0.25, 0.5, 0.75 and 1 MAC isoflurane
      administration in 10 patients during a zero-order propofol infusion and
      normocapnia. Isoflurane reduced mean arterial pressure (MAP), systemic vascular
      resistance and left ventricular stroke work in a dose-dependent manner (29%, 38%
      and 33%, respectively, at 1 MAC), while cardiac output (CO), stroke volume (SV)
      and heart rate were not affected significantly. Mean pulmonary artery pressure,
      pulmonary vascular resistance and right ventricular stroke work decreased by 13%,
      10% and 17%, respectively (not significant). Pulmonary capillary wedge pressure
      and central venous pressure were affected minimally, while intrapulmonary
      shunting and PaO2 remained constant. It is concluded that administration of
      isoflurane during infusion of propofol caused a dose-dependent decrease in MAP as
      a result of afterload reduction without modification in CO or SV.

PMID- 1637601
TI  - Influence of timing on the effect of continuous extradural analgesia with
      bupivacaine and morphine after major abdominal surgery.
AB  - We have studied the effect of continuous extradural analgesia with bupivacaine
      and morphine, initiated before or after colonic surgery, in a double-blind,
      randomized study. Thirty-two patients were allocated randomly to receive an
      identical extradural block initiated 40 min before surgical incision (n = 16) or
      at closure of the surgical wound (n = 16). The extradural regimen consisted of a
      bolus of 7 ml of plain bupivacaine 7.5 mg ml-1 plus morphine 2 mg and continuous
      extradural infusion of a mixture of bupivacaine 7.5 mg ml-1 plus morphine 0.05 mg
      ml-1, 4 ml h-1 for 2 h, followed by a continuous extradural infusion of a mixture
      of bupivacaine 2.5 mg ml-1 plus morphine 0.05 mg ml-1, 4 ml h-1, continued for 72
      h after operation. In addition, all patients received similar general
      anaesthesia. There was no significant difference in request for additional
      morphine and no significant differences between the groups in pain scores (visual
      analogue scale or verbal) during rest or ambulation at any time of measurement.
      These results do not suggest that timing of analgesia with a conventional
      extradural regimen is of major clinical importance in patients undergoing colonic
      surgery.

PMID- 1637602
TI  - Somatic movement and oesophageal motility during isoflurane anaesthesia.
AB  - The quantal responses for somatic movement, and spontaneous and provoked lower
      oesophageal contractions (motility) were noted at the time of incision in 72
      patients aged 40-65 yr, receiving varying concentrations of isoflurane. Probit
      analysis of the alveolar concentration of isoflurane required to prevent somatic
      movement revealed an MAC or EC50 (95% confidence limits) of 1.00 (0.82-1.17)% and
      EC95 of 2.16 (1.69-3.89)%. The EC50 of isoflurane to suppress spontaneous lower
      oesophageal contractions was 1.27 (1.12-1.43)%, and the EC95 2.13 (1.78-3.22)%.
      The EC50 for provoked lower oesophageal contractions was 1.31 (0.93-3.48)% and
      the EC95 was 6.18% (unable to compute confidence limits).

PMID- 1637603
TI  - Acid-base management during hypothermic cardiopulmonary bypass does not affect
      cerebral metabolism but does affect blood flow and neurological outcome.
AB  - In order to compare the effects of blood-gas management on cerebral blood flow,
      metabolism and neurological outcome after hypothermic cardiopulmonary bypass
      (CPB) we have studied 65 patients undergoing aorto-coronary bypass surgery
      allocated randomly to either a pH-stat (temperature-corrected blood-gas
      management) or an alpha-stat (temperature-uncorrected blood-gas management)
      group. All patients were examined neurologically on the day before and the 7th
      day after operation. In 20 patients of the pH-stat group and in 15 patients of
      the alpha-stat group we measured cerebral blood flow (CBF), using the argon
      washin technique, and also cerebral oxygen (CMRO2) and glucose (CMRg) uptake.
      Measurements were performed in awake patients, after induction of anaesthesia
      with fentanyl, midazolam and pancuronium under normothermic conditions, during
      CPB at a venous blood temperature of 26 degrees C and at the end of surgery.
      Compared with postinduction values, hypothermia was associated with an 18%
      reduction in CBF and decreases in CMRO2 and CMRg of 61% and 60%, respectively, in
      the alpha-stat group. In the pH-stat group, CMRO2 and CMRg decreased also, by 58%
      and 74%, respectively, whereas CBF increased by 191%, indicating uncoupling of
      flow and metabolism. As there were no statistically significant differences
      between the metabolic variables in both groups, we conclude that acid-base
      management did not affect cerebral metabolism, despite its influence on blood
      flow. After rewarming, CBF and cerebral metabolism normalized independently of
      acid-base management during hypothermia. Nevertheless, neurological dysfunction
      occurred more often in the pH-stat group (P = 0.036).

PMID- 1637604
TI  - Does etomidate cause haemolysis?
AB  - Etomidate is currently presented as a solution with propylene glycol as solvent.
      This organic solvent has an extremely high osmolality and is probably responsible
      for some of the side effects of this drug. In order to detect haemolysis, an
      indication for cell damage, we have measured serum haptoglobin concentrations in
      12 healthy male volunteers after administration of etomidate 0.3 mg kg-1. Six
      subjects received etomidate in propylene glycol (EtoPG) with an osmolality of
      4965 mosmol kg-1 and six received etomidate in lipid emulsion (EtoLip, 400 mosmol
      kg-1). Haptoglobin concentrations in the EtoPG group decreased by 44% and 43%
      from baseline values at 2 and 4 h after administration, respectively, and were
      significantly smaller than after administration of EtoLip. After 24 h,
      haptoglobin concentrations had not reached baseline values.

PMID- 1637606
TI  - Comparison of the relaxant effects of diazepam, flunitrazepam and midazolam on
      airway smooth muscle.
AB  - The mechanisms by which benzodiazepines produce muscle relaxation and respiratory
      depression are not known, but they may include actions on peripheral
      benzodiazepine receptors or central GABA receptors, or a direct action on airway
      smooth muscle may also be involved. We have compared, therefore, the effects of
      diazepam, flunitrazepam and midazolam on airway tone by measuring isometric
      tension of guineapig trachealis muscle. Cumulative concentrations of diazepam,
      flunitrazepam and midazolam caused concentration-dependent relaxation of resting
      tone in the tracheal smooth muscle with no significant differences in pD2 values
      (-log EC50--an index of potency) or intrinsic activities (% of maximum response)
      for relaxations for the three compounds. Pretreatment with propranolol 10(-6) mol
      litre-1, flumazenil 10(-7) and 10(-6) mol litre-1 or PK11195 10(-6) mol litre-1
      had no effect on diazepam- or midazolam-induced relaxation. Diazepam 3 x 10(-6)
      mol litre-1 pretreatment shifted the concentration-response curves for
      acetylcholine, histamine and serotonin (5-HT) to the right by a factor of
      approximately 2. Flunitrazepam 3 x 10(-6) mol litre-1 pretreatment also shifted
      the curves for histamine and 5-HT similarly to the right, whereas midazolam
      pretreatment did not inhibit any agonist-induced contractions. These results
      suggest that benzodiazepines relax airway smooth muscle, not via neural pathways
      or central and peripheral benzodiazepine receptors, but by a direct action on
      airway smooth muscle.

PMID- 1637605
TI  - Flumazenil does not antagonize halothane, thiamylal or propofol anaesthesia in
      rats.
AB  - We have studied the effects of flumazenil on sleep time and EEG in rats
      anaesthetized with 1.5% halothane, propofol 20 mg kg-1, thiamylal 30 mg kg-1, or
      combinations of diazepam 5 mg kg-1 and anaesthetic agents. We also studied the
      effects of flumazenil 0.3, 3 and 30 mg kg-1 on behaviour and EEG. Flumazenil 0.3
      and 3 mg kg-1 alone had no effect on behaviour or EEG, but flumazenil 30 mg kg-1
      had depressive effects similar to those of diazepam on behaviour and EEG.
      Flumazenil 0.3, 3 and 30 mg kg-1 i.v., antagonized the effects of diazepam 10 mg
      kg-1 i.v. on behaviour and EEG. Flumazenil had no antagonistic effect on sleep
      time induced by anaesthetic agents, but flumazenil 30 mg kg-1 potentiated
      propofol-induced anaesthesia. Flumazenil did not affect anaesthesia-induced EEG
      changes. Diazepam 5 mg kg-1 potentiated anaesthesia. Flumazenil antagonism of
      diazepam potentiation varied with anaesthetic agent: flumazenil 0.3 mg kg-1
      antagonized diazepam action in halothane anaesthesia, but 30 mg kg-1 was required
      in propofol anaesthesia; this large dose was insufficient in thiamylal
      anaesthesia.

PMID- 1637607
TI  - Comparison of the inhibitory effect of propofol, thiopentone and midazolam on
      neutrophil polarization in vitro in the presence or absence of human serum
      albumin.
AB  - Anaesthetic agents inhibit some aspects of immune function and this may be
      clinically important when prolonged infusions are used in an intensive care unit.
      We have studied the effects of propofol, thiopentone and midazolam on neutrophil
      polarization in vitro. At concentrations seen in plasma during anaesthesia,
      propofol and thiopentone produced significant (approximately 50%) and comparable
      degrees of inhibition. Inhibition was complete with greater concentrations of
      these drugs. When compared with equivalent concentrations of midazolam, propofol
      produced more inhibition (P less than 0.01) at all concentrations investigated,
      except the smallest. Midazolam produced no effect at clinically relevant
      concentrations. The effect of propofol was not attributable to its lipid carrier
      vehicle, as 10% Intralipid alone augmented neutrophil polarization. Human serum
      albumin conferred some degree of protection against the inhibition produced by
      clinically relevant concentrations of propofol and thiopentone, but not that
      produced by greater concentrations of these drugs.

PMID- 1637608
TI  - EEG and auditory evoked potential P300 compared with psychometric tests in
      assessing vigilance after benzodiazepine sedation and antagonism.
AB  - We have compared the EEG and auditory evoked wave P300 with psychometric tests in
      assessing vigilance after flumazenil antagonism of midazolam sedation in 12
      healthy volunteers. Measurements were made before and after midazolam 0.1 and 0.2
      mg kg-1 i.v., and immediately and 30, 60, 120 and 240 min after administration of
      flumazenil 1 mg. The sedative effects of midazolam and antagonism by flumazenil
      resulted in alterations in EEG, P300 and psychometric tests (syndrome short test,
      letter cancellation, choice reaction and recognition). However, 60 and 120 min
      after flumazenil a decrease in test performance indicating rebound sedation was
      seen only in P300 mapping. Thus P300 mapping was a sensitive method of detecting
      subtle differences in vigilance. Rebound sedation occurred even when midazolam
      0.2 mg kg-1 was antagonized with an adequate dose of flumazenil. We suggest that
      it is advisable to supervise patients for at least 240 min after flumazenil
      antagonism of midazolam 0.2 mg kg-1.

PMID- 1637609
TI  - Influence of vitamin B12 status on the inactivation of methionine synthase by
      nitrous oxide.
AB  - We have studied the influence of maternal serum B12 concentration on the
      inactivation of placental methionine synthase activity by nitrous oxide in an
      obstetric population. This group was known to include patients with a wide range
      of B12 values. Over 70% of patients were given nitrous oxide either for analgesia
      during labour or for delivery by Caesarean section, for periods ranging from a
      few minutes to 11 h. Patients undergoing normal delivery and Caesarean section
      under extradural anaesthesia served as controls. There was a highly significant
      relation between placental methionine synthase activity and duration of exposure
      to nitrous oxide. Inactivation was slower than that described for the liver,
      which may reflect the intermittent use. There was also a significant relation
      between maternal B12 and placental methionine synthase activity, but there was a
      wide scatter of results and the data were not thought to be predictive. There was
      evidence that inactivation by nitrous oxide was more rapid in patients with small
      concentrations of B12. We conclude that some patients with reduced serum
      concentrations of B12 may be at a disadvantage with nitrous oxide anaesthesia.

PMID- 1637610
TI  - In vitro diagnosis of malignant hyperthermia: influence of electrical stimulation
      on the contracture response to caffeine.
AB  - We have examined the influence of electrical stimulation on caffeine-induced
      tension generation during contracture testing used to diagnose malignant
      hyperthermia. The cumulative contracture response to caffeine was compared in
      pairs of morphologically comparable muscle bundles obtained from the same
      patient. Only one of the two bundles was stimulated electrically during the test.
      Statistically significant differences in tension were found at caffeine
      concentrations greater than or equal to 4 mmol litre-1, the tension developed
      being invariably larger in the unstimulated fascicles. These results suggest that
      electrical stimulation results in suppression of the dose-dependent, caffeine
      induced contracture. This effect could be a result of the potentiation of twitch
      tension by caffeine, muscle fatigue, or both. Overall, the observed differences
      did not alter the in vitro diagnosis of malignant hyperthermia.

PMID- 1637611
TI  - Prospective, controlled, double-blind study of i.v. tenoxicam for analgesia after
      thoracotomy.
AB  - We have shown that a single i.v. dose of tenoxicam 20 mg, after thoracotomy, when
      compared with placebo in 20 patients (with one exclusion), was associated with a
      reduction in consumption of papaveretum, assessed by patient-controlled
      analgesia, of 2.2 mg h-1 (22%) to 4 h and 1.4 mg h-1 (23%) to 12 h after
      operation (repeated measures analysis of variance: P less than 0.01). There was
      no reduction from 12 to 24 h. There was no significant difference between groups
      in pain scores or in side effects.

PMID- 1637612
TI  - Overdose of opioid from patient-controlled analgesia pumps.
AB  - Two incidence have occurred in our hospital when a patient-controlled analgesia
      pump has accidentally delivered the whole contents of the syringe of diamorphine
      (60 mg) over a period of approximately 1 h. Electrical corruption of the pumps'
      program has been identified as the probable cause. All pumps of this type have
      been modified to prevent such occurrences.

PMID- 1637613
TI  - Tracheal models which simulate the compliance of the adult male trachea.
AB  - Earlier models of the human trachea have not taken the characteristic compliance
      of the trachea into account. Two tracheal models are presented, which simulate
      the compliance of the adult male human trachea, intended for more valid
      laboratory testing of the function of the cuffs of tracheal tubes. The two models
      simulate the conditions with and without controlled ventilation.

PMID- 1637614
TI  - [The surgeon, the surgery and the new techniques].

PMID- 1637615
TI  - [Preoperative radiotherapy in locally advanced rectal cancer: risks and
      complications?].
AB  - Adjuvant radiotherapy in advanced rectal cancer is currently considered of
      interest: preoperative radiotherapy in particular seems to provide better
      results. However, doubts in its use arise from fear of technical difficulties at
      surgery and increase of complications. In Authors' opinion, though, preoperative
      radiotherapy associated with perineal omentoplasty represents a real progress in
      the management of rectal cancer. Preliminary experience supports this feeling.

PMID- 1637616
TI  - Modern operative thoracoscopy.
AB  - Laparoscopic surgery has demonstrated advantages of less pain, early recovery,
      and cosmesis. Applying laparoscopic surgical techniques to thoracic procedures
      may allow for similar advantages. New instrumentation provides for greater
      versatility in treating thoracic conditions. Described herein is the use of
      thoracoscopy for a variety of thoracic procedures.

PMID- 1637617
TI  - Thoracoscopic treatment of spontaneous pneumothorax without pleurodesis: a
      preliminary report.
AB  - Laparoscopy has shown to be associated with less morbidity than laparotomy.
      General surgeons are realizing that procedures so far performed through
      traditional incisions can be equally performed effectively by laparoscopy.
      Likewise it is apparent that some thoracic procedures are amenable to
      thoracoscopic approach. With the development of new instrumentation thoracoscopy
      is effective for the treatment of spontaneous pneumothorax. Pleurodesis seems to
      increase the morbidity associated with the thoracoscopic procedure and may reduce
      its effectiveness. Results of 17 consecutive cases of spontaneous pneumothorax
      treated thoracoscopically without pleurodesis are herein presented. No
      significant complications were encountered and no recurrences have been
      identified so far. Pleurodesis was omitted chiefly because it increases the
      morbidity of thoracoscopy.

PMID- 1637618
TI  - [Subtotal colectomy in splenic flexure carcinoma in a patient with transverse
      colostomy who had undergone gastric resection (Billroth II)].
AB  - The Authors report a case of subtotal colectomy for splenic flexure
      adenocarcinoma in a gastro-resected patient bearing a transverse colostomy. They
      underline the considerable technical difficulties encountered during dissection
      because of multiple adhesions related to the previous operations
      (gastrojejunostomy and transverse colostomy). In fact, a gastric resection
      according to Billroth II and an emergency colostomy for bowel obstruction had
      been performed 20 years and 30 days respectively prior to the present operation.
      Nevertheless, reconstructive steps resulted easier and faster with the use of
      staplers.

PMID- 1637619
TI  - [Nerve-sparing cystectomy and ileal bladder substitution].
AB  - Nerve-sparing techniques and bladder substitution following radical cystectomy
      allow today to obviate functional sequelae once registered in this type of
      surgery. Intraoperative identification of the pelvic plexus, which provides
      autonomic innervation to the corpora cavernosa, is necessary to preserve sexual
      function. Ileal orthotopic bladder substitution with preservation of the distal
      urethral sphincter assures a micturition per urethram and the urinary continence.
      The Authors report their experience with the Studer and Zingg procedure (ileal
      orthotopic bladder reservoir) performed in 26 cases. Results, technique,
      complications, and long-term evaluation are stressed.

PMID- 1637620
TI  - [Technique and immediate results of the Moreno Gonzalez-Carboni reconstruction
      after total gastrectomy].
AB  - Reconstruction following total gastrectomy for gastric cancer is still matter of
      debate. The Roux-en-Y esophagojejunostomy and the interposed loop esophago
      jejunoduodenostomy are the techniques commonly employed. The Authors describe
      their modification of Henley's jejunal interposition and report early results
      achieved in a series of 60 consecutive patients.

PMID- 1637621
TI  - [Use of the Ravo bypass in high-risk colonic anastomoses].
AB  - The Authors report a case of high risk colonic anastomosis treated by
      intracolonic by-pass procedure. The technique of Coloshield application is
      described. Its use prevents fecal contamination of the anastomotic site and, in
      case of dehiscence, anastomotic fistula formation.

PMID- 1637622
TI  - [Esophageal anastomosis using a stapler: new technical variants].
AB  - Stapling techniques are considered the safer alternative for esophageal
      anastomosis in the Authors experience. In order to further improve results they
      suggest stapled esophageal anastomoses should be constructed avoiding purse
      string sutures and the use of purse-string devices or Satinsky forceps.

PMID- 1637623
TI  - [Mechanical trans-sutural colorectal anastomoses in the treatment of rectal
      cancer].
AB  - The Authors report on 52 rectal cancers treated with anterior resection and
      mechanical anastomosis according to the Knight and Griffen technique. Such
      technique is quite practical, allows for easier sphincter-saving operations and
      is followed by a very low percentage of fistulas and anastomotic stenoses. In
      this series, a good anorectal function was restored in 6-12 months even in very
      low anastomoses; sexual complications were registered in 8% of cases; urinary
      troubles were not significant. The Authors conclude that the Knight & Griffen
      procedure is useful and advantageous.

PMID- 1637624
TI  - [The Soupault-Bucaillle operation in the treatment of Billroth II gastric
      resection syndrome].
AB  - The study analyzes the benefits related to the gastroduodenojejunoplasty (GDJP)
      according to Soupault & Bucaille, adopted as the corrective treatment of the
      Billroth II gastric resection syndrome in those cases resistant to the dieting
      pharmacological supports. Our experience is based on 18 cases (13 males, 5
      females, mean age 39 yrs), treated from 1982 to 1987 with GDJP for a gastric
      resection syndrome. The patients were observed 5 years after their resection: 10
      presented with an atrophic gastritis/gastric atrophy and all had a diffuse acute
      phlogosis in presence of biliary storage. Manual anastomoses were performed in
      the first 8 cases, while staplers were used in the remaining cases. Results were
      quite satisfying; no operative mortality or specific complications, nor pain and
      biliary vomiting were registered; 14 patients over 18 (77%) gained weight
      significantly; only 1 patient reported low-intense early "dumping-like" symptoms
      easily controlled by medical therapy. Endoscopy showed no biliary reflux in all
      cases. Biopsies of the stump, carried on before and after the GDJP intervention,
      showed a marked reduction of the inflammatory aspects in 76% (13) of the
      patients. Among the 10 patients with atrophic gastritis/gastric atrophy, only 2
      (20%) presented a significant increase in the number of gastric parietal cells
      and gastric principal cells.

PMID- 1637625
TI  - [Surgical staplers in thoracic surgery].
AB  - Since its introduction in our department, in 1987, stapling devices are used on
      routine basis for thoracic surgery. Overall, 133 operations were performed: 95
      lobectomies, 30 pneumonectomies, and 8 bilobectomies. Stapled related
      complications consisting of bronchopleural fistula following right pneumonectomy
      were registered in 3 cases. The use of vascular staplers was never associated
      with complications, and no air leakages following stapled parenchymal sutures
      were observed. The advantages related to the use of stapling devices are
      represented by low air leakage and bleeding rates, reduced operative trauma, and
      reduced operating time. However, confidence with the techniques is needed to
      avoid regrettable consequences.

PMID- 1637626
TI  - [Use of surgical staplers in proctocolectomy with ileal pouch. Effects on
      immediate results].
AB  - The immediate results of 37 restorative proctocolectomies are reported comparing
      morbidity of stapled vs manual procedures. The stapled technique is easier and
      faster but does not reduce the incidence of leakages and pelvic sepsis related to
      the ileal pouch. It seems, though, to be more useful in reducing the morbidity
      related to the ileoanal anastomosis.

PMID- 1637627
TI  - [Manual and stapled sutures in digestive surgery: a comparative evaluation].
AB  - Results concerning 819 digestive sutures and anastomoses, 376 (45.9%) of which
      hand sewn and 443 (54.1%) stapled, are retrospectively analyzed. Comparative
      evaluation of the two techniques yielded better results for oesophageal and
      rectal anastomoses as well as duodenal stump closure mechanically performed. For
      intestinal anastomoses the two techniques showed similar results when performed
      in election, on the contrary, mechanical sutures fared significantly worse than
      hand-sutures in non elective surgery, with a morbidity of 30.9% vs 10.2% (p less
      than 0.05) and a mortality of 4.8% vs 0%. In conclusion, for esophageal, rectal
      and duodenal anastomoses staplers may be preferred, while for the intestinal
      anastomoses in non elective surgery hand-sutures should be preferred.

PMID- 1637628
TI  - [Surgical staplers in colorectal surgery: 10 years of experience].
AB  - The Authors dissert on some technical details for a correct use of staplers in
      colorectal surgery. Surgical skill and technology assure always better results,
      nevertheless the experience and knowledge of the single surgeon must be a guide
      for further research.

PMID- 1637629
TI  - [Staplers and pulmonary surgery].
AB  - The Authors report their experience with staplers (model T.A. 30) in lung
      surgery: 152 stapled sutures were, in fact, performed in the IV Surgical
      Department of the University "La Sapienza" of Rome, during the period 1980/90.
      The use of staplers assures a perfect closure and prevents granulomas due to
      suture materials in typical as well as atypical lung resections.

PMID- 1637630
TI  - [Transhepatic and mini-laparotomic approach in the embolization of the left
      gastric vein].
AB  - The Authors depict the possibility to reduce the risk of variceal bleeding with
      the embolization of the left gastric vein through a transhepatic or mini
      laparotomic approach. Such treatment applied in 5 cases was effective: during a
      mean one-year follow-up no rebleeding was registered, while the stabilization of
      a satisfying haemodynamic state in relation to the chronic liver disease was
      observed.

PMID- 1637631
TI  - [J-pouch after total gastrectomy].
AB  - The Authors report their initial experience with the construction of a J-pouch as
      restorative surgery following total gastrectomy (TG) for malignant neoplasms. In
      the last 10 months of the 1990 upon 52 interventions for gastric cancer 31 TG
      were performed, and in 13 cases a J-pouch on the proximal end of the jejunal
      segment was constructed. No mortality or specific morbidity was registered using
      the totally stapled technique. Within one month 3/4 of the patients had normal
      meals as far as quantity and quality; also the foamy regurgitation seemed to be
      minimal. The ease of the reconstructive technique and the short term results
      obtained encourage the use of such approach.

PMID- 1637632
TI  - [Clinical use of a new compression surgical stapler in surgery of the large
      intestine].
AB  - The clinical experience with the use in colorectal surgery of a new compression
      anastomotic device developed by the Authors is reported. From May 1986 through
      June 1990, 95 patients underwent large bowel anastomosis using this device.
      Operations performed included 51 left hemicolectomies or anterior resections of
      the sigmoid and rectum, 23 left colon resections, 19 right hemicolectomies, and
      two total colectomies. Twenty-nine anastomoses were performed below the pelvic
      peritoneal reflection and 18.5% of them resulted less than 4 cms from the anal
      verge while 20% were located between 4.5 and 8 cms. Five (5.2%) intraoperative
      diverting colostomies were needed. The rings were evacuated postoperatively after
      a mean of 10.9 days with none or very little discomfort. Operative mortality was
      1.0% (one patient died of myocardial infarction). Anastomotic complications
      included five (5.2%) clinical and four (4.2%) subclinical leakages. No
      haemorrhages or stenoses were observed. This initial clinical experience shows
      the anastomotic device is reliable and justifies further experimentation.

PMID- 1637633
TI  - [Rational and mini-invasive approach to the therapy in varicose syndrome: the
      C.H.I.V.A. treatment].
AB  - The principles of the C.H.I.V.A. (Ambulatory conservative and haemodynamic
      therapy of venous insufficiency) procedure are reported. According to the Authors
      a careful haemodynamic evaluation of the venous system strictly correlates to the
      clinical and functional results. In their experience, in fact, results showed no
      variceal recurrence and a very low rate of complications. Therefore, the
      C.H.I.V.A. procedure is recommended for most of the patients with lower limb
      varices.

PMID- 1637634
TI  - [Roux-en-Y loop gastro-jejuno anastomosis].

PMID- 1637635
TI  - [Use of surgical staplers in reconstruction of the digestive continuity after
      total gastrectomy. Our experience in the aged].

PMID- 1637636
TI  - [Surgical staplers and preservation of the sphincter function in surgery of
      rectal cancer. Our experience with the Knight-Griffen technique in the aged].

PMID- 1637637
TI  - [Knight-Griffen reconstruction after low anterior resection for rectal carcinoma:
      personal experience and technical notes].

PMID- 1637638
TI  - [Intestinal recanalization after Hartman's operation: use of surgical staplers].

PMID- 1637639
TI  - [Our experience in the use of surgical staplers].

PMID- 1637640
TI  - [Total gastrectomy with lymph node excision and the Roux-Orr esophago-jejunal
      reconstruction: its role in the therapy of gastric cancer].

PMID- 1637641
TI  - [Ligation of the renal pedicle with a surgical stapler].

PMID- 1637642
TI  - [Ochsner's approach as alternative to thoraco-phreno-laparotomy (in some selected
      indications or needs)].

PMID- 1637643
TI  - [Surgical staplers in ultra-low anastomoses in rectal carcinoma: technical
      problems].

PMID- 1637644
TI  - [Recanalization of the colon using a surgical stapler P-CEEA: an aseptic personal
      method. Variants].

PMID- 1637645
TI  - [Ileal reservoir and ileo-rectal anastomosis with surgical staplers].

PMID- 1637646
TI  - [Use of new surgical staplers in the Knight-Griffen technique. Our experience].

PMID- 1637647
TI  - [Use of surgical staplers in general surgery: 11 years of experience].

PMID- 1637648
TI  - [Total gastrectomy in cancer: technical notes].

PMID- 1637649
TI  - [Ambulatory surgery of varicocele].

PMID- 1637650
TI  - [Proposal of a recanalization technique after Hartman's operation].

PMID- 1637651
TI  - [Proposal of a colorectal anastomosis technique previous to evagination of the
      rectal stump].

PMID- 1637652
TI  - [Proposal of a colorectal anastomosis technique without the use of tobacco pouch
      suture].

PMID- 1637653
TI  - [Esophagojejunostomy a la Roux after total gastrectomy].

PMID- 1637654
TI  - [Use of biological glue in the surgical treatment of sacrococcygeal fistulas].

PMID- 1637655
TI  - Leprosy situation in the world and multidrug therapy coverage.

PMID- 1637656
TI  - World malaria situation in 1990. Part I.

PMID- 1637657
TI  - Children and tobacco.

PMID- 1637659
TI  - Host cell reactivation of gamma-irradiated adenovirus 5 in human cell lines of
      varying radiosensitivity.
AB  - DNA repair processes play an important role in the determination of radiation
      response in both normal and tumour cells. We have investigated one aspect of DNA
      repair in a number of human cell lines of varying radiosensitivity using the
      adenovirus 5 host cell reactivation assay (HCR). In this technique, gamma
      irradiated virions are used to infect cells and the ability of the cellular
      repair systems to process this damage is assayed by a convenient immunoperoxidase
      method recognising viral structural antigen expression on the cell membrane 48 h
      after infection. Reduced HCR was exhibited by radioresistant HeLa cells and by a
      radiosensitive neuroblastoma cell line, HX142. In contrast, an ataxia
      telangiectasia cell line, AT5 BIVA, did not show reduced HCR. On the basis of
      these results we can make no general conclusions about the relevance of HCR to
      cellular radiosensitivity. We have extended these studies to determine whether
      our cell lines exhibited enhanced viral reactivation (ER) following a small
      priming dose of gamma-radiation given to the cells before viral infection. No
      evidence for this phenomenon was found either in normal or tumour cell lines.

PMID- 1637660
TI  - Cardiotoxicity of commercial 5-fluorouracil vials stems from the alkaline
      hydrolysis of this drug.
AB  - The cardiotoxicity of 5-fluorouracil (FU) was attributed to impurities present in
      the injected vials. One of these impurities was identified as fluoroacetaldehyde
      which is metabolised by isolated perfused rabbit hearts into fluoroacetate (FAC),
      a highly cardiotoxic compound. FAC was also detected in the urine of patients
      treated with FU. These impurities were found to be degradation products of FU
      that are formed in the basic medium employed to dissolve this compound. To avoid
      chemical degradation of this antineoplastic drug, the solution of FU that will be
      injected should be prepared immediately before use.

PMID- 1637661
TI  - Antitumour responses to flavone-8-acetic acid and 5,6-dimethylxanthenone-4-acetic
      acid in immune deficient mice.

PMID- 1637658
TI  - Towards selective pharmacological modulation of protein kinase C--opportunities
      for the development of novel antineoplastic agents.

PMID- 1637662
TI  - Rearrangement of chromosome 1p in breast cancer correlates with poor prognostic
      features.
AB  - In a cytogenetic study of breast cancer biopsies, clonal abnormalities of
      chromosome 1p were identified in 56% (14) of 25 informative patients.
      Translocations predominated, involving 1p22 (n = 1), 1p35 (n = 1) or 1p36 (n =
      10) breakpoints. Chromosome 1p abnormalities were associated with estrogen
      receptor (ER) negativity (P = 0.03, 2-tailed Fisher Exact Probability test), high
      histological grade (P = 0.02, 2-tailed Mann-Whitney U-test) and an unfavourable
      Melbourne Prognostic Score (NEPA P = 0.02, SEPA P = 0.04, 2-tailed Mann-Whitney U
      tests). These findings are consistent with the possibility that a gene located on
      chromosome 1p is implicated in tumour progression.

PMID- 1637663
TI  - Assessment of morbidity from complete axillary dissection.
AB  - The importance of axillary dissection as part of the primary surgical procedure
      in the treatment of operable cases of carcinoma of the breast is established. The
      morbidity of this procedure, however, is less well documented. A study of 126
      women who had had full axillary dissection as part of their initial surgical
      treatment was undertaken to assess their degree of morbidity in terms of
      numbness, pain, weakness, swelling, and stiffness. Seventy per cent of cases
      complained of numbness, 33% of pain, 25% of weakness, 24% of limb swelling, and
      15% of stiffness. Objective measurements confirmed decreased sensation in 81%,
      weakness in 27%, swelling in 10%, and stiffness in 10%. In no case were these
      symptoms described as severe, though they did have an effect upon the daily lives
      of 39%. The side effects of full axillary dissection are common and all women
      should be warned of them prior to surgery; however they are usually mild and
      therefore should not preclude this procedure as a part of definitive surgical
      treatment.

PMID- 1637664
TI  - Aromatase inhibition: 4-hydroxyandrostenedione (4-OHA, CGP 32349) in advanced
      prostatic cancer.
AB  - We report the use of the steroidal aromatase inhibitor, 4-hydroxyandrostenedione
      (4-OHA, CGP 32349), in the management of patients with advanced, hormone
      resistant, prostatic cancer. Eighteen of 25 patients (72%) showed a subjective
      response, mainly in the form of pain relief and increased performance. There were
      no objective improvements. A tumour flare occurred in 17/25 (68%). Detailed
      endocrine studies were performed during treatment. These showed that suppression
      of serum oestradiol levels occurred in 19/25 (76%) of patients during treatment
      with 4-OHA. Serum levels of androstenedione increased in 9/14 patients (64%).
      Concentration of serum testosterone and 5 alpha-dihydrotestosterone were elevated
      in 3/14 (21%) and 2/11 (18%) patients respectively. There appeared to be no
      correlation between response or tumour flare and changes in steroid levels during
      treatment with 4-OHA. The mechanism of action of 4-OHA in palliating patients
      with advanced prostatic cancer remains obscure. 4-OHA or its metabolites may be
      acting on metastatic bone metabolism via effects on oestrogen related
      osteoclastic and osteoblastic activity. Further investigation of the effects of
      aromatase inhibitors on prostatic biology, and bone metabolism in patients with
      metastatic prostate cancer, would appear worthwhile.

PMID- 1637665
TI  - The assessment of in vivo somatic mutations in survivors of childhood malignancy.
AB  - The assessment of chromosomal mutations in children may provide information about
      aetiology and risk of second malignancies. A somatic cell mutation assay which
      determines variant erythrocytes lacking expression of an allelic form of the
      sialoglycoprotein, glycophorin A, was applied to samples from children before and
      after receiving potentially genotoxic therapy. Fifty-six children who had
      received treatment for their malignancy, 15 with malignancy but prior to
      treatment and 43 control children were assessed for the presence of No and NN
      mutant variant red cells. Control children had mean (s.d.) No and NN variant
      frequencies (Vf) of 9.5 (7.0) and 5.8 (3.3) x 10(6) erythrocytes respectively.
      Comparison between pre-treatment and control groups demonstrated that prior to
      chemotherapy, patients with paediatric malignancy do not have mutant frequencies
      significantly different from the normal population. Children who had received
      chemotherapy, with or without radiotherapy, showed a significant elevation of
      both No and NN variants over 10 years from the end of treatment. Exposure of
      children to radiotherapy or known chemical mutagens leads to an increased
      frequency of variant erythrocytes which is probably the result of in vivo somatic
      cell mutations. The long term implications have yet to be determined.

PMID- 1637666
TI  - The pharmacokinetic advantages of isolated limb perfusion with melphalan for
      malignant melanoma.
AB  - We describe melphalan pharmacokinetics in 26 patients treated by isolated limb
      perfusion (ILP). Group A (n = 11) were treated with a bolus of melphalan (1.5 mg
      kg-1), and in a phase I study the dose was increased to 1.75 mg kg-1. The higher
      dose was given as a bolus to Group B (n = 9), and by divided dose to Group C (n =
      6). Using high performance liquid chromatography (HPLC) the concentrations of
      melphalan in the arterial and venous perfusate (during ILP) and in the systemic
      circulation (during and after ILP) were measured. Areas under the concentration
      time curves for perfusate (AUCa, AUCv) and systemic (AUCs) data were calculated.
      In all three groups the peak concentrations of melphalan were much higher in the
      perfusate than in the systemic circulation. The pharmacokinetic advantages of ILP
      can be quantified by the ratio of AUCa/AUCs, median value 37.8 (2.1-131). AUCa
      and AUCv were both significantly greater in Group B than in Group A (P values
      less than 0.01, Mann-Whitney). In Groups B and C acceptable 'toxic' reactions
      occurred but were not simply related to melphalan levels. Our phase I study has
      allowed us to increase the dose of melphalan to 1.75 mg kg-1, but we found no
      pharmacokinetic advantage from divided dose administration.

PMID- 1637667
TI  - The prognosis of breast cancer patients in relation to the oestrogen receptor
      status of both primary disease and involved nodes.
AB  - Nodal involvement is accepted as the best single marker of prognosis in breast
      cancer. However, there is little information on the sub-division of node-positive
      patients according to the oestrogen receptor status of the nodal tissue. We have
      previously reported (Eur. J. Ca. 1987, 23, 31) that, in almost all cases,
      involved nodes are only oestrogen receptor positive (ER+) in patients whose
      primary tumours are uniformly ER+. This paper presents clinical follow-up on a
      larger group of patients with node positive breast cancer. For each patient, both
      soluble and nuclear receptor concentrations were determined in three separate
      parts of the primary tumour and in at least one involved node (we have previously
      defined tumours which contained ER in all six fractions of the primary as HS++,
      those lacking receptor in some fractions as HS+- and wholly receptor negative
      tumours as HS--). Median follow-up time was 71.5 months. As expected, patients
      whose tumours were HS++ had a significant (P less than 0.008) survival advantage.
      More importantly, patients with ER in both the soluble and nuclear fractions of
      their involved nodes survived significantly (P less than 0.003) longer than those
      with ER- nodes. Thus, full oestrogen receptor status of involved nodes will give
      sufficient prognostic information when adequate primary tissue is not available.

PMID- 1637668
TI  - Increased activity of 6-phosphogluconate dehydrogenase and glucose-6-phosphate
      dehydrogenase in purified cell suspensions and single cells from the uterine
      cervix in cervical intraepithelial neoplasia.
AB  - The activities of 6-phosphogluconate dehydrogenase and glucose-6-phosphate
      dehydrogenase have been measured in squamous epithelial cells of the uterine
      cervix from normal patients and cases of cervical intraepithelial neoplasia
      (CIN). A biochemical cycling method, which uses only simple equipment and is
      suited to routine use and to automation, was applied to cells separated by
      gradient centrifugation. In addition, cells were examined cytochemically, and the
      intensity of staining in the cytoplasm of single whole cells was measured using
      computerised microcytospectrophotometry. Twenty per cent of cells in samples from
      normal patients (n=61) showed staining intensities above an extinction of 0.15 at
      540 nm, compared to 71% of cases of CIN 1 (n=14), 91% of cases of CIN 2 (n=11)
      and 67% of cases of CIN 3 (n=15). The cytochemical data do not allow definitive
      distinctions to be made between different grades of CIN whereas the biochemical
      assay applied to cell lysates shows convincing differences between normal samples
      and cases of CIN. There are no false negatives for CIN 3 (n=14) and CIN 2 (n=10)
      and 11% false negatives for CIN 1 (n=9) and 14% of false positives for normal
      cases (n=21). The results of this preliminary study with reference to automation
      are discussed [corrected].

PMID- 1637669
TI  - Recombinant human interleukin 4 (IL-4) given as daily subcutaneous injections--a
      phase I dose toxicity trial.
AB  - Recombinant Interleukin 4 was administered by subcutaneous injection at daily
      doses of 0.5, 1.0 or 5.0 micrograms kg-1 to nine patients as part of a Phase I
      Dose Toxicity Study. Dose limiting toxicity was reached at 5 micrograms kg-1 day
      1. Symptoms of toxicity included fatigue, 'flu like symptoms and elevated liver
      enzymes. Modest but significant elevations of neutrophil and platelet counts
      occurred. No clear evidence of antitumour effects emerged although pain in
      metastatic lymph nodes and a small fall in myeloma paraprotein levels during
      dosing were observed. In vitro and murine in vivo studies indicate that patients
      with lymphoproliferative disease should be selected for Phase II trials.

PMID- 1637670
TI  - Patterns of risk of hereditary retinoblastoma and applications to genetic
      counselling.
AB  - A registry including information about nearly 1,600 cases of retinoblastoma
      diagnosed in Britain has been created at the Childhood Cancer Research Group.
      Cases have been classified as 'old germ cell mutation', 'new germ cell mutation'
      or 'sporadic non-hereditary'. For a population-based group of 918 cases diagnosed
      between 1962 and 1985 we have calculated the proportions of unilateral/bilateral
      and hereditary/non-hereditary cases. Bilateral cases represent 40% of the total
      number over this period; the proportion known to be hereditary is 44%, a higher
      proportion than has been reported elsewhere. By following up selected groups of
      cases, an estimate has been made of the proportions of siblings of retinoblastoma
      patients and offspring of survivors from retinoblastoma who are themselves
      affected with the disease. Where there is no previous family history, the risk
      for siblings of retinoblastoma patients of developing the disease is
      approximately 2% if the disease in the affected child is bilateral and 1% if it
      is unilateral, assuming that there are no other siblings; if there are unaffected
      siblings the risks for subsequent children are lower. Children of patients with
      hereditary retinoblastoma have a one in two chance of carrying the germ cell
      mutation and for those who are carriers the probability of developing
      retinoblastoma is very close to the accepted figure of 90% if the parents have
      bilateral retinoblastoma but probably less if they have the unilateral form. For
      children of patients not known to be carriers, the probability of developing
      retinoblastoma is estimated to be about 1%, considerably lower than the
      previously accepted figure of about 5%. Retinoblastoma kindreds consist mainly of
      bilateral cases but there is evidence that some kindreds have a high proportion
      of unilateral cases. The ways in which these findings may be used in conjunction
      with modern techniques of molecular biology for prenatal and postnatal genetic
      counselling are discussed.

PMID- 1637671
TI  - 'Macrophages' and their putative significance in human breast cancer.

PMID- 1637672
TI  - Serum methotrexate in childhood ALL.

PMID- 1637673
TI  - Autocrine stimulation of growth of AR4-2J rat pancreatic tumour cells by gastrin.
AB  - The control of cell proliferation by gastrin has been investigated in a rat
      pancreatic tumour cell line, AR4-2J. Exogenous gastrin, 10(-12) to 10(-8) M,
      stimulated cell growth of thymidine-synchronised AR4-2J cells cultured over 48 h
      in serum-free medium. Cell lysates of AR4-2J cells contained an average of 4.5
      and 3.5 pg gastrin per 10(6) cells, when grown in serum-supplemented or serum
      free media, respectively, as revealed by radioimmunoassay. In serum-free medium,
      AR4-2J secrete 34 ng 1(-1) 10(-6) cells of gastrin over 48 h. Addition of an anti
      gastrin immunoglobulin preparation, but not control immunoglobulins, caused a
      maximum 52% reduction in cell growth. These data are consistent with an autocrine
      role for gastrin in the control of AR4-2J cell growth. These results were
      supported by studies with gastrin/CCK receptor antagonists. Six non-peptide
      gastrin/CCK receptor antagonists inhibited AR4-2J cell growth in a concentration
      related manner. The concentration required for 50% inhibition (IC50) of cell
      growth by the amino acid-derived antagonists proglumide (3.5 x 10(-3) M),
      benzotript (1.8 x 10(-3) M), loxiglumide (1.1 x 10(-4) M) and lorglumide (6.7 x
      10(-5) M) were of the same order and significantly correlated with their IC50 for
      inhibition of 125I-gastrin binding to AR4-2J cells. Inhibition of cell growth by
      these antagonists was partially reversed by the addition of exogenous gastrin. In
      contrast, the IC50 for inhibition of cell growth with two benzodiazepine-derived
      antagonists, the CCK-B receptor antagonist L-365,260 (4.6 x 10(-5) M) and the CCK
      A receptor antagonist devazepide (1.7 x 10(-5) M) were two-three orders of
      magnitude greater than those required to inhibit gastrin binding (10(-8)-10(-7)
      M). The growth inhibitory effects of L-365,260 and devazepide were not reversed
      by exogenous gastrin suggesting these benzodiazepine-derived antagonists do not
      inhibit cell growth by interaction with gastrin receptors. The results are
      consistent with gastrin being an autocrine growth factor in AR4-2J cells, and
      that stimulation of cell growth is due to stimulation of the gastrin, rather than
      CCK-B, receptor sub-type. This study highlights that gastrin receptor antagonists
      warrant further investigation as agents to control growth of tumours, such as
      those from the gastrointestinal tract, which express gastrin receptors.

PMID- 1637674
TI  - DNA cell cycle distribution and glutathione (GSH) content according to circadian
      stage in bone marrow of cancer patients.
AB  - DNA cell cycle distribution and glutathione (GSH) content in bone marrow were
      measured both at daytime and midnight over single 24 h periods in 15 cancer
      patients. Between patients the S-phase demonstrated a difference from lowest to
      highest value of 700%, whereas the corresponding difference for the G2/M-phase
      was nearly 900%. The mean GSH content measured in the bone marrow at the two
      timepoints was 2.24 +/- 0.21 nmol mg-1 protein, range 0.91-4.19 nmol mg-1
      protein. A statistically significant higher fraction of cells in S-phase and G2/M
      phase was found at daytime as compared to midnight when excluding the four
      patients with an abnormal circadian variation in cortisol. No significant
      temporal variation in total bone marrow GSH content was found, although a weak
      correlation between S-phase and GSH content was demonstrated (r = 0.42; P less
      than 0.05). This correlation was strengthened when not including the six patients
      with an abnormal cortisol pattern (4) and bone marrow infiltration (2) (r = 0.66;
      P = 0.005). Cells in S-phase demonstrated a positive correlation with cells in
      G2/M-phase (r = 0.64; P less than 0.0001). A negative correlation was found
      between GSH content and age (r = 0.53; P less than 0.005). Finally, a
      statistically significant positive correlation was demonstrated between cortisol
      and both S-phase and G2/M-phase (r = 0.57; P less than 0.001 and r = 0.38; P less
      than 0.05, respectively). The present study suggests a possibility of optimising
      cancer therapy and use of hematopoietic growth factors by determining individual
      average values and circadian stage dependent variation in bone marrow DNA cell
      cycle distribution. Furthermore, GSH content in bone marrow may predict this
      tissue's sensitivity to cytotoxic agents.

PMID- 1637676
TI  - Ataxia telangiectasia genes and predisposition to leukaemia, lymphoma and breast
      cancer.

PMID- 1637675
TI  - Role of cholecystokinin in dietary fat-promoted azaserine-induced pancreatic
      carcinogenesis in rats.
AB  - The role of cholecystokinin in dietary fat-promoted pancreatic carcinogenesis was
      investigated in azaserine-treated rats, using lorglumide, a highly specific
      cholecystokinin-receptor antagonist. The animals were killed 8 months after the
      start of treatment. Cholecystokinin, but not dietary unsaturated fat, increased
      pancreatic weight. Rats treated with cholecystokinin developed more acidophilic
      atypical acinar cell nodules, adenomas and adenocarcinomas than control animals.
      Rats maintained on the high-fat diet developed significantly more adenomas and
      adenocarcinomas than controls given a diet low in unsaturated fat. Lorglumide
      largely inhibited the enhancing effect of cholecystokinin, but not of dietary
      fat, on pancreatic carcinogenesis indicating that it is unlikely that the
      promoting effect of dietary unsaturated fat on pancreatic carcinogenesis is
      mediated via cholecystokinin.

PMID- 1637677
TI  - Lipid metabolism in cancer cachexia.
AB  - The effect of cancer cachexia on the oxidative metabolism of lipids has been
      studied in mice transplanted either with the MAC16 adenocarcinoma, which induces
      profound loss of body weight and depletion of lipid stores, or the MAC13
      adenocarcinoma, which is the same histological type, but which grows without an
      effect on host body weight or lipid stores. While oxidation of D-[U-14C]glucose
      did not differ between animals bearing tumours of either type and non-tumour
      bearing controls, oxidation of [1-14C]triolein administered by intragastric
      intubation was significantly (P less than 0.05) higher in animals bearing the
      MAC16 tumour than in either non tumour-bearing controls or in animals bearing the
      MAC13 tumour. Intestinal absorption of [14C]lipid was significantly (P less than
      0.05) reduced in animals bearing the MAC13 tumour when compared with either non
      tumour-bearing animals or MAC16 tumour-bearing animals, but was not significantly
      different in the latter two groups. The level of labelled lipids in heart and
      adipose tissue after an oral [14C]lipid load was significantly lower in animals
      bearing the MAC16 tumour compared with the other two groups. The level of tumour
      lipids was also higher in the MAC16 than in the MAC13 tumour after both an oral
      [14C]lipid load or by direct injection of [U-14C]palmitate complexed to albumin
      into epididymal fat pads. Oxidation of [U-14C]palmitate was also significantly
      enhanced in liver and heart homogenates from animals bearing the MAC16 tumour.
      These results suggest that in cachectic tumour-bearing animals mobilisation of
      body lipids is accompanied by an increased utilisation.

PMID- 1637678
TI  - Reversal of multidrug resistance by surfactants.
AB  - Cremophor EL, a pharmacologically inactive solubilising agent, has been shown to
      reverse multidrug resistance (MDR). Using flow cytometric evaluation of
      equilibrium intracellular levels of daunorubicin (DNR), we found that eight other
      surface active agents will also reverse MDR. All the active detergents contain
      polyethoxylated moieties but have no similarities in their hydrophobic
      components. The properties of three polyethoxylated surfactants that showed the
      lowest toxicities, Cremophor, Tween 80 and Solutol HS15, were examined in more
      detail. The concentrations of Tween 80 and Solutol required to reverse DNR
      exclusion were 10-fold lower than for Cremophor. However while concentrations
      greater than or equal to 1:10(2) of the former two surfactants resulted in
      breakdown of cells, even 1:10 of Cremophor did not lyse cells. Studies of the
      effects of Cremophor on the uptake and efflux of DNR in normal and MDR cell types
      showed that Cremophor increases intracellular DNR primarily by locking the rapid
      efflux from the cells. This blockage of drug efflux may be mediated by a
      substantial alteration in the fluidity of cell membranes induced by Cremophor, as
      shown by decreased fluorescence anisotropy of a membrane probe. Consistent with
      these data, coinjection of adriamycin plus Cremophor into mice carrying a
      multidrug resistant P388 transplantable tumour significantly increased the
      survival time of the mice compared with adriamycin treatment alone.

PMID- 1637679
TI  - In vitro interaction of lithotripter shock waves and cytotoxic drugs.
AB  - The effect of a combination of lithotripter shock waves and cytotoxic drugs was
      examined in vitro. L1210 cells in suspension were exposed to shock waves during
      incubation with cislatin, doxorubicin, daunorubicin, THP-doxorubicin, or
      aclacinomycin. Proliferation was determined using the 3-4,5 dimethylthiazol-2,5
      diphenyl tetrazolium bromide assay. Dose enhancement ratios were calculated for
      each drug in order to determine the effect of the additional exposure to shock
      waves. In addition, partition coefficients and IC50s of the drugs were
      determined. It was found, that the dose enhancement ratios increased for the
      drugs with decreasing cytotoxicity. The effect of all five drugs was enhanced by
      shock waves to a higher degree at 7 min incubation as compared to 50 min
      incubation. The effect of cisplatin was most significantly enhanced, with a dose
      enhancement ratio of 6.7 at 7 min incubation. The enhancement increased with the
      operating voltage used for generating the shock waves, and was only present when
      cells were exposed to shock waves during the incubation with the drug. An
      increase in cellular membrane permeability is proposed as the mechanism of
      interaction between shock waves and drugs.

PMID- 1637680
TI  - In vivo measurement of the association constant of a radio-labelled monoclonal
      antibody in experimental immunotargeting.
AB  - Exploring the fundamental mechanisms behind the low tumour uptake of labelled
      monoclonal antibodies (MoAbs) during in vivo immunotargeting, experiments were
      performed to estimate the in vivo value of the association constant (Ka) in an
      experimental targeting reaction. An artificial tumour model was utilised, based
      on diffusion chambers (DC) filled with antigen-coated polymer particles,
      implanted i.p. in normal, immunocompetent mice (NMRI/BOM). The MoAb H7 with
      specificity for placental alkaline phosphatase (PLALP) was chosen for this
      experiment. Each mouse carried two DC, one target DC filled with PLALP-coated
      particles, and a second control DC with the same amount of uncoated particles.
      The DC contained escalating doses of particles, ranging from 0.1 mg to 16 mg per
      DC, with groups of 6-12 animals per dose level. The next day after the
      implantation, a constant dose of 125I-labelled Fab fragments of H7 was injected
      i.v. in each mouse. The association constant Ka as measured from the binding data
      obtained in vivo was not significantly different from the value measured in vitro
      when the same target DC were incubated with the 125I-Fab in test tubes. This
      indicates that in vivo impairment of the antibody avidity is not the reason why a
      relatively low tumour uptake is generally experienced in immunotargeting studies.

PMID- 1637681
TI  - Normal human breast xenografts activate N-nitrosodimethylamine: identification of
      potential target cells for an environmental nitrosamine.
AB  - Normal human breast tissue maintained as xenografts in female Balb/c (nu/nu)
      athymic mice is capable of metabolising N-nitrosodimethylamine (NDMA) to active
      intermediates that will react with DNA. Administration of NDMA to mice with slow
      release implants of 17 beta-oestradiol which provide human physiological (luteal
      phase) circulating oestrogen levels and increase cell proliferation in the
      xenograft (Laidlaw et al., 1992), leads to an apparent increase in the extent of
      reaction with DNA compared to controls without oestrogen implants. In mice with
      oestrogen implants, measurements of the amounts of the promutagenic lesion, O6
      methyl-2'-deoxyguanosine formed in DNA clearly indicated a dose related increase
      in the extent of reaction. Detection of O6-methyl-2'-deoxyguanosine using
      immunohistochemical procedures revealed that the nuclei of cells of the glandular
      epithelium, supportive tissue and adipose tissue, in decreasing order of
      prevalence, were positively stained for the presence of this DNA lesion.
      Epithelial cells, which are the putative target cells for carcinogenesis in the
      breast, are therefore prone to promutagenic damage as a result of exposure to an
      environmental nitrosamine.

PMID- 1637683
TI  - Relationship of myc protein expression to the phenotype and to the growth
      potential of HOC-7 ovarian cancer cells.
AB  - In this investigation we demonstrate expression of myc oncoproteins in HOC-7
      ovarian adenocarcinoma cells. The cells were exposed to differentiation inducing
      agents such as dimethyl sulfoxide (DMSO), N,N-dimethylformamide (DMF), retinoic
      acid (RA) and transforming growth factor-beta 1 (TGF-beta 1). Myc protein
      expression in treated cells was then compared with that in control cultures and
      in monoclonal HOC-7 sublines, which are characterised by distinct phenotypes.
      Cells exposed to DMSO and DMF became markedly enlarged and flattened and
      developed cytoplasmic extensions. They looked similar to a subline, which
      revealed a less malignant and more differentiated cell phenotype. All four
      inducers prolonged the cell doubling time and reduced the saturation density to
      levels, normally found in the more differentiated subline. Furthermore, all
      inducers except RA elevated extracellular fibronectin, which is characteristic
      for less malignant epithelial cell phenotypes. All four agents inhibited myc
      oncoprotein expression reversibly (1% DMSO greater than 0.5% DMF greater than 10
      microM RA greater than 10 ng ml-1 TGF-beta 1) and in time-dependent manner. Down
      regulation of myc protein expression is, therefore, closely related to inducer
      dependent growth reduction of HOC-7 cells and to the development of a less
      malignant cell phenotype.

PMID- 1637682
TI  - Effect of epidermal growth factor in HLA class I and class II transcription and
      protein expression in human breast adenocarcinoma cell lines.
AB  - The spontaneous expression of HLA class I and class II molecules in two human
      breast carcinoma cell lines (MCF7, T47D) and their modulation during epidermal
      growth factor treatment are reported. Transcription was analysed by Northern blot
      and hybridisation with HLA class II and class I cDNA specific probes. The
      expression of cell surface determinants was examined by internal protein
      labelling with 35s-methionine, immunoprecipitation with monoclonal antibodies
      specific for HLA class I or class II, followed by isolation of the immune complex
      on protein A-Sepharose; at least a quantification of glycoprotein was performed
      by chromatofocusing. Glycoprotein quantification showed a significant increase of
      HLA class I and class II (DR) antigen expression after stimulation by epidermal
      growth factor (0.02 microgram ml-1) in the two cell lines, when compared with
      untreated cell controls. However, with epidermal growth factor treatment of MCF7
      and T47D cells, low increases in the amounts of HLA class I and class II RNA were
      obtained. These differences between expressed antigens and correspondent RNA
      amounts would be explained by the fact that EGF in these two cell lines acts more
      in post-transcription for HLA class I and class II antigens.

PMID- 1637684
TI  - Early and late changes in the normal mouse bladder reservoir function due to
      irradiation and cis-DDP.
AB  - Early and late changes in the reservoir function of the mouse bladder were
      investigated after radiation alone or a combination of radiation and cisplatinum
      (cis-DDP). Bladder function was investigated by repeated cystometries. Treatments
      consisted of either single fraction radiation (5-10-15-25-30 Gy) or 20 Gy in
      combination with cis-DDP (6 mg kg-1; i.p.) administered at various time intervals
      from 14 days before until 14 days after radiation. At two selected time intervals
      (15 min and 4 h before) radiation was given at different dose levels (5-10-15-20
      Gy). Within 30 days after irradiation a dose-dependent early response was noticed
      both in the radiation alone group and the group where cis-DDP was administered 15
      min before radiation. The dose-response curve showed a slight but non-significant
      shift to the left in the combined treatment group (dose effect factor (DEF) =
      1.18). Investigation of the early change in bladder reservoir function in the
      animals treated with 20 Gy alone or a combination of 20 Gy plus cis-DDP at
      various intervals in relation to irradiation demonstrated a significant increase
      in response when cis-DDP was administered 24 h and 15 min before and 4 h, 72 h
      and 336 h after 20 Gy (P less than 0.05). The reversible nature of the early
      damage was demonstrated. Late response was irreversible and significantly
      increased in most groups were cis-DDP was administered from 168 h before until 72
      h after compared to radiation alone. Comparing groups treated with radiation
      alone with groups where cis-DDP was administered 15 min and 4 h before radiation
      revealed DEF values up to 1.45 (P less than 0.05), reflecting the significantly
      larger response in combined treatment groups. Survival was significantly
      decreased in all combined treatment groups compared to groups treated with
      radiation only and likewise survival was decreased in the group treated by cis
      DDP alone compared to control (no treatment at all).

PMID- 1637685
TI  - Relations with parents and school and Chinese adolescents' self-concept,
      delinquency, and academic performance.
AB  - Current research and theory have suggested that the relational domains of family
      and school experiences are important to children's development. The present study
      thus examined how relations with parents and school were related to Chinese
      students' psychosocial and cognitive development in self-concept, delinquency,
      and academic performance. A total of 1668 secondary school students were studied,
      and results showed that better relation with parents was associated with higher
      general, academic, appearance, social, and physical ability self-concepts. Better
      relation with school was associated with higher academic performance, as shown in
      higher class rank, higher grand total exam scores, and higher scores in Chinese,
      English, mathematics, physical education, and music. Both poorer relations with
      parents and school were found to associate with more self-reported delinquency as
      well as more school records of misconduct.

PMID- 1637686
TI  - Shyness and education: the relationship between shyness, social class and
      personality variables in adolescents.
AB  - The study considers the relationship between shyness, some related personality
      variables and socio-economic status. Adolescent shyness levels are examined using
      two self-report questionnaires which cover the spectrum of inherent, emotional
      and situational shyness. These findings were correlated with individual levels of
      anxiety, neuroticism and also with socio-economic status. The educational
      implications of these results are discussed and the problem of the definition of
      shyness is addressed. The sample comprised 650 adolescents in the age range 11-18
      years, drawn at random from two secondary schools, the number of boys being 300
      and the number of girls 350. The results indicate that high levels of both
      situational and inherent shyness are related significantly to high levels of
      anxiety and neuroticism. Inherent shyness and situational shyness correlate only
      moderately with one another. Low levels of situational and inherent shyness are
      related positively and significantly to high levels of self-esteem and
      extraversion. Similar patterns of relationships occur for the other variables
      considered. The stability coefficients of correlations for each type of shyness
      were high after an interval of six months. Furthermore, shyness is related
      significantly to the socio-economic class of adolescents: a relatively higher
      percentage of shyness occurs among adolescents of lower socio-economic class.

PMID- 1637687
TI  - Sun protection with hats.
AB  - The degree of sun protection provided by various styles of hat at different
      anatomical sites on the head was measured using model headforms and ultraviolet
      sensitive film badges. It was found that hats with a small brim, such as the flat
      cap favoured by elderly male photosensitive patients, provided negligible
      protection at all sites apart from the vertex and forehead. Peaked baseball-style
      caps offer good protection to the nose but are relatively ineffective at other
      sites on the face. Hats with a wide (greater than 7.5 cm) brim are necessary in
      order to provide reasonable protection factors (greater than 3) around the nose
      and cheeks.

PMID- 1637689
TI  - Smoking habits in psoriasis: a case control study.
AB  - We have examined smoking habits in 108 patients with psoriasis, including some
      with palmoplantar distribution, and compared the results with matched controls
      from the community. There was a significant association between psoriasis,
      current smoking status (OR = 2.7, 95% CI 1.44-5.42, P less than 0.01) and smoking
      habits prior to the onset of disease (OR = 3.75, 95% CI 1.68-9.47, P less than
      0.001). There was also a marked dose-response relationship; the relative risk of
      psoriasis in those currently smoking more than 20 cigarettes/day was
      significantly elevated (OR = 5.3, 95% CI 2.1-13.0, P less than 0.001). Separate
      analysis of patients without palmoplantar distribution of psoriasis showed a
      significant association with smoking prior to onset of psoriasis (OR = 3.6, 95%
      CI 1.5-9.8, P less than 0.001). Smoking may play a role in the aetiology of this
      common skin disorder.

PMID- 1637688
TI  - Psoriasis: an audit of patients' views on the disease and its treatment.
AB  - This audit aimed to establish the effect of out-patient clinic attendance on
      patients' attitudes to their psoriasis, its severity and its treatment. A
      secondary aim was to determine if there was any correlation between the patients
      subjective concept of disease severity and objective medical assessment. The
      audit was carried out by means of paired questionnaires completed by patients at
      their first visit to the out-patient clinic and at a review visit 3 months later.
      On each of these occasions an objective assessment of psoriasis severity score
      was made by the dermatologist. We were able to confirm previous reports of major
      psychosocial effects of psoriasis on the life-style of many patients. At their
      first visit 67% (30/45) of patients stated that their life-style was affected by
      psoriasis, while at review 3 months later this figure was 40% (18/45). Overall
      76% (34/45) of patients felt their psoriasis had improved following attendance at
      the clinic, while 11% (5/45) of patients felt it had deteriorated over the 3
      month period. However, all patients stated they found attendance at the out
      patient clinic to be of benefit. There was a significant correlation between the
      psoriasis severity score by the patient and by the dermatologist (P less than
      0.001).

PMID- 1637690
TI  - Basal cell carcinoma in young adults.
AB  - The epidemiology and outcome of basal cell carcinoma (BCC) in adults aged 15-34
      years were examined. Northern Region Cancer Registry data from 1979 to 1989
      revealed a crude annual incidence of 37/100,000 total population and the
      incidence was constant in all age-groups during this period; 150 patients (1.2%)
      were aged 15-34 years. There was a small excess of females in the young age
      group. The outcome of BCC in young adults was determined using records of all
      patients registered over 5 years ago and additional information from family
      doctors where required. Patients with BCC in naevus sebaceous or with syndromes
      of which BCCs are a feature were excluded. Median duration of BCC pre-diagnosis
      was 3 years. Of 39 patients with completed 5-year follow-up data, 21% had either
      incomplete excision requiring further early treatment (n = 4), a later local
      recurrence (n = 2), metastatic BCC (n = 1) or a subsequent further primary tumour
      (n = 1); an additional three patients had two primary tumours at initial
      presentation. Median hospital follow-up was 12 months but the apparent disease
      free interval in patients with recurrent or new BCC was frequently over 2 years.
      BCC in young adults may not be suspected because it is uncommon. However, the
      high frequency of local recurrence and of multiple primary tumours indicates that
      careful follow-up is prudent in young patients with this tumour.

PMID- 1637691
TI  - Schopf-Schulz-Passarge syndrome.
AB  - Three siblings, the children of a marriage between first cousins, are reported
      with the characteristic ophthalmological and cutaneous changes of the Schopf
      Schulz-Passarge syndrome. There have been only eight reported cases of this
      disorder, and it has not previously been described in Great Britain.

PMID- 1637692
TI  - Sweet's syndrome responding to cyclosporin.
AB  - We report a case of Sweet's syndrome which responded to treatment with
      cyclosporin 4 mg/kg/day. Cyclosporin is effective in the treatment of many
      dermatoses, and although the immunosuppressive effects of cyclosporin are mainly
      attributed to inhibition of T-lymphocyte proliferation, it has also been shown to
      affect the functions of both neutrophils and monocytes. Possible mechanisms of
      action of cyclosporin in Sweet's syndrome are discussed.

PMID- 1637693
TI  - Successful treatment of steatocystoma multiplex by simple surgery.
AB  - Steatocystoma multiplex is usually a minor cosmetic problem but rarely can be
      extremely disfiguring. Unfortunately, the very patients who would benefit most
      from treatment are usually regarded as having too may cysts for surgery. We
      report a case of extensive steatocystoma multiplex which was treated by a simple
      surgical technique under general anaesthetic.

PMID- 1637694
TI  - Minimizing the risk of post-operative pyoderma gangrenosum.
AB  - A 61-year-old woman with seropositive rheumatoid arthritis developed numerous
      ulcers due to pyoderma gangrenosum at suture entry/exit sites following an
      arthroplasty of the right hip when interrupted silk sutures were used to close
      the skin. When a subsequent arthroplasty was performed on the left hip and
      subcuticular Dexon sutures were used to close the skin only two small ulcers
      developed. Sixteen cases of pyoderma gangrenosum developing in surgical wounds
      have previously been reported. We recommend that surgery in patients with a
      history of pyoderma gangrenosum is performed when the pyoderma is clinically
      quiescent, and that subcuticular sutures are used for skin closure, thus avoiding
      puncturing the skin surface.

PMID- 1637695
TI  - Systemic and cutaneous plasmacytosis with multiple skin lesions and polyclonal
      hypergammaglobulinaemia: significant serum interleukin-6 levels.
AB  - We report two patients who developed benign plasmacytosis with multiple skin
      lesions. The cases were characterized by hyperplasia of mature plasma cells, and
      polyclonal hypergammaglobulinaemia. One patient had hyperplasia of mature plasma
      cells not only in the skin, but also extensively in lymph nodes and the
      retroperitoneal areas around the ureters. The other had plasma cell hyperplasia
      limited to the skin. Extensive investigations failed to reveal any clinical or
      laboratory evidence suggesting the presence of any underlying disease
      accompanying the hypergammaglobulinaemia and/or plasma cell proliferation, such
      as chronic infectious disease, collagen disease or other chronic inflammatory
      disorder. Clinically and histologically, the first patient showed features
      compatible with a diagnosis of systemic plasmacytosis and the second with a
      diagnosis of cutaneous plasmacytosis. Significant serum interleukin-6 (IL-6)
      levels were detected in both patients, suggesting that IL-6 may be involved in
      the pathogenesis of these conditions.

PMID- 1637696
TI  - A comparison of the efficacy and relapse rates of narrowband UVB (TL-01)
      monotherapy vs. etretinate (re-TL-01) vs. etretinate-PUVA (re-PUVA) in the
      treatment of psoriasis patients.
AB  - Forty-five patients with extensive chronic plaque or guttate psoriasis were
      treated with either narrowband (TL-01) phototherapy, etretinate TL-01 combination
      therapy (re-TL-01) or etretinate and PUVA (re-PUVA) (15 patients in each group).
      Re-PUVA was the most effective therapy with 100% satisfactory clearance rate. TL
      01 monotherapy had an 80% success rate; the relapse rate compared favourably with
      re-PUVA (50% in remission after 6 months). In the etretinate-TL-01 group, there
      was a 93% success rate and a one-third reduction in the total irradiation dose
      (8.0 J/cm2 vs. 12.7 J/cm2) but the relapse rate was higher, only 33% remaining in
      remission after 6 months.

PMID- 1637697
TI  - Mycosis fungoides with a widespread follicular eruption, comedones and cysts.

PMID- 1637698
TI  - Familial occurrence of crusted (Norwegian) scabies with adult T-cell leukaemia.

PMID- 1637699
TI  - Successful interleukin-2 therapy of advanced cutaneous T-cell lymphoma.

PMID- 1637700
TI  - Capillary leak syndrome in generalized pustular psoriasis.

PMID- 1637701
TI  - Successful treatment of ulcerating livedo reticularis with infusions of
      prostacyclin.

PMID- 1637702
TI  - Allergic contact dermatitis to calcipotriol.

PMID- 1637704
TI  - 72nd annual meeting of the British Association of Dermatologists. Bournemouth, 1
      4 July 1992. Abstract.

PMID- 1637703
TI  - Severe lichen planus clears with very low-dose cyclosporin.

PMID- 1637705
TI  - Dust exposure and pneumoconiosis in a South African pottery. 1. Study objectives
      and dust exposure.
AB  - Dust exposure and pneumoconiosis were investigated in a South African pottery
      that manufactured wall tiles and bathroom fittings. This paper describes the
      objectives of the investigation and presents dust measurement data. x Ray
      diffraction showed that the clays used by the pottery had a high quartz content
      (range 58%-23%, mean 38%). Exposure to respirable dust was measured for 43
      workers and was highest (6.6 mg/m3) in a bathroom fitting fettler. Quartz
      concentrations in excess of 0.1 mg/m3 were found in all sections of the
      manufacturing process from slip production to biscuit firing and sorting. The
      proportion of quartz in the respirable dust of these sections was 24% to 33%.
      This is higher than is usually reported in English potteries. Four hundred and
      six (80%) of the 509 workers employed at the pottery were potentially at risk of
      occupational lung disease. The finding of large numbers of pottery workers
      exposed to unacceptable dust concentrations is not surprising as poor dust
      control was found in all six wall tile and sanitary ware factories surveyed by
      the National Centre for Occupational Health between 1973 and 1989. Dust related
      occupational disease can be expected in potters for many years to come.

PMID- 1637706
TI  - Dust exposure and pneumoconiosis in a South African pottery. 2. Pneumoconiosis
      and factors influencing reading of radiological opacities.
AB  - A cross sectional radiological survey of workers exposed to pottery dust during
      the manufacture of wall tiles and bathroom fittings was conducted in a South
      African factory. Roughly one third of workers with 15 or more years of service in
      high dust sections of the factory had pneumoconiosis. Previously undiagnosed
      advanced cases, including two with progressive massive fibrosis, were working in
      dusty occupations. A firm diagnosis of potters' pneumoconiosis was made in 11 of
      the 358 workers radiographed; all had served more than 10 years suggesting that
      radiography of workers with more than 10 years service would be a successful case
      finding strategy in South Africa. A combination of rounded and irregular
      opacities was the most common radiological finding in the workers with
      pneumoconiosis (55%). Three readers reported on the chest radiographs, and all
      found an association between small radiological opacities, which were usually
      irregular or a combination of irregular and rounded, and exposure to pottery
      dust. The occurrence of irregular radiological opacities in workers exposed to
      pottery dust deserves further study. The least experienced reader significantly
      associated age with small opacities when duration of service (years) was used to
      measure exposure to dust. Sex was not an important predictor of radiological
      changes consistent with pneumoconiosis. Breast shadows were not an important
      cause of false positive readings and participating women did not develop
      pneumoconiosis after less exposure than men.

PMID- 1637707
TI  - Fibres and asbestos bodies in bronchoalveolar lavage fluids of asbestos sprayers.
AB  - The alveolar content of fibres and asbestos bodies was assessed by
      bronchoalveolar lavage (BAL) in 21 asbestos sprayers. Transmission and scanning
      electron microscopy (TEM and SEM) and two light microscopical (LM) methods,
      cytocentrifugation, and Millipore filtration were used. The subjects had been
      exposed mainly to crocidolite asbestos for an average of 2.8 (range 0.2-13) years
      in 1950-75. The mean (median) total fibre count (of asbestos bodies and uncoated
      fibres) per ml of BAL fluid was 5500 (2800) by TEM and 2900 (1000) by SEM. The
      mean (median) count of asbestos bodies per ml with LM was 810 (500) with
      cytocentrifugation and 750 (480) with Millipore filtration, 840 (320) by TEM, and
      1750 (420) by SEM. The mean proportion of coated fibres was 35% by TEM and 45% by
      SEM. The mean length of the coated fibres was 22 (range 4-65) microns by TEM and
      34 (range 4.5-170) microns by SEM. The total fibre count exceeded 1000 fibres per
      ml in 70% of the cases by TEM. Asbestos body counts exceeded 1 per ml in 95% of
      the cases by LM. The fibre counts by SEM were in good accordance with counts by
      TEM except in a few cases in which the TEM result was considerably higher. In
      these cases the proportion of coated fibres was also low. All four counting
      methods appeared to give consistent results in heavily exposed cases when fibre
      load in the lungs was high. The counting of asbestos bodies may, however,
      underestimate the total alveolar fibre load in some cases.

PMID- 1637708
TI  - Pulmonary impairment in workers exposed to silicon carbide.
AB  - Two hundred and sixty seven workers employed in the manufacture of silicon
      carbide (SiC) were examined to determine the effects of exposure to contaminants
      (SiC, quartz, and SO2) in the workplace on pulmonary function. No exposure
      concentrations exceeded the current permissible limits. Ten subjects (3.7%)
      showed rounded opacities (profusion greater than or equal to 1/0). Two subjects
      employed only in the final stages of the production process and not exposed to
      crystalline silica showed opacities (profusion q1/0 and q2/1) on x ray film
      suggesting a role of SiC in the genesis of interstitial lung disease. Chest
      abnormalities on x ray film were correlated with cumulative exposure to dust and
      pulmonary function was affected by cumulative dust exposure, profusion of
      opacities, and smoking. It is concluded that the current standards do not provide
      adequate protection against pneumoconiosis and chronic pulmonary disease in this
      industry.

PMID- 1637709
TI  - The aetiology of experimental fibrosing alveobronchiolitis induced in rats by
      paprika dust.
AB  - The effect of a single intratracheal dose of respirable paprika (Hungarian) dust,
      paprika dust extract, and cellulose dust on the lungs of rats was examined
      sequentially one and three months after a treatment. Treatment with respirable
      paprika and cellulose dusts resulted in alveobronchiolitis at the end of the
      first month and fibrotic changes at the end of the third month. As the extract of
      paprika dust caused no histopathological alterations, it is assumed that the high
      cellulose content of paprika was responsible for the histological reactions.

PMID- 1637710
TI  - Recent trends in bagassosis in Japan.
AB  - The only workers presently exposed to bagasse dust in Japan are the employees of
      sugar refineries and lacquerware factories. A follow up study of six former cases
      of bagassosis from among the retired employees of a paper board factory, closed
      since 1973, showed that none of the subjects still had bagassosis. Examinations
      of 70 employees of a sugar refinery for allergic reactions also showed no case of
      bagassosis. Seven cases with suspicious shadows of bagassosis on chest
      radiographs and four cases with positive serum precipitin to stored bagasse were,
      however, found among those 70 subjects. The results show the disappearance of a
      past episode of bagassosis and the possibility of a new occurrence of bagassosis
      among the employees of sugar refineries and lacquerware factories in the near
      future in Japan.

PMID- 1637711
TI  - Spontaneous abortion and work with visual display units.
AB  - OBJECTIVE: To determine whether women who work with visual display units are at
      increased risk of spontaneous abortion. DESIGN: Case-control study. SETTING:
      Women were recruited during the three years 1987-9 from the Royal Berkshire
      Hospital in Reading, and from a large group practice situated within the
      hospital's catchment area. SUBJECTS: Cases were 150 nulliparous working women
      with a clinically diagnosed spontaneous abortion and controls were 297
      nulliparous working women attending for antenatal care. MAIN OUTCOME MEASURES:
      Cases and controls were contacted and personally interviewed using the same
      structured questionnaire. Exposure to visual display units (VDUs) at work was
      assessed from information supplied at interview. RESULTS: No evidence of an
      increased risk of spontaneous abortion was found in women who reported that they
      used a VDU at work compared with women who reported that they did not (odds ratio
      (OR) = 0.9, 95% confidence interval (95% CI) = 0.6-1.4); and no relation with the
      amount of time spent actively using a VDU was evident (OR = 0.9, 95% CI = 0.5-1.6
      for women who worked with a VDU for 21 hours or more each week). No effect of
      passive exposure to VDUs at work was found (OR = 0.9, 95% CI = 0.6-1.6 for women
      who reported working less than 10 feet away from a VDU that was usually switched
      on). These findings were not explained by maternal age, marital state, housing
      tenure, partner's social class, educational level, smoking, alcohol consumption,
      or number of previous spontaneous abortions. CONCLUSION: Given the findings and
      their consistency with the results from other recent studies it is concluded that
      pregnant women who work with VDUs are not at increased risk of clinically
      diagnosed spontaneous abortion. For the many women who use VDUs in their jobs,
      this finding provides reassurance.

PMID- 1637712
TI  - Control of diabetes mellitus in shift workers.
AB  - OBJECTIVE: To determine whether the control of diabetes is different in insulin
      treated diabetic subjects who work shifts compared with those who do not work
      shifts and whether control is related to the type of shift worked. DESIGN:
      Prospective controlled study of 32 diabetic subjects working either regular days
      or shifts in a large car assembly factory. Insulin treated subjects who underwent
      a change in their pattern of shift work had diabetic control assessed before and
      six months after a change in shifts. MAIN OUTCOME MEASURES: Random plasma
      glucose, serum fructosamine, and haemoglobin A1 while at work. RESULTS: Diabetic
      control of insulin treated subjects who worked shifts was not significantly
      different from insulin treated subjects who worked days only. Diabetic control
      was poor in both groups and similar to that of diabetic subjects treated with
      oral hypoglycaemic agents. In those subjects that moved to a more rapidly
      rotating shift pattern there was a significant deterioration in control (serum
      fructosamine concentration before, 405 (SD 68); after, 481 (SD 90) mumol/l, p
      less than 0.01). CONCLUSIONS: The control of diabetes in insulin treated diabetic
      subjects who worked shifts was no worse than those who worked days only. Slowly
      rotating shifts were associated with better diabetic control than more rapidly
      rotating shifts.

PMID- 1637713
TI  - A prospective study of morbidity patterns in a petroleum refinery and chemical
      plant.
AB  - This study examined the morbidity experience from 1981 to 1988 of a prospective
      cohort of 3422 refinery and petrochemical plant employees from the Shell Deer
      Park manufacturing complex. The morbidity data for this study, which include all
      illness and absence records in excess of five days, were extracted from the
      morbidity section of the Shell health surveillance system. Standardised morbidity
      ratios (SMRs) of disease prevalence in this cohort were calculated using an
      internal comparison group of all manufacturing employees of the Shell Oil
      Company. Among production employees, the overall morbidity was statistically
      significantly higher (SMR = 109) than that of the comparison group. Illness due
      to hypertension (SMR = 144), haemorrhoids (SMR = 149), diseases of the nervous
      system (SMR = 120), respiratory system (SMR = 108), and digestive system (SMR =
      117) were also raised for this group. The increased risk due to these medical
      conditions does not appear to be associated with occupational factors. Lymphatic
      and haematopoietic tissue neoplasms were raised (SMR = 124), but were based on
      only four cases.

PMID- 1637715
TI  - A cautionary note on the use of the correlation coefficient.

PMID- 1637714
TI  - Persistent asthma after accidental exposure to ethylene oxide.

PMID- 1637716
TI  - Polychlorinated biphenyls: estimated serum half lives.

PMID- 1637717
TI  - Two-level analysis of covariance structures for unbalanced designs with small
      level-one samples.
AB  - The main purpose of this paper is to develop basic statistical theory for two
      level analysis of covariance structures. Major asymptotic results for statistical
      inference, such as the asymptotic distributions of the estimator and the goodness
      of-fit test statistic are derived, based on an unbalanced design with only small
      numbers of level-one units. Computationally, it is shown that the solution can be
      obtained via standard programs, such as LISREL, EQS and COSAN. The behaviour of
      the estimates is illustrated by an artificial example and a real-life example.
      Some possibilities of extending the results to a more general two-level model,
      and to situations with arbitrary distributions and elliptical distributions are
      also investigated.

PMID- 1637718
TI  - Bayesian analysis of stochastic constraints in structural equation models.
AB  - Structural equation models are analysed in the presence of stochastic
      constraints. Based on a Bayesian perspective, a prior distribution on nuisance
      parameters in the unknown covariance matrix of error measurements with stochastic
      constraints is considered. An iterative procedure is implemented to produce the
      various Bayesian estimates with stochastic constraints. A simulation study is
      conducted to illustrate the accuracy and behaviour of this Bayesian approach. A
      real-life example is provided to illustrate the theory.

PMID- 1637719
TI  - The genomic organization and DNA sequence of the mouse vas deferens androgen
      regulated protein gene.
AB  - The gene for mouse vas deferens protein (MVDP) is expressed, under androgenic
      control, exclusively in the epithelial cells of the deferent duct. As a first
      step in correlating cell-specific and hormonal regulations with the structure of
      the gene, the complete sequence of the MVDP gene (11 kb) and 0.5 kb of the 5'
      flanking region have been determined. The size range for the 10 exons is 78 to
      168 bp, whereas that of introns is 292 to 2833 bp. A major site of transcription
      is located on an A residue 46 nucleotides upstream from the A of the ATG
      initiation codon. A TATA (CATAA) box, a CAAT box, a GC-rich motif and a (5'
      TGTTCT-3') element that closely resembles the consensus sequence of the androgen
      response elements are present in the 5' flanking region of the MVDP gene.

PMID- 1637720
TI  - Loss of androgen dependency with preservation of functional androgen receptors in
      androgen-dependent mouse tumor (Shionogi Carcinoma 115).
AB  - Shionogi Carcinoma 115 (SC 115) is an androgen-dependent mouse tumor. Chiba
      Subline 2 (CS 2) is an androgen-independent subline derived from SC 115. CS 2
      contains androgen receptors (AR), but is refractory to androgen and does not
      exhibit androgen-related responses which are observed in SC 115. In the present
      study the structure and function of AR in SC 115 and CS 2 are examined using
      cloned cells. There were no gross rearrangements or deletions in the AR genes of
      these cell lines when compared by Southern blot analysis with the AR gene in the
      mouse seminal vesicle. SC 115 and CS 2 expressed AR mRNA of normal size. When the
      cDNA containing DNA- and androgen-binding domains of the AR genes of both cell
      lines were amplified by polymerase chain reaction, no mutations were found in
      these regions. SC 115 and CS 2 were transfected with a plasmid containing a long
      terminal repeat of mouse mammary tumor virus linked to the chloramphenicol
      acetyltransferase (CAT) gene. Androgen stimulation of these transfectants
      resulted in equal elevation of CAT activity. These results indicated that the
      androgen-independent CS 2 contained functionally normal AR which were identical
      to those in the androgen-dependent parent tumor.

PMID- 1637721
TI  - Changes in the expression of cytochrome P450c17 associated with ovarian cystic
      follicles. An immunocytochemical and enzymatic analysis of porcine ovaries.
AB  - The steroidogenic activity of normal preovulatory and cystic follicles, and
      corpora lutea of porcine ovaries was investigated by immunocytochemical and
      radioenzymatic techniques. Using a specific antibody to porcine cytochrome
      P450c17, immunocytochemical staining was specifically localized in the theca
      interna layer of normal follicles and undetectable in the granulosa layer. The
      theca interna layers of non-luteinized cystic follicles were immunoreactive while
      those of luteinized follicles were not. Corpora lutea cells were essentially
      negative. The 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4 isomerase
      activity was similar in luteinized cystic follicular and corpora lutea tissues,
      which had 8 times higher activity than found in normal preovulatory follicles.
      The formation of either corpora lutea or luteinized cysts led to a profound
      decline (12- to 15-fold) in 17 alpha-hydroxylase and 17,20 lyase activities
      compared to normal preovulatory follicles. In agreement with these enzyme
      findings, radioimmunoassays revealed very high levels of progesterone with nearly
      undetectable levels of androgens in the luteinized cysts. These studies
      demonstrate the functional similarities between cells of luteinized cysts and
      those of normal corpora lutea and suggest a pathology associated suppression of
      P450c17 expression in porcine cystic follicles.

PMID- 1637722
TI  - The ontogeny and cellular distribution of estrogen receptors in normal mouse
      mammary gland.
AB  - The appearance, epithelial and stromal cell distribution of estrogen receptors
      (ER) in normal mouse mammary gland were determined between 1 and 10 weeks of age
      using immunohistochemistry. The effect of ovariectomy and estrogen (E)-treatment
      on the distribution and concentration of ER-positive cells at various ages was
      also analyzed. These studies demonstrate that ER are present in both mammary
      epithelial and stromal cells before the mammary gland exhibits a proliferative
      response or increase in progesterone receptor concentration as a result of E
      treatment. Furthermore, an analysis of E-treatment suggests that although ER are
      present at an early age, there may be additional factors that determine the
      nature and extent of E-responsiveness.

PMID- 1637723
TI  - Low density lipoprotein-receptors in primary cultures of rat glial cells.
AB  - Newborn rat glial cells in primary culture contain an active cholesterol side
      chain cleavage cytochrome P450. Cholesterol can be supplied either by
      biosynthesis or derive from low density lipoproteins (LDL), which bind
      apolipoprotein Band E (apoB,E) (LDL)-receptors and undergo receptor-mediated
      endocytosis. Using antibodies to purified human plasma LDL and antibodies to
      bovine adreno-cortical LDL-receptor, the presence of LDL-receptors was
      demonstrated on rat glial cells after 3-4 weeks of primary culture, by ligand
      blotting, immunoblotting, and indirect immunofluorescence staining. The latter
      approach indicated that oligodendrocytes express higher levels of LDL-receptors
      than astrocytes present in the same culture. The immunofluorescence staining was
      observed not only at the cell surface, but also within the cytoplasm, suggesting
      that the LDL-receptor complexes had been internalized. Western blotting of LDL
      receptors extracted from glial cells indicated a band of approximately 130 kDa,
      the size expected for intact receptors. Their functionality was shown by the
      conversion of [3H]cholesterol linoleate, incorporated into reconstituted LDL and
      added to the cell cultures, to [3H]pregnenolone and/or its 20 alpha-hydroxy
      metabolite. This is the first characterization of functional LDL-receptors on
      isolated, well characterized, normal brain cells.

PMID- 1637724
TI  - Estrogen receptor affinity and effects on MCF-7 cell growth of triarylethylene
      carboxylic acids related to tamoxifen.
AB  - The estrogen receptor binding, and growth suppressant and stimulating effects in
      MCF-7 human breast cancer cells, of four structural variants of the
      triarylethylene antiestrogen tamoxifen (1) were studied. In these analogs, the
      dialkylaminoethoxy side chain of 1 was replaced by carboxylic acid or oxyacetic
      acid substituents. The presence of a p-hydroxy group in the ring geminal to the
      one bearing the side chain resulted in ligands with estrogen receptor affinities
      greater than that of 1 but less than that of estradiol. Compared to 1, none of
      the test compounds were effective suppressants of cell growth. To the contrary,
      the phenolic oxyacetic acid analog effectively reversed the growth suppressive
      effect of 1. Also, it was as effective as estradiol, though less potent, in
      stimulating growth of cells grown in estrogen depleted medium, suggestive of full
      estrogen agonist activity. Its carboxylic acid counterpart had little or no
      effect on proliferation. Because the phenolic oxyacetic acid is a metabolite of 1
      in animals, its estrogenicity may have therapeutic implications of concern,
      depending on the extent to which it is formed and distributed in tissues of
      patients receiving 1.

PMID- 1637725
TI  - The effect of essential fatty acid deficiency on hepatic bile salt
      sulphotransferase in rats.
AB  - Hepatic bile salt sulphotransferase (BSS) activity and the contents of
      unconjugated oestradiol-17 beta (E2) and conjugated oestrone (cE1) in liver
      tissue was significantly lower in young essential fatty acid (EFA) deficient
      female rats than in female control rats. No corresponding differences were found
      between male EFA deficient and control rats. A significant sex difference, with
      higher values in females, was found for BSS activity and E2 and cE1 contents in
      control rats but not in EFA deficient rats. The decrease in hepatic BSS activity
      in female rats caused by EFA deficiency may be mediated via a decreased
      estrogenic action on the liver.

PMID- 1637726
TI  - The effects of sex hormone binding globulin (SHBG) on testosterone transport into
      the cerebrospinal fluid.
AB  - The movement of testosterone (T) from blood across the blood-brain barrier (BBB)
      is thought to reflect the combined effects of T's lipid solubility and the
      presence of circulating binding proteins for T such as albumin or sex hormone
      binding globulin (SHBG). Since the adult rat lacks a circulating specific high
      affinity sex steroid binding protein, examination of the disappearance from serum
      and uptake into cerebrospinal fluid (CSF) of [3H]T before and after SHBG or
      albumin infusion should provide insight into the function of these two proteins
      with respect T transport. Three groups of adult male Sprague-Dawley rats were
      cannulated at the femoral vein and cisterna magna. In a control group (n = 8),
      [3H]T was given as an intravenous bolus beginning at time zero; multiple serum
      and CSF collections were assayed for counts per min (cpm) during the subsequent
      45 min. Data from these animals were then compared to those seen in animals that
      received either purified human SHBG (hSHBG) (n = 7) or human albumin (hALB) (n =
      6) 10 min prior to the [3H]T infusion. High performance liquid chromatography was
      used to monitor the metabolic fate of the steroid infusate at the end of each
      study period. Infusion of hSHBG increased serum concentrations from undetectable
      to 93.8 nM/l (mean +/- SEM, n = 6). Administration of hALB significantly
      increased (25.0 +/- 1.2 g/l at baseline, 33.4 +/- 1.6 g/l post-infusion, mean +/-
      SEM, P less than 0.03, n = 5) the circulating albumin concentration. Comparison
      of data from each group of animals demonstrated that (1) following an i.v.
      injection of radiolabeled T, the initial decline in serum [3H]T was significantly
      reduced (P less than 0.03) in the presence of hSHBG, (2) hALB did not affect the
      movement of [3H]T out of serum, (3) the time to peak appearance of [3H]T in the
      CSF was significantly delayed (P less than 0.02) by the presence of circulating
      hSHBG, and (4) the net quantity of [3H]T found in the cSF under steady-state
      conditions was not affected by serum SHBG or albumin levels. This study
      demonstrates that high-affinity steroid binding proteins do modulate the
      transport of sex steroids across the BBB. Specifically, SHBG delays the clearance
      of T from serum and slows the rate of T uptake into the CSF during non
      equilibrium conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1637727
TI  - Hydroxylation of 19-norandrogens by porcine Leydig cells.
AB  - The metabolism of 19-norandrogens by porcine Leydig cells was investigated. Non
      radioactive 19-norandrostenedione (19-Nor A) and [3H]19-nortestosterone (19-Nor
      T) were used as substrates in incubations with cell preparations from mature male
      pigs. Steroid products were separated by reversed-phase HPLC and material in
      selected peaks was rechromatographed before attempts to identify them by GC-MS.
      Both 11 beta- and 6 beta-hydroxylated derivatives of 19-Nor A were found and a
      third product (11-oxo-19-Nor A) was tentatively identified. The profile of
      radioactive metabolites from [3H]19-Nor T also favours the view of a capacity for
      hydroxylation of 19-norandrogens by porcine Leydig cells. The significance of
      these findings together with our earlier report of direct 11 beta-hydroxylation
      of C19 steroids by such cells remains to be examined.

PMID- 1637728
TI  - ATP-sensitive potassium channels and myocardial ischemia: why do they open?
AB  - There is evidence that the "ATP-sensitive" potassium channel opens, at least
      during the early stages of myocardial ischemia, despite relatively high ATP
      levels. Thus, channel opening may partially contribute to potassium efflux and
      accumulation of extracellular potassium, but probably much more profoundly to
      electrical abnormalities associated with ischemia, including the development of
      lethal arrhythmias. Several factors are discussed that may promote a significant
      open-channel probability of the channel, in spite of relatively high levels of
      ATP. It is argued that, even with a very low open probability, the magnitude of
      total membrane current carried by these channels may be substantial (comparable
      to other potassium currents) because of the high density and conductance of the
      ATP-sensitive potassium channel. Finally, it is shown how the ATP-sensitive
      potassium channel may play a role in various tissue types, ranging from the
      physiological to the pathophysiological. This potassium channel is therefore
      increasingly targeted for drug development and research.

PMID- 1637729
TI  - Role of timing of administration in the cardioprotective effect of fructose-1,6
      bisphosphate.
AB  - We administered fructose-1,6-bisphosphate (FDP), 1 mM, to isolated and perfused
      rabbit hearts submitted, after 90 minutes of equilibration, to an ischemic period
      (60 minutes at a coronary flow of 0.17 ml/min/g), followed by a period of
      reperfusion (30 minutes at a coronary flow of 3.6 ml/min/g). FDP was delivered at
      different times following the experimental protocol: 60 minutes before ischemia
      and for the entire experiment; 60 minutes before and during ischemia, but not at
      reperfusion; at the onset of ischemia and during reperfusion; and only during
      reperfusion. The FDP cardioprotective effect was evaluated in terms of recovery
      of left ventricular pressure developed during reperfusion, creatine phosphokinase
      (CPK) and noradrenaline release, mitochondrial function (expressed as yield, RCI,
      QO2, ADP/O), ATP and creatine phosphate (CP) tissue contents, calcium
      homeostasis, and by measuring oxidative stress in terms of reduced and oxidized
      glutathione release and tissue contents. Our data show that the cytoprotective
      action of FDP is closely related to the time of administration. Optimal
      myocardial preservation was achieved when it was present prior to ischemia and
      during reperfusion. When given at the time of ischemia or only on reperfusion,
      FDP does not exert cardioprotection. The data suggest that the FDP
      cardioprotective effect is related to improvement of energy metabolism.

PMID- 1637730
TI  - Similar antiischemic effects of intracoronary atenolol and nifedipine during
      brief coronary occlusions in humans.
AB  - To compare the antiischemic effects of intracoronary administration of a beta
      blocker, atenolol, and of a calcium antagonist, nifedipine, on the clinical and
      electrocardiographic signs of myocardial ischemia induced by balloon occlusion of
      the coronary artery, we studied 32 consecutive patients undergoing routine PTCA.
      In each patient at least three balloon inflations were performed: the first
      served to verify the occurrence of ischemia (ST segment depression/elevation
      greater than 1.5 mm); the second was used as a control occlusion; the third was
      performed after the patients were assigned to receive either atenolol 1.0 mg IC
      (group 1, N = 16) or nifedipine V = 0.2 mg IC (group 2, N = 16). In a control
      population of 10 patients, the time to return to baseline of the ECG tended to be
      progressively shorter during the three consecutive inflations, but the other
      clinical and ECG parameters did not change significantly. In group 1 and group 2,
      two patients did not show ECG signs of ischemia at the third inflation; the time
      to ischemia increased in group 1 (+76%, p less than .001) and group 2 (+85%, p
      less than .01; NS group 1 versus group 2); ST segment displacement at 30 seconds
      decreased in group 1 (-38%, p less than .01) and group 2 (-36%, p less than .01;
      NS group 1 versus group 2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637731
TI  - Enalapril versus combined enalapril and nadolol treatment: effects on blood
      pressure, heart rate, humoral variables, and plasma potassium at rest and during
      exercise in hypertensive patients.
AB  - The effect of enalapril alone and in combination with nadolol on resting and
      exercising blood pressure, heart rate, plasma renin activity, aldosterone,
      noradrenaline, and potassium levels was studied in 10 hypertensive patients
      (diastolic blood pressure between 95 and 114 mmHg). Patients received placebo for
      4 weeks, enalapril (mean daily dose 24.5 mg) for 8 weeks, and nadolol, 40 mg once
      daily, was added for the remaining 8 weeks of the study. Exercise testing
      (modified Bruce, treadmill) was conducted at the end of the placebo run-in phase
      and at the end of each treatment period. Enalapril reduced resting and exercising
      blood pressure independent of any change in heart rate: This effect was increased
      with combination treatment. Plasma renin activity at rest and during exercise was
      increased by enalapril. Combination treatment attenuated this response and
      significantly reduced plasma aldosterone. Neither treatment had any effect on
      plasma noradrenaline levels. Resting plasma potassium levels were increased with
      combination treatment, whereas both treatment regimens increased plasma potassium
      levels during exercise. There were no clinically relevant episodes of
      hyperkalemia. Further investigation is required to qualify the nature of the
      blood pressure and plasma potassium response with combination treatment.

PMID- 1637732
TI  - Hibernating myocardium: a historical perspective.
AB  - Hibernating myocardium refers to the presence of persistent myocardial and left
      ventricular dysfunction at rest, associated with conditions of severely reduced
      coronary blood flow. This left ventricular dysfunction probably represents an
      adaptive mechanism preventing irreversible myocardial cell damage, since
      myocardial and left ventricular dysfunction in hibernating myocardium improve
      following the restoration of coronary blood flow. This review examines the
      evolution of the concept of hibernation from a clinical observation of the
      potential underlying mechanisms recently proposed.

PMID- 1637733
TI  - Hibernation and myocardial ischemia: clinical detection by positron emission
      tomography.
AB  - Regions of myocardium supplied by severely diseased epicardial arteries may
      develop chronic ischemia at rest and exhibit reduced contractility, contributing
      to a reduction in global left ventricular function. However, after
      revascularization, contractility in these regions may return to normal. These
      regions of asynergy are described as "hibernating myocardium." Such myocardium in
      which normal contractility may be restored often coexists with areas of
      infarcted, or scar, tissue, leading to the definition of hypoperfused hibernating
      myocardium as viable myocardium. It is important to identify viable myocardium,
      as revascularization of these areas should lead to the greatest improvement in
      left ventricular function and, thus, improvement in survival. Positron emission
      tomography is the best noninvasive method for quantifying regional myocardial
      blood flow and metabolism. Using 18F-fluorodeoxyglucose, which measures
      myocardial glucose utilization, it is possible to identify myocardial tissue that
      is hypoperfused at rest with preserved or increased glucose uptake. This mismatch
      of blood flow to metabolism has a high predictive accuracy in the recovery of
      contractile function. In order to reduce the need for metabolic imaging in
      documenting myocardial viability, a regional index of perfusable tissue derived
      from imaging with 15O water has been recently developed that also allows the
      quantification of tissue viability.

PMID- 1637734
TI  - Recovery of myocardial function in the hibernating heart.
AB  - Impaired contractile performance at rest is not necessarily due to irreversible
      tissue damage but may relate to the "hibernating" myocardium. Hibernating
      myocardium has been defined as potentially reversible, chronic contractile
      dysfunction during prolonged, painless ischemia. The extent and time course of
      functional recovery after restoration of flow is of major importance for clinical
      decision making. The existence of hibernating myocardium was first documented in
      patients following bypass surgery. Angiographic studies in patients undergoing
      coronary angioplasty revealed immediate recovery of global and regional systolic,
      as well as diastolic, function after revascularization. Subgroup analysis showed
      an improvement in patients without previous myocardial infarctions and in those
      with non-Q-wave infarctions, but a benefit was not consistently seen in patients
      with transmural infarctions. A further improvement of systolic function after 15
      weeks suggests a biphasic course of recovery. Prospective studies must clarify
      whether the potential for improvement in function constitutes an indication for
      revascularization independent of clinical symptoms.

PMID- 1637735
TI  - Hibernating myocardium in patients with coronary artery disease: identification
      and clinical importance.
AB  - The term hibernating myocardium describes a particular outcome of myocardial
      ischemia in which myocytes show a chronically depressed contractile ability but
      remain viable. Revascularization of hibernating tissue causes a recovery of
      mechanical function that correlates with long-term survival. Therefore it is
      important clinically to distinguish hibernating from infarcted myocardium, since
      asynergies due to hibernation will improve on reperfusion, whilst those due to
      infarct will not. One suggested technique to identify hibernating myocardium is
      to stimulate the myocytes acutely, but briefly, by administration of inotropic
      agents while monitoring contractile function by echocardiography. We report our
      experience on the use of low dosages of dobutamine. Myocardial viability was
      validated by measuring the recovery in contraction of the akinetic areas after
      coronary artery bypass surgery by means of intraoperative epicardial
      echocardiography. The test has a sensitivity of 93% and a specificity of 78%. It
      is useful for identification of viable myocardium and also for quantification of
      intraoperative risk in individual patients. Limitations of this test are related
      to the presence of downregulation of beta receptors and to the impossibility of
      differentiating hibernating from stunned myocardium. Another useful technique of
      identifying hibernating myocardium is the use of radionuclear markers for
      viability. In our experience the two most important tests are (1) rest
      redistribution imaging of thallium 201 (which has a high sensitivity of 93% but a
      low specificity of 44%) and (2) 99mTc-Sestamibi imaging, which provides
      information on both perfusion and function with a single injection. This latter
      technique allows differentiation between stunning and hibernating on the basis of
      coronary flow which is preserved in stunning and reduced in hibernation.

PMID- 1637736
TI  - Survival in very low birthweight infants at the University of Port-Harcourt
      Teaching Hospital, Nigeria.
AB  - Between January 1984 and December 1987, 1509 singleton neonates were admitted
      into Special Care Baby Unit at the University of Port Harcourt Teaching Hospital;
      29(1.9%) of these were Extreme Low Birthweight (ELBW), 86(5.7%) were Very Low
      Birthweight (VLBW), 406(26.9%) were Low Birthweight (LBW) and 988 (65.5%) were
      Normal Birthweight (NBW) infants. Survival rates in the four categories were
      10.3%, 46.5%, 89.2% and 94.7% respectively. Factors which significantly
      influenced survival in the VLBW infants included higher mean birthweight (p less
      than 0.01) longer mean gestation (p less than 0.001) and lower incidence of birth
      asphyxia (p less than 0.02 with Yates's correction). Furthermore the survivors
      were significantly more mature for their gestation than those who died (p =
      0.008, Fisher's Exact test). Care of the VLBW infant is not beyond the
      capabilities of Special Care Baby units in developing countries. In the light of
      our report, survival of Low Birthweight infants is a strong reflection of that of
      VLBW infants and survival of this category of babies could be improved by
      instituting general measures such as those aimed at reducing the incidence of LBW
      in the environment and by specific measures like carrying out prompt and
      effective resuscitation of the asphyxiated neonate and preventing sepsis.

PMID- 1637737
TI  - The pattern of human intestinal helminth infections in farming communities in
      different parts of Ondo State, Nigeria.
AB  - Faecal samples collected from people inhabiting project areas of Owena River
      Basin and Rural Development Authority at Okitipupa, Akure Ifon and Ajowa which
      are located in different geographical areas of Ondo State, Nigeria, were examined
      for helminth ova and larvae. The common worms were Ascaris lumbricoides,
      Trichuris trichiura and hookworms with average occurrences of 43.1% 23.4% and
      17.0% respectively. Infections were highest in subjects in the age groups of 6-10
      and 11-15 years and lowest in those over 25 years. The frequency of occurrence of
      Ascaris and Trichuris were high in all towns. Hookworms infection rates were
      24.6%, 19.7%, 21.5% and 2.1% at Akure. Ifon, Ajowa and Okitipupa respectively.
      The low hookworm incidence at Okitipupa which is near the coast has been
      attributed to the heavy soils of clay and silt coupled with heavy rainfall.

PMID- 1637739
TI  - Primary peripheral lymphadenopathy in Jos, Nigeria.
AB  - Surgical biopsy specimens of 129 enlarged peripheral nodes seen at Jos University
      Teaching Hospital over a 3-year period were analyzed. Enlarged peripheral nodes
      due to primary sarcomas or carcinomas were excluded from the series. Tuberculosis
      and malignant lymphomas were diagnosed in 48.0% and 28.8% of the patients
      respectively. Amongst children aged 12 years and below, these diseases account
      for 50.0% and 30.0% childhood primary peripheral lymph node enlargement
      respectively. Non-diagnostic features were seen in 20.8% of patients. The
      cervical (53.0%), axillary (18.2%) and inguinal (7.4%) nodes are affected in that
      order. Regional lymph node involvement is the usual pattern.

PMID- 1637738
TI  - Another look at the nephrotic syndrome in adult Nigerians: pathological and
      immunological findings.
AB  - One hundred and twenty adult Nigerians with the nephrotic syndrome were subjected
      to similar pathological investigations which included light microscopy and
      immunoperoxidase study of renal biopsy specimens, serum immunoglobulins and C3c
      levels. Histological findings showed a wide range of changes with the minimal
      change type of lesion and proliferative glomerulonephritis accounting each for
      33.3 percent of cases studied. Focal changes accounted for 26.3 percent of cases.
      Glomerular immune deposits were present in 78.6 percent of cases showing non
      minimal change glomerular lesions. Serum IgG and IgA were significantly depressed
      when compared with matched controls (P less than 0.05 and P less than 0.01
      respectively) while IgM levels were significantly increased, (P less than 0.001).
      There was no significant difference between the mean values of serum C3c in the
      nephrotic group and matched control group. This study shows the high incidence of
      minimal change nephropathy in our adult population. Although some immunoglobulin
      (especially IgM) may be identified in occasional glomeruli and cause uncertainty
      as to the diagnosis, such minor deposition of IgM which is often non specific
      does not preclude a diagnosis of minimal change nephropathy.

PMID- 1637740
TI  - Radiological assessment of the patella position in the normal knee joint of adult
      Nigerians.
AB  - A method of determining the patella position as described by Insall and Salvati
      (1971) was re-evaluated. Lateral radiographs of 300 normal knee joints were
      obtained. The length of the ligamentum patellae was compared with the patella
      length. Both measurements were found to be approximately equal and the normal
      variation did not exceed 20%. The ratio of the length of the ligamentum patellae
      to the diagonal length of the patella was found to be a useful index in
      determining Patella height (position). Clinical value of these measurements are
      also discussed. It is therefore believed that these ratios irrespective of racial
      differences, are relatively simple, practical and reproducible. The Insall and
      Salvati method should therefore be preferred to other previously described
      methods of determining patella position.

PMID- 1637741
TI  - Epidemiological survey of an outbreak of gastroenteritis in a rural community in
      Oyo State.
AB  - This report documents the investigation and control of an outbreak of gastro
      enteritis in Lagun, Oyo State, Nigeria. Prior to the outbreak which occurred in
      1981, there had been epidemics of gastro-enteritis, suspected to be cholera, in
      various parts of Nigeria. The investigations carried out included personal
      interviews of patients and their contacts, laboratory investigations of faecal
      specimens and analysis of water samples obtained from the village wells and
      stream. Available evidence indicates that the infection was probably introduced
      by one of the many visitors who had thronged the village for a festival. Neither
      Vibrio cholerae, Salmonella nor Shigella species were isolated from fecal
      specimens. However Vibrio metschnikovii organisms were present in water from the
      stream; and all the water samples tested revealed faecal contamination. The
      intervention consisted of intensive health education of various groups in the
      community, chlorination of water sources, treatment or referral of patients as
      necessary, with chemoprophylaxis and cholera immunization for contacts. A
      community environmental sanitation programme was also carried out, and
      recommendations have been made. This study highlighted what can be done at
      Primary Health Care level to investigate and control epidemics of gastro
      enteritis which are common occurrence in the rural communities of this country.

PMID- 1637742
TI  - The orthogonal electrocardiogram in adult Nigerians: a preliminary report.
AB  - The Orthogonal ECG (Frank Lead System) was analysed in 664 asymptomatic normal
      Nigerians (333 Males: 331 Females) aged 15 to 90 years (mean: 39.1 +/- 16.7). The
      system gave the same information as the 12-Lead EGG concerning the heart rate and
      rhythm, durations of waves, intervals and segments, J-point elevation and ST-T
      variants. QRS morphology was of the left ventricular pattern with the Rs greater
      than R greater than qRS greater than qR patterns dominating the scene in X and Y
      leads, and QR much greater than qR in 2. All these suggest that the cardiac
      vector is oriented leftwards, inferiorly and posteriorly. There was no QS pattern
      in any lead. There was no Sx dominance, and no S wave in Z. Septal Q, recorded in
      29.2% of X and 25.1% of Y did not exceed 0.3 seconds and 2 mm. There was no Tx or
      Ty inversion. Rather, they were upright (98.3% and 95.9% respectively) and rarely
      flat (1.7%:4.1%). The Orthogonal ECG is recommended as a simple, accurate system
      for clinical use either as a supplement to or in lieu of the 12-lead system.

PMID- 1637743
TI  - Short stature at the University College Hospital, Ibadan, Nigeria.
AB  - Twenty four patients were evaluated for short stature at the University College
      Hospital, Ibadan, Nigeria, over a seven year period. Fourteen were males, 10 were
      females and their ages ranged from 6 to 23 years at first presentation. Nine out
      of the 10 females came to the hospital primarily because of failure of sexual
      development whereas only 1 of the 14 males presented with this complaint. The
      causes of short stature were as follows: idiopathic hypopituitarism in 5 (20.8%)
      patients (4 males, 1 female), gonadal dysgenesis in 5 patients (all females),
      syndrome of hepatosplenomegaly, dwarfism and poor sexual development in 5
      patients (all males); 2 (8.3%) patients had hypothalamic-pituitary lesions, 2 had
      juvenile hypothyroidism and 1 (4.2%) had sickle cell hemoglobinopathy; the cause
      of the short stature was not certain in 4 (16.7%) patients. This is perhaps the
      first time that the syndrome of hepatosplenomegaly of uncertain etiology with
      delayed growth and sexual maturation previously reported in Iranian and Egyptian
      adolescents, is being described in black Africans. Although comprehensive
      hormonal data were not available in most of these patients, this clinical
      descriptive study is the first attempt at reporting some of the causes of short
      stature in Nigerians.

PMID- 1637744
TI  - Congenital malformations of the central nervous system at the Jos University
      Teaching Hospital, Jos Plateau State of Nigeria.
AB  - The pattern of congenital malformation of the central nervous system (CNS) as
      seen in Jos University Teaching Hospital (JUTH) is slightly different from that
      seen in Europe, Japan and Southern Nigeria. Not all the various types of CNS
      malformations reported from these centres have been seen in JUTH.
      Myelomeningocele was the commonest anomaly of the CNS seen and it accounted for
      more than 60% of all cases. Bilateral talipes equinovarus deformity was the
      commonest associated anomaly found. No case of anencephaly was seen in this
      study.

PMID- 1637745
TI  - Tropical splenomegaly syndrome in Nigerian adults.
AB  - Thirty-nine Tropical Splenomegaly Syndrome (TSS) patients. 19 males and 20
      females, aged 13 to 69 years, with a mean age of 44.4 years, seen over a two-year
      period, January 1987 to December, 1988, at the consultant Medical Out-patient
      Clinics of the University of Nigeria Teaching Hospital, Enugu, Nigeria, were
      retrospectively studied. The aetiopathogenetic basis of the syndrome was briefly
      reviewed. The implications of the probable extent of this medical problem TSS in
      the tropics was emphasized. The spectrum of clinical presentation, haematological
      picture and results of other investigations were reviewed. An attempt was made to
      possibly distinguish TSS from such other similarly presenting conditions as
      Hodgkin's Lymphoma, Chronic granulocytic leukaemia and Chronic lymphocytic
      leukaemia, on clinical grounds and simple laboratory data that can be easily
      available to the tropical physician. The probable complications of TSS, the ease
      of treatment and the impressive results of therapy were highlighted. The place of
      the different antimalarial chemoprophylactic agents in the treatment of TSS was
      reviewed. Finally, the question of the appropriate duration of therapy for TSS
      was entertained.

PMID- 1637746
TI  - Pericardial effusion associated with minoxidil therapy: case reports.
AB  - Symptomatic pericardial effusion (PE) occurred in two of our patients with
      chronic renal failure (CRF) who had taken minoxidil for control of their
      hypertension. One of them died from the effects of cardiogenic shock due to
      cardiac tamponade. The 2 patients had taken minoxidil for over 3 months. Other
      patients who had CRF had not developed symptomatic PE while being treated with
      other anti-hypertensive agents. Our experience conforms with reports from
      elsewhere that minoxidil may cause PE. Therefore, patients with CRF who need
      minoxidil as an anti-hypertensive agent should be examined regularly for clinical
      evidence of PE.

PMID- 1637747
TI  - Tek FRODO: a new version of FRODO for Tektronix graphics stations.
AB  - A new version of the molecular graphics program FRODO was developed to allow the
      range of Tektronix graphics stations to be used for molecular modeling and
      crystallographic applications. The work was divided into two parts: first, the
      universal molecular modeling graphic package (Tek_MMGP) was written to enable
      basic modeling operations for Tektronix stations. Second, all routines of FRODO
      involving computer graphics were modified to fit the new hardware environment,
      and linked with Tek_MMGP. The resulting package, Tek_FRODO, has been used
      successfully for crystallographic refinement in several projects. The program,
      written in FORTRAN, is ready to be ported to any of Tektronix 3D graphics
      stations; it is available from the authors on request.

PMID- 1637748
TI  - Protein structure prediction from predicted residue properties utilizing a
      digital encoding algorithm.
AB  - Although many disparate methods have been applied to the problem, the accuracy of
      protein structural prediction still remains disappointingly low, averaging about
      65% correct secondary structure assignment. A novel predictive method is
      presented here, which attempts to address some of the shortfalls inherent in
      representing a protein as a simple text-like sequence of amino acids, by deriving
      pattern-matching data from the predicted physical properties of a protein chain
      rather than from the sequence itself. A unique binary encoding algorithm is used
      to enable the property profiles to be correlated with known secondary structure,
      and hence to predict secondary structures for proteins with unknown structures.
      By treating the sequence in this manner, predictive accuracies averaging over 75%
      have been achieved.

PMID- 1637749
TI  - A molecular model for the retinol binding protein-transthyretin complex.
AB  - A three-dimensional model for the complex between human serum retinol binding
      protein and transthyretin (formerly named prealbumin) is presented. The model was
      obtained by interactive rigid-body computer graphics docking and the
      characterization of the molecular surfaces in terms of fractal dimension.
      Available experimental data, as well as results from molecular dynamics
      calculations, support the proposed model.

PMID- 1637750
TI  - PROBIT: a statistical approach to modeling proteins from partial coordinate data
      using substructure libraries.
AB  - A program (PROBIT) has been developed that allows the reconstruction of a
      complete set of three-dimensional protein coordinates from alpha-carbon
      coordinates. The program generates a statistical measure of polypeptide
      conformational behavior for substructures in a defined structural context from a
      library of highly refined protein structures. These statistics provide a
      prescription for substructure substitution from the database to allow
      regeneration of the complete protein structure.

PMID- 1637751
TI  - Automated site-directed drug design using molecular lattices.
AB  - Receptor-based drug design is predicated on the knowledge of the structure of a
      target receptor and the principles of molecule recognition. The objective is to
      produce a wide diversity of structures that are sterically and electrostatically
      complementary to a specified receptor site. Many drug-receptor interactions are
      controlled by a few key receptor groups. This observation leads to a design
      approach in which one focuses on chemical fragments that putatively interact with
      the key receptor groups. There then remains the difficult task of joining the
      fragments into molecular structures that match the spatial patterns of
      recognition forces in the receptor site. In this paper, we describe a new
      modeling program, BUILDER, that combines database searching techniques and
      structure generation algorithms within an interactive graphics modeling
      environment (MidasPlus). A novel tool for process communication (delegate) is
      introduced and examples of its use are given. To demonstrate the functionality of
      the package and its ability to produce novel structures, we examine the active
      site of HIV-1 protease.

PMID- 1637752
TI  - Computer graphics presentations and analysis of hydrogen bonds from molecular
      dynamics simulation.
AB  - To obtain better insights into the dynamic nature of hydrogen bonding, computer
      graphics representations were introduced as an aid for the analysis of molecular
      dynamics trajectories. A schematic representation of hydrogen bonding patterns is
      generated to reflect the frequency and the type of hydrogen bonding occurring
      during the simulation period. Various trajectory plots for monitoring geometrical
      parameters and for analyzing three-center hydrogen bonding were also generated.
      The methods proposed are applicable to a variety of biopolymers. In this study,
      hydrogen bonding in the d(G)6.d(C)6 system was examined. For the nucleic acid
      fragments examined, three-center hydrogen bonds can be classified as in-plane and
      major or minor groove types. The in-plane three-center hydrogen bond represents a
      stable state in which both bonds simultaneously satisfy the relaxed hydrogen
      bonding criteria for a measurable period. On the other hand, groove three-center
      hydrogen bonds behave as a transient intermediate state in a flip-flop hydrogen
      bonding system.

PMID- 1637753
TI  - Representation of noncovalent interactions in protein structures.
AB  - The energetics of solvent-atom and atom-atom nonbonded interactions can be
      described, for protein structures, in terms of the accessible and the contact
      atomic surface areas, respectively. This type of description emphasizes the
      importance of the local environment around groups in the three-dimensional
      structure of protein molecules. The graphical representation of nonbonded
      interactions according to this description allows one to visualize the spatial
      extent and distribution of these interactions and the relative stability of atoms
      or atomic groups in known or modified protein conformations. Applications of this
      short range description and of its graphical representation will be discussed.

PMID- 1637754
TI  - The House of Commons Health Committee Report on the Maternity Services. A
      personal view.

PMID- 1637755
TI  - Non-invasive first trimester antenatal diagnosis.

PMID- 1637756
TI  - Amnioinfusion: a question of benefits and risks.

PMID- 1637757
TI  - Is obstetric and neonatal outcome worse in fetuses who fail to reach their own
      growth potential?
AB  - OBJECTIVES: To determine the perinatal outcome of fetuses who had birthweights
      less than that expected from early third trimester ultrasound scanning. DESIGN:
      Retrospective estimation of centile fetal weight at early third trimester
      ultrasound scanning compared with actual centile birthweight corrected for
      gestational age, parity and sex. SETTING: Teaching Hospital Obstetric Unit,
      London. SUBJECTS: 197 unselected women with singleton cephalic pregnancies who
      were delivered at term in our unit between October 1989 and May 1990. MAIN
      OUTCOME MEASURES: CTG abnormality, need for fetal blood sampling in labour,
      meconium-staining of the amniotic fluid, mode of delivery, Apgar scores at 1 and
      5 min, need for transfer of baby to neonatal unit, and need for neonatal
      intubation of the neonate at delivery. RESULTS: An actual birthweight greater
      than 5% less than the birthweight estimated from ultrasound scanning identified
      44 babies (22%) with an increased risk of CTG abnormalities (chi 2 = 8.38, P less
      than 0.0025; Odds ratio (OR) = 2.54; 95% CI 1.36 to 4.78) and need for operative
      delivery (chi 2 = 5.81, P less than 0.0125; OR = 1.94; 95% CI 1.15 to 3.27), when
      compared with the remainder of the sample. Overall 14 (32%) of this group had
      birthweights above the 50th centile. A group of 44 babies selected as being the
      smallest for gestational age, without reference to growth pattern, had a similar
      excess morbidity. (All this group had birthweights below the 39th centile).
      CONCLUSIONS: This study supports the hypothesis that in-utero fetal growth
      pattern is as important for perinatal outcome as being small for gestational age
      per se.

PMID- 1637758
TI  - Sweeping of the membranes is an effective method of induction of labour in
      prolonged pregnancy: a report of a randomized trial.
AB  - OBJECTIVE: To determine whether sweeping of the membranes is an effective method
      of induction of labour in women with prolonged pregnancy. DESIGN: Randomized
      controlled trial. SETTING: A district maternity hospital. SUBJECTS: 65 women
      attending an antenatal clinic; 33 randomized to sweeping of the membranes and 32
      to a control group. MAIN OUTCOME MEASURE: Proportion of women achieving
      spontaneous labour. RESULTS: Spontaneous labour occurred more often in the
      sweeping of the membranes group than in the control group (25/33 (76%) vs 12/32
      (38%); odds ratio (OR) 4.65; 95% confidence interval (CI) 1.75 to 12.31; P =
      0.002). In addition a greater proportion of women in the sweeping group had a
      cervical dilatation of 4 cm or more at the first vaginal examination in the
      labour ward (16/33 (49%) vs 5/32 (16%); OR 4.39; 95% CI 1.56 to 12.32; P =
      0.005). There were fewer maternal infections in the sweeping group (0/33 vs 4/32
      (12%); OR 0.12; 95% CI 0.02 to 0.88; P = 0.04). There were no differences in the
      type of analgesia used in labour, the mode of delivery or neonatal outcome.
      CONCLUSIONS: Sweeping of the membranes is an effective method of induction of
      labour in women with prolonged pregnancy.

PMID- 1637759
TI  - An economic evaluation of daycare in the management of hypertension in pregnancy.
AB  - OBJECTIVE: To evaluate the efficiency of daycare in the management of
      hypertension in pregnancy compared with inpatient management with prior
      domiciliary visits. DESIGN: Comparative study. SETTING: Two maternity teaching
      hospitals, Glasgow Royal Maternity Hospital which has an established daycare unit
      and Aberdeen Maternity Hospital with no daycare unit. MAIN OUTCOME MEASURES:
      Pregnancy outcomes in terms of maternal hypertensive complications, gestation at
      delivery, mode of delivery, birthweight, Apgar scores, admission rates and length
      of admission to special care baby unit. RESULTS: There was no significant
      difference in any of the measured pregnancy outcomes between the two hospitals.
      The average cost of treating a women with mild hypertension was 154.91 pounds in
      Glasgow and 136.59 pounds in Aberdeen. The average cost of treating women with a
      single episode of hypertension and women with a past history of hypertension was
      88.65 pounds and 214.12 pounds in Glasgow and 31.18 pounds and 28.28 pounds in
      Aberdeen, respectively. If these two groups are excluded, the average cost of
      treating women with mild hypertension was 172.32 pounds in Glasgow and 201.13
      pounds in Aberdeen. The majority of women were willing to attend daycare five
      times per week to avoid admission. CONCLUSION: Daycare management of hypertension
      in pregnancy is more efficient than inpatient care with prior domiciliary visits
      for most women, but less efficient for women with transient or previous
      hypertension. It is very acceptable to women. Domiciliary checking of women with
      hypertension found at outpatient clinics would reduce resource use.

PMID- 1637760
TI  - Fetal breathing movements in oligohydramnios are not increased by aminoinfusion.
AB  - OBJECTIVE: To determine whether fetal breathing movements (FBM) in pregnancies
      with oligohydramnios change with restoration of amniotic fluid volume. DESIGN: A
      prospective experimental study. SETTING: Fetal Medicine Unit, tertiary referral
      hospital. SUBJECTS: 16 women with singleton pregnancies complicated by severe
      oligohydramnios. INTERVENTIONS: Restoration of amniotic fluid volume by
      transabdominal amnioinfusion. Controls comprised pregnancies in which infused
      fluid leaked vaginally, so that oligohydramnios was not corrected. MAIN OUTCOME
      MEASURES: Change in total breathing movements, change in FBM incidence derived
      from 40 min recordings immediately before and after amnioinfusion. RESULTS: There
      was no significant difference in the change in total breathing movements or in
      the change in incidence of FBM between the 10 pregnancies in which amniotic fluid
      volume was restored, and the other six in which fluid leaked after infusion and
      volume was not restored. In both groups, there was no significant change with
      infusion in number of FBM (mean change -72, 95% CI -218 to +74 in the fluid
      retained group and -64, 95% CI -273 to +145 in the fluid-leaked group) and
      incidence of FBM (median change -2.5%, range -27 to +10 in the fluid retained
      group and -4.5%, range -34 to +15 in the fluid-leaked group). CONCLUSIONS: This
      study suggests that restitution of amniotic fluid volume in human pregnancies
      complicated by severe oligohydramnios does not acutely alter the incidence of
      FBM. These data support an increasing literature suggesting that impairment of
      fetal breathing is not the mechanism for oligohydramnios-related pulmonary
      hypoplasia.

PMID- 1637762
TI  - Sonographic estimation of fetal weight in diabetic pregnancy.
AB  - OBJECTIVE: To investigate whether fetal weight estimation by ultrasound in
      diabetic pregnancy might be based upon fetal abdominal circumference (AC) alone.
      DESIGN: A retrospective study. SETTING: Diabetes Center, Rigshospitalet and
      Ultrasound Laboratory, Glostrup Hospital, Copenhagen. SUBJECTS: Eighty-six
      diabetic pregnant women who had an ultrasound study within 2 days before
      delivery. RESULTS: We assessed in 73 fetuses various formulas based upon
      biparietal diameter and AC against formulas based upon AC alone, and these were
      only marginally less effective than the more complex ones. In 86 fetuses an AC
      was available. These fetuses were divided into a study population and a test
      population. The linear model was customized for the study population. Evaluation
      on the test population showed that the relative error (error as a percentage of
      birthweight) in predicting birthweight had a standard deviation of 7.8%. The
      efficacy of AC in detecting fetuses greater than 4000 g was examined in the test
      population: If AC greater than 36.0 cm was chosen as criterion for macrosomia the
      positive and negative predictive values were 80% (8/10) and 91% (30/33),
      respectively. CONCLUSION: Formulas for estimating fetal weight in diabetic
      pregnancy based on AC alone are almost as effective as more complex ones. We
      recommend a simple linear formula of fetal weight as a function of AC.

PMID- 1637761
TI  - Detection of small-for-gestational-age fetuses by ultrasound screening in a high
      risk population: a randomized controlled study.
AB  - OBJECTIVE: To assess the value of fetal weight estimation during routine third
      trimester ultrasound examinations for the identification of small-for-gestational
      age (SGA) fetuses, to promote active pregnancy management and so reduce perinatal
      morbidity. DESIGN: A prospective controlled randomized study. SETTING: Outpatient
      clinic at the Department of Obstetrics, Herlev University Hospital, Denmark.
      SUBJECTS: One thousand pregnant women considered at risk were selected
      consecutively from April 1985 to September 1987 and randomized to either a
      revealed-results group or a withheld-results group. INTERVENTION: All the women
      had an early ultrasound examination for estimation of gestational age. Both
      groups had routine ultrasound estimates of fetal weight after 28 weeks and then
      every third week until delivery. The results were available for clinical use only
      in the revealed group. MAIN OUTCOME MEASURES: Number of interventions during
      pregnancy (admission to hospital, elective delivery), emergency intervention
      during labour, and fetal outcome. RESULTS: Revealing the results of ultrasound
      estimates of fetal weight for gestational age during the third trimester resulted
      in statistically significantly increased diagnosis of SGA fetuses, of elective
      deliveries based on this diagnosis, and of healthy preterm babies admitted to the
      neonatal care unit, but no detectable overall improvement in weight for
      gestational age at birth, or in neonatal morbidity or mortality. CONCLUSION: This
      method of screening improved the diagnosis of SGA fetuses, but this was not
      followed by improved fetal outcome.

PMID- 1637763
TI  - Lung volume measured by functional residual capacity in infants following first
      trimester amniocentesis or chorion villus sampling.
AB  - OBJECTIVE: To determine the incidence of respiratory problems and lung volume
      abnormalities in babies born after first trimester amniocentesis or chorion
      villus sampling. DESIGN: A prospective randomized study. SETTING: Harris
      Birthright Research Centre for Fetal Medicine, Paediatric Respiratory Laboratory,
      King's College Hospital. SUBJECTS: Babies of mothers who had undergone first
      trimester amniocentesis (n = 74) or chorion villus sampling (CVS) (n = 86) for
      fetal karyotyping because of advanced maternal age, parental anxiety or family
      history of chromosomal abnormality in the absence of parental chromosome re
      arrangement. MAIN OUTCOMES: Respiratory distress in the neonatal period and lung
      volume as assessed by measurement of functional residual capacity (FRC). RESULTS:
      CVS was associated with a significantly higher incidence of neonatal respiratory
      distress, six infants in the CVS group but none in the amniocentesis group
      required admission to the special care baby unit because of respiratory distress
      (P less than 0.05). Although there was no significant difference in the mean FRC
      between the two groups (amniocentesis 29.7 ml/kg vs CVS 29.6 ml/kg) the overall
      incidence of FRC values less than 2.5th centile of the normal range was 9%.
      CONCLUSION: Both amniocentesis and CVS performed in the first trimester of
      pregnancy may impair antenatal lung growth.

PMID- 1637764
TI  - Fetal middle cerebral artery blood flow during normal active labour and in labour
      with variable decelerations.
AB  - OBJECTIVE: To assess the distribution of fetal blood flow impedance of the
      umbilical and middle cerebral artery in active uncomplicated labour and in labour
      complicated by variable decelerations. INTERVENTIONS: Blood flow impedance of the
      umbilical and fetal middle cerebral arteries was assessed by means of pulsed
      Doppler ultrasonography and measured by the resistance index (RI) and the
      systolic/diastolic ratio. SUBJECTS: 35 women at 38-40 weeks gestation admitted
      to, or monitored in the intrapartum unit. One group of 25 women had a normal
      active labour, the second group of 10 women were in active labour with moderate
      variable decelerations. A control group of 25 women--healthy pregnant women at
      term but not in active labour. All three groups were comparable for maternal age
      and parity. SETTING: Hospital department of obstetrics and gynaecology, Israel.
      DESIGN: A prospective descriptive study. RESULTS: There was a 40% reduction in
      middle cerebral artery blood flow impedance in the two groups of women in active
      labour compared with the control group. Umbilical blood flow did not differ
      significantly between the three groups. Fetal middle cerebral blood flow
      impedance in labour was not significantly different in uncomplicated labours and
      those complicated by fetal heart rate decelerations. CONCLUSIONS: During active
      labour, mechanisms that may be unrelated to low fetal blood oxygen content reduce
      fetal brain blood vessel impedance.

PMID- 1637765
TI  - Endometrial phospholipases A2, polycystic ovaries and pelvic pain.
AB  - OBJECTIVE: To compare the activity of calcium independent phospholipase A2 in the
      endometrium of women with polycystic ovaries and in women with normal ovaries,
      and to investigate the influence of chronic pelvic pain on phospholipase A2
      activity. DESIGN: A prospective descriptive study. SETTING: The Samaritan
      Hospital for Women and the Unit of Metabolic Medicine, St Mary's Hospital Medical
      School, London. SUBJECTS: 73 women attending the Samaritan Hospital for Women for
      clip sterilization, infertility, early recurrent miscarriage or pelvic venous
      congestion. 45 of these women had no pelvic pain, 22 had normal ovaries and 23
      had polycystic ovaries diagnosed by ultrasound. The other 28 women had chronic
      pelvic pain, 14 of them had normal ovaries and 14 polycystic ovaries.
      INTERVENTIONS: Endometrial tissue was obtained at curettage or from the excised
      uterus in the proliferative or secretory phase of the menstrual cycle. The
      activities of calcium dependent (type 1) and calcium independent (type 2)
      phospholipase A2 isoenzymes were measured in all endometrial samples. RESULTS: In
      all the women phospholipase A2 type 1 activity, was significantly higher in the
      secretory phase than in the proliferative phase (P less than 0.001). There was no
      difference between women with normal ovaries and those with polycystic ovaries at
      either stage of the cycle irrespective of whether or not chronic pelvic venous
      congestion was present. In women with normal ovaries, both with and without
      chronic pelvic pain, phospholipase A2 type 2 activity was significantly higher in
      the secretory phase than in the proliferative phase (P less than 0.02 and P less
      than 0.05 respectively) but in women with polycystic ovaries, with and without
      chronic pelvic pain, there was no significant difference in activity between the
      two phases of the cycle. Women with polycystic ovaries had markedly higher
      proliferative phase type 2 activity than women with normal ovaries (P less than
      0.001). Secretory phase type 2 activity was similar in all the women
      investigated. CONCLUSION: These data suggest that phospholipase A2 type 2
      activity is increased in proliferative phase endometrium of women with polycystic
      ovaries but that the increase is not associated with chronic pelvic venous
      congestion.

PMID- 1637766
TI  - Is transcutaneous electrical nerve stimulation of any value during cervical laser
      treatment?
AB  - OBJECTIVE: To assess the value of transcutaneous electrical nerve stimulation
      (TENS) during cervical laser therapy. DESIGN: Randomized three arm controlled
      clinical trial comparing (i) TENS, (ii) local anaesthetic and (iii) TENS plus
      local anaesthetic (direct infiltration of 2% lignocaine and 0.03 iu/ml
      octopressin). SETTING: Colposcopy Unit adapted to run randomized trials.
      SUBJECTS: 100 women with CIN and no previous experience of cervical surgery. MAIN
      OUTCOME MEASURE: Visual linear analogue pain scores. RESULTS: The median pain
      score associated with TENS was greater than the score associated with local
      anaesthesia (23% compared with 17%; P = 0.1). Combining TENS with local
      anaesthesia did not further reduce pain scores. CONCLUSION: Although there was
      considerable consumer satisfaction with TENS it provided no additional pain
      relieving effect in addition to direct infiltration of lignocaine and it is
      inferior to lignocaine alone. We are unable to advocate the use of TENS for laser
      treatment of the cervix.

PMID- 1637767
TI  - The cytological detection of persistent cervical intraepithelial neoplasia after
      local ablative treatment: a comparison of sampling devices.
AB  - OBJECTIVE: To determine whether the cytological detection of persistent cervical
      intraepithelial neoplasia (CIN) after local ablative treatment is improved by the
      use of sampling devices other than the Ayre's spatula. DESIGN: A randomized
      controlled study. SETTING: Lothian Area Colposcopy Clinic. SUBJECTS: 856 patients
      who had received local therapy (CO2 laser or cold coagulation) for CIN II or III
      between 9 and 30 months earlier. INTERVENTION: Each patient had three consecutive
      cervical smears taken, one with the Ayre's spatula, one with either the
      Aylesbury, the Rocket or the Multispatula device, and finally one with the
      Cytobrush. The allocation of which spatula and the order of the first two was
      randomized. Each patient had a colposcopic examination immediately after the
      smears were taken. MAIN OUTCOME MEASURES: A comparison of the detection of
      histologically proven persistent CIN by the Ayre's spatula with the detection of
      persistent disease by alternative sampling devices. RESULTS: Of the 856 patients
      130 had histologically proven persistent CIN. Another 98 had suspicious findings
      on colposcopy but punch biopsies reported as histologically normal. Of the
      remaining patients with normal colposcopy 130 were randomly selected to form a
      control group. The cervical smears from these 358 women were reported.
      Significantly fewer Ayre's samples contained endocervical cells than Aylesbury
      samples (47% vs 59%, difference 12%; 95% CI 3%-21%; P less than 0.001), Rocket
      samples (47% vs 67%; difference 20%, 95% CI; 12%-32%; P less than 0.001) or
      Multispatula samples (47% vs 76%; difference 29%, 95% CI 19-38%; P less than
      0.001). When punch biopsies contained CIN, dyskaryotic cells were seen in 10% of
      Ayre's samples, 4.3% of Aylesbury samples, 8.3% of Rocket samples, and in no
      smear taken with the Multispatula. Obtaining a third smear with the Cytobrush did
      not substantially improve the detection rate of dyskaryosis. Neither the order of
      use of the spatulas, the form of initial treatment nor the size of the
      transformation zone had any apparent effect on the cytological detection of
      persistent CIN. CONCLUSIONS: We recommend that surveillance of patients who have
      received local ablative therapy for CIN should be by both cytology and
      colposcopy, and that cytological samples should be obtained using the Ayre's
      spatula.

PMID- 1637768
TI  - Erythrocyte membrane composition in pregnancy-induced hypertension: evidence for
      an altered lipid profile.
AB  - OBJECTIVE: To investigate whether the increased membrane fluidity postulated as a
      possible contributing factor to the hypertensive states of pregnancy is related
      to the lipid composition of the erythrocyte membrane. DESIGN: An observational
      case control study. SUBJECTS: 30 women with pregnancy induced hypertension, 26
      normotensive pregnant women matched for gestational age, and 10 normotensive non
      pregnant nulliparous women. INTERVENTIONS: Erythrocyte membranes were prepared
      from venous blood samples obtained from all the women. MAIN OUTCOMES MEASURES:
      Lipid analysis, including cholesterol to phospholipids ratio, distribution of
      phospholipid classes and fatty acid composition of total phospholipids in
      erythrocyte ghosts. RESULTS: The cholesterol/phospholipid ratio was significantly
      higher in the women with pregnancy induced hypertension compared with the
      normotensive pregnant women (mean 1.24, SD 0.31, 95% CI 1.12 to 1.35 vs mean
      0.90, SD 0.09, 95% CI 0.86 to 0.94; P less than 0.01). Normotensive non-pregnant
      erythrocyte membrane cholesterol/phospholipid ratio was 0.88 (SD 0.11, 95% CI
      0.79 to 0.96). The percentage distribution of different phospholipid classes and
      fatty acid composition was similar in all the four groups. CONCLUSIONS: The
      increased cholesterol/phospholipid ratio of the erythrocyte membrane found in
      pregnancy-induced hypertension represents one factor involved in the
      pathophysiology of this condition and a possible biochemical marker of the
      disease.

PMID- 1637770
TI  - Cord insulin and C-peptide--distribution in an unselected population.
AB  - OBJECTIVE: To assess the distribution of cord blood insulin in an unselected
      population, and examine its relation to birthweight centiles. SETTING: District
      General Hospital in Nottinghamshire. SUBJECTS: 209 unselected singleton births.
      MEAN OUTCOME MEASURE: Cord blood insulin; cord blood C-peptide; birthweight
      centiles. RESULTS: Hyperinsulinaemic babies (greater than 97th centile for cord
      insulin) were found at all birthweight centiles. 15% of high birthweight babies
      were hyperinsulinaemic. For low birthweight babies, the distribution of cord
      insulin/C-peptide was skewed indicating a high number of low values.
      Hypoinsulinaemic babies were present up to the 50th centile for birthweight.
      CONCLUSIONS: Abnormalities of fetal insulinisation may be found in babies of all
      birthweights.

PMID- 1637769
TI  - Detection of fetal DNA in trans-cervical swabs from first trimester pregnancies
      by gene amplification: a new route to prenatal diagnosis?
AB  - OBJECTIVE: To determine whether fetal sex can be predicted from fetal DNA
      retrieved transcervically from the lower part of the uterine cavity in the first
      trimester of pregnancy. DESIGN: Prospective observational study. SETTING: St
      James's University Hospital, Leeds. SUBJECTS: 33 women undergoing legal
      termination of pregnancy at 9 to 13 weeks gestational age. INTERVENTIONS: Before
      termination of pregnancy samples for DNA analysis were obtained with cotton wool
      swabs from the vagina, cervix and transcervically in 26 women. In the other seven
      women samples were obtained using a transcervical cell retrieval (TraCeR)
      procedure involving flushing the lower uterine cavity with 5 ml saline. MAIN
      OUTCOME MEASURES: Detection of Y-chromosome specific DNA sequences by the
      polymerase chain reaction (PCR) in cotton wool swabs taken from the lower uterus
      in the first trimester of pregnancy to predict fetal sex in comparison with
      standard cytogenetic analysis. Histological and immunohistochemical analysis of
      samples obtained by flushing of the lower uterine cavity (TraCeR) to confirm the
      presence of trophoblast. RESULTS: Fetal sex was predicted accurately in 25 of the
      26 pregnancies investigated. Immunohistochemical analysis identified syncytial
      trophoblast fragments in all seven pregnancies investigated by TraCeR.
      CONCLUSION: Trophoblast may be retrieved from the lower uterus in the first
      trimester by swabs or TraCeR. When purification of these syncytial fragments can
      be achieved using immuno-magnetic technology, this test will enable prenatal
      diagnosis of single gene defects in the fetus by the polymerase chain reaction.

PMID- 1637771
TI  - Spinal muscular atrophy and pregnancy.

PMID- 1637773
TI  - Polycystic ovaries in association with mullerian duct anomalies.

PMID- 1637772
TI  - Vaginal ultrasound in donor insemination.

PMID- 1637774
TI  - Laparoscopic tubal manipulating forceps for extrusion of early ectopic pregnancy.

PMID- 1637775
TI  - The prevalence, aetiology and clinical significance of pseudosinusoidal fetal
      heart rate patterns in labour.

PMID- 1637776
TI  - Emergency cervical cerclage.

PMID- 1637777
TI  - Is stage I epithelial ovarian cancer overtreated both surgically and
      systemically? Results of a five-year cancer registry review.

PMID- 1637778
TI  - Fetal heart block associated with anti-Ro(SS-A) antibody--current management. A
      review.

PMID- 1637779
TI  - Characterization of lymphocytes infiltrating human breast cancer: specific immune
      reactivity detected by measuring cytokine secretion.
AB  - Primary breast cancers from 19 patients and draining lymph nodes from nine of
      them (seven containing metastatic tumor) were used in growing tumor-infiltrating
      lymphocytes (TIL) in culture. TIL were studied for proliferation, phenotype,
      cytotoxicity, and the ability to secrete cytokines in response to autologous
      tumor. Lymphocytes from primary breast tumors proliferated in 15 of 19 cultures,
      a median of 6.7 x 10(3)-fold in 65 days. For eight of nine patients, lymphocytes
      derived from draining lymph nodes proliferated in culture, a median of 110-fold
      in 49 days. Breast TIL became predominantly CD4+ cells over time in culture and
      were 73% CD4+ and 21% CD8+ (means) at 63 days (median). Lymph node lymphocytes
      were 63% CD4+ at 51 days. TIL were poorly lytic in 4-hour 51Cr release assays.
      Lysis of autologous tumor occurred in only one of 12 breast TIL and one of nine
      lymph node cultures. This lysis was low (15% at effector:target = 40:1) and was
      nonspecific (non-major-histocompatibility-complex restricted). Cytokine secretion
      was tested by co-culturing TIL with autologous or allogeneic tumors for 24 hours.
      Cytokines were measured in culture supernatants by enzyme-linked immunosorbent
      assay or radioimmunoassay. TIL from three of 11 patients specifically secreted
      granulocyte macrophage-colony-stimulating factor, tumor necrosis factor-alpha and
      interferon-gamma when stimulated by autologous tumor and not by a panel of four
      to five allogeneic breast cancers. Cytokine secretion has made possible the
      identification of lymphocytes infiltrating breast cancers with specific immune
      reactivity. This finding will guide the development of new immunotherapies for
      patients with breast cancer.

PMID- 1637780
TI  - Inhibitory effects of cytokines on vascular endothelial cells: synergistic
      interactions among interferon-gamma, tumor necrosis factor-alpha, and interleukin
      1.
AB  - The formation of new blood vessels is critical to tumor growth and metastasis and
      since endothelial cells are the principal cell type comprising such blood
      vessels, we carried out experiments to test whether the growth of endothelial
      cells in vitro can be inhibited by low doses of combinations of cytokines. We
      show that growth of mouse aortic endothelial cells can be inhibited in vitro by
      combinations of cytokines that, administered singly even at ten times higher
      concentrations, have only marginal effects. In particular, interleukin-1 (IL-1),
      tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma), acting
      synergistically at low, subthreshold concentrations, are able to completely
      inhibit the growth of endothelial cells in vitro.

PMID- 1637781
TI  - Depot characteristics and biodistribution of interleukin-2 liposomes: importance
      of route of administration.
AB  - Due to rapid clearance of interleukin-2 (IL-2), it has had limited effective use
      as an in vivo immunostimulant. Current experimental and clinical protocols
      generally must utilize large doses, multiple injections, or continuous infusions
      of IL-2 in order to achieve significant immunostimulation, often at the expense
      of systemic toxicity. Therefore, the pharmacodynamics of IL-2 liposomes were
      investigated. IL-2 liposome incorporation efficiency was 80.4% (SD 5.5); vesicle
      diameter was 1.65 microns (SD 0.09) as determined by fluorescence-activated cell
      sorting (FACS). Both formulation (free cytokine vs. IL-2 liposomes) and route of
      administration were important variables in determination of the biodistribution
      and pharmacokinetic characteristics of IL-2. When free [125I]IL-2 was given i.v.
      to mice, only 6.5% was in the blood and 3% in liver and spleen 2 h after
      injection; on the other hand, at 2 h greater than 70% of i.v. [125I]IL-2
      liposomes were detected in the blood, liver, spleen, and lungs. Mean i.v.
      elimination t1/2 from the blood of rats given 20 x 10(6) U/kg free cytokine or IL
      2 liposomes was 41 versus 102 min, respectively, as measured by bioassay and 59
      and 119 min as measured by enzyme immunoassay (EIA). After i.v. administration,
      the estimated Vd of IL-2 liposomes was 13-fold smaller than the free cytokine.
      Intrathoracic (i.tx.), i.p., and s.c. administration of [125I]IL-2 to mice also
      demonstrated significant depot effects when IL-2 was incorporated into liposomes.
      These data suggest IL-2 liposomes may provide in vivo immunostimulation superior
      to the free cytokine due to biodistribution and depot characteristics.

PMID- 1637782
TI  - Phase I trial of recombinant macrophage colony-stimulating factor by rapid
      intravenous infusion in patients with cancer.
AB  - Fourteen patients were entered into a phase I dose-escalation trial of macrophage
      colony-stimulating factor (M-CSF). M-CSF was administered to inpatients by rapid
      15 min i.v. infusion every 8 h x 5 days, repeated after a 9-day rest. Dose levels
      evaluated were 20, 40, 80, 330, and 1,100 micrograms/m2. Monitoring of patients
      every 4 h included vital signs, daily complete blood count (CBC), and serum
      chemistries (SGOT, creatinine, and bilirubin) while receiving M-CSF. No clinical
      or laboratory evidence of toxicity was seen. The average serum t1/2 varied with
      dose level. At 330 and 1,100 micrograms/m2, the serum t1/2 was 25 and 84 min,
      respectively, implying a saturable mechanism of clearance. After 5 days of
      treatment, the t1/2 decreased by twofold, consistent with enhancement of the
      saturable mechanism. Monocyte cytotoxicity against the A375 melanoma cell line
      was evaluated pretreatment and day 5 of each cycle. No consistent enhancement of
      monocyte cytotoxicity was seen. No effect on peripheral blood monocyte number was
      seen until the 1,100 micrograms/m2 dose level. At this dose level, the mean
      monocyte number on day 5 was increased compared to baseline (1,300 mm3 vs.
      300/mm3). Clinical activity was seen in two patients with previously progressive
      leiomyosarcoma metastatic to the liver. A partial response (PR) lasting 7 months
      occurred at the 330 micrograms/m2 dose level while a patient treated at 1,100
      micrograms/m2 has had stable disease for 20+ months. The maximum tolerated dose
      (MTD) of M-CSF was not determined. Based on clinical responses, a phase II trial
      is warranted in patients with metastatic soft tissue sarcoma.

PMID- 1637783
TI  - Interferon-gamma induced by administration of recombinant interleukin-2 to
      patients with cancer: kinetics, dose dependence, and correlation with
      physiological and therapeutic response.
AB  - The administration of recombinant interleukin-2 as an i.v. bolus at dose levels
      of from 1 to 30 MIU/m2 to patients with cancer induces easily measurable serum
      interferon-gamma levels of 1 to 500 U/ml. After a lag of 1 h, interferon-gamma
      rises to a maximum at 4 h and then slowly decreases. The peak values are poorly
      correlated with the dose of interleukin-2, and thus must be also be dependent on
      other factors. Successive administration of interleukin-2 typically increases the
      peak level of interferon-gamma fourfold, but does not diminish the lag period.
      Peak levels of interferon-gamma are also increased by concurrent administration
      of interferon-beta with interleukin-2. Continuous i.v. infusion of 1.5 to 20
      MIU/m2 of interleukin-2/day results in interferon-gamma levels of 1 to 7 U/ml.
      Hypotension, which is characteristically associated with interleukin-2
      administration, is correlated with interferon-gamma levels in only some patients.
      There was no apparent correlation between tumor regression and serum interferon
      gamma levels.

PMID- 1637784
TI  - Human leukocyte antigen expression in renal cell carcinoma lesions does not
      predict the response to interferon therapy.
AB  - Human leukocyte antigen (HLA) classes I and II molecules are essential for
      antigen presentation to cytotoxic T cells and helper T cells, respectively.
      Consequently, they may play a role in anticancer immunotherapy as well. We
      studied whether the pretreatment HLA phenotype of the tumor is predictive for
      response to interferon immunotherapy in vivo. Therefore, renal cell carcinoma
      (RCC) primary tumor lesions from 31 patients treated with interferon-alpha and
      interferon-gamma (13 responders and 18 nonresponders) were analyzed
      retrospectively for HLA antigen expression with immunohistochemical methods.
      Furthermore, from eight patients, pretreatment metastatic lesions were examined.
      In the primary tumors HLA class I expression was high: in 26 of 30 lesions more
      than 50% cells were stained. HLA class II expression was mostly low: in 14 of 31
      primary tumors less than 5% cells were stained. A significant correlation was
      found between HLA phenotype of primary tumors and corresponding metastases. There
      was no association between tumor HLA classes I and II antigen expression and
      clinical response to interferon therapy. In conclusion, pretreatment HLA
      phenotype of RCC has no predictive value for outcome of interferon immunotherapy.
      A role for treatment-induced changes in HLA expression in vivo, however, can not
      be excluded. These findings do not provide indications for the working mechanism
      of interferon immunotherapy in vivo.

PMID- 1637785
TI  - Selective factor Xa inhibition by recombinant antistasin prevents vascular graft
      thrombosis in baboons.
AB  - A baboon model of high-shear, platelet-dependent vascular graft thrombosis was
      used to assess the antithrombotic effect of recombinant antistasin (rATS), a 119
      amino acid protein with selective, subnanomolar inhibitory potency against
      coagulation factor Xa. In this model, a Dacron vascular graft segment of a
      femoral arteriovenous (AV) shunt provided the thrombogenic stimulus.
      Antithrombotic efficacy of rATS was assessed by continuous monitoring of 111In
      labeled platelet and 125I-labeled fibrin(ogen) deposition onto the graft surface
      and blood flow through the vascular shunt. Systemic intravenous administration of
      rATS (2 or 4 micrograms/kg.min-1) dose dependently decreased both platelet and
      fibrin(ogen) deposition onto the graft. Vascular graft thrombus formation was
      completely inhibited at a systemic dose of rATS of 4 micrograms/kg.min-1. None of
      the AV shunts in animals receiving rATS at either dose occluded, and blood flow
      was maintained at 81 +/- 4% (2 micrograms/kg.min-1 rATS) or 96 +/- 3% (4
      micrograms/kg.min-1 rATS) of basal flow. Systemic fibrinopeptide A elevations in
      response to exposure to the Dacron graft segment were completely suppressed by
      both doses of rATS. The ex vivo activated partial thromboplastin times were
      extended to greater than 150 seconds during infusion of both doses of rATS;
      however, even at fully antithrombotic doses, template bleeding times were not
      significantly increased. Thus, in this baboon model, rATS is a potent
      antithrombotic agent that inhibits both platelet and fibrin(ogen) deposition onto
      a Dacron vascular graft segment. Furthermore, these results demonstrate that
      selective inhibition of coagulation factor Xa by rATS can completely prevent
      vascular graft thrombus formation without significantly compromising primary
      hemostasis as measured by template bleeding time.

PMID- 1637786
TI  - Turnover of synthetic class A amphipathic peptide analogues of exchangeable
      apolipoproteins in rats. Correlation with physical properties.
AB  - Peptide analogues of the class A amphipathic helixes from exchangeable
      apolipoproteins mimic apolipoprotein (apo) A-I in a number of ways, including the
      ability to activate the enzyme lecithin:cholesterol acyltransferase, to associate
      with high density lipoproteins (HDLs), and to form HDL-like particles in the
      presence of lipids. This study investigated the metabolic properties of several
      of these peptide analogues in the rat. Peptide analogues studied were 18A
      (referred to as L-18A to differentiate it from D-18A, and which mimics
      apolipoprotein amphipathic helical domains in its charge distribution), 37pA (a
      dimer of two 18A monomers separated by a proline), 18R (with reversed charge
      distribution compared with 18A), and D-18A (identical in amino acid sequence to
      18A but synthesized from D-amino acids). Peptides were radiolabeled with 125I. In
      addition, metabolism of rat and human 125I-apo A-I and human 14C-apo A-I was
      studied; no significant differences in clearance of these preparations were seen.
      Clearance data were fitted to multiexponential equations to give half-times of
      clearance; biexponential equations consistently provided the best nonlinear least
      squares curve fit. The order of relative lipid affinity determined in vitro was
      37pA greater than apo A-I greater than D-18A = L-18A greater than 18R. Half-times
      of clearance were in the same approximate rank order: 37pA, 6.9 +/- 3.3 hours
      (mean +/- SD); apo A-I, 6.9 +/- 1.8 hours; D-18A, 4.0 +/- 1.0 hours; L-18A, 4.6
      +/- 1.6 hours; and 18R, 0.9 +/- 0.1 hour.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637787
TI  - Significant association between low-molecular-weight apolipoprotein(a) isoforms
      and intermittent claudication.
AB  - The role of lipoprotein(a) (Lp[a]) and apolipoprotein(a) (apo[a]) isoforms in
      symptomatic peripheral atherosclerosis was studied in 100 randomly selected
      middle-aged (45-69 years) men with intermittent claudication (IC) and 100
      randomly selected healthy control (C) subjects. IC and C subjects were matched
      pairwise for sex, age, and smoking habits. Plasma Lp(a) concentrations were
      significantly higher in IC subjects, with a median value of 20.12 mg/dl, compared
      with 11.11 mg/dl in C subjects (p less than 0.0009). The elevated Lp(a)
      concentration was to a great extent due to a significant difference in the
      frequency distribution of apo(a) isoforms between IC and C subjects (p less than
      0.029). Low-molecular-weight apo(a) isoforms were more prevalent in IC than C
      subjects. Also, IC subjects with apo(a) S2 and S3 phenotypes had higher Lp(a)
      concentrations than control subjects with the same phenotypes: S2:60.70 mg/dl
      (IC) and 48.69 mg/dl (C), p less than 0.038; and S3: 30.18 mg/dl (IC) and 12.01
      mg/dl (C), p less than 0.042, so other still-unknown factors, genetic or
      nongenetic, may be important. Stepwise logistic regression analysis demonstrated
      that Lp(a) concentration contributed significantly (p less than 0.0002) to IC,
      independent of age, smoking, hypertension, diabetes mellitus, plasma total
      cholesterol, low density lipoprotein cholesterol, high density lipoprotein
      cholesterol, apo B, and plasma total triglycerides. Apo(a) isoforms grouped
      according to molecular weight were also independent of the above risk factors
      associated (p = 0.016) with the occurrence of IC because of their low-molecular
      weight but were not independent of Lp(a) concentrations.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1637788
TI  - Dietary fish oil plus lovastatin decreases both VLDL and LDL apo B production in
      miniature pigs.
AB  - Our previous apolipoprotein (apo) B kinetic studies of miniature pigs fed fish
      oil (Maxepa) demonstrated that very low density lipoprotein (VLDL) apo B
      concentrations were markedly reduced but that low density lipoprotein (LDL)
      concentrations were only modestly lowered because of a threefold increase in the
      conversion of VLDL apo B to LDL. In the present study, the effect of Maxepa plus
      lovastatin, a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, on apo B
      metabolism was assessed. Miniature pigs (n = 6) were simultaneously injected with
      autologous 131I-VLDL and 125I-LDL after a diet of pig chow supplemented with 30
      g/day of Maxepa and again after the addition of lovastatin, 30 mg/day. Kinetic
      data were analyzed by compartmental analysis with use of the CONSAM program.
      Compared with Maxepa alone, the addition of lovastatin reduced VLDL apo B
      concentrations by 21% (p less than 0.003) because of reduced VLDL apo B
      production (26%, p less than 0.005), as the fractional clearance rate was not
      affected. Conversion of VLDL apo B to LDL was reduced by 48% (p less than 0.005),
      and the direct removal of VLDL apo B from plasma was reduced by 25% (p less than
      0.01). Maxepa plus lovastatin reduced LDL apo B concentrations by 44% (p less
      than 0.004). This was due to a 38% (p less than 0.002) decrease in LDL
      production, which was primarily derived from VLDL. The LDL apo B fractional
      catabolic rate was not significantly changed. Thus, a combination of Maxepa and
      lovastatin reduces both VLDL and LDL apo B concentrations, primarily by
      decreasing production rates.

PMID- 1637789
TI  - Abnormalities of VLDL, IDL, and LDL characterize insulin-dependent diabetes
      mellitus.
AB  - To identify abnormalities of serum lipoprotein composition and concentration that
      were specific to insulin-dependent diabetes mellitus (IDDM), the procedure of
      discontinuous gradient ultracentrifugation was employed to isolate lipoprotein
      fractions in 44 patients with IDDM, 24 nondiabetic subjects with similar lipid
      and lipoprotein concentrations, and 19 healthy normocholesterolemic (less than
      5.2 mmol/l [less than 200 mg/dl]) subjects. The mass concentration of low density
      lipoprotein (LDL) was greater in IDDM than in both control groups. The free
      cholesterol to phospholipid ratio in large very low density lipoprotein (VLDL)
      was greatest in IDDM in comparison with both of the other groups. The
      contribution of triglyceride to total large VLDL mass was greater, whereas that
      of phospholipids was lower, in IDDM than in the dyslipidemic nondiabetic group.
      Protein concentration was reduced and phospholipid increased in small VLDL in
      IDDM in comparison with both control groups, and the contribution from protein to
      lipoprotein mass was least in IDDM. Similarly in intermediate density lipoprotein
      (IDL), the protein concentration and its contribution to overall mass was also
      lower in IDDM than in either control group, but by contrast, the phospholipid
      content was increased. The cholesteryl ester to protein ratio was highest in both
      small VLDL and IDL in IDDM in comparison with both control groups, whereas the
      free cholesterol to phospholipid ratio in IDL was least in IDDM. In LDL, total
      cholesterol and triglyceride concentrations were greatest and the contribution
      from protein to lipoprotein mass was least in IDDM in comparison with both
      control groups. The LDL free cholesterol to phospholipid ratio was greater in
      IDDM than in dyslipidemic control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637790
TI  - Oxidatively modified HDLs are potent inhibitors of cholesterol biosynthesis in
      human skin fibroblasts.
AB  - Several biological properties of lipoproteins are modified by oxidative
      reactions. Modified lipoproteins are rapidly degraded by macrophages, and this is
      likely to be a major pathway for the formation of foam cells in the early phases
      of atherosclerosis. The effect of modification on other aspects of cholesterol
      homeostasis has, however, received lesser attention. In this study, the influence
      of copper ion- as well as rat aortic smooth muscle cell-oxidation-modified high
      density lipoprotein (HDL) on cholesterol biosynthesis in human skin fibroblasts
      has been investigated. Modified lipoproteins eluted at higher ionic strength than
      did control HDL on a Mono-Q 5/5 anion-exchange column. However, only copper ion
      modified HDLs displayed greater electrophoretic mobility than did control
      lipoproteins on agarose gel electrophoresis. Both control and modified HDLs
      decreased cholesterol esterification in fibroblasts. On the other hand, whereas
      control HDLs were virtually ineffective in modulating cholesterol biosynthesis,
      modified HDLs had a significant suppressing effect. This was observed in normal
      as well as low density lipoprotein (LDL) receptor-defective fibroblasts, which
      are unresponsive to the LDL-mediated downregulation of cholesterol synthesis.
      These results are consistent with the concept that oxidative modification of HDLs
      drastically alters their effect on cholesterol homeostasis in fibroblasts. The
      data furthermore suggest the existence of a lipoprotein pathway for cholesterol
      biosynthesis regulation that is independent of the LDL receptor-mediated pathway.
      Downregulation of cholesterol biosynthesis would be a new function for
      oxidatively modified lipoproteins.

PMID- 1637791
TI  - Endocytosis of oxidized LDL and reversibility of migration inhibition in
      macrophage-derived foam cells in vitro. A mechanism for atherosclerosis
      regression?
AB  - The ability of macrophage-derived foam cells to migrate from atherosclerotic
      lesions represents one potential mechanism for the regression of atherosclerosis.
      It is, however, generally recognized that the transformation of macrophages into
      foam cells results in greatly reduced migrational ability. In the present study,
      we set out to investigate the factors affecting migratory capability in foam cell
      like cells with the use of an in vitro assay. Foam cell-like cells were prepared
      by incubating macrophages in the presence of oxidized low density lipoprotein
      (LDL). The transformation to a typical foam cell morphology was demonstrated by
      Nile red staining (light microscopy), and the mechanisms of binding, uptake, and
      intracellular processing of oxidized LDL were established by colloidal gold
      labeling on the ultrastructural level. With the in vitro assay, the migration of
      these foam cell-like cells was found to be markedly inhibited compared with
      untreated, control macrophages. However, zymosan-activated mouse serum restored
      migration in oxidized LDL-treated cells to levels similar to those of control
      cells. Restoration of migratory capacity was accompanied by alterations in the
      cytoskeleton system, especially in actin arrangement.

PMID- 1637792
TI  - Smoking is a potential confounder of the Chlamydia pneumoniae-coronary artery
      disease association.
AB  - Two recent studies, which did not adequately control for smoking status, found
      associations between Chlamydia pneumoniae serological titers and various
      manifestations of coronary artery disease (CAD). The validity of C. pneumoniae
      CAD associations found in case-control studies has been criticized on the basis
      that smoking, known to be associated with CAD and hypothesized to be associated
      with C. pneumoniae seroreactivity via an increased prevalence of respiratory
      infection in smokers, could be an uncontrolled confounder in these studies. We
      investigated associations between current smoking status and C. pneumoniae
      serological titers in a cohort of 365 outpatients (mean age, 34 years) with
      respiratory illness. Current smokers were significantly (p = 0.04) more likely
      than nonsmokers to have C. pneumoniae titers greater than or equal to 1:128, and
      there was a significant (p less than 0.05) "dose-response" association between
      titer category and smoking, which persisted after controlling for age and sex in
      a logistic-regression model. These results support the hypothesis that smoking
      may be a confounder of the association of C. pneumoniae antibody titer and
      smoking-associated diseases such as CAD. Future studies into these associations
      should control for cigarette use.

PMID- 1637793
TI  - Antithrombotic effect of a monoclonal antibody against tissue factor in a rabbit
      model of platelet-mediated arterial thrombosis.
AB  - Activation of the coagulation system by contact of circulating blood with tissue
      factor, a component of the extrinsic blood coagulation pathway that is produced
      in the vessel wall, may represent a pathway for the initiation of thrombosis in
      atherosclerotic vessels. This hypothesis was tested in vivo in a rabbit femoral
      artery eversion (inside-out) graft model, in which the adventitia, with its
      tissue factor, was exposed to circulating blood. Intra-arterial infusion of a
      neutralizing monoclonal antibody against tissue factor (D3) at a rate of 12 mg/kg
      over 15 minutes prevented thrombosis of a 7-8-mm eversion graft within a 2-hour
      observation period in four of five rabbits, whereas with a control antibody
      infusion (MA-15C5), occlusion occurred within 2 hours in five of six rabbits. In
      vitro immersion before reinsertion of the arterial segment in a solution
      containing 2 mg/ml of the control antibody for 30 minutes was associated with
      occlusion in all six rabbits, whereas pretreatment with D3 was associated with
      persistent patency in three of nine rabbits. Stepwise logistic-regression
      analysis of the results with perfusion status as the dependent variable and type
      of antibody (D3 or MA-15C5), application method (infusion versus immersion), and
      graft segment length as independent variables yielded a significant difference in
      frequency of occlusion with the two antibodies (p = 0.016). It is concluded that
      exposure of tissue factor to flowing blood may constitute a trigger mechanism for
      platelet-mediated arterial thrombosis.

PMID- 1637794
TI  - Influence of gender, body mass index, and age on response of plasma lipids to
      dietary fat plus cholesterol.
AB  - We have conducted a crossover, randomized, double-blind dietary trial that tested
      the hypothesis that gender influences the response of plasma lipids, in
      particular high density lipoprotein (HDL) cholesterol, to dietary fat plus
      cholesterol. Twenty-six men and 25 women were matched for age, low density
      lipoprotein (LDL) cholesterol, triglyceride, and body mass index (BMI). After a 2
      week baseline low-fat (27% of calories), low-cholesterol period, subjects were
      given two isocaloric liquid supplements for 3 weeks each, one containing 31 g fat
      (56% saturated) and 650 mg cholesterol, and the other fat free. The baseline HDL2
      cholesterol level was significantly higher in women: 0.41 versus 0.26 mmol/l (p
      less than 0.01). Importantly, women also showed a greater rise in HDL2
      cholesterol concentration with the fat/cholesterol supplement: 0.09 versus 0.03
      mmol/l (p less than 0.01). The greater increment in women was related to their
      higher baseline HDL2 cholesterol levels. With the fat and cholesterol supplement,
      LDL cholesterol values rose from 3.76 to 4.04 mmol/l in women and from 3.77 to
      4.13 mmol/l in men. The baseline LDL cholesterol value was found to account for
      about 35% of the variance in the rise in LDL cholesterol level with fat and
      cholesterol supplementation in both men and women less than 50 years. In men
      only, there was a significant effect of age: the change in LDL cholesterol with
      the fat/cholesterol supplement was 0.16 mmol/l in those less than 50 and 0.54
      mmol/l in those greater than 50 years old (p less than 0.01).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1637795
TI  - Flow affects development of intimal hyperplasia after arterial injury in rats.
AB  - This study examined the effects of blood flow on intimal hyperplasia after
      balloon catheter injury of the rat common carotid artery. Flow was altered by
      ligation of the opposite common carotid artery (increased flow) or of the
      ipsilateral internal carotid artery (decreased flow). Blood flow decreased by 35%
      in the low-flow group and increased by 29% in the high-flow group. Similar
      changes in mean velocity were observed. Cross-sectional intimal area was
      significantly greater in the low- than the high-flow group at 2 weeks (0.11 +/-
      0.01 versus 0.06 +/- 0.01 mm2, p less than 0.01) and 4 weeks (0.17 +/- 0.02
      versus 0.12 +/- 0.01 mm2, p = 0.01) but not at 1 or 8 weeks. Smooth muscle cell
      proliferation rates (thymidine labeling indexes) were not different in high- and
      low-flow groups at 2 days and at 1 and 4 weeks. Matrix accumulation at 2 and 4
      weeks was the same in both groups. Mature neointima did not respond to changes in
      flow; when vessel ligation was delayed until 2 months after injury, there was no
      effect on neointimal area. These data indicate that early neointimal hyperplasia
      is increased when flow is reduced, possibly because of alteration of smooth
      muscle cell migration.

PMID- 1637796
TI  - Normal postprandial lipemia in men with low plasma HDL concentrations.
AB  - To examine the relation between postprandial lipemia and high density lipoprotein
      (HDL) concentrations, we measured the plasma triglyceride and retinyl palmitate
      responses to 50-g fat meals of 1) 25 men with low HDL cholesterol concentrations
      (less than 36 mg.dl-1) and normal fasting triglyceride concentrations, 2) 25 men
      with normal HDL cholesterol (greater than 40 mg.dl-1) and normal fasting
      triglyceride concentrations, and 3) 20 men with mild to moderate fasting
      hypertriglyceridemia (250-347 mg.dl-1). The average magnitude of postprandial
      lipemia induced by the fat meals was markedly higher in the hypertriglyceridemic
      men (593 +/- 311 mg.dl-1.8 hr) than in either of the normolipidemic groups. In
      normotriglyceridemic men with low HDL cholesterol, mean postprandial lipemia (303
      +/- 158 mg.dl-1.8 hr) was similar to the corresponding value of men with normal
      HDL (283 +/- 130 mg.dl-1.8 hr). Postprandial plasma retinyl palmitate
      concentrations, which reflect chylomicron remnant metabolism, also were similar
      in normal-HDL and low-HDL groups. These data suggest that defects in chylomicron
      triglyceride clearance that give rise to excess postprandial lipemia are not a
      common occurrence in normolipidemic men with low HDL cholesterol concentrations.
      Accordingly, the low HDL cholesterol concentrations measured in the
      normotriglyceridemic men in this study must be attributable to factors other than
      an exaggerated postprandial lipemia.

PMID- 1637797
TI  - Persistence of abnormalities in metabolism of apolipoproteins B-100 and A-I after
      weight reduction in patients with primary hypertriglyceridemia.
AB  - Obesity commonly accompanies hypertriglyceridemia, and weight reduction is widely
      recommended for treatment of elevated triglyceride levels. To determine whether
      weight reduction will normalize lipoprotein metabolism in overweight,
      hypertriglyceridemic patients, 10 such male patients underwent weight loss until
      their body weights were within the desirable range. After reestablishment of a
      steady state in body weight at the lower level, measurements were made of plasma
      lipid, lipoprotein, and apolipoprotein levels and the kinetics of low density
      lipoprotein (LDL) apolipoprotein B-100 (apo B) and apolipoprotein A-I (apo A-I).
      The patients lost an average of 10.6 +/- 2.1 kg (mean +/- SEM). Plasma
      triglyceride concentrations fell from 431 +/- 42 mg/dl to 248 +/- 27 mg/dl (p
      less than 0.001), whereas concentrations of total cholesterol, LDL cholesterol,
      total apo B, and high density lipoprotein (HDL) cholesterol were unchanged after
      weight loss. On average, the fractional catabolic rates (FCRs) for LDL were much
      higher in the patients after weight loss than in 16 normal control subjects (0.55
      +/- 0.06 versus 0.31 +/- 0.06 pool/day), and input rates for LDL also were higher
      for hypertriglyceridemic patients after weight loss (22.2 +/- 2.4 versus 12.8 +/-
      2.3 mg/kg.day). Compared with 20 normal control subjects, hypertriglyceridemic
      patients after weight reduction had persistent low HDL cholesterol levels (32 +/-
      2 versus 54 +/- 3 mg/dl) as well as low apo A-I levels (99 +/- 5 versus 122 +/- 4
      mg/dl).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637798
TI  - Autoradiographic analysis of the distribution of 125I-tyramine-cellobiose-LDL in
      atherosclerotic lesions of the WHHL rabbit.
AB  - It is well established that plasma lipoproteins enter the artery wall and play a
      role in the atherogenic process. However, it is still unclear where within
      developing atherosclerotic lesions lipoproteins accumulate and which arterial
      cells participate in the metabolism of these lipoproteins. For this reason, light
      and electron microscopic autoradiograms were prepared from sections of lesioned
      aortas of Watanabe heritable hyperlipidemic (WHHL) rabbits 44 hours after
      injection of 125I-tyramine cellobiose-low density lipoprotein (TC-LDL). After
      uptake of 125I-TC-LDL and intracellular degradation of the LDL protein, the
      nondegradable TC ligand remains trapped and thus demarcates the cells
      participating in the degradation of LDL. Results of other studies indicate that
      48 hours after injection into WHHL rabbits, about one half of the 125I label
      present in lesions represents accumulated degradation products while the
      remaining 125I label is present as intact 125I-TC-LDL. The distribution of
      autoradiographic silver grains was analyzed at low resolution in fatty streaks,
      transitional lesions, and advanced atheroma. In all cases, the majority of silver
      grains were associated with superficially located subendothelial macrophage
      derived foam cells. In more advanced lesions, labeling was predominant in foam
      cells situated within the lateral margins of the lesions. Morphometric
      quantification of the distribution of silver grains in electron photomicrographs
      of fatty streaks from two young WHHL rabbits strongly supported the data obtained
      at the light microscopic level. In early fatty streaks from the aortic arch and
      the thoracic and abdominal aortas, subendothelial macrophage-derived foam cells
      contained a high proportion of the silver grains (40-60% of the total) and
      accounted for between 30% and 40% of the lesion volume. In contrast, smooth
      muscle cells in the lesions contained only 7-10% of the total silver grains and
      accounted for approximately 20% of the lesion volume. Endothelial cells contained
      the most silver grains on a per-unit-volume basis by occupying only 1-2% of the
      lesion volume. However, the endothelium contained less than 5% of the total
      grains in lesions. The remaining silver grains (25-45%) were associated with the
      extracellular matrix, which constituted between 40% and 50% of the lesion volume.
      These data indicate that in the WHHL rabbit, subendothelial macrophage-derived
      foam cells avidly accumulate and metabolize LDL despite having few functional LDL
      receptors.

PMID- 1637799
TI  - Biological markers and the concept of psychiatric illness.

PMID- 1637800
TI  - The dimensional approach to clinical psychopharmacology: a polysemous concept.
AB  - The last decade has seen significant progress in the development and specific
      clinical application of selective psychotropes. The dimensional approach to
      clinical psychopharmacology views the behavioral targets of psychotropes as
      phenomena existing on a continuum and as components, in varying degrees, of most
      psychopathologies. The modern concept of dimension has been used in different
      contexts. In psychology it has a mathematical sense, whereas in biological
      psychiatry it is associated more with biological function. This paper reviews
      these two concepts and the recent models attempting to merge them into one. The
      heuristic value of the dimensional approach, as well as some of its pitfalls and
      new avenues of research, are discussed.

PMID- 1637801
TI  - [Use of low doses of bromocriptine in chronic schizophrenia resistant to
      neuroleptics. A preliminary study].
AB  - In this work, we report the efficiency of bromocriptine (1.25 and 2.5 mg/day) in
      9 neuroleptic resistant chronic schizophrenics. Following an initial four-week
      placebo period, the subjects successively received bromocriptine (1.25 mg/day),
      placebo and bromocriptine (2.5 mg/day). The 2 bromocriptine treatments
      significantly improved the global psychiatric symptomatology and different scores
      and factors related to the more specific schizophrenic symptomatology. An escape
      phenomenon seems to occur during the 4th week of the first bromocriptine
      treatment (1.25 mg/day) but is not observed with the second treatment (2.5
      mg/day). All patients improved.

PMID- 1637802
TI  - Comparison of behavioral effects after single and repeated administrations of
      four benzodiazepines in three mice behavioral models.
AB  - The behavioral and clinical profiles of various benzodiazepines after acute and
      chronic treatment are not well defined and may differ. The aim of this study was
      to evaluate the behavioral profiles of alprazolam, bromazepam, diazepam and
      lorazepam in mice after single and repeated (every half-life for seven half
      lives) administrations using a stimulation-sedation test (actimeter), a
      myorelaxation test (rotarod), and an anxiolysis test ("four plates"). A dose
      range from 0.03 to 4 mg/kg was used. A single administration of alprazolam showed
      stimulating and anxiolytic effects which diminished after repeated
      administration. Lorezapam's sedative effect diminished but its anxiolytic effect
      increased upon repeated administration. Except for lorazepam, the myorelaxing
      effect of all four drugs increased after repeated treatment. These results
      suggest that the behavioral profile of benzodiazepines may not be identical
      during acute and chronic treatment. These differences may be present in clinical
      treatment and warrant investigation in humans.

PMID- 1637803
TI  - Sodium valproate and clonazepam for treatment-resistant panic disorder.
AB  - Sodium valproate (VA) and clonazepam (CLZ) were combined in the treatment of 4
      patients with panic disorders (PD) who were resistant to several antipanic drug
      treatments. A significant improvement was found in the symptomatology of these
      patients, but relapses occurred when CLZ dosage was reduced. A potentiation of
      the GABAergic properties of VA and clonazepam is postulated. This combined
      treatment could be advantageous for some treatment-resistant PD patients but
      needs to be studied further.

PMID- 1637804
TI  - Phorbol ester-mediated downregulation of tropoelastin expression is controlled by
      a posttranscriptional mechanism.
AB  - Expression of tropoelastin, the principal precursor of elastic fibers, is tissue
      specific and is limited to a brief developmental period. Little is known,
      however, about the mechanisms that regulate the tissue- and temporal-specific
      expression of elastogenesis. The tropoelastin promoter contains putative phorbol
      ester responsive elements, or AP-1 binding sites, but the functional significance
      of these sequences is unknown. To test if tropoelastin expression is influenced
      by phorbol esters, we exposed elastogenic fetal bovine chondrocytes to 10(-7) M
      12-O-tetradecanoylphorbol 13-acetate (TPA). Tropoelastin mRNA levels decreased
      greater than 10-fold in response to TPA, and this downregulation was paralleled
      by a decline in the secretion of tropoelastin protein into the culture medium. As
      determined by nuclear-runoff assay and transient transfection with a human gene
      promoter-CAT construct, tropoelastin transcription was unaffected after exposure
      to TPA. As indicated by actinomycin D experiments, the half-life of tropoelastin
      mRNA in control cells was about 20 h, but exposure to TPA resulted in an
      accelerated decay of the tropoelastin transcript (t1/2 = 2.2 h). These data
      indicate that downregulation of tropoelastin expression was controlled by a
      posttranscriptional mechanism and that the AP-1 elements in the bovine
      tropoelastin promoter may not be involved in regulation of production.

PMID- 1637805
TI  - Hydroxyethylene isostere inhibitors of human immunodeficiency virus-1 protease:
      structure-activity analysis using enzyme kinetics, X-ray crystallography, and
      infected T-cell assays.
AB  - Analogues of peptides ranging in size from three to six amino acids and
      containing the hydroxyethylene dipeptide isosteres Phe psi Gly, Phe psi Ala, Phe
      psi NorVal, Phe psi Leu, and Phe psi Phe, where psi denotes replacement of CONH
      by (S)-CH(OH)CH2, were synthesized and studied as HIV-1 protease inhibitors.
      Inhibition constants (Ki) with purified HIV-1 protease depend strongly on the
      isostere in the order Phe psi Gly greater than Phe psi Ala greater than Phe psi
      NorVal greater than Phe psi Leu greater than Phe psi Phe and decrease with
      increasing length of the peptide analogue, converging to a value of 0.4 nM. Ki
      values are progressively less dependent on inhibitor length as the size of the
      P1' side chain within the isostere increases. The structures of HIV-1 protease
      complexed with the inhibitors Ala-Ala-X-Val-Val-OMe, where X is Phe psi Gly, Phe
      psi Ala, Phe psi NorVal, and Phe psi Phe, have been determined by X-ray
      crystallography (resolution 2.3-3.2 A). The crystals exhibit symmetry consistent
      with space group P6(1) with strong noncrystallographic 2-fold symmetry, and the
      inhibitors all exhibit 2-fold disorder. The inhibitors bind in similar
      conformations, forming conserved hydrogen bonds with the enzyme. The Phe psi Gly
      inhibitor adopts an altered conformation that places its P3' valine side chain
      partially in the hydrophobic S1' pocket, thus suggesting an explanation for the
      greater dependence of the Ki value on inhibitor length in the Phe psi Gly series.
      From the kinetic and crystallographic data, a minimal inhibitor model for tight
      binding inhibition is derived in which the enzyme subsites S2-S2' are optimally
      occupied. The Ki values for several compounds are compared with their potencies
      as inhibitors of proteolytic processing in T-cell cultures chronically infected
      with HIV-1 (MIC values) and as inhibitors of acute infectivity (IC50 values).
      There is a rank-order correspondence, but a 20-1000-fold difference, between the
      values of Ki and those of MIC or IC50. IC50 values can approach those of Ki but
      are highly dependent on the conditions of the acute infectivity assay and are
      influenced by physiochemical properties of the inhibitors such as solubility.

PMID- 1637806
TI  - Conformations, interactions, and thermostabilities of RNA and proteins in bean
      pod mottle virus: investigation of solution and crystal structures by laser Raman
      spectroscopy.
AB  - We report and interpret laser Raman spectra of the three virion components of
      bean pod mottle virus (BPMV). The top component of BPMV is an empty capsid;
      middle and bottom components package the RNA2 and RNA1 genome segments,
      respectively. All components were investigated as both single crystals and
      aqueous solutions, the latter over wide ranges of temperature and ionic strength.
      The isolated RNA2 molecule of BPMV middle component was also investigated in both
      H2O and D2O solutions. The results permit assessment of RNA and protein
      structures, their mutual interactions in the virions, and their conformational
      thermostabilities and comparison of these structural characteristics for solution
      and crystal states of the particles. The principal findings of this study are (i)
      The extent of ordered A-form backbone (74%) and of base pairing (38% AU + 22% GC)
      in unpackaged (aqueous) RNA2 are significantly altered by packaging. The A-form
      secondary structure of RNA2 is increased by 12 +/- 4%, and guanine base
      interactions are also substantially increased with packaging. (ii) The
      thermostability of Raman-monitored secondary structure of unpackaged RNA2 (Tm
      approximately 43 degrees C) is greatly increased in the packaged state (Tm
      approximately 53 degrees C). This increase corresponds to a stabilization of the
      A-form backbone geometry in 15 +/- 5% of genome nucleotides. (iii) Packaging of
      RNA2 in the middle component stabilizes subunit-subunit interactions of the
      capsid, as evidenced by a thermal denaturation temperature Td approximately 65
      degrees C for the virion, compared with Td approximately 55 degrees C for the
      empty capsid. (iv) Raman marker-band shifts implicate the purine 7N sites of RNA2
      and aromatic side chains of subunits as the principal targets for RNA-subunit
      interaction. (v) At the conditions of the present experiments (8 degrees C, pH
      approximately 7, moderate ionic strength), the subunit secondary structures
      observed for solutions of the top, middle, and bottom components are
      indistinguishable by Raman spectroscopy from secondary structures observed for
      corresponding crystalline samples. (vi) On the other hand, side chains of
      subunits in the top component (empty capsid) yield significantly different Raman
      intensities in crystalline and solution states. These differences are interpreted
      as the result of changes in a small number of side-chain environments between
      crystal and solution. (vii) Similarly, small differences exist between RNA Raman
      markers of crystalline and aqueous virions, which are attributed to altered
      environments of nucleotide residues and to a small increase in the amount of A
      form backbone geometry upon going from the crystal to the solution.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1637807
TI  - Unfolding of trp repressor studied using fluorescence spectroscopic techniques.
AB  - The unfolding properties of the trp repressor of Escherichia coli have been
      studied using a number of different time-resolved and steady-state fluorescence
      approaches. Denaturation by urea was monitored by the average fluorescence
      emission energy of the intrinsic tryptophan residues of the repressor. These data
      were consistent with a two-state transition from dimer to unfolded monomer with a
      free energy of unfolding of 19.2 kcal/mol. The frequency response profiles of the
      fluorescence emission brought to light subtle urea-induced modifications of the
      intrinsic tryptophan decay parameters both preceding and following the main
      unfolding transition. The increase of lifetime induced by urea required higher
      concentrations of urea than the increase in the total intensity described by
      Gittelman and Matthews [(1990) Biochemistry 29, 7011]. This indicates that the
      intensity increase has both dynamic and static origins. To assess the effect of
      tryptophan binding upon repressor stability, and to determine whether repressor
      oligomerization would be detectable in an unfolding experiment, we examined
      denaturation profiles of repressor labeled with the long-lived fluorescence probe
      5-(dimethylamino)naphthalene-1-sulfonyl (DNS), by monitoring the average
      rotational correlation time of the probe. These experiments revealed a protein
      concentration dependent transition at low urea concentrations. This transition
      was promoted by tryptophan binding. We ascribe this transition to urea-induced
      dissociation of repressor tetramers. The main unfolding transition of the dimer
      to unfolded monomer was also observable using this technique, and the free
      energies associated with this transition were 18.3 kcal/mol in the absence of
      tryptophan and 24.1 kcal/mol in its presence, demonstrating that co-repressor
      binding stabilizes the repressor dimer against denaturation.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1637808
TI  - Speed of intersubunit communication in proteins.
AB  - To determine the speed of communication between protein subunits, time-resolved
      absorption spectra were measured following partial photodissociation of the
      carbon monoxide complex of hemoglobin. The experiments were carried out using
      linearly polarized, 10-ns laser pulses, with the polarization of the excitation
      pulse both parallel and perpendicular to the polarization of the probe pulse. The
      substantial contribution to the observed spectra from photoselection effects was
      eliminated by isotropically averaging the polarized spectra, allowing a detailed
      comparison of the kinetics as a function of the degree of photolysis. These
      results show that prior to 1 microsecond both geminate ligand rebinding and
      conformational relaxation are independent of the number of ligands dissociated
      from the hemoglobin tetramer, as expected for a two-state allosteric model. After
      this time the kinetics depend on the ligation state of the tetramer. The
      conformational relaxation at 10 microseconds can be interpreted in terms of the
      two-state allosteric model as arising from the R to T quaternary conformational
      change of both unliganded and singly liganded molecules. These results suggest
      that communication between subunits requires about 1 microsecond and that the
      mechanism of the communication which occurs after this time is via the R to T
      conformational change. The optical anisotropy provides a novel means of
      accurately determining the extinction coefficients of the transient photoproduct.
      The decay in the optical anisotropy, moreover, provides an accurate determination
      of the rotational correlation time of 36 +/- 3 ns.

PMID- 1637809
TI  - Ligand binding to the membrane-bound acetylcholine receptor from Torpedo
      marmorata: a complete mathematical analysis.
AB  - We have studied by means of equilibrium binding and kinetic experiments the
      interaction of the membrane-bound nicotinic acetylcholine receptor (nACHR) from
      Torpedo marmorata with [3H]acetylcholine and the fluorescent agonist NBD-5
      acylcholine. In agreement with previous studies by others, we observed the
      preexistence, in the absence of ligand, of an equilibrium between two states of
      the nAChR, one with high affinity and the other with low affinity for agonist. As
      additional requirements for a minimal reaction scheme, we recognized (i) the
      existence of two ligand-binding sites, each of which may exist in two
      conformational states when occupied, and (ii) ligand-induced transitions between
      these conformations. Employing a special form of the allosteric model which
      considers these requirements, we then developed a suitable algorithm in order to
      simultaneously fit the whole set of equilibrium binding and kinetic data obtained
      for the two ligands. In this way we determined for a minimal model of the
      mechanism of action of the nAChR the complete set of rate constants and KD values
      involved. With these values available, we were able to simulate the rise and fall
      in the concentrations of individual receptor-ligand complexes and conformations
      occurring in the course of excitatory events at the electrocyte synapse. The
      membrane environment of the nAChR plays a decisive role with respect to the rates
      of conformational change of the nAChR occurring in the course of ligand
      interaction. Thus, artificial changes in membrane structure and composition can
      speed up by several orders of magnitude the rate of conformational change
      ("desensitization"). A proper structure of the surrounding membrane hence is a
      prerequisite for the physiological function of the membrane-embedded nAChR.

PMID- 1637810
TI  - Lateral diffusion in the liquid phases of
      dimyristoylphosphatidylcholine/cholesterol lipid bilayers: a free volume
      analysis.
AB  - The technique of fluorescence recovery after photobleaching is used to perform an
      extensive study of the lateral diffusion of a phospholipid probe in the binary
      mixture dimyristoylphosphatidylcholine/cholesterol, above the melting temperature
      of the phospholipid. In the regions of the phase diagram where a single liquid
      phase exists, diffusion can be quantitatively described by free volume theory,
      using a modified Macedo-Litovitz hybrid equation. In the liquid-liquid
      immiscibility region, the temperature dependence of the diffusion coefficient is
      in excellent agreement with current theories of generalized diffusivities in
      composite two-phase media. A consistent interpretation of the diffusion data can
      be provided based essentially on the idea that the primary effect of cholesterol
      addition to the bilayer is to occupy free volume. On this basis, a general
      interpretation of the phase behavior of this mixture is also proposed.

PMID- 1637811
TI  - Calcium-43 NMR studies of calcium-binding lysozymes and alpha-lactalbumins.
AB  - The calcium-binding properties of equine and pigeon lysozyme as well as those of
      bovine and human alpha-lactalbumin were investigated by 43Ca NMR spectroscopy.
      All proteins were found to contain one high-affinity calcium-binding site. The
      chemical shifts, line widths, relaxation times (T1 and T2), and quadrupole
      coupling constants for the respective 43Ca NMR signals were quite similar; this
      is indicative of a high degree of homology between the strong calcium-binding
      sites of these four proteins. The measured chemical shifts (delta approximately 
      3 to -7 ppm) and quadrupole coupling constants (chi approximately 0.7-0.8 MHz)
      are quite distinct from those observed for typical EF-hand calcium-binding
      proteins, suggesting a different geometry for the calcium-binding loops. The
      correlation times for bound calcium ions in these proteins were on the order of 4
      8 ns, indicating that the flexibilities of these binding sites are limited. The
      apparent pKa values for the high-affinity sites ranged from 3.4 to 4.7,
      confirming the participation of carboxylate-containing residues in the
      coordination of the calcium ion. Competition experiments with EDTA showed that
      the affinities of these proteins for calcium follow the series bovine alpha
      lactalbumin approximately human alpha-lactalbumin greater than pigeon lysozyme
      greater than equine lysozyme (KD approximately 5 x 10(-8) to 10(-6) M). Evidence
      for the existence of a second weak calcium-binding site (KD = 3 x 10(-3) M) was
      obtained for bovine alpha-lactalbumin, but not for the other proteins
      studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637812
TI  - A single-stranded DNA exonuclease from Schizosaccharomyces pombe.
AB  - We have purified to near homogeneity a DNA exonuclease from meiotic cells of
      Schizosaccharomyces pombe. The enzyme, designated exonuclease II (ExoII), had an
      apparent molecular weight of 134,000 and was abundant in the cell. It
      specifically degraded single-stranded DNA in the 5'----3' direction with an
      apparent Km for 5' DNA ends of 3.6 x 10(-11) M and produced 5' deoxynucleoside
      monophosphates. Its mode of degradation is similar to that of the RecJ protein
      from Escherichia coli; ExoII may, therefore, be involved in genetic recombination
      and DNA damage repair.

PMID- 1637813
TI  - Structure of the DNA interstrand cross-link of 4,5',8-trimethylpsoralen.
AB  - 4,5',8-Trimethylpsoralen (TMP) cross-links a 5' TpA or a 5' ApT site by
      photoreacting with one thymine moiety in each DNA strand. We are interested in
      whether psoralen interstrand cross-links all share one structure or whether there
      are significant differences. In this paper, we employed a rapid method for
      probing the structure of the cross-link by making a series of TMP cross-linked
      duplexes containing specific base-pair mismatches. The relative stability
      provided by a base pair can be correlated with neighboring base pairs by
      comparing the extents of gel retardation when base-pair mismatches happen in each
      position. From our studies, we infer that with respect to the furan-side strand,
      the 5'T.A base pair of the two T.A base pairs in the TpA site is not hydrogen
      bonded. Immediately on each side of the cross-linked TpA site is a highly
      stabilized base pair. Next, a region of decreased stability occurs in each arm of
      a cross-linked duplex and these base pairs of least stability are located farther
      away from the cross-linked thymines as the lengths of the arms of the cross
      linked helix increase. Finally, even in 7 M urea at 49 degrees C the cross-linked
      helix is hydrogen bonded at both ends of a duplex of 22 base pairs. We propose
      that the structures of interstrand cross-links in DNA vary appreciably with the
      DNA sequence, the length of the DNA duplex, and the structures of the DNA cross
      linking agents.

PMID- 1637814
TI  - Recognition of a guanine-cytosine base pair by 8-oxoadenine.
AB  - Two oligodeoxyribonucleotides, d-CTTCTTTTTTATTTT, I(A), and d-ATTATTTTTTATTTT,
      II(A), where C is 5-methylcytosine and A is 8-oxoadenine, were prepared and their
      interactions with the duplex d-GAAGAAAAAAYAAAA/d-TTTTZTTTTTTCTTC, III.IV(Y.Z),
      were studied. Oligomers I(A) and II(A) each form triplexes with III.IV(G.C) at
      temperatures below 20 degrees C as shown by continuous variation experiments,
      melting experiments, and circular dichroism (CD) spectroscopy. The CD spectra of
      these triplexes are almost identical to those formed by I(C) and II(C), oligomers
      which contain cytosine in place of 8-oxoadenine. This suggests that the 8
      oxoadenine-containing triplexes have conformations which are very similar to
      those of the cytosine-containing triplexes. The melting temperature (Tm) for
      dissociation of the third strand of triplex II.III.IV(A.G.C) is 22 degrees C at
      pH 7.0 and 8.0, whereas the Tm of the corresponding transition in triplex
      II.III.IV(C.G.C) decreases from 28 degrees C at pH 7.0 to 17 degrees C at pH 8.0.
      The pH dependence of the Tm in the latter triplex reflects the necessity of
      protonating the N-3 of cytosine in order for it to form two hydrogen bonds with G
      of the G.C base pair. It appears that the keto form of 8-oxoadenine can
      potentially form two hydrogen bonds with the N-7 and O-6 atoms of G of the G.C
      base pair, when the 8-oxoadenine is in the syn conformation and in contrast to
      cytosine does not require protonation of the base. Oligomer I(A) does not form
      triplexes with III.IV(Y.Z) when Y.Z is A.T or T.A.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1637815
TI  - Translesion DNA synthesis in the dihydrofolate reductase domain of UV-irradiated
      CHO cells.
AB  - The studies that document the coupling of strand-specific DNA repair to
      transcription of active genes exclude replicated DNA from the analysis. Yet
      cyclobutane pyrimidine dimers (CPD) induced by ultraviolet light (UV) persist in
      most of the genome in surviving Chinese hamster ovary (CHO) cells. The mechanisms
      that allow DNA replication to occur in the presence of damaged templates are
      poorly understood. We have investigated the distribution of CPD in the
      dihydrofolate reductase gene (DHFR) domain in replicated DNA. CHO B11 cells were
      incubated in the presence of BrdUrd after UV irradiation; the replicated DNA was
      separated from the unreplicated DNA by isopycnic sedimentation in CsCl, and then
      the parental and daughter strands were resolved in alkaline CsCl. We determined
      the fraction of a 14-kb KpnI fragment of the DHFR gene that was resistant to
      digestion by T4 endonuclease V, a CPD-specific enzyme. In both parental and
      unreplicated DNA, approximately 80% of the CPD were removed from the transcribed
      strands while approximately 20% were removed from the nontranscribed strands of
      DHFR within 24 h. In a 15-kb KpnI fragment that contains an origin of replication
      and is located approximately 15 kb downstream of DHFR, we found very low repair
      levels, whether it had been replicated or not. We detected no CPD in the daughter
      strands of either fragment analyzed. These results suggest that the replication
      forks can move through the damaged DNA in the absence of significant levels of
      repair or strand exchange and that the repair of CPD is not affected by
      replication in these cells.

PMID- 1637816
TI  - Human dihydrofolate reductase: reduction of alternative substrates, pH effects,
      and inhibition by deazafolates.
AB  - The kinetics of the NADPH-dependent reduction of 7,8-dihydrofolate, folate, and
      7,8-dihydrobiopterin by human dihydrofolate reductase have been examined over the
      pH range from 4.0 to 9.5. The V and V/K profiles obtained with the three
      substrates indicate that a single ionizing residue at the active site of the
      enzyme must be protonated for catalysis. Both the maximum velocity of the
      reactions and the rate of interaction of the substrates with the enzyme-NADPH
      complex decrease in the order dihydrofolate greater than dihydrobiopterin much
      greater than folate. From the pK values of the V/K profiles, it can be concluded
      that, while dihydrofolate behaves as a sticky substrate and dihydrobiopterin
      exhibits slight stickiness, folate is not a sticky substrate. Further support for
      this conclusion comes from the results of deuterium isotope effects. The pK
      values obtained from both the V and V/Kfolate profiles are similar to the
      intrinsic pK value of 5.6 for both the free enzyme and the enzyme-NADPH complex.
      The folate analogue, 5-deazafolate, is not a substrate, but it undergoes strong
      interaction with the enzyme. This interaction, which is enhanced by the presence
      of NADPH, is due to protonation of the bound ligand that does not involve the
      single ionizing group at the active center of the enzyme. Difference spectra
      yield evidence for the protonation of bound 5-deazafolate and show that, on
      binding to the enzyme-NADPH complex, the pK of the N-8 atom is raised to about 10
      from a value of about 4 in solution. The results are in accord with those of a
      recent paper on the three-dimensional structure of the enzyme-5-deazafolate
      complex [Davies, J.F., Delcamp, T.J., Prendergast, N.J., Ashfors, V.A.,
      Freisheim, J.H., & Kraut, J. (1990) Biochemistry 29, 9467-9479] which indicate
      that there is hydrogen bond formation between N-8 of the ligand and the carbonyl
      group of Ile-7. However, the present findings do not support the idea that bound
      5-deazafolate resembles the transition-state complex for folate reduction.
      Quinazolines also interact strongly with the enzyme but in a pH-independent
      manner. The dissociation constants for the binary complexes are an order of
      magnitude lower than that for the binding to the enzyme of unprotonated 5
      deazafolate. This difference reflects the hydrophobic nature of the amino acid
      residues at the active site that are near the N-5 and N-8 nitrogens of bound
      pterins.

PMID- 1637817
TI  - Interaction of rabbit muscle aldolase at high ionic strengths with vanadate and
      other oxoanions.
AB  - Reductive, nonreductive, and photolytic interactions of vanadate with fructose
      1,6-bisphosphate aldolase were examined and used to explore the interactions of
      oxoanions with aldolase. Aldolase is known to interact strongly with oxoanions at
      low ionic strength and weakly at higher ionic strength. Oxoanions inhibit
      aldolase competitively with respect to fructose 1,6-bisphosphate although the
      location of the oxoanion binding site on aldolase remains elusive. In this work,
      the interaction of aldolase with a series of oxoanions was compared at ionic
      strength approaching physiologic levels. The size and shape of the anion were
      important for the effective binding to aldolase, and no significant increase in
      affinity for aldolase was observed by the addition of alkyl groups to the
      oxoanions. Vanadate competitively inhibits aldolase in a manner analogous to the
      other oxoanions. Since vanadate solutions contain a mixture of vanadate
      oxoanions, the nature of the inhibition was determined using a combination of
      enzyme kinetics and 51V NMR spectroscopy. Aldolase contains a significant number
      of thiol functionalities, and as expected, vanadate undergoes redox chemistry
      with them, generating an irreversibly inhibited aldolase. This oxidative
      chemistry was attributed to the vanadate tetramer, whereas vanadate dimer was a
      reversible inhibitor. Vanadate monomer does not significantly interact with
      aldolase reversibly or irreversibly. Vanadyl cation has the lowest inhibition
      constant under these high ionic strength conditions. Using Yonetani-Theorell
      analysis, it appears that phosphate, pyrophosphate, and sulfate bind to the same
      site on aldolase, whereas vanadate, arsenate, and molybdate bind to another site.
      UV light-induced photocleavage of aldolase by vanadate was examined, and the loss
      of aldolase activity was correlated with cleavage of the aldolase subunit.
      Further studies using vanadium as a probe should reveal details on the location
      of the vanadate and vanadyl cation binding sites. This study suggests several
      sites on aldolase will accommodate oxoanions, and one of these sites also
      accommodates vanadyl cation.

PMID- 1637818
TI  - Stereochemical course of tyramine oxidation by semicarbazide-sensitive amine
      oxidase.
AB  - Two semicarbazide-sensitive amine oxidases (SSAO's) from bovine and porcine
      aortic tissue were partially purified and characterized, and the stereochemical
      course of amine oxidation was evaluated. The porcine and bovine SSAO's were
      membrane bound glycoproteins, with Km values for benzylamine of 8 and 16 microM,
      respectively. The reactivity of SSAO with semicarbazide and phenylhydrazine
      suggests that the cofactor is a carbonyl type molecule. The stereochemical course
      of the bovine and porcine aortic semicarbazide-sensitive amine oxidase reaction
      was investigated using chiral tyramines, deuterated at C-1 and C-2, and 1H-NMR
      spectroscopy to establish the loss or retention of deuterium in product p
      hydroxyphenethyl alcohols. The preferred mode of tyramine oxidation was found to
      occur with the loss of pro-S proton at C-1, coupled with solvent exchange into C
      2, a pattern which has not been observed for any copper amine oxidase examined to
      date. The solvent exchange reaction also occurred stereospecifically, with loss
      from and reprotonation to the pro-R position, suggesting that these two processes
      occur from the same face of the enamine double bond.

PMID- 1637819
TI  - 3-Hydroxy-3-methylglutaryl coenzyme A lyase: affinity labeling of the Pseudomonas
      mevalonii enzyme and assignment of cysteine-237 to the active site.
AB  - Pseudomonas mevalonii 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) lyase is
      irreversibly inactivated by the reactive substrate analog 2-butynoyl-CoA. Enzyme
      inactivation, which follows pseudo-first-order kinetics, is saturable with a KI =
      65 microM and a limiting k(inact) of 0.073 min-1 at 23 degrees C, pH 7.2.
      Protection against inactivation is afforded by the competitive inhibitor 3
      hydroxyglutaryl-CoA. Labeling of the bacterial enzyme with [1-14C]-2-butynoyl-CoA
      demonstrates that inactivation coincides with covalent incorporation of
      inhibitor, with an observed stoichiometry of modification of 0.65 per site. Avian
      HMG-CoA lyase is also irreversibly inactivated by 2-butynoyl-CoA with a
      stoichiometry of modification of 0.9 per site. Incubation of 2-butynoyl-CoA with
      mercaptans such as dithiothreitol results in the formation of a UV absorbance
      peak at 310 nm. Enzyme inactivation is also accompanied by the development of a
      UV absorbance peak at 310 nm indicating that 2-butynoyl-CoA modifies a cysteine
      residue in HMG-CoA lyase. Tryptic digestion and reverse-phase HPLC of the
      affinity-labeled protein reveal a single radiolabeled peptide. Isolation and
      sequence analysis of this peptide and a smaller chymotryptic peptide indicate
      that the radiolabeled residue is contained within the sequence GGXPY. Mapping of
      this peptide within the cDNA-deduced sequence of P. mevalonii HMG-CoA lyase
      [Anderson, D. H., & Rodwell, V. W. (1989) J. Bacteriol. 171, 6468-6472] confirms
      that a cysteine at position 237 is the site of modification. These data represent
      the first identification of an active-site residue in HMG-CoA lyase.

PMID- 1637820
TI  - Purification of human S-adenosylmethionine decarboxylase expressed in Escherichia
      coli and use of this protein to investigate the mechanism of inhibition by the
      irreversible inhibitors, 5'-deoxy-5'-[(3-hydrazinopropyl)methylamino]adenosine
      and 5'-([(Z)-4-amino-2-butenyl]methylamino)-5'-deoxyadenosine.
AB  - Human S-adenosylmethionine decarboxylase (AdoMetDC) was expressed in high yield
      in Escherichia coli using the pIN-III(lppP-5) expression vector and purified to
      apparent homogeneity using affinity chromatography on methylglyoxal
      bis(guanylhydrazone)-Sepharose. The inactivation of the purified enzyme by 5'
      deoxy-5'-[(3-hydrazinopropyl)methylamino]adenosine (MHZPA) was accompanied by an
      increase in absorbance at 260 nm of the large subunit. This increase was
      equivalent to the addition of 1 molecule of MHZPA. After digestion with the
      protease Lys-C, a peptide that contained the bound MHZPA was isolated and found
      to have the amino acid composition consistent with that expected from the amino
      terminus of the large subunit. These results indicate that MHZPA inactivates
      AdoMetDC by forming a hydrazone derivative at the pyruvate prosthetic group.
      Inactivation of AdoMetDC by 5'-([(Z)-4-amino-2-butenyl]methylamino]-5'
      deoxyadenosine (AbeAdo) led to the appearance of a new peptide peak in the Lys-C
      protease digest. This peptide had the sequence ASMFVSK. This agrees with the
      expected sequence from the amino terminus, which is pyruvoyl-SMFVSK, with the
      exception that the pyruvate has been converted to alanine. Direct gas-phase
      sequencing of the large subunit of the enzyme also indicated the presence of
      alanine at the amino terminus after inactivation with AbeAdo. These results
      indicate that this inhibitor leads to transamination of the pyruvate prosthetic
      group. Since the pyruvate is covalently linked to the protein, its replacement by
      alanine leads to an irreversible inactivation of AdoMetDC.

PMID- 1637821
TI  - In pursuit of the molecular structure of amyloid plaque: new technology provides
      unexpected and critical information.

PMID- 1637822
TI  - Progress in establishing the rate-limiting features and kinetic mechanism of the
      glyceraldehyde-3-phosphate dehydrogenase reaction.
AB  - Primary hydrogen isotope effects and steady-state kinetics have been used to
      study the mechanism of glyceraldehyde-3-phosphate (GAP) dehydrogenase at pH 8.6.
      The isotope effect determined by using GAP-1d was unity and independent of
      arsenate (used as the acyl acceptor) and NAD+ concentrations when the aldehyde
      substrate was at saturating concentrations. At low GAP concentrations (apparent
      V/K conditions), the primary hydrogen isotope effect (H/D) was in the range of
      1.40-1.52 and independent of arsenate and NAD+ concentrations. Apparent V/K for
      NAD+ was independent of GAP concentration, and apparent V/K for GAP was
      independent of NAD+ concentration. The dependence of apparent V/K for GAP on
      arsenate concentration was more complex but extrapolated to nonzero V/K at the
      zero-arsenate intercept. These observations are consistent with the general
      features of the Segal and Boyer (1953) mechanism for the reaction.

PMID- 1637823
TI  - p-aminobenzoate synthesis in Escherichia coli: kinetic and mechanistic
      characterization of the amidotransferase PabA.
AB  - p-Aminobenzoic acid (PABA) is an important precursor in the bacterial
      biosynthetic pathway for folate enzymes. This biosynthesis requires three
      separate proteins: PabA, PabB, and PabC. Together PabA and PabB convert glutamine
      and chorismate to glutamate and 4-amino-4-deoxychorismate. This aminochorismate
      is subsequently transformed to PABA by PabC. In this study, PabA from Escherichia
      coli has been purified to homogeneity from an overproducing construct and found
      to have no detectable glutaminase activity until addition of the E. coli PabB
      subunit. PabB forms a 1:1 complex with PabA to yield a glutaminase k(cat) of 17
      min-1. The addition of chorismate, the substrate of PabB, induces a 2-fold
      increase of k(cat) as well as a 3-fold increase of Km for glutamine. The
      PabA/PabB complex has Kd less than 10(-8) M but does not form a stable complex
      isolable by gel filtration. Studies with the glutamine affinity label
      diazooxonorleucine (DON) reveal it is an inactivator of the glutaminase activity
      of the PabA/PabB complex, but DON does not alkylate and inactivate PabA alone.
      Similarly, while isolated PabA shows no tendency to form a glutamyl-enzyme
      intermediate, the PabA/PabB complex forms a covalent intermediate with
      [14C]glutamine on PabA that accumulates to 0.56 mol/mol in hydrolytic turnover.
      PabA is thus a conditional glutaminase, activated by 1:1 complexation with PabB.

PMID- 1637824
TI  - Topological mapping of the active sites of cytochromes P4502B1 and P4502B2 by in
      situ rearrangement of aryl-iron complexes.
AB  - Cytochrome P4502B1 reacts with phenylhydrazine or phenyldiazene to give an iron
      phenyl complex that oxidatively rearranges in situ to the two N
      phenylprotoporphyrin IX regioisomers with the phenyl group on pyrrole rings A
      (NA) and D (ND) [Swanson, B. A., Dutton, D. R., Lunetta, J. M., Yang, C. S., &
      Ortiz de Montellano, P. R. (1991) J. Biol. Chem. 266, 19258-19264]. The
      conclusion that the active site of cytochrome P4502B1 is open above pyrrole rings
      A and D but not B and C is extended here by studies with larger arylhydrazines.
      The N-arylprotoporphyrin IX standards required for product identification were
      obtained by reaction of the arylhydrazines with equine myoglobin. Cytochrome
      P4502B1 aryl-iron complex formation followed by oxidative shift of the aryl group
      produces the following N-aryl-protoporphyrin IX NA:ND regioisomer ratios:
      phenylhydrazine (39:61), 3,5-dimethylphenylhydrazine (29:71), 4-tert
      butylhydrazine (25:75), 2-naphthylhydrazine (less than 2:greater than 98), and 4
      (phenyl)phenylhydrazine (87:13). Electron-withdrawing substituents (as in 3,5
      dichlorophenyl) prevent the aryl group shift. The increase in the proportion of
      the ND regioisomer with increasing bulk of the aryl group suggests that the
      region over pyrrole ring A is more sterically encumbered than that over pyrrole
      ring D. The regiospecificity is reversed, however, with 4
      (phenyl)phenylhydrazine, which primarily gives the NA regioisomer. This reversal
      suggests that the active site has a sloping roof that is higher over pyrrole ring
      A than pyrrole ring D and that provides a larger steric barrier to the shift of
      tall aryl moieties than the barrier over pyrrole ring A.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1637825
TI  - Gene cluster of the energy-transducing NADH-quinone oxidoreductase of Paracoccus
      denitrificans: characterization of four structural gene products.
AB  - In previous reports from our laboratory, the three structural genes (NQO1, NQO2,
      and NQO3) of the energy-transducing NADH-quinone oxidoreductase of Paracoccus
      denitrificans were characterized [Xu, X., Matsuno-Yagi, A., & Yagi, T. (1991)
      Biochemistry 30, 6422-6428; (1991) Biochemistry 30, 8678-8684; (1992) Arch.
      Biochem. Biophys. 296, 40-48]. In this report, the four structural genes NQO4,
      NQO5, NQO6, and NQO7 of the same Paracoccus denitrificans oxidoreductase were
      cloned and sequenced. On the basis of sequence homology and immunological cross
      reactivity, these genes encode counterparts of the 49-, 30-, and 20-kDa
      polypeptides and the mitochondrial DNA ND3 polypeptides of bovine mitochondrial
      complex I. These seven structural genes were found to be located in the same gene
      cluster. The order of the seven structural genes of the Paracoccus NADH-quinone
      oxidoreductase in the gene cluster is NQO7, NQO6, NQO5, NQO4, NQO2, NQO1, and
      NQO3. Upstream of the NQO7 gene, an open reading frame encoding a predicted
      polypeptide homologous to the UV repair enzyme A of Escherichia coli and
      Micrococcus lysodeikticus was detected. The 5'-terminus of the gene cluster
      carrying the Paracoccus NADH-quinone oxidoreductase was studied, and the possible
      promoter region is discussed. The NQO4 and NQO5 genes appear to code for the M(r)
      48,000 and 21,000 polypeptides of the isolated Paracoccus NADH dehydrogenase
      complex [Yagi, T. (1986) Arch. Biochem. Biophys. 250, 302-311] on the basis of
      amino acid analyses and N-terminal protein sequence analyses. The antisera to the
      bovine complex I 49- and 30-kDa polypeptides cross-reacted with the Paracoccus 48
      and 21-kDa subunits, respectively.

PMID- 1637826
TI  - Infrared study of the L, M, and N intermediates of bacteriorhodopsin using the
      photoreaction of M.
AB  - Infrared spectroscopy is used to characterize the transitions in the photocycle
      of bR involving the M intermediate. It has been shown previously that in this
      part of the photocycle a large protein conformational change takes place that is
      important for proton pumping. In this work we separate the spectra of the L, M,
      and N intermediates in order to better describe the timing of the molecular
      changes. We use the photoreaction of the M intermediate to separate its spectrum
      from those of L and N. At temperatures between 220 and 270 K a mixture of M and L
      or N is produced by illumination with green light. Subsequent blue illumination
      selectively drives M back into the ground state and the difference between the
      spectra before and after blue excitation yields the spectrum of M. Below about
      250 K and L/M mixture is separated; at higher temperatures an M/N mixture is
      seen. We find that the spectrum of M is identical in the two temperature regions.
      The large protein conformational change is seen to occur during the M to N
      transition. Our results confirm that Asp-96 is transiently deprotonated in the L
      state. The only aspartic protonation changes between M and bR are the protonation
      of Asp-85 and Asp-212 that occur simultaneously during the L to M transition.
      Blue-light excitation of M results in deprotonation of both. The results suggest
      a quadrupolelike interaction of the Schiff base, Asp-85, Asp-212, and an
      additional positive charge in bR.

PMID- 1637827
TI  - Characterization of the adenine binding sites of two Dolichos biflorus lectins.
AB  - The seed lectin and a stem and leaf lectin (DB58) from Dolichos biflorus have
      high-affinity hydrophobic sites that bind to adenine. The present study employs a
      centrifugal filtration assay to characterize these sites. The seed lectin
      contains two identical sites with Ka's of 7.31 x 10(5) L/mol whereas DB58 has a
      single site with a Ka of 1.07 x 10(6) L/mol. The relative affinities of these
      sites for a host of adenine analogs and derivatives were determined by
      competitive displacement assays. The most effective competitors for adenine were
      the cytokinins, a class of plant hormone, for which the lectins had apparent Ka's
      of 1.96 x 10(5)-4.90 x 10(4) L/mol. Direct binding of the cytokinin 6
      (benzylamino)purine (BAP) to both lectins showed positive cooperativity for only
      the seed lectin, indicating the interaction of this ligand with more than one
      class of hydrophobic binding site. Fluorescence enhancement assays demonstrate
      cooperativity between hydrophobic sites of the seed lectin and also suggest that
      BAP binds to more than one class of site.

PMID- 1637828
TI  - cDNAs and deduced amino acid sequences of subunits in the binding component of
      mouse bactericidal factor, Ra-reactive factor: similarity to mannose-binding
      proteins.
AB  - The complement-dependent bactericidal factor, Ra-reactive factor, binds
      specifically to Ra polysaccharide, which is common to some strains of Gram
      negative enterobacteria, and its is a complex of proteins composed of a
      polysaccharide-binding component and a component that is presumably responsible
      for the complement activation. The former component consists of two different 28
      kDa polypeptides, P28a and P28b. We determined the partial amino acid sequences
      of P28a and P28b, and the results indicated that these polypeptides were similar
      to two species of mannose-binding protein, MBP-C and MBP-A (alternative names,
      liver and serum mannan-binding proteins, respectively), which have been isolated
      from rat liver and/or serum [Drickamer, K., Dordal, M. S., & Reynolds, L. (1986)
      J. Biol. Chem. 261, 6878-6887; Oka, S., Itoh, N., Kawasaki, T., & Yamashina, I.
      (1987) J. Biochem. 101, 135-144]. Thus, we cloned the respective cDNAs, using as
      probes synthetic oligonucleotides for which the sequences had been deduced from
      the amino acid sequences of P28a and P28b and of rat MBP cDNAs. The primary
      structures of P28a and P28b deduced from the cloned cDNAs are homologous to one
      another. They have three domains, a short NH2-terminal domain, a collagen-like
      domain, and a domain homologous to regions of some carbohydrate-binding proteins,
      as has been reported for rat MBPs. Southern and Northern blotting analyses using
      these cDNAs indicated that the P28a and P28b polypeptides are the products of two
      unique mouse genes which are expressed in hepatic cells.

PMID- 1637829
TI  - Characterization of the oligosaccharide structures on recombinant human prorenin
      expressed in Chinese hamster ovary cells.
AB  - Prorenin was isolated by immunoprecipitation from the culture medium of Chinese
      hamster ovary cells transfected with a human prorenin cDNA. The N-linked
      oligosaccharide structures on the in vivo [3H]mannose-labeled, purified protein
      were characterized using a combination of serial lectin affinity chromatography,
      high-pressure liquid chromatography, ion-exchange chromatography, and size
      exclusion chromatography and treatment with specific glycosidases and methylation
      analysis. Approximately 61% of the oligosaccharides on the molecule are complex
      type, in the form of tetraantennary (2%), 2,6-branched triantennary (13%), 2,4
      branched triantennary (3%), and biantennary (43%) structures. The majority of all
      complex type structures are core-fucosylated. Sialic acids are linked at the C-3
      position of terminal galactose, and the degree of sialylation of the bi- and
      triantennary structures varies between nonsialylated and fully sialylated; no
      tetraatennary structure contains more than three sialic acid residues.
      Recombinant prorenin contains 4% hybrid-type structures, all of which carry a
      terminal sialic acid residue. The remaining 35% of the structures on the molecule
      are high mannose type, composed of 5, 6, or 7 mannose residues. Approximately 6%
      of the high mannose type structures and 10% of the hybrid structures are
      phosphorylated, as judged by their susceptibility to treatment with alkaline
      phosphatase. Compositional analysis of an unlabeled preparation of the protein
      suggested the presence of approximately 1.4 oligosaccharide units per molecule.

PMID- 1637830
TI  - Solution conformations of GM3 gangliosides containing different sialic acid
      residues as revealed by NOE-based distance mapping, molecular mechanics, and
      molecular dynamics calculations.
AB  - The conformation of the GM3 ganglioside, Neu5Ac alpha 2-3Gal beta 1-4Glc beta 1-1
      Cer, and its analogs containing the Neu5Gc or Neu4Ac5Gc residues (Gc = glycolyl,
      CH2OHCO) was investigated in Me2SO-d6 solution with the aid of a distance-mapping
      procedure based on rotating-frame NOE contacts, with hydroxyl protons being used
      as long-range sensors defining the distance constraints. A pronounced flexibility
      found for both the Neu-Gal and Gal-Glc linkages was confirmed by 1000-ps
      molecular dynamics simulations. Similar results, although based on a smaller
      number of NOE constraints, were obtained for GM3 gangliosides anchored in mixed
      D2O/dodecylphosphocholine-d38 micelles and for the Neu5Ac-, Neu5Gc-, and
      Neu5,9Ac2-sialyllactoses dissolved in D2O. No noteworthy differences in
      conformational behavior of the glycan chains of the three gangliosides or
      sialyllactoses were observed in either of the media.

PMID- 1637831
TI  - Solution conformation of a peptide corresponding to the principal neutralizing
      determinant of HIV-1IIIB: a two-dimensional NMR study.
AB  - The 24 amino acid peptide RP135 corresponds in its amino acid sequence to the
      principal neutralizing determinant (PND) of the IIIB isolate of HIV-1. Although
      the sequence of the PND is highly variable, its central part, containing the
      sequence GPGR, is conserved in most HIV isolates. Using 2D NMR and CD
      spectroscopy, we have studied the conformation of RP135 and of two shorter
      versions: one (P547) that includes the GPGR sequence with the N-terminal part of
      the peptide and the other (P344) that includes GPGR and the C-terminal segment of
      RP135. In water, the C-terminal part of RP135 was found to exist in several
      transient turnlike conformations ("nascent helix"). A helical conformation was
      found to be stabilized by the addition of TFE. A transient turn was observed also
      in the GPGR sequence, both in water and in aqueous TFE solutions. While no
      nascent helix conformations could be observed in the N-terminal part of RP135 in
      water, a helical conformation was partially stabilized by the addition of TFE.
      The conformations of the two shorter versions of the peptide were similar to
      those of the corresponding parts of RP135, except that the transient turn in GPGR
      could not be detected in P547 dissolved in water. The turn in GPGR was previously
      predicted by Larosa et al. (1990) and was observed by Chandrasekhar et al. (1991)
      in the PND peptide of HIV-1MN (RP142), which shares only 56% identity with RP135.
      However, nascent helix conformations were not observed in aqueous solutions of
      RP142.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637832
TI  - Interactions between DNA-bound transcriptional regulators of the Escherichia coli
      gal operon.
AB  - Regulation of the initiation of gene transcription from the gal operon of
      Escherichia coli is activated by the binding of CAP (catabolite activator
      protein) to a site centered at base pair -41.5 relative to the S1 start site of
      transcription. This operon is repressed by the specific binding of Gal repressor
      (GalR) to two operators, OE and OI, centered at -60.5 and +53.5, respectively. It
      has been proposed that this negative regulation results from the interaction of
      GalR dimers bound to OE and OI to form a protein-mediated "looped complex" [cf.
      Adhya, S. (1989) Annu. Rev. Genet. 23, 207-230]. In order to test whether DNA
      bound CAP would facilitate or inhibit the binding of GalR, the simultaneous
      binding of these proteins was studied by quantitative DNase I footprint titration
      analysis. These studies demonstrate that GalR binding is noncooperative in the
      presence and in the absence of CAP and that GalR and CAP bind to the gal operon
      independently. No evidence was found that CAP stabilizes a putative Gal repressor
      mediated protein-DNA looped complex. It has been shown that the gal operon can be
      negatively regulated by the binding of Lac repressor (LacI) to a gal operon in
      which OE and OI were both modified to be recognized by LacI [Haber, R., & Adhya,
      S. (1988) Proc. Natl. Acad. Sci. U.S.A. 85, 9683-9687]. In contrast to GalR, LacI
      binds to the chimeric gal operon with moderate cooperativity via the formation of
      a stable protein-DNA looped complex.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637833
TI  - Structural comparisons of meizothrombin and its precursor prothrombin in the
      presence or absence of procoagulant membranes.
AB  - A stable form of meizothrombin derived from an active-site (Ser528----Ala) mutant
      of recombinant bovine prothrombin [Pei et al. (1991) J. Biol. Chem. 266, 9598
      9604] has been used to determine the physical properties and conformation of
      meizothrombin both in solution and when bound to a procoagulant membrane. As
      determined with quasi-elastic light scattering, meizothrombin and prothrombin had
      similar molecular dimensions normal to a membrane (9.4 +/- 1.0 nm) and similar
      binding affinities to procoagulant membranes (1.8 +/- 0.2 microM at 0.4 M NaCl).
      However, meizothrombin had a greater tendency to form oligomers or aggregates in
      solution. The enhanced oligomerization of meizothrombin was also evidenced by a
      high apparent z-weighted molecular weight in equilibrium sedimentation
      experiments at low spin speeds. However, velocity sedimentation experiments
      performed at high spin speeds demonstrated the same sedimentation coefficient for
      meizothrombin (s20,w(0) = 4.7 +/- 0.2 S) as for prothrombin (s20,w(0) = 4.7 +/-
      0.15 S). Circular dichroism measurements revealed minor differences in protein
      secondary structure between meizothrombin and prothrombin either in the presence
      or in the absence of phospholipid membranes, as reflected in an increased theta
      222/theta 208 ratio in meizothrombin relative to prothrombin. The main endotherm
      of the meizothrombin thermal denaturation profile in a Ca(2+)-containing buffer,
      as determined by differential scanning calorimetry, was indistinguishable from
      that of prothrombin. However, in the presence of phosphatidylserine-containing
      membranes, the peak temperatures of denaturation profiles of meizothrombin were
      distinct from those of prothrombin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637834
TI  - Resonance Raman study on the active-site structure of a cooperative hemerythrin.
AB  - Resonance Raman spectra were observed for the oxy and azidomet forms of a
      cooperative hemerythrin (Hr) isolated from Lingula unguis and a noncooperative Hr
      from Siphonosoma cumanense. The O-O stretching frequency of the oxy derivative of
      the L. unguis Hr was lower in the high-affinity form generated at pH 7.6 than in
      the low-affinity form generated at pH 6.2, while that of the S. cumanense Hr did
      not change at those two pH values. The Fe-O-Fe symmetric stretching mode of L.
      unguis azidomet-Hr exhibited a frequency shift between pH 7.6 and 6.2, while that
      of S. cumanense was not shifted. However, the corresponding band of the oxy form
      did not show a pH-dependent frequency change. Therefore, it is noted that the
      azidomet form is not a suitable model for studying a mechanism of cooperativity,
      contrary to the structural similarity between the oxy and azidomet forms. The Fe
      O2 as well as Fe-N3 stretching frequencies were found to have no relation with
      the oxygen affinity. Upon exchange of solvent from H2O to D2O, the O-O and Fe-O2
      stretching modes of L. unguis Hr were shifted to higher and lower frequencies,
      respectively, and their magnitudes were the same for the high- and low-affinity
      forms. The same frequency shifts were observed for S. cumanense Hr.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1637835
TI  - Isolation and characterization of a polyol-responsive monoclonal antibody useful
      for gentle purification of Escherichia coli RNA polymerase.
AB  - A modified enzyme-linked immunosorbent assay (ELISA) was used to screen
      monoclonal antibodies (MAbs) that react with Escherichia coli RNA polymerase for
      the ability to release the RNA polymerase in the presence of a low molecular
      weight polyhydroxylated compound (polyol) and a non-chaotropic salt. This assay,
      termed the ELISA-elution assay, identified 19 presumptive "polyol-responsive"
      MAbs out of a total of 218 antigen-specific MAbs screened. One of these MAbs,
      designated NT73, was examined in detail for the ability to release the antigen in
      response to various combinations of polyol and salt. Using NT73 conjugated to
      Sepharose, highly active RNA polymerase could be prepared rapidly by a single
      immunoaffinity chromatography step, replacing two lengthy chromatographic steps
      in our conventional purification procedure. Because NT73 reacts with the beta'
      subunit of RNA polymerase, a mixture of the core polymerase and holoenzyme was
      recovered from the immunoaffinity column. The holoenzyme (E sigma 70) could be
      separated from the core polymerase by subsequent chromatography on a Mono Q
      column. This demonstrates that polyol-responsive MAbs can be easily identified
      and characterized by the ELISA-elution assay. The use of polyol-responsive MAbs
      provides a means of adapting immunoaffinity chromatography to the purification of
      labile proteins.

PMID- 1637836
TI  - Structures of amphotericin B-cholesterol complex.
AB  - The structures of amphotericin B-cholesterol complex that forms a channel in a
      lipid membrane were analysed by molecular mechanics calculations. The symmetric
      complex consisting of eight rigid antibiotic and cholesterol molecules was
      considered. The presence of a continuous set of low-energy states of the complex
      with different values of the channel diameter was shown. These states are
      characterized by significant tilt of the amphotericin planes to the radial axis
      of the channel and by strong interaction between the charged ammonium and
      carboxyl groups of the antibiotic. Changes of the channel diameter may result in
      changes in pore permeability.

PMID- 1637837
TI  - Fatty acylation of a 55 kDa membrane protein of human erythrocytes.
AB  - The major palmitoylated human erythrocyte membrane protein has an M(r) of 55,000.
      It is distinct from the glucose transporter and is not derived from band 3 or
      ankyrin. It resists salt extraction suggesting a high affinity for the membrane.
      Pulse chase experiments demonstrate that palmitoylation is a dynamic process, and
      it may therefore have regulatory significance in membrane protein-protein or
      protein-lipid interaction. Slower dynamics of palmitoylation in erythrocytes from
      patients suffering from chronic myelogenous leukemia, which are less stable than
      normal erythrocytes, strengthen this view.

PMID- 1637838
TI  - Transport of procainamide in a kidney epithelial cell line LLC-PK1.
AB  - Transport of procainamide, an anti-arrhythmic drug, was investigated in LLC-PK1
      kidney epithelial cell line. The uptake of procainamide by LLC-PK1 monolayers
      cultured in plastic dishes was temperature-dependent, saturable and inhibited by
      organic cations such as cimetidine and N-acetylprocainamide. An
      aminocephalosporin antibiotic, cephalexin, also inhibited procainamide uptake,
      but an organic anion, p-aminohippurate, did not. The uptake of procainamide was
      greater at an alkaline external pH than at an acidic pH. In addition,
      procainamide uptake increased when intracellular pH was decreased and the uptake
      decreased when the intracellular pH was increased by ammonium chloride treatment,
      indicating the involvement of an H+/procainamide antiport system in apical
      membrane. The basolateral to apical flux of procainamide across LLC-PK1
      monolayers cultured on permeable supports was 2.5-times larger than the apical to
      basolateral flux, and only the former process was inhibited by other organic
      cations. These findings suggest that LLC-PK1 cells can transport procainamide by
      the organic cation transport system and that procainamide is transported
      unidirectionally from basolateral to apical side across the cell monolayers.

PMID- 1637839
TI  - Basolateral Cl-/HCO3- exchange in rat jejunum: evidence from H14CO3- uptake in
      membrane vesicles.
AB  - Bicarbonate transport across basolateral membrane vesicles from rat jejunal
      enterocyte was studied at 28 degrees C and pH 8.2. These experimental conditions
      make possible the determination of [14C]bicarbonate uptake. Inward gradients of
      Na+, K+, and Li+ did not stimulate HCO3- uptake, suggesting that a cotransport
      mechanism with these cations does not occur. On the contrary a countertransport
      of bicarbonate driven by a Cl- gradient was evidenced. The ability of other
      inorganic anions to exchange with HCO3- was examined and results indicate that Cl
      can be substituted by NO3-, Br- and SCN-. The Cl(-)-dependent HCO3- uptake was
      strongly inhibited by SITS and DIDS, whereas acetazolamide was ineffective: thus
      transfer of labelled CO2 is eliminated as a possible mode of HCO3- permeation.
      HCO3- uptake was also affected by the presence of superimposed membrane
      potentials, suggesting that a HCO3- conductive pathway is present in the jejunal
      basolateral membrane. These results show that there are no fundamental
      differences between data obtained performing H14CO3- and 36Cl- (previously
      reported) uptake experiments.

PMID- 1637841
TI  - K+/H+ exchange in yeast mitochondria: sensitivity to inhibitors, solubilization
      and reconstitution of the activity in proteoliposomes.
AB  - The K+/H+ exchange activity of the inner mitochondrial membrane was investigated
      in the yeast Saccharomyces cerevisiae. Swelling experiments in potassium acetate
      indicated that the K+/H+ exchange was active without any additional treatment
      after the mitochondria isolation, such as a Mg2+ depletion. As in mammalian
      mitochondria, the activity of yeast mitochondria was stimulated by increasing pH
      and was inhibited by the amphiphilic amines quinine and propranolol and by the
      carboxyl reagent dicyclohexylcarbodiimide. However, the activity was poorly
      inhibited by Mg2+ and consequently was only slightly stimulated by the Mg2+/H+
      exchanger A23187. On the other hand, Zn2+ was very efficient for inhibiting the
      exchange and consequently the activity was strongly stimulated by the permeant
      metal-chelator o-phenanthroline. The [86Rb]Rb+ accumulation in mitochondria and
      mitoplasts was only partially inhibited by quinine and propranolol suggesting
      that part of the accumulation monitored under these conditions was due to cation
      leak through the inner membrane together with adsorption on the membrane. The
      DCCD-sensitive activity could be reconstituted from mitochondria and from
      mitoplasts solubilized with Triton X-100; this activity, measured by [86Rb]Rb+
      accumulation, was quinine- and propranolol-sensitive. A spectrophotometric
      method, based on the capacity of negatively charged proteoliposomes to swell, was
      then developed in order to continuously follow the reconstituted activity.

PMID- 1637840
TI  - pHi controls cytoplasmic calcium in rat parotid cells.
AB  - The goal of this investigation was to determine if cytoplasmic pH (pHi) modulated
      the basal level of the concentration of calcium ions in the cytoplasm (Cai) in
      rat parotid cells. We investigated the effects of various experimental
      manipulations on both pHi and Cai as measured with BCECF and the calcium
      photoprotein aequorin, respectively. We found that various experimental
      manipulations that increased pHi, such as exposure of the cells to NH4Cl, a
      decrease of the partial pressure of CO2 or an increase in extracellular pH in the
      presence of nigericin invariably increased Cai. Moreover, experimental
      manipulations which lowered Cai, such as a reduction of extracellular [NaHCO3] or
      the removal of loaded NH4 invariably decreased Cai. Thus pHi and Cai are directly
      related in parotid cells. Since recent studies have shown that Cai directly
      influences pHi, we suggest that Cai-handling and pHi-handling are tightly linked
      in parotid cells.

PMID- 1637842
TI  - Conditions modulating the ionic selectivity of transport by monensin examined on
      Enterococcus hirae (Streptococcus faecalis) by 23Na-NMR and K+ atomic absorption.
AB  - Factors likely to modulate the ionic selectivity of monensin were examined on
      Enterococcus hirae (Streptococcus faecalis) in two states previously
      characterized: the resting (de-energized) cell and the active (energized) cell.
      Internal and external Na+ were followed by corresponding 23Na-NMR resonances K+
      concentrations were measured by atomic absorption. For a given cellular
      population of de-energized cells, the apparent transport rates and the final
      cationic concentrations reached at the steady state were decreasing with the
      ionophore dose. Monensin was selective for sodium only at low concentrations, in
      the range 1 mM-10(-4) mM the transport was depending on the effective cationic
      gradients. Comparison of the activity curves for two cell populations (7.10(9)
      and 7.10(10) cells/ml) showed the importance of the ratios of monensin/mg
      phospholipid and also of the ratios of external/internal volumes. On energized
      cells, except for low monensin concentrations, the main effect was a K(+)-induced
      efflux and not a Na+ influx. Two factors were modulating the resulting
      selectivity of this ionophore: the response of the intrinsic bacterial carriers
      and the generation of the gradients (mainly the external pH) which were
      favourable to a K+/Na+ transport. Once again the results obtained for two cell
      populations could be compared, the determining factors were the ratio
      external/internal volume and the generation of the pH gradient.

PMID- 1637843
TI  - Tyrosine protein kinase activity in renal brush-border membranes.
AB  - Tyrosine protein kinase (TPK) activity was detected in rat renal brush-border
      membranes (BBM) using poly(Glu80Na,Tyr20) as a substrate. Maximal TPK activity
      required prior detergent dispersion of the membranes with 0.05% Triton X-100 and
      the presence of vanadate, a potent inhibitor of phosphotyrosine protein
      phosphatases, in the phosphorylation medium. Optimal conditions for measurement
      of TPK activity were 10 mM of MgCl2 and MnCl2, at 30 degrees C and pH 7.0. TPK
      activity was inhibited by genistein, with a IC50 value of 15 microM, while no
      inhibition was observed in the presence of 1-(5-isoquinolinesulfonyl)-2-methyl
      piperazine dihydrochloride (H7), an inhibitor of serine-threonine kinases. TPK
      activity was enriched 4-fold in the BBM fraction relative to cortex homogenate.
      It was co-enriched with BBM enzyme markers, but not with those of the basolateral
      membrane (BLM). The endogenous substrates of TPK in brush-border and basolateral
      membranes were determined by Western blot analysis using an antiphosphotyrosine
      monoclonal antibody (PY20). Various phosphotyrosine-containing proteins were
      found in the BBM (31, 34, 46, 50, 53, 72, 90, 118 and 170 kDa) and in the BLM
      (37, 48, 50, 53, 72, 90, 130 and 170 kDa). Addition of exogenous insulin receptor
      to BBM and BLM increased the phosphorylation of most of the substrates.
      Solubilization of the TPK activity from BBM with 0.5% CHAPS and subsequent gel
      filtration on Superdex 75 yielded two peaks of tyrosine protein kinase activity
      with apparent molecular masses of 49 and 66 kDa. These results provide evidence
      for a non-receptor TPK activity associated with the renal tubular luminal
      membrane.

PMID- 1637844
TI  - Chemical exchange between lamellar and non-lamellar lipid phases. A one- and two
      dimensional 31P-NMR study.
AB  - One- and two-dimensional 31P-exchange NMR has been used to investigate chemical
      exchange between coexisting lamellar (L alpha) and non-lamellar (hexagonal HII
      and cubic I2) lipid phases. Samples of DOPE, DOPE/DOPC (9:1 and 7:3),
      DOPE/cholesterol sulfate (9:1), DOPC/monoolein (MO) (3:7 and 1:1), and
      DOPC/DOPE/cholesterol (1:1:2) were macroscopically oriented on glass plates and
      studied at the 0 degree orientation (angle between the bilayer normal and the
      external magnetic field), where the L alpha, HII, and I2 resonances are resolved.
      A reversible L alpha to HII transition was observed for all of the samples except
      for the DOPC/MO mixtures, which displayed a reversible L alpha to I2 transition.
      Near-equilibrium mixtures of L alpha and either HII or I2 were obtained after
      prolonged incubation at a given temperature. Two-dimensional exchange experiments
      were performed on DOPE at 9-14 degrees C for mixing times ranging from 500 ms to
      2 s. For all samples, one-dimensional exchange experiments were performed for
      mixing times ranging from 100 ms to 4 s, at temperatures ranging from 3 degrees C
      to 73 degrees C. No evidence of lipid exchange between lamellar and non-lamellar
      phases was observed, indicating that if such a process occurs it is either very
      slow on the seconds' timescale, or involves an undetectable quantity of lipid.
      The results place constraints on the stability or kinetic behaviour of proposed
      transition intermediates (Siegel, D.P. (1986) Biophys. J. 49, 1155-1170).

PMID- 1637845
TI  - Citrate as an aluminum chelator and positive effector of the sodium efflux in
      single barnacle muscle fibers.
AB  - The injection of citrate produces considerably greater stimulation of the Na
      efflux in ouabain-poisoned fibers (from the barnacle Balanus nubilus) than in
      unpoisoned fibers. When injected in excess together with Al into unpoisoned
      fibers it is without effect. Its injection is also without effect on the decline
      in the Na efflux elicited by injecting Al beforehand. Citrate injection into
      ouabain-poisoned fibers following peak stimulation by injecting Al produces a
      further rise which is a function of the Al concentration. Al injection after peak
      stimulation of the ouabain-insensitive Na efflux by citrate is usually without
      significant effect. Injection of aspartate into poisoned fibers causes a small
      rise in the remaining Na efflux and fails to prevent the response to Al injection
      from occurring. Taken together, these observations are in keeping with the view
      that citrate is not only a powerful chelator of Al but also a powerful activator
      of reverse Na+/Ca2+ exchange in ouabain-poisoned fibers, presumably because of
      its ability to raise myoplasmic pMg.

PMID- 1637846
TI  - Levitation, holding, and rotation of cells within traps made by high-frequency
      fields.
AB  - Biological cells and other particles can be electrically manipulated by means of
      negative dielectrophoresis within microchambers whose electrode geometry is of
      the order of the cell size. Very-high-frequency fields (50 MHz and above) and
      media of increased relative permittivity are especially suitable for the purpose,
      as shown by experimental data on levitation and rotation. It appears to be
      possible to move and rotate cells or particles at will using this technology.

PMID- 1637847
TI  - Membrane-structuring properties of bacterial long-chain alkylresorcinols.
AB  - To investigate the mechanism by which 5-n-alkyl(C19-C25)-resorcinols synthesized
      by certain bacteria of the Azotobacter genus affect the lipid bilayers of
      cellular membranes, planar bimolecular membranes were formed from these alkyl
      resorcinols and from mixtures of those and typical bacterial phospholipids such
      as phosphatidylethanolamine, phosphatidylglycerol, and diphosphatidylglycerol.
      The electrical properties and, in some instances, the stability of the prepared
      membranes have been studied. The alkylresorcinols have been found to associate
      with phospholipids to form oligomeric and polymeric complexes, thereby giving
      rise to modifications in the bilayer structure and properties. It has been shown
      that the same compounds suppress the mitochondrial respiration in the presence of
      NAD-dependent substrates, but they activate it if succinate is used as substrate.
      This fact is explained in terms of the interaction between the alkylresorcinols
      and membrane phospholipids.

PMID- 1637848
TI  - Generation and characterization of iron- and barium-loaded liposomes.
AB  - Previous work (Veiro and Cullis (1990) Biochim. Biophys. Acta 1025, 109-115) has
      shown that Ca2+ can be accumulated into large unilamellar vesicles (LUVs) in the
      presence of a transmembrane pH gradient (inside acidic) and the Ca(2+)-ionophore
      A23187. Here, the ability of A23187 to mediate the uptake of iron and barium into
      LUVs has been investigated. It is shown that under appropriate conditions of
      temperature and A23187 concentration, iron (in the form of Fe2+) can be
      accumulated into EPC and DSPC/cholesterol (55:45; mol/mol) LUVs with an acidic
      interior. This uptake is dependent on the internal buffer concentration, with
      maximum levels of uptake in the range of 300 nmol of cation per mumol lipid. The
      DSPC-cholesterol LUV systems exhibit superior retention properties compared to
      the EPC systems. It is demonstrated that Ba2+ can also be loaded by similar
      methods. It is also shown that the maximally loaded Fe(2+)- and Ba(2+)-containing
      LUVs exhibit increased densities. This is expressed by enhanced gravimetric
      properties, as an increased proportion of the loaded LUVs can be pelleted by low
      speed centrifugation, and by enhanced electron densities, in that the Ba(2+)
      loaded systems can be directly visualized employing cryo-electron microscopy.

PMID- 1637849
TI  - Lipid microsphere containing lipophilic heme: preparation and oxygen
      transportation under physiological conditions.
AB  - Lipophilic heme (1-laurylimidazole-ligated 5,10,15,20-tetrakis(alpha, alpha,
      alpha, alpha-o- pivalamidophenyl)porphinatoiron(II) complex) is solubilized in
      lipid (triglyceride) at high concentrations and emulsified with a phospholipid in
      physiological salt solution, giving a deeply red-colored suspension of lipid
      microspheres (approx. 250 nm in diameter). The heme forms an oxygen adduct in a
      similar manner as oxyhemoglobin and the lipid microspheres take up and release
      oxygen reversibly at 37 degrees C in the aqueous medium. The oxygen-transporting
      ability is comparable with that of the red blood cell. Intravenous injection of
      the heme/lipid microsphere solution to rabbits demonstrates that it transports
      oxygen even in vivo and that it is cleared from the blood stream with a half-life
      time of approx. 1 h.

PMID- 1637851
TI  - Lipids and lipid metabolism.

PMID- 1637850
TI  - Some negatively charged phospholipid derivatives prolong the liposome circulation
      in vivo.
AB  - A series of negatively charged phospholipid derivatives has been synthesized by
      coupling aliphatic dicarboxylic acids, HOOC(CH2)nCOOH, to
      dioleoylphosphatidylethanolamine (DOPE). The individual derivatives were
      incorporated into egg phosphatidylcholine/cholesterol liposomes (2:1, molar
      ratio) and injected into mice to test its effect on liposome circulation in vivo.
      The effectiveness of DOPE derivatives was dependent on the hydrocarbon chain
      length between the terminal carboxyl group and the amide bond. N-Glutaryl DOPE
      and N-adipyl DOPE were effective in prolonging the circulation time of liposomes.
      On the other hand, liposome uptake by the liver and spleen was increased by the
      addition of N-malonyl DOPE or N-succinyl DOPE, while it was not changed by the
      addition of N-pimelyl DOPE and N-suberyl DOPE. Our observation suggested that not
      all negatively charged phospholipids enhance liposome uptake by RES, some even
      reduce the uptake.

PMID- 1637852
TI  - Dietary supplementation with coenzyme Q10 results in increased levels of
      ubiquinol-10 within circulating lipoproteins and increased resistance of human
      low-density lipoprotein to the initiation of lipid peroxidation.
AB  - Ubiquinol-10 (CoQH2, the reduced form of coenzyme Q10) is a potent antioxidant
      present in human low-density lipoprotein (LDL). Supplementation of humans with
      ubiquinone-10 (CoQ, the oxidized coenzyme) increased the concentrations of CoQH2
      in plasma and in all of its lipoproteins. Intake of a single oral dose of 100 or
      200 mg CoQ increased the total plasma coenzyme content by 80 or 150%,
      respectively, within 6 h. Long-term supplementation (three times 100 mg CoQ/day)
      resulted in 4-fold enrichment of CoQH2 in plasma and LDL with the latter
      containing 2.8 CoQH2 molecules per LDL particle (on day 11). Approx. 80% of the
      coenzyme was present as CoQH2 and the CoQH2/CoQ ratio was unaffected by
      supplementation, indicating that the redox state of coenzyme Q10 is tightly
      controlled in the blood. Oxidation of LDL containing various [CoQH2] by a mild,
      steady flux of aqueous peroxyl radicals resulted immediately in very slow
      formation of lipid hydroperoxides. However, in each case the rate of lipid
      oxidation increased markedly with the disappearance of 80-90% CoQH2. Moreover,
      the cumulative radical dose required to reach this 'break point' in lipid
      oxidation was proportional to the amount of CoQH2 incorporated in vivo into the
      LDL. Thus, oral supplementation with CoQ increases CoQH2 in the plasma and all
      lipoproteins thereby increasing the resistance of LDL to radical oxidation.

PMID- 1637853
TI  - Tumor accumulation of novel RES-avoiding liposomes.
AB  - For passive targeting of liposomes to tumor tissues, we earlier developed
      reticuloendothelial system (RES)-avoiding liposomes modified with a uronic acid
      derivative, palmityl-D-glucuronide (PGlcUA) (Namba, Y., Sakakibara, T., Masada,
      M., Ito, F. and Oku, N. (1990) Chem. Pharm. Bull. 38, 1663-1666). In this present
      study, we examined the blood clearance and biodistribution of PGlcUA-liposomes
      (dipalmitoylphosphatidylcholine/cholesterol/PGlcUA = 40:40:20 as a molar ratio)
      in normal and tumor-bearing mice. Liposomes containing
      dipalmitoylphosphatidylglycerol (DPPG) instead of PGlcUA was also examined as a
      control. When [3H]inulin-encapsulated PGlcUA-liposomes and DPPG-liposomes were
      intravenously injected into normal mice, approx. 50% of the 3H radioactivity was
      recovered from the liver, the bulk of RES, at 12 h after administration of DPPG
      liposomes, while only approx. 20% of it was found there when PGlcUA-liposomes
      were administered. Radioactivity remaining in the plasma at 12 h after injection
      was 5-fold higher when PGlcUA-liposomes were injected than when DPPG-liposomes
      were used. Biodistribution of liposomes in tumor-bearing mice was also examined.
      Mice were inoculated with 10(7) S180 cells into the hind leg. After 1 week,
      liposomes were injected. Radioactivity of [3H]inulin originally encapsulated in
      the PGlcUA-liposomes accumulated in the tumor to an extent 3-4-fold higher than
      that of the marker in DPPG-liposomes. Liver/tumor ratio of the radioactivity was
      12 for DPPG-liposomes and only 2 for PGlcUA-liposomes. This latter value is the
      lowest of various liposome formulations ever reported.

PMID- 1637854
TI  - Biosynthesis of prostaglandins from 17(18)epoxy-eicosatetraenoic acid, a
      cytochrome P-450 metabolite of eicosapentaenoic acid.
AB  - Eicosapentaenoic acid (20:5(n - 3)) is oxygenated to
      17S(18R)epoxyeicosatetraenoic acid (EpETE) by microsomes of monkey seminal
      vesicles, which also are rich in prostaglandin (PG) H synthase. The metabolism of
      racemic [14C]17(18)EpETE by PGH synthase of sheep vesicular glands was
      investigated in the present report. The two main metabolites were identified by
      GC-MS as 17(18)epoxyprostagland E2 (17(18)EpPGE2) and 17(18)EpPGF2 alpha. The
      structures were confirmed by chemical synthesis of these prostaglandins from
      PGE3. 17(18)EpPGE1 was synthesized from 17,18-dehydro-PGE1 by the same method.
      Alkali treatment of 17(18)EpPGE2 yielded 17(18)EpPGB2, which could be resolved by
      RP-HPLC into the 17R(18S) and 17S(18R) stereoisomers. The 17S(18R) stereoisomer
      was identified by co-chromatography with [14C]17S(18R)EpPGB2, which was formed by
      PGH synthase from biosynthetic [14C]17S(18R)EpETE. The 17(18)epoxyprostaglandins
      were found to be relatively unstable during acidic extractive isolation.
      17(18)EpPGE1 and 17(18)EpPGE2 could not be detected in seminal vesicles of the
      cynomolgus monkey in significant amounts relative to 19-hydroxy-PGE1.
      Nevertheless, biosynthesis of 17(18)epoxyprostaglandins should be considered when
      the biological effects of 17S(18R)EpETE are investigated.

PMID- 1637855
TI  - Cultured oligodendrocytes metabolize a fluorescent analogue of sulphatide;
      inhibition by monensin.
AB  - It has been suggested that oligodendrocytes can actively phagocytose myelin
      debris during active myelination or after injury and experimental demyelination.
      Therefore, we have used a fluorescent analogue (N-lissamine rhodaminyl-(12
      aminododecanoyl) cerebroside 3-sulphate) to study the metabolic fate of
      sulphatide, a galactosphingolipid that is highly enriched in myelin membranes.
      The fluorescent sulphatide was incorporated in small unilamellar vesicles and
      administered to cultured oligodendrocytes. The association of the lipid probe to
      the cells in culture was saturable in time and with the concentration of the
      probe. The processes of association, internalization and subcellular distribution
      were followed by confocal scanning laser microscopy and appeared to be very
      rapid. Within 20 min a marked perinuclear staining was seen. After prolonged
      incubation the fluorescence distributed gradually over the cytoplasm and into
      cellular branches along structures suggestive of cytoskeletal elements. Lipid
      analysis demonstrated that ceramide was the major metabolite present in the cells
      but galactosylceramide, sphingomyelin and free fatty acid were also detected. In
      the culture medium only free fatty acid and sphingomyelin were found. Monensin
      did not affect the cellular association and internalization of the fluorescent
      sulphatide but markedly reduced its conversion to metabolic products. These
      results indicate that exogenous sulphatide is targeted to the Golgi apparatus
      prior to its lysosomal degradation.

PMID- 1637856
TI  - Possible influence of lysophospholipase on the production of 1-acyl-2
      acetylglycerophosphocholine in macrophages.
AB  - The rate of production of 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine (PAF)
      and 1-acyl-2-acetyl-sn-glycero-3-phosphocholine (acylPAF) was measured in
      macrophages following the incorporation of [3H]acetate. Upon activation by
      A23187, guinea pig alveolar macrophages incorporated [3H]acetate into PAF, but a
      little radioactivity was found in acylPAF. However, labeling of acylPAF and PAF
      with [3H]acetate was greatly enhanced in A23187-stimulated alveolar macrophages
      that had been pretreated with phenylmethanesulphonyl fluoride (PMSF). [3H]PAF was
      predominantly converted to 1-[3H]alkyl-2-acyl glycerophosphocholine, but
      [14C]acylPAF rapidly hydrolyzed to 14C-labeled free fatty acid by the incubation
      with lysates prepared from macrophages. The deacetylation of [14C]acylPAF and
      [3H]PAF by acetylhydrolase and also the hydrolysis of [14C]lysoPC by
      lysophospholipase were strongly inhibited in macrophages that had been pretreated
      with PMSF, while PMSF failed to inhibit the activities of acetyltransferase and
      acyltransferase. The relative proportions of PAF and acylPAF were quite different
      in different types of cells. In contrast to alveolar macrophages, peritoneal
      macrophages, neutrophils and spleen cells from guinea pigs incorporated 2-4 times
      more [3H]acetate into acylPAF than into PAF. The presence of high levels of
      acylPAF in peritoneal macrophages was confirmed by GLC-MS analysis. The
      activities of lysophospholipase, acetylhydrolase and acetyltransferase were
      measured in alveolar and peritoneal macrophages to determine whether the
      preferential formation of acylPAF as compared to PAF in peritoneal macrophages
      was due to differences in these activities between alveolar and peritoneal
      macrophages. The activity of acetylhydrolase of peritoneal macrophages was almost
      the same as that in alveolar macrophages. The activity of acetyltransferase in
      peritoneal macrophages was about half of that in alveolar macrophages. However,
      the activity of lysophospholipase in peritoneal macrophages was one-sixth of that
      in alveolar macrophages. These results suggest that lysophospholipase is one of
      the primary factors involved in the control of the production of acylPAF in
      activated cells, and that it acts by modulating the availability of lysoPC for
      the synthesis of acylPAF. Furthermore, high levels of activity of
      lysophospholipase allow the preferential formation of PAF, via the rapid
      hydrolysis of lysoPC which would act as a competitive inhibitor of the
      incorporation of acetate into lysoPAF.

PMID- 1637857
TI  - Modulation of sphingomyelinase-induced cholesterol esterification in fibroblasts,
      CaCo2 cells, macrophages and smooth muscle cells.
AB  - The present study has focused on three questions concerning the effect of
      sphingomyelinase on release of free cholesterol from the plasma membrane and its
      intracellular translocation: (i) Can one change the direction of the flow of
      cholesterol? (ii) Can one modulate the flow? (iii) May such a mechanism be
      relevant in atherogenesis? (i) The results obtained show that even in the
      presence of potent nonlipoprotein cholesterol acceptors in the medium, the
      intracellular flow of cholesterol is not reduced as measured by cholesterol
      esterification. Moreover, in sphingomyelinase-treated cells, cholesterol efflux
      in presence of nonlipoprotein acceptors was not enhanced even when intracellular
      esterification was inhibited. (ii) Modulation of the sphingomyelinase induced
      cholesterol flow can be obtained by 100 microM verapamil which reduces it. In
      human skin fibroblast, interference with the delivery of free cholesterol to its
      site of esterification was found in the presence of brefeldin A. (iii) Aortic
      smooth muscle cells in culture are sensitive to low concentrations of
      sphingomyelinase and the increase in esterified cholesterol is evident also after
      exposure to the enzyme for 24 h. The present results suggest that in the plasma
      membrane, free cholesterol bound to sphingomyelin may be in a compartment which
      renders it more available for transport to the cell interior than for efflux. In
      view of the sensitivity of aortic smooth muscle cells to sphingomyelinase, this
      mechanism for enhanced esterification of cholesterol could be relevant to the
      transformation of arterial smooth muscle cells into foam cells in the process of
      atherogenesis.

PMID- 1637858
TI  - Distribution of alkyl and alkenyl ether-linked phospholipids and platelet
      activating factor-like lipid in various species of invertebrates.
AB  - The levels of alkenylacyl, alkylacyl and diacyl subclasses of choline
      glycerophospholipid (CGP) and ethanolamine glycerophospholipid (EGP) fractions in
      28 species of various invertebrates were studied. We found that only small
      amounts of either 1-alkyl-2-acyl-sn-glycero-3-phosphocholine (alkylacyl-GPC) or 1
      alkenyl-2-acyl-sn-glycero-3-phosphoethanolamine (alkenylacyl-GPE) are present in
      most species of insects. On the other hand, almost all species examined in
      various phyla other than Arthropoda were shown to contain large amounts of both
      alkylacyl-GPC and alkenylacyl-GPE. The highest proportion of alkylacyl subclass
      in CGP was noted in sponge, Halichondria japonica (81.8% of CGP) and the highest
      proportion of alkenylacyl subclass in EGP was found in clam worm, Marphysa
      sanguinea (88.7% of EGP). We next surveyed the presence of platelet-activating
      factor (PAF)-like lipid in 45 species of invertebrates. PAF-like lipid was widely
      distributed among various lower animals. The highest value was obtained for sea
      cucumber, Stichopus japonicus, in which PAF-like lipid was present throughout the
      body. We also confirmed the presence of acetyltransferase activity in several
      lower animals. These results suggest that alkyl and alkenyl ether-linked
      phospholipids including PAF are physiologically important molecules particularly
      for invertebrates belonging to lower phyla.

PMID- 1637859
TI  - Diacylglycerol metabolism in neonatal rat liver: characterization of cytosolic
      diacylglycerol lipase activity and its activation by monoalkylglycerols.
AB  - Diacylglycerol lipase (glycerol ester hydrolase, EC 3.1.1.3) activities were
      investigated in subcellular fractions from neonatal and adult rat liver in order
      to determine whether one or more different lipases might provide the substrate
      for the developmentally expressed, activity monoacylglycerol acyltransferase. The
      assay for diacylglycerol lipase examined the hydrolysis of sn-1-stearoyl,2-
      [14C]oleoylglycerol to labeled monoacylglycerol and fatty acid. Highest specific
      activities were found in lysosomes (pH 4.8) and cytosol and microsomes (pH 8).
      The specific activity from plasma membrane from adult liver was 5.8-fold higher
      than the corresponding activity in the neonate. In other fractions, however, no
      developmental differences were observed in activity or distribution. In both
      lysosomes and cytosol, 75 to 90% of the labeled product was monoacylglycerol,
      suggesting that these fractions contained relatively little monoacylglycerol
      lipase activity. In contrast, 80% of the labeled product from microsomes was
      fatty acid, suggesting the presence of monoacylglycerol lipase in this fraction.
      Analysis of the reaction products strongly suggested that the lysosomal and
      cytosolic diacylglycerol lipase activities hydrolyzed the acyl-group at the sn-1
      position. The effects of serum and NaCl on diacylglycerol lipase from each of the
      subcellular fractions differed from those effects routinely observed on
      lipoprotein lipase and hepatic lipase, suggesting that the hepatic diacylglycerol
      lipase activities were not second functions of these triacylglycerol lipases.
      Cytosolic diacylglycerol lipase activity from neonatal liver and adult liver was
      characterized. The apparent Km for 1-stearoyl,2-oleoylglycerol was 115 microM.
      There was no preference for a diacylglycerol with arachidonate in the sn-2
      position. Bovine serum albumin stimulated the activity, whereas dithiothreitol, N
      ethylmaleimide, and ATP inhibited the activity. Both sn-1(3)- and 2
      monooleylglycerol ethers stimulated cytosolic diacylglycerol lipase activity 2-3
      fold. The corresponding amide analogs stimulated 28 to 85%, monooleoylglycerol
      itself had little effect, and 1-alkyl- or 1-acyl-lysophosphatidylcholine
      inhibited the activity. These data provide the first characterization of hepatic
      subcellular lipase activities from neonatal and adult rat liver and suggest that
      independent diacylglycerol and monoacylglycerol lipase activities are present in
      microsomal membranes and that the microsomal and cytosolic diacylglycerol lipase
      activities may describe an ambipathic enzyme. The data also suggest possible
      cellular regulation by monoalkylglycerols.

PMID- 1637860
TI  - Ribosomal proteins from Thermus thermophilus for structural investigations.
AB  - In parallel with crystallographic studies of ribosomes from Thermus thermophilus,
      a long-term program on the crystallization and structural investigations of
      ribosomal proteins from the same microorganism has been started at the Institute
      of Protein Research (Pushchino, Russia). At present, more than half of the
      individual ribosomal proteins from T thermophilus have been purified without
      denaturating agents on a preparative scale and some of them have been obtained in
      the crystalline form. X-ray structural analysis of two ribosomal proteins, L1 and
      S6, is being carried out jointly with the Institute of Molecular Biology (Moscow,
      Russia) and laboratory of professor A Liljas (Lund University, Sweden). L1 is the
      large protein of the large ribosomal subunit. It can bind not only to a specific
      site on the 23S rRNA, but also to the mRNA that codes for L1 and L11, thereby
      acting as a translational repressor for the synthesis of these proteins. The
      crystals of L1 are orthorhombic and diffract to about 2 A resolution. Native data
      and data for several heavy atom derivatives have been collected. S6 is a small
      acidic protein from the small ribosomal subunit. The crystals of S6 are
      orthorhombic and diffract to 2 A resolution. Native data and derivatives' data
      have been collected.

PMID- 1637861
TI  - Recognition of correct reading frame by the ribosome.
AB  - The translation frame-monitoring mechanism has been suggested earlier, based on
      transient complementary contacts, between mRNA and rRNA. Recent studies related
      to the frame-monitoring mechanism are reviewed. The mechanism is well supported
      by both new experimental and sequence analysis data. Experiments are suggested
      for further elucidation of the structural details of the mRNA-rRNA interaction in
      the ribosome.

PMID- 1637862
TI  - Functional topography of human ribosomes as studied by affinity labeling with
      reactive mRNA analogs.
AB  - Derivatives of 5'-32P labeled (pU)3 an (pU)6 bearing 4-(N-2-chloroethyl-N
      methylamino)benzylmethylamine residue attached to 5'-phosphate via phosphamide
      bond and (Up)5U[32P]pC and (Up)11U[32P]pC bearing 4-(N-2-chloroethyl-N
      methylamino)benzyl residue attached to 3'-end via benzylidene bond were applied
      for the affinity labeling of 80S ribosomes from human placenta in the presence of
      a cognate tRNA. The derivatives of 32P-labeled pAUG and pAUGU3 analogous to the
      5'-phosphamides of (pU)n were used for affinity labeling of 40S subunits in the
      presence of ternary complex eIF-2.GTP.Met-tRNA(f). The sites of the reagents'
      attachment to 18S ribosomal RNA were identified by blot-hybridization of the
      modified 18S rRNA with restriction fragments of the corresponding rDNA. They were
      found to be located within positions 976-1057 for (pU)6 and pAUGU3 derivatives
      and within 976-1164 for (pU)3 and pAUG ones. The sites of 18S rRNA modification
      with the derivatives of (Up)5UpC and (Up)11UpC were found within positions 1610
      1869 at 3'-end of the molecule. All the sites identified here are located
      presumably within highly conserved parts of the eukaryotic small subunit rRNA
      secondary structure.

PMID- 1637863
TI  - Photochemical cross-linking of the anticodon loop of yeast tRNA(Phe) to 30S
      subunit protein S7 at the ribosomal A and P sites.
AB  - Yeast tRNA(Phe), containing the photoreactive nucleoside 2-azidoadenosine at
      position 37 within the anticodon loop, has been cross-linked to the aminoacyl
      tRNA (A) and peptidyl-tRNA (P) binding sites of the Escherichia coli ribosome.
      The 30S subunit was exclusively labeled in each case, and cross-linking occurred
      to both protein and 16S rRNA. Electrophoretic and immunological analyses
      demonstrated that S7 was the only 30S-subunit protein covalently attached to the
      tRNA. However, digestion of the A and P site-labeled S7 with trypsin revealed a
      unique pattern of cross-linked peptide(s) at each site. Thus, while the anticodon
      loop of tRNA is in close proximity to protein S7 at both the A and P sites, it
      neighbors a different portion of the protein molecule in each. The placement of
      the aminoacyl- and peptidyl-tRNA binding sites is discussed in relationship to
      recent models of the 30S ribosomal subunit.

PMID- 1637864
TI  - Ribosome function determined by fluorescence.
AB  - Five different fluorescence phenomena are considered in relation to their use to
      study the structure and function of ribosomes. These are: quantum yield or
      emission intensity; emission wavelength maximum; fluorescence anisotropy;
      collisional quenching; and nonradiative energy transfer. Results from a number of
      studies in which these techniques were used are described and summarized in
      relation to the movement and conformation of tRNA, the nascent peptide, and mRNA
      in a ribosome during the reaction steps of peptide elongation.

PMID- 1637865
TI  - The two main states of the elongating ribosome and the role of the alpha-sarcin
      stem-loop structure of 23S RNA.
AB  - According to the allosteric three-site model of the elongation cycle the ribosome
      oscillates between two main-functional states, viz the pre-translocational state
      with occupied A and P sites (E site with low affinity) and the post
      translocational state with occupied P and E sites (A site with low affinity).
      This proposition could be confirmed by a determination of the thermodynamic
      parameters. High activation-energy barriers were found between both states,
      namely about 90 kJ mol-1 at 15 mM Mg2+ for either transition (post----pre
      transition = A-site binding and pre----post transition = translocation). The
      various A-site states (binding of ternary complex, EF-Tu dependent GTP cleavage,
      peptide-bond formation) are not separated by significant activation-energy
      barriers. The rate-limiting step of the elongation cycle is A-site binding, and
      not translocation as assumed previously. The principal role of both elongation
      factors is the reduction of the respective activation-energy barrier, thus
      accelerating the rate of the elongation cycle by several orders of magnitude.
      Cleavage of a single phosphodiester bond after G2661 of 23S rRNA by the RNase
      alpha-sarcin abolishes the functions of both elongation factors on the ribosome.
      This observation implies that the alpha-sarcin stem-loop structure plays an
      important role in the ribosomal conformational changes involved in the allosteric
      transitions. Indeed we could demonstrate that suitable oligodeoxynucleotide
      probes complementary to the alpha-sarcin region induce a conformational change in
      the 50S subunits; this conformational change causes an irreversible dissociation
      of tightly coupled ribosomes upon sucrose-gradient centrifugation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1637866
TI  - Novel data on interactions of elongation factor Ts.
AB  - Interactions of EF-Ts with EF-Tu at all steps of the elongation cycle were
      studied by limited trypsinolysis, gel-filtration, analytical centrifugation and
      fluorescence polarization techniques. It is shown that EF-Ts does not dissociate
      from EF-Tu after GDP to GTP exchange, but remains bound to the Aa-tRNA.EF-Tu.GTP
      complex up to GTP hydrolysis stage on the ribosome. The possible role of these
      interactions is discussed.

PMID- 1637867
TI  - Binding of ATP and messenger RNA by the beta-subunit of eukaryotic initiation
      factor 2.
AB  - In addition to forming a ternary complex with Met-tRNA(f) and GTP, eukaryotic
      initiation factor 2 (eIF-2) recognizes a specific site in mRNA molecules. Both
      binding activities are regulated by ATP, which itself binds tightly and
      specifically to eIF-2. Denaturation of eIF-2 with urea leads to complete loss of
      Met-tRNA(f) binding activity, while mRNA binding activity is stable. Hence,
      distinct conformational features in eIF-2 are required for ternary complex
      formation and for binding of mRNA. Chromatography of eIF-2 over ATP-agarose, in
      denaturing conditions that induce polypeptide subunit dissociation, results in
      selective retention of the beta-subunit of eIF-2. Isolated beta-subunit is
      capable of binding mRNA as well as ATP. Cibacron blue 3G-A binds tightly to eIF-2
      and inhibits the binding of mRNA. This inhibition is relieved upon addition of
      ATP, showing that Cibacron blue 3G-A competes with ATP for eIF-2. eIF-2 beta
      subunit, active in binding of mRNA, is recovered upon chromatography of eIF-2 in
      denaturing conditions over matrix-bound Cibacron blue 3G-A. These results show
      that the ability of eIF-2 to bind mRNA and its ability to bind ATP are both
      lodged within remarkably stable domains of its beta-subunit. During initiation of
      protein synthesis, the eIF-2 beta subunit may thus interact with three ligands
      important for translational control: Met-tRNA(f), mRNA and ATP.

PMID- 1637868
TI  - Cell-free translation systems from different eukaryotes differ in their
      sensitivity to a template sugar-phosphate backbone.
AB  - To study the role of a messenger sugar-phosphate backbone in the ribosomal
      decoding process, poly(U) and poly(dT) template activity in different eukaryotic
      systems has been compared. 80S ribosomes from Saccharomyces cerevisiae appeared
      to be able to translate poly(dT) both in the presence and in the absence of
      elongation factors, contrary to poly(U). However, ribosomes from higher
      eukaryotes (wheat germ, rabbit liver) are completely inefficient in poly(dT)
      translation. Moreover, rabbit liver ribosomes fail to bind effectively
      phenylalanyl-tRNA in the presence of poly(dT) although the polynucleotide seems
      to interact with the ribosomal decoding center. It is also of particular interest
      that hybrid ribosomes formed from the yeast and rabbit liver subunits can
      translate poly(dT) only when the large ribosomal subunit from yeast is used.

PMID- 1637869
TI  - Interaction of yeast tRNA(Phe) anticodon arm with 40S ribosomal subunit of rabbit
      liver.
AB  - The 15-nucleotide analog of yeast tRNA(Phe) anticodon arm binds cooperatively to
      two sites of poly(U) programmed 40S ribosome like intact tRNA(Phe). The
      cooperativity coefficients appeared to be about 4 for tRNA(Phe) and 50 for its
      anticodon arm. Anticodon arm contributes the majority of free energy of tRNA
      binding to a programmed 40S ribosomal subunit. The correct codon-anticodon
      pairing seems to play the key role in the cooperativity origin. Contrary to the
      anticodon arm template independent binding of the whole tRNA to the small
      ribosomal subunit is revealed.

PMID- 1637870
TI  - Interaction of wheat germ translation initiation factor 2 with GDP and GTP.
AB  - The wheat germ translation initiation factor 2 (WGeIF-2) was isolated in a
      homogeneous state by an efficient procedure and characterized. Its molecular
      mass, as determined by a gel-filtration method is approximately 150,000 Da.
      According to SDS-PAGE WGeIF-2 consists of four subunits with M(r) 37,000 (alpha),
      40,000 (beta), 42,000 (gamma) and 52,000 (delta). The beta- and gamma-subunits
      (but not the alpha-subunit) of WGeIF-2 can be readily phosphorylated by the
      double-stranded RNA activated kinase isolated from rabbit reticulocytes.
      Dissociation constants for WGeIF-2 complexes with GDP and GTP were measured. In
      our evaluation the WGeIF-2 affinity for GDP (KdGDP = 1.5 x 10(-7) M) was only 10
      times higher than for GTP (KdGTP = 1.5 x 10(-6) M), while for rabbit reticulocyte
      eIF-2 (RReIF-2) the difference has been estimated as as much as two orders of
      magnitude in accordance with the literature. Close values of dissociation
      constants for WGeIF-2 complexes with guanine nucleotides suggest that at a
      sufficiently high [GTP]/[GDP] ratio the nucleotide exchange in wheat cells may
      take place without the participation of specific factor (eIF-2B) which catalyzes
      the nucleotide exchange on eIF-2 from mammalian cells.

PMID- 1637871
TI  - Conservative system for dosage-dependent modulation of translational fidelity in
      eukaryotes.
AB  - Variations in dosage of some genes can alter the level of translational fidelity.
      The Saccharomyces cerevisiae genes that act as dosage-dependent suppressors
      and/or modulators of suppression, are the following: some tRNA genes (for
      example, tRNA(Gln)) inducing readthrough by mispairing; genes coding for either
      translational elongation factor or other proteins taking part in translation; and
      some genes of unknown function. We suggest that the SUP35 protein is a factor
      which may play a major role in balance-dependent regulation of translational
      fidelity. Homologues of this genes have been identified in other yeast genera
      (Pichia), green algae (Chlamydomonas) and various animals including man. No
      homologies have been found in the polychaeta (Nereis) or in insects (Drosophila).
      Rates of evolution differ for two separate parts of the genes; the N-terminal
      part, which is important for ambiguous translation in Saccharomyces, is markedly
      variable in the organisms tested. However, the C-terminal part which is required
      for yeast viability has a common origin but a separate evolution from that of the
      EF-Tu protein family.

PMID- 1637872
TI  - Interaction of protein synthesis initiation factors with the mRNA cap structure.
AB  - The mechanism of mRNA recognition by proteins interacting with the mRNA cap
      structure was investigated by photochemical cross-linking of proteins with 32P
      labelled reoviral RNAs. Using ribosomal washes as a source of eukaryotic protein
      synthesis initiation factors, we identified the well-known cap binding proteins
      eIF-4B and -4E, but eIF-2 and eIF-3 as well. The interplay of purified eIF-4A, 
      4B, and -4F was studied in relation to ATP dependence and cap analogue
      sensitivity of cap binding. Next to their well-known roles in the initiation
      process, eIF-2 and eIF-3 also cross-linked to the 5' cap. eIF-2 stimulated eIF-4B
      and -4E cross-linking, an observation that has been previously described more
      extensively. The interaction of eIF-2 with the 5' end of mRNA was extremely
      sensitive to K(+)-ions and was resistant to a high concentration of Mg(2+)-ions;
      this influence of mono- and divalent ions was in contrast with the cross-linking
      of eIF-4B and -4E. Optimal interaction of these factors was obtained at moderate
      K+ concentration and low Mg(2+)-ion concentrations. eIF-2 cross-linking was
      sensitive to high protein to mRNA ratios indicating a weak affinity as compared
      to eIF-4E and -4B. The interaction of eIF-3 with the cap of mRNA is also weak as
      it was counteracted by all other cap binding proteins, leading to an inability to
      detect the cross-linking of this protein in crude eIF preparations. Time kinetics
      of formation of complexes suggested eIF-2 to be one of the first factors to
      interact with mRNA. Preformed RNA-protein complexes were dissociated after cap
      analogue addition, suggesting reversible interactions between RNA and proteins.

PMID- 1637873
TI  - Role of cytoplasmic mRNP proteins in translation.
AB  - Polyribosomal and free mRNPs from rabbit reticulocytes were isolated and
      characterized. Translation of mRNPs was studied in the rabbit reticulocyte and
      wheat germ cell-free systems. Both classes of mRNPs were active in rabbit
      reticulocyte lysates. However, considerable differences between mRNPs and mRNA
      have been revealed. High concentrations of mRNA in the form of mRNP did not
      inhibit protein biosynthesis, whereas the same amounts of deproteinized mRNA
      caused inhibition of this process. Polyribosomal mRNPs and deproteinized mRNA,
      but not free mRNPs, are active in the wheat germ cell-free translation system.
      Translation of free mRNPs in this system can be restored by addition of 0.5 M KCl
      wash of rabbit reticulocyte ribosomes. These results suggest the existence of a
      special repressor/activator regulatory system which controls mRNA distribution
      between free mRNPs and polyribosomes in rabbit reticulocytes. This regulatory
      system should include: i) a translation repressor associated with mRNA within
      free mRNPs, preventing its translation; and ii) a translation activator
      associated with ribosomes, overcoming the effect of the repressor. Both classes
      of cytoplasmic mRNPs contain a major 50 kDa protein (p50). The content of this
      protein per mol of mRNA in free mRNPs is twice as much as in polyribosomal ones.
      The method of p50 isolation has been developed and some properties of this
      protein were investigated. It has been shown that small amounts of p50 stimulate,
      whereas high amounts inhibit mRNA translation. We suggest that p50 has a dual
      role in protein biosynthesis. In polyribosomal mRNPs (p50:mRNA approximately 2:1,
      mol/mol), this protein promotes the translation process.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1637874
TI  - Structural consensus of RNA templates replicated by Q beta replicase.
AB  - Q beta replicase replicates a variety of enzyme-specific small RNAs in addition
      to the phage genomic RNA. The sequence analysis has revealed that all these RNAs
      are potentially capable of forming a consensus secondary structure element. It
      represents a stalk which is formed by the 5'-GGG ... and ... CCCA-3'
      complementary stretches at the termini of the replicating RNA molecules and
      adjacent 5'- and 3'-hairpins, which may form a stacking with the stalk. The
      structure found is rather similar to the analogous structure in the tRNA
      molecule. The genomic RNA of the Q beta phage and other related phages can also
      form a similar structural element.

PMID- 1637875
TI  - Regulation of transcription by translational components in coupled translation
      transcription cell-free system.
AB  - A coupled translation-transcription cell-free system was established from
      eukaryotic cells. The biosynthetic activity of this coupled system closely
      resembles the synthetic behavior of cells in vivo, and exhibits regulatory
      phenomena similar to that of intact cells. The translational system consists of
      rabbit reticulocyte lysate, or its components fractionated by centrifugation. The
      transcriptional portion consists of cockerel liver nuclei. Incorporation of amino
      acids into protein by the coupled system is linear for hours. Similarly,
      transcription in the coupled system is continuous for hours and is proportional
      with time. More than 90% of the transcriptional products are secreted into the
      incubation medium. The components of the translational system influence and
      regulate transcriptional activities. In the presence of ribosomes the nuclei
      transcribe mostly poly(A)+ RNA with alpha-amanitin sensitivity consistent with
      activation of RNA polymerase II. Hybrid selection experiments demonstrate
      authentic preproalbumin mRNA among the transcriptional products. The putative
      mRNA secreted into the medium in the coupled system is found on polysomes,
      indicating translation of de novo synthesized message. Addition of excess
      reticulocyte mRNP to the medium of the coupled system results in transcription of
      primarily ribosomal RNA, 5S RNA, and tRNA, the products of RNA polymerases I and
      III. These activities closely imitate the behavior of liver in vivo under
      conditions of nutritional shifts or hormonal influences. The coupled system
      transcribes, processes, and transports substantial quantities of RNA, about 1.6
      micrograms/10(6) nuclei/h. Thus, a coupled system has been established that lends
      itself to the exploration of regulatory interactions of cell components as it
      appears to closely resemble the in vivo situation.

PMID- 1637876
TI  - Enzymatic biosynthesis of cyclosporin A and analogues.
AB  - The final assembly of the undecapeptide chain of cyclosporin A and its
      cyclization is accomplished in Beauveria nivea by cyclosporin synthetase. This
      multienzyme is the largest integrated enzyme structure so far reported. Its size
      has been estimated at approximately 1,400 kDa by two different methods: 1), by 3%
      SDS-PAGE using the related multienzymes ACV synthetase and gramicidin S
      synthetase 2 as references (420 and 556 kDa, respectively); and 2), by CsCl
      density gradient centrifugation experiments using fluorescence-labeled
      cyclosporin synthetase. Besides cyclosporin A and a number of cyclosporins known
      from fermentation studies cyclosporin synthetase is capable of synthesizing some
      new cyclosporins which are so far unobtainable by fermentation. So, for example
      the synthesis of [N-methyl-(+)-2-amino-3-hydroxy-4,4-dimethyloctanoic acid1]CyA,
      dihydro-CyA, [L-norvaline2,5, N-methyl-L-norvaline11]CyA, [L-allo-isoleucine5, N
      methyl-L-allo-isoleucine11]CyA, [D-2-aminobutyric acid8]CyA, [beta-chloro-D
      alanine8]CyA and some related compounds could be established. By using a related
      but different enzyme from Cylindrotrichum Bonorden, the peptolide [L-threonine2,
      L-leucine5,10, D-2-hydroxyisovaleric acid8]CyA could be synthesized in vitro. We
      were able to synthesize these cyclosporins in sufficient quantities to examine
      their structure by FAB mass spectroscopy and explore their immunosuppressivity.
      It was found that all new cyclosporins so far synthesized in the in vitro system
      are immunosuppressive.

PMID- 1637877
TI  - Graft-versus-leukemia activity after bone marrow transplantation does not require
      graft-versus-host disease.
AB  - Clinical data have suggested that graft-versus-host disease (GVHD) plays a
      crucial role in the antileukemic effects of bone marrow grafts. We investigated
      (a) whether bone marrow cells unable to induce GVHD can effect graft-versus
      leukemia (GVL) activity and (b) whether such antileukemic capacity depends on the
      presence of T lymphocytes in the graft. Balb/c mice were inoculated with A20
      cells, a B-cell lymphoma/leukemia of Balb/c origin. Four weeks after tumor
      inoculation the animals were lethally irradiated and received a bone marrow
      graft. Cells from (Balb/c x C57) F1 or (C3H x Balb/c) F1 hybrids were
      transplanted into parental-strain Balb/c mice. Since lymphocytes from F1 hybrids
      are unable to cause graft-versus-host reactivity against a parental-strain
      animal, we used this experimental setting to explore GVL effects in a GVHD-free
      system. In vitro incubation with monoclonal anti-Thy-1.2 antibody plus complement
      was used to eliminate Thy-1+ cells. After syngeneic transplantation, the death
      rate due to leukemia remained unchanged (91%) compared with that among untreated
      animals (86%). Following transplantation of F1 marrow cells of either (C57 x
      Balb/c) F1 or (C3H x Balb/c) F1 origin, death rates of 40% and 50% were observed;
      these were significantly lower. Depletion of Thy 1+ cells from bone marrow graft
      caused only a slight increase in the leukemic death rate after transplantation of
      bone marrow of (C57 x Balb/c) F1 hybrid origin (50%), but a high leukemic death
      rate was seen after transplantation of (C3H x Balb/c) F1 bone marrow (100%).
      Additional experiments with fully allogeneic, T-cell-depleted C57 bone marrow
      transplantation suggest an antileukemic effect that is comparable to that seen
      after transplantation of unmanipulated F1 bone marrow. Taken together, our
      results indicate that GVL activity can be dissociated from graft-versus-host
      reaction.

PMID- 1637878
TI  - Prevention of viridans-group streptococcal septicemia in oncohematologic
      patients: a controlled comparative study on the effect of penicillin G and
      cotrimoxazole.
AB  - In a controlled randomized study among 48 patients undergoing 75 courses of
      aggressive antileukemic therapy, it was shown that cotrimoxazole was less
      effective than penicillin G in preventing septicemia due to viridans
      streptococci. Both antibiotics were given intravenously. During 35 episodes of
      chemotherapy in the group of patients on penicillin G only, one patient developed
      a streptococcal bacteremia; this contrasted with bacteremia and septicemia in
      seven patients during 40 episodes in the group on cotrimoxazole. In three of
      these seven patients, septicemia was associated with respiratory failure and it
      was the cause of death in one. Both aerobic gram-negative rods and streptococci
      which caused infection despite cotrimoxazole prophylaxis were resistant to
      cotrimoxazole. Side effects such as hypersensitivity and favorable or unfavorable
      interaction with the oral selective decontamination regimen were similar for the
      two drugs, with the exception of colonization with Candida spp, which occurred
      more often in patients on cotrimoxazole than in patients on penicillin.

PMID- 1637879
TI  - A simple elimination of clonogenic tumor cells from human bone marrow in vitro by
      heat: its application to autologous bone marrow transplantation for B-cell
      lymphoma.
AB  - The application of hyperthermia to the treatment of neoplastic disease has
      focused on solid tumors. Since the hyperthermic sensitivity of human B-cell
      lymphoma cells is not known, we have examined the effect of hyperthermia on the
      growth of B-cell lymphoma cell lines (Raji and Daudi) in vitro to evaluate the
      ability to purge tumor cells from normal bone marrow by heat, utilizing a
      limiting-dilution assay to measure log depletion of tumor cells in a 20-fold
      excess of normal bone marrow. When exposed at 42 degrees C and 43 degrees C for
      120 min, both clonogenic Raji and Daudi cells were dramatically decreased (a 4-
      to 6-log reduction) with exposure time, while leaving over half of the normal
      granulocyte-macrophage progenitor cells surviving at 42 degrees C and 10% at 43
      degrees C. This high level of lymphoma-cell depletion by heat correlated with
      that obtained in immunologic and pharmacologic studies. These results suggest
      that in vitro hyperthermia might be applied effectively for the elimination of
      residual lymphoma cells in autologous marrow grafts before autologous bone marrow
      transplantation in B-cell non-Hodgkin's lymphoma.

PMID- 1637880
TI  - Retinoic acid in the treatment of acute promyelocytic leukemia: inefficacy of the
      13-cis isomer and induction of complete remission by the all-trans isomer
      complicated by thromboembolic events.
AB  - The clinical course of three patients with acute promyelocytic leukemia receiving
      all-trans retinoic acid (ATRA) as a single agent is reported. The first two
      patients were in first and second relapse of their leukemia that had occurred
      despite maintenance treatment with 13-cis retinoic acid after chemotherapy
      induced complete remission (CR). A switch to ATRA was followed by achievement of
      a CR in two patients. The third patient received ATRA as first-line therapy. Two
      patients experienced thromboembolic complications during the phase of ATRA
      induced leukocytosis. One of them died of pulmonary embolism on day 16 of
      treatment. The two responding patients who did not receive consolidation
      chemotherapy relapsed after 6 and 9 months, respectively. Increase of the ATRA
      dose failed to induce a new remission.

PMID- 1637881
TI  - The frequency and significance of megakaryocytic emperipolesis in
      myeloproliferative and reactive states.
AB  - Sixty-three bone marrow (BM) biopsy paraffin sections from patients with platelet
      counts of 1000 x 10(9)/1 or greater were examined to determine the incidence of
      megakaryocytic emperipolesis for the various myeloproliferative disorders (MPDs)
      and for reactive thrombocytosis. Of those cases classified as specific MPDs, 77%
      of primary thrombocythemia (PT) specimens, 100% of the polycythemia vera (PV)
      specimens, a single idiopathic myelofibrosis (IMF) specimen, and 17% of the
      chronic granulocytic leukemia (CGL) specimens demonstrated emperipolesis within
      megakaryocytes. Two of three cases grouped as MPDs but not further classified
      also demonstrated emperipolesis. Of the cases of reactive thrombocytosis (RT),
      75% showed the presence of emperipolesis. Our results indicate that, with the
      exception of CGL, emperipolesis can be found in the BM megakaryocytes of the
      great majority of patients who have extreme thrombocytosis. The underlying cause,
      whether myeloproliferative or reactive, does not apparently influence the
      incidence of the phenomenon.

PMID- 1637882
TI  - Cold agglutinins of anti-Pr specificity in rubella embryopathy.
AB  - Cold agglutinins of anti-Pr specificity were detected in two newborn infants
      suffering from serologically ascertained rubella embryopathy, an IgM kappa anti
      Pr(a), titer 64, and an IgM lambda anti-Pr1, titer 16. The cases are rare
      examples of cold agglutinin production in newborns; a possible relationship
      between anti-Pr specificity and rubella infection is discussed.

PMID- 1637883
TI  - Erythropoietin levels in patients depositing autologous blood in short intervals.
AB  - Plasma immunoreactive erythropoietin (EPO) concentrations were studied in ten
      patients (7 men, 3 women) predonating autologous blood for hip arthroplasty.
      Donations were scheduled on day 1, 3, 7, 14 (and 21 if four units could not be
      donated previously). A predonation hemoglobin concentration of 11 g/dl was
      required. The donations led to a decline of the hemoglobin concentration from
      14.1 +/- 1.0 g/dl (X +/- SD) prior to donation to 11.0 +/- 0.9 g/dl on day 15.
      EPO concentration prior to donation was 17.6 +/- 2.6 mU/ml. Each phlebotomy was
      followed by a rise in EPO levels that reached a peak concentration within 1 day.
      The highest concentration (35.8 +/- 15.0 mU/ml) was measured on day 16. The peak
      concentration was followed by a plateau at lower, although still elevated levels
      after the first and second donation, and by a slow, continuous decline after the
      third and fourth donation. This particular time course is similar to that during
      weekly donations [15]. The time integral of the EPO concentration during the
      first 3 weeks, however, was greater in the present study. This increased
      availability of EPO early during donation may lead to a more efficient
      stimulation of erythropoiesis.

PMID- 1637885
TI  - A study of von Willebrand's disease in Jordan.
AB  - This work reports on the results of a 9-year study of von Willebrand's disease
      and its subtypes in Jordan, a country with a predominantly Arab population. There
      were a total of 65 patients in 32 families. Detailed study of 61 patients
      including von Willebrand factor multimers was done for the purpose of subtyping
      them. Type I and variants were seen in 36 patients (59%). Type II A and variants
      with decreased ristocetin response accounted for seven patients (11.5%), while 11
      (18%) were of type II B. The severe type (type III) accounted for seven patients
      (11.5%). Von Willebrand's disease was the second most commonly seen inherited
      bleeding disorder after hemophilia A. It is concluded that although the observed
      frequency of von Willebrand's disease in this study in Jordan is lower than that
      in Europe and the USA, the true prevalence cannot be ascertained since many of
      the mild cases presumably were missed because of referral patterns. Type I and
      its variants was the most common type found, but the observed frequency of types
      II B and III was more than that reported in Europeans and Americans.

PMID- 1637884
TI  - Histologic findings in bone marrow biopsies of patients with thrombocythemic cell
      counts.
AB  - Histologic diagnoses from bone marrow biopsies were analyzed in a total of 1165
      patients presenting with thrombocythemic platelet counts at initial examination.
      Two cut-off points suggested by the Polycythemia Vera Study Group to define
      thrombocythemia by platelet counts were compared: the former limiting value of
      1000 x 10(9)/l platelets versus the recently proposed value of 600 x 10(9)/l. The
      percentage of all nonproliferative disorders was 41% under the lower, dropping to
      11% under the high cut-off point. The respective figures for myeloproliferative
      disorders increased from 49% under the lower to 74% under the high limiting
      value. Primary thrombocythemia was included in 72% by the lower, and in only 40%
      by the high limiting value when classified by its histologic pattern in bone
      marrow biopsy. A striking decrease of platelet counts occurs, related to fiber
      increase, among each of three main groups of myeloproliferative disorders: in CML
      with megakaryocytic predominance from 40% down to 25%, in megakaryocytic
      granulocytic myelosis (primary, i.e., agnogenic myelofibrosis) from 36.6% to 10%,
      and in primary thrombocythemia from 72.6% to 28.6% in cases with reticulin
      sclerosis.

PMID- 1637886
TI  - High interleukin-6 plasma levels in acute promyelocytic leukemia.

PMID- 1637887
TI  - Frequency and DNA sequence of tal-1 rearrangement in children with T-cell acute
      lymphoblastic leukemia.
AB  - Using nested polymerase chain reaction (PCR) a gene rearrangement named tal-1
      deletion was found in five of 56 leukemic bone marrow samples from children with
      T-cell acute lymphoblastic leukemia (ALL). The DNA sequences of the PCR fragments
      consisted of the known conserved germline sequences in addition to short DNA
      insertions at the breakpoint region, which were different in each patient.
      Moreover, one patient was examined at diagnosis and at relapse 11 months later,
      revealing identical DNA sequences at the rearrangement site. The recombination
      site of the tal rearrangement therefore may be used as a genetic marker for
      detecting minimal residual disease in about 10% of T-cell ALL in childhood.

PMID- 1637888
TI  - Myocardial infarction after FEIBA therapy in a hemophilia-B patient with a factor
      IX inhibitor.
AB  - A case of myocardial infarction (MI) in a hemophilia B patient with a factor IX
      (FIX) inhibitor (6 BU) is described. MI occurred after two infusions of FEIBA
      concentrate. Unexpectedly, these infusions resulted in a neutralization of the
      inhibitor and a consistent plasma FIX activity which may have increased the
      thrombotic risks. Four days later, a psoas hematoma was suspected. At that time
      the inhibitor remained undetectable, allowing a therapy with purified FIX
      concentrates. No recurrence of thrombotic complication was observed. This is an
      additional illustration of the thrombotic risks associated with the use of
      activated prothrombin complex concentrates, especially in patients having pre
      existing risk factors for thrombosis. The management of bleeding episodes in
      hemophilia B patients with inhibitor represents an especially difficult
      challenge.

PMID- 1637889
TI  - Parvovirus B19 infection and bone marrow transplantation.
AB  - Parvovirus B19 lytically infects erythroid progenitor cells and thereby causes
      cessation of erythropoiesis in infected individuals. Anemia develops only if red
      cell turnover is increased, as in patients with chronic hemolysis (transient
      aplastic crisis). In addition to transient marrow failure, B19 can cause chronic
      anemia and, rarely, pancytopenia in immunodeficient patients who are not able to
      mount an adequate immune response to clear the virus. Bone marrow
      transplantation, although causing significant immunosuppression, is rarely
      complicated by symptomatic B19 infection. This is probably due to effective
      passive immunotherapy by immunoglobulin infusions immediately after
      transplantation and early reconstitution of antibody responses after
      uncomplicated transplantation.

PMID- 1637890
TI  - Serum beta-carotene: a mechanism or "yellow finger"?

PMID- 1637891
TI  - Time-related confounders and intermediate variables.

PMID- 1637892
TI  - Serum cholesterol, beta-carotene, and risk of lung cancer.
AB  - This paper hypothesizes that beta-carotene mediates the association between low
      serum cholesterol and increased risk of lung cancer, predicts that the
      association should be greater in population strata with low intake of beta
      carotene than in those with high intake if the hypothesis is correct, and
      investigates this prediction with data from a 24-year cohort study of 1,960
      middle-aged employed men. In the total cohort, serum cholesterol was not related
      to risk of lung cancer. The relative risk associated with a difference of -1.0
      mmol per liter in serum cholesterol was 1.01 (95% confidence interval of 0.80
      1.27) after adjustment for cigarette smoking, age, and intake of beta-carotene.
      In contrast, however, when the study group was restricted to men with intake of
      beta-carotene less than 5,000 (N = 929) or less than 3,000 IU per day (N = 272),
      comparable relative risks were 1.10 and 1.21, respectively. Although the 95%
      confidence intervals for these relative risks were broad and included unity, the
      result is consistent with expectation. We conclude that the hypothesis warrants
      further investigation.

PMID- 1637893
TI  - High-fat foods and the risk of lung cancer.
AB  - We conducted a population-based case-control study of the association of dietary
      cholesterol and fat with lung cancer between 1983 and 1985 on Oahu, Hawaii. The
      study population included 226 men and 100 women with lung cancer, and 597 male
      and 268 female community controls matched for age (+/- 5 years) and sex. There
      was a positive dose-response relation between the consumption of processed meats
      (luncheon meats, bacon, sausage), dairy foods (whole milk, regular ice cream),
      eggs, and particular desserts (fruit pies, custard/cream pies) and the risk of
      lung cancer in men. We also found a positive trend in the risk of lung cancer in
      women with increasing intake of some processed meats (bacon, Spam) and desserts
      (cakes, custard/cream pies). The dose-response relation tended to be stronger
      among men who were heavy smokers and who were diagnosed with squamous cell cancer
      of the lung. A positive trend in risk was found for nitrite intake in men and
      dimethylnitrosamine intake in men and women. These data indicate that smokers
      with a high intake of foods rich in fat and animal protein or who have a
      preference for cured meats are at increased risk of lung cancer.

PMID- 1637894
TI  - Oral and pharyngeal cancer and occupation: a case-control study.
AB  - We studied the relation between occupation and oral and pharyngeal cancer with a
      population-based case-control study conducted in four areas of the United States.
      The study group included 1,114 incident male and female cases and 1,268 frequency
      matched controls. After adjustment for age, race, smoking, alcohol, and study
      location, an analysis of lifetime occupational histories revealed a small number
      of noteworthy associations. Risk was increased among male carpet installers (23
      cases, 4 controls), with an adjusted odds ratio of 7.7 [95% confidence interval
      (CI) = 2.4-24.9], and tended to rise with longer duration of employment. A
      decreased risk was found among male and female textile mill workers (odds ratio
      0.48, 95% CI = 0.27-0.88). Previously reported increases in oral cancer risks
      among printing workers, electrical and electronics workers, and workers other
      than carpet installers who were possibly exposed to formaldehyde were not found
      in this study. For several employment groups, including male machinists, primary
      metal industry workers, petroleum industry workers, painters, furniture and
      fixture industry workers, woodworking machine operators, and workers with
      inferred exposure to fossil fuel combustion, odds ratios were approximately 2.0
      for cancers of pharyngeal sites.

PMID- 1637895
TI  - G-estimation of the effect of prophylaxis therapy for Pneumocystis carinii
      pneumonia on the survival of AIDS patients.
AB  - AIDS Clinical Trial Group Randomized Trial 002 compared the effect of high-dose
      with low-dose 3-azido-3-deoxythymidine (AZT) on the survival of AIDS patients.
      Embedded within the trial was an essentially uncontrolled observational study of
      the effect of prophylaxis therapy for pneumocystis carinii pneumonia on survival.
      In this paper, we estimate the causal effect of prophylaxis therapy on survival
      by using the method of G-estimation to estimate the parameters of a structural
      nested failure time model (SNFTM). Our SNFTM relates a subject's observed time of
      death and observed prophylaxis history to the time the subject would have died
      if, possibly contrary to fact, prophylaxis therapy had been withheld. We find
      that, under our assumptions, the data are consistent with prophylaxis therapy
      increasing survival by 16% or decreasing survival by 18% at the alpha = 0.05
      level. The analytic approach proposed in this paper will be necessary to control
      bias in any epidemiologic study in which there exists a time-dependent risk
      factor for death, such as pneumocystis carinii pneumonia history, that (A1)
      influences subsequent exposure to the agent under study, for example, prophylaxis
      therapy, and (A2) is itself influenced by past exposure to the study agent.
      Conditions A1 and A2 will be true whenever there exists a time-dependent risk
      factor that is simultaneously a confounder and an intermediate variable.

PMID- 1637896
TI  - Nonsteroidal antiinflammatory drugs and gastrointestinal hospitalizations in
      Saskatchewan: a cohort study.
AB  - We evaluated the association between individual nonsteroidal antiinflammatory
      drugs (NSAIDs) and gastrointestinal (GI) toxicity in a retrospective cohort study
      aimed at examining and comparing the incidence of serious gastrointestinal
      disorders among NSAIDs users. We observed 2,302 GI hospitalizations among
      diclofenac, indomethacin, naproxen, piroxicam, sulindac, and other NSAIDs users
      in the province of Saskatchewan, Canada, from 1982 to 1986 for 228,392 persons
      who contributed 679,075 person-years of follow-up and filled close to 1.5 million
      NSAID prescriptions. Current NSAID users presented an increased risk of GI
      hospitalization [rate ratio (RR) = 3.9, 95% confidence interval = 3.5-4.4]. RRs
      decreased as time since the last prescription increased: 2.2 (1.9-2.6) for recent
      past users and 1.3 (1.1-1.5) for less recent past users. Among current users, RRs
      were the highest in indomethacin users (5.1, 4.3-6.0), and the lowest in sulindac
      users (3.1, 2.3-4.2). All of these results are adjusted for calendar time, sex,
      and age. Age showed a particularly strong association with the risk of GI
      hospitalization.

PMID- 1637897
TI  - Ethics, scientific validity, and the design of epidemiologic studies.
AB  - Ethical conflicts between moral principles and methodologic standards sometimes
      occur in epidemiologic research. When dilemmas are discerned, they may be
      analyzed using the ethical principles of beneficence, nonmaleficence, justice,
      and respect for the autonomy of persons. We argue that, in addition to scientific
      validity, the welfare and rights of research subjects should be taken into
      account in making decisions regarding all aspects of the design and conduct of
      epidemiologic studies, and that the commitment of epidemiologists to the
      advancement of scientific knowledge should not outweigh or override all other
      considerations.

PMID- 1637898
TI  - Geographical differences in myocardial infarction incidence in eight Swedish
      counties, 1976-1981.
AB  - Considerable regional variation in coronary heart disease mortality has been
      observed in Sweden. This variation is of public health concern and is also a
      point of departure for etiologic studies. The central aim of the present study
      was to investigate whether there are also regional differences in myocardial
      infarction incidence and to evaluate whether these are likely to be explained by
      regional differences in smoking, blood pressure, and serum cholesterol. The study
      base consisted of subjects age 30-64 living in eight Swedish counties during 1976
      1981. Cases of myocardial infarction were identified using both hospital
      discharge and death records. A 30-40% increased incidence of myocardial
      infarction was found in the two northernmost counties compared with Stockholm
      county. The regional differences in myocardial infarction incidence were not
      related to differences in smoking but might be due in part to differences in
      serum cholesterol and blood pressure, and to socioeconomic factors as well.

PMID- 1637899
TI  - Reporting and selection bias in case-control studies of congenital malformations.
AB  - Retrospective studies of congenital malformations frequently rely on exposures
      reported by study subjects. Differential error in exposure reporting by cases and
      controls, which has alternatively been referred to as "recall bias" and
      "reporting bias," may result in a biased effect measure. Some authors have
      attempted to avoid reporting bias by comparing exposures between two malformed
      groups, rather than between cases and nonmalformed controls. This approach,
      however, may introduce its own bias, which we call selection bias. Both reporting
      bias and selection bias are shown to be algebraically equivalent to bias arising
      from exposure misclassification. The magnitudes of these biases are compared for
      a range of plausible parametric values. The case-control design is sensitive to
      both differential reporting and selection bias, and the choice of study design
      involves balancing these two sources of bias.

PMID- 1637900
TI  - Moderate maternal and paternal alcohol consumption and the risk of spontaneous
      abortion.
AB  - Maternal alcoholism can lead to the fetal alcohol syndrome in offspring, but the
      effect of more moderate alcohol consumption during pregnancy remains an issue of
      concern. Therefore, we analyzed data from a large case-control study of
      spontaneous abortion (626 cases, 1,300 controls) that ascertained maternal
      alcohol consumption before and during pregnancy, as well as paternal consumption.
      Asking when in pregnancy alcohol consumption changed allowed us to calculate a
      weighted average of the amount consumed weekly during the first trimester. The
      odds ratio for consumption of seven or more drinks per week was 1.9 [95%
      confidence interval (CI) = 1.1-3.4] when adjusted for maternal smoking, passive
      smoking, and maternal age. Data were too sparse to examine higher consumption
      levels. There was some evidence that cases may have had less opportunity than
      controls to decrease consumption during their shorter pregnancies, potentially
      biasing the odds ratio upward. The adjusted odds ratio for any paternal alcohol
      consumption was 1.2 (CI = 0.93-1.5), with no dose-response effect seen. Among
      pregnancies in which the mother did not drink, there was no association with
      paternal drinking.

PMID- 1637901
TI  - The protective effect of alcohol on the occurrence of epidemic oyster-borne
      hepatitis A.
AB  - Limited data indicate that drinking alcoholic beverages along with eating food
      contaminated with Shigella or Salmonella decreases the risk and/or the severity
      of illness. No such study has been reported following exposure to a viral
      pathogen. During an oyster-borne outbreak of hepatitis A, we studied the effect
      of ingestion of alcoholic beverages concomitant with consumption of contaminated
      oysters. The analysis was restricted to 51 cases and 33 controls who had consumed
      the implicated raw oysters. After controlling for potential confounders, we found
      a protective effect for beverages that have an alcohol concentration of greater
      than or equal to 10% (odds ratio = 0.1, 95% confidence interval = 0.02-0.9), but
      not for beverages with an alcohol concentration of less than 10% (odds ratio =
      0.7, 95% confidence interval = 0.2-2.9).

PMID- 1637902
TI  - Oral contraceptive use and the risk of inflammatory bowel disease.
AB  - We used rosters of the Crohn's and Colitis Foundation of America to identify
      potential cases and peer-nominated controls to explore the reported association
      between oral contraceptives and inflammatory bowel disease. Overall, women who
      used oral contraceptives were at increased risk of developing Crohn's disease
      (odds ratio = 1.49, 95% confidence interval (CI) = 0.99-2.26). The findings
      persisted after adjustment for age at symptom onset, decade of onset, education,
      marital status, and location of disease. There was an interaction with cigarette
      smoking; the risk associated with oral contraceptives was elevated in current
      smokers (odds ratio = 2.64, 95% CI = 1.22-5.75), but not in former smokers or
      never-smokers. The risk was not elevated for ulcerative colitis (odds ratio =
      1.10, 95% CI = 0.65-1.85).

PMID- 1637903
TI  - Validation of a method for the estimation of food portion size.
AB  - In the context of the planning phase of a large cohort study on dietary habits
      and cancer, we have developed a food frequency questionnaire on usual food
      intake, which includes a set of pictures to estimate the portion size of 23
      different dishes. The validity of the estimation of portion size of recently
      consumed foods has been questioned by other researchers. To validate the use of
      pictures, we organized a field trial with 103 volunteers. They were invited to a
      dinner where standard Italian dishes were offered (total 17 foods); all of the
      portions they chose were recorded and weighed. The following day, we interviewed
      the volunteers on what they consumed during the dinner, and we compared the
      weight of the food actually eaten with the weight of the food represented in the
      pictures. The volunteers overestimated the portion size by more than 20% for six
      foods and underestimated the portion size by more than 20% for four foods. In
      addition, we found a tendency toward overestimation of portion size by those who
      ate smaller portions and underestimation, by those who ate larger portions ("flat
      slope syndrome").

PMID- 1637904
TI  - Confounding of algorithmic efficiency by programming language in exact odds ratio
      estimation.

PMID- 1637905
TI  - A delicate subject.

PMID- 1637906
TI  - Health care reform: do we need it? Do we need it now?

PMID- 1637907
TI  - Advance directive.

PMID- 1637908
TI  - Urostomy and urinary pH.
AB  - Significant variations of urinary pH can cause problems for all human beings, but
      these problems are magnified when an individual has a urostomy. Most significant
      stomal and peristomal complications are related to an alkaline urine including
      hyperkeratosis; stoma bleeding, incrustation, and ulceration; stoma stenosis;
      urinary tract infection; odor; and urinary calculi. Treatment of these conditions
      includes both external and internal measures. External methods of treatment
      involve keeping urine away from the stoma and the peristomal skin by use of a
      correctly fitting clean appliance and a night drainage system. Vinegar solution
      compresses can help to restore the acid mantle of the skin. Internal methods of
      treatment that are advocated in the literature include ingestion of cranberry
      juice and ascorbic acid to promote urine acidity. Increasing oral intake of
      fluids is the least risky method to promote the production of acidic, dilute
      urine, and results are equally effective.

PMID- 1637909
TI  - Analgesic administration via rectum or stoma.
AB  - The rectal and stomal routes for administering analgesics are discussed as
      alternatives to invasive, parenteral routes when a patient is unable to take
      medication by mouth. The ET nurse has an important role in reminding members of
      the health care team about these routes and in teaching patients and family
      members (i.e., caregivers) to use them properly.

PMID- 1637910
TI  - Options in the surgical treatment of bladder cancer.
AB  - In general, bladder cancers may be divided into two classes: superficial and
      invasive. Superficial cancers can be treated without systemic chemotherapy or
      radical surgery. However, until recently, treatment of invasive cancers usually
      involved removal of the bladder and construction of an ileal conduit. Newer
      methods of treatment focus on preservation and reconstruction. In this article,
      surgical procedures that incorporate these goals and other treatment options,
      specifically chemotherapy and radiation therapy, are discussed, and the
      individual needs of patients are emphasized.

PMID- 1637911
TI  - Aspects of sexuality for patients with stomas and continent pouches.
AB  - An alteration in a person's body image can have an impact on sexual issues for
      that person. A person who has a conventional or continent diversion should
      receive instruction in the promotion of sexual health as a component of nursing
      care. ET nurses have an excellent opportunity to provide information on and
      direction in sexual rehabilitation for their patients.

PMID- 1637912
TI  - Treatment options for men with sexual dysfunction.
AB  - Erectile dysfunction can occur in men of any age, but it is more common in older
      men. It is one of the most devastating problems a man can face. An estimated 10
      to 12 million American men experience impotence. Increased sexual expectations
      for an aging population have resulted in an increased interest in the treatment
      of impotence. Treatment options range from a simple adjustment in medication to
      surgical implantation of a penile prosthesis. The good news is that sexual
      function can almost always be restored. The bad news is that many men with
      chronic erectile dysfunction never seek help. A sensitive nurse who has an
      understanding of sexual health and functioning and the conditions that interfere
      with them can steer those who need help in the direction of treatment.

PMID- 1637913
TI  - Training programs for retail personnel.

PMID- 1637914
TI  - Regulatory update.

PMID- 1637915
TI  - [Regulation of the specific and nonspecific ion conductivity of mitochondria by
      adenine nucleotide carriers].
AB  - The functioning of the adenine nucleotide carrier as a regulated pore which,
      depending on incubation conditions, operates as either a specific conductivity
      channel for H+ and K+ ions, or a nonspecific channel for low molecular weight
      metabolites, is reviewed. Both specific and nonspecific conductivities over this
      specific channel are controlled by the conformational state of the carrier
      protein molecule. The conformational states of the ATP/ADP-carrier alter by the
      specific effect of adenine nucleotides, ATP/ADP transport inhibitors, Ca2+ ions,
      medium tonicity, and energization of mitochondria. The transition of the ATP/ADP
      carrier to the conformational state characterized by nonspecific conductivity is
      inhibited by cyclosporin A. The roles of the adenine nucleotide carrier in the
      realization of effects of Ca(2+)-mobilizing hormones and glucagon during
      mitochondrial function are discussed.

PMID- 1637916
TI  - [Lipid metabolism in rat tissues during chronic gamma-irradiation and action of
      ubiquinone Q-9].
AB  - Chronic gamma-irradiation of rats with the daily dose of 0.129 Gy activates the
      synthesis of various classes of lipids in the thymus, spleen and bone marrow
      cells and induces lipid accumulation in these tissues. Feeding of rats with the
      antioxidant, ubiquinone Q-9, under conditions of chronic irradiation causes a
      considerable normalization of lipogenesis and levels of the lipid concentration
      in the tissues of animals irradiated with the dose of 20 Gy.

PMID- 1637917
TI  - [Limited proteolysis of human albumin and immunoglobulin G by Legionella
      pneumophila metalloproteinase].
AB  - Metalloproteinase of Legionella pneumophila is the major extracellular proteinase
      of this bacterial species which splits human immunoglobulin G in the hinge region
      to form the (Fab')2 fragment. This fragment is relatively stable and undergoes
      further proteolysis at a slow rate. The c' fragment is unstable and is apparently
      split down to fragments CH2 and CH3. The metalloproteinase splits human serum
      albumin down to products having lower molecular masses. Another bacterial
      metalloproteinase, thermolysin, produces a similar effect, although at a slower
      rate.

PMID- 1637918
TI  - [Binding of cholesterol by apolipoproteins A-I and E].
AB  - It was shown that cholesterol can interact with some guanidine group-containing
      compounds (guanidine proper, arginine, metformine and dodecylguanidine bromide)
      as well as with the arginine-rich proteins--apoproteins A-1 and E. In the latter
      case this interaction results in the formation of cholesterol-apoprotein
      complexes. Analysis of such complexes revealed that one apo-A-1 molecule binds 17
      22, whereas one apo-E molecule--30-35 sterol molecules, which approximately
      correspondence to the amount of arginine residues in these proteins. The
      formation of cholesterol-apoprotein complexes seems to be due to: (1) formation
      of hydrogen bonds and ion-dipole interactions between the hydroxyl groups of
      cholesterol and the guanidine groups of the apoprotein arginine residues and,
      presumably, the carboxylic groups of aspartic or glutamic acids, eventually
      resulting in the production of chelate complexes; (2) hydrophobic interaction of
      the cholesterol aliphatic chain with the nonpolar side chains of the amino acids
      occupying the third position from arginine in the protein molecule.

PMID- 1637919
TI  - [Reactivation and reconstitution of glutamate decarboxylase upon the interaction
      of its dimers with pyridoxal phosphate].
AB  - The relationship between the reactivation and reconstitution of the hexameric
      form of glutamate decarboxylase during the interaction of inactive apoenzyme
      dimers with pyridoxal phosphate (PLP) has been studied. It was shown that the
      restoration of enzymatic activity, appearance of spectral maximum at 340 nm, and
      reconstitution of the hexamer depend on the amount of PLP added; this reaction is
      completed when the PLP concentration reaches that of the initial enzyme. This
      native hexamer of the holo- and apoenzyme does not practically contain exposed
      sulfhydryl groups. Ten cysteine residues become available after DS-Na
      denaturation. The dimer of the apoenzyme contains 8 exposed and 2 buried cysteine
      residues. The hexamer formation from the dimers is accompanied by the burying of
      the cysteine residues. When half of the required PLP was added, 7 cysteine
      residues became buried in experiments with DTNB and six in experiments with 4.4'
      DTDP. Further addition of PLP led to the disappearance of the exposed sulfhydryl
      groups.

PMID- 1637920
TI  - [Interaction of sex steroids with proteins from the soluble fraction of swine and
      cattle liver (a preliminary analysis)].
AB  - The interactions of [3H]estradiol, [3H]testosterone and [3H]progesterone with
      soluble proteins from porcine and calf liver were studied. The specific binding
      of [3H]progesterone and [3H]testosterone in calf liver cytosol seems to be due to
      serum transcortin or its intracellular precursor (analog). Contrariwise, the
      specific binding of [3H]progesterone observed in porcine liver cytosol was absent
      in the serum. This binding was characterized by slow association and dissociation
      dynamics, moderate affinity for the [3H]-ligand and a high binding capacity. The
      structural determinants of the ligands were studied by competitive inhibition of
      the [3H]-ligand binding. The delta 4-3-keto group in the steroid A-ring was found
      to be the most important determinant. An intensive metabolism of [3H]progesterone
      was observed during its incubation with cytosol (data from thin-layer
      chromatography). A 3H-metabolite (presumably, 20 beta-dihydroprogesterone) was
      predominant in the bound ligand fraction. The data obtained suggest that proteins
      of a steromodulin type are widely distributed in the mammalian liver.

PMID- 1637921
TI  - [The effect of monoclonal and polyclonal antibodies to peroxidase on combined
      peroxidase oxidation of 4-iodophenol with luminol and 4-aminoantipyrine].
AB  - The kinetics of peroxidase-dependent cooxidation for two substrate pairs [p
      iodophenol + 4-aminoantipyrine (AAP) and p-iodophenol + luminol was studied both
      in the absence and presence of polyclonal antibodies (polyAB), three types of
      peroxidase-specific monoclonal antibodies (monoAB) and their double or triple
      mixtures in a wide range of H2O2 concentrations (0.01-10.0 mM). MonoAB 2C, 3E and
      9D at concentrations of 0.05-500 nM inhibited the cooxidation of p-iodophenol +
      AAP at H2O2 concentration above 1.0 mM but activated the cooxidation of p
      iodophenol + luminol. The double and triple mixtures of monoAB activated the
      cooxidation of p-iodophenol + AAP at the same H2O2 concentrations without any
      effect on the p-iodophenol + luminol cooxidation. PolyAB activated the
      cooxidation of p-iodophenol + AAP more effectively and only slightly activated
      (or inhibited) that of p-iodophenol + luminol. PolyAB diminished the values of
      rate constants for the interaction of the peroxidase active intermediates, E1 and
      E2, with p-iodophenol, AAP or luminol. Possible modes of monoAB and polyAB
      effects on the two substrate pair cooxidation are discussed.

PMID- 1637922
TI  - [A simple method of isolating monoclonal immunoglobulin M, possessing rheumatoid
      activity].
AB  - A simple procedure for obtaining highly purified preparations of native
      monoclonal (Waldenstrom's disease) immunoglobulin M possessing a rheumatoid
      activity (IgM-RF) has been developed. The method is based on the use of affinity
      chromatography with a new readily available adsorbent (immunoglobulin G-porous
      glass) and 3 M LiCl in Tris-buffer pH 8.3-8.4 able to induce the dissociation of
      the IgM-RF-IgG complex. The IgM-RF preparation thus obtained was characterized in
      terms of amino acid composition (relative to conventional monoclonal IgM),
      carbohydrate composition and structure of oligosaccharide moieties of a complex
      type. It was shown that some dissociation conditions for the IgM-RF-IgG complex
      routinely used to isolate IgM-RF provoke irreversible denaturation of IgM-RF when
      applied to a preliminarily purified complex.

PMID- 1637923
TI  - [Regulation of the phospholipid turnover rate and protein kinase C activity as a
      necessary stage in the realization of the growth-inhibiting effect of
      dexamethasone on hepatoma 22 cells].
AB  - The role of protein kinase C and phospholipid turnover in the realization of the
      cytostatic effect of dexamethasone on hormone-sensitive cells of mouse hepatoma
      22 has been studied. It was found that dexamethasone added to hepatoma cells
      induces a rapid (within 30 min) inhibition of the protein kinase C activity with
      a simultaneous decrease of the 32P incorporation into the major phospholipids
      (phosphatidylglycerol, phosphatidylcholine, and phosphoinositides). Analysis of
      correlation between the protein kinase C activity and phospholipid turnover rate
      revealed that phosphatidylglycerol and phosphatidylcholine synthesis is under the
      positive control of protein kinase C, whereas that of phosphoinositides is not
      controlled by the enzyme. A proportional decrease in the rates of metabolism of
      all the three major phospholipids after addition of the hormone to hepatoma cells
      suggests that inhibition of phospholipid turnover is one of the primary
      manifestations of the dexamethasone effect. The hormone-induced decrease in the
      protein kinase C activity may be regarded as being due to these changes.

PMID- 1637924
TI  - [Functioning of latrotoxin channels during pH changes].
AB  - Using the fluorescent probe BCECP, the pH dependence of Ca2+ transport in
      synaptosomes along alpha-latrotoxin-formed channels, was studied. It was found
      that the pH value in synaptosomes is equivalent to 7.16 +/- 0.09. Acidification
      or alkalinization of the intracellular medium by 0.1-0.3 pH units had no
      appreciable influence on the Ca2+ influx along latrotoxin-formed channels.
      Alteration of external pH caused a parallel shift in the cytoplasmic pH in the
      synaptosomes. The pH decrease in the external medium down to 6.0 caused the
      inhibition of Ca2+ fluxes along latrotoxin-formed channels. Dissipation of the
      proton gradient by high concentrations of KCl in the presence of nigericin
      decreased the latrotoxin ability to form ionic channels without any loss in the
      activity of the preformed channels. The influx of bivalent cations along
      latrotoxin-formed channels led to alkalinization of the synaptosomal cytoplasm to
      pH of the external medium. This pH change did not depend on the presence of Na+
      in the external medium and was blocked by cadmium.

PMID- 1637925
TI  - [Bimodal effect of exogenous hydrogen peroxide on human neutrophils: cytotoxic
      effect and modulation of respiratory burst in response to an agonist].
AB  - It has been found that high concentrations of exogenous hydrogen peroxide kill
      human neutrophils, the range of toxic concentrations being 100 times as high as
      that for human endothelial cells. Whereas the H2O2 doses of 30-100 mM induce a
      fast massive death of neutrophils, 10 mM hydrogen peroxide induces appreciable
      death only within several hours after treatment. H2O2 used at 30 mM decreases
      superoxide anion generation by neutrophils stimulated with PMA or FMLP. This
      decrease is commensurate in value with cell death, thus indicating a high
      functional resistance of survived cells. In the dose of 10 mM hydrogen peroxide
      potentiates FMLP (but not PMA-)-induced generation of superoxide anions.
      Augmentation of superoxide anion generation by H2O2-primed neutrophils in
      response to FMLP amounts to 200% of the control value. Hydrogen peroxide alone is
      incapable of inducing superoxide anion generation. It is concluded that exogenous
      oxidants can alter the functional activity of leukocytes freshly recruited in
      inflammatory and ischemic tissues.

PMID- 1637927
TI  - Conditioned fear and psychological trauma.

PMID- 1637926
TI  - [Study of the structure-activity features of lactate dehydrogenase isoenzymes
      using antipeptide antibodies to the M4-isoform of swine lactate dehydrogenase].
AB  - The structure-function peculiarities of human, porcine, rabbit, and rat lactate
      dehydrogenase (LDH) isoenzymes have been studied using antipeptide antibodies
      (AB) against the M4-isoform of porcine LDH. Antipeptide AB were raised against
      the hypervariable (40% homology) N-terminal fragment (residues 1-32), and the
      highly conservative fragment 180-214 containing histidine in the enzyme active
      center. Whereas antipeptide AB against the fragment of the active center of
      porcine LDH M4-isoform selectively inhibited the catalytic activities of LDH
      isoenzymes from various sources, antipeptide AB directed against the N-end were
      without effect. The ability of antipeptide AB to specifically interact with
      various isoforms of LDH suggests that sequences 1-32 and 180-214 are
      immunochemically identical only in the case of human and porcine M4 isoenzymes;
      the relatedness of the amino acid sequence to the common antigenic determinant
      required the absence in the given sequence of essential amino acid substituents.
      Chemical modification of porcine M4-isoform by diethylpyrocarbonate and the use
      of specific AB revealed that histidine-195 located in the active center of LDH is
      not directly involved in the binding to AB.

PMID- 1637928
TI  - Aging of core and optional sleep.
AB  - Two consecutive 24-hr ambulatory recordings of 14 healthy elderly persons (7
      women, 7 men, ages 88-102) and of 19 healthy young adults (10 women, 9 men, ages
      25-35) were evaluated. In addition to the classical sleep parameter analysis,
      sleep structure was also analyzed in terms of a proposed distinction between
      "core" and "optional" sleep (Horne 1989). Core sleep is the essential part of the
      sleep and is mainly slow wave sleep. This type of sleep is composed of stages 3
      and 4 on non-REM sleep (NREM 3-4). Core sleep is obtained during the first three
      sleep cycles and the remainder of the night sleep is considered optional sleep.
      Optional sleep is more altered than core sleep. However, in both optional and
      core sleep, NREM sleep and REM are reduced. There is also an increase in
      drowsiness and in the time spent awake after sleep onset; however, the extent of
      these effects are more obvious in elderly men. Aging effects of slow wave sleep
      probably represent an amplification of the changes as observed in awake
      electroencephalic (EEG) patterns in healthy seniors. The decrease in slow wave
      sleep (stages NREM 3-4) is gender related and prevails in elderly men. REM sleep
      diminishes with increasing age. In the elderly, most REM sleep occurs at the
      beginning of the night. This contrasts to younger persons where the duration of
      REM sleep is longer at the end of the night. Furthermore, a decrease in REM sleep
      latency is particularly obvious in elderly men and probably secondary to the
      curtailment of slow wave sleep. The ultradian NREM-REM cycle rhythm (as defined
      by the periodic occurrence of REM sleep) shows a monophasic trend suggesting a
      diminished adaptive function of aged sleep. The informative value of true,
      continuous ambulatory recordings in the assessment of sleep-wakefulness patterns
      in normal and pathological aging is stressed.

PMID- 1637929
TI  - Decreased (3H) quinuclidinyl benzilate binding to lymphocytes in Gilles de la
      Tourette syndrome.
AB  - In spite of an unknown pathophysiology, it has been suggested that central
      dopaminergic hyperactivity exists in Gilles de la Tourette syndrome (TS).
      Cholinergic influences have also been postulated as a dopaminergic-cholinergic
      balance seems to be important in other movement disorders. If TS is due to
      alterations of cholinergic activity, this may also be expressed at postsynaptic
      levels. Recently, we showed that circulating lymphocytes may serve as useful
      peripheral markers reflecting induced alterations or inherent changes in
      muscarinic receptors in the central nervous system (CNS). In the present study,
      we compared the muscarinic binding characteristics in peripheral lymphocytes as
      measured by (3H) quinuclidinyl benzilate [(3H)-QNB] in 27 unmedicated TS
      patients, against 22 healthy (age and gender-matched) controls. B(max) and Kd
      values were determined using Lineweaver-Burke plots. The mean B(max) values in
      nontreated TS patients was markedly and significantly lower than in controls
      (10.59 +/- 8.4 versus 40.16 +/- 9.2 fmole/10(6) cells, p less than 10(-6), while
      Kd values were similar in both groups. Our findings suggest that changes in
      cholinergic receptors may play a role in the pathophysiology of Tourette
      syndrome.

PMID- 1637930
TI  - Immunity, major depression, and panic disorder comorbidity.
AB  - Because recent research reports indicated clinical and biological differences in
      major depression with and without comorbid Diagnostic and Statistical Manual of
      Mental Disorders (DSM-III-R) panic disorder, and as altered immune measures were
      reported in selected subgroups of depressive patients, we investigated 51 pairs
      of major depressive episode (MDE) subjects, and gender- and age-matched healthy
      controls in order to determine if T lymphocytes number and function abnormalities
      were associated with Panic Disorder comorbidty. We found that those MDE subjects
      with DSM-III-R panic disorder (PD) had greater numbers of T cells (p less than
      0.05) and PHA mitogen (p less than 0.05) responses than depressive patients
      without PD, as well as increased phytohemagglutinin (PHA) (p less than 0.05)
      concanavalin A (ConA) (p less than 0.02) mitogen responses compared to their
      controls. These data suggest that panic disorder comorbidity significantly
      contributes to the variance of immunologic parameters in major depression and has
      to be carefully assessed within psychoimmunological studies of psychiatric
      patients with affective disorders.

PMID- 1637931
TI  - Attentional asymmetry in schizophrenia: controlled and automatic processes.
AB  - Two versions of Posner's covert orienting task were administered to 14 drug-free
      schizophrenic patients and 12 normal controls. In the schizophrenic subjects,
      automatic orienting to exogenous cues in the right visual field was impaired.
      However, this lateralizing general deficit was not present when the
      schizophrenics were able to direct attention effortfully in the second version of
      the task using endogenous cues. These findings support the hypothesis that there
      is a deficit in left hemispheric mechanisms mediating visual spatial attention in
      schizophrenia. However, when schizophrenics are given the opportunity to use an
      attentional strategy they are able to partially overcome this lateralized
      processing deficit.

PMID- 1637932
TI  - Impaired recognition of affect in facial expression in depressed patients.
AB  - Measures of recognition of seven affects in facial and verbal expressions to 17
      depressed patients and 31 controls were administered. Depressed patients were
      significantly impaired in the recognition of affect in the facial, but not
      verbal, expressions. Among the seven affects examined, depressed patients made
      significantly or near significantly fewer correct matches for sad, happy, and
      interested face items. The performance of the depressed patients was similar to
      that observed by Kolb and Taylor in patients with right, but not left, hemisphere
      cortical excisions. The neurobiology of facial recognition is reviewed, and the
      relevance of the observed perceptual deficit in depressed patients to the
      pathophysiology and symptomatology of depression is discussed.

PMID- 1637933
TI  - Third-ventricle enlargement and neuropsychological deficit in schizophrenia.
AB  - Cerebral ventricular enlargement is present in a substantial subgroup of
      schizophrenic patients. Most, but not all studies examining neuropsychological
      performance and ventricular size in schizophrenics show more severe cognitive
      impairment in those patients with greatest ventricular enlargement.
      Inconsistencies in this literature have been attributed to different neuroimaging
      techniques, variation in patient characteristics across studies, and the variety
      of neuropsychological batteries used. In the present study, schizophrenic
      patients (n = 49 men, n = 23 women) and normal controls (n = 13 men, n = 18
      women) underwent magnetic resonance (MR) imaging of the brain and extensive
      neuropsychological testing including measures of frontal and temporal lobe
      function. A complete coronal set of MR images was used to calculate volumetric
      estimates of lateral and third cerebral ventricles. Highly significant
      associations were found between cognitive deficits and third-ventricle volume,
      with measures of frontal functioning, attention, and concentration showing the
      most robust correlations. In contrast, neuropsychological performance was not
      highly associated with lateral ventricular size. These findings further support
      the pathophysiological relevance of ventricular enlargement in schizophrenia.
      More specifically, third, but not lateral, ventricular enlargement was associated
      with greater cognitive disturbance in this sample. Results are consistent with
      pathological involvement of periventricular diencephalic structures resulting in
      dysfunctional frontal and limbic processing in a subgroup of patients.

PMID- 1637934
TI  - Somatostatin-like immunoreactivity in CSF in schizophrenic patients during
      haloperidol treatment.

PMID- 1637935
TI  - Seasonality in atypical depression.

PMID- 1637936
TI  - Early antipsychotic response to resumption of neuroleptics in drug-free chronic
      schizophrenic patients.

PMID- 1637937
TI  - The influence of beta-endorphin on testicular endocrine function in adult rats.
AB  - The role of beta-endorphin in testicular steroidogenesis is poorly understood. To
      address this issue, we treated adult hypophysectomized rats intratesticularly
      with either saline-50% polyvinylpyrrolidone (SAL-PVP) or human beta-endorphin
      (0.5 microgram/testis; a total of 1 microgram/rat/day) in SAL-PVP for 3 days.
      Testicular injections were made under ether anesthesia. On Day 3, rats also
      received injections (s.c.) of either SAL-PVP or 5 micrograms beta-endorphin in
      SAL-PVP to minimize the dilution of ether in the testis. One hour later, rats
      were treated (i.p.) with either saline or ovine LH (25 micrograms/rat). One hour
      after saline or LH injection, blood was obtained via heart puncture for
      determination of plasma progesterone (P), androstenedione (A-dione), and
      testosterone (T) levels. The effects of beta-endorphin (50 ng, equivalent to 13.9
      pM; or 250 ng, equivalent to 69.6 pM) on P and androgen secretions in vitro were
      also examined. Intratesticular injections of beta-endorphin significantly (p less
      than 0.025) decreased the T response to LH treatment, but failed to affect plasma
      P and A-dione levels. Response of P to LH treatment was increased (p less than
      0.005) in medium containing testicular fragments exposed to 250 ng (69.6 pM) beta
      endorphin. However, beta-endorphin attenuated LH effects on A-dione and T
      production in vitro. These studies demonstrate that beta-endorphin inhibits T
      secretion, possibly because of its effect on the synthesis of T precursors. Thus,
      testicular beta-endorphin modulates the endocrine function of the testis in adult
      rats.

PMID- 1637938
TI  - Purification and microsequencing of the intra-acrosomal protein SP-10. Evidence
      that SP-10 heterogeneity results from endoproteolytic processes.
AB  - The human sperm antigen SP-10 has been shown to be a testis-specific, intra
      acrosomal protein that is associated with the membranes and matrix of the
      acrosomal vesicle. Sperm extracts, analyzed on Western blots with a monoclonal
      antibody to SP-10, have shown heterogeneity of SP-10 peptides ranging from 17.5
      34 kDa. Although the entire SP-10 amino acid sequence of 265 amino acids (28.3
      kDa) has been deduced from sequencing SP-10 cDNAs, the nature of multiple SP-10
      peptide bands is incompletely understood. In this study, we developed a three
      step purification method for SP-10 peptides using monoclonal antibody affinity
      chromatography, reverse-phase HPLC, and preparative gel electrophoresis. Eight SP
      10 peptides separated by this protocol and sequenced using Edman degradation
      showed amino termini that corresponded to regions on the deduced SP-10 amino acid
      sequence. Peptides with progressively lower apparent mass aligned further toward
      the carboxy terminus. On the basis of putative cleavage sites on the SP-10
      sequence, endoproteases that act at five different peptide bonds are predicted to
      cleave SP-10: these hydrolyze following arginine (a trypsin-like protease,
      possibly acrosin), and following serine, proline, glycine, and glutamic acid
      (previously undescribed intra-acrosomal protease specificities). The present
      studies 1) provide a purification method for SP-10 peptides; 2) confirm that the
      SP-10 cDNAs previously sequenced encode authentic SP-10; and 3) yield indirect
      evidence that endoproteases act to contribute to SP-10 heterogeneity.

PMID- 1637939
TI  - Protein kinase C mediates gonadotropin-releasing hormone agonist-induced meiotic
      maturation of follicle-enclosed rabbit oocytes.
AB  - The present study was undertaken to determine the effects of a protein kinase C
      inhibitor, staurosporine, on gonadotropin-releasing hormone agonist (GnRHa)
      induced oocyte maturation and follicular prostaglandin (PG) production, and the
      response to direct activators of protein kinase C using rabbit mature follicle
      culture. Treatment of mature follicles with GnRHa (buserelin and leuprolide
      acetate) neither stimulated nor inhibited cAMP accumulation in both the follicle
      and oocyte. Exposure to staurosporine at 10(-6) M 60 or 15 min before GnRHa
      (buserelin) administration reduced significantly the meiotic maturation of
      follicle-enclosed oocytes induced by GnRHa at 10(-7) M. However, staurosporine
      addition coincident with the agonist or thereafter did not inhibit meiotic
      maturation. Staurosporine suppressed GnRHa-induced meiotic maturation in a dose
      dependent manner, whereas hCG-stimulated oocyte maturation was not inhibited.
      Similarly, staurosporine administered 60 min before exposure to GnRHa suppressed
      GnRHa-stimulated PG production by mature follicles. The active phorbol esters,
      10(-6) M 12-0-tetra-decanoyl phorbol 13-acetate (TPA) and 10(-6) M 4 beta-phorbol
      12,13-didecanoate (4 beta-PDD) stimulated meiotic maturation whereas the
      biological inactive isomer, 4 alpha-PDD, did not. The kinetics of germinal
      versicle breakdown of follicle-enclosed oocytes in the presence of active phorbol
      esters paralleled that of GnRHa-treated oocytes. Furthermore, the concomitant
      addition of staurosporine at 10(-6) M to the culture medium inhibited
      significantly (p less than 0.05) TPA-induced meiotic maturation. These data
      demonstrate that GnRHa stimulated both the meiotic maturation of follicle
      enclosed oocytes and follicular PG formation via a mechanism other than the cAMP
      mediated process.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637940
TI  - Identification and content of insulin-like growth factors in porcine oviductal
      fluid.
AB  - Oviductal fluid (OvF) was collected from gilts by indwelling catheters during the
      estrous cycle and analyzed for content of insulin-like growth factors (IGF-I, IGF
      II). Group 1, composed of 9 gilts in a summer environment near a boar, yielded
      mean daily fluid volumes of 1.18 +/- 0.16 ml during estrus and 0.69 +/- 0.03 ml
      post-estrus. Group 2, composed of 7 gilts in a moderate-temperature, light
      regulated room, yielded 1.20 +/- 0.18 ml during estrus and then OvF flow
      essentially stopped. Serum samples were also collected 2 times daily during the
      cycle and analyzed along with the OvF for IGF-I and IGF-II. Serum was also
      analyzed for estradiol-17 beta (E2). For group 1, OvF content (concentration x
      fluid volume) of IGF-I and IGF-II was greater (p less than 0.05) at estrus than
      pre- and post-estrus. Daily mean content values (ng/day) for IGF-I and IGF-II
      during peri-estrus were 30.9 +/- 6.3 and 62.2 +/- 12.3, respectively. During
      nonestrus, values were 6.8 +/- 6.3 and 11.7 +/- 12.3, respectively. For group 2,
      OvF content of IGF-I and IGF-II during estrus was similar to that of group 1.
      Whereas IGF content differed between estrus and nonestrus periods, IGF
      concentrations were similar (p greater than 0.05), a finding that results from
      the difference in OvF produced. Compared with OvF concentrations of IGF for a
      given pig, blood plasma concentrations of IGF-I and IGF-II were 2- to 5-fold
      higher in the plasma sample collected the same day.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1637941
TI  - Controlled vaginal delivery of antibodies in the mouse.
AB  - Controlled delivery of monoclonal antibodies to the mucus secretions of the
      vagina might provide women with passive immunoprotection against both sexually
      transmitted diseases and unwanted pregnancy. We have developed intravaginal
      devices composed of poly(ethylene-co-vinyl acetate) (EVAc) that continuously
      release IgG antibodies for over 30 days into buffered saline, and we have tested
      these devices in the vagina of mice. Polymeric devices containing either BSA (as
      a test reagent for proteins) or anti-hCG antibody, when inserted into the vaginas
      of mice, provided a continuous supply of either BSA or hCG-binding antibodies to
      the vaginal mucus for 30 days. Antibodies released by the devices achieved high
      concentration in the mucus within the lumen of the vagina, but did not
      significantly ascend into the uterine horns, as determined by epifluorescence
      microscopy of fluorescently labeled mouse IgG and by immunohistochemical
      localization of rabbit IgG. Our results suggest that long-term intravaginal
      delivery of functionally intact antibodies can be achieved with devices composed
      of EVAc.

PMID- 1637942
TI  - Tumor necrosis factor-alpha messenger ribonucleic acid and protein in human
      endometrium.
AB  - Although previous studies have shown that the tumor necrosis factor-alpha (TNF)
      gene is expressed in pregnancy decidua, it has not been determined whether this
      gene is transcribed or translated in the endometrium prior to implantation. To
      address this question and to identify cells expressing the TNF gene, samples of
      normal cycling human endometria were tested for TNF mRNA by in situ hybridization
      using a biotinylated antisense RNA probe, and the corresponding protein was
      localized in the same tissues by immunocytochemistry with a monoclonal antibody
      to TNF. Both TNF message and protein were identified in the endometrium
      throughout the menstrual cycle, and the same types of cells that contained
      transcripts also contained protein. As judged by the intensities of the
      hybridization signals, TNF mRNA increased during the proliferative phases,
      declined in the early secretory phase, and again rose during mid-to-late
      secretory phases, suggesting positive associations with levels of female sex
      hormones that show similar cyclic fluctuations. At the initiation of the cycle,
      transcripts were primarily localized to glandular epithelial cells whereas by the
      midproliferative phase, message was also present in stromal cells. Hybridization
      signals were consistently more intense in functionalis-region than in basalis
      region stromal cells, and were frequently stronger in basalis-region glandular
      epithelia than in functionalis-region glands. These observations document that
      the TNF gene is expressed in normal cycling endometria, suggest that ovarian
      hormones may regulate TNF gene transcription, and identify differences in
      specific endometrial compartments. The findings are also consistent with the
      postulate that TNF is a local mediator of cellular communications in the human
      endometrium.

PMID- 1637943
TI  - Immunocytochemical localization and messenger ribonucleic acid levels of a
      progesterone-dependent endometrial secretory protein (cathepsin L) in the
      pregnant cat uterus.
AB  - The purpose of this study was to localize immunocytochemically a progesterone
      dependent protein (PDP) and to determine PDP mRNA levels during the initial stage
      of the implantation period. Uterine tissue was collected from Day 0-18 postcoital
      animals. The tissue was processed for immunocytochemical localization of PDP, and
      the endometrial RNA was isolated and analyzed for PDP gene expression by slot
      blot hybridization. PDP was detected immunocytochemically as early as Day 5
      postcoitus in the epithelial cells of the deep uterine glands, and the intensity
      of immunostaining appeared to peak by Day 12 postcoitus. PDP was absent in the
      endometrium obtained from implantation sites after Day 16 postcoitus, but the
      synthesis of PDP was maintained in the endometrium obtained from nonimplantation
      sites. Immunogold electron microscopy demonstrated that PDP was present in
      electron-dense granules of the glandular epithelial cells. PDP mRNA was
      detectable in the endometrium at Day 5 postcoitus and peaked around Day 10
      postcoitus. PDP mRNA was absent in the endometrium from implantation sites after
      Day 16 postcoitus, but was maintained in the endometrium from nonimplantation
      sites. In summary, the results of this study illustrate that PDP is synthesized
      within the epithelial cells of the deep uterine glands, packaged within membrane
      bound secretory granules, and released into the uterine lumen. Also, the process
      of implantation alters the gene expression in a very localized way since PDP mRNA
      and PDP-positive granules were absent in the endometrial glands obtained from the
      implantation site within 1-2 days of the onset of implantation, whereas both PDP
      mRNA and PDP-positive granules were maintained in the endometrial glands from
      nonimplantation-site regions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1637944
TI  - Genes regulating testis size.
AB  - The studies described here provide information about the genetic and
      morphological bases for the significant differences in testis size among three
      closely related C57BL mouse substrains: C57BL/6J, C57BL/6ByJ, and C57BL/10J.
      C57BL/6J mice have normal-size testes while the other two substrains have small
      size testes. Genes controlling testis size are postulated to be among the
      estimated forty genes that differ between the C57BL/6J and C57BL/6ByJ substrains.
      The number of genes involved in testis size regulation was examined using
      recombinant inbred mouse strains. An investigation of the role of Y chromosome
      genes was performed by completing molecular analyses with a mouse Y chromosome
      specific probe. Sertoli and germ cell counts provided insight into the
      morphological basis for the different testis sizes. The experimental results
      suggest that there are at least two autosomal testis-size genes and that they
      control testis size by regulating the number of Sertoli cells.

PMID- 1637945
TI  - The effects of mate removal on pregnancy success in prairie voles (Microtus
      ochrogaster) and meadow voles (Microtus pennsylvanicus).
AB  - The effects of removing the stud male have not been controlled in many studies
      relating pregnancy block to the presence of an unfamiliar male. We examined the
      effects of removing the male on pregnancy success in prairie voles and meadow
      voles, two species that differ in degree of paternal investment. Whereas prairie
      vole males provide extensive care to offspring and accelerate pup development,
      meadow vole males display little or no care and delay development of pups. We
      predicted that removal of the stud male would decrease pregnancy success in
      prairie voles and either have no effect or increase success in meadow voles. In
      experiment 1, females were in male-induced estrus, and their mates were either
      left with them or were removed 4 h, 1 day, 2 days, or 8 days after mating. In
      experiment 2, females were in postpartum estrus, and their mates were either left
      with them or were removed 1 day, 2 days, or 8 days after birth of their first
      litter. Removal of the male soon after mating in postpartum estrus decreased
      pregnancy success in prairie voles and increased success in meadow voles. Thus,
      although removal of the stud male influenced litter production, the direction of
      the effect varied with species.

PMID- 1637947
TI  - Transcriptional expression of a testis-specific variant of the mouse pyruvate
      dehydrogenase E1 alpha subunit.
AB  - An isogene of the E1 alpha subunit of the mouse pyruvate dehydrogenase complex
      was shown in a previous study to map to chromosome 19. Here we demonstrate using
      Northern blot analysis that this gene is expressed in a testis-specific fashion.
      Two testis-specific E1 alpha transcripts were detected: (1) a 2.0-kb transcript
      that is abundant in pachytene cells but also detectable during earlier stages of
      spermatogenesis, and (2) a shorter 1.7-kb transcript detectable only in round
      spermatids. Analysis of both transcripts following RNase H digestion revealed
      that the smaller message is not derived from the shortening of the poly(A) tail
      and most likely results from the alternate use of two polyadenylation signals.
      Finally, analysis of polysomes isolated from 20- and 80-day-old mouse testes
      demonstrated that the 2.0-kb transcript is associated with the polysomal
      fraction, suggesting that this message is transcribed and actively translated at
      the same time. We conclude from these results that expression of the testis
      specific E1 alpha is initially expressed during the meiotic prophase stage of
      spermatogenesis and not under any apparent post-transcriptional regulation.

PMID- 1637946
TI  - Comparison of histone H1 kinase activity during meiotic maturation between two
      types of porcine oocytes matured in different media in vitro.
AB  - Histone H1 kinase (H1K) activity was assayed during meiotic maturation in porcine
      oocytes matured in a modified Krebs-Ringer bicarbonate solution (KRB) or in
      porcine follicular fluid (pFF) in vitro. Oocytes matured in KRB displayed lower
      male pronucleus formation ability, delayed first polar body emission, and a
      higher spontaneous activation rate than oocytes matured in pFF. In oocytes
      matured in pFF, H1K activity was low at the germinal vesicle stage and increased
      about 8-fold at first and second metaphases, with a transient depression at first
      anaphase and telophase. The H1K activity at second metaphase in oocytes matured
      in KRB was significantly lower than that in oocytes matured in pFF. These results
      suggest that the maturation medium used influences the fluctuation pattern of H1K
      activity and the biological characteristics of porcine oocytes cultured in vitro.

PMID- 1637948
TI  - Platelet-activating factor mediates phosphatidylcholine hydrolysis by
      phospholipase D in human endometrium.
AB  - Human preimplantation embryos and endometrium secrete platelet-activating factor
      (PAF). The mechanism of phosphatidylcholine (PC) degradation stimulated by PAF
      was investigated in endometrial explants prelabeled with [methyl-3H]choline or
      preincubated with [3H]butan-1-ol. Analysis of the water-soluble metabolites of
      PAF-induced PC hydrolysis in secretory endometrium demonstrated that the
      stimulated generation of [3H]choline ([3H]Cho) precedes that of [3H]choline
      phosphate ([3H]ChoP) and [3H]glycerophosphocholine ([3H]GPC). Within 30 sec there
      was a rapid rise in PAF-induced [3H]Cho generation and by 2 min this had
      increased to 59.9% +/- 10.6% (p less than 0.02), with no effect upon [3H]ChoP and
      [3H]GPC during this period. Both [3H]GPC and [3H]ChoP, however, were increased at
      a later time point. The slower [3H]ChoP generation may suggest that PC-specific
      phospholipase C activation as well as delayed [3H]GPC rise may be due to PC
      specific phospholipase A2 and lysophospholipase activation. Phospholipase D
      activity was confirmed by the incorporation of high-specific-activity [3H]butan-1
      ol into [3H]phosphatidylbutanol ([3H]PBut). The rapid generation of [3H]PBut,
      which paralleled the rise in intracellular [3H]Cho, strongly suggests that PC
      breakdown is catalyzed by the phospholipase D pathway. It is proposed that PAF
      induces PC hydrolysis as a consequence of an early phospholipase D-catalyzed
      breakdown of PC in human secretory endometrium. This may be an alternative source
      for prostaglandin synthesis and an important pathway essential for long-term
      activation of local cellular events at the time of implantation.

PMID- 1637949
TI  - Timing of birth in Syrian hamsters.
AB  - The effects of mating time and of LD cycles on the timing of birth and length of
      gestation were examined in Syrian hamsters (Mesocricetus auratus). Hamsters
      maintained on 14L:10D cycles were mated for 2 h either in the evening or in the
      morning, and groups of hamsters mated in the morning were subjected to either a 6
      h advance shift or a 6-h delay shift of the LD cycle on Days 5-14 of gestation.
      For the last 2 days of gestation the hamsters were kept in constant dim light and
      observed every hour to determine the time of birth. Hamsters mated in the evening
      gave birth an average of 4.8 h before those mated in the morning, and the
      hamsters subjected to an advance shift gave birth an average of 8.1 h before
      those subjected to delay shift. The results show that 80-100% of births occur
      during the subjective day on Day 16 of gestation and that the minimum duration of
      gestation is 15 days and 2 h. The regulation of birth appears to involve two
      processes, an interval timer related to the time of conception and a circadian
      rhythm that is governed by the LD cycle.

PMID- 1637950
TI  - Photoperiodic regulation of pulsatile luteinizing hormone secretion and
      adenohypophyseal gene expression in female golden hamsters.
AB  - LH concentrations were measured in serum collected at 10-min intervals from
      chronically ovariectomized female Syrian hamsters that had been maintained for 9
      wk in stimulatory (long) or inhibitory (short) photoperiods. Short days reduced
      the number of detectable LH pulses during both the morning and the afternoon.
      Most short-day hamsters experienced a gradual afternoon rise in serum LH
      concentrations; this rise was not composed of multiple pulses. In separate groups
      of similarly treated hamsters, pituitary LH-beta mRNA abundance was significantly
      reduced by short-day exposure at both times of day even though serum LH
      concentrations rose in the afternoon. Estradiol treatment induced an afternoon
      surge of serum LH in both photoperiods, and eliminated the effect of photoperiod
      on LH-beta mRNA abundance in the afternoon. Serum prolactin (PRL) concentrations
      were not consistently influenced by day length in castrated hamsters with or
      without estrogen treatment, but PRL mRNA abundance was significantly suppressed
      by short-day exposure in all groups. The results indicate that day length exerts
      profound steroid-independent effects upon hypophyseal gene expression, and that
      the regulation of LH-beta mRNA abundance may be due to photoperiodic control of
      the neural GnRH pulse generator.

PMID- 1637951
TI  - Changes in peripheral levels of bioactive and immunoreactive inhibin, estradiol
      17 beta, progesterone, luteinizing hormone, and follicle-stimulating hormone
      associated with follicular development in cows induced to superovulate with
      equine chorionic gonadotropin.
AB  - Changes in concentrations of bioactive and immunoreactive (ir-) inhibin,
      estradiol-17 beta, progesterone, LH, and FSH in peripheral blood were determined
      in cows induced to superovulate with eCG. The pattern of follicular growth was
      also characterized by daily ultrasonographic examination. Hormonal profiles and
      follicular development during the intact estrous cycle of the same animals before
      eCG treatment served as controls. Equine CG increased the number of follicles of
      various sizes (small, greater than or equal to 4 less than 7, medium, greater
      than or equal to 7 less than 10; large, greater than or equal to 10 mm in
      diameter) by 4 days after administration. The second growth of large follicles
      occurred within 1 day after superovulation. Inhibin bioactivity in jugular vein
      blood was detectable 48 h after eCG injection (44 h before LH peak), whereas it
      was not detected before administration of eCG or during control cycles.
      Circulating levels of bioactive inhibin further increased during the two waves of
      growth of large follicles. The highest activity of inhibin was noted at the time
      of the preovulatory LH peak (0 h). Thereafter, bioactivity of inhibin in
      peripheral plasma dropped from 0 to 24 h after the LH peak, and the activity
      increased again at 72 h compared to the value at -44 h. Plasma levels of ir
      inhibin showed a pattern similar to changes in bioactive inhibin in the eCG
      treated cows. Plasma concentrations of estradiol-17 beta also increased
      concomitantly with two waves of growth of large follicles. There was no
      correlation between plasma levels of progesterone and inhibin.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1637952
TI  - Effect of estriol on the structure and organization of collagen in the lamina
      propria of the immature rat uterus.
AB  - Estradiol produces both hypertrophic and hyperplastic changes in the uterus, and
      these changes are associated with alterations in the structure of collagen in the
      lamina propria. Estriol induces only hypertrophic responses in the immature rat
      uterus; its effects on collagen structure were characterized in this study. Light
      micrographs of Masson's trichrome-stained sections revealed that the intensity of
      the collagen stain in the lamina propria of the rat uterus was profoundly
      reduced, relative to that in controls, 4 h after estriol (40 micrograms/kg)
      administration. These changes were not evident 24 h after estriol administration.
      In control uteri, transmission electron micrographs revealed that the collagen
      fibers surrounding stromal cells formed dense collections of bundles that were
      seen throughout the extracellular matrix, whereas in tissues exposed to estriol 4
      h earlier, large regions of the extracellular spaces were devoid of collagen
      bundles. The 4-h changes in collagen were eliminated when animals were pretreated
      with actinomycin D (8 mg/kg) or cycloheximide (4 mg/kg). Dense collections of
      collagen bundles were present in tissues 24 h after estriol treatment, and their
      appearance was not altered by actinomycin D or cycloheximide treatment.
      Alterations in collagen 4 h after hormone administration appeared to be estrogen
      specific since dexamethasone (600 micrograms/kg) and dihydrotestosterone (400
      micrograms/kg) had no effect. These data provide evidence that the changes in
      collagen structure in the uterus are associated with events that function during
      the hypertrophic growth responses induced by estrogens.

PMID- 1637953
TI  - The effect of testosterone withdrawal and subsequent germ cell depletion on
      transferrin and sulfated glycoprotein-2 messenger ribonucleic acid levels in the
      adult rat testis.
AB  - We have examined the effects of decreasing intratesticular testosterone
      concentration and of decreasing germ cell number on levels of transferrin mRNA
      and sulfated glycoprotein (SGP)-2 mRNA in the adult rat testis. Intact rats
      received implants of testosterone- and estradiol-filled capsules to suppress LH
      secretion from the pituitary, thereby suppressing Leydig cell testosterone
      production. The levels of intratesticular testosterone declined 70% to 20 ng/ml
      within 3 days, were reduced further to approximately 15 ng/ml by 14 days, and
      subsequently reached a minimum of about 10 ng/ml. In contrast, the number of
      elongated spermatids per testis remained unchanged through 14 days, then declined
      to fewer than 20% of normal between 14 and 28 days, and reached zero by 56 days
      postimplantation. Likewise, both pachytene spermatocytes and round spermatids
      declined only after 14 days postimplantation. Northern blots of testicular RNA
      showed that Sertoli cell transferrin mRNA per testis decreased markedly between
      14 and 28 days postimplantation. However, SGP-2 mRNA per testis was unchanged
      over the time course of the experiment. The decrease in transferrin mRNA,
      concomitant with germ cell loss, suggests that this mRNA is regulated by the
      number of germ cells in the testis and not directly by testosterone. In contrast,
      the constant level of SGP-2 mRNA in the face of reduced intratesticular
      testosterone and the subsequent loss of germ cells suggests that this mRNA is
      constitutively maintained in the adult rat testis.

PMID- 1637954
TI  - Differences in the characteristics and distribution of rat luteal receptors for
      native and deglycosylated human choriogonadotropin.
AB  - Previous work has suggested that rat luteal cells have two populations of LH/hCG
      receptors that are located in different parts of the cell membrane. The
      possibility that these two receptor pools may have functional differences has
      been investigated through examination of the binding and action of native and
      deglycosylated hCG to different membrane fractions. Ovaries from eCG/hCG-primed
      immature female rats were separated into 1,000 x g (heavy) and 20,000 x g (light)
      particulate fractions. Increasing concentrations of NaCl had a biphasic effect on
      the binding of native and deglycosylated hCG to both membrane fractions, causing
      an increase in binding at low concentrations and a decrease in binding at higher
      concentrations. The binding of deglycosylated hCG to both membrane preparations
      and the binding of native hCG to light-membrane preparations was maximal at
      approximately the same NaCl concentration (50-65 mM). This was higher than the
      concentration of NaCl necessary for maximal binding of native hCG to the heavy
      membrane preparation. In addition, maximal native hCG binding to this preparation
      occurred over a broader NaCl concentration range (15-65 mM). Equilibrium binding
      experiments showed differences in hCG binding to both fractions. In light
      membranes there were significantly more receptor sites for deglycosylated hCG
      (11.2 +/- 4.8 fmol/mg ovary) than for native hCG (4.8 +/- 0.7 fmol/mg ovary),
      with no significant different in affinity. In contrast, in heavy membranes the
      affinity for deglycosylated hCG (6.30 +/- 0.19.10(9) M-1), was significantly
      higher than that for native hCG (2.60 +/- 0.13.10(9) M-1), with no significant
      differences in receptor number.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1637955
TI  - [The behavior of BAEE-lytic proteinases in the sulcus fluid in inflammatory
      periodontopathies].
AB  - The esterolytic activity of proteinases was measured in the gingival crevicular
      fluid from healthy and inflamed periodonts using BAEE as substrate. The BAEE
      activity was significantly increased in crevices with inflamed periodonts.

PMID- 1637956
TI  - [The treatment of neuralgiform facial pains with the combined therapy of
      transcutaneous electric nerve stimulation (TENS) and the iontophoresis of
      nonsteroidal antiphlogistics].
AB  - In a prospective study, 46 patients suffering from facial pain were treated by
      transcutaneous electrical nerve stimulation (TENS). In case of insufficient pain
      relief the combined use of TENS and iontophoresis of non-steroidal
      antiphlogistics was employed. Benzydamine was applied to the anode and diclofenac
      to the cathode instead of the contact gel, reducing average pain intensity to a
      marked 18%, compared to 81% to 63% by TENS only. Furthermore, the consumption of
      analgetics declined considerably with combined therapy. Severe side effects could
      not be registered. Therefore, this new combined therapy must be considered to be
      an alternative treatment before using systemic medication.

PMID- 1637957
TI  - [The pre- and intraoperative localization of superficially situated metallic
      objects in the head and neck area using a metal detector].
AB  - For prevention of infections and with regard to forensic implications foreign
      bodies lost in the soft tissues should be taken out. A good alternative for the
      localization of metallic objects superficially situated in the soft tissues of
      the oral facial region, other than the use of radiographic means and stereotactic
      localization, is the use of a metal detector. This method can be used without
      complication before or during each operation demonstrated by two clinical cases.
      Its use avoids a large-scale tissue removal and exposure in the search of foreign
      bodies in superficial soft tissues. It is a non invasive simple method for
      localization of metallic foreign bodies.

PMID- 1637958
TI  - [Septic granulomatosis (chronic granulomatous disease = CGD) in the jaw area. A
      case report].
AB  - A rare case of chronic granulomatous disease with manifestation in the mandible
      is presented. A 10-year-old boy showed the clinical picture of osteomyelitis
      without paresthesia (Vincent syndrome). Diagnosis was done by the nitroblue
      tetrazolium test (NBT) and by demonstration of a complete cytochrome-b deficiency
      of the granulocytes. In septic granulomatosis a continuous application of
      Sulfamethoxazol-Trimetoprim is recommended for prophylaxis of infection. For
      treatment of infection further antibiotics who pass into the granulocytes like
      rifampicin and fosfomycin are necessary. Oral surgical procedures request a
      careful tissue handling and a tight wound closure.

PMID- 1637959
TI  - [The late results in conservatively treated fractures of the mandibular condylar
      process].
AB  - The results of conservative treatment of 128 patients, who suffered an isolated
      fracture of the mandibular condylar process at least 5 years ago and their
      dependence upon localisation and dislocation of the fracture are demonstrated.
      The advantages and disadvantages of conservative and operative therapy are
      discussed.

PMID- 1637960
TI  - [The use of different conscious sedation procedures in ambulatory dental
      surgery].
AB  - Conditions and selections of patients undergoing oral surgery under intravenous
      conscious sedation are reviewed. The practicability of several medicaments and
      combinations are discussed. Intravenous conscious sedation in combination with
      local anesthesia is an alternative during unpleasant surgical and dental
      procedures, and in several cases, can replace general anesthesia. A sufficient
      monitoring as well as a good trained staff makes the methods safe and allows to
      reduce complications.

PMID- 1637961
TI  - A review of the ability of non-clinical testing strategies currently applied to
      drugs to detect known human carcinogens.

PMID- 1637962
TI  - Toxicity of aluminium: a historical review, Part 1.

PMID- 1637963
TI  - Famous names in toxicology. Mateo Orfila (1787-1853).

PMID- 1637964
TI  - Adverse effects of the lipid-lowering drugs.

PMID- 1637965
TI  - On the design of genome mapping experiments using short synthetic
      oligonucleotides.
AB  - The DNA of an organism can be digested into smaller fragments, stored
      individually as clones in phage, for example, to create a clone library, and
      retrieved later, when needed. The original ordering of fragments is lost in the
      process of creating the library. Hence, it is important to be able to place
      clones in order according to their position along chromosome(s), and this process
      is referred to as "in vitro reconstruction" or "contig mapping" of an organismal
      genome. Clones in the phage library can be assigned binary call numbers by
      scoring each clone for hybridization (0 or 1) with a battery of short
      manufactured DNA sequences called synthetic oligonucleotides or with restriction
      enzyme digests of each clone. Those clones with similar call numbers are placed
      close together in the ordered library. We address the design question of how many
      clones and probes to use to carry out in vitro reconstruction of an organism's
      chromosomes. This physical mapping problem is placed in the context of coverage
      problems in geometrical probability. Various statistics are developed to
      summarize how an ordered library covers a chromosome, the extent of clone
      overlap, and the similarity between clone call numbers. Several tests for whether
      clones overlap are given, together with their power properties. A simulation
      study is used to determine how robust some of the tests for clone overlap are to
      model violations. Tables are presented for researchers to choose the number of
      clones and probes on the basis of both power and technical considerations
      surrounding the hybridization experiments.

PMID- 1637966
TI  - Performing the exact test of Hardy-Weinberg proportion for multiple alleles.
AB  - The Hardy-Weinberg law plays an important role in the field of population
      genetics and often serves as a basis for genetic inference. Because of its
      importance, much attention has been devoted to tests of Hardy-Weinberg
      proportions (HWP) over the decades. It has long been recognized that large-sample
      goodness-of-fit tests can sometimes lead to spurious results when the sample size
      and/or some genotypic frequencies are small. Although a complete enumeration
      algorithm for the exact test has been proposed, it is not of practical use for
      loci with more than a few alleles due to the amount of computation required. We
      propose two algorithms to estimate the significance level for a test of HWP. The
      algorithms are easily applicable to loci with multiple alleles. Both are
      remarkably simple and computationally fast. Relative efficiency and merits of the
      two algorithms are compared. Guidelines regarding their usage are given.
      Numerical examples are given to illustrate the practicality of the algorithms.

PMID- 1637967
TI  - A new procedure for group sequential analysis in clinical trials.
AB  - Since Pocock (1977, Biometrika 64, 191-199), many methods have been developed for
      group sequential analysis of clinical trials. However, these methods remain
      underemployed partly because of inconsistencies of sequential testing [Berry
      (1987, The Statistician 36, 181-189)]. This paper considers a new approach,
      which, by requiring that a succession of interim analyses be significant at the
      alpha level, both preserves the overall significance level alpha and does not
      present some of the inconsistencies of the previous methods. Results are obtained
      for a normal or binary response and for survival data. A comparison with the
      usual group sequential testing is also presented.

PMID- 1637968
TI  - Sample size determination for case-control studies and the comparison of
      stratified and unstratified analyses.
AB  - Woolson, Bean, and Rojas (1986, Biometrics 42, 927-932) present a simple
      approximation of sample size for Cochran's (1954, Biometrics 10, 417-451) test
      for detecting association between exposure and disease. It is useful in the
      design of case-control studies. We derive a sample size formula for Cochran's
      statistic with continuity correction which guarantees that the actual Type I
      error rate of the test does not exceed the nominal level. The corrected sample
      size is necessarily larger than the uncorrected one given by Woolson et al. and
      the relative difference between the two sample sizes is considerable. Allocation
      of equal number of cases and controls within each stratum is asymptotically
      optimal when the costs per case and control are the same. When any effect of
      stratification is absent, Cochran's stratified test, although valid, is less
      efficient than the unstratified one except for the important case of a balanced
      design.

PMID- 1637969
TI  - When does it pay to break the matches for analysis of a matched-pairs design?
AB  - Two methods of analysis are compared to estimate the treatment effect of a
      comparative study where each treated individual is matched with a single control
      at the design stage. The usual matched-pairs analysis accounts for the pairing
      directly in its model, whereas regression adjustment ignores the matching but
      instead models the pairing using a set of covariates. For a normal linear model,
      the estimated treatment effect from the matched-pairs analysis (paired t-test) is
      more efficient. For a Bernoulli logistic model, matched-pairs analysis performs
      better when the sample size is small, but is inferior to logistic regression for
      large sample sizes.

PMID- 1637970
TI  - Relative risk trees for censored survival data.
AB  - A method is developed for obtaining tree-structured relative risk estimates for
      censored survival data. The first step of a full likelihood estimation procedure
      is used in a recursive partitioning algorithm that adopts most aspects of the
      widely used Classification and Regression Tree (CART) algorithm of Breiman et al.
      (1984, Classification and Regression Trees, Belmont, California: Wadsworth). The
      performance of the technique is investigated through stimulation and compared to
      the tree-structured survival methods proposed by Davis and Anderson (1989,
      Statistics in Medicine 8, 947-961) and Therneau, Grambsch, and Fleming (1990,
      Biometrika 77, 147-160).

PMID- 1637971
TI  - Estimation of the size distribution of fibrillar centres in nucleoli--an example
      of the "Swiss cheese" problem in stereology.
AB  - The "Swiss cheese" problem in stereology is that variant of the classical
      corpuscle problem where the size distribution of randomly distributed spherical
      "holes" in an opaque medium is to be inferred from the size distribution of the
      circular holes observed in sections. In our electron microscopical studies of the
      neurons of the rat supraoptic nucleus, we encountered a Swiss cheese problem in
      connection with the size distribution of the fibrillar centres of the nucleoli.
      We found no practical examples in the literature, and attempts to obtain a
      Wicksell-type algorithm met with severe numerical instability problems. The
      present paper shows that the chi-distributions of Keiding, Jensen, and Ranek
      (1972, Biometrics 28, 813-829) may be used as the basis for a parametric maximum
      likelihood solution for the Swiss cheese problem. The concept of a capping angle
      (nonobservability of spheres cut at too acute an angle), also introduced by
      Keiding et al., carries over as well. The methods are illustrated on data from
      the mentioned experiment.

PMID- 1637972
TI  - On the use of historical control data to estimate dose response trends in quantal
      bioassay.
AB  - New tests for trend in proportions, in the presence of historical control data,
      are proposed. One such test is a simple score statistic based on a binomial
      likelihood for the "current" study and beta-binomial likelihoods for each
      historical control series. A closely related trend statistic based on estimating
      equations is also proposed. Trend statistics that allow overdispersed proportions
      in the current study are also developed, including a version of Tarone's (1982,
      Biometrics 38, 215-220) test that acknowledges sampling variation in the beta
      distribution parameters, and a trend statistic based on estimating equations.
      Each such trend test is evaluated with respect to size and power under both
      binomial and beta-binomial sampling conditions for the current study, and
      illustrations are provided.

PMID- 1637973
TI  - Estimating exposure effects by modelling the expectation of exposure conditional
      on confounders.
AB  - In order to estimate the causal effects of one or more exposures or treatments on
      an outcome of interest, one has to account for the effect of "confounding
      factors" which both covary with the exposures or treatments and are independent
      predictors of the outcome. In this paper we present regression methods which, in
      contrast to standard methods, adjust for the confounding effect of multiple
      continuous or discrete covariates by modelling the conditional expectation of the
      exposures or treatments given the confounders. In the special case of a
      univariate dichotomous exposure or treatment, this conditional expectation is
      identical to what Rosenbaum and Rubin have called the propensity score. They have
      also proposed methods to estimate causal effects by modelling the propensity
      score. Our methods generalize those of Rosenbaum and Rubin in several ways.
      First, our approach straightforwardly allows for multivariate exposures or
      treatments, each of which may be continuous, ordinal, or discrete. Second, even
      in the case of a single dichotomous exposure, our approach does not require
      subclassification or matching on the propensity score so that the potential for
      "residual confounding," i.e., bias, due to incomplete matching is avoided. Third,
      our approach allows a rather general formalization of the idea that it is better
      to use the "estimated propensity score" than the true propensity score even when
      the true score is known. The additional power of our approach derives from the
      fact that we assume the causal effects of the exposures or treatments can be
      described by the parametric component of a semiparametric regression model. To
      illustrate our methods, we reanalyze the effect of current cigarette smoking on
      the level of forced expiratory volume in one second in a cohort of 2,713 adult
      white males. We compare the results with those obtained using standard methods.

PMID- 1637974
TI  - A coupling procedure for the discrimination of mixed data.
AB  - A procedure is described for coupling different discriminators to a new (common)
      decision rule using the corresponding allocation vectors only. This enables one
      to cope jointly with data of different structure and/or scales of measurement but
      without strong restrictions on the number of (especially categorical) features.
      The method is combined with a consequent cross-validation process securing the
      results reached. Examples from medical diagnostics demonstrate the usefulness of
      the proposed procedure, especially in comparison with the known linear
      discriminant analysis as judged from the error rates obtained.

PMID- 1637975
TI  - Assessing influence in regression analysis with censored data.
AB  - In this paper we show how to evaluate the effect that perturbations to the model,
      data, or case weights have on maximum likelihood estimates from censored survival
      data. The ideas and methods also apply to other nonlinear estimation problems. We
      review the ideas behind using log-likelihood displacement and local influence
      methods. We describe new interpretations for some local influence statistics and
      show how these statistics extend and complement traditional case deletion
      influence statistics for linear least squares. These statistics identify
      individual and combinations of cases that have important influence on estimates
      of parameters and functions of these parameters. We illustrate the methods by
      reanalyzing the Stanford Heart Transplant data with a parametric regression
      model.

PMID- 1637976
TI  - An empirical assessment of saddlepoint approximations for testing a logistic
      regression parameter.
AB  - Saddlepoint methods provide quick and easy approximations to significance levels
      for conditional tests of logistic regression parameters. We evaluate the
      accuracies of saddlepoint approximations for three well-known conditional tests:
      Bartlett's test for no three-factor interaction in a 2 x 2 x 2 table, the test
      for trend in a series of probabilities, and the exact test of no association in
      stratified 2 x 2 tables with a common odds ratio. General recommendations are
      suggested regarding the use of saddlepoint approximations for exact conditional
      significance levels.

PMID- 1637977
TI  - Maximum-penalized-likelihood estimation for independent and Markov-dependent
      mixture models.
AB  - This paper concerns the use and implementation of maximum-penalized-likelihood
      procedures for choosing the number of mixing components and estimating the
      parameters in independent and Markov-dependent mixture models. Computation of the
      estimates is achieved via algorithms for the automatic generation of starting
      values for the EM algorithm. Computation of the information matrix is also
      discussed. Poisson mixture models are applied to a sequence of counts of
      movements by a fetal lamb in utero obtained by ultrasound. The resulting
      estimates are seen to provide plausible mechanisms for the physiological process.

PMID- 1637978
TI  - An inferential procedure for the Poisson intervention parameter.
AB  - To describe a health chance mechanism whose incidence rate is altered in the
      middle of a data collection period due to preventive treatments taken by health
      service agencies, a model called Intervened Poisson Distribution (cf. Shanmugam,
      1985, Biometrics 41, 1025-1029) was introduced. In this article, we derive a
      statistic to test the hypothesis concerning the effectiveness of such preventive
      treatments, and compare its power with another suggested test (cf. Streit, 1987,
      Biometrics 43, 999-1000).

PMID- 1637979
TI  - Interval estimation for mark-recapture studies of closed populations.
AB  - Textbooks continue to recommend the use of an asymptotic normal distribution to
      provide an interval estimate for the unknown size, N, of a closed population
      studied by a mark-recapture experiment or multiple-record system. A likelihood
      interval approach is proposed and its implementation demonstrated for a range of
      models for such studies, including all main effect and interaction models for
      incomplete contingency tables.

PMID- 1637980
TI  - A simple method for the analysis of clustered binary data.
AB  - A simple method for comparing independent groups of clustered binary data with
      group-specific covariates is proposed. It is based on the concepts of design
      effect and effective sample size widely used in sample surveys, and assumes no
      specific models for the intracluster correlations. It can be implemented using
      any standard computer program for the analysis of independent binary data after a
      small amount of preprocessing. The method is applied to a variety of problems
      involving clustered binary data: testing homogeneity of proportions, estimating
      dose-response models and testing for trend in proportions, and performing the
      Mantel-Haenszel chi-squared test for independence in a series of 2 x 2 tables and
      estimating the common odds ratio and its variance. Illustrative applications of
      the method are also presented.

PMID- 1637981
TI  - On prevalence, incidence, and duration in general stable populations.
AB  - The relationship between prevalence, incidence, and duration of disease is
      studied in exponentially growing/declining stable populations. Prevalence odds is
      shown to be a weighted average of age-specific products between incidence and
      discounted disease duration. If and only if the covariance between incidence and
      duration is zero, does prevalence odds equal the product of average incidence and
      average duration. The product of averages is shown typically to overestimate
      prevalence in epidemiologic applications. Ignoring population growth also tends
      to lead to overestimation of prevalence.

PMID- 1637982
TI  - Use of baseline data for estimation of treatment effects in the presence of
      regression to the mean.
AB  - We consider a regression to the mean problem with a very large sample for the
      first measurement and relatively small subsample for the second measurement,
      selected on the basis of the initial measurement. This is a situation that often
      occurs in screening trials. We propose to estimate the unselected population mean
      and variance from the first measurement in the larger sample. Using these
      estimates, the correlation between the two measurements, as well as an effect of
      treatment, can be estimated in simple and explicit form. Under the condition that
      the size of the subsample is of a smaller order, the new estimators for all the
      four parameters are as asymptotically efficient as the usual maximum likelihood
      estimators. Tests based on this new approach are also discussed. An illustration
      from a cholesterol screening study is included.

PMID- 1637983
TI  - The effect of diagnostic misclassification on non-cancer and cancer mortality
      dose response in A-bomb survivors.
AB  - We used the EM algorithm in the context of a joint Poisson regression analysis of
      cancer and non-cancer mortality in the Radiation Effects Research Foundation
      (RERF) Life Span Study (LSS) to assess whether the observed increased risk of non
      cancer death due to radiation exposure (Shimizu et al., RERF Technical Report 02
      91, 1991) can be attributed solely to misclassification of cancer as non-cancer
      on death certificates. We show that greater levels of dose-independent
      misclassification than are indicated by a series of autopsies conducted on a
      subset of LSS members would be required to explain the non-cancer dose response,
      but that a relatively small amount of dose-dependence in the misclassification of
      cancer would explain the result. The adjustment for misclassification also
      results in higher risk estimates for cancer mortality. We review applications of
      similar statistical methods in other contexts and discuss extensions of the
      methods to more than two causes of death.

PMID- 1637984
TI  - Estimating compliance to study medication from serum drug levels: application to
      an AIDS clinical trial of zidovudine.
AB  - This paper examines the use of serum drug levels to assess compliance to study
      medication in a clinical trial. We discuss problems of false-positivity, false
      negativity, and bias that arise because of experimental errors in the drug
      assays, pharmacokinetic variations of the drug, and differential dosing levels.
      Basic concepts in probability are applied to derive a simple model that
      quantifies these problems. This model is used to obtain an estimate of compliance
      rate that corrects for these problems. However, derivation of this estimate
      requires additional information about false-positive and false-negative rates of
      the assay as well as some knowledge of the pharmacokinetic properties of the
      drug. We illustrate the evaluation of such a compliance estimate in the setting
      of an AIDS clinical trial of zidovudine (ZDV), in which some accessory data are
      available on the properties of ZDV serum assays and on the pharmacokinetic
      behavior of ZDV. We also describe a method that uses the accessory data to
      provide the additional information needed for computing the compliance estimate.

PMID- 1637985
TI  - Generalized linear models with random effects; salamander mating revisited.
AB  - In recent years much effort has been devoted to extending regression methodology
      to non-Gaussian data, where responses are not independent. These methods for
      dependent responses are suitable for data from longitudinal studies or nested
      designs. However, use of these methods for crossed designs seems to have serious
      limitations due to the intensive computations involved because of the intractable
      nature of the joint distribution. In this paper, we cast the problem in a
      Bayesian framework and use a Monte Carlo method, the Gibbs sampler, to avoid
      current computational limitations. The flexibility of this approach is
      illustrated by analyzing the interesting salamander mating data reported by
      McCullagh and Nelder (1989, Generalized Linear Models, 2nd edition, London:
      Chapman and Hall).

PMID- 1637986
TI  - Efficacy of repeated measures in regression models with measurement error.
AB  - Ignoring measurement error may cause bias in the estimation of regression
      parameters. When the true covariates are unobservable, multiple imprecise
      measurements can be used in the analysis to correct for the associated bias. We
      suggest a simple estimating procedure that gives consistent estimates of
      regression parameters by using the repeated measurements with error. The relative
      Pitman efficiency of our estimator based on models with and without measurement
      error has been found to be a simple function of the number of replicates and the
      ratio of intra- to inter-variance of the true covariate. The procedure thus
      provides a guide for deciding the number of repeated measurements in the design
      stage. An example from a survey study is presented.

PMID- 1637987
TI  - Helix-forming tendencies of amino acids depend on the restrictions of side-chain
      rotamer conformations: crystal structure of the tripeptide GAI in two crystalline
      forms.
AB  - In our attempts to design crystalline alpha-helical peptides, we synthesized and
      crystallized GAI (C11H21N3O4) in two crystal forms, GAI1 and GAI2. Form 1 (GAI1)
      Gly-L-Ala-L-Ile (C11H21N3O4.3H2O) crystals are monoclinic, space group P2(1) with
      a = 8.171(2), b = 6.072(4), c = 16.443(4) A, beta = 101.24(2) degrees, V = 800
      A3, Dc = 1.300 g cm-3 and Z = 2, R = 0.081 for 482 reflections. Form 2 (GAI2) Gly
      L-Ala-L-Ile (C11H21N3O4.1/2H2O) is triclinic, space group P1 with a = 5.830(1), b
      = 8.832(2), c = 15.008(2) A, alpha = 102.88(1), beta = 101.16(2), gamma =
      70.72(2) degrees, V = 705 A3, Z = 2, Dc = 1.264 g cm-3, R = 0.04 for 2582
      reflections. GAI1 is isomorphous with GAV and forms a helix, whereas GAI2 does
      not. In GAI1, the tripeptide molecule is held in a near helical conformation by a
      water molecule that bridges the NH3+ and COO- groups, and acts as the fourth
      residue needed to complete the turn by forming two hydrogen bonds. Two other
      water molecules form intermolecular hydrogen bonds in stabilizing the helical
      structure so that the end result is a column of molecules that looks like an
      incipient alpha-helix. GAI2 imitates a cyclic peptide and traps a water molecule.
      The conformation angles chi 11 and chi 12 for the side chain are (-63.7 degrees,
      171.1 degrees) for the helical GAI1, and (-65.1 degrees, 58.6 degrees) and (-65.0
      degrees, 58.9 degrees) for the two independent nonhelical molecules in GAI2; in
      GAI1, both the C gamma atoms point away from the helix, whereas in GAI2 the C
      gamma atom with the g+ conformation points inward to the helix and causes
      sterical interaction with atoms in the adjacent peptide plane. From these
      results, it is clear that the helix-forming tendencies of amino acids correlate
      with the restrictions of side-chain rotamer conformations. Both the peptide units
      in GAI1 are trans and show significant deviation from planarity [omega 1 = 
      168(1) degrees; omega 2 = -171(1) degrees] whereas both the peptide units in both
      the molecules A and B in GAI2 do not show significant deviation from planarity
      [omega 1 = 179.3(3) degrees; omega 2 = -179.3(3) degrees for molecule A and omega
      1 = 179.5(3) degrees; omega 2 = -179.4(3) degrees for molecule B], indicating
      that the peptide planes in these incipient alpha-helical peptides are
      considerably bent.

PMID- 1637988
TI  - Molecular conformation of ascidiacyclamide, a cytotoxic cyclic peptide from
      Ascidian: X-ray analyses of its free form and solvate crystals.
AB  - In order to investigate the conformational variation of ascidiacyclamide, a
      cytotoxic cyclic peptide from marine tunicate Ascidian, single crystals were
      prepared from ethanol and aqueous ethanol solutions as its free form (crystal I)
      and H2O/0.5 C2H5OH solvate (crystal II), respectively, and were determined by the
      x-ray diffraction method. Crystal I showed a pseudo C2-symmetric saddle-shaped
      rectangular conformation. Similar conformations were also observed in crystal II,
      where there were two crystallographically independent C2-symmetric molecules
      (named Mol-A and -B) per asymmetric unit. Mol-A and -B included H2O and
      H2O/C2H5OH solvents within their ring structures, respectively. These water and
      ethanol molecules were located on the crystallographic dyad axes, and were
      stabilized by the van der Waals contacts (including hydrogen bonds) with the
      polar-ring N atoms and nonpolar D-Val side-chain atoms. The conformational
      characteristics of ascidiacyclamide and its fluctuation/variation were discussed
      based on the present and previously reported x-ray results.

PMID- 1637989
TI  - The electrostatic contribution to DNA base-stacking interactions.
AB  - Base-stacking and phosphate-phosphate interactions in B-DNA are studied using the
      finite difference Poisson-Boltzmann equation. Interaction energies and dielectric
      constants are calculated and compared to the predictions of simple dielectric
      models. No extant simple dielectric model adequately describes phosphate
      phosphate interactions. Electrostatic effects contribute negligibly to the
      sequence and conformational dependence of base-stacking interactions.
      Electrostatic base-stacking interactions can be adequately modeled using the
      Hingerty screening function. The repulsive and dispersive Lennard-Jones
      interactions dominate the dependence of the stacking interactions on roll, tilt,
      twist, and propellor. The Lennard-Jones stacking energy in ideal B-DNA is found
      to be essentially independent of sequence.

PMID- 1637990
TI  - Molecular dynamics study of the conformational behavior of a representative
      elastin building block: Boc-Gly-Val-Gly-Gly-Leu-OMe.
AB  - The conformational behavior of the synthetic peptide, Boc-Gly-Val-Gly-Gly-Leu
      OMe, containing the X-Gly-Gly and Gly-Gly-X (X = Val or Leu) repeating sequences
      and constituting a fragment of elastin was investigated by molecular mechanics
      and molecular dynamics (MD) simulation. The results suggest that, irrespective of
      the approximations used, the molecule shows a manifold of low energy
      conformations characterized by gamma-turns and type II beta-turns. Furthermore,
      MD simulations point out a conformational floppiness due to very low barriers
      between different conformations. Experimental CD measurements in a virtually
      apolar medium (dioxane--epsilon = 2.209), which better mimics the vacuum
      conditions of the simulation, support the theoretical results. The general
      emerging picture, indicating the molecule as characterized by a combination of
      flexibility with conformational preferences, is in agreement with previous
      experimental findings and enriches of new aspects the description of the
      microscopic behavior of this molecule suggesting more detailed interpretation of
      previous data.

PMID- 1637991
TI  - Beta-alanine containing peptides: a novel molecular tool for the design of gamma
      turns.
AB  - In the present paper we describe the synthesis, purification, single crystal x
      ray analysis, and solution conformational characterization of the cyclic
      tetrapeptide cyclo-(L-Pro-beta-Ala-L-Pro-beta-Ala). This peptide was synthesized
      by classical solution methods and the cyclization of the free tetrapeptide was
      accomplished in good yields in diluted methylene chloride solution using N,N
      dicyclohexyl-carbodiimide (DCCI). The compound crystallizes in the orthorombic
      space group P2(1)2(1)2(1) from ethyl acetate. All peptide bonds are trans. The
      molecular conformation is stabilized by two intramolecular hydrogen bonds between
      the CO and NH groups of the two beta-alanine residues. These hydrogen bonds take
      place in a C7 structure in which both proline residues occupy the 2 position of
      an inverse gamma-turn. The two beta-alanine residues have a typical folded
      conformation (around the C alpha-C beta bond) observed in other cyclic peptides
      containing this residue. A detailed 1H-nmr analysis in CD3CN solution has been
      carried out. The molecule assumes a twofold symmetry in solution with a molecular
      conformation consistent with that observed in the solid state.

PMID- 1637992
TI  - Helix formation in poly (N epsilon,N epsilon,N epsilon-trimethyl-L-lysine) and
      poly (L-lysine): dependence on concentration and molecular weight.
AB  - Helix formation in (Lys)n.HClO4 and poly(N epsilon,N epsilon,N epsilon-trimethyl
      L-lysine).HClO4 +AD(LysMe3)n.HClO4+BD is dependent on peptide concentration and
      on molecular weight. For (LysMe3)n.HClO4 of degree of polymerization (DP) 2510
      the midpoint of the coil-to-helix transition is 2 mM and for DP of 190 it is 5
      mM. For (Lys)n.HClO4 the peptide concentration for half-helix is 30-60 times as
      high, and is only weakly dependent, if at all, on molecular weight. Helix
      formation is an intermolecular process. The use of methylated (Lys)n as the
      perchlorate permits study of the intermolecular coil-helix transition at low
      concentration, instead of the high concentration (ca. 1-2 M) required for
      (Lys)n.HBr. At constant peptide concentration helix content increases with added
      NaClO4. The higher the peptide concentration, the less NaClO4 is needed to induce
      helix.

PMID- 1637993
TI  - Bound water in the collagen-like triple-helical structure.
AB  - The ir amide bands of the triple-helical polytripeptides and collagens upon
      hydration of films are investigated. On the basis of our assignment of the amide
      I components, the formation of hydrogen bonds between the peptide backbone and
      structural water is studied. The C1O1--HOH hydrogen bonds are found more ordered
      than the C3O3--HOH hydrogen bonds. The specific incorporation of water in the
      triple helix is followed by multistep conformational changes and by increasing of
      the interpeptide hydrogen-bond strength. The formation of the polypeptide hydrate
      structure depending on the amino acid composition and the chain length is
      examined.

PMID- 1637994
TI  - [Is conventional tomography still necessary?].

PMID- 1637995
TI  - Acro-osteolysis of the phalanges and phaeochromocytoma.

PMID- 1637996
TI  - [Vascular diagnosis with color-coded duplex sonography].

PMID- 1637997
TI  - [The magnetic resonance tomographic signs of Wegener's granulomatosis in the head
      area].
AB  - MRI of the head was performed in 25 patients suffering from Wegener's granuloma.
      23 patients showed evidence of mucosal thickening in the paranasal sinuses, the
      middle and inner ears and in the mastoid cells; these were characterised by low
      signal intensity of T1-weighted and high signal intensity of T2-weighted images.
      In 10 patients there were granulomas in the paranasal sinuses and in the orbits
      which showed low signal intensity of both T1-weighted and T2-weighted images. In
      4 patients, additional images were obtained after the intravenous injection of Gd
      DTPA. In 2 patients this resulted in non-homogeneous contrast accumulation in the
      granuloma. In 7 patients there were signal changes in the brain which were
      typical of infarcts. The complete extent of bone destruction in the facial
      skeleton was visible only by CT.

PMID- 1637998
TI  - [MR angiography. Its use in pulmonary and mediastinal space-occupying lesions].
AB  - MR angiography (MRA) proved to be promising combined to MR imaging (MRI) in the
      assessment of intrathoracic masses. Sequential FLASH 2D angiograms were acquired
      in breath-hold technique using the following parameters: TR = 30 ms, TE = 10 ms,
      FA = 30 degrees. Section thickness was 5 mm with 1 mm overlap between sequential
      sections. Individual conditions of the examination were achieved by an
      automatized control procedure. Targeted MIP postprocessing resulted in 3D
      reconstructions illustrating vascular anatomy and avoiding superimposition.
      Presentation should be done by cine-mode for better spatial impression. This
      method was evaluated in a prospective study of 21 patients with malignant
      pulmonary and mediastinal masses in addition to spin-echo imaging. The diagnostic
      contribution concerning the relationship between the mass and the vasculature
      like displacement, stenosis, and poststenotic perfusion defect were assessed.

PMID- 1637999
TI  - [High-resolution computed tomography (HR-CT) of the lung before transplantation.
      The value of methods for evaluating the recipient].
AB  - We examined the lungs of 49 patients with end-stage lung disease non-responding
      to conventional therapy when referred to lung transplantation by means of high
      resolution computed tomography (HR-CT). In 24 of these patients lung
      transplantation has been performed meanwhile. All scans were evaluated separately
      for both lungs with special regard to presence and extend to the following
      findings, in order to select the adequate type of transplantation procedure:
      pleural thickening, bullae and bronchiectasis. In patients with end-stage
      emphysema the severity of parenchymal damage was recorded additionally. In 20
      patients (40.8%) HR-CT results had a major impact on the selection of the
      surgical procedure. In 16 cases single lung transplantation was recommended
      because parenchymal changes were either localised unilaterally or a significant
      difference regarding the severity of emphysematous changes from one side to the
      other. In 4 cases double lung transplantation was the adequate procedure due to
      bilateral bronchiectasis or bullae. Based upon these results HR-CT seems
      indispensable in patients prior to lung transplantation.

PMID- 1638000
TI  - [Percutaneous CT-controlled cutting-needle biopsy of diffuse interstitial and
      alveolar lung diseases--the technic and results].
AB  - Twenty-three patients underwent CT-guided large-bore biopsy of diffuse lung
      disease of clinically and radiologically indeterminate etiology. The procedure
      was preceded by negative transbronchial biopsy in 20 cases. CT-guided biopsies
      were performed with a 14-gauge Trucut-needle. Obtaining at least 3 specimens of
      different parts of the diseased area, a correct histologic diagnosis was achieved
      in all cases. The size of the histologic specimens (mean: 5-6 mm) exceeded that
      of the specimens obtained by transbronchial biopsy as reported in the literature.
      Two major complications occurred and included a rapidly developing tension
      pneumothorax treated by a small-bore catheter and one self-limited hemoptysis.
      Major advantages of percutaneous CT-guided biopsy are the nonsuperimposed and
      very sensitive imaging of lung alterations in diffuse lung diseases that allows
      evidence of adjacent less and more involved areas accessible by one biopsy
      approach. CT-guided large-bore biopsy with a cutting needle seems to be a very
      promising, accurate method in the pathomorphologic work-up of diffuse lung
      diseases rendering open biopsy unnecessary in many cases.

PMID- 1638001
TI  - [The clinical relevance of anti-CEA immunoscintigraphy with the 99mTc-labelled
      monoclonal antibody BW 431/26. A critical assessment after 119 studies].
AB  - The results of 119 radioimmunoscintigraphies (RIS) in 113 patients with the 99mTc
      labeled monoclonal anti-CEA-antibody BW 431/26 (Behring) have been analysed. The
      aim of our study was the estimation of the method's sensitivity and specificity
      under different aspects to find out for which indications and questions the 99mTc
      RIS is useful. Colorectal primary tumours in 19 patients were scintigraphically
      detected with a sensitivity of 83% and a specificity of 100%; 3 out of 7 other
      tumour sites were localised correctly. 55 patients were examined during the
      follow-up of colorectal cancer. There were 17 out of 22 true positive findings of
      local recurrences (sensitivity 77%, specificity 88%). Liver metastases were
      imaged as hot lesions with only 41% sensitivity and 86% specificity. The
      detection of extrahepatic tumour sites is difficult because of the persistently
      high blood-pool activity of the monoclonal antibody and, in the pelvic area, the
      unspecific bowel activity. Skeletal metastases were recognised in 7 out of 9
      cases. In 14 patients with other non-colorectal carcinomas, RIS was successful in
      single cases. It is not helpful, however, when searching for tumours of unknown
      origin or for the screening of patients with elevated CEA levels without tumour
      history. The high technical, methodological and time effort required by RIS is
      justified in the follow-up of cancer patients when conventional diagnostic
      procedures are inconclusive or the status of morphological findings remains
      unclear. The use of RIS as an unspecific screening tool in tumour diagnosis must
      be rejected because of the not completely explored risks of the examination.
      Repeated applications of monoclonal antibodies require controls of the patients'
      HAMA titers before performing RIS.

PMID- 1638002
TI  - [Radiological findings in pseudohypoparathyroidism].
AB  - Clinical and radiodiagnostic changes in pseudohypoparathyroidism are described in
      three members of one family. Radiodiagnostic changes consist of symmetric
      calcifications in basal ganglia, perivascular calcifications in soft tissues, and
      of alterations on the skeleton--Albright's osteodystrophy. Bone changes include a
      combination of osteoproductive and osteomalacic alterations. All these changes
      were observed in both brothers, their mother had only calcifications localised in
      upper and lower extremities.

PMID- 1638003
TI  - [MR tomography versus CT arthrography in glenohumeral instabilities].
AB  - In a prospective study the diagnostic value of MRI compared to CT arthrography
      (CT-A) was evaluated in 26 patients with 27 instable shoulder joints. Surgical
      and/or arthroscopic correlation was available in all cases. Both methods showed a
      high accuracy (96% CT-A, 94% MRI) in the evaluation of the glenoid labrum. CT-A
      was significantly superior to MRI in the detection of capsular lesions
      (sensitivity 96% vs. 44%, accuracy 96% vs. 72%, negative predictive value 96% vs.
      67%). CT-A and MRI results regarding humeral head fractures were similar;
      fractures of the glenoid rim were better detected by CT-A, the difference,
      however, was statistically not significant. Overall, CT-A proved to be superior
      to MRI, as lesions of the joint capsule were shown with greater certainty.

PMID- 1638004
TI  - [Apophyseal elements of the sacroiliac joint in the computed tomographic image].
AB  - Between the ages of 12 and 18 years apophyseal elements appear within the SI
      joints which fuse subsequently with the sacrum. These apophyses could be
      demonstrated during two autopsies on juveniles and were seen in 7 CT examinations
      of patients between the ages of 15 and 19. On CT they appeared as narrow, round
      or band-like opacities situated on the ventral aspect of the joint. The
      differentiation of these normal findings from pathological changes within the SI
      joints is discussed.

PMID- 1638005
TI  - [Epiphyseal dysplasia of the hip joint, its diagnosis and differential diagnosis
      with MRT].
AB  - Sixteen hip joints of eight patients with multiple epiphyseal dysplasia were
      examined by clinical investigation, plain films and by magnetic resonance imaging
      (MRI), using T1- and T2-weighted images and gradient echoes. MRI is useful in
      demonstrating the congruity of the joint, in the changes of the epiphyseal signal
      intensities and the epiphyseal line. Individual changes of the signal intensity
      patterns on T1- and T2-weighted scans are described. Although MRI exhibits a
      variety of patterns in different patients, a clearcut differentiation from Legg
      Calve-Perthes' disease is possible.

PMID- 1638006
TI  - [Magnetic resonance tomographic screening studies of the bone marrow with
      gradient-echo sequences. II. Gadolinium-DTPA-supported studies of plasmocytoma
      patients].
AB  - MR imaging was performed in 19 patients with proven multiple myeloma. Both plain
      and Gd-DTPA enhanced in-phase and opposed-phase gradient-echo techniques were
      used (0.1 mmol Magnevist/kg body weight). Plain, opposed-phase imaging
      demonstrated more lesions than plain in-phase imaging (35 vs. 16); enhanced
      opposed-phase imaging demonstrated more lesions than plain opposed-phase and
      enhanced in-phase imaging (47 vs. 35 and 17 lesions). These results suggest that
      enhanced opposed-phase images which have a high contrast between normal and
      infiltrated bone marrow are especially suited for MR screening in multiple
      myeloma.

PMID- 1638007
TI  - [The evaluation of 2D- and 3D-"time of flight" magnetic resonance angiography
      (MRA) in the diagnosis of renal artery stenoses].
AB  - This study was carried out to evaluate time-of-flight RA in renal artery stenosis
      (RAS) in selected hypertensive patients (n = 41). In i.a. DSA studies, 10
      unilateral, 8 bilateral RAS, and 4 unilateral RA occlusions were proven. MRA was
      done in coronal and axial 2D technique (FLASH), and in 3D technique (FISP) using
      GE-pulse sequences. DSA results were correlated with both 2D-individual slices,
      2D- and 3D-MIP angiograms. Highest sensitivity and specificity was found for the
      axial 2D individual slice analysis (88%, 85% resp.), followed by the 3D-MIP MRA
      (78%, 80% resp.), and axial 2D-MIP MRA (73%, 79% resp.). MRA of renal arteries
      used in this study shows to be not adequate to DSA results due to many drawbacks.
      All MRA techniques, in particular the 3D-technique, tend to overestimate RAS
      occasionally pretending occlusions.

PMID- 1638008
TI  - [Ureteropelvic stenosis in infancy. The value of diuresis sonography compared
      with diuresis excretory urography].
AB  - Examinations under conditions of diuresis produced by drugs can be useful to
      differentiate pyelo-ureteric obstruction from a dilated collecting system with
      normal flow. 22 infants with 42 kidneys showing moderate dilatation of one of
      both renal collecting systems were examined by sonography and excretory urography
      under conditions of diuresis and the results were compared. Depending on the
      radiological appearances and contrast clearance rates, four diagnostic groups
      could be identified; these also differed significantly on the sonographic
      examinations. In general, there was good agreement between the two methods.
      Carefully performed, diuresis sonography will clearly distinguish between
      urodynamically significant obstruction from a wide but non-obstructive collecting
      system. The number of radiographic examinations can therefore be reduced in these
      patients.

PMID- 1638009
TI  - [Cystic space-occupying lesions of the seminal vesicles. Their demonstration with
      MRT].
AB  - Between October 1990 and March 1991, 8 patients with cystic lesions in the region
      of the posterior bladder wall, the seminal vesicles and the prostate were
      examined by MRI. In all cases there was accurate characterisation of the lesion
      and of its anatomy. In 3 patients with abnormalities in the retrovesical space
      there was very good agreement with the operative findings. 4 patients were
      treated conservatively. In these patients there was good agreement with the
      findings on cystoscopy, CT and sonography.

PMID- 1638010
TI  - [The visualization of bony and vascular structures in digital subtraction images
      depending on the contribution of the anatomical background].
AB  - We examined the loss of contrast leaving a part of the anatomic background in
      digital subtraction angiography by visual analysis and densitometry. We observed
      a greater loss of the quality at the representation of the bone below than above
      an amount of anatomic background of 60%. The loss of quality at the
      representation of the vessels decreases more above than below an anatomical
      background of 45%. We think that, depending on the clinical problem, an
      anatomical background between 15 and 30% should be left.

PMID- 1638011
TI  - High flow run-off angiography. Timing of film sequence.

PMID- 1638012
TI  - [Transfemoral catheter blockade of the vena cava inferior for the thrombectomy of
      a pelvic venous thrombosis].

PMID- 1638013
TI  - Cholesterol granuloma of the petrous apex with peritubal extension.

PMID- 1638014
TI  - [The clinical picture of neurosarcoidosis. The MR tomographic follow-up].

PMID- 1638015
TI  - [The CT image of a hemangioleiomyoma of the kidney].

PMID- 1638016
TI  - Development of iron-chelating agents for clinical use.

PMID- 1638017
TI  - GATA-binding transcription factors in hematopoietic cells.

PMID- 1638018
TI  - Efficacy and possible adverse effects of the oral iron chelator 1,2-dimethyl-3
      hydroxypyrid-4-one (L1) in thalassemia major.
AB  - Eleven patients with beta thalassemia major were entered into the trial of the
      oral chelator 1,2-dimethyl-3-hydroxypyrid-4-one (L1). Their ages ranged from 17
      to 26 years (mean +/- SD, 22.3 +/- 2.7). Six were male and five were female. L1
      was administered at an initial daily dose of 42.5 to 60 mg/kg as a single dose.
      After 4 weeks, the dose was increased to 85 to 119 (102 +/- 10.7) mg/kg for 191
      to 352 days divided into either two or four doses daily, except for one patient
      who developed agranulocytosis after 11 weeks and was taken off the trial. Initial
      serum ferritin values in the remaining 10 patients ranged between 1,000 and 9,580
      (5,549 +/- 3,333) micrograms/L and at end of the trial their mean serum ferritin
      was significantly lower (4,126 +/- 2,278; P less than .05 using the paired t
      test). Urinary iron excretion at a daily dose of 85 to 119 mg/kg administered as
      two divided doses ranged between 0.14 and 0.82 (0.44 +/- 0.26) mg/kg/24 h. In
      three patients, the four doses per day schedule caused substantially more iron
      excretion than the same total dose divided into two. During the course of the
      trial, several possible adverse effects have been encountered. One patient
      (female, aged 20) developed agranulocytosis 11 weeks after starting treatment and
      6 weeks after beginning treatment with a daily dose of 105 mg/kg. This patient's
      neutrophil count recovered spontaneously 7 weeks after the discontinuation of L1.
      A decrease in serum zinc levels to subnormal levels was observed in four patients
      with symptoms of dry skin, with an itchy scaly rash in two that was associated
      with low serum zinc levels that responded to zinc therapy. Urinary zinc levels
      ranged from 4.7 to 23.4 (13 +/- 5.5) mumol/24 h and were above 9 mumol/24 h
      (upper limit of normal) in eight patients. Mild nausea occurred in three patients
      and transient diarrhea in a fourth. Mild musculoskeletal symptoms occurred in
      three patients but settled without discontinuation of L1 therapy in two and with
      temporary discontinuation of L1 in the third. A transient increase in serum
      aspartate transaminase was also noted in five patients, but serum aspartate
      transaminase levels subsequently decreased in all of them. No cardiovascular,
      neurologic, renal, or retinal toxicities were demonstrable. These results confirm
      that L1 is an effective oral iron chelator. Further clinical trials are needed to
      determine the incidence and severity of adverse effects.

PMID- 1638019
TI  - Interleukin-3 regulates the activity of the LYN protein-tyrosine kinase in
      myeloid-committed leukemic cell lines.
AB  - The lymphokine interleukin-3 (IL-3) promotes the growth and survival of immature
      hematopoietic cells. Previous studies have shown that IL-3 induces rapid
      increases in protein-tyrosine kinase (PTK) activity in IL-3--dependent cells.
      Unlike some other hematopoietic growth factor receptors (eg, c-fms and c-kit),
      however, the known subunits of the IL-3 receptor (IL-3R) lack intrinsic kinase
      activity. Recently, it was reported that the IL-2R (whose p75 beta-subunit shares
      sequence homology with a known murine IL-3R subunit and a common beta-subunit of
      the human IL-3R and granulocyte-macrophage colony-stimulating factor [GM-CSF]
      receptors) can physically associate with and regulate the activity of the SRC
      family PTK, p56-LCK. Because most IL-3--dependent cells contain p53/56-LYN, but
      not p56-LCK, we explored the effects of IL-3 on the activities of LYN and other
      SRC-like PTKs in two human leukemic cell lines, AML-193 and TALL-101, which are
      phenotypically myeloid, and whose in vitro growth is dependent on IL-3. These
      cells expressed four of the eight known SRC-family proto-oncogenes: lyn, fyn,
      yes, and hck. When these factor-dependent leukemic cell lines were deprived of
      lymphokine to achieve cellular quiescence and then restimulated with IL-3, rapid
      increases (detectable within 1 minute and maximal by 10 minutes) were observed in
      the activity of the p53/56-LYN kinase, as assessed by in vitro kinase assays. In
      contrast, no alteration in the activities of other SRC-family PTKs present in
      these cells was detected after restimulation with IL-3 under the same conditions.
      This effect of IL-3 reflected an increase in the specific activity of the LYN
      kinase, because levels of the 53-Kd and 56-Kd LYN proteins were unaltered by IL-3
      stimulation, as assessed by immunoblotting. Furthermore, the magnitude of these
      inducible increases in LYN kinase activity was dependent on the concentration of
      IL-3, and correlated with IL-3--induced proliferation. The IL-3--induced
      upregulation of LYN kinase activity may be mediated by the 120-Kd common subunit
      of the human IL-3 and GM-CSF receptors, because GM-CSF also stimulated marked
      increases in the activity of the LYN kinase, whereas granulocyte-CSF (G-CSF) did
      not, despite inducing cellular proliferation. These observations provide the
      first example of an IL-3--regulable PTK, and strongly suggest that the p53/56-LYN
      kinase participates in early IL-3--initiated signalling events, at least in some
      human leukemic cell lines.

PMID- 1638020
TI  - Comparison of in vitro growth characteristics of blast cell progenitors (CFU-L)
      in patients with myelodysplastic syndromes and acute myeloid leukemia.
AB  - Current knowledge is inadequate to explain the different patterns of blast cell
      accumulation in myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML).
      We compared the growth patterns of blast cell progenitors (CFU-L) in 23 patients
      with advanced MDS and 32 patients with de novo AML. Circulating blast progenitors
      were identified in 74% of MDS and 81% of AML samples. Primary plating
      efficiencies (PE1) were similar in both disorders, despite marked differences in
      peripheral blast cell concentrations. By cytological and cytochemical
      examination, colonies from MDS patients were indistinguishable from those
      obtained in AML. Cell cycle status was assessed by loss of colony formation
      following short-term exposure to cytosine arabinoside. CFU-L suicide rates
      (median, range) were 40% (12% to 77%) in MDS and 60.5% (27% to 98%) in AML.
      Actively proliferating blast cell progenitors are thus not confined to AML, but
      are also present in the majority of MDS patients. An important difference between
      MDS and AML was found when self-renewal capacity of CFU-L was examined by means
      of secondary plating efficiencies (PE2). Colonies could be successfully replated
      in 74% of AML cases. PE2 showed marked heterogeneity (2 to 730 colonies/10(5)
      mononuclear cells), with some values indicating excessive self-renewal capacity
      of CFU-L. In contrast, 62% of the MDS specimens failed to produce any secondary
      colony growth, and PE2 in the remaining cases was low (5 to 99/10(5) MNC). We
      conclude that a different balance between self-renewal and determination could be
      responsible for a slower pace of clonal expansion in MDS, even if the
      proliferative activity of clonogenic cells is similar to that in AML.

PMID- 1638021
TI  - Changes in cell surface antigen expressions during proliferation and
      differentiation of human erythroid progenitors.
AB  - Cell surface antigen expression during proliferation and differentiation of human
      erythroid progenitors was examined using a combination of sequential
      micromanipulations of paired daughter cells derived from erythroid burst-forming
      units (BFU-E) and immuno-staining with a panel of monoclonal antibodies. Single
      hematopoietic progenitors were identified in methylcellulose cultures containing
      human cord blood mononuclear cells and micromanipulated individually to secondary
      culture. Paired daughter cells, granddaughter cells, and subsequent generations,
      whose counterparts produced erythroid bursts, were stained with various
      cytochemical and immuno-alkaline phosphatase stainings. Most paired daughter
      cells of BFU-E immunostained positively with anti-platelet glycoprotein(GP) IIb,
      antiplatelet GPIIb/IIIa, anti-HLA-DR, and antitransferrin receptor antibodies.
      Acid phosphatase staining was also positive. Neither CD34 nor CD33 antigens were
      identified on the cells. CD36 and blood group A antigens were first identified on
      cells from aggregates containing 32 to 64 cells after 4 days of secondary culture
      and preceded the expression of glycophorin A and hemoglobin alpha. These results
      indicate that various cell surface antigens were sequentially expressed during
      the proliferation and differentiation of erythroid progenitors, and that our
      procedure may be useful for clarifying the morphologic and immunologic properties
      of hematopoietic stem cells.

PMID- 1638022
TI  - Recombinant glycosylated human interleukin-6 accelerates peripheral blood
      platelet count recovery in radiation-induced bone marrow depression in baboons.
AB  - This report was aimed at confirming the potential clinical use for a genetically
      engineered glycosylated human interleukin-6 (rhIL-6) in hematopoiesis. Its
      tolerance and efficacy were assessed on hematopoietic restoration after neutron
      radiation-induced bone marrow injury on baboons, which represent an adequate
      model of parallelism for studying hematology in the human. The particular neutron
      radiation absorption pattern in the body allows the preservation of underexposed
      bone marrow areas that mimics an autotransplantation-like situation. An initial
      dose finding study (1 microgram up to 20 micrograms/kg/d for 8 consecutive days)
      in normal baboons established a dose-dependent response regarding the peripheral
      platelet count (range of increase, 1.5- to 4-fold). A significant elevation in
      white blood cell (WBC) count, as well as a substantial reversible normochromic
      normocytic anemia, were observed for the highest doses only (10 and 20
      micrograms/kg/d). All rhIL-6 administered doses were clinically well tolerated.
      In myelosuppressed baboons, a selected dose of 10 micrograms/kg/d of rhIL-6 for
      13 consecutive days significantly lessened the degree of induced thrombocytopenia
      as compared with the control group (P = .01) and shortened the time to occurrence
      of the nadir, showing that the onset of recovery occurs much earlier, ie, an
      average of 5 days (P = .003), in the treated group. Moreover, this accelerated
      platelet recovery is evidenced by an 8-day shorter mean time back to baseline
      values (P = .03) in the rhIL-6--treated animals. At this dose no effect was
      observed on the WBC recovery pattern. Importantly rhIL-6 did not accentuate the
      radiation-induced anemia and was clinically well tolerated. All tested monkeys
      recovered from their induced pancytopenia and no animal loss was recorded. IL-6,
      tumor necrosis factor, and IL-1 blood measurements are reported. In conclusion,
      rhIL-6 is a potent thrombopoietic factor for the treatment of induced
      thrombocytopenia in nonhuman primates at a clinically well-tolerated dose.

PMID- 1638024
TI  - C-reactive protein and beta-2 microglobulin produce a simple and powerful myeloma
      staging system.
AB  - Multiple myeloma (MM) staging procedures are still inadequate for detection of
      the optimal therapeutic procedure for an individual patient. The Durie & Salmon
      staging system and serum beta 2-microglobulin (beta 2M) are used worldwide
      because of their easy clinical application. Other prognostic parameters, such as
      myeloma cell proliferative activity, are of exceeding importance, but are not as
      simple as standard methods. Recently, interleukin-6 (IL-6) has been shown to be a
      major growth factor for MM. IL-6 is a pleiotropic cytokine acting on several cell
      lineages, and, at the hepatocyte level, stimulates the synthesis of acute phase
      proteins, such as the well known C-Reactive Protein (CRP). Serum CRP
      concentration actually reflects the IL-6 activity. A survival analysis carried
      out in 162 MM patients at diagnosis showed that serum CRP level is a highly
      significant prognostic factor. Moreover, serum CRP was independent of serum beta
      2M. This feature allowed stratification of MM patients into 3 groups according to
      CRP and beta 2M serum levels: (1) low risk group, CRP and beta 2M less than 6
      mg/L (50% of patients); (2) intermediate risk group, CRP or beta 2M greater than
      or equal to 6 mg/L (35% of patients); (3) high risk group, CRP and beta 2M
      greater than or equal to 6 mg/L (15% of patients). Survival was 54, 27, and 6
      months, respectively (P less than .0001). We thus propose a new and powerful
      myeloma staging system based on simple and reliable laboratory evaluations.

PMID- 1638023
TI  - A defect of platelet aggregation associated with an abnormal distribution of
      glycoprotein IIb-IIIa complexes within the platelet: the cause of a lifelong
      bleeding disorder.
AB  - A young Italian man (A.P.) has a lifelong history of bleeding from gums and
      mucocutaneous tissue. Electron microscopy showed a wide diversity of platelet
      size including giant forms. In citrated platelet-rich plasma (PRP), platelet
      aggregation induced by adenosine diphosphate (ADP) and other agonists was much
      reduced. Both secretion and clot retraction were normal. The aggregation of
      washed platelets with ADP was improved but remained subnormal, as was aggregation
      with collagen and thrombin. Fibrinogen-binding was analyzed by flow cytometry
      using platelets in whole blood or PRP and was markedly decreased. Crossed
      immunoelectrophoresis of Triton X-100 extracts of (A.P.) platelets showed that GP
      IIb-IIIa levels were 40% to 50% of normal. Glycoprotein (GP) IIb and GP IIIa were
      of usual migration in sodium dodecyl sulfate-polyacrylamide gel electrophoresis,
      but their labeling was much reduced during lactoperoxidase-catalyzed iodination.
      Binding to (A.P.) platelets of four different 125I-labeled monoclonal antibodies
      to GP IIb-IIIa complexes was reduced to 12% to 20% of normal levels. However,
      when the patient's platelets were stimulated with alpha-thrombin, monoclonal
      antibody binding showed the same increase (approximately 20,000 sites) as normal
      platelets. Both flow cytometry and immunocytochemical studies showed that the
      distribution of residual surface GP IIb-IIIa within the total (A.P.) platelet
      population was heterogeneous and not related to platelet size. Staining of
      ultrathin sections confirmed the presence of an internal pool of GP IIb-IIIa.
      Monoclonal antibodies to other membrane glycoproteins bound normally to (A.P.)
      platelets. The patient has a selective deficiency of the surface pool of GP IIb
      IIIa complexes that is manifested clinically by a mild Glanzmann's thrombasthenia
      like syndrome.

PMID- 1638025
TI  - Absence of immunoglobulin variable region hypermutation in a large cell lymphoma
      after in vivo and in vitro propagation.
AB  - Several genetic mechanisms have been shown to diversity the expressed antibody
      repertoire of committed B lymphocytes. These include somatic hypermutation, V
      gene replacement, and ongoing gene rearrangement. These mechanisms may be
      operational at discrete points in the B-cell differentiation pathway and may
      generate idiotypic diversity in various malignant B-cell tumors. Hypermutation of
      the Ig variable region has been shown to occur in follicular lymphoma, but not in
      pre-B cell acute lymphoblastic leukemia, Burkitt's lymphoma, chronic lymphocytic
      leukemia, or myeloma. To study hypermutation in a large cell lymphoma, we use a
      polymerase chain reaction-based approach, employing consensus VH and JH primers,
      to clone and sequence rearranged Ig heavy chain variable regions. Neither tumor
      cells immortalized in rescue fusions nor idiotypic variants of a tumor-derived
      cell line generated through ongoing lambda light chain gene rearrangements show
      any significant number of variable region mutations. Thus, at the in vivo stage
      of B-cell differentiation from which this large cell lymphoma arose, Ig variable
      region hypermutation was not occurring, nor did it occur during propagation in
      vitro of these tumor cells. Thus, the window of hypermutation in malignant B-cell
      tumors is more precisely defined, which may have clinical implications for
      diagnostic and therapeutic approaches directed at the Ig variable region.

PMID- 1638026
TI  - Effect of mast cell growth factor (c-kit ligand) on clonogenic leukemic precursor
      cells.
AB  - Mast cell growth factor (MGF), the ligand for the c-kit receptor, has been shown
      to be a hematopoietic growth factor that preferentially stimulates the
      proliferation of immature hematopoietic progenitor cells (HPC). We studied the
      effect of MGF on the in vitro growth of clonogenic leukemic precursor cells in
      the presence or absence of interleukin-3 (IL-3), granulocyte-macrophage colony
      stimulating factor (GM-CSF), and/or erythropoietin (EPO). Leukemic blood and bone
      marrow cells from patients with various types of acute myeloid leukemia (AML),
      chronic myeloid leukemia (CML) in chronic phase, as well as bone marrow samples
      from patients with myelodysplastic syndromes (MDS) were studied. MGF as a single
      factor did not induce significant colony formation by clonogenic leukemic
      precursor cells. In the presence of IL-3 and/or GM-CSF, MGF weakly stimulated the
      colony formation by clonogenic precursor cells from patients with AML. In
      contrast, in the presence of IL-3 and/or GM-CSF, MGF strongly induced both size
      and number of leukemic colonies from patients with CML in chronic phase.
      Furthermore, in the presence of EPO, MGF strongly stimulated erythroid colony
      formation by CML precursor cells. Cytogenetic analysis of the colonies showed
      that all metaphases after 1 week of culture were derived from the leukemic clone.
      In patients with MDS, MGF strongly stimulated myeloid colony formation in the
      presence of IL-3 and/or GM-CSF (up to fourfold), and erythroid colony formation
      in the presence of EPO (up to eightfold). Not only the number, but also the size
      of the colonies increased. In the presence of MGF, the percentage of normal
      metaphases increased in three patients tested after 1 week of culture compared
      with the initial suspension, suggesting that the normal HPC were preferentially
      stimulated compared with the preleukemic precursor cells. In the absence of
      exogenous EPO and in the presence of 10% human AB serum, MGF in the presence of
      IL-3 and/or GM-CSF induced erythroid colony formation from normal bone marrow and
      patients with MDS or CML, illustrating that MGF greatly diminished the EPO
      requirement for erythroid differentiation. These results indicate that MGF may be
      a candidate as a hematopoietic growth factor to stimulate normal hematopoiesis in
      patients with acute myeloid leukemia, or with myelodysplastic syndromes.

PMID- 1638027
TI  - MYC rearrangements in histologically progressed follicular lymphomas.
AB  - Histologic transformation of low-grade follicular lymphoma to an aggressive-grade
      lymphoma occurs in 60% to 80% of patients during their clinical course. The
      events that drive the transformation process are poorly understood. Deregulation
      of the MYC gene has been implicated in a small number of cases. This observation
      led us to examine the molecular organization of the MYC oncogene in 38 cases of
      histologically transformed lymphomas that arose from follicular lymphomas, and in
      18 of the initial pretransformation follicular lymphomas. In addition, we
      examined 58 "control" low-grade follicular lymphomas that had not yet shown
      evidence of histologic progression. Immunoglobulin heavy chain and light chain
      gene rearrangements were detected in all biopsies and rearrangements of the BCL-2
      locus were seen in 36 of 38 of the transformed lymphomas (consistent with their
      origin from follicular lymphomas), in 18 of 18 of the pretransformation
      follicular lymphomas, and in 51 of 58 of the control follicular lymphomas. All 18
      pretransformation follicular lymphoma specimens displayed at least one
      immunoglobulin gene and BCL-2 rearrangement in common with the corresponding
      histologically progressed lymphoma, indicating a clonal relationship between the
      original follicular lymphoma and the histologically transformed lymphoma. MYC
      rearrangements were detected in 3 of 38 (8%) transformed lymphomas and in 1 of 58
      (2%) control follicular lymphomas. The latter MYC rearranged follicular lymphoma
      was clinically aggressive and transformed to a high-grade lymphoma that led to
      the death of the patient within 20 months. None of the 18 pretransformation
      follicular lymphomas showed MYC rearrangement, including two from patients who
      later demonstrated MYC rearrangement in the progressed aggressive lymphoma. PvuII
      mutational analysis failed to identify additional MYC gene abnormalities in the
      progressed lymphomas. Because the Epstein-Barr virus (EBV) is associated with a
      fraction of high-grade lymphomas and is known to upregulate BCL-2, we looked for
      a potential role for this agent in our progressed lymphomas. We did not detect
      viral sequences in any case indicating that EBV does not play a major role in
      progression. The presence of MYC rearrangements in a small fraction of progressed
      aggressive lymphomas, and not in the corresponding antecedent follicular
      lymphomas, suggests that acquisition of a MYC rearrangement is in some cases
      associated with the transformation event.

PMID- 1638028
TI  - bcl-2 gene expression in hematopoietic cell differentiation.
AB  - Nonrandom translocations with breakpoint at band q21 on chromosome 18 might cause
      bcl-2 gene deregulation and might contribute to neoplastic transformation in
      human lymphomas. As the pattern of expression of bcl-2 in hematopoietic cells is
      still unclear, we have measured the level of the corresponding messenger RNA
      (mRNA) in a variety of myeloid and lymphoid cell malignancies not usually
      associated with the t(14;18) translocation. Molecular genetic analysis showed
      that bcl-2 was rearranged in only 2 of 77 patients: one was affected by hairy
      cell leukemia and one by diffuse small cleaved cell lymphoma with peripheral
      blood invasion. Although in rare cases of myeloid leukemia fairly high levels can
      be found, the expression of bcl-2 appears to be typical of certain lymphoid
      malignancies. High levels of bcl-2 mRNA had been found, previously, in
      established pre-B-cell lines. However, in fresh specimens, the peak level of bcl
      2 expression shifts to a more differentiated cell type, represented by the long
      living B lymphocytes that are found in most cases of chronic lymphocytic
      leukemia. bcl-2 gene product might have a role in prolonging cell survival and,
      even in the absence of translocations, might contribute to some of the biologic
      features that are typical of this disorder.

PMID- 1638029
TI  - Phagocytosis of Plasmodium falciparum-infected human red blood cells by human
      monocytes: involvement of immune and nonimmune determinants and dependence on
      parasite developmental stage.
AB  - The stage-dependent phagocytosis of Plasmodium falciparum-infected erythrocytes
      (IRBC) opsonized with nonimmune serum has been investigated. An average of 2.9
      red blood cell (RBC) harboring ring-forms (RIRBC) and 7.5 RBC infected with
      trophozoites (TIRBC) or schizonts (SIRBC) were ingested per monocyte, in
      comparison with 0.8 noninfected RBC (NRBC) or 5 RBC oxidatively damaged with
      diamide. Abrogation of generation of complement component C3b or blockage of its
      binding to the phagocyte inhibited phagocytosis of RIRBC by 78% to 95% and of
      TIRBC by 25% to 50%. Blockage of immunoglobulin G (IgG) binding reduced
      phagocytosis of both RIRBC and TIRBC nonsignificantly by 14%. Preincubation of
      monocytes with phosphatidylserine (PS)-containing liposomes reduced phagocytosis
      of TIRBC by 22%, but had little effect on RIRBC. Residual, noncomplement, non-IgG
      , and non-PS-dependent phagocytosis amounted to 6% to 18% of total phagocytosis
      in RIRBC and TIRBC, respectively. RIRBC bound 2.5 times more protein A and 3.1
      times more anti-C3c (a stable derivative of C3b) antibodies, and TIRBC bound 20
      times more protein A and 6.8 times more anti-C3c antibodies than NRBC.
      Phagocytosis of oxidatively damaged RBC and RIRBC are similar, whereas a higher
      portion of phagocytosis appears to be noncomplement-dependent and PS-suppressible
      in TIRBC. It is concluded that RIRBC generate recognition signals similar to
      those present in oxidatively damaged or senescent RBC. Extensive membrane
      modifications in TIRBC produce additional, hitherto undefined signals that induce
      much higher and qualitatively distinct phagocytosis.

PMID- 1638030
TI  - Spectrin Jendouba: an alpha II/31 spectrin variant that is associated with
      elliptocytosis and carries a mutation distant from the dimer self-association
      site.
AB  - Spectrin Jendouba (alpha II/31) was found in a Tunisian family. In the
      heterozygous state, it is associated with asymptomatic elliptocytosis and a
      minimal defect in spectrin dimer self-association. On partial digestion of
      spectrin with trypsin, an abnormal cleavage appeared following Lys 788. Peptide
      and DNA sequencing indicated that the responsible mutation is alpha 791 Asp---
      Glu (GAC----GAA). As in most alpha-spectrin variants associated with
      elliptocytosis, the change alters helix 3 of the proposed triple helical model of
      spectrin structure. Modified helix 3 in repeat alpha 8 is the most distant from
      the N-terminus of alpha-spectrin in known variants associated with
      elliptocytosis.

PMID- 1638031
TI  - Dynamic assessment of quality of life after autologous bone marrow
      transplantation.
AB  - To determine the quality of life in adult patients after autologous bone marrow
      transplantation (BMT), we administered a questionnaire to a cohort of patients
      seen at a single referral-based center. The sample included adults 18 years and
      older during the 1 year following an autologous BMT. Both disease-free patients
      and those who relapsed with 1-year of follow-up data available were included. Of
      59 eligible patients, 58 (98%) responded to the questionnaire. Patients completed
      a telephone questionnaire administered by a nurse specialist in the field of BMT
      approximately every 90 days. At the time of initial contact on day +90, the mean
      quality of life was 7.8 (range, 1 to 10) on a scale of 1 to 10, with 10 being the
      best. By the end of the first year of follow-up, the mean quality of life was 8.9
      (range, 3 to 10). Seventy-eight percent of the patients were employed. Twenty-one
      percent lost weight during the first year, with the majority reporting voluntary
      weight loss. Fourteen percent reported difficulties with sexual activity. Only 5%
      reported difficulty with sleeping or with frequent colds. One patient felt that
      her appearance was worse, and none of the patients reported a poor appetite.
      Eighty-eight percent of surviving adult patients reported an above-average to
      excellent quality of life 1 year following autologous BMT. This outcome is
      encouraging and suggests that this procedure is not associated with long-term
      morbidity in the surviving adult patient.

PMID- 1638032
TI  - Effect of age on human immunodeficiency virus type 1-induced changes in
      lymphocyte populations among persons with congenital clotting disorders.
      Transfusion Safety Study Group.
AB  - Children other than neonates infected with human immunodeficiency virus type 1
      (HIV-1) have low rates of progression to acquired immunodeficiency syndrome
      (AIDS). Through 1989, 5.3% of 95 infected hemophiliacs aged 5 to 13 years
      developed AIDS, compared with 20.3% of 364 aged greater than or equal to 25
      years. We asked whether the HIV-1 impact on peripheral blood mononuclear cell
      subpopulations differed with age using pairwise comparisons of uninfected and
      infected male children and adult hemophiliacs. Infected children had lesser
      reductions of total lymphocytes than adults, but proportionately lower numbers of
      CD2+, CD4+, CD2+CD26+, and CD4+CD29+ counts. CD4+CD45RA+ cell counts were greater
      than twofold higher in uninfected and infected children than adults; with
      infection, the CD4+CD45RA+/CD4+ proportion increased by 1.4-fold in adults, but
      was unchanged in children. Infected adults had highly significantly increased
      total CD8+ counts; both age groups had elevated CD8+HLA-DR+ counts. Infected
      children had significantly higher total B-cell counts than infected adults, with
      a disproportionately lower number of resting B cells (CD20+CD21+). During 2 years
      of follow-up, infected children and adults had lymphocyte changes in the same
      directions and these were proportionately equal. The lower rate of HIV-1
      progression in children may be partly associated with differences in lymphocyte
      populations compared with adults; functional properties of immune cells may be
      equally or more important.

PMID- 1638033
TI  - Subcutaneous erythropoietin for treatment of refractory anemia in hematologic
      disorders.

PMID- 1638034
TI  - Therapy of Plasmodium falciparum parasitemia with desferrioxamine.

PMID- 1638035
TI  - Clonal origin of abnormal granulocytes in paroxysmal nocturnal hemoglobinuria.

PMID- 1638036
TI  - [Contamination of foods with chemical substances and its control].

PMID- 1638037
TI  - [Behavior therapy as a new procedure in health education--recommendation for
      introducing behavior science into personal health services].
AB  - Recent efforts to integrate biomedical and behavioral science perspectives and
      techniques have revealed the creativity and efficacy of behavioral health
      approaches to health enhancement and disease prevention. There are expectations
      that behavioral medicine and behavioral health will be significant in approaches
      toward changing life style, improving patient's compliance with medical advice,
      and in rehabilitation. Three examples of actual practice of behavioral procedures
      in a public health center are studied-behavior therapies for obesity and
      hypercholesterolemia, and prompting of patient clinic utilization behavior by a
      letter of introduction. The importance of proper selection of target problems,
      staff training is emphasized. In conclusion, it is recommended that behavioral
      science and its techniques of assessment and treatment are incorporated into
      public health activities, especially in the field of health education.

PMID- 1638038
TI  - [A study of dietary intakes and dietary preferences by questionnaire at a health
      facility in an urban area].
AB  - Dietary preferences and intakes of 2504 patients in a human dock in Tokyo were
      studied by questionnaire and analyzed according to: 1. Comparison of dietary
      patterns for breakfast to that for lunch and dinner. 2. Consistency between
      dietary patterns according to Category Score Table for Breakfast and that from
      Hayashi's Quantification Theory Type III (QIII). Dietary patterns for breakfast
      were shown to fall into four Types based on dietary intakes and dietary
      preferences: Balanced Diet-Japanese Style (Type 1); Balanced Diet-Western Style
      (Type 2); Unbalanced Diet-Western Style (Type 3); and Unbalanced Diet-with drinks
      (Type 4). Based on the responses to the questionnaire, there was no correlation
      between the dietary pattern for lunch to that for breakfast. On the other hand,
      the dietary pattern for dinner tended to correlate with breakfast. The sample
      population was divided into two random groups A and B. Group A was analyzed by
      QIII, and B by the four types of breakfast dietary patterns. Comparison of scores
      for categorized values for Group A with those of the Group B indicated 91.8%
      consistent rate. These results, demonstrate that this questionnaire can be used
      effectively to sort intakes into four dietary patterns, and may be useful in
      preventive health care studies.

PMID- 1638039
TI  - [A population based survey of attendance at screenings in urban areas].
AB  - To clarify the present situation of screenings in urban areas, a population based
      survey on attendance at screenings was conducted in Kitakyushu City. Self
      administered mailed questionnaires were sent to three thousand randomly selected
      subjects 40 years of age or over living in Kitakyushu City. The results are
      summarized as follows: 1. Considerable differences were observed in the number of
      people who were offered screenings at work sites for those between the ages of 40
      59 compared to those 60 years of age or over, and between full-time employees and
      part-time or self-employed workers. 2. Among people who obtained stomach
      examinations, middle age men mainly received cancer screenings at work sites,
      while women or older men were mainly examined when they went to clinics or
      hospitals when abdominal discomforts occurred. Among women who received uterine
      examinations, all age groups mainly received cancer screenings at city
      administered screenings at clinics or hospitals, and rates decreased as age
      increased. 3. Among people who did not obtain stomach examinations, many middle
      age people wanted to be examined for stomach cancer but were unable to, while
      older people did not think it necessary. In the case of uterine cancer screening,
      middle age women did not want to receive it, while older women did not think it
      necessary. 4. For those people who are not offered cancer screenings at
      workplaces, it is assumed that those who have a positive attitude toward
      screening will obtain it, if offered, at sites conducted by the local
      government.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638040
TI  - [Studies of bacterial indicators for water pollution--growth of Escherichia coli
      and enterococci in limited nutrient conditions].
AB  - Bacteria, that would be an ideal indicator for fecal contamination in
      environmental water, should not proliferate but at the same time should survive a
      little longer than enteropathogenic bacteria in the environmental water. While
      conventional methods have recommended Escherichia coli as an indicator,
      enterococci is recommended as a preferable indicator for the estimation of fecal
      contamination based on the following observation. The relationship between the
      specific growth rate of organism and the concentration of peptone was determined
      and the value of Ks, a parameter analogous to Michaelis-Menten constant, was
      estimated. Ks of Escherichia coli, Enterococcus faecalis and Enterococcus faecium
      were 3.8, 11.1 and 12.5 mg/ml respectively, indicating that Escherichia coli will
      grow at lower concentration of peptone than enterococci. Escherichia coli also
      grew in human fecal suspension and in filtrated (0.22 microns) river water, and
      while in those conditions enterococci did not grow or survive longer than
      Escherichia coli, survival time was longer than for Salmonella typhi and Shigella
      sonnei. It appears that enterococci reflect more accurately actual fecal
      contamination.

PMID- 1638041
TI  - [The relation between physical status, life style and subjective feeling of
      health].

PMID- 1638042
TI  - [An index of urinary hydroxyproline (HOP) in epidemiological surveys].

PMID- 1638043
TI  - The determination of low d5-phenylalanine enrichment (0.002-0.09 atom percent
      excess), after conversion to phenylethylamine, in relation to protein turnover
      studies by gas chromatography/electron ionization mass spectrometry.
AB  - A gas chromatography/mass spectrometry (GC/MS) method for measuring very low
      levels of enrichment of d5-phenylalanine (0.002-0.09 atom percent excess) is
      described. This method makes it possible to determine the enrichment of amino
      acid incorporated into tissue protein during studies of protein synthesis in man.
      Phenylalanine is enzymatically converted to phenylethylamine and the d5
      enrichment is measured in the heptafluorobutyryl derivative by selective-ion
      recording under electron ionization conditions. The coefficients of variation for
      muscle-protein hydrolysate samples enriched with d5-phenylalanine at the 0.005
      and 0.05 atom percent excess levels were 6.0 and 1.2%, respectively. This
      precision at low enrichment and the small amount of protein needed (about 1 mg)
      provide real advantages for clinical studies of tissue protein synthesis.
      Moreover, in contrast to the conventional approach which uses GC/MS for plasma
      amino acids (typically 2-20 atom percent excess) but gas isotope-ratio mass
      spectrometry for protein-bound amino acids, the enrichment of both plasma-free
      and protein-bound d5-phenylalanine can be measured with a single instrument.

PMID- 1638044
TI  - Ion-trap mass spectrometry applications in forensic sciences. I. Identification
      of morphine and cocaine in hair extracts of drug addicts.
AB  - Daughter-ion spectra obtained by ion-trap mass spectrometry have been
      successfully employed in the field of drug abuse investigation. Selection and
      collision-induced fragmentation of molecular-ion species of morphine and cocaine
      lead to an easy identification of such molecules in hair extracts of heroin and
      cocaine addicts.

PMID- 1638045
TI  - Improvements in ion-trap chemical-ionization performance.
AB  - Ion-trap chemical-ionization performance has been improved by application of a
      modified scan function for the rejection of the undesired electron-ionization
      like (EI-like) ions formed at the beginning of the reaction ionization period.
      The net effect of this software modification to the automatic reaction control is
      to produce chemical ionization (CI) spectra that are no longer adulterated with
      concentration-dependent EI-like ions. Under such improved conditions, CI spectra
      from an ion trap can now be directly compared with CI spectra produced on
      conventional quadrupole and magnet-scanning instruments.

PMID- 1638046
TI  - Differences in the conformational state of a zinc-finger DNA-binding protein
      domain occupied by zinc and copper revealed by electrospray ionization mass
      spectrometry.
AB  - Transition metal ions are important in biological regulation partly because they
      can bind to and stabilize protein surface domain structures in specific
      conformations that are involved in key molecular recognition events. There are
      two C2-C2 type zinc-finger sequences within the highly conserved DNA-binding
      domain of the estrogen receptor protein (ERDBD). Electrospray ionization (ESI)
      mass spectrometry has been used to demonstrate that the metal-binding sites
      within the 71-residue ERDBD can bind either Zn (up to 2) or Cu (up to 4).
      Evidence for the induction and/or stabilization of a different conformational
      state with bound Cu is revealed by a characteristic shift in the ESI charge
      envelope. The 10+ charge state is most abundant for the fully reduced ERDBD
      apopeptide and the ERDBD-Zn holopeptide (bound Zn does not alter the charge
      envelope). In contrast, the 8+ charge state is typically the optimum charge state
      observed for the ERDBD-Cu holopeptide; indeed, the entire charge envelope is
      frame-shifted to lower charge states with bound Cu. Interpretation of the altered
      charge states is simplified because (i) a single type of metal-binding ligand
      (sulfur) is involved in the case of both Zn and Cu binding, and (ii) the two
      different metal cations are both divalent. Thus, it is likely that the dissimilar
      charge envelopes represent different peptide conformers, each of which is
      stabilized by a different type of bound metal ion.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1638047
TI  - Biological stereology: history, present state, future directions.
AB  - The development of a quantitative structural platform for experimental biology-
      extending across a hierarchy of sizes ranging from molecules to organisms--has
      been punctuated by a series of major achievements over the last 30 years.
      Stereology, a form of quantitative morphology, has contributed handsomely to this
      success. A personal view is presented highlighting key events in the development
      of biological stereology. We also examine stereology with a view toward future
      developments in biology and speculate how stereology might contribute to the new
      biological infrastructure currently being built with computers.

PMID- 1638048
TI  - Computer-assisted morphometry: point, intersection, and profile counting and
      three-dimensional reconstruction.
AB  - The use of computers in morphometry can involve 1) automated image analysis,
      semiautomated image analysis and point, intersection, intercept and profile
      counts of two-dimensional images on tissue sections with mathematical
      extrapolation to the third dimension, 2) direct measurement of volumes, surfaces,
      lengths, and curvature using x,y,z coordinates of serial sectioned images, or 3)
      stereologic techniques and serial sections which is a combination of 1 and 2
      above. Automated and semiautomated image analysis are generally restricted to
      specimens that are characterized by differential contrast such as interalveolar
      septa in the lung or histochemically stained mucous granules in pulmonary
      epithelium. Point, intersection, and profile counts using hand-held, notebook
      PCs, portable PCs, or standard PCs and MS-DOS-based application programs are
      extremely efficient, precise, affordable, and convenient methods of quantitating
      average values of a population. When morphometric measurements of individual
      structures are required, computer-assisted three-dimensional reconstruction using
      x,y,z coordinates of the surface outline from serial sections is a tedious yet
      precise method. We describe a computer program that efficiently estimates mean
      caliper diameter, volume, and surface area with less than five percent error with
      five sections per structure. We also describe a program that does digital image
      subtraction on serial sections, superimposes digitally generated test systems on
      biological images, and accumulates point, intersection, and profile counts using
      a Macintosh II series computer.

PMID- 1638049
TI  - An image processing/stereological analysis system for transmission electron
      microscopy.
AB  - This study examines the feasibility of combining computer image digitization,
      image enhancement, and point counting stereological techniques to quantify video
      images from transmission electron microscopes (TEM). The essential hardware
      consists of an IBM PC/AT, a Matrox imaging board, a digitizing tablet, a high
      resolution black and white monitor, and a portable mass storage device. In
      addition a video camera must be mounted to the TEM. The software is written in
      three modules which have numerous routines for image acquisition, enhancement,
      and quantification. Quantification is achieved by selecting an electronic lattice
      and superimposing it on the cell image. A cursor is moved on the lattice (via the
      digitizing tablet) and the points are entered into a spreadsheet. One of the
      major limitations of the system was the reduced resolution inherent in the
      current hardware. However, sampling experiments showed that one could compensate
      for the reduced resolution by increasing the magnification of the digitized
      images, and the stereological values from digitized images compared favorably to
      those from electron micrographs. Furthermore, the system proved advantageous by
      eliminating the usual darkroom work, and in enhancing low contrast tissue. In
      spite of several hardware limitations, the concept of quantifying computer
      digitized TEM images appears promising.

PMID- 1638050
TI  - The microcomputer and image analysis in diagnostic pathology.
AB  - This paper presents a snapshot view of the influence and direction of
      microcomputer technology for image analysis techniques in diagnostic pathology.
      Microcomputers have had considerable impact in bringing image analysis to wider
      application. Semi-automated tracing techniques are a simple means of providing
      objective data and assist in a wide range of diagnostic problems. From the common
      theme of reducing subjectivity in diagnostic assessment, an extensive body of
      research has accrued. Some studies have addressed the need for quality control
      for reliable, routine application. Video digitizer cards bring digital image
      analysis within the reach of laboratory budgets, providing powerful tools for
      investigation of a wide range of cellular and tissue features. The use of
      staining procedures compatible with quantitative evaluation has become equally
      important. As well as assisting scene segmentation, cytochemical and
      immunochemical staining techniques relate the data to biological processes. With
      the present state of the art, practical use of microcomputer based image analysis
      is impaired by limitations of information extraction and specimen throughput.
      Recent advances in colour video imaging provide an extra dimension in the
      analysis of multi-spectral stains. Improvements will also be felt with
      predictable increase in speed of microprocessors, and with single chip devices
      which deliver video rate processing. If the full potential of this hardware is
      realized, high-speed, routine analysis becomes feasible. In addition, a
      microcomputer imaging system can play host to companion functions, such as image
      archiving and transmission. With this outlook, the use of microcomputers for
      image analysis in diagnostic pathology is certain to increase.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1638051
TI  - Quantitative perimeter and area measurements of digital images.
AB  - Quantitative estimations of perimeter and area from digitized video images, and
      the application of these features in morphometry, are discussed. Estimations from
      manual tracings via interactive peripherals and from chain codes are addressed.
      Topics discussed are calibration, determination of vertical and horizontal pixel
      resolution, effects of tracing jitter, and for chain codes, the spatial
      quantization scheme representation of the digital contour. Finally, new perimeter
      estimators for 4-connected and 8-connected chain codes for non-unity pixel aspect
      ratio are presented with simulation results.

PMID- 1638052
TI  - Quantitative morphology for biologists and computer scientists: I. Computer-aided
      tutorial for biological stereology (version 1.0).
AB  - This paper describes a computer-aided tutorial for biological stereology.
      Stereology, a type of quantitative morphology, includes a collection of
      statistical methods that quantify the structural compartments that can be viewed
      in sections with light and electron microscopy. These methods provide volume,
      surface, length, shape, and number data, and help define the quantitative
      relationships among the structural compartments of biological hierarchies.
      Hierarchies, which connect structural data ranging in size from molecules to
      organs, serve as a central core to which the data of biological databases can be
      linked. The tutorial focuses on two objectives. It provides the user primarily
      interested in using quantitative morphology databases with background
      information, and offers a set of state-of-the-art tools to researchers wishing to
      use these methods in the laboratory. The main topics of the tutorial include:
      introduction to quantitative morphology, symbols/terms, data types, sampling,
      hierarchies, data interpretation, and utilities. The tutorial runs under the MS
      DOS operating system and requires at least an IBM PC AT (or compatible), a color
      monitor (EGA, VGA), 540 KB of RAM, and 3 MB of hard disk space.

PMID- 1638053
TI  - Computer assisted data collection for stereology: rationale and description of
      point counting stereology (PCS) software.
AB  - The paper describes microcomputer software for point counting stereology.
      Stereology includes a collection of statistical methods that quantify the images
      of light and transmission electron microscopy. The methods use test grids placed
      over images to collect raw data, which includes counts of points, intersections,
      transections, and profiles. In turn, the counts are included in stereological
      equations that give estimates of compartmental volumes, surfaces, lengths, or
      numbers. These parameters describe the composition of a structure in three
      dimensional space. The PCS (point counting stereology) System Software III serves
      as a data collection, storage, and management tool. Users set up point counting
      protocols without programming, enter data by pressing predefined function (MS
      DOS) or alphabetic keys (UNIX), store data in files, select files for analysis,
      and calculate results as stereological densities. The latest version of the PCS
      software includes a new user interface and is designed as a research "front end"
      that can feed data either into the calculation tools of a stereology tutorial
      (Bolender, 1992, this issue) or into the analysis routines of quantitative
      morphology databases (Bolender and Bluhm, 1992).

PMID- 1638054
TI  - A new procedure for handling impervious biological specimens.
AB  - A new application of techniques for preparing impervious biological specimens for
      light microscopy (LM) and transmission electron microscopy (TEM) has been
      developed. Microwave irradiation was used to facilitate fixation. A priming
      technique was used to increase the bonding of the outer surface of the specimens
      with the resin. Priming the waxy or cuticular surface with Z-6040 (gamma
      glycidoxypropyl trimethoxysilane) solved the problem of specimen "pull out" from
      the resin. Insect specimens with various types of cuticles (waxy or chitinous)
      and seeds were successfully studied ultrastructurally using this technique.

PMID- 1638055
TI  - The influence of lens chromatic aberration on electron energy-loss spectroscopy
      quantitative measurements.
AB  - An investigation has been made into the effect of chromatic aberrations of a pre
      spectrometer lens system on quantitative elemental analysis by electron energy
      loss spectroscopy (EELS). In transmission electron microscopy (TEM) diffraction
      mode, the measured effects are typically 150-330 times larger than if only
      objective-lens chromatic aberration were important. We discuss several methods of
      avoiding errors arising from chromatic aberration, including selection of a
      suitable optical mode (dependent on the desired spatial resolution), adjustment
      of the TEM imaging system so as to focus the system for a chosen energy loss, and
      analysis of a large area of a uniform specimen.

PMID- 1638056
TI  - [Cytochemical ultrastructural study of adenosine 5'monophosphate hydrolysis in
      human spermatozoa].
AB  - A specific 5'nucleotidase activity (pH 7.4) is localized by cytochemical
      technics, in the head (nuclear membrane, periacrosomal cytoplasm) and in the
      mitochondrial membrane of human spermatozoa. The effect of different effectors
      (manganese, nickel, fluoride, tartrate, tetramisole), studied in the head by rate
      assessment of cells with or without hydrolysis sites, changes the cellular
      distribution, the depth of reactions and their localization. The 5'nucleotidase
      interferences with some unspecific phosphatases are discussed.

PMID- 1638057
TI  - Morphology, distribution and types of valves in the adult male's testicular
      veins.
AB  - Morphologically, the pampiniform plexuses investigated had, in their majority, no
      vascular spiraling on the left side, the same occurring on the right side;
      however, as for the total number of valves, except for those of the pampiniform
      plexuses, the left side was found contain a greater number of valves. As regards
      valve types, there is a predominance of double semilunar one on both sides rather
      than single semilunar valves.

PMID- 1638058
TI  - [DIfferentiation of enthesis and the synovial membrane in the rat].
AB  - The development of the knee joint in Wistar rats was observed from the 14th fetal
      day to the 40th postnatal day by light microscopy, transmission electron
      microscopy and scanning electron microscopy. The differentiation of the capsular
      ligamentous and tendinous attachments, synovial cavity, and A and B cells were
      particularly compared. Capsular attachments appeared for the first time at the
      15th day of fetal life. The formation of the cavity started at the 17th day of
      fetal life. The differentiation of A and B cells was observed by the 20th fetal
      day by T.E.M., and only by the 15th postnatal day by S.E.M.

PMID- 1638059
TI  - [Anatomy and physiology of the muscles in cleft lip and palate].
AB  - The authors present the anatomy and the physiology of the normal and pathological
      muscles of the cleft lip and palate. The authors insist not only on the anatomic
      defects but mainly on the muscle functions which are the most disturbed. The
      purpose of this study is to guide the surgical technique in order to improve not
      only the cosmetic but the functional results as well.

PMID- 1638060
TI  - [Gracilis muscle in man].
AB  - This study is based upon the dissection of 84 gracilis muscles in 42 cadavers. It
      allowed to emphasize the following features: 1-The proximal insertion of the
      muscle is a strong tendinous lamina arising from the anterior aspect of the pubis
      and from the ischio-pubic branch; the distal insertion to the tibia is common to
      both the gracilis and the semi-tendinous muscles. 2-The distal tendon of the
      gracilis is tightly connected to the posterior branch of the internal saphenous
      nerve which crosses the muscle behind the medial femoral condyle. 3-The arterial
      supply (52 dissections) appears to be very rich, consisting in various pedicles
      entering the muscle by is lateral side. The main neurovascular bundle is issued
      from the profound vessels of the thigh, coming either from the adductors artery
      (73%), either from the medial circumflex artery (19.2%), either from both
      networks (7.7%). The site of penetration of the vessels in the muscle is
      remarkably constant. The remaining pedicles (2 to 4, one of which is quite
      constant at the musculotendinous junction) arise from the muscular branches of
      the femoral artery. 4-There is a good correlation between the measured length of
      the muscle and the distance between the superior aspect of the pubic arch and the
      medial epicondyle. A 0.37 corrective factor applied to this latter distance
      allows to determine the exact sit of penetration of the main neurovascular bundle
      in the muscle.

PMID- 1638061
TI  - [Study of cells harvested in nasal secretions after lavage. Improvement of the
      cytologic technique and application to ORL and bronchial pathology].
AB  - The study of the cells found in the nasal lavage fluid is now a very used method.
      It has many advantages and it is better than the study of nasal smears obtained
      by nose blowing and/or swabbing. In this work, we have studied the nasal cytology
      of patients with a nasal or bronchial pathology. A count of inflammatory cells in
      a hemocytometer is performed in 301 noses then the percentage of various cell
      types (eosinophils, lymphocytes and neutrophils) is performed on a glass slide
      stained by May Grunwald Giemsa. The results are correlated with the literature.
      The patients with a known NARES have a mean nasal eosinophilia of 26.8%; in the
      allergic rhinitis, the eosinophilia is 41.4%; the patients with a Fernand Widal
      Syndrome or with a nasosinusal polyposis have respectively a eosinophil
      percentage of 24.2% and 18.8%.

PMID- 1638062
TI  - [A study of the cranio-pharyngo-mandibular space by sections at low temperature].
AB  - After acrylic injections into the vessels and mandibular block anaesthesia the
      pterygo-mandibular space is studied in 38 anatomical pieces. 538 colour slides
      have been obtained from anatomical cuts at low temperature with the scannigraph
      system. The results point out that a cranio-pharyngo-mandibular space is clearly
      distinguished laterally, from a medial maxillo-pharyngeal space. There is no
      transversal communication between them. On the contrary, the cranio-pharyngo
      mandibular space communicates, forward and upward, with the temporal space;
      forward and downward, with the sub-mandibular space. The cranio-pharyngo
      mandibular space contains an interpterygoid space communicating with the oval
      foramen by a "chimney" largely filled by the emissary pterygoid veins. A
      pericondilar plexus of veins is also observed. The cranio-pharyngo-mandibular
      space is characterised by the cellulo-adipose tissue by which it is filled and
      which guides the diffusion of injected solutions to the oval foramen.

PMID- 1638063
TI  - Variations of the blood supply of the human conus arteriosus.
AB  - The conus arteriosus was divided into right and left halves and each half was
      subdivided into 3 portions: superior, middle and inferior. The study of the blood
      supply of the conus was performed in 8O human hearts. The results showed that the
      sternocostal wall of the conus arteriosus may be supplied by the arteria coni
      arteriosi but, more frequently by branches of the right and left coronary
      arteries. The most frequent branches supplying the conus arteriosus were the
      ramus anterior ventriculi dextri medialis and lateralis (85%), ramus coni
      arteriosi dexter (51.2%), ramus anterior ventriculi dextri medius I (47.5%),
      ramus anterior ventriculi dextri intermedius (41.2%), ramus coni arteriosi
      sinister (40%) and ramus anterior ventriculi dextri superior I (38.7%).

PMID- 1638064
TI  - Research support supports research support.

PMID- 1638065
TI  - Expression of adhesion molecules in early allergic patch test reactions.
AB  - In order to study the relevance of intercellular adhesion molecule 1 (ICAM-1),
      vascular cell adhesion molecule 1 (VCAM-1) and endothelial leukocyte adhesion
      molecule 1 (ELAM-1) for lymphocyte extravasation in the early phase of allergic
      contact dermatitis, the time courses of lymphocyte infiltration and adhesion
      molecule expression during initiation of this disorder were determined.
      Sequential biopsies of positive allergic patch test reactions were obtained 4, 8,
      16 and 24 h after antigen application, cryostat sectioned and stained with
      monoclonal antibodies for ICAM-1, VCAM-1, ELAM-1 and lymphocytes by use of an
      immunoperoxidase technique. The slides were evaluated semiquantitatively
      according to appropriate gradation scales that had been defined separately for
      the staining with each antibody. Our results show that there is a significant
      upregulation of VCAM-1 and ELAM-1 expression within the first 8 h after antigen
      application, when lymphocyte extravasation is just beginning. In contrast, ICAM-1
      is already expressed in higher levels in normal skin and is hardly enhanced
      during the first 8 h of patch test reactions. The main influx of lymphocytes
      occurs 16-24 h after antigen application and is accompanied by a further increase
      in all three adhesion molecules. We conclude that VCAM-1 and ELAM-1 rather than
      ICAM-1 may be of particular importance for the start phase of allergic contact
      dermatitis and that all three of them contribute to an amplification of this
      inflammation.

PMID- 1638066
TI  - Sterile transient neonatal pustulosis is a precocious form of erythema toxicum
      neonatorum.
AB  - A sterile pustular skin eruption was observed in 17 of 3,541 newborn infants
      examined over a period of 30 months. The skin eruption was always present at
      birth and fulfilled the clinical criteria of transient neonatal pustular
      melanosis (TNPM). However, some days after birth, all of them but 1 developed
      skin lesions typical of erythema toxicum neonatorum (ETN). Histological
      examination of 11 biopsies obtained at the age of 1 day showed intracorneal
      neutrophilic pustules in 4 and subcorneal intraepidermic eosinophilic pustules in
      7. On the basis of our findings and a literature review we consider that a clear
      cut differentiation between TNPM and ETN is not always possible. We propose the
      name sterile transient neonatal pustulosis to unify these conditions.

PMID- 1638067
TI  - Rapid diagnosis of Chlamydia trachomatis in male patients by antigen detection in
      urine samples.
AB  - To investigate the diagnostic value of testing urine samples as a rapid method
      for the detection of chlamydial antigen in males, first-catch urine (FCU) and
      urethral swab samples were obtained from 668 male patients and examined by an
      enzyme immunosorbent assay (EIA). Positive results were further analyzed by
      direct fluorescence antibody tests of the EIA sediment. Antigen detection was
      possible in 12.7% out of the urethra, in 10.8% out of FCU and in a total of 14.5%
      of the tested persons. Testing only FCU would have missed chlamydia detection in
      25 (25.8%) out of a total of 97 chlamydia-positive males. Testing only genital
      samples would have missed 12 positive cases (12.4%). The sensitivity and
      specificity of the EIA test of FCU as compared with urethral swabs were 70.6 and
      97.9%, respectively, and differed between urine collected before (sensitivity:
      84%; specificity: 98.6%) and after (sensitivity: 65%; specificity: 97.7%; p =
      0.1254) urethral sampling. The quantitative evaluation of the EIA results
      demonstrates that the mean value of the extinction rates was highest in specimens
      corresponding to a positive result from both sampling sites. This study indicates
      that the chlamydial detection rate was lower in FCU than in urethral samples. FCU
      testing may be suitable when urethral sampling is not possible; due to its high
      rate of unconfirmed borderline extinction, positive results should be confirmed
      with another chlamydial antigen detection test such as direct immunofluorescence.

PMID- 1638068
TI  - Desmoplastic melanoma: clinicopathologic aspects of six cases.
AB  - We report 6 cases of desmoplastic melanoma. Upon removal and histologic
      examination, each lesion consisted of a dermal nodule of fascicles of spindle
      cells, many of which showed pleomorphic and hyperchromatic nuclei. Fascicles, as
      well as single cells, were seen infiltrating the dermal collagen. Lentiginous
      hyperplasia of melanocytes with varying but usually slight cellular atypia
      overlay the dermal proliferations in all cases. Melanophages and some pigmented
      cells, albeit few in number, were present in the infiltrate, whereas mitotic
      figures were also noted. These features are most consistent with desmoplastic
      melanoma, a rare tumor of which a limited number of cases has been described. The
      clinical and histopathologic features of the lesions presented exemplify the
      diagnostic and therapeutic dilemma associated with desmoplastic melanoma.

PMID- 1638069
TI  - Microscopic evaluation of the dansyl chloride test.
AB  - The classical dansyl chloride test relies on visual assessment of the extinction
      of fluorescence in time. We introduce a microscopic and morphometric rating of
      this test. We show that soaps may remove the fluorescing dye from corneocytes.
      Therefore caution should be taken in interpreting fluorescence extinction only as
      an estimate of the stratum corneum renewal.

PMID- 1638070
TI  - Steroid-induced dermal thinning: discontinuous application of clobetasol-17
      propionate ointment.
AB  - The skin thinning effect of discontinuous topical clobetasol-17-propionate
      applications was tested in human volunteers. Application frequencies were daily
      (1/0), every third day (1/2), every fifth day (1/4), every seventh day (1/6) and
      every ninth day (1/8). Clobetasol-17-propionate was administered topically under
      occlusion for 1 h. The treatment period was 41 days. There were no differences of
      the skin thinning effect of daily and 1/2 administration. The skin thinning
      effect of 1/4, 1/6 and 1/8 was smaller but also significant compared to controls.
      The curves demonstrating skin thinning effects initially were dropping off and
      reached a plateau within about 2 weeks. After finishing application, skin
      thickness normalized within 2 weeks. Because of these findings, a treatment
      interval of 3 days is discussed as therapeutically efficient.

PMID- 1638071
TI  - Malignant melanoma in 20-MHz B scan sonography.
AB  - In order to assess the value of 20-MHz sonography in the pre-operative diagnosis
      of malignant melanomas, 54 melanomas were examined. The pre-operative ultrasound
      scans were compared with corresponding histological sections from the excised
      tumours. A computer-aided measurement of the tumour thickness (sonometry) and the
      internal echo density (densitometry) was performed in the ultrasound scans. The
      melanomas appeared as largely echolucent zones. There was a significant
      correlation between the tumour thickness measured in the ultrasound scan and
      those measured in the histological sections (r = 0.938, p less than 0.001). As a
      rule the tumour thickness determined by sonometry were greater than the
      histometrically determined values. Subtumoral inflammatory infiltrate and other
      hypo-echoic structures in the region of the tumour are possible causes of the
      discrepancies. Some of those hypo-echoic structures can be identified and
      disregarded in B scan measurement. Even if a definite differential diagnosis is
      not possible on the basis of the ultrasound scan alone, 20-MHz sonography
      provides additional information which can be of use in surgical planning.

PMID- 1638072
TI  - Familial supernumerary nipples and breasts.
AB  - We report 3 cases of supernumerary breasts in the same family. The presence of
      glandular tissue (polymastia) was demonstrated by ultrasound examination. No
      associated kidney lesions were found.

PMID- 1638073
TI  - Bilateral segmental neurofibromatosis.
AB  - Neurofibromatosis (NF) is a heterogeneous disorder clinically characterized by
      the presence of neurofibromas, multiple cafe au lait spots, intertriginous
      freckles and Lisch nodules. We describe an unusual case of NF with cutaneous
      neurofibromas localized on the anterior chest, in a bilateral dermatomal
      distribution. No other signs were detected. The family history was negative for
      NF. The different subsets of NF are briefly discussed, with particular emphasis
      on the segmental type.

PMID- 1638074
TI  - Cutaneous lymphadenoma: report of 2 cases.
AB  - Cutaneous lymphadenoma is a recently described tumor with a distinctive
      histological picture associating a basaloid epithelial proliferation and
      intraepithelial lymphocytes; it seems to represent a benign adnexal neoplasm of
      uncertain histogenesis. We documented 2 additional examples of cutaneous
      lymphadenoma with typical histological features; the contiguity of some tumor
      lobules with preexisting follicular structures was noted. In 1 case, a cutaneous
      osteoma was present below the tumor. On immunostainings, S-100 protein revealed
      numerous dendritic intraepithelial and stromal cells. The basaloid proliferation
      was positive for broad-spectrum keratin antibodies, but negative for KL1
      antibody. In addition, several areas were positive for involucrin within tumor
      lobules. Our findings are consistent with a pilosebaceous origin of cutaneous
      lymphadenoma.

PMID- 1638075
TI  - Menkes' disease: report of a case and determination of eumelanin and pheomelanin
      in hypopigmented hair.
AB  - We report a male infant with Menkes' disease who showed, at the age of 3 months,
      slow growth, hair abnormalities such as pili torti and white hair, and low levels
      of serum copper and ceruloplasmin. The exceptionally bright portions of his hair
      contained eumelanin and pheomelanin at levels only half those of normal Japanese
      controls. After subcutaneous administration of copper-histidinate for 2 months,
      his scalp hair changed to dark brown.

PMID- 1638077
TI  - May calcitonin spray cause nasal deformation?

PMID- 1638076
TI  - Evidence for CD8+ cell increase in long-term PUVA-treated psoriatic patients
      after PUVA discontinuation.
AB  - Long-term PUVA-treated psoriatic patients given maintenance therapy (UVA doses
      greater than 1,000 J/cm2) have been demonstrated to undergo lymphopenia and a
      decrease in the total number of circulating CD3+ and CD4+ T cells. The aim of
      this study was to assess whether the impairment of T cells is detectable also in
      psoriatic patients after long-lasting PUVA discontinuation. A group of 34
      psoriatic patients (25 males, 9 females; mean age 52.7 +/- 12.82 years), who had
      previously been treated by PUVA therapy (average cumulative dose 1,898.48 +/-
      1,207.12 J/cm2), was studied 1 year or more after discontinuation of PUVA
      therapy. The patients studied failed to show any impairment in CD3+ and CD4+
      cells. Nevertheless, a significant increase (p less than 0.05) in circulating
      CD8+ cells (both in the percentage and the total number) was detectable in PUVA
      patients as compared to appropriate controls. The significance and implications
      of this finding are not known and need further investigations.

PMID- 1638078
TI  - Systemic reaction during a dansyl chloride test.

PMID- 1638079
TI  - Bullous and erosive stomatitis induced by nimesulide.

PMID- 1638080
TI  - A probable mechanism for hyperpigmentation by fotemustine.

PMID- 1638081
TI  - Survival in pemphigus.

PMID- 1638082
TI  - Unresponsiveness to etretinate during anticonvulsant therapy.

PMID- 1638083
TI  - Skin cancers and HLA frequencies in renal transplant recipients.
AB  - An association between HLA DR7 and the development of multiple non-melanoma skin
      cancer was detected in immunosuppressed patients in southern Australia. The
      relative risk was 2.6 which was lower than for immunocompetent patients with the
      same skin cancers. HLA frequencies of renal transplant recipients with multiple
      skin cancers were determined. The types HLA B27 and HLA Dr7 were found in
      significantly higher frequency, and there was no absence of HLA A11.

PMID- 1638084
TI  - Confirmation of the influence of a chromosome 7 locus on susceptibility to
      audiogenic seizures.
AB  - Mouse strain differences in susceptibility to audiogenic seizures (AGS) are due
      to allelic differences at multiple genetic loci. Three loci that influence
      susceptibility to AGS have been mapped on Chromosomes (Chr) 12, 4, and 7 (Asp-1,
      Asp-2, and Asp-3, respectively). Here we report evidence that confirms linkage of
      Asp-3 to c on Chr 7 and parental effects on AGS susceptibility, but not genomic
      imprinting of Asp-3.

PMID- 1638085
TI  - Characterization of murine carcinoembryonic antigen gene family members.
AB  - The carcinoembryonic antigen (CEA) is a human tumor marker whose gene belongs to
      a family with more than 20 members. This gene family codes for a group of
      proteins with in vitro cell adhesion properties and for a group of abundantly
      expressed pregnancy-specific glycoproteins (PSG) with unknown functions. As a
      basis for in vivo functional studies, we have started to analyze the murine CEA
      gene family and have identified five new members (Cea-2 to Cea-6). cDNA clones
      were isolated for Cea-2, Cea-3, and Cea-6. The deduced amino acid sequences of
      Cea-2 and Cea-6 indicate three IgV-like (N), followed by one IgC-like (A) domain
      (N1-N2-N3-A). We have also partially characterized the Cea-2 gene and two
      additional ones, Cea-4 and Cea-5. Cea-2 and Cea-4 are separated by only 16 kb,
      suggesting a close linkage of murine CEA-related genes, as found for the human
      CEA gene family. Cea-5 was located to the proximal region of mouse Chromosome
      (Chr) 7, which is syntenic to part of human Chr 19, containing the human CEA gene
      family cluster. Cea-2, Cea-3, and a Cea-4-like gene are differentially
      transcribed in the placenta during pregnancy, but not in other organs tested.
      This expression pattern strongly suggests that they represent counterparts of the
      human PSG subgroup members, despite the presence of multiple IgV-like domains, a
      feature not found for human PSGs. The more distantly related Cea-5 seems to be
      ubiquitously expressed. The putative promoter region of Cea-2 lacks typical TATA-
      or CAAT-boxes, but contains other conserved motifs that could play a role in the
      initiation of transcription.

PMID- 1638086
TI  - The mouse male germ cell-specific gene Tpx-1: molecular structure, mode of
      expression in spermatogenesis, and sequence similarity to two non-mammalian
      genes.
AB  - Tpx-1 is a testis-specific gene that maps on mouse Chromosome (Chr) 17. The
      deduced TPX-1 protein shows 55% amino acid sequence similarity to acidic
      epididymal glycoprotein (AEG), assumed to be involved in sperm maturation. In the
      present study, we determined the genomic structure of the mouse Tpx-1 gene and
      the cellular localization of its transcripts. The gene was found to contain ten
      exons, with an unusually large intron (approximately 17.0 kilobase pairs) between
      exons 8 and 9. In situ hybridization of testicular sections showed that Tpx-1 is
      transcribed abundantly by haploid male germ cells. A computer search of protein
      databases revealed that deduced TPX-1/AEG proteins have significant sequence
      similarity (approximately 30%) to two non-mammalian proteins: "pathogenesis
      related" proteins 1 of tobaccos, and venom sac proteins of white-face hornets,
      known as Dol m V. Amino acid residues encoded by exon 10 of the Tpx-1 gene and
      most of those encoded by exon 9 were absent in the non-mammalian proteins. This
      result suggests that the ancestor of Tpx-1 acquired exons 9 and 10 after its
      divergence from the ancestors of the plant and insect proteins.

PMID- 1638087
TI  - Cross-species conservation of a polymorphic dinucleotide repeat in the dystrophin
      gene.

PMID- 1638088
TI  - Brain beta spectrin isoform 235 (Spnb-2) maps to mouse chromosome 11.

PMID- 1638089
TI  - A novel polymorphism near the mouse Int-2 locus.

PMID- 1638090
TI  - Peroxyoxalate chemiluminescence detection of condensates of malondialdehyde with
      thiobarbituric acids using a flow system.
AB  - The peroxyoxalate chemiluminescence(CL) detection method for the evaluation of
      the CL intensity of malondialdehyde(MDA) condensates with seven 2-thiobarbituric
      acid derivatives is described. The method consists of a flow injection technique
      together with a CL detection system using bis(2,4,6-trichlorophenyl)
      oxalate(TCPO) and hydrogen peroxide as chemiluminogenic reagents. Linear
      correlations between CL intensity and concentration are obtained for pmol levels
      of condensates. Among the condensates, 1,3-diethyl-2-thiobarbituric acid(DETBA)
      MDA shows the largest CL intensity. High performance liquid chromatography
      (HPLC)/CL detection of DETBA-MDA and 1,3-diphenyl-2-thiobarbituric acid(DPTBA)
      MDA using a mixture of TCPO and hydrogen peroxide in acetonitrile as a postcolumn
      reagent solution is also described. The detection limits for DETBA-MDA and DPTBA
      MDA are 20 and 200 fmol, respectively, per 20 microL injection at a signal-to
      noise ratio of 2. This HPLC/CL detection system was applied to the determination
      of MDA in rat brains by using DETBA as a fluorescent derivatizing reagent.

PMID- 1638091
TI  - High performance liquid chromatographic determination of 1,5-anhydroglucitol in
      human plasma for diagnosis of diabetes mellitus.
AB  - This paper describes a high performance liquid chromatographic (HPLC) method for
      determining 1,5-anhydroglucitol in plasma, in which anion exchange chromatography
      and pulsed amperometric detection are used. Plasma samples deproteinized with
      trichloroacetic acid are passed through a three-layer column packed with (1)
      strongly basic anion (BO3(3-) form, the upper layer), (2) strongly basic anion
      (OH- form, the middle layer) and (3) strongly acidic cation (H+ form, the lower
      layer) exchange resins. 1,5-Anhydroglucitol is efficiently recovered in the flow
      through fraction and interfering substances are completely removed by the column
      treatment. The analytical response of the method is linear with concentration to
      40 mg/L, and it is possible to detect as little as 0.1 mg 1,5-anhydroglucitol per
      litre of plasma. Analytical recovery is between 96 and 103%, and there is good
      agreement between the results measured by our method and by a gas/liquid
      chromatographic method (r = 0.998). The method has been successfully used for the
      determination of very low 1,5-anhydroglucitol concentrations (less than 1 mg/L)
      in the plasma of diabetic patients.

PMID- 1638092
TI  - Combined application of analytical high performance thin layer chromatography and
      electroblotting for the detection of anti-ganglioside antibodies in human sera.
AB  - Antibodies against gangliosides isolated from small tumour and nervous tissue
      specimens can be reliably detected in serum samples by the ganglioside
      electrotransfer technique without the need for previous purification steps. After
      separation by high performance thin layer chromatography gangliosides are
      transferred from silica gel plates to hydrophobic polyvinylidene difluoride
      membranes. These membranes are highly suitable for immunostaining. The use of a
      15-slit device allows simultaneous testing of up to 15 serum samples. Samples of
      serum from 39 patients with clear-cell carcinoma of the kidney, mammary
      carcinoma, ovarian carcinoma and neurological disorders together with samples
      from healthy controls were tested for anti-ganglioside antibodies from various
      tissues.

PMID- 1638093
TI  - Phosphotungstate as a useful eluent for hepatitis-B virus surface antigen
      purification by heparin-sepharose affinity chromatography.
AB  - On the basis of the heparin-like effect of phosphotungstate (PTA), we have shown
      that it is useful for the purification of hepatitis-B virus surface antigen
      (HBsAg) using heparin-Sepharose affinity chromatography. HBsAg was eluted with
      0.2-0.6 M NaCl. HBsAg was also eluted with PTA at approximately 1 mM, and the
      HBsAg fraction thus obtained contained fewer impurities than the corresponding
      fraction eluted with NaCl. Moreover, PTA yielded HBsAg and hepatitis-B virus e
      antigen simultaneously. PTA may specifically reduce the affinity of HBsAg for
      heparin as well as simply competing with heparin for an anion-binding site of
      HBsAg. Residual PTA in the eluate was easily decomposed by alkalization, which
      was useful for subsequent studies.

PMID- 1638094
TI  - The combination of normal phase with reversed phase high performance liquid
      chromatography for the analysis of asparagine-linked neutral oligosaccharides
      labelled with p-aminobenzoic ethyl ester.
AB  - We have developed a novel approach for the analysis of asparagine-linked neutral
      oligosaccharides derived from glycoproteins. The oligosaccharides are labelled
      with p-aminobenzoic ethyl ester and the derivatives are separated on two high
      performance liquid chromatographic columns, one containing amide-silica and the
      other containing octadecyl-silica. The elution positions of 39 different ABEE
      oligosaccharides on the two columns were plotted on a two-dimensional map. Unique
      non-overlapping positions of these oligosaccharides demonstrate that this
      technology would be useful for the identification of Asn-linked oligosaccharides
      at high sensitivity.

PMID- 1638095
TI  - A universal peroxyoxalate-chemiluminescence detection system for mobile phases of
      differing pH.
AB  - A universal peroxyoxalate-chemiluminescence detection system for high performance
      liquid chromatography, available for a variety of mobile phases, has been
      developed. The system consisted of a dual-head short-stroke pump and a
      chemiluminescence detector. The standard conditions using bis(2,4,6
      trichlorophenyl) oxalate (TCPO) as aryl oxalate were as follows. The first
      postcolumn solution was the mixture of 0.5 M imidazole-nitric acid (pH 7.5) and
      acetonitrile (1:4, v/v). The second was acetonitrile containing TCPO-hydrogen
      peroxide. These two solutions were delivered by the two pump-heads. After the pH
      of the column eluate was adjusted to the optimum range (6.5-7.5) by the first
      postcolumn solution, the solution was mixed with the second postcolumn solution.
      After flowing through a reaction coil, the chemiluminescence of the mixture was
      monitored. Using this system, a high sensitivity (fmol level) was obtained for
      perylene as an analyte with mobile phases having different pH values (2.0-8.0).
      Polycyclic aromatic hydrocarbons became detectable to a high sensitivity even
      after the column separation using an acidic mobile phase. The detection
      sensitivity of nitrated pyrenes after on-line electrochemical reduction using an
      acidic mobile phase was also increased. This system might be available for other
      aryl oxalates by some modifications of the postcolumn solutions.

PMID- 1638096
TI  - Determination of panaxadiol and panaxatriol in ginseng and its preparations by
      capillary supercritical fluid chromatography (SFC).
AB  - Capillary supercritical fluid chromatographic (SFC) method has been developed for
      the determination of panaxadiol and panaxatriol in ginseng and its preparations.
      0.1 g ginseng or an appropriate amount of its preparations was hydrolysed by 15%
      H2SO4 in an ethanol:water (1:1 v/v) solution for 4 h followed by 15% NaOH for 0.5
      h. The mixture was extracted by cyclohexane. The cyclohexane extracts were
      purified by a partition column and concentrated by an adsorption column and then
      analysed by SFC. Methyltestosterone was used as the internal standard.

PMID- 1638097
TI  - Simultaneous determination of paraquat and diquat in serum using capillary
      electrophoresis.
AB  - The use of capillary electrophoresis for simultaneous separation and detection of
      the two bipyridylium herbicides, paraquat and diquat, was investigated. Both
      herbicides were extracted from fortified sera with disposable ODS-silica
      cartridges. Separation was carried out using a capillary tube (50 microns i.d.,
      750 mm) of fused silica containing 10 mM glycine-HCl buffer (pH 3.0), 40 mM NaCl
      and 20% methanol as the carrier. Paraquat and diquat were completely separated in
      10 min at an applied potential of 20 kV. On-column UV monitoring allowed
      detection of both herbicides simultaneously. The assay sensitivity was 0.05
      micrograms/mL (signal-to-noise ratio, 2:1), which probably increases with
      increase in the sample volume of serum. Analytical recovery of both herbicides
      added to serum was about 97% at concentrations of 0.5-2.0 micrograms/mL.

PMID- 1638098
TI  - Membrane affinity chromatography used for the separation of trypsin inhibitor.
AB  - Polysulphone (PS) was chemically modified by acrylation-amination and by
      chloromethylation-amination, respectively. An ultrafiltration membrane of
      chemically modified polysulphone (CMPS) was prepared by the phase inversion
      method. Trypsin was then covalently bonded onto the CMPS membrane by
      diazotization. The activity of immobilized trypsin reaches up to 10200 U/g; 15 mg
      trypsin was immobilized on 1 g CMPS membrane. Separation of soybean trypsin
      inhibitor was carried out on the affinity membrane, yielding 6.5 mg pure trypsin
      inhibitor in one run. The enzyme membrane has good activity and stability.

PMID- 1638099
TI  - Rapid chiral separation of metoprolol in plasma--application to the
      pharmacokinetics/pharmacodynamics of metoprolol enantiomers in the conscious
      goat.
AB  - The plasma concentrations of metoprolol enantiomers have been determined by means
      of a direct phenyl carbamate-cellulose-based chiral high performance liquid
      chromatography assay using fluorimetric detection. This assay has been used to
      investigate the pharmacokinetics and pharmacodynamics of metoprolol enantiomers
      in the conscious goat. There is evidence that the pharmacokinetics of metoprolol
      in the goat occurs stereoselectively and that enantiomer-enantiomer
      pharmacokinetic interactions occur. R-Metoprolol is less effective in reducing
      the mean arterial blood pressure than S- and R/S-metoprolol.

PMID- 1638100
TI  - Pupillary responses and blink reflex in myotonic dystrophy.
AB  - We have studied pupillary responses to parasympathetic and sympathomimetic
      agents, pupillary cycle time and the electrophysiology of the blink reflex in 18
      patients with myotonic dystrophy. The response of the iris to dilute pilocarpine
      and phenylephrine did not indicate pharmacologic supersensitivity. Pupillary
      cycle time was prolonged in nine of the 18 patients. Ipsilateral R1 blink reflex
      latencies were normal in all cases, and bilateral R2 were normal in 16 of the 18
      patients. These results do not support either autonomic or brainstem dysfunction
      in the majority of patients with myotonic dystrophy. In 50% of the patients the
      results are compatible with smooth muscle involvement of the iris.

PMID- 1638101
TI  - Positive pressure on neck reduces baroreflex response to apnoea.
AB  - This study was designed to evaluate the arterial blood pressure and heart rate
      responses to positive pressure applied to the neck during repetitive inspiratory
      apnoea. Twenty-five subjects (aged 20-40 years) were trained to exert a positive
      pressure on the neck by actively contracting the neck muscles and pressing the
      chin in the jugular notch. Blood pressure and heart rate were evaluated during 5
      min long periods at rest, at the beginning and end of a 25-min period of apnoea
      with and without positive pressure and after a second period of rest. Positive
      pressure diminished the initial hypotensive and bradycardiac reactions to apnoea
      and augmented the heart rate and blood pressure increase towards the end of
      apnoea. Both systolic and diastolic pressures and heart rate were significantly
      elevated during both apnoeic sequences, and also remained significantly elevated
      after the release of pressure. Spectral analysis (FFT) and auto-regressive model
      showed the entrainment of the slow 0.03 Hz oscillations by repetitive apnoea and
      the occurrence of 0.1 Hz and respiratory 0.2 Hz components in the heart rate and
      blood pressure in both types of apnoea. It is suggested, since the positive
      pressure decreases the baroreflex and the increased sympathetic tone persists
      after apnoea, that such effects may contribute to the development of cardiac
      complications in prediposed individuals with obstructive apnoea syndrome.

PMID- 1638102
TI  - In vivo studies on receptor pharmacology of the human eccrine sweat gland.
AB  - The receptor pharmacology of the human sweat gland was studied in vivo. The axon
      reflex response was mediated by nicotinic receptors which were activated by
      nicotine and acetylcholine, but not pilocarpine, and inhibited by hexamethonium.
      The direct response was mainly muscarinic, responding to pilocarpine and
      acetylcholine. A component of the direct response was nicotinic, since it was
      activated by nicotine and blocked by hexamethonium in a dose-dependent manner.
      The axon-reflex response to nicotine and acetylcholine was partially blocked by
      pilocarpine, especially when application of pilocarpine preceded the procedure.
      The inhibition of the nicotinic response may be secondary to M1 antagonism since
      pilocarpine is an M2 agonist and M1 antagonist and pirenzepine, a specific M1
      antagonist, caused similar effects as pilocarpine.

PMID- 1638103
TI  - Heart rate responses to deep breathing and 4-seconds of exercise before and after
      pharmacological blockade with atropine and propranolol.
AB  - Two autonomic tests which evaluate cardiac vagal activity, the respiratory sinus
      arrhythmia and the newer 4-second exercise test, have been compared. From
      electrocardiograph tracings, respiratory sinus arrhythmia was quantified by the
      ratio between the longest R-R interval during expiration and the shortest one
      during inspiration (E/I ratio), and the 4-second exercise test by the ratio
      between the last R-R interval before and the shortest one during exercise (B/C
      ratio). In 29 healthy subjects there was a correlation (R = 0.60, p less than
      0.05) between the responses to the two tests. In a group of six healthy subjects
      the same tests were performed after autonomic blockade with intravenous atropine
      and/or propranolol. The heart rate rise during the 4-second exercise test was
      nearly abolished by atropine (mean +/- SD) (B/C: control = 1.53/0.33; after
      atropine = 1.04/0.03), whereas RSA was diminished to a lesser extent (E/I:
      control = 1.59/0.24; after atropine = 1.13/0.07). beta-adrenoceptor blockade did
      not affect the test ratios (after propranolol: B/C = 1.51/0.33 and E/I =
      1.45/0.14). Successive tests during the following hour after atropine infusion
      showed a somewhat faster recovery of the respiratory sinus arrhythmia than the
      heart rate acceleration induced by the 4-second exercise test (p less than 0.05).
      We conclude that there may be some difference in the mechanisms which contribute
      to the heart rate changes in these two autonomic cardiovascular tests; these
      remain to be clarified. The 4-second exercise test may be an alternative to the
      respiratory sinus arrhythmia test in the non-invasive evaluation of cardiac
      parasympathetic activity.

PMID- 1638104
TI  - Autonomic involvement in inherited neuropathies.
AB  - The inherited peripheral neuropathies constitute a large group of disorders, in
      some of which the causative metabolic defect has been identified whereas in the
      majority it is still unknown. Amongst the former, autonomic involvement is an
      important component in porphyric neuropathy, in the familial amyloid
      polyneuropathies, in Fabry's disease and in dopamine beta-hydroxylase deficiency.
      The latter group includes the hereditary sensory and autonomic neuropathies in
      some of which, such as the Riley-Day syndrome, autonomic disturbances are
      prominent, whereas in others they constitute only a minor component of the
      symptomatology. Autonomic dysfunction is an important component of the
      neurological manifestations in multiple endocrine neoplasia type IIB.

PMID- 1638105
TI  - Spectral analysis of heart rate variability in bronchial asthma.
AB  - Sympathetic and parasympathetic activity was evaluated in ten healthy controls,
      nine asymptomatic, untreated asthmatic subjects and ten asthmatic patients during
      treatment for acute asthma, by measurement of the variation in resting heart rate
      using frequency spectrum analysis. Heart rate was recorded by ECG and respiratory
      rate by impedance plethysmography. Spectral density of the beat-to-beat heart
      rate was measured within the low frequency band 0.04 to 0.10 Hz (low frequency
      power) modulated by sympathetic and parasympathetic activity, and within a 0.12
      Hz band width at the respiratory frequency mode (respiratory frequency power)
      modulated by parasympathetic activity. Acute asthmatics had higher heart rates
      than either of the other two groups; this was probably related to the effects of
      beta-adrenoceptor agonist medication. Sympathetically mediated heart rate
      variability (normalized low frequency power) was significantly lower in both
      asymptomatic (p less than 0.002) and acute (p less than 0.02) asthma subjects
      compared to controls. This is consistent with altered sympathetic/parasympathetic
      regulation of heart rate in subjects with bronchial asthma.

PMID- 1638106
TI  - Redistribution of blood flow in the cerebral cortex of normal subjects during
      head-up postural change.
AB  - Regional cerebral blood flow was measured in 21 normotensive subjects during
      supine rest and during head-up tilt to 70 degrees. The results showed significant
      and consistent regional cerebral blood flow changes in the frontal areas with
      lower relative flow distribution values (percentage of mean flow) during head-up
      tilt than during supine rest. The lower frontal flow distribution values during
      tilt were not related to habituation, to repeated measurements, or to the
      estimated level of arterial CO2 which was derived from expired end-tidal CO2
      levels. None of the subjects had orthostatic hypotension and there was no
      significant difference in mean hemispheric blood flow between lying down and
      standing up. There was no significant gender difference in regional cerebral
      blood flow, although female subjects tended to have higher mean hemispheric flow
      than males in both postures. It remains to be established whether the flow
      decreases in the frontal cortex are caused by cerebral functional factors or by
      haemodynamic mechanisms.

PMID- 1638107
TI  - Cardiovascular instability during sleep and calm waking state in normal man.
AB  - Stroke volume, blood pressure, heart rate and blood flow in the calf and forearm
      were sampled every 20 min during the night sleep in eleven normal subjects.
      Stroke volume was measured by an impedance method with the use of a Minnesota
      cardiograph, and blood flow with venous occlusion plethysmography. The
      electroencephalogram was monitored routinely. Large variations in all sampled
      cardiovascular parameters were observed in all subjects. These variations were
      not interrelated nor were they correlated with any sleep stages. Variability in
      stroke volume ranged from 23% to 174%. Variability in vascular conductance in the
      calf was from 26% to 898%, in the forearm it was from 12% to 805%, in systolic
      blood pressure from 62% to 132%, diastolic blood pressure from 50% to 141% and in
      heart rate from 53% to 152%. In eight subjects sampling of cardiovascular
      parameters was carried out during the day, in a quiet but waking state. All
      sampled parameters varied, although during the day variations were smaller. It
      was therefore concluded that in normal man the cardiovascular system is in a
      state of perpetual oscillation during sleep or waking state until a specific
      pattern of adjustment is commanded by the central neurones.

PMID- 1638108
TI  - The autonomic nervous system and cardiac arrhythmias.
AB  - Disturbed autonomic nervous 'balance' of the sympathetic nervous and vagal
      outflows to the heart potentiates the experimental development of ventricular
      arrhythmias in laboratory animals. For some time the best evidence for the
      occurrence of a similar phenomenon in humans was provided by the long QT interval
      syndrome, sufferers of which are very prone to develop serious ventricular
      arrhythmias and in whom evidence exists of abnormal anatomy and function of the
      cardiac sympathetic nerves. Recently the case for disturbed autonomic function
      causing clinical arrhythmias has become more broadly based. Reduced baroreflex
      sensitivity after myocardial infarction, and low heart rate variability, both of
      which rest largely on vagal underactivity, have been shown to be associated with
      substantially increased risk of subsequent sudden death. A second observation is
      that patients having recovered from unexpected ventricular tachycardia or
      ventricular fibrillation have markedly increased cardiac sympathetic activity
      compared with appropriate reference groups, based on measurements of the rate of
      spillover of the sympathetic neurotransmitter, noradrenaline, from the heart to
      plasma. These clinical findings support a role for cardiac autonomic dysfunction,
      specifically sympathetic activation and vagal withdrawal, in arrhythmogenesis.
      These observations are timely, given the recent demonstration that most
      conventional anti-arrythmics are of little benefit in preventing sudden death. A
      reappraisal of the anti-arrhythmic activity of beta-adrenergic blocking drugs,
      and evaluation of potential benefits of other pharmacological and non
      pharmacological means of favourably altering cardiac autonomic function is now
      needed.

PMID- 1638109
TI  - Functional assessment of the sympathetic innervation of the microcirculation of
      the lower urinary tract: a preliminary report.
AB  - This paper presents preliminary data on a new method for testing the sympathetic
      innervation of the urothelium. A flexible laser Doppler probe was introduced into
      the urethra of two females and two male subjects. The percentage fall in laser
      Doppler flux following generalized sympathetic stimulation by taking an
      inspiratory gasp was measured. This resulted in 36%, 32%, 68% and 34% mean drop
      in urothelial blood flux. In the female subjects, the probe was advanced into the
      bladder and the procedure repeated, and the gasp resulted in 60% and 83% drop in
      flux. With laser Doppler fluxmetry, fall in microcirculatory blood flow
      associated with a generalized increase in sympathetic tone, therefore can be
      demonstrated. This method may be useful in the assessment of the integrity of the
      sympathetic innervation of the urothelium in patients with suspected autonomic
      dysfunction of the genitourinary tract.

PMID- 1638110
TI  - Influence of post-exercise activity on plasma catecholamines, blood pressure and
      heart rate in normal subjects.
AB  - The purpose of this study was to evaluate whether or not the type of activity
      performed during recovery might influence the magnitude of catecholamine outflow
      following exercise. Six active, male volunteers between 40-52 years recovered
      from strenuous treadmill exercise in three different ways; standing, supine rest
      and walking (2 mph, 0% grade). Measurements of noradrenaline (NA), adrenaline
      (A), heart rate and blood pressure were made at rest, peak exercise, and at 30 s
      intervals through 5-min of recovery. Peak exercise NA concentrations were
      approximately 1000% above those recorded as rest. Early recovery was marked by a
      continued increase in NA from peak exercise concentrations (4614 +/- 548 vs. 3264
      +/- 485 pg/ml) which did not return to peak exercise levels until approximately
      90 s of recovery. Adrenaline responses followed similar trends; however, the
      changes were not as sizable. Heart rate and diastolic blood pressure were
      significantly affected by the post-exercise condition; supine recovery produced
      significantly lower mean heart rates and mean diastolic blood pressures in
      comparison to standing or continued walking recovery conditions. Thus, these data
      indicate no specific recovery strategy will stem the rise in exercise-induced
      plasma catecholamines. Clinically, a strategy of continued walking, or better,
      supine recovery will best meet special clinical requirements, as well as limit
      the magnitude of the peak catecholamine increases.

PMID- 1638112
TI  - Gene expression and differentiation.

PMID- 1638111
TI  - Ambulatory blood pressure in patients with Parkinson's disease without and with
      orthostatic hypotension.
AB  - Non-invasive ambulatory recordings of blood pressure and heart rate were
      performed using a Spacelabs device during day and night periods in patients with
      Parkinson's disease with (n = 19) or without orthostatic hypotension (n = 19). In
      patients with orthostatic hypotension, the average systolic and diastolic blood
      pressure during the night (137 +/- 5/80 +/- 3 mmHg) was higher (p less than 0.05)
      than during the day period (121 +/- 3/76 +/- 2 mmHg). In patients without
      orthostatic hypotension, a decrease in blood pressure was recorded during the
      nocturnal period. In patients with orthostatic hypotension, the blood pressure
      variability was higher (p less than 0.05) during the day (systolic: 14.6 +/-
      1.3%; diastolic: 16.5 +/- 1.0%) than during the night (systolic: 9.1 +/- 0.8%;
      diastolic: 10.8 +/- 1.1%). The blood pressure load (percentage of values above
      140/90 mmHg) during the night was significantly higher than during the day for
      both systolic (41.2 +/- 8.1 vs. 19.6 +/- 4.7%) and diastolic blood pressure (24.9
      +/- 6.9 vs. 16.3 +/- 4.9%). There was a decrease in heart rate in both groups
      during the night. A fall of 25 mmHg or more in systolic blood pressure after
      meals occurred in ten patients with orthostatic hypotension and in one patient
      without orthostatic hypotension. These results indicate that orthostatic
      hypotension in Parkinson's disease is associated with specific modifications of
      ambulatory blood pressure including loss of circadian rhythm of blood pressure,
      increased diurnal blood pressure variability and post-prandial hypotension.

PMID- 1638113
TI  - Gene expression and differentiation.

PMID- 1638114
TI  - Structure of the leucine zipper.
AB  - In the basic-region leucine-zipper domain, flexible DNA-binding arms are
      juxtaposed by a two-stranded, parallel coiled-coil motif called the leucine
      zipper. Genetic, physical and structural studies of the leucine zipper identify
      interactions that help determine the stability and specificity of dimerization
      and DNA binding.

PMID- 1638115
TI  - The SRF and MCM1 transcription factors.
AB  - The mammalian transcription factor SRF (serum-response factor) and the related
      Saccharomyces cerevisiae transcription factor MCM1 are the prototypes of a new
      class of dimeric DNA-binding proteins. Their function is regulated in part by the
      interactions of their DNA-binding domains with accessory proteins. Recent work
      has advanced the functional characterization of the contributions of SRF and
      MCM1, and their accessory proteins to transcriptional activation.

PMID- 1638116
TI  - Myc and Max function as a nucleoprotein complex.
AB  - The Myc family of oncoproteins are thought to regulate proliferation and
      differentiation in a wide variety of cell types. Recent studies show that Myc
      proteins form sequence-specific DNA-binding complexes with Max, a new member of
      the helix-loop-helix leucine zipper protein class. The properties of the Myc-Max
      complex suggest a mechanism for Myc's function in both normal and neoplastic cell
      behavior.

PMID- 1638117
TI  - Eukaryotic coactivators associated with the TATA box binding protein.
AB  - Recent studies of regulated RNA polymerase II transcription have uncovered a new
      class of molecules called coactivators. These are tightly associated with the
      TATA box binding protein and are required in addition to promoter-specific
      activators and the basal transcription factors in order to achieve stimulated
      levels of transcription.

PMID- 1638118
TI  - Muscle basic helix-loop-helix proteins and the regulation of myogenesis.
AB  - Significant progress has been made in defining the structural motifs that
      distinguish the muscle-specific from other basic helix-loop-helix proteins.
      Evidence is accumulating for multiple levels of regulation of the expression and
      action of the muscle basic helix-loop-helix factors.

PMID- 1638120
TI  - Mechanisms of liver-specific gene expression.
AB  - Significant advances in the field of hepatocyte-specific gene expression have
      been made during the past year. Several new transcription factors have been
      cloned and partially characterized. Analyses of the promoter regions of several
      factors have also been initiated and Drosophila homologs for two of these factors
      have been found, opening the way for studies on development.

PMID- 1638119
TI  - Myb: a transcriptional activator linking proliferation and differentiation in
      hematopoietic cells.
AB  - Myb is a transcriptional activator protein with repeated helix-turn-helix DNA
      binding motifs distantly related to the homeodomain. In hematopoiesis, c-myb
      appears to control both cell proliferation and differentiation. The mechanisms by
      which the leukemogenic potential of c-Myb is activated are complex and involve
      truncations, point mutations, and fusion or coexpression with other proteins.

PMID- 1638121
TI  - Expression of spatially regulated genes in the sea urchin embryo.
AB  - Spatially controlled genes expressed in the early sea urchin embryo have been
      characterized, and the patterns of expression in terms of the mechanisms by which
      this embryo accomplishes its initial set of founder cell specifications are the
      subject of current discussion. Sea urchin transcription factors that have been
      cloned are classified with respect to their target sites and the genes they
      regulate. Among the best known of the sea urchin cis-regulatory systems is that
      controlling expression of the Cyllla gene, which encodes an aboral ectoderm
      specific cytoskeletal actin. The Cyllla regulatory domain includes approximately
      20 sites of DNA-protein interaction, serviced by about ten different factors.
      Certain of these factors are known to negatively control spatial expression,
      while others positively regulate temporal activation and the level of Cyllla gene
      expression. Differential, lineage-specific gene expression is instituted in the
      sea urchin embryo by mid-late cleavage, prior to any cell migration or overt
      differentiation, and shortly following lineage segregation.

PMID- 1638122
TI  - The Drosophila nuclear receptors: new insight into the actions of nuclear
      receptors in development.
AB  - In Drosophila melanogaster, an increasing number of members of the steroid
      hormone receptor superfamily are being identified and characterized. Molecular
      and genetic analysis of receptor function provides evidence for a set of
      functions underlying the determination of pattern formation, metamorphosis, eye
      development, and reproduction. Many of the Drosophila receptor genes show
      striking homologies to mammalian receptor genes. This suggests that genetic
      analysis in flies could facilitate the generation of biological models that
      pertain to complex hormonal responses in development and which are relevant to
      both vertebrate and invertebrate systems.

PMID- 1638123
TI  - Silencing: the establishment and inheritance of stable, repressed transcription
      states.
AB  - Silencing refers to a particular type of transcriptional repression characterized
      by the formation of a genetically heritable, repressed transcriptional state.
      Examples of silencing include position-effect variegation, X-chromosome
      inactivation, and the repression of the silent mating-type gene loci in yeast.
      Recent discoveries suggest that silencing in yeast, like silencing in larger
      eukaryotes, results from a particular chromatin structure that defines a
      chromosomal domain. In addition, a chromosomal origin of DNA replication is
      required for silencing in yeast, suggesting that DNA replication plays a role in
      forming functional chromosomal domains.

PMID- 1638124
TI  - Activation of HIV transcription by Tat.
AB  - Recent studies suggest that the human immunodeficiency virus transactivator, Tat,
      increases expression of viral genes primarily by enhancing the efficiency of
      transcriptional elongation. The degree to which Tat influences elongation may
      depend on the rate of transcriptional initiation. Current models in which Tat
      interacts with the transcription complex suggest directions for future studies.

PMID- 1638125
TI  - Sex differentiation: the role of alternative splicing.
AB  - Sex differentiation in Drosophila is controlled by a regulatory cascade with at
      least three regulated alternative RNA-processing events. The results of recent
      work have verified much of the earlier molecular and genetic work in this field
      and have provided a demonstration that both positive and negative regulatory
      mechanisms are involved.

PMID- 1638126
TI  - Gene expression and differentiation.

PMID- 1638127
TI  - Development.

PMID- 1638128
TI  - Control of photoreceptor development.
AB  - Recent studies of cell type determination in the vertebrate retina suggest that
      rod photoreceptor development involves interactions among cells that are
      mediated, at least in part, by temporally regulated diffusible signals. In this
      review the strategies used to generate rods in the vertebrate retina are compared
      with those described for photoreceptor development in the Drosophila retina.

PMID- 1638129
TI  - The control of neuronal identity in the developing cerebral cortex.
AB  - Recent studies of the lineages and developmental potential of cortical neurons
      show that cell fates are progressively restricted during cerebral cortical
      development. Cell lineage experiments suggest that individual cortical precursors
      are multipotent, as their progeny can end up in different cortical areas, and in
      different layers within an area. Transplantation studies have shown that young
      neurons are committed very early on to adopting a given laminar position, in a
      manner correlated with their birth date in the ventricular zone. Neurons in
      different neocortical areas, however, retain a functional and anatomical
      equipotentiality well into cortical development, suggesting that positional cues
      determine a cell's area-specific identity.

PMID- 1638130
TI  - Motor axon pathfinding.
AB  - Recent studies have provided a significant advance in our understanding of motor
      axon pathfinding. In particular, sources of guidance cues and some of the
      mechanisms used by motor growth cones during pathfinding have been identified.

PMID- 1638131
TI  - Mesodermal control of neural cell identity in vertebrates.
AB  - It has long been appreciated that the differentiation and patterning of neural
      cells is controlled in part by inductive signals from the mesoderm. Several
      recent experiments have revealed that distinct mesodermal signals act throughout
      early neural development and have begun to address the nature and sources of such
      signals.

PMID- 1638132
TI  - Growth cone guidance in the zebrafish central nervous system.
AB  - The accessibility and simplicity of the zebrafish embryo have allowed researchers
      to make a detailed characterization of pathfinding by identifiable growth cones.
      The growth cones follow precise cell-specific pathways to their targets. Analyses
      of pathfinding in mutant and experimentally manipulated wild type embryos have
      shown that growth cones accomplish this by interacting with specific cellular
      cues in their environment, many of which are likely to be redundant.

PMID- 1638133
TI  - Guidance of neuroblast migrations and axonal projections in Caenorhabditis
      elegans.
AB  - The nematode Caenorhabditis elegans provides an excellent model system in which
      to study the mechanisms involved in the development of the nervous system.
      Mutation analyses have now identified several genes that appear to be important
      in the interaction of neuroblasts and axons with both guidance cues and their
      target cells.

PMID- 1638134
TI  - Pathway recognition by neuronal growth cones: genetic analysis of neural cell
      adhesion molecules in Drosophila.
AB  - Genetic analysis has finally come of age in the study of neural cell adhesion
      molecules and their function during growth cone guidance in Drosophila. Recent
      studies have shown that fasciclin II, a neural cell adhesion molecule of the
      immunoglobulin superfamily, functions as a recognition molecule for the MP1 axon
      pathway, thus serving as the first molecular confirmation for the existence of
      functional labels on specific axon pathways in the developing organism.

PMID- 1638135
TI  - Guidepost cells.
AB  - Guidepost cells, as classically defined in the grasshopper embryo have only
      rarely been found in other systems. If the concept of guidepost cells is
      expanded, recognizing that any special role of specific cells in axon guidance is
      a function of the entire landscape in which axons are growing, and that growth
      cone--guidepost interactions may share mechanisms with many other cell--cell
      interactions, then numerous examples are found in both the peripheral and central
      nervous systems of many species.

PMID- 1638136
TI  - Repellent cues in axon guidance.
AB  - There is increasing evidence that axons are guided by repulsion in several
      regions of the developing nervous system, although this has yet to be confirmed
      directly in vivo. As more candidate repulsion molecules are identified, it is
      becoming clear that collapse of the growth cone in vitro may be mediated by more
      than one intracellular mechanism. The present emphasis on molecular cloning of
      the ligands and their receptors should enable a proper definition of their
      function during development.

PMID- 1638137
TI  - Axon guidance by molecular gradients.
AB  - In the past year, evidence indicating that some developing axons are guided to
      their targets, at least in part, by gradients of diffusible chemoattractants
      secreted by their target cells has continued to accumulate. It has also been
      shown for the first time that axons can orient in response to smooth gradients of
      immobilized substrate molecules.

PMID- 1638138
TI  - Development of connectional diversity and specificity in the mammalian brain by
      the pruning of collateral projections.

PMID- 1638139
TI  - How are specific connections formed between thalamus and cortex?
AB  - During development precise thalamocortical connections are established, with
      reciprocal connections forming correctly in a laminar pattern as well as between
      the correct thalamic and cortical areas. Recent evidence suggests that both
      spatial and temporal cues may account for this specificity.

PMID- 1638140
TI  - Patterning of retinotectal connections in the vertebrate visual system.
AB  - Recent work on the retinotectal projection clearly establishes the roles of
      neuronal activity and position-based cues in the patterning of nerve connections.
      In some species, the high degree of spatial order has been shown to emerge from a
      continued process of terminal growth and refinement. The future challenge is now
      to determine how multiple cues work together to guide the sculpting of the final
      pattern.

PMID- 1638142
TI  - Development.

PMID- 1638141
TI  - Acquisition of regional and cellular identities in the developing zebrafish
      nervous system.
AB  - In the past year, several new techniques have been used with great success in the
      study of nervous system development in the zebrafish. Perhaps the most exciting
      results have come from experiments in which single identified cells or small
      groups of cells have been transplanted between embryos in order to examine cell
      determination and the site of action of genetic mutations.

PMID- 1638143
TI  - Cognitive neuroscience.

PMID- 1638144
TI  - The status of cognitive neuroscience.
AB  - Cognitive neuroscience rests on findings, methods, and theory from three fields:
      experimental psychology, systems-level neuroscience, and computer science. The
      strong trend over the past few years has been for a greater integration across
      these fields. The influence of this interdisciplinary approach on current
      research on memory, perception, and language will be illustrated.

PMID- 1638145
TI  - Visual cortex: cartography, connectivity, and concurrent processing.
AB  - The mammalian visual cortex contains a complex mosaic of areas that are richly
      connected with one another. Recent progress has advanced our understanding of
      both macroscopic and microscopic aspects of cortical organization, and of
      information flow within and between functionally specialized processing streams.

PMID- 1638146
TI  - Face recognition.
AB  - The study of face-selective neurons in the monkey temporal lobe, and face
      recognition deficits in humans after brain damage have both become very active
      fields of investigation. Face-selective neurons appear to be members of ensembles
      for coding faces rather than individual face detectors or grandmother cells. They
      reflect the more general role of temporal cortex in pattern recognition. In
      humans there are a variety of face-processing impairments that result from damage
      to different areas, and which reflect interference at different levels of
      processing of the facial image.

PMID- 1638147
TI  - Agnosia.
AB  - Object recognition can break down in a variety of ways after brain damage. The
      resulting different forms of agnosia provide us with useful constraints on
      theories of normal object recognition. Recent studies suggest a division of labor
      for the recognition of different types of stimuli (common objects, words, faces,
      direction of eye gaze, spatial relations among parts of the human body), a high
      degree of interactivity in the processes underlying object recognition, and the
      possibility that recognition and awareness of recognition may be neurally
      distinct.

PMID- 1638149
TI  - Organization of space perception: neural representation of three-dimensional
      space in the posterior parietal cortex.
AB  - The representation of perceptual space in the posterior parietal cortex can be
      divided into at least two categories: far space, beyond arm's reach, and
      peripersonal space, within arm's reach. These are encoded by different groups of
      neurons that are closely related to the control of gaze and the guidance of arm
      and hand movement, respectively.

PMID- 1638148
TI  - The neurobiology of selective attention.
AB  - Research in the field of selective visual attention has recently seen substantial
      progress in several areas. Neuroimaging and electrical recording results have
      indicated that selective attention amplifies neural activity in prestriate areas
      concerned with basic visual processing. Imaging and cellular studies are
      delineating the networks of anatomical areas that serve as the source of
      attentional modulation and have suggested that these networks are anatomically
      distinct from the sites of the resulting amplifications. Cognitive studies of
      visual search have explored the role of these amplified computations in the
      integration of visual features into objects. Attentional effects in normal
      subjects, and their disruption following brain injury, have revealed the mental
      representations upon which attention operates.

PMID- 1638150
TI  - The perception of visual motion.
AB  - Recent developments have led to a greater insight into the complex processes of
      perception of visual motion. A better understanding of the neuronal circuitry
      involved and advances in electrophysiological techniques have allowed researchers
      to alter the perception of an animal with a stimulating electrode. In addition,
      studies have further elucidated the processes by which signals are combined and
      compared, allowing a greater understanding of the effects of selective brain
      damage.

PMID- 1638151
TI  - Language development.
AB  - Recent research suggests that our ability to learn language is innate, but not
      necessarily domain-specific. That is, language development appears to be based on
      a relatively plastic mix of neural systems that also serve other cognitive and
      perceptual functions. Evidence in support of this conclusion includes neural
      network simulations of language learning, event-related brain potential studies
      of normal language development, and studies of language development in several
      clinical populations of subjects suffering focal brain injury, specific language
      impairment, and contrasting forms of mental retardation.

PMID- 1638152
TI  - Knowledge systems.
AB  - The primate brain appears to store knowledge in widely distributed neural
      systems. Recent evidence suggests that these systems are specialized with respect
      to their capacity for supporting acquisition and retrieval of different domains
      and levels of knowledge.

PMID- 1638153
TI  - Brain mechanisms of emotion and emotional learning.
AB  - The amygdala appears to play an essential role in many aspects of emotional
      information processing and behavior. Studies over the past year have begun to
      clarify the anatomical organization of the amygdala and the contribution of its
      individual subregions to emotional functions, especially emotional learning and
      memory. Researchers can now point to plausible circuits involved in the
      transmission of sensory inputs into the amygdala, between amygdaloid subregions,
      and to efferent targets in cortical and subcortical regions, for specific
      emotional learning and memory processes.

PMID- 1638154
TI  - Oculomotor control and spatial processing.
AB  - In the past year research in the oculomotor system has concentrated on some
      hitherto neglected areas, and also caused a re-evaluation of several long
      standing concepts. Careful studies of the translational (otolith) vestibulo
      ocular reflex and the torsional system have demonstrated their importance. A re
      evaluation of the role of the superior colliculus in the generation of saccades
      has provided evidence for its participation in the feedback process. New studies
      of the interaction of eye movements and visual processing have shown that the
      brain can compensate for the visual effects of eye movements and maintain a
      retinotopic representation of visual space for the saccadic system.

PMID- 1638155
TI  - Memory.
AB  - The key interrelated issues in the neurobiology of memory are to identify the
      neural circuitries essential for memory formation, localize sites of memory
      storage and analyze mechanisms of memory formation, storage and retrieval.
      Several circuits have now been identified in vertebrates and researchers are
      investigating their properties, in particular the role of glutamate receptors and
      long-term potentiation, in memory formation. Invertebrate preparations continue
      to be of value and recent studies suggest that changes in gene expression and
      protein synthesis may be important in long-term sensitization.

PMID- 1638156
TI  - Computational approaches to hippocampal function.
AB  - The results of theoretical work have led researchers to suggest that the
      hippocampal formation may maximize its memory storage capacity by recoding events
      into patterns that are as dissimilar to one another, and which use as few neurons
      per event, as possible.

PMID- 1638157
TI  - Is the cerebellum involved in learning and cognition?
AB  - Current studies are examining whether the cerebellum has a functional role in non
      motor tasks using both behavioral and physiological methods with animals, and
      computer simulations of a classical conditioning task. Cerebellar involvement in
      cognition has been assessed in studies with healthy and neurologically impaired
      humans. The results have led to new hypotheses that are providing testable
      predictions about the role of the cerebellum in perception, attention, and other
      cognitive functions.

PMID- 1638158
TI  - Neuroimaging.
AB  - Recent advances in neuroimaging have led to an increase in the types of studies
      possible in the field of cognitive neuroscience. Researchers are now using
      neuroimaging to enhance classic approaches, such as lesion-behavior studies, as
      well as provide information about normal functions at levels that were previously
      difficult to assess.

PMID- 1638159
TI  - Cognitive neuroscience.

PMID- 1638160
TI  - Kearns-Sayre syndrome: a case report and review.
AB  - In 1958, Kearns and Sayre described a multisystem entity, now known as Kearns
      Sayre syndrome (KSS). The syndrome is defined as exhibiting a triad of thus far
      unexplained degenerative conditions: progressive external ophthalmoplegia,
      retinal pigmentary degeneration, and heart block. Commonly accompanying findings
      include cerebellar dysfunction and CSF protein levels above 100 mg/dl. Symptoms
      usually appear in early childhood, but the onset has been seen occasionally in
      young adults. KSS is a mitochondrial disorder that occurs rarely; the actual
      incidence is unknown. Ocular findings consist of bilateral ptosis, chronic
      progressive external ophthalmoplegia, and pigmentary retinopathy. Corneal
      clouding and optic neuritis are infrequent. We herein report a classic case of
      Kearns Sayre syndrome and discuss the findings.

PMID- 1638161
TI  - A study of the effects of angiotensins 1, 2, 3 and bradykinin on the replication
      of bovine retinal capillary endothelial cells and pericytes.
AB  - The renin-angiotensin system of the human eye may play a role in the regulation
      of retinal blood flow and the development of new vessels. We have investigated
      whether angiotensins 1, 2 and 3 or bradykinin, in concentrations ranging between
      1 x 10(-12) and 1 x 10(-6), have any mitogenic activity on cultured bovine
      retinal endothelial cells (BREC) and pericytes (BRP). Cell replication was
      assessed by 3H-thymidine incorporation and, in the case of BREC and AT-2, also by
      cell counts. AT-2 was also tested on bovine aortic EC (BAEC). None of the
      substances elicited any response on BREC, BRP or BAEC. Whether angiotensin(s)
      induce angiogenesis in retinal vessels in vivo remains to be established but this
      does not appear to occur through direct stimulation of cell replication.

PMID- 1638162
TI  - Treatment of calcific band keratopathy by Nd:YAG laser.
AB  - A new technique is presented for the treatment of secondary calcific band
      keratopathy. The Nd:YAG laser was used for the disruption and removal of corneal
      calcium deposits. This technique was used in seven cases with satisfying results.

PMID- 1638164
TI  - Prevalence of myopia in open angle glaucoma.
AB  - In this study concerning the prevalence of myopia in patients with open angle
      glaucoma, its distribution was analyzed within the sample tested in relation to
      the refraction defect size, compared with a control group of non-glaucomatous
      myopic subjects. The overall myopic rate was 17.2% of the glaucomatous patients;
      high myopia was more frequent in the subjects with open angle glaucoma (p less
      than 0.001) than in the myopic patients, thus appearing as a possible risk factor
      for the development of glaucoma.

PMID- 1638163
TI  - Hypertensive gas technique for enucleation of choroidal melanomas: a preliminary
      report.
AB  - The hypertensive gas technique induces avascularity within the eye during
      enucleation of a melanoma. Before touching the eye for enucleation, pressure is
      raised to maximum by an intravitreal injection of approximately 1.4 ml of gas
      (perfluorocarbon, air) resulting in a rock-hard eye. Avascularity persists for
      the duration of enucleation. From 9/1987 to 6/1989, 15 patients with choroidal
      melanomas were enrolled in a prospective study with the hypertensive gas
      technique instead of prior radiotherapy (the death rate in that series was five
      out of 26 melanoma patients at three years). Inclusion criteria for the
      hypertensive gas technique study were the same as for our previous irradiation
      series: (1) absence of detectable metastases and (2) a choroidal melanoma too
      large for a radioactive plaque. The average base diameter of melanomas measured
      13.2 mm, height 8.4 mm. The cytology was: 11x spindle, 3x mixed, 1x epithelioid
      cells. At re-examination in 7/1991 (average follow-up 33 months) two diabetics
      had died with no detectable metastases prior to death, and one of the 15 melanoma
      patients had died with metastases 24 months after enucleation. So far the
      hypertensive gas technique for enucleation of a melanoma eye seems to have no
      adverse effect on survival. It seems to be a simple alternative to the
      precautions taken otherwise and it facilitates enucleation with practically no
      bleeding from the globe.

PMID- 1638165
TI  - Repeated melting of corneal grafts in a patient with rheumatoid arthritis and
      Sjogren's syndrome.
AB  - We present a case of corneal melting in a patient with severe rheumatoid
      arthritis and Sjogren's syndrome. The melting appeared in the area of a bacterial
      corneal ulcer that healed after treatment with antibiotics. No signs of scleritis
      were present. Repeated melting of two corneal grafts was seen after surgery.

PMID- 1638166
TI  - Dark choroid in cone-rod dystrophy.
AB  - An unusual pattern of dark choroid in an eight-year-old girl is described. The
      ophthalmoscopic, fluorescein angiographic and functional changes were indicative
      of progressive cone-rod dystrophy.

PMID- 1638167
TI  - Rickettsial keratitis in a case of Mediterranean spotted fever.
AB  - The first documented case of infectious keratitis (an ameboid-like corneal ulcer)
      caused by Rickettsia conorii is described. Corneal infection was probably caused
      by contamination through the tears during systemic rickettsial dissemination.
      Topical tetracyclin ointment was effective. Rickettsial keratitis should be
      considered in the differential diagnosis of ameboid-like corneal ulcers in areas
      where Mediterranean spotted fever is endemic.

PMID- 1638168
TI  - Improvement of siderotic ERG.
AB  - For fear of endophthalmitis and siderosis, ferrous intraocular foreign bodies are
      usually removed as soon as they are discovered; markedly reduced, siderotic ERG
      changes are considered permanent. We report a patient who presented with a
      chronically retained intravitreal foreign body and significant clinical as well
      as electrophysiologic signs of siderosis. Only 3 months after surgery, the ERG
      showed almost complete recovery. If siderosis is not present, adequate and
      regular follow-up examinations may in certain cases substitute for immediate
      removal of chronically retained intraocular foreign bodies.

PMID- 1638169
TI  - Panic disorder: a biological perspective.
AB  - Panic disorder (PD) was first delineated as a separate diagnostic entity 25 years
      ago. It is a prevalent disorder that responds well to pharmacological
      interventions, most notably to antidepressants and benzodiazepines. PD and other
      psychiatric disorders, such as generalized anxiety disorder and major depression,
      overlap clinically, but it is unresolved whether they also overlap biologically.
      Finally, the pathogenesis of PD is still unclear. Theories linking panic to
      increased sensitivity to CO2 or serotonin are preliminary, while alpha 2
      adrenergic dysregulation in panic is still unproven. However, the development of
      new, selective, receptor agonists and antagonists in combination with imaging
      techniques may produce some of the answers to the questions raised since.

PMID- 1638170
TI  - Psychopharmacological treatment of social phobia: clinical and biochemical
      effects of brofaromine, a selective MAO-A inhibitor.
AB  - There is circumstantial evidence that antidepressants, particularly monoamine
      oxidase inhibitors (MAOIs) and beta-blockers, may have some beneficial effects in
      social phobia. In this study 30 patients with social phobia (DSM-IIIR) were
      treated with the selective and reversible MAO-A inhibitor brofaromine, using a 12
      week double-blind placebo controlled design. A clinical relevant improvement was
      seen in 80% of the patients treated with brofaromine (150 mg daily). A
      significant improvement was found on measures of social anxiety, phobic
      avoidance, general (or anticipatory) anxiety and interpersonal sensitivity in
      patients on brofaromine, but not on placebo. Biochemical measurements revealed a
      decrease in turnover of noradrenaline, serotonin and dopamine as assessed by the
      plasma metabolite levels, and an increase in nocturnal release of melatonin. Most
      prominent side-effect was middle sleep disturbance. No changes in blood pressure
      were observed. During a follow-up period of 12 weeks a further improvement was
      found in patients treated with brofaromine.

PMID- 1638171
TI  - CBF and cognitive evaluation of Alzheimer type patients before and after IMAO-B
      treatment: a pilot study.
AB  - Ten patients diagnosed as affected by primary degenerative dementia of the
      Alzheimer type, with a mild to moderate cognitive and behavioral impairment, were
      studied in a double blind design when taking for 60 days 5 mg twice a day of L
      deprenyl or placebo. Cognitive functions and cerebral blood flow were assessed at
      the beginning and at the end of treatment by a wide array of memory, attention,
      and language efficiency measures and by SPECT-99TcHMPAO procedure. Reduced CBF on
      the parietal lobes was demonstrated in the patients at baseline together with a
      reduction of memory and cognitive efficiency. At the end of the treatment
      patients who received L-deprenyl showed an improvement in cognitive efficiency
      and no changes in CBF, while patients treated with placebo showed a worsening of
      cognitive efficiency and further reduction of parietal lobe CBF.

PMID- 1638172
TI  - Effects of MK-801 and antidepressant drugs in the forced swimming test in rats.
AB  - The effects of MK-801, a non-competitive NMDA receptor antagonist, and of
      antidepressant drugs were studied in the forced swimming test in rats. MK-801
      reduced immobility time. Combined treatment with MK-801 + imipramine induced a
      stronger effect in Porsolt's test than administration of either drug alone.
      Citalopram was inactive when given alone but it potentiated the antidepressant
      like effect of MK-801. Haloperidol and prazosin antagonized the effect induced by
      MK-801 + IMI or CIT. Mianserin interacted with MK-801 in a similar way but to a
      lesser extent. Its effect was antagonized by haloperidol but not by prazosin. The
      reduction of the immobility time was also observed in those experimental
      paradigms in which the locomotor activity was not increased. The results indicate
      that synergism may exist between antidepressants and MK-801.

PMID- 1638173
TI  - Antidepressant treatment prevents chronic unpredictable mild stress-induced
      anhedonia as assessed by ventral tegmentum self-stimulation behavior in rats.
AB  - The effect of chronic unpredictable mild stress on sensitivity to reward was
      evaluated using the brain self-stimulation procedure. Rats were allowed to
      electrically self-stimulate the ventral tegmental area, one of the main cerebral
      structures subserving positive reinforcement. Stimulation thresholds (frequency
      of stimuli) for self-stimulation responses were determined prior to, during, and
      following a 19-day period of exposure to a variety of mild unpredictable
      stressors. Stimulation threshold was increased in stressed rats, suggesting a
      decrease in the rewarding properties of brain stimulation. This deficit became
      evident after about 1 week of mild stress, lasted throughout the stress period,
      and progressively diminished following termination of the stress regime. In
      stressed rats concomitantly treated with the tricyclic antidepressant desipramine
      (5 mg/kg b.i.d.), no stress-induced increase in self-stimulation threshold was
      observed. However, desipramine did not modify self-stimulation threshold in non
      stressed animals. Thus, the increased threshold for brain self-stimulation
      produced by a period of chronic unpredictable mild stress can be completely
      prevented by concomitant antidepressant treatment and may provide an heuristic
      animal model of depression.

PMID- 1638174
TI  - Relationship of symptomatology of schizophrenia and tardive dyskinesia.
AB  - The role of drug factors and patient factors in the development of tardive
      dyskinesia (TD) was examined in 31 TD patients and 31 non-TD patients matched by
      age and sex. TD patients achieved significantly lower total scores on the anxiety
      depression factor of Brief Psychiatric Rating Scale (BPRS) (5.2 +/- 1.4 vs. 6.5
      +/- 2.2; less than P) and significantly higher total scores on the activation
      factor (6.4 +/- 2.2 vs. 5.3 +/- 2.5; less than P). The finding that TD patients
      were less depressed may be explained by a hypermonoaminergic state developing in
      TD. Based on the findings of this study it is suggested that catatonic
      schizophrenic patients are more vulnerable to the development of TD.

PMID- 1638175
TI  - Alterations in brain cholecystokinin receptors in suicide victims.
AB  - Cholecystokinin (CCK) and benzodiazepine receptor binding characteristics were
      analyzed in the brain tissue samples from 19 suicide victims and 23 control
      cases. In the frontal cortex, significantly higher apparent number of CCK
      receptors and affinity constants were found in the series of suicide victims.
      These differences between suicides and controls were present in similar
      proportions when the suicide cases with depressive syndrome or violent or non
      violent means of self-killing were compared to matched controls. However, when
      the samples were split into subgroups consisting of persons either below or over
      the age of 60 years, significant differences in the CCK receptor characteristics
      in the frontal cortex were observed only between younger suicides and controls.
      Furthermore, the younger suicide victims had a higher density of CCK receptors in
      the cingulate cortex, whereas in older suicides the value was lower as compared
      to age-matched controls. No difference in benzodiazepine receptor binding was
      found between control and suicide groups. The results of this investigation
      suggest that CCK-ergic neurotransmission is linked to self-destructive behaviour,
      probably through its impact on anxiety and adaptational deficits.

PMID- 1638176
TI  - Low doses of morphine reduce voluntary alcohol consumption in rhesus monkeys.
AB  - Experimental opioid modulation has been found to influence the consumption of
      alcohol in animals. Whereas it has generally been agreed upon that opiate
      antagonists reduce alcohol consumption, the results with opiate agonists are less
      consistent. The present study reports on the effect of low doses of morphine in 8
      adult male rhesus monkeys that had a free choice in drinking water, a 16% and a
      32% ethanol/water solution, (a) during continuous ad libitum access (Experiment
      I), and (b) after 2 days of alcohol abstinence (Experiment II). In both
      experiments each monkey received a single morphine injection (i.m.) in 5
      different doses (0.03, 0.06, 0.17, 0.50, 1.50 mg.kg-1); each morphine injection
      (i.m.) was placebo-controlled in a cross-over design. Consumption was measured
      from 16.00 h in the afternoon (30 min after injection) to 08.30 h the next
      morning. In Experiment I after 0.50 and 1.50 mg.kg-1 of morphine ethanol intake
      and water consumption were both reduced during the first hours after injection;
      only ethanol intake remained reduced during the subsequent night. Effects lasted
      not longer than 24 h. In Experiment II, morphine administered 30 min before
      reintroduction of ethanol solutions reduced ethanol intake at doses of 0.17, 0.50
      and 1.50 mg.kg-1; water consumption was unaffected. The reduction lasted for the
      subsequent night after the 2 highest doses. Records obtained of various
      spontaneous behavioural activities made it unlikely that the used dose range had
      induced some aspecific sedation; monkeys remained alert and active. The results
      are contradictory with studies in which low doses of morphine stimulated alcohol
      drinking in rats. The present results seem to support the hypothesis that at
      least in monkeys morphine can compensate for some effects of alcohol.

PMID- 1638177
TI  - Galactorrhea in the neuroleptic malignant syndrome.
AB  - A case of schizophrenia with neuroleptic malignant syndrome (NMS) presented
      difficulties in differential diagnosis. However, the presence of severe
      galactorrhea contributed decisively to relate the clinical picture with the
      administration of neuroleptics. We propose that presence of galactorrhea or
      disorders in prolactin (PRL) secretion should be investigated in NMS.

PMID- 1638178
TI  - Arsenic in induced hair of the rat and its relation to the content in various
      organs during chronic exposure.
AB  - The behaviour of the rate of transfer of arsenic to hair induced at various times
      during a long-term exposure experiment was examined in rats supplied with 3 mg
      arsenic per litre of drinking water in the form of chloride. The arsenic was
      supplied during a period of 560 days. At the beginning a sharp increase was seen
      in the rate of transfer of arsenic to induced hair, as well as in the content of
      arsenic in the various organs. Subsequently, the rate of transfer to hair
      increased slowly but steadily up to the end of the experiment. During that time
      the level of arsenic in the liver and in the kidneys remained constant, whereas
      that in the brain and in some other organs increased slowly and irregularly. The
      correlation between the arsenic in the induced hair and that in the organs was
      statistically significant in all comparisons. Correlation coefficients greater
      than 0.7 were found in the comparisons of the content in the induced hair with
      those in the heart, the pancreas and the forebrain. The findings suggest that the
      rate of transfer of endogenous arsenic depends on two factors, one being the
      level of body intake of arsenic during the period of hair growth, the other the
      degree to which the element had accumulated in the body during the time which
      elapsed between the onset of arsenic supply and the start of hair growth.

PMID- 1638179
TI  - Taste alterations in liver cirrhosis: are they related to zinc deficiency?
AB  - Patients with chronic liver disease may have taste impairment and altered zinc
      metabolism. We evaluated Taste Detection Thresholds (TDTs) in 60 patients with
      liver cirrhosis and correlated the findings with disease severity and alcoholic
      etiology. Plasma zinc levels and urinary output were also measured. A placebo
      controlled treatment trial with zinc sulphate was made in 15 patients with
      compensated cirrhosis in order to ascertain whether zinc deficiency caused taste
      alterations. Taste detection of salty, sweet and acid tastants was significantly
      impaired in all cirrhotic patients in comparison with normal subjects. TDTs were
      not influenced either by the etiology or the severity of the disease. All groups
      of patients had low plasma zinc levels and decompensated cirrhosis had a
      significantly increased urinary output of zinc. No correlation was found between
      taste acuity and plasma zinc levels when only cirrhotic patients were considered.
      The effect of zinc supplementation on TDTs did not appear to be inferior to that
      of the placebo. Our results indicate that taste impairment in cirrhotics is due
      to the disease process per se and not to zinc deficiency.

PMID- 1638180
TI  - Sex-related effects of zinc deficiency on the selenium metabolism in rats.
AB  - The effects of a low zinc status on selenium metabolism were investigated in
      female and male rats which were fed diets with low and adequate zinc contents and
      a suboptimal selenium content. For the selenium content and glutathione
      peroxidase activity in the liver and plasma of the female animals no differences
      were found between the low zinc group and the pair-fed zinc-adequate control
      group. In the male rats zinc depletion resulted in testis atrophy and decreased
      testicular contents of selenium and glutathione peroxidase. In the pair-fed and
      ad libitum-fed control groups the levels of hepatic selenium and glutathione
      peroxidase and plasma glutathione peroxidase in the males were lower than those
      in the females. In the low zinc group, however, they rose to the levels of the
      females. The results indicate that these effects of zinc deficiency on selenium
      metabolism are sex-specific and suggest that they are related to changes in the
      sex hormone status of the male animals.

PMID- 1638181
TI  - Trace elements in full-term neonate hair.
AB  - Proton Induced X-ray Emission (PIXE) was employed to measure simultaneously the
      concentration of 12 trace elements in the hair of 141 AGA newborn infants at
      term. Log-normal distributions were measured for all elements. There were no
      significant differences in trace elements in relation to sex, gestational age and
      body weight. The geometric means (mg/kg) were: Cr, 1.5 +/- 0.2; Mn, 1.5 +/- 0.1;
      Fe, 51 +/- 4; Ni, 1.0 +/- 0.2; Cu, 6.1 +/- 0.3; Zn, 133 +/- 3; As, 0.055 +/-
      0.005; Se 0.81 +/- 0.05; Br, 1.3 +/- 0.1; Pb, 1.4 +/- 0.2; Rb, 0.22 +/- 0.03; and
      Sr, 1.5 +/- 0.2. Some direct and inverse partial correlations among elements were
      found at different levels of significance. Each element was significantly
      correlated with at least one other. Zinc and copper concentrations were lower
      compared to data in the literature. The high values of chromium and selenium
      concentrations were in agreement with previous findings. The manganese level was
      in accordance with previous data. The Zn/Cu ratio agreed very well with the data
      in the literature. This indicates that while concentration values may be
      subjected to large variations due to living conditions, correlations could be
      more stable and therefore offer insight on the regulatory mechanisms governing
      trace element metabolism in man.

PMID- 1638182
TI  - Excretion and distribution of injected radiozinc in rats as influenced by the
      type of carbohydrate.
AB  - The aim of this study was to investigate the effect of different dietary sugars
      on Zn status by measuring the excretion and body distribution of intramuscularly
      injected zinc-65 in growing rats. Thirty-two weanling rats (39.4 +/- 2.7 g) were
      allotted to six diets in which starch (56%) was partially substituted for glucose
      (15%), fructose (15%), sucrose (30%), galactose (15%) or lactose (30%). Diets
      uniformly supplied 22 mg/kg (dry matter) of Zn. Three days after the start of the
      dietary regimen each rat was injected with 40 micrograms Zn, labelled with 380
      kBq 65Zn, in saline solution. Feces and urine were collected for 15 days;
      thereafter 65Zn distribution in the liver, pancreas, kidneys, gastrointestinal
      tract and residual carcass was assessed. Fecal 65Zn excretion was not
      significantly influenced by the diets, although the gastrointestinal tract of the
      galactose- and lactose-fed animals contained more 65Zn than did those fed the
      other diets. 65Zn in the urine and kidneys of the galactose-fed rats was markedly
      increased as compared with the other groups. Dietary carbohydrate source did not
      materially affect concentrations of stable zinc in the liver, kidneys, pancreas
      and residual carcass.

PMID- 1638183
TI  - Selenium intakes of children from Malawi and Papua New Guinea consuming plant
      based diets.
AB  - Dietary selenium intakes were determined over three seasons for 66 children aged
      4-6 y in rural Malawi, and at one season for 67 children aged 6-10 y in rural
      Papua New Guinea. The selenium content of the foods consumed was assessed using
      instrumental neutron activation analysis. Median intakes of selenium for the
      Malawian children were 20 micrograms per day, 21 micrograms per day, and 15
      micrograms per day at harvest, postharvest, and preharvest seasons, respectively.
      More than 43% of the Malawian intakes were below the U.S. Recommended Dietary
      Allowances for 4-6 y olds (20 micrograms per day). Median intake of Se for the
      Papua New Guinean children was 20 micrograms per day, with 87% of the intakes
      below the recommended level for 7-10 y olds (30 micrograms per day). Statistical
      comparisons of selenium intakes over three seasons for the 51 children present in
      all survey periods revealed that mean intakes were not significantly different in
      survey periods one and two, but decreased significantly in survey period three,
      when expressed per day (p less than 0.002), per MJ (p less than 0.003), or per kg
      (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638184
TI  - Relationships between myocardial macrominerals and trace elements and luminal
      narrowing of coronary arteries in Finnish children.
AB  - In addition to the traditional risk factors for cardiovascular diseases it has
      been hypothesized that a suboptimal intake of macrominerals and trace elements
      plays a role in the etiology of such diseases. We studied the possible
      correlation between preatherosclerotic changes in the coronary arteries and the
      myocardial concentration of K, Ca, Mg, Fe, Zn, Cu and Se in an autopsy series of
      children who had died mainly from accidental causes (n = 58). The concentrations
      of myocardial elements were comparable to values published elsewhere except for a
      slightly higher Cu concentration. The myocardial Se concentration indicated an
      adequate Se status. Narrowing of the coronary artery lumen was not correlated
      with myocardial element concentration except in the case of Se, for which a
      positive correlation was found (r = 0.23, p less than 0.04). Myocardial K was
      positively correlated with myocardial Mg (r = 0.65, p less than 0.001) and
      inversely correlated with Ca (r = -0.50, p less than 0.001). The intake of
      saturated vs. unsaturated fats was associated with myocardial Cu and Ca
      concentrations. Our results suggest that myocardial macrominerals and trace
      elements do not play a role in juvenile preatherosclerotic changes of the
      arteries.

PMID- 1638185
TI  - Review of publications.

PMID- 1638186
TI  - The use of animals in research.

PMID- 1638187
TI  - Spreading HIV is not an offence.

PMID- 1638188
TI  - Cholesterol lowering trials in coronary heart disease: frequency of citation and
      outcome.
AB  - OBJECTIVE: To see if the claim that lowering cholesterol values prevents coronary
      heart disease is true or if it is based on citation of supportive trials only.
      DESIGN: Comparison of frequency of citation with outcome of all controlled
      cholesterol lowering trials using coronary heart disease or death, or both, as
      end point. SUBJECTS: 22 controlled cholesterol lowering trials. RESULTS: Trials
      considered by their directors as supportive of the contention were cited almost
      six times more often than others, according to Science Citation Index. Apart from
      trials discontinued because of alleged side effects of treatment, unsupportive
      trials were not cited after 1970, although their number almost equalled the
      number considered supportive. In three supportive reviews the outcome of the
      selected trials was more favourable than the outcome of the excluded and ignored
      trials. In the 22 controlled cholesterol lowering trials studied total and
      coronary heart disease mortality was not changed significantly either overall or
      in any subgroup. A statistically significant 0.32% reduction in non-fatal
      coronary heart disease seemed to be due to bias as event frequencies were
      unrelated to trial length and to mean net reduction in cholesterol value;
      individual changes in cholesterol values were unsystematically or not related to
      outcome; and after correction for a small but significant increase in non-medical
      deaths in the intervention groups total mortality remained unchanged (odds ratio
      1.02). CONCLUSIONS: Lowering serum cholesterol concentrations does not reduce
      mortality and is unlikely to prevent coronary heart disease. Claims of the
      opposite are based on preferential citation of supportive trials.

PMID- 1638189
TI  - Smoking and the young.

PMID- 1638190
TI  - Reducing home accidents in elderly people.

PMID- 1638191
TI  - Randomised controlled trial of azathioprine withdrawal in ulcerative colitis.
AB  - OBJECTIVE: To determine whether azathioprine can prevent relapse in ulcerative
      colitis. DESIGN: One year placebo controlled double blind trial of withdrawal or
      continuation of azathioprine. SETTING: Outpatient clinics of five hospitals.
      SUBJECTS: 79 patients with ulcerative colitis who had been taking azathioprine
      for six months or more. Patients in full remission for two months or more (67),
      and patients with chronic low grade or corticosteroid dependent disease (12) were
      randomised separately. 33 patients in remission received azathioprine and 34
      placebo; five patients with chronic stable disease received azathioprine and
      seven placebo. MAIN OUTCOME MEASURE: Rate of relapse. Relapse was defined as
      worsening of symptoms or sigmoidoscopic appearance. RESULTS: For the remission
      group the one year rate of relapse was 36% (12/33) for patients continuing
      azathioprine and 59% (20/34) for those taking placebo (hazard rate ratio 0.5, 95%
      confidence interval 0.25 to 1.0). For the subgroup of 54 patients in long term
      remission (greater than six months before entry to trial) benefit was still
      evident, with a 31% (8/26) rate of relapse with azathioprine and 61% (17/28) with
      placebo (p less than 0.01). For the small group of patients with chronic stable
      colitis (six were corticosteroid dependent and six had low grade symptoms) no
      benefit was found from continued azathioprine therapy. Adverse events were
      minimal. CONCLUSIONS: Azathioprine maintenance treatment in ulcerative colitis is
      beneficial for at least two years if patients have achieved remission while
      taking the drug. Demonstration of the relapse preventing properties of
      azathioprine has implications for a large number of patients with troublesome
      ulcerative colitis, who may benefit from treatment with azathioprine.

PMID- 1638192
TI  - Farm accidents in children.
AB  - OBJECTIVE: To examine the problem of accidental injury to children on farms.
      DESIGN: Prospective county based study of children presenting to accident and
      emergency departments over 12 months with injuries sustained in a farm setting
      and nationwide review of fatal childhood farm accidents over the four years April
      1986 to March 1990. SETTING: Accident and emergency departments in Aberystwyth,
      Carmarthen, Haverfordwest, and Llanelli and fatal accidents in England, Scotland,
      and Wales notified to the Health and Safety Executive register. SUBJECTS:
      Children aged under 16. MAIN OUTCOME MEASURE: Death or injury after farm related
      accidents. RESULTS: 65 accidents were recorded, including 18 fractures. Nine
      accidents necessitated admission to hospital for a mean of two (range one to
      four) days. 13 incidents were related to tractors and other machinery; 24 were
      due to falls. None of these incidents were reported under the statutory
      notification scheme. 33 deaths were notified, eight related to tractors and
      allied machinery and 10 related to falling objects. CONCLUSIONS: Although safety
      is improving, the farm remains a dangerous environment for children. Enforcement
      of existing safety legislation with significant penalties and targeting of safety
      education will help reduce accident rates further.

PMID- 1638193
TI  - Farm accidents in adults.

PMID- 1638194
TI  - Utilisation of medical care by abused women.

PMID- 1638195
TI  - Cutaneous vasculitis due to ciprofloxacin.

PMID- 1638196
TI  - Effect of iodinated water soluble contrast media on urinary protein assays.

PMID- 1638197
TI  - Adenosine and cardiac arrhythmias.

PMID- 1638198
TI  - Home accidents in older people: role of primary health care team.
AB  - OBJECTIVES: To determine the incidence and nature of unreported and reported home
      accidents in older people and to investigate associated environmental factors.
      DESIGN: Postal questionnaire requesting information on home accidents in the
      preceding month. SETTING: Inner London general practice. SUBJECTS: All registered
      patients aged over 65 years (n = 1662), of whom 120 were inappropriately
      registered and 1293 responded. MAIN OUTCOME MEASURE: Circumstances and
      consequences of accidents in the home. RESULTS: 108 accidents were recorded in
      100 patients, giving a home accident rate of 84/1000 patients, equivalent to an
      annual rate of 1002/1000. 73 accidents were falls, and 83 were unreported. Of the
      25 reported accidents, 19 were reported to general practice and six to accident
      and emergency departments (5.6% of all events). Rates of home accidents increased
      with age and were higher in women than men (79/819 upsilon 29/474; chi 2 = 4.5,
      df = 1, p less than 0.05). CONCLUSIONS: The incidence of home accidents in people
      aged over 65 years was high but few events were reported to medical services.
      General practice provided the main contact for patients who reported home
      accidents, and primary care workers have important opportunities for advising
      elderly patients on home accident prevention. Improved publicity on home safety
      targeted at older people and their carers would support the primary health care
      team in this role.

PMID- 1638199
TI  - The chains of education, experience, and culture.

PMID- 1638200
TI  - Drug management of ulcerative colitis.

PMID- 1638201
TI  - Non-Hodgkin's lymphoma. II: Management problems.

PMID- 1638202
TI  - Juvenile myoclonic epilepsy.

PMID- 1638203
TI  - Oesophageal achalasia in adolescent women mistaken for anorexia nervosa.

PMID- 1638204
TI  - ABC of colorectal diseases. Appendicitis.

PMID- 1638205
TI  - Awareness under anaesthesia.

PMID- 1638206
TI  - Awareness under anaesthesia.

PMID- 1638207
TI  - Risks associated with assisted conception.

PMID- 1638208
TI  - Cancer chemotherapy and fertility.

PMID- 1638209
TI  - Risks associated with assisted conception.

PMID- 1638210
TI  - Steroid receptors in early breast cancer.

PMID- 1638211
TI  - Diarrhoea.

PMID- 1638212
TI  - Hyponatraemia in children.

PMID- 1638213
TI  - Reversing vasectomy.

PMID- 1638214
TI  - Monitoring lithium treatment.

PMID- 1638215
TI  - Monitoring ambulatory blood pressure in general practice.

PMID- 1638216
TI  - Fulminant hepatitis B in infants.

PMID- 1638217
TI  - Hypercalcaemia in patients receiving dialysis.

PMID- 1638218
TI  - Hypercalcaemia in patients receiving dialysis.

PMID- 1638219
TI  - Breast feeding in developing countries.

PMID- 1638220
TI  - Day hospitals for elderly people.

PMID- 1638221
TI  - Epidemiological aspects of travel related illness.

PMID- 1638222
TI  - Gonad protection in young orthopaedic patients.

PMID- 1638223
TI  - Consultants' communications with general practitioners.

PMID- 1638224
TI  - Health and safety on the farm.

PMID- 1638225
TI  - Severe "silent" mitral regurgitation after myocardial infarction: a clinical
      conundrum.

PMID- 1638226
TI  - ABC of colorectal diseases. Lower gastrointestinal haemorrhage.

PMID- 1638227
TI  - Teaching vaginal examination.

PMID- 1638228
TI  - Teaching vaginal examination.

PMID- 1638229
TI  - Teaching vaginal examination.

PMID- 1638230
TI  - Management of breast cancer.

PMID- 1638231
TI  - Management of breast cancer.

PMID- 1638233
TI  - Babies' sleeping position.

PMID- 1638232
TI  - Management of breast cancer.

PMID- 1638234
TI  - Percutaneous endoscopic gastrostomy feeding.

PMID- 1638235
TI  - Percutaneous endoscopic gastrostomy feeding.

PMID- 1638236
TI  - Percutaneous endoscopic gastrostomy feeding.

PMID- 1638237
TI  - Percutaneous endoscopic gastrostomy feeding.

PMID- 1638238
TI  - Percutaneous endoscopic gastrostomy feeding.

PMID- 1638239
TI  - Psychosocial problems in epilepsy.

PMID- 1638240
TI  - Treating obesity in children.

PMID- 1638241
TI  - Harm minimisation for drug misusers.

PMID- 1638242
TI  - Farmer's hip.

PMID- 1638243
TI  - Farmer's hip.

PMID- 1638244
TI  - Making air crashes more survivable.

PMID- 1638245
TI  - Cite the workers.

PMID- 1638246
TI  - Health technology assessment.

PMID- 1638247
TI  - Giant cell arteritis.

PMID- 1638248
TI  - Polio eradication as 2000 approaches.

PMID- 1638249
TI  - Promoting sexual health.

PMID- 1638250
TI  - Service increment for teaching and research.

PMID- 1638251
TI  - Recruitment methods for screening programmes: trial of a new method within a
      regional osteoporosis study.
AB  - OBJECTIVE: To estimate the response rates and operating costs of three
      recruitment methods within a regional osteoporosis screening programme. DESIGN:
      Randomised trial of three types of invitation letter: one offering fixed
      appointments with option to change time, one offering fixed appointments but
      requiring telephoned confirmation of intention to attend, and one inviting
      recipient to telephone to make an appointment. SETTING: Osteoporosis screening
      unit, Aberdeen. SUBJECTS: 1200 women aged 45-49 years living within 32 km of
      Aberdeen and randomly selected from the community health index. 400 women were
      randomised to each appointment method. MAIN OUTCOME MEASURES: Numbers attending
      for screening; default rate among women who confirmed appointments; social class
      of attenders; cost per appointment slot and per completed scan. RESULTS: 299
      (75%), 277 (69%), and 217 (54%) women were scanned after fixed, confirmable, and
      open invitations respectively. Women who attended were given a questionnaire, and
      694 (87.5%) returned it. No significant differences were found in the social
      class of attenders among the three methods. Of the 514 women who made or
      confirmed appointments, 494 attended for a scan. Total costs per scan were 25.00
      pounds, 21.40 pounds, and 21.00 pounds for fixed, confirmable, and open
      invitations respectively. CONCLUSIONS: The offer of a fixed appointment requiring
      telephoned confirmation has the potential to reduce the costs of scanning without
      exaggerating any social bias or significantly reducing response rates provided
      that empty appointments can be rebooked at short notice.

PMID- 1638252
TI  - Mild and moderate dyskaryosis: can women be selected for colposcopy on the basis
      of social criteria?
AB  - OBJECTIVE: To describe the distribution of cervical intraepithelial neoplasia
      grades among women with mild and moderate dyskaryosis after a single cervical
      smear and to determine whether social criteria could help identify women who are
      at increased risk of grade II or III disease. DESIGN: Cross sectional analysis
      within a randomised prospective study. Subjects had a repeat smear, a colposcopic
      examination, and an excision biopsy of the transformation zone. In addition,
      women were asked to complete a social questionnaire. SETTING: Colposcopy clinic,
      Aberdeen. SUBJECTS: 228 women with a single smear test showing mild or moderate
      dyskaryosis. MAIN OUTCOME MEASURES: Histology, age, sexual and contraceptive
      history, cigarette smoking. RESULTS: 159 (70%) women had cervical intraepithelial
      neoplasia grades II or III. Among current smokers the prevalence of grade II and
      III disease was higher in women who smoked greater than or equal to 20 cigarettes
      a day (84%) than among those who smoked less (66%; p less than 0.04). Women with
      more than one sexual partner also had a higher prevalence (75%) than women with
      only one partner (50%; p = 0.0028). Use of oral contraceptives and younger age
      were not significantly associated. The prevalence of grade II or III disease was
      up to 66% in the lower risk groups. CONCLUSIONS: Because of the high prevalence
      of cervical intraepithelial neoplasia grades II and III in both the high and the
      low risk groups social factors are not useful for selecting women with mild or
      moderate dyskaryosis for either early referral to colposcopy or cytological
      surveillance.

PMID- 1638253
TI  - Does the MRCGP examination discriminate against Asian doctors?
AB  - OBJECTIVE: To ascertain whether the membership examination for the Royal College
      of General Practitioners (MRCGP) discriminates against doctors of Indian
      subcontinent ethnic origin ("Asian doctors"). DESIGN: Retrospective analysis of
      data from five administrations of the MRCGP examination (December 1988-December
      1990). SETTING: United Kingdom national examination body. SUBJECTS: 3686 doctors
      taking the examination for the first time, 244 of whom were classified as Asian,
      the remainder as non-Asian. MAIN OUTCOME MEASURES: Comparison of performance in
      each of the written and oral components of the examination between Asian doctors,
      identified by their names and classified into subgroups by countries of birth and
      primary medical training from data provided at registration, and non-Asian
      doctors. RESULTS: On written components of the examination (multiple choice paper
      mean score Asians versus non-Asians 42.3 v 48.6, modified essay paper 40.9 v
      48.9, practice topic/critical reading paper 41.5 v 48.7, all p less than 0.001 by
      t testing). But analysis by countries of birth and primary training showed that
      these differences were due largely to poor performance by certain groups of Asian
      doctors, especially those born and trained in the Indian subcontinent or
      elsewhere outside the United Kingdom. Asian doctors born and trained in the
      United Kingdom and those born in Africa or the West Indies and trained in the
      United Kingdom performed similarly to the non-Asian doctors. CONCLUSIONS: The
      examination does not systematically discriminate against Asian doctors, but the
      poor performance of the two subgroups of Asians is cause for serious concern and
      requires investigation.

PMID- 1638254
TI  - King's model for allocating service increment for teaching and research (SIFTR).

PMID- 1638255
TI  - Hodgkin's disease--I: Identification and classification.

PMID- 1638256
TI  - Dynamics and topology of idiotypic networks.
AB  - Jerne's idiotypic network was previously modelled using simple proliferation
      dynamics and a homogeneous tree as a connection structure. The present paper
      studies analytically and numerically the genericity of the previous results when
      the network connection structure is randomized, e.g., with loops and varying
      connection intensities. The main feature of the dynamics is the existence of
      different localized attractors that can be interpreted in terms of vaccination
      and tolerance. This feature is preserved when loops are added to the network,
      with a few exceptions concerning some regular lattices. Localized attractors
      might be destroyed by the introduction of a continuous distribution of connection
      intensities. We conclude by discussing possible modifications of he elementary
      model that preserve localization of the attractors and functionality of the
      network.

PMID- 1638257
TI  - Ising model for B-Z transition in supercoiled DNA.
AB  - The possible existence of nucleic acids in right-handed and left-handed helical
      forms is considered. A statistical mechanical model is developed to obtain an
      expression for a change in twist during helical transformation in terms of
      corresponding free energies and linking for a supercoiled DNA. The theoretically
      predicted values are compared with those determined experimentally. The physico
      chemical significance of the parameters is discussed.

PMID- 1638258
TI  - Vaccination in density-dependent epidemic models.
AB  - This paper examines the effect of vaccination for an epidemic model where the
      death rate depends on the number of individuals in the population. The basic
      model which is described is based on measles or other childhood diseases in
      developing countries or viral diseases such as rabies in animal populations. An
      equilibrium analysis of the model and the local stability of small perturbations
      about the equilibrium values are discussed. The biological implications of these
      results are examined and similar results presented for modifications of the basic
      model.

PMID- 1638259
TI  - Tree asymmetry--a sensitive and practical measure for binary topological trees.
AB  - The topological structure of a binary tree is characterized by a measure called
      tree asymmetry, defined as the mean value of the asymmetry of its partitions. The
      statistical properties of this tree-asymmetry measure have been studied using a
      growth model for binary trees. The tree-asymmetry measure appears to be sensitive
      for topological differences and the tree-asymmetry expectation for the growth
      model that we used appears to be almost independent of the size of the trees.
      These properties and the simple definition make the measure suitable for
      practical use, for instance for characterizing, comparing and interpreting sets
      of branching patterns. Examples are given of the analysis of three sets of
      neuronal branching patterns. It is shown that the variance in tree-asymmetry
      values for these observed branching patterns corresponds perfectly with the
      variance predicted by the used growth model.

PMID- 1638260
TI  - Poisson, compound Poisson and process approximations for testing statistical
      significance in sequence comparisons.
AB  - DNA and protein sequence comparisons are performed by a number of computational
      algorithms. Most of these algorithms search for the alignment of two sequences
      that optimizes some alignment score. It is an important problem to assess the
      statistical significance of a given score. In this paper we use newly developed
      methods for Poisson approximation to derive estimates of the statistical
      significance of k-word matches on a diagonal of a sequence comparison. We require
      at least q of the k letters of the words to match where 0 less than q less than
      or equal to k. The distribution of the number of matches on a diagonal is
      approximated as well as the distribution of the order statistics of the sizes of
      clumps of matches on the diagonal. These methods provide an easily computed
      approximation of the distribution of the longest exact matching word between
      sequences. The methods are validated using comparisons of vertebrate and E. coli
      protein sequences. In addition, we compare two HLA class II transplantation
      antigens by this method and contrast the results with a dynamic programming
      approach. Several open problems are outlined in the last section.

PMID- 1638261
TI  - The study of combined action of agents using differential geometry of dose-effect
      surfaces.
AB  - Although graphic surfaces have been used routinely in the study of combined
      action of agents, they are mainly used for display purposes. In this paper, it is
      shown that useful mechanistic information can be obtained from an analytical
      study of these surfaces using the tools of differential geometry. From the
      analysis of some simple dose-effect surfaces, it is proposed that the intrinsic
      curvature, referred to in differential geometry as the Gaussian curvature, of a
      dose-effect surface can be used as a general criterion for the classification of
      interaction between different agents. This is analogous to the interpretation of
      the line curvature of a dose-effect curve as an indication of self-interaction
      between doses for an agent. In this framework, the dose-effect surface would have
      basic uniform fabric with zero curvature in the absence of interaction,
      tentatively referred to as null-interaction. Pictorially speaking, this fabric is
      distorted locally or globally like the stretching and shrinking of a rubber sheet
      by the presence of interaction mechanisms between different agents. Since self
      interaction with dilution dummies does not generate intrinsic curvature, this
      criterion of null-interaction would describe the interaction between two truly
      different agents. It is shown that many of the published interaction mechanisms
      give rise to dose-effect surfaces with characteristic curvatures. This possible
      correlation between the intrinsic geometric curvature of dose-effect surfaces and
      the biophysical mechanism of interaction presents an interesting philosophical
      viewpoint for the study of combined action of agents.

PMID- 1638262
TI  - Stochastic models for toxicant-stressed populations.
AB  - We obtain conditions for the existence of an invariant distribution on (0,
      infinity) for stochastic growth models of Ito type. We interpret the results in
      the case where the intrinsic growth rate is adjusted to account for the impact of
      a toxicant on the population. Comparisons with related results for ODE models by
      Hallam et al. are given, and consequences of taking the Stratonovich
      interpretation for the stochastic models are mentioned.

PMID- 1638264
TI  - Behaviour rehabilitation of the challenging client in less restrictive settings.
AB  - Individuals who have sustained traumatic brain injury may provide friends,
      family, and rehabilitation professionals with challenges through an increased
      likelihood of their engaging in socially inappropriate behaviours. At extremes
      the inappropriate behaviours include vocal and physical assault, non-compliance,
      self-injurious behaviours, elopement, and property destruction. While these
      maladaptive behaviours are by themselves troublesome, for some individuals they
      provide severe barriers to rehabilitation. One option for the challenging
      rehabilitation client is a neurobehavioural programme, typically offering an
      access-limited or otherwise secure physical environment and which focuses on
      behaviour reduction. While outcomes from neurobehavioural programmes are
      typically positive, their expense and the negative connotations of this type of
      programme will at times dissuade family members from enrolling the client. We
      describe an alternative, less restrictive behavioural programme operated in the
      physical and social context of a larger, more typical community-based
      rehabilitation programme for traumatically brain-injured individuals. This
      programme has been in operation for nearly three years, successfully serving more
      than 200 clients, of which approximately 20% posed behaviour management problems.
      Identified variables accounting for these successes include: formal guidelines
      for programme development, staff training and monitoring, data collection,
      integration of an interdisciplinary team, discharge planning and post-discharge
      follow-up. We provide a general programme description followed by discussions of
      four brief case studies to illustrate basic principles of the programme.
      Programme strengths are discussed, as are constraints placed on the programme by
      the physical and social environments in which it operates.

PMID- 1638263
TI  - On the kinetics and optimal specificity of cytotoxic reactions mediated by T
      lymphocyte clones.
AB  - Using the chromium release assay and the single cell assay in agarose, we study
      the cytotoxic reaction of the MHC-restricted T lymphocyte clones P89:15 and P1:3,
      which recognize distinct but specific tumour antigens on the surface of syngeneic
      P815 mastocytoma cells. We propose a mathematical model which describes these
      experiments, accounts for the strongly non-Michaelian behaviour of the reaction
      and permits us to estimate the kinetic parameters characterizing effector-target
      conjugation and lethal hit delivery. The results show that the binding and lytic
      activity of effector cells is modulated by the number of targets bound to them.
      The binding of a second target by an effector having already a target bound is
      facilitated; on the other hand, an effector having bound two targets delivers a
      lethal hit more slowly than one with a single target bound. We investigate the
      role of these kinetic properties in the competition between the process of tumour
      progression due to cancer cell replication and the process of tumour regression
      due to T lymphocyte cytotoxic activity. For both clones, we estimate the effector
      target ratio beyond which rejection prevails. This ratio is nine times larger for
      P1:3 than for P89:15. Furthermore, our analysis suggests that there exists an
      optimal specificity minimizing this ratio. Deviations from this optimum, be it in
      the sense of an increase or decrease of specificity, tends to stabilize the
      tumoural state: a situation which in the broader context of the immune response
      evolution and regulation can be viewed as an immune response dilemma.

PMID- 1638265
TI  - Fluoxetine as a treatment for emotional lability after brain injury.
AB  - Emotional lability or emotionalism is a relatively common phenomenon and
      frequently occurs following vascular or traumatic brain injury. It is distressing
      and embarrassing to sufferers and their families, and often interferes with
      rehabilitation. At present there is no satisfactory or reliable treatment for
      this condition. We describe an open trial using fluoxetine, a newer
      antidepressant with a specific serotonergic action, in the treatment of emotional
      lability due to brain injury. Six consecutive cases of emotional lability
      attending a rehabilitation unit were studied (five cases of cerebrovascular
      accident and one of traumatic brain injury). Response to treatment was measured
      using a modification of the scale described by Lawson and MacLeod [1]. All showed
      a marked improvement within one week of commencing fluoxetine and the drug was
      well tolerated with no reported side-effects. The speed of onset and degree of
      improvement suggest that fluoxetine may be a useful agent in the treatment of
      emotional lability due to brain injury. Our observations indicate that further
      investigation of the role of fluoxetine in the treatment of emotional lability is
      warranted.

PMID- 1638266
TI  - Problems and changes after traumatic brain injury: differing perceptions within
      and between families.
AB  - This study is an attempt to characterize subgroups of families based on differing
      perceptions of problems and changes after traumatic brain injury. The Problem
      Checklist of the NYU Head Injury Family Interview was administered to 34 people
      with head injuries (PHI), and a significant other (SO) of each, between 1 and 3
      years post-injury. Families were found to differ systematically in their
      responses and could be divided into three groups: High Agreement group (HAF),
      where there was high agreement between the PHI and the SO regarding problems and
      changes; High Disagreement--PHI endorsing more problems than the SO (HD-PHI); and
      High Disagreement--SO endorsing more problems than the PHI (HD-SO). No
      differences were found between these groups in age, sex, duration of coma, time
      since injury, educational achievement of the PHI, or the SO's relationship to the
      PHI. However, the HD-PHI group tended to have a higher return-to-work rate, the
      SOs in the HAF group reported the highest rates of subjective burden, and groups
      were found to differ in types of items endorsed by the PHI v. the SOs.
      Implications of findings are discussed regarding reliability of reporting
      problems, awareness issues in return to work and subjective burden of family
      members, and methodological and treatment issues.

PMID- 1638267
TI  - Effect of blood alcohol level on recovery from severe closed head injury.
AB  - A retrospective archival study of 129 moderate to severe closed head-injury
      patients from a university-based rehabilitation hospital was conducted to
      investigate the effect of blood alcohol level (BAL) at time of trauma on the
      length of post-traumatic amnesia (PTA), length of hospitalization and cognitive
      status on clearing PTA. While no statistical significance was obtained for the
      effect of BAL on length of PTA, a mean difference of 15.4 days between 'no
      alcohol' and 'intoxicated' patient groups was observed. A low, but significant
      correlation, r = 0.249, p less than 0.05, indicated that as blood alcohol level
      increased, time to rehabilitation admission increased. The sex of the patient had
      a significant effect on length of PTA, BAL and time of recovery variable F (6,81)
      = 2.468, p less than 0.05. Females experienced longer length of PTA, but had
      lower BALs than males. Measures of cognitive status on clearing PTA did not show
      a statistically significant effect of BAL. Results are discussed in terms of
      mediating variables in the relationship between BAL and the length of acute
      hospitalization, prolonged PTA in patients with a positive BAL, and potential
      physiological bases for the interaction among sex, BAL and PTA duration.

PMID- 1638268
TI  - Superior mesenteric artery syndrome: an unusual cause of intestinal obstruction
      in brain-injured children.
AB  - Superior mesenteric artery syndrome is a rare cause of upper intestinal
      obstruction in both adults and children. Sixteen children with severe traumatic
      brain injury and spastic quadriparesis developed small intestinal obstruction
      while undergoing a rehabilitation programme between 1981 and 1990. Five patients
      met the roentgenographic diagnostic criteria. The presenting symptom was post
      prandial bilious vomiting. The mean age was 13 (10-16) years. The mean time
      clapsed from injury to diagnosis was 53 days and from rehabilitation admission to
      diagnosis 22 days. The mean delay in diagnosis after onset of symptoms was 4
      days. All patients were of disproportionately lower body weight in relation to
      height, with a mean weight loss of 7 kg. The mean percentile for weight was 18
      and height 58, with a difference of 30 between height and weight percentiles. The
      patients were receiving nasogastric or gastrostomy tube feedings at the onset of
      the symptoms. All patients were treated non-surgically with gastric aspiration,
      nasojejunal or gastrojejunal feeding by passing a feeding tube distal to
      obstruction. No patient required intravenous hyperalimentation. There was no
      recurrence in any patient during the follow-up period of 1-5 years. Though rare,
      superior mesenteric artery syndrome can develop in brain-injured children with
      spastic quadriparesis, prolonged recumbency and recent weight loss. Increased
      awareness of occurrence of this condition and timely management will decrease
      morbidity and complications that may interfere with recovery.

PMID- 1638269
TI  - Epidemiological findings in traumatic post-comatose unawareness.
AB  - We have examined the epidemiological background of 134 consecutive patients
      admitted to our centre who suffered from post-traumatic unconsciousness of over 1
      month's duration. The incidence of such unconsciousness in Israel is estimated as
      4 per 1,000,000, or one case in 410 hospitalizations for head trauma. The cause
      of trauma was a road accident in 69% of cases. Among victims, pedestrians and
      cyclists were more likely than four-wheeled vehicle drivers and their passengers
      to suffer from prolonged unconsciousness, from which they were less likely to
      recover.

PMID- 1638270
TI  - Functional improvement in severe head injury after readmission for
      rehabilitation.
AB  - Early rehabilitation has been shown to minimize complications and optimize
      functional outcomes in head-injured patients. Although cognitive, behavioural and
      vocational issues continue for years after injury, many investigations maintain
      that physical improvement is limited after 6 months. At 12 months after injury,
      expectations for physical improvement are generally limited. In addition,
      although repeated inpatient admissions for rehabilitation are common, gains in
      self-care and mobility skills during readmissions for rehabilitation have not
      been specifically investigated. In this retrospective study the records of 49
      severely head-injured patients were evaluated. All were readmitted to an
      inpatient rehabilitation facility more than 12 months after injury. Barthel Index
      scores were obtained to evaluate physical function. Although previous studies
      would predict few improvements, in this study 53% (26 patients) showed
      improvement, and the difference between readmission and discharge Barthel scores
      was statistically significant (p = 0.0001). Gains were highly correlated with
      length of readmission, but not with age of patient, age at time of injury, length
      of coma, time since injury, or duration of previous rehabilitation. Patients with
      mid-range admission Barthel scores (21-85) demonstrated the largest gains, with
      79% showing improvement. Gains averaged 11.2 points on the Barthel Index.
      Severely head-injured patients may show clinically significant improvement in
      physical function well after current standards predict a plateau.

PMID- 1638271
TI  - Post-traumatic amnesia and Glasgow Coma Scale related to outcome in survivors in
      a consecutive series of patients with severe closed-head injury.
AB  - A consecutive series of 93 severe closed-head injury (SCHI) patients, discharged
      from hospital in a conscious state, were rated on the Glasgow Outcome Scale at 6
      and 12 months post-injury. Patients were included in this study if they had a
      period of post-traumatic amnesia (PTA) exceeding 24 h. Approximately 80% of
      patients had made a good recovery by 12 months post-injury; a better outcome than
      has been found in studies using the presence of coma during the first 6 h post
      admission to hospital to define severe head injury. When analysed individually,
      duration of PTA and Glasgow Coma Scale scores on admission to hospital were both
      strongly correlated with outcome. Only duration of PTA, however, contributed
      significantly to outcome variance when potential outcome predictors were assessed
      using a stepwise multiple regression analysis. The definition of severe head
      injury, the higher than usual incidence of good recovery in the present study,
      and the relationship between injury severity and outcome are discussed.

PMID- 1638272
TI  - The Simulation Index: a reliability study.
AB  - The Simulation Index was derived from 15 error types on the WAIS-R and WMS
      occurring with a high degree of specificity in a criterion simulation group (n =
      16) and a further five error types specific to a group of patients sustaining
      severe head injury (n = 16). The reliability of the scoring criteria was
      evaluated in terms of the rate of agreement in scoring for the presence or
      absence in each of the 20 error types achieved by two independent
      neuropsychologists. Percentage agreement rates for each of the 20 error types
      ranged between 83 and 100%. When identification of group membership was attempted
      on the basis of simple inspection of the test protocols, diagnostic hit rates
      were at chance level. When identification of group membership was based on
      Simulation Index cut-off scores, each of the raters achieved a diagnostic hit
      rate of 94% for each of the simulation and head-injury group patients. The
      results support the reliability and clinical utility of the Simulation Index.

PMID- 1638273
TI  - Neural changes in acute arthritis in monkeys. I. Parallel enhancement of
      responses of spinothalamic tract neurons to mechanical stimulation and excitatory
      amino acids.
AB  - Somatosensory neurons of the spinal cord, including projection neurons, become
      hyperexcitable to mechanical stimuli during the development of experimental
      arthritis in rats and cats and hence are suggested to participate in the
      generation of arthritic hyperalgesia in humans. The experiments described here
      show a potentiation of the responses of spinothalamic tract (STT) neurons in
      monkeys during the development of an acute arthritis. The results demonstrate
      that the responses of STT neurons to mechanical stimuli and to iontophoretically
      applied excitatory amino acids (EAAs), particularly those acting at non-N-methyl
      D-aspartate (non-NMDA) receptors, become enhanced during the development of
      inflammation produced by intra-articular injection of kaolin and carrageenan.
      Since the enhancement of both responses follows a similar time course, the
      results of this work suggest a role for EAAs in the hyperalgesia associated with
      arthritis and hence may provide a possible pharmacologic target for alleviation
      and/or prevention of arthritic pain.

PMID- 1638274
TI  - Neural changes in acute arthritis in monkeys. IV. Time-course of amino acid
      release into the lumbar dorsal horn.
AB  - Extracellular levels of amino acids were measured during the development of
      experimental arthritis in anesthetized monkeys. Levels of glutamate, aspartate,
      glycine, serine, glutamine, taurine, cysteic acid and asparagine were each
      measured in consecutive 30 min samples before, during and for several hours after
      injection of kaolin and carrageenan into the articular capsule of one knee.
      Samples were obtained via a microdialysis probe placed in the lumbar dorsal horn
      ipsilateral to the injected knee and assayed using HPLC with fluorescence
      detection. Glutamate, aspartate, glycine and serine increased transiently
      following intra-articular injection of inflammatory agents. During this period
      glutamine levels decreased. A second phase of release then occurred which
      included more prolonged changes in amino acid levels that were sometimes of
      greater magnitude than those immediately following the injection. In animals
      which were later observed to have depletion of SP in the dorsal horn of the
      inflamed side, taurine levels increased starting after the Glu, Asp and Gly had
      plateaued at near baseline concentrations. Thus during the first stages of joint
      inflammation EAAs are released into the dorsal horn, followed by increased levels
      of IAAs, possibly representing activation of the descending endogenous analgesia
      system. This phase is followed by a semiacute response consisting in part of
      increased extracellular levels of SP and Tau. While SP is presumably part of an
      ascending nociceptive transmission system, Tau could be part of a second system
      aimed at reducing excessive neural activity including neural transmission
      resulting in intense maintained pain.

PMID- 1638275
TI  - Vestibular influences on the sympathetic nervous system.
AB  - Studies using both electrical and natural stimulation have established that the
      vestibular system has prominent effects on sympathetic outflow and blood
      pressure. Preliminary evidence suggests that receptors in both otolith organs and
      semicircular canals are involved in producing these effects. Furthermore,
      vestibulosympathetic reflexes appear to be mediated by the medial vestibular
      nucleus and slowly conducting projections from the rostral ventrolateral medulla
      and caudal medullary raphe nuclei to preganglionic neurons in the thoracic spinal
      cord. However, many details are missing from our knowledge and understanding of
      the functional significance and neural substrate of vestibular influences on the
      sympathetic nervous system.

PMID- 1638276
TI  - Brain macrophages: evaluation of microglia and their functions.
AB  - There is now evidence approaching, if not having already surpassed, overwhelming
      in support of microglial cells as macrophages. Consistent with this cellular
      identity, they appear to arise from monocytes in developing brain where amoeboid
      microglia function in removing cell death-associated debris and in regulating
      gliogenesis. In normal adult tissue, ramified microglial cells with down
      regulated macrophage functional properties may serve a constitutive role in
      cleansing the extracellular fluid. Under all conditions of brain injury,
      microglia appear to activate and convert into active macrophages. Activated and
      reactive microglia participate in inflammation, removal of cellular debris and
      wound-healing, the latter through regulation of gliosis in scar formation and a
      potential contribution to neural regeneration and neovascularization. In the
      activated state, microglia also express MHC's and, thus, may function in antigen
      presentation and lymphocyte activation for CNS immune responses. As uniquely
      adapted tissue resident macrophages within the CNS, microglia serve a variety of
      functional roles over the lifespan of this tissue. These cells may therefore be
      involved in or contribute to some disease states; such has been indicated in
      multiple sclerosis and AIDS dementia complex.

PMID- 1638277
TI  - Protective effect of antibiotics on mortality risk from acute respiratory
      infections in Mexican children.
AB  - A case-control study of mortality from acute respiratory infections (ARI) among
      children under five years of age was conducted in Naucalpan, an urban-suburban
      area of Mexico City, and in rural localities of Tlaxcala, Mexico. The study found
      that ARI deaths tended to occur in the poorest neighborhoods; 78% of the deceased
      study subjects were infants under six months old; and 68% of the deaths occurred
      at home. Comparison of the data for cases (fatalities) and control children who
      had severe ARI but recovered showed that failure to receive antibiotics was
      associated with death (odds ratio 28.5, 95% confidence interval 2.1-393.4). This
      antibiotic effect was controlled for numerous potentially confounding factors. It
      is evident that antibiotics had a much greater effect in the early days of the
      illness than later on. In general, the findings strongly support PAHO/WHO primary
      health care strategies--including such strategies as standardized management of
      severe ARI cases--that seek to reduce childhood ARI mortality.

PMID- 1638278
TI  - Installation of a water disinfection system in a Mexico City hospital.
AB  - With a view to evaluating a small-scale water disinfection system based on
      production and application of oxidizing gases, the level of equivalent residual
      chlorine and the degree of contamination by fecal and total coliform bacteria was
      assessed at various points in the drinking water system of a Mexico City hospital
      before and after installation of the disinfection equipment. Tests done in May
      and June 1989, prior to installation of the equipment, showed that residual
      chlorine concentrations were lower than the national standard in most of the
      samples and that a sizable portion of these samples were also contaminated with
      fecal and total coliform concentrations exceeding national standards. After
      installation of the disinfection system at the main inflow to the hospital's
      drinking water supply in August 1989, the equivalent residual chlorine
      concentrations were found adequate and no coliform bacteria were detected. These
      results indicate that the oxidant mixture generated by the newly installed system
      was effectively disinfecting the water.

PMID- 1638279
TI  - Maternal and infant feeding practices in rural Bolivia.
AB  - Seventy-four members of mothers' clubs in a rural area outside of La Paz,
      Bolivia, were interviewed in order to learn more about maternal and infant
      nutritional practices and use of child health services. Most of the women used a
      combination of western and traditional child health services, though a
      substantial percentage used only traditional services. Almost all of their
      deliveries were attended solely by family members, most notably the pregnant
      woman's husband. All the interviewed mothers breast-fed their infants, although
      most gave them other prelacteal liquids in the immediate postpartum period.
      Breast milk supplementation generally began when the infants were between four
      and eight months old, occasionally later. Most of those interviewed said they
      stopped breast-feeding when they knew they were pregnant again; some continued
      breast-feeding through all or part of the pregnancy; only a small number stopped
      breast-feeding before they knew that they were pregnant. Almost all the women
      increased their food intake when they were breast-feeding, primarily by consuming
      additional liquids. These findings suggest that some current maternal and infant
      nutritional practices in the study area (such as universal breast-feeding and
      increased consumption of liquids by lactating mothers) should be encouraged,
      while others (particularly prelacteal feeding of liquids other than breast milk
      and late supplementation) should be discouraged. Both traditional and western
      health providers should be mobilized to perform this task.

PMID- 1638280
TI  - Serologic screening for Trypanosoma cruzi among blood donors in central Brazil.
AB  - The study reported here compares results obtained by blood banks screening sera
      for chagasic (Trypanosoma cruzi) infection with results obtained by the Chagas'
      Disease Reference Laboratory of the Federal University of Goias in Goiania,
      Brazil. It also evaluates results obtained using the ELISA technique to screen
      the study sera. The survey used data from six of eight blood banks serving the
      city of Goiania, an urban region of Central Brazil where Chagas' disease is
      highly endemic. The survey population consisted of 1,513 voluntary first-time
      blood donors whose donations occurred between October 1988 and April 1989. This
      group included 50% of all the first-time blood donors in that period. The six
      participating blood banks, which accounted for about 90% of all blood donations
      in Goiania during the study period, routinely used indirect hemagglutination
      (IHA) and complement fixation (CF) tests to screen sera for antibodies to T.
      cruzi. Comparison of the results provided by the blood banks with the reference
      laboratory's results indicated a relative sensitivity of 77%, which ranged from
      50% to 100% depending on the blood bank studied. The comparison, which found 12
      false negative results, indicated that transfusions of infected blood might have
      occurred despite the serologic screening performed by the blood banks. Relative
      to the standard of positivity established for the study, the enzyme-linked
      immunosorbent assay (ELISA) technique was found to have a sensitivity of 96.3%.
      Considering as positive only those sera yielding positive IHA and indirect
      immunofluorescence (IIF) test results, the ELISA technique yielded 2 false
      negative and 41 false positive responses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638281
TI  - Cysticercosis: first 12 months of reporting in California.
AB  - Cysticercosis, a sometimes fatal ailment caused by larvae of the pork tapeworm
      Taenia solium, became a reportable disease in California in 1989. During the
      first year, from 1 April 1989 through 31 March 1990, 134 cases were reported to
      the California Department of Health Services. All of the 112 patients for whom
      laboratory diagnostic test data were obtained had neurocysticercosis. Nearly all
      (117) of the 127 patients whose race and ethnic background were known had a
      Hispanic background, and most of the 112 patients whose country of birth or prior
      residence was known had immigrated from T. solium-endemic countries. However,
      three of 11 patients born in the United States said they had never traveled
      outside the country, and it appears possible that indigenous transmission has
      been occurring. These findings affirm that neurocysticercosis should be included
      in the differential diagnosis of neurologic symptoms in patients who have
      immigrated from or traveled to T. solium-endemic countries, and also in those who
      have been in close contact with immigrants from endemic countries.

PMID- 1638282
TI  - Cost-benefit analysis of a regional system for vaccination against pneumonia,
      meningitis type B, and typhoid fever.
AB  - In early 1989 PAHO began examining a proposal for a regional program that would
      develop and disseminate vaccines of particular interest to its Member Countries.
      As part of that examination, a cost-benefit analysis was performed. That general
      analysis, presented here, sought to point up key factors that would strongly
      influence whether or not the program's benefits outweighed its costs. The
      program's two fundamental components, vaccine development and vaccine
      administration, were evaluated separately. Using a discount rate (r) of 10%, 10
      year vaccine development costs were estimated at US$80.3 million in constant
      dollars. It was felt that enough people (at least 19.5 million a year) would be
      vaccinated so that the program would benefit from economics of scale. The total
      discounted number of vaccinations administered over a 20-year period was expected
      to be in the range of 400 to 506 million. Using these figures, estimates were
      made of the maximum that could be spent on vaccine administration without
      exceeding anticipated benefits. Considering only treatment costs saved through
      vaccination, assuming all sick people were treated, the ceiling cost for
      vaccinating one person against one target disease would be in the range of
      US$0.52-0.58. Even if not all the sick were treated, however, the Regional
      Vaccine System (SIREVA) would still appear justified if the benefits per disease
      case prevented were found to average between US$1,000 and US$2,000. Even so, it
      should be noted that these estimates are subject to a good deal of additional
      variation because of uncertainties regarding the worth of many elements evaluated
      -including the costs of lost work time, disability, and mortality--and because
      some of the elements involved--such as pain, suffering, and death--fall outside
      the purely economic realm.

PMID- 1638283
TI  - Tobacco or health: status in the Americas, 1992.

PMID- 1638284
TI  - Wound healing in foetal sheep: a histological and electron microscope study.
AB  - A study was made of the healing of excised, unsutured and sutured skin wounds in
      foetal sheep of 75, 90 and 120 days gestation and of wounds in newborn lambs and
      adult ewes. Foetal and postnatal wounds were found to heal in a very similar way.
      At each stage of development studied, excised wounds contract rapidly and
      histological and electron microscope examination demonstrates formation of
      granulation tissue and its maturation to scar tissue in all types of wound.
      Examination of polyvinyl sponges 7 and 14 days after subcutaneous implantation
      confirms the ability of foetal sheep to form vascularised scar tissue. The
      cellular inflammatory response to wounding is much less prominent in foetal than
      in postnatal sheep, the number and type of extravascular cells reflecting the
      changes in blood leucocyte content during development. From a very early stage
      foetal sheep react to insoluble irritants by the formation of multinucleate giant
      cells.

PMID- 1638285
TI  - A comparison of heparinised saline irrigation solutions in a model of
      microvascular thrombosis.
AB  - The use of heparinised irrigation solutions has become common in microvascular
      surgery, but the concentration of heparin has been determined empirically. A
      laboratory model of microvascular thrombosis, employing a crush injury, intimal
      abrasion, and stasis to the rat superficial femoral artery was used to compare
      heparinised saline irrigation solutions of various concentrations. The solutions
      included normal saline (Group I, controls) and heparinised normal saline in
      concentrations of 10 U/ml (Group III), 250 U/ml (Group IV), and 500 U/ml (Group
      V). Group I animals had a patency rate of 25% at 20 min and 0% at 24 h. Group II
      showed a patency rate of 75% at 20 min but fell to 37.5% at 24 h. Patency in
      Group III was 87.5% at 20 min and at 24 h. Group IV had a 100% patency rate at 20
      min and at 24 h. Group V animals were 100% patent at 20 min and 87.5% patent at
      24 h. The activated partial thromboplastin time was prolonged in animals exposed
      to 250 U/ml and 500 U/ml of heparinised saline. Patency was significantly
      improved in animals exposed to 100 U/ml, 250 U/ml and 500 U/ml when compared to
      the control group (p less than 0.001). These results suggest that topical
      heparinised saline administration is of benefit in the prevention of
      microvascular thrombosis. Higher concentrations tested in this study resulted in
      a significant increase in patency, but also prolonged the activated partial
      thromboplastin time. 100 U/ml is the ideal concentration of heparinised saline
      irrigation because it significantly improved patency but did not produce
      detectable systemic effects in this model.

PMID- 1638286
TI  - An in vitro study on the effect of UVA radiation on human gingival fibroblasts.
AB  - The recent availability of a 99.9% UVA source has made possible studies that show
      that low energy wavelengths, previously considered innocuous, significantly
      affected wound healing in hairless guinea pigs. Decreased wound tensile strength
      and a slower rate of wound contraction in irradiated animals were among the
      changes noted. Because of their advocated role in the wound healing process,
      fibroblasts were chosen to study the effects of pure UVA exposure at a cellular
      level. 3H-thymidine uptake levels were measured in 8 groups of fibroblast
      cultures (12 samples/group). The cultures were exposed to varying concentrations
      of pure UVA. Previously incorporated 14C-thymidine levels were used to compensate
      for differences in cell numbers between samples. At a fluence of 3.65 x 10(-3)
      watts/cm2, a significant decrease in 3H-thymidine incorporation (compared to
      controls) was seen for all exposure periods and there was a dose-dependent
      decrease only in 3H-thymidine uptake for cells exposed to 1-4 min of UVA. Using
      post-exposure incubations of 2-16 h, a time-dependent recovery of 3H-thymidine
      uptake was also demonstrated, from 40% of control at 4 h, to 75% at 8 h, and 99%
      at 16 h. The near-complete recovery at 16 h was seen in exposures up to 2.73
      joules/cm2 (12 min), whereas higher concentrations showed only partial recovery.
      These studies demonstrated the deleterious, though reversible, effects of UVA on
      fibroblasts and suggest a possible pathophysiologic process for UVA's effect on
      wound healing in this animal model.

PMID- 1638287
TI  - New grafts for old? A review of alternatives to autologous skin.
AB  - Immediate resurfacing of skin defects is a challenging prospect, especially in
      patients with extensive full-thickness burns. Currently, split-thickness
      autografts offer the best form of wound coverage, but limited donor sites and
      their associated morbidity have prompted the search for alternatives. The
      application of allogeneic skin is restricted by availability and the risk of
      transmission of infection, whilst synthetic skin substitutes are simply expensive
      dressings. The problems of limited expansion may be overcome by culturing
      keratinocytes in vitro. Unlike autologous cells, allogeneic keratinocytes are
      available immediately, although they survive for less than a week when applied to
      full-thickness skin defects. Moreover, the absence of a dermal component in these
      grafts predisposes to instability and contracture. A cross-linked collagen and
      glycosaminoglycan dermal substitute, covered with thin split-skin grafts or
      cultured autologous keratinocytes, shows promise in burns patients. An
      alternative is a collagen matrix populated by allogeneic fibroblasts and overlaid
      with cultured autologous or allogeneic keratinocytes. The clinical application of
      cultured grafts remains imperfect but offers the prospect of immediate coverage
      and massive expansion.

PMID- 1638288
TI  - A vascularised rib strut technique for funnel chest correction.
AB  - We have refined the Ravitch technique of sternal elevation for surgical
      correction of funnel chest. Our major modification is introducing a living rib
      strut for supporting the elevated sternum. The left 5th rib with a vascular
      pedicle from the internal thoracic artery is turned 180 degrees beneath the
      sternum. We have used this method in 10 cases. The results have all been
      satisfactory.

PMID- 1638289
TI  - Improved chest wall fixation for correction of pectus excavatum.
AB  - Pectus excavatum, the most common congenital chest wall abnormality, is
      manifested by deformity of the costal cartilages resulting in a depressed and
      often rotated sternum. Although there are conflicting data to support and reject
      the concept that physiologic improvement can be a consequence of surgical repair,
      correction is frequently indicated for aesthetic improvement alone. The most
      popular current repair involves resection of abnormal costal cartilages, sternal
      osteotomy and mobilisation, followed by fixation of the sternum in the corrected
      position. Improved fixation techniques have evolved, but generally have not
      employed current concepts of rigid fixation. The correction of pectus excavatum
      using reconstruction plates incorporates the benefits of rigid fixation, while
      allowing custom chest wall contouring and sternal reorientation. Reconstruction
      plate fixation of the sternum should be considered during correction of pectus
      excavatum in adult and adolescent patients.

PMID- 1638290
TI  - Intra- and postoperative steroid injections for keloids and hypertrophic scars.
AB  - Treating keloids and hypertrophic scars is difficult. Here we report our method
      of treating recurrent keloid and hypertrophic scars. This involves surgical
      excision associated with intraoperative steroid injection, followed by routine
      weekly steroid injections for 2-5 weeks dependent on clinical signs and symptoms
      (pain, pruritus or paraesthesia), and monthly injections for another 3-6 months.
      The preliminary results thus far are promising.

PMID- 1638292
TI  - A bipedicled neurovascular step-advancement flap for soft tissue lengthening in
      clinodactyly.
AB  - Recommendations for the surgical treatment of clinodactyly have centered on
      techniques of osteotomy with or without bone grafting. However, the limiting
      factor to the correction may be tension in the soft tissues. A new technique to
      correct clinodactyly is described utilising an opening wedge osteotomy and bone
      grafting plus a bipedicled neurovascular step-advancement flap to correct the
      soft tissue deficiency. The procedure has been performed in five cases.

PMID- 1638291
TI  - Evaluation of various methods of treating keloids and hypertrophic scars: a 10
      year follow-up study.
AB  - An attempt was made to assess the value of beta radiation alone or in combination
      with surgery, and of intralesional triamcinolone acetonide in treating 100
      keloids and hypertrophic scars in 65 patients. Beta radiation alone was found to
      be effective in the eradication of symptoms (55% symptomatic relief), while
      results in the reduction of size of lesions have been poor (11% success rate).
      Surgery combined with postoperative beta radiation therapy yielded a 67% success
      rate. The success rate was 75% when radiation was delivered within 48 h of
      surgery. Preoperative radiation was found to be of no advantage. Intralesional
      triamcinolone acetonide produced symptomatic relief in 72% and complete
      flattening in 64% of the lesions.

PMID- 1638293
TI  - Organisation of cleft lip and palate services--results of a questionnaire.

PMID- 1638294
TI  - Extracorporeal tissue transfer for intra-oral reconstructions.
AB  - After the introduction of the concept of extracorporeal tissue transfer by the
      author in 1988, the technique has gained world wide acceptance and popularity.
      However it has not been used intraorally and in this paper we present its use in
      three very difficult intra-oral reconstructions. The technique is presented along
      with the results, and the merits discussed.

PMID- 1638295
TI  - A modified Le Fort I osteotomy for maxillofacial deformity: a preliminary report.
AB  - A new technique of Le Fort I osteotomy using a wedge-shaped bony incision is
      described. After forward mobilisation of the osteotomised maxilla, the bone graft
      is held firmly in contact under some compression between the maxilla and the
      mobilised wedged portion to achieve greater stability. This is a very effective
      technique for those maxillary osteotomies which need bone graft stabilisation,
      such as in cleft lip and palate patients.

PMID- 1638296
TI  - Relationship between intracranial pressure and intracranial volume in
      craniosynostosis.
AB  - Premature fusion of cranial sutures in craniosynostosis has been thought to lead
      to craniostenosis, which in turn may lead to increased intracranial pressures. In
      41 consecutive patients with craniosynostosis, intracranial pressure and
      intracranial volume were measured. Of the 41 patients, 38 (92.6%) had raised
      intracranial pressure but only 4 (9.7%) had a decreased skull volume. In the
      present study, there is no correlation between intracranial volume and
      intracranial pressure. This study confirms that the measurement of intracranial
      volume, a non invasive procedure, cannot be used to assess intracranial pressure
      and to avoid an invasive procedure.

PMID- 1638298
TI  - The sensate deep inferior epigastric artery local musculocutaneous flap: report
      of a further case.

PMID- 1638297
TI  - The cervical tube pedicle flap: uses in facial reconstruction.
AB  - Most reconstructive surgeons will not commonly need to use the transverse
      cervical tube pedicle flap in facial reconstruction but this straightforward and
      simple technique can be very useful in certain instances. Some of the techniques
      of reconstructive surgery which have stood the test of time should not be
      forgotten even when the most recent reconstructive options are available.

PMID- 1638299
TI  - Complete bilateral cleft lip.

PMID- 1638300
TI  - A comparison of the use of polythene and jelonet as temporary dressing for
      excised wound.

PMID- 1638301
TI  - Venous flaps.

PMID- 1638302
TI  - Evaluation in mental health care.

PMID- 1638303
TI  - Long-term mortality in anorexia nervosa. A 20-year follow-up of the St George's
      and Aberdeen cohorts.
AB  - Two cohorts of anorexia nervosa patients were followed up for a mean of 20 years.
      All except 4% of each cohort was traced. The crude mortalities were: St George's,
      4%; Aberdeen, 13%. The SMRs were: St George's, 136; Aberdeen, 471. If the
      untraced were assumed to be dead, crude mortalities were 7.6% and 15.9%
      respectively, and SMRs were 276 and 592 respectively. Causes of death were
      complications of the illness and suicide. Medical treatment may reduce early
      mortality, while comprehensive medical and psychotherapeutic treatment may reduce
      late mortality.

PMID- 1638305
TI  - Deliberate self-poisoning in Asian and Caucasian 12-15-year-olds.
AB  - The mean annual rates of hospital admission for deliberate self-poisoning were
      calculated for Caucasian and Asian 12-15-year-olds between 1982 and 1990 as 2.31
      and 2.47 per 1000 respectively. There was an excess of girls in each group.

PMID- 1638304
TI  - Screening of acute psychiatric admissions for previously undiagnosed systemic
      lupus erythematosus.
AB  - An auto-antibody screen for SLE, which included antinuclear antibodies, was
      performed on 296 patients admitted to acute psychiatric and psychogeriatric
      wards. Three cases (1% of those screened) of previously undiagnosed SLE were
      found, and one patient was found to have autoimmune chronic active hepatitis. An
      auto-antibody screen may be a useful investigation in psychiatric practice.

PMID- 1638306
TI  - Minaprine in depression. A controlled trial with amitriptyline.
AB  - Minaprine (200 mg daily, either once or divided b.d.) was compared with
      amitriptyline (25-50 mg t.d.s.) over six weeks in 144 patients with major
      depression. Significant reductions in HRSD scores at the end of six weeks'
      treatment were recorded with both dose regimes of minaprine and with
      amitriptyline, with no significant differences between them. There was a
      significantly greater incidence of drowsiness and dry mouth with amitriptyline
      than with minaprine.

PMID- 1638307
TI  - Depression and 'hassles' in globus pharyngis.
AB  - A group of 25 patients (16 women, 9 men) attending an ENT department with globus
      sensation and 25 matched ENT controls were assessed using the Beck Depression
      Inventory and scales for daily stressful events ('hassles'). Globus patients of
      both sexes were significantly more depressed than controls and had Beck scores
      suggestive of significant depression. Thirteen patients, but only two controls,
      had an independent life event within two months of disease onset, and patients
      had higher hassles scores than controls.

PMID- 1638308
TI  - The treatment of a chronic organic mental disorder with dextromethorphan in a man
      with severe mental retardation.
AB  - Response to dextromethorphan (15 mg b.i.d.), an antitussive agent not usually
      considered to have psychotropic properties, was seen in a 25-year-old man with
      severe developmental disabilities, congenital rubella, and an organic mental
      disorder. Dextromethorphan affects CNS serotonergic systems, and this was the
      probable therapeutic mechanism. This and other published cases suggest the
      existence of a distinct organic mental syndrome in developmentally disabled
      persons which responds to drugs that increase indoleaminergic activity.

PMID- 1638310
TI  - Dementia presenting with sore eyes.
AB  - A patient who presented with soreness of her eyes was given a diagnosis of
      dementia of the frontal type (DFT) complicated by a major depressive illness. The
      report illustrates the multiplicity of presenting symptoms in patients with
      dementia. Resistance to treatment is often an indication that a depressive
      disorder is symptomatic of underlying organic brain disease.

PMID- 1638309
TI  - Psychiatric aspects of liver disease.
AB  - This paper reviews the literature on the effects of liver disease on mental
      health, a topic which has been relatively neglected in the recent psychiatric
      literature. It discusses both the encephalopathy which may be associated with
      liver disease of almost any type and the psychological consequences of specific
      liver disorders. Also considered are the effects of liver disease on sexual
      function; the relationship between alcohol and hepatic disorder in causing mental
      disturbance; the effects of childhood liver disease; psychiatric aspects of liver
      transplantation; and the use of psychotropic drugs in patients with hepatic
      dysfunction.

PMID- 1638311
TI  - Capgras and koro.

PMID- 1638312
TI  - Daily living programme.

PMID- 1638314
TI  - Schizophrenia following prenatal exposure to influenza epidemics between 1939 and
      1960.

PMID- 1638313
TI  - Enhancement of recovery from psychiatric illness by methylfolate.

PMID- 1638315
TI  - Psychotherapy in non-Western cultures.

PMID- 1638316
TI  - Lithium augmentation in antidepressant-resistant patients.

PMID- 1638317
TI  - Who benefits from ECT?

PMID- 1638318
TI  - Acute transient stress-induced hallucinations in soldiers.

PMID- 1638319
TI  - Drug therapy of post-traumatic stress disorder.

PMID- 1638320
TI  - Child psychiatry in the 20th century.

PMID- 1638321
TI  - Sex differences in the familial risk of schizophrenia: data from Rudin's study.

PMID- 1638323
TI  - The distorting influence of time.

PMID- 1638324
TI  - Iron Maiden's deja vu.

PMID- 1638325
TI  - Currie's complaint?

PMID- 1638326
TI  - Psychotherapy in borderline and narcissistic personality disorder.
AB  - Psychodynamic concepts about borderline personality disorder are reviewed and the
      literature concerning psychotherapeutic treatment of this group is examined. The
      treatment contexts considered include: psychoanalysis and intensive (expressive)
      psychoanalytic psychotherapy, supportive psychotherapy, group psychotherapy,
      family therapy, in-patient treatment, the therapeutic community, cognitive
      behavioural approaches, and combinations of drugs and psychotherapy. The
      practical implications of recent follow-up studies for intervention strategies
      are considered.

PMID- 1638327
TI  - Psychosocial factors, arousal and schizophrenic relapse. The psychophysiological
      data.

PMID- 1638322
TI  - Amnesia in fugue states--neurological or psychogenic basis.

PMID- 1638328
TI  - Social factors and recovery from anxiety and depressive disorders. A test of
      specificity.
AB  - Analysis of 33 instances of recovery or improvement among 92 women with anxiety,
      and 49 instances of recovery and improvement among 67 episodes of depression,
      showed that recovery and improvement, when compared with conditions not changing,
      were associated with a prior positive event. Such events were characterised by
      one or more of three dimensions: the 'anchoring' dimension involved increased
      security; 'fresh-start', increased hope arising from a lessening of a difficulty
      or deprivation; and 'relief', the amelioration of a difficulty not involving any
      sense of a fresh start. Events characterised by anchoring were more often
      associated with recovery or improvement in anxiety, and those characterised as
      fresh-start were associated with recovery or improvement in depression. Recovery
      or improvement in both disorders was more likely to be associated with both
      anchoring and fresh-start events. The study involved the reworking of some social
      and clinical material, and although done blind should be seen as exploratory.

PMID- 1638329
TI  - Evidence for a pseudoautosomal locus for schizophrenia. I: A replication study
      using phenotype analysis.
AB  - A locus for schizophrenia within the pseudoautosomal region of chromosomes X and
      Y has been suggested by Crow on the basis of epidemiological data. The present
      report replicates this finding in a sample of 38 French multiply affected
      families with schizophrenia. Sibship and pairwise analysis, with or without
      weighted-pair correction, with three different systems of family classifications,
      showed there to be an excess of same-sex pairs in paternally derived sibships, as
      predicted by the pseudoautosomal hypothesis.

PMID- 1638330
TI  - Evidence for a pseudoautosomal locus for schizophrenia. II: Replication of a non
      random segregation of alleles at the DXYS14 locus.
AB  - Because of an association between sexual aneuploidies and schizophrenia, and
      because schizophrenic siblings have been found to be more often of the same than
      of the opposite sex, the susceptibility locus for schizophrenia is thought to lie
      within the pseudoautosomal region of the sex chromosomes. We analysed 33 sibships
      comprising 18 pairs, 13 trios, and 2 quartets of affected siblings, and found
      support for non-random segregation of of alleles at the DXYS14 locus in affected
      siblings. These findings are consistent with the pseudoautosomal hypothesis for
      schizophrenia and favour a genetic linkage between DXYS14 and the disease.

PMID- 1638332
TI  - Estimation of premorbid intelligence in schizophrenia.
AB  - To determine whether the National Adult Reading Test (NART) would provide a valid
      estimate of premorbid intelligence in schizophrenia, two schizophrenic samples
      were recruited, one consisting of 35 patients resident in long-stay wards, the
      other of 29 patients normally resident in the community. Schizophrenic patients
      were individually matched for age, sex, and education with a healthy, normal
      subject. Both schizophrenic samples scored significantly lower on the Wechsler
      Adult Intelligence Scale (WAIS) than their respective control groups. NART
      estimated IQ did not differ significantly between the community-resident
      schizophrenics and their controls, suggesting that the NART provides a valid
      means of estimating premorbid intelligence in such a population. NART-estimated
      IQ was significantly lower in the long-stay sample than in their controls.
      Although low NART scores in this latter sample could be a valid reflection of low
      premorbid IQ, the alternative explanation that NART performance was impaired by
      onset of the disease cannot be ruled out.

PMID- 1638334
TI  - Physical illness in chronic psychiatric patients from a community psychiatric
      unit revisited. A three-year follow-up study.
AB  - A group of 156 psychiatric patients from an urban community psychiatric unit for
      chronic psychiatric patients was routinely medically screened and reported on. Re
      evaluation of the medical diseases found in those patients was carried out three
      years later. Those who were still being treated--73 patients (47%)--were
      interviewed, as were their psychiatrist and, where necessary, their general
      practitioner (GP). The implementation of medical recommendations given following
      the physical screening by the specialist in internal medicine was also assessed.
      Re-evaluation of the diagnoses confirmed that 36% of this population had one or
      more physical diseases, rather than the 53% found earlier. The results show that
      the majority of physical complaints and diseases as well as functional illnesses
      were as persistent as the psychiatric diagnoses in this patient group. The
      patients' GP seems to be the person best suited as the primary physician
      responsible for the patient's physical health.

PMID- 1638333
TI  - A needs survey among patients in Leros asylum.
AB  - The recent exposure of the plight of inmates living in poor conditions at the
      state asylum on the Greek island of Leros has caused public and professional
      outrage. If Greece is to avoid mistakes made by other countries, the plans for
      rehabilitating the patients and closing the hospital should from the outset
      include identification of the precise needs of patients for support and care. The
      survey of the patients' characteristics and needs for care found that most
      patients had no outside friends or relatives, and most were unable to perform
      basic daily skills. They shared many basic characteristics, however, with a large
      sample of the long-stay population in the UK, and 25% were thought to be able to
      live independently.

PMID- 1638335
TI  - Disulfiram treatment of alcoholism.
AB  - To assess the efficacy of supervised disulfiram as an adjunct to out-patient
      treatment of alcoholics, a randomised, partially blind, six-month follow-up study
      was conducted in which 126 patients received 200 mg disulfiram or 100 mg vitamin
      C under the supervision of a nominated informant. In the opinion of the (blinded)
      independent assessor, patients on disulfiram increased average total abstinent
      days by 100 and patients on vitamin C by 69, thus enhancing by one-third this
      measure of treatment outcome. Mean weekly alcohol consumption was reduced by 162
      units with disulfiram, compared with 105 units with vitamin C, and the disulfiram
      patients reduced their total six-month alcohol consumption by 2572 units compared
      with an average reduction of 1448 units in the vitamin C group. Serum gamma-GT
      showed a mean fall of 21 IU/I in patients on disulfiram but rose by a mean of 13
      IU/I with vitamin C. Unwanted effects in the disulfiram group led to a dose
      reduction in seven patients and to treatment withdrawal in four (and in one
      vitamin C patient). Two-thirds of the disulfiram group asked to continue the
      treatment at the end of the study. There were no medically serious adverse
      reactions.

PMID- 1638336
TI  - Sexual abuse and the severity of bulimic symptoms.
AB  - In a clinical series of 40 bulimic women, a reported history of unwanted sexual
      experience was associated with more frequent bingeing and (to a lesser extent)
      vomiting. These symptoms were more marked when the abuse was intrafamilial,
      involved force, or occurred before the victim was 14 years old. Further research
      is required to establish the causal links between the phenomena of sexual abuse
      and bulimic symptoms.

PMID- 1638338
TI  - Coping with hearing voices: an emancipatory approach.
AB  - A questionnaire comprising 30 open-ended questions was sent to 450 people with
      chronic hallucinations of hearing voices who had responded to a request on
      television. Of the 254 replies, 186 could be used for analysis. It was doubtful
      whether 13 of these respondents were experiencing true hallucinations. Of the
      remaining 173 subjects, 115 reported an inability to cope with the voices. Ninety
      seven respondents were in psychiatric care, and copers were significantly less
      often in psychiatric care (24%) than non-copers (49%). Four coping strategies
      were apparent: distraction, ignoring the voices, selective listening to them, and
      setting limits on their influence.

PMID- 1638339
TI  - J-wire facilitates retrograde manipulation of ureteric calculi prior to
      extracorporeal shock wave lithotripsy.
AB  - During a 13-month period, 55 patients underwent attempted retrograde manipulation
      for ureteric lying above the pelvic brim. The mean stone burden was 11 mm (range
      5-21); 41 stones (75%) were primary ureteric calculi and 14 (25%) were fragments
      resulting from extracorporeal shock wave lithotripsy to renal calculi. The method
      of retrograde manipulation was recorded prospectively. Retrograde flushing
      through an 8F angiography catheter with a mixture of saline and lignocaine gel
      was successful in 27 patients (49%). The insertion of a J-wire through the
      angiocath allowed for successful manipulation in a further 17 patients (31%).
      Retrograde manipulation was impossible in 11 patients (20%). There were 4
      complications (7%), none attributable to the use of a J-wire.

PMID- 1638337
TI  - The effects of electroconvulsive therapy on plasma insulin and glucose in
      depression.
AB  - The effects of ECT on plasma insulin and glucose were assessed in 20 depressed
      patients, during the first, third and fifth session of ECT. After each
      administration of ECT there was a significant rise in blood glucose and plasma
      insulin levels, both of which peaked at 15 minutes. Insulin responses tended to
      attenuate over the course of ECT, whereas the glucose responses were similar for
      all three treatments. ECT was effective in all patients, although two months
      after the last treatment nine patients had partially relapsed (Hamilton score
      greater than 15). Those who relapsed had a more attenuated insulin response at
      the fifth treatment than those who had remained well, which suggests that insulin
      response to ECT may be predictive of clinical outcome.

PMID- 1638342
TI  - Long-term follow-up of women treated with perurethral Teflon injections for
      stress incontinence.
AB  - The perurethral injection of Teflon has been advocated as a simple, economical
      and effective treatment of stress incontinence in women. We have reviewed
      patients treated by this technique in Nottingham. Improvement in their symptoms
      fell from 80% immediately after operation to 27% at follow-up 3 years later.
      Because of the disappointing long-term results we have abandoned this procedure
      for the treatment of stress incontinence.

PMID- 1638341
TI  - Dialysis in patients with upper urinary tract transitional cell carcinoma.
AB  - In some patients with primary malignant disease of the kidney the only way of
      achieving a cure may involve radical surgery. If the tumour is bilateral or
      involves a solitary kidney, renal failure may be unavoidable. The role of
      dialysis and transplantation in these patients following "curative" cancer
      surgery is not clear. A review of the literature and experience with 4 patients
      who ultimately had bilateral nephrectomies for multiple recurrent upper tract
      urothelial malignancy is reported. These 4 patients remained free of tumour
      recurrence on dialysis at 5, 8, 12 and 72 months respectively since commencing
      dialysis, although 2 have died from unrelated causes. It would seem reasonable to
      offer dialysis followed by subsequent transplantation in this group of patients
      after a period of 1 to 2 years has elapsed without any evidence of malignant
      recurrence.

PMID- 1638343
TI  - Subjective and objective effects of intravaginal electrical myostimulation and
      biofeedback in patients with genuine stress urinary incontinence.
AB  - A group of 36 patients (18 premenopausal and 18 postmenopausal), all suffering
      from genuine stress urinary incontinence, underwent conservative treatment with 6
      sessions of intravaginal electromyostimulation followed by 6 sessions of
      biofeedback; 89% of patients reported an improvement, 5.5% considered themselves
      cured and 5.5% reported no change. Intravaginal pressure measured before and
      after therapy increased by an average of 11 cm H2O in premenopausal patients and
      17 cm H2O in the postmenopausal group. Intravaginal pressure increased in all
      patients and, according to maximal urethral closure pressure, this increasing
      intravaginal pressure was observed even in patients with low pressure urethras.
      The urodynamic factors studied were functional length, maximum urethral closing
      pressure and pressure transmission, together with urethral surface at rest and
      during stress, and residual surface. No significant changes were noted before and
      after treatment. The excellent subjective results contrast with the absence of
      improvement in these values.

PMID- 1638331
TI  - No evidence for a pseudoautosomal locus for schizophrenia. Linkage analysis of
      multiply affected families.
AB  - Evidence for a pseudoautosomal locus for a schizophrenia susceptibility gene was
      sought by two forms of analysis of 25 multiply affected families. Firstly, in the
      sample as a whole there was an excess of same-sex over mixed-sex siblings
      compared with that expected. Secondly, linkage analysis was performed in six of
      the families. The genotypes were studied for DXYS14, a highly polymorphic marker
      in the telomeric pseudoautosomal region. No evidence for positive linkage was
      found with two-point analysis under eight different genetic models for the mode
      of transmission. A non-parametric, sibling-pair analysis also failed to detect
      linkage. Our findings provide no evidence for linkage within the pseudoautosomal
      region; same-sex concordance must arise from some other mechanism.

PMID- 1638340
TI  - Thiazide treatment for calcium urolithiasis in patients with idiopathic
      hypercalciuria.
AB  - In a randomised trial based on a parallel design to determine the prophylactic
      effect of thiazide on stone formation, 210 calcium urolithiasis patients with
      idiopathic hypercalciuria were allocated either to treatment with
      trichlormethiazide (4 mg/day) or no treatment with only close follow-up; 35
      patients were excluded for various reasons, including voluntary withdrawal. The
      background of the remaining 175 patients (82 in the thiazide group and 93 in the
      control group), including age and sex, was similar for both groups. In patients
      treated with thiazide there was a statistically significant fall in urinary
      calcium output. Statistical analyses also demonstrated that the stone formation
      rate in the thiazide group was significantly less than that in the control group.
      Adverse clinical reactions probably due to the drug were observed in 9 patients.
      These findings indicate that trichlormethiazide has a prophylactic effect on
      calcium urolithiasis in patients with idiopathic hypercalciuria.

PMID- 1638344
TI  - Reconstruction of the lower urinary tract for neurogenic bladder: lessons from
      the adolescent age group.
AB  - Of 42 adolescents with neurogenic bladder who presented for lower urinary tract
      reconstruction, 4 patients with severe spina bifida were unfit for major surgery.
      Five patients had a simple undiversion; 4 of these had a poor outcome because of
      unpredicted sphincter incontinence (1 patient) or instability (3). A total of 26
      patients had an enterocystoplasty. All 7 patients who had a substitution
      cystoplasty had a good result, as did 3 males with a clam cystoplasty. Nine of 16
      females had a poor result from a clam procedure. In 3 the problem lay with self
      catheterisation difficulties. One each had persistent hyper-reflexia and
      sphincter incontinence. Four had hyper-reflexia on sexual intercourse. Overall,
      42% of females had problems from the retained bladder segment. Seven patients had
      continent urinary diversions. The results were good, although 2 Kock nipples
      required revision. Surgery was well tolerated. There was a 21% re-operation rate
      for complications. Pre-operative investigation correctly predicted sphincter
      competence and the need for self-catheterisation in 79 and 86% respectively.

PMID- 1638346
TI  - Long-term results of one-stage scrotal patch urethroplasty.
AB  - Of 211 patients with urethral strictures undergoing one-stage dartos pedicled
      island patch urethroplasty between 1970 and 1987, 194 have been followed up from
      3 to 20 years. There was 1 post-operative death (from hepatitis). During the
      period of follow-up, strictures recurred in 14 patients (7%), some of them as
      late as 15 years after an apparently successful urethroplasty. Calculi forming on
      hairs required treatment in 6 patients (3%) and it was necessary to revise a
      redundant skin pouch in 6.

PMID- 1638347
TI  - Pre-operative assessment of Peyronie's disease using colour Doppler sonography.
AB  - Colour Doppler ultrasonography was used to assess 39 patients with Peyronie's
      disease with a suspected organic cause for their impotence. In 20 patients who
      complained of a uniform loss of erection, the impotence was likely to be
      functional in origin (90%) or occasionally venogenic (10%), the penile arterial
      blood flow being normal. However, patients who complained of distal flaccidity
      were likely to have an organic cause for their impotence (68%). This was due to
      proximal arterial disease (10%), plaque involvement of the distal vessels (37%),
      veno-occlusive dysfunction (5%) or to the soft glans syndrome (16%).

PMID- 1638348
TI  - Contralateral testicular blood flow in unilateral testicular torsion measured by
      the 133Xe clearance technique.
AB  - Contralateral testicular blood flow was measured by the intratesticular injection
      of 133Xe in 9 controls (Group 1) and in 34 adult male albino rats with
      experimentally induced left testicular torsion. In Group 2 (n = 9) testicular
      torsion was maintained for 3 h; in Group 3 (n = 7) torsion was maintained for 9 h
      and in Group 4 (n = 10) for 15 days. In Group 5 (n = 16) torsion was maintained
      for 9 h in 8 rats and the sera were given to 8 normal animals. In Groups 3, 4 and
      5 there was a significant increase in contralateral testicular blood flow on the
      fifteenth day. This increase may be the cause of contralateral testicular damage
      in prolonged unilateral testicular torsion.

PMID- 1638349
TI  - Complete resolution of a large seminal vesicle cyst--evidence for an obstructive
      aetiology.
AB  - Seminal vesicle cysts may arise from inflammation or obstruction of the seminal
      vesicle or from embryological remnants such as the mullerian duct. Surgical
      removal has been proposed as the treatment of choice. A 19-year-old boy presented
      with abdominal pain and constipation. Investigations revealed a 14-cm
      multiloculated cyst arising from the right seminal vesicle and a small stone
      lodged at the orifice of the ipsilateral ejaculatory duct. Following endoscopic
      removal of the stone the mass decreased in size considerably and 2 months later
      transrectal ultrasound and magnetic resonance imaging showed normal seminal
      vesicles and no evidence of the cyst. This case strongly supports an obstructive
      aetiology for this cyst and we would suggest that, in similar cases, full
      assessment of the ejaculatory apparatus should be carried out to exclude an
      obstructive cause before embarking on major surgery.

PMID- 1638350
TI  - Survey of mycobacteria isolated from urine and the genitourinary tract in south
      east England from 1980 to 1989.
AB  - Between 1980 and 1989, the Public Health Laboratory Service Regional Tuberculosis
      Centre, Dulwich, received cultures of mycobacteria isolated from urine and the
      genitourinary tract of 1392 new patients: 803 isolates were members of the
      tuberculosis complex (753 M. tuberculosis, 45 M. bovis, 4 M. africanum) and 589
      were various species of environmental mycobacteria. The incidence of the latter
      isolations varied by region and by year and, with 17 exceptions (13 from
      endometrial curettings, 2 from hydrocele fluid, 1 from a scrotal abscess and 1
      from a kidney), all isolations of environmental mycobacteria were from urine;
      very few of them appeared to be clinically significant. Those that could be
      significant included 1 isolate from a kidney, 1 from a post-renal transplant
      patient and 4 from patients with AIDS, 3 of whom had disseminated mycobacterial
      disease. Reports of clinically significant isolations of environmental
      mycobacteria from the genitourinary tract are reviewed.

PMID- 1638352
TI  - The development of synthetic polymers that resist encrustation on exposure to
      urine.
AB  - The consequences of long-term exposure of synthetic materials to urine have
      prevented the development of alloplastic replacement of diseased or damaged parts
      of the urinary tract. Similarly, urethral and ureteric catheters require regular
      replacement if the complications of encrustation and blockage are to be avoided.
      The mechanism of encrustation is not understood completely and thus it is unclear
      why certain materials appear better able to resist encrustation. This study has
      involved the development of a new encrustation model to provide a reproducible
      and quantitative assessment of the susceptibility of polymers to encrustation.
      This model will allow beneficial characteristics of co-polymer design to be
      recognised, with the aim of finding new materials that are tolerant of exposure
      to urine. Results of co-polymers examined show that the incorporation of fluorine
      containing components confers significant resistance to the formation of
      encrustation. It is suggested that the physico-chemical properties of polymer
      surfaces may be important determinants of resistance to encrustation.

PMID- 1638353
TI  - Inferior vena cava obstruction secondary to urinary retention in a neonate.

PMID- 1638351
TI  - Potential use of tissue adhesive in urinary tract surgery.
AB  - The search for a tissue adhesive which obviates the need for suture materials in
      the apposition of wound edges is not new. The early adhesive products lacked the
      required safety and efficacy. Experimental use of a new fibrin adhesive has shown
      that it may have potential use where inflammatory reaction to the suture material
      is undesirable or water-tight sealing of the anastomosis is required.

PMID- 1638355
TI  - Metastatic malignant melanoma of the epididymis.

PMID- 1638354
TI  - Development of Leydig cell tumour in association with clomiphene treatment for
      oligozoospermia.

PMID- 1638356
TI  - Hypereosinophilia, cardiomyopathy and transitional cell carcinoma of the bladder.

PMID- 1638345
TI  - Total substitution of the lower urinary tract. A technique for either
      reconstruction or continent diversion.
AB  - A technique is described in which the right side of the colon is used for
      substitution cystourethroplasty, based on the flap valve principle, in order to
      produce a continent catheterisable outflow. The technique can equally well be
      used for continent diversion.

PMID- 1638357
TI  - Iontophoretic local anaesthesia for bladder dilatation in the treatment of
      interstitial cystitis.

PMID- 1638358
TI  - Metastatic melanoma to the testis simulating primary seminoma.

PMID- 1638359
TI  - Diagnosis of urinary leak in a critically ill patient using bedside 99mTc-DTPA
      renal scanning.

PMID- 1638360
TI  - Re: Gastrocystoplasty in children. Evelyn H. Dykes and P. G. Ransley. Br. J.
      Urol., 69, 91-95, 1992.

PMID- 1638361
TI  - Re: The persistent indwelling catheter. S. K. Iyer. Br. J. Urol., 69, 100, 1992.

PMID- 1638362
TI  - Re: Partial extraction of Double-J stent during nephrostomy tube removal and its
      prevention. S. Gepi-Attee et al. Br. J. Urol., 68, 552-553, 1991.

PMID- 1638364
TI  - Pontine pathology and voiding dysfunction.

PMID- 1638363
TI  - Re: Gluteal device for penile injection. A. M. Helmy. Br. J. Urol., 68, 400-403,
      1991.

PMID- 1638365
TI  - Metastatic carcinoid tumour involving the prostate.

PMID- 1638366
TI  - Use of the lachrymal duct probe in epididymal aspiration.

PMID- 1638367
TI  - Effect of vaginal ultrasound probe on lower urinary tract function.
AB  - Vaginal ultrasonography has been advocated as an alternative to
      videocystourethrography. Ultrasound avoids the potential risks of X-rays and
      reduces the cost of equipment. We have investigated the effect of the vaginal
      probe on the physiology of the bladder and urethra. A series of 24 women
      underwent urethral pressure profilometry, with and without a vaginal probe in
      situ. There was a significant increase in maximum urethral pressure, functional
      urethral length and area under the profile curve both at rest and during stress
      in the presence of the device. This was due to stretching and compression of the
      urethra by the probe. Transmission pressure ratios were significantly increased
      for the first 3 quartiles of the urethra. Twenty women underwent lateral bead
      chain urethrocystography with and without a vaginal probe. At rest, the probe
      resulted in elevation of the bladder neck and apposition to the symphysis pubis,
      and during a Valsalva manoeuvre the descent of the bladder neck was restricted by
      the presence of the probe. These results indicate that a vaginal probe alters the
      position and function of the lower urinary tract. We postulate that incontinence
      is reduced as a result of the probe. The use of vaginal ultrasonography in the
      assessment of women with urinary incontinence is therefore not recommended.

PMID- 1638369
TI  - Electromyographic abnormalities in the urethral and anal sphincters of women with
      idiopathic retention of urine.
AB  - Previous concentric needle studies of the urethral sphincter in women with
      idiopathic urinary retention have found evidence of denervation and reinnervation
      as well as abnormal patterns of muscle fibre discharge--complex repetitive
      discharges (CRDs). In order to test the hypothesis that these abnormalities
      represented a more widespread disease process of pelvic floor function, we
      carried out an electromyographic (EMG) study of both anal and urethral sphincters
      in 18 women with idiopathic urinary retention. The urethral sphincter EMG was
      abnormal in 15 patients. These abnormalities included polyphasic and long
      duration potentials. Complex repetitive discharges were identified in 8 women.
      However, abnormalities of the anal sphincter were found in 14 of the 15 patients
      with abnormal urethral sphincter EMGs, polyphasic and abnormally long duration
      potentials being found in the anal sphincters of all 14 patients. In addition, 7
      of the 8 women who had complex repetitive discharges in the urethral sphincters
      had similar complex repetitive discharges in their anal sphincters. Women with
      complex repetitive discharges had a significantly greater proportion of abnormal
      potentials than women with no such repetitive discharges. These results support
      the previous findings of electromyographic urethral sphincter abnormalities in
      women with idiopathic urinary retention, but also suggest that these
      abnormalities reflect a widespread disease process involving the pelvic floor in
      such patients.

PMID- 1638368
TI  - Detrusor mast cells in refractory idiopathic instability.
AB  - The diagnosis of interstitial cystitis (IC) is not usually considered in patients
      with idiopathic instability. Because histamine provokes detrusor contractions in
      vitro, we assessed detrusor mast cell counts in 29 females with refractory
      instability. Raised mast cell counts (greater than 28/mm2 of detrusor muscle,
      consistent with a histological diagnosis of IC) were found in 29% of such cases.
      Thus cystoscopy and bladder biopsy should be considered in patients with
      idiopathic instability which fails to respond to anticholinergic drugs, as
      alternative therapy may be useful. Patients with refractory instability and
      normal detrusor mast cell counts often gave a history of prolonged childhood
      nocturnal enuresis (55% of cases); in contrast, patients with intractable
      instability and abnormally high mast cell counts seldom gave such a history
      (12%). These trends may give some insight into the aetiology of idiopathic
      instability--"congenital" or acquired?

PMID- 1638370
TI  - Continent urinary diversion using an artificial urinary sphincter.
AB  - We report a new and simplified method of continent urinary diversion employing a
      modified AMS 800 artificial urinary sphincter (AUS). Our aim in using this
      artificial valve is to make a stoma continent, while allowing intermittent
      catheterisation. The AMS 800 pump is replaced by a subcutaneous injection port.
      This allows, by direct puncture, the accurate setting of the closing pressure by
      varying the volume of the intra-prosthetic liquid, with subsequent adjustment of
      this pressure as necessary. The cuff is placed on the subcutaneous part of the
      intestinal loop diversion. The pressure-regulating balloon is implanted within
      the area of abdominal pressure, retroperitoneally. After first confirming the
      efficacy of the system in 3 dogs, the device was placed in 2 patients. The first
      had a neuropathic bladder treated initially by enterocystoplasty with an
      appendicocutaneous stoma. Secondary leakage was subsequently controlled by
      placement of the device, with continuing excellent results at 32 months. The
      second patient was a girl in whom a urogenital rhabdomyosarcoma had been treated
      by anterior exenteration, radiotherapy and a sigmoid conduit diversion. This was
      subsequently converted to a continent reservoir by simple augmentation of the
      conduit and placement of the device, with a good result being maintained after a
      follow-up of 20 months. These two cases illustrate the best indications for this
      procedure, namely primary or secondary leakage from a supposedly continent
      urinary diversion, and conversion of a freely draining conduit into a continent
      reservoir. Although long-term results are still pending, our experience thus far
      encourages us to recommend this technique as a simple means of achieving a
      continent urinary diversion.

PMID- 1638371
TI  - The effect of ranitidine on urine mucus concentration in patients with
      enterocystoplasty.
AB  - We describe the effect of ranitidine in reducing mucus in urine in 8 patients
      with enterocystoplasty and present a simple technique for measuring the
      concentration of mucus in urine. After a 10-day course of ranitidine (300 mg
      daily in divided doses) the concentration of mucus had fallen significantly from
      an initial level of 1.38 +/- 0.18 to 0.39 +/- 0.04 mg/ml.

PMID- 1638374
TI  - Bladder cancer mortality in The Netherlands, 1955-1988.
AB  - In 1955, 234 men and 116 women died from bladder cancer in the Netherlands. In
      1988 the numbers were 794 and 317 respectively. After adjusting for the ageing of
      the Dutch population since 1955, female mortality rates per 10(5) person-years
      appear to be very stable: 2.9 from 1955 to 1959 and 3.0 from 1985 to 1988. By
      contrast, an increasing trend exists in males. From 1955 to 1959 and from 1985 to
      1988, bladder cancer mortality rates per 10(5) person-years were 7.5 and 12.4
      respectively. For men in particular, increasing mortality (and incidence) rates
      are seen all over the world. In many cases this increasing trend is thought to
      originate from a higher risk of dying from bladder cancer in successive birth
      cohorts rather than from a higher risk in successive calendar periods. This so
      called cohort effect is explained by changes in smoking behaviour in the male
      population. Statistical modelling of bladder cancer mortality data from 1955 to
      1988 in the Netherlands shows that the increasing temporal trend in men can also
      be described as a cohort effect. The risk of dying from bladder cancer increases
      from the 1875 birth cohort to the 1910 birth cohort, but decreases thereafter. It
      is concluded that this decreasing risk for generations born after 1910 will
      probably result in a decreasing trend in mortality in the near future, when more
      and more of these "youngsters" reach the age of 70+.

PMID- 1638372
TI  - Male and female sexual function and activity following ileal conduit urinary
      diversion.
AB  - A group of 66 patients (40 males, 26 females) underwent an ileal conduit urinary
      diversion because of bladder cancer (44 patients) or incontinence/bladder
      dysfunction (22). They were questioned about pre- and post-operative sexual
      function and activity and it was found that 90% of the males (26/29) who were
      sexually active before surgery lost the ability to achieve erection following
      radical cystectomy. Although they were unable to achieve penile erection, 41%
      were able to experience orgasm by means of masturbation. Five of the 29 males
      received penile implants. Five of the 6 females treated by cystectomy, who were
      sexually active before the operation, reported either a decrease or cessation of
      sexual activity (i.e. coitus) post-operatively. The main problems were a decrease
      in sexual desire, dyspareunia and vaginal dryness. One women reported the
      inability to experience orgasm after surgery. Compared with women with bladder
      cancer, those with incontinence/bladder dysfunction were more likely to have an
      active sexual life after urostomy surgery. Seven females in this group, of whom 4
      were sexually inactive before surgery, increased their sexual activity after the
      operation. For these women the conduit operation removed the need to use
      incontinence pads or indwelling catheters.

PMID- 1638373
TI  - Cystoprostatectomy and substitution cystoplasty for locally invasive bladder
      cancer.
AB  - The results and long-term follow-up of 48 patients undergoing cystoprostatectomy
      and substitution cystoplasty for T2/3, M0 transitional cell carcinoma of the
      bladder are reported. There was no operative mortality but 1 early death from
      thromboembolic disease. Thirty-six patients are alive with a mean follow-up of 57
      months (range 12-120). Eleven patients died of disseminated disease. Thirty-one
      patients (64%) regained normal continence by day and night and a further 8 were
      dry by day but incontinent at night; 9 patients underwent further surgery for
      incontinence and this was successful in 8, giving an overall continence rate of
      79% and a day-time continence rate of 98%. Of the 38 patients claiming to be
      potent pre-operatively, 24 (63%) were potent post-operatively. Nerve-sparing
      cystoprostatectomy and substitution cystoplasty is a safe alternative to a
      "standard" cystectomy and ileal conduit diversion in a selected group of men
      undergoing radical surgery for invasive bladder cancer and it achieves its aims
      of preserving continence and potency in the majority of patients.

PMID- 1638375
TI  - Selective renal tumour biopsy under ultrasonic guidance.
AB  - Selective renal biopsy under ultrasonic guidance has been used widely because it
      provides safe and accurate tissue sampling. Using this technique, we biopsied 36
      renal tumours and obtained specimens in 35 cases. Histology of the biopsy
      coincided with that of the surgical specimen in 18/21 cases. Dissemination of
      tumour cells, thought to have been caused by needle biopsy and/or surgical
      manipulation, was observed in only 1 case of sarcoma. The method thus proved
      effective in determining treatment and it is suggested that it should be used in
      accordance with the criteria which we have devised.

PMID- 1638376
TI  - Long-term results of treatment of urethral injuries in males caused by external
      trauma.
AB  - Of 134 males with traumatic rupture of the urethra seen between 1967 and 1989, 10
      have been lost to follow-up and 124 have been followed up for 1 to 22 years (mean
      8); 100 patients had a pelvic fracture (3 with associated rectal injury) and 24
      had perineal injuries. Prior to referral 31 patients (25%) had undergone
      treatment in addition to suprapubic cystostomy. Wherever possible, strictures
      were managed by optical urethrotomy (33) or intermittent dilatation (4). In 2
      patients only a suprapubic cystostomy was possible. Skin inlay urethroplasty in 1
      or 2 stages was performed in 75 cases, an end-to-end anastomosis with or without
      resection of the symphysis pubis in 7 and a scrotal tube pull-through in 3. The
      immediate and long-term results depended on the severity of the original injury.
      With minimal displacement the management was simple and the long-term prognosis
      good, a single urethrotomy being sufficient in 22 patients. Where there was
      considerable displacement the initial management was more difficult and there was
      a high incidence of long-term complications: of 73 patients treated by
      urethroplasty or end-to-end anastomosis, significant post-operative infection
      occurred in 11 (15%) and restenosis in 15 (20%), of whom 7 required a revision
      urethroplasty. Data in respect of potency were recorded in 80 patients: 28 of
      these were impotent, 20 of the 28 having sustained an injury with considerable
      displacement.

PMID- 1638379
TI  - Vacuum constriction devices: second-line conservative treatment for impotence.
AB  - Intracavernosal pharmacotherapy is not a universally successful treatment of
      impotence. Vacuum constriction devices are reported to be an effective non
      operative alternative. This study investigated the value of these devices in 45
      impotent men who had failed to become established on intracavernosal papaverine.
      Although 38 were able to obtain an erection-like state using a vacuum
      constriction device, only 12 were able to enjoy satisfactory sexual intercourse
      and, of these, just 7 men found them of sufficient benefit to warrant purchase.
      Success is not predicted by aetiology. Vacuum constriction devices are of some
      use, but a trial period of use should be allowed to each patient before purchase.

PMID- 1638378
TI  - New approach to the management of Fournier's gangrene.
AB  - A new method of treating Fournier's gangrene is described in 13 patients. There
      was no mortality and the average hospital stay was 10 days. Considerable gain in
      man-hours and expense was recorded when compared with the old method of treatment
      with antibiotics and wound debridement.

PMID- 1638377
TI  - Treatment of hydrocele: randomised prospective study of simple aspiration and
      sclerotherapy with tetracycline.
AB  - Following reports in the literature on the efficacy of tetracycline sclerotherapy
      in the treatment of hydroceles, we carried out a randomised prospective study of
      45 patients (50 hydroceles), comparing simple evacuation with tetracycline
      sclerotherapy. The results revealed no statistically significant difference in
      the percentage of success between the 2 groups, but complications were more
      common in the patients treated with tetracycline. The good results reported by
      other authors in non-randomised studies are, therefore, not confirmed.

PMID- 1638380
TI  - Occupational urothelial cancer in a former iron foundry worker.

PMID- 1638382
TI  - Verrucous carcinoma of the bladder.

PMID- 1638381
TI  - Malignant hypertension due to embolisation of a clear cell renal carcinoma.

PMID- 1638384
TI  - Columnar metaplasia complicating neurogenic bladder in a child.

PMID- 1638383
TI  - Late metastasis from ovarian tumour. An unusual cause of hydronephrosis.

PMID- 1638385
TI  - Syphilis of the ureter.

PMID- 1638386
TI  - Photoreceptor differentiation in retinal xenografts of fetal monkey retina.
AB  - Although the potential of retinal grafts to provide the host eye with rod cells
      is presently well established, the possibility of grafting cone photoreceptors
      has not been documented. In this study, the neural retinas of two Cebus apella
      monkey fetuses were xenografted into immunosuppressed Fischer 344 adult rats.
      Histological analysis showed intimate apposition between the grafted donor cells
      and the neighboring host rat retina. The transplanted cells survived well and
      often overgrew the boundaries of the host retina, expanding into the host
      vitreous cavity. These cells formed histogenetically differentiated structures
      predominantly populated by the photoreceptors. When transplanted into a foreign
      environment, donor cells formed inner segments which exhibited the basic
      morphology of cells developed in situ. This study demonstrates that embryonic
      monkey neural retina is a viable source of xenograft material. It also indicates
      that an advanced embryonic stage is not a deterrent to survival and
      differentiation of grafted primate neuroretinal cells. The successful
      transplantation of these cells, especially under the relatively adverse
      conditions of a xenograft, raises the hope that retinal transplantation may in
      fact be a useful technique for repairing both rod and cone function in damaged
      retinas of higher animals including humans.

PMID- 1638388
TI  - Repetitive transient forebrain ischemia in gerbils: delayed neuronal damage in
      the substantia nigra reticulata.
AB  - Repetitive cerebral ischemia results in severe neuronal damage in multiple
      regions of the brain including the hippocampus, striatum, thalamus, medial
      geniculate nucleus and the substantia nigra reticulata (SNr). We postulated that
      the damage in the SNr was delayed, resulting from a loss of striatal inhibitory
      input. We used the gerbil model of repetitive ischemia (3 min times 2 and 3 min
      times 3) to evaluate the extent of neuronal damage at 2, 3, 5 and 7 days after
      the ischemic insult. Silver degeneration stain was used for histological
      evaluation. Our results indicate that damage in the SNr begins after 48 h and is
      maximum at 7 days. This delay in onset of damage offers a window for
      pharmacological protection.

PMID- 1638387
TI  - Ultrastructural concomitants of anoxic injury and early post-anoxic recovery in
      rat optic nerve.
AB  - To study the effects of anoxia on CNS white matter, we examined the
      ultrastructure of axons and glial cells in a white matter tract, the rat optic
      nerve, that was subjected to a standardized anoxic insult in vitro. Previous
      electrophysiological studies showed that in this model, action potential
      conduction is rapidly abolished by anoxia, and conduction is restored after
      reoxygenation in about 30% of axons following a 60-min anoxic period. The present
      study examined the ultrastructural correlates of anoxic injury and early post
      anoxic recovery in this model. Optic nerves examined immediately following 60 min
      of anoxia displayed numerous large, apparently empty zones located within myelin
      sheaths adjacent to the axon. The myelin remained compact and retained its
      periodicity. In some regions, the extracellular space was enlarged. There was
      mitochondrial swelling with loss of normal cristae. There was also loss of
      microtubules and, to a smaller degree, of neurofilaments in large-diameter axons.
      Some nodes of Ranvier in anoxic optic nerves displayed detachment of terminal
      oligodendroglial loops or retraction of the myelin from the node; the presence of
      tongue-like processes, extending from nearby cells under the detached myelin
      loops, suggested a possible role of cell-mediated damage to the paranodal myelin.
      Bundles of dense astrocyte processes were present, and there was vesicular
      degeneration of perinodal astrocyte processes. In optic nerves that had been
      permitted to recover for 60 min in oxygenated Ringers following the anoxic
      period, empty zones were only rarely observed within myelin sheaths and, when
      present, were smaller than in optic nerves immediately following 60 min of
      anoxia. The axoplasm of large fibers continued to show loss of microtubules and
      neurofilaments, as well as mitochondrial swelling. Myelin appeared normal, and
      only rare paranodal oligodendroglial processes remained unattached from the axon
      membrane. These results provide support for the idea that, during anoxia,
      myelinated axons are damaged with significant injury to cytoskeletal elements,
      probably due to an influx of calcium. The ultrastructural results, together with
      our earlier observations on the physiological correlates of anoxia and re
      oxygenation, suggest that the development of intramyelinic spaces or damage to
      paranodes lead to conduction block in the anoxic optic nerve. These results also
      suggest that repair of these structural abnormalities may provide a morphological
      basis for the early recovery of conduction that occurs after re-oxygenation.

PMID- 1638390
TI  - Excitatory inputs to layer V pyramidal cells of rat primary visual cortex
      revealed by acetylcholine activation.
AB  - Cells in layers II-III or VI were activated by microdrop application of
      acetylcholine (ACh), while monitoring the intracellular response of layer V
      pyramidal cells. This enabled the tracing of functional connections between the
      cells of layers II-III or VI with those of layer V. ACh activation of layer II
      III or VI cells resulted in a small depolarization of these cells, accompanied by
      a burst of excitatory postsynaptic potentials (EPSPs) from layer V pyramidal
      cells. These effects of ACh were blocked by tetrodotoxin (TTX), suggesting the
      involvement of action potentials in their production. The input resistance of
      layer V pyramidal cells during and after the EPSP burst was not significantly
      different from control values, further suggesting an indirect effect of ACh on
      layer V pyramidal cells. Isolation of the supragranular layer, by horizontal
      cutting, did not prevent the EPSP burst evoked by ACh application to the lower
      layer VI, suggesting a direct input from layer VI to layer V pyramidal cells. ACh
      applied near pyramidal cells in layers II-III, V or VI caused transient
      hyperpolarization associated with a decrease in input resistance followed by a
      large depolarization, an increase in input resistance, and action potential
      discharges. The ACh-mediated hyperpolarization and the train of action potentials
      of layer II-III pyramidal cells were blocked by TTX. Thus the ACh-activated cells
      in layers II-III and VI make an excitatory synaptic contact with layer V
      pyramidal cells, producing the EPSP burst observed in layer V.

PMID- 1638389
TI  - Dissociation between in vivo hippocampal norepinephrine response and
      behavioral/neuroendocrine responses to noise stress in rats.
AB  - The behavioral and extracellular hippocampal norepinephrine responses to
      audiogenic stress were concomitantly characterized in freely moving rats using in
      vivo microdialysis. Noise stimulation produced a rapid, but short-lived increase
      in norepinephrine release from the hippocampus during the first 20 min of noise
      presentation that declined to baseline levels for the duration of the noise
      stimulation and following noise offset. In contrast, the behavioral response
      persisted throughout the duration of the noise stimulation. In a separate group
      of similarly treated animals, neuroendocrine indices of stress were monitored
      during exposure to noise. Consistent with the behavioral response, corticosterone
      and adrenocorticotropic hormone remained elevated for the duration of noise
      presentation. These findings support a dissociation between the hippocampal
      norepinephrine response and the behavioral and neuroendocrine response patterns
      and suggest that other systems may be involved in the regulation of behavioral
      responsiveness to aversive stimuli.

PMID- 1638391
TI  - Differential effect of self-stimulation on dopamine release and metabolism in the
      rat medial frontal cortex, nucleus accumbens and striatum studied by in vivo
      microdialysis.
AB  - Changes in the extracellular levels of dopamine (DA) and its metabolites in the
      dopaminergic terminal regions, the medial frontal cortex (MFC), nucleus accumbens
      (NAC), and striatum (STR), were measured by microdialysis during self-stimulation
      of the medial forebrain bundle (MFB) in rats pretreated with the DA uptake
      inhibitor, nomifensine (1 mg/kg, i.p.). Self-stimulation of the MFB in
      nomifensine-pretreated rats caused an increase in the extracellular DA level in
      the MFC and NAC but not in the STR. Self-stimulation also increased the
      extracellular concentrations of the main DA metabolites, 3,4
      dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) to a similar
      extent in the MFC and NAC and to a lesser extent in the STR. Thus, there was a
      regional difference in the neurochemical changes following self-stimulation with
      either the MFC or the NAC showing larger extracellular levels of DA, DOPAC, and
      HVA than the STR. Furthermore, these changes were observed on both hemispheres
      ipsilateral and contralateral to the stimulation. The results indicate that self
      stimulation of the MFB preferentially activates the mesocorticolimbic DA systems,
      thereby bilateral increases in the release of DA and its metabolism being
      produced in their terminal regions, the MFC and NAC.

PMID- 1638392
TI  - Conduction properties of central nerve fibers remyelinated by Schwann cells.
AB  - Demyelination of central axons arises from a number of conditions, including
      multiple sclerosis and spinal cord compression. The demyelination disrupts
      conduction and leads directly to the production of symptoms. Repair of the
      demyelination by peripheral myelinating cells could potentially relieve the
      symptoms, but the conduction properties of central axons remyelinated by Schwann
      cells have yet to be studied in detail. This paper examined the conduction
      properties of such axons. Large focal demyelinating and remyelinating lesions
      were induced in the dorsal columns of rats by the intraspinal injection of
      ethidium bromide. Recordings of compound action potentials conducted through
      these lesions were then made at various recovery times. Thus the changing
      conduction properties of the affected fibers could be correlated with the
      different stages of lesion development. During the early stages of demyelination
      there was widespread conduction block, with no evidence of appreciable conduction
      occurring with prolonged latency or refractory period of transmission (RPT).
      However, with the onset of remyelination by Schwann cells, conduction was
      restored in many axons, and most, if not all, of the affected axons eventually
      showed successful conduction through the lesion. Initially the conduction was
      characterized by very prolonged latency, long RPT, and an inability to conduct
      fast trains of impulses. These deficits became less prominent as remyelination
      progressed. In chronically remyelinated axons the RPT was restored to within
      normal limits, although some deficit in both conduction velocity and the ability
      to conduct trains of impulses persisted. Since these deficits were not severe we
      conclude that remyelination of central demyelinated axons by Schwann cells should
      be effective in promoting the restoration of normal function.

PMID- 1638394
TI  - Signal shaping by voltage-gated currents in retinal ganglion cells.
AB  - The role of voltage-gated currents in information processing by retinal ganglion
      cells was assessed by comparing the light-evoked current and voltage responses of
      identified ganglion cells with those produced by current injection. These
      experiments show that the light-evoked signal is clipped at the bipolar-to
      ganglion cell synapse because the synaptic current evoked by illumination with
      bright light is greater than that which the cell can convert into a change in
      action potential frequency. Ganglion cell responses to injected current fell into
      2 classes: those producing sustained spiking responses and those producing
      transient responses. Further, this division is correlated with the light response
      of the cells; those producing transient responses to exogenous current produced
      transient responses to light, while those with sustained responses to current
      injection produced sustained responses to light flashes. The voltage-gated
      currents present in the ganglion cell membrane contribute to information
      processing in the retina by clipping the light-evoked signal and by producing
      transcience in the output of the retina.

PMID- 1638393
TI  - Gender differences in correlations of cerebral glucose metabolic rates in young
      normal adults.
AB  - Correlational analysis of normalized regional cerebral metabolic data obtained by
      positron emission tomography, in healthy subjects in the 'resting' state (eyes
      covered, ears plugged) using [18F]2-fluoro-2-deoxy-D-glucose, demonstrated gender
      differences in patterns of functional associations. Fifteen women and 18 men
      (less than 40 yr) were scanned with a Scanditronix PC1024-7B tomograph. The brain
      was divided into 65 regions of interest (ROIs). There were no differences between
      men and women in global or regional metabolic rates, or in metabolic right-left
      asymmetries. Although the total number of significant correlations did not differ
      between men and women, patterns differed: female correlations rF were most
      positive than male correlations rM more often than rM greater than rF; and most
      rF greater than rM cases involved left frontal and sensorimotor ROIs, whereas
      most rM greater than rF cases involved right sensorimotor and occipital ROIs. The
      findings demonstrate gender differences in the pattern of functional neocortical
      interactions at the 'resting' state.

PMID- 1638395
TI  - Quantitation of ventricular size in normal and spontaneously hypertensive rats by
      magnetic resonance imaging.
AB  - Magnetic resonance imaging (MRI) performed at high field (4.7 Tesla), and high
      spatial resolution (0.6 mm slice thickness, 0.18 mm inplane) enabled noninvasive
      quantitative measurement of the ventricular vol. in live rats. Comparing the
      results for 15 male Wistar-Kyoto (WKY) rats, aged 2.5-10 months, with those from
      17 spontaneously hypertensive rats (SHR), clearly confirmed the previously
      reported elevated ventricular vols. in the SHR strain. A significant difference
      in ventricular vol. between the two strains was detected above the age of 3
      months. For mature animals above the age of 6 months the mean vol. in the SHR
      strain was elevated by about a factor of two compared to the WKY control animals.

PMID- 1638396
TI  - Stimulation of substantia nigra pars reticulata suppresses neocortical seizures.
AB  - The effects of unilateral electrical stimulation of the substantia nigra pars
      reticulata (SNpr) on the electrocorticographic (ECoG) manifestations of seizures
      were studied in anesthetized rats. Epileptiform activity was provoked in the
      primary focus (Pf) by unilateral, local application of 3-aminopyridine which
      induced secondary focus in the homologous area of the contralateral cortex
      (mirror focus, Mf). The position of the electrode for stimulation of SNpr was
      contralateral to the Pf. The results showed a strong suppressive nigral effect on
      cortical seizure propagation and on seizure susceptibility in both hemispheres.
      Stimulation of the SNpr prevented the manifestation of sustained epileptiform
      events, decreased the rate of seizure appearance in the Mf, delayed the onset of
      paroxysmal activity and markedly reduced the amplitude and duration of ictal
      episodes at both foci. Seizure potentials of lower frequencies disappeared, while
      the relative proportion of those of higher frequency increased in SNpr-stimulated
      animals. SNpr stimulation had no significant effect on fully developed seizures.
      Our observations support the idea that SNpr might be involved in the control of
      cortical seizure susceptibility, regulating other structures which are possibly
      involved in the generation and propagation of seizure.

PMID- 1638397
TI  - L1 immunoreactivity in the developing fish visual system.
AB  - Previous studies have suggested that L1, the cell adhesion molecule, is present
      in the regenerating fish optic nerve. The present study was undertaken in order
      to determine whether L1 is expressed by fish neurons and specifically by non
      myelinated axons, using fish retinal explants in vitro and the developing fish
      visual system in vivo. In vitro, the nonmyelinated axons emerging from retinal
      explants showed L1 immunoreactivity and in vivo, L1 immunoreactive sites were
      found to be associated with areas rich in non-myelinated axons. At embryonic
      stage 23, as the eye developed and optic nerve axons began to elongate towards
      the tectum, L1-like immunoreactivity was seen both in optic nerve and in
      plexiform layers of the retina. At this stage and until hatching, the cellular
      layers within the retina showed little or no staining relative to the layers
      containing axons or dendrites. After hatching, L1 immunoreactivity was also
      observed in the ganglion cell layer, but upon maturation both the retina and the
      optic nerve lost most of their L1 immunoreactivity. We therefore suggest that non
      myelinated axons of the fish visual system express L1 during development, which
      is lost after myelination and presumably reappears during regeneration.

PMID- 1638399
TI  - Characterization of a neurotrophic factor produced by cultured astrocytes
      involved in the regulation of subcortical cholinergic neurons.
AB  - When dissociated subcortical cells were cultured in the presence of conditioned
      medium of relatively differentiated astrocytes (ACM), a marked increase was
      observed in the expression of choline acetyltransferase (ChAT), an enzyme
      required for the synthesis of the neurotransmitter acetylcholine. Astrocytes from
      the target regions of subcortical neurons, the hippocampus and the cerebral
      cortex, produced neurotrophic factor consistently more than those derived from
      the nontarget region, the cerebellum. The production of cholinergic trophic
      activity was increased with the maturation of astrocytes. Even though, nerve
      growth factor (NGF) and ciliary neurotrophic factor (CNTF) are known cholinergic
      trophic compounds produced by astrocytes in vitro, a large part of the
      neurotrophic activity in our ACM was not related to either of these 2 factors.
      This is because (i) ACM and NGF produced an additive effect on ChAT activity,
      (ii) only a small proportion of the cholinergic trophic activity in ACM was
      abolished by anti-NGF antibody, and (iii) treatment with CNTF had no effect on
      ChAT activity of basal forebrain cholinergic neurons. On the other hand, when
      cholinergic neurons are cultured on a preformed layer of astrocytes, addition of
      basal fibroblast growth factor (bFGF) failed to increase further the ChAT
      activity. Similarly the effects of ACM and bFGF were not additive. A large
      proportion of the cholinergic trophic activity in ACM was neutralized by anti
      bFGF antibody. These findings would suggest that the trophic activity on septal
      cholinergic neurons in our ACM was due to bFGF or a bFGF-like compound.

PMID- 1638398
TI  - Differential inhibition by NMDA antagonists of rapid tolerance to, and cross
      tolerance between, ethanol and chlordiazepoxide.
AB  - We have recently found that the non-competitive N-methyl-D-aspartate (NMDA)
      antagonists, (+)MK-801 and ketamine, block the development of rapid tolerance to
      ethanol. In the present report we show that they also block rapid cross-tolerance
      from chlordiazepoxide to ethanol as well as ethanol to chlordiazepoxide. However,
      NMDA antagonists fail to block the development of rapid tolerance to
      chlordiazepoxide. Our results suggest that NMDA antagonists may affect not only
      the acquisition of rapid tolerance or cross-tolerance to sedatives but also the
      ability to express that tolerance or cross-tolerance, depending on the drugs
      used. It is also possible that the phenomena of rapid tolerance and rapid cross
      tolerance have basic differences not previously reported in the literature.

PMID- 1638400
TI  - 5-Hydroxytryptamine stimulates corticosteroid-sensitive CRF release from cultured
      foetal hypothalamic cells. Role of protein kinases.
AB  - 5-Hydroxytryptamine (5-HT) has been shown to activate the hypothalamo-pituitary
      adrenal axis, possibly by a direct action on hypothalamic CRF synthesis and
      release. In order to study the mechanisms involved in this effect, foetal
      hypothalamic cells were cultured and corticotropin-releasing factor-41 (CRF)
      release was measured by radioimmunoassay. 5-HT induced CRF release in a dose
      dependent manner. Further studies were performed with a specific protein kinase C
      inhibitor, H-7 (1-(5-isoquinolinesulfonyl)-2-methyl-piperazine) and a specific
      cyclic adenosine monophosphate-dependent protein kinase inhibitor, IP-20. Basal
      release of CRF-41 from the cultured hypothalamic cells was unaffected by IP-20
      and was only diminished at a high (50 microM) concentration of H-7. 5-HT
      stimulated-CRF release, however, was blocked by both H-7 and IP-20. Dexamethasone
      and aldosterone both caused a dose-dependent inhibition of 5-HT induced CRF
      release. These results demonstrate that CRF can be released from hypothalamic
      neurons in response to 5-HT through a protein kinase C and protein kinase A
      dependent mechanism and that 5-HT stimulated CRF release can be inhibited by
      dexamethasone and aldosterone.

PMID- 1638401
TI  - Neuroanatomical specificity in the autoregulation of aromatase-immunoreactive
      neurons by androgens and estrogens: an immunocytochemical study.
AB  - Testosterone (T) increases brain aromatase activity (AA) in quail and other avian
      and mammalian species. It was shown both in quail and in rat that this enzymatic
      induction results from a synergistic action of androgens and estrogens. These
      studies provide little information on possible anatomical or cellular specificity
      of the effect. Using a polyclonal antiserum against human placental aromatase, we
      have previously identified aromatase-immunoreactive (ARO-ir) neurons in the quail
      brain and demonstrated that T increases the number of ARO-ir cells in the quail
      preoptic area (POA) supporting previous evidence that T increases AA in the
      brain. However, which T metabolites are involved, the actual mechanism of
      regulation and the possibility of anatomical specificity for these effects are
      not yet clear. In the present study, we disassociated the effects of androgens
      and estrogens in aromatase induction by comparing ARO-ir neurons of quail treated
      with T alone or T in the presence of a potent aromatase inhibitor (R76713), which
      has been shown to depress AA levels and to suppress T-activated copulatory
      behavior. T increased the number of ARO-ir cells in POA, bed nucleus striae
      terminalis (BNST) and tuberal hypothalamus (Tu). The T effect was inhibited by
      concurrent treatment with aromatase inhibitor in Tu, but not in POA and BNST.
      This differential effect of the aromatase inhibitor fits in very well with our
      previous studies of the co-localization of aromatase and estrogen receptors. The
      T effect was blocked by R76713 in areas where ARO-ir and estrogen receptor-ir are
      generally co-localized (Tu) and was not affected in areas with mainly ARO-ir
      positive, estrogen receptor-ir negative cells (POA, BNST). This suggests
      anatomical differences in the expression or clearance of aromatase which may be
      differentially sensitive to androgens and estrogens and dependent upon the
      presence of sex steroid receptors.

PMID- 1638402
TI  - Interneurons in the rat striatum: relationships between parvalbumin neurons and
      cholinergic neurons.
AB  - A pre-embedding double-labeling immunocytochemical method was used to examine the
      synaptic relationships between cholinergic neurons and the parvalbumin
      immunoreactive (PV+) neurons. The PV+ neurons were labeled by silver-intensified
      colloidal gold particles, and the cholinergic neurons by immunoperoxidase
      reaction products. Cholinergic and PV+ axon terminals form synapses with both the
      somata and dendrites of PV+ neurons, as well as unlabeled medium-sized somata
      with round un-indented nuclei, a typical characteristic of the medium spiny
      projection neurons. These observations suggest that the PV+ and the cholinergic
      neurons have converging influences on both the projection neurons and the PV+
      interneurons in the striatum.

PMID- 1638404
TI  - Bulbar reticular neurons relaying somatosensory information to the mesencephalic
      parabrachial area of the cat.
AB  - Somatosensory neurons projecting to the mesencephalic parabrachial area (MPBA),
      which is located ventral to the inferior colliculus and dorsal to the brachium
      conjunctivum, were recorded from the bulbar reticular formation of adult cats
      anesthetized with alpha-chloralose. The majority (41 of 50 neurons) were
      nociceptive-specific neurons responding only to noxious mechanical and/or thermal
      stimuli to the skin, cornea and/or oral mucosa. The size of their receptive
      fields was smaller than that of the intrinsic MPBA-neurons, but larger than that
      of the trigeminal sensory nucleus neurons. Twenty-three neurons received input
      from the tooth pulp nerve and 10 of 32 neurons tested responded to electrical
      stimulation of the vagal nerve. These results indicate that these bulbar
      reticular neurons receive noxious inputs and transmit them to the MPBA, which
      also receives input from spinal or trigeminal sensory nucleus neurons projecting
      directly to the MPBA.

PMID- 1638403
TI  - Electrical stimulation of nucleus tractus solitarius excites vagal preganglionic
      cardiomotor neurons of the nucleus ambiguus in rats.
AB  - Recent evidence indicates that the cell bodies of vagal cardioinhibitory neurons
      are located principally in the external formation of the nucleus ambiguus (NA).
      As activation of baroreceptor afferent fibers projecting to the nucleus tractus
      solitarius (NTS) elicits a decrease in heart rate it is likely that there is a
      connection between the NTS and NA. To test the hypothesis that stimulation of the
      NTS can excite vagal preganglionic cardiomotor neurons (VPCN) in the NA, activity
      from 78 neurons in the NA was recorded extracellularly before and during
      stimulation of a depressor site in the NTS (1 Hz, 0.1 ms) in urethan anesthetized
      and artificially ventilated male Wistar rats. Sixteen neurons were characterized
      as vagal preganglionic cardiomotor neurons (VPCN) because they were excited by
      baroreceptor activation (1-3 micrograms phenylephrine i.v.) and showed
      rhythmicity of their spontaneous activity in synchrony with the cardiac cycle.
      Stimulation of the NTS increased the firing rate of all these VPCN. The remaining
      62 neurons could not be considered as VPCN because they either had respiratory
      rhythmicity or were not sensitive to baroreceptor activation, or they were
      sensitive to baroreceptor activation but did not display cardiac cycle related
      rhythmicity. These results provide evidence for the existence of an excitatory
      pathway from NTS to vagal preganglionic cardiomotor neurons in the NA.

PMID- 1638406
TI  - Cross-adapted salt responses in the mouse taste cell.
AB  - The exact nature of taste adaptation is not known. Intracellular recordings from
      taste receptor cells are appropriate to clarify cellular adaptation properties. I
      approached the study of the sugar and salt receptor mechanisms of mammalian taste
      cells with cross-adaptation experiments. Sucrose pre-adaptation suppresses the
      cross-adaptation responses to salts. The results show that the taste adaptation
      is located in the taste receptor cell.

PMID- 1638405
TI  - Secretion from rat neurohypophysial nerve terminals (neurosecretosomes) rapidly
      inactivates despite continued elevation of intracellular Ca2+.
AB  - Cytoplasmic calcium concentration was measured in neurosecretory nerve terminals
      (neurosecretosomes) isolated from rat neurohypophyses by fura-2 fluorescence
      measurements and digital video microscopy. Hormone release and cytoplasmic
      calcium concentration were measured during depolarizations induced by elevated
      extracellular potassium concentration. During prolonged depolarizations with 55
      mM [K+]o, the cytoplasmic calcium concentration remained elevated as long as
      depolarization persisted, while secretion inactivated after the initial sharp
      rise. The amplitude and duration of the increase in [Ca2+]i was dependent on the
      degree of depolarization such that upon low levels of depolarizations (12.5 mM or
      25 mM [K+]o), the calcium responses were smaller and relatively transient, and
      with higher levels of depolarization (55 mM [K+]o) the responses were sustained
      and were higher in amplitude. Responses to low levels of depolarization were less
      sensitive to the dihydropyridine calcium channel blocker, nimodipine, while the
      increase in [Ca2+]i induced by 55 mM [K+]o became transient, and was
      significantly smaller. These observations suggest that these peptidergic nerve
      terminals possess at least two different types of voltage-gated calcium channels.
      Removal of extracellular sodium resulted in a significant increase in [Ca2+]i and
      secretion in the absence of depolarizing stimulus, suggesting that sodium-calcium
      exchange mechanism is operative in these nerve terminals. Although the [Ca2+]i
      increase was of similar magnitude to the depolarization-induced changes, the
      resultant secretion was 10-fold lower, but the rate of inactivation of secretion,
      however, was comparable.

PMID- 1638408
TI  - Hippocampal pyramidal cell response to 6-hydroxydopamine lesions of the rat
      ventral tegmental area.
AB  - The occurrence of neurofibrillary tangles (NFT) in the perforant pathway in
      association with dopaminergic cell loss in the ventral tegmental area (VTA) in
      human mesolimbic dementia, raises the possibility that denervation is a cause of
      NFT formation. This was tested in the rat by lesioning dopaminergic neurons which
      project to the hippocampus from the ventral tegmental area by means of
      stereotaxic injections of 6-hydroxydopamine. This resulted in the appearance of
      immunoreactivity to the paired helical filament protein plus an increase of tau
      and MAP-2 proteins in pyramidal neurons of CA-1 and CA-2. These neuronal
      responses to dopaminergic denervation are consistent with a precursor stage to
      NFT development.

PMID- 1638409
TI  - Differential vulnerability of neuropeptides in nerves of the vasa nervorum to
      streptozotocin-induced diabetes.
AB  - Neuropeptides in perivascular nerves of vasa nervorum supplying blood to rat
      optic, sciatic, vagus and sympathetic chain nerve trunks are differentially
      vulnerable to streptozotocin (STZ)-induced diabetes. Immunohistochemical analysis
      of epineurial/perineurial nerve sheaths showed that 8 weeks after induction of
      diabetes, the density of neuropeptide Y (NPY)-immunoreactive nerve fibres in
      optic nerve sheaths was increased, while it was decreased in sciatic, vagus and
      sympathetic nerve sheaths. Vasoactive intestinal polypeptide (VIP)
      immunoreactivity was increased in vasa and nervi nervorum of optic, sciatic,
      vagus and sympathetic chain nerve sheaths. Immunoassay of NPY confirmed increased
      levels in optic nerve sheaths and showed that substance P and calcitonin gene
      related peptide levels increased in sciatic but not optic nerve sheaths.
      Neuropeptide levels in the intrafascicular nerve fibres were unaffected. This
      provides further evidence for a disturbance in the autonomic control of blood
      flow to peripheral and cranial nerve trunks via vasa nervorum in STZ-induced
      diabetes, which may lead to ischaemic changes, alter local axon reflexes and
      contribute to the pathogenesis of the disease.

PMID- 1638410
TI  - Remote astrocytic response of prefrontal cortex is caused by the lesions in the
      nucleus basalis of Meynert, but not in the ventral tegmental area.
AB  - The nucleus basalis of Meynert (nbM) was lesioned by injection of ibotenic acid,
      in 200 g male Wistar rats. The rats were killed 1, 3, 7 or 21 days after surgery,
      the brains were removed and the prefrontal cortices were subjected to
      immunohistochemical and Western blot analysis for the expression of glial
      fibrillary acidic protein (GFAP). In some rats, vehicle was injected into the nbM
      and in others 6-hydroxydopamine (6-OHDA) was injected into the ventral tegmental
      area (VTA). Quantitative Western blot analysis revealed significantly greater
      immunoreactivity for GFAP in the prefrontal cortex of nbM-lesioned rats.
      Immunohistochemical examination revealed fibrous and hypertrophic GFAP-positive
      astrocytes even one day after surgery, and this reaction was stronger at 3 days
      after surgery. After this peak, GFAP-immunoreactivity of the astrocytes decreased
      from 7 days to 21 days. In contrast, GFAP-positive astrocytes were not observed
      in the brains of vehicle-injected or VTA-lesioned rats, even 21 days after
      surgery. The present results indicate that cortical astrocytes respond to
      cholinergic deafferentation. In addition, our findings provide new insights into
      the abnormalities of cortical glial cells after cholinergic deafferentation in
      Alzheimer's disease.

PMID- 1638407
TI  - Chronic estradiol administration did not cause loss of hypothalamic LHRH or TIDA
      neurons in young or middle-aged C57BL/6J mice.
AB  - Age-related decline in estrous cycle frequency and impaired pre-ovulatory
      gonadotropin surges at mid-life are modelled in young C57BL/6J mice by chronic (3
      months) oral administration of estradiol (E2). However, the cellular events that
      induce damage to the neuroendocrine center that regulate gonadotropins with age
      or following E2 treatment are unclear. To address this issue, possible neuron
      loss was examined in relation to the loss of estrous cyclicity in E2-treated
      mice, in particular neurons of the hypothalamic luteinizing hormone releasing
      hormone (LHRH) and/or tuberoinfundibular dopaminergic (TIDA) systems. By
      immunocytochemical methods, there was no change in the number of LHRH or TIDA
      neurons in mice that have become acyclic due to age or E2 treatment. We conclude
      that the onset of acyclicity at middle-age or following chronic E2 treatment is
      not associated with loss of LHRH or TIDA neurons and that other neuroendocrine
      changes must be considered for the cause of acyclicity, particularly those
      involved in the synaptic regulation of LHRH secretion.

PMID- 1638411
TI  - CRF in the paraventricular nucleus of the hypothalamus induces dose-related
      behavioral profile in rats.
AB  - Corticotropin-releasing factor (CRF) administered into the cerebrospinal fluid
      (CSF) alters grooming and locomotion in rats. The present study was designed to
      investigate if CRF microinjected into the paraventricular nucleus of the
      hypothalamus (PVN) influences grooming and spontaneous locomotor behavior in
      fasted rats maintained in a familiar environment. Unilateral microinfusion of CRF
      (0.06, 0.2 and 0.6 nmol) into the PVN induced a dose-related increase in
      grooming, whereas locomotion was dually affected. At lower doses of CRF (0.06 and
      0.2 nmol) spontaneous locomotion was significantly increased. At the highest
      dose, locomotor activity was markedly reduced and, in about 30% of animals,
      freezing behavior occurred intermittently. The behavioral effects of CRF were
      maintained throughout the 60 min post injection period. Microinjection of CRF
      (0.2 nmol) into the lateral hypothalamus, or outside of PVN boundaries had no
      effect on these behavioral parameters. These results demonstrate that the PVN is
      a selective and potent site of action for CRF to induce a dose-dependent range of
      alterations in grooming and locomotion that mimics those observed after CSF
      injection in a familiar environment. These data also suggest that CRF in the PVN
      may be involved in mediating behavioral activation and the anxiogenic effect.

PMID- 1638414
TI  - Effects of intracerebral administration of neuropeptide-Y on secretion of
      luteinizing hormone in ovariectomized sheep.
AB  - Ovariectomized ewes received unilateral infusions of 20 micrograms neuropeptide-Y
      (NPY) at a total of 13 intracerebral sites. Episodic secretion of luteinizing
      hormone (LH) was transiently suppressed on more than one occasion by daily
      infusions at a total of five intracerebral sites. Four of the effective sites
      were located within the third ventricle (two sites) and the rostral and ventral
      part of a lateral ventricle (two sites). The precise neural site of action of
      exogenous NPY cannot be determined from intraventricular administration, but it
      indicates a neural rather than pituitary site of NPY action to inhibit LH
      releasing hormone (LHRH) in sheep. The only tissue infusion site (ventromedial
      nucleus) at which NPY also suppressed LH/LHRH also supports a neural action on
      LHRH, but this single result is insufficient to establish the neural area at
      which NPY acted. It is known from other work that the production of endogenous
      NPY in neural tissue of underfed animals is increased, and if endogenous NPY
      exerts effects on LH/LHRH similar to the suppression presently observed following
      exogenous NPY this neuropeptide might serve as one neuroendocrine factor that
      suppresses reproduction in underfed animals.

PMID- 1638412
TI  - Behavioural and neurohistological changes in aging Sepia.
AB  - The life cycle of the cuttlefish in the English Channel is characterized by a
      succession of homogeneous population cohorts. These conditions provide an
      excellent opportunity for the study of aging in this cephalopod. In a first
      longitudinal study, we considered the oldest animals and compared their success
      rates at the first capture attempt. During the first weeks of the study, the
      results remained constant and then, during the weeks immediately preceding the
      natural death, a dramatic drop was observed. This deterioration may be due to
      defects of visuomotor coordination. In a second study, we used an associative
      learning protocol with negative reinforcement and the performances of young and
      old animals were compared. The most striking results showed that the performances
      of the oldest animals during the retention test were very mediocre. Such results
      suggest that the long-term memory process is affected. Finally, a modification of
      the Fink-Heimer silver stain enabled us to draw a map of spontaneous terminal
      degeneration in the central nervous system of the oldest animals. The structures
      which are characterized by the presence of multimodal inputs (the spine of the
      peduncle lobe and the basal lobes) present the most obvious signs of
      degeneration.

PMID- 1638415
TI  - Third ventricular subependymal oxytocin-like immunoreactive neuronal plexus in
      the rat.
AB  - In a previous retrograde tracing study, a dense subependymal neuronal plexus was
      found along the anterior ventral third ventricle that projects to the posterior
      pituitary. In the work reported here, the oxytocin-like immunoreactive neurons of
      this plexus were studied in detail. It has a population of about 650 cells with a
      great wealth of dendrites. The neurons are of magnocellular neurosecretory type
      with long straight dendrites running parallel to the ependyma. The plexus is
      composed of a dorsal and a ventral part. The dorsal part consists of about 75% of
      the whole population and is most dense at the levels of the anterior and medial
      magnocellular paraventricular nuclei. Their dendrites appear vacuous in
      immunohistochemically stained sections and have a tendency to form fascicles. The
      ventral part is more sparse. The dendrites of the subependymal plexus are well
      organized so the anteriorly located ones tend to be directed rostrally and the
      posteriorly ones caudally. The functional significance of the plexus is
      discussed.

PMID- 1638413
TI  - Comparison of atropine pre- and post-treatment in ganglion neurons exposed to
      soman.
AB  - The prevention and reversal of the effects of soman (pinacoloxymethylphosporyl
      fluoride) have been examined on the electrical properties of sympathetic ganglion
      neurons in vitro from the adult bullfrog Rana catesbeiana. Atropine (10 microM)
      pre-treatment (before soman) blocked the soman-induced decrease in the membrane
      potential, membrane resistance, and afterhyperpolarization (AHP) duration.
      Atropine post-treatment (after soman exposure) restored the soman-induced
      decrease in the membrane potential but was ineffective in reversing either the
      membrane resistance or the duration of the AHP. These results demonstrate: 1)
      that the effects of soman on the electrical properties of these neurons are
      mediated by the activation of muscarinic receptors, 2) that following receptor
      activation different cellular mechanisms may be involved in the regulation of the
      electrical properties of the neuron, and 3) pre-treatment rather than post
      treatment with atropine is more effective in blocking these direct effects of
      soman. These results are discussed in reference to the increased effectiveness of
      atropine pretreatment in the protocols for soman-induced neurotoxicity.

PMID- 1638416
TI  - Enhancement of glutaminase-like immunoreactivity in rat brain by an irreversible
      inhibitor of the enzyme.
AB  - Changes of glutaminase immunoreactivity in rat brain were examined after
      intracranial injection of 6-diazo-5-oxo-L-norleucine (DON), an irreversible
      inhibitor of glutaminase. When 1 M DON was injected into the lateral ventricle, a
      half-lethal dose was 7.5-10 mumol. After intraventricular injection of 2-7.5
      mumol DON, glutaminase immunoreactivity was dose dependently enhanced with the
      maximum enhancement 3-5 days after the injection. The enhanced glutaminase
      immunoreactivity was recognized by enlarged granular immunodeposits in both
      perikarya and neuropil in many regions, such as the hippocampus, thalamus,
      hypothalamus, periaqueductal gray, and some brain stem, cerebellar, and spinal
      cord regions. Intrathalamic injection of 0.2 mumol DON enhanced glutaminase
      immunoreactivity in many neuronal perikarya in the thalamus and in some perikarya
      in layer VI of the cerebral cortex. Intrastriatal injection of the same dose of
      DON enhanced glutaminase immunoreactivity in neuropil of the caudoputamen and in
      many neuronal perikarya of the intralaminar thalamic nuclei. These results
      suggested that DON induced a new massive synthesis of glutaminase in the affected
      neurons.

PMID- 1638418
TI  - Effects of noradrenergic DSP4 lesion on the effectiveness of pilocarpine in
      reversing scopolamine-induced amnesia.
AB  - We studied the effectiveness of pilocarpine in reversing the scopolamine-induced
      water maze learning deficit (increase in escape latencies, decrease in spatial
      bias) in control and DSP4- (a noradrenergic neurotoxin) lesioned rats. The water
      maze acquisition deficit (escape latency, first spatial bias) induced by
      scopolamine 0.8 mg/kg was augmented by DSP4 treatment. The water maze performance
      deficit induced by scopolamine was reversed by pilocarpine 4 mg/kg in both DSP4
      lesioned and control rats. A smaller dose of pilocarpine (1 mg/kg) did not
      reverse scopolamine-induced acquisition deficit in either control or DSP4
      lesioned rats. Analysis of the second spatial bias test measured 2 weeks after
      training revealed that pilocarpine 4 mg/kg reversed scopolamine-induced retention
      deficit in control and DSP4-lesioned rats. Pilocarpine 1 mg/kg reversed
      scopolamine-induced retention performance deficit during the second spatial bias
      test in control but not in DSP4-lesioned rats. The present results suggest that
      1) noradrenergic and cholinergic systems may interact in the regulation of
      spatial acquisition and retention and 2) the effectiveness of cholinergic drugs
      in reversing scopolamine-induced spatial retention deficit may be affected by
      noradrenergic lesioning.

PMID- 1638417
TI  - AV3V lesion reduces the pressor, dipsogenic, and natriuretic responses to
      ventromedial hypothalamus activation.
AB  - In the present study, we investigated the effect of anteroventral third ventricle
      (AV3V) lesion on pressor, tachycardic, dipsogenic, natriuretic, and kaliuretic
      responses induced by the injection of the cholinergic agonist carbachol into the
      ventromedial hypothalamic nucleus (VMH) of rats. Male rats with sham or AV3V
      lesion and a stainless steel cannula implanted into the VMH were used. Carbachol
      (2 nmol) injected into the VMH of sham rats produced pressor (32 +/- 4 mmHg),
      tachycardic (83 +/- 14 bpm), dipsogenic (8.2 +/- 1.1 ml/h), natriuretic (320 +/-
      46 microEq/120 min), and kaliuretic (155 +/- 20 microEq/120 min) responses. In
      AV3V-lesioned rats (2 and 15 days), the pressor (4 +/- 2 and 15 +/- 2 mmHg,
      respectively), dipsogenic (0.3 +/- 0.2 and 1.4 +/- 0.7 ml/h), natriuretic (17 +/-
      7 and 99 +/- 21 microEq/120 min), and kaliuretic (76 +/- 14 and 79 +/- 7
      microEq/120 min) responses induced by carbachol injection into the VMH were
      reduced. The tachycardia was also abolished (27 +/- 15 and -23 +/- 29 bpm,
      respectively). These results show that the AV3V region is essential for the
      pressor, tachycardic, dipsogenic, natriuretic, and kaliuretic responses induced
      by cholinergic activation of the VMH in rats.

PMID- 1638419
TI  - Postnatal development of the locus coeruleus in trisomy 19 mice: morphological
      and morphometric study.
AB  - To study the effect of trisomy upon a brain region that is generated very early
      during development, the locus coeruleus (LC) has been examined morphologically
      and morphometrically in 23 Trisomy 19 (Ts19) mice and their chromosomally
      balanced control littermates aged 2-18 days postpartum. Gross morphological
      alterations of the Ts19 LC could neither be observed by light nor by electron
      microscopy. The LC was properly located. Ultrastructural features indicating
      increasing protein synthesis such as nucleolus-like bodies and a rise in the
      amount of granular endoplasmic reticulum and in the size of the nucleoli have
      been observed both in Ts19 and control mice. Maturation of the LC was delayed in
      Ts19. Morphometric studies on the volume, cell number, and cell density revealed
      that, apart from a 2-day delay in development, the Ts19 LC was of normal size.
      The present study supports the observation that the noradrenergic system is not
      affected in the Ts19 CNS. Taking into account that the cerebellum of Ts19 mice is
      markedly hypoplastic, the results indicate a differential pathogenic effect of
      trisomy upon different neural systems.

PMID- 1638420
TI  - Neurochemical and morphological evidence of an antinociceptive neural pathway
      from nucleus raphe dorsalis to nucleus accumbens in the rabbit.
AB  - Previous studies using a pharmacological approach suggested a neural pathway
      emanating from the periaqueductal gray (PAG) to the nucleus accumbens relevant to
      antinociception. This was investigated with neurochemical and histochemical
      methods in the present study. Push-pull perfusion and radioimmunoassay were used
      to measure the release of immunoreactive-(ir) enkephalin (ir-ENK) and ir-beta
      endorphin (ir-beta-EP) in the nucleus accumbens after microinjection of morphine
      into the PAG and the nucleus raphe dorsalis (NRD) of the rabbit. Morphine
      administration elicited an increase in ir-ENK and ir-beta-EP in the nucleus
      accumbens. Horseradish peroxidase (HRP) retrograde tracing in combination with 5
      hydroxytryptamine (5-HT) immunocytochemistry revealed a serotonergic projection
      from the NRD and ventral PAG to the nucleus accumbens in the rabbit. About 7% of
      the serotonin-positive cells in the NRD and ventral PAG send fibers directly to
      the nucleus accumbens, with an ipsilateral dominance. These results indicate the
      existence of a serotonergic pathway from the NRD to the N. accumbens involved in
      opioid analgesia.

PMID- 1638423
TI  - The diaphragm.
AB  - Intrinsic disorders of the diaphragm are uncommon. However, the diaphragm is a
      useful radiographic landmark for detecting adjacent pulmonary, pleural and
      abdominal abnormalities, which may lead to the elevation of one or both
      hemidiaphragms or to focal irregularities in the diaphragmatic contour. In this
      review the authors summarize the most common diaphragmatic abnormalities and
      suggest the optimal approach for each to allow a specific diagnosis.

PMID- 1638421
TI  - Serotonin-CRF interaction in the bed nucleus of the stria terminalis: a light
      microscopic double-label immunocytochemical analysis.
AB  - The purpose of the present study was to examine in the bed nucleus of the stria
      terminalis (BST) of the rat brain the morphological characteristics of
      interactions between corticotropin-releasing factor (CRF)-producing neuron
      populations and serotonin (5-HT) axons. A double-label immunocytochemical, light
      microscopic technique was used to demonstrate axosomatic and axodendritic
      interactions between 5-HT axons and CRF neurons in the BST. Both the dorsolateral
      and ventrolateral subpopulations of CRF neurons were targets for the 5-HT
      afferents. Projections of monoamine neurons to the BST and the CRF neurons that
      are in the BST are implicated as being major contributors to the neurochemically
      mediated central regulation of the stress response.

PMID- 1638426
TI  - Pulmonary edema complicating upper airway obstruction in infants and children.
AB  - The association of pulmonary edema with upper airway obstruction occurs in three
      clinical settings: acute and chronic upper airway obstruction and immediately
      after the relief of acute upper airway obstruction. Iatrogenic causes, such as
      adenotonsillectomy and tracheal intubation, were the most frequently encountered
      in the authors' series of 21 pediatric patients with such an association. The
      pathogenesis of this kind of pulmonary edema is multifactorial. The application
      of moderate continuous positive airway pressure in conjunction with the
      administration of diuretics rapidly clears pulmonary edema in all three clinical
      settings, usually within 24 hours, and can probably prevent pulmonary edema
      immediately after acute obstruction is relieved.

PMID- 1638424
TI  - Peripancreatic fluid collections: vascular structures masquerading as
      pseudocysts.
AB  - Five patients with splanchnic arterial aneurysms and one patient with a tortuous
      splenic vessel presented with peripancreatic masses that exhibited an anechoic
      portion in real-time ultrasonography (US) images; the masses were incorrectly
      diagnosed as pseudocysts. In two patients a vascular abnormality was suspected,
      and colour-flow Doppler and pulsed Doppler US were performed; these techniques
      showed the presence of pseudoaneurysms. In the other four patients the
      possibility of a pseudoaneurysm was not entertained until further studies had
      been performed. These results emphasize the need for colour-duplex US evaluation
      of all peripancreatic fluid collections during the initial US examination to
      avoid the misinterpretation of an aneurysm or a pseudoaneurysm as a simple or
      complex fluid collection and to prevent the potential disaster of performing
      biopsy, surgery or other interventions.

PMID- 1638425
TI  - Estimation of splenic weight from ultrasonographic measurements.
AB  - The author assessed the predictability of the weight of a resected spleen from
      measurements obtained from real-time ultrasonography (US) scans. In a preliminary
      study of 12 spleens obtained at autopsy and then examined by US the product of
      splenic length, width and thickness was linearly related to splenic weight (R2 =
      0.97, r = 0.92, p less than 0.001). In a subsequent retrospective study of 81
      patients who had undergone a total of 101 abdominal US examinations within 4
      months of death and whose spleens were weighed during autopsy, splenic weight in
      grams was equal to 0.43 (length x width x thickness) for measurements in
      centimetres (R2 = 0.92, r = 0.78, p less than 0.001). Estimation of splenic
      weight is therefore possible by a simple calculation; this method offers an
      alternative to subjective assessment of spleen size, and the information it
      provides compares well to established norms.

PMID- 1638422
TI  - Effects of spontaneous bioelectric activity and gangliosides on cell survival in
      vitro.
AB  - Chronic suppression of spontaneous bioelectric activity in spinal cord explants
      in the presence of tetrodotoxin (TTX) during network formation caused a large
      reduction in cell number (lowered DNA levels). The addition of gangliosides
      failed to protect against this cell loss. Conversely, the omission of galactose
      from the growth medium had no effect on DNA levels. It was concluded that the
      presence or absence of afferent selectivity is unlikely to require the survival
      of a regionally specific subpopulation of preferred dorsal root ganglion target
      cells. Neocortical explants also showed a large reduction in DNA levels following
      chronic TTX treatment, and morphometric analysis confirmed that neuronal survival
      was affected to the same degree. Chronic ganglioside supplementation failed to
      influence DNA and cell counts in either control or TTX-treated explants, but one
      of the added gangliosides (GD1a) stimulated extensive neuritic outgrowth in
      electrically silenced cultures. Particular ganglioside species, therefore, may
      exert a growth stimulating influence that can partially compensate for the
      absence of bioelectric self-stimulation during early development.

PMID- 1638427
TI  - Reprint requesters and providers in radiology.
AB  - After the publication of any medical paper, its authors normally receive requests
      for reprints. An analysis was performed to determine the geographic origin of
      requests, the frequency of requests and the response rate for individual
      requesters, the additional work that these requests entail for major authors and
      some of the associated costs. A total of 209 consecutive reprint requests
      received over a 11-month period for radiologic articles written by one of the
      authors of this paper were reviewed. Overall, 45% of the requests originated in
      the United States, 22% in Western Europe (excluding Britain), 19% in Eastern
      Europe, 8% in Canada, 4% in Britain and 2% collectively in India, Cuba and
      Mexico. A questionnaire was sent to each requester; 122 (58%) replied. The
      respondents requested between 3 and 2000 reprints each year; respondents from the
      United States requested by far the most reprints. The respondents received
      reprints for between 25% and 100% (mean, 70%) of their requests. The requesters
      found the articles in the original journal in 41% of cases, in Current Contents
      (ISI Press, Philadelphia) in 34%, in both the journal and Current Contents in 23%
      and in other sources in 2%. Twenty-seven of 39 frequently published authors (69%)
      replied to a questionnaire about the requests they received; 19 reported
      receiving at least 100 requests and 4 at least 500 requests every year. Inquiries
      to 29 radiologic journals about the cost of reprints and the frequency of
      requests for additional copies yielded 18 replies. Twelve journals provided free
      reprints, and for the other 6 the average cost of 100 reprints was $90 (Can) when
      the reprints were ordered at the time of the original printing (as offprints).

PMID- 1638428
TI  - Complete duplication of the bladder and the urethra with associated anomalies.

PMID- 1638429
TI  - Management of postnephrolithotomy perforation of the renal vein by a double
      catheter technique.
AB  - Significant venous bleeding after nephrolithotomy is a relatively frequent and
      well-described complication. The authors report a case of renal vein perforation
      and its management through combined flank and groin access to the site of
      bleeding.

PMID- 1638431
TI  - Subarachnoid hemorrhage resulting from methanol intoxication: demonstration by
      computed tomography.
AB  - Subarachnoid hemorrhage developed in a patient intoxicated with methanol.
      Computed tomography performed at the time of admission suggested this
      complication. The hemorrhage was definite and extensive by the 5th day after
      admission and was accompanied by left caudate and pontine hemorrhage, as well as
      severe cerebral edema. The authors are unaware of any previous reports of
      subarachnoid hemorrhage associated with ingestion of methanol.

PMID- 1638430
TI  - Pseudoaneurysm of the inferior gluteal artery.
AB  - Aneurysms of the inferior gluteal artery are uncommon, and have not previously
      been described in detail in the radiologic literature. The authors report the
      findings of computed tomography and angiography for a patient with a
      pseudoaneurysm of the inferior gluteal artery who was successfully treated by
      embolization alone.

PMID- 1638432
TI  - Answer to case of the month #14. Tornwaldt's cyst of the nasopharynx.

PMID- 1638433
TI  - [Implication of growth hormone in experimental induction of vitellogenesis by
      estradiol-17 beta in female silver eel (Anguilla anguilla L.)].
AB  - The effect of different preparations of growth hormone (GH) was assayed with 17
      beta-estradiol on vitellogenesis in hypophysectomized or normal female silver
      eels. Vitellogenin (Vg) plasma levels were taken as the index of hepatic
      vitellogenesis. The E2 doses were chosen to give the same pattern for the plasma
      Vg level as in the controls. They decreased or remained undetectable in
      hypophysectomized or normal animals. GH also failed to induce alone a significant
      modification. When E2 was injected together with a GH, plasma Vg levels were 5.13
      +/- 1.30 times higher with salmon GH in hypophysectomized eels and 2.01 +/- 0.25
      times higher with bovine GH in normal eels. GH is shown to enhance the effects of
      E2 on hepatic vitellogenesis induction in a teleost.

PMID- 1638434
TI  - Transport of the critically ill.

PMID- 1638436
TI  - Education of personnel involved in the transport program.
AB  - Inclusive in the demand for transport services is the need for an ongoing formal
      educational curriculum to ensure that a high standard of care is consistently
      provided to patients. Those who provide transport services must ensure that the
      staff has an adequate baseline level of training and licensure, an ongoing system
      of educational review, and the frequency of activity necessary to maintain
      skills. Team members should have an acceptable level of cognitive and technical
      skills to transport patients and perform needed procedures safely. Such skills
      may be acquired and maintained by participation in nontransport activities,
      through a didactic curriculum and a system of ongoing case review, through team
      members providing training to referring hospitals, and through a "buddy" system
      of supervised transport activities. While an ongoing educational curriculum and
      its structure remain constant, the content can and should be tailored to the type
      of patients transported, from the very low birth weight infant and pregnant
      mother to pediatric and adult patients.

PMID- 1638435
TI  - The nuts and bolts of organizing and initiating a pediatric transport team. The
      Sutter Memorial experience.
AB  - Specialized interfacility transport teams are capable of delivering critical care
      medicine to the patient at the referring hospital and while en route to the
      tertiary care center. To do so effectively, however, requires adequate financial
      and human resources; management of equipment, supplies and personnel; ongoing
      education for transport team members; and an aggressive quality assurance
      program. Team members and team management should always be prepared for worst
      case scenarios, and develop a method for problem resolution as troublesome issues
      arise. The ultimate goal of serving the needs of the critically ill child can be
      consistently met only if there is a high level of commitment of all involved-
      from the hospital administrator and medical director to the transport coordinator
      and team members.

PMID- 1638437
TI  - Critical incident stress debriefing in health care.
AB  - Transport team professionals have unique responsibilities and are exposed to
      powerful demands. They cannot avoid incidents that pose personal threats to their
      own emotional well being. Contact with dead or severely ill or injured children,
      for example, can be detrimental to the caregiver. Discussions called debriefings
      held after these critical incidents can decrease acute and delayed stress
      reactions.

PMID- 1638439
TI  - Interhospital transport. A pediatric perspective.
AB  - Interhospital transport of children must not be undertaken in a vacuum. Basic
      medical ethics and federal laws demand that there be some responsibility in
      providing adequate care during the transport process, and that this care meets or
      exceeds the level provided by the referring hospital. The care provided must also
      be appropriate to the severity of illness of the transported children. National
      guidelines and standards are needed to establish and coordinate a uniform
      interhospital transport process for critically ill children.

PMID- 1638440
TI  - Intrahospital transport of critically ill patients.
AB  - Intrahospital transport of critically ill patients must be considered as part of
      the critical care continuum. The level of care provided must be commensurate with
      the severity of illness. These transfers are intensive in terms of utilization of
      personnel and resources. Advance preparation and optimal coordination of the
      transport process go a long way toward safer transfers of the critically ill.

PMID- 1638438
TI  - Medical-legal considerations involved in the transport of critically ill
      patients.
AB  - The author explains the basic elements of negligence and describes how these
      elements are complicated by the very nature of the transport process. The author
      also provides information on establishing a transport program that will minimize
      patient injury and protect the transport team from liability. A list of tips for
      avoiding liability is also included.

PMID- 1638441
TI  - Evaluation of ground ambulance, rotor-wing, and fixed-wing aircraft services.
AB  - It is hoped that this article has offered insightful suggestions and criteria in
      choosing the most appropriate method to transport patients. Ground ambulances,
      rotor-wing, and fixed-wing aircraft each have advantages and disadvantages in
      particular circumstances. The advantages and disadvantages of any mode of
      transport must be considered to best meet the needs of the patient. In the
      twentieth century alone, great strides have been made in the field of emergency
      stabilization and transport. An efficient, well-trained ground ambulance program
      remains the backbone of prehospital and interhospital transport systems.
      Helicopters and fixed-wing transports must be integrated into the EMS system. One
      advantage of the helicopter and fixed-wing aircraft is rapid travel times when
      time is critical. As Hicks et al said, "early resuscitation and timely transfer
      of selected patients are critical factors in reducing morbidity and mortality."
      The future holds many possibilities for enhanced patient transport. Hospitals may
      be able to use tilt-rotor, vertical landing, fixed-wing aircraft to combine the
      advantages of helicopter and fixed-wing aircraft. After all, our primary goal is
      to get the right patient, with the right personnel, to the right place in the
      right amount of time.

PMID- 1638442
TI  - Ten years of maternal-fetal transport.
AB  - One maternal-fetal transport system and the public health policies that supported
      its development are presented. System development, the components necessary for
      successful two-way maternal-fetal transports, and growth between 1981 and 1991
      are summarized.

PMID- 1638443
TI  - Transport of critically ill patients in need of extracorporeal life support.
AB  - In the past 10 years, we have seen tremendous growth in the use of ECMO for
      neonatal cardiopulmonary failure, and new indications are being recognized for
      the use of ECMO and other forms of ECLS in older children and adults. The number
      of medical centers providing ECLS is and will always be limited, so services are
      needed to transport critically ill patients to ECLS centers. Transport teams
      should be thoroughly familiar with the pathophysiology of cardiac and respiratory
      failure. They should be equipped to continue the monitoring and treatment
      initiated at the referring center, to maintain that level of care during
      transfer, and to treat complications of the diseases or of the therapy itself.
      The responsibilities of the referring centers are to acquaint themselves with
      ECLS programs in their geographic areas and with transport services available.
      Early communication with complete and accurate information is essential.
      Developing a program for ECLS during transport is a huge undertaking that should
      be considered seriously. Not every ECLS center has the resources to embark on
      such a program. Timely referral should make such complex transfers unnecessary
      for most patients.

PMID- 1638444
TI  - Flight physiology. Clinical considerations.
AB  - Altitude-related complications and the stresses of flight represent the
      components of flight physiology. Understanding the complexities associated with
      patient management relative to barometric pressure changes and hypoxia is of
      paramount concern to air medical personnel. This article reviews flight
      physiology as well as appropriate precautions and interventions that must be
      practiced to provide optimal patient care at various altitudes.

PMID- 1638445
TI  - Management of the patient with head injury during transport.
AB  - The most important principles of initial management of the head-injured patient
      are rapid transport to an institution capable of providing the sophisticated
      evaluation, neurosurgical services, and monitoring necessary to improve outcome
      because definitive management of the head-injured patient is not possible in the
      field. The emphasis of care during stabilization and transport should be on the
      prevention of secondary central nervous system injury, primarily by prompt
      stabilization of the airway and assurance of proper ventilation and oxygenation,
      and by control of bleeding and provision of adequate circulation.

PMID- 1638446
TI  - Transport of the critically ill patient with upper airway obstruction.
AB  - Upper airway obstruction is a life-threatening emergency requiring prompt
      evaluation and careful intervention. The pathophysiology of upper airway
      obstruction is reviewed. Assessment techniques and stabilization are discussed
      with specific attention to intervention and stabilization prior to transport.

PMID- 1638447
TI  - Emotional impact on parents of transported babies. Considerations for meeting
      parents' needs.
AB  - The authors discuss the transport of critically ill newborns in relation to the
      psychological impact of attachment in pregnancy, transition to parenthood, and
      prenatal experience of a medical emergency. Interviews with parents and medical
      staff are included to provide an understanding of the experience from these
      perspectives. Considerations and recommendations are given for building an
      effective program to address the emotional needs of families of transported
      babies.

PMID- 1638449
TI  - [Preliminary results on the residence distribution at birth of patients with
      Alzheimer's disease in the Saguenay-Lac-Saint-Jean/Quebec (the IMAGE project)].
AB  - The IMAGE Project is pursuing the establishment of a population-based registry of
      Alzheimer's disease (AD) cases in the Saguenay-Lac-Saint-Jean (SLSJ) (Quebec).
      The authors report on the spatial distribution at birth of 221 possible, probable
      and definite cases. A large network of key-informants for screening AD cases has
      been established over SLSJ. The spatial distribution of cases at birth and at the
      onset of disease has been computed by calculating the Alzheimer birth rate (ABR)
      on the basis of three scales: six specific geographical spheres of screening, all
      municipalities, and the public health departments. The statistical significance
      of results was determined using the theoretical Poisson and the Chi square
      distributions. ABR for each of the geographical spheres of screening showed no
      statistically significant differences considering either residence at the onset
      of the disease or residence at birth. Furthermore, differences were observed
      between rural and urban areas with an interesting trend for a higher number of
      cases than expected in one area of SLSJ. The spatial distribution of cases
      considered on the basis of residence at birth appears to show a different
      pattern, but no significant, from that measured on the basis of residence at the
      onset of disease. Screening of cases is actively being pursued all across SLSJ by
      the IMAGE network. There is a clear trend towards rural residence at birth of
      cases. It remains to see whether or not this observation is due to a geographical
      concentration of familial cases.

PMID- 1638448
TI  - Some aspects of adult mortality in developed countries.

PMID- 1638451
TI  - Psychosomatic medicine: specificity and integration.

PMID- 1638450
TI  - [Medical students facing their future career: a survey in Lille].
AB  - A questionnaire was attached to the registration form which had to be filled out
      by the medical students in October 1990 at the Faculty of Lille, France. Among
      the 1660 respondents, 60% thought that there was an oversupply of medical
      manpower and nearly 50% were in favour of a stronger numerous clauses. Unified
      Europe was perceived as a threat to their future practice by 37% but 19%
      considered it as an additional opportunity. Private general practice was favoured
      only by 12% younger students and 50% "residents" (those who have failed to enter
      the courses of specialties).

PMID- 1638453
TI  - Seasonality in psychiatry--a review.
AB  - This paper reviews the literature pertaining to seasonal patterns in psychiatric
      illnesses. Evidence on the season of birth phenomenon suggests that a greater
      risk of pre-, peri-, or post-natal damage is associated with the winter months.
      There is currently insufficient evidence to pinpoint the exact mechanism involved
      or to ascertain whether the mechanism is common to each condition. Studies of
      seasonal patterns of incidence of psychiatric disorders have highlighted the role
      of seasonally regulated environmental factors on internal biological processes.
      There is growing evidence that serotonin is involved in a variety of psychiatric
      disorders. Seasonal patterns have been observed in processes involving
      serotonergic functioning. Furthermore, it has been postulated that these
      processes may be influenced by photoperiod, suggesting that the seasonal patterns
      of incidence of several psychiatric conditions may share a common
      neurophysiological substrate.

PMID- 1638454
TI  - Advances in diagnosis and treatment of anorexia nervosa and bulimia nervosa.
AB  - This paper reviews four areas of research into anorexia nervosa (AN) and bulimia
      nervosa (BN). First, in terms of diagnosis, the psychological concerns about
      weight and shape are now addressed in BN, bringing it more in line with the
      related disorder, anorexia nervosa. Second, studies of psychiatric comorbidity
      confirm the overlap between eating disorders and depression, obsessive compulsive
      disorder, substance abuse, and personality disorder. Nevertheless, there are
      reasons to accept the distinct qualities of each syndrome, and eating disorders
      are not merely a variant of these other conditions. Third, treatment advances in
      BN involve mainly cognitive-behavioural or interpersonal psychotherapies and
      pharmacotherapies primarily with antidepressants. The effect of combining more
      than one approach is beginning to be addressed. Finally, outcome studies
      involving people with both AN and BN have shown that the disorders "cross over"
      and that both conditions have a high rate of relapse. A renewed interest in the
      treatment of AN is needed.

PMID- 1638452
TI  - Psychophysiological contributions to phantom limbs.
AB  - Recent studies of amputees reveal a remarkable diversity in the qualities of
      experiences that define the phantom limb, whether painless or painful. This paper
      selectively reviews evidence of peripheral, central and psychological processes
      that trigger or modulate a variety of phantom limb experiences. The data show
      that pain experienced prior to amputation may persist in the form of a
      somatosensory memory in the phantom limb. It is suggested that the length and
      size of the phantom limb may be a perceptual marker of the extent to which
      sensory input from the amputation stump have re-occupied deprived cortical
      regions originally subserving the amputated limb. A peripheral mechanism
      involving a sympathetic-efferent somatic-afferent cycle is presented to explain
      fluctuations in the intensity of paresthesias referred to the phantom limb. While
      phantom pain and other sensations are frequently triggered by thoughts and
      feelings, there is no evidence that the painful or painless phantom limb is a
      symptom of a psychological disorder. It is concluded that the experience of a
      phantom limb is determined by a complex interaction of inputs from the periphery
      and widespread regions of the brain subserving sensory, cognitive, and emotional
      processes.

PMID- 1638455
TI  - Psychiatric morbidity during the early phase of coronary care for myocardial
      infarction: association with cardiac diagnosis and outcome.
AB  - We evaluated the association of psychiatric morbidity during the early phase of
      admission to a coronary care unit with cardiac diagnosis and subsequent
      morbidity. Ninety-two patients admitted for the first time for presumed
      myocardial infarction were evaluated within 48 hours of hospitalization. Anxiety
      and depressive symptoms and cognitive impairment were rated. Data were collected
      on cardiac diagnosis and morbidity. Three and 12 months after hospitalization,
      cardiac morbidity, psychiatric symptoms and psychosocial morbidity were assessed.

PMID- 1638458
TI  - A review of schizoaffective disorder: II. Somatic treatment.
AB  - Studies on the response of schizoaffective patients to somatic treatments are
      reviewed. Research suggests that in many cases the response of schizoaffective
      disorder to pharmacological intervention is similar to that of primary affective
      disorder. However, it is necessary to take into account the heterogeneity of the
      category when treating patients. The drugs used most frequently are lithium,
      neuroleptics (antipsychotics), antidepressants and anticonvulsants. Often a
      combination of drugs is found to be more effective than a single drug.
      Electroconvulsive therapy has been found to be very effective in the treatment of
      schizoaffective depression.

PMID- 1638457
TI  - A review of schizoaffective disorder: I. Current concepts.
AB  - This paper reviews recent literature on schizoaffective disorder. Research
      studies of diagnosis, clinical course and outcome and family history are
      evaluated. It is concluded that schizoaffective disorder is a heterogeneous
      category which includes patients with bipolar disorder, schizophrenia, a
      genetically distinct psychosis and a genetic disposition to both schizophrenia
      and bipolar disorder.

PMID- 1638456
TI  - A Canadian medical-psychiatric inpatient service.
AB  - Patients with both psychiatric and medical illnesses present complex and, at
      times, difficult diagnostic and management problems. Medical-psychiatric units
      designed to provide integrated medical and psychiatric care have been established
      in the United States. This paper describes the development and structure of such
      a unit established at a Canadian general hospital, using psychiatric facilities
      and resources already in place. A one year review of the characteristics of
      patients discharged from the service found that their mean length of stay was
      similar to that of inpatients discharged from the general adult inpatient
      services, but shorter than that of patients discharged from the psychogeriatric
      service. Many of these patients had neurological conditions; coexisting affective
      disorders, substance abuse, organic mental syndromes and somatoform disorders
      were diagnosed frequently. We believe that a medical-psychiatric inpatient unit
      can provide integrated care to patients who might otherwise receive less than
      adequate care.

PMID- 1638459
TI  - The prevention of sexual exploitation of patients: educational issues.

PMID- 1638460
TI  - Antiemetic drugs for chemotherapeutic support. Current treatment and rationale
      for development of newer agents.

PMID- 1638462
TI  - Biologic therapy of human cancer.

PMID- 1638463
TI  - The colony-stimulating factors. An overview.
AB  - Hemopoietic cell proliferation, differentiation, and function appear to be
      regulated by cytokines designated as colony-stimulating factors (CSF) or
      interleukins (IL) based on their original description. These cytokines are
      characterized by pleiotropic actions in multiple lineages and at multiple levels.
      Additionally, synergistic interactions are prominent, particularly at the level
      of early stem cells. Baseline regulation of hemopoiesis may be regulated by
      presentation of multiple growth factors at the bone marrow stromal cell surface.

PMID- 1638461
TI  - Managing chemotherapy-induced nausea and vomiting. A paradigm for supportive
      care.
AB  - BACKGROUND: Clinical research on the problem of chemotherapy-induced nausea and
      vomiting (N & V) originated out of the necessity of keeping patients engaged with
      aggressive treatment protocols. The degree of sophistication available today is
      reviewed. METHODS: A supportive care model is proposed for describing the
      developments as a six-step paradigm, ending with the suggestion that
      institutionalization is a final critical step in applying the results of
      research. CONCLUSIONS: The proposed model for control of N & V is suggested as a
      paradigm for the diffusion of a new technology designed to alleviate some aspect
      associated with suffering from the effects of cancer or its treatments.

PMID- 1638465
TI  - The role of hypoxia in renal production of erythropoietin.
AB  - Hypoxia is the fundamental stimulus for erythropoietin (EP) production. It is
      clear that hypoxia increases erythropoietin messenger RNA in a renal cell, which
      leads to the production of increased amounts of erythropoietin in the kidney.
      Hypoxia also increases external messenger substances that amplify the effects of
      hypoxia and increases erythropoietin messenger RNA to further accelerate
      erythropoietin production. Some of these messenger substances are adenosine,
      eicosanoids, oxygen-derived metabolites, and beta-2 adrenergic agonists that are
      postulated to act through the activation of cell membrane receptors and are
      coupled to an increase in a G stimulatory protein which activates adenylate
      cyclase. This leads to increased production of cyclic adenosine monophosphate
      (AMP) for the production of key phosphoproteins that are involved in the
      biosynthesis/secretion of erythropoietin. This paper considers the
      physicochemical properties of human erythropoietin, pharmacologic agents that
      increase and decrease erythropoietin production/secretion, serum erythropoietin
      levels in normal human subjects and in patients with several types of anemia, and
      a model for the role of adenosine and other external messenger substances in
      erythropoietin biosynthesis/secretion.

PMID- 1638464
TI  - The use of colony-stimulating factors in primary hematologic disorders.
AB  - BACKGROUND: The cloning of the human colony-stimulating factors (CSF),
      granulocyte CSF, granulocyte-macrophage CSF, and interleukin-3 has led to their
      use in a variety of clinical settings. RESULTS: These CSF have been used
      successfully to raise neutrophil counts and prevent or control infection in
      patients with neutropenia due to primary hematologic disorders. Their effects on
      platelet and erythrocyte counts have been modest; occasional patients have
      multilineage improvement in hematopoiesis. CONCLUSIONS: The CSF can be given for
      several months at effective and tolerable doses. Their long-term efficacies and
      toxicities remain to be elucidated, and the optimal dose and dosing schedule to
      be used for each indication are not defined currently. Although the CSF can
      improve hematopoiesis in patients with primary hematologic disorders, they are
      not curative.

PMID- 1638466
TI  - New agents for the treatment of multiple myeloma and non-Hodgkin lymphoma.
AB  - Several important new agents are effecting the management of non-Hodgkin lymphoma
      (NHL) and multiple myeloma. The two selected for review in this article include a
      biologic-response modifier and a new chemotherapeutic agent. The biologic
      response modifiers offer entirely new approaches to these diseases. The most
      extensively tested agent currently has been recombinant alpha-interferon (alpha
      IFN). The IFN are active, albeit weak, remission-induction agents for low-grade
      NHL and some T-cell lymphomas, but they appear to be ineffective as single agents
      in most intermediate-grade or high-grade NHL and myeloma. However, an emerging
      pattern in follicular lymphomas and myeloma is that alpha-IFN in combination with
      chemotherapy may lead to more complete and durable clinical responses and the
      increased prospect of prolonged disease control. Fludarabine, a new
      chemotherapeutic agent, is a promising drug with demonstrated activity in low
      grade lymphomas that parallels its impressive activity in chronic lymphocytic
      leukemia.

PMID- 1638467
TI  - The strategic use of antiestrogens to control the development and growth of
      breast cancer.
AB  - Tamoxifen has become the endocrine treatment of choice for all stages of breast
      cancer. Its low incidence of side effects and proven survival advantage observed
      during adjuvant therapy in postmenopausal women with node-positive disease has
      encouraged the use of long-term treatment for patients to benefit fully from
      therapy. The drug has an appropriate level of estrogen-like effects that could be
      beneficial to maintain bone density and prevent development of coronary heart
      disease by lowering circulating cholesterol. These effects might be useful in all
      patients with estrogen receptor-positive breast cancer who currently are
      receiving no therapy. This antiestrogenic agent could be effective therapy to
      deter recurrence, and the estrogen-like side effects support the physiologic
      processes of the patient as hormone-replacement therapy. In the laboratory, a
      tamoxifen-stimulated breast cancer model has been described in vivo. This form of
      drug resistance may occur in patients after long-term or indefinite adjuvant
      therapy. Novel pure antiestrogenic drugs have been discovered that soon will
      become available as second-line therapy after tamoxifen failure. In addition,
      tamoxifen is being evaluated in the United Kingdom as chemosuppressive therapy to
      prevent the development of breast cancer in high-risk women. A similar clinical
      evaluation is underway in the United States.

PMID- 1638468
TI  - Topical absorption and inactivation of cytotoxic anticancer agents in vitro.
AB  - BACKGROUND: Cytotoxic anticancer agents may pose carcinogenic or teratogenic
      risks to personnel who prepare or administer drugs to patients with cancer.
      METHODS: A series of laboratory studies were done to quantify the extent of
      percutaneous absorption and topical inactivation for various cytotoxic anticancer
      agents. Topical inactivation of anthracyclines and anthracene DNA intercalating
      agents was evaluated using Ames bacterial mutagenicity assays and reverse-phase
      high-performance liquid chromatography measurements. RESULTS: Drug levels passing
      through human abdominal skin exposed in vitro for 24 hours to 100 micrograms of
      daunorubicin, doxorubicin, and melphalan were negligible and typically less than
      the high-performance liquid chromatography sensitivity limit of 1-5 ng/ml (less
      than or equal to 0.001% possible absorption). Melphalan powder was recoverable
      from the air near a mortar and pestle used to crush 14 2-mg tablets manually;
      beyond 12 inches, no airborne drug was recoverable. A standard (4%) concentration
      of calcium hypochlorite completely inactivated the anthracyclines daunorubicin
      and doxorubicin but not mitoxantrone. This agent required treatment at a calcium
      hypochlorite concentration of 432 milligrams for complete inactivation.
      CONCLUSIONS: In summary, topical cytotoxic drug absorption is negligible (if it
      occurs at all). However, mechanical manipulations of oral formulations may
      present a risk of exposure to airborne drug particles. Concentrated calcium
      hypochlorite is extremely effective in the the topical inactivation of certain
      carcinogenic cytotoxic agents.

PMID- 1638469
TI  - Hazards of chemotherapy. Implementing safe handling practices.
AB  - Over the last decade, concerns about the hazards of handling cytotoxic
      chemotherapeutic agents increased as various studies were published. Analysis of
      these data suggest possible carcinogenic, teratogenic, and mutagenic risk for
      health professionals (predominantly nurses and pharmacists) that handle these
      drugs. However, the research is inconclusive. The nature of the problem, along
      with methodologic issues, may make it difficult or impossible to provide
      definitive data on the type and degree of risk for those exposed to
      chemotherapeutic agents. Guidelines and recommendations have been published by
      various groups including the Occupational Safety and Health Administration, the
      American Society of Hospital Pharmacists, the Oncology Nursing Society, and
      others. In essence, they recommend that only health professionals with
      specialized training should prepare or administer chemotherapeutic agents. In
      addition, equipment, unused drugs, and human excreta should be treated as
      chemically hazardous waste and disposed of according to the individual facility's
      policies and procedures. These guidelines should provide protection for those
      involved in preparing chemotherapy for administration, regardless of where this
      is done. Studies have shown differences in the degree and type of procedures
      followed and between existing procedures and actual practice. Some of these
      differences are based on the site of care (e.g., hospital [also influenced by bed
      size], private practice, or home care). Issues involved in implementing
      reasonable approaches to lower the relative risk for health-care professionals
      that handle cytotoxic chemotherapy will be discussed.

PMID- 1638471
TI  - Controversial issues in 5-fluorouracil infusion use. Dose intensity, treatment
      duration, and cost comparisons.
AB  - BACKGROUND: The use of ambulatory infusions of 5-fluorouracil (5-FU) improves the
      therapeutic index of this drug and is superior to the traditional schedule of
      bolus administration weekly or daily for 5 days at 5-week intervals. The infusion
      schedules that have been used vary as follows: (1) 24-hour infusion weekly; (2)
      48-hour infusion weekly or biweekly; (3) 120-hour infusion at 4-5-week intervals;
      (4) 14-day infusion; and (5) protracted infusions continuously for 10 weeks or
      more. The relationship of dose intensity to infusion duration and the analysis of
      costs of chemotherapy were reviewed. METHODS: Selected clinical trials of
      infusional 5-FU were analyzed regarding infusion duration and dose intensity in
      relationship to response rates (RR). Chemotherapy cost was analyzed
      distinguishing "cost" definitions. RESULTS: The response rates for the infusion
      durations studied in Phase II and III trials were: (1) 24 hours, 25%; (2) 48
      hours, 30%; (3) 120 hours, 3%; (4) 14-day, 12%; and (5) 10 weeks, 30%. The
      corresponding DI for each infusion duration was (1) 24 hours, 2.6 g/m2/week; (2)
      48 hours, 2.4 g/m2/week; (3) 120 hours, 1.25 g/m2/week; (4) 14-days, 1.225
      g/m2/week; and (5) 10 weeks, 2.1 g/m2/week. Cost analysis by actual reimbursement
      was compared for 5-FU infusion and bolus 5-FU with leucovorin (high and low dose)
      and 5-FU with interferon. Monthly reimbursement for each is $1400, $2000, and
      $1150, and up to $3000, respectively. CONCLUSIONS: DI and infusion duration have
      a complex interaction that may contribute meaningfully to the therapeutic index,
      but this issue can only be resolved by randomized clinical trials. The cost of 5
      FU infusion is comparable to that of bolus therapy when leucovorin or interferon
      are added in combination. Considering the relative absence of patient toxicity,
      the costs of 5-FU infusion are substantially less than bolus delivery.

PMID- 1638470
TI  - Treatment of the patient with cancer using parenteral electronic drug
      administration.
AB  - Oncologic therapy demands technologic sophistication to meet the clinical
      challenges of proper drug administration for chemotherapeutic agents, pain
      management, antibiotics, hydration, antiemetic drugs, and total parenteral
      nutrition. Drug administration systems for patient-controlled analgesia include
      benefits of improved pain control, minimal adverse reactions, lower doses
      compared with conventional therapy, a high degree of patient acceptance, reduced
      labor costs, and achievable home therapy. System advances have made epidural,
      intrathecal, intravenous with bolus capability, and regional or implantable
      administration possible. In chemotherapy, protracted drug infusions and
      considerations of circadian rhythms, sequences, and cytostatic treatment will be
      enhanced further by automated programmable pumps that can meet the challenges of
      complex protocols. Multidrug antibiotic treatments also are a reality. Electronic
      drug administration will continue to meet the challenges of site-specific agents
      and complex dosing regimens to provide therapy for the patient with cancer to
      achieve an efficacious safe acceptable efficient cost-benefit ratio.

PMID- 1638472
TI  - Familial occurrence of multiple nonmelanoma skin cancer.
AB  - A survey of patients with histologically confirmed nonmelanoma skin cancer (NMSC)
      found 12 families in which several members developed skin cancers. The prevalence
      of NMSC in these families was far greater than in the normal population. The
      trait appeared to be dominantly inherited, and NMSC developed at an earlier age
      in succeeding generations, possibly because of a change in sun exposure habits.

PMID- 1638474
TI  - Translocation (6;8)(q22;q12) in Ph+ chronic myelocytic leukemia.

PMID- 1638473
TI  - Structural rearrangement of the Y chromosome in a case of acute myeloid leukemia
      M2.
AB  - Involvement of the Y chromosome in numerical changes associated with acute
      nonlymphocytic leukemia is quite common, whereas acquired structural
      rearrangements of the Y chromosome are much rarer, there being only four such
      cases documented in the literature [1]. We identified a case of acute myeloid
      leukemia (AML M2) with rearrangements of chromosomes 1, 10, and Y; at remission,
      all analyzed metaphases were normal, confirming the acquired nature of the Y
      chromosome abnormality.

PMID- 1638475
TI  - Non-random involvement of chromosome 5 in ALL.

PMID- 1638477
TI  - Prognostic impact of karyotype and immunologic phenotype in 125 adult patients
      with de novo AML.
AB  - One hundred-twenty-five adult patients with de novo acute myeloid leukemia (AML)
      were treated according to a standard 7 + 3 induction regimen. Karyotype and
      immunological phenotype of blasts examined prior to treatment were correlated
      with each other, with response to treatment and duration of survival. The
      following monoclonal antibodies (mAbs) were used for immunological phenotyping:
      VIM-D5 (CD15), MY7 (CD13), MY9 (CD33), VIM-2 (CDw65), VIM-13 (CD14), 63D3 (CD14),
      VID-1 (anti HLA-DR), WT1 (CD7), CLB-Ery3 (antiblood group H antigen), C17-27
      (CD61), and an antiserum against TdT. Despite a considerable overlap between the
      individual groups, patients with specific aberrations as defined by the MIC
      classification (n = 39) showed distinct, characteristic, myeloid or
      myelomonocytic immunophenotypes. In M2/t(8;21) there was a significant
      association with negativity to CD13, in M3/t(15;17) with negativity to CD15 and
      HLA-DR, whereas in M4/inv(16) expression of blood group H antigen was
      unexpectedly found. The response to therapy, as well as rate of complete
      remission as duration of survival, was better in patients with M2/t(8;21),
      M3/t(15;17), and M4Eo/inv(16) as compared to all other patients and significantly
      worse in patients with M5a/t/del(11)(q23). In 35 patients with normal karyotype
      and 16 patients with cytogenetic anomalies not presently associated with FAB
      subtypes the expected correlations of rather immature myeloid immunologic
      phenotypes with M1 and M2 morphology and CD14 expression in monoblastic leukemias
      was found. Remission rate and survival were significantly worse in 19 patients
      with complex nonrandom aberrations, where blast cell expression of blood group H
      antigen and of TdT were significantly increased.

PMID- 1638476
TI  - -Y,-1 as recurrent anomaly in oncocytoma.

PMID- 1638478
TI  - Cytogenetic analysis of a United Kingdom series of non-Hodgkins lymphomas.
AB  - We describe cytogenetic analyses of cells derived from 40 non-Hodgkins lymphoma
      (NHL) node biopsies, 23 of which were from patients who had not been treated
      before biopsy. We noted that the chromosomes most frequently gained were X (32%),
      12 (27%), and 3 (24%). Monosomies were much less common; loss of chromosome 13
      (13.5%) was most frequent. Structural abnormalities primarily involved
      chromosomes 14 (70%), 1 (40.5%), 18 (38%), 6 (35%), and 17 (22%). Low-and high
      grade disease showed similar patterns of structural changes; however, a markedly
      greater number of chromosome gains were associated with low-grade disease. Biopsy
      samples from patients who had previously been treated showed an increased
      frequency of structural abnormalities, as well as a significantly larger number
      of chromosome gains. The importance of these observations, particularly with
      regard to possible oncogene involvement in lymphoma evolution, is discussed.

PMID- 1638479
TI  - Loss of Y chromosome in gastric carcinoma. Fact or artifact?
AB  - Loss of chromosome Y has been reported in gastric cancer cells together with
      other chromosomal abnormalities. We noted loss of chromosome Y and near-diploid
      karyotypes in five cases of gastric adenocarcinoma, but DNA flow cytometry
      performed on fresh tumor tissue showed aneuploid peaks in four of them. Our
      findings suggest that loss of the Y chromosome in gastric cancer probably
      reflects the karyotype of a subpopulation of stromal cells and not a neoplasia
      related chromosomal aberration.

PMID- 1638480
TI  - Constitutional balanced translocations in patients with solid tumors.
AB  - In a sample of 329 patients with a solid tumor (colon and breast adenocarcinoma,
      cervical carcinoma, and meningioma), four balanced constitutional translocations
      were observed. Two were t(13q14q), and two were reciprocal translocations.
      Comparison with surveys of newborns showed a significant excess of translocations
      in our sample.

PMID- 1638481
TI  - Multiple chromosomal changes and karyotypic evolution in a patient with
      myelofibrosis.
AB  - Several subclones were identified in unstimulated peripheral blood cells from a
      patient with chronic myeloproliferative disease, which was classified as
      myelofibrosis by morphologic terms. These subclones were characterized by an
      unusual number of different karyotype anomalies. Some of the more complex
      chromosomal rearrangements could be clearly defined by fluorescence in situ
      hybridization. Chromosome arms involved in clonal aberrations were 1q, 3p, 6p,
      7q, 11q, 13q, 15q, 17q, 18p, and 20q. Reconstruction of karyotype evolution was
      attempted by karyotypic analysis of 100 metaphase spreads each in two separate
      investigations.

PMID- 1638482
TI  - Cytogenetic analysis of six renal oncocytomas and a chromophobe cell renal
      carcinoma. Evidence that -Y, -1 may be a characteristic anomaly in renal
      oncocytomas.
AB  - Renal oncocytomas are benign tumors whose morphologic features may sometimes be
      confused with those of certain low-grade malignant neoplasms of the kidney, e.g.,
      chromophobe cell and granular cell variants of renal carcinoma. The presence of a
      specific genetic abnormality might help differentiate these tumors. Because very
      few cytogenetic studies of renal oncocytomas have been published, we investigated
      a consecutive series of six such tumors. We also performed chromosome analysis on
      a chromophobe cell carcinoma because cytogenetic analyses of this tumor have not
      been previously reported. Tumor cell metaphases were analyzed after mechanical
      and enzyme disaggregation, in situ culture, and robotic harvesting. Clonal
      abnormalities were present in five of the six oncocytomas, and loss of chromosome
      1 with loss of the Y chromosome occurred in two. Review of the literature
      disclosed four other renal oncocytomas with the 44,X,-Y,-1 karyotype. In the
      chromophobe cell carcinoma, we noted an abnormal clone with a del(11)(p12p15.1);
      similar anomalies were not observed in the renal oncocytomas. We conclude that
      renal oncocytomas have clonal chromosome abnormalities and that a subgroup of
      these tumors may be specifically associated with loss of chromosomes 1 and Y.
      Because this is a small series, further investigation may help establish whether
      cytogenetic studies can provide diagnostic and pathogenic information about renal
      oncocytomas.

PMID- 1638483
TI  - Cytogenetic analysis of the mature teratoma and the choriocarcinoma component of
      a testicular mixed nonseminomatous germ cell tumor.
AB  - We karyotyped two histologically distinct components with different metastatic
      behavior of a testicular nonseminomatous germ cell tumor. The two components
      showed an almost identical chromosomal pattern. These almost identical karyotypes
      of the two components with different metastatic potential suggest that the
      difference in biologic behavior might result from subtle differences (on
      microscopic or submicroscopic level) in chromosomal pattern or that these
      differences are predominantly epigenetically determined and depend primarily on
      the lineage of differentiation of the tumor component. Trophoblastic
      differentiation results in an aggressive, angioinvasive tumor but in development
      of teratoma in a tumor with low malignant potential.

PMID- 1638484
TI  - Fibroblast cultures of patients with basal cell epithelioma exhibit a normal
      sensitivity to the genotoxic effect of ultraviolet irradiation.
AB  - Fibroblast cultures of 16 basal cell epithelioma (basalioma, BCE) patients with
      an unusually young age at onset of disease (29-51 years; 42.5 +/- 7.04), and
      healthy normal controls (27-55 years; 40.73 +/- 9.52) were studied for chromosome
      instability induced by ultraviolet rays (UV). We used an UV source that emitted
      predominantly UV-A and UV-B at an intensity of 375 J/m2 and evaluated the
      induction of micronuclei (MN) and sister chromatid exchange (SCE). Young
      basalioma patients and normal controls showed no significant differences in MN
      and SCE frequencies, neither with respect to spontaneous nor to UV-induced values
      (MN spontaneous: 10.80 +/- 5.65 vs. 11.32 +/- 8.21; UV-induced increase: 7.36 +/-
      4.40 vs. 9.93 +/- 7.55; SCE spontaneous: 10.28 +/- 1.61 vs. 10.72 +/- 1.09; UV
      induced increase: 7.30 +/- 2.19 vs. 7.55 +/- 2.14). We conclude from these data
      that an enhanced UV sensitivity as observed in cells from patients with cutaneous
      malignant melanoma and xeroderma pigmentosum is not a constitutive risk factor in
      basalioma patients.

PMID- 1638485
TI  - Establishment and characterization of four Sinclair swine cutaneous malignant
      melanoma cell lines.
AB  - Cutaneous malignant melanoma of Sinclair Swine (SSCM) is a heritable, congenital
      neoplasm which either proves fatal to the neonatal animal or undergoes
      spontaneous regression. Four SSCM cell lines, UISO-SSCM-433, UISO-SSCM-438, UISO
      SSCM-5052, and UISO-SSCM-8093, were derived from biopsy specimens of primary
      tumors removed from swine at 26, 8, and 8 weeks of age, and 15 weeks gestation,
      respectively. Morphologic features, DOPA oxidase staining, and abnormal karyotype
      were suggestive of malignant melanoma. Each cell line was morphologically
      heterogeneous in culture with dendritic, spindle- and cuboidal-shaped cells.
      Pigmented melanosomes and DOPA oxidase activity were present in all cell lines at
      passages 20-22. UISO-SSCM-433 and UISO-SSCM-5052 contained hypodiploid and
      hypotetraploid sublines whereas UISO-SSCM-438 and UISO-SSCM-8093 were hypodiploid
      and hypotetraploid, respectively. At later passages, all cell lines presented
      evolutionary, karyotypic changes; the same chromosomes were involved in the
      alterations, however. Chromosomes 2, 6, 13, and 14 were the most affected,
      exhibiting numerical and structural alterations in all four cell lines. Despite
      the presence of multiple chromosomal anomalies in all cell lines, each with a
      unique set of chromosomal markers, clonal growth was not detected in soft agar,
      nor were any of the lines tumorigenic following s.c. inoculation in athymic mice.
      This suggests that the loss of malignant potential in SSCM may be inherent.

PMID- 1638486
TI  - Deletion of the long arm of chromosome 5 in essential thrombocythemia.
AB  - A 51-year-old woman with no history of prior chemotherapy or radiation therapy
      was diagnosed with essential thrombocythemia (ET) according to the diagnostic
      criteria established by the Polycythemia Vera Study Group (PVSG). Cytogenetic
      analysis of bone marrow metaphases revealed both normal female karyotype and a
      single clonal abnormality, 46,XX,del(5)(q22q35). While chromosomal abnormalities
      have been reported in ET, their incidence is very low, and no specific
      abnormality has been found. Many of the reported cases of ET with chromosomal
      aberrations, including 5q-, do not meet the diagnostic criteria proposed by the
      PVSG, and may represent one of the other myeloproliferative disorders or a
      myelodysplastic syndrome. Furthermore, it is important to distinguish the 5q-
      syndrome, which may present with thrombocytosis and megakaryocytic hyperplasia,
      from ET. Our patient appears to be the first example of untreated ET clearly
      meeting the PVSG criteria in which 5q- was the only clonal abnormality seen at
      diagnosis.

PMID- 1638487
TI  - Cytogenetic studies of an adrenal cortical carcinoma.
AB  - Cytogenetic findings in the third reported case of adrenal cortical carcinoma are
      described. In contrast to the two previous cases, hypodiploidy characterized
      almost all cells, which had as many as eight abnormal chromosomes in each cell
      analyzed.

PMID- 1638489
TI  - Monosomy 21 in two patients with acute nonlymphocytic leukemia.
AB  - Among 50 cases of acute nonlymphocytic leukemia (ANLL) with available cytogenetic
      data seen in our section since May 1988, two were found to carry a monosomy 21
      abnormality which has been rarely reported in hematologic malignancies. The first
      case is a 58-year-old male with a diagnosis of AML, FAB M2, who died of
      refractory leukemia 9 months later. The other case is a 59-year-old female with
      AML, FAB M2. Complete remission was achieved initially but she died of sepsis 3
      months later with no evidence of leukemic relapse. Monosomy 21 is not yet
      recognized as a nonrandom cytogenetic abnormality in ANLL, whereas its unusual
      predilection in AML, especially the FAB M2 or M4 categories, as noted in our
      study and others' reports, have raised this possibility. Further studies and the
      accumulation of new cases are needed in the hope of defining it as a subtype of
      ANLL.

PMID- 1638488
TI  - Acute monoblastic leukemia of infancy in Klinefelter's syndrome.
AB  - A 7-month-old infant with Klinefelter's syndrome was diagnosed as having acute
      monoblastic leukemia (AMoL). Chromosome studies of bone marrow at diagnosis
      showed the karyotype 46,XXY,-Y,t(10;11)(p13;q14). This is the first report of M5A
      leukemia associated with Klinefelter's syndrome.

PMID- 1638490
TI  - The use of giant cell tumor conditioned media in cytogenetic studies of
      hematologic malignancies.
AB  - The use of conditioned media produced from solid tumor cell lines has been
      beneficial in the study of hematologic malignancies. Conditioned media from giant
      cell tumors (GCT), human lung adenocarcinoma, and human bladder carcinoma express
      growth factors that have been used to stimulate growth of bone marrow cells and
      improve the quality of the preparations. It has been reported that addition of Lu
      CSF1-conditioned media from a lung adenocarcinoma cell line masks abnormalities
      in cases of acute leukemia [1.] Because we routinely use GCT-CM in bone marrow
      and leukemic blood cultures for chromosome analysis in our lab, we investigated
      this potential effect on our case analysis. We have performed a serial study of a
      100 cases of hematologic malignancies received for analysis in our lab to
      determine the effect of the addition of GCT-CM to our culture media with respect
      to 1) mitotic index, 2) quality of preparation, and 3) differential selection of
      either chromosomally normal or abnormal cell lines. Our results indicate that the
      mitotic index and quality of metaphases is enhanced with the addition of GCT
      media and that there is no difference in the rate of abnormality detection with
      or without the addition of GCT media.

PMID- 1638491
TI  - Inversion (X)(p22q13) in a uterine leiomyoma.
AB  - We report a case of uterine leiomyoma which showed a karyotype
      46,X,inv(X)(p22q13) as the only clonal change in most of the cells. A few cells
      had an additional del(7), though del(7) has been found to be a primary change in
      leiomyomas. These findings indicate that the abnormality involving the X
      chromosome and particularly Xp22 can be considered as a primary chromosomal
      abnormality. We discuss the findings together with few reports of cases involving
      chromosome X in leiomyomas.

PMID- 1638492
TI  - Analysis of a giant marker chromosome in a well-differentiated liposarcoma using
      cytogenetics and fluorescence in situ hybridization.
AB  - Well-differentiated liposarcomas (LPS) are cytogenetically very complex,
      characterized by giant marker chromosomes, ring chromosomes, and telomeric
      associations. We report a case of well-differentiated LPS in which the only
      cytogenetic anomaly was an additional giant marker. In an attempt to identify the
      origin of this marker, centromeric probes (chosen on the basis of the morphology
      of the marker) to chromosomes 1,2,3,4,6,7,8,9,10,11,12,16,17, and X and a shared
      satellite probe for chromosomes 1,5, and 19, were used with fluorescence in situ
      hybridization (FISH). This was successful at eliminating certain chromosomes as
      candidates for centromeric trisomy but could not identify the origin of the
      marker. This case is unusual in that it does not conform to the typical
      cytogenetic pattern for well-differentiated LPS and is the first known example
      with an apparently normal diploid karyotype with only one additional change.

PMID- 1638493
TI  - AML with unusual chromosomal changes. Translocation (15;21) and 5q- in the
      presence of two normal chromosomes 5.
AB  - We performed serial cytogenetic studies of the bone marrow (BM) of a patient with
      acute myeloblastic leukemia (AML) and noted abnormal karyotypes
      47,XY,+del(5)(q12q34),t(15;21)(q21;q22)/47,XY,+del(5)(q12q34 ) during the second
      relapse. Although a case of this t(15;21) was recently observed in a female
      patient with acute nonlymphocytic leukemia (ANLL) of subtype M4 of the French
      American-British (FAB) classification, the present article constitutes the first
      report of its occurrence in association with ANLL of subtype M1-M2. Furthermore,
      the presence of the 5q- accompanied by two chromosomes 5 of normal appearance is
      very rare and of great interest.

PMID- 1638494
TI  - Sister chromatid exchange frequency in breast cancer cases.
AB  - Sister chromatid exchange (SCE) were studied in 22 patients with breast cancer
      (i.e., four stage II; 12 stage III, six stage IV) and 10 normal healthy females
      as age-matched controls. The data obtained in these cases followed a Poisson
      distribution. An apparent increase in the average rate of SCE/cell was observed
      with the advancing stage of breast cancer.

PMID- 1638495
TI  - Chromosomal abnormalities in Waldenstrom's macroglobulinemia.
AB  - We report the results of cytogenetic studies of direct bone marrow (BM)
      preparations and of short-term BM and peripheral blood (PB) cultures from 17
      patients with Waldenstrom's macroglobulinemia. We noted clonal chromosome changes
      in 10 patients. Abnormalities affected chromosomes X, Y, 2, 4, 5, 15, 16, 18, 19,
      20, 21, and 22; in particular, chromosomes 2, 4, and 5 were involved in
      structural changes: a homogeneously staining region [hsr(2)], a
      der(4)t(4;?)(q32;?), and a 5q+. The other chromosomes were involved in numerical
      abnormalities, such as pseudodiploidy (a 46,X, -X, + 15 clone), loss of
      chromosome Y, and monosomy of chromosomes 16, 18, 19, 20, 21, and 22. Nonclonal
      chromosome rearrangements were also observed. The results are discussed in
      comparison with the few data reported in the literature, and the finding of an
      hsr in the long arm of chromosome 2 is emphasized; indeed, this is the first
      report of hsr in WM.

PMID- 1638496
TI  - Graft-versus-leukemia effects after allogeneic bone marrow transplantation are
      active also in the presence of clones with chromosomal anomalies in addition to
      the Ph chromosome.
AB  - Two male patients with Philadelphia-chromosome (Ph+) chronic myelogenous leukemia
      (CML) underwent allogeneic bone marrow transplantation (ABMT) in the first
      chronic phase after busulfan treatment. In both cases, the donor was a sister,
      and engrafting was demonstrated by chromosome analyses which showed only donor
      cells in the BM. Cytogenetic relapse occurred 29 and 30 months after ABMT,
      respectively, when host cells reappeared: in both cases, the Ph and additional
      anomalies typical of the blastic phase of CML were evident. We then monitored the
      chromosome picture for 52 and 39 months, respectively: no striking evolution
      occurred, and cells with the Ph and additional anomalies persisted together with
      donor cells, which were a minority in the first patient and a great majority in
      the second throughout the observation period. A clinical relapse was observed in
      the first patient, but the disease never progressed to a blastic phase, whereas
      the second patient has not relapsed 7 years after ABMT. We reviewed data from the
      literature on cytogenetic relapse after ABMT in CML without clinical relapse,
      especially the 12 patients in whom cytogenetic relapse included chromosome
      anomalies in addition to the Ph, as in our patients. We suggest that graft-versus
      leukemia (GVL) reactions in such patients are able to arrest progression of the
      leukemic blastic clone and prevent a possible relapse in blastic phase.

PMID- 1638497
TI  - Multiple unrelated chromosome abnormalities in a metastatic mucoepidermoid
      carcinoma of the parotid gland.
AB  - We describe cytogenetic findings in a poorly differentiated, metastatic
      mucoepidermoid carcinoma of the parotid gland. The tumor was characterized by
      multiple, unrelated chromosome abnormalities. Except for two small aberrant
      clones showing t(1;7) and t(2;15), respectively, all other abnormal cells showed
      unique, mostly structural rearrangements peculiar to each cell. No less than 34
      different abnormal karyotypes were observed. A similar karyotypic heterogeneity
      was also described recently in squamous cell carcinomas of the head and neck.

PMID- 1638498
TI  - Leukemic evolution in three patients with myelodysplastic syndrome and unusual
      chromosome changes.
AB  - The authors describe three patients with myelodysplastic syndrome without a
      history of exposure to chemical agents and who showed many chromosome
      rearrangements not previously reported in this hematologic disorder, and a rapid
      outcome of the disease. The authors discuss the significance of the chromosome
      changes, suggesting, in agreement with others, that patients with complex
      rearrangements have a poor prognosis.

PMID- 1638499
TI  - Cytogenetics of primary prostatic adenocarcinoma. Clonality and chromosome
      instability.
AB  - We have examined 62 prostatic adenocarcinomas by conventional cytogenetic
      analysis. Most were primary cultures harvested in 14 days or less. The most
      consistent finding was a normal male diploid karyotype, found in 87% of all cells
      analyzed, and as the exclusive finding in 19 tumors. Nonrandom chromosomal
      changes included gain of chromosome 7 and loss of the Y chromosome. In addition,
      clonal gains of chromosomes 8, 12, and 18, and clonal losses of chromosomes 14
      and 19 were noted in individual cases. Two structural clonal aberrations, a 9p+
      in one case and a t(Y;22) (q11.2;p12) in another, were also seen. Ten of 62
      cultures demonstrated chromosome instability, defined herein as nonclonal gain or
      loss of chromosomes in more than 10% of the metaphases examined from that
      culture. In those cases with nonclonal numerical aberrations, loss of chromosomes
      was more common than gain. The distribution of apparently random numeric
      abnormalities was similar to that of the clonal abnormalities in that the most
      frequent nonclonal gain was of chromosome 7 and the most frequent nonclonal loss
      was of the Y chromosome. Apparently random structural aberrations were observed
      in less than 1% of all analyzed cells. These included a 4p-,del(3)(q13), and
      t(1;11). The extent of apparently random aneuploidy suggests that chromosome
      instability characterizes cultured prostatic adenocarcinomas. An increase in the
      frequency of nonclonal aberrations may be an indicator of tumor origin in a
      predominantly diploid cell population. The coexistence of clonally aberrant,
      nonclonally aberrant, and normal diploid cells in culture may reflect
      heterogeneity of prostate tumors in vivo.

PMID- 1638500
TI  - Cytohematologic and cytogenetic prognostic factors at diagnosis and in the
      evolution in 46 primary myelodysplastic syndromes.
AB  - The myelodysplastic syndromes (MDS) are a heterogeneous group of diseases with
      different prognosis and evolution. Most of the studies on prognostic factors
      performed previously have independently evaluated the clinico-hematologic or
      cytogenetic data at diagnosis. In the present paper, 46 primary MDS were
      clinically, hematologically, and cytogenetically investigated at diagnosis, in
      order to determine the principal factors affecting the survival probability
      between a great number of characteristics. A univariate regression analysis of
      all the data allows one to recognize that the main factors are: the complexity of
      karyotype (p = 0.00001), the percentage of type I and total marrow blast cells (p
      = 0.001), and the abnormal localized immature myeloid precursors' (ALIP) presence
      (p = 0.001). Twenty-five patients underwent consecutive studies during their
      evolution. The karyotype instability gives information both on the likely
      evolution to acute leukemia and on poor survival.

PMID- 1638501
TI  - Karyotype at relapse following allogeneic bone marrow transplantation for chronic
      myelogenous leukemia.
AB  - Eighty-four patients underwent allogeneic or syngeneic bone marrow
      transplantation as therapy for chronic myelogenous leukemia (CML) during a 5-year
      period at The Johns Hopkins Oncology Center. We describe the karyotype at relapse
      in 19 patients who were Ph chromosome positive (Ph+) at diagnosis. Eighty-four
      percent of patients demonstrated clonal and/or nonclonal chromosome abnormalities
      in addition to the t(9;22)(q34;q11) at first detection of relapse or later during
      relapse. These abnormalities included: Ph plus additional clonal abnormalities
      (three patients), Ph plus nonclonal abnormalities (five patients), Ph plus
      additional clonal and nonclonal abnormalities (eight patients). Three patients
      had only the original Ph+ clone. The additional chromosome abnormalities were
      primarily structural, and entirely different from those most frequently observed
      during karyotypic evolution in conventionally treated CML. Chromosome 1 was most
      frequently involved, with 1q32 being the location of three clonal and two
      nonclonal abnormalities. Other sites included 6p21-22 (the site of two clonal
      abnormalities), 7p21-22, and 10q21 (the site of two clonal and one nonclonal
      abnormality each). Chromosomes 5 and 7q, regions of frequent involvement in acute
      nonlymphocytic leukemia that follows chemotherapy for other malignancies, were
      infrequently involved. The clinical significance of these additional
      abnormalities remains undetermined at this time.

PMID- 1638502
TI  - Cytogenetic evidence for a chromosome 22 tumor suppressor gene in ependymoma.
AB  - Although ependymomas comprise 5-10% of pediatric brain tumors, consistent
      cytogenetic aberrations have not been identified in these neoplasms. We report
      karyotypes for two ependymomas. A predominantly well-differentiated ependymoma
      contained several numerical chromosome aberrations, including monosomy 22. In
      contrast, an anaplastic ependymoma had a more complex karyotype that included
      loss of one chromosome 22 homologue and a balanced translocation at q13.3 in the
      remaining 22 homologue. These findings suggest the location of an ependymoma
      tumor suppressor gene on the long arm of chromosome 22.

PMID- 1638503
TI  - Inversion of chromosome 16 and bone marrow eosinophilia in a myelomonocytic
      transformation of chronic myeloid leukemia.
AB  - We report a case of chronic myeloid leukemia (CML) in myelomonocytic
      transformation associated with bone marrow (BM) eosinophilia. At diagnosis, all
      BM cells showed a Ph chromosome. At the time of blastic phase, more than 50% of
      Ph+ cells had a pericentric inversion of chromosome 16, inv(16)(p13q22). This
      case confirms that blastic transformation of CML can involve any committed
      progenitor, and myelomonocytic leukemia with BM eosinophilia is specifically
      associated with rearrangement of chromosome 16 at band p13 and q22.

PMID- 1638504
TI  - 5q- anomaly in acute lymphoblastic leukemia.
AB  - We report two new cases of common acute lymphoblastic leukemia (ALL) with 5q-.
      This abnormality, which is uncommon in ALL, was previously reported in 14 cases
      of ALL of various subtypes and appears to occur less frequently in common ALL
      than in other types of ALL.

PMID- 1638505
TI  - Significant telomere shortening in childhood leukemia.
AB  - Telomere length was studied by Southern analysis in five cases of childhood acute
      leukemia. In four cases, the length of the telomere sequence of the blast phase
      cells was shortened as compared with that of the cells examined during remission.
      Study of telomere length during chemotherapy for hematologic malignancies may
      show rapidly dividing subpopulations of malignant cells and thereby guide further
      treatment needs. In addition, such loss of telomere sequence would give rise to
      chromosomal instability and could be one of the mechanisms of oncogene activation
      in acute leukemia.

PMID- 1638506
TI  - Cytogenetic analysis of a juvenile granulosa cell tumor.
AB  - We report chromosomal changes in a juvenile granulosa cell tumor with complex
      chromosomal rearrangements. These tumors have not been subjected previously to
      cytogenetic analysis.

PMID- 1638508
TI  - Relationship between fragile sites and cancer breakpoints.

PMID- 1638507
TI  - Loss of chromosome 22 in patients with refractory anemia with excess of blasts
      (RAEB) in transformation and acute leukemia after RAEB.
AB  - We report studies of 12 patients with refractory anemia and excess of blasts in
      transformation (RAEB-t) and 17 with acute myeloblastic leukemia (AML) after RAEB.
      Besides chromosome 5 and 7 abnormalities, five patients with complex karyotypic
      changes had monosomy 22. This association is discussed in relation to the
      hypothesis of a suppressor gene located on chromosome 22.

PMID- 1638509
TI  - A case of trisomy 5 in a Philadelphia positive leukemia.

PMID- 1638510
TI  - Duplication of the der(14) chromosome of a translocation (8;14) in a case of
      Burkitt's type L3-ALL.

PMID- 1638512
TI  - Effects of inositol hexaphosphate on growth and differentiation in K-562
      erythroleukemia cell line.
AB  - Inositol hexaphosphate (InsP6) has recently been shown to inhibit experimental
      cancers in vivo. Since the lower phosphorylated forms of InsP6 are important in
      cell growth in a wide variety of mammalian cells, we tested the efficacy of InsP6
      in growth reduction of K-562 human erythroleukemia cells in vitro. We report that
      InsP6 decreases the K-562 cell population by 19-36% (P less than 0.001)
      concomitant to an increased differentiation as evidenced by ultrastructural
      morphology and increased hemoglobin synthesis. Pilot experiments to study the
      mechanism of action of InsP6 show that following treatment with InsP6, the
      concentration of intracellular [Ca2+] ([Ca2+]i) is increased by 57% (P less than
      0.02). Likewise, a 41% increase (P less than 0.05) in InsP3 and a 26% decrease (P
      less than 0.02) in InsP2 were noted 1 h following treatment with InsP6. Contrary
      to the dogma that cell division is associated with increased [Ca2+]i, our data
      show that reduced cell growth and enhanced differentiation is associated with
      increased [Ca2+]i and increased InsP3 in the presence of InsP6.

PMID- 1638511
TI  - Differential stimulation of macrophages for tumor cytostasis and monokine
      production.
AB  - We have investigated whether antitumor activity could be expressed independently
      of cytokine production. Resident macrophages treated with interferon-gamma (IFN
      gamma), lipopolysaccharide (LPS) plus muramyldipeptide (MDP) expressed a
      cytostatic activity against P815 tumor cells and released interleukin 6 (IL-6)
      and nitrite but produced neither IL-1 nor tumor necrosis factor (TNF).
      Thioglycollate-elicited macrophages required only LPS plus IFN-gamma for
      cytostatic activity which was expressed concomitantly with the release of high
      levels of TNF, IL-1 and IL-6, whereas C3H/HeJ macrophages produced low levels of
      monokines and were not cytostatic. LPS, alone, was sufficient for triggering
      Concanavalin A-primed macrophages leading to a full cytostatic activity, even in
      C3H/HeJ macrophages that was expressed, for these latter, in the absence of
      monokine production. TNF did not appear to play a role either in autocrine
      stimulation of macrophages or in the cytostatic process because anti-TNF
      antiserum affected neither the cytostatic activity nor the nitrite production.

PMID- 1638513
TI  - The control by estradiol of pituitary tumor and cell growth is not correlated
      with that of kallikrein gene expression.
AB  - From an MtTF4 pituitary tumor we established new cell lines and tumors whose
      growth is sensitive (stimulation or inhibition) or insensitive to estradiol
      (Cancer Res., 1991, 50, 3786-3794). The main objective of the present work was to
      determine whether such a diversity of responses is correlated with the estradiol
      control of kallikrein gene expression. From kallikrein mRNA analyses and from
      kallikrein activity assays in conditioned medium it appears highly probable that
      the diversity of responses to estradiol of pituitary tumors and cell growth is
      not due to a differential regulation of kallikrein gene expression. In addition,
      prolactin gene expression and estrogen receptor mRNA have been studied to further
      characterize this experimental model.

PMID- 1638514
TI  - Glyceraldehyde-3-phosphate dehydrogenase (GAPDH, E.C. 1.2.1.12.) gene expression
      in two malignant human mammary epithelial cell lines: BT-20 and MCF-7. Regulation
      of gene expression by 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3).
AB  - Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is a key enzyme in the control
      of glycolysis. Its gene expression was analyzed in two breast cancer cell lines
      of human origin, BT-20 and MCF-7. We used a cDNA probe of 1.3 kb for Northern
      blot hybridization. It is found that GAPDH mRNA is overexpressed only in the
      poorly differentiated BT-20 cell line and that treatment of these cells by 1,25
      dihydroxyvitamin D3 (1,25-(OH)2D3) stimulates GAPDH mRNA expression in a dose-and
      time-dependent manner. The present investigation on the BT-20 cells indicates
      that the expression of GAPDH is sensitive to 1,25-(OH)2D3 and up-regulated by low
      doses of this steroid.

PMID- 1638515
TI  - Glutathione conjugation of microsome-mediated and synthetic aflatoxin B1-8,9
      oxide by purified glutathione S-transferases from rats.
AB  - Glutathione (GSH) conjugation of microsome-mediated and synthetic aflatoxin B1
      (AFB1)-epoxide and styrene oxide has been investigated with purified GSH S
      transferases (GSTs) from rats. Both styrene oxide and AFB1-epoxide were
      conjugated preferentially by millimicrons GSTs 3-3, 3-4 and 4-4 as compared to
      alpha GSTs 1-1, 1-2 and 2-2. The highest catalytic activity with styrene oxide
      conjugation was associated with GST 4-4. The highest catalytic activity with
      microsome-mediated AFB1-epoxide conjugation was observed with GST 3-3 whereas
      with the synthetic AFB1-epoxide conjugation was seen with GST 4-4. The catalytic
      activity of pi GST 7-7 was intermediate to millimicrons and alpha GSTs. It is
      suggested that GST 3-3 may play an important role in inactivation of AFB1-epoxide
      generated in vivo in the rat.

PMID- 1638516
TI  - Characterization of potentially mutagenic products from the nitrosation of
      piperine.
AB  - Piperine is the main pungent principle of pepper, a spice consumed by people all
      over the world. It is the trans-trans isomer of 1-piperoylpiperidine and contains
      the methylene dioxy moiety. It is known to give unidentified mutagenic products
      on reaction with nitrite. The nitrosation reaction of piperine is of concern as
      endogenous nitrosation could take place in the human stomach from ingested
      precursors, piperine and nitrite. Nitrites can be ingested directly by consuming
      cured foods or indirectly as nitrates, which could be converted to nitrites under
      appropriate conditions. We have nitrosated piperine using aqueous nitrous acid
      and have isolated and identified some N-nitroso and C-nitro compounds. Their
      isolation, characterization and potential mutagenicity has been discussed.

PMID- 1638517
TI  - The growth inhibitory action of melatonin on human breast cancer cells is linked
      to the estrogen response system.
AB  - The pineal hormone, melatonin, was examined for its capacity to modulate the
      proliferation of a panel of human breast cancer cell lines. Melatonin inhibited,
      to a varying extent, the proliferation of all three estrogen-responsive cell
      lines, but had no effect on estrogen-insensitive breast tumor cell lines.
      Melatonin was also able to specifically block estrogen-induced proliferation in
      MCF-7 breast cancer cells. However, this action was abolished in the presence of
      tamoxifen. Therefore, it appears that the antiproliferative effects of melatonin
      are mediated through the estrogen-response pathway.

PMID- 1638518
TI  - Azidothymidine-induced cytotoxicity and incorporation into DNA in the human colon
      tumor cell line HCT-8 is enhanced by methotrexate in vitro and in vivo.
AB  - We have reported that 5-fluorouracil can increase the cytotoxic and
      antineoplastic activity of 3'-azido-3'-deoxythymidine (AZT). To further evaluate
      the antineoplastic utility of AZT we now have assessed its effect in combination
      with methotrexate (MTX) in the human colon tumor model HCT-8. Incubation of these
      cells for 5 days in AZT and MTX caused a reduction in the 50% inhibitory
      concentration of AZT and isobologram analysis revealed additive effects which
      were reversed by the addition of 50 microM thymidine to the incubation media.
      This enhanced cytotoxicity appeared not to be related to an effect of AZT on MTX
      activity; in whole-cell assays the ability of MTX to inhibit de novo dTMP
      synthesis and deplete intracellular pools of dTTP was not affected by AZT. In
      contrast, although MTX did not alter AZT triphosphate production, it did affect
      AZT triphosphate utilization in DNA synthesis. Incubation of cells for 24 h in
      [3H]AZT alone (5 microM, 3 microCi/ml) resulted in 6.6 pmol AZT incorporated into
      cellular DNA/10(6) cells. Coincubation of these cells in [3H]AZT (5 microM) plus
      5 or 15 nM MTX increased AZT incorporation into DNA to 8.0 and 20.5 pmol/10(6)
      cells, respectively. Biochemically, this effect appeared to correlate with the
      concentration-dependent ability of 5 or 15 nM MTX to deplete intracellular dTTP
      pools, which were reduced by 25 and 49%, respectively. Further evidence of the
      relationship between intracellular dTTP pools and AZT cytotoxicity was that, in
      the presence of both MTX and 50 microM thymidine, intracellular dTTP pools
      remained near normal levels and the incorporation of 5 microM AZT into DNA was
      not enhanced. Therapeutically, studies conducted in athymic (nude) mice bearing
      HCT-8 xenografts that received six weekly cycles of MTX (87.5 mg/kg) and AZT (300
      mg/kg) revealed that the two-drug regimen exerted superior antineoplastic effects
      compared to either drug alone (treated versus control approximately 0.9 for AZT
      or MTX and approximately 0.3 for MTX plus AZT). In addition, the combination did
      not increase toxicity compared to therapy with MTX alone. These findings are
      discussed in light of their biochemical and clinical implications.

PMID- 1638519
TI  - Prevention of acute chemotherapy-induced death in mice by recombinant human
      interleukin 1: protection from hematological and nonhematological toxicities.
AB  - Previous studies have demonstrated that interleukin 1 (IL-1) can protect most
      mice from the acute lethal toxicity mediated by high doses of radiation and/or
      some chemotherapeutic drugs. The results presented herein demonstrate that the
      pretreatment of mice with recombinant human interleukin 1 alpha (rhIL-1 alpha)
      protects mice from the lethal effects of several myelotoxic chemotherapeutic
      drugs, including 5-fluorouracil (5FUra), cyclophosphamide, cis-diammine(1,1
      cyclobutanedicarboxylato)platinum(II), and 1,3-bis-(2-chloroethyl)-1-nitrosourea.
      However, pretreatment with rhIL-1 alpha was not effective against the acute
      lethal toxicity generated by doxorubicin and cisplatin. The chemoprotective
      effects appear to be at least partially due to myeloprotection/restoration, since
      the recovery of myeloid colony-forming units and the total cellularity in the
      bone marrow and spleen were accelerated in the rhIL-1 alpha-pretreated mice.
      However, the chemoprotective effects of rhIL-1 alpha are apparently not limited
      to myeloprotection, since pretreatment with rhIL-1 alpha protects mice against
      the lethal toxicity of both 5FUra and cyclophosphamide, yet bone marrow
      transplants rescue mice treated with 5FUra but not those treated with
      cyclophosphamide. The chemoprotective effects of rhIL-1 alpha may be at least
      partially indirect, since the efficacy of chemoprotection by rhIL-1 alpha is
      reduced in athymic mice, and interleukin 6, but not tumor necrosis factor alpha,
      can substitute for rhIL-1 alpha in chemoprotection from 5FUra.

PMID- 1638520
TI  - Multiparameter assessment of the cell cycle effects of bioactive and cytotoxic
      agents.
AB  - This paper describes the use of the bromodeoxyuridine/propidium iodide method to
      assess the effects of bioactive and cytotoxic agents on the kinetic
      characteristics of acute myelogenous leukemia cells. By careful selection of
      gates, the following parameters can be measured simultaneously using only 50,000
      cells: the proportion of cells in S-phase, the distribution of cells within the S
      phase compartment, the relative rate of DNA synthesis, the relative distribution
      of S-phase times, the proportion of S0 cells, and the proportion of cells in G1
      and G2/M. This method was used to demonstrate that while retinoic acid, alpha
      interferon, and cytosine arabinoside may all "inhibit" DNA synthesis, the actual
      effects of these agents differ. Retinoic acid appears to arrest cells in G1
      without affecting the rate of DNA synthesis, while alpha-interferon and cytosine
      arabinoside "inhibit" DNA synthesis by reducing the rate of synthesis per se.

PMID- 1638521
TI  - Increased therapeutic efficacy induced by tumor necrosis factor alpha combined
      with platinum complexes and whole-body hyperthermia in rats.
AB  - This study examined the effect of a trimodality therapy of the combination of
      recombinant human tumor necrosis factor alpha (TNF), whole-body hypertheria
      (WBH), and cis-diamminedichloroplatinum(II) (CDDP) or cis-diammine-1,1
      cyclobutane dicarboxylate platinum(II) (CBDCA) on a fibrosarcoma and normal
      tissue in F344 rats. TNF (1 x 10(5) units/kg) increased the antitumor effect of
      both CDDP (1.5 mg/kg) + WBH (2 h at 41.5 degrees C) and CBDCA (30 mg/kg) + WBH.
      Tumor growth delay, which was 1.9 days for CDDP + WBH and 2.7 days for CBDCA +
      WBH (P less than 0.01 compared to control), was significantly increased to 2.9
      days with TNF + CDDP + WBH and 5.4 days with TNF + CBDCA + WBH (P less than
      0.05). WBH, TNF, CDDP or CBDCA alone, TNF + CDDP, TNF + CBDCA, or TNF + WBH had
      no significant effect on tumor growth. In contrast, administration of TNF did not
      enhance the CDDP- or CBDCA-mediated dose limiting normal tissue toxicity. CDDP +
      WBH-mediated acute renal injury and CBDCA + WBH-mediated acute myelosuppression,
      as determined by blood urea nitrogen and peripheral blood cell counts,
      respectively, were not increased with the addition of TNF to either dual modality
      therapy. Histopathologically, addition of TNF produced no significant alterations
      in the kidney and the bone marrow as compared to CDDP + WBH or CBDCA + WBH. These
      data show that TNF enhanced the platinum + WBH-mediated antitumor effect without
      increasing normal tissue toxicity, suggesting that TNF may increase the
      therapeutic efficacy of CDDP or CBDCA combined with WBH.

PMID- 1638522
TI  - Resistance to tamoxifen with persisting sensitivity to estrogen: possible
      mediation by excessive antiestrogen binding site activity.
AB  - The growth of a large proportion of estrogen receptor-positive breast tumors is
      stimulated by estrogen and can often be controlled through antiestrogen therapy.
      Resistance to antiestrogen (AE) therapy can occur while tumors retain the
      expression of estrogen receptors (ERc) and remain functionally responsive to
      estrogens. The ability of specific antiestrogen binding sites (AEBS) to prevent
      AE from interacting with ERc has been examined as a possible mechanism through
      which this appropriation of AE could interfere with antiestrogen action.
      Comparisons were performed between uterine preparations where ERc activity
      exceeded AEBS binding and liver preparations where AEBS binding predominated.
      Identical estimates of ERc activity were obtained in uterine preparations using
      either [3H]estradiol or [3H]-4OH-tamoxifen and radioinert diethylstilbestrol
      (alpha,alpha'-diethyl-4,4'-stilbenediol) to estimate nonspecific binding. AEBS
      binding was observed only when [3H]-4OH-tamoxifen was used, while binding to Type
      II sites was resolved only with [3H]estradiol. When excess AEBS activity
      predominated, analyses with radiolabeled estrogen and antiestrogen present
      simultaneously showed that virtually all of the antagonist was bound to AEBS with
      little of the antagonist available to associate with ERc. In an effort to relate
      these observations to AE resistance per se, ERc and AEBS were measured in MCF-7
      human breast cancer cells (ERc-positive, responsive to estrogens and
      antiestrogens) and in variant AE-insensitive LY-2 human breast cancer cells (ERc
      positive, responsive only to estrogens). In AE-resistant LY-2 cells, the ratio of
      AEBS:ERc was approximately three times greater than in MCF-7 cells. Examination
      of 128 human breast carcinomas revealed that AEBS activity was present and could
      exceed ERc activity. Importantly, the partition of significant AE away from ERc
      was observed in human specimens. These observations identify a biochemical
      mechanism for antiestrogen resistance through which AE access to ERc can be
      totally incapacitated while sensitivity to estrogens continues. These
      observations indicate that AEBS activity, in addition to ERc activity, may
      provide helpful information for predicting the response of certain cancers to
      hormonal therapy.

PMID- 1638523
TI  - Interleukin 6 reduces lipoprotein lipase activity in adipose tissue of mice in
      vivo and in 3T3-L1 adipocytes: a possible role for interleukin 6 in cancer
      cachexia.
AB  - To investigate whether interleukin 6 (IL-6) might be a potential mediator of the
      depleted fat reserves observed in malignancy-associated cachexia, we measured
      lipoprotein lipase (LPL) activity in adipose tissue of mice after administration
      of IL-6 or tumor necrosis factor and in cultured adipocytes after addition of
      these cytokines. Injection of IL-6 i.p. reduced adipose tissue LPL activity by
      53% within 4.5 to 5.5 h. Injection of tumor necrosis factor elevated serum IL-6
      levels and reduced adipose tissue LPL activity by 70%. Both human and murine IL-6
      reduced heparin-releasable LPL activity in 3T3-L1 adipocytes in a dose-dependent
      manner; half-maximal inhibition of LPL activity was achieved with 5000 hybridoma
      growth factor units/ml. Thus, IL-6 reduces adipose LPL activity and may
      contribute to the loss of body fat stores associated with some cases of cancer
      cachexia. Since tumor necrosis factor increases circulating IL-6, some of its
      effects may be mediated or potentiated by IL-6.

PMID- 1638524
TI  - Tumor resistance induced by syngeneic bone marrow transplantation and enhanced by
      interleukin 2: a model for the graft versus leukemia reaction.
AB  - Lethally irradiated C3H/HeN mice reconstituted with normal syngeneic bone marrow
      survived significantly longer than unmanipulated control mice following challenge
      with a lethal dose of 38C13 lymphoma cells 2 to 3 weeks post-bone marrow
      transplantation (BMT). Although the magnitude of this effect was modest, it was
      highly reproducible. This resistance-producing effect of BMT could be enhanced by
      interleukin 2 administration and could be abrogated by anti-asialo-GM1 antiserum
      treatment of recipients. These findings are consistent with the hypothesis that
      cells with a natural killer phenotype are activated by BMT and can mediate tumor
      resistance. These studies provide a model to explore the cellular basis,
      independent of donor alloreactivity, of the graft antitumor effect of BMT
      observed in humans.

PMID- 1638525
TI  - Structure-activity study and design of multidrug-resistant reversal compounds by
      a computer automated structure evaluation methodology.
AB  - We have studied the relation between the structure and the multidrug resistance
      reversal activity of a set of diverse chemicals with the MULTICASE structure
      activity program. A number of key structural features were identified as being
      related to multidrug resistance reversal activity. Using these key features, we
      identified seven new compounds predicted to have substantial activity. These were
      obtained and tested experimentally on a CHO/CHRC5 cell line derived from the AB1
      Chinese hamster ovary line in the presence of vincristine and vinblastine. Of the
      seven compounds tested so far, four showed substantial reversal activity, the
      most potent of them exhibiting activity at par with verapamil.

PMID- 1638526
TI  - CI-973, a new platinum derivative with potential antileukemic activity.
AB  - We examined the effects of CI-973 (supplied by Parke-Davis) on several human
      leukemia cell lines and a Chinese hamster ovary (CHO) line and their drug
      resistant counterparts. The cell lines used were HL-60, HL-60/mAMSA, HL-60/DOX,
      KBM3, KBM3/mAMSA 6, KBM3/mAMSA 6(85), CHO, and CHO/AC-7. DOX, mAMSA, and AC-7
      indicate resistance to doxorubicin, amsacrine, or 1-beta-D
      arabinofuranosylcytosine, respectively. Cells were incubated with CI-973, and the
      effect was evaluated by two methods: growth inhibition assay and inhibition of
      colony formation. All cell lines examined were inhibited by CI-973; two of three
      amsacrine-resistant lines and the one cytarabine-resistant line demonstrated
      collateral sensitivity. At equivalent dosages, a 4-day exposure provided much
      greater cell kill than a 1-h exposure. Clonogenic assay showed exponential
      killing over 3 log units. Maximum CI-973 levels required to kill 50% of cells
      were 10-fold lower than the peak plasma levels achieved in a phase I solid tumor
      study. A continuous infusion phase I study in acute leukemia has been initiated.

PMID- 1638527
TI  - Adriamycin: protection from cell death by removal of extracellular drug.
AB  - Adriamycin is a cytotoxic drug which has enjoyed considerable success in the
      treatment of cancer. This agent has a bewildering variety of biological effects
      both within and on the surface of cells exposed to drug, and it has proved
      difficult to unambiguously assign a single mechanism of action. In this report we
      are able to separate intracellular and extracellular actions by taking advantage
      of the complete lack of Adriamycin-induced cytotoxicity at low temperature. For
      example, cells exposed to 100 microM Adriamycin at 0 degree C are not killed by
      the drug, even though this concentration is orders of magnitude higher than the
      concentration needed to cause 100% cell death at 37 degrees C. If cells exposed
      to 100 microM Adriamycin at 0 degree C are shifted to fresh drug-free medium at
      37 degrees C, there is a time-dependent decrease in survival. However, if the
      drug-free medium contains calf thymus DNA (1.5 mg/ml) to act as a reservoir for
      Adriamycin binding of effluxed drug, there is no ensuing cytotoxicity. Thus, the
      results show that no matter how much drug is present inside the cell, there must
      also be extracellular drug available for membrane interaction in order to
      initiate nuclear DNA damage and the cytotoxic cascade.

PMID- 1638528
TI  - Nitrite and nitrosamine synthesis by hepatocytes isolated from normal woodchucks
      (Marmota monax) and woodchucks chronically infected with woodchuck hepatitis
      virus.
AB  - Hepatocytes isolated from woodchucks (Marmota monax) were shown to produce
      nitrite in vitro from L-arginine after stimulation with lipopolysaccharide (LPS).
      Hepatocytes isolated from woodchucks that were chronic carriers of woodchuck
      hepatitis virus formed twice as much nitrite as hepatocytes from noninfected
      animals. Nitrite synthesis by hepatocytes was directly related to L-arginine and
      LPS concentrations in the tissue culture medium and reached a plateau at 0.5 mM L
      arginine and 1.0 micrograms/ml LPS. LPS-stimulated hepatocytes nitrosated
      morpholine to form N-nitrosomorpholine in the presence of L-arginine at a
      physiological pH of 7.4. There was a 10-fold increase in N-nitrosomorpholine
      production when hepatocytes were stimulated with LPS compared to unstimulated
      hepatocytes under similar conditions when both nitrite and morpholine were
      directly added to the medium. NG-monomethyl-L-arginine, a selective inhibitor of
      nitric oxide synthase, inhibited formation of both nitrite and N
      nitrosomorpholine. These results demonstrate that nitrosating agents are formed
      in hepatocytes via the L-arginine-nitric oxide pathway. This suggests that
      endogenous formation of carcinogenic N-nitroso compounds could influence the
      process of hepatocarcinogenesis in woodchucks with chronic woodchuck hepatitis
      virus infection.

PMID- 1638529
TI  - Inhibition of hematopoietic tumor growth by combined treatment with deferoxamine
      and an IgG monoclonal antibody against the transferrin receptor: evidence for a
      threshold model of iron deprivation toxicity.
AB  - Recent studies have suggested that iron deprivation may represent a useful new
      approach in cancer therapy, and several strategies for producing such deprivation
      are now under investigation. Thus, for example, we recently provided evidence
      that combined treatment with the iron chelator deferoxamine and an IgG monoclonal
      antibody against the transferrin receptor (ATRA) produces synergistic inhibition
      of hematopoietic tumor cell growth in vitro (J. D. Kemp, K. M. Smith, L. J.
      Kanner, F. Gomez, J. A. Thorson, and P. W. Naumann, Blood, 76: 991-995, 1990).
      The current study is an attempt to analyze the mechanisms responsible for the
      synergistic interaction. The data show that a single IgG ATRA can produce up to
      75% inhibition of iron uptake while having little effect on DNA synthesis; this
      suggests that tumor cells either take up or have stored amounts of iron well in
      excess of that required to support immediate metabolic needs. When deferoxamine
      and the IgG ATRA are used together, the effects on iron acquisition and receptor
      down-modulation are either additive or subadditive but are clearly not
      synergistic. Overall, the findings suggest that the IgG ATRA produces an injury
      to iron uptake that is just below a critical threshold and that the additional
      effect provided by the iron chelator is sufficient to exceed that threshold and
      produce a rapid depletion of iron pools that are vital for short-term DNA
      synthesis. IgG ATRAS thus seem to be of even greater interest as therapeutic
      reagents, and further study of their properties and of how they interact with
      deferoxamine appears to be warranted.

PMID- 1638530
TI  - Development of a murine lymphoma model system for the characterization of natural
      killer:tumor cell interactions.
AB  - We have developed a model system which can be utilized for characterizing both
      the molecular basis of natural killer (NK):tumor interactions and the
      consequences of these interactions on tumor growth in vivo. This model system
      consists of several tumor lines which were derived from the murine lymphoma ASL1w
      under conditions which permitted the isolation of clonal lines that differ in
      their susceptibility to NK-mediated lysis. The NK-resistant clones used in this
      study (AW5J and AW5E) were susceptible to cytotoxic T-lymphocyte-mediated lysis
      and thus appear to be resistant to lytic processes utilized uniquely by NK cells.
      In competitive (cold target) inhibition assays, the AW5J clone did not inhibit NK
      recognition as well as the NK-sensitive clones. Thus AW5J may not be efficiently
      recognized by NK cells. The AW5E clone, on the other hand, competitively
      inhibited NK recognition as efficiently as the NK-sensitive clones; therefore,
      AW5E appears to evade a post-recognition event which is required for NK-mediated
      lysis. The susceptibility of these clones to killing by NK cells directly
      correlated with their lethality, suggesting that NK cells regulated the growth of
      these tumors in vivo. The level of host NK activity was also an important
      determinant of the level and site of tumor localization. Two-step
      immunofluorescence assays and flow cytometric analysis were used to quantitate
      the number of tumor cells in the bone marrow, spleen, and lymph nodes of mice
      with augmented or depleted NK activity. Increasing host NK activity decreased the
      number of tumor cells in each organ which could support the growth of the
      particular tumor tested. Furthermore, the extent of NK regulation was dependent,
      in part, upon the susceptibility of the particular tumor to NK-mediated lysis and
      the site of tumor growth. Thus, the data presented here demonstrate the utility
      of the ASL1w-derived clones as a model system which can be used to delineate the
      requirements and consequences of NK:tumor interactions.

PMID- 1638531
TI  - Effect of bivalent interaction upon apparent antibody affinity: experimental
      confirmation of theory using fluorescence photobleaching and implications for
      antibody binding assays.
AB  - The affinity of a monoclonal antibody for its tumor-associated antigen is one of
      several parameters governing in vivo monoclonal antibody distribution. However,
      there is a lack of apparent correlation between the affinity of a bivalent
      monoclonal antibody measured using equilibrium binding experiments and its in
      vivo delivery. Furthermore, differences in the reported affinity for identical
      antibody/antigen pairs are quite common in the literature. In this paper, both of
      these discrepancies are addressed in terms of variation in avidity due to
      bivalent interaction. The enhancement of avidity afforded by bivalent attachment
      is addressed theoretically by extending the model of Crothers and Metzger
      (Immunochemistry, 9: 341-357, 1972). Theoretical assessment of Lineweaver-Burk,
      Scatchard, Steward-Petty, Langmuir, fluorescence recovery after photobleaching,
      and Sips models demonstrates quantitatively that the measured affinity using
      equilibrium binding experiments may vary over four orders of magnitude with
      similar variation in experimental cellular antigen density. Further, the measured
      affinity is a function of the experimental protocol. Predictions of avidity
      enhancement were confirmed experimentally using fluorescence recovery after
      photobleaching. These experiments measured the equilibrium binding constant and
      concentration of binding sites for an immunoglobulin G monoclonal antibody and
      its F(ab) fragment directed against the rabbit VX2 carcinoma cell line. Bivalent
      binding data agree quantitatively with those predicted by the bivalent model with
      no adjustable parameters. It is concluded that bivalent equilibrium binding
      constants are useful only in antibody screening, where experimental conditions
      are identical for all series. They must be used with caution in predicting in
      vivo antibody distribution, and it is recommended that the intrinsic, monovalent
      affinity be measured in tandem with any bivalent antibody study as a standard
      reference.

PMID- 1638532
TI  - Gene- and strand-specific damage and repair in Chinese hamster ovary cells
      treated with 4-nitroquinoline 1-oxide.
AB  - 4-Nitroquinoline 1-oxide (4NQO) is a model chemical carcinogen that has often
      been referred to as a UV mimetic agent. Previous studies have indicated that UV
      induced pyrimidine dimers are repaired preferentially and strand-specifically in
      actively transcribing genes. In the current study we have examined the gene
      specific and strand-specific repair of 4NQO in Chinese hamster ovary B-11 cells
      treated with 2.5 microM 4NQO. The methodology used for detecting adducts involved
      the treatment of DNA from 4NQO-exposed cells with uvrABC excinuclease, which
      incises DNA at adduct sites, followed by denaturing gel electrophoresis of DNA,
      Southern hybridization, and probing for the sequence of interest. We examined the
      active and inactive coding regions of the DHFR gene, the active adenine
      phosphoribosyltransferase gene, relatively inactive c-fos oncogene, and the
      mitochondrial genome for 4NQO adducts. Initial 4NQO adduct levels found in these
      genes varied from 1.10 to 1.52 adducts/10 kilobases. Little difference in repair
      was found between active coding and inactive regions of the DHFR gene, or between
      DHFR, adenine phosphoribosyltransferase, and c-fos genes, which are transcribed
      at different levels. Approximately 71% of 4NQO adducts were repaired within 24 h
      in all gene sequences examined. During this same time period, approximately 51%
      of adducts were repaired from the genome overall, as determined by comparing the
      removal of bound radiolabeled 4NQO to total DNA. The results indicate that 4NQO
      adducts, unlike UV light-induced cyclobutane pyrimidine dimers (UV dimers), are
      not preferentially repaired in transcriptionally active genes. However, there may
      be regions of the genome that are not repaired with the same efficiency as the
      specific genes examined here. In addition, little to no difference was observed
      in the repair of 4NQO adducts in the transcribed and nontranscribed strands of
      the DHFR gene, a finding which is also in contrast to results with UV dimers.
      Interestingly, 4NQO adducts, unlike UV dimers, were removed from the
      mitochondrial genome, suggesting that repair of select lesions occurs in this
      organelle. Thus, there appear to be some differences in the repair pathways
      operating for 4NQO adducts and UV dimers, particularly with respect to gene- and
      strand-specific DNA repair.

PMID- 1638533
TI  - Targeting of tumor cells and DNA by a chlorambucil-spermidine conjugate.
AB  - Many tumor cells, including murine ADJ/PC6 plasmacytoma cells, possess an active
      energy dependent polyamine uptake system which selectively accumulates endogenous
      polyamines and structurally related compounds. We have attempted to target the
      cytotoxic drug chlorambucil to a tumor possessing this uptake system by
      conjugating it to the polyamine spermidine. Furthermore, since polyamines have a
      high affinity for DNA, the attachment of spermidine to chlorambucil should also
      facilitate its targeting to DNA. This was supported by the observation that the
      chlorambucil-spermidine conjugate was approximately 10,000-fold more active than
      chlorambucil at forming interstrand crosslinks with naked DNA. In vitro
      cytotoxicity and in vivo antitumor studies were carried out using the ADJ/PC6
      plasmacytoma. In vitro, using [3H]thymidine incorporation to assess cell
      viability following a 1-h exposure to control and polyamine depleted ADJ/PC6
      cells, chlorambucil-spermidine was 35- and 225-fold, respectively, more toxic
      than chlorambucil. The increased toxicity of the conjugate compared to
      chlorambucil was possibly due to enhanced DNA binding and/or facilitated uptake
      via the polyamine uptake system. The enhanced toxicity of the conjugate but not
      chlorambucil by prior polyamine depletion with difluoromethylornithine, together
      with the observation that the conjugate but not chlorambucil competitively
      inhibited spermidine uptake into tumor cells, supported the suggestion that the
      conjugate utilized the polyamine uptake system. In vivo following a single i.p.
      dose, the conjugate was 4-fold more potent than chlorambucil in its ability to
      inhibit ADJ/PC6 tumor growth in BALB/c mice. However, the therapeutic index was
      not increased. Our results support the hypothesis that polyamines linked to
      cytotoxics facilitate their entry into tumor cells possessing a polyamine uptake
      system and increase their selectivity to DNA. This may have therapeutic
      application in the delivery of cytotoxic agents linked to polyamines to certain
      tumors.

PMID- 1638534
TI  - Abnormal structure and expression of the p53 gene in human ovarian carcinoma cell
      lines.
AB  - In an effort to analyze molecular mechanisms of human ovarian carcinogenesis, we
      studied the structure and expression of the p53 gene in different cell lines
      established from human ovarian carcinomas. In all six lines (PA-1, Caov-3 and -4,
      OVCAR-3, SK-OV-3, and Kuramochi), p53 abnormalities were detected. In the SK-OV-3
      cell line, Southern analysis suggested the presence of sequence
      deletions/rearrangements in at least one allele of the p53 gene, and transcripts
      were not detectable by either Northern or polymerase chain reaction analysis.
      Sequence analysis of the entire coding region of the p53 gene revealed point
      mutations resulting in codon changes of a highly conserved region of the protein
      in four cell lines, Caov-3 and -4, OVCAR-3, and Kuramochi. In the Caov-3 cell
      line, the point mutation resulted in chain termination at codon 136. Quantitation
      of p53 protein by immunoprecipitation analysis revealed a 6-fold higher than
      control cell level in PA-1. By contrast, p53 protein was not detectable in lines
      Caov-3 and SK-OV-3. We conclude that altered levels of p53 gene expression and/or
      mutant forms of the p53 gene product are associated with all human ovarian cancer
      cells tested.

PMID- 1638535
TI  - Inhibition of proliferation by c-myb antisense RNA and oligodeoxynucleotides in
      transformed neuroectodermal cell lines.
AB  - Transfection of a neuroblastoma cell line with expression vectors containing two
      different segments of human c-myb complementary DNA in antisense orientation
      yielded far fewer transfectant clones than did the transfection with the
      identical segments in sense orientation. In cell clones expressing c-myb
      antisense RNA, levels of the c-myb protein were down-regulated and the
      proliferation rate was slower than that of cells transfected with sense
      constructs or the untransfected parental cell line. Treatment of neuroblastoma
      and neuroepithelioma cell lines with a c-myb antisense oligodeoxynucleotide
      strongly inhibited cell growth. These data indicate a definite involvement of c
      myb in the proliferation of neuroectodermal tumor cells extending the role of
      this protooncogene beyond the hematopoietic system. The availability of cell
      clones that transcribe c-myb antisense RNA provides a useful tool to study the
      involvement of other genes in the proliferation and differentiation of
      neuroblastoma cells.

PMID- 1638537
TI  - Expression of platelet-derived growth factor-independent phenotypes in BALB/c 3T3
      cell variant with high susceptibility to chemically or physically induced
      neoplastic cell transformation: dissociation from activation of protein kinase C.
AB  - A31-I-13, a clonal cell variant of nontransformed BALB/c 3T3 that is highly
      susceptible to chemically or physically induced malignant cell transformation but
      is not sensitive to cell killing or susceptible to induced somatic cell mutation
      compared with another less transformation-susceptible A31-I-1 cell variant, was
      previously found to be constitutively competent [platelet-derived growth factor
      (PDGF)-independent] to synthesize DNA (M. Tatsuka et al., J. Cell. Physiol., 139:
      18-23, 1989). The present study has demonstrated that density-arrested, quiescent
      A31-I-13 cells autonomously exhibit disruption of actin filamentous bundles and
      perturbations of dynamic morphology. PDGF induced these cytoskeletal modulations
      in quiescent A31-I-1 cells, which require PDGF for the induction of DNA
      synthesis. Furthermore, the cytoskeletal modulations of quiescent A31-I-13 cells
      were not accompanied by an increased production of plasminogen activators,
      activation of protein kinase C, or phosphorylation of a Triton X-100-soluble
      protein (molecular weight, 90,000) known as 80K, a major substrate for protein
      kinase C. However, these modulations were accompanied by the tyrosine
      phosphorylation of Triton X-100-insoluble (cytoskeletal) proteins with molecular
      weights of 24,000, 32,000-33,000, and 36,000. These Triton X-100-insoluble
      proteins, as well as the 80K protein, were phosphorylated by the exposure of
      quiescent A31-I-1 cells to PDGF. Thus the pathway for producing the
      transformation-susceptible phenotype in A31-I-13 appears to coincide with the
      PDGF signaling pathway but does not involve the protein kinase C pathway.

PMID- 1638536
TI  - Pyrimidine dimer removal enhanced by DNA repair liposomes reduces the incidence
      of UV skin cancer in mice.
AB  - UV exposure has been linked to skin cancer in humans by epidemiology and the rare
      genetic disease xeroderma pigmentosum. However, UV produces multiple
      photoproducts in DNA, and their relative contribution is uncertain. An enzyme
      which specifically repairs cyclobutane pyrimidine dimers in DNA, T4 endonuclease
      V, was encapsulated in liposomes for topical delivery into mouse and human skin.
      In both species, liposomes applied after UV exposure localized in the epidermis
      and stimulated the removal of cyclobutane pyrimidine dimers. UV-irradiated mice
      treated with these liposomes had a dose-dependent decrease in the incidence of
      squamous cell carcinoma compared to controls. The results demonstrate that
      unrepaired cyclobutane pyrimidine dimers in DNA are a direct cause of cancer in
      mammalian skin.

PMID- 1638538
TI  - Effect of testosterone on the growth properties and on epidermal growth factor
      receptor expression in the teratoma-derived tumorigenic cell line 1246-3A.
AB  - 1246-3A is an insulin-independent tumorigenic cell line isolated from the C3H
      mouse teratoma-derived adipogenic cell line 1246. In the present paper, we have
      demonstrated that testosterone inhibits the in vivo tumorigenic properties of the
      1246-3A cells. Castrated male mice receiving injections of 1246-3A cells
      developed larger tumors at a higher frequency than sham-operated animals.
      Administration of testosterone to castrated male mice resulted in a dramatic
      decrease in tumor development. In vitro studies indicated that testosterone
      inhibited by 50% the proliferation of the 1246-3A cells in culture. However,
      growth inhibition was observed only if the cells had been cultivated in the
      presence of testosterone for at least 4 days. In contrast, testosterone had
      little effect on the proliferation of the parent cell line 1246. Binding of
      several polypeptide growth factors was examined in cells cultivated in the
      absence and in the presence of testosterone. Testosterone increased 125I-EGF
      specific binding to 1246-3A cells. Scatchard analysis of EGF binding indicated
      that testosterone treatment induced a 2.4-fold increase in the number of cell
      surface EGF binding sites. This was accompanied by an increase in the intensity
      of cross-linked EGF receptors on the cells treated with testosterone. In
      addition, 1246-3A cells cultivated for 9 days in the presence of testosterone
      displayed a 10-fold increase in the level of EGF receptor mRNA when compared to
      1246-3A cells maintained in its absence. Similar to its action on cell
      proliferation, the increase in EGF receptor number and mRNA expression was
      observed mainly if 1246-3A cells had been exposed to testosterone for 9 days. The
      data presented in this paper demonstrate that both in vivo and in vitro,
      testosterone induces in the teratoma-derived 1246-3A cell line phenotypic changes
      such as growth inhibition and modulation of EGF receptor expression.

PMID- 1638539
TI  - Diminished leukocyte-endothelium interaction in tumor microvessels.
AB  - Leukocyte-endothelium interaction in vivo consists of the rolling of leukocytes
      along the vascular wall and, under certain conditions, their adherence to
      endothelial cells. In a rat tumor microcirculation model (mammary adenocarcinoma
      implanted in rat skinfold window chamber), we demonstrated that this interaction,
      measured as flux of rolling leukocytes and density of adhering leukocytes, was
      significantly reduced in tumor microvessels compared to normal microvessels, both
      under control conditions and during inflammation induced by N
      formylmethionylleucylphenylalanine (1 microM), bacterial lipopolysaccharide (1
      microgram/ml), or tumor necrosis factor alpha (500 units/ml). We also measured
      the blood flow shear rate in the tumor and normal microvessels and found that the
      difference in shear rate between the two types of microvessels could not account
      for the differences in leukocyte-endothelium interaction. The diminished
      leukocyte-endothelium interaction in tumors under various stimulated conditions
      suggests that a number of adhesion molecules may not be expressed properly on
      tumor endothelial cells.

PMID- 1638540
TI  - The pattern of p53 mutations in Burkitt's lymphoma differs from that of solid
      tumors.
AB  - Available evidence suggests that, among hematological malignancies, p53 is most
      often mutated in Burkitt's lymphoma (BL). However, much of the published data is
      based on cell lines. We have, therefore, analyzed BL biopsies to determine more
      accurately the frequency and pattern of p53 mutations in primary tumors and to
      determine whether there are differences among the various subtypes of BL. Among
      27 BL biopsies from South Africa, we have observed mutations in the p53 gene
      (exons 5 through 8) in 37% of tumors. The higher frequency of mutations in cell
      lines (70%) suggests that mutation of p53 may be associated with tumor
      progression. Summarizing available data we conclude that the presence of mutated
      p53 in BL is independent of the geographic origin of the tumor, the 8;14
      chromosomal breakpoint locations and Epstein-Barr virus association. We also find
      that the mutational spectrum of p53 in BL differs from that observed in
      nonlymphoid tumors. More than 50% of mutations in BL are clustered in a small
      stretch of 33 amino acids (codons 213 to 248). Interestingly, codon 213 appears
      to be as frequently mutated as codon 248. Conversely, codon 273, often mutated in
      solid tumors, is rarely involved in BL.

PMID- 1638541
TI  - Murine bladder carcinoma cells present antigen to BCG-specific CD4+ T-cells.
AB  - Intravesical administration of Bacillus Calmette-Guerin (BCG) is the most
      effective therapy for superficial transitional cell carcinoma of the bladder
      although its mechanism of action is not known. To determine if bladder tumors are
      capable of antigen presentation and thus might interact directly with BCG
      specific T-cells, we studied the murine bladder tumor MB49. MB49 (MHC Class II
      negative) (IA-), when induced to express IA with interferon, presented BCG to
      specific CD4+ T-cells obtained from bladder-draining lymph nodes following
      intravesical BCG administration. This interaction resulted in antigen- and IA
      dependent interleukin 2 and tumor necrosis factor production. Interferon also
      induced MB49 IA expression in vivo. This first demonstration of antigen
      presentation by epithelial tumors supports new approaches to immunotherapy of
      these malignancies.

PMID- 1638543
TI  - Tumor suppressor genes, the cell cycle and cancer.

PMID- 1638542
TI  - Correspondence re: Giovanna Caderni et al., Effect of dietary carbohydrates on
      the growth of dysplastic crypt foci in the colon of rats treated with 1,2
      dimethylhydrazine. Cancer Res., 51:3721-3725, 1991.

PMID- 1638544
TI  - Genetic alterations underlying colorectal tumorigenesis.
AB  - Colorectal tumours have proven to be an excellent system in which to identify and
      study the genetic alterations involved in the development of a common human
      neoplasm. A prevalent view is that colorectal tumours appear to arise as the
      result of multiple genetic alterations in the alleles of both oncogenes and
      tumour suppressor genes. The accumulation of genetic alterations appears to
      accompany the clinical and biological progression of the tumours and may
      determine the phenotype of the tumour cells. In addition to the many somatic
      alterations identified at various stages of colorectal tumour development, recent
      studies have led to the identification of the adenomatous polyposis coli (APC)
      gene, which, when mutated in the germline, predisposes to the development of
      colorectal tumours. On the basis of studies of inherited and somatic mutations in
      colorectal tumours, a genetic model for colorectal cancer development has been
      proposed. Although the model is undoubtedly incomplete, it nevertheless provides
      a useful framework for further studies of the multiple events that underlie human
      tumour initiation and progression. Numerous questions remain to be answered,
      including identification of the normal function of the genes implicated in
      tumorigenesis, how mutations in these genes arise and are selected for and what
      the relative contribution of the altered genes is to various stages of the
      neoplastic process. Nevertheless, an optimistic outlook is that fundamental
      insights into the pathogenesis of human cancer are within our reach.

PMID- 1638545
TI  - Friend virus induced murine erythroleukaemia: the p53 locus.
AB  - The development of Friend virus induced murine erythroleukaemia is associated
      with specific genetic events. One of these events is loss of wild type p53
      expression, which can occur by internal deletion or proviral insertion in the p53
      gene and by single point mutations in the coding sequence. In all cases, the
      corresponding wild type allele is absent. The high frequency of observed p53
      mutations strongly suggests that inactivation of p53 may be an obligatory step in
      the development of Friend disease. Further evidence that abrogation of normal p53
      expression contributes to the development of malignant clones was provided by in
      vitro reconstitution experiments in Friend cell lines: whereas exogenous mutant
      p53 was stably expressed in p53 negative FCLs, long term wild type p53 expression
      was not detected. Friend erythroleukaemia arises as a late consequence of
      infection of susceptible mice with Friend virus. In addition to p53 gene
      mutations, proviral insertions occur frequently adjacent to one of two cellular
      genes, Spi-1/PU.1 or Fli-1. Aberrant expression of these genes may therefore be
      involved in virus induced erythroleukaemia. Interaction of SFFV env gp55 with the
      EPO-R also appears to be important in providing a mitogenic signal to infected
      cells. The order in which these events occur and whether the order is relevant to
      the progression of the disease are not known. Investigation of the stepwise
      appearance of these events could provide information on the possible interactions
      of the gene products involved. Abrogation of normal p53 expression is not
      restricted to Friend erythroleukaemia: the observation of p53 mutations and
      allele loss in human breast, lung, colon and hepatocellular carcinomas and in
      leukaemia suggests that mutation of p53 may be the most common genetic
      abnormality detected in human cancer (reviewed in this issue). Studies of p53
      expression in FCLs provided an early indication that p53 was a tumour suppressor
      gene. Further studies of the mechanisms by which wild type and mutant p53 affect
      the growth of p53 negative FCLs may reveal important biochemical properties of
      p53 in relation to cell cycle control and differentiation of erythroid cells.

PMID- 1638546
TI  - Functional analysis of the retinoblastoma gene product and of RB-SV40 T antigen
      complexes.

PMID- 1638547
TI  - The retinoblastoma gene and gene product.
AB  - Retinoblastoma, an uncommon childhood cancer of the eye, sometimes occurs in
      families but is often sporadic. Cytological analysis suggested that the
      retinoblastoma gene resided on chromosome 13 band q14. Subsequent isolation of
      the RB gene from this locus allowed a more detailed analysis, showing that both
      copies of RB are mutated or lost in retinoblastoma, a finding that has been
      extended to a surprising number of other malignancies. In familial
      retinoblastoma, one copy of RB is mutant in the conceptus, consistent with the
      familial predisposition to the disease and indicating that a single wild type
      copy is sufficient for normal development. These studies provided the first good
      evidence that loss of a gene function correlated with tumorigenesis and led to
      the concept of "tumour suppressor genes", which have an important negative
      influence on the regulation of cell growth. Examinations of the biological
      properties of the gene product are consistent with this proposed role in cell
      proliferation. Further insight into the potential molecular mechanisms concerned
      has come from observations showing an association of some viral oncoproteins with
      the RB gene product. Thus, there is strong evidence that the RB protein has a key
      role in the integrated network of signals that control the cell cycle.

PMID- 1638548
TI  - The p53 tumour suppressor gene and product.

PMID- 1638549
TI  - Transforming growth factor-beta.
AB  - This chapter has described some of the most salient features of the biology of
      the TGF-beta s. The TGF-beta s are of great interest as growth inhibitors,
      regulators of cell phenotype and regulators of cell adhesion. The various TGF
      beta isoforms are highly conserved and display a complex pattern of interactions
      with multiple membrane receptor components. Activation of these receptors leads
      to inhibition of epithelial cell proliferation by a mechanism that may involve
      proteins related to the growth suppressor, RB. TGF-beta receptors are also
      coupled to mechanisms that control expression of differentiation commitment genes
      and differentiated cell functions. TGF-beta can affect cell proliferation and
      differentiation through indirect mechanisms involving regulation of expression of
      cytokines, extracellular matrix molecules and their respective receptors. These
      responses strongly influence the growth and phenotype of an array of cell types.
      Excess or reduced TGF-beta activity may contribute to the pathogenesis of certain
      fibrotic disorders and certain hyperproliferative disorders including cancer,
      respectively.

PMID- 1638550
TI  - Antitumor effects of interleukin-2 and mismatched double-stranded RNA,
      individually and in combination, against a human malignant melanoma xenograft.
AB  - The antitumor effects of recombinant interleukin-2 (rIL-2) and mismatched double
      stranded RNA (dsRNA) were assessed in tissue culture and in a nude mouse model.
      Mismatched dsRNA did not show a direct antiproliferative effect against the human
      malignant melanoma cell line, BRO, in tissue culture. However, treatment of the
      BRO cells with up to 1000 units/ml rIL-2 in culture showed a slight increase in
      growth rate. Combined rIL-2/mismatched dsRNA treatment also demonstrated a
      similar slight enhancement of growth. Nude mice bearing subcutaneous tumors were
      treated by intraperitoneal injection of low doses (5000-20,000 units) of rIL-2
      and mismatched dsRNA (500 micrograms). The in vivo tumor growth was significantly
      inhibited by the combined treatments (P less than 0.05) and survival was
      significantly increased (P less than 0.05). Measurement of cytotoxicity using
      splenocytes from treated animals showed significant augmentation of lytic
      activity against natural killer (NK)-sensitive YAC-1 cells in all rIL
      2/mismatched dsRNA treatment groups, compared to the individual treatments or
      controls (P less than 0.05). Cytotoxicity of the splenocytes against the NK
      resistant BRO cells was also augmented in animals treated with mismatched dsRNA
      and the highest rIL-2 dose utilized here (P less than 0.01). Renal, liver, and
      hematological toxicity was evaluated by measurement of blood urea nitrogen,
      creatinine, serum asparrtate aminotransferase, and a complete blood count with
      differential. There were no significant differences in these parameters in any of
      the treatment groups. Similarly, no differences in weight of the animals was seen
      in any treatment group. These results indicate that the combination of low-dose
      rIL-2 and mismatched dsRNA can potentiate host-mediated antitumor effects,
      yielding increased survival, without significant toxicity.

PMID- 1638551
TI  - Cytotoxic functions of blood mononuclear cells in patients with colorectal
      carcinoma treated with mAb 17-1A and granulocyte/macrophage-colony-stimulating
      factor.
AB  - Unconjugated monoclonal antibodies (mAb) may induce tumour regression in
      patients. The mechanisms of action are complex. Antibody-dependent cellular
      cytotoxicity (ADCC) is considered one of the effector functions. Augmentation of
      the killing capacity of cytotoxic cells may thus be a way to increase the
      therapeutic potential of mAb. Granulocyte/macrophage-colony-stimulating factor
      (GM-CSF) has been shown to enhance this function in vitro. Eighteen patients with
      metastatic colorectal carcinoma received GM-CSF (250 micrograms m-2 day-1 s.c.)
      for 10 days and a single infusion of the anti-(colon carcinoma) mAb 17-1A (mouse
      IgG2A) (400 mg) on day 3 of the cycle. The cycles were repeated once a month four
      times. Neutrophils, eosinophils, monocytes and lymphocytes increased
      significantly in a biphasic way. However, at the fourth cycle the rise in white
      blood cells was significantly lower compared to the preceding courses. ADCC
      (SW948, a human CRC cell line,+mAb 17-1A) or peripheral blood mononuclear cells
      (PBMC) was significantly (P less than 0.05) augmented by day 6 of a cycle and
      then declined gradually and, at the end of a cycle, the ADCC activity had
      returned to the pretreatment level. The spontaneous cytotoxicity of PBMC against
      the natural-killer-resistant cell line, SW948, varied in a similar way. During GM
      CSF treatment there was also a significant increase in FcRI+ (CD64), FcRII+
      (CD32), FcRIII+ (CD16) and CD14+ cells but not of CD56+ cells.

PMID- 1638552
TI  - Comparative biological properties of a recombinant chimeric anti-carcinoma mAb
      and a recombinant aglycosylated variant.
AB  - It has been demonstrated previously that the degree of glycosylation of a
      molecule may alter its pharmacokinetic properties and, in the case of an
      antibody, its metabolism and other biological properties. Transfectomas producing
      aglycosylated chimeric B72.3(gamma 1) pancarcinoma monoclonal antibody (mAb) were
      developed by introduction of the eukaryotic expression construct pECMgpB72.3 HuG1
      agly, into SP2/0 murine myeloma cells producing the chimeric kappa chain of mAb
      B72.3. After cell cloning, one subclone with the highest binding to the TAG-72
      positive human colon carcinoma was designated mAb aGcB72.3, and its biological
      and biochemical properties were compared with those of the chimeric B72.3(gamma
      1), designated mAb cB72.3. Polyacrylamide gel electrophoresis showed that under
      non-reducing conditions, the molecular masses of the aGcB72.3 and cB72.3 mAbs
      were 162 kDa and 166 kDa respectively. The heavy chain of mAb aGcB72.3 had a
      slightly faster mobility than that of cB72.3, while the mobility of the light
      chains of the two chimeric mAbs was similar. No difference was observed in the
      isoelectric points of either chimeric mAb. Liquid competition radioimmunoassays
      demonstrated that the aGcB72.3 and cB72.3 mAbs have comparable binding properties
      to TAG-72. These studies demonstrate that aglycosylation of the chimeric IgG1 mAb
      B72.3 at the CH2 domain, as has been shown for other mAbs [Dorai H., Mueller B.,
      Reisfeld R. A., Gillies S. D. (1991) Hybridoma 10:211; Morrison S. L., Oi V. T.
      (1989) Adv Immunol 44:65], eliminates antibody-dependent cell-mediated
      cytotoxicity activity, but does not substantially alter affinity or plasma
      clearance in mice. These studies also demonstrate for the first time (a) no
      difference in plasma clearance of an aglycosylated and a chimeric mAb in a
      primate after i.v. inoculation; (b) a difference (P less than or equal to 0.05)
      in mice in the more rapid peritoneal clearance of a chimeric mAb versus an
      aglycosylated chimeric mAb; (c) higher (0.05 less than or equal to P less than or
      equal to 0.1) tumor: liver ratios at 24, 72 and 168 h using 111In-labeled
      aglycosylated chimeric mAb versus chimeric mAb. Since the liver is the major site
      of metastatic spread for most carcinomas, slight differences in tumor to normal
      liver ratios may be important in diagnostic applications. These studies thus
      indicate that comparative analyses of a novel recombinant construct (i.e.,
      aglycosylated) and its standard chimeric counterpart require documentation in
      more than one system and are necessary if one is ultimately to define optimal
      recombinant/chimeric constructs for diagnosis and therapy in humans.

PMID- 1638554
TI  - An extract of seeds from Aeginetia indica L., a parasitic plant, induces potent
      antigen-specific antitumor immunity in Meth A-bearing BALB/c mice.
AB  - The antitumor activity of an extract of seeds from Aeginetia indica L., a
      parasitic plant, was investigated. BALB/c mice, inoculated i.p. 1 x 10(5)
      syngeneic Meth A tumor cells, were administered 2.5 mg/kg A. indica extract i.p.
      every 2 days from day 0. The untreated mice died of an ascitic form of tumor
      growth within 21 days, whereas all the treated mice completely recovered from
      tumor challenge without any side-effects. The extract did not exert direct
      cytotoxic activity against Meth A in vitro. Mice that survived after the first
      challenge as a result of A. indica treatment overcame the rechallenge with
      homologous Meth A without additional administration of the extract. On the other
      hand, those mice could not survive after rechallenge with Meth 1 tumor cells,
      which were also established in BALB/c mice but were different in antigenicity
      from Meth A, suggesting the development of antigen-specific concomitant immunity
      in the A. indica-cured mice. In the induction phase of antitumor resistance in
      this system, CD4+ T cells appeared to be the main contributors, since in vivo
      administration of anti-CD4 mAb completely abolished such resistance. In contrast,
      anti-CD8 mAb administration did not influence the effect of A. indica. The
      importance of CD4+ T cells in antitumor immunity was again clarified by Winn
      assay; that is, spleen and lymph node cells depleted of CD4+ T cells in vitro
      prior to assay abolished antitumor activity on co-grafted Meth A tumor cells in
      vivo.

PMID- 1638553
TI  - Glycosidically bound sialic acid levels as a predictive marker of postoperative
      adjuvant therapy in gastric cancer.
AB  - A group of 293 gastric cancer patients were examined to see if the preoperative
      value of glycosidically bound sialic acid is a predictor of prognosis and
      effectiveness of postoperative adjuvant therapy. All patients had gastrectomies
      and were histologically confirmed to have primary adenocarcinoma of the stomach.
      Some patients then received either postoperative adjuvant chemotherapy or
      immunochemotherapy. Patients with sialic acid levels less than 74.5 mg/dl
      survived significantly longer than those with sialic acid levels of 74.5 mg/dl or
      of 85.3 mg/dl and over. No significant differences in survival were found among
      patients treated by gastrectomy alone, gastrectomy plus chemotherapy and
      gastrectomy plus immunochemotherapy. However, patients with abnormally elevated
      levels of sialic acid survived significantly longer when they were treated with
      immunochemotherapy after gastrectomy than those treated by gastrectomy alone or
      with chemotherapy after gastrectomy. By using Cox's multivariate regression
      model, pTNM stages, postoperative adjuvant therapy (chemotherapy and
      immunochemotherapy) and preoperative serum levels of sialic acid were examined as
      prognostic variables. Postoperative therapy was a significant prognostic variable
      in patients with abnormally elevated levels of sialic acid. The preoperative
      serum level of sialic acid is a promising predictive marker of the response to
      postoperative adjuvant immunochemotherapy.

PMID- 1638555
TI  - Immunotargeting of daunomycin to localized and metastatic human colon
      adenocarcinoma in athymic mice.
AB  - A monoclonal antibody (designated SF25), which recognizes a protein antigen
      expressed on a large number of human colon carcinomas, was used for drug
      targeting. Daunomycin-antibody conjugates were prepared by two previously
      described procedures. In one, the drug was bound to the antibody through a spacer
      of small molecular mass (cis-aconitic acid), while in the other a dextran bridge
      served as the link between drug and antibody. High substitution rates of drug to
      antibody were obtained using the latter binding procedure. Both conjugates were
      tested in vitro against two human colon carcinoma cell lines, LS180 and KM-12.
      The efficacy of a daunomycin-dextran-SF25 antibody conjugate was tested against
      colon carcinoma LS180 tumors transplanted at different sites into athymic mice.
      The specific conjugate was significantly more inhibitory to a subcutaneous tumor
      growth than its components or their mixture. SF25 antibody alone showed
      antitumoral effects against all three forms of transplanted tumor tested, namely,
      local, metastatic or intrahepatic, whereas daunomycin, on its own, was effective
      only against the subcutaneous tumor. Binding of daunomycin to dextran partially
      improved its inhibitory activity against the metastatic tumor. The conjugate,
      daunomycin-dextran-SF25 antibody reduced the number of metastatic foci, increased
      the survival rate and delayed death. Yet against lymph node metastases it was not
      significantly better than a mixture of both constituents. However, results
      obtained with an intrahepatic tumor, a model that mimics the natural progression
      of the disease, resembled those described with the subcutaneous tumor. Daunomycin
      dextran-SF25 antibody was significantly more effective than all components
      separately and than a mixture of drug and antibody, provided a highly drug
      substituted conjugate was used.

PMID- 1638556
TI  - The polysaccharide K (PSK) potentiates in vitro activation of the cytotoxic
      function in human blood lymphocytes by autologous tumour cells.
AB  - We have studied the effect of polysaccharide K (PSK) in the in vitro recognition
      of ex vivo carcinoma, sarcoma and lymphoma cells by the autologous blood
      lymphocytes. In 4/25 experiments PSK treatment activated the lymphocytes for auto
      tumour lysis. Tumour cells alone generated lytic activity both in short- (16 h)
      and in long-term (6 days) mixed lymphocyte/tumour cell cultures (MLTC), in 2/12
      and 3/13 cases respectively. The tumours that activated the lymphocytes expressed
      high levels of major histocompatibility complex (MHC) class I molecules. In vitro
      cytokine (interferon gamma and tumour necrosis factor alpha) treatment of the
      tumour cells elevated the amounts of class I antigens and the treated cells
      acquired stimulatory potential. When PSK was added to the MLTC, in which
      untreated tumour cells were used, lytic potential was induced in 9/13 short-term
      and in 11/12 long-term cultures. It is noteworthy that in the presence of PSK the
      untreated, negative or low-class-I-expressor tumours also activated the cytotoxic
      function of the lymphocytes in 4/5 long-term and in 6/7 short-term cultures. Even
      in the case of those lymphocytes that could be activated by PSK or tumour cells
      alone, the simultaneous exposure was more efficient. The effect of PSK was dose
      dependent, being optimal at 1 micrograms/ml and 10 micrograms/ml. The presence of
      EDTA and/or cytochalasin B in the cytotoxic test performed with the activated
      effectors abrogated the lysis, indicating the requirement of contacts with the
      effector cells.

PMID- 1638557
TI  - A phase I study of neuroblastoma with the anti-ganglioside GD2 antibody 14.G2a.
AB  - Nine patients with neuroblastoma stage IV were treated with the murine monoclonal
      antibody 14.G2a, directed against disialoganglioside GD2. The antibody was
      injected daily for 5-10 days and the total applied dosage ranged between 100
      mg/m2 and 400 mg/m2. The peak serum levels of mAb 14.G2a ranged from 28
      micrograms/ml to 61 micrograms/ml. Pharmacokinetic data obtained in three
      patients indicated that the serum elimination of mAb 14.G2a fits a two
      compartment model, with an alpha-half-time (t1/2 alpha) between 0.66 h and 1.98 h
      and a beta-half-time (t1/2 beta) between 30.13 h and 53.33 h. All patients
      presented with a human anti-(mouse IgG) antibody response either during or
      shortly after therapy. Eight patients showed a continuous decrease in complement
      component C4 during therapy, as well as an initial decrease in C3c and an initial
      increase in C3a, all suggesting an activation of the complement cascade. Side
      effects consisted of allergic reactions like pruritus, exanthema, urticaria and
      of severe pain, predominantly located in the abdomen and lower extremities, which
      required the use of continuous intravenous morphine. Four patients additionally
      developed a transient hypertension and one patient experienced a transient
      nephrotic syndrome. Three patients were treated in an adjuvant setting and are
      not evaluable for tumor response. Of the remaining six patients, two had a
      complete remission, two showed a partial remission, and two patients did not
      respond to treatment.

PMID- 1638558
TI  - Comment on the interpretation of lymphocyte phenotyping.

PMID- 1638559
TI  - A modified model of global ischaemia: application to the study of syncytial
      mechanisms of arrhythmogenesis.
AB  - OBJECTIVE: The aim was to develop a simple modified global ischaemia preparation
      to study the relation between ischaemic zone size and the incidence of ischaemia
      induced and reperfusion induced arrhythmias, to test the hypothesis that
      arrhythmias are initiated by flow of injury current between the ischaemic zone
      and the uninvolved myocardium. The new model was used to examine whether injury
      current suppression is involved in the mechanism of action of a new
      antiarrhythmic intervention, substitution of chloride anion by nitrate. METHODS:
      Isolated perfused (Langendorff mode) rat hearts (n = 12 per group) were subjected
      to 30 min global or regional ischaemia. Ventricular arrhythmia incidence during
      ischaemia and during reperfusion were related to the size of the involved region.
      The modified model of global ischaemia employed right intra-atrial superfusion to
      maintain normal sinus rate and 1:1 atrioventricular (AV) conduction. RESULTS:
      Sham ligation, low left coronary ligation, high left coronary ligation, and
      global ischaemia produced, as a percentage of total ventricular weight, 0%,
      21.0(SEM 0.8)%, 47.0(1.0)%, and 100% regions of ischaemia (occluded zones). Heart
      rates were similar in each group and AV block did not occur. The incidences of
      ischaemia induced ventricular fibrillation (VF) were 0, 17, 75, and 17% with
      increasing occluded zone sizes. Incidences of reperfusion induced VF were 0, 8,
      92, and 92% respectively. The antiarrhythmic action of substitution of
      extracellular chloride by nitrate, previously shown using models of regional
      ischaemia, was confirmed in the modified global ischaemia model. CONCLUSIONS:
      These findings strongly support the theory that current of injury between
      ischaemia and adjacent non-ischaemic zones is necessary for initiation of
      ischaemia induced VF, since susceptibility was maximal when ischaemic and
      uninvolved regions were equivalent in size (and the scope for injury current was
      maximal) whereas susceptibility was negligible when scope was minimal. In
      contrast, reperfusion induced VF appears to depend only on the presence and
      amount of reperfused tissue, indicating that flow of injury current between
      involved and uninvolved tissue is unnecessary for its initiation. Discrimination
      of the mechanism of action of antiarrhythmic interventions may be possible since
      drugs effective solely via amelioration of flow of injury current (or
      incrementation of collateral flow) will not influence arrhythmias in this model.
      Modification of injury current and collateral flow do not appear to contribute to
      the antiarrhythmic action of substitution of extracellular chloride by nitrate.

PMID- 1638560
TI  - Rate of reflow and reperfusion induced arrhythmias: studies with dual coronary
      perfusion.
AB  - OBJECTIVE: The aim was to determine the relationship between the rate of reflow
      and vulnerability to reperfusion induced arrhythmias. METHODS: Isolated rat
      hearts, in which left and right coronary arteries were perfused independently,
      were subjected to transient (10 min) cessation of flow to the left coronary bed.
      During the subsequent 10 min of reperfusion, flow in the left coronary bed was
      regulated to create five different reflow profiles (n = 12 per group): (1)
      immediate restoration of 100% flow which was maintained throughout reperfusion
      (control); (2) stepwise restoration of flow with 10% flow from 0-1 min, 20% flow
      from 1-2 min, 40% flow from 2-3 min, 60% flow from 3-4 min, 80% flow from 4-5
      min, and 100% flow from 5-10 min; (3) 10% flow from 0-5 min and 100% flow from 5
      10 min; (4) 20% flow from 0-5 min and 100% flow from 5-10 min; and (5) 40% flow
      from 0-5 min and 100% flow from 5-10 min. RESULTS: There were no significant
      differences between the groups in the incidences of reperfusion induced
      ventricular tachycardia or fibrillation, which were 100% and 58-92%,
      respectively. However, the time to onset of reperfusion induced ventricular
      fibrillation was delayed (p less than 0.05) from 15 (SEM 1) s in group (1) to
      191(39), 210(38), and 77(29) s in groups 2, 3, and 4, respectively. No
      significant delay was observed in group 5. There were no significant differences
      between the groups in size of ischaemic zone or heart rate. CONCLUSIONS: In
      crystalloid perfused hearts, restricted reflow delays the time to onset of
      reperfusion induced ventricular fibrillation but does not reduce the incidence of
      reperfusion induced ventricular tachycardia or fibrillation.

PMID- 1638561
TI  - Cardiac autonomic dysfunction and neuroganglionitis in a rat model of chronic
      Chagas' disease.
AB  - OBJECTIVE: The aim was to evaluate whether the cardiac parasympathetic function
      in a rat model of chronic Chagas' disease is impaired as in the human disease,
      and to correlate the functional state to histopathology of the intrinsic
      autonomic innervation of heart. METHODS: 70 male Wistar rats 8 months infected
      with strains Y (n = 22), Sao Felipe (n = 18), and Colombia (n = 30) of
      Trypanosoma cruzi, were compared with 20 age and sex matched non-infected
      controls. Baroreflex bradycardia was quantified after multiple bolus injections
      of phenylephrine (3 to 12 micrograms). For each rat studied a mean was obtained
      of the absolute and relative (delta %) ratio (index) between the maximum heart
      rate decrease and the maximum systolic blood pressure increase. RESULTS: For the
      relative index the means were smaller (p less than 0.05) in the Y [-0.52(SD
      0.19)%], Sao Felipe [-0.45(0.28)%], and Colombia [-0.53(0.21%)] subgroups, as
      well as in the pooled chagasic group [-0.51(0.22)%], than in the control group [
      0.64(0.13)%]. In 32% (7/22), 33% (6/18), and 20% (6/30) of rats infected with Y,
      Sao Felipe, and Colombia strains, respectively, and in 27% (19/70) of the pooled
      group rats, the index exceeded the control group mean by -2 SD. After
      atropinisation, a similar pronounced reduction (p less than 0.01) in the index
      was observed in all groups [-84(28)% to -95(17)%]; however, rats with depressed
      bradycardia showed a smaller (p less than 0.05) reduction in the relative index
      than control rats, at -70(34) v -92(16%). Inflammatory and degenerative lesions
      of the intrinsic cardiac innervation were observed in 87% of the rats with
      autonomic dysfunction. Rats with the lesions showed a mean relative index that
      was smaller than those without lesions, at -0.44(0.23) v -0.64(0.20)% (p less
      than 0.01), and also smaller than in the controls. CONCLUSIONS: Cardiac autonomic
      dysfunction expressed by reduced baroreflex bradycardia was detected in rats
      chronically infected with T cruzi, as in human Chagas' disease. The disturbance,
      shown for the first time in an animal model of chagasic infection, resulted
      primarily from impaired efferent parasympathetic activity caused by intrinsic
      neuroganglionar lesions.

PMID- 1638562
TI  - Regional myocardial deoxyglucose uptake following electrical stimulation of
      canine efferent sympathetic cardiopulmonary nerves.
AB  - OBJECTIVE: The aim was to study the effect of stimulating individual acutely
      decentralised cardiopulmonary nerves on myocardial uptake of deoxyglucose.
      METHODS: In 17 open chest anaesthetised dogs the efferent axons of individual
      decentralised cardiopulmonary nerves were stimulated intermittently throughout 1
      h while haemodynamic variables were measured. Tritiated 2-deoxyglucose was
      injected intravenously at the beginning of stimulation. Atropine was given when a
      cardiopulmonary nerve with efferent parasympathetic axons was studied.
      Distribution of label was detected using a multiwire proportional chamber. It was
      compared to blood concentration of deoxyglucose to permit quantitative mapping of
      regional myocardial uptake during the stimulation of each nerve. RESULTS: Neural
      stimulation of most of sympathetic efferent cardiopulmonary nerves increased
      deoxyglucose uptake in all myocardial tissue. Uptake was greatest in the left
      ventricle, less in the right ventricle, and least in the left and right atria.
      Regional myocardial uptake was also observed following individual cardiopulmonary
      nerve stimulation. Some nerves caused greater uptake than others. Cardiopulmonary
      nerves which are known to enhance inotropism when stimulated induced little
      increase of deoxyglucose uptake, whereas other nerves known to exert little
      positive inotropic effect induced considerable uptake. There was no correlation
      between haemodynamic changes and deoxyglucose uptake. CONCLUSIONS: It appears
      that (1) efferent sympathetic axons in one cardiopulmonary nerve can
      preferentially increase deoxyglucose uptake in specific regions of the myocardium
      and (2) the mechanisms responsible for enhancement of glucose uptake may differ
      from those responsible for inotropic responses.

PMID- 1638563
TI  - Postischaemic hypercontraction is enhanced in ischaemically injured canine
      myocardium.
AB  - OBJECTIVE: The aim was to identify the role of calcium flux in the pathogenesis
      of transient overshoot of regional myocardial contraction after brief ischaemia,
      ie, postischaemic hypercontraction. METHODS: Ten anaesthetised mongrel dogs were
      examined under open chest conditions. The left anterior descending coronary
      artery was initially occluded for 2 min and reperfused for 10 min. A further
      period of coronary occlusion of 15 min duration was followed by 15 min
      reperfusion to produce postischaemic regional dysfunction. A third occlusion of 2
      min duration was followed by 10 min reperfusion to induce postischaemic
      hypercontraction. Coronary blood flow was measured using an ultrasonic transit
      time flow meter. Segment length was measured by ultrasonic microcrystals.
      RESULTS: Postischaemic hypercontraction after 2 min coronary occlusion was
      exaggerated in ischaemically injured myocardium. The 10 dogs were divided into
      two groups, a control group (n = 5) and a verapamil treated group (n = 5), and
      were exposed to a final 2 min period of coronary occlusion with or without
      verapamil in the ischaemically injured myocardium. Postischaemic hypercontraction
      was attenuated in the verapamil treated group compared with the control group.
      CONCLUSIONS: Exaggeration of postischaemic hypercontraction in ischaemically
      injured myocardium may be mediated by a trans-sarcolemmal calcium flux. Changes
      in calcium flux may play a role in the pathogenesis of this phenomenon in the
      normal myocardium.

PMID- 1638564
TI  - Whole body heat stress fails to limit infarct size in the reperfused rabbit
      heart.
AB  - OBJECTIVE: It has recently been shown that induction of heat stress proteins by
      whole body heat stress confers myocardial protection in the isolated in vitro rat
      and rabbit heart. This study extends the above studies by examining the effects
      of stress protein synthesis on the limitation of infarct size in the in vivo
      rabbit heart model. METHODS: 30 male New Zealand white rabbits were used. Six
      rabbits were used for measurement of heat stress protein; 10 were used for
      infarct size determination in a heat stress group (HS); 14 were used for infarct
      size determination in a control group. There were 10 exclusions. Under
      anaesthesia, body temperature was raised to 42 degrees C for 15 min in the HS
      group. Following 24 hours of recovery rabbits were reanaesthetised and the hearts
      subjected to a 45 min period of regional ischaemia followed by 3 h reperfusion.
      The risk zone was defined with fluorescent particles and the infarct area
      determined by tetrazolium staining. Western blotting showed an increase in the 72
      KD heat stress protein in hearts in the HS group. RESULTS: Infarct size as a
      percent of risk area was 61.4 (SEM 6.4)% (n = 14) in control hearts and
      71.8(7.3)% (n = 10) in the HS hearts. These results were not statistically
      significant. CONCLUSIONS: No protective effect of heat stress could be seen when
      infarct size was used as the end point. Either the protection seen in earlier
      studies using the Krebs perfused isolated heart model does not accurately reflect
      protection against myocardial infarction, or heat stress itself may induce
      injurious factors in the blood which will negate any direct protective effect to
      the myocardium in this model.

PMID- 1638565
TI  - Endothelium bound extracellular superoxide dismutase type C reduces damage in
      reperfused ischaemic rat hearts.
AB  - OBJECTIVE: The aim was to determine if endothelium associated extracellular
      superoxide dismutase type C (EC-SOD C) exerts any protective effect against
      cardiac damage induced by ischaemia and reperfusion. METHODS: Langendorff
      perfused rat hearts were subjected to 15 min global ischaemia followed by
      reperfusion. Prior to the ischaemia the hearts were perfused for 15 min with a
      buffer containing recombinant human EC-SOD C (rh-EC-SOD C, 20 mg.litre-1), or the
      corresponding vehicle, followed by extensive perfusion with SOD free medium.
      RESULTS: In hearts receiving the vehicle, reperfusion was associated with a
      marked release of creatine kinase into the effluent [28 (SEM 1.5) IU.15 min-1, n
      = 5] and coronary flow measured 15 min after initiation of reperfusion was
      reduced by 68% compared to preischaemic flow. In hearts pretreated with EC-SOD C
      but washed with enzyme free buffer before being subjected to ischaemia, the
      creatine kinase release was significantly smaller, at 14(2.1) IU.min-1, n = 5 (p
      less than 0.001), and the reduction in coronary flow less extensive (54%, p less
      than 0.05, v vehicle). To demonstrate the binding of EC-SOD C to the endothelium,
      heparin, which releases EC-SOD C from the endothelial surfaces, was added to the
      perfusate 30 min after initiation of reperfusion. The same amount of EC-SOD C was
      released to the effluent from previously ischaemic hearts [(12.4(2) micrograms)]
      as from hearts not subjected to ischaemia [(13.8(1.4) micrograms)]. CONCLUSIONS:
      Recombinant human EC-SOD type C bound to the endothelial surface reduces the
      cardiac damage associated with ischaemia and reperfusion. The protective effect
      was evident both in terms of a reduction of biochemical markers of injury and a
      better preservation of postischaemic coronary flow. Furthermore, ischaemia and
      subsequent reperfusion did not cause any alteration in the binding capacity of EC
      SOD C to the cardiac vasculature.

PMID- 1638566
TI  - The thromboxane A2 mimetic U46619 worsens canine myocardial hypoperfusion during
      exercise in the presence of a coronary artery stenosis.
AB  - OBJECTIVE: The aim was to test the hypothesis that thromboxane A2 can cause
      vasoconstriction of coronary resistance vessels during exercise in hypoperfused
      regions of myocardium distal to an arterial stenosis. METHODS: Eight adult
      mongrel dogs were studied. Chronically instrumented animals with a left
      circumflex coronary artery Doppler flow meter, hydraulic occluder, and indwelling
      catheter underwent treadmill exercise at heart rates of 190-200 beats.min-1.
      Myocardial blood flow was measured with microspheres during unimpeded arterial
      inflow and in the presence of a coronary stenosis which decreased distal pressure
      to 42-45 mm Hg. Measurements were repeated during infusion of the thromboxane A2
      analogue, U46619. RESULTS: When the occluder was partially inflated to produce a
      stenosis, blood flow in the region perfused by the stenotic artery was 58 (SEM
      6)% of flow in the normally perfused region (p less than 0.01). U46619 (0.01
      microgram.kg-1.min-1) caused a further 21 (7)% decrease in blood flow in the
      region perfused by the stenotic artery (p less than 0.05). The vasoconstriction
      produced by U46619 was uniform across the left ventricular wall from epicardium
      to endocardium. U46619 did not significantly decrease myocardial blood flow in
      the absence of a coronary stenosis. CONCLUSIONS: Even during hypoperfusion
      produced by a flow limiting arterial stenosis, the coronary resistance vessels
      remain responsive to the vasoconstrictor effect of thromboxane A2. Liberation of
      thromboxane A2 during platelet activation at the site of a proximal coronary
      stenosis may worsen myocardial hypoperfusion by causing vasoconstriction of the
      distal resistance vessels.

PMID- 1638567
TI  - Importance of nitric oxide in canine femoral circulation: comparison of two NO
      inhibitors.
AB  - OBJECTIVE: The aim was to assess the importance of endothelium derived nitric
      oxide (NO) in the regulation of vascular tone in the limbs. Changes in the canine
      femoral circulation were investigated after inhibition of NO synthesis. METHODS:
      The effects of two NO inhibitors, NG-monomethyl-L-arginine (LNMMA) and NG-nitro-L
      arginine (NOARG), were compared on basal femoral blood flow and on endothelium
      dependent (acetylcholine) and endothelium independent (glyceryl trinitrate)
      vasodilatation in 15 pentobarbitone anaesthetised mongrel dogs. An
      electromagnetic flow probe was placed on the femoral artery to measure femoral
      blood flow. One catheter was advanced into the femoral artery proximal to the
      flow probe for blood pressure recording and another catheter distal to the flow
      probe for drug infusions. RESULTS: LNMMA (0.28 mumol.ml-1) reduced basal femoral
      blood flow by 44(SEM 3)%, NOARG (0.07 mumol.ml-1) by 21(4)%, and NOARG (0.56
      mumol.ml-1) by 29(3)%. The flow responses to acetylcholine were reduced after
      LNMMA by 27(8)%, unaltered after NOARG (0.07 mumol.ml-1), and reduced after NOARG
      (0.56 mumol.ml-1) by 60(7)%. The flow response to glyceryl trinitrate was
      unaltered. L-arginine re-established femoral blood flow after infusion of LNMMA
      and NOARG (0.07 mumol.ml-1), but L-arginine did not re-establish femoral blood
      flow after NOARG (0.56 mumol.ml-1), even when infused in a 60-fold molar excess.
      CONCLUSIONS: There is a continuous basal release of NO in the canine femoral
      circulation. The results obtained by infusing LNMMA suggest that more than 40% of
      basal femoral blood flow is mediated by endothelium derived NO. Whereas LNMMA was
      more potent than NOARG in reducing basal NO release, NOARG (0.56 mumol.ml-1)
      reduced acetylcholine induced vasodilatation by as much as 60%.

PMID- 1638568
TI  - Evaluation of indices of left ventricular contractility and relaxation in
      evolving canine experimental heart failure.
AB  - OBJECTIVE: The aim was to evaluate changes in indices of left ventricular
      contractility and relaxation in relation to changes in loading conditions in dogs
      with rapid pacing induced heart failure. METHODS: 14 conscious male mongrel dogs
      were paced at 250 beats.min-1 to severe heart failure, which occurred at
      4.2(SD1.9) weeks. Six sham operated dogs served as controls. Right sided
      pressures were obtained by a thermodilution catheter. Left ventricular pressure
      and its derived variables were obtained by a high fidelity manometer tipped
      catheter. Rate corrected velocity of circumferential fibre shortening--end
      systolic wall stress relations were obtained by simultaneous haemodynamic and
      echocardiographic studies. RESULTS: In the paced dogs, baseline right atrial
      pressure, 6.4(2.0) mm Hg, and pulmonary capillary wedge pressure, 7.1(2.5) mm Hg,
      increased to 13.3(3.1) mm Hg and 34.5(7.1) mm Hg respectively at severe heart
      failure (both p less than 0.0001). The peak first derivative of left ventricular
      pressure dP/dt decreased from 1515(274) mm Hg.s-1 at baseline to 975(321) mm Hg.s
      1 at severe heart failure (p less than 0.05) while baseline left ventricular end
      diastolic pressure, 4.4(3.7) mm Hg, and relaxation time constant tau, 18.0(4.5)
      ms, increased to 37.2(6.6) mm Hg (p less than 0.01) and 51.9(21.4) ms (p less
      than 0.05) respectively. The shortening-wall stress relation was markedly
      displaced downward from baseline. Furthermore, weekly studies revealed a major
      downward displacement of this relation by one week of pacing with no significant
      further shift at severe heart failure, whereas both end diastolic diameter
      (preload) and end systolic wall stress (afterload) increased significantly
      further from one week. In the sham operated dogs, there was no change over time
      in any of these study variables. CONCLUSIONS: In pacing induced heart failure,
      there is impairment of left ventricular contractility and relaxation. The major
      downward shift of the shortening-wall stress relation at one week suggests that
      left ventricular contractility is impaired early and may be the initiating
      mechanism of heart failure in this model.

PMID- 1638569
TI  - Acid optimum kininogenases in canine myocardium and aorta.
AB  - OBJECTIVE: Canine coronary artery was recently reported to contain a cathepsin
      like acid optimum enzyme and a kallikrein like alkaline optimum enzyme which
      cleaved from a crude kininogen preparation a vasodilator uterus contracting
      substance. The aim of this study was to seek the presence of similar acid optimum
      enzymes in canine ventricular myocardium and in a large systemic artery, the
      aorta. METHODS: Aqueous canine tissue extracts were tested for the ability at
      different pHs to release uterus contracting substance (using rat isolated
      oestrous uterus) from a kininogen preparation. After gel filtration, the extracts
      were tested for the presence of arginine-amidase activity (substrate: D
      Val.Leu.Arg.pNA) and enzymic activity forming bradykinin like immunoreactivity.
      Tissues were obtained from anaesthetised greyhounds which had been used in
      control studies and had received no other drug treatment. RESULTS: Ventricular
      extracts released uterus contracting substance optimally at pH 5.2-5.4, but not
      at alkaline pH, neither was bradykinin like immunoreactivity formed at alkaline
      pH. Inhibitor studies and gel filtration showed this activity to be due to a
      cathepsin-D-like enzyme, molecular weight (MW) 42.6 (SD 0.9) kd, which was an
      arginine amidase and released bradykinin like immunoreactivity from a plasma
      kininogen. Aortic extracts showed two pH related peaks of uterus contracting
      substance formation, at pH 5.2 and (unlike myocardium) at pH 8. Also unlike
      myocardium, aortic extracts gave two acid optimum kininogenase peaks on gel
      filtration, with MW 42(4.6) kd and 252(39) kd, respectively. Both peaks released
      bradykinin like immunoreactivity. CONCLUSIONS: Canine aorta contained an alkaline
      optimum and two acid optimum enzymes, while ventricle contained only a cathepsin
      D-like acid optimum enzyme, all of which could form bradykinin like
      immunoreactivity. The ability of the ventricular enzyme to form a kinin in the
      slightly acid conditions of myocardial ischaemia may have a protective role.

PMID- 1638570
TI  - Acute effects of doxorubicin on skinned cardiac muscle fibres of guinea pigs.
AB  - OBJECTIVE: The aim was to examine the effect of doxorubicin on spontaneous cyclic
      Ca2+ release from the sarcoplasmic reticulum of skinned fibres, as measured by
      isometric tension development in EGTA free, Ca2+ free solution. METHODS:
      Experiments were done on fragments of papillary muscles from the right ventricles
      of guinea pigs. Skinned fibres were prepared by treatment with saponin. The
      effects of doxorubicin in concentrations of 2 x 10(-9) to 2 x 10(-5) M on cyclic
      contractions were evaluated in 20 muscles. The effects of doxorubicin in
      concentrations of 2 x 10(-7) and 2 x 10(-5) M on pCa-tension relation were
      examined in 14 muscles treated with Brij-58. RESULTS: Doxorubicin (2 x 10(-9) to
      2 x 10(-5) M) increased the frequency of cyclic contractions and induced an
      incomplete muscle relaxation in a dose dependent manner. Doxorubicin 2 x 10(-7) M
      had no effect on pCa-tension relation. Doxorubicin 2 x 10(-5) M shifted the pCa
      tension curve slightly to the left. CONCLUSIONS: An incomplete muscle relaxation
      is considered to be due to an increase in Ca2+ release from the sarcoplasmic
      reticulum and a slight increase in the sensitivity of the contractile proteins to
      Ca2+. These observations suggest that one cause of the intracellular Ca2+
      overload induced by doxorubicin, a putative mechanism of the doxorubicin induced
      cardiomyopathy, is attributable to the direct effects of doxorubicin on the
      sarcoplasmic reticulum, impairing its ability to sequester Ca2+.

PMID- 1638571
TI  - Action potential duration and endocardial modulation of myocardial contraction in
      the ferret.
AB  - OBJECTIVE: Endocardial endothelium releases substances which modulate myocardial
      contraction. Selective endocardial removal abbreviates contraction by removing a
      contraction prolonging substance "endocardin". The aim of the study was to
      investigate whether changes in action potential duration underlie these
      contractile effects. METHODS: The contractile effects of shortening the action
      potential were first characterised, using a potassium channel "opener" cromakalim
      (3 microM). Transmembrane action potentials were then recorded in isolated ferret
      papillary muscles before and after endocardial removal. RESULTS: Cromakalim
      induced action potential abbreviation reduced contractile twitch duration.
      Endocardial removal itself however did not alter action potential duration.
      CONCLUSIONS: Endocardial modulation of cardiac contraction does not involve
      changes in action potential duration.

PMID- 1638572
TI  - Effect of hypertonicity on contractility of isolated working rat left ventricle.
AB  - OBJECTIVE: The aim was to evaluate the effect of hypertonic perfusate on isolated
      left ventricular mechanical and energetic characteristics. METHODS: An isolated
      working rat heart model was perfused with a hyponatraemic Krebs-Heinseleit
      bicarbonate buffer (240 mOsmol.litre-1). To this buffer was added increasing
      amounts of mannitol to achieve 280, 320, and 360 mOsmol.litre-1 perfusates.
      RESULTS: Left ventricular peak pressure, maximum time derivative of left
      ventricular pressure (dP/dtmax), and end systolic pressure were all increased to
      a maximum value at 280 or 320 mOsmol.litre-1 perfusate tonicity. A similar
      response was evident with cardiac output, which changed from 33.7(SEM 0.6) to
      43.5(0.8) ml.min-1 following changing the perfusate tonicity from 240 to 280
      mOsmol.litre-1 (p less than or equal to 0.003). However, increasing perfusate
      tonicity further decreased cardiac output to 36.5(1.3) ml.min-1 at 360
      mOsmol.litre-1. Maximal left ventricular elastance remained unchanged during
      perfusion with increasing perfusate tonicities. CONCLUSIONS: Changing perfusate
      osmolality using mannitol has a positive inotropic effect at low osmolalities and
      a negative inotropic effect at perfusate osmolality greater than 320 mOsm.litre
      1.

PMID- 1638573
TI  - Pacemaker current, membrane resistance, and K+ in sheep cardiac Purkinje fibres.
AB  - OBJECTIVE: The pacemaker current in cardiac Purkinje fibres has been attributed
      to either a decrease in potassium conductance or an increase in a non-specific
      (Na-K) conductance. The former mechanism would be associated with an increase in
      membrane resistance (Rm) and the latter with a decrease in Rm. The aim of this
      study was to obtain evidence in support of one or other mechanism by measuring Rm
      during the pacemaker current (Idd) under conditions where there is a small or no
      extracellular potassium depletion. METHODS: Hearts were obtained from
      anaesthetised sheep and thin strands of ventricular Purkinje fibres were
      shortened to less than or equal to 1.6 mm. Purkinje fibres were voltage clamped
      to potentials positive and negative to the potassium equilibrium potential (EK)
      using a two microelectrode technique. Small current pulses were superimposed on
      Idd to measure Rm changes. Procedures were used that decrease either the
      background potassium current IKl or Idd in order to dissect changes in Rm due to
      K depletion from those due to Idd. RESULTS: Rm increased during Idd, whether the
      pacemaker current increased or decreased as a function of time. Increasing [K]o
      from 2.7 to 5.4 mmol.litre-1 decreased Rm and during hyperpolarising steps
      increased the instantaneous current but did not change Idd amplitude. In 2.7
      mmol.litre-1 K, caesium (Cs, 2 mmol.litre-1) increased the holding current (Ih),
      had little effect on the instantaneous current, and eliminated Idd and associated
      Rm changes. In 5.4 and 10.8 mmol.litre-1 K, Cs increased Ih and decreased Idd
      amplitude and in 10.8 mmol.litre-1 K Cs decreased the instantaneous current on
      hyperpolarisation. If the current was reversed, Cs decreased but did not abolish
      it. In normal [K]o, barium (Ba, 0.05-0.5 mmol.litre-1) increased Ih and Rm,
      reduced the instantaneous current but did not increase Idd amplitude. In high
      [K]o, Ba instead increased the amplitude and rate of development of Idd. When Cs
      was applied in the presence of Ba, Idd was reduced or eliminated depending on
      [K]o. CONCLUSIONS: The changes in membrane resistance during the pacemaker
      current cannot be accounted for by K depletion and suggest that in the range of
      diastolic depolarisation the pacemaker current results predominantly from a time
      dependent decrease in K conductance.

PMID- 1638574
TI  - Consequences of opiate agonist and antagonist in myocardial ischaemia suggest a
      role of endogenous opioid peptides in ischaemic heart disease.
AB  - OBJECTIVE: The aim was to evaluate the effects of an opiate agonist (U50,488H)
      and an opiate antagonist (naloxone) in myocardial ischaemia. METHODS: A left
      thoracotomy was performed and the left coronary artery was ligated in adult
      Sprague-Dawley rats of either sex (350-400 g). Blood pressure, heart rate and
      electrocardiogram were measured before and after injections of U50,488H or
      naloxone and throughout the 30 min postligation period. RESULTS: Following
      coronary artery occlusion, all rats in the control group developed arrhythmias,
      bradycardia, and hypotension. U50,488H potentiated and naloxone attenuated the
      ischaemia induced arrhythmias, bradycardia, and hypotension. CONCLUSIONS: The
      potentiating and blocking effects of U50,488H and naloxone, respectively, suggest
      that endogenous opioid peptides are involved in the pathophysiology of myocardial
      ischaemia and play an important role in ischaemic heart disease.

PMID- 1638575
TI  - Mitochondrial dysfunction observed in situ in cardiomyocytes of rats in
      experimental diabetes.
AB  - OBJECTIVE: The aim was to investigate effects of experimental diabetes and
      insulin treatment on heart myocytes, particularly on the mitochondrial function
      studied in situ in isolated cardiomyocytes. METHODS: 20 male Sprague-Dawley rats
      (140-160 g) were made diabetic by intraperitoneal streptozotocin, 70 mg.kg-1. Ten
      then received daily subcutaneous injections of ultra lente insulin (starting dose
      of 3 units.d-1) for 7-15 d from the 20th day after streptozotocin. There was a
      control group of 11 rats. The rats were killed 21-35 d after the induction of
      diabetes, and heart myocytes were isolated by collagenase digestion. The 45[Ca]2+
      uptake of mitochondria in situ in permeabilised myocytes, the transmembrane
      potential gradient of mitochondria, and the respiration of myocytes, as well as
      the cell yield and cell [45Ca]2+ uptake, were examined. RESULTS: Mitochondrial
      uptake of [45Ca]2+ was significantly decreased in the diabetic group compared to
      control at cytosolic calcium concentrations between 760 nM and 44.6 microM. The
      mitochondrial potential of diabetic myocytes, estimated from the distribution of
      [3H]triphenylmethylphosphonium+, was slightly but significantly decreased from
      the control value. Cell respiration, measured polarographically in the presence
      of pyruvate and malate or succinate as oxidisable substrates, and with or without
      2,4-dinitrophenol, was decreased by diabetes. The rapidly exchangeable [45Ca]2+
      content in the myocyte with intact sarcolemmal membrane ("cell Ca2+ uptake") and
      the yield of cells from heart tissue were also diminished in diabetic rats. These
      changes were returned to normal by insulin treatment of 7 d or longer.
      CONCLUSIONS: Insulin deficiency at early stages causes defects of mitochondrial
      function detectable in situ in cardiomyocytes. This suggests the possibility that
      such alterations are causative factors in the development of diabetic
      cardiomyopathy.

PMID- 1638576
TI  - Effects of progressive myocardial ischaemia on systolic function, diastolic
      dysfunction, and load dependent relaxation.
AB  - OBJECTIVE: The aims were to determine (1) the relationship between changes in
      contractile function (systolic shortening) and the appearance of diastolic
      dysfunction (postsystolic shortening) during progressive regional left
      ventricular ischaemia; (2) the effects of increased afterload (acute constriction
      of the descending thoracic aorta) on ischaemic contractile dysfunction; and (3)
      the effects of loading during ischaemia on load dependent relaxation. METHODS:
      Regional myocardial function, using sonomicrometry, was measured in the short and
      long axes of the apex of the left ventricle of eight open chest anaesthetised
      dogs (16-20 kg). Progressive apical ischaemia was induced by graded reductions in
      left anterior descending coronary artery flow (critical constriction, ischaemia
      1, ischaemia 2, total coronary occlusion, and postocclusive maximum reactive
      hyperaemia). Acute afterloading was induced by a snare placed around the
      descending aorta. RESULTS: Consistent decreases in systolic shortening and
      increases in postsystolic shortening relative to the total segmental shortening
      in the short axis of the apical region were seen with worsening ischaemia. Aortic
      constriction increased the magnitude of apical postsystolic shortening and
      decreased apical systolic shortening in the short axis during critical
      constriction, ischaemia 1, and ischaemia 2. Long axis function changed in a
      qualitatively similar but quantitatively different manner. There was a
      significant decrease in the load dependency of relaxation with total coronary
      occlusion. CONCLUSIONS: (1) Changes in systolic and diastolic function occurred
      concomitantly as mild regional myocardial ischaemia developed and intensified;
      (2) afterloading significantly worsened regional systolic and diastolic
      dysfunction during mild ischaemia; and (3) progression of regional ischaemia
      resulted in loss of load dependent relaxation.

PMID- 1638577
TI  - Fluoroquinolone antibiotics: properties of the class and individual agents.
AB  - The broad spectrum of activity and bactericidal nature of the fluoroquinolones,
      together with their excellent absorption, rapid distribution, and high tissue
      concentration, make them excellent therapeutic agents for the management of a
      number of complicated community-acquired and nosocomial infections of the urinary
      tract, bone and soft tissue, gastrointestinal tract, and prostate, as well as
      some respiratory tract infections and sexually transmitted diseases. Data are
      presented and reviewed concerning the in vitro activity, pharmacology, and
      clinical use of ciprofloxacin, norfloxacin, and ofloxacin, which have been
      available for some time, and lomefloxacin and temafloxacin, which are recently
      approved agents. The comparable qualities and differences in activity and
      clinical applications of these agents are considered. For many infections in
      selected patients, quinolones are excellent substitutes for parenteral agents. In
      general, adverse effects have been infrequent and rarely require drug
      discontinuation. Significant interactions, such as with theophylline and
      caffeine, have occurred but are quinolone dependent. Antacids can markedly impair
      the absorption of all quinolones. Because emerging resistance to Pseudomonas and
      Staphylococcus species have been observed, the improper use of the quinolones
      must be avoided, and the clinician must be aware that an unfavorable response may
      signal resistance. The development of future agents with better gram-positive
      activity, improved gram-negative coverage, and activity against unusual pathogens
      such as Chlamydia species and Mycobacterium species, will make these oral agents
      invaluable. Assessing the usefulness and safety of these antibiotics in children
      is an ongoing challenge.

PMID- 1638579
TI  - Effects of dilevalol in hypertension assessed by digital pulse plethysmography.
AB  - For two weeks, with the exception of one case involving long-term therapy, 15
      hypertensive patients received 100 mg of dilevalol once daily and seven patients
      received 50 mg. Blood pressure and heart rate were measured and digital pulse
      plethysmography (DPG) was performed before and after the two-week trial. Systolic
      and diastolic blood pressure decreased significantly during treatment; heart rate
      did not change. There were also significant changes on the three DPG measures of
      vasodilatation: peak amplitude increased, the dicrotic index decreased, and peak
      amplitude on the differentiated DPG increased. A weak correlation was found
      between the changes in systolic blood pressure and changes in the two measures of
      DPG peak amplitude. It is concluded that dilevalol is effective in the treatment
      of hypertension and that DPG is a sensitive noninvasive method to measure
      vasodilatation.

PMID- 1638578
TI  - Randomized, prospective comparison of cefoxitin and gentamicin-clindamycin in the
      treatment of acute colonic diverticulitis.
AB  - In a randomized, prospective study, single-drug antibiotic therapy with cefoxitin
      (CFX) was compared to combination therapy with gentamicin and clindamycin (G/C)
      as definitive treatment for acute colonic diverticulitis. Excluding individuals
      requiring immediate operation, 51 patients with a clinical diagnosis of
      diverticulitis, who were hospitalized at five different medical centers, were
      randomized to receive CFX (30 patients) or G/C (21 patients). Age, sex, and the
      severity of diverticulitis were similar in the two groups. The cure rates of 90%
      and 85.7% observed for CFX and G/C, respectively, did not differ significantly.
      Leukocytosis resolved in a shorter time period in patients treated with CFX than
      in those treated with G/C (2.5 +/- 0.4 vs 4.1 +/- 0.6 days, respectively) (P =
      0.03, Student's t test, unpaired data). Two cases of possibly antibiotic-related
      toxicity occurred in the CFX group versus three cases in the G/C group. The
      average cost of a course of CFX therapy was $417 compared with $488 for G/C. In
      this study, cefoxitin demonstrated efficacy and tolerability similar to that of
      gentamicin-clindamycin in the treatment of acute colonic diverticulitis and may
      be preferred in view of its narrower antimicrobial spectrum and lower cost.

PMID- 1638580
TI  - Efficacy and tolerability of lovastatin in hypercholesterolemic women.
AB  - In a previous report of a multicenter study (Kannel et al, 1990), the results of
      6 months' treatment with lovastatin in 489 adults with primary
      hypercholesterolemia were presented. The present report contains the results from
      the 236 women patients. The intial dose of lovastatin was 20 mg daily and could
      be increased to a maximum of 80 mg/day. At the end of 1 month of treatment,
      levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, very-low
      density lipoprotein cholesterol, triglycerides, and the total cholesterol:high
      density lipoprotein (HDL) cholesterol and LDL:HDL cholesterol ratios were
      significantly lower and the HDL cholesterol levels were significantly higher.
      These improvements in the lipid profile were maintained for 6 months. The results
      in the 88 women aged 65 to 83 years and in the 147 women aged 25 to 64 years were
      similar. LDL-cholesterol goals of less than 3.36 mmol/L in patients with coronary
      heart disease (CHD) or two or more CHD risk factors and less than 4.14 mmol/L
      among the other patients were achieved by 48% of the women at 1 month and 58% by
      6 months. At least one adverse effect was reported by 18% of the women, the most
      common being abdominal pain, diarrhea, and constipation. The results indicate
      that hypercholesterolemic women respond well to treatment with lovastatin.

PMID- 1638581
TI  - Effects of ulinastatin, an antiprotease, on alloxan-induced lung injury in dogs.
AB  - To determine if alloxan-induced lung injury could be prevented by an
      antiprotease, ulinastatin, we used three groups of five anesthetized, ventilated
      dogs. They were given saline (20 ml/kg/hr) infusion alone (saline group), alloxan
      (75 mg/kg) + saline infusion (alloxan group), or ulinastatin (50,000 U/kg) +
      alloxan + saline infusion (ulinastatin group). The course of all dogs was
      followed for three hours. In the saline group, extravascular lung water to blood
      free dry weight (Qwl/dQl) was 3.22 +/- 0.31 g/g (mean +/- SE). The alloxan group
      presented the following significant findings: a decrease in white blood cell and
      platelet counts (44.2% and 68.2% of control, respectively) at five minutes; an
      increase in thromboxane B2 and 6-keto-prostaglandin F1 alpha (731.6% and 476.6%
      of control, respectively) at 15 minutes; an increase in beta-glucuronidase
      (124.8% of control) at 30 minutes; and an increase in Qwl/dQl (8.84 +/- 1.82 g/g)
      at the end of experiment. The addition of ulinastatin significantly reduced most
      alloxan-induced effects: differences in white blood cell counts, thromboxane B2,
      6-keto-prostaglandin F1 alpha, and Qwl/dQl between the saline and ulinastatin
      groups were small. We conclude that ulinastatin significantly reduces the extent
      of lung water accumulation in alloxan-induced lung injury.

PMID- 1638582
TI  - Conversion from glipizide to glyburide: a prospective cost-impact survey.
AB  - Despite extensive clinical experience with second-generation oral hypoglycemic
      agents, the relative dosing equivalence of glyburide and glipizide remains
      controversial. A prospective survey was conducted to determine the feasibility
      and cost of converting noninsulin-dependent diabetic patients from glipizide to
      glyburide. A total of 211 patients previously stabilized on glipizide were
      converted to glyburide and returned to their respective clinics at least once
      during the following six months. The mean daily dose (+/- SD) of glipizide before
      conversion was 18.7 +/- 12.32 mg; the mean daily dose of glyburide after seven
      months was 9.9 +/- 6.52 mg (P less than 0.001, paired t test). Glyburide was well
      tolerated. The conversion program appeared to be successful and resulted in a 47%
      reduction in the mean daily dose after conversion from glipizide to glyburide,
      which, in turn, conferred a 43% savings in the projected yearly expenditures for
      second-generation oral hypoglycemics.

PMID- 1638583
TI  - Amoxicillin/clavulanate therapy of respiratory tract infections: a microbiologic
      perspective.
AB  - The development of beta-lactamase-producing strains of the common respiratory
      tract pathogens Hemophilus influenzae and Moraxella catarrhalis has caused
      increasing resistance to a number of antimicrobial agents, including ampicillin
      and amoxicillin, that are traditionally used to treat respiratory tract
      infections. Because antimicrobial therapy for upper and lower respiratory tract
      infections is usually empiric, an understanding of beta-lactamase-mediated
      resistance and its implications for antibiotic therapy is critical for the
      successful treatment of these infections.

PMID- 1638584
TI  - Treatment of Alzheimer-type dementia with intravenous mecobalamin.
AB  - The efficacy of intravenous mecobalamin in the treatment of Alzheimer-type
      dementia was evaluated in ten patients using several rating scales. Vitamin B12
      levels and unsaturated binding capacities were also measured and compared to the
      evaluated intellectual function scores. Mecobalamin was shown to improve
      intellectual functions, such as memory, emotional functions, and communication
      with other people. Improvements in cognitive functions were relatively constant
      when the vitamin B12 levels in the cerebrospinal fluid were high. Improvements in
      communication functions were seen when a certain level of vitamin B12 was
      maintained for a longer period. There were no side effects attributable to
      mecobalamin. We conclude that mecobalamin is a safe and effective treatment for
      psychiatric disorders in patients with Alzheimer-type dementia.

PMID- 1638585
TI  - Comparison of two transdermal nitroglycerin systems: Transderm-Nitro and Nitro
      Dur.
AB  - Sixty-four patients with stable angina pectoris were enrolled in a four-week,
      multicenter, office-based study to compare the adhesive properties of an
      patients' preferences for two transdermal nitroglycerin systems, Transderm-Nitro
      (TDN) and Nitro-Dur (ND). Each patient simultaneously wore one 0.2 mg/hr
      (formerly 5 mg/24 hr) TDN patch and one 0.2 mg/hr ND patch. At the first and last
      study visits, patients completed questionnaires that assessed preferences based
      on ease of application, handling, and removal; ease of removing the backing;
      overall adhesion; adhesion under certain conditions; comfort; curling or rolling;
      and skin irritation. Each day of the study, patients recorded the number of
      anginal episodes experienced, frequency of sublingual nitroglycerin use, patch
      adhesion, and problems at the sites of application or any other medical problems.
      Differences in adhesive properties were statistically significant in favor of TDN
      over ND (P less than or equal to 0.001). Of the TDN patches, 98.5% adhered
      completely, compared with 81.8% of the ND patches. No serious or unexpected
      adverse reactions occurred. Overall, patients preferred TDN to ND by a
      statistically significant margin (P = 0.0002).

PMID- 1638586
TI  - Ofloxacin versus trimethoprim/sulfamethoxazole in the treatment of uncomplicated
      urinary tract infection.
AB  - A multicenter randomized study was conducted to compare the efficacy and safety
      of ofloxacin with that of trimethoprim/sulfamethoxazole (TMP/SMX) in the
      treatment of uncomplicated urinary tract infection in adults. Patients were
      randomized to receive either oral ofloxacin 200 mg daily for three days (102
      patients), or oral TMP/SMX 160 mg/800 mg twice daily for seven days (100
      patients). The pathogen was eradicated in 73 (97.3%) of the 75 evaluable patients
      receiving ofloxacin and in 66 (97.1%) of the 68 evaluable patients receiving
      TMP/SMX. The most frequently isolated pathogens were Escherichia coli, Klebsiella
      pneumoniae, and Proteus mirabilis. More urinary pathogens were susceptible to
      ofloxacin than to TMP/SMX, although this difference was not statistically
      significant. The clinical cure rate for patients receiving ofloxacin was 93.3%,
      with 4% improved and 2.7% failed. For patients receiving TMP/SMX, the clinical
      cure rate was 86.4%, with 12.1% improved and 1.5% failed. Side effects were
      reported by 29.7% of the patients receiving ofloxacin and by 40.4% of the
      patients receiving TMP/SMX. Drug-related adverse experiences, as determined by
      the investigators, occurred in 5% of the ofloxacin patients and in 15.2% of the
      TMP/SMX patients, a statistically significant difference. No patients receiving
      ofloxacin, compared with three patients receiving TMP/SMX, discontinued therapy
      because of an adverse reaction. These results indicate that short-course
      ofloxacin is as effective as TMP/SMX in the treatment of uncomplicated urinary
      tract infection. Ofloxacin therapy is also better tolerated than TMP/SMX.

PMID- 1638587
TI  - Cefprozil versus cefaclor in the treatment of mild to moderate skin and skin
      structure infections. The Cefprozil Multicenter Study Group.
AB  - In a multicenter study, 598 patients with skin or skin-structure infections were
      randomly assigned to receive 500 mg of cefprozil once daily (or 20 mg/kg once
      daily) or 250 mg of cefaclor three times daily (or 20 mg/kg daily in three equal
      doses) for 5 to 10 days. Treatment was evaluated in 212 cefprozil-treated
      patients and in 210 cefaclor-treated patients. The patients were aged 2 to 99
      years (mean, 28 years) and their primary diagnoses were impetigo (in 99
      patients), pyoderma (in 98), superficial abscess (in 70), and cellulitis (in 64).
      A satisfactory clinical response was found in 93% of the cefprozil-treated
      patients and in 92% of the cefaclor-treated patients, the pathogens were
      eradicated in 91% and 89%, and overall treatment was rated effective in 87% of
      both groups. Adverse clinical events were reported by 5% of the patients in both
      groups; one cefprozil-treated patient and three cefaclor-treated patients
      withdrew from treatment because of adverse events. It is concluded that cefprozil
      administered once daily is as effective and safe as cefaclor administered three
      times daily in the treatment of mild to moderate skin and skin-structure
      infections.

PMID- 1638588
TI  - Efficacy of cefaclor AF in the treatment of skin and skin-structure infections.
AB  - Cefaclor advanced formulation (cefaclor AF) was compared with cefaclor for the
      treatment of skin and skin-structure infections in a double-blind study at 28
      centers in North America. Of the 563 patients originally randomized, 278 patients
      received cefaclor AF (375 mg twice daily) and 285 patients received cefaclor (250
      mg three times daily). A total of 154 patients treated with cefaclor AF and 157
      patients treated with cefaclor qualified for the efficacy analysis after
      completing 7 days of therapy. At the post-therapy visit, favorable clinical
      response rates for evaluable patients were 97.4% in the cefaclor AF group and
      94.9% in the cefaclor group; favorable bacteriologic response rates were 85.7%
      and 84.1%, respectively. At the late post-therapy evaluation, 7 to 14 days after
      completion of therapy, favorable clinical response rates were 90.1% in the
      cefaclor AF group versus 89.9% in the cefaclor group, and favorable bacteriologic
      response rates were 88.7% and 86.9%, respectively. No significant difference was
      seen between the groups in clinical or bacteriologic efficacy at either
      evaluation or in the frequency of nature of side effects reported during the
      study.

PMID- 1638589
TI  - Milestones in clinical pharmacology. From experimental to clinical
      pharmacokinetics.

PMID- 1638590
TI  - Guidelines for pharmacoeconomic studies.

PMID- 1638591
TI  - [The role and importance of ambulatory monitoring of blood pressure in the
      diagnosis, control and therapy of hypertension].
AB  - For the diagnosis, control and treatment of hypertension for non-invasive
      assessment of the blood pressure at present a combination of three methods is
      used. Clinical assessment (by a physician in the surgery or in bed in bedridden
      patients) is the basic approach, if necessary supplemented by assessment at home
      and/or ambulatory monitoring of the blood pressure. Twenty-four-hour ambulatory
      monitoring can provide representative blood pressure readings. It furnishes
      information which cannot be obtained in another way; if correctly indicated and
      the results are used in practice, it is effective and economical. It permits
      evaluation of the blood pressure response to physical and emotional activity in
      the course of the day, to assess changes of blood pressure during sleep and to
      define the prognosis of the disease more accurately. It makes it possible to
      establish a correct indication of medicamentous therapy, selection of effective
      drugs and correct timing of the doses. In the submitted paper the authors
      describe also the limitations of the method as well as possible complications
      during implementation. Long-term monitoring of the blood pressure should resolve
      special problems in selected groups of patients. In indicated cases it should be
      available also in this country and introduced to an appropriate extent also in
      selected departments concerned with hypertensiology.

PMID- 1638592
TI  - [Membrane transport of cations in erythrocytes during treatment of essential
      hypertension with angiotensin-converting enzyme inhibitors].
AB  - The authors investigated in ten patients with essential hypertension changes in
      the membrane transport of sodium in red blood cells and the intracellular calcium
      content of thrombocytes during the control period during treatment of
      hypertension with central sympatholytics and after three-week treatment with an
      inhibitor of the angiotensin converting enzyme (ACE), enalapril. The effect of
      enalapril in hypertonic patients was manifested by a rise of the renin plasma
      activity and the potassium concentration and a reduction of the sodium plasma
      concentration which corresponds to the inhibition of angiotensin II. The
      intracellular calcium and sodium content was unaltered. In 8 of 10 patients after
      enalapril treatment increased values of Vmax for Na(+)-K+ cotransport occurred,
      incl. 6 patients where at the same time a rise of Vmax Na(+)-Li+ countertransport
      was recorded.

PMID- 1638593
TI  - [The effect of inactivity on bone mineralization].
AB  - In a group of 88 patients, immobile for various reasons a markedly reduced bone
      mineralization was found, significantly more in patients with denervation of the
      muscles. As to laboratory indicators, the author recorded a significantly reduced
      serum calcium level which correlated positively with the mineralization level;
      there was an insignificantly elevated alkaline phosphatase activity and
      calciuria. After comprehensive calcium treatment with small doses of vitamin D,
      and in patients without signs of osteomalacia also with sodium fluoride raised
      also significantly the serum calcium level, while there was a decline of the
      alkaline phosphatase activity and a slight increase of calciuria. The fundamental
      requirement of therapy is burdening of the bones by graded mobilization of the
      patients. The following series proved useful: isometric contraction of muscles in
      a recumbent position--standing up, assisted next to the bed--moving round the bed
      -active rehabilitation.

PMID- 1638594
TI  - [Culture of skin grafts in vitro].
AB  - The paper deals with utilization of skin grafts generated in vitro in treatment
      of burns, skin ulcers and other defects. Specific properties of autografts,
      allografts and composite skin substitutes are discussed. The cultivation of
      keratinocytes, which were successfully applied as autografts in treatment of burn
      wounds in Kosice, is described in detail.

PMID- 1638595
TI  - [Long-term prognosis in chronic primary glomerulonephritis in relation to urinary
      findings].
AB  - A long-term followed-up group of 993 patients with primary glomerulonephritis
      (GN) was divided by urinary syndromes, defined according to the degrees of
      proteinuria and haematuria. Responding morphological diagnoses and prognoses were
      found for each urinary syndrome. Isolated and predominant haematuria were
      determined as benign, with stationary course even without immunosuppressive
      therapy. The prognosis of isolated, even moderate, proteinuria is more serious
      finding. Its relevance increases with the degree of haematuria. Severe combined
      proteinuria and haematuria is the most serious urinary syndrome. Both proteinuria
      and haematuria may be changing in the course of GN and increasing proteinuria
      points to the future glomerular filtration rate decrease.

PMID- 1638596
TI  - [Composite carcinoma-carcinoid of the large intestine].
AB  - The authors give an account of a bioptically revealed adenocarcinoma of the large
      bowel which was combined with a carcinoid. The carcinoid constituent of the tumor
      had massive metastases as revealed by the postmortem examination.

PMID- 1638597
TI  - [The significance of antioxidants in pathologic states].
AB  - Based on a review of the literature the authors discuss problems of antioxidants
      which are recently in the foreground of interest of human medicine. In the first
      part of the paper the authors discuss the importance of antioxidation enzymes and
      other antioxidants, their correlation with the life span and possibilities of
      their use in experimental therapy of diseases. The second part of the paper is
      devoted to the evaluation of antioxidation activity in pathological conditions
      and the use of antioxidants in the prevention and therapy of various diseases.

PMID- 1638598
TI  - [How should treatment of esophageal varices proceed?].
AB  - The authors submit their experience and data from the literature on the problem
      of oesophageal varices. In haemorrhage of varices at present the most successful
      procedure is endoscopic haemostasis concurrently with intensive treatment focused
      on the basic disease and replacement of blood losses. In patients with a history
      of haemorrhage from varices endoscopic sclerotization is generally recommended.
      The authors supplement it with the promising medicamentous reduction of the
      portal pressure. Other procedures, i.e. surgery, are indicated only in a minority
      of patients whose varices do not reposed to haemostasis and medicamentous
      reduction of high portal pressure. The problem how to proceed in varices which
      did not bleed so far is still unresolved. The authors recommend individual
      evaluation and submit their own procedure.

PMID- 1638599
TI  - [Significance of the detection of the familial carcinoma syndrome (Lynch I and
      II) in the early diagnosis of colorectal carcinoma].
AB  - In 1982-1991 at the Fourth Medical Clinic 309 asymptomatic family members meeting
      the criteria of the hereditary form of colorectal carcinoma (Lynch syndrome-
      syndrome of familial cancer, also "non-polypous" hereditary colorectal carcinoma)
      which differs from familial polyposis (adenomatosis) of the colon. The syndrome
      is characterized by autosomal dominant heredity and by familial incidence of
      colorectal carcinoma (Lynch I) or colorectal carcinoma and carcinoma of other, in
      particular gynaecological areas (Lynch II) and a younger age of the affected
      subjects, a more frequent localization in the right colon, synchronous and
      metachronous neoplasia. In the authors group 34% were type I, the remainder type
      II. Initial total coloscopy revealed carcinoma in 51 subjects (78% in the right
      colon), adenomatous polyps in 99 (73% in the right colon). The mean age of the
      patients with carcinoma was 47.5 years, of those with adenoma 46.5 years. The
      majority of cases were recorded in subjects with three or more than three direct
      relatives with carcinoma (highest risk grade). During subsequent coloscopic check
      up examinations at intervals depending on individual risk, colorectal carcinoma
      was detected in another six subjects. In 30 patients it was carcinoma Dukes A, in
      12 B and in 3 Dukes C. These results indicate that identification of asymptomatic
      cases of Lynch syndromes via the family-history and coloscopic follow-up
      contributes to the early diagnosis of colorectal carcinoma.

PMID- 1638600
TI  - [Results of studies of indicators of hemostasis in hemodialyzed patients during
      administration of 1-deamino-8-D-arginine vasopressin].
AB  - The fibrinolytic activity (FA) evaluated according to the euglobulin clot lysis
      time was in haemodialyzed patients (3.0 +/- 0.2 arb. u.) lower than in patients
      with chronic renal failure treated by conservative methods (4.7 +/- 0.6, p less
      than 0.05) and than in healthy subjects (4.2 +/- 0.4, p less than 0.05). After
      stimulation by intravenous administration of 1-deamino-8-D-arginine vasopressin
      the FA in haemodialyzed patients rose to (4.5 +/- 1.6), less than in
      conservatively treated (14.1 +/- 2.1, p = 0.06) and than in healthy subjects
      (18.2 +/- 3.9, p less than 0.001). By using specific methods it was proved that
      the inadequate rise of FA in haemodialyzed patients after stimulation is
      conditioned by a defect of the release of the plasminogen tissue activator from
      the vascular wall. Contrary to healthy subjects (7.0 +/- 1.3 vs. 16.7 +/- 2.3
      ng/ml, p less than 0.01) is plasma concentration in haemodialyzed subjects (5.3
      +/- 0.5 vs. 7.9 +/- 0.8, NS) did not increase significantly. Repeated
      examinations of some of the haemodialyzed patients revealed that almost 20 months
      of regular haemodialysis do not lead to further changes of basal (2.9 +/- 0.3 vs.
      2.8 +/- 0.2) nor stimulated (4.2 +/- 0.5 vs. 4.8 +/- 0.9) FA. Basal plasma
      concentrations of the von Willebrand factor were in the dialyzed patients (89.1
      +/- 8.8%) higher than in healthy subjects (67.2 +/- 4.4, p less than 0.05). After
      stimulation the concentration of the von Willebrand factor increased
      significantly in healthy subjects (99.1 +/- 4.3, p less than 0.01), but not in
      dialyzed patients (82.9 +/- 3.1, NS), obviously due to the pathological
      reactivity of their vascular wall. The above findings may be associated with
      thromboses and atherosclerosis in patients on long-term dialysis.

PMID- 1638602
TI  - [Folk healing causing severe diabetic coma].
AB  - The authors demonstrate on the case of a 21-year-old female diabetic (type I),
      who had been well compensated with insulin for five years, the life threatening
      procedure of a popular healer. By eliminating insulin he induced severe keto
      acidotic coma.

PMID- 1638601
TI  - [Could the Czech King Ladislav Pohrobek have had hypophosphatemic osteomalacia
      caused by a neoplastic disease?].
AB  - Histological examination of undecalcified specimens from different parts of
      skeletal remnants of king Ladislaus revealed a considerable degree of
      demineralization of a similar type as found in osteomalacia. This fact along with
      the finding of multiple osteolytic foci in different parts of the skeleton, and
      consistent with reports of the clinical picture of the disease made the authors
      present the hypothesis according to which the king may have suffered from so
      called oncogenic osteomalacia. This bone disease may develop as a complication of
      some neoplastic disease incl. haemoblastoses and haemoblastomas. The authors
      think that with regard to the age of the king, historical reports and the
      multiplicity of osteolytic lesions that the most plausible hypothesis is that of
      oncogenic osteomalacia associated with some type of malignant non-Hodgkin
      lymphoma.

PMID- 1638603
TI  - [Alternative versus scientific medicine].

PMID- 1638604
TI  - [Prof. Jan Horbaczewski. On the 50th anniversary of his death].

PMID- 1638605
TI  - [Diseases of civilization from the aspect of evolution of the human diet].
AB  - The authors discuss contemporary views regarding the causes of diseases of
      civilization which developed on an epidemic scale in industrial societies during
      the last 60-70 years. They are due to the immense changes of lifestyle adopted by
      these societies. On the whole this lifestyle is a marked deviation from optimal
      conditions for humans. The genetic equipment of man which determines the
      evolutional advantages and function of different metabolic processes which ensure
      the homeostasis of the healthy organism is conservative and is entirely adapted
      to the human genome which developed in the course of hundreds of thousands of
      years. The aim of preventive medicine is to analyze, point out and enforce
      diminution of the effect of risk factors, as an important way towards improvement
      of the general health status of the population.

PMID- 1638606
TI  - [New recommendations for nutritional requirements for the Czechoslovak
      population].
AB  - The authors present new recommended energy and nutrient allowances for the
      population of CSFR. The allowances are defined for 29 physiological groups, incl.
      11 groups of children and adolescents and 18 groups of adults (productive age and
      more advanced age groups). The recommended allowances are the result of research
      of two teams--a Czech and a Slovak one--, results are published in the world
      literature, FAO and WHO reports. The recommended system can be considered an
      important step in the area of nutritional prevention of cardiovascular diseases,
      diabetes and obesity.

PMID- 1638607
TI  - [Atherosclerotic changes in the carotid artery detected by ultrasound in newly
      diagnosed type II diabetics].
AB  - In a group of 107 middle-aged men with newly detected diabetes type II the
      authors investigated by means of a double ultrasonographic examination the
      incidence of atherosclerotic changes of the carotid artery. The incidence of
      atherosclerotic lesions on the carotid artery was relatively high (44% of the
      group), the majority of arterial stenoses was, however, without haemodynamic
      impact. A frequent finding were calcifications in the sclerotic plaques.
      Affection of the carotid artery was significantly frequently associated with
      ischaemic heart disease and ischaemia of the lower extremities. As compared with
      the results of examinations of the lipoprotein and carbohydrate metabolism, the
      authors found in men with affected carotid arteries as compared with not affected
      subjects significantly higher triacylglycerol levels, higher levels of
      circulating insulin and a higher ratio of total to HDL cholesterol.

PMID- 1638608
TI  - [Treatment of diabetic retinopathy using panretinal laser coagulation].
AB  - The author presents an account of his experience with panretinal photocoagulation
      by means of greenish-blue light of an argon laser in diabetics. He evaluates the
      technique of treatment. In a group of 156 eyes of 103 patients 1-18 months after
      photocoagulation with a mean follow-up period of nine months the author compares
      the development of visual acuity after treatment. Based on these findings he
      describes the success and asset of treatment for the patient. After one year in
      62% of 63 investigated eyes deterioration of visual acuity was arrested, in 16%
      improvement was achieved. After one and a half year 64% of 33 followed up
      patients were stabilized, in 12% the visual acuity was still better than at the
      onset of treatment. Panretinal photocoagulation by means of an argon laser can be
      considered at present the most effective treatment of diabetic retinopathy.

PMID- 1638609
TI  - [Botulinum toxin in the treatment of blepharospasm. Initial experience].
AB  - The clinical effects of botulinum toxin A were evaluated in eight patients with
      idiopathic blepharospasm and hemifacial spasm. A substantial reduction or
      disappearance of muscle spasms were observed after the treatment. The action of
      botulinum toxin became noticeable 2 days after administration with a peak effect
      at 2 weeks. This effect diminished with muscle spasms returning about 12 weeks
      after administration. No serious adverse events were noted. The treatment with
      botulinum toxin has become method of choice in blepharospasm, it is proposed for
      the management of local muscle spasms of various origin.

PMID- 1638610
TI  - [The medical history of a small town].

PMID- 1638611
TI  - [Nutritional recommendations for adults with diabetes mellitus according to the
      Czech Diabetology Society].

PMID- 1638612
TI  - [Development of indications for cesarean section in the Czech Republic and
      certain developed countries].
AB  - The author analyzes the reasons for the rapid increase of pregnancies terminated
      by caesarean section; in some countries (USA, Canada and others) the frequency is
      as high as 20%. The main reason was a change of indication for caesarean section:
      not only hazard to the mother, but above all hazard to the foetus. It seems
      however that there is no relationship between the frequency of caesarean and the
      level of perinatal mortality. On the contrary, in many instances caesarean
      section increases the risk of mother and foetus and the neonate. In the Czech
      Republic the rate of caesarean sections was 7.8%: the main indications were the
      hazard of foetal hypoxia and an unfavourable presentation of the foetus. Some non
      obstetric indications play a part: in particular orthopaedic and ophthalmological
      ones: they are the indication for every tenth caesarean section. In multiple
      pregnancies (in our country 42% are terminated by caesarean section), in
      particular pathological presentations of the foetus are involved. So far efforts
      of the international obstetric organization to reduce the use of caesarean
      section did not prove very successful.

PMID- 1638613
TI  - [Characteristics of the regulation of blood circulation in patients with heart
      transplants].
AB  - The author gives an account and conclusions of investigations pertaining to the
      circulation in patients with a transplanted heart. Attention is focused on the
      problem of the central and peripheral circulation, systemic hypertension and
      electrophysiology. The conclusions of these clinical and experimental
      observations reveal new findings and pathophysiological relations which
      contribute to the spread of basic knowledge on the circulation in patients with a
      transplanted heart and may serve as a starting point for seeking their prevention
      and therapy.

PMID- 1638614
TI  - [Mental therapy of headache].
AB  - In a group of patients with headache the authors found that mental therapy was
      very effective. It produced a better effect than previous therapeutic procedures.
      The authors discuss contemporary views of mechanisms of modern pharmacotherapy of
      headache and draw attention to its hazards, economic pretentiousness and
      frequently low availability. The authors mention also non-pharmacological methods
      used nowadays in the therapy of headache and their relationship to the endogenous
      opioid system. They explain mental therapy as the interaction and energy exchange
      between the aura of the emitor and percipient of the mental energy. The authors
      expressed the hypothetical idea on the basis of analgetic action of mental
      therapy. They recommend to extend research of mental energy in medical
      disciplines--theoretical and clinical--and to introduce mental therapy into
      practice on a professional level. Based on their own experience the authors
      decided to apply it already now where it gives hope of recovery or mitigation of
      the patients' suffering. They consider it their duty.

PMID- 1638615
TI  - [The first cases of transmission of tularemia in Southern Moravia].
AB  - The authors described two cases of the ulceroglandular form of tularaemia where
      the infection was transmitted to man after a sting by a tick in the Brno area.
      The incubation period was two weeks and 11 days resp., the course of the disease,
      in particular in the female patient was relatively severe and complicated,
      obviously due to the late establishment of the diagnosis and thus delayed
      aetiological treatment. The authors recommend to consider a tularaemic aetiology
      in case of a febrile disease which develops within two weeks after a tick sting,
      in particular if the site of the prick becomes inflamed and regional
      lymphadenitis develops.

PMID- 1638616
TI  - [Creatine phosphate as a drug in acute myocardial infarct].
AB  - The reserves of endogenous creatine phosphate are very rapidly exhausted in
      ischaemia. This leads at first to reversible and later to irreversible cell
      damage. Creatine phosphate can be administered in the preparation Neoton. It
      serves not only as a source of energy after arrest of oxidative phosphorylation;
      its main effect is stabilization of sarcolemma and protection against its
      disintegration. Several publications provide evidence of its favourable effect on
      the protection of the heart muscle during operations on the open heart, on a
      reduced incidence of ventricular arrhythmias in acute myocardial infarction and
      improvement in chronic cardiac insufficiencies. In Czechoslovakia multicentre
      clinical studies are under way testing Neoton in cardiological indications.

PMID- 1638617
TI  - [Principles of specimen collection and information which can be derived from a
      cytological examination].

PMID- 1638618
TI  - [Jan Amos Komensky--still with us].

PMID- 1638619
TI  - [Endoscopic "perestrojka"].
AB  - The authors discuss in a brief review the mighty development of invasive
      endoscopy in the next few years. Based on their own findings as well as data in
      the literature, they assume that it will be necessary to prepare theoretical as
      well as practical material for this quite newly developing discipline. It
      penetrates already at present to all European surgical and gastroenterological
      departments and changes fundamentally the approach to diagnosis and treatment of
      diseases of the gastrointestinal tract.

PMID- 1638620
TI  - [Spinal cord tumors and tumors causing spinal cord compression in the aged].
AB  - In incipient disorders of gait in old people frequently the possible presence of
      a benign spinal tumour is not taken into account. The patients are treated for
      assumed common complaints associated with old age. Thus much valuable time is
      lost before the only correct approach--surgery--is made. The author describes in
      her own group of patients early symptoms of spinal compression and supplements
      data by case-histories. The results of surgery in a group of patients with benign
      spinal tumours depended on the degree of spinal compression as well as on the
      duration of this compression. In the group of epidural secondary spinal tumours
      the results of surgery were not satisfactory.

PMID- 1638621
TI  - [Incidence of cholecystolithiasis in a population 20-59 years of age].
AB  - In 1989-1990 sonographic examination of the gallbladder of 1186 people aged 20-59
      years revealed in 262 cholecystolithiasis (22.1%). The group comprised 477 men
      (40.2%) and 709 women (59.8%). The general prevalence which is 22.1% comprises
      prevalence of sonographically revealed lithiasis--213 patients (18%) and
      lithiasis treated by cholecystectomy before sonographic examination--49 patients
      (4.1%). Among men cholecystolithiasis was revealed in 60 (12.6%) and among women
      in 202 (28.5%). The author discusses the relationship of cholecystolithiasis and
      body weight and the incidence of the disease in the family.

PMID- 1638622
TI  - [Increased acid phosphatase in isolated transitory hyperphosphatasemia].
AB  - In a 13-month-old girl with typical signs of isolated transient
      hyperphosphatasaemia the authors found repeatedly elevated acid phosphatase
      values. This finding supports the hypothesis of a temporary increase of bone
      remodelling in this condition.

PMID- 1638623
TI  - [Training and specialization of physicians in the Federal Republic of Germany].

PMID- 1638624
TI  - [Purkinje's role in obtaining the Comenian from the Lesny archives].

PMID- 1638625
TI  - [Evolution in biology--yes or no? Thoughts on the 400th anniversary of the birth
      of J.A. Comenius].

PMID- 1638626
TI  - [Recommendations for the prevention of atherosclerosis and ischemic heart
      disease. Detection and treatment of persons with increased lipids in adulthood].

PMID- 1638627
TI  - One rotten apple spoils the whole bushel: the role of ethylene in fruit ripening.

PMID- 1638628
TI  - Bacterial plasmids and gene flux.

PMID- 1638629
TI  - corkscrew encodes a putative protein tyrosine phosphatase that functions to
      transduce the terminal signal from the receptor tyrosine kinase torso.
AB  - We describe the characterization of the Drosophila gene, corkscrew (csw), which
      is maternally required for normal determination of cell fates at the termini of
      the embryo. Determination of terminal cell fates is mediated by a signal
      transduction pathway that involves a receptor tyrosine kinase, torso, a
      serine/threonine kinase, D-raf, and the transcription factors, tailless and
      huckebein. Double mutant and cellular analyses between csw, torso, D-raf, and
      tailless indicate that csw acts downstream of torso and in concert with D-raf to
      positively transduce the torso signal via tailless, to downstream terminal genes.
      The csw gene encodes a putative nonreceptor protein tyrosine phosphatase
      covalently linked to two N-terminal SH2 domains, which is similar to the
      mammalian PTP1C protein.

PMID- 1638630
TI  - Genetic isolation of ADA2: a potential transcriptional adaptor required for
      function of certain acidic activation domains.
AB  - We have devised a genetic strategy to isolate the target of acidic activation
      domains of transcriptional activators based on toxicity in yeast cells of the
      chimeric activator, GAL4-VP16. Toxicity required the integrity of both the VP16
      acidic activation domain and the GAL4 DNA-binding domain, suggesting that
      inhibition resulted from trapping of general transcription factors at genomic
      sites. Mutations that break the interaction between GAL4-VP16 and general factors
      would alleviate toxicity and identify transcriptional adaptors, if adaptors
      bridged the interaction between activators and general factors. We thus
      identified ADA1, ADA2, and ADA3. Mutations in ADA2 reduced the activity of GAL4
      VP16 and GCN4 in vivo. ada2 mutant extracts exhibited normal basal transcription,
      but were defective in responding to GAL4-VP16, GCN4, or the dA:dT activator.
      Strikingly, the mutant extract responded like wild type to GAL4-HAP4. We conclude
      that ADA2 potentiates the activity of one class of acidic activation domain but
      not a second class.

PMID- 1638631
TI  - Sorting of protein A to the staphylococcal cell wall.
AB  - The cell wall of gram-positive bacteria can be thought of as representing a
      unique cell compartment, which contains anchored surface proteins that require
      specific sorting signals. Some biologically important products are anchored in
      this way, including protein A and fibronectin binding protein of Staphylococcus
      aureus and streptococcal M protein. Studies of staphylococcal protein A and
      Escherichia coli alkaline phosphatase show that the signal both necessary and
      sufficient for cell wall anchoring consists of an LPXTGX motif, a C-terminal
      hydrophobic domain, and a charged tail. These sequence elements are conserved in
      many surface proteins from different gram-positive bacteria. We propose the
      existence of a hitherto undescribed sorting mechanism that positions proteins on
      the surface of gram-positive bacteria.

PMID- 1638632
TI  - Identification of a neural alpha-catenin as a key regulator of cadherin function
      and multicellular organization.
AB  - The function of cadherin cell adhesion molecules is thought to be regulated by a
      group of cytoplasmic proteins, including alpha-catenin. We identified a subtype
      of alpha-catenin, termed alpha N-catenin, which is associated with N-cadherin and
      expressed mainly in the nervous system. cDNA transfection experiments showed that
      alpha N-catenin can also bind with E-cadherin. To investigate the role of alpha N
      catenin, we transfected lung carcinoma PC9 cells, which express E-cadherin and
      beta-catenin but neither alpha- nor alpha N-catenin, with alpha N-catenin cDNA.
      While parental PC9 grew as isolated cells, the transfectant lines formed
      aggregates in which cells were tightly adhered to each other, showing epithelial
      arrangements, and they occasionally gave rise to cystic spheres. These results
      suggest that alpha N-catenin is crucial not only for cadherin function but also
      for organization of multicellular structures.

PMID- 1638633
TI  - A transcription factor with SH2 and SH3 domains is directly activated by an
      interferon alpha-induced cytoplasmic protein tyrosine kinase(s).
AB  - Interferon-stimulated gene factor 3 (ISGF3), the primary transcription factor
      induced by interferon alpha, is a complex of four (113, 91, 84, and 48 kd)
      proteins. This paper reports that the 113, 91, and 84 kd (ISGF3 alpha) proteins
      of ISGF3 contain conserved SH2 and SH3 domains. A specific interferon alpha
      induced cytoplasmic protein tyrosine kinase(s) can form a transient complex with
      ISGF3 alpha proteins. These ISGF3 alpha proteins can be immunoprecipitated by
      anti-phosphotyrosine antibodies only after interferon alpha treatment.
      Phosphoamino acid analyses of 32P-labeled ISGF3 alpha proteins confirm that ISGF3
      alpha proteins are directly tyrosine phosphorylated both in vitro and in vivo in
      response to interferon alpha, and this tyrosine phosphorylation can be inhibited
      by staurosporine and genistein. Phosphatase treatment of these ISGF3 alpha
      proteins results in inhibition of ISGF3 complex formation in vitro. These
      observations indicate that interferon alpha-induced direct tyrosine
      phosphorylation of ISGF3 alpha proteins is necessary for activation of the
      transcription factor ISGF3.

PMID- 1638634
TI  - A cDNA encoding a pRB-binding protein with properties of the transcription factor
      E2F.
AB  - The retinoblastoma protein (pRB) plays an important role in the control of cell
      proliferation, apparently by binding to and regulating cellular transcription
      factors such as E2F. Here we describe the characterization of a cDNA clone that
      encodes a protein with properties of E2F. This clone, RBP3, was identified by the
      ability of its gene product to interact with pRB. RBP3 bound to pRB both in vitro
      and in vivo, and this binding was competed by viral proteins known to disrupt pRB
      E2F association. RBP3 bound to E2F recognition sequences in a sequence-specific
      manner. Furthermore, transient expression of RBP3 caused a 10-fold
      transactivation of the adenovirus E2 promoter, and this transactivation was
      dependent on the E2F recognition sequences. These properties suggest that RBP3
      encodes E2F, or an E2F-like protein.

PMID- 1638636
TI  - Epidemiology of tendon injuries in sports.
AB  - During the last few decades, the role of sports and physical activity has become
      more and more important in all modern communities. Conditioning sports are
      generally considered positive by many governments because of their beneficial
      effect on human well-being. The risk of injury is increased, for both acute
      traumas and overuse injuries, and prevention has also become more important in
      sports. Epidemiologic studies are important when planning prevention programs for
      sports injuries. Because of individual sport cultures and different sport habits
      in different countries, national epidemiologic studies are of importance in each
      individual country.

PMID- 1638635
TI  - Expression cloning of a cDNA encoding a retinoblastoma-binding protein with E2F
      like properties.
AB  - An expression vector was modified to permit the rapid synthesis of purified, 32P
      labeled, glutathione S-transferase (GST)-retinoblastoma (RB) fusion proteins. The
      products were used to screen lambda gt11 expression libraries, from which we
      cloned a cDNA encoding a polypeptide (RBAP-1) capable of binding directly to a
      putative functional domain (the pocket) of the retinoblastoma gene product (RB).
      The RB "pocket" is known to bind, directly or indirectly, to the cellular
      transcription factor, E2F, implicated in cell growth control. We have found that
      RBAP-1 copurifies with E2F, interacts specifically with the adenovirus E4 ORF 6/7
      protein, binds specifically and directly to a known E2F DNA recognition sequence,
      and contains a functional tranasactivation domain. Therefore, RBAP-1 is a species
      of E2F and can bind specifically to the RB pocket.

PMID- 1638637
TI  - Tendinitis I: basic concepts.

PMID- 1638638
TI  - Functional anatomy and physiology of tendons.
AB  - Tendons vary in type, shape, and size. The anatomy, histology, and physiology of
      tendons are described in this article, with particular reference to those tendons
      that are vulnerable in sports medicine.

PMID- 1638639
TI  - Biomechanical loading of Achilles tendon during normal locomotion.
AB  - Direct in vivo Achilles tendon force measurements open up new possibilities for
      understanding the loading of the Achilles tendon during natural locomotion. This
      article describes how these human experiments can be performed. The results of
      these experiments imply that Achilles tendon forces are unexpectedly high in
      certain activities (e.g., hopping) and that the rates of loading rather than the
      absolute magnitudes of the recorded forces may be more relevant for clinical
      purposes as well as for the construction of artificial tendon materials.

PMID- 1638640
TI  - Cell-matrix response in tendon injury.
AB  - The healing response after tendon injury is defined by cell matrix adaptive
      capability. There are distinct macrotraumatic and microtraumatic injury patterns
      and a spectrum of pathologic responses from inflammation to tissue degeneration,
      as characterized by the tendinosis phenomenon. Epigenetic and genetic factors
      govern recovery from tendon injury. The potential for future modulation of injury
      repair by protein mediators or growth factors appears promising.

PMID- 1638641
TI  - Radiologic evaluation of tendon injuries.
AB  - This article reviews the imaging choices available to assess the tendons of the
      shoulder, knee, ankle, and wrist. Principles of tendon imaging and fundamental
      considerations of computer-derived image techniques are briefly discussed, with
      particular reference to magnetic resonance imaging. Although the criteria used to
      classify various tendon abnormalities are provided, the clinical role of imaging
      is emphasized.

PMID- 1638642
TI  - The use of eccentric training and stretching in the treatment and prevention of
      tendon injuries.
AB  - Tendon injuries are a common consequence of either sports or daily routine
      activity. Most people will suffer at least one tendon injury in his or her
      lifetime. It is therefore prudent to understand the different ways to load tendon
      and the ways in which the muscle-tendon-bone unit responds to these stresses. By
      maximizing tendon training and rehabilitation, one can maximize the stresses
      (eccentric) a tendon will withstand. This article provides an explanation of
      these principles.

PMID- 1638643
TI  - Medical modifiers of sports injury. The use of nonsteroidal anti-inflammatory
      drugs (NSAIDs) in sports soft-tissue injury.
AB  - This article provides a background for the use of nonsteroidal anti-inflammatory
      drugs (NSAIDs) in sports medicine, including the nature of the drugs, the
      settings and rationale for their use, and concerns about their general safety.
      The criteria for the ideal study to examine the efficacy and safety of NSAIDs
      after acute injury is then enumerated, including a review of how many of the
      published studies have met each of the major criteria. Selected studies are
      described to demonstrate those that have or have not provided the basis for a
      rational decision on the use of NSAIDs in sports medicine and in the treatment of
      tendinitis. Finally, this article draws conclusions based on these published
      studies.

PMID- 1638644
TI  - Physical modalities in the treatment of tendon injuries.
AB  - Physical modalities such as heat, cold, and electricity have been used for many
      years in the treatment of tendon injuries. This article examines the basic
      modalities that the athletic trainer and physical therapist use in these
      treatment programs and how well they have performed. The indications and
      contraindications for both are included.

PMID- 1638646
TI  - [Treatment of dilated cardiomyopathy in childhood].
AB  - Authors reviewed available information concerning etiology and pathophysiology of
      dilated cardiomyopathy. Diagnostic criteria and current poor results of
      conservative treatment are discussed. Between August 1984 and August 1991 67
      children with various types of cardiomyopathy underwent heart and heart and lung
      transplantation at Harefield Hospital, U.K. Dilated cardiomyopathy was the
      indication for transplantation in 47 patients (mean age at operation was 6.5
      years, range 0.3-4.8 years). Eighty-one percent actuarial survival at 4 years
      after operation represents reasonable progress in the treatment of this severe
      acquired disease. Currently, early transplantation is recommended in children
      with dilated cardiomyopathy and with low shortening fraction of left ventricle
      (below 0.13), without any improvement after 3 months of conservative treatment,
      will familial trait of dilated cardiomyopathy and/or with severe myocardial
      fibrosis.

PMID- 1638647
TI  - [Normal values of 2-dimensional echocardiographic parameters in children].
AB  - The authors examined by two-dimensional echocardiography a group of 186 healthy
      children from birth to the age of 18 years. From the assembled records they
      measured the following: the inner diameter of the inferior vena cava, the
      diameter of the abdominal aorta, the area of the right and left atrium at the end
      of systole, the width of the ring of the tricuspid and mitral valve at the end of
      diastole, the area of the right and left ventricle at the end of systole and its
      circumference, the width of the annulus of the pulmonary artery, the diameter of
      the aortic arch, the diameter of the right and left branch of the pulmonary
      artery. The systolic function of the left ventricle and the curvature of the
      ventricular septum during systole was calculated from the assessed parameters of
      the left ventricle. By means of a computer the regression equations of the
      relation of assessed echocardiographic parameters and body weight and body
      surface were calculated as well as their mean values +/- 2 standard deviations
      for the given body weight and body surface which are considered normal for the
      child population.

PMID- 1638645
TI  - Principles of rehabilitation after chronic tendon injuries.
AB  - This article describes a framework for the evaluation, diagnosis, and management
      of tendon injuries that result from repetitive microtrauma overload. These
      injuries are commonly called tendinitis injuries, but are more often degenerative
      lesions. The initial management of acute tendon injuries with rupture is usually
      quite different than that of chronic injuries, but the functional rehabilitation
      of the acute injuries can follow the same framework.

PMID- 1638648
TI  - [Treatment of a patent duct in neonates].
AB  - The authors analyze clinical and laboratory aspects of Indomethacin treatment of
      neonates with a patent ductus arteriosus. From June 1987 to November 1990 the
      authors treated 19 neonates with a patent ductus arteriosus with Indomethacin.
      The drug was administered, 0.1-0.3 mg/kg body weight, by the oral route three
      times/24 or 36 hours. In 17 infants after Indomethacin treatment the duct closed,
      in two infants the duct did not close during Indomethacin treatment, in three
      infants the authors observed oliguria which improved after discontinuation of
      treatment.

PMID- 1638649
TI  - [Personal experience with the use of human recombinant erythropoietin in the
      treatment of anemia in children with chronic renal insufficiency].
AB  - The authors analyze the course of treatment with human recombinant erythropoietin
      (rHuEPO) in five children in the preterminal stage of chronic renal insufficiency
      and one premature infant with a low birth weight and anaemia and acute renal
      insufficiency. rHuEPO was administered, 50-100 u./kg, by the s.c. route 2-3X per
      week. During the first month of treatment the haemoglobin rose from 7.0 dag/l to
      8.2 dag/l and persisted at this level approximately to the third month of
      treatment. The haematocrit reached values of 0.30 during the 4th month of therapy
      when the authors observed also the maximum increase of reticulocytes (20%). The
      authors did not find a marked decline of iron and ferritin concentrations. In the
      child with a low birth weight treatment with rHuEPO was started at the age of six
      weeks and the age haemogram was favourably influenced already after four weeks of
      treatment with rHuEPO.

PMID- 1638650
TI  - [Prevention of post-exertion airway obstruction in children and adolescents with
      bronchial asthma].
AB  - In 86 asthmatics (age 8-16 years), divided into several groups, the protective
      effects of pharmacological and non-pharmacological agents on the exercise-induced
      airway obstruction (e.i.a.o.) by 5 minutes free running were studied. There were
      studied the preventive inhalations of bronchodilators, i.e. fenoterol (0.2 mg),
      ipratropium-bromide (0.06 mg) and both combined of 0.15 mg of fenoterol and 0.06
      mg of ipratropium-bromide on the exercise-induced airway obstruction. The
      protective effects of breathing through nose as well as the effect of the
      temperature in the surrounding environment on the e.i.a.o. were studied too. The
      exercise-induced airway obstruction was assessed on the basis of parameters
      measured from maximum expiratory flow-volume curves. Maximum expiratory flow at
      25% of vital capacity was most sensitive in the assessment of e.i.a.o. The
      studied bronchodilators protected all patients against e.i.a.o. The textile face
      mask (surgical mask) put on the nose and mouth during 5 min. free running
      outdoors and in a closed room protected some asthmatics completely against
      e.i.a.o. or reduced substantially e.i.a.o. in others. The nose breathing had a
      similar effect on e.i.a.o. as the textile face mask. The surrounding temperature
      of air was not decisive in the induction of post-exercise airway obstruction. Non
      pharmacological agents ought to be thus more included among the therapeutical
      means in pediatric and adolescent asthmatics.

PMID- 1638651
TI  - [Hypertrophy of neonates in diabetic mothers and their long-term prognosis].
AB  - Hundred and seventy five infants of diabetic mother born and followed up
      carefully in the Institute for the Care of Mother and Child were examined at a
      mean age of 20.75 +/- 4.08 years. The purpose of the investigation was to assess
      the relationship of hypertrophy of neonates of diabetic mothers to other
      deviations in neonates and their long-term prognosis. In neonates with a marked
      degree of hypertrophy the authors recorded significantly more frequently
      hypoglycaemia, early asphyctic syndrome, impaired respiration and neurological
      symptoms. Children born as hypertrophic developed equally frequently diabetes
      (8.7%) as children of diabetic mothers who did not develop hypertrophy (8.0%).
      Abnormal glucose tolerance was recorded in those with hypertrophy in 6.6%, in the
      group without hypertrophy in 5.0%. As compared with the offspring of healthy
      mothers, they suffered significantly more frequently from higher blood sugar
      levels and higher insulinaemia (sigma C ad sigma I) during the oGTT. The body
      weight expressed as BMI and systolic blood pressure were also higher than in the
      control group. None of the investigated indicators in adult age was associated
      with body weight and the degree of hypertrophy. The development of diabetes is
      determined more by genetic factors.

PMID- 1638652
TI  - [A/B type behavior in relation to changes in the ocular background in juvenile
      diabetics].
AB  - Within a broadly conceived interdisciplinary project pertaining to some specific
      problems of the psychology of health (preventive psychology) attention was
      focused also on an analysis of interrelations of A/B type of behaviour and
      juvenile diabetes. The methodological basis were the results, reported in the
      work of Skorodensky, Kralikova et al in 1988 in the Journal Cs. Pediatrie (1).
      The results of this work confirmed that the Hunter-Wolf scale (for more details
      of the scale see ref. 1) relevantly divided the group of somatically healthy
      children into type A and B and that its retrospective discriminating capacity is
      adequate as regards biochemical, physiological and anthropometric values
      (specified as risk factors of IHD in adults). Children in Part A of the scale
      tended to have a higher score of the above risk factors, leading later in adult
      age to the development of IHD. Obviously only longitudinal perspective research
      of a selected sample of children can confirm definitely or rule out this
      assumption.

PMID- 1638653
TI  - [Eczema herpeticum in children: clinical picture and therapy].
AB  - The authors submit information on the course and therapeutic experience with
      acyclovir (Zovirax Wellcome Co. and Herpesin Lachema Co.) in 67 children with
      eczema herpeticatum (EH) who were hospitalized at the Clinic of Infectious Child
      Diseases in Brno from January 1983 to January 1991. In all instances treatment
      led to rapid drying of the herpetis eruptions, a shorter period of new eruption
      and rapid improvement of the serious clinical condition. In none of the children
      visceral dissemination of the virus of herpes simplex (HSV) were occurred and in
      none of the children toxic side-effects were found. The authors confirmed the
      assumed identical course of EH after i. v. administration of acyclovir of foreign
      or local origin. After i.v. administration frequently dramatic improvement of the
      general and local finding was recorded, as compared with oral administration.
      There were no therapeutic differences in the clinical effects of tablets and
      suspension, the clinical effect being comparable.

PMID- 1638654
TI  - [Histochemical findings in the atrioventricular conduction system in congenital
      heart defects].
AB  - The authors examined, using histochemical methods, the AV conduction system in
      five infants and two children who died unexpectedly with a congenital heart
      disease. The activity of "glycogen dependent" phosphorylase in the AV conduction
      system was mostly negative or weak. The probable cause of this finding is
      hypoxia, although the effect of hypotrophy must be admitted. In groups of cells
      penetrating into connective septal tissue a decrease of oxidoreductases and
      hydrolases was found. These findings may be associated with regressive changes in
      the postnatal reduction of the AV conduction system.

PMID- 1638655
TI  - [Hypophosphatasia--one of the causes of congenital rickets].

PMID- 1638656
TI  - [Recommendations for the Prague population on behavior during smog conditions].

PMID- 1638657
TI  - [The Jindrichuv Hradec model of a clinic for pediatric pneumonology. 2. Results].

PMID- 1638658
TI  - Insecticide-impregnated bed nets for malaria control: a review of the field
      trials.
AB  - Insecticide-impregnated bed nets act as a physical barrier to repel and kill
      mosquitos. Community intervention trials suggest that these nets are effective in
      preventing malaria-related mortality and morbidity--but not malaria infection--in
      areas of low and moderate transmission; the results from areas of high
      transmission are not so encouraging. Comparison of the results from these trials
      and their interpretation are difficult because of variations in the epidemiology
      of malaria and several methodological flaws. Problems such as defining
      appropriate health indicators, monitoring bed-net usage, introducing bed nets
      randomly, selecting adequate controls, performing statistical analysis, and
      comparing bed nets with other available interventions are considered. Further
      community intervention trials are needed, paying attention to the methods and to
      assessment of their impact on malaria.

PMID- 1638659
TI  - A low-cost, community-based measles outbreak investigation with follow-up action.
AB  - An outbreak of measles in Kampala, Uganda, in 1990 raised concern about the
      effectiveness of the measles vaccine that was used. The Uganda EPI programme and
      the medical office of the Kampala City Council therefore conducted a community
      based investigation, with door-to-door interviews in two selected communities.
      They revealed 68 measles cases ranging in age from 5 months to 12 years; the
      highest age-specific attack rate (32%) was found in children aged 12 to 23
      months. BCG immunization coverage was high (85%), but measles immunization
      coverage was moderate (48%). One community, served by a mobile clinic, presented
      a vaccine efficacy of only 55%. Responses by mothers revealed that many had
      failed to have their children completely immunized because of a lack of
      information, and not because of difficulties in access to the service. In a
      follow-up, community leaders initiated monthly checking of immunization cards of
      both children and mothers. The low vaccine efficacy found in one of the
      communities resulted in a thorough assessment of the city's cold chain. This
      community-based approach proved to be cost-effective and practical for
      identifying the obstacles to effective immunization delivery.

PMID- 1638660
TI  - Detection of HIV-1 antibodies in blood specimens spotted on filter-paper.
AB  - Described are the results of an international collaborative study to evaluate the
      use of whole blood samples spotted on filter-paper (BSP) for the detection of
      antibodies to human immunodeficiency virus type 1 (HIV-1). BSP samples were
      collected from 40 patients at risk for HIV-1 infection and tested blindly using
      commercially available HIV antibody test kits, either specifically manufactured
      or modified for this purpose. Parallel serum samples were also collected, and the
      antibody reactivity was defined and confirmed by Western blot. The results
      demonstrate that recovery of antibodies from BSP samples after elution can be
      comparable to that from serum. Some kits can be easily adapted to test BSP
      samples, while others cannot. At present, detection of HIV antibodies in BSP
      samples should therefore be carried out using kits specifically manufactured for
      this purpose or by the development of a modified protocol using a panel of BSP
      and their corresponding serum specimens.

PMID- 1638661
TI  - Missed opportunities for immunization during visits for curative care: a
      randomized cross-over trial in Sudan.
AB  - Infants who come to health facilities for curative care in developing countries
      are usually not vaccinated at the same time. To assess what could be done a
      randomized cross-over study was carried out in twelve urban health centres in
      Sudan where two approaches were investigated: (1) the place for vaccination was
      moved very close to the consulting room, and (2) the doctor seeing the infant
      wrote a prescription recommending vaccination for the child. On average, 55% of
      the infants needing immunization were vaccinated when either of these approaches
      was followed. No difference was found between the two interventions in terms of
      the proportion of eligible children who were immunized (mean difference, 2%; 95%
      Cl, -4% to +7%). The more sick an infant appeared to be to the mother, the more
      likely she was to refuse vaccination. Older infants and infants not previously
      vaccinated were also less likely to be immunized. The number of missed
      opportunities can thus be reduced using these simple approaches. However, to
      immunize infants who are sick, unvaccinated, or have limited access to health
      facilities will require more social mobilization, health education, and outreach
      activities.

PMID- 1638662
TI  - Ten years of kala-azar in west Bengal, Part I. Did post-kala-azar dermal
      leishmaniasis initiate the outbreak in 24-Parganas?
AB  - Following resurgence in Bihar of epidemic kala-azar, outbreaks of the disease
      were identified simultaneously in two separate foci about 500 km apart in West
      Bengal in 1980. While the outbreak in one of these foci, in northern West Bengal,
      was the result of a direct extension of the Bihar epidemic, the source of
      parasite in the other (in the village of Bandipur in the south of West Bengal)
      remained unknown until a case of nodulo-ulcerative post-kala-azar dermal
      leishmaniasis (PKDL) was located in the village. The continued presence of this
      case in the village from a time long before the outbreak aroused strong suspicion
      about its causal role. Laboratory-bred female Phlebotomus argentipes sandflies
      were allowed to feed on four cases of PKDL, including the case from Bandipur, to
      determine the transmission potential of these cases. Of a total of 400 flies in
      the experiment, 104 (26%) fed on the cases, and of these flies 44 died (31 within
      48 hours of feeding). Of the surviving 60 flies, 32 developed promastigotes in
      the mid-gut. In view of the presence of the case of PKDL in the village prior to
      the outbreak and the availability of a susceptible human population and vectors,
      it is possible that the patient with PKDL was a source of Leishmania donovani
      parasites for the local focus. Furthermore, PKDL may act as a reservoir of
      parasites during inter-epidemic periods.

PMID- 1638663
TI  - Factors influencing the response to chemotherapy in human cystic echinococcosis.
AB  - As the effectiveness of mebendazole and albendazole in patients with
      echinococcosis has been found to vary, we investigated some of the factors likely
      to be responsible. A total of 79 patients who were treated with mebendazole (44
      patients) or albendazole (35 patients) were included in the study. Evaluation of
      the treatment results was based on the changes in cyst morphology, as evidenced
      by the results of X-ray radiography, sonography, and computed tomography, and on
      analysis of the findings in relation to parasitic and drug factors. The response
      of cysts according to their site did not vary much, with the exception of the
      poor response of bone cysts. A more important factor seems to be cyst size, since
      the treatment was more efficacious against smaller and younger cysts. The
      presence of daughter cysts should be regarded as an unfavourable factor for
      treatment response. Cyst multiplicity did not present insurmountable
      difficulties, provided the cysts were small and a prolonged course of therapy was
      undergone. The choice of drug used for the therapy was important, with the
      results supporting the advantage of albendazole. In planning the chemotherapy of
      hydatid disease, factors such as cyst condition and drug used should therefore be
      taken into consideration.

PMID- 1638664
TI  - [Comparative study of 3 bacteriological tests of cerebrospinal meningitis during
      the epidemiological period].
AB  - During an outbreak of group A meningococcal meningitis in Chad in 1988, a
      comparative study of three bacteriological techniques (direct microscopic
      examination, latex agglutination, and culture) was conducted with 120 samples of
      cerebrospinal fluid (CSF) for diagnosis. The results correlated well with cloudy
      or purulent CSF specimens. Direct microscopic examination was as good a
      diagnostic indicator as the other tests. The authors recommend using direct
      microscopic examination, which is easy to perform under field conditions and
      accurate enough for a rapid diagnosis of cerebrospinal meningitis during an
      epidemic. However, complete identification of the first cases in the epidemic is
      important in order to establish control measures as soon as possible.

PMID- 1638665
TI  - Susceptibility of Plasmodium falciparum strains to mefloquine in an urban area in
      Senegal.
AB  - A total of 47 nonimmune febrile patients from Pikine, Senegal, with greater than
      1,000 Plasmodium falciparum asexual forms per microliter whole blood were given
      12.5 mg per kg body weight of mefloquine in a single oral dose and were followed
      up daily until day 7 and also on day 14 of the study. Seven of the patients who
      vomited, four who had 4-aminoquinolines in their blood, and five dropouts were
      excluded. Fever and parasitaemia were suppressed within four days until day
      fourteen in 29 of the 31 remaining patients, including 10 with P. falciparum
      strains that had a low sensitivity to mefloquine. Two failures were due to poor
      absorption of mefloquine. The presence of P. falciparum strains with low in vitro
      susceptibility to mefloquine did not affect, within 14 days, the clinical and
      parasitological efficacy of a single oral dose mefloquine regimen in patients who
      had received no previous antimalarial treatment and who did not have partial
      immune protection.

PMID- 1638666
TI  - Epidemiology of blindness and visual impairment in Vanuatu.
AB  - A population-based survey of blindness was conducted in Vanuatu. Data were
      gathered on a sample of 3520 of the approximately 150,000 inhabitants of Vanuatu
      aged at least 6 years, in order to estimate the prevalence and causes of
      blindness among the whole population. An overall prevalence of blindness of 4.0
      per 1000 was found, 85% of which was due to cataract, an avoidable cause of this
      disability.

PMID- 1638668
TI  - Public health actions and nuclear emergencies.

PMID- 1638667
TI  - Health care utilization patterns in developing countries: role of the technology
      environment in "deriving" the demand for health care.
AB  - Health care services, in combination with several intermediate (proximate)
      determinants of health such as environmental sanitation and nutrition, directly
      influence health status. In the economics literature, this is referred to as the
      health production technology. Although many studies recognize that demand for
      health care depends on the health production technology, otherwise known as a
      "derived" demand, this review indicates that few of them have so far been able to
      fully incorporate this technology in estimating significant determinants of
      health care use. Understanding the technology environment could help explain why
      substantial portions of the population do not gain access to care even when
      financial factors do not appear to be a barrier. Also, low utilization of health
      services may simply reflect the low productivity of these services when other
      complementary factors such as nutrition or clean water and sanitation are
      lacking. Finally, since health-producing technology is often a multistep
      (multivisit) process, health care demand studies generally offer an incomplete
      picture of health care utilization patterns because they focus on a single event
      such as the first visit of an illness episode. Researchers should obtain more
      complete information on the interaction between all health production inputs,
      their availability and access to them. Multidisciplinary methodologies are likely
      to be useful.

PMID- 1638669
TI  - Expanded programme on immunization for the 1990s.

PMID- 1638670
TI  - Human biomonitoring and the 32P-postlabeling assay.

PMID- 1638671
TI  - Phorone (diisopropylidene acetone), a glutathione depletor, decreases rat
      glucocorticoid receptor binding in vivo.
AB  - The exact mechanism by which carcinogens and tumor promoters act on the
      glucocorticoid receptor system in vivo is not known. Based on earlier studies
      that sulfhydryl-reducing agents stabilize glucocorticoid receptor binding in
      vitro, some workers have postulated that endogenous reducing factors may be
      important for glucocorticoid receptor function in vivo. To test whether
      glutathione (GSH) may serve this purpose, we investigated the effects of phorone,
      an agent that partially depletes intracellular GSH, on the hepatic cytosolic
      glucocorticoid receptor (GRc) binding characteristics in intact and 7-10 day
      adrenalectomized (ADX) adult female Sprague-Dawley rats. Biochemical analysis
      revealed that a single treatment of phorone (300 mg/kg) to both intact and ADX
      rats significantly decreased the liver GSH concentration (70-90% of control
      levels) as well as the GRc maximum binding concentration (30% of control levels).
      The decrease in GSH levels preceded the reduction in GRc maximum binding
      concentrations; both effects were reversible after 24 h of treatment. The phorone
      mediated decrease of GSH levels was maximum at doses greater than 75 mg/kg,
      whereas GRc maximum binding concentrations in vivo appeared dose dependent up to
      400 mg/kg. Pretreatment with phorone or the carcinogens mirex and 3
      methylcholanthrene significantly decreases GRc binding and nuclear uptake in
      vivo, as well as diminishes intracellular cytosolic GSH levels. Although a
      temporal relationship between the GSH levels and the GRc maximum binding
      concentrations in vivo was observed, there was no quantitative relationship
      between these two parameters based on our phorone dose-response and the
      carcinogen pretreatment data. Our findings suggest that during the early phases
      of carcinogenesis, the hepatocellular GSH does not play a direct role upon the
      biochemical action of certain carcinogens and tumor promoters on the
      glucocorticoid receptor binding in the liver.

PMID- 1638672
TI  - Acetoxime is metabolized by human and rodent hepatic cytochrome P450 enzymes to
      the genotoxicant and carcinogen propane 2-nitronate.
AB  - The hepatocarcinogenicity of acetoxime has been tentatively linked with its
      metabolic oxidation to the potent genotoxicant and carcinogen propane 2-nitronate
      (P2-N). In order to test the hypothesis that acetoxime is metabolized to P2-N,
      the oxime (20 mM) was incubated with liver microsomes from mice, rats and two
      humans. Ion-pair HPLC analysis of the incubates afforded a peak that co-eluted
      with P2-N. P2-N exists in tautomeric equilibrium with 2-nitropropane (2-NP).
      Samples of the microsomal incubates, which had been adjusted to pH 5.5 and kept
      for 24 h in order to allow maximal tautomeric equilibration of P2-N to 2-NP to
      occur, were extracted with hexane. GLC analysis of the extracts yielded a peak
      that co-eluted with 2-NP, and gave a mass spectrum identical to that of authentic
      2-NP. The metabolite peak obtained on HPLC was isolated and its hexane extract
      contained also 2-NP when investigated by GLC. P2-N was found by HPLC in the urine
      of rats that had received acetoxime (3.36 mmol/kg i.p.). Hexane extracts of urine
      samples, which had been adjusted to pH 5.5 and left for 24 h, contained 2-NP as
      demonstrated by GLC analysis. The results are consistent with the suggestion that
      the toxicity of acetoxime is associated with its biotransformation to P2-N.

PMID- 1638673
TI  - Chromosome aberrations following cytotoxic therapy in patients in complete
      remission from lymphoma.
AB  - The frequency of chromosome aberrations in the peripheral blood of patients
      successfully treated for Hodgkin's disease (HD) and non-Hodgkin's lymphoma is
      compared with that seen in age-matched haematologically normal subjects. Findings
      are considered in relation to risk factors associated with the development of
      secondary myelodysplastic syndrome (MDS) or acute myeloid leukaemia (AML).
      Overall aberration frequencies were not significantly increased in patients
      compared with normal subjects. However, there were differences in aberration
      type. The frequency of exchanges was significantly higher among patients (P less
      than 0.01) and the frequency of gaps lower (P less than 0.0005). The mean
      frequency of exchanges was also greater in patients receiving multiple compared
      to single courses of therapy (P less than 0.0005) and in patients receiving
      radiotherapy or combined modality therapy compared to chemotherapy alone (P less
      than 0.005 and P less than 0.0005). Four patients had aberration frequencies
      greater than 2 SD above the patient mean. One of these was also found to have a
      mutation of the ras oncogene. None of the patients has yet developed secondary
      MDS/AML.

PMID- 1638674
TI  - Systemic and local carcinogenesis by directly acting N-nitroso compounds given to
      rats by intravesicular administration.
AB  - A number of directly acting carcinogenic N-nitroso compounds were administered to
      female F344 rats intravesically, to assess their ability to induce tumors locally
      in the urinary bladder and systemically following absorption through the bladder
      mucosa. The compounds were alkylnitosoureas and alkylnitrosocarbamates and could
      be formed by interaction of amides with bacterially produced nitrite in infected
      bladders. Methylnitrosourethane was very toxic: doses of 1-2 mg caused death of
      some rats. A total dose of 0.15 mmol of ethylnitrosourethane, which was much less
      toxic, was administered to each rat and almost all developed bladder tumors.
      Ethylnitrosourea also gave rise to bladder tumors following intravesical
      treatment, and induced some tumors systemically, whereas methylnitrosourea, 2
      methoxyethylnitrosourea and 2-hydroxypropylnitrosourea induced bladder tumors in
      high incidence and few tumors systemically. Nitrosooxazolidone was quite toxic
      and induced few bladder tumors. The dialkylnitrosoureas were more stable and some
      induced more tumors systemically than the monoalkylnitrosoureas. 1,3
      Dimethylnitrosourea induced no bladder tumors and 1,3-diethylnitrosourea very
      few, but both induced tumors systemically that were similar to those induced by
      gavage treatment of rats. 1-Ethyl-1-nitroso-3-hydroxyethylurea, 1-hydroxyethyl-1
      nitroso-3-ethylurea and 1-(2-hydroxypropyl)-1-nitroso-3-(2-chloroethyl)-urea
      induced bladder tumors in a majority of rats treated intravesically; the first
      induced many tumors systemically. Most of the bladder tumors were transitional
      cell papillomas and carcinomas, but there were a few squamous cell tumors, smooth
      muscle tumors, sarcomas and carcinosarcomas. The effects of intravesical
      administration of the directly acting alkylating compounds are compared with the
      effects of similar doses given to rats by gavage.

PMID- 1638675
TI  - Inhibition of cellular transformation by triphenylmethane: a novel
      chemopreventive agent.
AB  - Triphenylmethane (TPM) was found to inhibit 3-methyl-cholanthrene-induced
      neoplastic transformation of 10T1/2 cells in a dose-dependent manner (ED50 = 2.8
      microM). This activity was independent of any effect on intercellular
      communication and did not appear to be directly related to the general
      antioxidant properties of TPM as measured by cellular thiobarbituric acid
      reactive substances. Triphenylmethanol (TPMOL) and diphenylmethane also inhibited
      transformation (ED50 = 6.9 and 90 microM respectively). TPM had no effect on the
      proliferation of exponentially growing cells. At higher concentrations TPM and
      its analogues enhanced plating efficiency of cells indicating no significant
      toxicity for these compounds at levels up to 50 microM. The inhibitory effects of
      TPM on transformation were reversible when TPM was removed from the medium. While
      TPM had no effect on the growth of fully transformed cell lines, it was able to
      inhibit the growth of 1/3 neoplastic foci in the presence (but not absence) of
      10T1/2 cells. TPM was found to stimulate protein kinase C (PKC) activity for both
      crude C3H10T1/2 cytosolic PKC and purified PKC obtained from rat brain. The
      ability of TPM to stimulate PKC activity appeared to be dependent on [CaCl2] and
      the order of reagent addition in the assay. Tamoxifen, a structurally related
      compound to TPM, was also found to enhance PKC activity over the same
      concentration range but was less potent than TPM. The biological effects of TPM
      and related compounds indicate that they function in a manner distinct from other
      highly unsaturated transformation inhibitors such as carotenoids and retinoids.
      The inability of triphenylene to inhibit transformation suggests that a reactive
      methyl carbon may be essential for activity.

PMID- 1638676
TI  - Alterations in protein kinase C isozymes alpha and beta 2 in activated Ha-ras
      containing papillomas in the absence of an increase in diacylglycerol.
AB  - The levels of protein kinase C (PKC) activity, PKC isozymes, as well as the level
      of endogenous diacylglycerols (DAG) were examined in early emergence mouse skin
      papillomas and compared to the levels in the epidermis. The papillomas were
      derived from a two-stage carcinogenesis protocol in which mice were initiated
      with 7,12-dimethylbenz[a]anthracene (DMBA) and promoted twice weekly for only 12
      weeks with 12-O-tetradecanoylphorbol-13-acetate (TPA). As expected, greater than
      90% of these early emergence papillomas contained an activated Ha-ras gene with
      an A----T transversion in the 61st codon. There was a TPA-independent,
      irreversible decrease in total PKC activity (70%) in the early emergence
      papillomas compared to that in the epidermis. Immunoblot analysis of epidermis
      and papillomas taken 4 weeks following the cessation of TPA treatment, a time
      when PKC catalytic activity has completely recovered to control level in
      epidermis but not in papillomas, revealed that the levels of PKC-alpha and PKC
      beta 2 were dramatically decreased in the cytosol of the papillomas, while the
      levels of these two isozymes in the particulate fraction were approximately equal
      to the epidermis. PKC-delta, -epsilon and -zeta immunoreactive proteins were
      present in both epidermis and papillomas and only minor changes were observed in
      the papillomas. PKC-delta and PKC-epsilon displayed a particulate fraction
      localization in both the epidermis and papillomas, while PKC-zeta was found in
      both subcellular fractions. We were unable to detect PKC-gamma in mouse epidermis
      or papillomas. Since the level of DAG has been shown to be elevated in some ras
      transformed cells, we examined DAG levels in the papillomas, as an increased DAG
      level could explain the constitutive decreases in the levels of PKC. Measurements
      of cellular DAG indicated that there was no elevation in the total pool of DAG in
      the early emergence papillomas. These data demonstrate an irreversible decrease
      in and alteration of the subcellular distribution of PKC-alpha and beta 2 in DMBA
      initiated/TPA-promoted papillomas. These changes are TPA-independent, and occur
      in the absence of an elevation in the total pool of endogenous DAG. These
      alterations of PKC isozymes may be important early events in multistage
      tumorigenesis.

PMID- 1638677
TI  - Inhibition of 2-amino-3-methylimidazo[4,5-f]quinoline (IQ)-DNA binding by
      chlorophyllin: studies of enzyme inhibition and molecular complex formation.
AB  - Chlorophyllin (CHL), a copper/sodium salt of chlorophyll used in the treatment of
      geriatric patients, is an anti-mutagen that has been demonstrated to inhibit
      carcinogen--DNA binding in vivo. To study the mechanism of inhibition, the
      microsomal metabolism of 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and the
      kinetics of IQ--DNA binding were investigated in the presence and absence of CHL.
      In time-course studies, CHL produced greater than 80% inhibition of IQ--DNA
      binding and blocked the metabolism of IQ, such that 80% of the initial dose of
      carcinogen was recovered unmetabolized from the incubations after 1 h. Kinetic
      constants were determined for the in vitro DNA binding reaction, with the
      reaction rate measured as 'pmol IQ bound/mg DNA/min/mg microsomal protein'.
      Without altering V(max), the Km of the IQ--DNA binding reaction was increased by
      CHL, and the replot of Km/V(max) versus CHL concentration yielded a straight line
      with an inhibitor constant of 58.3 microM CHL. Spectrophotometric studies
      provided evidence in vitro for the formation of a non-covalent complex between
      CHL and IQ. The CHL--IQ complex had a stoichiometric ratio of 2:1 (mole ratio
      method) and an apparent dissociation constant from the Benesi-Hilderbrand plot of
      1.41 x 10(-4)M at pH 7.4. These results are discussed in the context of a CHL
      inhibitory mechanism involving enzyme inhibition and molecular complex formation.

PMID- 1638678
TI  - Detection and characterization by 32P-postlabelling of DNA adducts induced by a
      Fenton-type oxygen radical-generating system.
AB  - Reactive oxygen species can give rise to numerous modifications of DNA. We have
      investigated the formation of such modifications using the nuclease P1 digestion
      method of the 32P-postlabelling procedure for the detection of DNA damage.
      Analysis of DNA that had been treated with a Fenton-type system of copper (or
      iron) ions and H2O2 resulted in the detection of up to ten discrete 32P-labelled
      spots, displaying chromatographic characteristics similar to aromatic adducts, on
      PEI-cellulose TLC. Maximum total levels equivalent to 28 adducts/10(8)
      nucleotides were achieved after 15 min of treatment with Cu2+/H2O2. The formation
      of adducts was 1.5 times greater if single-stranded rather than double-stranded
      DNA was employed, suggesting an intrastrand effect. Experiments with 3'
      deoxyribonucleotides demonstrated that the adducts detected did not represent
      base modifications such as 8-hydroxydeoxyguanosine or thymidine glycols. However,
      treatment of specific dinucleotides (dApdG and dApdA) was found to produce two
      major adducts that were chromatographically identical by TLC and HPLC to the two
      major adducts formed in DNA. It is proposed that these species with aromatic
      adduct-like characteristics are the result of the intrastrand linking of specific
      adjacent bases in DNA.

PMID- 1638679
TI  - Role of DNA repair in malignant neoplastic transformation of human mammary
      epithelial cells in culture.
AB  - Epithelial cells derived from normal human mammary tissue were examined for
      capacity to repair radiation-induced chromatin DNA damage. Repair capacity was
      estimated by quantifying chromatid aberrations in metaphase cells arrested 0.5
      1.5 h after X-irradiation during G2. The parental cells at passage 12 had 19
      chromatid breaks and 16 gaps per 100 metaphase cells, representing efficient
      repair. Of two continuous cell lines, derived after benzo[a]pyrene treatment, A1
      maintained the efficient repair phenotype through passage 50, while a subline of
      A1 developed the repair-deficient phenotype characterized by a 3- to 5-fold
      higher frequency of chromatid breaks or gaps. This line was transformed to
      tumorigenic cells by HaMSV and SV40 T antigen. The second continuous line B5 and
      derivatives had 102-165 chromatid breaks and 87-134 gaps per 100 metaphases
      (deficient repair phenotype). This line was transformed to tumorigenic cells by
      KiMSV. As reported previously for human epidermal keratinocytes, acquisition of
      this repair-deficient phenotype appears to be an early requisite step in the
      malignant neoplastic transformation of human cells in culture.

PMID- 1638680
TI  - Comparison of the biotransformation of 1,3-butadiene and its metabolite,
      butadiene monoepoxide, by hepatic and pulmonary tissues from humans, rats and
      mice.
AB  - 1,3-Butadiene (BD), a widely used monomer in the production of synthetic rubber
      and other resins, is one of the 189 hazardous air pollutants identified in the
      1990 Clean Air Act Amendments. BD induces tumors at multiple organ sites in
      B6C3F1 mice and Sprague-Dawley rats; mice are much more susceptible to the
      carcinogenic action of BD than are rats. Previous in vivo studies have indicated
      higher circulating blood levels of butadiene monoepoxide (BMO), a potential
      carcinogenic metabolite of BD, in mice compared to rats, suggesting that species
      differences in the metabolism of BD may be responsible for the observed
      differences in carcinogenic susceptibility. The metabolic fate of BD in humans is
      unknown. The objective of these studies was to quantitate in vitro species
      differences in the oxidation of BD and BMO by cytochrome P450-dependent
      monooxygenases and the inactivation of BMO by epoxide hydrolases and glutathione
      S-transferases using microsomal and cytosolic preparations of livers and lungs
      obtained from Sprague-Dawley rats, B6C3F1 mice and humans. Maximum rates for BD
      oxidation (Vmax) were highest for mouse liver microsomes (2.6 nmol/mg
      protein/min) compared to humans (1.2) and rats (0.6). The Vmax for BD oxidation
      by mouse lung microsomes was similar to that of mouse liver but greater than 10
      fold higher than the Vmax for the reaction in human or rat lung microsomes.
      Correlation analysis revealed that P450 2E1 is the major P450 enzyme responsible
      for oxidation of BD to BMO. Only mouse liver microsomes displayed quantifiable
      rates for metabolism of BMO to butadiene diepoxide (Vmax = 0.2 nmol/mg
      protein/min), a known rodent carcinogen. Human liver microsomes displayed the
      highest rate of BMO hydrolysis by epoxide hydrolases. The Vmax in human liver
      microsomes ranged from 9 to 58 nmol/mg protein/min and was at least 2-fold higher
      than the Vmax observed in mouse and rat liver microsomes. The Vmax for
      glutathione S-transferase-catalyzed conjugation of BMO with glutathione was
      highest for mouse liver cytosol (500 nmol/mg protein/min) compared to human (45)
      or rat (241) liver cytosol. In general, the KMs for the detoxication reactions
      were 1000-fold higher than the KMs for the oxidation reaction. Because of the low
      solubility of the BD and the relatively high KM for oxidation, it is likely that
      the Vmax/KM ratio will be important for BD and BMO metabolism in vivo. In vivo
      clearance constants were calculated from in vitro data for BD oxidation and BMO
      oxidation, hydrolysis and GSH conjugation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1638681
TI  - Inhibitory effect of calcium chloride on gastric carcinogenesis in rats after
      treatment with N-methyl-N'-nitro-N-nitrosoguanidine and sodium chloride.
AB  - The effects of calcium chloride on glandular stomach carcinogenesis induced by N
      methyl-N'-nitro-N-nitrosoguanidine (MNNG) and sodium chloride were investigated
      in male outbred Wistar rats. Animals were given MNNG solution (100 p.p.m.) as
      drinking water and simultaneously fed a diet supplemented with 5% sodium chloride
      for 8 weeks. Matched negative controls received neither MNNG nor sodium chloride.
      Rats were then fed basal diet and given calcium chloride solution (1 or 0.2%) or
      tap water for the following 52 weeks. The incidences and multiplicities of
      preneoplastic hyperplasias in the glandular stomachs of rats given MNNG/sodium
      chloride followed by 1 and 0.2% calcium chloride were significantly lower than
      those in rats given MNNG/sodium chloride alone. The inhibitory effects of calcium
      were exerted in a dose-dependent manner. Calcium treatment also showed a tendency
      to inhibit the development of gastric adenocarcinomas although this was not
      statistically significant. Rats without carcinogen treatment had neither
      carcinomas nor preneoplastic hyperplasias in the glandular stomach. Calcium
      intake also significantly reduced the levels of malondialdehyde, a measure of
      lipid peroxidation, in the gastric mucosa and urine, the former in a dose
      dependent manner. Thus, calcium chloride exerted inhibitory effects when given
      during the post-initiation phase of two-stage glandular stomach carcinogenesis in
      rats.

PMID- 1638682
TI  - Comparison of selenium and sulfur analogs in cancer prevention.
AB  - Several organoselenium compounds have been shown to have powerful
      anticarcinogenic activity. In view of certain similarities between selenium and
      sulfur biochemistry, we have evaluated the chemopreventive efficacy of three
      pairs of analogs using the 7,12-dimethylbenz[a]anthracene (DMBA)-induced mammary
      tumor model in rats. The compounds tested were selenocystamine/cysteamine,
      Semethylselenocysteine/S-methylcysteine, selenobetaine/sulfobetaine. In the first
      study, each agent was added to the basal AIN-76A diet and was given before and
      continued after DMBA treatment until the end. All three selenium compounds were
      active; a 50% inhibition was achieved at approximately 25 x 10(-6) mol/kg with Se
      methylselenocysteine and selenobetaine and at approximately 40 x 10(-6) mol/kg
      with selenocystamine. In the sulfur series, only cysteamine and S-methylcysteine
      produced anticancer activity, and the levels required for comparable responses
      were 500- to 750-fold higher compared to the corresponding selenium analogs.
      Sulfobetaine was inactive even when present at near maximally tolerated levels.
      In the second study, Se-methylselenocysteine and S-methylcysteine were chosen for
      further examination during the initiation and post-initiation phases of mammary
      carcinogenesis. Se-Methylselenocysteine was effective when it was given either
      before or after DMBA administration. In contrast, S-methylcysteine was effective
      only after DMBA treatment. Thus, compared to the sulfur structural analogs,
      selenium compounds are much more active in cancer protection and may have a multi
      modal mechanism in preventing cellular transformation as well as in delaying or
      inhibiting the expression of malignancy after carcinogen exposure.

PMID- 1638683
TI  - Effects of ethanol and various alcoholic beverages on the formation of O6
      methyldeoxyguanosine from concurrently administered N-nitrosomethylbenzylamine in
      rats: a dose-response study.
AB  - Consumption of alcoholic beverages has been identified as a major cause of
      oesophageal cancer in industrialized countries, with an exceptionally high risk
      associated with apple-based liquors (calvados). In the present study, we have
      determined the dose--activity relationship of the effects of coincident ethanol
      on the formation of O6-methyldeoxyguanosine (O6-MEdG) by the oesophageal
      carcinogen N-nitrosomethylbenzylamine (NMBzA). Male Fischer 344 rats received a
      single intragastric dose of NMBzA (2.5 mg/kg body wt; 7.4 ml/kg body wt) in tap
      water containing 0-20% ethanol (v/v). Survival time was 3 h. In controls,
      concentrations of O6-MEdG were similar in oesophagus, lung and liver (11-14.9
      mumol/mol dG). In oesophagus, coincident ethanol increased levels of O6-MEdG from
      15.2 mumol/mol (0.1% ethanol) to 46.0 mumol/mol (20%). This increase was dose
      dependent for 1-20% ethanol; however, low doses produced a larger effect per gram
      of ethanol than higher doses. In lung, concentrations of O6-MEdG increased from
      11 mumol/mol (0.1%) to a plateau value of 24 mumol/mol (greater than or equal to
      5%). In nasal mucosa, an increase in O6-MEdG from 3.9 mumol/mol (controls) to
      30.7 mumol/mol was observed with 4% ethanol. Effects of ethanol on hepatic DNA
      methylation were statistically non-significant. Modulation of NMBzA bioactivation
      by various alcoholic beverages (adjusted to 4% ethanol) was also investigated.
      Increases in oesophageal O6-MEdG were similar (+50% to +116%) with pear brandy,
      rice wine (sake), farm-made calvados, gin, Scotch whisky, white wine, Pilsner
      beer and aqueous ethanol. Significantly higher increases were elicited by
      commercially distilled calvados (+125%) and red burgundy (+162%). In contrast to
      its effects at an ethanol content of 4%, farm-made calvados diluted to 20%
      ethanol produced significantly higher (+200%) increases in oesophageal DNA
      methylation than aqueous ethanol (+148%). Our results show that ethanol is an
      effective modulator of nitrosamine bioactivation in vivo at intake levels
      equivalent to moderate social drinking, and that some alcoholic beverages contain
      congeners that amplify the effects of ethanol, suggesting that modulation of
      nitrosamine metabolism by acute ethanol may play a role in the etiology of human
      cancer.

PMID- 1638684
TI  - Variant protein patterns in hepatomas and transformed liver cell lines as
      determined by high resolution two-dimensional gel electrophoresis (2DE).
AB  - Deviations in the pattern of soluble proteins from chemically induced primary rat
      hepatomas and from transformed, tumorigenic liver cell lines were determined by
      high resolution two-dimensional gel electrophoresis (2DE). As compared with the
      protein pattern of normal rat liver with approximately 1300 protein spots visible
      in silver-stained gels, quantitative and qualitative alterations were found in
      hepatomas including neoexpression of glutathione-S-transferase P, as described
      earlier. After correction for proliferation-related changes by comparison with
      gels of cells from regenerating rat liver, 30 protein variants remained, which
      were identically up- (n = 6) or down-regulated (n = 18) or were detected as new
      spots (n = 6) in primary hepatomas and transformed tumorigenic liver cell lines
      which are devoid of contaminating nonparenchymal cells. Seven of these variants
      showed a reduced expression in short-term cultured liver cells indicating
      dedifferentiation processes in the transformed state. Several hepatoma- and
      transformation-associated variants were found in clusters of similar mol. wt
      and/or pI, among them a complex of eight protein variants at approximately 33
      35.5 kDa and a pI of approximately 6.6-7.4. Spots of this cluster show
      considerable changes between the investigated experimental groups and might be
      suited for being studied at the level of posttranslational modification during
      carcinogenesis.

PMID- 1638685
TI  - Cytotoxic and mutagenic effects of methylnitrosourea in two human fetal
      fibroblast strains differing in O6-methylguanine-DNA methyltransferase activity.
AB  - A non-transformed human fibroblast strain, GM11, established from the skin of a
      therapeutically aborted fetus, has been reported to exhibit the Mer- phenotype,
      i.e. inability to support the growth of adenovirus 5 damaged with 1-methyl-3
      nitro-1-nitrosoguanidine. In the present study we determined (i) loss of colony
      forming ability and frequency of mutants resistant to 6-thioguanine (6TG) on
      exposure to the SN1 alkylating agent methylnitrosourea (MNU) and (ii) amount of
      O6-methylguanine-DNA methyltransferase (MGMT), the protein responsible for
      repairing O6-methylguanine (O6mG) produced by MNU, in GM11 cells compared to
      GM10, a Mer+ human fetal fibroblast strain. Irrespective of in vitro culture age,
      GM10 cells responded normally to the cytotoxic action of the alkylating agent,
      i.e. their clonogenic survival curves exhibited a shoulder at low MNU
      concentrations (less than or equal to 0.4 mM) and a D10 (dose reducing survival
      to 10%) of approximately 1.4 mM. By contrast, no shoulder was observed on the
      survival curves of GM11 cells and their D10 values decreased from approximately
      0.6 mM at passage 4 to 0.1 mM at passage 27. In GM10 (Mer+) cells, unlike the
      biphasic dose response seen for cell killing, the frequency of 6TG-resistant
      mutants increased as a linear function of chemical concentration delivered (range
      0.05-1.2 mM); the induced mutation frequency in these cells (passage 16-20) was
      equal to 220 x 10(-6)/mM MNU, a yield some 5-fold greater than that reported by
      others for non-fetal human fibroblasts. GM11 cells proved to be only
      approximately 1.5 times more mutable by MNU than GM10 cells at late passage, and
      the susceptibility of the former strain to MNU-induced mutations did not change
      significantly as a function of culture age (i.e. 316 x 10(-6) and 326 x 10(-6)
      mutants/mM MNU at passages 4 and 16-20 respectively). The GM10 strain contained
      approximately 75,000 MGMT molecules/cell at all passages (4-20) examined, whereas
      the GM11 strain harbored deficient amounts of the protein (approximately 22,500
      molecules/cell) at the lowest passage available (4), and this residual activity
      decreased precipituously to undetectable amounts by passage 16. Together, these
      data demonstrate that in the two human fetal strains examined the constitutive
      level of cellular MGMT activity correlates much better with resistance to
      reproductive inactivation than with mutagenesis by MNU, implying that inefficient
      repair of O6meG lesions impacts more severely on cell lethality than on mutation
      induction in at least some biological systems.

PMID- 1638686
TI  - Effects of cytochrome P450 inducers on I-compounds in rat liver and kidney DNA.
AB  - I-compounds are covalent DNA modifications presumably derived from endogenous
      electrophiles. To investigate the possible role of cytochrome P450 in I-compound
      metabolism, groups of female Sprague-Dawley rats (225-250 g) were treated i.p.
      with vehicle or cytochrome P450 inducers, i.e. 80 mg/kg phenobarbital (PB), 20
      mg/kg 3-methylcholanthrene (MC) or 50 mg/kg pregnenolone-16 alpha-carbonitrile
      (PCN), once daily for 4 days. DNA synthesis rate was measured via
      [3H]methylthymidine incorporation. DNA adducts and I-compounds in liver and
      kidney were analyzed 1 and 8 days after the last treatment. Total liver and
      kidney microsomal cytochrome P450 content and activities of representative drug
      metabolizing enzymes for PB, MC and PCN, i.e. benzphetamine N-demethylase,
      ethoxycoumarin O-deethylase (ECD) and erythromycin N-demethylase, were also
      determined in all groups. PCN caused significant depletion of total non-polar I
      compounds at 1 day, compared to controls. Levels of several individual I-spots in
      liver were differentially reduced by each of the three inducers at 1 day. Most I
      spots were restored to control levels at 8 days. Kidney I-compounds were not
      affected by PB or PCN, but MC reduced the level of one non-polar individual I
      compound at 1 day. Except for the expected DNA adduct formation from MC, there
      were no qualitative changes in profiles of postlabeled modified nucleotides.
      Total cytochrome P450 content in liver microsomes and activities of individual
      P450 enzymes were significantly increased by treatment with each of the inducers
      at 1 day. This was, however, not the case at 8 days in PB- and PCN-treated
      livers. MC-treated rats, on the other hand, displayed elevated levels of liver
      cytochrome P450 and ECD at 8 days. In kidney, PB and PCN did not elicit induction
      of P450 and individual enzymes, but MC increased total P450 content and ECD
      activity at 1 day, and ECD activity alone at 8 days. These results suggest a
      major role for cytochrome P450 enzymes in the metabolism of I-compounds.

PMID- 1638687
TI  - NADPH-supported and arachidonic acid-supported metabolism of the enantiomers of
      trans-7,8-dihydrobenzo[a]pyrene-7,8-diol by human liver microsomal samples.
AB  - Using a new sensitive reverse-phase HPLC assay relying on UV detection at 344 nm,
      the capacity of 18 human liver microsomal samples to support NADPH-dependent,
      cytochrome P450-mediated oxidation and arachidonic acid-dependent oxidation of
      the enantiomers of trans-7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene (B[a]P-7,8-DHD)
      was determined. The (-)-7R,8R-enantiomer, the preferred substrate of cytochrome
      P450, formed 94% diolepoxide 2 (anti-isomer; 7R,8S-dihydroxy-9S,10R-epoxy
      7,8,9,10-tetrahydrobenzo[a]-pyrene) measured as derived alcohols, and the (+)
      7S,8S-enantiomer formed 67% diolepoxide 1 (syn-isomer; 7S,8R-dihydroxy-9S,10R
      epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene). Arachidonic acid-supported oxidations
      gave approximately 70% diolepoxide 2 from each enantiomer. The involvement of
      different sets of cytochrome P450 isozymes was supported by incubations in the
      presence of alpha-naphthoflavone (alpha-NF) (50 microM) and correlation studies.
      In the absence of alpha-NF, a positive correlation was found between the
      metabolism of the (-)-enantiomer but not the (+)-isomer of B[a]P-7,8,-DHD and the
      relative content of P450IA2. In the presence of alpha-NF, the P450IIIA3/4 content
      correlated positively with the metabolism of both the (+)-enantiomer and the (-)
      enantiomer. Gestodene (100 microM) inhibited the alpha-NF-stimulated metabolism,
      confirming the involvement of cytochrome P450IIIA3/4. No difference was found
      between the extent of arachidonic acid-supported, peroxyl radical-mediated
      metabolism of the (+)- and (-)-enantiomers of B[a]P-7,8-DHD. The metabolism was
      almost completely abolished by 2 microM butylatedhydroxyanisole and 100 microM
      nordihydroguaiaretic acid, confirming the free radical nature of the reaction.

PMID- 1638688
TI  - Mechanisms associated with the expression of cisplatin resistance in a human
      ovarian tumor cell line following exposure to fractionated X-irradiation in
      vitro.
AB  - Interactions between cisplatin (CDDP) and irradiation are of potential
      significance for the combined modality treatment of cancer. Previous data have
      indicated that following in vitro exposure to X-irradiation certain tumour cells
      expressed resistance to CDDP. To identify parameters associated with this CDDP
      resistance, the human ovarian carcinoma cell line SK-OV-3/P was pre-exposed to
      fractionated X-irradiation (total dose: 50 Gy) in vitro. The resultant subline
      (SK-OV-3/DKR-10) proved 2-fold resistant to CDDP, but not to acute X-irradiation.
      Consistent with unaltered dihydrofolate reductase and thymidylate synthase
      activities, SK-OV-3/DXR-10 cells were neither cross-resistant to methotrexate nor
      to 5-fluorouracil. Verapamil (6.6 microM) significantly (P less than 0.05)
      enhanced CDDP-induced cytotoxicity in the resistant DXR-10 subline, but not in
      the parental cells. Total glutathione levels were significantly (P less than
      0.01) lower in the resistant subline and BSO pretreatment failed to influence
      cytotoxicity, whilst related enzyme activities were not consistently modified in
      the SK-OV-3/DXR-10 cells. Resistance in these cells was associated with
      significantly decreased cisplatin uptake (P less than 0.002). Immediately
      following drug exposure the total platination level of the DNA, quantitated
      immunochemically, was higher (P less than 0.05) in the resistant subline
      indicative of increased tolerance to DNA damage. After an 18 h post-treatment
      incubation the parental cell line appeared proficient in the removal of the
      intrastrand adduct Pt-AG, but deficient in removing the major adduct Pt-GG and
      the difunctional Pt-(GMP)2 lesion, whilst the DXR-10 resistant subline appeared
      proficient in removal of all four Pt-DNA adducts. DNA polymerases alpha and beta
      activities, however, were comparable in both cell lines. These data implicate
      both enhanced repair and increased tolerance of DNA damage as mechanisms of
      resistance to CDDP resulting from in vitro exposure of a human ovarian carcinoma
      cell line to fractionated X-irradiation.

PMID- 1638689
TI  - Biological markers of exposure to benzene: S-phenylcysteine in albumin.
AB  - Results of experiments in our laboratory have shown that benzene is metabolized
      by animals in part to an intermediate that binds to cysteine groups in hemoglobin
      to form the adduct S-phenylcysteine (SPC). These results suggested that SPC in
      hemoglobin may be an effective biological marker for exposure to benzene.
      However, we could not detect SPC in the globin of humans occupationally exposed
      to benzene concentrations as high as 28 p.p.m. for 8 h/day, 5 days/week. As
      another approach, we examined the binding of benzene to cysteine groups of a
      different blood protein, albumin. To facilitate the process, a new method for the
      precipitative isolation of albumin from plasma was also developed. The isolated
      albumin was analyzed for SPC by isotope dilution GC-MS. We used this approach to
      measure SPC in the albumin of F344/N rats exposed by gavage to 0-10,000 mumol/kg
      benzene. Amounts of albumin-associated SPC increased as a function of dose,
      followed by a leveling off in the amount of SPC seen at doses greater than 1000
      mumol/kg. Levels of SPC were measured in humans occupationally exposed to average
      concentrations of 0, 4.4, 8.4 and 23 p.p.m. benzene 8 h/day, 5 days/week. Of nine
      controls, seven had levels of SPC below the limit of detection (0.1 pmol SPC/mg
      albumin). SPC increased in the exposed groups linearly, giving a statistically
      significant slope (P less than 0.001) of 0.044 +/- 0.008 pmol/mg albumin/p.p.m.
      with an intercept of 0.135 +/- 0.095 pmol/mg albumin. From this study, we
      conclude that SPC in albumin may prove useful as a biomarker for benzene
      exposure.

PMID- 1638690
TI  - 32P-postlabeling analysis of adducts formed from 1-phenylazo-2-hydroxynaphthalene
      (Sudan I, Solvent Yellow 14) with DNA and homopolydeoxyribonucleotides.
AB  - A 32P-postlabeling assay was employed for detection and quantitation of DNA
      adducts formed with carcinogenic 1-phenylazo-2-hydroxynaphthalene (Sudan I,
      Solvent Yellow 14) activated by a peroxidase system. Enrichment of adducts by
      digestion with nuclease P1 or by extraction into n-butanol prior to 32P-labeling
      was used. Both enrichment procedures exhibited comparable results for recovery of
      individual DNA adduct spots. Co-chromatographic analyses of adduct spots obtained
      by reaction with DNA and homopolydeoxy-ribonucleotides showed that four out of
      the eight major Sudan I-DNA adducts were formed by reaction of activated Sudan I
      with deoxyadenosine or deoxyguanosine in DNA. The accuracy of quantitation of
      adducts by 32P-postlabeling procedure is discussed.

PMID- 1638691
TI  - Inhibitory effect of dietary iron deficiency on inductions of putative
      preneoplastic lesions as well as 8-hydroxydeoxyguanosine in DNA and lipid
      peroxidation in the livers of rats caused by exposure to a choline-deficient L
      amino acid defined diet.
AB  - Effects of dietary iron deficiency on inductions of putative preneoplastic
      lesions and oxidative alterations in the livers of rats by a choline-deficient L
      amino acid defined (CDAA) diet were examined. Male Fischer 344 rats, 4 weeks old,
      were used with a total experimental period of 16 weeks, consisting of 4-week
      pretreatment and 12-week treatment periods (periods A and B respectively). During
      period A, a choline-supplemented L-amino acid defined (CSAA) or an iron-deficient
      CSAA diet was administered, and the CDAA or an iron-deficient CDAA diet was fed
      in period B. Formation of 8-hydroxydeoxyguanosine (8OHdG), a DNA adduct generated
      by activated oxygen species, in DNA and lipid peroxidation in liver cell
      membranes were sequentially determined after the beginning of period B. At the
      end of the experiment, development of gamma-glutamyltransferase (GGT) and
      glutathione S-transferase placental form (GSTP) positive liver lesions were
      quantitatively analysed. In the animals fed the CDAA diet, formation of 8OHdG and
      lipid peroxidation increased with time, and GGT and GSTP positive liver lesions
      developed. Formation of 8OHdG, lipid peroxidation and the numbers of induced
      enzyme-altered liver lesions were all reduced in rats fed the iron-deficient CSAA
      diet in period A and/or the iron-deficient CDAA diet in period B. The present
      results indicate that iron plays an important role in induction of preneoplastic
      liver lesions in rats caused by exposure to the CDAA diet possibly in connection
      with its known catalytic role in generation of highly reactive activated oxygen
      species.

PMID- 1638692
TI  - Role of N-glucuronidation in benzidine-induced bladder cancer in dog.
AB  - The mechanism by which benzidine induces bladder cancer in dog was evaluated by
      assessing metabolism of [3H]benzidine by dog liver slices and microsomes. Slices
      incubated with 0.05 mM [3H]benzidine exhibited a 32.5 min incubated with 0.05 mM
      [3H]benzidine exhibited a 32.5 min peak, which was also produced when microsomal
      incubations were supplemented with UDP-glucuronic acid. In contrast to
      microsomes, very little of the 32.5 min peak was produced with the 100,000 g
      supernatant fraction. Microsomal metabolism was increased 5-fold by pretreatment
      with Triton X-100. Very little activity was observed with rat microsomes in
      either the presence or absence of Triton X-100. This metabolite was also
      generated by incubating benzidine with glucuronic acid at 4 degrees C for 3 days.
      Thermospray MS identified this metabolite as benzidine N-glucuronide. At 37
      degrees C, the t1/2 stability of purified N-glucuronide was 99, 25 and 3 min in
      dog urine adjusted to pH 7.3, 6.3 and 5.3 respectively. The N-glucuronide was
      quite stable at pH 9.3, in dog plasma, and in aprotic solvents for 4 h at 37
      degrees C. Relative to benzidine, its N-glucuronide is weakly bound to plasma
      proteins but not more reactive with DNA. Thus, detoxification by liver provides a
      mechanism for accumulation of benzidine in acidic urine, uptake of benzidine into
      bladder epithelium, and activation of benzidine in bladder. The liver and N
      glucuronidation play a potentially important role in the species specificity of
      benzidine carcinogenesis.

PMID- 1638693
TI  - Liver DNA adducts in methyl-deficient rats administered a single dose of
      aflatoxin B1.
AB  - Using an 8 week Solt-Farber protocol with selection pressure (2
      acetylaminofluorene/partial hepatectomy) applied during weeks 6 and 7, we have
      observed that a single oral administration of aflatoxin B1 (AFB1) to Fischer 344
      rats on day 1 of the study, followed by a 3 week feeding regimen of either a
      methyl-deficient (CMD) or a basal (CMS) diet, results in a relative increase in
      hepatic preneoplastic lesions in CMD diet fed rats. It has previously been shown
      that a multiple dosing regimen with AFB1, started after 3 weeks of CMD diet,
      enhances tumor incidence. In the present study, the role of metabolic activation
      in the induction of preneoplastic lesions, and liver DNA adduct levels after the
      first dose of AFB1 in the tumorigenesis model have been investigated. AFB1-DNA
      adducts were determined at 2-168 h following a single non-necrogenic (100
      micrograms/kg body wt) or necrogenic (600 micrograms/kg body wt) dose of AFB1 on
      day 1 or day 21 of a 3 week treatment with a complete basal or CMD diet. In all
      rats irrespective of dose, dietary treatment or time of AFB1 dosing, the patterns
      of adduct formation and repair did not change. In rats receiving AFB1 on day 1,
      total DNA adduct levels between the diet or dose groups were not significantly
      different, and quantitatively did not correlate with the observed increase in
      preneoplastic lesions, suggesting a contribution by additional factors in the
      initiation of these lesions. Administration of AFB1 on day 21, however, resulted
      in significantly reduced levels of total adducts at both dose levels in CMD diet
      fed rats compared to controls. Serum biochemistry data suggest that a prolonged
      exposure to CMD diet may cause pathological and/or biochemical alterations in
      hepatocytes with a resultant decrease in metabolic activation of AFB1, thus
      making it difficult to evaluate whether DNA damage is directly related to
      tumorigenesis.

PMID- 1638694
TI  - Determination of N7-methylguanine in DNA of white blood cells from cancer
      patients treated with dacarbazine.
AB  - An ELISA method was used to determine N7-methylguanine (N7-MeGua) adducts in DNA
      of white blood cells from cancer patients treated with the methylating antitumor
      drug dacarbazine by i.v. administration. From four patients who received
      dacarbazine only, at dosages of 250, 400 or 800 mg/m2, the blood samples were
      collected before and several days after administration, and from one patient also
      during the first few hours. N7-MeGua levels increased rapidly during the first
      hour after treatment, hardly changed during the following 7 h and decreased
      during the next days (half-life of approximately 72 h). The adduct levels
      appeared to be dose-dependent. Blood cells were also analyzed from three patients
      who received dacarbazine (225 mg/m2) in combination with other chemotherapeutic
      drugs during three successive days. One of these patients showed a larger initial
      level of N7-MeGua and a cumulative increase with the dacarbazine dose compared to
      the other two patients. For several patients adduct levels were monitored during
      two chemotherapy cycles, for which quite similar data were obtained.

PMID- 1638695
TI  - Chemoprevention of mammary carcinogenesis by hydroxylated derivatives of d
      limonene.
AB  - The monoterpene d-limonene has been shown to an effective, non-toxic
      chemopreventive agent in mammary and other rodent tumor models. The studies
      reported here investigated structure-activity relationships among limonene and
      three hydroxylated derivatives in the prevention of dimethylbenz[a]anthracene
      (DMBA)-induced mammary cancer. Rats were fed control or 1% limonene, carveol,
      uroterpenol or sobrerol diets from 2 weeks before to one week after carcinogen
      administration. Carveol, uroterpenol and sobrerol significantly prolonged tumor
      latency and decreased tumor yield. Sobrerol was the most potent of the
      monoterpenes tested, decreasing tumor yield to half that of the control, a level
      previously achieved with 5% limonene diets. Excretion of radioactivity from
      [3H]DMBA was doubled in rats fed 5% limonene and nearly tripled in rats fed 1%
      sobrerol. Sobrerol is thus 5-fold more potent than limonene in both enhancing
      carcinogen excretion and in preventing tumor formation. These data demonstrate
      that hydroxylation of monoterpenes affects chemopreventive potential, with 2
      hydroxyl groups greater than 1 greater than 0. Sobrerol, carveol and uroterpenol
      are novel cancer chemopreventive agents with little or no toxicity.

PMID- 1638696
TI  - O6-alkylguanine-DNA alkyltransferase activity in epidermal tumor and normal
      epidermal cells of mice of various stocks and strains.
AB  - The level of the DNA repair enzyme O6-alkylguanine-DNA alkyltransferase (MGMT)
      was examined in benign and malignant skin tumors induced with different
      initiating and promoting agents and from both SENCAR and Sensitive SENCAR Inbred
      (SSIN) mice. The MGMT levels in the tumors were approximately one-half the level
      observed in normal surrounding epidermis and in keratinocytes from untreated
      controls. In addition, a carcinoma-producing cell line, VT 17DT, derived from
      papillomas in SENCAR mice had no detectable MGMT activity (Mer- phenotype),
      whereas in the non-tumor forming line, 3PC, MGMT activity was comparable to that
      in papillomas. The comparatively low level of MGMT in papillomas may contribute
      to their ease of conversion to squamous cell carcinomas by N-ethyl-N-nitrosourea
      or n-methyl-N'-nitro-N-nitrosoguanidine. MGMT activity was also determined in the
      epidermis of non-exposed mice of various stocks and strains. Epidermal MGMT
      activity was similar to levels in the corresponding livers and was, in general,
      parallel with stock/strain susceptibility to tumor formation. This is the first
      report that examined MGMT activity in skin tumors and normal keratinocytes in the
      mice of several stocks and strains.

PMID- 1638697
TI  - Increased 8-oxodeoxyguanosine levels in lung DNA of A/J mice and F344 rats
      treated with the tobacco-specific nitrosamine 4-(methylnitrosamine)-1-(3-pyridyl)
      1-butanone.
AB  - Evidence for the involvement of free radicals in nitrosamine carcinogenesis comes
      mainly from increased lipid peroxidation as a result of nitrosamine treatment.
      More direct evidence for nitrosamine-induced oxidative DNA damage has been
      lacking. In this study we examined the levels of 8-oxodeoxyguanosine or 8
      hydroxydeoxyguanosine (8-OH-dG) in tissue DNA of mice and rats treated with the
      tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone
      (NNK). Multiple doses of NNK (0.25 or 0.50 mg/mouse, 3 times weekly for 3 weeks)
      administered by gavage resulted in a significant elevation of 8-OH-dG in lung
      DNA, from 2.1 to 3.8 adducts/10(5) dG for the lower dose or to 6.6 adducts/10(5)
      dG for the higher dose, 2 h after the last NNK administration. A single dose
      treatment of NNK by gavage (4 mg/mouse) also resulted in an increase of this
      lesion in the lung DNA, however, the increase was not statistically significant.
      In liver, however, the increase was only significant by multiple doses at the
      higher dose, from 2.3 to 3.4 adducts/10(5) dG. This lesion appeared to be
      repaired efficiently. At 4 and 24 h after NNK treatment, the 8-OH-dG levels
      declined to the basal levels in both liver and lung. A single dose of NNK (20
      mg/rat) also caused a significant increase of 8-OH-dG from 3.0 to 5.1
      adducts/10(5) dG in rat lung DNA. An increase of 8-OH-dG in liver DNA was also
      seen, however, it was not statistically significant. Unlike the liver and the
      lung, the 8-OH-dG levels in rat kidney, a non-target tissue, were inert to NNK
      treatment. These results provide for the first time direct evidence supporting
      the role of oxidative DNA damage in NNK lung tumorigenesis.

PMID- 1638698
TI  - Temporal changes in the mutant frequency and mutation spectra of the 61st codon
      of the H-ras oncogene following exposure of B6C3F1 mice to N-nitrosodiethylamine
      (DEN).
AB  - Hepatocellular tumors were induced in 15 day old male B6C3F1 mice following a
      single exposure to N-nitrosodiethylamine (DEN; 5 mg/kg, i.p.). Tumors were
      collected at 38 and 65 weeks to compare the frequencies and types of mutations in
      the 61st codon of the H-ras oncogene. The 61st codon was amplified using the
      polymerase chain reaction (PCR). Allele-specific oligonucleotide (ASO) probes
      were used to determine the frequency and types of mutations present in these
      tumors. Forty-nine nodular hepatic lesions were obtained from seven animals at
      the 38 week timepoint. Five of these samples (10%) had mutations at the 61st
      codon with one CAA-AAA, one CAA-CGA and three CAA-CTA. Thirty-six nodular hepatic
      lesions were obtained from six animals at the 65 week timepoint. Ten of these
      samples (28%) had mutations at the 61st codon with one CAA-AAA, five CAA-CGA and
      four CAA-CTA. These data indicate that DEN-induced mutations at the 61st codon of
      the mouse H-ras oncogene (i) are an infrequent event, (ii) have different
      frequencies at the 38 and 65 week timepoints and (iii) are different from the
      types of mutations seen in spontaneous lesions.

PMID- 1638699
TI  - Development and characterization of a sex-dependent metastatic preputial gland
      adenocarcinoma in human tumor-bearing immunosuppressed F344 rats.
AB  - Newborn F344 rats were treated with polyclonal rabbit anti-thymocyte serum, which
      caused partial immunosuppression for a limited period. These rats were injected
      s.c. with cells from human tumor cell lines (two melanomas and a B lymphoma).
      Within 46 days after the tumor regression a renal carcinosarcoma, resembling
      Wilms' tumor, developed in each animal, however in male rats an adenocarcinoma of
      the preputial gland arised. Chromosome analysis and transplantation experiments
      proved the rat origin of the new tumors. In the present study we describe the
      biological and morphological characteristics of the adenocarcinoma of the
      preputial gland (ACPG). Their invasive properties were demonstrated in the lung
      colony assay, after intra-arterial injection and in the spleen-liver model. ACPG
      showed unique metastatic phenotype: dependence on the sex of the host.

PMID- 1638700
TI  - Induction of DNA repair synthesis in human monocytes/B-lymphocytes compared with
      T-lymphocytes after exposure to N-acetoxy-N-acetylaminofluorene and
      dimethylsulfate in vitro.
AB  - We have explored the induction of DNA repair synthesis in monocyte/B- and T
      lymphocyte enriched cell fractions from 12 different human mononuclear blood cell
      populations. Unscheduled DNA synthesis was measured in monocyte/B- and T-cells
      after exposure to the DNA-damaging agents dimethylsulfate (DMS) and N-acetoxy-N
      acetylaminofluorene in vitro. Also, the binding of DMS to DNA was measured. An
      increased DNA repair synthesis was measured in monocyte/B-lymphocytes after
      induction of the two different types of DNA lesions, whereas no induction of
      unscheduled DNA synthesis was observed in T-lymphocytes. A significantly higher
      DMS-DNA binding was also observed in monocyte/B-lymphocytes when compared with T
      lymphocytes. Specific characterization of mononuclear blood cell populations used
      in biomonitoring of DNA adducts and repair is recommended.

PMID- 1638701
TI  - Phenol sensitization of DNA to subsequent oxidative damage in 8-hydroxyguanine
      assays.
AB  - The DNA base adduct, 8-hydroxyguanine (8-OHGua), has been reported to be a key
      biomarker relevant to carcinogenesis and cellular oxidative stress important in
      tumor promotion. Although investigators often report artificially high levels of
      8-OHGua in DNA samples that have been exposed to phenol solutions and/or air
      during processing, few quantitative results are available. We show that routine
      phenol-based DNA purification procedures can increase 8-hydroxydeoxyguanosine (8
      OHdG) levels 20-fold in samples that are exposed to air after the phenol is
      removed from the solutions. Surprisingly, air exposure alone accounts for a
      significant portion of this increase (4-fold) when compared to dG or DNA samples
      that have been solubilized in buffers purged with nitrogen. Most importantly,
      phenol treatments of DNA are shown to sensitize DNA to 8-OHdG formation by
      subsequent exposures to air. The sensitization of DNA occurs even though
      extensive dialysis is used between phenol treatment and enzymatic DNA digestion.
      Alternate procedures, including chloroform:isoamyl-alcohol extractions, also
      yield air-sensitive DNA samples. Other artifacts of organic extraction prior to
      air exposure include alterations in DNA base ratios after nuclease digestions.
      Overall, these results strongly suggest that studies of 8-OHdG in carcinogenesis
      should avoid dry conditions, such as lyophilization followed by exposure to air,
      and that all four of the bases should be monitored before 8-OHdG concentrations
      are normalized by undamaged deoxynucleoside concentrations. Failure to heed these
      precautions can lead to 2- to 20-fold overestimates of 8-OHdG in target tissues
      or in vitro models.

PMID- 1638702
TI  - The carcinogenic effect of methapyrilene combined with nitrosodiethylamine given
      to rats in low doses.
AB  - The carcinogenic effects of combinations of methapyrilene hydrochloride (MP),
      nitrosodiethylamine (NDEA), and phenobarbital (PB) or partial hepatectomy (PH)
      were examined following sequential treatment of rats. MP is a generally non
      genotoxic liver carcinogen of moderate potency, NDEA is a genotoxic liver
      carcinogen, PB is primarily a liver tumor promoter and PH induces cell
      proliferation. The dose of each carcinogen was chosen to be below that causing
      significant liver tumor incidence when given singly. There were 12 protocols
      involving groups of 28 female rats each. Short treatments with NDEA and MP were
      followed by 60 weeks of PB promotion or by partial hepatectomy. Each treatment
      was given separately or in double combination as controls. Several animals of
      each group were killed at intervals during the experiment for examination of
      toxic effects and the presence of altered hepatic foci. In only 3 of 12 groups
      was there a significant incidence of rats with liver neoplasms: the two groups
      given three treatments: NDEA, MP and PB (86% tumors) or NDEA, MP and PH (33%),
      and the group receiving NDEA and MP without promotion (46%). The results clearly
      indicated a co-carcinogenic effect between NDEA and MP. Continuous PB potentiated
      tumor development, while PH did not. There was no evidence of liver toxicity from
      any of the treatments, but clear cell foci observed in three groups at weeks 13
      and 33 correlated with the later development of liver neoplasms.

PMID- 1638703
TI  - Differences in clinical expression of hypertrophic cardiomyopathy associated with
      two distinct mutations in the beta-myosin heavy chain gene. A 908Leu----Val
      mutation and a 403Arg----Gln mutation.
AB  - BACKGROUND: The disease gene for hypertrophic cardiomyopathy (HCM) has been
      identified as the beta-myosin heavy chain (beta-MHC) gene in some HCM families.
      We describe extensive clinical evaluations in two kindreds with two distinct
      point mutations in the beta-MHC gene. METHODS AND RESULTS: We used single-strand
      confirmation polymorphism (SSCP) gel analysis of polymerase chain reaction
      amplified products capturing each of the 40 beta-MHC gene exons to identify
      distinct missense mutations in two HCM kindreds. Clinical, ECG, and
      echocardiographic studies were performed in the two kindreds: kindred 2755 with
      amino acid 908Leu----Val mutation and kindred 2002 with amino acid 403Arg----Gln
      mutation. The morphological appearances of HCM were similar in these two
      kindreds. However, the two kindreds differed with respect to disease penetrance,
      age of onset of disease, and incidence of premature sudden death. Twelve of 31
      adults (greater than or equal to 17 years) with the disease gene in kindred 2755
      did not have left ventricular hypertrophy (LVH), and only five of these had ECG
      abnormalities. Thus, the disease penetrance in adults with this mutation was only
      61%. None of 11 children aged less than 16 years had LVH. The 908 mutation was
      associated with a low incidence of cardiac events: Only two sudden deaths and one
      syncope occurred in 46 individuals with the mutant allele. In contrast, LVH was
      present in all 11 adults in kindred 2002 with the 403 mutation (100% disease
      penetrance). In addition, three of four affected children were symptomatic and
      had clinical evidence of HCM. The disease in this kindred was severe and resulted
      in six premature sudden deaths. Seven additional patients had syncope or
      presyncope. CONCLUSIONS: In some kindreds, the HCM disease gene is more prevalent
      than indicated by echocardiography and ECG. Some point mutations may be
      associated with a more malignant prognosis. Preclinical identification of
      children with mutations associated with a high incidence of sudden death and
      syncope provides the opportunity to evaluate efficacy of early therapeutic
      interventions.

PMID- 1638704
TI  - Transesophageal echocardiographic recognition of subaortic complications in
      aortic valve endocarditis. Clinical and surgical implications.
AB  - BACKGROUND: Secondary involvement of the mitral-aortic intervalvular fibrosa and
      the anterior mitral leaflet (subaortic structures) can occur in patients with
      aortic valve endocarditis. The secondary involvement of these structures occurs
      as a result of direct extension of the infection from the aortic valve or as a
      result of an infected aortic regurgitant jet striking the ventricular surfaces of
      the mitral-aortic intervalvular fibrosa and the anterior mitral leaflet. The
      abscess of mitral-aortic intervalvular fibrosa can expand to form an aneurysm.
      Subsequently, this mitral-aortic intervalvular fibrosa aneurysm can develop a
      perforation and communicate with the left atrium, resulting in the systolic
      regurgitation of blood from the left ventricular outflow tract into the left
      atrium. Secondary infection can also occur on the ventricular surface of the
      anterior mitral leaflet and result in the formation of an aneurysm or perforation
      of anterior mitral leaflet. METHODS AND RESULTS: This study examines the utility
      of transesophageal echocardiography in the detection of these subaortic
      complications in 55 consecutive patients with aortic valve endocarditis. A total
      of 24 patients (44%) had involvement of subaortic structures, including four with
      an abscess in the mitral-aortic intervalvular fibrosa, four with mitral-aortic
      intervalvular fibrosa aneurysm, seven with perforation of the mitral-aortic
      intervalvular fibrosa with communication into the left atrium, two with an
      aneurysm of the anterior mitral leaflet, and seven with perforation of the
      anterior mitral leaflet. The transesophageal echocardiographic findings were
      confirmed at surgery in 20 patients and at necropsy in two. By comparison,
      transthoracic echocardiography visualized these lesions in five of 24 patients
      (21%), including none of four with mitral-aortic intervalvular fibrosa abscesses,
      two of four with mitral-aortic intervalvular fibrosa aneurysms, one of seven with
      mitral-aortic intervalvular fibrosa perforations, one of two with anterior mitral
      leaflet aneurysms, and one of seven anterior mitral leaflet perforations.
      Eccentric mitral regurgitation-type systolic jets were noted in eight additional
      patients by transthoracic color flow imaging, and this finding suggested the
      possibility of these unusual subaortic complications. If these patients are
      included, then transthoracic echocardiography suggested the presence of these
      subaortic complications in 13 of 24 patients (54%). CONCLUSIONS: The results
      indicate that 1) involvement of the subaortic structures in patients with aortic
      valve endocarditis may be more common than previously recognized, 2) patients
      with aortic valve endocarditis and eccentric jets of mitral regurgitation on
      transthoracic echocardiography should undergo further evaluation by
      transesophageal echocardiography to exclude these unusual complications, 3)
      precise recognition of these complications is of value in the optimal medical and
      surgical management of these patients, and 4) these complications may be
      responsible for unexplained congestive heart failure and hemodynamic
      deterioration in some patients with aortic valve endocarditis.

PMID- 1638705
TI  - Efficacy of automatic multimodal device therapy for ventricular tachyarrhythmias
      as delivered by a new implantable pacing cardioverter-defibrillator. Results of a
      European multicenter study of 102 implants.
AB  - BACKGROUND: Third-generation implantable cardioverter-defibrillators are devices
      designed to treat ventricular tachycardia (VT) and ventricular fibrillation (VF)
      by means of overdrive pacing, cardioversion, or defibrillation. So far, the
      efficacy of tiered therapy has been documented only in small series. Therefore, a
      European multicenter clinical evaluation study of a new tachyarrhythmia control
      device, the Medtronic PCD pacer-cardioverter-defibrillator with epicardial patch
      lead configuration, was undertaken. METHODS AND RESULTS: We report on 102
      patients (mean age, 55 +/- 13 years) from 11 European centers. PCD devices
      implanted between May 1989 and February 1991 were included. The patients suffered
      from hemodynamically significant ventricular tachyarrhythmias not suppressed by
      antiarrhythmic drug therapy and unrelated to acute myocardial infarction; one
      patient had nonsustained VT and severely depressed left ventricular function.
      Seventy patients had coronary artery disease with old myocardial infarctions, 23
      had cardiomyopathies of various etiologies, and nine patients had no detectable
      heart disease. Mean ejection fraction was 36 +/- 14% (range, 10-76%). Mean
      intraoperative defibrillation threshold (51 patients) was 10.6 +/- 5.1 J (range,
      2-18 J). The documented follow-up ranged from 1 to 21 months (mean, 9.4 +/- 5.8
      months), or 79.9 cumulative patient-years. Perioperative mortality was 3.9%. The
      actuarial survival rate at 12 months was 91%. One sudden arrhythmic death
      occurred. Sixty patients (58%) received device therapy. Seventeen patients had
      therapies only for "VF" episodes, 16 patients only for VT, and 28 patients for VT
      and "VF" episodes. Based on device memory data, 1,235 spontaneous VT episodes
      were detected and treated in 43 patients. Twelve hundred four of these VT
      episodes received painless initial antitachycardia pacing therapy, restoring
      sinus rhythm in 91%. The 108 ongoing episodes received 209 multiple therapeutic
      attempts. Eighty-five additional overdrive pacing therapies restored sinus rhythm
      in 30%. Initial ineffective antitachycardia pacing therapies received 51
      cardioversion pulses. The success rate was 61%. Seventy-three additional
      cardioversion pulses were delivered to backup ineffective pacing therapy as well
      as ineffective secondary cardioversion pulses. Their success rate was only 40%.
      Two hundred eighty-six spontaneous episodes were detected in 44 patients as "VF."
      Overall defibrillation efficacy was 97.6%. CONCLUSIONS: The implanted device
      nearly eliminates sudden arrhythmic death in patients with documented,
      potentially fatal ventricular tachyarrhythmias. Automatic tiered therapy is
      highly effective to restore sinus rhythm, provided that an integrated two-zone
      tachycardia detection algorithm is used, assigning lower tachycardia rates to
      overdrive pacing and/or cardioversion and higher tachycardia rates to
      defibrillation. In general, spontaneous VTs can be terminated by automatic
      overdrive pacing, and painful or disturbing countershock therapies are not
      required to terminate the majority of spontaneous VT episodes.

PMID- 1638706
TI  - Evidence for transient linking of atrial excitation during atrial fibrillation in
      humans.
AB  - BACKGROUND: Atrial fibrillation is usually thought of as a "random" pattern of
      circulating wavelets. However, local atrial activation should be influenced by
      the constant anatomy and receding tail of refractoriness from the previous
      activation. The general tendency for wave fronts to follow paths of previous
      excitation has been termed "linking." We examined intra-atrial electrograms
      recorded during atrial fibrillation for evidence of linking. METHODS AND RESULTS:
      Two minutes of atrial fibrillation were recorded in 15 patients with an
      orthogonal catheter. We have previously demonstrated that this catheter can be
      used to detect changes in the direction of local atrial activation. A mean vector
      was calculated for each electrogram. The similarity of the direction of the
      vectors from two consecutive electrograms can be quantified on a scale of 1 to -1
      by calculating the cosine (cos) of the smallest angle (theta) between them. Two
      vectors pointing in the same or opposite directions then have cos(theta) = 1 or 
      1, respectively. For the entire group of patients, mean cos(theta) was
      significantly greater than 0 (mean, 0.36; p less than 0.001). In nine of 15
      patients, there were groups of six or more consecutive beats (total, 44 groups;
      range, six to 14 beats per group) in which the direction of activation of each
      beat was within 30 degrees of the previous beat. The likelihood of one group of
      six or 14 consecutive similar beats occurring by chance in any one patient in 1
      minute is less than 0.05 and less than 0.0000001, respectively. There was a
      significant correlation (r = 0.90) between the amount of linking during the first
      and second minutes of atrial fibrillation in each patient. CONCLUSIONS: Transient
      similarities in the direction of wavelet propagation in the majority of patients
      with atrial fibrillation is consistent with the presence of transient linking. To
      our knowledge, this is the first direct evidence that atrial activation during
      atrial fibrillation in humans is not entirely random.

PMID- 1638707
TI  - Electrocardiographic body surface mapping in patients with ventricular
      tachycardia. Assessment of utility in the identification of effective
      pharmacological therapy.
AB  - BACKGROUND: Body surface maps of net QRST deflection areas (isointegrals) reflect
      regional ventricular repolarization properties. Vulnerability to ventricular
      tachyarrhythmias is associated with maps that feature multiple islands (extrema)
      of positive and negative values; such maps reflect regional disparity of
      ventricular recovery properties. The value of body surface mapping in prediction
      of the efficacy of antiarrhythmic therapy for ventricular tachyarrhythmias has
      not been determined. METHODS AND RESULTS: Isointegral ECG body surface mapping
      was performed in 51 patients with inducible ventricular tachycardia having
      programmed stimulation studies at baseline and after oral quinidine therapy. The
      degree of nondipolarity of QRST isointegral distribution was expressed by the
      number of extrema and by the percentage contribution of nondipolar eigenvectors
      after Karhunen-Loeve transformation. QRST isointegral nondipolarity was greater
      in ventricular tachycardia patients than in 51 age- and sex-matched normal
      subjects expressed as mean number of extrema (4.1 +/- 2.8 versus 2.0 +/- 0.2,
      respectively), mean eigenvector-determined nondipolar content percentages (12.4
      +/- 10.1% versus 4.5 +/- 4.9%), prevalence of abnormal numbers of extrema (63%
      versus 4%), or prevalence of abnormal nondipolar content percentages (33% versus
      4%) (each p less than 0.01). Quinidine prevented ventricular tachycardia
      induction in 14 patients. Patients for whom quinidine was or was not effective
      had similar nondipolarity indexes at baseline. However, maps on quinidine
      differed as a function of antiarrhythmic efficacy. Although effective therapy
      produced no significant mean changes in nondipolarity, ineffective therapy
      increased the number of extrema compared with baseline (5.4 +/- 3.4 versus 3.8 +/
      2.5, respectively) (p = 0.002). Individually, 43% of patients on effective
      therapy had drug-induced decreases in numbers of extrema compared with 14% of
      those on ineffective therapy (p = 0.02). Furthermore, 29% of patients on
      effective therapy showed drug-induced increases in numbers of extrema compared
      with 62% of those on ineffective therapy (p = 0.03). CONCLUSIONS: QRST
      isointegral body surface mapping shows promise as a noninvasive measure of drug
      efficacy in patients with ventricular tachycardia.

PMID- 1638708
TI  - Association between heart rate and atherogenic blood lipid fractions in a
      population. The Tromso Study.
AB  - BACKGROUND: Prospective epidemiological studies indicate that elevated heart rate
      may carry increased risk for coronary heart disease. Little is known about the
      relation between heart rate and serum lipid and lipoprotein concentrations in the
      general population. METHODS AND RESULTS: We assessed anthropometric and life
      style determinants of heart rate and examined the association between heart rate
      and serum lipid and lipoprotein concentrations in a cross-sectional study of
      9,719 men and 9,433 women 12-59 years old. Stratified and multivariate analyses
      were used to detect possible modification of effect and to control for
      confounding variables. Heart rate was positively associated with male sex and
      smoking, decreased with body height and physical activity, and showed a U-shaped
      relation to body mass index. In both sexes, there was a significant progressive
      increase in age-adjusted levels of total cholesterol, non-high density
      lipoprotein (HDL) cholesterol, and triglycerides and a decrease in HDL
      cholesterol with heart rate. Men with heart rate greater than 89 beats per minute
      had 14.5% higher non-HDL cholesterol and 36.3% higher triglyceride levels than
      men with heart rate less than 60 beats per minute. The corresponding differences
      in women were 12.5% and 22.2%. The associations remained significant when
      anthropometric and life-style factors were controlled for. The slopes relating
      total and non-HDL cholesterol level to heart rate were steeper with advancing
      age. CONCLUSIONS: Increases in heart rate correlate with higher levels of
      atherogenic serum lipid fractions in the general population. Alterations in
      aortic impedance and/or autonomic influences may underlie these associations.

PMID- 1638709
TI  - Effects of traditional coronary risk factors on rates of incident coronary events
      in a low-risk population. The Adventist Health Study.
AB  - BACKGROUND: California Seventh-Day Adventists have lower mortality rates from
      coronary heart disease (CHD) than other Californians. Associations between
      traditional risk factor and CHD events have not been reported previously for
      Adventists. METHODS AND RESULTS: A cohort study allowed 6 years of follow-up of
      27,658 male and female California Seventh-Day Adventists. Data collected included
      age, sex, physician-diagnosed hypertension and diabetes mellitus, body height,
      weight, previous and current cigarette smoking habits, and current exercise
      habits. Incident cases of definite myocardial infarction (MI) and definite fatal
      CHD were diagnosed according to recognized criteria. Both stratified and
      proportional hazards analyses demonstrated that in this low-risk population, the
      above traditional coronary risk factors exhibit their usual associations with
      risk of CHD events. It was noted that exercise had a strong negative association
      with fatal CHD events (relative risks [RR], 1.0, 0.66, and 0.50 with increasing
      exercise) but no association with risk of MI (either nonfatal or all cases).
      Conversely, obesity was much more clearly associated with MI (RR, 1.0, 1.18, and
      1.83 with increasing tertiles of obesity) than with fatal events. The importance
      of the risk factors was similar in both sexes, except that the effect of
      cigarette smoking seemed more pronounced in women. CONCLUSIONS: The epidemiology
      of coronary heart disease in this low-risk California population appears to be at
      least qualitatively similar to that seen in other groups. There was evidence that
      the effects of exercise and obesity may differ depending on whether fatal CHD and
      MI (either all MI or nonfatal alone) is the end point.

PMID- 1638710
TI  - Thrombus regression in deep venous thrombosis. Quantification of spontaneous
      thrombolysis with duplex scanning.
AB  - BACKGROUND: Thrombus regression in heparin-treated, acute deep venous thrombosis
      of the lower extremity is poorly documented in the literature; different rates of
      thrombus resolution and recanalization are reported. METHODS AND RESULTS: In a
      prospective follow-up study, duplex scanning was used to evaluate the thrombus
      regression in patients with documented acute femoropopliteal thrombosis. Eighty
      vein segments in 20 legs of 18 patients were subjected to repeat duplex scans at
      1, 3, 6, 12, and 26 weeks after diagnosis; 49 segments showed thrombus at
      diagnosis. The popliteal vein showed the highest thrombus load at diagnosis,
      followed in descending order by the superficial femoral, profunda femoris, and
      common femoral vein segments (p less than 0.001). Thrombus regression was
      significant (p less than 0.001) in all segments and proceeded at an exponential
      rate that was equal in the different vein segments of the upper leg. Both
      thrombus resolution and recanalization appeared to be a function of the initial
      thrombus load and could not be related to individual vein segments.
      Recanalization was seen in 23 of 31 initially occluded segments and occurred
      within the first 6 weeks after diagnosis in 20 of 23 segments. Extension of
      thrombus despite anticoagulant therapy was observed in 15 vein segments and was
      not related to the initial thrombosis score (p = 0.1) or individual vein segments
      (p = 0.23). Thrombus extension in seven patients with prethrombotic conditions
      was not different (p = 0.9) from the other patients. CONCLUSIONS: Duplex scanning
      is an important noninvasive tool to quantify thrombus regression in acute deep
      venous thrombosis in detail without unnecessary discomfort to the patient.

PMID- 1638711
TI  - Structural remodeling of cardiac myocytes in patients with ischemic
      cardiomyopathy.
AB  - BACKGROUND: Chronic ischemic heart disease may lead to ventricular dilation and
      congestive heart failure (ischemic cardiomyopathy [ICM]). The changes in cardiac
      myocyte shape associated with this dilation, however, are not known. METHODS AND
      RESULTS: Left ventricular myocyte dimensions were assessed in cells isolated from
      explanted human hearts obtained from patients with ICM (n = 6) who were
      undergoing heart transplantation. Cells were also examined from three nonfailing
      donor hearts with normal coronary arteries (NCA). Compared with cells from
      patients with NCA, myocyte length was 40% longer in hearts from patients with ICM
      (197 +/- 8 versus 141 +/- 9 microns, p less than 0.01), cell width was not
      significantly different, and cell length/width ratio was 49% greater (11.2 +/-
      0.9 versus 7.5 +/- 0.6, p less than 0.01). Sarcomere length was the same in
      myocytes from both groups. The extent of myocyte lengthening is comparable to the
      increase in end-diastolic diameter commonly reported in patients with ICM.
      CONCLUSIONS: These data suggest that increased myocyte length (an intracellular
      event), instead of myocyte slippage (an extracellular event), is largely
      responsible for the chamber dilation in ICM. Furthermore, maladaptive remodeling
      of myocyte shape (e.g., increased myocyte length/width ratio) may contribute to
      the elevated wall stress (e.g., increased chamber radius/wall thickness) in ICM.

PMID- 1638712
TI  - Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term
      progression of left ventricular dysfunction in patients with heart failure. SOLVD
      Investigators.
AB  - BACKGROUND: In patients with heart failure, activation of the renin-angiotensin
      system is common and has been postulated to provide a stimulus for further left
      ventricular (LV) structural and functional derangement. We tested the hypothesis
      that chronic administration of the angiotensin converting enzyme (ACE) inhibitor
      enalapril prevents or reverses LV dilatation and systolic dysfunction among
      patients with depressed ejection fraction (EF) and symptomatic heart failure.
      METHODS AND RESULTS: We examined subsets of patients enrolled in the Treatment
      Trial of Studies of Left Ventricular Dysfunction (SOLVD). Fifty-six patients with
      mild to moderate heart failure underwent serial radionuclide ventriculograms, and
      16 underwent serial left heart catheterizations, before and after randomization
      to enalapril (2.5-20 mg/day) or placebo. At 1 year, there were significant
      treatment differences in LV end-diastolic volume (EDV; p less than 0.01), end
      systolic volume (ESV; p less than 0.005), and EF (p less than 0.05). These
      effects resulted from increases in EDV (mean +/- SD, 136 +/- 27 to 151 +/- 38
      ml/m2) and ESV (103 +/- 24 to 116 +/- 24 ml/m2) in the placebo group and
      decreases in EDV (140 +/- 44 to 127 +/- 37 ml/m2) and ESV (106 +/- 42 to 93 +/-
      37 ml/m2) in the enalapril group. Mean LVEF increased in enalapril patients from
      0.25 +/- 0.07 to 0.29 +/- 0.08 (p less than 0.01). There was a significant
      treatment difference in LV end-diastolic pressure at 1 year (p less than 0.05),
      with changes paralleling those of EDV. The time constant of LV relaxation changed
      only in the placebo group (p less than 0.01 versus enalapril), increasing from
      59.2 +/- 8.0 to 67.8 +/- 7.2 msec. Serial radionuclide studies over a period of
      33 months showed increases in LV volumes only in the placebo group. Two weeks
      after withdrawal of enalapril, EDV and ESV increased to baseline levels but not
      to the higher levels observed with placebo. CONCLUSIONS: In patients with heart
      failure and reduced LVEF, chronic ACE inhibition with enalapril prevents
      progressive LV dilatation and systolic dysfunction (increased ESV). These effects
      probably result from a combination of altered remodeling and sustained reduction
      in preload and afterload.

PMID- 1638713
TI  - Furosemide-induced natriuresis is augmented by ultra-low-dose captopril but not
      by standard doses of captopril in chronic heart failure.
AB  - BACKGROUND: Ten chronic heart failure patients were studied on three occasions in
      randomized double-blind fashion to compare the acute hemodynamic, neurohormonal,
      and renal sodium-handling responses to 1 mg captopril versus 25 mg captopril,
      both in the absence of loop diuretic therapy and during furosemide-stimulated
      natriuresis. METHODS AND RESULTS: Compared with placebo, 1 mg captopril caused
      nonsignificant decreases in mean arterial pressure and circulating angiotensin II
      level and had no effect on glomerular filtration rate as determined by 51Cr-EDTA
      elimination. Captopril (25 mg) produced marked suppression of serum angiotensin
      II with or without oral furosemide (both p less than 0.002), a marked decrease in
      mean arterial pressure (p less than 0.001) that was accentuated by furosemide (p
      less than 0.00001), and a decrease in glomerular filtration rate (p = 0.0007). No
      difference from placebo in renal sodium excretion was noted with either 1 or 25
      mg captopril in the absence of furosemide. In contrast, while 25 mg captopril
      caused slight attenuation of the natriuretic response to furosemide, 1 mg
      captopril significantly enhanced furosemide-induced natriuresis (p less than
      0.05). No correlation was found in our patients between the natriuretic effect of
      furosemide and either absolute mean arterial pressure or change in mean arterial
      pressure during the furosemide phase of each study session. This suggests that
      blood pressure is not the important factor mediating the divergent renal
      responses to furosemide of the two captopril dosage regimens. CONCLUSIONS: We
      propose that in the face of furosemide-induced postglomerular vasodilatation in
      chronic heart failure, captopril at a starting dose of 1 mg (but not 25 mg)
      preserves enough circulating angiotensin II to maintain efferent arteriolar tone
      and thus glomerular filtration, while offsetting the antinatriuretic renal
      tubular effects of angiotensin II.

PMID- 1638714
TI  - Effect of completeness of revascularization on long-term outcome of patients with
      three-vessel disease undergoing coronary artery bypass surgery. A report from the
      Coronary Artery Surgery Study (CASS) Registry.
AB  - BACKGROUND: Complete revascularization after coronary artery bypass surgery is a
      logical goal and improves symptomatic outcome and survival. However, the impact
      of complete revascularization in patients with three-vessel coronary disease with
      varying severities of angina and left ventricular dysfunction has not been
      clearly defined. METHODS AND RESULTS: The study was performed as a retrospective
      analysis of 3,372 nonrandomized surgical patients from the Coronary Artery
      Surgery Study (CASS) Registry who had three-vessel coronary disease. Group 1 (894
      patients) had class I or II angina (Canadian Cardiovascular Society criteria) and
      group 2 (2,478 patients) had class III or IV angina. In group 1, adjusted
      cumulative 4-year survivals according to the number of vessels bypassed were 85%
      (one vessel), 94% (two vessels), 96% (three vessels), and 96% (more than three
      vessels) (log rank, p = 0.022). Adjusted event-free survival (death, myocardial
      infarction, definite angina, or reoperation) was not influenced by the number of
      vessels bypassed, nor was the anginal status among patients remaining alive after
      5 years. In group 2, adjusted cumulative 5-year survivals were 78% (one vessel),
      85% (two vessels), 90% (three vessels), and 87% (more than three vessels) (log
      rank, p = 0.074). Adjusted event-free survivals after 6 years were 23% (one
      vessel), 23% (two vessels), 29% (three vessels), and 31% (more than three
      vessels) (p = 0.025); at 5 years, those with more complete revascularization were
      more likely to be asymptomatic or free of severe angina. Among group 2 patients
      with ejection fractions less than 0.35, 6-year survival was 69% for those with
      grafts to three or more vessels versus 45% for those with grafts to two vessels
      (p = 0.04). Placing grafts to three or more vessels was independently associated
      with improved survival and event-free survival in group 2 but not group 1
      patients. The case-fatality rates among 529 patients experiencing a myocardial
      infarction during follow-up was significantly higher for patients with less
      complete revascularization. CONCLUSIONS: Complete revascularization (grafts to
      three or more vessels) in patients with three-vessel coronary disease appears to
      most benefit those with severe angina and left ventricular dysfunction.

PMID- 1638715
TI  - Coronary angioplasty in cardiac transplant patients. Results of a multicenter
      study.
AB  - BACKGROUND: Accelerated allograft atherosclerosis is the main cause of death of
      cardiac transplant recipients after the first year after transplantation. Because
      no medical therapy is known to prevent or retard graft atherosclerosis and
      transplantation is associated with a shortened allograft survival, alternative,
      palliative therapy with percutaneous transluminal coronary angioplasty (PTCA) has
      been attempted. Because no single medical center has performed angioplasty in a
      large number of cardiac transplant recipients, representatives of 11 medical
      centers retrospectively analyzed their complete experience of coronary
      angioplasty in cardiac transplant patients to determine the safety, efficacy,
      limitations, and long-term outcome of angioplasty in allograft coronary vascular
      disease. METHODS AND RESULTS: Thirty-five patients underwent 51 angioplasty
      procedures for 95 lesions 46 +/- 5 months (mean +/- SEM) after transplantation.
      The primary indications for angioplasty included angiographic coronary disease in
      22 cases (43%) and noninvasive evidence of ischemia in 18 procedures (35%).
      Angiographic success, defined as less than or equal to 50% post-PTCA stenosis,
      occurred in 88 of 95 lesions (93%). Mean pre-PTCA stenosis was 83 +/- 1.1%; mean
      post-PTCA stenosis was 29 +/- 2.1% (p less than 0.0001). Periprocedural
      complications included myocardial infarction and late in-hospital death in one
      patient and three groin hematomas. Twenty-three of the 35 patients (66%) had no
      major adverse outcome such as death, retransplantation, or myocardial infarction
      at 13 +/- 3 months after angioplasty. Four patients died less than 6 months after
      angioplasty, and four died more than 6 months after angioplasty (range, 6-23
      months). Two patients had retransplantation 2 months after PTCA, and one patients
      had retransplantation 18 months after angioplasty. CONCLUSIONS: Coronary
      angioplasty may be applied in selected cardiac transplant recipients with
      comparable success and complication rates to routine angioplasty. Whether
      angioplasty prolongs allografts survival remains to be determined by a
      prospective, controlled trial.

PMID- 1638716
TI  - Ventricular fibrillation in hypertrophic cardiomyopathy is associated with
      increased fractionation of paced right ventricular electrograms.
AB  - BACKGROUND: Intraventricular conduction in hypertrophic cardiomyopathy (HCM) has
      been characterized to test the hypothesis that myofibrillar disarray will cause
      dispersion of activation throughout the ventricular myocardium. METHODS AND
      RESULTS: Of 37 patients with HCM, four had spontaneous ventricular fibrillation
      (VF), five had nonsustained ventricular tachycardia (VT), 13 had no risk factors,
      and 15 had a family history of sudden death. These patients and four controls
      were studied by pacing one site in the right ventricle and recording electrograms
      from three other right ventricular sites. These electrograms were high-pass
      filtered to emphasize small deflections due to activation of small bundles of
      myocytes close to the electrode. Intraventricular conduction curves were obtained
      with S1S2 coupling intervals decreasing in 1-msec steps from 479 msec to
      ventricular effective refractory period (VERP). These curves were repeated by
      pacing each RV site in turn and were characterized by two parameters: the point
      at which latency increased by 0.75 msec/20 msec reduction of the S1S2 coupling
      interval and an increase in electrogram duration between an S1S2 of 350 msec and
      VERP. Patients with VF, VT, and family history of sudden death had a mean
      increase in electrogram duration of 12.8 (2.9-32.3) msec versus 4.6 (-4.2 to
      14.0) msec in low-risk patients and controls. Electrogram latency increased at an
      S1S2 of 363 msec in the VF group (342-386), 269 msec in the controls (266-279),
      and 326 msec in the non-VF group (260-399). Discriminant analysis separated VF
      patients from the remainder (p less than 0.0001) and VF, VT, and family history
      of sudden death patients from the low-risk and control groups (p less than 10(
      6)). CONCLUSIONS: Patients with HCM who are at risk of sudden death have
      increased dispersion and inhomogeneity of intraventricular conduction, and this
      may create the conditions for reentry and arrhythmogenesis.

PMID- 1638717
TI  - Effects of aging, sex, and physical training on cardiovascular responses to
      exercise.
AB  - BACKGROUND: The relative contributions of decreases in maximal heart rate, stroke
      volume, and oxygen extraction and of changes in body weight and composition to
      the age-related decline in maximal oxygen uptake (VO2max) are unclear and may be
      influenced by sex and level of physical activity. METHODS AND RESULTS: To
      investigate mechanisms by which aging, sex, and physical activity influence
      VO2max, we quantified VO2, cardiac output, and heart rate during submaximal and
      maximal treadmill exercise and assessed weight and fat-free mass in healthy
      younger and older sedentary and endurance exercise-trained men and women. For
      results expressed in milliliters per kilogram per minute, a three-to-four-decade
      greater age was associated with a 40-41% lower VO2max in sedentary subjects and a
      25-32% lower VO2max in trained individuals (p less than 0.001). A smaller stroke
      volume accounted for nearly 50% of these age-related differences, and the
      remainder was explained by a lower maximal heart rate and reduced oxygen
      extraction (all p less than 0.001). Age-related effects on maximal heart rate and
      oxygen extraction were attenuated in trained subjects (p less than 0.05). After
      normalization of VO2max and maximal cardiac output to fat-free mass, age- and
      training-related differences were reduced by 24-47% but remained significant (p
      less than 0.05). For trained but not sedentary subjects, maximal cardiac output
      and stroke volume normalized to fat-free mass were greater in men than in women
      (p less than 0.05). CONCLUSIONS: A lower stroke volume, heart rate, and
      arteriovenous oxygen difference at maximal exercise all contribute to the age
      related decline in VO2max. Effects of age and training on VO2max, maximal cardiac
      output, and stroke volume cannot be fully explained by differences in body
      composition. In sedentary subjects, however, the sex difference in maximal
      cardiac output and stroke volume can be accounted for by the greater percentage
      of body fat in women than in men.

PMID- 1638718
TI  - Differences in cardiovascular responses to isoproterenol in relation to age and
      exercise training in healthy men.
AB  - BACKGROUND: Cardiac aging is characterized by a reduced heart rate response to
      beta-agonist stimulation with isoproterenol, but whether the ejection fraction
      and other cardiovascular responses are reduced in humans is largely unknown. In
      addition, whether reduced beta-agonist responses can be improved with exercise
      training has not been determined in humans. METHODS AND RESULTS: Cardiovascular
      responses to graded isoproterenol infusions (3.5, 7, 14, and 35 ng/kg/min for 14
      minutes each) were assessed in 15 older (age, 60-82 years) and 17 young (age, 24
      32 years) rigorously screened healthy men. Thirteen older and 11 young subjects
      completed 6 months of endurance training and were retested. At baseline, the
      older group had reduced responses to isoproterenol for heart rate (+65% older
      versus +92% young, p less than 0.001), systolic blood pressure (+9% versus +24%,
      p less than 0.001), diastolic blood pressure (-12% versus -24%, p less than
      0.05), ejection fraction (+12 versus +20 ejection fraction units, p less than
      0.001), and cardiac output (+70% versus +100%, p less than 0.001). The mean
      plasma isoproterenol concentrations achieved during the infusions were marginally
      higher (p = 0.07) in the older group (128 +/- 58, 227 +/- 64, 354 +/- 114, and
      700 +/- 125 pg/ml) than in the young (79 +/- 20, 178 +/- 49, 273 +/- 79, and 571
      +/- 139 pg/ml). Intensive training increased maximal oxygen consumption by 21% in
      the older group (28.9 +/- 4.6 to 35.1 +/- 3.8 ml/kg/min, p less than 0.001) and
      by 17% in the young (44.5 +/- 5.1 to 52.1 +/- 6.3 ml/kg/min, p less than 0.001),
      but training did not augment any of the cardiovascular responses to isoproterenol
      in either group. The mean plasma isoproterenol concentrations at the four
      infusion doses were unchanged after training in both groups. CONCLUSIONS: We
      conclude that there is an age-associated decline in heart rate, blood pressure,
      ejection fraction, and cardiac output responses to beta-adrenergic stimulation
      with isoproterenol in healthy men. Altered beta-adrenergic responses probably
      contribute to the reduced cardiac responses to maximal exercise that also occur
      with aging. Furthermore, intensive exercise training does not increase cardiac
      responses to beta-adrenergic stimulation with isoproterenol in either young or
      older men. The reduced beta-adrenergic response appears to be a primary age
      associated change that is not caused by disease or inactivity.

PMID- 1638719
TI  - Effective arterial elastance as index of arterial vascular load in humans.
AB  - BACKGROUND: This study tested whether the simple ratio of ventricular end
      systolic pressure to stroke volume, known as the effective arterial elastance
      (Ea), provides a valid measure of arterial load in humans with normal and aged
      hypertensive vasculatures. METHODS AND RESULTS: Ventricular pressure-volume and
      invasive aortic pressure and flow were simultaneously determined in 10 subjects
      (four young normotensive and six older hypertensive). Measurements were obtained
      at rest, during mechanically reduced preload, and after pharmacological
      interventions. Two measures of arterial load were compared: One was derived from
      aortic input impedance and arterial compliance data using an algebraic expression
      based on a three-element Windkessel model of the arterial system [Ea(Z)], and the
      other was more simply measured as the ratio of ventricular end-systolic pressure
      to stroke volume [Ea(PV)]. Although derived from completely different data
      sources and despite the simplifying assumptions of Ea(PV), both Ea(Z) and Ea(PV)
      were virtually identical over a broad range of altered conditions: Ea(PV) =
      0.97.Ea(Z) + 0.17; n = 33, r2 = 0.98, SEE = 0.09, p less than 0.0001. Whereas
      Ea(PV) also correlated with mean arterial resistance, it exceeded resistance by
      as much as 25% in older hypertensive subjects (because of reduced compliance and
      wave reflections), which better indexed the arterial load effects on the
      ventricle. Simple methods to estimate Ea (PV) from routine arterial pressures
      were tested and validated. CONCLUSIONS: Ea(PV) provides a convenient, useful
      method to assess arterial load and its impact on the human ventricle. These
      results highlight effects of increased pulsatile load caused by aging or
      hypertension on the pressure-volume loop and indicate that this load and its
      effects on cardiac performance are often underestimated by mean arterial
      resistance but are better accounted for by Ea.

PMID- 1638720
TI  - A recombinant, chimeric enzyme with a novel mechanism of action leading to
      greater potency and selectivity than tissue-type plasminogen activator.
AB  - BACKGROUND: Early intervention with thrombolytic agents has been shown
      unequivocally to reduce mortality after acute myocardial infarction. Presently
      used agents have disadvantages such as short half-life, immunogenicity,
      hypotension, and bleeding complications. Therefore, there is a need to develop
      improved thrombolytic drugs with novel mechanisms of action leading to improved
      properties. METHODS AND RESULTS: Hybrid plasminogen/tissue-type plasminogen
      activator (t-PA) complementary DNA was constructed and expressed in Chinese
      hamster ovary cells. The chimeric protein, comprising the fibrin-binding domains
      of plasminogen covalently linked to the catalytic domain of t-PA, was purified
      and evaluated in vitro and in vivo. The hybrid was inhibited rapidly in human and
      animal plasmas. The mediator of this rapid inhibition was shown to be alpha 2
      antiplasmin. The active center of the hybrid could be protected by reversible
      active center acylation with a novel inverse acylating agent, 4'-amidinophenyl-4
      chloroanthranilic acid (AP-CLAN). An acylated (CLAN-) hybrid was cleared from the
      bloodstream of guinea pigs at 0.35 +/- 0.02 ml/min.kg-1 compared with a clearance
      rate of 36 +/- 4 ml/min.kg-1 for t-PA. The CLAN-plasminogen/t-PA hybrid was
      evaluated in a quantitative, "humanized" guinea pig pulmonary embolism model and
      shown to be approximately threefold more potent when given by bolus than an
      infusion of t-PA. Furthermore, the acylated hybrid was more fibrin selective than
      t-PA as determined by the relation between clot lysis and fibrinogen degradation.
      CONCLUSIONS: An acylated, recombinant plasminogen/t-PA hybrid has sufficiently
      slow clearance to be administered by bolus and is more potent and fibrin
      selective than t-PA in vivo.

PMID- 1638721
TI  - A mathematical model for the quantification of mitral regurgitation. Experimental
      validation in the canine model using contrast echocardiography.
AB  - BACKGROUND: Because the clearance of contrast from the left atrium (LA) relative
      to the left ventricle (LV) depends on the degree of mitral regurgitation (MR), we
      hypothesized that a mathematical model can be developed that would provide a
      quantitative estimation of MR from the washout of contrast from these chambers.
      METHODS AND RESULTS: After mathematically developing the model, we performed
      experiments in two groups of dogs with the use of contrast echocardiography.
      Group 1 consisted of nine dogs in which different degrees of MR were produced by
      creating ischemic LV dysfunction. Contrast was injected into the LV, and MR was
      graded visually on a scale of from 0 to 4+. Videointensity plots generated from
      the LA and LV were provided to the model. There was excellent correlation between
      visual assessment of MR and model-derived regurgitant fraction in the 33 stages:
      y = 0.16x + 0.002 (r = 0.97, p less than 0.001, SEE = 0.06). To obtain a more
      quantitative validation, we placed electromagnetic flow probes on the aorta and
      just cephalad to the mitral annulus in six dogs (group 2) during cardiopulmonary
      bypass. Different degrees of MR were produced by chordal traction and/or
      myocardial ischemia. Regurgitant fraction was calculated at each stage from the
      flow probe and videointensity data. There was excellent correlation between flow
      probe and model-derived regurgitant fraction (y = 0.90x + 0.03; r = 0.96, p less
      than 0.001, SEE = 0.06), and close interobserver and intraobserver correlations
      were noted using flow probe and contrast echocardiographic data. CONCLUSIONS: A
      mathematical model that uses the clearance of contrast from the LA relative to
      the LV can be used to accurately measure the severity of MR. These findings may
      have important practical implications for the quantification of MR.

PMID- 1638722
TI  - Influence of the force-frequency relation on left ventricular function during
      exercise in conscious dogs.
AB  - BACKGROUND: The magnitude of the force-frequency effect on myocardial
      contractility in the conscious animal has been studied at rest, but it has not
      been assessed during exercise. METHODS AND RESULTS: The influence of heart rate
      (HR) changes were evaluated during treadmill exercise in eight preinstrumented,
      conscious dogs in which high-fidelity left ventricular (LV) pressure, LV volume
      (by sonomicrometry), and aortic pressure were measured. Under resting conditions,
      end-systolic pressure-volume relations were obtained using inferior vena caval
      occlusion. Dogs were run on a treadmill, and the intrinsic exercise HR was
      reduced by infusion of a specific bradycardic drug (UL-FS 49 0.5 mg/kg) during
      continuing exercise while HR was maintained at 240 beats per minute by atrial
      pacing. At 6 minutes of running at a fixed, paced HR when a stable drug effect
      had been achieved, no effects of UL-FS 49 on measures of LV contractility were
      detected compared with exercise before drug administration. HR was then reduced
      stepwise from 240 to 210, 180, or 150 beats per minute in a random manner,
      returning to 240 beats per minute between steps. Progressive reductions in
      measures of myocardial contractility occurred as the HR was slowed, and reduction
      of rate from 240 to 150 beats per minute reduced the LV maximum positive dP/dt by
      31% and (dP/dt)DP40 by 21% despite increases in LV end-diastolic pressure. The
      entire end-systolic pressure-volume could not be determined during exercise, but
      beat-averaged end-systolic pressure-volume points during exercise were
      progressively shifted to the right and downward by slowing the exercise HR. Thus,
      a pronounced negative inotropic influence of slowing the heart was observed
      during exercise, and the rate of ventricular relaxation (tau) was also
      significantly prolonged. CONCLUSIONS: These findings indicate that force
      frequency effects on the inotropic state of the intact LV are markedly enhanced
      by exercise.

PMID- 1638723
TI  - Severe right ventricular pressure loading in fetal sheep augments global
      myocardial blood flow to submaximal levels.
AB  - BACKGROUND: It has previously been shown that the fetal right ventricle (RV) is
      sensitive to changes in arterial pressure and that its stroke volume is
      significantly reduced with acute increases in pulmonary arterial pressure.
      However, the myocardial blood flow (MBF) response to increases in pulmonary
      arterial pressure have not been investigated in the fetus. METHODS AND RESULTS:
      To assess whether the RV afterload sensitivity to arterial pressure is associated
      with limitation in MBF, seven fetal lambs were instrumented at 130 days of
      gestation with a pulmonary arterial occluder and intravascular catheters. RV
      stroke volume was measured by an electromagnetic flow probe and MBF by 15-microns
      labeled microspheres. MBF was determined at baseline and during incremental
      increases in pulmonary arterial pressure. Maximal MBF was determined in seven
      additional fetuses during adenosine infusion. The highest tolerated pressure was
      associated with a 50% reduction in RV stroke volume. The highest pulmonary
      arterial occlusion pressure resulted in a doubling of MBF to all regions of the
      heart (266 +/- 99 to 504 +/- 158, 193 +/- 69 to 387 +/- 100, and 171 +/- 66 to
      338 +/- 134 ml/min/100 g for the RV, septum, and left ventricle, respectively).
      The best correlation for increases in both RV and global MBF was the RV heart
      rate-systolic pulmonary pressure product. Adenosine infusion was associated with
      a threefold increase in global MBF that was significantly greater than the MBF
      achieved during pulmonary arterial occlusion. CONCLUSIONS: The fetal RV
      sensitivity to acute pressure loading is not associated with limitation of MBF.
      The fetal myocardium has a remarkable flow reserve that allows for preservation
      of function during acute increases in arterial pressure.

PMID- 1638724
TI  - Sustained protection by acadesine against ischemia- and reperfusion-induced
      injury. Studies in the transplanted rat heart.
AB  - BACKGROUND: We have shown that acadesine (AICAr: 5-amino-4-imidazole carboxamide
      riboside) improves the early recovery of function of the ischemic and reperfused
      rat heart. In the present studies we used the transplanted rat heart, with
      reperfusion for up to 24 hours, to assess whether the beneficial effect of
      acadesine is a transient or a sustained phenomenon (i.e., to determine whether
      the drug improves the extent of recovery or only the rate). METHODS AND RESULTS:
      Hearts (n = 8 per group) were excised and immediately arrested with an infusion
      (2 minutes at 20 degrees C) of the St. Thomas' Hospital cardioplegic solution
      with or without the addition of acadesine (20 mumol/l). They were then subjected
      to 4 hours of global ischemia (20 degrees C), and the cardioplegic solution (with
      or without acadesine) was infused for 2 minutes every 30 minutes. The hearts then
      were transplanted (1 hour additional ischemic time) into the abdomens of
      recipient rats, which had been given acadesine (100 mg/kg i.v.) or saline. They
      were reperfused in situ for 30 minutes or 24 hours and then excised and perfused
      aerobically for 20 minutes. Contractile function was assessed, and the hearts
      were taken for metabolite analysis. Two sets of four groups (n = 8 per group)
      were studied (one set with 30 minutes and the other with 24 hours of
      reperfusion): group A, acadesine-free control; group B, acadesine during
      cardioplegia alone; group C, acadesine during reperfusion alone; and group D,
      acadesine during both cardioplegia and reperfusion. With 30 minutes of
      reperfusion, a significant improvement in functional recovery was seen in the two
      groups (groups B and D) in which acadesine had been added to the cardioplegic
      solution. Left ventricular developed pressure (LVDP) at 12 mm Hg of left
      ventricular end-diastolic pressure (LVEDP) was 104 +/- 3 mm Hg in both groups
      versus 88 +/- 3 mm Hg in the acadesine-free controls (p less than 0.05). No
      protection was observed after 30 minutes of reperfusion when acadesine had been
      added during reperfusion alone (89 +/- 4 mm Hg). In contrast, after 24 hours of
      reperfusion there was a significant improvement in postischemic LVDP in all
      acadesine-treated groups (group B, 104 +/- 6 mm Hg; group C, 106 +/- 7 mm Hg; and
      group D, 117 +/- 3 mm Hg versus only 73 +/- 6 mm Hg in the acadesine-free
      controls; p less than 0.05 in each case). Metabolite analysis indicated that at
      the end of ischemia ATP was less depleted and levels of tissue adenosine were
      higher in the acadesine group. During early (30 minutes) reperfusion, acadesine
      produced higher mean ATP contents, although this achieved a level of statistical
      significance only when the drug was administered during both cardioplegia and
      reperfusion. After 24 hours of reperfusion, the adenine nucleotide pools were
      similar in all groups. CONCLUSIONS: Acadesine can afford sustained functional
      protection against injury during extended periods of ischemia and reperfusion. We
      present evidence that the beneficial effect of acadesine may be mediated by two
      different components, with one operative during ischemia and early reperfusion
      and the other acting later in the reperfusion period.

PMID- 1638725
TI  - Acadesine and myocardial protection. Studies of time of administration and dose
      response relations in the rat.
AB  - BACKGROUND: Although there are many factors that might contribute to tissue
      injury during ischemia and reperfusion, the loss of adenine nucleotides has long
      been considered to be of importance. This has led to the study of interventions
      designed to limit the loss of nucleotides or to enhance the rate of nucleotide
      resynthesis during reperfusion. Alternatively, the breakdown of adenosine
      triphosphate to adenosine might represent a protective response of the ischemic
      heart because adenosine is considered an anti-injury autocoid. Augmentation of
      endogenous adenosine levels might be beneficial. For these reasons, the
      protective properties of acadesine (AICAr: 5-amino-4-imidazole carboxamide
      riboside) were assessed in a rat model of myocardial ischemia and reperfusion.
      METHODS AND RESULTS: The protective properties of acadesine were studied in the
      isolated, perfused rat heart subjected to global hypothermic (20 degrees C)
      ischemia and reperfusion. When acadesine was given as an in vivo pretreatment
      (100 mg/kg i.v. 15 minutes before study) followed by being administered as an
      additive (20 mumol/l) to the St. Thomas' Hospital cardioplegic solution (single
      dose) and then as an additive (20 mumol/l) to the initial reperfusion (15
      minutes) solution, the recovery of aortic flow after 2.5 hours of ischemia was
      improved from its control value of 16.5 +/- 3.9 ml/min to 28.9 +/- 4.1 ml/min (n
      = 8 per group; p less than 0.05). Similar protection was seen with other indexes
      of cardiac function. Analysis of hearts obtained at the end of 2.5 hours of
      ischemia and 35 minutes of reperfusion revealed no significant differences in
      metabolite content between control and drug-treated hearts with the exception of
      inosine monophosphate, which was increased from its drug-free control value of
      0.10 +/- 0.01 mumol/g dry wt to 0.86 +/- 0.06 mumol/g dry wt (p less than 0.05).
      In further studies (n = 8 per group), with multidose (every 30 minutes)
      cardioplegia and extended periods (6 hours) of hypothermic ischemia, acadesine
      consistently led to higher mean recoveries of function and lower levels of
      creatine kinase leakage. Again, the only significant metabolic effect was an
      increase in tissue inosine monophosphate content. In studies (n = 12 per group)
      to determine whether acadesine was acting before, during, or after ischemia, the
      drug was given 1) only as pretreatment (100 mg/kg i.v.), 2) only during single
      dose cardioplegia (20 mumol/l), or 3) only during reperfusion (20 mumol/l).
      Significant protection was observed in the first two groups (recovery of aortic
      flow increased from 10.6 +/- 2.6 ml/min in the acadesine-free control to 22.6 +/-
      2.8 and 23.6 +/- 3.1 ml/min, respectively; p less than 0.05). No significant
      protection was observed when acadesine was given only during reperfusion. In dose
      response studies, acadesine (0, 5, 20, 50, 200, and 1,000 mumol/l; n = 12 per
      group) was given only as a cardioplegic additive; the postischemic recoveries of
      aortic flow were 15.4 +/- 2.8, 16.9 +/- 3.6, 29.5 +/- 3.8, 27.4 +/- 3.8, 26.7 +/-
      4.2, and 27.1 +/- 2.7 ml/min, respectively. CONCLUSIONS: Acadesine improves the
      ability of the heart to recover from ischemia and reperfusion when administered
      before ischemia or with cardioplegia. The mechanism underlying the protection
      remains to be resolved.

PMID- 1638726
TI  - Pleural effusion as a cause of right ventricular diastolic collapse.
AB  - BACKGROUND: We hypothesized, after seeing several suggestive clinical examples,
      that a process leading to a large bilateral pleural effusion in the presence of
      an otherwise insignificant pericardial effusion could result in right ventricular
      diastolic collapse (RVDC) as seen by two-dimensional echocardiography. This
      noninvasive marker for hemodynamically significant cardiac tamponade occurs when
      pericardial fluid is under pressure. Therefore, RVDC resulting from a large
      pleural effusion would represent a false-positive indication of cardiac tamponade
      caused by excessive pericardial fluid. METHODS AND RESULTS: Seven spontaneously
      breathing dogs were chronically instrumented to measure ascending aortic, right
      atrial, intrapericardial, intrapleural, left atrial, and pulmonary artery
      pressures and cardiac output. Intravascular volume was adjusted before each
      experiment to the euvolemic range with saline solution. The onset of RVDC was
      observed in each animal by two-dimensional echocardiography during seven paired
      episodes of tamponade induced by infusions of warm saline into the pericardial
      space alone and, after drainage of the pericardial fluid and complete recovery,
      into the pleural space in the presence of a small pericardial effusion. The onset
      of RVDC occurred at the same intrapericardial (8.17 versus 9.47 mm Hg) and right
      atrial (7.41 versus 7.46 mm Hg) blood pressures regardless of whether it was
      produced by an intrapericardial or an intrapleural effusion but began in
      expiration during the former and in inspiration during the latter.
      Intrapericardial pressure increased in the same manner as intrapleural pressure
      during intrapleural saline infusion. Nevertheless, cardiac output and aortic
      blood pressure were better preserved, and at the onset of RVDC, the pulmonary
      artery systolic blood pressure was higher (p less than 0.0001) and the degree of
      pulsus paradoxus lower (p less than 0.01) with intrapleural infusion.
      CONCLUSIONS: These results indicate that a large bilateral pleural effusion can
      elevate intrapericardial pressure sufficiently to cause RVDC and, perhaps, lead
      to misdirected therapy of an otherwise insignificant pericardial effusion.

PMID- 1638727
TI  - Mechanism of double potentials recorded during sustained atrial flutter in the
      canine right atrial crush-injury model.
AB  - BACKGROUND: During atrial flutter, double potentials may be recorded at specific
      sites in the atria. It has been suggested that double potentials represent
      sequential activations at the center of the reentrant circuit. An alternative
      hypothesis is that double potentials represent electrical activity in an area of
      slow conduction. Understanding their mechanism is important because double
      potentials have been considered a possible indicator of target sites for catheter
      ablation. METHODS AND RESULTS: We systematically studied double potentials in our
      canine model of atrial flutter produced by right atrial crush injury using a 64
      channel computerized mapping system with 56 electrodes on the right atrium in
      seven mongrel dogs under general anesthesia. Activation maps were recorded during
      sinus rhythm before and after crush injury, during rapid pacing above and below
      the crush injury, and during sustained atrial flutter, entrainment of atrial
      flutter, and termination of atrial flutter induced with D-sotalol (2 mg/kg).
      During sinus rhythm before crush injury, activation was uniform, and double
      potentials were not recorded in any dog. After crush injury, activation proceeded
      up to and around the crush injury, and narrowly split double potentials were
      recorded in two of seven dogs. During rapid pacing above and below the crush
      injury, double potentials were recorded in five dogs. During 14 episodes of
      atrial flutter (mean cycle length, 140 +/- 16 msec), double potentials were
      recorded at electrodes along the crush injury. The activation time of the early x
      component of the double potentials (25 +/- 13 msec) was similar to that of
      adjacent electrodes above the crush injury (24 +/- 11 msec), and the activation
      time of the late y component (89 +/- 13 msec) was similar to that of adjacent
      electrodes below the crush injury (91 +/- 14 msec). The timing of the x and y
      components was dependent on the location of the recording electrode, with x and y
      widely spaced at the end of the crush injury near the area of earliest atrial
      activation during atrial flutter, more equally timed at the center of the crush
      injury, and more closely timed at the end of the crush injury opposite the area
      of earliest activation. During transient entrainment, double potentials were
      accelerated to the pacing rate, but their activation time relative to adjacent
      electrodes was maintained. During abrupt termination of atrial flutter, the early
      x component of the double potential was always recorded, but the late y component
      was not, because of conduction block below the posterior end of the crush injury.
      CONCLUSIONS: This study has shown in our canine model of atrial flutter that
      double potentials are recorded from the center of the reentrant circuit and that
      they represent sequential activations as the reentrant wave front passes on
      either side of the crush injury.

PMID- 1638728
TI  - Abnormal laterality and congenital cardiac anomalies. Relations of visceral and
      cardiac morphologies in the iv/iv mouse.
AB  - BACKGROUND: In the management of hearts with deranged laterality, it is essential
      that the left and right atrial chambers are correctly identified. There are two
      major approaches, which are based on venous connections or on the morphology of
      the atrial appendages, and there is no consensus as to which is the most useful.
      We used the iv/iv mouse mutant, which is known to be pertinent to this problem,
      to evaluate the relations of cardiac defects with atrial, venous, and other
      visceral morphologies. METHODS AND RESULTS: The morphology of the heart and other
      organs was examined in 275 iv/iv mice using criteria based on abnormal laterality
      in humans. The arrangement of the atrial appendages was determined by
      morphological examination of the junction between the appendage and the venous
      component of the atrium. On this basis, 45.1% of cases were shown to have usual
      atrial arrangement, 50.2% had mirror imagery, 1.5% had right isomerism, and 3.3%
      had left isomerism. Every case of atrial isomerism had a cardiac lesion; the
      morphological types were similar to those seen in human cases. Of cases with
      either usual or mirror-image arrangement of the appendages, 33.2% had abnormal
      spleens, but only 3.1% had cardiac defects. Similarly, venous abnormalities were
      much more common (30.1%) than cardiac defects. CONCLUSIONS: Study results endorse
      the importance of the morphology of atrial appendages in predicting cardiac
      abnormalities and point to the marked inconsistency of the arrangement of other
      organs, including the spleen and the connections of the systemic veins.

PMID- 1638729
TI  - Influence of loading conditions and contractile state on pulmonary venous flow.
      Validation of Doppler velocimetry.
AB  - BACKGROUND: Although recent studies suggest that pulmonary venous flow velocities
      may be used to evaluate left ventricular diastolic function, the influence of
      loading conditions and contractile state on the magnitude and pattern of
      pulmonary venous flow are poorly understood. METHODS AND RESULTS: Fourteen
      anesthetized open-chest mongrel dogs were instrumented with pulmonary venous flow
      probes, atrial sonomicrometer crystal paris, and high-fidelity micromanometers;
      transesophageal Doppler echocardiography was used to obtain simultaneous
      pulmonary venous flow velocities. Measurements were made over a wide range of
      left atrial pressure obtained by either intravascular volume infusion and
      inferior vena caval balloon inflation (n = 8), halothane inhalation (n = 6), or
      phenylephrine infusion (n = 5). There was an excellent correlation for pulmonary
      venous systolic (J) to diastolic (K) time integral between the Doppler and flow
      probe signal (r = 0.94; SEE, 0.18). When left atrial pressure was increased by
      volume infusion, there was a significant linear relation between mean left atrial
      pressure and the Doppler J/K peak (r = 0.64; SEE, 3.4 mm Hg) and flow velocity
      time integral ratio (r = 0.75; SEE, 2.9 mm Hg). By contrast, when left atrial
      pressure was elevated by halothane-induced cardiac depression, there was no
      correlation. The independent determinants of the pattern of pulmonary venous flow
      (stepwise multiple linear regression analysis) under all conditions were atrial
      systolic shortening, aortic systolic pressure, heart rate, and left ventricular
      end-systolic dimension (cumulative r = 0.80). CONCLUSIONS: The pattern of
      pulmonary venous flow can be measured accurately with Doppler velocities and is
      differentially influenced by loading conditions and myocardial contractile state;
      in the absence of myocardial contractile dysfunction, the pattern of pulmonary
      venous flow may provide an estimate of left atrial pressure; and pulmonary venous
      flow is determined largely by atrial systolic function.

PMID- 1638730
TI  - Chronic reduction of myocardial ischemia does not attenuate coronary collateral
      development in miniswine.
AB  - BACKGROUND: Myocardial ischemia is considered to be a possible stimulus for
      development of the coronary collateral circulation. We therefore hypothesized
      that chronic reduction of myocardial oxygen demand to lessen ischemia would
      attenuate coronary collateral development over an 8-week period using left
      circumflex coronary artery (LCx) ameroid-induced constriction in pigs. METHODS
      AND RESULTS: Collateral development was assessed by myocardial blood flow
      (radioactive microspheres) and left ventricular regional function (sonomicrometer
      dimension gauges). beta-Adrenoceptor blockade with propranolol (160 or 320 mg
      b.i.d.p.o.) was initiated in 15 animals 1 day after surgery. Compared with 16
      untreated animals, beta-adrenoceptor antagonism was documented in the treated
      group by 1) pharmacological stimulation with isoproterenol, 2) physiological
      stimulation during graded treadmill exercise, and 3) repeated long-term
      biotelemetry recordings of oxygen demand (heart rate and blood pressure) and
      regional myocardial function. In addition to pharmacological and physiological
      verification of beta-blockade, biotelemetry showed that, compared with the
      untreated animals, propranolol significantly reduced the daily number, individual
      duration, and severity of events representing myocardial dysfunction. This
      suggests that in the beta-blocked group, little if any ischemia was present
      throughout the first 5 weeks when collateral growth occurs. Transmural myocardial
      blood flow (expressed as a ratio of flow in the LCx region to the nonoccluded
      region of the left ventricle) and systolic wall thickening in the LCx region were
      determined at rest and during treadmill exercise (240 beats per minute) 31-38
      days (5 weeks) and 60-67 days (8 weeks) after surgery. Propranolol was withdrawn
      3 days before flow and function determinations and was resumed immediately after
      testing. Blood flow ratios at 5 weeks decreased similarly from rest to exercise
      in the untreated (0.83 +/- 0.04 to 0.60 +/- 0.05, p less than 0.05) and beta
      blockade group (0.82 +/- 0.09 to 0.57 +/- 0.10, p less than 0.05). Systolic wall
      thickening from rest to exercise was attenuated to the same degree in the
      untreated (59 +/- 6% to 38 +/- 6%, p less than 0.05) and beta-blockade group (50
      +/- 8% to 30 +/- 5%, p less than 0.05). Similar flow and function responses were
      observed in both groups at 8 weeks. CONCLUSIONS: We conclude that growth and
      development of the coronary collateral circulation measured functionally during
      exercise at 90% of maximal heart rate is unrelated to the extent and duration of
      myocardial ischemia in this model.

PMID- 1638731
TI  - PEG-SOD and myocardial protection. Studies in the blood- and crystalloid-perfused
      rabbit and rat hearts.
AB  - BACKGROUND: Polyethylene glycol, covalently linked to superoxide dismutase (PEG
      SOD), has a long plasma half-life (greater than 30 hours) and has been proposed
      as an effective agent for reducing free radical-mediated injury ischemia and
      reperfusion. METHODS AND RESULTS: Using an isolated rabbit heart perfused with
      arterial blood from a support rabbit, we have demonstrated that pretreatment with
      PEG-SOD (30,000 units/kg, intravenous bolus, 12-24 hours before 60 minutes of
      normothermic global ischemia), combined with addition of PEG-SOD to the blood
      perfusion circuit (30,000 units/kg to the support rabbit) and inclusion of PEG
      SOD (150 micrograms/ml) in a cardioplegic solution, enhanced the postischemic
      recovery of left ventricular developed pressure (LVDP) from 51 +/- 6 to 74 +/- 9
      mm Hg (p less than 0.05; n = 9 per group). In further studies we showed that,
      whereas maximum protection was obtained when PEG-SOD was given as a combined
      pretreatment and additive to both the cardioplegic and the reperfusate solutions
      (postischemic LVDP recovery increased from 44 +/- 4% in the control group to 70
      +/- 3% in the PEG-SOD group), the administration of PEG-SOD during pretreatment
      plus cardioplegia or during reperfusion alone also resulted in a significant
      improvement in postischemic function (62 +/- 7% and 60 +/- 3%, respectively).
      However, the use of PEG-SOD as a cardioplegic additive alone failed to afford
      protection (47 +/- 4% recovery of LVDP). In dose-response studies (with 0, 3,000,
      6,000, 12,000, 30,000, or 60,000 units/kg; n = 8 per group), maximum recovery of
      LVDP was obtained with the administration of 12,000 units/kg of PEG-SOD. Studies
      of the plasma activity of PEG-SOD confirmed its long half-life and showed that
      the treatment with PEG-SOD either 1 hour or 12-24 hours before the study resulted
      in similar levels of plasma activity. In an attempt to assess any involvement of
      blood-borne elements in the protection afforded by PEG-SOD, studies were also
      carried out in the crystalloid-perfused rabbit heart, and no protection was
      observed. Similarly, no protection was observed at any one of a variety of doses
      in the crystalloid-perfused rat heart. CONCLUSIONS: PEG-SOD can afford protection
      in the blood-perfused rabbit heart; this protection is dose dependent and
      probably involves some action of PEG-SOD on blood-borne elements, possibly
      leukocytes.

PMID- 1638732
TI  - An approach to evaluating thrombolytic therapy in acute myocardial infarction.
      The 'unsatisfactory outcome' end point.

PMID- 1638733
TI  - Risk, genotype, and cardiovascular disease.

PMID- 1638734
TI  - Evolution, evaluation, and efficacy of implantable cardioverter-defibrillator
      technology.

PMID- 1638736
TI  - Insurability of the adolescent and young adult with heart disease. Report from
      the Fifth Conference on Insurability, October 3-4, 1991, Columbus, Ohio.
AB  - By the mid-1990s there will be more than 500,000 young adults in the United
      States over the age of 21 with a cardiac malformation. Presently more than half
      of this population is denied insurance coverage entirely or in part because of
      their preexisting condition. Because some did not have coverage and because of
      uncertainty about whom to see for their cardiology care, patients assessed in NHS
      II who were evaluated by their physician on an annual basis before the age of 21
      were seen by a cardiologist only every 10 years after the age of 21. However,
      they have been shown by NHS-II to be well-educated, productive in the workplace,
      and to share an equal place in society with the general population. Their health
      care costs are decidedly lower after the age of 21 than before. This group
      represents a microcosm of a general society of more than 37 million Americans
      who, for various reasons, are not insured. Dr. Wiener described an American
      health-care system in crisis. Smaller companies are no longer able to afford
      health insurance for all their employees, especially for those with preexisting
      conditions, because of an industry pricing concept based on a claims-experience
      standard rather than a community standard. The insurance industry, the
      government, and patients are demanding medical cost-containment. Health-care
      costs, 12.2% of the gross national product in 1990, are climbing, and no end to
      this increase is presently in sight.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638735
TI  - Environmental tobacco smoke and cardiovascular disease. A position paper from the
      Council on Cardiopulmonary and Critical Care, American Heart Association.
AB  - Although the number of cardiovascular deaths associated with environmental
      tobacco smoke cannot be predicted with absolute certainty, the available evidence
      indicates that environmental tobacco smoke increases the risk of heart disease.
      The effects of environmental tobacco smoke on cardiovascular function, platelet
      function, neutrophil function, and plaque formation are the probable mechanisms
      leading to heart disease. The risk of death due to heart disease is increased by
      about 30% among those exposed to environmental tobacco smoke at home and could be
      much higher in those exposed at the workplace, where higher levels of
      environmental tobacco smoke may be present. Even though considerable uncertainty
      is a part of any analysis on the health affects of environmental tobacco smoke
      because of the difficulty of conducting long-term studies and selecting sample
      populations, an estimated 35,000-40,000 cardiovascular disease-related deaths and
      3,000-5,000 lung cancer deaths due to environmental tobacco smoke exposure have
      been predicted to occur each year. The AHA's Council on Cardiopulmonary and
      Critical Care has concluded that environmental tobacco smoke is a major
      preventable cause of cardiovascular disease and death. The council strongly
      supports efforts to eliminate all exposure of nonsmokers to environmental tobacco
      smoke. This requires that environmental tobacco smoke be treated as an
      environmental toxin, and ways to protect workers and the public from this health
      hazard should be developed. According to a 1989 Gallup survey commissioned by the
      American Lung Association, 86% of nonsmokers think that environmental tobacco
      smoke is harmful and 77% believe that smokers should abstain in the presence of
      nonsmokers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638737
TI  - Distribution and expression of G-protein in rat cerebral cortical cells. I.
      Intact tissue.
AB  - Localization and developmental expression of guanine nucleotide-binding
      regulatory protein (G-protein) were investigated in cerebral cortical tissue of
      rat. Immunohistochemical techniques using a rabbit polyclonal antibody were
      applied to reveal the pattern of G-protein distribution. Fluorescent staining in
      cortical sections was localized mainly to neurons; cell bodies were stained along
      with the proximal region of processes, including apical dendrites. All neurons
      appeared to be equally stained, and thus the staining activity reflected the
      laminar pattern of these cells in cortex. Moreover, areas of neuropil, white
      matter, and layer I were immunonegative, although synaptic labelling could not be
      directly eliminated. Most glial cells also lacked staining; however, moderately
      intense labelling was observed in the choroid plexus, ependymal cells and a
      subpopulation of microglia. Using Western immunoblot analysis, the antigens
      recognized in rat cerebral cortex were shown to co-electrophorese with the alpha-
      and beta-subunits of bovine brain G-protein, thus supporting the specificity of
      the antibody preparation utilized. In contrast to the adult tissue, in fetal and
      neonatal cortex faint to moderate staining was uniformly exhibited by essentially
      all cells. As determined by the immunoblot procedure, the overall level of G
      protein increased from the fetal stage through the neonatal and adolescent
      periods to reach a maximum concentration in young adult tissue. Based on cellular
      distribution, G-protein may function in the overall regulation of neuronal
      activity within cerebral cortex. Further, these results suggest that there is a
      selective developmental increase in expression of G-protein in specific cell
      populations, particularly neurons.

PMID- 1638738
TI  - Cytoarchitectonic abnormalities in hippocampal formation and cerebellum of dreher
      mutant mouse.
AB  - The laminated structures in the hippocampal formation and cerebellum of
      homozygous dreher mice were compared to their littermates and to C57BL/6J mice in
      Nissl- and myelin-stained preparations. In the dreher dentate gyrus, ectopic
      granule cells were situated in the molecular layer, and frequently there was
      either partial or complete absence of the infrapyramidal limb of the granule cell
      layer. In the dreher hippocampus, the cells of the pyramidal cell layer in area
      CA3 formed widely dispersed arrangements, and there were ectopically situated
      pyramidal cells in the stratum radiatum and stratum oriens. In the dreher
      cerebellum, 3 abnormal patterns were observed: (1) disruptions of foliation with
      normal cytoarchitectonic structure, (2) foliation with a mixture of normal
      laminated structure and abnormal laminated structure, and (3) almost complete
      absence of the cerebellum. In abnormal folia exhibiting the second or third
      pattern, islands consisting of agglomerations of both granule cells and Purkinje
      cells or just granule cells were observed. The neuronal heterotopias and
      cytoarchitectonic disorganization observed in the present study are apparently
      secondary to disruption of cell proliferation and neuronal migration produced
      directly or indirectly by the dreher mutation. In addition, the fact that the
      phenotypic abnormalities in homozygous dreher mice produces different abnormal
      morphologies in different specimens may be useful for analyzing the development
      of the hippocampal formation and cerebellum.

PMID- 1638739
TI  - Distribution and expression of G-protein in rat cerebral cortical cells. II.
      Primary tissue culture.
AB  - In continuing an assessment of the cellular distribution and developmental
      expression of brain guanine nucleotide-binding protein (G-protein) (Go), this
      component was investigated in primary cultures of dissociated cerebral cortical
      cells derived from fetal rat. Using a polyclonal antibody recognizing brain
      Gi/Go, G-protein was detected through immunohistochemical staining and a Western
      immunoblot procedure. In initial studies, the presence of G-protein in cultures
      containing mature cells was demonstrated using the immunoblot technique; this G
      protein corresponded predominately to the Go form as the alpha- and beta-subunits
      were revealed, and these co-migrated with similar antigens from the intact tissue
      and of purified bovine brain G-protein. The pattern of cellular localization or
      distribution in stained cultures was very similar to that observed in vivo, as
      differentially high staining was present in neurons, ependymal cells and
      microglia. In neurons, the immunofluorescent staining was relatively uniform over
      the cell body and at least the initial segment of processes. When cultures of
      different ages were assessed, the G-protein exhibited a developmental pattern of
      increase in expression similar to that observed in whole tissue, as determined by
      immunoblotting. The cortical cultures reflect the distribution and expression of
      G-protein in vivo and, thus, specific cell types therein may be useful in
      investigating the functional role of the predominate type of this protein in
      brain tissue (Go).

PMID- 1638740
TI  - The effects of systemic morphine on behavior and EEG in newborn rats.
AB  - Early studies suggested that newborn animals are far more susceptible to the
      convulsant effect of systemic morphine than adult animals. The present study
      reassessed morphine's (0, 6, 12.5, 25, 50, 100 and 300 mg/kg) toxic effects,
      making use of electroencephalographic (EEG) recordings, behavioral observations
      and the specific opiate antagonist naloxone in immature rats (postnatal days 1,
      3, 6, 12 and 24). Although morphine had opiate-specific effects (such as
      inhibition of activity at low doses), non-specific effects (such as
      hyperactivity) elicited by the highest doses, predominated in the 3 youngest age
      groups. At day 12 high doses of morphine first produced Straub tail and
      catatonia. At this age morphine produced EEG spikes that were not reversed by
      naloxone. Only at day 24 were electrographic spikes temporarily inhibited by
      naloxone. Behavioral convulsions were never observed, at any age. These findings
      indicate that morphine is less toxic in newborns than suggested previously.

PMID- 1638741
TI  - Microglial cell response to neuronal degeneration in the brain of brindled mouse.
AB  - Reactive changes of microglia in response to neuronal degeneration were
      investigated in the brains of brindled mottled mice with immunocytochemical
      technique. This mutant has a genetic defect in copper metabolism and spontaneous
      neuronal degeneration develops around postnatal day 10, in particular in the
      parasagittal regions of the cerebral cortex and thalamus. The antibodies to
      macrophage specific antigen, F4/80 and to type-three complement receptor, Mac-1
      were used for the study. Reactive morphological changes of microglia, which are
      immuno-reactive to the antibodies to F4/80 and/or Mac-1, were demonstrated in
      areas corresponding to those of neuronal degeneration, coincident with the
      emergence of cells expressing major histocompatibility complex class II, Ia,
      antigen. Some of the Ia expressing cells had morphological features of ramified
      microglia, while others were rod shaped with few processes and were mostly
      located in the perivascular regions. The focal nature of such cellular changes
      suggests that signal(s) from the degenerating neurons may be responsible for
      microglial activation and cellular expression of the Ia antigen in the brain of
      the brindled mouse.

PMID- 1638742
TI  - Refinement of dendritic arbors along the tonotopic axis of the gerbil lateral
      superior olive.
AB  - We have investigated the development of dendritic arbors in a central auditory
      nucleus in the Mongolian gerbil, the lateral superior olive (LSO). The morphology
      of these arbors has been shown to vary with tonotopic position in adults, with
      high frequency neurons having a more restricted field. In the present study,
      qualitative observations were made on horseradish peroxidase-filled neurons from
      animals 1-11 days postnatal, and quantitative results were obtained from Golgi
      impregnated material from animals 10 days postnatal and older. The tonotopic
      position of each cell was computed as a percent of the total distance along the
      LSO. The dendritic arbors of high frequency neurons became spatially constrained
      along the frequency axis during the 3rd postnatal week, while those in the low
      frequency region retained a broader arborization into adulthood. This refinement
      was correlated with a decrease in total dendritic length and the number of branch
      points per neuron, particularly in the high frequency projection region. The
      distribution of octave bandwidths to which single LSO neurons responded in 13-16
      day animals showed a similar course of maturation across the tonotopic axis: high
      frequency neurons responded to a larger number of octaves, and with greater
      variability, than those in adults. These data suggest that a specific alteration
      in dendrite morphology, which occurs after the onset of response to airborne
      sound, may contribute to adult frequency selectivity.

PMID- 1638743
TI  - Pyramidal neurons in immature rat hippocampus are sensitive to beta-adrenergic
      agents.
AB  - The development of hippocampal neuronal sensitivities to the beta-noradrenergic
      agent, isoproterenol, was examined in tissue from immature rats. The in vitro
      hippocampal slice preparation was used to assess intracellularly recorded
      responses from hippocampal neurons to pressure-pulse and bath application of
      noradrenergic drugs. Effects of the drug on individual hippocampal CA3 pyramidal
      neurons were compared across several stages of development, ranging from
      postnatal day 4-5 (P4-5) to maturity. Isoproterenol, pressure-pulse applied to
      CA3c pyramidal cells, produced a depolarization of membrane potential and an
      increase in cell input resistance in tissue as young as P7. Spike frequency
      adaptation (in trains of action potentials triggered by depolarizing pulses) was
      reduced, as were the slow after-hyperpolarizations following the spike trains.
      All agonist effects were blocked by timolol, a beta-antagonist. Drug-induced
      changes in cell membrane and firing properties in immature tissue were
      qualitatively similar to beta-receptor-mediated noradrenergic effects in adult
      tissue. These results indicate that the beta-receptor-mediated component of the
      noradrenergic effect in rat hippocampus is physiologically functional by the
      seventh day of postnatal life; at earlier times (P4-5) these beta-receptor
      mediated noradrenergic actions are, at best, equivocal.

PMID- 1638744
TI  - Environmental enrichment, neocortical ectopias, and behavior in the autoimmune
      NZB mouse.
AB  - New Zealand Black (NZB) mice have severe autoimmune disease and approximately 40%
      have cortical ectopias in layer I of sensorimotor cortex. Because the ectopias
      are similar to those found in dyslexics, NZB mice have been used as an animal
      model for developmental learning disorders. In addition, these mice have been
      used as a model of learning deficits associated with autoimmune disease. To
      determine whether early intervention would affect learning processes in NZB mice,
      they were reared after weaning in standard cages or enriched environments. They
      were given a battery of behavioral tests to measure learning, laterality, and
      activity, after which they were sacrificed and their brains examined for cortical
      ectopias. The tests sorted into two behavioral sets. Ectopia-associated behaviors
      included black-white discrimination learning and the Morris spatial maze. As a
      group, the mice performed well on these tasks. Ectopic mice had poorer
      performance than non-ectopics on these measures, and environmental enrichment
      countered the effects of the ectopias. Autoimmune-associated behavior involved
      two-way avoidance learning in a shuttlebox. Mice were uniformely poor on this
      task, ectopias did not affect behavior, and environmental enrichment was without
      benefit. Evidence from this and other studies shows that poor shuttlebox
      performance is related to the presence of autoimmune disease. Thus, autoimmune
      disease and cortical ectopias each appear to affect a separate set of behavioral
      processes. Environmental enrichment is most effective for behavioral impairments
      mediated via cortical ectopias, but is much less effective, if at all, if
      autoimmunity is the primary mediator of the impairments.

PMID- 1638745
TI  - Possible role for chondroitin sulfate in urolithiasis: in vivo studies in an
      experimental model.
AB  - The effect of chondroitin sulfate upon the growth of calcium oxalate crystals was
      measured in vivo by using an experimental model in rats. Adult male Wistar rats
      were treated by chronic i.p. injections of chondroitin sulfate solutions (1, 5 or
      10 mg in 0.3 ml of saline, every 2 days). This treatment led to a dose-dependent
      increase in the urinary chondroitin sulfate concentration. Urolithiasis was
      induced by the introduction of a calcium oxalate seed into the bladder of the
      animals. Urine samples were collected and the calculi formed were removed after
      42 days. The chondroitin sulfate concentration have decreased in the lithiasic
      urines, as compared to controls and higher chondroitin sulfate doses correlated
      with larger calculi. The presence of chondroitin sulfate in the matrices of
      stones obtained from chondroitin sulfate-treated animals suggested that there was
      some adsorption of chondroitin sulfate on to the growth sites of the calcium
      oxalate crystals. In contrast to the chondroitin sulfate effect observed in
      vitro, which inhibits the growth of calcium oxalate crystals, our results suggest
      that in vivo chondroitin sulfate promotes the growth of stones in the urinary
      tract.

PMID- 1638746
TI  - Abnormal lysosomal cathepsin activities in leukocytes and cultured skin
      fibroblasts in late infantile, but not in juvenile neuronal ceroid-lipofuscinosis
      (Batten disease).

PMID- 1638747
TI  - Liquid chromatography determination of alpha-tocopherol in erythrocytes.

PMID- 1638748
TI  - Fetal and amniotic alpha 1-acid glycoprotein.

PMID- 1638749
TI  - A method for quantitative collection of stool and urine for nitrogen balance
      studies in infants.

PMID- 1638750
TI  - Rapid and sensitive colloidal silver staining on cellulose acetate membranes.

PMID- 1638751
TI  - The effect of reducing and non-reducing sugars on the bicinchoninic acid reaction
      for protein determination.

PMID- 1638752
TI  - Procedure for development of an enzyme-linked immunosorbent assay. Development of
      an assay for human apolipoprotein A-I.
AB  - A set of criteria for selection of antibodies during the development of enzyme
      linked immunosorbent assay (ELISA) is described. Using these criteria, a
      competitive ELISA for human apo A-I using a polyclonal goat antibody was
      developed. The assay recognizes apo A-I from plasma and high-density lipoprotein
      (HDL), as well as the pure delipidated apo A-I, equally. Intra- and inter-assay
      variations were 5.2% and 3.5%, respectively. Recovery rate, as determined by
      spiking a known quantity of pure delipidated apo A-I into a reference plasma, was
      determined to be 101.3%. The assay was validated by comparing the concentration
      of apo A-I in HDL with the dye elution method. The apo A-I ELISA to apo A-I dye
      elution ratio was 1.01. Apo A-I concentration in Centers for Disease Control
      reference material determined by this method was in agreement with the reported
      consensus value. Repeated freezing and thawing of the samples (three freeze-thaw
      cycles at -20 degrees C) as well as long-term freezing (up to 1 year at -70
      degrees C) did not affect the concentration of apo A-I in the samples. The assay
      was applicable both to normolipidemic and dyslipidemic plasmas. No immunologic
      difference was noted when plasma from dyslipidemic subjects was assayed. A
      frequent problem of long-term storage is deamidation. The values found for apo A
      I in a deamidated plasma were the same as those for the corresponding fresh
      plasma. Plasma apo A-I values were also positively correlated with that of HDL
      cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638753
TI  - 13C and 31P NMR studies of glucose and 2-deoxyglucose metabolism in normal and
      enzyme-deficient human erythrocytes.
AB  - The flux of 13C-labeled glucose through the Embden-Meyerhof and pentose phosphate
      pathways was studied by 13C NMR in intact erythrocytes isolated from normal
      subjects or from patients suffering of glucose-6-phosphate dehydrogenase (G6PD,
      EC 1.1.1.49) deficiency. Similar rates of glucose catabolism and similar fluxes
      of the 13C-label into 2,3-bisphosphoglycerate and lactate were found, under basal
      conditions, in normal and in G6PD-deficient erythrocytes incubated in the
      presence of either [1-13C]- or D[6-13C]glucose. Exposure to oxidative stress by
      preincubation with tert-butylhydroperoxide induced in normal, but not in G6PD
      deficient erythrocytes, a significant enhancement of glucose consumption, as well
      as a substantial reduction in 13C-label transfer from C1-glucose into lactate. It
      was also possible, by 31P NMR, to evaluate the conversion of 2-deoxyglucose to
      its phosphate-containing metabolites. The oxidation and subsequent
      decarboxylation of 2-deoxyglucose-6-phosphate was assessed in reconstituted
      systems and could subsequently be evidenced also in ethanolic extracts from
      normal (but not from G6PD-deficient) erythrocytes which had been exposed to
      oxidative stress. The results indicate that, in terms of glucose flux through the
      glycolytic pathway, there is little or no difference between normal and G6PD
      deficient erythrocytes, regardless of previous exposure to oxidative stress.
      Faster consumption of either glucose or 2-deoxyglucose is induced, only in normal
      cells, by treatment with tert-butylhydroperoxide, essentially as a consequence of
      the activation of the pentose-phosphate pathway.

PMID- 1638754
TI  - Optimized determination of malondialdehyde in plasma lipid extracts using 1,3
      diethyl-2-thiobarbituric acid: influence of detection method and relations with
      lipids and fatty acids in plasma from healthy adults.
AB  - We investigated the influence of different concentrations of Fe3+, phosphoric
      acid, butylated hydroxytoluene and glutathione on the production of the
      malondialdehyde-1,3-diethyl-2-thiobarbituric acid adduct in plasma lipid
      extracts. Following organic solvent extraction the stable product was analyzed by
      spectrophotometry (537 nm), fluorometry (547 nm) and high-performance liquid
      chromatography with fluorometric detection. Using optimized reaction conditions
      there was good agreement between the three methods, with slightly higher values
      for the spectrophotometric method. Plasma total lipid malondialdehyde reference
      values for 24 healthy adults amounted to 1.30 +/- 0.23 mumol/l
      (spectrophotometric method) and 1.11 +/- 0.31 mumol/l (fluorometric method).
      Plasma lipid malondialdehyde concentrations correlated significantly with plasma
      triglycerides (r = 0.527), total cholesterol (r = 0.612) and total fatty acids (r
      = 0.810) and with the total number of double bonds present in plasma fatty acids
      with three or more double bonds (r = 0.923).

PMID- 1638755
TI  - The glycosaminoglycan composition of the lung with acute and chronic pathology
      and in senescence.
AB  - The content and distribution of GAGs in the anatomic structures of pathological
      (pneumoconiosis, pneumonia, pulmonary embolism) and senescent lungs have been
      measured. The total GAG content of the lung structures, except central bronchi is
      generally lower than normal in the pathological lungs. The GAG distribution in
      the pleura (DS predominant), central bronchi (C6S predominant), arteries, veins
      and 'total lung' is similar to the corresponding normal distribution. The other
      notable observations are: the concentration of HA in peripheral bronchi and
      alveoli is increased possibly in response to the high local concentration of coal
      dust; an age related GAG switch from DS in the arteries of the young to C6S in
      the arteries of the mature lung is confirmed; the arterial GAG content generally
      increases with age up to age 103 in the male; the arteries of a female smoker
      display the mature male pattern of GAG composition. The data suggest that gender,
      smoking and age, more than acute pathology, determine the GAG composition of the
      anatomic structures of the lung.

PMID- 1638756
TI  - Determination of (S)- and (R)-2-oxo-3-methylvaleric acid in plasma of patients
      with maple syrup urine disease.
AB  - An enzymatic method for the separate measurement of both chiral 2-oxo-3
      methylvaleric acid (OMV) compounds, (S)- and (R)-OMV, by NADH-dependent
      enantioselective amination using leucine dehydrogenase in the presence of a NADH
      regenerating system is described. This method allows the quantitative
      determination of all branched-chain 2-oxo acids, simultaneously. In plasma
      samples from classical maple syrup urine disease patients under therapy the
      average (R)-OMV/(S)-OMV ratio was 0.35 and great differences in the
      transamination equilibria of the diastereomeric branched-chain amino acids L
      isoleucine and L-alloisoleucine were demonstrated.

PMID- 1638757
TI  - Serum immunoreactive beta-glucuronidase determined by an enzyme-linked
      immunosorbent assay in patients with hepatic diseases.
AB  - An enzyme-linked immunosorbent assay (ELISA) was developed for human beta
      glucuronidase, using a specific polyclonal antibody raised against the purified
      enzyme. beta-Glucuronidase from human liver consisted of three subunits with
      molecular mass of 76, 64 and 18 kDa. The assay offered a specific, sensitive and
      convenient means of measuring immunoreactive beta-glucuronidase in human sera.
      beta-Glucuronidase activity determined by the conventional method appeared to be
      extremely low, indicating that in human sera beta-glucuronidase exists in an
      enzymatically inactive form. The sensitivity of the assay permitted the detection
      of 1-100 ng of purified beta-glucuronidase. A mean serum level in normal subjects
      was 108 +/- 25 ng/ml (mean +/- S.D.). A high level of beta-glucuronidase was
      found in sera of patients with severe hepatocellular necrosis, including liver
      cirrhosis (152 +/- 130 ng/ml) and chronic active hepatitis (220 +/- 99 ng/ml),
      whereas no significant increase of the enzyme protein was observed in chronic
      persistent hepatitis (102 +/- 42 ng/ml). beta-Glucuronidase was also increased in
      sera of patients with primary hepatoma (156 +/- 125 ng/ml). The immunoreactive
      beta-glucuronidase determined in this assay was thought to be a supplementary
      serological indicator for hepatocellular necrosis.

PMID- 1638758
TI  - An immunoreactive xanthine oxidase protein-possessing xanthinuria and her family.
AB  - The presence of immunoreactive xanthine oxidase protein was proven in a
      xanthinuric patient, using a polyclonal antibody against xanthine oxidase. The
      antibody was raised against purified human liver xanthine oxidase in a rabbit.
      Double immunodiffusion method demonstrated the existence of an immunologically
      reactive xanthine oxidase which did not possess xanthine oxidase activity. In
      addition, urinary excretion of oxypurines in the patient and her family was
      investigated. The results indicated that a brother and a sister had xanthinuria.

PMID- 1638759
TI  - A receptor assay for serum low density lipoprotein-apolipoprotein B-100:
      preliminary report.

PMID- 1638760
TI  - Experimental autoimmune uveoretinitis (EAU) versus experimental allergic
      encephalomyelitis (EAE): a comparison of T cell-mediated mechanisms.
AB  - EAU is a model of ocular inflammatory disease. EAU resembles another T cell
      mediated autoimmune disease--experimental allergic encephalomyelitis--since both
      have increased expression of MHC class II molecules in the target tissue, can be
      adoptively transferred by activated CD4+ T cells and are inhibited by cyclosporin
      A. The immunological findings will be compared to find out if the same cellular
      mechanisms are involved in both diseases.

PMID- 1638761
TI  - Rapamycin prevents the onset of insulin-dependent diabetes mellitus (IDDM) in NOD
      mice.
AB  - The effect of the immunosuppressive agent rapamycin (RAPA) was assessed in the
      non-obese diabetic (NOD) mouse which is an autoimmune model of IDDM. RAPA was
      prepared in a vehicle of 8% cremophor EL/2% ethanol and investigated in two
      studies. NOD/MrK female mice (six per group, study no. 1; 10 per group, study no.
      2) were dosed three times per week p.o. by gavage from 56 to 170 days of age
      (study no. 1) or from 64 to 176 days of age (study no. 2). Mice treated with RAPA
      at 0.6 mg/kg, 6 mg/kg, or 12 mg/kg maintained normal plasma glucose through 170
      or 176 days of age with 10%, 0%, and 0% incidence of diabetes respectively. In
      contrast, naive, vehicle-treated, or RAPA 0.06 mg/kg-treated mice exhibited
      elevated plasma glucose and disease incidence typical for female NOD mice. Mice
      which became diabetic had elevated levels of beta-hydroxybutyrate, triglycerides
      and cholesterol. These plasma lipid concentrations were positively correlated
      with the duration of hyperglycaemia (r = 0.85, 0.87 and 0.84 respectively).
      Outside of its ability to prevent diabetes, RAPA itself did not affect the lipid
      profile of the mice. Intervention therapy with RAPA was ineffective at reversing
      the course of disease after IDDM onset under these experimental conditions.
      Finally, we report here that prophylactic treatment with RAPA was able to protect
      against IDDM development in some RAPA-treated mice 41 weeks after cessation of
      treatment. These data show that orally administered RAPA is effective in
      preventing onset of disease in the NOD mouse, a relevant model of autoimmune type
      I diabetes in man.

PMID- 1638762
TI  - The effects of CP 17193, an immunosuppressive pyrazaloquinoline, on the
      development of spontaneous lupus disease in NZBW F1 hybrid mice.
AB  - The effects of the immunosuppressive agent CP 17193 on the development of
      spontaneous lupus disease in female NZBW F1 hybrid mice were investigated. Long
      term dosing with CP 17193 markedly delayed the onset of mortality but did not
      extend the long term survival of the mice. CP 17193 significantly inhibited
      immune complex deposition in the glomeruli of 30- and 35-week-old mice and also
      reduced the levels of proteinuria in the 35-week-old mice. There was a slight
      reduction in the levels of circulating antinuclear antibody to ds DNA in CP 17193
      treated mice but this was not statistically significant. Studies on immune cell
      function of 35-week-old mice dosed with CP 17193 showed significant reduction in
      the total numbers of spontaneous polyclonal antibody producing cells. Analysis of
      the results revealed these effects to result from a marked reduction in total
      spleen cell numbers in CP 17193-treated mice. When results were expressed as
      activity per cell unit the differences between drug-treated and control mice were
      small. Spleen cells from mice given a shorter dosing schedule of 7 weeks with CP
      17193 showed an augmentation of IL-2 production and responsiveness. These results
      show CP 17193 having interesting selective immunomodulating activity on the
      immunopathogenesis of spontaneous murine lupus disease. Furthermore, compounds
      with this profile of activity may have a potential role in the treatment of some
      autoimmune diseases.

PMID- 1638763
TI  - T cell heterogeneity in patients with common variable immunodeficiency as
      assessed by abnormalities of T cell subpopulations and T cell receptor gene
      analysis.
AB  - T lymphocyte regulation of immunoglobulin production may be abnormal in some
      patients with common variable immunodeficiency (CVI). Phenotypic analysis of
      peripheral blood T lymphocytes from nine patients with CVI was conducted to
      examine whether an abnormal distribution could be detected in a functionally
      distinct T lymphocyte subpopulation. The percentage of CD8+ lymphocytes proved to
      be increased in some patients and decreased in others. In comparison with normal
      controls, many patients with CVI had reduced percentages of lymphocytes
      expressing both CD4 and CD45RA, a phenotype associate with naive CD4+ cells.
      There was no significant difference in CD4+ populations bearing CD29 or leucocyte
      adhesion molecule-1 (LAM-1) antigens. The pattern of gene rearrangement of the T
      cell antigen receptor (TCR) was studied using peripheral blood lymphocytes from
      these patients with CVI. Genomic DNA from freshly isolated lymphocytes as well as
      from selectively propagated CD4+ or CD8+ populations were examined using Southern
      blot analysis and a probe for the beta chain of the TCR. A polyclonal pattern of
      TCR gene rearrangement, without the appearance of dominant non-germline bands,
      was demonstrated in all patient samples. These data suggest that the T
      lymphocytes in patients with CVI have a polyclonal pattern of TCR rearrangement
      despite an abnormal distribution of T cell subpopulations in some patients.

PMID- 1638764
TI  - Possible role of IL-2 deficiency for hypogammaglobulinaemia in patients with
      common variable immunodeficiency.
AB  - Common variable immunodeficiency (CVID) patients are unable to produce specific
      immunoglobulins after antigen contact in vivo. The aim of this study was to
      investigate whether in some cases of CVID a decreased de novo synthesis of IL-2
      might be the cause of immunodeficiency and whether this deficiency can be
      corrected by IL-2 supplementation in vitro. Mononuclear cells from 17 CVID
      patients and from 10 healthy controls were cultured with monoclonal anti-CD3
      antibody OKT3, pokeweed mitogen (PWM) or tetanus toxoid (TT) to stimulate IL-2
      synthesis. In parallel, in vitro IgG and IgM synthesis was stimulated with
      Staphylococcus aureus Cowan I (SAC), PWM or TT in the presence or absence of IL
      2. While lymphocytes of 11 out of 17 patients produced low to normal amounts of
      IL-2 upon stimulation with anti-CD3, only three patients showed low IL-2
      production in response to PWM and five in response to TT. Regarding
      immunoglobulin synthesis in vitro, five patients completely failed to produce IgM
      or IgG upon stimulation with PWM, SAC or TT irrespective of the addition of IL-2.
      By contrast, four patients did not show any defect in vitro and synthesized
      normal amounts of IgM and IgG with any of the three stimuli. Finally, eight
      patients could be reconstituted for PWM-, SAC- and TT-induced IgM and/or IgG
      synthesis in vitro, by adding IL-2 to the culture system. This enhancing effect
      of IL-2 could be blocked by adding anti-IL-2 receptor antibodies to the cultures.
      Our findings indicate that a defective IL-2 synthesis after antigen stimulation
      may be one reason for the impaired immunoglobulin production in some cases of
      CVID.

PMID- 1638765
TI  - Raised serum neopterin levels in patients with primary hypogammaglobulinaemia;
      correlation to other immunological parameters and to clinical and histological
      features.
AB  - Serum neopterin levels were analysed in 43 patients with primary
      hypogammaglobulinaemia (25 common variable immunodeficiency (CVI), 12 congenital
      hypogammaglobulinaemia (CH), six X-linked hypogammaglobulinaemia (XLH)), and in
      33 healthy controls. The neopterin values were correlated to lymphocyte subset
      counts in peripheral blood, lymphocyte mitogen responses and clinical and
      histological manifestations in the study group. Serum neopterin levels were
      significantly elevated in all subgroups of patients and particularly in the CVI
      groups where the highest concentrations were found (P less than 0.001, CVI versus
      controls). Furthermore, in CVI and CH patients elevated neopterin levels were
      strongly correlated to decreased number of CD4+ lymphocytes (rs = -0.61, P less
      than 0.005 and rs = -0.83, P less than 0.001, respectively). In the CVI group
      high neopterin levels were also significantly correlated to low number of
      circulatory B (CD19+) lymphocytes (rs = -0.58, P less than 0.05). Both patients
      with moderately and those with severely depressed lymphocyte mitogen responses
      had significantly higher neopterin levels than those with normal responses. In
      addition, high neopterin levels were significantly associated with the occurrence
      of splenomegaly and nodular intestinal lymphoid hyperplasia. The immunological
      findings were consistently observed in longitudinal testing, and appeared to be
      characteristic for the individual patient. High serum neopterin levels are
      thought to be a marker for hyperactivity in monocytes/macrophages, and
      dysfunction of these cells may therefore be associated with fundamental immune
      pathology in some subgroups of primary hypogammaglobulinaemia.

PMID- 1638766
TI  - Induction of experimental systemic lupus erythematosus (SLE) in mice with severe
      combined immunodeficiency (SCID).
AB  - A model in which experimental SLE is induced in normal mice by the injection of a
      human anti-DNA MoAb expressing a common idiotype 16/6 Id has been established in
      our laboratory. In the present study we have attempted the induction of
      experimental SLE in mice with SCID by the transfer of lymphocytes obtained from
      mice with experimental SLE. Disease could not be induced by direct immunization
      of SCID mice with the 16/6 Id nor by transfusion of normal splenocytes and
      immunization with the 16/6 Id thereafter. In contrast, disease was induced in
      SCID mice which were transplanted with splenic lymphocytes obtained from SLE
      afflicted BALB/c mice. The disease was expressed by the presence of high titres
      of antibodies and glomerular immune complex deposits were present in the kidney
      sections of these mice. Mice that received spleen cells from donors with
      experimental SLE together with the 16/6 Id developed higher titres of
      autoantibodies and had, in addition to the immune complex deposits, glomerular
      histological pathology. The model of experimental SLE induction in SCID mice
      should help in the elucidation of the role of different cell types in the
      pathogenesis of SLE.

PMID- 1638767
TI  - Acceleration of onset of collagen-induced arthritis by intra-articular injection
      of tumour necrosis factor or transforming growth factor-beta.
AB  - We examined whether tumour necrosis factor (TNF) or transforming growth factor
      beta 1 (TGF-beta 1) could alter the course of collagen-induced arthritis (CIA).
      Injection of 100 ng TNF or 500 ng TGF-beta 1 into ankle joints of normal rats
      induced a very limited inflammatory response, observable only upon histological
      analysis. However, when injected into ankle joints of rats 9 days after
      immunization with bovine type II collagen (CII), identical doses of TNF or TGF
      beta 1 induced a sustained, clinically obvious inflammation and oedema that began
      within 8 h on average, as compared to 90 h in CII-immunized control rats given no
      injections or intra-articular injections of buffer. The incidence of arthritis at
      2 weeks post-immunization was 100% for TNF-injected hindpaws, compared with 55%
      for the control groups, a statistically significant difference. In rats passively
      immunized with a subarthritic dose of affinity purified antibody to rat-CII,
      intra-articular injection of 100 ng TNF or 500 ng of TGF-beta 1 also induced
      intense, though transient arthritis. The rapid proinflammatory effects in CIA
      described in this study and the synergy demonstrated between anti-CII IgG and
      either cytokine, suggest that these cytokines can participate locally in the
      pathogenesis of arthritis.

PMID- 1638768
TI  - Activation of IL-6 production by UV irradiation of blood mononuclear cells from
      patients with systemic lupus erythematosus.
AB  - Cultured mononuclear cells from patients with systemic lupus erythematosus (SLE),
      rheumatoid arthritis (RA), and normal donors were assayed for their ability to
      secrete IL-6 both spontaneously and after exposure to UV light. Mononuclear cells
      from SLE, RA and atopic control patients produced IL-6 spontaneously, while those
      from normal donors did not. Spontaneous production of IL-6 occurred in the non
      adherent cell population. UV light-induced IL-6 production was confined
      exclusively to the SLE patients and was present only in the macrophage/monocyte
      fraction. This stimulation was induced by wavelengths in the UVA, UVB but not the
      UVC portion of the spectrum. These results suggest that cytokine release may be
      involved in the exacerbations of SLE provoked by photosensitivity.

PMID- 1638769
TI  - Serum levels of IL-1, IL-6 and tumour necrosis factors in patients undergoing
      coronary artery bypass grafts or cholecystectomy.
AB  - Plasma levels of biologically active IL-1, tumour necrosis factor (TNF) and IL-6
      were measured before, during and after coronary artery bypass graftings (CABG) (n
      = 9) and cholecystectomy (CHO, n = 9), and in normal controls (nine healthy
      volunteers). Mean pre-operative IL-1 concentration in four of the nine CABG
      patients was 0.452 + 0.03 ng/ml, significantly (P less than 0.001) higher than
      that of the other five (0.045 +/- 0.009 ng/ml), CHO patients (0.035 +/- 0.005
      ng/ml) and controls (0.029 +/- 0.008 ng/ml). Three of the four patients with high
      pre-operative IL-1 had functional capacity IV, while the other five had
      functional capacity IIa or IIb. Slight IL-1 elevation after anaesthesia, followed
      by reduction after initiation of bypass, elevation on completion of surgery and
      reduction to basal levels after 7 days was found in patients undergoing CABG.
      Mean basal TNF levels of CABG and CHO patients did not differ, but were higher
      than those of controls (2.85 +/- 0.5 ng/ml for CABG, 2.05 +/- 0.06 ng/ml for CHO,
      0.72 +/- 0.07 ng/ml for normals, P less than 0.001). A unique kinetics of release
      during CABG was observed also for TNF. Mean pre-operative IL-6 levels were normal
      (50 +/- 3 ng/ml for CABG, 50 +/- 0.5 ng/ml for CHO and 65 +/- 10 ng/ml for
      controls). Gradual elevation to a mean peak of 725 +/- 100 ng/ml on completion of
      CABG was observed as compared with 275 +/- 50 ng/ml in CHO (P less than 0.01). On
      the seventh post-operative day mean IL-6 levels returned to normal. Two patients
      with post-operative low-grade fever (38 degrees C) had high, late cytokine
      levels. One of these two patients had leucocytosis, sterile discharge from the
      operative wound and was diagnosed as suffering from the Dressler syndrome. In
      this study elevated cytokine values and unique kinetics of release into the serum
      were found in patients undergoing CABG.

PMID- 1638770
TI  - IL-4 and transforming growth factor-beta suppress human immunoglobulin secretion
      in vitro by surface IgD- B cells.
AB  - The effect of IL-4 and transforming growth factor-beta (TGF-beta) on
      immunoglobulin secretion in vitro by peripheral blood mononuclear cells (PBMC) or
      purified B cells activated with murine EL4 thymoma cells and phorbol myristate
      acetate (PMA) was investigated. As previously reported, IL-4 induced IgE and IgG4
      secretion by B cells in PBMC preparations and B cells activated with EL4 cells
      and PMA. However, when B cells, either in PBMC preparations or purified and
      activated with EL4 cells and PMA, spontaneously secreted large quantities of
      immunoglobulin, IL-4 suppressed the immunoglobulin secretion of all isotypes. IL
      4 also suppressed the IgE secretion by B cells from an atopic dermatitis patient.
      This suppressive effect was not reversed by adding IL-2 or interferon-gamma (IFN
      gamma) to the cultures. We also showed that TGF-beta suppressed the
      immunoglobulin secretion by purified B cells activated by EL4 cells and PMA. To
      investigate whether IL-4 or TGF-beta suppressed immunoglobulin secretion by in
      vivo 'switched' and isotype-committed B cells, sIgD- B cells were isolated,
      activated with EL4 cells and PMA and cultured with IL-4 or TGF-beta. Such
      activated B cells secreted large quantities of IgG1, IgG2, IgG3, IgA1, IgA2 and
      IgM, and IL-4 and TGF-beta suppressed all these isotypes by greater than 80%. The
      data demonstrated that IL-4 and TGF-beta suppress immunoglobulin secretion in
      vitro by in vivo isotype-committed sIgD- B cells, suggesting that these
      lymphokines may play a down-regulatory role on differentiated isotype-committed B
      cells in an isotype-unrestricted manner. The data also showed that IL-4 and TGF
      beta acted directly on isolated B cells.

PMID- 1638771
TI  - Interferon-gamma (IFN-gamma) and macrophage inflammatory proteins (MIP)-1 and -2
      are involved in the regulation of the T cell-dependent chronic peritoneal
      neutrophilia of mice infected with mycobacteria.
AB  - In mycobacterial infections of mice there is a chronic, immune-mediated
      mobilization of neutrophils to the infectious site. In this study we evaluated
      the role played by cytokines in the chronic peritoneal neutrophilia which occurs
      in mice intraperitoneally infected with Mycobacterium bovis BCG or M. avium.
      Antibodies to IFN-gamma and to MIP-1 and -2 were effective in reducing peritoneal
      neutrophilia when given during the infection. Whereas the former antibody was
      only effective when given early, the latter two were effective when administered
      late in infection, suggesting the MIPs were direct mediators of neutrophil
      recruitment. Recombinant IFN-gamma given intraperitoneally induced the
      accumulation of neutrophils and primed the peritoneal cells for an enhanced
      recruitment of neutrophils. Our data show that chronic neutrophilia during
      mycobacterial infection is regulated by different cytokines acting at different
      stages and levels of neutrophil recruitment.

PMID- 1638772
TI  - In vitro activation of peripheral mononuclear cells by zinc in HIV-infected
      patients and healthy controls.
AB  - Zinc is a mitogen for peripheral blood mononuclear cells (PBMC). The optimal
      mitogenic concentration was found to be 0.05 mmol/l (327 micrograms/dl), four
      times higher than physiological serum levels. Maximal proliferation was observed
      after 6 days. Limited dilution technique revealed a frequency of zinc reactive
      cells of 1:3467 (median; range 1:1628-1:6235). Cord blood mononuclear cells from
      four of six healthy children could be stimulated to proliferate by zinc. A normal
      zinc-induced proliferative response could be demonstrated in all six HIV-infected
      patients in the Walter-Reed-stage I, in nine of 11 patients in Walter-Reed II and
      in only two of five patients in Walter-Reed III. In Walter-Reed IV to VI all
      eight patients showed a weak response to zinc (less than 50% of the healthy day
      control). Decreased zinc serum levels were found in 10 of 28 patients and in one
      of 16 controls. There was a significant correlation of a diminished zinc-induced
      proliferation with lower serum levels of zinc and a reduced proportion of CD4
      helper cells in HIV-1-infected men. Because of a suppression of mitogenesis by
      high dose of zinc an excessive intake of zinc as used by some HIV-1-infected
      patients can presently not be recommended. The value of zinc-induced
      proliferation for monitoring HIV-infected patients has still to be established.

PMID- 1638773
TI  - Severe malaria in Gambian children is not due to lack of previous exposure to
      malaria.
AB  - The reasons why only a small proportion of African children infected with
      Plasmodium falciparum develop severe or fatal malaria are not known. One possible
      reason is that children who develop severe disease have had less previous
      exposure to malaria infection, and hence have less acquired immunity, than
      children who develop a mild clinical attack. To investigate this possibility we
      have measured titres of a wide range of anti-P. falciparum antibodies in plasma
      samples obtained from children with severe malaria, children with mild malaria
      and from children with other illnesses. Mean antibody levels in patients with
      malaria were higher than those in patients with other conditions but, with only
      one exception, there were no significant differences in antibody titres between
      cases of severe or mild malaria. A parasitized-erythrocyte agglutination assay
      was used to estimate the diversity of parasite isolates to which children had
      been exposed; plasma samples obtained from children with cerebral malaria
      recognized as many isolates as did samples obtained from children with mild
      disease. Our findings do not provide any support for the view that the
      development of severe malaria in a small proportion of African children infected
      with P. falciparum is due to lack of previous exposure to the infection.

PMID- 1638774
TI  - Disease association of antibodies to human and mycobacterial hsp70 and hsp60
      stress proteins.
AB  - Structural homology between microbial and human stress proteins has been
      postulated to be a basis for autoimmunization in chronic inflammatory diseases.
      Therefore, we estimated by ELISA titration the antibody levels to mycobacterial
      (M) and human (H) recombinant hsp70 and M-hsp65 heat-shock proteins in sera of
      patients with Crohn's disease (n = 29), ulcerative colitis (n = 20) and
      nontuberculous mycobacterial disease of the lungs (n = 20). Antibodies to H
      hsp60, separated by two-dimensional gel electrophoresis, were tested in six sera
      of each group of patients. In Crohn's disease, antibody titres to the M-hsp65
      antigen without detectable H-hsp60 binding were significantly elevated in 52% of
      the patients. In contrast titres to both M-hsp70 and H-hsp70 were demonstrable
      and correlated, but increased over control values only in four (14%) patients.
      The antibody pattern in ulcerative colitis was found to be quite different: anti
      H-hsp60 binding was demonstrable in most patients, although anti-M-hsp65 titres
      were not elevated. Furthermore, 25% of patients had significantly elevated titres
      to M-hsp70, but not to H-hsp70. In non-tuberculous mycobacterial pulmonary
      disease, about 50% of patients had elevated titres to both hsp65 and hsp71
      mycobacterial antigens but not to the corresponding human proteins; patients with
      Mycobacterium xenopi infection had the highest titres in this group. These
      results demonstrate the existence of distinct disease-associated patterns in the
      human antibody response to stress protein antigens. However, these data are not
      sufficient to imply sensitization with mycobacteria in patients with inflammatory
      bowel diseases, since certain epitopes of heat-shock proteins are shared by
      several bacterial genera.

PMID- 1638775
TI  - IgA-containing immune complexes after challenge with food antigens in patients
      with IgA nephropathy.
AB  - The possibility that patients with IgA nephropathy (IgAN) might have abnormal IgA
      immune responses to immunogens commonly encountered at mucosal surfaces,
      resulting in the formation of circulating immune complexes (CIC), was examined.
      Since it is generally held that such increased IgA responses are characterized by
      detectable aberrancies in handling of IgA-containing CIC, IgAN patients and
      controls were given a large volume of bovine milk (after dietary deprivation of
      bovine antigens) and immune complex levels were measured over a period of 12 h.
      An assay based on binding of CIC containing C3 to solid-phase anti-C3 and
      subsequent development with isotype-specific antibody revealed no differences in
      responses of patients and controls with respect to IgG- and IgM-containing CIC.
      Although IgAN patients tended to have higher levels of IgA-containing CIC, there
      were no differences in response patterns when IgA CIC levels after ingestion of
      the milk stimulus were related to baseline levels. Polymorphonuclear leucocytes
      (PMNC), which bear surface receptors for IgA, were isolated from some subjects at
      the same times as the samples for CIC levels and examined by two-colour
      immunofluorescence for the coincident presence of IgA and milk antigens. In
      contrast to the data obtained in the CIC assays, these experiments revealed the
      simultaneous presence of IgA and two of three milk proteins in PMNC of IgAN
      patients but not controls. Follow-up experiments designed to assess more
      quantitatively the coincidental presence of IgA and milk antigens indicated no
      significant differences between patients and controls. However, milk proteins
      seemed to be more commonly associated with IgA in PMNC of IgAN patients,
      suggesting the presence of non-complement-fixing IgA/antigen CIC after mucosal
      challenge of some IgAN patients.

PMID- 1638776
TI  - How frequent is glomerulonephritis in diabetes mellitus type II?
AB  - A high frequency of glomerulonephritis (GN) in diabetics, or coexistence of GN
      with diabetic glomerulosclerosis, has been reported by previous authors, but the
      true prevalence of GN in diabetics remains to be established. In the Department
      of Pathology, Heidelberg, from 1.1.1987 to 31.12.1989 we examined all consecutive
      patients (89 male, 121 female, median age 74 years; 47-98) who came to autopsy
      with the diagnosis of "diabetes mellitus" to assess this issue in an unbiased
      sample. Five patients had known type I diabetes, the others type II diabetes or
      diabetes of unknown classification. In 61/159 patients, proteinuria had been
      present (no information in 51 patients) and in 99/169 patients renal failure,
      i.e. serum creatinine above 1.4 mg/dl (no information in 41 patients). Paraffin
      embedded kidney specimens from the upper pole of the left kidney were examined by
      immunohistochemistry (PAP technique; rabbit antihuman IgG; IgM; IgAab). 166/210
      of the patients had glomerulosclerosis by light microscopy (129 diffuse, 37
      nodular GS). Concomitant glomerulonephritis, i.e. typical mesangial IgA (and IgG)
      deposits, with mesangial enlargement by light microscopy were detected in only
      one case. Membranous GN was not found. These findings must be interpreted against
      the observation of mesangial immune deposits in 6 of 250 consecutive non-diabetic
      patients who had come to autopsy [Waldherr et al. 1989]. The findings show that
      an excessive prevalence of undiagnosed glomerulonephritis in our cohort of
      elderly type II diabetics was not to be found.

PMID- 1638777
TI  - Lovastatin in the treatment of hypercholesterolemia in nephrotic syndrome due to
      diabetic nephropathy stage IV-V.
AB  - The efficacy and safety of lovastatin, a drug for lowering hypercholesterolemia,
      have been evaluated in ten adult patients with insulin-dependent diabetes
      mellitus (IDDM) and nephrotic syndrome due to diabetic nephropathy stage IV or V
      of Mogensen. For the first 8 weeks the patients received only a sugar-free
      isocaloric diet of which fats supplied approximately 30% of the total caloric
      intake and with not more than 300 mg cholesterol daily. After this run-in period
      patients were treated with 20 mg lovastatin once daily for 12 weeks while
      receiving the same isocaloric diet as previously. Body weights and glycosylated
      hemoglobin concentrations (HbAlc) did not change significantly during this
      period. The baseline plasma cholesterol concentrations (mean +/- SD) decreased
      only by 2% (from 310 +/- 54 to 303 +/- 46 mg/dl) during the 8 weeks with low
      cholesterol diet and by 25% (from 303 +/- 46 to 228 +/- 38 mg/dl) during the 12
      week period on lovastatin therapy (p less than 0.005). The mean concentrations of
      low-density lipoprotein (LDL-)-cholesterol decreased by 3% (from 218 +/- 53 to
      211 +/- 52 mg/dl) during the diet period and by 35% (from 211 +/- 52 to 137 +/-
      38 mg/dl) during the period with lovastatin therapy (p less than 0.001).
      Concentrations of high-density lipoprotein (HDL) cholesterol increased slightly
      (11%) during the therapy with lovastatin (NS). Baseline plasma triglycerides fell
      by 22% (from 188 +/- 97 to 146 +/- 59 mg/dl) during the period with fat
      restriction (p less than 0.05) and by 13% (from 146 +/- 59 to 127 +/- 54 mg/dl)
      during the period of lovastatin therapy (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638778
TI  - Mesangial anionic sites are decreased in human focal glomerular sclerosis.
AB  - We studied the mesangial anionic sites in two patients with focal glomerular
      sclerosis (FGS), using polyethyleneimine as a cationic probe. The mesangial
      negative charge in the FGS patients was less than that in three control patients.
      The decrease in negative charge in FGS concerned the central, paramesangial, as
      well as the subendothelial region of the mesangium; the decrease was most
      pronounced in the central region. It is proposed that loss of mesangial negative
      charge may have pathogenic significance in FGS.

PMID- 1638779
TI  - Two distinct types of crescentic glomerulonephritis.
AB  - For a characterization of the clinical course of crescentic glomerulonephritis
      (Cres. GN), reciprocals of serum creatinine concentration (1/Cr) as a function of
      time were studied in 24 patients. The patients fulfilled the following criteria;
      1) crescents were observed in more than 50% of glomeruli, and 2) the increment of
      serum creatinine could be determined sequentially on three or more occasions in
      the phase of progression of renal impairment. In all patients 1/Cr declined
      linearly with time with correlation coefficients between 0.881 and 0.993.
      According to the slope, the patients were divided into two groups; an acute group
      (13 patients) with slopes of -1.0 x 10(-2) dl/mg/day or more steep, i.e. with
      increments of serum creatinine from 1.0 to 10.0 mg/dl within 90 days, and a
      subacute group (11 patients) with less steep slopes. Histologically, there was no
      difference in the percentage of glomeruli with crescents between the two groups.
      However, in the acute group a negative correlation was found between the period
      from onset to histological examination and the percentage of glomeruli with
      cellular crescents in all glomeruli with various crescents (r = -0.872, p less
      than 0.001), while in the subacute group the percentage was nearly constant
      regardless of the time of histological examination. These mean drastic but
      transient activation of the disease in the former in spite of a persistence of
      indolent activity in the latter. Clinically, in the acute group an improvement of
      serum creatinine was observed in 8 (61.5%) vs. only 2 (18.2%) in the subacute
      group (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638780
TI  - Nephrotic-range proteinuria associated with right atrial myxoma.
AB  - A case of right atrial myxoma presenting with right heart failure and proteinuria
      is described. Proteinuria was variable and this corresponded with the degree of
      systemic venous congestion. On one occasion the proteinuria was within the
      nephrotic range. There was no evidence of intrinsic renal pathology. The right
      heart failure and proteinuria resolved after tumour removal, suggesting that the
      etiology of urinary protein loss was a reversible increase in glomerular
      permeability.

PMID- 1638781
TI  - Acquired renal cystic disease in HD: a study of 82 nephrectomies in young
      patients.
AB  - In order to study the development of acquired renal cystic disease (ARCD) and its
      potential complications, we studied, macro- and microscopically, 82 surgical
      specimens of nephrectomy carried out on young patients with chronic renal failure
      previous to renal transplantation. Statistical correlation of pathological
      findings with age, sex and time on hemodialysis (HD) have been done. There were
      72 cases of ARCD (87.8%). It was statistically correlated with male sex (p less
      than 0.02) and prolonged time on HD (p less than 0.001) as has been previously
      reported. Hyperplasia of the cystic epithelium was found in 42 cases (52%), with
      18 (22%) showing marked papillary proliferation. Also, there were 22 cases (27%)
      with renal adenomas. This incidence of hyperplastic and neoplastic
      proliferations, more than would be common in such a young population (males: 33.5
      +/- 9.3 years; females: 35.4 +/- 11.7 years), suggests the potential of patients
      affected by ARCD to develop neoplasms. Thus, we consider that these patients must
      be checked periodically to detect possible malignant neoplasms.

PMID- 1638782
TI  - Serum creatinine concentration at the onset of uremia: higher levels in black
      males.
AB  - We compared serum creatinine and blood urea nitrogen concentrations, estimated
      creatinine clearances and frequency of uremic symptoms at the start of chronic
      hemodialysis in all 20 black and 179 white males treated between 1969 and 1983.
      Serum creatinine concentrations were significantly higher in black males (16.5 +/
      5.9 mg/dl) than in white males (11.7 +/- 4.7 mg/dl; p = 0.016). There were no
      significant differences in blood urea nitrogen concentration, estimated
      creatinine clearance and frequency of uremic symptoms between the two groups.
      Blood urea nitrogen to serum creatinine ratios were lower in black males, (7.3 +/
      1.9) than in white males (11.4 +/- 3.8; p = 0.0001), and only one black male had
      a ratio greater than 10 compared to 60% of whites. We concluded that black males
      tend to have higher serum creatinine concentrations than white males at the onset
      of uremic symptoms, and that higher striated muscle creatinine production in
      black males and not lower renal function may be the cause.

PMID- 1638783
TI  - Blood pressure reduction during hemodialysis correlates to intradialytic changes
      in plasma volume.
AB  - Blood pressure alterations during hemodialysis were related to changes in body
      fluid in 14 patients with chronic renal failure. Changes in plasma volume (PV)
      and extracellular volume (ECV) were calculated from determinations of fluid
      volumes before and after hemodialysis, using 125I-albumin and 51Cr EDTA
      respectively. Reduction in body water was estimated from body weight changes.
      Weight loss was 3.3 +/- 0.3 kg (range 1.8-6.0 kg). The relative reduction of
      fluid was greater in the ECV, 21.6 +/- 3.2%, compared to plasma volume, 6.9 +/-
      1.8%. The reduction in systolic blood pressure was related to both absolute (r =
      0.66, p less than 0.05) and relative PV reduction (r = 0.72, p less than 0.02).
      There was no correlation between blood pressure reduction and weight loss or ECV
      changes. Only minor alterations were found in diastolic blood pressure. Plasma
      volume maintenance relates to blood pressure changes. Plasma volume monitoring
      could be useful for improving intradialytic hemodynamic control.

PMID- 1638784
TI  - Progression of membranous glomerulopathy during cyclosporin A.

PMID- 1638785
TI  - Symposium: The Future of Academic Medicine in Canada. Quebec City, Quebec,
      September 1991.

PMID- 1638786
TI  - The future of academic medicine within the health care system in Canada.

PMID- 1638787
TI  - How to attract candidates to academic medicine.
AB  - The current trends in career choices of our graduates, the changing expectations
      of the health care sector, the increasing complexity of the health care delivery
      system, and the changing demographics of our health care providers suggest that
      Canada may be facing an undersupply of academic physicians for the future needs
      of academic medicine unless we, collectively, address the issue and provide some
      solutions. It is equally clear that there is no single or simple solution to the
      problem of attracting candidates to academic medicine. Based on the best
      available information and projections, I would suggest that the following might
      be part of the solution: 1. Medical schools need to articulate their missions and
      goals, especially with respect to the desired educational outcomes. In doing so,
      it is critical that they not become 'carbon copies' of each other, but that each
      builds on individual strengths, recognizing the value of diversity of missions.
      The 16 medical schools should cooperate and formulate complementary objectives to
      meet the needs of society. 2. Planning of physician resources must be broad and
      nationally based, and must include the needs of academic medicine. In defining
      the nature and numbers of clinician-scientists required, the best available data
      must be sought - not just for the current situation, but for trends that have
      created the present situation. This must also be coupled to realistic projections
      of future needs of the health care delivery system and of academic research and
      teaching needs. 3. Educational programs at all levels (undergraduate,
      postgraduate, and continuing medical education) must be structured to ensure that
      they do not inadvertently discourage potential academics from their career goals.
      They must actively seek and encourage the talented individual destined for an
      academic career, and provide a career pathway that facilitates achievement of
      those goals and eliminates the barriers and restrictions that preclude the
      attainment of those career goals. Medical schools, accrediting groups, specialty
      societies, colleges, and licensing bodies must participate in a joint dialogue to
      meet these goals. The special needs of women must be addressed to enhance their
      participation in the academic enterprise. 4. Governments, universities, and
      funding agencies must begin to address the special needs of the research and
      teaching community, to provide security and stability that translates into a
      realistic career goal worthy of the commitment and dedication of our scientists,
      and to make academic medicine an attractive option for our bright and talented
      individuals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1638788
TI  - How to attract candidates to academic medicine: the role of postsecondary
      institutions.

PMID- 1638789
TI  - Restructuring undergraduate medical curriculum: an opportunity to attract
      students to academic medicine.

PMID- 1638790
TI  - Research education in residency programs.

PMID- 1638791
TI  - Results of recent initiatives such as the MD/PhD program in the training of
      clinician-scientists.

PMID- 1638792
TI  - The training pathway of clinician-scientists and teachers.

PMID- 1638793
TI  - The training pathway of clinician-scientists and teachers: the view from the
      university.

PMID- 1638794
TI  - The responsibility of department chairmen and deans to ensure training of
      clinician-scientists.

PMID- 1638795
TI  - Is there a fast track for the training pathway of clinician-scientists and
      teachers?

PMID- 1638796
TI  - The training pathway of clinician-scientists: the view from the Royal College.

PMID- 1638797
TI  - [The role of research centers and institutes for biomedical contemporary
      research].

PMID- 1638798
TI  - Cost-effectiveness of academic medicine.

PMID- 1638799
TI  - Nurturing the young academician.
AB  - The young academic physician requires a well prepared and supportive environment
      if the trials and uncertainties associated with the early years of an academic
      appointment are to be successfully overcome. It is the responsibility of the
      appropriate university and hospital authorities to create this environment and to
      ensure that the appointed academician is appropriately supported within it. Of
      particular importance is the development by all parties of an understanding of
      the job description of the new faculty member and of the time and income
      arrangements that must be made if this description is to be fulfilled.

PMID- 1638800
TI  - The young investigator in Canada.

PMID- 1638801
TI  - Salary structure, promotion, and tenure policies in nurturing the young
      academician.
AB  - With respect to salary structure, promotion, and tenure for academic clinical
      faculty, and based on the issues I have described, we must consider the following
      five priorities: 1. To provide salary support which is appropriate for
      responsibilities in teaching, research, and clinical administration, and not
      dependent on clinical earnings, 2. To maintain flexible salary arrangements which
      may include a component of clinical fee-for-service earnings, and partial salary
      support for defined clinical teaching or administration, 3. To design a more
      integrated management system for these new funding arrangements which brings
      together medical schools and teaching hospitals and is accountable to the
      appropriate government agencies. 4. To improve performance review and promotion
      procedures, based on agreed job descriptions and recognizing the importance of
      teaching, research, clinical administration, and service, and 5. To review
      critically the role of tenure for academic clinicians and examine alternatives
      such as renewable term appointments There is a growing momentum to address these
      issues and priorities among all of those involved. This will be critical in the
      continued career development of Canadian academic physicians.

PMID- 1638802
TI  - Nurturing the young academician: the role of funding agencies.

PMID- 1638803
TI  - Nurturing the young academician: view from the Fonds de la Recherche en Sante du
      Quebec (Medical Research Council of Quebec).

PMID- 1638804
TI  - Career development and the training of clinician-scientists.

PMID- 1638805
TI  - The role of the pharmaceutical industry in nurturing the young academician.

PMID- 1638806
TI  - Nurturing the young academician: the role of funding agencies and industry.

PMID- 1638807
TI  - The influence of governmental decision-making on academic medicine: Part II.

PMID- 1638808
TI  - Government decision-making and academic medicine.

PMID- 1638809
TI  - Influence of immigration and licensing bodies on academic medicine.

PMID- 1638810
TI  - Lobbying for research and academic medicine.

PMID- 1638811
TI  - The academic physician as spokesman and salesman.

PMID- 1638813
TI  - Operative hysteroscopy.

PMID- 1638812
TI  - The influence of governmental decision-making on academic medicine: view from the
      government of Quebec.

PMID- 1638814
TI  - Instruments and video cameras for operative hysteroscopy.

PMID- 1638815
TI  - Operative hysteroscopy for infertility.

PMID- 1638816
TI  - Hysteroscopic laser surgery.

PMID- 1638817
TI  - Hysteroscopic surgery using the resectoscope: myomas, ablation, septae &
      synechiae. Does pre-operative medication help?

PMID- 1638818
TI  - Complications of operative hysteroscopy: how safe is it?

PMID- 1638819
TI  - Electricity inside the uterus.
AB  - Although electrosurgery has been employed for decades, few surgeons have received
      formal training in its proper use. The erroneous belief that electrosurgery
      techniques increase scar formation or impair healing processes led surgeons to
      use other methods to deliver energy to the living cell. At the cellular level, 1
      watt is 1 watt. Knowing how to calculate and administer this amount of energy is
      the challenge. Laser technology fostered the development of improved
      electrogenerators and accessories that are easier to understand and control. The
      use of digital reader boards, displayed in watts rather than an arbitrary dial
      setting, is one example. A good electrosurgical system, with proper accessory
      electrodes, costs only 10% of the price of the average laser. For hysteroscopic
      resectoscopy procedures, a thorough knowledge and appreciation of the physics of
      electrosurgery is a basic requirement. In the future, I hope the power density
      and wattage delivered at the electrode tip will be displayed easily for surgeons
      using the resectoscope. One day, we may have a "laser-electrode" system to meet
      all our needs.

PMID- 1638820
TI  - Office hysteroscopy.
AB  - Most operative office surgery can be done easily. If, midway through a procedure
      in the office, the operator finds that a myoma is too large or deep to resect
      safely in the office, the procedure can be terminated and rescheduled for the
      operating room. Polyps, retained products, and the lost intrauterine device all
      can be treated similarly. With the proper equipment and patient selection, the
      well-trained hysteroscopist can do extensive operative hysteroscopy in the
      office. With experience, the hysteroscopist can do diagnostic and operative
      hysteroscopy at the same time, resulting in a substantial savings of both cost
      and time for the patient and the physician. The future of office hysteroscopy may
      include endometrial ablation and transcervical sterilization, in addition to the
      procedures described in this chapter. Diagnostic hysteroscopy is becoming a
      standard part of office gynecology. With continued training, operative
      hysteroscopy will move into the realm of office gynecology at the same level as
      diagnostic hysteroscopy.

PMID- 1638821
TI  - Hysteroscopic sterilization.

PMID- 1638822
TI  - Tubal surgery from the inside out: falloposcopy and balloon tuboplasty.

PMID- 1638823
TI  - Hypertension in pregnancy.

PMID- 1638824
TI  - Pathogenesis of preeclampsia: a hypothesis.

PMID- 1638825
TI  - Abnormal hemostasis and coagulopathy in preeclampsia and eclampsia.
AB  - Preeclampsia and eclampsia appear to be a state of increased coagulopathy as
      evidenced by an increase in fibrin formation, activation of the fibrinolytic
      system, platelet activation and a decrease in platelet count. Routine tests used
      to assess decompensated disseminated intravascular coagulopathy are of limited
      value in the preeclamptic and eclamptic population. More sophisticated tests such
      as determinations of antithrombin III, thrombin-antithrombin III complex, D
      dimer, factor VIII antigen/activity ratio, and beta-thromboglobulin, however,
      show a compensated coagulopathy in the preeclamptic patient. These hemostatic
      changes, probably the result of endothelial damage, are implicated in the
      pathogenesis of this disease. A better understanding about the abnormalities of
      hemostasis and coagulation in the preeclamptic and eclamptic patient may allow
      the clinician to provide improved management and possibly peripartum therapy.

PMID- 1638826
TI  - The prediction of preeclampsia.

PMID- 1638827
TI  - Prophylaxis of eclamptic seizures: current controversies.
AB  - Treatment of this pathophysiologically poorly understood disease is
      controversial. Despite this uncertainty, the goals of management of the patient
      with preeclampsia and eclampsia are diagnosis, stabilization, and delivery of the
      baby. Stabilization refers to both mother and fetus and should include the
      prevention of eclampsia or the recurrence of eclamptic seizures. There are
      empiric data supporting the use of magnesium sulfate for the management of
      preeclampsia and eclampsia in North America, but there are few data to support
      its efficacy as a classic anticonvulsant. Until controlled trials are completed,
      we suggest that magnesium sulfate continue to be used in preeclampsia, with the
      addition of established anticonvulsant medications when eclampsia occurs. Data on
      established antiepileptic drugs such as diazepam and phenytoin support their use
      in treating patients with eclamptic seizures. As stated in an earlier review, "in
      treating preeclampsia, magnesium sulfate therapy may have a role and may moderate
      factors leading to eclampsia. Whether magnesium sulfate therapy may have some as
      yet unproved effect on epileptogenic foci or seizure propagation is not the
      important issue for the physician caring for the eclamptic patient. Until
      adequately designed therapeutic trials are available, it is our opinion that
      treatment should be based on the use of anticonvulsant drugs of established
      efficacy in seizure control and prophylaxis (p. 1363)."

PMID- 1638828
TI  - The maternal hemodynamics of preeclampsia.

PMID- 1638829
TI  - Surveillance of the pregnant hypertensive patient with Doppler flow velocimetry.

PMID- 1638830
TI  - Portable blood pressure monitoring for borderline or mild hypertension during
      pregnancy.
AB  - Several advantages are apparent in the use of self-monitored or automatic
      ambulatory blood pressure monitoring by pregnant patients who appear to have
      borderline or mild hypertension. Home recordings, combined with conventional
      office measurements, can give a more accurate picture of the patient's dynamic
      blood pressure. Blood pressures are often lower outside the physician's office,
      probably because of the patient's increased awareness and decreased anxiety in
      other settings. When blood pressures are normal at home, the patient may be able
      to avoid antihypertensive therapy, antepartum hospitalization, and intervention
      during her pregnancy. Monitoring at home or work also provides a more thorough
      screening for preeclampsia, especially with patients who have chronic
      hypertension or other predisposing conditions.

PMID- 1638831
TI  - Acute life-threatening emergencies in preeclampsia--eclampsia.
AB  - Severe dysfunction of the pulmonary, renal, hepatic, and central nervous systems
      as a consequence of preeclampsia--eclampsia warrant aggressive multidisciplinary
      management and treatment. Preventive therapy, when possible or early recognition
      and therapy are clearly associated with improved maternal and neonatal outcome.
      Should cardiopulmonary arrest occur as a function of the disease process or
      management, then perimortem cesarean delivery initiated within 4 minutes of
      maternal cardiac arrest is associated with the highest rates of maternal and
      neonatal survival.

PMID- 1638832
TI  - Pathophysiology and anesthetic implications in preeclampsia.

PMID- 1638833
TI  - Management and counseling of patients with preeclampsia remote from term.

PMID- 1638834
TI  - Hepatobiliary scintigraphy in pediatric liver transplant recipients.
AB  - The clinical usefulness of hepatobiliary scintigraphy was evaluated in pediatric
      liver transplant recipients. One hundred fifteen hepatobiliary scintigraphic
      studies were performed in 30 patients who received 22 whole liver and 16
      segmental grafts. Parameters that were useful in predicting an adverse outcome
      were failure to visualize excreted radiopharmaceutical at or beyond the biliary
      anastomosis on a study performed within 24 hours after transplant, and persistent
      or increasing delay in the time of visualization of excreted radiopharmaceutical.
      Abnormalities of liver uptake and excretion were seen in rejection, but they were
      also seen in patients who remained well without rejection or parenchymal disease.
      Significant biliary leaks were identified in the three cases in which they were
      known to be present. In liver transplant recipients, hepatobiliary imaging is
      useful in predicting graft survival and identifying biliary leaks.

PMID- 1638835
TI  - Rapid determination of glomerular filtration rate in infants using Tc-99m DTPA.
AB  - Glomerular filtration rate obtained by using Tc-99m DTPA was compared with that
      obtained from Schwartz's formula using serum creatinine and length in 21 infants
      (age range, 3 to 348 days). The GFR (mean +/- SD) obtained by Tc-99m DTPA was 76
      +/- 37 ml/min per 1.73m2 and by the Schwartz formula was 83 +/- 49 ml/min per
      1.73m2. GFR by Tc-99m DTPA method overestimated GFR by 3.6% compared to the
      Schwartz method. The imaging technique and the advantages are discussed.

PMID- 1638836
TI  - Panostotic fibrous dysplasia. A new craniotubular dysplasia.
AB  - The authors describe the radiographic-scintigraphic features of an unusual
      craniotubular dysplasia characterized by diffuse osteopenia with bone expansion
      and a "ground glass" appearance, markedly increased skeletal turnover,
      myelofibrosis, hypophosphatemia, and pigmented "coast-of-Maine" patches. This
      syndrome, termed panostotic fibrous dysplasia, is distinct from previously
      reported disorders.

PMID- 1638837
TI  - Melorheostosis on three-phase bone scintigraphy. Case report.
AB  - Melorheostosis is a benign sclerosing bone dysplasia with a very unusual and
      characteristic roentgenographic appearance. Its scintigraphic appearance also is
      characteristic, with asymmetric cortical activity that may cross joints to
      involve contiguous bones. The authors report the appearance of melorheostosis on
      angiogram and blood pool phases of three-phase bone scintigraphy.

PMID- 1638838
TI  - The relationship between thallium uptake, blood flow, and blood pool activity in
      bone and soft tissue tumors.
AB  - Twenty patients with known primary untreated and recurrent bone and soft tissue
      tumors underwent thallium imaging and three-phase bone imaging in the same
      session. The ratio of thallium uptake in the tumor tissue to the contralateral
      normal tissue areas was compared with the same ratio for phase 1 (blood flow or
      arterial phase), phase 2 (blood pool), and phase 3 (delayed medroxy
      diphosphonate, MDP, uptake). There was poor correlation between Tl uptake and
      phases 1 and 3 of the bone scan ratios; r = 0.37 and 0.46; P = 0.097 and 0.047,
      respectively. The thallium uptake ratios correlated well with blood pool ratios
      (phase 2) (r = 0.84 and P less than 0.01). In contrast to uptake into normal
      muscle, Tl-201 uptake into tumor is not highly dependent on blood flow alone and
      other factors predominate in determining its magnitude.

PMID- 1638839
TI  - Metastatic malignant struma ovarii. Two case reports.
AB  - Struma ovarii is an ovarian germ cell tumor consisting mainly of thyroid tissue.
      Five percent of struma ovarii are malignant, and of these only five percent
      metastasize. The rarity of this disease has resulted in difficulty in agreeing on
      treatment regimes and in limited imaging experience. The authors report two cases
      and highlight the imaging and monitoring difficulties encountered in their
      management. The authors conclude that I-131 has a role to play both
      therapeutically and in monitoring these patients, but that biochemical testing is
      a more reliable indicator of disease status.

PMID- 1638840
TI  - The 'hot halo' sign. Pyogenic pericarditis on In-111 leukocyte scintigraphy.
AB  - The authors report a patient with diffuse pyogenic pericarditis and focal
      myoendocarditis initially detected using In-111 WBC scintigraphy. The patient was
      in septic shock after hemodialysis for the treatment of chronic renal failure.
      This was preceded by clinical signs and symptoms of pericarditis thought to be
      viral in nature. Initial investigations found no septic focus, and the patient
      was referred for In-111 WBC scintigraphy. This revealed a striking "halo" of
      increased activity around the heart, strongly suggesting bacterial pericarditis.
      A subsequent pericardiocentesis yielded 400 ml of purulent material, confirming
      the diagnosis.

PMID- 1638841
TI  - Acetazolamide effect on vascular response in areas with diaschisis as measured by
      Tc-99m HMPAO brain SPECT.
AB  - The effects of acetazolamide (Diamox) on vascular response were investigated in
      areas with intrahemispheric thalamic diaschisis and crossed cerebellar diaschisis
      using consecutive Tc-99m HMPAO brain SPECT studies before and after Diamox
      administration. All six patients with thalamic diaschisis and five of eight
      patients with crossed cerebellar diaschisis at baseline showed significantly
      augmented perfusion after Diamox administration in the affected thalamus and
      cerebellum compared with that in the contralateral unaffected areas. These
      results suggest more dilatation of the arterioles in areas with diaschisis after
      Diamox administration than in areas without diaschisis. Diamox may produce
      relative luxury perfusion in areas with diaschisis.

PMID- 1638842
TI  - Detection of pseudomembranous colitis by Tc-99m HMPAO labeled WBC and Ga-67
      citrate.

PMID- 1638843
TI  - Demonstration of a lymphocele by interstitial immunolymphoscintigraphy.

PMID- 1638844
TI  - Diagnostic significance of dental history in the clinical evaluation of patients
      with thyroid carcinoma. Periodontal surgery mimicking a metastasis on I-131 whole
      body survey.

PMID- 1638845
TI  - Visualization of a popliteal pseudoaneurysm by radionuclide imaging.

PMID- 1638847
TI  - Free-floating thrombus identified by radionuclide venogram.

PMID- 1638846
TI  - Infected knee prosthesis. Visualization of the fistulous tract by Tc-99m HMPAO
      leukocyte scintigraphy.

PMID- 1638848
TI  - Renal scintigraphy of en bloc transplantation of pediatric kidneys.

PMID- 1638849
TI  - Heterotopic calcification of the popliteal fossae.

PMID- 1638850
TI  - Scintigraphic diagnosis of costal periostitis in actinomycosis.

PMID- 1638851
TI  - 'Bull's eye' appearance of hyperostosis frontalis interna.

PMID- 1638852
TI  - [New horizons of the scientific thought. The use of systems science and
      cybernetics in medicine].

PMID- 1638853
TI  - [Correction by physiotherapy of immune disorders in high-grade athletes].
AB  - It is well known that during intense training and competitions athletes show a
      remarkable reduction of their immunological responses. As a matter of fact,
      during these periods athletes very frequently (five to ten times more than
      average) fall ill. In order to correct this situation, in the USSR
      immunomodulator drugs are used together with high frequency electromagnetic waves
      which are applied on the body surface corresponding to the adrenal glands. In
      this way body desensitisation is accelerated. One hundred high-level athletes
      received an application of electromagnetic waves on the body surface
      corresponding to the thyroid gland and thymus, so as to lower glucocorticoid
      activity and activate lymphoid tissue. Indices of immunologic reactivity and
      hormonal levels after electromagnetic treatment were measured in all athletes.

PMID- 1638854
TI  - [Behavior of the lithium excretion fraction in hypertensive patients during
      variations of sodium intake].
AB  - Fractional excretion of lithium (FeLi) is a marker of proximal tubular sodium
      reabsorption. During different sodium intakes (normal = 120 mEq/day, low = 40
      mEq/day and high = 240 mEq/day) fractional lithium excretion was evaluated in
      essential hypertensive patients (n. 19) and control subjects (n. 5). Our data
      showed that FeLi was higher in hypertensives than in controls. Dividing
      hypertensives on the basis of blood-pressure sensitivity, salt resistant patients
      showed lower FeLi levels as compared to salt sensitive ones. Our findings
      indicate that proximal tubular sodium reabsorption is decreased in essential
      hypertension; this behavior is particularly evident in salt sensitive patients,
      suggesting that factors affecting proximal tubular function are activated in
      these patients in order to reduce the impairment of renal excretory capability.

PMID- 1638855
TI  - [Ultrasonography and ultrasound-guided biopsy in lymphomas].
AB  - The authors have reviewed the literature on imaging techniques for the diagnosis
      of lymphoma. Lymphography, axial computerized tomography (CT) and echotomography
      have been compared as to their sensitivity and specificity. Lymphography allows
      diagnosis of the disease even in lymph nodes of less than 0.5 cm diameter, but
      this technique cannot be applied to all lymphatic station. Echotomography and CT
      are equivalent as to the accuracy of diagnosis and are both helpful for guided
      needle biopsy. In view of its low cost, echotomography is considered by most
      workers the first-line approach to the evaluation of lymphoma patients. In spite
      of its advantages over other methods, echotomography must, nevertheless, be
      integrated by CT, lymphography, and nuclear magnetic resonance.

PMID- 1638856
TI  - [Psycho-functional changes in attention and learning under the action of L
      acetylcarnitine in 17 young subjects. A pilot study of its use in mental
      deterioration].
AB  - The aim of the study was the investigation of the ability of L-acetylcarnitine
      (Acn; 1.5 g daily oral route for 1 month) to enhance some performances requiring
      a high level of attention and reflex velocity. The sample includes 17 healthy
      subjects, 8 males and 9 females, 22 to 27 years old; 10 of the subjects practice
      sports at agonistic level, while 7 have a sedentary life style. Reflexes have
      been measured, baseline and after 17 and 30 days of Acn administration, through a
      purposely constructed reflex-meter able to determine the latency (csec) of the
      reaction to an auditory stimulus. The ability as well as the time of learning was
      determined, before and after treatment, as the time and the number of errors to
      get out of the maze of a videogame (the test was also carried out by an untreated
      control group). Acn seems to induce an enhancement of reflex velocity, with
      complete annulment of the difference between the dominant and the opposite hand,
      as well as a significant reduction (3 to 4 times superior to controls) of both
      the errors and the time with the maze test.

PMID- 1638857
TI  - [Drug-induced changes in the teeth and mouth. II].
AB  - As in the previous paper the unwanted effects of drugs or chemicals in the
      orofacial region are described. The authors take into consideration alterations
      such as gingival hyperplasia and hypertrophy, discoloration of the oral mucosa
      and teeth, oral ulceration and stomatitis, cervical lymphadenopathy, drug induced
      blood dyscrasias, bleeding caused by aspirin and other drugs, and cleft lip and
      cleft palate.

PMID- 1638858
TI  - Ten-year review of overall survival rates for stage I cutaneous melanoma in 3,009
      residents of Connecticut.

PMID- 1638859
TI  - Yersinia enterocolitica contamination of blood products. Connecticut State
      Medical Society Committee on Organ and Tissue Transfers.

PMID- 1638860
TI  - Renal failure associated with lymphoma in acquired immunodeficiency syndrome.
AB  - An unusual case of acute renal failure associated with lymphoma and acquired
      immunodeficiency syndrome (AIDS) is described. There was an impressive response
      to chemotherapy and parallel improvement in renal function. The rare occurrence
      of lymphoma-related renal failure in AIDS patients is presented as well as a
      review of the different ways AIDS and lymphoma can impair renal function.

PMID- 1638861
TI  - 7 practice-management tips to increase productivity.

PMID- 1638862
TI  - Leverett Hubbard, M.D. A biographical memoir of the first president of the
      Connecticut State Medical Society, 1942.

PMID- 1638863
TI  - Connecticut's second medical school.

PMID- 1638865
TI  - Mutual interest or self interest.

PMID- 1638864
TI  - Reconsidering confidentiality.

PMID- 1638866
TI  - Pluripotent stem cells and early B lymphocyte precursors in mice.

PMID- 1638867
TI  - Evaluating functional abilities of primitive hematopoietic stem cell populations.

PMID- 1638868
TI  - The stem cell compartment: assays and negative regulators.

PMID- 1638869
TI  - Marrow transplantation.

PMID- 1638870
TI  - Careful maintenance of undifferentiated mouse embryonic stem cells is necessary
      for their capacity to differentiate to hematopoietic lineages in vitro.

PMID- 1638871
TI  - The pre-spleen colony-forming unit assay: measurement of spleen colony-forming
      unit regeneration.

PMID- 1638872
TI  - Spleen colony-forming unit: a myeloid stem cell.

PMID- 1638873
TI  - Being old. A subjective description of becoming and being old.
AB  - Every individual is unique. The history and the life of a person is unique. This
      is a description by an old general practitioner of the experience of becoming and
      being old.

PMID- 1638874
TI  - The elderly in Denmark.

PMID- 1638875
TI  - Images of aging--over the last 100 years.
AB  - Discussions on care of the elderly today often lack definitions of various issues
      and concepts relating to the elderly in question and their needs. One problem is
      the tendency to categorise the elderly in general as one homogeneous group of
      frail individuals. Another is an increasing tendency to paint a posy picture of
      the third age, overlooking the problems of "the fourth age". The categorisation
      of "the elderly" dates back 100 years in history, when the first political
      initiatives on pension policy were taken. Denmark was the first country to
      introduce such legislation, with old age (over 60) as the basic criterion.
      However, the basis for drawing a vertical line at the age of 60 was a series of
      findings by German and French scholars of medicine and statistics on age-related
      decline in various functions. The development of geriatric medicine occurred
      rather late in Denmark, probably because of a relatively high level of quality
      and capacity of social institutions and other services for the elderly. Thus,
      longterm care for old people was not a major issue in the health care system
      until recent decades. Today, the new images of aging are not limited to
      visualisation of old people in "the third age". Nursing homes are changed to
      individual flats and provision of 24-hour home care services is available. This
      development requires coordinated education, training, and management of staff. A
      better knowledge of the changing images of aging in history is an important
      element of staff development.

PMID- 1638876
TI  - The Glostrup Population Studies, 1964-1992.
AB  - The Glostrup Population Studies, 1964-92, comprise descriptive and analytical,
      clinical epidemiological studies. Since 1964, different birth cohorts have been
      examined. More than 20,000 persons, randomly selected from the background
      population of 300,000 inhabitants (Copenhagen County), have been invited to
      participate. The project started in 1964 with a survey of the 1914 population on
      risk factors for coronary heart disease. As the 1914 population has been followed
      and new cohorts added, a time-sequential design, suited for studies of aging, has
      been constructed. The staff has been kept in the unit for up to 28 years.
      Doctoral candidates in medical science and Ph.D candidates have defended their
      analyses of Glostrup data in several fields and continue to belong to the group
      of representatives, supporting the board of leaders. The head of Medical
      Department C serves as chairman, thus maintaining a close connection with
      clinical medicine.

PMID- 1638877
TI  - 85-year-olds in Denmark. The socio-psychological conditions and general health
      and disorders in a representative group of 85-year-old Danes.
AB  - A population of persons born in 1897 and resident in Glostrup and eight
      surrounding municipalities was investigated when these persons were 70, 80 and 85
      years old. Some of the results are mentioned from the cross-sectional,
      epidemiological survey on the socio-psychological conditions and general health
      and disorders in this representative population which includes almost 2% of the
      Danish 85-year-olds. The examination programme was extensive, and of data rather
      comprehensive. The aim of this article is to make known some of the information,
      observations and results of several tests performed, including 56 different
      laboratory tests and nutritional analyses. It is worth mentioning that about
      three fourths of the 85-year-olds were self-reliant and contended with their
      actual life and lifestyle. Nevertheless suggestions or recommendations for
      interventions were given to 85% of the participants as well as the general
      practitioners. The data have already formed the basis of several frames of
      references.

PMID- 1638878
TI  - To grow old. From a socio-medical epidemiological intervention study among old
      citizens of Copenhagen.
AB  - A cross-sectional, epidemiological, sociomedical survey, followed by
      intervention, was conducted with the participation of 585 men and women in the
      75, 80 and 85 year-old age groups living in the city of Copenhagen. The main
      objectives of the study were to describe the health and social conditions of the
      elderly people, to register the physical and social unmet needs and then
      intervene to relieve these needs, to assess the effect of such an intervention
      through a follow-up study, and to demonstrate possible risk factors. Age, marital
      status, recent hospitalisation were shown to be connected with the functional
      condition. The quality of life study showed that health, functional ability to
      stay independent, and housing conditions are most important factors when growing
      old. The socio-medical intervention did not show any effect with regard to
      mortality, hospitalisation, institutionalisation, subjective health and economy,
      loneliness, quality of life and functional ability. The most striking risk
      markers in relation to death were: low systolic blood pressure among women,
      subjective poor health, low score on the ladder-scale used to quantify quality of
      life, and impaired functional capacity in nine out of ten partial functions. All
      together, it is concluded that if we want to improve the living conditions of the
      elderly we should reserve the efforts for old people at risk and enable as many
      as possible to stay independent.

PMID- 1638879
TI  - Attitudes to aging and old age.
AB  - In the 1980s a marked shift in the attitude to aging and the elderly made itself
      felt. In the beginning of the decade the commission for the elderly proposed a
      policy based on continuity and self-determination and with a starting point in
      the resources of the elderly. This attitude has come through in the political
      activities on different levels and is also reflected in the DaneAge Future study,
      where three cohorts--40-44 years, 50-54 years, 60-64 years--show an optimistic
      and self-confident attitude to their own old age.

PMID- 1638880
TI  - Ten years after the Commission on Aging--ideas and results.
AB  - During the years 1979-82, the Commission on Aging scrutinised public measures
      relating to the elderly and recommended adherence to the principles of
      continuity, self determination and use of own resources in future aging policy. A
      central point in the Commission's perception of aging was that a number of
      functional impairments previously considered exclusively a reflection of the
      biological aging processes were now seen as equally induced by loss of roles and
      social functions. The renewal of structures and development work carried out
      throughout the country are based on these principles, integrating social and
      psychological considerations. Work is also based on the Report on the Public
      Sector (1988) which recommends enhancement of social networks and self-help
      capabilities of the old as well as new forms of cooperation between the public
      sector and citizens. Self determination and self control have become new key
      words in current aging policy. The new policy is not only induced by financial
      pressure on the public sector, but equally to the realisation that many social
      tasks are best solved in cooperation with individuals. The renewal of aging
      policy is also adapted to the new generations of elderly people, who want freer
      lifestyles and more options than many of the old have today. They will very
      likely be more mobile and make more demands for their life. They have been
      accustomed to creating networks and cross-contacts, as their jobs and interests
      have required it, and their health and financial circumstances will frequently be
      better than those of the elderly generation today.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1638881
TI  - The situation of the elderly in Denmark.
AB  - In this paper, basic socio-economic and demographic data about the elderly are
      presented. Since the younger elderly are more active and have better health than
      previous generations and since the older elderly comprise the group likely to
      make most demands on society, the paper concentrates mainly on those aged 75 and
      over. The demography of the elderly is considered by way of introduction,
      followed by more specific topics of particular interest for the group in
      question, such as finance, household composition, institutions and service,
      health and family structure. In conclusion, the inter-action between the public
      sector, the private sector, the independent sector (volunteers) and the family
      (social) network is considered in relation to ensuring acceptable quality of life
      for elderly persons in Denmark.

PMID- 1638882
TI  - The development in local authority services for the elderly.
AB  - Services for elderly people in Denmark are managed by the local authorities.
      Expenses for the elderly account for 65% of the local authority expenses in the
      social sector. During recent years, the Danish government has made increasing
      demands on the local authorities to limit public resources. The number of elderly
      people is still increasing, particularly within the oldest age groups; an
      increasing number of elderly suffer from senile dementia, and sick elderly people
      remain in their own homes, due largely to changes in discharge practice by the
      public hospitals. Therefore, the local authorities have tried new ways and have
      modified the level of service for the elderly within unchanged financial limits.
      In order to maintain a good level of service, it has become necessary to increase
      the efficiency and flexibility in the use of resources and to transfer a number
      of tasks to both the staff and the elderly themselves. The article gives a broad
      survey of the Danish services for the elderly and the local authorities'
      experience with the restructuring.

PMID- 1638883
TI  - The role of private organisations in welfare work. The historical perspective.
AB  - The Danish welfare measures originated in private initiatives. From the end of
      the last century, welfare activities have developed through private relief
      organisations and with support from the State, local governments, and counties.
      Since the 1960s, many institutions which had been built up by private relief
      organisations were actually taken over by local governments or counties. By way
      of illustration, the development of EGV DaneCare (the Danish Association for the
      Care of the Elderly), from its origin as a voluntary relief organisation based on
      voluntary work and collected funds, is described. From 1910, EGV was the pioneer
      within the field of, for example, old people's homes, winter shelters, and
      holidays in the country for elderly people. In the 1960s, EGV became a
      professional service organisation which assisted the local governments in
      developing a wide range of variegated offers within the work for elderly people.
      Assistance offered to the local governments became the organisation's principal
      project up to the 1980s. The population's confidence in the ability of the public
      authorities to cope with the social tasks was at the time undermined by
      increasing scepticism. That was why EGV founded the DaneAge Association, which
      soon became a national cause with more than 200,000 members. The DaneAge
      Association operates as an association independent of the public authorities
      pursuing both local and national policies concerning the elderly and implementing
      humanitarian initiatives based on voluntary work. Studies made by the DaneAge
      Association show, among other things, that 20 per cent of the people aged 60 and
      over need practical assistance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638884
TI  - Changing elderly in a changing society. Danish elderly in the next century.
AB  - A cross-sectional and multidisciplinary study on the situation of the elderly in
      Denmark at the beginning of the next century was undertaken in the late 1980s.
      The intention was to give a picture of the future cohorts of elderly, and their
      expectations for old age. The study also looked into the ways in which future
      societal developments might affect the situation of the elderly. In order to test
      a number of hypotheses on the future elderly and their preferences for life when
      they grow older, 1200 persons in the age groups 40-44, 50-54, and 60-64 years old
      were interviewed. Further, a number of studies were commissioned on developments
      which may affect the elderly with regard to health, housing, family, work and
      retirement, financial conditions, leisure activities and political participation.
      A main conclusion is that the future elderly in most areas--be it financial
      conditions, health, housing education--will be in a more favourable position than
      their predecessors after retirement. But there will still be a minority who
      suffer a hard life. They are the people whose finances are weak, whose health is
      impaired, and who lack social contacts.

PMID- 1638885
TI  - Elderly people in a large Danish city.
AB  - The Aalborg Model of elderly care contains the following new concepts: It is a
      comprehensive system, including housing, activities, a food service, practical
      assistance, nursing care, physical rehabilitation and counselling. High priority
      is given to the earlier detection of illness and of special needs in an attempt
      to enrich the quality of life of the elderly and to reduce the cost of treatment.
      Suitable, independent housing for the elderly has been integrated into ordinary
      residential areas. The elderly choose their own housing and the assistance they
      require based on the principle that they will be given help to help themselves,
      no matter where they live. The former division between visiting nurses and
      nursing homes has been eliminated, and the elderly are no longer classified
      according to "diagnosis." One exception to this is the geronto-psychiatric
      patients who are cared for in special nursing homes. The various kinds of
      assistance give many options to choose from, regardless of where you live. The
      services offered are flexible and are provided according to need. They can range
      from the once a week delivery of frozen, ready-to-serve dishes to extensive care
      both day and night. Decisions regarding the content and extent of the services
      are made by members of the permanent staff and the group leaders in cooperation
      with the elderly users. The various kinds of assistance can be adjusted to suit
      changing priorities and are provided in accordance with the special character of
      a local district. One group leader in each district is responsible for
      coordinating the services. The users have great influence.

PMID- 1638886
TI  - Non-institutional care for the elderly. A Danish model.
AB  - A 4 year long Action Research Project including the reorganization and co
      ordination of services and facilities for the elderly had been conducted in a
      Danish municipality. The project was started in June 1984 when a conceptual
      framework was developed to establish the foundation for the design of the
      project. The concept of self-care and WHO's strategy "Health for all by the year
      2000" were central aspects of the framework. Self-care is the process of choosing
      and deciding over our own bodies and lives. In a more institutionalized health
      care system, citizens are often not able to take part in the decision-making
      process, or only with difficulty. A survey study was conducted to assess the
      social and health service needs and wishes of persons over 67 years of age.
      Comprehensive interdisciplinary training of staff was carried out. During the
      latter part of this period, a 24 hour service was planned, and the former nursing
      home was converted into a health care centre, with sheltered flats, guests flats
      and a day centre, open to all citizens, irrespectively of age. Out of
      consideration for both the inhabitants of the former nursing home and the staff,
      who were to test both the new ways of working together and the new working
      methods the changes were initiated slowly with careful preparation and
      coordination among the respective parties.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638887
TI  - Housing of the elderly.
AB  - The housing conditions of the elderly in Denmark are undergoing rapid
      improvement. The main reason for this is that the first generations to benefit
      from the growth of prosperity that started in the 1950s are now joining the ranks
      of the elderly. Similarly, the oldest of the elderly population--many of whom
      live in some of the country's oldest, smallest and technically worst housing--are
      now dying off. Most of the new elderly generation own their own home, usually a
      detached house, and the vast majority of them must be expected to be extremely
      satisfied with their homes and to want to remain in them in their old age.
      However, this may present difficulties, partly because it requires a certain
      income and partly because the dwellings require quite a lot of maintenance,
      gardening, street-cleaning, etc. The general rule seems to be that the elderly
      mainly only move from a good, big home when they lose their husband or wife or
      reach a point at which they need more care. Danish policy on housing for the
      elderly attaches importance to supporting the elderly in their own homes, and the
      available resources are largely concentrated on this intention. Here at the
      beginning of the 1990s this policy has run into difficulties because it has led
      to the allocation of resources being slanted in favour of relatively well
      situated elderly people, while the weakest and poorest old people with the
      biggest need for care are not served satisfactorily.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1638888
TI  - Special dwellings for the elderly.
AB  - The policy governing old people's housing is administered individually in the
      various Danish municipalities. Those municipalities with a high housing coverage
      give the widest scope with regard to suitable housing, frequently applying The
      Housing for the Elderly Act, with common housing and service areas generally
      available. This is not the case, however, with municipalities operating with low
      housing coverage where suitable nursing homes are usually available, but not to a
      degree sufficient to offset the difference. These conclusions were reached after
      a study to establish how the policy governing housing for the elderly is applied
      in the various municipalities following the 1987 amendment of the Act concerning
      the building of special housing for the elderly.

PMID- 1638890
TI  - Financial circumstances of the elderly in Denmark--now and in the coming years.
      Pension systems and other economic possibilities.
AB  - The situation concerning pensions in Denmark has been changing in recent years.
      There is a trend for the population itself has to pay into private pension to
      ensure a satisfactory financial situation after retirement. There are three
      categories of pensions and supplementary grants influencing the financial
      situation of the elderly: social-political grants, labour market political
      grants, and private arrangements. The national retirement pension is paid to
      everyone in accordance with certain rules. One condition is residence in Denmark
      for 40 years after reaching the age of 15. The pension age is 67 years. It is
      possible to receive early retirement pay or to obtain partial pension from the
      age of 60. This means that the age for retirement from the labour market on
      average is 62 years. Supplements to the national pension can be given as a net
      sum. Such a payment, however, makes it more difficult for the elderly person to
      overview his or her financial circumstances in retirement. The partial pension is
      a new form of pension which was introduced in 1986. About 2% of the 60-66 year
      olds have taken advantage of this possibility, most of them independent trade
      men. In contrast, 105,000 wage earners are receiving early retirement pay, which
      is based on unemployment insurance. Certain considerations apply when the social
      pension is paid in a gross amount. This amount will not be free of tax. A number
      of special grants for the elderly will be included in the gross amount of the
      social pension. A system of that sort will make the financial circumstances of
      the retired person more clear.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638889
TI  - Retirement from work. The recent lowering of retirement age--causes and
      consequences.
AB  - The recent change in early retirement is described and related to the development
      in social policy, labour market and individual attitudes towards work and
      retirement. Particular attention is given to the orientation toward life after
      work in relation to retirement. The development in retirement pattern is seen as
      an institutionalisation of early retirement.

PMID- 1638891
TI  - Geriatrics in the Danish health care system.
AB  - After having occupied a modest place in the Danish health system for many years,
      geriatrics now shows signs of stability and growth. Instruction in geriatrics has
      been strengthened by the creation of a professorship in 1991. Structural changes,
      particularly in the Copenhagen hospital system since 1987, have given geriatrics
      a more prominent place, and from 1992, there will be more emphasis on this field.
      There has been increased interest in geriatrics in the primary health care sector
      on the part of general practitioners and home nurses. Geriatrics in the hospital
      sector takes the form of separate departments in large acute hospitals and
      independent hospital units and elsewhere is seen as a part of departments of
      internal medicine. In Denmark, the geriatric patient is a patient with many
      concomitant physical and psychic illnesses and the resultant social problems.
      Acute organ specific problems are generally taken care of outside of geriatric
      departments.

PMID- 1638892
TI  - Dementia in Denmark from a medical view.
AB  - The field of psychogeriatrics, including diagnosis and treatment of age
      associated dementia, is still in its early years in Denmark. Most of the
      treatment of the elderly with psychiatric conditions lies in the hands of general
      practitioners and staff of somatic nursing homes. In a few places in Denmark, a
      more academic approach to the elderly patients has developed in general
      psychiatric hospitals. Psychogeriatric department D at The Psychiatric University
      Hospital in Arhus is an example. Treatment ideology, strategies, education,
      outpatient treatment and hospital-treatment is described, especially regarding
      age-associated dementia.

PMID- 1638893
TI  - Improving environment and care for elderly people with dementia.
AB  - The increasing number of demented elderly people makes it necessary to develop
      new ways of organising care for this particular group, which up to now has not
      attracted much interest amongst old-age policy decision makers. The life of the
      demented and their relatives can be improved by developing environments with
      suitable physical, social and psychological elements. Such efforts can contribute
      to better maintaining the abilities of the demented person instead of reducing
      them further. The everyday life can be organised in small units, where the staff
      is specifically trained to care for the demented. This approach is now being
      tried in nursing homes, dementia groups, and collective housing projects.

PMID- 1638894
TI  - Preventive home visits among elderly people.
AB  - Recurrent preventive home visits are an important part of the efforts for elderly
      people in about 15% of the communities in Denmark. Based on these experiences,
      this paper describes how to conduct the preventive visits. The content consists
      of structured conversations, attention to possible risk situations, action
      proposals and followup on previous discussions and planned changes. The empathy
      of the visitor is an important factor. A hypothesis is proposed about the cause
      of the positive effect of the preventive visits on institutionalisation and
      mortality.

PMID- 1638895
TI  - Involvement. Senior citizens' recreational activities.
AB  - During the last 18 years, senior citizens in Viborg, Denmark, have participated
      in study circles based on the theory of impression pedagogy and socially relevant
      activities. They arrange excursions at home and abroad and make films about the
      trips. They teach schoolchildren, students at folk high schools, and nurses, as
      well as occupational therapists and physiotherapists. They publish poems and
      books, write role plays, stage musicals, sing in choirs, and function as tour
      guides in town. They set up educational color slide programmes on preventing bone
      fractures, dealing with the problem of reduced hearing, and the importance of
      healthy food and exercise. They travel abroad and talk about Denmark and the
      conditions for senior citizens in our country. With the support of the Danish
      Ministry for Social Affairs, they produce videos about their activities as a
      source of inspiration to others. The use of drugs by the participants in the
      study circles has declined, while the level of activities has increased, and none
      of the participants has ever had to enter residential care.

PMID- 1638896
TI  - The elderly at folk high schools. An educational experience.
AB  - The following article tells about a special feature of Danish society, namely the
      Danish Folk High School. The traditional folk high school has existed since the
      era of Grundtvig, but after 1970, efforts were made both by means of hard work
      and by legislation so that today we are able to offer courses for our senior
      citizens at four different high schools. Rapid technical development threatens to
      bring our society into imbalance. One can fear that the spiritual world, overrun
      by technocrats, is close to break down. However, the Danish folk high school
      affords an enormous chance to fight back by helping people to reestablish their
      self-reliance, appreciating human values like solidarity and the exchange of
      thoughts and dreams. The Danish folk high school is one possible antidote for a
      world of too much body and too little spirit.

PMID- 1638897
TI  - Care for the dying in Denmark.
AB  - In Denmark terminal nursing and care (TC) have become a hospital duty during the
      last four to five decades. The terminal stage of the elderly is hard to delimit.
      Death often comes undramatically and unpredictably. Many are found dead in their
      beds in the morning without any preliminary complaints. In 1989, 63% of all
      deaths occurred in hospitals, 78% of which were persons over 65 years old.
      Seventeen per cent died in rest homes, and only about 5% died a planned death in
      their homes. TC can be considered from four different angles: communication,
      practical arrangements, pain treatment, nursing and care. A definition of the
      general demands for the care offer is made, and the development of TC in Denmark
      is explained, extended home care nursing arrangements with care 24 hours day,
      better pain control, introduction of support for nursing the dying at home. Thus,
      dying at home is now an actual alternative to institutional death.

PMID- 1638898
TI  - Legal and ethical aspects of Danish elder policy--progress, dilemmas, and
      challenges.
AB  - The article deals with the fundamental principles of Danish social and health
      law: individual rights to basic benefits for all elderly citizens, but also a
      right to supplementary benefits earned by one's own efforts. The principle of
      informed consent has been accepted by the medical and legal professions and has,
      from there, spread to care giving activities within the social services. There
      are many unsolved ethical and legal problems concerning the care of the frail and
      vulnerable elderly, especially those who are not capable of giving or refusing
      consent.

PMID- 1638899
TI  - The new social and health education programmes.
AB  - On 1 January 1991, a comprehensive restructuring of the basic social and health
      education programmes in the fields of assistance, nursing, and care was carried
      out in Denmark. This article briefly describes the background and contents of the
      new educational programmes.

PMID- 1638900
TI  - Habits and rituals.
AB  - On-going restructuring in the Danish care for the elderly is to a very high
      degree based on recognition of the significance of habits and rituals, as well on
      the knowledge of what is needed to alter them. Habits and rituals are concepts
      that are often confused in everyday patterns of thought. It is necessary to be
      able to distinguish between the two concepts before change can be effected. To
      varying degrees people are characterised by unconscious and conscious habits as
      well as inherited and personal rituals. Personal development, age, support from
      one's surroundings, and so on, determine the degree to which a person may
      continue or alter acquired patterns of habit and ritual.

PMID- 1638901
TI  - The privileged old in Denmark.
AB  - The author builds on personal experience as a retired civil servant. He has been
      the initiator of the Academy for the Third Age and, as chairman of The Danish
      Social Political Association, has worked with the problems of the elderly. In his
      attempt to describe the situation of privileged elderly citizens, he has tried to
      emphasise that their limited time perspective urges them to live one more life of
      intense experiences. The freedom which they have acquired with retirement makes
      this easier to achieve.

PMID- 1638902
TI  - When staff members sexually abuse children in residential care.
AB  - When an agency staff member is accused of sexually abusing a client, the
      administration is faced with the Solomonic task of balancing the necessity of
      protecting the child, supporting the staff, and maintaining the integrity and
      reputation of the agency. This article presents practical suggestions for
      managing the agency through such a crisis.

PMID- 1638903
TI  - Critical issues in residential care for young mothers and infants: an overview of
      model licensing rules.

PMID- 1638904
TI  - Traumatic bonding: clinical implications in incest.
AB  - The concept of traumatic bonding, taken from the literatures on trauma,
      victimization, and exploitation, holds promise for explaining some of the more
      confusing dynamics of incest. This article offers a definition of traumatic
      bonding, demonstrates how it can be applied in cases of incest, and discusses the
      implications of this concept for therapeutic intervention.

PMID- 1638905
TI  - Implementing critical health services for children in foster care.
AB  - This article reports recommendations that were developed at the California
      Conference on Health Care for Children in Foster Care, organized to discuss
      implementation in the state of CWLA's Standards for Health Care Services for
      Children in Out-of-Home Care. Programs and legislation developed in the state are
      also discussed.

PMID- 1638906
TI  - The Child Well-Being Scales: a field trial.
AB  - The Child Well-Being Scales [Magura and Moses 1986] were developed to evaluate
      programs of child welfare services. Although appealing in format, the scales have
      lacked adequate validation. For the field trial reported here, 17 of the scales
      were extracted and used to form measures of physical and psychological care of
      children. A comparison between families identified as neglectful and low-income
      control families yielded differences in the predicted direction. The composite
      indices showed good internal consistency. The concurrent validity of this segment
      of the scales was supported. The scales yielded three factors that reliably
      classified families externally verified as neglectful and nonneglectful control
      families.

PMID- 1638908
TI  - Cocaine in perspective.
AB  - In a medical text published in 1883, Dr Benjamin Ward Richardson FRS denounced
      the evils of tea drinking, suggesting that it commonly gave rise to an 'Extremely
      nervous semi-hysterical condition'. That this distinguished Victorian physician
      could take such a view invites a sensitivity toward the perspective within which
      any debate on drugs is conducted--the historical, cultural and professional
      assumptions which will colour views as to what needs to be explained and how
      explanation is to be accomplished. The reality and significance of 'perspective'
      is further illustrated by examples drawn from contemporary literature which
      contrast the laboratory and social science approaches to study of cocaine. No one
      narrow disciplinary perspective on the cocaine problem will suffice; the
      challenge is to build bridges.

PMID- 1638907
TI  - Reactions by Native American parents to child protection agencies: cultural and
      community factors.
AB  - The oppression suffered by Native Americans has so undermined their culture and
      ability to parent that child abuse and neglect are frequent problems. Yet the
      history of oppression often seriously damages the capacity of many Native
      American parents to accept help from child protective service agencies and staff
      members. This article explains the particular characteristics and behaviors of
      some Native American parents, and closes with a summarized guide to understanding
      these parents and to appropriate behavior on the part of social workers.

PMID- 1638909
TI  - How toxic is cocaine?
AB  - The toxicities of cocaine are far-ranging. They include sudden death, acute
      medical and psychiatric illness, infectious complications, reproductive
      disturbances, trauma, criminal activities and societal disruption, including
      child neglect and abuse and lost job productivity. This chapter focuses on the
      medical complications. Medical complications in general reflect the intense
      sympathomimetic activities of cocaine ('sympathetic neural storm'). Psychiatric
      complications include acute anxiety or panic and paranoid psychosis.
      Cardiovascular complications include arrhythmias and sudden death, acute
      myocardial infarction, myocarditis, dissecting aneurysm and bowel infarction.
      Neurological complications include seizure, intracerebral haemorrhage and brain
      injury due to hyperthermia and/or seizures, and headache. The incidence of
      medical complications has been estimated using two databases collected
      prospectively in the United States. In 1989 and 1990 cocaine ranked first in
      total encounters, major medical complications and drug-related deaths. An attempt
      was made to assess the intrinsic toxicity of cocaine by computing the incidence
      of adverse health outcomes per population of drug abusers. Rates of emergency
      department visits and deaths were 15.1 and 0.5 respectively, per 1000 persons
      using drugs in the past year. The magnitude of the cocaine problem, while
      considerable, is relatively small compared with that of cigarette smoking or
      alcohol abuse.

PMID- 1638910
TI  - Determinants of cocaine self-administration by laboratory animals.
AB  - The reinforcing effect of a drug is that effect that increases the probability
      that the drug will be self-administered again. Like other drug effects, a
      reinforcing effect is the result of an interaction between organism, drug and
      environment. Laboratory research using animal subjects has helped elucidate the
      contribution of each of these factors to the self-administration of cocaine. A
      substantial amount of research indicates that increased dopamine
      neurotransmission in the brain, particularly in mesolimbic and mesocortical
      regions, plays a major role in cocaine self-administration. Both indirect and
      direct dopamine agonists can function as positive reinforcers in animals, whereas
      noradrenergic and serotonergic (5-HT, 5-hydroxytryptamine) agonists have not been
      found to do so. In addition, evidence suggests that dopamine but not
      noradrenaline (norepinephrine) or serotonin antagonists can attenuate the
      reinforcing effect of cocaine. Environmental factors have also been shown to be
      critical determinants of the reinforcing effect of cocaine. The schedule of
      reinforcement essentially determines the rate and pattern of drug-maintained
      behaviour. In addition, punishing self-administration, increasing the value of
      alternative reinforcers that are available, and increasing the cost of cocaine
      have all been shown to decrease the reinforcing effect of cocaine. With regard to
      organismic factors, recent research has suggested that there are significant
      genetic determinants of cocaine consumption. Taken together these research
      findings in animals imply that certain individuals may be more sensitive to the
      reinforcing effect of cocaine but that cocaine abuse can be decreased by
      pharmacological or behavioural means or by a combination of the two.

PMID- 1638911
TI  - Self-administration of cocaine by humans: a laboratory perspective.
AB  - Laboratory research evaluating the behavioural and physiological effects of
      cocaine has produced important basic information relevant to the prediction and
      control of cocaine abuse. Adaptation for human subjects of laboratory procedures
      originally developed with non-humans has provided the methodology for assessing
      the relationship between cocaine-taking and the self-reported effects of cocaine.
      This laboratory model for evaluating drug-taking has been adapted to include all
      the routes of administration by which cocaine is abused. Data collected in
      cocaine choice/self-administration studies indicate that there is a generally
      good correlation between cocaine self-administration and its stimulant-like
      'positive' effects. There are, however, areas in which these two measures clearly
      diverge, and drug self-administration procedures provide a sensitive measure of
      cocaine's effects when it is taken by the routes and in the patterns people use
      outside the laboratory. Combining these measures with other behavioural
      evaluations provides useful information for understanding cocaine use and abuse.
      In addition, and importantly, these laboratory procedures are useful tools in the
      development and assessment of treatment interventions which might be used
      effectively.

PMID- 1638912
TI  - AIDS and HIV infection in cocaine users.

PMID- 1638913
TI  - Treatment of cocaine abuse: pharmacotherapy.
AB  - Until recently the treatment of cocaine addicts was limited to non
      pharmacological methods because cocaine abuse was viewed as a psychological
      addiction to the drug's euphoriant effects. Chronic stimulant abuse is now known
      to lead to neurophysiological adaptation. This physiological evidence, and the
      failure of many patients to respond adequately to psychological treatment,
      prompted clinicians and researchers to explore numerous pharmacological agents in
      the early 1980s. Promising medications that may affect the euphoria, the craving,
      withdrawal, or the toxic effects associated with cocaine are under development.
      Potential pharmacological agents being studied include tricyclic antidepressants,
      anticonvulsants, neurotransmitter precursors, stimulants and dopamine agonists,
      serotonin re-uptake blockers and agonists, neuroleptics and opioid
      agonists/antagonists. Most of the research to date is on anti-craving agents.
      While many positive clinical reports exist, most reports are anecdotal and
      uncontrolled. The available data are reviewed. Potential pharmacotherapies
      require further research to elucidate the differences between treatments, the
      target populations, the optimal dosages and duration, and the interaction with
      behavioural and psychotherapeutic approaches.

PMID- 1638914
TI  - Epidemiological research on cocaine use in the USA.
AB  - In the study of cocaine, epidemiology offers a way to reckon the experience of
      human populations, from time to time, from region to region, from community to
      community, and from group to group. Continuing surveillance of cocaine
      experiences in diverse segments of the United States population has allowed us to
      plot the course of our most recent cocaine epidemic in more detail than in the
      past. Still, much remains to be learned about the dynamics of the cocaine
      epidemic before public health agencies or anyone else should ride to glory on the
      descending limb of this epidemic curve. Beyond basic surveillance, epidemiology
      has the capacity to teach us about the conditions under which human cocaine use
      starts, is maintained, and stops, including the array of perceived and actual
      consequences of cocaine use that may determine specific patterns of use. In this
      respect, there is some value in making a chronicle of cocaine users' life
      experiences, with a comparison to the life experiences of others. However, the
      perceptions of cocaine users do not always map onto observations made under
      controlled conditions of laboratory research. Finally, it is not essential for
      epidemiology to rely solely upon what individuals perceive and report as causal
      linkages between cocaine use and their other life experiences. One effective
      alternative is to use the epidemiological case-control method and related
      strategies to probe suspected causal linkages involving cocaine. As demonstrated
      in recent research, these strategies have a resolving power that goes beyond that
      of standard epidemiological survey reports. Of course, the resulting
      epidemiological evidence does not stand alone. Rather, it complements laboratory
      and clinical research, giving a more complete view of cocaine's impact on human
      health.

PMID- 1638915
TI  - Psychotherapy for cocaine dependence.
AB  - Dependence on cocaine is a new disorder for contemporary US clinicians. Until the
      1980s sufficient quantities of the drug were not available to produce a true
      dependence. Thus far the only models for pharmacological intervention involve an
      interaction between medication and psychotherapy; that is, medication may be able
      to facilitate a drug-free interval during which time the patient can be engaged
      in psychotherapy. Psychotherapy programmes for cocaine dependence have generally
      been modelled on group-oriented treatments of the type used by Alcoholics
      Anonymous. Controlled studies of therapy programmes for cocaine dependence are
      currently being conducted and one prospective random-assignment study comparing
      day hospital and in-patient rehabilitation shows generally good results.
      Behavioural treatments aimed at reducing or extinguishing conditioned responses
      in cocaine addicts have also shown efficacy in a controlled study. More general
      relapse prevention procedures including rehearsal and role-playing are also used
      in the treatment of cocaine dependence. Combinations of psychotherapy and
      pharmacotherapy have so far shown the most promise in the treatment of this
      disorder.

PMID- 1638916
TI  - Alternative strategies.
AB  - Drug treatment alternatives in the United States are constrained by what is
      politically correct and expedient and by a federal policy of 'zero tolerance' for
      any illicit psychoactive drug use. A war on drugs will not solve all the problems
      posed by cocaine. Alternative strategies must address fundamental problems in
      ghetto life: violence, poverty, poor health, no education, no jobs, and few
      reasons for not taking drugs. Despite warnings of pharmacological determinism,
      cocaine is like other psychoactive drugs. Even with cocaine, when alternative
      behaviours are possible most people avoid out-of-control use. Public health
      strategies promoting a harm-reduction policy offer advantages. Recent reductions
      in cocaine use are a consequence of education, awareness of good health
      practices, and interest in other activities. Alternatives could include cocaine
      in a safer, non-lethal and controllable form but are unlikely in a political
      climate where politics and law prevail rather than medicine and humanity.

PMID- 1638917
TI  - The economics of drug use and abuse.
AB  - The markets for drugs such as cocaine are characterized by much ignorance about
      the nature of trading relationships, in particular the volumes and prices
      exhibited by overlapping national and international networks of buyers and
      sellers (i.e. markets), and by severe regulation by the State. The regulation of
      illegal markets is expensive; for example, in 1988 in the UK, over 5000 Customs
      officers and 1800 CID and uniformed policemen were involved in enforcing the law
      at a cost of about 140 million pounds. The size of the markets can be only
      'guesstimated': in 1989 just over 520 kg of cocaine was seized. If this is
      assumed to be 10% of the market, the total size of the cocaine market was
      somewhere in excess of 5000 kg. The 'cost-effectiveness' of both Customs and the
      police in enforcing the law may have declined in the late 1980s. What economic
      arguments are there for sustaining illegality and an expensive enforcement
      effort? Some arguments for State regulation are explored; for example, the drug
      user harms 'innocent' third parties, the drug user is less productive and reduces
      national income, the drug user will impose costs on the National Health Service,
      the drug user's behaviour is offensive, and the drug user should be protected
      from his own stupidity. Where do these arguments leave the case for maintaining
      public policy towards illicit drugs? Would it be cost effective to move towards
      the liberalization of these markets?

PMID- 1638918
TI  - Formulating policies on the non-medical use of cocaine.
AB  - The formulation of policy on cocaine, as on any other social issue, involves
      explicit or implicit cost-benefit analyses with many factors. Cocaine use carries
      many medical, psychiatric and social risks, and its inherent pharmacological risk
      of dependence is greater than for other drugs. The reported frequency of these
      problems has increased exponentially over the past fifteen years. However,
      current levels of use are decreasing in the general population, though still
      increasing among certain subpopulations in which it is accompanied by violent
      crime. On the other hand, the attempt to control use mainly or exclusively by
      reducing the supply has been of low efficacy and extremely expensive, in both
      human and monetary terms, for the consuming countries and economically and
      politically devastating for the producing countries. Yet past experience with
      other drugs suggests that legalization of cocaine would increase its use
      substantially. Moreover, legalization runs counter to public sentiment, even in
      those countries where the law is applied leniently against users and small-scale
      traffickers. The most practical policy appears to be to maintain prohibition as a
      sign of social disapproval, but to rely much more heavily on non-coercive
      measures to reduce demand by strengthening public consensus against all drug use.

PMID- 1638919
TI  - Drug use and abuse: the ethical issues.
AB  - Drug abuse is both a personal and a public issue, raising questions about
      individual rights and the boundaries of law, as well as about national
      sovereignty and international control. Ethical issues that arise under these
      headings may be related to certain broad ethical positions. The implications of
      adopting utilitarian assumptions may be contrasted with basing ethics on a theory
      of individual rights, closely related to a theory of human nature. Neither
      position justifies a libertarian presumption against control, for, first, an
      individual decision to expose one's mind and personality to the control of drugs
      cannot be ethically justified and, second, there are no ethical reasons, nor any
      compelling arguments from social and political theory, for decriminalizing non
      medical drug use.

PMID- 1638920
TI  - Cocaine problems in the coca-growing countries of South America.
AB  - The problems of cocaine present a rather particular profile in the Central Andes
      region from which this drug originates. On the one hand there is a relatively
      harmless pattern of use (coca leaf chewing) in the countries concerned which
      minimizes the drug's most hazardous properties. On the other hand the region
      suffers from some of the most severe cocaine-related problems to be observed
      anywhere: (a) easy access to the newer, highly toxic preparations of the drug
      (such as coca paste) and a rapid growth in the number of new users; (b) the
      abandonment of certain traditional and essential agricultural activities in
      favour of the more profitable coca leaf production; (c) the severe ecological
      damage being caused in the coca growing areas; and (d) the establishment of a
      powerful coca trade economy which is subverting the very fabric of society and is
      creating corruption, lawless violence and political anarchy.

PMID- 1638921
TI  - Are there 'casual users' of cocaine?
AB  - Medical and public opinion about cocaine use have shifted dramatically over the
      past decade. New research methodologies and definitions to evaluate the impact of
      cocaine are needed. This paper presents a theoretical definition and empirical
      analysis of the 'casual user' of cocaine. Data have been drawn from a subsample
      of 58 cocaine users and their cocaine-using contacts in Rotterdam. The
      methodology of the study presents a novel approach to patterns of cocaine use
      involving the integration of social network variables with 'snowball' sampling
      data collection techniques. The theoretical definition is systematically related
      to two social context variables: (1) the scope of settings where contacts use
      cocaine; (2) the degree of involvement in social network relations of actual
      cocaine use. Scope of settings has been defined in terms of the number of cocaine
      using social circuits contacts are drawn from: i.e. 'narrow' setting where all
      contacts originate from one circuit while a 'wide' setting indicates contacts
      come from two or more circuits. Involvement has been defined in terms of the
      percentage of contacts where the relation with study participants is
      characterized by cocaine use most or all of the time. Additional social network
      variables measuring the mean duration (in years) of contacts' cocaine use and the
      use of cocaine with contacts in the last six months are subsequently related to
      the scope and involvement variables. The implications of the analysis for a new
      cross-classification of cocaine use patterns are discussed with special reference
      to public health policy issues.

PMID- 1638922
TI  - Cocaine's history, especially the American experience.
AB  - The history of cocaine in America can be traced to the late 19th century. After
      the discovery of its physiological and psychological effects, cocaine figured in
      consumables as diverse as hay fever remedies, local anaesthetics and soft drinks.
      The development of its different usages as well as eventual control of its use
      through restrictive legislation followed a different pattern in America from that
      in Europe. In the United States, national laws to control drugs faced
      constitutional obstacles until the era of World War I. Initially acclaimed as an
      ideal tonic, within two decades of its introduction in the mid 1880s cocaine was
      perceived as an extremely dangerous drug. By the 1930s cocaine had declined in
      use and in the 1960s, when it gradually emerged again, almost no public memory
      existed of the earlier 'epidemic'. Once again this substance evolved into a
      threatening and seductive hazard with some similarities to the earlier episode.

PMID- 1638923
TI  - Molecular pharmacology of cocaine: a dopamine hypothesis and its implications.
AB  - The reinforcing properties of cocaine have been related to cocaine binding at the
      dopamine transporter in mesolimbocortical neurons. The molecular properties of
      the transporter have been studied in a number of laboratories. While this
      'dopamine hypothesis' is strongly supported in animal studies of drug self
      administration, the extent of its involvement in human drug dependence has not
      been fully elucidated.

PMID- 1638924
TI  - The neurobiology of cocaine-induced reinforcement.
AB  - Cocaine has potent pharmacological actions on a number of monoaminergic systems
      in the brain, including those that use noradrenaline, dopamine and serotonin as
      neurotransmitters. There is growing evidence that cocaine's effects on
      dopaminergic neurons, particularly those that make up the mesolimbic system, are
      closely associated with its rewarding properties. For example, low doses of
      dopamine receptor antagonists reliably influence cocaine self-administration,
      whereas noradrenaline and serotonin receptor antagonists are without consistent
      effects. Similarly, selective lesions of dopaminergic terminals in the nucleus
      accumbens, a major target of the mesolimbic dopamine projection, disrupt cocaine
      self-administration in a manner that is consistent with loss of cocaine-induced
      reward. The introduction of in vivo brain microdialysis as a tool with which to
      investigate the neurochemical correlates of motivated behaviour has provided new
      opportunities for investigating the role of dopamine in the nucleus accumbens in
      the acquisition and maintenance of cocaine self-administration. Although the body
      of literature that has been generated by this approach appears to contain some
      important inconsistencies, these probably reflect the use of inappropriate
      microdialysis conditions by some investigators. A critical review of the
      literature suggests that microdialysis results are generally consistent with a
      role for mesolimbic dopamine in cocaine-induced reward, although it does not seem
      to be the case that animals will work to maintain consistent increases in
      extracellular concentrations of dopamine in the nucleus accumbens in all
      experimental conditions. Elucidation of the complete neural circuitry of cocaine
      induced reward remains an important priority for future research.

PMID- 1638925
TI  - Toxic effect of endocytobionts from Dermacentor reticulatus ticks in three tick
      species after in vivo application.
AB  - The endocytobionts from ovaries of partially engorged female Dermacentor
      reticulatus ticks, inoculated introcoelomally into females of three tick species,
      D. reticulatus, Ixodes ricinus and Haemaphysalis inermis, caused considerable
      morphological alterations in the examined cells and tissues of the synganglion,
      fat body, tracheal complex and ovary of these recipients.

PMID- 1638926
TI  - Effects of precocenes on vitellogenesis in the adult female tick, Ornithodoros
      moubata (Acari: Argasidae).
AB  - Vitellogenin (Vg) concentrations in the hemolymph and ovarian development were
      studied in Ornithodoros moubata after treatment with precocenes 1 (P1) and 2
      (P2). Precocene was dissolved in acetone or DMSO and topically applied to the
      dorsal surface of ticks: (1) at adult ecdysis; (2) 24 h before engorgement; (3)
      immediately after engorgement; and (4) 24 h after engorgement. Subsequently, P1
      and P2 were dissolved in olive oil and injected through the gonopore into the
      body cavity 24 h after engorgement. Vitellogenin concentration was measured on
      days 5 and 10 after engorgement and ovarian development was scored on day 10, 20
      or 30. Oviposition was also recorded and the average weight of eggs laid by
      females was determined. No differences in concentration of Vg in the hemolymph
      occurred between the control ticks and ticks treated topically or by injection
      with P1 and P2. Precocene did not suppress the synthesis of Vg in O. moubata.
      However, oviposition was reduced in ticks that survived repeated treatment with
      high doses of P2 dissolved in acetone.

PMID- 1638928
TI  - Morphology and structural organization of spiracles in female Argas (Persicargas)
      walkerae (Acari: Argasidae).
AB  - Scanning electron microscopical investigations of fractures and corrosion casts
      of the spiracles from female A. walkerae ticks revealed a four-part structure,
      consisting of spiracular plate, ostium and macula forming the external closure,
      followed by the subostial space and the vestibulum of regulable volume, as well
      as the atrial chamber as the innermost part from which the main tracheal trunks
      originate. On the average, the spiracular plate was 158 microns long and 188
      microns at the broadest width. It consisted of a thin, highly perforated external
      and a thick internal layer, which enclosed the interpedicellar space with
      numerous stout pedicels. In its posterior region, the spiracular plate was
      covered by the macula, which was up to 80 microns in length and 110 microns in
      width. The interpedicellar cavity opened into the subostial space measuring 95.5
      microns in length and 159.6 microns in width, which proceeded into the 112
      microns long vestibulum. The roof of the vestibulum was flexible and could be
      everted and inverted. Inverted, the roof formed a quadratic bulge with numerous
      deep cuticular folds, which confined the lumen of the vestibulum either partially
      or completely. In corrosion casts, the roof was everted to a length of up to 89.3
      microns. In the posterior part of the vestibulum, as well as in the initial
      fourth of the atrial chamber, numerous anvil-, cone- or drop-like cuticular
      projections were arranged in wedge-like fashion. The atrial chamber was almost
      spherical with a diameter of 138.4 microns. Five main tracheal trunks of
      different luminal diameter as well as numerous channels opened into the atrial
      chamber.

PMID- 1638927
TI  - Observation on the composition and biosynthesis of egg wax lipids in the cattle
      tick, Boophilus microplus.
AB  - The biosynthesis of wax lipids by Gene's organ, the egg waxing organ in ticks,
      was investigated. Gene's organ, a complex dermal gland system, applies a
      superficial wax layer to the eggs during oviposition which prevents desiccation
      and is essential for egg viability. The detailed anatomy and histology of the
      three gland cell types are unambiguously described. Serial sectioning of ticks
      showed that all three gland cell types are capable of contributing to the egg
      wax. The wax synthetic ability of these three gland types was characterized. The
      composition of wax lipids extracted from the surface egg wax, and from the three
      types of wax gland dissected from ovipositing ticks, was analysed using thin
      layer and gas-liquid chromatography. Injection of ovipositing ticks with
      radiolabelled acetate resulted in the incorporation of the label into wax lipids
      by gland cells of Gene's organ. The egg wax was a complex mixture of long-chain
      alkanes and fatty acid esters. The gland cells contained a greater proportion of
      shorter chain alkanes than were present in the egg surface wax. Some unsaturated
      long-chain fatty acids were present, and these were more abundant in the gland
      cells than in the surface wax of oviposited eggs, suggesting that oxidation
      occurs after oviposition. The results confirm that the tubular glands, acinar
      accessory glands and lobular glands of Gene's organ all contribute to the egg
      waxes, although the lipid components differed in relative abundance. The results
      are also consistent with alkane synthesis from fatty acids in Gene's organ by a
      chain-elongation-decarboxylation pathway.

PMID- 1638929
TI  - A comparison of methods for sampling the deer tick, Ixodes dammini, in a Lyme
      disease endemic area.
AB  - The purpose of this study was to compare the trapping and examining of mice, drag
      sampling, and CO2-baited traps for their ability to detect the presence and
      abundance of immature deer ticks, Ixodes dammini, in a Lyme disease endemic area
      in southern New York State. Eight study sites were sampled 14 times between 28
      May and 31 August by setting 49 live-traps, four CO2-baited traps, and drag
      sampling 500 m2. A total of 1540 nymphs and 3079 larvae was collected during the
      study. Drag sampling collected the most nymphs (705), while more larvae were
      recovered from CO2-baited traps (1105). Comparisons among the methods showed a
      significant difference in the numbers of both larval and nymphal ticks collected
      (P less than 0.01). There was a positive correlation between the numbers of
      nymphs collected by drag sampling and CO2-baited tick traps (rs = 0.83, P less
      than 0.05), and between the numbers of larvae collected by drag sampling and
      mouse trapping (rs = 0.75, P less than 0.05). These results suggest that drag
      sampling would be the single most reliable method for quantitatively sampling
      immature I. dammini populations in a Lyme disease endemic area.

PMID- 1638930
TI  - Prognostic factors in breast cancer: integrating the cytology laboratory.

PMID- 1638931
TI  - Diagnostic accuracy of fine-needle aspiration cytology in persistent or recurrent
      gynecologic malignancies.
AB  - A retrospective 7 1/4-yr study was performed to evaluate the diagnostic accuracy
      of fine-needle aspiration (FNA) cytology in the cell typing of persistent or
      recurrent gynecologic malignancies. A total of 202 aspirates were obtained from
      163 patients with documented malignancies of the cervix, uterus, ovary, vulva,
      and vagina. Information concerning the primary tumor was obtained from surgical
      reports and/or medical records. In 168/202 cases (83%), the histological
      diagnosis, including primary tumor cell type and subtype (ex. squamous cell
      carcinoma, large cell keratinizing), were available. In 12/202 cases (6%), only
      the tumor cell type (ex. squamous cell carcinoma) was known, and in the remaining
      22 cases (11%), only the location of the primary neoplasm was attainable.
      Aspirated sites included pelvic wall and organs (77 cases), lymph nodes (51
      cases), thoracic organs (18 cases), and abdominal wall and organs (56 cases),
      including liver (33 cases). Of the 168 cases with known histologic diagnoses, the
      FNA results were positive in 109 (65%). The positive results were divided into
      three groups: group I, the cytologic findings were predictive of the histologic
      diagnoses (84 cases, 77%); group II, tumor cell subtyping was not possible on
      cytology (17 cases, 16%); group III, neither tumor cell typing nor subtyping was
      possible on cytology (8 cases, 7%). Of the 34 cases in which only the histologic
      tumor cell type or primary tumor location was known, 13 (38%) were positive on
      FNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638932
TI  - Needle aspiration cytology of the irradiated breast.
AB  - During a 3-year period (1987-1989), 60 fine-needle aspiration biopsies (FNAs)
      were obtained from new breast lesions in patients previously treated by radiation
      and surgery for breast carcinoma. The lesions occurred at or near the site of
      previous excision, 3-117 months after initiation of radiotherapy. FNAs were
      classified as follows: acellular (11); negative (29); atypical (13); suspicious
      (4); and positive (3). For statistical analysis, acellular, negative, and
      atypical diagnoses were considered negative findings, and suspicious and positive
      diagnoses were considered positive findings. On the basis of subsequent biopsy
      and/or patient follow-up, FNA yielded a sensitivity of 86%, a specificity of 98%,
      a positive predictive value of 86%, a negative predictive value of 98%, and an
      efficiency of 97%. Excluding cystic lesions, the most reliable criterion for
      distinguishing malignant from benign lesions was the abundance of epithelial
      cells, both singly and in large clusters. Cellular characteristics were less
      helpful, since nuclear atypia was seen in both benign and malignant lesions. It
      is concluded that (1) FNA is a reliable technique in the evaluation of the
      irradiated breast; (2) when performed by an experienced operator, an acellular
      aspirate may be interpreted as evidence against recurrent carcinoma; and (3)
      epithelial atypia must be interpreted with caution to avoid a false-positive
      diagnosis.

PMID- 1638933
TI  - Cytopathology of malignant mesothelioma: a stepwise logistic regression analysis.
AB  - Twenty-four cytologic features, previously reported to be useful in the
      distinction of malignant mesothelioma, adenocarcinoma, and benign mesothelial
      proliferation in serous effusions were assessed. Forty-four cases of malignant
      mesotheliomas, 46 cases of metastatic adenocarcinomas, and 30 cases of benign
      mesothelial proliferations were examined for these parameters. When these
      cytologic features were subjected to a stepwise logistic regression analysis,
      five features were selected to distinguish malignant mesothelioma from
      adenocarcinoma. These were true papillary aggregates, multinucleation with
      atypia, cell-to-cell apposition, acinus-like structures, and balloon-like
      vacuolation, the latter two features being characteristic of adenocarcinoma. The
      four variables selected to distinguish malignant mesothelioma from benign
      mesothelial proliferations were nuclear pleomorphism, macronucleoli, cell-in-cell
      engulfment, and monolayer cell groups, the latter being a feature of benign
      proliferations. Using these selected variables, the logistic model correctly
      predicted 95.4% of cases of malignant mesothelioma versus 100% of adenocarcinoma
      and 100% of malignant mesotheliomas versus 90% of benign mesothelial
      proliferations. The results of regression analysis suggest that many of the
      previously described cytologic features are not important diagnostic
      discriminators.

PMID- 1638934
TI  - Columnar cells in posthysterectomy vaginal smears.
AB  - Columnar cells in posthysterectomy vaginal smears are unusual and rare. Nine such
      cases are reported here during a 6-yr period. All nine patients were asymptomatic
      and total hysterectomy with bilateral salpingoophorectomy for gynecological
      malignancies was performed 8 mo to 25 yr ago. Three patients had local radiation
      and one had systemic chemotherapy not less than 8 mo before the cytology. The
      columnar cells showed one of three patterns: 1) long, bipolar cells in sheets,
      resembling reparative columnar cells (4 cases), 2) goblet-type cells with
      eccentric nuclei (3 cases), and 3) tight clusters of small round cells (2 cases).
      No consistent relationship with age, treatment, or background was seen with any
      of the patterns. Follow-up of all cases by thorough pelvic examination, repeat
      smears, colposcopy, and biopsy showed no vaginal pathology. Benign mucinous or
      goblet cell metaplasia in atrophic vaginal epithelium may be the source of some
      of these cells in the vaginal smears.

PMID- 1638935
TI  - Nucleolar organizer regions in FNAC smears of breast lesions.
AB  - The argyrophil technique for staining proteins associated with nucleolar
      organizing regions was applied to the fine-needle aspiration cytology smears of
      45 cases of breast disease. These included 14 malignant and 31 benign lesions. A
      correlation with histology sections was done in 12 cases. There was a significant
      difference between AgNOR count of benign and malignant breast disease with one
      case out of 45 falling in the "gray" zone of overlap. Infiltrating lobular
      carcinoma was found to have the lowest NOR counts among the malignant lesions.
      The smear staining was superior to that on sections, the positive features being
      lack of background staining and better dispersion of NORs in the nucleoli.

PMID- 1638936
TI  - Aspiration cytodiagnosis of breast carcinoma in pregnancy and lactation with
      immunohistochemical and electron microscopic study of an unusual mammary
      malignancy with pleomorphic giant cells.
AB  - We have reviewed our experience with 8,706 needle aspiration cytology (NAC) of
      the breast which were done from January 1983 to June 1991. During our study we
      diagnosed four cases of breast carcinomas (three ductal type and one with
      pleomorphic giant cells) in pregnant or lactating women; in all of these the
      cytologic findings corresponded with the subsequent tissue diagnosis and cell
      block preparations. Considering that carcinoma of breast during pregnancy and
      lactation is rare and is second only to cervical cancer, it was felt that its
      diagnosis by NAC was useful for timely management. In the case in which
      pleomorphic giant cells were present as an integral component of the tumour,
      immunohistochemical and electron microscopic study was done. This is discussed in
      view of our recent experience with this unusual tumour.

PMID- 1638937
TI  - Cytologic diagnosis of malignant mesothelioma in serous effusions using an
      antimesothelial-cell antibody.
AB  - Differentiating mesothelioma, reactive mesothelium, and adenocarcinoma in serous
      effusions is often difficult, despite the application of ancillary techniques in
      support of the traditional cytomorphologic criteria. A polyclonal antimesothelial
      cell antibody recently developed by our group was evaluated as a histogenetic
      marker on a series of primary (n = 12) and metastatic (n = 12) malignant
      effusions. Immunostaining was performed on paraffin sections from cell blocks.
      All mesothelioma effusions stained positive for the antibody, whereas, in
      contrast, all metastatic carcinoma specimens failed to react. These results (100
      percent specificity and 100% sensitivity for mesothelioma) provide a basis for a
      reliable use of the antibody in the cytologic examination of suspicious or
      malignant serous effusions.

PMID- 1638938
TI  - Simultaneous fine-needle aspiration of thyroid lesions and regional cervical
      lymph nodes: clinicopathologic implications.
AB  - Occasionally patients with thyroid nodules to be evaluated by fine-needle
      aspiration (FNA) biopsy also present with regional cervical lymphadenopathy.
      Aspiration biopsies should be performed on both the thyroid and nodal lesions.
      This approach will yield important information about whether the lesions are
      related, with profound impact on further workup, management, prognosis, and
      staging.

PMID- 1638939
TI  - Fine-needle aspiration biopsy of hepatic angiosarcoma: report of a case with
      immunocytochemical findings.
AB  - Hepatic angiosarcoma (Kupffer cell sarcoma) is a very rare but ominous
      malignancy. We report a case diagnosed by fine-needle aspiration biopsy (FNAB).
      The smear showed malignant spindle cells and a few rounded cells. The diagnosis
      was made on the cell block by the characteristic scaffolding arrangement of
      malignant cells along preexisting hepatocytes. This is the first report with
      immunocytochemical findings. The tumour cells stained positively for vimentin and
      negatively for keratin, factor VIII, Ulex europaeus agglutinin I (UEA-1),
      carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), and lysozyme. This case
      demonstrates the possibility of a definitive diagnosis by FNAB prior to death
      without inflicting serious complications.

PMID- 1638940
TI  - Breast filariasis diagnosed by needle aspiration cytology.
AB  - A case of nodular lesion of the breast in a 37 year old female caused by
      filariasis is described. The case is instructive since the diagnosis was made by
      fine-needle aspiration cytology.

PMID- 1638941
TI  - Cerebrospinal fluid cytology: selected issues.

PMID- 1638942
TI  - Nodular goiter: a histo-cytological study with some emphasis on pitfalls of fine
      needle aspiration cytology.
AB  - A comprehensive comparative histo-cytological study of 48 nodular goiters from an
      endemic goiter region was undertaken. Practically all features observed on the
      biopsies were identified, although with less frequency, on the smears. In
      agreement with previous observations, characteristic components of nodular goiter
      (NG) in aspirates included small to medium size epithelial cells with regular
      round nuclei, honeycomb pattern, large follicles, papillae showing the previously
      mentioned epithelial features, oxyphilic cells, and moderate to abundant
      background colloid material and thyroid phagocytes (macrophages). All eight
      features occurred together in only 2% of the studied cases, seven in 6 (12.5%),
      six in 4 (8%), five in 6 (12.5%), four in 12 (25%), three in 6 (12.5%), two in 11
      (23%), and one in 2 (4%) cases, respectively. Regardless of the number and
      combination of features present, specific identification of NG on the smears may
      not always be possible and diagnostic pitfalls include thyroid cyst, Hashimoto's
      thyroiditis, granulomatous lesions, and, more frequently, follicular neoplasia.
      Our findings suggest that thyroid aspirates should be analysed with critical
      clinico-pathological approach and surgery considered only for nodules that are
      clinically suspicious or unresponsive to hormonotherapy when a diagnosis of
      follicular neoplasia is made.

PMID- 1638943
TI  - Evaluation of cytocentrifuge apparatus with special reference to the cellular
      recovery rate.
AB  - Two types of commercially available cytocentrifuge apparatus (type A and type B
      apparatus) using disposable funnels were compared for percentage of cell recovery
      and degree of cell preservation. The cellularity of each cell suspension was
      determined using a Sysmex micro cell counter for blood analysis, and the cell
      recovery was obtained by counting cells in the total smeared area on the May
      Grunwald Giemsa (MGG)-stained slide. Overall recovery rate by the type A
      apparatus was between 54.3% and 74.9% with a mean of 63.0%, whereas, the recovery
      rate for type B apparatus was between 30.6% and 51.8%, with a mean of 42.5%,
      indicating that the type A apparatus was significantly better. In the type A
      apparatus, a higher yield of all cells was obtained (69.7-74.9%) in the group of
      low cell counts (350 cells/0.5 ml), which was run for 10 minutes at 2,000 rpm. On
      the other hand, in the type B apparatus a higher yield of all cells was obtained
      (38.6-42.6%) in the group of low cell counts which was run for 10 minutes at
      2,000 rpm. Cellular structure was better preserved on the slides in the type A
      apparatus. However, the percentage of ghost cells was somewhat higher in the type
      B apparatus. The cytocentrifugation of the type A apparatus consistently
      recovered a higher percentage of cells than with the type B apparatus. Using the
      type A apparatus, a high rate of cellular recovery, which is extremely important,
      such as for accurate morphological evaluation of cerebrospinal fluid, can be
      consistently obtained.

PMID- 1638944
TI  - New technique for cell block preparation after fine-needle aspiration of breast
      lumps.

PMID- 1638946
TI  - Cytopathology in Egypt.

PMID- 1638945
TI  - Protoplasmic astrocytoma: cytologic features on tissue imprint preparation.

PMID- 1638947
TI  - [Mimicry of gastrointestinal regulator peptides in human immunodeficiency virus
      gp120 and gp41 [correction of gp40] proteins as a possible factor of its tissue
      polytropism].

PMID- 1638948
TI  - [Psychotropic properties of brain proline endopeptidase inhibitors].

PMID- 1638949
TI  - [Bent DNA in the area of the replication initiation domain of chicken alpha
      globin genes].

PMID- 1638950
TI  - [The connection between DNA topology and acetylation of histones].

PMID- 1638951
TI  - [Perception of low intensity electromagnetic radiation in the millimeter range by
      skate electrical receptors].

PMID- 1638952
TI  - [Analysis of the distribution of actin filaments in rat large intestine
      enterocytes during nutrient absorption. An immunoelectron microscopic study)].

PMID- 1638953
TI  - [Light sensitivity of human vision during change of position of the eye in the
      orbit].

PMID- 1638954
TI  - [Asymmetry of phenotypical and functional properties of lymphoid organ cells].

PMID- 1638955
TI  - [Cobalt and immunogenesis in birds (using domestic chickens as an example)].

PMID- 1638956
TI  - [Hepatocytes, stimulated to proliferation in vivo, induce DNA synthesis in nuclei
      of resting fibroblasts in heterokaryons].

PMID- 1638957
TI  - [NMR spectroscopy of tumors. Effects of subpopulation replacement in a growing
      tumor].

PMID- 1638958
TI  - [Structural analysis of a protein component from black widow spider venom,
      interacting with alpha-latrotoxin].

PMID- 1638959
TI  - [Spinal muscle atrophy in Brown Swiss x Braunvieh cross calves].
AB  - The report describes seven SMA-cases in descendents of crossbreeds of American
      Brown Swiss x Deutsches Braunvieh. Symptoms and course: After initially normal
      development of the calves for one to six weeks the disease set in suddenly
      followed by a rapid lethal course of one to one and a half weeks duration due to
      asphyxia and/or secondary diseases. Only one case was reported having been sick
      since birth (?). Characteristic signs were rapidly progressing muscular atrophy,
      paresis and paralysis of the limbs, the trunk and the diaphragm, usually
      accompanied by progressive dyspnoea. Signs of congenital neuromyodysplasia
      (arthrogryposis) of different degree were present in four of the seven calves.
      Six calves had contracted a secondary pneumonia. Blood gas analysis (6/7)
      revealed a compensated (1x) or decompensated (4x) respiratory acidosis.
      Neurohistological findings: Degeneration and loss of motor neurons in the ventral
      horns of the spinal cord and neurogenic muscular atrophy. Immunohistochemistry
      revealed a pronounced accumulation of type 200 kD-neurofilaments in perikarya and
      dendrites of ventral horn motoneurons indicating disturbed mechanisms of the
      axonal transport. The disease seems to be inherited as a recessive trait.

PMID- 1638960
TI  - Abnormal ruminal digestion in cattle with dominantly non-digestive disorders.
AB  - Health disturbances of ruminal origin in cattle are summed up. The problems are
      classified in those caused by special feed (NPN for example), those caused by
      insufficient ruminal detoxication capacity (poisoning by nitrate or aliphatic N
      derivates) and belonging to ruminal toxin production (3-methyl-indole, S-methyl
      cysteine-sulfoxide, glucosinolates) and arranged in pathophysiological sense.

PMID- 1638961
TI  - [Dynamics of the acid-base balance of venous and arterial blood in clinically
      healthy calves].
AB  - Values of the acid base balance were examined in both venous and arterial blood
      of healthy calves (n = 6) of the Slovak Spotted breed aged, 3, 6, 8, 10, 12, 14,
      18, and 24 weeks, respectively. Until week 4 of age the animals were fed milk
      only, until the age of 9 weeks a milk-roughage transition fodder and from week 10
      on they were given classical herbage. Blood samples were taken from the V.
      jugularis and A. carotis communis or A. axillaris, respectively. The results
      achieved were corrected to a body temperature of 39 degrees C. During the
      examination period the following values were stated for both arterial and venous
      blood: actual acidity (pH) 7.391 +/- 0.014 and 7.362 +/- 0.013 logmolc, pCO2 6.35
      +/- 0.15 and 7.35 +/- 0.11 kPa, HCO3-28.38 +/- 1.42 and 30.32 +/- 1.02 mmol. l(
      1), ABE 3.57 +/- 1.44 and 4.34 +/- 1.09 mmol. l(-1); pO2 12.63 +/- 1.15 and 5.21
      +/- 0.73 kPa, SAT 95.8 +/- 1.03 and 61.2 +/- 9.59%, respectively. A gradual
      increase in most indices of the acid base balance could be stated both in
      arterial and venous blood. The trends either revealed a parallel increase (HCO3-,
      pH) or they were more pronounced either in venous blood (SAT) or in arterial
      blood (ABE, pO2). Some trends were almost balanced (pCO2 and pO2 in venous blood
      and SAT and pCO2 in arterial blood). Thus pH, pO2 and SAT indices of the acid
      base balance were higher in arterial blood as compared to venous blood while
      pCO2, HCO3- and ABE values were higher in venous blood.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1638962
TI  - Epizootic botulism of cattle in Brazil.
AB  - The first diagnosis of botulism in cattle in Brazil and its epizootiology are
      reviewed. The high prevalence of the disease raised on phosphorus deficient
      pastures in Savanna regions has caused severe economic losses in the past. The
      temperature induced microcomplement fixation test (TIMCF) confirmed the clinical
      pathological diagnosis in all of the 24 cases studied by this method. The most
      important reason why botulism has not been controlled satisfactorily in Brazil is
      the lack of an available effective vaccine (type C and D). Additional
      prophylactic measures are phosphorus supplementation and removal of carcasses
      from the pasture.

PMID- 1638963
TI  - [The effect of technopathologically limited stress factors on the fertility of
      cattle].
AB  - The influence of purulent claw-diseases on the development of uterus infections,
      its involution and ovary dysfunctions (acyclia, cysts) was examined. It was shown
      that A. pyogenes, Ps. aeruginosa, Fus. necrophorum and other microorganisms
      involved in these lesions are potential sources for the infections of the uterus.
      In comparison with the controls the frequency of endometritis was twice in the
      group with claw-problems. Similar differences existed in the involution-time of
      the uterus or its atonia, acyclia and the development of ovarian cysts (p less
      than 0.01). The Index of insemination was elevated by about 65%.

PMID- 1638964
TI  - [Clinical forms of enzootic pneumonia in calves and their effects on
      respiration].
AB  - Enzootic pneumonia was diagnosed in 160 of 225 bullocks in a livestock fattening
      unit. Within the first 10 weeks, 51 of those affected contracted the disease a
      second time after the symptoms had vanished. Acute catarrhal bronchopneumonia
      were most common (49.3%) during the first outbreak, whereas acute catarrhal
      purulent bronchopneumonia (39.2%) and chronic pneumonia (29.4%) were most common
      during the second. Arterial blood gas analysis was undertaken for 33 clinically
      healthy bullocks and 100 bullocks with clinically diagnosed acute bronchitis,
      acute catarrhal bronchopneumonia, acute catarrhal purulent bronchopneumonia and
      chronic pneumonia. The pO2, SATO2 and A-aDO2 levels found in blood from the
      abdominal aorta of all diseased animals differed significantly from those of
      healthy animals. The values for animals with distinct catarrhal bronchopneumonia
      and catarrhal purulent bronchopneumonia showed the greatest differences.

PMID- 1638965
TI  - [Results of experimental immunization of calves with different Pasteurella
      antigens].
AB  - Calves immunised with different Pasteurella antigens (inactivated whole cells,
      sodium chloride extract) where challenged two weeks after the second immunization
      with the homologous strain. The intracutaneous application of whole cells of P.
      haemolytica A1 and P. multocida A was effective. The incidence of pneumonia was
      reduced and the pneumonic lesions were less severe. The sodium chloride extract
      was not effective.

PMID- 1638966
TI  - Ki-67 antigen expression in lymphocytes of cattle infected with bovine leukemia
      virus (BLV).
AB  - The Ki-67 monoclonal antibody, which recognizes an antigen present on the nuclear
      membrane surface of mammalian cells in the replication phase, has been used for
      the determination of the cellular cycle of peripheral blood lymphocytes on a
      group of cattle positive for bovine leukemia virus (BLV) and with blood values
      showing a persistent lymphocytosis. The results obtained have shown that: 1. Both
      of the techniques used (immunofluorescence and immunoperoxidase) are easily
      applicable and give uniform results; 2. Cattle with a persistent lymphocytosis
      show an absolute number of cells in cycle significantly more elevated compared
      with cattle positive for BLV with normal blood values.

PMID- 1638967
TI  - [A new treatment for trichophytosis of cattle].
AB  - A new way to treat ringworm in calves and young cattle giving 1 ml formaldehyde
      solution (10%) per kg BW intravenously is described.

PMID- 1638968
TI  - [The effect of the lactation period on the cell content of sheep milk].
AB  - Milk samples of 201 ewes were examined in 6 week intervals during a complete
      lactation period. Those samples were analyzed for the presence of pathogenic
      bacteria and the somatic cell count was determined. Besides, the California
      Mastitis Test (CMT) was performed and the udder was clinically examined. The cell
      counts were found to depend on the lactation period. During 6 weeks following
      parturition the cell count was 63,000 cells/ml. This number decreased towards the
      24th week of lactation to 32,000 cells/ml. At the end of lactation this value
      increased again to 425,000 cells/ml. The median value of ewes with normal udder
      health was 56,000 cells/ml milk. For samples from which pathogenic bacteria were
      isolated this value was 159,000 cells/ml. The most frequent pathogens isolated
      from the milk samples were coagulase-negative cocci (59.6% of bacteriologically
      positive samples), the median number being 88,000 somatic cells/ml in these
      sheep. Coagulase-positive cocci were isolated in 25.3% of the samples, the median
      value of the cell count was 295,000 cells/ml. In 12.1% of the samples
      streptococci were found. The median value was 167,000 cells/ml. From the
      remaining 3.0% of bacteriologically positive samples Pasteurellae, E. coli and
      Actinomycetae were isolated. The median value of the somatic cell count was
      184,000 cells/ml. We consider coagulase-positive cocci therefore as the most
      pathogenic bacteria for the ovine udder.

PMID- 1638969
TI  - [The effect of seasonal undernutrition on the protein fractions in the blood of
      Moroccan cattle].
AB  - In a trial including 84 cattle from three farms near Rabat (Morocco) the
      influence of undernutrition (dry season September to February) on the
      concentration of total protein and its fractions in the blood of cattle was
      investigated. The results out of the field were confirmed by comparing these
      concentrations during an experimental cycle of sufficient--insufficient-
      sufficient feed. It was obvious that malnutrition decreases the concentration of
      total protein and some of its fractions (albumins, gamma-globulins) in the blood
      by about 10%, while alpha- and beta-globulins remained nearly uneffected.

PMID- 1638970
TI  - [BVD/MD and its control in Lower Saxony (after the support of the Lower Saxony
      animal epidemic fund)].
AB  - A report is given on the development of the subsidies granted by the
      "Niedersachsische Tierseuchenkasse" fur BVD/MD since 1973. The article shows the
      cyclic procedure and regional differences as well as the participation of
      vaccinations and embryo transfer at the frequent occurrence of persistent
      viraemic animals in single herds. According to the authors' opinion the struggle
      against BVD/MD must have two aims: 1. to search for and to cull out persistent
      viraemic animals 2. to prevent the arise of new persistent viraemic animals.

PMID- 1638971
TI  - [The effect of energy-rich feed supplements for cows on the health of their
      calves].
AB  - Experiments were carried out with 24 pregnant cows and their calves. The cows
      were divided in 2 equal groups. One of these received a supplement of animal fat
      additional to the feed from 4 weeks a. p. to 6 weeks p. p. Apart from clinical
      examinations following laboratory investigations in the blood were performed:
      hematological parameters, cholesterol, lipids, free fatty acids, ketone bodies,
      protein, glucose, bilirubin, transaminases, alkaline phosphatase, Ca, Mg, P, K,
      Na, Cl. The addition of fat to the feed of cows influenced the energy metabolism
      of the cows, the body weight of the newborn ones and some hematological
      parameters (incl. protein) of the calves positively.

PMID- 1638972
TI  - [Elimination kinetics of several clinically relevant enzymes in the blood plasma
      of cattle after intravenous bolus infusion of homologous preparations].
AB  - Extracts of homologous organs (liver, muscle) and of colostrum were infused
      intravenously in cattle of two different age groups: heifers (n = 9, each
      preparation was infused in 3 animals) and calves (n = 6, preparations from liver
      and muscle were infused in 3 animals each). Parameters of elimination kinetics
      were determined for some clinically relevant enzymes. Enzyme elimination was
      quicker in the younger animals. The volume of enzyme distribution was comparable
      to plasma volume. Biological half-lives in calves and heifers respectively were:
      CK from muscle 3.46 +/- 0.65 h and 8.27 +/- 3.27 h, AST from muscle 9.74 +/- 1.38
      h and 33.48 +/- 3.74 h, AST from liver 14.99 +/- 0.81 h and 16.71 +/- 0.58 h,
      GLDH from liver 14.61 +/- 1.88 h and 25.09 +/- 4.13 h, SDH from liver 13.95 +/-
      2.25 h and 17.68 +/- 0.81 h, GGT from colostrum 1.69 +/- 0.95 h (only heifers).

PMID- 1638973
TI  - [The composition of rumen fluid of cattle collected from fistulas using
      ultrasound].
AB  - Concentrations of rumen fluid characteristics were compared between rumen fluid
      which was taken by standardized conditions via stomach tube and via rumen fistula
      respectively depending on time after feeding (2.5 or 9 hours ppr.). The results
      were as follows: Differences (%) of the characteristics of rumen fluid taken via
      stomach tube to that by rumen fistula: [table: see text] Other investigations
      showed that the admixture of saliva to rumen fluid resulted in a degradation of
      the concentrations especially of VFA. The pH was not appreciable changed. The
      consequences for veterinary practitioners are discussed.

PMID- 1638974
TI  - Cytoplasmic and cortical determinants interact to specify ectoderm and mesoderm
      in the leech embryo.
AB  - In leech embryos, segmental ectoderm and mesoderm are produced by a pair of
      sister cells located near the animal and vegetal poles, respectively. We have
      investigated the mechanism that localizes ectodermal and mesodermal fates along
      the animal-vegetal axis. The results of cleavage arrest and cell ablation
      experiments suggest that the full range of normal cell interactions are not
      required for this process. However, when the animal and vegetal hemispheres are
      separated by re-orientation of the first cleavage plane from meridional to
      equatorial, the ectodermal fate co-segregates with the animal hemisphere and the
      mesodermal fate with the vegetal hemisphere. Two pools of yolk-deficient
      cytoplasm, called teloplasm, are located at the animal and vegetal poles of the
      zygote, but separation of the animal and vegetal teloplasms is not sufficient for
      the segregation of ectodermal and mesodermal fates. Rather, complete segregation
      of fates requires an equatorial cleavage orientation that separates not only the
      two teloplasms, but also the animal and vegetal cortical regions. This, in
      conjunction with previous findings, indicates that ectodermal determinants are
      localized to the cell cortex in the animal hemisphere of the zygote. We propose
      that these determinants segregate to the ectodermal precursor and interact with
      factors in teloplasm to transform the fate of this cell from a mesodermal ground
      state to ectoderm.

PMID- 1638975
TI  - c-ros: the vertebrate homolog of the sevenless tyrosine kinase receptor is
      tightly regulated during organogenesis in mouse embryonic development.
AB  - The c-ros proto-oncogene is the vertebrate homologue of the Drosophila sevenless
      tyrosine kinase receptor. Examination of c-ros mRNA transcripts in the mouse
      embryo reveals a stringent pattern of expression. Only kidney, intestine and lung
      exhibit ros-specific RNA using sensitive techniques such as RNAase protection and
      in situ hybridization. The temporal and spatial arrangement of c-ros transcripts
      is coincident with the phenotypic induction and proliferation of epithelium
      during organogenesis of the kidney and intestine. The data provide evidence for a
      role of c-ros in the obligate cell-cell interactions that characterize the
      morphogenic induction and proliferation of epithelial cells in the kidney,
      intestine and lung. The c-ros tyrosine kinase receptor may provide a signal
      transduction pathway for epithelial-mesenchymal interactions.

PMID- 1638976
TI  - A PDGF receptor mutation in the mouse (Patch) perturbs the development of a non
      neuronal subset of neural crest-derived cells.
AB  - The Patch (Ph) mutation in mice is a deletion of the gene encoding the platelet
      derived growth factor receptor alpha subunit (PDGFR alpha). Patch is a recessive
      lethal recognized in heterozygotes by its effect on the pattern of neural crest
      derived pigment cells, and in homozygous mutant embryos by visible defects in
      craniofacial structures. Since both pigment cells and craniofacial structures are
      derived from the neural crest, we have examined the differentiation of other
      crest cell-derived structures in Ph/Ph mutants to assess which crest cell
      populations are adversely affected by this mutation. Defects were found in many
      structures populated by non-neuronal derivatives of cranial crest cells including
      the thymus, the outflow tract of the heart, cornea, and teeth. In contrast, crest
      derived neurons in both the head and trunk appeared normal. The expression
      pattern of PDGFR alpha mRNA was determined in normal embryos and was compared
      with the defects present in Ph/Ph embryos. PDGFR alpha mRNA was expressed at high
      levels in the non-neuronal derivatives of the cranial neural crest but was not
      detected in the crest cell neuronal derivatives. These results suggest that
      functional PDGF alpha is required for the normal development of many non-neuronal
      crest-derived structures but not for the development of crest-derived neuronal
      structures. Abnormal development of the non-neuronal crest cells in Ph/Ph embryos
      was also correlated with an increase in the diameter of the proteoglycan
      containing granules within the crest cell migratory spaces. This change in matrix
      structure was observed both before and after crest cells had entered these
      spaces. Taken together, these observations suggest that functional PDGFR alpha
      can affect crest development both directly, by acting as a cell growth and/or
      survival stimulus for populations of non-neurogenic crest cells, and indirectly,
      by affecting the structure of the matrix environment through which such cells
      move.

PMID- 1638978
TI  - Demonstration of a phagocytic cell system belonging to the hemopoietic lineage
      and originating from the yolk sac in the early avian embryo.
AB  - It is well established that hemopoietic cells arising from the yolk sac invade
      the avian embryo. To study the fate and role of these cells during the first 2.5
      4.5 days of incubation, we constructed yolk sac chimeras (a chick embryo grafted
      on a quail yolk sac and vice versa) and immunostained them with antibodies
      specific to cells of quail hemangioblastic lineage (MB1 and QH1). This approach
      revealed that endothelial cells of the embryonic vessels are of intraembryonic
      origin. In contrast, numerous hemopoietic cells of yolk sac origin were seen in
      embryos ranging from 2.5 to 4.5 days of incubation. These cells were already
      present within the vessels and in the mesenchyme at the earliest developmental
      stages analyzed. Two hemopoietic cell types of yolk sac origin were
      distinguishable, undifferentiated cells and macrophage-like cells. The number of
      the latter cells increased progressively as development proceeded, and they
      showed marked acid phosphatase activity and phagocytic capacity, as revealed by
      the presence of numerous phagocytic inclusions in their cytoplasm. The macrophage
      like cells were mostly distributed in the mesenchyme and also appeared within
      some organ primordia such as the neural tube, the liver anlage and the nephric
      rudiment. Comparison of the results in the two types of chimeras and the findings
      obtained with acid phosphatase/MB1 double labelling showed that some hemopoietic
      macrophage-like cells of intraembryonic origin were also present at the stages
      considered. These results support the existence in the early avian embryo of a
      phagocytic cell system of blood cell lineage, derived chiefly from the yolk sac.
      Cells belonging to this system perform phagocytosis in cell death and may also be
      involved in other morphogenetic processes.

PMID- 1638977
TI  - Expression of the L14 lectin during mouse embryogenesis suggests multiple roles
      during pre- and post-implantation development.
AB  - A cDNA encoding L14, the lactose-binding, soluble lectin of relative molecular
      mass 14 x 10(3), has been isolated in a differential screen designed to identify
      genes that are regulated during the differentiation of murine embryonic stem
      cells in vitro. The expression patterns of the gene and of the encoded protein
      during mouse embryogenesis are consistent with the lectin playing a role at
      several stages of development. Firstly, it is initially synthesised in the
      trophectoderm of expanded blastocysts immediately prior to implantation,
      suggesting that it may be involved in the attachment of the embryo to the uterine
      epithelium. Secondly, in the postimplantation embryo, the lectin is abundantly
      expressed in the myotomes of the somites. This observation, when taken together
      with data indicating a role for the lectin in myoblast differentiation in
      culture, suggests that the protein is important in muscle cell differentiation.
      Finally, within the nervous system expression of this gene is activated early
      during the differentiation of a particular subset of neurones.

PMID- 1638979
TI  - Histone H1 subtype synthesis in neurons and neuroblasts.
AB  - Rat cerebral cortex neurons contain the five histone H1 subtypes H1a-e and the
      subtype H1 zero present in other mammalian somatic tissues. The four subtypes H1a
      d decay exponentially during postnatal development and are partially or totally
      replaced by H1e that becomes the major H1 subtype in adults. H1 zero accumulates
      in a period restricted to neuronal terminal differentiation. Here we study the
      synthesis of the H1 subtypes in cortical neurons and their neuroblasts by in vivo
      labeling with [14C]lysine. The subtype synthesis pattern of neuroblasts has been
      determined by labeling gravid rats during the period of proliferation of cortical
      neurons and synthesis in neurons has been studied by postnatal labeling. The
      subtype H1a is synthesized in neuroblasts but not in neurons and is therefore
      rapidly removed from neuronal chromatin. The synthesis of H1b and H1d is much
      lower in neurons than in neuroblasts so that these subtypes are replaced to a
      large extent during postnatal development. H1c is synthesized at levels much
      higher than the other subtypes both in neurons and neuroblasts, but its very high
      turnover, about one order of magnitude faster than that of H1e in neurons, favors
      its partial replacement during postnatal development. Comparison of the synthesis
      rates of H1 zero in newborn and 30-day-old rats shows that the accumulation of H1
      zero in differentiating neurons is due to an increased level of synthesis.

PMID- 1638981
TI  - A 102 base pair sequence of the nicotinic acetylcholine receptor delta-subunit
      gene confers regulation by muscle electrical activity.
AB  - Muscle electrical activity suppresses expression of the embryonic-type (alpha,
      beta, gamma, and delta) nicotinic acetylcholine receptor (nAChR) genes. The
      molecular mechanism by which electrical activity regulates these genes is not
      known. One approach to this problem is to identify regions of the nAChR genes
      that mediate electrical regulation. Here we report results from such a study of
      the nAChR delta-subunit gene. We cloned the rat delta-subunit promoter region and
      created an expression vector in which this DNA controlled the expression of a
      down-stream luciferase structural gene. The effect that muscle electrical
      activity had on the expression from this promoter was assayed by introducing this
      expression vector into electrically stimulated and tetrodotoxin (TTX)-treated rat
      primary myotubes, and assaying for luciferase activity. These myotubes, when
      stimulated with extracellular electrodes, suppressed endogenous embryonic-type
      nAChR gene expression compared to those treated with TTX. Transfection of these
      cells with delta-promoter-luciferase expression vectors resulted in the delta
      promoter conferring electrical regulation on luciferase expression. Additional
      experiments using deletions from the 5' end of the delta-promoter region have
      identified an element between -677 and -550 bp that suppressed delta-promoter
      activity and a minimal 102 bp sequence that promotes and regulates luciferase
      expression in response to muscle electrical activity. This latter sequence also
      contains all the necessary elements to confer tissue and developmental stage
      specific expression.

PMID- 1638980
TI  - Developmentally regulated expression of alpha 6 integrin in avian embryos.
AB  - The distribution pattern of the avian alpha 6 integrin subunit was examined
      during early stages of development. The results show that this subunit is
      prevalent in cells of the developing nervous system and muscle. alpha 6 is first
      observed on neuroepithelial cells of the cranial neural plate and trunk neural
      tube. With time, immunoreactivity becomes prominent near the lumen and
      ventrolateral portions of the neural tube, co-distributing with neurons and
      axons, particularly notable on commissural neurons. The alpha 6 expression
      pattern is dynamic in the neural tube, with immunoreactivity peaking by embryonic
      day 6 (stage 30) and decreasing thereafter. The ventral roots and retina exhibit
      high levels of immunoreactivity throughout development. In the peripheral nervous
      system, alpha 6 immunoreactivity first appears on a subpopulation of
      sympathoadrenal cells around the dorsal aorta and later in the dorsal root
      ganglia shortly after gangliogenesis. Immunoreactivity appears on prospective
      myotomal cells as the somites delaminate into the dermomyotome and sclerotome,
      remaining prominent on myoblasts and differentiated muscle at all stages. The
      mesonephros also has intense immunoreactivity. In the periphery, alpha 6
      immunoreactive regions often in proximity to laminin, which is thought to be the
      ligand of alpha 6 beta 1 integrin.

PMID- 1638982
TI  - Polarity of the ascidian egg cortex before fertilization.
AB  - The unfertilized ascidian egg displays a visible polar organization along its
      animal-vegetal axis. In particular, the myoplasm, a mitochondria-rich subcortical
      domain inherited by the blastomeres that differentiate into muscle cells, is
      mainly situated in the vegetal hemisphere. We show that, in the unfertilized egg,
      this vegetal domain is enriched in actin and microfilaments and excludes
      microtubules. This polar distribution of microfilaments and microtubules persists
      in isolated cortices prepared by shearing eggs attached to a polylysine-coated
      surface. The isolated cortex is further characterized by an elaborate network of
      tubules and sheets of endoplasmic reticulum (ER). This cortical ER network is
      tethered to the plasma membrane at discrete sites, is covered with ribosomes and
      contains a calsequestrin-like protein. Interestingly, this ER network is
      distributed in a polar fashion along the animal-vegetal axis of the egg: regions
      with a dense network consisting mainly of sheets or tightly knit tubes are
      present in the vegetal hemisphere only, whereas areas characterized by a sparse
      tubular ER network are uniquely found in the animal hemisphere region. The
      stability of the polar organization of the cortex was studied by perturbing the
      distribution of organelles in the egg and depolymerizing microfilaments and
      microtubules. The polar organization of the cortical ER network persists after
      treatment of eggs with nocodazole, but is disrupted by treatment with
      cytochalasin B. In addition, we show that centrifugal forces that displace the
      cytoplasmic organelles do not alter the appearance and polar organization of the
      isolated egg cortex. These findings taken together with our previous work suggest
      that the intrinsic polar distribution of cortical membranous and cytoskeletal
      components along the animal-vegetal axis of the egg are important for the spatial
      organization of calcium-dependent events and their developmental consequences.

PMID- 1638983
TI  - bicoid and the terminal system activate tailless expression in the early
      Drosophila embryo.
AB  - In the early Drosophila embryo, the maternal terminal genes are required for
      formation of the acron at the anterior and the telson at the posterior. We show
      here that the terminal system, a signal transduction pathway active at the poles
      of the embryo, is required to activate transcription of the key zygotic gene
      tailless (tll) in two symmetrical domains. Consistent with the characterization
      of the tll protein as a putative transcription factor (a member of the steroid
      receptor superfamily) that represses segmentation genes and activates terminal
      specific genes, we observe a correlation between the presence of the posterior
      cap of tll expression and differentiation of a telson. While the maternal
      patterning systems of the Drosophila embryo function for the most part
      independently, the maternal anterior system, in which the bicoid (bcd) protein
      functions as a graded morphogen, is required together with the terminal system to
      establish the acron. This dual requirement is evident at the molecular level in
      the control of tll expression. We find that bcd and the terminal system are
      required together to activate the anterior-dorsal stripe of tll expression that
      is correlated with formation of the acron. In the absence of bcd, the anterior
      cap of tll expression established by the terminal system persists and an ectopic
      telson forms at the anterior, while in the absence of terminal system activity
      only an abnormal anterior stripe forms. This is the first described example of
      how, by jointly controlling expression of the same gene, two systems of
      positional information function together to set unique positional values.

PMID- 1638984
TI  - Control of proliferation in the retina: temporal changes in responsiveness to FGF
      and TGF alpha.
AB  - Proliferation in the rat retina, as in other parts of the nervous system, occurs
      during a restricted period of development. In addition to regulating cell number,
      the mechanisms that control proliferation influence the patterning of tissues,
      and may affect the determination of cell type. To begin to determine how
      proliferation is controlled, several growth factors found in the retina were
      tested for effects on progenitor cell division in culture. Proliferation was
      enhanced by TGF alpha, bFGF and aFGF, and many of the dividing cells later
      differentiated into cells with the antigenic phenotypes of retinal neurons and
      glial cells. The mitotic response of retinal cells to these factors changed
      during development: progenitor cells from younger retinas (embryonic day 15 to
      18; E15-E18) were more responsive to FGF's, while progenitor cells from older
      retinas (greater than E20) were more responsive to TGF alpha. Progenitor cells
      stopped dividing in vitro, even when treated with excess mitogen. These
      observations suggest that proliferation in the retina may be stimulated by
      multiple mitogenic signals provided by TGF alpha, FGF, or related factors, and
      that proliferation is not controlled by limiting concentrations of mitogen alone.
      Rather, these data demonstrate that retinal cells change during development in
      their responsiveness to mitogenic signals. Such changes may contribute to the
      regulation of proliferation.

PMID- 1638985
TI  - Dynamic expression of the cell adhesion molecule fasciclin I during embryonic
      development in Drosophila.
AB  - A number of different cell surface glycoproteins expressed in the central nervous
      system (CNS) have been identified in insects and shown to mediate cell adhesion
      in tissue culture systems. The fasciclin I protein is expressed on a subset of
      CNS axon pathways in both grasshopper and Drosophila. It consists of four
      homologous 150-amino acid domains which are unrelated to other sequences in the
      current databases, and is tethered to the cell surface by a glycosyl
      phosphatidylinositol linkage. In this paper we examine in detail the expression
      of fasciclin I mRNA and protein during Drosophila embryonic development. We find
      that fasciclin I is expressed in several distinct patterns at different stages of
      development. In blastoderm embryos it is briefly localized in a graded pattern.
      During the germ band extended period its expression evolves through two distinct
      phases. Fasciclin I mRNA and protein are initially localized in a 14-stripe
      pattern which corresponds to segmentally repeated patches of neuroepithelial
      cells and neuroblasts. Expression then becomes confined to CNS and peripheral
      sensory (PNS) neurons. Fasciclin I is expressed on all PNS neurons, and this
      expression is stably maintained for several hours. In the CNS, fasciclin I is
      initially expressed on all commissural axons, but then becomes restricted to
      specific axon bundles. The early commissural expression pattern is not observed
      in grasshopper embryos, but the later bundle-specific pattern is very similar to
      that seen in grasshopper. The existence of an initial phase of expression on all
      commissural bundles helps to explain the loss-of-commissures phenotype of embryos
      lacking expression of both fasciclin I and of the D-abl tyrosine kinase.
      Fasciclin I is also expressed in several nonneural tissues in the embryo.

PMID- 1638986
TI  - Identification and characterization of a novel, evolutionarily conserved gene
      disrupted by the murine H beta 58 embryonic lethal transgene insertion.
AB  - The H beta 58 transgenic mouse line carries a recessive insertional mutation that
      results in developmental abnormalities beginning at day 7.5 p.c. and embryonic
      arrest at about day 9.5. In this paper, we describe the characterization of a
      novel gene encoded at the H beta 58 locus, whose disruption appears to be
      responsible for the mutant phenotype. The wild-type H beta 58 gene encodes a
      single 2.7 kb mRNA during embryonic and fetal development, and in many adult
      somatic tissues. In the mutant locus, this transcription unit is split by the
      transgene insertion, and one of its coding exons is deleted. Consistent with the
      physical disruption of the gene, the level of the H beta 58 mRNA in heterozygous
      mutant mouse tissues was half the normal level, indicating that the mutant allele
      fails to encode a stable mRNA. In situ hybridization studies revealed that
      expression of the wild-type H beta 58 gene begins in the oocyte, and continues
      throughout pre- and post-implantation embryogenesis, despite the fact that
      homozygous mutant embryos develop successfully through the egg cylinder stage
      (day 6.5 p.c.). In the early post-implantation embryo, expression of the normal H
      beta 58 gene is relatively low in the embryonic ectoderm, the tissue displaying
      the earliest phenotypic effects of the mutation, and highest in the visceral
      endoderm. We therefore propose that the effects of the mutation on the embryonic
      ectoderm may be exerted indirectly, via the visceral endoderm. Sequence analysis
      of H beta 58 cDNA clones revealed no homology between the 38 x 10(3) M(r) H beta
      58 protein and other known proteins. However, the H beta 58 gene displayed
      extremely strong conservation between mammals and birds (greater than 96% amino
      acid identity), although it appeared less conserved in amphibians and
      invertebrates.

PMID- 1638987
TI  - Developmental expression and cellular localization of glucose transporter
      molecules during mouse preimplantation development.
AB  - Two general mechanisms mediate glucose transport, one is a sodium-coupled glucose
      transporter found in the apical border of intestinal and kidney epithelia, while
      the other is a sodium-independent transport system. Of the latter, several
      facilitated transporters have been identified, including GLUT1
      (erythrocyte/brain), GLUT2 (liver) and GLUT4 (adipose/muscle) isoforms. In this
      study, we used Western-blot analysis and high resolution immunoelectron
      microscopy (IEM) to investigate the stage-related expression and cellular
      localization of GLUT1, 2 and 4. The Western blot results demonstrate that GLUT1
      is detectable in the oocyte and throughout preimplantation development. GLUT2
      isoforms were not detectable until the blastocyst stage, while the GLUT4 isoform
      was undetectable in the oocyte through blastocyst stages. The present findings
      confirm previous studies at the molecular level which demonstrated that mRNAs
      encoding the same GLUT isoforms are detectable at corresponding developmental
      stages. GLUT1 and GLUT2 display different cellular distributions at the
      blastocyst stage as shown by IEM studies. GLUT1 has a widespread distribution in
      both trophectoderm and inner cell mass cells, while GLUT2 is located on
      trophectoderm membranes facing the blastocyst cavity. This observation suggests a
      different functional significance for these isoforms during mouse preimplantation
      development.

PMID- 1638988
TI  - Synthesis and phosphorylation of uvomorulin during mouse early development.
AB  - The cell adhesion molecule, uvomorulin, is synthesised in both the 135 x 10(3)
      M(r) precursor and 120 x 10(3) M(r) mature forms on maternal mRNA templates in
      unfertilized and newly fertilized mouse oocytes. Synthesis on maternal message
      ceases during the 2-cell stage to resume later on mRNA encoded presumptively by
      the embryonic genome. Uvomorulin is detectable by immunoblotting at all stages
      upto the blastocyst stage, but shows variations in its total amount and
      processing with embryonic stage. Whilst only trace levels of phosphorylated
      uvomorulin are detectable in early and late 4-cell embryos, uvomorulin in 8-cell
      embryos is phosphorylated.

PMID- 1638989
TI  - Development of surface pattern during division in Paramecium. II. Defective
      spatial control in the mutant kin241.
AB  - kin241 is a monogenic nuclear recessive mutation producing highly pleiotropic
      effects on cell size and shape, generation time, thermosensitivity, nuclear
      reorganization and cortical organization. We have analyzed the nature of the
      cortical disorders and their development during division, using various specific
      antibodies labelling either one of the cortical cytoskeleton components, as was
      previously done for analysis of cortical pattern formation in the wild type.
      Several abnormalities in basal body properties were consistently observed,
      although with a variable frequency: extra microtubules in either the triplets or
      in the lumen; nucleation of a second kinetodesmal fiber; abnormal orientation of
      the newly formed basal body with respect to the mother one. The latter effect
      seems to account for the major observed cortical disorders (reversal,
      intercalation of supplementary ciliary rows). The second major effect of the
      mutation concerns the spatiotemporal map of cortical reorganization during
      division. Excess basal body proliferation occurs and is correlated with modified
      boundaries of some of the cortical domains identified in the wild type on the
      basis of their basal body duplication pattern. This is the first mutant described
      in a ciliate in which both the structure and duplication of basal bodies and the
      body plan are affected. The data support the conclusion that the mutation does
      not alter the nature of the morphogenetic signal(s) which pervade the dividing
      cell, nor the competence of cytoskeletal structures to respond to signalling, but
      affects the local interpretation of the signals.

PMID- 1638990
TI  - Secretory and inductive properties of Drosophila wingless protein in Xenopus
      oocytes and embryos.
AB  - Like its vertebrate homologues, Xenopus wnt-8 and murine wnt-1, we find that
      Drosophila wingless (wg) protein causes axis duplication when overexpressed in
      embryos of Xenopus laevis after mRNA injection. In many cases, the secondary axes
      contain eyes and cement glands, which reflect the induction of the most
      dorsoanterior mesodermal type, prechordal mesoderm. We show that the extent of
      axis duplication is dependent on the embryonic site of expression, with ventral
      expression leading to a more posterior point of axis bifurcation. The observed
      duplications are due to de novo generation of new axes as shown by rescue of UV
      irradiated embryos. The true dorsal mesoderm-inducing properties of wg protein
      are indicated by its ability to generate extensive duplications after mRNA
      injection into D-tier cells of 32-cell embryos. As revealed by lineage mapping,
      the majority of these D cell progeny populate the endoderm; injections into
      animal blastomeres at this stage are far less effective in inducing secondary
      axes. However, when expressed in isolated animal cap explants, wg protein induces
      only ventral mesoderm, unless basic fibroblast growth factor is added, whereupon
      induction of muscle and occasionally notochord is seen. We conclude that in
      intact embryos, wg acts in concert with other factors to cause axis duplication.
      Immunolocalisation studies in embryos indicate that wg protein remains localised
      to the blastomeres synthesizing it and has a patchy, often perinuclear
      distribution within these cells, although some gets to the surface. In oocytes,
      the pool of wg protein is entirely intracellular and relatively unstable. When
      the polyanion suramin is added, most of the intracellular material is recovered
      in the external medium.

PMID- 1638991
TI  - Apoptotic cell death and tissue remodelling during mouse mammary gland
      involution.
AB  - During post-lactational mammary gland involution, the bulk of mammary epithelium
      dies and is reabsorbed. This massive cell death and tissue restructuring was
      found to be accompanied by a specific pattern of gene expression. Northern blot
      analysis showed that weaning resulted in a dramatic drop in ODC, a gene involved
      in synthesis of a component of milk, and the nearly simultaneous induction of SGP
      2, a gene associated with apoptotic cell death. These changes were followed by
      decreases in expression of milk protein genes to basal levels and expression of
      genes associated with regulation of cell proliferation and differentiation, p53,
      c-myc and TGF-beta 1. Subsequently, additional genes implicated in stress
      response, tissue remodelling, and apoptotic cell death were transiently
      expressed, expression peaking at about 6 days post-weaning. A non-random
      degradation of DNA yielding the oligonucleosomal length fragmentation pattern
      typical of apoptotic cell death (Wyllie, 1980; Wyllie et al., 1980) was detected
      in association with morphological changes and gene expression. The correlations
      between: (a) changes in morphology, (b) pattern of gene expression and (c)
      changes in DNA integrity suggest that complementary programs for cell death and
      tissue remodelling direct post-lactational mammary gland involution.

PMID- 1638992
TI  - Establishment and maintenance of stable spatial patterns in lacZ fusion
      transformants of Polysphondylium pallidum.
AB  - Polysphondylium pallidum cells were transformed with a construct containing the
      Dictyostelium discoideum ecmA promoter fused to a lacZ reporter gene. Two stably
      transformed lines, one in which beta-galactosidase (beta-gal) is expressed in
      apical cells of the fruiting body (p63/2.1), and one in which it is expressed in
      basal cells (p63/D), have enabled us to infer how cells move during aggregation
      and culmination. Several types of cell movement proposed to occur during slime
      mold culmination, such as random cell mixing and global cell circulation, can be
      ruled out on the basis of our observations. Cells of the two transformant lines
      express beta-gal very early in development. In both cases, stained cells are
      randomly scattered in a starving population. By mid to late aggregation,
      characteristic spatial patterns emerge. Marked cells of p63/2.1 are found
      predominantly at tips of tight aggregates; those of p63/D accumulate at the
      periphery. These patterns are conserved throughout culmination, showing that
      marked cells maintain their relative positions within the multicellular mass
      following aggregation. Neither the apical nor the basal pattern appears to be
      regulated within the primary sorogen by de novo gene expression or by cell
      sorting as whorls are formed. However, marked cells within a whorl re-establish
      the original pattern in secondary sorogens. This must be achieved by cell
      migration, since beta-gal is not re-expressed.

PMID- 1638993
TI  - Interactions between retinoids and TGF beta s in mouse morphogenesis.
AB  - Using immunocytochemical methods we describe the distribution of different TGF
      beta isoforms and the effects of excess retinoic acid on their expression during
      early mouse embryogenesis (8 1/2 - 10 1/2 days of development). In normal embryos
      at 9 days, intracellular TGF beta 1 is expressed most intensely in
      neuroepithelium and cardiac myocardium whereas extracellular TGF beta 1 is
      expressed in mesenchymal cells and in the endocardium of the heart. At later
      stages, intracellular TGF beta 1 becomes very restricted to the myocardium and to
      a limited number of head mesenchymal cells; extracellular TGF beta 1 continues to
      be expressed widely in cells of mesenchymal origin, particularly in head and
      trunk mesenchyme, and also in endocardium. TGF beta 2 is widely expressed at all
      stages investigated while TGF beta 3 is not expressed strongly in any tissue at
      the stages examined. Exposure of early neural plate stage embryos to retinoic
      acid caused reduced expression of TGF beta 1 and TGF beta 2 proteins but had no
      effect on TGF beta 3. Intracellular TGF beta 1 expression was reduced in all
      tissues except in the myocardium, while extracellular TGF beta 1 was specifically
      reduced in neuroepithelium and cranial neural crest cells at early stages. TGF
      beta 2 was reduced in all embryonic tissues. The down-regulation of intracellular
      TGF beta 1 was observed up to 48 hours after initial exposure to retinoic acid
      while some down-regulation of TGF beta 2 was still seen up to 60 hours after
      initial exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638994
TI  - The Drosophila orb gene is predicted to encode sex-specific germline RNA-binding
      proteins and has localized transcripts in ovaries and early embryos.
AB  - We report the identification of a new gene, orb, which appears to be expressed
      only in the germline and encodes ovarian- and testis-specific transcripts. The
      predicted proteins contain two regions with similarity to the RRM family of RNA
      binding proteins but differ at their amino termini. In testes, orb RNA
      accumulates in the primary spermatocytes and at the caudal ends of the spermatid
      bundles. In ovaries, orb transcripts display an unusual spatial pattern of
      accumulation in the oocyte. Preferential accumulation in the oocyte of orb RNA is
      first detected in region 2 of the germarium and is dependent on Bicaudal-D and
      egalitarian. While in stage 7 egg chambers orb RNA is localized posteriorly in
      the oocyte, during stages 8-10 it is localized at the anterior of the oocyte,
      asymmetrically along the dorsal-ventral axis. In embryos the transcripts
      accumulate at the posterior end and are included in the pole cells. This pattern
      of localization and the similarity to RNA-binding proteins suggest that the orb
      gene product may mediate the localization of maternal RNAs during oogenesis and
      early embryogenesis.

PMID- 1638995
TI  - A unique mutation in the Enhancer of split gene complex affects the fates of the
      mystery cells in the developing Drosophila eye.
AB  - An unusual recessive allele of the Drosophila groucho gene, which encodes a
      transducin-like protein, affects the fates of specific cells in the eye disc.
      groucho is one of several transcription units in the Enhancer of split complex.
      Most groucho mutations are zygotic lethal due to the proliferation of embryonic
      neural cells at the expense of epidermal cells. In contrast, flies homozygous for
      the mutant allele described here, groBFP2, are viable but have abnormal eyes. The
      Drosophila compound eye is composed of several hundred identical facets, or
      ommatidia, each of which contains eight photoreceptor cells, R1-R8. In groBFP2
      mutant retinas, most of the facets contain eight normally determined
      photoreceptor cells and one or two additional R-cells of the R3/4 subtype. The
      extra photoreceptors appear to arise from the mystery cells, which are part of
      the precluster that initiates the ommatidium, but do not normally become neurons.
      groBFP2 behaves as a partial loss-of-function mutant. Analysis of ommatidia
      mosaic for wild-type and groBFP2 mutant cells suggests that the focus of action
      of the groBFP2 mutation is outside of the photoreceptor cells. These results
      imply that one function of groucho is in a pathway whereby neuralization of the
      mystery cells is inhibited by other non-neural cells in the eye disc. In
      addition, determination of R3/4 photoreceptors usually requires contact with R2
      and R5. Specification of the mystery cells as ectopic R3/4 subtype photoreceptors
      in groBFP2 mutant eye discs implies that induction by R2 or R5 is not absolutely
      necessary for R3/4 cell determination.

PMID- 1638996
TI  - [Towards a neurodevelopmental hypothesis in schizophrenia].
AB  - Since the first designation by E. Bleuler, various etiopathogenic theories have
      been proposed in schizophrenia. The dopaminergic hyperactivity hypothesis remains
      the more valid one. Recently, a neurodevelopmental hypothesis has been suggested
      in schizophrenia. This hypothesis postulates an early disturbance in the
      development of central nervous system, mainly in the temporo-limbic areas. This
      disturbance is not secondary to a degenerative process. It may take place during
      the end of the second trimester of the pregnancy and be complete at the time of
      puberty. Genetic and environmental factors co-occur to explain these brains
      developmental disturbances. This hypothesis has been formulated according to a
      tremendous amount of various data obtained with different methodologies.
      Neuropathological techniques observed a reduction in the number of cells and cyto
      architectural anomalies in different brain areas such as hippocampus and para
      hippocampus gyrus. The lack of associated gliosis suggests an early phenomenon
      developing before birth. Structural brain abnormalities have been demonstrated
      using various neuroimaging techniques. Computed tomographic scanning and magnetic
      resonance imaging reveal structural anomalies such as ventricular dilatation, and
      positron emission tomography functional ones such as frontal hypometabolism.
      These results appear to be unrelated to the severity, the duration and the
      treatment of the disease. More informations are needed to eventually confirm this
      hypothesis. Clinical, cognitive and neuropsychological data have to be completed.
      Longitudinal studies are urgently needed using clinical, epidemiological, genetic
      and neuroimaging techniques.

PMID- 1638997
TI  - [Methodological obstacles encountered in the evaluation of psychotherapies of
      schizophrenic patients. A general review].
AB  - Through a critical review of literature, authors suggest a methodological
      reflexion about problems in evaluation of effects of psychotherapies of
      schizophrenics, taking into account not only individual techniques but also
      institutional ones with psychotherapeutic orientations. Among the main
      difficulties are: evaluation with too much unspecific and over simplified
      criteria, for example criterium of rehospitalisation; lack of real comparability
      between groups, or techniques, and lack of validity of randomisation, still
      considered as a pawn of methodological rigour; diversity of levels of experience,
      and education of therapists, too unmatched model of functional organisation of
      the different centers, and in the same time too unequal recruitment of patients
      and at length of proposed therapeutic programs. Moreover, and even before these
      methodological bias, a more basic obstacle must be considered. It is the non
      opening of models to the falsification, denounced by Bignami as the impossible
      verification of the heuristic value of the proposed models, ie the impossible
      verification of the utility of the proposed programs for individual therapies of
      schizophrenics.

PMID- 1638998
TI  - [Behavior dyscontrol scale: validation and initial results].
AB  - The numerous recent trials devoted to disruptive behavior disorders indicate the
      renewed interest of clinicians for these so-called dimensions and call for
      revision of the instruments with which they are evaluated. The present paper
      provides a brief review of the currently used scales for rating impulsivity. A
      new scale for evaluating the behavioural dyscontrol is proposed. The items of
      this scale are selected a priori according to clinical experience with patients
      suffering from lack of behavioural control. The Behaviour Dyscontrol Scale (BDS)
      includes, in the initial version, 4 parts. The first part concerns the
      generalized lack of control (G-BDS). This is a questionnaire of 24 items. The
      second part is constituted by a questionnaire which lists a number of specific
      behaviours where impulsivity has a central role (S-BDS). Part III is constituted
      with 4 Visual Analogue Scales for evaluating handicap linked to dyscontrol. Part
      IV is constituted by 3 Visual Analogue Scales concerning the physician global
      impression about the lack of general control in cognitions, emotions and
      behaviours. For validation, 166 patients (111 females and 55 males), either
      hospitalized or ambulatory, and 35 controls (16 females and 19 males) were
      included in this study. Mean age of patients was 38.5 (SD = 10.5) years. The
      patients population is subdivided in 4 subgroups, anxious, depressed, abusers and
      bulimics according to DSM III-R criteria. Patients and controls global scores
      were significantly different at the G-BDS (p less than 10(-4)) and not at S
      BDS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1638999
TI  - [French translation of Schalling-Sifneos Personality Scale Revised and Beth
      Israel Questionnaire, 2 evaluation tools of alexithymia].
AB  - The concept of alexithymia was first proposed in the 1960's by Sifneos and Nemiah
      to describe personality traits originally found in psychosomatic patients but
      which have since been found in other types of patients (alcoholics, drug addicts,
      traumatic stress disorder patients, sociopaths) as well as in the general
      population. Etymologically, alexithymia signifies: incapacity to speak one's
      emotions (from the Greek: a, lack; lexis, word; thymos, sentiments). Alexithymia
      is not the impossibility of feeling one's emotions, but rather the impossibility
      of associating them with corresponding mental representations and thus
      verbalizing them. Such patients tend to act out, to speak circumstantially, and
      to have difficulty in relationships. A neurophysiological substratum, the absence
      of connexions between the limbic system and the neo-cortical regions, has been
      suggested by Sifneos, who has distinguished primary and secondary alexithymia. A
      "biological" deficit seems to be responsible for primary alexithymia, such as in
      found in split-brain patients or aprosodias in patients with right hemispheric
      strokes. Secondary alexithymia, on the other hand, seems to be due to
      psychodynamic factors such as massive utilisation of defense mechanisms like
      denial, repression and regression. Appropriate psychotherapy for such patients is
      debatable, but it seems that in most cases the analytical approach should be
      replaced by more directive therapies, including relaxation and bio-feedback, to
      help patients learn to stimulate, master, and verbalize their emotions. The Beth
      Israel Questionnaire (BIQ) is a rating scale evaluating such traits that is
      filled out by the rater based on a clinical interview.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1639000
TI  - [X-ray computed tomographic abnormalities in schizophrenia. Trial of relationship
      with clinical data].
AB  - Computerized tomography (CT-scan) studies in schizophrenia revealed that some
      patients have neuromorphological abnormalities. The structural changes consist
      mainly in lateral and third ventricle enlargement, and in cortical atrophy. The
      present study evaluates these three changes in 42 schizophrenics aged 18 to 50,
      compared to 24 healthy controls. Diagnosis were established from information
      gathered by personal interview with the SADS-LA. Clinical sub-types were
      evaluated according to the DSM III-R criteria. Moreover, detailed symptoms were
      rated according to the Positive And Negative Syndrome Scale (PANSS). CT scans
      were recorded in floppy disks and blindly analyzed. Schizophrenics shown
      significant higher mean size of lateral and third ventricles, and higher mean
      anterior cortical atrophy than healthy subjects. Significant differences were
      also found between subtypes, with more marked abnormalities in the disorganized
      group. The relationship between brain abnormalities and clinical symptoms
      recorded with the PANSS, were analysed using Pearson correlates. Positive
      correlations concerned mainly negative symptoms like blunted affect, emotional
      withdrawal, difficulties in abstract thinking, passive apathetic social
      withdrawal and lack of spontaneity of conversation. Positive correlations are
      also observed with some symptoms classified with the PANSS in the General
      Psychopathology scale such as mannerism and disorientation. Negative correlation
      concerned most of PANSS positive symptoms.

PMID- 1639001
TI  - [Panic disorder and microcirculation. Controlled study of capillaries in anxiety
      disorders].
AB  - However varied the clinical descriptions of anxiety, a sizeable proportion is
      always allotted to the cardiovascular aspect. One is reminded of Krishaber's
      cerebral-cardiac neuropathy and Brissaud's conception of anxiety. The implication
      of the heart in anxiety disorders, especially paroxystic disorder, i.e. panic
      attacks (PA) is important. Cardiovascular symptoms (tachycardia, increased
      systolic blood pressure, chest pain) are among the most frequent manifestations
      of panic; furthermore, recent studies suggest that male panic disorder (PD)
      patients have an increased mortality risk from cardiovascular diseases. It is
      with this implication in mind that we undertook this study, the main aim of which
      was to confirm the existence of an abnormal microcirculation, characteristic of
      PD, taking the form of an excess number of twisted capillaries. Abnormal
      capillaries had been described previously in non-controlled studies of patients
      with psychiatric disorders diagnosed as neurasthenia, neurosis, neurovegetative
      disorders and more recently as neurocirculatory asthenia, a syndrome similar to
      PD. This led us to undertake a study of the total number of capillaries observed
      by photomicrography (capillaroscopy) in the supra-ungueal fold of the fingers of
      both hands (except thumbs), comparing the number of twisted capillaries of 16
      subjects suffering from panic disorder with or without agoraphobia according to
      the DSM III-R criteria, with those of 16 healthy volunteers matched for age and
      sex and 14 subjects suffering from other anxiety disorders (10 of them fulfilling
      criteria for generalized anxiety disorders).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639002
TI  - [Relations between mood disorders and personality. Recent data].
AB  - In the field of studies of links between mood disorders and personality, the need
      to study only completely remitted patients has been demonstrated recently.
      Indeed, the clinically depressed state strongly influences the assessment of some
      personality traits in a more pathological direction (for instance for emotional
      stability, extraversion, interpersonal dependency, ego strength). The studies
      concerning unipolar depression have been mainly made according to two
      methodological approaches which results are relatively consistent. The first one
      uses batteries of standard self-report personality inventories such as the
      Hirschfeld and Klerman battery which includes the Guilford-Zimmerman Temperament
      Survey, the Interpersonal Dependency Inventory, the shortened version of the
      Lazare-Klerman-Armor Personality Inventory and two subscales of the MMPI. This
      approach shows that compared to normal population, recovered depressive, have
      less emotional strength more interpersonal dependency and a more introverted
      personality. The second approach uses diagnostic criteria of personality
      disorders according to DSM III. The clinical evaluation can be performed with the
      help of the Structured Interview for DSM III Personality Disorders (SIDP) or with
      of the help the Millon Clinical Multiaxial Inventory (MCMI), a self rated
      questionnaire. The most frequent personality disorder among recovered unipolar
      patients is dependent personality, followed by the avoidant and histrionic
      personalities and lastly the schizoid, schizotypal, borderline, compulsive and
      passive-aggressive personalities. But the interpretation of all these results
      must be cautious given that a recent study dealing with premorbid personality
      invites one to consider that not only depression influences personality
      assessment during illness, but also that depression may result in personality
      change after recovery. Few studies are available concerning bipolar
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639003
TI  - [Lithium and aggression in adults].
AB  - The use of lithium as an antiaggressive agent independently of its action in
      bipolar illness is now well documented. It appears particularly effective in the
      control of aggressive behavior in chronically aggressive prisoners and mentally
      retarded patients. Approximately 70-75% of these patients are likely to show a
      positive response to lithium therapy. No convincing features have been identified
      as being predictive of a good response. The clinical effect of lithium is to
      reduce the frequency and the severity of both hetero and auto aggressive
      outbursts. The use of lithium for aggressive behavior remains controversial in
      epileptic disorders and inconclusive in chronically psychotic patients. Careful
      monitoring of lithium blood levels is necessary to ensure adequate therapeutic
      efficacy without toxicity. A caution is needed in patients with brain damage
      especially when concurrent neuroleptic treatment is used. The antiaggressive
      effect of lithium seems rather specific and may be associated with a
      serotoninergic effect.

PMID- 1639004
TI  - [Effects of callosotomy in the treatment of intractable epilepsies in children on
      psychiatric disorders].
AB  - Two children, 13 and 14 years old, presented an intractable epilepsy of Lennox
      Gastaut. In front of dangerous tonic and atonic epileptic crisis, a corpus
      callosotomy was performed. Corpus callosotomy is becoming a more widely used
      procedure in the treatment of intractable epilepsy as Lennox-Gastaut syndrome, or
      frontal epilepsy. However, there have been very few series that have reported
      results in children. It is not a complete but a partial, callosal section
      including approximately the anterior two thirds of the callosum. After this
      surgery the two children improved dramatically because the dangerous tonic and
      atonic crisis disappeared. Secondly we observed improvement of pre-surgical
      psychiatric troubles, that is a data not developed in the literature. Before
      surgery, the two children had a frontal syndrome with hyperkinesia,
      distractibility, aggressiveness, alexithymia, loss of the program of ideas.
      During the two months after the section of the anterior two thirds of the corpus
      callosum, we observed a progressive improvement of the frontal syndrome, with
      possibility to learn new praxies. The intellectual quotient was not altered and
      associative functions, depending of the posterior third of the corpus callosum
      were spared. Anti-epileptic medications were not stopped. We think that the
      improvement of the frontal syndrome is due to reduction of seizures. Therefore,
      we insist on the interest of the section of the anterior two thirds of the corpus
      callosum as treatment of tonic and atonic seizures but also as treatment of
      psychiatric symptoms depending of a frontal syndrome.

PMID- 1639005
TI  - The concept of negative feedback--Moore and Price.

PMID- 1639006
TI  - Thyroxine transport and the free hormone hypothesis.

PMID- 1639007
TI  - Developmental hormonal profiles accompanying the neonatal hypothyroidism-induced
      increase in adult testicular size and sperm production in the rat.
AB  - Neonatal treatment with the reversible goitrogen 6-N-propyl-2-thiouracil (PTU)
      results in a near doubling of testicular size and a 25% increase in the
      efficiency of spermatogenesis, without affecting circulating testosterone (T)
      levels in adult rats. The objectives of the present study were to examine the
      effects of neonatal PTU treatment on the pattern of testicular growth and
      circulating levels of anterior pituitary (FSH, LH, PRL, GH, and TSH), gonadal
      [immunoreactive inhibin-alpha (irI alpha) and T], and thyroid (T3 and T4)
      hormones over the first 100 days of life. Treatment of rats with PTU from birth
      to 24 days of age significantly reduced testicular weights between 10 and 60 days
      of age. However, the duration of testicular growth was extended in treated males,
      resulting in a 68% increase at 100 days of age. Serum gonadotropin levels in
      treated males were reduced throughout the experimental period, typically
      remaining between 50-70% of control levels. The characteristic robust prepubertal
      FSH peak was absent in PTU-treated males. Initially high until 20 days of age,
      irI alpha levels characteristically declined to adult levels (200-300 pg/ml) in
      control males. In treated males, irI alpha levels were reduced during the period
      of hypothyroidism, increased between 30 and 60 days, and then declined, but
      remained significantly higher (1.7- to 2-fold greater) than those observed in
      control males. Serum T levels were similar in treated and control males. Control
      males demonstrated increased T levels beginning at 45 days of age, earlier than
      observed in treated males; however, similar peak T levels were observed in all
      males. PTU treatment significantly suppressed serum GH and PRL and led to a 14
      fold increase in circulating TSH during the period of treatment. However, unlike
      the gonadotropins, these hormones returned to control levels after PTU treatment,
      suggesting that the reduced levels of FSH and LH observed are not due to a
      generalized reduction in pituitary function. Serum T4 and T3 levels returned to
      control levels within 15 days after the removal of PTU. These results demonstrate
      that the neonatal PTU treatment-induced increases in adult testicular size and
      sperm production were not due to increased levels of FSH at any point in
      development. On the contrary, the observed increases occur in spite of
      chronically reduced FSH levels.

PMID- 1639008
TI  - Thyroid albumin originates from blood.
AB  - Iodoalbumin has been found in the goiter of Dutch goats with a thyroglobulin
      synthesis defect. Immunohistochemical studies showed that in the goiter the
      percentage of follicles containing albumin was higher than that in normal thyroid
      glands. In the albumin-containing follicles of normal and goitrous glands,
      transferrin and immunoglobulin G could be found. Also, between the epithelial
      cells, serum proteins were detected. These results indicate intercellular passage
      of serum proteins. After in vivo labeling with 125I, goiter slices were incubated
      with [3H] leucine. Purified 125I-containing albumin did not contain [3H]leucine,
      while thyroglobulin antigens were double labeled. Cyanogen bromide treatment of
      albumin out of the goiter and of serum albumin gave comparable cleavage patterns,
      indicating that no great differences in amino acid composition, especially
      methionine, exist. In total RNA from goiter, no albumin mRNA could be detected
      after blotting and hybridization with goat albumin cDNA. Also, the polymerase
      chain reaction method with albumin DNA primers was unable to detect any albumin
      mRNA in normal and goitrous glands of goats. From these results we conclude that
      "thyralbumin" originates from blood and is not synthesized by the thyroid gland.

PMID- 1639009
TI  - Prolactin isoform 2 as an autocrine growth factor for GH3 cells.
AB  - Because PRL has growth factor activities in several tissues, we have asked
      whether it also has autocrine growth factor activity in pituitary GH3 cells. GH3
      cells were grown at increasing densities in the presence or absence of antirat
      PRL (polyclonal and monoclonal) or nonspecific antibodies. Cell proliferation
      increased with increasing cell density, as did the concentration of PRL in the
      medium. Antirat PRL, but not control antibody, markedly inhibited but did not
      eliminate cell proliferation, and this effect was diminished with increasing PRL
      concentration in the medium. PRL receptors were demonstrated on 40-50% of the
      cells by indirect immunofluorescence using a specific antirat PRL receptor
      monoclonal antibody. Cell surface PRL was colocalized to the same 40-50% of the
      cells and copatched or cocapped along with the receptors. Absence or presence of
      PRL receptors did not correlate with stage of the cell cycle, as judged by
      ethidium bromide dual labeling. Cell surface PRL was found to be on PRL
      containing cells. These data have fulfilled four criteria necessary for
      establishment of a substance as a secreted autocrine growth factor: 1) the factor
      must be secreted; 2) in log growth phase, increased cell proliferation should
      occur at increased cell densities; 3) the cells must display a receptor for the
      factor; and 4) there must be a growth response to the factor. Thus we have
      established that PRL is an autocrine growth factor for at least 40-50% of the GH3
      cell population. This, to our knowledge, is the first example of autocrine growth
      factor activity of a major hormone normotopically expressed.

PMID- 1639010
TI  - Endothelin-1 actions on resorption, collagen and noncollagen protein synthesis,
      and phosphatidylinositol turnover in bone organ cultures.
AB  - The effects of endothelin-1 (ET) on several tissues are mediated by
      prostaglandins. In this study, we investigated the actions of ET on bone and
      determined whether they are mediated through prostaglandin-dependent pathways.
      Bone resorption, collagen, and non-collagen protein synthesis and inositol
      phosphate (IP) production were studied in neonatal mouse calvaria and fetal rat
      limb bone cultures. The effects of ET in the calvaria model were examined in the
      presence or absence of the cyclooxygenase inhibitor indomethacin (INDO). Bone
      resorption was stimulated by ET in the neonatal mouse calvaria, and this effect
      was inhibited by INDO. 45Ca release in the fetal rat limb bones was not affected
      by ET. ET stimulated collagen and noncollagen protein synthesis significantly in
      the calvaria model in the presence but not in the absence of INDO, suggesting
      that the anabolic effects of ET were masked by endogenous prostaglandin
      production. ET increased phosphatidylinositol turnover in both bone organ
      cultures. Although the addition of INDO reduced IP production slightly in the
      mouse calvaria, it was still significantly stimulated by ET. Our results
      demonstrate that ET has marked effects on bone tissue in vitro. Effects on
      resorption appear to be prostaglandin dependent, whereas the anabolic effects
      were not prostaglandin mediated. The stimulatory effects of ET on protein
      synthesis could be mediated through the IP signaling pathway. Since ET stimulates
      both bone resorption and anabolism, this peptide may have a role in the coupling
      of bone remodeling.

PMID- 1639011
TI  - In vitro study of acute toxic effects of high iodide doses in human thyroid
      follicles.
AB  - The acute effects of increasing doses of sodium iodide were studied on human
      thyroid follicles isolated from normal paranodular tissue. After 24 h incubation
      in culture medium, follicles isolated from most thyroids maintained their
      capacity for 125I accumulation and organification and a normal cellular
      ultrastructure. 125I accumulation was significantly increased after addition of
      TSH, whereas 125I organification was not affected. In presence of TSH, numerous
      follicles had large empty-looking follicular lumina unlabeled on
      autoradiographies. Follicles incubated for 24 h in the presence of a low
      concentration (10(-7) M) of iodide retained their function and morphology.
      However, incubation with a high dose of iodide (10(-3) M) caused marked
      inhibition of 125I accumulation and organification reaching values similar to
      those obtained in presence of inhibitors of iodide trapping and organification.
      At high doses, iodide induced necrosis of thyroid epithelial cells: the
      percentage of necrotic cells was significantly increased with 10(-5) M and
      doubled with 10(-3) M as compared to values measured at 10(-7) M. Ultrastructural
      lesions such as apical blebbing, cytoplasmic fragments desquamation, endoplasmic
      reticulum vesiculation, and accumulation of lipofuscin in secondary lysosomes
      were also present. The necrotic effect and the ultrastructural alterations also
      occurred in the presence of TSH but were prevented by the addition of inhibitors
      of iodide trapping or organification. These results demonstrate a direct acute
      toxic effect of iodide in human thyroid cells. The nature of the ultrastructural
      alterations is in agreement with a mechanism of toxicity involving a free radical
      attack and lipid peroxidation as observed in other tissues.

PMID- 1639012
TI  - Synergistic effect of insulin-like growth factor-I administration on the protein
      sparing effects of total parenteral nutrition in fasted lambs.
AB  - Using primed constant isotopic infusions, we investigated the effects of
      recombinant human insulin-like growth factor-I (IGF-I) infusion on protein
      kinetics in both fasted and parenterally fed (TPN) lambs. Infusion of IGF-I at a
      dose of 50 micrograms/kg.h in fasted animals increased (P less than 0.005) the
      mean plasma IGF-I concentration from 77.5 +/- 9.7 to 454.4 +/- 51.4 ng/ml. During
      IGF-I infusion the rate of net protein catabolism (NPC) was decreased (P less
      than 0.005) by 17% from 3.5 +/- 0.2 to 2.9 +/- 0.2 g/kg.day, and the rate of
      appearance (Ra) of leucine in plasma decreased (P less than 0.01) from 5.0 +/-
      0.4 to 3.4 +/- 0.4 mumol/kg.min. In addition, the fractional synthetic rate of
      protein in cardiac and diaphragmatic muscle increased by 100% (P less than 0.05)
      during the same period. After 3 h of TPN, the rate of NPC was decreased (P less
      than 0.01) in the TPN animals compared to that in their fasted counterparts (1.89
      +/- 2.27 vs. 4.1 +/- 0.2 g/kg.day, respectively). The rate of NPC was further
      decreased after another 300 min of TPN to 0.76 +/- 0.27 g/kg.day. However, the Ra
      of leucine was not changed compared to the initial value. Infusion of IGF-I
      concurrently with TPN reversed (P less than 0.001) the rate of NPC from 1.02 +/-
      0.21 g/kg.day after 180 min of TPN alone to a state of net protein gain of 0.14
      +/- 0.19 g/kg.day after a further 300 min of combined IGF-I and TPN infusion. The
      Ra of leucine decreased (P less than 0.01) from 3.9 +/- 0.8 to 2.5 +/- 0.47
      mumol/kg.min during IGF-I and TPN infusion. Similarly, the fractional synthetic
      rates of protein in cardiac muscle, diaphragm, adductor muscle, psoas muscle, and
      hepatic tissue were increased (P less than 0.05) compared to those in animals
      that received only TPN. The protein-sparing effects of IGF-I and TPN were
      synergistic, and the infusion of both agents resulted in the induction of a
      protein anabolic state within 60 min of commencing IGF-I infusion. In contrast,
      neither IGF-I nor TPN alone resulted in a state of net protein anabolism, and
      neither had an effect on protein kinetics until 120 min into the infusion.
      Consequently, IGF-I shows considerable potential as an anticatabolic agent when
      used synergistically with nutritional support.

PMID- 1639013
TI  - Insulin regulation of messenger ribonucleic acid for the surfactant-associated
      proteins in human fetal lung in vitro.
AB  - Respiratory distress syndrome (RDS) is primarily caused by an immaturity in the
      synthesis and secretion of surfactant by the fetal lung type II cell. Fetal
      hyperinsulinemia associated with maternal diabetes places the newborn at an
      increased risk of developing RDS, and therefore, it has been hypothesized that
      insulin inhibits type II cell differentiation. We have previously shown that
      insulin inhibits the accumulation of surfactant-associated protein A (SP-A), the
      major surfactant-associated protein, in human fetal lung explants maintained in
      vitro. In the present study, we used Northern blot analysis to evaluate the
      effects of insulin on the content of SP-A messenger RNA (mRNA) as well as on the
      content of mRNA for the hydrophobic surfactant-associated proteins SP-B and SP-C
      in human fetal lung explants maintained in vitro. Lung explants were maintained
      in serum-free medium with or without added insulin (0.25-2500 ng/ml) for up to 6
      days. We observed that insulin, at concentrations of 25-2500 ng/ml, significantly
      inhibited the accumulation of SP-A mRNA when compared to controls (P less than
      0.01). The inhibitory effect of insulin on SP-A mRNA accumulation was dose
      dependent with an approximately 75% inhibition observed at 2500 ng/ml. Insulin,
      at the concentration of 2500 ng/ml, significantly inhibited the accumulation of
      SP-B mRNA by approximately 30% when compared to control levels (P less than 0.01)
      but had no effect at lower concentrations. Insulin had no significant effect on
      SP-C mRNA levels at any concentration tested. Our findings provide evidence that
      insulin may delay fetal lung development by inhibiting SP-A and SP-B gene
      expression. A deficiency of these proteins in pulmonary surfactant may account
      for the increased incidence of RDS in infants of diabetic mothers.

PMID- 1639014
TI  - Interleukin-2 induces corticotropin-releasing hormone release from superfused rat
      hypothalami: influence of glucocorticoids.
AB  - The present work shows that interleukin-2 (IL-2) is able to increase in a dose
      dependent manner (25-100 U/ml) CRF release from continuous perifused hypothalami.
      The effects of IL-2 and IL-1 on CRF secretion are potentiated by the simultaneous
      action of the two cytokines at the hypothalamus. The stimulatory effect of IL-2
      on CRF secretion is significantly inhibited by the presence of dexamethasone in
      the perifusion medium. However, the CRF response to IL-2 was similar in
      adrenalectomized animals and sham-operated rats. It is suggested that the action
      of IL-2 on hypothalamic CRF secretion is integrated in the communication between
      the immune system and the hypothalamic-pituitary-adrenocortical axis, and that
      such action is subjected to glucocorticoid negative feedback modulation. The
      mechanism underlying the effect of IL-2 on CRF release is unknown, but
      arachidonic acid metabolites do not seem to be involved, since neither a
      lipooxygenase (nordihidrogueretic acid) nor a cyclooxigenase (indomethacin)
      inhibitor affected the hypothalamic secretory response to IL-2.

PMID- 1639015
TI  - Neuropeptide Y release is elevated from the microdissected paraventricular
      nucleus of food-deprived rats: an in vitro study.
AB  - Intracerebroventricular injection of neuropeptide Y (NPY) stimulates a robust
      dose-related feeding response in the rat. Experimental evidence attests to the
      view that the release of NPY in the paraventricular nucleus (PVN), a site richly
      innervated by NPY immunopositive fibers, is responsible for stimulation of
      feeding behavior. However, there is little information on the neuroendocrine
      factors involved in regulation of NPY release, in part due to the unavailability
      of reliable techniques to monitor PVN NPY release. In this study, we have
      validated an in vitro technique to assess NPY release from the PVN and other
      neighboring hypothalamic sites of the rat brain. In the first experiment, freshly
      dissected brains from male rats were processed for 300-microns thick sections
      with a vibratome. The PVNs were microdissected from the brain sections under a
      stereomicroscope and incubated in 250 microliters Krebs Ringer bicarbonate buffer
      at 37 C for basal and KCl-induced NPY release. The results showed that basal NPY
      efflux from the excised PVN was detectable and increased in relation to the
      number of PVNs in the incubation chambers. Addition of KCl at the end of the 60
      min basal incubation period increased NPY release further, the increments were
      again closely related to the number of PVN punches in the incubation chambers. In
      the second experiment, the assumption that in vitro basal and KCl-evoked NPY
      release from the PVN reflected the in vivo pattern of PVN NPY secretion was
      validated. The effects of 4-day food deprivation (FD), an experimental paradigm
      known to augment in vivo PVN NPY secretion, on the in vitro NPY release from PVN
      and ventromedial nucleus were evaluated. The results showed that both basal and
      KCl-evoked NPY release was significantly higher from the PVN of food-deprived
      than control rats on ad libitum rat chow. This FD-induced incremental NPY
      response was site-specific because the basal and KCl-evoked NPY effluxes from the
      ventromedial nucleus of FD and control rats were similar. Thus, in agreement with
      previous in vivo findings, NPY release in vitro is also augmented selectively
      from the PVN in response to fasting. Cumulatively, these results demonstrate that
      NPY release in vitro from hypothalamic sites microdissected from fresh brains can
      be assessed in a reliable fashion and are in accord with the proposal that
      enhanced NPY action within the PVN is responsible for increased drive for food.

PMID- 1639016
TI  - The regulation of porcine theca cell proliferation in vitro: synergistic actions
      of epidermal growth factor and platelet-derived growth factor.
AB  - An important but poorly understood aspect of mammalian follicle development
      involves the regulation of theca cell proliferation. To investigate the premise
      that growth factors regulate theca cell proliferation, porcine theca cells were
      prepared by collagenase/DN'ase digestion of follicle linings after the removal of
      the granulosa cells and allowed to attach for 24 h. This method provided a
      monolayer of theca cells that had little if any granulosa cell contamination and
      which secreted high levels of androstenedione relative to granulosa cells during
      moderate-term culture (33-fold difference, P less than 0.01). In medium
      containing fetal calf serum (10%), theca cells were significantly more responsive
      to platelet-derived growth factor (PDGF) than epidermal growth factor (EGF) in
      terms of proliferation (13.4 +/- 0.2-vs. 7.0 +/- 0.1-fold increases relative to
      the initial cell count, P less than 0.05). This is in contrast to granulosa cells
      which were significantly more responsive to EGF than PDGF (7.1 +/- 0.1 vs. 4.0 +/
      0.2 fold-increases, P less than 0.05). Since serum has been shown to contain
      both EGF and PDGF, proliferation studies were performed using plasma-derived
      serum (PDS) which is growth factor restricted to examine more closely the direct
      effects of growth factors. In medium containing 0.25% PDS and within experiments,
      PDGF (1-25 ng/ml) stimulated theca cell proliferation in a dose-dependent manner
      (2.3-fold increase relative to controls, P less than 0.05) whereas EGF did not.
      EGF, however, markedly enhanced the proliferative action of PDGF (6.4-fold
      increase relative to controls, P less than 0.05). Insulin-like growth factor I
      and low density lipoprotein, factors which enhance markedly the proliferative
      effects of EGF and PDGF in terms of granulosa cell proliferation, exhibited only
      a modest synergistic effect with respect to EGF and PDGF upon theca cells (9.5
      fold increase vs. a 6.4-fold increase above controls, P less than 0.05). Temporal
      studies in vitro indicate that theca cell proliferation is low during the first 3
      day exposure to growth factors irrespective of treatment (a 2-fold increase over
      the seeding density). During the second 3-day exposure, however, theca cell
      proliferation increases 4- to 5-fold. The temporal pattern of theca cell
      proliferation stimulated by fetal calf serum supplemented with EGF or PDGF and
      PDS-containing medium supplemented with PDGF, EGF, insulin-like growth factor I,
      and low density lipoprotein is similar. These results suggest that PDGF is a
      major mitogen toward porcine theca cells and that EGF greatly enhances its
      activity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1639017
TI  - Prolactin enhancement of its own uptake at the choroid plexus.
AB  - The choroid plexus contains PRL receptors that function in part to transport PRL
      from the blood into the cerebrospinal fluid (CSF). The blood PRL concentration of
      female rats was altered by 1) three daily injections of haloperidol (chronic
      hyperprolactinemia) with or without bromocriptine administration 4 h before
      death, 2) bromocriptine alone for 4 h (acute hypoprolactinemia), and 3) a single
      vascular injection of ovine PRL (acute hyperprolactinemia). Changes in the uptake
      of PRL by the choroid plexus was assessed by quantitative in vivo autoradiography
      after the injection of radiolabeled PRL. Correlation of changes in PRL uptake at
      the choroid plexus with changes in PRL transport from blood to CSF was evaluated
      by subjecting CSF samples to sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis after vascular injection of radiolabeled PRL. Autoradiography
      revealed that both chronic and acute hyperprolactinemia resulted in a significant
      increase in the uptake of radiolabeled PRL by the choroid plexus compared to that
      in untreated control animals. In contrast, bromocriptine had no effect on PRL
      uptake at the choroid plexus relative to that in control (untreated) animals.
      Chronic hyperprolactinemia, but not acute hyperprolactinemia, resulted in a
      significant increase in the transport of radiolabeled PRL from the blood to the
      CSF compared to that in untreated controls. The results are consistent with the
      up-regulation of PRL receptors in the choroid plexus by circulating PRL and the
      consequent augmentation of transport of PRL from blood to CSF.

PMID- 1639018
TI  - IL-6 increases endothelial permeability in vitro.
AB  - The effect of interleukin 6 (IL-6) on endothelial permeability was examined by
      measuring fluorescein isothiocyanate-labeled albumin flux across an endothelial
      cell monolayer. Bovine vascular endothelial cells (BVEC) were cultured up to
      confluency on collagen-coated polycarbonate micropore filters and then the
      filters were mounted on modified Boyden chambers. Treatment of the BVEC with IL-6
      at 100 ng/ml for 21 h caused a remarkable increase in the permeability of
      fluorescein isothiocyanate-labeled albumin across the endothelial monolayer. This
      effect of IL-6 was concentration dependent, in the range from 10-200 ng/ml of IL
      6. The effect of IL-6 was also time dependent, the maximal level being reached at
      21 h from the beginning of the treatment. This stimulatory effect of IL-6 on
      albumin clearance was completely abolished by the addition of anti-IL-6 antibody.
      Light microscopic observation of a cross-section of a monolayer showed that the
      IL-6-induced increase in the permeability was correlated with changes in cell
      shape and rearrangement of intracellular actin fibers. IL-6 did not show any
      cytotoxicity toward or growth inhibition of endothelial cells, even at more than
      200 ng/ml. The enhancing effect of IL-6 on the increase in the permeability was
      reversible; when IL-6 was removed by a medium change and the cells were incubated
      for a further 24 h without IL-6, the permeability was restored to the control
      level. These results suggest that IL-6 can induce an increase in endothelial
      permeability in vitro by rearranging actin filaments and by changing the shape of
      endothelial cells.

PMID- 1639019
TI  - Activity of vasoactive intestinal peptide and serotonin in the paraventricular
      nucleus reflects the periodicity of the endogenous stimulatory rhythm regulating
      prolactin secretion.
AB  - PRL secretion in the female rat is regulated by an endogenous stimulatory rhythm
      (ESR) of prolactin-releasing factors of hypothalamic origin which has a bimodal
      periodicity with distinct nocturnal (N) and diurnal (D) phases. The N phase
      reaches peak magnitude by 0300 h and the D phase reaches peak magnitude by 1700
      h. This rhythm was first unmasked in ovariectomized rats by correctly timed
      injection of a dopamine antagonist. OT, vasoactive intestinal peptide (VIP), and
      serotonin (5-HT) are differentially involved in generating the ESR.
      Pharmacological studies suggest that OT is the neurohormone and VIP and 5-HT are
      neuromodulators which act to stimulate OT release. Recently, we reported that
      activity of OTergic neurons in the paraventricular nucleus (PVN) and OT
      concentrations in the anterior pituitary mirror the periodicity of the ESR. The
      present experiments were conducted to determine if VIP and 5-HT activity in the
      hypothalamus also mirrors the periodicity of the ESR. Push-pull cannulae were
      surgically implanted in the PVN of ovariectomized female rats. Following
      recovery, push-pull perfusion was conducted from either 0600-1400 h, 1400-2200 h,
      or 2200-0600 h. VIP was measured in perfusates by RIA. There was no difference in
      VIP pulse frequency between rats perfused during the three periods studied.
      However, animals perfused from 2200-0600 h had significantly greater pulse
      amplitude as compared to rats at either 0600-1400 h or 1400-2200 h. Activity of 5
      HTergic neurons in the hypothalamus was studied by estimating the turnover of 5
      HT 10 min following the injection of pargyline. Hypothalamic nuclei were
      dissected using Palkovits' punch technique and 5-HT concentration assayed by HPLC
      in conjunction with electrochemical detection. Turnover of 5-HT was estimated by
      calculating the slope of the accumulation of 5-HT over 10 min at differing times
      of day using least squares regression analysis. There was a distinct diurnal
      rhythm of 5-HT accumulation in the PVN. Rats killed at 1700 h had significantly
      greater slopes of 5-HT accumulation in the PVN than rats killed at either 0300 or
      1200 h. Similarly, there was a diurnal rhythm of 5-HT turnover in the
      suprachiasmatic nucleus. Rats sampled at either 1200 or 1700 h had significantly
      greater slopes of 5-HT accumulation in the suprachiasmatic nucleus than rats
      sampled at 0300 h. There was no diurnal rhythm of 5-HT turnover evident in either
      the median eminence or the supraoptic nucleus.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1639020
TI  - Activation of the phosphatidylinositol pathway in the primate corpus luteum by
      prostaglandin F2 alpha.
AB  - The current study was designed to investigate the ability of prostaglandin F2
      alpha (PGF2 alpha) to activate a second messenger system (phosphatidylinositol
      pathway) in corpora lutea (CL) of rhesus monkeys. Activation of this pathway was
      assessed by monitoring the hydrolysis of phosphatidylinositol to inositol
      phosphates. Since inositol triphosphate mobilizes intracellular Ca2+,
      intracellular free calcium concentrations ([Ca2+]i) were also assessed in
      individual cells by fura-2 fluorescence photometry. These responses to PGF2 alpha
      were measured in luteal cells collected from nonpregnant rhesus monkeys. CL were
      collected during the early (days 4-5 after estimated LH surge; n = 4), mid (days
      8-9; n = 4), and late (days 13-14; n = 5) luteal phase and 1 day after in vivo
      hCG treatment (15 IU/dose, morning and evening), which began during the midluteal
      phase (n = 5). PGF2 alpha significantly increased the accumulation of inositol
      phosphates in all groups (P less than 0.05), except the midluteal phase (P =
      0.07). The luteal sensitivity to PGF2 alpha, judged by phosphatidylinositol
      hydrolysis, was low in the early to midluteal phase compared to that in the late
      luteal phase and after in vivo hCG treatment. PGF2 alpha also caused a rapid, yet
      transient, increase in [Ca2+]i in a large proportion of primate luteal cells. The
      proportion of luteal cells that responded to PGF2 alpha with an increase in
      [Ca2+]i was smaller (P less than 0.05) in CL collected during the early luteal
      phase than in the other groups. Luteal progesterone production was inhibited by
      PGF2 alpha in CL collected after in vivo hCG. CL treated in vivo with hCG also
      displayed in vitro the largest increases in phosphatidylinositol hydrolysis and
      [Ca2+]i in response to PGF2 alpha. Therefore, this study demonstrates that PGF2
      alpha is a potent activator of the phosphatidylinositol pathway in the primate
      CL. This activation is augmented as the luteal phase progresses and is influenced
      by in vivo hCG treatment. This study also provides evidence that the inhibitory
      effects of PGF2 alpha on progesterone production are associated with the
      activation of the phosphatidylinositol pathway.

PMID- 1639021
TI  - Synergistic interaction between insulin-like growth factors-I and -II in central
      regulation of pulsatile growth hormone secretion.
AB  - Insulin-like growth factor (IGF)-I and -II peptides, receptors, mRNAs, and
      binding proteins are widely distributed in the central nervous system (CNS), yet
      their physiological role in the brain remains largely unknown. While earlier in
      vivo studies in the rat suggested that IGF-I may participate in feedback
      regulation of GH secretion at a CNS level, the preparations used were only
      partially pure. The recent availability of purified recombinant IGF-I and -II
      peptides prompted us to reexamine the involvement of the IGFs in vivo in central
      regulation of pulsatile GH secretion. Five groups of free-moving adult male rats
      bearing chronic intracerebroventricular (icv) and intracardiac venous cannulae
      were icv administered IGF-I (in doses of 0.5, 2, 3, and 10 micrograms) or the
      acid-saline vehicle; an additional group received 1 microgram of the potent IGF-I
      analog, long R3 IGF-I. Spontaneous 6-h plasma GH secretory profiles were obtained
      from all groups. Vehicle-injected control animals exhibited the typical pulsatile
      pattern of GH secretion, with most peak GH values above 150 ng/ml and trough
      levels below 1.2 ng/ml. Central administration of IGF-I alone or long R3 IGF-I at
      all doses tested failed to alter the pulsatile pattern of GH release; there were
      no significant differences in GH peak amplitude, GH trough level, GH interpeak
      interval, or mean 6-h plasma GH level compared to those in vehicle-injected
      controls. In a second study, designed to determine the effects of central
      administration of IGF-I and IGF-II, in combination, icv injection of 1 microgram
      IGF-I and 1 microgram IGF-II resulted in a marked suppression in the amplitude of
      spontaneous GH secretory bursts approximately 3 h after injection; both GH pulse
      amplitude (43.5 +/- 5.6 vs. 130.6 +/- 14.6 ng/ml; P less than 0.001) and mean
      plasma GH level (16.3 +/- 1.9 vs. 35.2 +/- 1.8 ng/ml; P less than 0.001) were
      severely reduced 3-6 h after injection compared to those in vehicle-injected
      controls. These results demonstrate that IGF-I alone does not play a
      physiologically important role in feedback regulation of GH secretion at the
      level of the CNS. Our findings suggest a synergistic interaction between IGF-I
      and -II in the brain for central control of pulsatile GH secretion.

PMID- 1639022
TI  - Antithyrotropin-releasing hormone serum inhibits secretion of glucagon from
      isolated perfused rat pancreas: an experimental model for positive feedback
      regulation of glucagon secretion.
AB  - TRH is synthesized in the islets of Langerhans and was found in the perfusate of
      isolated rat pancreas. In the present study, designed to determine the role of
      endogenous TRH, we first characterized chromatographically the identity of
      immunoreactive TRH with synthetic pGlu-His-Pro-NH2. Since endogenous TRH
      secretion may mask the effects of exogenous TRH, we performed, in parallel to
      dose-response studies, immunoneutralization experiments using anti-TRH serum to
      neutralize the endogenous TRH secretion from isolated perfused rat pancreas. The
      data indicate that exogenous TRH enhances basal glucagon secretion; inversely,
      anti-TRH serum inhibits glucose plus arginine-induced glucagon secretion and
      produces a concomitant slight inhibition of somatostatin secretion. The present
      study shows a physiological contribution for endogenous TRH as a local modulator
      of intraislet hormone regulation; from these observations, we postulate a direct
      effect of pancreatic TRH on glucagon-containing (alpha) cell secretion, which, in
      turn, may produce the fluctuation in somatostatin secretion. Local TRH secretion
      provides a model for positive feedback regulation of glucagon secretion,
      frequently associated with diabetes.

PMID- 1639023
TI  - Growth hormone increases intracellular free calcium in rat adipocytes:
      correlation with actions on carbohydrate metabolism.
AB  - Adipocytes that have been preincubated for 3 h or more in hormone-free medium
      respond to GH with a transient insulin-like increase in glucose metabolism,
      followed by a period of refractoriness to further insulin-like stimulation.
      Adipocytes freshly isolated from normal rats and adipocytes that were exposed to
      GH in the first hour of a 4-h incubation period are refractory to this insulin
      like effect. Because earlier studies revealed a relationship between
      refractoriness and cellular calcium, we examined the effects of GH on the
      intracellular calcium concentration ([Ca2+]i) under a variety of conditions in
      which sensitivity to insulin-like stimulation or refractoriness is known to be
      affected. A dual nitrogen laser imaging microscope with computer-assisted image
      processing to measure fluorescence changes in individual adipocytes loaded with
      fura-2 AM was used to measure [Ca2+]i. After prolonged incubation in vitro,
      resting [Ca+2]i was 120 +/- 6 nM and remained unchanged for more than 1 h after
      the addition of 100 ng/ml human GH (hGH), which doubled the rate of incorporation
      of [3-3H] glucose into triglycerides in this interval. Lipogenesis declined in
      the second hour, and [Ca+2]i slowly increased, reaching 324 +/- 49 nM by the end
      of the third hour (P less than 0.05). When added with GH, actinomycin-D, an
      inhibitor of RNA synthesis, caused the accelerated rate of lipogenesis to persist
      for at least 5 h and blocked the delayed increase in resting [Ca+2]i. Resting
      [Ca2+]i in freshly isolated, and hence refractory, adipocytes was 342 +/- 34 nM
      and declined to 112 +/- 11 nM concomitant with acquisition of insulin-like
      sensitivity to GH. The addition of 100 ng/ml hGH to these cells at the beginning
      of incubation, under conditions known to sustain refractoriness prevented the
      decline in resting [Ca2+]i and enabled them to exhibit a further acute increase
      in [Ca2+]i in response to a second exposure to hGH in the fourth hour. When added
      60 min after GH, actinomycin-D blocked the ability to raise [Ca2+]i acutely in
      response to GH, but did not interfere with GH's action to sustain resting
      [Ca2+]i, which remained at about 300 nM. The concentration of GH needed to
      increase [Ca2+]i acutely in refractory cells is about 6-fold higher than that
      needed to maintain resting [Ca+2]i. Differences in the time of sensitivity to
      actinomycin-D and dose dependency suggest that sustaining resting [Ca2+]i and
      production of the acute increase in [Ca2+]i are separate phenomena.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1639024
TI  - Effect of hypothalamic lesions that induce precocious puberty on the
      morphological and functional maturation of the luteinizing hormone-releasing
      hormone neuronal system.
AB  - Recent evidence has implicated the transforming growth factor-alpha (TGF
      alpha)/epidermal growth factor receptor (EGFR) system in the mechanism by which
      hypothalamic lesions accelerate female sexual development. Since acquisition and
      maintenance of reproductive functions depend on the secretory activity of LHRH
      neurons, the present studies were undertaken to characterize some of the cellular
      and molecular events that underlie lesion-induced activation of the LHRH neuronal
      network. Bilateral electrolytic lesions of the posterior portion of the preoptic
      region and anterior hypothalamic area (POA-AHA) in 22-day-old rats resulted in
      vaginal opening and ovulation within 7 days. Morphological maturation of LHRH
      neurons was assessed by the relative frequency of irregular and smooth neurons
      (the former being the predominant type in adult animals). Within 20 h after the
      lesion, there was a significant decrease in the proportion of LHRH neurons with
      spiny irregular contours, indicating reversal to a more immature morphological
      type. This change was followed by accelerated spine reformation, so that at the
      time of precocious proestrus, the incidence of irregular LHRH neurons was similar
      in lesioned and age-matched control rats. A striking increase in c-fos mRNA
      levels occurred within 1 h after the lesion in the area neighboring the site of
      injury, reflecting the immediate cell response to trauma. Immunohistochemical
      localization of the c-fos protein, used to estimate changes in cellular activity
      at the single cell level, demonstrated c-fos induction in unidentified cells near
      the lesion and astrocytes, but not in LHRH neurons 20 h after injury. In
      contrast, a selective increase in c-fos expression was observed in LHRH neurons
      during the initiation of precocious puberty 5-7 days later at the time of the
      first proestrus. An increase in plasma LH associated with a drop in LHRH content
      in the median eminence and an increase in pro-LHRH precursor in the POA-AHA, with
      no changes in LHRH mRNA, was found to antedate the first preovulatory surge of
      gonadotropins in lesioned rats. Assessment of the changes in PC2 mRNA, which
      encodes a novel dibasic endoprotease presumptively involved in tissue-specific
      processing of a class of prohormones that includes pro-LHRH, showed that the
      content of PC2 mRNA in the AHA-POA increases during normal puberty, but not in
      lesioned animals, thus providing a potential explanation for the divergent
      changes in pro-LHRH and mature decapeptide found in lesioned rats.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1639025
TI  - Specific antibody to the thyrotropin receptor identifies multiple receptor forms
      in membranes of cells transfected with wild-type receptor complementary
      deoxyribonucleic acid: characterization of their relevance to receptor synthesis,
      processing, structure, and function.
AB  - An antibody to a peptide of the TSH receptor, residues 352-366 which are not
      present in gonadotropin receptors, specifically identifies three major forms of
      the receptor on Western blots of detergent-solubilized membrane preparations from
      Cos-7 cells transfected with full-length rat and human TSH receptor cDNA: 230,
      180, and 95-100 kilodaltons (kDa), based on simultaneously run protein standards.
      The 95- to 100-kDa protein is absent in cells transfected with a mutant receptor
      with no signal peptide and is sensitive to endoglycosidase-F. Its size is
      consistent with the sum of amino acids predicted from its cDNA sequence (84 kDa
      after subtracting the signal peptide) plus its carbohydrate content (14 kDa
      estimated from glycosylation mutants). It alone is absent in two deletion mutants
      that have lost TSH binding and activity after transfection: M1 missing residues
      37-121 and M2 missing residues 110-307. It, thus, appears to be the processed
      glycosylated functional receptor on the cell surface. The 230-kDa protein is a
      nonprocessed form of the receptor, as evidenced by its insensitivity to
      endoglycosidase-F and its continued presence in cells transfected with a mutant
      receptor with no signal peptide. It is the primary form identified in rat FRTL-5
      thyroid cells that have a functioning TSH receptor; it is not present in rat FRT
      thyroid cells with no functioning TSH receptor or receptor RNA. It appears,
      therefore, to be a early synthetic form of the functional TSH receptor. The 180
      kDa protein is endoglycosidase-F sensitive and appears to be a processed
      intermediate between the 230-kDa early synthetic form and the 95- to 100-kDa
      functional receptor, rather than a dimer of the latter. Thus, with decreases in
      size appropriate to a receptor monomer, it remains present in membranes from the
      M1 and M2 deletion mutants that contain the 230-kDa protein but are missing the
      95- to 100-kDa receptor form in association with lost TSH binding and activity
      after transfection. Minor receptor forms (54 kDa in rat receptor transfectants,
      54 and 48 kDa in human receptor transfectants) appear to be degraded forms of the
      processed and glycosylated 95- to 100-kDa receptor. The presence or absence of
      reducing agents in the detergent solubilization mixture does not change the
      pattern or amount of the receptor forms recognized by the antibody, including the
      54-kDa form; however, boiling does.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1639026
TI  - A study of the characteristics of hepatic iodothyronine 5'-monodeiodinase in
      various vertebrate species.
AB  - Rat type I iodothyronine 5'-monodeiodinase (5'-MD) has recently been shown to be
      a selenium-containing enzyme. In the present study we compared the
      characteristics of the 5'-MD from liver microsomes of rat, mouse, guinea pig,
      man, beef, pig, sheep, and chicken. Aurothioglucose (ATG), a known potent
      inhibitor of selenium-containing enzymes, was a consistent, very potent inhibitor
      of 5'-MD activity in all species studied, with a 50% inhibitory dose in the
      narrow range of 5.8-12 nM. ATG was also a potent and selective inhibitor of
      [125I]bromoacetyl T3 affinity labeling of 5'-MD. Thus, in the species studied,
      only one affinity-labeled band, which was selectively displaced by gold, was
      identified. The mol wt of the affinity-labeled proteins in various liver
      microsomal preparations ranged between 28-36 kilodaltons (kDa), and the ATG
      concentrations necessary for the inhibition of affinity labeling of microsomes
      with [125I]bromoacetyl T3 were comparable to those required for inhibition of the
      enzyme activity in all species except the pig. The pig liver microsomes
      demonstrated a dominant affinity-labeled 36-kDa band, but much higher ATG
      concentrations (micromolar) were required for inhibition of affinity labeling. In
      view of the potent inhibition of pig liver 5'-MD activity by ATG, it appears
      unlikely that this band in the pig corresponds only to the substrate-binding site
      of 5'-MD, but this issue requires further study. A synthetic peptide of 16 amino
      acids corresponding to the carboxy-terminal portion of rat 5'-MD was synthesized,
      and rabbits were immunized with the peptide-BSA conjugate. Western blot studies
      using the rabbit antiserum showed one specific 29-kDa band in rat liver and
      kidney microsomes and thyroid homogenate. No specific bands were observed in
      other adult rat tissues studied or in fetal rat liver. No specific bands were
      observed when Western blot studies with antibody against the carboxy-terminal
      portion of rat 5'-MD were performed in liver microsomes from species other than
      the rat. In conclusion, our studies indicate that selenium is a likely component
      of type I 5'-MD in all species studied. However, substantial structural
      differences exist between the rat type I 5'-MD and that in various other species.

PMID- 1639027
TI  - Hypoglycemic action of a novel constrained analog of human growth hormone-(6-13).
AB  - The amino-terminal region of human GH (hGH), in particular the amino acid
      sequence Leu-Ser-Arg-Leu-Phe-Asp-Asn-Ala[hGH-(6-13)], has been implicated as a
      functional region for the regulation of energy metabolism by exerting an insulin
      potentiating action on insulin-sensitive tissues. Recent structural studies have
      revealed that the cyclization of the aspartate (Asp11) residue to form the alpha
      aminosuccinimide (Asu11) ring is essential for the biological action of peptides
      related to this hGH fragment. The pharmacological application of these hGH-(6-13)
      peptides has been hindered by the vulnerability of the alpha-aminosuccinimide to
      hydrolytic modification leading to the loss of biological action. We have
      succeeded in stabilizing the structure of the Asu11-hGH-(6-13) peptide by
      replacing the alpha-aminosuccinimide ring with compatible and less rapidly
      metabolized gamma-lactam structures. In the present paper we report the
      bioactivity profile of an analog of hGH-(6-13) containing a gamma-lactam at
      residue position 11 that mimics the stereoelectronic and conformational
      characteristics of the alpha-aminosuccinimide ring. In vitro, the gamma-lactam11
      hGH-(6-13) peptide analog increased [14C]glucose incorporation into glycogen in
      muscles and conversion to lipid in adipose tissues. In vivo, the gamma-lactam11
      hGH-(6-13) peptide enhanced hypoglycemia during iv insulin tolerance tests. The
      results demonstrate that the gamma-lactam11-hGH-(6-13) peptide analog has similar
      biological properties to the Asu11-hGH-(6-13) peptide fragment, but with improved
      molecular stability and bioavailability.

PMID- 1639029
TI  - Expression of the growth hormone receptor and growth hormone-binding protein
      during pregnancy in the mouse.
AB  - A 20-fold increase in the relative expression of the hepatic GH-binding protein
      (GHBP)-encoding message between nonpregnant and 17-day pregnant mice was found.
      The hepatic GH receptor (GHR)-encoding message increased 8-fold between
      nonpregnant and pregnant mice. The increase in both messages began on day 9 of
      pregnancy. The steady state level of the GHBP-encoding message continued to
      increase steadily until day 17 of pregnancy; however, by day 13 of pregnancy, the
      steady state level of the GHR-encoding message reached a plateau that continued
      to day 17. The ratio between the GHBP- and GHR-encoding messages gradually
      increased during the second half of pregnancy, reaching a maximum on day 17.
      There was a 10- to 16-fold increase in GH-binding capacity in liver microsomes
      and a 30- to 50-fold increase in serum GH-binding capacity between nonpregnant
      and late pregnant mice. The increase in hepatic GH-binding capacity began on day
      9 of pregnancy and reached a plateau on day 11, which was maintained until the
      end of gestation. The increase in serum GH-binding capacity began on day 9 of
      pregnancy and continued to increase until day 17. No significant change in mouse
      (m) GHR (mGHR) or mGHBP affinity constants were observed between nonpregnant and
      pregnant mice; however, the mGHR had a 20-fold greater affinity for mGH than did
      the mGHBP. The serum GH concentration increased in the second half of pregnancy.
      The GHBP-bound and the free fractions of GH during pregnancy were predicted.
      While the bound fraction of GH is predicted to parallel the total GH
      concentration measured by RIA, the concentration of free mouse GH remains
      unchanged during pregnancy.

PMID- 1639028
TI  - Mullerian inhibiting substance messenger ribonucleic acid expression in granulosa
      and Sertoli cells coincides with their mitotic activity.
AB  - In males, Mullerian inhibiting substance (MIS) mRNA was first detected on the
      medial aspect of the urogenital ridge early on the morning of day 13 of gestation
      before testicular differentiation was evident, and localized to the more obvious
      Sertoli cells later on embryonic day 13. MIS transcripts remained at maximal
      levels between 14.5 and 17.5 days gestation, while the Mullerian duct involutes,
      and remained high until birth. MIS gene expression decreased progressively after
      birth and, as germ cell meiosis increased, became barely detectable in the
      Sertoli cells of the seminiferous tubules. In female rats, MIS mRNA was first
      detected in the single layer of cuboidal granulosa cells surrounding larger
      primary follicles 3 days after birth, coincident with the initiation of
      follicular growth. As follicular growth progressed, MIS mRNA expression was high
      in preantral and small antral follicles, especially in those granulosa cells
      closest to the oocyte. MIS mRNA expression decreased gradually in larger antral
      follicles, remaining prominent only in the cumulus cells and the dividing
      population of granulosa cells closest to the lumen. MIS gene expression was
      absent in follicles with features of atresia and in the larger antral follicles.
      The expression of MIS mRNA in actively dividing Sertoli and granulosa cells
      correlates with the stages of germ cell division. These findings are suggestive
      of a role for MIS in the control of germ cell maturation.

PMID- 1639031
TI  - Effect on insulin production sorting and secretion by major histocompatibility
      complex class II gene expression in the pancreatic beta-cell of transgenic mice.
AB  - Expression of major histocompatibility complex (MHC) class II protein in islet
      beta-cells of transgenic mice causes severe diabetes without an attendant
      autoimmune component. Little is known of the aberrant beta-cell function and site
      of biological lesions responsible for the diabetic state. Therefore, changes in
      (pro)insulin production, processing, sorting, storage, and secretion were
      evaluated using the in vitro perfused pancreas from male hyperglycemic BALB/cBYJ
      Tg (O pinsproA alpha d pinsproA beta d) mice and a RIA capable of detecting mouse
      insulin or proinsulin with quantitative equivalency. Results were compared to
      control pancreases from normal BALB/cBYJ mice. Extractable pancreatic insulin
      plus proinsulin content in the transgenics was 4% of normal. Normal pancreases
      responded characteristically with a diphasic insulin release during 30-min
      stimulation by glucose, a response that was enhanced by subsequent forskolin. In
      contrast, hormone release from transgenic pancreases was undetectable; based on
      the sensitivity of the immunoassay, fractional secretion of the residual
      pancreatic hormone content from the transgenic pancreases was less than 25% of
      normal. Proinsulin or insulin constitutive release was also not detected in the
      absence or presence of glucose-containing stimuli even when experiments were
      extended to 3 h. In contrast, fractional secretion in response to nonglucose
      stimuli (carbachol-leucine and arginine-leucine) was greater than normal from the
      transgenic diabetic pancreases. Responses to glucose stimuli did not normalize
      even after 90 min in the absence of glucose. In other experiments, pancreases
      were stimulated with carbachol/leucine/forskolin for 90 min, and the proportion
      of proinsulin to insulin released by the regulated pathway was determined after
      Sep-Pak and HPLC separation of combined eluates. Proinsulin was undetectable
      (and, therefore, accounted for less than 10% of the total hormone secretion). It
      is concluded from the observations of hyperglycemia, low pancreatic insulin
      content, and impaired release that insulin production in the pancreas of the MHC
      diabetic transgenic is severely depressed. The limited insulin production and
      chronic hyperglycemia do not (as speculated) cause missorting to a constitutive
      pathway or impaired conversion of proinsulin to insulin, since a proportionately
      increased proinsulin release does not occur. Although the response of the
      secretory process to glucose-containing stimuli is almost completely destroyed,
      fractional secretion in response to nonglucose stimuli is enhanced. The possible
      contribution of hyperglycemia-induced beta-cell desensitization or specific
      lesions in the glucose recognition signals induced by MHC expression are
      discussed. Results suggest that expression of MHC class II protein causes highly
      specific beta-cell lesions which, in themselves, could be a contributing factor
      in human insulin-dependent diabetes.

PMID- 1639030
TI  - Mechanism of action of estrogen on intramembranous bone formation: regulation of
      osteoblast differentiation and activity.
AB  - Dynamic bone histomorphometry, [3H]thymidine radioautography, and Northern
      analysis for bone matrix proteins and insulin-like growth factor-I (IGF-I) were
      performed in calvariae of ovariectomized (OVX) and estrogen-treated OVX rats.
      Treatment of OVX rats with diethylstilbestrol (DES) for 2 weeks reduced the
      periosteal mineral apposition rate, osteoblast number, and osteoblast size in
      calvarial periosteum. DES treatment also reduced the number of preosteoblasts in
      the S phase of the cell cycle, suggesting that the decrease in osteoblast number
      was due in part to inhibition of proliferation of osteoprogenitor cells. One week
      after ovariectomy, there were small increases in mRNA levels for pre pro-alpha 2
      (I) subunit of type I collagen (collagen), osteocalcin, and osteonectin and a
      large increase in the mRNA level for IGF-I. DES treatment resulted in rapid
      decreases (3 h) in the mRNA levels for osteonectin, osteocalcin, and IGF-I. In
      contrast, mRNA levels for collagen were virtually unchanged after short term DES
      treatment. Uterus and liver served as positive and negative control tissues,
      respectively, for the effects of DES on IGF-I mRNA levels in OVX rats; mRNA
      levels were increased in uterus and decreased in liver after hormone treatment.
      We conclude from these studies that estrogen reduces periosteal bone formation by
      inhibiting both the differentiation and activity of osteoblasts. Furthermore,
      down-regulation of mRNA levels for IGF-I and bone matrix proteins precedes the
      changes in dynamic bone histomorphometry.

PMID- 1639032
TI  - Expression of epidermal growth factor (EGF) receptor and its ligands, EGF and
      transforming growth factor-alpha, in human fallopian tubes.
AB  - Although human uterus is known to contain epidermal growth factor (EGF) and its
      receptors, it is virtually unknown whether human fallopian tubes, which are an
      anatomical continuation of the uterus, also contain them. Therefore, the present
      studies investigated whether EGF and its structural and functional homolog, i.e.
      transforming growth factor-alpha (TGF-alpha), and their common receptor are
      expressed in human fallopian tubes. Human fallopian tubes contain major 10.5
      kilobase (kb) and minor 6.0-kb receptor messenger RNA (mRNA) transcripts, a
      single 5.0-kb EGF mRNA transcript, and a single 170-kilodalton receptor protein.
      The transcripts, along with their corresponding proteins and TGF-alpha protein,
      are present in ciliated and nonciliated epithelial cells, tubal smooth muscle,
      vascular smooth muscle, and endothelium. The cellular distribution and
      reproductive state dependency of these three regulatory molecules varied. For all
      of them, however, ampullary segments contained more than isthmus; proliferative
      phase and/or postpartum specimens contained more than secretory phase; and
      postmenopausal specimens contained the lowest amounts. The cell periphery and
      nuclear/perinuclear area of the cells contained EGF, TGF-alpha, and their
      receptors. Immunogold electron microscopy showed the receptors to be present in
      cell membranes, cilia, basal bodies which control ciliary activity, endoplasmic
      reticulum, nuclear membranes, and chromatin. In summary, human fallopian tubes
      contain EGF, EGF/TGF-alpha receptor mRNA and protein, and TGF-alpha protein. The
      expression of all these regulatory molecules was dependent on anatomical region,
      cell type, and reproductive state of the fallopian tubes. These findings suggest
      that EGF and TGF-alpha may regulate numerous tubal functions, thus potentially
      influencing fertility in women.

PMID- 1639033
TI  - Quantification of vasoactive intestinal peptide immunoreactivity in the anterior
      pituitary glands of intact male and female, ovariectomized, and estradiol
      benzoate-treated rats.
AB  - There are considerable data suggesting that vasoactive intestinal peptide (VIP)
      is involved in the regulation of PRL secretion; however, the role and cell of
      origin of anterior pituitary VIP remain to be determined. Immunocytochemical
      (ICC) studies have generally failed to detect VIP-immunoreactive (IR) cells in
      the pituitary of the untreated rat, although VIP-IR cells have been observed in
      the pituitaries of hypothyroid or estrogen-treated rats. This study was designed
      to examine the cellular distribution and tissue content of VIP in the anterior
      pituitary gland of rats under selected endocrine conditions known to alter the
      rates of PRL and VIP synthesis and secretion. To this end, anterior pituitary VIP
      and PRL content (ICC and RIA) and serum PRL levels were determined in
      ovariectomized (OVX) and OVX rats 3 days after treatment with 7 or 70 micrograms
      estradiol benzoate (EB). For comparison, pituitary VIP and PRL content (ICC and
      RIA) and serum PRL levels in untreated male and diestrous female rats were
      determined. Immunostaining for VIP was accomplished using a newly developed
      primary antiserum. Significant numbers of VIP-IR cells per 5-microns section were
      found in the anterior pituitary glands of all animals examined (275 +/- 33 in
      diestrous to 481 +/- 103 cells in male rats). VIP was not colocalized with PRL in
      any of the pituitaries regardless of steroid treatment or sex. Furthermore, the
      number of VIP-IR cells per pituitary gland was not significantly correlated with
      sex or EB treatment. Treatment with 70 micrograms, but not 7 micrograms, EB
      significantly increased the pituitary content of VIP and serum PRL levels
      compared to those after ovariectomy. However, both EB treatments resulted in a
      significant increase in pituitary PRL content compared to that in untreated OVX
      rats. Pituitaries from male rats had several-fold more VIP and less PRL content
      than pituitaries from diestrous rats. These data show that 1) in contrast to
      previous ICC studies, VIP-IR cells are readily detected in the anterior pituitary
      of intact male and female and OVX as well as EB-treated rats; 2) VIP is localized
      to cells other than lactotrophs, regardless of the steroid background; and 3)
      marked changes in anterior pituitary VIP content are not accompanied by changes
      in VIP-IR cell number.

PMID- 1639034
TI  - Tissue-specific distribution of the NAD(+)-dependent isoform of 11 beta
      hydroxysteroid dehydrogenase.
AB  - 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) converts the active
      glucocorticoid corticosterone to inactive 11-dehydrocorticosterone in rat (or
      cortisol to cortisone in man), thereby protecting renal mineralocorticoid
      receptors from corticosterone or cortisol and allowing preferential access for
      aldosterone. Recent work suggests that a nicotinamide adenine dinucleotide (NAD+)
      dependent 11 beta-OHSD isoform is expressed in distal renal tubule, in contrast
      with the hepatic isoform which is NAD(+)-phosphate (NADP+)-dependent. To
      establish the distribution of the NAD(+)-dependent isoform we measured in vitro
      conversion of [3H]corticosterone to [3H]11-dehydrocorticosterone in homogenized
      rat tissues in the presence of NADP+ or NAD+. In most tissues (liver, testis,
      hippocampus, heart, aorta, mesenteric artery) NADP+ increased activity and NAD+
      was without effect. However, in whole renal cortex, colon, placenta, and lung
      both NADP+ and NAD+ increased activity. No difference in cofactor utilization was
      demonstrated between proximal and distal renal tubules following density gradient
      separation. This distribution of NAD(+)-dependent activity corresponds with: (i)
      the distribution of multiple mRNA and/or protein species of 11 beta-OHSD; (ii)
      the distribution of aldosterone-specific mineralocorticoid receptors; and (iii)
      the equilibrium between active and inactive glucocorticoids in each tissue. We
      suggest that the tissue-specific expression of isoforms of 11 beta-OHSD with
      different kinetic properties confers on them diverse roles in modulating
      corticosteroid receptor activation.

PMID- 1639035
TI  - Evidence for a rapid stimulation of tyrosine kinase activity by prolactin in Nb2
      rat lymphoma cells.
AB  - Studies were designed to determine if the activation of tyrosine kinases may be
      involved in the signal transduction pathway for PRL. Tyrosyl phosphorylation of
      cellular proteins was evaluated by western blot analysis of Nb2 cell proteins
      employing an antibody to phosphotyrosine. Physiological concentrations of ovine
      PRL (oPRL) had a pronounced effect on the tyrosyl phosphorylation of a 121 kDa
      protein. Increased tyrosyl phosphorylation of the 121 kDa protein was detectable
      with concentrations of oPRL as low as 0.5 ng/ml. Consistent with oPRL acting
      through a PRL receptor, hGH also stimulated tyrosyl phosphorylation of the 121
      kDa protein when tested at concentrations between 5 and 20 ng/ml. In time course
      experiments, increased tyrosyl phosphorylation of the 121 kDa protein was
      apparent after a 5 min incubation with 20 ng/ml hGH, and maintained for at least
      one h. At higher concentrations of hGH (200 ng/ml), increased phosphorylation of
      the 121 kDa protein was clearly evident after only 1 min, indicating that tyrosyl
      phosphorylation of cellular proteins is an early event following ligand binding
      to the PRL receptor. Increased tyrosyl phosphorylation of proteins of 40, 90 and
      55-65 kDa was also evident after incubation with hGH for 10, 10, and 60 min
      respectively. These findings are consistent with PRL-dependent tyrosine kinase
      activation being an early and perhaps initiating event in the signal transduction
      pathway for PRL in Nb2 cells.

PMID- 1639036
TI  - Hypothyroidism increases vasoactive intestinal polypeptide (VIP) immunoreactivity
      and gene expression in the rat hypothalamic paraventricular nucleus.
AB  - Vasoactive intestinal polypeptide (VIP) is produced by neurons in the rat
      hypothalamic paraventricular nucleus (PVN) and may have an important role as a
      prolactin-releasing factor. Recent work from our laboratories has shown that
      thyroid hormone regulates the content of VIP and VIP mRNA in the rat anterior
      pituitary, but its effect on VIP in the PVN is not known. To determine whether
      thyroid hormone alters VIP biosynthesis in the PVN, we studied the effect of
      hypothyroidism on the content of immunoreactive (IR)-VIP and VIP mRNA in PVN
      neurons using histochemical techniques. By immunocytochemistry, only scattered IR
      VIP fibers were present in the PVN of control animals whereas IR-VIP perikarya
      and fibers were present in hypothyroid rats. By in situ hybridization
      histochemistry, no labeled neurons were recognized in the PVN in control animals
      whereas PVN neurons were labeled in hypothyroid rats. These findings raise the
      possibility that hypothyroidism exerts negative feedback regulation on VIP
      producing neurons in the PVN and suggest that this may be important to modulate
      the stimulatory effects of VIP on anterior and/or posterior pituitary function.

PMID- 1639037
TI  - Transcriptional regulation of prolactin receptor gene expression by sodium
      butyrate in MCF-7 human breast cancer cells.
AB  - The prolactin receptor (PRLR) mediates the diverse effects of prolactin, which in
      the mammary gland include the development of lobuloalveolar structures and
      increased tumor cell proliferation. Treatment of mammary carcinoma cells with the
      differentiating agent sodium butyrate (NaB) is known to reduce PRLR binding
      activity and PRLR gene expression, however the mechanism which mediates these
      changes is unknown, prompting this investigation. Using MCF-7 human breast cancer
      cells, assay of the rate of PRLR gene transcription by the nuclear run-on
      technique indicated that 3 mM NaB reduced PRLR gene transcription by 50% after 3
      h of treatment and that this effect was maintained for at least 24 h. The protein
      synthesis inhibitor cycloheximide failed to abrogate this effect, which indicated
      that NaB did not require continuing protein synthesis to reduce the rate of PRLR
      transcription. Measurement of PRLR mRNA stability, using Northern blot analysis
      at various times after the inhibition of transcription with actinomycin D, showed
      that NaB treatment did not alter PRLR mRNA half-life. These results indicate that
      NaB inhibits PRLR gene expression by a transcriptional mechanism that does not
      require continuing protein synthesis.

PMID- 1639038
TI  - Citation for the Ernst Oppenheimer Award of the Endocrine Society to James Larry
      Jameson.

PMID- 1639039
TI  - Citation for the Richard E. Weitzman Memorial Award to Fred E. Cohen.

PMID- 1639040
TI  - Citation for the Fred Conrad Koch Award of the Endocrine Society to Melvin M.
      Grumbach and Selna L. Kaplan.

PMID- 1639041
TI  - Citation for the Edwin B. Astwood Lectureship of the Endocrine Society to Michael
      O. Thorner.

PMID- 1639042
TI  - Citation for the Sidney H. Ingbar Distinguished Service Award to Nettie Karpin.

PMID- 1639043
TI  - Citation for the Robert H. Williams Distinguished Leadership Award to Claude J.
      Migeon.

PMID- 1639044
TI  - Citation for the Rhone-Poulene Rorer Pharmaceutical Clinical Investigator Award
      of the Endocrine Society to Samuel S.C. Yen.

PMID- 1639045
TI  - Effect of diet on glucose tolerance 36 hours after glycogen-depleting exercise.
AB  - In order to estimate the effect of muscle glycogen content on the glycaemic
      response, glucose tolerance and glucose oxidation were measured in eight healthy
      male subjects. Each subject followed three different treatments, consisting of
      either a physical exercise session followed by 36 h of a low-carbohydrate high
      fat diet (glycogen depletion treatment); or a physical exercise followed by 36 h
      of a high carbohydrate diet (glycogen repletion treatment); or a low-carbohydrate
      high-fat diet alone (diet treatment). After both the glycogen depletion and the
      diet treatments, the subjects showed a high glycaemic response (443 +/- 57 and
      419 +/- 63 mmol.min/l resp.), a high insulinaemic response (7158 +/- 671 and 7643
      +/- 913 mU.min/l), and a low rate of glucose oxidation (27.5 +/- 2.4 and 31.0 +/-
      5.8 g/3 h respiration). In contrast, after the glycogen repletion treatment, the
      subjects had a lower glycaemic response (197 +/- 21 mmol.min/l), a lower
      insulinaemic response (4645 +/- 327 mU.min/l) and a higher glucose oxidation
      level (47.4 +/- 2.0 g/3h). Fasting free fatty acids (FFA) were positively
      correlated with glucose area (P less than 0.001) and negatively with glucose
      oxidation (P less than 0.01). These results show a strong inhibitory effect of
      the low-carbohydrate high-fat diet on glucose tolerance despite prior strenuous
      exercise. Because of this, the effect of the muscle glycogen content could not be
      tested. However, the results suggest that the FFA/glucose interrelationship may
      override exercise-induced changes in insulin-stimulated glucose uptake.

PMID- 1639046
TI  - Dietary intervention in breast cancer patients: effects on food choice.
AB  - Effects of dietary intervention on food choice were studied in 240 women aged 50
      65 years who had been operated for a stage I-II breast cancer. Following surgery,
      the women participated in a dietary history interview and were then randomized to
      one of two groups. The intervention group (n = 121) received individual dietary
      counselling aimed at reducing dietary fat intake to 20-25% energy (E%), whereas
      no dietary advice was given to women in the control group (n = 119). For the 52%
      of the women in the intervention group that completed the study the total fat
      intake decreased from 36 to 23 E% (P less than or equal to 0.01) and from 37 to
      34 E% (P less than or equal to 0.01) for the control group. There were
      significant reductions in the intake of table fat, high-fat milk products, pork
      and sausages (containing greater than 11% fat), eggs, rice, pasta, cakes and
      chocolate for the intervention group. Concurrently the intake of vegetables,
      fruits, potatoes, bread, cereals, low-fat milk products, low-fat meat, sausages
      and fish increased significantly. For the control group there was a significant
      decrease in the consumption of total milk products, total meats, rice, pasta,
      cakes, and butter intake while the consumption of vegetables, fruits, cereals and
      fish increased (P less than or equal to 0.01). Reduction of high-fat foods and
      increases of carbohydrate-rich foods were more pronounced for the intervention
      group than for the control group. Formal education influenced dietary changes,
      and dietary counselling should therefore ideally be adapted to education level.
      This study showed that dietary counselling can bring about significant changes in
      consumption of high-fat foods for at least a 2-year period for women operated for
      breast cancer.

PMID- 1639047
TI  - Salmon diet and human immune status.
AB  - We examined the effect of feeding a salmon-containing diet on the immune status
      of nine healthy men (age 30-65 years) who lived at the metabolic suite of the
      Western Human Nutrition Research Center for 100 days. During the first 20 days
      all nine subjects consumed a basal diet (BD). For the next 40 days, three
      subjects continued to consume BD, while the diet of remainder six subjects was
      modified to contain 500 g salmon every day. During the last 40 days, the diets of
      the two groups were crossed over. Feeding 500 g salmon daily for 40 days did not
      significantly suppress the blastogenesis of peripheral blood mononuclear cells
      cultured with phytohemagglutinin, Concanavalin A, protein A or pokeweed when
      compared to the corresponding pre-salmon diet values. It also did not
      significantly affect the delayed hypersensitivity skin response to seven recall
      antigens, serum concentrations of immunoglobulins G, M, and A, and complement
      fractions C3 and C4. Our results indicate that the short-term consumption of a
      high fish (salmon)-containing diet does not adversely affect the immune system,
      as has been reported with fish oil supplements.

PMID- 1639048
TI  - Urea kinetics: comparison of oral and intravenous dose regimens.
AB  - Urea kinetics were measured on two separate occasions in five adults with normal
      haemoglobin genotype (HbAA) and in four who were homozygous for sickle cell
      disease (HbSS). Prime/intermittent doses of [15N15N]urea were given orally on one
      occasion and intravenously on the other. In three of the nine individuals there
      appeared to be significant hydrolysis of the oral dose of urea before absorption,
      leading to spurious results for the urea kinetics. When only the studies in which
      isotope was given intravenously were considered, there was a difference in the
      rate at which urea-N was salvaged, with more urea-N being salvaged by HbSS
      subjects than HbAA. It is concluded that the oral presentation of isotope can be
      used to measure urea kinetics provided care is taken to exclude those subjects
      who are likely to display upper intestinal hydrolysis, and that there are
      differences in aspects of urea kinetics between HbAA and HbSS which may be of
      metabolic importance.

PMID- 1639049
TI  - Protein turnover in pregnancy.
AB  - Whole-body protein metabolism was studied at 13, 24 and 35 weeks gestation in six
      healthy women using a continuous infusion [13C]leucine technique. Values were
      expressed in terms of fat-free body weight (FFM) calculated using literature
      standards for changes in total body potassium during pregnancy. Mean protein
      synthesis increased from 5.3 (+/- 0.6 SD) g/kg FFM/24h at 13 weeks to 5.9 +/- 0.5
      (P less than 0.1) at 24 weeks and 6.1 +/- 0.6 at 35 weeks (P less than 0.05 vs 3
      weeks). Similar increases were noted in catabolism so that net loss changed
      little. Protein synthesis at 24 and 35 weeks gestations was significantly greater
      than that in 17 healthy, non-pregnant women (4.9 +/- 0.6, P less than 0.001).
      These data indicate that there are substantial increases in protein turnover
      during pregnancy.

PMID- 1639050
TI  - Body mass index, body composition and the chronic energy deficiency
      classification of rural adult populations in Guatemala.
AB  - The present study tested the hypotheses that: (a) individual body composition
      estimates obtained with the Durnin-Womersley (D-W) equations have low validity in
      certain populations in developing countries; (b) there exists a poor relationship
      between the body mass index (BMI) and body composition estimates (fat mass (BFM)
      and fat-free mass (FFM)), and (c) BMI cut-off estimates (fat mass (BFM) and fat
      free mass (FFM)), and (c) BMI cut-off points provide an invalid classification of
      chronic energy deficiency (CED) in adults. The study involved four samples of
      rural men and women in Guatemala, who had mean BMI of approximately 21 kg/m2.
      Body composition estimates were obtained by densitometry in three of the samples.
      Mean body fat (%) and mean FFM (kg) were: men: 11.6 (+/- 4.7) and 47.7 (+/- 4.9);
      and women: 21.6 (+/- 5.3) and 35.8 (+/- 3.5), respectively. The D-W equations
      based on various combinations of skinfold measurements consistently overestimated
      body fat content with low precision and validity. The BMI was more related to BFM
      and FFM than to fat proportion, but explained little of the variation in both
      body components, particularly at low BMI levels. A small number of men and women
      had BMI values below 18.5 kg/m2, and only one woman fell below 16 kg/m2. The
      power coefficients of height in the weight/height ratio which provided the
      strongest correlations with BFM and FFM were: BFM: women: 1.0; men: 1.5; FFM: 0.5
      for both women and men. We conclude that the Quetelet index should not be
      recommended as a universally valid indicator to classify CED in adult groups
      similar to the study population.

PMID- 1639051
TI  - Should mono- or poly-unsaturated fats replace saturated fat in the diet?
AB  - The effects of diets differing in saturated, monounsaturated and polyunsaturated
      fatty acid composition (SAFA, MUFA and PUFA, respectively) on plasma lipoproteins
      and factor VIIc were investigated in 28 middle-aged men and women with mild to
      moderate hyperlipidaemia. The subjects were stabilized on a diet with a total fat
      content fairly typical of New Zealand, containing approximately 40% energy as
      fat, before entering a randomized cross-over trial of diets high in PUFA (20%
      energy; SAFA and MUFA 10% each) or a high MUFA diet (20% energy; SAFA and PUFA
      10% each). After 6-week periods on each diet the subjects returned to a high SAFA
      diet. Body weight and blood pressure remained unchanged during the study. Total
      and LDL cholesterol, HDL cholesterol and the HDL2 subfraction were significantly
      lower on both the MUFA and the PUFA diet than on SAFA. However, there were no
      statistically significant differences in lipoprotein concentrations on the MUFA
      and PUFA diet. Factor VIIc concentrations were similar on the three diets. The
      proportion of PUFA in a MUFA diet appears to be a major determinant of the
      relative lipoprotein response to such a diet. In order to avoid a reduction in
      HDL-C when replacing SAFA with MUFA it may be necessary to ensure that PUFA does
      not provide more than about 8% total energy. Thus careful planning is needed to
      identify the most appropriate foods to replace those rich in SAFA in diets
      designed to reduce the lipoprotein-mediated risk of coronary heart disease.

PMID- 1639052
TI  - Lack of therapeutic efficacy of vitamin A for non-cholera, watery diarrhoea in
      Bangladeshi children.
AB  - Vitamin A deficiency has been postulated to increase childhood mortality,
      possibly through increasing the severity and case-fatality of infectious diseases
      like diarrhoea. A clinical trial was conducted to measure the effect of vitamin A
      therapy on the severity and duration of acute episodes of non-cholera, watery
      diarrhoea; 83 children with less than 48 h of illness were randomized to receive
      vitamin A (200,000 IU of retinyl palmitate) orally or placebo during
      hospitalization at the International Centre for Diarrhoeal Disease Research in
      Bangladesh. The patients were similar initially with regard to age, nutritional
      status and severity of diarrhoea prior to admission. No adverse effects of
      vitamin A were detected. During hospitalization there were no differences between
      groups in duration of illness or stool output. Thus, vitamin A can be given
      safely during diarrhoeal illness to augment hepatic reserves and possibly provide
      a beneficial effect in regard to subsequent episodes of diarrhoea and other
      infections, but this supplementation should not be expected to have a therapeutic
      effect on a current episode.

PMID- 1639053
TI  - Supplementation with selenium-rich bread does not influence platelet aggregation
      in healthy volunteers.
AB  - In order to establish the effect of an increased dietary selenium supply on
      platelet glutathione peroxidase (EC 1.11.1.9.; GSH-Px) and platelet aggregation,
      six healthy subjects were supplemented with 200 micrograms Se as Se-rich bread
      for 6 weeks. Another six subjects received low-Se bread and served as controls.
      Platelet GSH-Px activity increased significantly in the supplementation group,
      whereas no effect could be observed on platelet aggregation. The results of this
      study do not support the hypothesis that an increased dietary Se intake has a
      favourable influence on platelet aggregation.

PMID- 1639054
TI  - Tumour regression following chemotherapy does not increase food intake.
AB  - Forty-six patients with cancer of the breast, ovary or lung (small cell) were
      followed for 5 months after initiation of cyclical chemotherapy to examine if any
      changes in voluntary food intake or nutritional status were related to treatment
      response. The study showed a slight decrease in protein (P less than 0.05) and
      energy intake (not significant) at 3 months compared to pretreatment intakes in
      31 patients with objective tumour regression. In 15 non-responding patients no
      changes were demonstrated. There were no changes in anthropometric status related
      to treatment response. Despite the lower protein intake in treatment responders p
      albumin increased significantly compared to pretreatment value. Thus, initially
      successful chemotherapeutic treatment is not automatically followed by improved
      nutrition, and many of these patients are potential candidates for early dietary
      intervention.

PMID- 1639055
TI  - Studies on the expression of the pufX polypeptide and its requirement for
      photoheterotrophic growth in Rhodobacter sphaeroides.
AB  - The puf operon in Rhodobacter sphaeroides contains the genes for the light
      harvesting antenna complex I (LHI), the reaction centre (RC) L and M subunits and
      an additional small open reading frame identified as pufX. It has been
      demonstrated before that a photosynthetically incompetent pufLMX deletion strain
      was not complemented by a plasmid-borne truncated puf operon version lacking only
      pufX, although expression of the pufL and pufM gene products was restored. We
      demonstrate here that the functional reinsertion of only the pufX open reading
      frame into the same construct is sufficient and necessary for complementation of
      the non-photosynthetic phenotype. We also demonstrate that the observed lack of
      photoheterotrophic growth in the absence of pufX is not the result of decreased
      light-harvesting ability, but rather the result of an impairment in light-driven
      cyclic electron transfer. Western blots using polyclonal antibodies against a
      synthetic peptide corresponding to a portion of the DNA-derived pufX amino acid
      sequence showed that the pufX open reading frame is expressed and that the gene
      product has an M(r) of 8-10,000 on SDS gels; a value close to the predicted mass
      of 9 kDa. The pufX polypeptide was localized to the intracytoplasmic membrane
      fraction and appeared to co-purify with the RC-LHI complex. It is suggested that
      the pufX polypeptide is associated with the RC-LHI complex and that it may play a
      critical role in facilitating the interaction between this complex and other
      components required for light-driven cyclic electron transfer.

PMID- 1639056
TI  - A role for clathrin in the sorting of vacuolar proteins in the Golgi complex of
      yeast.
AB  - We have investigated the role of clathrin in vacuolar protein sorting using yeast
      strains harboring a temperature-sensitive allele of clathrin heavy chain (chc1
      ts). After a 5 min incubation at the non-permissive temperature (37 degrees C),
      the chc1-ts strains displayed a severe defect in the sorting of lumenal vacuolar
      proteins. Sorting of a vacuolar membrane protein, alkaline phosphatase, and
      transport to the surface of a cell wall protein, was not affected at 37 degrees
      C. In chc1-ts cells incubated at 37 degrees C, secretion of the missorted lumenal
      vacuolar protein carboxypeptidase Y (CPY) was blocked by the sec1 mutation which
      prevents fusion of secretory vesicles to the plasma membrane. Unexpectedly, chc1
      ts cells incubated for extended periods at 37 degrees C regained the ability to
      sort CPY. Cells carrying deletions of the CHC1 gene (chc1 delta) also sorted CPY
      to the vacuole even when subjected to temperature shifts. Vacuolar delivery of
      CPY in chc1 delta cells was not blocked by sec1 suggesting that transport does
      not occur by secretion and endocytosis. These results provide in vivo evidence
      that clathrin plays a role in the Golgi complex in sorting of vacuolar proteins
      from the secretory pathway. With time, however, yeast cells lacking functional
      clathrin heavy chains are able to adapt in a way that allows restoration of
      vacuolar protein sorting in the Golgi complex. These conclusions clarify previous
      studies of chc1 delta cells which raised the possibility that clathrin is not
      involved in vacuolar protein sorting.

PMID- 1639057
TI  - Signal peptidase I of Bacillus subtilis: patterns of conserved amino acids in
      prokaryotic and eukaryotic type I signal peptidases.
AB  - Signal peptidases (SPases) remove signal peptides from secretory proteins. The
      sipS (signal peptidase of subtilis) gene, which encodes an SPase of Bacillus
      subtilis, was cloned in Escherichia coli and was also found to be active in
      E.coli. Its overproduction in B.subtilis resulted in increased rates of
      processing of a hybrid beta-lactamase precursor. The SipS protein consisted of
      184 amino acids (mol. wt 21 kDa). The protein showed sequence similarity with the
      leader peptidases of E.coli and Salmonella typhimurium, and the mitochondrial
      inner membrane protease I of Saccharomyces cerevisiae. Patterns of conserved
      amino acids present in these four proteins were also detected in the Sec11
      subunit of the SPase complex of S.cerevisiae and the 18 and 21 kDa subunits of
      the canine SPase complex. Knowledge of the sequence of SipS was essential for the
      detection of these similarities between prokaryotic and eukaryotic SPases. The
      data suggest that these proteins, which have analogous functions, belong to one
      class of enzymes, the type I SPases.

PMID- 1639058
TI  - Stable surface expression of invariant chain prevents peptide presentation by HLA
      DR.
AB  - Class II major histocompatibility complex (MHC) molecules are cell surface
      glycoproteins that bind and present immunogenic peptides to T cells.
      Intracellularly, class II molecules associate with a polypeptide referred to as
      the invariant (Ii) chain. Ii is proteolytically degraded and dissociates from the
      class II complex prior to cell surface expression of the mature class II alpha
      beta heterodimer. Using human fibroblasts transfected with HLA-DR1 and Ii cDNAs,
      we now demonstrate that truncation of the cytoplasmic domain of Ii results in the
      failure of Ii to dissociate from the alpha beta Ii complex and leads to stable
      expression of class II alpha beta Ii complexes on the cell surface. Furthermore,
      biochemical analysis and peptide presentation assays demonstrated that
      transfectants with stable surface alpha beta Ii complexes expressed very few free
      alpha beta heterodimers at the surface and were very inefficient in their ability
      to present immunogenic peptides to T cells. These results support the hypothesis
      that the cytoplasmic domain of Ii is responsible for endosomal targeting of alpha
      beta Ii and directly demonstrate that association with Ii interferes with the
      antigen presentation function of class II molecules.

PMID- 1639059
TI  - RAS residues that are distant from the GDP binding site play a critical role in
      dissociation factor-stimulated release of GDP.
AB  - We have previously shown that a conserved glycine at position 82 of the yeast
      RAS2 protein is involved in the conversion of RAS proteins from the GDP- to the
      GTP-bound form. We have now investigated the role of glycine 82 and neighbouring
      amino acids of the distal switch II region in the physiological mechanism of
      activation of RAS. We have introduced single and double amino acid substitutions
      at positions 80-83 of the RAS2 gene, and we have investigated the interaction of
      the corresponding proteins with a yeast GDP dissociation stimulator (SDC25 C
      domain). Using purified RAS proteins, we have found that the SDC25-stimulated
      conversion of RAS from the GDP-bound inactive state to the GTP-bound active state
      was severely impaired by amino acid substitutions at positions 80-81. However,
      the rate and the extent of conversion from the GDP- to the GTP-bound form in the
      absence of dissociation factor was unaffected. The insensitivity of the mutated
      proteins to the dissociation factor in vitro was paralleled by an inhibitory
      effect on growth in vivo. The mutations did not significantly affect the
      interaction of RAS with adenylyl cyclase. These findings point to residues 80-82
      as important determinants of the response of RAS to GDP dissociation factors.
      This suggests a molecular model for the enhancement of nucleotide release from
      RAS by such factors.

PMID- 1639060
TI  - Identification of the binding interface involved in linkage of cytoskeletal
      protein 4.1 to the erythrocyte anion exchanger.
AB  - Linkages of the cytoskeleton to integral membrane proteins of the plasma membrane
      have been shown to be important for diverse cellular functions. The erythrocyte
      membrane provides the best studied example of how the spectrin-actin based
      membrane cytoskeleton is linked via two proteins, ankyrin and protein 4.1, to the
      anion exchanger (anion exchanger 1, AE1). Although these and other types of
      cytoskeleton-membrane connections have been well documented by in vitro binding
      studies it has not been possible to establish any of such interactions by
      defining the binding interface at the amino acid level. In the present study we
      have performed binding studies between protein 4.1 and AE1 using peptides and
      corresponding idiotypic and anti-idiotypic antibodies to show that arginine-rich
      clusters of the cytoplasmic domain of AE1 (IRRRY/LRRRY) serve as a major binding
      site for a motif with opposite charge and identical hydrophobicity present on the
      membrane-binding domain of protein 4.1 (LEEDY). Both motifs appear to be highly
      conserved during evolution and may also be involved in other types of
      cytoskeleton-membrane association, i.e. in binding of protein 4.1 to the
      glycophorins.

PMID- 1639061
TI  - Cytoplasmic calcium transients due to single action potentials and voltage-clamp
      depolarizations in mouse pancreatic B-cells.
AB  - Changes in the cytoplasmic free calcium concentration ([Ca2+]i) in pancreatic B
      cells play an important role in the regulation of insulin secretion. We have
      recorded [Ca2+]i transients evoked by single action potentials and voltage-clamp
      Ca2+ currents in isolated B-cells by the combination of dual wavelength emission
      spectrofluorimetry and the patch-clamp technique. A 500-1000 ms depolarization of
      the B-cell from -70 to -10 mV evoked a transient rise in [Ca2+]i from a resting
      value of approximately 100 nM to a peak concentration of 550 nM. Similar [Ca2+]i
      changes were associated with individual action potentials. The depolarization
      induced [Ca2+]i transients were abolished by application of nifedipine, a blocker
      of L-type Ca2+ channels, indicating their dependence on influx of extracellular
      Ca2+. Following the voltage-clamp step, [Ca2+]i decayed with a time constant of
      approximately 2.5 s and summation of [Ca2+]i occurred whenever depolarizations
      were applied with an interval of less than 2 s. The importance of the Na(+)-Ca2+
      exchange for B-cell [Ca2+]i maintenance was evidenced by the demonstration that
      basal [Ca2+]i rose to 200 nM and the magnitude of the depolarization-evoked
      [Ca2+]i transients was markedly increased after omission of extracellular Na+.
      However, the rate by which [Ca2+]i returned to basal was not affected, suggesting
      the existence of additional [Ca2+]i buffering processes.

PMID- 1639062
TI  - The mec-7 beta-tubulin gene of Caenorhabditis elegans is expressed primarily in
      the touch receptor neurons.
AB  - Mutants of the mec-7 beta-tubulin gene of Caenorhabditis elegans lack the large
      diameter 15-protofilament microtubules normally found only in the set of six
      touch receptor neurons. Both a mec-7-lacZ reporter gene and affinity-purified
      anti-mec-7 antibodies were used to show that mec-7 is expressed primarily in the
      touch neurons. These data are consistent with a possible instructive role for the
      mec-7 tubulin in determining microtubule protofilament number. The antibodies and
      the mec-7-lacZ transgene were also used to examine mec-7 expression in mutants
      affecting the generation, differentiation or maintenance of the touch neurons.
      Decreased expression was observed in mutants of unc-86 and mec-3, genes that
      encode transcription factors essential for touch receptor neuron generation and
      differentiation, respectively.

PMID- 1639063
TI  - A family of human cdc2-related protein kinases.
AB  - The p34cdc2 protein kinase is known to regulate important transitions in the
      eukaryotic cell cycle. We have identified 10 human protein kinases based on their
      structural relation to p34cdc2. Seven of these kinases are novel and the products
      of five share greater than 50% amino acid sequence identity with p34cdc2. The
      seven novel genes are broadly expressed in human cell lines and tissues with each
      displaying some cell type or tissue specificity. The cdk3 gene, like cdc2 and
      cdk2, can complement cdc28 mutants of Saccharomyces cerevisiae, suggesting that
      all three of these protein kinases can play roles in the regulation of the
      mammalian cell cycle. The identification of a large family of cdc2-related
      kinases opens the possibility of combinatorial regulation of the cell cycle
      together with the emerging large family of cyclins.

PMID- 1639064
TI  - The human p50csk tyrosine kinase phosphorylates p56lck at Tyr-505 and down
      regulates its catalytic activity.
AB  - Protein tyrosine kinases participate in the transduction and modulation of
      signals that regulate proliferation and differentiation of cells. Excessive or
      deregulated protein tyrosine kinase activity can cause malignant transformation.
      The catalytic activity of the T cell protein tyrosine kinase p56lck is normally
      suppressed by phosphorylation of a carboxyl-terminal tyrosine, Tyr-505, by
      another cellular protein tyrosine kinase. Here we characterize a human cytosolic
      50 kDa protein tyrosine kinase, p50csk, which specifically phosphorylates Tyr-505
      of p56lck and a synthetic peptide containing this site. Phosphorylation of Tyr
      505 suppressed the catalytic activity of p56lck. We suggest that p50csk
      negatively regulates p56lck, and perhaps other cellular src family kinases.

PMID- 1639065
TI  - Activation of mammalian DNA ligase I through phosphorylation by casein kinase II.
AB  - Mammalian DNA ligase I has been shown to be a phosphoprotein. Dephosphorylation
      of purified DNA ligase I causes inactivation, an effect dependent on the presence
      of the N-terminal region of the protein. Expression of full-length human DNA
      ligase I in Escherichia coli yielded soluble but catalytically inactive enzyme
      whereas an N-terminally truncated form expressed activity. Incubation of the full
      length preparation from E. coli with purified casein kinase II (CKII) resulted in
      phosphorylation of the N-terminal region and was accompanied by activation of the
      DNA ligase. Of a variety of purified protein kinases tested, only CKII stimulated
      the activity of calf thymus DNA ligase I. Tryptic phosphopeptide analysis of DNA
      ligase I revealed that CKII specifically phosphorylated a major peptide also
      apparently phosphorylated in cells, implying that CKII is a protein kinase acting
      on DNA ligase I in the cell nucleus. These data suggest that DNA ligase I is
      negatively regulated by its N-terminal region and that this inhibition can be
      relieved by post-translational modification.

PMID- 1639066
TI  - Mobile nucleosomes--a general behavior.
AB  - We have previously reported the mobility of positioned nucleosomes on sea urchin
      5S rDNA. In this study we demonstrate the temperature dependence and the range of
      this mobility on 5S rDNA constructs. We find that this dynamic behavior also
      applies to bulk mononucleosomes and nucleosomes reconstituted onto sequences of
      the Alu family of ubiquitous repeats. We conclude that short range sliding is
      potentially a general phenomenon that is dependent on the underlying sequence and
      its position on the histone octamer. The nucleoprotein gel analysis used also
      reveals the dramatic effect on gel electrophoretic migration caused by the
      location of the histone octamer on DNA fragments. The usefulness of this
      technique for studying nucleosome positioning and its dynamics is demonstrated.

PMID- 1639067
TI  - Identification of a stage selector element in the human gamma-globin gene
      promoter that fosters preferential interaction with the 5' HS2 enhancer when in
      competition with the beta-promoter.
AB  - The erythroid-specific enhancer within hypersensitivity site 2 (HS2) of the human
      beta-globin locus control region is required for high level globin gene
      expression. We investigated interaction between HS2 and the gamma- and beta
      promoters using reporter constructs in transient assays in human erythroleukemia
      (K562) cells. The beta-promoter, usually silent in K562 cells, was activated by
      HS2. This activity was abolished when a gamma-promoter was linked in cis.
      Analysis of truncation mutants suggested that sequences conveying the competitive
      advantage of the gamma-promoter for HS2 included those between positions -53 and 
      35 relative to the transcriptional start site. This sequence, when used to
      replace the corresponding region of the beta-promoter, increased beta-promoter
      activity 10-fold when linked to HS2. The modified beta-promoter was also capable
      of competing with a gamma-promoter modified internally in the -53 to -35 region,
      when the two promoters were linked to HS2 in a single plasmid. The corresponding
      sequences from the Galago gamma-promoter, a species which lacks fetal gamma-gene
      expression, were inactive in analogous assays. We have identified and partially
      purified a nuclear protein found in human (fetal stage) erythroleukemia cells,
      but present in much lower concentration in murine (adult stage) erythroleukemia
      cells, that binds the -53 to -35 sequence of the gamma-promoter. We speculate
      that this region of the gamma-promoter functions as a stage selector element in
      the regulation of hemoglobin switching in humans.

PMID- 1639068
TI  - Cell-specific transcription of the peripherin gene in neuronal cell lines
      involves a cis-acting element surrounding the TATA box.
AB  - Peripherin is a neurone-specific intermediate filament protein expressed mostly
      in the peripheral nervous system. To localize sequences that are important for
      the regulation of peripherin gene transcription, we have functionally dissected
      its promoter. Transfection into different cell lines and deletion mapping of
      peripherin-lacZ hybrid constructs indicated that the first 98 bp preceding the
      transcription start site of the gene were sufficient to confer cell-type specific
      expression. DNase I footprinting experiments revealed three protected sequences
      in this region, that were named PER1, PER2 and PER3. The PER2 and PER3 elements,
      localized between -98 to -46, interact with proteins that seem widely
      distributed. Deletion of these elements severely decreased the level of reporter
      gene activity. The PER1 element, which overlaps the TATA box, interacts with a
      DNA-binding protein prevailing in peripherin expressing cell lines. However, the
      core promoter, which contains the PER1 element, was inefficient in driving gene
      expression. Experiments designed to test the contribution of each element showed
      that PER2 and PER3 were important in determining the level of expression, while
      PER1 was important for cell-type specificity. In fact the polyoma virus enhancer
      linked to the peripherin gene core promoter was found to limit reporter gene
      activity to peripherin expressing cell lines. Together, these experiments
      indicate that co-operative interactions between different regions of the promoter
      are necessary for efficient and cell-type specific transcription of the
      peripherin gene in a subset of neuronal cells.

PMID- 1639069
TI  - Hepatitis B virus transactivator MHBst: activation of NF-kappa B, selective
      inhibition by antioxidants and integral membrane localization.
AB  - C-terminal truncation of the middle surface antigen from hepatitis B virus (MHBs)
      gives rise to a novel transactivating protein, called MHBst. In this study we
      show that MHBst like the HBx protein of HBV, can cause nuclear appearance of NF
      kappa B DNA binding activity and induce various kappa B-controlled reporter
      genes. While an inhibitor of protein kinase C could not block gene induction by
      MHBst, the antioxidants N-acetyl-L-cysteine (NAC) and pyrrolidine dithiocarbamate
      (PDTC) could potently suppress transactivation at mM and microM concentrations,
      respectively. Also, kappa B-dependent gene induction by the transactivator HBx
      was blocked. The effects were selective because PDTC did not interfere with MHBst
      and HBx-induced activation of the c-fos promoter/enhancer, nor with the basal
      activity of several other reporter genes lacking functional NF-kappa B binding
      motifs. Our data suggest that induction of a prooxidant state is crucial for the
      activation of NF-kappa B by MHBst and HBx and might be related to the
      hepatocarcinogenic potential of the viral proteins. MHBst had a subcellular
      localization unusual for a viral transactivator: it appeared to be an integral
      membrane protein of the endoplasmic reticulum.

PMID- 1639070
TI  - The NF-kappa B p50 precursor, p105, contains an internal I kappa B-like inhibitor
      that preferentially inhibits p50.
AB  - The p50 subunit of NF-kappa B is apparently synthesized as a precursor molecule
      of 105 kDa (p105); subsequent processing releases the amino-terminal p50
      polypeptide with rel homology, DNA binding activity and transcriptional
      activation potential. The carboxy-terminal region of p105 contains seven copies
      of an ankyrin-related sequence previously found in several genes involved in
      differentiation and cell cycle control. Two proteins with I kappa B activity, MAD
      3 and pp40, have been cloned and found to contain five obvious ankyrin repeats
      that align with those in the carboxy-terminus of p105. Both proteins target their
      inhibitory activity to the p65 subunit of NF-kappa B and to c-rel. Here we show
      that the bacterially expressed and purified carboxy-terminal region (CTR) of p105
      abolishes the binding of p50 homodimers to a kappa B motif but minimally affects
      the binding of p65 homodimers and NF-kappa B. By contrast, MAD-3 inhibits the
      binding of p65 and NF-kappa B but not p50. Both the CTR and MAD-3 interact with
      their respective targets through physical association both in vitro and in vivo.
      The CTR can be expressed as an independent entity and thus may play two roles, as
      a cis inhibitor built into the p105 molecule and as a trans regulator of p50.

PMID- 1639071
TI  - Ternary complex formation over the c-fos serum response element: p62TCF exhibits
      dual component specificity with contacts to DNA and an extended structure in the
      DNA-binding domain of p67SRF.
AB  - The serum response element (SRE) plays an essential role in the transcriptional
      regulation of proto-oncogene c-fos. A ternary complex, consisting of
      transcription factors p67SRF and p62TCF bound to the SRE is present in several
      cell types and its formation has been correlated with inducibility of the gene in
      different cells by serum, epidermal growth factor and phorbol esters. Interaction
      of p62TCF with the SRE in vitro exhibits both a degree of sequence specificity
      and a strict dependence on the presence of bound p67SRF. A 90 amino acid DNA
      binding domain of p67SRF (coreSRF) suffices for ternary complex formation. DNase
      I footprinting and UV-mediated DNA-protein crosslinking experiments presented
      here show that direct DNA contacts are made by p62TCF with the 5' sequence of the
      SRE and thus explain the sequence dependence of ternary complex formation.
      Additionally, analysis of ternary complex formation by chimaeras of coreSRF and
      the related yeast protein ArgRI as well as comprehensive mutagenesis of non
      conserved residues between the two proteins has yielded a coreSRF mutant
      specifically unable to interact with p62TCF and demonstrates that an extended
      structure in coreSRF is required for this interaction. Thus p62TCF exhibits dual
      component specificity in ternary complex formation over the c-fos SRE.

PMID- 1639073
TI  - Sequence-specific interaction of the HMG box proteins TCF-1 and SRY occurs within
      the minor groove of a Watson-Crick double helix.
AB  - The high mobility group I (HMG) box is proposed to mediate DNA binding in a novel
      group of transcription-regulating proteins. Two of these, the proteins encoded by
      the T cell-specific TCF-1 and the mammalian sex-determining gene SRY, carry a
      single HMG box with specificity for the heptamer motif A/T A/T C A A A G. We have
      now analysed the mode of interaction of the HMG boxes of TCF-1 and SRY with this
      motif. Methylation interference footprinting revealed that both HMG boxes
      contacted adenines on both strands in the minor groove, whereas no major groove
      guanine contacts were discerned. Diethylpyrocarbonate (DEPC) carbethoxylation
      interference footprinting of TCF-1 indicated the absence of major groove contacts
      on positions 5, 6 and 7 of the motif. Carbethoxylation interference was observed,
      however, on positions 2, 3 and 4 and to a lesser extent on position 1 in the
      major groove. Combined T----C and A----I substitution, which changes the surface
      of the major groove but leaves the minor groove intact, did not interfere with
      sequence-specific binding by TCF-1 and SRY. These observations indicate that
      recognition of the heptamer motif by the HMG boxes of the distantly related TCF-1
      and SRY proteins predominantly occurs through nucleotide contacts in the minor
      groove.

PMID- 1639072
TI  - The DNA target of the trp repressor.
AB  - Unexpected features seen by high resolution X-ray crystallography at the
      interface of the trp repressor and the 'traditional' trp operator provoked the
      claim that the DNA fragment used in the crystal structure is not the true
      operator, and therefore that the crystal structure of the trp repressor-operator
      complex does not portray a specific interaction. An alternative sequence was
      proposed mainly on the basis of mutational studies and gel retardation analysis
      of short target duplexes (Staacke et al., 1990a,b). We have reexamined the
      sequence consensus in trpR-repressible promoters and analyzed the mutagenesis
      experiments of others including Staacke et al. (1990a) and found them fully
      consistent with the interactions of the traditional operator sequence seen in the
      crystal structure, and stereochemically inconsistent with the above referenced
      alternative model. Moreover, an in vitro trp repressor-DNA binding analysis,
      employing both novel DNA constructs devised to avoid previously encountered
      artifacts as well as full-length promoter sequences, indicates that the
      traditional operator used in the crystal structure is the preferred target of the
      trp repressor.

PMID- 1639074
TI  - Determination of the structure of the nucleocapsid protein NCp7 from the human
      immunodeficiency virus type 1 by 1H NMR.
AB  - The retroviral gag nucleocapsid protein NCp7 (72 amino acids) of HIV-1 (LAV
      strain), which contains two successive zinc fingers of the Cys-X2-Cys-X4-His-X4
      Cys form linked by a stretch of basic residues, promotes viral RNA dimerization
      and encapsidation and activates annealing of the primer tRNA to the initiation
      site of reverse transcription. The structure of NCp7 and other shorter fragments
      was studied by 600 MHz 1H nuclear magnetic resonance (NMR) in aqueous solution to
      account for its various biological properties. Complete sequence specific 1H NMR
      assignments of the 13-51 residues of NCp7 encompassing the two zinc fingers was
      achieved by two-dimensional NMR experiments and the three-dimensional structure
      of (13-51)NCp7 was deduced from DIANA calculations, using nuclear Overhauser
      effects as constraints. The structure of the zinc complexed form of NCp7 is
      characterized by a kink at the Pro31 level in the basic Arg29-Ala-Pro-Arg-Lys-Lys
      Gly35 RNA binding linker leading to a proximity of the Lys14-Cys18 to the Gly35
      Cys39 sequences, which belong to the folded proximal and distal zinc fingers,
      respectively. Accordingly, the aromatic residues Phe16 and Trp37 were found to be
      spatially close. The Lys33 and Lys34 side-chains involved in viral RNA
      dimerization were solvent exposed. The N- and C-terminal sequences of NCp7 behave
      as flexible independent domains. The proposed structure of NCp7 might be used to
      rationally design new anti-viral agents aimed at inhibiting its functions.

PMID- 1639075
TI  - Identification of a portable determinant of cell cycle function within the
      carboxyl-terminal domain of the yeast CDC34 (UBC3) ubiquitin conjugating (E2)
      enzyme.
AB  - The ubiquitin conjugating (E2) enzyme encoded by CDC34 (UBC3) in Saccharomyces
      cerevisiae is required for the G1 to S transition of the cell cycle. CDC34
      consists of a 170 residue amino-terminal domain that is homologous to that found
      in other E2s, followed by a 125 residue carboxyl-terminal domain that is specific
      to CDC34. We found that a truncation mutant of CDC34 which lacked the CDC34
      carboxyl-terminal domain could not support the essential function of CDC34 in the
      cell cycle in vivo. To explore further the role of the carboxyl-terminal domain
      in determining the cell cycle function of CDC34, we constructed and characterized
      genes encoding chimeric E2s incorporating sequences from CDC34 and the related
      but functionally distinct E2 RAD6 (UBC2). We found that a construct encoding a
      chimeric RAD6-CDC34 ubiquitin conjugating enzyme, in which the 21 residue acidic
      carboxyl-terminal domain of RAD6 has been replaced with the 125 residue carboxyl
      terminal domain of CDC34, performed the essential functions of CDC34 in vivo.
      This chimeric E2 also complemented the growth deficiency, UV sensitivity and
      sporulation deficiency of rad6 mutant strains. Deletion analysis of the CDC34
      carboxyl-terminal domain in both CDC34 and the RAD6-CDC34 chimeric E2 identified
      a region comprising residues 171-244 of CDC34 that was sufficient to confer CDC34
      function on the amino-terminal domains of CDC34 and RAD6. We suggest that this
      region interacts with substrates of CDC34 or with trans-acting factors (such as
      CDC34-specific ubiquitin protein ligases) that govern the substrate selectivity
      of CDC34. Congruent results demonstrating a positive role for the carboxyl
      terminal domain of CDC34 in the essential function of CDC34 have also been
      obtained by Silver et al. (1992) and are reported in the accompanying paper.

PMID- 1639076
TI  - A chimeric ubiquitin conjugating enzyme that combines the cell cycle properties
      of CDC34 (UBC3) and the DNA repair properties of RAD6 (UBC2): implications for
      the structure, function and evolution of the E2s.
AB  - The CDC34 (UBC3) protein from Saccharomyces cerevisiae has a 125 residue tail
      that contains a polyacidic region flanked on either side by sequences of mixed
      composition. We show that although a catalytic domain is essential for CDC34
      activity, a major cell cycle determinant of this enzyme is found within a 74
      residue segment of the tail that does not include the polyacidic stretch or
      downstream sequences. Transposition of the CDC34 tail onto the catalytic domain
      of a functionally unrelated E2 such as RAD6 (UBC2) results in a chimeric E2 that
      combines RAD6 and CDC34 activities within the same polypeptide. In addition to
      the tail, the cell cycle function exhibited by the chimera and CDC34 is probably
      dependent on a conserved region of the catalytic domain that is shared by both
      RAD6 and CDC34. Despite this similarity, the CDC34 catalytic domain cannot
      substitute for the DNA repair and growth functions of the RAD6 catalytic domain,
      indicating that although these domains are structurally related, sufficient
      differences exist to maintain their functional individuality. Expression of the
      CDC34 catalytic domain and tail as separate polypeptides are capable of only
      partial function; thus, while the tail displays autonomous structural
      characteristics, there is considerable advantage gained when both domains coexist
      within the same polypeptide. The ability of these and other derivatives to
      restore partial function to a cdc34 temperature-sensitive mutant but not to a
      disruption mutant suggests that interaction between two CDC34 polypeptides is a
      requirement of CDC34 activity. Based on this idea we propose a model that
      accounts for the initiating steps leading to multi-ubiquitin chain
      synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639077
TI  - HSD restriction-modification proteins partake in latent anticodon nuclease.
AB  - Phage T4-induced anticodon nuclease triggers cleavage-ligation of the host
      tRNA(Lys). The enzyme is encoded in latent form by the optional Escherichia coli
      locus prr and is activated by the product of the phage stp gene. Anticodon
      nuclease latency is attributed to the masking of the core function prrC by
      flanking elements homologous with type I restriction-modification genes (prrA
      hsdM and prrD-hsdR). Activation of anticodon nuclease in extracts of uninfected
      prr+ cells required synthetic Stp, ATP and GTP and appeared to depend on
      endogenous DNA. Stp could be substituted by a small, heat-stable E. coli factor,
      hinting that anticodon nuclease may be mobilized in cellular situations other
      than T4 infection. Hsd antibodies recognized the anticodon nuclease holoenzyme
      but not the prrC-encoded core. Taken together, these data indicate that Hsd
      proteins partake in the latent ACNase complex where they mask the core factor
      PrrC. Presumably, this masking interaction is disrupted by Stp in conjunction
      with Hsd ligands. The Hsd-PrrC interaction may signify coupling and mutual
      enhancement of two prokaryotic restriction systems operating at the DNA and tRNA
      levels.

PMID- 1639079
TI  - Detection of direct-acting mutagens in ambient air: a comparison of two highly
      sensitive mutagenicity assays.
AB  - Ambient air has been shown to contain numerous hazardous pollutants, many of
      which are known or suspected carcinogens and mutagens. Bioassays play a prominent
      role in the characterization of these genotoxic pollutants, and as new test
      methods are developed, it is incumbent upon researchers to evaluate assay
      performance and report relative merits. In this study, two Salmonella test
      methods (the spiral and preincubation assays) were assessed to determine their
      usefulness as screening methods for monitoring direct-acting mutagens in ambient
      air. The spiral assay automates the conventional plate-incorporation assay and
      has been shown to reduce the labor, materials, and sample mass required to
      perform mutagenicity testing. The preincubation assay has been shown to enhance
      test sensitivity for certain classes of compound, thereby reducing the amount of
      sample required for dose-response analysis. Both assays were used to test organic
      extracts of airborne particulate matter collected in Tokyo during the winters of
      1988 and 1990. In addition to the conventional tester strains TA98 and TA100, two
      newly developed YG strains were evaluated. Strains YG1024 and YG1029-derived from
      TA98 and TA100, respectively-contain an acetyltransferase plasmid that confers
      upon the strains greater sensitivity towards nitroarenes. Results from this study
      indicated that both assays were able to detect direct-acting mutagens in the
      Tokyo air samples. The mutagenic activity associated with the samples was
      directly related to the particle mass present in a given volume of air. Mutagenic
      response was greater in the spiral assay relative to the preincubation assay,
      especially when YG tester strains were used. The YG strains were significantly
      more sensitive to mutation than the TA strains in both assays, which suggests
      that nitroaromatics are an important class of genotoxic contaminant present in
      Tokyo air.

PMID- 1639078
TI  - Molecular analysis of mutations induced by the intercalating agent ellipticine at
      the hisD3052 allele of Salmonella typhimurium TA98.
AB  - We have used DNA colony hybridization, the polymerase chain reaction (PCR), and
      direct DNA sequencing to determine the mutations induced by the intercalating
      agent ellipticine in Salmonella typhimurium TA98 in the presence of S9. Of 400
      ellipticine-induced revertants that were selected at a mutant yield that was
      ninefold over the background, 85.5% contained a GC or CG deletion within a common
      CGCGCGCG hotspot; this deletion occurred among 47% of the spontaneous revertants.
      In addition to this hotspot, the ellipticine spectrum contained two deletion
      warmspots that reside opposite each other in looped-out regions of a possible DNA
      secondary structure. Ellipticine and its metabolites likely revert Salmonella
      strain TA98 by forming DNA adducts that promote slippage-mismatches and by
      stabilizing these slipped mismatched sequences via intercalation. The involvement
      of these mechanisms, along with a likely role for DNA secondary structures and a
      possible role for DNA gyrase, may account for the site specificity exhibited by
      ellipticine in strain TA98.

PMID- 1639080
TI  - Genetic and environmental influences on baseline SCE.
AB  - Previous population-based studies have identified subject characteristics that,
      when combined, can account for approximately 20% of the observed interindividual
      variation in baseline SCE rates. In the present investigation, a classic twin
      study design was used to address the issue of the relevance of genetic factors to
      baseline SCE rates and to identify other demographic, hematologic, and exposure
      variables predictive of SCE rate. Questionnaire data and peripheral blood samples
      from 136 monozygotic and 88 dizygotic twins (age range: 25-81 years) were
      obtained. Among the large number of variables examined, univariate analyses
      (including ANOVA tests for the categorical variables and Pearson-product moment
      correlations for the quantitative variables) revealed smoking status, coffee
      drinking status, sex, white blood cell count, and absolute numbers of lymphocytes
      and neutrophils to have significant effects on SCE rates. A stepwise multiple
      regression analysis showed that together, smoking and coffee drinking status
      entered at the first step accounted for 21% of the observed variance in SCE, with
      a further 6% being contributed by the demographic and hematologic variables added
      in subsequent steps. Finally, the twin analyses showed that after adjustment of
      the data set for smoking and other significant predictors, genetic factors
      accounted for approximately 30% of the variation in SCE rates. Thus these data
      support the hypothesis of a significant genetic influence on baseline SCE.

PMID- 1639081
TI  - Mitogenesis, micronuclei, and carcinogenesis in the rat liver: some basic
      inconsistencies.
AB  - The rodent liver carcinogen, mitogen, and peroxisome proliferator,
      methylclofenapate (MCP), has been investigated as a chemical mitogen for use in
      the rat liver micronucleus assay. A series of experiments comparing MCP with the
      potent mitogen 4-acetylaminofluorene (4AAF) and with 2/3 partial hepatectomy
      showed unexpected differences between the three treatment regimes as monitored by
      the expression of micronucleated hepatocytes (MH) in livers initiated with N
      nitrosodimethylamine (NDMA). These differences were observed in both the profile
      of MH induction, as a function of time after mitogenic stimulation, and in the
      magnitude of response. There was no correlation between the magnitude of MH
      induction and the degree of mitogenesis triggering the MH induction. It is
      concluded that the yield of MH observed in a rat liver micronucleus assay is not
      a simple function of the level of DNA damage induced by the initiating agent
      (here NDMA). This indicates the need for caution in the interpretation of data
      obtained in the liver micronucleus assay for chemicals of unknown
      carcinogenicity. The use of acridine orange as a fluorescent stain for use with
      isolated hepatocytes is described.

PMID- 1639082
TI  - Mitogenic activity of quinoline to the rat, mouse, and guinea pig liver:
      empirical correlations with hepatic carcinogenicity.
AB  - Previous studies have shown that the rat liver carcinogen quinoline is
      essentially nongenotoxic to the rat liver in vivo. Those studies also established
      it as a potent mitogen to rat liver. The present experiments have established
      quinoline as a mitogen to the mouse liver, a tissue in which it is also reported
      to be carcinogenic. In contrast, quinoline is reported to be noncarcinogenic to
      the guinea pig liver, and the present data establish it to be essentially
      nonmitogenic to the guinea pig liver. It is concluded that the mitogenicity of
      quinoline correlates better with its hepatocarcinogenic properties than does its
      genotoxicity in vivo.

PMID- 1639083
TI  - Evidence that inhibitor(s) are formed which may interfere with the growth of
      revertant colonies in the Ames Salmonella and the E. coli tryptophan reverse
      mutation assays when strictly anaerobic conditions are used.
AB  - Spontaneous and chemically induced revertant colonies were not observed on plates
      when a strictly anaerobic environment and anaerobically prepared media were used
      to perform the Ames histidine reversion assay with each of eight different
      Salmonella strains. A similar effect was observed when the E. coli tryptophan
      reverse mutation assay was performed under strictly anaerobic conditions. We
      provide evidence here that under anaerobic conditions growth inhibitor(s) are
      formed by the S. typhimurium and E. coli bacteria when the limited histidine and
      tryptophan, respectively, are depleted from the medium. The inhibitor(s) are
      nonspecific and inhibit the growth not only of prototrophic bacteria but also of
      the inhibitor-producing bacteria as measured by neutralized supernatants of
      growth-limiting minimal liquid cultures. Inhibitor(s) are also formed in
      stationary phase cultures of Salmonella and E. coli in minimal liquid medium
      supplemented with excess histidine and tryptophan, respectively. These results
      suggest that inhibitor formation under anaerobic conditions is a physiological
      phenomenon which interferes with at least two reverse mutation assays. Whether or
      not it also interferes with the reverse mutagenesis process remains to be
      determined.

PMID- 1639084
TI  - Adaptive response of Vibrio cholerae and Escherichia coli to nitrofurantoin.
AB  - Pretreatment with sublethal doses of nitrofurantoin induced adaptive response in
      both Vibrio cholerae and Escherichia coli cells as indicated by their greater
      resistance to the subsequent challenging doses of the same drug. Adaptive
      response was maximum corresponding to pretreatment drug concentrations of 0.40
      microgram/ml and 0.015 microgram/ml respectively for V. cholerae OGAWA 154 (wild
      type) and E. coli K-12 AB 2463 (recA-) cells. Adaptive response was inhibited by
      chloramphenicol (100 micrograms/ml) indicating the need of concomitant protein
      synthesis. Induction of adaptive response in recA deficient E. coli cells
      indicated that it was different from the conventional "SOS" response. Melting
      temperature of DNA of V. cholerae cells subjected to adaptive (0.4 microgram/ml
      for 1 hr) and challenging (120 micrograms/ml for 1 hr) doses of nitrofurantoin
      (76 degrees C) was closer to that of native DNA (75 degrees C) vis-a-vis DNA
      isolated from nonadapted and drug treated cells (77.5 degrees C). Also, DNA
      isolated from V. cholerae cells subjected to adaptive and challenging doses of
      the drug revealed the presence of fewer interstrand cross-links (16% reversible
      DNA) vis-a-vis DNA from nonadapted but drug treated cells (55% reversible DNA).
      Photomicrographic studies revealed that V. cholerae cells that were nonadapted
      but drug treated grew into long filamentous forms (4.25 +/- 2.97 micron) whereas
      those subjected to both adaptive and challenge doses of the drug exhibited much
      less filamentation (2.08 +/- 0.84 micron) vis-a-vis native cells (1.42 +/- 0.5
      micron). Similar results on DNA melting temperature, cross-links in DNA, and
      filamentation of cells were obtained for E. coli AB 2463 (recA-) cells subjected
      to adaptive and challenging treatments with nitrofurantoin. Almost equal degree
      of resistance against nitrofurantoin could be induced in both V. cholerae OGAWA
      154 (wild type) and E. coli strain PJ3 (AB 1157 ada-) when these cells were
      pretreated with nontoxic doses of hydrogen peroxide or nitrofurantoin. Evidence
      obtained in this work on the nature of the nitrofuratoin induced adaptive
      response with particular references to the oxidative and/or alkylating DNA
      damages were discussed. Nitrofuratoin induced adaptive response appeared similar
      to that elicited by furazolidone in V. cholerae cells and appeared to be directed
      towards oxidative and not alkylating adaptive repair pathway.

PMID- 1639085
TI  - Decemtione (Imidan)-induced single-strand breaks to human DNA, mutations at the
      hgprt locus of V79 cells, and morphological transformations of embryo cells.
AB  - To study the genotoxic activity of Decemtione (Imidan), this substance was
      subjected to a series of tests. After preliminary cytotoxicity testing, the
      capacity of Decemtione to damage human DNA was determined by alkaline elution of
      DNA and DNA unwinding. Both tests gave positive results, suggesting that
      Decemtione was able to induce single-strand breaks in DNA. This capacity was
      higher in the absence and lower in the presence of the S9 fraction. The potential
      mutagenicity of Decemtione was followed on the basis of its ability to induce
      resistance to 6-thioguanine in V79 hamster cells. Unlike the induction of single
      strand breaks, Decemtione showed, in the absence of the metabolic activation
      system, a very weak mutagenic effect, which was, however, significantly higher in
      the presence of the S9 fraction. The ability of the substance to transform
      diploid cells under in vitro conditions was followed on the basis of
      morphological transformation of Syrian hamster embryo cells. The results showed
      that Decemtione, like positive carcinogenes, induced a significant elevation in
      morphologically transformed colonies of embryo cells. The results suggest a
      carcinogenic potential of this organophosphate insecticide.

PMID- 1639086
TI  - Intermixing of resident Golgi membrane proteins in rat-hamster polykaryons
      appears to depend on organelle coalescence.
AB  - We have used the synchronized formation of a mixed cytoplasm upon heterokaryon
      formation as a model for investigating the cisternal-specific transport of
      resident proteins between neighboring Golgi apparatus. Rat NRK and hamster 15B
      cells were fused by UV-inactivated Sindbis virus and then incubated for various
      time periods in the presence of cycloheximide. The resident Golgi apparatus
      proteins, rat GIMPc and Golgp 125, were localized with species-specific
      monoclonal antibodies. Immunofluorescent colocalization of rat and hamster Golgi
      membrane proteins was observed with a t1/2 of 1.75 h at 37 degrees C.
      Colocalization of resident, but not transient, Golgi membrane protein was
      concomitant with formation of a large extended Golgi complex and was accompanied
      by the acquisition of endoglycosidase H resistance by preexisting Golgp 125.
      Dispersal of the extended Golgi complex by nocodazole revealed that
      colocalization of resident Golgi proteins was due to intermixing of proteins in
      the same Golgi element rather than overlapping of closely apposed Golgi
      structures. Incubation of the polykaryons at 20 degrees C inhibited both the
      colocalization of GIMPc and Golgp 125 and the formation of an extended Golgi
      complex. Little change in the number of cisternae/stack in cross sections of the
      Golgi apparatus was observed upon cell fusion, and in the extended Golgi complex
      the hamster resident protein remained localized to one side of the Golgi stack.
      Surprisingly, the morphological identity of the rat and hamster Golgi units
      appeared to be maintained in the heterokaryons. These results suggest that the
      intermixing of resident Golgi membrane proteins requires direct physical
      continuity between Golgi elements and that resident Golgi membrane proteins are
      preferentially excluded from the non-clathrin-coated transport vesicles budding
      from Golgi cisternae.

PMID- 1639087
TI  - Modulation of proteoglycan metabolism by human fibroblasts maintained in an
      endogenous three-dimensional matrix.
AB  - This report describes synthesis and degradation of proteoglycans by human
      gingival fibroblasts growing in an endogenous three-dimensional matrix. Cells
      grown in the matrix cultures demonstrated a high rate of proteoglycan synthesis,
      varying between 2 and 4 times that of cells maintained in monolayer cultures. In
      addition, the relative amount deposited into the cell layer was increased in the
      matrix cultures, constituting 70% to 90% of the synthesized material during the
      first 24 h. Comparable levels for the monolayer cultures were 30% to 60%. The
      majority of the 35S-sulfate-labeled material in both matrix (80%) and monolayer
      (62%) cultures was susceptible to chondroitin ABC-lyase digestion. The major
      product was a low Mr (120,000) proteoglycan which could be immunoprecipitated by
      an antibody against PGII (decorin). In addition, the cells synthesized two
      chondroitin ABC-lyase-sensitive proteoglycans, one with Mr greater than 400,000,
      one with an apparent Mr of 250,000, as well as two heparan sulfate proteoglycans
      with Mr greater than 250,000. The low Mr dermatan sulfate, decorin, was also the
      major component deposited in the three-dimensional matrix, constituting about 60%
      of the total sulfate incorporation. In contrast, fibroblasts in monolayer
      cultures deposited only a small amount (13%) of decorin (PGII) in the cell layer,
      and the major proteoglycan in this compartment was heparin sulfate. The rate of
      release of the newly deposited proteoglycans was the same in the two culture
      conditions, although material released from the three-dimensional matrix cultures
      contained small Mr components indicating a higher degree of degradation. These
      studies show differences in proteoglycan metabolism by gingival fibroblasts grown
      in an endogenous matrix and in monolayer cultures.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1639088
TI  - N-linked glycoproteins associated with flagellar scales in a flagellate green
      alga: characterization of interactions.
AB  - Glycoproteins associated with one type of flagellar scale (p-scale) isolated from
      the flagellate green alga Tetraselmis striata (Prasinophyceae) were shown to bind
      the mannose-specific lectin GNA (Galanthus nivalis agglutinin). Enzymatic
      deglycosylation of the glycoproteins with N-glycosidase F led to an
      electrophoretic mobility shift to lower molecular masses in sodium dodecyl
      sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and abolished GNA-binding
      strongly indicating that most of the scale-associated glycoproteins contain
      asparagine-linked oligosaccharide side chains presumably of the high mannose
      type. To evaluate the significance of N-linked glycoproteins for scale structure
      and integrity, p-scales were digested with various proteases or extracted with 8
      M urea and their ultrastructure and protein composition determined. The results
      show that while scale-associated N-linked glycoproteins do not determine the
      overall structure of the scale subunits (which consist of complex
      polysaccharides), they are apparently involved in mediating linkages between
      scale subunits; we have tentatively identified one glycoprotein of Mr 280,000
      which may link outer scale subunits to one another. In addition, some scale
      associated N-linked glycoproteins may provide connections between the layer of p
      scales and the underlying flagellar membrane.

PMID- 1639089
TI  - Construction of an apparatus for perfusion cell cultures which enables in vitro
      experiments under organotypic conditions.
AB  - The value of cultured cells in cell biological, pharmaceutical or
      biotechnological research depends on the degree of terminal cell differentiation.
      In conventional Petri dishes or tissue culture plates it is often difficult to
      achieve culture conditions which resemble the in situ situation of intact tissue,
      as regards optimal cell adhesion, exchange of nutrients and metabolic products.
      These limitations prompted us to develop simple laboratory tools which optimize
      the environment of cultured cells. A perfusion apparatus with various culture
      containers and compatible cell holder sets was constructed which allows the
      simulation of organotypic conditions. (i) The cells can be kept on individual and
      interchangeable support materials for an optimal cell attachment. (ii) Culture
      medium can be perfused during the whole culture period. (iii) One type of the new
      culture container can be perfused with different media at the apical and basal
      side of the cells, thus mimicking the organotypic environment that applies for
      epithelial monolayers. Cell culture experiments with renal collecting duct
      epithelia exhibited an excellent morphological appearance showing typical
      features of principal and intercalated cells.

PMID- 1639090
TI  - Milk lipid globule precursor release from endoplasmic reticulum reconstituted in
      a cell-free system.
AB  - Lipid droplet precursors of milk lipid globules are believed to be derived from
      elements of endoplasmic reticulum in milk-secreting mammary epithelial cells.
      Endoplasmic reticulum isolated from mammary gland was able to generate small
      droplets morphologically resembling microlipid droplet precursors of milk lipid
      globules. Droplet generation was time and temperature dependent and required a
      cytosol fraction of Mr greater than 10,000. Droplet generation was enhanced by,
      but did not require, addition of nucleoside triphosphates, fatty acids, coenzyme
      A, glycerol-3-phosphate, and dithiothreitol. Microlipid droplets generated in
      this cell-free system were enriched in triacylglycerols and resembled microlipid
      droplets formed within mammary epithelial cells in polar lipid and polypeptide
      composition. Endoplasmic reticulum immobilized onto nitrocellulose retained
      activity in generation of putative microlipid droplets, and this immobilization
      method provided a facile means for separation of the donor from the generated
      products.

PMID- 1639091
TI  - Immunolocalization of a specific type of prosome close to the bile canaliculi in
      fetal and adult rat liver.
AB  - Prosomes are mRNA-associated RNP particles and cofactors of untranslated
      (ribosome-) free mRNP having a multicatalytic proteinase (MCP; proteasome)
      activity. The expression of prosomal proteins in fetal development of the rat
      liver was investigated by indirect immunofluorescence, using a panel of
      monoclonal antibodies to individual prosomal proteins (p-mAbs). In all fetal and
      adult stages tested, strong immunofluorescence staining was observed with the
      p31K-specific p-mAb exclusively, whilst Western blot analysis showed reactivity
      also with the p27K and p33K antigens. Double labeling with the 31K p-mAb and an
      anti-cytokeratin antibody showed that the prosome antigen superimposes partially
      onto this type of intermediate filaments (IF), confirming earlier observations
      made on cultured cell lines of various types. Most interestingly, the p31K
      antigen was found preferentially in the pericanalicular zone of hepatocytes in
      the developing liver, from day 17 onwards up to the adult state. This shows a
      preferential concentration of prosomes of a specific type, including the p31K
      antigen, in the morphologically and possibly functionally specialized apical
      domain of the hepatocyte, in a differentiation-related fashion.

PMID- 1639092
TI  - Identification of two distinct microtubule binding domains on recombinant rat MAP
      1B.
AB  - A set of partially overlapping cDNA clones covering 9 kb of continuous sequence
      encoding the high molecular weight microtubule-associated protein (MAP) 1B, was
      isolated from a rat brain library in lambda gt11. The protein encoded was
      immunoreactive with monoclonal antibodies raised against calf MAP 1B, rat MAP 1X,
      and rat MAP 5, as shown by immunoblotting. Using Northern blot analysis, it was
      shown that the level of MAP 1B mRNA increased dramatically upon nerve growth
      factor-induced PC12 cell differentiation. The expression of polypeptides encoded
      by cDNA constructs, in conjunction with microtubule binding assays, revealed two
      separate microtubule binding domains, corresponding to sequences at the 5' and 3'
      end of the mRNA. As shown by DNA sequencing, the binding domain encoded by 5'
      terminal sequences consisted of the basic repeat motif KKEE(I/V), previously
      identified in mouse MAP 1B (Noble, M., S. A. Lewis, N. J. Cowan, J. Cell Biol.
      109, 3367-3376 (1989)). The second binding domain, too, was found to be basic,
      but without any apparent repeat structure. It is concluded that single
      proteolytically unprocessed MAP 1B molecules would have the potential to function
      as microtubule cross-linkers.

PMID- 1639093
TI  - Role of cytoskeleton in cell shaping of developing mesophyll of wheat (Triticum
      aestivum L.).
AB  - The effects of oryzalin and cytochalasin B (CB) on microtubule and actin
      microfilament arrays and on cell shaping were investigated in developing wheat
      mesophyll. Excised immature leaf sections capable of differentiating were
      incubated with the drugs. The behavior of the cytoskeleton was monitored by
      fluorescence microscopy after labeling with fluorescent dyes. Brief incubation
      with oryzalin (40 min, 10 microM) caused disassembly of microtubules. Recovery of
      microtubule arrays was comparatively slow after removal of the drug. Cells failed
      to establish transverse cortical bands of microtubules and transverse hoops of
      wall reinforcement. They expanded isodiametrically rather than longitudinally
      without forming lobes typical of wheat mesophyll cells. Brief treatment with CB
      (60 min, 20 micrograms ml-1) appeared to disrupt the microfilament arrays.
      Filaments recovered rapidly after removal of CB, and cells were able to shape in
      an apparently normal fashion. Continuous incubation at comparatively low
      concentration of CB (4 micrograms ml-1) appeared to cause selective loss of the
      fine transverse cortical microfilament arrays. Cortical transverse microtubule
      arrays persisted, but failed to form distinct bands in the majority of the cells.
      Cells were able to elongate in an almost normal fashion, but no lobes were
      formed.

PMID- 1639094
TI  - Lung surfactant protein A (SP-A) enhances serum-independent phagocytosis of
      bacteria by alveolar macrophages.
AB  - Surfactant protein A (SP-A) is the main protein component of lung surfactant. We
      studied the involvement of SP-A in body defense, i.e., effect of SP-A on the
      phagocytosis of bacteria by alveolar macrophages. We show here that SP-A enhances
      the phagocytosis of some non-opsonized bacteria: Escherichia coli growing
      logarithmically (E. coli/log), Pseudomonas aeruginosa/log as well as from
      stationary phase (P. aeruginosa/stat) and Staphylococcus aureus/log. Furthermore,
      not only serum-independent phagocytosis was effected by SP-A but also
      phagocytosis of serum-opsonized S. aureus/stat. No effect of SP-A on phagocytosis
      was observed with E. coli/stat neither on serum-independent nor on serum
      dependent phagocytosis and on phagocytosis of non-opsonized S. aureus/stat. Thus,
      effect of SP-A on phagocytosis is dependent on bacterial species and on the
      growth phase of the microorganisms, and this effect is concentration dependent.
      We studied two different human recombinant SP-As and SP-A isolated from lung
      lavage material from proteinosis patients. These SP-A molecules contain different
      isomeric chains, and they differ in complexity of their structure. Qualitatively,
      we found the same effect with all three substances. Quantitatively, the
      proteinosis SP-A that forms the most complex structure was the most effective.
      Taken together, we demonstrated a stimulating effect of SP-A on serum-independent
      as well as on serum-dependent phagocytosis of bacteria by alveolar macrophages,
      both depending on species and growth phase of the bacteria.

PMID- 1639095
TI  - Long-term comprehensive care of cardiac patients. Recommendations by the Working
      Group on Rehabilitation of the European Society of Cardiology.

PMID- 1639096
TI  - Ischemic heart disease: risk stratification and intervention. Risk of poor
      quality of life.

PMID- 1639097
TI  - Cardiac surgery.

PMID- 1639098
TI  - Chronic heart failure.

PMID- 1639099
TI  - Regulation of graft-versus-host-reaction by Mlsa-reactive donor T cells.
AB  - Injection of A/J splenocytes (H-2Dd, Mlsc) into unirradiated (A/J x CBA)F1 (BAF1)
      host mice (H-2Dd/k, Mlsd) results in an acute suppressive graft-vs.-host reaction
      (GVHR), characterized by immune dysfunction and appreciable donor cell
      engraftment; injection of the CBA/J parent (H-2Dk, Mlsd), which recognizes no Mls
      disparity in the host, results in little or no GVHR. Furthermore, the Mlsa
      reactive V beta 6 and V beta 8.1 T cell subsets in A/J T cells expand
      significantly in the GVHR host. Finally, depletion of V beta 6+ and V beta 8.1+
      from the A/J population abrogates the proliferative response to BAF1 in vitro and
      the development of GVHR in vivo. Thus, the response to Mls determinants can
      contribute to the generation of a GVHR.

PMID- 1639100
TI  - Evidence that mannose recognition by splenic sinusoidal cells plays a role in the
      splenic entry of lymphocytes.
AB  - Previous studies demonstrated that mannan is a potent inhibitor of splenic entry
      of lymphocytes and mediates its inhibitory effect at an unidentified site in the
      spleen rather than acting directly on lymphocytes. This report describes the in
      vivo site of action of mannan. In vivo localization studies with fluoresceinated
      preparations of mannan (Fl-mannan) and a mannose-6-phosphate-containing yeast
      phosphomannan monoester core from P. holstii exopolysaccharide (Fl-PPME)
      demonstrated that the polysaccharide specifically localize in the splenic
      marginal sinuses in cells with a dendritic morphology termed splenic sinusoidal
      cells (SSC). Uptake of the polysaccharides by SSC was mediated by a mannan
      specific receptor which was saturable and of high avidity. Several lines of
      evidence suggested that mannan uptake by SSC inhibited splenic entry of
      lymphocytes. First, the ability of SSC to bind Fl-mannan and Fl-PPME closely
      paralleled the ability of these polysaccharides to inhibit splenic entry of
      lymphocytes. In fact, doses of mannan and PPME which would saturate SSC mannan
      receptors completely blocked splenic entry of lymphocytes. Second, SSC are
      situated at the initial entry point of lymphocytes into spleen and passage of
      lymphocytes through the SSC region of spleen was profoundly inhibited by mannan.
      Finally, direct evidence for adhesion between lymphocytes and SSC was obtained
      with spleen cell suspensions where clustering between Fl-mannan labeled SSC and
      lymphocytes was observed. Collectively, these data indicate that mannan (and
      PPME) inhibit splenic entry of lymphocytes by interacting with SSC, cell which
      play a critical role in the entry of lymphocytes into the spleen. Whether mannan
      specific receptors on SSC directly mediate lymphocyte-SSC adhesion or play on
      indirect role in modifying lymphocyte migration requires further investigation.

PMID- 1639101
TI  - Anti-human interleukin-6 receptor antibody inhibits human myeloma growth in vivo.
AB  - Myeloma is one of the interleukin (IL)-6-related diseases to which abnormal
      expression of IL-6 has been reported to be linked. We examined the in vivo
      inhibitory effect of anti-human IL-6 receptor (IL-6R) antibody on human myeloma
      cell growth in mice. SCID mice were subcutaneously inoculated with solid tumor of
      the myeloma cell line S6B45 in which human IL-6 was acting as an autocrine growth
      factor. Ten intraperitoneal administrations of 100 micrograms of the anti-human
      IL-6R antibody PM1 at 48-h intervals strongly inhibited the growth of S6B45 cells
      when the administration started 24 h after tumor inoculation. The tumor growth
      inhibition in vivo was also observed by administration of the anti-human IL-6
      antibody MH166 using the same procedure as for PM1. The inhibitory effect of PM1
      was not significant when the administration started 5 or more days after tumor
      inoculation. This work indicates that anti-human IL-6R antibody, as well as anti
      human IL-6 antibody inhibits human myeloma growth in vivo, and provides an animal
      model for testing the therapeutic value of agents such as antibodies to human IL
      6, IL-6R and gp130, an IL-6R-associated signal transducer, in the treatment of
      human myelomas.

PMID- 1639102
TI  - Glycosidase inhibitors (castanospermine and swainsonine) and neuraminidase
      inhibit pokeweed mitogen-induced B cell maturation.
AB  - Castanospermine (CSP), an inhibitor of alpha-glucosidase, enhanced immunoglobulin
      (Ig) release in a Staphylococcus aureus Cowan I (SAC)-induced lymphocyte culture
      (Scand. J. Immunol. 1990. 32: 529). In a pokeweed mitogen (PWM)-human lymphocyte
      culture, unlike the SAC-stimulated system, CSP strongly decreased the number of
      IgG-, IgA- and IgM-secreting cells as well as that of Ig-bearing cells.
      Peripheral blood lymphocytes treated with swainsonine, a mannosidase II
      inhibitor, or with neuraminidase also showed a reduced response to PWM. In cross
      culture experiments, only a mixture of B cells pretreated with either agent and
      untreated T cells showed such a suppressive effect. Adhesion was decreased
      between B cells treated with either agent and untreated T cells, but not between
      treated T cells and untreated B cells. These results demonstrate that a certain
      alteration in B cell membrane oligosaccharides inhibited the T cell-B cell
      adhesion in the PWM culture, leading to an arrest of B cell maturation.
      Considering that these inhibitors eventually prevent terminal sialic acid
      addition, the present study provides evidence that sialic acids on B cell surface
      oligosaccharides play a biological role in the T cell-B cell interaction.

PMID- 1639103
TI  - Phenotypic characterization of KU812, a cell line identified as an immature human
      basophilic leukocyte.
AB  - The knowledge about the differentiation of basophilic leukocytes is fragmentary.
      This report discusses a detailed phenotypic characterization of molecular markers
      for hematopoietic differentiation in a basophilic leukemia cell line, KU812. The
      expression of markers for lymphoid, erythroid, neutrophil, eosinophil, monocytic,
      megakaryocytic, mast cell and basophil differentiation was analyzed at the mRNA
      level by Northern blots in the KU812 cells, and for reference, in a panel of
      human cell lines representative of the different hematopoietic differentiation
      lineages. KU812 was found to express a number of mast cell and basophil-related
      proteins, i.e. mast cell tryptase, mast cell carboxypeptidase A, high-affinity
      immunoglobulin (IgE) receptor alpha and gamma chains and the core protein for
      heparin and chondroitin sulphate synthesis. We found no expression of a number of
      monocyte/-macrophage or neutrophil leukocyte markers except for lysozyme. From
      earlier studies, it has been shown that lysozyme is not expressed in murine
      mucosal mast cell lines. This finding, together with the expression of the mast
      cell carboxypeptidase in KU812 might distinguish the phenotype of this cell line
      from that typical of mucosal mast cell lines in rodents. We found a low level of
      expression of the eosinophil and basophil marker, major basic protein, which
      might indicate a relationship between basophils and eosinophils. No expression
      is, however, detected with the eosinophil-specific markers eosinophil cationic
      protein, eosinophil-derived neurotoxin or eosinophil peroxidase. We also report
      an extensive screening for inducers of basophilic differentiation of the KU812
      cells. The most efficient protocol of induction included serum starvation which
      led to a dramatic increase in a number of markers specific for mast cells and
      basophils such as tryptase, carboxypeptidase A and the heparin core protein.
      Finally, diisopropylfluorophosphate analysis of total protein extracts from KU812
      show four labeled protein bands with sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, indicating that this cell line expresses at least three
      previously undescribed serine proteases of which one or more could be a potential
      basophil-specific marker(s).

PMID- 1639104
TI  - Strong serum inhibition of specific IgE correlated to competing IgG4, revealed by
      a new methodology in subjects from a S. mansoni endemic area.
AB  - A method allowing the immunopurification of human IgE from small volumes of sera
      with a yield close to 100% (mean = 97.8%; SEM = 0.7) has been developed. The
      immunopurification eluates were cleared of other class antibodies that could
      compete with IgE in specific assays. Immunopurification of IgE followed by
      specific IgE enzyme-linked immunosorbent assay (ELISA) (IMMEL) was then applied
      to sera of 160 individuals from an area endemic for Schistosoma mansoni. In
      comparison with radioimmunosorbent test (RAST) and ELISA performed on
      unfractionated sera, IMMEL provided the highest specific IgE signals.
      Furthermore, the best correlations between the specific IgE levels and either the
      specific basophil histamine release levels (r = 0.84; p less than 10(-4) or the
      anti-S. mansoni skin test values (r = 0.45; p = 10(-4)) were obtained with IMMEL.
      Measurement of anti-S. mansoni IgE levels in immunopurified fractions and in
      unfractionated sera of these 160 individuals revealed a strong serum inhibition
      (geometric means of 98.6% and 96.8% for the adult worms and the larvae,
      respectively) of the specific IgE reactivity in ELISA. This inhibition was
      correlated with the anti-adult worm and anti-larval IgG4 levels (r = 0.65; p less
      than 10(-4) and r = 0.58; p less than 10(-4), respectively). In contrast, this
      inhibition did not correlate with the specific IgG1, IgG2, IgG3 and IgM levels.
      Furthermore, the level of specific IgG4 was clearly lower than that of specific
      IgG1, suggesting that the major contribution of IgG4 in the competition effect is
      not due to higher levels but rather to a specificity spectrum close to that of
      the specific IgE. These results support the idea that a specific function of IgG4
      in serum might be to control antigen recognition by IgE and consequently, to
      regulate anaphylactic reactions and IgE-mediated immunity.

PMID- 1639105
TI  - Structural requirements for the peptide-induced conformational change of free
      major histocompatibility complex class I heavy chains.
AB  - In an attempt to define the structural features of peptides which are important
      for inducing the folding of free class I heavy chains in the absence of beta 2
      microglobulin, and to determine whether they are the same as those required to
      form stable major histocompatibility complex (MHC): peptide adducts, we have used
      a panel of peptides related to the Db-binding nonamer ASNENMDAM (influenza
      nucleoprotein residues 366-374) with altered primary structures, and a number of
      other peptides which have the Db-binding "motif". In this way, we have shown that
      in addition to the "anchor" residues which define this motif, the alpha amino and
      carboxyl groups at the N and C termini also play a major role in both inducing
      the conformational change in free heavy chain (HC) and formation of a stable
      Db:peptide complex. We also show that the importance of the key residues is
      affected by the primary sequence "context" in which they appear. In addition, we
      have extended our original finding that naturally processed epitopes induce a
      conformational change in free HC to the H2Kb HC, and show that the effect does
      not require the presence of the class I alpha 3 domain.

PMID- 1639106
TI  - A survey of protein-DNA interaction sites within the murine immunoglobulin heavy
      chain locus reveals a particularly complex pattern around the DQ52 element.
AB  - The expression of immunoglobulin (Ig) genes is regulated at two levels:
      rearrangement of individual gene segments and transcription of continuous genes.
      To find transacting factors involved in mediating locus- and segment specific
      gene activation and expression, we surveyed a 3600-bp genomic region of the
      murine Ig heavy chain locus, spanning from the DQ52 element to the Ig heavy chain
      intron enhancer. We discovered nine, previously undescribed, protein-DNA
      complexes and estimated their individual binding-affinity preferences (Kr) by
      quantitative gel shift measurements. We observed one novel protein DNA
      interaction at the enhancer, two in the JH1 region and six within a 300-bp region
      immediately 5' to the DQ52 locus. The latter show a complex and specific binding
      pattern when comparing nuclear extracts derived from pre-B cells and fibroblasts.
      Further characterization of the interactions at the DQ52 locus by electron
      microscopy revealed the preferential formation of a protein complex binding to
      the DQ52 locus with pre B cell extracts. This behavior and the clustering of
      interaction sites 5' to the DQ52 element suggest that this region is involved in
      the regulation of heavy chain gene assembly.

PMID- 1639107
TI  - Naturally occurring ABO antibodies: long-term stable, individually distinct anti
      A IgG spectrotypes.
AB  - Spectrotypes of naturally occurring IgG antibodies to histo-blood group substance
      A were analyzed by isoelectric focusing and a newly developed, non-radioactive
      affinity immunoblotting assay. Specificity was tested by preabsorption of sera on
      red blood cells and on four different types of blood group substance A. Clonotype
      banding patterns of sera from 18 different blood donors were individually
      distinct, most of them showing an oligoclonal pattern with less than 15 visible
      bands. To analyze the influence of IgG subclass composition on spectrotype
      patterns, IgG subclasses were measured by ABO enzyme-linked immunosorbent assay
      (ELISA) and were shown to be mostly IgG1 and IgG2. Anti-A IgG1 spectrotypes could
      be detected with four sera and were also individually distinct. A series of six
      and seven serum samples, respectively from two donors was used to analyze the
      time-related changes of anti-A IgG spectrotypes. Banding pattern of both
      individuals remained stable during the whole observation period of 167 and 82
      days, respectively, and no differences between follow-up samples could be
      detected. This long-term stability of individual anti-A IgG spectrotypes is
      backed by constant serum levels of anti-A IgG and -IgM antibodies during the
      observation period as measured by ABO ELISA.

PMID- 1639108
TI  - Nitric oxide mediates intestinal pathology in graft-vs.-host disease.
AB  - We have investigated the involvement of nitric oxide (NO) in intestinal graft-vs.
      host reaction (GvHR) in mice. Treatment of mice with L-NG-monomethyl arginine (L
      NMMA), a specific inhibitor of NO synthesis, abolished the mucosal pathology of
      intestinal GvHR and reduced the associated lymphocytic infiltration of the
      epithelium. L-NMMA had no effect on splenomegaly in GvHR, nor did it interfere
      with the growth of an undifferentiated crypt stem cell line, or the production of
      tumor necrosis factor-alpha by activated macrophages in vitro. In contrast, L
      NMMA inhibited the enhanced activity of natural killer (NK) cells which occurs in
      GvHR. We conclude that a NO-dependent mechanism is essential for intestinal
      immunopathology in GvHR and that this may reflect a role for NO in NK cell
      function.

PMID- 1639109
TI  - Correlation between killing activity towards the murine L929 cell line and
      expression of membrane-associated lymphotoxin-related molecule of human
      lymphokine-activated killer cells.
AB  - Human lymphokine-activated killer (LAK) cells expressed a membrane-associated
      lymphotoxin-related molecule (mLT) which was detected by flow cytometric analysis
      with anti-lymphotoxin antibody. Upon removal of exogenous interleukin-2 from LAK
      cell culture medium and another 24 h cultivation, the expression of mLT was
      decreased. Corresponding to the decrease of mLT expression, the killing activity
      of LAK cells towards L929 cells was remarkably reduced and killing of MIA PaCa-2
      and U937 cells was moderately reduced, whereas killing of Daudi and K562 cells
      was fully restored. The supernatant of mLT-expressing LAK cells had no cytotoxic
      activity towards L929 cells in the absence of actinomycin D. Moreover, not only
      the killing of L929 cells but also that of human tumor cell lines (MIA PaCa-2,
      U937) by mLT-expressing LAK cells was partially inhibited in the presence of anti
      lymphotoxin antibody. These results suggest an involvement of mLT in the killing
      of some tumor target cells by LAK cells.

PMID- 1639110
TI  - The specificity and efficiency of endogenous peptides in the induction of HLA
      class I alpha chain refolding.
AB  - The specificity and efficiency of endogenous peptides in the HLA class I binding
      have been investigated by the use of a simple procedure that is based on the
      serological detection of the folding of HLA class I alpha chains that is induced
      by the binding to specific peptides in the presence of beta 2 microglobulin. HLA
      class I proteins were solubilized with a nonionic detergent from cultured HLA
      homozygous B lymphoblastoid cells and dissociated by alkaline denaturation. The
      resulting unfolded alpha chains were isolated by gel filtration at a neutral pH.
      The unfolded alpha chains showed a high refolding capacity and specificity when
      tested in the presence of an excess beta 2 microglobulin against endogenous
      peptides extracted by alkaline or acid treatment from cultured B lymphoblastoid
      cells of various HLA class I phenotypes. Cells of identical or overlapping HLA
      phenotypes clearly showed shared peptides, whereas such peptide sharing was
      rarely, if at all, seen between cells of non-overlapping HLA phenotypes. The
      efficiency of endogenous peptides in the induction of refolding was high; at an
      estimated concentration of 0.2 microM or less, a strong refolding effect was
      observed.

PMID- 1639111
TI  - Agonist-induced changes in [Ca2+]i in N1E-115 cells: differential effects of
      bradykinin and carbachol.
AB  - The addition of bradykinin to populations of fura-2 loaded N1E-115 neuroblastoma
      cells produced an increase in intracellular calcium which rapidly reached a peak
      and returned to baseline within 60 s. The response was concentration dependent
      and unaffected by removal of extracellular calcium or addition of the inorganic
      channel blocker Ni2+. Similar transient responses were seen with histamine and
      angiotensin II and experiments monitoring manganese entry suggest that agonist
      responses in this cell line involve mainly release of calcium from intracellular
      stores. However, unlike bradykinin, the response to carbachol, at all
      concentrations, failed to return completely to baseline suggesting a small
      secondary influx component and highlighting possible differences between the
      mechanisms of calcium elevation by these two agonists.

PMID- 1639112
TI  - The AT2 subtype of the angiotensin II receptors has differential sensitivity to
      dithiothreitol in specific brain nuclei of young rats.
AB  - We studied the effect of the sulfhydryl reducing agent dithiothreitol on the
      binding of the angiotensin II agonist [125I][Sar1]-angiotensin II to AT2
      receptors in selected brain areas of young (2-week-old) rats. In the inferior
      olive and the hypoglossal nucleus, angiotensin II binding to AT2 receptors was
      insensitive to 5 mM dithiothreitol. Conversely, in the ventral and mediodorsal
      thalamic, medial geniculate, and oculomotor nuclei, the superior colliculus and
      the cerebellar cortex, incubation with 5 mM dithiothreitol significantly
      decreased angiotensin II binding to AT2 receptors to about 40% of control. These
      data suggest that brain AT2 receptors are heterogeneous with respect to their
      sensitivity to sulfhydryl reducing agents.

PMID- 1639113
TI  - TMB-8 (8-(N,N-diethylamino) octyl-3,4,5-trimethoxybenzoate) inhibits the ATP
      sensitive K+ channel.
AB  - Whole-cell current clamp, single-channel recordings and 86Rb+ flux techniques
      have been used to show that 8-(N,N-diethyl-amino)octyl-3,4,5-trimethoxybenzoate
      (TMB-8) inhibits ATP-sensitive K+ channels in HIT-T15 beta-cells. TMB-8
      inhibition is observed when KATP channels are activated by ATP depletion or by
      the K+ channel opener, diazoxide.

PMID- 1639114
TI  - Monoclonal antibodies to the nonpeptide angiotensin II receptor antagonist,
      losartan.
AB  - Two murine monoclonal antibodies were produced to losartan (DuP 753), a
      nonpeptide angiotensin II receptor antagonist. Using a solid phase competitive
      enzyme-linked immunosorbent assay (ELISA), each antibody was examined for its
      ability to bind to a set of losartan analogs that differ structurally in varying
      degrees. Both antibodies distinguished fine structural changes in the analogs,
      particularly at the R5 position of the imidazole ring. No cross-reactivity
      towards either antibody was observed with the natural ligand angiotensin II, the
      peptide antagonist saralasin, or the AT2 selective nonpeptide antagonist
      PD123177.

PMID- 1639115
TI  - The molecular pharmacology of L-deprenyl.
AB  - L-Deprenyl, the selective inhibitor of monoamine oxidase type B (MAO-B), has
      gained wide acceptance as a useful form of adjunct therapeutic drug in the
      treatment of Parkinson's disease. This review summarizes the molecular
      pharmacology of L-deprenyl, and the advances in our understanding of its possible
      mode of action in Parkinson's disease. L-Deprenyl belongs to the class of enzyme
      activated irreversible inhibitors also described as 'suicide' inhibitors, because
      the compound acts as a substrate for the target enzyme, whose action on the
      compound results in irreversible inhibition. L-Deprenyl first of all forms a
      noncovalent complex with MAO as an initial, reversible step. The subsequent
      interaction of L-deprenyl with MAO leads to a reduction of the enzyme-bound
      flavin-adenine dinucleotide (FAD), and concomitant oxidation of the inhibitor.
      This oxidized inhibitor then reacts with FAD at the N-5-position in a covalent
      manner. The observed in vitro selectivity of L-deprenyl for MAO-B may be
      accounted for by differences in the affinities of the two MAO subtypes for
      reversible interaction with L-deprenyl, differences in the rates of reaction
      within the noncovalent complexes to form the irreversibly inhibited adduct, or a
      combination of both these factors. However, if selective inhibition is to be
      maintained in vivo, correct dosage schedules are critically important, since all
      selective MAO inhibitors described up to now lack selectivity at high doses. In
      experimental animals L-deprenyl is protective against the damaging effects of
      several neurotoxins, including the dopaminergic agents 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine (MPTP) and 6-hydroxydopamine (6-OHDA) and the noradrenergic
      neurotoxin N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4). Beside MAO-B
      inhibition, which above all explains the prevention of neurotoxic action of MPTP
      by preventing its metabolism, L-deprenyl appears to exhibit other mechanisms of
      action which are independent of its action on MAO-B.

PMID- 1639116
TI  - Increased prevalence of proliferative retinopathy and cardiovascular autonomic
      dysfunction in IDDM patients with proteinuria.
AB  - The purpose of the present cross-sectional clinical study was to evaluate the
      prevalence of retinopathy in Type 1 diabetic patients without nephropathy and
      with different degrees of nephropathy. In addition we investigated the
      association between retinopathy, nephropathy, and other variables, and studied
      the importance of cardiovascular autonomic dysfunction to these conditions. 76
      Type 1 diabetic patients were investigated. All patients were initially selected
      on the basis of body weight, and 47 proteinuric patients were further selected
      for age, diabetes duration and the duration of insulin treatment (see Table 1).
      Proteinuric diabetic patients were categorized by degree of nephropathy, i.e. for
      incipient nephropathy (proteinuria of less than 0.5 g/day), for overt nephropathy
      (proteinuria of more than 0.5 g/day), and for renal failure (serum creatinine of
      more than 103 mumol/l). Retinopathy was assessed by ophthalmoscopy.
      Cardiovascular autonomic dysfunction (CAD) was assessed by heart rate variations,
      30:15 ratios, the Valsalva maneuver, and systolic blood pressure fall upon
      standing. Our findings revealed increased prevalence of retinopathy in patients
      with more advanced stages of nephropathy. CAD abnormalities exhibited increased
      prevalence among proteinuric patients. Our data clearly revealed differences
      between proteinuric and non-proteinuric patients. In both proteinuric and non
      proteinuric patients there were found correlations of retinopathy with diabetes
      duration, and only in proteinurics was retinopathy correlated with kidney
      function, systolic blood pressure and CAD findings. In patients in identical
      stages of nephropathy, increased prevalence of CAD abnormalities was shown in
      patients suffering from proliferative retinopathy. Thus our data suggest that CAD
      abnormalities might be related in some way to both the proliferative retinopathy
      and to diabetic nephropathy.

PMID- 1639117
TI  - Influence of the electrical stimulation of the hypothalamus on adrenocortical
      steroidogenesis in hypophysectomized rats.
AB  - The electrical stimulation of the ventromedial hypothalamus (VMH), lateral
      hypothalamic area (LHA), periventricular arcuate nucleus (ARC), and posterior
      hypothalamus (PHY), on 14C transfer rates from 14C-1-acetate into adrenocortical
      steroids in adrenal slices of hypophysectomized rats were investigated. The 14C
      transfer rates into corticosterone and cortisol were increased by the stimulation
      of the VMH, ARC, and PHY, but decreased by the stimulation of the LHA. From these
      results, it might be suggested that these hypothalamic structures were involved
      in the regulation of adrenocortical steroidogenesis without participation of the
      pituitary.

PMID- 1639118
TI  - Clinical and experimental diabetes are associated with an impairment of
      peripheral nerve function.

PMID- 1639119
TI  - Cyclic changes of exopeptidase activities in the rat brain: a regional study.
AB  - The present report describes the activity of three neuropeptide-degrading
      enzymes, in 12 brain areas during the estrous cycle of Sprague-Dawley rats. The
      quantitation of the enzyme activities was performed by measuring the rate of
      hydrolysis of the chromogenic substrates Leu-, Lys- and Asp-2-naphthylamides, by
      neutral, basic and acid aminopeptidase (AP) activities, respectively. Lys- and
      Leu-AP activities show a significant increase during the proestrus stage in the
      hypothalamus and the pituitary gland. Also there is a significant increase of Leu
      AP activity in the occipital cortex. No significant decreases for Asp-AP activity
      during the proestrus in the hypothalamus and the pituitary were observed. As the
      changes seem to be limited at the hypothalamic-pituitary axis, these findings
      could be interpreted to mean that these exopeptidase activities play a role in
      the hormonal changes that take place during the estrous cycle of the rat.

PMID- 1639120
TI  - The correlation of serum prolactin level and psychic stress in women undergoing a
      chronic hemodialysis programme.
AB  - Altogether eight women undergoing a chronic hemodialysis treatment were studied
      for five months. Four of them were in the premenopause and four in the
      postmenopause. Once a month levels of prolactin, FSH, LH, estradiol and
      progesterone were measured, Luscher colour test was performed, from which the
      screamer index as an indicator of psychic stress was calculated and the levels of
      urea, creatinine and hematocrite were assessed to inform us of the adequacy of
      dialysis. We tested the hypothesis, whether there exists a correlation between
      psychic stress and the prolactin level in these women. For statistic evaluation
      we used linear regression under the use of dummy variables to intercept the
      interindividual differences in the Luscher test. We found that the fluctuation of
      the prolactin level and of the value of the screamer index of the Luscher test
      are parallel (p less than 0.05). These results bear witness of a participation of
      psychic stress in the onset and level of hyperprolactinemia in women being in a
      chronic hemodialysis treatment.

PMID- 1639121
TI  - Somatomedin-C/IGF-I, insulin and prolactin levels in Ullrich-Turner's syndrome.
AB  - To clarify the pathogenesis of growth retardation in patients with Ullrich
      Turner's syndrome (TS) we have investigated basal SmC/IGF-I, insulin and
      prolactin concentrations. Compared with 56 age matched healthy controls basal
      SmC/IGF-I concentration in 51 patients with TS older than 9-11 years was
      significantly lower (age group 13-14 years; TS 273 +/- 47 and controls 479 +/-
      114 ng/ml). Mean basal prolactin level in 43 patients with TS (406 +/- 211
      microU/ml) was significantly higher (p less than 0.01) than in 192 female
      controls (age 3-11 years; 264 +/- 176 microU/ml). Basal insulin concentration in
      28 TS patients in comparison to 20 healthy children of a control group was
      significant higher (TS 18 +/- 8 microU/ml; controls 9 +/- 4 microU/ml; p less
      than 0.01). It seems that neither insulin nor prolactin are relevant stimulators
      of Smc/IGF-I in man, especially in patients with gonadal dysgenesis. Considering
      these results we speculate that despite higher prolactin and higher insulin
      levels in TS, the lower SmC/IGF-I concentrations may be predominantly related to
      the abnormal sex steroid secretion.

PMID- 1639122
TI  - Effects of acetylcholine on the release of thyrotropin-releasing hormone from the
      rat retina in vitro.
AB  - Effects of acetylcholine on the release of thyrotropin-releasing hormone (TRH)
      from the rat retina were studied in vitro. The retina was incubated in medium 199
      (pH 7.4) with 1.0 mg/ml of bacitracin and 100 micrograms/ml of ascorbic acid
      (medium) for 20 min. The amount of TRH release into the medium was measured by
      radioimmunoassay. The TRH release from the rat retina was enhanced significantly
      in a dose-related manner with the addition of acetylcholine and inhibited with
      addition of atropine. The stimulatory effect of acetylcholine on TRH release from
      the retina was blocked with the addition of atropine. The elution profile of
      methanol-extract of the rat retina was identical to that of synthetic TRH. The
      findings suggest that the cholinergic system stimulates TRH release from the rat
      stomach in vitro.

PMID- 1639123
TI  - Serum parathyroid hormone and calcitonin levels following ovariectomy in the
      adult rat.
AB  - The ovariectomized rat is a reasonably good and often utilized model of human
      post-menopausal osteoporosis (Devlin and Ferguson, 1989). Mature rats were either
      ovariectomized or underwent a sham operation, killed at intervals following
      operation and the serum concentration of parathyroid hormone and calcitonin at
      death related to the histomorphometry of the cancellous bone of the proximal
      ilium. The mean serum calcitonin concentration for all ovariectomized rats was
      66.4 pg/ml (SD = 18) and for the control rats was 76.42 pg/ml (SD = 20). The
      serum calcitonin concentration in the ovariectomized rats was significantly
      negatively correlated with the extent of erosion cavities of the cancellous bone
      (r = -0.598, t = -2.36, p = 0.039). No significant correlation was observed for
      the control rats (r = -0.107, t = -0.357, p = 0.727). The mean extent of erosion
      cavities in the ovariectomized group was 6.81% (SD = 1.94) and in the control
      group was 6.47% (SD = 2.21), with no significant differences between the two
      groups (t = 0.41, p = 0.69). No significant correlations were observed in serum
      parathyroid hormone (PTH) concentration with the bone resorption parameters. From
      this study it was concluded that calcitonin may be of aetiological importance in
      bone loss in the ovariectomized rat.

PMID- 1639124
TI  - Serum urate and renal function in different forms of hypercalcemia.
AB  - In order to investigate the relationships between serum calcium, urate and kidney
      function, serum calcium, urate, creatinine and urea were measured at 100
      occasions in hypercalcemic cancer patients together with 113 preoperative
      measurements in HPT subjects and 106 measurements in normocalcemic control
      persons. When compared to normocalcemic control subjects (serum urate 336 +/- 110
      mumol/l) both HPT subjects (356 +/- 98 mmol/1, p less than 0.006) and the cancer
      patients (407 +/- 179 mmol/l, p less than 0.001) showed raised levels of serum
      urate. While serum urate was correlated to serum creatinine in all groups (r =
      0.40-0.59, p less than 0.0001) a significant correlation to serum calcium was
      only seen in the HPT group (r = 0.28, p less than 0.004). This relation persisted
      also after correction for age, sex and serum creatinine in the multiple
      regression analysis. Serum creatinine was similar in all groups but significantly
      correlated to serum calcium only in the HPT subjects (r = 0.29, p less than
      0.003). Serum urea was not significantly correlated to serum calcium in any of
      the groups but was elevated in the cancer group (8.3 +/- 4.4 vs 6.2 +/- 2.9
      mumol/l in the control group, p less than 0.0001). This elevation in serum urea
      seen in the cancer patients might rather be explained by dehydration or
      catabolism than an impaired kidney function. In conclusion, while serum urate is
      related to the kidney function both in normo- and hypercalcemia, it also seems to
      be related to the hypercalcemia in HPT subjects but not in cancer
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639125
TI  - Lifelong enhanced diabetes susceptibility and obesity after temporary
      intrahypothalamic hyperinsulinism during brain organization.
AB  - Newborn male Wistar-rats received bilateral intrahypothalamic insulin-agar
      implants on the 2nd or 8th day of life. In male control animals only the insulin
      free indifferent agar-vehicle was implanted at the same age. In both experimental
      groups with temporary intrahypothalamic hyperinsulinism during brain organization
      the following results were obtained: 1) Higher body weight gain starting at the
      end of the hypothalamic differentiation period and continuing during juvenile
      life until adulthood, resulting in increased relative body weight as a sign of
      obesity; 2) A tendency to basal hyperinsulinaemia in juvenile and adult age; 3)
      Impaired glucose tolerance in adulthood; 4) Increased diabetes susceptibility to
      a single "subdiabetogenic" dose of streptozotocin in adult age. In view of these
      and previous observations a teratogenetic role of high insulin concentrations
      during the organization of glucoregulatory hypothalamic structures is
      hypothesized and the possible relevance of such hyperinsulinism as a predisposing
      factor for a lifelong enhanced diabetes and/or obesity risk is suggested.

PMID- 1639126
TI  - Hypothermia in insulin-treated obese rats.
AB  - Changes of colonic temperature were investigated to examine a mechanism of
      hypothermia in the obese rats which received subcutaneous administration of
      intermediate type-insulin (8 U/day) for 8 weeks. Although diurnal rhythmicity of
      colonic temperature levels was maintained similarly with those of vehicle
      injected controls, the overall colonic temperature levels were significantly
      lowered in insulin-treated animals. In the condition of cold exposure at 5
      degrees C, colonic temperature levels of insulin-treated animals were immediately
      and significantly decreased at 60 minutes after the start of cold exposure. The
      data obtained herein demonstrated that hyperinsulinemia accompanying with
      hyperphagia should be profoundly involved in hypothermia, observed in various
      experimental models of obesity.

PMID- 1639127
TI  - Colonic temperature was not changed in the development of obesity after
      ovariectomy.
AB  - We tested the hypothesis that altered heat production ability after ovariectomy
      may be involved in the development of obesity. Two weeks after ovariectomy, food
      intake of ovariectomized (Ovx) rats was increased and body weight gain was
      obvious, compared with sham-operated animals. However, colonic temperature of Ovx
      rats was not different from that of sham-operated animals. Food intake of Ovx
      rats was similar with that of sham-operated rats at 8 weeks later. In this
      period, colonic temperature of Ovx rats was not different from that of sham
      operated animals and diurnal rhythmicity was maintained. The present data
      suggested that changes in heat production may be not an important inducer of
      obesity in both the dynamic and static phases of the development of obesity after
      ovariectomy.

PMID- 1639128
TI  - Immortalization of murine primary spleen cells by v-myc, v-ras, and v-raf.
AB  - Growth factor-independent cell lines, including four lines characterized as
      macrophages, were isolated by infection of BALB/c mouse primary spleen cells with
      combinations of three retroviruses encoding v-myc, v-ras, and v-myc/v-raf.
      Proliferating cell lines were isolated only rarely, and after long crisis
      periods, following the introduction of myc and raf by infection with J2 virus, or
      of myc and ras by coinfection with myc309 and raszip6 viruses. However,
      sequential infections with all three viruses--myc plus ras cells reinfected with
      J2, or J2 followed by myc plus ras coinfection--resulted in rapid outgrowth of
      cell lines which grew at high growth rates to high densities. When cells were
      treated with anti-IgG F(ab')2/IL-4/IL-5 to specifically stimulate B cells, cell
      lines were isolated readily by infection with myc plus ras alone, J2 alone, or
      all three viruses. These cell lines arose after shorter crisis times and all grew
      at high growth rates and to high densities. Analysis of cell surface markers and
      immunoglobulin gene arrangement revealed no lymphoid characteristics in any of
      the lines. Four cell lines express all three macrophage markers analyzed (F4/80,
      Mac1, FcR), and many others are Mac1+ and/or FcR+. Out of 20 immortalized cell
      lines tested, 13 show clonal growth in soft agar, and 3/6 of these produced
      tumors in BALB/c mice, indicating that fully transformed cells may be isolated by
      these procedures. In at least one of the cell lines, integration of all three
      infecting viruses has occurred.

PMID- 1639129
TI  - Formation of primary constriction and heterochromatin in mouse does not require
      minor satellite DNA.
AB  - Whereas the major satellite fraction in mouse extends its domain from the
      centromere to the distal end of the pericentric heterochromatin, the minor
      satellite DNA is present specifically in the centromere or primary constriction.
      We hybridized the biotinylated minor satellite sequence to L929 cells of mouse
      origin. The sequence hybridized to all chromosomes. Whereas hybridization was
      detected on all active centromeres, the inactive centromeres in certain
      dicentrics did not show any signal. This satellite, however, was detected in all
      inactive centromeres in a heptacentric chromosome. The intensity of fluorescence
      on the inactive centromeres of the heptacentric was similar to that present on
      the active centromeres. Several heterochromatin blocks, which were not associated
      with any centromere, were also found to lack hybridization with the minor
      satellite. The inactive centromeres, whether carrying the minor satellite DNA
      fraction or not, generally do not react with the antikinetochore antibodies
      present in the scleroderma serum. These studies are interpreted to show that (1)
      the primary constriction in mouse can be formed without the participation of
      minor satellite, (2) heterochromatin in mouse may constitute without this
      fraction, (3) the major and minor satellite may not be interspersed but are
      joined at some defined boundary, and (4) the binding of CENP-B does not depend
      upon the quantity of minor satellite or the number of CENP boxes present in the
      inactive centromeres.

PMID- 1639130
TI  - Transformation and characterization of mutant human fibroblasts defective in
      peroxisome assembly.
AB  - Human skin fibroblasts deficient in peroxisome biogenesis were transformed by
      transfecting SV40 ori- DNA with the use of an electroporator, and the
      biochemical, immunocytochemical, and cytogenetic properties of the transformants
      were analyzed. Cells (1 x 10(6)) from a patient with Zellweger syndrome and one
      with neonatal adrenoleukodystrophy were suspended with 2 micrograms of SV40 ori-
      DNA in PBS; then a high-voltage pulse (2000 V, 30 microseconds) was generated two
      times. Several colonies expressing large T-antigen were picked up 4 weeks after
      transfection. Doubling time of the transformants was about half of that and the
      saturation density was 5 to 10 times greater than that of the parental cells.
      Biochemical abnormalities including defective lignoceric acid oxidation,
      dihydroxyacetone phosphate acyltransferase deficiency, and disturbed biosynthesis
      of peroxisomal beta-oxidation enzymes were preserved in the transformants.
      Peroxisomes were defective in all colonies, as determined by immunofluorescence
      staining using anti-catalase IgG. Cell fusion studies confirmed that the
      transformants belong to the same complementation groups as those of the parental
      cells. These transformed mutant cell lines are expected to be useful tools for
      investigating the pathogenesis of inherited diseases related to defects in
      peroxisome biogenesis.

PMID- 1639131
TI  - Biogenesis of endoplasmic reticulum transport vesicles transferring gastric
      apomucin from ER to Golgi.
AB  - Rough endoplasmic reticulum (RER) transport vesicles were generated from gastric
      mucous cell RER microsomes in the presence of labeled precursors of
      phospholipids. The vesicles contained 7-10% of their proteins in the form of
      apomucin (cargo), and 80% of de novo synthesized phosphatidylcholine (PC) was
      incorporated into the vesicular membrane. In the absence of choline and
      ethanolamine precursors or in the presence of 3 mM N-ethylmaleimide (NEM), an
      inhibitor of CTP:phosphocholine cytidylyltransferase, formation of the transport
      vesicles, their enrichment in the newly synthesized PC, and the total synthesis
      of PC decreased by 86%, whereas in the presence of 3 mM Zn2+, complete blockage
      of vesicle formation and PC synthesis was observed. Analysis of the mucin
      transporting vesicles indicated that the CTP:phosphocholine cytidylyltransferase
      and 1,2-diacyl-sn-glycerol:CDP-choline phosphotransferase remained associated
      with transport vesicles released from ER. The enzymes and other proteins
      separated from the vesicle surface prior to vesicle fusion with Golgi and the
      process was induced by phosphorylation. Based on the results of this study, it is
      proposed that the formation of the ER transport vesicles of gastric mucosal cells
      is in concert with synthesis of phospholipids and thus in part is regulated by
      phospholipid-synthesizing enzymes that reside on the membrane during its
      biogenesis and dissociate from its surface once the task is completed.

PMID- 1639132
TI  - Colonic cancer cell (HT29) adhesion to laminin is altered by differentiation:
      adhesion may involve galactosyltransferase.
AB  - The effects of cell differentiation on cell adhesion to laminin were studied
      using the human colon tumor cell line, HT29. HT29 cells were induced to
      differentiate either by glucose deprivation (HT29glc- vs HT29glc+) or by 2 mM
      butyrate (HT29glc-+B+). Adhesion was assayed after incubating cell suspensions in
      microtiter wells previously coated with laminin or other substrates. HT29glc+
      cells adhered preferentially to laminin over BSA, fibronectin, and ovalbumin. The
      adhesion to laminin was greater than 50% of maximum within 15 min. HT29glc- cell
      adhesion to laminin was consistently lower than that for HT29glc+ or HT29glc+B+
      cells. alpha-Lactalbumin (ALA), a modifier of galactosyltransferase (GT)
      substrate specificity, caused a significant reduction (greater than 50%) in
      HT29glc+ cell adhesion to laminin when ALA was added to the adhesion incubation
      mixture. Addition of glucose+ALA to the suspension restored adhesion to laminin.
      Ovalbumin, a GT substrate, increased adhesion of HT29glc+ and HT29glc- cells to
      laminin, but lactose, a GT product, did not. The data show that undifferentiated
      HT29 cells adhere preferentially to laminin over fibronectin and collagen IV and
      that differentiation of HT29 cells reduces adhesion to laminin. In addition, the
      data imply that cell adhesion to laminin may be mediated by factors that also
      modify galactosyltransferase activity.

PMID- 1639133
TI  - Disruption of microtubules inhibits the stimulation of tissue plasminogen
      activator expression and promotes plasminogen activator inhibitor type 1
      expression in human endothelial cells.
AB  - The expression of certain proteolytic enzymes involved in cell migration
      (collagenase, urokinase) can be enhanced by the disruption of cellular
      cytoskeletal organization, suggesting an association between cell shape and gene
      expression. We have examined the effect of cytoskeleton-disrupting agents on the
      production and secretion of another proteolytic enzyme, tissue plasminogen
      activator (tPA), and its inhibitor, plasminogen activator inhibitor-1 (PAI-1), in
      human endothelial cells. Addition of 1 x 10(-6) M colchicine, 5 x 10(-6) M
      cytochalasin B, 10(-6) M nocodazole, or 10(-6) M tubulazole had no effect on the
      constitutive rate of release of tPA. However, the three microtubule-disrupting
      agents--colchicine, nocodazole, and tubulazole--depressed the stimulation of tPA
      secretion by phorbol myristate acetate (PMA) by 50- to 65%. Disruption of
      microfilament structure by cytochalasin B had no effect. In contrast, microtubule
      disruption in the absence or presence of PMA stimulated PAI-1 secretion by 2.5
      and 2 times, respectively. The depression of tPA secretion was not due to
      inhibition of the secretory function since tPA did not accumulate intracellularly
      during colchicine treatment. Nor did colchicine affect the PMA activation of
      protein kinase C-alpha, upon which stimulation of tPA is dependent; neither
      translocation of the kinase nor phosphorylation of the protein kinase C substrate
      protein, P80, was inhibited. Measurement of tPA mRNA levels demonstrated that the
      increase which precedes PMA-enhanced tPA secretion was also inhibited by
      colchicine by 50%. However, tPA gene transcriptional activity was only reduced
      13%, suggesting that a post-transcriptional event was affected by microtubule
      disruption. PAI-1 mRNA levels and transcription rates were elevated 3.5 times.
      This study suggests that the changes that occur in endothelial cells during PMA
      induced signal transmission leading to enhanced tPA mRNA levels and tPA antigen
      production can be partly blocked by agents that disrupt microtubule organization.

PMID- 1639134
TI  - The use of caged substrates to assess the activity of 6-phosphogluconate
      dehydrogenase in living sea urchin eggs.
AB  - As part of our inquiries into the regulation of the hexose monophosphate shunt in
      the early development of sea urchin eggs and embryos, we have developed a novel
      method to assess the in vivo activity of the enzyme 6-phosphogluconate
      dehydrogenase (6PGDH) before and after fertilization. Our measurements show that
      the intracellular level of 6-phosphogluconate (6PG) in eggs decreases 60% after
      fertilization, which is consistent with the increase in the activity of 6PGDH
      previously reported using irreversibly permeabilized cell assays (Swezey and
      Epel, Proc. Natl. Acad. Sci USA 85, 812-816, 1988). The in vivo turnover of the
      6PG pool was assessed using a new radioisotopic technique. 1-14C-labeled 6PG was
      chemically modified such that it was not metabolized by cellular 6PGDH and could
      be rapidly converted back to 6PG by photolysis. This "caged" 6PG was introduced
      into unfertilized sea urchin eggs using a transient permeabilization procedure,
      and then the oxidation of [1-14C]6PG in vivo upon irradiation was followed.
      Oxidation of 6PG was complete within 7-11 s of irradiation, indicating an
      extremely rapid turnover of this pool in sea urchin eggs. Based on the 6PG pool
      sizes and the kinetic properties of 6PGDH, determined here, along with the
      activity levels seen in permeabilized cells, the half-time for the label in the
      6PG pool in sea urchin eggs is calculated to be 26 s. This is inconsistent with
      the in vivo turnover rates seen in these studies, indicating that the
      permeabilized cell assays overestimate the degree of inhibition of 6PGDH before
      fertilization. These results suggest that caution should be exercised in
      extrapolating data obtained from permeabilized cells to the situation in vivo.

PMID- 1639135
TI  - Lithium mimics dexamethasone in stimulating DNA synthesis by WI-38 cells.
AB  - Lithium interferes with the responses of neural and secretory cells to calcium
      mobilizing agonists by blocking the generation of phospholipase C-dependent
      second messengers. However, the mechanism by which lithium stimulates the
      proliferation of other cells in response to agonists that do not activate
      phospholipase C remains obscure. We investigated the pathways that mediate the
      mitogenic action of lithium on WI-38 cells in a defined, serum-free medium.
      Lithium, like dexamethasone (Dex), potentiated DNA synthesis in response to the
      combination of insulin+epidermal growth factor (EGF) (+50%), but not in response
      to either growth factor alone or with Dex. As in the case of Dex, lithium could
      be added as late as 8 h following stimulation of quiescent cells by insulin+EGF
      without loss of potentiating activity. While DNA synthesis in control cultures
      was essentially complete by 24 h, lithium and Dex stimulated "late" DNA synthesis
      (24-30 h) 10-fold and 5-fold, respectively. The potentiating activity of Dex, but
      not that of lithium, was blocked by the specific glucocorticoid receptor
      antagonist, RU486. Both lithium and Dex stimulated log-phase growth, but only Dex
      increased saturation density. These data indicate that both lithium and Dex
      recruit into the cell cycle a subpopulation of cells with a longer mean
      prereplicative phase (G1). The effect of lithium on DNA synthesis in WI-38 cells
      may be mediated by the glucocorticoid response pathway at some point distal to
      activation of the glucocorticoid receptor, or by an independent mechanism that
      can be switched on late in G1.

PMID- 1639136
TI  - The autoantigen La/SSB: detection on and uptake by mitotic cells.
AB  - The nuclear autoantigen La, a transcription/termination factor of RNA polymerase
      III, was recently shown to translocalize to the cell surface of growth-stimulated
      cells during transition from G0- to G1-phase. Here we describe the staining of
      living mitotic cells with the anti-La mab La11G7. Moreover, La protein added to
      cell culture medium was able to enter into synchronized mitotic cells. Uptake was
      inhibited by the anti-La mab. La protein taken up into prophase cells assembled
      into a fibrillar network. Taken up byu ana/telophase cells, La protein was
      preferentially transported into the newly forming or formed nuclei. This import
      allowed us to study directly the intranuclear localization of La protein in
      living cells by the use confocal laser scanning microscopy (cLSM). Adsorbed La
      protein was found in the nucleoplasm but also assembled into nuclear speckles.
      Some of these speckles surrounded the nucleolus like a ring.

PMID- 1639137
TI  - Reorganization of the endocytic compartment in regenerating liver.
AB  - Antibodies raised to two membrane proteins present in rat liver endosomal
      fractions were used to study changes occurring in the endocytic compartment of
      hepatocytes during liver regeneration. Antibodies to the 42-kDa subunit (RHL-1)
      of the asialoglycoprotein receptor showed, by Western blotting of liver
      microsomes and endosomes, that there was a reduced expression of the receptor in
      liver 24 h following a partial hepatectomy. Immunocytochemical staining of thin
      sections of regenerating livers using these antibodies indicated that there was
      an intracellular relocation of endocytic structures in hepatocytes. The two main
      endocytic regions immunocytochemically stained in normal liver--one located
      beneath the sinusoidal plasma membrane and the other abutting the bile
      canaliculus--were replaced, in regenerating liver, by staining more closely
      associated with a region underlying the baso-lateral plasma membrane. A 140-kDa
      pI 4.3 calmodulin-binding protein located in endocytic and plasma membranes was
      also demonstrated, using a radio-iodinated calmodulin-binding assay, to be
      present at reduced levels in endosomes isolated from regenerating livers.
      Antibodies to this calmodulin-binding protein stained the hepatocyte's cytoplasm
      in a punctate manner. However, in regenerating liver, the staining was located in
      regions underlying the baso-lateral and apical plasma membrane of hepatocytes.
      Together, the results demonstrate that a reorganization of the endocytic
      compartment has occurred in hepatocytes 24 h following hepatectomy, with two
      endosomal proteins becoming relocated to a region below the baso-lateral-apical
      surface regions of hepatocytes.

PMID- 1639138
TI  - Adenovirus capsid proteins interact with HSP70 proteins after penetration in
      human or rodent cells.
AB  - Soon after penetration of adenovirus serotype 2 in BHK-21 and HeLa cells, HSP70
      and HSC70 proteins become associated with the viral capsid. By analysis with a
      polyclonal antibody derived from a fusion protein containing the C-terminal
      domain, 290 amino acids of HSP70, and using both immunological methods and
      infected cells fractionation we observed that a significant amount of HSP70
      proteins moved to the nucleus and colocalized with the adenovirus particles.
      HSP70 proteins of infected cells were isolated as a complex cross-linked with
      intracytoplasmic adenovirus type 2. By coprecipitation, using a polyclonal
      specific antiserum derived from the fusion protein, or two different monoclonal
      specific antisera, we showed that HSP70 and HSC70 proteins were associated with
      hexon, the major adenovirus capsid protein.

PMID- 1639139
TI  - Immunolocalization of Ku-proteins (p80/p70): localization of p70 to nucleoli and
      periphery of both interphase nuclei and metaphase chromosomes.
AB  - Distribution on both nuclei and metaphase chromosomes of Ku-proteins, recognized
      by autoantibodies from a patient with systemic lupus erythematosus, has been
      studied using a specific monoclonal antibody (mAbH6) that recognizes p70, one Ku
      protein. Observation with either a conventional fluorescent microscope or a
      confocal laser scanning microscope revealed mAbH6-stained p70 antigen localized
      on both nuclear periphery and nucleoli of human interphase cells. The specific
      staining of nucleoli with mAbH6 has been confirmed using isolated nucleoli from
      rat liver in which the staining was seen as fine granules surrounding nucleolar
      DNA. During mitosis p70 antigen moved away from association with the nuclear
      envelope region to localization on the periphery of condensed chromosomes with no
      apparent staining of chromosome interior. The p70 antigen was copurified with DNA
      fragments by immunoaffinity column chromatography using mAbH6. The mAbH6 staining
      of both nuclear periphery and nucleoli was lost upon digestion with DNase I at
      low concentrations. These results suggest that p70 antigen is connected with
      these nuclear structures through DNA.

PMID- 1639140
TI  - Gap junctional communication of primary human keratinocytes: characterization by
      dual voltage clamp and dye transfer.
AB  - We have compared dye coupling in pairs of small (less than 10 microns in
      diameter) and large (greater than 20 microns in diameter) keratinocytes isolated
      from normal human epidermis, using Lucifer yellow microinjection. Under control
      conditions, dye coupling was found in only 1 out of the 25 small pairs tested,
      whereas it was evident in 75% of the large pairs (n = 52). After a 30-min
      incubation of the latter pairs in the presence of 10(-6) and 10(-4) M all
      transretinoic acid (RA), the percentage of coupling was 53% (n = 15; NS) and 7%
      (n = 14; P less than 0.001), respectively. The almost complete uncoupling
      observed after 10(-4) M RA was not reversible even 30 min after return to control
      medium (n = 8). Dual whole-cell patch-clamp recordings from large keratinocyte
      pairs showed a macroscopic junctional conductance (gj) of 9 +/- 2 nS (n = 43),
      which was abolished by heptanol (3.5 mM) in a fully reversible way. Compared to
      heptanol, 10(-4) M RA abolished keratinocyte gj more slowly and irreversibly (n =
      10). By contrast, 10(-6) M RA had no significant effect on gj (n = 8). Single-gap
      junctional channels were also identified between large keratinocytes. Events
      histograms of 152 transitions from three experiments revealed three main unitary
      conductances (gamma j) of 45 +/- 4, 78 +/- 4, and 106 +/- 7 pS. The dye coupling
      results indicate that junctional communication is markedly different in pairs of
      small and large cells, which showed the phenotype and keratin markers of basal
      and suprabasal keratinocytes, respectively. In the latter cell type, coupling is
      ensured by channels of three sizes and is blocked irreversibly by pharmacologic
      concentrations of RA.

PMID- 1639141
TI  - The effect of in vitro heat exposure on the recovery of nuclear matrix-bound DNA
      polymerase alpha activity during the different phases of the cell cycle in
      synchronized HeLa S3 cells.
AB  - HeLa S3 cells were synchronized by a double thymidine block or aphidicolin
      treatment and the levels of nuclear matrix-bound DNA polymerase alpha activity
      were then measured using activated calf thymus DNA as template. The nuclear
      matrix was obtained by 2 M NaCl extraction and DNase I digestion of isolated
      nuclei incubated at 37 degrees C for 45 min prior to subfractionation. In all
      phases of the cell cycle 25-30% of nuclear DNA polymerase alpha activity remained
      matrix-bound, even when cells were in the G1 phase. No dynamic association of DNA
      polymerase alpha activity with the matrix was seen, at variance with previous
      results obtained in regenerating rat liver. The variations measured in matrix
      bound activity closely followed those detected in isolated nuclei throughout the
      cell cycle. If nuclei were not heat-stabilized very low levels of DNA polymerase
      alpha activity were measured in the matrix (1-2% of total nuclear activity). Heat
      incubation of nuclei failed to produce any enrichment in matrix-associated newly
      replicated DNA, whereas the sulfhydryl cross-linking chemical sodium
      tetrathionate did. Therefore the results obtained after the heat stabilization
      procedure do not completely fit with the model that envisions the nuclear matrix
      as the active site where eucaryotic DNA replication takes place.

PMID- 1639142
TI  - Conventional and confocal microscopic studies of insulin receptor induction in
      Tetrahymena pyriformis.
AB  - Tetrahymena pyriformis reportedly possesses binding structures for the vertebrate
      hormone insulin that are amplified in cells having prior exposure to the hormone.
      Conventional and confocal microscopic studies were conducted to verify the
      validity of the reports and to localize the binding sites. Logarithmic cultures
      were exposed to insulin concentrations of 0, 3, 6, and 12 micrograms/ml for 1 h
      (receptor induced, RI). After an additional culture period the cells were fixed,
      exposed to porcine insulin (antigen), immunocytochemically processed, and
      examined for staining intensity by video image analysis. Observations indicate
      that T. pyriformis does bind insulin whether or not the cells have prior exposure
      to insulin. Staining intensity increased at the two highest RI concentrations
      over 0 microgram/ml (P less than 0.01) but the staining intensity at 0
      microgram/ml was not different from that at 3 micrograms/ml. The results confirm
      that T. pyriformis does bind insulin and that prior exposure to insulin increases
      the binding capacity for insulin in what may be a concentration-dependent manner.
      Confocal microscopy of RI cells that had been labeled with either fluorescein
      isothiocyanate-insulin or the immunocytochemical technique outlined above
      revealed labeling of the cytoplasm that appeared to be vesicular. Both techniques
      produced very similar labeling patterns when optical sections through the cells
      were viewed. Conventional fluorescence revealed ciliary labeling that could be
      decreased by incubation with excess unlabeled insulin. Further studies with the
      exo- mutant of T. thermophila, SB 255, showed that mucocyst discharge and capsule
      formation are not involved in insulin binding.

PMID- 1639143
TI  - Reorganization of the cytoskeleton and morphological changes induced by 1,25
      dihydroxyvitamin D3 in C3H/10T1/2 mouse embryo fibroblasts: relation to
      inhibition of proliferation.
AB  - The effects of 1,25-dihydroxyvitamin D3 (1,25(OH)2 D3) on cell morphology, the
      cytoskeleton, and fibronectin were studied in three lines of C3H/10T1/2 mouse
      embryo fibroblasts in which the antiproliferative effect of the hormone had
      previously been investigated. We showed that 1,25(OH)2D3 induced morphological
      changes in the nontransformed C3H/10T1/2 Cl 8 cells, which flattened and spread
      out markedly. Visualization of actin and tubulin by immunocytochemistry disclosed
      a reorganization of the microfilament and microtubular systems. 1,25(OH)2D3 also
      induced an increase in cell-surface-associated fibronectin. These changes were
      only slight in the transformed cell line C3H/10T1/2 Cl 16 and absent in the
      transformed C3H/10T1/2 TPA 482 cell line. These effects were correlated with the
      growth inhibition induced by the hormone, and this suggests a possible
      relationship between the 1,25(OH)2D3-induced alterations of cell shape and of the
      cytoskeleton and the effects of the hormone on cell proliferation.

PMID- 1639144
TI  - Overexpression of the two-chain form of cathepsin B in senescent WI-38 cells.
AB  - We have examined differential protein expression in serum-stimulated young and
      senescent WI-38 human fetal lung-derived cells in culture using high-resolution
      two-dimensional gel electrophoresis. Overexpression of a protein with an
      approximate M(r) of 29,000 and pI of 5.8 was observed in senescent cells during
      the G0 and throughout the G1 stage of the cell cycle. Automated amino-terminal
      sequencing of the peptide from polyvinylidene difluoride electroblots showed 100%
      sequence identity to cathepsin B or pre-procathepsin B in a 12-amino acid
      overlap, beginning at residue 48 or 129, respectively. The 29-kDa peptide
      corresponds to the heavy chain of the two-chain enzyme form. Cathepsin B activity
      was found to be decreased in cells aged in vitro in comparison to that in young
      controls. Changes in the steady-state levels of both the 4.0- and the 2.2-kb
      cathepsin B transcripts between young and senescent cells cannot account for the
      overexpression of the two-chain form of the enzyme. These results suggest that
      increased proteolysis of a conformationally more labile single-chain form and/or
      decreased turnover and accumulation of a less active form of this lysosomal
      protease occur in senescent fibroblasts and may account for the observed
      decreased cathepsin B activity in senescent cells in culture.

PMID- 1639146
TI  - Increased histone H1(0) expression in differentiating mouse erythroleukemia cells
      is related to decreased cell proliferation.
AB  - The amount of histone H1(0) increases relative to other H1 subtypes in terminally
      differentiated cells, and its expression has been associated with the onset of
      differentiation. We have studied the kinetics of H1(0) accumulation in mouse
      erythroleukemia (MEL) cells and found that the levels of H1(0) reflect the rate
      of cell proliferation rather than the state of differentiation. This suggests
      that changes in the relative amount of H1(0) during MEL cell differentiation are
      primarily a consequence of cell cycle arrest.

PMID- 1639145
TI  - RGD-directed attachment of isolated rat osteoclasts to osteopontin, bone
      sialoprotein, and fibronectin.
AB  - Osteoclasts isolated from the long bones of 5-day-old rats were seeded onto glass
      surfaces coated with osteopontin, bone sialoprotein, or fibronectin. Cell binding
      was promoted by all three proteins and inhibited in a dose-dependent manner by an
      RGD-containing peptide, while an RGE-containing peptide was ineffective.
      Immunocytochemistry of bone tissue showed enhanced concentration of osteopontin
      in bone opposite the clear zone of the osteoclasts, whereas immunolocalization of
      bone sialoprotein and fibronectin showed no accumulation on bone surfaces facing
      cells. The observations corroborate previous findings that the osteoclast is
      attached via an integrin to osteopontin on the bone surface. Although bone
      sialoprotein and fibronectin can mediate osteoclast binding in vitro, such a role
      in vivo is not supported by the immunocytochemical observations.

PMID- 1639147
TI  - Failure of kinetochore development and mitotic spindle formation in okadaic acid
      induced premature mitosis in HeLa cells.
AB  - The mitotic events associated with okadaic acid (OA)-induced premature chromosome
      condensation (PCC) in S-phase-blocked HeLa cells were studied at the light
      microscope, immunofluorescence, and electron microscope level. The development of
      PCC in these cells has been compared with that in multinucleate cells and also in
      uninucleate hamster cells induced by caffeine. In OA-induced PCC, the nuclear
      envelope breaks down and chromosomes condense, but the mitotic spindle and
      trilaminar kinetochores fail to develop. In S-phase PCC in multinucleate cells,
      only the mitotic spindle does not develop, whereas in caffeine-induced PCC, all
      these events are found to be associated. The possible difference in their
      pathways of induction and, in this connection, the dissociability of the early
      mitotic events have been discussed.

PMID- 1639148
TI  - Cultured microvascular endothelial cells derived from the bovine corpus luteum
      possess NCAM-140.
AB  - Previously, five phenotypically different, stable types of microvascular
      endothelial cells (MVE) were isolated from the bovine corpus and cultured
      successfully. We found that three out of these five types of MVE express the
      neural cell adhesion molecule (NCAM). As shown by immunocytochemistry, weak NCAM
      immunoreactivity occurred mainly in the perinuclear area of cell type 1.
      Monolayers of types 2 and 5 revealed heavy NCAM immunoreactivity, which was
      localized predominantly at the lateral cell surface outlining the contact zones
      of adjacent cells. In contrast, cell types 3 and 4 were not NCAM immunoreactive.
      Western blot analyses substantiated these results: While cell type 1 showed a
      weak immunoreactive band, cell types 2 and 5 displayed strong NCAM-immunoreactive
      bands of a molecular weight of approximately 140 kDa (NCAM-140), which was absent
      in cell types 3 and 4. These results reveal for the first time that NCAM can be
      expressed by cultured MVE and may serve in mediating endothelial cell contacts.
      Since luteal cells also express NCAM-140, this adhesion molecule could in
      addition be involved in the interactions of luteal cells with MVE.

PMID- 1639149
TI  - A historical perspective of research on the biology of aging from Nathan W.
      Shock.
AB  - This article describes some of the thoughts and the conceptual framework from
      which Nathan W. Shock prepared his last major presentation. This paper, written
      some 8 months following Dr. Shock's death on November 12, 1989, is based upon his
      extensive notes and discussions with one of the authors (George T. Baker). This
      presentation in no way is meant to encapsulate the long and distinguished career
      of Nathan Shock, but rather to provide a glimpse of his perspectives on the
      development of the field of aging. Furthermore, we believe that the scientific
      principles concerning aging research laid out by Dr. Shock in this publication
      are still valid today and may provide valuable insights for researchers in the
      field.

PMID- 1639150
TI  - Memory performance of young and old subjects related to their erythrocyte
      characteristics.
AB  - Several papers reported in recent years on a change in the age population
      distribution of the circulating erythrocytes in old mice, rats, rabbits, and
      humans. The results indicate the presence of a chronologically younger cell
      population in old animals and humans. The cells are typically lower in density
      and larger. In some reports, the cells have higher levels of enzymatic activity.
      We wanted to know whether changes in the characteristics of the circulating
      erythrocytes in old people are related to the changes in cognitive performance
      often observed in the elderly. Twenty young (20-40) and 21 old (70-90) volunteers
      submitted to memory and blood tests. Density and size distribution, aspartate
      aminotransferase/glutamic oxalacetic transaminase (AST/GOT) activity, and the
      level of glycosylated hemoglobin (HbA1) of erythrocytes were determined. The
      Wechsler Memory Scale--Revised (Wechsler, 1987) was used to determine general
      memory and delayed recall scores for each subject. We have confirmed that old
      subjects have larger and less dense cells. Erythrocyte volume was the only blood
      parameter examined that revealed statistically significant correlations with
      memory performance. The old subjects with no age-related memory impairment had
      significantly smaller cells than the other old subjects.

PMID- 1639151
TI  - Aging reduces cardiovascular and sympathetic responses to NTS injections of
      serotonin in rats.
AB  - Serotonergic mechanisms for baroreflex modulation could become altered with age.
      This possibility was explored by comparing cardiovascular and sympathetic effects
      elicited in 2-month- and 24-month-old rats by injecting serotonin (5-HT) directly
      into the nucleus tractus solitarius (NTS) which is the primary baroreflex relay
      station in the medulla. Ensuing decreases in mean pressure, heart rate, and renal
      nerve firing were significantly smaller in 24-month-old than in 2-month-old rats.
      By contrast, similar injections into the NTS of the vehicle alone were
      ineffective in both age groups. Postmortem examination of brain sections showed
      that NTS injection sites were equally distributed in both age groups, thereby
      indicating that the brain areas affected by 5-HT were identical regardless of
      age. Reduced sensitivity of peripheral myocardial beta-adrenergic and vascular
      alpha-adrenergic receptors was considered partly responsible because 5-HT
      injected into the NTS lowers blood pressure by decreasing sympathetic vasomotor
      tone and slows the heart by increasing vagal tone with reciprocal sympatho
      inhibition. But since reduced adrenergic sensitivity would not account for the
      concurrent decrease in renal nerve firing, a more logical explanation is that the
      sensitivity of serotonergic mechanisms in the NTS for inhibiting blood pressure,
      heart rate, and renal nerve activity decreases with age.

PMID- 1639152
TI  - Effect of aging and caloric restriction on intestinal permeability.
AB  - Intestinal permeability is increased in several disorders such as Crohn's disease
      or rheumatoid arthritis. Since aging leads to alteration of many biological
      functions, the effect of aging on intestinal permeability was studied by
      measuring the intestinal permeability in aging rats gavaged with different size
      permeability probes--mannitol, polyethylene glycol (PEG) 400, and inulin. In rats
      fed with control diet, there was a significant increase in intestinal
      permeability to medium size probes PEG 400 (14.8 +/- 0.4 and 21.0 +/- 1.1% at 3
      and 28 months respectively, p less than .01) and mannitol (3.41 +/- 0.4 and 5.3
      +/- 0.5% at 3 and 28 months, respectively, p less than .01). Intestinal
      permeability of the large macromolecule inulin did not change (0.42 +/- 0.03 and
      0.38 +/- 0.02% at 3 and 28 months, respectively) with aging. There was no
      correlation between weight of the rats and their intestinal permeability. Because
      dietary caloric restriction has been found to prolong the life span, retard
      deterioration of several biological functions, and affect intestinal absorptive
      functions, we examined the effect of lifelong calorie restriction on intestinal
      permeability changes. Lifelong calorie-restricted diet did not affect age-related
      change in intestinal permeability. We conclude that intestinal permeability of
      medium size probes increases with aging and that lifelong caloric restriction
      does not prevent this change. We speculate that age-associated deterioration in
      intestinal barrier functions could permit increased systemic absorption of
      lumenal antigens and could perhaps contribute to the genesis of antigen-related
      age-associated diseases.

PMID- 1639153
TI  - Interaction of aging and lifelong ethanol ingestion on ethanol-related behaviors
      and longevity.
AB  - The interactions of aging and long-term voluntary ethanol consumption were
      studied in the alcohol-preferring AA (Alko Alcohol) rats. The mean daily ethanol
      intake was 6.45 +/- 0.31 g/kg/day (mean +/- SE) at the beginning of the exposure
      at 3 months of age. The control animals were given only food and water ad
      libitum. There was no difference in survival or weight gain between the control
      and ethanol groups. When tested for voluntary ethanol intake at the age of 24
      months, the rats in the ethanol group consumed significantly more ethanol than
      the controls. The two groups did not differ in ethanol-induced motor impairment,
      sleep-time, or hypothermia, nor in the rate of ethanol elimination. The 24-month
      old animals, however, showed higher sensitivity to ethanol than the 3-4-month-old
      rats in the sleep-time test. It is concluded that the feeding regimen used in
      this study did not produce any detectable interactions between ethanol and the
      aging processes in the AA rats.

PMID- 1639154
TI  - The heterogeneity of the age-related decline in immune response: impairment in
      delayed-type hypersensitivity and cytotoxic T-lymphocyte activity occur
      independently.
AB  - Aged mice are known to have a heterogeneous cytotoxic T-lymphocyte (CTL) response
      to an influenza challenge. We sought to determine whether delayed-type
      hypersensitivity (DTH) to sheep red blood cells (SRBC) was also heterogeneous in
      aging and, if so, whether this correlated with anti-influenza CTL activity. Aged
      mice developed mean footpad swelling of 0.24 +/- 0.09 mm following SRBC challenge
      and mean CTL activity of 35 +/- 18%. Even though these values were significantly
      lower than those from young mice (0.54 +/- 0.10 mm and 51 +/- 2%, respectively),
      no correlation was found between anti-influenza CTL activity and DTH to SRBC (r =
      0.01). We believe the most likely reason for this independent decline in immune
      response is because different activation signals are required for DTH and CTL
      activity. Our data thus suggest an age-related functional mosaicism in the immune
      system.

PMID- 1639155
TI  - Trichinella spiralis: modifications of the cuticle of the newborn larva during
      passage through the lung.
AB  - A scintigraphic method was developed to study the distribution of radioactivity
      after iv injection of 131I-labeled Trichinella spiralis newborn larvae into
      normal rats. It was found that the radioactivity was immediately retained in the
      lungs and thereafter slowly released, with a mean transit time in excess of 9 hr,
      as calculated by image analysis. At various times after iv injection of newborn
      larvae into normal mice, the lungs were removed and parasites were recovered and
      counted. Fifty to seventy percent of the larvae injected were recovered after 30
      sec, between 10 and 30% after 1 min, and less than 4% at 15 min. These results
      indicate that during the very rapid passage of newborn larvae through the lungs,
      labeled components of the cuticle are detached and retained. It is suggested that
      the modifications produced in the cuticle of the newborn larva during its passage
      through the lung may increase its resistance to the nonspecific defense
      mechanisms of the host.

PMID- 1639156
TI  - Plasmodium falciparum: identification and purification of the phosphoglycerate
      kinase of the malaria parasite.
AB  - Multiplication of the human malaria parasite Plasmodium falciparum within red
      blood cells is an energy-dependent process and glucose consumption increases
      dramatically in infected red blood cells (IRBC) versus normal red blood cells
      (NRBC). The major pathway for glucose metabolism in P. falciparum IRBC is
      anaerobic glycolysis. Phosphoglycerate kinase (PGK) is one of the key enzymes of
      this pathway as it generates ATP. We found that the PGK specific activity in P.
      falciparum IRBC is seven times higher than that in NRBC. The parasitic origin of
      the increase in PGK activity is confirmed by isoelectric focusing. Indeed, two P.
      falciparum isoenzymes with neutral isoelectric points were detected. P.
      falciparum PGK in purified form has a molecular mass of 48 kDa. Antiserum raised
      against purified P. falciparum PGK specifically recognizes the 48-kDa protein
      band in P. falciparum and also reacts with P. berghei and P. yoelii IRBC lysates
      but does not cross-react with PGK associated with NRBC.

PMID- 1639157
TI  - Ascaris suum: are trypsin inhibitors involved in species specificity of Ascarid
      nematodes?
AB  - Inhibitors of porcine trypsin were prepared from aqueous extracts of the
      parasitic nematodes Ascaris suum (hogs) and Ascaris lumbricoides (human). In this
      study three experiments were performed. (1) Polyclonal antibodies were prepared
      against one isoform of trypsin inhibitor from each parasitic nematode. Each
      antibody reacted with all isoforms from itself as well as all isoforms from the
      other parasite. (2) Association equilibrium constants were measured by titrating
      host trypsins (porcine or human) with the isoforms of trypsin inhibitors from A.
      suum and A. lumbricoides. While three of the combinations formed tight complexes
      that can be precipitated, the fourth complex, A. suum trypsin inhibitor-human
      trypsin has a Ka that is a 300 to 1000 times weaker interaction than the three
      other titration pairs. (3) Live A. suum worms were incubated in isosmotic media
      that contained either porcine trypsin or human trypsin. A suum worms survived in
      porcine trypsin and in the controls but were killed and digested after exposure
      for 5 days in human trypsin. The first experiment suggests that the trypsin
      inhibitors from A. suum and A. lumbricoides have similar epitopes, while the
      second experiment suggests that there are differences near the reactive site of
      the inhibitors. The consequences of these differences are dramatically
      demonstrated by the third experiment in which live A. suum worms in the presence
      of human trypsin die and are digested but those in porcine trypsin survive. These
      experiments suggest that in order to parasitize a host, a nematode requires a
      complement of protease inhibitors that interact strongly with those host
      proteases that are in their environment.

PMID- 1639158
TI  - Biomphalaria glabrata: influence of calcium, lectins, and plasma factors on in
      vitro phagocytic behavior of hemocytes of noninfected or Schistosoma mansoni
      infected snails.
AB  - In vitro phagocytosis of erythrocytes by hemocytes of B. glabrata, intermediate
      host of S. mansoni, is strongly influenced by calcium, several lectins, and
      plasma factors. Our results indicate that two different mechanisms of non-self
      recognition in B. glabrata may occur: (1) In the presence of calcium,
      phagocytosis occurs in noninfected and in infected snails without involvement of
      any other substances, and hemocytes of schistosome resistant as well as those of
      susceptible snails are able to recognize and phagocytose the target cells. (2) In
      the absence of calcium, phagocytosis occurs if bridging molecules (heterologous
      lectins in our assays) were present for which effector and target cells possess
      binding sites or if target cells were plasma coated prior to the assays. In
      suspensions in homologous plasma, hemocytes of both snail strains, infected or
      noninfected, subsequently showed phagocytic activities of about 70-80%.
      Preincubation of target cells in homologous plasma resulted in similar high
      phagocytic activities of hemocytes even in the absence of plasma during the
      standard assay. In these assays, a significantly higher proportion of hemocytes
      of resistant snails phagocytosed plasma-opsonized erythrocytes, whereas hemocytes
      of susceptible snails internalized less erythrocytes per cell and needed 60 min
      to phagocytose at percentages equivalent to that of resistant hemocytes within 10
      min. Preincubation of erythrocytes in resistant plasma significantly increased
      the subsequent phagocytic activity of susceptible hemocytes, whereas
      preincubation of erythrocytes in susceptible plasma decreased the phagocytosis
      level of resistant hemocytes.

PMID- 1639159
TI  - Trypanosoma cruzi: involvement of IgG isotypes in the parasitemia control of mice
      immunized with parasite exoantigens of isoelectric point 4.5.
AB  - In a previous work we demonstrated that Trypanosoma cruzi exoantigens of pI 4.5
      (Ea 4.5), whose most important epitopes are glucidic, are able to induce a
      partially protective immune response in mice. To ascertain the involvement of
      antibody isotypes in this protection, we immunized mice with Ea 4.5 plus
      Bordetella pertussis as adjuvant. The analysis of immune response by skin test
      revealed the occurrence of specific immediate type hypersensitivity on Day 15
      after the last immunization. By ELISA and using Ea 4.5 as antigen, specific IgG1
      antibody was detected. When formaldehyde-fixed epimastigotes were used as
      antigen, binding of IgG1 and IgG2 was observed. Trypomastigotes incubated for 1
      hr at 33 degrees C with the immune sera and then injected in normal syngeneic
      mice produced a significantly lower parasitemia than trypomastigotes incubated
      with the control sera. This capacity of anti-Ea 4.5 sera was resistant to 56
      degrees C for 2 hr and was diminished after the absorption of immune sera with
      the carbohydrate moiety of Ea 4.5. The assay with the immune IgG1 and IgG2,
      separated through protein A-Sepharose affinity chromatography, showed that IgG1
      retains most of this capacity. Purified immune IgG1 revealed two antigenic bands
      of molecular weight between 50 and 55 kDa in SDS-PAGE of Ea 4.5.

PMID- 1639160
TI  - Brugia pahangi: production of a monoclonal antibody reactive with the surface of
      infective larvae.
AB  - Monoclonal antibodies against infective third-stage larvae (L3) of Brugia pahangi
      were generated from mice immunized with L3 antigens. The monoclonal antibodies
      were L3 stage-specific or stage-nonspecific. A BpG1 monoclonal antibody (IgG1
      subclass) showing L3 stage-specificity was examined in detail. BpG1 recognized
      the surface of B. pahangi L3 and also reacted with the surface of Brugia malayi
      L3 but not with the surface of filarial worms of other genera, such as
      Acanthocheilonema viteae and Litomosoides carinii. BpG1 promoted cellular
      adhesion to the surface of B. pahangi L3. BpG1 bound on living L3 was shed but
      the shedding rate was relatively slow. The surface antigen recognized by BpG1 had
      a molecular weight of 58 kDa. It was stable to heat and periodate treatments but
      sensitive to trypsin digestion and was released from living L3 by SDS but not by
      Triton X-100 or CTAB. Preincubation of L3 with BpG1 significantly reduced the
      recovery rate of worms compared with the preincubation with a monoclonal antibody
      (IgG1 subclass) against the inner tissues of B. pahangi L3 or control supernatant
      of P3U1 myeloma cells. This result suggests that the antigen containing the BpG1
      epitope may be one of the targets of a protective immune response against Brugia
      infection.

PMID- 1639161
TI  - Plasmodium falciparum: induction of biologically active antibodies to gp195 is
      dependent on the choice of adjuvants.

PMID- 1639162
TI  - Schistosoma mansoni: silver ion (Ag +) stimulates and reversibly inhibits lipid
      induced cercarial penetration.
AB  - Certain long-chain polyunsaturated fatty acids (FA) found on mammalian skin
      trigger cercariae to penetrate and transform into schistosomules; however, the
      mechanism by which FAs stimulate cercariae is unknown. In order to determine
      whether argentophilic papillae concentrated at the apical region of the cercariae
      are the chemoreceptors that may mediate cercarial response to FAs, an assay
      assessed the proportion of cercariae that penetrated a 0.25% agar matrix in the
      presence (61%) and the absence (2.3%) of linolenic acid at 0.22 mM. Silver
      nitrate (Ag+) which selectively binds to cercarial papillae (Short and Cartrett,
      J. Parasitol. 59, 1041, 1973) is nontoxic (at 0.09 mM used in this study) as
      demonstrated by the ability of Ag+ treated cercariae to mature successfully into
      adult worms (8.8% maturation compared to 10.2% of untreated controls, n = 5)
      after subcutaneous injection. When Ag+ was added to cercarial suspensions,
      penetration into linolenic-impregnated agar was significantly inhibited (80.8%).
      Washing cercariae free of Ag+ reversed this inhibition. These data, as well as
      observations that both argentophilic papillae and cercarial response to FAs
      disappeared within 3 to 4 hr after mechanical conversion to schistosomules,
      implicate argentophilic papillae on cercariae as chemoreceptors for lipid
      stimulation.

PMID- 1639163
TI  - Ancylostoma caninum: reduced glutathione stimulates feeding by third-stage
      infective larvae.
AB  - The resumption of feeding in vitro has been proposed as an indicator of the
      reactivation of development by arrested third-stage hookworm larvae. The
      tripeptide glutathione was tested for its ability to induce in vitro feeding by
      third-stage infective larvae of the canine hookworm Ancylostoma caninum. Reduced
      glutathione, but not oxidized glutathione, stimulated larval feeding in a
      specific, concentration-dependent manner. Feeding began at 5-10 mM, and reached a
      plateau at 25-50 mM. Incubation in reduced glutathione for 3 hr was sufficient to
      stimulate the maximum feeding response at 24 hr. Larvae began feeding within 6 hr
      of incubation with reduced glutathione, and feeding reached a maximum percentage
      by 24 hr. The reducing agents dithiothreitol and 2-mercaptoethanol failed to
      stimulate feeding, whereas S-alkyl derivatives of reduced glutathione were
      stimulatory. Reduced glutathione synergistically increased serum-stimulated
      feeding to greater than 90% of the sample population, and low concentrations of
      glutathione appeared to enhance feeding by sensitizing the larvae to a
      stimulatory component in serum and not by a chemical interaction with a serum
      component. The data suggest that reduced glutathione might participate in the
      transition from the free-living third-stage larva to the parasitic third-stage
      larva during infection.

PMID- 1639164
TI  - Schistosoma mansoni: single-step purification and characterization of glutathione
      S-transferase isoenzyme 4.
AB  - A soluble glutathione S-transferase isoenzyme, designated SmGST-4 was purified to
      apparent homogeneity in a single step from the cytosol of adult Schistosoma
      mansoni by selective elution of the enzyme from a glutathione-agarose affinity
      column using glutathione disulfide. SmGST-4, which comprised about 5% of the
      bound glutathione S-transferase activity, could be distinguished from the
      previously characterized glutathione S-transferase isoenzyme family (SmGST
      1/2/3), by its unique chromatographic behavior, lower subunit M(r) (26,000),
      differences in substrate specificity and inhibitor sensitivity, and a lack of
      reactivity with antiserum to SmGST-3. The purified isoenzyme catalyzed the
      conjugation of several model xenobiotics including 1-chloro-2,4-dinitrobenzene,
      ethacrynic acid, and trans-4-phenyl-3-buten-2-one. Like the SmGST-1/2/3 isoenzyme
      family, SmGST-4 failed to catalyze the conjugation of a model epoxide substrate,
      1,2-epoxy-3-(p-nitrophenoxy)propane. Because glutathione S-transferases from
      other organisms play a role in protecting cells against the toxic products of
      lipid peroxidation, SmGST-4 and the members of the SmGST-1/2/3 isoenzyme family
      were tested for their capacity to reduce cumene hydroperoxide and to catalyze the
      conjugation of 4-hydroxyalk-2-enals. Although all four isoenzymes catalyzed both
      reactions, the specific activity of SmGST-1, SmGST-2, and SmGST-3 toward cumene
      hydroperoxide was at least 10-fold greater than that of SmGST-4. In contrast, the
      latter more effectively conjugated a homologous series of 4-hydroxyalk-2-enal
      isomers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639165
TI  - Toxocara canis: a labile antigenic surface coat overlying the epicuticle of
      infective larvae.
AB  - An electron-dense coat covering the surface of Toxocara canis infective-stage
      larvae is described. This coat readily binds to cationized ferritin and ruthenium
      red, indicating a net negative charge and mucopolysaccharide content, and can be
      visualized by immuno-electron microscopy only if cryosectioning is employed.
      Monoclonal antibodies reactive to the surface of live larvae bind the surface
      coat but not the underlying cuticle in ultrathin cryosections. The surface coat
      is dissipated on exposure to ethanol, explaining the lack of surface reactivity
      of conventionally prepared immunoelectron microscopy sections of T. canis.
      Differential ethanol extraction of surface-iodinated larvae demonstrates that the
      major component associated with the coat is TES-120, a 120-kDa glycoprotein
      previously identified by surface iodination, which is also a dominant secreted
      product. The surface-labeled TES-70 glycoprotein is linked with a more
      hydrophobic stratum at the surface, while a prominent 32-kDa glycoprotein, TES
      32, is more strongly represented within the cuticle itself. Antibody binding to
      the coat under physiological conditions results in the loss of the surface coat,
      but this process is arrested at 4 degrees C. This result gives a physical basis
      to earlier observations on the shedding of surface-bound antibodies by this
      parasite. An extracuticular surface coat has been demonstrated on Toxocara larvae
      prior to hatching from the egg and during all stages of in vitro culture,
      suggesting that it may play a role both in protecting the parasite on hatching in
      the gastrointestinal tract and on subsequent tissue invasion in evading host
      immune responses directed at surface antigens.

PMID- 1639166
TI  - Schistosoma mansoni: cell-specific expression and secretion of a serine protease
      during development of cercariae.
AB  - Eukaryotic serine proteases are an important family of enzymes whose functions
      include fertilization, tissue degradation by neutrophils, and host invasion by
      parasites. To avoid damaging the cells or organisms that produced them, serine
      proteases must be tightly regulated and sequestered. This study elucidates how
      the parasitic blood fluke Schistosoma mansoni synthesizes, stores, and releases a
      serine protease during differentiation of its invasive larvae. In situ
      hybridization with a cDNA probe localized the protease mRNA to acetabular cells,
      the first morphologically distinguishable parasite cells that differentiate from
      the embryonic cell masses present in the intermediate host snail. The acetabular
      cells contained vimentin but not cytokeratins, consistent with a mesenchymal, not
      epithelial, origin. Antiprotease antibodies, localized by immunoperoxidase,
      showed that the protease progressively accumulated in these cells and was
      packaged in vesicles of three morphologic types. Extension of cytoplasmic
      processes containing protease vesicles formed "ducts" which reached the anterior
      end of fully differentiated larvae. During invasion of human skin, groups of
      intact vesicles were released through the acetabular cytoplasmic processes and
      ruptured within the host tissue. Ruptured protease vesicles were noted adjacent
      to degraded epidermal cells and dermal-epidermal basement membrane, as well as
      along the surface of the penetrating larvae themselves. These observations are
      consistent with the proposed dual role for the enzyme in facilitating invasion of
      host skin by larvae and helping to release the larval surface glycocalyx during
      metamorphosis to the next stage of the parasite.

PMID- 1639167
TI  - Trichinella spiralis: dose dependence and kinetics of the mucosal immune response
      in mice.
AB  - The role of the mucosal immune response in helminth infections is not clear. In
      this study, the dose dependence and kinetics of the mucosal immune response to
      Trichinella spiralis were determined in experimentally infected Swiss Webster and
      BALB/c mice. The primary mucosal isotype was sIgA, although IgG was also
      detected, and primary infections with 10 and 150 larvae produced an anamnestic
      response on challenge. The mucosal and systemic immunoglobulin responses were
      dose dependent in both primary and challenge infections. The fecundity and length
      of worms and the rate of expulsion from the gut were determined on Day 6
      postchallenge in Swiss Webster mice. Adult worm recovery and fecundity were
      reduced by greater than 50% and worm length by 28% in mice infected and
      challenged with 10 larvae and by 90, 85, and 35%, respectively, in mice infected
      and challenged with 150 larvae. The rate of expulsion was correlated with the
      size of both primary and challenge doses and a reduction in fecundity was
      correlated with the size of the primary dose only. The reduction in worm length
      did not differ significantly between the infection doses, but the trend was
      similar to that for expulsion. In BALB/c mice the expulsion response was
      dissociated from a reduction in fecundity and worm length, the latter two being
      positively correlated with sIgA levels, supporting a role for sIgA and/or IgG in
      these effects. However, expulsion does not appear to be dependent on the mucosal
      immunoglobulin response.

PMID- 1639168
TI  - Heat shock proteins. Introduction.

PMID- 1639170
TI  - Mammalian heat shock protein families. Expression and functions.
AB  - When prokaryotic or eukaryotic cells are submitted to a transient rise in
      temperature or to other proteotoxic treatments, the synthesis of a set of
      proteins called the heat shock proteins (hsp) is induced. The structure of these
      proteins has been highly conserved during evolution. The signal leading to the
      transcriptional activation of the corresponding genes is the accumulation of
      denatured and/or aggregated proteins inside the cells after stressful treatment.
      The expression of a subset of hsp is also induced during early embryogenesis and
      many differentiation processes. Two different functions have been ascribed to
      hsp: a molecular chaperone function: chaperones mediate the folding, assembly or
      translocation across the intracellular membranes of other polypeptides, and a
      role in protein degradation: some of the essential components of the cytoplasmic
      ubiquitin-dependent degradative pathway are hsp. These functions of hsp are
      essential in every living cell. They are required for repairing the damage
      resulting from stress.

PMID- 1639169
TI  - Heat shock response in Drosophila.
AB  - Major alterations in genetic activity have been observed in every organism after
      exposure to abnormally high temperatures. This phenomenon, called the heat shock
      response, was discovered in the fruit fly Drosophila. Studies with this organism
      led to the discovery of the heat shock proteins, whose genes were among the first
      eukaryotic genes to be cloned. Several of the most important aspects of the
      regulation of the heat shock response and of the functions of the heat shock
      proteins have been unraveled in Drosophila.

PMID- 1639171
TI  - Heat shock proteins and infection: interactions of pathogen and host.
AB  - Invasive microorganisms encounter defensive attempts of the host to starve,
      destroy and eliminate the infection. In experimental model systems aiming to
      imitate defensive actions of the host, microorganisms respond by the rapid
      acceleration in the rate of expression of heat shock and other stress proteins.
      Heat shock proteins (hsp) of most if not all pathogens are major immune targets
      for both B- and T-cells. Host cells involved in the defensive action cannot avoid
      exposure to their own reactive compounds, such as oxygen radicals, resulting in
      premature cell death and tissue damage. Long-term consequences to the host may
      include cancer. In cells in tissue culture, induction of host-specific hsps
      occurs upon exposure to oxidants and in viral infections. Drugs that bind to
      members of the hsp70 family induce peroxisome proliferation and hepatocarcinoma,
      but may open the way for the development of novel drugs in support of
      antimetabolite treatment of infections and cancer.

PMID- 1639172
TI  - The humoral immune response to heat shock proteins.
AB  - Humoral immune reactions to heat shock proteins (hsp) from microorganisms are one
      aspect of microbial infections in humans. The production of antibodies which are
      specific to epitopes present on procaryotic hsp leads also to the appearance of
      cross-reactive serum antibodies in the host organism that react with human hsp.
      This article discusses the consequences of such autoreactive antibodies for the
      host in context with the development of immune tolerance and autoimmune diseases,
      especially rheumatoid arthritis (RA), and in experimental animal models for
      arthritis such as adjuvant arthritis in rats. On the basis of epitope cross
      reactivity between hsp and other host proteins, a hypothesis is presented for the
      development of autoimmune disease following the production of hsp-specific
      antibodies.

PMID- 1639174
TI  - Deficiency of fibrinolytic enzyme activities in the serum of patients with
      Alzheimer-type dementia.
AB  - Previously we reported that there is a kallikrein deficiency in the cerebral
      tissue of patients with Alzheimer-type dementia. The present study was performed
      to investigate protease changes in the serum of these patients. The results
      showed that the kallikrein activity was normal, but that the activities of
      plasmin and urokinase were significantly low. The present findings indicate a
      derangement in the clotting and fibrinolytic systems in Alzheimer patients.

PMID- 1639173
TI  - Heat shock proteins in autoimmune disease. From causative antigen to specific
      therapy?
AB  - Heat shock proteins (hsp) are highly conserved from bacteria to man. Bacterial
      hsp, with approximate molecular weights of 60 kDa (hsp60), are immunodominant
      antigens that are immunologically cross-reactive with their mammalian
      counterparts. Hsp molecules are therefore useful in studies of fundamental
      questions concerning immune responses to foreign as opposed to self antigens. The
      finding that immune responses to hsp are associated with both experimentally
      induced and spontaneous autoimmune diseases in animals has prompted intensive
      research to assess the role of bacterial hsp as the etiological agents involved
      in the development of autoimmune diseases. Recent evidence from animal models of
      autoimmune disease has clearly demonstrated the involvement of hsp in both the
      pathogenesis and the immunoregulation of autoimmune diseases. Studies with
      arthritogenic and diabetogenic T cell clones have identified immunogenic epitopes
      of hsp. These have been shown to ameliorate adjuvant arthritis in Lewis rats, and
      insulin-dependent diabetes mellitus (IDDM) in non-obese diabetic (NOD) mice. Such
      studies may have important therapeutic implications for the future treatment of
      human autoimmune disease.

PMID- 1639176
TI  - Catecholamine metabolism in the vas deferens and the adrenal gland with special
      reference to the central catecholamine-depleted state.
AB  - Experiments were carried out to elucidate the role of central catecholamines in
      regulating catecholamine metabolism in the vas deferens and adrenal gland of the
      rat. Rats were injected intracerebroventricularly (i.c.v.) with either vehicle or
      6-hydroxydopamine (6-OHDA). Groups of animals pretreated with vehicle or 6-OHDA
      (i.c.v.) were injected intraperitoneally (i.p.) with alpha-methyl-para-tyrosine
      (AMT), a tyrosine hydroxylase inhibitor. Catecholamine turnover rates were
      estimated by determining norepinephrine or epinephrine content after
      administering AMT. Central norepinephrine and dopamine contents decreased
      significantly (p less than 0.05) after treatment with 6-OHDA and AMT. The
      norepinephrine content of the vas deferens of rats pretreated with 6-OHDA was
      markedly reduced (p less than 0.001) after administration of AMT, whereas that of
      the vehicle-treated rats remained unchanged. Administration of 6-OHDA had no
      effect on the norepinephrine or epinephrine content of the adrenal gland. The
      present results indicate that central monoaminergic neurons have an inhibitory
      effect on the adrenergic neurons of the vas deferens. In contrast, this
      inhibitory regulation does not appear to be exerted on the adrenal glands.

PMID- 1639175
TI  - Reversal of experimental hemorrhagic shock by dimethylphenylpiperazinium (DMPP).
AB  - In a rat model of hemorrhagic shock which caused the death of all control rats
      within 30 min, i.v. injection of the ganglion-stimulating drug
      dimethylphenylpiperazinium (DMPP) caused a dose-dependent reversal of the shock
      condition--without the need for reinfusion of the shed blood--starting from the
      dose of 4 ng/kg i.v. Shock reversal was associated with the mobilization of
      residual blood and improvement in blood flow, particularly at the carotid level.
      These results could influence our thinking on pathophysiology and first-aid
      management of shock.

PMID- 1639177
TI  - Rapid isolation of mitochondrial DNA. Mitochondrial DNA from Drosophila serrata.
AB  - A simple and rapid method for isolation of high quality mitochondrial DNA (mtDNA)
      is presented in this report. Using this method, isolation and restriction site
      maps for 10 enzymes of the mtDNA of Drosophila serrata were established.

PMID- 1639178
TI  - Age-related differences in the effect of in vivo administration of indomethacin
      on hemopoietic cell lineages of the spleen and bone marrow of mice.
AB  - During 21 days of indomethacin treatment, erythroid cells in the spleens of both
      young adult and older mice, and in the bone marrow of young adult mice, were
      increased significantly early in treatment, relative to age-matched control
      organs, and remained high throughout treatment. During drug exposure, the numbers
      of myeloid cells in young adult bone marrow, but not spleen, were reduced, but in
      older mice these cells were elevated in both organs. Lymphoid cells in the young
      adult and older mouse spleens decreased and increased, respectively, during
      treatment, but were unchanged and decreased, respectively, in the bone marrow of
      young adult and older mice. Monocyte-macrophage cells in the spleen were elevated
      but unchanged in the bone marrow of both age groups. During 14 days of
      indomethacin treatment of young adult mice, the proportions of precursor cells in
      DNA synthesis of only the splenic erythroid lineage were increased. Thus, the
      major hemopoietic lineages in both the bone marrow and spleen are affected by
      exposure to indomethacin in a time-dependent and age-dependent manner. For all
      lineages studied, those of the bone marrow were least disturbed and/or were first
      to recover, even during continued drug exposure.

PMID- 1639179
TI  - Prevention of carbon tetrachloride-induced liver necrosis by the chelator
      alizarin sodium sulfonate.
AB  - The administration of the calcium chelator alizarin sodium sulfonate (ASR) (100
      mg/kg ip in saline) 30 min before or 6 or 10 hr after CCl4 (1 ml/kg ip as a 20%
      v/v solution in olive oil) partially prevents the necrogenic effect of the
      hepatotoxin at 24 hr, but prevention of CCl4 fat accumulation was not observed.
      Protective action cannot be attributed to potential decreasing effects of ASR on
      CCl4 levels reaching the liver, on the covalent binding of CCl4-reactive
      metabolites to cellular components, or on CCl4-induced lipid peroxidation because
      ASR does not modify these parameters significantly. ASR administration increases
      GSH levels in livers of both control and CCl4-poisoned animals and decreases the
      calcium content of intoxicated animals at 24 hr of poisoning. ASR significantly
      lowers the body temperature of CCl4-treated animals at different times of the
      intoxication process. Present and previous results from our laboratory on the
      preventive effects of another very specific calcium chelator, calcion, and
      several anticalmodulins suggest that the beneficial effects of ASR might be
      associated with its calcium chelating ability. Other protective effects of ASR,
      such as lowering body temperature or increasing GSH content in liver, cannot be
      excluded.

PMID- 1639180
TI  - A microscopic and ultrastructural evaluation of dibasic esters (DBE) toxicity in
      rat nasal explants.
AB  - Dibasic esters (DBE) solvent has been demonstrated to induce a mild degeneration
      of the olfactory, but not the respiratory epithelium of the rat nasal cavity
      following a 90-day inhalation exposure. Previous work has demonstrated that acid
      phosphatase release is a reliable index of DBE-induced cytotoxicity in an in
      vitro system of rat nasal explants. In the present study, rat nasal explants were
      examined microscopically and ultrastructurally following incubation in varying
      concentrations of a representative DBE, dimethyl adipate (DMA). DMA-induced
      microscopic and ultrastructural changes in rat nasal explants correlated well
      with biochemical perturbations associated with DBE exposure in a previous study.
      In both studies, olfactory epithelium was more susceptible to DMA-induced
      toxicity than respiratory epithelium and DMA-induced nasal toxicity was
      attenuated by pretreatment with a carboxylesterase inhibitor. The results of this
      study support the hypothesis that DBE and potentially other inhaled organic
      esters induce nasal toxicity via a common mechanism, carboxylesterase-mediated
      production of toxic acid metabolites. It was established that carboxylesterase
      rich sustentacular cells are the primary target cells for DBE toxicity in rat
      nasal explants. It was proposed that degeneration of nasal olfactory sensory
      cells observed in rats following 90-day inhalation exposure to DBE may be
      secondary to necrosis and loss of sustentacular cells.

PMID- 1639181
TI  - State and activity of protein kinase C in postischemic reperfused liver.
AB  - We have studied the activity and the phorbol-binding capacity of protein kinase C
      (PKC) in subcellular fractions, as well as the relative amount of the enzyme
      protein in rat livers reperfused after severe nonnecrogenic ischemia. Ischemia
      causes a significant decrease in PKC phosphotransferase activity in both
      membranes and cytosol which lasts long after the reestablishment of the blood
      flow. The phorbol-binding capacity of the membrane fraction shows the same
      behavior. The amount of PKC protein decreases during ischemia (-25%) but returns
      to normal after reperfusion more promptly than activity and binding capacity,
      suggesting that PKC resynthesized in postischemic livers is either functionally
      defective or incapacitated by unsuitable conditions of the environment. We have
      also measured the contents of some lipids that may influence PKC activity in the
      cell. During ischemia and reperfusion there is a significant increase in the
      content of 1,2-diacylglycerol (DAG), which is the physiological activator of PKC,
      but under the conditions occurring in the ischemic/postischemic livers DAG
      apparently cannot bind to the enzyme and fulfill its function. Total
      phospholipids, phosphatidylcholine, and phosphatidylethanolamine, which
      significantly decrease at 60 min of ischemia, return to normal levels 1 hr after
      reperfusion.

PMID- 1639182
TI  - Interaction of cardiac alpha-actinin and actin in the presence of doxorubicin.
AB  - The therapeutic use of doxorubicin (an antitumoral antibiotic belonging to the
      anthracycline group) is limited by its cardiotoxicity. Adriamycin (DXR) causes
      myocardial subcellular damage, such as myocytolysis, disarray of actin filaments,
      and alterations in the Z-band with loss of sarcomeric organization. We studied
      the effect of stoichiometrical concentrations of DXR on the interaction between
      cardiac actin and alpha-actinin in solution. Doxorubicin inhibits the formation
      of alpha-actinin/actin tridimensional networks and bundles. The main effect of
      the drug seems to be on the size of the actin polymers.

PMID- 1639183
TI  - Autometallographic detection of gold in dorsal root ganglia of rats treated with
      sodium aurothiomalate.
AB  - Ultraviolet light autometallography, a very sensitive method for gold detection,
      was applied to sections of dorsal root ganglia from adult male Wistar rats
      treated with intraperitoneal injections of sodium aurothiomalate. Silver
      amplified traces of gold were detected within the cytoplasm of ganglion cells,
      satellite cells, Schwann cells, macrophages, endothelial cells, and fibroblasts
      throughout the ganglia. Gold was never detected in axons nor myelin sheaths. In
      the electron microscope, gold deposits were restricted to the lysosomes
      irrespective of cell type or dosage.

PMID- 1639184
TI  - Concepts in protein folding.
AB  - Certain concepts and misconceptions in the field of protein folding are discussed
      from the viewpoint of a theoretical physicist. It is argued that there can be no
      protein folding code and that perceived correlations between sequence or
      composition and three-dimensional structure are more likely to be an artefact of
      a limited database than a real result. Attempts at using molecular dynamics
      algorithms are also likely to produce artefactual results because results depend
      critically on the unknown hamiltonian energy function. Correct calculations of
      configurational entropy are thought to be the most likely next step in
      understanding how and why proteins fold.

PMID- 1639185
TI  - Recent advances in minisatellite biology.
AB  - Highly polymorphic tandemly repeated 'minisatellite' loci are very abundant in
      the human genome, and of considerable utility in human genetic analysis. This
      review describes the use of an ordered-array Charomid library in the systematic
      and efficient cloning of these regions, and in the analysis of the relative
      overlap between the different probes used to screen for hypervariable loci.
      Recent work on the process of mutation leading to the generation of new-length
      alleles is also discussed, including the observation that at least some mutations
      may be due to unequal exchanges.

PMID- 1639186
TI  - Elucidation of the gene defect in Marfan syndrome. Success by two complementary
      research strategies.
AB  - Marfan syndrome, which is characterized by manifestations in the skeletal, ocular
      and cardiovascular systems, is one of the most common inherited connective-tissue
      disorders. The independently performed genetic assignment of the Marfan locus and
      classical biochemical and immunohistochemical analyses complemented each other in
      the search for the Marfan gene defect and in 1991 the fibrillin gene in
      chromosome 15 was identified as the Marfan gene. So far, three mutations leading
      to the Marfan phenotype have been reported in this gene coding for a
      microfibrillar protein. The available data suggests a wide spectrum of different
      mutations of fibrillin and although mutations of the fibrillin gene account for
      the majority of Marfan cases, evidence also exists for locus heterogeneity in a
      minority of Marfan cases.

PMID- 1639187
TI  - Apoptosis. Biochemical events and relevance to cancer chemotherapy.
AB  - Two distinct pathways for cell death exist. Compared to necrotic death,
      physiological or apoptotic cell death is an active suicidal process that consists
      of a cascade of well-regulated synthetic events. Participation of specific genes
      in apoptosis, and its possible molecular regulation, are considered in order to
      investigate the mechanism of cell death induced by some cancer chemotherapeutic
      agents.

PMID- 1639188
TI  - Protein dynamics. An overview on flash-photolysis over broad temperature ranges.
AB  - Ligand binding kinetics to heme-proteins between 40 and 300 K point to a
      regulatory role of protein dynamics. A protein-specific susceptibility of the
      heme-iron reactivity to dynamic fluctuations emerges from the distribution of
      reaction enthalpies derived from flash-photolysis measurements below ca. 180 K;
      we quantify it in terms of 'intramolecular viscosity', postulating that narrow
      low-temperature enthalpy distributions correspond to low internal viscosity and
      vice versa. The thermal evolution of ligand binding kinetics suggests, with other
      results, an interplay between high-frequency transitions of the amino acid side
      chains and low-frequency collective motions as a possible regulatory mechanism of
      protein dynamics.

PMID- 1639189
TI  - Amino acid substitutions influencing intracellular protein folding pathways.
AB  - Though an increasing variety of chaperonins are emerging as important factors in
      directing polypeptide chain folding off the ribosome, the primary amino acid
      sequence remains the major determinant of final conformation. The ability to
      identify cytoplasmic folding intermediates in the formation of the tailspike
      endorhamnosidase of phage P22 has made it possible to isolate two classes of
      mutations influencing folding intermediates-temperature-sensitive folding
      mutations and global suppressors of tsf mutants. These and related amino acid
      substitutions in eukaryotic proteins are discussed in the context of inclusion
      body formation and problems in the recovery of correctly folded proteins.

PMID- 1639190
TI  - The membrane insertion of colicins.
AB  - Pore-forming toxins, such as colicin A, are water-soluble proteins that insert
      into lipid bilayers. The water-soluble structure of Colicin A is known at a high
      resolution and this review describes the kinetic and structural steps involved in
      its soluble-to-membrane bound transformation.

PMID- 1639191
TI  - Crystallographic binding studies with triosephosphate isomerases: conformational
      changes induced by substrate and substrate-analogues.
AB  - TIM catalyses the interconversion of a triosephosphate aldehyde into a
      triosephosphate ketone. This is a simple chemical reaction in which only protons
      are transferred. The crystallographic studies of TIM from chicken, yeast and
      trypanosome complexed with substrate and substrate analogues are discussed. The
      substrate binds in a deep pocket. On substrate binding, large conformational
      changes are induced in three loops. As a result of these conformational changes
      in the liganded structure, the active site pocket is sealed off from bulk solvent
      and the sidechain of the catalytic glutamate becomes optimally positioned for
      catalysis.

PMID- 1639192
TI  - Multidomain enzymes involved in peptide synthesis.
AB  - Biosynthesis of peptides in non-ribosomal systems is catalyzed by multifunctional
      enzymes that employ the thio-template mechanism. Recent studies on the analysis
      of the primary structure of several peptide synthetases have revealed that they
      are organized in highly conserved and repeated functional domains. The aligned
      domains provide the template for peptide synthesis, and their order determines
      the sequence of the peptide product.

PMID- 1639193
TI  - Understanding the functions of titin and nebulin.
AB  - Individual molecules of the giant muscle proteins titin and nebulin span large
      distances in the sarcomere. Approximately one-third of the titin molecule forms
      elastic filaments linking the ends of thick filaments to the Z-line. The
      remainder of the molecule is probably bound to the thick filament where it may
      regulate assembly of myosin and the other thick filament proteins. This region
      also contains a sequence similar to catalytic domains in protein kinases. Nebulin
      appears to be associated with thin filaments and may regulate actin assembly.

PMID- 1639194
TI  - The modular architecture of vertebrate collagens.
AB  - Collagens are typical mosaic proteins containing a number of shuffled domains.
      These domains have been classified by sequence similarity in order to
      characterize their structural and functional relationships to other proteins.
      This analysis provides an overview of homologies of collagen domains. It also
      reveals two new relationships: (i) a module common to type V, IX, XI, and XII
      collagens was found to be homologous to the heparin binding domain of
      thrombospondin; (ii) the modular architecture of a human type VII collagen
      fragment was identified. Its N-terminal globular domain contains fibronectin type
      III repeats located adjacent to a Von Willebrand factor type A module. The
      proposed structural similarities point to analogous subfunctions of the
      respective domains in otherwise distinct proteins.

PMID- 1639195
TI  - SH3--an abundant protein domain in search of a function.
AB  - Src-homology 3 is a small protein domain of about 60 amino acid residues. It is
      probably made of beta-sheets. SH3 is present in a large number of eukaryotic
      proteins which are involved in signal transduction, cell polarization and
      membrane-cytoskeleton interactions. Here we review its occurrence and discuss
      possible functions of this domain.

PMID- 1639196
TI  - Prokaryotic polyprotein precursors.
AB  - Polyproteins have been found only recently in prokaryotes. The four known
      examples of single bacterial genes encoding precursors that are
      posttranslationally processed into two mature proteins are addressed here with
      respect to (i) their genomic arrangement, (ii) the sites of proteolytic
      processing, (iii) the relevant proteases, (iv) their maturation pathway, and (v)
      the function of the mature proteins. How these polyproteins may have evolved is
      also discussed.

PMID- 1639197
TI  - Peptide display on filamentous phage capsids. A new powerful tool to study
      protein-ligand interaction.
AB  - Peptides can be displayed on the surface of filamentous bacteriophages by fusion
      to phage coat proteins. It was recently shown that vast (10(8)) collections of
      phages, each exposing a variant of the original peptide, can be constructed and
      utilized as a general source of peptide ligands. By panning these libraries on a
      target molecule linked to a solid support it is possible to select, out of the
      hundreds of millions of clones, those few phages that display a peptide that
      binds the target molecule. Searching these libraries is a powerful tool to be
      applied in many areas of fundamental and applied biology.

PMID- 1639198
TI  - Monoclonal antibody engineering in plants.
AB  - Techniques for plant transformation have been developed to such an extent that a
      number of foreign genes are currently being introduced into transgenic plants.
      Tobacco plants that produce monoclonal antibodies are of interest, because in
      addition to synthesis of two gene products (i.e. the heavy and light chains), the
      two polypeptides need to be assembled correctly, in order to result in a
      functional antibody. The studies on a catalytic antibody suggest that this is the
      case, and that the antibody functions identically to the native murine-derived
      antibody. The only difference observed was in the glycosylation of the heavy
      chain. Further transgenic plants are being generated to produce monoclonal
      antibodies that may be used therapeutically (and are therefore required in large
      quantities), or to provide disease resistance in plants. In addition, the ability
      of plants to assemble antibody complexes is being investigated further, to study
      the possibility of generating secretory IgA, which consists of heavy and light
      chains as well as two additional polypeptide units.

PMID- 1639199
TI  - Do unconventional myosins exert functions in dynamics of membrane compartments?
AB  - Unconventional myosins have now been identified in amoeba as well as in higher
      eucaryotic cells. Their cellular localization, their ability to bind membrane
      vesicles and their ability to produce in vitro movement suggest that they can
      generate forces on the plasma membrane relative to actin filaments as well as on
      membrane compartments relative to actin. Genetic approaches and biochemical
      analysis of cells over-producing nonfunctional domains of unconventional myosins
      have provided direct evidence for a role of unconventional myosins in movement of
      intracellular vesicles and have allowed us to formulate hypotheses about the
      possible mechanisms by which unconventional myosins could participate in the
      intracellular transport of membrane proteins and secretory proteins.

PMID- 1639200
TI  - Brefeldin A and the endocytic pathway. Possible implications for membrane traffic
      and sorting.
AB  - A number of recent observations have suggested that the endocytic and
      biosynthetic pathways may share fundamentally similar transport mechanisms at the
      molecular level. Some of the more striking of these suggestions have come from a
      comparison of the effects of the macrocyclic lactone brefeldin A (BFA) on
      endosomes and the Golgi complex. BFA is thought to affect Golgi-specific coat
      proteins that may be involved in maintaining the structural integrity of the
      organelle and in regulating membrane transport in the secretory pathway. Many of
      the effects of BFA on the endocytic system, such as the guanine nucleotide and
      aluminum fluoride (AlF4-)-regulated induction of microtubule-dependent endosomal
      tubules, are strikingly reminiscent of the action of the drug on the Golgi
      complex. Therefore, the similar mechanisms of action of the drug on endosomes
      suggest that organelles of the endocytic pathway may be associated with similar
      cytoplasmic coats that could regulate endosome function and integrity.

PMID- 1639201
TI  - Interleukin-8, a chemotactic and inflammatory cytokine.
AB  - Interleukin-8 (IL-8) belongs to a family of small, structurally related cytokines
      similar to platelet factor 4. It is produced by phagocytes and mesenchymal cells
      exposed to inflammatory stimuli (e.g., interleukin-1 or tumor necrosis factor)
      and activates neutrophils inducing chemotaxis, exocytosis and the respiratory
      burst. In vivo, IL-8 elicits a massive neutrophil accumulation at the site of
      injection. Five neutrophil-activating cytokines similar to IL-8 in structure and
      function have been identified recently. IL-8 and the related cytokines are
      produced in several tissues upon infection, inflammation, ischemia, trauma etc.,
      and are thought to be the main cause of local neutrophil accumulation.

PMID- 1639202
TI  - [Arterial hypertension and diabetes mellitus].

PMID- 1639203
TI  - [Is angiotensin II a growth factor?].
AB  - Angiotensin II is an octapeptide resulting from the enzymatic cascade of the
      renin-angiotensin system and involved in vasoconstriction and aldosterone
      secretion. The extensive use of converting enzyme inhibitors recently suggested
      that angiotensin II may have a specific action on growth of its target tissues.
      Cellular models confirm that angiotensin II is able to produce in vitro a
      cellular hypertrophy of many cell types. Nevertheless a controversy was developed
      on the real possibility for angiotensin II to act on cell division. Some cells,
      such as adrenocortical cells, present a clear induction of their division by
      angiotensin II, but contradictory results were obtained on vascular smooth muscle
      cells. The mechanism by which angiotensin II induces hypertrophy of its target
      tissues, is largely unknown but may involve a direct action on proto-oncogene
      synthesis, or an indirect action on growth factor secretion. The nature of the
      angiotensin II receptor involved in these mechanisms has to be identified.

PMID- 1639205
TI  - [Hypertension associated with diabetes: inquiry into the attitudes and behaviors
      of French physicians].
AB  - In order to assess the prevalence of arterial hypertension, diabetes mellitus,
      and of the association of both diseases, and furthermore, to underline the
      behaviours and feelings of French physicians in front of these combined diseases,
      a survey has been undertaken by the SOFRES Medical institute and by Laboratoires
      Hoechst, which involved 304 physicians in private practice and 67 hospital
      doctors. After face-to-face interviews, each participant had to fill up a
      questionnaire dealing with his general feelings and attitudes, and then completed
      2 case record forms (5 cases for hospital doctors) from their last patients who
      presented with hypertension and diabetes mellitus. All these informations have
      allowed us to describe their behaviours. The 304 physicians have been selected
      with a regional stratification by a random survey quota method that gave a valid
      sample from the French medical population: 213 general practitioners (GPs), 67
      cardiologists, 24 endocrinologists have been involved in the survey. They have
      been able to observe 149 hypertensive insulin-dependent diabetic patients and 470
      hypertensive non insulin-dependent diabetic patients (respectively 24% and 76%).
      In addition, 67 hospital doctors (32 cardiologists, 17 diabetologists, 18
      nephrologists) have been involved and have filled 255 case record forms (120
      insulin-dependent and 135 non insulin-dependent diabetic patients). The
      association between hypertension and diabetes mellitus is very common: 55% out of
      the diabetic patients treated by GPs presented with hypertension, 20% out of the
      hypertensive patients presented with diabetes mellitus. The discovery of
      hypertension is usually followed by the discovery of non insulin-dependent
      diabetes mellitus. The opposite feature is observed for the insulin-dependent
      diabetic patients. The majority of the doctors feels that the cardiovascular
      prognosis of the association is worse than each single disease. The level of
      blood pressure that is suitable to start an antihypertensive treatment in
      hypertensive insulin-dependent and non insulin-dependent diabetic patients is
      generally lower than for non diabetic hypertensive patients, especially for the
      diabetologists. Concerning antihypertensive treatments, discrepancies have been
      observed in between feelings and behaviours of physicians. The class of drug that
      is thought to be used is obviously different from the one which is really used:
      angiotensin-converting enzyme inhibitors and calcium antagonists, two rather new
      classes of drugs are popular while classical classes of antihypertensive agents
      like diuretics and betablockers are still commonly used. Non pharmacological
      interventions which are useful for both the treatment of hypertension and
      diabetes mellitus are not commonly recommended by GPs and specialists.

PMID- 1639204
TI  - [Control of vascular tone by the endothelium: the coupling active vasodilation in
      the kidney to renin secretion].
AB  - The vascular endothelium plays an essential role in regulating the contractility
      of the adjacent smooth muscle cell through its secretory and metabolic
      properties. One of these well known properties is the conversion of angiotensin I
      into angiotensin II. But the endothelium also secretes at least three compounds
      able to diffuse to the smooth muscle cell and exerting a paracrine action: these
      are the prostacyclin (PGI2), the endothelium derived relaxing factor (EDRF) and
      the endothelin 1. The secretion of these different vasoactive compounds by
      endothelial cells is triggered by mechanical events, such as the shear stress, or
      by the effect of several humoral factors locally released, for example from
      platelets. The compound NO (nitric oxide) is produced by the endothelial enzyme
      NO synthase from its precursor L-arginine, and is responsible for the
      vasodilatory and antiplatelets properties of EDRF. NO, by activating the soluble
      guanylate cyclase in the smooth muscle cell, is responsible for the endothelium
      dependent vasodilatation. We observed in an isolated perfused rat kidney that the
      compound L-NAME (NG-monomethyl-L-arginine methyl ester), a competitive inhibitor
      of NO synthase blocking the production of NO, induces renal vasoconstriction and
      inhibits renin release. This suggests that not only the renal vasoconstriction
      but also the renal vasodilatation are active processes, permanently regulated by
      vasoactive compounds such as EDRF. It seems also that EDRF plays an important
      role in maintaining the secretion of renin. It can be hypothetized that an
      abnormality in the release or fate of EDRF might perhaps contribute to high blood
      pressure, by both a direct effect on the vascular tone and an indirect effect on
      the release of renin, which in turn regulates also the renal and systemic
      hemodynamics.

PMID- 1639206
TI  - [Treatment of hypertension in diabetes: threshold of intervention and therapeutic
      options].
AB  - Early screening for hypertension in diabetic patients and for glycoregulation
      abnormalities in hypertensives is justified by the additive cardiovascular risks
      when hypertension and diabetes co-exist and by the accelerated development of
      diabetic nephropathy and retinopathy if hypertension co-exists. In insulin
      dependent diabetes, hypertension is generally preceded by microalbuminuria, known
      to be reduced by angiotensin converting enzyme inhibitors. The requirement for
      nephropathy prevention and the hemodynamic and/or tissular effects of this
      therapeutic class could justify their use at a blood pressure level less than
      that conventionally considered hypertensive. This strategy must be confirmed by
      prospective trials, already underway, evaluating the nephroprotective efficacy of
      this therapy. In non-insulin-dependent diabetes, hypertension is often present
      before the diabetes is diagnosed and antihypertensive therapy, especially
      thiazide diuretics, could play a demasking or favorizing role. The optimal blood
      pressure level to which these patients at high renal and coronary risk should be
      lowered still has to be determined. A prospective study, comparing the effects of
      strict (treated diastolic blood pressure less than 80 mmHg) and less strict
      (treated diastolic blood pressure between 90 and 100 mmHg) hypertensive control
      on coronary event prevention in essential hypertension, is in progress and will
      have important implications for hypertension treatment in diabetics. Appropriate
      treatment of other risk factors, such as hyperlipidaemia and smoking, contributes
      to coronary and renal prevention in all diabetic hypertensives.

PMID- 1639207
TI  - Ovarian follicular atresia as an apoptotic process: a paradigm for programmed
      cell death in endocrine tissues.

PMID- 1639208
TI  - 11 beta-hydroxysteroid dehydrogenase and the short-chain alcohol dehydrogenase
      (SCAD) superfamily.

PMID- 1639209
TI  - Detection and partial purification of a potent mitogenic factor for human thyroid
      follicular cells.
AB  - Normal adult human thyroid follicular cells have an extremely limited
      proliferative capacity in vitro. No previously studied mitogen, including
      thyrotropin (TSH) or epidermal growth factor (EGF), has in our hands resulted in
      a significant improvement over the 3-4% nuclear [3H]thymidine pulse-labelling
      index (LI) obtainable with 10% fetal calf serum. Here we report the detection in
      the conditioned medium from a sub-clone of NIH3T3 fibroblasts of a mitogenic
      activity capable of increasing this response up to 10-fold, to an LI of over 20%,
      together with an even greater relative stimulation of mitotic activity.
      Preliminary characterisation has excluded EGF and TGF alpha, and demonstrated
      that the activity is bound reversibly by heparin-Sepharose, thus pointing to a
      member of the heparin-binding fibroblast- or hepatocyte-growth factor families.
      This material should have wide practical application in facilitating primary
      culture of follicular cells, and may reveal new mechanisms of stromal-epithelial
      interaction regulating normal and neoplastic thyroid growth in vivo.

PMID- 1639210
TI  - Identification of a minor Tg mRNA transcript in RNA from normal and goitrous
      thyroids.
AB  - Polymerase chain reaction (PCR) amplification of nt 4502 to nt 5184 of the
      thyroglobulin (Tg) mRNA from several patients, with or without elevated serum
      thyrotropin (TSH), showed a predominant fragment of the expected size (683 bp)
      and a minor fragment of 512 bp. The sequence of this minor fragment revealed that
      171 bp were missing between position 4567 and 4737. It is highly probable that
      the deleted sequence corresponds to a complete exon, suggesting an alternative
      splicing as mechanism for the generation of the minor transcript.

PMID- 1639211
TI  - Testosterone-induced diminution of two peptides in spleen cells from testosterone
      immunosuppressed B10 mice.
AB  - High-performance liquid chromatography (HPLC) is used to detect testosterone (T)
      sensitive peptides in spleen cells isolated from female C57BL/10 mice
      immunosuppressed against Plasmodium chabaudi malaria by T treatment. Two peaks
      with retention times of about 25 min and 34 min, respectively, were identified to
      be diminished by about 52% and 47%, respectively, in spleen cells from T-treated
      mice compared to those from untreated mice. Amino acid sequencing revealed that
      the 24 min peak consisted of the dipeptide Met-Phe and the 34 min peak contained
      a degradative fragment of the alpha-chain of hemoglobin. Our data suggest that
      the immunosuppressive T treatment of B10 mice induces a perturbation of
      erythrophagocytosis in spleens.

PMID- 1639212
TI  - Effects of tumour necrosis factor-alpha on growth hormone and interleukin 6 mRNA
      in ovine pituitary cells.
AB  - The inflammatory cytokines tumour necrosis factor-alpha (TNF alpha), interleukin
      1 (IL-1) and interleukin 6 (IL-6) have been demonstrated to influence pituitary
      hormone synthesis directly and via the hypothalamus. Furthermore, IL-6 is
      produced by some anterior pituitary cells suggesting a paracrine/autocrine role
      for this cytokine. We show that TNF alpha induces dispersed ovine pituitary cells
      to produce increased levels of growth hormone (GH) and IL-6 mRNA and secreted IL
      6 in a dose and time dependent manner. TNF alpha at concentrations between 1-1000
      U/ml increased GH and IL-6 mRNA, relative to control levels, by 5 h post
      stimulation. For IL-6, TNF alpha increased specific mRNA at 5 h and 12 h but not
      24 h post-stimulation. TNF alpha also induced secreted IL-6 to levels above that
      spontaneously secreted at all time points from 5 h to 48 h. Levels of common
      glycoprotein alpha-subunit and follicle stimulating hormone-beta (FSH beta)
      subunit mRNA were unaffected by TNF alpha. We conclude that TNF alpha can
      regulate both GH and IL-6 synthesis in dispersed ovine pituitary cells. The
      implications for paracrine/autocrine control of pituitary hormone synthesis in
      acute and chronic disease are discussed.

PMID- 1639213
TI  - Immunohistochemical localization of transforming growth factor-beta 1 and -beta 2
      during follicular development in the adult rat ovary.
AB  - The transforming growth factors-beta (TGF-beta) affect the metabolic activities
      of each of the cell types in the ovary. In vitro studies using immature rat
      ovaries have shown the expression of TGF-beta 1 and/or TGF-beta 2 mRNA in
      thecal/interstitial cells and in granulosa cells (Mulheron and Schomberg, 1990;
      Mulheron et al., 1991). To obtain information on the localization of TGF-beta 1
      and TGF-beta 2 in the rat ovary in vivo, we have examined the immunohistochemical
      staining using antibodies specific for either TGF-beta 1 or TGF-beta 2. In the
      adult ovary the immunostaining for TGF-beta 1 was intense, whereas the staining
      for TGF-beta 2 was faint. The pattern of immunostaining for TGF-beta 1 and TGF
      beta 2 remained constant in the interstitial cell compartment and was not
      affected by the stage of the oestrous cycle. Since the interstitium surrounds
      follicles at all stages of development we conclude that TGF-beta is not actively
      involved in regulating the progression of follicles at discrete stages. At the
      time of antrum formation in the follicle, intense staining for TGF-beta 1 was
      observed in thecal cells. Around the preovulatory stage of development, TGF-beta
      1 and TGF-beta 2 immunoreactivity was also found in the granulosa cells. In the
      corpus luteum, intense staining for TGF-beta 1 was found in some areas, whereas
      other areas were negative. Weak to moderate staining for TGF-beta 2 was
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639214
TI  - Expression and characterization of full-length and partial human androgen
      receptor fusion proteins. Implications for the production and applications of
      soluble steroid receptors in Escherichia coli.
AB  - We have expressed fusion proteins encoding defined segments of the coding segment
      of the human androgen receptor (hAR) in Escherichia coli using the pGEX-2T
      expression vector. Large quantities of fusion proteins containing glutathione-S
      transferase (GST) linked to the amino or carboxy terminal region of the receptor
      and a fusion protein containing the complete amino acid sequence of the androgen
      receptor were produced in soluble form. The GST hAR fusion proteins containing
      the hormone-binding domain of the androgen receptor exhibit high affinity
      specific binding for a variety of natural and synthetic androgens. Analysis of
      the binding properties of the complete and truncated androgen receptor fusion
      proteins revealed that the amino terminus affects the Kd of the fusion proteins
      for mibolerone (0.89 vs. 3.43 nM for the truncated and complete fusion proteins,
      respectively). Despite these differences, both the truncated and complete hAR
      fusion proteins exhibit a higher affinity for dihydrotestosterone than for
      testosterone, implying that the preferential affinity for dihydrotestosterone
      observed in androgen receptor prepared from native sources is a measure of the
      inherent structure of the hormone-binding domain. Furthermore, the ligand
      receptor complex is stable, as the ligand is not easily displaced with unlabelled
      competitor and is stable to mild heat denaturation. Fusion proteins containing
      the DNA-binding domain demonstrate specific DNA binding, as evidenced by studies
      using segments of the mouse mammary tumor virus long terminal repeat (MMTV-LTR)
      and synthetic glucocorticoid response elements. These studies establish that GST
      hAR fusion proteins exhibit physical properties similar to those of native
      androgen receptor. Affinity purification using a glutathione affinity resin and
      cleavage of the fusion proteins at a thrombin cleavage site permits a marked
      enrichment using a two-step purification. The use of such methods will facilitate
      the study of the normal and mutant receptor proteins.

PMID- 1639216
TI  - Prostaglandin F2 alpha and gonadotropin-releasing hormone increase intracellular
      free calcium in rat granulosa cells.
AB  - Changes in cytosolic free calcium concentration ([Ca2+]i) in response to
      prostaglandin F2 alpha (PGF2 alpha) and gonadotropin-releasing hormone (GnRH)
      were measured in single rat granulosa cells, using the calcium-sensitive
      fluorescent dye, fura-2AM. In 90 out of 135 granulosa cells (67%), there was a 3-
      to 4-fold increase in resting [Ca2+]i within 30 s of administration of PGF2 alpha
      (10(-6) M). The resting [Ca2+]i returned to pre-stimulation levels in
      approximately 80 s. Granulosa cells were responsive to PGF2 alpha at
      concentrations ranging from 10(-7) M to 10(-4) M (n = 7). Within this range of
      concentrations, the magnitude of the calcium response did not differ. In another
      series of experiments, the majority (93%, n = 57) of the granulosa cells which
      responded to PGF2 alpha also responded to GnRH. Neither the magnitude of the
      [Ca2+]i response nor the time to response differed between PGF2 alpha and GnRH.
      Furthermore, simultaneous treatment of granulosa cells with both hormones did not
      generate a larger response than with either hormone alone. During perifusion with
      low calcium media, the characteristic [Ca2+]i response to PGF2 alpha decreased,
      and was eliminated within 10 min (n = 9). Similar observations were made in
      response to GnRH under these conditions. These data confirm that PGF2 alpha and
      GnRH stimulate a transient increase in [Ca2+]i in rat granulosa cells, the source
      of which may be shared intracellular stores.

PMID- 1639215
TI  - Stimulation of DNA synthesis in rat uterine cells by growth factors and uterine
      extracts.
AB  - Replicative DNA synthesis, as measured by thymidine incorporation, has been
      measured in rat uterine cells in primary culture in response to growth factors.
      Insulin, insulin-like growth factor-I (IGF-I), multiplication-stimulating
      activity (MSA) and platelet-derived growth factor (PDGF) stimulated DNA
      synthesis, while estradiol, epidermal growth factor (EGF), transforming growth
      factor-beta (TGF-beta), basic fibroblast growth factor (bFGF) and relaxin did not
      stimulate or did so weakly and only at very high concentrations. Uterine acid
      extracts also stimulated DNA synthesis. IGF-I stimulated at concentrations
      consistent with its acting through the IGF-I receptor; however, insulin
      stimulated at concentrations higher than expected for its acting through its
      receptor and this its action may be mediated through the IGF-I receptor. IGF-I
      was found in uterine tissue by radioimmunoassay (RIA). There was a 5- to 10-fold
      increase in IGF-I in the uteri from ovariectomized rats that had been treated
      with estradiol 24 h earlier. This is analogous to the increase in growth factor
      activity found previously in rat uterus after 24-h estradiol treatment (Beck,
      C.A. and Garner, C.W. (1989) Mol. Cell. Endocrinol. 63, 93-101). These data are
      consistent with the hypothesis that estradiol effects in the uterus are in part
      mediated through IGF-I.

PMID- 1639217
TI  - Thyroid hormone and androgen regulation of nerve growth factor gene expression in
      the mouse submandibular gland.
AB  - The nerve growth factor (NGF) content of the mouse submandibular gland (SMG) is
      under hormonal control and is modulated by both thyroid hormones (TH) and
      androgens. The sexual dimorphism of the gland is well documented. In the adult
      male mouse, the SMG contains 10 times more NGF compared to the female.
      Conversely, castration of male mice reduces the SMG NGF levels to those found in
      control females. In order to determine the locus at which androgens and TH exert
      their effect on NGF gene expression in the SMG, steady-state NGF mRNA levels were
      determined. Daily treatment of adult female mice with TH for 1 week increased NGF
      mRNA levels 6-fold. Androgen treatment produced a 20-fold increase in SMG NGF
      mRNA, which was comparable to levels detected in the control adult male SMG. The
      effect of TH on NGF mRNA levels was time-dependent and coincided with the
      increase in NGF protein concentrations. At 48 h after a single TH injection, NGF
      mRNA levels (measured in SMG total RNA) increased 2-4-fold, while heteronuclear
      (hn) RNA levels were increased 1.5-2-fold. The NGF gene transcription rate was
      determined by run-on assay following TH treatment. A small but significant 2-fold
      induction by TH of NGF gene transcription was found at 24-48 h. Cytoplasmic RNA
      prepared from the same SMGs used in the run-on experiments was tested by S1
      nuclease protection; NGF cytoplasmic RNA was increased 7-fold in the SMGs of
      females treated with TH 48 h previously. These results demonstrate that the
      effect of TH on NGF gene expression is due in part to an induction of NGF gene
      transcription. The discrepancies observed between transcription rate and mRNA
      levels suggest that the major effect of TH is at the post-transcriptional level,
      possibly mRNA stabilization. The time required to observe an induction of TH on
      NGF gene transcription is suggestive of an indirect effect, possibly through the
      induction by TH of another protein which in turn activates the NGF gene.

PMID- 1639218
TI  - Protein synthesis and insulin regulation of p33 and PEPCK gene expression.
AB  - Insulin stimulates transcription and cytoplasmic accumulation of a specific mRNA
      (termed p33), while inhibiting transcription and accumulation of
      phosphoenolpyruvate carboxykinase (PEPCK) mRNA in rat H4IIE (H4) hepatoma cells.
      The present work examines the role of protein synthesis in regulation of these
      genes by insulin and dexamethasone. Like insulin, cycloheximide and anisomycin,
      two protein synthesis inhibitors, induced p33 transcription and reduced PEPCK
      transcription. The combination of either protein synthesis inhibitor and insulin
      did not induce p33 transcription or inhibit PEPCK transcription beyond that
      observed with either protein synthesis inhibitor alone. Dexamethasone induced
      both p33 and PEPCK transcription. The combination of insulin and dexamethasone,
      or protein synthesis inhibitors and dexamethasone, abolished dexamethasone
      induced PEPCK transcription. Thus, protein synthesis inhibitors regulate
      transcription of the p33 and the PEPCK genes in an insulin-like manner.

PMID- 1639219
TI  - Importance of the carboxyl terminus of human thyroid peroxidase in the efficient
      expression of the protein in eukaryotic cells.
AB  - Carboxyl terminal truncation of membrane-associated human thyroid peroxidase
      (hTPO), with the elimination of its single membrane-spanning and short
      intracytoplasmic regions, generates a soluble, secreted, enzymatically active
      protein (amino acids 1-848). In order to determine the effects of further
      carboxyl terminal deletions on the expression of hTPO, Chinese hamster ovary
      cells were stably transfected with plasmids constructed to express amino acids 1
      771, 1-636, 1-539 and 1-382 of the 933 amino acid TPO protein, respectively.
      Unlike hTPO1-848, the more severely truncated TPO mutant proteins could not be
      detected in conditioned media by polyclonal anti-TPO antibodies. Using detergent
      solubilized microsomal proteins from these cells, very low levels of hTPO1-771
      (approximately 90 kDa), but not the more extensive deletion mutations, were
      detected by these anti-TPO antibodies. Confirmation of the loss of efficient
      expression of more severely truncated hTPO was obtained using a anti-hTPO
      monoclonal antibody with an epitope near the amino terminus and which recognizes
      only the denatured protein. The mRNA for all hTPO mutants was detected in the
      stably-transfected Chinese hamster ovary cells. In summary, the present study
      indicates that a largely intact extracellular portion of hTPO is required for
      expression in eukaryotic cells.

PMID- 1639220
TI  - Defective inhibition of gastrin release by antral distension in duodenal ulcer
      patients.
AB  - The gastrin response to a low and a high dose of gastrin-releasing peptide
      infusion was studied in healthy volunteers and in patients with duodenal ulcer
      disease. In duodenal ulcer patients, the gastrin response was exaggerated.
      Cholinergic blockade did not change the gastrin release in healthy volunteers.
      Antrum distension during neutralization of the gastric lumen was unable to
      stimulate gastrin release, also under cholinergic blockade. However, in healthy
      volunteers distension of the antrum significantly inhibited the gastrin response
      to gastrin-releasing peptide infusion. This inhibitory influence was most
      pronounced in patients given the lower dose of the neuropeptide. Cholinergic
      blockade counteracted the inhibitory effect exerted by antral distension. On the
      other hand, antral distension did not alter the gastrin response to gastrin
      releasing peptide in patients with duodenal ulcer disease. These results suggest
      an additional defective inhibitory mechanism in duodenal ulcer patients.

PMID- 1639221
TI  - Regulation of cholesterol metabolism and low-density lipoprotein binding in human
      intestinal Caco-2 cells.
AB  - In the present paper, the regulation of 3-hydroxy-3-methylglutarylcoenzyme A (HMG
      CoA) reductase, acylcoenzyme A cholesterol acyltransferase (ACAT) and low-density
      lipoprotein (LDL) binding was studied in the human colon cancer carcinoma cell
      line Caco-2. LDL down-regulated HMG-CoA reductase activity in a dose-dependent
      fashion to a minimum of 28% of control at 200 micrograms/ml and LDL binding to
      52% of control. The activity of ACAT was stimulated by LDL. High-density
      lipoprotein 3 (HDL3) increased HMG-CoA reductase activity, whereas cholesteryl
      ester formation was slightly decreased. Inhibition of the endogenous cholesterol
      biosynthesis by mevinolin increased both LDL binding and activity of HMG-CoA
      reductase. This effect was reversed by the addition of mevalonolactone but not by
      LDL. It is concluded that regulation of HMG-CoA reductase and LDL binding is
      subject to the availability of non-sterol products of mevalonic acid and of
      exogenous cholesterol. ACAT is regulated mainly by the level of its substrate
      cholesterol.

PMID- 1639222
TI  - Soluble interleukin-2 receptor, interleukin-6 and interleukin-1 beta in patients
      with Crohn's disease and ulcerative colitis: preoperative levels and
      postoperative changes of serum concentrations.
AB  - Crohn's disease (CD) and ulcerative colitis (UC) show an intestinal activation of
      T cells and macrophages within the inflamed lesions. The aim of the present
      prospective study was to determine whether circulating interleukins (IL)
      represent useful markers of immune activation in vivo and to characterize their
      respective roles in monitoring disease activity. Serum concentrations of the
      soluble IL-2 receptor (sIL-2R), IL-6 and IL-1 beta were measured in 10 patients
      with CD and 10 patients with UC before, at day 10 and 2 years after resection of
      inflamed bowel segments. The data were correlated with neopterin, C-reactive
      protein and other standard parameters of disease activity. Preoperatively, mean
      sIL-2R concentration was 495 +/- 62 U/ml (mean +/- SEM; healthy controls; 210 +/-
      25 U/ml; p less than 0.02) in CD and 705 +/- 120 U/ml (p less than 0.00002) in
      UC. The corresponding IL-6 serum concentrations were 37 +/- 6 U/ml in CD
      (controls: 11 +/- 0.6 U/ml; p less than 0.0036) and 33 +/- 6 U/ml (p less than
      0.04) in UC. Two years postoperatively, sIL-2R was still elevated in 6 out of 9
      patients in both disease groups. These patients did not differ from the remaining
      group with respect to disease activity. Serum IL-6, elevated in 7 patients with
      CD and in 6 patients with UC at day 10 postoperatively, had returned to normal in
      all patients by this time.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639223
TI  - Recurrent gastrointestinal bleeding due to angiodysplasias in the small bowel.
      Experience with panendoscopic diagnosis and treatment in 6 patients.
AB  - Detection of bleeding from angiodysplasias located in the small bowel remains a
      diagnostic challenge. Intraoperative panendoscopy of the small bowel is a safe
      method with high diagnostic yield. The experience with this technique in 6
      patients with overt bleeding or melena is described. During the panendoscopy a
      suture technique was used as therapeutic modality. This method is easy, cheap,
      does not require special skills or instruments, and the result is seen
      immediately.

PMID- 1639225
TI  - The identification of genes specifically expressed in epithelial cells of the rat
      intestinal crypts.
AB  - Undifferentiated embryonic and dedifferentiated tumor cells express genes that
      are down-regulated or not expressed in differentiated tissue. The progenitor
      cells of the intestinal crypt are undifferentiated cells that, similarly, should
      express genes that are not evident in the more differentiated villus cells. Some
      of these genes may be related to the control of differentiation. We attempted to
      define crypt-associated genes by constructing a cDNA library from isolated rat
      intestinal crypt cells and screening for messages that remained after subtractive
      hybridization using greater than 20-fold more mRNA from villus than from the
      crypt cells. This process identified about two percent of the colonies containing
      transcripts expressed by the crypt cell. Northern blot analysis showed
      hybridization to messages in a range from 700 to 12,000 base pairs. Six clones
      out of 136 initial isolates were shown to hybridize to crypt mRNAs at levels four
      to tenfold greater than to villus mRNAs. Three of these clones showed greater
      hybridization to mRNA of the distal (ileum) when compared to the proximal end of
      the adult small bowel. Increased expression in fetal rat intestine was seen for
      five mRNAs and in fetal liver for four mRNAs when compared to adult. Most of the
      crypt associated gene probes preferentially bound mRNA from ovary, kidney, and
      spleen but did not bind mRNA derived from testis, muscle and brain. Cultured
      mouse teratocarcinoma cells (F9) showed high levels of three of these
      transcripts. Portions of each insert were sequenced and examined for homology to
      entries in national computer banks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639224
TI  - Genomic potential of erythroid and leukocytic cells of Rana pipiens analyzed by
      nuclear transfer into diplotene and maturing oocytes.
AB  - In order to determine whether differentiated somatic cells maintain genetic
      totipotency, nuclear transplantations from several differentiated somatic cell
      types into eggs and oocytes were performed previously in Rana pipiens and Xenopus
      laevis. The formation of postneurula embryos and tadpoles under the direction of
      the test nuclei demonstrated their genetic multipotency. In addition, Rana
      erythrocyte nuclei transplanted to oocytes directed more extensive tadpole
      development than those injected into eggs. We have extended our studies of the
      genomic potential of differentiated somatic nuclei from the peripheral blood of
      Rana pipiens. First, we show that the developmental potential of erythrocyte
      nuclei injected into oocytes at first meiotic metaphase was greater than those
      injected into diplotene oocytes. Second, we demonstrate that erythroblast and
      leukocyte nuclei transplanted to oocytes at first meiotic metaphase promoted more
      advanced tadpole development than those previously injected into Xenopus eggs.
      Third, erythrocyte nuclei were more successful in promoting advanced tadpole
      development compared with erythroblast and leukocyte nuclei. The results show
      that differentiated somatic nuclei transferred to the cytoplasm of oocytes at
      first meiotic metaphase display enhanced genomic and developmental potential over
      those transplanted to diplotene oocytes and eggs, at least for the three nuclear
      cell types tested from the peripheral blood.

PMID- 1639226
TI  - Organization of non-muscle myosin during early murine embryonic differentiation.
AB  - A monoclonal antibody (3D10) recognizing myosin heavy chain was isolated
      following immunization with a synthetic peptide sequence of eight amino acids.
      The antibody reacted with purified rabbit skeletal myosin and light mero-myosin
      in enzyme-linked immunosorbent assays and Western immunoblotting. A band of
      approximately 200 kDa was detected in cell extracts of an embryonal carcinoma
      (EC) cell line (P19EC) and one of its cloned differentiated derivatives,
      suggesting reactivity against non-muscle myosin. By indirect immunofluorescence,
      typical myosin banding patterns were observed in cryostat sections of human
      skeletal and cardiac muscle tissue. In undifferentiated P19EC cells, speckled
      immunofluorescent staining was observed in the cytoplasm that became organized in
      cortical rings where the cells made direct contact with each other. These rings
      consisted of circular bundles of F-actin decorated by myosin. Undifferentiated
      embryonic stem (ES) cells derived directly from mouse embryos shared the same
      features, although the pattern was less pronounced. Human testicular primary germ
      cell tumours showed cortical staining in the embryonal carcinoma component
      reminiscent of the staining of EC cells in vitro while cytoplasmic staining was
      observed in tumour cells with a differentiated morphology. In preimplantation
      embryos, the immunofluorescent staining was observed at cell apices of
      blastomeres of morula stage embryos. In blastocysts, staining of inner cell mass
      cells was not detectable. By contrast, various differentiated derivatives of
      P19EC contained extensive F-actin microfilament bundles throughout the cytoplasm
      decorated with myosin. Thick stress fibers in filopodious extensions of cells
      were particularly highly decorated by myosin. Over the nucleus, linear arrays of
      myosin containing speckled patterns of immunofluorescence were observed that were
      not associated with F-actin. The same pattern of staining could be observed in
      trophectoderm cells of the blastocyst. We conclude that embryonic non-muscle
      myosin is organized in specific patterns depending on the state of
      differentiation. As the myosin is primarily associated with F-actin we suspect
      that it forms part of a contractile apparatus that may have significance during
      embryonic development.

PMID- 1639227
TI  - In vivo effects of indomethacin--II. Antioxidant enzymes in metal-deficient rats.
AB  - 1. The in vivo effects of indomethacin on the activity of antioxidant enzymes in
      erythrocytes, liver and small intestinal mucosa of rats fed a metal-deficient
      diet were studied. 2. Metal deficiency led to a significant decrease in the
      activity of the enzymes studied. 3. Neither with the "ulcerogenic" nor with the
      "therapeutic" dose of indomethacin significant alterations in the enzyme activity
      were observed. 4. The oral treatment of metal-deficient rats with a copper
      complex of indomethacin caused a significant increase in the activity of the
      enzymes studied. 5. The results suggest the participation of indomethacin in the
      regulation and redistribution of metals in the organism, which is probably
      effected through in vivo chelation of endogenous metals.

PMID- 1639229
TI  - Brain and adrenal monoamines and neuropeptide Y in codeine tolerant rats.
AB  - 1. Monoamine turnover and neuropeptide Y (NPY) levels were investigated in the
      central and peripheral nervous systems in adult male rats chronically treated
      with codeine. 2. An increase in the dopaminergic turnover was observed in the
      striatum and cortex. The norepinephrine levels and the serotoninergic turnover
      were unchanged in all the brain areas. 3. Epinephrine levels were decreased in
      the adrenal glands. 4. In addition, we observed a significant decrease of NPY
      levels in the hypothalamus, the striatum and the adrenal glands. These observed
      changes were not found when assessing NPY level in plasma fluid. 5. The
      implication of these modifications in the induction of codeine dependence are
      discussed in view of previous results obtained with morphine.

PMID- 1639228
TI  - Plasma concentration of paracetamol and its major metabolites after p.o. dosing
      with paracetamol or concurrent administration of paracetamol and its N-acetyl-DL
      methionine ester in mice.
AB  - 1. Single doses of paracetamol 400 (PAR 400) and 800 mg/kg (PAR 800), SUR 2647
      combination (free paracetamol + paracetamol-N-acetyl-DL-methionate,
      paracetamol/methionine ratio 2:1) equivalent to PAR 400 (SURc 400) and PAR 800
      (SURc 800) were given p.o. to male Bom:NMRI mice. 2. The objective was to compare
      the plasma concentrations of free paracetamol and the major metabolites
      paracetamol-sulphate and paracetamol-glucuronide for a 6 hr period after each
      test drug. 3. There was no significant difference between PAR 400 and SURc 400
      with respect to plasma paracetamol, paracetamol-glucuronide and paracetamol
      sulphate concentration with the exception of lower plasma paracetamol
      concentration (P less than 0.03) at 3 hr following PAR 400. 4. There was no
      significant difference between PAR 800 and SURc 800 with respect to plasma
      paracetamol, paracetamol-glucuronide and paracetamol-sulphate concentrations with
      the exception of lower plasma paracetamol-glucuronide concentration (P less than
      0.03) at 4 hr after dosing following SURc 800. 5. Combining free paracetamol and
      its methionine ester does not seem to alter the pattern of plasma paracetamol,
      paracetamol-glucuronide and paracetamol-sulphate compared to equal doses of free
      paracetamol alone after p.o. administration of toxic doses to male Bom:NMRI mice.

PMID- 1639230
TI  - Comparative pharmacological profile of muscarinic agonists in the isolated ileum,
      the pithed rat, and the mouse charcoal meal transit test.
AB  - 1. Several reportedly selective (McN-A-343, M1; RS-86, M2; pilocarpine, M3) and
      non-selective (oxotremorine, acetylcholine, cis-dioxalone, arecoline, muscarine)
      muscarinic agonists were examined for comparative pharmacological potency in
      three diverse models: the guinea pig ileum, the pithed rat, and the mouse
      charcoal meal transit test. 2. In the guinea pig ileum, all of the compounds
      examined were associated with concentration-dependent contractions. 3. The
      apparent order of potency in the isolated ileum was cis-dioxalone greater than
      acetylcholine greater than oxotremorine greater than arecoline greater than RS-86
      greater than pilocarpine greater than McN-A-343. 4. The pA2 values for atropine
      and pirenzepine in the ileum ranged from 8.4 to 9.4 and 6.1 to 7.7, respectively,
      indicative of a single receptor, most likely M3. 5. In the mouse charcoal meal
      transit test, non-selective muscarinic agonists produced dose-dependent increases
      in gastrointestinal transit, while selective agonists failed to produce any
      significant changes. 6. Scopolamine methylbromide, a peripherally acting non
      selective muscarinic antagonist, significantly reduced the ability of muscarine
      to increase transit. 7. The compounds were further examined for dose-dependent
      pressor effects in the pithed rat, which are known to be mediated by stimulation
      of M1-receptors in sympathetic ganglia. 8. McN-A-343 produced the greatest
      pressor response, as measured by the percent increase in mean pressure, followed
      by pilocarpine. 9. Pirenzepine antagonized the pressor response of McN-A-343 and
      pilocarpine in a dose-dependent manner.

PMID- 1639231
TI  - Antiulcer activity of the calcium antagonist propyl-methylenedioxyindene--V.
      Localization of site of action.
AB  - 1. Propyl-methylenedioxyindene (pr-MDI) is an intracellular calcium antagonist
      which inhibits cold-restraint stress ulceration at subcardiovascular doses (less
      than or equal to 30 mg/kg). It also inhibits gastric acid secretion evoked by
      RX77368 (a stable analog of thyrotropin-releasing hormone, the putative mediator
      of cold-restraint stress ulcers). 2. The objective of this investigation was to
      localize the site of the inhibitory effect of pr-MDI on gastric acid secretion
      stimulated by intracisternal (i.c.) administration of RX77368 (100 ng) in rats.
      3. Peripheral administration of pr-MDI (30 mg/kg i.p. or i.v.) inhibited the
      elevated basal and the RX 77368-induced acid secretion in conscious 2-hr pylorus
      ligated rats. This effect was completely blocked in anesthetized (urethane or
      pentobarbital) acute gastric fistula rats. 4. Intracisternal administration of pr
      MDI (0.1-1 mumol) produced a dose-related inhibition of acid secretion in
      conscious pylorus-ligated rats. However, urethane anesthesia completely blocked
      the inhibitory effect of i.c.-administered pr-MDI (1 mumol) on RX77368-induced
      acid secretion. 5. Since previous studies indicate that anesthesia does not
      inhibit peripheral actions of pr-MDI (e.g. the antiarrhythmic effect), the
      convergent evidence suggests that the inhibitory effect of pr-MDI on gastric acid
      secretion is mediated primarily via the central nervous system.

PMID- 1639233
TI  - Ca-blocking action of stereoisomers of CI-951, (+)-CI-951 (NC-1500) and (-)-CI
      951 in the isolated muscle preparations.
AB  - 1. Stereoselectivity of CI-951 in Ca-entry blocking activity was tested in guinea
      pig taenia caecum and urinary bladder and rabbit thoracic aorta and basilar
      artery. 2. NC-1500 ((+)-CI-951) and (-)-CI-951 had a selectivity to the basilar
      artery. 3. NC-1500 ((+)-CI-951) was about 6-16 times as potent as (-)-CI-951. 4.
      These results suggest that NC-1500 ((+)-CI-951) may be considered a cerebral
      vasodilator and have potential usefulness as a therapeutic drug.

PMID- 1639232
TI  - Ebrotidine effect on the proteolytic and lipolytic activities of Helicobacter
      pylori.
AB  - 1. The effect of ebrotidine, a new antiulcer agent, on the activity of mucus
      degrading of protease and lipase enzymes elaborated by Helicobacter pylori was
      investigated. 2. In the absence of ebrotidine, the H. pylori protease caused
      extensive degradation of gastric mucus protein, while free fatty acids, glycerol
      mono-oleate and lysophosphatidylcholine were produced by the action of H. pylori
      lipase and phospholipase A enzymes. 3. Introduction of ebrotidine to the
      incubation system led to the reduction in the rate of mucus protein and lipid
      degradation. The rate of proteolysis inhibition was proportional to ebrotidine
      concentration up to 35 micrograms/ml at which point, a 57% reduction in mucus
      degradation was obtained, while the maximum inhibition of phospholipase A (96%)
      and lipase (93%) activities occurred at ebrotidine concentration of 60
      micrograms/ml. 4. The results indicate that ebrotidine is capable of
      counteracting the mucolytic activity of H. pylori towards protein and lipid
      constituents of gastric mucus layer.

PMID- 1639234
TI  - Haloperidol differentiates smooth muscle contractions induced by release of
      intracellularly stored Ca and by influx of extracellular Ca.
AB  - 1. The effects of haloperidol on smooth muscle contraction induced by carbachol,
      histamine, high K or caffeine in the presence or absence of extracellular Ca were
      investigated. 2. In the presence of extracellular Ca, the maximal contraction
      induced by carbachol was reduced by haloperidol, while that by histamine or high
      K was much less affected. 3. In Ca-free solution, contraction induced by
      histamine was extremely reduced by haloperidol, while that by carbachol was not
      affected. 4. These results suggest that haloperidol selectively inhibited signal
      transduction processes from activation of muscarinic acetylcholine receptors to
      influx of extracellular Ca and from activation of histamine H1-receptors to
      release of intracellularly stored Ca. 5. Caffeine-induced contraction in Ca-free
      solution was markedly potentiated by haloperidol, although haloperidol did not
      elicit contraction in Ca-free solution by itself. 6. These results suggest that
      haloperidol increased the sensitivity of Ca-induced Ca release channels to
      caffeine.

PMID- 1639235
TI  - Effect of hypolipidemic drugs on cholinesterase activity in the rat.
AB  - 1. The effect of four hypolipidemic agents with different mechanisms of action
      (fenofibrate, probucol, colestipol and nicotinic acid) on plasma and liver
      cholinesterase has been studied. 2. Liver weight and liver weight/body weight
      ratio increased only after treatment with fenofibrate. 3. Plasma and liver
      cholinesterase activity increased markedly after fenofibrate, a strong peroxisome
      proliferator, and slightly after nicotinic acid, a weak peroxisome proliferator.
      4. The data obtained suggest that increased cholinesterase activity is due to
      increased rate of fatty acid oxidation caused by peroxisome proliferators.

PMID- 1639236
TI  - The effect of physostigmine on the haemorrhagic hypovolemia in anaesthetized
      rabbits.
AB  - 1. The effects of physostigmine (70 micrograms kg-1, intravenously) on mean
      arterial blood pressure, blood volume and survival were studied in anaesthetized
      rabbits subjected to haemorrhagic hypovolemia. 2. It was found that physostigmine
      increased the mean arterial blood pressure, increased the residual blood volume,
      decreased the haematocrit values and increased the survival of the animals. 3.
      The increase of blood pressure might be due to a general adrenergic activation
      produced by physostigmine, whereas the increase in plasma volume might be due to
      changes in pre- to postcapillary resistance ratio. 4. The beneficial effect of
      physostigmine might also be due to antagonism of humoral factors known to
      aggravate the hypovolemia (e.g. endogenous opioids).

PMID- 1639237
TI  - Involvement of GABAergic mechanisms in chloroquine-induced seizures in mice.
AB  - 1. The influence of some GABAergic agents on tonic seizures elicited by
      chloroquine was investigated in mice. 2. Chloroquine (45-100 mg/kg) elicited
      seizures in mice in a dose related manner. 3. Muscimol (1-2 mg/kg), DABA (8-16
      mg/kg) and baclofen (4-16 mg/kg) profoundly delayed the onset of chloroquine (65
      mg/kg)-induced seizures. The incidence of the seizures was also significantly
      reduced by muscimol (1-2 mg/kg), DABA (8 mg/kg) and baclofen (4-8 mg/kg). 4. AOAA
      (10 mg/kg) profoundly reduced the proportion of mice that convulsed while AOAA
      (20 mg/kg) completely protected mice against chloroquine (65 mg/kg)-induced
      seizures. 5. Bicuculline (5 mg/kg) and picrotoxin (0.5-1 mg/kg) significantly
      potentiated chloroquine (50 mg/kg)-induced seizures. The onset of seizures and
      the number of mice that convulsed were shortened and increased respectively. The
      onset of chloroquine (65 mg/kg)-elicited seizures was also profoundly shortened.
      Bicuculline (5 mg/kg) and picrotoxin (0.5 mg/kg) effectively antagonised the
      protective effects of muscimol (2 mg/kg), AOAA (10 mg/kg) and DABA (8 mg/kg)
      against chloroquine (65 mg/kg)-elicited seizures. 6. Diazepam (1 mg/kg) and
      phenobarbitone (20 mg/kg) significantly antagonised chloroquine (65 mg/kg)
      seizures. The onset of seizures was significantly delayed by both diazepam (0.25
      1 mg/kg) and phenobarbitone (10-20 mg/kg). 7. These data suggest that enhancement
      and inhibition of GABAergic neurotransmission respectively attenuate and
      potentiate chloroquine seizures in mice.

PMID- 1639238
TI  - Nicotinylalanine increases cerebral kynurenic acid content and has anticonvulsant
      activity.
AB  - 1. Nicotinylalanine is an analogue of kynurenine which has been reported to
      inhibit the enzymes kynurenine hydroxylase and kynureninase. 2. In the present
      study rats were given a tryptophan load together with nicotinylalanine two hours
      before killing, and the brain, liver and kidneys analysed by HPLC for their
      kynurenic acid content. 3. Tryptophan alone produced a significant elevation of
      kynurenate but with the additional administration of nicotinylalanine, levels
      rose dramatically, including a 19-fold increase in brain. 4. In mice the same
      dose of nicotinylalanine reduced the incidence of seizures induced by leptazol or
      electroshock treatment. 5. Since kynurenic acid is an antagonist at excitatory
      amino acid receptors the results may herald a new approach to producing a
      pharmacological blockade of amino acid receptors in the brain.

PMID- 1639239
TI  - Changes in GABAergic function after chronic chemical stress.
AB  - 1. The function of the gamma-aminobutyric acid (GABA)-ergic system in certain
      areas of the rat brain was investigated after chronic chemical stress (exposure
      to either vapours 30 sec/day for 20 days). 2. GABA concentration, [3h] -GABA
      uptake and the activity of the synthesis enzyme glutamate decarboxylase (GAD)
      were measured. 3. Chronic stress: (a) reduced neuronal uptake of [3H] -GABA in
      the frontal cerebral cortex (43%) and increased non-neuronal uptake of [3H] -GABA
      in the hypothalamus (62%); (b) enhanced the activity of GAD (under subsaturating
      substrate concentration) in the frontal cortex (91%) and in the corpus striatum
      (69%); (c) did not modify GABA endogenous concentration; (d) did not affect the
      animals' body weight increase or produce any signs of toxicity. 4. The
      stimulation of GAD and reduction of [3H] -GABA neuronal uptake in the frontal
      cortex might suggest the stimulation of GABAergic neurotransmission induced by
      chronic stress in this area of the rat brain. Together with previous findings the
      frontal cortex would appear to be a key area in chronic stress processing.

PMID- 1639240
TI  - Isolation of proteoglycans synthesized by rat heart: evidence for the presence of
      several distinct forms.
AB  - 1. The proteoglycans (Ps) synthesized by auricle and ventricle from adult rat
      heart were studied. 2. Auricle tissue incorporated over two times radioactive
      sulfate compared to ventricle tissue and the Ps were mainly found in the
      detergent insoluble fraction. 3. The Ps from both tissues were isolated by ion
      exchange chromatography on DEAE-Sephacel, followed by gel filtration on Sepharose
      CL-6B and SDS-PAGE electrophoresis. 4. Enzymatic and chemical degradation of
      these Ps suggest that at least three and probably four different species of Ps
      can be observed in heart tissue. 4. A high molecular weight chondroitin sulfate
      P, a high molecular weight heparan sulfate-P, a chondroitin/dermatan sulfate-P of
      240-200 kDa and a dermatan sulfate of 115 kDa. 5. This latter P was specifically
      immunoprecipitated using rat decorin antiserum.

PMID- 1639241
TI  - Mechanisms involved in the cardiovascular responses to opioid products of
      proenkephalin in the anaesthetised rat.
AB  - 1. Cardiovascular effects of opioid peptide products of proenkephalin, [Met]
      enkephalin (ME), [Leu] enkephalin (LE), [Met] enkephalyl Arg6-Phe7 (MEAP) and
      [Met] enkephalyl Arg6-Gly7-Leu8 (MEAGL) have been studied in urethane
      anaesthetised rats. 2. ME, LE, MEAP and MEAGL produced vasodepression and
      bradycardia mediated by mu-opioid receptors. 3. Atypical responses to MEAP were
      observed in a quarter of the animals studied showing tachycardia and pressor
      effects. This response was probably due to the release of the dipeptide Arg-Phe
      which exerted its effects at sympathetic ganglia. 4. Studies with the peptidase
      inhibitors captopril and bestatin showed a differential potentiation of the
      cardiovascular effects of the proenkephalin products by inhibition of angiotensin
      converting enzyme and aminopeptidase. 5. The effects of vagotomy, pithing and
      studies with atropine, and N-methyl levallorphan were used to demonstrate that,
      for all four proenkephalin peptides, cardiovascular effects were mediated by
      peripheral opioid receptors and transmission to the CNS via vagal afferents.

PMID- 1639242
TI  - Triflusal vs aspirin on the inhibition of human platelet and vascular
      cyclooxygenase.
AB  - 1. Triflusal is a salicylic derivative that inhibits platelet aggregation in
      human whole blood with a minimal inhibition of prostacyclin production. 2.
      Aspirin inhibits platelet aggregation at concentrations that reduce vascular
      prostacyclin production.

PMID- 1639243
TI  - Genetic markers associated with high density lipoprotein cholesterol levels in a
      biracial population sample.
AB  - An explanation for the consistently documented finding of higher levels of high
      density lipoprotein-cholesterol in black men relative to white men was sought by
      comparing the frequency of restriction fragment length polymorphism markers
      present in blacks and in whites at the gene loci coding for the two major
      apolipoprotein constituents of high density lipoprotein, apolipoproteins AI and
      AII. The measurements were made in population-based samples of 45 to 54-year-old
      black (n = 190) and white (n = 370) subjects from the Minnesota Heart Survey for
      whom lipoprotein levels were available. The mean high density lipoprotein
      cholesterol level for black men in the sample (47 +/- 1.5 mg/dl) was higher (P
      less than 0.05) than that for white men (42 +/- 0.9 mg/dl), while levels in women
      were not different between races. While the SacI and MspI markers at the
      apolipoprotein AI-CIII-AIV gene locus showed similar frequencies in blacks
      compared to whites, the degree of the linkage disequilibrium previously noted
      between these markers in white subjects was altered in blacks and the minor
      allele of the PstI marker at this locus was virtually absent in the black
      subjects (P less than 0.005 vs whites). For black men, there were significant
      associations of the M2 allele and the S2M2 haplotype at the apolipoprotein AI
      locus with lower high density lipoprotein-cholesterol levels. The results are
      consistent with the hypothesis that DNA sequence variations in the vicinity of
      the apolipoprotein AI-CIII-AIV gene locus are associated with the difference in
      high density lipoprotein-cholesterol levels between blacks and whites.

PMID- 1639244
TI  - Linkage studies of schizophrenia: a stimulation study of statistical power.
AB  - In planning for a linkage study, it is important to determine the number of
      pedigrees needed to show linkage. Our study overcomes some of the limitations of
      previous power studies by simulating multigeneration pedigrees to be compatible
      with the demographic and genetic epidemiological features of schizophrenia; these
      are variable age at onset, reduced fertility, and increased mortality after
      onset. We evaluate the power of these pedigrees by first simulating an
      ascertainment rule requiring at least three ill family members per pedigree and
      then simulating the trait and marker genotypes according to a single gene model
      known to fit epidemiological family study data. Our analysis allows for
      incomplete and age-dependent penetrance, phenocopies, and interpedigree
      heterogeneity. We present the power to detect linkage at several lod score
      thresholds since the multiple tests and phenotypic models required for complex
      diseases may necessitate using a lod score significance level greater than three.
      The sample size needed to achieve sufficient power is feasible if 50% of the
      pedigrees are linked to the marker under test. It may not be feasible to detect
      linkage if only 25% of the pedigrees are linked, even if a very closely linked
      marker is used. Our results indicate that to be certain of adequate statistical
      power, linkage analyses of schizophrenia will require very large samples that do
      not have a marked degree of genetic heterogeneity.

PMID- 1639246
TI  - Extended pedigree patterned covariance matrix mixed models for quantitative
      phenotype analysis.
AB  - Overt computational constraints in the formation of mixed models for the analysis
      of large extended-pedigree quantitative trait data which allow one to reliably
      characterize and partition sources of variation resulting from a variety sources
      have proven difficult to overcome. The present paper suggests that by combining a
      restricted patterned covariance matrix approach to modeling and partitioning the
      variation arising from polygenic and environmental forces with an Elston-Stewart
      like algorithmic approach to modeling variation resulting from a single genetic
      locus with large phenotypic effects one can produce a model that is at once
      intuitively appealing, efficient computationally, and reliable numerically.
      Extensions and variations of this approach are also discussed, as are some
      simulation and timing studies carried out in an effort to validate the accuracy
      and computational efficiency of the proposed methodology.

PMID- 1639245
TI  - An analytical method for assessing patterns of familial aggregation in case
      control studies.
AB  - This paper describes an analytical method that is used to assess patterns of
      disease aggregation within family based on family history information collected
      in case-control studies. In such a study, cases and controls are thought of as
      probands whose relatives are identified, and relatives' phenotypes and other
      covariates such as age, sex, and genealogical relationship with the probands are
      recorded. By modeling the dependence of relatives' phenotypes on case-control
      status and other covariates, this method yields adjusted odds ratios that
      quantify familial aggregation. The estimated standard errors are obtained for
      statistical inference since the method acknowledges the potential correlations
      between relatives' phenotypes by using the estimating equations technique. In
      population-based case-control studies, the estimates and statistical inferences
      are generalizable to the general population. To illustrate this method, we
      analyzed a case-control study of colorectal cancer involving 5,190 relatives of
      792 cases and 4,478 relatives of 680 population-based controls conducted in
      Hawaii. Although detailed results will be presented elsewhere, the colorectal
      cancer was found to aggregate within family with an odds ratio of 2.74 (95%
      confidence interval (CI): 1.78-4.21). Among parents, the odds ratio for familial
      aggregation was 2.38 (95% CI: 1.25-4.54). The corresponding value for siblings
      was 3.09 (95% CI: 1.87-5.11). It was also found that the odds ratio increases
      from about 2.00 for relatives of the probands who were 50 years or older to 7.66
      and 12.84 for relatives of the probands who were between 40 and 50 years and
      under 40 years, respectively, suggesting that the familial aggregation of
      colorectal cancer decreases as probands' age increases.

PMID- 1639247
TI  - Using multidimensional scaling on data from pairs of relatives to explore the
      dimensionality of categorical multifactorial traits.
AB  - An accurate specification of the dimensionality and ordering of categorical
      multifactorial phenotypes (e.g., smoking status, including heavy, moderate,
      light, and nonsmokers) is an important prerequisite for the genetic analysis of
      these traits. Typically, phenotypic dimensionality and ordering are determined by
      comparing the relative fits of alternative parametric threshold models. Here, a
      method of analysis is described which addresses the same issue of trait
      dimensionality but does not require parametric assumptions. Specifically, we
      detail how nonmetric multi-dimensional scaling (MDS), applied to contingency
      tables which cross-classify the phenotypes or responses of one relative with
      another, may be used to explore trait dimensionality. Scaling results from
      deterministic simulation studies indicate that the latent structure of
      categorical phenotypes can be recovered with nonmetric MDS. Results from
      stochastic simulations, however, indicate that the accuracy of recovery, as well
      as the rejection of models of incorrect dimensionality, are strongly dependent
      upon sample size and the latent liability correlation between relatives. As an
      application of the method, the dimensionality of a measure of smoking status in
      1,656 pairs of monozygotic twins ascertained through the American Association of
      Retired Persons is considered. The MDS results indicate that the onset of the
      smoking habit and the quantity smoked in this aging population represent a
      unidimensional process. The implication this finding has for subsequent genetic
      analysis is discussed.

PMID- 1639248
TI  - [Preparation of monosomal lines containing individual human 15, 21, and X
      chromosomes].
AB  - Sorting of human--mouse or human--hamster hybrid cells with particular human
      chromosomes was performed by in situ hybridization. Total human genomic DNA was
      heavily labelled with. H and hybridized to metaphase spreads from hybrid clone
      cells. The method allowed us to not only identify human chromosomes in hybrid
      cells but also to detect terminal translocations and insertions from 1-2 bands in
      length to large ones. Biochemical markers of some human chromosomes were analysed
      using electrophoretic technique in the clones selected. Cytogenetic analysis (G
      staining) of these clones was made to visualize human chromosomes. Total 99
      initial hybrid human--hamster and 26 human--mouse clones were obtained. 53 clones
      were analysed by in situ hybridization, only one of them being monochromosomal;
      the latter contained human X chromosome on the background of Chinese hamster
      chromosomes. Two other monochromosomal clones containing particular 15 and 21
      chromosomes, respectively, were obtained by more complicated way from human-
      mouse hybrid clones using back selection, repeated hybridization and passing
      through a number of subsequent subclonings.

PMID- 1639249
TI  - [Genetic differentiation between breeds of horses by polymorphic blood protein
      loci].
AB  - The estimation of genetic differentiation between 27 horses breeds originated in
      USSR, based on serum proteins polymorphism (loci Tf, Al, Es) is shown. Genetical
      variability among aborigine breeds is higher then among cultural ones. The
      erosion of gene pool of Przewalski's Horse is explained by special history of
      this population and a few horses in analyzing group. Genetic distances reflect
      the directions and intensity of breeding. High genetical distances between
      Przewalski's Horse, Shetland Pony and other horses obtained could be explained by
      overcoming the "bottle neck" of selections in breeding process. Results of
      investigation shown that 9 aborigine breeds of USSR are clustered in a special
      group, differed from foreign horse breeds, because their gene pool was quite
      unique.

PMID- 1639250
TI  - [Study of interlocus interactions using a series of gene markers in samples from
      groups with different health status].
AB  - Interloci equilibrium between pairs of gene markers in the samples of different
      health rate in the population of Buryats of Chitinskaya Province was tested. The
      following methods were used: calculation of interloci correlation coefficients,
      chi 2-testing of the hypothesis of interloci equilibrium and the modification of
      principal components analysis on the basis of the matrix of Pearson's
      coefficients of contingency. In the groups of "extreme" health rate the tendency
      to increase in interloci disequilibrium was discovered. The reason for this
      effect is the increase in some phenotype combination frequencies that can be
      considered as markers of non-specific individual resistance in the environmental
      condition of the populations studied.

PMID- 1639251
TI  - [An ecogenetic approach to studying the adaptation and human health].
AB  - Genetic markers--blood groups ABO, RH, MN; serum proteins HP, PI, TF, C3;
      erythrocyte enzymes ACP1, ESD, AK1, PGM1, GLO1, PGD, PGP; and the other: PTC
      tasting, ear wax types and color vision, were studied in two aboriginal Buryatian
      populations of Baikal Lake region: in Chitinskaya and Irkutskaya Provinces. Two
      samples were further divided into subgroups, according to their health status:
      "healthy", "indefinite" and "sick" by means of special regression procedure. The
      "healthy" subgroup of the Chitinskaya Province population is characterized by
      higher frequencies of PTC-tasters: 0.871 vs. 0.757 in the "sick" part (chi 2 =
      5.36, p less than 0.05); higher frequency of the phenotype PI M1M1: 0.734 in
      "healthy" vs. 0.547 in "sick" (chi 2 = 8.89, p less than 0.01); also, lower
      frequency of the PI M1M2 phenotype: 0.148 and 0.299, respectively (chi 2 = 7.49,
      p less than 0.01); the frequencies of the phenotype TF C2C2 are: 0.015 and 0.076
      (chi 2 = 5.48, p less than 0.05). In Irkutskaya Province population differences
      between "healthy" and "sick" subgroups were discovered for blood group AB:
      "healthy" 0.046 and "sick"--0.175 (chi 2 = 11.28, p less than 0.010); for GC (1F
      2)--0.214 and 0.116 (chi 2 = 4.45, p less than 0.05). Some other differences
      between "healthy" and "sick" in both populations are not significant. Some trends
      concerning heterozygosity in loci--GC, PGM, TF were discovered. The results are
      considered from the viewpoint of higher fitness of some genetic traits in the
      populations studied.

PMID- 1639252
TI  - [Frequency of non-disjunction and loss of sex chromosomes in oogenesis in the
      Drosophila melanogaster mutant I(1) ts 403 with a defect in the heat-shock
      protein system in anoxia and at high temperature].
AB  - A unique property of Drosophila melanogaster l(1)ts403 strain with the defect in
      heat shock protein system (HSP) is high frequency of losses and non-disjunction
      of sex chromosomes induced by heat shock (HS) (37 degrees C, 1 h). This effect
      was shown in only 6-14-th stages of oocytes. Anoxia was not effective in
      induction of these mutations. Successive action of anoxia and HS decreased loss
      frequency and non-disjunction in comparison with the only action of HS. These
      findings agree with the data in literature indicating that HSP synthesis was
      increased in the l(1)ts403 mutant when first anoxia and then HS were
      administered, in contrast to the action of HS only. The role of HSP in the
      recovery of HS-induced disruptions (chromosomal proteins and meiotic division
      apparatus) which can lead to chromosome non-disjunction and losses is discussed.

PMID- 1639253
TI  - [Properties of super unstable mutations in the Drosophila melanogaster yellow
      locus].
AB  - The properties of super-unstable systems of the white, singed and ocetilless loci
      obtained as a result of P-M dysgenesis induction in the strains with a mobilized
      Stalker were described earlier. In the studies of super-instability in ocetilless
      locus, six super-unstable mutations in the yellow locus were obtained. Detailed
      genetic analysis was performed resulting in isolation of 80 alleles with
      different phenotype expression. In general, super-instability in the yellow locus
      reminds that in the white and ocetilless loci. Most of alleles are highly
      unstable possessing a characteristic pattern of mutation changes. Also, sub
      systems were found in the yellow super-unstable system. Each consists of several
      mutually inter-converting alleles which possess a characteristic phenotype, mode
      and rate of mutation changes.

PMID- 1639254
TI  - [PHO2 and GCN4 transcription activators in the regulation of Saccharomyces
      cerevisiae acid phosphatase synthesis].
AB  - The possibility of substitution of the PHO2 activator protein by GCN4 protein in
      transcriptional regulation of acid phosphatase genes PHO5 and PHO11 was
      demonstrated in the yeast Saccharomyces cerevisiae. We observed the increase in
      acid phosphatase synthesis in the case of gcn4-delta 1 pho2-delta 1 mutant
      transformed with YCp88 (GCN4-wt) plasmid in comparison with that in
      nontransformed cells. The mode of repression of acid phosphatase synthesis in two
      types of transformants gcn4-delta 1 pho2-delta 1 (GCN4-wt) and gcn4-delta 1 pho2
      delta 1 (PHO2-wt) was studied. It wat demonstrated that repression of acid
      phosphatase synthesis in the first type of transformants took place at lower
      concentration of Pi than was necessary for the second type of transformants. The
      model of interactions between the GCN4 activator protein and PHO regulatory
      factors is proposed.

PMID- 1639255
TI  - [Structure and evolution of the D17LeH80-like locus in the murine t-complex].
AB  - The t complex in the proximal part of chromosome 17 is one of the most thoroughly
      studied regions of the mouse genome. We determined the sequence of Tu80, a
      molecular clone derived from microdissected fragments of chromosome 17. The
      sequence data demonstrated that the total length being 324 bp, Tu80 contains an
      open-reading frame (ORF) of 204 bp. Two fragments were detected within the ORF,
      one homologous to the LINE1-element, the other to the first intron of the C
      epsilon gene of mouse immunoglobin. A sequence designated NOV1 was isolated from
      the genomic library of mouse chromosome 17. NOV1 was found to contain a B2
      insert, making in structurally different from Tu80. The sequences of Tu80 and
      NOV1 were compared with those of LINE1 and the first intron of the C epsilon
      gene. The results suggested that the ancestor of the Tu80-like sequence might
      have arisen through illegitimate recombination between the fragments of LINE1 and
      the C epsilon gene. It is concluded that Tu80 and NOV1 might have resulted from
      duplication of the ancestral sequence and following divergence. The comparative
      analysis also demonstrated high degree of conservation of the LINE1 fragments in
      Tu80 and NOV1, as well as in the LINE1 in a number of mammalian species. Based on
      the structure of human, rat, rabbit and mouse LINE1 fragments, and also on that
      of NOV1 and Tu80, phylogenetic tree has been constructed. Its topology is
      consistent with the accepted phylogenetic relationships among the species
      studied. The data available tend to support the assumption that the ancestor for
      the Tu80-like sequence might have arisen not later than 27-33 million years ago.

PMID- 1639256
TI  - [Mathematical modeling of the dynamics of frequency of the mutation process. I.
      Age features of SA frequency dynamics tendency].
AB  - A mathematical method for modelling SA frequency dynamics tendencies, depending
      on age, for different fixation moments and in general for the whole interval of
      observation is suggested. The criteria of remainder dispersion attitude is used
      for choosing an optimal model. The initial hypothesis about discrepancies
      distribution law is used for checking adequateness of the optimal model to the
      research process. In addition, aposteriory trust intervals are built for the
      initial and forecast SA frequency values and the hit into them corresponding the
      experimental values of SA frequencies is controlled. An example of practical
      realization of the model proposed is considered and the results obtained
      analysed.

PMID- 1639257
TI  - [Suppressor mutation, interacting with the white alleles of Drosophila
      melanogaster].
AB  - A system of genetic instability was developed by crosses of males y2 wa4 with
      females C(1)DX, ywf. Mutations occurred in the second and third generations with
      the rate 0.7.10(-3)-1.5.10(-3). A novel gene named Suppressor of wa4--Su(wa4) was
      selected in this system. The Su(wa4)M1 is dominant and was localised in the
      position of 309 map units. Su(wa4)M1 suppressed wa, wa4, wbf, waG which had
      insertions of different transposable elements in different introns of the white
      locus. However, Su(wa4) does not interact with other w mutations. So, we
      suggested that Su(wa4) is trans-regulatory gene and its product involves in the
      expression regulation the white locus, probably, on the transcriptional level.

PMID- 1639258
TI  - [Polymerase chain reaction with universal primers for studying genomes].
AB  - Universal primer ability of generating conservative and variable UP-PCR
      (universally primed polymerase chain reaction) species-specific patterns was
      analysed on bacteria to serve as an example. Also, two important properties of
      the UP-PCR patterns (species/primer DNA hybridization specificity) are
      characterized.

PMID- 1639259
TI  - [Bacillus subtilis gene rec223: molecular cloning and proposed function of its
      protein product].
AB  - Chromosomal DNA fragment which complemented rec223 mutation of Bacillus subtilis
      was cloned. Introduction of one copy of the cloned gene into the cells of the rec
      mutant restored both normal activity for DNA damages repair after mitomycin C
      action and recombination proficiency. Using multicopy vector led to no formation
      of recombinants, which was probably connected with overproduction of rec223 gene
      protein product in Bacillus subtilis cells.

PMID- 1639260
TI  - [Isolation and characteristics of new mutants of Saccharomyces cerevisiae with
      increased spontaneous mutability].
AB  - To isolate some new genes controlling the process of spontaneous mutagenesis, a
      collection of 16 yeast strains with enhanced rate of spontaneous canavanine
      resistant mutations was obtained. Genetical analysis allowed to define that the
      mutator phenotype of these strains is due to a single nuclear mutation. Such
      mutations were called hsm (high spontaneous mutagenesis). Recombinational test
      showed that 5 mutants under study carried 5 nonallelic mutations. It was revealed
      that the mutation hsm3-1 is a nonspecific mutator elevating the rate of both
      spontaneous canavanine resistant mutations and the frequency of reversions in
      mutations lys1-1 and his1-7. Genetical analysis revealed that mutation hsm3-1 is
      recessive. The study of cross sensitivity of mutator strains to physical and
      chemical mutagens demonstrated that 12 of 16 hsm mutants were resistant to the
      lethal action of UV, gamma rays and methylmethanesulfonate, and 4 mutants were
      only sensitive to these factors. Possible nature of hsm mutations is discussed.

PMID- 1639262
TI  - [Participation of the HIM1 gene from Saccharomyces cerevisiae in correction of
      heteroduplex DNA. Molecular cloning of the gene].
AB  - A group of Saccharomyces cerevisiae mutants deficient in repair of induced
      premutation lesions (him mutants) were previously isolated in our laboratory.
      Recessive him1 mutant had enhanced level of spontaneous and induced mutagenesis
      as well as specific altered mitotic conversion. This HIM1 gene was supposed to be
      involved in the process of mismatch correction of heteroduplexes. In this paper
      the correction efficiency of in vitro constructed heteroduplex DNA in wild-type
      cells and him1 mutant was studied. In the former cells heteroduplex DNA was
      repaired highly efficiently (about 90%), this repair efficiency being reduced in
      him cells approx. two times as compared with the wild-type cells. Molecular
      cloning of yeast chromosomal DNA fragments containing HIM1 gene was carried out.
      The clones were selected from the bank of yeast DNA fragments by complementing
      him1-1 mutation which enhances conversion frequency in ADE2 gene. One of the DNA
      fragments was analysed by restriction endonuclease digestion and shown to contain
      an insert of 6 Kb. Chromosomal integrants were obtained by homologous
      recombination between the plasmid and chromosomal gene him1.

PMID- 1639261
TI  - [Cloning and regulation of the expression of the lysA gene from Bacillus
      subtilis].
AB  - Cloning of Bacillus subtilis DNA fragment with the lysA gene encoding
      diaminopimelatecarboxylase (EC 4.1.1.20) was done. The cloned gene in poorly
      expressed both in Escherichia coli and in Bacillus subtilis. Some DNA sequence
      distant from the lysA gene seems to be necessary for full gene expression, this
      sequence having been not cloned together with the lysA. The sequence in needed
      for regulation of the expression as well.

PMID- 1639263
TI  - [Isolation and analysis of protease-deficient mutants of Bacillus
      amyloliquefaciens].
AB  - Four types of protease negative mutants of Bacillus amyloliquefaciens A50 were
      selected after four stages of step-by-step UV light mutagenesis. EDTA, and PMSF
      were used as inhibitors of protease activity to characterize the protease
      negative mutants with regard to the protease type. The electrophoretic patterns
      of proteases from culture medium of B. amyloliquefaciens protease deficient
      mutants were studied. The proinsulin stability in the culture medium of different
      mutants was analysed. Protease deficient B. amyloliquefaciens strain A50-32 may
      be used as a recipient for cloning and expression of a foreign proteins genes.

PMID- 1639264
TI  - [Gene-enzyme system of alcohol dehydrogenase and adaptation of Drosophila to
      increased temperature].
AB  - Properties and allelic ADH (alcohol dehydrogenase) control in Drosophila
      melanogaster were studied upon flies' cultivation under conditions of hypotherm
      of different intensity and duration. Lines homozygotic for F allele (vg) and S
      allele (cn) of the Adh gene as well as genetically enriched experimental cn' and
      vg' populations containing a small number of AdhF/AdhS heterozygotes at the
      initial stage were used. It was found out that physiological adaptation of the
      species to momentary influence of elevated temperature is accompanied by
      modification of physical properties of ADH-F according to ADH-S. Constant
      influence (during the life span of 25 generations) of elevated temperature on the
      population changes its genetic structure, due to selective advantages of the S
      allele of Adh under these conditions.

PMID- 1639265
TI  - Vectors for plant transformation and cosmid libraries.
AB  - A series of vectors has been constructed for the purpose of introducing cloned
      DNAs into plant genomes, using Agrobacterium tumefaciens-mediated transformation
      methods. One of these vectors, pCIT20, is a plasmid that contains a multiple
      cloning site (MCS), and a marker (Hph) that confers hygromycin resistance to
      plant cells. The others are all cosmid vectors which allow insertion of up to 46
      kb of plant genomic DNA, and which also contain all of the necessary sequences
      for A. tumefaciens-mediated plant transformation. The cosmid vectors either
      contain a Hph marker (pCIT30), or a kanamycin-resistance marker (pCIT101-104).
      Three of the cosmid vectors (pCIT30, pCIT101, and pCIT103) carry bacteriophage T7
      and SP6 promoters flanking the cloning Bg/II site, for synthesis of end-specific
      RNAs. The end-specific RNAs may be used as probes when labeled with radioactive
      or biotinylated nucleotides, for example, in a chromosome-walking experiment. The
      other two cosmid vectors (pCIT102 and pCIT104) carry restriction sites flanking
      the insertion site (XhoI) for convenient release of the insert by restriction
      digests. These sites, in combination with sites internal to the insert, allow the
      generation of end fragments for subcloning or labeling probes. These vectors
      should be valuable for isolation and analysis of plant genes, using
      transformation, library screening, and chromosome-walking approaches.

PMID- 1639266
TI  - Ribozymes designed to inhibit transformation of NIH3T3 cells by the activated c
      Ha-ras gene.
AB  - We have designed hammerhead ribozymes that cleave c-Ha-ras mRNA mutated at codon
      12 (GGU----GUU). Plasmids containing the ribozyme-encoding genes were expressed
      under the control of the long terminal repeats of Rous sarcoma virus in NIH3T3
      cells transfected with the activated c-Ha-ras gene. These ribozymes were found to
      inhibit formation of foci (by about 50%) by cleaving the oncogene mRNA, rather
      than by hybridizing to it. Furthermore, when the activated c-Ha-ras gene was
      cotransfected with the ribozyme-encoding gene, three morphologically flat
      colonies were found and isolated. We also found that expression of c-Ha-ras was
      suppressed in cells containing ribozymes.

PMID- 1639267
TI  - Structure and myofiber-specific expression of the rat muscle regulatory gene
      MRF4.
AB  - We have cloned an 11.3-kb rat genomic DNA fragment encompassing the muscle
      regulatory factor 4 (MRF4) protein-coding sequence, 8.5 kb of 5'-flanking
      sequence, and 1.0 kb of 3'-flanking sequence. In order to study MRF4 gene
      expression, the rat myogenic cell line, L6J1-C, which expresses the endogenous
      MRF4 gene only in differentiated myofibers, was transfected stably with the full
      length genomic clone and various 5' deletions. RNase protection assays
      demonstrated that MRF4 genes containing as little as 430 bp of 5'-flanking
      sequence exhibited an increase in expression as the cells differentiated into
      myofibers, indicating that elements responsible for fiber-specific expression are
      contained within this cloned DNA fragment. Similar up-regulation was observed
      with genes containing 1.5 kb of 5'-flanking sequence. Interestingly, MRF4 genes
      containing 5.0 kb and 8.5 kb of 5'-flanking sequence were up-regulated to even
      higher levels, suggesting that additional myofiber-specific regulatory elements
      located between 1.5 and 5.0 kb upstream from the coding region play a role in
      regulating the expression of this muscle-specific gene.

PMID- 1639268
TI  - Differential regulation of TIMP-1 and TIMP-2 mRNA expression in normal and Ha-ras
      transformed murine fibroblasts.
AB  - A cDNA containing the complete coding region of the murine tissue inhibitor of
      metalloproteinases-2 (TIMP-2) was isolated using reverse transcription-polymerase
      chain reaction amplification. The predicted murine TIMP-2 amino acid sequence
      shows 96% identity with human TIMP-2, but only 42% identity with murine TIMP-1.
      This high degree of evolutionary conservation between the human and mouse
      proteins suggests that TIMP-2 performs an essential biological function. The
      expression of the TIMP-1 and TIMP-2 mRNAs was examined in normal and ras
      transformed murine fibroblasts. While TIMP-1 transcription was highly serum
      inducible in normal murine C3H10T1/2 fibroblasts, TIMP-2 mRNA expression was
      largely constitutive. A series of ras-transformed derivatives of C3H10T1/2
      fibroblasts showed great variability in TIMP-1 expression: some lines retained
      serum inducibility, others displayed constitutive expression at either high or
      low levels. In contrast, TIMP-2 expression was insensitive to transformation.
      Neither TIMP-1 nor TIMP-2 expression at the RNA level, or total TIMP activity in
      conditioned media could be correlated with the metastatic potential of the ras
      transformed lines. Our data demonstrate that the mechanisms that regulate murine
      TIMP-1 and TIMP-2 expression are distinct arguing for different physiological
      roles for the two TIMPs.

PMID- 1639269
TI  - Production of v-Myb and c-Myb in insect cells infected with recombinant
      baculoviruses.
AB  - Recombinant baculoviruses expressing the v-myb and c-myb genes in infected insect
      cells were constructed. The electrophoretic mobilities of their immunoreactive
      products were the same as those of the authentic Myb proteins from chicken cells.
      The system provides a convenient source of relatively large amounts of v-Myb or c
      Myb for in vitro binding studies.

PMID- 1639271
TI  - Structure of the murine gene encoding apolipoprotein A-I.
AB  - A 1.6-kb DNA fragment containing the gene encoding apolipoprotein A-I from the
      mouse, Mus musculus, has been cloned and sequenced. It contains three exons
      separated by two introns and encodes a secreted polypeptide of 262 amino acids
      (aa), 238 of which constitute the mature protein. Comparisons with the rat and
      human proteins indicate moderate levels of shared identity (71 and 66%,
      respectively), although the overall aa compositions yield proteins with identical
      pIs (5.4). Kyte-Doolittle analyses of the three proteins indicate that there is
      no significant difference in the structure of these apolipoproteins.

PMID- 1639270
TI  - Cloning and characterization of a highly conserved satellite DNA from the mollusc
      Mytilus edulis.
AB  - Sperm DNA of the common mussel, Mytilus edulis, has been found to contain a
      highly repeated sequence identifiable upon restriction with the endonuclease
      ApaI. The repetitive nucleotide (nt) sequence amounts to 0.63% of the mollusc
      genome with an estimated copy number of 5.4 x 10(4) copies per haploid
      complement. The monomer unit with a 173-bp repeat length has been cloned.
      Progressive DNA digestions with ApaI yield ladder-like banding patterns on
      agarose gels, indicating that the repeated elements are tandemly arranged in the
      genome and therefore represent a sequence of satellite DNA. The degree of
      internal redundancy of the reiterated sequence is deemed negligible, since nt
      sequence analysis of a random set of cloned monomers has detected the presence of
      only a few direct repeats while inverted repeated motifs or any other internal
      substructures appear absent. The homologies found among cloned monomers are
      strikingly high, averaging 95%. The results suggest that the exceptional sequence
      homogeneity of this satellite DNA may be attributed either to some homogenizing
      mechanism or to evolutionary conserved trends.

PMID- 1639272
TI  - Tissue-specific and hormonally regulated expression of the puromycin N
      acetyltransferase-encoding gene under control of the rabbit uteroglobin promoter
      in transgenic mice.
AB  - Transgenic mice bearing two fragments of the rabbit uteroglobin 5'-flanking
      region fused to the new reporter gene (pac) encoding puromycin N
      acetyltransferase (PAC) showed a different pattern of expression. Transgenic
      lines (C0.4) harboring a 404-bp fragment (-396/+8) had a uterus-specific
      expression slightly inducible by estrogen, lacking detectable expression in other
      tissues where the uteroglobin-encoding gene is naturally expressed in rabbit.
      Transgenic lines (C3.2) bearing a longer fragment of 3.2-kb (-3254/+8) showed
      hormonally regulated expression in the uterus and the male genital tract, and
      detectable expression in the lung. In addition, the nonstimulated uterine
      expression of the transgene was higher in C0.4 lines than in C3.2 lines. It could
      be concluded that all sequences required for uterus-specific expression should be
      present within the 404-bp fragment, and that other upstream (-396) sequences are
      responsible for expression in the lung and male genital tract, as well as for a
      possible down modulation of expression in the uterus.

PMID- 1639273
TI  - Synthesis of a gene encoding bovine substance P precursors and its expression in
      Escherichia coli.
AB  - Using an efficient Escherichia coli expression system, we have been able to
      obtain the precursor of substance P, alpha-preprotachykinin (alpha PPT). The
      alpha PPT protein is produced in E. coli as a fusion to beta-galactosidase, and
      accumulates in the cytoplasm as insoluble inclusion bodies. We also produced
      protachykinin (alpha PT), i.e., alpha PPT without a signal peptide. Further
      purification and characterization of the alpha PPT and alpha PT polypeptides
      strongly suggest that fully purified products can be obtained using our
      procedures.

PMID- 1639274
TI  - Production of human serum transferrin in Escherichia coli.
AB  - Transferrin (Tf) crystals diffract to only medium resolution. The mediocre
      quality of the crystals may be due to two factors: (1) the genetic variations
      naturally present in the primary sequence of Tf, and (2) the glycosylation of the
      protein. To control genetic variations and glycosylation of samples of Tf, it
      would be desirable to express the Tf gene from a recombinant clone. Additionally,
      expression of Tf from a clone would allow for manipulation of the structure of
      Tf. The cDNA encoding Tf has been cloned into the pL-based expression vector,
      pRE1, and the T7-based expression vectors, pRSETA and pET11A. The Tf expression
      plasmids, pTF-SSn and pTF-ESn, based on the T7 expression vectors, efficiently
      produce a 76-kDa protein that is approximately the same size as deglycosylated
      Tf, cross reacts with anti-Tf antibodies, and matches the deduced N-terminal
      amino acid sequence. Expression of Tf in Escherichia coli will allow the
      production of genetically pure, unglycosylated protein.

PMID- 1639275
TI  - Polymorphism at codon 72 of the p53 gene in human acute myelogenous leukemia.
AB  - A common polymorphism at codon 72 of the p53 gene in patients with acute
      myelogenous leukemia (AML) was analyzed by single-strand conformation
      polymorphism assay and sodium dodecyl sulfate polyacrylamide-gel electrophoresis
      of immunoprecipitated 35S-labeled P53 protein. No association between this
      polymorphism and a marked predisposition to AML was found. The half-lives of
      these two polymorphic forms of P53 were equivalent in normal phytohemagglutinin
      stimulated lymphocytes, while the P53 Pro72 isoform was found to be twice as
      stable as the Arg72 isoform in Daudi cells.

PMID- 1639276
TI  - A rat beta-interferon-induced mRNA: sequence characterization.
AB  - Polymerase chain reaction amplification of a cDNA derived from rat aortic smooth
      muscle cells, using sequences from conserved regions of the intramembrane domains
      of adrenergic receptors as primers, yielded the clone, rat8. This clone possesses
      a high degree of sequence similarity to a series of human interferon (IFN)
      inducible genes. The rat8 sequence is 70% similar to that derived from the human
      alpha-IFN-induced gene, 9-27; there is 66% similarity between the deduced amino
      acid sequences encoded by the rat and the human genes. The rat homologue
      hybridizes with many bands in Southern analysis of rat DNA, suggesting that it is
      a member of a large multigene family.

PMID- 1639277
TI  - The application of eight reported temperature-based algorithms to calculate the
      postmortem interval.
AB  - There exist numerous temperature-based techniques to calculate the early
      postmortem interval of human corpses. This paper presents eight commonly used
      time of death algorithms and describes how they were applied to eight corpses.

PMID- 1639278
TI  - Remote control skull positioning device for superimposition studies.
AB  - The success of the superimposition technique requires positioning the skull in
      the same posture of the face as seen in the given photograph. A scientific method
      for positioning the skull has already been proposed by Sekharan. This paper deals
      with the simple remote control tilt and rotatory device developed in the Forensic
      Sciences Department, Madras. A pan and tilt arrangement usually utilized in
      surveillance cameras and two a.c. servomotors, one to tilt the pan and the other
      to rotate the pan are used.

PMID- 1639279
TI  - Sex diagnosis of Chinese skulls using multiple stepwise discriminant function
      analysis.
AB  - Sixty Chinese skulls (30 males and 30 females) from Liaoning Province of the
      People's Republic of China were used in this study. Forty-one variables on each
      skull were measured and one group of 14 and a second group of 5 variables were
      selected from all the variables by applying multiple stepwise regression on a
      computer. Discriminant equations for the 14 and 5 variables for sex diagnosis
      have been obtained and these variables are highly significant. The discriminant
      rate for the group of 5 variables resulted in accurate sex determination in 96.7%
      of cases. For the group of 14 variables there was 100% success rate.

PMID- 1639280
TI  - Toxicological screen on gastric aspirates: the Singapore experience.
AB  - In the early eighties, in response to increasing self-poisoning incidents by
      pharmaceuticals in Singapore, a comprehensive wide-sweep screen for these drugs
      in clinical gastric aspirates was devised and implemented by us. The
      toxicological screen which involved quadruplicate extractions, two in acidic
      conditions and the other two in alkaline conditions, required the following
      analyses to be carried out: UV on the acidic fraction, TLC on the basic fraction
      and mega-bore capillary GC/NPD (nitrogen phosphorus detector) on the combined
      fraction. The combined fraction if necessary was subjected to GC/MS analysis. Our
      screen satisfied the need to confirm the analytical outcome of one method by
      another. Combining the acidic and basic fractions for a single GC analysis saves
      on instrument time and manpower. All coma and emergency cases were required to
      undergo GC/MS analysis to prove the identity of toxic agents beyond reasonable
      doubt. Quality control procedures were instituted at key steps to ensure quality
      of analytical outcome.

PMID- 1639281
TI  - The use of either the nose or outer ear as a means of determining the postmortem
      period of a human corpse.
AB  - Presented in this paper are the initial results involving the use of the nose or
      outer ear as temperature measurement sites to determine the postmortem period of
      the human corpse. Simple mathematical models for both sites are developed based
      on cooling curves of five corpses. Analysis of errors between actual and
      calculated postmortem intervals suggest that in its present form, the described
      methods would not be suitable for use in accurately determining the time since
      death of human corpses.

PMID- 1639282
TI  - Rapid isolation with Sep-Pak C18 cartridges and capillary gas chromatography of
      triazine herbicides in human body fluids.
AB  - A simple and rapid method, for the isolation of eight triazine herbicides from
      human serum and urine, using Sep-Pak C18 cartridges is presented. After mixing
      with distilled water, serum and urine samples containing the herbicides, were
      loaded on Sep-Pak C18 cartridges and eluted with either chloroform only or
      chloroform/methanol (9:1). The herbicides were detected by capillary gas
      chromatography with both flame ionization detection (FID) and nitrogen-phosphorus
      detection (NPD). Separation of eight triazine herbicides from each other and from
      impurities was generally satisfactory with the use of a non-polar DB-1 capillary
      column. Recovery of most compounds was excellent for both chloroform and
      chloroform/methanol (9:1) as elution solvents. Backgrounds were cleaner and
      evaporation time was shorter for the chloroform only than for the
      chloroform/methanol (9:1). The NPD gave sensitivity more than 10-20 times higher
      than that of FID.

PMID- 1639283
TI  - Flow cytometric studies in spontaneous abortions. Applications in the medico
      legal practice.
AB  - In the medico-legal practice differential diagnosis between spontaneous and non
      spontaneous abortion is important because causes of pregnancy wastage are often
      obscure and, moreover, spontaneous abortion is more common than accidental or
      voluntary. In all the cases in which the cause of abortion is not otherwise
      detectable and especially in cases of discovery of fetal adnexa, it is necessary
      to investigate genetic causes. Recently, DNA flow cytometric analysis has been
      applied in determining the genetic causes of spontaneous abortions. Among
      karyotypic abnormalities, flow cytometric analysis on paraffin embedded material
      can detect only polyploidies (triploidy and tetraploidy). Trisomies, monosomies
      and structural anomalies cannot be detected. In our study we tried to establish
      whether flow cytometry could be useful in determining the genetic cause of
      spontaneous abortions, in the lack of any other detectable cause. Histologic
      examination and flow cytometric analysis were performed on a series of 395
      consecutive spontaneous abortions. Histologic examination allowed the detection
      of a molar pattern in about 9% of cases. DNA flow cytometric analysis showed
      diploidy in 346 (87.59%) cases, triploidy in 37 (9.36%) cases and tetraploidy in
      12 (3.03%) cases. Combined microscopic and flow cytometric analysis revealed
      abnormalities in 17.5% of cases. A non-diploid pattern is more frequent in molar
      cases (P less than 0.001). Flow cytometry seems to be interesting in forensic
      pathology, as it allows the detection of some frequent genetic abnormalities in
      dead tissues and cells, when other techniques are no longer practicable.

PMID- 1639284
TI  - A high endrin concentration in a fatal case.
AB  - Gas chromatography coupled to mass spectrometry was employed to quantify endrin
      in biological fluids in a death attributed to endrin overdose. The blood
      concentration of endrin was 544.9 mg/l. Results are discussed in the light of the
      existing literature.

PMID- 1639285
TI  - Is mummification possible in snow?

PMID- 1639286
TI  - [Therapy of mouth cancer. 41st annual meeting of the German Association for Oral,
      Mandibular and Facial Surgery. Wurzburg].

PMID- 1639287
TI  - [The epidemiology of lip and mouth malignancies].

PMID- 1639288
TI  - [Statistical aspects of survival analysis in head-neck tumors].

PMID- 1639289
TI  - [Mandible resection in mouth cancer--rim resection versus continuity resection].

PMID- 1639291
TI  - [Radical neck dissection versus conservative neck dissection. A statistical
      evaluation of literature data].

PMID- 1639290
TI  - [Saving the mandible in surgical treatment of mouth floor cancer].

PMID- 1639292
TI  - [4th German-Austrian-Swiss Study Group therapy study. Prospective, randomized,
      clinical study of squamous cell cancer of the mouth: "Radical neck dissection
      versus conservative neck dissection"].

PMID- 1639293
TI  - [The problem of elective (preventive) neck dissection in mouth cancer exemplified
      by a comparison of pre- and postoperative neck lymph node findings].

PMID- 1639294
TI  - [Significance of lymph node staging in the trigonum caroticum in supra-hyoid
      lymph node excision].

PMID- 1639295
TI  - [Morphologic and functional changes in the shoulder girdle after neck
      dissection].

PMID- 1639296
TI  - [Modification of neck lymph node dissection in squamous cell cancers of the oral
      cavity].

PMID- 1639297
TI  - [Maxillary cancers--a retrospective study].

PMID- 1639298
TI  - [Preoperative radio-chemotherapy and radical operation of advanced mouth cancers-
      final results of a prospective therapy study of the German-Austrian-Swiss Study
      Group].

PMID- 1639299
TI  - [Preoperative short-term preliminary irradiation with 3 x 6 Gy, immediate radical
      tumor resection and postoperative booster irradiation to 60 Gy as an effective
      therapy concept for the treatment of T2 squamous cell carcinomas of the mouth.
      Results of a prospective randomized bi-center study].

PMID- 1639300
TI  - [Has preoperative irradiation of mouth cancer produced advantageous results?].

PMID- 1639301
TI  - [Combined radiochemotherapy with cis-DDP and radical resection in patients with
      operable squamous cell cancers of the oropharynx. Results of 4 years of treatment
      of 132 patients].

PMID- 1639302
TI  - [Causes and time of fatal events after therapy of mouth cancer].

PMID- 1639303
TI  - [5-year survival rate of patients with squamous cell cancers of the mouth; a
      retrospective comparative study].

PMID- 1639304
TI  - [Importance of clinical observation studies of the German-Austrian-Swiss Study
      Group for the oncology of mouth cancer].

PMID- 1639305
TI  - [10 years study of the recurrence behavior and survival after radical surgery of
      not pre-treated mouth cancer].

PMID- 1639306
TI  - [Statistical results in patients with squamous cell cancer of the mouth, 1981
      1990 patient sample].

PMID- 1639307
TI  - [Onco-surgical radical treatment, recurrence and rehabilitation in the Jena
      Clinic patient sample (1968-1989)].

PMID- 1639308
TI  - [Comparative studies of two patient groups with primary mouth cancer 1981 to
      1989].

PMID- 1639309
TI  - [Long-term results of radical therapy of squamous cell cancers of the mouth with
      special reference to late recurrence and second malignancies--a catamnestic study
      of 20 years].

PMID- 1639310
TI  - [Results of operative treatment of squamous cell cancers of the mouth and
      oropharynx with and without additional postoperative therapy].

PMID- 1639311
TI  - [Change in the prognosis of surgically treated cancer of the mouth mucosa in the
      course of time].

PMID- 1639312
TI  - [Possibilities and limits of the CIP (computer-assisted individual prognosis)
      program in clinical oncology].

PMID- 1639313
TI  - [From the oncologic viewpoint is there an indication for immediate reconstruction
      in oral cancer?].

PMID- 1639314
TI  - [Mouth cancer--intra-oral tumor resection].

PMID- 1639315
TI  - [Individualized tumor therapy based on biological parameters and prognostic
      evaluation using the TPI (therapy-oriented prognostic index)].

PMID- 1639316
TI  - [Survival of patients with mouth cancer in relation to age and concomitant
      diseases].

PMID- 1639317
TI  - [Verrucous cancer of the mouth].

PMID- 1639318
TI  - [Multiple primary malignant tumors in the area of the jaw, face and upper
      aerodigestive tract].

PMID- 1639319
TI  - [Results of treatment of lip cancer].

PMID- 1639320
TI  - [Functional and esthetic aspects of therapy for lip cancer].

PMID- 1639321
TI  - [Results of surgical therapy of regional lymph nodes in lower lip cancer].

PMID- 1639322
TI  - [Treatment concepts in surgical therapy of lip cancer].

PMID- 1639324
TI  - [Determining indications for primary removal of regional lymph drainage vessels
      in lip cancer].

PMID- 1639323
TI  - [Two years clinical documentation of head-neck tumors in the central tumor
      registry of the German-Austrian-Swiss Study Group].

PMID- 1639325
TI  - [Survival rate and functional results after microsurgical reconstruction
      procedures in the area of the oral cavity].

PMID- 1639326
TI  - [Effect of modern reconstruction procedures on radicality and survival time in
      mouth cancer].

PMID- 1639327
TI  - [Survival rate of patients with jejunum transplants in comparison with the
      prospective German-Austrian-Swiss Study Group study].

PMID- 1639328
TI  - [Primary defect coverage of mouth cancers by musculocutaneous flaps--results of a
      follow-up study].

PMID- 1639329
TI  - [Does defect coverage with extensive flaps after surgery for advanced oral cancer
      have an effect on survival rate of patients?].

PMID- 1639330
TI  - [Retrospective analysis of a mandible sparing therapy concept in cancers of the
      mouth floor].

PMID- 1639332
TI  - Transcatheter ablation of cardiac tissue: advantages and disadvantages of
      different ablative techniques.
AB  - Transcatheter ablation techniques are emerging as an alternative therapeutical
      tool in the management of cardiac arrhythmias. Catheter ablation was initially
      introduced as the last resort to ablate the atrioventricular nodal conduction in
      patients with atrial fibrillation and uncontrolled ventricular response and in
      patients with drug refractory ventricular tachycardias. Direct current energy was
      used as the sole source of energy, but because of potential significant
      complications and early and late mortality, presumably mostly due to ventricular
      tachyarrhythmias, other sources of energy were sought. Radiofrequency current
      which does not produce barotrauma and does not require general anesthesia rapidly
      replaced direct current ablation in many centers. Early results with
      radiofrequency current ablation of the atrioventricular node and accessory
      atrioventricular pathways are very encouraging. The results of radiofrequency as
      well as direct current ablation for atrial flutter, atrial tachycardia and
      ventricular tachycardia, where the components of reentry circuit are less
      defined, are not as favorable as those of AV junctional tachycardias. However,
      improvement of catheter and generatory technology and better understanding of the
      mechanisms of ventricular tachycardias and characteristics of the target site
      will enhance the results of catheter ablation in ventricular tachcardias. The
      procedures are still considered investigational, and mostly done by very
      experienced groups at tertiary referral hospitals with surgical teams available
      in case of serious complications. Larger patient populations and longer follow-up
      periods are required before these techniques expand to community hospitals and to
      patients with minimal symptoms or asymptomatic individuals as a prophylaxis
      therapy.

PMID- 1639331
TI  - [Indications for partial mandibular resection in tumors of the mouth floor].

PMID- 1639333
TI  - Transcatheter modification of the atrioventricular node using radiofrequency
      energy.
AB  - 120 consecutive patients with symptomatic atrioventricular nodal reentrant
      tachycardia (AVNRT) underwent catheter ablation using radiofrequency energy. Fast
      pathway ablation was attempted in the first 16 consecutive patients by
      application of radiofrequency current in the anterior and superior aspect of the
      tricuspid annulus. Successful results were accomplished in 13 patients, complete
      AV block occurred in three. The other 104 patients initially underwent ablation
      of the slow pathway in the posterior and inferior aspects of the tricuspid
      annulus which was successful in 98 patients. The remaining six patients
      subsequently underwent a fast pathway ablation with successful results in four
      and AV block in two. Therefore, 102 (98%) of the last 104 patients became free of
      AVNRT while maintaining intact AV conduction. This study demonstrates that both
      AV nodal conduction pathways can be selectively ablated. However, slow pathway
      ablation seems safer and should be considered as the first approach.

PMID- 1639334
TI  - Current status of radiofrequency ablation in the preexcitation syndromes.
AB  - Catheter ablation techniques have become an accepted treatment form for a variety
      of supraventricular arrhythmias. After the introduction of radiofrequency energy,
      catheter ablation has become the first line of treatment and has replaced surgery
      in patients with the preexcitation syndromes. The success rate in large series is
      very high, while the complication rate in experienced hands is very low. Despite
      all this progress, the ablation of a small subset of accessory atrioventricular
      pathways poses some problems. The ideal source of energy is still unknown and
      improvement in catheter technology are needed. This review will try to focus on
      some of these issues dealing with a very exciting area of clinical cardiology.

PMID- 1639335
TI  - Identifying sites for catheter ablation of ventricular tachycardia.
AB  - The approach to localizing sites for catheter ablation of ventricular tachycardia
      foci depends on the type of tachycardia. In large reentry circuits such as those
      arising from infarct scars, areas of slow conduction in and around the scar
      should be targeted. During sinus rhythm, these can be suspected from the presence
      of fractionated electrograms and, at some sites, long stimulus to QRS delays
      during pacing. Slow conduction areas can be classified as: 1. central slow
      conduction zone sites, 2. exits from the slow conduction zone, 3. entrances to
      the slow conduction zone, and 4. bystander areas which are not involved in the
      tachycardia circuit. In the central slow conduction zone stimulation entrains or
      resets tachycardia with a long stimulus to QRS (S-QRS) delay (40 to greater than
      300 ms) without altering the QRS morphology (entrainment with concealed fusion).
      At slow conduction zone exits, presystolic electrograms are recorded during VT,
      the pacemap matches the VT QRS morphology, and with pacing during VT the S-QRS
      interval is relatively short and VT may or may not be entrained. At entrances to
      the slow conduction zone electrogram timing is variable but early diastolic
      electrograms are expected and the pace-map QRS may differ from the VT QRS
      morphology. Relatively late stimuli or slow trains of stimuli entrain VT with
      concealed fusion with a relatively longer S-QRS interval than observed in the
      central slow conduction zone. Early stimuli may entrain VT while altering the QRS
      morphology due to propagation of the stimulated antidromic wavefront out of the
      scar from a site other than the tachycardia exit. At bystander sites electrogram
      timing, pace-mapping, and the effects of programmed stimulation are variable but
      may occasionally mimic reentry circuit sites. Relatively late stimuli are likely
      to capture the site without altering the VT. If discrete electrograms are
      present, analysis of these during pacing may provide further evidence that the
      site is not in the reentry circuit. Catheter ablation will probably be most
      effective at central slow conduction zone sites. When VT originates from a small
      focus surrounded by normal myocardium, such as is likely for idiopathic RV
      outflow tract and some idiopathic left ventricular tachycardias, presystolic
      electrical activity and pacemapping are likely to identify the tachycardia focus.
      For macroreentry involving the bundle branches, the right bundle branch can be
      easily targeted.

PMID- 1639336
TI  - Catheter ablation of ventricular tachycardia using radiofrequency current.
AB  - Catheter ablation techniques have evolved as an alternative to map-guided surgery
      and proven effective in a variety of supraventricular tachyarrhythmias. Direct
      current catheter ablation has been shown to be effective in about 50 to 70% of
      cases. Approximately, 60% of patients with structural heart disease and
      monomorphic ventricular tachycardia were successfully treated using direct
      current ablation techniques. This overall success rate and possible risks
      associated with the use of direct current have stimulated the search for other
      energy sources appropriate for catheter ablation. Presently, only a few
      preliminary reports on the clinical efficacy of radiofrequency energy for the
      treatment of ventricular tachyarrhythmias in man exist. 23 patients with
      identifiable heart disease at a mean age of 52 +/- 17 years underwent
      radiofrequency catheter ablation. 16 patients had coronary artery disease, one
      patient dilative cardiomyopathy and six patients had arrhythmogenic right
      ventricular disease. All patients presented with chronic current sustained
      ventricular tachycardia. After detailed endocardial catheter mapping
      radiofrequency energy was applied at the site of earliest ventricular activation
      during ventricular tachycardia which could be entrained during fixed rate
      ventricular pacing at the site of origin of ventricular tachycardia. At all
      ablation sites a long latency between the stimulus and QRS complex was noted. Of
      23 patients 18 were treated with radiofrequency alone whereas in five patients a
      second ablation procedure using direct current was performed. Following the
      ablation procedures, 14 patients (61%) remained free of ventricular tachycardia.
      One patient died due to congestive heart failure 21 months following
      ablation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639337
TI  - Catheter ablation of ventricular tachycardia using radiofrequency techniques in
      patients without structural heart disease.
AB  - It has been previously demonstrated that radiofrequency (RF) energy can be safely
      applied to successfully eliminate accessory pathways in patients with the Wolff
      Parkinson-White syndrome. This technique may also be used to successfully
      eliminate atrioventricular (AV) nodal reentrant tachycardia by elimination of
      either the fast or slow AV nodal pathways. However, RF energy has achieved only
      limited success in eliminating ventricular tachycardia (VT) in patients with
      structural heart disease, such as coronary artery disease and dilated
      cardiomyopathy. Direct-current catheter techniques have successfully eliminated
      VT in patients with and without structural heart disease, but this technique is
      limited by the risk of barotrauma and proarrhythmia. We used RF catheter ablation
      techniques to eliminate VT in patients without structural heart disease. Our
      results from the basis of this report. 16 patients (nine women and seven men;
      mean age 38; range 18 to 55 years) who did not have any identifiable structural
      heart disease by echocardiography where included in this study. These patients
      underwent RF catheter ablation to eliminate VT. Two patients had presented with
      syncope, nine with presyncope and five with palpitations only. The mean duration
      of symptoms was 6.7 years (range 0.5 to 20 years). VT was successfully eliminated
      by RF catheter techniques in 15 of the 16 patients (a 94% success rate).
      Importantly, successful ablation sites included regions other than the right
      ventricular outflow tract. Areas of VT origin therefore included the high right
      ventricular outflow tract (twelve patients), right ventricular septum near the
      tricuspid valve (three patients), and the left ventricular septum (one patient).
      The only ablation failure was in a patient whose VT arose from a region near the
      His bundle. Successful ablation occurred in patients in whom an accurate pace map
      could be obtained and early local endocardial activation was obtainable. Further,
      firm catheter contact with endocardium was required for successful elimination of
      VT. RF ablation did not cause any identifiable arrhythmia and produced a minimal
      cardiac enzyme rise. It also resulted in no detectable change in cardiac function
      by Doppler echocardiography. Based on these findings, we conclude that RF
      catheter ablation of VT in patients without structural heart disease was highly
      effective and safe. It may therefore be considered as early therapy in these
      patients.

PMID- 1639339
TI  - Hormonal status of postmenopausal women with alcohol-induced cirrhosis: further
      findings and a review of the literature.
AB  - The derangements of levels of sex hormones and gonadotropins in alcoholic
      cirrhotic men are well delineated. The countersituation in alcoholic cirrhotic
      women has not yet been fully described. This study was performed in
      postmenopausal women among whom menstrual cycle variations in hormones no longer
      occur; with such a study population, it is possible to control for confounding
      factors and thus optimize detection of differences in levels of hormones and
      hormone interrelationships. Both estradiol levels and a rough estimate of
      aromatization of testosterone to estradiol, the estradiol to testosterone ratio,
      were significantly elevated in the 20 alcoholic subjects with alcohol-induced
      cirrhosis, as compared with the 27 normal controls; similarly, testosterone,
      luteinizing hormone and follicle-stimulating hormone were all significantly
      reduced in the alcoholic cirrhotic women. In addition, the normal relationships
      of estradiol with luteinizing hormone, follicle-stimulating hormone, body mass
      and the estradiol/testosterone ratio were detected in the control group but not
      in the group of cirrhotic women. Further, among the alcoholic cirrhotic
      postmenopausal women, testosterone, luteinizing hormone, follicle-stimulating
      hormone and the estradiol/testosterone ratio were all significantly correlated
      with the Child's liver disease severity score. That the hormone levels and their
      interrelationships differ markedly between normal and alcoholic cirrhotic women
      extends previous findings in both men and postmenopausal women; the correlations
      of hormone levels and markers of liver disease will require further
      investigation.

PMID- 1639338
TI  - [Long-term results of Mustard operation in transposition of the great arteries.
      Angiographic and nuclear medicine study of ventricular function].
AB  - The fate of the right ventricle as systemic ventricle after atrial repair of
      complete transposition of the great arteries has not been clearly elucidated. In
      order to assess the long-term results of the Mustard operation in patients with
      complete transposition of the great arteries we present the clinical data of 23
      patients who had been operated in the years 1974 and 1975. Twenty of these
      patients had simple complete transposition of the great arteries with intact
      ventricular septum, two had an additional small ventricular septal defect and one
      an additional left ventricular outflow tract obstruction with a 40 mm Hg systolic
      pressure gradient. The Mustard operation had been performed at a mean age of 2.2
      (1 to 3.7) years. Seventeen of the 23 patients underwent a postoperative
      hemodynamic study with angiocardiography 1.1 (1 to 1.8) years following surgery.
      At that time the right ventricular ejection fraction, which had been calculated
      from biplane angiographic right ventricular volume measurements in twelve
      patients was 62 (52 to 68) %. However the right ventricle was dilated and the
      mean enddiastolic volume was 132 (108 to 192) % of normal. In twelve of the 23
      patients right ventricular function was reassessed 12.6 (11 to 15.3) years after
      surgery by Technetium-99m-scintigraphy at rest and in ten of those after exercise
      with a workload of 2 watt/kg. The mean ejection fraction was 51 (38 to 66) % at
      rest and 52 (40 to 80) % during exercise. Only three patients had a normal
      response to exercise, which was defined as an increase of ejection fraction with
      exercise of more than 5%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639340
TI  - Cholesterol metabolism in human gallbladder mucosa: relationship to cholesterol
      gallstone disease and effects of chenodeoxycholic acid and ursodeoxycholic acid
      treatment.
AB  - The objective of this study was to investigate cholesterol metabolism in human
      gallbladder mucosa, especially in relation to hepatic cholesterol metabolism,
      gallstone disease and treatment with bile acids. Gallbladder mucosa and liver
      tissue samples were collected in 44 patients undergoing cholecystectomy; 30 had
      cholesterol gallstones and the rest were stone free. Ten of the gallstone
      patients were treated with chenodeoxycholic acid and eight received
      ursodeoxycholic acid, with a daily dose of 15 mg/kg body wt, for 3 wk before
      surgery. The 3-hydroxy-3-methylglutaryl coenzyme A reductase activity, governing
      cholesterol synthesis, was considerably lower in the gallbladder mucosa than in
      liver tissue (28 +/- 6 and 120 +/- 40 pmol/min/mg protein). The acyl coenzyme
      A:acyltransferase activity in the gallbladder mucosa catalyzing the
      esterification of cholesterol was, on the other hand, several times higher than
      corresponding activity in the liver (92 +/- 23 and 11 +/- 2 pmol/min/mg protein).
      In the presence of exogenous cholesterol, the acyl coenzyme A:acyltransferase
      activity increased about twofold in the gallbladder mucosa. The acyl coenzyme
      A:acyltransferase activity of the gallbladder mucosa from untreated gallstone
      patients was not stimulated further by the addition of exogenous cholesterol.
      Otherwise, there were no significant differences in acyl coenzyme
      A:acyltransferase and 3-hydroxy-3-methylglutaryl coenzyme A reductase activities
      in the gallbladder mucosa of gallstone patients compared with gallstone-free
      controls. Treatment with chenodeoxycholic and ursodeoxycholic acids did not
      affect the 3-hydroxy-3-methylglutaryl coenzyme A reductase activity of the
      gallbladder mucosa but reduced the acyl coenzyme A:acyltransferase activity by
      60% to 65%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639341
TI  - Postinfantile giant-cell transformation in hepatitis.
AB  - Giant-cell hepatitis is a frequent pattern of liver injury in the neonate, but it
      is rare after infancy. Such cases have been attributed to autoimmune disease, to
      non-A, non-B hepatitis and, most recently, to paramyxovirus infection. To better
      define the entity of postinfantile (syncytial) giant-cell hepatitis, we reviewed
      24 biopsy specimens from 20 patients with this finding, either alone or in
      combination with other diagnoses. The number of multinucleated giant cells varied
      greatly from one specimen to another. Varying degrees of portal inflammation
      appeared in all but one of the patients, and all had hepatitislike acinar
      inflammation associated with hepatocellular injury. Fibrosis was a common
      finding, varying from mild periportal fibrosis to established cirrhosis (33%).
      The changes were interpreted as acute giant-cell hepatitis in 25%, as CAH in 42%
      and as active cirrhosis in the remainder. The patients ranged in age from 2 to 80
      yr, with a mean of 35 yr and a male/female ratio of approximately 1:1. The signs
      and symptoms of liver disease were present for more than 1 mo in most patients. A
      positive antinuclear antibody titer was found in seven of the patients. Three
      patients had a direct Coombs reaction and anemia. Overall, evidence of autoimmune
      disease was found in 40% of the patients. One patient had non-Hodgkin's lymphoma
      involving the liver. Only one patient had a history of blood transfusion or risk
      factors for hepatitis C. No patient underwent serological study for paramyxovirus
      antibodies. Liver tissue from one patient was examined ultrastructurally, but no
      viral particles could be identified.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639342
TI  - Cystic dilatation of peribiliary glands in livers with adult polycystic disease
      and livers with solitary nonparasitic cysts: an autopsy study.
AB  - Cystic dilatation of peribiliary glands of intrahepatic and extrahepatic bile
      ducts was investigated in autopsied livers with adult polycystic disease (n = 8),
      in autopsied livers with solitary nonparasitic cysts (n = 18) and in normal
      autopsied livers (n = 23). In normal livers, cystic dilatation of intrahepatic
      peribiliary glands was absent or slight, when present. In livers with solitary
      nonparasitic cysts, cystic dilatation of intrahepatic peribiliary glands was
      present in varying degrees. In livers with adult polycystic disease, intrahepatic
      peribiliary glands showed frequent and severe cystic dilatation so marked that it
      was grossly recognizable. In contrast, peribiliary glands of the extrahepatic
      bile ducts showed no cystic dilatation in most cases, regardless of the three
      conditions examined. Liver parenchymal cysts were numerous in livers with adult
      polycystic disease, few in livers with solitary nonparasitic cysts and
      nonexistent in normal livers. Von Meyenburg complexes were present in 87.5% of
      livers with adult polycystic disease, in 16.7% of livers with solitary
      nonparasitic cysts and in 4.3% of normal livers. These findings suggest that
      intrahepatic peribiliary glands undergo cystic dilatation in livers with adult
      polycystic disease-and, to a lesser degree and frequency in livers with solitary
      nonparasitic cysts, probably because of congenital or genetic factors-and that
      these cystic changes may comprise a part of numerous cysts of adult polycystic
      disease.

PMID- 1639343
TI  - Metabolism of 15N-ammonia in patients with cirrhosis: a three-compartmental
      analysis.
AB  - Urinary 15N-ammonia and 15N-urea were measured by gas chromatography-mass
      spectrometry after the intravenous administration of 15N-ammonia (0.2
      mumol/kg/hr) to 6 volunteers and 11 patients with cirrhosis. Urinary 15N-nitrogen
      excretion as ammonia and urea was measured during the 210-min infusion period,
      and urea synthesis and ammonia conversion to amino acids were analyzed with a
      three-compartment model using the nonlinear least-squares method. The rate of
      urea synthesis in control subjects was 14.1 +/- 1.2 mg/kg/hr (mean +/- S.E.M.),
      and in cirrhotic patients it was 11.0 +/- 3.2 mg/kg/hr. The cirrhotic group was
      divided into those with compensated cirrhosis (Child class A patients) and those
      with decompensated cirrhosis (Child classes B and C patients), and the rates of
      urea synthesis for these groups were 14.5 +/- 1.5 and 8.9 +/- 1.6 mg/kg/hr,
      respectively. The difference between decompensated cirrhotic patients and control
      subjects was statistically significant (p less than 0.001). The percentage of
      ammonia reutilization of a given dose of 15N-ammonia was 75.9% +/- 2.4% in
      compensated cirrhotic patients and 82.9% +/- 3.6% in decompensated cirrhotic
      patients (p less than 0.05). Fasting venous ammonia levels correlated inversely
      with urea synthesis (p less than 0.001) and correlated positively with ammonia
      reutilization (p less than 0.05). These results are consistent with a decreased
      capacity to synthesize urea and an increased capacity to convert ammonia to amino
      acids in chronic liver failure.

PMID- 1639344
TI  - Immunomodulatory effects of ursodeoxycholic acid on immune responses.
AB  - Ursodeoxycholic acid was recently recognized as an effective agent in the
      treatment of primary biliary cirrhosis. Experimental evidence supporting the
      usefulness of ursodeoxycholic acid as a potentially beneficial therapeutic agent
      for primary biliary cirrhosis has been reported from the biochemical and
      physiological aspects. In this study, we investigated the direct effects of
      ursodeoxycholic acid on immunoglobulin and cytokine production in vitro using
      plaque-forming cell assay and enzyme-linked immunosorbent assay. It was
      demonstrated that ursodeoxycholic acid suppressed the production of IgM, IgG and
      IgA induced by Staphylococcus aureus Cowan I in peripheral blood mononuclear
      cells derived from healthy subjects and patients with primary biliary cirrhosis
      and also in human B lymphoma cell lines. Furthermore, ursodeoxycholic acid
      suppressed interleukin-2 and interleukin-4 production induced by concanavalin A
      and interferon-gamma production induced by polyinosinic-polycytidylic acid, but
      it did not affect interleukin-1 and interleukin-6 production induced by
      lipopolysaccharide in peripheral blood mononuclear cells. In addition,
      ursodeoxycholic acid suppressed the concanavalin A-induced thymocyte
      proliferation mediated by interleukin-1. Cytotoxicity against lymphocytes was not
      observed at the concentrations of ursodeoxycholic acid used. These results
      suggest that the beneficial effect of ursodeoxycholic acid in primary biliary
      cirrhosis is mediated in part by immunosuppression.

PMID- 1639345
TI  - Purification of 3 alpha-hydroxysteroid and 3 beta-hydroxysteroid dehydrogenases
      from human liver cytosol.
AB  - We previously reported that the human Y' bile acid binder, which has higher bile
      acid binding affinities than rat Y' binders (3 alpha-hydroxysteroid
      dehydrogenases), has dihydrodiol dehydrogenase activity and is different from 3
      alpha-hydroxysteroid dehydrogenases. In this study, 3 alpha-hydroxysteroid
      dehydrogenases and 3 beta-hydroxysteroid dehydrogenase were purified from human
      liver, and bile acid binding affinities and enzyme kinetics of the 3 alpha
      hydroxysteroid dehydrogenases were studied. On chromatofocusing of pooled Affigel
      blue fraction of the Y' fraction, three 3 alpha-hydroxysteroid dehydrogenase
      peaks eluted at pH 6.0, 5.7 and 5.4. These peaks did not bind bile acids, and
      further purification by hydroxyapatite-high-performance liquid chromatography
      gave pure 3 alpha-hydroxysteroid dehydrogenases with identical M(r) (36,000)
      having dihydrodiol dehydrogenase activity. 3 beta-Hydroxysteroid dehydrogenase
      was eluted together with Y' bile acid binder at pH 7.2 on chromatofocusing and
      was separated from Y' bile acid binder on hydroxyapatite-high-performance liquid
      chromatography as a pure protein with M(r) 32,000. The apparent Kms of 3 alpha
      hydroxysteroid dehydrogenases were similar to those of rat enzymes. In
      conclusion, we purified human hepatic 3 alpha-hydroxysteroid dehydrogenases,
      which have similar characteristics to rat enzymes, but do not bind bile acids or
      reduce bile acid precursors. These data further support the importance of human
      bile acid binder in intracellular bile acid transport in the human liver.

PMID- 1639346
TI  - Bile-duct destruction and collagen deposition: a prominent ultrastructural
      feature of the liver in cystic fibrosis.
AB  - To study the liver disease of patients with cystic fibrosis, percutaneous liver
      biopsies were performed in 10 patients with cystic fibrosis aged 6 to 22 yr. Nine
      of 10 patients had high Shwachman scores, eight had normal serum levels of
      transaminases. Light-microscopical examination showed steatosis in seven cases
      and in five slight or moderate inflammatory infiltration. Eight patients showed
      varying degrees of fibrosis and even cirrhosis. Six patients had bile-duct
      proliferation and, in one case a bile plug was found. Other signs of cholestasis
      were not seen. Electron-microscopical investigation showed no specific signs of
      cholestasis such as ductal plugs or intracellular bile pigments. The canaliculi
      were not dilated, except in one case. Most patients had bile-duct cells with
      irregular shapes, protruding into the lumen, and some cases even had necrotic
      cells. Around the bile ducts and ductules, collagen was deposited and fat-storing
      cells were a common finding. Our findings do not support the view that
      cholestasis is the pathogenetic factor in liver disease in cystic fibrosis. A
      cytotoxic influence on the biliary cells, stimulating collagen deposition, seems
      more likely.

PMID- 1639347
TI  - Expression of 27-kD heat-shock protein isoforms in human neoplastic and
      nonneoplastic liver tissues.
AB  - Previous study of rat liver during chemically induced hepatocarcinogenesis has
      shown that expression of isoforms of the 27-kD heat-shock protein was greater in
      neoplastic nodules and in hepatocellular carcinoma than in control livers. In
      this study, various human neoplastic and nonneoplastic liver tissues were
      investigated with electrophoresis after amino acid labeling to evaluate the
      expression of 27-kD heat-shock protein isoforms. This revealed that human liver
      contains 27-kD proteins that are recognized by a polyclonal antibody raised
      against human 27-kD heat-shock protein. Basal levels of fluorographical and
      immunostaining intensity of the 27-kD heat-shock protein spots (respectively,
      after [3H]leucine or 32P incorporation or as checked with a specific human 27-kD
      heat-shock protein antibody) were higher in hepatomas than in non-tumorous liver.
      Phosphorylation patterns of the 27-kD heat-shock protein isoforms were, however,
      similar in hepatocellular carcinoma and in uninvolved surrounding liver. Heat
      inducibility of the 27-kD heat-shock protein, tested in one case of liver cell
      adenoma and in the surrounding liver, was also preserved in both tissues. The
      role of the overexpression of 27-kD heat-shock protein in neoplastic liver
      tissues remains unknown. We propose, as a working hypothesis, that it is related
      to the resistant phenotype acquired by some tumors during malignant progression.

PMID- 1639348
TI  - Amino acid substitutions at position 38 of the DR beta polypeptide confer
      susceptibility to and protection from primary sclerosing cholangitis.
AB  - Previous studies based on serological HLA phenotyping have implicated genes in
      the HLA class II region in susceptibility to and protection from primary
      sclerosing cholangitis. In a recent report, the HLA DRw52a antigen was present in
      all 29 patients who had been referred for liver transplantation. In this study,
      HLA DRB, DQA and DQB genotypes were studied using gene amplification and sequence
      specific oligonucleotide probing in 71 patients with primary sclerosing
      cholangitis and 68 healthy controls to determine the frequency among the patients
      of the DRB3*0101 allele that encodes DRw52a and whether other class II alleles
      are involved in susceptibility or protection. DRB3*0101 was the most strongly
      associated allele, being present in 55% of the patients and 22% of the controls.
      Survival among the DRB3*0101-positive patients was reduced compared with the
      DRB3*0101-negative patients. Both DRB3*0101 and DRB5*0101, a possible second DRB
      susceptibility allele, encode a leucine residue at position 38 of the DR beta
      molecule. The DRB4*0101 allele, which encodes DRw53 and may be protective,
      encodes an alanine residue at this position. Susceptibility to and protection
      from primary sclerosing cholangitis may result from amino acid substitutions at
      position 38 of the DR beta molecule because maximum relative risk was conferred
      by two leucine-38-containing DR beta molecules, whereas minimum relative risk was
      conferred by two alanine-38-containing molecules.

PMID- 1639349
TI  - Globulin correction of the albumin gradient: correlation with measured serum to
      ascites colloid osmotic pressure gradients.
AB  - The albumin difference or gradient between serum ascites is presumed to be an
      effective estimate of the colloid osmotic pressure gradient, although this has
      never been directly demonstrated. The colloid osmotic pressure gradient is
      controlled by the degree of portal hypertension. Thus the albumin gradient is
      clinically useful in detecting patients with ascites caused by portal
      hypertension, although some overlap in such patients' albumin gradients exists
      compared with those of patients without portal hypertension. Part of this overlap
      is related to the inverse correlation of the albumin gradient with serum
      globulin; globulins also contribute to colloid osmotic pressure. The ability to
      calculate colloid osmotic pressure in serum and ascites with albumin and globulin
      concentration or to correct the albumin gradient for the impact of globulins
      might improve the clinical usefulness of the ascitic fluid analysis in
      determining the presence of portal hypertension in ascitic patients with
      borderline albumin gradients. Thus we developed equations to calculate colloid
      osmotic pressure from multivariate discriminate analyses of albumin and globulin
      concentrations in serial dilution samples of pooled serum and subsequently
      validated these equations, along with older methods of calculating colloid
      osmotic pressure. In an initial set of dilution experiments, globulin
      concentration was closely correlated with the colloid osmotic pressure to albumin
      concentration ratio (r = 0.956; p less than 0.001). Multivariate discriminate
      analysis yielded an equation for calculating colloid osmotic pressure from
      albumin (A) and globulin (G) concentration with a ratio of colloid osmotic
      pressure to albumin (calculated colloid osmotic pressure = A(1.058G + 0.163A +
      3.11) and two other equations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639350
TI  - Increased tissue-type plasminogen activator activity in orthotopic but not
      heterotopic liver transplantation: the role of the anhepatic period.
AB  - The major cause of the increased tissue-type plasminogen activator activity
      during orthotopic liver transplantation is still unclear. Both the lack of
      hepatic clearance of tissue-type plasminogen activator in the anhepatic period
      and increased endothelial release from the graft on reperfusion have been
      proposed as the major causes. Heterotopic liver transplantation avoids the
      resection of the host liver and is a useful model to help differentiate between
      these two possibilities. In this study the fibrinolytic system was evaluated in
      10 orthotopic liver transplantations, 18 heterotopic liver transplantations and a
      control group of 10 partial hepatic resections. A marked increment in tissue-type
      plasminogen activator activity, from 0.2 to 5.2 IU/ml (p less than 0.02), was
      observed during the anhepatic period of orthotopic liver transplantation, which
      rapidly normalized after reperfusion. In contrast, tissue-type plasminogen
      activator activity levels remained normal in heterotopic liver transplantation
      and partial hepatic resections. In orthotopic liver transplantation and in
      heterotopic liver transplantation no increase occurred in tissue-type plasminogen
      activator activity after reperfusion. The first venous hepatic outflow after
      reperfusion did not contain elevated tissue-type plasminogen activator activity
      levels. Plasma degradation products of fibrin and fibrinogen increased during the
      anhepatic period of orthotopic liver transplantation (from 2.60 to 8.80
      micrograms/ml [p less than 0.008] and from 0.40 to 1.60 micrograms/ml [p less
      than 0.04], respectively) and remained elevated thereafter. In heterotopic liver
      transplantation and partial hepatic resections these levels remained low. In
      conclusion, the lack of hepatic clearance during the anhepatic period is probably
      the most important factor in the evolution of increased tissue-type plasminogen
      activator activity during orthotopic liver transplantation.

PMID- 1639351
TI  - Administration of interleukin-2 induces major histocompatibility complex class II
      expression on the biliary epithelial cells, possibly through endogenous
      interferon-gamma production.
AB  - In various organ-specific autoimmune diseases, aberrant expression of major
      histocompatibility complex class II antigens on each target epithelial cell has
      been reported. Some researchers have attempted to link this phenomenon to the
      antigen-presenting capacity and the induction of autoimmunity, whereas others
      think it might serve as a peripheral mechanism for the induction and the
      maintenance of self-tolerance in autoreactive T cells. In this study, we showed
      that intraperitoneal administration of interleukin-2 (1.2 x 10(6) IU/kg) to 4-wk
      old male BALB/c mice for 35 consecutive days induced lymphocyte infiltration
      around bile ducts in the liver and major histocompatibility complex class II
      expression on biliary epithelial cells, which was immunoelectron microscopically
      confined to the luminal cell surface. Immunohistochemically, lymphocytes
      accumulating around bile ducts were mainly T cells, positive for CD3, L3T4 and H
      2 class II molecules, and a few of them were positive for Lyt-2 and negative for
      immunoglobulin. Half of the infiltrates were positive for asialo GM1, and one
      third was positive for interferon-gamma. Interferon-gamma-positive, L3T4-positive
      cells were detected in mirror sections. However, neither the destruction of
      biliary epithelial cells nor the presence of granulomas was observed.
      Autoantibodies were serologically undetectable. The existence of interferon-gamma
      positive cells in the lesion and the fact that intravenous administration of anti
      interferon-gamma twice a week completely inhibited the lymphocyte infiltration
      and the major histocompatibility complex class II expression on biliary
      epithelial cells suggested that these changes were induced through endogenous
      interferon-gamma production.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639352
TI  - Nodular regenerative hyperplasia in the rat induced by a selenium-enriched diet:
      study of a model.
AB  - Weaned male rats were fed a 4 ppm selenium diet. Compared after 2 mo with a
      control group fed a 0.4 ppm diet, the rats' body weights had not significantly
      decreased and liver function was normal, but portal pressure was 1.8 times higher
      (p less than 0.05). Liver weight was slightly increased (10.3%; p less than
      0.05). All livers had an abnormal appearance. In the less severe cases the
      surface was only slightly irregular, but in the more severe cases, atrophic
      micronodular lobes and hypertrophic lobes, with mildly irregular surfaces, were
      present. On light microscopy, atrophic lobes displayed a peripheral nodular zone
      with micronodules separated by rows of atrophic hepatocytes without fibrosis,
      characteristic of nodular regenerative hyperplasia, and a central atrophic zone
      that was sometimes peliotic. Hypertrophic lobes and livers in the less severe
      cases had only minor and relatively localized evidence of nodular regenerative
      hyperplasia; occasional peliosis was seen. In all cases portal veins, hepatic
      veins and hepatic arteries were normal. By electron microscopy, in nonnodular
      zones with no obvious evidence of parenchymal atrophy, the endothelial wall
      showed signs of complete or incomplete capillarization with frequent enlargement
      of the Disse space. The selenium-enriched diet is a reproducible model of liver
      nodular regenerative hyperplasia. In this model, damage to the sinusoidal wall
      could represent the primum movens of microcirculatory disturbances.

PMID- 1639353
TI  - Spontaneously diabetic biobreeding rats and impairment of bile acid-independent
      bile flow and increased biliary bilirubin, calcium and lipid secretion.
AB  - Chemically induced diabetes has been reported to induce profound changes in bile
      formation, but possible toxic effects of the streptozotocin or alloxan used
      cannot be excluded totally. This study was undertaken to evaluate biliary
      function in spontaneously diabetic female biobreeding rats with a diabetes
      duration of 2 wk and compare them with nondiabetic littermates. Diabetic animals
      evidenced glycosuria, hyperglycemia and hypoinsulinemia. Biliary concentration
      and secretion of bile acids, cholesterol and phospholipids were significantly
      increased, with no enhancement in the lithogenic index of bile. Bile flow and the
      biliary secretion of sodium, potassium, chloride and bicarbonate were
      significantly reduced despite the increased bile acid secretion. The cholestatic
      condition was confirmed by an increased serum concentration of bile acids and a
      higher activity in serum of the alkaline phosphatase liver isoenzyme. Biliary
      calcium concentration increased without any change in its serum concentration. A
      linear relationship was observed between biliary calcium and bile acid secretion.
      Serum concentration of unconjugated and of conjugated bilirubin was increased 1.6
      fold and 8-fold, respectively, with a 1.5-fold enhanced biliary secretion of
      bilirubins despite the cholestasis; this points to an enhanced bilirubin
      production. An increased proportion of conjugated bilirubin was found in serum
      together with an enhanced bilirubin diconjugate/monoconjugate ratio in bile. A
      higher UDP-glucuronyltransferase activity and a delayed transit of bilirubin
      could account for these effects. Administration of insulin to diabetic animals
      tended to reverse the above reported changes. The spontaneously diabetic
      biobreeding rat thus represents a model of bile acid-independent cholestasis with
      enhanced biliary bile acid and calcium secretion and with presumably an enhanced
      bilirubin production.

PMID- 1639354
TI  - Increased 4-hydroxynonenal levels in experimental alcoholic liver disease:
      association of lipid peroxidation with liver fibrogenesis.
AB  - The precise role of lipid peroxidation in the pathogenesis of alcoholic liver
      disease is still being debated. To explore the issue, this study was undertaken
      to investigate the status of lipid peroxidation, antioxidants and prooxidants at
      two discrete stages of experimental alcoholic liver disease. Male Wistar rats
      were intragastrically fed a high-fat diet plus ethanol for 5 or 16 wk (the
      duration that resulted in initiation of centrilobular liver necrosis or liver
      fibrosis, respectively). Lipid peroxidation was assessed in isolated microsomes
      and mitochondria with three parameters: malondialdehyde equivalents as determined
      by thiobarbituric acid assay, conjugated diene formation and 4-hydroxynonenal as
      a 2,4-dinitrophenylhydrazone derivative. To assess antioxidant systems, hepatic
      concentrations of glutathione, methionine and alpha-tocopherol were determined.
      The concentration of nonheme iron, a known prooxidant, was also measured. At wk
      5, centrilobular liver necrosis was already evident in the ethanol-fed animals,
      with two- or threefold increases in plasma AST and ALT levels. At this stage,
      neither malondialdehyde equivalents nor conjugated diene values were elevated,
      and the 4-hydroxynonemal level was below 0.2 nmol/mg protein. Hepatic
      concentrations of methionine and alpha-tocopherol in these animals were increased
      two- and threefold, respectively, whereas the reduced glutathione level remained
      unchanged. When alcoholic liver disease had progressed to perivenular or bridging
      fibrosis at wk 16, all three parameters of lipid peroxidation showed consistent
      increases that were accompanied by significant reductions in the hepatic
      glutathione and methionine levels. Interestingly, the control animals pair-fed
      with the high-fat diet also had significantly elevated 4-hydroxynonenal levels at
      wk 16 compared to the wk 5 level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639355
TI  - Ischemic injury in liver transplantation: difference in injury sites between warm
      and cold ischemia in rats.
AB  - Using liver allografts with warm or cold ischemia, we evaluated functional and
      morphological alterations in hepatocytes, sinusoidal endothelial cells and
      Kupffer cells in a rat transplantation model. All recipients of allografts with
      either 4 hr of cold or 30 min of warm ischemia lived more than 22 days and were
      judged viable. On the other hand, all recipients of grafts with 6 hr of cold or
      60 min of warm ischemia died within 2 days and were therefore judged to be
      nonviable. With these viable and nonviable allograft models, hepatocyte function
      was evaluated by the bile output and serum glutamic-oxaloacetic transaminase,
      serum glutamic-pyruvic transaminase and serum lactate dehydrogenase levels;
      endothelial cell function was judged by the serum hyaluronic acid level, and
      Kupffer cell function was measured by an intravenous colloidal carbon clearance
      test. Hepatocyte injury was the prominent feature in warm ischemic grafts,
      especially in the nonviable ones. On the other hand, serum hyaluronic acid values
      were significantly higher in the nonviable cold ischemic group, compared with the
      viable counterpart, suggesting that the functional depression of endothelial
      cells was predominant in cold, nonviable livers. Histological examinations
      coincided with the above findings. The phagocytic activity of Kupffer cells was
      depressed by warm or cold ischemia, whereas the number of Kupffer cells was
      reduced in the warm ischemia group. We conclude that in liver allografts the main
      site of injury in warm ischemia is the hepatocytes and suggest that cold ischemia
      is associated with endothelial cell damage.

PMID- 1639356
TI  - Inhibition of hepatic metastasis of colon carcinoma by asialo GM1--positive cells
      in the liver.
AB  - This study investigates the role of hepatic asialo GM1-positive cells in
      inhibiting hepatic metastasis of colon carcinoma (colon adenocarcinoma 38) in
      mice after administration of a biological response modifier, streptococcal
      derivative (OK432). Administration of OK432 increased the number of asialo GM1
      positive cells in the liver, enhanced natural killer activity of hepatic
      mononuclear cells and reduced the number of hepatic metastases of colon carcinoma
      inoculated into the superior mesenteric vein. Administration of antiserum against
      asialo GM1 reduced the number of hepatic asialo GM1-positive cells, abolished
      natural killer activity of hepatic mononuclear cells and increased the number of
      hepatic metastases. In addition, administration of antiserum against asialo GM1
      even after OK432 treatment also decreased the number of asialo GM1-positive
      cells, reduced natural killer activity of hepatic mononuclear cells and increased
      the number of hepatic metastases of colon carcinoma. However, administration of
      gadolinium chloride, which suppresses phagocytic function of Kupffer cells, did
      not influence the natural killer activity of hepatic mononuclear cells or the
      number of hepatic metastases. In vivo tumor-neutralization assay revealed that
      tumor growth was inhibited by the hepatic mononuclear asialo GM1-positive cells,
      but not by T lymphocytes or Kupffer cells after OK432 administration. These
      results suggest that an increased number of hepatic asialo GM1-positive cells
      after administration of OK432 plays an important role in protecting against
      metastasis of colon carcinoma in the liver.

PMID- 1639357
TI  - Tumor necrosis factor and endotoxin in the pathogenesis of liver and pulmonary
      injuries after orthotopic liver transplantation in the rat.
AB  - This study examines whether tumor necrosis factor and endotoxin are involved in
      the pathogenesis of primary nonfunction of graft and pulmonary complication after
      orthotopic liver transplantation. Livers from Lewis rats were stored for either 1
      or 4 hr in ice-cold Euro-Collins solution (1-hr storage and 4-hr storage group,
      respectively). Subsequently, donor livers were implanted orthotopically. In some
      experiments, anti-tumor necrosis factor antibody was administered intravenously
      before and immediately after the surgery into animals that received livers stored
      for 4 hr. Blood samples for the measurement of tumor necrosis factor and
      endotoxin were collected by way of an indwelling catheter placed in the
      suprahepatic vena cava. Serum tumor necrosis factor was elevated at all time
      points studied postoperatively in rats of the 4-hr storage group; however, tumor
      necrosis factor was not detected in the serum in the 1-hr storage group.
      Endotoxin was also elevated significantly in the serum of the former group
      compared with levels in the serum of the latter group. The peak value of
      endotoxin occurred 1 hr earlier than that of tumor necrosis factor, suggesting
      that the rise in endotoxin stimulated release of tumor necrosis factor. The
      histological study of livers stored for 4 hr showed substantial hepatocellular
      degeneration 24 hr after surgery, whereas hepatocellular damage was minimal in
      the 1-hr storage group. Serum ALT levels 24 hr after the operation in the 1-hr
      and 4-hr storage groups were 169 +/- 46 IU/L and 374 +/- 41 IU/L (mean +/-
      S.E.M., p less than 0.05), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639358
TI  - Therapy of acute hepatitis C with interferon: how good is it really?

PMID- 1639359
TI  - The immune response in chronic hepatitis B virus infection: the "core" of the
      problem?

PMID- 1639360
TI  - An "ironic" case of mistaken identity?

PMID- 1639361
TI  - Efficacy of ursodeoxycholic acid in preventing cholestatic episodes in a patient
      with benign recurrent intrahepatic cholestasis.

PMID- 1639363
TI  - The International Association for the Study of the Liver. Biennial scientific
      meeting. Brighton, United Kingdom, June 3-6, 1992. Abstracts.

PMID- 1639362
TI  - Interferon-alpha therapy combined with nonsteroid antiinflammatory drugs for
      treatment of chronic viral hepatitis?

PMID- 1639364
TI  - Data watch. Office visits to specialists continue to increase.

PMID- 1639365
TI  - Beyond tech assessment: balancing needs, strategy.
AB  - Technology assessment is undergoing a profound transformation in some hospitals.
      Driven by diverse (and sometimes contradictory) pressures from consumers and
      payers for cutting-edge yet cost-effective care, hospitals are finding that the
      evaluation process is growing more complex. Experts say that a formalized
      assessment process can balance organizational goals and community needs.

PMID- 1639366
TI  - Out of chaos: a rational approach to assessing technology.

PMID- 1639367
TI  - Women's, children's groups say reform debate ignores needs.
AB  - In putting their plans on the table, some health care reformers are forgetting
      the needs of women and children, advocates for those groups say. Meanwhile,
      hospitals are collaborating in efforts to fulfill still-unmet health needs.

PMID- 1639368
TI  - Financial outlook: more mergers, new payer partnerships.

PMID- 1639369
TI  - First-quarter data show slower inflation, strong jobs growth.

PMID- 1639370
TI  - PROs, providers and physicians to collaborate on cardiac outcomes.

PMID- 1639372
TI  - NY hospital consortium takes high-tech turn.

PMID- 1639371
TI  - Tallahassee Memorial: focusing the culture on customer service.

PMID- 1639373
TI  - Managing the participatory-style meeting.

PMID- 1639374
TI  - Pain centers take many approaches to patient care.

PMID- 1639375
TI  - Joint Commission cracks down on falsified records.

PMID- 1639376
TI  - Image obsession: is it healthy for CEOs?

PMID- 1639378
TI  - Organization of the gene encoding the mouse T-cell-specific serine proteinase
      "granzyme A".
AB  - The mouse serine protease granzyme A is a member of a closely related family of T
      cell-associated proteolytic enzymes, designated granzymes A-G. Previous studies
      have indicated that granzymes A and B are involved in various T-cell-mediated
      processes. Here we report the genomic organization of the granzyme A gene. We
      have cloned a 15-kb DNA fragment from a genomic library of a cloned CD8+ T-cell
      line and sequenced the exon-intron boundaries. The gene consists of five exons,
      and its genomic organization is very similar to that described for granzymes B,
      C, and F. In addition, we have sequenced 1.4 kb of the 5'-region and 1.1 kb of
      the 3'-region flanking the granzyme A gene. Putative promoter and enhancer
      elements were identified by sequence comparison with known consensus sequences.
      Some of these regulatory elements seem to be associated exclusively with granzyme
      A, whereas others are shared by members of the granzyme family.

PMID- 1639377
TI  - Mapping the human liver/islet glucose transporter (GLUT2) gene within a genetic
      linkage map of chromosome 3q using a (CA)n dinucleotide repeat polymorphism and
      characterization of the polymorphism in three racial groups.
AB  - The human liver/islet glucose transporter (GLUT2), a candidate gene for diabetes,
      has been incorporated into a genetic linkage map for chromosome 3q using a (CA)n
      dinucleotide repeat polymorphism adjacent to the 3'-end of exon 4a. We have found
      a total of nine alleles ranging in length from 153 to 169 nucleotides in three
      racial groups and have determined the precise structure of the variable region
      for four of the alleles by DNA sequencing. Five alleles were found to be common
      to the American Black, Caucasian, and Pima Indian racial groups studied. One
      allele (169 bp) was unique to American Blacks, and another rare allele (153 bp)
      was found only in the Caucasian population studied. Observed heterozygosity of
      the polymorphism in the Caucasian (CEPH) reference pedigree collection is 60%,
      for American Blacks 71%, and for Pima Indians 53%. An independent study recently
      identified the same dinucleotide repeat and found six alleles in a Caucasian
      population (Froguel et al., 1991), a result that we confirm; however, our
      sequencing data indicate a different molecular structure for the polymorphism for
      some of the alleles. We have constructed a new genetic linkage map of chromosome
      3q uniquely placing the GLUT2 gene between flanking markers D3S26 and D3S43. The
      genetic map consists of 23 loci (25 RFLPs and 2 (CA)n dinucleotide repeat
      markers) with 14 markers uniquely localized with odds of at least 1000:1. Three
      genes (FTHL4, TF, GLUT2) are integrated into the map, which spans a sex-average
      distance of 147.3 cM, 103.8 cM in males and 227.0 cM in females.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1639379
TI  - Physical and genetic characterization of the distal segment of the myotonic
      dystrophy area on 19q.
AB  - The mutation involved in myotonic dystrophy (DM) has been mapped to the region
      between the ERCC1 DNA repair gene and the anonymous D19S51 locus on 19q13.3.
      Starting at locus D19S112 (probe pX75b), which served as a novel entry site for
      this chromosome region, we have established a cosmid contig of approximately 200
      kb. In the contig, a gene expressed in the brain and a highly informative, 12
      allele (TG)n variable simple sequence motif (VSSM) were identified. With this
      marker, designated X75b-VSSM, a highly characteristic size distribution of
      alleles linked with DM, which differed significantly from that on normal
      chromosomes, was observed. Combining our physical mapping and genetic data, we
      show that the X75b-VSSM marker is the closest distal to DM, thus excluding the DM
      mutation from the entire telomeric portion of the ERCC1-D19S51 region.

PMID- 1639380
TI  - Physical mapping and cloning of the proximal segment of the myotonic dystrophy
      gene region.
AB  - The myotonic dystrophy (DM) region has been recently shown to be bracketed by two
      key recombinant events. One recombinant occurs in a Dutch DM family, which maps
      the DM locus distal to the ERCC1 gene and D19S115 (pE0.8). The other recombinant
      event is in a French Canadian DM family, which maps DM proximal to D19S51
      (p134c). To further resolve this region, we initiated a chromosome walk in a
      telomeric direction from pE0.8, a proximal marker tightly linked to DM, toward
      the genetic locus. An Alu-PCR approach to chromosome walking in a cosmid library
      from flow-sorted chromosome 19 was used to isolate DM region cosmids. This effort
      has resulted in the cloning of a 350-kb genomic contig of human chromosome
      19q13.3. New genetic and physical mapping information has been generated using
      the newly cloned markers from this study. As a result of this new mapping
      information, the minimal area that is to contain the DM gene has been redefined.
      Approximately 200 kb of sequence between pE0.8 and the closest proximal marker to
      DM, pKEX0.8, that would have otherwise been screened for DM candidate genes, has
      been eliminated as containing the DM gene.

PMID- 1639381
TI  - Characterization of a YAC and cosmid contig containing markers tightly linked to
      the myotonic dystrophy locus on chromosome 19.
AB  - Myotonic dystrophy (DM) is caused by a defect in an unknown gene that maps to
      19q13.3, flanked by the tightly linked markers ERCC1 on the proximal side and
      D19S51 on the distal side. We report the isolation and characterization of
      overlapping YAC and cosmid clones around D19S51 for the construction of a
      physical map around this locus. The resulting contig contains the markers D19S51
      and D19S62 (another new marker tightly linked to the DM locus) and the distal
      breakpoint of a radiation hybrid cell line used in the physical mapping of the DM
      region. We have compared the restriction maps of the YACs and cosmids with that
      of the genome to investigate the fidelity of these clones.

PMID- 1639382
TI  - Continuous linkage map of human chromosome 14 short tandem repeat polymorphisms.
AB  - Nine moderately to highly informative short tandem repeat polymorphisms were
      assigned to chromosome 14 using somatic cell hybrids and were mapped using
      linkage analysis. The nine markers formed a continuous linkage map covering
      almost the entire long arm from 14q11.2 to q32. The markers filled a large gap
      within previously reported linkage maps for this chromosome. Best order of the
      new loci from q11.2 to q32 was D14S50, D14S54, D14S49, D14S47, D14S52, D14S53,
      D14S55, D14S48, and D14S51. The order shown for all adjacent pairs of loci was
      very strongly favored with the exception of loci pair D14S55 and D14S48, for
      which the order was moderately favored. Map lengths for the nine loci were 142 cM
      in females and 72 cM in males. Female recombination frequencies exceeded male
      recombination frequencies in the middle and distal portions of the map.

PMID- 1639383
TI  - Characterization of human adenylate kinase 3 (AK3) cDNA and mapping of the AK3
      pseudogene to an intron of the NF1 gene.
AB  - We have isolated cDNA clones for human adenylate kinase isozyme 3 (AK3) with a
      genomic probe from the neurofibromatosis type 1 (NF1) region. Three overlapping
      clones isolated from a human frontal-cortex cDNA library gave rise to a consensus
      sequence of 1.7 kb. The open reading frame identified in this sequence predicted
      a peptide of 223 residues. A database search revealed striking homology, about
      58% amino acid sequence identity, between this predicted protein and bovine AK3.
      Human AK3 protein also showed significant homology to other members of the
      adenylate kinase family isolated from various species. Genomic Southern analysis
      suggested that multiple AK3 loci exist in the human genome, including one located
      in an intron of NF1 on chromosome 17. The chromosome-17 locus appears to be a
      processed pseudogene, since it is intronless and contains a polyadenylate tract;
      it nevertheless retains coding potential because the open reading frame is not
      impaired by any observed base substitutions.

PMID- 1639384
TI  - Detection of point mutations and a gross deletion in six Hunter syndrome
      patients.
AB  - We have used screening with the polymerase chain reaction and chemical mismatch
      detection of amplified cDNA to detect and characterize deletions and point
      mutations in six Hunter Syndrome patients. A high degree of mutational
      heterogeneity was observed. The first patient is completely deleted for the gene
      coding for alpha-L-iduronate sulfate sulfatase, while the second has a point
      mutation that creates a stop codon. The third patient shows a point mutation that
      creates a novel splice site that is preferentially utilized and results in
      partial loss of one exon in the RNA. Patients 4, 5, and 6 have point mutations
      resulting in single amino acid substitutions. Four of the six single-base changes
      observed in this study were examples of transitions of the highly mutable
      dinucleotide CpG to TpG. This study has demonstrated a procedure capable of
      detecting all types of mutation that affect the function of the IDS protein and
      should enable direct carrier and prenatal diagnosis for Hunter syndrome families.

PMID- 1639385
TI  - Somatic cell hybrids, sequence-tagged sites, simple repeat polymorphisms, and
      yeast artificial chromosomes for physical and genetic mapping of proximal 17p.
AB  - Somatic cell hybrids retaining the deleted chromosome 17 from 15 unrelated Smith
      Magenis syndrome (SMS) [del(17)(p11.2p11.2)] patients were obtained by fusion of
      patient lymphoblasts with thymidine kinase-deficient rodent cell lines. Seventeen
      sequence-tagged sites (STSs) were developed from anonymous markers and cloned
      genes mapping to the short arm of chromosome 17. The STSs were used to determine
      the deletion status of these loci in these and four previously described human
      chromosome 17-retaining hybrids. Ten STSs were used to identify 28 yeast
      artificial chromosomes (YACs) from the St. Louis human genomic YAC library. Four
      of the 17 STSs identified simple repeat polymorphisms. The order and location of
      deletion breakpoints were confirmed and refined, and the regional assignment of
      several probes and cloned genes were determined. The cytogenetic band locations
      and relative order of six markers on 17p were established by fluorescence in situ
      hybridization mapping to metaphase chromosomes. The latter data confirmed and
      supplemented the somatic cell hybrid results. Most of the hybrids derived from
      [del(17)(p11.2p11.2)] patients demonstrated a similar pattern of deletion for the
      marker loci and were deleted for D17S446, D17S258, D17S29, D17S71, and D17S445.
      However, one of them demonstrated a unique pattern of deletion. This patient is
      deleted for several markers known to recognize a large DNA duplication associated
      with Charcot-Marie-Tooth (CMT) disease type 1A. These data suggest that the
      proximal junction of the CMT1A duplication is close to the distal breakpoint in
      [del(17)(p-11.2p11.2)] patients.

PMID- 1639387
TI  - Sequence, higher order repeat structure, and long-range organization of alpha
      satellite DNA specific to human chromosome 8.
AB  - We have characterized alphoid repeat clones derived from a chromosome 8 library.
      These clones are specific for human chromosome 8, as demonstrated by use of a
      somatic cell hybrid mapping panel and by in situ hybridization. Hybridization of
      the clones to HindIII digests of human genomic DNA reveals a complex pattern of
      fragments ranging in size from 1.3 to greater than 20 kb. One clone, which
      corresponds in size to the most prevalent genomic HindIII fragment, appears to
      represent a major higher order repeat in the chromosome 8 centromere. The DNA
      sequence of this clone reveals a dimeric organization of alphoid monomers.
      Restriction analysis of two other clones indicates that they are derivatives of
      this same repeat unit. The chromosome 8 alphoid clones hybridize to EcoRI
      fragments of genomic DNA ranging up to 1000 kb in length and reveal a high degree
      of polymorphism between chromosomes. Distribution of higher order repeat units
      across the centromere was examined by two-dimensional gel electrophoresis. Repeat
      units of the same size class tended to cluster together in restricted regions of
      centromeric DNA.

PMID- 1639386
TI  - A microsatellite polymorphism associated with the PLC1 (phospholipase C) locus:
      identification, mapping, and linkage to the MODY locus on chromosome 20.
AB  - A highly polymorphic (dC-dA)n.(dG-dT)n dinucleotide repeat at the PLC1 locus on
      human chromosome 20 has been identified. Primers flanking the dinucleotide repeat
      were used for PCR amplification of the repeat region in 37 informative kindreds
      from the Centre d'Etude du Polymorphisme Humain. Two-point linkage analysis
      indicates that PLC1 is closely linked to several chromosome 20 markers, including
      D20S16 (Zmax = 41.25; theta = 0.07), D20S17 (Zmax = 42.81; theta = 0.09), and ADA
      (Zmax = 57.24; theta = 0.05). Multipoint linkage analysis places the PLC1 locus
      between D20S18 and D20S17, 11.2 and 6.6 cM, respectively, from these loci (sex
      averaged distances). In addition, the PLC1 gene shows linkage to the maturity
      onset diabetes of the young (MODY) locus on chromosome 20 with a lod score of
      4.57 at theta = 0.089.

PMID- 1639388
TI  - Structure and expression of the human p58clk-1 protein kinase chromosomal gene.
AB  - A cDNA corresponding to a 58-kDa cell division control-related protein kinase,
      p58clk-1, has previously been isolated, sequenced, and assigned to human
      chromosome 1p36. Aberrant expression of this protein kinase negatively regulates
      normal cellular growth. The p58clk-1 protein contains a central domain of 299
      amino acids that is 46% identical to human p34cdc2, the master mitotic protein
      kinase. Deletion of 1p36 has been correlated to numerous tumors, and this
      chromosome region has been suggested to harbor a putative tumor suppressor gene
      on the basis of the growth characteristics of these tumors. In this report we
      detail the complete structure of the p58clk-1 chromosomal gene, including its
      putative promoter region, transcriptional start sites, exonic sequences, and
      intron/exon boundary sequences. The gene is 10 kb in size and contains 12 exons
      and 11 introns. Interestingly, the rather large 2.0-kb 3' untranslated region is
      interrupted by an intron that separates a region containing numerous AUUUA
      destabilization motifs from the coding region. Furthermore, we detail the
      expression of this gene in normal human tissues as well as several human tumor
      cell samples and lines. The origin of multiple human transcripts from the same
      chromosomal gene, and the possible differential stability of these various
      transcripts, is discussed with regard to the transcriptional and post
      transcriptional regulation of this gene. This is the first report of the
      chromosomal gene structure of a member of the p34cdc2 supergene family.

PMID- 1639389
TI  - Isolation and chromosomal assignment of 100 highly informative human simple
      sequence repeat polymorphisms.
AB  - One hundred highly informative simple sequence repeat (SSR) polymorphisms have
      been isolated and mapped to specific human chromosomes by somatic cell hybrid
      analysis. These markers include 97 (CA)n, 2 (AGAT)n, and a single (AACT)n repeat.
      All the SSRs have heterozygosities greater than 0.50 and can be amplified using
      identical PCR conditions. At least one SSR was detected on every chromosome,
      except for chromosomes 22 and Y. The frequency of (CA)n repeats on each
      chromosome was proportional to the relative chromosomal length, except for
      chromosome 15, on which a substantial excess of markers was identified.

PMID- 1639390
TI  - Genomic organization, sequence analysis, and chromosomal localization of the
      human carboxyl ester lipase (CEL) gene and a CEL-like (CELL) gene.
AB  - The gene encoding human carboxyl ester lipase (CEL), including 1628 bp of the 5'
      flanking region, has been isolated and characterized from two overlapping lambda
      phage clones. The gene spans 9832 bp and contains 11 exons interrupted by 10
      introns. The exons range in size from 88 to 204 bp, except for the last exon,
      which is 841 bp. A major and a minor transcription initiation site were
      determined 13 and 7 bp, respectively, upstream of the initiator methionine. The
      nucleotide sequence is identical with that of the previously reported cDNA,
      except for the third nucleotide in the 5'-untranslated sequence, a C, which in
      the cDNA is a T. A TAAATA sequence is present 26 nt upstream from the major CAP
      site, and within the 5'-flanking region there are several putative transcription
      factor binding sites. Seven Alu repetitive sequence elements are present in the
      region analyzed. The organization of the human CEL gene is similar to that of the
      recently reported rat pancreatic cholesterol esterase gene. The CEL gene was
      assigned to chromosome 9q34-qter, which confirms the recently reported results of
      Tayler et al. (1991, Genomics 10: 425-431). A previously unknown gene with a
      striking homology to the human CEL gene, here called the CEL-like gene (CELL),
      has also been isolated and characterized, including 1724 bp of the 5'-flanking
      region. The CELL gene, which most likely is a psuedogene, spans 4846 bp, and due
      to the absence of a 4.8-kb segment, the CEL gene exons 2-7 are not present in the
      CELL gene. Despite these differences, the CELL gene is transcribed. We have also
      assigned the CELL gene to a separate locus at chromosome 9q34-qter.

PMID- 1639391
TI  - Cloning of six new genes with zinc finger motifs mapping to short and long arms
      of human acrocentric chromosome 22 (p and q11.2).
AB  - Zinc finger genes encode proteins containing tandemly repeated zinc-mediated
      folded structures that are found in several transcriptional regulatory proteins.
      To identify new zinc finger genes, we have screened at low stringency human
      cosmid libraries enriched in chromosome 22 sequences with a probe derived from
      the finger region of the mouse Kruppel-like gene, mKr2. We identified 23
      nonoverlapping human cosmids cross-hybridizing with the probe. All sequences
      obtained from cosmid subclones hybridizing with the probe revealed Kruppel-type
      consensus sequences. Hybridizations to somatic cell hybrid panels and to
      metaphase chromosomes revealed that 2 nonoverlapping zinc finger cosmids map to
      chromosome 22p and 4 map to 22q11.2. The 17 other nonoverlapping cosmids most
      likely map to other chromosomes. The short arms of acrocentric chromosomes are
      thought to encode only ribosomal RNA genes. Therefore, the identification of two
      zinc finger genes on chromosome 22p represents an unexpected finding of unknown
      significance. The four zinc finger genes that map to 22q11.2 are within the cat
      eye and DiGeorge syndrome regions and thus provide us with potential candidate
      genes for these developmental malformations.

PMID- 1639392
TI  - A missense mutation (Asp250----Asn) in exon 6 of the human lipoprotein lipase
      gene causes chylomicronemia in patients of different ancestries.
AB  - We have previously reported two common lipoprotein lipase (LPL) gene mutations
      underlying LPL deficiency in the majority of 37 French Canadians (Monsalve et
      al., 1990. J. Clin. Invest. 86: 728-734; Ma et al., 1991. N. Engl. J. Med. 324:
      1761-1766). By examining the 10 coding exons of the LPL gene in another French
      Canadian patient, we have identified a third missense mutation that is found in
      two of the three remaining patients for whom mutations are undefined. This is a G
      to A transition in exon 6 that results in a substitution of asparagine for
      aspartic acid at residue 250. Using in vitro site-directed mutagenesis, we have
      confirmed that this mutation causes a catalytically defective LPL protein. In
      addition, the Asp250----Asn mutation was also found on the same haplotype in an
      LPL-deficient patient of Dutch ancestry, suggesting a common origin. This
      mutation alters a TaqI restriction site in exon 6 and will allow for rapid
      screening in patients with LPL deficiency.

PMID- 1639393
TI  - Characterization and chromosomal mapping of the gene encoding the cellular DNA
      binding protein HTLF.
AB  - A region of the human T-cell leukemia virus long terminal repeat (HTLV-I LTR)
      located between -155 and -117 is important in the regulation of gene expression
      by the ets family of transcription factors. In an attempt to identify additional
      cellular transcription factors that bind to this portion of the HTLV-I LTR, we
      used lambda gt11 expression cloning with oligonucleotides corresponding to this
      element. A 1239-bp cDNA was isolated from a Jurkat cDNA library, which encoded a
      protein capable of binding to this purine-rich region. This protein, which we
      designated human T-cell leukemia virus enhancer factor (HTLF), contains a domain
      with homology to the recently described fork head DNA binding domain. Chromosome
      mapping of the HTLF gene demonstrated that it was localized to human chromosome
      2p16-p22. HTLF is a unique cellular gene that may function in the transcriptional
      regulation of HTLV-I LTR.

PMID- 1639394
TI  - A yeast artificial chromosome contig encompassing the type 1 neurofibromatosis
      gene.
AB  - The yeast artificial chromosome (YAC) system (Burke et al., 1987, Science 236:
      806-812) allows the direct cloning of large regions of the genome. A YAC contig
      map of approximately 700 kb encompassing the region surrounding the type 1
      neurofibromatosis (NF1) locus on 17q11.2 has been constructed. A single YAC
      containing the entire NF1 locus has been constructed by homologous recombination
      in yeast. In the process of contig construction a novel method of YAC end rescue
      has been developed by YAC circularization in yeast and plasmid rescue in
      bacteria. YACs containing homology to the NF1 region but mapping to another
      chromosome have also been discovered. Sequences of portions of the homologous
      locus indicate that this other locus is a nonprocessed pseudogene.

PMID- 1639395
TI  - North Carolina macular dystrophy is assigned to chromosome 6.
AB  - North Carolina macular dystrophy (NCMD) is an autosomal dominant macular
      dystrophy causing impaired central vision at an early age, is completely
      penetrant, and is present in a single large family. With the development of the
      hypervariable microsatellite (CA repeats) markers in the human genome, it was
      possible to relatively rapidly screen most of the genome for linkage to the NCMD
      gene. After utilizing 124 genetic markers, which excluded over 95% of the human
      genome, three Marshfield microsatellites located at 6q13-q21 were linked to the
      NCMD locus. Marshfield marker (MFD) 131 gave a lod score of Z(theta) = 4.36 at
      theta = 0.137; MFD 171 gave a Z(theta) = 8.42 at theta = 0.004; and MFD 97 gave a
      Z(theta) = 13.10 at theta = 0.017. Other retinal diseases have been reported on
      6q stressing the importance of this region and possibly suggesting that these
      diseases may be allelic or located in part of a large macular gene family.
      Locating and characterizing the NCMD gene may be an important step in
      understanding this group of maculopathies as well as age-related macular
      degeneration (AMD), a common cause of blindness in the elderly.

PMID- 1639396
TI  - A single serine:pyruvate aminotransferase gene on rat chromosome 9q34-q36.
AB  - It was found in our previous study (Oda et al., 1990. J. Biol. Chem. 265: 7513
      7519) that in the rat two mRNAs encoding mitochondrial and peroxisomal
      serine:pyruvate aminotransferase (SPT/AGT) are formed from a single SPT/AGT gene
      through alternative transcription initiation in exon 1. In an attempt to analyze
      the mechanisms underlying this unique phenomenon, we have isolated genomic clones
      harboring the entire rat SPT/AGT gene. In the present study, the location of the
      rat SPT/AGT gene was determined to be in the q34-q36 region of chromosome 9 by
      fluorescence in situ hybridization. Southern blot analysis of rat genomic DNA
      revealed an allelic BamHI restriction fragment length polymorphism among three
      different inbred rat strains. These results indicated that a single copy SPT/AGT
      gene is located on chromosome 9q34-q36 in the rat genome. This locus has been
      assigned the gene symbol Spat.

PMID- 1639397
TI  - Ordering of human chromosome 3p markers by radiation hybrid mapping.
AB  - To construct a panel of radiation hybrids (RHs) for human chromosome 3p mapping,
      mouse microcell hybrid cells, A9(neo3/t)-5, containing a single copy of human
      chromosome 3p with pSV2neo plasmid DNA integrated at 3p21-p22 were irradiated and
      fused to mouse A9 cells. A panel of 96 RHs that retain several sizes and portions
      of human chromosome 3p segments was used to map 25 DNA markers for chromosome 3p.
      Eight of them, H28, H29, H32, H33, H35, H38, H48, and H64, were cloned from Alu
      primed PCR products using A9(neo3/t)-5 cell DNA as a template. The most likely
      order of the 24 markers, except for H28, based on the statistical ordering method
      proposed by Falk, was cen-D3S4-D3S3-D3S30-H29-D3S13-D3S2-+ ++H48-D3F15S2-D3S32
      D3S23-CCK-H35-H33- D3S11-D3S12-RARB-THRB(ERBA2-pBH302)- H64-H38-RAF1-D3S18-H32
      D3S22-pter. The order and location of these markers were in good agreement with
      those previously determined by other mapping methods, suggesting that a panel of
      these 96 RHs is a valuable source for a rapid mapping of human chromosome 3p
      markers.

PMID- 1639398
TI  - Gene-centromere linkage mapping by PCR analysis of individual oocytes.
AB  - We describe a general method of determining the recombination fraction between a
      polymorphic locus and the centromere in any species where single oocytes can be
      obtained. After removal of the first polar body, each oocyte is analyzed by PCR.
      The frequency of oocytes heterozygous at the polymorphic locus is used to
      estimate the recombination fraction. We estimate a recombination fraction of 0.15
      between the mouse major histocompatibility complex (H-2) and the centromere of
      chromosome 17.

PMID- 1639399
TI  - Degenerate oligonucleotide-primed PCR: general amplification of target DNA by a
      single degenerate primer.
AB  - A version of the polymerase chain reaction (PCR), termed degenerate
      oligonucleotide-primed PCR (DOP-PCR), which employs oligonucleotides of partially
      degenerate sequence, has been developed for genome mapping studies. This
      degeneracy, together with a PCR protocol utilizing a low initial annealing
      temperature, ensures priming from multiple (e.g., approximately 10(6) in human)
      evenly dispersed sites within a given genome. Furthermore, as efficient
      amplification is achieved from the genomes of all species tested using the same
      primer, the method appears to be species-independent. Thus, for the general
      amplification of target DNA, DOP-PCR has advantages over interspersed repetitive
      sequence PCR (IRS-PCR), which relies on the appropriate positioning of species
      specific repeat elements. In conjunction with chromosome flow sorting, DOP-PCR
      has been applied to the characterization of abnormal chromosomes and also to the
      cloning of new markers for specific chromosome regions. DOP-PCR therefore
      represents a rapid, efficient, and species-independent technique for general DNA
      amplification.

PMID- 1639400
TI  - YAC mapping by FISH using Alu-PCR-generated probes.
AB  - Human genomic mapping has been greatly advanced by the independent development of
      three new methods: large DNA fragment cloning in yeast artificial chromosomes,
      amplification from complex DNAs of human specific segments by Alu-PCR, and high
      resolution localization of complex DNA probes by fluorescent in situ
      hybridization. We describe here the combination of these three analytical tools
      for efficient and accurate localization of randomly screened or especially
      selected human YAC recombinants to chromosome 11. We map a YAC clone encompassing
      the pepsinogen A (PGA) locus to 11q13.1-11q13.3.

PMID- 1639401
TI  - Construction, analysis, and application of a radiation hybrid mapping panel
      surrounding the mouse agouti locus.
AB  - The region surrounding the agouti coat color locus on mouse Chromosome 2 contains
      several genes required for peri-implantation development, limb morphogenesis, and
      segmentation of the nervous system. We have applied radiation hybrid mapping, a
      somatic cell genetic technique for constructing long-range maps of mammalian
      chromosomes, to eight molecular markers in this region. Using a mathematical
      model to estimate the frequency of radiation-induced breakage, we have
      constructed a map that spans approximately 20 recombination units and 475
      centirays8000. The predicted order of markers, Prn-p-Pygb-Emv-13-Psp-Xmv-10-Emv
      15-Src-Ada, is consistent with a previously derived multipoint meiotic map for
      six of the eight markers and suggests that Xmv-10 may lie relatively close to one
      or more of the agouti recessive lethal mutations. The resolution of our map is
      approximately 40-fold higher than the meiotic map, but the median retention
      frequency of mouse DNA in hybrid cells, 0.12, is 4-fold lower than similar
      experiments with human chromosomes. From one of the radiation hybrid lines that
      contained a minimum amount of mouse DNA, 25 independent cosmids were isolated
      with a mouse-specific hybridization probe. Single-copy fragments from two of
      these cosmids were shown to originate from mouse Chromosome 2, and the meiotic
      map position of one was found to be within 10 recombination units of the region
      of interest. Our results indicate more precise map positions for Pygb and Xmv-10,
      demonstrate that radiation hybrid mapping can provide high-resolution map
      information for the mouse genome, and establish a new method for isolating large
      fragments of DNA from a specific subchromosomal region.

PMID- 1639402
TI  - The beta globin gene cluster of the prosimian primate Galago crassicaudatus:
      nucleotide sequence determination of the 41-kb cluster and comparative sequence
      analyses.
AB  - The nucleotide sequence of the beta globin gene cluster of the prosimian Galago
      crassicaudatus has been determined. A total sequence spanning 41,101 bp contains
      and links together previously published sequences of the five galago beta-like
      globin genes (5'-epsilon-gamma-psi eta-delta-beta-3'). A computer-aided search
      for middle interspersed repetitive sequences identified 10 LINE (L1) elements,
      including a 5' truncated repeat that is orthologous to the full-length L1 element
      found in the human epsilon-gamma intergenic region. SINE elements that were
      identified included one Alu type I repeat, four Alu type II repeats, and two
      methionine tRNA-derived Monomer (type III) elements. Alu type II and Monomer
      sequences are unique to the galago genome. Structural analyses of the cluster
      sequence reveals that it is relatively A+T rich (about 62%) and regions with high
      G+C content are associated primarily with globin coding regions. Comparative
      analyses with the beta globin cluster sequences of human, rabbit, and mouse
      reveal extensive sequence homologies in their genic regions, but only human,
      galago, and rabbit sequences share extensive intergenic sequence homologies.
      Divergence analyses of aligned intergenic and flanking sequences from orthologous
      human, galago, and rabbit sequences show a gradation in the rate of nucleotide
      sequence evolution along the cluster where sequences 5' of the epsilon globin
      gene region show the least sequence divergence and sequences just 5' of the beta
      globin gene region show the greatest sequence divergence.

PMID- 1639403
TI  - Molecular mapping of mouse chromosomes 4 and 6: use of a flow-sorted Robertsonian
      chromosome.
AB  - The development of dense genetic maps of mammalian chromosomes is facilitated
      when chromosome-specific libraries are used as a source of genetic markers. To
      saturate the genetic maps of mouse chromosomes 4 and 6, we have made use of
      fluorescent-activated chromosome sorting to purify a 4:6 Robertsonian chromosome
      from a cell line harboring the Rb(4:6)2Bnr translocation. After staining with
      chromomycin A3 and Hoechst 33528, this chromosome was separated from the other
      mouse chromosomes. DNA was isolated from the fraction containing the Robertsonian
      chromosome and subcloned into the insertion vector lambda gt10, generating a
      library with 4.6 x 10(5) independent phage. A total of 19 single-copy sequences
      were used to type the progeny of a C57BL/6J x Mus spretus backcross that had
      previously been typed for loci on chromosomes 4 and 6. Approximately 70% of the
      clones in the library mapped to either chromosome 4 or 6 as assessed by genetic
      mapping and by use of a somatic cell hybrid panel. Simple sequence repeats have
      also been isolated from this library. Further characterization of these
      microsatellites should accelerate efforts to map mouse chromosomes 4 and 6 using
      PCR. In addition, flow sorting of Robertsonian chromosomes suggests a general
      approach for making chromosome-specific libraries in mouse.

PMID- 1639404
TI  - Nucleotide sequence analysis of human hypoxanthine phosphoribosyltransferase
      (HPRT) gene deletions.
AB  - We have determined the nucleotide sequences of 10 intragenic human HPRT gene
      deletion junctions isolated from thioguanine-resistant PSV811 Werner syndrome
      fibroblasts or from HL60 myeloid leukemia cells. Deletion junctions were located
      by fine structure blot hybridization mapping and then amplified with flanking
      oligonucleotide primer pairs for DNA sequence analysis. The junction region
      sequences from these 10 HPRT mutants contained 13 deletions ranging in size from
      57 bp to 19.3 kb. Three DNA inversions of 711, 368, and 20 bp were associated
      with tandem deletions in two mutants. Each mutant contained the deletion of one
      or more HPRT exon, thus explaining the thioguanine-resistant cellular phenotype.
      Deletion junction and donor nucleotide sequence alignments suggest that all of
      these HPRT gene rearrangements were generated by the nonhomologous recombination
      of donor DNA duplexes that share little nucleotide sequence identity. This result
      is surprising, given the potential for homologous recombination between copies of
      repeated DNA sequences that constitute approximately a third of the human HPRT
      locus. No difference in deletion structure or complexity was observed between
      deletions isolated from Werner syndrome or from HL60 mutants. This suggests that
      the Werner syndrome deletion mutator uses deletion mutagenesis pathway(s) that
      are similar or identical to those used in other human somatic cells.

PMID- 1639405
TI  - Molecular structure and genetic stability of human hypoxanthine
      phosphoribosyltransferase (HPRT) gene duplications.
AB  - We have determined the genetic stability of three independent intragenic human
      HPRT gene duplications and the structure of each duplication at the nucleotide
      sequence level. Two of the duplications were isolated as spontaneous mutations
      from the HL60 human myeloid leukemia cell line, while the third was originally
      identified in a Lesch-Nyhan patient. All three duplications are genetically
      unstable and have a reversion rate approximately 100-fold higher than the rate of
      duplication formation. The molecular structures of these duplications are
      similar, with direct duplication of HPRT exons 2 and 3 and of 6.8 kb (HL60
      duplications) or 13.7 kb (Lesch-Nyhan duplication) of surrounding HPRT sequence.
      Nucleotide sequence analyses of duplication junctions revealed that the HL60
      derived duplications were generated by unequal homologous recombination between
      clusters of Alu repeats contained in HPRT introns 1 and 3, while the Lesch-Nyhan
      duplication was generated by the nonhomologous insertion of duplicated HPRT DNA
      into HPRT intron 1. These results suggest that duplication substrates of
      different lengths can be generated from the human HPRT exon 2-3 region and can
      undergo either homologous or nonhomologous recombination with the HPRT locus to
      form gene duplications.

PMID- 1639406
TI  - Mapping of the motor neuron degeneration (Mnd) gene, a mouse model of amyotrophic
      lateral sclerosis (ALS).
AB  - The motor neuron degeneration mutation (Mnd) causes a late-onset, progressive
      degeneration of upper and lower motor neurons in mice. After establishing genetic
      and environmental conditions that distinguish the phenotypes of Mnd/Mnd from
      +/Mnd mice, Mnd was mapped to proximal Chr 8, using endogenous retroviruses as
      markers. The map location was confirmed with additional linked polymorphic
      markers. The outcross/intercross matings to the strain AKR/J, which were used to
      follow the segregation of the retroviral markers with respect to Mnd, also
      revealed the existence of a timing effect. Approximately one-fourth of the
      affected Mnd/Mnd F2 progeny showed accelerated disease. The Mnd mouse model
      should allow study of mechanisms affecting onset and progression of specific
      neuronal degeneration in both animal and human neurological disease.

PMID- 1639407
TI  - Colocalization of the genes for the alpha 3(IV) and alpha 4(IV) chains of type IV
      collagen to chromosome 2 bands q35-q37.
AB  - Each type of basement membrane in man contains between two and five genetically
      distinct type IV collagens: alpha 1(IV)-alpha 5(IV). Genes for alpha 1(IV), alpha
      2(IV), alpha 3(IV), and alpha 5(IV) have been isolated. We have recently isolated
      partial cDNAs for the fifth member of the family, designated alpha 4(IV). On the
      basis of comparison of the deduced peptide sequences of all five chains, the type
      IV collagens can be divided into two families: alpha 1-like, comprising alpha
      1(IV), alpha 3(IV), and alpha 5(IV); and alpha 2-like, comprising alpha 2(IV) and
      alpha 4(IV). Genes encoding the alpha 1(IV) and alpha 2(IV) chains (COL4A1 and
      COL4A2) both map to human chromosome 13q34 and have been shown to be transcribed
      from opposite DNA strands using a common bidirectional promoter that allows
      coordinate regulation of the two chains. Indeed, these two chains are commonly
      found together in basement membrane and form [alpha 1]2.[alpha 2] heterotrimers.
      Whereas alpha 1(IV) and alpha 2(IV) have been found in all basement membranes
      studied hitherto, it has been shown that alpha 3(IV) and alpha 4(IV) are found in
      only a subset of basement membranes. In basement membranes where either of these
      molecules is present, however, they are found together. In view of this
      relationship and the structural similarities between alpha 1(IV) and alpha 3(IV)
      and between alpha 2(IV) and alpha 4(IV), we hypothesized that COL4A3 and COL4A4,
      the genes encoding alpha 3(IV) and alpha 4(IV), respectively, have a genomic
      organization similar to that of COL4A1 and COL4A2.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1639408
TI  - Fluorescence in situ hybridization of YAC clones after Alu-PCR amplification.
AB  - Alu-PCR protocols were optimized for the generation of human DNA probes from
      yeast strains containing yeast artificial chromosomes (YACs) with human inserts
      between 100 and 800 kb in size. The resulting DNA probes were used in chromosome
      in situ suppression (CISS) hybridization experiments. Strong fluorescent signals
      on both chromatids indicated the localization of specific YAC clones, while two
      clearly distinguishable signals were observed in greater than or equal to 90% of
      diploid nuclei. Signal intensities were generally comparable to those observed
      using chromosome-specific alphoid DNA probes. This approach will facilitate the
      rapid mapping of YAC clones and their use in chromosome analysis at all stages of
      the cell cycle.

PMID- 1639409
TI  - Refinement of diagnostic assays for a probable causal mutation for porcine and
      human malignant hyperthermia.
AB  - The substitutions of T for C1843 in the porcine ryanodine receptor (RYR1) gene,
      which deletes a HinPI restriction endonuclease site and creates a HgiAI site, and
      of T for C1840 in human RYR1, which deletes a RsaI site, lead to Cys for Arg
      substitutions in the ryanodine receptors and are probable causal mutations for
      malignant hyperthermia (MH). To improve the restriction endonuclease assay of
      these sites, thereby providing an accurate, reliable diagnosis for MH, introns
      flanking the exon containing the mutation were sequenced, permitting
      identification and PCR amplification of a 659-bp porcine gene sequence that
      contains both constant and variant HgiAI sites and a 922-bp human gene sequence
      that contains both constant and variant RsaI sites. As a result, these PCR
      amplified sequences contain constant internal controls for the reliable
      differentiation by restriction endonuclease digestion of normal, heterozygous,
      and MH genotypes.

PMID- 1639410
TI  - XY sex reversal associated with a nonsense mutation in SRY.
AB  - Sex determination in humans is mediated through the expression of a testis
      determining gene on the Y chromosome. In humans, a candidate gene for the testis
      determining factor (TDF) that encodes a protein with a putative DNA-binding motif
      and has been isolated is termed SRY. Here we describe an XY sex-reversed female
      with pure gonadal dysgenesis who harbors a de novo nonsense mutation in the SRY
      open reading frame (SRY-orf). This single-basepair substitution results directly
      in the formation of a termination codon in the putative SRY DNA-binding motif,
      presumably leading to a nonfunctional gene product. This brings the number of
      reported XY sex-reversed females with de novo mutations in the known SRY-orf to
      three, each occurring in the putative DNA-binding domain. This provides further
      evidence to support SRY being TDF in humans and also indicates the functional
      importance of the putative DNA-binding domain of the SRY protein.

PMID- 1639411
TI  - A radiation-reduced hybrid cell line containing 5 Mb/17 cM of human DNA from
      9q34.
AB  - Disease gene loci for tuberous sclerosis (TSC1), idiopathic torsion dystonia
      (DYT1), and nail-patella syndrome (NPS1) have been mapped by genetic linkage
      analysis to human chromosome 9q band 34. To create a resource for physical
      mapping and manipulation of this region of the genome, we have created a
      radiation-reduced hybrid cell line containing DNA from human 9q34 as its only
      human component. This cell line, E6B, has been characterized by Southern blot and
      PCR analysis using a panel of 9q markers and fluorescent in situ hybridization.
      We estimate that it contains 5 Mb of human DNA, equal to 17 cM of genetic
      distance, extending from AK1 to ABO on 9q34.

PMID- 1639412
TI  - A cluster of expressed zinc finger protein genes in the pericentromeric region of
      human chromosome 10.
AB  - Three members of the human zinc finger Kruppel family, ZNF11/KOX2, ZNF22/KOX15,
      and ZNF25/KOX19, have been regionally localized to the pericentromeric region of
      chromosome 10 by in situ chromosomal hybridization and somatic cell hybrid
      analysis. ZNF25/KOX19 is located centromeric to a breakpoint in chromosome band
      10q11.2 in the chromosome region 10p11.2-q11.2, whereas ZNF22/KOX15 maps distal
      to it in band 10q11.2. Sequences hybridizing to the KOX2 probe are found at two
      loci, ZNF11A and ZNF11B, that map proximal and distal to the 10q11.2 breakpoint,
      respectively. The two ZNF11 loci probably represent two related sequences in
      10p11.2-q11.2. This cluster of ZNF/KOX genes is of particular interest since the
      loci for multiple endocrine neoplasia type 2A and 2B (MEN2A and MEN2B) syndromes
      have been assigned to this region by linkage analysis.

PMID- 1639413
TI  - MAF45, a highly polymorphic marker for the pseudoautosomal region of the sheep
      genome, is not linked to the FecXI (Inverdale) gene.
AB  - A highly polymorphic dinucleotide repeat, or microsatellite, that shows partial
      sex-linked inheritance in sheep has been isolated from the sheep genome. Our data
      indicate that the locus is in the pseudoautosomal region approximately 13 cm from
      the boundary with the sex-linked regions. The locus, designated MAF45, has 12
      alleles with a PIC of 0.84. The same primers amplify a single polymorphic locus
      in cattle and goats. This locus was not linked to the Inverdale gene, an X-linked
      gene that increases the ovulation rate in sheep.

PMID- 1639414
TI  - The Machado-Joseph disease locus is different from the spinocerebellar ataxia
      locus (SCA1).
AB  - Machado-Joseph disease (MJD) is an autosomal dominant neurodegenerative
      spinocerebellar ataxia that has been described primarily in families of Azorean
      or Portuguese descent. MJD and chromosome 6p-linked spinocerebellar ataxia (SCA1)
      are difficult to differentiate clinically, and it has been suggested that they
      may be allelic variants of the same disorder. We have tested MJD families for
      linkage to six DNA sequence polymorphisms located on chromosome 6p, including the
      highly informative dinucleotide repeat, D6S89. Seventeen centimorgans telomeric
      to and 41 cM centromeric to D6S89, a region that includes the SCA1 locus reported
      to be within 3 cM of D6S89, have been excluded. These data provide conclusive
      evidence that MJD and SCA1 are nonallelic.

PMID- 1639415
TI  - Sequence of the human factor VIII-associated gene is conserved in mouse.
AB  - cDNA and genomic clones corresponding to the human factor VIII-associated gene
      (F8A) were isolated from mouse cDNA and F8A-enriched genomic libraries. The
      sequences of these clones revealed an intronless gene coding for 380 amino acids,
      with 85% identity to the predicted human sequence. The single murine gene copy is
      genetically linked to factor VIII, but appears to lie outside the factor VIII
      gene by physical mapping. Like the human gene, the mouse F8A gene is highly
      expressed in a wide variety of tissues. This evolutionary comparison has helped
      to clarify the derived amino acid sequence in the human and strongly supports the
      hypothesis that the F8A gene encodes a protein.

PMID- 1639416
TI  - Chromosomal localization of an SH2-containing tyrosine phosphatase (PTPN6).
AB  - We have used panels of somatic cell hybrids and fluorescent in situ hybridization
      to determine the chromosomal localization of the novel nontransmembrane tyrosine
      phosphatase PTPN6 (protein tyrosine phosphatase, nonreceptor type 6), which
      contains two SH2 domains. PTPN6 maps to 12p13, a region commonly involved in
      leukemia-associated chromosomal abnormalities. Since PTPN6 is expressed at high
      levels in hematopoietic cells of all lineages and its expression is induced early
      in hematopoietic differentiation, altered expression and/or structure of PTPN6
      may play a role in leukemogenesis.

PMID- 1639417
TI  - Expressed sequence tags and chromosomal localization of cDNA clones from a
      subtracted retinal pigment epithelium library.
AB  - Expressed sequence tags (ESTs) provide useful molecular landmarks for physical
      mapping and identify the position of an expressed region in the genome. The use
      of subtracted cDNA libraries enriched for tissue-specific genes as a source of
      ESTs should reduce the repetitive isolation of constitutively expressed
      sequences. We report here the sequence tags from the 3'-end region of 58 new
      directionally cloned cDNAs from a subtracted human retinal pigment epithelium
      (RPE) cell line library. Eight of the cDNAs have been assigned to human
      chromosomes using PCR-based EST assays. Chromosomal mapping of subtracted RPE
      cDNA clones may also help in identifying candidate genes for inherited eye
      diseases.

PMID- 1639418
TI  - Assignment of the human stromelysin 3 (STMY3) gene to the q11.2 region of
      chromosome 22.
AB  - The human stromelysin 3 (STMY3) gene, a new member of the matrix
      metalloproteinase (MMP) gene family, may contribute to breast cancer cell
      invasion, and has been localized by in situ hybridization to the long arm of
      chromosome 22. As demonstrated using a panel of somatic cell hybrids, the STMY3
      gene is in band 22q11.2, in close proximity to the BCR gene involved in chronic
      myeloid leukemia, but far from the (11;22) translocation breakpoint observed in
      Ewing sarcoma. This position differs from that reported on chromosomes 11 and 16
      for the other MMP genes, suggesting that stromelysin 3 could be a member of a new
      MMP subfamily.

PMID- 1639419
TI  - Synteny between the loci for a novel FACIT-like collagen locus (D6S228E) and
      alpha 1 (IX) collagen (COL9A1) on 6q12-q14 in humans.
AB  - A 1.8-kb cDNA encoding portion of a novel collagenous chain was isolated from a
      human rhabdomyosarcoma cell line by cross-hybridization using a chicken type V
      collagen probe. Sequence analysis suggests that this chain belongs to the
      recently discovered group of collagens, termed the FACIT class of macromolecules.
      This cDNA was used to locate the corresponding gene (D6S228E) to chromosome 6,
      notably at position 6q12-q14. Interestingly, within this region of human
      chromosome 6 residues the alpha 1 (IX) collagen gene (COL9A1), a member of the
      FACIT group.

PMID- 1639421
TI  - CpG suppression in vertebrate genomes does not account for the rarity of (CpG)n
      microsatellite repeats.
AB  - Simple microsatellite repetitive sequences are widely distributed in eukaryotic
      genomes. Using the GCG Find program, the distribution of each type of mono- and
      dinucleotide repetitive sequence has been examined in GenBank sequences. Examples
      of each type of simple satellite sequence could be found, although the frequency
      of (CpG)n greater than or equal to 8 repeats was extremely low. The suppression
      of CpG dinucleotides in vertebrates does not adequately explain the rarity of
      this repeat since (CpG)n repeats are also extremely infrequent in species genomes
      where CpG dinucleotides are not suppressed. Instead, it is proposed that (CpG)n
      repeats must possess a DNA conformation that has a deleterious structural effect.

PMID- 1639420
TI  - Gene-dosage mapping of 30 DNA markers on chromosome 21.
AB  - Using a slot-blot method for the dosage of single-copy sequences, the copy
      numbers of 30 chromosome 21 markers were assessed in the blood DNA of 11 patients
      with partial trisomy or monosomy 21 and in the DNA of a patient-derived human
      hamster hybrid cell line carrying a microduplication of chromosome 21. The
      physical order of these markers on chromosome 21 was thereby determined.

PMID- 1639422
TI  - Sequence analysis of a partial deletion of the human steroid sulfatase gene
      reveals 3 bp of homology at deletion breakpoints.
AB  - The majority of patients with steroid sulfatase deficiency have a deletion of the
      entire STS gene located on the distal short arm of the human X chromosome;
      however, two patients with partial gene deletions have been identified. We now
      report the sequences at the breakpoints of a deletion of the 3' end of the STS
      gene. The deletion starts within intron 7 of the gene and extends over 150 kb
      downstream toward the centromere. Analysis of sequences flanking the deletion
      breakpoints revealed 3 bp of homology. The 3' flanking sequence provides a new
      probe for isolation of YAC clones and for studying patients with deletions in
      this region of the X chromosome.

PMID- 1639423
TI  - Identification of three novel missense PKU mutations among Chinese.
AB  - Three novel missense mutations have been identified in the phenylalanine
      hydroxylase (PAH) genes of Chinese individuals afflicted with various degrees of
      phenylketonuria (PKU). A T-to-C transition was observed in exon 5 of the gene,
      resulting in the substitution of Phe161 by Ser161. Two substitutions, G-to-T and
      T-to-G, were observed in exon 7, resulting in the substitution of Gly247 by
      Val247 and Leu255 by Val255, respectively. Expression analysis demonstrated that
      these mutant proteins produced between 0 and 15% of normal PAH enzyme activity.
      Population screening of a Chinese sample population indicates that these
      mutations are quite rare, together accounting for only about 4% of all PKU
      alleles among the Chinese. The P161S and G247V mutations were each present on a
      single PAH RFLP haplotype 4 chromosome in patients form Northern China, while the
      L255V mutation was present on chromosomes of both haplotypes 18 and 21 in
      patients from Southern China. These results suggest that the remaining 30% of
      uncharacterized PKU alleles in the Chinese population may bear a large number of
      relatively rare PAH mutations.

PMID- 1639424
TI  - Characterization of a highly polymorphic region near the first exon of the human
      MAOA gene containing a GT dinucleotide and a novel VNTR motif.
AB  - The genes encoding the A and B forms of the human monoamine oxidase enzymes (MAOA
      and MAOB) are localized at Xp11.23-Xp11.4. We report the characterization of a
      highly informative polymorphic region within a 2.9-kb cloned fragment containing
      the first exon of the MAOA gene. The polymorphic region consists of a GT
      microsatellite directly adjacent to an imperfectly duplicated novel 23-bp VNTR
      motif. DNA sequencing within and flanking the repeated segment allowed the design
      of specific amplification primers. In 56 unrelated females, 15 different alleles
      were identified with sizes ranging from 285 to 388 bp. The alleles differed in
      both the number of dinucleotide and the number of VNTR repeats, yielding a highly
      informative polymorphic marker locus with a calculated heterozygosity value of
      75%.

PMID- 1639425
TI  - Mapping of two chromosome 15 microsatellites.

PMID- 1639426
TI  - Regional localization of the gene for cardiac muscle actin (ACTC) on chromosome
      15q.

PMID- 1639427
TI  - The gene for receptor-linked protein-tyrosine-phosphatase (PTPA) is assigned to
      human chromosome 20p12-pter by in situ hybridization (ISH and FISH).

PMID- 1639428
TI  - Localization of a bile acid UDP-glucuronosyltransferase gene (UGT2B) to
      chromosome 4 using the polymerase chain reaction.

PMID- 1639429
TI  - Detection of mutations in the factor VIII gene using single-stranded
      conformational polymorphism (SSCP).

PMID- 1639430
TI  - Beneficial effects of endotoxin treatment on metabolism in tumour-bearing rats.
AB  - The effects of endotoxin treatment on host metabolism in tumour-bearing rats were
      investigated. Metabolism in control rats (non-tumour-bearing) was slightly
      altered by endotoxin treatment, whereas in tumour-bearing rats a number of
      biochemical parameters that were initially perturbed by the presence of the
      tumour had returned to normal at 48 h post-treatment. The beneficial effects
      included increased blood glucose and insulin concentrations, and decreased ketone
      body, triglyceride and lactate concentrations. Potentially non-beneficial effects
      of endotoxin observed in both tumour-bearing and control rats included decreased
      plasma cholesterol, and increased plasma phosphate, potassium and alkaline
      phosphatase levels. Endotoxin caused haemorrhaging in the encapsulated tumour,
      and this was associated with histological evidence of endothelial damage, red
      cell infiltration into surrounding tumour tissue and a marked decrease in cell
      viability. The in vivo uptake of glucose by the tumour, measured by 2-deoxy [U
      14C]glucose uptake, was decreased by 96% following endotoxin treatment, and this
      was associated with a two-fold increase in glucose uptake by muscle. It is
      concluded that endotoxin treatment has major effects on cell viability and the
      integrity of vasculature in the tumour, which limits glucose uptake by the tumour
      and thereby decreases the energy and substrate requirements of the tumour, thus
      benefiting the host. It is suggested that tumour cytotoxicity and intra-tumour
      haemorrhage are the result of endotoxin stimulating cytokine release from
      macrophages that are already activated by the presence of the tumour.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1639431
TI  - Increased release of interleukin-1 and tumour necrosis factor by interleukin-2
      induced lymphokine-activated killer cells in the presence of cisplatin and FK
      565.
AB  - The supernatants of peripheral blood lymphocytes cultured in interleukin-2 (IL-2)
      for 4 days contained tumour necrosis factor (TNF) and interleukin-1 (IL-1).
      Addition of cisplatin (CP) or FK-565 to these cultures increased the level of
      both of these cytokines in culture supernatants. Furthermore, when the LAK cells
      induced by culture with IL-2 in the presence or absence of CP/FK-565 were co
      cultured with tumour cells, the production of these cytokines was significantly
      enhanced. The level of enhancement depended on the ratio of LAK cells to tumour
      cells used and the length of coincubation of the two cell types. Culture
      supernatants of LAK cells and LAK cells stimulated by tumour cells were also
      cytotoxic to MCF-7 and U937 cells in 72 h cytotoxic assay, and antibodies
      specific for TNF and IL-1 inhibited the supernatant-mediated cytotoxicity. These
      results suggest that, in addition to the up-regulation of IL-2-induced LAK
      activity, treatment of PBL with CP/FK-565 leads to enhanced production of various
      cytokines with potential antitumour and immunoregulatory activity.

PMID- 1639432
TI  - Lymphoid tissue in rat oral mucosa: structure and function.
AB  - Lymphocyte and macrophage/dendritic cell populations in the oral cavity of the
      rat were studied by immunohistochemistry. Furthermore, the reactivity of the oral
      mucosa towards antigen and its position in the mucosal immune system was
      investigated by staining antibody-forming cells and comparing serum and saliva
      antibody titres. Although numerous lymphocytes and non-lymphoid cells were
      present in the oral mucosa, organized lymphoid tissue could not be found. The
      majority of the lymphocytes are T cells, particularly of the T-helper phenotype.
      Macrophages were found only in the connective tissue, whereas dendritic cells
      also occurred in the epithelium. The possible functions of the cells in the
      different sites of the oral mucosa are discussed. Antibody-forming cells were
      mainly detected in the draining superficial and posterior cervical lymph nodes
      and in the submandibular glands. The roles of the various compartments of the
      oral mucosal immune system are discussed with particular reference to the
      epithelium and connective tissue as induction sites, the draining lymph nodes as
      sites of proliferation and differentiation, and the submandibular glands as
      effector sites.

PMID- 1639433
TI  - Enhanced H2O2 release from immune chicken leucocytes following infection with
      Eimeria tenella.
AB  - Cell-mediated immunity is thought to be important in the resistance of chickens
      to infection by coccidia, and it has been demonstrated that sporozoites of
      Eimeria tenella are very sensitive to superoxide ions. Therefore an investigation
      into the cellular responses in naive specific pathogen-free and hyperimmune birds
      was carried out with particular attention to their ability to produce reactive
      derivatives of oxygen. Leucocytes were isolated from the blood, spleen and caecal
      mucosa of chickens infected with E. tenella and assessed for their ability to
      release H2O2. Leucocytes obtained from the blood and spleen of hyperimmune birds
      1 day after challenge showed an elevated ability to produce reactive oxygen
      intermediates. In contrast, the ability of leucocytes from naive chickens to
      produce these molecules was transiently depressed after challenge. Prior to
      challenge, mucosal leucocytes from immune chickens were also able to release
      heightened levels of H2O2 when compared with cells from naive chickens.

PMID- 1639434
TI  - A transgenic window on peripheral T cell tolerance.
AB  - There is convincing evidence for the imposition of self-tolerance by means of the
      clonal deletion of self-reactive T cells within the thymus. Since not all self
      components may be encountered there, the question must be asked whether tolerance
      can occur post-thymically. To test this, we have used transgenic technology to
      direct expression of a 'non-self' gene, H-2Kb, to the insulin-producing beta
      cells of the pancreas in mice. These 'RIP-Kb' transgenic mice were specifically
      tolerant of H-2Kb-bearing skin grafts. To test the fate of potentially reactive H
      2Kb-specific T cells in these tolerant mice, the RIP-Kb mice were mated to a
      second series of transgenic mice with rearranged T cell receptor (TCR) genes
      encoding an H-2Kb-specific TCR to produce 'double transgenic' offspring. The TCR
      was detectable by a clonotype-specific antibody. Although there was some evidence
      of intrathymic deletion of those T cells that expressed the highest density of
      the H-2Kb-specific TCR, lower density cells were present in the periphery. These
      may have been either indifferent to the H-2Kb molecule expressed on the beta
      cells or functionally silenced by it. Further experiments are planned to
      determine which of these two situations exists.

PMID- 1639435
TI  - Quantitative analysis of lymphokine expression in vivo and in vitro.
AB  - Constitutive lymphokine production by cells isolated from mice injected with
      keyhole limpet haemocyanin (KLH) or from mice undergoing an acute graft vs host
      reaction (GVHR) was very low, but could be markedly increased by T cell receptor
      (TCR) ligation. This suggested that in vivo levels of lymphokine production are
      much lower than those induced by in vitro stimulation. Serum lymphokine titres
      were consistent with this possibility, and analysis of lymphokine mRNA levels
      using S1-nuclease protection demonstrated that in vitro-stimulated cells from
      normal, KLH and GVHR mice all had markedly increased levels of lymphokine
      transcripts relative to levels found in vivo. A novel method combining limiting
      dilution analysis with polymerase chain reaction amplification of cDNA was
      developed that showed that these differences in levels of lymphokine production
      were due at least in part to differences in the frequencies of lymphokine mRNA
      containing cells. Studies of the means by which differential lymphokine
      production is achieved demonstrated that CD4+, CD8+ and cytotoxic T lymphocyte
      (CTL) clones all express a common, restricted set of lymphokines in response to a
      defined in vitro stimulus, but that individual in vivo primed cells can express
      at least seven distinct patterns of lymphokine production.

PMID- 1639436
TI  - Viral escape from immune recognition: multiple strategies of adenoviruses.
AB  - Human adenoviruses can cause persistent infections in man. The strategies of C
      type adenoviruses (types Ad2 and Ad5) to evade immune recognition are many, but
      all involve single early genetic regions (E3). Gene(s) within E3 have been shown
      to allow the adenovirus to avert cytokine-mediated apoptosis. Furthermore, the E3
      region controls the cytotoxic T cell epitope (a major histocompatibility complex
      [MHC] class I molecule with an adenovirus-derived peptide) on the cell surface of
      infected cells. On the one hand the E3 gene product 19 kDa can bind to nascent
      class I MHC in the endoplasmic reticulum and thus prevent its transport to the
      cell surface, and on the other hand the E3 region down-regulates the E1a gene
      product, the immunodominant cytotoxic T cell determinant.

PMID- 1639437
TI  - Frequency of D8/17 B lymphocyte alloantigen in north Indian patients with
      rheumatic heart disease.
AB  - Ninety patients with rheumatic heart disease and 50 age- and sex-matched healthy
      human volunteers representing a North Indian population were typed for the B cell
      alloantigen D8/17 using a monoclonal antibody and a single step
      immunofluorescence technique. This alloantigen was expressed in 66.44% patients
      with RHD as compared with 14% of the normal population. A high relative risk (RR
      = 11.13) indicated a strong association of D8/17 B cell alloantigen with
      rheumatic heart disease. Increase in the frequency of the marker was observed
      with increasing age up to the fifth decade (40-49 years) in these patients.
      However, the frequency of this alloantigen, in the present study, in North Indian
      patients with rheumatic heart disease is lower than that reported in the American
      population.

PMID- 1639438
TI  - Possible association of the extended MHC haplotype B44-SC30-DR4 with autism.
AB  - We previously reported that the complement C4B null allele appears to be
      associated with infantile autism. Since the C4B null allele is known to be part
      of the extended or ancestral haplotype [B44-SC30-DR4], we investigated the
      incidence of [B44-SC30-DR4] in 21 autistic children and their parents. This
      extended haplotype was increased by almost six-fold in the autistic subjects as
      compared with healthy controls. Moreover, the total number of extended haplotypes
      expressed on chromosomes of autistic subjects was significantly increased as
      compared with those expressed on chromosomes of healthy subjects. We conclude
      that a gene related to, or included in, the extended major histocompatibility
      complex may be associated with autism.

PMID- 1639439
TI  - Possible role of Abb gene in mouse resistance to EL4 metastases.
AB  - "S" (survivor) mutants were produced in mice for genetic analysis of host
      resistance to metastatic cancers. S-mutants S-27 and S-31 resist transplantation
      of lymphoma EL4 of parental C57BL/6J (B6) mice while they accept parental skin
      grafts. Mutant S-27 also resists formation of spontaneous metastases from
      intradermally growing EL4 tumor into lymph nodes; mutant S-31 is highly
      susceptible to EL4 metastases. Another mutant, H-2bm26 (bm26), resists EL4 and
      rejects B6 skin grafts. Major histocompatibility complex (MHC) class I and class
      II gene expression was compared in these mutants and normal B6 mice. All three
      mutants tested, S-27, S-31, and bm26, expressed a low amount of Kb mRNA in organ
      specific fashion. Mutants bm26 and S-31 expressed a low amount of Abb mRNA and of
      Ab antigen on their spleen cells. Some oligonucleotide probes designed to
      hybridize to the second exon of the class II MHC gene Abb did not hybridize with
      DNA from all three mutants. These findings suggest extensive sequence alterations
      in the Abb gene in mutants S-27, S-31, and bm26; they also suggest a major role
      of MHC in the control of host resistance to spontaneous metastases of the EL4
      tumor.

PMID- 1639440
TI  - Screening mouse mutations for resistance to cancer metastasis.
AB  - To search for host genes for resistance/susceptibility to cancer metastasis,
      mutation analysis was employed. Ten putative mutants of resistance to lymphoma
      EL4 and four putative mutants of resistance to sarcoma MCA/77-23 of C57BL/6J (B6)
      mice were produced. These mutants were designated S (for "survivor") mutants;
      they do not reject parental strain B6 skin grafts. S-mutants resist moderate
      tumor cell doses: TD50 values in them were increased by a factor of 12 to 600.
      Genetic linkage tests showed that five S-mutants were linked to mouse major
      histocompatibility complex (H-2) and five other S-mutants were not linked to this
      locus. A group of H-2-linked S-mutants resisting EL4 and a mutant, S-87/2,
      resisting MCA/77-23 were tested for resistance to spontaneous metastases of the
      same two tumors, EL4 and MCA/77-23. Two of the mutants, S-31 (lymphoma-resisting)
      and S-87/2 (sarcoma-resisting), were shown to carry mutations of mouse gene(s)
      for resistance to tumor metastases. In both of these mutants resistance to the
      original tumor transplant coexisted with highly increased susceptibility to
      metastasis. These mutants are a new tool to study genes for resistance to cancer
      metastasis and of mechanism of resistance controlled by each individual gene.

PMID- 1639441
TI  - A new approach to HLA-DPB1 typing combining DNA heteroduplex analysis with allele
      specific amplification and enzyme restriction.
AB  - Allelic polymorphism of HLA-class II antigens plays a key role in the regulation
      of the immune response and in transplantation immunity. The allelic diversity of
      these antigens can now be analyzed at the DNA level after amplification by
      polymerase chain reaction. In this study we apply a simple technique based on the
      electrophoretic analysis of DNA heteroduplexes to the typing of HLA-DPB1 alleles.
      In order to increase its resolution, a group-specific amplification was used
      which subdivides the 19 HLA-DPB1 alleles in two non-overlapping families. A
      separate analysis was then performed within each group of alleles. This approach
      allowed an unequivocal one-step typing of the alleles belonging to group 1 which
      comprises few alleles of high frequency. Some group 2 alleles require, as a
      further step, the test with a restriction enzyme. The combination of more than
      one technique represents, in our opinion, the easiest way to solve the
      micropolymorphism of class II alleles. We conclude that this method, which is
      very simple, quick, and accurate and does not require probes, may become the
      method of choice for HLA-DPB1 typing.

PMID- 1639443
TI  - Molecular cloning of the Ig-alpha subunit of the human B-cell antigen receptor
      complex.

PMID- 1639442
TI  - Hypomethylation of MHC class II Eb gene is associated with expression.
AB  - Methylation patterns in the major histocompatibility complex (MHC) class II Eb
      locus have been analyzed in cell lines representative of different cell types; in
      particular those with phenotypes found at various stages of B cell development. A
      series of variant B cell lymphoma lines which serves as a model in which to
      investigate mechanisms regulating class II gene expression in normal peripheral B
      cells has been examined. Eb methylation patterns have also been determined in
      various healthy mouse tissues. The pattern of methylation of the Eb locus varies
      between different cell lines and tissue types such that hypomethylation is
      associated with gene expression. There appears to be a methylation pattern which
      is permissive for class II gene expression and which is characteristic of a
      variety of cell lines, but is lost in cell lines representing terminally
      differentiated class II nonexpressing plasma cells. Another methylation pattern
      has been identified which is found in cloned cell lines selected for expression
      of very high levels of cell surface class II product. The patterns of methylation
      associated with MHC class II expression involve changes in methylation sites
      located within the first intron and several kilobase pairs 5' of the promoter,
      but no changes were observed in the 3' end of the locus. Moreover, the different
      methylation patterns do not map to the prominent CpG rich cluster located 5' of
      the Eb promoter and which remains completely methylated regardless of
      transcriptional status.

PMID- 1639444
TI  - Hepatic encephalopathy in Saudi Arabia: retrospective analysis of 51 patients.
AB  - The clinical features, prognostic factors, and outcome of 51 patients with
      hepatic encephalopathy (HE), were retrospectively reviewed. The mean (+/- SD) age
      of patients was 47.2 (+/- 14.8) years. Seventy-five percent of patients were
      males and 73% were Saudi. All identified episodes of hepatic encephalopathy were
      associated with chronic underlying liver disease and no episode occurred as a
      result of acute fulminant hepatic failure. Most patients presented in advanced
      stage of hepatic dysfunction and had one or more precipitating factors. In
      hospital mortality rate was 41% (21 out of 51 patients). Gastrointestinal tract
      bleeding, electrolytes imbalance and alkalosis were associated with significantly
      higher mortality rate. However, unadjusted analysis failed to identify certain
      base-line independent prognostic factors.

PMID- 1639445
TI  - AIDS with special reference to pediatric aspect.
AB  - The article discusses the disease AIDS, and its increasing incidence all over the
      world. The alarming rise of HIV infection amongst those tested in India is noted.
      The projection as made by WHO are mentioned. The various modes of transmission of
      HIV infection and the high risk groups for each mode are identified. Clinical
      manifestation of an adult case is followed by that of a pediatric patient in whom
      the infection is mostly transplacental. The risk of TAA amongst children is
      highlighted as also the difference between adult and pediatric AIDS. Diagnosis of
      AIDS, its management, prognosis and prevention are mentioned. The similarity
      between HIV-1, SIV and HIV-2 induced immunodeficiency is recorded.

PMID- 1639446
TI  - Pararectal duplication.

PMID- 1639447
TI  - Hereditary spherocytosis: experience of 145 cases.
AB  - 145 patients were diagnosed to have hereditary spherocytosis (HS) over a period
      of 25 years. Jaundice (66.9%), fever (65.5%), weakness (44.8%), and abdominal
      pain (35.8%) were the commonest complaints. 94.5% had splenomegaly (JP-17 cm) and
      71.7% had hepatomegaly (JP-6 cm). Spherocytes were detected in the peripheral
      smears of all patients at presentation on careful examination. 67 patients had
      been investigated elsewhere and spherocytes missed in 86.6%. Gall stones were
      seen in 20 of the 54 patients investigated. Family history suggestive of HS was
      available in only 16.6% of cases, whereas examination and investigations revealed
      HS in almost all families. Splenectomy was done in all symptomatic patients. In
      the 39 patients followed up for 1-9 years after splenectomy.

PMID- 1639448
TI  - Role of vagal and sinoaortic baroreflexes in circulatory adjustments to passive
      head up tilt.
AB  - To evaluate the contribution of vagal and sinoaortic baroreflexes in circulatory
      adjustments anaesthetized rabbits were subjected to 70 degree head up tilt with
      (i) both reflexes intact; (ii) after elimination of sinoaortic reflexes; (iii)
      after elimination of vagal reflexes; and (iv) after elimination of both
      categories of reflexes. The results suggest that vagal mediated baroreflexes from
      cardiopulmonary baroreceptors contribute significantly in circulatory adjustments
      to passive head up tilt while sinoaortic baroreflexes play the major role.

PMID- 1639449
TI  - Hematometrocolpos presenting as pelvic outlet obstruction.

PMID- 1639450
TI  - Response of canine brain loci to intracerebroventricular thyroxine.
AB  - The effect of intracerebroventricular T4 on certain hypothalamic i.e., POA and
      VMN and cortical i.e., HPC and CO loci was investigated by recording their
      electroencepgraphic activity after chronic implantation of cannulae and bipolar
      electrodes in ten male dogs. Recordings were made for two hours after the
      microinjection. The predominant pattern of EEG activity was a synchrony of brain
      waves in all derivations except for POA where biphasic desynchronization
      synchronization was observed. Final synchrony suggest refractoriness of these
      loci to T4 which might be playing a protective role.

PMID- 1639451
TI  - Ultrasonography versus roentgenography in suspected cases of cholecystolithiasis.
AB  - The present study was carried out to evaluate the relative merits of
      ultrasonography and roentgenography in 50 cases of suspected cholecystolithiasis.
      The accuracy rate with roentgenography (plain X-ray abd, OCG and IVC) in the
      diagnosis of cholecystolithiasis was 92.5% where as it was 95% with
      ultrasonography. Oral cholecystography should be done in patients with normal
      ultrasound examination if the symptoms are strongly suggestive of
      cholecystolithiasis.

PMID- 1639452
TI  - Pregnancy in a rudimentary uterine horn.
AB  - A case of pregnancy reaching term in a rudimentary non-communicating horn of the
      uterus is presented. The pregnancy resulted in the delivery of a live child by
      cesarian section. The case is being reported for the rarity with which the foetus
      survives in this condition.

PMID- 1639453
TI  - Immuno-modulation by exercise: review.
AB  - Chronic and exhaustive exercise leads to a decline in mitogen-induced lymphocyte
      proliferation in-vitro and in-vivo. This is suggestive of decrease in cellular
      and humoral immunity. Majority of workers are of opinion that exercise-induced
      immunosuppression is related to the production of glucocorticoids in response to
      the stress associated with exercise.

PMID- 1639454
TI  - Regulation of contraction and relaxation in arterial smooth muscle.
AB  - Intracellular calcium concentration ([Ca2+]i)-dependent activation of myosin
      light chain kinase and its phosphorylation of the 20-kd light chain of myosin is
      generally considered the primary mechanism responsible for regulation of
      contractile force in arterial smooth muscle. However, recent data suggest that
      the relation between [Ca2+]i and myosin light chain phosphorylation is variable
      and depends on the form of stimulation. The dependence of myosin phosphorylation
      on [Ca2+]i has been termed the "[Ca2+]i sensitivity of phosphorylation." The
      [Ca2+]i sensitivity of phosphorylation is "high" when relatively small increases
      in [Ca2+]i induce a large increase in myosin phosphorylation. Conversely, the
      [Ca2+]i sensitivity of phosphorylation is "low" when relatively large increases
      in [Ca2+]i are required to induce a small increase in myosin phosphorylation.
      There are two proposed mechanisms for changes in the [Ca2+]i sensitivity of
      phosphorylation: Ca(2+)-dependent decreases in the [Ca2+]i sensitivity of
      phosphorylation induced by phosphorylation of myosin light chain kinase by Ca(2+)
      calmodulin protein kinase II and agonist-dependent increases in the [Ca2+]i
      sensitivity of phosphorylation by inhibition of a myosin light chain phosphatase.
      I will review the proposed mechanisms responsible for the regulation of [Ca2+]i
      and the [Ca2+]i sensitivity of phosphorylation in arterial smooth muscle.

PMID- 1639455
TI  - 12-Lipoxygenase products modulate calcium signals in vascular smooth muscle
      cells.
AB  - Previous studies have shown that inhibition of the lipoxygenase pathway of
      arachidonic acid metabolism can prevent the development of elevated blood
      pressure in renin-dependent models of hypertension. Agents that inhibit the
      lipoxygenase pathway such as phenidone and the flavonoid baicalein can
      selectively attenuate contractile responses to angiotensin II in vivo as well as
      in isolated vascular tissue. In the present study, the effects of lipoxygenase
      inhibitors on pressor-induced changes in cytosolic calcium were examined in
      cultured rat vascular smooth muscle cells using the fluorescent dye fura-2. Two
      structurally unrelated lipoxygenase inhibitors, baicalein and 5,8,11
      eicosatriynoic acid, attenuated angiotensin II-stimulated increases in cytosolic
      calcium in both normal and calcium-poor buffer. The addition of 5-, 12-, or 15(S)
      hydroxyeicosatetraenoic acid alone to the cells had no acute effect on
      intracellular calcium concentration. However, the addition of 12(S)
      hydroxyeicosatetraenoic acid but not 5- or 15(S)-hydroxyeicosatetraenoic acid
      restored the initial calcium response to angiotensin II in vascular smooth muscle
      cells pretreated with both inhibitors; 5,8,11-eicosatriynoic acid also reduced
      [Arg8]-vasopressin and endothelin-stimulated increases in intracellular calcium.
      The attenuation of vasopressor-induced calcium transients by agents that inhibit
      lipoxygenase may explain their observed hypotensive effects in vivo. Moreover,
      lipoxygenase products, in particular 12(S)-hydroxyeicosatetraenoic acid, may act
      as mediators for the intracellular actions of angiotensin II and possibly other
      pressor hormones in vascular tissue by regulation of intracellular calcium
      metabolism.

PMID- 1639456
TI  - Distribution and metabolism of angiotensin I and II in the blood vessel wall.
AB  - The demonstration of all components of the renin-angiotensin system in vascular
      tissue has raised questions as to the precise location of the local angiotensin
      II generation within the vascular wall. We investigated the metabolism of
      angiotensin I to angiotensin II in the vascular wall in the isolated rabbit
      thoracic aorta. Angiotensin I (3 x 10(-9) M) applied into the aortic lumen was
      partially converted to angiotensin II (14% after 60 minutes), but most of the
      luminal angiotensin I was degraded to peptide fragments or diffused as intact
      angiotensin I, peptide fragments, or both, into the vessel wall. Incubation
      studies with [3H]angiotensin I revealed that angiotensin I or angiotensin I
      fragments mainly diffused into the medial layer of the aorta and to a lesser
      degree into the adventitia and the endothelium. After removal of the endothelium,
      angiotensin II generation could no longer be detected. Addition of the
      angiotensin converting enzyme inhibitor ramiprilat (10(-7) M) to the incubation
      medium led to a complete blockade of angiotensin II generation by endothelial
      angiotensin converting enzyme. Our results underline the importance of the
      endothelium for conversion of angiotensin I to angiotensin II and provide
      evidence that conversion of angiotensin I to angiotensin II is predominantly
      achieved by endothelial cells. They also support the concept of an endocrine
      versus autocrine/paracrine renin-angiotensin system where the endothelium of the
      vasculature is the critical target site for angiotensin II production by both
      systems and, thus, the most important site for the actions of angiotensin
      converting enzyme inhibitors.

PMID- 1639457
TI  - Tissue renin-angiotensin systems in renal hypertension.
AB  - Angiotensinogen messenger RNA (mRNA) levels were measured in the brain
      (hypothalamus, lower brain stem, cerebellum), liver, kidneys, and adrenal glands
      of rats made hypertensive by ligation of the aorta between the renal arteries. We
      also measured renin mRNA in the kidneys of these renal hypertensive rats. The
      early phase of hypertension (day 6) was associated with significant increases in
      plasma renin activity and levels of circulating angiotensin II. The circulating
      renin-angiotensin system was not activated in the later phase of hypertension
      (day 24). Angiotensinogen mRNA levels were elevated in the lower brain stem of
      hypertensive rats at both stages of hypertension. In contrast, angiotensinogen
      mRNA levels in the hypothalamus were increased only at day 6 after aortic
      ligation. Decreased levels of angiotensinogen mRNA were observed in the
      cerebellum in both the early and later phases of the hypertension.
      Angiotensinogen mRNA levels in the adrenal gland below the ligature fell in the
      early phases but rose in the later phases of hypertension. Renin mRNA levels of
      the ischemic kidney remained elevated at both the early and later phases, whereas
      in both ischemic and nonischemic kidneys, levels of angiotensinogen mRNA remained
      below sham values throughout the period of study. These results indicate
      differential expression of renin-angiotensin system mRNAs in tissues of renal
      hypertensive rats. The differential changes in the expression of angiotensinogen
      mRNA over the course of development and maintenance of renal hypertension suggest
      that factors in addition to angiotensin II are important in modulating the
      expression of renin-angiotensin system genes.

PMID- 1639458
TI  - Captopril improves impaired endothelium-dependent vasodilation in hypertensive
      patients.
AB  - Animal studies suggest that some angiotensin converting enzyme inhibitors augment
      endothelium-dependent vasorelaxation. We aimed to determine if captopril augments
      endothelium-dependent vasodilation in middle-aged hypertensive patients. By using
      strain-gauge plethysmography, forearm vasodilation evoked with intra-arterial
      acetylcholine (4, 8, 16, and 24 micrograms/min) or nitroprusside (0.2, 0.4, 0.8,
      and 1.2 micrograms/min) was examined before and after captopril administration
      (25 mg per os). Before captopril, forearm vasodilation with acetylcholine was
      less in hypertensive patients (n = 12) than in age-matched (n = 7) or young (n =
      7) normotensive subjects, but forearm vasodilation with nitroprusside did not
      differ among the three groups. Captopril improved forearm vasodilation in
      hypertensive patients (n = 7) with acetylcholine but nitroprusside did not. In
      contrast, nifedipine (10 mg per os) did not alter forearm vasodilation with
      acetylcholine or nitroprusside in hypertensive patients (n = 5). The decreases in
      mean blood pressure caused by captopril and nifedipine in hypertensive subjects
      were comparable. Captopril did not alter forearm vasodilation with acetylcholine
      or nitroprusside in young normotensive subjects (n = 7). These results suggest
      that captopril in hypertensive patients may acutely improve impaired endothelium
      dependent forearm vasodilation that does not result from reduction in blood
      pressure per se.

PMID- 1639459
TI  - Effects of chronic angiotensin converting enzyme inhibition on glucose tolerance
      and insulin sensitivity in essential hypertension.
AB  - The relation between the renin-angiotensin-aldosterone (RAA) system and
      carbohydrate metabolism and insulin sensitivity in essential hypertension has not
      been investigated systematically. Twenty nondiabetic patients (age, 49 +/- 1
      years; body mass index (BMI), 26.1 +/- 0.4 kg/m2) with essential hypertension
      (blood pressure, 155 +/- 3/105 +/- 1 mm Hg) received an oral glucose tolerance
      test (OGTT) at the end of a 1-month placebo period and again monthly during 3
      months of angiotensin converting enzyme (ACE) inhibition (cilazapril, 5 mg/day).
      Furthermore, a two-step euglycemic insulin clamp was performed after placebo and
      again at the end of treatment. Blood pressure fell by 7 +/- 4/10 +/- 3 mm Hg (p
      less than 0.001), while BMI remained stable. On the euglycemic clamp, insulin
      mediated (plasma insulin, 470 pM) whole body glucose use averaged 42.5 +/- 1.6
      mumol.min-1.kg-1 before and 43.6 +/- 1.9 after ACE inhibition (p = NS). Substrate
      concentrations and oxidative rates and energy expenditure (as estimated by
      indirect calorimetry) were not altered by ACE inhibition, either in the fasting
      state or in response to insulin. In contrast, oral glucose tolerance was
      significantly (p less than 0.05) improved after treatment (area under OGTT curve
      (AUC), 240 +/- 24 versus 282 +/- 23 mmol 2 hr.l-1). The latter change was
      associated with enhanced (+16%, p less than 0.05) insulin responsiveness to
      glucose (estimated as the insulin AUC divided by the glucose AUC) throughout the
      3 months of ACE inhibition. At baseline, both the OGTT and the clamp had a marked
      hypokalemic effect (mean decrements in plasma potassium of 0.75 +/- 0.05 and 0.92
      +/- 0.05 mmol/l, respectively) in association with plasma aldosterone reductions
      of 30% and 50%. Chronic ACE inhibition caused a further 20% (p less than 0.03)
      lowering of plasma aldosterone concentrations but attenuated insulin-induced
      hypokalemia. Plasma sodium, which was unaltered by the pretreatment tests, fell
      during the posttreatment tests (by 3 mmol/l, p less than 0.001). In the urine,
      the ratio of the fractional excretion of potassium to that of sodium was
      decreased by both oral glucose (-22%, p less than 0.01) and ACE inhibition (-21%,
      p less than 0.001). Higher plasma potassium levels before treatment predicted a
      better blood pressure response to ACE inhibition (r = 0.60, p less than
      0.005).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1639460
TI  - Increased insulin sensitivity in the high sodium one-kidney, one figure-8
      hypertensive rat.
AB  - This study examines the relation between sympathetic activity and in vivo insulin
      mediated glucose metabolism in a rat model of acquired hypertension. Two groups
      of conscious, unrestrained rats were studied in the postabsorptive state: sham
      operated normotensive rats (n = 10) and renal-wrapped hypertensive rats (n = 10).
      Mean arterial pressure was increased in the hypertensive compared with the
      normotensive group in the fed (184 +/- 9 versus 144 +/- 6 mm Hg; p less than
      0.01) and in the fasting (147 +/- 8 versus 112 +/- 7 mm Hg; p less than 0.01)
      state. After a 24-hour fast, hepatic glucose production, plasma glucose, insulin,
      and norepinephrine concentrations were similar in the two groups. Blood pressure
      did not change in either group during the 3-milliunits/kg.min euglycemic insulin
      clamp study; however, plasma norepinephrine concentration rose significantly in
      hypertensive (207 +/- 24 versus 329 +/- 11 pg/ml; p less than 0.05) but not in
      normotensive rats (229 +/- 23 versus 267 +/- 27 pg/ml; p = NS). During the
      insulin clamp study, the hepatic glucose production was similar in the
      hypertensive (3.8 +/- 0.8 mg/kg.min) compared with the normotensive (4.0 +/- 0.3
      mg/kg.min) rats. Insulin-mediated glucose uptake was significantly higher in
      hypertensive than in normotensive rats (33.0 +/- 0.7 versus 25.8 +/- 0.8; p less
      than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639461
TI  - Acute hyperinsulinemia induces sodium retention and a blood pressure decline in
      diabetes mellitus.
AB  - Hyperinsulinemia supposedly contributes to hypertension in diabetes mellitus. We
      sought to determine if the renal and cardiovascular effects of insulin are
      preserved in diabetes despite resistance to its glucose-lowering effect. We
      studied the effects of two doses of insulin (50 and 500 milliunits/kg.hr-1),
      using the euglycemic clamp technique, on fractional sodium excretion, blood
      pressure, and heart rate in two groups of non-insulin-dependent diabetics: eight
      patients with and eight patients without hypertension. Hypertensive diabetics had
      higher basal insulin levels than normotensive diabetics (21.8 +/- 2.9 and 14.4 +/
      1.6 milliunits/l, respectively [mean +/- SEM]; p = 0.03). The degree of insulin
      resistance, but not plasma insulin levels, correlated with the height of mean
      arterial blood pressure (r = 0.60 and 0.73 at the low and high insulin dose,
      respectively; p less than 0.05). In contrast, the change in mean arterial blood
      pressure correlated negatively with the change in endogenous insulin levels
      during the control experiment (r = -0.41, p less than 0.02). Exogenous insulin
      induced a similar reduction in fractional sodium excretion in normotensive and
      hypertensive diabetics (43 +/- 5.9% and 48 +/- 16.4% during the low insulin dose
      and 57 +/- 9.1% and 62 +/- 12.5% during the high insulin dose, respectively). A
      decline in blood pressure was noted that correlated with the whole body glucose
      uptake during the high insulin dose (r = 0.52, p less than 0.05). Since heart
      rate response and plasma norepinephrine level during the insulin clamp were
      comparable in both groups, an abnormality of the baroreceptor reflex is
      suggested. It appears that insulin resistance, but not insulin, is primarily
      related to hypertension. At the same time, insulin may still exert some effect on
      blood pressure by way of its renal or vasodilatory, or both, action.

PMID- 1639462
TI  - Converting enzyme inhibition and blood pressure reactivity to psychological
      stressors.
AB  - There is considerable interest in blood pressure reactivity to psychological
      stressors. Because the sympathetic nervous system and the renin-angiotensin
      system are so responsive to stressors and are themselves the targets of many
      antihypertensive medications, many investigators have wondered if such
      medications decrease the blood pressure response to stressful stimuli. We studied
      25 normotensive and 21 hypertensive men in a double-blind crossover study during
      which they received either placebo for 4 days or captopril (25 mg b.i.d.) for 4
      days while they were hospitalized in a clinical research center. Patients were
      studied at resting baseline, while performing a mathematics task, and while
      reading out loud a disturbing newspaper article. Although captopril lowered the
      resting blood pressure levels, it had no effect on the amplitude of reactivity to
      stressors.

PMID- 1639463
TI  - Job strain and ambulatory work blood pressure in healthy young men and women.
AB  - The effect of high job strain (defined as high psychological demands plus low
      decision latitude at work) on blood pressure was determined in 129 healthy,
      nonhypertensive men (n = 65) and women (n = 64). Blood pressure measures included
      mean screening levels obtained in a clinical environment, mean ambulatory levels
      from one 8-hour workday, and the change in levels from screening to mean work
      levels. In male workers, men with high and low job strain showed similar blood
      pressures at screening, but men with high job strain showed greater increases
      from screening to work, resulting in higher mean work blood pressure.
      Occupational status was unrelated to job strain or blood pressure in men. In
      female workers, women with high and low job strain did not differ in any measure
      of blood pressure; however, there were trends for higher occupational status and
      greater skill discretion to be associated with higher blood pressure responses at
      work in women.

PMID- 1639464
TI  - Acute depressor effect of alcohol in patients with essential hypertension.
AB  - To investigate the time course of the effects of alcohol on blood pressure, we
      studied the response of ambulatory blood pressure, neurohumoral variables, and
      hemodynamics to a single moderate dose of alcohol in hypertensive patients.
      Sixteen Japanese men (22-70 years old) with essential hypertension who were
      habitual drinkers were examined under standardized conditions. On the alcohol
      intake day, they ingested 1 ml/kg ethanol (vodka) at dinner, and on the control
      day they consumed a nonalcoholic beverage. The order of the two periods was
      randomized. Mean ambulatory blood pressure was lower in the alcohol intake period
      than in the control period (125 +/- 3/74 +/- 2 versus 132 +/- 4/78 +/- 2 mm Hg, p
      less than 0.05), and the significant depressor effect of alcohol lasted for up to
      8 hours after drinking. Blood pressure on the next day did not differ with or
      without alcohol intake. The acute hypotensive effect of alcohol was associated
      with an increase in heart rate and cardiac output and with a decrease in systemic
      vascular resistance as determined by echocardiography. Plasma catecholamine
      levels and renin activity rose significantly at 2 hours after dinner, whereas
      vasopressin and potassium levels fell on the alcohol day. Blood glucose and serum
      insulin levels were comparable between the two periods. Three patients with
      marked alcohol-induced flush had greater hypotensive and tachycardiac responses
      than those who did not show an alcohol-induced flush. The change in mean blood
      pressure induced by alcohol was negatively correlated with age, the baseline
      blood pressure, and the change in plasma norepinephrine. These results indicate
      that the major effect of acute alcohol intake is to lower blood pressure through
      systemic vasodilatation in hypertensive subjects. Ambulatory blood pressure
      monitoring may be useful for assessing blood pressure in habitual drinkers.

PMID- 1639465
TI  - Evaluation of noninvasive blood pressure monitoring devices Spacelabs 90202 and
      90207 versus resting and ambulatory 24-hour intra-arterial blood pressure.
AB  - This study evaluated the accuracy of blood pressure values provided by the
      Spacelabs 90202 and 90207 devices in comparison with intra-arterial recording in
      19 subjects at rest and in nine subjects in ambulatory conditions (Oxford
      method). At rest Spacelabs monitors reflected intra-arterial systolic blood
      pressure values very closely but overestimated to a considerable extent intra
      arterial diastolic blood pressure (Spacelabs-intra-arterial differences, -0.8 +/-
      9.2, NS, and 9.1 +/- 8.8 mm Hg, p less than 0.01, for systolic and diastolic
      blood pressures, respectively). In ambulatory conditions Spacelabs-intra-arterial
      average differences in 24-hour values were +0.4 +/- 5.1 mm Hg for systolic blood
      pressure (NS) and +14.0 +/- 2.9 mm Hg for diastolic blood pressure (p less than
      0.01) when group data were considered. The performance of both Spacelabs devices
      was worse when assessed in individual subjects or for each hourly interval. In
      spite of these differences between noninvasive and intra-arterial absolute blood
      pressure values, however, Spacelabs 90202 and 90207 monitors were able to
      faithfully reflect directional hour-to-hour changes in intra-arterial blood
      pressure (chi 2 = 18.2 and chi 2 = 23.1 for systolic and diastolic blood
      pressures, respectively, p less than 0.01). No differences were found between the
      performance of the two Spacelabs devices. Thus, although the absolute accuracy of
      blood pressure values provided by these monitors in ambulatory subjects is still
      limited, they seem to be suitable for studies aimed at assessing 24-hour blood
      pressure profiles quantitatively as well as qualitatively.

PMID- 1639466
TI  - Adverse effect of the calcium channel blocker nitrendipine on nephrosclerosis in
      rats with renovascular hypertension.
AB  - The effect of a 6-week treatment with the calcium channel blocker nitrendipine or
      the angiotensin converting enzyme inhibitor enalapril on blood pressure,
      albuminuria, renal hemodynamics, and morphology of the nonclipped kidney was
      studied in rats with two-kidney, one clip renovascular hypertension. Six weeks
      after clipping of one renal artery, hypertensive rats (178 +/- 4 mm Hg) were
      randomly assigned to three groups: untreated hypertensive controls (n = 8),
      enalapril-treated (n = 8), or nitrendipine-treated (n = 10). Sham-operated rats
      served as normotensive controls (128 +/- 3 mm Hg, n = 8). After 6 weeks of
      treatment, renal hemodynamics (glomerular filtration rate and renal plasma flow)
      were measured in the anesthetized rats. Renal tissue was obtained for
      determination of glomerular size and sclerosis. Enalapril but not nitrendipine
      reduced blood pressure significantly. After 6 weeks of therapy, glomerular
      filtration rate was not different among the studied groups. Renal plasma flow
      increased, but albumin excretion and glomerulosclerosis did not change after
      enalapril treatment. In contrast, in the nitrendipine-treated group albuminuria
      increased from 12.8 +/- 2 progressively to 163 +/- 55 compared with 19.2 +/- 9
      mg/24 hr in the hypertensive controls. Furthermore, glomerulosclerosis index was
      significantly increased in the nitrendipine-treated group compared with the
      hypertensive controls (0.38 +/- 0.1 versus 0.13 +/- 0.04). In addition,
      glomerular size was higher in the nitrendipine-treated group (14.9 +/- 0.17 10(
      3) mm2) but lower in the enalapril-treated group (11.5 +/- 0.15 10(-3) mm2)
      compared with the hypertensive controls (12.1 +/- 0.17 10(-3) mm2).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1639467
TI  - Increase in erythrocyte disaggregation shear stress in hypertension.
AB  - The aggregation and disaggregation behaviors of red blood cells were investigated
      in 17 normotensive and 21 hypertensive subjects with a laser reflectometry
      technique, and simultaneous measurements were taken of blood viscosity with a
      coaxial viscometer. Increased red blood cell aggregation (26%, p less than 0.001)
      and disaggregation shear rate (20%, p less than 0.01) and shear stress (18%, p
      less than 0.01) were observed in hypertensive subjects when compared with
      normotensive subjects. Similar elevations in hypertensive subjects were found
      when the hematocrit was adjusted to 40%. Variation of red blood cell
      concentration caused the red blood cell disaggregation shear rate to change in an
      opposite direction but did not modify red blood cell aggregability and
      disaggregation shear stress. The increase of the reversible aggregation of red
      blood cells was associated with higher fibrinogen and plasma protein
      concentrations in hypertension. An increase in red blood cell aggregability and
      in the shear resistance of red blood cell aggregates may play a role in the
      development of the cardiovascular complication in hypertension. The
      quantification of red blood cell disaggregation shear stress, which represents
      the hydrodynamic force required to disperse the aggregates, may provide a useful
      parameter for clinical investigations.

PMID- 1639468
TI  - Hypertension, the endothelial cell, and the vascular complications of diabetes
      mellitus.
AB  - Hypertension is a major factor that contributes to the development of the
      vascular complications of diabetes mellitus, which primarily include
      atherosclerosis, nephropathy, and retinopathy. The mechanism of the
      pathophysiological effects of hypertension lies at the cellular level in the
      blood vessel wall, which intimately involves the function and interaction of the
      endothelial and vascular smooth muscle cells. Both hypertension and diabetes
      mellitus alter endothelial cell structure and function. In large and medium size
      vessels and in the kidney, endothelial dysfunction leads to enhanced growth and
      vasoconstriction of vascular smooth muscle cells and mesangial cells,
      respectively. These changes in the cells of smooth muscle lineage play a key role
      in the development of both atherosclerosis and glomerulosclerosis. In diabetic
      retinopathy, damage and altered growth of retinal capillary endothelial cells is
      the major pathophysiological insult leading to proliferative lesions of the
      retina. Thus, the endothelium emerges as a key target organ of damage in diabetes
      mellitus; this damage is enhanced in the presence of hypertension. An overall
      approach to the understanding and treatment of diabetes mellitus and its
      complications will be to elucidate the mechanisms of vascular disease and
      endothelial cell dysfunction that occur in the setting of hypertension and
      diabetes.

PMID- 1639469
TI  - Purification of a Trypanosoma cruzi trypomastigote 60-kilodalton surface
      glycoprotein that primes and activates murine lymphocytes.
AB  - We have purified a glycoprotein with a relative molecular mass of 60 kDa and
      present on the surface of Trypanosoma cruzi trypomastigotes and studied its
      ability to prime and stimulate the proliferation of murine spleen cells. T. cruzi
      trypomastigote membrane proteins were separated by preparative
      isoelectrofocusing. A trypomastigote 60-kDa surface protein with an isoelectric
      point of 4.2 was enriched by chromatofocusing and was readily purified in native
      form to homogeneity by gel filtration on a Superose column by use of a fast
      protein liquid chromatography system. Biotinylated wheat germ agglutinin, Ricinus
      communis agglutinin, and Datura stramonium agglutinin bound to blots containing
      the purified trypomastigote 60-kDa surface protein, indicating that this protein
      was glycosylated. The purified trypomastigote 60-kDa glycoprotein was recognized
      by antibodies produced during human infection, and immunoglobulin G against the
      purified glycoprotein immunoprecipitated a biotinylated 60-kDa molecule from the
      surface of trypomastigotes but not epimastigotes. Specific immunoglobulin G
      against the 60-kDa glycoprotein also increased the uptake of trypomastigotes and
      promoted parasite killing by macrophages. The purified 60-kDa glycoprotein was
      able to specifically activate primed lymphocytes, since there was a significant
      increase in [3H]thymidine incorporation by spleen cells obtained from CBA mice
      primed with this glycoprotein, with respect to control values. Furthermore, the
      60-kDa glycoprotein did not stimulate unprimed spleen cells, indicating that the
      lymphoproliferation induced by this glycoprotein was specific and was not due to
      polyclonal activation. Our findings indicate that this T. cruzi trypomastigote 60
      kDa surface glycoprotein primes and activates lymphocytes, which could lead to a
      beneficial immune response in the host.

PMID- 1639470
TI  - Evidence for B-lymphocyte mitogen activity in Borrelia burgdorferi-infected mice.
AB  - Borrelia burgdorferi produces a mitogen for murine B lymphocytes which can be
      measured in vitro by polyclonal stimulation of proliferation and immunoglobulin
      production (R. Schoenfeld, B. Araneo, Y. Ma, L. Yang, and J. J. Weis, Infect.
      Immun. 60:455-464, 1992). Sonicated B. burgdorferi cells also stimulated IL-6
      production by splenocyte cultures. We have used the murine model for Lyme disease
      described by Barthold et al. (S. W. Barthold, D. S. Beck, G. M. Hansen, G. A.
      Terwilliger, and K. D. Moody, J. Infect. Dis. 162:133-138, 1990) to determine
      whether the B. burgdorferi B-cell mitogen is expressed during active infection.
      To correlate arthritic changes with immune events, we have studied two strains of
      mice injected with B. burgdorferi; one of them, C3H/HeJ, developed severe
      disease, and the other, BALB/c, developed only mild disease. C3H/HeJ mice
      displayed a persistent 10-fold increase in circulating immunoglobulin G (IgG)
      levels, a 2-fold increase in IgM levels, and a 15-fold increase in peripheral
      lymph node B-cell numbers, providing evidence of mitogenic activity. Infected
      BALB/c mice also had evidence for mitogen activity, since the IgG level in serum
      increased three- to fourfold. The bulk of the increase in circulating IgG levels
      was not directed against B. burgdorferi antigens, supporting the occurrence of
      polyclonal B-cell activation. Analysis of IgG isotypes pointed out a contrast
      between C3H/HeJ and BALB/c mice in that levels of all isotypes were elevated
      somewhat in both strains of infected mice but IgG2a levels were much more
      dramatically increased in the C3H/HeJ mice (28-fold) than in the BALB/c mice (4
      fold). In this study, interleukin-6 levels were found to be persistently elevated
      in the serum of infected C3H/HeJ mice. Interestingly, interleukin-6 levels in
      serum were much lower in the infected BALB/c mice. These findings indicate that
      the B. burgdorferi mitogen is active in infected animals and may contribute to
      the inflammatory and immune response to infection.

PMID- 1639471
TI  - Preparation, characterization, and immunogenicity of conjugate vaccines directed
      against Actinobacillus pleuropneumoniae virulence determinants.
AB  - Conjugate vaccines were prepared in an attempt to protect pigs against swine
      pleuropneumonia induced by Actinobacillus pleuropneumoniae (SPAP). Two subunit
      conjugates were prepared by coupling the A. pleuropneumoniae 4074 serotype 1
      capsular polysaccharide (CP) to the hemolysin protein (HP) and the
      lipopolysaccharide (LPS) to the HP. Adipic acid dihydrazide was used as a spacer
      to facilitate the conjugation in a carbodiimide-mediated reaction. The CP and the
      LPS were found to be covalently coupled to the HP in the conjugates as determined
      by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and detergent gel
      chromatography analyses. Following a booster vaccination, pigs exhibited
      significantly high (P less than 0.05) immunoglobulin G antibodies against CP,
      LPS, and HP. The anti-CP and anti-LPS immunoglobulin G antibodies were found to
      function as opsonins in the phagocytosis of A. pleuropneumoniae by
      polymorphonuclear leukocytes, whereas antibodies to the HP neutralized the
      cytotoxic effect of the HP on polymorphonuclear leukocytes. No killing of A.
      pleuropneumoniae was observed when the effects of the antibodies were tested in
      the presence of complement. Thus, polysaccharide-protein A. pleuropneumoniae
      conjugates elicit significant antibody responses against each component of each
      conjugate, which could be instrumental in protecting swine against SPAP.

PMID- 1639472
TI  - Expression of interleukin-8 by lipopolysaccharide-stimulated bone marrow-derived
      mononuclear cells.
AB  - Interleukin-8 (IL-8) is a potent neutrophil chemoattractant, produced by a
      variety of immune and nonimmune cells in response to exogenous and host-derived
      inflammatory stimuli. We demonstrate here that a suspension of normal bone marrow
      mononuclear cells, consisting principally of myeloid precursors, produces IL-8 in
      response to stimulation with lipopolysaccharide (LPS). IL-8-specific mRNA is
      rapidly induced, being detected first 30 min after stimulation. IL-8 is detected
      by enzyme-linked immunosorbent assay within 2 h of stimulation, with steady a
      increase in its level through 72 h. Further studies demonstrated that LPS could
      serve as a primary stimulus for the expression of IL-8, since LPS challenge in
      the presence of cycloheximide resulted in superinduction of bone marrow
      mononuclear cell-derived IL-8 mRNA. These investigations suggest that the
      stimulatory effect of LPS is independent of other cytokines such as IL-1 beta.
      When compared with LPS, IL-1 beta proved to be a weak signal for the expression
      of IL-8 by bone marrow mononuclear cells. In a dose-response study, the maximum
      stimulatory concentration of IL-1 beta (300 pg/ml) resulted in the production of
      500 pg of IL-8 per 10(6) cells, whereas 1 microgram of LPS resulted in the
      production of 5.5 ng/10(6) cells. Although IL-1 beta was not a particularly
      potent stimulus for IL-8 production by bone marrow mononuclear cells, peripheral
      blood mononuclear cells were highly susceptible to IL-1 beta challenge. In
      addition, the potential dependence of LPS-induced marrow-derived IL-8 production
      on the intermediate synthesis of IL-1 beta was further investigated. Results of
      studies assessing kinetics, addition of cycloheximide, and blocking with IL-1
      beta neutralizing antibody were all consistent with the ability of LPS to
      directly induce bone marrow-derived IL-8 independently of IL-1 beta. These
      investigations demonstrate that bone marrow may be a significant source of IL-8
      and may play a significant role in acute infectious, inflammatory responses.

PMID- 1639473
TI  - Functional analysis of the Ca(2+)-regulated hemolysin I operon of Actinobacillus
      pleuropneumoniae serotype 1.
AB  - The genetic determinant encoding the synthesis and secretion of hemolysin I
      (HlyI; gene designation, hlyI) by Actinobacillus pleuropneumoniae serotype 1
      4074T was cloned in the lambda vector EMBL4. A 10.2-kb fragment that encoded
      hemolytic activity in the phage lysate was aligned by Southern blot hybridization
      to genes hlyC, hlyA, hlyB, and hlyD of the Escherichia coli hemolysin operon, and
      expression of the A. pleuropneumoniae genes in E. coli revealed that they have
      the same functions as their E. coli analogs: hlyIC encodes a protein that
      activates inactive 105-kDa prohemolysin I (encoded by hlyIA) to active hemolysin
      I, while hlyIB and hlyID are necessary for HlyIA secretion. Northern (RNA)
      hybridization of A. pleuropneumoniae RNA revealed that the gene cluster is
      transcribed as two RNA species, a major one of 3.5 kb, corresponding to hlyICA,
      and a second, minor one of 7.5 kb, corresponding to the whole operon, hlyICABD.
      The level of hlyI mRNA was substantially higher in A. pleuropneumoniae 4074T
      cells grown in the presence of Ca2+, supporting the view that the expression of
      the hlyI determinant is Ca2+ regulated. Parallel RNA hybridization with random
      gene probes suggested that this Ca2+ regulation is specific for the hlyI
      determinant.

PMID- 1639474
TI  - Identification of eNAP-1, an antimicrobial peptide from equine neutrophils.
AB  - Endogenous, cysteine-rich antimicrobial peptides known as defensins are prominent
      components of human, rabbit, and rat neutrophils, yet little is known about their
      occurrence in other mammalian species. Although we did not detect mature (i.e.,
      processed) defensins in equine neutrophil granules, we found that these granules
      contained small amounts of other cysteine-rich peptides with antimicrobial
      activity. One of these, eNAP-1, was purified by a combination of gel permeation
      and reversed-phase high-performance liquid chromatography from acid extracts
      prepared from the cytoplasmic granules of equine neutrophils. The molecular mass
      of eNAP-1 was approximately 7.2 kDa, as determined by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis analysis. Amino acid analysis revealed that
      eNAP-1 had an unusually high cysteine content and that it was relatively enriched
      in alanine, glycine, lysine, and proline residues. The partial (N-terminal) amino
      acid sequence of eNAP-1 was DVQCGEGHFCHDXQTCCRASQGGXACCPYSQGVCCADQRHCCPVGF.
      Thirty-six of these residues (78.3%) were identical to those of a recently cloned
      human neutrophil peptide of unknown function and belonging to the granulin
      family. Homologous peptides have also been noted in rat bone marrow cells and rat
      kidney epithelins. We tested the ability of eNAP-1 to kill several equine uterine
      pathogens. Streptococcus zooepidemicus was killed most effectively, sustaining a
      greater than 99.8% decrease in CFU per milliliter after a 2-h exposure to 100
      micrograms of eNAP-1 per ml (approximately 15 microM). Escherichia coli and
      Pseudomonas aeruginosa were somewhat less susceptible, manifesting 87.0 and 87.1%
      mean decreases in CFU per milliliter, respectively, after incubation for 2 h with
      200 micrograms of eNAP-1 per ml. Klebsiella pneumoniae numbers were not
      significantly reduced after exposure to eNAP-1. These antimicrobial properties
      suggest that eNAP-1 may contribute to phagocyte-mediated host defense against
      equine infections.

PMID- 1639475
TI  - A 66-kilodalton heat shock protein of Salmonella typhimurium is responsible for
      binding of the bacterium to intestinal mucus.
AB  - Salmonella typhimurium infections have increased during the last few years.
      However, the interplay of virulence factors in S. typhimurium pathogenesis is
      still poorly understood, particularly with regard to the mechanisms and
      components of the bacterium which are involved in its interaction with the
      intestinal mucus. We have observed that S. typhimurium is aggregated by
      incubation with colonic mucus (guinea pig model). To quantify this phenomenon, an
      aggregation assay was established. By using this assay, it was found that the
      aggregation profile of S. typhimurium strains freshly isolated from patients (age
      9 and older) with salmonellosis correlated with the severity of the disease. An
      isolate with high aggregation behavior was chosen for characterization of the
      bacterial component involved in binding to colonic mucus material. The component
      of S. typhimurium responsible for aggregation was purified and characterized as a
      66-kDa protein which was able to completely inhibit mucus-mediated bacterial
      aggregation. This protein was recognized by monoclonal antibodies against the 65
      kDa heat shock protein (HSP) of Mycobacterium leprae. The 66-kDa protein of S.
      typhimurium was inducible by incubating the bacteria at 50 degrees C and was
      secreted into the supernatant, from which it could be isolated in both dimeric
      and polymeric forms. The monoclonal anti-HSP 65, as well as a polyclonal antibody
      against the 66-kDa protein of S. typhimurium, caused dose-dependent inhibition of
      the aggregation of S. typhimurium by crude mucus preparations. This is the first
      report showing that a bacterial HSP is involved in mucus-mediated interaction of
      pathogens with the host.

PMID- 1639476
TI  - Presence of parasite antigen on the surface of P388D1 cells infected with
      Ehrlichia risticii.
AB  - Indirect immunofluorescence staining of macrophages infected with Ehrlichia
      risticii by anti-E. risticii serum revealed a punctate staining pattern on the
      surface of the host cell. This pattern was distinguishable by fluorescence
      microscopy from E. risticii bound to the surface of the macrophage and from
      intracellular E. risticii. The surface localization of ehrlichial antigen on
      infected macrophages was confirmed by electron microscopy with immunoferritin
      labeling. As the intracellular ehrlichial burden increased, the amount of
      ehrlichial antigen on the host cell surface increased. Prokaryotic protein
      synthesis was necessary for the maintenance of ehrlichial antigen on the host
      cell surface, as demonstrated by disappearance of the surface antigen following
      treatment with oxytetracycline. However, host cell protein synthesis was not
      required, as demonstrated by the continued presence of ehrlichial antigen on the
      surface of host cells after cycloheximide treatment. Pronase treatment abolished
      the ehrlichial antigen present on the cell surface, indicating that this antigen
      is a protein. Anti-E. risticii serum or immunoglobulin G-mediated antibody
      dependent cellular cytotoxicity of infected cells was demonstrated in a chromium
      release assay. These results imply that the parasite antigen on the host cell
      surface has a role in the pathogenesis of ehrlichiosis.

PMID- 1639477
TI  - Selection of an escape variant of Borrelia burgdorferi by use of bactericidal
      monoclonal antibodies to OspB.
AB  - Two immunoglobulin G (IgG) monoclonal antibodies (MAbs) to outer surface protein
      B (CB2 and CB6), affinity purified from mouse ascitic fluid, exhibited
      concentration-dependent inhibitory and bactericidal properties against Borrelia
      burgdorferi after a 24-h incubation period in spirochete medium. Fab fragments
      derived from these MAbs showed the same effects, indicating that they were not
      caused by agglutination of the organisms by the intact MAbs. The inhibition of
      spirochete growth in cultures containing MAbs was also detected by
      spectrophotometric analysis of the media. CB2 did not inhibit the growth of
      Borrelia hermsii or the BEP4 strain of B. burgdorferi, neither of which is
      recognized by the MAb. Affinity-purified IgG from hybridoma supernatants had
      similar effects on B. burgdorferi as the ascitic-fluid-derived IgG did,
      indicating that the inhibitory and bactericidal properties were not due to
      nonspecific toxic contaminants. The bactericidal properties of the MAbs were not
      complement dependent as there was none in the serum-free system. Sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis analysis of B. burgdorferi organisms
      surviving after exposure to CB2 revealed an escape variant which failed to
      express OspB. The continued presence of OspA in these escape variants indicates
      that the lack of OspB was not due to the loss of the plasmid which contains the
      genes for both of these proteins.

PMID- 1639478
TI  - hsp70 synthesis in Schwann cells in response to heat shock and infection with
      Mycobacterium leprae.
AB  - Induction of heat shock protein synthesis was monitored in murine and monkey
      Schwann cells exposed to elevated temperatures. Synthesis of the stress-inducible
      70-kDa heat shock protein (hsp70) was detected in both murine and primate Schwann
      cells by metabolic labelling and by immunoblotting with a specific monoclonal
      antibody. hsp70 synthesis was also induced in Schwann cells after infection with
      Mycobacterium leprae and was detected from 24 h to 1 week postinfection. These
      results are discussed with respect to the possible role of heat shock proteins in
      immunopathological events associated with the clinical manifestations of leprosy.

PMID- 1639479
TI  - A 16-kilodalton lipoprotein of the outer membrane of Serpulina (Treponema)
      hyodysenteriae.
AB  - Serpulina (Treponema) hyodysenteriae P18A and VS1 were extracted by using the
      detergent Triton X-114 and separated into detergent and aqueous phases. Sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis and Western immunoblot
      analysis confirmed that a membrane-associated 16-kDa antigen was hydrophobic,
      since it was found in the detergent phase. A 45-kDa antigen partitioned into the
      aqueous phase, suggesting that it was hydrophilic and may be of periplasmic
      origin. When spirochetes were grown in the presence of [3H]palmitic acid, a
      predominant 16-kDa antigen was labeled; from the results of immunoprecipitation
      experiments, this antigen appeared to be the same as that recognized by both
      polyclonal and monoclonal antisera to a previously described 16-kDa antigen. This
      antigen was proteinase K sensitive and was not a component of the
      lipopolysaccharide, which, although [3H]palmitate labeled, was resistant to
      proteinase K digestion. The most probable explanation is that the 16-kDa antigen
      is a membrane-associated, surface-exposed, immunodominant lipoprotein.

PMID- 1639480
TI  - Comparison of susceptibility of inbred and outbred infant mice to Escherichia
      coli heat-stable enterotoxin STa.
AB  - Comparison of the susceptibility of outbred OF1 and inbred BALB/c, C57BL/6,
      DBA/2, and CBA mice to heat-stable toxin (STa) of enterotoxigenic Escherichia
      coli was made at different levels of induced secretion. STa was able to elicit
      fluid accumulation into the intestine of each strain of mice; however,
      quantitatively different results were obtained. Results were as usual expressed
      by gut weight/remaining body weight ratios. Fluid accumulation weight and fluid
      accumulation weight/remaining body weight ratios were also estimated. Values
      obtained for BALB/c and OF1 mice were never significantly different, but values
      for OF1 mice were significantly higher than those for DBA and C57BL/6 mice at the
      highest concentrations of toxin (toxin dilutions of 1/2, 1/4, and 1/5). At the
      highest toxin concentration, gut weight/remaining body weight ratio in C57BL/6
      mice was significantly lower than that for every other strain, but the fluid
      accumulation value obtained for DBA mice did not differ from that for C57BL/6
      mice. Fluid accumulation values for DBA mice were also significantly lower at
      toxin dilutions of 1/5 and 1/8 than those for every other strain, and this was
      also the case when estimating the fluid accumulation weight/remaining body weight
      ratio at a dilution of 1/8. Although the intestine of each strain of mice was
      able to respond to STa by fluid accumulation, differences in susceptibility of
      the STa receptor could exist and make DBA mice more resistant to enterotoxigenic
      E. coli diarrhea.

PMID- 1639481
TI  - Kinetic analysis of the amplification phase for activation and binding of C3 to
      encapsulated and nonencapsulated Cryptococcus neoformans.
AB  - Encapsulated and nonencapsulated cryptococci exhibit quantitative and qualitative
      differences in their activation of the complement system. We examined the
      kinetics for the rapid amplification phase in which C3 was activated and bound to
      encapsulated cryptococci, nonencapsulated cryptococci, and zymosan particles.
      Yeast cells were incubated in normal human serum containing 125I-labeled C3, and
      bound C3 fragments were measured after 1 to 64 min of incubation. A kinetic
      analysis showed that the apparent first-order rate constant (k') for binding of
      C3 to nonencapsulated cryptococci did not differ significantly from k' for
      binding of C3 to zymosan particles (P greater than 0.05). However, the rate
      constant for binding of C3 to encapsulated cryptococci was significantly (P less
      than 0.001) greater than k' for binding of C3 to nonencapsulated cryptococci and
      zymosan particles. A plot of C3 molecules bound to encapsulated cryptococci
      versus time cubed was nearly linear, suggesting that accumulation of C3 in the
      cryptococcal capsule follows the kinetics predicted by an expanding sphere. In
      contrast, the plot of C3 molecules bound to nonencapsulated cryptococci or
      zymosan particles against time was nearly linear, but those plots against time
      squared or time cubed were not. This result indicates that the rate-limiting step
      for the addition of C3 fragments to these latter yeast cells follows the kinetics
      of neither the perimeter of an expanding circle nor the surface of an expanding
      sphere. Taken together, the results indicate that the high rate of accumulation
      of C3 in the cryptococcal capsule is consistent with the expected geometry of an
      expanding sphere of bound C3 within the three-dimensional matrix of the capsule.

PMID- 1639482
TI  - Mechanism of stimulation of T cells by Streptococcus pyogenes: isolation of a
      major mitogenic factor, cytoplasmic membrane-associated protein.
AB  - Our previous studies established that heat-killed Streptococcus pyogenes, as well
      as other gram-positive cocci, when incubated with human peripheral blood
      leukocytes (PBLs) in culture, induced polyclonal activation of T lymphocytes. The
      activated T lymphocytes included CD4+ CD8- helper T cells and CD3+ and CD4- CD8-
      double-negative T cells with gamma delta T-cell receptors. In the present study,
      we isolated a major factor with this unique mitogenic activity against human T
      lymphocytes from S. pyogenes. This active fraction was found in the cytoplasmic
      membrane (CM) of the heat-killed organisms but not in other cellular fractions
      such as cell walls, peptidoglycan, lipoteichoic acids, or cytoplasmic soluble
      fractions. An active molecule(s) was further isolated from the CM by cholic acid
      extraction followed by Sephacryl S-200 chromatography. The molecule was protease
      labile but highly resistant to heat, had a pI of greater than or equal to 9.3 and
      a molecular weight of 10,000 to 15,000 according to gel filtration experiments,
      and was termed CM-associated protein. Sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis of the protein purified by anion-exchange chromatography showed a
      single band with a molecular weight of 15,000, corresponding to mitogenically
      active regions. Purified CM-associated protein induced activation of T
      lymphocytes, which consisted of CD4+ CD8- T cells and CD4- CD8- double-negative T
      cell receptor gamma/delta + T-cell populations, as did the whole cells of S.
      pyogenes.

PMID- 1639483
TI  - Monoclonal antibodies specific for elongation factor Tu and complete nucleotide
      sequence of the tuf gene in Mycobacterium tuberculosis.
AB  - Monoclonal antibodies against mycobacterial antigens were produced by immunizing
      LOU/C rats with live Mycobacterium bovis BCG. The antibodies were characterized
      by an enzyme-linked immunosorbent assay and by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis followed by Western blotting (immunoblotting).
      One antibody, MAMB 2, reactive with a 47-kDa protein was used to screen a lambda
      gt11 M. tuberculosis gene library (R. A. Young, B. R. Bloom, C. M. Grosskinsky,
      J. Ivanji, D. Thomas, and R. W. Davis, Proc. Natl. Acad. Sci. USA 82:2583-2587,
      1985). Three recombinant phages reactive with MAMB 2 in plaque lysates were
      isolated, and part of the insert was sequenced. The mycobacterial inserts were
      all expressed as proteins fused with beta-galactosidase when the phages were
      induced as lysogens in Escherichia coli. The entire M. tuberculosis tuf gene was
      obtained by screening the lambda gt11 library with a DNA probe specific for the
      primary clones. A phage isolated from this screening was able to express the
      native protein in E. coli when introduced as a lysogen. A comparison of the
      entire gene sequence and the deduced protein sequence with the EMBL DNA and Swiss
      Prot protein data libraries revealed strong homologies with elongation factors of
      bacteria, yeast mitochondria, and a plant chloroplast.

PMID- 1639484
TI  - Antibody responses to the chlamydial heat shock proteins hsp60 and hsp70 are H-2
      linked.
AB  - The effects of both H-2 and non-H-2 genes on antibody responses to two Chlamydia
      trachomatis heat shock proteins (hsp60 and hsp70) were investigated. These
      chlamydial proteins are homologs of Escherichia coli GroEL (hsp60) and DnaK
      (hsp70) and are highly sequence conserved between bacterial and mammalian
      sources. Antibody responses among 17 different strains of mice immunized with C.
      trachomatis serovar B and serovar C elementary bodies were evaluated by
      immunoblot, radioimmunoprecipitation and enzyme-linked immunosorbent assay.
      Antibody responses to the two proteins displayed host genetic restriction. Of six
      distinctive H-2 haplotypes, only H-2d generated high antibody responses to hsp70.
      Five of the six H-2 haplotypes, i.e., H-2a, H-2d, H-2k, H-2q, and H-2s, produced
      high antibody responses to hsp60. Only the H-2b-bearing strain had low antibody
      responses to hsp60. By using congenic and H-2 recombinant strains, the genes
      responsible for regulating antibody responses to hsp70 and hsp60 were mapped to
      the K-IA region of the H-2 locus. In F1 hybrid crosses between high and low
      responders, high responses to hsp60 and hsp70 were dominant traits. Other genes
      outside the H-2 locus also influenced antibody responses to hsp60 and hsp70,
      since inbred strains of identical H-2 but different background genes displayed
      variable antibody responses to the proteins. The genetic control of murine immune
      responses to C. trachomatis hsp60, a putative chlamydial immunopathologic
      antigen, suggests that a similar genetic mechanism may also exist in humans, and
      this observation may help to explain the observed variability in the spectrum of
      chlamydial diseases seen in humans.

PMID- 1639485
TI  - Induction of inflammatory mediator release (serotonin and 12
      hydroxyeicosatetraenoic acid) from human platelets by Pseudomonas aeruginosa
      glycolipid.
AB  - Purified glycolipid from Pseudomonas aeruginosa induced the generation of
      significant amounts of 12-hydroxyeicosatetraenoic acid (12-HETE) and serotonin
      release from human platelets. The release of serotonin was first observed 2 min
      after addition of the glycolipid and increased with time. Significant serotonin
      release was obtained at glycolipid concentrations above 5 micrograms/ml and
      increased dose-dependently up to 100% at glycolipid concentrations above 40
      micrograms/ml. Glycolipid induced 12-HETE in a time- and dose-dependent manner.
      12-HETE formation was first measured after 10 min of incubation and increased
      with time. Optimal 12-HETE formation was obtained at a glycolipid concentration
      of 50 micrograms/ml; higher concentrations of glycolipid led to a decrease in 12
      HETE formation, indicating a cytotoxic effect. Stimulation of platelets with
      glycolipid (12-HETE formation and serotonin release) was accompanied by calcium
      influx, translocation of protein kinase C, activation of guanylylimidodiphosphate
      binding, and increased GTPase activity in platelet membranes within the same
      concentration range.

PMID- 1639486
TI  - Construction of a multivalent meningococcal vaccine strain based on the class 1
      outer membrane protein.
AB  - Outer membrane complexes (OMCs) are promising vaccine candidates for protection
      against meningococcal disease. However, a major obstacle to this approach is the
      fact that the protective antibodies induced are generally type specific. In an
      attempt to overcome this problem, we have investigated the possibility of
      constructing a multivalent vaccine strain by insertion of an additional class 1
      outer membrane protein-encoding gene. Starting with a derivative of strain H44/76
      deficient in class 3 outer membrane protein, a second class 1 gene was inserted
      into the chromosome, through homologous recombination with a suicide plasmid
      carrying the class 1 gene from strain 2996 placed within a class 5 gene. In this
      way, a strain was obtained in which a class 3 protein was in effect replaced by a
      class 1 protein from another subtype, i.e. P1.5,2 in addition to the P1.7,16
      protein of H44/76. Immunization of mice with such OMCs resulted in high
      bactericidal titers against both H44/76 and 2996, where normally only strain
      specific antibodies are induced. Mutational removal of class 3 protein from the
      immunizing OMCs had no detectable effect on the bactericidal titer against
      H44/76, whereas removal of class 1 protein led to a strong reduction. These
      results demonstrate the dominant role of the subtype-specific sequences of class
      1 protein in the induction of bactericidal antibodies and show that construction
      of a multivalent OMC-based vaccine should be feasible.

PMID- 1639488
TI  - Modulation of tumor necrosis factor production by macrophages in Entamoeba
      histolytica infection.
AB  - The macrophage-derived mediator tumor necrosis factor alpha (TNF) is a cytokine
      with pleiotropic effects. TNF exhibits potent immunologic and inflammatory
      properties in parasitic diseases. The present study examined the production of
      TNF by macrophages isolated from gerbils infected with Entamoeba histolytica and
      by naive macrophages in response to amoebae in vitro. Amoebic liver abscess
      derived macrophages produced low constitutive basal levels of TNF; in response to
      lipopolysaccharide (LPS) stimulation, TNF production was enhanced by 14-, 11-,
      and 6-fold at 10, 20, and 30 days postinfection, respectively. Amoebic liver
      abscess-derived macrophages pretreated with either recombinant gamma interferon
      (IFN-gamma) or the cyclooxygenase inhibitor indomethacin augmented TNF production
      in response to soluble amoebic proteins and LPS. Kupffer cells and peritoneal and
      spleen macrophages from infected animals did not release TNF constitutively in
      vitro. However, TNF production in response to LPS stimulation was significantly
      higher at 10 and 20 days postinfection. Macrophages from infected and naive
      animals pretreated with recombinant IFN-gamma or indomethacin produced increased
      amounts of TNF in response to LPS but not in response to soluble amoebic protein
      stimulation. Pretreatment of naive macrophages with amoebic proteins inhibited
      LPS-induced TNF production by 69 to 79%; the effect of the amoebic proteins was
      partially reversed by indomethacin pretreatment. In contrast, IFN-gamma- and LPS
      activated naive macrophages produced enhanced levels of TNF in response to live
      amoebae and soluble amoebic proteins. Our results demonstrate that TNF production
      by macrophages is altered during E. histolytica infection and in response to
      amoebae and suggest a role for IFN-gamma and prostaglandin E2 in regulating TNF
      production during the infection.

PMID- 1639487
TI  - Induction of tumor necrosis factor (TNF) and interleukin-1 (IL-1) by Pseudomonas
      aeruginosa and exotoxin A-induced suppression of lymphoproliferation and TNF,
      lymphotoxin, gamma interferon, and IL-1 production in human leukocytes.
AB  - Pseudomonas aeruginosa is a dominant pathogen in infection in cystic fibrosis.
      This bacterium is thought to play a major role in the chronic bronchial infection
      induced pathophysiology. Our data showed that whole formalin-fixed heat-killed P.
      aeruginosa was mitogenic for human lymphocytes and induced production of
      substantial amounts of tumor necrosis factor alpha (TNF) in peripheral blood
      mononuclear leukocytes in cultures. Significant amounts of TNF were produced at
      10(3) bacteria per 2 x 10(5) mononuclear leukocytes. Treatment of P. aeruginosa
      with polymixin B did not affect its ability to stimulate TNF production,
      suggesting that bacterial lipopolysaccharide is not involved. P. aeruginosa,
      however, did not stimulate production of the T-cell lymphokine lymphotoxin (TNF
      beta). Exotoxin A, considered to be an important virulence factor produced by P.
      aeruginosa, did not stimulate either lymphoproliferation or production of TNF. In
      fact, this toxin, at nontoxic concentrations, was found to depress
      lymphoproliferation induced by phytohemagglutinin and Staphylococcus aureus and
      decreased production of TNF, lymphotoxin, and gamma interferon in either
      lymphocytes or macrophages. This toxin similarly inhibited the production of
      interleukin-1 beta (IL-1 beta) and IL-1 alpha, but for the inhibition of the
      latter, 25-fold-less toxin was required than for inhibition of the former.
      Inhibition of production of TNF was as sensitive as the IL-1 alpha to exotoxin A.
      The effects of exotoxin A on lymphoproliferation and cytokine production could be
      neutralized by the addition of anti-exotoxin A antibodies. These results suggest
      that two mechanisms by which P. aeruginosa could contribute to the chronic
      bronchial infection-induced pathophysiology are the nonspecific stimulation of
      TNF and IL-1 and the release of exotoxin A, a toxin which depresses immune
      responses.

PMID- 1639489
TI  - Adhesion of Salmonella typhimurium to porcine intestinal epithelial surfaces:
      identification and characterization of two phenotypes.
AB  - Salmonella typhimurium 798 is known to persistently colonize swine. A key step
      required to initiate colonization of intestines is adhesion of the organism to
      the intestinal epithelium. However, S. typhimurium 798 initially failed to attach
      to porcine enterocytes in vitro. An enrichment procedure was used to select
      adhesive S. typhimurium, and when cells of one colony type were grown in tryptone
      phosphate broth they were adhesive. Cells from a colony with a different
      morphology were not adhesive. Adhesion was time dependent, with maximal adhesion
      occurring at 1 h. As determined by electron microscopy, cells of the adhesive
      phenotype had pili while none of the cells with the nonadhesive phenotype
      produced pili. The pili on the adhesive cells were morphologically similar to
      type 1 pili. Mannose (0.5%) did not affect adhesion, suggesting that the adhesin
      on strain 798 did not recognize mannose as a receptor. An analysis of envelope
      proteins from cells of both phenotypes showed that the adhesive-phenotype cells
      expressed at least 10 unique proteins ranging in size from 20 to 60 kDa. Absorbed
      antiserum against cells of the adhesive phenotype agglutinated adhesive cells and
      was used to detect unique surface antigens on the cells of the adhesive phenotype
      by Western blots (immunoblots). These antigens were in the range of 30 kDa in
      size. An envelope extract competitively inhibited the binding of S. typhimurium
      to enterocytes, as did Fab fragments prepared from the absorbed serum. Cells of
      both phenotypes contained two plasmids, and each had identical restriction
      digestion patterns. Cells of the adhesive phenotype consistently were found to be
      more readily phagocytosed by pig leukocytes, and once in the phagocytes they
      survived better than cells of the nonadhesive phenotype.

PMID- 1639490
TI  - Synthesis, characterization, and some immunological properties of conjugates
      composed of the detoxified lipopolysaccharide of Vibrio cholerae O1 serotype
      Inaba bound to cholera toxin.
AB  - Protection against cholera has been correlated with the level of serum
      vibriocidal antibodies. The specificity of these vibriocidal antibodies was
      mostly to the lipopolysaccharide (LPS). We synthesized conjugates of detoxified
      LPS with cholera toxin (CT) and other proteins in order to elicit serum LPS
      antibodies with vibriocidal activity. Treatment with hydrazine (deacylated LPS)
      reduced the endotoxic properties of the LPS to clinically acceptable levels and
      resulted in a molecule larger and more antigenic than the saccharide produced by
      acid hydrolysis. More immunogenic conjugates resulted from multipoint compared
      with single-point attachment of the deacylated LPS to the protein. The conjugates
      containing CT had low levels of pyrogen and no toxic activity upon Chinese
      hamster ovary cells and elicited booster responses of vibriocidal and CT
      antibodies when injected subcutaneously as saline solutions into mice; the
      vibriocidal titers were similar to those elicited by comparable doses of cellular
      vaccines. We suggest how serum vibriocidal antibodies might prevent cholera.

PMID- 1639491
TI  - Utilization of fractionated soluble egg antigens reveals selectively modulated
      granulomatous and lymphokine responses during murine schistosomiasis mansoni.
AB  - Worm eggs deposited in the livers and intestines of Schistosoma mansoni-infected
      mice secrete soluble egg antigens (SEA) and induce T cell-mediated circumoval
      granulomas. In the present study, we fractionated crude SEA by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis and tested the fractions for granuloma
      elicitation and lymphokine production at different stages of the infection. SEA
      fraction-coupled beads were used to elicit artificial pulmonary granulomas.
      Acutely infected mice responded with granulomas to seven fractions (less than 21
      , 25- to 30-, 32- to 38-, 60- to 66-, 70- to 90-, 93- to 125-, and greater than
      200-kDa fractions) of SEA, whereas chronically infected mice responded to four
      fractions (60- to 66-, 70- to 90-, 93- to 125-, and greater than 200-kDa
      fractions). In response to both crude and fractionated SEA, granuloma T cells
      produced high levels of gamma interferon at the preacute (6-week) stage of
      infection, but production subsequently diminished. Interleukin-2 (IL-2) and IL-4
      production peaked at the acute (8-week) stage of infection and concurrently
      decreased at the chronic (20-week) stage. At the acute stage of the infection,
      the granulomagenic SEA fractions also elicited IL-2 and IL-4 production; at the
      chronic stage, IL-2 production and, to a lesser degree, IL-4 production
      corresponded to SEA fractions that elicited granulomas. Isolated SEA proteins
      from the 32- to 38-kDa fraction demonstrated differential lymphokine responses:
      predominant gamma interferon and IL-2 production was elicited by the 32-kDa
      fraction, whereas the 35- and 38-kDa proteins elicited predominant gamma
      interferon and IL-4 production. However, all three proteins elicited granuloma
      formation. The present study reveals changes in granulomatous responses to SEA
      fractions during the acute and chronic stages of the infection as well as
      distinct phases of gamma interferon, IL-2, and IL-4 lymphokine production
      throughout the infection. Based on these results, it is concluded that granuloma
      formation and IL-2 and IL-4 production are interrelated.

PMID- 1639492
TI  - Effect of passive immunization with purified specific or cross-reacting
      immunoglobulin G antibodies against Treponema pallidum on the course of infection
      in guinea pigs.
AB  - Whole immune serum or highly purified immunoglobulin G (IgG) antibodies to
      Treponema pallidum exhaustively adsorbed with three strains of nonpathogenic
      treponemes (TPI-IgG) were used for passive immunization of inbred strain 2 guinea
      pigs before and after intradermal challenge with 3.4 x 10(7) virulent T. pallidum
      Nichols organisms. Before challenge, control animals received a similarly
      purified IgG fraction containing either a cocktail of antibodies against three
      nonpathogenic treponemes (NPTI-IgG) or IgG prepared from normal guinea pig serum
      (NGPS-IgG). The purified fractions contained both IgG1 and IgG2 isotypes. The
      antibody levels (detected by fluorescent treponemal antibody test and enzyme
      linked immunosorbent assay) and molecular specificities (immunoblot) of sera
      obtained from recipient animals before infection reflected those of the purified
      fractions used for immunization. Three protocols of passive immunization were
      used. Whole immune serum containing specific and cross-reacting antibodies
      afforded better protection than TPI-IgG even though asymptomatic animals were not
      fully protected. A single intradermal injection (0.1 ml) of TPI-IgG or NPTI-IgG
      into one hind leg 22 h before infection at the same site provided relatively
      higher protection than multiple intravenous injections (total, 15 ml) of the
      respective individual preparations. Since purified NGPS-IgG injected in the same
      animals, into the opposite hind leg, failed to protect against the challenging
      infection, it is reasonable to assume that specific and cross-reacting
      antitreponemal antibodies of the IgG1 subclass, which in guinea pigs are
      homocytotropic, play a relevant role in local protection.

PMID- 1639493
TI  - Hemolytic activity of Borrelia burgdorferi.
AB  - Zones of beta-hemolysis occurred around colonies of Borrelia burgdorferi grown on
      Barbour-Stoenner-Kelly medium containing agarose and horse blood. Blood plates
      were inoculated with either the infective strain Sh-2-82 or noninfective strain B
      31 in an overlay and incubated in a candle jar. Both strains of B. burgdorferi
      displayed beta-hemolysis after 1 to 2 weeks of incubation. The hemolytic activity
      diffused out from the borrelial colonies, eventually resulting in lysis of the
      entire blood plate. Hemolysis was most pronounced with horse blood and was less
      intense with bovine, sheep, and rabbit blood. Hemolysis was enhanced by hot-cold
      incubation, which is typical of phospholipase-like activities in other bacteria.
      Further characterization of the borrelial hemolysin by using a spectrophotometric
      assay revealed its presence in the supernatant fluids of stationary-phase
      cultures. Detection of the borrelial hemolytic activity was dependent on
      activation of the hemolysin by the reducing agent cysteine. This study provides
      the first evidence of hemolytic activity associated with B. burgdorferi.

PMID- 1639494
TI  - Characterization of two genes encoding distinct transferrin-binding proteins in
      different Actinobacillus pleuropneumoniae isolates.
AB  - The gene encoding the Actinobacillus pleuropneumoniae serotype 1 transferrin
      binding protein (tfbA) was cloned, and the carboxy-terminal 70% of the protein
      was expressed as an aggregate protein in Escherichia coli. The nucleotide
      sequences of the tfbA genes from A. pleuropneumoniae serotypes 7 (G.-F. Gerlach,
      C. Anderson, A. A. Potter, S. Klashinsky, and P. J. Willson, Infect. Immun.
      60:892-898, 1992) and 1 were determined, and a comparison revealed that they had
      65% sequence identity. The deduced amino acid sequences showed a sequence
      agreement of 55%, and both proteins possessed a lipoprotein-like signal sequence.
      The serotype 1 TfbA protein had a predicted molecular mass of 65 kDa, compared
      with 60 kDa for the serotype 7 TfbA protein, and both proteins were
      immunologically distinct as assessed in a competitive enzyme-linked immunosorbent
      assay. Southern hybridization and Western blot (immunoblot) analysis of the 13 A.
      pleuropneumoniae type strains revealed that serotypes 2, 3, 4, 8, 9, 10, and 11
      encode and express a TfbA protein highly homologous to that of A.
      pleuropneumoniae serotype 7 whereas the TfbA proteins and the encoding genes of
      serotypes 6 and 12 were highly homologous to that found in A. pleuropneumoniae
      serotype 1. The tfbA genes of A. pleuropneumoniae serotypes 5A and 5B were
      recognized, under medium-stringency hybridization conditions, by the A.
      pleuropneumoniae serotype 1-derived tfbA probe, and the respective proteins were
      weakly reactive with the antibody raised against the A. pleuropneumoniae serotype
      7 TfbA protein.

PMID- 1639495
TI  - Site-specific growth of Nocardia asteroides in the murine brain.
AB  - The growth of Nocardia asteroides GUH-2 and two mutants (NG-49 and I-38-syn) in
      regions of the brains of BALB/c mice was determined by microdissection and viable
      counting. GUH-2 grew throughout the murine brain but at different growth rates
      that depended on the specific location. The rate of increase in total CFU per
      brain during GUH-2 infection was unaffected by the inoculum size; however, in
      five of eight brain regions, an alteration in the inoculum size resulted in
      altered nocardial growth rates. Mutant NG-49 showed a significantly slower rate
      of increase in total CFU per brain than did the parental strain, GUH-2, and
      significantly decreased growth rates in seven brain regions. Mutant I-38-syn
      showed a rate of increase in total CFU per brain similar to that of the parental
      strain; however, this mutant grew significantly faster in the cerebellum and pons
      medulla. Growth appeared to be a necessary precursor to the cellular damage that
      resulted in the variety of neurological disorders observed in mice infected with
      N. asteroides GUH-2, because mutant NG-49 exhibited a decreased ability to grow
      in specific regions of the brain and did not induce signs of neurological damage.
      In contrast, mutant I-38-syn induced neurological signs in a larger percentage of
      the infected animals than did parental strain GUH-2 and grew better in certain
      regions of the brain than did the parental strain. Furthermore, there appeared to
      be a relationship between the growth of N. asteroides in the substantia nigra and
      the induction of an L-dopa-responsive head shake that was observed in some of the
      mice following a sublethal intravenous injection of N. asteroides GUH-2.

PMID- 1639496
TI  - mxiA of Shigella flexneri 2a, which facilitates export of invasion plasmid
      antigens, encodes a homolog of the low-calcium-response protein, LcrD, of
      Yersinia pestis.
AB  - The plasmid-encoded invasion plasmid antigen (Ipa) export accessory locus of
      Shigella flexneri 2a, mxiA, was cloned, and the complete DNA sequence of the gene
      was determined. The mixA open reading frame was found to encode a polypeptide of
      74.03 kDa with a pI of 5.02. A hydropathy analysis of the predicted protein
      revealed a hydrophilic C terminus and an extremely hydrophobic N terminus without
      a cleavable signal sequence but with several potential membrane-spanning regions.
      While a homology search did not reveal any significant relatedness of the mxiA
      DNA sequence to any known bacterial gene sequences, the derived amino acid
      sequence of MxiA was found to be highly homologous (68%) to the sequence of the
      protein encoded by the low-calcium-response locus, lcrD, of Yersinia pestis. The
      lcrD encodes an inner membrane regulatory protein that has an N-terminal membrane
      anchor and that is implicated in facilitating the export of Y. pestis outer
      membrane proteins (G. V. Plano, S. S. Barve, and S. C. Straley, J. Bacteriol.
      173:7293-7303, 1991). Congo red binding, HeLa cell invasion, and Ipa excretion
      were restored in two avirulent mxiA fusion mutants when they were transformed
      with a cloned copy of the mxiA gene. Furthermore, the expression of the cloned
      mxiA gene was independent of any vector-specified promoter, suggesting that the
      transcription of mxiA is driven by its own promoter in this clone. In contrast,
      the overexpression of mxiA that resulted when it was placed under the control of
      the lac promoter was found to be deleterious in Escherichia coli. We conclude
      that mxiA is a homolog of the Y. pestis lcrD locus and may function similarly in
      S. flexneri, either by directly affecting the excretion of virulence factors or
      by regulating the expression of export accessory genes.

PMID- 1639497
TI  - Membrane translocation of diphtheria toxin carrying passenger protein domains.
AB  - For diphtheria toxin to be cytotoxic, the enzymatically active part (fragment A)
      must be translocated to the cytosol. We here demonstrate that additional proteins
      linked as N-terminal extensions can be translocated along with fragment A across
      the plasma membrane of toxin-sensitive cells. Thus, an extra fragment A of
      diphtheria toxin and some of apolipoprotein AI were translocated as passenger
      proteins along with mutant diphtheria toxin fragment A. Translocation was
      monitored by the cytotoxic effect of the additional fragment A as well as by the
      translocation of [35S]methionine-labelled protein to a compartment protected from
      externally added pronase. Cytotoxicity experiments indicated that double A
      fragments can also be translocated across the membrane of intracellular vesicles.
      The results demonstrate that the translocation apparatus used for toxin
      translocation is not limited to a single A fragment but can accommodate
      additional proteins as well. The fact that proteins as large as 20 kDa can be
      brought into cells by way of diphtheria toxin under both in vitro and in vivo
      conditions opens up the possibility of using diphtheria toxin mutants for
      introducing molecules with biological activity into cells.

PMID- 1639498
TI  - Biological activity of synthetic phosphonooxyethyl analogs of lipid A and lipid A
      partial structures.
AB  - We investigated the biological activity of four new synthetic analogs of lipid A,
      termed PE-1, PE-2, PE-3, and PE-4. All compounds contain an alpha-oxyethyl-linked
      (-O-CH2-CH2-) phosphoryl group in position 1 of the reducing glucosaminyl residue
      (GlcN I) of lipid A. PE-1 is a hexaacylated analog of Escherichia coli lipid A
      (compound 506). PE-2 differs from PE-1 in carrying two myristic acid residues at
      GlcN I. PE-3 has the same acylation pattern as PE-2, but GlcN I is present in the
      beta anomeric form. Finally, PE-4 represents an analog of tetraacyl precursor Ia
      (compound 406). Structure-activity relationships of these compounds were
      determined by measuring their capacity to induce tumor necrosis factor alpha,
      interleukin 1, and interleukin 6 release by human mononuclear cells and to cause
      mitogenicity of murine spleen cells. The results show that replacement of the
      glycosidic phosphoryl residue by a phosphonooxyethyl group had no substantial
      effect on the biological activity of compounds. However, the anomeric
      configuration of GlcN I was found to be of great biological relevance, as, in
      general, the alpha anomer (PE-2) expressed high activity, and the beta anomer (PE
      3) expressed low mediator-inducing and mitogenic activity. The absence of the 3
      hydroxyl groups within the acyl residues at GlcN I in PE-2 was found to only
      slightly affect the induction of monokines in human mononuclear cells compared
      with that of PE-1 or lipid A (506). These stable 1-phosphonooxyethyl analogs of
      lipid A may be candidates in the development of immunomodulators for the
      treatment of systemic endotoxicosis.

PMID- 1639499
TI  - Localization of the tube precipitin and complement fixation antigens of
      Coccidioides immitis by immunoelectron microscopy with murine monoclonal
      antibodies.
AB  - The cellular localization of the tube precipitin (TP) and complement fixation
      (CF) antigens of Coccidioides immitis was examined by immunoelectron microscopy
      with murine immunoglobulin G1 monoclonal antibodies directed against the TP and
      CF antigens, respectively. Immunoelectron microscopic analyses of saprobic- and
      parasitic-phase cells showed that the TP antigen is present at a high
      concentration within the inner cell wall layer and along the plasma membrane. The
      antigen was also detected, at a lesser concentration, within cytoplasmic
      vacuoles. In contrast to the predominant localization of the TP antigen in the
      cell walls, the CF antigen residues primarily within the cytoplasm, where it
      appears to be dispersed throughout the cytoplasm rather than associated with a
      specific cytoplasmic organelle. A sparse amount of the CF antigen within the
      inner cell walls was also demonstrable. The localization of the TP and CF
      antigens throughout the morphogenetic phases of C. immitis has important
      implications in antigen production and in analyses of host response in
      coccidioidomycosis.

PMID- 1639500
TI  - Immune responses to Cryptosporidium muris and Cryptosporidium parvum in adult
      immunocompetent or immunocompromised (nude and SCID) mice.
AB  - Adult murine models of Cryptosporidium infection involving Cryptosporidium muris
      and C. parvum were used to study immunity to cryptosporidiosis in the mammalian
      host. Immunocompetent BALB/c or C57BL/6 mice developed a highly patent infection
      with the RN 66 strain of C. muris but overcame the infection and were immune to
      reinfection. In contrast, severe combined immunodeficiency (SCID) mice or nude
      mice had a chronic infection lasting at least 109 days. The development of the C.
      muris infection appeared to be confined to the gastric epithelium in
      immunocompetent and immunocompromised mice. SCID mice injected intraperitoneally
      with histocompatible spleen or mesenteric lymph node cells from uninfected BALB/c
      mice were able to recover from the C. muris infection. The protective effect of
      donor spleen cells was not reduced by depletion of the B cell population but was
      significantly reduced by depletion of Thy.1 cells. Treatment of C57BL/6 or BALB/c
      mice during infection with a gamma interferon-neutralizing monoclonal antibody,
      but not a tumor necrosis factor-neutralizing monoclonal antibody, resulted in a
      significant increase in oocyst production. In the C. parvum model, a severe and
      eventually fatal chronic infection with a cervine isolate was established in SCID
      mice, with parasitization occurring in the ileum, cecum, and colon. SCID mice
      injected with unprimed BALB/c spleen cells prior to inoculation of C. parvum
      oocysts were resistant to infection. These results suggested that the two animal
      models should be valuable in the study of immunity to cryptosporidial infection.

PMID- 1639502
TI  - A novel murine model of disseminated trichosporonosis.
AB  - Serious infections caused by Trichosporon beigelii have been noted with
      increasing frequency in immuno-compromised patients. Progress in understanding
      the pathogenesis of this emerging infection has been limited by the lack of an
      animal model. We developed a CF1 mouse intravenous inoculation model of
      disseminated trichosporonosis to evaluate the pathogenicity of T. beigelii in
      transiently immunosuppressed mice. Four inocula (1 x 10(6), 1 x 10(7), 2 x 10(7),
      and 4 x 10(7) CFU per animal) of one clinical strain of T. beigelii 3001 were
      tested. Mice in groups of 10 were each injected with a single intravenous dose of
      one inoculum. Mortality correlated with inoculum size, as survival time was
      significantly shorter in mice injected with 4 x 10(7) or 2 x 10(7) CFU than in
      mice that received 1 x 10(7) or 1 x 10(6) CFU (P less than 0.01). Necrotizing
      abscesses with conidial and hyphal elements and neutrophil and macrophage
      infiltration were observed in all major organs examined. Resistance to infection
      was markedly lowered by immunosuppression with either cyclophosphamide or
      cortisone acetate, with a significantly shorter survival time and a greater
      fungal burden per organ in immunosuppressed animals than in normal animals (P
      less than 0.01). Nine additional strains were inoculated intravenously with
      around 5 x 10(6) CFU. Injection of each of these strains caused 100% mortality,
      in a pattern similar to that observed with strain 3001.

PMID- 1639501
TI  - Characterization of antibody-mediated inhibition of Pseudomonas aeruginosa
      adhesion to epithelial cells.
AB  - An enzyme-linked immunosorbent assay system was developed and used to study
      adhesion of Pseudomonas aeruginosa to human epithelial cells and the abilities of
      specific antibodies to inhibit this process. Human buccal epithelial cells coated
      onto microtiter plates were incubated with P. aeruginosa suspensions, and
      adherent bacteria were detected by using anti-P. aeruginosa serum and a
      horseradish peroxidase-conjugated secondary antiserum. Adhesion, quantitated as
      an increase in A405, varied linearly with increasing numbers of bacterial CFU
      added per well in the range of 10(5) to 10(8) CFU per well. Adhesion of P.
      aeruginosa increased following trypsinization of buccal epithelial cells.
      Preincubation of bacteria with monoclonal antibodies directed against P.
      aeruginosa outer membrane protein H2 inhibited adhesion with all eight of the
      isolates tested. Preincubation of P. aeruginosa with sera from infected cystic
      fibrosis patients also resulted in inhibition of adhesion in the enzyme-linked
      immunosorbent assay system. This inhibitory activity was shown to be due to two
      factors: P. aeruginosa-specific immunoglobulin G and a non-immunoglobulin G serum
      component. These data support the hypothesis that bacterial components other than
      pili are involved in adhesion and suggest that anti-P. aeruginosa antibodies may
      be of use in preventing adhesion and subsequent colonization with P. aeruginosa.

PMID- 1639503
TI  - Construction of stable LamB-Shiga toxin B subunit hybrids: analysis of expression
      in Salmonella typhimurium aroA strains and stimulation of B subunit-specific
      mucosal and serum antibody responses.
AB  - The complete Shiga toxin B subunit and two N-terminal segments of the B subunit
      have been inserted into a cell surface exposed loop of the LamB protein, and
      expression of the hybrid proteins from three different promoter systems, i.e.,
      (i) an in vitro-inducible tac promoter that provides high-level expression, (ii)
      the iron-regulated aerobactin promoter presumably induced in vivo under the iron
      limiting conditions of the intestinal mucosal environment, and (iii) a synthetic,
      modified beta-lactamase promoter providing moderate level constitutive
      expression, has been analyzed in Escherichia coli, Salmonella typhimurium, and
      attenuated antigen carrier strains of S. typhimurium (aroA mutants). The hybrid
      vaccine strains were used to immunize mice by the oral and intraperitoneal
      routes. S. typhimurium aroA mutants apparently have a membrane export defect
      which prevents the transport of LamB and its derivatives across the cytoplasmic
      membrane. High-level expression of hybrid proteins through use of the tac
      promoter proved deleterious to the vaccine strains and prevented the production
      of viable cells at reasonable cell densities. The lower levels of gene expression
      observed with the beta-lactamase and aerobactin promoters did not have this
      effect. Immunization of mice with S. typhimurium aroA strains carrying the hybrid
      genes expressed from these two promoters resulted in significant B subunit
      specific mucosal and serum antibody responses. This suggests that such expression
      systems may be useful when incorporated into candidate antidysentery live oral
      vaccines for inducing protection against the effect of Shiga toxin in infections
      caused by Shigella dysenteriae 1 and other Shiga toxin-or Shiga-like toxin
      producing pathogens.

PMID- 1639504
TI  - Treponema denticola induces actin rearrangement and detachment of human gingival
      fibroblasts.
AB  - Spirochetes are associated with destructive periodontal diseases, and one
      cultivatable oral species, Treponema denticola, binds to mammalian cells and
      perturbs metabolism. To evaluate the cytoskeletal responses and attachment
      functions of human gingival fibroblasts (HGF) exposed to T. denticola, monolayers
      of HGF were incubated with T. denticola strains ATCC 35405, e, and e' in serum
      free medium. HGF retracted pseudopods, rounded up, and ultimately detached from
      the substratum. Scanning electron microscopy showed spirochetes in close contact
      with HGF surfaces; occasionally, bacteria were partially submerged between folds
      in the HGF membrane. Blebbing and numerous microvilli formed on the cell surface
      as the HGF retracted. By confocal microscopy, spirochetes were detected in
      contact with the HGF surface but were never found on the ventral surface of
      fibroblasts between the substratum and cell. Morphological alterations were
      associated with and preceded by actin assembly, as measured by microscopic
      fluorimetry: there was a 263% increase in actin fluorescence over controls within
      30 min. Detachment of fibroblasts from the substratum was related to incubation
      time and was dependent on the concentration of T. denticola. Detachment was
      observed for all strains tested and was also dependent on the viability of T.
      denticola: UV light, heat, and metronidazole treatment markedly reduced the HGF
      detachment response. Detachment was also significantly reduced by the protease
      inhibitor phenylmethylsulfonyl fluoride. HGF viability was not significantly
      affected by coincubation with spirochetes, as measured by lactate dehydrogenase
      release. Thus, T. denticola induces rapid cytoskeletal remodelling followed by
      cell detachment, which might be stimulated by a bacterially associated protease
      but is not likely directly mediated by proteolytic degradation at the cell
      substratum adhesive contact points.

PMID- 1639505
TI  - Replicon typing of virulence plasmids of enterotoxigenic Escherichia coli
      isolates from cattle.
AB  - Plasmid DNA hybridization with probes for virulence factors used for basic
      replicons of plasmids was used to identify the virulence plasmids of a collection
      of enterotoxigenic Escherichia coli isolates from cattle. The virulence probes
      were derived from the genes coding for the heat-stable enterotoxin STaP and for
      the F5 (K99) and F41 fimbrial adhesins. The replicon probes were derived from 16
      different basic replicons of plasmids (probes repFIA, repFIB, repFIC, repFIIA,
      repI1, repHI1, repHI2, repL/M, repN, repP, repQ, repT, repU, repW, repX, and
      repY). The virulence genes coding for the STaP enterotoxin and for the F5 adhesin
      were located on a single plasmid band in each isolate. The sizes of most of these
      virulence plasmids were from 65 to 95 MDa. The F41 probe failed to hybridize with
      any plasmid band. The virulence plasmids had multireplicon types typical of
      plasmids of the IncF groups. The most common basic replicon association was the
      triple RepFIA-RepFIB-RepFIC family association.

PMID- 1639506
TI  - Glucose and nonmaintained pH decrease expression of the accessory gene regulator
      (agr) in Staphylococcus aureus.
AB  - The effect of glucose on accessory gene regulator (agr) expression in
      Staphylococcus aureus was examined. agr is a global regulator that affects the
      expression of numerous genes, including those for some factors implicated in
      virulence, such as toxic shock syndrome toxin 1, alpha-hemolysin, and protein A.
      The agr locus determines two divergent transcripts, designated RNAII and RNAIII.
      RNAII contains four open reading frames (agrABCD), and RNAIII encodes delta
      hemolysin. The mechanisms responsible for agr-mediated regulation are not well
      understood, but it appears that the RNAIII transcript plays a central role in the
      regulation of a number of target genes, including those for alpha-hemolysin
      (hla), beta-hemolysin (hlb), protein A (spa), and staphylococcal enterotoxin B
      (seb+). In this study, S. aureus cultures were grown either in a shake flask
      system with a complex medium or in a fermentor system with a completely defined
      medium in which the pH and glucose concentration were maintained. Northern (RNA)
      blot analysis revealed that a dramatic reduction in agr expression was apparent
      only when the cultures contained glucose and when the pH was 5.5 or was not
      maintained. The effect of glucose on two agr target genes, sec+ and hla, was also
      studied. Glucose-containing cultures produced less sec+ and hla mRNAs at
      maintained pH (6.5). In addition, the glucose effect on sec+ and hla was enhanced
      under conditions that inhibited agr expression (i.e., pH 5.5 or a nonmaintained
      pH).

PMID- 1639507
TI  - T-cell-mediated cytotoxicity against Mycobacterium antigen-pulsed autologous
      macrophages in leprosy patients.
AB  - The involvement of CD4+ T lymphocytes in the defense mechanisms against
      intracellular pathogens is widely recognized. Little information is available on
      the generation and specificity of the cytotoxic cells that eliminate human
      monocytes/macrophages infected with mycobacteria. In this work, we tested whether
      mononuclear cells from leprosy patients could generate cytotoxic T-cell activity
      against autologous macrophages pulsed with Mycobacterium leprae or purified
      protein derivative (PPD) in a 4-h 51Cr release assay. Peripheral blood
      mononuclear cells from normal Mycobacterium bovis BCG-immunized controls or from
      leprosy patients stimulated with antigen for 7 days were used as effector cells.
      Paucibacillary (PB) patients and normal controls yielded more active effector
      cells in this system than multibacillary (MB) patients. MB patients were able to
      develop cytotoxicity against M. leprae, BCG, or PPD, in contrast with the
      immunological anergy widely described. We did not find cytotoxicity against
      unpulsed macrophages. Cross-reactivity was observed between PPD, BCG, and M.
      leprae. Only antigen-pulsed autologous macrophages were suitable as target cells.
      M. leprae-induced cytotoxic cells were found in both CD4+ CD8- and CD4- CD8+ T
      cell subsets, whereas CD4+ cells were the main component of PPD-induced
      cytotoxicity. In MB patients, BCG-induced cytotoxic cells were better killers of
      M. leprae-pulsed macrophages than cells induced by M. leprae. This is an
      interesting finding in view of the ongoing vaccination trials. The involvement of
      CD4- or CD8-mediated cytotoxicity may be important in the balance between
      protection and tissue or nerve damage.

PMID- 1639509
TI  - Antibodies to lipooligosaccharide of a Brazilian purpuric fever isolate of
      Haemophilus influenzae biogroup aegyptius lack bactericidal and protective
      activity.
AB  - The immunological basis for protection against Brazilian purpuric fever (BPF), a
      fulminant infection of young children associated with bacteremia with Haemophilus
      influenzae biogroup aegyptius, is unknown. Candidate antigens to which protective
      antibodies may be directed include cell surface proteins and lipooligosaccharide
      (LOS). We studied the activity of antisera to LOS purified from a BPF H.
      influenzae biogroup aegyptius isolate. Anti-LOS antisera contained anti-LOS
      antibody by enzyme immunoassay and immunoblot and no detectable anti-outer
      membrane protein antibodies by immunoblot. Anti-LOS antisera had minimal
      bactericidal activity and were not protective against the homologous strain in an
      infant rat model of bacteremia. Antiserum to whole bacterial cells had a titer of
      anti-LOS antibody similar to that of anti-LOS antisera and was bactericidal and
      protective. Removal of anti-LOS antibodies from anti-whole cell antiserum by
      affinity chromatography did not result in a loss of bactericidal activity. Serum
      from a normal adult contained anti-LOS antibodies and had bactericidal activity.
      However, anti-LOS antibodies purified from this serum did not have detectable
      bactericidal activity. These studies suggest that anti-LOS antibodies produced in
      rats are not bactericidal and do not contribute to protection against
      experimental bacteremia with BPF strains of H. influenzae biogroup aegyptius.

PMID- 1639508
TI  - Adoptively transferred anti-idiotype pulsed B cells mediate autoimmune
      myocarditis.
AB  - Syngeneic mice receiving adoptively transferred enriched B cells or splenocytes
      pulsed in vitro with polyclonal anti-idiotypic antibodies (anti-Ids) against anti
      CVB3 virus antibodies developed coxsackievirus B3 antigen-binding and virus
      neutralizing antibodies during a 30-day period, in addition to overt expression
      of autoimmune myocarditis. Adoptive transfer of anti-Id pulsed T cells resulted
      in delayed appearance and transient expression of antiviral antibodies, and
      antiviral antibodies were marginal to absent in syngeneic animals receiving anti
      Id pulsed macrophage populations. Proliferation analysis of recipient splenocytes
      indicated lack of proliferative capacity in response to monoclonal or polyclonal
      anti-Ids and only marginal proliferative capacity in response to coxsackievirus
      B3 virus antigen(s). In vitro assessment of delayed hypersensitivity in recipient
      animals demonstrated some specific immunity to anti-Ids in recipients receiving
      splenocytes or T cells. Anti-Ids expressing mimicry for heart-associated and/or
      viral antigen(s) interacting with B cells or other accessory cells suggest an
      autoantibody or anti-Id triggering of B-cell-mediated mechanisms involved in the
      development of myocarditis.

PMID- 1639511
TI  - An enhanced murine model for studies of Serpulina (Treponema) hyodysenteriae
      pathogenesis.
AB  - A defined diet was used to increase the susceptibility of mice to Serpulina
      hyodysenteriae. BALB/cByJ, C3H/HeN, and C3H/HeJ mice, when fed the defined diet 7
      to 14 days prior to and throughout the challenge period, consistently showed
      higher incidences of disease than mice maintained on normal rodent chow. The use
      of this defined diet will increase the consistency of in vivo studies following
      infection with S. hyodysenteriae in the mouse model.

PMID- 1639510
TI  - Characterization of the humoral response induced by a peptide corresponding to
      variable domain IV of the major outer membrane protein of Chlamydia trachomatis
      serovar E.
AB  - A 30-amino-acid peptide corresponding to variable domain IV (VD IV) of the major
      outer membrane protein of Chlamydia trachomatis serovar E was conjugated to
      keyhole limpet hemocyanin (KLH) and used to immunize mice. The resulting antisera
      (anti-KLH-VD IV sera) recognized all 15 serovars of C. trachomatis when assayed
      by indirect immunofluorescence and Western blotting. Probing of overlapping
      hexameric peptides representing VD IV with mouse anti-KLH-VD IV sera revealed
      that two main regions of the peptide were recognized by the antisera, the N
      terminus of the peptide, which contains B-complex-specific epitopes, and the
      middle region of the peptide, which contains a species-conserved domain. When
      used in an in vitro neutralization assay, these antisera were able to neutralize
      mainly serovars in the B complex. These data provide evidence that a linear
      peptide corresponding to VD IV can induce in vitro protection from C. trachomatis
      infectivity that is subspecies specific.

PMID- 1639512
TI  - Cross-reactivity of polyclonal serum antibodies generated against Cryptosporidium
      parvum oocysts.
AB  - Polyclonal antibodies raised against Cryptosporidium parvum oocysts were found to
      cross-react with Eimeria spp. oocyst antigens in an indirect immunofluorescence
      assay, and sera from Eimeria spp.-infected lambs reacted with some antigens from
      sonicated C. parvum oocysts (between 29 to 30 and 66 to 69 kDa) by Western blot
      (immunoblot). No cross-reaction was observed with cystozoites of Toxoplasma and
      Sarcocystis spp. These results show the existence of epitopes common to C. parvum
      and various Eimeria spp.

PMID- 1639513
TI  - Mouse neutrophils lack defensins.
AB  - Defensins are broad-spectrum antimicrobial peptides that are abundant in human,
      rat, and rabbit neutrophils. We now report that neutrophils from nine strains of
      mice lacked appreciable defensin content. Mice may therefore be imperfect
      experimental surrogates for humans or rats in models of infection in which
      neutrophil function is significant.

PMID- 1639514
TI  - Elevated body temperature restricts growth of Haemophilus influenzae type b
      during experimental meningitis.
AB  - Elevation of the environmental temperature appeared to counteract the temperature
      depressing effects of urethane anesthetic and allowed rabbits intracisternally
      infected with Haemophilus influenzae type b to mimic the development of a fever
      following infection. Elevated core body temperature (greater than 39 degrees C)
      was associated with an inhibition of the growth of H. influenzae in cerebrospinal
      fluid (CSF) during the first 12 h postinfection, whereas bacterial growth was
      essentially unrestricted in rabbits with reduced (approximately 37 degrees C)
      body temperature. Bacterial densities 24 h postinfection were different,
      hyperthermic animals having log 6.0 +/- 0.4 CFU/ml of CSF and hypothermic rabbits
      having log 8.2 +/- 0.8 CFU/ml of CSF (P less than 0.05, Wilcoxon rank sum test).
      However, the growth of this bacterium in vitro, in either pooled rabbit CSF or
      brain heart infusion broth, was not inhibited at 39 degrees C. These results
      suggest that elevated body temperature associated with the development of fever
      during meningitis may be associated with restriction of the growth of H.
      influenzae in vivo but that this effect is apparently not due to an innate
      inability of the bacterium to grow at elevated temperatures.

PMID- 1639515
TI  - Infection of macrophages with Legionella pneumophila induces phosphorylation of a
      76-kilodalton protein.
AB  - Infection of peritoneal macrophages from susceptible A/J mice with Legionella
      pneumophila induced phosphorylation of a 76-kDa protein. The phosphorylation
      occurred when macrophages were infected with a virulent strain of L. pneumophila
      but did not occur when they were infected with an avirulent strain or with other
      bacteria such as either Pseudomonas aeruginosa or Salmonella typhimurium. Also,
      no phosphorylation of this protein was observed when macrophages were stimulated
      with either lipopolysaccharide or phorbol myristate acetate. However,
      phosphorylation did occur in macrophages infected with a virulent strain of L.
      pneumophila and treated with either erythromycin to inhibit growth or with
      cytochalasin D to inhibit uptake of L. pneumophila by macrophages. These results
      support the view that phosphorylation of this protein occurs during the early
      phases of interaction between L. pneumophila and macrophages. The role of this
      specific protein in the recognition, intracellular uptake, and growth of L.
      pneumophila in permissive macrophages remains to be clarified.

PMID- 1639516
TI  - Staphylococcal toxic shock syndrome toxin 1-induced tumor necrosis factor alpha
      and interleukin-1 beta secretion by human peripheral blood monocytes and T
      lymphocytes is differentially suppressed by protein kinase inhibitors.
AB  - The signal transduction pathways by which staphylococcal toxic shock syndrome
      toxin 1 (TSST-1) induces tumor necrosis factor alpha (TNF-alpha) and interleukin
      1 beta (IL-1 beta) secretion were examined with various protein kinase
      inhibitors. TNF-alpha secretion by normal human monocytes and T cells in response
      to TSST-1 was suppressed by inhibitors of protein kinase C (H7) and tyrosine
      kinases (genistein). In contrast, the secretion of IL-1 beta was blocked by a
      cyclic AMP- and cyclic GMP-dependent kinase inhibitor (HA1004) as well as by H7
      and genistein. These results suggest that the secretion of TNF-alpha and IL-1
      beta may be differentially regulated by TSST-1 and that protein kinases play an
      important role in mediating cytokine responses to the toxin.

PMID- 1639517
TI  - Acanthamoebae bind to glycolipids of rabbit corneal epithelium.
AB  - By use of a thin-layer chromatogram (TLC) overlay procedure, 35S-labeled
      acanthamoebae were shown to bind to seven glycolipids of rabbit corneal
      epithelium. Corneal epithelial cells were grown in culture and were subjected to
      Folch extraction to isolate a chloroform-rich lower phase containing neutral
      glycosphingolipids (NGSL) and an aqueous upper phase containing gangliosides,
      i.e., sialic acid-containing glycolipids. Thin-layer chromatography of the upper
      phase revealed the presence of 10 ganglioside components. Acanthamoebae were
      shown to bind to four of these components, referred to as 2, 3, 6, and 7. On TLC
      plates, ganglioside components 2 and 3 migrated slightly ahead of the glycolipid
      standard GD1a, component 7 comigrated with standard GM3, and component 6 migrated
      a little more slowly than GM3. Likewise, of the 10 NGSL known to be present in
      the lower phase, acanthamoebae bound to components 1, 5, and 6. NGSL components
      1, 5, and 6 migrated on TLC plates with relative mobilities similar to those of
      standards asialo GM1, asialo GM2, and ceramidetrihexoside, respectively. We
      propose that one or more of the Acanthamoeba-reactive glycolipids of corneal
      epithelium identified in this study may play a role in the pathogenesis of
      Acanthamoeba keratitis by mediating the adherence of the parasites to the cornea.

PMID- 1639519
TI  - Purification and immunological studies of the cross-reaction between the 65
      kilodalton gonococcal parietal lectin and an antigen common to a wide range of
      bacteria.
AB  - The 65-kDa gonococcal parietal lectin (GPL) has been purified and found to have a
      lectinlike activity exhibiting both structural and immunological similarities to
      the common antigen family. Ultrastructural localization of GPL was done by using
      anti-GPL monoclonal antibodies: GPL is a major component of the outer membrane
      and is also present in blebs formed by gonococci.

PMID- 1639518
TI  - Frequent loss of Shiga-like toxin genes in clinical isolates of Escherichia coli
      upon subcultivation.
AB  - Forty-five consecutive patients with various gastrointestinal disorders were
      identified as having Shiga-like toxin (SLT)-producing Escherichia coli
      infections. This was shown by the cytotoxic effect of stool extracts in Vero cell
      cultures which was neutralizable by antibodies to SLTs and by isolation of E.
      coli that hybridized with DNA probes complementary to SLT-I and SLT-II sequences.
      When we tested the same strains for SLT genes after subcultivation, the isolates
      from 15 patients became negative by colony hybridization and polymerase chain
      reaction and failed to produce SLTs. The instability of SLT genes warrants direct
      screening methods for clinical material and the development of new culture
      methods to prevent the loss of SLT genes.

PMID- 1639520
TI  - Serotype diversity and antigen variation among invasive isolates of Ureaplasma
      urealyticum from neonates.
AB  - Ureaplasma urealyticum has previously been isolated from the cultured
      cerebrospinal fluid of 13 of 418 newborn infants; additional bloodstream isolates
      were obtained from the same population. Ten of the 13 cerebrospinal fluid and 3
      bloodstream isolates were available for serotyping in the present study. By the
      use of serotype-specific reagents, including monoclonal antibodies, 70% of the
      cerebrospinal fluid isolates were identifiable as serotype 1, 3, 6, 8, or 10;
      i.e., they represented 5 of the 14 established serotypes or both presently
      defined genomic clusters. One of the bloodstream isolates was identified as
      serotype 3. Our data support the hypothesis that the property of invasiveness for
      unreaplasmas is likely not limited to one or a few particular serotypes among the
      14 established serovars. Additionally, our study has shown that even in isolates
      of the same serotype, there can be size variation in the antigens expressed.
      Therefore, it would appear that many serotypes are invasive and that perhaps
      antigen variability and host factors may be more important determinants for
      ureaplasma infections than different serotypes per se.

PMID- 1639522
TI  - Blood flow outside regularly spaced hollow fibers: the future concept of membrane
      devices?

PMID- 1639521
TI  - Is atherogenesis accelerated in hemodialysis patients.

PMID- 1639523
TI  - Characterisation and evaluation of a new double lumen central venous catheter.
AB  - The performance of a new double lumen central venous haemodialysis catheter was
      tested in two laboratory models. In a bench model the patient's venous system was
      simulated by a reservoir from which water or glycerol was drawn through a fixed
      tube. A double lumen silastic catheter was then inserted into the tube, as it
      would in a major vein, with the tip directed away from the direction of flow. The
      catheter was linked to a dialysis circuit incorporating pressure sensors and dye
      was infused at constant rate so that recirculation at the tip could be measured
      and found to be less than 5%. The same catheters were inserted operatively into
      the superior vena cava via the external jugular vein of three pigs (weight 27-31
      kg). The catheters remained patent for four weeks and when connected to an
      extracorporeal circuit had recirculation and pressure flow characteristics
      comparable to the bench model in the range 50-400 ml/min. The new double lumen
      catheter is worthy of clinical evaluation.

PMID- 1639524
TI  - A new central supply system as alternative source for bicarbonate dialysate.
AB  - Bicarbonate dialysis is mandatory for high efficiency treatment. In most cases
      bicarbonate is delivered either as prepacked powder or as a stable liquid
      concentrate in 6-10 I plastic containers. With a newly designed central supply
      system (CSS) using 800 I tanks of custom-made sterile and pyrogen free
      concentrates, we investigated the risk of bacterial contamination of dialysate in
      a 30-bed dialysis unit. During three months, samples of reverse osmosis (RO)
      water, concentrates and dialysate were taken every two weeks. Colony forming
      units (CFU) were counted after 48 h incubation. Further samples were taken during
      nine months of continuous use of the CSS without further intermittent
      disinfection. None of the samples had greater than 10/ml CFU. Pseudomonas,
      corynebacteria and enterobacter were the predominant species. In summary, this
      CSS proved reliable in providing bacteriologically safe bicarbonate dialysate as
      defined by international standards (CFU less than 200/ml). It significantly
      reduces costs, workload and environmental pollution by plastic waste.

PMID- 1639525
TI  - Correlation of blood pressure in end-stage renal disease with platelet cytosolic
      free calcium concentration during treatment of renal anemia with recombinant
      human erythropoietin.
AB  - The hemodynamic hallmark of hypertension complicating the treatment of renal
      anemia with recombinant human erythropoietin (rHu-EPO) is increased total
      peripheral vascular resistance, but the mechanisms underlying the arteriolar
      vasoconstriction are still an enigma. We studied body fluid volumes, plasma renin
      activity, plasma norepinephrine, and calcium metabolism in platelets in 40
      previously normotensive hemodialysis patients before and after 12 weeks of rHu
      EPO treatment. Partial correction of anemia caused a rise in arterial pressure
      (94 +/- 6 mmHg vs 124 +/- 7 mmHg, p less than 0.05) and in platelet cytosolic
      calcium concentration (113 +/- 5 nM vs 171 +/- 18 nM, p less than 0.05) in eight
      patients. Hypertensive patients had significantly higher plasma noradrenaline
      concentrations, but they did not differ significantly in body fluid volumes and
      plasma renin activities. There was a close correlation between free calcium
      concentration in platelets and mean arterial pressure in patients developing rHu
      EPO-induced-hypertension (r = 0.95). Short-term antihypertensive treatment
      resulted in a reduction of free calcium concentrations in platelets and a
      concomitant fall in blood pressure. The main results of the present studies
      suggest that rHu-EPO-induced hypertension might be associated with altered
      cellular calcium homeostasis and hyperactivity of the sympathetic nervous system.
      If rHu-EPO therapy induces alterations of pressor factors or the hormone itself
      raises the cytosolic calcium not only in platelets but also in vascular smooth
      muscle cells, altered cellular calcium influx may contribute to the arteriolar
      vasoconstriction.

PMID- 1639526
TI  - Hemodynamic and cardiac effects of erythropoietin in patients on regular
      dialysis.
AB  - The long-term impact of erythropoietin (EPO) treatment on cardiac structures and
      function was prospectively studied in eight hypertensive (Group I) and seven
      normotensive (Group II) patients on hemodialysis (HD). Doppler-echocardiograms
      were done before EPO and at two and twelve months of treatment. Mean hemoglobin
      (+/- SD) before EPO was 6.4 +/- 0.9; it rose significantly up to two months and
      then remained constant. At two months, cardiac index (CI) had significantly
      decreased, while peripheral vascular resistances increased. Five patients
      required increased antihypertensive drug treatment. No changes were seen in
      myocardial parameters at this short follow-up. After one year, left ventricular
      mass index (LVMi) decreased (p less than 0.05) in both groups concomitantly with
      a decrease in diastolic diameter and septum and posterior wall thicknesses. Basal
      LVMi was higher in Group I than in Group II, and after one year the regression
      was more marked in Group II. Left cardiac work showed prompt and steady
      improvement in both groups. Maintained partial correction of anemia with EPO
      during one year was associated with a return to normal of high CI, decreased left
      cardiac work and impressive regression of left ventricular hypertrophy.

PMID- 1639527
TI  - An equation for calculating postdialysis plasma sodium.
AB  - Well defined dry weight is a must for adequate UF control during haemodialysis
      (HD). However, interdialytic weight gain (delta BW) must not be excessive. delta
      BW is closely related to interdialytic thirst which in turn is strongly
      influenced by post-dialysis plasma sodium (CPNa post), but little is known about
      the desired CPNa post. The points below serve as a basis for establishing this
      value. a) Thirst is mediated by osmoreceptors. b) A strong correlation has been
      found between delta BW and intradialytic increase in plasma sodium but no such
      correlation exists with the interdialytic increase in plasma urea. This indicates
      that fluid intake between dialyses depends solely on electrolytes. c) Pre
      dialysis plasma sodium in an individual is stable, indicating that the patient is
      at his "set value" of electrolyte osmolality. d) Half of the potassium removed
      during HD comes from the extra- and half from the intracellular space. Assuming
      that it is desirable not to disturb a patient's pre-dialysis osmotic steady
      state, it can be calculated that the desired CPNa post should be higher than the
      pre-dialysis value by half of the intradialytic plasma potassium drop, i.e.,
      approx. CPNa post = CPNa pre + 1 to 2 mmol/l.

PMID- 1639528
TI  - Dynamic catheterography in the early diagnosis of peritoneal catheter
      malfunction.
AB  - The dynamic catheterography is an image technique that allows to study the
      peritoneal solution inflow and outflow phases in case of catheter malfunction.
      The examination is carried out in three subsequent steps: 1) direct examination
      without contrast media in order to define the position of the catheter inside the
      abdomen; 2) low speed catheterography by normal injection of 10 ml of
      hydrosoluble contrast medium to verify the patency of the cannula; 3) high speed
      catheterography by 30 ml hydrosoluble dye injected with an automateds high
      pressure system to study the inflow phase, the fluid distribution in the
      peritoneal cavity and the patency of the catheter holes. Different radiographic
      patterns can be found: dislocation of the catheter tip, KinKing, one way
      obstruction, inner lumen obstruction. The procedure is simple, safe and reliable
      for a correct diagnosis and for the choice of a successful therapeutic approach
      to peritoneal catheter malfunction.

PMID- 1639529
TI  - Blood coagulation, fibrinolytic and inhibitory profiles in renal transplant
      recipients: comparison of cyclosporine and azathioprine.
AB  - Renal transplant recipients treated with cyclosporine (CS) have been reported to
      be at increased risk of thrombotic complications. The present study was intended
      to examine the blood coagulation, fibrinolytic, and inhibitory systems in such
      patients. Eight transplant recipients on maintenance immunosuppression with CS
      and prednisone were studied. Five transplant recipients maintained on
      azathioprine (AZA) and prednisone and 32 normal volunteers served as controls.
      Plasma antigen concentrations and/or activities of various proteins in the above
      pathways were measured. Both the CS and AZA groups exhibited significant
      elevations of factor IX activity, von Willebrand factor (vWF), D-dimer, protein C
      and tissue type plasminogen activator (t-PA) levels when compared with the normal
      controls. In addition, CS group showed a significant elevation of alpha 2
      macroglobulin activity and AZA group showed a significant reduction in factor XII
      activity when compared with the normal controls. Comparison of data from CS and
      AZA groups revealed higher factor XII activity and vWF concentration in the
      former group. In conclusion, transplant recipients treated with long-term
      cyclosporine and prednisone exhibited significant elevation of plasma vWF, D
      dimer and protein C concentrations. In addition, both CS and AZA-treated
      transplant recipients showed increased plasma concentrations of D-dimer and t-PA.
      The latter observations suggest in vivo thrombin generation, fibrin formation and
      degradation.

PMID- 1639530
TI  - Formation of thrombin-antithrombin III complex using polyamide and hemophan
      dialyzers.
AB  - The recently developed ELISA for the thrombin-antithrombin III complex (TAT) is a
      sensitive, specific, and simplified means of detecting intravascular coagulation.
      For further evaluation of the thrombogenicity of a polyamide (P) and a Hemophan
      (H) hollow-fibre dialyzer a cross-over study was done in ten stable patients on
      maintenance hemodialysis. At the same doses of heparin (mean bolus of 30 U/kg bw
      and maintenance doses of 86 U/kg bw), thrombin time and partial thromboplastin
      time were significantly lower using H. At the end of dialysis TAT was
      significantly higher in H (mean +/- SEM before HD 3.57 +/- .56, at 240 min 14.9
      +/- 6.5 ng/ml, p less than 0.05, Wilcoxon-test) than in P (before HD 4.36 +/-
      .98, at 240 min 8.95 +/- 3.0 ng/ml, p less than 0.05 H 240 vs. P 240, Wilcoxon
      test). Visible clotting was more pronounced in the H filter. Among other
      favourable features of blood compatibility the polyamide/polyvinylpyrrolidone
      copolymer with a hydrophilic/hydrophobic microdomain structure has less
      thrombogenicity. The modified cellulosic membrane H has advantages in complement
      activation and leukocyte depression, but thrombogenicity seems less favourable
      since the incorporated diethyl-amino-ethyl groups with their positive charge bind
      and inactivate negatively charged heparin.

PMID- 1639531
TI  - A cardiac assist device as blood supply in ischemic heart disease.
AB  - Before the event of modern bypass surgery revascularisation of the heart was
      tried with the transplantation of pedicled muscle flaps onto the heart. For
      patients who cannot undergo bypass surgery this method could be--in a modified
      way--of help. This was shown in 12 dogs. In those a free muscle flap was
      transplanted onto the heart which had undergone a previous artificial infarction.
      The muscle flap was anastomosed with the a. mammaria, venous flow was directed
      into the right atrium. After 5 months the muscle was almost completely atrophic,
      but a fit capillary network was penetrating the underlying myocardium.

PMID- 1639532
TI  - Transcutaneous transmission of digital data and energy in a cochlear prosthesis
      system.
AB  - This paper describes the inductive power and data link employed in the CAP
      Cochlear Prosthesis System (CAP stands for Combined Analog and Pulsative
      Stimulation Strategy). The inductive link consisting of a parallel-tuned receiver
      resonant circuit weakly coupled to a series-tuned transmitter resonant circuit,
      is driven by a self-oscillating class-E-tuned power amplifier. The class-E
      concept allows coupling-insensitive high-efficiency transcutaneous transmission
      of power. In the CAP implant, variations of the coil distance within a range of 0
      to 9 mm result in changes of the implant supply voltage which are lower than 10%.
      Within this coil distance range, the mean overall efficiency is 49%. In view of
      the excellent switching properties of the class-E tuned power oscillator, a
      practical scheme for data transmission is ASK (Amplitude Shift Keying). To ensure
      constant energy flow and easy synchronization of the bitstream in the implant, a
      self-clocking bit format is employed.

PMID- 1639533
TI  - Comparison of plasma separation and immunospecific LDL-elimination in severe
      hypercholesterolemia.

PMID- 1639534
TI  - Colon cancer in Argentina. I: Risk from intake of dietary items.
AB  - A case-control study has been conducted to investigate the relationship between
      dietary components and risk of colon cancer in the La Plata area of Argentina.
      Cases are 110 patients newly diagnosed with colon cancer in 10 major hospitals
      between 1985 and 1986. Two neighbourhood controls per case were individually
      matched by age, sex and place of residence. Personal interviews elicited
      information on frequency of consumption of 140 food items during the 5-year
      period up to 6 months prior to interview. Risk is analyzed by quartiles of
      individual food items and groups of items. Multivariate conditional logistic
      regression modelling indicates that consumption of eggs is associated with
      increased risk for colon cancer (odds ratios by quartile: 1.0, 1.58, 2.02, 4.66),
      as are some dairy products (ORs of 1.93 for the highest quartile of consumption
      of cheese). Intake of vegetables, fish and poultry is associated with
      statistically significant decreasing risk (ORs of 0.075, 0.39 and 0.39, for the
      highest categories of consumption of vegetables, fish and poultry, respectively).
      The risk for red meat does not consistently increase as consumption increases.
      Risks are not altered by the inclusion of potential confounders such as education
      or body mass index. These findings confirm those of several previous studies and
      are of particular interest, since the Argentinean diet typically includes a high
      intake of red meat.

PMID- 1639535
TI  - An analysis of autologous T-cell anti-tumour responses in colon-carcinoma
      patients following active specific immunization (ASI).
AB  - As part of a phase-II clinical trial of post-operative active specific
      immunization (ASI) with virus-modified autologous tumour cells (AuTu) in
      colorectal carcinoma patients, we have analyzed in vitro anti-AuTu immune
      responses with lymphocytes isolated from the peripheral blood (PBL) of 5 treated
      patients. The PBL of 3 "responder patients", those who developed a positive DTH
      reaction to AuTu, when stimulated in standard in vitro autologous lymphocyte
      tumour-cell cultures (ALTC), showed cytotoxic anti-AuTu reactivity only in
      association with natural-killer-cell(NK)-like activity. We removed nonspecific
      cytotoxic cells (CD56-positive) from PBL of colon carcinoma or melanoma patients
      and positively selected T cells with strong CD8 staining (CD8hi) using FACS.
      Following in vitro stimulation, specific cytotoxic T cells (CTL) directed against
      either autologous EBV-transformed B cells (AuEBV-B) or autologous melanoma cells
      were identified in the CD8hi T-cell population. However, even using this novel
      technique, no specific CTL against autologous colon carcinoma cell lines were
      detected in PBL from ASI-treated patients (2 DTH responders and 2 DTH non
      responders). If AuTu-specific CTL precursors existed in these blood samples,
      their frequency must have been very low (less than 1 in 8 x 10(4) CD8 positive T
      cells). Sorted CD4 T cells from these patients, in the presence of autologous
      antigen-presenting cells, showed no specific anti-tumour proliferative response,
      and in one instance we observed inhibition of proliferation in the presence of
      tumour cells.

PMID- 1639536
TI  - A prospective study of transmission by transfusion of HTLV-I and risk factors
      associated with seroconversion.
AB  - To evaluate the risk of transfusion-related transmission of HTLV-I in Jamaica, a
      prospective study was initiated, prior to availability of a licensed HTLV-I
      serological screening assay. This information would prove useful in formulating
      strategies for blood-donor screening. We followed 118 pre-transfusion HTLV-I
      negative transfusion recipients at monthly intervals post-transfusion for 1 year.
      Laboratory and questionnaire data were obtained at each visit to evaluate the
      clinical and immunological status of recipients. Cumulative incidence of HTLV-I
      seroconversion was estimated and risk-factor data associated with seroconversion
      among 66 HTLV-I-exposed transfusion recipients were analyzed. Seroconversion
      occurred in 24/54 (44%) of recipients of HTLV-I-positive cellular blood
      components, 0/12 recipients of positive non-cellular donor units and 0/52
      recipients of HTLV-I-negative donor units. Significant risk factors associated
      with recipient seroconversion were receipt of a seropositive cellular blood
      component stored for less than one week [odds ratio (OR) = 6.34, 95% confidence
      interval (CI) = 1.83 to 21.92], male sex (OR = 4.79, 95% CI = 1.15 to 20.0) or
      use of immuno-suppressive therapy at time of transfusion (OR = 12.20, 95% CI =
      0.95 to 156). Risk of blood-borne infection per person per year in Jamaica was
      estimated to be 0.009%. Our results confirm that blood transfusion carries a
      significant risk of HTLV-I transmission and that screening of donor blood
      effectively prevents HTLV-I seroconversion. Recipients at greatest risk for
      seroconversion were those who required multiple transfusions or who were
      receiving immunosuppressive therapy at the time of transfusion. These patients
      should be given priority in receiving selectively screened blood components, if
      universal blood-donor screening for HTLV-I is not possible.

PMID- 1639537
TI  - Alcoholism and liver cirrhosis in the etiology of primary liver cancer.
AB  - The aim of this study was to determine the risk of developing primary liver
      cancer in patients with a diagnosis of alcoholism, liver cirrhosis, or both.
      Three population-based, mutually exclusive cohorts were defined on the basis of
      hospital discharge diagnosis between 1965 and 1983. Complete follow-up through
      1984--excluding the first year of follow-up--showed that among 8,517 patients
      with a diagnosis of alcoholism, 13 cancers occurred, vs. 4.2 expected
      (standardized incidence ratio (SIR) = 3.1; 95% confidence interval (CI) = 1.6 to
      5.3); among 3,589 patients with liver cirrhosis, 59 cancers occurred, vs. 1.7
      expected (SIR = 35.1; 95% CI = 26.7 to 45.3), and among 836 patients with both
      diagnoses, 11 cancers occurred, vs. 0.3 expected (SIR = 34.3; 95% CI = 17.1 to
      61.3). Thus, alcoholism alone entailed a moderately increased risk and alcoholism
      with liver cirrhosis did not increase the high relative risk for liver cancer
      more than cirrhosis alone. We conclude that alcohol intake may be a liver
      carcinogen only by being causally involved in the development of cirrhosis; and
      further, that the risk of developing liver cancer following cirrhosis in this
      population is similar to or higher than that after chronic hepatitis-B-virus
      infection in other Western countries.

PMID- 1639538
TI  - In vitro activity of novel antifolates against human squamous carcinoma cell
      lines of the head and neck with inherent resistance to methotrexate.
AB  - A series of 7 human squamous carcinoma cell lines of the head and neck (HNSCC),
      grown in standard medium containing high folate concentrations and in "folate
      conditioned" medium containing nanomolar concentrations of folates, were all
      found to be sensitive (IC50: less than or equal to 50 nM) in growth-inhibition
      studies to methotrexate (MTX) following drug exposure for 7 days. However, when
      MTX exposure was limited to 24 hr, only 2 out of 7 HNSCC cell lines were
      sensitive to MTX (IC50: less than 500 nM), 2 were moderately sensitive (IC50: 1-2
      microM), and 3 exhibited inherent resistance to MTX (IC50: greater than 250
      microM). In these last 3 cell lines, the mechanism of resistance was not
      correlated with altered membrane transport of MTX or changes in dihydrofolate
      reductase activity, but rather was associated with a 3-fold lower activity of
      intracellular folylpolyglutamate synthase (FPGS) activity compared to MTX
      sensitive HNSCC cells. The 3 cell lines exhibiting inherent resistance to a short
      exposure to MTX, however, did not show inherent cross-resistance after exposure
      for 24 hr to one or more of 3 novel antifolate compounds. These compounds, which
      appear to be more efficiently transported and polyglutamylated than MTX, include:
      10-ethyl-10-deazaaminopterin (10-EdAM), 2-desamino-2-methyl-N10-propargyl-5,8
      dideazafolic acid (ICI-198,583), and 5,10-dideazatetrahydrofolic acid (DDATHF).
      These results indicate that antifolate membrane transport and intracellular FPGS
      activity are important factors in determining sensitivity or resistance of HNSCC
      cells to short-term antifolate compound exposures.

PMID- 1639539
TI  - Inhibitory effects of human interferons on the immortalization of human, but not
      rabbit, T lymphocytes by human T-lymphotropic virus type-I (HTLV-I).
AB  - The effects of human interferon (IFN)-alpha, -beta, and -gamma on the
      immortalization of human and rabbit lymphocytes by human T-lymphotropic virus
      type-I (HTLV-I) have been investigated. The immortalization of human peripheral
      blood lymphocytes co-cultured with lethally X-ray-irradiated HTLV-I-producer
      cells, MT-2, was blocked in the presence of more than 40 u/ml human recombinant
      IFN-alpha or more than 200 u/ml human natural type IFN-beta. However, rhIFN-gamma
      did not block immortalization by HTLV-I even at higher doses. On the other hand,
      the presence of high doses of hIFN-alpha, -beta, or -gamma did not exhibit any
      biological effect on the immortalization of rabbit peripheral-blood lymphocytes
      co-cultured with lethally X-ray-irradiated MT-2 cells. Integration of the full
      length of HTLV-I genome was detected in every transformant by Southern blot
      analysis. All cell lines established were CD4+/CD8 divided by T-lymphocytes,
      except for one cell line of CD4+/CD8+. Morphologically intact HTLV-I production
      was observed by electron microscopy in these cells. Our results indicate that
      HTLV-I released under the strongly suppressed condition in the presence of IFNs
      remains active and able to immortalize T lymphocytes. It is also suggested that
      immortalization of human T lymphocytes by HTLV-I can be inhibited by the
      antiviral state induced by the treatment with low doses of hIFN-alpha and -beta,
      whereas immortalization of rabbit T lymphocytes is not inhibited because of the
      species specificity of hIFNs.

PMID- 1639540
TI  - The effect of schedule, protein binding and growth factors on the activity of
      suramin.
AB  - Suramin has been shown to have antiproliferative activity, either by blocking the
      binding of growth factors to their receptors or by inhibiting critical cellular
      enzymes. In 6 different cell lines from 5 tumour types (MCF-7, MCF-7/ADRR, PC3,
      HT-29, UM-SCC-11B and SW-1573/IR500), we studied the effect of scheduling of
      suramin, of FCS and of human serum albumin (HSA), of epidermal growth factor
      (EGF) and of the addition of growth factors in serum-free medium on the activity
      of suramin. The concentration of suramin which gave 50% growth inhibition (IC50)
      varied from 45 microM in SW-1573/IR500 to 153 microM in PC3 cells grown in medium
      supplemented with 5% FCS, after 6 days of continuous exposure. Exposure for more
      than 4 days did not enhance the sensitivity to suramin, except in PC3. At
      exposure to suramin for 1 day followed by 5 days recovery, high IC50 values
      (greater than 0.5 mM) were observed in MCF-7 cells. In medium with 1% and 0.5%
      FCS these values were 3 to 8 and 14 to 26 times lower respectively. Addition of
      HSA increased the IC50 in PC3 and MCF-7 cells. Suramin binding to protein was
      dependent on the concentration of protein and of suramin. Excess of EGF in medium
      with different FCS concentrations did not change the IC50 values of suramin in
      PC3 and MCF-7 cells. Addition of EGF, fibroblast growth factor or platelet
      derived growth factor in PC3 cells cultured in serum-free medium did not increase
      the IC50 values. Suramin was active against these 6 cell lines at clinically
      achievable concentrations. This activity varied depending on the cell line,
      exposure time and suramin concentration. The most significant factor interfering
      with sensitivity to suramin was the amount of protein present in the culture
      medium.

PMID- 1639541
TI  - Correlation of myc expression with the growth-arrested and transformed phenotypes
      in hybrids between a T lymphoma and an antigen-responsive T-cell line.
AB  - Fusion of the YACUT lymphoma cell line with the Mls-1a-antigen-specific non
      tumorigenic T-cell line G4 produced growth-arrested hybrids that could be induced
      to proliferate in the presence of Mls-1a antigen. Prolonged growth of such
      hybrids by repeated antigenic stimulation resulted in the appearance of
      autonomously growing hybrid lines. Of the 4 antigen-independent hybrid clones, I
      was weakly tumorigenic (25% incidence) while the other 3 were highly tumorigenic
      (100% incidence). In the growth-arrested hybrids the de-regulated c-myc
      expression characteristic of the YACUT cells was suppressed. In the autonomously
      growing clones, however, c-myc expression had reverted to the levels of the
      lymphoma parent and 1 to 2 extra copies of chromosome 15 were consistently
      present. These results indicate that repeated antigenic stimulation somehow
      abrogated the down-regulation of c-myc in the growth-arrested hybrid lines. The
      increase in the number of copies of chromosome 15, however, suggests that genes
      located on this chromosome may abolish the effect of the negative regulatory
      functions of the non-malignant parent in a gene-dosage-dependent manner.

PMID- 1639542
TI  - Therapy of primary and metastatic mouse mammary carcinomas with doxorubicin
      encapsulated in long circulating liposomes.
AB  - The purpose of our study was to compare the therapeutic effects of doxorubicin in
      3 different formulations: (1) in PBS, (2) in conventional liposomes composed of
      egg phosphatidylglycerol/egg phosphatidylcholine/cholesterol/dl-alpha tocopherol,
      and (3) in sterically stabilized, long-circulating "Stealth" liposomes composed
      of hydrogenated soy phosphatidylcholine/cholesterol/polyethylene glycol
      distearoylphosphatidylethanolamine. The doxorubicin formulations were used to
      treat recently implanted and well-established, growing primary mouse mammary
      carcinomas, and to inhibit the development of spontaneous metastases from intra
      mammary tumor implants. In the treatment of recently implanted primary tumors,
      the formulations were given in 3 i.v. injections over 15 days, starting 3 or 10
      days after tumor implantation. In the treatment of well-established primary
      tumors, the mice received 4 i.v. injections over 22 days, starting an average 38
      days after tumor implantation. In the preventive treatment against metastases,
      the formulations were given in 4 i.v. injections over 22 days, starting 22 days
      or 58 days after primary tumor implantation. The Stealth liposome formulation was
      significantly more effective than the conventional liposome formulation or the
      free drug in reducing the incidence of metastases from intra-mammary implants of
      tumor MC19 and tumor MC65, in curing mice with recent implants of tumor MC2A,
      tumor MC2B, and tumor MC65, and in increasing the 8-week survival of mice with
      well-established implants of tumor MC2B. It is concluded that the long
      circulation time of the Stealth liposome doxorubicin formulation accounts for its
      superior therapeutic effectiveness.

PMID- 1639543
TI  - Growth in serum-free medium of NIH3T3 cells transformed by the EJ-H-ras oncogene:
      evidence for multiple autocrine growth factors.
AB  - Rodent fibroblastic cells transformed by ras oncogenes can grow in serum-free (S
      ) medium. We have studied clonal lines of mouse NIH3T3 fibroblasts transfected
      with the EJ-H-ras oncogene, and observed that practically all become independent
      of exogenous growth and attachment factors shortly after transfection. Moreover,
      all the clones tested soon form anchorage-independent (AI) colonies in S- medium,
      and most give rise to spheroids able to grow in suspension. The cell-conditioned
      S- medium of the transformed (TR) cells stimulates autocrinally the AI and
      anchored growth of these cells, in the absence of serum, and it contains growth
      factors related to TGF-alpha (or EGF), PDGF and bFGF, and other uncharacterized
      factors. Some of these factors are not found, or are found only in very small
      amounts, in the S- medium of non-transformed NIH3T3 cells, which also stimulates
      the growth of the TR cells, in the absence of serum. In addition, the TR cells
      contain 4-6 times more cell-associated bFGF than the non-transformed cells and
      release more latent TGF-beta activatable by acid treatments. However, no active
      TGF-beta is secreted by either cell type. Activated TGF-beta and pure TGF-beta 1
      stimulate the growth of the anchored TR and NIH3T3 cells, but inhibit the AI
      growth of the TR cells. Another inhibitor of this growth is also found in the
      concentrated medium of the NIH3T3 cells.

PMID- 1639544
TI  - Human RT-4 bladder carcinoma is highly metastatic in nude mice and comparable to
      ras-H-transformed RT-4 when orthotopically onplanted as histologically intact
      tissue.

PMID- 1639545
TI  - A new patient-like metastatic model of human lung cancer constructed
      orthotopically with intact tissue via thoracotomy in immunodeficient mice.

PMID- 1639546
TI  - Patterns of substance use among students meeting lifetime DSM-II criteria for
      alcohol misuse.
AB  - A cross-sectional survey of 989 college students was conducted to investigate
      substance use patterns between students meeting lifetime DSM-III alcohol misuse
      criteria and students not meeting misuse criteria. Students meeting alcohol
      misuse criteria (n = 294) reported a significantly greater history of lifetime
      substance use and were more likely to have used marijuana in the 6 months prior
      to the receipt of the questionnaire. No significant differences in the frequency
      of substance use within the 6-month period were indicated between the two student
      groups with the exception of marijuana. Students meeting lifetime DSM-III alcohol
      misuse criteria also reported having experimented with marijuana at an earlier
      age.

PMID- 1639547
TI  - Alcohol misuse among college students and other young adults: findings from a
      general population study in New York State.
AB  - The predictors of heavier drinking patterns and alcohol-related problems are
      examined for young adults aged 18 to 25 years by using a large representative
      sample. The sample includes both college students and noncollege students. Young
      adult males have the highest rates of alcohol misuse when compared with all other
      age groups. Beginning to drink at an early age and growing up with a heavy
      drinking father are strong predictors of both current heavier drinking and
      alcohol-related problems. For males, the effect of father's heavy drinking is
      especially strong. Furthermore, living in a dorm as a college student makes a
      unique contribution to alcohol misuse.

PMID- 1639548
TI  - Conceptions of alcoholism.
AB  - Alcoholism educators have assumed that endorsement of the disease concept of
      alcoholism would reduce the moral stigma associated with the condition, thereby
      promoting a more humanitarian approach to the alcoholic. The present study
      presents data relevant to these assumptions. Measures of beliefs about the
      medical and moral nature of alcoholism were collected from 1,446 work supervisors
      in federal agencies. Additionally, social acceptance, tolerance of the
      alcoholic's absenteeism, and charitable responses to the alcoholic were measured.
      Results indicated that beliefs about the moral character of the alcoholic and
      beliefs about the medical nature of alcoholism are significant predictors of
      social acceptance of the alcoholic, tolerance of work behavior of the alcoholic,
      and a charitable response to the alcoholic. Findings are discussed in terms of
      the importance of educational efforts aimed at dispelling beliefs about the moral
      nature of alcoholism.

PMID- 1639549
TI  - Testing the progressive nature of alcoholism.
AB  - The authors employed a new data collection methodology to assess Jellinek's
      progressive model of alcoholism. Data were collected to explore whether (a)
      symptoms occurred in four distinct phases, one phase following another, as
      described by Jellinek's model; (b) the phase markers and the phases of the
      symptom progression follow one another as predicted in the Jellinek model; and
      (c) the sequence of each of the 46 individual symptoms is as described by a
      serial interpretation of Jellinek's model. The authors also compared male
      participants with female participants on the conditions described above.

PMID- 1639550
TI  - Relations among stressors, strains, and substance use among resident physicians.
AB  - This study examined the relationship between work-related stress and substance
      use among resident physicians in the United States. Unlike previous studies of
      physician stress, this study distinguished between "stressors" (stressful job
      conditions) and "strains" (reactions to the work environment) and correlated each
      of these with substance use. Results indicated that relations among stressors,
      strains, and substance use were not strong. Strains, however, were more strongly
      related to substance use than stressors. Additionally, benzodiazepines were more
      strongly related to strains than other substances, suggesting that they may be
      used for self-treatment. Other implications of these findings and future research
      needs are discussed.

PMID- 1639552
TI  - Redecision therapy.
AB  - Redecision therapy has grown out of an amalgam of transactional analysis and
      Gestalt therapy along with extensive clinical experience. This approach as
      developed by the Gouldings presents a model that differs from group-focused
      therapy in a number of ways. The treatment is centered on the individual. The
      therapist takes an active role in the treatment and works within the contract for
      change of each individual. Many of the traditional concepts of group therapy like
      transference, cohesion, resistance, and group process are not used. The theory of
      transactional analysis serves as a conceptual core along with terms developed to
      describe the processes used in redecision therapy. Impasses, contact, cons,
      games, early decisions, anchoring, injunctions, and scripts are part of the
      lexicon of this treatment.

PMID- 1639551
TI  - Resistance to drug offers among college students.
AB  - This study investigated the social context of drug offers among college students.
      The communicative processes involved in drug offers and resistance were examined
      along with drug use history, gender, family income, relationship to offerer, and
      location of offer. The prevailing pattern was of simple offers followed by simple
      statements of no, with no continuing pressure by the offerer. However, some form
      of pressure was reported in almost half of the cases and most frequently resulted
      from resisting through statements of dislike for product or lack of desire. The
      least amount of pressure was associated with marijuana offers.

PMID- 1639553
TI  - The place of self psychology in group psychotherapy: a status report.
AB  - This article reviews the growing contribution of self psychology to group
      psychotherapy. The basic self-psychological concepts as they are applied to group
      dynamics and the treatment process are explored. Transference,
      countertransference, and self-restitutive patterns are illustrated in a clinical
      vignette that includes a "difficult" patient's impact upon the interactional and
      group-as-a-whole processes. Several directions for future investigation are
      described.

PMID- 1639554
TI  - Reflections on a developing body of group-as-a-whole theory for children's
      therapy groups: an introduction.
AB  - This essay serves as an introduction to a collection of articles on group
      psychotherapy for children that appears in the following pages. These articles
      are an outgrowth of a symposium on children's group treatments presented at the
      1990 Annual Conference of the American Group Psychotherapy Association. The
      present author provides a general overview of relevant literature and offers an
      orientation to the subsequent theoretical and practical integrations.

PMID- 1639555
TI  - Complementary cultures in children's psychotherapy groups: conflict, coexistence,
      and convergence in group development.
AB  - This article presents a model for understanding development within children's
      psychotherapy groups. It is proposed that two complementary cultures exist within
      children's groups, one, indigenous peer culture, strictly of the children's
      making and the other, therapeutic group culture, created by the therapist in
      collaboration with group members. The therapist is wise to approach indigenous
      peer culture as an ethnographer might a native culture, with an emphasis on
      observation and seeking understanding rather than on intervention. The therapist
      can use the indigenous peer culture to speak to the children in their own
      language and eventually to engage them in collaboratively building a meaning
      system that is uniquely designed to address their psychotherapeutic needs. The
      article defines these concepts, develops them theoretically, and illustrates them
      clinically.

PMID- 1639556
TI  - The evolution of culture and cohesion in the group treatment of ego impaired
      children.
AB  - The challenge of group treatment with ego impaired children is to provide a
      situation in which their maladaptive efforts to organize volatile affects and
      impulses can be tolerated and structured. This article addresses the process of
      culture building in group and how it can provide a cohesive structure for
      affective expression that is acceptable and tolerable to the defensive, resistant
      child. In particular, the author will argue that it is through the sense of
      normality and commonality engendered by indigenous peer culture that the members
      initially develop a structure and language for affiliation, play, and mutual
      identification. By facilitating the cohesion of indigenous peer culture, the
      therapist creates a sufficient holding environment to begin a dialogue involving
      both verbal and nonverbal communication. For children who are difficult to engage
      in discussion, let alone treatment, this dialogue is the essential process for
      creating a corrective emotional experience. Through a concise case study, the
      author describes the process by which the children's efforts to express and
      create their own culture are cultivated, managed, and understood.

PMID- 1639557
TI  - A world between realities: an exploration of therapeutic group culture and
      transitional phenomena in a long-term psychotherapy group.
AB  - In long-term, open-ended psychotherapy groups in which there are inevitable, yet
      potentially disruptive changes in membership, therapeutic group culture can
      become particularly important in sustaining a group's sense of cohesion. This
      article focuses on how transitional phenomena, as defined by D. W. Winnicott, and
      representational play serve as vehicles for establishing therapeutic group
      culture in a preadolescent girls' group. Applications of both transitional
      phenomena and therapeutic group culture to group stage development, as outlined
      by Garland, Jones, and Kolodny (1970), will also be explored.

PMID- 1639558
TI  - The establishment of individual and collective competency in children's groups as
      a prelude to entry into intimacy, disclosure, and bonding.
AB  - This article offers a theory about the evolution of small group systems through a
      series of stages. It discusses the relationship of these stages to and their
      effect on the self-other and therapeutic interventive spheres in the long-term
      group treatment of children. The developmental unfolding is seen as universal to
      small groups and as operating on an interpersonal and collective level,
      distinguishable from individual psyches and close dyadic bonds but influenced by
      them. On an isomorphic level the group stages contain emotive, cognitive, and
      interactive themes and processes that parallel and evoke those of the bonding and
      work processes. As such, the group dynamic provides an enabling matrix and a
      mirror for the other goings on in the member-therapist encounter. Its pacing and
      its progressions and regressions appear to correspond with those of the
      development of the transitional space and therapeutic culture of the group. Like
      the other articles in the symposium, this one offers specific examples in which
      the three spheres intersect and are integrated.

PMID- 1639559
TI  - Inpatient group processes parallel unit dynamics.
AB  - The authors conducted a quantitative examination of parallels between milieu and
      therapy group dynamics on a short-term inpatient unit. The Ward Atmosphere Scale
      was used to assess the milieu, and the Group Climate Questionnaire-S to measure
      processes in key groups. Assessments were made by patients and staff once each
      week for 10 months. The authors found clear parallels between ward and therapy
      group processes. The parallels reflected the impact of patterns utilization of
      the unit, its treatment philosophy, and the emotional dynamics of its
      constituents. Examination of these associations also revealed limitations of the
      treatment setting, clarified the potential impact of particular staff
      interventions, and demonstrated biases in the rating methods. Study of parallel
      process on the psychiatric unit is a rich source of information on the nature of
      inpatient treatment.

PMID- 1639560
TI  - Points in question. Endangered parasite species.

PMID- 1639561
TI  - The use of Taylor's power law to describe the aggregated distribution of gastro
      intestinal nematodes of sheep.
AB  - The distribution of gastro-intestinal nematodes collected from lambs was
      investigated using the Taylor's power law index of aggregation beta, which is
      known to be independent of the mean population size. For 12 out of the 15
      nematode species investigated the estimate of beta was not significantly
      different from 2.0. For these species a logarithmic transformation would
      stabilize the variance of the distributions prior to further statistical
      analysis. The remaining species had values of beta which were significantly lower
      than 2.0. For these species a variance-stabilizing transformation is given by z =
      x1-beta/2.

PMID- 1639562
TI  - Detection by allozyme electrophoresis of cryptic species of Hypodontus macropi
      (Nematoda: Strongyloidea) from macropodid marsupials.
AB  - Allozyme electrophoresis of 98 Hypodontus macropi from eight different species of
      hosts using 24 enzymes revealed a complex of at least six sibling species, with
      15-50% fixed genetic differences between taxa. Except for the taxon parasitizing
      Macropus rufus/M. robustus, pairs of parasite taxa were, in each case, sympatric
      at each locality examined, thus supporting the conclusion that they represent
      valid species. The existence of a series of host-specific nematode taxa explains
      many of the inconsistencies noted previously in the host distribution of H.
      macropi. Comparison of parasite allozyme phenograms with host phylogeny suggests
      that four of the speciation events could be attributable to cospeciation and two
      to host switching. A clear case of host switching between M. rufus/M. robustus
      and M. fuliginosus was found.

PMID- 1639563
TI  - Fasciola hepatica: free radical generation by peritoneal leukocytes in challenged
      rodents.
AB  - Free radical generation by peritoneal leukocytes from hosts able to develop
      resistance to reinfection with Fasciola hepatica (rats) was compared with that of
      hosts unable to develop resistance (mice). Free radical generation by rat
      leukocytes was 3.5 times higher per cell and 30 times higher per animal than
      radical production by mouse leukocytes. The capacity of peritoneal leukocytes to
      produce free radicals in response to adult fluke crude antigen was increased by
      the presence of host plasma and was quantitatively greater in challenged rats
      than in naive or primary infected rats. This was not the case for mice, in which
      cells from primary infected animals were equally as responsive as cells from
      challenged mice. Further experiments revealed that challenge infection in rats
      apparently caused the in vivo activation of peritoneal leukocytes and increased
      levels of unidentified factors in plasma and that both of these responses were
      involved in the initiation of free radical generation in response to F. hepatica.
      Dramatic increases in the number of eosinophils present in the peritoneal
      cavities of primary infected and challenged rats (but not mice) were observed but
      the role of eosinophils in the production of free radicals in response to F.
      hepatica remains to be determined.

PMID- 1639564
TI  - Investigations on the protonephridial system of post-larval Gyrocotyle urna and
      Amphilina foliacea (Cestoda).
AB  - The gross morphology and ultrastructure of the different parts of the
      protonephridial system of the monozoic tapeworms Gyrocotyle urna and Amphilina
      foliacea are described. The terminal cell in both species has numerous cilia
      which are interconnected and extend into the lumen of the first canal cell. The
      filtration area is built up from projections of two cells, the terminal cell and
      the first canal cell. The first canal cell forms a solid hollow cylinder without
      a cell gap and a desmosome as found in Neodermata other than cestodes and
      Udonella. In Gyroctyle the nucleus of the first canal cell is located in the wall
      cytoplasma whereas more distally located ductules of both species have
      subepithelial cell bodies containing the nuclei. In both taxa the protonephridial
      canal system is reticulate. In Amphilina the distal canals lack non-terminal
      ciliary flames, such ciliary tufts can be found in the larger capillaries of
      Gyrocotyle. The capillary cilia have rootlets and the ultrastructure of the duct
      wall cytoplasm containing large numbers of vesicles indicates highly active
      transport processes. The morphology of the protonephridial systems is discussed
      with regard to the evolution of Neodermata (especially of the Cestoda) and the
      function of the protonephridial system in cestodes as a probable organ of
      nutrient distribution.

PMID- 1639565
TI  - Cross-reactions of sera from Toxocara canis-infected mice with Toxascaris leonina
      and Ascaris suum antigens.
AB  - The ELISA method using larval excretory-secretory (E/S) products and homogenized
      Toxocara canis, Toxascaris leonina and Ascaris suum adult worm extract were used
      to determine possible cross-reactions in BALB/c and C57BL/10 mice, inoculated
      with embryonated eggs or adult worm extract of T. canis in single and multiple
      doses. When we used sera of mice infected with embryonated eggs of T. canis
      against different heterologous antigens, we observed no cross-reactions in BALB/c
      mice against A. suum E/S and adult worm extract antigens with a single dose. In
      multiple doses this was absent too against T. leonina adult worm extract in
      BALB/c mice, and in both strains against A. suum E/S and adult worm extract. In
      BALB/c mice inoculated with adult worm extract of T. canis we did not observe
      cross-reactions with A. suum E/S antigen with both inoculation doses. In the
      remainder of the experiments, we observed cross-reactions of different
      intensities.

PMID- 1639566
TI  - Vaccines against blowfly strike: the effect of adjuvant type on vaccine
      effectiveness.
AB  - Vaccination of sheep with a partially purified extract of Lucilia cuprina larvae
      in some cases resulted in marked reduction of growth in larvae which fed on the
      sheep. Twelve adjuvants were assessed, in vitro and in vivo, to determine which
      induced the largest inhibitory effect on larval growth. The Freund's complete
      adjuvant and Quil A groups produced ELISA antibody levels significantly higher (P
      less than 0.05) than other groups. Seven adjuvants mediated an immune response
      which caused significant inhibition of larval growth (P less than 0.05). When the
      sheep were assessed by in vivo larval culture, only larvae feeding on sheep
      vaccinated with the antigen presented in Freund's complete adjuvant or dextran
      sulphate or a dextran sulphate/Freund's incomplete adjuvant mixture weighed
      significantly less (P less than 0.05) than larvae feeding on control sheep. The
      effect on larvae was monitored in vitro for 70 days after vaccination, by which
      time significant reduction in larval weight was no longer observed. The loss of
      larval growth inhibition was not associated with a corresponding reduction in
      overall antibody levels.

PMID- 1639567
TI  - The mortality and fecundity of Haemonchus contortus in parasite-naive and
      parasite-exposed sheep following single experimental infections.
AB  - Parasite-exposed lambs and their parasite-naive controls were experimentally
      infected once only with 30,000 H. contortus larvae at 3, 9, 12, and 20 weeks
      following termination of a moderate immunizing infection of 30,000 H. contortus
      larvae. Previously exposed lambs, challenged at 3 weeks, had a significant
      reduction in the total H. contortus worm burden as compared to parasite-naive
      controls. No difference in the total H. contortus worm burden was found between
      parasite-exposed or parasite-naive lambs challenged at 9 weeks or thereafter.
      Female worms were found to be significantly smaller in lambs previously exposed
      to the parasite as compared to those found in parasite-naive lambs. The average
      parasite fecundity was 4700 eggs per female worm per day. Previous exposure of
      the lambs to the parasite had no effect on parasite fecundity. Various
      mathematical models were used to examine parasite fecundity. Parasite fecundity
      was found to increase in the initial post-challenge period reaching a constant
      value approximately 58 days after challenge infection. No density-dependent
      constraints on fecundity were observed.

PMID- 1639568
TI  - Interspecific interactions in naturally acquired nematode communities from sheep
      abomasum in relation to age of host and season in four areas of Leon (Spain).
AB  - The abomasa of naturally infected ewes (407) and lambs (190) from four areas of
      Leon were collected weekly over 2 years in the abattoir of Leon (north-west
      Spain). The major species and morphs found were Teladorsagia circumcincta and
      Trichostrongylus axei and to a lesser extent Marshallagia marshalli and
      Teladorsagia trifurcata. The putative interactions between species were assessed
      by Euclidian distances based on the results of multivariate analyses. The
      estimation of interaction was either based on mean intensities of worm burdens or
      on frequencies of nematode species within individual hosts. The areas, years,
      seasons and categories of sheep (ewes or lambs) did not influence the interaction
      estimates. These were not dependent upon the size of worm burden. The majority of
      interactions were positive. Slight negative interactions were found only with T.
      circumcincta-T. axei, T. circumcincta-M. marshalli and M. marshalli-T. axei.
      Positive interactions were recorded between the less frequent species.

PMID- 1639569
TI  - Viability of Echinococcus granulosus cysts in mice following cultivation in
      vitro.
AB  - The viability of hydatid cysts developed in vitro for 90 days was assessed by
      implantation into mice. Cysts removed from mice at 270 days post-infection (p.i.)
      increased their size 13.5-fold and contained several brood capsules containing
      protoscoleces. Thus, cysts remain viable after prolonged in vitro culture. The
      implantation in mice of 15 cysts developed in vitro yielded an average of 10
      cysts per mouse, which is indicative of a high survival rate in these
      experimental infections. The ultrastructural study of cysts recovered from mice
      270 days p.i. showed that the germinal membrane was more compact than before
      implantation and several layers of tegumental cells had developed. Observations
      of cysts removed from mice indicated that the plasma membrane surrounding
      microtriches had prolongations opening into the laminated layer.

PMID- 1639570
TI  - The role of the fat body, midgut and ovary in vitellogenin production and
      vitellogenesis in the female tick, Dermacentor variabilis.
AB  - Polyclonal antibodies directed against D. variabilis vitellin were utilized for
      immunocytochemistry at the ultrastructural level. We localized vitellogenin (Vg)
      in rough endoplasmic reticulum cisternae, secretory granules and secreted
      products of fat body trophocytes and midgut vitellogenic cells from feeding and
      ovipositing females. Vg was localized in the oocyte Golgi bodies and in the yolk
      bodies of both feeding and ovipositing females. Uptake of exogenous Vg was
      indicated by the presence of immunospecific gold probe in coated pits and coated
      vesicles at the apical plasma membrane of oocytes from females in rapid
      engorgement and oviposition. In unmated females little detectable evidence of Vg
      uptake by developing oocytes suggests that mating and host detachment signal the
      beginning of vitellogenesis. We conclude that fat body trophocytes, midgut
      vitellogenic cells and oocytes are involved in the synthesis and/or processing of
      Vg and that feeding is the signal associated with the initiation of Vg synthesis
      and/or processing.

PMID- 1639571
TI  - The dynamics of trickle infections with Heligmosomoides polygyrus in syngeneic
      strains of mice.
AB  - NIH, CBA, SWR and C57B1/10 mice were repeatedly infected with Heligmosomoides
      polygyrus, using doses of 10-50 larvae at frequencies of 2-16 days. NIH and SWR
      mice regulated the worm burdens at a stable dose-dependent level for a period of
      several weeks, following which expulsion occurred and immunity to subsequent re
      infection was established. This regulation did not occur in CBA or C57B1/10 mice,
      and was inhibited by cortisone treatment. Evidence was found to suggest that
      regulation is the result of an immune response directed against the late larval
      stages of the parasite, shortly after their emergence into the lumen of the gut.
      The frequency of infection was an important factor in determining the course of
      infection. Frequently infected mice expelled the parasites more rapidly than mice
      infected with the same total number of larvae in fewer less frequent doses.

PMID- 1639572
TI  - Ultrastructural studies on oocysts, sporulation and sporozoites of Schellackia
      cf. agamae from the intestine of the starred lizard Agama stellio.
AB  - Young intracellular oocysts of Schellackia cf. agamae in the gut epithelium of
      agama stellio were bound by several fine membranes. Later-stage oocysts and
      sporoblasts in the lamina propria were intercellular and were bound by a thin but
      firm tri-layered wall. Oocysts had a large central refractile body which, during
      sporulation, sent extensions into the developing sporozoites. Sporozoites escaped
      into the gut tissue, leaving a large oocyst residuum with the remains of a
      refractile body. These sporozoites invaded a variety of connective tissue cells,
      endothelial cells and circulatory leucocytes in the lamina propria. Sporozoites
      caused lysis of the host cell cytoplasm at their perimeter and multiple
      sporozoite infections led to complete degradation of the host cell.

PMID- 1639573
TI  - Resistance to ivermectin by Haemonchus contortus in goats and calves.
AB  - Efficacy of ivermectin on susceptible or resistant populations of the parasitic
      nematode Haemonchus contortus was determined in cattle and goats held in a barn.
      Goats were each infected with 3000 infective, ivermectin-susceptible or 
      resistant H. contortus larvae on day 0 and reinfected with 2000 infective larvae
      on day 24. Goats were treated orally with 600 micrograms kg-1 ivermectin on day
      31. No significant differences were detected in blood packed cell volume (PCV) or
      total protein (TP), prepatent period, or epg among the four groups of goats that
      were each infected with one of four parasite strains (one susceptible, three
      resistant). There were no differences among the four parasite strains in the
      numbers of infective larvae that developed to the third larval stage from fecal
      cultures or in the viability of cultured infective larvae when held in the
      laboratory at 27 +/- 1 degrees C for 14 weeks. After treatment with ivermectin,
      there were significant differences among the parasite strains in PCV, TP, and
      epg. Total worm counts were reduced by 94 to 97% with three times the recommended
      dose. Immature and adult Skrjabinema ovis were also present in two treated goats.
      In a second test, one goat infected once with 10,000 infective larvae of a
      resistant strain of H. contortus and then treated with nine doses of ivermectin,
      increasing from 500 to 2000 micrograms kg-1 over a period of 133 days, had 35
      adult worms at necropsy. In a third test, three calves were readily infected with
      an ivermectin-resistant strain of H. contortus from goats.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1639574
TI  - No adaptation of Haemonchus contortus to genetically resistant sheep.
AB  - A composite population of Haemonchus contortus was established with larvae from
      seven diverse sources, then maintained in Merino sheep bred to have either
      increased or decreased resistance to Haemonchus. After five, seven and 14
      parasite generations, the two resulting lines of parasites were used to infect
      sheep from the increased resistance line, an unselected control line and the
      decreased resistance line. Line of sheep had a highly significant effect on
      average faecal egg counts 4 and 5 weeks after infection (geometric means 329, 735
      and 1490 epg, respectively after the 14th generation), but the two lines of
      parasites yielded similar egg counts. There was no significant interaction
      between line of sheep and line of parasite, indicating that the parasite
      populations had not diverged significantly in their reproductive fitness, as
      measured by faecal egg count.

PMID- 1639575
TI  - Codon usage in Entamoeba histolytica.
AB  - The codon usage of 10 E. histolytica genes comprising 4455 codons was analysed.
      The codon usage revealed an extremely biased use of synonymous codons with a
      preference for NNU (44%) and NNA (41.4%) codons. Codons CGG (arg), AGG (arg) and
      CCG (pro) were absent in the E. histolytica genes examined. The codon usage of E.
      histolytica resembled that of Plasmodium falciparum.

PMID- 1639576
TI  - Bovine babesiosis: failure to induce interferon gamma production in response to
      Babesia bovis antigens in cattle.
AB  - The immune response to Babesia bovis infection or vaccination was evaluated by
      measuring antibody and interferon gamma (IFN-gamma) production to protective
      recombinant and crude native B. bovis antigens. Cells from vaccinated or infected
      cattle failed to produce detectable IFN-gamma when stimulated with B. bovis
      antigens in vitro. In contrast, antibody was induced by protective recombinant B.
      bovis antigens. These findings are consistent with the argument that immunity to
      B. bovis infection is correlated most strongly with humoral rather than cell
      mediated immune responses.

PMID- 1639577
TI  - Differential stability of the benzimidazole (BZ)-tubulin complex in BZ-resistant
      and BZ-susceptible isolates of Haemonchus contortus and Trichostrongylus
      colubriformis.
AB  - The binding of [3H]mebendazole ([3H]MBZ) to tubulin from BZ-susceptible (BZ-S)
      and BZ-resistant (BZ-R) isolates of Haemonchus contortus and Trichostrongylus
      colubriformis was investigated using charcoal extraction and gel filtration
      techniques. The amount of [3H]MBZ bound at infinite free ligand concentration
      (Bmax) was significantly reduced for the BZ-R isolate compared with the BZ-S
      isolate in both species when assayed by charcoal extraction. However, Bmax was
      increased to comparable levels for both BZ-S and BZ-R isolates of each species
      when assayed by the less stringent gel filtration technique. These results
      indicate that the BZ-tubulin interaction in trichostrongylid nematodes is
      comprised of a minimum of two components. As similar levels of total [3H]MBZ
      binding were observed for both BZ-S and BZ-R isolates of each species when
      assayed by gel filtration, it is suggested that the reduction in the pseudo
      irreversible BZ binding component in BZ-R isolates results in an increase in the
      level of reversible BZ binding and therefore provides a survival advantage to BZ
      R nematodes.

PMID- 1639578
TI  - Changes in allozyme pattern of the protozoan parasite Giardia intestinalis.
AB  - The present study compares the allelic profiles of Giardia intestinalis grown in
      vivo and in vitro. Three clinical isolates of G. intestinalis were established in
      suckling mice and subsequently adapted to in vitro culture to test the null
      hypothesis that samples of the same clinical isolate grown in different culture
      conditions have identical allelic profiles. For each isolate, a mouse-derived and
      an axenically cultured sample were analysed electrophoretically at 11 enzyme
      loci. In each case, the axenically cultured sample of each isolate showed marked
      allelic differences from its corresponding in vivo sample. These data suggest
      that there may be either regulated expression of alternative genes encoding
      distinct isozymes (i.e. gene switching) or selection by different growth
      conditions of specific genotypes from a mixture present within the original
      clinical isolate. Although these hypotheses are not tested in this study, the
      data highlight the importance of confirming that allozymes (or isozymes) are
      stable genetic characters for the identification and characterization of
      protozoan taxa.

PMID- 1639579
TI  - The electronic fight against the schistosomes.
AB  - A DOS-compatible model for use on personal computers has been constructed for
      teaching in parasite epidemiology. The program is based on the Macdonald model of
      schistosome dynamics and enables simulation of the effect of a control campaign
      on a human worm load by reducing four transmission factors in the parasite life
      cycle: (1) egg contamination, (2) snail lifetime, (3) exposure to cercariae and
      (4) adult worm lifetime.

PMID- 1639580
TI  - Collagen as a pharmacological approach in wound healing.
AB  - The authors have reviewed the most important biological mechanisms involved in
      wound healing, the main agents that modify the healing process and the
      physiological and pharmacological role of collagen. Putative mechanisms of
      collagen in wound repair are described with particular emphasis on haemostatic
      effect, interaction with platelets and fibronectin, properties of of increasing
      fluid exudate and its cellular component (macrophages) and the "scaffold" role
      for fibroblastic proliferation. Experimental and clinical data clearly suggest
      that the potential use of collagen in wound repair and its main therapeutical
      applications: treatment chronic leg ulcers and pressure sores, burns, urological
      surgery, gynaecological surgery, dentistry and oral surgery, reconstructive
      surgery, abdominal and vascular surgery, orthopaedy.

PMID- 1639581
TI  - Lyophilized non-denatured type-I collagen (Condress) extracted from bovine
      Achilles' tendon and suitable for clinical use.
AB  - On account of the biological role of collagen in wound healing, and because of
      its biocompatibility, the use of heterologous collagen-based devices is becoming
      more widespread. Here we describe the extractive procedure and properties of a
      lyophilized type-I collagen (Condress) suitable for clinical use. Condress is
      extracted from bovine Achilles' tendon through a non-denaturing procedure in the
      absence of proteolytic enzymes. It has not been submitted to a chemical cross
      linking process before lyophilization. Chemical identification of Condress as
      type-I acid-insoluble collagen has been carried out by evaluation of total
      nitrogen and hydroxyproline contents and by chromatographic examination.
      Electrophoretic analysis and morphological examination by electron microscopy
      confirm that the procedure employed to extract collagen does not alter the
      polypeptidic composition of the molecule and its structure. A gamma-ray dose
      between 0.5 and 1.5 Mrad is quite adequate to sterilize the final product and
      certainly devoid of degradative effect. The finished product has a special
      (peculiar) absorbing capacity, immersion time, strain resistance, wrinkling
      temperature and enzymatic digestion time. It is a nonallergenic product suitable
      for clinical use. When it has been applied in chronic leg ulcers, pressure sores,
      or reconstructive surgery, Condress seems to substantially improve wound repair.

PMID- 1639582
TI  - Heterologous collagen in wound healing: a clinical study.
AB  - The author reports an open controlled trial on 72 patients affected by different
      types of skin ulcers, in which a heterologous lyophilized collagen sponge was
      compared with Dextranomer as healing adjuvant. The rationale of use and
      pharmacological properties of this collagen are outlined and explain its
      outstanding results.

PMID- 1639583
TI  - Healing of open skin surfaces with collagen foils.
AB  - Applications of Condress (patented sheets of pure bovine collagen) on open skin
      surfaces (30 cases of "ulcus cruris", 5 cases of decubitus, and malum perforans;
      10 cases of full-thickness burns) were examined in a controlled trial.
      Quantification of regeneration speed, macrophotographic survey of granulation
      tissue and epithelial border, thermographic and chromometric evaluation of the
      skin microcirculation, and histological observation of regenerating tissues, were
      the parameters used. The following results were obtained: marked reduction of
      healing time, different aspects of the granulation-tissue responses, different
      times of topical collagenolysis, increased vascular perfusion, histological
      activation of angiogenesis, fibrogenesis, histiomacrophage function and
      superficial absorption. The employment of Condress in burn areas seems to be
      highly promising.

PMID- 1639584
TI  - The use of lyophilized collagen in gynaecology.
AB  - Collagen plays an important physiological role in the process of wound healing
      and the possibility of using lyophilized collagen has opened up prospects in
      surgery. The author reports his experience in gynaecological surgery: myomectomy,
      vaginal or abdominal hysterectomy and repair surgery for vaginal prolapse with
      hysterectomy and cystourethropexy. The results obtained suggest the use of
      lyophilized collagen in the above-mentioned cases and a possible wider
      application in gynaecological surgery.

PMID- 1639585
TI  - Heterologous, lyophilized, non-denatured type-I collagen in dentistry.
AB  - Experience in the use of a heterologous collagen, extracted from bovine Achilles'
      tendon by a non-denaturing procedure, is reported. Normal tooth extraction
      procedures, periodontal surgery, treatment of alveolitis, oroparanasal
      communications and maxillary cysts, and oral surgery in patients affected by a
      defective haemostatic mechanism, benefit from its use.

PMID- 1639587
TI  - Europe: AIDS nurses join forces.

PMID- 1639586
TI  - Potential role of heterologous collagen in promoting cutaneous wound repair in
      rats.
AB  - The effect of native bovine tendon type-I collagen sponges (CONDRESS) on wound
      repair was evaluated by employing an experimental animal (rat) model which
      utilized subcutaneously implanted collagen and polyurethane sponges. Lesions were
      also created in the control groups with the exception that implants were omitted.
      The fusion of the hypodermal layer was selected as the index of wound repair
      expressed as % healing. In order to assess the extent of the healing process,
      parameters of clinical evaluation such as exudate volume, number of
      polymorphonuclears (PMNs) and macrophages (MOs) were also determined. All studies
      were effected at time intervals of 24, 48 and 72 h post wounding and
      implantation. The collagen-treated groups showed a greater healing capacity as
      compared to the polyurethane sponge-treated and control groups. Likewise, the
      exudate volume, number of leukocytes and mononuclear-type cells were all
      significantly higher for the collagen-treated animals than those of the
      polyurethane sponge-treated and control ones. Furthermore, the healthier
      appearance of the artificially produced wounds in the collagen sponge-treated
      groups (when compared to the others after 24 h) further confirmed collagen's
      validity in the treatment of wounds.

PMID- 1639588
TI  - Hepatitis B: a major human cancer.

PMID- 1639589
TI  - Sharing the challenge: mobilizing nurses against HIV/AIDS in Africa.
AB  - For two years ICN implemented a WHO/GPA-funded project in Africa to increase the
      capability and effectiveness of selected national nurses' associations (NNAs) to
      participate in their countries' campaigns to prevent HIV transmission; reduce the
      impact of HIV/AIDS on individuals, families and communities; and decrease
      morbidity and mortality associated with HIV/AIDS. The results have been
      gratifying. Not only have the nurses from the participating NNAs become a force
      to be reckoned with in their countries' HIV/AIDS efforts but they have activated
      major changes in nursing practice and in the delivery of care. Serving as role
      models, these nurses (numbering over 800) are mobilizing not only their
      colleagues but all others involved in caring for persons with AIDS.

PMID- 1639590
TI  - Linking primary health care and self-care through case management.
AB  - Primary health care (PHC) strategies have heightened health care providers'
      awareness of the need to understand their communities and provided knowledge on
      how to mobilize communities for health. Orem, a nurse theorist, has developed a
      similar philosophical position on mobilizing individuals for self-care, which
      complements PHC theory at the community level. This article links the
      philosophies and strategies of PHC with self-are and proposes a delivery model of
      case management, drawing on examples from the HIV/AIDS pandemic and the aging
      population to illustrate the type of coordinating activities required of case
      managers in the 21st century.

PMID- 1639592
TI  - Orbital disease.

PMID- 1639591
TI  - Nurses' role in promoting the health of the elderly.
AB  - Professional nurses have taken a leading role in promoting health of the older
      adult through a variety of innovative programmes. Among the most important
      worldwide are in the areas of nutrition; safety; physical, mental, and economic
      health; and access to services. Some of the major issues and nursing care
      strategies in each of these areas are described below.

PMID- 1639593
TI  - Advances in orbital imaging.

PMID- 1639594
TI  - Periorbital intraosseous hemangiomas.
AB  - Periorbital intraosseous hemangiomas are a rare clinical entity that may present
      with visual or cosmetic disturbances. They may be difficult to distinguish from
      other bony lesions such as malignant metastases. If the diagnosis of hemangioma
      can be confidently made in a mildly symptomatic patient, the lesion may be
      observed. In patients in whom the diagnosis is uncertain or when there is visual
      compromise such as optic nerve compression, total surgical excision is
      recommended. Preoperative evaluation with angiography should be strongly
      considered, particularly if embolization can be accomplished prior to surgery.
      Even then, the surgeon and the patient must be prepared for the risk of
      significant hemorrhage.

PMID- 1639595
TI  - Ocular motility disorders and orbital trauma.

PMID- 1639596
TI  - Correction of enophthalmos with porous polyethylene implants.

PMID- 1639597
TI  - Correction of telecanthus in the blepharophimosis syndrome.

PMID- 1639598
TI  - Prophylactic use of antibiotics in oculoplastic surgery.

PMID- 1639599
TI  - Optic nerve sheath decompression: a review.

PMID- 1639600
TI  - Update on laboratory tests for diagnosis of orbital disease.

PMID- 1639601
TI  - Special laboratory methods for pathological diagnosis of orbital disease.

PMID- 1639602
TI  - The spectrum of orbital vascular disease.

PMID- 1639603
TI  - Management of lesions at the cranioorbital junction.

PMID- 1639604
TI  - Treatment options for periorbital hemangioma of infancy.

PMID- 1639605
TI  - Reconstruction of degenerate rd mouse retina by transplantation of transgenic
      photoreceptors.
AB  - Photoreceptors from neonatal transgenic mice with normally developing retinas
      were transplanted to the subretinal spaces of 2-3-month-old rd mutant mice that
      lack photoreceptors. The transgenic mouse photoreceptors express high levels of
      the lac Z reporter gene product, beta-galactosidase, which facilitated tracking
      the transplanted cells. Two sources were used for these cells: (1) dissection of
      retinal microaggregates containing photoreceptors and (2) papain-dissociated
      photoreceptors. Host retinas were examined after transplantation. Both methods
      led to survival of photoreceptors for at least 2 mo after transplantation.
      Relatively mature outer segments were found only in transplanted microaggregates;
      this occurred optimally when the cells were adjacent to the retinal pigment
      epithelium (RPE). beta-galactosidase-labeled outer segments associated closely
      with the apical processes of the host RPE, which, together with labeled
      phagosomes in the RPE cells, suggested functional interaction between the
      transplanted photoreceptors and the host RPE. This study is the first to the
      authors' knowledge to show electron microscopically that a morphologically normal
      appearing photoreceptor layer can be reconstructed in an otherwise
      photoreceptorless retina.

PMID- 1639606
TI  - Cultured Muller cells have high levels of epidermal growth factor receptors.
AB  - High levels of epidermal growth factor (EGF)-receptors have been reported in
      membrane homogenates of bovine retinas, but the biologic function and tissue
      target of EGF in the retina have not been established fully. Because EGF
      participation has been suggested in the mechanisms of wound healing and Muller
      cells undergo changes after retinal injury, the authors studied EGF receptor
      expression and functional role of this substance in cultured Muller cells. These
      cells (isolated from normal rats) were tested for the glial cell markers:
      vimentin, S-100 protein, and carbonic anhydrase C. These markers were found to be
      positive through all passages used in the experiments. The 125I-EGF binding in
      Muller cells was highly specific, concentration dependent, and saturable.
      Compared with 3T3 fibroblasts, Muller cells bound threefold more EGF. Binding
      kinetics and Scatchard analyses showed the higher level of binding was related to
      the greater number of receptors on these cells (Muller cells, 2.4 x 10(5)
      receptors/cell; 3T3 fibroblasts, 7.1 x 10(4) receptors/cell) rather than a change
      in affinity of the receptors to bind the ligand. Nonlinear-regression analyses
      suggested the presence of two classes of affinity sites. The high level of EGF
      receptor expression in Muller cells was confirmed by western blot analyses that
      showed increased reactivity of the approximately 170-kilodalton receptor band to
      a monoclonal anti-EGF receptor antibody. Moreover, EGF treatment of Muller cells
      resulted in two- to threefold increase in DNA synthesis, as evidenced by 3H
      thymidine uptake studies. These findings support a functional role for EGF in
      Muller cell proliferation in retinal disease.

PMID- 1639607
TI  - The directional reflectance of the retinal nerve fiber layer of the toad.
AB  - Various optical methods for assessing the retinal nerve fiber layer (RNFL) depend
      on reflected light, but little is known about the characteristics of the RNFL as
      a reflecting structure. The authors investigated the angular dependence of light
      reflected by the unmyelinated nerve fibers of the toad eyecup using a small 500
      nm light source that could illuminate the retina from various directions and a
      movable low-power microscope that imaged the retina onto a cooled charge-coupled
      device in a digital camera system. Measured areas had nerve fiber bundles
      separated by gaps. Therefore, the reflectance of a bundle alone could be
      determined from the difference in intensity between the bundle and an adjacent
      gap. The RNFL reflectance showed striking directional dependence; nerve fiber
      bundles seen when illuminated from one direction disappeared completely when
      illuminated from another. Light reflected by a bundle was confined to a conical
      sheet concentric with the axis of the bundle. The apex angle of the cone was
      twice the angle between the incident light and the bundle axis, and the
      orientation of the cone changed with the orientation of the RNFL. This behavior
      was consistent with the theory of light scattering by cylinders. Therefore, it
      was concluded that the RNFL reflectance arises from cylindric structures. These
      results have clinical significance for imaging the RNFL in the human eye because
      the apparent intensity of the RNFL will depend, not just on its thickness, but
      also on its orientation relative to the imaging system.

PMID- 1639608
TI  - Reduced phagosomal content of the retinal pigment epithelium in response to
      retinoid deprivation.
AB  - Previous investigations have shown that lipofuscin accumulation in the retinal
      pigment epithelium (RPE) is reduced greatly as a consequence of vitamin A
      deprivation. The mechanism by which vitamin A regulates RPE lipofuscin deposition
      remains to be determined. It is possible that retinoids are direct precursors of
      this substance. Alternatively, vitamin A deficiency may reduce the uptake and
      processing of other potential precursors. In retinas lacking photoreceptor cells,
      RPE lipofuscin accumulation is decreased substantially. This finding suggested
      that components of phagocytosed photoreceptor outer segments may be precursors
      for RPE lipofuscin. The effect of vitamin A deprivation on RPE lipofuscin content
      therefore could be the result of reduced outer segment phagocytosis by the RPE of
      vitamin A-deprived animals. To evaluate this possibility, experiments were
      conducted to determine whether vitamin A deprivation altered the phagosomal
      content of the RPE. Rats were fed diets containing or lacking retinoid precursors
      of 11-cis retinal. Retinoic acid was included in the diets of the vitamin A
      deprived animals. After both 10 and 26 weeks, the RPE phagosomal contents were
      determined in animals from each dietary group. Photoreceptor cell densities also
      were measured in these rats. At both time points, the RPE phagosomal content was
      lower significantly in the retinoid-deprived animals than in those fed a vitamin
      A precursor of the visual pigment chromophore. This reduction was not the result
      of photoreceptor cell death; the density of these cells was not affected
      significantly by dietary vitamin A. Thus, it appears that retinoid deprivation
      reduces the rate of photoreceptor outer segment turnover and, consequently, outer
      segment phagocytosis by the RPE.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639609
TI  - Human retinal pigment epithelial cells cultured in hyperglycemic media accumulate
      increased amounts of glycosaminoglycan precursors.
AB  - Confluent human retinal pigmented epithelial cells were cultured on microcarrier
      beads in the presence of 5.6 or 26 mmol/l glucose with or without the aldose
      reductase inhibitor Sorbinil (200 microM) for 2 wk. At the end of the incubation
      period, perchloric acid extracts were prepared and analyzed by 31P nuclear
      magnetic resonance spectroscopy. As assessed by this method, the phosphorylated
      metabolites of cells incubated with 5.6 or 26 mmol/l glucose differed
      significantly in the concentrations of a number of uridine diphosphate (UDP)
      conjugated monosaccharides, which were elevated two- to threefold in cells
      incubated in 26 mmol/l glucose over control samples. The affected metabolites
      were identified (through a series of spiking experiments) to be UDP-N
      acetylglucosamine, UDP-N-acetylgalactosamine, and UDP-glucuronic acid.
      Coincubation of the cells with Sorbinil 200 microM in the presence of 26 mmol/l
      glucose had no effect on this accumulation. Under normal circumstances, these
      molecules selectively and sequentially are incorporated into the polysaccharide
      chains of glycosaminoglycans (GAGs), whose presence and distribution in the
      basement membranes is affected adversely by diabetes mellitus. These data suggest
      that the availability of the monosaccharide precursor is not the rate-limiting
      step for GAG synthesis in the presence of pathologic glucose concentrations.
      Thus, the lost GAG content in the basement membranes of diabetic patients may be
      caused by changes elsewhere in the biosynthesis and/or catabolism of the
      polysaccharide-linked protein molecules.

PMID- 1639610
TI  - Ethacrynic acid induces reversible shape and cytoskeletal changes in cultured
      cells.
AB  - Cell cultures derived from trabecular meshworks of human and bovine eyes and from
      bovine vascular endothelia were incubated at 37 degrees C for 1 hr with
      ethacrynic acid (ECA, 0.1-0.5 mmol/l) dissolved in culture medium. At 2 hr after
      the initial exposure, ECA at concentrations up to 0.4 mmol/l induced a reversible
      alteration in cell shape in all three cell types that was coincident with a
      change in the staining pattern of major cytoskeletal components including actin,
      alpha-actinin, vinculin, and vimentin. Distinct progressive alterations in beta
      tubulin also occurred, with initial changes observed 10 min after ECA exposure.
      The ECA-induced changes in tubulin were blocked in part by preincubation with
      taxol (which stabilizes the microtubule structure), but they appeared to differ
      from those occurring with nocodazole (which interferes with tubulin assembly).
      These results suggest the possibility that ECA-induced increases in outflow
      facility may be mediated by alterations in the cytoskeletons of outflow pathway
      cells.

PMID- 1639611
TI  - Immunomodulation of experimental autoimmune uveoretinitis by intravenous
      injection of uveitogenic peptides.
AB  - Intravenous (IV) injection of antigenic proteins induces specific
      unresponsiveness, as shown by the diminished response to a challenge with these
      proteins in complete Freund's adjuvant. This study examined the effect of IV
      treatment with uveitogenic peptides on the development of experimental autoimmune
      uveoretinitis (EAU). The peptides used were derived from the sequence of bovine
      interphotoreceptor retinoid-binding protein (IRBP) and included R16 (sequence,
      1177-1191), which is immunodominant and highly uveitogenic, and R4 (sequence,
      1158-1180), which is nondominant and weakly uveitogenic. The efficacy of this
      treatment was found to depend on both the dose used for the IV injection and that
      used for the challenge. Thus, EAU induced by R16 at a dose of 0.2 nmol/rat was
      inhibited completely in all rats treated with the peptide at doses of 400 or 133
      nmol and partially by the low dose of 5 nmol/rat. However, the EAU induced by a
      R16 challenge of 40 nmol/rat was inhibited only partially by the high treatment
      dose of 400 nmol/rat. The IV treatment was found to be effective in inhibiting
      the EAU induced by peptide R4. A large dose of R4 was needed to induce EAU (40
      nmol/rat), and the disease was inhibited completely in all rats treated IV with
      this peptide at doses of 800, 400, or 133 nmol. In most animals injected with the
      44-nmol dose, also, inhibition was complete. These data show that there is a
      correlation between the doses needed for achieving inhibition and those used for
      the challenge. The ratios between these doses in all experiments were found
      within the range 1-20.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639612
TI  - Immune response to Staphylococcus epidermidis-induced endophthalmitis in a rabbit
      model.
AB  - Although Staphylococcus epidermidis is the most common cause of postoperative
      pseudophakic endophthalmitis, little is known about the immune response to S.
      epidermidis-induced endophthalmitis. Using a rabbit model, the immune response to
      an intravitreal injection of 7000 S. epidermidis (group 1) or 30,000 S.
      epidermidis (group 2) organisms was investigated. Clinical evaluations showed
      that rabbits in group 2 had a more severe inflammatory reaction in the
      conjunctiva, cornea, iris, and vitreous than those in group 1. The inflammatory
      reaction in group 1 largely resolved by day 30; group 2 continued to show a
      severe inflammatory response. Histopathologic findings correlated with clinical
      findings, with rabbits in group 2 showing a more severe inflammatory reaction in
      both the anterior and posterior segments of the globe. Positive vitreous cultures
      for S. epidermidis were present in rabbits in group 1 on days 3, 7, 10, 14, and
      21 but not thereafter. However, group 2 had higher vitreous colony counts at days
      3, 7, and 14 and negative vitreous cultures thereafter. Neither group showed
      delayed hypersensitivity to S. epidermidis antigens (evaluated by skin tests).
      Serum immunoglobulin (Ig) G antibody levels to phenol-inactivated S. epidermidis
      and glycerol teichoic acid (GTA) increased progressively, reached a peak at days
      10-14, and then declined in both groups. Serum IgA antibody levels to these
      antigens were not detected. Group 2 had a more prolonged IgG antibody response in
      vitreous and aqueous than group 1. Tear fluid showed the weakest IgG and IgA
      antibody response to S. epidermidis and GTA. S. epidermidis-induced
      endophthalmitis was associated with a humoral but not a delayed hypersensitivity
      response to this organism.

PMID- 1639613
TI  - Ultrastructural changes of human trabecular meshwork after photocoagulation with
      a diode laser.
AB  - A diode laser, which emitted infrared radiation at a wavelength of 810 nm, was
      used to perform trabecular photocoagulation in a human eye due for enucleation
      for malignant melanoma. For comparison, burns were applied with an argon blue
      green laser (488-514.5 nm). With each laser, the treatment spot size was 100
      microns and the pulse duration was 0.20 sec. Visible lesions were produced with a
      power of between 750 mW and 1.2 W with the diode laser, and 500-900 mW with the
      argon laser. The pattern of damage produced by both modalities was similar and
      essentially consisted of contraction or expansion of trabecular beams, with
      trabecular destruction occurring only in relation to high power exposures. These
      findings confirm that trabecular photocoagulation is not a process that depends
      upon the wavelength of the incident energy at the two spectral extremes of 488 nm
      and 810 nm.

PMID- 1639614
TI  - Propagation of ciliary smooth muscle cells in vitro and effects of prostaglandin
      F2 alpha on calcium efflux.
AB  - The effect of prostaglandin F2 alpha (PGF2 alpha) on calcium efflux from ciliary
      smooth muscle cells was studied. Ciliary smooth muscle cells, cultured from human
      ciliary muscle explants, retained the morphologic and immunologic characteristics
      of smooth muscle cells. High concentrations (to 10(-6) mol/l) of PGF2 alpha were
      associated with a dose-dependent increase of calcium (45Ca) efflux, whereas at
      concentrations lower than 10(-8) mol/l there was little or no 45Ca efflux. Our in
      vitro data are inconsistent with the experimental hypothesis that PGF2 alpha at
      pharmacologic concentrations relaxes ciliary muscle with a consequent increase in
      uveoscleral outflow.

PMID- 1639615
TI  - Urokinase-type plasminogen activator in human aqueous humor.
AB  - In the anterior segment of the eye, fibrin clots must be rapidly resorbed to
      prevent further fibrosis and scarring. The aqueous humor of patients undergoing
      cataract surgery was analyzed for the presence of components of the fibrinolytic
      cascade. In 30 patients, aqueous humor and plasma were compared for their content
      of urokinase-type plasminogen activator (uPA), tissue-type plasminogen activator
      (tPA), plasminogen activators inhibitors (PAIs), plasminogen, and total proteins.
      With gel electrophoresis and zymographic assays of serial dilutions of plasma and
      aqueous humor, all these components were found to be present at lower
      concentrations in aqueous humor than in plasma. For total proteins, the
      aqueous/plasma ratio was approximately 0.003, and for plasminogen it was 0.001.
      Interestingly, the aqueous/plasma ratio for uPA was not as low and varied from
      0.01 to 0.03. A significant proportion of the uPA in aqueous humor was present in
      the two-chain active form. In addition to uPA, aqueous humor contained lower
      levels of tPA, but no detectable levels of reactive plasminogen activators
      inhibitors (PAIs). The presence of a relatively high concentration of active uPA
      shows that the proteolytic balance of the aqueous humor in the anterior chamber
      of the eye is shifted toward fibrinolysis.

PMID- 1639616
TI  - Reciprocal corneal transplantation fails to correct mucopolysaccharidosis VI
      corneal storage.
AB  - This report contains the results of studies designed to evaluate corneal clearing
      in mucopolysaccharidosis VI (MPS VI)-affected cats. Corneal buttons from affected
      cats were transplanted into normal cat corneas and, as controls, normal-to-normal
      and normal-to-affected transplants also were done. No clearing of the MPS VI
      graft or host beds occurred, nor was there any clouding of the normal donor or
      recipient corneal tissues. This assessment was made by serial clinical
      examinations over a 14-30 mo period and by light and electron microscopic
      examination of the corneal tissues at the end of the study. Lack of corneal
      clearing under conditions that would maximize such a process in this animal model
      indicates that corneal clearing is not an appropriate index for measuring the
      success of systemic therapy in MPS VI.

PMID- 1639618
TI  - Visual acuities and scotomas after one week levodopa administration in human
      amblyopia.
AB  - The authors previously showed that a single dose of levodopa improves the
      contrast sensitivity and decreases the size of fixation point scotomas in
      amblyopic patients. In the present study, they investigated the effect of
      levodopa after 1 wk of daily administration using a cross-over, double masked
      design. The decrease of fixation point scotomas was confirmed with automatic
      static perimetry. An improvement of visual acuity occurred in 70% of the patients
      after 1 wk of levodopa administration compared to only 22% in the authors'
      previous study using one single dose. The improvements in visual acuities and
      visual fields persisted even after the levodopa administration was completed.

PMID- 1639617
TI  - Regulation of HLA class II antigen expression on cultured corneal epithelium by
      interferon-gamma.
AB  - The effect of recombinant human interferon gamma (IFN-gamma) on the induction of
      HLA class II (HLA-DR, -DP, -DQ) antigen expression on human corneal epithelial
      (HCE) cells was examined in different stages of culture. Primary cultures were
      established with limbal explants without endothelium. HCE cells in Stage 1 and
      Stage 2, with cells negative and positive for the 64K corneal keratin (the marker
      for advanced corneal epithelial differentiation), respectively, were prepared.
      HCE cells in both stages were treated with IFN-gamma at a concentration of 0 to
      1000 U/ml for two to six days and were stained by the avidin-biotin peroxidase
      complex method. Class II antigens were not detected on HCE cells in either stage
      without IFN-gamma treatment. IFN-gamma induced three class II antigens on HCE
      cells in both stages in a dose- and time-dependent manner but at different levels
      for each antigen (DR greater than DP greater than DQ). In addition, DQ expression
      was related to cell differentiation, with DQ extremely rare at Stage 1 and more
      frequent at Stage 2 (5% vs. 20%). These findings indicate that the induction of
      class II antigens on HCE cells may be regulated by IFN-gamma independently for
      each of the antigens and that DQ induction may depend upon the differentiation of
      HCE cells in culture.

PMID- 1639619
TI  - The lateral geniculate nucleus in human strabismic amblyopia.
AB  - Cell shrinkage in monkey lateral geniculate nucleus (LGN) layers supplied by the
      amblyopic eye have been described in experimental amblyopia caused by visual
      deprivation, anisometropia, and strabismus. A human brain from a strabismic
      amblyope became available for study and the authors compared cell sizes in LGN
      layers receiving input from the normal and the amblyopic eye. Significant cell
      shrinkage was present in layers connected with the amblyopic eye, and was most
      evident in the ipsilateral LGN. These findings support the validity of the monkey
      model for the study of strabismic amblyopia by showing, for the first time,
      changes in the brain from a human strabismic amblyope that are similar to those
      previously described in monkeys.

PMID- 1639620
TI  - Lateral phoria at distance: contributions of accommodation.
AB  - Lateral heterophoria at distance often is cited as an index of tonic vergence,
      yet recent research has shown that vergence in darkness is more convergent than
      most measures of phoria. Two experiments were conducted to investigate the
      possible role of accommodation in this discrepancy. Experiment I compared
      measures of distance phoria of 19 young adults with measures of vergence and
      accommodation of the same subjects. Dark vergence was found to be correlated with
      but significantly more convergent than distance phoria. Hierarchical regression
      analysis showed that individual measures of phoria were related to subjects'
      negative accommodation (from the dark focus to the distant target) as well as to
      dark vergence. Experiment II tested 13 young adults to evaluate three simple
      models of the influence of accommodation on distance phoria. Distance phoria was
      predicted best by a model that included the subjects' negative accommodation,
      accommodative vergence, and dark vergence. These findings support the hypothesis
      that distance phoria is influenced by accommodation for the fixation target. Dark
      vergence is a simpler index of tonic vergence.

PMID- 1639621
TI  - Visual accommodation and sustained visual resolution in multiple sclerosis.
AB  - Many multiple sclerosis (MS) patients frequently experience transient blurring.
      We investigated the possibility that this symptom is due to the inability of
      patients to sustain an accommodative response to stimuli viewed at distances
      nearer than or farther from the individual tonus position of accommodation. In a
      group of MS patients and age-matched healthy control subjects, we measured (1)
      accommodative range and tonus position; (2) reaction time (RT) to detect a change
      in a small optotype (viewed in a Badal lens system) as a function of viewing
      distance; and (3) contrast sensitivity at a fixed viewing distance. MS patients
      did not differ significantly from healthy controls on near point, far point,
      pupil size, accommodative range, or tonus position measures. However, as a group,
      MS patients showed significantly slower RTs than controls to detect optotype
      changes for stimuli viewed at distances nearer to or farther from the individual
      tonus position of accommodation. All subjects showed significantly slower RTs to
      detect changes in optotypes viewed at extreme near and far optical distances
      compared to RTs to detect changes in stimuli viewed at the tonus position. This
      difference was significantly larger for MS patients than for controls. These data
      also suggest that dynamic dioptric factors contribute to the magnitude of
      contrast sensitivity deficits in this patient population and indicate that the
      relationship between the individual tonus accommodation position and viewing
      distance is an important variable in CS testing.

PMID- 1639623
TI  - Establishing an in-house service program--a case study.

PMID- 1639622
TI  - Calculation of the pulsatile ocular blood flow.
AB  - Based on reasonable assumptions, it is theoretically possible to determine the
      pulsatile ocular blood flow. The pertinent parameter is not the pulse amplitude
      but the steepest decay value of record (ie, the minimum of dV(t)/dt). Some
      advantages of developing the record in Fourier series are discussed. The
      importance of careful analysis of the recording system is stressed.

PMID- 1639624
TI  - Radiologic quality control and servicing.

PMID- 1639625
TI  - In-house servicing of x-ray and CT equipment.

PMID- 1639626
TI  - Job description for x-ray and CT equipment technicians.

PMID- 1639627
TI  - Birtcher 4400 electrosurgical units and 6400 argon beam coagulation systems.

PMID- 1639628
TI  - Overheating of replacement batteries in Physio-Control Lifepak 6, 6s, and 7
      defibrillator/monitors.

PMID- 1639629
TI  - T-cell recognition of class II products that result from the combined presence of
      two different HLA haplotypes.
AB  - To analyze DR2 haplotypes as recognized by alloreactive T cells, lymphocytes from
      a DR7; DQw2 homozygous donor were cocultured with irradiated lymphocytes that
      were DRw15, DR7; DQw6, DQw2 heterozygous. In this report, we focus on two HLA-DQ
      specific T-cell clones obtained from this priming. These two clones (c3518 and
      c3523) responded to the positive control (original stimulator) and five of 66
      panel donors. Three of these donors typed DRw15, DR7; DQw6, DQw2, as did the
      positive control. One stimulatory donor typed DRw15, DR7; DQw6, DQw9 and one
      stimulatory donor typed DRw14, DR7; DQw5, DQw2. Oligonucleotide typing revealed
      that recognition by the clones depended on the simultaneous presence of the
      DQB1*0602 gene on one haplotype and DRB1*0701 or DQA*0201 on the other. The
      hypothesis that c3518 and c3523 recognize an HLA class II product that results
      from the combination of two different HLA haplotypes was further confirmed in
      family studies. In three families, it was shown that the DRw15, DR7; DQw6, (DQw2
      or DQw9)-positive individuals were recognized, whereas the cells carrying either
      DRw15; DQw6, DR7; DQw2, or DR7; DQw9 were nonstimulatory. Our results can be
      explained in two ways: (a) the T cells recognize a class II dimer that results
      from trans-complementation of DQA1*0101 and DQB1*0602, and (2) the T cells
      recognize a DR7-derived peptide that is presented by DQw6.

PMID- 1639630
TI  - T-cell responses against products of oncogenes: generation and characterization
      of human T-cell clones specific for p21 ras-derived synthetic peptides.
AB  - Peptides derived from mutated human proto-oncogenes bound to HLA may represent a
      novel type of tumor-specific antigen. Mutated ras genes are the oncogenes most
      frequently identified in human cancer. The transforming genes carry a mutation in
      codons 12, 13, or 61. We have investigated whether the T-cell repertoire of
      healthy individuals contains T cells capable of recognizing and responding to
      oncogene-derived peptides. Synthetic peptides derived from mutated p21 ras proto
      oncogenes, covering mutations at codons 12 or 13 were selected. It was feasible
      to elicit T-cell responses and isolate several new T-cell clones (TCC) with
      specificity for a number of different mutated ras peptides after repeated in
      vitro immunization. Four TCC were characterized with respect to fine specificity
      and HLA restriction. TCC B and I were restricted by HLA-DR molecules, and
      recognized the mutated p21 ras-derived peptide carrying Arg and Lys at residue
      12, respectively. TCC E and F were restricted by HLA-DQ molecules, the former
      being specific for a mutated p21 ras-derived peptide with Val in position 13 and
      the latter more broadly reactive. Peptide competition experiments with a panel of
      ten peptides derived from p21 ras indicated that all could bind to HLA-DQ
      molecules of the T-cell donor, while several were also able to bind his HLA-DR
      molecules. These results show that several p21 ras mutations resulting in aa
      substitutions at residues 12 or 13 could be recognized by T cells derived from
      precursor T cells of relatively low frequency present in the normal repertoire of
      a single donor.

PMID- 1639631
TI  - Linkage between HLA-DRB1 and -DRB3 types in the Japanese population analyzed by
      oligonucleotide genotyping.
AB  - We analyzed linkage between HLA-DRB1 and -DRB3 types in 219 Japanese donors by
      oligonucleotide genotyping. In the Japanese population, DRB1*1201 was linked with
      DRB3*0101 in all donors analyzed; in contrast, most Caucasian DRB1*1201 is known
      to be linked with DRB3*02(01/02) (*0201 or *0202). However, most DRB1*1202 was
      linked with DRB3*0301. Thus, the two DRw12-related DRB1 types are linked with
      DRB3 types distinct from each other. All the three DRw14-related DRB1 types,
      DRB1*1401, DRB1*1402, and DRB1*1405, were linked with DRB3*02(01/02) in the
      Japanese population, contrasting with the known linkage between DRB1*1402 and
      DRB3*0101 in other ethnic populations. The serologically "blank" DR type,
      DRB1*1403, was linked with DRB3*0101. Other DRB1 types, DRB1*0301, DRB1*11(01/04)
      (*1101 or *1104), and DRB1*13(01/02) (*1301 or *1302) in the Japanese population
      were linked mostly with the same DRB3 types, like those known in other ethnic
      populations.

PMID- 1639632
TI  - HLA-DR expression in human fetal thymocytes.
AB  - We analyzed the expression of MHC class I (W6/32) and class II (HLA-DR) antigens
      on human fetal and postnatal thymocytes by fluorescence-activated cell sorting.
      Less than 5% of prenatal thymocytes expressed HLA-DR before week 12 of gestation.
      However, the number of HLA-DR-positive cells significantly increased during the
      late second and third trimester of gestation, when greater than 50% of prenatal
      thymocytes expressed HLA-DR. Such high-level expressions of HLA-DR in fetal
      thymocytes were also demonstrated by Northern-blot analysis and
      immunohistochemistry. After birth, the percentage of HLA-DR-positive cells in
      thymocytes decreased gradually. A high-level expression of class I antigen was
      also observed in thymocytes from the early stages of gestation, but, in contrast
      to MHC class II, a majority of postnatal thymocytes maintained high levels of
      class I antigen after birth.

PMID- 1639633
TI  - Blood flow and steady state temperatures in deep-seated tumors and normal
      tissues.
AB  - Blood flow related data obtained in different deep-seated tumors and adjacent
      normal tissues were analyzed in 28 patients who were treated with combined
      regional hyperthermia and radiation for recurrent or metastatic tumors. The
      evaluation of blood flow related data has been made using the thermal
      clearance/thermal cooling coefficient technique and dynamic computed tomography.
      With both methods significant differences in global perfusion have been observed
      between tumor center and tumor periphery, between tumor and normal tissue (deep
      muscle and fat tissue), and between tumor entities. Washout rates or thermal
      cooling coefficient values, as well as the enhancement of contrast material over
      baseline (expressed in delta Hounsfield Units), correlated significantly with the
      achieved steady state temperatures for different tissue categories (i.e., tumor
      center, tumor periphery, different tumor entities, normal tissue). Thermal
      cooling coefficient values higher than 63000-83000 W/m3-K (washout rates higher
      than 15-20 ml/100 g-min) or values of enhancement of contrast material higher
      than delta 20-25 HU coincide with a limitation in achieving therapeutic
      temperatures higher than 40 degrees C.

PMID- 1639634
TI  - Feasibility of estimating the temperature distribution in a tumor heated by a
      waveguide applicator.
AB  - The feasibility of using a 2-dimensional (2D) modeling approach for
      retrospectively describing complete temperature distributions in the midplane of
      a tumor during a clinical hyperthermia treatment was tested. An experimental
      treatment, using a 915-MHz waveguide applicator to heat a large melanoma in a
      dog, was modeled. Detailed measurements of temperatures were made during the
      treatment. The steady-state blood flow distribution at the midplane was imaged by
      positron emission tomography (PET), and these data were used to prescribe the
      modeled perfusion pattern. A 2D finite element method (FEM) was used to
      approximate the solution to Maxwell's Equations to obtain the specific absorption
      rate (SAR) distribution. The blood-flow estimates, assumed material properties,
      SAR distribution, and temperature boundary conditions were then used with the
      same mesh in a second FEM program to obtain a solution to the bioheat transfer
      equation. This latter routine was embedded in a state-and-parameter-estimation
      program that systematically varied selected parameters until the differences
      between computed and measured temperatures were minimized. Optimizations were
      performed independently for three subsets of the measured temperature data to
      assess the sensitivity of the predicted temperature field to the number of
      measurements. The calculated temperature distributions that resulted were similar
      to each other, and the predicted temperatures at the sensor points excluded from
      these optimizations were in reasonable agreement with the measurements. However,
      lack of unique blood flow values following optimization indicates that the
      methods of estimating blood flow will need to be improved or that there are
      problems with model mismatch. This work is a clinical case study of an evolving
      2D system of thermal dosimetry which relies on both empirical and theoretical
      concepts. The methodology is being evaluated for its ability to generate
      prognostically significant descriptors of the treatment temperature field.

PMID- 1639635
TI  - Post-mastectomy radiotherapy following adjuvant chemotherapy and autologous bone
      marrow transplantation for breast cancer patients with greater than or equal to
      10 positive axillary lymph nodes. Cancer and Leukemia Group B.
AB  - Between 2/87 and 2/91, 49 women with operable breast cancer involving greater
      than or equal to 10 axillary nodes were treated following mastectomy, with four
      cycles of Cyclophosphamide, Adriamycin, 5FU, followed by high doses of
      Cyclophosphamide, Cisplatin, Carmustine (HDCT) with autologous bone marrow
      transplant support. Forty patients received local-regional radiotherapy
      (generally to the chest wall, internal mammary, supraclavicular, +/- axillary
      nodal areas; minimum 44-50 Gy, 1.8-2 Gy/fraction, +/- 10-15 Gy scar boost;
      standard radiation techniques). The first nine patients did not receive local
      regional radiotherapy. Three developed a local-regional failure (6-12 months
      after HDCT); six are without evidence of disease. Local-regional radiotherapy (LR
      XRT) was delivered to the subsequent 40 patients following HDCT+autologous bone
      marrow transplant. Six received less than 44 Gy of the planned local-regional
      radiotherapy due to significant toxicity and one of these failed locally. Only
      one local failure was observed among the 34 patients who received greater than or
      equal to 44 Gy. Two additional patients developed distant metastases. None of
      these 40 patients have failed in the axilla despite the fact that the axilla was
      irradiated in only 18 cases. Overall, 36/40 (90%) of these patients are without
      evidence of disease 4-30 months following HDCT (approximately 10-36 months after
      mastectomy, median 22 months). Radiotherapy was interrupted or discontinued
      because of progressive dyspnea, thrombocytopenia, or neutropenia in nine
      patients. Further studies to determine the roles of local-regional radiotherapy
      and HDCT in the development of these toxicities are underway. These encouraging
      results suggest that HDCT + autologous bone marrow transplant+local-regional
      radiotherapy may improve the survival rate in these high risk patients. A
      national randomized study to test the efficacy of this HDCT regimen is currently
      underway (Cancer and Leukemia Group B#9082 and Southwest Oncology Group #9114).

PMID- 1639636
TI  - Marrow transplantation following escalating doses of fractionated total body
      irradiation and cyclophosphamide--a phase I trial.
AB  - Thirty-six patients with advanced hematologic malignancy were entered into a
      Phase I study designed to define the maximum tolerated dose of unshielded total
      body irradiation delivered from dual 60 Cobalt sources at an exposure rate of 8
      cGy/min and given in fractions twice daily for total doses ranging from 12 Gy to
      17 Gy. All patients received cyclophosphamide, 120 mg/kg administered over 2 days
      before total body irradiation. Allogeneic marrow was infused from HLA-identical
      siblings (n = 29) or one locus HLA incompatible family members (n = 3); three
      patients received cryopreserved autologous marrow and one patient received
      syngeneic marrow. The maximum tolerated dose of total body irradiation given as 2
      Gy fractions twice a day was 16 Gy. One of eight patients receiving 12 Gy, none
      of four receiving 14 Gy, three of 20 receiving 16 Gy, and two of four receiving
      17 Gy developed severe (Grade 3-4) regimen-related toxicity. The primary dose
      limiting toxicity was pneumonitis, followed by veno-occlusive disease of the
      liver, renal impairment, and mucositis. Five patients (14%) are alive, four
      disease-free 798-1522 days posttransplant. Twenty (56%) relapsed posttransplant.
      Further investigation of regimens containing 16 Gy of hyperfractionated total
      body irradiation is warranted to assess anti-tumor efficacy.

PMID- 1639637
TI  - Permanent interstitial implantation using palladium-103: the New York Medical
      College preliminary experience.
AB  - Palladium-103 is a low energy photon emitter available for permanent interstitial
      implantation. Pd-103 has energy and safety characteristics similar to Iodine-125,
      but its initial peripheral dose rate is approximately three times greater. This
      may provide improved control of rapidly proliferating tumors. At the Westchester
      Campus of New York Medical College, 15 patients with residual or recurrent
      unresectable lesions were implanted with Pd-103. There were five males and 10
      females with an age range of 41 to 93 years (median 58). Implanted sites included
      the chest wall, nasopharynx, vagina, and zygomatic region. Peripheral doses
      ranged from 55 to 203 Gy (median 107 Gy). A complete response was achieved in
      eight patients and a partial response in seven patients, for an overall response
      rate of 100%. We noted improved control with smaller volumes and peripheral doses
      at or above 115 Gy. No unusual skin or mucosal reactions were recorded. Possible
      advantages of Pd-103 as a substitute for I-125 include improved control of
      rapidly proliferating tumors and a more rapid clinical response of lesions.
      Disadvantages include current higher cost and an impracticality in maintaining a
      running inventory because of the short half-life of the isotope. Our experience
      suggests that Pd-103 is an attractive alternative to I-125.

PMID- 1639638
TI  - Thymoma: treatment and prognosis.
AB  - Thirty-six patients with pathologically confirmed thymoma were treated at M.D.
      Anderson Cancer Center from 1962 to 1987. The tumors were staged based on
      invasion and intrathoracic dissemination. Twenty-one patients had total
      resection, five had subtotal resection, and 10 had biopsy alone. Twenty-two
      patients had definitive megavoltage radiation therapy with a median dose of 50
      Gy. The 5-year, disease-free survival by stage was 74% for Stage I (n = 11), 71%
      for Stage II (n = 8), 50% for Stage III (n = 10), and 29% for Stage IVA (n = 7)
      (p less than 0.03). The 5-year, disease-free survival by extent of surgery was
      74% for total resection, 60% for subtotal resection and 20% for biopsy only (p =
      0.001). There were 15 patients with recurrences: two in Stage I, two in Stage II,
      five in Stage III, and six in Stage IVA. The median months to relapse, for those
      who failed treatment, were 46, 36, 2, and 13 for Stages I, II, III, and IVA
      respectively. Of the patients with recurrences four had a total resection, two
      subtotal resection, and nine biopsy only. Only one patient had distant metastases
      as the first site of relapse without intrathoracic relapse. For the eight
      patients who relapsed following radiation therapy, four were in the radiotherapy
      field. All four of the in-field failures were in patients who had a partial
      response. There were insufficient numbers of patients to determine a dose
      response to radiotherapy. For patients with invasive, incompletely resected
      disease, a multimodality approach may be necessary for long term, disease-free
      survival.

PMID- 1639639
TI  - Radiation therapy as a treatment for benign lymphoepithelial parotid cysts in
      patients infected with human immunodeficiency virus-1.
AB  - Patients who are infected with the human immunodeficiency virus (HIV) may develop
      benign lymphoepithelial cysts within the parotid gland that cause severe facial
      deformity. Standard treatment for this disorder has been superficial
      parotidectomy, repeated fine-needle aspirations or observation alone. These
      approaches are unsatisfactory because elective surgery in immunocompromised
      patients should be avoided, the cysts recur soon after aspiration, and
      observation alone for a treatable deforming facial process is unacceptable.
      Radiotherapy's proven effectiveness in treating other benign disorders of the
      parotid gland led us to evaluate its usefulness as a treatment for this disorder.
      Eight patients with parotid enlargement, who were seropositive for HIV, received
      8-10 Gy to the parotids in 1 week. Five patients had complete response and three
      patients had partial response. All were very satisfied with the cosmetic result.
      Treatment-related toxicity was well tolerated and consisted of mild xerostomia
      and transient taste loss. In all cases, these side effects resolved within 1
      month. Radiation therapy thus appears to be an effective and well-tolerated
      treatment for AIDS-related parotid enlargement.

PMID- 1639640
TI  - The influence of lung and bone dosimetry on the choice of radiation energy for
      total body irradiation.
AB  - The radiation absorbed dose to lung and bone is of importance for total body
      irradiation performed prior to bone marrow transplantation for hematologic
      malignancies. The measurement and calculation of radiation absorbed dose to low
      density materials such as lung has been discussed in several publications and
      most total body irradiation procedures account for the increased radiation dose
      to the lung. However, radiation absorbed dose to bone and soft tissues within
      bone is not calculated and is assumed to be the same as the dose to soft tissues.
      Because the bone is different in both density and atomic number from soft
      tissues, radiation dose calculations are more complex for bone than for lung. As
      the energy of the radiation beam changes, the dose to heterogeneous tissue
      varies. This variation of the radiation dose is investigated for radiation beams
      ranging in energy from 60Cobalt to x-ray beams produced at 18 MV. The radiation
      absorbed dose to soft tissues within bone is found to increase relative to the
      dose to soft tissue for higher megavoltage radiations, while at the same time
      there is a decrease in lung dose. Therefore, since for total body irradiation
      procedures the target tissues are the soft tissues within bone, a higher dose to
      those tissues would be an advantage.

PMID- 1639641
TI  - Rapid two-dimensional dose measurement in brachytherapy using plastic
      scintillator sheet: linearity, signal-to-noise ratio, and energy response
      characteristics.
AB  - Because of the large dose gradients encountered near brachytherapy sources, an
      efficient, accurate, low-atomic number areal detector, which can record dose at
      many points simultaneously, is highly desirable. We have developed a prototype of
      such a system using thin plates of plastic scintillator as detectors. A micro
      channel plate (MCP) image intensifier was used to amplify the optical
      scintillation images produced by radioactive 125I and 137Cs sources in water
      placed 0.5-5.7 cm distance from the detector. A charge-coupled device (CCD)
      digital camera was used to acquire 2-D light-intensity distributions from the
      image intensifier output window. For both isotopes, a small area (2 x 3 mm2) PVT
      detector yields a CCD net count rate that is linear with respect to absorbed dose
      rate within +/- 3% out to 5.7 cm distance. Acquisition times range from 1.5-400
      sec with a reproducibility of 0.5-5.5%. If a large-area (6 x 20 cm2) PVT detector
      is used, a four-fold increase in count rate and large deviations from linearity
      are observed, indicating that neighboring pixels contribute light to the signal
      through diffusion and scattering in PVT and water. A detailed noise analysis
      demonstrates that the image intensifier reduces acquisition time 10000-fold,
      reduces noise relative to signal 200-fold, and reduces amplifier gain noise as
      well.

PMID- 1639642
TI  - The structure for a radiation oncology protocol. The Committee of Radiation
      Oncology Group Chairmen.
AB  - Multi-institutional Cooperative Group clinical trials involving radiotherapy
      require unambiguous therapeutic guidelines, so that patients entered from each of
      the participating institutions will receive essentially uniform treatment. The
      technical guidelines for a Radiation Oncology Protocol presented in this report
      represents a consensus of the Radiotherapy Committees in the major NCI funded
      Cooperative Groups and is derived from over a decade of experience. Although they
      have been written for external beam therapy, they are applicable to brachytherapy
      with appropriate technical considerations. It is anticipated that further
      evolution will occur with the introduction of new technologies such as 3-D
      treatment planning and delivery, multi-leaf collimation and small field
      irradiation.

PMID- 1639643
TI  - Local control for locally advanced breast cancer: many opinions, few facts.

PMID- 1639644
TI  - Is more therapy better? Locoregional irradiation as part of aggressive therapy
      for poor risk breast cancer patients.

PMID- 1639645
TI  - The pathogenesis of radiation myelopathy: widening the circle.

PMID- 1639646
TI  - Comparison of "orthovoltage" X-ray versus "megavoltage" electrons in treating
      tumors near the eye.

PMID- 1639647
TI  - The outcome of definitive radiotherapy for localized prostate carcinoma.

PMID- 1639648
TI  - Radical prostatectomy--possible indications for postoperative radiotherapy.

PMID- 1639649
TI  - Late effects after radiotherapy in head and neck malignancies: overall treatment
      time, number of fractions and the linear-quadratic model.

PMID- 1639650
TI  - Does hyperfractionation reduce late complications in head and neck cancers?

PMID- 1639651
TI  - Proposed universal standard for specifying schedules.

PMID- 1639652
TI  - ASTRO Gold Medal address.

PMID- 1639653
TI  - Long-term radiation complications following conservative surgery (CS) and
      radiation therapy (RT) in patients with early stage breast cancer.
AB  - The frequency of brachial plexopathy, rib fracture, tissue necrosis,
      pericarditis, and second non-breast malignancies occurring in the treatment field
      among 1624 patients with early stage breast cancer treated with conservative
      surgery and radiation therapy at the Joint Center for Radiation Therapy between
      1968 and 1985 is reported. The median follow-up time for survivors was 79 months
      (range 5-233 months). Brachial plexopathy was related to the use of a third
      field, the use of chemotherapy and the total dose to the axilla. Brachial
      plexopathy developed in 20 of 1117 women (1.8%) who received supraclavicular
      irradiation with or without axillary irradiation. The median time to its
      occurrence was 10.5 months (range 1.5-77 mo), and the majority (80%) of cases
      completely resolved. Among patients treated with a three-field technique, the
      incidence of brachial plexopathy was 1.3% (13/991) in patients treated with a
      dose to the axilla of less than or equal to 50 Gy, compared with 5.6% (7/126) in
      women treated with an axillary dose of greater than 50 Gy. The incidence of
      brachial plexopathy was 4.5% (15/330) among patients receiving chemotherapy,
      compared with 0.6% (5/787) when chemotherapy was not used (p less than 0.0001).
      Rib fracture was seen in 29 patients (1.8%), at a median time of 12 months
      following treatment (range 1-57). In all cases, the rib fracture healed without
      intervention. The incidence of rib fracture was 2.2% (28/1300) among patients
      treated on a 4 MV linear accelerator, compared with 0.4% (1/276) for patients
      treated on a 6 or 8 MV machine (p = 0.05). Of patients treated on a 4 MV machine,
      0.4% (1/279) developed a rib fracture when a whole breast dose of 45 Gy or less
      was given, 1.4% (10/725) after receiving between 45 and 50 Gy, and 5.7% (17/296)
      following 50 Gy or higher. Tissue necrosis requiring surgical correction
      developed in three patients (0.18%) 22, 25, and 114 months after treatment.
      Presumed pericarditis (requiring hospitalization) was seen in 0.4% of women
      (3/831) who received radiation therapy to the left breast 2, 2, and 11 months
      after the start of treatment. Three women (0.18%) developed sarcomas in the
      treatments field at 72, 107, and 110 months, for a 10-year actuarial rate of
      0.8%. Two of these sarcomas developed in areas of probable match-line overlap.
      One patient (0.06%) developed an in-field basal cell carcinoma at 42 months. In
      conclusion, the risk of significant complications following conservative surgery
      and radiation therapy for early stage breast cancer is low.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1639654
TI  - Are cosmetic results following conservative surgery and radiation therapy for
      early breast cancer dependent on technique?
AB  - To assess the cosmetic results in relation to treatment technique, we
      retrospectively reviewed the results for 1159 Stage I-II breast cancer patients
      treated with conservative surgery and radiotherapy between 1970-1985. All
      patients underwent gross excision followed by radiation therapy including an
      implant or electron beam boost. The total dose to the primary site was greater
      than or equal to 60 Gy. Because of technical modifications introduced over time
      after 1981, the population was divided arbitrarily into two cohorts: 504 patients
      treated through 1981 and 655 treated between 1982-1985. Median follow-up time for
      surviving patients in the two cohorts were 107 months and 67 months,
      respectively. Cosmetic outcome was evaluated by the examining physician and
      scored as excellent, good, fair or poor. Excellent results at 5 years were scored
      in 59% of early cohort patients and 74% of the latter cohort (p = 0.002).
      Acceptable results (either good or excellent) were seen in 84% and 94%,
      respectively (p = 0.02). In the latter cohort, the likelihood of achieving an
      excellent result, but not an acceptable result, was significantly related to the
      volume of resected breast tissue and the use of chemotherapy. The number of
      fields (three-field technique, provided that fields are precisely matched,
      compared to tangents only) and boost type (implant vs electrons) did not
      influence the cosmetic outcome. We conclude that our current technique using
      breast RT to 45-46 Gy and a boost to the primary site of 16-18 Gy is associated
      with a high likelihood of acceptable cosmetic results and that this likelihood is
      not diminished by the use of adjuvant chemotherapy, a large breast resection, the
      use of a third field, or boost type.

PMID- 1639655
TI  - The effect of systemic therapy on local-regional control in locally advanced
      breast cancer.
AB  - One hundred and seven patients with locally advanced breast cancer were
      prospectively referred for multimodality treatment on protocol using
      chemohormonal therapy to maximal response followed by local treatment and
      maintenance therapy. Forty-eight patients (45%) were diagnosed with Stage IIIA
      disease, 46 (43%) with Stage IIIB inflammatory cancer, and 13 (12%) with Stage
      IIIB non-inflammatory disease. Induction therapy consisted of cyclophosphamide,
      doxorubicin, methotrexate, and 5-fluorouracil with hormonal synchronization using
      tamoxifen and conjugated estrogens. Local treatment was determined by response to
      chemotherapy. Patients with a clinical parital response underwent mastectomy
      followed by local-regional radiotherapy while patients with a clinical complete
      response were biopsied for pathologic correlation. Those with residual disease
      received mastectomy followed by radiotherapy while those with a pathologic
      complete response received radiation only to the intact breast and regional
      nodes. With a median follow-up of 64 months, patients with IIIA disease had a
      significantly lower local-regional failure rate compared to IIIB inflammatory
      patients, with the 5-year actuarial local-regional failure rate as only site of
      first failure 3% for IIIA disease versus 21% for IIIB inflammatory cancer (p =
      .02), and local-regional failure as any component of first failure 12% versus 36%
      (p = .01), respectively. When local-regional failure was analyzed by repeat
      biopsy, 5/31 (16%) patients with a pathologic complete response treated with
      radiation only developed a local-regional failure versus 2/53 (4%) with residual
      disease treated with mastectomy and postoperative radiotherapy. The 5-year
      actuarial local-regional failure rate as first site of failure was 23% for
      radiation only versus 5% for mastectomy and post-operative radiotherapy (p =
      .07). The response to chemotherapy did not reliably predict local-regional
      control. Both relapse-free survival and overall survival were significantly
      better for IIIA versus IIIB patients; stratification by repeat biopsy did not
      however, significantly affect either relapse-free or overall survival.

PMID- 1639656
TI  - Radiosensitization of cultured human colon adenocarcinoma cells by 5
      fluorouracil: effects on cell survival, DNA repair, and cell recovery.
AB  - Although 5-fluorouracil (5-FU) is commonly used in conjunction with radiotherapy
      to treat gastrointestinal malignancies, the molecular mechanisms underlying the
      clinically observed therapeutic advantage of this combination of agents have not
      been clearly established. The present in vitro studies addressed the possibility
      that the radiosensitization of log-phase cultured human colon adenocarcinoma
      cells by postirradiation administration of 5-FU was accompanied by an
      interference either with the rejoining of radiation-induced DNA double-strand
      breaks (DSB's) or with recovery from potentially lethal damage (PLD).
      Significantly more killing was observed in cells exposed to gamma-rays (1-6 Gy)
      and then treated with 5-FU (100 micrograms/mL; 0.77 mM) for 1 hr at 37 degrees C
      than in cells given gamma-rays but not 5-FU; essentially, the survival curve
      shoulder was removed. DSB rejoining measured using the neutral filter elution
      method after exposure to 25 Gy was identical regardless of whether 5-FU (100
      micrograms/mL) was present during the repair period; thus, radiosensitization by
      this high-concentration postirradiation 5-FU protocol does not appear to be a
      result of interference with the overall rate of ligation of gamma-ray-induced
      DSB's. The effect of 5-FU on the ability of log-phase cells to recover from that
      sector of PLD that can be expressed by postirradiation incubation with hypertonic
      (0.5 M) salt solution (HSS) was also examined. When irradiated cells were treated
      with 5-FU during their recovery period and then incubated with HSS, no clonogenic
      cells survived. Therefore, although it was not possible to assess the actual
      kinetics of recovery from gamma-ray-induced PLD in 5-FU-treated cells, the drug
      clearly altered the metabolism or structure of the cells such that their
      susceptibility to HSS was markedly enhanced.

PMID- 1639657
TI  - Restriction enzyme-induced DNA double-strand breaks as a model system for
      cellular responses to DNA damage.
AB  - To learn more about cellular responses to DNA double-strand breakage, we used
      three methods to assay cellular damage after treatment with a restriction enzyme
      that causes DNA double-strand breaks by cleaving at specific recognition sites in
      the DNA. Chinese hamster ovary cells were treated with increasing doses of Pvu II
      and studied for double-strand breakage, chromosomal aberration yield, and cell
      survival. The yield of DNA double-strand breaks, as measured by pulsed-field gel
      electrophoresis, increased at concentrations up to 500 units and saturated
      thereafter. The maximum yield of metaphase cells showing aberrant chromosomes was
      reached at 100 units and stayed constant up to 1,000 units. Although exchange
      type aberrations saturated at approximately 4.5 per cell at 100 units, deletion
      type aberrations appeared to increase at concentrations up to 500 units. Cell
      survival, as measured by colony-forming ability after Pvu II treatment, saturated
      at 100 units. The observed dose-response data are probably due to the saturation
      of accessible Pvu II cleavage sites within the cell. These data indicate that
      restriction enzymes induce the same DNA-damaging effects as many of the agents
      used in cancer treatment. Because the primary DNA lesion induced by restriction
      enzymes is known, they provide a unique opportunity to understand cellular
      responses to DNA damage and repair.

PMID- 1639658
TI  - Incest, Freud's seduction theory, and borderline personality.
AB  - In the early 1890s Freud expressed the belief that many cases of hysteria had a
      basis in childhood incest. Later he expressed a different view, emphasizing
      childhood fantasies of sexual intimacies with a parent that never actually took
      place. Freud never totally repudiated his original seduction theory, however,
      maintaining to the end of his life that at least some cases of actual incest
      occurred and that these instances underlay certain types of psychopathology. In
      our era we have become aware that incest is frequently a forerunner of subsequent
      borderline disorders, especially in women hospitalized with borderline
      personality disorder (B.P.D.). All the clinical manifestations of B.P.D. can be
      related to the prior incest experiences.

PMID- 1639659
TI  - Stress in the personal and professional development of a psychoanalyst.

PMID- 1639660
TI  - Reflections on dream material from Arctic Native people.
AB  - This article presents several theoretical and methodological perspectives from
      which psychoanalytic understanding of the dreams of people in a foreign culture
      might be obtained. The dreams of two Inuit (Eskimos) are examined as they reflect
      the cosmologies, narrative styles, and individual psychologies of each dreamer.
      Caveats are noted regarding notions of universal symbolism, typical cultural
      character, and facile interpretations of dreams.

PMID- 1639661
TI  - The parenting process: a psychoanalytic perspective.

PMID- 1639663
TI  - Fromm's concept of biophilia.

PMID- 1639662
TI  - The semiotics of gender.
AB  - The semiotics of gender are investigated in this article for the purpose of
      exploring the way that deep unconscious motives in relationship to cultural
      biases give rise to gender concepts. Theories of semiotic processes, including
      Jacques Lacan's concept of the psychoanalytic signifier, are explained briefly
      and applied to the signs of gender. The article concludes that gender concepts
      develop out of biology, unconscious feelings, and social patterning, and are not
      given, natural, and irrevocable.

PMID- 1639664
TI  - The adolescent crack dealer: a failure in the development of empathy.

PMID- 1639665
TI  - Psychoanalysis and psychosomatics: a new synthesis.
AB  - The usefulness of psychoanalysis to psychosomatic medicine has been limited by
      the longstanding assumption that the psychological disorder in psychosomatic
      patients resembles the conflict-based psychopathology that Freud identified in
      psychoneurotic patients. Recent investigations of the alexithymia construct, and
      the discovery that social relationships can influence health over the entire life
      span, have challenged this assumption and created an opportunity for a new and
      active involvement of psychoanalysis with psychosomatic medicine. In this
      contribution, I offer a synthesis of contemporary psychoanalytic observations and
      theories with concepts and research findings from developmental psychology,
      developmental biology, and the biomedical sciences. The proposed synthesis is
      consistent with the view that living organisms are self-regulating cybernetic
      systems; it also extends an evolving new psychosomatic model that conceptualizes
      illnesses and diseases as disorders of psychobiological regulation. A modern
      psychoanalytic approach to physically ill and disease-prone individuals focuses
      less on the resolution of neurotic conflicts, and more on correcting deficits in
      these patients' self and object representations and capacity cognitively to
      process emotions.

PMID- 1639666
TI  - The phoenix rises from eros, not ashes: creative collaboration in the lives of
      five impressionist and postimpressionist women artists.
AB  - Women yearn to express themselves through their affiliative bonds and
      professional goals. Historically, it has been difficult for women to find and
      maintain close affirmative ties with men while they also strived to advance their
      careers. The lives of five impressionist and postimpressionist women artists in
      fin-de-siecle Europe permit a glimpse into the possibilities and pitfalls of
      relationships in career development. When mentors or supportive partners are
      available to women, their creative productivity flourishes. In contrast, when the
      male partner seeks greedily to control or enviously to attack the woman's
      aspirations, her creativity wanes, and her life may be ravaged. Yet the keystone
      of any creative partnership is the ability to reckon with the potential sources
      of destructiveness within one's self that may lead to disparagement of the other.
      The lives of men and women may be enhanced when neither partner disavows or seeks
      to denigrate the talents of the other. Creative partnerships that support the
      emotional and productive intensity of both members of the dyad can lead to great
      personal expansion and enrichment for the culture at large.

PMID- 1639667
TI  - ERP augmenting/reducing and sensation seeking: a critical review.
AB  - Event-related potentials (ERPs) are generally considered capable of throwing
      light on the biological basis of personality traits. In particular, the ERP
      augmenting/reducing (A/R) phenomenon has been consistently associated with
      personality dimensions such as sensation seeking or impulsivity. However, doubts
      have been expressed regarding the validity of published evidence that individuals
      scoring high as sensation seekers are ERP augmenters. Reports of A/R-sensation
      seeking correlation in the opposite direction (in keeping with Petrie's
      hypotheses) threaten the construct validity of A/R, and lack of intermodal
      consistency throws serious doubts upon the existence of the central input
      regulating mechanism once thought to be associated with sensation seeking. With
      the aim of clarification this article reviews the literature on the relationship
      between ERP A/R and sensation seeking, discusses the chief problems confronted by
      research in this area, and makes suggestions for future studies. It is concluded
      that experimental conditions of stimulus intensity and inter-stimulus interval
      may have played a part in the inconsistencies. The need to use a variety of
      measures of sensation seeking is stressed, and a number of other recommendations
      for research in this field are made.

PMID- 1639668
TI  - Event-related potentials in the dual task paradigm: P300 discriminates engaging
      and non-engaging films when film-viewing is the primary task.
AB  - Five groups of subjects (11-16/group) were run in three experiments. In each
      study P300 amplitude and latency were studied as a function of three sensory task
      conditions: (1) baseline (oddball task: target and non-target tones only); (2)
      boring film viewing plus oddball task; and (3) exciting film viewing plus oddball
      task. In Experiment I, target probability was P = 0.22. In Experiments II and
      III, each of two groups of subjects was run at P = 0.22 or P = 0.33. Two
      different exciting films and two different boring films were used. Oddball-target
      amplitude was found to consistently decrease from baseline to boring to exciting
      film-viewing conditions at P = 0.22. At P = 0.33, the 2-film discrimination was
      successful in one of two experiments. P300 amplitude consistently differed from
      baseline to film-viewing conditions. For the non-target (frequent) tones, the
      smaller P300 amplitudes consistently discriminated boring and exciting films, as
      well as single from dual tasks. For target P300 latency, single (baseline) and
      dual (film-watching) conditions were always discriminable, but boring and
      exciting films were not discriminable. There were no effects on non-target P300
      latency. N100 amplitude discriminated baseline and film viewing conditions, but
      not boring and engaging films.

PMID- 1639669
TI  - Visual attention and evoked otoacoustic emissions: a slight but real effect.
AB  - The effect of auditory or visual attention tasks on the peripheral auditory
      system, studied by Brainstem Auditory Evoked Potentials (BAEPs),
      electrocochleography or Evoked Oto-Acoustic Emissions (EOAEs), has been a subject
      of controversy. To investigate the divergences in findings, a study using EOAE
      and visual and auditory attention was run on 12 subjects. A significant effect
      during visual attention was obtained. A general diminution of EOAEs of 0.35 dB
      (equivalent reduction) was found. This result seems to prove that BAEPs are not
      the best technique to reveal the effect of attention on cochlear mechanisms,
      because of the weakness of the effect.

PMID- 1639670
TI  - P3 from auditory stimuli in healthy elderly subjects: hearing threshold and tone
      stimulus frequency.
AB  - The P3 event-related potential (ERP) was elicited by auditory stimuli under two
      conditions: (1) 250 Hz standard, 500 Hz target; and, (2) 1000 Hz standard, 2000
      Hz target. A group with normal hearing (n = 10), defined as subjects with less
      than a 16 dB loss at each tone frequency was compared to a group with hearing
      impairment (n = 8), defined as subjects with a loss of 16 dB or more at each tone
      frequency. The hearing impaired group showed significant P3 latency prolongations
      compared to those with normal hearing under the 2000 Hz, but not the 500 Hz
      target, even though subject age was used as a covariate. Under both conditions,
      hearing impaired subjects showed reduced P3 amplitudes compared to those with
      normal hearing. These findings are discussed in relation to the sensitivity of
      ERP assessment procedures in older adults.

PMID- 1639671
TI  - Psychophysiological treatment for learning disabilities: controlled research and
      evidence.
AB  - Research data are presented on the effects of a psychophysiological treatment
      method for learning disabilities. A total of 238 subjects with learning
      disabilities were selected based on their school records. Of these, 105 received
      the full treatment which consisted of the manipulation and maintenance of
      bilateral electrodermal activity between 6.5-8.5 mu mhos simultaneously combined
      with increasingly complex perceptual tasks (Mangina, 1981a, b, c; Mangina and
      Beuzeron-Mangina, 1988). Another 133 subjects with learning disabilities were
      assigned into four different conditions: (a) classmate controls; (b) only
      attachment of electrodes; (c) only optimal activation; (d) only perceptual
      stimulation. Evidence for the effectiveness of the treatment method was found
      based on different experimental conditions which are presented in this paper.
      ANOVA and multiple comparison tests indicate that beneficial effects were only
      obtained by the administration of the full treatment method and were significant
      at all three time intervals investigated (P less than 0.001). The evidence
      supports that the treatment method has induced a 'synergistic simultaneity' which
      is required by the brain both in terms of its bilaterally 'optimal' physiological
      activation and the appropriate quality of incoming stimulation in order to
      produce a beneficial neural integration.

PMID- 1639672
TI  - The facilitative effect of facial expression on the self-generation of emotion.
AB  - Twenty-seven female undergraduates completed three tasks: (1) feel four emotions
      (happiness, sadness, anger, peacefulness); (2) express these emotions, without
      trying to feel them; and (3) feel and express clearly these four emotions. During
      each trial subjects pressed a button to indicate when they had reached the
      required state, and the latency from emotion cue to button press was measured.
      Heart rate, skin conductance and EMG from four facial sites (brow, cheek, jaw and
      mouth) were recorded for 15 s before and after the button press and during a
      baseline period prior to each trial. Self-reports were obtained after each trial.
      Facial EMG and patterns of autonomic arousal differentiated among the four
      emotions within each task. Shorter self-generation latency in the Feel-and-Show
      versus the Feel condition indicated the facilitative effect of facial expression
      on the self-generation of emotion. Furthermore, the presence of autonomic changes
      and self-reported affect in the Show condition supports the sufficiency version
      of the facial feedback hypothesis. The self-generation method employed as an
      emotion elicitor was shown to reliably induce emotional reactions and is proposed
      as a useful technique for the elicitation of various emotional states in the
      laboratory.

PMID- 1639673
TI  - Physiological and subjective effects of traffic noise: the role of negative self
      statements.
AB  - This study assesses physiological and subjective effects of traffic noise and the
      mediator role that negative self-statements play. 84 female students underwent a
      Physiological Reaction Test to two 15 min presentations of high intensity traffic
      noise (85-95 dB) under two Noise conditions--with and without negative self
      statements. Half of the subjects were given specific instructions to increase the
      credibility of the self-statements. Dependent variables were frontal EMG,
      electrodermal variables (conductance level and number of responses) and
      subjective tension. Traffic noise provoked subjective tension and physiological
      responses. Only the number of electrodermal responses habituated between noise
      presentations, the rest of the physiological variables did not habituate.
      Negative self-statements had the greatest effect on frontal EMG. In fact, only
      the noise with negative self-statements condition produced a significant EMG
      increase in the first part of the Test. Instructions increased subjective tension
      and also increased the effect of the self-statements on the electrodermal
      variables. The implications of these results for psychosomatic problems and the
      importance of negative self-statements are discussed.

PMID- 1639674
TI  - Fast decrement with stimulus repetition in ERPs generated by neuronal systems
      involving somatosensory SI and SII cortices: electric and magnetic evoked
      response recordings in humans.
AB  - The effect of stimulus repetition (short trains of stimuli with 1-s inter
      stimulus intervals and 15-s inter-train intervals) on both electric and magnetic
      evoked responses were studied in four subjects. In addition to the later N140 and
      P300 deflections in electric potentials, a distinct and immediate amplitude
      decrement was obtained also for the earlier P50 and P100 deflections. The
      magnetic evoked responses also demonstrated the amplitude decrement for 50 ms
      (M50) and 100 ms (M100) latency deflections. The time-course and degree of
      amplitude decrement of the M100 magnetic response corresponded especially well to
      those of P100 electric deflections. The results thus show the rate effect on
      electric and magnetic responses at 50 and 100 ms latencies, and further suggest
      that the electric and magnetic responses, reflecting the activation of
      somatosensory SI and SII cortical areas at these latencies, respectively, are
      generated by related neuronal mechanisms.

PMID- 1639675
TI  - Oddball-evoked P300-based method of deception detection in the laboratory. II:
      Utilization of non-selective activation of relevant knowledge.
AB  - We used a deception paradigm modeled on the type used for pre-employment
      screening procedures. Our novel dependent measure was P300 amplitude. Event
      related potentials (ERPs) were recorded while subjects were presented with a list
      of eight antisocial acts one at a time, and one target-response phrase to which a
      'yes' button press was required. Subjects were instructed to try to escape
      detection during the ERP test if they were guilty of any of the acts. After the
      ERP test, ground truth was established by the completion of an innocent/guilty
      check list of antisocial acts under perceived anonymous conditions tending to
      favor honest responding. Subjects were classified as innocent (n = 14) or guilty
      (n = 17) based on their check list response to the relevant act 'Used Falsified
      ID'. When comparing the P300 amplitudes in response to the relevant and to
      another act, we found that most group analyses revealed significant differences
      between guilty and innocent subjects. The subjects were also individually
      classified by a 3-step algorithm which involved: (1) a bootstrap amplitude test
      that compared the bootstrapped amplitudes of the P300s to the relevant and to
      another act; (2) relevant-to-target item P300 amplitude ratios; and (3) relevant
      act P300 amplitudes. Overall, the algorithm yielded 87% accuracy. The present
      study was intended to be an advance over our previous study (Rosenfeld, et al.,
      1991), in which we correctly classified 89% of the subjects using a similar P300
      based deception detection paradigm. However, the possible confounding limitation
      of that study was that subjects had to complete an innocent/guilty check list of
      their antisocial acts prior to the ERP test. The present study investigated the
      accuracy of the P300-based test when subjects did not admit or selectively
      rehearse their guilt of the relevant act prior to the ERP test.

PMID- 1639676
TI  - Avocado poisoning.

PMID- 1639678
TI  - AVMA initiative begins Capitol Hill climb.

PMID- 1639677
TI  - Relief for relief veterinarians.

PMID- 1639679
TI  - From the bottom(s) up: how two veterinarians escaped their world of drugs and
      alcohol.

PMID- 1639680
TI  - Amend FD&C Act, says Veterinary Medicine Advisory Committee.

PMID- 1639681
TI  - What's holding up animal drug approval?

PMID- 1639682
TI  - Follow-up study of owner attitudes toward home care of paraplegic dogs.
AB  - A questionnaire was mailed to 30 owners of paraplegic dogs who had been caring
      for their dogs at home for 3 to 72 months. It was designed to collect information
      on demographic variables, duration of ownership and paralysis, age of the pet,
      pet/owner relationship, owner expectations and perceptions of the pet's quality
      of life, problems the pet experienced, effect that maintaining a paralyzed pet
      had on the owners' quality of life, and whether use of a cart was beneficial.
      Significant correlation was found between prior expectations that the pet would
      lead a high-quality life and perception that the pet, in fact, had a high quality
      of life during paralysis (r2 = 0.61, P = 0.01). Owners who had anticipated that
      extra work would be necessary to care for their paraplegic dog had a more
      positive attitude toward home care (r2 = 0.55, P = 0.03). Overall, owners
      involved in the study were satisfied with all aspects of maintaining paraplegic
      dogs at home. Our findings support the feasibility of dedicated owners
      successfully maintaining small (average body weight, 9 kg) paraplegic dogs at
      home for extended periods.

PMID- 1639683
TI  - Economic impact of an epizootic of pseudorabies in a commercial swine herd in
      Ohio, achieving test negative status and quarantine release by use of vaccination
      and test and removal.
AB  - The effect of pseudorabies in a commercial farrow-to-finish operation on selected
      production and economic values was estimated. Pseudorabies was first diagnosed in
      this herd by circle testing done in March 1988, as a required part of follow up
      from another herd that had been diagnosed with pseudorabies in the area. A
      pseudorabies virus vaccination program was initiated in the herd at that time.
      The mean litter size of pigs born alive varied from 9.26 to 10.02 pigs/litter
      throughout the study period; however, there was a twofold increase in suckling
      pig mortality and a 2.6-fold increase in nursery pig mortality when the months of
      the epizootic were compared with pre-epizootic months. In the 6-month period
      following the epizootic, suckling pig mortality was three-fold higher than that
      reported in the preepizootic months. Total net loss for this operation was
      estimated at $99,700 from when the epizootic started until eradication, when
      calculating losses directly. The major economic losses (76.5% of total loss) were
      related to suckling pig mortality, which was $16,240 during the epizootic or
      $24/inventoried sow/week; $19,395 in the 6 months following the epizootic or
      $3.8/inventoried sow/week; and $40,628 thereafter until eradication 26 months
      later or $0.37/inventoried sow/week. Nursery pig mortality losses were 12.6% of
      total net losses; $754 during the epizootic, $357 in the 6 months after the
      enzootic, and $11,444 thereafter until eradication 26 months later. Sow culling
      and deaths accounted for 9.4% of net losses that took place from 6 months after
      the epizootic until eradication.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639684
TI  - To live or not to live with the risk of extra-label use.

PMID- 1639685
TI  - Use of ultralente insulin in cats with diabetes mellitus.

PMID- 1639686
TI  - Building good client relations.

PMID- 1639687
TI  - Circulatory shock and cardiopulmonary resuscitation: current perspectives and
      future directions.

PMID- 1639688
TI  - New perspectives in circulatory shock: pathophysiologic mediators of the
      mammalian response to endotoxemia and sepsis.

PMID- 1639690
TI  - Role of oxygen-derived free radicals in the pathogenesis of shock and trauma,
      with focus on central nervous system injuries.

PMID- 1639689
TI  - Involvement of prostaglandins and leukotrienes in the pathogenesis of endotoxemia
      and sepsis.

PMID- 1639691
TI  - Clinical aspects of septic shock and comprehensive approaches to treatment in
      dogs and cats.

PMID- 1639692
TI  - Systemic and pulmonary reactions in swine with endotoxemia and gram-negative
      bacteremia.

PMID- 1639693
TI  - Endotoxemia and gram-negative bacteremia in swine: chemical mediators and
      therapeutic considerations.

PMID- 1639694
TI  - Shock attributable to bacteremia and endotoxemia in cattle: clinical and
      experimental findings.

PMID- 1639695
TI  - Endotoxemia and septicemia in horses: experimental and clinical correlates.

PMID- 1639696
TI  - Management of septic shock.

PMID- 1639697
TI  - Basic life support and external cardiac compression in dogs and cats.

PMID- 1639698
TI  - Recognition and frequency of dysrhythmias during cardiopulmonary arrest.

PMID- 1639699
TI  - Controversial issues in drug treatment during cardiopulmonary resuscitation.
AB  - The goal of advanced life support in CPR must be to restore and maintain
      respiratory and hemodynamic effectiveness, and to correct the underlying
      dysrhythmia. Optimal basic life-support techniques must be continued to meet
      these goals. Many drugs have been suggested in the treatment of cardiac arrest,
      but unfortunately, drug effects are inconsistent and resuscitation rates remain
      low. Epinephrine, atropine, lidocaine, bretylium, and naloxone remain important
      drugs for consideration in CPR in most animals with cardiac arrest. The best
      chance of survival remains in early recognition of animals susceptible to arrest
      and in treatment of the underlying cause.

PMID- 1639700
TI  - Internal cardiac compression.

PMID- 1639701
TI  - Effects of lasalocid on coccidial infection and growth in young dairy calves.
AB  - Effects of lasalocid on coccidial infection and on calf growth were examined in
      16 Holstein bull calves. Calves were assigned randomly to a 2 x 2 factorial
      arrangement of starter ration containing 0 or 40 mg of lasalocid/kg of starter,
      beginning when calves were 3 days old (SE = 0.046), and single oral inoculation
      with 0 or 30,000 sporulated oocysts (Eimeria bovis) at 28 days. Pelleted calf
      starter was fed ad libitum from day 1; milk replacer was fed at a rate of 3.6
      kg/d until day 28. Mean daily gain, dry-matter intake, and body weight were
      increased in calves fed lasalocid and decreased in those inoculated with
      coccidia. Addition of lasalocid to the feed improved gains by 8% in uninoculated
      calves and by 50% in inoculated calves. Fecal oocyst numbers were reduced when
      lasalocid was fed to inoculated calves. Feces were more abnormal in calves
      inoculated with coccidia. Respiration rates, rectal temperatures, PCV, and serum
      sodium and potassium concentrations were unaffected by treatment. On the basis of
      findings in this study, lasalocid minimized effects of coccidial challenge
      inoculation and increased growth of calves.

PMID- 1639702
TI  - Cardiopulmonary and behavioral effects of combinations of
      acepromazine/butorphanol and acepromazine/oxymorphone in dogs.
AB  - Cardiopulmonary and behavioral effects of the following tranquilizer-opioid drug
      combinations were compared in conscious dogs: acepromazine (0.22 mg/kg of body
      weight, IV) and butorphanol (0.22 mg/kg, IV); acepromazine (0.22 mg/kg, IM) and
      butorphanol (0.22 mg/kg, IM); and acepromazine (0.22 mg/kg, IV) and oxymorphone
      (0.22 mg/kg, IV). Marked sedation and lateral recumbency that required minimal or
      no restraint was achieved with every drug combination. Analgesia was
      significantly better in dogs receiving oxymorphone than in dogs receiving
      butorphanol, as evaluated by response to toe pinch. There were no significant
      differences between the effects of the 3 drug combinations on heart rate,
      respiratory rate, arterial blood pressure, body temperature, and arterial pH,
      PCO2, PO2, and bicarbonate concentration. Heart rate, respiratory rate, and
      systolic arterial pressure decreased significantly over time with all drug
      combinations. Total recovery time (minutes from the initial injection to
      standing) was significantly longer in the dogs given acepromazine and
      oxymorphone.

PMID- 1639703
TI  - Salivary mucocele associated with dirofilariasis in a dog.
AB  - Salivary mucocele associated with dirofilariasis was diagnosed in a dog with a
      mass in the cranioventral cervical region. The diagnosis was based on the finding
      of microfilariae in fluid aspirated from the mucocele, immunoassay confirmation
      of circulating Dirofilaria immitis antigen, and the finding of an adult filariid
      within the mucocele. Drainage of the mucocele and treatment of the D immitis
      infection resulted in resolution of the mucocele and dirofilariasis.

PMID- 1639704
TI  - Keratoconjunctivitis sicca and diabetes mellitus in a dog.
AB  - Diabetes mellitus and keratoconjunctivitis sicca were diagnosed in a female
      Poodle. The dog was treated for diabetes and keratoconjunctivitis sicca until
      blood glucose concentrations were within normal limits. Treatment for
      keratoconjunctivitis sicca was suspended then, and signs of this disorder did not
      appear again. Most of the factors known to predispose to keratoconjunctivitis
      sicca were not applicable to this dog. On the basis of observations made in this
      dog, we suggest that diabetes mellitus and keratoconjunctivitis sicca may be
      linked. Clinical signs of the disorders developed simultaneously and resolved
      when diabetes mellitus was controlled with insulin.

PMID- 1639705
TI  - Insect defensive spray-induced keratitis in a dog.
AB  - Ulcerative keratitis was seen in a dog after it had been sprayed in the face by
      the larger striped walking stick, Anisomorpha buprestoides. This insect has
      defensive glands from which it can spray a secretion that is lachrymogenic and
      irritating.

PMID- 1639706
TI  - Hypervitaminosis A in a cat.
AB  - A 10-year-old cat that was kept on a diet consisting largely of raw liver was
      evaluated because of lethargy, partial anorexia, and weight loss of several
      months' duration. The cat's head and neck were rigidly extended, and a hard mass
      was palpable in the ventral cervical region. Cervical and thoracic radiography
      revealed proliferative bony lesions of the cervical and thoracic vertebrae as
      well as of the sternum and costal cartilages. Serum vitamin A concentration was 4
      times normal. For reasons unrelated to hypervitaminosis A, euthanasia and
      necropsy were performed 6 months after evaluation. The skull and the cervical and
      first few thoracic vertebrae were rigidly fused, and the vertebral architecture
      was altered by deposition of new bone. The sternum and costal cartilages were
      similarly affected. The historical, physical, radiographic, laboratory, and
      postmortem findings were consistent with the diagnosis of hypervitaminosis A. On
      the basis of findings in this cat, hypervitaminosis A should be suspected in any
      sick cat fed a diet consisting partly or completely of raw liver.

PMID- 1639708
TI  - Nonpharmacologic management of stereotypic self-mutilative behavior in a
      stallion.
AB  - Self-mutilative behavior, a form of stereotypic behavior, can be a serious
      problem in stallion management. An 11-year-old Quarter Horse stallion was
      referred for evaluation of repeated episodes of self-mutilation and aggressive
      behavior. Historically, this behavior worsened when the horse was isolated from
      other animals and confined to a stall for long periods. Observations of the
      stallion revealed episodes of self-mutilation and other forms of stereotypic
      behavior precipitated by stressful situations. Modification of this behavior was
      achieved by environmental and nutritional management and provision of adequate
      exercise. Nonpharmacologic intervention can be a simple and inexpensive way to
      correct self-mutilative behavior.

PMID- 1639709
TI  - Ileocecal intussusception corrected by resection within the cecum in two horses.
AB  - Irreducible ileocecal intussusceptions pose a difficult surgical problem.
      Strangulating ileocecal intussusceptions involving the ileum and jejunum were
      identified in 2 horses undergoing exploratory laparotomy because of colic.
      Surgical correction in both horses was achieved by amputation of the ileocecal
      intussusception from within the cecal lumen, via typhlotomy. The inverted ileal
      stump was blindly stapled near the ileocecal orifice after pulling the
      intussusceptum into the cecum. A jejunocecostomy was performed to reestablish
      intestinal continuity.

PMID- 1639707
TI  - Ultrasonographic imaging of a keratoma in a horse.
AB  - Ultrasonography was used to confirm the tentative diagnosis of keratoma in a
      horse admitted for chronic progressive lameness. A definitive diagnosis of
      keratoma traditionally has been diagnosed by history, clinical findings, and
      radiographic evaluation. Confirmation of the keratoma by use of ultrasonography
      facilitated the formulation of a treatment plan that resolved the condition.

PMID- 1639710
TI  - Cystic structures in the guttural pouch (auditory tube diverticulum) of two
      horses.
AB  - Two horses were examined for compression of the pharynx from the dorsal
      pharyngeal wall. Neither horse had a patent opening of 1 of the guttural pouches.
      Radiography of the guttural pouch region revealed a retropharyngeal opacity that
      occluded 1 guttural pouch. Organisms were not isolated on bacteriologic culture
      of fluid obtained from the affected guttural pouch. Surgical exploration of the
      guttural pouch revealed the lining to be easily removeable by blunt dissection in
      1 horse; however, the lining was more firmly attached and removal was not
      attempted in the second horse. A fenestration between the normal and affected
      guttural pouch was created in both horses to allow for drainage. The
      etiopathogenesis of the cyst in the guttural pouches is unknown.

PMID- 1639711
TI  - Distal metacarpal sequestration in a bison.
AB  - A 2-year-old 400-kg female American bison was admitted for evaluation and
      treatment of an open fracture of the right metacarpal bones 3 and 4. Radiography
      revealed osteolysis of the distal metaphysis and epiphysis, with extensive bony
      callus formation along the dorsoproximal and proximomedial aspects extending
      distally to the proximomedial aspect of the proximal phalanx. Evidence of
      periosteal or bony proliferation at the fracture site or along the distal segment
      of the third and fourth metacarpal bones was not visible, suggesting that the
      distal fracture fragment was becoming a sequestrum. Treatment consisted of soft
      tissue debridement and placement of the limb in a full-limb cast. The cast was
      changed every 4 weeks until the sequestrum was removed and the bone healed. It is
      rare for the distal half of a long bone to sequester following fracture.
      Additionally, it is remarkable that the sequestrum served as a buttress, which
      prevented collapse of the bone until the sequestrum was replaced by functional
      bony callus.

PMID- 1639712
TI  - Ocular lymphangiosarcoma in a cow.
AB  - Ocular lymphangiosarcoma was diagnosed in a Holstein cow with a progressively
      enlarging limbal mass. The cow was treated by exenteration. The cow survived for
      2 years without clinical signs of recurrence. Lymphangiosarcoma is a vascular
      neoplasm that rarely has been reported in domestic animals. In other species, it
      has a high rate of metastasis and is associated with poor long-term survival.

PMID- 1639713
TI  - Respiratory and cardiopulmonary arrest in dogs and cats: 265 cases (1986-1991).
AB  - Outcomes of cardiopulmonary arrest and resuscitation in clinically affected dogs
      and cats have not been adequately studied. We examined the records from 200 dogs
      and 65 cats that had received cardiopulmonary resuscitation for respiratory or
      cardiopulmonary arrest; none of the animals had been anesthetized or intubated at
      the time of arrest, and all had been hospitalized in a veterinary critical care
      facility. Cardiopulmonary arrest was found to be more common than respiratory
      arrest in dogs and cats. Hospital discharge rates for animals with
      cardiopulmonary arrest ranged from 4.1% for dogs to 9.6% for cats, and were
      consistent with those reported from studies of human beings with cardiopulmonary
      arrest. Hospital discharge rates for dogs and cats with respiratory arrest were
      28% and 58.3%, respectively.

PMID- 1639714
TI  - Surgical treatment of dorsal cortical fractures of the third metacarpal bone in
      thoroughbred racehorses: 53 cases (1985-1989).
AB  - Between January 1985 and May 1989, 53 Thoroughbred horses (mean age 3.2 years)
      were surgically treated for dorsal cortical fractures of the third metacarpal
      bone (MC III). All horses were treated with cortical drilling through the
      fracture line (osteostixis). Diagnosis of the fractures was confirmed by
      xeroradiography. Lifetime racing records were obtained for all horses. Forty
      seven horses returned to racing after surgery (89%). The mean time between
      surgery and the first race was 6.8 months. Horses had a mean of 10.9 starts
      before surgery and 16.1 starts after surgery. The mean earnings per start before
      surgery was $6,459 and after surgery was $5,685. Of the 47 horses that raced
      after surgery, 70% raced at the same class or improved. Complications related to
      surgery were seen in 10 horses. Two horses had a second fracture of MC III at the
      same site, and were again treated by osteostixis, after which both horses
      returned to competition. Fractured drill bits were left in the MC III of 4
      horses. One of these horses had catastrophic failure of MC III. Two horses
      developed subcutaneous infections and 2 horses had catastrophic failure of MC III
      in the surgically treated limb. Osteostixis appears to be an effective treatment
      for returning horses affected with dorsal cortical fractures to racing.

PMID- 1639715
TI  - Treatment of dogs with osteosarcoma by administration of cisplatin after
      amputation or limb-sparing surgery: 22 cases (1987-1990).
AB  - Twenty-two dogs with appendicular osteosarcoma were treated by amputation (n =
      17) or limb-sparing surgery (n = 5). All dogs were given cisplatin (60 mg/m2 of
      body surface, IV) at 3-week intervals, beginning 1 week after surgery. Number of
      cisplatin treatments ranged from 1 to 6. Survival data for the 22 dogs were
      compared with survival data from a historical control group consisting of 162
      dogs with appendicular osteosarcoma treated by amputation alone. Median survival
      time for the 22 dogs given cisplatin was estimated to be 46.4 weeks, and 1- and 2
      year survival rates were estimated to be 45.5 and 20.9%, respectively. Survival
      time was significantly (P less than 0.0001) longer for treated dogs than for
      control dogs. Statistically significant relation was not found between survival
      time and number of cisplatin treatments. Three dogs were alive with no evidence
      of disease at the time of reporting. Of the remaining 19 dogs, 14 (73.4%) were
      euthanatized for problems documented to be related to metastases. Nine (47.4%)
      dogs were euthanatized because of bone metastases, and 5 (26.3%) were
      euthanatized because of pulmonary metastases. The proportion of dogs euthanatized
      because of bone metastases was significantly (P less than 0.0001) higher for
      treated than for control dogs. Median survival times for dogs developing bone and
      lung metastases were estimated to be 51.2 weeks and 21.2 weeks, respectively;
      however, this difference was not statistically significant. One local tumor
      recurrence was observed among dogs that had limb-sparing surgery. Significant
      difference in survival time was not observed between dogs that had limb-sparing
      surgery and dogs that underwent amputation.

PMID- 1639716
TI  - Characteristics of dogs admitted for treatment of cervical intervertebral disk
      disease: 105 cases (1972-1982).
AB  - Case histories of 105 dogs that were treated for cervical intervertebral disk
      disease (IVDD) were studied retrospectively. To compare with previous data, dogs
      were grouped by age, gender, and breed. Dogs were also grouped by clinical signs
      of disease, and by presence and location of radiologic change. The age range of
      cases of cervical IVDD was 1 to 13 years (mean, 6.3 years). Fifty-nine percent of
      dogs treated for cervical IVDD were females, but the proportion of diseased
      females was similar to females in total hospital admissions. Twenty-eight breeds
      of dogs were treated for cervical IVDD. Dachshunds and Beagles were significantly
      over represented (P less than or equal to 0.001). However, gender-breed
      interaction was not observed. Prevalence of radiologic evidence of disk disease
      was detected at the following levels of the vertebral column: C2-3, 29%; C3-4,
      24%; C4-5, 21%; C5-6, 15%; C6-7, 9%; and C7-T1, 2%. Significant difference was
      not observed in prevalence of cervical IVDD affecting the first 4 disk spaces.
      However, prevalence of cervical IVDD at C7-T1 was significantly less than that
      involving the first 4 disk spaces (P less than 0.02), and the space at C6-7 was
      significantly less affected than were the first 3 spaces (P less than 0.08).
      Significant association was not evident between clinical signs (pain and
      neurologic deficits) and radiologic signs of IVDD, although neurologic deficits
      were more likely to be observed in association with radiologic signs than with
      signs of pain.

PMID- 1639717
TI  - Important curriculum content for baccalaureate allied health programs: a survey
      of deans.
AB  - The purpose of this study was to assist deans of baccalaureate-level schools of
      allied health professions to come to consensus on knowledge and skills that
      graduates should have over and above what is required for professional
      accreditation and credentialing, and prerequisite or cognate courses that may be
      utilized to develop them. An adaptation of the Delphi method was used in 1990
      1991 to survey the deans of 74 institutional members of the Association of
      Schools of Allied Health Professions (ASAHP) offering programs at the bachelor's
      degree level. Three rounds of questionnaires were completed. The study concluded
      that there was consensus among the 54 deans who responded to the third
      questionnaire that 19 items of knowledge and skill are important for allied
      health students, and that 14 courses are important for the development of this
      knowledge and these skills.

PMID- 1639718
TI  - Allied health in a contemporary university: strategies for survival.

PMID- 1639719
TI  - Allied health and ethics: a grand rounds approach.

PMID- 1639720
TI  - AIDS and the responsibilities of academic health science centers: a case law
      approach.
AB  - The advent of AIDS and HIV infection has heightened administrator and faculty
      concern over providing and maintaining a safe environment for students in the
      health professions. Failure to provide this environment may result in litigation.
      Although case law on AIDS-related issues in higher education is sparse, court
      decisions on related issues are helpful in providing guidance on university
      responsibility. Case law indicates that if faculty provide appropriate
      supervision and give adequate instruction, including accepted safety practices,
      the courts will determine that the university has provided reasonable care to
      prevent student exposure to HIV. Other issues, related to HIV-positive students,
      demand that universities create carefully deliberated policies and procedures
      that do not discriminate against these individuals. This paper is the result of
      research on case law as it pertains to the potential legal issues of HIV and the
      university.

PMID- 1639721
TI  - Results of a summer academy to increase minority student access to allied health
      and other health professions.
AB  - To promote interest among incoming ninth grade students at two specialized high
      schools for health professions, and to help these students prepare for the
      upcoming high school experience and for pursuit of education and careers in
      allied health and other health professions, a three-week Summer Health
      Professions Academy was established. Students, 82.8% of whom were African
      American or Hispanic, participated in relevant didactic and experiential
      activities, with emphasis on allied health. Science, problem solving,
      communications, health career counseling, and allied health career exploration
      activities are described. Results of instruments administered both prior to and
      following the Academy indicated that students improved their abilities to analyze
      and solve science problems, and increased their knowledge of the nine primarily
      allied health professions emphasized during the program. Students also
      demonstrated heightened awareness of the factors that could impede their pursuit
      of allied health professions and other health careers.

PMID- 1639722
TI  - The impact of multiskilled practice on the job satisfaction of medical laboratory
      personnel.
AB  - This study examined practice patterns of medical laboratory personnel and
      investigated relationships of job-related variables and job satisfaction for
      single- and multiskilled practitioners. Data were collected from a random sample
      of American Society of Clinical Pathologist-registered practitioners in a five
      state region. Twenty-five percent of the sample was categorized as multiskilled.
      Regression analysis revealed that work performed had a significant positive
      contribution to overall job satisfaction for medical laboratory technicians
      (MLTs) and medical technologists. The strength of the relationship was weakest
      for multiskilled MLTs. Results support the contention that when jobs are
      redesigned, enriching them by adding tasks of increased complexity and challenge
      is possibly more effective than simply enlarging the jobs with lower- or parallel
      level tasks.

PMID- 1639723
TI  - Periodicity coding in the auditory system.
AB  - Periodic envelope fluctuations are a common feature of acoustic communication
      signals, and as a result of physical constraints, many natural, nonliving sound
      sources also produce periodic waveforms. In human speech and music, for example,
      periodic sounds are abundant and reach a high degree of complexity. Under noisy
      conditions these amplitude fluctuations may be reliable indicators of a common
      sound source responsible for the activation of different frequency channels of
      the basilar membrane. To make use of this information, a central periodicity
      analysis is necessary in addition to the peripheral frequency analysis. The
      present review summarizes our present knowledge about representation and
      processing of periodic signals, from the cochlea to the cortex in mammals, and in
      homologous or analogous anatomical structures as far as these exist and have been
      investigated in other animals. The first sections describe important physical and
      perceptual attributes of periodic signals, and the last sections address some
      theoretical issues.

PMID- 1639724
TI  - Estrogen influences auditory brainstem responses during the normal menstrual
      cycle.
AB  - We evaluated the impact of the menstrual cycle on auditory brainstem response
      (ABR) latency in nine normally cycling women. Subjects (age 23-40 years) using no
      hormonal therapy were recruited and underwent ABR testing during four different
      phases of the same menstrual cycle: early follicular (cycle days 1 to 3); mid
      cycle (cycle days 12 to 15); mid-luteal (cycle days 17 to 22), and premenstrual
      (cycle days 25-27). Cycles were verified by basal body temperature, and serum
      estrogen (E2), progesterone (P), and gonadotropin levels. A control group of nine
      women (age 23-40 years) on oral contraceptives (Nordette-28) was also studied
      four times during a pill cycle. Results show a significant increase in the
      latency of wave III and wave V peak latencies and in the I-V interpeak interval
      associated with a high estrogen state at the mid-cycle phase. No statistically
      significant variations in latency were found in the birth control pill group.
      These data suggest the existence of brainstem auditory neural pathways that are
      sensitive to fluctuations in E2 levels during the menstrual cycle.

PMID- 1639725
TI  - Effect of low level acoustic stimulation on temporary threshold shift in young
      humans.
AB  - To assess the effect of a low level acoustic stimulation on the susceptibility to
      noise, young human subjects were exposed to music at 70 dBA for 6 h per day
      during 9 days (training period). Noise sensitivity was assessed by measuring
      temporary threshold shift (TTS) induced by 105 dBSPL, 1/3 octave band noise at 2
      kHz for 10 min. On the fifth day of the training period, a significant decrease
      of TTS was observed in the frequency range 3-3.5 kHz, in comparison with the
      baseline TTS obtained before being trained. As the training continued, the
      frequency range which showed a significant reduction of TTS expanded to 2-5 kHz.

PMID- 1639726
TI  - High frequency distortion products from the ears of two bat species, Megaderma
      lyra and Carollia perspicillata.
AB  - In two echolocating bat species, Megaderma lyra and Carollia perspicillata 2f1-f2
      distortion products were measured acoustically in the outer ear canal for f1
      frequencies between 5 and 95 kHz in an attempt to study nonlinear cochlear
      processes at high frequencies. Similar to other mammals, the input/output (I/O)
      functions of 2f1-f2 show non-monotonicities and notches at f1 levels between 40
      70 dB SPL. The slope of the initial rise of the 2f1-f2 I/O functions increased
      with f1 frequency from 0.73 (5 kHz) to 1.41 (95 kHz) in Megaderma and from 0.66
      (7.5 kHz) to 1.47 (95 kHz) in Carollia. With increasing f1 frequency the optimum
      frequency ratio f2/f1 in order to evoke maximum distortion level decreases from
      1.18 (5 kHz) to 1.09 (95 kHz) in Megaderma and from 1.21 (7.5 kHz) to 1.11 (95
      kHz) in Carollia. This is taken as indication of a general increase of the
      quality of tuning of the distortion generating mechanism with frequency. The f1
      levels that were sufficient to elicit distortion levels of -10 dB SPL were used
      to construct iso-distortion threshold curves which lay on average 37.2 dB
      (Megaderma) and 33.9 dB (Carollia) above the neuronal threshold curves [Rubsamen
      et al., J. Comp. Physiol. A 163 (1988); Sterbing et al., Proc. 18th Gottingen
      Neurobiol. Conf. Thieme Verlag, Stuttgart (1990)] and roughly paralleled these.
      Highest distortion levels (40-50 dB SPL with f1 levels of 80 dB SPL) and lowest
      distortion thresholds were measured in the f1 frequency range of 10-30 kHz
      (Megaderma) and 15-30 kHz (Carollia).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639727
TI  - Additivity of threshold elevations produced by disruption of outer hair cell
      function.
AB  - We present a simple model describing the additivity of hearing loss in the
      mammalian cochlea produced by disruption of the outer hair cell transduction
      processes. The validity of this model has been tested experimentally in the
      guinea-pig by inducing threshold elevations using two simultaneous cochlear
      manipulations, including acoustic overstimulation, two-tone suppression, low
      frequency acoustic biasing of the cochlear partition and electrical stimulation
      of the medial olivo-cochlear system of efferent fibres. The results of these
      experiments suggest that the model presented is an adequate description, within
      the measurement error of our experiments, of the hearing losses produced.

PMID- 1639728
TI  - Selectivity for temporal characteristics of sound and interaural time difference
      of auditory midbrain neurons in the grassfrog: a system theoretical approach.
AB  - The selectivity for temporal characteristics of sound and interaural time
      difference (ITD) was investigated in the torus semicircularis (TS) of the
      grassfrog. Stimuli were delivered by means of a closed sound system and consisted
      of binaurally presented Poisson distributed condensation clicks, and pseudo
      random (RAN) or equidistant (EQU) click trains of which ITD was varied. With RAN
      and EQU trains, 86% of the TS units demonstrated a clear selectivity for ITD.
      Most commonly, these units had monotonically increasing ITD-rate functions. In
      general, units responding to Poisson clicks, responded also to RAN and EQU
      trains. One category of units which showed strong time-locking had comparable
      selectivities for ITD with both stimulus ensembles. A second category of units
      showed a combined selectivity for temporal structure and ITD. These units
      responded exclusively to EQU trains in a nonsynchronized way. From the responses
      obtained with the Poisson click ensemble so-called Poisson system kernels were
      determined, in analogy to the Wiener-Volterra functional expansion for nonlinear
      systems. The kernel analysis was performed up to second order. Contralateral (CL)
      first order kernels usually had positive or combinations of positive and negative
      regions, indicating that the contralateral ear exerted an excitatory or combined
      excitatory-inhibitory influence upon the neural response. Ipsilateral (IL), units
      were characterized by first order kernels which were not significantly different
      from zero, or kernels in which a single negative region was present. A large
      variety of CL second order kernels has been observed whereas rarely IL second
      order kernels were encountered. About 35% of the units possessed nonzero second
      order cross kernels, which indicates that CL and IL neural processes are
      interacting in a nonlinear way. Units demonstrating a pronounced selectivity for
      ITD, were generally characterized by positive CL combined with negative IL first
      order kernels. Findings suggested that, in the grassfrog, neural selectivity for
      ITD mainly is established by linear interaction of excitatory and inhibitory
      processes originating from the CL and IL ear, respectively. Units exhibiting
      strong time-locking to Poisson clicks and RAN and EQU trains had significantly
      shorter response latencies than moderately time-locking units. In the first
      category of units, a substantial higher number of nonzero first and second order
      kernels was observed. It was concluded that nonlinear response properties, as
      observed in TS units, most likely have to be ascribed to nonlinear
      characteristics of neural components located in the auditory nervous system
      peripheral to the torus semicircularis.

PMID- 1639729
TI  - Immunochemical detection of glucocorticoid receptors within rat cochlear and
      vestibular tissues.
AB  - A monoclonal antibody, BuGR2, to liver glucocorticoid receptor sites was tested
      for its reactivity and specificity in inner ear tissue supernatants by an Enzyme
      Linked Immuno Sorbant Assay (ELISA) and a Western blotting technique. Results
      demonstrated that this antibody specifically recognized a protein of 93 kDa in
      inner ear supernatant fractions, which conformed to the reported molecular
      weights of the glucocorticoid receptor in other tissues. Antigenic sites were
      determined to be higher within cochlear supernatant fractions compared to
      vestibular supernatant fractions by ELISA. This anti-glucocorticoid receptor
      antibody combined with the quantitative ELISA provides a sensitive means to
      further investigate the inner ear glucocorticoid receptor system.

PMID- 1639730
TI  - Tone-induced stereocilia lesions as a function of exposure level and duration in
      the hamster cochlea.
AB  - The present study presents an atlas of the effects of 10 kHz tone exposures of
      different levels and durations on cochlear hair cells and their stereocilia in
      the Syrian golden hamster. Animals were sound exposed while under anesthesia. The
      exposure conditions were varied over an intensity range of 90-129 dB SPL; at the
      highest levels (126-129 dB SPL) the exposure periods were varied over a range of
      30 min to 4 h. In animals with mild damage the lesions were commonly restricted
      to either the inner hair cells and/or the first row of outer hair cells; the
      order of damage susceptibility was IHC, OHC1, OHC2, OHC3. Damage to the second
      and third rows of outer hair cells were found only in animals with the severest
      lesions. Possible mechanisms underlying the row-specific distributions of these
      lesions and relative susceptibilities of the 4 rows of hair cells are discussed.

PMID- 1639731
TI  - Additivity of threshold losses produced by acute acoustic trauma.
AB  - We have previously [Patuzzi and Rajan, Hear. Res. 60, 165-177, 1992] formulated a
      model to describe how the threshold elevations produced by a variety of
      independent, short-term cochlear manipulations add when the manipulations are
      combined. The manipulations were presumed to affect only the 'active process' in
      the cochlea. The present report applied this model to the effects observed after
      acute acoustic trauma in normal-hearing guinea pigs and in guinea pigs with
      idiopathic threshold losses. Successive loud pure-tone exposures were presented
      to the normal-hearing guinea pigs, while only a single exposure was presented to
      the guinea pigs with idiopathic hearing losses. Various parameters of exposure
      and inter-exposure delays were used to create a variety of threshold elevations,
      and the total hearing losses observed in the various groups were compared to the
      total hearing losses predicted by the model. In most cases a statistically-valid
      1:1 relationship was obtained between the predicted values and the observed
      values. In cases where the model's predictions were found not to fit the data,
      this appeared to be due to inclusion of data previously defined to be outside the
      scope of the model. When such data were excluded, there was good agreement
      between the model's predictions and the observed data. The model was further
      tested by comparing its predictions with data obtained in studies of acute noise
      trauma in chinchillas and humans by other researchers. The model's predictions
      were found to agree with these data as well. Thus, across a number of different
      types and conditions of exposures, the model appears to provide a very good
      description of the additivity of threshold losses produced by acute acoustic
      trauma. The generality of and constraints on the model are discussed.

PMID- 1639732
TI  - Loudness balance between electric and acoustic stimulation.
AB  - Binaural loudness balance between electric and acoustic stimulation is obtained
      in auditory brainstem implant listeners who had substantial acoustic hearing in
      one ear. The data are well described by a linear relationship between acoustic
      decibels and electric microamps. Based upon this linear relationship, we propose
      an exponential model of loudness growth in electric stimulation. The exponential
      model predicts that the loudness growth function can be determined solely by the
      threshold and the uncomfortable loudness level in electric stimulation. This
      prediction is consistent with previous psychophysical data on loudness functions.
      Implications of this finding for speech processor designs are discussed.

PMID- 1639733
TI  - High frequency radial movements of the reticular lamina induced by outer hair
      cell motility.
AB  - Recently, it was shown in cochlear explants from the guinea pig cochlea that
      electrokinetic motile responses of outer hair cells can induce radial and
      transverse motion of the reticular lamina. Here we demonstrate, that the radial
      component of these motions can be measured up to high frequencies (15 kHz).
      Cochlear explants were taken from guinea pig inner ears and exposed to a
      sinusoidal electric field. A double photodiode was used as a linear position
      detector with high spatial and temporal resolution to detect radial movements in
      the plane of the reticular lamina. The organ of Corti of the second, third and
      fourth cochlear turns was stimulated with frequencies of the electrical field
      between 0.5 Hz and 20 kHz. Sinusoidal movements of up to 15 kHz were recorded. At
      higher frequencies the signal-to-noise ratio became too small. The largest
      responses were measured at the three rows of outer hair cells. If the strength of
      the electrical field was 2 kV/m, into which the cochlear explants were placed,
      the amplitudes of outer hair cell movements were around 1 micron at 1 Hz and 10
      nm at 10 kHz. Uncoupling of the outer hair cells from the tunnel of Corti and
      from the inner hair cells decreased the oscillations of inner hair cells but did
      not affect outer hair cells. The movements showed frequency dependent amplitudes
      like a complex low-pass filter but no best frequency was observed.

PMID- 1639734
TI  - Treatment satisfaction with an asthma management program: a "five"-year
      retrospective assessment.
AB  - The results of a five-year follow up of asthmatic children and parents who had
      completed a structured asthma management program are reported. The purpose of
      this project is (1) to assess treatment satisfaction, and (2) to identify which
      of the training components are considered most useful and/or which components are
      still being used by the participants. Eight families are interviewed. Results
      indicate that educational information and behavioral asthma management techniques
      are considered most useful. Improvement in asthma after program completion is
      reported and is attributed to the asthma management program, maturation, and
      medication.

PMID- 1639735
TI  - The effect of disodium cromoglycate against bronchial hyperresponsiveness in
      asthmatic children.
AB  - A long-term study of the effect of cromolyn sodium against bronchial
      hyperresponsiveness in asthmatic children is described. Cromolyn sodium powder
      (20 mg), as the capsule formulation, was inhaled by Spinhaler Turbohaler, tid,
      for three years. Histamine inhalation tests were performed every 6 months
      according to the standardized methods of the Japanese Allergy Congress. No other
      antiasthmatic therapy was given throughout the study except during an acute
      attack. Bronchial hyperresponsiveness decreased, and clinical symptoms improved
      throughout the trials. It is suggested that long-term use of cromolyn sodium
      reduces bronchial hyperresponsiveness concomitant with improved symptomatology in
      asthmatic children.

PMID- 1639736
TI  - Champ Camp: the Colorado Children's Asthma Camp experience.
AB  - To encourage children with asthma to enjoy outdoor activities without physical or
      psychosocial impairment, children's asthma camps are established throughout the
      country sponsored by organizations including local and state allergy societies.
      We wish to describe our Colorado "Champ Camp" experience as a model and reference
      for future similar efforts and to encourage networking by medical leadership for
      information sharing and guidelines development nationally. Statistics from
      parents' satisfaction surveys over 8 years demonstrate a positive influence on
      attitudes toward asthma and confidence to enter activities and sports with
      children without asthma.

PMID- 1639737
TI  - The potential role of anesthesia in status asthmaticus.

PMID- 1639738
TI  - Antiasthma drugs: key issues in clinical trial methodology.

PMID- 1639739
TI  - Alternative treatments for asthma: assessing the need.
AB  - Alternative treatments such as troleandomycin methotrexate, gold, and intravenous
      gamma globulin are sometimes considered for severe asthmatics to minimize the
      need for systemic corticosteroids and reduce adverse effects. These alternative
      therapies may also be associated with significant toxicity and expense. The
      ability to reduce corticosteroid use and the need for alternative treatment
      interventions in 125 pediatric patients at our institution were reviewed. Because
      corticosteroid requirements were reduced significantly, only 23 of 125 children
      evaluated were considered for treatment alternatives with only 10 receiving such
      therapy. This study emphasizes the importance of a thorough and comprehensive
      review of corticosteroid requirements and usage prior to initiating alternative
      approaches to treatment in moderate to severe asthmatics as well as in patients
      thought to be "steroid-dependent."

PMID- 1639740
TI  - A self-efficacy scale for children and adolescents with asthma: construction and
      validation.
AB  - A self-efficacy scale for children and adolescents with asthma between 10 and 18
      years of age is described. A scale of 38 items was constructed and administered
      to 60 children and adolescents. A factor analysis of the results yielded a scale
      consisting of 22 items which can be divided into three subscales: factor one
      (24.8% of variance) measured efficacy expectations concerning medical treatment,
      factor two (10.3% of variance) measured efficacy expectations concerning the
      environment, and factor three (6.7% of variance) measured efficacy concerning
      problem-solving skills. Confirmation of several predicted conceptual
      relationships between the self-efficacy measures and other measures (Personality
      Questionnaire, Coping, Anxiety, Knowledge, Optimism, and Shame) provided
      preliminary evidence of construct validity. Further research and clinical
      applications are discussed.

PMID- 1639741
TI  - Response of negative symptoms of schizophrenia to neuroleptic treatment.
AB  - BACKGROUND: In view of the inconclusive reports in the literature about the
      response to neuroleptics of chronic schizophrenics with negative symptoms, the
      authors further evaluated this issue. METHOD: A sample of 30 ambulatory chronic
      schizophrenics meeting DSM-III-R criteria who had to a marked degree at least two
      negative symptoms of the five on the Scale for the Assessment of Negative
      Symptoms (SANS) received various therapeutic dosages of thiothixene for 3 months.
      The average dose was 26.75 mg/day. Subjects were periodically evaluated with the
      Brief Psychiatric Rating Scale, Negative Symptoms Rating Scale (a modified
      version of the SANS), and the Randt Memory Test. The time effect on treatment was
      calculated by repeated measures of analysis of variance. The relationship between
      the positive and negative symptoms was tested by an analysis of covariance.
      RESULTS: Both negative and positive symptoms improved with treatment. The
      negative symptoms tended to respond to treatment predominantly independently of
      the positive ones. At the end of the study, 63% (N = 19) of patients had improved
      moderately, 16% (N = 5) had improved slightly, and 20% (N = 6) had not improved.
      CONCLUSION: The data require further support from a long-term follow-up study
      that may show the extent to which these gains are maintained over time.

PMID- 1639742
TI  - Lack of association between fluoxetine and suicidality in bulimia nervosa.
AB  - BACKGROUND: The coincidence of major depressive disorder in bulimia nervosa
      ranges from 35% to 80%. Because of this comorbidity and because suicidality
      (suicidal acts and ideation) is an inherent part of depression, assessment of the
      risk of suicide in patients with bulimia nervosa is of considerable interest.
      METHOD: Data from United States Investigational New Drug double-blind, placebo
      controlled fluoxetine clinical trials in bulimia nervosa were analyzed
      comprehensively to assess the potential association between fluoxetine treatment
      and suicidality in 785 patients with DSM-III-R bulimia nervosa. Patients were
      predominantly women (98%), aged 17 to 63 years; of the randomly assigned
      patients, 16.9% exhibited 17-item Hamilton Rating Scale for Depression (HAM-D)
      total scores of 17 or greater at baseline (range, 0-31). Incidence of suicidality
      was analyzed by the incidence difference method. RESULTS: No fatal suicidal acts
      occurred; 9 (1.15%) of 785 patients made nonfatal attempts; 24 (3.06%)
      experienced emergent (text-defined) suicidal ideation. No statistically
      significant increases in the incidence of suicidal acts or suicidal ideation were
      observed among fluoxetine-treated compared with placebo-treated patients. A
      smaller percentage of fluoxetine-treated (2.0%) than placebo-treated (3.8%)
      patients experienced emergence of substantial suicidal ideation (change in
      baseline HAM-D Item 3 [suicide item] score of 0 or 1 to 3 or 4 during therapy). A
      statistically significantly greater proportion of fluoxetine-treated than placebo
      treated patients experienced improvement in suicidal ideation (decrease in HAM-D
      Item 3 score) from baseline to endpoint (p = .026). CONCLUSION: Analyses of the
      incidence of suicidal acts and suicidal ideation did not indicate an increased
      risk of suicidality in patients with bulimia nervosa treated with fluoxetine
      compared with those treated with placebo.

PMID- 1639743
TI  - Clozapine-induced agranulocytosis in a Native American: HLA typing and further
      support for an immune-mediated mechanism.
AB  - BACKGROUND: Approximately 30% of schizophrenic patients defined as treatment
      refractory significantly improve with clozapine. However, clozapine produces
      agranulocytosis in approximately 1% to 2% of patients in the United States. The
      mechanism of clozapine-induced agranulocytosis has not been established, but
      evidence suggests an immune-mediated mechanism. METHOD: Human leukocyte antigen
      (HLA) typing was performed in a native American with clozapine-induced
      agranulocytosis. RESULTS: Our findings support previous observations of a role of
      the HLA-B16, DR4, DQw3 haplotype in predicting susceptibility to agranulocytosis
      in clozapine-treated patients. CONCLUSION: We suggest that HLA typing of
      clozapine candidates may be useful for predicting the risk for clozapine-induced
      agranulocytosis.

PMID- 1639744
TI  - Granulocyte-macrophage colony-stimulating factor (GM-CSF) treatment of clozapine
      induced agranulocytosis: a case report.
AB  - BACKGROUND: Granulocytopenia and agranulocytosis are severe side effects of
      clozapine therapy. Even if these side effects are detected early and if clozapine
      is discontinued, patients suffering from agranulocytosis are extremely endangered
      by infectious diseases for up to 3 to 4 weeks until hematologic recovery.
      Therefore, any treatment that reduces this critical time span would decrease the
      risks of clozapine treatment. METHOD: The case of a patient in whom severe
      agranulocytosis developed after 7 weeks of clozapine treatment is presented.
      RESULTS: After clozapine discontinuation, treatment with granulocyte-macrophage
      colony-stimulating factor (GM-CSF), a glycoprotein that has been shown to
      stimulate the proliferation of precursor cells in the bone marrow and their
      differentiation into granulocytes and macrophages, was initiated. Under GM-CSF
      treatment, total granulocyte count rose from 63/cu mm to a value greater than
      1500/cu mm within 5 days without complications or major side effects. CONCLUSION:
      This case report suggests that treatment with GM-CSF may lower the risks
      associated with clozapine-induced agranulocytosis and therefore may indirectly
      improve the safety of clozapine therapy.

PMID- 1639745
TI  - The efficacy of bupropion in winter depression: results of an open trial.
AB  - BACKGROUND: Seasonal affective disorder (SAD) refers to regularly recurring
      episodes of affective illness bearing a fixed relationship to season. Wintertime
      depression is its most widely recognized form. This study was undertaken to
      assess the efficacy of bupropion as a treatment for this disorder. METHOD:
      Fifteen consecutively presenting patients were treated with bupropion (200 to 400
      mg/day). All met DSM-III-R criteria for major depression with a seasonal pattern.
      All were moderately to severely depressed. A modified version of the Hamilton
      Rating Scale for Depression (mHAM-D) including ratings of hypersomnia, increased
      appetite and carbohydrate craving, and weight gain was used to quantify the
      severity of illness. Up to 5 weeks of treatment was allowed before the subjects
      were categorized as nonresponders, partial responders, or responders. RESULTS:
      The mean +/- SD mHAM-D scores before and after treatment were 25.5 +/- 6.4 and
      4.1 +/- 3.1, respectively. Ten (66.7%) of the subjects had a complete response to
      treatment (mHAM-D score less than or equal to 5). The other 5 (33.3%) had a
      partial response (mHAM-D score = 6-10). Five of the subjects had chronic pain and
      3 had panic attacks restricted to episodes of depression. These problems resolved
      simultaneously with the symptoms of depression. CONCLUSION: The results of this
      open trial suggest that bupropion is an effective treatment for winter
      depression. However, controlled studies are required to confidently determine
      whether this is the case.

PMID- 1639746
TI  - Fluoxetine and suicidality.

PMID- 1639747
TI  - Paranoid psychosis, epidermoid tumor, and epilepsy: "symptomatic" psychosis or
      coincidence?

PMID- 1639748
TI  - Do monoamine oxidase inhibitors alter carbamazepine blood levels?

PMID- 1639749
TI  - Purification and characterization of beta-galactoside-binding proteins from
      Caenorhabditis elegans.
AB  - Two carbohydrate-binding proteins (subunit molecular masses, 32 and 16 kDa,
      respectively) were isolated for the first time from a nematode, Caenorhabditis
      elegans. They were specifically extracted with lactose and adsorbed on
      asialofetuin-Sepharose in the absence of a metal ion. Although these two proteins
      were co-eluted from a gel filtration column at a position corresponding to an
      apparent molecular size of 30 kDa under non-denaturing conditions, they could be
      separated by reversed-phase chromatography. The 32 kDa protein, the main
      component, was further characterized. Together with its solubility, saccharide
      specificity and metal independence, some other structural properties, including
      its amino acid composition, UV spectrum, and partial amino acid sequence,
      strongly suggested that the 32 kDa protein is a member of a class of soluble beta
      galactoside-binding lectins which had previously been only found in vertebrates.

PMID- 1639750
TI  - Genomic structure of human midkine (MK), a retinoic acid-responsive
      growth/differentiation factor.
AB  - Midkine (MK) is a product of a retinoic acid-responsive gene and a new heparin
      binding growth/differentiation factor. The coding sequence of human MK was
      located on 1.5 kb DNA segment. The structure of the cloned human MK gene was
      determined and compared with that of the mouse gene. The coding sequence was
      divided into 4 exons, and each exon and exon-intron boundary was highly
      homologous to those of the mouse. Furthermore, 170 bases in the upstream region
      of the putative transcription initiation sites and 3 blocks of 200-350 bases in
      regions further upstream were highly conserved. These sequences are likely to be
      involved in developmentally regulated expression of MK.

PMID- 1639751
TI  - Characterization of beta 1----4 galactosyltransferase purified from rat liver
      microsomes.
AB  - beta 1----4 Galactosyltransferase was purified from rat liver microsomes.
      Catalytic properties of the enzyme resembled those of previously purified soluble
      and membrane-bound beta 1----4 galactosyltransferases. The enzyme purified in the
      present study showed a major band around a molecular weight of 53,000 on SDS
      PAGE. The NH2-terminal sequence of the enzyme was determined up to the 20th
      residue. The sequence was identical to the amino acid sequence from Ala-13 to Lys
      32 deduced from mouse beta 1----4 galactosyltransferase cDNA. These results
      suggest that most of the mature enzyme in rat liver microsomes is produced by
      removal of the NH2-terminal 12 amino acids from a precursor polypeptide.

PMID- 1639752
TI  - Subcellular distribution of glycolyltransferases in rodent liver and their
      significance in special reference to the synthesis of N-glycolyneuraminic acid.
AB  - The enzymic synthesis, transfer, and utilization of glycolyl-CoA (i.e. 2
      hydroxyacetyl-CoA) have been studied in rat and mouse livers. On the one hand,
      these tissues contain the enzyme activities allowing the synthesis of glycolyl
      CoA from fatty acids (palmitate omega-hydroxylase, omega-hydroxypalmitoyl-CoA
      synthetase, and mitochondrial beta-oxidation of omega-hydroxypalmitoyl-CoA) and 3
      hydroxypyruvic acid (oxidation by intact mitochondria). On the other hand, three
      types of glycolyltransferase activities can be demonstrated in rodent livers,
      depending on either carnitine, glucosamine, or glucosamine-6-phosphate. The
      subcellular distributions of these glycolyltransferase activities are similar to
      those of the corresponding acetyltransferase counterparts. Concerning carnitine
      glycolytransferase, the activity is widely distributed in the subcellular
      fractions, pointing out its occurrence in most cell compartments. By contrast,
      the glucosamine and glucosamine-6-phosphate glycolytransferase activities were
      located preferentially in the microsomal fraction. The condensation between
      glycolyl-CoA and glucosamine (or glucosamine-6-phosphate) raises the interesting
      question of the nature and the role of the resulting glycolylglucosamine
      molecule, especially in an alternative N-glycolylneuraminic acid synthesis
      pathway.

PMID- 1639753
TI  - The effect of amino acid deletion in subtilisin E, based on structural comparison
      with a microbial alkaline elastase, on its substrate specificity and catalysis.
AB  - Subtilisin from a wide variety of Bacillus species has been extensively
      investigated as a promising target for protein engineering. In this study, we
      analyzed the substrate specificity of B. subtilis subtilisin E based on the
      structure of a new alkaline elastase produced by the alkalophilic Bacillus strain
      Ya-B, which has very high elastolytic activity. Despite the high homology of the
      primary sequences of both enzymes (54% identical), alkaline elastase was found to
      lack four consecutive amino acids which, in subtilisin, have been shown by X-ray
      analysis to lie close to the P1 binding cleft. To examine the influence of such a
      deletion in subtilisin on its substrate specificity, we constructed several
      mutants missing four amino acids by site-directed mutagenesis. When assayed with
      synthetic peptides, elastin and casein as substrates, a mutant lacking Ser161
      Thr162-Ser163-Thr164 showed considerably lower specific activity toward the
      substrates for subtilisin, and its substrate specificity approached that of
      alkaline elastase. The results indicate that the deletion in subtilisin E
      influences the catalytic efficiency as well as the P1 specificity, and that this
      region is, in part, responsible for the difference in specificity between the two
      enzymes.

PMID- 1639754
TI  - Essential histidine residue in 3-ketosteroid-delta 1-dehydrogenase.
AB  - The variation with pH of kinetic parameters was examined for 3-ketosteroid-delta
      1-dehydrogenase from Nocardia corallina. The Vmax/Km profile for 4
      androstenedione indicates that activity is lost upon protonation of a cationic
      acid-type group with a pK value of 7.7. The enzyme was inactivated by
      diethylpyrocarbonate at pH 7.4 and the inactivation was substantially prevented
      by androstadienedione. Analyses of reactivation with neutral hydroxylamine, pH
      variation, and spectral changes of the inactivated enzyme revealed that the
      inactivation arises from modification of a histidine residue. Studies with
      [14C]diethylpyrocarbonate provided support for the idea that the 1-2 essential
      histidine residues are essential for the catalytic activity of the enzyme. Dye
      sensitized photooxidation led to 50% inactivation of the enzyme with the
      decomposition of two histidine residues. This inactivation was also prevented by
      androstadienedione. Dancyl chloride caused a loss of the enzyme activity.
      Modifiers of glutamic acid, aspartic acid, cysteine, and lysine did not affect
      the enzyme activity. Butanedione and phenylglyoxal in the presence of borate
      rapidly inactivated the enzyme, indicating that arginine residues also have a
      crucial function in the active site. The data described support the previously
      proposed mechanism of beta-oxidation of 3-ketosteroid.

PMID- 1639755
TI  - Adsorption mode of exo- and endo-cellulases from Irpex lacteus (Polyporus
      tulipiferae) on cellulose with different crystallinities.
AB  - The adsorption mode of two highly purified cellulases, exo- and endo-type
      cellulases, from Irpex lacteus (Polyporus tulipiferae) was investigated by using
      pure cellulosic materials with different crystallinity as substrates. Adsorption
      of the two enzymes on the substrates was found to fit the Langmuir-type
      adsorption isotherm. Maximum amount of adsorbed enzyme obtained from the Langmuir
      plots showed an inverse correlation to the crystallinity of the substrate with
      both enzymes, and this value of endo-type cellulase was less dependent on the
      degree of crystallinity of substrates than that of exo-type cellulase, whose
      isotherms reached saturation in the range of low enzyme concentrations. The two
      enzymes showed relatively high affinities for all the substrates and their
      affinities increased with increasing crystallinity, but this tendency was less
      marked with endo-type cellulase than with exo-type one. In addition, large
      negative values of free energy change were observed on the adsorption of both
      enzymes, and the values became more negative with increasing crystallinity.
      Consequently, both cellulases showed high adsorption on crystalline cellulose and
      the adsorption process became smoother with increasing crystallinity. The
      adsorption of the two types of cellulases was endothermic with an increase in
      entropy, especially for amorphous cellulose, suggesting the occurrence of water
      release from the substrates during enzyme adsorption. In addition, the changes in
      thermodynamic parameters (delta H, delta S, and delta G) in adsorption of exo
      type cellulase were larger than in that of endo-type enzyme.

PMID- 1639756
TI  - Instability of F-actin in the absence of ATP: a small amount of myosin
      destabilizes F-actin.
AB  - The effects of the neutral salt concentration, pH, and coexistence of myosin on
      the denaturation of F-actin without ATP at low temperature were studied using the
      DNase I inhibition assay. The percent denaturation of F-actin gradually increased
      with a decrease in pH from 8.0 to 5.2, on incubation for 2 weeks in the presence
      of 50 mM KCl at 0 degrees C. This change was much faster in 0.5 M KCl and more
      than 75% of the F-actin became denatured on incubation for 1 week at pH 5.2. The
      buffer composition was found to exert a strong influence on the denaturation of F
      actin. That is, there was a tendency for the denaturation of F-actin at pH 6.0 to
      be faster in MES[2-(N-morpholino)ethanesulfonic acid]-NaOH buffer than in sodium
      phosphate buffer, the critical concentrations of actin in 0.5 M KCl being 0.31
      mg/ml for MES-NaOH buffer and 0.15 mg/ml for sodium phosphate buffer. A sigmoidal
      relationship was found between the percent denaturation of F-actin and the KCl
      concentration added, the greatest change occurring at KCl concentrations between
      0.25 and 0.75 M. The time courses of the denaturation of F-actin showed that the
      percent denaturation rose at first and that in time the rate of the increase
      decreased. In the case of pH 8.0 and 0.5 M KCl, it took about 1 week for the
      denaturation rate to begin to drop. The pH of 6.0 further promoted the
      instability of F-actin exposed to high KCl concentrations.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1639757
TI  - 13C-nuclear magnetic resonance of glycosphingolipids.
AB  - Spectra of 125 MHz 13C-nuclear magnetic resonance (NMR) of glycosphingolipids,
      GlcCer, GalCer, sulfatide, LacCer, and nLc4Cer have been studied, and the
      following results were obtained. (i) Signals of ring carbons of each sugar
      component are distributed in a wide field (50-110 ppm) and clearly separated.
      (ii) Chemical shifts of anomeric carbon (C1) and methylene carbon (C6) of sugars
      are far from those of other methine carbons of sugars and characteristic of sugar
      components, which makes it possible to identify each sugar component and its
      molar raito. (iii) The downfield shifts (about 6-9 ppm) of alpha-carbon signals
      involved in the glycosidic linkages and upfield shifts (about 1.5-2 ppm) of the
      neighboring beta-carbons, which are known as glycosylation shifts, could be
      observed. (iv) Characteristic shifts of aglycon signals caused by the presence of
      an OH group at the alpha-position of fatty acid were assigned. These observations
      are useful for the characterization of glycosphingolipid structures.

PMID- 1639758
TI  - A simple method for the release of asparagine-linked oligosaccharides from a
      glycoprotein purified by SDS-polyacrylamide gel electrophoresis.
AB  - A simple method for the release of oligosaccharides from glycoproteins separated
      by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) has been developed. Asialo
      alpha 1-acid glycoprotein, which was tritiated at the nonreducing terminal D
      galactopyranosyl residue by reduction with sodium borotritide after incubation
      with D-galactose oxidase, was used as a model compound. After electrophoretic
      separation of the glycoprotein, oligosaccharides were released by the use of a
      gas-phase hydrazinolysis apparatus. In the first method, the gel was stained with
      Coomassie Blue and the glycoprotein together with the gel was directly subjected
      to gas-phase hydrazinolysis after removal of water in a P2O5 desiccator. The
      recovery of released oligosaccharides was 25.9 +/- 2.4%, based on the amount of
      the glycoprotein loaded on the gel within the range of 3.5-28.5 micrograms. In
      the second method, the glycoprotein was electroblotted onto an Immobilon transfer
      membrane and was visualized by staining with Coomassie Blue. A small piece of the
      membrane with the corresponding band was cut out, dried in a desiccator and
      subjected to gas-phase hydrazinolysis. In this case, the recovery of released
      oligosaccharides was 15.2 +/- 1.0%. These procedures, particularly the first one,
      should be widely applicable for the isolation of oligosaccharides from
      glycoproteins separated by SDS-PAGE.

PMID- 1639759
TI  - Analysis of lectin properties with membrane ultrafiltration and high-pressure
      liquid chromatography.
AB  - A convenient method for the analysis of the binding properties of lectin with
      fluorogenic sugar chains is described. A lectin (concanavalin A or Datura
      stramonium agglutinin) was mixed with pyridylaminated sugar chains in buffer and
      the free chains obtained were isolated by membrane ultrafiltration. The amount of
      free sugar chains in the filtrate was measured by high-pressure liquid
      chromatography. The binding constants with the sugar chains, reaction kinetics,
      and other properties of these lectins were easily investigated. The method is
      simple and could be used to study the characteristics of any lectin in native
      form.

PMID- 1639760
TI  - Detection of large COOH-terminal domains processed from the precursor of Serratia
      marcescens serine protease in the outer membrane of Escherichia coli.
AB  - The Serratia marcescens serine protease gene encoding a 1,045-amino-acid
      precursor protein of 112 kDa directs excretion of the mature protease of ca. 58
      kDa through the outer membrane of Escherichia coli. A typical signal peptide of
      27 amino acids and a large COOH-terminal domain of the precursor are both
      functionally essential for the excretion of the mature protease into the medium.
      Sequence analysis of the fragment peptides of the mature protease as well as site
      directed mutagenesis indicated that the COOH-terminus of the mature enzyme was
      Asp645. By using the polyclonal antibody against the 112-kDa precursor protein,
      not only the intact precursor but also two proteins, C-1 (40 kDa) and C-2 (38
      kDa), corresponding to the processed COOH-terminal domains were detected in the
      insoluble fraction of E. coli cells. Further fractionation by sucrose density
      gradient centrifugation showed that C-1 and C-2 were localized in the outer
      membrane. The NH2-terminal residues of C-1 and C-2 were determined to be Ala702
      and Phe717, respectively. All these data suggest that the precursor is cleaved at
      three positions, between Asp645-Ser646, Glu701-Ala702, and Gly716-Phe717,
      probably by the self-processing activity in the normal excretion pathway through
      the outer membrane.

PMID- 1639761
TI  - Dihydrofolate reductase from Bacillus subtilis and its artificial derivatives:
      expression, purification, and characterization.
AB  - The Bacillus subtilis dihydrofolate reductase (DHFR) gene was expressed in
      Escherichia coli. The gene product was purified to homogeneity by Butyl
      Toyopearl, Toyopearl HW55, and DEAE-Toyopearl column chromatographies, and its
      molecular properties were compared to those of E. coli DHFR. The specific enzyme
      activity of the B. subtilis DHFR was 240 units/mg under the standard assay
      conditions, being about four times higher than that of the E. coli DHFR. Km for
      coenzyme NADPH was 20.7 microM, a value about three times larger than that of E.
      coli, whereas Km (1.5 microM) for the substrate, dihydrofolate, was similar to
      that of E. coli DHFR. This seems to reflect the low homology of the amino acid
      sequence in residues 61-88 of the two DHFRs where one of the NADPH binding sites
      is located [Bystrof, C. & Kraut, J. (1991) Biochemistry 30, 2227-2239]. Similar
      to the E. coli DHFR [Iwakura, M. et al. (1992) J. Biochem. 111, 37-45], the
      extension of amino acid sequences at the C-terminal end of the B. subtilis DHFR
      could be attained without loss of the enzyme function or decrease of the protein
      yield. Thus, the DHFR is useful as a carrier protein for expressing small
      polypeptides, such as leucine enkephalin, bradykinin, and somatostatin.

PMID- 1639762
TI  - mGK-6-derived true tissue kallikrein is synthesized, processed, and targeted
      through a regulated secretory pathway in mouse pituitary AtT-20 cells.
AB  - mGK-6-derived true tissue kallikrein was shown to be synthesized in mouse
      pituitary AtT-20 cells. This cell line, which is capable of processing other
      prohormones, only partially processed the proform of kallikrein to its active
      form, secreting it predominantly as the proform. The secretion of the active form
      was stimulated in response to a secretagogue, 8-bromo-cyclic AMP. These results
      imply that not only cellular elements capable of directing the processing of the
      proform to the active form and the intracellular transport of the kallikrein, but
      also a pathway that regulates the release of the active form may be present in
      the AtT-20 cells, thus the availability of this cell line for investigation of
      biosynthetic and secretory processes for tissue kallikrein in vivo being
      suggested.

PMID- 1639763
TI  - The trypsin-catalyzed activation of glutamate dehydrogenase purified from eel
      liver.
AB  - Eel liver glutamate dehydrogenase (GDH) [EC 1.4.1.3] was eightfold activated by
      trypsin and the molecular weight of the subunit of the native GDH decreased from
      54,000 to 50,000. The C-terminal amino acid of both subunits was Thr. One peptide
      was released after proteolysis of the native GDH by trypsin and purified by
      anhydrotrypsin agarose and reversed-phase HPLC. The isolated peptide consisted of
      39 amino acids and its amino acid sequence was as follows: H2NS-E-A-V-E-K-E-D-D-P
      N-F-F-K-M-V-E-G-F-F-D-K-G-A-A-I- V-E-N-K-L-V-E-E-D-L-K-T-R-COOH. The peptide
      contained the N-terminal of the native GDH and its molecular weight was
      calculated to be 4,413. We concluded that the trypsin-catalyzed activation was
      caused by release of this peptide from the native GDH. p-Chloromercuribenzoic
      acid inhibited the activity of the trypsin-treated GDH, but stimulated that of
      the native GDH. The response of trypsin-treated GDH to ADP and GTP was decreased
      compared with that of the native GDH.

PMID- 1639764
TI  - Chemical distribution of glycosphingolipids in third-instar larval organs of the
      blowfly, Calliphora vicina (Insecta: Diptera).
AB  - As a first approach to testing the working hypothesis that glycosphingolipids are
      functionally involved in the ontogeny of insects, their chemical distribution in
      larval organs was determined and any stadium-correlated differences documented.
      Selected organs, i.e., the fatbody, striated muscle, intestinal tract, salivary
      glands, imaginal discs, and central nervous system, were dissected from seven-day
      old larvae of the blowfly, Calliphora vicina, and their glycolipids isolated. Two
      dimensional, high-performance thin-layer chromatography was used to separate the
      neutral and acidic glycolipids of each organ. Significantly different total
      glycolipid component-patterns were obtained for the individual organs, whereby,
      except for a number of additional uncharacterized components in the intestinal
      tract, the neutral glycolipids of all organs were found to be qualitatively
      similar. However, major quantitative differences between the selected organs were
      found in their total glycolipid-carbohydrate contents, as well as the respective
      quantitative neutral glycosphingolipid-component distributions. The acidic
      glycolipids showed pronounced qualitative as well as quantitative organ-dependent
      variations. Whereas the highest proportion of uncharged glycolipids was
      characteristic of the fatbody, a high proportion of zwitterionic glycolipid
      components was observed to be typical of the central nervous system and imaginal
      discs, i.e., of organs persisting during larval life and throughout
      metamorphosis. Imaginal disc glycolipids were distinguished by their high content
      of acidic glycolipids, a putative reflection of the functional role of these
      glycoconjugates in regulated cell reorganization during metamorphosis.

PMID- 1639765
TI  - Purification and characterization of two isoforms of T-kininogens from rat liver
      microsomes.
AB  - T-Kininogen is one of the acute phase proteins, and is a precursor of T-kinin and
      a cysteine protease inhibitor. Two homologous T-kininogens (TI- and TII
      kininogens) were isolated from microsomal fraction of inflamed rat liver, by
      chromatographies on columns of DEAE-Sepharose CL-6B and DEAE-5PW and by affinity
      chromatography on a column of anti T-kininogen monoclonal antibody. The amino
      terminal amino acid sequences of the two microsomal pyridylethylated T-kininogens
      after pyroglutamyl aminopeptidase treatment were identical with those of TI- and
      TII-kininogens from inflamed rat plasma. Microsomal T-kininogens moved faster on
      SDS-PAGE after treatment with endoglycosidase H. The amounts of microsomal TI-
      and TII-kininogens in inflamed and non-inflamed rat liver were quantitated by
      immunoblotting of homogenates of liver microsomes using anti T-kininogen rabbit
      antiserum. The amounts of microsomal T-kininogens were increased in inflamed rat
      liver, but the ratio of the amounts of TI-kininogen to TII-kininogen was not
      different in the inflamed and non-inflamed rat liver. On the other hand, TII
      kininogen was not significantly detected in non-inflamed rat plasma. These
      results indicate that the secretion of one of the T-kininogens, TII-kininogen,
      into plasma may be prevented by some unknown mechanism.

PMID- 1639766
TI  - Sudden increase in speed of an actin filament moving on myosin cross-bridges of
      "mismatched" polarity observed when its leading end begins to interact with cross
      bridges of "matched" polarity.
AB  - Under in vitro movement assay conditions, actin filaments move about 10 times
      faster toward, than away from, the center of large bipolar thick filaments of
      molluscan smooth muscle. Using thick filaments isolated from the anterior byssus
      retractor muscle of Mytilus edulis, the two speed modes of movement were studied
      in detail. Some thick filaments crossed over each other on the surface of the
      assay chamber, allowing actin filaments that moved into the crossover region to
      transfer to other thick filaments. When an actin filament that had been moving in
      the low speed mode crossed over to another thick filament and the speed changed
      to fast, the entire actin filament started to move in the high speed mode at the
      moment of transfer of its leading end, leaving the trailing part still in contact
      with the original thick filament. This indicates that myosin cross-bridges
      interacting in the slow mode do not impose a significant load on the cross
      bridges interacting in the fast mode. Assuming the theoretical model of Tawada
      and Sekimoto [Biophys. J. 59, 343-356 (1991)], we suggest that the magnitude of
      force developed, as well as the speed of unloaded movement, differs greatly,
      depending on the orientation of the myosin cross-bridges.

PMID- 1639767
TI  - cDNA cloning and expression of rat tissue factor pathway inhibitor (TFPI).
AB  - Tissue factor pathway inhibitor (TFPI) is a factor Xa-dependent inhibitor for the
      factor VIIa-tissue factor complex. We isolated cDNA for rat TFPI by screening a
      lambda gt10 rat liver cDNA library. We determined the 1,228 bp nucleotide
      sequence, comprising a 88 bp 5' non-coding region, a 906 bp open reading frame,
      and a 234 bp 3' non-coding region, which encodes a protein of 302 amino acid
      residues. On Northern blot analysis of rat TFPI mRNA, rat TFPI mRNA was detected
      as two forms with different molecular sizes, 4.0 and 1.4 kb, which were expressed
      abundantly in heart, lung, kidney, and aortic endothelial cells. The homology of
      the amino acid sequence of rat TFPI with those of human and rabbit TFPI was found
      to be 60.7 and 57.4%, respectively. The lengths of the three tandem Kunitz-type
      inhibitor domains were strictly conserved not only among TFPI from the three
      species, but also among other proteins containing Kunitz-type inhibitor domains.
      The homology of the Kunitz-type domains in TFPI among the three species was 57,
      86, and 69% in the 1st, 2nd, and 3rd domains, respectively. There was no
      significant difference in hydropathy profiles of TFPI from man, rabbit, and rat.

PMID- 1639768
TI  - Study on human erythrocyte thioltransferase: comparative characterization with
      bovine enzyme and its physiological role under oxidative stress.
AB  - Thioltransferase, an enzyme which catalyzes the thiol/disulfide exchange reaction
      in the presence of GSH, was purified to homogeneity on 15% SDS-PAGE from human
      (36,000-fold purification) and bovine (23,000-fold) erythrocyte hemolysates.
      These enzymes had similar properties in their monomeric structures (M(r) =
      11,000) and broad specificities for substrates ranging from low-molecular
      disulfides (S-sulfocysteine, cystamine, and cystine) to protein disulfides
      (trypsin and insulin). They were highly sensitive to SH-reagents (monoiodoacetic
      acid and mercuric chloride), but were protected from inactivation by the presence
      of disulfides (GSSG, cystamine, and cystine). Phosphofructokinase and pyruvate
      kinase that had been inactivated by disulfides were reactivated effectively by
      the addition of thioltransferase with GSH. In addition, disulfides in membrane
      proteins of human erythrocytes that have been oxidatively damaged by diamide
      treatment were reduced to the SH-free form more effectively by incubation with
      thioltransferase.

PMID- 1639769
TI  - The p53 tumor suppressor protein, a modulator of cell proliferation.

PMID- 1639770
TI  - Reversible exposure of the pseudosubstrate domain of protein kinase C by
      phosphatidylserine and diacylglycerol.
AB  - The lipid activators of protein kinase C, phosphatidylserine and diacylglycerol,
      induce a reversible conformational change that exposes the auto-inhibitory
      pseudosubstrate domain of the enzyme. The pseudosubstrate domain of beta-II
      protein kinase C is cleaved after the first residue, arginine 19, by the
      endoproteinase Arg-C only when the kinase is bound to the activating lipid
      phosphatidylserine. Exposure of this residue is markedly enhanced by
      diacylglycerol. In contrast, the pseudosubstrate domain is not cleaved in the
      absence of lipids, when protein kinase C is bound to non-activating acidic
      lipids, when the kinase has autophosphorylated on the amino terminus, or after
      dilution of the activating lipids. This work reveals specificity in the
      interaction of protein kinase C with phosphatidylserine since only this
      phospholipid causes the specific conformational change detected in the regulatory
      domain of the enzyme, and demonstrates that allosteric regulators expose the
      intramolecular auto-inhibitory domain of a kinase.

PMID- 1639771
TI  - The multiple ADP/ATP translocase genes are differentially expressed during human
      muscle development.
AB  - The expression of the genes encoding the three isoforms of the human ADP/ATP
      translocase (T1, T2, and T3) has been analyzed at different stages of myogenic
      differentiation in an in vitro muscle cell system and compared with that in
      mature muscle. The results indicate that the three stages of muscle
      differentiation corresponding to myoblast proliferation, myotube formation, and
      mature muscle fibers are characterized by a different pattern of expression of
      the ADP/ATP translocase genes. In particular, the two T2-specific mRNAs are
      present at high, similar levels in myoblasts and myotubes and markedly decrease
      in amount in mature adult muscle. By contrast, the T3-specific mRNA is present in
      high amount in growing myoblasts, decreases markedly in myotubes, and is barely
      detectable in adult muscle. Finally, the T1-specific mRNA is present at a high
      level in adult muscle and is not detectable in either myoblasts or myotubes.
      Therefore, T1 gene expression appears to be a marker of a late stage in
      myogenesis. A parallel investigation of expression of the myosin heavy chain mRNA
      revealed absence of hybridization with the specific probe in RNA from
      proliferating myoblasts, a significant hybridization in myotube RNA, and a strong
      signal in adult muscle RNA.

PMID- 1639772
TI  - Presence of a repressor protein for testis-specific H2B (TH2B) histone gene in
      early stages of spermatogenesis.
AB  - The rat testis-specific TH2B histone gene assumes a hypomethylated chromatin
      structure at all stages of spermatogenesis. However, the TH2B mRNA level is very
      low in pre-meiotic spermatogenic cells and rises sharply in meiotic pachytene
      spermatocytes. The low level of TH2B mRNA in pre-meiotic spermatogenic cells
      appears to be a result of transcriptional repression of the gene by a pre-meiotic
      cell-specific protein which binds to a site between the TATA element and the
      transcription initiation site of TH2B gene.

PMID- 1639773
TI  - Interleukin-2 (IL-2) induces tyrosine kinase-dependent translocation of active
      raf-1 from the IL-2 receptor into the cytosol.
AB  - Stimulation of the interleukin-2 (IL-2) receptor results in phosphorylation and
      activation of cytosolic Raf-1 serine/threonine kinase. Herein, we report that
      enzymatically active Raf-1 is physically associated with the IL-2 receptor beta
      chain (p75) in T-cell blasts. Following stimulation with IL-2, Raf-1 dissociates
      from the IL-2 receptor complex and translocates to the cytosol. Genistein, a
      protein tyrosine kinase inhibitor, prevents the dissociation of enzymatically
      active Raf-1 from the ligand-stimulated IL-2 receptor complex. These data favor a
      model of IL-2 receptor activation in which an IL-2-activated protein tyrosine
      kinase phosphorylates the IL-2 receptor and/or receptor-bound Raf-1. Following
      tyrosine phosphorylation, enzymatically active Raf-1 dissociates from the IL-2
      receptor and translocates into the cytosol.

PMID- 1639774
TI  - The 4F2 antigen heavy chain induces uptake of neutral and dibasic amino acids in
      Xenopus oocytes.
AB  - The 4F2 cell surface antigen is a disulfide-linked heterodimer induced during the
      process of cellular activation and expressed widely in mammalian tissues
      (Parmacek, M. S., Karpinski, B. A., Gottesdiener, K. M., Thompson, C. B., and
      Leiden, J. M. (1989) Nucleic Acids Res. 17, 1915-1931). The human heavy chain
      component, a type II membrane glycoprotein, has 29% identity to the amino acid
      transport-related protein encoded by the recently cloned rat D2 cDNA. We have
      demonstrated that Xenopus oocytes injected with in vitro transcribed cRNA from D2
      take up cystine and dibasic and neutral amino acids (Wells, R. G., and Hediger,
      M. A. (1992) Proc. Natl. Acad. Sci. U. S. A. 89, 5596-5600). In the present
      study, we examine the role of the human 4F2 heavy chain in amino acid transport.
      In vitro transcribed 4F2 cRNA was injected into Xenopus oocytes which were
      assayed for the uptake of radiolabeled amino acids. Our results show that cRNA
      from 4F2 stimulates the uptake of dibasic and neutral amino acids into oocytes at
      levels up to 3-fold higher than for water-injected control oocytes. There is no
      demonstrable uptake of cystine. Uptake is saturable, with characteristics of high
      affinity transport, and inhibition data suggest that uptake occurs via a single
      transporter. Dibasic amino acids are taken up by both 4F2 and D2 cRNA-injected
      oocytes in a sodium-independent manner. In contrast, 4F2-induced but not D2
      induced neutral amino acid uptake has a significant component of sodium
      dependence. Likewise, neutral amino acids in excess inhibit the 4F2-induced
      uptake of radiolabeled arginine but not leucine in a sodium-dependent manner. The
      4F2-induced uptake we observe most likely represents the activity of a single
      transport system with some characteristics of systems y+, b0,+, and B0,+. We
      suggest that 4F2 and D2 represent a new family of proteins which induce amino
      acid transport with distinct characteristics, possibly functioning as transport
      activators or regulators.

PMID- 1639775
TI  - A transitional state of pro-urokinase that has a higher catalytic efficiency
      against glu-plasminogen than urokinase.
AB  - Plasminogen activation by single-chain urokinase-type plasminogen activator or
      pro-urokinase (pro-UK) is accompanied by the generation of two-chain urokinase
      (UK) by plasmin which provides a positive feedback. In the present study, the
      time course of the activation of Glu-plasminogen and of Lys-plasminogen (10
      microM) by pro-UK (1.0 nM) was studied. In the presence of native plasminogen
      (Glu-plasminogen), three distinct phases with different rates of plasmin
      generation were observed. The initial phase was slow and corresponded to the
      intrinsic activity of pro-UK as reflected by the activity of a plasmin-resistant
      mutant (Lys158----Ala). This was followed by a second phase which had the most
      rapid rate. The third phase had a plasminogen activation rate which was
      significantly slower than the second and paralleled the rate of activation by UK
      (1.0 nM). The second phase coincided with the time at which there was only about
      50% conversion of pro-UK to UK, whereas the final phase coincided with
      essentially complete conversion. In the presence of fibrin fragment E-2 (20
      microM), previously shown to strongly promote plasminogen activation by pro-UK,
      the identical phenomenon was observed, but at one-tenth the concentration of pro
      UK. The most rapid rate of plasmin generation again coincided with transitional
      (25-60%) pro-UK to UK conversion. To further examine this phenomenon, the rate of
      pro-UK to UK conversion was controlled by using kallikrein in the presence of a
      plasmin inhibitor. In this experiment, the activation of Glu-plasminogen bound to
      solid-phase fibrin was measured. A similar three-phase sequence was observed, the
      highest rate of plasmin generation coinciding with about 45% conversion of pro-UK
      to UK. A mechanism for this transitional state phenomenon was postulated based on
      the established significantly higher affinity of pro-UK than of UK for Glu
      plasminogen. This exceptional property for a proenzyme may enable a transient
      activity to be generated during the transition from pro-UK to UK corresponding to
      the more favorable KM of pro-UK and the kcat of UK. This hypothesis was supported
      by the results from experiments in which Lys-plasminogen was substituted for the
      Glu form. No transitional state activity was observed, consistent with the
      relatively high KM of pro-UK against Lys-plasminogen.

PMID- 1639776
TI  - Adenine affects the structure and stability of telomeric sequences.
AB  - Adenine occurs in the strand containing repeated G clusters in the telomeric DNA
      of a variety of organisms, including that of humans. The role of adenine has been
      investigated by constructing two sets of oligonucleotides each with one, two, or
      four copies of the telomeric sequence dTTTAGGG together with a control sequence
      in which T replaces the A residue, dTTTTGGG. Comparison of the stability and
      spectral properties of these two sequences in the presence of Na+ or K+ affords a
      basis for defining the role of adenine in these structures. In Na+, the A residue
      stabilizes the structure formed by each oligomer significantly, presumably by a
      base-pairing interaction with T. In K+, by contrast, there is little difference
      in stability. In two- and four-copy oligomers, the A sequence has a different
      structure from its T analog, as detected by CD spectroscopy. In the presence of
      either Na+ or K+, the tetraplexes of A and T interact with intercalators.

PMID- 1639777
TI  - Analysis of two novel classes of plant antifungal proteins from radish (Raphanus
      sativus L.) seeds.
AB  - Two novel classes of antifungal proteins were isolated from radish seeds. The
      first class consists of two homologous proteins (Rs-AFP1 and Rs-AFP2) that were
      purified to homogeneity. They are highly basic oligomeric proteins composed of
      small (5-kDa) polypeptides that are rich in cysteine. Both Rs-AFPs have a broad
      antifungal spectrum and are among the most potent antifungal proteins hitherto
      characterized. In comparison with many other plant antifungal proteins, the
      activity of the Rs-AFPs is less sensitive to the presence of cations. Moreover,
      their antibiotic activity shows a high degree of specificity to filamentous
      fungi. The amino-terminal regions of the Rs-AFPs show homology with the derived
      amino acid sequences of two pea genes specifically induced upon fungal attack, to
      gamma-thionins and to sorghum alpha-amylase inhibitors. The radish 2S storage
      albumins were identified as the second novel class of antifungal proteins. All
      isoforms inhibit growth of different plant pathogenic fungi and some bacteria.
      However, their antimicrobial activities are strongly antagonized by cations.

PMID- 1639778
TI  - Substrate specificity of a CoA-dependent stearoyl transacylase from bovine testis
      membranes.
AB  - We identified a CoA-dependent stearoyl transacylase activity in bovine testis
      membranes, then examined the enzyme's specificity in mixed micelle systems
      containing the neutral detergent Triton X-100. The enzyme transferred stearoyl
      groups from a variety of phospholipids to sn-2-arachidonoyl lysophosphatidic acid
      (lysoPA), but showed very little palmitoyl transacylase activity. Its ability to
      transfer stearoyl groups was both donor- and acceptor-dependent. For example, it
      used weakly acidic phospholipids, such as sn-1-stearoyl-2-acyl species of
      phosphatidylinositol (PI), as donors, but did not use phosphatidylinositol-4,5
      bisphosphate or sn-1-stearoyl-2-arachidonoyl phosphatidylcholine. Moreover, it
      used sn-2-acyl species of lysoPA and sn-2-arachidonoyl lysoPI as acceptors but
      did not use sn-2-arachidonoyl species of lysophosphatidylserine,
      lysophosphatidylethanolamine, or lysophosphatidylcholine. When taken together,
      our results raise the possibility that sn-1-stearoyl-2-acyl species of PI may be
      the primary acyl donors in the transacylase reaction in vivo, while sn-2-acyl
      species of lysoPA may be the primary acyl acceptors. Available evidence suggests
      that the PA that is formed may subsequently be converted into PI, but the
      metabolic fate of the other reaction product, sn-2-acyl lysoPI, remains to be
      determined.

PMID- 1639779
TI  - Characterization and nucleotide binding properties of a mutant dihydropteridine
      reductase containing an aspartate 37-isoleucine replacement.
AB  - Kinetic constants for the interaction of NADH and NADPH with native rat
      dihydropteridine reductase (DHPR) and an Escherichia coli expressed mutant (D-37
      I) have been determined. Comparison of kcat and Km values measured employing
      quinonoid 6,7-dimethyldihydropteridine (q-PtH2) as substrate indicate that the
      native enzyme has a considerable preference for NADH with an optimum kcat/Km of
      12 microM-1 s-1 compared with a figure of 0.25 microM-1 s-1 for NADPH. Although
      the mutant enzyme still displays an apparent preference for NADH (kcat/Km = 1.2
      microM-1 s-1) compared with NADPH (kcat/Km = 0.6 microM-1 s-1), kinetic analysis
      indicates that NADH and NADPH have comparable stickiness in the D-37-I mutant.
      The dihydropteridine site is less affected, since the Km for q-PtH2 and K(is) for
      aminopterin are unchanged and the 14-26-fold synergy seen for aminopterin binding
      to E.NAD(P)H versus free E is decreased by less than 2-fold in the D-37-I mutant.
      No significant changes in log kcat and log kcat/Km versus pH profiles for NADH
      and NADPH were seen for the D-37-I mutant enzyme. However, the mutant enzyme is
      less stable to proteolytic degradation, to elevated temperature, and to
      increasing concentrations of urea and salt than the wild type. NADPH provides
      maximal protection against inactivation in all cases for both the native and D-37
      I mutant enzymes. Examination of the rat DHPR sequence shows a typical
      dinucleotide binding fold with Asp-37 located precisely in the position predicted
      for the acidic residue that participates in hydrogen bond formation with the 2'
      hydroxyl moiety of all known NAD-dependent dehydrogenases. This assignment is
      consistent with x-ray crystallographic results that localize the aspartate 37
      carboxyl within ideal hydrogen bonding distance of the 2'- and 3'-hydroxyl
      moieties of adenosine ribose in the binary E.NADH complex.

PMID- 1639780
TI  - Isolated cardiomyocytes in conjunction with NMR spectroscopy techniques to study
      metabolism and ion flux.
AB  - To distinguish cellular from vascular responses to physiological and
      pathophysiological stimuli, we developed methods to perform NMR spectroscopy on
      isolated ventricular cardiomyocytes. Isolated adult rat cardiomyocytes, placed in
      agarose beads and superfused with phosphate-free buffer (Media 199 (GIBCO 400
      1100) gassed with 95% O2, 5% CO2), were used to evaluate a variety of cellular
      processes during different pharmacological and physiological interventions.
      Bioenergetic function was monitored with 31P NMR. Intermediary metabolism,
      gluconeogenesis, and glycolysis were monitored with 13C NMR. Sodium flux was
      monitored with 23Na NMR. Calcium flux was monitored with 19F NMR in conjunction
      with an intracellular calcium-chelating agent, 5F-1,2-bis(2-amino-phenoxy)ethane
      N,N,N',N'-tetraacetic acid. Creatine kinase kinetics (forward rate constant (Kf)
      and flux of phosphocreatine to ATP) were estimated with 31P NMR saturation
      transfer data. Various combinations of NMR parameters were monitored
      simultaneously so that the interaction of metabolism and ion flux could be
      evaluated. We have demonstrated that it is possible to simultaneously monitor a
      variety of cellular processes in intact heart cells in real time, without the
      confounding influences of perfusion, contractile function, and extrinsic blood
      borne neurohumoral agents. This model will be useful for longitudinal studies of
      myocyte metabolism and ion flux.

PMID- 1639781
TI  - Mechanism of loss of thermodynamic control in mitochondria due to hyperthyroidism
      and temperature.
AB  - Incubation of normal mitochondria at 45 degrees C results in increases of
      respiration and of total apparent proton conductance (TAPC, respiration/proton
      motive force) and in an upward shift of the flow-force relationships. Similar
      effects are observed during operation of the redox proton pumps at different
      sites of the respiratory chain. These effects are accompanied by an almost
      equivalent increase of the passive proton conductance (PPC, proton leakage/proton
      motive force). In mitochondria from 3,3,5-triiodo-L-thyronine (T3)-treated rats
      there are also increases of respiration and of TAPC and an upward shift of flow
      force relationships, more pronounced at the level of the cytochrome oxidase
      proton pump. However, at variance from the incubation at 45 degrees C, in
      mitochondria from T3-treated rats there is only a slight increase of PPC.
      Addition of bovine serum albumin to normal mitochondria incubated at 45 degrees C
      results in a marked depression of TAPC in the nonlinear range of the flow-force
      relationships. An equivalent effect is not observed in mitochondria from T3
      treated rats. The experimental results have been compared with computer
      simulations obtained on the basis of a chemiosmotic model of energy transduction.
      The increase of TAPC following incubation at high temperature is apparently due
      to changes of the proton conductance mainly at the level of PPC, while the
      increase of TAPC following T3 administration is rather due to changes presumably
      at the level of the redox or ATPase proton pumps.

PMID- 1639782
TI  - Structure of the gene and its retinoic acid-regulatory region for murine J6
      serpin. An F9 teratocarcinoma cell retinoic acid-inducible protein.
AB  - We have recently reported a protein sequence deduced from the retinoic acid (RA)
      inducible mRNA J6 as a novel serine protease inhibitor (serpin). In this study we
      have reported that the J6 serpin gene is 7.7 kilobases in length and consists of
      five exons with an additional option. Comparison of the organization of the J6
      gene and other serpin genes reveals that the structure of the J6 gene is
      different from the reported four serpin gene groups. Nonetheless, intron B of the
      J6 gene and members of the alpha-antitrypsin gene group are at the equivalent
      positions, suggesting that the J6 gene is more closely related to the members of
      alpha-anti-trypsin gene group than other serpins. To identify the RA response
      region, we have further examined the nucleotide sequence of the 1-kilobase 5'
      flanking region of the J6 gene. The DNA sequence from position -1050 to -738 is
      essential for the gene activation by RA as revealed by the stable transfection
      experiments. Within this region, present are four GA-GATAG motifs which are the
      known binding sites for GATA transcription factor family. Interestingly, there is
      a potential heat shock element with alternate arrays of blocks XGAAX and XTTCX
      spanning from -88 to -59, indicating that the J6 gene perhaps is heat-inducible.

PMID- 1639783
TI  - Intrinsic fluorescence changes and rapid kinetics of the reaction of thrombin
      with hirudin.
AB  - Stopped-flow fluorescence spectroscopy has been used to study the reaction of
      human alpha-thrombin with recombinant hirudin variant 1 (rhir) at 37 degrees C
      and an ionic strength of 0.125 M. A 35% enhancement in intrinsic fluorescence
      accompanied formation of the thrombin-rhir complex. Over one third of this
      enhancement corresponded to a structural change that could be induced by binding
      of either the NH2-terminal fragment (residues 1-51) or the COOH-terminal fragment
      (residues 52-65) of rhir. Three kinetic steps were detected for reaction of
      thrombin with rhir. At high rhir concentrations (greater than or equal to 3
      microM), two intramolecular steps with observed rate constants of 296 +/- 5 s-1
      and 50 +/- 1 s-1 were observed. By using the COOH-terminal fragment of rhir as a
      competitive inhibitor, it was possible to obtain an estimate of 2.9 x 10(8) M-1 s
      1 for the effective association rate constant at low rhir concentrations. At
      higher ionic strengths, this rate constant was lower, which is consistent with
      the formation of the initial complex involving an ionic interaction. The
      mechanism for the reaction of both the COOH- and NH2-terminal fragments of rhir
      appeared to involve two steps. When thrombin was reacted with the COOH-terminal
      fragment at high concentrations (greater than or equal to 6 microM), the
      bimolecular step occurred within the dead time of the spectrometer and only one
      intramolecular step, with a rate constant of 308 +/- 5 s-1 was observed. At
      concentrations of NH2-terminal fragment below 50 microM, its binding to thrombin
      appeared to be a bimolecular reaction with an association rate constant of 8.3 x
      10(5) M-1 s-1. In the presence of saturating concentrations of the COOH-terminal
      fragment, a 1.7-fold increase in this rate constant was observed. At
      concentrations of NH2-terminal fragment greater than 50 microM, biphasic reaction
      traces were observed which suggests a two-step mechanism. By comparing the
      reaction amplitudes and dissociation constants observed with rhir and its COOH
      terminal fragment, it was possible to obtain approximate estimates for the values
      of the rate constants of different steps in the formation of the rhir-thrombin
      complex.

PMID- 1639784
TI  - Kinetics of leucine transport in brush border membrane vesicles from lepidopteran
      larvae midgut.
AB  - The kinetics of K(+)-leucine cotransport in the midgut of lepidopteran larvae was
      investigated using brush border membrane vesicles. Initial rate (3 s) of leucine
      uptake was determined under experimental conditions similar to those occurring in
      vivo, i.e. in the presence of delta psi much greater than 0 (inside negative) and
      a delta pH of 1.4 units (7.4in/8.8out). Leucine and K+ bind to the carrier
      according to a sequential mechanism, and the binding of one substrate changed the
      dissociation constant for the other substrate by a factor of 0.15. Both trans-K+
      and trans-leucine were mixed-type inhibitors of leucine uptake. Moreover, a
      portion of total leucine uptake was K+ independent, and it was competitively
      inhibited by trans-leucine. We interpret the trans inhibitory effects to mean
      that the partially loaded K+ only form is virtually unable to translocate across
      the membrane, whereas the binary complex carrier, leucine, can isomerize from the
      trans to the cis side of the membrane. However, the K(+)-independent leucine
      uptake occurs with a Keq greater than 1, i.e. the efflux route through the
      partially loaded leucine only form is slower than the rate of isomerization of
      the unloaded carrier from trans to cis side. Taken together, these results
      suggest a model in which transport occurs by an iso-random Bi Bi system. Since K+
      does not act as a pure competitive activator, this model is different from that
      proposed for most of the Na(+)-linked solutes transport agencies and may be
      related to the broadening of the cation specificity of the amino acid
      transporters in lepidopteran larvae.

PMID- 1639785
TI  - Roles of FAD and 8-hydroxy-5-deazaflavin chromophores in photoreactivation by
      Anacystis nidulans DNA photolyase.
AB  - DNA photolyase from the cyanobacterium Anacystis nidulans contains two
      chromophores, flavin adenine dinucleotide (FADH2) and 8-hydroxy-5-deazaflavin (8
      HDF) (Eker, A. P. M., Kooiman, P., Hessels, J. K. C., and Yasui, A. (1990) J.
      Biol. Chem. 265, 8009-8015). While evidence exists that the flavin chromophore
      (in FADH2 form) can catalyze photorepair directly and that the 8-HDF chromophore
      is the major photosensitizer in photoreactivation it was not known whether 8-HDF
      splits pyrimidine dimer directly or indirectly through energy transfer to FADH2
      at the catalytic center. We constructed a plasmid which over-produces the A.
      nidulans photolyase in Escherichia coli and purified the enzyme from this
      organism. Apoenzyme was prepared and enzyme containing stoichiometric amounts of
      either or both chromophores was reconstituted. The substrate binding and
      catalytic activities of the apoenzyme (apoE), E-FADH2, E-8-HDF, E-FAD(ox)-8-HDF,
      and E-FADH2-8-HDF were investigated. We found that FAD is required for substrate
      binding and catalysis and that 8-HDF is not essential for binding DNA, and
      participates in catalysis only through energy transfer to FADH2. The quantum
      yields of energy transfer from 8-HDF to FADH2 and of electron transfer from FADH2
      to thymine dimer are near unity.

PMID- 1639786
TI  - Relations between factor VIIa binding and expression of factor VIIa/tissue factor
      catalytic activity on cell surfaces.
AB  - The kinetics of the binding of rVIIa to cell surface tissue factor (TF) and the
      resultant expression of VIIa/TF activity were studied. Binding of 125I-rVIIa (10
      nM) to cell surface TF required 30-60 min for saturation, whereas VIIa/TF
      activity was fully expressed toward factor X (F X) on intact monolayers after
      only 1 min of incubation. At the time only 10-20% of the total VIIa TF complexes
      present at saturation had formed. Freeze-thawing the monolayers before assay
      increased VIIa/TF activity up to 30-fold, and the time course of its expression
      was similar to that of TF-specific binding of VIIa to the monolayers. Equilibrium
      binding revealed a single high affinity binding class of TF sites on intact
      monolayers for rVIIa with a Kd of 1.6 nM. Experiments with active-site inhibited
      rVIIa yielded evidence for two populations of VIIa. TF complexes on intact
      monolayers: (1) a minor population (less than 20%) that formed within 1 min of
      incubation and accounted for all VIIa/TF activity toward F X present on the
      intact monolayers, and (2) a major population that was inactive toward F X on
      intact monolayers but which was fully active after the monolayers were lysed.
      Tissue factor pathway inhibitor (TFPI).F Xa complexes inhibited the VIIa/TF
      activity of the first population, i.e. of the complexes active on intact
      monolayers, half maximally at a concentration of 0.2 nM TFPI. TFPI/Xa also bound
      to the second population of VIIa.TF complexes on intact monolayers and inhibited
      their expression of VIIa/TF activity following cell lysis with a half-maximal
      inhibitory concentration of 2.0 nM. The potential physiologic implications of
      these findings are discussed.

PMID- 1639788
TI  - Determination of residue specificity in the EF-hand of troponin C for Ca2+
      coordination, by genetic engineering.
AB  - Utilizing protein engineering of troponin C (TnC), combined with the physiology
      of skinned fibers, the present study sought to delineate the mechanisms for metal
      ion coordination and sensitivity in the sites (EF-hands) that execute the Ca2+
      switch for contraction. A total TnC-encoding gene comprising multiple target
      sequences for restriction enzymes was synthesized, furnishing a pliant molecular
      handle to manipulate sites I and II in the NH2 terminus of the protein. Of the
      six positions (X, Y, Z, -Y, -X, and -Z) essential for metal ion chelation in a
      typical EF-hand, invariably the X position has aspartate, and -Z position has
      glutamate. In the X position of site II, mutation of aspartate for either
      glutamate (gamma-carboxylate) or asparagine (same side chain length as aspartate)
      yielded functionally inactive proteins with concomitantly diminished Ca2+ binding
      capacity. Similarly, in -Z position (site I), neither aspartate nor glutamine
      were compatible in exchange for the conserved glutamate. In contrast, for the Y
      coordinate of site II, a preference for asparagine comparable to that for wild
      type aspartate was detected, but glutamate was impermissible. Evidently,
      physicochemical and steric factors both are critical in governing the mechanism
      for metal ion chelation in TnC in a physiological milieu. Furthermore, the
      findings manifest that the quaternary structure of hydrated TnC restrains the EF
      hands during on-off operation of the Ca2+ switch.

PMID- 1639787
TI  - Molecular cloning and characterization of (R)-3-hydroxybutyrate dehydrogenase
      from human heart.
AB  - The complete amino acid sequence of human heart (R)-3-hydroxybutyrate
      dehydrogenase (EC 1.1.1.30) has been deduced from the nucleotide sequence of cDNA
      clones. This mitochondrial enzyme has an absolute and specific requirement of
      phosphatidylcholine for enzymic activity (allosteric activator) and is an
      important prototype of lipid-requiring enzymes. Despite extensive studies, the
      primary sequence has not been available and is now reported. The mature form of
      the enzyme consists of 297 amino acids (predicted M(r) of 33,117), does not
      appear to contain any transmembrane helices, and is homologous with the family of
      short-chain alcohol dehydrogenases (SC-ADH) (Persson, B., Krook, M., and
      Jornvall, H. (1991) Eur. J. Biochem. 200, 537-543) (30% residue identity with
      human 17 beta-hydroxysteroid dehydrogenase). The first two-thirds of the enzyme
      includes both putative coenzyme binding and active site conserved residues and
      exhibits a predicted secondary structure motif (alternating alpha-helices and
      beta-sheet) characteristic of SC-ADH. Bovine heart peptide sequences (174
      residues in nine sequences determined by microsequencing) have extensive homology
      (89% identical residues) with the deduced human heart sequence. The C-terminal
      third (Asn-194 to Arg-297) shows little sequence homology with the SC-ADH and
      likely contains elements that determine the substrate specificity for the enzyme
      including the phospholipid (phosphatidylcholine) binding site(s). Northern blot
      analysis identifies a 1.3-kilobase mRNA encoding the enzyme in heart tissue.

PMID- 1639789
TI  - Evidence that Caenorhabditis elegans 32-kDa beta-galactoside-binding protein is
      homologous to vertebrate beta-galactoside-binding lectins. cDNA cloning and
      deduced amino acid sequence.
AB  - We have cloned a full-length cDNA for a beta-galactoside-binding protein with a
      relative molecular mass of 32 kDa (32-kDa GBP), recently purified from a
      nematode, Caenorhabditis elegans (Hirabayashi, J., Satoh, M., Ohyama, Y., and
      Kasai, K. (1992) J. Biochem. 111, 553-555). The clone contained a single open
      reading frame encoding 279 amino acids, including the initiator methionine.
      Significant sequence homology to metal-independent beta-galactoside-binding
      lectins (25-30% identities), which had previously been found only in vertebrates,
      was observed. Moreover, the nematode 32-kDa GBP proved to have a unique
      polypeptide architecture; that is, it is composed of two tandemly repeated
      homologous domains, each consisting of about 140 amino acids. The internal
      homology was about 32%. Thus, this protein is constructed with a duplicated
      fundamental unit which is similar to the subunit of vertebrate 14-kDa lectins. In
      spite of the extreme phylogenic distance between nematodes and vertebrates
      (divergence greater than 6 x 10(8) years ago), both of the two repeated domains
      of the nematode 32-kDa GBP retained most of the amino acid residues conserved in
      vertebrate lectins. This means that members of the metal-independent animal
      lectin family are distributed much more widely than had been believed: from
      nematodes to vertebrates. The implication is that proteins belonging to this
      family have fundamental roles which are not restricted to vertebrates but are
      common to almost all animals.

PMID- 1639790
TI  - Resonance Raman and magnetic circular dichroism studies of reduced [2Fe-2S]
      proteins.
AB  - The structural and electronic properties of the [2Fe-2S] clusters in reduced
      putidaredoxin, Spinacea oleracea ferredoxin, and Clostridium pasteurianum [2Fe
      2S] ferredoxin have been investigated by resonance Raman and variable temperature
      magnetic circular dichroism spectroscopies. Both techniques are shown to provide
      diagnostic fingerprints for identifying [2Fe-2S]+ clusters in more complex
      multicomponent metalloenzymes. The Fe-S stretching modes of oxidized and reduced
      putidaredoxin are assigned via 34S and D2O isotope shifts and previous normal
      mode calculations for adrenodoxin (Han, S., Czernuszewicz, R. S., Kimura, T.,
      Adams, M. W. W., and Spiro, T. G. (1989) J. Am. Chem. Soc. 111, 3505-3511). The
      close similarity in the resonance Raman spectra of reduced [2Fe-2S] centers, in
      terms of both the vibrational frequencies and enhancement profiles of the Fe-S
      stretching modes, permits these assignments to be generalized to all clusters of
      this type. Modes primarily involving Fe(III)-S(Cys) stretching are identified in
      all three reduced [2Fe-2S] proteins, and the frequencies are rationalized in
      terms of the conformation of the cysteine residues ligating the Fe(III) site of
      the localized valence reduced cluster. D2O isotope shifts indicate few, if any,
      amide NH-S hydrogen bond interactions involving the cysteines ligating the
      Fe(III) site. Preliminary resonance Raman excitation profiles suggest assignments
      for the complex pattern of electronic bands that comprise the low temperature
      magnetic circular dichroism spectra of the reduced proteins. S----Fe(III) and
      Fe(II)----S charge transfer, Fe d-d, and Fe(II)----Fe(III) intervalence bands are
      identified.

PMID- 1639791
TI  - Genistein inhibits protein histidine kinase.
AB  - Protein histidine kinase was prepared from whole cell extracts of the yeast,
      Saccharomyces cerevisiae. The enzyme was assayed using either histone H4 or a
      synthetic peptide corresponding to residues 70 to 102 of histone H4 as an in
      vitro substrate. With either substrate, both genistein and its solvent, dimethyl
      sulfoxide (Me2SO), inhibited protein histidine kinase. Me2SO alone gave a
      cooperative dose-response curve, with inhibition changing from almost zero below
      10% Me2SO to 80% at 20% Me2SO with either substrate. Genistein gave a simple dose
      response curve with 50% inhibition of protein histidine kinase at 110 microM
      genistein. In experiments with protein histidine kinase, genistein was a
      noncompetitive inhibitor with respect to ATP, histone H4 or the synthetic
      peptide, although, in the case of the synthetic peptide, the data were also
      consistent with competitive inhibition. These data gave Km values for both ATP
      and histone H4 of 15 microM, in satisfactory agreement with previously reported
      values (Huang, J., Wei, Y., Kim, Y., Osterberg, L., and Matthews, H. R. (1991) J.
      Biol. Chem. 266, 9023-9031). The Km for the synthetic peptide was 80 microM. The
      KI values were 270 or 310 microM measured with histone H4 or the synthetic
      peptide as substrate, respectively. While these KI values are relatively high,
      relative to published KI values for genistein inhibition of protein tyrosine
      kinases, many reported experiments use genistein at concentrations where
      inhibition of protein histidine kinase occurs. It is possible that some of the
      observed effects of genistein in vivo may be due to inhibition of protein
      histidine kinase.

PMID- 1639792
TI  - Changes in rates of protein synthesis and eukaryotic initiation factor-4
      inhibitory activity in cell-free translation systems of sea urchin eggs and early
      cleavage stage embryos.
AB  - The characteristics of cell-free translation systems prepared from unfertilized
      eggs and early cleavage stage embryos of the sea urchin, Strongylocentrotus
      purpuratus, closely reflect the developmentally regulated changes in protein
      synthesis initiation observed in vivo. Cell-free translation systems prepared
      over the first 0-6 h following fertilization show gradually increasing
      activities, mimicking the changes observed in vivo. The mechanisms underlying
      these increases are complex and occur at several levels. One factor contributing
      to the rise in protein synthetic rate is the gradual increase in eukaryotic
      initiation factor (eIF)-4 activity. This is correlated with the progressive
      inactivation of an inhibitor of eIF-4 function, which can be reactivated by in
      vitro manipulations. The relatively slow activation of eIF-4 follows similar
      kinetics to the increased utilization of maternal mRNA and ribosomes, in contrast
      to the rapid rise in maternal mRNA activation, and the increase in eIF-2B
      activity. This slow release from eIF-4 inhibition following a rapid release from
      eIF-2B inhibition and increased mRNA availability is reflected in the pattern of
      initiator tRNA binding to the small ribosomal subunit observed in cell-free
      translation systems. In translation systems from unfertilized eggs, initiator
      tRNA is unable to interact with the small ribosomal subunit, consistent with an
      initial block in both eIF-2B and eIF-4 activity. In translation systems from 30
      min embryos, 48 S preinitiation complexes accumulate, reflecting the release from
      inhibition of mRNA availability and eIF-2B activity, but continued low activity
      of eIF-4. The accumulation of initiator tRNA in 48 S preinitiation complexes
      disappears gradually in translation systems from later embryos, as eIF-4 is
      slowly released from inhibition.

PMID- 1639793
TI  - Fusions of anthrax toxin lethal factor to the ADP-ribosylation domain of
      Pseudomonas exotoxin A are potent cytotoxins which are translocated to the
      cytosol of mammalian cells.
AB  - The lethal factor (LF) and edema factor (EF) components of anthrax toxin are
      toxic to animal cells only if internalized by interaction with the protective
      antigen (PA) component. PA binds to a cell surface receptor and is
      proteolytically cleaved to expose a binding site for LF and EF. To study how LF
      and EF are internalized and trafficked within cells, LF was fused to the
      translocation and ADP-ribosylation domains (domains II and III, respectively) of
      Pseudomonas exotoxin A. LF fusion proteins containing Pseudomonas exotoxin A
      domains II and III were less toxic than those containing only domain III. Fusion
      proteins with a functional endoplasmic reticulum retention sequence, REDLK, at
      the carboxyl terminus of domain III were less toxic than those with a
      nonfunctional sequence, LDER. The most potent fusion protein, FP33, had an EC50 =
      2 pM on Chinese hamster ovary cells, exceeding that of native Pseudomonas
      exotoxin A (EC50 = 420 pM). Toxicity of all the fusion proteins required the
      presence of PA and was blocked by monensin. These data suggest that LF and LF
      fusion proteins are efficiently translocated from acidified endosomes directly to
      the cytosol without trafficking through other organelles, as is required for
      Pseudomonas exotoxin A. This system provides a potential vehicle for importing
      diverse proteins into the cytosol of mammalian cells.

PMID- 1639794
TI  - Chimeric L6 anti-tumor antibody. Genomic construction, expression, and
      characterization of the antigen binding site.
AB  - We report the cloning of the genomic variable region genes of the human carcinoma
      reactive murine monoclonal antibody L6 and their genetic linkage to human
      constant region exons to encode a human IgG1/kappa chimeric antibody. The
      chimeric protein was produced at levels greater than 20 micrograms/ml (enabling
      the initiation of clinical trials) and was found to have binding properties
      identical with that of the murine parent. The nucleic acid sequence of the
      variable regions was determined and found to be different than that previously
      reported (1). The deduced amino acid sequence was then used to generate a
      structural homology based three-dimensional model of the antibody binding site,
      which was found to share features with antibodies known to interact with a
      protein surface, but distinct from those that bind to carbohydrate epitopes.
      Biochemical analysis of binding between antibody and the in vitro-translated
      product of a cDNA clone that confers L6 immunoreactivity demonstrates that the
      antibody recognizes a protein epitope encoded by this transcript which requires
      the presence of membranes, but is unaffected by the removal of carbohydrate side
      chains.

PMID- 1639796
TI  - Function independence of microhelix aminoacylation from anticodon binding in a
      class I tRNA synthetase.
AB  - The monomeric form of the class I Escherichia coli methionine tRNA synthetase has
      a distinct carboxyl-terminal domain with a segment that interacts with the
      anticodon of methionine tRNA. This interaction is a major determinant of the
      specificity and efficiency of aminoacylation. The end of this carboxyl-terminal
      domain interacts with the amino-terminal Rossman fold that forms the site for
      amino acid activation. Thus, the carboxyl-terminal end may have evolved in part
      to integrate anticodon recognition with amino acid activation. We show here that
      internal deletions that disrupt the anticodon interaction have no effect on the
      kinetic parameters for amino acid activation. Moreover, an internally deleted
      enzyme can aminoacylate an RNA microhelix, which is based on the acceptor stem of
      methionine tRNA, with the same efficiency as the native protein. These results
      suggest that, in this enzyme, amino acid activation and acceptor helix
      aminoacylation are functionally integrated and are independent of the anticodon
      binding site.

PMID- 1639795
TI  - Sea urchin collagen evolutionarily homologous to vertebrate pro-alpha 2(I)
      collagen.
AB  - We isolated several overlapping cDNA clones covering the 4242 nucleotides of a
      Strongylocentrotus purpuratus transcript that codes for a fibrillar procollagen
      chain. The sea urchin polypeptide includes a 124-amino acid long amino pre
      propeptide, a 1064-amino acid alpha-chain inclusive of 338 uninterrupted Gly-X-Y
      repeats, and a 226-residue carboxyl-propeptide. The distribution of the highly
      conserved cysteines within the last domain together with the structural
      configuration of the amino-propeptide and the organization of the corresponding
      coding region, strongly suggest that the sea urchin gene is evolutionarily
      related to the vertebrate pro-alpha 2(I) collagen. This work, therefore,
      represents the first report of the complete primary structure of an invertebrate
      fibrillar procollagen chain. It also provides a new insight into the evolution of
      the amino-propeptide, the most divergent among the major protein domains of
      fibrillar procollagen chains.

PMID- 1639797
TI  - Fibrinogen binding to purified platelet glycoprotein IIb-IIIa (integrin alpha IIb
      beta 3) is modulated by lipids.
AB  - Soluble fibrinogen binding to the glycoprotein IIb-IIIa complex (integrin alpha
      IIb beta 3) requires platelet activation. The intracellular mediator(s) that
      convert glycoprotein IIb-IIIa into an active fibrinogen receptor have not been
      identified. Because the lipid composition of the platelet plasma membrane
      undergoes changes during activation, we investigated the effects of lipids on the
      fibrinogen binding properties of purified glycoprotein IIb-IIIa. Anion exchange
      chromatography of lipids extracted from platelets exposed to thrombin or other
      platelet agonists resolved an activity that increased fibrinogen binding to
      glycoprotein IIb-IIIa. A monoester phosphate was important for activity, and
      phosphatidic acid coeluted with the peak of activity. Purified phosphatidic acid
      dose-dependently promoted a specific interaction between glycoprotein IIb-IIIa
      and fibrinogen which possessed many but not all of the properties of fibrinogen
      binding to activated platelets. Phosphatidic acid appeared to increase the
      proportion of fibrinogen binding-competent glycoprotein IIb-IIIa complexes
      without altering their affinity for fibrinogen. The effects of phosphatidic acid
      were a result of specific structural properties of the lipid and were not
      mimicked by other phospholipids. Lysophosphatidic acid, however, was a potent
      inducer of fibrinogen binding to glycoprotein IIb-IIIa. These results demonstrate
      that specific lipids can affect fibrinogen binding to purified glycoprotein IIb
      IIIa and suggest that the lipid environment has the potential to influence
      fibrinogen binding to its receptor.

PMID- 1639798
TI  - Tocopherol analogs suppress arachidonic acid metabolism via phospholipase
      inhibition.
AB  - alpha-Tocopherol and three derivatives in which the phytol chain is modified or
      deleted were examined for their effect on cultured keratinocyte arachidonic acid
      metabolism. 2,2,5,7,8-Pentamethyl-6-hydroxychromane (PMC), in which the phytol
      chain is replaced by a methyl group, inhibited basal, bradykinin (BK)- and A23187
      stimulated prostaglandin E2 (PGE2) synthesis with an apparent Ki of 1.3 microM.
      The Ki of the analogue with six carbon atoms in the side chain (C6) was 5 microM
      while that of the C11 analogue was 10 microM. No effect of alpha-tocopherol was
      observed. The mechanism of inhibition was studied using PMC. The effect of PMC on
      phospholipase and cyclooxygenase activity was assayed using stable isotope mass
      measurements of PGE2 formation, which assesses arachidonate release and
      cyclooxygenase metabolism simultaneously. BK-stimulated formation of PGE2,
      derived from endogenous phospholipid, was decreased 60% by 5 microM PMC and
      eliminated by 50 microM PMC, compared with controls. No difference in PGE2 formed
      from exogenous arachidonic acid was observed, indicating no effect of PMC on
      cyclooxygenase activity. In contrast, no effect of 5 microM PMC was observed on
      BK-stimulated [3H]arachidonic acid release from prelabeled cultures. The capacity
      of PMC to inhibit phospholipase activity in vitro was also assessed. PMC
      inhibited hydrolysis of phospholipid substrate by up to 60%. These results
      suggest that alpha-tocopherol analogues with alterations in the phytol chain
      inhibit eicosanoid synthesis by preferential inhibition of phospholipase.

PMID- 1639799
TI  - Translocation of protein kinase C isozymes in thrombin-stimulated human
      platelets. Correlation with 1,2-diacylglycerol levels.
AB  - Human platelets were found by immunoblot analysis to express protein kinase C
      (PKC) isozymes alpha, beta, delta, and zeta, but not gamma, epsilon, or eta.
      Exposure of platelets to thrombin, in the presence of 1 mM calcium, induced
      increased membrane association of PKC-alpha, -beta, and -zeta, while the
      subcellular distribution of PKC-delta remained unaltered. Maximal membrane
      association (2-fold) of PKC-alpha, -beta, and -zeta occurred within 1 min and was
      sustained for at least 10 min after the addition of thrombin. Similar results
      were obtained in the presence of the RGDS peptide, which blocks thrombin-induced
      binding of fibrinogen to its receptor, which indicates that PKC translocation was
      independent of fibrinogen binding. In the absence of added extracellular calcium,
      thrombin-induced translocation of PKC-alpha, -beta, and -zeta was transient,
      reaching a maximum at 1 min and returning to base line by 10 min. In the presence
      of calcium, thrombin induced a rapid (within 15 s) 8-fold rise in inositol 1,4,5
      trisphosphate, which returned to baseline levels within 1 min, and a biphasic
      increase in sn-1,2-diacylglycerol (DAG), with peaks at 15 s and 2 min, which
      remained elevated for at least 5 min. Chelation of external calcium abolished the
      second phase of DAG formation but had no effect on the kinetics or magnitude of
      the increase in inositol 1,4,5-trisphosphate or the first phase of DAG formation.
      Two early PKC-dependent functions, serotonin release and 40-kDa protein
      phosphorylation, were independent of extracellular calcium and sustained DAG.
      These data demonstrate that in thrombin-stimulated human platelets the duration
      of the increased PKC membrane association closely parallels that of increased DAG
      content, and sustained elevations in DAG content and PKC translocation are
      dependent on extracellular calcium.

PMID- 1639800
TI  - Photoaffinity labeling of T4 endonuclease V with a substrate containing a
      phenyldiazirine derivative.
AB  - T4 endonuclease V recognizes thymine photodimers in DNA duplexes and, in a two
      step reaction, cleaves the glycosyl linkage of the 5'-side thymidine and the
      phosphodiester linkage. To determine the amino acid residues responsible for
      binding thymine photodimers, a photoaffinity reagent, 4-(1-azi-2,2,2
      trifluoroethyl)-benzoate, was linked to the aminoalkylphosphonate of a thymine
      photodimer in a 14-mer duplex. The reactive substrate was treated with the enzyme
      under UV light (365 nm). The nascent enzyme and the modified enzyme were treated
      with lysyl endopeptidase, and the peptide maps were compared. Three peptides from
      the C terminus were found to interact with the reactive oligonucleotide to
      various extents. The three modified peptides were isolated and analyzed by Edman
      degradation. The amino acid residues Gly-133, Tyr-129, and Thr-89 were partially
      linked with the reactive substrate and may be involved in the binding of thymine
      photodimers.

PMID- 1639801
TI  - V(D)J recombination on minichromosomes is not affected by transcription.
AB  - It has been shown previously by others that transcription is temporally
      correlated with the onset of V(D)J recombination at the endogenous antigen
      receptor loci. We have been interested in determining whether this temporal
      correlation indicates a causal connection between these two processes. We have
      compared V(D)J recombination minichromosome substrates that have transcripts
      running through the recombination zone with substrates that do not in a transient
      transfection assay. In this system, the substrates acquire a minichromosome
      conformation within the first several hours after transfection. We find that the
      substrates recombine equally well over a 100-fold range in transcriptional
      variation. In additional studies, we have taken substrates that have low levels
      of transcription and inhibited transcription further by methylating the substrate
      DNA or by treating the cells with a general transcription inhibitor (alpha
      amanitin). Although these treatments decrease the level of expression an
      additional 10-100-fold, there is still no observable effect on V(D)J
      recombination. Based on these results, we conclude that transcription is not
      necessary for the V(D)J reaction mechanism and does not alter substrate structure
      at the DNA level or at the simplest levels of chromatin structure in a way that
      affects the reaction.

PMID- 1639802
TI  - Characterization of the charged components and their topology on the surface of
      plant seed oil bodies.
AB  - Oil bodies of plant seeds contain a triacylglycerol matrix surrounded by a
      monolayer of phospholipids embedded with alkaline proteins called oleosins. Oil
      bodies isolated from maize (Zea mays L.) in a medium of pH 7.2 maintained their
      entities but aggregated when the pH was lowered to 6.8 and 6.2. Aggregation did
      not lead to coalescence and was reversible with an elevation of the pH. Further
      decrease of the pH from 6.2 to 5.0 retarded the aggregation. Aggregation at pH
      7.2 was induced with 2 mM CaCl2 or MgCl2 but not with NaCl. Aggregation at pH 6.8
      was prevented by 10 microM sodium dodecyl sulfate but not with NaCl. We conclude
      that oil bodies have a negatively charged surface at pH 7.2 and an isoelectric
      point of about 6.0. This conclusion is supported by isoelectrofocusing results
      and by theoretical calculation of the positive charges in the oleosins and the
      negative charges in phosphatidylserine, phosphatidylinositol, and free fatty
      acids. Apparently, lowering of the pH from 7.2 to 6.2 protonates the histidine
      residues in the oleosins, and neutralizes the oil bodies. Further decrease of the
      pH to 5.0 likely protonates the free fatty acids and produces positively charged
      organelles. Similar charge properties were observed in the oil bodies isolated
      from rape, flax, and sesame seeds. An analysis of the oleosin secondary
      structures reveals an N-terminal amphipathic domain, a central hydrophobic anti
      parallel beta-strand domain (not found in any other known protein), and a C
      terminal amphipathic alpha-helical domain. In the two amphipathic domains, the
      positively charged residues are orientated toward the interior facing the
      negative charged lipids, whereas the negatively charged residues are exposed to
      the exterior. The negatively charged surface is a major factor in maintaining the
      oil bodies as stable individual entities.

PMID- 1639803
TI  - Subunit structure of cell-specific E box-binding proteins analyzed by
      quantitation of electrophoretic mobility shift.
AB  - Expression of insulin and immunoglobulin genes is dependent on the presence of E
      boxes (consensus sequence CAXXTG) within the enhancer regions. These sequences
      are recognized by cell-specific nuclear factors IEF1 (insulin enhancer factor 1)
      and LEF1 (lymphoid enhancer factor 1). Although IEF1 and LEF1 are distinct by
      several parameters, they are both recognized by antisera to the mouse helix-loop
      helix (HLH) protein A1 (a homolog of the human protein E47, product of the E2A
      gene). This suggests that A1/E47 or a close relative is a component of both
      complexes. In order to further characterize the complexes, we have used in vitro
      translated DNA-binding proteins of known size to verify that electrophoretic
      mobility shift analysis can be used to estimate the molecular weight of DNA
      binding proteins from both the HLH family and the leucine zipper family. Under
      the conditions used, migration is relatively insensitive to changes in protein
      charge. This analysis, in combination with mixing experiments between nuclear
      extracts and in vitro translated HLH proteins, indicates that IEF1 and LEF1 are
      dimeric complexes. IEF1 behaves as a complex of two proteins, one of which is 67
      kDa and is recognized by antibodies to A1, and the second of which is 25 kDa.
      LEF1 on the other hand, appears to be a complex of two proteins of 67 kDa. The
      size of the 67-kDa subunits is consistent with that reported for the full-length
      E2A gene products. The 25-kDa subunit of IEF1 forms DNA-binding heterodimers with
      A1 but not MyoD and is present in a limited range of cell types, features
      characteristic of class B HLH proteins such as MyoD and achaete-scute. Taken
      together, the data support the idea that the E2A gene products are involved
      directly in regulation of insulin and immunoglobulin gene expression; regulation
      of the insulin gene apparently requires, in addition, the 25-kDa HLH protein
      (designated IESF1 for insulin enhancer-specific factor 1).

PMID- 1639804
TI  - Oleate-mediated stimulation of apolipoprotein B secretion from rat hepatoma
      cells. A function of the ability of apolipoprotein B to direct lipoprotein
      assembly and escape presecretory degradation.
AB  - Physiological concentrations of oleate stimulate apolipoprotein (apo) B
      containing lipoprotein secretion from HepG2 cells without increasing apoB mRNA
      levels. The purpose of this study was to determine whether oleate acts by
      increasing translation of apoB mRNA or through posttranslational effects on the
      apoB protein. To address the mechanism of oleate-stimulated secretion of apoB, a
      series of carboxyl terminally truncated apoB constructs was made. Each contained
      the SV40 early promoter, the apoB 5'-untranslated region, and SV40
      polyadenylation signals. Any difference in the response to oleate between
      endogenous apoB and the proteins encoded by the constructs or between the
      constructs themselves should thus depend on the protein sequence. Stable
      transformants were established for each of the constructs in the rat hepatoma
      cell line McArdle-RH7777. The effect of oleate on secretion of the apoB protein
      products was determined by labeling with [35S]methionine, immunoprecipitation,
      and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Carboxyl-terminal
      truncation of apoB41 resulted in a loss of the ability of apoB secretion to
      respond to oleate. Ultracentrifugation of secreted proteins on continuous CsCl
      gradients from 1.0-1.4 g/ml revealed that this correlated with a decrease in the
      ability of apoB to be recovered as a buoyant lipoprotein particle. Addition of
      oleate decreased the densities at which the short forms of apoB secreted as
      lipoproteins were recovered. Pulse-chase analysis of the secretion of apoB100 and
      of the truncated proteins revealed that they all underwent rapid
      posttranslational intracellular degradation. We conclude that oleate has no
      effect on the translation of apoB mRNA but promotes the secretion of apoB
      containing lipoproteins by reducing presecretory degradation of those forms of
      apoB that can produce buoyant lipoproteins.

PMID- 1639805
TI  - Identification of mitochondrial branched chain aminotransferase and its isoforms
      in rat tissues.
AB  - The tissue distribution and subcellular location of branched chain
      aminotransferase was analyzed using polyclonal antibodies against the enzyme
      purified from rat heart mitochondria (BCATm). Immunoreactive proteins were
      visualized by immunoblotting. The antiserum recognized a 41-kDa protein in the
      100,000 x g supernatant from a rat heart mitochondrial sonicate. The 41-kDa
      protein was always present in mitochondria which contained branched chain
      aminotransferase activity, skeletal muscle, kidney, stomach, and brain, but not
      in cytosolic fractions. In liver mitochondria, which have very low levels of
      branched chain aminotransferase activity, the 41-kDa protein was not present.
      However, two immunoreactive proteins of slightly higher molecular masses were
      identified. These proteins were located in hepatocytes. The 41-kDa protein was
      present in fetal liver mitochondria but not in liver mitochondria from 5-day
      neonates. Thus disappearance of the 41-kDa protein coincided with the
      developmental decline in liver branched chain aminotransferase activity. Two
      dimensional immunoblots of isolated BCATm immunocomplexes showed that the liver
      immunoreactive proteins were clearly different from the heart and kidney proteins
      which exhibited identical immunoblots. Investigation of BCATm in subcellular
      fractions prepared from different skeletal muscle fiber types revealed that
      branched chain aminotransferase is exclusively a mitochondrial enzyme in skeletal
      muscles. Although total detergent-extractable branched chain aminotransferase
      activity was largely independent of fiber type, branched chain aminotransferase
      activity and BCATm protein concentration were highest in mitochondria prepared
      from white gastrocnemius followed by mixed skeletal muscles with lowest activity
      and protein concentration found in soleus mitochondria. These quantitative
      differences in mitochondrial branched chain aminotransferase activity and enzyme
      protein content suggest there may be differential expression of BCATm in
      different muscle fiber types.

PMID- 1639806
TI  - Histamine N-methyltransferase from rat kidney. Cloning, nucleotide sequence, and
      expression in Escherichia coli cells.
AB  - Complementary DNA clones encoding rat kidney histamine N-methyltransferase have
      been isolated using synthetic oligonucleotide probes based on partial amino acid
      sequences of tryptic peptides of the purified enzyme. The 1.3-kilobase cDNA
      consisted of a 5'-noncoding region of 8 nucleotides, a coding region of 885
      nucleotides, and a 3'-noncoding region of 369 nucleotides. The encoded protein of
      295 amino acid residues had a calculated molecular weight of 33,940.2. After
      introduction of a prokaryotic expression vector containing the isolated cDNA,
      Escherichia coli cells expressed histamine N-methyltransferase activity. The
      enzyme expressed in these cells was isolated and purified as a single band on
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis, whose mobility was
      identical to the natural enzyme purified from rat kidney. The recombinant enzyme
      had Vmax and Km values for both histamine and S-adenosylmethionine identical to
      those of the natural enzyme. All of the inhibitors of the natural enzyme tested
      showed similar Ki values on both recombinant and natural enzyme.

PMID- 1639807
TI  - Biologically important interactions between synthetic peptides of the N-terminal
      region of troponin I and troponin C.
AB  - The interaction between troponin I and troponin C plays a critical role in the
      regulation of muscle contraction. In this study the interaction between troponin
      C (TnC) and the N-terminal region of TnI was investigated by the synthesis of
      three TnI peptides (residues 1-40/Rp, 10-40, and 20-40). The regulatory peptide
      (Rp) on binding to TnC prevents the ability of TnC to release the inhibition of
      the acto-S1-tropomyosin ATPase activity caused by TnI or the TnI inhibitory
      peptide (Ip), residues 104-115. A stable complex between TnC and Rp in the
      presence of Ca2+ was demonstrated by polyacrylamide gel electrophoresis in the
      presence of 6 M urea. Rp was able to displace TnI from a preformed TnI.TnC
      complex. In the absence of Ca2+, Rp was unable to maintain a complex with TnC in
      benign conditions of polyacrylamide gel electrophoresis which demonstrates the
      Ca(2+)-dependent nature of this interaction. Size-exclusion chromatography
      demonstrated that the TnC.Rp complex consisted of a 1:1 complex. The results of
      these studies have shown that the N-terminal region of TnI (1-40) plays a
      critical role in modulating the Ca(2+)-sensitive release of TnI inhibition by
      TnC.

PMID- 1639808
TI  - Microtubule-associated protein tau is phosphorylated by protein kinase C on its
      tubulin binding domain.
AB  - We have analyzed the in vitro phosphorylation of tau protein by Ca2+/calmodulin
      dependent protein kinase, casein kinase II, and proline-directed serine/threonine
      protein kinase. These kinases phosphorylate tau protein in sites localized in
      different regions of the molecule, as determined by peptide mapping analyses.
      Focusing on the phosphorylation of tau by protein kinase C, it was calculated as
      an incorporation of 4 mol of phosphate/mol of tau. Limited proteolysis assays
      suggest that the phosphorylation sites could be located within the tubulin
      binding domain. Direct phosphorylation of synthetic peptides corresponding to the
      cysteine-containing tubulin-binding region present in both fetal and adult tau
      isoforms demonstrates that serine 313 is modified by protein kinase C.
      Phosphorylation of the synthetic peptide by protein kinase C diminishes its
      binding to tubulin, as compared with the unphosphorylated peptide.

PMID- 1639809
TI  - Regulated expression of syndecan in vascular smooth muscle cells and cloning of
      rat syndecan core protein cDNA.
AB  - cDNA encoding the core protein of rat syndecan was cloned from a neonatal rat
      aortic cDNA library by polymerase chain reaction amplification. Expression of
      syndecan mRNA in rat aortic vascular smooth muscle (VSM) cells was demonstrated
      by reverse transcriptase-linked polymerase chain reaction amplification of
      syndecan sequences using total RNA from rat aortic VSM cells as templates.
      Polyclonal antibodies against rat syndecan core protein were produced by
      immunizing rabbits with a recombinant fusion protein containing a fragment of the
      extracellular domain. The anti-syndecan antibodies immunoprecipitated a large
      35SO4-labeled molecule synthesized by cultured rat aortic VSM cells. The
      immunoprecipitated molecule was identified as a hybrid proteoglycan, based on
      results of alkaline, nitrous acid, and chondroitinase ABC digestions. On
      immunoblots the antibodies recognized a proteoglycan of greater than 200 kDa,
      with a core protein size after deglycosylation of approximately 50 kDa. The anti
      syndecan antibodies stained cultured rat aortic VSM cells as well as tissue
      sections of neonatal and adult rat aortas in the medial, smooth muscle layer. On
      Northern blots of RNA isolated from cultured VSM cells, a syndecan cDNA probe
      hybridized to a major RNA species of 2.6 kilobases. Quantitative Northern blot
      analysis of total RNA isolated from VSM cells harvested at different cell
      densities revealed a decrease in syndecan mRNA levels with increased cell
      density. These results demonstrate the regulated synthesis of syndecan by rat VSM
      cells.

PMID- 1639810
TI  - The bimB3 mutation of Aspergillus nidulans uncouples DNA replication from the
      completion of mitosis.
AB  - A conditionally lethal mutation in the bimB gene of Aspergillus nidulans disrupts
      the normal regulatory patterns associated with mitotic events. This results in
      DNA replication in the absence of the completion of mitosis in the mutant at
      restrictive temperature. This defect yields large polyploid nuclei after several
      hours at restrictive temperature. The bimB gene has been cloned by genetic
      mapping and chromosome walking from the previously cloned amdS gene. The cloned
      DNA complements the temperature-sensitive recessive bimB3 mutation. Sequence
      analysis of overlapping complementary DNA clones for bimB predicts a polypeptide
      of 2,068 amino acids. The predicted polypeptide of 227,958 Da is shown to have a
      carboxyl-terminal region similar to those of the budding yeast ESP1 and fission
      yeast cut1+ genes. In contrast these genes exhibit no other regions of similarity
      to one another. The conserved domain in these three proteins and the similarity
      of the terminal mutant phenotypes for these genes are suggestive of a conserved
      function for this domain in each of the predicted polypeptides. We also present
      evidence for a second gene in the genome of A. nidulans which also has this
      conserved carboxyl-terminal region, suggesting that bimB, ESP1, and cut1+ may be
      members of a small gene family.

PMID- 1639811
TI  - Hormone- and substrate-regulated intracellular degradation of cytochrome P450
      (2E1) involving MgATP-activated rapid proteolysis in the endoplasmic reticulum
      membranes.
AB  - We have examined differences in post-translational regulation between rat liver
      ethanol-inducible cytochrome P450 2E1 (CYP2E1) and phenobarbital-inducible CYP2B1
      using hepatocyte cultures and subcellular fractions, prepared from starved and
      acetone-treated rats. The intracellular degradation of CYP2E1 was rapid
      (approximate t1/2 = 9 h) and increased by glucagon treatment of the cells in an
      isozyme-specific manner, whereas CYP2B1 degradation in the same cells, was slower
      (t1/2 = 21 h). The glucagon effect on CYP2E1 degradation was abolished by either
      cycloheximide treatment of cells, indicating the involvement of protein
      components with rapid turnover, or by lowering of the culture temperature to 23
      degrees C. The rapid phase of CYP2E1 degradation was not influenced by inhibitors
      of the autophagosomal/lysosomal pathway. In vitro experiments with isolated liver
      microsomes revealed the presence of a Mg(2+)-ATP-activated proteolytic system
      active on CYP2E1, previously modified by phosphorylation on Ser-129 or denatured
      by reactive metabolites formed from carbon tetrachloride. Imidazole, a CYP2E1
      substrate, specifically inhibited the rapid intracellular degradation of CYP2E1
      and also prevented phosphorylation and subsequent proteolysis in isolated
      microsomes. In contrast, no proteolysis of CYP2B1 occurred under the conditions
      used. The microsomal Mg(2+)-ATP-dependent CYP2E1 proteolysis could not be
      solubilized with high salt and 0.05% sodium cholate, indicating the action of
      membrane-integrated protease(s). Subfractionation of microsomes revealed that the
      Mg(2+)-ATP-dependent proteolytic system active on CYP2E1 was present in both
      rough and smooth endoplasmic reticulum. It is suggested that hepatic cytochromes
      P450 are degraded both in a bulk process, according to the
      autophagosomal/lysosomal pathway and more rapidly, in a hormone- and substrate
      regulated fashion, by a specific proteolytic system in the endoplasmic reticulum,
      active on physiologically or exogenously modified molecules.

PMID- 1639812
TI  - Agonist-induced changes in the structure of the acetylcholine receptor M2 regions
      revealed by photoincorporation of an uncharged nicotinic noncompetitive
      antagonist.
AB  - To characterize structural changes induced in the nicotinic acetylcholine
      receptor (AChR) by agonists, we have mapped the sites of photoincorporation of
      the cholinergic noncompetitive antagonist 3-(trifluoromethyl)-3-(m
      [125I]iodophenyl)diazirine (]125I]TID) in the presence and absence of 50 microM
      carbamylcholine. [125I]TID binds to the AChR with similar affinity under both
      these conditions, but agonist inhibits photoincorporation into all subunits by
      greater than 75% (White, B. H., Howard, S., Cohen, S. G., and Cohen, J. B. (1991)
      J. Biol. Chem. 266, 21595-21607). [125I]TID-labeled sites on the beta- and delta
      subunits were identified by amino-terminal sequencing of both cyanogen bromide
      (CNBr) and tryptic fragments purified by Tricine sodium dodecyl sulfate
      polyacrylamide gel electrophoresis followed by reversed-phase high-performance
      liquid chromatography. In the absence of agonist, [125I]TID specifically labels
      homologous aliphatic residues (beta L-257, delta L-265, beta V-261, and delta V
      269) in the M2 region of both subunits. In the presence of agonist, labeling of
      these residues is reduced approximately 90%, and the distribution of labeled
      residues is broadened to include a homologous set of serine residues at the amino
      terminus of M2. In the beta-subunit residues beta S-250, beta S-254, beta L-257,
      and beta V-261 are all labeled in the presence of carbamylcholine. This pattern
      of labeling supports an alpha-helical model for M2 with the labeled face forming
      the ion channel lumen. The observed redistribution of label in the resting and
      desensitized states provides the first direct evidence for an agonist-dependent
      rearrangement of the M2 helices. The efficient labeling of the resting state
      channel in a region capable of structural change also suggests a plausible model
      for AChR gating in which the aliphatic residues labeled by [125I]TID form a
      permeability barrier to the passage of ions. We also report increased labeling of
      the M1 region of the delta-subunit in the presence of agonist.

PMID- 1639813
TI  - In vitro specificity of EcoRI DNA methyltransferase.
AB  - The sequence selectivity of enzyme-DNA interactions was analyzed by comparing
      discrimination between synthetic oligonucleotides containing the canonical site
      GAATTC and altered DNA sequences with the EcoRI DNA methyltransferase. The
      specificities (kcat/KmDNA) are decreased from 5- to 23,000-fold relative to the
      unmodified site. For several substrates the decrease in kcat makes a
      disproportionate contribution to the specificity difference, suggesting that
      discrimination is mediated by the placement of critical catalytic residues rather
      than binding interactions. This is supported by our observation that specificity
      changes are generally not followed by changes in the stability of the
      methyltransferase-DNA complexes. Also, base pair substitutions near the site of
      methylation result in greater decreases in complex stability, suggesting that
      recognition and catalytic mechanisms overlap.

PMID- 1639814
TI  - Purification and characterization of indolepyruvate decarboxylase. A novel enzyme
      for indole-3-acetic acid biosynthesis in Enterobacter cloacae.
AB  - Indolepyruvate decarboxylase, a key enzyme for indole-3-acetic acid biosynthesis,
      was found in extracts of Enterobacter cloacae. The enzyme catalyzes the
      decarboxylation of indole-3-pyruvic acid to yield indole-3-acetaldehyde and
      carbon dioxide. The enzyme was purified to apparent homogeneity from Escherichia
      coli cells harboring the genetic locus for this enzyme obtained from E. cloacae.
      The results of gel filtration experiments showed that indolepyruvate
      decarboxylase is a tetramer with an M(r) of 240,000. In the absence of thiamine
      pyrophosphate and Mg2+, the active tetramers dissociate into inactive monomers
      and dimers. However, the addition of thiamine pyrophosphate and Mg2+ to the
      inactive monomers and dimers results in the formation of active tetramers. These
      results indicate that the thiamine pyrophosphate-Mg2+ complex functions in the
      formation of the tetramer, which is the enzymatically active holoenzyme. The
      enzyme exhibited decarboxylase activity with indole-3-pyruvic acid and pyruvic
      acid as substrates, but no decarboxylase activity was apparent with L-tryptophan,
      indole-3-lactic acid, beta-phenylpyruvic acid, oxalic acid, oxaloacetic acid, and
      acetoacetic acid. The Km values for indole-3-pyruvic acid and pyruvic acid were
      15 microM and 2.5 mM, respectively. These results indicate that indole-3-acetic
      acid biosynthesis in E. cloacae is mediated by indolepyruvate decarboxylase,
      which has a high specificity and affinity for indole-3-pyruvic acid.

PMID- 1639815
TI  - Transcriptional regulation of human apolipoprotein genes ApoB, ApoCIII, and
      ApoAII by members of the steroid hormone receptor superfamily HNF-4, ARP-1, EAR
      2, and EAR-3.
AB  - Apolipoproteins B, CIII, and AII are synthesized primarily in the liver and
      intestine and play an important role in lipid and cholesterol metabolism. It was
      previously shown that the cis-acting elements (BA1 (-79 to -63), CIIIB (-87 to 
      63), and AIIJ (-740 to -719) present in the regulatory regions of the human apoB,
      apoCIII, and apoAII genes, respectively, are recognized by common transcription
      factors present in hepatic nuclear extracts. This report shows that four members
      of the steroid receptor superfamily, ARP-1, EAR-2, EAR-3, and HNF-4, bind
      specifically to the regulatory elements BA1, CIIIB, and AIIJ. Dissociation
      constant measurements showed that ARP-1, EAR-2, and HNF-4 bind to elements BA1
      and CIIIB with similar affinities (Kd 1-3 nM). Cotransfection experiments in
      HepG2 cells revealed that ARP-1, EAR-2, and EAR-3 repressed the BA1, CIIIB, and
      AIIJ element-dependent transcription of the reporter gene constructs and the
      transcription driven by homopolymeric promoters containing either five BA1 or two
      CIIIB elements. In contrast, HNF-4 activated transcription of reporter genes
      containing the elements BA1, CIIIB, and AIIJ and reversed the ARP-1-mediated
      repression of the apoB and apoCIII genes. These results suggested that the
      opposing transcription effects observed between HNF-4 and ARP-1 may be due to
      competition for binding to the same regulatory element. Mutations which affected
      the binding of HNF-4 to elements BA1 and CIIIB affected its ability to activate
      transcription of the apoB and apoCIII reporter genes, respectively.
      Transcriptional activation by HNF-4 depended on the presence of elements II (-112
      to -94) and III (-86 to -62) of the apoB and H (-705 to -690), I (-766 to -726),
      and J (-792 to -779) of the apoCIII promoters, indicating that transcriptional
      activation of apoB and apoCIII genes by HNF-4 requires the synergistic
      interaction of factors binding to these elements. The finding that HNF-4, ARP-1,
      EAR-2 and EAR-3 can regulate the expression of the apoB, apoCIII, and apoAII
      genes suggest that these nuclear hormone receptors may be an important part of
      the signal transduction pathways modulating lipid metabolism and cholesterol
      homeostasis.

PMID- 1639816
TI  - Specificity of phosphatidylserine-containing membrane binding sites for factor
      VIII. Studies with model membranes supported by glass microspheres (lipospheres).
AB  - Factor VIII functions in an enzyme complex upon the activated platelet membrane
      where phosphatidylserine exposure correlates with expression of receptors for
      factor VIII. To evaluate the specificity of phosphatidylserine-containing
      membrane binding sites for factor VIII, we have developed a novel membrane model
      in which phospholipid bilayers are supported by glass microspheres (lipospheres).
      The binding of fluorescein-labeled factor VIII to lipospheres with membranes of
      15% phosphatidylserine was equivalent to binding to phospholipid vesicles (KD =
      4.8 nM). Purified von Willebrand factor (vWf), a carrier protein for factor VIII,
      decreased membrane binding of factor VIII with a Ki of 10 micrograms/ml.
      Likewise, normal plasma decreased bound factor VIII by more than 90% whereas
      plasma lacking vWf decreased the binding of factor VIII by only 20%. Proteolytic
      activation of factor VIII by thrombin, which releases factor VIII from vWf,
      increased liposphere binding in the presence of vWf and in the presence of normal
      plasma. Although factor V is homologous to factor VIII and binds to lipospheres
      with the same affinity, purified factor V was not an efficient competitor for the
      membrane binding sites of factor VIII. These results indicate that
      phosphatidylserine-containing membrane sites have sufficient specificity to
      select thrombin-activated factor VIII from the range of phospholipid-binding
      proteins in plasma.

PMID- 1639817
TI  - A family of bacterial regulators homologous to Gal and Lac repressors.
AB  - We describe a family of proteins which regulate transcription of inducible genes
      in bacteria (GalR-LacI family). An alignment of the proteins in the GalR-LacI
      family is presented in which these proteins show a very high degree of similarity
      (60%) throughout the entire sequences. The homology is greatest among the amino
      terminal DNA binding domains. Since a portion of the operator sequences occupied
      by these proteins is also conserved, a similar DNA structure may be required for
      specific recognition of DNA by members of the GalR-LacI family. Highly conserved
      motifs involved in effector binding and oligomerization are also identified. This
      compilation suggests a widespread conservation of these regulators among
      bacteria, and have strong implications for further study of peptide motifs in
      domain function, as well as pathways of protein evolution.

PMID- 1639818
TI  - Inhibition of the relative movement of actin and myosin by caldesmon and
      calponin.
AB  - Contractile activity of myosin II in smooth muscle and non-muscle cells requires
      phosphorylation of myosin by myosin light chain kinase. In addition, these cells
      have the potential for regulation at the thin filament level by caldesmon and
      calponin, both of which bind calmodulin. We have investigated this regulation
      using in vitro motility assays. Caldesmon completely inhibited the movement of
      actin filaments by either phosphorylated smooth muscle myosin or rabbit skeletal
      muscle heavy meromyosin. The amount of caldesmon required for inhibition was
      decreased when tropomyosin is present. Similarly, calponin binding to actin
      resulted in inhibition of actin filament movement by both smooth muscle myosin
      and skeletal muscle heavy meromyosin. Tropomyosin had no effect on the amount of
      calponin needed for inhibition. High concentrations of calmodulin (10 microM) in
      the presence of calcium completely reversed the inhibition. The nature of the
      inhibition by the two proteins was markedly different. Increasing caldesmon
      concentrations resulted in graded inhibition of the movement of actin filaments
      until complete inhibition of movement was obtained. Calponin inhibited actin
      sliding in a more "all or none" fashion. As the calponin concentration was
      increased the number of actin filaments moving was markedly decreased, but the
      velocity of movement remained near control values.

PMID- 1639820
TI  - Conjugation of soluble CD4 without loss of biological activity via a novel
      carbohydrate-directed cross-linking reagent.
AB  - Chemical conjugates of recombinant soluble CD4 (sCD4) with toxins, or with
      antibodies that activate cytotoxic T cells, can be used to direct selective
      killing of human immunodeficiency virus (HIV)-infected cells. This approach takes
      advantage of the ability of sCD4 to bind with high affinity to gp120, the
      envelope protein of HIV-1, which is expressed on actively infected cells.
      However, conjugation of sCD4 via reagents that target amino groups may reduce its
      affinity for gp120, since at least one such group is important for gp120 binding.
      Here, we describe a novel cross-linking reagent which enables the conjugation of
      sCD4 via its carbohydrate moieties rather than its free amino groups. This
      heterobifunctional reagent, 4-(4-N-maleimidophenyl)butyric acid hydrazide (MPBH),
      combines a nucleophilic hydrazide with an electrophilic maleimide, thereby
      allowing coupling of carbohydrate-derived aldehydes to free thiols. We describe
      conditions by which MPBH is coupled selectively to the sialic acid residues of
      sCD4, and exemplify the use of MPBH by conjugating sCD4 to hemoglobin and to beta
      galactosidase. We show that, whereas conjugation of sCD4 via amino groups
      markedly reduces its gp120 binding affinity, conjugation via the carbohydrate
      chains using MPBH does not affect binding. Moreover, we demonstrate the ability
      of a sCD4-MPBH-fluorescein conjugate to label HIV-infected human CEM cells
      selectively. These results indicate that, by targeting its carbohydrate moieties,
      sCD4 can be cross-linked to other molecules without compromising its function.
      The approach described here can be useful for glycoproteins in which amino
      groups, but not carbohydrates, are important for function. More generally, this
      approach can be considered for use in cross-linking glycoconjugates to compounds
      which either contain thiols, or to which thiols can be added.

PMID- 1639819
TI  - Deficiencies in sex-regulated expression and levels of two hepatic sterol carrier
      proteins in a murine model of Niemann-Pick type C disease.
AB  - Hepatic sterol carrier protein-2 (SCP2) and sterol carrier protein-X (SCPx)
      levels in normal and in mutant Niemann-Pick Type C mice were determined by
      immunoblotting with antiserum against rat SCP2. A 14-kDa protein (SCP2) was
      detected in the cytosol fraction and a 58-kDa protein (SCPx) was found in both
      cytosolic and organellar fractions. Expression of hepatic SCPx protein was
      developmentally regulated in a sex-specific pattern. The amounts of organelle
      associated SCPx increased 4-fold during sexual development of normal males but
      decreased dramatically during development of normal females. Levels of hepatic
      SCP2 increased much less dramatically during sexual maturation of normal males
      and females. Adult Niemann-Pick Type C mice were deficient in both hepatic SCPx
      and SCP2. The deficit in SCPx in affected males reflected a failure to increase
      hepatic SCPx levels during sexual maturation. In affected males SCPx remained at
      levels found in immature mice. Affected male and female mice were also unable to
      maintain levels of hepatic SCP2. The level of SCP2 was near normal in affected
      immature males and subnormal in affected immature females. During sexual
      maturation hepatic SCP2 declined in affected animals.

PMID- 1639821
TI  - In vivo expression and stoichiometric sulfation of the artificial protein
      sulfophilin, a polymer of tyrosine sulfation sites.
AB  - To gain insight into the structural requirements for tyrosine sulfation in vivo,
      we have constructed and expressed an artificial gene encoding a polypeptide
      substrate for tyrosylprotein sulfotransferase. This gene codes for a protein,
      referred to as sulfophilin, which consists of a 12-times repeated heptapeptide
      unit corresponding to the identified tyrosine sulfation site of chromogranin B
      (secretogranin I), Glu-Glu-Pro-Glu-Tyr-Gly-Glu. The gene was fused to the signal
      sequence of secretogranin II to direct the sulfophilin protein to the secretory
      pathway. Stable expression of the artificial gene in NIH 3T3 cells resulted in
      the secretion of sulfated sulfophilin. Analysis of the stoichiometry of sulfation
      revealed that each of the 12 tyrosyl residues in sulfophilin was sulfated.
      Remarkably, up to 50% of the total protein-bound tyrosine sulfate secreted by the
      cells was contained in sulfophilin. The results indicate that the structural
      information contained in the heptapeptide motif is sufficient for stoichiometric
      tyrosine sulfation to occur in the living cell.

PMID- 1639822
TI  - Mapping of the functional domains in the amino-terminal region of calponin.
AB  - Three chymotryptic fragments accounting for almost the entire amino acid sequence
      of gizzard calponin (Takahashi, K., and Nadal-Ginard, B. (1991) J. Biol. Chem.
      266, 13284-13288) were isolated and characterized. They encompass the segments of
      residues 7-144 (NH2-terminal 13-kDa peptide), 7-182 (NH2-terminal 22-kDa
      peptide), and 183-292 (COOH-terminal 13-kDa peptide). They arise from the
      sequential hydrolysis of the peptide bonds at Tyr182-Gly183 and Tyr144-Ala145
      which were protected by the binding of F-actin to calponin. Only the NH2-terminal
      13- and 22-kDa fragments were retained by immobilized Ca(2+)-calmodulin, but only
      the larger 22 kDa entity cosedimented with F-actin and inhibited, in the absence
      of Ca(2+)-calmodulin, the skeletal actomyosin subfragment-1 ATPase activity as
      the intact calponin. Since the latter peptide differs from the NH2-terminal 13
      kDa fragment by a COOH-terminal 38-residue extension, this difference segment
      appears to contain the actin-binding domain of calponin. Zero-length cross-linked
      complexes of F-actin and either calponin or its 22-kDa peptide were produced. The
      total CNBr digest of the F-actin-calponin conjugate was fractionated over
      immobilized calmodulin. The EGTA-eluted pair of cross-linked actin-calponin
      peptides was composed of the COOH-terminal actin segment of residues 326-355
      joined to the NH2-terminal calponin region of residues 52-168 which seems to
      contain the major determinants for F-actin and Ca(2+)-calmodulin binding.

PMID- 1639823
TI  - The soybean vegetative storage proteins VSP alpha and VSP beta are acid
      phosphatases active on polyphosphates.
AB  - The soybean vegetative storage protein genes (vspA, and vspB) are regulated in a
      complex manner developmentally and in response to external stimuli such as
      wounding and water deficit. The proteins accumulate to almost one-half the amount
      of soluble leaf protein when soybean plants are continually depodded and have
      been identified as storage proteins because of their abundance and pattern of
      expression in plant tissues. We have shown that purified VSP homodimers (VSP
      alpha and VSP beta) and heterodimers (VSP alpha/beta) possess acid phosphatase
      activity (alpha = 0.3-0.4 units/mg; beta = 2-4 units/mg; alpha/beta = 7-10
      units/mg). Specific activities were determined by monitoring o-carboxyphenyl
      phosphate (0.7 mM) cleavage at pH 5.5 (VSP alpha) or pH 5.0 (VSP alpha/beta and
      VSP beta) in 0.15 M sodium acetate buffer at 25 degrees C. These enzymes are
      active over a broad pH range, maintaining greater than 40% of maximal activity
      from pH 4.0 to 6.5 and having maximal activity at pH 5.0-5.5. They are
      inactivated by sodium fluoride, sodium molybdate, and heating at 70 degrees C for
      10 min. These phosphatases can liberate Pi from several different substrates,
      including napthyl acid phosphate, carboxyphenyl phosphate, sugar-phosphates,
      glyceraldehyde 3-phosphate, dihydroxyacetone phosphate, phosphoenolpyruvate, ATP,
      ADP, PPi, and short chain polyphosphates. VSP alpha/beta cleaved
      phosphoenolpyruvate, ATP, ADP, PPi, and polyphosphates most efficiently. Apparent
      Km and Vmax values at 25 degrees C and pH 5.0 were 42 microM and 2.0
      mumol/min/mg, 150 microM and 4.2 mumol/min/mg, and 420 microM and 4.1
      mumol/min/mg, for tetrapolyphosphate, pyrophosphate, and phosphoenolpyruvate,
      respectively.

PMID- 1639824
TI  - Rat procathepsin B. Proteolytic processing to the mature form in vitro.
AB  - Expression of rat procathepsin B in yeast led to the secretion of both the latent
      and mature forms of the enzyme. Culture in the presence of a cysteine proteinase
      inhibitor prevented this processing. We have expressed and purified a mutant form
      of rat procathepsin B whose active-site cysteine residue has been changed to a
      serine, and which also lacks the glycosylation site in the mature region of the
      protein. This non-active mutant protein was secreted essentially in an
      unprocessed form. The purified protein has been incubated with a variety of
      proteinases, and results indicate that cathepsins D and L, as well as mature
      cathepsin B itself, can produce a processed (single-chain) form of cathepsin B
      from this precursor. Amino-terminal sequencing of these processed forms has
      revealed that they are all elongated by a few residues with respect to the mature
      form found in vivo. The action of a combination of cathepsin B with
      dipeptidylpeptidase I produced a single-chain form of cathepsin B with the
      correct amino terminus. This work has also shown that the processing of
      procathepsin B to a single-chain form can be an autocatalytic process, in at
      least an intermolecular manner.

PMID- 1639825
TI  - Expression of TTK, a novel human protein kinase, is associated with cell
      proliferation.
AB  - We have isolated the full-length sequence for a unique human kinase, designated
      TTK. TTK was initially identified by screening of a T cell expression library
      with anti-phosphotyrosine antibodies. The kinases most closely related to TTK are
      the SPK1 serine, threonine and tyrosine kinase, the Pim1, PBS2, and CDC2
      serine/threonine kinases, and the TIK kinase which was also identified through
      screening of an expression library with anti-phosphotyrosine antibodies. However,
      the relationships are distant with less than 25% identity. Nevertheless, TTK is
      highly conserved throughout phylogeny with hybridizing sequences being detected
      in mammals, fish, and yeast. TTK mRNA is present at relatively high levels in
      testis and thymus, tissues which contain a large number of proliferating cells,
      but is not detected in most other benign tissues. Freshly isolated cells from
      most malignant tumors assessed expressed TTK mRNA. As well, all rapidly
      proliferating cell lines tested expressed TTK mRNA. Escherichia coli expressing
      the complete kinase domain of TTK contain markedly elevated levels of
      phosphoserine and phosphothreonine as well as slightly increased levels of
      phosphotyrosine. Taken together, these findings suggest that expression of TTK, a
      previously unidentified member of the family of kinases which can phosphorylate
      serine, threonine, and tyrosine hydroxyamino acids, is associated with cell
      proliferation.

PMID- 1639826
TI  - The relationship of mechanical properties to morphology in patellar tendon
      autografts after posterior cruciate ligament replacement in sheep.
AB  - In a sheep model the posterior cruciate ligament (PCL) was replaced by a patellar
      tendon autograft (PTAG) using the central one-third of the ipsilateral patellar
      tendon (PT). The sheep were sacrificed at 16, 26, 52 and 104 weeks postoperation.
      The PTAG, and, as controls, the contralateral PCL and PT were harvested. These
      were examined using biomechanical testing as well as light and transmission
      electron microscopy, including immunohistological techniques. The material
      properties (maximum stress, elastic modulus) were compared to the morphological
      features. The cellular distribution, the distribution of glycosaminoglycans
      (GAGs), the collagen fibril diameter and the occurrence of Type III collagen were
      studied. Prior to transplantation, the PTAG was shown to be superior in maximum
      stress (57.2 +/- 5.5 MPa vs 41.3 +/- 1.9 MPa) and elastic modulus (368.8 +/- 49.3
      MPa vs 172.3 +/- 14.6 MPa) to the PCL. The early decline in material properties
      of the PTAG (maximum stress 22% and elastic modulus 42% of the control) after
      free grafting paralleled a cell- and capillary-rich PTAG tissue with remnants of
      necrosis and a poorly organized extracellular matrix. Two years after
      implantation, with progressive alignment of the tissue matrix, maximum stress and
      elastic modulus acquired approximately 60 and 70% of the control, respectively.
      However, there was also an evidence of degenerative changes characterized by
      acellular areas, loss of the normal bundling pattern of collagen fibers and
      abnormal accumulation of GAGs. Ultrastructurally, there was a predominant shift
      to thin collagen fibrils in the PTAG compared to PCL and PT, both consisting of
      thick and thin collagen fibrils. Thin fibrils were demonstrated to be, in part,
      split thick fibrils as well as newly formed fibrils. Most of these thin fibrils
      revealed a positive reaction with antibodies to Type III collagen.

PMID- 1639827
TI  - Water content alters viscoelastic behaviour of the normal adolescent rabbit
      medial collateral ligament.
AB  - Testing environment is an important factor in the outcome of mechanical tests on
      connective tissue. The purpose of this investigation was to determine the effect
      of ligament water content on ligament mechanical behaviour by altering the test
      environment. Water content of medial collateral ligament (MCLs) from 19 three
      month-old New Zealand White rabbits was varied in subsets of ligaments pairs by
      means of immersion in 2, 10 or 25% sucrose or 0.9% phosphate-buffered saline
      (PBS) solutions for 1 h. One knee joint was cycled 50 times in the designated
      solution (experimental), while the contralateral knee (uncycled control) was
      simultaneously soaked in the same tank. Following cycling, the water contents of
      both test and control ligaments were determined. Water contents of 22 normal MCLs
      were determined immediately post-sacrifice and served as 'normal water content'
      controls. Normalized peak cyclic load changes were used as a measure of the
      viscoelastic behaviour of each MCL. Results demonstrated that only ligaments
      soaked (but not cycled) in a 10% sucrose solution had water contents (60.5 +/-
      2.5%) which were statistically similar to the 22 fresh normal MCLs (63.9 +/-
      6.0%). Ligaments soaked in PBS (74.0 +/- 1.3%) or 2% sucrose (69.2 +/- 2.3%) had
      significantly higher water contents compared to fresh normal MCLs. Ligaments with
      higher water contents (e.g. soaked in PBS or 2% sucrose) demonstrated greater
      cyclic load relaxation compared to ligaments with lower contents (e.g. soaked in
      25 or 10% sucrose). Different fluid test environments can significantly alter
      ligament water content and, in turn, significantly affect ligament viscoelastic
      behaviour.

PMID- 1639828
TI  - Impedance response characteristics of the primate Mucaca mulatta exposed to
      seated whole-body gz vibration.
AB  - A mathematical model was used to quantify and describe the variability in the
      mechanical impedance response of the Rhesus monkey subjected to vibrations in the
      range 3-20 Hz at 0.5 g peak acceleration. Due to the similarities in response, a
      two-mass, one-degree-of-freedom (DOF) model was selected and the associated
      mechanical parameters determined using a nonlinear least-squares optimization
      program. For the six tests conducted on each of the four subjects, appreciable
      parameter variations were observed within a subject; however, the majority of the
      mean parameter values among different subjects and among the repeated tests on
      the population were within +/- 1 S.D. of each other. Significant differences were
      observed in the stiffness coefficient and the total mass among different
      subjects, and in the mass ratio (between inert and sprung masses) among the
      repeated tests. Variations in the profile shapes following resonance were
      described and limited by changes in the mass ratio and the damping factor. Higher
      mass ratios (greater than 1.0) were associated with lower damping factors (less
      than 0.50). The impedance response beyond resonance approached the response
      described by the impedance of the inert mass and the damper elements of the model
      combined in parallel, and supported the assumption that the lower torso was
      rigidly attached to the seat. Physically, the reactive force produced by the
      upper torso increasingly diminished following resonance, due to the load
      transmission/attenuation characteristics of the spinal structures at 0.5 g peak
      acceleration. The impedance measured at the seat becomes dominated by the
      transmitted damping force associated with the spine and the force generated by
      the rigid lower-torso mass.

PMID- 1639829
TI  - Evaluation of linear finite-element analysis models' assumptions for external
      fixation devices.
AB  - Linear finite-element models (FEMs) have enjoyed an increased use in orthopaedic
      research, including the use for modeling external fixation devices. These fixator
      FEMs depend on a number of basic assumptions concerning the overall fixation
      frame stability and the components' rigidity. Among the more important ones are:
      (i) rigid fixation at both ends of the pin and sidebar; (ii) that the sidebar can
      be treated essentially as a rigid entity, with all bending occurring in the bone
      pins; and (iii) that the system can be treated as linearly elastic. Prior work
      done by the authors questions some of these assumptions. Thus, this study sought
      an empirical evaluation of the validity of some of these a priori assumptions. A
      Hoffmann single half-frame was tested in its standard form and then according to
      a stepwise protocol wherein the frame was welded to eliminate any possible points
      of instability. These tests looked at the stability and rigidity in various modes
      (axial compression, torsion, and medial-lateral and anterior-posterior four-point
      bending). The basic assumptions concerning the frame stability, frame rigidity
      and the frame's response to loads were found to be erroneous. Component failure
      was common under minimal loads and statistically significant differences (p less
      than 0.05) of up to 75% were noted in frame rigidity among the various frame
      forms tested. Thus, considerable caution must be exercised when employing the FEM
      technique for evaluating the fixator properties.

PMID- 1639830
TI  - A general approach for modelling and mathematical investigation of the human
      upper limb.
AB  - This paper is an attempt to systematize and solve the problems connected with
      biomechanical modelling and mathematical investigation of the upper limb, when
      all muscles acting on the shoulder, elbow and wrist joint are included. The basic
      problem is the assumption of a hypothesis for the unit vectors, collinear with
      muscle forces. The so-called segment-lines modelling of the muscle force
      direction is proposed for solving this problem. This approach combines the
      simplicity of the straight line joining the muscle tendon origin to the insertion
      point, its application for the analytical description of the model and the real
      description of the muscle anatomical functions. The principle of the anatomically
      adequate moment is the general criterion for choosing the segments (straight and
      curvilinear sections) by which the direction of the muscle action is replaced.
      The different optimization techniques which are used for solving the statically
      indeterminate problem, formulated for musculoskeletal biomechanical models, are
      considered. Aiming to obtain strictly positive and continuous solutions for the
      muscle forces moduli, the application of the Lagrange multipliers method is
      proposed. The possibility of applying different optimization criteria is
      explored. A general conclusion may be formulated: if there exists any criterion
      which is independent of the joint angles, it follows than that it must be
      dependent on the joint reactions and, in addition, it must be nonlinearly
      dependent on the muscle forces moduli.

PMID- 1639831
TI  - Collagen fiber orientation and geometry effects on the mechanical properties of
      secondary osteons.
AB  - The effects of collagen fiber orientation and osteon geometry on the mechanical
      properties of secondary osteons under axial compression/tension and combined
      loadings (compression, bending and torsion) were investigated using a composite
      beam finite-element model. Three cross-sectional shapes of secondary osteons were
      studied to show the effect of geometry. The results of stiffness are presented
      using the tension and compression properties for each lamella. The model shows
      that the mechanical properties of osteons are enhanced in bending and torsion
      when collagen fibers are oriented within 30 degrees of the loading axis. Osteons
      with alternating lamellar orientation are not well adapted to resist torsional
      moments, but alternate collagen fiber orientation has virtually no effect on the
      bending stiffness of osteons. Fiber orientation affects the mechanical properties
      less significantly when osteons are non-circular. Collagen fiber orientation and
      osteon geometry interact to determine the mechanical behavior of the osteon, and
      may act in a compensatory manner in the adaptive process.

PMID- 1639832
TI  - Energy transformations in human movement by contact.
AB  - This study focuses on the transformation of energy in multilinkage systems by a
      deliberate use of the contact with the ground, leading to a derivation of the
      directional change of translational velocity of the body's center of mass. The
      coefficient of friction on the surface on which the impact occurs, and its effect
      on the overall movement, is studied for general multilinkage systems undergoing
      impact. The effect of surface friction is made apparent via simulation studies
      for a two-link example, where two interesting conditions arise: slippage or no
      slippage on the surface at impact. It is found that once the system stops on the
      surface, the translational energy increases as the angular velocity increases.
      Likewise, it is seen that the rotational energy after impact increases as the
      angular velocity of the first link increases, but the rate of increase of energy
      is less in the case where the system stops on the ground with no slippage.

PMID- 1639833
TI  - The influence of dynamic factors on triaxial net muscular moments at the L5/S1
      joint during asymmetrical lifting and lowering.
AB  - Asymmetrical lifting and lowering are predominant activities in the workplace.
      Mechanical causes are suggested for many back injuries and the dynamic conditions
      within which spine loading occurs are related to spine loading increase. More
      data on tridimensional biomechanical lumbar spine loading during asymmetrical
      lifting and lowering are needed. A tridimensional dynamic multisegment model was
      developed to compute spinal loading for asymmetrical box-handling situations. The
      tridimensional positions of the anatomical markers were generated by a direct
      linear transformation algorithm adapted for the processing of data from two real
      and two virtual views (mirrors). Two force platforms measured the external
      forces. Five male subjects performed three variations (slow, fast and
      accelerated) of asymmetric lifting and two variations (slow and fast) of
      asymmetric lowering. The torsional, extension/flexion and lateral bending net
      muscular moments at the L5/S1 joint were computed and peak values selected for
      statistical analysis. For the lifting task, the fast and accelerated conditions
      showed significant increases over the slow condition for torsion,
      extension/flexion and lateral-bending moments. The accelerated condition also
      showed significant increases over the fast condition for extension. A comparison
      between lifting and lowering tasks showed equivalent loadings for torsion and
      extension. The moments were compared to average maximal values measured on
      equivalent male subject populations by isokinetic dynamometry. This showed
      torsional and extension values of 30 and 83% of the maximal possible subject
      capacity, respectively. These results demonstrated that dynamic factors do
      influence the load on the spine and highlighted the influence of both lifting and
      lowering on the loading of the spine. This suggested that for a more complete
      analysis of asymmetrical handling, the maximal velocity and acceleration produced
      during lifting should be included.

PMID- 1639834
TI  - The isometric length-force models of nine different skeletal muscles.
AB  - The length-force relations of nine different skeletal muscles in the hindlimb of
      the cat were determined experimentally, with electrical stimulation of the
      sciatic nerve as the activation mode. It was shown that the active-, passive-,
      and total-force patterns varied widely among the muscles. The tibialis posterior
      (TP), medial and lateral gastrocnemius (MG, LG) and flexor digitorum longus (FDL)
      had a symmetric active-force curve, whereas the tibialis anterior (TA), peroneus
      brevis (PB), peroneus longus (PL), extensor digitorum longus (EDL), and soleus
      (SOL) had an asymmetric curve which exhibits about 25% of the maximal isometric
      force at extreme lengths. The SOL, EDL, and LG had a low-level passive force
      which appeared at short muscle length, whereas all other muscles exhibited
      initial passive force just before the optimal length. The total force was rising
      quasi-linearly for the SOL, whereas the other muscles exhibited an intermediate
      plateau about the optimal length. The LG and FDL had a substantial but temporary
      intermediate dip in the total force as the muscle was elongated past the optimal
      length. The elongation range of the various muscles also varied, ranging from +/-
      15 to +/- 30% of the optimal length. The elongation range was symmetric for the
      FDL, LG, MG, TP, SOL, and EDL, and asymmetric for the PL, PB, and TA, being -12
      to + 17%, -12 to + 17%, and -35 to + 12%, respectively. Two different models
      which incorporate muscle architecture were successfully fitted to the
      experimental data of the muscles except for the MG and TA. The architecture of
      these two muscles is highly nonhomogeneous and contains compartments with two
      pennation patterns or two different optimal lengths. New models, which add
      spatially and temporally the individual characteristics of each compartment of
      the muscles, were constructed for these two muscles. The new models demonstrated
      high correlation to the experimental data obtained from the MG and TA. It was
      concluded that the length-force relation varies widely among various skeletal
      muscles and is probably dependent on the primary function of the muscle in the
      context of integrated movement; this is a manifestation of architectural factors
      such as fiber pennation pattern and angle, cross-sectional area, ratio of muscle
      to tendon length, distribution of the fiber length within the muscle and
      compartmental pennation.

PMID- 1639835
TI  - A proposed tolerance criterion for diffuse axonal injury in man.
AB  - The head injury criterion (HIC) is currently the government-accepted head injury
      indicator. The HIC is not injury-specific, does not relate to injury severity,
      nor does it take into account variations in the brain mass or load direction.
      This report focuses on one type of inertial brain injury, diffuse axonal injury
      (DAI), and utilizes animal studies, physical model experiments, and analytical
      model simulations to determine the kinematics of DAI in the subhuman primate and
      to scale these results to man. A human injury tolerance for moderate to severe
      DAI, which includes the influences of rotational loads and brain mass, is
      proposed.

PMID- 1639836
TI  - Strain rate effects on tensile failure properties of the common carotid artery
      and jugular veins of ferrets.
AB  - We have recently reported the insensitivity of tensile failure properties of
      human cerebral bridging veins to strain rate. Due to data scattering, however,
      concerns remain regarding this finding. To pursue the issue further, the common
      carotid arteries and external and internal jugular veins from seven ferrets were
      stretched longitudinally in vitro at either a low strain rate of 0.2-2.0 s-1 or a
      high rate of approximately 200 s-1. The ultimate stretch ratios and loads were
      found to be independent of strain rate in all the vessels tested. Therefore, the
      present results appear to support our previous finding on human bridging veins.

PMID- 1639837
TI  - A study on the constitutive equation of blood.
AB  - This paper proposes and studies a new three-parameter constitutive equation for
      whole human blood, tau = tau y+eta 2 gamma 1/2 + eta 1 gamma. The model aims at a
      proper description of the shear thinning behavior of blood at both low and high
      shear rates. While empirically based, it relies on continuum constitutive
      theories. The model has been verified by fitting the experimental data available
      in the literature using the weighted least squares. Results show that the
      proposed model fits the experimental data with nearly constant parameters in a
      wide shear range, and with average deviations epsilon less than 6.24%. Formulae
      to calculate the velocity profile and flow rate of the proposed model in a
      straight tube flow were deduced. Compared to Casson's and Newtonian models, it is
      concluded that the proposed model is more effective in describing the shear
      thinning behavior of blood within a wide shear range.

PMID- 1639838
TI  - Pulsatile flow visualization in a model of the human abdominal aorta and aortic
      bifurcation.
AB  - The infrarenal abdominal aorta and aortic bifurcation are frequent sites of
      atherosclerosis. The local hemodynamics are considered to be atherogenetic
      factors; a detailed description of these flow fields is, therefore, essential to
      understand their relationship to atherosclerosis. The aim of this study was,
      therefore, to provide such detailed information using a flow visualization
      technique in an anatomically realistic flow model of the abdominal aorta and its
      main branches in which the complex pulsatile flow waveforms and flow rates were
      simulated for two physiologic flow conditions (rest and exercise). At rest, the
      particle path lines in the suprarenal abdominal aorta were straight with no
      visible signs of flow reversal. Vortices were initiated opposite to the main
      branches. In the infrarenal aorta, large flow separation zones formed at the
      posterior aortic wall and at the lateral walls in the aortic bifurcation during
      systolic deceleration, and flow reversal was present during diastole. Under
      exercise conditions, the particle path lines were straight, and only slight flow
      reversal was seen. This study emphasizes, that rather than being a straight tube
      with forward-moving fluid, the abdominal aorta has to be considered as a complex
      part of the arterial tree. Distinct local hemodynamic qualities of importance for
      explaining atherogenesis were pointed out. At rest, the suprarenal abdominal
      aorta had much less complicated flow characteristics than the infrarenal
      abdominal aorta where the distal, posterior vessel wall and the lateral walls of
      the bifurcation were sites of flow patterns thought to be associated with
      atherosclerosis. During exercise, the infrarenal flow patterns changed
      dramatically away from the flow patterns associated with the induction of
      atherosclerosis.

PMID- 1639839
TI  - Myofilament lengths of cat skeletal muscle: theoretical considerations and
      functional implications.
AB  - The cat is the primary model for neuromuscular research. However, sarcomere
      geometry, in particular thin-myofilament lengths of cat skeletal muscles, is not
      known, thus preventing adequate muscle modeling on the sarcomere level. The
      purpose of this study was to determine thin-myofilament lengths in cat skeletal
      muscle. It was found that average thin-myofilament lengths of cat tibialis
      anterior muscles (1.12 microns) were larger than the average values reported for
      frog (approximately 0.95 microns), rat (1.09 microns), and rabbit muscles (1.09
      microns) and were smaller than the values reported for monkey (1.16 microns) and
      human skeletal muscles (1.27 microns). According to the cross-bridge theory of
      muscular contraction, this result implies that the range of sarcomere length on
      the ascending limb of the force-length relation for cat muscle is between those
      of frog, rat, and rabbit on the one side and monkey and human on the other side.
      It is speculated that the differences in thin-myofilament lengths of different
      animals are related to the functional demands of these muscles in everyday
      movement tasks. Isolated experimental observations appear to support this
      speculation.

PMID- 1639840
TI  - Transport of microinjected alcohol oxidase from Pichia pastoris into vesicles in
      mammalian cells: involvement of the peroxisomal targeting signal.
AB  - This report describes the microinjection of a purified peroxisomal protein,
      alcohol oxidase, from Pichia pastoris into mammalian tissue culture cells and the
      subsequent transport of this protein into vesicular structures. Transport was
      into membrane-enclosed vesicles as judged by digitonin-permeabilization
      experiments. The transport was time and temperature dependent. Vesicles
      containing alcohol oxidase could be detected as long as 6 d after injection.
      Coinjection of synthetic peptides containing a consensus carboxyterminal
      tripeptide peroxisomal targeting signal resulted in abolition of alcohol oxidase
      transport into vesicles in all cell lines examined. Double-label experiments
      indicated that, although some of the alcohol oxidase was transported into
      vesicles that contained other peroxisomal proteins, the bulk of the alcohol
      oxidase did not appear to be transported to preexisting peroxisomes. While the
      inhibition of transport of alcohol oxidase by peptides containing the peroxisomal
      targeting signal suggests a competition for some limiting component of the
      machinery involved in the sorting of proteins into peroxisomes, the organelles
      into which the majority of the protein is targeted appear to be unusual and
      distinct from endogenous peroxisomes by several criteria. Microinjected alcohol
      oxidase was transported into vesicles in normal fibroblasts and also in cell
      lines derived from patients with Zellweger syndrome, which are unable to
      transport proteins containing the ser-lys-leu-COOH peroxisomal targeting signal
      into peroxisomes (Walton et al., 1992). The implications of this result for the
      mechanism of peroxisomal protein transport are discussed.

PMID- 1639841
TI  - PDGF-AA and PDGF-BB biosynthesis: proprotein processing in the Golgi complex and
      lysosomal degradation of PDGF-BB retained intracellularly.
AB  - Platelet-derived growth factor is a potent mitogen for cells of mesenchymal
      origin. It is made up of two polypeptide chains (A and B) combined in three
      disulfide-linked dimeric forms (AA, AB, and BB). Here, the biosynthesis and
      proteolytic processing of the two homodimeric forms of PDGF (AA and BB) were
      studied in CHO cells stably transfected with A-chain (short splice version) or B
      chain cDNA. PDGF-AA was processed to a 30-kD molecule which was secreted from the
      cells. In contrast, PDGF-BB formed two structurally distinct end products; a
      minor secreted 30-kD form and a major cell-associated 24-kD form.
      Immunocytochemical studies at light- and electron-microscopical levels revealed
      presence of PDGF in the Golgi complex, in lysosomes, and to a smaller extent in
      the ER. From analysis of cells treated with brefeldin A, an inhibitor of ER to
      Golgi transport, it was concluded that dimerization occurs in the ER, whereas the
      proteolytic processing of PDGF-AA and PDGF-BB precursors normally occurs in a
      compartment distal to the ER. Exposure of the cultures to the lysosomal inhibitor
      chloroquine led to an increased cellular accumulation of PDGF-BB, as determined
      both by metabolic labeling experiments and immunocytochemical methods, indicating
      that the retained form of PDGF-BB is normally degraded in lysosomes. Structural
      analysis of the two end products of PDGF-BB revealed that the secreted 30-kD form
      is a dimer of peptides processed as the B-chain of PDGF purified from human
      platelets, and that the retained 24-kD form is made up of subunits additionally
      processed in the NH2-terminus. Also, the 24-kD form was shown to be composed of
      proteolytic fragments held together by disulfide bridges. Taken together these
      findings suggest that the newly synthesized PDGF A- and B-chains are dimerized in
      the ER and thereafter transferred to the Golgi complex for proteolytic
      processing. From there, PDGF-AA is carried in vesicles to the cell surface for
      release extracellularly by exocytosis. A smaller part of PDGF-BB (the 30-kD form)
      is handled in a similar way, whereas the major part (the 24-kD form) is generated
      by additional proteolysis in the Golgi complex, from which it is slowly carried
      over to lysosomes for degradation.

PMID- 1639842
TI  - Protein targeting via the "constitutive-like" secretory pathway in isolated
      pancreatic islets: passive sorting in the immature granule compartment.
AB  - We have suggested the existence of a novel "constitutive-like" secretory pathway
      in pancreatic islets, which preferentially conveys a fraction of newly
      synthesized C-peptide, insulin, and proinsulin, and is related to the presence of
      immature secretory granules (IGs). Regulated exocytosis of IGs results in an
      equimolar secretion of C-peptide and insulin; however an assay of the
      constitutive-like secretory pathway recently demonstrated that this route conveys
      newly synthesized C-peptide in molar excess of insulin (Arvan, P., R. Kuliawat,
      D. Prabakaran, A.-M. Zavacki, D. Elahi, S. Wang, and D. Pilkey. J. Biol. Chem.
      266:14171-14174). We now use this assay to examine the kinetics of constitutive
      like secretion. Though its duration is much shorter than the life of mature
      granules under physiologic conditions, constitutive-like secretion appears
      comparatively slow (t1/2 approximately equal to 1.5 h) compared with the rate of
      proinsulin traffic through the ER and Golgi stacks. We have examined whether this
      slow rate is coupled to the rate of IG exit from the trans-Golgi network (TGN).
      Escape from the 20 degrees C temperature block reveals a t1/2 less than or equal
      to 12 min from TGN exit to stimulated release of IGs; the time required for IG
      formation is too rapid to be rate limiting for constitutive-like secretion.
      Further, conditions are described in which constitutive-like secretion is blocked
      yet regulated discharge of IGs remains completely intact. Thus, constitutive-like
      secretion appears to represent an independent secretory pathway that is
      kinetically restricted to a specific granule maturation period. The data support
      a model in which passive sorting due to insulin crystallization results in
      enrichment of C-peptide in membrane vesicles that bud from IGs to initiate the
      constitutive-like secretory pathway.

PMID- 1639843
TI  - Osmotic stress and the yeast cytoskeleton: phenotype-specific suppression of an
      actin mutation.
AB  - In the yeast Saccharomyces cerevisiae, actin filaments function to direct cell
      growth to the emerging bud. Yeast has a single essential actin gene, ACT1.
      Diploid cells containing a single copy of ACT1 are osmosensitive (Osms), i.e.,
      they fail to grow in high osmolarity media (D. Shortle, unpublished observations
      cited by Novick, P., and D. Botstein. 1985. Cell. 40:415-426). This phenotype
      suggests that an underlying physiological process involving actin is
      osmosensitive. Here, we demonstrate that this physiological process is a rapid
      and reversible change in actin filament organization in cells exposed to osmotic
      stress. Filamentous actin was stained using rhodamine phalloidin. Increasing
      external osmolarity caused a rapid loss of actin filament cables, followed by a
      slower redistribution of cortical actin filament patches. In the recovery phase,
      cables and patches were restored to their original levels and locations. Strains
      containing an act1-1 mutation are both Osms and temperature-sensitive (Ts)
      (Novick and Botstein, 1985). To identify genes whose products functionally
      interact with actin in cellular responses to osmotic stress, we have isolated
      extragenic suppressors which revert only the Osms but not the Ts phenotype of an
      act1-1 mutant. These suppressors identify three genes, RAH1-RAH3. Morphological
      and genetic properties of a dominant suppressor mutation suggest that the product
      of the wild-type allele, RAH3+, is an actin-binding protein that interacts with
      actin to allow reassembly of the cytoskeleton following osmotic stress.

PMID- 1639844
TI  - Alzheimer-like paired helical filaments and antiparallel dimers formed from
      microtubule-associated protein tau in vitro.
AB  - Recent evidence from several laboratories shows that the paired helical filaments
      of Alzheimer's disease brains consist mainly of the protein tau in an abnormally
      phosphorylated form, but the mode of assembly is not understood. Here we use EM
      to study several constructs derived from human brain tau and expressed in
      Escherichia coli. All constructs or tau isoforms are rodlike molecules with a
      high tendency to dimerize in an antiparallel fashion, as shown by antibody
      labeling and chemical crosslinking. The length of the rods is largely determined
      by the region of internal repeats that is also responsible for microtubule
      binding. One unit length of the repeat domain (three or four repeats) is around
      22-25 nm, comparable to the cross-section of Alzheimer PHF cores. Constructs
      corresponding roughly to the repeat region of tau can form synthetic paired
      helical filaments resembling those from Alzheimer brain tissue. A similar self
      assembly occurs with the chemically cross-linked dimers. In both cases there is
      no need for phosphorylation of the protein.

PMID- 1639845
TI  - Microtubule dissassembly in vivo: intercalary destabilization and breakdown of
      microtubules in the heliozoan Actinocoryne contractilis.
AB  - In the marine heliozoan Actinocoryne contractilis, uninterrupted rods of
      microtubules stiffen the axopodia and the stalk. Stimulation in sea water elicits
      an extremely fast contraction (millisecond range) accompanied by almost complete
      Mt dissociation. Using high-speed cinematography and light transmittance
      measurements, we have studied the process of Mt disassembly in real time. In sea
      water, Mt disassembly follows an exponential decrease (mean half time of 4 ms) or
      proceeds by short steps. Cell contraction and Mt disassembly have been inhibited
      or slowed down through the use of artificial media. Although kinetics are slower
      (mean half time of 3 s), the curves of the length change against time look
      similar. The rapid as well as the slower process are accompanied by the formation
      of breakpoints on the stalk, from which disassembly proceeds. In specimens fixed
      during the slowed contraction, the presence across the Mt rods, of a single or
      multiple destabilization band that may consist of granular material and
      polymorphic forms of tubulin supports the hypothesis of "intercalary
      destabilization and breakdown" of axonemal Mts.

PMID- 1639846
TI  - A temperature-sensitive calmodulin mutant loses viability during mitosis.
AB  - Although rare, a recessive temperature-sensitive calmodulin mutant has been
      isolated in Saccharomyces cerevisiae. The mutant carries two mutations in CMD1,
      isoleucine 100 is changed to asparagine and glutamic acid 104 is changed to
      valine. Neither mutation alone conferred temperature sensitivity. A single
      mutation that allowed production of an intact but defective protein was not
      identified. At the nonpermissive temperature, the temperature-sensitive mutant
      displayed multiple defects. Bud formation and growth was delayed, but this defect
      was not responsible for the temperature-sensitive lethality. Cells synchronized
      in G1 progressed through the cell cycle and retained viability until the movement
      of the nucleus to the neck between the mother cell and the large bud. After
      nuclear movement, less than 5% of the cells survived the first mitosis and could
      form colonies when returned to permissive conditions. The duplicated DNA was
      dispersed along the spindle, extending from mother to daughter cell. Cells
      synchronized in G2/M lost viability immediately upon the shift to the
      nonpermissive temperature. At a semipermissive temperature, the mutant showed
      approximately a 10-fold increase in the rate of chromosome loss compared to a
      wild-type strain. The mitotic phenotype is very similar to yeast mutants that are
      defective in chromosome disjunction. The mutant also showed defects in
      cytokinesis.

PMID- 1639847
TI  - Calmodulin concentrates at regions of cell growth in Saccharomyces cerevisiae.
AB  - Calmodulin was localized in Saccharomyces cerevisiae by indirect
      immunofluorescence using affinity-purified polyclonal antibodies. Calmodulin
      displays an asymmetric distribution that changes during the cell cycle. In
      unbudded cells, calmodulin concentrates at the presumptive site of bud formation
      approximately 10 min before bud emergence. In small budded cells, calmodulin
      accumulates throughout the bud. As the bud grows, calmodulin concentrates at the
      tip, then disperses, and finally concentrates in the neck region before
      cytokinesis. An identical staining pattern is observed when wild-type calmodulin
      is replaced with mutant forms of calmodulin impaired in binding Ca2+. Thus, the
      localization of calmodulin does not depend on its ability to bind Ca2+ with a
      high affinity. Double labeling of yeast cells with affinity-purified anti
      calmodulin antibody and rhodamine-conjugated phalloidin indicates that calmodulin
      and actin concentrate in overlapping regions during the cell cycle. Furthermore,
      disrupting calmodulin function using a temperature-sensitive calmodulin mutant
      delocalizes actin, and act1-4 mutants contain a random calmodulin distribution.
      Thus, calmodulin and actin distributions are interdependent. Finally, calmodulin
      localizes to the shmoo tip in cells treated with alpha-factor. This distribution,
      at sites of cell growth, implicates calmodulin in polarized cell growth in yeast.

PMID- 1639848
TI  - H and T subunits of acetylcholinesterase from Torpedo, expressed in COS cells,
      generate all types of globular forms.
AB  - We analyzed the production of Torpedo marmorata acetylcholinesterase (AChE) in
      transfected COS cells. We report that the presence of an aspartic acid at
      position 397, homologous to that observed in other cholinesterases and related
      enzymes (Krejci, E., N. Duval, A. Chatonnet, P. Vincens, and J. Massoulie. 1991.
      Proc. Natl. Acad. Sci. USA. 88:6647-6651), is necessary for catalytic activity.
      The presence of an asparagine in the previously reported cDNA sequence (Sikorav,
      J.L., E. Krejci, and J. Massoulie. 1987. EMBO (Eur. Mol. Biol. Organ.) J. 6:1865
      1873) was most likely due to a cloning error (codon AAC instead of GAC). We
      expressed the T and H subunits of Torpedo AChE, which differ in their COOH
      terminal region and correspond respectively to the collagen-tailed asymmetric
      forms and to glycophosphatidylinositol-anchored dimers of Torpedo electric
      organs, as well as a truncated T subunit (T delta), lacking most of the COOH
      terminal peptide. The transfected cells synthesized similar amounts of AChE
      immunoreactive protein at 37 degrees and 27 degrees C. However AChE activity was
      only produced at 27 degrees C and, even at this temperature, only a small
      proportion of the protein was active. We analyzed the molecular forms of active
      AChE produced at 27 degrees C. The H polypeptides generated
      glycophosphatidylinositol-anchored dimers, resembling the corresponding natural
      AChE form. The cells also released non-amphiphilic dimers G2na. The T
      polypeptides generated a series of active forms which are not produced in Torpedo
      electric organs: G1a, G2a, G4a, and G4na cellular forms and G2a and G4na secreted
      forms. The amphiphilic forms appeared to correspond to type II forms (Bon, S., J.
      P. Toutant, K. Meflah, and J. Massoulie. 1988. J. Neurochem. 51:776-785; Bon, S.,
      J. P. Toutant, K. Meflah, and J. Massoulie. 1988. J. Neurochem. 51:786-794),
      which are abundant in the nervous tissue and muscles of higher vertebrates (Bon,
      S., T. L. Rosenberry, and J. Massoulie. 1991. Cell. Mol. Neurobiol. 11:157-172).
      The H and T catalytic subunits are thus sufficient to account for all types of
      known AChE forms. The truncated T delta subunit yielded only non-amphiphilic
      monomers, demonstrating the importance of the T COOH-terminal peptide in the
      formation of oligomers, and in the hydrophobic character of type II forms.

PMID- 1639849
TI  - A cytomechanical investigation of neurite growth on different culture surfaces.
AB  - We have examined the relationship between tension, an intrinsic stimulator of
      axonal elongation, and the culture substrate, an extrinsic regulator of axonal
      elongation. Chick sensory neurons were cultured on three substrata: (a) plain
      tissue culture plastic; (b) plastic treated with collagen type IV; and (c)
      plastic treated with laminin. Calibrated glass needles were used to increase the
      tension loads on growing neurites. We found that growth cones on all substrata
      failed to detach when subjected to two to threefold and in some cases 5-10-fold
      greater tensions than their self-imposed rest tension. We conclude that adhesion
      to the substrate does not limit the tension exerted by growth cones. These data
      argue against a "tug-of-war" model for substrate-mediated guidance of growth
      cones. Neurite elongation was experimentally induced by towing neurites with a
      force-calibrated glass needle. On all substrata, towed elongation rate was
      proportional to applied tension above a threshold tension. The proportionality
      between elongation rate and tension can be regarded as the growth sensitivity of
      the neurite to tension, i.e., its growth rate per unit tension. On this basis,
      towed growth on all substrata can be described by the simple linear equation:
      elongation rate = sensitivity x (applied tension - tension threshold) The
      numerical values of tension thresholds and neurite sensitivities varied widely
      among different neurites. On all substrata, thresholds varied from near zero to
      greater than 200 mudynes, with some tendency for thresholds to cluster between
      100 and 150 mudynes. Similarly, the tension sensitivity of neurites varied
      between 0.5 and 5.0 microns/h/mudyne. The lack of significant differences among
      sensitivity or threshold values on the various substrata suggest to use that the
      substratum does not affect the internal "set points" of the neurite for its
      response to tension. The growth cone of chick sensory neurons is known to pull on
      its neurite. The simplest cytomechanical model would assume that both growth cone
      mediated elongation and towed growth are identical as far as tension input and
      elongation rate are concerned. We used the equation above and mean values for
      thresholds and sensitivity from towing experiments to predict the mean growth
      cone-mediated elongation rate based on mean rest tensions. These predictions are
      consistent with the observed mean values.

PMID- 1639850
TI  - Plakoglobin, or an 83-kD homologue distinct from beta-catenin, interacts with E
      cadherin and N-cadherin.
AB  - E- and N-cadherin are members of a family of calcium-dependent, cell surface
      glycoproteins involved in cell-cell adhesion. Extracellularly, the transmembrane
      cadherins self-associate, while, intracellularly, they interact with the actin
      based cytoskeleton. Several intracellular proteins, collectively termed catenins,
      have been noted to co-immunoprecipitate with E- and N-cadherin and are thought to
      be involved in linking the cadherins to the cytoskeleton. Two catenins have been
      identified recently: a 102-kD vinculin-like protein (alpha-catenin) and a 92-kD
      Drosophila armadillo/plakoglobin-like protein (beta-catenin). Here, we show that
      plakoglobin, or an 83-kD plakoglobin-like protein, co-immunoprecipitates and
      colocalizes with both E- and N-cadherin. The 83-kD protein is immunologically
      distinct from the 92-kD beta-catenin and, because of its molecular mass, likely
      represents the cadherin-associated protein called gamma-catenin. Thus, two
      different members of a plakoglobin family associate with N- and E-cadherin and,
      together with the 102-kD alpha-catenin, appear to participate in linking the
      cadherins to the actin-based cytoskeleton.

PMID- 1639851
TI  - The vertebrate adhesive junction proteins beta-catenin and plakoglobin and the
      Drosophila segment polarity gene armadillo form a multigene family with similar
      properties.
AB  - Three proteins identified by quite different criteria in three different systems,
      the Drosophila segment polarity gene armadillo, the human desmosomal protein
      plakoglobin, and the Xenopus E-cadherin-associated protein beta-catenin, share
      amino acid sequence similarity. These findings raise questions about the
      relationship among the three molecules and their roles in different cell-cell
      adhesive junctions. We have found that antibodies against the Drosophila segment
      polarity gene armadillo cross react with a conserved vertebrate protein. This
      protein is membrane associated, probably via its interaction with a cadherin-like
      molecule. This cross-reacting protein is the cadherin-associated protein beta
      catenin. Using anti-armadillo and antiplakoglobin antibodies, it was shown that
      beta-catenin and plakoglobin are distinct molecules, which can coexist in the
      same cell type. Plakoglobin interacts with the desmosomal glycoprotein desmoglein
      I, and weakly with E-cadherin. Although beta-catenin interacts tightly with E
      cadherin, it does not seem to be associated with either desmoglein I or with
      isolated desmosomes. Anti-armadillo antibodies have been further used to
      determine the intracellular localization of beta-catenin, and to examine its
      tissue distribution. The implications of these results for the structure and
      function of different cell-cell adhesive junctions are discussed.

PMID- 1639852
TI  - Cadherin-mediated cell-cell adhesion is perturbed by v-src tyrosine
      phosphorylation in metastatic fibroblasts.
AB  - Rat 3Y1 cells acquire metastatic potential when transformed with v-src, and this
      potential is enhanced by double transformation with v-src and v-fos (Taniguchi,
      S., T. Kawano, T. Mitsudomi, G. Kimura, and T. Baba. 1986. Jpn. J. Cancer Res.
      77:1193-1197). We compared the activity of cadherin cell adhesion molecules of
      normal 3Y1 cells with that of v-src transformed (SR3Y1) and v-src and v-fos
      double transformed (fosSR3Y1) 3Y1 cells. These cells expressed similar amounts of
      P-cadherin, and showed similar rates of cadherin-mediated aggregation under
      suspended conditions. However, the aggregates or colonies of these cells were
      morphologically distinct. Normal 3Y1 cells formed compacted aggregates in which
      cells are firmly connected with each other, whereas the transformed cells were
      more loosely associated, and could freely migrate out of the colonies.
      Overexpression of exogenous E-cadherin in these transformed cells had no
      significant effect on their adhesive properties. We then found that herbimycin A,
      a tyrosine kinase inhibitor, induced tighter cell-cell associations in the
      aggregates of the transformed cells. In contrast, vanadate, a tyrosine
      phosphatase inhibitor, inhibited the cadherin-mediated aggregation of SR3Y1 and
      fosSR3Y1 cells but had little effect on that of normal 3Y1 cells. These results
      suggest that v-src-mediated tyrosine phosphorylation perturbs cadherin function
      directly or indirectly, and the inhibition of tyrosine phosphorylation restores
      cadherin action to the normal state. We next studied tyrosine phosphorylation on
      cadherins and the cadherin-associated proteins, catenins. While similar amounts
      of catenins were expressed in all of these cells, the 98-kD catenin was strongly
      tyrosine phosphorylated only in SR3Y1 and fosSR3Y1 cells. Cadherins were also
      weakly tyrosine phosphorylated only in the transformed cells. The tyrosine
      phosphorylation of these proteins was enhanced by vanadate, and inhibited by
      herbimycin A. Thus, the tyrosine phosphorylation of the cadherin-catenin system
      itself might affect its function, causing instable cell-cell adhesion.

PMID- 1639853
TI  - Altered metabolic and adhesive properties and increased tumorigenesis associated
      with increased expression of transforming growth factor beta 1.
AB  - Transforming growth factor-beta (TGF-beta) is a potent mediator of cell
      proliferation and extracellular matrix formation, depending on the cell type and
      the physiological conditions. TGF-beta is usually secreted in a "latent" complex
      that needs activation before it can exert its effects. Several observations
      correlate increased expression of TGF-beta 1 with tumorigenesis. To evaluate the
      physiological relevance of increased TGF-beta 1 synthesis in tumor cells we
      established cell clones overexpressing TGF-beta 1 and observed the resulting
      physiological changes in TGF-beta overproducing cells in vitro and in vivo. As a
      model system we used the human E1A-transformed 293 tumor cells, which are
      insensitive to the direct growth modulatory effects of TGF-beta. The selection of
      this cell line allows an assessment of physiological alterations independent of
      TGF-beta induced proliferative changes. The use of two TGF-beta 1 expression
      vectors containing either the natural or a modified TGF-beta 1 precursor cDNA
      permitted the establishment of separate 293 cell lines overexpressing latent or
      active TGF-beta. Comparison of the resulting changes in glycolytic rate,
      adhesiveness and integrin and plasminogen activator expression established that,
      in vitro, both types of clones behaved similarly, indicating that expression of
      latent TGF-beta induces autocrine changes in the tumor cells and thus suggesting
      that some level of cell-associated activation occurs. TGF-beta overexpression
      resulted in an increased metabolic rate due to enhanced glycolysis, a property
      long associated with tumor cells. This increased glycolysis was not associated
      with altered proliferation. Cells overexpressing TGF-beta also displayed enhanced
      fibronectin mRNA and plasminogen activator synthesis and increased adhesiveness
      in vitro. They showed enhanced survival when plated sparsely on plastic in the
      absence of serum, and attached more readily to laminin. In addition, synthesis of
      several beta 1 integrins, in particular the alpha 1/beta 1, alpha 2/beta 1, and
      alpha 3/beta 1, all of which recognize laminin, were enhanced. Finally, cells
      overexpressing active TGF-beta, but not latent TGF-beta, also showed increased
      tumorigenicity in nude mice. Thus, an increase in endogenous TGF-beta synthesis
      confers several proliferation-independent phenotypic changes which may be of
      significance for the survival of the tumor cell inoculum or its subsequent
      growth, and for tumor formation and development. In the case of cells expressing
      active TGF-beta, the release of active TGF-beta into the vicinity of the tumor
      cells may also result in a more hospitable environment for tumor growth.

PMID- 1639854
TI  - Targeted disruption of the tissue inhibitor of metalloproteinases gene increases
      the invasive behavior of primitive mesenchymal cells derived from embryonic stem
      cells in vitro.
AB  - The metalloproteinase family of proteolytic enzymes can degrade extracellular
      matrix and facilitate invasive migration. This class of enzymes is specifically
      inhibited by the tissue inhibitor of metalloproteinases (TIMP-1). Using
      homologous recombination, we have disrupted the gene encoding TIMP-1 in
      pluripotent embryonic stem cells. Because the TIMP-1 gene is X linked and is
      hemizygous in embryonic stem cells, we have been able to study the effect of this
      mutation in culture. Using a basement membrane invasion assay, we found that the
      mutant cells, differentiated in low concentrations of serum with retinoic acid,
      were more invasive than their normal cell counterparts, and that this was
      specifically reversed by adding exogenous TIMP-1 protein. The invasive cell
      population had characteristics of an early population of primitive mesenchymal
      cells, including expression of vimentin and a transient period of invasiveness
      from 4-8 d after initiation of differentiation. Therefore, metalloproteinase
      activity can be rate limiting for cell invasion.

PMID- 1639855
TI  - Autocrine action of amphiregulin in a colon carcinoma cell line and
      immunocytochemical localization of amphiregulin in human colon.
AB  - Amphiregulin (AR) is a newly discovered glycosylated, 84-amino acid residue
      polypeptide growth regulator which has sequence homology to the EGF family of
      proteins. To obtain immunological reagents to study the biological role of AR,
      two synthetic peptides containing sequences corresponding to distinct regions of
      AR were used to generate polyclonal antibodies in rabbits. One preparation of
      antipeptide antibodies directed against residues 26-44 of AR (AR-Ab2) was most
      effective in the detection of native AR, whereas another preparation of
      antibodies against residues 8-26 (AR-Ab1) was found to be most efficacious in the
      detection of AR in formalin-fixed and paraffin-embedded tissues. The growth of a
      colon carcinoma cell line, Geo, which proliferates autonomously under serum-free
      conditions, was stimulated by the exogenous addition of AR or EGF. Half-maximal
      stimulation of this growth was observed at 40 and 200 pM of EGF and AR,
      respectively. A mAb to the extracellular domain of the EGF receptor blocked the
      stimulation of cell proliferation induced by the exogenous addition of AR,
      suggesting that this stimulation was mediated via the EGF receptor. Geo cells
      were found to constitutively express significant levels of the AR mRNA transcript
      as determined by analysis of the polymerase chain reaction-amplified cDNA product
      and AR protein was detected immunocytochemically using the AR-Ab1 antibodies in
      these cells. AR was immunoprecipitated specifically using the AR-Ab2 antibodies
      from the conditioned medium of Geo cells, which had been metabolically labeled
      with [35S]cysteine. The secreted AR migrated as a broad band (18.5-22.5 kD) with
      a median molecular weight of approximately 20.7 kD in SDS-PAGE. Immunospecific
      removal of AR from serum-free medium conditioned by the Geo cells and readdition
      of the AR-depleted medium to Geo cells resulted in an approximately 40%
      inhibition of cell growth relative to controls. Furthermore, the growth of the
      Geo cells was also inhibited by approximately 50% by the addition of the anti-EGF
      receptor mAb alone. These results indicate that AR and the EGF receptor are
      involved in the autocrine growth of these cells and suggests that AR may act
      through the EGF receptor via an extracellular autocrine loop. To study the
      expression of AR in human colon in vivo, AR was localized immunocytochemically in
      formalin-fixed, paraffin-embedded sections from normal and malignant human colon
      using the AR-Ab1 antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1639856
TI  - Correction. Molecular cloning of a novel hyaluronan receptor that mediates tumor
      cell motility.

PMID- 1639857
TI  - Interleukin 1: the patterns of translation and intracellular distribution support
      alternative secretory mechanisms.
AB  - Interleukin-1 (IL-1) is synthesized as a 31 kDa precursor protein, whose multiple
      extracellular activities are attributed to receptor binding of a processed,
      carboxy-terminal 17 kDa peptide. Unlike other secreted proteins, the IL-1
      precursor lacks a hydrophobic leader sequence and is not found in organelles
      composing the classical secretory pathway. In order to further clarify the
      intracellular processing of IL-1, we studied its site of synthesis in human
      monocytes. Secreted and integral membrane proteins are translated on membrane
      bound polyribosomes, while intracellular proteins are translated on free
      polyribosomes. Free and membrane-bound polysomes were isolated from Lipid A
      stimulated monocyte lysates and immunoblotted using antibodies specific to the N
      terminal regions of the IL-1 alpha and beta precursors. Free polysome fractions
      showed multiple small bands consistent with nascent peptide chains; membrane
      bound polysomes yielded no detectable IL-1. Polysome fractions were then analyzed
      by immunoelectron microscopy; nascent IL-1 alpha and beta peptide chains were
      readily seen emerging from cytoskeletal-associated free polyribosomes, but not
      membrane-bound polyribosomes. Electron microscopic in situ hybridization revealed
      IL-1 mRNA chains attached to cytoskeletal-associated free, but not membrane-bound
      polyribosomes. The intracellular distribution of the fully synthesized IL-1 beta
      precursor was studied in human mesangial cells (HMC), whose cytoskeletal
      organization is more readily evaluated than that of monocytes. Dual
      immunofluorescence microscopy of these cells revealed a complex intracellular
      distribution of the fully synthesized 31 kDa IL-1 precursors. IL-1 was
      asymmetrically distributed between cytosolic, microtubule, and nuclear
      compartments, without association with actin or intermediate filaments. This
      demonstration of the sites of IL-1 synthesis and patterns of intracellular
      distribution provide further evidence for an extracellular release mechanism
      which is clearly distinct from the classical secretory pathway.

PMID- 1639858
TI  - Modulation of mRNA levels during human keratinocyte differentiation.
AB  - Cultures of human keratinocytes provide an excellent model system in which to
      study differentiation. Using the phorbol ester 12-O-tetradecanoyl-phorbol 13
      acetate (TPA) and calcium, two agents known to induce keratinocyte
      differentiation in vitro, we examined the expression of the genes encoding c-fos,
      c-myc, and c-jun; involucrin, a protein precursor of the keratinocyte cornified
      envelope; and L-7, a ribosomal protein. Overall, at the doses studied, TPA
      induced a more rapid and profound differentiation than did calcium, as evaluated
      by culture morphology and northern blot analysis. Our studies showed a constant
      low level of c-fos and c-jun expression in unstimulated cells with no significant
      change after addition of either TPA or calcium except when transcript breakdown
      was inhibited by cycloheximide. The c-myc proto-oncogene, known to have a high
      constitutive expression in actively proliferating cells, was strongly
      downregulated by TPA, but calcium had no effect over a 32 hour period, consistent
      with the greater growth inhibition of TPA in this system. Involucrin was induced
      about ninefold by both TPA and calcium as early as 8 hours after stimulation,
      suggesting transcriptional regulation of this gene during differentiation. L-7,
      recently demonstrated to be downregulated in late passage human fibroblasts in an
      in vitro model of senescence, was also strongly downregulated by either TPA or
      calcium, consistent with an interrelationship between the basic cellular
      processes of aging and differentiation. These finding expand our knowledge of the
      differentiation process in human keratinocytes.

PMID- 1639859
TI  - Identification of multiple PKC isoforms in Swiss 3T3 cells: differential down
      regulation by phorbol ester.
AB  - The expression of members of the Ca2+ and phospholipid-dependent protein kinase
      (PKC) family were studied in murine Swiss 3T3 cells. In addition to PKC-alpha,
      the presence of immunoreactive PKC-delta, -epsilon, and zeta was detected.
      Treatment with 500 nM 12-0-tetradecanoylphorbol-13-acetate (TPA) led to the down
      regulation of alpha, delta, and epsilon isoforms, but not that of zeta. Higher
      concentrations of TPA similarly had no effect on the level of PKC-zeta. In
      contrast to PKC-alpha, the membrane localization of PKC-delta, -epsilon, and 
      zeta was not enhanced by extraction in Ca(2+)-containing buffers, whereas acute
      TPA treatment increased membrane association of PKC-alpha, -delta, and -epsilon
      but not that of PKC-zeta.

PMID- 1639860
TI  - Analysis of the influences of the E5 transforming protein on kinetic parameters
      of epidermal growth factor binding and metabolism.
AB  - The E5 protein of the bovine papillomavirus induces cellular transformation when
      transfected into NIH 3T3 cells, and the extent of focal transformation is
      enhanced by cotransfection with the epidermal growth factor (EGF) receptor
      (Martin et al., Cell 59:21-32, 1989). To determine whether E5 affects
      EGF:receptor interactions we analyzed the kinetics of 125I-EGF processing using a
      mathematical model that enabled us to evaluate rate constants for ligand
      association (ka), dissociation (kd), internalization (ke), recycling (kr), and
      degradation (kh). These rate constants were measured in NIH 3T3 cells transfected
      with the human EGF receptor (ER cells) and in cells transfected with both the EGF
      receptor and E5 (E5/ER cells). We found that the rate constant for 125I-EGF
      association ka was significantly decreased in E5/ER cells, but was apparently
      occupancy-independent in both cell lines. The 125I-EGF dissociation rate constant
      kd was significantly lower in E5 transformed cells, and increased with occupancy
      in both cell lines. This suggests that E5 alters the receptor before or during
      EGF binding so that ligand association is slower; however, once complexes are
      formed, EGF is bound more tightly to the receptor. Rate constants for
      internalization ke were also found to be occupancy-dependent, although at a given
      level of occupancy ke was similar for both cell lines. Also, there was no
      apparent effect of E5 on the recycling rate constant kr. The 125I-EGF degradation
      rate constant kh was 30% lower in E5 transformed cells, and was occupancy
      independent. The overall effect of E5 is to stabilize intact EGF:receptor
      complexes which may alter mitogenic signaling of the receptor.

PMID- 1639861
TI  - Interleukin-1 beta induction of TNF-alpha gene expression: involvement of protein
      kinase C.
AB  - In the human astroglioma cell line CH235-MG, interleukin-1 beta (IL-1 beta)
      induces transcriptional activation of the tumor necrosis factor-alpha (TNF-alpha)
      gene, resulting in expression of TNF-alpha mRNA and biologically active TNF-alpha
      protein. This study was undertaken to elucidate intracellular signaling pathways
      involved in IL-1 beta induction of the TNF-alpha gene. We demonstrated that the
      protein kinase C (PKC) activator 4 beta-phorbol 12 beta-myristate 13 alpha
      acetate (PMA) in concert with Ca++ ionophore A23187 induced expression of TNF
      alpha mRNA and protein, whereas an inactive PMA analogue (alpha PMA) had no
      effect. Various cyclic nucleotide activators such as 8-Bromo cAMP, cholera toxin,
      and forskolin had no effect on TNF-alpha production. Two PKC inhibitors, H7 and
      staurosporine (SS), abrogated IL-1 beta induced TNF-alpha expression in a dose
      dependent fashion. Treatment of CH235-MG cells with a high concentration of PMA
      (1 microM) for an extended period of time (48 h) caused a greater than 90%
      reduction in total PKC activity. Further strengthening a role for PKC in this
      cytokine response is the fact that IL-1 beta was no longer able to induce TNF
      alpha expression in these PKC depleted cells. Last, IL-1 beta treatment produced
      an increase of total PKC activity in CH235-MG cells. Taken together, these data
      demonstrate that IL-1 beta induces TNF-alpha gene expression in CH235-MG cells in
      a PKC-dependent manner.

PMID- 1639862
TI  - Induction of fibronectin gene expression by transforming growth factor beta-1 is
      attenuated in bronchial epithelial cells by ADP-ribosyltransferase inhibitors.
AB  - Transforming growth factor-beta (TGF-beta) exerts several effects on cultured
      airway epithelial cells including inhibition of proliferation and stimulation of
      fibronectin gene expression. ADP-ribosylation is one potential regulatory
      mechanism of gene expression by TGF-beta. We tested this possibility by exposing
      cultured bovine bronchial epithelial cells to the chemical inhibitor of ADP
      ribosyl transferase enzymes, 3-aminobenzamide (3-AB) and, for comparison, 3
      aminobenzoic acid (3-ABA), which is structurally similar to 3-AB but which does
      not inhibit ADP-ribosyl transferases. Exponential cell growth rate (1.2
      doublings/day) or cellular morphology observed by phase contrast microscopy were
      not affected by 3 mM 3-AB or 3-ABA. Neither compound antagonized inhibition of
      cell division or induction of squamous morphology by TGF-beta 1. In contrast, the
      sixfold stimulation of fibronectin production by exposure of cells to 30 pM TGF
      beta 1 for 48 h was reduced by 50% in the presence of 3 mM 3-AB, whereas 3 mM 3
      ABA had no effect. The antagonistic effect was augmented by administration of 3
      AB 24 h prior to induction by TGF-beta 1. Northern blot hybridization analyses
      demonstrated that 3-AB, but not 3-ABA, attenuated the induction of fibronectin
      mRNA by TGF-beta 1 by up to 50%. These observations may implicate a role of
      cellular ADP-ribosylation in the regulation of some gene expression by TGF-beta.

PMID- 1639863
TI  - Changes in responsiveness of rat tracheal epithelial cells to transforming growth
      factor-beta 1 with time in culture.
AB  - Primary rat tracheal epithelial (RTE) cell cultures have previously been shown to
      be highly sensitive to growth inhibition by transforming growth factor-beta 1
      (TGF beta 1) when treated within 1-2 days after plating. The purpose of the
      present studies was to examine the effects of TGF beta 1 on the growth of RTE
      cells as a function of time in culture. We found that the sensitivity of RTE
      cells to growth inhibition by TGF beta 1 decreased dramatically as the cultures
      aged. The IC50 for inhibition of colony forming efficiency was 0.18 pM when TGF
      beta 1 was added 24 h after cell plating. When TGF beta 1 treatment was begun on
      day 5 of culture, the IC50 was 3-4 pM as measured by inhibition of growth (cell
      number) and DNA synthesis. However, when TGF beta 1 was begun on day 19, the IC50
      was 65 pM or greater than 500 pM, depending on whether inhibition of growth or
      DNA synthesis, respectively, was measured. TGF beta 1 accelerated cell death, as
      measured by exfoliation of cells, and inhibited cell proliferation. The decrease
      in responsiveness to TGF beta 1 in late cultures was shown to be dependent on
      culture age as well as on cell density. No evidence was found for inactivation or
      degradation of the added TGF beta 1 by the late stage cultures. Cells subcultured
      from late stage primary cultures remained less responsive to TGF beta 1 than
      subcultured cells from early cultures. Similar to its effect on proliferation,
      TGF beta 1 down-regulated the expression of two proliferation-related genes, c
      myc and transforming growth factor-alpha, in early but not late RTE cell
      cultures. On the other hand, fibronectin expression was increased by TGF beta 1
      by about twofold at both early and late times in culture. This indicates that the
      changes in TGF beta 1 responsiveness with time in culture are selective,
      apparently affecting primarily proliferation-related events.

PMID- 1639864
TI  - Epidermal growth factor dependence and TGF alpha autocrine growth regulation in
      primary rat tracheal epithelial cells.
AB  - We have examined dependence of primary rat tracheal epithelial (RTE) on exogenous
      epidermal growth factor (EGF) and determined whether a TGF alpha autocrine
      pathway is operating in these cells. Primary RTE cells plated in serum free media
      (SFM) without EGF and bovine pituitary factor (BPE) show little proliferation
      compared to cultures propagated in media containing EGF/BPE (CSFM). Removal of
      EGF/BPE shortly after plating, however, results in significant proliferation,
      although plateau cell densities are reduced and cell morphology is significantly
      altered compared to cells propagated in CSFM. Addition of EGF and/or BPE to
      cultures propagated in SFM minus EGF/BPE restores maximum cell density. The
      concentration of TGF alpha peptide in media conditioned by cells propagated
      without EGF/BPE is lower than the concentration in the media of CSFM cultures.
      TGF alpha mRNA and protein levels are also significantly lower in cells late in
      culture compared to logarithmically growing cells regardless of the presence or
      absence of EGF/BPE. The proliferation of primary RTE cells propagated without
      EGF/BPE is inhibited by neutralizing TGF alpha antiserum and by a tyrphostin
      compound that blocks TGF alpha/EGF receptor tyrosine kinase activity. These
      results indicate that primary RTE cells utilize TGF alpha as an autocrine growth
      factor and that the autocrine pathway is regulated as a function of growth state
      of the cells. However, this pathway does not provide growth autonomy to primary
      RTE cells, since cultures remain dependent on exogenous EGF/BPE for sustained
      proliferation.

PMID- 1639866
TI  - Effect of protein and steroidal osteotropic agents on differentiation and
      epidermal growth factor-mediated growth of the CFK1 osseous cell line.
AB  - The effects of factors known to influence bone metabolism were examined using the
      osseous cell line CFK1. Parathyroid hormone (PTH) and dexamethasone (DEX)
      appeared to enhance the formation of cell foci of CFK1 cells in culture whereas
      retinoic acid (RA) caused a marked alteration in individual cell morphology. Bone
      morphogenetic protein (BMP-2) and PTH increased alkaline phosphatase activity,
      however, this index of differentiation was suppressed by epidermal growth factor
      (EGF), DEX, and RA. BMP-2 and EGF each stimulated DNA synthesis in a dose
      dependent manner and enhanced cell numbers, but, no synergistic response of EGF
      and BMP-2 was observed. PTH and DEX failed to significantly alter cell number or
      EGF-stimulated DNA synthesis or cell proliferation. Although RA treatment of CFK1
      cells resulted in a reduction in cell number compared to control, pretreatment
      with RA enhanced EGF-stimulated DNA synthesis and proliferative effects. At least
      part of this effect was by increasing the EGF receptor binding capacity of the
      cells. Furthermore, using cell cycle analysis, addition of EGF stimulated the
      progression of RA-treated cells into the DNA synthesis (S) phase with a reduced
      lag time. EGF and BMP-2, therefore, appear to exert a role in the expansion
      dynamics of the CFK1 population although BMP-2 may also enhance differentiation.
      PTH and DEX may act primarily to modulate the differentiated function of the CFK1
      cells. RA inhibited cell proliferation and may mediate differentiation towards a
      less established cell population with upregulation of EGF receptors. The CFK1
      cell model may, therefore, provide insight into microenvironmental control of
      growth and differentiation of precursor osseous cells.

PMID- 1639865
TI  - Characterization of metformin transport system in NIH 3T3 cells.
AB  - The biochemical properties of the metformin transport system were studied in NIH
      3T3 cells. 14C-metformin uptake appeared to be a sodium dependent process. Iso
      osmotical replacement of Na+ by choline chloride in the assay medium resulted in
      a decrease of metformin uptake. Amiloride (200 microM) inhibited the metformin
      transport by 35% in these cells. Gramicidin, a channel ionophore, was the most
      effective in inhibiting the metformin transport as compared to valinomycin, a
      mobile ion carrier, and Ca2+ ionophore (A 23187). Loading of cells with
      asparagine, ornithine, or polylysine did not influence the uptake process.
      However, the addition of lysine or arginine significantly stimulated the
      metformin uptake by NIH 3T3 cells. Similarly, the addition of metformin
      stimulated the arginine uptake by these cells, suggesting that metformin shares
      the y+ transport system. Metformin inhibited competitively the uptake of 14C
      spermidine, a molecule of the polyamine family, by NIH 3T3 cells, whereas the
      latter failed to influence the uptake of the former significantly by these cells.
      Incubation of NIH 3T3 cells in the presence of difluoromethyl-ornithine (a
      suicidal inhibitor of polyamine biosynthesis) stimulated the spermidine, but not
      the metformin, uptake by these cells. Interestingly, a prolonged incubation of
      these cells in the presence of metformin failed to down-regulate the spermidine
      transport process. The spermidine- and methylglyoxal-bis(guanylhydrazone), MGBG
      transport deficient (3T3MG) cells which do not accumulate exogeneous spermidine
      or MGBG, took up 14C-metformin. However, 14C-metformin uptake by 3T3MG cells was
      lower than that by normal NIH 3T3 cells.

PMID- 1639867
TI  - UV induction of transforming growth factor alpha in melanoma cell lines is a
      posttranslational event.
AB  - Low, mitogenic fluences of UVC (3.7-5.6 Jm-2) have previously been shown to cause
      increases of radioimmunoassayable transforming growth factor alpha (TGF alpha) in
      the medium and cells of cultures of melanocytes, melanoma lines, and HeLa cells
      (Ellem, K.A.O., Cullinan, M., Baumann, K.C., Dunstan, A.: Carcinogenesis 9:797
      801, 1988). Here the cellular mechanism of this increase is explored by Northern
      blotting to detect any changes in TGF alpha mRNA levels, and the use of
      inhibitors of macromolecular synthesis to attempt to block the increase in TGF
      alpha protein. We were unable to detect any increase in TGF alpha mRNA levels
      attributable to UVC between 2 and 24 hours after irradiation. Inhibition of DNA
      synthesis (arabinosylcytosine, 10 microM), RNA synthesis (actinomycin D, 3
      micrograms/ml; DRB 93 microM), or protein synthesis (cycloheximide, 10
      micrograms/ml) failed to prevent the UVC induced increase in TGF alpha. We
      conclude that the UVC induction of TGF alpha is by a posttranslational mechanism.
      There was considerable discordance between the amount of TGF alpha protein and
      its mRNA in cultures of 15 different melanoma cell lines, which again emphasized
      that posttranscriptional mechanisms modulate the release of immunodetectable TGF
      alpha. We also found that the inhibitors themselves were capable of inducing an
      increase in TGF alpha in MM229 cultures. This suggests that the inhibitors and UV
      may effect the increase by a common mechanism, perhaps the activation of cell
      surface proteases as suggested for other stimuli (e.g., Pandiella, A., and
      Massague, J.: Proc. Natl. Acad. Sci., USA 88:1726-1730, 1991) and that the
      response may be part of a global response to perturbation of DNA synthesis.

PMID- 1639868
TI  - Distinct mechanisms of zinc uptake at the apical and basolateral membranes of
      caco-2 cells.
AB  - Zinc uptake mechanisms at the apical and basolateral membrane borders of caco-2
      cells were examined. This human-derived cell line possesses many morphological
      and functional characteristics of absorptive small intestinal cells. By day 14,
      confluent and well-differentiated monolayers were formed when the cells were
      grown on porous polycarbonate filters. Labelled zinc was placed on the apical or
      basal side of the monolayer and its uptake by the cells, as well as its transport
      across the monolayer, were measured. Zinc uptake by the cells from the apical
      side was found to be a saturable process (Kt = 41 microM; Vmax = 0.3 nmols/cm2/10
      min) with a diffusional term at higher concentrations (1.0 sec/cm). Apical uptake
      was not affected by metabolic inhibitors or potential zinc ligands. Zinc uptake
      from the basolateral side was concentration dependent (Kd = 1.3 sec/cm) and was
      partially inhibited (30%) by ouabain and vanadate, suggesting that the (Na-K)
      ATPase on the basolateral membrane is involved in the serosal uptake of zinc by
      the cell. Transport of zinc across the monolayers from the apical or basolateral
      compartment was concentration dependent and was not affected by metabolic
      inhibitors. Zinc transport from the basolateral side was greater than 2-fold
      greater than apical transport. Hence, separate mechanisms can be distinguished
      with respect to zinc uptake at the apical and basolateral membranes of caco-2
      cells.

PMID- 1639869
TI  - Insulin-like growth factor-I (IGF-I) stimulates protein synthesis and collagen
      gene expression in monolayer and lattice cultures of fibroblasts.
AB  - Fibroblasts cultivated in three-dimensional tissue-like matrices are
      characterized by a slowed metabolism and a decrease of protein synthesis, unless
      they are submitted to physical tensions. We checked the effects of insulin like
      growth factor-I (IGF-I), known as a potent stimulator of mitogenesis and protein
      synthesis for many cell types, in various models of cultures: confluent
      monolayers, collagen lattices, non-retracting or retracting fibrin lattices. IGF
      I (1-100 ng.ml-1) had no effect on cell divisions in lattice cultures. It was
      able to stimulate collagen lattice retraction when the medium was supplemented
      with low concentrations of serum. IGF-I at 10 or 100 ng.ml-1 stimulated collagen
      and non-collagen syntheses in all culture systems, but stimulation of collagen
      synthesis only began at the highest concentration (100 ng.ml-1) in retracted
      lattices. Northern blot and dot-blot analyses of mRNAs extracted from monolayer
      cultures of fibroblasts showed that IGF-I stimulated pro alpha 1(I) collagen
      synthesis at the pretranslational level. Cycloheximide (7.5 micrograms.ml-1)
      completely inhibited pro alpha 1(I) collagen gene expression induced by IGF-I.
      These results show that IGF-I is a potent stimulus for protein synthesis and
      collagen gene expression in monolayers and tridimensional cultures of
      fibroblasts, but that it exerts no mitogenic activity in tridimensional lattices.
      Synergistic associations of IGF-I with other growth factors will have to be found
      in order to reverse the quiescent status of fibroblasts in lattices.

PMID- 1639870
TI  - Influence of cyclosporine A on growth and extracellular matrix synthesis of human
      fibroblasts.
AB  - Cyclosporine A (CyA) is a powerful nonsteroidal immunosuppressive agent used to
      prevent graft rejection of organ and bone marrow transplants. A major side effect
      observed can be attributed to the fibroblast and its functions: proliferation of
      fibroblasts and formation of fibrotic tissue in the gingiva (fibrous hyperplasia)
      and in the kidney are induced. The mechanism of both is still obscure. In order
      to elucidate whether these side effects are due to the drug acting on human
      fibroblasts itself or whether they are indirect ones mediated by factors released
      by lymphocytes, cultures of human gingiva fibroblasts were exposed to CyA under
      defined in vitro conditions. Incubation with CyA for 72 hours resulted in a dose
      dependent stimulation of DNA synthesis, whereas glycosaminoglycan (GAG) synthesis
      was slightly suppressed. Long-term incubation (6 weeks) with 1 micrograms/ml CyA
      resulted again in stimulation of growth parameters: compared to the drug-free
      control, cell number increased to 168%, incorporation of 3H-thymidine into DNA to
      143%, and overall protein content to 159%. Collagen and GAG synthesis were
      elevated to approximately 120%. When corrected for cell number or cell protein
      content, this represents a decline in matrix synthesis, comparable to short-term
      incubations. These results indicate that a direct effect of CyA on proliferation
      of human gingival fibroblasts is responsible for some of the observed
      hyperplasia.

PMID- 1639871
TI  - Signal transduction during liver regeneration: role of insulin and vasopressin.
AB  - The relationship between cell proliferation and inositol lipid turnover has been
      studied by comparing the steady state of inositol derivative metabolism in
      quiescent and regenerating rat hepatocytes isolated at 4 h (G1 phase of first
      cell cycle) and 24 h (onset of M phase) after partial hepatectomy. The effect of
      two hormones able to regulate hepatic regeneration, insulin and vasopressin, has
      been considered, and the results can be summarized as follows: (i) at 4 h after
      partial hepatectomy, the precursor incorporation into inositol polyphosphates and
      the particulate phospholipase C activity increase with respect to quiescent
      hepatocytes, whereas the content of 11, 4, 5P3 does not change, suggesting an
      increased turnover of this molecule in this step of cell cycle priming; (ii) 24 h
      after partial hepatectomy, the radioactivity linked to IP3 and IP4, as well as
      soluble and particulate phospholipase C activity, and IP3 content increase,
      suggesting the presence, at the onset of M phase, of second messenger
      accumulation; (iii) only 24 h after partial hepatectomy, the inositol derivative
      metabolism is affected by vasopressin; and (iv) insulin exerts a modulatory role
      on inositol polyphosphate production without involving membrane-bound PLC
      activity or phosphoinositide hydrolysis. These data suggest that inositol-derived
      signal molecules are associated with hepatic regeneration; moreover, the
      metabolic pathway of such compounds seems to be regulated so that only specific
      inositol phosphates are present in each step of the cell cycle.

PMID- 1639872
TI  - Competition between cell-substratum interactions and cell-cell interactions.
AB  - Clusterin, a glycoprotein which elicits the aggregation of a wide variety of
      cells (Fritz, I. B., and Burdy, K.:J. Cell Physiol., 140:18-28, 1989), has been
      utilized to investigate some of the factors modulating the competition between
      cell-substratum interactions and cell-cell interactions. We compared the
      responses to clusterin by anchorage-independent cells (erythrocytes) with those
      by anchorage-dependent TM4 cells (a cell line derived from neonatal mouse testis
      cells). Cells were maintained in culture in the presence of various substrata
      chosen to enhance cell-substratum interactions (laminin-coated wells), or to
      diminish cell-substratum interactions (agarose-coated wells). Results obtained
      showed that the aggregation of erythrocytes elicited by clusterin was independent
      of the nature of the substratum. In contrast, clusterin addition resulted in
      aggregation of anchorage-dependent TM4 cells only when TM4 cell-substratum
      interactions were weak. Thus, clusterin did not aggregate TM4 cells plated upon a
      laminin substratum, but readily aggregated TM4 cells plated upon an agarose
      coated substratum, independent of the sequence of addition of cells and clusterin
      to the culture dish. We utilized YIGSR, a peptide which competes with laminin for
      laminin receptors, to determine the possible role of laminin receptors on TM4
      cells in the competition between cell-substratum interactions and cell-cell
      interactions. The presence of YIGSR did not alter responses of erythrocytes to
      clusterin under all conditions examined. In contrast, the responses of TM4 cells
      to clusterin were greatly changed. YIGSR addition resulted in the inhibition of
      aggregation of TM4 cells otherwise elicited by clusterin. YIGSR also prevented
      attachment of TM4 cells to a laminin-coated surface, but this was reversed by the
      presence of clusterin. We discuss the possible roles of clusterin and laminin in
      altering the balance in the competition between cell to cell interactions and
      cell to substratum interactions.

PMID- 1639873
TI  - Transforming growth factor-beta 1 is a heparin-binding protein: identification of
      putative heparin-binding regions and isolation of heparins with varying affinity
      for TGF-beta 1.
AB  - Previous studies indicated that a major factor in heparin's ability to suppress
      the proliferation of vascular smooth muscle cells is an interaction with
      transforming growth factor-beta 1 (TGF-beta 1). Heparin appeared to bind directly
      to TGF-beta 1 and to prevent the association of TGF-beta 1 with alpha 2
      macroglobulin (alpha 2-M). The present studies indicate that 20-70% of iodinated
      TGF-beta 1 binds to heparin-Sepharose and the retained fraction is eluted with
      approximately 0.37 M NaCl. Native, unlabelled platelet TGF-beta 1, however, is
      completely retained by heparin-Sepharose and eluted with 0.9-1.2 M NaCl. Using
      synthetic peptides, the regions of TGF-beta 1 that might be involved in the
      binding of heparin and other polyanions were examined. Sequence analysis of TGF
      beta 1 indicated three regions with a high concentration of basic residues. Two
      of these regions had the basic residues arranged in a pattern homologous to
      reported consensus heparin-binding regions of other proteins. The third
      constituted a structurally novel pattern of basic residues. Synthetic peptides
      homologous to these three regions, but not to other regions of TGF-beta 1, were
      found to bind to heparin-Sepharose and were eluted with 0.15 M-0.30 M NaCl. Only
      two of these regions were capable of blocking the binding of heparin to 125I-TGF
      beta. Immobilization of these peptides, followed by affinity purification of
      heparin, indicated that one peptide was capable of isolating subspecies of
      heparin with high and low affinity for authentic TGF-beta 1. The ability of TGF
      beta 1 to bind to heparin or related proteoglycans under physiological conditions
      may be useful in understanding the biology of this pluripotent growth and
      metabolic signal. Conversely, a subspecies of heparin molecules with high
      affinity for TGF-beta 1 may be a factor in some of the diverse biological actions
      of heparin.

PMID- 1639874
TI  - A shrinking world.

PMID- 1639875
TI  - Advances in paediatric pharmacotherapy.
AB  - Marked differences in body composition and organ function development have been
      demonstrated among neonates, infants, and children versus adults. Specific dosage
      guidelines for the paediatric population, however, are still not available for
      the majority of marketed drugs. Much needs to be learned about the
      pharmacokinetics, pharmacodynamics, comparative efficacy and safety of drugs in
      infants and children. Recent developments in paediatric therapeutics include the
      availability of several new antibiotics for the treatment of infections
      including, streptococcal pharyngitis, otitis media, bacterial meningitis, herpes
      encephalitis, neonatal herpes, and AIDS. Corticosteroids and intravenous
      immunoglobulin have become important adjunctive treatments for certain
      infections. A variety of drugs are available to treat asthma but the mortality
      due to this disease is still increasing. The identification of a gene defect in
      patients with cystic fibrosis could lead to more effective treatment in the
      future. Ondansetron, marketed for use in adults only, shows promise as a more
      effective and safer antiemetic in children receiving cancer chemotherapy.
      Numerous drugs are not available in suitable dosage forms for paediatric use and
      extemporaneous formulations are required. Documentation on the stability of the
      reformulated drugs is therefore needed. Studies have shown that the methods used
      for intravenous delivery can influence the serum concentrations of drugs in
      infants and children. Large numbers of children could be saved worldwide solely
      with improved vaccination and control of diarrhoea. Despite this, it is
      encouraging to witness the continued advances being made in paediatric
      pharmacotherapy.

PMID- 1639876
TI  - Hypertension, coronary artery disease and insulin resistance--linked disorders
      with an impact on treatment.
AB  - Coronary artery disease is a very common disorder for which hypertension is a
      well-recognized risk factor. However many trials of antihypertensive therapy have
      failed to demonstrate a reduction in the incidence of coronary events. One
      explanation is that hypertension is a disorder associated with hyperinsulinaemia,
      obesity and non-insulin dependent diabetes. Furthermore certain antihypertensive
      drugs, notably thiazide diuretics, increase the hyperinsulinaemia and thereby
      increase one of the other coronary risk factors. In this review the links between
      hypertension and hyperinsulinaemia are explored and the mechanisms whereby an
      increased plasma insulin can lead to the more rapid development of coronary
      artery disease are explained. These observations may influence the choice of
      drugs used to treat hypertension.

PMID- 1639877
TI  - Thioethers in urine of sterilization personnel exposed to ethylene oxide.
AB  - Biological monitoring of exposure to ethylene oxide (EO) was carried out in 31
      hospital workers in the sterilization facilities of five hospitals. The excretion
      of total thioethers was determined in the urine of sterilization workers. An
      occupational nonexposed group served as a control (n = 31). The air EO level was
      not monitored routinely, however, peak concentrations of EO up to 200 p.p.m. were
      detected mainly when the sterilization chambers were open. Our results show a
      significant difference in urinary thioether excretion between the exposed and
      control groups (P less than 0.001). Sterilization workers seem to absorb
      significant quantities of EO. We feel that other alternative and more sensitive
      methods for detecting thioether metabolites of EO should be carried out to
      confirm our results.

PMID- 1639878
TI  - Inappropriate digoxin monitoring.
AB  - The digoxin therapeutic drug monitoring service was evaluated during a 7-week
      period at Leeds General Infirmary. Data were collected for 88 patients who had
      one or more assays performed. The requesting clinician was contacted for each
      assay, and a questionnaire completed. Results were assessed to determine the
      appropriateness of the assay request and the action taken following receipt of
      the result. During the assessment period, 113 serum digoxin assays were
      requested. Data were collected for 88 (78%) of these, of which 22 (25%) were
      considered to have met all the criteria for an appropriate assay request and
      subsequent action. A total of 66 (75%) serum digoxin assays were assessed as
      wasted. The digoxin therapeutic drug monitoring service is used inappropriately
      at Leeds General Infirmary.

PMID- 1639879
TI  - Lack of effect of codeine in the treatment of cough associated with acute upper
      respiratory tract infection.
AB  - Codeine is often used as a standard antitussive against which new antitussives
      are compared. However there is little information available about the effects of
      codeine on cough associated with upper respiratory tract infection. The present
      study investigated the effects of codeine syrup B.P. (30 mg/10 ml, q.d.s.) or
      syrup vehicle on cough frequency and the subjective severity of cough during a 3
      h laboratory phase and a 4-day home phase of treatment. Cough frequency and
      subjective scores of cough severity were significantly decreased during the 3-h
      laboratory phase but at no time point was there a significant difference between
      the codeine- and placebo-treated groups. The results of the 4-day home phase
      diary were similar to those of the laboratory phase as at no time point was there
      a significant difference between the mean scores for the codeine- and placebo
      treated groups. The results indicate that codeine, either as a single 30-mg dose
      or in a total daily dose of 120 mg, is no more effective than the syrup vehicle
      in controlling cough associated with acute upper respiratory tract infection.

PMID- 1639880
TI  - Stability of mupirocin ointment (Bactroban) admixed with other proprietary
      dermatological products.
AB  - This study involved the mixing of 1:1 combinations of Bactroban (mupirocin)
      Ointment 2% with various cream, lotion, ointment, gel, solution and liquid soap
      formulations with storage at 37 degrees C for 60 days. The mixtures were assayed
      for mupirocin content at 0, 15, 30, 45 and 60 days using a high-pressure liquid
      chromatographic (HPLC) assay. At the time of preparation of these admixtures,
      Bactroban Ointment is chemically and physically compatible with all of the
      topical dermatological products studied except for Valisone lotion where a
      physical incompatibility is immediately observed. Admixtures of Hibiclens liquid
      soap or Lotrimin solution with Bactroban Ointment were stable throughout the
      entire 60-day study. Combinations of Lotrimin cream, Hytone cream, Valisone
      ointment or Vytone cream with Bactroban Ointment also retained chemical stability
      of mupirocin for the entire period even though two layers were observed and
      mixing was required to restore a physically homogenous mixture. Other Bactroban
      Ointment admixtures were found to be either chemically stable for mupirocin for
      periods less than 60 days or physically incompatible mixtures were observed upon
      storage. No conclusions were drawn from these studies concerning the efficacy or
      safety of any of these products when used in extemporaneously prepared
      combinations.

PMID- 1639881
TI  - Stability of captopril in some aqueous systems.
AB  - A stability-indicating high performance liquid chromatographic method has been
      proposed to quantify captopril. The method has been used to determine the
      stability of captopril in oral liquid dosage forms prepared from either
      commercially available tablets or powder. The dosage forms in water were more
      stable than when the vehicle was a syrup. Furthermore, the dosage form prepared
      using powder in water was more stable than when tablets were used. While the
      decomposition of captopril followed first-order equation when the dosage forms
      were prepared in syrup (in two of the three solutions studied), this equation was
      not followed when water was the vehicle. This is probably due to an uncontrolled
      factor, oxygen, because captopril is very sensitive to oxidation. Captopril
      solution prepared in water using tablets was stable for about 20 days when stored
      at 5 degrees C, and that prepared using powder in water was stable for about 27
      days. One commercial syrup hastened the process of decomposition with an
      additional unidentified product of decomposition.

PMID- 1639882
TI  - The decomposition of phenylmercuric nitrate caused by disodium edetate in
      neomycin eye drops during the process of heat sterilization.
AB  - High-performance liquid chromatographic (HPLC) assays have been developed for
      phenylmercuric nitrate and mercuric ions in the presence of disodium edetate.
      Application of these methods to neomycin eye drops of the Pharmaceutical Codex
      and Australian Pharmaceutical Formulary, which contain both phenylmercuric
      nitrate and disodium edetate, show that edetate promotes approximately 20%
      decomposition of the phenylmercuric nitrate in the drops of the Pharmaceutical
      Codex but little in the drops of the Australian Pharmaceutical Formulary during
      sterilization by the recommended method. The reason for the stability of the
      organomercurial in the Australian product was determined as being due to the
      presence of sodium chloride in the formulation.

PMID- 1639883
TI  - [A new surgical method for chronic pancreatitis: Vankemmel's wirsungo
      sphincteroclasis (50 cases)].
AB  - Since 1986, Vankemmel M. has been advocating, in case of severe chronic
      pancreatitis with dilatation, even slight, of the pancreatic duct without
      associated cavity formation, to carry out wirsungosphincteroclasis (W-SC): 50
      cases. This original technique includes a short cephalic wirsungotomy followed by
      the removal of canal obstruction by transampullary wirsungoduodenal caliber
      restoration, then a temporary wirsungonasal drainage. This procedure has been
      associated to a biliodigestive anastomosis in 27 cases, including 25 cases in
      which a gallbladder loop was used. RESULTS: Only one patient (2%) who had already
      been treated with caudal splenopancreatectomy with pancreaticojejunal anastomosis
      and presented with portal thrombosis and compression of the common bile duct,
      died of mesentericointestinal infarction during the postoperative period. During
      the first month, no pancreatic fistula was noted but 3 patients were operated
      again: one at D3 to reposition the torn-off wirsungonasal drain, one for
      angiocholitis requiring a biliodigestive anastomosis, and the third one for acute
      intestinal obstruction. Later on, only 4 patients (8%) were operated on
      successfully (3rd, 16th, 20th, 33rd month) to complete the removal of canal
      obstruction.

PMID- 1639884
TI  - [Fatal hydatid pulmonary embolism during hepatectomy for hydatid cyst. Apropos of
      a case].
AB  - Liver Hydatid cysts located close to the inferior vena cava and the sus-hepatic
      veins are known for their risk of rupture inside these veins. The authors report
      the case of a patient who died from massive pulmonary embolism during the
      surgical treatment (hepatectomy) of liver hydatid cysts. Diagnosis and treatment
      of these fistula are reviewed.

PMID- 1639885
TI  - [Splenosis after splenic rupture: a disease to be recognized].
AB  - One case of peritoneal splenosis is reported. The diagnosis was established at
      surgery in a 17-year-old female patient presenting with dull abdominopelvic pain,
      who had undergone total splenectomy after a trauma ten years earlier. This
      autograft of splenic tissue must be known to be acknowledged, especially today,
      when the conservative treatment advocated for ruptures of the spleen may increase
      its incidence. The literature reports only about one hundred cases. The treatment
      only consists in removing the sole symptomatic nodules.

PMID- 1639886
TI  - [Problems posed by the inferior vena cava in liver transplantation].
AB  - On the basis of a 200-case series, we report about the problems posed by the
      inferior vena cava for liver transplantation, and about the means implemented to
      solve these problems. Before hepatic transplantation, agenesia of the vena cava,
      which was encountered once, did not prevent grafting. During transplantation, the
      inferior vena cava posed problems due to its size or to the approach. These were
      solved using an extracorporeal venovenous shunt, which we advocate to
      systematically use for liver transplantation. Following transplantation, in
      addition to hemorrhages, the problems posed by the IVC included supra- or
      infrahepatic anastomotic stenoses (2 cases) and infrarenal, retrohepatic or
      suprahepatic thromboses (2 cases). Their repair again resorted to a venovenous
      shunt, for which we specify the strategy of use.

PMID- 1639887
TI  - [Bacterial endocarditis complicated by popliteal and mesenteric aneurysms].
AB  - The authors report about one case of bacterial endocarditis complicated by fungal
      aneurysms in a superior mesenteric and a popliteal site. While the diagnosis was
      easy for the popliteal aneurysm, it was not so for the mesenteric aneurysm.
      Arteriography must have wide indications. The treatment of such aneurysms must
      always be medical, but surgical as well. The surgical tactics must be carefully
      discussed, and the restoration of vascular continuity with autologous venous
      material through an extra-anatomic course should be preferred.

PMID- 1639888
TI  - [Cancer of the urachus. A rare form of tumors of the bladder].
AB  - Cancers of the middle umbilical fold are very infrequent, making up 0.1% to 0.7%
      of all bladder tumors. This type of tumor affects male subjects in 60% to 75% of
      cases, in the 5th or 6th decade of life. In more than 90% of all cases, the
      lesion is a mucosecretory adenocarcinoma developing from embryonic remains within
      the wall of the bladder and respecting the superficial urothelium of the bladder,
      which is affected only secondarily, contrary to what occurs in the other
      adenocarcinomas of the bladder. The pathogenesis remains controversial,
      especially the role of middle umbilical fold patency and of bladder carcinogens.
      The diagnosis is most often established late, because of a long clinical latency.
      It is mainly based on ultrasonography and computed tomography. Explorations of
      the bladder are useful only at an advanced stage. The prognosis is very poor,
      survival at 5 years ranging from 6.5% to 25% according to the authors. The
      treatment is mainly surgical. Only extensive exeresis with partial cystectomy
      extending to the peri- and supravesical environment, including the peritoneum and
      the umbilicus, and associated with pelvic lymphadenectomy may give some hope.
      Chemotherapy and radiation therapy, either alone or complementary, are
      disappointing. The prognosis may be improved only by an early diagnosis.

PMID- 1639889
TI  - [Necrotizing fasciitis: a medical and surgical emergency. Apropos of a case].
AB  - We report about a 66-years-old obese and diabetic female patient, treated with
      anti-inflammatories for osteoarthritis of the hip and operated for varices of the
      lower limbs by a bilateral stripping of the internal saphenous veins, who
      presented with a mortal necrotizing fasciitis during the postoperative period.
      Necrotizing fasciitis is a severe, infrequent disease jeopardizing the vital
      prognosis, in which an appropriate and early treatment (medical, using
      antibiotics, and surgical by extensive debridement) can prevent a fatal outcome.
      The most often involved germs are streptococci (45%). The association of
      anaerobic and aerobic germs sometimes causes mixed cellulitis. The vital
      prognosis is always threatened by postoperative fasciitis. The mortality rate
      ranges from 50 to 75%, the main causes of death being a septic shock or pulmonary
      embolism. The functional prognosis of the surviving patients depends on the
      extent and quality of surgery.

PMID- 1639890
TI  - [Regional portal hypertension revealing malignant adrenal cortical carcinoma].
AB  - The authors report a rare case of regional portal hypertension secondary to
      splenic vein obstruction by left adrenal carcinoma metastasis. They review the
      principal literature data concerning regional portal hypertension and adrenal
      cortical carcinoma.

PMID- 1639891
TI  - [Subtalar prosthesis. Operative technique and first results].
AB  - Subtular arthrodesis is the only surgical procedure used in case of post
      traumatic arthrosis following fractures of the os calcis. The author proposes an
      original technique, which allows restoring the mobility of the hindfoot and
      suppressing pain: the subtalar prosthesis is described, as well as the surgical
      procedure. The short-term results for a series of five patients are very
      satisfactory.

PMID- 1639892
TI  - Assessment of the biotransformation of the cardiotonic agent piroximone by high
      performance liquid chromatography and gas chromatography-mass spectrometry.
AB  - 14C-labelled piroximone was administered to rats at a dose of 10 mg/kg body
      weight. Of the total radioactivity administered, 74.9 +/- 7.9% (n = 4) and 87.8
      +/- 1.7 (n = 3) were recovered in the 8-h urine collection after oral and
      intravenous administration, respectively. Two major metabolites, M1 and M2, were
      detected in methanol extracts and accounted for 7.1 +/- 1.2% (n = 4) (M1) and 4.3
      +/- 0.4% (n = 4) (M2) in response to oral administration and 5.7 +/- 0.8% (n = 3)
      (M1) and 6.7 +/- 2.0% (n = 3) (M2) in response to intravenous administration. In
      addition, three minor metabolites were detected; M3 and M4 in the 8-h urine
      collection and M5 in the 12-h urine collection. Separation of piroximone and
      metabolites was achieved by high-performance liquid chromatography on a C18
      column by gradient elution with 0.05 M ammonium acetate (pH 7) using 0-60%
      methanol over 20 min at a flow-rate of 1 ml/min, followed by isocratic elution
      with 60% methanol for 10 min. M1 and M2 were isolated by fraction collection
      following the addition of 1 mM tetrabutylammonium acetate in the mobile phase.
      Between each injection a column re-equilibration time of 45 min was necessary to
      achieve optimum collection of M1 and M2 fractions. Gas chromatography-mass
      spectrometry of M1 provided evidence for a molecular structure consistent with
      isonicotinic acid methyl ester. Corroborative evidence for this identification
      was obtained by comparison with a synthetic standard. Isonicotinic acid is
      assumed to be the actual metabolite while esterification with methanol had
      occurred as a result of the work-up procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639893
TI  - High-performance liquid chromatography of amino acids, peptides and proteins.
      CXV. Thermodynamic behaviour of peptides in reversed-phase chromatography.
AB  - The thermodynamic behaviour of three peptides, bombesin, beta-endorphin and
      glucagon, was studied under reversed-phase high-performance liquid
      chromatographic conditions. Experimental data related to the interactive surface
      contact area (S values) and solute affinity (log k0) were derived over a range of
      temperatures between 5 and 85 degrees C. These experimental conditions allowed
      changes in the secondary structure of the solute to be monitored. The influence
      of the nature of the stationary phase ligand on the relative conformational
      stability of the three peptides was analysed by acquiring data with n-octadecyl
      silica (C18) and n-butyl silica (C4) sorbents. Values for the relative changes in
      entropy and enthalpy associated with the interactive process were also
      determined. The results provide further insight into the factors involved with
      the stabilization of secondary structure and the mechanism of the interaction of
      peptides with hydrophobic surfaces.

PMID- 1639894
TI  - Direct determination of kallikrein by high-performance liquid chromatography.
AB  - A direct and specific identification of porcine pancreatic kallikrein by high
      performance hydrophobic chromatography is proposed; the minimum amount which can
      be injected is 2.5 U. An application to the quantitative determination of the
      enzyme by high-performance size-exclusion chromatography is reported; the method
      is precise with a mean coefficient of variation of 2.8% and the minimum amount
      which can be injected is 0.02 U of kallikrein. The results obtained with
      determinations in real biological samples (porcine pancreatic powder and human
      urine) are reported. The method is based on direct and specific chromatographic
      signals and does not destroy the biological activity of this enzyme.

PMID- 1639895
TI  - Isolation and characterization of alpha-glucosidase from Aspergillus niger.
AB  - alpha-Glucosidase is an enzyme widely used in biochemical analytical methods.
      Aspergillus niger was selected as a potential source for its production.
      Conditions for glucosidase production were optimized and the enzyme was isolated
      from the culture supernatant by dialysis and anion-exchange chromatography. The
      activity of the enzyme was determined by maltose hydrolysis to glucose, which was
      determined using a glucose-specific electrode or by high-performance liquid
      chromatography. The isolated enzyme was further characterized by sodium dodecyl
      sulphate-polyacrylamide gel electrophoresis, substrate specificity and fast
      protein liquid chromatography. The Michaelis constant, optimal temperature and
      stability of the enzyme preparation were determined.

PMID- 1639896
TI  - Reversed-phase high-performance liquid chromatography-thermospray mass
      spectrometry of radiation-induced decomposition products of thymine and
      thymidine.
AB  - High-performance liquid chromatography-thermospray mass spectrometry was applied
      to the analysis of various radiation-induced decomposition products of thymidine
      including N-(2-deoxy-beta-D-erythro-pentofuranosyl)formamide and the various
      diastereomers of 5,6-dihydroxy-5,6-dihydrothymidine, 5-hydroxy-5,6
      dihydrothymidine and 5,6-dihydrothymidine. This method combines high sensitivity
      and product resolution, rendering it particularly useful for monitoring the
      formation of radiation-induced base damage within DNA.

PMID- 1639897
TI  - Improved determination of individual molecular species of phosphatidylcholine in
      biological samples by high-performance liquid chromatography with internal
      standards.
AB  - Phosphatidylcholine isolated from samples of bile, liver and plasma was converted
      into 1,2-diradylglycerobenzoate molecular species by hydrolysis with
      phospholipase C and reaction with benzoic anhydride. Up to seventeen molecular
      species were separated and determined by reversed-phase high-performance liquid
      chromatography with detection at 230 nm. The major improvement introduced here
      was the use of distearoylphosphatidylcholine as the internal standard, which
      corrected the results for incomplete hydrolysis and benzoylation. Other
      improvements concerned the clean-up of benzoyl derivatives and the
      chromatographic separation. The analytical results obtained were validated by
      comparison with the results of either lipid phosphorus or gas chromatographic
      determinations.

PMID- 1639898
TI  - Determination of benzene metabolites in urine of mice by solid-phase extraction
      and high-performance liquid chromatography.
AB  - A method was developed for quantitative measurement of trans,trans-muconic acid,
      catechol, hydroquinone and phenol in urine. Hydrolysis of esterified and
      glucuronized phenolic compounds was effected by specific enzymes. The hydrolysed
      mixture was purified and separated by solid-phase extraction with an anion
      exchanger, followed by extraction with diethyl ether. By using a clean-up
      procedure the natural background from mouse urine could be reduced, so that the
      detection limit of the metabolites was in the range 3-60 mg/l. Optimization of
      the chromatographic conditions resulted in a short high-performance liquid
      chromatography analysis time. Phenol had the longest retention time of about 10
      min. The clean-up procedure could also be used for phenylmercapturic acid, an
      additional benzene metabolite, but for sensitive high-performance liquid
      chromatographic detection of phenylmercapturic acid other conditions are
      necessary.

PMID- 1639899
TI  - High-performance liquid chromatographic determination of penicillin G, penicillin
      V and cloxacillin in beef and pork tissues.
AB  - The objective was to develop confirmatory high-performance liquid chromatographic
      methods for penicillin residues in animal tissues with detection limits of less
      than or equal to 10 ng/g. A previously described procedure was modified by using
      a larger sample size and isocratic analysis. Tissues (15 g) were blended with 45
      ml of water and 20 ml of homogenate were mixed with 40 ml acetonitrile and
      filtered. The filtrate (30 ml) was mixed with 10 ml of 0.2 M H3PO4 and extracted
      with methylene chloride. The combined methylene chloride layers were mixed with
      acetonitrile and hexane, washed with two 4-ml portions of water and then
      extracted with four 1-ml portions of 0.01 M phosphate buffer (pH 7). The combined
      buffer extracts were concentrated to 1 ml under reduced pressure. Analysis was
      isocratic during 0.01 M phosphate buffer (pH 7)-acetonitrile with proportions
      85:15 (penicillin G), 82:18 (penicillin V) or 78:22 (cloxacillin). A polystyrene
      divinylbenzene copolymer column, 150 x 4.6 mm I.D. (Polymer Labs. PLRP-S), was
      used with a flow-rate of 1 ml/min and detection at 210 nm. The presence of
      penicillins was confirmed by treating a duplicate sample with penicillinase.
      Recoveries were greater than 90% in most instances. Detection limits were 5 ng/g
      in muscle and higher in liver and kidney. The procedure is a simple and sensitive
      method for confirming the presence of penicillins in animal tissues.

PMID- 1639900
TI  - Determination of inositol polyphosphates from human T-lymphocyte cell lines by
      anion-exchange high-performance liquid chromatography and post-column
      derivatization.
AB  - The intracellular amounts of several inositol tris-, tetrakis- and
      pentakisphosphates and inositol hexakisphosphate were determined in resting and
      stimulated cells from human T-lymphocyte lines. The inositol polyphosphates were
      separated by anion-exchange high-performance liquid chromatography and were
      detected on-line by a recently developed post-column dye system. In the human T
      lymphocyte cell line Jurkat, basal intracellular concentrations ranged between 25
      +/- 10 pmol per 10(9) cells for inositol 1,4,5-trisphosphate to 6380 +/- 355 pmol
      per 10(9) cells for inositol hexakisphosphate. Similar basal concentrations were
      observed in the human T-lymphocyte cell line HPB.ALL, with the exception that
      inositol hexakisphosphate was approximately 665 +/- 10 pmol per 10(9) cells.
      Stimulation of the human T-lymphocyte cell line Jurkat via the T-cell receptor by
      a monoclonal antibody directed against the T-cell receptor-CD3 complex induced
      time-dependent changes in the intracellular concentrations of multiple inositol
      polyphosphate isomers, including inositol 1,3,4-trisphosphate, inositol 1,3,4,5
      tetrakisphosphate, inositol 1,3,4,6-tetrakisphosphate, an as yet unidentified
      inositol tetrakisphosphate isomer, inositol 1,3,4,5,6-pentakisphosphate, inositol
      1,2,3,4,6-pentakisphosphate and DL-inositol 1,2,4,5,6-pentakisphosphate. Inositol
      1,4,5-trisphosphate increased only transiently after 5 min, whereas DL-inositol
      1,4,5,6-tetrakisphosphate (determined as the enantiomeric mixture) increased
      after 20 min.

PMID- 1639901
TI  - Separation of flavonol-2-O-glycosides from Calendula officinalis and Sambucus
      nigra by high-performance liquid and micellar electrokinetic capillary
      chromatography.
AB  - Calendula officinalis and Sambucus nigra flowers were analysed by reversed-phase
      high-performance liquid chromatography (RP-HPLC) and micellar electrokinetic
      capillary chromatography (MECC). RP-HPLC was performed on C8 Aquapore RP 300
      columns with eluents containing 2-propanol and tetrahydrofuran. MECC was carried
      out on a 72-cm fused-silica capillary using sodium dodecyl sulphate and sodium
      borate (pH 8.3) as the running buffer. The results obtained by these techniques
      are compared.

PMID- 1639902
TI  - High-performance liquid chromatographic method with fluorescence detection for
      the determination of total homocyst(e)ine in plasma.
AB  - A high-performance liquid chromatographic method for the determination of total
      plasma homocyst(e)ine [H(e)] after reduction with sodium tetrahydroborate and
      precolumn derivatization with o-phthaldialdehyde is described. The analyses,
      carried out on a reversed-phase C18 column, were based on spectrofluorimetric
      detection. The sensitivity was 1 pmol per injection and the intra- and inter
      assay relative standard deviations were 1.8% and 5%, respectively. The plasma
      H(e) concentration determined in 40 healthy volunteers (20-60 years old) was 12.4
      +/- 2.9 microM (mean +/- S.D.), in good agreement with reference values.

PMID- 1639903
TI  - Determination of catecholamines in urine by liquid chromatography and
      electrochemical detection after on-line sample purification on immobilized
      boronic acid.
AB  - Norepinephrine, epinephrine and dopamine in urine were measured by an automated
      liquid chromatographic method. After sample purification on a column containing
      silica-immobilized boronic acid, which showed great affinity for catecholamines
      at neutral pH, the catecholamines were eluted by backflushing with an acidic
      mobile phase and transferred to a cation exchanger for separation. Detection was
      performed electrochemically and the relative standard deviation was 2% for the
      analysis of endogenous concentrations in human urine.

PMID- 1639904
TI  - Determination of cinnamic acid and paeoniflorin in traditional Chinese medicinal
      preparations by high-performance liquid chromatography.
AB  - A high-performance liquid chromatographic method for the determination of
      cinnamic acid in Cinnamomi ramulus and paeoniflorin in Paeoniae radix was
      established. The samples were separated by a LiChrospher RP-18 column with water
      acetonitrile-methanolacetic acid (61:34:5:0.1 or 80:15:5:0.1, v/v) as the mobile
      phase at a flow-rate of 1.0 ml/min. Cinnamic acid and paeoniflorin were
      determined by UV detection at 280 and 250 nm, respectively. The method was
      applied to determine the optimum conditions for the extraction of the traditional
      Chinese medicinal preparation Huang Chi Chien Chung Tong, which contains
      Cinnamomi ramulus and Paeoniae radix. The results indicate that the best
      extraction conditions involved the use of an ultrasonic bath at 60 degrees C for
      30 min. In this experiment, butyl paraben and methyl paraben were used as the
      internal standards for cinnamic acid and paeoniflorin, respectively. A good and
      reproducible separation of cinnamic acid and paeoniflorin was obtained within 15
      min. The method was also applicable to other preparations that contain Cinnamomi
      ramulus and Paeoniae radix such as Guey Chi Chia Long Ku Muu Li Tong, Kuei Chi
      Chien Chung Tong and Tang Kuei Chien Chung Tong.

PMID- 1639905
TI  - Use of high-performance liquid chromatographic peak deconvolution and peak
      labelling to identify antiparasitic components in plant extracts.
AB  - Artemisia absynthium L. is a commonly used medicinal plant for parasitic diseases
      all over the world. By means of high-performance liquid chromatography with diode
      array detection and the PU6100 solvent optimization system, two sesquiterpene
      lactones, alpha-santonin and ketopelenolid-A, were tentatively identified in
      methanolic extracts of this plant. alpha-Santonin is a well known antiparasitic
      compound and could be one of the active principles of this plant species.
      Reconstructed spectra are potentially useful in scanning a complex chromatogram
      for pharmacologically active compounds.

PMID- 1639906
TI  - Automated high-performance liquid chromatographic method for the determination of
      rifampicin in plasma.
AB  - Due to the unstable nature of rifampicin, a rapid automated high-performance
      liquid chromatographic method had to be developed for the analysis of a large
      number of plasma samples generated during a bioavailability trial. Extraction and
      injection of the samples were automatically done by a sample preparation system
      using C2, 100 mg Bond Elut extraction columns. The extracts were chromatographed
      on a 4-microns reversed-phase C18 column with a citrate buffer and acetonitrile
      as mobile phase. The analytes were detected at 342 nm. Calibration curves were
      linear to at least 20 micrograms/ml and the limit of quantification was 0.16
      micrograms/ml.

PMID- 1639907
TI  - Improved high-performance liquid chromatographic method for the determination of
      coenzyme Q10 in plasma.
AB  - Coenzyme (Co) Q10 was dissociated from lipoproteins in plasma by treatment with
      methanol and extraction with n-hexane. Subsequent clean-up on silica gel and C18
      solid-phase extraction cartridges with complete recovery (99 +/- 1.2%) produced a
      clean extract. High-performance liquid chromatographic (HPLC) separation was
      performed on a C18 reversed-phase column. Three simple, rapid procedures are
      presented: HPLC with final UV (275 nm) detection, a microanalysis utilizing a
      three-electrode electrochemical detector and a microanalysis with column
      switching HPLC and electrochemical detection. The methods correlate very well
      with classical ethanol-n-hexane extraction with UV detection. The identity and
      purity of the Co Q10 peak were investigated and the resulting methods were
      concluded to be suitable for total plasma Co Q10 determination. The average level
      in healthy subjects was 0.80 +/- 0.20 mg/l; the minimum detectable Co Q10 plasma
      level was 0.05 and 0.005 mg/l for UV and electrochemical detection, respectively.
      The methods were applied to many samples and the plasma Co Q10 reference values
      for healthy subjects, athletes, hyperthyroid, hypothyroid and
      hypercholesterolaemic patients are given.

PMID- 1639908
TI  - High-performance liquid chromatographic analysis of FCE 24304 (6-methylenandrosta
      1,4-diene-3,17-dione) and FCE 24928 (4-aminoandrosta-1,4,6-triene-3,17-dione),
      two new aromatase inhibitors.
AB  - The cytochrome P-450-dependent aromatase enzyme plays an important role in
      hormone-dependent diseases. Many products that inhibit this type of enzyme were
      obtained: FCE 24304 (I) and FCE 24928 (II) proved to possess remarkable activity
      and are presently under development. Compounds I and II and their synthetic
      intermediates are analyzed by means of a high-performance liquid chromatographic
      method, affording rapid and efficient separation, good resolution and
      identification of all the examined compounds. The linearity, specificity,
      sensitivity, precision and accuracy for the method are also provided.

PMID- 1639909
TI  - Determination of substituted purines in body fluids by micellar electrokinetic
      capillary chromatography with direct sample injection.
AB  - Many substituted purines (theobromine, caffeine, paraxanthine, theophylline and
      uric acid, as well as other methylated xanthines and uric acids) can easily be
      separated and analysed in one run using micellar electrokinetic capillary
      chromatography with a boratephosphate buffer containing 75 mM sodium dodecyl
      sulphate (pH approximately 9). Serum, saliva and urine samples collected after
      the self-administration of caffeine and serum samples from patients receiving
      theophylline or caffeine pharmacotherapy were screened for substituted purines.
      The data presented show the ease of using on-column multi-wavelength detection
      for investigating the feasibility of direct sample application, the
      characterization of sample pretreatment procedures and peak confirmation by
      comparing absorption spectra. It is shown that the determination of purines in
      serum and saliva samples, including therapeutic concentrations of caffeine and
      theophylline, can be accomplished without any sample pretreatment, whereas sample
      extraction is required for the determination of purines in urine. Quantitative
      data for the determination of micromolar amounts of theophylline (samples from
      adult patients) and caffeine (samples from infants born prematurely) in serum
      samples compared well with data obtained by non-isotopic immunoassays. Micellar
      electrokinetic capillary chromatography with the direct injection of serum or
      saliva samples requires only microlitre volumes of sample and several different
      compounds can be determined within a few minutes.

PMID- 1639910
TI  - Prediction of migration behavior of oligonucleotides in capillary gel
      electrophoresis.
AB  - The influence of the primary structure (base composition) on the electrophoretic
      migration properties of single-stranded oligodeoxyribonucleotides in capillary
      polyacrylamide gel electrophoresis was investigated using homo- and
      heterooligomers under denaturing and non-denaturing conditions.
      Homooligodeoxyribonucleotides of equal chain lengths but of different base
      composition showed significant differences in mobility. In addition, the
      migration properties of heterooligomers were found to be highly dependent on
      their base composition. A simple equation is presented for predicting relative
      migration times using denaturing and non-denaturing polyacrylamide capillary gel
      electrophoresis. Orange-G was used as an internal standard and as the basis of
      the relative migration time calculations. Examples are presented using homo- and
      heterooligomers in the 10-20-mer range to show the correlation of the primary
      structure and their predicted and observed migration rates.

PMID- 1639911
TI  - Simple reversed-phase high-performance liquid chromatographic method for 13-cis
      retinoic acid in serum.
AB  - An isocratic reversed-phase high-performance liquid chromatographic method for
      the analysis of 13-cis-retinoic acid in serum is developed. Sample preparation
      includes deproteination with acetonitrile-perchloric acid-acetic acid followed by
      centrifugation. 9-Methylanthracene is used as the internal standard.
      Chromatographic separation is achieved on a C18 column (Zorbax) using an
      acetonitrile-aqueous 0.5% acetic acid (85:15, v/v) eluent containing 0.05% (w/v)
      sodium hexanesulfonate. The limit of detection is 12 ng/ml in serum, using 0.5 ml
      samples. Quantitative recoveries and excellent intra-day and inter-day precision
      are reported.

PMID- 1639912
TI  - Stability studies with a high-performance liquid chromatographic method for the
      determination of a new anthracycline analogue, 3'-deamino-3'-[2-(S)-methoxy-4
      morpholino)doxorubicin (FCE 23762), in the final drug formulation.
AB  - A high-performance liquid chromatographic method was studied to optimize the
      separation of FCE 23762, a new antitumour agent, from both synthetic impurities
      and degradation products having very similar molecular structures. The main
      problems faced in the analytical method development using the most common
      reversed-phase columns available arose from the presence of analytical peaks with
      poor symmetry, a long analysis time and the separation between FCE 23762 and its
      R-isomer, which was often unsuitable for the correct determination of the drug
      substance. The use of a new stationary phase, Zorbax Rx-C8, together with a
      suitable mobile phase resulted in a good separation between the diastereomers,
      with satisfactory peak symmetry and run time. The method permitted the study of
      the stability of the drug substance in formulations for clinical trials.

PMID- 1639913
TI  - Determination of the catechol-O-methyltransferase inhibitor Ro 40-7592 in human
      plasma by high-performance liquid chromatography with coulometric detection.
AB  - A sensitive and specific high-performance liquid chromatographic method has been
      developed to measure the catechol-O-methyl-transferase (COMT) inhibitor 3,4
      dihydroxy-4'-methyl-5-nitrobenzophenone (Ro 40-7592) in human plasma. The
      compound and the internal standard were extracted from plasma at pH 2 with n
      butyl chloride-ethyl acetate (95:5, v/v). The extract was chromatographed on a
      reversed-phase column (Hypersil ODS, 5 microns) using a mixture of phosphate
      buffer (0.05 M, pH 2), methanol and tetrahydrofuran (45:55:5, v/v/v) as the
      mobile phase. Long-retained components were removed from the system by means of a
      simple column-switching system. Quantification of the catechol-O
      methyltransferase inhibitor was performed by means of coulometric detection (0.1
      V). The limit of quantification was about 1 ng/ml, using a 1-ml specimen of
      plasma. The recovery from human plasma was greater than 88%. The mean inter-assay
      precision was 5.3% in the range 2.5-1000 ng/ml. Linearity of the standard curve
      was obtained in the concentration range 2.5-500 ng/ml. The catechol-O
      methyltransferase inhibitor was stable in human plasma when stored for six months
      at -20 degrees C and for 24 h at room temperature. The practicability of the new
      method was demonstrated by the analysis of more than 400 plasma samples from a
      tolerance study performed in human volunteers.

PMID- 1639914
TI  - Determination of Zy 17617B in plasma by solid-phase extraction and liquid
      chromatography with automated pre-column exchange.
AB  - An automated chromatographic system, combining solid-phase extraction and
      automated pre-column exchange, is described for the routine determination of Zy
      17617B at the pmol/ml level in human plasma. The sample extraction and elution
      onto the analytical column were performed automatically and concomitantly using a
      conventional liquid chromatographic apparatus equipped with a Merck OSP-2 on-line
      sample preparator. Validation data demonstrate the reliability of the method.

PMID- 1639915
TI  - Determination of (S)-(-)-cathinone and its metabolites (R,S)-(-)-norephedrine and
      (R,R)-(-)-norpseudoephedrine in urine by high-performance liquid chromatography
      with photodiode-array detection.
AB  - A high-performance liquid chromatographic (HPLC) procedure with photodiode-array
      detection (DAD) is described for the determination of (S)-(-)-cathinone (S-CA)
      and its metabolites (R,S)-(-)-norephedrine (R-NE) and (R,R)-(-)
      norpseudoephedrine (R-NPE) in urine. Extraction and clean-up of 1-ml urine
      samples were performed on a cyano-bonded solid-phase column using (+/-)
      amphetamine as internal standard. The concentrated extracts were separated on a 3
      microns ODS-1 column with acetonitrile-water-phosphoric acid-hexylamine as the
      mobile phase. Peak detection was done at 192 nm. The detection limits for S-CA
      and R-NE/R-NPE in urine were 50 and 25 ng/ml, respectively. The differentiation
      of the enantiomers of cathinone and norephedrine was achieved by derivatization
      with (S)-(-)-1-phenylethyl isocyanate to the corresponding diastereomers followed
      by HPLC-DAD on a 5-microns normal-phase column. The R and S enantiomers of
      norpseudoephedrine were determined by gas chromatography-mass spectrometry after
      on-column derivatization with (S)-(-)-N-trifluoroacetylprolyl chloride. Following
      a single oral dose of 0.5 mg/kg of S-CA, the concentrations found in urine ranged
      from 0.2 to 3.8 micrograms/ml of S-CA, from 7.2 to 46.0 micrograms/ml of R-NE and
      from 0.5 to 2.5 micrograms/ml of R-NPE.

PMID- 1639916
TI  - Determination of psychotropic phenylalkylamine derivatives in biological matrices
      by high-performance liquid chromatography with photodiode-array detection.
AB  - Several procedures using high-performance liquid chromatography with photodiode
      array detection have been developed to create phytochemical and toxicological
      profiles of phenylalkylamine derivatives in biological samples (e.g. plant
      materials and urine). Mescaline-containing cactus samples were extracted with
      basic methanol, using methoxamine as internal standard; the extraction and clean
      up of urine samples were performed on cation-exchange solid-phase extraction
      columns. The extracts were separated on a 3-micron ODS column with acetonitrile
      water-phosphoric acid-hexylamine as the mobile phase. Peak detection was
      performed at 198 or 205 nm; peak identity and homogeneity were ascertained by on
      line scanning of the UV spectra from 190 to 300 nm. The detection limit of
      phenylalkylamine derivatives in urine and cactus material was 0.026-0.056
      micrograms/ml and 0.04 micrograms/mg, respectively. Following a single oral dose
      of 1.7 mg/kg methylenedioxymethylamphetamine (MDMA) the concentrations found in
      urine ranged from 1.48 to 5.05 micrograms/ml MDMA and 0.07-0.90 micrograms/ml
      methylenedioxyamphetamine (a metabolite of MDMA). The mescaline content of the
      cactus Trichocereus pachanoi varied between 1.09 and 23.75 micrograms/mg.

PMID- 1639917
TI  - High-performance liquid chromatographic determination of alpha-tocopheryl
      nicotinate in cosmetic preparations.
AB  - alpha-Tocopheryl nicotinate (alpha-TN) accelerates blood circulation and
      stimulates hair follicle cells, hence it is an active ingredient in a broad range
      of cosmetic products. A reversed-phase high-performance liquid chromatographic
      method was developed to determine alpha-TN in cosmetic preparations with alpha
      tocopheryl acetate as internal standard. The method was found to be rapid,
      precise and specific.

PMID- 1639918
TI  - Rapid determination of amino acids by high-performance liquid chromatography:
      release of amino acids by perfused rat liver.
AB  - Perfused rat liver can be considered as one of the most suitable ex vivo models
      for studies of liver metabolism. To assess the possible effect of L-carnitine and
      some of its acyl esters on proteolysis in the rat liver, the amino acid
      derivatization and high-performance liquid chromatographic separation of Tapuhi
      et al. [Anal. Biochem., 115 (1981) 123] was modified.

PMID- 1639919
TI  - Selective adsorption of immunoglobulins and glucosylated proteins on
      phenylboronate-agarose.
AB  - Aminophenylboronate-substituted agarose in 20 mM N-2-hydroxyethylpiperazine-N'-2
      ethanesulphonic acid, pH 8.5, selectively adsorbs immunoglobulins and complement
      factors C3 and C4 from human serum. The selectivity of binding is strongly
      influenced by the presence of magnesium chloride in the sample buffer. Adsorbed
      immunoglobulins are quantitatively eluted by sorbitol, but only partially by
      ethylene glycol or methylcellosolve. Aniline-agarose of a similar degree of
      substitution shows only weak adsorption of serum proteins under similar
      experimental conditions, thus indicating the important contribution of the
      boronate moiety to this interaction. Immunoglobulin adsorption seems not to be
      due to the cis-diol complexation used extensively for the chromatographic
      determination of non-enzymatically glucosylated proteins. Hydrophobic and pi-pi
      interactions with the aromatic structure of the ligand seem also to contribute to
      protein binding. The behaviour of aminophenylboronate-liganded agarose is, in
      some respects, rather similar to that of the so-called "thiophilic adsorbents".

PMID- 1639921
TI  - Synthetic metal-binding protein surface domains for metal ion-dependent
      interaction chromatography. I. Analysis of bound metal ions by matrix-assisted UV
      laser desorption time-of-flight mass spectrometry.
AB  - To extend the analytical capabilities of immobilized metal ion affinity
      chromatography (IMAC) for evaluation of biologically relevant peptide-metal ion
      interactions, we have prepared synthetic peptides representing metal-binding
      protein surface domains from the human plasma metal transport protein known as
      histidine-rich glycoprotein (HRG). Three synthetic peptides, representing
      multiples of a 5-residue repeat sequence (Gly-His-His-Pro-His) from within the
      histidine- and proline-rich region of the C-terminal domain were prepared. Prior
      to immobilization, the synthetic peptides were evaluated for identity and sample
      homogeneity by matrix-assisted UV laser desorption time-of-flight mass
      spectrometry (LDTOF-MS), a method developed recently for the mass determination
      of high-molecular-mass biopolymers. 2,5-Dihydroxybenzoic acid was evaluated as a
      matrix to facilitate the laser desorption and ionization of intact peptides and
      was found to be ideally suited for determinations of mass within the low-mass
      region of interest (641.7 to 1772.8 dalton). We observed minimal chemical noise
      from photochemically generated peptide-matrix adduct signals, clustering, and
      multiply-charged peptide species. Peptides with bound sodium and potassium ions
      were observed; however, these signal intensities were reduced by immersion of the
      sample probe tip in water. Mixtures of the three different synthetic peptides
      were also evaluated by LDTOF-MS after their elution through a special immobilized
      peptide-metal ion column designed to investigate metal ion transfer. We found
      LDTOF-MS to be a useful new method to verify the presence of peptide-bound metal
      ions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639920
TI  - Immobilized hemoglobin in the purification of hemoglobin-based oxygen carriers.
AB  - Chemically modified hemoglobins can be used as oxygen carriers in cell-free
      fluids provided that they have a low oxygen affinity and are stable towards
      dissociation into subunits. The latter species are undesirable because they are
      filtered rapidly through the kidneys, have renal toxicity and are characterized
      by a high oxygen affinity. A most important step in the preparation of hemoglobin
      based oxygen carriers is therefore their purification from any dissociable
      material. Hemoglobin immobilized as alpha beta dimers on Sepharose lends itself
      naturally to this purpose as it is able to interact in a specific and reversible
      way with soluble alpha beta dimers. Hemoglobin affinity columns are very
      effective in the purification of cross-linked and pseudo-cross-linked human and
      bovine hemoglobin. The applicability of the technique is enhanced by the ease
      with which alpha beta dimers from different species cross-interact to yield
      hybrid alpha 2 beta 2 tetramers. It is shown that hemoglobin affinity columns may
      provide analytical information on the cross-linking reaction itself.

PMID- 1639922
TI  - Synthetic metal-binding protein surface domains for metal ion-dependent
      interaction chromatography. II. Immobilization of synthetic metal-binding
      peptides from metal ion transport proteins as model bioactive protein surface
      domains.
AB  - This preliminary investigation tests the premise that biologically relevant (1)
      peptide-metal ion interactions, and (2) metal ion-dependent macromolecular
      recognition events (e.g., peptide-peptide interactions) may be modeled by
      biomimetic affinity chromatography. Divinylsulfone-activated agarose (6%) was
      used to immobilize three different synthetic peptides representing metal-binding
      protein surface domains from the human plasma metal transport protein histidine
      rich glycoprotein (HRG). The synthetic peptides represented 1-3 multiple repeat
      units of the 5-residue sequence (Gly-His-His-Pro-His) found in the C-terminal of
      HRG. By frontal analyses, immobilized HRG peptides of the type (GHHPH)nG, where n
      = 1-3, were each found to have a similar binding capacity for both Cu(II) ions
      and Zn(II) ions (31-38 mumol/ml gel). The metal ion-dependent interaction of a
      variety of model peptides with each of the immobilized HRG peptide affinity
      columns demonstrated differences in selectivity despite the similar internal
      sequence homology and metal ion binding capacity. The immobilized 11-residue HRG
      peptide was loaded with Cu(II) ions and used to demonstrate selective adsorption
      and isolation of proteins from human plasma. These results suggest that
      immobilized metal-binding peptides selected from known solvent-exposed protein
      surface metal-binding domains may be useful model systems to evaluate the
      specificity of biologically relevant metal ion-dependent interaction and transfer
      events in vitro.

PMID- 1639923
TI  - Production, purification and characterization of recombinant human interferon
      gamma.
AB  - An essentially three-step chromatographic purification procedure, i.e., ion
      exchange, immobilized metal ion affinity and size-exclusion chromatography, is
      described for the purification to homogeneity of recombinant human interferon
      gamma (rhIFN-gamma) from the inclusion bodies produced in genetically transformed
      Escherichia coli cells. Batchwise adsorption of the cloudy solution of renatured
      rhIFN-gamma obviated the need for high-speed centrifugation to clarify the
      suspension. This step effectively removed about 70% of extraneous protein
      impurities. The established purification process is reproducible and leads to a
      total recovery of 32%. Pilot-scale processing of E. coli cells grown in a 30-l
      fermentor gave about 70 mg of a homogeneous preparation of rhIFN-gamma. The
      specific biological activity of purified rhIFN-gamma is ca. 3.4 x 10(7) I.U./mg
      protein, which is comparable to that of its natural counterpart. It is basic
      protein (pI greater than pH 9) with a monomer relative molecular mass of 15,000.
      It behaves, however, as a dimer on size-exclusion chromatography. Its partial NH2
      terminal sequence is identical with that established for the rhIFN-gamma.
      However, its amino acid composition and its relative molecular mass (15,067 as
      determined by electrospray mass spectrometry) indicate that the purified protein
      is a truncated form lacking fifteen amino acid residues from its carboxyl
      terminal side. This modification does not seem to have any adverse effect on its
      biological potency. The levels of DNA, bacterial endotoxins and Ni(II) ions in
      the final product were determined.

PMID- 1639925
TI  - Isolation and characterization of catalase from Penicillium chrysogenum.
AB  - Catalase from a crude preparation of Penicillium chrysogenum was isolated in a
      single chromatographic step by immobilized metal ion affinity chromatography
      (IMAC) on Cu(II)-Chelating Sepharose Fast Flow. A chromatographically and
      electrophoretically homogeneous enzyme was obtained in 89% yield. IMAC was found
      to be superior to ion-exchange, hydrophobic interaction, size-exclusion and
      concanavalin A affinity chromatography. Analytical and preparative chromatography
      gave essentially the same chromatograms. Isoelectric point, molecular weight (by
      ultracentrifugation), amino acid composition, carbohydrate content and subunit
      organization were determined. The apparent Michaelis-Menten constant, KM, and the
      azide competitor constant, Ki, were calculated and found to be 59 microM and 6.1
      microM, respectively.

PMID- 1639924
TI  - Affinity chromatographic separation of gonadotropic hormone agonist and
      antagonist antibodies. Implications for structure, immunological and biological
      properties of glycoproteins.
AB  - Gonadotropic hormones which have lost peripheral sugar residues in their
      oligosaccharide chains display antagonistic properties and produce antibodies
      that fail to recognize the fully glycosylated hormone (agonist form). These
      polyclonal antibodies were separated by successive affinity chromatography on
      divinylsulfonyl-Sepharose coupled agonist and antagonist columns. The
      immunoglobulin G fraction from the agonist affinity columns recognizes both free
      agonist and antagonist in solution radioimmunoassays and also when these hormone
      forms are bound to receptors on gonadal cells. However, antagonist-specific
      antibodies recognize only the free antagonist in solution but not when it is
      receptor bound, implying that the conformation of the receptor-bound antagonist
      is different from that of the agonist. Affinity-purified antibodies against the
      different forms are useful in analyzing immunological and biological properties
      of the hormones. The studies with these glycosylated hormones serve as a useful
      model for other glycoproteins of pharmaceutical value.

PMID- 1639926
TI  - Model studies on iron(III) ion affinity chromatography. II. Interaction of
      immobilized iron(III) ions with phosphorylated amino acids, peptides and
      proteins.
AB  - The chromatographic behaviour of phosphoamino acids, phosphopeptides and
      phosphoproteins and their non-phosphorylated counterparts was studied on Fe(III)
      Chelating Sepharose and Fe(III)-Chelating Superose. The phosphorylated compounds,
      in contrast to their non-phosphorylated or dephosphorylated counterparts, adsorb
      to immobilized iron(III) ions at pH 5.5 and can be desorbed by an increase in pH.
      Phosphoamino acids were eluted at pH 6.5-6.7, whereas monophosphopeptides and
      phosphoprotamine eluted in the pH range 6.9-7.5. Molecules possessing clusters(s)
      of carboxylic groups are weakly retained (gamma-carboxyglutamic acid, Ala-Ser
      Glu5) or bound (polyglutamic acid, beta-casein) to the immobilized iron(III) ions
      at pH 5.5. Dephosphorylated beta-casein was desorbed at pH 7.0, whereas for
      elution of native (non-dephosphorylated) beta-casein, phosphate buffer of pH 7.7
      was required. The homopolymer of polyglutamic acid was desorbed in the pH range
      6.0-6.3, whereas copolymers of glutamic acid and tyrosine require pH 7.0-7.3 or
      even phosphate buffer at pH 7.7 for elution.

PMID- 1639927
TI  - Interaction of immunoglobulin G with immobilized histidine: mechanistic and
      kinetic aspects.
AB  - A systematic investigation of coupling methods for and the chemistry and
      chromatographic parameters of immunoglobulin gamma (IgG) adsorption to histidine-
      and imidazole-coupled Sepharose gels was undertaken in order to elucidate the
      interactions involved in the mechanism of recognition between IgG and the
      immobilized histidine. The effects of pH, salt and temperature effects indicated
      an ion-pairing mechanism, rather than a mechanism based on the net charge of the
      protein (IgG), but with some localized complementary charges recognizing the
      unprotonated imidazole nitrogen. The effects of the addition of ethylene glycol
      and urea indicated the involvement of hydrogen bonding between the ligand and the
      protein. The immobilized histidine binds to the Fc fragment of IgG with a fairly
      low affinity, in a way similar to the N-terminum of protein A binding to the Fc
      fragment of IgG. The kinetic parameters of the chromatographic system indicated a
      good capacity but a low adsorption rate constant.

PMID- 1639928
TI  - Adsorption behavior of milk proteins on polystyrene latex. A study based on
      sedimentation field-flow fractionation and dynamic light scattering.
AB  - Sedimentation field-flow fractionation (SdFFF) has been used to characterize the
      adsorption of the proteins beta-casein (BCN) or beta-lactoglobulin (BLG) on
      colloidal polystyrene latices; this system was used to model hydrophobic
      interactions between the proteins and the surfaces of fat droplets in protein
      stabilized emulsions. It was found that the SdFFF technique could determine
      directly the surface concentrations of BCN and BLG irreversibly adsorbed to the
      latex surface, provided care was taken to maintain the ionic strength of the
      carrier at a level which suppressed particle-wall repulsion in the separation
      channel. The measured surface concentrations were similar for the two proteins
      (about 1 mg/m2), and this was verified by quantitative amino acid analysis. These
      concentrations were smaller than those found in depletion studies (3 and 4 mg/m2
      respectively for BCN and BLG), in which loosely associated protein may have been
      included in the determinations. The thickness of the adsorbed layers was
      determined in situ by dynamic light scattering and was found to differ
      significantly for the two proteins (up to 15 nm for BCN vs. 2-3 nm for BLG). The
      implication of these findings in terms of different surface arrangements of the
      two proteins is discussed.

PMID- 1639929
TI  - Recycling isoelectric focusing: use of simple buffers.
AB  - Using the recycling free-flow focusing (RF3) apparatus, we have demonstrated that
      single ampholytes can be utilized to establish very stable pH regions, separating
      all proteins into three groups: a sharply resolved zone of proteins isoelectric
      at the prevailing pH, this "pH window" being bracketed by zones of more acidic
      and/or basic proteins. The ampholytes used are either amino acids or their
      dipeptides and other derivatives. Where necessary, because of lack of an
      ampholyte with the required pH, a binary mixture of ampholytes can be utilized.
      The closer their isoelectric points (pI), the narrower will be the pH window,
      i.e., the sharper the resolution of the bracketed proteins. This method overcomes
      the necessity of using ill-defined commercial carrier ampholytes, such as
      Ampholine, for preparative isoelectric focusing. It is recommended that the
      ampholytes be utilized at relatively high concentration, 100mM or higher, this
      contributing to pH stability and minimizing protein precipitation.

PMID- 1639930
TI  - Analysis of food additives by ion-pairing electrokinetic chromatography.
AB  - A mixture of food additives is separated using ion-pairing electrokinetic
      chromatography with on-column ultraviolet detection at 190 nm. Tetrabutyl
      ammonium hydrogen sulfate (TBA) is used as modifier. The effect of the
      concentration of TBA on the migration behavior of the solutes is investigated.
      This method is used for the determination of the amount of additives in food
      samples. The percent relative standard deviation (%RSD) for the migration time is
      found to be less than 0.9% and that of the peak area is less than 2.5%.

PMID- 1639931
TI  - Clinical review 36: Cardiovascular manifestations of endocrine disease.

PMID- 1639932
TI  - Non-thyrotropin-dependent thyroid secretion.

PMID- 1639933
TI  - Levothyroxine dose requirements for thyrotropin suppression in the treatment of
      differentiated thyroid cancer.
AB  - We have compared the dose of levothyroxine (L-T4) required to suppress serum TSH
      to given levels in two clinical groups: 1) 44 patients with thyroid cancer whose
      thyroid glands had been ablated by surgical thyroidectomy and 131I treatment, and
      2) 113 patients with thyroidal failure due either to spontaneous primary
      hypothyroidism (31 patients) or after 131I treatment for Graves' hyperthyroidism
      (82 patients). The dose of L-T4 needed to attain serum TSH levels in the
      euthyroid range (0.5-6.2 microU/mL) was significantly greater (P less than 0.01)
      in patients with thyroid cancer (2.11 micrograms/kg.day) than in the patients
      with primary hypothyroidism associated with nonmalignant disease (1.63
      micrograms/kg.day). Similarly, patients with thyroid cancer required a higher
      dose of L-T4 to suppress serum TSH to a given subnormal level. These findings
      suggest that the secretion of hormone from residual thyroid tissue in patients
      who have not been subjected to near-total thyroid ablation contributes
      substantially to the circulating levels of serum T4 and T3. We, therefore, infer
      that residual thyroidal secretion in the patients with hypothyroidism due to
      benign causes is relatively independent of TSH stimulation. Further subdivision
      of patients with benign hypothyroidism revealed that patients with Graves' who
      developed hypothyroidism after 131I treatment showed a lower mean dose
      requirement than patients with spontaneous hypothyroidism. This raises the
      possibility that continued secretion of thyroid-stimulating immunoglobulin in
      such patients might account for the lower dose requirement in the combined group
      with hypothyroidism. Our studies also have allowed us to make serial observations
      in 4 patients with thyroid cancer who exhibited elevated levels of serum
      thyroglobulin. In this limited series, maximal suppression of serum thyroglobulin
      was produced by doses of L-T4, which reduced circulating TSH to 0.4 mU/L.

PMID- 1639934
TI  - Effects of low-protein diets on protein metabolism in insulin-dependent diabetes
      mellitus patients with early nephropathy.
AB  - The dietary protein requirements of patients with insulin-dependent diabetes
      mellitus (IDDM) are unknown. We studied the metabolic adaptation of IDDM patients
      with early nephropathy to therapeutic, low-protein diets. Six patients were
      studied at baseline and following 1 and 12 weeks of consuming 0.6 g/kg-1 ideal
      body weight.day-1 protein. Outcome variables included quadriceps muscle strength,
      body composition, nitrogen balance, and estimates of whole body protein turnover
      using an infusion of L-[1-13C]leucine. All subjects experienced decreased muscle
      strength (6.6% decline in maximal torque, P = 0.05) and increased body fatness
      (11% increase in fat mass, P = 0.03) with no change in total body weight. This
      was accompanied by an initial 40% decrease in the rate of whole-body leucine
      oxidation after 1 week of dietary restriction which returned almost to baseline
      rates by 12 weeks (P less than 0.001, 1 week vs. 12 weeks). Nitrogen balance
      remained negative throughout the period of protein restriction. We conclude that
      IDDM subjects with early nephropathy experience protein undernutrition during the
      first 3 months of the dietary protein restriction currently recommended for the
      treatment of nephropathy. This may result, in part, from an inability to conserve
      essential amino acids from oxidative loss over the time period of the study.

PMID- 1639935
TI  - Peculiar distribution of adipose tissue in patients with congenital generalized
      lipodystrophy.
AB  - Congenital generalized lipodystrophy (CGL) is a rare genetic disease with extreme
      paucity of fat from birth which is believed to be generalized, involving the
      whole body. Affected patients are characterized by severe insulin resistance.
      Sites of adipose tissue distribution in patients with CGL have not been studied
      systematically. Therefore, the fat distribution in three women (17-20 yr old)
      with CGL was investigated. Determination of body composition by underwater volume
      displacement suggested the complete absence of body fat (range, -3 to -7%;
      normal, 15-25%). Whole body magnetic resonance imaging, however, detected fat in
      particular anatomical sites, namely in orbits, palms and soles, and periarticular
      and epidural regions. Some fat was also localized in the tongue, breasts, vulva,
      and buccal area. Fat in other subcutaneous areas, intraabdominal and
      intrathoracic regions, and bone marrow was essentially absent. Thus, patients
      with CGL do not have a complete absence of body fat; of interest, fat is present
      in those sites where adipose tissue may be serving mainly a mechanical function.
      Patients with CGL, therefore, provided a unique opportunity to identify the
      various sites of localization of "mechanical" adipose tissue in the human body.
      Our study suggests that the genetic defect in CGL results in poor growth and
      development of metabolically active adipose tissue, whereas mechanical adipose
      tissue is well preserved.

PMID- 1639936
TI  - Studies in a kindred with parathyroid carcinoma.
AB  - We report a family with primary hyperparathyroidism in four patients in two
      generations with apparent autosomal dominant transmission. A fifth member was
      probably affected. Two cases had definite parathyroid carcinoma (PC), and two had
      parathyroid adenoma with atypical features that could represent an early stage of
      cancer. In each of our patients, one parathyroid gland was abnormal. Five other
      parathyroid glands (in two patients) were normal in histology and size. There was
      no evidence of neoplasia in other tissues. Constitutional karyotypes were normal
      in all four patients. We identified three chromosomal abnormalities (a reciprocal
      translocation between chromosomes 3 and 4, trisomy 7, and a pericentric inversion
      in chromosome 9) in cultured PC tissue from one patient. These chromosomal
      changes are of unclear significance. Analyses on tumor DNA from one case of PC
      and one of atypical adenoma showed no evidence of ras gene mutations, PTH gene
      rearrangement, or allelic loss from chromosome 11q13 (locus of the gene for
      multiple endocrine neoplasia type 1). This family shows susceptibility to cancer
      without antecedent hyperplasia in all parathyroids. It could help identify a
      novel tumor susceptibility gene.

PMID- 1639937
TI  - Development of melatonin production in infants and the impact of prematurity.
AB  - The development of rhythmic 6-sulfatoxymelatonin excretion in urine was studied
      in healthy full-term and premature infants during the first 12 months of life.
      There was little evidence of rhythmic 6-sulfatoxymelatonin excretion before 9 to
      12 weeks of age in full-term infants. Over this period, excretion increased five
      to six times compared to the excretion at 6 weeks (08 +/- 103 vs. 2973 +/- 438
      pmol/24 h) with the major proportion of the hormone metabolite being excreted
      between 0200-1000 h. At 24 weeks of age, total 6-sulfatoxymelatonin excretion was
      25% of adult levels. Premature infants (51 +/- 4 days premature) had a delay in
      the appearance of rhythmic 6-sulfatoxymelatonin of approximately 9 weeks. Even
      after correcting for gestational age or length of time at home, the premature
      infants were found to have a 2-3 week delay in the development of 6
      sulfatoxymelatonin rhythmicity compared to full-term infants. These results
      provide evidence that neural centers responsible for rhythm generation and/or the
      pineal gland fail to accelerate their development after premature delivery. This
      may be due to the environment the infants are exposed to during their stay in
      hospital, particularly the pattern and intensity of lighting.

PMID- 1639938
TI  - Food contains the bioactive peptide, cyclo(His-Pro).
AB  - Cyclo(His-Pro) (CHP) is a cyclic dipeptide with numerous biological activities.
      As small di- and tripeptides may be absorbed intact when ingested orally, we were
      interested in examining several common foods for the presence of cyclo(His-Pro)
      like immunoreactivity (CHP-LI). In all foods tested, CHP-LI was found at levels 5
      1500 times those previously found in human plasma. This CHP-LI was identical to
      authentic CHP by immunoidentity and chromatographic behavior. We conclude that 1)
      CHP-LI is readily detectable in several common food sources; 2) this CHP-LI is
      indistinguishable from authentic CHP; and 3) it is likely the CHP-LI in foods is
      absorbed in quantities sufficient to cause elevations of CHP-LI in plasma to
      biologically significant levels.

PMID- 1639939
TI  - Simultaneous assessment of insulin secretion and insulin sensitivity using a
      hyperglycemia clamp.
AB  - A hyperglycemic clamp is an established method to assess insulin secretion and is
      generally used only for this purpose. To determine whether it could also be used
      to assess insulin sensitivity, we compared insulin sensitivity indices (ISI)
      obtained during euglycemic and hyperglycemic clamp experiments in 22 nonobese
      volunteers (body mass index, 23.9 +/- 0.6 kg/m2) and in 20 obese individuals
      (body mass index, 30.8 +/- 1.3 kg/m2) matched for age and gender. The ISI values
      (micromoles per kg.min/pmol) of the obese group assessed during hyperglycemic
      (0.088 +/- 0.011) and euglycemic (0.050 +/- 0.005) clamp experiments were both
      significantly lower than the ISI of the nonobese group assessed in hyperglycemic
      and euglycemic clamp experiments (0.179 +/- 0.024 and 0.096 +/- 0.009,
      respectively; both P less than 0.01). Although the ISI values obtained with
      hyperglycemic clamps were consistently greater than those obtained with
      euglycemic clamp (0.137 +/- 0.016 vs. 0.075 +/- 0.007; P less than 0.001), they
      were highly correlated (r = 0.84; P less than 0.0001). Moreover, when these
      indices were converted to clearance rates, thereby correcting for the mass action
      effects of glucose on glucose disposal, the values obtained with the
      hyperglycemic clamp (0.0137 +/- 0.0016 mL/kg.min/pmol) were statistically
      identical to those obtained with the euglycemic clamp (0.0142 +/- 0.0013
      mL/kg.min/pmol), as indicated by a regression equation having an intercept of 0
      and a slope (1.03) not different from 1. We, therefore, conclude that the
      hyperglycemic clamp and the euglycemic clamp yield comparable estimates of
      insulin sensitivity and that, under appropriate conditions, the hyperglycemic
      clamp technique may be used to assess both insulin sensitivity and insulin
      secretion in the same individual in a single experiment.

PMID- 1639940
TI  - Determinants of bone density in young women. I. Relationships among pubertal
      development, total body bone mass, and total body bone density in premenarchal
      females.
AB  - Bone mass accretion during puberty appears to be critical in the development of
      peak bone mass, which, in turn, is believed to be a major determinant of
      osteoporosis risk. Although genetics may be the primary determinant of peak bone
      mass, modifiable secondary factors, such as nutrition and hormone exposure, may
      significantly affect bone mass accretion during the second decade of life. As
      part of a longitudinal study of major determinants of bone development during
      puberty, we obtained cross-sectional measurements from 112 premenarchal caucasian
      females (mean +/- SD age, 11.9 +/- 0.49 yr at study entry). Total body bone
      mineral density (TBBMD) and total body bone mineral content (TBBMC) were measured
      by dual energy x-ray absorptiometry and compared to anthropometric, pubertal
      development, urinary steroid and gonadotropin levels, and nutrient intake. An
      integrated estrogen exposure index was developed and used to evaluate the
      cumulative effect of circulating estrogen levels on both development. Compared to
      normative reference data for adults, our subjects possessed 90% of adult height,
      68% of adult weight, 83% of adult TBBMD, and 53% of TBBMC. The strongest combined
      predictors of prepubertal TBBMD and TBBMC were body weight, followed by height
      and pubertal development. Urinary estradiol levels were positively correlated
      with dietary intake of iron and vitamin B6.

PMID- 1639941
TI  - Effective suppression of luteinizing hormone and testosterone by single doses of
      the new gonadotropin-releasing hormone antagonist cetrorelix (SB-75) in normal
      men.
AB  - In rats and nonhuman primates the new GnRH antagonist cetrorelix (SB-75; [Ac-D
      Nal(2)1,D-Phe(4Cl)2,D-Pal(3)3,D-Cit6,D-Ala10]GnR H) has been shown to suppress
      testosterone secretion effectively and persistently. A clinical phase I study was
      performed to assess the hormonal effects of this highly potent antagonist in
      normal men. After 2 control examinations 30 young male volunteers were randomly
      assigned to 6 treatment groups (n = 5/group), and single doses of 0 (placebo),
      0.25, 0.5, 1.0, 2.0, and 5.0 mg cetrorelix were administered sc. Blood samples
      were obtained over the course of 7 days postinjection. After maximal cetrorelix
      serum levels were achieved 1 h postinjection, the GnRH antagonist serum levels
      decreased with a terminal t1/2 of 29.8 +/- 4.2 h (mean +/- SE). LH secretion was
      suppressed dose- and time-dependently; maximal suppression occurred 4-6 h
      postinjection. Suppression of FSH did not reach statistical significance. Doses
      of 1.0, 2.0, and 5.0 mg cetrorelix significantly suppressed testosterone
      secretion compared to that in the placebo group. After the administration of 1.0
      mg cetrorelix, maximal suppression was seen 8 h after injection, with
      testosterone levels of 7.5 +/- 1.1 nmol/L compared to 15.8 +/- 2.2 nmol/L in the
      placebo group. Maximal testosterone suppression by 2.0 and 5.0 mg cetrorelix
      occurred 12 h after injection, with testosterone concentrations of 4.9 +/- 0.5
      and 2.2 +/- 0.4 nmol/L, respectively, compared to 16.5 +/- 1.7 nmol/L in the
      placebo group. Twenty-four hours after the injection of 1.0 and 2.0 mg
      cetrorelix, testosterone values were no longer significantly different from those
      in the placebo group, whereas in the 5.0-mg dose group testosterone
      concentrations increased slightly and reached serum concentrations in the lower
      normal range after 48 h. The only side-effect observed after the administration
      of cetrorelix was a transient local erythema at the injection site that
      disappeared within 30 min. No local induration or pruritus, or any adverse
      systemic side-effect occurred in any volunteer. In conclusion, the new GnRH
      antagonist cetrorelix effectively decreases serum LH and testosterone
      concentrations in a dose- and time-dependent manner and, therefore, has potential
      for treatment of sex hormone-dependent diseases and male contraception.

PMID- 1639942
TI  - Age-dependent effect of resistance exercise on growth hormone secretion in
      people.
AB  - We measured serum GH responses to a standardized circuit of resistance exercise
      in 12 young subjects (6 men and 6 women; 27 +/- 1.6 yr old) and in 11 elders (6
      men and 5 women; 72 +/- 0.8 yr old). Initial assessment of strength [1 repetition
      maximum (1RM)] was made of 12 muscle groups using Nautilus equipment. One week
      later, subjects carried out the exercise protocol, 3 sets of 8 repetitions for
      each of the 12 exercises, at 70% of predetermined 1RM values. Venous blood was
      drawn at baseline, after each exercise, and every 2 min during 10 min of
      recovery. In young subjects serum immunoreactive GH rose by completion of the
      second exercise, increased and remained elevated through the remainder of the
      exercise period, and decreased toward baseline by 10 min of recovery. In the
      elderly subjects, baseline GH values were similar to those in the young (1.76 +/-
      0.41 vs. 2.61 +/- 0.73 micrograms/L) and did not increase above 6 micrograms/L at
      any time during or after exercise. Exercise increased GH in both groups, but peak
      values (14.9 +/- 3.5 micrograms/L in young; 2.44 +/- 0.6 micrograms/L in old) and
      integrated (198 +/- 47 in young; 37.8 +/- 0.8 in old) were significantly greater
      in the young subjects (P less than 0.05). GH responses showed no gender
      difference in either group. Brief increases in pulse rate were observed during
      individual exercises, but sustained elevations did not occur. To assess the
      effect of exercise intensity on GH response, we compared responses to exercise at
      70% and 85% of 1RM in 7 young and 11 older people. In the young subjects, GH
      responses were nonsignificant at 60% and increased progressively at 70% and 85%
      of 1RM. No significant effect of exercise intensity was observed in the older
      subjects. We conclude that resistance exercise promptly elevates circulating GH
      concentrations in healthy young adults. This response is related to the intensity
      of the resistance stimulus, although a small contribution of aerobic stress
      cannot be excluded. The GH response to resistance activity is grossly diminished
      in healthy elderly men and women.

PMID- 1639943
TI  - Normal calcitonin stimulation of serum calcitriol in patients with X-linked
      hypophosphatemic rickets.
AB  - Patients with X-linked hypophosphatemic rickets (XLH) have normal or low
      calcitriol concentrations despite manifesting hypophosphatemia, a known stimulus
      of 25-hydroxyvitamin D-1 alpha-hydroxylase activity. In accord, administration of
      pharmacological doses of PTH results in a markedly blunted stimulation of
      calcitriol levels. In the murine homolog of the human disorder, the Hyp mouse,
      regulation of 25-hydroxyvitamin D-1 alpha-hydroxylase activity is defective in
      response to hypophosphatemia and PTH administration, but not in response to
      calcitonin administration. In the current study we administered calcitonin to
      controls and patients with XLH to test the hypothesis that calcitonin
      stimulatable 25-hydroxyvitamin D-1 alpha-hydroxylase activity is normal in
      patients with XLH. We found that calcitriol concentrations increased in both
      groups to a similar degree (78.5 +/- 20.9 pmol/L in patients and 49.9 +/- 19.7
      pmol/L in controls) and with a similar time course. Our results indicate that the
      complex and incomplete defect in the regulation of 25-hydroxyvitamin D-1 alpha
      hydroxylase observed in Hyp mice also exists in humans.

PMID- 1639944
TI  - Effects of a physiological growth hormone pulse on substrate metabolism in
      insulin-dependent (type 1) diabetic subjects.
AB  - When present in inappropriate amounts GH induces substantial insulin resistance
      and it has furthermore been suggested that modest nocturnal surges of GH may
      precipitate the emergence of the dawn phenomenon. To characterize the metabolic
      effects of physiologically relevant, small-scale GH exposure, six type 1 diabetic
      subjects were studied for 5 h in the postabsorptive state after an iv pulse of
      either 210 micrograms GH or saline. Identical amounts of insulin were infused on
      both occasions to maintain a prevailing blood glucose concentration of 125 +/- 12
      mg/100 ml. The GH bolus caused an increase in serum GH levels to a peak value of
      22 +/- 2 micrograms/L after 10 min, a 70% increase in serum FFA (from 570 +/- 80
      to 980 +/- 60 mumol/L) and a 400% increase in blood 3-hydroxybutyrate (3-OHB)
      (from 100 +/- 15 to 420 +/- 35 mumol/l) concentrations after 180 and 240 min
      respectively (P less than 0.05). Blood glycerol and forearm uptake of 3-OHB rose
      in parallel (P less than 0.01). Plasma glucose, isotopically measured glucose
      turnover and forearm glucose uptake was not affected by GH. Blood lactate
      concentrations increased (P less than 0.05) and nonoxidative glucose use and
      lipid oxidation tended to increase with GH. Energy expenditure remained
      unaffected. These results suggest that under everyday conditions GH acts as an
      important regulator of fuel fluxes in type 1 diabetic subjects, the main effect
      being a transient stimulation of lipolysis. Since no significant effect on
      glucose metabolism was recorded, we do not presently find evidence to support a
      primary role for small surges of GH in the pathogenesis of the dawn phenomenon.

PMID- 1639945
TI  - Body fat mass, body fat distribution, and pubertal development: a longitudinal
      study of physical and hormonal sexual maturation of girls.
AB  - The rate at which girls progress through the stages of puberty in relation to
      body fat mass and body fat distribution and its relation to their hormonal
      profiles was studied. Sixty-eight schoolgirls participated in a longitudinal
      study during 3 yr. The girls were divided into subgroups with increasing skinfold
      thicknesses and waist-hip ratio. They were also grouped depending on Tanner's
      breast development classification (M2 and M3). The age at M2 was only marginally
      correlated with the menarcheal age, but the age at M2 and the time interval from
      that age to menarche was negatively correlated. Age at the onset of puberty was
      not related to body fat mass or distribution. The rate of pubertal development
      after pubertal stage M3 was negatively related to the body fat mass. Age at M2
      was only correlated with estrone (E1), while the rate of pubertal development was
      associated with higher FSH, E1, estradiol (E2), the fraction of E2 that was not
      bound to sex-hormone-binding globulin (non-sex-hormone-binding globulin bound E2)
      and androstenedione plasma levels at the onset of puberty. Body fat distribution,
      rather than body fat mass was related to the total and the non-sex-hormone
      binding globulin bound plasma levels of E2 and testosterone at the onset of
      puberty. Changes in body fat distribution in early female puberty were chiefly
      related to the waist circumferences. We found no evidence that body fat mass or
      body fat distribution triggers the onset of puberty. Body fat distribution was
      related to early pubertal endocrine activity. Body fat mass was negatively
      related to the rate of pubertal development toward menarche, but no clear
      indications for an endocrine-related process is found. We conclude that onset of
      puberty and menarche are not parallel pubertal events, and that early pubertal
      plasma E1, E2 and androstenedione levels are predictors for the rate of pubertal
      development toward menarche. We propose that the control of the onset of puberty
      and maturation of the hypothalamic-pituitary gonadal axis, with regard to
      negative feedback control, are at least partially independent. This induces on
      the average a "catch up" pubertal maturation in girls with a late onset of
      puberty.

PMID- 1639946
TI  - Melatonin: a major regulator of the circadian rhythm of core temperature in
      humans.
AB  - The circadian rhythm of core body temperature (BTc), with maxima during the day
      and minima at night, is normally coupled with the sleep-wake cycle. Pineal
      melatonin secretion occurs contemporaneously during the nighttime hours and is
      mediated by the activation of beta-adrenergic receptors during darkness. The
      hypothesis that nocturnal melatonin secretion may be involved in the regulation
      of the human circadian BTc rhythm was examined. The temporal relationship between
      melatonin and the circadian BTc rhythm was characterized in 12 young women,
      normally entrained to the light-dark cycle. Melatonin levels were manipulated
      through the administration of exogenous melatonin (2.5 mg, orally) during the
      daytime (n = 6) or suppression of endogenous nocturnal melatonin secretion by the
      beta-adrenergic antagonist atenolol (100 mg; n = 6) in double blind placebo
      controlled experiments conducted during 2 consecutive days. Serum melatonin
      levels and BTc were monitored at 20- and 10-min intervals, respectively. In a
      nightshift worker the temporal relationship between the circadian rhythm of
      melatonin and BTc was investigated before and after entrainment to a reversed
      wake-sleep cycle. Our data show that in normally entrained subjects, the time
      course and amplitude of nocturnal melatonin secretion were temporally coupled
      with the decline of BTc (r = 0.97; P less than 0.00001). The same occurred in the
      nightshift worker, both during the dissociation and after entrainment to the
      reversed sleep-wake cycle. Compared with placebo, administration of melatonin
      significantly reduced daytime BTc (P less than 0.01), and the suppression of
      melatonin (by atenolol) attenuated the nocturnal decline of BTc (P less than
      0.01). Cosinor analysis showed that the amplitude of the circadian BTc rhythm was
      reduced by about 40% in response to both daytime melatonin administration (P less
      than 0.05) and nocturnal melatonin suppression (P less than 0.02). In conclusion,
      circadian rhythms of melatonin and BTc are inversely coupled. The demonstrated
      hypothermic properties of melatonin are accountable for the generation of at
      least 40% of the amplitude of the circadian BTc rhythm. Manipulation of melatonin
      levels might be clinically useful to resynchronize the BTc rhythm under
      conditions of BTc rhythm desynchronization.

PMID- 1639947
TI  - Role of basal triglyceride and high density lipoprotein in determination of
      postprandial lipid and lipoprotein responses.
AB  - The present study reports on the interaction between basal triglyceride and high
      density lipoprotein (HDL) cholesterol in determining the magnitude of
      postprandial triglyceridemia. The vitamin A fat-loading test was used to label
      intestinally derived triglyceride-rich particles after a high fat meal in 18
      subjects with low HDL cholesterol and 6 control subjects who had normal fasting
      triglyceride and HDL cholesterol levels. The patients with low HDL cholesterol
      were divided into 2 groups on the basis of their basal triglyceride
      concentrations; 11 had normal triglyceride levels, and 7 had elevated serum
      triglycerides (HTG). In the HTG-low HDL group, the incremental area under the
      triglyceride curve was significantly greater (P less than 0.0003) than that in
      the other 2 groups, between whom no significant differences in triglyceride
      response were observed. Retinyl palmitate levels measured in whole plasma, an Sf
      greater than 1000 chylomicron fraction, and an Sf less than 1000 nonchylomicron
      fraction were also significantly greater in low HDL subjects with HTG, while the
      concentrations in low HDL subjects with normal triglyceride levels and control
      subjects were similar. Although basal HDL cholesterol levels in all study
      subjects were negatively correlated with the area under the incremental
      triglyceride curve (r = -0.42; P less than 0.05), this correlation was weak, in
      contrast to the correlation between fasting triglyceride levels and incremental
      triglyceride area (r = 0.56; P less than 0.005). Furthermore, basal HDL
      cholesterol levels did not correlate with the area under the chylomicron or
      nonchylomicron curves, whereas basal triglyceride levels were significantly
      correlated (P = 0.0001) with both of these variables. The HDL particles of both
      low HDL groups had a significantly higher proportion of triglyceride compared to
      the HDL particles in the control subjects. In conclusion, 1) fasting triglyceride
      levels are a more powerful indicator of the postprandial lipid response than
      basal HDL cholesterol in subjects with low HDL cholesterol levels; 2) patients
      with low HDL cholesterol levels do not preferentially accumulate chylomicron
      remnants after a meal unless they have coexisting hypertriglyceridemia; and 3)
      abnormalities in the levels of triglyceride-rich particles post-prandially are
      unlikely to be responsible for the increased incidence of atherosclerosis in low
      HDL patients who are normotriglyceridemic.

PMID- 1639949
TI  - Onset and characteristics of the midcycle surge in bioactive and immunoactive
      luteinizing hormone secretion in normal women: influence of physiological
      variations in periovulatory ovarian steroid hormone secretion.
AB  - Limited studies in nonhuman primates suggest that the midcycle LH surge is
      characterized by distinctly different patterns of bioactive (LH-BIO) and
      immunoactive (LH-RIA) LH secretion. To further examine the patterns of midcycle
      LH-BIO and LH-RIA secretion and explore the influence of physiological variations
      in steroid hormone feedback on LH surge dimensions we studied seven normal
      ovulatory women over the periovulatory interval. In each, blood samples were
      obtained every 3 h and transvaginal ultrasonography was performed every 12 h over
      a 5-7 day interval at midcycle. Serum levels of LH-RIA, FSH, estradiol (E2),
      progesterone (P4), and 17-hydroxyprogesterone were determined by RIA; LH-BIO was
      estimated using a mouse leydig cell bioassay. Hormone data were standardized to
      the time of surge onset in LH-RIA (time zero), defined as a 100% increase above a
      6-point running mean baseline value; surge cessation was defined as a decline to
      below baseline concentration. Mean LH-RIA surge duration was 54.0 +/- 4.0 h. LH
      BIO surge onset was simultaneous with that of LH-RIA and coincident with the peak
      in E2 levels (mean data). Mean P4 and 17-hydroxyprogesterone rose in a parallel,
      phasic manner, an abrupt increase in slope occurred between -6 h and +30 h but an
      acute rise in P4 was not consistently observed among individuals. The surge onset
      to follicle rupture interval (mean 37.6 +/- 4.2 h) positively correlated with
      peak LH-RIA (r = 0.76, P less than 0.05), surge amplitude (r = 0.74, P less than
      0.05) and surge onset to peak interval (r = 0.87, P less than 0.02), but not
      surge duration. There were no significant relationships between E2 or P4 (mean,
      peak, integrated, slope) and surge amplitude or duration (LH-RIA, FSH), peak
      value, or surge onset to peak interval (LH-RIA, LH-BIO, FSH). These data suggest
      that in women, 1) onset of the midcycle surge in LH-RIA and LH-BIO is
      simultaneous, and 2) surge characteristics are not influenced by physiological
      variations in steroid hormone secretion that occur beyond the thresholds required
      for surge initiation.

PMID- 1639948
TI  - Induction of azoospermia in normal men with combined Nal-Glu gonadotropin
      releasing hormone antagonist and testosterone enanthate.
AB  - The effects of a combined GnRH antagonist and testosterone (T) replacement
      regimen on gonadotropins and spermatogenesis were examined to assess its
      potential as a male contraceptive regimen. The potent Nal-Glu GnRH antagonist
      ([Ac-D2-Nal1,D4-Cl-Phe2,D3-Pal3,Arg5, D4-p-methoxybenzoyl-2-amino butyric acid6,D
      Ala10]GnRH) was administered daily (7.5 mg, sc) to eight normal men for 16 weeks.
      T enanthate was given im starting at week 2 and every 2 weeks thereafter through
      week 14 of the treatment phase. Serum LH, FSH, T, and estradiol concentrations
      were measured frequently during the 5-week control period, the 16-week treatment
      phase, and the 14-week recovery phase. Semen analyses were performed every week
      during the control phase and every 2 weeks during the treatment and recovery
      phases. Seven of eight subjects became azoospermic by 6-10 weeks of treatment;
      the eighth subject, who failed to achieve azoospermia, suppressed his sperm count
      to 7 million/mL by week 14 (from a mean baseline of 42 million/mL) before
      treatment was prematurely terminated because of localized swelling at each of his
      injection sites. Sperm counts returned to baseline 10-14 weeks after the end of
      Nal-Glu administration. Seven of the eight subjects showed suppression of LH to
      the limit of assay detection (less than 0.2 U/L), whereas the eighth subject
      showed incomplete suppression. Serum bioactive and immunoreactive LH
      concentrations showed concordant responses. Mean serum FSH concentrations were
      also markedly suppressed. Serum T and estradiol concentrations declined
      dramatically during the first 2 weeks of Nal-Glu GnRH treatment, but returned to
      the normal physiological range after T enanthate replacement was initiated.
      Libido and sexual potency were maintained. No systemic side-effects, other than
      erythema and induration at injection sites, were observed. These data demonstrate
      that combined GnRH antagonist plus T treatment can predictably and reversibly
      induce azoospermia in most men and has potential as a male contraceptive regimen.

PMID- 1639950
TI  - Influence of vitamin D on parathyroid function in the elderly.
AB  - The effect of age and vitamin D status on parathyroid function was studied in 129
      healthy subjects between 20 and 89 yr old, with normal serum creatinine (less
      than 0.11 mmol/L), and living in Cordoba, Spain. Serum calcium and phosphorus as
      well as 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D [1,25-(OH)2D]
      decreased, whereas serum alkaline phosphatase increased, with age. Serum PTH also
      increased significantly with age when measured with either a carboxyl-terminal
      (cPTH) or an intact [PTH(1-84)] assay. The increase in cPTH, however, exceeded
      largely the increase in PTH(1-84) (+120% and +30% in subjects above 80 yr vs.
      young adults, respectively). Serum PTH(1-84) was negatively correlated with serum
      (ionized) calcium, 25OHD, and insulin-like growth factor I (IGF-I) but not with
      serum 1,25-(OH)2D. Serum 1,25-(OH)2D decreased with age and was highly correlated
      with serum 25OHD, cPTH, and IGF-I. In multiple regression analysis 50-60% of the
      variation of total and free 1,25-(OH)2D could be explained by serum 25OHD, PTH(1
      84), and especially IGF-I, suggesting a possible role of decreasing GH and IGF-I
      concentrations in the mineral homeostasis of the elderly. Calcium infusion (1.5
      mg/kg body weight over 10 min) decreased serum PTH(1-84) to below normal
      concentrations in young adults (nadir 14% of basal concentration), whereas the
      nadir in elderly subjects with secondary hyperparathyroidism was only 32% of
      basal concentration. The relative decrease was, however, identical in both age
      groups when simultaneous changes in ionized calcium were taken into account.
      Basal serum PTH(1-84) in selected elderly subjects (50 +/- 10 ng/L or 5 +/- 1
      pmol/L, n = 10) decreased significantly (2.7 +/- 0.9 pmol/L, P less than 0.01)
      after 3 iv injections of 1,25-(OH)2D during 1 week without changes in serum
      (ionized) calcium. The PTH suppressibility after calcium infusion did not further
      improve. IN CONCLUSION: elderly patients with normal serum creatinine had a small
      (+30%) but significant increase in intact serum PTH concentration but the mean
      concentration still remained within the normal range. The PTH secretion remained
      normally suppressible by acute calcium infusion. Treatment with 1,25-(OH)2D
      decreased basal calcium-PTH setpoint without further additional effects during
      calcium infusion.

PMID- 1639951
TI  - Administration of human luteinizing hormone (hLH) to macaques after follicular
      development: further titration of LH surge requirements for ovulatory changes in
      primate follicles.
AB  - After stimulation of multiple follicular development, endogenous LH surges
      elicited by GnRH or GnRH agonist were of insufficient duration (4-14 h) to evoke
      oocyte maturation and luteinization in this species. In this study, periovulatory
      LH surge requirements were further titrated using hLH as the ovulatory stimulus.
      Beginning at menses, rhesus monkeys were treated with human gonadotropins for 9
      days to stimulate follicular growth. To induce ovulatory maturation on day 10,
      animals received: 1) hCG (1000 IU, im; n = 8); 2) highly-purified, urinary hLH
      (2542 IU, im; n = 4); or 3) hLH (2542 IU, im) followed by three injections of hLH
      (200 IU, im) at 8-h intervals (0800, 1600, 2400 h) daily during the luteal phase
      until menses (n = 3). Oocytes and luteinizing granulosa cells were obtained via
      follicle aspiration 27 h after the initial hLH or hCG injection. Estradiol and
      progesterone levels were measured in daily serum samples by RIA. Bioactive LH
      levels were determined at selected intervals within 36 h of the hLH ovulatory
      stimulus. Nuclear maturity of oocytes was evaluated as an indicator for
      reinitiation of meiosis. Luteinizing granulosa cells were processed for indirect
      immunocytochemistry using a monoclonal antibody to human progesterone receptor.
      In vitro progesterone production by luteinizing granulosa cells over 24 h was
      also assessed in the absence and presence of hCG. In all groups, serum estradiol
      rose to similar peak levels on day 10. After hLH, bioactive LH levels peaked
      (1262 +/- 79 ng/mL; mean +/- SEM) by 2-6 h, declined thereafter but remained
      above surge levels (100 ng/mL) for 18-24 h. Within 24 h of hLH injection, serum
      progesterone increased to 13 +/- 3 nmol/L, but returned to baseline in 1-6 days.
      In contrast, higher levels of progesterone were observed after hCG (114 +/- 51
      nmol/L) and during luteal phase treatment with hLH (137 +/- 25 nmol/L) and the
      luteal phase was longer (11.5 +/- 0.4 and 14.3 +/- 0.7 days, respectively). Of
      the total cohort of oocytes aspirated, the proportion of oocytes resuming meiotic
      maturation (metaphase I plus metaphase II) was similar after hCG (76%) and hLH
      (74%). However, the proportion of oocytes maturing to metaphase II tended to be
      less (P = 0.08) after hLH (13%) than hCG (22%). Fertilization rates were similar
      between the two groups. Progesterone receptor was detected in nuclei of
      luteinizing granulosa cells from all animals receiving hCG, but only in some
      given hLH.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1639953
TI  - Hypothalamic-pituitary-thyroidal function in eumenorrheic and amenorrheic
      athletes.
AB  - The impact of chronic high volume athletic training on thyroid hormone economy
      has not been defined. We investigated the status of the hypothalamic-pituitary
      thyroid axis (H-P-T) in women athletes with regular menstrual cycles (CA) and
      with amenorrhea (AA). Their data were compared with each other and with those
      derived from cyclic sedentary women (CS) matched for a variety of confounding
      factors including the intensity of exercise, caloric intake, and body weight.
      Alterations of the H-P-T axis were observed in women athletes compared to CS.
      While serum levels of T4, T3, free T4, free T3 and rT3 were substantially reduced
      (P less than 0.01) in AA, only serum T4 levels were significantly decreased in
      CA. Further, remarkable differences were found between CA and AA in that serum
      levels of free T4 (P less than 0.01), free T3 (P less than 0.01), and rT3 (P less
      than 0.05) were significantly lower in AA than in CA. Thyroid binding globulin
      and sex-hormone binding globulin concentrations were within their normal ranges
      for all groups of subjects. Both 24-h mean TSH levels and the circadian rhythm of
      TSH secretion were also comparable. However, the TSH response to TRH stimulation
      was blunted (P less than 0.01) in AA when compared to CA, but not to CS. Whereas
      the underlying mechanism(s) to account for the "global" reduction of circulating
      thyroid hormone in the face of normal TSH levels in AA is presently unknown,
      these observations provide information of clinical significance: 1) chronic high
      volume athletic training in women athletes with menstrual cyclicity is
      accompanied by an isolated T4 reduction; 2) an impaired H-P-T axis occurs
      selectively in athletic women in whom chronic high volume athletic training is
      associated with compromised hypothalamic-pituitary-ovarian function and
      amenorrhea.

PMID- 1639952
TI  - Polycystic ovary syndrome: lack of hypertension despite profound insulin
      resistance.
AB  - It has been hypothesized that insulin resistance and hyperinsulinemia contribute
      to the development of arterial hypertension. To further investigate this
      relationship, we compared arterial blood pressure in controls and women with
      polycystic ovary syndrome (PCO), an insulin-resistant state. Fourteen PCO women
      and 18 normal control women of similar age, body mass index, and race were
      studied. Plasma glucose and insulin levels were determined in an oral glucose
      tolerance test. The insulin sensitivity (SI) index was determined by the minimal
      model method. Systolic and diastolic blood pressure were measured by 24-h
      ambulatory monitoring. Left ventricular mass was assessed by echocardiography.
      The two groups had comparable fasting glucose levels, but the 2-h postload
      glucose was higher in PCO (8.0 +/- 0.5 vs. 5.6 +/- 0.3 mmol/L; P less than
      0.001). Compared to controls, PCO women were significantly more insulin resistant
      by fasting insulin, 2-h insulin concentrations, and SI (28.3 +/- 6.7 vs. 68.3 +/-
      10.0 min-1/nmol.mL; P less than 0.01). Average ambulatory systolic (121 +/- 2 vs.
      118 +/- 2 mm Hg) and diastolic (76 +/- 2 vs. 73 +/- 2 mm Hg) blood pressures were
      similar for PCO and control women. No difference was found in left ventricular
      mass. Therefore, despite profound insulin resistance and hyperinsulinemia, women
      with PCO do not have increased arterial pressure or left ventricular mass.

PMID- 1639954
TI  - Progestin antagonism of estrogen stimulated 1,25-dihydroxyvitamin D levels.
AB  - Progestins are frequently used in combination with estrogen to prevent or treat
      postmenopausal osteoporosis. Progestins protect against the undesirable
      hyperplastic effects of estrogen on the endometrium. The possibility that
      progestins might antagonize the beneficial effects of estrogen on calcium
      homeostasis has received little attention. In this study we determined whether
      the addition of progestin to estrogen would alter the ability of estrogen to
      raise serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] levels. Women within 5 yr of
      menopause were treated with three cycles of oral unopposed estrogen [1 or 2
      mg/day (3.67 or 7.34 mumol/day) 17 beta-estradiol (E2) for 25/30 days of each
      cycle] followed by three cycles of E2 plus progestin [10 mg/day (29 mumol/day)
      medroxyprogesterone on days 12-25]. E2 increased both total and free 1,25-(OH)2D
      concentrations in a dose-dependent fashion. These levels increased progressively
      over the three cycles of unopposed estrogen treatment. In contrast the vitamin D
      binding protein concentration reached maximal levels after one cycle of E2. With
      the addition of progestin, the levels of total and free 1,25-(OH)2D returned
      toward baseline although vitamin D binding protein levels remained elevated. PTH
      levels rose with both doses of E2 as serum calcium levels fell. Progestin did not
      significantly alter the effects of E2 on PTH or calcium. Our results raise the
      possibility that progestin may antagonize part of the salubrious effects of
      estrogen on calcium homeostasis.

PMID- 1639955
TI  - Epidemiology of menarche and menstrual disturbances in an unselected group of
      women with insulin-dependent diabetes mellitus compared to controls.
AB  - To describe the age at menarche and the prevalence of menstrual disturbances in
      an unselected group of women with insulin-dependent diabetes mellitus compared to
      controls, we identified all women having debut of diabetes mellitus before the
      age of 30 yr and living in the County of Funen, Denmark on July 1, 1987 and being
      between 18 and 49 yr old. The women received a structured questionnaire inquiring
      information concerning menstrual conditions. An age comparable group of
      nondiabetic women was used as controls; 245 (94%) diabetic women and 253 (88%)
      controls answered the questionnaire. Among women with debut of diabetes before
      the age of 10 yr, the age at menarche was delayed 1 yr when comparing to controls
      (P less than 0.0001). During the past 6 months before answering the
      questionnaire, 8.2% of the diabetic women and 2.8% of the controls had
      experienced episodes of secondary amenorrhea (P less than 0.01). Corresponding
      figures for oligomenorrhea were 10.6% and 4.8% (P less than 0.02), for
      polymenorrhea 7.3% and 5.2% (NS), and for all types of menstrual disturbances
      21.6% and 10.8%, respectively (P less than 0.005). Episodes of secondary
      amenorrhea occurring more than 6 months before answering the questionnaire had
      been experienced by 10.7% of the diabetic population vs. 4.8% of the controls (P
      less than 0.05); corresponding figures for primary amenorrhea were 4.9% and 1.2%,
      respectively (P less than 0.05). We conclude that the age at menarche among women
      having developed insulin-dependent diabetes mellitus before the age of 10 yr was
      delayed by 1 yr when compared to controls. The overall prevalence of menstrual
      disturbances is increased in diabetic women compared to nondiabetic controls.

PMID- 1639956
TI  - Corticoid-induced growth hormone (GH) secretion in GH-deficient and normal
      children.
AB  - Acute administration of corticoids is a potent stimulus of GH secretion in man.
      To ascertain their mechanism and point of action as well as the suitability of
      this novel test in the diagnosis of GH-deficient states, normal controls and GH
      deficient children were studied. They were selected based on auxological criteria
      and the GH response to provocative stimuli. The GH-deficient children presented a
      blunted GH (mean +/- SEM; microgram/L) discharge after insulin-induced
      hypoglycemia (2.9 +/- 0.4), propranolol-exercise (7.4 +/- 1.5), and clonidine
      (6.5 +/- 0.8) compared with values in the normal children (7.2 +/- 2.2, 15.8 +/-
      2.4, and 15.6 +/- 1.8, respectively). As expected, GH-releasing hormone (GHRH)
      induced GH discharge in GH-deficient children (33.2 +/- 4.9) was similar to that
      in the control children (35.1 +/- 6.0). Administration of 2 mg/m2 body surface
      dexamethasone, iv, to normal children induced, 3 h later, a mean GH peak of 14.1
      +/- 1.2 micrograms/L. This was significantly higher that the corticoid-induced GH
      peak in GH-deficient children (6.7 +/- 1.1 micrograms/L). The corticoid-induced
      areas under the secretory curve were 1130 +/- 55 and 616 +/- 54 for the control
      and GH-deficient children, respectively. GH release in children after
      dexamethasone administration followed the pattern previously described for
      adults, i.e. there were no modifications of basal GH levels in the first 2 h, the
      GH peak appeared around the third hour, and the GH levels remained increased
      until the fourth hour after dexamethasone administration. Individually
      considered, practically all control children, but only 2 of 12 GH-deficient
      children, presented a dexamethasone-induced GH peak over the 10 micrograms/L
      level. In both normal and GH-deficient patients, corticoids appeared just as
      potent a stimulus as propranolol-exercise and clonidine, and more potent than
      hypoglycemia. This new stimulus showed a pattern similar to that of the
      hypothalamic stimuli, but clearly different with respect to the pituitary one
      (GHRH), suggesting that corticoids activate GH secretion by acting at
      hypothalamic level. In conclusion, acute administration of corticoids could be a
      suitable test in the diagnostic armamentaria of GH-deficient states.

PMID- 1639957
TI  - Aldosterone-secreting adrenal adenoma as part of multiple endocrine neoplasia
      type 1 (MEN1): loss of heterozygosity for polymorphic chromosome 11
      deoxyribonucleic acid markers, including the MEN1 locus.
AB  - A 63-year-old female presented with the extremely rare occurrence of an
      aldosterone-secreting adrenocortical adenoma as part of the syndrome of multiple
      endocrine neoplasia type 1 (MEN1). Only two other MEN1 patients were reported in
      the literature with hyperaldosteronism. The patient's MEN1 syndrome consisted of
      the association of primary hyperparathyroidism due to parathyroid adenoma, a
      prolactinoma, and a toxic multinodular goiter. Elevated basal and meal-stimulated
      serum PP levels without demonstrable pancreatic tumor were also found. Genetic
      analysis of the aldosterone-secreting adenoma with DNA markers localized on
      chromosome 11 showed loss of heterozygosity in tumor DNA. Since the MEN1 syndrome
      is caused by loss of the tumor suppressor gene on chromosome 11 in the 11q13
      region, it is probable that the same mechanism is associated with the formation
      of the adrenocortical adenoma.

PMID- 1639958
TI  - Localization and regulation of the activin-A dimer in human placental cells.
AB  - Subunits of activin and inhibin and their mRNAs are present in human placental
      and decidual cells. However, evidence for the presence of intact activin dimers
      in the human placenta and their regulation has been lacking. Using a monoclonal
      antibody raised against the human activin-A dimer, we examined the cellular
      localization of immunoreactive activin-A dimer in human placentas of different
      gestational ages (8-41 weeks). In addition, we determined the effects of culture
      and various potential regulators on the cellular accumulation of immunoreactive
      activin-A dimer in trophoblast cells from human first trimester placentas.
      Activin-A dimer was found in both cyto- and syncytiotrophoblast cells of all
      gestational ages studied. Immunoreactive activin-A also was detected in placental
      Hofbauer cells in first and second trimester placentas as well as in cells of the
      placental membranes. Exposure of these cells to cAMP, GnRH, activin, inhibin,
      transforming growth factor-beta, dexamethasone, and interleukin-1 did not
      significantly change the intensity of immunostaining for activin-A dimer. These
      results together with previous data suggest that placental cells are a source of
      activin-A and that activin-A may be a paracrine and/or endocrine regulator of
      feto-maternal interactions during pregnancy.

PMID- 1639959
TI  - Steroid hormones regulate the release of immunoreactive beta-endorphin from the
      Ishikawa human endometrial cell line.
AB  - Immunoreactive beta-endorphin (IR-beta END) is present in human endometrium.
      Several indirect lines of evidence suggest that endometrial beta END is under
      steroid hormone control, i.e. IR-beta END is detectable in the secretory, but not
      the proliferative, endometrium, and progesterone administration increases the
      concentration of IR-beta END in uterine secretions of ovariectomized gilts. To
      study the effect of steroid hormones on endometrial beta END, we first questioned
      whether Ishikawa human endometrial adenocarcinoma cells (which respond to steroid
      hormones) express the proopiomelanocortin (POMC) gene. Indeed, on Northern blot
      analysis, a RNA similar or identical in size to pituitary POMC mRNA was present
      in Ishikawa cell RNA extracts. IR-beta END was also present in Ishikawa cell
      extracts and culture medium, which coeluted with synthetic human beta END in a
      Sephadex G-50 column. Ishikawa cells released most of their IR-beta END into the
      culture medium. Estradiol decreased the release of IR-beta END from Ishikawa
      cells, an effect that was dependent upon dose and time. The maximal effect was
      observed after a 4-day exposure to 10 nM estradiol (44 +/- 6% of the control
      value; n = 6; P less than 0.001). This effect was almost completely counteracted
      by a 100-fold excess of the antiestrogen 4-hydroxytamoxifen. Progesterone and
      dihydrotestosterone did not have a statistically significant effect on IR-beta
      END release. Dexamethasone had effects similar to those of estradiol, i.e.
      decreased the release of IR-beta END in a time- and dose-dependent manner. The
      maximal effect was detected after a 4-day exposure to 10 nM dexamethasone (53 +/-
      6% of the control value; n = 6; P less than 0.001). Interestingly, the
      antiprogestin-antiglucocorticoid RU486 exhibited agonistic properties, i.e.
      diminished the release of IR-beta END in a time- and dose-dependent fashion,
      possibly via the glucocorticoid receptor. Its maximal effect was reached after a
      4-day exposure to 10 nM RU486 (55 +/- 6% of the control value; n = 6; P less than
      0.001). In conclusion, our data demonstrate that the release of IR-beta END from
      Ishikawa cells in culture is inhibited by estradiol and dexamethasone, suggesting
      that endometrial beta END is under estrogen and glucocorticoid regulation, as is
      the case with hypothalamic and pituitary POMC-derived peptides. This is the first
      time that the in vitro release of a peripheral-extracranial POMC-derived peptide
      has been found to be under the direct control of estrogens and glucocorticoids.

PMID- 1639961
TI  - Steroid hormones during puberty: racial (black-white) differences in
      androstenedione and estradiol--the Bogalusa Heart Study.
AB  - A large biracial cross-section of 1038 healthy children aged 6-18 yr with 519
      blacks, 519 whites, 678 males, and 360 females was evaluated for Tanner stage and
      serum levels of androstenedione, dehydroepiandrosterone-sulfate, estradiol,
      progesterone, and testosterone. The anthropometric values of the blacks and
      whites were very similar at each Tanner stage with only minor differences in age,
      height, and weight related to an earlier onset of puberty in blacks. The hormones
      dehydroepiandrosterone-sulfate, progesterone, and testosterone did not exhibit
      any racial differences. Estradiol showed a significantly higher level among black
      males compared to white males (P less than or equal to 0.05) whereas
      androstenedione was significantly higher in both white males (P = 0.0001) and
      females (P less than or equal to 0.01) compared with blacks. Many hormones are
      known to effect insulin resistance and others have reported a correlation between
      insulin levels and androstenedione. Blacks suffer disproportionately from
      diabetes. Since puberty is a time of dramatic changes in insulin resistance,
      racial (black-white) differences in steroid hormone changes were explored. This
      study shows that a racial difference in androstenedione levels exist during
      puberty, at a time when racial differences in insulin resistance are becoming
      manifest.

PMID- 1639960
TI  - A direct immunoradiometric assay for human plasma prorenin: concentrations in
      cycling women and in women taking oral contraceptives.
AB  - Two synthetic penta deca peptides corresponding to the N-terminal portion (amino
      acid sequence 1-15) and the C-terminal portion (sequence 32-46) of the pro moiety
      of the human prorenin (PR) molecule were coupled to BSA and used as antigens to
      generate antibodies against PR. In a RIA system using the 125I-labeled peptide as
      tracer, it could be shown that antibodies against peptide 32-46 bound the peptide
      and the native PR in the follicular fluid (FF) to a similar degree, whereas
      antibodies generated against peptide 1-15 did not specifically recognize native
      PR. The specificity of the PR-(32-46) antibodies for PR was demonstrated by
      comparative measurements of PR by RIA and by an indirect procedure (involving
      trypsin treatment of PR) in different individual FF samples, plasma samples, and
      fractions of FF obtained by gel filtration or immunoaffinity chromatography.
      Normal plasma PR levels could not be measured by RIA, since they were below the
      detection limit of the assay (0.5 micrograms PR/L approximately 10 pmol/L). For
      measurement of the low PR levels in plasma, a sensitive direct immunoradiometric
      assay with a detection limit of 0.1 fmol PR/tube was developed. It was based on
      the combined action of a commercially available solid phase renin antibody and
      the affinity-purified and 125I-labeled PR-(32-46) antibody. The measurement of 35
      individual plasma samples with different PR concentrations showed an excellent
      correlation (r = 0.99) between the new direct and the conventional indirect
      assays. The direct assay of PR concentrations in plasma of healthy women during
      the length of a menstrual cycle resulted in a biphasic pattern of PR
      concentrations, with peak levels (approximately 3-fold increase) at the time of
      the LH surge. The intake of monophasic and triphasic contraceptives caused a
      suppression of normal PR concentrations (96.9 +/- 34 ng/L; early follicular
      phase; n = 12) by 39% and 25%, respectively, which was also observed in the pill
      free phase of the artificial cycle.

PMID- 1639962
TI  - Flow cytometric analysis of deoxyribonucleic acid in human granulosa cells as a
      function of chronological age and ovulation induction regimen.
AB  - We examined whether the proliferative index of granulosa cells as determined by
      flow cytometry varied with a women's age or ovulation induction regimen that
      included leuprolide acetate (LA). This prospective cohort study included three
      groups of patients undergoing assisted reproductive technologies. Group I
      consisted of 9 women age less than or equal to 30 yr, who received LA plus human
      menopausal gonadotropin (hMG). Group II included 9 women age more than or equal
      to 40 yr, who received LA plus hMG. Group III consisted of 6 women age less than
      or equal to 30 yr who received hMG alone. A total of 79 preovulatory follicles
      containing greater than 10(4) granulosa cells were obtained from these 24 women
      and examined by flow cytometry. Group I was compared to group II to match for
      ovulation induction regimen and to examine proliferative index as a function of
      age. Group I was compared to group III to match for age and to examine
      proliferative index as a function of ovulation induction regimen. Outcome
      measures included proliferative index of granulosa cells as a function of age,
      ovulation induction regimen, ampules of hMG, estradiol on day of hCG, and serum
      FSH. Group I demonstrated a greater proliferative index than group II: 23.4% +/-
      1.4 vs. 18.4% +/- 0.96 (P less than 0.01). Group I had a greater proliferative
      index than group III: 23.4% +/- 1.4 vs. 11.9 +/- 0.61 (P less than 0.001).
      Although both age and the presence of LA appeared to affect the PI, multiple
      linear regression demonstrated that only the addition of LA and not age, per se,
      had an independent effect upon granulosa cells undergoing proliferation (P less
      than 0.0005). We conclude that LA followed by hMG leads to an increase in the
      percentage of granulosa cells undergoing proliferation when compared to ovulation
      induction regimens that include hMG alone. Chronological age does not appear to
      have a significant independent influence upon the proliferative index.

PMID- 1639963
TI  - The regulation of endothelin production in human umbilical vein endothelial
      cells: unique inhibitory action of calcium ionophores.
AB  - Endothelins (ETs) are a recently discovered family of small proteins that have
      potent long-lasting vasoconstrictive activities. Increased circulating
      concentrations of ETs have been found in hypertensive and renal disorders,
      including pregnancy-induced hypertension (PIH). PIH has been postulated to be the
      end result of endothelial cell damage and aberrant calcium metabolism. We
      evaluated the effects of calcium ionophores, calcium channel blockers, and two
      forms of cellular damage on ET production by human umbilical vein endothelial
      cells (HUVEC). Cells were grown to confluence and then incubated for 16 h with
      these treatments: physical trauma ("scratching"), oxidant damage (hydrogen
      peroxide, 1-20 mM), ionomycin (0.25-2.0 microM), A-23187 (10(-9)-10(-5) M),
      verapamil (0.22-22.0 microM), and nifedipine (2-200 micrograms/mL). ET production
      was determined using a commercial RIA that detects ET-1 and ET-2. Physical trauma
      enhanced ET production, whereas oxidant damage had the opposite effect. Both
      ionomycin and A-23187 caused concentration-dependent inhibition of ET production.
      Neither verapamil nor nifedipine consistently altered ET production. We conclude
      that specific forms of cellular damage can stimulate HUVEC ET production,
      although oxidant damage may be slightly inhibitory. Thus, enhanced ET levels in
      PIH may represent endothelial cell activation, rather than damage. HUVEC ET
      production is regulated in an inverse manner by intracellular calcium
      concentrations, suggesting a negative feedback from mediators of ET action on
      cells.

PMID- 1639964
TI  - Melatonin augments the sensitivity of MCF-7 human breast cancer cells to
      tamoxifen in vitro.
AB  - Cultured MCF-7 human breast cancer cells were pre-exposed to either melatonin
      (232 ng/mL) or vehicle for 24 hrs prior to being washed and then re-exposed to
      either ethanol-vehicle or varying concentrations of tamoxifen (37.1 ng/mL, 3.71
      micrograms/mL, 371 micrograms/mL) or melatonin (2.32 pg/mL, 232 ng/mL, 23.2
      ng/mL) for 5 additional days. Only 371 ng/mL tamoxifen caused a 38% growth
      inhibition of cells pre-exposed to vehicle whereas all concentrations of
      tamoxifen inhibited the growth of melatonin pre-exposed cells by 28% to 61% in a
      dose-dependent manner. Melatonin pre-exposure, potentiated the inhibitory effect
      of only 232 ng/mL melatonin. Comparison of IC50 values indicate that tamoxifen is
      approximately a 100 times more potent inhibitor of breast cancer cell growth
      following the pretreatment of cells with a physiological concentration of
      melatonin. These results indicate that melatonin has the capability to augment
      the inhibitory actions of tamoxifen, and to a lesser extent itself, on human
      breast cancer cell growth.

PMID- 1639965
TI  - Citation for the Ernst Oppenheimer Award of the Endocrine Society to James Larry
      Jameson.

PMID- 1639966
TI  - Citation for the Richard E. Weitzman Memorial Award to Fred E. Cohen.

PMID- 1639967
TI  - Citation for the Fred Conrad Koch Award of the Endocrine Society to Melvin M.
      Grumbach and Selna L. Kaplan.

PMID- 1639968
TI  - Citation for the Edwin B. Astwood Lectureship of the Endocrine Society to Michael
      O. Thorner.

PMID- 1639969
TI  - Citation for the Sidney H. Ingbar Distinguished Service Award to Nettie Karpin.

PMID- 1639970
TI  - Citation for the Robert H. Williams Distinguished Service Award to Claude J.
      Migeon.

PMID- 1639971
TI  - Citation for the Rhone-Poulene Rorer Pharmaceutical Clinical Investigator Award
      of the Endocrine Society to Samuel S. C. Yen.

PMID- 1639972
TI  - Preimplantation genetic diagnosis--counting chickens before they hatch?

PMID- 1639973
TI  - In-vitro progesterone production of human granulosa--luteal cells: the impact of
      different stimulation protocols, poor ovarian response and polycystic ovarian
      syndrome.
AB  - Granulosa cells from 85 patients undergoing in-vitro fertilization were cultured
      to investigate the impact of different stimulation protocols on in-vitro steroid
      secretion. A luteinizing hormone-releasing hormone analogue (LHRHa) was used
      either in the long protocol (pituitary desensitization) or in the short, 'flare
      up' regime. The steroidogenesis of granulosa cell cultures was investigated under
      basal conditions as well as after stimulation with luteinizing hormone (LH). The
      results were compared to the secretory capacity of cells obtained after treatment
      with gonadotrophins only. No correlation was found between the preovulatory
      oestradiol peak and subsequent in-vitro progesterone production. Granulosa-luteal
      cells from long protocol cycles exhibited lower progesterone production on day 2
      after follicular aspiration. On days 3 and 4 there was no difference between the
      three stimulation protocols regarding either basal or stimulated progesterone
      secretion. Cells from poor responders produced significantly (P less than 0.05)
      less basal progesterone during culture but they responded sufficiently to an LH
      stimulus. Granulosa cells from polycystic ovaries showed the lowest basal
      progesterone secretion (P less than 0.01 versus control); however, a normal
      stimulated level was achieved by adding LH to the culture medium. It is concluded
      that long protocol LHRHa pretreatment affects the very early progesterone
      formation of granulosa-luteal cells. Based on these in-vitro results, both poor
      responders and patients with polycystic ovaries should be supported vigorously in
      the luteal phase.

PMID- 1639974
TI  - In-vitro fertilization and the ovarian hyperstimulation syndrome.
AB  - Eight patients who developed severe ovarian hyperstimulation syndrome (OHSS) were
      identified among 1302 patients undergoing in-vitro fertilization (IVF) over a 1
      year period (prevalence of 0.6%); 63% had ultrasonically diagnosed polycystic
      ovaries (PCO) and 75% were undergoing their first attempt at IVF. Pretreatment
      with a superactive luteinizing hormone-releasing hormone (LHRH) analogue
      significantly increased the prevalence of severe OHSS (1.1% versus 0.2%, P less
      than 0.05) compared with ovarian stimulation with clomiphene citrate and human
      menopausal gonadotrophin (HMG). The mean serum oestradiol concentration on the
      day of human chorionic gonadotrophin (HCG) administration was 8200 +/- 2300
      pmol/l. A mean of 19.6 +/- 6.8 follicles had been aspirated and 13.1 +/- 7.7
      oocytes recovered at transvaginal ultrasound-directed oocyte recovery. All
      patients had an embryo transfer and luteal support in the form of HCG. The
      clinical pregnancy rate was 88%, multiple pregnancy rate 71% and implantation
      rate 63.5 +/- 41.3%. In a group of seven patients who were hospitalized for
      moderate OHSS during the same period, peak oestradiol levels were significantly
      lower than in those with severe OHSS (P less than 0.05). Of the group with
      moderate OHSS, 57% had PCO, the clinical pregnancy rate was 100% and multiple
      pregnancy rate 43%. Patients with ultrasound-diagnosed PCO have an increased risk
      of developing OHSS and the dose of HMG administered to them should be minimized.
      In patients at risk of developing OHSS, progesterone instead of HCG should be
      used for luteal support. Transfer of a maximum of two embryos or freezing all
      embryos for transfer in a subsequent cycle may reduce the likelihood of multiple
      pregnancy.

PMID- 1639975
TI  - Treatment with mifepristone (RU486) and oestradiol facilitates the development of
      genital septic disease after copulation in female rats.
AB  - Ovariectomized female rats were treated with oestradiol and the progesterone
      antagonist mifepristone. They allowed males to copulate to a similar extent as
      ovariectomized rats treated with oestradiol alone. The additional treatment with
      mifepristone, however, resulted in uterine infections following copulation,
      together with the prolonged presence of copulatory plugs in the uterine lumen. On
      several occasions rats became severely ill during the days after copulatory
      tests, occasionally with lethal consequences. Microscopic examination of the
      cervix and uterus 1 day after a copulation test in rats treated with oestradiol
      plus mifepristone, showed that copulatory plugs passed through the cervical
      canals directly into the uterine lumen. Bacterial infections and local
      destruction of the uterine epithelium were found in all rats examined. These
      features were not found in rats treated with oestradiol alone. Actions of
      mifepristone on the cervix of oestradiol treated rats are likely to play a key
      role in the passage of copulatory plugs and, thereafter, the development of
      uterine sepsis.

PMID- 1639976
TI  - Simultaneous induction of multiple follicular development with gonadotrophins and
      steroid replacement for in-vitro fertilization.
AB  - Simultaneous administration of follicle stimulating hormone, oestradiol valerate
      and progesterone was employed in a patient with a possible enzymatic deficiency
      involving low production of oestradiol. The patient became pregnant after in
      vitro fertilization. This case demonstrates that this treatment is useful in
      women with low oestradiol production and subsequent inadequate endometrial
      development; it also illustrates the role of oestradiol in follicular development
      and questions the importance of serum oestradiol measurements in the monitoring
      of ovulation induction.

PMID- 1639977
TI  - Do women want a once-a-month pill?
AB  - The attitudes of women of reproductive age in Scotland, Romania and Slovenia to
      the idea of a contraceptive pill which is taken only once each month or only when
      menses are delayed was investigated. In all three centres, the great majority of
      women felt positive towards the idea of a once-a-month pill which inhibited
      ovulation and greater than 50% found a pill which inhibited or interfered with
      implantation an acceptable idea. Only 24% of women in Scotland were attracted to
      the idea of a pill which was taken only if menstruation was delayed by 1 or 2
      days, that is a pill which would cause an abortion, while in contrast 58% of
      women in Slovenia and 80% in Romania thought that such a method of controlling
      fertility would be acceptable. Attitudes were not related to age, social class or
      marital status but were influenced by religious belief and in Scotland by a
      history of abortion. In countries where the availability of contraception is
      limited and abortion is common, women would seem to welcome another method of
      fertility regulation--even one which disrupts the very early stages of pregnancy.

PMID- 1639978
TI  - Microbial colonization and sperm--mucus interaction: results in 1000 infertile
      couples.
AB  - After screening a large series of infertile patients (n = 1000 couples),
      potentially pathogenic microorganisms were identified in genital secretions of
      the majority of couples. None of the patients displayed signs or symptoms of
      infection of the lower genital tract. In semen specimens and cervical swabs,
      mycoplasmas were found in 18 and 12%, potentially pathogenic aerobic bacteria in
      50 and 31%, additionally commensal aerobes in 38% and 25%, respectively. The
      microbial pattern showed great variability with polymicrobial growth most common.
      The rate of cultures positive for potentially pathogenic anaerobes was markedly
      influenced by the transport conditions. In endocervical material, Herpes simplex
      virus (HSV) was identified in 4.5%. Yeasts were found in the posterior vaginal
      fornix in 10%. Concerning both partners, there were only 10 couples (1%) from
      whom microorganisms in genital secretions could not be isolated, not including
      lactobacilli in females. This high prevalence of microbes and the low number of
      leukocytes indicate colonization rather than infection. When the microbial
      findings from both partners were analysed with regard to the outcome of sperm
      cervical mucus penetration testing in vitro, which was performed simultaneously,
      no significant correlation was found. Furthermore, microbial prevalence did not
      differ between couples with 'explained' and 'unexplained' infertility. The
      results of this study demonstrate that in patients without symptoms of genital
      tract infection, microbial colonization is of minor importance for sperm--mucus
      interaction and that extensive microbial screening should be preferentially
      performed in cases of poor sperm and/or mucus function.

PMID- 1639979
TI  - Chlamydial serology in the investigation of infertility.
AB  - Almost one-quarter of 100 asymptomatic men under fertility investigation had
      significant titres of IgA antibodies (greater than 1:8) specific for Chlamydia
      trachomatis in seminal plasma. No clear association was evident between the
      presence of these antibodies and sperm quality. In a second study, the female
      partners of men with consistently high serum or seminal plasma levels of
      chlamydia-specific IgA also exhibited a positive IgA reaction in serum without
      any clinical indications of the presence of an infection. In one group of men and
      women, antibiotic treatment for 4 weeks resulted in the disappearance of the IgA
      from the serum after a variable period of less than or equal to 12 weeks. The
      study indicates that chronic asymptomatic infections with Chlamydia trachomatis
      may be responsible for a large number of cases of infertility. It also implies
      that all men and women under investigation for infertility should be routinely
      screened with chlamydial serology regardless of previous history and clinical
      findings.

PMID- 1639980
TI  - Clinical complications during in-vitro fertilization treatment.
AB  - A questionnaire was sent to 12 large in-vitro fertilization (IVF) clinics in
      Nordic countries, asking about the number of clinical complications in connection
      with IVF treatment. The total number of cycles included was 10,125, with 7331
      embryo transfers performed. Clinical complications were rare, although
      hyperstimulation syndrome was reported in 0.7% of the cycles started and follicle
      puncture complications in 0.5% of cycles. Post-operative infections were reported
      in 0.3% of embryo transfers.

PMID- 1639981
TI  - Is mild endometriosis always a disease?
AB  - The easy access to the pelvis via laparoscopy has led to an appreciable increase
      in the diagnosis of endometriosis in women with infertility or chronic pelvic
      pain. This could suggest a rising incidence of the disease but is probably
      largely related to the recently acquired ability to demonstrate minimal and mild
      lesions. However, estimates of the distribution of endometriosis in the female
      population might be unreliable due to lack of control of the variables which
      influence diagnosis of the disease in the initial stages. Analysis of data from
      prospective studies on asymptomatic women undergoing tubal sterilization reveals
      a markedly higher than expected frequency of endometriosis. This raises doubts on
      the clinical significance of the minimal lesions that are often found. The
      concept that initial endometriosis should always be treated to avoid worsening of
      the condition seems to lack a convincing rational basis and is not supported by
      definitive scientific evidence. Minimal/mild endometriosis could represent a
      temporary phase in an on-going process that usually results in cytolysis of
      recently implanted endometrial cells, whereas in a few immunologically 'tolerant'
      subjects, nodular, cystic and infiltrating lesions develop, with eventual
      progression to moderate and severe stages.

PMID- 1639982
TI  - Reliability of detection by polymerase chain reaction of the sickle cell
      containing region of the beta-globin gene in single human blastomeres.
AB  - Human preimplantation embryos at various stages of development have been analysed
      using the polymerase chain reaction to amplify a 680 base pair fragment of the
      beta-globin gene. Successful amplification was achieved more frequently with DNA
      from intact embryos containing between one and 11 cells, single cumulus cells,
      oocytes which had failed to fertilize and polar bodies than from single
      blastomeres disaggregated from intact embryos and treated in an identical manner.
      The distribution of nuclei demonstrated using the nuclear chromophore diamino
      phenyl-indole showed considerable inter-blastomere variation; however, no clear
      correlation between staining pattern and successful amplification was observed.
      The reason for the unreliable amplification of DNA from single blastomeres is
      unclear but this finding has important implications for preimplantation diagnosis
      of genetic disease.

PMID- 1639983
TI  - Characterization and cellular distribution of human spermatozoal heat shock
      proteins.
AB  - Heat shock proteins (hsp) are ubiquitous components of all living systems. They
      are up-regulated in response to adverse changes in the cellular environment and
      at least one highly conserved group (hsp 70) is associated with the development
      of tolerance to various physico-chemical stress inducers. Spermatozoa have highly
      condensed chromatin and unlike somatic cells, are consequently unable to mount a
      stress response. However, using a combination of gel electrophoresis and
      immunoblotting with hsp-specific monoclonal antibodies, we report that proteins
      of M(r) 95 kDa and 70-75 kDa corresponding to hsp 90, and multiple forms of hsp
      70 are present in human spermatozoa. Immunohistochemistry localized hsp 90 to the
      neck and tail of unfixed, acrosome-intact spermatozoa. In contrast, an equatorial
      ring surrounding the nucleus was observed in unfixed spermatozoa, acrosome
      reacted with the calcium ionophore A23187. The ring was stained in cells fixed
      and permeabilized with ethanol, regardless of acrosomal status. Hsp 70 was an
      abundant surface antigen and as this protein was also abundant in seminal plasma,
      we believe that it may have been directly adsorbed onto the cell surface. More
      specific midpiece, equatorial and nuclear staining was also observed. Possible
      functions for spermatozoal heat shock proteins are discussed.

PMID- 1639984
TI  - Replacement of frozen embryos generated from epididymal spermatozoa: the first
      two pregnancies.
AB  - This report describes the first two pregnancies which occurred after
      cryopreservation, thawing and transfer of embryos generated using epididymal
      spermatozoa from men with congenital absence of the vas deferens. Of the 32
      embryos that were thawed, 24 survived (75%) and were replaced in seven transfer
      cycles resulting in two (29%) pregnancies successfully delivered. The
      demonstration that excess embryos obtained with the use of epididymal spermatozoa
      can be safely frozen/thawed, and that their survival is not different from other
      embryos generated by in-vitro fertilization, represents a great advantage for the
      reproductive performance of men with congenital absence of the vas deferens
      undergoing microsurgical aspiration of epididymal spermatozoa.

PMID- 1639985
TI  - The age of pronucleate mouse ova influences their development in vitro and
      survival after freezing.
AB  - The influence of pronuclear age on embryo development in vitro and on survival
      and post-thaw development after cryopreservation was investigated. Pronucleate
      mouse ova were removed from the oviductal environment at three different times:
      18 h after human chorionic gonadotrophin (HCG) (just after fertilization), 23 h
      after HCG (during DNA replication) and 28 h after HCG (just before cleavage).
      Control ova were either cultured in vitro or transferred in vivo without any
      treatment or exposed to dimethyl sulphoxide (DMSO) or 1,2-propanediol (PROH)
      before culture, but without cryopreservation. The effect on survival was
      evaluated by the development in vitro and in vivo after ultrarapid freezing in
      3.5 M DMSO and after slow programmed freezing in 1.5 M PROH. In vitro, the
      development of control ova to blastocysts was 39, 54 and 77% per treated ovum at
      18, 23 and 28 h after HCG, respectively. The survival rate was 78, 92 and 96%
      after ultrarapid freezing and 69, 90 and 81% after slow freezing, respectively.
      The subsequent rate of development to blastocysts per survived ovum was 21%, 35%
      and 62% after ultrarapid freezing and 38, 54 and 63% after slow freezing. In
      vivo, however, the pronuclear age did not influence the implantation rate or the
      number of living fetuses per transferred ovum, for neither the control, nor the
      frozen/thawed ova. The implantation rate and the numbers of living fetuses were
      not significantly different for frozen/thawed and control ova. In conclusion,
      early pronucleate mouse ova have a lower developmental capacity in vitro and a
      lower survival rate after freezing and thawing than pronucleate mouse ova just
      before cleavage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1639987
TI  - The use of cryopreserved aged human oocytes in a test of the fertilizing capacity
      of human spermatozoa.
AB  - The use of cryopreserved aged human oocytes in a diagnostic test of sperm
      fertilizing ability was evaluated. Oocytes arising from assisted conception
      cycles and showing no signs of fertilization 48 h post-insemination were
      cryopreserved by one of two methods. An ultrarapid method using dimethyl
      sulphoxide gave poor post-thaw results, with only 5/69 (7.2%) oocytes surviving.
      Oocytes frozen by a slow method using propanediol as the cryoprotectant gave
      better survival rates (359/594; 60%). Fertilization by donor spermatozoa of these
      thawed oocytes was poor (15/63; 24%) when the zona pellucida was left intact. To
      improve this, the zona was enzymatically removed using pronase. These zona-free
      oocytes were then inseminated with spermatozoa from a fertile donor or from men
      previously exhibiting fertilization failure in an in-vitro fertilization
      treatment cycle. The fertilization rate in the patient group (41/91; 45%) was
      significantly lower than in the donor group (16/18; 89%) (P less than 0.02).
      There was also a significant (P less than 0.03) reduction in the median number of
      pronuclei per oocyte (2.9 versus 4.5). These results show that aged oocytes can
      be effectively cryopreserved to establish a bank for use in a test to identify
      men with impaired sperm fertilizing capacity.

PMID- 1639986
TI  - Interdependent influence of follicular fluid oestradiol concentration and
      motility characteristics of spermatozoa on in-vitro fertilization results.
AB  - Methods are presented for an objective assessment of the quality of both gametes
      in an in-vitro fertilization programme. The concentrations of oestradiol and
      progesterone in follicles whose oocytes did or did not fertilize, were measured
      and assessed as potential markers of oocyte maturity. There was no difference in
      the mean concentrations of either steroid in follicular fluid of fertilized and
      unfertilized oocytes. However, a highly significant inverse correlation was
      observed between the oestradiol concentration in follicles of oocytes becoming
      fertilized and the number of spermatozoa added for fertilization (P less than
      0.001). Follicular fluid concentrations of progesterone did not correlate with
      the number of inseminated spermatozoa. The correlation between follicular
      oestradiol concentrations and the number of spermatozoa needed for fertilization
      was then used to identify movement characteristics of spermatozoa in the culture
      medium which were relevant for fertilization. Sufficient numbers of spermatozoa
      having specific values of head cross frequency, lateral head displacement,
      linearity and curvilinear velocity were critical for the occurrence of
      fertilization in vitro.

PMID- 1639988
TI  - Sonographic appearance of the endometrium: the predictive value for the outcome
      of in-vitro fertilization in stimulated cycles.
AB  - We evaluated the predictive value for pregnancy of the endometrial thickness and
      pattern assessed by vaginal sonography on the day of human chorionic
      gonadotrophin (HCG) injection and the day of embryo transfer in 74 stimulated
      cycles for in-vitro fertilization (IVF) which were analysed prospectively.
      Thickness was measured from the echogenic interface of the endometrial-myometrium
      junction in transverse fundal sections. The distribution of endometrial pattern
      on the day of HCG was 19 A (poor quality) cases (25.7%) and 55 B (good quality)
      cases (74.3%). On the day of embryo transfer, 16 out of the 19 A cases (84%)
      remained as A pattern, while the remaining three cases (16%) had changed to B
      pattern; of the 55 B cases, 29 (53%) remained the same, while 26 cases (47%)
      changed to A pattern. There was no significant correlation between the
      endometrial pattern on the day of HCG and/or on the day of embryo transfer and
      the peak serum oestradiol levels, the number of preovulatory oocytes aspirated,
      the serum progesterone levels and oestradiol: progesterone ratio on the day of
      transfer. In contrast, on the day of HCG, endometrial thickness correlated with
      serum oestradiol levels on that day (P = 0.02). The presence of pattern A on the
      day of HCG was associated with a lower pregnancy rate [three out of 19 cases,
      (15.8%)], compared to pattern B [16 out of 55 cases, (29.1%)], although this was
      not statistically significant (P greater than 0.05). On the day of embryo
      transfer, comparable pregnancy rates between A pattern [11 out of 42 cases,
      (26.1%)] and B pattern [eight out of 32 cases, (25%)] were found.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1639989
TI  - Pregnancy achieved by transferring blastocysts into endometrial stroma in mice.
AB  - To prevent the extra-uterine discharge of transferred embryos, we directly
      inserted mouse embryos into the endometrial stroma (intra-endometrial embryo
      transfer). A 27G injection needle was inserted near the utero-tubal junction into
      the endometrial stroma. After removal of the needle, a glass micropipette was
      inserted and one embryo was transferred with a very small amount of culture
      medium. To determine the feasibility of this method, the uterine lumen was
      flushed with phosphate-buffered saline from the tubal ends immediately after
      transferring blastocysts into pseudopregnant mice on day 2 and day 4. The rates
      of recovery of embryos from the uterine lumen were 5.0% (1/20; day 4) and 15.0%
      (3/20; day 2). These results suggest that a high rate of intra-endometrial embryo
      transfer is possible. The embryonic viability rates (number of viable grown
      fetuses/number of blastocysts transferred) of this method were 50.0% (28/56; day
      4) and 25.0% (5/20; day 2). Living offspring were delivered from both recipients
      which had received embryos on day 2 and day 4 of pseudopregnancy. In human in
      vitro fertilization and embryo transfer, attempts have also been made to
      immobilize the embryos, and this method might be clinically applicable. Moreover,
      this method will be a good in-vivo model for studies on the mechanism of
      implantation.

PMID- 1639990
TI  - Implantation enhancement by selective assisted hatching using zona drilling of
      human embryos with poor prognosis.
AB  - Assisted hatching by zona drilling using acidic Tyrode's solution was performed
      during three randomized trials in 330 in-vitro fertilization patients. The trials
      were designed in order to study the overall effect of the procedure and whether
      characteristic patient [i.e. maternal age and basal levels of follicle
      stimulating hormone (FSH)] and embryonic features (i.e. zona pellucida thickness)
      are important for the decision to perform assisted hatching routinely. Couples (n
      = 137; Trial 1) in whom the female partner had normal basal FSH levels were
      randomized in a control group (without micromanipulation) and a zona drilling
      group (all embryos micromanipulated). The incidence of implantation (67/239; 28%)
      of zona-drilled embryos compared favourably with that of control embryos (49/229;
      21%), but the difference was not significant. Retrospective analysis revealed
      that those embryos whose zonae were thicker than 15 microns were rescued. In
      order to test the validity of this finding, selective assisted hatching was
      performed on embryos with a poor prognosis in 163 other patients (Trial 2). The
      couples were randomized into a control group and a group in which embryos were
      selectively zona-drilled, based on zona thickness and other embryonic features.
      The rate of embryonic implantation in the selectively zona-drilled group was 25%
      (70/278), significantly (P less than 0.05) higher than that of control embryos
      (51/285; 18%). Although it was demonstrated retrospectively and prospectively
      that assisted hatching by zona drilling is effective in embryos with thick zonae
      (greater than or equal to 15 microns), patients whose embryos have thin (less
      than 13 microns) zonae may be jeopardized by the procedure.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1639991
TI  - Pregnancy tests: a review.
AB  - Pregnancy tests are widely used both by the public and by healthcare
      professionals. All tests depend on the measurement of human chorionic
      gonadotrophin (HCG) in urine. Other pregnancy-specific materials have been
      proposed as pregnancy tests but none can better the sensitivity and convenience
      offered by immunoassay of HCG. Ultrasound detection is also not as sensitive as
      HCG measurement. The current generation of tests is based on monoclonal
      antibodies to the beta-subunit of HCG; these virtually eliminate the possibility
      of cross-reaction with pituitary luteinizing hormone (LH) and it is this feature
      which permits the high sensitivity. However, it is important to recognize that
      the 'beta-subunit' antibody reacts with both intact HCG, which is the major
      component in pregnancy serum, and with fragments of the beta-subunit (beta-core),
      which are the major form in urine. Both the blood and urine of non-pregnant
      subjects contain small amounts of HCG. HCG from the implanting blastocyst first
      appears in maternal blood around 6-8 days following fertilization; the levels
      rise rapidly to reach a peak at 7-10 weeks. With most current pregnancy test kits
      (sensitivity 25 units per litre) urine may reveal positive results 3-4 days after
      implantation; by 7 days (the time of the expected period) 98% will be positive. A
      negative result 1 week after the missed period virtually guarantees that the
      woman is not pregnant. With the present generation of test kits, false positive
      results due to interfering materials are extremely unlikely. Pregnancy tests have
      now reached a level of sensitivity and specificity which is unlikely to be
      surpassed either by better tests or alternative technology.

PMID- 1639992
TI  - Intravenous immunoglobulin treatment of women with multiple miscarriages.
AB  - Eleven women who had previously experienced four to eight unexplained fetal
      losses (median 6.0 fetal losses/woman) were treated in their next pregnancy with
      individualized doses of pooled intravenous immunoglobulins. Nine women (82%)
      delivered healthy infants subsequent to the treatment. Prior to treatment, the
      pregnant patients had a significantly (P less than 0.05) increased median level
      of complement C3 neodeterminants in the blood compared with a group of 33 normal
      first trimester pregnant women. This may be a sign of increased turnover of
      complement in these women.

PMID- 1639993
TI  - Oocyte donors: a demographic analysis of women at the University of Southern
      California.
AB  - A summary is presented of 3 years' experience with donors in an oocyte donation
      programme. During this interval, 50 women participated as gamete donors. All
      proffered their services without solicitation from the programme. Most were
      college-educated, working mothers. The majority stated that the primary
      motivation for participation was concern for others' infertility. Oocytes donors
      generally found the required use of parenteral medication taxing but tolerable.
      In most cases, injections were administered to the donor by her husband or by the
      female recipient. The majority of donations were performed without anonymity
      (66%). Cycles were performed at approximately 3-month intervals. This approach as
      well tolerated by donors and allowed predictable scheduling of cases. All women
      felt their participation was of great significance and each was willing to donate
      oocytes again if asked.

PMID- 1639994
TI  - Assessment at 1 year of the psychological consequences of having triplets.
AB  - The purpose of this study was to assess the psychological difficulties
      encountered by mothers 1 year after the birth of triplets. Twelve mothers entered
      the study having delivered triplets in a public hospital in Paris. Nine
      pregnancies had been initiated after in-vitro fertilization (IVF) or gamete intra
      Fallopian transfer (GIFT), two after ovarian stimulation and one was spontaneous.
      The method consisted of tape-recorded semi-structured interviews at the mothers'
      homes. At 1 year, a majority of mothers reported considerable fatigue and stress.
      In most cases, home help was no longer provided by social services or by
      relatives. A majority suffered from social isolation and had difficulties in
      going out because of a lack of help, and inquisitive looks and questions from
      other people. Most mothers said that having triplets placed a strain on the
      marital relationship. The relationship with the children was often disturbed.
      Mothers reported that it was difficult to give adequate attention to the three
      children at the same time. Most of them tended to become emotionally detached.
      Eight mothers expressed psychological difficulties and three of them were treated
      for depression. Families with triplets should be provided with increased help,
      special attention, counselling and support, either at home, in clubs or in
      special clinics.

PMID- 1639995
TI  - Centralized drug development.

PMID- 1639996
TI  - Dosage regimen design: pharmacodynamic considerations.
AB  - Pharmacokinetic methodology to define the time course of drug in an accessible
      biologic fluid is now well established as are models that relate concentration to
      effect. When steady-state conditions are not readily available to define a dose-
      or concentration-effect relationship, non-steady-state
      pharmacokinetic/pharmacodynamic models can be applied. Despite these methodologic
      advances, many aspects of clinical drug development and therapy do not readily
      lend themselves to pharmacokinetic/pharmacodynamic scrutiny. Barriers to this
      scrutiny include: drug assay problems or lack of an accessible biologic fluid
      that can be sampled to measure drug concentration; lack of a immediate
      pharmacologic effect in the clinic that can be related to concentration; and lack
      of a relationship between an immediate measurable pharmacologic effect and long
      term clinical benefit. In the evaluation and application of any drug, the
      following questions are useful: 1) what is the pharmacologic effect of interest?
      2) is it a positive (benefit) or negative (risk) effect? 3) are there more than
      one positive or negative effects of interest? 4) how is the effect measured and
      can the measurement be applied reasonably in a clinical setting? 5) is the effect
      immediate (for example, blood pressure reduction) or long-term (for example,
      prevention of stroke with an antihypertensive)? 6) can the effect be usefully
      related to a concentration to guide dosimetry? and 6) if a concentration/effect
      relationship is likely, can it be defined at steady state or must non-steady
      state pharmacokinetic/pharmacodynamic models be constructed?(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1639997
TI  - Ethnicity and ambulatory blood pressure measurement: relationship to clinic and
      laboratory measurements.
AB  - African Americans have a higher prevalence of hypertension than white Americans.
      Morbid consequences of hypertensive disease are greater in blacks than whites.
      For members of high-risk groups such as blacks, ambulatory blood pressure
      monitoring may be useful in supplementing casual clinic measurements to prevent
      misdiagnosis, better characterize the temporal topography of blood pressure
      responses, and improve prediction of left ventricular hypertrophy, hypertensive
      complications, morbidity, and mortality. In conjunction with other data,
      laboratory experiments showing that African Americans as a group show greater
      peripheral resistance and slowed natriuretic responses to behavioral stressors
      than whites, appear to provide insights as to why blacks generally respond better
      to diuretics and calcium channel blockers than to beta-adrenergic antagonists or
      angiotensin-converting enzyme inhibitors. It is suggested that ambulatory blood
      pressure monitoring and behavioral tasks in the laboratory may help predict
      individual responsiveness to antihypertensive agents.

PMID- 1639998
TI  - Ambulatory blood pressure monitoring for evaluation and management of
      hypertensives: effect on outcome and cost effectiveness.
AB  - Blood pressure monitoring of hypertensives in the ambulatory state by automated
      portable devices (ABPM) as compared with casual office readings (COBPM) may
      predict outcome with greater precision and at an overall lower cost. Prospective
      trials that in random fashion require evaluation and management decisions on the
      basis of ABPM compared with COBPM are required to determine whether the above is
      true. End points such as death, stroke, or myocardial infarction occur at a low
      frequency rate. This would require thousands of patients to be followed 5 or more
      years to determine if evaluation and management by ABPM compared with COBPM
      results in a different outcome. A much smaller population can be used if end
      points are changes in left ventricular mass and left ventricular ischemia,
      arterial wall stiffness and thickness, endogenous creatinine clearance, renal
      albumin excretion, antihypertensive drug requirements, and adverse reactions.
      Until results from such a prospective trial are available, COBPM is the method of
      choice for evaluation and management of hypertensives. Automated blood pressure
      measurement can provide useful information in special circumstances and is of
      value for research purposes.

PMID- 1639999
TI  - Variability and similarity of manual office and automated blood pressures.
AB  - The evaluation and management of hypertension is based on indirect blood
      pressures obtained in the office (COBPs) using the mercury sphygmomanometer. The
      usefulness of COBPs is limited by factors such as observer bias, which confound
      the ability to discern the true blood pressure value. Automated portable monitors
      have been marketed, which also measure blood pressure (ABP) indirectly throughout
      24 hours, but without human intervention. Acceptance of a new device that
      indirectly records blood pressure depends largely on its the agreement with the
      established method of blood pressure measurement. This review compares the
      variability of blood pressures collected indirectly by standard mercury
      sphygmomanometer and by an auscultatory automated portable blood pressure
      monitor. The results indicate that blood pressure, when measured indirectly in a
      hypertensive patient, is quite variable. Automated blood pressures were lower and
      demonstrated less within-subject variability during repeated measures than COBPs.
      The agreement between ABPs and COBPs was better than the agreement between COBPs
      alone on successive visits. In addition, the mean hourly blood pressure profiles
      recorded throughout 24 hours by automated and manual methods from ten
      hypertensive patients were nearly identical. These data suggest that blood
      pressures measured by auscultatory automated methods are similar to and
      representative of those obtained manually.

PMID- 1640000
TI  - Clinical utility of ambulatory blood pressure monitoring in target organ
      complications and equipment choices.
AB  - Although population studies have demonstrated a relationship between casual
      office blood pressures and target organ events, the variability of these blood
      pressure measurements for individual patients has generated an interest in the
      role of ambulatory blood pressure monitoring for defining the presence of
      hypertension and assessing the response to therapy. Noninvasive devices provide
      fewer data than intra-arterial ambulatory blood pressure monitoring devices, but
      are safer. No current noninvasive device performs well during ambulation.
      Rigorous evaluation of these rapid proliferating electronic devices is important,
      as would be the case with any new antihypertensive agent. Although ambulatory
      blood pressure measurements correlate better with target organ damage for groups
      of patients than do casual office measurements, the predictability and limited
      data on reproducibility for individual patients does not support widespread
      application for routine testing for hypertensive patients. Ambulatory blood
      pressure monitoring should be viewed as a standard research tool for the
      evaluation of new cardiovascular drugs.

PMID- 1640001
TI  - Antihypertensive drug therapy does not perturb the circadian blood pressure
      pattern.
AB  - The literature was reviewed to determine whether failure of older
      antihypertensive drugs to suppress the early morning increase of blood pressure
      was responsible, in part, for the less than satisfactory rate of reduction in
      cardiovascular mortality rates in the United States. The authors found that
      neither the old nor the new antihypertensive drugs altered the 24-hour blood
      pressure curve pattern, although long-acting drugs did show continued effect at
      the end of the 24-hour period when compared with placebo. The efficacy of these
      drugs most likely lies with their blood pressure lowering and other ancillary
      effects and not with pattern changes. More importantly, examination of new data
      (1989) shows that the rate of decline in death due to diseases of the heart has
      exceeded that for cerebrovascular diseases. Our overall health care effort may be
      more successful than we thought.

PMID- 1640002
TI  - Pharmacokinetics of fluvastatin after single and multiple doses in normal
      volunteers.
AB  - The pharmacokinetics of fluvastatin, a potent inhibitor of hydroxymethylglutaryl
      CoA reductase and thus cholesterol synthesis, have been studied in 24 normal male
      volunteers who received [3H] fluvastatin in three different studies: a single
      dose study using oral doses of 2 or 10 mg, an absolute bioavailability study
      using doses of 2 mg intravenously or 10 mg orally, and a multiple-dose study
      using 40 mg orally once daily for 6 days. Serial blood and plasma samples and
      complete urine and feces were collected and analyzed for total radioactivity as
      well as for intact fluvastatin. Fluvastatin was rapidly and almost completely
      (greater than 90%) absorbed from the gastrointestinal tract, although the
      estimated bioavailability from the 2- and 10-mg doses was only 19 to 29% because
      of extensive first-pass metabolism. Fluvastatin pharmacokinetics appeared to be
      linear over the 2- to 10-mg dose range, as indicated by dose-proportional blood
      levels of total radioactivity and the parent drug. Absorbed fluvastatin was
      completely metabolized before excretion, the biliary/fecal route being the major
      excretory pathway. The recovery of radioactivity after a single dose was
      virtually complete within 120 hours. The terminal half-lives of fluvastatin and
      total radioactivity averaged 0.5 to 1 hour and 55 to 71 hours, respectively,
      whereas the total body clearance of fluvastatin was 0.97 L/hour/kg. Repeated oral
      administration of 40-mg doses of [3H]fluvastatin resulted in no time-related
      change in pharmacokinetic characteristics, but this dose yielded greater than
      proportional increases in circulating levels of the parent drug, thus suggesting
      a saturable first-pass effect on fluvastatin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640003
TI  - Big platelets in hyperlipidemic patients.
AB  - Both "big" platelets and hyperlipidemia are associated with increased coronary
      risk. This study was undertaken to search for a possible effect of various
      hypolipidemic drugs on big platelets. The percentage of big platelets, assessed
      microscopically, was measured in 66 patients who had hyperlipidemia of various
      types. Twenty-seven patients with hypertriglyceridemia were randomly selected to
      receive either fish oil or placebo in a crossover study. Another group of 39
      patients with hypercholesterolemia, among them 13 with heterozygous familial
      hypercholesterolemia (FH), received lovastatin. The pretreatment level of big
      platelets was elevated, and similar in all groups: 23.3 +/- 12% versus 22 +/- 9%,
      in the fish oil versus placebo group, 19.1 +/- 6.3% versus 24 +/- 11% in the FH
      versus non-FH primary hypercholesterolemia group (reference value, 6.8 +/- 3.5%).
      After treatment, despite the improvement in lipoprotein profile, the percentage
      of big platelets did not change. The relationship between lipid reduction and big
      platelets is thus questionable, and necessitates further study.

PMID- 1640004
TI  - Sertraline does not alter steady-state concentrations or renal clearance of
      lithium in healthy volunteers.
AB  - An open-label, placebo-controlled study was conducted to determine the effects of
      sertraline on the steady-state levels and renal clearance of lithium in 20
      healthy volunteers. Subjects received 600 mg of lithium twice daily for 9 days.
      On the evening of day 8, subjects received orally either placebo or 100 mg of
      sertraline; these were administered twice, 8 hours apart, beginning 2 hours after
      the evening dose of lithium. In a comparison of day 8 with day 9 (before
      administration of the morning doses of lithium), sertraline was associated with
      only a 0.01 mEq/L (1.4%) decrease in steady-state levels and a 0.11 L/hour (6.9%)
      increase in the renal clearance of lithium. Neither change was statistically
      significant relative to placebo. Four subjects were excluded from analysis
      because of protocol violations or laboratory abnormalities unrelated to
      sertraline. Seven subjects who received lithium plus sertraline experienced side
      effects, mainly tremors, possibly related to treatment, whereas none of those
      administered lithium plus placebo experienced side effects. No sertraline-related
      laboratory abnormalities were observed.

PMID- 1640005
TI  - The effects of estazolam on sleep, performance, and memory: a long-term sleep
      laboratory study of elderly insomniacs.
AB  - Insomnia, a common complaint among the elderly, is generally treated with
      benzodiazepines. Long-acting benzodiazepines (e.g., flurazepam) often produce
      daytime somnolence and performance deficits, whereas short-acting drugs (e.g.,
      triazolam) have been associated with marked rebound insomnia and anterograde
      memory loss. The authors designed a pilot study to evaluate the efficacy of an
      intermediate-acting benzodiazepine, estazolam (e.g., ProSom), as well as its side
      effects. The parameters studied were sleep, daytime performance, and memory. Ten
      geriatric patients (greater than 60 years of age) with insomnia participated in
      the study. They received placebo nightly for 2 weeks (baseline), estazolam 1 mg
      nightly for the next 4 weeks (treatment phase), and placebo again for 2 weeks
      (withdrawal period). Sleep was monitored by polysomnography the first two nights
      of each week in a sleep laboratory. Estazolam significantly decreased sleep
      latency, nocturnal awakenings, and wake time after sleep onset. Total sleep time
      increased an average of 63 minutes the first night of treatment. Significant
      improvements in wake time after sleep onset and total sleep time also were
      observed in the fourth week of estazolam treatment. Rebound insomnia occurred on
      the first withdrawal night only for wake time and total sleep time. By the next
      night, these sleep parameters returned to baseline. Neither day-time performance
      nor anterograde memory was adversely affected by estazolam treatment or its
      withdrawal. A 1-mg dose of estazolam appears to be a safe and effective hypnotic
      for elderly patients with insomnia.

PMID- 1640006
TI  - Hair analysis of cocaine: differentiation between systemic exposure and external
      contamination.
AB  - Cocaine has been shown to accumulate in hair of admitted users. Before using this
      test to verify cocaine use, however, it is crucial to differentiate between
      systemic exposure and external contamination from being in contact with crack
      smoke. In the present studies, the authors document that pyrolysis of crack
      results in hair accumulation of cocaine, but not its benzoylecgonine metabolite,
      whereas after admitted cocaine use both species are detectable in hair. External
      contamination with crack smoke is washable, whereas systemic exposure is not. The
      authors suggest these two criteria to distinguish systemic exposure from external
      contamination.

PMID- 1640007
TI  - Effect of the amount of internal standard on the precision of an analytical
      method.
AB  - In an earlier published paper, a confidence interval approach was used to show
      that the use of a large amount of internal standard (relative to the analyte)
      would adversely affect the precision of the analytical method. However, the
      confidence intervals were not calculated correctly. The authors recalculated the
      confidence intervals and found that there is no effect on the precision as
      measured by the confidence intervals.

PMID- 1640008
TI  - Shaping the future profession: a new tableau for dental education.

PMID- 1640009
TI  - Reliability and validity of the pilot National Board Dental Examination.
AB  - The reliability and validity of the pilot National Board Dental Examination were
      examined. The results indicate that the pilot examination is a reliable test that
      assesses a full range of cognitive behaviors. Furthermore, the findings indicate
      that the pilot examination is a unidimensional test of comprehensive general
      dentistry. The performance of examinees on the pilot examination was found to be
      similar to their performance on the traditional Part II examination. These
      findings suggest that the restructured Part II examination will be a more
      reliable and valid measure of dental students' knowledge and problem-solving
      skills than the traditional Part II.

PMID- 1640010
TI  - The role of the deans and the AADS in licensure: a call for leadership and a
      necessity to toil on "the road less travelled".

PMID- 1640011
TI  - Results of the Ohio non-patient dental board examinations for 1990 and 1991.

PMID- 1640012
TI  - Licensure--entry-level examinations: strategies for the future.

PMID- 1640013
TI  - Implications of PGY-1 to the present entry-level dental licensure system.

PMID- 1640014
TI  - Standardized national dental clinical examinations.

PMID- 1640015
TI  - Licensure based upon graduation or the real issue in protecting the public.

PMID- 1640016
TI  - Applicants versus first-year enrollment in selected postdoctoral dental education
      programs.

PMID- 1640017
TI  - American Association of Dental Schools. 1991-92 annual proceedings. March 14,
      1991--March 7, 1992. Including the proceedings of the 1992 annual session.

PMID- 1640018
TI  - Expression of human T-cell lymphotropic virus type-1 gene products in the short
      term cultured skin tissues of an adult T-cell leukemia/lymphoma patient with
      cutaneous manifestations.
AB  - Adult T-cell leukemia/lymphoma (ATLL) is recognized as a disease etiologically
      associated with human T lymphotropic virus type-1 (HTLV-1) infection, but,
      neither viral replication nor specific virus antigen expression have been
      detected on ATLL cells distributed in organs, including skin. To examine the
      latent expression of HTLV-1 in the cutaneous lesions of ATLL patients, we
      cultured the lesional skin tissues in vitro and applied immunofluorescence
      staining with mouse monoclonal antibodies Lt-4, GIN-14, and F10, which react with
      p40tax, p19 and gp21, respectively. We recognized HTLV-1 specific antigens on
      clustered ATLL cells only in the deeper dermis of the skin after 24 hrs
      cultivation of the lesional skin tissue from an ATLL patient in RPMI-1640 medium
      supplemented with 20% fetal calf serum. In the electron microscope, we observed
      HTLV-1 like particles, 80-140 nm in diameter with envelope and core structures,
      in the same tissue specimen. These findings suggest that HTLV-1 gene products may
      be expressed in the skin lesions of ATLL patients and involved in the
      pathogenesis of skin eruptions in cutaneous type ATLLs. To our knowledge, this is
      the first report that envisages the potency of intracutaneous HTLV-1 expression
      in vivo.

PMID- 1640019
TI  - A new animal model for contact dermatitis: the hairless guinea pig.
AB  - Allergic and irritant contact reactions were evaluated in the recently identified
      hairless guinea pig, Crl:IAF(HA)BR, a mutant from the Hartley strain. The
      cutaneous changes were observed macro- and microscopically. The irritant contact
      dermatitis was induced by croton oil, 2,4-dinitrochlorobenzene (DNCB), or
      anthralin. Both hairless and hairy guinea pigs developed similar reactions to
      these chemicals. The density of the epidermal Langerhans cells (LC) of hairless
      guinea pigs was significantly higher than that in the hairy strain. Allergic
      contact sensitization was easily induced with DNCB. Photoallergic contact
      sensitization was also induced with tetrachlorosalicylanilide (TCSA) but not with
      tribromosalicylanilide (TBS). However, by administration of cyclophosphamide
      before sensitization, positive photocontact responses were seen with TBS. These
      results indicate that hairless guinea pigs can be used as animal models for
      investigation of immunologic and nonimmunologic contact reactions.

PMID- 1640020
TI  - Immunohistochemical characterization of cellular infiltrates in epidermal tumors
      induced by two-stage and complete chemical carcinogenesis in mouse skin.
AB  - We investigated the population and pattern of the infiltrated cells in both
      benign and malignant epidermal tumors which were induced chemically with
      benzo(a)pyrene (B(a)P) in murine skin. In benign papillomas, which were evolved
      by a two stage carcinogenesis regimen, a slight to mild inflammatory infiltration
      around the tumors was observed, and cells infiltrating into the tumor nests were
      rarely seen. In carcinomas, which were produced by a complete carcinogenesis
      regimen, a dense inflammatory infiltration was observed around the tumor nests.
      The infiltrated cells were characterized as T-lymphocytes, macrophages, and
      neutrophils. Natural killer (NK) cells were found around and in the tumor nests,
      but their number was small. Both T-lymphocytes and macrophages were found to
      invade the tumor nests in squamous cell carcinoma whose duration was more than
      four weeks. This experimental carcinogenesis animal model allows the detailed
      quantitative and functional analysis of the infiltration of immunocompetent cells
      into epidermal tumors.

PMID- 1640021
TI  - Malignancy and interstitial pneumonitis as fatal complications in
      dermatomyositis.
AB  - By sending questionnaires to the major dermatological clinics in Japan, we
      examined the outcome and causes of death in 182 cases of dermatomyositis (DM)
      observed between 1983 and 1987. The mortality rate in adults was 26.7%.
      Associated malignancy occurred in 47 cases (25.8% of adults), and 16 of them died
      of neoplasms. In contrast to 43 carcinomas, only 1 patient died of lymphoma.
      Associated interstitial pneumonitis (IP) appeared in 31 cases. IP started
      simultaneously or within 6 months after the diagnosis of DM in the majority of
      these cases. Of the 13 fatal cases due to IP, 8 died of respiratory failure
      within two months of the onset of lung disease. In the malignancy group,
      periungual erythema was noted in a higher proportion. Raynaud's phenomenon was
      more frequently noted in the IP group. DM overlapped with other collagen diseases
      in 14 cases.

PMID- 1640022
TI  - Clinicopathological and immunohistochemical study of basal cell carcinoma with
      reference to the features of basement membrane.
AB  - One hundred and thirty-five cases of basal cell carcinoma (BCC) were
      investigated, focusing upon factors determining a postoperative prognosis. Out of
      the 135, nine tumors on the face recurred. All of these nine tumors were
      insufficiently extirpated at the initial operation, and showed micronodular or
      infiltrative patterns with stromal fibrosis. Dividing the degree of dermal
      invasion into four levels, all tumors with recurrence reached levels 3 and 4, the
      two deeper groups. The immunohistochemical study using anti-laminin and anti-type
      IV collagen antibodies showed various changes of staining pattern around tumor
      cell nests, such as attenuation, disruption, and thickening of basement membrane,
      in contrast with the normal thinly continuous staining around nontumorous control
      epidermis. The disruption of basement membranes was remarkable around the tumor
      cells showing a micronodular growth pattern, although the discontinuity of
      basement membrane was observed in all types of BCCs to a greater or lesser
      degree. Ultrastructural thickening, multiplication, or discontinuity of basement
      membranes were found in all 19 cases examined with a greater or lesser degree,
      although they were most frequently observed around the cell nests showing
      micronodular growth patterns. It was concluded that deep dermal and marginal
      invasions were the most ominous signs of recurrence of BCCs. Although the
      disruption of basement membranes might participate in the local aggressiveness of
      BCCs, especially in the tumor cells showing micronodular infiltrative growth,
      other factors may concern the recurrence of BCCs.

PMID- 1640023
TI  - Reduction of environmental mites improved atopic dermatitis patients with
      positive mite-patch tests.
AB  - During a series of studies on the involvement of house dust mite antigens in 183
      cases of atopic dermatitis, we observed an improvement in two patients following
      the removal of mites from their environment by means of a thorough housecleaning
      and replacement of the mattress. Both patients manifested the typical clinical
      skin lesions of atopic dermatitis and had similar laboratory findings. Although
      the serum IgE concentrations and specific IgE to Dermatophagoides pteronyssinus
      and Dermatophagoides farinae were each relatively low, the results of patch tests
      with these antigens were positive. Thus, a regimen aimed at reducing the presence
      of house dust mites can produce clinical improvement in a subset of patients with
      atopic dermatitis who show contact hypersensitivity to mite antigens on skin
      testing, but negative results on IgE (RAST; radioallergosorbent technique)
      testing.

PMID- 1640024
TI  - A case of neutrophilic dermatosis (ND) complicated by cryofibrinogenemia (CFGN)
      and myelodysplastic syndrome (MDS).
AB  - A case of neutrophilic dermatosis (ND) complicated by cryofibrinogenemia (CFGN)
      and myelodysplastic syndrome (MDS) is reported. Although the patient presented
      pancytopenia, the skin lesions were compatible with those of ND from the clinical
      and histopathological findings. Further, immunofluorescence technique revealed
      cryofibrinogen (CFG) deposits on the walls of the blood vessels in the skin
      lesion, and a high titer of CFG components was disclosed in the patient's
      peripheral blood. In this case, CFGN may have been associated with MDS; hence CFG
      deposits probably played a role, at least in part, in the skin lesion formation.
      This is probably the first case of ND complicated by CFGN. And careful
      examination of an underlying disease is recommended in association with ND and/or
      CFGN.

PMID- 1640025
TI  - Superficial epithelioma with sebaceous differentiation.
AB  - In 1980, Rothko, Farmer, and Zeligman first described the disease entity
      "Superficial epithelioma with sebaceous differentiation" as a histologically
      distinct, rare, benign lesion. We report here the first Japanese case fitting
      this description. The patient is a 38-year-old Japanese woman, who had a small,
      yellow, flat-topped, well-defined plaque on her right upper eyelid.
      Histologically, the lesion was a multilobular, superficial, dermal tumor with
      numerous broad attachments to the overlying epidermis. The overall configuration
      was a plate-like proliferation of tumor cells with well-defined borders. The
      tumor cells were basically uniform basaloid cells with single or clustered
      sebocytes in the upper part of the tumor and multiple well differentiated
      sebaceous lobules in the middle and lower parts of the tumor. Multiple cystic
      spaces were formed in the lobules. Differential diagnosis of several tumors with
      sebaceous differentiation is discussed.

PMID- 1640026
TI  - A case of congenital trichofolliculoma.
AB  - A case of congenital trichofolliculoma on the right cheek of a 3-month-old boy is
      reported. Trichofolliculoma usually appears in middle age; it is unusual in
      childhood. This is the first reported case of congenital trichofolliculoma.

PMID- 1640028
TI  - Prevention of pneumonia by selective decontamination of the digestive tract
      (SDD).
AB  - Prevention of respiratory tract infections is only possible when the pathogenesis
      is known. Three types of infection can be distinguished: primary endogenous
      infections, caused by pathogens carried in the throat at the commencement of
      mechanical ventilation, generally develop early and can only be prevented by
      intravenous antibiotics. Secondary endogeneous infections, caused by hospital
      acquired pathogens, generally develop later and can be prevented by selective
      decontamination of the digestive tract (SDD). The GI-tract is decontaminated by
      oral nonabsorbable antibiotics and for oropharyngeal decontamination a sticky
      antibiotic ointment is used. To date 16 controlled SDD trials in intensive care
      have been fully published. In all except one study, the pneumonia rate decreased
      significantly from 40%-50% in controls to about 10% in SDD-treated patients. All
      studies showed a consistent reduction of ventilator days, ICU-stay and an
      improved outcome in SDD-treated patients. However, in only few studies did these
      differences reach statistical significance. Selection of resistant strains has
      not been observed during prolonged use of SDD. Sucralfate reduces the pneumonia
      rate compared to H2-blockers or antacids by not interfering with the gastric
      barrier. However, gastric colonization is reduced rather than eliminated and
      sucralfate has almost no effect on oropharyngeal or tracheal colonization.
      Whether sucralfate is significantly better than a placebo remains to be
      established. SDD is superior to sucralfate in preventing both colonization and
      infection.

PMID- 1640027
TI  - Procedures for the diagnosis of pneumonia in ICU patients.
AB  - The optimal technique for diagnosing nosocomial bacterial pneumonia in critically
      ill patients cared for in the intensive care unit remains unclear, especially in
      the subgroup of patients requiring mechanical ventilation. An important advance
      has been the development of the protected specimen brush technique. Secretions
      obtained using this technique and evaluated by quantitative cultures are useful
      in distinguishing patients with and without pneumonia. However, this procedure
      has important limitations in that results are not available immediately, and in
      that a few false negative of false positive results may occur. Bronchoalveolar
      lavage has been suggested to be of value in establishing the diagnosis of
      pneumonia, because the cells and liquid recovered can be examined microscopically
      immediately after the procedure and are also suitable for quantitative culture.
      Microscopic identification of bacteria within cells recovered by lavage may
      provide a sensitive and specific means for the early and rapid diagnosis of
      pneumonia in this setting. The lavage technique can also be conveniently
      incorporated into a protocol along with quantitative culture of samples obtained
      using the protected specimen brush. This combination will probably improve the
      overall accuracy of diagnosis while allowing the administration of prompt empiric
      antimicrobial therapy in most patients with pneumonia.

PMID- 1640029
TI  - Systemic and endotracheal antibiotic prophylaxis of nosocomial pneumonia in ICU.
AB  - Nosocomial pneumonias, especially in ventilated patients, are a continuing
      problem in modern medicine. Pathogens most commonly involved with these
      pneumonias are Enterobacteriaceae, Ps. aeruginosa and S. aureus. Several
      prevention measures for nosocomial pneumonia are possible such as parenteral and
      topical antibiotics--a very controversial issue. Several studies with parenteral
      antibiotics, starting as early as 1954, could not prove any benefit of parenteral
      antibiotics in pneumonia prevention. Topical antibiotics, starting with polymyxin
      or gentamicin via the endotracheal tube in the 70s, gave controversial results.
      In a prospective, randomized, double-blind placebo controlled study with
      gentamicin via the endotracheal tube in ventilated ICU patients we found no
      significant reduction of pneumonia rate and mortality. However, the combined
      approach (SDD) of oropharyngeal, gastrointestinal and parenteral use of certain
      antibiotics appears to give promising results in specific patient subgroups such
      as ventilated polytrauma patients in ICU.

PMID- 1640030
TI  - Systemic antibiotic treatment of nosocomial pneumonia.
AB  - Nosocomial pneumonia continues to represent a significant cause of morbidity and
      mortality in hospitalized patients. Bacteria are responsible for greater than 90%
      of the pneumonias, the most common isolates being aerobic Gram-negative bacilli
      and S. aureus. Cornerstones of treatment are intravenous antibiotics and
      supportive care. In the individual case the true etiology is usually unknown;
      therefore empiric broad spectrum treatment is commonly used based on the
      prevalence of local pathogens, their antibiotic sensitivity pattern and on host
      factors. Combination antibiotic regimens, including beta-lactams and
      aminoglycosides, are considered as standard therapy and are associated with
      clinical success rates of greater than 80%. Monotherapy with broad spectrum
      antibiotics, such as third generation cephalosporins, imipenem and
      fluoroquinolones, can be considered as equally effective in non-neutropenic
      patients and in the absence of P. aeruginosa infection. More active and less
      toxic antibiotics are still needed for problematic pathogens such as methicillin
      resistant S. aureus strains, multiresistant Enterobacteriaceae and Pseudomonas
      species. Because further improvement in morbidity and mortality may be limited
      with antibiotics alone, new emphasis should be placed on prevention of infection
      and the use of immunotherapy.

PMID- 1640033
TI  - Working the bugs out. Integrated pest management saves crops and the environment.

PMID- 1640031
TI  - Nosocomial pneumonia: epidemiology and infection control.
AB  - Elderly, debilitated, or critically ill patients are at high risk for hospital
      acquired or nosocomial respiratory tract infection. Gram-negative bacilli,
      Staphyloccoccus aureus, and anaerobes colonizing the oropharynx are the most
      frequent etiologic agents. Colonization of the oropharynx may be related to the
      patient's age, underlying disease, nutritional status, prior exposure to
      antibiotics, supine position, and gastric colonization. Nosocomial pathogens may
      also be acquired from the hands of hospital personnel, contaminated equipment or
      fluids. The absence of sensitive and specific methods for accurate diagnosis
      remain a concern. Despite treatment with appropriate antimicrobial therapy, there
      is a high mortality and morbidity. Measures for the prevention of nosocomial
      pneumonia should include compliance with infection control principles,
      appropriate use of antibiotics, proper patient position, and removal of potential
      sources of cross colonization.

PMID- 1640032
TI  - Immunological perspectives in prevention and treatment of nosocomial pneumonia.
AB  - The high mortality associated with current therapeutic approaches to nosocomial
      pneumonia has motivated consideration of newer immunologic approaches to
      prevention or therapy of this infection. Serotype specific vaccines, hyperimmune
      immunoglobulins, and monoclonal antibodies have been developed for certain
      problematic pathogens. Pseudomonas aeruginosa has been the major focus of this
      approach, and trials of hyperimmune anti-Ps. aeruginosa globulins for treatment
      of pneumonia are underway. Broad-spectrum, anti-lipopolysaccharide antibody
      preparations have also been employed for prophylaxis of nosocomial pneumonia, but
      to date these trials have not been successful. Finally, anticytokine antibody
      therapy to reduce infection-initiated inflammatory lung damage is under
      consideration.

PMID- 1640034
TI  - Factors affecting a student's choice of dietetics as a profession.
AB  - In order to design more effective recruitment strategies, 419 junior students in
      38 coordinated dietetics programs completed self-administered questionnaires to
      identify factors that attracted them to the profession. The majority (43.9%)
      first became interested in a dietetics career while in college; 24.9% became
      interested before or during secondary school; and 17.7% were making a career
      change. Factors that most frequently led to a career in dietetics were a course
      in nutrition (32.9%), a friend or relative other than parent (31.0%), and a
      dietitian (30.3%). Students rated the opportunity to help others (95.2%) and the
      relationship of nutrition to health (94.0%) as characteristics of the profession
      that had a highly positive influence on their decision. Interests in health,
      disease, and health care (70.5%); teaching and health promotion (42.7%); sports
      and fitness (40.7%); counseling and behavior change (35.6%); and food and cooking
      (35.4%) were most frequently cited as influencing the choice of a dietetics
      career. Students were most interested in practicing dietetics as a consultant or
      in private practice (37.5%) or as a clinical dietitian (34.8%). New and
      innovative recruitment strategies should target high school and college students
      and pay special attention to second-career students. Interests such as health,
      disease, and health care and health promotion and characteristics of the
      profession such as the opportunity to help others attracted present dietetics
      students and should be emphasized in recruiting. The best marketing tools may be
      the practicing dietitian and a course in nutrition.

PMID- 1640035
TI  - Development of moral judgment and its relationship to the education and training
      of dietitians.
AB  - The purpose of this study was to compare the development of moral judgment in 171
      dietetics students before and after training from internships (n = 96),
      coordinated undergraduate programs (n = 61), and preprofessional practice
      programs (n = 14). The results of the study supported the research hypothesis
      that greater moral development growth would occur in supervised practices that
      allow students more experiences promoting moral growth, such as clinical
      rotations with patients, peer discussions on ethical issues, and access to
      instructors trained in ethics. Analysis of covariance indicated differences in
      the posttest scores of the three groups. Student scores for the internship and
      the coordinated undergraduate program were significantly different. Scores of
      preprofessional practice program students did not differ from those of the other
      groups. Internship programs offered more time in clinical rotations, used trained
      ethicists more, and used more methods to introduce ethics into the curriculum
      than did the other programs.

PMID- 1640036
TI  - Prediction of plasma lipids in a cross-sectional sample of young women.
AB  - We studied 60 premenopausal women to identify the best predictors of plasma lipid
      levels. Eligible subjects gave one venous blood sample during menstruation, kept
      a 3-day food record, completed a demographic questionnaire, had their height and
      weight measured, and participated in a standardized physical activity interview.
      Dietary constituents, anthropometric measures, serum progesterone and estradiol
      concentrations, and leisure-time activity level were then examined for
      relationships to plasma lipids. Pearson correlations revealed associations among
      diet, adiposity, alcohol intake, and plasma lipids. Saturated fatty acid (SFA)
      intake was positively related to plasma total cholesterol, low-density
      lipoprotein (LDL) cholesterol, and high-density-lipoprotein (HDL) cholesterol.
      Height and weight were significantly related to total triglycerides. Furthermore,
      in the multivariate analyses, dietary constituents and height or body weight
      explained more of the variance in plasma lipids than did physical activity level
      or sex hormones. The final models for each lipid are as follows: for plasma total
      cholesterol and LDL cholesterol, SFA intake was the only significant predictor,
      for HDL cholesterol, refined carbohydrate and SFA intake; and for total plasma
      triglycerides, body weight and crude fiber intake.

PMID- 1640037
TI  - Prevalence of eating disorders among dietetics students: does nutrition education
      make a difference?
AB  - Several studies have indicated that college students majoring in dietetics have
      more problems associated with food than do students majoring in other
      disciplines. If this is true, dietetics students may need more counseling and
      education on eating disorders, especially because many will eventually be
      counseling others professionally. To assess the prevalence of negative eating
      behaviors among college dietetics majors, surveys based on the Eating Pattern
      Questionnaire were distributed to college women with majors in dietetics and
      other selected disciplines at a medium-sized California university. Two surveys
      were administered 1 year apart; the first was distributed to junior and senior
      women only, and the second was distributed to women of all class levels. Results
      from the first survey revealed that the incidence of eating disorders was not
      greater among the dietetics majors than among the other selected majors. In fact,
      dietetics majors often had more positive responses to questionnaire items, which
      suggests that dietetics students have better eating habits and fewer eating
      disorders. The results of the second survey, however, indicated that dietetics
      majors had significantly more negative eating patterns than did students from
      other majors. When separated by class, junior and senior dietetics majors had
      significantly more positive eating habits than did freshmen dietetics majors.
      These findings imply that junior and senior dietetics majors may have more
      positive eating patterns than freshmen dietetics majors as a result of their
      increased exposure to nutrition information.

PMID- 1640038
TI  - Effects of packaging, equipment, and storage time on energy used for reheating
      beef stew.
AB  - Energy used to reheat 3 kg of a standard beef stew to 74 degrees C was measured
      to determine (a) the benefits of a retort pouch packaging processing system that
      keeps food microbially safe at room temperature compared with a system that
      packages food in a plastic bag that requires refrigerated storage; (b) the most
      economical form for reheating (in bulk in bags, in bulk out of bags, or in
      portions); (c) the most economical equipment for reheating (convection oven,
      infrared oven, microwave oven, compartment steamer, or steam-jacketed kettle);
      and (d) the influence of storage time (7, 28, or 85 days). Energy used for
      reheating the retort product was 18,883.7 British thermal units (BTU) compared
      with 31,035.6 BTU for the plastic bag product. Reheating in portions used 6,857
      BTU; reheating in bulk out of bag used 23,419 BTU; and reheating in bulk in bag
      used 64,247 BTU. The order of least to greatest energy use for equipment was
      microwave oven, 324 BTU; infrared oven, 5,406 BTU; convection oven, 11,399 BTU;
      steam-jacketed kettle, 30,713 BTU; and steamer, 51,412 BTU. Storage time in the
      plastic bag significantly (P less than .05) affected initial product temperature
      and the energy required for reheating; this was not true for the retort product.
      Our findings indicate that microwave heating, heating in portions rather than in
      larger quantities, refrigerated storage of 7 days instead of 28 days, and use of
      retort pouch products achieve the least energy cost in reheating a product such
      as beef stew.

PMID- 1640039
TI  - Assessing the nation's diet: limitations of the food frequency questionnaire.

PMID- 1640040
TI  - Nutrition and cancer prevention knowledge, beliefs, attitudes, and practices: the
      1987 National Health Interview Survey.
AB  - This article examines the nutrition and cancer prevention knowledge, beliefs,
      attitudes, and self-reported dietary changes of a US national probability sample.
      The data were drawn from the Cancer Control Supplement of the 1987 National
      Health Interview Survey, which was answered by 22,043 adults. Thirty-five percent
      of the sample reported that they had made dietary changes in the past 1 to 5
      years for health reasons. Respondents reported eating more vegetables, fruit,
      lower-fat meats, and whole grains/fiber and less high-fat meats, fats,
      sweets/snacks, salty foods, refined grain products, alcohol, and dairy products.
      Those who did not make any dietary changes most often said the reason was that
      they enjoyed the food they were presently eating and did not want to make any
      changes. More than 90% of the sample agreed that diet and disease were related
      and 73% knew that diet and cancer were related, yet 44% believed there was
      nothing a person could do to reduce the risk of getting cancer or didn't know
      what could be done. In response to open-ended questions about foods that either
      increase or decrease cancer risk, vegetables, whole grains/fiber, fruit, and
      lower-fat meats were thought to decrease risk, and high-fat meats, fats, alcohol,
      sweets/snacks, and additives were thought to increase cancer risk. We found
      education and income levels to be the major demographic variables that have an
      impact on cancer prevention knowledge, attitudes, and beliefs. People with lower
      incomes and at lower educational levels should be targeted for education about
      cancer risk reduction.

PMID- 1640041
TI  - Estimates of nutrient intake from a food frequency questionnaire: the 1987
      National Health Interview Survey.
AB  - Nutrient intake data are reported from a 60-item food frequency questionnaire
      administered in the 1987 National Health Interview Survey to a representative
      sample of US adults 18 to 99 years of age (n = 22,080). These data provide for
      the first time an estimate of the distribution of usual nutrient intakes in a
      national probability sample. For several nutrients, 10% to 25% of respondents may
      habitually consume substantially less than the Recommended Dietary Allowance,
      despite apparently adequate group means. Hispanics reported higher energy and
      carbohydrate intakes and a lower percentage of energy from fat than blacks or
      whites (35.6%, 38.4%, and 38.7% of energy from fat for Hispanics, blacks, and
      whites, respectively.) Whites had lower cholesterol intake than the other two
      groups, and blacks had a higher intake of sweets. Alcohol intake was lower among
      women and persons older than 65 years, but no other differences in alcohol intake
      emerged. Use of adjustment factors improved nutrient intake estimates from this
      shortened questionnaire to levels similar to those obtained from other national
      dietary surveys. The nutrient intake data from this research can be used to
      compare demographic subgroups and to describe the mean and distribution of
      nutrient intake. Furthermore, this research provides national reference data to
      investigators who use this or related questionnaires in nutrition research.

PMID- 1640042
TI  - What works best for worksite cholesterol education? Answers from targeted focus
      groups.
AB  - Focus group discussions are an effective way to determine the needs and interests
      of a target population. In August 1989, eight focus group discussions were
      conducted with municipal employees in Phoenix, Ariz, to determine the needs and
      interests of potential participants in a worksite cholesterol education program.
      Employees were selected for the focus groups on the basis of an initial screening
      that determined their motivation to change customary eating habits. Individuals
      categorized as "somewhat motivated" were invited to participate in the focus
      groups because researchers thought they would best represent the motivation level
      of the majority of potential participants in the cholesterol education program.
      The focus group participants indicated that they preferred educational formats
      and approaches that appealed to diverse learning styles and recognized individual
      differences. Several of the program features identified by the focus groups are
      consistent with principles of adult education, especially active participation in
      the learning activity. The focus group participants wanted information presented
      in a simple, easy-to-understand manner, and they asked for behavioral directives
      rather than background information or medical jargon. Release time from work and
      employer commitment to the program were viewed as important to the success of the
      program. We conclude that employees respond best to worksite wellness programs
      that are simple, practical, and relevant and that allow them to participate
      actively in the learning activity during work time.

PMID- 1640043
TI  - Development and use of preprinted forms and adhesive labels in medical record
      charting.
AB  - Clear delineation of specific clinical and administrative responsibilities (eg,
      content requirements, cost constraints) is necessary in the development,
      approval, and implementation of effective preprinted documentation materials.
      Input early in the development stage from medical record and legal department
      staff ensures that proposed materials will meet organizational and legal
      standards. The development and use of time-saving preprinted documentation
      materials in medical record charting by the Johns Hopkins Oncology Nutrition
      Service is described. We conclude that the use of preprinted materials expedites
      and enhances both the consistency and quality of documentation.

PMID- 1640044
TI  - Dietary intakes of male endurance cyclists during training and racing.

PMID- 1640045
TI  - Antihistamine effects and complications of supplemental vitamin C.

PMID- 1640046
TI  - Peer involvement in the nutrition education of college students.

PMID- 1640047
TI  - Computerized analysis of selected menu items: a practical tool for the university
      nutritionist.

PMID- 1640048
TI  - Eating quality of biscuits and pastry prepared at reduced fat levels.

PMID- 1640049
TI  - Position of The American Dietetic Association: issues in feeding the terminally
      ill adult.

PMID- 1640050
TI  - The hamster transferrin receptor contains Ser/Thr-linked oligosaccharides: use of
      a lectin-resistant CHO cell line to identify glycoproteins containing these
      linkages.
AB  - We recently reported that the human transferrin receptor (TfR) contains O-linked
      GalNAc residues [1]. To investigate whether this modification is shared by
      transferrin receptors in other mammals, we investigated the glycosylation of TfR
      in hamster cells. To facilitate our analysis the lectin-resistant Chinese hamster
      ovary (CHO) cell line Lec8 was used. These cells are unable to galactosylate
      glycoproteins, resulting in truncation of the Ser/Thr-linked oligosaccharides to
      a single residue of terminal alpha-linked GalNAc. This structure is bound with
      high affinity by the lectin Helix pomatia agglutinin (HPA). The TfR was affinity
      purified from Lec8 cells metabolically radiolabeled with [3H]glucosamine and the
      receptor was found to bind tightly to HPA-Sepharose. Treatment of the purified
      TfR with mild alkaline/borohydride released [3H]GalNAcitol, demonstrating the
      presence of O-linked GalNAc. We also found that many other unidentified
      [3H]glucosamine-labeled glycoproteins from Lec8 cells were bound by HPA
      Sepharose. The bound and unbound glycoproteins were separated by SDS/PAGE and
      individual species were selected for treatment with mild base/borohydride.
      Treatment of glycoproteins bound by HPA, but not those unbound, resulted in the
      release of [3H]GalNAcitol. These studies demonstrate both that the hamster TfR
      contains O-linked oligosaccharides and that this approach may have general
      utility for identifying the presence of these oligosaccharides in other
      glycoproteins.

PMID- 1640051
TI  - A rapid reliable method to use specific probes labelling polymerase chain
      reaction (PCR) products.
AB  - Polymerase chain reaction (PCR) has allowed highly sensitive detection and
      amplification of individual DNA sequences. To generate specific probes for genes
      or cDNAs that have not yet been cloned, it is often necessary to label PCR
      products which are then used in Southern or Northern hybridizations or for
      screening cDNA and genomic DNA libraries. In this paper a rapid and versatile
      method of using PCR products, as specific probes, is described, after digestion
      with EcoRI in buffer H, in the presence of PCR reaction buffer, and purification
      of the PCR products for avoid the interference by competition of unlabelled dCTP
      in the directionally random labelling.

PMID- 1640052
TI  - Transverse agarose pore gradient gel electrophoresis of DNA.
AB  - Transverse agarose pore gradient gels were prepared on GelBond in the
      concentration range of nominally 0.2-1.5% SeaKem GTG agarose, using density
      stabilization by glycerol and incorporation of a dye to define the gel
      concentration at each point on the pore gradient gel. The distribution of the dye
      was evaluated by photography, video-acquisition and digitization of the gradient
      mixture and by densitometry of the gel. The gel was applied to the
      electrophoresis of a 1-kb standard ladder of DNA fragments, using standard
      submarine apparatus. The method extends to agarose gel electrophoresis the
      benefits of semi-automated analysis of 'Ferguson curves' described in application
      to polyacrylamide gel by Wheeler et al. (J. Biochem. Biophys. Methods 24, 171
      180).

PMID- 1640053
TI  - Analysis of tubulin isoforms by two-dimensional gel electrophoresis using SDS
      polyacrylamide gel electrophoresis in the first dimension.
AB  - A two-dimensional electrophoretic system using SDS-polyacrylamide gel
      electrophoresis (SDS-PAGE) in the first dimension and isoelectric focusing (IEF)
      in the second dimension was devised. In spite of its simplicity, this method
      could show a markedly high resolution for tubulin isoforms and moreover could
      classify them into alpha- or beta-tubulin as a two-dimensional profile. With this
      method, seven alpha- and four beta-tubulin isoforms could be detected within
      axoneme from Tetrahymena cilia. Moreover this method could also resolve tubulin
      isoforms from the rabbit brain. These results indicate that the present two
      dimensional gel electrophoresis is a useful tool for the electrophoretic analysis
      of tubulin isoforms from various sources.

PMID- 1640054
TI  - An optical method for the determination of platelet count in platelet samples
      contaminated with red blood cells.
AB  - We present a simple photometric method to determine the total concentration of
      platelets present in a sample independently of red blood cell concentration.
      Standard optical density curves for platelet samples ranging in concentration
      from 0 to 1.5 x 10(9) cells/ml and contaminated with red blood cells ranging in
      concentration from 0 to 0.03 x 10(9) cells/ml are determined. A study of the
      absorbance spectra of red blood cells and platelets suggests that by calculating
      the absorbance difference between two wavelengths, an estimate of red blood cell
      concentration can be made. Then, in the second step of this two-step method, the
      individual absorbance measurements at the two wavelengths are matched to the
      standard values determined previously to derive an estimate of platelet
      concentration. In a trial of 62 unknown platelet samples contaminated with red
      blood cells, the standard deviation for the error in platelet count was 0.16 x
      10(9) cells/ml with a mean difference of 0.011 x 10(9) platelets/ml. We conclude
      that our method may be useful in laboratories not equipped with electronic cell
      counters as well as in applications such as the development of noninvasive
      measurements of platelet concentration in platelet transfusion packs.

PMID- 1640055
TI  - Quantitative PAS assay of some carbohydrate compounds and detergents.
AB  - A spectrophotometric method for determination of color development of
      glycocompounds subjected to PAS reaction was investigated with various
      carbohydrate compounds and related chemicals. The conditions of the oxidation
      with periodic acid was found to influence the amount of the colored Schiff dye
      produced. Mono- and di-saccharides (mannose, glucose and maltose) were PAS
      negative. Glycogen was more reactive than dextran. When glycogen was hydrolyzed
      by amylase the intensity of the PAS product dropped until a certain limit
      probably reflecting the limit dextrin. The presence of proteins (albumin) or
      electrolytes (NaCl) did not influence the PAS reaction. Many non-ionic detergents
      commonly used in membrane biology such as alkyl glycosides and gluco-methyl
      alkanamides were strongly PAS-positive and so was the anionic detergent SDS while
      the zwitterionic detergents tested, such as CHAPS and CHAPSO, were PAS-negative.
      The color development of the spectrophotometric PAS reaction showed linearity
      with the concentration of a simple glycoprotein solution (peroxidase) and a
      complex solution (bovine serum). By the PAS reaction it was also possible to
      measure the content of soluble and membrane bound carbohydrate compounds in a
      pellet of liver cell membranes. We find that the PAS reaction is sensitive and
      reliable for quantitative estimations of complex carbohydrates as well as soluble
      and membrane-bound carbohydrate compounds. The latter should be treated with PAS
      unreactive zwitterionic detergents.

PMID- 1640056
TI  - A novel technique for the preparation of osmotically stabilized and permeabilized
      cells of extremely halophilic bacteria.
AB  - The cells of Haloferax mediterannei were stabilized by cross-linking with 0.5%
      glutaraldehyde for 10 min. Such cells were found to be osmotically stable even
      when suspended in water. The stabilized cells could be permeabilized by treatment
      with chloroform without leakage of intracellular components. No significant
      difference in the properties of an intracellular enzyme aldolase was observed,
      using either cell-free extract or the osmotically stabilized and permeabilized
      cells. This novel technique can serve as a useful tool for studying in situ
      regulatory characteristics of intracellular functions in halobacteria and can
      also help in their re-use under more stabilized conditions for biotechnological
      applications.

PMID- 1640057
TI  - Relationship between the hydrophobic and hydrophilic molecular parameters of some
      monoamine oxidase inhibitory drugs, determined by means of adsorptive and
      reversed-phase thin-layer chromatography.
AB  - The absorption capacity, the specific hydrophilic surface area, the lipophilicity
      and the specific hydrophobic surface area of 17 monoamine oxidase inhibitory
      drugs were determined by means of adsorptive and reversed-phase thin-layer
      chromatography for future application of these molecular parameters in
      quantitative structure-activity relationship studies. Principal component
      analysis suggests that most of the physicochemical parameters have a different
      information content, and their application in the elucidation of their mode of
      action is therefore justified.

PMID- 1640058
TI  - Comparison of the Coomassie brilliant blue, bicinchoninic acid and Lowry
      quantitation assays, using non-glycosylated and glycosylated proteins.
AB  - The concentrations of several non-glycosylated and glycosylated recombinant and
      native proteins were determined by three widely used colorimetric methods:
      Coomassie brilliant blue, bicinchoninic acid and Lowry, and, for comparison, by
      amino acid composition analysis. The colorimetric methods gave results differing
      from the values derived from the amino acid analysis, in some cases by up to 60%.
      For the non-glycosylated recombinant proteins, the results were in relatively
      good agreement with each other and with the values determined on the basis of the
      amino acid analysis. The Coomassie blue method was strongly dependent on the
      hydrophobicity of the individual protein. The bicinchoninic acid method gave
      results closest to those of the amino acid analysis. For the glycosylated
      proteins, both recombinant and native, the Coomassie blue assay gave values
      lower, whereas the two other methods gave values higher than those determined on
      the basis of the amino acid analysis. The concentration of a recombinant
      interferon gamma receptor produced in two differently glycosylated forms was
      underestimated by the Coomassie blue assay and overestimated by the bicinchoninic
      acid and Lowry methods, while for the non-glycosylated form of the same protein,
      the three colorimetric methods delivered comparable values. The results suggest a
      potential interference of protein glycosylation with the colorimetric assays.

PMID- 1640059
TI  - Immunochemical quantification of procion red HE-3B used as ligand in affinity
      chromatography.
AB  - The quantification of Procion Red HE-3B used as a ligand in affinity
      chromatography for proteins is reported. It's based on an enzyme-linked
      immunosorbent assay using antibodies against the dye. Polyclonal antibodies were
      classically prepared after conjugation of the dye on KLH and injection into
      rabbits. The development of the assay was based on the competitive inhibition
      between hemoglobin-dye complex and free dye. The sensitivity of this method was
      about 1000-times higher than a classical spectrophotometric assay, and was
      modulated by some chemical substituents attached on the native dye. It was
      demonstrated that the assay was applicable to the determination of dye traces
      that may be released from dye affinity sorbents. Moreover, the quantification of
      the dye was successfully applied to proteins that are being purified from a dye
      affinity column.

PMID- 1640060
TI  - A sensitive and rapid in situ immunoassay to quantitatively determine the
      cellular antigens in intact cultured cells.
AB  - A sensitive and rapid in situ immunoassay to quantitatively determine the
      cellular antigens in intact cells was developed. Antigens located in plasma
      membrane, endosome, cytosol, lysosome or endoplasmic reticulum of cultured cells
      were fixed in situ and reacted with monoclonal antibodies after permeabilization
      of cells with saponin. The antigen-antibody complexes were quantified by
      colorimetric method of peroxidase-substrate reaction. Epidermal growth factor
      receptor, monomer of pyruvate kinase M2 and the endoplasmic reticulum-associated
      thyroid hormone-binding protein were easily detected from 0.5-1 x 10(4) cells by
      this method. Antibody as low as 10 ng/ml gave reproducible results. Using this
      method, the in vivo dynamic interconversion of monomer-tetramer of pyruvate
      kinase M2 was found to be regulated by glucose. The ligand-induced epidermal
      growth factor receptor through different subcellular compartments during
      endocytosis was easily quantified by this method. This method was also used to
      compare the different amounts of the endoplasmic reticulum-associated thyroid
      hormone-binding protein in various cultured cells. Thus, the in situ immunoassay
      is an easy and versatile method which can be used to study various cellular
      antigens and their involvement in cellular processes.

PMID- 1640061
TI  - Stripping interfering sugars from samples using adapted bacteria.
AB  - Bacteria adapted to individual sugars quickly remove targeted sugars--stripping
      them--from samples in which unwanted sugars interfere. Adapted bacteria are
      equivalent to specific reagents for removal of sugars down to bacterial Km
      values, micromolar to submicromolar concentrations. Bacterial stripping is a
      simple method, useful when background sugars in micro-to millimolar
      concentrations (or larger) interfere with analysis of sought-for sugars. Bacteria
      such as Escherichia coli and Klebsiella are easily adapted to individual sugars
      such as lactose, fructose, etc., by growing the bacteria on them. Hence one can
      easily create (and store) many kinds of cells ready to sponge up or strip out
      unwanted compounds. E. coli specifically remove several sugars from samples
      containing 100-500 nmol of sugars, using 1-5 mg of adapted cells, and 25 degrees
      C temperatures. Stripping requires 1-5 min and consists of mixing cells and
      sample, spinning down the cells, and withdrawal of stripped supernate. A 1-5 min
      interval is adequate for uptake and stripping, but far too short for cells to
      metabolize the sugars that were taken up. Hence the cells do not leak
      metabolites, but act as specific adsorbants without injection of appreciable
      byproducts into the sample.

PMID- 1640062
TI  - [Sterile corneal ulcers in dry eye. Incidence and factors of occurrence].
AB  - Sterile corneal ulceration is a serious complication in patients with
      keratoconjunctivitis sicca. The records of 134 patients, 19 males and 115
      females, who presented with dry eyes in the Ophthalmologic Clinic were reviewed.
      Over a period of 6 years, 33 eyes of 23 (17%) patients developed a sterile
      corneal ulcer. The etiologies of dry eyes in these patients were: Primary
      Sjogren's syndrome: 10 cases, rheumatoid arthritis: 5 cases, ocular pemphigoid 6
      cases, atopy: 1 case, local irradiation: 1 case. Patient's age and sex were not
      significantly associated with ulcer development (p greater than 0.05). The
      presence of a major underlying disease was the major contributing factor.
      Appropriate local treatment and patient compliance were also contributing
      factors. Blepharitis was found in 90% of patients.

PMID- 1640063
TI  - [Sterile corneal ulcers in dry eye. II. Treatment, complications and course].
AB  - Over a period of 6 years, 23 patients (4 males and 19 females: mean age 56 years)
      who presented dry eyes developed 33 sterile corneal ulcers. Treatment included
      occlusion of the eyes or bandage soft contact lenses, prophylactic topical
      administration of antibiotics, punctal occlusions and currently available tear
      substitutes. Seventeen eyes healed completely without any corneal opacity and 10
      eyes healed with opacity. Nine of the 33 eyes developed microbial keratitis. The
      causes of microbial keratitis were Staphylococcus aureus in 7 cases, beta
      hemolytic Streptococcus in one and Pseudomonas aeruginosa in one case. The
      microbial keratitis was treated with intensive topical antibiotics. In 6 eyes,
      corneal perforation occurred. Rheumatoid arthritis coexisted in four cases.

PMID- 1640064
TI  - [Study of the crystalline lens by fluorophotometry in 60 control subjects and 56
      diabetics].
AB  - Lens autofluorescence was measured with a commercially available computer
      fluorophotometer: Fluorotron Master, in 56 diabetic patients (34 insulin
      dependent and 22 non insulin-dependent) mean age +/- S.E.M. = 45.65 +/- 3.92
      years; and in 60 control patients, mean age +/- 44.82 +/- 4.70 years. Scanning
      measurement of fluorescence was performed along the optical axis of the two eyes.
      Lens fluorescence refers to the highest fluorescence intensity found in the
      anterior part of the lens nucleus: anterior lens peak. For both populations, lens
      autofluorescence increased linearly with age (p less than 0.001) and was
      significantly higher in the diabetic population at all ages. Statistical analysis
      revealed a significant correlation with the duration of diabetes for insulin
      dependent (p less than 0.001) but not for non insulin-dependent diabetic
      subjects, and not on metabolic control: mean Hb A1C levels over last five years.
      These results showed that fluorophotometry was an objective and reproducible
      method for in vivo human lens study.

PMID- 1640065
TI  - [Juvenile serous macular detachment of the pigmented epithelium].
AB  - Juvenile macular detachment of the retinal pigmented epithelium is rarely seen
      clinically. Single or multiple detachments can occur and are due to the
      accumulation of liquid in the subretinal space. The natural history of the
      disease, which usually affects young people, has not yet been defined. We
      examined and followed 19 eyes of 15 patients affected by macular juvenile serous
      detachment of the retinal pigment epithelium, not associated with other retinal
      disturbances. The patients were followed for a mean period of 12 months (range 6
      33 months). The mean age was 48 years (range 40-59 years): 7 patients were male
      and 8 female. Mean initial visual acuity was 8/10 (range 1/10-10/10) and mean
      final visual acuity was 9.2/10 (range 6/10-10/10). Detachment of the retinal
      pigmented epithelium was unchanged in 58% of cases, decreased or disappeared in
      37% of cases and increased in 5% of cases. These results indicate that the
      natural course is usually good and photocoagulation is not necessary.

PMID- 1640066
TI  - [Late macular pseudo-hole after surgical peeling of a premacular membrane].
AB  - We present three clinical cases showing a pseudo macular hole that developed late
      after an uneventful surgical removal of an epiretinal membrane. The pseudo
      macular hole developed 3 to 19 months postoperatively. The macular changes seen
      in all cases showed stricking differences when compared with pseudo macular holes
      associated with epiretinal membranes. A hypothesis is suggested for the
      pathogenesis.

PMID- 1640067
TI  - [Behcet's disease disclosed by ocular conjunctival aphthous ulcer. Apropos of a
      case].
AB  - Aphthosis in Behcet's disease is usually located in the oro-genital areas, but
      other locations have been described. The authors report the case of a 45 year old
      woman who presented with an ocular conjunctival aphthous ulcer. This was the
      initial presentation of Behcet's disease. This case report illustrates that
      aphthosis in Behcet's disease can have unusual sites such as the ocular
      conjunctiva. Furthermore, in this case, the conjunctival aphthosis was presenting
      sign of this systemic disease.

PMID- 1640069
TI  - [Repair of palpebral substance loss by the technique of tarsomarginal graft].

PMID- 1640068
TI  - [Viscoelastic solutions for intraocular surgical use. Application in surgery of
      the anterior segment of the eye].

PMID- 1640070
TI  - [Pilomatrixoma of the eyelid. Apropos of a case].
AB  - Primary adnexal tumors of the eyelids are quite uncommon. This diagnosis should
      be considered in the case of a sub-epidermal tumor. We report the case of a 25
      year-old female patient presenting with a left eyelid nodular tumor, which
      appeared clinically as a whitish swelling of the lateral part of the eyelid,
      covered by normal epidermis. Ultrasonography showed a heterogeneous structure
      probably containing calcified areas. Complete surgical removal was performed
      under local anesthesia. Macroscopically, the tumor was encapsulated, with an
      irregular surface, and it appeared stony under section. Microscopically, it was
      characteristic of a pilomatrixoma, with sheets of mummified cells devoid of
      nuclei, either clear or basophilic, and partially calcified. Neither
      granulomatous reaction nor ossification were observed. This clinicopathological
      report recalls that pilomatrixoma may appear as a single nodular tumor of the
      eyelid.

PMID- 1640071
TI  - [Programmed replacement of lenses: prevention of complications from contact
      lenses?].

PMID- 1640072
TI  - [Surgical decompression of the optic nerve in intracanal injuries. Indications
      and results].
AB  - Fifteen patients with traumatic optic neuropathy (anatomical section excluded)
      underwent surgical anterior decompression of the optic nerve, via the trans
      ethmoid-sphenoid approach. Improvement of visual function assessed by visual
      acuity and visual field measurements, was obtained in 10 patients. Results
      remained stable for a follow-up period of at least 6 months. There was a delay of
      several weeks before improvement in some of the patients. Thus a long follow-up
      period seems recommended. Trans ethmoid-sphenoid optic nerve decompression is a
      reliable procedure with low morbidity, and represents a promising therapy for
      indirect injuries of the optic nerve.

PMID- 1640073
TI  - [X-ray computed tomography in surgical indication of physiological section of the
      optic nerve. Apropos of 15 cases].
AB  - Optic nerve trauma induces loss of vision and absence of direct pupillary light
      reflex. Persistence of consensual pupillary light reflex excludes anatomical
      section. Trans ethmoidal-sphenoidal decompression relieves the optic nerve and
      allows an improvement of visual function. Ten patients among 15 surgical
      decompressions recovered visual function. There is a good correlation between
      improvement and the release of an anatomical nerve compression. Recognition of
      direct or indirect computed tomographic signs of optic nerve compression are
      essential in the surgical indications. The prognosis post-surgical improvement is
      dependent on the sensitivity of computed tomography scan.

PMID- 1640074
TI  - [Exfoliative syndrome and cataract surgery].
AB  - In the present prospective study, we compared the results of cataract surgery in
      two groups with or without exfoliation syndrome; 210 eyes were studied. The
      preoperative pupillary dilatation was smaller in the group with exfoliation
      syndrome (SE). We noticed a higher incidence of complications during planned
      extracapsular cataract extraction in patients with SE. A pupillary diameter
      smaller than 6 mm increases the incidence of capsulozonular rupture (22.5%) in
      these patients. After surgery, an inflammatory reaction and a transient increase
      in intraocular pressure were more frequent and the visual results were less
      favourable in the group with SE. The exfoliation syndrome is a major risk factor
      for cataract surgery. We recommend extracapsular extraction associated with a
      sector iridectomy when the pupillary diameter measures less than 6 mm.

PMID- 1640075
TI  - [Contrast vision in patients with aphakia and pseudophakia].
AB  - A study was carried out on contrast vision in 26 aphakic patients (48 operated
      eyes) and 37 pseudophakic patients (37 operated eyes); in some cases an
      intraocular PMMA lens had been implanted, in others an IOGEL (polimacon) had been
      implanted. The level of sensitivity to contrast in both cases was found to be
      lower than expected by the Vistech company for aphakics. At the same time a
      comparative study was carried out of the results obtained for sharpness of vision
      in aphakic and pseudophakic patients, with the traditional tests of Snellen (long
      sightedness) and Parinaud (short sightedness) and those obtained with the
      Contrast Sensitivity Test System (VCTS-6500 for long sightedness and VCTS-6000
      for short sightedness). The former tests were found to overestimate the visual
      results. Corrected aphakia was found to affect the sensitivity to contrast more
      than in pseudophakic cases. Nevertheless no significant differences were found
      between contrast vision in eyes with PMMA lens implantation and eyes with IOGEL
      (polimacon) lens implantation. Summing up, alterations in the sensitivity to
      contrast undetected by the simple measurement of visual sharpness were found.

PMID- 1640076
TI  - [Retinal involvement in Gaucher's disease].
AB  - Gaucher's disease, a storage disease, causes storage of the sphingolipid
      glucosylceramide in the reticulo endothelial system. The manifestations of such
      deposits within the retina consist of the appearance of numerous whitish spots,
      such as preretinian infiltrates. Several authors have noticed the higher
      frequency of appearance of such spots in splenectomized patients, with marked
      extrasplenic infiltration. In our case, the systemic infiltration was massive at
      the time of the ophthalmoscopic examination, as confirmed by the bone-marrow
      biopsy and computerized axial tomography study, in spite of the fact that the
      spleen had not been removed. Our hypothesis is that the appearance of the whitish
      preretinian deposits in the course of the disease is connected with the degree of
      systemic infiltration, stressing the importance of examination of the eye fundus
      in Gaucher's disease.

PMID- 1640077
TI  - [Retinopathy in premature infants. Present value of surveillance of premature and
      newborn infants at risk].
AB  - Systematic ophthalmologic screening of infants in a Neonatal Intensive Care Unit
      is time consuming and sometimes difficult. In this retrospective study of 1200
      infants examined in the neonatal unit of Toulouse Regional Hospital from January
      88 through December 89, we tried to summarize our findings and assess the value
      of systematic screening. We found 118 infants with abnormal examination: 58
      preterms had retinopathy of prematurity (ROP) (5.16%) with 36 stage I, 15 stage
      II, 7 stage III (2 stage III+ had cryotherapy), no stage IV. Risk factors are
      discussed. 40 preretinal hemorrhages, all found in the first week of life. Only 2
      of them persisted beyond the 2nd month (0.2%) and we found vascular anomalies
      that were cryotreated. 20 had various diseases. Diseases requiring early
      treatment were found in a general context with obvious need of ophthalmologic
      examination. Our study shows that 4 infants: 2 ROP III+ and 2 retinal hemorrhages
      or 0.4% of all infants obtained an effective benefit from this systematic
      screening. We confirmed the value of this screening: all infants in the neonatal
      care unit have at least one ophthalmologic exam, before they leave the hospital.
      Preterm less than 1600 g or less than 2000 g with initial resuscitation are
      checked during first and second month. Preterm less than 1200 g or less than 1600
      g who had more than one month of oxygen therapy are checked every month until the
      6th month.

PMID- 1640078
TI  - [Cataract surgery after injection of silicone].
AB  - Thirty eyes were studied retrospectively, after cataract surgery following
      intraocular silicone oil injection. Cataract surgery took place before silicone
      oil removal in 9 eyes, at the same time as silicone oil removal in 2 eyes, and
      after silicone oil removal in 19 eyes. Extracapsular extraction was performed in
      27 eyes, and intracapsular extraction was performed in 3 eyes. A posterior
      chamber intraocular lens was placed in 14 cases, and an anterior chamber
      intraocular lens in one case. Capsular fibrosis was observed in 19 cases, and it
      was treated with YAG laser in 10 eyes during follow-up. Twenty five eyes had a
      postoperative follow up of 3 to 37 months. Total retinal detachment occurred in 2
      eyes.

PMID- 1640079
TI  - [Complications of disposable extended-wear contact lenses. Apropos of 6 cases].
AB  - We report six cases of corneal complications observed in disposable extended-wear
      contact lens users: two corneal ulcers, one superficial infiltrate, two punctate
      keratitis with subepithelial infiltrates and one superficial punctate keratitis.
      In four cases a bacterial etiology was confirmed. Disposable contact lenses are
      not complication-free. In our series, complications were favoured or provoked by
      incorrect use in most cases. Other possible risk factors include poor hygiene
      during lens manipulation, damage to the corneal epithelium during lens exchange
      or lens wear, use of contaminated lubricant eyedrops, relative corneal hypoxia
      during overnight wear or in the case of improper fitting. Correct and adequate
      patient information is therefore essential to ensure that these lenses constitute
      a safe choice.

PMID- 1640080
TI  - [Congenital hypertrophy of the pigment epithelium].

PMID- 1640081
TI  - [Treatment of central retinal vein occlusion].

PMID- 1640082
TI  - [Implantation of a posterior chamber artificial lens sutured to the iris in the
      absence of the posterior capsule].

PMID- 1640083
TI  - Growth, development and allometry of Philophthalmus nocturnus in the eyes of
      domestic chicks.
AB  - Fifty day-old chicks were each infected with 10 excysted metacercariae of
      Philophthalmus nocturnus Looss, 1907 around each orbit and growth, development
      and allometry were studied. The growth rate showed two phases over a period of 35
      days, a limited lag phase lasting two days post-infection in which flukes did not
      exceed 440 microns in length, and a rapid phase during which growth was rapid and
      flukes reached a size of 3.008-3.504 mm on day 35. Five developmental stages were
      noticed during the course of development of the metacercaria to the egg-producing
      adult stage. Eggs appeared in the uterus on day 14 and oculate miracidia on day
      25. The hindbody, testes and ovary showed positive allometric growth, the pharnyx
      less so, whereas negative allometric growth was shown by the forebody. Body
      width, oral sucker and ventral sucker were close to isometry, growing at the same
      rate as the body length.

PMID- 1640084
TI  - Effect of concurrent infection with Muellerius capillaris on the development of
      redial generations of Fasciola hepatica in Lymnaea truncatula.
AB  - The rediae of Fasciola hepatica were counted according to generation in adult and
      juvenile Lymnaea truncatula following single infection with Fasciola hepatica,
      double infection with F. hepatica and then Muellerius capillaris, or double
      infection with M. capillaris and F. hepatica. The rediae found in double
      infections were essentially first generation and an early cohort from the second
      generation. The following differences were observed in adult snails which
      underwent double infection when compared to corresponding single infections: i)
      dependent rediae were almost completely absent; ii) degenerating independent
      rediae were found in identical or decreased numbers; iii) living independent
      rediae of the first generation were decreased in number, while those of the
      second generation had variable decreased numbers. The results were similar in
      juvenile snails with double infections, except that the numbers of degenerating
      independent rediae were higher than those found in corresponding single
      infections and the numbers of rediae of the second generation were increased. The
      order of exposure in double infections had no influence on the number and
      maturation of fasciolid rediae.

PMID- 1640085
TI  - Clinical manifestations of taeniasis in Taiwan aborigines.
AB  - From 1974 to 1989, a total of 24,500 aborigines at 67 villages in ten mountainous
      districts/towns in Taiwan were examined for the Taiwan Taenia infection and 12%
      were found to be infected. In order to define the clinical manifestations of
      taeniasis caused by the Taiwan Taenia, 1661 aborigines in ten mountainous
      districts were surveyed. The overall clinical rate was 76%. The clinical rate was
      highest among Atayal aborigines (81%), followed by Bunun (66%) and Yami (61%)
      aborgines and lowest among Ami aborigines (40%). Among 1153 infected people, 10%
      had passed gravid segments in the faeces for less than 1 year, 24% for 1-3 years,
      17% for 4-5 years, 23% for 6-10 years, 16% for 11-20 years, 7% for 21-30 years,
      and 3% over 30 years. Twenty-six occurrences of gastrointestinal and neurological
      symptoms were reported by 1258 infected persons. Passing proglottides in the
      faeces (95%) was the most frequent sign, followed by pruritus ani (77%), nausea
      (46%), abdominal pain (45%), dizziness (42%), increased appetite (30%), headache
      (26%), etc.

PMID- 1640086
TI  - Comparative cytotoxicity of secondary hydatid cysts, protoscoleces, and in vitro
      developed microcysts of Echinococcus granulosus.
AB  - Infection with the metacestode of Echinococcus granulosus is characterized by a
      concomitant immunity. Survival of established and developing hydatid cysts in the
      intermediate host implies a mechanism to modulate its immunological reactions. In
      order to investigate this mechanism, secondary hydatid cysts were isolated from
      intraperitoneally infected laboratory white mice (strain NMRI) 12 months p.i. A
      number of hydatid cysts were freed from the surrounding host adventitial tissue.
      Monolayer cultures of non-stimulated peritoneal macrophages of NMRI mice were
      prepared and incubated in the presence of the hydatid cysts. By means of a trypan
      blue exclusion test and by measuring the incorporation of tritium labelled
      uridine, it was found that the presence of hydatid cysts reduced the viability of
      the macrophages in vitro. Toxic substances are probably secreted since the medium
      of cultured hydatid cysts also displayed cytotoxic activity. Hydatid cysts with
      adventitia, as well as culture medium of those cysts, were less toxic. When
      toxins, partially purified from hydatid cyst fluid, were previously incubated on
      a collagen coated surface, a reduced level of toxicity was found, suggesting that
      collagen of the host adventitia may play a role in controlling the liberation of
      toxins by the hydatid cyst. Virtually no toxicity was exerted by protoscoleces or
      by the medium of cultured protoscoleces, in contrast to in vitro vesiculated
      protoscoleces (so called microcysts). The results reveal a novel feature of
      hydatid cysts that may play a role in the survival of the parasite in the
      immunized host.

PMID- 1640087
TI  - Differential establishment and survival of Hymenolepis diminuta in syngeneic and
      outbred rat strains.
AB  - Experimental Hymenolepis diminuta infection was carried out in inbred strains of
      rats (F344/N, JAR-2, LOU/M, TM, DA and DA-bg/bg) and outbred Wistar rats. All
      strains became infected with this cestode, but clear strain-dependent variation
      in the susceptibility to H. diminuta infection was observed. Marked differences
      in worm persistence and worm weight were found at 6 weeks post-infection in TM
      and DA rats. These strains would be useful to clarify the interactions between H.
      diminuta and its rat host.

PMID- 1640088
TI  - In vivo passage through calves of nematophagous fungi selected for biocontrol of
      parasitic nematodes.
AB  - The experiment was designed to test the survival and performance of stress
      selected nematophagous fungi after passage through the gastro-intestinal tract of
      cattle. Ruminating calves were fed daily with a fixed amount of fungal material
      grown on barley grains. The excreted dung was collected on days four and five
      after the start of the feeding experiment. Barley grains were washed out of the
      excreted dung and incoculated on water-agar plates. After incubation for one
      week, nine of ten fungal isolates were re-isolated from these plates. The
      predatory capacity of the fungi in the excreted faeces was tested in a dung pat
      bioassay and a faecal culture system. In the dung pat bioassay, two fungi of the
      genus Arthrobotrys and six of the genus Duddingtonia reduced the development of
      Ostertagia ostertagi third stage larvae by 85% (61%-93%), compared to the number
      of larvae developed from fungus-free control pats. In seven out of these eight
      isolates, the reduction of larvae in the faecal cultures was 92% (76%-99%).

PMID- 1640089
TI  - Isozymic pattern of lactate dehydrogenase in cases of bancroftian filariasis.
AB  - Isozymic patterns of lactate dehydrogenase (E.C. 1.1.1.27) by polyacrylamide gel
      electrophoresis (PAGE) were observed in various categories of filariasis and
      controls, i.e. asymptomatic microfilaraemia and symptomatic amicrofilaraemia,
      endemic normal and non-endemic normal. Lactate dehydrogenase (LDH) activity was
      also observed amongst the above categories of patients. An increase in enzyme
      activity and change in the isozymic pattern was observed in the above categories
      of filaria infected serum. LDH activity doubled in asymptomatic microfilaraemia
      whereas in symptomatic amicrofilaraemia the increase in LDH activity was
      thirtyfold. The isozymic pattern of microfilaraemic cases showed the presence of
      three bands B4, A1B3, A2B2, which are quite thick as compared to normal healthy
      subjects, whereas the patients with symptomatic amicrofilaraemia showed marked
      elevation of serum LDH-4 or A3B1. The LDH was partially purified by combined
      treatment of (NH4)2SO4 fractionation and gel filtration. The isozymic pattern of
      purified LDH showed a similar pattern.

PMID- 1640090
TI  - Induction of protective immunity to Brugia pahangi in jirds by drug-abbreviated
      infection.
AB  - Protective immunity of homologous challenge infection was examined in jirds after
      drug-abbreviated infection with Brugia pahangi. Mebendazole (MBZ) treatment at
      the early prepatent (5-7 weeks of post infection) or the late prepatent (7-9
      weeks of post infection) period was highly effective in causing almost complete
      eradication of the primary infection. After challenge infection, the worm burden
      was significantly reduced 19% (31.1 in average) and 77% (9.5) to that of the
      controls (38.8 and 41.7), respectively. The magnitude of eosinophil response
      paralleled the degree of protection. No or only a few microfilariae were seen
      after challenge infection in jirds treated during the prepatent periods. They
      were also resistant to intravenous challenge with the microfilariae of B.
      pahangi. MBZ treatment at the patent period was, on the contrary, incomplete
      against primarily infected adult worms, and was not able to induce either
      significant protection (30.1 vs 33.1 in control) or eosinophil response to the
      challenge infection.

PMID- 1640091
TI  - Protease resistant interleukin-3 stimulating components in excretory and
      secretory products from adult worms of Strongyloides ratti.
AB  - Excretory and secretory (ES) products collected from adult worms of Strongyloides
      ratti stimulated interleukin-3 (IL-3) production with mesenteric lymph node cells
      from infected C57BL/6 mice, but not with normal mesenteric lymph node cells. The
      IL-3 stimulating components were not major IgG binding antigens. Activity of the
      IL-3 stimulating components was stable by treatment with protease, although
      reduced by heating in boiling water.

PMID- 1640092
TI  - Seasonal patterns in the transmission of Schistosoma haematobium in Attaouia,
      Morocco.
AB  - In the Attaouia area, the density of Bulinus truncatus (Audouin, 1827), was
      monitored monthly for a period of one year in correlation with weather
      variations. Snails were active throughout the year and particularly abundant at
      the end of spring and summer. Two snail generations were found to overlap. The
      infection rate of B. truncatus reached a maximum of 3.5% in the summer when human
      water contact was frequent. A selective survey conducted in the village of
      Lamyayha showed that the prevalence of infection with S. haematobium among the
      local population was 21.2% who were passing from 10 to 80 eggs per 10 ml of
      urine.

PMID- 1640093
TI  - Sites of encystment by the metacercariae of Echinoparyphium recurvatum in Lymnaea
      peregra.
AB  - Experimental infection of Echinoparyphium recurvatum von Linstow (Digenea:
      Echinostomatidae) cercariae in the snail second intermediate host Lymnaea peregra
      Muller shows that metacercarial encystment takes place on the lining of the
      mantle cavity, pericardial cavity and kidney lumen, with the mantle cavity the
      most preferred site. All three sites are accessible via the body openings. The
      metacercariae appear to be more susceptible to encapsulation in the visceral mass
      than in the cavity of the mantle, pericardium and the lumen of the kidney.

PMID- 1640094
TI  - Allergic reactions to latex gloves.

PMID- 1640095
TI  - Evaluation of a mechanical/chemical infectious waste disposal system.
AB  - OBJECTIVES: The mechanical/chemical infectious waste disposal system (IWDS),
      model Z-5000 HC, manufactured by Medical SafeTEC Inc. (Indianapolis, Indiana) was
      evaluated for its ability to disinfect biomedical waste. METHODS: The IWDS was
      operated with a sodium hypochlorite solution and tested with loads consisting of
      microbial cultures and blood. During and after processing, samples of liquid,
      milled solid waste, and leachate were collected to determine the efficacy of
      disinfection and the chemical by-products released. An inactivation factor was
      calculated. Aerosol emission was studied. All tests were done in triplicate.
      RESULTS: Our results showed the expected level of disinfection (inactivation
      factor greater than or equal to 5 log10) for all tests carried out with Bacillus
      subtilis, Enterococcus faecalis, Candida albicans, and Serratia marcescens, and
      for most of the tests with Mycobacterium fortuitum and bacteriophages OX174 and
      f2. Further tests performed in the absence of blood resulted in an inactivation
      factor greater than or equal to 5 log10 for all tests with M fortuitum, but not
      for those of the milled solids with bacteriophage f2. Aerosols were found to
      escape the apparatus when the IWDS was operated in the absence of chlorine. The
      liquid effluent contained an average of 17,600, and 15 mg/l of free chlorine,
      chloramines, and trihalomethanes (THM), respectively. The air effluent contained
      1.1 mg/m3 of total chlorine and 1.4 micrograms/m3 of THM. CONCLUSIONS: Under our
      study conditions and except for certain tests with bacteriophage f2, the IWDS
      reduced the microbial populations tested by a factor of 5 log10. The aerosol
      dispersion problem remains to be solved, and the significance of the chemical by
      products released will require further investigation.

PMID- 1640096
TI  - Delayed detection of an increase in resistant Acinetobacter at a Detroit
      hospital.
AB  - OBJECTIVE: To study an increase of antimicrobial-resistant Acinetobacter
      baumannii and to assess reasons for the delayed detection of this increase.
      DESIGN: Review of medical, laboratory, and infection control records. Plasmid
      profile analysis of available A baumannii isolates. SETTING: A 340-bed trauma and
      intensive care hospital in Detroit, Michigan. RESULTS: The number of hospitalized
      patients with resistant A baumannii increased during late 1989 and early 1990: 4
      in September, 10 in October, 12 in November, 18 in December, and 23 in January
      (chi square for trend = 14.6, p = .0001). Forty-four (66%) of the 67 patients
      culture-positive for resistant A baumannii had respiratory tract colonization or
      infection. Of 11 resistant isolates, 6 had a similar plasmid profile and 5 had no
      plasmids. Under the hospital's targeted surveillance system, only positive
      cultures from blood or wounds were investigated; this largely respiratory
      increase of resistant A baumannii went unrecognized until January 1990.
      CONCLUSIONS: Antimicrobial resistance in A baumannii is an important concern.
      Such resistance is not necessarily plasmid mediated. Targeted surveillance for
      this and other agents of nosocomial infection should be used with caution,
      particularly in hospitals with many debilitated patients.

PMID- 1640097
TI  - Epidemiology of measles immunity in a population of healthcare workers.
AB  - OBJECTIVE: To evaluate epidemiologic factors that can be used to predict lack of
      measles immunity in healthcare workers. DESIGN: During mandatory screening of
      employees for measles antibody, a questionnaire was used to collect demographic
      information. SETTING: Inpatient hospital, acute care clinics, and skilled nursing
      facility of a health maintenance organization. PARTICIPANTS: Employees of all
      ages and occupations. RESULTS: Measles immunity could not be predicted from
      history of measles disease and vaccination, gender, or birthplace. Of nonimmune
      employees, 63.7% were in the 20- to 29-year-old age group and 26.5% were in the
      30- to 39-year-old age group. CONCLUSIONS: Age is the most clinically significant
      predictor of measles antibody, especially in persons born after 1950, who make up
      a large group susceptible to measles.

PMID- 1640098
TI  - Applying a standard of care to the quality assessment of bacteremia.
AB  - OBJECTIVE: To identify an indicator of appropriate antibiotic use for bacteremia
      that is scientifically sound, that is noncontroversial, and that can be broadly
      applied as an index of the quality of care. DESIGN: Retrospective review of
      consecutive cases of significant documented bacteremias. SETTING: Suburban
      tertiary-care hospital. RESULTS: Two hundred ninety-one of 300 (97%) patients
      received appropriate antibiotics within 48 hours after the final antibiotic
      sensitivity report was placed on the hospital chart. Therapy was not appropriate
      in 6 patients with methicillin-resistant Staphylococcus aureus and in 3 patients
      with enterococcal bacteremia. INTERVENTIONS: Following this study, we instituted
      a program to prospectively monitor antibiotic use in bacteremias. During the most
      recent 1-year period, the infectious disease fellow or pharmacist called the
      attending physician to change antibiotics in 84 of 731 (11.5%) patients with
      bacteremia. The program was well-accepted by attending physicians. CONCLUSIONS: A
      scientifically sound, non-controversial standard of care was identified and used
      to evaluate the appropriateness of antibiotic use. When this standard was applied
      prospectively and incorporated into the hospital's routine operations, the
      quality of care was improved.

PMID- 1640099
TI  - The OSHA bloodborne hazard standard.

PMID- 1640100
TI  - Aspects of truth: statistics, bias, and confounding.

PMID- 1640101
TI  - Scabies in long-term care facilities.

PMID- 1640102
TI  - AIDS: is it an ill wind?

PMID- 1640103
TI  - When your patient complains.
AB  - A caregiver's attitude and mood sets the tone for the interpersonal environment
      in which patients and caregivers relate. Caregivers should role model a positive
      attitude. When complaints are expressed, the caregiver should listen and make
      careful note not only of the content of what is expressed but the feelings behind
      the message. The caregiver should assess the meaning behind the complaint in
      order to be able to appropriately receive, investigate, and respond to
      complaints. It is the wise caregiver who accepts that complaints are an
      inevitable part of the care setting and works to develop expertise in ways of
      handling this human patient reaction.

PMID- 1640104
TI  - Parameters affecting the adsorption of ligands to polyvinyl chloride plates in
      enzyme immunoassays.
AB  - In the present work, we studied the efficacy of three blocking agents (HSA, BSA
      and OVA) in the inhibition of non-specific binding to PVC plates. According to
      the inhibition data, 1% OVA was the most effective blocking agent. On the other
      hand, the presence of detergents in all of the blocking solutions drastically
      decreased the percent inhibition of the non-specific binding. Furthermore, the
      effect of ligand concentration on adsorption and the kinetics of ligand
      adsorption to PVC plates were also investigated. Ligand adsorption is a linear
      function of input up to a limit (around 8.70 ng/mm2) where saturation is reached.
      The rate of adsorption of pure human IgG to PVC plates was proportionally
      increased with the temperature, as shown by proportional rate constants almost 2
      times faster at 37 degrees C than at 4 degrees C. These results have practical
      implications for investigators using PVC for immunoassays and should be taken
      into consideration when designing such assays.

PMID- 1640105
TI  - Comparison of Freund's and Ribi adjuvants for inducing antibodies to the
      synthetic antigen (TG)-AL in rabbits.
AB  - Antibody responses and health parameters were compared in rabbits immunized with
      a synthetic polypeptide antigen, [L-Tyr,L-Glu,DL-Ala]-poly-L-lysine ((TG)-AL), in
      Freund's (FA) or Ribi (RA) adjuvants. Rabbits, 12 weeks old, of both sexes, were
      inoculated with 0.5 ml divided between two intramuscular (i.m.) sites. Eight
      received FA and antigen (50 micrograms); eight RA and antigen, eight PBS and
      antigen; four FA and PBS; four RA and PBS, and four PBS. Identical booster
      inoculations were made 21 days later, except that incomplete FA was substituted
      for complete FA. Rabbits were monitored until euthanasia and necropsy 7 weeks
      after the primary inoculation. Sera, obtained weekly, were analyzed for
      immunoglobulins using an enzyme immunoassay. Only rabbits given antigen with
      adjuvant produced high titered antibodies. Mean optical density values for
      immunoglobulin (Ig)M were greater the week after the booster in the group given
      FA. IgG values were similar for both adjuvant/antigen groups the week after the
      booster, but thereafter decreased in rabbits given RA. Antisera from rabbits
      given antigen with FA had greater avidity for the antigen than that from rabbits
      given antigen with RA, however, the difference was not significant (p greater
      than 0.05). Rabbits inoculated with FA and antigen had high serum creatinine
      kinase levels the day after inoculation, showed evidence of discomfort, and
      extensive granulomatous inflammation at the inoculation sites. Lesions were
      minimal to mild in rabbits given antigen with RA and PBS with either adjuvant.
      While RA did not result in adverse side effects, the IgG response to (TG)-AL with
      RA was transient compared to FA.

PMID- 1640106
TI  - Comparison of methodologies to measure human lung histamine.
AB  - The measurement of histamine in samples obtained from human lung is important in
      determining the roles of histamine and mast cells in normal and disease states.
      We, therefore, compared different assays for the measurement of histamine in
      human lung samples. Both a single isotope enzymatic assay and a radioimmunoassay
      (RIA) were capable of accurately measuring the low concentrations of histamine
      (0.05-2.0 ng/ml) normally found in bronchoalveolar lavage fluid. The RIA was also
      able to measure histamine levels up to 1500 ng/ml in human lung tissue samples.
      Moreover, the RIA measurement of high levels of histamine in lung samples
      compared favorably to an automated spectrofluorometric method. Unlike either the
      single isotope enzymatic assay or the automated spectrofluorometric assay which
      have effective capabilities at less than and greater than 2 ng/ml, respectively,
      the RIA can accurately measure histamine levels from 0.05 to 1500 ng/ml. Since
      the RIA is easier to perform, less costly, and has a wider range of
      effectiveness, this assay should prove valuable in assessing histamine levels
      from a variety of human lung samples, thereby, providing an avenue to elucidate
      the roles of histamine and mast cells in lung functions.

PMID- 1640107
TI  - Detection of Salmonella enteritidis in environmental samples by monoclonal
      antibody-based ELISA.
AB  - We have developed a enzyme-linked immunosorbent assay (ELISA) using a monoclonal
      antibody (ASCII) for the detection of Salmonella enteritidis in environmental
      samples. ELISA was used to test for sensitivity and specificity of ASCII. 38
      other species of bacteria, including 31 Salmonella species were included in cross
      reactivity testing with ELISA. ASCII showed no reactivity with any other species
      tested. ASCII was found to be an IgG1 specific for S. enteritidis
      lipopolysaccharide (LPS). The lower limits for S. enteritidis detection was 10(5)
      cells/ml for pure cultures and in 10% sludge (w/v). Environmental samples (raw
      wastewater, wastewater effluents, mixed liquor and aerobically digested sludge)
      were obtained twice from five sites and ELISA tested for the presence of S.
      enteritidis. ELISA results compared to the American Public Health Association
      (APHA) method of Salmonella detection were not significantly different (P greater
      than 0.05). The ELISA took 24 h for completion compared to 96-120 h for the APHA
      procedure. Results demonstrate the reliability of the ELISA and, more
      importantly, provides a rapid means of detection of S. enteritidis in
      environmental samples.

PMID- 1640108
TI  - Evaluation of a flow cytometric model for monitoring HIV antigen expression in
      vitro.
AB  - Using flow cytometry, monoclonal antibodies to the HIV proteins p24, gp41 and p17
      were evaluated for their ability to detect HIV antigens associated with HIV
      infected T cells. Mixtures containing varying ratios of HIV-infected and
      uninfected cells were subjected to analysis with these monoclonal antibodies. In
      most cases, the monoclonal antibodies identified the correct ratio of HIV
      infected cells to uninfected cells in the mixtures tested. An HIV anti-p24
      monoclonal antibody was selected for further studies. Flow cytometric analysis
      was performed on various populations of cells including uninfected, acutely
      infected and chronically infected cells. Based on cell population fluorescence
      intensity three distinct regions were identified. In the first region were cells
      having low level fluorescence that were considered negative for HIV antigens, a
      profile detected in uninfected cells, and in the majority of cells in the first
      days following acute HIV infection. In the second region were those cells
      exhibiting strong fluorescence such as chronically infected cells or acutely
      infected cells several days after infection. A third region was identified
      containing cells that were intermediate in fluorescence intensity. Cells
      exhibiting intermediate intensity fluorescence appeared to have low
      concentrations of HIV p24 antigen associated with them either through viral
      adsorption and uptake or through low level virus expression. These intermediate
      region cells appeared in the early stages following acute infection, and also
      when chronically infected cells and uninfected cells were permeabilized together,
      suggesting a 'leaching' of HIV proteins from highly infected cells to uninfected
      cells. This leaching type of phenomenon could present problems in determining
      gating parameters for positive cells since uninfected cells that have associated
      HIV antigens exhibit higher fluorescence intensity than uninfected cells.

PMID- 1640109
TI  - Detection of mycoplasma contamination through modulation (stimulation or
      inhibition) of thymidine incorporation by unstimulated mouse spleen cells.
AB  - In the present report we describe a rapid and sensitive assay for mycoplasma
      detection in cell cultures. The assay is based on the ability of contaminated
      culture supernatants to modulate [3H]TdR incorporation by unstimulated mouse
      splenocytes. Several mycoplasma species (Mycoplasma orale, culturable and non
      culturable strains of Mycoplasma hyorhinis) inhibited [3H]TdR incorporation and
      permitted the detection of some contaminated cell cultures that would otherwise
      have escaped detection in assays measuring [3H]TdR incorporation by mitogen
      stimulated splenocytes. On the other hand, several other mycoplasma species
      (Mycoplasma arginini, Mycoplasma hominis) strongly enhanced [3H]TdR incorporation
      by unstimulated splenocytes. This enhancement was optimally detectable on day 2
      after initiation of the cultures. The sensitivity of the assay was determined for
      a mycoplasma species (culturable M. hyorhinis) that inhibited as well as for one
      (M. arginini) that enhanced [3H]TdR incorporation. In both cases, the sensitivity
      was such that 1-3 x 10(2) mycoplasma colony-forming units (CFU) could be
      detected.

PMID- 1640110
TI  - Chimaeric protein A/protein G and protein G/alkaline phosphatase as reporter
      molecules.
AB  - The IgG binding domains of staphylococcal protein A and streptococcal protein G
      were expressed as a chimaera using the pGEX vector which has been advocated
      because its fusion proteins tend to be soluble and easily isolated on immobilised
      glutathione. This chimaera was soluble and abundant (yield = 18 mg/l of bacterial
      culture) and was tested by double diffusion in agarose and by ELISA. It was found
      to bind IgG of all species that either parent could bind. It was superior to
      protein A or protein G in binding mouse Ig. A chimaera of protein G and alkaline
      phosphatase was also constructed and found to be soluble and abundant (yield = 20
      mg/l of bacterial culture). This protein could be used as a secondary reagent in
      ELISA at 5 micrograms/ml for human, rabbit and mouse and at 25 micrograms/ml for
      sheep.

PMID- 1640111
TI  - A new approach to the generation of human or murine antibody producing
      hybridomas.
AB  - A new and very efficient method for the generation of human and murine monoclonal
      antibodies has been developed. The method is based on clonal expansion of single
      B cells in the presence of human T cell supernatant and irradiated murine thymoma
      helper cells. Subsequently, the clonally expanded B cells are immortalized by
      electric field mediated cell fusion. The high efficiency of the method permits
      the processing of small numbers of lymphocytes, e.g., obtained by preselection of
      specific B cells, small amounts of human donor material and murine PBL or lymph
      node cells. The method may be an alternative for the EBV-transformation technique
      used for the generation of human monoclonal antibodies, which immortalizes only a
      subset of B cells and frequently yields poorly growing or unstable cell lines.
      This report describes the generation of murine anti-HIV and human anti-rubella
      antibodies combining the clonal expansion of B cells and mini-electrofusion.

PMID- 1640112
TI  - Novel vectors for the expression of antibody molecules using variable regions
      generated by polymerase chain reaction.
AB  - A new family of vectors has been produced which facilitates the cloning and
      expression of immunoglobulin variable regions cloned by polymerase chain reaction
      (PCR). The vectors are designed to express the cloned variable regions joined to
      human constant regions and take advantage of priming in the leader sequence so
      that no amino acid changes will be introduced into the mature antibody molecule.
      Both the heavy chain and light chain vectors utilize a murine VH promoter
      provided with an EcoRV restriction site so that the amplified variable regions
      can be directly cloned into a functional promoter. For the heavy chain an NheI
      restriction site has been generated at the first two amino acids of CH1 and the
      cloned leader and variable region are fused directly to the CH1 domain of the
      constant region. When the leader and variable regions of the light chain were
      fused directly to C kappa, no expression was observed. Therefore the light chain
      expression vector was designed with a SalI restriction site for cloning into a
      splice junction 3' of the variable region; VL then is joined to C kappa by
      splicing. Both vectors direct the expression of functional, fully assembled
      immunoglobulin molecules with the expected molecular weight. Use of redundant
      oligomers to prime the PCR permits the cloning and expression of recombinant
      antibodies without any prior information as to their sequence and makes it
      possible to rapidly generate recombinant antibodies from any monoclonal antibody
      producing cell line.

PMID- 1640113
TI  - The issue of interferon-alpha production in hemophiliacs with HIV antibodies: a
      slight but significant decrease?

PMID- 1640114
TI  - Modulation of 2',5'-oligoadenylate synthetase in patients treated with alpha
      interferon: effects of dose, schedule, and route of administration.
AB  - The interferon (IFN)-induced intracellular enzyme 2',5'-oligoadenylate (2-5A)
      synthetase was measured in extracts of peripheral mononuclear cells isolated from
      patients receiving a 300-fold range of doses of alpha interferon (IFN-alpha). The
      range of enzyme induction was 2.3- to 5.7-fold. The maximum fold increase varied
      from individual to individual as did the dose required for maximum enzyme
      stimulation. The magnitude and endurance of the enzyme response was a function of
      IFN dose and was unrelated to the duration of treatment or number of injections
      or to the route of administration. The enzyme assay was a more sensitive
      indicator of IFN administration than was measurement of the level of circulating
      IFN. These results substantiate the potential of a clinical 2-5A synthetase assay
      for monitoring IFN treatment.

PMID- 1640115
TI  - Production of interferon by peripheral blood mononuclear cells from normal
      individuals and patients with chronic lymphocytic leukemia.
AB  - Peripheral blood mononuclear cells (PBMC) from normal individuals were studied to
      identify which cells produce alpha-interferon (IFN-alpha) in response to a virus
      stimulus. It was found that cells both adherent and nonadherent to plastic formed
      IFN-alpha after induction by any one of several viruses studied. When nonadherent
      cells were separated on discontinuous Percoll gradients, only the cells in the
      less dense Percoll fractions produced IFN, whatever the virus used. By indirect
      immunofluorescence with monoclonal antibodies to HLA-DR and to Leu 11b, the
      distribution of the HLA-DR+ cells was shown to resemble most closely that of the
      IFN-producing population. Elimination of these cells (by complement-mediated
      lysis with the same antibodies) abrogated the IFN response, but NK cells remained
      and thus do not produce IFN-alpha. In confirmation, elimination of the Leu 11b+
      cells had no effect on the amount of IFN produced. PBMC preparations from
      patients with chronic lymphocytic leukemia (CLL) appeared incapable of producing
      IFN-alpha but were shown to contain identifiable IFN-producing cells. The low or
      absent IFN levels in CLL are probably due to the relative scarcity of IFN
      producing cells in their PBMC.

PMID- 1640116
TI  - Molecular cloning of a gene encoding porcine interferon-beta.
AB  - A gene encoding the porcine interferon-beta (poIFN-beta) was cloned from a
      genomic library. The sequence of a potential intronless coding region as well as
      1,265 bp of the 5'- and 277 bp of the 3'-flanking regions is presented. The gene
      is predicted to encode a mature protein of 165 amino acids and a signal peptide
      of 21 amino acids. This probable poIFN-beta shows high homology (63%) with human
      (hu) IFN-beta at the amino acid level, but less with porcine (po) IFN-alpha 1
      (32%). It contains three cysteines and three potential N-glycosylation sites. A
      region of the 5' flank (-116 to -159) of the gene is homologous to the IFN gene
      regulatory element (IRE) of the huIFN-beta gene which mediates virus
      inducibility. Southern blot analysis indicates that the poIFN-beta gene is
      present as a single copy in the porcine genome. Its expression in porcine
      peripheral blood leukocytes stimulated in vitro by pseudorabies virus (PRV) was
      demonstrated at the RNA level both by Northern blot analysis and by in situ
      hybridization. The latter approach in addition detected only about one IFN-beta
      mRNA-containing cell per 2,000 PRV-stimulated porcine leukocytes, a frequency in
      the same range as that for leukocytes containing IFN-alpha mRNA.

PMID- 1640117
TI  - Mouse recombinant interferon-beta augments the induction of macrophage cytolytic
      activity by interleukin-2 in vitro.
AB  - We investigated the augmenting effect of mouse recombinant interferon-beta
      (MurIFN-beta) on the induction of macrophage (M phi) cytolytic activity by
      interleukin-2 (IL-2). C3H/He spleen cells were cultured with various doses of
      recombinant (r) IL-2 and/or MurIFN-beta for 4 days, and their cytotoxic
      activities against syngeneic M phi were assessed by a 4-h 51Cr-release assay.
      Although MurIFN-beta itself induced little M phi cytolytic activity, it
      significantly augmented the IL-2-induced cytotoxicity against M phi. MurIFN-beta
      showed a dose-dependent enhancement on the induction of anti-M phi activity by IL
      2 with a peak at 2,000-10,000 U/ml, and the augmenting effect of rIFN-beta was
      more marked on lower doses of rIL-2 than on higher doses. This augmenting effect
      was also observed in IFN-alpha, whereas IFN-gamma showed no influence on IL-2
      induced anti-M phi activity. The phenotype analysis by depletion technique with
      antibody and completement showed that anti-M phi effectors induced by either rIL
      2 or the combination of rIL-2 and rIFN-beta were Thy-1+, asialoGM1+, L3T4-, and
      Ly2-. These results suggest that IFN-alpha or IFN-beta has a synergistic effect
      with IL-2 on the induction of nonspecific killer cells with M phi cytolytic
      activity.

PMID- 1640118
TI  - O6-alkylguanine DNA alkyltransferase is induced by human recombinant interferon
      alpha A/D in mouse liver.
AB  - Treatment of C57Bl or BALB/C mice with human interferon-alpha A/D (HuIFN-alpha
      A/D) significantly increased hepatic levels of the DNA repair enzyme O6
      alkylguanine DNA alkyltransferase (AT). The maximum induction was seen 24 h after
      a single dose of 50-100 micrograms/kg IFN-alpha A/D. No induction was observed in
      rat liver hepatocytes cultured in vitro. Liver AT was also induced by poly(I:C),
      which is a potent IFN inducer. By increasing AT levels, IFN could protect against
      the potentially mutagenic alkylation at guanine O6 position caused by some
      carcinogens. Moreover this finding suggests a link between immune response and
      the DNA repair system, possibly acting in concert to defend the body from
      potentially toxic compounds.

PMID- 1640119
TI  - Differential responsiveness of normal and simian virus 40-transformed human
      fibroblast cells to interferon-gamma.
AB  - The effect of interferon-gamma (IFN-gamma) on epidermal growth factor (EGF)
      receptor binding and the proliferation of normal and simian virus 40 (SV40)
      transformed human fibroblast cells was compared under identical culture
      conditions. IFN-gamma induced an enhancement of EGF binding to normal cells,
      whereas it decreased the EGF binding to SV40-transformed cells. Half-maximal
      enhancement occurred at 72 h after the normal cells were exposed to 10 U/ml of
      IFN-gamma, and maximal stimulation was obtained at about 10(2) U/ml of IFN-gamma
      at 72 h. On the other hand, half-maximal reduction was observed for SV40
      transformed cells at less than 10 U/ml of IFN-gamma at 72 h, and maximal
      reduction was obtained at around 10(3) U/ml of IFN-gamma at 72 h. Scatchard
      analysis indicated that the number of EGF binding sites of normal and SV40
      transformed cells was calculated to be 1.6 x 10(5) and 0.88 x 10(5) per cell,
      respectively, and was little altered by IFN-gamma treatment. The dissociation
      constant (Kd) of normal cells, however, decreased from 4.5 nM (control) to 2.0 nM
      (IFN-gamma-treated), while the Kd of SV40-transformed cells increased from 3.6 nM
      (control) to 17.0 nM (IFN-gamma-treated). The immunoprecipitation of 125I-labeled
      EGF-bound EGF receptors with anti-receptor antiserum indicated that a 72-h IFN
      gamma treatment did not induce a conformational alteration in the EGF receptors
      of both normal and transformed cells. The DNA synthesis of normal cells was
      enhanced by EGF, and IFN-gamma treatment potentiated the effect of EGF on DNA
      synthesis, probably due to the increased binding affinity of EGF to the
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640120
TI  - Cloning of the cDNA for canine interferon-gamma.
AB  - We have taken advantage of conserved regions of cDNA sequences for interferon
      gamma (IFN-gamma) from other species to design polymerase chain reaction (PCR)
      primers capable of amplifying the protein-coding region of the canine mRNA. We
      report here the cDNA cloning of this region from dog lymphocytes and the cDNA
      sequence. The predicted amino acid sequence is also reported and compared to the
      known sequences of these other species. The molecular clone for the canine IFN
      gamma will allow direct study of this important cytokine's role in graft
      rejection in the widely used experimental canine transplant model.

PMID- 1640121
TI  - Interferon-beta treatment does not elevate cortisol in multiple sclerosis.
AB  - Interferons (IFN) are used to treat cancer and multiple sclerosis (MS). High
      doses of IFN elevate serum cortisol, which may indirectly affect the course of
      either of these diseases. IFN-induced elevation of serum cortisol could speed
      recovery from exacerbations of MS. We find that IFN-beta at 9 or 45 MU every
      other day does not elevate serum or urine cortisol in MS. Clinical effects of IFN
      beta in MS are likely to be direct, and not mediated indirectly through
      alteration of serum cortisol levels.

PMID- 1640122
TI  - Regulation of the natural killer cell response to interferon-alpha by biogenic
      amines.
AB  - Monocytes, recovered from human peripheral blood by counter-current centrifugal
      elutriation (CCE), suppressed baseline natural killer (NK) cell cytotoxicity
      (NKCC) and rendered NK cells resistant to activation of cytotoxicity by human
      recombinant interferon-alpha (IFN-alpha) by a cell contact-dependent mechanism.
      Monocyte-induced suppression of resting and IFN-activated NK cells was abrogated
      by the biogenic amines histamine [via H2-type receptors (H2R)] and serotonin [via
      5-HT1A-type receptors (5-HT1AR)]. Our data are suggestive of a monocyte/NK cell
      interaction that is subject to regulation by biogenic amines.

PMID- 1640123
TI  - International guidelines for specialty training in oral and maxillofacial
      surgery.

PMID- 1640124
TI  - Fascia lata interpositional arthroplasty in the treatment of temporomandibular
      joint ankylosis caused by psoriatic arthritis.
AB  - A patient with bilateral temporomandibular joint ankylosis, secondary to
      psoriatic arthritis, was treated by interpositional arthroplasty using fascia
      lata autogenous grafts. Despite gross limitation of mandibular movements prior to
      operation, radiological and functional recovery was complete at 2 years.

PMID- 1640125
TI  - Titanium mesh in orbital wall reconstruction.
AB  - Successful use of titanium mesh sheets in the reconstruction of orbital wall
      defects of up to 2.5 x 2.5 cm following trauma and followed up for a mean of 24
      months is demonstrated. This material is especially useful in orbital floor and
      medial wall blow-out fractures, and is a valuable additional material for use in
      maxillofacial reconstruction.

PMID- 1640126
TI  - Asymptomatic impacted teeth in edentulous jaws undergoing preprosthetic surgery.
      A long-term evaluation.
AB  - A long-term evaluation is made of 15 patients with asymptomatic impacted teeth in
      edentulous jaws. Seventeen impacted teeth in 15 patients were recorded and
      analysed. They were located in denture-bearing areas and in areas undergoing
      preprosthetic surgery. All patients, except one lost after 1-year period, were
      followed clinically and radiographically for 1 to 10 years with an average of 4
      years. The asymptomatic impacted teeth in edentulous jaws embedded in bone or
      covered with mucosa did not cause any problem to the patients. The findings of
      this study support the view that removal of asymptomatic impacted teeth in
      denture-bearing areas, or in areas undergoing preprosthetic surgery, is
      unnecessary as long as the integrity of the covering tissues is preserved. A
      policy or radiological surveillance is recommended.

PMID- 1640127
TI  - Computer-aided individual prognoses of squamous cell carcinomas of the lips, oral
      cavity and oropharynx.
AB  - Computer-aided individual prognoses (CIP) is a software-package developed on the
      basis of an empirical study and can be installed on any IBM-compatible personal
      computer. The project which went into the making of CIP was called "Prospective
      DOSAK-study on squamous cell carcinomas of the lips, oral cavity and oropharynx".
      In the course of the study 1485 patients were treated between 1977 and 1982, and
      followed up through 1985. CIP facilitates individual prognoses and comparisons of
      independent patient groups with parallel groups from the data of the above
      mentioned study. In practical clinical work individual prognoses allow exact and
      reliable judgements on individual patients. In clinical cancer research it
      provides the information about prognostic factors required for controlled
      clinical studies. The comparison of independent patient populations allows for an
      ongoing qualitative control of the patients in each clinical institution. In
      clinical cancer research such a comparison means that certain characteristics of
      the patient, the tumor and of the disease can be given higher prognostic value.
      The same is true of the clinical testing of therapeutic measures which is
      typically carried out during phase-II-studies. Due to its menu-based organization
      CIP does not presuppose any specialist knowledge on the part of its users and can
      be regarded as particularly user-friendly.

PMID- 1640128
TI  - Intraoral cheek transposition flap for primary reconstruction of the soft palate.
AB  - A method for primary reconstruction of the soft palate following radical tumor
      resection is described. The resulting defects can be repaired with 2 layers of
      tissue by combination of a cranial pedicled pharyngeal flap and a cranial
      pedicled intraoral cheek transposition (IOCT-) flap. For additional resection of
      the lateral pharyngeal wall the technique can be combined with a masseter
      crossover flap. The method allows satisfying restoration of swallowing and speech
      with relatively small operative effort.

PMID- 1640129
TI  - Heterotopic salivary gland tissue in lymph nodes of the cervical region.
AB  - The occurrence and composition of intranodal salivary gland tissue (ISGT) in the
      head and neck region were investigated. ISGT was mainly composed of mature acini,
      intercalated ducts and intralobular ducts but immature acini (20.8%) and immature
      small ducts (18.8%) were also observed. The latter resembled salivary gland
      tissue in an early developmental stage. Various histological changes of ISGT were
      observed including cyst formation (16.7%), oncocytic metaplasia (8.3%), oncocytic
      adenomatous hyperplasia (8.3%) and ductal proliferation (20.8%). Thus ISGT may
      contain immature components with a potential for differentiation and
      proliferation.

PMID- 1640130
TI  - Bolus dose with continuous infusion of midazolam as sedation for outpatient
      surgery.
AB  - This double-blind, randomised, cross-over trial in 41 patients for 3rd molar
      surgery compared the safety, amnesic properties and psychomotor recovery between
      a bolus injection of midazolam and a bolus injection followed by continuous
      infusion of midazolam. The latter showed good safety and better amnesia to events
      during the procedure, but prolonged the recovery time.

PMID- 1640131
TI  - Migratory facial swelling due to gnathostomiasis.
AB  - Two cases of facial gnathostomiasis in female Thai patients are described.
      Gnathostomiasis is caused by a roundworm, Gnathostoma spinigerum. In both
      patients the disease was characterised by intermittent and migratory swelling of
      the face. At present no effective therapy is available. Surgical removal of the
      parasite would be a curative treatment; it is however, rarely successful due to
      the parasite moving relatively rapidly within the soft tissues. The disease can
      be prevented by avoiding undercooked meat including fish. In endemic areas such
      as Southeast Asia, gnathostomiasis must be considered in cases of oro-facial
      swelling of otherwise unknown cause.

PMID- 1640132
TI  - An experimental study of the osteogenicity of free periosteal allografts with
      cyclosporine A administration.
AB  - Free tibial periosteum was grafted onto the dorsum (m. cutaneous trunci) of
      Sprague-Dawley rats to examine its osteogenic potential. The animals were divided
      into 3 groups based on type of: A. autogenous periosteum, B. allogeneic
      periosteum and C. allogeneic periosteum, and treated with cyclosporine A
      immunosuppression. The osteogenic response was evaluated radiologically and
      histologically. This study indicates that in this model periosteal allografts
      with immunosuppression of the recipient result in osteogenesis. Clinical
      application of the technique will only be possible if immunosuppressive methods
      with minimal morbidity are developed so that they can be used for prolonged
      periods.

PMID- 1640133
TI  - Temporomandibular joint eminence augmentation by down-fracture and
      interpositional cartilage graft. A new surgical technique.

PMID- 1640134
TI  - Cardiac dysrhythmias complicating maxillofacial surgery.

PMID- 1640135
TI  - The recovery of sensation and function after cross-finger flaps for fingertip
      injury.
AB  - Over a five-year period, 54 patients had cross-finger flaps at Mount Vernon
      Hospital for single fingertip injuries. A retrospective study was carried out to
      evaluate the recovery of sensation and function. 92% of the patients were
      satisfied with the result although 53% suffered cold sensitivity. All the cross
      finger flaps tested had diminished sweating and a raised threshold for electrical
      stimulation. Despite the presence of protective sensation, dynamic sensory
      discrimination and the return of advanced A beta fibre innervation, none of the
      cross-finger flaps was found to have recovered tactile gnosis.

PMID- 1640136
TI  - Mixed sclerosing bone dystrophy presenting with upper extremity deformities. A
      case report and review of the literature.
AB  - We present a detailed study of a 59-year-old white woman with mixed sclerosing
      bone dystrophy: the rare occurrence of two or more sclerosing bone dysplasias in
      a single subject. She exhibited features of osteopoikilosis, osteopathia striata
      and melorheostosis. The symptoms were primarily the result of the melorheostosis
      lesions which were distributed within the C6 sclerotome. This is an unusual case
      of mixed sclerosing bone dystrophy in that the upper extremity was the main site
      of involvement, instead of the usual symmetrical involvement of all limbs. The
      patient developed a recalcitrant lateral epicondylitis in the un-involved
      contralateral elbow that required surgical treatment.

PMID- 1640137
TI  - An unusual association of the windblown hand with upper limb hypertrophy.
AB  - An eight-year-old boy presented with a congenital windblown hand deformity
      associated with partial hypertrophy of that arm. Many of the classical features
      of the windblown hand syndrome described in previous papers were absent. In this
      case, the primary cause of the ulnar-drift deformity was an anomalous epiphysis
      at the base of the second metacarpal. Surgical correction was readily obtained by
      osteotomy at the base of the metacarpal combined with soft tissue re-alignment.

PMID- 1640138
TI  - Magnetic resonance imaging in Kienbock's disease.
AB  - With a 1.5 tesla superconducting M.R. imager and surface coil, M.R. imaging
      achieved high resolution analysis of the wrist on five normal wrists and 26
      wrists with Kienbock's disease. The purpose of this study was to establish new
      criteria for diagnosis, staging and prognosis of Kienbock's disease, based on
      signal characteristics on T1- and T2-weighted images. Focal loss of signal
      intensity of the lunate on T1-weighted image was an indication of Kienbock's
      disease. A decreased signal containing a high spot and increased signal intensity
      of the lunate on T2-weighted images indicated a better prognosis. After osteotomy
      of the radius, the signal intensity of the lunate returned to normal and
      Lichtman's stage II cases had better results than those in stage III. M.R.
      imaging is ideal for evaluating the lunate in Kienbock's disease.

PMID- 1640139
TI  - Anatomy, descriptive and surgical.

PMID- 1640140
TI  - Magnetic resonance imaging in scaphoid fractures.
AB  - The use of a 1.5 tesla superconducting M.R. imager and surface coil was found to
      enhance the ability of M.R.I. to depict the fine anatomy of the wrist. Five
      healthy volunteers and 28 patients with scaphoid fractures underwent M.R.I.,
      which made possible a definitive diagnosis of scaphoid fractures at an early
      stage. A fresh fracture was identified by decreased or iso signal intensity on
      the T1-weighted image and increased signal intensity on the T2-weighted image.
      This increase continued until bony union was apparent on radiographs. On the T2
      weighted image, high signal intensity was characteristic of fresh fractures and
      suggested that bony union was possible. When bony union was complete, the
      intensity of the signal for the scaphoid on both T1- and T2-weighted images
      returned to normal. M.R.I. should thus prove useful in the diagnosis of scaphoid
      fractures.

PMID- 1640141
TI  - Detecting fractures of the scaphoid: the value of comparative X-rays of the
      uninjured wrist.
AB  - Pain or tenderness in the anatomical snuff-box following trauma suggests an
      injury to the scaphoid or surrounding soft tissues. It is often difficult to make
      a definite diagnosis since normal bone markings across the scaphoid can be
      misinterpreted as a fracture. To clarify whether a fracture is present or not, an
      X-ray of the uninjured scaphoid is taken in a comparable position to the most
      suspicious view. If bone markings are similar on both views, then a fracture can
      be excluded. Conversely, if the bone markings differ, then suspicion of a
      fracture may be confirmed. In combination with the clinical features, a more
      accurate diagnosis can be made and unnecessary out-patient and X-ray reviews can
      be avoided.

PMID- 1640142
TI  - Kienbock's disease.

PMID- 1640143
TI  - Arthroscopy for the diagnosis of post-traumatic wrist pain.
AB  - 30 patients with post-traumatic wrist pain were investigated by arthroscopy. The
      clinical findings and type of injury were compared to the pathological morphology
      seen at arthroscopy. In 21 (70%) of the patients, arthroscopic findings gave a
      plausible explanation for the symptoms.

PMID- 1640144
TI  - Scapho-trapezio-trapezoid arthrodesis in the treatment of Kienbock's disease. A
      study of 16 cases.
AB  - Sixteen scapho-trapezio-trapezoid arthrodeses were performed for Kienbock's
      disease. In ten cases, a prosthetic replacement of the lunate was inserted at the
      same time. Clinical results were good with regard to pain and fair with regard to
      grip strength which was improved by an average of 32%. In contrast, the arc of
      flexion-extension was 38% less than on the unoperated side. Long-term
      radiographic assessment showed the efficacy of the procedure in maintaining
      carpal height. Biomechanical observations and a review of poor results showed the
      limits of the method and the importance of correct positioning of the scaphoid.
      We concluded that triscaphe arthrodesis was a useful procedure for the treatment
      of Kienbock's disease in Decoulx's stage 3.

PMID- 1640145
TI  - The natural history of undiagnosed wrist pain in young women. A long-term follow
      up.
AB  - 43 young women with undiagnosed wrist pain were followed up for a median of 13
      years (range 3 to 19). 26% were now free of pain and 35% had improved; 30% were
      unchanged and 9% were worse. Overall, 40% were still significantly troubled.
      There was no evidence that those patients suffered or had suffered from emotional
      or psychiatric disturbance which might have been responsible for the pain. Only
      three patients had developed ganglia.

PMID- 1640146
TI  - Percutaneous Kirschner wire stabilisation following closed reduction of Colles'
      fractures.
AB  - 32 consecutive unstable Colles' fractures were treated by closed reduction and
      percutaneous Kirschner wire stabilisation through the radial styloid, followed by
      a below-elbow cast. Radiological assessment was made at five stages of treatment:
      at the time of the fracture, immediately after operation, after two weeks, after
      six weeks and a final review at an average period of 15.9 months. Functional
      assessment was made at the final review. Only three fractures developed secondary
      displacement, which was due to the wrong placement of the Kirschner wire. There
      were no complications.

PMID- 1640147
TI  - Pilon fractures of the wrist. Displaced intra-articular fractures of the distal
      radius.
AB  - 22 patients who sustained high energy wrist injuries are reported. These complex
      injuries resulted in articular disruption of the distal radius. Associated
      injuries included scapho-lunate dissociation (18%), central die-punch injuries
      (14%), ulnar fractures (41%) and diastasis at the distal radioulnar joint (23%).
      Nine fractures (41%) were open and almost a third of patients had other skeletal
      injuries. All patients were treated by external fixation and reviewed after a
      mean follow-up of 2 1/2 years. There were no excellent results and only ten good
      ones (45%). The mean functional impairment was 32%. The external fixator was
      effective in maintaining extra-articular alignment, but not in ensuring accurate
      reduction of the articular surface. Residual incongruity of the joint surface was
      an adverse prognostic feature. All five patients (22%) with an articular step of
      more than 2 mm. developed symptomatic arthritis. Failure to restore the joint
      line did not account for all the unsatisfactory results; persistent scapho-lunate
      dissociation and problems at the distal radioulnar joint were also important.

PMID- 1640148
TI  - Controlled study of the use of local steroid injection in the treatment of
      trigger finger and thumb.
AB  - A controlled double-blind prospective study of injection of methylprednisolone
      acetate plus local anaesthetic against a control injection of a local anaesthetic
      in the treatment of trigger finger and thumb has shown a 60% success rate for the
      steroid injection against 16% for the control group (p less than 0.05). This is
      the first controlled trial of local steroid therapy in this condition.

PMID- 1640149
TI  - The association between alcohol, hepatic pathology and Dupuytren's disease.
AB  - We have looked at the incidence of Dupuytren's disease in alcoholics, those with
      non-alcoholic liver disease and a control population. Both alcoholic patients and
      those with non-alcohol related liver disease had a higher rate (28% and 22%
      respectively) than the controls (8%), but this did not quite reach statistical
      significance (p greater than 0.05). In addition we found no Dupuytren's disease
      in 50 Egyptian patients with bilharzia and no consistent biochemical
      abnormalities in 134 patients with significant Dupuytren's disease. We conclude
      that alcoholics probably do have a higher rate of Dupuytren's disease and that
      this effect is largely due to the liver disease caused by alcohol abuse, but that
      the genetic factors are of greater aetiological importance.

PMID- 1640150
TI  - The long term result of digital nerve repair in no-man's land.
AB  - 30 isolated lesions of digital nerves which had been repaired by microsurgical
      techniques were examined in 27 patients. The average length of follow-up was 25
      months (range: 12-48 months). Patients were assessed subjectively using a visual
      analogue scale and examined for light touch, pain, two-point discrimination,
      electrical conductance and sensory threshold. Although 37% of fingers regained
      normal two-point discrimination, only 27% of patients graded their overall result
      as excellent and 40% complained of persistent hyperaesthesia for up to two years.
      None felt that their finger had regained normal sensation. All patients
      undergoing digital nerve repair should be warned that hyperaesthesia may persist
      for several years and that an adult will never regain normal sensation.

PMID- 1640151
TI  - The recovery of peripheral nerves following tissue expansion.
AB  - A rat sciatic nerve model has been used to study the response of nerves to tissue
      expansion and their recovery at intervals up to 100 days using electrophysiology
      and histological methods. Tissue expansion has been shown to increase nerve
      length by 32% of which half remained at 100 days. Following tissue expansion the
      mean conduction velocity of the sciatic nerve was reduced to 30.0 +/- 1.35 m/s
      which represented 60.3% of control values, by 100 days the conduction velocity
      had almost returned to normal. Histological examination showed the cause of the
      reduction in function to be due to segmental demyelination without axonal
      degeneration, these changes returned towards normal during the recovery period
      but were not completely reversed by 100 days.

PMID- 1640152
TI  - The mechanical strength of various suture techniques.
AB  - The mechanical strengths of five techniques of tendon repair have been evaluated
      using human cadaver tendons. A modified Kessler repair with a peripheral
      circumferential suture and the method of Becker were found to require the
      greatest load to produce gapping, but the Becker and Savage repairs withstood the
      highest load before failure.

PMID- 1640153
TI  - A biomechanical analysis of a new interlock suture technique for flexor tendon
      repair.
AB  - Using a computerised tensometer, both the gap-producing and breaking forces of a
      new interlocking suture for flexor tendon repair were compared to the modified
      Kessler and the Strickland techniques. 30 porcine deep flexor tendons were used
      in each group and all repairs were performed with 3/0 polypropylene sutures. The
      interlock technique withstood gap-producing and breaking forces significantly
      better than the modified Kessler and Strickland techniques. Also, the gap
      producing force was closer to the breaking force with the interlock technique
      than with the other two techniques.

PMID- 1640154
TI  - The effect of constant direct electrical current on intrinsic healing in the
      flexor tendon in vitro. An ultrastructural study of differing attitudes in
      epitenon cells and tenocytes.
AB  - Light and electron microscopy were performed in a study of the effects of
      electrical stimulation upon the reparative processes in flexor tendons cultured
      in vitro. After one or two weeks of incubation, the unstimulated control tendons
      were covered with fibroblastic surface cells, thought to have originated from the
      epitenon. In contrast, the tendons subjected to electrical stimulation had no
      proliferation of the epitenon cells in the surface layer. The results indicate
      that electrical currents of low amperage suppress adhesion-causing synovial
      proliferation in the epitenon and promote active collagen synthesis in the
      tenocytes. This suggests the potential value of electrical stimulation in the
      control of adhesion formation after flexor tendon repair.

PMID- 1640155
TI  - Repair of the ruptured distal tendon of the biceps brachii.
AB  - The biceps brachii is the main supinator of the forearm. Unless the ruptured
      distal tendon is reattached to its correct anatomical site on the radial
      tuberosity, its action cannot be restored. We report four cases treated
      surgically, who all regained full forearm function, and on the basis of our
      experience suggest a simple method of reattaching the tendon.

PMID- 1640157
TI  - School reform: opportunities for excellence and equity for individuals with
      learning disabilities. A special report by the National Joint Committee on
      Learning Disabilities.

PMID- 1640156
TI  - Irlen lenses.

PMID- 1640158
TI  - Reading disabilities and aggression: a critical review.
AB  - Several authors have suggested that there is a strong association between
      specific learning disabilities and aggression, antisocial behavior, and juvenile
      delinquency. Claims that learning disabilities cause aggressive behavior and
      delinquency are increasingly common in the popular press, and a variety of
      theories concerning this purported causal relationship have been proposed. This
      research is flawed by a lack of specificity in the definition of learning
      disabilities, with studies often examining heterogeneous groups of children with
      learning problems. The present review examines the relationship between specific
      reading disabilities (the most frequently diagnosed learning disability) and
      aggressive behavior. The data suggest that there is not enough evidence to
      conclude that reading disability causes aggressive or delinquent behavior,
      although limited evidence does suggest that reading disability may worsen
      preexisting aggressive behavior.

PMID- 1640159
TI  - Cluster analysis of children and adolescents with brain damage and learning
      disabilities using neuropsychological, psychoeducational, and sociobehavioral
      variables.
AB  - The purpose of the study was to employ psychoeducational, neuropsychological, and
      sociobehavioral (Conners Rating Scale) variables in determining if definable
      subtypes exist within a diverse population of subjects with learning disabilities
      (LD) and documented brain damage. The sample of 95 subjects (27% female and 73%
      male) had been referred for neuropsychological assessment at a large, Midwestern
      medical center. Mean age was 10.6 years. Brain damage (BD) was documented for 45%
      of the sample. The first cluster analysis employed neuropsychological,
      psychoeducational, and sociobehavioral data and revealed four interpretable
      clusters. A second cluster analysis excluded sociobehavioral data and yielded two
      interpretable clusters. In neither analysis did a cluster consist exclusively of
      BD or LD subjects. Results were interpreted as supporting the importance of the
      sociobehavioral component in LD subtyping, as well as supporting the contention
      that parallels may exist in cerebral function and/or structure between the LD and
      BD classifications.

PMID- 1640160
TI  - A reading level match study of nonword reading skills in poor readers with
      varying IQ.
AB  - This study evaluated the hypothesis that poor readers are characterized by poor
      nonword reading skills, but that a specific deficit, as opposed to a
      developmental lag, in nonword reading will be found only in subjects whose
      reading is discrepant from intellectual ability. To test this hypothesis, we
      measured nonword reading skills in 93 (64 male, 29 female) third-grade poor
      readers and 54 (37 male, 17 female) fifth-grade poor readers (with and without
      reading/IQ discrepancies) who were matched to 147 (81 male, 66 female)
      nondisabled first graders on word identification skills. Results showed third-
      and fifth-grade poor readers to be significantly more impaired than word
      identification level match first graders on all measures on nonword reading.
      These findings were not related to the verbal IQ level within the poor reader
      groups and, thus, provide strong evidence for a deficit in nonword reading skills
      that is not explained by verbal intelligence.

PMID- 1640161
TI  - The effects of computer-based attribution retraining on the attributions,
      persistence, and mathematics computation of students with learning disabilities.
AB  - The purpose of the present study was to examine the impact of attribution
      retraining, embedded within a mathematics computer-assisted instructional (CAI)
      program, on students' attributions, persistence, and mathematics computation.
      Twenty-nine school-identified students with learning disabilities from five urban
      schools participated in the study. The sample's mean age was 13.3 years. After
      blocking on initial attributional patterns, students were randomly assigned to a
      mathematics CAI program that provided either attribution retraining or neutral
      feedback. Students used their assigned program for eight 30-minute sessions.
      Results did not support the contention that attribution retraining would have a
      significant impact on students' attributions. However, students who participated
      in the attribution retraining condition completed significantly more levels of
      the program than their counterparts who received neutral feedback. Attribution
      retraining students also obtained significantly higher scores on a test of
      problems practiced during the CAI program. These results suggest that attribution
      retraining may be a desirable addition to the type of feedback typically provided
      by CAI programs. However, they also highlight the need for further research that
      examines the conditions under which specific attributions are most advantageous.

PMID- 1640162
TI  - Drug addiction and mother/child welfare. Rights, laws, and discretionary
      decisionmaking.

PMID- 1640163
TI  - The adequacy of hospital reimbursement under Medicaid's Boren Amendment.

PMID- 1640164
TI  - Cytokine secretion by immune cells in space.
AB  - Cultured, bone marrow-derived macrophages, murine spleen and lymph node cells,
      and human lymphocytes were tested for their ability to secrete cytokines in
      space. Lipopolysaccharide-activated bone marrow macrophages were found to secrete
      significantly more interleukin-1 and tumor necrosis factor when stimulated in
      space than when stimulated on earth. Murine spleen cells stimulated with poly I:C
      in space released significantly more interferon-alpha at 1 and 14 hours after
      stimulation than cells stimulated on earth. Similarly, murine lymph node T cells
      and human peripheral blood lymphocytes, stimulated with concanavalin A in space,
      secreted significantly more interferon-gamma than ground controls. These data
      suggest that space flight has a significant enhancing effect on immune cell
      release of cytokines in vitro.

PMID- 1640166
TI  - The role of oxidative stress in disease progression in individuals infected by
      the human immunodeficiency virus.
AB  - This review describes the potential role of oxidative stress as a cofactor of
      disease progression from asymptomatic human immunodeficiency virus (HIV)
      infection to the acquired immunodeficiency syndrome (AIDS). Oxidative stress is a
      known activator of HIV replication in vitro through the activation of a factor
      that binds to a DNA-binding protein, NF-kappa B, which in turn stimulates HIV
      gene expression by acting on the promoter region of the viral long terminal
      repeat. Tumor necrosis factor alpha (TNF-alpha), an essential cytokine produced
      by activated macrophages, is also involved in the activation of HIV infection
      through similar mechanisms. TNF-mediated cytotoxicity of cells exposed to this
      substance is related to the generation of intracellular hydroxyl radicals. An
      indirect argument in favor of the role of oxidative stress in HIV-associated
      disease progression is the consumption of glutathione (GSH), a major
      intracellular antioxidant, during HIV infection and progression. GSH is known to
      play a major role in regulation of T cell immune functions. Oxidative stress may
      also play an important role in the genesis of cellular DNA damage and, in this
      context, may be related to HIV-associated malignancies and disease progression.
      Finally, the role of antioxidants as components of therapeutic strategies to
      combat HIV disease progression is discussed.

PMID- 1640165
TI  - Subcellular localization of CD66, CD67, and NCA in human neutrophils.
AB  - CD66 and CD67 are granulocyte-specific activation antigens; their surface
      expression is up-regulated when neutrophils are activated. CD66 antibodies
      recognize an approximately 180-kd neutrophil surface protein that is also
      recognized by anti-carcinoembryonic antigen (CEA) antibodies and is therefore a
      nonspecific cross-reacting antigen (NCA). CD67 antibodies recognize an
      approximately 100-kd neutrophil surface protein that is attached to the membrane
      via a glycosyl-phosphatidylinositol anchor. To identify an intracellular pool
      from which CD66 and CD67 could be up-regulated, the subcellular distribution of
      proteins recognized by CD66 and CD67 monoclonal antibodies and polyclonal anti
      CEA was studied. Neutrophil plasma membranes, granules, and cytoplasm were
      prepared by nitrogen cavitation and differential centrifugation and then analyzed
      by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting.
      Most of the 180-kd protein recognized by CD66 antibodies and the 100-kd protein
      recognized by CD67 antibodies were located in the secondary granule fraction,
      with lesser amounts detectable in the plasma membrane fraction. Several NCA
      species ranging from approximately 40 to 200 kd were identified, and the
      distribution of these NCAs was different in the primary granules, secondary
      granules, and plasma membrane fractions. The major NCAs in the plasma membrane
      fraction were of approximately 95 to 100 and approximately 180 to 200 kd; the
      secondary granule fraction contained major NCAs of approximately 42, 85, 95 to
      100, and 180 to 200 kd. NCAs were also detected in the primary granule fraction,
      the most prominent being of approximately 90-100 kd; no NCA of approximately 180
      to 200 kd was detected in the primary granules. The presence of CD66, CD67, and
      NCAs in the secondary granules suggests secondary granules as a likely source
      from which these antigens could be recruited to the cell surface with activation.
      The potential role for NCAs in the primary granules is unknown.

PMID- 1640167
TI  - Regulatory role of cytokines in IgE-mediated allergy.
AB  - The discovery of immunoglobulin E (IgE) is considered the most important
      contribution, to date, in the field of clinical allergy. Studies in rodents and
      humans have suggested that IgE production could be regulated by antigen-specific
      helper and suppressor T cells and by isotype-specific factors having affinity for
      IgE. In recent years, the synthesis of IgE has been shown to be regulated, in
      part, by a cytokine network. This review summarizes the cytokines that up
      regulate (interleukins-4, 5, and 6) and down-regulate (interferon-gamma and
      interleukin-2) the production of IgE. Emphasis is placed on IL-4 and IFN-gamma,
      two lymphokines known to play a major, but reciprocal, role in IgE synthesis.
      Increased insight into the various mechanisms of IgE control by cytokines and
      their receptors will eventually lead to improved treatment strategies in the
      clinical management of IgE-mediated allergy.

PMID- 1640168
TI  - Inhibitory role of interleukin-6 in macrophage proliferation.
AB  - We have shown that there are two forms of progenitor cells for macrophages. The
      first is characterized by a short lag period (about 1 day) before initiating the
      cell cycle, forms large colonies, is found in the bone marrow, and is in the
      nonadherent fraction. The second progenitor cell, found primarily in the adherent
      cell fraction of bone marrow and in peripheral tissues, forms small colonies
      after 14 days. We investigated the effect of combining interleukin-6 (IL-6) with
      colony-stimulating factor 1 (CSF-I) on macrophage proliferation. We found that IL
      6 inhibited the proliferation of both types of progenitor cells, as well as more
      differentiated macrophages. This inhibitory effect was reversible because
      macrophages could initiate a proliferative response after removal of IL-6 from
      the culture medium. The introduction of anti-IL-6 into macrophage cultures
      containing IL-6 allowed proliferation, indicating that the effect was IL-6
      specific. These results suggest that IL-6 may play a regulatory role in vivo by
      suppressing the production of bone marrow and tissue macrophages.

PMID- 1640169
TI  - Mouse macrophages contain a truncated CD4 transcript.
AB  - Mouse macrophages do not express CD4 on their surfaces. We used the polymerase
      chain reaction to investigate CD4 gene transcription in individual clones of
      primary mouse splenic macrophages and cell lines of spleen and bone marrow
      macrophages. The results show only the presence of CD4 mRNA transcripts that are
      truncated in the 3' coding sequence, thus explaining the lack of expression of a
      mature CD4 gene product by these cells.

PMID- 1640170
TI  - Monoclonal antibody NIMP-R10 directed against the CD11b chain of the type 3
      complement receptor can substitute for monoclonal antibody 5C6 to exacerbate
      listeriosis by preventing the focusing of myelomonocytic cells at infectious foci
      in the liver.
AB  - Treatment of mice with a monoclonal antibody (mAb) designated NIMP-R10, directed
      against the CD11b polypeptide of the CD18/CD11b heterodimeric type 3 complement
      receptor (CR3), exacerbates listeriosis by preventing myelomonocytic cells from
      focusing at sites of infected hepatocytes in the liver. Under these conditions an
      otherwise sublethal Listeria inoculum grows unrestrictedly within hepatocytes and
      causes death in 3 days. The results obtained with NIMP-R10 are similar to those
      previously obtained with a different anti-CD11b mAb (5C6), although mAb NIMP-R10
      is more effective at enhancing infection. Therefore, both mAbs can be used to
      analyze host antibacterial defenses in vivo.

PMID- 1640171
TI  - Increased CD4/CD8 coexpressed cells in a healthy subject.

PMID- 1640172
TI  - Tissue-specific expression of murine IP-10 mRNA following systemic treatment with
      interferon gamma.
AB  - We have examined the tissue distribution of 10-kd inflammatory protein (IP-10)
      mRNA expression in C57Bl/6 mice injected intravenously (i.v.) with various
      inflammatory stimuli. IP-10 mRNA was strongly induced by interferon-gamma (IFN
      gamma) in liver and kidney but only poorly in skin, heart, and lung. IFN-gamma
      had nearly equivalent access to these tissues as indicated by the distribution of
      radiolabeled recombinant IFN-gamma 1 h after injection. The time course of IP-10
      mRNA appearance was rapid and transient in both liver and kidney; maximal
      expression in the liver (2 h) preceded that in the kidney (3 h) and declined
      rapidly thereafter in both tissues. Expression of IP-10 mRNA in the liver and
      kidney was highly sensitive to IFN-gamma treatment; nearly maximal stimulation
      occurred with injection of 500 U of IFN-gamma per mouse. Comparable stimulation
      of IP-10 mRNA expression in splenic macrophages required 10,000 U of IFN-gamma
      administered i.v., indicating that liver and kidney responses are 10- to 20-fold
      more sensitive. IP-10 mRNA expression in both tissues was not restricted to
      stimulation by IFN-gamma but was also seen with injection of lipopolysaccharide
      (LPS) (25 micrograms/mouse) or IFN-beta (100,000 U/mouse). Two other members of
      the IP-10 gene family, KC (gro) and JE (MCP-1), were expressed at lower levels
      under similar treatment conditions. Analysis of IP-10 mRNA distribution in the
      liver and kidney by in situ hybridization indicated that expression in both
      tissues was most prominent in the reticuloendothelial cell system, particularly
      in the endothelial lining of the microvascular circulation. Although the function
      of the IP-10 gene product has not been defined, these results suggest that it may
      play an important role in the response of both the liver and kidney to systemic
      inflammation.

PMID- 1640173
TI  - Wheat germ agglutinin inhibits the C5a receptor interaction: implications for
      receptor microheterogeneity and ligand binding site.
AB  - Wheat germ agglutinin (WGA) has been shown to inhibit the interaction of C5a with
      the C5a receptor on both polymorphonuclear neutrophils (PMNs) and the histiocytic
      cell line U937. The level of inhibition with isolated receptor preparations is
      100%, and on intact cells 10 to 20% of the receptor population appear to retain
      their ability to bind C5a in the presence of WGA. In contrast, this lectin
      completely inhibits the C5a-mediated degranulation of PMN primary and secondary
      granules, suggesting that the population of C5a receptors responsible for
      mediating degranulation is also recognized by WGA. More than 50% of the receptors
      appear to be blocked before an effect on degranulation occurs. This inhibition by
      WGA does not appear to be due to down-regulation of C5a receptors from the cell
      surface, excessive aggregation of receptor sites, or interaction of WGA with the
      carbohydrate portion of the C5a molecule. The inhibition is reversed by N
      acetylglucosamine but not by sialic acid. This effect appears to be specific for
      WGA because various other lectins do not inhibit the C5a receptor interaction.
      That the inhibition by WGA is due to direct binding of the lectin to N
      acetylglucosamine residues on the C5a receptor is strongly supported by the
      ability of the cross-linked C5a-receptor complex to bind to and be specifically
      eluted from a WGA-Affigel affinity matrix. These observations are consistent with
      hypothesis that the population of C5a receptors on leukocytes exhibits
      microheterogeneity with respect to structure (carbohydrate content) and/or
      function.

PMID- 1640174
TI  - Interleukin-8 induces changes in human neutrophil actin conformation and
      distribution: relationship to inhibition of adhesion to cytokine-activated
      endothelium.
AB  - Interleukin-8 (IL-8) induces diverse biological responses in neutrophils,
      including inhibition of adhesion to cytokine-activated endothelium, which we have
      termed the leukocyte adhesion inhibition (LAI) effect. Pretreatment of
      neutrophils with cytochalasin B abolished the LAI effect of IL-8, suggesting a
      microfilament-dependent mechanism. Interleukin-8 induced a rapid increase (less
      than or equal to 15 s) in the polymerization of actin filaments in human
      neutrophils that was blocked by pretreatment with cytochalasin B. F-actin
      depolymerization occurred gradually at a rate inversely proportional to IL-8
      concentration. This temporal pattern of actin polymerization-depolymerization was
      similar to that induced by other chemotactic factors such as C5a and N
      formylmethionyl-leucyl-phenylalanine, which also exhibit a marked LAI effect, but
      the lipid mediators, leukotriene B4 and platelet-activating factor, lack any
      significant LAI effect. Scanning confocal microscopy demonstrated that neutrophil
      actin microfilaments undergo a dramatic rearrangement prior to detachment of the
      neutrophil from a surface. We suggest that the ability of IL-8 and certain other
      leukocyte agonists to regulate the actin polymer network of neutrophils may play
      an important role in adhesive interactions with the vascular endothelium.

PMID- 1640176
TI  - Interactions between HIV-infected monocytes and the extracellular matrix:
      increased capacity of HIV-infected monocytes to adhere to and spread on
      extracellular matrix associated with changes in extent of virus replication and
      cytopathic effects in infected cells.
AB  - Monocytes express cell surface receptors for extracellular matrix (ECM) proteins
      of basement membranes. These receptors are engaged during extravasation of cells
      through capillary endothelium into tissue. The number of human immunodeficiency
      virus (HIV)-infected monocytes that adhered to ECM over 2 h was threefold higher
      than that of uninfected control cells. This difference was ECM specific and was
      not observed with a bovine serum albumin substrate. Enhanced adhesion to ECM was
      evident in monocytes by 4 days after HIV infection and increased through 10 days.
      Monocytes exposed to a T cell-tropic HIV strain that binds to but does not
      replicate in monocytes showed no changes in adherence to ECM. Thus, productive
      infection of monocytes by HIV induces a significant increase in the capacity of
      these cells to interact with ECM. Enhanced adhesion of HIV-infected monocytes to
      ECM was associated with increased spreading: at 12 h, sixfold more HIV-infected
      monocytes were spread on ECM than were uninfected control cells. Cell processes
      of HIV-infected monocytes formed a complex network on ECM: many of these cells
      expressed HIV proteins as detected by indirect immunofluorescence. HIV-associated
      cytopathic effects and levels of virion-associated reverse transcriptase activity
      depended on the substrate to which monocytes were attached. Virus replication and
      cytopathic effects in monocytes adhered to ECM, fibronectin, or plastic alone
      were comparable. In contrast, HIV-infected monocytes attached to laminin showed a
      significant increase in virus replication and in extent of cytopathic effects
      through 2 weeks after infection. The lowest levels of HIV replication and
      cytopathic effects were in monocytes attached to collagen IV. Interactions
      between monocytes and ECM profoundly affect the manner in which these cells
      control HIV infection: HIV infection changes the capacity of infected monocytes
      to attach and spread on ECM; attachment to ECM alters the extent of virus
      replication in infected cells.

PMID- 1640175
TI  - Development, differentiation, and proliferation of epidermal Langerhans cells in
      rat ontogeny studied by a novel monoclonal antibody against epidermal Langerhans
      cells, RED-1.
AB  - An antirat monoclonal antibody (mAb) against nonlymphoid dendritic cells, RED-1,
      was produced using epidermal Langerhans cells (LCs) as the immunogen. This mAb
      reacted mainly with the LCs and indeterminate dendritic cells (ICs),
      interdigitating cells in the T cell areas of lymphoid tissues, and
      monocyte/macrophages in various organs and tissues of adult rats. In the
      epidermal sheets prepared from adult rats, it specifically recognized the cell
      surface antigen(s) present on LCs and ICs. In the fetal rat skin, primitive or
      fetal macrophages migrated into the epidermis and expressed RED-1 at fetal day
      17. With advance of gestation, RED-1-positive cells increased, started expressing
      Ia antigens at fetal day 18, and subsequently differentiated into dendritic
      cells. Most of them showed Ia expression by fetal day 20 and differentiated into
      LCs within a few days after birth. The labeling index of 5-bromo-2'-deoxyuridine
      in RED-1-positive cells was 18% at fetal day 17 and decreased to 5 to 6% in the
      postnatal period. These results imply that proliferative capacity of RED-1
      positive cells is important for the formation and expansion of the IC population
      in the fetal stage and for the survival of LCs in the postnatal period.

PMID- 1640177
TI  - Listericidal and nonlistericidal mouse macrophages differ in complement receptor
      type 3-mediated phagocytosis of L. monocytogenes and in preventing escape of the
      bacteria into the cytoplasm.
AB  - Listeria monocytogenes is a facultative intracellular bacterium that escapes
      phagocytic vesicles and replicates in the cytoplasm, where it becomes coated with
      F-actin. Macrophages, important anti-Listeria effector cells, are heterogeneous
      in their ability to kill Listeria. Complement receptor type 3 (CR3) mediates most
      phagocytosis of Listeria by listericidal macrophages. Experiments described here
      tested whether nonlistericidal macrophages also phagocytosed Listeria through CR3
      and whether the ability of Listeria to escape into the cytoplasm correlated with
      lack of listericidal activity. We show here that CR3 mediated an average of 66%
      of the phagocytosis of serum-opsonized Listeria by listericidal peptone-elicited
      macrophages but only 35% by nonlistericidal thioglycolate-elicited macrophages.
      In thioglycolate-elicited macrophages, most Listeria were cytoplasmic and actin
      coated, whereas in peptone-elicited macrophages most were retained in the
      phagosome. These results indicate that listericidal and nonlistericidal
      macrophages phagocytose Listeria through different receptors and that
      nonlistericidal macrophages allow Listeria to escape into the cytoplasm.

PMID- 1640178
TI  - Asymptotic rates of growth of the extinction probability of a mutant gene.
AB  - We prove that a result of Haldane (1927) that relates the asymptotic behaviour of
      the extinction probability of a slightly supercritical Poisson branching process
      to the mean number of offspring is true for a general Bienayme-Galton-Watson
      branching process, provided that the second derivatives of the probability
      generating functions converge uniformly to a non-zero limit. We show also by
      examples that such a result is true more widely than our proof suggests and
      exhibit some counter-examples.

PMID- 1640179
TI  - The survival probability of a mutant in a multidimensional population.
AB  - We prove a general result about the asymptomatic behaviour of the survival
      probability of a slightly supercritical multitype Bienayme-Galton-Watson
      branching process. This is the complete analogue of a result which Ewens (1968)
      obtained for a Poisson branching process.

PMID- 1640180
TI  - Rates of decay for the survival probability of a mutant gene.
AB  - If qk is the extinction probability of a slightly supercritical branching process
      with offspring distribution [pkr:r = 0, 1, 2, ...], then it is shown that if supk
      sigma r r3pkr less than infinity, inf sigma 2k greater than 0, and mk----1, then
      1-qk approximately 2(mk - 1)sigma -2k, where mk = sigma r rpkr, sigma 2k = k
      sigma r r2pkr - m2k. This provides a simple set of sufficient conditions for the
      validity of a conjecture of Ewens (1969) for the survival probability of a
      slightly advantageous mutant gene.

PMID- 1640181
TI  - Survival probabilities for some multitype branching processes in genetics.
AB  - Consider a positively regular, slightly supercritical branching process with K
      types. An approximation to the probability of survival of a line descended from a
      single individual of type i has recently been derived by Hoppe. If K is large,
      however, this approximation may not be easy to compute. A further approximation
      that is easily computable is given. The result is used to estimate probabilities
      of survival of an allele A that is originally present in one male or one female
      in a large, random mating, age-structured population. Both autosomal and sex
      linked loci are considered. Another application of the approximation is also
      discussed.

PMID- 1640182
TI  - Mutation in autocatalytic reaction networks. An analysis based on perturbation
      theory.
AB  - A class of kinetic equations describing catalysed and template induced
      replication, and mutation is introduced. This ODE in its most general form is
      split into two vector fields, a replication and a mutation field. The mutation
      field is considered as a perturbation of the replicator equation. The
      perturbation expansion is a Taylor series in a mutation parameter lambda. First,
      second and higher order contributions are computed by means of the conventional
      Rayleigh-Schrodinger approach. Qualitative shift in the positions of rest points
      and limit cycles on the boundary of the physically meaningful part of
      concentration space are predicted from flow topologies. The results of the
      topological analysis are summarized in two theorems which turned out to be useful
      in applications: the rest point migration theorem (RPM) and the limit cycle
      migration theorem (LCM). Quantitative expressions for the shifts of rest points
      are computed directly from the perturbation expansion. The concept is applied to
      a collection of selected examples from biophysical chemistry and biology.

PMID- 1640183
TI  - How the anisotropy of the intracellular and extracellular conductivities
      influences stimulation of cardiac muscle.
AB  - The bidomain model, which describes the behavior of many electrically active
      tissues, is equivalent to a multi-dimensional cable model and can be represented
      by a network of resistors and capacitors. For a two-dimensional sheet of tissue,
      the intracellular and extracellular conductivity tensors can be visualized as two
      ellipses. For any pair of conductivity tensors, a coordinate transformation can
      be found that reduces the extracellular ellipse to a circle and aligns the
      intracellular ellipse with the coordinate axes. The eccentricity of the
      intracellular ellipse in this new coordinate system is an important parameter. It
      can have two special values: zero (in which case the tissue has equal anisotropy
      ratios) or one (in which case the tissue is comprised of one-dimensional fibers
      coupled through the two-dimensional extracellular space). Thus the bidomain model
      provides a unifying framework within which the electrical behavior of a wide
      variety of nerve and muscle tissues can be studied. When the anisotropy ratios in
      the intracellular and extracellular domains are not equal, stimulation with an
      anode always causes depolarization of some region of tissue. An analogous effect
      occurs in models that describe one-dimensional fibers, in which an "activating
      function" determines the site of stimulation. Experiments indicate that cardiac
      muscle does not have equal anisotropy ratios. Therefore, models developed to
      describe stimulation of axons may also help in understanding stimulation of two-
      or three-dimensional cardiac tissue, and may explain the concept of anodal
      stimulation of cardiac tissue through a "virtual cathode".

PMID- 1640184
TI  - A threshold result for an epidemiological model.
AB  - A threshold parameter R0 is identified for an SIRS epidemiological model which
      has nonlinear incidence and a distributed delay for transfer out of the removed
      class. For R0 less than 1, the disease free equilibrium is proved to be the
      global attractor for all solutions.

PMID- 1640185
TI  - Sodium-extruding and calcium-extruding sodium/calcium exchangers display similar
      calcium affinities.
AB  - Na+/Ca2+ exchange activities in purely inside-out and mixed inside-out and right
      side-out fish enterocyte basolateral plasma membrane vesicle preparations display
      equal affinities for Ca2+, showing that only the intracellular Ca2+ transport
      site of the Na+/Ca2+ exchanger is detected in experiments on vesicle preparations
      with mixed orientation. Therefore, Ca2+ pump and Na+/Ca2+ exchange activity may
      be compared directly without correction for vesicle orientation. The Na+/Ca2+
      exchange activity in fish enterocyte vesicles is compared to the activity found
      in dog erythrocyte vesicles. The calcium-extruding exchanger in fish basolateral
      plasma membranes shows values of Km and V(max) for calcium similar to those found
      for the sodium-extruding exchanger in dog erythrocyte membranes, indicating that
      differences in electrochemical gradients underlie the difference in cellular
      function of the two exchangers.

PMID- 1640186
TI  - Scaling of muscle fibres and locomotion.
AB  - To reconcile the scaling of the mechanics and energetics of locomotion to recent
      data on the scaling of the mechanics of muscle fibres, I have extended the theory
      of Taylor and colleagues that the energetic cost of locomotion is determined by
      the cost of generating force by the fibres. By assuming (1) that the cost of
      generating force in a fibre is proportional to V(max) (maximum velocity of
      shortening) and (2) that, at physiologically equivalent speeds, animals of
      different body sizes recruit the same fibre types, this extension quantitatively
      predicts the scaling of the energetics of locomotion, as well as other
      observations, from the scaling of V(max) of the muscle fibres. First, the
      energetic cost of locomotion at physiologically equivalent speeds scales with Mb
      0.16, where Mb is body mass, as does V(max) of a given fibre type. However, the
      energetic cost at absolute speeds (cost of transport) scales with Mb-0.30,
      because small animals must compress their recruitment order into a narrower speed
      range and, hence, recruit faster muscle fibre types at a given running speed.
      Thus, it costs more for small animals to move 1 kg of their body mass 1 km not
      only because a given muscle fibre type from a small animal costs more to generate
      force than from a large one, but also because small animals recruit faster fibre
      types at a given absolute running speed. In addition, this analysis provides
      evidence that V(max) scales similarly to 1/tc (where tc is foot contact time) and
      muscle shortening velocity (V), in agreement with recent models. Finally, this
      extension predicts that, at physiologically equivalent speeds, the weight
      specific energetic cost per step is independent of body size, as has been found
      empirically.

PMID- 1640187
TI  - Biochemical comparison of fast- and slow-contracting squid muscle.
AB  - The myofilament protein compositions of muscle fibres from the transverse muscle
      mass of the tentacles and the transverse muscle mass of the arms of the loliginid
      squid Sepioteuthis lessoniana were compared. These two muscle masses are distinct
      types, differing in their ultrastructural and behavioural properties. The
      transverse muscle of the tentacles consists of specialized muscle fibres that
      exhibit cross-striation and unusually short sarcomeres and thick filaments. The
      transverse muscle of the arms consists of obliquely striated muscle fibres that
      are typical of cephalopod skeletal muscle in general. The specialization of the
      tentacle muscle results in a high shortening speed and reflects its role in
      creating rapid elongation of the tentacles during prey capture. Comparison of
      samples of myofilament preparations of the two muscle fibre types using sodium
      dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and peptide
      mapping of myosin heavy chains from the two muscle fibre types, however, showed
      little evidence of differences in contractile protein isoforms. Thus,
      specialization for high shortening speed appears to have occurred primarily
      through changes in the dimensions and arrangement of the myofilament lattice,
      rather than through changes in biochemistry. The thick filament core protein
      paramyosin was tentatively identified in the squid muscle fibres. This protein
      was less abundant in the short thick filament cross-striated tentacle muscle
      cells than in the obliquely striated arm cells.

PMID- 1640188
TI  - Prophylaxis: the next haemophilia treatment.

PMID- 1640189
TI  - A Swedish view on the diagnosis of renovascular hypertension.

PMID- 1640190
TI  - Twenty-five years' experience of prophylactic treatment in severe haemophilia A
      and B.
AB  - In Sweden, prophylactic treatment of boys with severe haemophilia has been
      practised since 1958 in an attempt to convert the disease from a severe to a
      milder form. The present study population consisted of 60 severe haemophiliacs
      (52 A, 8 B), aged 3-32 years. Treatment is started when the boys are 1-2 years of
      age, the regimens used being 24-40 IU F VIII kg-1 three times weekly in
      haemophilia-A cases (i.e. greater than 2000 IU kg-1 annually) and 25-40 IU F IX
      kg-1 twice weekly in haemophilia-B cases. The orthopaedic and radiological joint
      scores (maximum scores of 90 and 78, respectively) are evaluated as recommended
      by the World Federation of Haemophilia. Of those subjects aged 3-17 years, 29 out
      of 35 individuals had joint scores of zero. The oldest group had only minor joint
      defects. The VIII:C and IX:C concentrations had usually not fallen below 1% of
      normal. All 60 patients are able to lead normal lives. In conclusion, it appears
      to be possible to prevent haemophilic arthropathy by giving effective continuous
      prophylaxis from an early age, and preventing the VIII:C or IX:C concentration
      from falling below 1% of normal.

PMID- 1640191
TI  - Close correlation between high-density lipoprotein and triglycerides in
      normotriglyceridaemia.
AB  - The relationship between high-density-lipoprotein (HDL) particle size subclasses
      and the levels of the major lipoprotein lipids was studied in 74 men
      consecutively referred to the lipid clinic. HDL (density 1.070-1.21 kg l-1) was
      separated by polyacrylamide gradient gel electrophoresis (GGE) into five size
      defined subclasses, in order of decreasing size as follows: HDL2b, HDL2a, HDL3a,
      HDL3b and HDL3c. Cholesterol and triglyceride concentrations in very-low-density
      (VLDL), low-density (LDL) and high-density (HDL) lipoproteins were determined.
      The level of VLDL triglycerides was negatively correlated with HDL2b (r = -0.66,
      P less than 0.0001), and positively correlated with HDL3b concentrations (r =
      0.65, P less than 0.0001). Both correlations were restricted to subjects with
      VLDL triglyceride concentrations of less than 1.80 mmol l-1, i.e. those with
      normotriglyceridaemia. Patients with a history of myocardial infarction and/or
      angina pectoris (n = 18) had significantly lower HDL2b levels than subjects with
      asymptomatic hyperlipidaemia (n = 50), i.e. 0.16 vs. 0.22 mg protein ml-1 (P less
      than 0.05), despite essentially similar cholesterol and triglyceride levels in
      the VLDL, LDL and HDL fractions, including HDL2 and HDL3 cholesterol.

PMID- 1640192
TI  - Improved working capacity in patients with ischaemic heart disease during a 10
      day treatment with oral theophylline.
AB  - The objective of this study was to assess whether a 10-d treatment with oral
      theophylline improves the working capacity in patients with ischaemic heart
      disease, and to compare theophylline with conventional anti-anginal therapy.
      Twenty-four patients with stable effort-induced angina were included in the
      study. The patients received double-blind treatment in randomized order during 4
      consecutive 10-d periods, separated by a 4-d wash-out period, with (a) metoprolol
      durules 200 mg once daily + theophylline durules 300 mg b.i.d., (b) theophylline
      + placebo, (c) metoprolol + placebo, and (d) placebo alone. At the end of each
      period a supine exercise stress test was performed. Maximal workload increased to
      111 +/- 6 W during treatment with theophylline, compared to 106 +/- 6 W during
      placebo treatment (P = 0.01). Metoprolol increased the maximal workload to 117 +/
      6 W (P less than 0.001). The effects of metoprolol and theophylline were
      additive, and the working capacity increased to 123 +/- 7 W during combined
      therapy. Neither the degree of ST-depression nor the scoring of chest pain at
      maximal workload differed between the four treatment regimens. An improved
      working capacity was shown in patients with stable effort-induced angina pectoris
      during long-term theophylline treatment. The effect was additive to that of beta
      blockade.

PMID- 1640193
TI  - Low plasma levels of insulin-like growth factor 1 (IGF-1) in male patients with
      idiopathic osteoporosis.
AB  - Experimental studies in vitro indicate that insulin-like growth factor 1 (IGF-1)
      could be of importance for normal bone growth and remodelling, but the clinical
      relevance of these observations is unknown. In 12 consecutive young to middle
      aged male patients (mean age (+/- SD) 46 +/- 8 years, range 30-57 years) with
      symptomatic idiopathic osteoporosis, the plasma concentrations of IGF-1 were
      significantly lower than in healthy subjects (0.51 +/- 0.25 vs. 0.73 +/- 0.23 U
      ml-1; P less than 0.01). The bone mineral densities in the spine, the femoral
      neck, and the forearm were significantly different between patients and control
      subjects. There were positive correlations between the plasma IGF-1
      concentrations and the bone densities of the spine and the forearm. Three of the
      patients received a 5-d course of human recombinant growth hormone (GH). During
      this short period significant increases in plasma IGF-1 levels and in biochemical
      indices of bone turnover (serum bone-specific alkaline phosphatase, urinary
      calcium excretion) were recorded. These observations indicate that circulating
      IGF-1 could have an important role in maintaining bone mass, and suggest that
      impairment of IGF-1 production is involved in the pathogenesis of osteoporosis.

PMID- 1640195
TI  - Function of terminal ileum in patients with Yersinia-triggered reactive
      arthritis.
AB  - In order to study the function of the intestinal epithelium in the terminal
      ileum, the Schilling test was performed in 10 patients with Yersinia-triggered
      reactive arthritis, in 10 patients who had recovered from Yersinia enteritis
      without complications, and in five patients with rheumatoid arthritis treated
      with non-steroidal anti-inflammatory agents. The Schilling test indicates
      absorption of vitamin B12 in the terminal ileum, i.e. the area affected by
      Yersinia and inflamed in patients with reactive arthritis. The findings obtained
      demonstrate increased uptake through the epithelium in this area of the intestine
      in patients with Yersinia-triggered reactive arthritis. There are two possible
      explanations. First, Yersinia infection may have a long-term effect on the gut
      mucosa. Secondly, some individuals may, at the level of the terminal ileum, show
      enhanced absorption of vitamin B12 and/or other substances such as microbes or
      their components, resulting in increased susceptibility to certain infections.

PMID- 1640194
TI  - Autonomic nervous function and its relationship to cardiac performance in middle
      aged diabetic patients without clinically evident cardiovascular disease.
AB  - Autonomic nervous function was evaluated in 36 patients with insulin-dependent
      diabetes mellitus (IDDM), 39 patients with non-insulin-dependent diabetes
      mellitus (NIDDM) and 48 control subjects, all without clinically evident
      cardiovascular disease. Valsalva ratio and heart rate variation during deep
      breathing were lower in both diabetic groups than in the control group. Autonomic
      nervous function score (ANFS) was more abnormal in patients with IDDM than in
      control subjects, but was not significantly increased in patients with NIDDM.
      There was a negative correlation between ANFS and left ventricular diastolic
      filling evaluated by echocardiography or peak heart rate during exercise in both
      diabetic groups. There were no correlations between ANFS and left ventricular
      systolic function at rest or during exercise in any of the groups. In conclusion,
      autonomic nervous function was abnormal in middle-aged diabetic patients, and it
      was associated with impaired left ventricular diastolic filling at rest and
      decreased heart rate response to exercise, but not with left ventricular systolic
      function.

PMID- 1640196
TI  - Bilateral emphysematous pyelonephritis resolving to medical therapy.
AB  - We describe a case of bilateral emphysematous pyelonephritis, in a diabetic
      female, that responded to medical therapy alone. Her complete improvement is
      documented radiologically. Emphysematous pyelonephritis, as a cause of serious
      infection in diabetic patients, is briefly reviewed.

PMID- 1640197
TI  - Inhibition of Ca2+ uptake in freshwater carp, Cyprinus carpio, during short-term
      exposure to aluminum.
AB  - In carp exposed to pH 5.2 in fresh water, the Ca2+ influx from the water is
      reduced by 31% when compared to fish in water of neutral pH. At pH 5.2, the Ca2+
      influx but not Na+ uptake is decreased by aluminum (Al). Al reduces Ca2+ influx
      dose-dependently: a maximum 55% reduction was observed after 1-2 h exposure to
      200 micrograms.1(-1) (7.4 microM) Al. Branchial Ca2+ efflux is less sensitive to
      Al and affected only by exposure for more than 1 h to high Al concentrations. Na+
      influx is not affected by concentrations Al up to 400 micrograms.1(-1). Na+
      efflux, similarly to Ca2+ efflux, increased when fish were exposed for more than
      1 h to 400 micrograms.1(-1) Al.

PMID- 1640198
TI  - Calcitonin-like immunoreactivity in the blue crab: tissue distribution,
      variations in the molt cycle, and partial characterization.
AB  - Calcitonin-like immunoreactivity has been found in blood and tissues of the
      marine blue crab, Callinectes sapidus Rathbun. The activity in blood rises
      significantly during the immediate premolt (D4) stage, but tissue
      immunoreactivity does not vary significantly with molt stage. The
      immunoreactivity to antisalmon calcitonin serum is due to a 27.2 kDa protein that
      shows strong similarities in amino acid composition to a similar protein in a
      lobster and to human calcitonin precursor. The protein is most abundant in the
      midgut glands (hepatopancreas), but is also found in significant quantities in
      several other tissues. Immunoreactivity in the blood appears to be primarily due
      to the same molecular weight fraction, with secondary contributions from smaller
      molecules, closer in size to vertebrate calcitonin. A physiological function of
      the calcitonin-like substance in calcium transport during or after molt has yet
      to be demonstrated.

PMID- 1640199
TI  - Effects of human insulin-like growth factor-I on release of growth hormone by
      rainbow trout (Oncorhynchus mykiss) pituitary cells.
AB  - A recombinant human IGF-I (rhIGF-I) was applied to primary cultures of rainbow
      trout pituitary cells. In wells containing 3 x 10(4) and 6 x 10(4) cells/well,
      rhIGF-I inhibited basal GH release both in short (6 h) and long (12 and 24 h)
      exposures. The decline in GH release was dose-dependent over the range of 0.01
      and 100 mM. The combination of rhIGF-I and low concentrations of synthetic
      somatostatin (SRIF) enhanced the inhibitory effect of rhIGF-I in an additive
      manner. Any appreciable effect of rhIGF-I on PRL release was not evidenced. To
      our knowledge, this report demonstrates for the first time the participation of
      IGFs on the inhibitory component of fish GH regulation.

PMID- 1640200
TI  - Development of the chick chorioallantoic capillary plexus under normoxic and
      normobaric hypoxic and hyperoxic conditions: a morphometric study.
AB  - Fertile eggs from the domestic fowl were incubated under normobaric normoxic (21%
      O2), hypoxic (14% O2), and hyperoxic (40% O2) conditions in order to examine the
      influence of the prevailing oxygen level on the growth and maturation of the
      chorioallantoic membrane. Eggs were sampled at regular stages throughout
      incubation for morphometric analysis. Under normoxic conditions, maturation of
      the capillary plexus occurred in two distinct stages, both of which contributed
      to a reduction in the thickness of the air-blood barrier. Between days 6 and 10,
      the capillaries sprouted and fused to form a dense plexus. Subsequently, between
      days 10 and 14, this plexus invaginated into the chorionic epithelium.
      Differentiation of the chorioallantoic membrane appeared maximal by the end of
      this period. Hypoxia resulted in diminished growth of the embryo and
      chorioallantoic membrane, but in accelerated maturation of the capillary plexus.
      Hyperoxia had a less marked effect but appeared to retard the final invagination
      of the plexus, resulting in a thicker air-blood barrier.

PMID- 1640201
TI  - Length regulation in the Dictyostelium discoideum slug is a late event.
AB  - Time-lapse video light microscopy was used to study the emergence and maturation
      of the migratory slug from a D. discoideum aggregate. The anterior part, the tip
      of this simple multicellular organism, establishes migration prior to the
      definition of the rear, and hence the length of the slug. It was found that newly
      formed slugs of wild-type strain WS380B can reach lengths greater than 1 cm, yet
      mature slugs of this strain are rarely longer than 2-3 mumm. Often the tip
      extended out of the aggregation mound upon an arching pillar of cells. After the
      tip first touched the substratum, it commenced migration with a rapid succession
      of movement steps. Here we show that at the initiation of migration, a
      differential rate of cell movement along the developing slug axis results in a
      series of complicated changes, before the stable and mature shape of the slug is
      formed. Our results lead to new conclusions about D. discoideum slug formation
      and shape maintenance. Evidence is presented for regulation of slug length.

PMID- 1640202
TI  - Activation of Xenopus laevis eggs in the absence of intracellular Ca activity by
      the protein phosphorylation inhibitor, 6-dimethylaminopurine (6-DMAP).
AB  - Xenopus laevis eggs pricked or microinjected with water or saline in medium
      containing a limited quantity of free Ca (1.0 to 2.0 microM) remain unactivated
      for at least 6 hr, even after transfer to oocyte medium containing Ca at higher
      concentrations (0.5-1.0 mM). These injected eggs, when later pricked in oocyte
      medium or exposed to A23187 or urethane are fully capable of activation. This
      confirms the observations of Wangh ('89). However, eggs injected in this Ca
      limited medium (CaLM) with 6-DMAP as well as those simply exposed to this drug
      undergo changes characteristic of activation, including cortical contraction,
      cortical granule breakdown, a loss of MPF and CSF activities, and pronuclear
      formation. The time required for 6-DMAP to induce egg activation is inversely
      correlated to its concentration. Interestingly, eggs that have been injected with
      EGTA, and thus are unable to respond to activation stimuli such as pricking and
      A23187 or urethane treatment, can also be activated by exposure to 6-DMAP. In
      contrast, eggs exposed to or injected with a 6-DMAP analogue (6-aminopurine or
      puromycin) or a protein synthesis inhibitor (cycloheximide or emetine or
      puromycin) are not activated. As well, eggs injected in CaLM with 6-DMAP
      simultaneously with a phosphatase inhibitor (NaF or ammonium molybdate) fail to
      become activated. Although 6-DMAP-activated eggs remain at the pronucleus stage
      so long as 6-DMAP is present, they resume cell cycle activities after the drug is
      withdrawn. They form cleavage furrows, disassemble pronuclear envelopes, and
      recondense chromosomes. Also, MPF activity reappears and cycles at least twice,
      peaking each time shortly before cleavage furrow formation. These results suggest
      that activation of Xenopus eggs arrested at metaphase II by inhibition of protein
      phosphorylation does not require intracellular Ca release and that maintenance of
      the egg at metaphase II depends upon continuous protein phosphorylation.

PMID- 1640203
TI  - Effect of slow and ultra-rapid freezing on cell surface antigens of 8-cell mouse
      embryos.
AB  - The distribution of four cell surface antigens (SSEA-1, SSEA-3, SSEA-4, and I)
      present on mouse preimplantation embryos was examined on 8-cell stage embryos
      immediately after flushing from the reproductive tract and after slow or ultra
      rapid freezing. Frozen-thawed and nonfrozen embryos were also examined after
      culture in vitro for 5, 24, or 48 h. Immediately after thawing, embryos showed a
      disruption in the polarity of cell surface antigens SSEA-3, SSEA-4, and I, but no
      differences were detected in fluorescence intensity or various other staining
      characteristics. No long-term changes in the distribution of cell surface
      components were detected. Implantation and embryonic development were similar for
      frozen and nonfrozen embryos transferred to the uterine horns of pseudopregnant
      recipients.

PMID- 1640204
TI  - Winners of the 1992 Teaching Awards.

PMID- 1640205
TI  - Vile thoughts on the new coding system.

PMID- 1640206
TI  - Nolo nocere.

PMID- 1640207
TI  - Neuropsychiatric effects of drugs in the elderly.
AB  - Since the elderly consume large numbers of drugs, drug-induced disease must be
      high on the list as a suspected cause of changes in behavior. Neuropsychiatric
      side effects of drugs in the elderly are not rare events. While proceeding to
      investigate medical, neurological, and psychiatric causes of a change in the
      cognitive status or behavior in an elderly patient, it is important to consider a
      possible psychotoxic drug as an offender or co-offender. Failing to do so may
      lead to inappropriate testing and further unnecessary and possibly deleterious
      therapeutic measures. In the case of dementia, the worst treatment would be
      institutionalization before identifying a drug as the cause of the cognitive
      dysfunction.

PMID- 1640208
TI  - Obesity. A big problem. Introduction.

PMID- 1640209
TI  - Role of dietary fat in obesity. Fat is fattening.
AB  - Total caloric intake has not increased significantly over the last century as
      obesity increased, but there has been an increase in consumption of dietary fat.
      Its role in obesity is reviewed. Fat is the most concentrated form of calories in
      the diet; being compact, it contributes to overeating. High fat foods can be
      eaten faster with less chewing. Dietary fat is the most efficiently stored
      foodstuff, thus contributing to obesity. A low fat diet is an important adjunct
      to advising decreasing caloric intake for a weight reduction plan. Physicians
      should advise patients to decrease fat, not just "count calories."

PMID- 1640210
TI  - Physician's and dietitian's role in obese care.
AB  - In the Surgeon General's Report on Nutrition and Health, of the ten leading
      causes of death in the United States, five are nutrition related. Instead of
      nutritional deficiencies as seen in the 1940s, the national diet has shifted to
      dietary excesses and imbalances. Dietary excesses and imbalances are reflected in
      obesity, a major health problem affecting approximately 30% of the United States'
      population. Unfortunately, the diet industry is not regulated and, hence,
      patients have many avenues from which to choose. Many of these leave patients
      lost and confused as to why they have failed in maintaining their weight loss. It
      is well documented that the recidivism rate in the obese is high with only 5%
      maintaining their weight loss after one year. The following is a review of the
      physician's and dietitian's roles in long-term weight maintenance.

PMID- 1640211
TI  - Community resources in obese care.
AB  - Community resources can augment care provided by physicians and dietitians for
      the obese. The well-distributed community resources in Florida are reviewed. They
      are well-established and provide emotional support, peer group dynamics, a
      variety of formats and prices, and information about food and life-style changes.

PMID- 1640212
TI  - Group office visits in obesity.
AB  - A conference convened by the NIH in 1985 officially designated obesity a health
      hazard, stopping short of calling it a disease; yet its characteristic
      progressive, debilitating and refractory nature is impressively disease-like.
      Long-term weight loss occurs in only 5% of patients. Group office visits led by
      physicians have been used in a number of life-style conditions. In diabetes this
      format enhances blood sugar control and in obesity it improves five-year weight
      loss success to 20%. In patients with coronary artery disease risk factor a 21%
      decrease in angina, 55% improvement of exercise tolerance, and 21% decrease in
      cholesterol occurred in a pilot study. Group office physician-led visits offer
      encouraging results for the mitigation of life-style conditions.

PMID- 1640213
TI  - Surgical approach to the obese patient.
AB  - Morbid obesity is a life-threatening disorder associated with medical and
      psychological complications. The failure of medical therapy has led to the
      development of a new surgical discipline called bariatric surgery, which has
      evolved over the past three decades. Initial techniques created malabsorption to
      produce weight loss. Due to complications, later techniques limited oral intake
      to produce weight loss. Currently, most bariatric surgeons perform either gastric
      bypass or gastric partition (vertical banded gastroplasty or vertical ring
      gastroplasty). However, other techniques are also being evaluated, including a
      modified intestinal bypass, gastric banding, and a new gastric balloon. Only with
      continued follow-up will we determine the ultimate risk/benefit ratio of these
      procedures and their place in the management of the morbidly obese. In the
      setting of an experienced multidisciplinary team committed to long-term follow
      up, surgical therapy can be considered.

PMID- 1640214
TI  - Exercise in the treatment of obesity.
AB  - Medical literature reveals that neither diet nor exercise are effective as single
      modes of intervention in the treatment of obesity. While it is logical that they
      be combined in the context of multidisciplinary treatment, restrictions in
      calorie or protein intakes while dieting may impair short-term or long-term
      function. While properly constituted diets can effectively preserve physical
      function across major weight loss, long-term preservation of this weight loss is
      strongly influenced by post-diet exercise habits. To develop these positive long
      term habits, patients need guidance on safe and effective exercise practices
      during dietary treatment of obesity, with the ultimate goal being life-long
      exercise behaviors that will contribute to sustained weight maintenance.

PMID- 1640215
TI  - Cytochrome P450. Mechanisms of action and clinical implications.
AB  - The term cytochrome P450 refers to a group of hemoproteins whose Fe(2+)-carbon
      monoxide complex shows an absorption spectrum with a maximum near 450 nm. There
      is a broad interest in the P450s because of their significance in a variety of
      disciplines ranging from medical genetics to inorganic chemistry. Cytochrome P450
      enzymes are involved in the metabolism of drugs, carcinogens, steroids,
      pesticides, hydrocarbons and natural products. The toxicity of many of these
      products may be modulated, either via replacement or by the various oxidations
      catalyzed by the cytochrome P450 enzymes. In recent years the roles of cytochrome
      P450 enzymes in the metabolism of endogenous compounds have been partially
      elucidated. Physiological compounds such as steroids, fatty acids, prostanoids
      and other eicosanoids, fat-soluble vitamins and mammalian alkaloids have been
      shown to be substrates. Aside from their roles in metabolism, certain of these
      enzymes were found to be involved in the metabolic activation of a variety of
      chemical carcinogens and possibly in the overall process of chemical
      carcinogenesis. Studies show that alterations in cytochrome P450 activities
      toward various substrates have been implicated in diseases which affect human
      health. The roles are reviewed of the various cytochrome P450 enzymes in the
      metabolism of substrates which may be associated with clinical disease states.

PMID- 1640216
TI  - Risk management for individual practices.

PMID- 1640217
TI  - Concurrent care.

PMID- 1640218
TI  - Health care for the whole person.

PMID- 1640219
TI  - Contribution from all.

PMID- 1640220
TI  - Effects of conditioning depolarization and repetitive stimulation on Q beta and Q
      gamma charge components in frog cut twitch fibers.
AB  - Charge movement was measured in frog cut twitch fibers with the double Vaseline
      gap technique. Steady-state inactivation of charge movement was studied by
      changing the holding potential from -90 mV to a level ranging from -70 to -30 mV.
      Q beta and Q gamma at each holding potential were separated by fitting the Q-V
      plot with a sum of two Boltzmann distribution functions. At -70 mV Q beta and Q
      gamma were inactivated to 54.0% (SEM 2.2) and 82.7% (SEM 3.0) of the amounts at 
      90 mV. At holding potentials greater than or equal to -60 mV, more Q gamma was
      inactivated than Q beta, and at -30 mV Q gamma was completely inactivated but Q
      beta was not. There was no holding potential at which Q beta was unaffected and Q
      gamma was completely inactivated. The differences between the residual fractions
      of Q beta and Q gamma are significant at all holding potentials (P less than
      0.001-0.05). The plot of the residual fraction of Q beta or Q gamma versus
      holding potential can be fitted well by an inverted sigmoidal curve that is a
      mirror image of the activation curve of the respective charge component. The pair
      of curves for Q gamma correlates well with those for tension generation or Ca
      release obtained by other investigators. The time courses of the inactivation of
      Q beta and Q gamma were studied by obtaining several Q-V plots with conditioning
      depolarizations lasting 1-20 s and separating each Q-V plot into Q beta and Q
      gamma components by fitting with a sum of two Boltzmann distribution functions.
      The inactivation time constant of Q beta was found to be 5-10 times as large as
      that of Q gamma. During repetitive stimulation, prominent I gamma humps could be
      observed in TEST-minus-CONTROL current traces and normal Q gamma components could
      be separated from the Q-V plots, whether 20 or 50 mM EGTA was present in the
      internal solution, whether 2 or 10 stimulations were used, and whether the
      stimuli were separated by 400 ms or 6 s. Repetitive stimulation slowed the
      kinetics of the I gamma hump and could shift the Q-V curve slightly in the
      depolarizing direction in some cases, resulting in an apparent suppression of
      charge at the potentials that fall on the steep part of the Q-V curve.

PMID- 1640221
TI  - Contribution of sarcolemmal sodium-calcium exchange and intracellular calcium
      release to force development in isolated canine ventricular muscle.
AB  - The aim of this work was to determine the relationship between peak twitch
      amplitude and sarcoplasmic reticulum (SR) Ca2+ content during changes of
      stimulation frequency in isolated canine ventricle, and to estimate the extent to
      which these changes were dependent upon sarcolemmal Na(+)-Ca2+ exchange. In
      physiological [Na+]o, increased stimulation frequency in the 0.2-2-Hz range
      resulted in a positive inotropic effect characterized by an increase in peak
      twitch amplitude and a decrease in the duration of contraction, measured as
      changes in isometric force development or unloaded cell shortening in intact
      muscle and isolated single cells, respectively. Action potentials recorded from
      single cells indicated that the inotropic effect was associated with a
      progressive decrease of action potential duration and a marked reduction in
      average time spent by the cell near the resting potential during the stimulus
      train. The frequency-dependent increase of peak twitch force was correlated with
      an increase of Ca2+ uptake into and release from the SR. This was estimated
      indirectly using the phasic contractile response to rapid (less than 1 s)
      lowering of perfusate temperature from 37 degrees C to 0-2 degrees C and changes
      of twitch amplitude resulting from perturbations in the pattern of electrical
      stimulation. Lowering [Na+]o from 140 to 70 mM resulted in an increase of
      contractile strength, which was accompanied by a similar increase of apparent SR
      Ca2+ content, both of which could be abolished by exposure to ryanodine (1 x 10(
      8) M), caffeine (3 x 10(-3) M), or nifedipine (2 x 10(-6) M). Increased
      stimulation frequency in 70 mM [Na+]o resulted in a negative contractile
      staircase, characterized by a graded decrease of peak isometric force development
      or unloaded cell shortening. SR Ca2+ content estimated under identical conditions
      remained unaltered. Rate constants derived from mechanical restitution studies
      implied that the depressant effect of increased stimulation frequency in 70 mM
      [Na+]o was not a consequence of a decreased rate of refilling of a releasable
      pool of Ca2+ within the cell. These results demonstrate that frequency-dependent
      changes of contractile strength and intracellular Ca2+ loading in 140 mM [Na+]o
      require the presence of a functional sarcolemmal Na(+)-Ca2+ exchange process. The
      possibility that the negative staircase in 70 mM [Na+]o is related to inhibition
      of Ca(2+)-induced release of Ca2+ from the SR by various cellular mechanisms is
      discussed.

PMID- 1640222
TI  - On the mechanism of G protein beta gamma subunit activation of the muscarinic K+
      channel in guinea pig atrial cell membrane. Comparison with the ATP-sensitive K+
      channel.
AB  - The mechanism of G protein beta gamma subunit (G beta gamma)-induced activation
      of the muscarinic K+ channel (KACh) in the guinea pig atrial cell membrane was
      examined using the inside-out patch clamp technique. G beta gamma and GTP-gamma S
      bound alpha subunits (G alpha *'s) of pertussis toxin (PT)-sensitive G proteins
      were purified from bovine brain. Either in the presence or absence of Mg2+, G
      beta gamma activated the KACh channel in a concentration-dependent fashion. 10 nM
      G beta gamma almost fully activated the channel in 132 of 134 patches (98.5%).
      The G beta gamma-induced maximal channel activity was equivalent to or sometimes
      larger than the GTP-gamma S-induced one. Half-maximal activation occurred at
      approximately 6 nM G beta gamma. Detergent (CHAPS) and boiled G beta gamma
      preparation could not activate the KACh channel. G beta gamma suspended by Lubrol
      PX instead of CHAPS also activated the channel. Even when G beta gamma was
      pretreated in Mg(2+)-free EDTA internal solution containing GDP analogues (24-48
      h) to inactivate possibly contaminating G i alpha *'s, the G beta gamma activated
      the channel. Furthermore, G beta gamma preincubated with excessive GDP-bound G o
      alpha did not activate the channel. These results indicate that G beta gamma
      itself, but neither the detergent CHAPS nor contaminating G i alpha *, activates
      the KACh channel. Three different kinds of G i alpha * at 10 pM-10 nM could
      weakly activate the KACh channel. However, they were effective only in 40 of 124
      patches (32.2%) and their maximal channel activation was approximately 20% of
      that induced by GTP-gamma S or G beta gamma. Thus, G i alpha * activation of the
      KACh channel may not be significant. On the other hand, G i alpha *'s effectively
      activated the ATP-sensitive K+ channel (KATP) in the ventricular cell membrane
      when the KATP channel was maintained phosphorylated by the internal solution
      containing 100 microM Mg.ATP. G beta gamma inhibited adenosine or mACh receptor
      mediated, intracellular GTP-induced activation of the KATP channel. G i alpha *'s
      also activated the phosphorylated KATP channel in the atrial cell membrane, but
      did not affect the background KACh channel. G beta gamma subsequently applied to
      the same patch caused prominent KACh channel activation. The above results may
      indicate two distinct regulatory systems of cardiac K+ channels by PT-sensitive G
      proteins: G i alpha activation of the KATP channel and G beta gamma activation of
      the KACh channel.

PMID- 1640224
TI  - Brain mapping--a useful tool or a dangerous toy?

PMID- 1640223
TI  - Separation of Q beta and Q gamma charge components in frog cut twitch fibers with
      tetracaine. Critical comparison with other methods.
AB  - Charge movement was measured in frog cut twitch fibers with the double Vaseline
      gap technique. 25 microM tetracaine had very little effect on the maximum amounts
      of Q beta and Q gamma but slowed the kinetics of the I gamma humps in the ON
      segments of TEST-minus-CONTROL current traces, giving rise to biphasic transients
      in the difference traces. This concentration of tetracaine also shifted V gamma
      3.7 (SEM 0.7) mV in the depolarizing direction, resulting in a difference Q-V
      plot that was bell-shaped with a peak at approximately -50 mV. 0.5-1.0 mM
      tetracaine suppressed the total amount of charge. The suppressed component had a
      sigmoidal voltage distribution with V = -56.6 (SEM 1.1) mV, k = 2.5 (SEM 0.5) mV,
      and qmax/cm = 9.2 (SEM 1.5) nC/microF, suggesting that the tetracaine-sensitive
      charge had a steep voltage dependence, a characteristic of the Q gamma component.
      An intermediate concentration (0.1-0.5 mM) of tetracaine shifted V gamma and
      partially suppressed the tetracaine-sensitive charge, resulting in a difference Q
      V plot that rose to a peak and then decayed to a plateau level. Following a TEST
      pulse to greater than -60 mV, the slow inward current component during a post
      pulse to approximately -60 mV was also tetracaine sensitive. The voltage
      distribution of the charge separated by tetracaine (method 1) was compared with
      those separated by three other existing methods: (a) the charge associated with
      the hump component separated by a sum of two kinetic functions from the ON
      segment of a TEST-minus-CONTROL current trace (method 2), (b) the steeply voltage
      dependent component separated from a Q-V plot of the total charge by fitting with
      a sum of two Boltzmann distribution functions (method 3), and (c) the sigmoidal
      component separated from the Q-V plot of the final OFF charge obtained with a two
      pulse protocol (method 4). The steeply voltage-dependent components separated by
      all four methods are consistent with each other, and are therefore concluded to
      be equivalent to the same Q gamma component. The shortcomings of each separation
      method are critically discussed. Since each method has its own advantages and
      disadvantages, it is recommended that, as much as possible, Q gamma should be
      separated by more than one method to obtain more reliable results.

PMID- 1640225
TI  - Johannes Kepler 1571-1630.

PMID- 1640226
TI  - Enhanced physical therapy improves recovery of arm function after stroke. A
      randomised controlled trial.
AB  - Previous research on stroke rehabilitation has not established whether increase
      in physical therapy lead to better intrinsic recovery from hemiplegia. A detailed
      study was carried out of recovery of arm function after acute stroke, and
      compares orthodox physiotherapy with an enhanced therapy regime which increased
      the amount of treatment as well as using behavioural methods to encourage motor
      learning. In a single-blind randomised trial, 132 consecutive stroke patients
      were assigned to orthodox or enhanced therapy groups. At six months after stroke
      the enhanced therapy group showed a small but statistically significant advantage
      in recovery of strength, range and speed of movement. This effect seemed
      concentrated amongst those who had a milder initial impairment. More work is
      needed to discover the reasons for this improved recovery, and whether further
      development of this therapeutic approach might offer clinically significant gains
      for some patients.

PMID- 1640227
TI  - The Scottish Motor Neuron Disease Register: a prospective study of adult onset
      motor neuron disease in Scotland. Methodology, demography and clinical features
      of incident cases in 1989.
AB  - The Scottish Motor Neuron Disease Register (SMNDR) is a prospective,
      collaborative, population based study of motor neuron disease (MND) in Scotland.
      The register started in January 1989 with the aim of studying the clinical and
      epidemiological features of MND by prospectively identifying incident patients.
      It is based on a system of registration by recruitment from multiple sources,
      followed by the collection of complete clinical data and follow up, mainly
      through general practitioners. In this report the register's methodology and the
      demography and incidence data for the first year of study are presented. One
      hundred and fourteen newly diagnosed patients were identified in 1989 giving a
      crude incidence for Scotland of 2.24/100,000/year. Standardised incidence ratios
      showed a non-significant trend towards lower rates in north eastern regions and
      island areas.

PMID- 1640228
TI  - Suicide and multiple sclerosis: an epidemiological investigation.
AB  - In a nationwide investigation the risk of death by suicide for patients with
      multiple sclerosis (MS) was assessed using records kept at the Danish Multiple
      Sclerosis Registry (DMSR) and the Danish National Register of Cause of Death. The
      investigation covers all MS patients registered with DSMR with an onset of the
      disease within the period 1953-85, or for whom MS was diagnosed in the same
      period. Fifty three of the 5525 cases in the onset cohort group committed
      suicide. Using the figures from the population death statistics by adjustment to
      number of subjects, duration of observation, sex, age, and calendar year at the
      start of observation, the expected number of suicides was calculated to be nearly
      29. The cumulative lifetime risk of suicide from onset of MS, using an actuarial
      method of calculation, was 1.95%. The standard mortality ratio (SMR) of suicide
      in MS was 1.83. It was highest for males and for patients with onset of MS before
      the age of 30 years and those diagnosed before the age of 40. The SMR was highest
      within the first five years after diagnosis.

PMID- 1640229
TI  - Primary intracerebral haemorrhage in the Jyvaskyla region, central Finland, 1985
      89: incidence, case fatality rate, and functional outcome.
AB  - The age and sex specific incidence rates, the case fatality rates, and the
      functional outcome of patients with primary intracerebral haemorrhage occurring
      in a population of 116,000 during a period of four years four months are
      presented. A total of 158 patients were identified, the diagnosis was confirmed
      in 78% by CT, and in 22% by necropsy. The crude annual incidence rate was
      31/100,000 population, the age specific rates increased from two to 222/100,000
      from the age of 30-39 to over 80 years. Men had higher incidence rates between
      the ages of 40 and 79 years. The short term case fatality rate was high, 27% of
      patients dying during the first day after onset of symptoms, and 50% were dead at
      30 days. After the first month the probability of survival did not differ from an
      age- and sex-matched average population. Large haematoma volume had an adverse
      effect on the short term, old age (greater than 70 years) on the long term
      survival. Ventricular extension, especially when combined with hydrocephalus was
      a bad omen for short term survival. Infratentorial and large basal ganglionic
      haematomas, and primary intraventricular haemorrhage carried a worse prognosis
      than haematomas of other locations. At the end of a median 32 month follow up 55
      (35%) of the patients were alive, 51% of these were independent in activities of
      daily living, 45% were dependent on outside help, and 4% needed constant nursing
      care. Old age (greater than 70 years), but not the haematoma volume or location,
      was associated with a poor functional recovery.

PMID- 1640230
TI  - Endoneurial capillary abnormalities in mild human diabetic neuropathy.
AB  - Microvascular factors have been implicated in the pathogenesis of human diabetic
      neuropathy. The extent of microangiopathy was assessed in 15 diabetic patients
      with clinically mild neuropathy and compared with eight age matched control
      subjects. Endoneurial capillary density was reduced (p less than 0.04) and
      correlated significantly with reduced myelinated fibre density (p less than
      0.01). Both basement membrane area (p less than 0.0001) and endothelial cell
      profile number per capillary (p less than 0.002) were significantly increased in
      diabetic patients and correlated significantly with both neurophysiological and
      neuropathological measures of neuropathic severity. There was no evidence of
      endothelial cell hypertrophy as assessed by either cross sectional endothelial
      cell area or a reduction in luminal size. Furthermore, the percentage of closed
      vessels did not differ between diabetic patients and control subjects and failed
      to relate to measures of neuropathic severity. It was concluded that
      microvascular abnormalities are prominent in patients with clinically mild human
      diabetic neuropathy, and that these data provide further support for the role of
      endoneurial capillary disease in the development of this condition.

PMID- 1640231
TI  - Directional hypokinesia in spatial hemineglect: a case study.
AB  - A patient with an ischaemic lesion involving the right frontal lobe and basal
      ganglia showed left spatial hemineglect in visuomotor exploratory tasks,
      requiring the use of the right unaffected hand. Her performance was, however,
      entirely preserved, with no evidence of neglect, when she was required to
      identify targets among distractors in both the left and right halves of space,
      and in the Wundt-Jastrow illusion test. The latter tasks do not require any arm
      movement in extrapersonal space. In this patient spatial hemineglect may be
      explained in terms of defective organisation of movements towards the left half
      space (directional hypokinesia). The frontal lesion of the patient may be the
      neural correlate of this selective disorder. This pattern of impairment may be
      contrasted with the typical deficit found in patients with right brain damage
      with perceptual neglect. One case had a defective performance both in visuomotor
      and in purely perceptual tasks.

PMID- 1640232
TI  - A controlled, longitudinal study of dementia in Parkinson's disease.
AB  - Serial assessments of cognition, mood, and disability were carried out at nine
      month intervals over a 54 month period on a cohort of 87 patients with
      Parkinson's disease (PD) and a matched cohort of 50 control subjects. Dementia
      was diagnosed from data by rigorously applying DSM-III-R criteria. Initially, 6%
      (5/87) PD patients were demented, compared with none of the 50 control subjects.
      A further 10 PD patients met the dementia criteria during the follow up period;
      this was equivalent, with survival analysis, to a cumulative incidence of 19%.
      With the number of person years of observation as the denominator, the incidence
      was 47.6/1000 person years of observation. None of the control subjects fulfilled
      dementia criteria during the follow up period. The patients with PD who became
      demented during follow up were older at onset of Parkinson's disease than
      patients who did not become demented, had a longer duration of Parkinson's
      disease, and were older at inclusion to the study.

PMID- 1640233
TI  - A component analysis of the generation and release of isometric force in
      Parkinson's disease.
AB  - Paradigms of isometric force control allow study of the generation and release of
      movement in the absence of complications due to disordered visuomotor
      coordination. The onset and release of isometric force in Parkinson's disease
      (PD) was studied, using computerised determinants of latency of response and rate
      of force generation and release. Components of isometric force control were
      related to measures of cognitive, affective and clinical motor disability. The
      effects of treatment were determined by longitudinal study of de novo patients.
      Patients with PD showed impairment in latency and rate of force change for
      movement release as well as onset. Rate of force change correlated with
      depression, clinical motor disability and memory quotient but latency showed no
      correlation with any of these measures. Treatment improved rate of force release,
      in concert with clinical motor disability, but not latency. These results suggest
      dissociations between latency and rate of force change that may be linked to
      different neurochemical deficits. Further, they demonstrate akinetic deficits in
      force release that argue against the "neural energy hypothesis" of akinesia.

PMID- 1640234
TI  - Progressive anarthria with secondary parkinsonism: a clinico-pathological case
      report.
AB  - The pathological process and lesion topography in patients with the syndrome of
      progressive aphasia are heterogeneous and few necropsy examination cases have
      been investigated. This is a case report of a 53 year old right handed man with
      progressive anarthria and secondary Parkinsonism over a period of six years.
      Positron emission tomography (PET) showed a decreased cerebral blood flow and
      metabolism in the frontal cortex, which was more pronounced on the left.
      Neuropathology disclosed a spongiform vacuolation in layer II of the frontal
      cortex, mostly in the Broca area, and neuronal loss in the substantia nigra. This
      original case reinforces the view that there are different entities of the
      syndrome of progressive aphasia which can be identified on the basis of clinical,
      neuroimaging and anatomical data.

PMID- 1640235
TI  - Hemiataxia-hypesthesia: a thalamic stroke syndrome.
AB  - Six patients had isolated hemiataxia and ipsilateral sensory loss, as a
      manifestation of thalamic infarction in the thalamogeniculate territory. Acute
      hemiataxia-hypesthesia was not found in 1075 other patients from the Lausanne
      Stroke Registry who were admitted during the same period. Stroke onset was
      progressive in five patients and immediately complete in one. Five patients had
      an objective sensory loss. In two patients this affected light touch, pain and
      temperature sense, and in another three light touch, pain temperature, position
      and vibration sense. One patient had a purely subjective sensory disturbance. The
      sensory deficit cleared or was clearing although the ataxia persisted in all
      patients. On lesion mapping on CT or MRI, all patients had involvement of the
      lateral part of the thalamus (ventral posterior nucleus and ventral lateral
      nucleus). The presumed causes of stroke were cardioembolism in one patient,
      posterior cerebral artery occlusion in one patient and meningovascular syphilis
      in one patient, hypertensive small vessel disease in two patients, and
      undetermined in one patient. Hemiataxia-hypesthesia is a new stroke syndrome
      involving the perforating branches to the lateral thalamus, but in which small
      vessel disease may not be the leading cause.

PMID- 1640236
TI  - Risk of sudden death during sleep in syringomyelia and syringobulbia.
AB  - Clinical, respiratory, and polysomnographic findings in three patients with
      syringomyelia and syringobulbia who developed severe respiratory complications
      are described. Neurological examination showed evidence of IXth and Xth cranial
      nerve involvement with dysphagia and dysphonia, but there were no complaints of
      serious sleep difficulties. Two patients died during sleep and the other was
      resuscitated during a nap. All patients showed moderate restrictive ventilatory
      defects with reduced maximal buccal pressures and one also showed a low
      ventilatory response to CO2 rebreathing. Protracted central, obstructive, and
      mixed apnoeas and hypopnoeas were commonly observed during sleep. There were no
      changes in heart rate during these events. A combination of respiratory and
      cardiovascular mechanisms might have been responsible for the severe
      complications described.

PMID- 1640237
TI  - Stereotactic linac radiosurgery for arteriovenous malformations.
AB  - Stereotactic linear accelerator (linac) radiosurgery has been in operation in the
      West Midlands since 1987, the first of its kind in the United Kingdom. Forty two
      patients with high-flow cerebral arteriovenous malformations have been treated,
      26 of whom have been followed up. Angiography one year after treatment showed
      that five lesions were obliterated, 11 were reduced in size and/or flow rate and
      10 were unchanged. Overall results show that nine out of 10 patients reviewed at
      24 months had total obliteration. Three patients had complications; one has fully
      recovered, one died of an unrelated cause at 36 months and the other died from
      recurrent haemorrhage at nine months. Two patients had recurrent non-fatal
      haemorrhage within 24 months of treatment; both recovered without further
      deficit. All patients are fit to work but eight are unemployed. Although the
      follow up period is short, the early results indicate a success rate similar to
      those published by others using linac radiosurgery.

PMID- 1640238
TI  - Cerebral blood flow, arteriovenous oxygen difference, and outcome in head injured
      patients.
AB  - Cerebral blood flow (CBF) and other physiological variables were measured
      repeatedly for up to 10 days after severe head injury in 102 patients, and CBF
      levels were related to outcome. Twenty five of the patients had a reduced CBF
      [mean (SD) 0.29 (0.05) ml/g/min]; 47 had a normal CBF, (0.41 (0.10) ml/g/min);
      and 30 had a raised CBF (0.62 (0.14) ml/g/min). Cerebral arteriovenous oxygen
      differences were inversely related to CBF and averaged 2.1 (0.7) mumol/ml in the
      group with reduced CBF, 1.9 (0.5) mumol/ml in the group with normal CBF, and 1.6
      (0.4) mumol/ml in the group with raised CBF. Patients with a reduced CBF had a
      poorer outcome than patients with a normal or raised CBF. Mortality was highest
      in patients with a reduced CBF, and was 32% at three months after injury, whereas
      only 21% of the patients with a normal CBF and 20% of the patients with a raised
      CBF died. There were no differences in the type of injury, initial score on the
      Glasgow Coma Scale, mean intracranial pressure (ICP), highest ICP, or the amount
      of medical treatment required to keep the ICP less than 20 mm Hg in each group.
      Systemic factors did not significantly contribute to the differences in CBF among
      the three groups. A logistic regression model of the effect of CBF on
      neurological outcome was developed. When adjusted for variables which were found
      to be significant confounders, including age, initial Glasgow Coma Score,
      haemoglobin concentration, cerebral perfusion pressure and cerebral metabolic
      rate of oxygen, a reduced CBF remained significantly associated with an
      unfavourable neurological outcome.

PMID- 1640239
TI  - Cervical myelopathy due to nuclear herniations in young adults: clinical and
      radiological profile, results of microdiscectomy without interbody fusion.
AB  - A study was made of the clinical and radiological characteristics and the results
      of microsurgical discectomy without interbody fusion, of 26 young adults, who
      presented with cervical myelopathy due to nuclear herniations. Neck trauma was
      not a significant aetiological factor. The disease produced moderate to very
      severe functional disability in most patients (73%), in a relatively short period
      (mean symptom duration 6.3 months). Radiological assessment revealed the presence
      of canal stenosis, significant disc protrusions with paucity of spondylotic
      changes in most patients. At operation, soft disc lesions were found in 85% and
      sequestrated discs in 31%. Microsurgical discectomy without fusion produced
      gratifying recovery of functional disability without significant deleterious
      effects on the cervical spine.

PMID- 1640240
TI  - Somatosensory and brainstem auditory evoked potential in congenital
      craniovertebral anomaly; effect of surgical management.
AB  - Clinical features and evoked potential recordings were analysed in 32 patients
      with congenital atlantoaxial dislocation before and after surgery. Seven patients
      (group 1) had atlantoaxial dislocation, while 22 patients had associated basilar
      invagination (group 2). In both groups, pyramidal tract signs, posterior column
      signs, wasting of the upper limbs, and abnormality of somatosensory evoked
      potentials (SSEP) were similar. Conversely, lower cranial nerve involvement and
      abnormal brainstem auditory evoked potentials (BAEP) were significantly more in
      patients with basilar invagination (p less than 0.05). All seven patients in
      group 1 and 17 patients in group 2 were operated upon. Clinical and
      electrophysiological deterioration were significant in patients with basilar
      invagination (group 2), following posterior fixation compared with group 1. Among
      the patients in group 2, who clinically deteriorated following posterior
      fixation, seven had transoral excision of odontoid and six of them improved both
      clinically and electrophysiologically. Two patients in group 2 had odontoid
      excision before posterior fixation, and in both the evoked potentials improved
      postoperatively. In group 1 the patient's BAEP remained unaffected following
      posterior fixation, however, in group 2, eight patients over 53% showed
      improvement in brainstem function following posterior fixation. This study shows
      the value of evoked potentials in congenital atlantoaxial dislocation, and
      rationalizes the surgical procedure in these patients. In patients with basilar
      invagination, odontoid excision is the preferred first stage procedure.

PMID- 1640241
TI  - Cerebellar syndrome in myxoedema revisited: a published case with carcinomatosis
      and multiple system atrophy at necropsy.
AB  - One of six patients in a 1960 paper on "Cerebellar syndrome in myxoedema" was
      subsequently found to have adenocarcinoma. General post-mortem revealed
      carcinomatosis and basal pneumonia. Neuropathological examination revealed the
      changes of multiple system atrophy. The relationship between hypothyroidism,
      carcinoma, and cerebellar, pontine and striatonigral degeneration is discussed.

PMID- 1640242
TI  - Histoplasmosis of the central nervous system.
AB  - Histoplasma capsulatum infection of the central nervous system is extremely rare
      in the United Kingdom partly because the organism is not endemic. However,
      because the organism can remain quiescent in the lungs or the adrenal glands for
      over 40 years before dissemination, it increasingly needs to be considered in
      unexplained neurological disease particularly in people who lived in endemic
      areas as children. In this paper a rapidly progressive fatal myelopathy in an
      English man brought up in India was shown at necropsy to be due to
      histoplasmosis. The neurological features of this infection are reviewed.

PMID- 1640243
TI  - IgA producing primary intracerebral lymphoma.
AB  - The first case of a primary and solitary IgA (lambda) producing tumour (possibly
      a non-Hodgkin's lymphoma) in the CNS is reported. Clinical and neuroimaging
      findings are described. Early diagnosis without brain biopsy and successful
      therapy were possible by CSF and serum immunoglobulin analysis which proved local
      paraprotein production restricted to the CNS.

PMID- 1640245
TI  - Cocaine abuse simulating the aura of migraine.

PMID- 1640244
TI  - Spasms of amputation stumps.
AB  - Two patients are presented with muscle spasms in an amputation stump. Neither
      patient experienced neuropathic pain nor phantom sensations, though phantom
      sensory phenomena, severe pain, and lack of response to treatment is
      characteristic of reported cases. One patient, a 75 year old man, has had
      myoclonic activity of the stump for more than two years, and the other, a 79 year
      old woman, recovered spontaneously after three months and is symptom free after a
      one year follow up. We emphasise the lack of association with pain and the need
      to consider spontaneous improvement when therapy is evaluated.

PMID- 1640246
TI  - Pathological laughter and brain stem glioma.

PMID- 1640247
TI  - Post radiation monomelic amyotrophy.

PMID- 1640248
TI  - Sellar tuberculoma.

PMID- 1640249
TI  - Posterior ischaemic optic neuropathy after a spontaneous extradural haematoma.

PMID- 1640250
TI  - Central pontine myelinolysis in a patient with AIDS.

PMID- 1640251
TI  - Could midbrain "resting" tremor be caused by postural maintenance at rest?

PMID- 1640252
TI  - Transcutaneous phrenic nerve stimulation.

PMID- 1640253
TI  - Dietary lipid regulates the amount and functional state of UDP
      glucuronosyltransferase in rat liver.
AB  - The effect of a fat-free diet on the amount and functional state of UDP
      glucuronosyltransferase was studied in rat liver microsomes. Measurements of
      enzyme activity showed that activity was approximately 30% lower in untreated
      microsomes in response to the fat-free diet as compared with the control diet.
      Immunoblotting with anti-UDP-glucuronosyltransferase showed approximately 200%
      less enzyme in rats fed the fat-free diet. A kinetic method for measuring total
      UDP-glucuronosyltransferase confirmed the result of the immunoblot. Thus, the
      total amount of enzyme declined to a greater extent than enzyme activity.
      Responses of the enzyme to activation by palmitoyl-lysophosphatidylcholine or UDP
      N-acetyl-glucosamine suggested that rats fed the fat-free diet had a greater
      activity per molecule of UDP-glucuronosyltransferase than did rats fed the
      control diet. This result explained the relatively small decline in enzyme
      activity as compared with enzyme concentration in microsomes prepared from
      animals fed the fat-free diet. Fatty acid analysis of microsomal lipids
      demonstrated that the fat-free diet was associated with lower levels of
      arachidonic and linoleic acids and greater amounts of palmitoleic, oleic and cis
      vaccenic acids.

PMID- 1640254
TI  - Developmental stages and energy restriction affect cellular oncogene expression
      in tissues of female rats.
AB  - The influence of developmental stages and energy restriction on c-Ha-ras and c
      fos cellular oncogene mRNA level was examined in mammary tissue and liver of
      female rats. c-Ha-ras and c-fos RNA transcripts in mammary tissue peaked at 9 wk
      of age, decreased during pregnancy, were lowest at mid-lactation and then
      increased at 25 wk. c-Ha-ras in liver showed highest expression at 5 wk and was
      hardly detectable at 11 wk, mid-pregnancy, mid-lactation and 25 wk. Liver c-fos
      and c-Ha-ras mRNA levels were similar. Lower c-Ha-ras and c-fos mRNA levels were
      observed in mammary tissue of energy-restricted (to 70% of ad libitum intake)
      rats at 25 wk compared with those allowed ad libitum access to food. Energy
      restriction did not affect liver c-Ha-ras and c-fos mRNA levels throughout the
      experimental period. These results demonstrate that developmental stages and
      energy restriction affect cellular oncogene mRNA levels with tissue-specific
      patterns.

PMID- 1640255
TI  - Dietary selenium stabilizes glutathione peroxidase mRNA in rat liver.
AB  - The objective of these studies was to determine the step at which dietary
      selenium (Se) regulates the pre-translational expression of the gene for
      cytosolic Se-glutathione peroxidase (Se-GPX) in rat liver. Weanling male Sprague
      Dawley rats were fed a Torula yeast-based Se-deficient diet, or the same diet
      supplemented with 0.5 mg/kg as Na2SeO3, for at least 40 d. Livers were excised
      and divided into three portions for isolation of nuclei, for purification of
      total RNA and for assay of Se-GPX activity. Nuclei were used in run-on
      transcription assays and for isolation of total nuclear RNA. Nuclear RNA and
      total liver RNA were probed with segments from a rat Se-GPX cDNA in Northern blot
      and slot blot assays. Despite marked differences in Se-GPX activity, there were
      no significant differences between dietary groups in the transcription rates of
      the Se-GPX gene. Species hybridizing to Se-GPX were not detected in nuclear RNA.
      However, steady state levels of Se-GPX mRNA were markedly reduced by Se
      deficiency. These results suggest that dietary Se exerts its effect on
      pretranslational Se-GPX gene expression at the level of cytosolic mRNA
      stabilization.

PMID- 1640256
TI  - Lung eicosanoid synthesis is affected by age, dietary fat and vitamin E.
AB  - The effect of age, dietary fat type and all-rac-alpha-tocopheryl acetate (vitamin
      E) supplementation on ex vivo synthesis of lung eicosanoids was measured in
      C57BL/6NIA mice using a 2 (age) x 3 (fat) x 3 (vitamin E) factorial design. Young
      (3-mo-old) and old (24-mo-old) mice were fed a semipurified diet containing 5%
      (by wt) corn oil, coconut oil or fish oil supplemented with 30, 100 or 500 mg
      vitamin E/kg for 4 wk. Ex vivo synthesis of thromboxane B2 (TXB2) and 6-keto
      prostaglandin F1 alpha (PGI2) were measured by RIA in lung homogenates. Old mice
      had significantly higher concentrations of TXB2 and PGI2 than did young mice,
      resulting in a significant increase in the TXB2:PGI2 ratio with aging. Young and
      old mice fed fish oil had significantly lower concentrations of PGI2 and TXB2
      than those fed corn oil or coconut oil. The degree of reduction varied according
      to age and vitamin E status. Old mice fed fish oil and 30 mg vitamin E/kg diet
      had the lowest plasma vitamin E concentration and the highest TXB2:PGI2 ratio.
      The TXB2:PGI2 ratio was significantly reduced in old mice fed coconut oil or fish
      oil by vitamin E supplementation. Vitamin E supplementation (100 mg/kg)
      significantly increased PGI2 concentration in young mice fed coconut oil. Thus,
      significant changes in the capacity of lung to synthesize eicosanoids occur with
      age and are influenced by dietary fat type and vitamin E. J. Nutr.

PMID- 1640257
TI  - Lymph chylomicron size is modified by fat saturation in rats.
AB  - Mesenteric lymph chylomicrons were characterized during and after the
      establishment of steady-state triglyceride transport. Chylomicrons were isolated
      from lymph at 0, 2, 4, 6, 8 and 12 h after the start of an 8-h infusion of
      triglyceride emulsion (prepared using either corn or butter oil) at 160
      mumol/(kg.h). Lymph flow was not influenced by triglyceride source. Output of
      triglyceride, measured both in whole lymph and in the chylomicron fraction, was
      not significantly affected by triglyceride source. Butter oil infusion produced a
      higher output of chylomicron phospholipid and unesterified cholesterol than was
      observed in response to corn oil emulsion. Ratios of transported phospholipid to
      triglyceride for butter oil chylomicrons were higher (1.3- to 1.7-fold) than
      those for corn oil chylomicrons at every time point examined after the start of
      lipid infusion. No other compositional differences in chylomicrons due to
      triglyceride source were observed. These results support the hypothesis that
      differences in efficiency of absorption and transport between saturated and
      unsaturated fat are sufficient to explain size differences in secreted
      chylomicrons in response to corn and butter oil infusions, and suggest that
      chylomicron number may be influenced by dietary fat saturation.

PMID- 1640259
TI  - Meats and fish consumed in the American diet contain substantial amounts of ether
      linked phospholipids.
AB  - The primary goal of this study was to determine the amounts of ether-containing
      phospholipids, along with their concentration of certain polyunsaturated acyl
      groups, from selected, commonly consumed foods of animal origin (salmon, catfish,
      pork, beef, turkey and chicken). Levels of ether-linked glycerolipids in the
      samples were of particular interest, because ingestion of ether lipids could
      contribute to the production of platelet-activating factor (PAF; 1-alkyl-2-acetyl
      sn-glycero-3-phosphocholine), one of the most potent biological mediators known.
      Alkylacyl-sn-glycero-3-phosphocholine was found in all of the meats, with pork
      loin having the highest levels (0.9 mumol/g tissue) and chicken breasts the
      lowest (0.1 mumol/g tissue). Although choline plasmalogens were not as evident as
      the ubiquitous ethanolamine plasmalogens, substantial amounts (1.0 mumol/g
      tissue) of alk-1-enylacyl-sn-glycero-3-phosphocholine were found in tissues from
      beef and turkey. Triacylglycerols contained greater proportions of saturated
      fatty acids than phospholipids, and the ether-linked phospholipids were generally
      more unsaturated than diacyl species of the same phospholipid. Our data indicate
      that in addition to the phospholipid fraction of commonly eaten animal tissues
      supplying substantial amounts of polyunsaturated fatty acids, they are also a
      rich source of ether-linked lipids. Dietary ether-linked phospholipids could
      influence the lipid composition of host tissues to the extent that biological
      responses produced by ether lipid mediators would be affected.

PMID- 1640258
TI  - Prolonged lactation contributes to depletion of maternal energy reserves in
      Filipino women.
AB  - This paper identifies determinants of women's postpartum weight and weight change
      in a large group of Filipino women followed for 24 mo. Longitudinal, multivariate
      models focused on the effects of lactation, while controlling for energy intake,
      energy expenditure, reproductive history and seasonality. Lactation was found to
      have a significant negative effect on weight of urban women. The negative effects
      of lactation increased with the intensity and duration of breast-feeding. Among
      rural women negative effects of lactation on weight were observed only after 10
      14 mo. Models of net postpartum weight change (from 2 to 24 mo) among nonpregnant
      women confirmed an important role for lactation. The likelihood of weight loss
      was significantly increased by lactation of more than 12-mo duration, by greater
      maternal age and by low dietary energy intake. The effects of lactation on
      maternal energy reserves can be mitigated substantially be increasing maternal
      dietary energy intakes.

PMID- 1640260
TI  - Dietary fatty acids temporarily alter liver very long-chain fatty acid
      composition in mice.
AB  - To determine the influence of dietary fatty acids on tissue very long-chain fatty
      acid (VLFA) composition, mice were fed four diets containing 15 g fat/100 g diet
      derived largely from either safflower oil, peanut oil, olive oil or glycerol
      trioleate oil. The diets varied widely in the composition of VLFA and other fatty
      acids. Digestibility of total dietary VLFA ranged from 84.6% in mice fed the
      glycerol trioleate diet to 96.7% in those fed the safflower oil diet. After 3 mo,
      the saturated VLFA composition of liver total lipids and sphingomyelin was lower
      in animals fed the glycerol trioleate oil diet than in mice fed most other diets.
      Although the saturated VLFA content of the peanut oil diet was more than 15-fold
      greater than that of the other diets, animals fed the peanut oil diet showed
      little or no selective increase in liver saturated VLFA. The VLFA composition of
      brain was comparable in all dietary groups. After 8 mo of feeding, the liver
      saturated VLFA composition tended to increase and differences between groups
      disappeared. Liver peroxisomal beta-oxidation of lignocerate (24:0) was similar
      among all dietary groups. These results demonstrate that dietary fatty acids
      shorter than VLFA temporarily influence the saturated VLFA composition of liver.

PMID- 1640261
TI  - Administration modalities and intestinal lymph absorption of arachidonic acid in
      rats.
AB  - We investigated the effects of the proportion of arachidonic acid on lymph
      lipoprotein synthesis in rats, when infused in the presence of lipids with
      varying degrees of saturation. A single dose of 90 mumol of lipid was
      administered intraduodenally and intestinal lymph was collected. Emulsion lipid
      constituents were 90 mumol of [14C]arachidonic acid alone, or either 30 mumol of
      [14C]arachidonic acid or 5 mumol of [14C]arachidonic acid and 25 mumol of
      linoleic acid, with 30 mumol of a free fatty acid and 30 mumol of a monoglyceride
      (the more saturated: oleic acid + monopalmitin; the more unsaturated: linoleic
      acid + monoolein). Radioactive lymph recovery of [14C]arachidonic acid infused
      alone reached 32.6 +/- 1.3% of the radioactivity administered and the presence of
      another fatty acid and a monoglyceride increased it from 38.7 +/- 2.6 to 51.9 +/-
      1.1%. For 30 mumol of arachidonic acid, integration into lymph phospholipids was
      higher when arachidonic acid was infused with oleic acid and monopalmitin than
      with linoleic acid and monoolein (7.3 +/- 2.7 and 2.8 +/- 0.2% at the absorption
      peaks, respectively), and it was 4.8 +/- 0.5% when arachidonic acid was infused
      alone. For 5 mumol of arachidonic acid, the degree of unsaturation of the added
      lipid did not modify phospholipid incorporation, which was maintained at 6.9 to
      7.2%. The proportion and size of chylomicrons increased with the degree of lipid
      emulsion unsaturation. Percentages of [14C]phospholipids and of chylomicrons were
      highly correlated. The proportion of arachidonic acid and degree of lipid
      emulsion unsaturation affected lymphatic arachidonic acid absorption modalities.

PMID- 1640262
TI  - Inbred strains of rats have differential sensitivity to dietary phosphorus
      induced nephrocalcinosis.
AB  - The degree of nephrocalcinosis after increasing the dietary phosphorus
      concentration from 0.2 to 0.5 g/100 g was measured in weanling female rats of 10
      inbred strains. Based on kidney calcium concentrations and histological kidney
      calcification scores, there were considerable strain differences in
      nephrocalcinogenesis; 86% of the strain variability in nephrocalcinosis was
      attributable to genetic factors. Two strains with the most extreme
      nephrocalcinogenic responses were retested and the strain difference was found to
      be reproducible. Mean plasma phosphorus concentrations after phosphorus feeding
      were lower in the sensitive strain than in the insensitive strain. The high
      phosphorus diet produced greater urinary phosphorus concentrations, with the
      increase being greater in the sensitive strain. The strain difference in the
      response of urinary phosphorus concentrations after raising dietary phosphorus
      level may determine the strain difference in phosphorus-induced nephrocalcinosis.
      After consuming the high phosphorus diet, RP rats housed in groups in solid
      floored cages had significantly higher degrees of nephrocalcinosis than their
      counterparts housed individually in metabolism cages with wire-mesh bases.

PMID- 1640263
TI  - The splanchnic organs, liver and kidney have unique roles in the metabolism of
      sulfur amino acids and their metabolites in rats.
AB  - The arterial-venous differences for methionine and cysteine and their
      metabolites, glutathione, taurine and sulfate, were measured across the
      splanchnic organs, the liver, the kidney and the hindlimb of fed rats. Methionine
      and cysteine were released into the blood by the splanchnic organs and removed by
      the liver. These results indicate that more than half of the sulfur amino acids
      taken up by the liver were used for synthesis of glutathione for export into the
      plasma. The kidney removed about half of the glutathione exported by the liver,
      presumably due to action of gamma-glutamyl transpeptidase and dipeptidase, and
      released to the circulation a comparable amount of cysteine. Taurine, presumably
      from deconjugation of bile acids, was released into the plasma by the splanchnic
      organs; taurine was also released by the liver. The hepatosplanchnic release of
      taurine into the plasma indicates that the liver is the major site of taurine
      biosynthesis; taurine was removed by the kidney for excretion in the urine. A
      small amount of methionine was removed by the kidney, and the hindlimb released a
      small amount of glutathione and methionine into the plasma. The splanchnic organs
      seemed to remove substantial sulfate from the plasma in addition to that provided
      by the diet, and a net release of sulfate from the liver was observed. The
      relative roles of the various tissues in sulfate production and removal was not
      clear from these studies, due to the large variability in the arterial-venous
      differences observed.

PMID- 1640264
TI  - Medium-chain triacylglycerols enhance release of cholecystokinin in chicks.
AB  - Whether medium-chain triacylglycerols (MCT) affect the plasma concentration of
      cholecystokinin (CCK) and crop-emptying rate in chicks was investigated after 0,
      30, 60, 90, 120 or 180 min of diet intubation. Triacylglycerol sources used were
      corn oil [containing long-chain triacylglycerols (LCT)], glyceryl tricaprate and
      glyceryl tricaprylate at a level of 200 g/kg diet. Plasma CCK concentration was
      significantly enhanced in chicks given the two MCT treatments, but not in those
      given the LCT treatment, after 30 min feeding relative to the initial level. At
      all time points, chicks fed the diet containing LCT had significantly lower
      plasma CCK concentrations than those fed MCT, and chicks fed glyceryl tricaprate
      had higher concentrations than those fed glyceryl tricaprylate. Dietary MCT
      sources significantly delayed diet passage from the crop compared with dietary
      LCT. These results indicate that MCT are more potent stimulators of CCK secretion
      in chicks than LCT.

PMID- 1640265
TI  - Increases in serum sphingosine and sphinganine and decreases in complex
      sphingolipids in ponies given feed containing fumonisins, mycotoxins produced by
      Fusarium moniliforme.
AB  - Consumption of food contaminated with Fusarium moniliforme causes
      leucoencephalomalacia and hepatotoxicity in horses, pulmonary edema in pigs and
      liver cancer in rats, and has been correlated with esophageal cancer in humans.
      The causative agents are thought to be a family of compounds called fumonisins,
      which have recently been shown to be potent inhibitors of sphingosine
      (sphinganine) N-acyltransferase. Because inhibition at this step blocks the
      formation of complex sphingolipids while leading to accumulation of sphinganine,
      we hypothesized that exposure of animals to fumonisin-contaminated feed might be
      detected by analyses of serum sphingolipids. Within days of giving ponies feed
      contaminated with 15 to 44 micrograms/g fumonisin B1, there was an increase in
      the amount of free sphinganine (and sometimes sphingosine) and a reduction in
      complex sphingolipids. Free sphinganine and sphingosine decreased when ponies
      consumed less of the contaminated feed, and increased again when they consumed
      more fumonisin. When toxicosis was evident as indicated by other serum markers,
      complex sphingolipids as well as free sphingosine and sphinganine were elevated,
      probably due to loss of sphingolipids from dying cells. These findings establish
      that consumption of fumonisin-contaminated feed disrupts sphingolipid metabolism.
      Because the changes in sphinganine and sphingosine were seen before liver enzymes
      were noticeably elevated, they may be an early marker of exposure to fumonisins.

PMID- 1640266
TI  - Abomasal infusion of casein enhances nitrogen retention in somatotropin-treated
      steers.
AB  - The effects of bovine somatotropin (bST) administration and abomasal protein
      infusion on nitrogen metabolism were investigated using four abomasally
      cannulated Holstein steers in a 4 x 4 Latin square design. Treatments were
      factorially arranged to include daily abomasal infusion (water or casein, 0.9
      g/kg body wt) and daily bST injection (0 or 200 micrograms/kg body wt). Each
      treatment period lasted for 23 d and consisted of an adjustment period (d 1 to
      7), casein infusion (d 8 to 23) and bST treatment (d 10 to 23). Nitrogen
      metabolism and serum insulin-like growth factor-I (IGF-I) profiles were
      characterized on d 16-22. Animals were fed a total mixed diet balanced to achieve
      0.75 kg gain/d and supplemented to provide 115% of requirements for crude protein
      and minerals. Nitrogen retention was increased by casein and bST individually (21
      and 33%, respectively) or in combination (75%). Somatotropin treatment increased
      the biological value of absorbed N, which was consistent with reductions in
      plasma urea nitrogen. Circulating IGF-I was increased by bST and was highly
      correlated (r = 0.73) with N retention. Overall, bST altered requirements so that
      less absorbed N was required per unit of N retained. However, results also
      demonstrated that because of limitations in amino acids supplied from microbial
      and ruminal escape protein in young growing cattle, amino acid supply may limit
      the magnitude of N retention response to bST under many situations.

PMID- 1640267
TI  - Chronic food restriction amplifies the effect of lactation on the duration of
      postpartum anestrus in rats.
AB  - We studied the effects of food intake and lactation on the duration of postpartum
      infecundability in rats. Sprague-Dawley rats were given free access to a purified
      diet (AIN-76A) or a similar diet (modified to contain twice the concentrations of
      vitamins and minerals) in amounts equal to 50% of that consumed by controls. At 
      65 d of age, animals were bred. At parturition, dams were allowed to nurse 4-5
      pups, or all pups were removed. Thus, four groups were created: lactating control
      (n = 11), nonlactating control (n = 11), lactating food restricted (n = 8), and
      nonlactating food restricted (n = 10). Vaginal cytology was observed twice daily
      for the detection of proestrus, which occurred at 4.5 +/- 0.5 and 6.7 +/- 0.5 d
      (mean +/- SD) postpartum in nonlactating control and food restricted groups,
      respectively (P less than 0.005), and at 16.5 +/- 0.5 and 28.8 +/- 0.5 d
      postpartum in lactating control and food restricted groups, respectively (P less
      than 0.0001). The interaction between food intake and lactation was significant
      (P less than 0.0001). These results indicate that maternal food restriction
      exacerbates the effects of lactation in prolonging postpartum anestrus.

PMID- 1640268
TI  - Dietary fish protein modulates high density lipoprotein cholesterol and
      lipoprotein lipase activity in rabbits.
AB  - To explore the pathways by which fish protein feeding influences HDL metabolism,
      postheparin plasma lipoprotein lipase and hepatic triglyceride lipase activities
      were measured in rabbits fed fish protein or soybean protein combined with corn
      oil or coconut oil in a 2 x 2 factorial arrangement. In addition to greater serum
      total and LDL-cholesterol concentrations, the elevated HDL cholesterol
      concentration caused by feeding fish protein, compared with soybean protein, was
      accompanied by lower VLDL triglycerides and parallel higher lipoprotein lipase
      activity in fish protein-fed rabbits. These results suggest an enhanced assembly
      of circulating HDL through promoted lipoprotein lipase activity in rabbits fed
      fish protein. Moreover, dietary proteins and lipids interacted with one another
      to alter HDL triglycerides and liver cholesterol concentrations. Diet-induced
      changes in lipoprotein lipase activity were, however, not related to insulinemia,
      which was unaltered by purified diet feeding. The present results suggest that
      fish protein may affect HDL metabolism through the modulation of lipoprotein
      lipase activity in rabbits.

PMID- 1640269
TI  - Prolonged acetaminophen ingestion by mice fed a methionine-limited diet does not
      affect iron-induced liver lipid peroxidation or S-adenosylmethionine.
AB  - This study determined whether acetaminophen (ACAP)-induced glutathione depletion
      was associated with liver lipid peroxide formation, or the concentrations of
      liver S-adenosylmethionine and S-adenosylhomocysteine in mice fed diets with L
      methionine below or at the requirement level (0.25 or 0.5%) for 7 wk. Iron
      dextran (281 mg/kg body wt) or saline was administered for 2 d before measurement
      of lipid peroxide formation. Chronic dietary ACAP (0.5%) in mice fed 0.25%
      methionine caused a failure to maintain body weight even though food intake was
      similar to intake by all other treatment groups. Liver GSH (measured as
      nonprotein sulfhydryl concentration) and cysteine concentrations were depleted by
      ACAP and by ACAP plus iron. Liver lipid peroxide formation was increased by iron
      but was not altered additionally by ACAP ingestion. Liver glutathione peroxidase
      activity was increased by methionine in controls, whereas glutathione S
      transferase activity was increased by ACAP ingestion in mice fed 0.5% methionine
      compared with controls. Liver S-adenosylmethionine and nuclear 5
      methyldeoxycytidine concentrations were not affected by dietary ACAP or
      methionine. Liver S-adenosylhomocysteine levels were lower in mice fed ACAP and
      0.25% methionine compared with mice fed ACAP and 0.5% methionine. In conclusion,
      chronic ACAP did not increase the susceptibility of mice to liver lipid
      peroxidation or alter the availability of methyl groups for methylation
      reactions.

PMID- 1640270
TI  - Inanition may reduce alkaline phosphatase activity in liver and intestine of zinc
      deficient mice.
AB  - Zinc-deficiency was induced in mice by feeding a Zn-deficient basal diet (ZD
      dietary group) containing 9% lipid (6% corn oil, 3% cod liver oil) for 8 wk.
      Thereafter, the corn oil was withdrawn from the basal diet and a subset of Zn
      deficient animals (ZDLR group) was fed this modified low fat diet for another 8
      wk. Alkaline phosphatase activity in intestine and liver was compared in these
      mice and in those allowed ad libitum access to the lipid-adequate Zn-supplemented
      diet (ZS group), in those pair-fed the Zn-supplemented diet (PF group) and in
      those fed the lipid-adequate, Zn-deficient diet ad libitum (ZD group). The enzyme
      activity in both intestine and liver of the ZDLR group was greater than in those
      of the ZD group and greater than or equal to those of the ZS and PF diet groups.
      The results of this study suggest that the reduction in alkaline phosphatase in
      Zn-deficient animals is a response secondary to associated inanition.

PMID- 1640271
TI  - (n-3) fatty acids, tissue lipid peroxidation and tocopherol status.

PMID- 1640272
TI  - Success: yours, mine, and ours.

PMID- 1640273
TI  - Nursing diagnoses as guidelines in the care of the neonatal ECMO patient.
AB  - The number of centers offering extracorporeal membrane oxygenation (ECMO) as a
      treatment for neonatal respiratory failure continues to grow. To ensure high
      quality patient care and consistency among centers, nursing care guidelines
      should be established. A plan of care using nursing diagnoses as guidelines for
      the ECMO nurse is presented.

PMID- 1640274
TI  - Pulmonary edema in pregnancy.
AB  - Normal cardiovascular and respiratory changes in pregnancy can predispose women
      to the development of pulmonary edema. Conditions and treatments unique to
      pregnancy, such as multiple gestation or tocolysis, further increase this risk.
      Recognition of risk factors and signs and symptoms of pulmonary edema allows the
      nurse to intervene quickly, thus decreasing potential complications to the mother
      and child.

PMID- 1640275
TI  - Nursing care of the neonate receiving high-frequency jet ventilation.
AB  - Respiratory distress remains a major source of morbidity and mortality among
      infants, despite advances in conventional mechanical ventilation over the past 20
      years. High-frequency jet ventilation provides an alternative treatment modality
      for neonates suffering from pulmonary air leak syndromes, such as pulmonary
      interstitial emphysema and pneumothorax. This new technology presents special
      challenges to the nurse caring for these critically ill neonates and their
      families.

PMID- 1640276
TI  - Understanding bulimia and its implications in pregnancy.
AB  - Bulimia is a serious eating disorder that affects up to 19% of women in the
      United States. Research shows that bulimia may present a threat to the normal
      course of pregnancy. Nursing can play an important role in the prevention of
      maternal and neonatal morbidity through the early detection of bulimia. Bulimia
      and its impact on pregnancy are described to assist nurses in the early detection
      and referral of women with this disorder.

PMID- 1640277
TI  - Syphilis. An old disease, a contemporary perinatal problem.
AB  - The incidence of syphilis in the United States has almost doubled in the past 5
      years, with some cities posting an increase of more than 500% during this period.
      As a result, greater numbers of neonates infected with congenital syphilis are
      treated in nurseries across the country. The incidence, pathogenesis, diagnosis,
      and treatment of syphilis are described, and the nursing implications associated
      with caring for those at risk of contracting the disease are presented.

PMID- 1640278
TI  - Efficacy of heparin in peripheral venous infusion in neonates.
AB  - OBJECTIVE: To determine the efficacy of continuous, low-dose heparin infusion in
      prolonging peripheral venous catheter patency in neonates. DESIGN: Randomized,
      prospective study. SETTING: Level III neonatal intensive-care unit. PARTICIPANTS:
      113 neonates requiring i.v. therapy. INTERVENTIONS: The neonates were randomly
      assigned to heparin (n = 63). The heparin group received 1/2 unit of heparin per
      milliliter of continuous intravenous infusate or intermittent heparin flush. MAIN
      OUTCOME MEASURES: Low-dose heparin infusion does not make a difference in the
      duration of peripheral venous catheter patency. The incidence of catheter-related
      complications in the heparin group is the same as for those receiving no heparin.
      RESULTS: The mean duration of catheter patency was 62.75 hours in the heparin
      group and 27.3 hours in the no-heparin group (p = .0001). The occurrence of
      infection, bleeding, and extravasation injury was zero in the sample studied. The
      incidence of phlebitis was 18 cases in 132 (13%) in the heparin group and 13
      cases in 122 (10%) in the no-heparin group. According to chi-square analysis, the
      difference between groups was not statistically significant (p greater than .05).
      CONCLUSION: Low-dose heparin infusion in peripheral venous catheters in neonates
      increased the duration of intravenous catheter patency (p = .0001) without
      increased risks of bleeding, infection, phlebitis, or extravasation injury.

PMID- 1640280
TI  - Second-trimester termination.

PMID- 1640279
TI  - Second-trimester termination.

PMID- 1640281
TI  - Clinical application of ultrasonography in the diagnosis of intussusception.
AB  - Sixty-five consecutive patients seen in a pediatric emergency department, in whom
      the diagnosis of intussusception was considered, had an ultrasound examination of
      the abdomen before a barium enema. The mean age of the patients was 1.7 years
      (range 2 weeks to 5 years). Intussusception was detected by ultrasonography in
      all 20 cases proved by barium enema. There were three false-positive ultrasound
      results (sensitivity = 100%, confidence interval (Cl) = 86% to 100%; specificity
      = 93%, Cl = 86% to 96%). Normal findings on ultrasonography correlated with a
      negative barium enema results in 42 of 42 cases (negative predictive value =
      100%, Cl = 94% to 100%). No intussusception was missed by ultrasonography. To
      determine which patients would most benefit from ultrasonography, we divided
      patients into either a high-risk group (81% with intussusception) or a low-risk
      group (14% with intussusception) on the basis of clinical symptoms (p less than
      0.01). If each high-risk child had a barium enema and each low-risk child had an
      ultrasound study as their initial diagnostic test, 89% of the patients in this
      study would have undergone only one examination. We conclude that ultrasonography
      can be used as a rapid, sensitive screening procedure in the diagnosis or
      exclusion of childhood intussusception. Children considered at low risk of having
      intussusception on the basis of clinical symptoms should initially have an
      ultrasound examination; patients at high risk should have an immediate barium
      enema.

PMID- 1640282
TI  - Differences in the immunogenicity of three Haemophilus influenzae type b
      conjugate vaccines in infants.
AB  - OBJECTIVE: To compare the immunogenicity of three Haemophilus influenzae type b
      (Hib) conjugate vaccines in infants residing in different geographic areas.
      DESIGN: A multicenter, randomized immunogenicity trial with sera assayed in one
      laboratory without knowledge of vaccine brand status. In Minneapolis and Dallas,
      infants were vaccinated at 2, 4, and 6 months of age; in St. Louis, infants were
      vaccinated at 2 and 4 months of age. SUBJECTS: A convenience sample of 458
      infants recruited largely from private pediatric practices. MEASUREMENTS AND
      RESULTS: At each of the study sites, the respective trends between the
      anticapsular antibody responses of the infants assigned to the different
      conjugate vaccine groups were similar. After one or two doses, Hib polysaccharide
      conjugated to outer membrane protein complex of Neisseria meningitidis (PRP-OMP)
      was more immunogenic than Hib polysaccharide-tetanus toxoid conjugate (PRP-T), or
      Hib oligomers conjugated to the mutant diphtheria toxin CRM197 (HbOC) (p less
      than 0.001). After two doses, PRP-T was more immunogenic than HbOC (p less than
      or equal to 0.001). After three doses there was no significant difference in the
      geometric mean antibody concentrations of the three groups, and 88% to 97% of the
      infants had greater than 1.0 microgram/ml of antibody. The HbOC vaccine elicited
      a 10-fold lower antibody response after two doses (0.45 micrograms/ml vs 5.9
      micrograms/ml) and a threefold lower antibody response after three doses (6.3
      micrograms/ml vs 22.9 micrograms/ml) than observed by us previously with a
      prelicensure lot of this vaccine (p less than 0.001). Because of these low
      responses, the infants in St. Louis who received two doses of HbOC were
      revaccinated with unconjugated PRP at a mean age of 8.9 months. This group was
      immunologically primed, as evidenced by a 10-fold increase in geometric mean
      antibody concentration after vaccination at an age when unprimed infants do not
      normally respond to this vaccine. CONCLUSIONS: In infants in three geographic
      regions, PRP-OMP elicited earlier acquisition of serum antibody than the other
      two conjugate vaccines; however, after three doses the antibody concentrations of
      the three groups were not significantly different. The reason for the markedly
      lower immunogenicity of HbOC vaccine than reported previously is unknown.

PMID- 1640283
TI  - Mycobacterium haemophilum causing perihilar or cervical lymphadenitis in healthy
      children.
AB  - We describe five apparently immunologically normal children with infection caused
      by Mycobacterium haemophilum and resulting in perihilar or cervical
      lymphadenitis. Clinical distinction from Mycobacterium tuberculosis infection
      could be made by culture only, because differential Mantoux test results
      suggested tuberculosis. Treatment of these children involved chemotherapy or
      surgery or both, and outcome in all cases has been excellent. We believe that M.
      haemophilum should be added to the list of non-tuberculosis mycobacteria known to
      cause lymphadenitis in otherwise healthy children.

PMID- 1640284
TI  - Inappropriate suppression of thyrotropin during medical treatment of Graves
      disease in childhood.
AB  - Twenty-nine patients (22 female) aged 2 to 17 years were followed with serial
      measurements of serum triiodothyronine, thyroxine, and thyrotropin during medical
      therapy for Graves disease. Fourteen patients had 17 instances of hypothalamic
      pituitary-thyroid suppression with inappropriately low thyrotropin levels. Five
      patients had six episodes of low thyroxine and triiodothyronine levels with
      normal levels of thyrotropin, and 10 patients had 11 episodes of normal thyroxine
      and triiodothyronine levels with subnormal levels of thyrotropin. We conclude
      that thyrotropin values may not be reliable for diagnosing either mild
      hypothyroidism or persistent hyperthyroidism during the medical treatment of
      Graves disease.

PMID- 1640285
TI  - Growth and thyroid function in children treated with growth hormone.
AB  - We examined the effect of growth hormone (GH) therapy on thyroid function in 57
      children with isolated GH deficiency and whether this effect could influence
      their growth response. Thyroid function and insulin-like growth factor I levels
      were measured before and after 3, 6, and 12 months of recombinant-GH therapy (20
      U/m2 per week, given subcutaneously), after a 1-month withdrawal from therapy,
      and after a further 6 months of GH administration. The serum concentration of
      triiodothyronine (T3) and the T3/T4 (thyroxine) ratio increased after 12 months
      of GH treatment, whereas total T4 and free T4 levels decreased; thyrotropin
      levels did not change significantly during treatment but increased after a 1
      month withdrawal. After a further 6 months of GH therapy, an increase in T3
      levels and in the T3/T4 ratio and a decrease in total T4 and free T4 levels were
      found again, and thyrotropin levels decreased. The increment in growth velocity
      after 12 months of therapy correlated positively with the T3/T4 ratio and
      negatively with total T4 and free T4 values. These data confirm in children a GH
      induced enhancement of peripheral conversion of T4 to T3. This effect appears to
      be more evident in children who are most sensitive to GH in terms of growth
      promoting activity.

PMID- 1640286
TI  - Nocturnal thyrotropin surge in growth hormone-deficient children.
AB  - Because some patients with growth hormone (GH) deficiency are found to be
      hypothyroid after initiation of treatment with GH, we assessed the predictive
      value of the nocturnal thyrotropin surge (a sensitive test for central
      hypothyroidism) in 56 untreated GH-deficient children and adolescents. Eighteen
      patients had a subnormal thyrotropin surge (mean 18% (range -30% to 46%)),
      significantly less than that of 96 normal control subjects (mean 124%; 95%
      confidence limits, 47% to 300%; p less than 0.01); 13 of the 18 had a subnormal
      total thyroxine (T4) level or a subnormal free T4 level, or both. These 18
      patients were given thyroid hormone replacement therapy; GH deficiency was
      confirmed during treatment with thyroxine. Of the remaining 38 patients, who had
      no initial evidence of dysfunction of the hypothalamic-pituitary-thyroid axis, 23
      were re-examined while they were receiving GH treatment. Hypothyroidism developed
      in none of those 23 children during GH therapy. The nocturnal thyrotropin surge
      test and determination of iodothyronine levels were repeated in 14 of these
      euthyroid patients. There was no significant change in mean thyrotropin surge
      (129% (range +49% to +300) vs 125% (range +51% to +222%)), mean serum level of
      total T4 (111 +/- 4 vs 103 +/- 3 nmol/L), mean serum level of free T4 (19 +/- 0.7
      vs 18 +/- 0.8 pmol/L), mean serum level of triiodothyronine (2.5 +/- 0.1 vs 2.5
      +/- 0.1 nmol/L), or mean serum level of thyrotropin (2.9 +/- 0.3 vs 2.9 +/- 0.5
      mU/L (mean +/- SEM)). We conclude that GH treatment does not appreciably alter
      thyroid function in GH-deficient patients who have no evidence of thyroid axis
      dysfunction before GH treatment.

PMID- 1640287
TI  - Maximal voluntary work and cardiorespiratory fitness in patients who have had
      Kawasaki syndrome.
AB  - To assess the natural history of Kawasaki syndrome and its effect on maximal
      voluntary work and cardiorespiratory fitness, we performed cycle ergometry
      testing in 47 patients who had had the syndrome. Forty-one patients performed
      maximal effort as judged by achievement of 95% predicted heart rate response.
      Oxygen consumption, carbon dioxide production, and minute ventilation were
      performed in 23 patients. There was no difference in maximal voluntary work
      (total work, mean power) or maximal oxygen consumption between case subjects and
      control subjects. There were no differences between patients with and those
      without aneurysms. Serial exercise studies were performed in 10 patients; of
      these, two with initially normal exercise study findings had decreased maximal
      voluntary work and oxygen consumption with ischemic changes, and both were at
      high risk for the development of stenotic or occlusive coronary arteries. The
      other eight patients had normal cardiorespiratory reserve and no ischemic changes
      with serial studies. These results suggest that patients have normal
      cardiorespiratory fitness after Kawasaki syndrome. With the development of
      ischemic heart disease, they may have decreased cardiorespiratory reserve. Serial
      evaluation of cardiorespiratory fitness may demonstrate ischemic heart disease.

PMID- 1640288
TI  - Oxygen desaturation during sleep in infants and young children with congenital
      heart disease.
AB  - Oxygen saturation (SaO2) during sleep and pulmonary functions were evaluated in
      19 infants with congenital heart disease, aged 6 +/- 4 months, and in 11 normal
      infants, aged 8 +/- 5 months, to determine whether infants with congenital heart
      disease have more frequent oxygen desaturation during sleep and, if so, its
      relationship to underlying pulmonary function. Infants with congenital heart
      disease were classified as acyanotic (n = 11) or cyanotic (n = 8) on the basis of
      their aortic SaO2 at the time of cardiac catheterization (greater or less than
      90% SaO2). Pulmonary function tests included respiratory rate, functional
      residual capacity, total respiratory system compliance, and maximal flows at
      functional residual capacity. Significant differences were found in the values
      for the lowest SaO2 of each 5-minute epoch (SaO2L) averaged during the entire
      sleep time (normal 94% +/- 2%, acyanotic 90% +/- 3%, and cyanotic 74% +/- 4%; p
      less than 0.01). The three groups also differed significantly in frequency
      distributions of percentage of total sleep time with SaO2L less than 90% (SaO2%T)
      (normal 10% +/- 17%, acyanotic 36% +/- 34%, and cyanotic 97% +/- 4%; p less than
      0.05). Compared with the control group, the acyanotic group had a higher
      respiratory rate (66 +/- 19 breaths/min vs 35 +/- 6 breaths/min; p less than
      0.01), a lower tidal volume (65% +/- 29% predicted vs 105% +/- 18% predicted; p
      less than 0.01), and a lower total respiratory compliance (59% +/- 18% predicted
      vs 106% +/- 30% predicted; p less than 0.01). A negative correlation existed
      between SaO2%T and aortic SaO2 (R2 = 0.64; p less than 0.01). We conclude that
      oxygen desaturation occurs during sleep in infants with congenital heart disease;
      the presence of desaturation appears to be related to the initial degree of
      hypoxemia and the presence of abnormal pulmonary function.

PMID- 1640289
TI  - Primary distal tubular acidosis in childhood: clinical study and long-term follow
      up of 28 patients.
AB  - The long-term follow-up of 28 patients with congenital primary tubular acidosis
      is described. Ten patients had affected siblings but no history of similar
      symptoms in the preceding generation. Deafness was associated in 14 patients and
      developed before 12 years of age. Deafness was present in all familial cases, and
      patients without deafness showed no familial incidence, suggesting the existence
      of two different entities. All patients had growth retardation, which was more
      severe in the older patients and was always markedly improved by alkaline
      therapy. Rickets was found in some patients but seemed related to vitamin D
      deficiency. Catch-up growth was limited to the first 2 years of therapy in
      patients treated before 2 years of age, but sometimes lasted longer in older
      patients. Of the 12 patients who reached adulthood, those without rickets
      achieved a normal height but the others did not. We believe that therapy should
      be continued throughout life because of the risk of nephrocalcinosis.

PMID- 1640290
TI  - Sudden infant death syndrome in Washington State: why are Native American infants
      at greater risk than white infants?
AB  - Washington State reports one of the highest rates of sudden infant death syndrome
      (SIDS) in the United States; within the state, Native Americans have the highest
      rate of any racial group. To explore this apparent genetic predisposition, we
      conducted a population-based retrospective cohort study. Using the state's linked
      birth and death certificate file for 1984 to 1988, we compared infants whose
      mothers were coded as "American Indian" with infants whose mothers were coded as
      "white." Native American infants were more than three times more likely than
      white infants to die of SIDS (crude relative risk = 3.25; 95% confidence interval
      = 2.41 to 4.38). However, this elevated risk diminished after adjustment for
      differences between Native American and white mothers in age, marital status,
      parity, and smoking status during pregnancy (adjusted relative risk = 1.82; 95%
      confidence interval = 1.28 to 2.58). The high SIDS rate of Washington's Native
      Americans appears to be due to the high prevalence of SIDS risk factors among
      Native American mothers, rather than to a genetic predisposition in the infants.
      Because many of these maternal factors are related to socioeconomic status, it is
      likely that programs to improve the overall health of Native Americans might
      lessen both the impact of SIDS and that of other causes of infant morbidity and
      death.

PMID- 1640291
TI  - Immunoglobulin G, total and subclass, in children with or without recurrent
      otitis media.
AB  - Total IgG and subclasses IgG1, IgG2, IgG3, and IgG4 were measured in 89 subjects
      with recurrent otitis media. There was no significant difference between the
      groups with respect to the arithmetic or geometric mean levels for total IgG or
      subclasses IgG1, IgG2, IgG3, or IgG4.

PMID- 1640292
TI  - Iodine supplementation in children receiving long-term parenteral nutrition.
AB  - In 18 children receiving long-term total parenteral nutrition (TPN) without
      iodide supplements, thyroid function test results were normal but serum iodide
      levels were greater than in control subjects (p less than 0.01). Iodine
      contamination of TPN solutions and fat emulsions accounted for only half of the
      recommended parenteral intake. Skin absorption of topical iodinated disinfectant
      may explain the adequate, if not excessive, iodine intake. We conclude that
      iodine is an unnecessary supplement in TPN solutions.

PMID- 1640293
TI  - Alpha-ketoglutarate dehydrogenase deficiency presenting as congenital lactic
      acidosis.
AB  - We report an inborn error of the tricarboxylic acid cycle, alpha-ketoglutarate
      dehydrogenase deficiency, in three siblings with hypotonia, metabolic acidosis,
      and hyperlactatemia immediately after birth. Neurologic deterioration resulted in
      death at about 30 months of age. We propose low molar ratios of ketone bodies in
      plasma of neonates with congenital lactic acidosis as an indication of
      dysfunction of the tricarboxylic acid cycle.

PMID- 1640294
TI  - Plasma glutamine concentration: a guide in the management of urea cycle
      disorders.
AB  - Because increases in plasma glutamine concentrations are almost always associated
      with hyperammonemia in patients with urea cycle disorders, we determined the
      correlation between these two variables for 2 years in a child with ornithine
      transcarbamylase deficiency. A correlation coefficient of 0.77 (p less than
      0.0001) was found. Hyperammonemia was rarely observed when plasma glutamine
      levels were near normal. These data suggest that one goal of therapy is the
      maintenance of plasma glutamine levels at or near normal values.

PMID- 1640295
TI  - Lactoferrin and lysozyme deficiency in airway secretions: association with the
      development of bronchopulmonary dysplasia.
AB  - To test whether the presence of airway inflammatory markers differentiated babies
      with hyaline membrane disease (HMD) who recovered (n = 18) from those in whom
      bronchopulmonary dysplasia (BPD) developed (n = 18), tracheal aspirate samples
      from 36 newborn infants with HMD who underwent intubation were collected during
      days 1 to 28 of life and analyzed for the mucosal antimicrobial proteins
      lactoferrin and lysozyme. For babies with HMD in whom BPD developed, lactoferrin
      concentrations were decreased during the first 4 days of life (7 +/- 3, 14 +/- 3,
      18 +/- 3, and 18 +/- 3 micrograms/ml, respectively) in comparison with those in
      babies with HMD who recovered (23 +/- 8, 29 +/- 6, 41 +/- 9, and 81 +/- 19
      micrograms/ml); group differences reached statistical significance on days 3 and
      4 (p less than 0.05). Lysozyme levels in the secretions of babies with BPD were
      also lower on day 3 (31 +/- 5 micrograms/ml) than in those of babies who
      recovered (54 +/- 7.5 micrograms/ml). For babies with BPD whose endotracheal tube
      remained in place beyond day 4, lysozyme levels on days 5 to 12 were
      significantly lower for those classified as having severe BPD than for those with
      mild to moderate BPD. Because lysozyme and lactoferrin are products of serous
      cells found in submucous glands, it seems possible that the relative immaturity
      of submucous glands may influence the development of BPD.

PMID- 1640296
TI  - Phospholipid and surfactant protein A concentrations in tracheal aspirates from
      infants requiring extracorporeal membrane oxygenation.
AB  - To test the hypothesis that infants with severe respiratory failure and the need
      for extracorporeal membrane oxygenation (ECMO) are surfactant deficient, we
      measured the amount of surfactant phospholipids, disaturated phosphatidylcholine,
      surfactant protein A, and protein in tracheal aspirates from 22 infants, who
      received ECMO therapy for respiratory failure with meconium aspiration syndrome
      (n = 18) or pneumonia (n = 4). Tracheal suction material was obtained in a
      standardized way every 4 hours during the period of ECMO treatment and pooled for
      24-hour periods. During ECMO, mean total phospholipid, disaturated
      phosphatidylcholine, and surfactant protein A values in tracheal aspirates
      increased and protein values decreased significantly, predominantly during the 72
      hour period before infants were weaned from ECMO. Of the 22 infants, 14 had an
      increase in tracheal aspirate phospholipid values of more than 200% and were
      found to need a shorter period of ECMO support (p less than 0.005) and post-ECMO
      ventilatory support (p less than 0.025) than did the eight infants with
      stationary or only moderate increases in tracheal aspirate phospholipid values,
      three of whom had pneumonia. We conclude that infants with respiratory failure
      who require ECMO treatment often have surfactant deficiency. We speculate that
      surfactant treatment might decrease the need for or the duration of ECMO support.

PMID- 1640298
TI  - Effects of intraventricular hemorrhage and socioeconomic status on perceptual,
      cognitive, and neurologic status of low birth weight infants at 5 years of age.
AB  - A prospective longitudinal study assessed the effects of intraventricular
      hemorrhage (IVH) and socioeconomic status on the perceptual, cognitive, and
      neurologic status of preterm infants at 5 years of age. The preterm group
      consisted of infants with no IVH, grade I to II IVH, and grade III to IV IVH; a
      control group of normal term infants was also studied. Outcome was evaluated at
      3, 4, and 5 years of age. Twenty-four percent of infants with grade III to IV IVH
      had abnormal neurologic diagnoses at 5 years of age. Correlations of predictor
      variables including IVH status, latency of visual evoked response, days of
      hospitalization, and socioeconomic status with 5-year neurologic outcome
      indicated that IVH status and visual evoked response at 1, 2, and 3 years
      continued to have an effect on neurologic outcome, but socioeconomic status and
      days of hospitalization did not; socioeconomic status did have a significant
      effect on the McCarthy cognitive scores but not on the perceptual scores at 5
      years. Multiple regression analyses revealed that duration of hospitalization
      (reflecting neonatal morbidity), visual evoked response, and socioeconomic status
      all have independent effects on the cognitive index, whereas only duration of
      hospitalization has an independent effect on the perceptual index. These data
      support the concept that a complex interaction of biologic and environmental risk
      factors determines the degree of recovery from IVH by high-risk preterm infants.

PMID- 1640297
TI  - Hyperkalemia in very low birth weight infants.
AB  - PURPOSE: To assess the frequency and pathogenesis of hyperkalemia in the very low
      birth weight infant. METHODS: Infants who weighed less than 1000 gm at birth were
      prospectively entered into the study within 12 hours of birth. Potential risk
      factors for hyperkalemia were assessed. Body weight, fluid and electrolyte
      balance, serum levels of sodium and potassium, creatinine clearance, fractional
      sodium excretion, and urine sodium/potassium ratio were measured every 8 hours
      for 72 hours. Measurements of plasma renin, serum aldosterone, and plasma atrial
      natriuretic factor were made at study entry and repeated when hyperkalemia (serum
      potassium greater than 6.5 mmol/L) occurred or at 72 hours. Infants in whom
      hyperkalemia developed were compared with those in whom it did not. RESULTS:
      Thirty-one infants completed the study; hyperkalemia developed in 16 (51.6%). The
      only difference in the occurrence of perinatal complications was the more
      frequent occurrence of pH less than 7.20 in infants with subsequent development
      of hyperkalemia. Creatinine clearance, urine output, and potassium excretion were
      significantly lower in the hyperkalemia group during the first 24 hours. Serum
      potassium concentration at 24 hours was inversely related to urine output in the
      prior 24 hours. Fractional sodium excretion, urine sodium/potassium ratio, and
      levels of renin, aldosterone, and atrial natriuretic factor did not differ
      between groups. CONCLUSIONS: Hyperkalemia is a frequent complication in very low
      birth weight infants. Infants with low urinary flow rates during the first few
      hours after birth are at greatest risk for the development of hyperkalemia.

PMID- 1640299
TI  - Adherence of human newborn infants' monocytes to matrix-bound fibronectin.
AB  - The localization of monocytes to sites of inflammation is mediated by
      interactions with extracellular matrix components including fibronectin, a
      nonimmune opsonin with binding sites for collagen, fibrin, heparin, and cell
      surfaces. This study demonstrates that newborn infants' monocytes bind to both
      gelatin (i.e., denatured collagen) and matrix-bound fibronectin to a degree
      comparable to that of adult-derived cells.

PMID- 1640300
TI  - Persistent hypertension after prenatal cocaine exposure.
AB  - Multiple blood pressure readings were obtained with time in 12 infants with
      documented in utero exposure to cocaine. Approximately half had hypertension or
      high-normal blood pressure with no evidence of renal, cardiovascular, or
      endocrinologic abnormalities.

PMID- 1640301
TI  - Blood-brain barrier permeability in "healthy" infected and stressed neonates.
AB  - The assessment of the blood-brain barrier permeability (BBBP) showed that BBBP
      values were higher in stressed neonates and those with bacterial meningitis than
      in "healthy" infants or neonates with aseptic meningitis. The BBBP determination
      may be helpful in differentiating bacterial from aseptic meningitis; the high
      BBBP should be considered in the management of stressed neonates.

PMID- 1640302
TI  - Acute toxic reaction to carbamazepine: clinical effects and serum concentrations.
AB  - The clinical spectrum of toxic effects and serum concentrations after ingestion
      of carbamazepine were studied in 82 pediatric patients. Serum carbamazepine level
      was related to the depth of coma (p less than 0.001), convulsions (p = 0.002),
      hypotension (p less than 0.001), and the requirement for mechanical ventilation
      (p less than 0.001). In 10 patients in deep coma with a Glasgow Coma Scale (GCS)
      of 3-4, the mean serum level was 213 mumol/L (range 143 to 343); seizures,
      ventilatory failure, or hypotension caused by myocardial failure and conduction
      defects were observed. In four of these, large doses of inotropic agents were
      required, one patient was treated with plasmapheresis, and two died--one of
      cardiac failure and one of aspiration pneumonitis. In 27 patients with moderate
      coma (GCS 5-8), the mean serum level of carbamazepine was 112 mumol/L (range 63
      to 176); convulsions were observed in two patients in this group. In 45 patients
      whose conscious state was mildly depressed or normal (GCS 9-15), the mean serum
      level was 73 mumol/L (range 37 to 128); additional effects were drowsiness (80%),
      ataxia (53%), nystagmus (38%), vomiting (17%), and dystonia (7%). I conclude that
      patients with serum carbamazepine levels of approximately 100 mumol/L require
      close observation, whereas those with levels greater than 150 mumol/L may require
      intensive life support.

PMID- 1640303
TI  - Randomized, controlled trial of antibiotic therapy for Escherichia coli O157:H7
      enteritis.
AB  - We undertook a prospective, controlled study to evaluate the effect of
      trimethoprim-sulfamethoxazole in children with proven Escherichia coli O157:H7
      enteritis on the duration fo symptoms, on fecal excretion of pathogen, and on the
      risk of progression to hemolytic-uremic syndrome. There was no statistically
      significant effect of treatment on progression of symptoms, fecal pathogen
      excretion, or the incidence of HUS (2/22 vs 4/25; p = 0.67). Our results suggest
      that a multicentric trial using rapid diagnostic methods to permit early
      randomization should be carried out.

PMID- 1640304
TI  - Use of ciprofloxacin in an infant with ventriculitis.
AB  - Ciprofloxacin was used successfully in a neonate with ventriculitis caused by a
      multiply resistant strain of Enterobacter cloacae. Limited pharmacokinetic data
      indicated that adequate concentrations of drug could be attained in cerebrospinal
      fluid.

PMID- 1640305
TI  - Hemodynamic responses to upright exercise of adolescent cardiac transplant
      recipients.
AB  - To characterize the hemodynamic response to exercise after cardiac
      transplantation, we asked seven adolescent transplant patients (aged 15.1 +/- 0.7
      years; mean +/- SE) to perform upright discontinuous exercise to volitional
      exhaustion on a mechanically braked cycle ergometer. Data were compared with
      those of seven control subjects matched for age, gender, body mass, percentage of
      fat, and body surface area. The transplant group had lower peak power output
      values (92 +/- 13 vs 146 +/- 30 watts; p less than or equal to 0.001) and maximum
      oxygen consumption values (22 +/- 8 vs 32 +/- 8 ml/kg per minute; p less than or
      equal to 0.03), despite achieving the same peak venous lactic acid concentration
      (6.2 +/- 3 vs 5.9 +/- 3 mEq/L; p = not significant). The transplant group had a
      diminished heart rate in response to exercise--44% lower than the control group
      had (delta = 49 +/- 6.4 vs 87 +/- 9.1 beats/min; p = 0.005). The cardiac output
      response to exercise was maintained in the transplant group (delta = 6.5 +/- 1.5
      vs 4.6 +/- 0.8 L/min; p = not significant) by an augmented stroke volume response
      (delta = 31 +/- 10 vs -4 +/- 3.4 ml; p = 0.01), which may relate to a greater
      decrease in systemic vascular resistance during exercise (delta = -13.7 +/- 2.2
      vs -6.3 +/- 1.2 Wood units; p = 0.02). Thus adolescents who have undergone
      cardiac transplantation have a normal cardiac output response to upright
      exercise. This is accomplished, despite a blunted heart rate response, by an
      augmented stroke volume that may relate to the greater decrease in systemic
      resistance during exercise.

PMID- 1640306
TI  - Eleven-year-old girl with acute renal failure, arthritis, hyperuricemia, and
      family history of rheumatic disorders.

PMID- 1640307
TI  - Unforgettable patients.

PMID- 1640308
TI  - Breast-feeding and maternal-infant transmission of human immunodeficiency virus
      type 1.

PMID- 1640309
TI  - Use of alveolar-arterial gradient as predictor of outcome in respiratory failure.

PMID- 1640310
TI  - Use of alveolar-arterial gradient as predictor of outcome in respiratory failure.

PMID- 1640311
TI  - Breast-feeding and urinary tract infections.

PMID- 1640312
TI  - IgG4 deficiency and recurrent respiratory infections.

PMID- 1640313
TI  - Adjustment to chronic disease in relation to age and gender: mothers' and
      fathers' reports of their childrens' behavior.
AB  - Investigated age and gender differences in adjustment to chronic disease in
      children suffering from one of five conditions: diabetes, asthma, cardiac
      disease, epilepsy, and leukemia. Ratings of adjustment and disease-related
      restrictions were obtained separately from mothers and fathers. Factor analysis
      of the adjustment scale yielded 6 subscales which differentiated between children
      in terms of age and disease type, and to a lesser extent, gender. Mothers' and
      fathers' ratings of adjustment and restrictions were comparable, though fathers
      made less differentiation on the basis of disease or age. For both parents,
      perceived restrictions of the disease were associated with poorer adjustment in
      the child, and this was particularly reflected on indices of peer relations and
      work.

PMID- 1640314
TI  - Psychosocial adjustment in juvenile arthritis.
AB  - Psychosocial adjustment in 102 children with arthritis, ages 4-16, and their
      families was assessed by parents, who completed the Child Behavior Checklist
      (CBCL) and Profile of Mood States (POMS). On average, parental distress (POMS)
      was lower than reference norms. POMS distress was correlated with children's
      behavioral problems (r = .41) but not with children's social competence (r =
      .15). General linear models explained 25% of the variance in CBCL behavioral
      problem scores. Older age was associated with more behavior problems in males,
      but not females. Disease severity and disease activity were also associated with
      behavioral problems. Although 27% of the variance in CBCL social competence could
      be explained, no single predictor variable was especially strong. Poorer social
      competence was associated with older age and shorter disease duration. Teenagers,
      especially those with recent onset and those with mild disease activity, may be
      at increased risk for psychosocial maladjustment.

PMID- 1640315
TI  - Maternal depression, assessment methods, and physical symptoms affect estimates
      of depressive symptomatology among children with cancer.
AB  - Investigated the incidence of depressive symptoms and their covariates in a
      sample of 99 children undergoing treatment for cancer and their mothers. Although
      the prevalence of depressive symptoms falling within the clinical range was low
      (7 to 8%), classification of these children was highly dependent upon the
      informant and instrument used. Interrater reliabilities did not differ from
      chance levels. Separate multiple regression analyses of the mother's and nurse's
      ratings of the child's level of depression, the child's self-report on the Child
      Depression Inventory, and the mother's responses to the Child Behavior Checklist
      depression scales revealed different statistical models for each method of
      assessment. However, increased severity of the mother's self-report of depressive
      symptoms on the Beck Depression Inventory, which was predicted by low perceived
      social support and hospitalization of her child, was associated with higher
      levels of child depression on all child- and parent-report measures. Parental
      adjustment, sociodemographic, and medical factors as well as methods of
      assessment must be addressed by models explaining the etiology of depressive
      symptoms among pediatric oncology patients.

PMID- 1640316
TI  - Family resources and stress: a comparison of families of children with cystic
      fibrosis, diabetes, and mental retardation.
AB  - Assessed patterns of stress in families of children with pediatric conditions
      that varied on 2 dimensions: (a) fatal vs. nonfatal outcome and (b) presence vs.
      absence of cognitive impairment. Families of children with cystic fibrosis (n =
      23), diabetes (n = 24), and moderate mental retardation (n = 24) were compared to
      families of well children (n = 24) in 3 age groups. Maternal responses to a
      multidimensional measure of family stress, the Questionnaire on Resources and
      Stress--Short Form (QRS-S), indicated that families of children with chronic
      conditions did not differ from families of well children on scales assessing
      generic aspects of family stress, such as family conflict. However, diagnostic
      groups differed on QRS-S scales assessing stressors specific to the child's
      disability (e.g., families of children with mental retardation were characterized
      by concerns about caring for the child as an adult). There was no evidence of
      higher levels of stress for families of older children. Data on the internal
      consistency of QRS-S scales and their relation to measures of maternal and child
      adjustment are presented.

PMID- 1640317
TI  - Measuring marital distress in couples with chronically ill children: the Dyadic
      Adjustment Scale.
AB  - The idea that couples with chronically ill children are particularly at risk for
      marital distress has been supported by clinical observation and empirical
      research. Three recent controlled studies, however, did not find evidence for
      this increased risk. A possible explanation for the discrepant findings is that
      these three studies employed Spanier's Dyadic Adjustment Scale (DAS) as a
      unidimensional measure of marital adjustment. To develop a better understanding
      of the discrepant findings of risk for marital distress in couples with
      chronically ill children, the present study examined both the appropriateness of
      the DAS's published norms as well as the criterion validity of the DAS for use in
      this population of couples. Three hundred and sixteen parents (158 couples) from
      a large urban pediatric health care setting completed a survey investigating
      interest and need to participate in an intervention program for marital distress.
      Results indicated that this instrument can reliably predict marital distress in
      this population of couples, however, mean DAS scores are higher than those
      established by Spanier.

PMID- 1640318
TI  - Emotional distress of mothers of hospitalized children.
AB  - Compared 20 mothers of children hospitalized on a pediatric intensive care unit
      (PICU), 20 mothers of children hospitalized on a general pediatric medical
      surgical unit, and 20 mothers of nonhospitalized ill children on standardized
      measures of anxiety and negative moods. The mothers of children admitted to the
      PICU experienced greater state anxiety, depression, confusion, and anger than the
      other mothers. There were no differences between the mothers of children admitted
      to the general pediatric floor and mothers of nonhospitalized ill children.
      Maternal age, family stress, number of prior hospitalizations of the ill child,
      and the mother's rating of the severity of her child's illness were predictive of
      emotional distress. Results indicate that hospitalization of a mildly or
      moderately ill child per se may not necessarily increase maternal emotional
      distress.

PMID- 1640319
TI  - Fetal intestinal transplantation: a new therapeutic approach in short-bowel
      syndrome.
AB  - Intraperitoneally transplanted fetal rat intestine can be anastomosed to the
      intestine of the host after 4 weeks of maturation. In syngeneic transplant
      combinations morphological findings as well as functional parameters suggest that
      the intestinal transplant might provide a substitute for normal intestinal
      tissue. Four weeks after fetal intestinal transplantation in adult Lewis rats we
      resected the total small bowel of the host and interposed the matured transplant.
      Resection of total small bowel without transplant interposition led to a decline
      of body weight in control animals but was prevented in the transplanted group.
      After total small bowel resection and cecectomy (a lethal resection in the
      control group) we found a 40% (4/10) survival in the group in which the
      transplant had been anastomosed to the remaining bowel.

PMID- 1640320
TI  - The effect of surgical trauma on the bacterial translocation from the gut.
AB  - Bacterial translocation is the passage of viable bacteria from the lumen of the
      gastrointestinal tract through the intestinal mucosa to other sites. It is
      believed that bacterial translocation may lead to infection and septicemia. The
      purpose of this study was to determine what factors in experimental surgical
      trauma lead to bacterial translocation. Two-month-old Wistar albino rats were
      divided into five groups: (A) control; (B) anesthesia (ether inhalation); (C)
      anesthesia and surgery (median laparotomy and transient compression of the
      intestines); (D) fasting only; and (E) anesthesia, surgery, and fasting. After 48
      hours, ileum, mesenteric lymph nodes, and blood were cultured for aerobic and
      anaerobic organisms. In each group the number of animals with bacteria overgrowth
      was calculated. The incidence of bacterial translocation to mesenteric lymph
      nodes and blood in groups B and D were similar to the controls (P greater than
      .01). There was a significant increase in the number of animals with bacterial
      translocation in groups C and E (P less than .001). The majority of translocating
      bacteria were E coli.

PMID- 1640321
TI  - Indomethacin administration after temporary ischemia causes bowel necrosis in
      mice.
AB  - Several reports have suggested indomethacin administration causes necrotizing
      enterocolitis (NEC) in infants. Few experimental studies have addressed this
      relationship. We studied the effects of indomethacin after temporary intestinal
      ischemia in CD-1 mice, using a previously reported method of simulating NEC in
      mice. This involved occlusion of both superior mesenteric vessels for 15 minutes.
      Three groups were studied. In group 1, 12 mice had superior mesenteric vessels
      occluded for 15 minutes, followed by intravenous (IV) administration of saline
      for three doses over 3 days. In group 2, 12 mice had sham laparotomy, without
      occlusion of vessels, followed by IV administration of indomethacin for three
      doses over 3 days. In group 3, 36 mice had mesenteric vessel occlusion for 15
      minutes, followed by IV administration of indomethacin for three doses over 3
      days. The results were as follows: group 1, bowel necrosis developed in 1 of 12
      animals (8%); group 2, all 12 animals survived without bowel damage (0%); and
      group 3, 22 of 36 animals developed bowel necrosis (61%) (Fisher's Exact Test:
      occlusion alone v occlusion and indomethacin, P = .002; indomethacin alone v
      occlusion and indomethacin, P = .00015.) We conclude that whereas occlusion alone
      or indomethacin alone does not cause bowel necrosis, temporary intestinal
      occlusion followed by indomethacin causes bowel necrosis in over 60% of animals
      studied. In the shocked preterm infant who may have suffered temporary intestinal
      ischemia, administration of indomethacin may be the second step to development of
      NEC.

PMID- 1640322
TI  - Intravascular haemolysis in association with necrotising enterocolitis.
AB  - Severe haemolysis is an unusual occurrence in association with necrotising
      enterocolitis (NEC). Activation of the Thomsen-Friedenreich (T) antigen on the
      neonatal erythrocytes is proposed as the mechanism. This haemolytic process is
      precipitated by transfusion with serum-containing blood products, which should
      therefore be avoided. Once haemolysis has become established the outcome is
      usually fatal. This report describes the management of four neonates who had
      established haemolysis complicating severe NEC. T activation was confirmed in two
      infants, but could not be tested for in the other two. Exchange transfusion
      abolished the haemolysis in two patients, who survived. Despite reduced use of
      blood products the other two infants died. We believe that exchange transfusion
      was essential in the successful management of the infants who survived, and
      recommend early exchange transfusion when haemolysis complicates NEC.

PMID- 1640323
TI  - Differences in phosphorylation state of neurofilament proteins in ganglionic and
      aganglionic bowel segments of children with Hirschsprung's disease.
AB  - Hirschsprung's disease is characterized by the absence of enteric neurons in the
      myenteric and submucosal plexus and the presence of many unmyelinated axons,
      visible in ganglion like structures, in the aganglionic part of the bowel. In
      previous studies we showed that the immunoreactivity of a monoclonal antibody
      (2F11) specific for neurofilament proteins is increased in aganglionic bowel
      segments. We now investigated whether the increased neurofilament protein
      staining results from an increase in neurofilament protein immunoreactivity in
      the aganglionic segment or if it is also related to differences in the
      phosphorylation state of neurofilament proteins. Bowel resection specimens of
      patients with Hirschsprung's disease and control patients were investigated by
      immunohistochemical techniques using a panel of different monoclonal antibodies
      that are specific for neurofilament proteins and have well known reaction
      patterns against different phosphorylated epitopes present on two neurofilament
      proteins, the middle (NF-M) and the high (NF-H) molecular weight subunit. For
      comparison the specimens were also stained for acetylcholinesterase, neuron
      specific enolase (NSE), S-100, and glial fibrillary acidic protein (GFAP).
      Immunostaining with this panel of antineurofilament-antibodies showed differences
      in the phosphorylation state of neurofilament proteins in the aganglionic and the
      ganglionic bowel segments of patients with Hirschsprung's disease. These changes
      involved the phosphorylation state of these proteins and the ratio of NF-H and NF
      M in neurofilament proteins. Staining with NSE and S-100 showed no significant
      differences between Hirschsprung's disease patients and control patients. We
      surmise that during the ingrowth and differentiation of hypertrophic axons the
      composition of neurofilament proteins formed in the aganglionic bowel segment
      differs from the neurofilament proteins formed in the ganglionic and control
      bowel segments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640324
TI  - Hirschsprung's disease: diagnosis using monoclonal antibody 171B5.
AB  - A new reliable immunohistochemical method for diagnosing Hirschsprung's disease
      (HD) using our unique monoclonal antibody (MAb) 171B5 against synaptic vesicles
      is described. Fresh frozen sections of rectal tissues were used from 13 patients
      with HD aged 2 weeks to 13 months; 9 had rectosigmoid HD and 4 had total colonic
      aganglionosis (TCA). Comparable normal colonic and rectal specimens were also
      obtained from 13 age-matched controls. All specimens were labeled with MAb 171B5,
      to demonstrate neuronal innervation patterns of both mucosa and submucosa. In all
      control specimens, many synapses arranged in variciform plexuses were seen in the
      lamina propria, a moderate number in the muscularis mucosae, and dense clusters
      in the submucosal plexus. In all aganglionic specimens, only scanty numbers of
      synapses which were not organized in variciform plexuses were seen in the lamina
      propria, none in the muscularis mucosae, and a few in the submucosa. These
      findings suggest that MAb 171B5 immunohistochemistry on the lamina propria alone
      can differentiate between normal and aganglionic bowel and appears to be a
      reliable and useful method for detecting HD on suction rectal biopsy.

PMID- 1640325
TI  - Mucosal neuroendocrine cell abnormalities in the colon of patients with
      Hirschsprung's disease.
AB  - We studied the distribution of mucosal neuroendocrine (NE) cells in the colon
      from 13 patients with Hirschsprung's disease (HD) and from 8 controls.
      Immunohistochemical studies were carried out using monoclonal and polyclonal
      antibodies against chromogranin A and synaptophysin (general markers of NE
      cells), 5-hydroxytryptamine (5-HT) (a marker of amine), peptide YY (PYY), and
      somatostatin (markers of neuropeptides). Chromogranin A immunoreactive cells were
      significantly increased in the aganglionic bowel compared with ganglionic bowel
      and controls (P less than .05). There was an increase in the number of
      synaptophysin immunoreactive cells in the aganglionic bowel compared with
      ganglionic bowel and controls but the results were not statistically significant.
      5-HT immunoreactive cells were also significantly increased in the aganglionic
      bowel compared with ganglionic bowel and controls (P less than .05). The
      immunostaining for PYY demonstrated abundance of this NE cell type in the
      aganglionic bowel and this was highly significant compared with ganglionic bowel
      and controls (P less than .001). There was a significant increase in somatostatin
      immunoreactive cells in the aganglionic bowel compared with ganglionic bowel (P
      less than .01). The increase in neuroendocrine cells was found over the entire
      length of the aganglionic segment in rectosigmoid HD as well as in long-segment
      HD. These results demonstrating the increased levels of NE cells in the mucosa of
      aganglionic colon suggest that the NE cells may have a role in regulating the
      sustained contraction of the aganglionic intestine in HD.

PMID- 1640326
TI  - A study of mucosal gut immunity in infants who develop Hirschsprung's-associated
      enterocolitis.
AB  - The aim of this study was twofold. First, to establish quantitatively the
      distribution of the immunoglobulin-containing (plasma) cells, T and B lymphocytes
      in the lamina propria of the rectal mucosa of normal neonates and neonates with
      Hirschsprung's disease (HD). Second, to review the neonates with HD to determine
      any differences in these cell populations between those who subsequently
      developed Hirschsprung's enterocolitis (HEC) and those who did not. Two
      conclusions can be drawn from the results of our study of rectal mucosal immune
      defenses. First, neonates with HD have no deficiencies in these defenses when
      compared with normal neonates. Second, neonates with HD who subsequently develop
      HEC have no premorbid deficiency in these defenses. It was noted that the pan-T
      cell count in the infants who went on to develop HEC appeared to be increased,
      although this did not reach statistical significance. The use of fresh or frozen
      material would permit a more detailed analysis of the separate T cell subsets.

PMID- 1640327
TI  - Paediatric liver transplantation: life after portoenterostomy in biliary atresia.
AB  - Seventy-five percent to 80% of patients with biliary atresia (BA) will be
      candidates for paediatric liver transplantation (PLTx) throughout the first 14
      years of life. They form the main group of recipients in our Paediatric Liver
      Transplant Unit. Of 48 children transplanted, 21 (44%) had BA. These patients
      present particular features, average weight of 12 kg, mean age of 3 years, and
      severe malnutrition prior to PLTx, which distinguish them from other paediatric
      candidates. With the advent of PLTx, portoenterostomy (PE) has ceased to be the
      only recourse for treating the majority of patients with BA. Different factors
      converge in these patients: some, including haemorrhage and adhesions, may
      present technical difficulties, and others, such as infections (19% in this
      series) due to severe malnutrition and malabsorption and consequent chronic
      rejection (14% in this series), often lead to death in the postoperative period
      (33% in this series). BA is treated by all paediatric surgeons, but the overall
      success rate now depends not only on PE but also on PLTx. In an attempt to
      facilitate possible later PLTx in pts with BA, the authors as paediatric surgeons
      performing PE or PLTx present surgical modifications and emphasize the most
      important medical aspects conducive to the improved general status of these pts.
      Our aim was to establish guidelines for taking full advantage of PE while
      preventing posterior problems and facilitating future transplant surgery.

PMID- 1640328
TI  - Symptomatic hemorrhoids and anorectal varices in children with portal
      hypertension.
AB  - There have been few reports of the anorectal problems encountered in children
      with portal hypertension. We report the incidence of anorectal symptoms in a
      retrospective study of 189 children treated by injection sclerotherapy for
      esophageal varices secondary to portal hypertension. Anorectal symptoms,
      proctoscopic findings and treatment have been recorded in this group. The
      incidence of symptomatic hemorrhoids and rectal varices was 4.2%. Hemorrhoids are
      rare in children and the increased incidence can be assumed to be secondary to
      portal hypertension. Treatment is advised only for symptomatic patients and
      injection sclerotherapy is satisfactory for the majority.

PMID- 1640329
TI  - A prospective analysis of vascular access device-related infections in children.
AB  - To identify significant predictors of device-related infections, we performed a
      prospective, nonrandomized analysis of our experience with vascular access
      devices over a 2-year period in a pediatric oncology population. Variables
      analyzed included: (1) age at placement, (2) sex, (3) underlying disease, (4)
      type of device used (catheter v port), and (5) total white blood cell count at
      placement. Quantitative microbiologic criteria were used for diagnosis of
      bacteremia while clinical and microbiologic criteria were used in diagnosis of
      tunnel/port/site infections. During the study period a total of 351 devices,
      comprising 78,159 days in situ, were placed and data for univariate and
      multivariate analysis were available on 271 (77%). The mean age at placement was
      7.2 +/- 4.7 years for catheters and 9.5 +/- 4.8 years for implantable devices (P
      less than or equal to .01). Significant predictors of device-related infections
      in univariate analysis were type of device (P less than or equal to .0001) and
      age (P less than or equal to .002). External catheters and age less than or equal
      to 7 years were associated with increased risk of infection. Underlying disease
      had a marginal effect on the infection rate (P = .08). In multivariate analysis,
      device type (P less than or equal to .0001) and age (P less than or equal to
      .002) continued to affect infections, whereas underlying disease demonstrated
      only a borderline effect (P = .14). We conclude that device type and age
      significantly affect the rate of device-related infections. These data support
      increased use of implantable devices in pediatric oncology patients.

PMID- 1640330
TI  - Experimental reovirus type 3-induced murine biliary tract disease.
AB  - The aims of this experiment were: (1) to establish a reovirus type 3-induced
      murine model of biliary atresia/neonatal hepatitis that as far as possible
      corresponds to the human disease; (2) to demonstrate that the disease is
      histologically similar to the human disease, and to investigate the natural
      history of reovirus type 3 infection in this model; (3) to study the host-virus
      interrelationships at a molecular level; and (4) to develop sensitive assays that
      could be translated to the human disease. In this study we were unable to produce
      an exact model for extrahepatic biliary atresia (EHBA) in the laboratory mouse
      following a perinatal reovirus type 3 infection. However, the ability of reovirus
      type 3 to persist in the murine liver and the effects produced in the offspring
      of infected pregnant mice indicate that this preparation may provide the basis
      for the eventual development of the experimental model of EHBA.

PMID- 1640331
TI  - Predicting preoperatively the outcome of respiratory symptoms of gastroesophageal
      reflux.
AB  - The fact that bronchopulmonary symptoms remain unchanged in about 15% of patients
      after successful operation for gastroesophageal reflux (GER) with respiratory
      tract disease (RTD) makes surgical indications uncertain and warrants further
      research into preoperative prognostic predictors. This problem has been addressed
      in infants by demonstrating that those most likely to be cured by antireflux
      procedures have long nocturnal episodes of GER and/or temporal coincidence
      between drops in pH levels and respiratory episodes. In an attempt to validate
      these predictors and, at the same time, to search for other reliable ones, we
      have retrospectively studied the charts, manometric studies, pH tracings, and
      pathology reports of 55 patients aged 48 +/- 36 months (range, 2 to 170) who had
      Nissen funduplication for GER with RTD in the last 10 years. Forty-five children
      were cured or improved of their RTD symptoms after operation, but in 10 (18%)
      they were unchanged in spite of the control of GER. Patients with a former
      history of vomiting (n = 38) had better results than those (n = 17) without it
      (95% of RTD cure v 53%, P less than .001). The success rate in children with
      recurrent obstructive airway disease (n = 20) was definitely lower than in those
      without it (n = 35) (70% v 89%, P less than .05). Neither esophageal manometry
      nor mucosal biopsy provided any predictive clue, but pH studies confirmed that
      the mean duration of nocturnal episodes of reflux (ZMD) was definitely longer in
      patients responding favourably to surgical cure of GER than in those in whom this
      failed (12.2 +/- 9.6 v 3.9 +/- 2.8 minutes, P less than .01).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1640332
TI  - Congenital esophageal stenosis due to tracheobronchial remnants: a rare but
      important association with esophageal atresia.
AB  - Congenital esophageal stenosis caused by tracheobronchial remnants occurred in
      eight children, six of whom had associated esophageal atresia and/or
      tracheoesophageal fistula. Symptoms usually began in early infancy but delayed
      diagnosis was a common feature. The mean lag period between presentation and
      definitive operation was 4.6 years (range, 1 month to 16 years). Errors in
      diagnosis were common. Six were initially diagnosed as having inflammatory
      strictures secondary to reflux esophagitis. Seven children were subjected to
      repeated esophagoscopy and bouginage of the "stricture" (mean no. = 3.4), with
      invariable failure to ameliorate dysphagia. Antireflux procedures were performed
      in three patients. In all children, symptoms were dramatically relieved following
      resection of the stenotic segment or esophageal replacement. Although a rare
      entity, congenital esophageal stenosis due to tracheobronchial remnants should be
      considered a possibility in patients with esophageal stricture, presumed to be
      inflammatory in nature, which fails to respond to standard therapy.

PMID- 1640333
TI  - A new oesophageal tube: assessment of collagen/vicryl composite membrane.
AB  - Collagen/vicryl composite membrane has been previously shown to be of use in an
      experimental model as a patch graft in the bladder and oesophagus. Attempts to
      use it as a circumferential tube graft have been unsuccessful due to the
      development of strictures at the site of anastomosis. We inserted a
      polytetrafluoroethylene (PTFE) stented collagen/vicryl bioprosthetic tube into
      rat omentum, which served as a vascular pedicle. Subsequent histology of the
      graft showed serial replacement of the bioprosthesis with host collagen and the
      development of a blood supply. In a second stage procedure, the bioprosthesis was
      anastomosed to the distal ileum and brought out on the skin to form a fistula.
      Squamous epithelium was subsequently identified growing the full length of the
      graft. Therefore, we have developed a vascularised bioprosthetic tube graft which
      will support the growth of unspecialised epithelium. This model could be of use
      in bridging congenital atresias or pathological strictures.

PMID- 1640334
TI  - Long-term endoscopic and flow cytometric follow-up of colon interposition.
AB  - During 1963 to 1978 colon interposition was performed on 20 children. Early and
      late mortality accounted for 3 patients and two transplants failed. Of the 15
      long-term survivors, subjective results were obtained from 12 patients 12 to 26
      years after the reconstruction. Three patients had an excellent subjective result
      and 9 had a good result. Nine patients underwent esophagogastroduodenoscopy 12 to
      26 years after the reconstruction. The endoscopic findings included: marked
      tortuosity or dilatation (6), pooling of bile or yellow bezoar (3), macroscopic
      colitis (3), and polyps in the distal anastomosis (2). Only two patients had a
      straight colon tube without mucosal changes or marked retention. Specimens for
      histology were obtained in each endoscopy. Colitis was found in 3 patients, 1
      patient had gastric metaplasia in the transplant, 1 patient had dysplasia of
      colonic mucosa and an inflammatory colonic polyp, and in 4 patients histology
      showed normal colonic mucosa. Flow cytometric samples were obtained from 8
      patients. Two showed an aneuploid cell population; the other 6 had normal diploid
      findings. Because of frequent endoscopic and histological changes, regular
      endoscopic follow-up of these patients is warranted.

PMID- 1640335
TI  - Pulmonary vascular abnormalities in experimentally induced congenital
      diaphragmatic hernia in rats.
AB  - In infants with congenital diaphragmatic hernia (CDH), abnormalities of the
      pulmonary arteries are present consisting of increased medial wall thickness and
      decreased external diameter. This forms the morphological substrate for
      persistent pulmonary hypertension, one of the leading causes of the high
      mortality in these patients. To elucidate the significance of these
      abnormalities, experimental models are required that mimic as close as possible
      the human situation. In our rat model we are able to study the hypoplastic CDH
      lungs extensively. In this study we performed a histological evaluation of the
      pulmonary arterial bed in the control group and the nitrofen-treated group in
      which the latter was divided into two subgroups, CDH and normal diaphragm. We
      examined the newborn rats after perfusion of the pulmonary arteries with barium
      gelatine and subsequent fixation. At the level of the respiratory bronchioles
      significant differences in the vessels were found consisting of decreased
      external diameter and increased wall thickness as percentage of the external
      thickness in CDH lungs compared with controls. Abnormal muscularization of the
      peripheral branches of the CDH pulmonary arteries was also found. We concluded
      that the rat model strongly resembles the human situation concerning the arterial
      bed in the lungs.

PMID- 1640336
TI  - Pathophysiology of congenital diaphragmatic hernia. III: Exogenous surfactant
      therapy for the high-risk neonate with CDH.
AB  - Exogenous surfactant therapy (EST) in surfactant-deficient premature infants has
      been shown to improve lung compliance, decrease morbidity, and improve survival.
      Reports have demonstrated that newborns with congenital diaphragmatic hernia
      (CDH) have lung compliance, pressure-volume curves, and hyaline membrane
      formation resembling those changes seen in surfactant deficient premature
      newborns. We hypothesize that EST may also benefit infants with CDH. All high
      risk cases of prenatally diagnosed CDH at Children's Hospital of Buffalo from
      November 1988 to February 1991 were prospectively evaluated for EST. In those
      families who chose to participate, the surfactant preparation, Infasurf (100
      mg/kg), was instilled into the newborn's lungs prior to the first breath. The
      remainder of the perinatal, neonatal, and surgical care was performed in a
      routine manner. Three high-risk prenatally diagnosed newborns with left CDH were
      treated with EST. All showed signs of decreased pulmonary compliance, but could
      still be adequately oxygenated and ventilated. Surgical correction was performed
      after stabilization and all required patch closures. Two of the three infants
      suffered no life-threatening episodes of pulmonary hypertension and all survived.
      These infants had many known indicators for poor outcome in CDH with an expected
      survival of less than 20%. We believe that EST in these neonates with CDH
      contributed to their survival with minimum morbidity. These results suggest that
      surfactant replacement for the high-risk neonate with CDH warrants further
      consideration and a randomized clinical trial is being planned.

PMID- 1640337
TI  - Prenatal diagnosis and clinical outcome of ovarian cysts.
AB  - Technical refinements of ultrasound (US) have greatly affected the antenatal
      diagnosis and treatment of ovarian cysts. From 1985 to 1990 25 consecutive
      fetuses with ovarian cysts were followed-up by US both during pregnancy and
      postnatally. All cases were diagnosed between the 28th and 39th weeks of
      gestation. Deliveries were all at term; cesarean section was required only for
      obstetric complications. Eight fetuses (32%) showed US patterns of cyst torsion,
      a finding confirmed at surgery in all. In five patients US patterns suggested
      complications postnatally that were also confirmed at operation. In six cases
      cysts increased or remained unchanged in size after 15 days of life: in 50% of
      these surgery showed ovarian torsion. In the remaining six cases spontaneous
      resolution occurred within 1 to 4 months. One patient required intrauterine
      needle aspiration. There were two cases of intestinal obstruction. To date, more
      than 60% of newborns with ovarian cysts require oophorectomy; however, different
      treatments (cystectomy, needle aspiration, uncapping) combined with a close US
      follow-up are likely to reduce this percentage.

PMID- 1640338
TI  - Advantages and pitfalls of amnion inversion repair for the treatment of large
      unruptured omphalocele: results of 22 cases.
AB  - This is a report of our experience with 22 cases of large unruptured omphaloceles
      treated by amnion inversion during the period 1973 through 1990. The method is
      characterized by three stages: (1) a silastic sheet is sutured directly to the
      skin around the amniotic membrane, under local anaesthesia, without dissection
      between the skin and the amnion; (2) the reduction of herniated viscera into the
      abdominal cavity is achieved by squeezing the sheeting using a specially modified
      stapler; and (3) the amniotic membrane is preserved intact, and inverted into the
      abdominal cavity at the time of abdominal wall closure. Of the 22 infants, 19
      survived with satisfactory results. Two patients died of multiple associated
      anomalies, and the remaining patient died of sepsis arising at the time of the
      final abdominal closure. This procedure has proved to be effective and safe for
      high-risk patients with congenital heart diseases, anal atresia,
      tracheoesophageal fistula, or bronchial stenosis and prematurity. The practical
      aspects of the procedure, as well as its advantages and pitfalls, are
      illustrated.

PMID- 1640339
TI  - Intestinal vaginoplasty for congenital absence of the vagina.
AB  - Congenital absence of the vagina is rare and occurs as a result of aplasia of the
      Mullerian ducts (46,XX) or complete androgen insensitivity syndrome (AIS--46,XY).
      Both syndromes are associated with normal female external genitalia and these
      patients are raised as females. These children are usually treated during
      adolescence with chronic dilatation of the shallow vaginal introitus (pressure
      tube technique) or by skin graft vaginoplasty (McIndoe procedure). Neither of
      these procedures is entirely satisfactory, as both may lead to neovaginal
      stenosis, inadequate length, poor lubrication, or all three. We have recently
      modified the operation first described by Baldwin in which a loop of sigmoid
      colon or small bowel is isolated, closed at one end, and brought down on its
      vascular pedicle as a neovagina and anastomosed to the hymenal ring. We have
      performed this operation on four adolescents (mean age, 15 years) and two infants
      (aged 4 days and 14 months) with excellent results (mean follow-up, 7.5 years for
      the adolescents and 1.8 years for the infants).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640340
TI  - Cloacal malformations: experience with 105 cases.
AB  - A personal experience with 105 cloacal malformations is described, showing the
      wide range of anatomy that can occur with the urogenital sinus, the vagina(s),
      and the rectum, as well as in the external features of the perineum. Follow-up is
      presented on 98 patients, excluding 4 who died preoperatively, 2 who are
      preoperative, and 1 lost to follow-up but never repaired. Fifty-seven patients
      had vesicoureteral reflux. Data are given on urinary control, bowel control, and
      sexual function for those who are now adults. Two have had babies. Operation
      often requires multiple positions, including the posterior sagittal approach,
      laparotomy, and lithotomy position. Isolated rectal pull-through should never be
      performed in these patients, because the urogenital aspects of the malformations
      are the most difficult to repair and are the most life-threatening to the
      patient. Six recent cases are presented to illustrate the breadth of the cloacal
      spectrum. In most of these patients a satisfactory functional result can be
      achieved for urinary and bowel control as well as sexual function.

PMID- 1640341
TI  - Fecal continence and quality of life in adult patients with an operated low
      anorectal malformation.
AB  - Fecal continence and quality of life were evaluated by a questionnaire in 83
      adult patients (mean age, 35 years; 53 women, 30 men) who underwent surgery for a
      low anorectal anomaly between 1947 and 1963. Fecal continence was assessed by a
      score described by Holschneider. Seventy-eight healthy people with similar age
      and sex distributions were used as controls. All controls had good fecal
      continence, 76% with completely normal bowel function. The aberrations in anal
      function found in 24% of the controls were minor, such as constipation or
      occasional slight smearing. Only 60% of the patients who had a low anorectal
      anomaly had good continence and completely normal bowel function was observed in
      15%. Male patients had a slightly better outcome than females. Social problems
      related to deficient fecal control were reported by 39% of the patients. In
      addition, 13% of the patients had difficulties in sexual functions. Other health
      problems were reported by 52% of the patients. Social or sexual problems
      associated with anal function were not reported by the control population; 6% of
      them had other health problems. The present controlled study shows that at the
      adult age, a significant proportion of patients with low anorectal anomalies
      suffer from deficient fecal control and a diminished quality of life.

PMID- 1640342
TI  - Long-term anorectal function in imperforate anus treated by a posterior sagittal
      anorectoplasty: manometric investigation.
AB  - Thirty imperforate anus patients were investigated by anorectal manometry 5 to 10
      years after a posterior sagittal anorectoplasty. Anal resting tone (ART) and anal
      squeezing pressure (ASP) were subnormal in most patients. Rectal volume (RV) and
      sensation to balloon distension were within the normal range. Rectoanal reflex
      inhibition was demonstrated in 9 of 30 patients. Soiling was more common in
      patients with a very low ART (less than 40 cm H2O) and a low ASP (less than 100
      cm H2O). Constipation was more common in patients with a large RV (greater than
      150 mL). Still, the correlation to clinical results was incomplete. As regards to
      the correlation to type of malformation the rectal atresia patients showed near
      normal results. The vestibular fistula patients were next in results showing
      rectoanal reflex inhibition in 5/6 patients. There was no difference in the
      results between bulbar and prostatic fistula patients.

PMID- 1640343
TI  - Sacrococcygeal teratoma in Sweden between 1978 and 1989: long-term functional
      results.
AB  - Thirty-four patients operated with sacrococcygeal teratoma in Sweden between 1978
      and 1989 were reviewed. Twenty-five children were available for functional follow
      up. The patients and their parents were interviewed for bowel and micturition
      habits. Fourteen patients from this number were subjected to anorectal manometry
      (56%). Fifteen children reported normal bowel habits (60%). In 10 patients (40%)
      soiling was observed. However, four of them were under 3 years of age and wearing
      diapers, which made the functional evaluation difficult. The manometries showed
      normal and resting tone and squeezing pressures in 10 patients and subnormal
      values in four patients who also had soiling problems. All investigated children
      showed normal rectoanal inhibition reflex. Twenty-one patients reported normal
      micturition, in four (16%) urinary incontinence was recorded. Two of the latter
      children required intermittent clean catheterization, one was on medication and
      the last one lives without any treatment. No difference in functional outcome was
      noted between patients with intrapelvic or extrapelvic tumor location.
      Retrospectively, it is not possible to know whether the observed functional
      outcome is due to tumor growth or the result of surgery. Preoperative clinical
      investigation and in some cases anorectal manometry and cystometry could
      theoretically resolve this problem.

PMID- 1640344
TI  - Colorectal carcinoma in children.
AB  - An increasing incidence of colorectal carcinoma has been noted at this
      institution. We report seven children with colorectal carcinoma. The average
      delay between onset of symptoms and diagnosis was 41/2 months, and in five
      patients distant metastases were present at the first operation. Initial symptoms
      were ignored in all cases and in only one was the serious nature of the condition
      realized at first presentation. In five lesions the histology was mucin secreting
      adenocarcinoma, a poor prognostic variant. All seven died on average 11 months
      after diagnosis. These three factors--delay in diagnosis, advanced stage of
      disease, and poorly differentiated histology--contribute overall to a poor
      prognosis in the young.

PMID- 1640345
TI  - Volatile sulfur compounds in mouth air from clinically healthy subjects and
      patients with periodontal disease.
AB  - Volatile sulfur compounds (VSC) in mouth air were estimated by gas
      chromatography. The amount of VSC and the methyl mercaptan/hydrogen sulfide ratio
      were significantly increased in patients with periodontal disease. These two
      parameters also increased in proportion to the bleeding index and probing depth.
      A study was also done on the effect of removal of tongue coating on VSC
      concentrations in mouth air from patients with periodontal involvement. VSC and
      the methyl mercaptan/hydrogen sulfide ratio were reduced to 49% and 35%,
      respectively, by removal of the tongue coating. The average amount of tongue
      coating removed from patients with periodontal disease was significantly higher
      than from controls (90.1 mg vs. 14.6 mg, p less than 0.01). Estimated production
      of VSC from tongue coating was 4 times higher than the control value, and the
      methyl mercaptan/hydrogen sulfide ratio was also markedly increased. However, a
      saliva putrefaction study suggested that saliva does not contribute to the
      elevated ratio of methyl mercaptan in mouth air. These results strongly suggest
      that, in addition to periodontal pockets, tongue coating has an important role in
      VSC production, in particular leading to an elevated concentration of methyl
      mercaptan, which is more pathogenic than hydrogen sulfide.

PMID- 1640346
TI  - A re-evaluation of the distribution of the elastic meshwork within the
      periodontal ligament of the mouse.
AB  - The elastic properties of the periodontal ligament have been attributed, in part,
      to oxytalan fibers, as no other types of elastic fibers are described there. It
      has been difficult to study the periodontal elastic meshwork by standard
      microscopic techniques because it is partially obscured by the adjacent
      periodontal ligament collagen fibers. Our study employed methods which either
      completely or partially removed mandibular molar periodontal ligament collagen
      fibers, exposing a previously undescribed periodontal elastic meshwork. The
      periodontal elastic meshwork was composed of many elastin lamellae containing
      both peripheral microfibrils of regular arrangement and central microfibrils of
      irregular arrangement, which could only be demonstrated in oxidized tissues.
      Peripheral, regularly arranged bundles of microfibrils resembled oxytalan fibers,
      which were often adherent to the border of the elastin lamella. Elastin lamellae
      containing irregular microfibrils resembled elaunin fibers. These fibers probably
      enclosed either blood vessels, nerves or collagen fiber bundles. Peripheral
      microfibrils attached elaunin to cementum, alveolar bone, blood vessels, and
      principal periodontal collagen fibers. Thus, the periodontal elastic meshwork is
      composed of both oxytalan and elaunin fibers. Microfibrils attach elaunin fibers
      to the adjacent non-elastic tissue and also form bundles which traverse the
      periodontal ligament space and are probably the oxytalan fibers demonstrable by
      light microscopic techniques. This meshwork of oxytalan and elaunin fibers
      probably contributes to tooth support and maintenance of periodontal homeostasis
      by dissipating chewing forces and maintaining patency of periodontal blood
      vessels.

PMID- 1640347
TI  - Effect of interleukin-1 beta on gene expressions and functions of fibroblastic
      cells derived from human periodontal ligament.
AB  - The present study shows the effect of interleukin-1 beta (IL-1 beta) on some gene
      expressions and functions of fibroblastic cells (HPLF) derived from human
      periodontal ligament. HPLF were used at passages number 5 to 10. IL-1 beta
      increased DNA synthesis in both a dose- and an incubation time-dependent manner.
      IL-1 beta in combination with tumor-necrosis factor alpha or transforming growth
      factor beta synergistically stimulated the DNA synthesis in the cells. Since many
      studies have shown that the c-myc oncogene is involved in cell proliferation and
      differentiation, the effect of IL-1 beta on c-myc messenger RNA (mRNA) level in
      HPLF was examined. IL-1 beta induced a marked c-myc mRNA level in the cells at 90
      minutes after initiation of the cytokine treatment. On the other hand, IL-1 beta
      significantly inhibited alkaline phosphatase (ALP) activity of the cells in a
      dose-dependent manner. Also an inhibitory effect was observed on the
      liver/bone/kidney ALP mRNA level of the cells, and this inhibition by IL-1 beta
      was dose- and incubation time-dependent. These results suggest that IL-1 beta is
      a regulatory cytokine involved in the regeneration of the human periodontal
      ligament.

PMID- 1640348
TI  - Ultracytochemical localization of basal lamina anionic sites in the rat
      epithelial attachment apparatus.
AB  - The basal lamina anionic sites of the epithelial attachment apparatus (EAA) were
      investigated at the electron microscopic level in adult rat periodontium. After
      1M NaCl junctional epithelium detachment, an irregular and fluffy basal lamina
      like structure appeared to cover the cementum surface. This structure reacted
      positively with polyethyleneimine (PEI), a strongly cationized ultrastructural
      tracer, appearing to be composed of highly electron-dense microaggregates.
      Depending on section plane, double-tracked structures of undefined length were
      found within PEI precipitates and closely related to cementum collagen fibrils.
      After nitrous acid de-N-sulphation, 8 nm wide sets of two parallel lines were
      clearly identified. "Double tracks", i.e., sets of paired lines with peripherical
      PEI electron-dense material, were found to self-assemble to form dimers, clusters
      or more complex organizational patterns. From sensitivity towards nitrous acid
      oxidation and positive control observations, it was concluded that basal lamina
      anionic sites in the EAA, represented by PEI microaggregates, contain heparan
      sulfate proteoglycans (HSPGs). Furthermore, high resolution ultrastructural
      images demonstrated that HSPGs adopt a morphological appearance of "double
      tracks" in the tissue. On the other hand, the present findings suggest that HSPGs
      clusters, never found in the mucosal basement membrane used as positive control,
      may be related to a functional specificity of the tissue at the dento-gingival
      junction.

PMID- 1640349
TI  - Numbers and vitality of leukocytes in pocket washings of untreated periodontitis
      lesions in humans utilizing a novel intracrevicular lavage technique.
AB  - The purpose of the present study was to develop an intracrevicular lavage
      technique, and to use it for assessment of the total number and % of vital
      leukocytes from untreated periodontitis pockets. A lavage device was developed,
      consisting of specially crafted cannulas, a vacuum pump and a charge amplifier.
      In vivo evaluations showed that there was a linear relationship between lavage
      time and lavage volume; 2-6 lavage samples were obtained from each of 20 patients
      with untreated advanced periodontitis, and the lavage time was measured in a
      subsample of 16 pockets. The lavage fluid was centrifuged, and the supernatant
      was separated from the cellular components. The cells were vital-stained using
      two methods, trypanblue exclusion method (TB) and ethidium-bromide fluorescein
      diacetate stain (EB-FDA). Numbers of vital and non-vital leukocytes per sample
      were assessed using a Neubauer chamber. The number of erythrocytes per sample was
      evaluated using the same counting method. The results included 95 samples
      obtained from the 20 patients: 76% of all samples ranged in pocket depth between
      4 and 8 mm. The lavage technique provided an overall mean lavage volume of 282.37
      microliters in an average time of 16.44 seconds. The mean number of leukocytes
      per sample was 22.20 x 10(3) (TB) and 24.48 x 10(3) (EB-FDA). Percent vital
      leukocytes were 72.27 (TB) and 72.63 (EB-FDA). EB-FDA had a lower counting error
      than TB. The low erythrocyte counts per sample suggested that subgingival
      bleeding during sampling was negligible. Spearman correlation coefficients showed
      weak associations between pocket depth and leukocyte counts, % of vital
      leukocytes and erythrocytes. Due to the short sampling time this new
      intracrevicular sampling technique permits sampling of pockets before the tissue
      responds to the stimulus of the lavage device, and provides subgingival washings
      with high numbers of leukocytes.

PMID- 1640350
TI  - Platelet-derived and insulin-like growth factors stimulate regeneration of
      periodontal attachment in monkeys.
AB  - Regeneration of cementum, ligament, bone and new attachment was achieved by
      introducing mixtures of recombinant human platelet-derived growth factor and
      insulin-like growth factor into debrided lesions of experimentally induced
      periodontitis in monkeys. This growth factor therapeutic regimen induced the
      regeneration of nearly 50% of the lost attachment within 4 weeks. New attachment
      in some cases included regeneration of horizontally resorbed interdental septa.
      These observations suggest that predictable, clinically significant gains in new
      attachment may be possible through the use of highly purified human recombinant
      growth factors delivered to debrided lesions of adult periodontitis in
      appropriate, inert carrier vehicles.

PMID- 1640351
TI  - Epidermal growth factor expression in junctional epithelium of rat gingiva.

PMID- 1640352
TI  - Acute response of periodontal ligament blood flow to external force application.

PMID- 1640353
TI  - Influence of age-dependent pharmacokinetics and metabolism on acetaminophen
      hepatotoxicity.

PMID- 1640354
TI  - Pharmacokinetics of cyclosporine in bone marrow transplantation: longitudinal
      characterization of drug in lipoprotein fractions.
AB  - The pharmacokinetics of cyclosporine (CSA; 2 mg/kg given iv over a period of 2 h
      every 12 h) in whole blood, plasma, high-density lipoproteins (HDL), and low
      density lipoproteins (LDL) were studied after single (n = 10) and multiple (31
      days; n = 6) doses in patients receiving allogeneic bone marrow transplants.
      Whereas HDL-cholesterol levels decreased significantly, LDL-cholesterol levels
      increased from day 1 to day 31 of CSA dosing. The mean area under the
      concentration-time curve and half-life values of CSA in whole blood or total
      plasma did not differ after single or multiple doses. Greater amounts of CSA were
      contained in the HDL relative to the LDL fraction over the 24-h period after a
      single dose; the reverse was found after multiple dosing. Cyclosporine was not
      detectable in the very LDL fractions. The percentage of total plasma CSA
      contained in each lipoprotein fraction was independent of the concentration of
      CSA in total plasma or whole blood. The pharmacokinetics of CSA in the various
      biologic matrices were not associated with measurements of kidney and liver
      function. Taken together, the variability of CSA pharmacokinetics previously
      reported in whole blood or total plasma was also found in lipoprotein fractions.
      The relative changes in CSA content of lipoproteins may offer an explanation for
      differences in drug effect with multiple dosing.

PMID- 1640355
TI  - Erythrocytes as a total barrier for renal excretion of hydrochlorothiazide: slow
      influx and efflux across erythrocyte membranes.
AB  - The potential barrier effect of erythrocytes (RBC) on renal excretion (mainly by
      tubular secretion) of hydrochlorothiazide (HCTZ) was evaluated in nine
      anesthetized rats during steady-state iv infusion. Drug concentrations in plasma
      and blood from the carotid artery and renal vein were assayed by a simple
      modified HPLC method. Renal extraction ratios were concentration-independent with
      a mean of 0.17 +/- 0.05 (SD). The renal excretion was found to occur primarily
      from the drug in plasma; the mean net fractional removal from plasma was 0.57 +/-
      0.12, while that from RBC was less than 0.008 +/- 0.041. The virtual total
      unavailability of HCTZ from RBC (containing approximately 70% of drug in arterial
      blood) for renal excretion is attributed to relatively slow efflux of drug from
      RBC to plasma during each passage through the kidney compared with the blood
      transit time (in seconds). Preliminary in vitro influx and efflux kinetics of
      HCTZ across RBC membranes were studied using rat and human blood. The flux data
      could be adequately described by a linear, reversible, closed two-component
      system model, and the mean equilibration half-times (ET1/2) in rat and human
      blood were 10.9 and 20.5 min, respectively. The mean residence time of drug in
      blood circulation of rats was estimated to be 8.32 +/- 1.06 min, which is shorter
      than the ET1/2. This is consistent with data indicating that distribution
      equilibrium of HCTZ in arterial blood might not be reached in vivo even at steady
      state. Other implications of slow transport kinetics of drugs across RBC
      membranes are discussed.

PMID- 1640356
TI  - Effect of nasolacrimal occlusion on timolol concentrations in the aqueous humor
      of the human eye.
AB  - We studied the effect of manual nasolacrimal occlusion on the concentration of
      timolol in the aqueous humor of eyes of patients undergoing cataract extraction.
      Aqueous humor samples were obtained at various times after timolol maleate
      instillation from patients with or without 5 min of nasolacrimal occlusion;
      aliquots were assayed by HPLC. In patients receiving occlusion treatment, average
      timolol concentrations were statistically greater than those in control patients
      both between 15 and 90 min after instillation and also at 180 min.
      Pharmacokinetic analysis indicated that occlusion increased the concentration of
      timolol in the aqueous humor 1.7 times. In both groups, timolol concentrations
      were highest approximately 1 h after instillation. The decline in aqueous humor
      timolol concentrations occurred at similar rates in both groups.

PMID- 1640357
TI  - Human pharmacokinetics of ibuprofen enantiomers following different doses and
      formulations: intestinal chiral inversion.
AB  - The influences of absorption rate and dosage size on the pharmacokinetics of
      ibuprofen (IB) enantiomers were studied in six healthy subjects. Rapidly absorbed
      solutions (50, 100, 200, 400, 600, and 1200 mg) and regular 600-mg tablets of
      racemic IB were given orally, and plasma concentration-time courses of the
      enantiomers were followed. Solutions were absorbed faster (tmax less than 0.25 h)
      than the tablet (tmax = 2.17 +/- 1.17 h). While the S:R AUC ratios were
      unaffected by increasing the dose, they were significantly greater after the
      tablet (1.35 +/- 0.14) as compared with the solutions (1.15 +/- 0.16 to 1.24 +/-
      0.26). This indicates a greater extent of chiral inversion for the tablet,
      perhaps due to a longer residence time in the gut, thereby allowing more
      presystemic inversion. To test this hypothesis, R-IB was incubated at 37 degrees
      C in the presence of excised segments of human ileum and colon obtained from
      three patients. Chiral inversion was evident in all segments. After 3 h, the
      extent of inversion ranged from 20.0 to 33.0%. In addition, incubation resulted
      in the formation of up to 23.3 and 13.0% of acylglucuronides of S- and R-IB,
      respectively. In all subjects, the AUC-dose relationships were nonlinear,
      indicating a gradual increase in the clearance of both enantiomers due, perhaps,
      to a parallel saturation of plasma protein binding sites. In humans, the chiral
      inversion of IB is not influenced by the dosage size but is enhanced by
      prolongation of the residence time in the intestine.

PMID- 1640358
TI  - Stereoselective hydrolysis of O-acetyl propranolol as prodrug in rat tissue
      homogenates.
AB  - The stereochemical characteristics of the hydrolysis of O-acetyl propranolol were
      studied using phosphate buffer (pH 7.4), rat plasma, and rat tissue homogenates.
      In the phosphate buffer, no difference was observed in the hydrolysis rate
      between the esters of (R)- and (S)-propranolol. In rat plasma and tissue
      homogenates, hydrolysis of the ester was both accelerated and stereoselective.
      Hydrolysis of O-acetyl (R)-propranolol was five times faster than that of the (S)
      isomer in rat plasma. However, in the liver and intestine homogenates, the (S)
      isomer was hydrolyzed faster than the (R)-isomer. Interconversion between the (R)
      and (S)-isomers was not observed under the experimental conditions. The same
      stereoselective hydrolysis was also observed with racemic O-acetyl propranolol.
      However, observed rate constants for the hydrolysis were lower than those for the
      pure isomers. These results indicate that enzymatic hydrolysis of O-acetyl
      propranolol occurred stereoselectively and the selectivity of the plasma enzyme
      was different from those of liver and intestine enzymes.

PMID- 1640359
TI  - Pharmacokinetic-pharmacodynamic modeling: time-dependent protein binding--an
      alternative interpretation of clockwise and counterclockwise hysteresis.
AB  - Development of effect compartment model theory has greatly enhanced our
      understanding of the relationship between pharmacokinetics and pharmacodynamics.
      When effect versus concentration in serum (usually total concentration) is
      plotted and counterclockwise hysteresis is observed, an initial disequilibrium
      between receptor(s) and serum is generally presumed and an effect compartment
      model is used; alternatively, clockwise hysteresis may infer tolerance, which may
      be characterized by an adaptation model. In this simulation study, the influence
      of time-dependent binding to serum protein on the relationship between effect and
      concentration in serum was investigated. In these simulations, time-dependent
      protein binding occurred as a result of an increase in protein concentration in
      serum or displacement by a metabolite. When concentration of free drug in serum
      was responsible for the pharmacological response, and response versus total drug
      concentration in serum was plotted, counterclockwise hysteresis, consistent with
      an effect compartment, occurred with a time-dependent decrease in binding to
      serum protein. Clockwise hysteresis, consistent with tolerance, occurred with a
      time-dependent increase in binding to serum protein. For both sets of
      simulations, no hysteresis was observed when response was plotted against
      concentration of free drug in serum. These results indicate that, when response
      is related to concentration of free drug, measurement of concentration of free
      drug may allow a clearer interpretation of the pharmacokinetic-pharmacodynamic
      relationship.

PMID- 1640360
TI  - Effect of basic cholane derivatives on intestinal cholic acid metabolism: in
      vitro and in vivo activity.
AB  - A representative series of hydroxy-5 beta-cholanyl-24-amines were tested both in
      vitro and in vivo with respect to their activity against the intestinal bacteria
      responsible for bile acid metabolism. For the in vitro studies, radiolabeled
      [14C]cholic acid was incubated with human stools both in aerobic and anaerobic
      conditions in the presence of the title compounds at a dose of 10 micrograms/mL,
      and the biotransformation of cholic acid into radiolabeled deoxycholic acid and
      other metabolites was followed by TLC-radiochromatography. Of the compounds
      studied, 3 alpha, 12 alpha-dihydroxy-5 beta-cholan-24-N-methylamine showed the
      highest activity. This compound was used for the in vivo studies and was shown to
      inhibit the formation of endogenous secondary bile acids when chronically
      administered to rats at a dose of 60 micrograms/day for 15 days. The treated rats
      showed an increased ratio of taurocholic acid (primary bile acid) to
      taurodeoxycholic acid (secondary bile acid) in bile, a fact further suggesting a
      potent antibacterial activity of the compound toward bacteria responsible for
      bile acid metabolism.

PMID- 1640361
TI  - Pharmacokinetic studies of N-butyric acid mono- and polyesters derived from
      monosaccharides.
AB  - The pharmacokinetics of seven butyric esters derived from monosaccharides were
      studied after iv administration of a bolus dose to rabbits. Results obtained
      showed that a constant plasma level of butyric acid is maintained due to the slow
      disappearance of butyric acid esters from the plasma in contrast to the case of
      salts, such as arginine butyrate, which are rapidly cleared. The maintenance of
      these covalent compounds in the body can increase concentrations of n-butyric
      acid in the tumor area for more efficient chemotherapy. These results seem to be
      directly related to the in vitro anticellular activity of butyric esters and the
      prolonged therapeutic protection in tumor-bearing animals.

PMID- 1640362
TI  - Performance of a modified starch hydrophilic matrix for the sustained release of
      theophylline in healthy volunteers.
AB  - Two experimental formulations of theophylline with a hydrophilic starch matrix
      were evaluated for their sustained-release characteristics after single
      administration in healthy human volunteers. Theo-dur was chosen as a reference
      sustained-release formulation. In a first study, the extent of absorption was
      similar for a syrup, for Theo-dur, and for the experimental formulation of
      theophylline with 70% drum-dried corn starch as the sustained-release agent (DDCS
      70). The maximal plasma concentration (Cmax) was significantly lower, and the
      time to reach Cmax as well as the time span during which the plasma concentration
      was at least 75% of the Cmax were significantly higher for Theo-dur than for the
      DDCS-70 formulation. A sustained-release profile, as for Theo-dur, was not
      reached for DDCS-70. In a second study the influence of the starch:drug ratio on
      the bioavailability was investigated. The decrease in starch content from 70 to
      50% of the formulation did not improve the plasma concentration-time profile
      towards a sustained-release profile.

PMID- 1640363
TI  - Liposomes containing fluorinated steroids: an analysis based on photon
      correlation and fluorine-19 nuclear magnetic resonance spectroscopy.
AB  - Small unilamellar liposomes containing fluorinated steroids (flumethasone and
      dexamethasone) were obtained. A physicochemical evaluation was conducted based on
      photon correlation spectroscopy (PCS) and fluorine-19 (19F) nuclear magnetic
      resonance (NMR) spectroscopy compared with standard biochemical methods (HPLC).
      The PCS method provides a fast and adequate evaluation of some critical features
      of liposomes (size, physical stability). In addition, 19F NMR spectroscopy gives
      substantial information, in a nondestructive manner, on steroid behavior in the
      membrane upon encapsulation and also when the temperature of liposomes is
      increased. The combined spectroscopic approach proposed here might prove useful
      in (1) the management of liposomal formulation, especially in the documentation
      of physicochemical properties, (2) pharmaceutical control in the industrial
      production line, and (3) control preceding injection at the clinical site.
      Spectroscopic techniques might offer a complementary approach to classical
      biochemical methods in the evaluation of the properties of a liposomal
      formulation and could be usefully integrated into quality control procedures.

PMID- 1640364
TI  - Propranolol disposition in the rat: variation in hepatic extraction with unbound
      drug fraction.
AB  - The plasma protein binding of propranolol has been described as nonrestrictive
      for its hepatic extraction to explain the observation that propranolol is
      efficiently removed by the liver, in spite of extensive protein binding. The
      present study was designed to examine the relationship between propranolol
      protein binding, metabolism by isolated hepatocytes, and extraction by the
      isolated perfused rat liver. In isolated hepatocytes, the intrinsic clearance of
      free drug increased three- to fourfold as albumin and alpha 1-acid glycoprotein
      (AAG) concentrations increased, suggesting that albumin and AAG facilitate the
      elimination of propranolol by hepatocytes. In the isolated perfused liver,
      propranolol extraction was almost complete (E = 0.996) in the absence of albumin
      and AAG. With 40 g/L of albumin and 2 g/L of AAG in the perfusate, the free
      fraction of propranolol decreased to 0.031, but extraction remained high (E =
      0.960). With 40 g/L of albumin and 10 g/L of AAG in the perfusate, the free
      fraction further decreased to 0.014 and extraction dropped sharply (E = 0.820).
      The observed relationship between propranolol extraction and the free fraction of
      propranolol was in good agreement with that predicted using estimates of
      intrinsic clearance measured in isolated hepatocytes suspensions. These data
      indicate that propranolol extraction is sensitive to changes in binding at very
      low free fraction values and suggest a facilitation of propranolol clearance by
      albumin and AAG.

PMID- 1640365
TI  - Factors affecting in vitro protein binding of etoposide in humans.
AB  - Clinical studies have demonstrated that the plasma protein binding of etoposide,
      a widely used anticancer drug, is extensive (approximately 94%), highly variable
      among patients (10-fold range), and significantly related to serum albumin and
      total bilirubin concentration. The present study was designed to more thoroughly
      evaluate factors likely to affect etoposide protein binding under controlled in
      vitro conditions where single variables could be changed. Protein binding was
      determined using an equilibrium dialysis method with tritiated etoposide. The
      binding of etoposide was similar in serum or plasma, and heparin had no effect on
      binding. Etoposide binding decreased with increased pH, but no clinically
      significant difference was noted within the range of physiologic pH. Etoposide
      binding evaluated in single-source donor plasma was concentration-dependent over
      a concentration range of 1 to 250 micrograms/mL. Etoposide binding parameters
      determined in normal human plasma were characterized by a single class of binding
      sites of moderate affinity (K = 2.88 +/- 0.47 x 10(4)) and high capacity (nP =
      5.07 +/- 0.5 x 10(-4); where n is the number of binding sites). The etoposide
      binding ratio was significantly correlated with albumin concentration (r2 = 99%,
      p less than 0.05). The characteristics of etoposide binding in a 4.0-g/dL
      solution of human serum albumin (K = 3.56 +/- 1.22 x 10(4) and nP = 5.58 +/- 0.16
      x 10(-4)) suggest that the single class of binding sites is on albumin. Bilirubin
      caused a significant decrease in K, consistent with competitive binding, but only
      at higher bilirubin concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640366
TI  - Experimental studies of transient mass transfer and reaction in the liver:
      interpretation with a heterogeneous compartment model.
AB  - The uptake and metabolism of lipophilic compounds by the liver were studied by
      administering a model compound, lidocaine, to the isolated rat liver. Lidocaine
      was continuously infused into the liver until steady state was reached.
      Subsequent step changes in the inlet concentration were used to obtain
      information on rates of cellular uptake and release and to assess the extent of
      mixing within the organ. A simple heterogeneous model combining mass transfer and
      enzyme reactions was required to simulate the effluent levels of lidocaine and
      two primary metabolites, monoethylglycinexylidide and 3-hydroxylidocaine. The
      rate constants for uptake and release of lidocaine were 1200 and 46 min-1,
      respectively. The rate-limiting step was intracellular reaction, with a rate
      constant of 0.49 min-1. Although the rate of lidocaine uptake was fast, it was 50
      times slower than the rate of facilitated uptake of galactose, a fact suggesting
      passive transport of lidocaine between the tissue and the vasculature. The rates
      of mass transfer of lidocaine and its metabolites differed, but the ratios of the
      rate of uptake to the rate of release were the same. The results suggested that
      all three species had an affinity for the cellular region of the liver;
      concentrations in tissue were approximately five times greater than
      concentrations in effluent. Because of the large capacity of the organ for uptake
      of lidocaine and its metabolites, concentrations from washout experiments were
      controlled by linear mass transfer from the tissue.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1640367
TI  - An extended version of a novel method for the estimation of partition
      coefficients.
AB  - Using the semi-empirical AM1 method, 302 compounds have been studied and
      equilibrium properties calculated. Functions based on linear combinations of
      subsets of calculated properties have been fit to the 1-octanol-water partition
      coefficients. The best such semi-empirical approach function has 18 parameters,
      has a standard deviation of 0.306, and seems to describe the partition
      coefficients of the 302 compounds. The predictive power of the function was
      tested and found to be good. Since this new version is based on a much larger
      number of, and structurally more varied, compounds and uses an improved, new
      function, we expect it to be a very useful method to predict partition properties
      of a wide variety of compounds.

PMID- 1640368
TI  - Dissolution of fludrocortisone from phospholipid coprecipitates.
AB  - The physical properties and dissolution behavior of phospholipid coprecipitates
      of fludrocortisone acetate (FA) prepared from ethyl acetate, as well as the
      effect of added polymer, have been determined. The fraction dissolved after 90
      min and the initial dissolution rate (IDR) of coprecipitates containing
      dimyristoyl phosphatidylcholine (DMPC) (4:1, w/w; FA:DMPC) were 77% and 3.5-fold
      greater than for FA at pH 2.0 and 37 degrees C. The mechanisms of dissolution
      were similar to those previously established for griseofulvin, but no aging
      occurred over 4 months at room temperature in a desiccator. The addition of 0.01
      mol% of dextran (MW = 2 million) or 0.1 mol% of poly(lactic acid) reduced the
      fraction of FA dissolved in 90 min by 15% and reduced the IDR by 35%. The
      addition of poly(vinylpyrrolidone) (PVP) resulted in a minimum of dissolution
      efficiency at 1 mol% of PVP 10 (MW = 10,000) or PVP 24 (MW = 24,000) and at 0.1
      mol% PVP 40 (MW = 40,000). Only PVP 24 influenced the melting point and heat of
      fusion of the coprecipitates (determined by differential thermal analysis).
      Coprecipitate dissolution was reasonably described by either second-order or
      Weibull distribution kinetic models. These results support the application of
      high drug-containing solid dispersions using phospholipids to increase the
      dissolution behavior of poorly water-soluble drug solvates and the possibility of
      modifying drug release by the incorporation of small amounts of polymers.

PMID- 1640369
TI  - First-derivative spectroscopic determination of binding characteristics of
      rifampicin to human albumin and serum.
AB  - A first-derivative spectroscopic method for the simultaneous determination of
      bound and unbound drug in human serum and serum albumin solution was developed.
      As an example, the binding characteristics of rifampicin were studied. In serum
      albumin solution, the rifampicin bound and unbound fractions were determined at
      473.5 and 475.8 nm, respectively. For human serum, the unbound fraction was
      determined at 479.4 nm. The results obtained by the first-derivative
      spectroscopic method were in agreement with those obtained by equilibrium
      dialysis. The proposed method is very simple and accurate when applied to
      measurements of drug:protein binding. Moreover, it allows a direct measurement of
      the bound and unbound forms without any physical separation.

PMID- 1640370
TI  - Punch geometry and formulation considerations in reducing tablet friability and
      their effect on in vitro dissolution.
AB  - The tablet friability resulting from formulation variations was studied under
      controlled granulation moisture content and tablet crushing strength. Tablets
      made with lactose were more friable than tablets made with microcrystalline
      cellulose. Replacement of 0.5% magnesium stearate with 0.5% stearic acid in the
      formula reduced tablet friability, whereas the combination of 0.5% stearic acid
      and up to 0.25% magnesium stearate did not increase tablet friability, decrease
      drug dissolution rate, or increase tablet-to-tablet variability in dissolution.
      Tablets compressed with extra deep concave punches resulted in lower friability
      compared with tablets compressed with standard concave or deep concave punches.
      The friabilities of the standard convex and deep convex tablets were similar,
      indicating that a critical level of punch tip curvature was important in reducing
      tablet friability. The dissolution rate was not affected by the punch tip
      geometry, but the tablet-to-tablet dissolution variability at the 0.5% stearic
      acid level for the extra deep convex tablets was higher compared with the
      standard convex tablets.

PMID- 1640371
TI  - Effects of structural variations on the rates of enzymatic and nonenzymatic
      hydrolysis of carbonate and carbamate esters.
AB  - The effect of structural variations on the rates of elastase-catalyzed hydrolysis
      of model carbonate and carbamate esters was studied using HPLC. It is shown that
      branching in the immediate vicinity of the carbonate or carbamate functionally
      results in decreased hydrolysis rates. Whereas aryl carbonates act as substrates
      for elastase, p-nitrophenyl butyl carbamate inhibits the enzyme. A novel method
      was developed for the entrapment and quantitation of 14CO2 produced upon
      hydrolysis of carbonyl-14C-labeled carbonate esters. This technique could be
      useful in studying the mechanism of enzymatic hydrolysis of this type of compound
      and has the potential of being adapted as a convenient method in the assessment
      of estrolytic activity of tissue homogenates.

PMID- 1640372
TI  - Stability studies of topical carbonic anhydrase inhibitor 6-hydroxyethoxy-2
      benzothiazole sulfonamide.
AB  - A new carbonic anhydrase inhibitor, 6-hydroxyethoxy-2-benzothiazole sulfonamide
      (6-hydroxyethyoxyzolamide), was studied to determine its stability in aqueous
      solution from pH 2.9 to 9.2 at a constant ionic strength of 0.15 M. This newly
      synthesized derivative of ethoxyzolamide has demonstrated clinical efficacy for
      use as an ophthalmic drug to lower intraocular pressure. Drug solution in sealed
      ampules was placed in a constant temperature over either at two temperatures (75
      and 85 +/- 0.2 degrees C) or four temperatures (75, 80, 85, and 90 +/- 0.2
      degrees C). Samples were analyzed by known HPLC methods. The results indicated
      that 6-hydroxyethoxyzolamide is most stable at pH 4 to 5.5. The aqueous drug
      solutions at pH 7.0 and 8.0 were, nevertheless, sufficiently stable, based on
      extrapolation of kinetic data at high temperatures using the experimentally
      determined Arrhenius equation. The degradation compound was identified by
      spectral analysis to have a hydroxyl group substituting for the original -SO2NH2
      group.

PMID- 1640373
TI  - Statistical approaches to stability protocol design.
AB  - In stability protocols, data are usually visualized as being generated, and
      stability evaluation is accomplished at a point in time when sufficient data have
      been accumulated. Often, data are simply treated by the "statistically best fit"
      and, as a consequence, statements describing some batches as being first order
      and some being zero order are frequently used. From a scientific point of view,
      it is more advantageous at the preformulation stage to ascertain what the
      stability profile should be (i.e., what the mechanism is) and then apply the
      statistics to this format. Examples are given of pH profiles, Arrhenius plotting,
      and dissolution data. In the first case, the use of fractional factorials (a
      matrix approach) is suggested.

PMID- 1640374
TI  - Modification of the crescentic osteotomy for hallux valgus correction. A
      preliminary report.
AB  - A new proximal osteotomy for hallux valgus correction, which has several
      advantages, is presented. These advantages include good stability; ease of rigid,
      two-point internal fixation; accurate, reproducible correction of the
      intermetatarsal angle; minimal shortening or elevation of the metatarsal; and
      early weightbearing. Preliminary results on 12 feet of 12 patients over a 3-year
      period have been encouraging and may indicate that this osteotomy is a viable
      alternative when considering proximal osteotomy for correction of hallux valgus.

PMID- 1640375
TI  - Bone graft reconstruction of a flail digit.
AB  - The author presents a case report with a 1-year follow-up period demonstrating
      successful bone graft stabilization of an iatrogenic flail second toe. The author
      discusses the techniques for calcaneal autogenous bone grafting for
      reconstruction of the iatrogenic shortened toe combined with ancillary procedures
      to improve the digital length pattern. After 18 months, this staged approach to
      stabilization of the digit and realignment of the digital length pattern appears
      to be successful.

PMID- 1640376
TI  - Shaping a life-style of independence. Abilities, aging, and environmental design.
AB  - What makes our own aging so interesting and predictions about normative aging
      profiles so difficult is that there are many different capacities that may be
      altered. The composite pattern of strengths and needs and of the degree of need
      has yet to be described. This makes predictions about what people can or could do
      difficult. Each individual represents a mosaic of capacity and loss resulting
      from the impact of capacities such as vision, hearing, response time, posture,
      gait, energy level, and even recall and the demands placed upon them by their
      individual circumstances, life-styles, and environments. A person with major
      memory loss and tremendous energy may be different from one who experiences
      slight losses in vision, hearing, mobility, agility, and a crystal clear memory.
      Their behavioral changes may be more evident in strange environments than in
      familiar ones. This mosaic of capabilities and needs makes traditional
      interventions that are focused on a singular disability or major diagnostic
      conditions difficult. Traditional rehabilitation methods need to be adapted to
      grapple with the diversity of older people functioning in a community.
      Adaptations in our understanding of people, activities, and environments will put
      us in a better position to facilitate the normal interactions of older people in
      senior centers and, importantly, in public intergenerational settings. Older
      people have not been well served by services, programs, and legislation that have
      focused on single disabilities or devices.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640377
TI  - Metabolic and hemodynamic responses to concurrent voluntary arm crank and
      electrical stimulation leg cycle exercise in quadriplegics.
AB  - This study determined the metabolic and hemodynamic responses in eight spinal
      cord injured (SCI) quadriplegics (C5-C8/T1) performing subpeak arm crank exercise
      (ACE) alone, subpeak functional electrical stimulation leg cycle exercise (FES
      LCE) alone, and subpeak FES-LCE concurrent with subpeak ACE (hybrid exercise).
      Subjects completed 10 minutes of each exercise mode during which steady-state
      oxygen uptake (VO2), pulmonary ventilation (VE), heart rate (HR), cardiac output
      (CO), stroke volume (SV), mean arterial pressure (MAP), arteriovenous oxygen
      difference (a-v O2 diff), and total peripheral resistance (TPR) were determined.
      Although mean VO2 for both ACE alone and FES-LCE alone was matched at 0.66 l/mi,
      individualized power outputs ranged from 0-30 W (mean = 19.4 +/- 1.3) and 0-12.2
      W (mean = 2.3 +/- 0.6), respectively. Hybrid exercise elicited significantly
      higher VO2 (by 54 percent), VE (by 39-53 percent), HR (by 19-33 percent), and CO
      (by 33-47 percent), and significantly lower TPR (by 21-34 percent) than ACE or
      FES-LCE performed alone (P less than or equal to 0.05). Stroke volume was similar
      between hybrid exercise and FES-LCE alone, and these two exercise modes evoked a
      significantly higher SV (by 41-56 percent) than during ACE alone. These data
      clearly demonstrate that hybrid exercise creates a higher aerobic metabolic
      demand and cardiac-volume load in SCI quadriplegics than either subpeak levels of
      ACE or FES-LCE performed separately. Therefore, hybrid exercise may provide more
      advantageous central cardiovascular training effects in quadriplegics than either
      ACE or FES-LCE alone.

PMID- 1640378
TI  - Biomechanical analysis of wheelchair propulsion for various seating positions.
AB  - The pattern of propulsion was investigated for five male paraplegics in six
      seating positions. The positions consisted of a combination of three horizontal
      rear-wheel positions at two seating heights on a single-purpose-built racing
      wheelchair. To simulate wheelchair propulsion in the laboratory, the wheelchair
      was mounted on high rotational inertia rollers. For three trials at each seating
      position, the subjects propelled the designed wheelchair at 60 percent of their
      maximal speed, which was determined at the beginning of the test session. At each
      trial, the propulsion technique of the subject was filmed at 50 Hz with a high
      speed camera for one cycle, and the raw electromyographic (EMG) signal of the
      biceps, brachii, triceps brachii, pectoralis major, deltoid anterior, and deltoid
      posterior muscles were simultaneously recorded for three consecutive cycles. The
      digitized film data were used to compute the angular kinematics of the upper
      body, while the EMG signals were processed to yield the linear envelope (LE EMG)
      and the integrated EMG (IEMG) of each muscle. The kinematic analysis revealed
      that the joint motions of the upper limbs were smoother for the Low positions
      since they reached extension in a sequence (wrist, shoulder, and elbow), when
      compared to the High positions. Also, the elbow angular velocity slopes were
      found to be less abrupt for the Backward-Low position. It was observed that in
      lowering the seat position, less IEMG was recorded and the degrees of contact
      were lengthened. Among the seat positions evaluated, the Backward-Low position
      had the lowest overall IEMG and the Middle-Low position had the lowest pushing
      frequency. It was found that a change in seat position caused more variation in
      the IEMG for the triceps brachii, pectoralis major, and deltoid posterior. The
      trunk angular momentum was not found to be affected by a change in seat position
      which may be related to the variability among the subject's technique of
      propulsion or to a posture compensation.

PMID- 1640379
TI  - The contribution of selected anthropometric and physiological variables to 10K
      performance of wheelchair racers: a preliminary study.
AB  - The purpose of this study was to determine the relationship between selected
      anthropometric and physiological variables and 10K time. Eleven male wheelchair
      athletes with spinal cord injuries in training for national competition performed
      continuous progressive exercise tests on a wheelchair ergometer to determine
      maximal metabolic and cardiorespiratory values. Anthropometric data were also
      collected. The laboratory data were analyzed for correlation with the best 10K
      time of each subject during the test period. The subjects averaged 27 min 30 sec
      for their 10K races, 2.49 L.min-1 for VO2max and 35 percent for maximal gross
      mechanical efficiency during submaximal exercise. Speed at peak oxygen
      consumption (r = -0.66), gross mechanical efficiency (r = -0.56), and body
      density (r = -0.57) was found to be significantly (p less than 0.10) correlated
      with 10K time. The results show very little correlation between VO2max and 10K
      time (r = 0.02). Further study is indicated for the relationship between gross
      mechanical efficiency, speed at maximal oxygen consumption, body density, and 10K
      time; these variables may be useful in evaluating training programs for improving
      race performance.

PMID- 1640380
TI  - A computer-aided socket design procedure for above-knee prostheses.
AB  - A computer-aided socket design procedure (CASD) has been developed whereby an
      above-knee socket shape can be created based on anthropometric measurements taken
      from an amputee. The anthroometric measurements are used to select a subset of
      three reference shapes from a Reference Shape Library stored in the computer in
      the form of three-dimensional numerical data. Transformation procedures then
      scale the reference shapes at each cross-sectional level to match the amputee's
      cross-sectional areas. Blending of the three shapes is determined by tissue mass
      weighting factors, to yield a single custom socket configuration, known as the
      "basic socket shape." Subsequent graphical procedures in the CASD system allows
      further sculpting of the shape in the form of interactive adjustments of the
      numerical data to reach the socket shape desired by the prosthetist. The
      resultant shape data can then be transferred to a computer numerically controlled
      (CNC) milling machine to carve a model of the socket shape.

PMID- 1640381
TI  - A two-step segmentation method for automatic recognition of speech of persons who
      are deaf.
AB  - The development and use of a two-step word segmentation method for automatic
      recognition of the speech produced by deaf persons are described in this paper.
      This method incorporates the segmental and temporal characteristics of deaf
      speech, particularly the intra- and inter-word pauses, to achieve accurate
      recognition. In the first step, estimates of word boundaries were obtained by
      detecting these pauses. In the second step, the word boundaries were determined
      by matching all possible groupings of speech segments against all reference
      templates during recognition. This method was applied to recognition of isolated
      words and connected-speech utterances produced by two deaf speakers. Recognition
      rates of 93.01 percent and 81.81 percent were obtained in recognizing isolated
      words and connected speech, respectively.

PMID- 1640382
TI  - Computer as a group teaching aid for persons who are blind.
AB  - A concept has been formulated whereby a teacher in a classroom for students who
      are blind can communicate line diagrams and text directly to the students. This
      approach is based upon a single computer placed on the teacher's desk, with
      monitors on the students' desks. Access to the information displayed on the
      monitors is obtained by means of an optoelectronic sensor and vibrotactile
      output. Two versions of the sensor have been made--one for sensing line diagrams,
      and the other for Braille text. A simple, low-cost arrangement has also been
      designed by which students who are blind can prepare a hard copy of the diagrams
      from the monitor display. The special feature of the system is that it allows the
      teacher to convey information directly to the students, that is, diagrams and
      text that have been entered into the computer while the students are in the
      classroom. Information previously stored on floppy disks may also be communicated
      in this way. This methodology will overcome the current limitation where the
      teacher is able to hand out only embossed diagrams and text that have been
      previously prepared. Learning to use the new system can be accomplished in a
      short time, with the added advantage that the system is relatively inexpensive.

PMID- 1640383
TI  - Phylogenetic analysis of the Diplomonadida (Wenyon, 1926) Brugerolle, 1975:
      evidence for heterochrony in protozoa and against Giardia lamblia as a "missing
      link".
AB  - A suite of 23 ultrastructural characters was used in a phylogenetic analysis of
      the protozoan order Diplomonadida. A single most parsimonious solution was found,
      with a length of 38 transformations and a consistency index of 0.84. The
      cladogram supports previous hypotheses of the relationships of the genera in the
      suborder Diplomonadina, as well as the inclusion of the genera Enteromonas and
      Trimitus in the order. Heterochrony is suggested in the change to binary axial
      symmetry, as hypermorphosis resulting from delayed cytokinesis in the ancestor.
      Hypotheses regarding a pivotal position for Giardia lamblia in the evolution of
      eukaryotes are inconsistent with the phylogeny proposed here.

PMID- 1640384
TI  - Identification of Tetrahymena ciliary surface proteins labeled with
      sulfosuccinimidyl 6-(biotinamido) hexanoate and Concanavalin A and fractionated
      with Triton X-114.
AB  - Tetrahymena thermophila cells were labeled with sulfosuccinimidyl 6-(biotinamido)
      hexanoate, a sensitive nonradioactive probe for cell surface proteins, and
      Western blots of axonemes and ciliary membrane vesicles were compared to cilia
      fractionated with Triton X-114 (TX-114) in order to study the orientation of
      ciliary membrane proteins. Greater than 40 ciliary surface polypeptides, from
      greater than 350 kDa to less than 20 kDa, were resolved. The major surface 50-60
      kDa proteins are hydrophobic and partition into the TX-114 detergent phase. Two
      high molecular weight proteins, one of which is biotinylated, comigrate with the
      heavy chains of ciliary dynein, sediment at 14S in a sucrose gradient, and
      partition into the TX-114 aqueous phase. Fractions containing these high
      molecular weight proteins as well as fractions enriched in 88-kDa and 66-kDa
      polypeptides contain Mg(2+)-ATPase activities. Detergent-solubilized tubulins
      partition into the TX-114 aqueous phase, are not biotinylated, and must not be
      exposed to the ciliary surface. The detergent-insoluble axoneme and membrane
      fraction contains a 36-kDa polypeptide and a portion of the 50-kDa polypeptides
      that otherwise partition into the detergent phase. These polypeptides could not
      be solubilized by ATP or by NaCl extraction and appear to be associated with
      pieces of ciliary membrane tightly linked to the axoneme. The ciliary membrane
      polypeptides were also tested for Concanavalin A binding and at least sixteen Con
      A-binding polypeptides were resolved. Of the major Con A-binding polypeptides,
      three are hydrophobic and partition into the TX-114 detergent phase, three
      partition into the TX-114 aqueous phase, and four partition exclusively in the
      detergent-insoluble fraction, which contains axonemes and detergent-resistant
      membrane vesicles.

PMID- 1640385
TI  - Identification of Acanthamoeba at the generic and specific levels using the
      polymerase chain reaction.
AB  - We have adapted the polymerase chain reaction to identify strains of
      Acanthamoeba. Using computer-assisted analysis, primers were designed from an
      anonymous repetitive sequence and from published sequences of 18S and 5S
      ribosomal RNA genes of A. castellanii. Amplification of a short ribosomal DNA
      target (272 base pairs) at restrictive annealing conditions (greater than 50
      degrees C) resulted in a single band that was unique for the genus and
      distinguished Acanthamoeba from Naegleria. This assay functioned with fresh and
      formalin-fixed cells as starting material. Amplification of longer targets (400
      700 base pairs) at less restrictive annealing conditions (less than 47 degrees C)
      led to more than one band. This multiple banding pattern could reproducibly
      classify Acanthamoeba at the strain level and was, in certain cases, diagnostic
      for known pathogenic strains. However, these assays need to be further refined to
      make them relevant for clinical purposes.

PMID- 1640386
TI  - Characterization of the calcium-binding contractile protein centrin from
      Tetraselmis striata (Pleurastrophyceae).
AB  - Centrin is a major protein of the contractile striated flagellar roots of the
      green alga Tetraselmis striata. We present a newly modified procedure for the
      preparation of centrin in sufficient quantity and purity to allow for detailed
      biochemical characterization. We establish that centrin purified by differential
      solubility, followed by phenyl-Sepharose and DEAE-Sephacel chromatography is
      identical with the protein extracted directly from striated flagellar roots with
      regard to molecular weight, isoelectric point, and calcium-dependent behavior in
      SDS-PAGE. We also compare the biochemical properties of purified centrin with
      calmodulin isolated from Tetraselmis and calmodulin isolated from mammalian
      brain. Centrin can be fully distinguished from either algal or mammalian
      calmodulin on the basis of molecular weight, isoelectric point, calcium-dependent
      behavior in SDS-PAGE, proteolytic peptide maps, amino acid composition, ability
      to activate bovine brain phosphodiesterase, and reactivity with specific
      antibodies.

PMID- 1640387
TI  - Evidence of tyrosine kinase activity in the protozoan parasite Trypanosoma
      brucei.
AB  - Phosphorylation of proteins at tyrosine is an important mechanism for regulating
      cell growth and proliferation in metazoan organisms. In this report, we have
      demonstrated that Trypanosoma brucei, a protozoan parasite, possesses a tyrosine
      kinase that plays a role in regulation of proliferation of this protozoan.
      Genistein, a tyrosine kinase inhibitor, prevented multiplication of the parasite.
      An in vitro kinase assay demonstrated the presence of a kinase capable of
      phosphorylating an exogenous substrate at tyrosine, and genistein was able to
      reduce trypanosome-mediated phosphorylation of this substrate. An alkali
      digestion of 32P-labeled trypanosome proteins separated by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis indicated several proteins phosphorylated at
      tyrosine. These results indicate that T. brucei has a tyrosine kinase that is
      involved in proliferation or growth regulation of the parasite and provide
      further evidence for the possibility of growth factor regulation and signal
      transduction in trypanosomes.

PMID- 1640388
TI  - Characterization of the T, L, I, S, M and P cell surface (immobilization)
      antigens of Tetrahymena thermophila: molecular weights, isoforms, and cross
      reactivity of antisera.
AB  - In the ciliate protist Tetrahymena thermophila the L, H, T, I, S, M and P cell
      surface proteins (immobilization antigens) are expressed under different
      conditions of temperature (L, H, T), culture media (I, S), and mutant genotype
      (M, P). Immunoblot and autoradiographic studies using antisera to purified
      protein show that the molecular weights of these proteins range from 25,000 to
      59,000. The H, T, S, M and P antigens are recognized as single polypeptides,
      whereas L, I, and one allelic form of T each appear to consist of a family of
      polypeptides. Although antisera are specific in immobilization and
      immunofluorescence assays of surface protein in living cells, cross-reactivity is
      seen with denatured protein on immunoblots. It is hypothesized that the surface
      protein genes are organized into families of evolutionarily related isoloci.

PMID- 1640389
TI  - Enhanced gametocyte formation in young erythrocytes by Plasmodium falciparum in
      vitro.
AB  - Two gametocyte-forming clones, HB-3 and 3D7, were used. Concentrates of late
      stage parasites were mixed with bloods containing different proportions of young
      erythrocytes, and the parasitemia and proportion of gametocytes determined after
      2, 3 or 4 days of culture. Significantly more gametocytes were formed in light
      cells than in heavy cells separated from the same normal blood samples. Up to
      seven times more gametocytes were formed in reticulocyte-rich bloods from
      patients with sickle cell anemia than in normal control blood.

PMID- 1640390
TI  - The psychological treatment of patients with functional somatic symptoms: a
      practical guide.
AB  - Functional somatic symptoms (FSS) are bodily sensations which do not result from
      physical disease, but which the patient responds to as if they did. Such symptoms
      are common and usually transient. In some patients they become persistent and
      associated with distress and disability. In such cases specific treatment is
      indicated. A cognitive-behavioural model of the aetiology of FSS and a
      psychological treatment approach based on the model, are outlined. The practical
      details of treatment are described.

PMID- 1640391
TI  - Social relations, social support and survival among patients with cancer.
AB  - This study examined the relationship between social relationships and social
      support and survival following a first diagnosis of breast, colorectal, or lung
      cancer. Findings showed different factors related to survival for those with
      breast vs lung or colorectal cancer and for those with localized vs non-localized
      cancers. Results provide important evidence that social relations and social
      support may operate differently depending on cancer site and extent of disease.

PMID- 1640392
TI  - Power spectral analysis of heart rate variability in Type As during solo and
      competitive mental arithmetic task.
AB  - It has been reported that there are differences in autonomic balance between Type
      As and Type Bs. This study evaluated the sympathovagal interaction in Type A (N =
      10) and Type B (N = 10) male students during mental arithmetic task in a solo and
      a competitive condition by the spectral component analysis of heart rate
      variability (HRV). The low-frequency (LF) component to high-frequency (HF)
      component ratio was significantly greater in Type As than in Type Bs, though no
      significant differences were found in task performance, heart rate change, and
      blood pressure between the two subject groups in both conditions. The present
      findings indicate that there was a significant difference in sympathovagal
      balance between Type As and Type Bs, and that Type As showed dominant sympathetic
      activity. The results suggest that the power spectral analysis of HRV, which is
      convenient and non-invasive, has enough sensitivity to discriminate differences
      in autonomic balance between Type A subjects and Type B subjects, not only during
      the solo and competitive task period but also during the resting period.

PMID- 1640393
TI  - Psychosocial adjustment following major gynaecological surgery for carcinoma of
      the cervix and vulva.
AB  - One-hundred and five women had undergone major gynaecological surgery for
      carcinoma of the cervix and vulva were interviewed retrospectively to elicit post
      operative psychosocial and psychosexual problems. This interview took place
      between 6 months and 5 yr after surgery. Responses to the Hospital Anxiety and
      Depression Scale indicated that 20% of the women were 'probable' cases of anxiety
      and 21% were 'definite' cases. On the depression scale, 18% were 'doubtful' cases
      and 14% were 'definite' cases. Scores on the scales were not associated with age
      of the woman, the type of operation or the time period between being interviewed
      and the operation. Two-thirds of the women who were sexually active prior to the
      operation indicated ongoing sexual problems when interviewed and the presence of
      these problems was found to be significantly associated with the woman's level of
      anxiety.

PMID- 1640394
TI  - The premenstrual syndrome: amelioration of symptoms after hysterectomy.
AB  - What is the role of the uterus in the aetiology of the premenstrual syndrome
      (PMS)? Twelve women kept a daily symptom record before and after hysterectomy.
      Psychological and physical symptom patterns were analysed by Fourier analysis and
      the response to hysterectomy by maximum likelihood ANOVA. Hysterectomy was
      associated with a 66% reduction in mean premenstrual tension (PMT) severity for
      both psychological and physical symptoms (p less than 0.005). The milder symptoms
      appeared unrelated to post-operative changes in health or ovarian function. Seven
      women experienced mood-related PMT in every pre-hysterectomy cycle; the
      persistence of unfailing mood-related PMT in one of these women after
      hysterectomy suggests that her symptoms were hormonally controlled and the loss
      of regular PMT in the other six women suggests that a uterine factor, or
      psychological factors associated with the menstrual cycle were implicated. We
      conclude that a uterus is not essential for the expression of PMT, but that its
      removal often results in the amelioration of symptoms.

PMID- 1640395
TI  - Psychopathology and pain in medical in-patients predict resource use during
      hospitalization but not rehospitalization.
AB  - The authors investigated the relationship between psychopathology and resource
      use in general medical in-patients during hospitalization and rehospitalization.
      Between 1 July 1987, and 30 April 1989, 1020 in-patients were prospectively
      screened for depression, anxiety, cognitive dysfunction, and pain. Overall, the
      screen identified 47% of patients as having high psychopathology or pain,
      including 25.7% depressed, 21.8% anxious, 17.6% with cognitive dysfunction, and
      5.2% with high pain. There were no measured differences in demographics or
      disease severity between high and low psychopathology groups. High
      psychopathology patients had longer stays and higher costs during the index
      hospitalization but there were no differences during subsequent hospitalizations.
      Length of stay declined overall during the study period, but there were no
      changes over time in the association between high psychopathology or pain with
      increased resource use. The measured symptoms of psychopathology and pain we
      measured are associated with increased short-term utilization of health care
      resources, but the increase does not extend to subsequent hospitalizations.
      Outcome studies aiming to reduce psychopathology in medical in-patients should
      pay particular attention to short term costs.

PMID- 1640396
TI  - Measuring coping in breast cancer.
AB  - The emotional distress associated with breast cancer varies between individual
      women. These variations may be accounted for by differences in cognitive and
      behavioural coping responses to diagnosis. This study has attempted to develop a
      reliable, situation-specific approach to the measurement of coping responses in
      women with breast cancer. It has adapted a general coping questionnaire and
      modified an interview-based schedule for coping with cancer. The strengths and
      weaknesses of the interview and self-report methods of assessment are
      highlighted. Consistent results from these complementary approaches have been
      obtained. Both indicate the extensive use of cognitive avoidance and positive
      reappraisal. It has been shown that the majority of patients use a wide
      repertoire of coping responses which challenges the notion of mutually exclusive
      coping styles. These measures may be employed to examine the relationship between
      women's thoughts and behaviours in response to the diagnosis and treatment of
      breast cancer and subsequent psychological outcome.

PMID- 1640397
TI  - [Mediastinal extension of retropharyngeal abscess].
AB  - Retropharyngeal abscesses in children are unusual and the involvement of the
      mediastinum is exceptional since the era of the antibiotics. It can be explained
      by the anatomic continuity between the retropharyngeal space and the
      retrooesophageal space. We report a case where the CT Scanner allows a complete
      evaluation of the disease in the mediastinum and a good follow-up.

PMID- 1640398
TI  - [Ileocolic intussusception in adults. Apropos of a case caused by benign
      inflammatory polyp of the terminal ileum].
AB  - A case of an adult intussusception secondary to a fibroid polyp of the terminal
      ileum is reported. Adult intussusceptions are observed rarely, usually caused by
      an organic lesion. The preoperative diagnosis is based on US patterns, target
      aspect and sandwich sign.

PMID- 1640399
TI  - [Entrapped popliteal artery. Value of medical imaging and review of the
      literature].
AB  - Medical imaging techniques (Duplex-scan, arteriography, CT scan, magnetic
      resonance) are obviously the most important elements in the diagnosis and
      prognostic evaluation in cases of "entrapped" popliteal artery. The
      physiopathogenic mechanism of this arteriopathy is a localized microtrauma of the
      arterial wall due to vascular compression by pre-existing anatomic abnormalities
      of the popliteal fossa.

PMID- 1640400
TI  - [Temporomandibular joint and rheumatoid polyarthritis. X-ray computed tomographic
      aspects].
AB  - Direct coronal computed tomography (CT) examination of the temporomandibular
      joint (TMJ) was performed in 26 patients with rheumatoid arthritis (RA) and 26
      control subjects. Changes in condylar shape, erosions and cysts of the mandibular
      condyle and condylar head resorption were more frequent among the RA group than
      the control group. Only the erosions and cysts of the mandibular condyle had a
      significantly higher frequency in the RA group than in the control group (p less
      than 0.05). Bone changes were bilateral in RA. Coronal view of the CT examination
      allow a clear visualization of the osseous elements of the TMJ but a control
      group is absolutely necessary to affirm with certainty the rheumatoid origin of
      the bone changes. The erosions and cysts of the mandibular condyle and their
      bilateral nature are the most specific features of RA on TMJ.

PMID- 1640401
TI  - [MRI and Sturge-Weber syndrome. Value of the injection of gadolinium. Apropos of
      a case].

PMID- 1640402
TI  - [New elements in the recommendations of the International Commission for
      Radiological Protection].

PMID- 1640403
TI  - [Radiodiagnosis at the University of California].

PMID- 1640404
TI  - By-laws of the European Society of Uroradiology. Established August 26, 1990.

PMID- 1640405
TI  - The new immunology.
AB  - Among the biomedical sciences, immunology stands out as a discipline in which
      knowledge emanating from fundamental research has rapidly been transferred to the
      clinical paradigm, with consequent improvement in human health. Virtually all
      medical subspecialties have benefitted from diagnostic reagents and technologies
      provided by basic immunology. In terms of numbers of lives saved, immunologic
      based therapeutic strategies, most notably vaccination, rank among the most
      effective measures ever achieved by medical intervention. Yet, despite
      immunology's profound impact on medicine and the longstanding recognition of many
      of the general principles and cellular components involved in immunity, until
      relatively recently, the operational workings of the immune system eluded precise
      definition. The abstract nature of the immune system rendered the field
      intangible or, at the very least, confusing, to the nonimmunologic medical
      community. However, in recent years, this situation has changed radically, as
      cell cloning, hybridoma, and recombinant DNA technologies have provided the means
      to delineate the precise immunologic cellular structures and interactions. The
      purpose of this review is to highlight a few of the most significant advances in
      immunology during the past decade, and to show how they have made possible the
      translation of abstract concepts of classical immunology into tangible,
      structural information. Striking gains in the understanding of antigen
      recognition, one of the most fundamental aspects of immunity, are described as an
      illustrative case.

PMID- 1640406
TI  - Assessment of flap perfusion in a porcine model with a heated laser Doppler
      probe.
AB  - Skin and musculocutaneous flaps in a pig model were studied for their response to
      heating of the laser Doppler probe, both in the perfused state and in conditions
      of vascular occlusion. Even though heating the probe resulted in an elevation of
      perfusion of the flaps with no occlusions, it also increased the apparent
      perfusion of flaps that were occluded. The ability of flows to a augment with
      heating, therefore, could not be perfectly correlated with impeded vascular flow.
      The addition of a heated perfusion reading for assessment of vascular occlusion
      did not improve the accuracy of the laser Doppler for monitoring of capillary-bed
      perfusion to detect vascular occlusion.

PMID- 1640407
TI  - Health education works--at least for syphilis!

PMID- 1640408
TI  - Malignant melanomas masquerade--as benign naevi.

PMID- 1640409
TI  - Salt baths.

PMID- 1640410
TI  - Leptospirosis--a cause for concern?

PMID- 1640411
TI  - Leptospirosis--a cause for concern?

PMID- 1640412
TI  - Preferences in forms of address among female patients in military hospitals.

PMID- 1640413
TI  - Military cardiac rehabilitation.

PMID- 1640414
TI  - The smoking habits of young soldiers.
AB  - In a survey of the smoking habits of over 6,000 young soldiers, it was found that
      the prevalence of regular smoking was 45%. Though the prevalence of regular
      smoking in young soldiers is higher than the general prevalence rate for smoking
      in 16 to 19-year olds in the civilian population, the excess is considered to be
      a reflection of the social and geographical background of Army recruits. The
      survey found that young soldiers who smoke, smoke heavily. Eighty two percent
      smoked more than 20 cigarettes per week, 58% more than 40 cigarettes per week.
      This is higher than has been recorded by any previous survey of young soldiers.
      The proportion of young soldiers who have never smoked has risen markedly over
      the years. This survey found that 34% had never smoked.

PMID- 1640415
TI  - A survey of soldiers' attitudes to tattooing.
AB  - A study was performed at the Garrison Medical Centre, Larkhill to assess the
      incidence of skin tattoos in a sample of soldiers. The soldiers were questioned
      with the aim of establishing where they had had their tattoos done, identifying
      any factors involved in becoming tattooed and assessing what proportion later
      regretted their actions. The study included 450 male soldiers. Assessment was by
      a questionnaire completed in the medical centre waiting room. Overall 44% of the
      soldiers questioned were tattooed. Most (85.7%) had had tattoos done by
      recognised artists in the United Kingdom. Younger soldiers had a significantly
      higher incidence of 'home made' tattoos. Peer pressure was identified as an
      important influence on the decision to become tattooed. 31.1% of tattooed
      soldiers regretted their tattoos. This figure rose to 44.6% in those over 26
      years old. The author advocates increased education to encourage the young
      soldier to think hard about its implications before becoming tattooed.

PMID- 1640416
TI  - An audiometric survey of territorial Army personnel.
AB  - A cross sectional survey of 581 TA personnel from Wales, the Midlands and
      Scotland was performed. The aim was to determine their hearing levels, to attempt
      to relate any degree of noise induced hearing loss detected with military,
      occupational and leisure noise and to make recommendations to improve the
      existing Army Hearing Conservation Programme. Each subject answered a
      questionnaire, had a clinical examination of each ear and pure tone audiometry.
      The hearing acuity of the TA group as a whole was similar to the regulars in the
      lower H gradings but there was a worrying number of H4/8 (5.6%) who had not been
      picked up before on routine screening and would probably have been discharged if
      they were in the Regular Army.

PMID- 1640417
TI  - British Army recruits: 100 years of heights and weights.
AB  - The heights and weights of Army recruits have been placed on record since 1860 in
      Reports of the Army Medical Department with certain gaps, particularly during the
      two World Wars and the period between them, until their publication was
      discontinued in 1975. Mean values corrected where necessary for minimum standards
      of height and weight--in order that the results should represent the civilian
      population from which they were drawn--are presented, showing the trends over a
      century. The Quetelet index w/h2, an indicator of weight corrected for height, is
      recommended as a measure of obesity for the Army. The value to the Army Medical
      Services of a continuously published record of heights and weights is assessed,
      and the hope is expressed that publication of these data will be recommenced.

PMID- 1640418
TI  - Post-operative wound infections in Belize.
AB  - The incidence of post-operative wound infections in Belize in 1986 and 1987 was
      studied. Both military practice in the military hospital and civilian practice in
      the rural hospitals of the local towns were included. Despite previous misgivings
      and sub-optimal conditions in the rural hospitals an acceptably low incidence was
      found in both areas of work.

PMID- 1640419
TI  - Management of respiratory complications after maxillofacial surgery on board
      ship.
AB  - An eight year old girl who probably inhaled gastric contents during surgery for
      cleft palate repair was ventilated for 10 days in the post-operative recovery
      area on board the Mercy Ship Anastasis with pulse oximetry as the only monitor of
      oxygenation. She walked off the ship on the seventeenth day.

PMID- 1640420
TI  - Tracheobronchomalacia. A rare cause of respiratory distress in children.
AB  - Tracheobronchomalacia is a rare cause of respiratory distress in children. An
      infant with tracheobronchomalacia is presented. The aetiology, pathophysiology
      and management are discussed.

PMID- 1640421
TI  - The genetics of type I (insulin dependent) diabetes mellitus.

PMID- 1640422
TI  - A submicroscopic translocation, t(4;10), responsible for recurrent Wolf
      Hirschhorn syndrome identified by allele loss and fluorescent in situ
      hybridisation.
AB  - A 2 year old girl presented with developmental delay and subtle dysmorphic
      features suggestive of Wolf-Hirschhorn syndrome (WHS). High resolution chromosome
      analysis was normal in the child and both parents. Molecular analysis indicated
      that the child had not inherited a maternal allele of probes from 4p16,
      confirming the clinical diagnosis. Prenatal diagnosis in the next pregnancy
      showed that again the fetus had no maternal allele for probes mapping to 4p16.
      Fluorescent in situ hybridisation in the mother showed a submicroscopic
      translocation, t(4;10). A normal karyotype in a child with clinical features of
      WHS is an indication for further investigation.

PMID- 1640423
TI  - Short stature in a girl with a terminal Xp deletion distal to DXYS15:
      localisation of a growth gene(s) in the pseudoautosomal region.
AB  - This report describes a Japanese girl with short stature and a rearranged X
      chromosome. Her height remained below the 3rd centile growth curve for Japanese
      girls, and her predicted adult height (148.5 cm) was below her target height (163
      cm) and target range (155 to 171 cm). Cytogenetic studies showed that the
      rearranged X chromosome was formed by a breakage at q26 and a transfer of the Xq
      fragment onto the tip of Xp. The abnormal X was always late replicating. No
      mosaicism was detected. Molecular analysis showed an Xp terminal deletion distal
      to DXYS15. Biochemical and radiological studies for short stature disclosed no
      abnormality. On the basis of height analysis of previous reports and a genotype
      phenotype correlation of this patient, we propose that a growth gene(s) is
      present in the distal part of the pseudoautosomal region.

PMID- 1640424
TI  - Meiotic and sperm chromosome analysis in a male carrier of an inverted insertion
      (3;10)(q13.2;p14p13).
AB  - A phenotypically normal male who fathered a son with the karyotype
      46,XY,del(10)(p13) was found to be a balanced carrier of an inverted insertion
      (3;10) (q13.2;p14p13). Karyotyping five later pregnancies showed four to be
      unbalanced with respect to the insertion, one of which was also trisomic for
      chromosome 18. The latest pregnancy was balanced with respect to insertion but
      had the additional complexity of 47,XXY. In the light of six out of six
      chromosomally abnormal pregnancies, two of which potentially exhibit an
      interchromosomal effect, it was decided to investigate the gametic output of the
      father. Testicular biopsy and semen samples were obtained permitting both meiotic
      and sperm chromosome analysis. Information was thus obtained at three levels of
      gamete production, that is, prophase I pairing, chiasma frequency distribution at
      metaphase I, and sperm karyotypes. Electron microscope studies of synaptonemal
      complexes showed the rearranged chromosomes to pair fully in meiotic prophase I
      with no indication of the presence of an insertion. This non-homologous pairing
      of the inserted region was accompanied by an abnormal frequency distribution of
      pachytene substages. There was also a reduction in chiasma frequency throughout
      the genome. However, this did not lead to detectable autosomal univalence or
      abnormally high X/Y univalence. Thus, the trisomy 18 and XXY pregnancies are
      unlikely to reflect increased non-disjunctional rates either before or during the
      first meiotic division. Sperm karyotyping showed that the proportion of
      chromosomally balanced:unbalanced gametes did not differ from the theoretically
      expected 1:1. There was no evidence of any increase of unrelated abnormalities in
      the sperm, further indicating that the overall rate of meiotic non-disjunction
      was not increased above normal.

PMID- 1640425
TI  - Linkage studies of four fibrillar collagen genes in three pedigrees with Larsen
      like syndrome.
AB  - We report seven children from three families who had a set of common clinical
      features suggestive of Larsen-like syndrome, including unusual facies, bilateral
      dislocations of the knees and elbows, club foot, and short stature. All of the
      patients originated from the island of La Reunion in the Indian Ocean. The
      occurrence of several affected sibs in these families and the large number of
      consanguineous marriages on this island are consistent with autosomal recessive
      inheritance of the disease. Based on this hypothesis, the pedigrees were used for
      linkage analysis in a candidate gene assay. Lod score calculations in a pairwise
      study with four different fibrillar collagen genes, COL1A1, COL1A2, COL3A1, and
      COL5A2, allowed us to exclude these genes as the mutant loci. Supporting this,
      electrophoretic analysis of collagens derived from fibroblast cultures failed to
      show defective molecules. We conclude that this syndrome is not a collagen
      disorder.

PMID- 1640426
TI  - A model to estimate the expression of the dystrophin gene in muscle from female
      Becker muscular dystrophy carriers.
AB  - The purpose of the present investigation was to assess the possibility of
      building a model to estimate, through dystrophin western blotting analysis, the
      expression of the DMD/BMD gene in muscle from heterozygotes. Dystrophin was
      analysed by mixing in increasing proportions (from 0% to 100%) aliquots of
      solubilised muscle from BMD patients with a qualitatively abnormal dystrophin and
      a normal male control. The intensity of the abnormal bands, which could be
      detected starting with 20% of muscle from the BMD patient, increased
      progressively according to the affected muscle concentration. In five obligate
      BMD carriers, two dystrophin bands were observed (corresponding to the products
      from the X bearing the normal and the BMD alleles), even among those with normal
      serum enzyme activities. Surprisingly, in the four obligate BMD carriers related
      to patients in whom an additional dystrophin fragment of 250 kd was present (two
      of them with raised serum enzymes), this band could not be seen, suggesting that
      the stability or the mechanism responsible for the synthesis of abnormal
      dystrophin products differs in heterozygotes compared to affected patients.

PMID- 1640427
TI  - Prevalence of congenital anomaly syndromes in a Spanish gypsy population.
AB  - We analysed the sample of gypsies included in the Spanish Collaborative Study of
      Congenital Malformations (ECEMC), a hospital based, case-control study and
      surveillance system. Special emphasis was placed on the birth prevalence of
      recessive multiple congenital anomaly syndromes, comparing their frequency in the
      gypsy population with that observed among non-gypsies. We observed an increased
      prevalence of birth defects, mostly because of groups of children with patterns
      of multiple anomalies and with autosomal recessive syndromes. The latter were
      approximately seven times more frequent in gypsies than in non-gypsies. We also
      estimated the carrier frequency in both groups (gypsy and non-gypsy). We consider
      that the frequent occurrence of the conditions observed reflects the high rate of
      consanguineous couples among the Spanish gypsy population.

PMID- 1640428
TI  - Echocardiography and genetic counselling in tuberous sclerosis.
AB  - OBJECTIVE: To assess echocardiography as an investigation for the detection of
      occult gene carriers in tuberous sclerosis. PATIENTS: Sixty parents of children
      with tuberous sclerosis who had been extensively investigated for signs of the
      disease and 60 age and sex matched controls. PROCEDURE: Blind study by two
      experienced echocardiographers and blind interpretation of video recordings by an
      adult cardiologist. SETTING: Cardiology department of a district general
      hospital. RESULTS: Two parents and three controls had bright echodense areas
      interpreted as possible rhabdomyomas. CONCLUSIONS: In our hands echocardiography
      of adults is not an investigation with a high specificity for gene detection in
      tuberous sclerosis.

PMID- 1640430
TI  - Charcot-Marie-Tooth (CMT) 1a duplication at 17p11.2 in Italian families.

PMID- 1640429
TI  - Attitudes towards prenatal diagnosis and carrier screening for cystic fibrosis
      among the parents of patients in a paediatric cystic fibrosis clinic.
AB  - The parents of all children attending the Royal Brompton National Heart and Lung
      Hospital cystic fibrosis paediatric clinic were asked to complete an anonymous
      postal questionnaire addressing attitudes towards prenatal diagnosis and
      population carrier screening for cystic fibrosis (CF); 65% (170/261) of parents
      responded. Of the respondents, 92% would support the introduction of a population
      screening test to detect carriers of CF and 19% felt such a test should be
      mandatory. A total of 64% of CF parents felt they would choose not to have any
      further children in the knowledge that they were both carriers, 74% would choose
      to have a prenatal test if they became pregnant, 44% would consider terminating
      an affected pregnancy, 33% would not, and 23% were unsure. Overall, 72% of
      respondents indicated they would choose to avoid having a further child with CF
      either by not having further children or by terminating an affected pregnancy.

PMID- 1640431
TI  - Spastic disorder in patients with hereditary multiple exostoses, but without
      spinal cord compression: a new syndrome?
AB  - We describe a 37 year old man with a history of a gait disorder which had been
      worsening over a period of three years. Clinical examination showed the typical
      signs of a spastic tetraparesis with increased tone of all the extremities.
      Sensation, autonomic and cerebellar functions were not disturbed. Multiple
      exostoses had been present since early childhood, but none had been found in the
      spine or the cranium to cause the tetraspastic disorder. MRI scan was normal.
      Pedigree analysis of four generations showed that other family members were
      affected by both disorders. Chromosomal analysis was normal. We consider this to
      be a previously unknown hereditary syndrome transmitted as an autosomal dominant
      and manifesting a combination of spastic tetraparesis and multiple exostoses.

PMID- 1640433
TI  - Three sibs with phalangeal anomalies, microcephaly, severe mental retardation,
      and neurological abnormalities.
AB  - This paper describes three children of a Pakistani first cousin marriage with a
      distinctive, non-progressive disorder characterised by variable phalangeal
      anomalies, microcephaly, pre- and postnatal growth retardation, poor vision,
      dystonic movements, a characteristic face, and severe mental retardation. This
      combination of features seems to be distinct and to represent a new autosomal
      recessive syndrome.

PMID- 1640432
TI  - Cerebrofaciothoracic dysplasia: a new family.
AB  - We describe two brothers, born to consanguineous parents, who had facial
      dysmorphism, complex anomalies of the vertebrae and ribs, enlarged cerebral
      ventricles and septum pellucidum, mental retardation, and affable behaviour. The
      features are similar to those previously described in three unrelated children
      and may represent new cases of cerebrofaciothoracic dysplasia.

PMID- 1640434
TI  - Necropsy findings in a fetus with a 46,XY,dic t(X;21)(p11.1;p11.1).
AB  - We report the findings in a fetus terminated because of multiple abnormalities
      diagnosed on ultrasound, including asymmetry of the limbs, a hypoplastic
      diaphragm, unilateral duplex kidney with a double ureter, unilateral cystic
      kidney, and congenital heart disease including total pulmonary atresia.
      Cytogenetic studies showed an unbalanced translocation of the long arm of the X
      chromosome to chromosome 21, resulting in a 46,XY,dic t(X;21)(p11.1;p11.1)
      karyotype. The cytogenetics were confirmed by non-isotopic in situ hybridisation
      using probes specific to pericentric alphoid repeats. Parental chromosomes were
      normal indicating this to be a de novo translocation. It is suggested that the
      inactivation of the long arm of the X chromosome has resulted in an effective
      monosomy for chromosome 21.

PMID- 1640435
TI  - Balanced translocation (14;20) in a mentally handicapped child with cystinuria.
AB  - A mentally handicapped 3 year old child with cystinuria is presented. Routine
      chromosomal analysis showed an apparently balanced de novo translocation in the
      child with breakpoints 14q22 and 20p13. Family studies suggested that the child
      is a type I/type II compound heterozygote for cystinuria. This translocation may
      indicate a possible locus for the gene for cystinuria.

PMID- 1640436
TI  - A terminal deletion of 11q.

PMID- 1640437
TI  - Trisomy 18 with karyotype 47,XX,-18,+i psu dic(18p).

PMID- 1640438
TI  - Chromosomes 14 and 21 as possible candidates for mapping the gene for Sanfilippo
      disease type IIIC.

PMID- 1640439
TI  - Prevalence of other birth defects among relatives of oral cleft probands.

PMID- 1640440
TI  - Microtia, absent patellae, short stature, micrognathia syndrome.

PMID- 1640441
TI  - Defining valve performance: importance and difficulties in testing heart valve
      replacement devices.
AB  - Defining and assessing the performance of heart valve replacement devices is
      difficult. This article is a brief discussion of the problems and present state
      of the art.

PMID- 1640442
TI  - In vitro evaluation of prosthetic heart valves: towards comparable testing.
AB  - The Laboratory of Biomedical Engineering (of the National Health Institute,
      technical body of the Italian Health Service) performs in vitro testing of
      prosthetic heart valves for mechanical characteristics of materials, fatigue
      life, and fluidodynamic performance. Testing of materials is directed towards the
      physicomechanical characterization of the structural components of the valves,
      e.g. elasticity and resistance to stress of biological tissues and stents. Long
      term fatigue life tests are conducted by means of systems which make valves beat
      at more than 1200 cycles/min. These tests are preceded and followed by
      geometrical characterization and by steady flow testing in order to obtain
      information about stenosis and leakage. Special attention is devoted to pulsatile
      flow testing which is performed on two pulse duplicators: the Dynatek system and
      the system developed by the University of Sheffield. The same valve was tested
      with these systems according to their different possible set-ups within the
      general requirements established by ISO-DIS 5840. This paper presents significant
      measurements, taking into account their dependence on the systems adopted.
      Results show (a) the difficulties in comparing test results because of different
      operating conditions, and (b) the systems' sensitivity with regards to some
      parameters which affect measurements under comparable set-up conditions (FDA
      Interlaboratory Comparison Testing Protocol).

PMID- 1640443
TI  - Clinical assessment of prosthetic valve function.
AB  - The advent of high-quality ultrasound technology has made the assessment of
      prosthetic valve function quicker, easier, and more accurate than ever before. By
      using cross-sectional imaging, colour flow mapping, and spectral Doppler
      techniques from both the precordium and the oesophagus, it is possible to assess
      a prosthetic valve fully. Cardiac catheterization with its attendant risks can be
      avoided. Echocardiography gives detailed morphological information, and it can be
      used for routine serial follow-up of individual patients. Using the patient as
      his or her own control avoids the problems caused by poorly-defined 'normal
      ranges' for prosthetic function.

PMID- 1640444
TI  - Understanding valve/host interactions through explanted valve analysis.
AB  - It is essential that the factors leading to bioprosthetic valve dysfunction are
      fully understood if a more durable bioprosthesis is to be developed and the
      incidence of premature failure reduced. Studies of explanted bioprostheses yield
      important information on both the aetiology of valve failure and influence of
      valve/host interactions. Details are given of the Sheffield Explant Study which
      holds data on 570 explants and 34 different models. Advantages and disadvantages
      of this type of study are discussed.

PMID- 1640445
TI  - A synthetic three-leaflet valve.
AB  - To increase durability and decrease calcification tendencies, the reduction of
      mechanical leaflet stress is of prime importance. In order to achieve this for a
      three-leaflet valve, the leaflets of a new design of prosthesis (the J-3) are
      manufactured in a medium open, almost flat shaped position, whereby the stent
      posts are expanded by a cone-shaped mold. Owing to this design, the leaflets have
      stable closed and open positions, the transition succeeds with low opening
      pressure. Valves are manufactured by dip-coating in polyurethane. Hydrodynamic
      evaluation of this polyurethane valve shows minimum pressure drop and very low
      energy losses compared with other commercially available valves. Very low shear
      stresses in the flow field downstream of the valve are observed by laser-Doppler
      anemometry. In durability tests, prototypes have reached lifetimes equivalent to
      17 years. For comparative testing of durability and biocompatibility, six
      bioprostheses and seven J-3 valves were implanted in mitral position of growing
      Jersey calves. While animal tests are encouraging, they also reveal necessary
      manufacturing improvements.

PMID- 1640446
TI  - Issues surrounding the preservation of viable allograft heart valves.
AB  - Allograft heart valves have been used for over 30 years. During the first decades
      of use, the research and clinical objectives were to find a means for long-term
      storage of tissue. Methods such as irradiation, glutaraldehyde fixation, long
      term antibiotic storage at 4 degrees C and other methods were common. These
      methods, however, were found to give reduced long-term clinical performance when
      compared with viable fresh tissue or tissue which had been cryopreserved.
      Recognizing this fact, more recent emphasis has been to address issues
      surrounding means by which allografts can be cryopreserved and thawed to retain
      maximum viability. An additional concern was to find a means to maximize donor
      retrieval by salvaging tissue which normally would be discarded because of
      bacterial contamination. This study demonstrates that when a proper
      cryopreservation technique is used, with stringent antibiotic treatments,
      biomechanical parameters remain normal with only a slight decrease in cell
      viability.

PMID- 1640447
TI  - Valve data collection: problems and pitfalls.
AB  - Since 1981, the Department of Medical Physics and Clinical Engineering at the
      University of Sheffield has been responsible for the organization, management and
      data collection associated with the largest multicentre heart valve implant
      patient follow-up study in the Western world. At the present time, the database
      comprises information on over 16,000 valve implants, which have been provided by
      57 surgeons working at 22 centres in the UK. All this data is available for in
      depth statistical analysis. Over 30 individual valve models presently are
      included in the Study and these can be categorized into five main types: ball,
      disc, porcine, pericardial and homograft. Analysis includes descriptive
      statistics as well as valuable information on the various performances of the
      different valves. Survival and event-free survival graphs are obtained by
      actuarial methods and individual valve types can be studied in depth in terms of
      freedom from thromboembolic complications and valve dysfunction. Whilst this
      approach provides interesting and valuable survival data, it does not take
      account of the wide variation in prognostic factors which occur within large
      groups of patients. This latter problem can be addressed by the use of
      proportional hazards analysis and this paper provides details of this approach
      and typical results obtained from the use of this method. These include the
      comparative performances of the major types of valves currently in use in terms
      of the event-free survival of the patients.

PMID- 1640448
TI  - Binding of proteins from embryonic and differentiated cells to a bidirectional
      promoter contained within a CpG island.
AB  - We have analysed binding sites of nuclear protein factors to a CpG island (HTF9),
      which contains the promoter for a pair of overlapping, divergently-transcribed
      "housekeeping" genes. Using DNaseI protection assays with extracts from a range
      of differentiated and undifferentiated cell lines, including mouse embryonic stem
      (ES) and embryonal carcinoma (EC) cells, we located multiple protein binding
      sites on HTF9. Most of the sites were outside the defined core promoter and could
      bind to previously identified transcription factors. These included constitutive,
      inducible and apparently tissue-specific factors in an extremely asymmetric array
      relative to the transcription start sites of the two genes. A number of sites
      showed different binding specificities or affinities in different cell types,
      including ES cells. However, we found no factors that were specific for both ES
      and EC cells, and no protein-binding site protected exclusively in
      undifferentiated embryonic cells.

PMID- 1640449
TI  - Eukaryotic initiation factor 3 does not prevent association through physical
      blockage of the ribosomal subunit-subunit interface.
AB  - The "native" 40 S ribosomal subunit, in which the protein eukaryotic initiation
      factor 3 is bound to the 40 S small ribosomal subunit, has been reconstructed to
      48 A resolution. Comparison with a previous three-dimensional reconstruction of
      the "derived" 40 S subunit lacking any non-ribosomal components reveals the
      attachment site and morphology of the factor. It is a large (approximately 165 to
      170 A long), bilobed, elongate structure, attached to the back lobes of the 40 S
      subunit by two strand-like features. Significantly, the factor is oriented away
      from the 60 S-subunit-40 S-subunit interface surface of the 40 S particle,
      suggesting that its anti-association activity is not accomplished via simple
      physical blockage of that surface.

PMID- 1640450
TI  - Kinking of RNA helices by bulged bases, and the structure of the human
      immunodeficiency virus transactivator response element.
AB  - We have used gel electrophoresis to show that the pyrimidine bulge of the HIV-1
      TAR sequence causes a local bending of the helical axis. The TAR bulge caused a
      retardation in electrophoretic mobility in polyacrylamide gels. When this was
      placed adjacent to an additional bulged sequence in a linear RNA fragment, the
      mobility of the molecule varied sinusoidally with the spacing between the two
      bulges. Electrophoretic mobilities suggested that the TAR sequence context of the
      pyrimidine bulge causes a greater degree of axial kinking than in an equivalent
      randomly chosen sequence. Experiments in which an A5 bulge was progressively
      opposed by adenine bases inserted in the opposite strand showed that even a
      single opposed adenine markedly reduced electrophoretic mobility, i.e. axial
      bending, and two adenine bases reduced the mobility virtually to that of a normal
      duplex. We suggest that the pronounced kinking resulting from an unopposed bulge
      provides a particularly recognizable feature in RNA, and that this is the basis
      of the interaction between the HIV Tat protein and the TAR sequence.

PMID- 1640451
TI  - Formation of the right before the left mature DNA end during packaging-cleavage
      of bacteriophage T7 DNA concatemers.
AB  - During bacteriophage T7 morphogenesis in a T7-infected cell, mature length T7 DNA
      molecules join end-to-end to form concatemers that are subsequently both packaged
      in the T7 capsid and cut to mature size. In the present study, the kinetics of
      the appearance in vivo of the mature right and left T7 DNA ends have been
      analyzed. To perform this analysis, the intercalating dye proflavine is used to
      interrupt DNA packaging. When used at 0.5 to 8.0 micrograms/ml, proflavine
      progressively inhibits events in the T7 DNA packaging pathway, without either
      altering protein synthesis or degrading intracellular T7 DNA. Restriction
      endonuclease kinetic analysis reveals that proflavine (8 micrograms/ml)
      completely blocks formation of the mature T7 DNA left end, but only partially
      blocks formation of the mature T7 DNA right end. Both these and other
      observations are explained by the hypothesis that, in the T7 DNA packaging
      pathway, events occur in the following sequence: (1) formation of a mature right
      end; (2) packaging of at least some of the genome; (3) formation of the mature
      left end.

PMID- 1640452
TI  - Mutational substitution of residues implicated by crystal structure in binding
      the substrate glutathione to human glutathione S-transferase pi.
AB  - Site-directed substitution mutations were introduced into a cDNA expression
      vector (pUC120 pi) that encoded a human glutathione S-transferase pi isozyme to
      non-conservatively replace four residues (Tyr7, Arg13, Gln62 and Asp96). Our
      earlier X-ray crystallographic analysis implicated these residues in binding
      and/or chemically activating the substrate glutathione. Each substitution
      mutation decreased the specific activity of the enzyme to less than 2% of the
      wild-type. Glutathione-binding was also reduced; however, the Tyr7----Phe mutant
      still retained 27% of the wild-type capacity to bind glutathione, underlining the
      primary role that this residue is likely to play in chemically activating the
      glutathione molecule during catalysis.

PMID- 1640453
TI  - Effect of conformational features on the aminoacylation of tRNAs and consequences
      on the permutation of tRNA specificities.
AB  - The structure and function of in vitro transcribed tRNA(Asp) variants with
      inserted conformational features characteristic of yeast tRNA(Phe), such as the
      length of the variable region or the arrangement of the conserved residues in the
      D-loop, have been investigated. Although they exhibit significant conformational
      alterations as revealed by Pb2+ treatment, these variants are still efficiently
      aspartylated by yeast aspartyl-tRNA synthetase. Thus, this synthetase can
      accommodate a variety of tRNA conformers. In a second series of variants, the
      identity determinants of yeast tRNA(Phe) were transplanted into the previous
      structural variants of tRNA(Asp). The phenylalanine acceptance of these variants
      improves with increasing the number of structural characteristics of tRNA(Phe),
      suggesting that phenylalanyl-tRNA synthetase is sensitive to the conformational
      frame embedding the cognate identity nucleotides. These results contrast with the
      efficient transplantation of tRNA(Asp) identity elements into yeast tRNA(Phe).
      This indicates that synthetases respond differently to the detailed conformation
      of their tRNA substrates. Efficient aminoacylation is not only dependent on the
      presence of the set of identity nucleotides, but also on a precise conformation
      of the tRNA.

PMID- 1640454
TI  - Transcriptional commitment of mitochondrial RNA polymerase from Saccharomyces
      cerevisiae.
AB  - The transcriptional commitment of mitochondrial RNA (mtRNA) polymerase and the
      conditions required for the formation of a stable ternary complex have been
      determined by in vitro transcription study. Four different transcription
      complexes were made in vitro by incubating purified mtRNA polymerase, cloned
      synthetic mitochondrial promoters and selective ribonucleotides. The responses of
      these complexes to heparin, an inhibitor of unbound mtRNA polymerase, have been
      examined to determine their involvement in transcription. This study leads to the
      following observations. (1) Under normal reaction conditions, 40 nM-heparin
      completely inhibited mitochondrial transcription. (2) A preinitiation
      mitochondrial DNA-RNA polymerase complex (complex 0) showed partial resistance to
      heparin (approximately 25% resistant to 40 nm-heparin) when heparin and
      ribonucleoside triphosphates (rNTPs) were added together to the preformed
      complex. This complex was rapidly inactivated when preincubated with heparin
      before the addition of rNTPs. (3) The early initiation (complexes 2 and 4)
      containing DNA template, RNA polymerase and a short RNA product showed more
      resistance (approx. 40 to 50%) to 40 nM-heparin but destabilized upon further
      incubation with heparin before addition of the rest of the rNTPs. (4) After
      generation of ten or more phosphodiester bonds (complex 11), the early
      transcription complex is converted into a stable initiation complex, leading to
      the polymerase consignment to elongation. On the basis of stability and heparin
      sensitivity, three initial steps of mitochondrial transcription have been
      defined: polymerase-promoter interaction, initiation, and the transition from
      initiation to elongation. The formation of preinitiation complex is the rate
      limiting step t 1/2 approx. 50 s), whereas the initiation and elongation
      reactions are very fast processes (t 1/2 greater than 5 s) in mitochondrial
      transcription.

PMID- 1640455
TI  - Sequence-specific DNA binding by a two zinc-finger peptide from the Drosophila
      melanogaster Tramtrack protein.
AB  - We show that the DNA-binding domain of the Drosophila melanogaster regulatory
      protein Tramtrack consists of a 66 amino acid sequence containing two zinc-finger
      motifs and a short sequence N-terminal to the first finger motif. This short N
      terminal sequence is essential for DNA binding and we suggest it is involved in
      maintaining the three-dimensional structure of the first finger domain, as has
      been seen in the nuclear magnetic resonance structure of one of the zinc-finger
      domains of the yeast transcription factor SW15. The characterization of the DNA
      binding activity of this 66 residue peptide (delta 911zf) shows that it binds in
      a sequence-specific manner, as a monomer, to a natural target site with an
      apparent KD approximately 4 x 10(-7) M. The shortest delta 911zf binding site,
      which retains full affinity, consists of an 11 base-pair sequence with a one
      nucleotide overhang at each 5' end. DNase I, hydroxyl radical and methylation
      protection footprinting studies show that, in common with other zinc-finger
      proteins, delta 911zf binds in the major groove of DNA. The data presented are
      consistent with the zinc-fingers of Tramtrack contacting both strands of the DNA,
      and thus the binding differs in detail to that observed in the crystal structure
      of the three zinc-fingers of Zif268 complexed to their target DNA.

PMID- 1640456
TI  - Arginine regulon of Escherichia coli K-12. A study of repressor-operator
      interactions and of in vitro binding affinities versus in vivo repression.
AB  - The 12 genes which in E. coli K-12 constitute the arginine regulon are organized
      in nine transcriptional units all of which contain in their 5' non-coding region
      two 18 bp partially conserved imperfect palindromes (ARG boxes) which are the
      target sites for binding of the repressor, a hexameric protein. In vitro binding
      experiments with purified repressor (a gift from W. K. Maas) were performed on
      the operator sites of four genes, argA, argD, argF, argG, and of two operons,
      carAb and the bipolar argECBH cluster. A compilation of results obtained by DNase
      I and hydroxyl radical footprinting clearly indicates that in each case the
      repressor binds symmetrically to four helical turns covering adjacent pairs of
      boxes separated by 3 bp, but to one face of the DNA only. Methylation protection
      experiments bring to light major base contacts with four highly conserved G
      residues symmetrically distributed in four consecutive major grooves. Symmetrical
      contacts in the minor groove with A residues have also been identified.
      Stoichiometry experiments suggest that a single hexameric repressor molecule
      binds to a pair of adjacent ARG boxes. Although the wild-type operator consists
      of a pair of adjacent ARG boxes separated by 3 bp (except argR where there are
      only 2 bp), repressor can bind to a single box but with a greatly reduced
      affinity. Therefore, adjacent boxes behave co-operatively with respect to the Arg
      repressor binding, in the sense that the presence of one box largely stimulates
      the binding of the properly located second box. The optimal distance separating
      two boxes is 3 bp, but one bp more or less does not abolish this stimulation
      effect. However, it is completely abolished by the introduction of two or more
      additional bp unless a full helical turn is introduced. Large variations in the
      in vivo repression response between individual arginine genes or a wild-type gene
      and cognate Oc type mutants are not reflected by similar differences in the in
      vitro binding results where only small differences are observed. The significance
      of this lack of correlation is discussed.

PMID- 1640457
TI  - Binding of the arginine repressor of Escherichia coli K12 to its operator sites.
AB  - In the arginine regulon of Escherichia coli K12 each of the eight operator sites
      consists of two 18-base-pair-long palindromic sequences called ARG boxes. In the
      operator sites for the structural genes of the regulon the two ARG boxes are
      separated by three base-pairs, in the regulatory gene argR they are separated by
      two base-pairs. The hexameric arginine repressor, the product of argR, binds to
      the two ARG boxes in an operator in the presence of L-arginine. From the results
      of various kinds of in vitro footprinting experiments with the ARG boxes of argF
      and argR (DNase I protection, hydroxyl radical, ethylation and methylation
      interference, methylation protection) it can be concluded that: (1) the repressor
      binds simultaneously to two adjacent ARG boxes; (2) that it binds on one face of
      the double helix; and (3) that it forms contacts with the major and minor grooves
      of each ARG box, but not with the central three base-pairs. The repressor can
      bind also to a single ARG box, but its affinity is about 100-fold lower than for
      two ARG boxes. From gel retardation experiments with 3H-labeled repressor and 32P
      labeled argF operator DNA, it is concluded that the retarded DNA-protein complex
      contains no more than one repressor molecule per operator site and that most
      likely one hexamer binds to two ARG boxes. The bound repressor was shown to
      induce bending of argF operator DNA. The bending angle calculated from the
      results of gel retardation experiments is about 70 degrees and the bending center
      was located within the region encompassing the ARG boxes. The main features that
      distinguish the arginine repressor from other repressors studied in E. coli are
      its hexameric nature and the simultaneous binding of one hexameric molecule to
      two palindromic ARG boxes that are close to each other.

PMID- 1640458
TI  - Morphological pathway of flagellar assembly in Salmonella typhimurium.
AB  - The process of flagellar assembly was investigated in Salmonella typhimurium.
      Seven types of flagellar precursors produced by various flagellar mutants were
      purified by CsCl density gradient protocol. They were characterized
      morphologically by electron microscopy, and biochemically by two-dimensional gel
      electrophoresis. The MS ring is formed in the absence of any other flagellar
      components, including the switch complex and the putative export apparatus. Four
      proteins previously identified as rod components, FlgB, FlgC, FlgF, FlgG, and
      another protein, FliE, assemble co-operatively into a stable structure. The hook
      is formed in two distinct steps; formation of its proximal part and elongation.
      Proximal part formation occurs, but elongation does not occur, in the absence of
      the LP ring. FlgD is necessary for hook formation, but not for LP-ring formation.
      A revised pathway of flagellar assembly is proposed based on these and other
      results.

PMID- 1640459
TI  - Conformational switching in the flagellar filament of Salmonella typhimurium.
AB  - The flagellar filament of the mutant Salmonella typhimurium strain SJW814 is
      straight, and has a right-handed twist like the filament of SJW1655. Three
      dimensional reconstructions from electron micrographs of ice-embedded filaments
      reveal a flagellin subunit that has the same domain organization as that of
      SJW1655. Both show slight changes from the domain organization of the subunits
      from SJW1660, which possesses a straight, left-handed filament. This points to
      the possible role of changes in subunit conformation in the left-to-right-handed
      structural transition in filaments. Comparison of the left and right-handed
      filaments shows that the subunit's orientation and intersubunit bonding appear to
      change. The orientation of the subunit in the SJW814 filament is intermediate
      between that of SJW1655 and SJW1660. Its intermediate orientation may explain why
      the filaments of SJW1655 and SJW1660 are locked in one conformation, whereas the
      filament of SJW814 can be induced to switch by, for example, changes in pH and
      ionic strength.

PMID- 1640460
TI  - Three-dimensional structure of a cloning vector. X-ray diffraction studies of
      filamentous bacteriophage M13 at 7 A resolution.
AB  - Filamentous bacteriophage M13 is a single-stranded DNA phage about 65 A in
      diameter and 9300 A long. X-ray diffraction studies of magnetically oriented
      fibers of native, mercury and iodine-labeled phage particles have been used to
      determine the arrangement of the major coat protein, the gene 8 product, in the
      virion. The coat protein is made up of a single gently curving alpha-helix
      extending from approximately Pro6 to near the carboxyl terminus. The axis of the
      alpha-helix is tilted about 20 degrees from the viral axis and wraps around the
      axis in a right-handed helical sense. The surface of the virus is made up largely
      of polar residues in the amino-terminal half of the protein including the segment
      of alpha-helix extending from Pro6 to Tyr24. The interior surface of the protein
      coat faces the DNA and consists of an amphipathic helical segment extending from
      Thr36 to Ser50. The alpha-helices form a tightly packed 15 to 20 A thick
      cylindrical coat around the DNA. This structural model provides insight into the
      potential sites for incorporating foreign protein domains that may act as
      functional binding sites on the surface of M13.

PMID- 1640461
TI  - Determination of eukaryotic protein coding regions using neural networks and
      information theory.
AB  - Our previous work applied neural network techniques to the problem of
      discriminating open reading frame (ORF) sequences taken from introns versus
      exons. The method counted the codon frequencies in an ORF of a specified length,
      and then used this codon frequency representation of DNA fragments to train a
      neural net (essentially a Perceptron with a sigmoidal, or "soft step function",
      output) to perform this discrimination. After training, the network was then
      applied to a disjoint "predict" set of data to assess accuracy. The resulting
      accuracy in our previous work was 98.4%, exceeding accuracies reported in the
      literature at that time for other algorithms. Here, we report even higher
      accuracies stemming from calculations of mutual information (a correlation
      measure) of spatially separated codons in exons, and in introns. Significant
      mutual information exists in exons, but not in introns, between adjacent codons.
      This suggests that dicodon frequencies of adjacent codons are important for
      intron/exon discrimination. We report that accuracies obtained using a neural net
      trained on the frequency of dicodons is significantly higher at smaller fragment
      lengths than even our original results using codon frequencies, which were
      already higher than simple statistical methods that also used codon frequencies.
      We also report accuracies obtained from including codon and dicodon statistics in
      all six reading frames, i.e. the three frames on the original and complement
      strand. Inclusion of six-frame statistics increases the accuracy still further.
      We also compare these neural net results to a Bayesian statistical prediction
      method that assumes independent codon frequencies in each position. The
      performance of the Bayesian scheme is poorer than any of the neural based
      schemes, however many methods reported in the literature either explicitly, or
      implicitly, use this method. Specifically, Bayesian prediction schemes based on
      codon frequencies achieve 90.9% accuracy on 90 codon ORFs, while our best neural
      net scheme reaches 99.4% accuracy on 60 codon ORFs. "Accuracy" is defined as the
      average of the exon and intron sensitivities. Achievement of sufficiently high
      accuracies on short fragment lengths can be useful in providing a computational
      means of finding coding regions in unannotated DNA sequences such as those
      arising from the mega-base sequencing efforts of the Human Genome Project. We
      caution that the high accuracies reported here do not represent a complete
      solution to the problem of identifying exons in "raw" base sequences. The
      accuracies are considerably lower from exons of small length, although still
      higher than accuracies reported in the literature for other methods. Short exon
      lengths are not uncommon.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1640462
TI  - Crystal structure of a berenil-d(CGCAAATTTGCG) complex. An example of drug-DNA
      recognition based on sequence-dependent structural features.
AB  - The AT-selective drug berenil has been co-crystallized with the dodecanucleotide
      sequence d(CGCAAATTTGCG)2. The crystal structure has been solved to a resolution
      of 2.0 A and an R factor of 18.3%, with the location of 65 water molecules. The
      drug is symmetrically bound in the 5'-AATT region of the minor groove, with its
      amidinium groups hydrogen-bonding to O-2 atoms of the thymine base at each end of
      the binding site. This arrangement is distinct from that previously found for
      berenil with the sequence d(CGCGAATTCGCG)2, which has the drug bound to the
      sequencing 5'-ATT via hydrogen bonds to adenine N-3 atoms with the involvement of
      a bridging water molecule at one end of the binding site. The reasons for these
      differences are discussed in terms of changes in helical parameters; in
      particular propeller twist and base-pair roll are considered to be important. The
      conformational and base-pair geometry of the dodecanucleotide in the structure
      reported here, is closely similar to that for the native structure, suggesting
      that the 5'-AAATTT sequence does not significantly alter during drug binding,
      either because of its inflexibility or because its geometry is nearly ideal for
      berenil binding.

PMID- 1640463
TI  - Accurate modeling of protein conformation by automatic segment matching.
AB  - Segment match modeling uses a data base of highly refined known protein X-ray
      structures to build an unknown target structure from its amino acid sequence and
      the atomic coordinates of a few of its atoms (generally only the C alpha atoms).
      The target structure is first broken into a set of short segments. The data base
      is then searched for matching segments, which are fitted onto the framework of
      the target structure. Three criteria are used for choosing a matching data base
      segment: amino acid sequence similarity, conformational similarity (atomic co
      ordinates), and compatibility with the target structure (van der Waals'
      interactions). The new method works surprisingly well: for eight test proteins
      ranging in size from 46 to 323 residues, the all-atom root-mean-square deviation
      of the modeled structures is between 0.93 A and 1.73 A (the average is 1.26 A).
      Deviations of this magnitude are comparable with those found for protein co
      ordinates before and after refinement against X-ray data or for co-ordinates of
      the same protein in different crystal packings. These results are insensitive to
      errors in the C alpha positions or to missing C alpha atoms: accurate models can
      be built with C alpha errors of up to 1 A or by using only half the C alpha
      atoms. The fit to the X-ray structures is improved significantly by building
      several independent models based on different random choices and then averaging
      co-ordinates; this novel concept has general implications for other modeling
      tasks. The segment match modeling method is fully automatic, yields a complete
      set of atomic co-ordinates without any human intervention and is efficient (14
      s/residue on the Silicon Graphics 4D/25 Personal Iris workstation.

PMID- 1640464
TI  - Order-disorder phenomena in myelinated nerve sheaths. IV. The disordering effects
      of high levels of local anaesthetics on rat sciatic and optic nerves.
AB  - Sequences of 15 minute X-ray scattering spectra were recorded with rat sciatic
      and optic nerves, superfused with tetracaine-containing Ringer solutions. The
      spectra were analysed using the algorithm advocated in this series of papers. The
      main results, as a function of the time of exposure to tetracaine, were: the mean
      value of the repeat distance increases; its variance decreases; the average
      number of membrane pairs per coherent domain decreases; the fraction of isolated
      membrane pairs increases. Eventually, the spectra were observed to give way to
      the continuous intensity curve of a single, isolated membrane pair. At all stages
      of the experiment the continuous intensity curves were found to differ from one
      type of nerve to the other, and to be invariant, for each type of nerve, with
      respect to the tetracaine treatment. The X-ray scattering study clearly
      identified the nature of the structural differences between the two types of
      myelin sheaths: in that of native sciatic nerves, packing disorder preferentially
      affects the cytoplasmic space of the membrane pair, and tetracaine disrupts the
      packing in that space; in the myelin of optic nerves it is the external space
      that is preferentially affected by packing disorder and disrupted by tetracaine.
      The time-course of the structure parameters showed that, at any stage of the
      experiment, tetracaine acts preferentially on the more highly disordered regions
      of the structure and totally disrupts them. These results corroborate earlier
      conclusions reported in the previous papers of this series. An electron
      microscope study was also performed on tetracaine-treated nerves: the results, in
      close agreement with those of the X-ray scattering study, neatly confirm the
      conclusions given above. In a more general way, the remarkable agreement between
      the results of the analysis of the X-ray scattering spectra and the electron
      microscope observations strongly supports the validity of the physical model used
      in this series of papers and the correctness of the mathematical treatment that
      we advocate. Finally, the relations between this work and the work of others are
      discussed. It must be stressed that the present work bears on the toxic rather
      than on the anaesthetic effects of tetracaine.

PMID- 1640465
TI  - Nuclear magnetic resonance detection of bound water molecules in the active site
      of Lactobacillus casei dihydrofolate reductase in aqueous solution.
AB  - Proton nuclear magnetic resonance spectroscopy has been used to detect two water
      molecules bound to residues in the active site of the Lactobacillus casei
      dihydrofolate reductase (DHFR). Their presence was detected by measuring nuclear
      Overhauser effects between NH protons in protein residues and protons in the
      individual bound water molecules in two-dimensional nuclear Overhauser effect
      spectroscopy (NOESY), in nuclear Overhauser effect spectroscopy in the rotating
      frame (ROESY) and three-dimensional 1H-15N ROESY-heteronuclear multiple quantum
      coherence spectra recorded on samples containing appropriately 15N-labelled DHFR.
      For the DHFR-methotrexate-NADPH complex, two bound molecules were found, one
      close to the Trp5 amide NH proton and the other near to the Trp21 indole HE1
      proton: these correspond to two of the water molecules (Wat201 and Wat253)
      detected in the crystal structure studies described by Bolin and co-workers.
      However, the nuclear magnetic resonance experiments did not detect any of the
      other bound water molecules observed in the X-ray studies. The nuclear magnetic
      resonance results indicate that the two bound water molecules that were detected
      have lifetimes in the solution state that are longer than approximately two
      nanoseconds. This is of considerable interest, since one of these water molecules
      (Wat253) has been implicated as the likely proton donor in the catalytic
      reduction of dihydrofolate to tetrahydrofolate.

PMID- 1640466
TI  - Purification and crystallization of human cathepsin D.
AB  - The two-chain form of human cathepsin D was purified from human spleen with a
      method utilizing an ion exchange chromatography step prior to the pepstatin
      affinity column normally used to purify aspartic proteases. The protein was
      crystallized from 21% polyethylene glycol 8000 at pH 4.0 using the hanging drop
      vapour diffusion method. Small crystals were used as seeds to grow crystals
      suitable for X-ray data collection. The crystals diffract to a resolution of 3.2
      A and have space group P2(1)2(1)2(1) with unit cell dimensions a = 59.9 A, b =
      99.6 A, c = 133.6 A. There are two molecules in the asymmetric unit.

PMID- 1640467
TI  - Crystallization of kappa-bungarotoxin: preliminary X-ray data obtained from the
      venom-derived protein.
AB  - kappa-Bungarotoxin is a 66 residue polypeptide found in the venom of the
      Taiwanese banded krait, Bungarus multicinctus. It binds tightly to neuronal
      nicotinic acetylcholine receptors and inhibits nerve transmission mediated by
      these postsynaptic receptors. It is related, by similarity in amino acid
      sequence, to alpha-bungarotoxin and other alpha-neurotoxins, but differs sharply
      in physiologic action. The alpha-neurotoxins inhibit nerve transmission in
      nicotinic acetylcholine receptors associated with vertebrate skeletal muscle and
      fish electric organs. The kappa-neurotoxins inhibit nerve transmission in
      neuronal nicotinic acetylcholine receptors such as those found in chick ciliary
      ganglia. The kappa-neurotoxins display a low level of interaction with receptors
      that are strongly affected by alpha-neurotoxins, but alpha-neurotoxins are
      completely without effect on receptors that are affected by kappa-bungarotoxin.
      The structural basis for this physiologic differentiation is not known. Crystals
      of kappa-bungarotoxin have now been obtained that diffract to at least 2.3 A.
      These crystals are hexagonal, space group P6, and have dimensions of a = b = 80.2
      A, c = 39.6 A, and angles of alpha = beta = 90 degrees and gamma = 120 degrees.
      Each unit cell contains 12 molecules of the 66 residue protein or two molecules
      per asymmetric unit. Comparison of the structure of kappa-bungarotoxin, which
      will result from further diffraction analysis of these crystals, with the
      structures of the alpha-neurotoxins that have been determined may provide
      information on the structural basis of physiologic action in these acetylcholine
      receptor antagonists.

PMID- 1640468
TI  - Crystallographic data for the 9000 dalton wheat non-specific phospholipid
      transfer protein.
AB  - The wheat non-specific phospholipid transfer protein belongs to a family of small
      proteins sharing a common pattern of four disulphide bridges. Its function in
      vivo is not known, but it has a high affinity to phospholipids and is involved in
      phospholipid transfer in vitro. The molecular weight is 9607, and it crystallizes
      in the space group P2(1) with a = 40.73 A, b = 112.11 A, c = 50.44 A and beta =
      106.80 degrees. The crystals diffract to 3 A resolution.

PMID- 1640469
TI  - Crystallization of the NAD-dependent malic enzyme from the parasitic nematode
      Ascaris suum.
AB  - The malic enzyme from muscle mitochondria of the parasitic nematode Ascaris suum
      is a tetramer of 65 kDa monomers that catalyzes the oxidative decarboxylation of
      malate to pyruvate and CO2 with NAD cofactor as oxidant. This malic enzyme is
      critical to the nematode for muscle function under anaerobic conditions. Unlike
      mammalian versions of the enzyme such as that found in rat liver, which require
      NADP as cofactor, the nematode version is an NAD-dependent enzyme. We report the
      crystallization of samples of the nematode enzyme at room temperature from pH 7.5
      solutions of polyethylene glycol 4000 containing magnesium sulfate, NAD and
      sodium tartronate. Immediately upon mixing of protein and precipitant solutions,
      a marked precipitation of the protein occurs. Out of this precipitate, crystals
      appear almost immediately, most commonly in a truncated cube form that can grow
      to 0.5 to 0.7 mm on a cube edge in two to three days. The crystals are trigonal,
      space group P3(1)21 or its enantiomer, with a = b = 131.2(7) A, c = 152.6(9) A,
      and two monomers per asymmetric unit. Fresh crystals diffract X-radiation from a
      synchrotron source (lambda = 0.95 A) to about 3.0 A resolution. Rotational
      analysis of Patterson functions indicates that the malic enzyme tetramer has 222
      symmetry.

PMID- 1640470
TI  - Factors influencing a woman's decision to end an extramarital sexual
      relationship.
AB  - While the role of individual characteristics has been examined for extramarital
      sexual involvement, the literature has yet to document personal factors
      associated with the termination of an affair. In doing so, this study examines
      the impact of a woman's sex role attributes ("masculinity") and attitudes toward
      sex (erotophobia-erotophilia) on her decision to terminate an extramarital
      affair. Masculinity was not related to affair length. The more positive a woman's
      attitude toward sex, the longer she continued the extramarital relationship. A
      further descriptive analysis suggests that this relationship may hold only for
      women in sexual affairs. The implications of these findings, methodological
      advances, and limitations of this study are discussed. Finally, recommendations
      for future research are explored.

PMID- 1640471
TI  - Infrequent orgasms in women.
AB  - Out of a sample of 2,425 gynecological patients aged 21-40 and married for at
      least one year, three groups were selected according to the frequency of coital
      orgasm. The first, orgastic, group contained 1,266 (52.2%) orgastic women, the
      second group included 466 (19.2%) patients with infrequent orgasms, and the third
      group consisted of 151 (6.2%) patients whose infrequent orgasms were felt by the
      examinees as distressing. Significant differences were found between the three
      groups concerning family environment and childhood, level of education and
      professional standing, sexual development and life, and in the incidence of
      psychopathological symptoms. It appears that the insufficient capacity of many
      women to attain regular orgasms in sexual intercourse is caused by several
      factors of both biological and psychosocial nature.

PMID- 1640472
TI  - It takes two to tango but one to infect (on the underestimation of the calculated
      risk for infection with HIV in sexual encounters, arising from nondisclosure of
      previous risk behavior or seropositivity).
AB  - The effects of nondisclosure of either HIV seropositivity or previous engagement
      in risk behavior on the estimation of risk in sexual intercourse is studied
      through the use of a probability model. Equations are utilized to derive an
      Underestimation Factor for three cases, which is shown to range from 2 to 20 in
      the case of insertive anal intercourse between an HIV+ and an HIV- man, and to 1
      x 10(4) in a similar case of heterosexual insertive vaginal intercourse. This
      factor remains constant regardless of the number of sexual encounters between the
      same partners, and regardless of the protective measures as long as unawareness
      prevails. The discussion focuses on the implications of this formulation for
      education and social attitudes toward disclosure and nondisclosure in sexual
      encounters. It also raises the question of moral responsibility of sexual
      partners and some legal aspects of nondisclosure.

PMID- 1640473
TI  - Sexoanalysis: a new insight-oriented treatment approach for sexual disorders.
AB  - Sexoanalysis is an innovative therapeutic approach for the treatment of complex
      sexual disorders. This approach integrates current knowledge on sexual/erotic
      development pathology within a psychodynamic framework to help patients gain
      insight on the secondary gains, anxieties, and intrapsychic issues that are at
      the roots of their sexual problem. The treatment process essentially focuses on
      the analysis of sexual fantasies and the modification of maladaptive erotic
      imagery. The present authors present a brief overview of sexoanalytic theory and
      describe how sexoanalysis can resolve sexual disorders, improve sexual/erotic
      functioning, and promote sexual maturity. A clinical illustration is provided to
      help further clarify the sexoanalytic treatment process and demonstrate the use
      and utility of this promising sexotherapeutic approach.

PMID- 1640474
TI  - Brief report: recent findings on the Sexual Aversion Scale.
AB  - This study provides additional information on the psychometric properties of the
      Sexual Aversion Scale (SAS). Results suggest a positive relationship between
      sexual aversion, generalized anxiety, and history of sexual victimization.
      Variables such as age and religiosity were unrelated to scores on the SAS,
      although females reported significantly more sexual anxiety than males. The
      factor structure of the SAS is described and suggests that sexual aversion is a
      multifaceted problem with at least three and possibly four different dimensions.

PMID- 1640475
TI  - Sex therapy with dissociative disorders: a protocol.
AB  - Female victims of childhood sexual abuse who develop dissociative disorders often
      suffer from sexual dysfunction but do not receive sex therapy as often as might
      be expected due to the problems created by dissociative defenses. A modification
      of standard sex therapy techniques is proposed as a step toward restoring sexual
      function to this population. Key elements of the protocol are Eriksonian
      utilization of dissociative defenses, reduced expectations, and careful
      preparation of the male partner.

PMID- 1640476
TI  - Etiological attributions, responsibility attributions, and marital adjustment in
      erectile dysfunction patients.
AB  - The relationships between responsibility attributions, etiological attributions
      (psychogenically versus biogenically caused), and marital adjustment were
      explored in 30 erectile dysfunction patients and their partners via the
      Attributions Regarding Sexual Dysfunction Questionnaire and the Dyadic Adjustment
      Scale. Exploration of responsibility attributions yielded a consistent pattern of
      blaming the identified patient. This pattern is discussed in terms of two
      perspectives in attributional theory: the "self-serving bias" and the "just
      world" hypothesis. Etiological attributions were not relevant to actual
      diagnosis, marital adjustment, choice of treatment professional, or expectations
      for treatment outcome. Partner agreement regarding etiology was not related to
      actual cause or marital adjustment.

PMID- 1640477
TI  - Probing for prognostic markers at the cellular level: potentials and pitfalls.

PMID- 1640478
TI  - Crystallography getting attention on earth and in space.

PMID- 1640479
TI  - NASA and NIH sign research agreement.

PMID- 1640480
TI  - Nordic countries see rapid increase in melanoma.

PMID- 1640481
TI  - Sun-less tans may be possible with synthetic hormone.

PMID- 1640482
TI  - Antiproliferative and antitumor activity of the 2-cyanoaziridine compound imexon
      on tumor cell lines and fresh tumor cells in vitro.
AB  - BACKGROUND: Imexon, a 2-cyanoaziridine, is therapeutic and reverses
      lymphadenopathy and splenomegaly in the LP-BM5 murine retrovirus-induced
      immunodeficiency disease (murine AIDS). It can restore chemotherapy-induced
      immunosuppression. Imexon reduced the incidence of lymphoma in severe combined
      immune deficient mice inoculated with human lymphocytes. PURPOSE: To determine
      its antitumor activity, we screened imexon against fresh human tumor cells and
      tumor cell lines. To determine the time-concentration relationships of its
      cytotoxicity, we studied the effects of imexon on macromolecular synthesis and on
      the cell cycle. METHODS: Imexon was incubated at 1-200 micrograms/mL with various
      tumor cell lines, mitogen-stimulated peripheral blood lymphocytes, and fresh
      tumor cells. Cell survival, macromolecular synthesis, and cell cycle progression
      were studied. RESULTS: The concentration of imexon that caused 50% inhibition of
      growth was under 10 micrograms/mL for lymphocytes stimulated with mitogens. It
      was about 3-10 micrograms/mL for B-cell lymphomas and both multi-drug-resistant
      and -sensitive myeloma cell lines. Imexon inhibited four of seven fresh lymphoma
      and 11 of 16 fresh myeloma biopsy specimens to less than 40% of the control. A 1
      hour exposure of lymphoma cells to 50-100 microgram/mL followed by removal of
      drug by washing the cells and continuing culture resulted in greater than 95%
      inhibition during the next 48-72 hours. Imexon selectively inhibited protein
      synthesis during the first 24-48 hours of exposure of lymphoma and myeloma cells.
      Cells exposed to inhibitory concentrations of imexon were blocked in cell cycle
      progression. CONCLUSION: Imexon may be a potentially useful agent in the
      treatment of malignant disease, particularly lymphoid malignancies, and should be
      explored further.

PMID- 1640483
TI  - Adjuvant radiotherapy and risk of contralateral breast cancer.
AB  - BACKGROUND: The risk of contralateral breast cancer is increased twofold to
      fivefold for breast cancer patients. A registry-based cohort study in Denmark
      suggested that radiation treatment of the first breast cancer might increase the
      risk for contralateral breast cancer among 10-year survivors. PURPOSE: Our goal
      was to assess the role of radiation in the development of contralateral breast
      cancer. METHODS: A nested case-control study was conducted in a cohort of 56,540
      women in Denmark diagnosed with invasive breast cancer from 1943 through 1978.
      Case patients were 529 women who developed contralateral breast cancer 8 or more
      years after first diagnosis. Controls were women with breast cancer who did not
      develop contralateral breast cancer. One control was matched to each case patient
      on the basis of age, calendar year of initial breast cancer diagnosis, and
      survival time. Radiation dose to the contralateral breast was estimated for each
      patient on the basis of radiation measurements and abstracted treatment
      information. The anatomical position of each breast cancer was also abstracted
      from medical records. RESULTS: Radiotherapy had been administered to 82.4% of
      case patients and controls, and the mean radiation dose to the contralateral
      breast was estimated to be 2.51 Gy. Radiotherapy did not increase the overall
      risk of contralateral breast cancer (relative risk = 1.04; 95% confidence
      interval = 0.74-1.46), and there was no evidence that risk varied with radiation
      dose, time since exposure, or age at exposure. The second tumors in case patients
      were evenly distributed in the medial, lateral, and central portions of the
      breast, a finding that argues against a causal role of radiotherapy in
      tumorigenesis. CONCLUSIONS: The majority of women in our series were
      perimenopausal or postmenopausal (53% total versus 38% premenopausal and 9% of
      unknown status) and received radiotherapy at an age when the breast tissue
      appears least susceptible to the carcinogenic effects of radiation. Based on a
      dose of 2.51 Gy and estimates of radiation risk from other studies, a relative
      risk of only 1.18 would have been expected for a population of women exposed at
      an average age of 51 years. Thus, our data provide additional evidence that there
      is little if any risk of radiation-induced breast cancer associated with exposure
      of breast tissue to low-dose radiation (e.g., from mammographic x rays or
      adjuvant radiotherapy) in later life.

PMID- 1640484
TI  - Altered expression of the retinoblastoma gene product: prognostic indicator in
      bladder cancer.
AB  - BACKGROUND: It has been reported that 50%-70% of patients with bladder cancer
      experience recurrence after initial successful treatment and about 10%-20% of
      these patients die of the disease. Despite precise pathologic staging and
      grading, we are unable to predict clinical outcome in all patients. The
      retinoblastoma-susceptibility (RB) gene, a prototype of tumor suppressor genes,
      has recently been associated with development and/or progression of bladder
      cancer, as well as sarcoma and small-cell lung cancer. In transitional cell
      carcinomas of the bladder, we have observed altered expression of the Rb gene
      product--a nuclear phosphoprotein thought to function as a cell cycle regulator.
      PURPOSE: The aim of this study was to investigate the hypothesis that altered
      patterns of Rb expression correlate with prognosis in bladder cancer. METHODS:
      Expression of the RB gene was evaluated in specimens from 48 primary bladder
      tumors obtained by cystectomy or transurethral resection. Rb protein expression
      was correlated with disease outcome in these patients. Rb expression was examined
      by immunohistochemistry, using the mouse monoclonal antibody Rb-PMG3-245 on
      frozen tissue sections. Computerized image analysis was used to quantify the
      level of Rb protein in individual tumor cells. RESULTS: The overall 5-year
      disease-free survival was 66%, with a median follow-up of 42 months. Normal
      levels of Rb protein expression were found in 34 patients (Rb-positive group). A
      spectrum of altered patterns of expression from undetectable levels to
      heterogeneous expression, however, was observed in 14 patients (altered Rb
      group). Of the 38 patients with muscle-invasive tumors, 13 were categorized as
      having altered expression of Rb protein. Only one of 10 patients with superficial
      carcinomas had altered expression of Rb protein. The 5-year survival was
      significantly decreased in patients with altered Rb protein compared with the
      survival in patients with positive Rb expression (P less than .001). CONCLUSIONS:
      The results suggest that tumors exhibiting decreased expression of the RB gene
      coded product (Rb protein) had a more aggressive biological behavior than those
      that expressed the Rb protein in the majority of their tumor cells. IMPLICATIONS:
      This study demonstrates that altered patterns of Rb protein expression may be an
      important prognostic variable in patients presenting with invasive bladder
      cancer.

PMID- 1640485
TI  - Altered expression of retinoblastoma protein and known prognostic variables in
      locally advanced bladder cancer.
AB  - BACKGROUND: The clinical behavior of the tumor in patients with locally advanced
      bladder carcinoma is unpredictable. Current predictors of clinical behavior
      include depth of muscle invasion, presence of vascular invasion, proliferation
      rate, and loss of blood group antigens. Treatment selection would be facilitated
      by the development of a reliable marker of tumor progression. Functional
      retinoblastoma (RB) gene loss has been reported to occur in bladder carcinoma,
      but the significance of this loss is unknown. PURPOSE: We have evaluated the
      frequency of functional loss of the RB gene in locally advanced bladder carcinoma
      and have compared the results to known prognostic factors in the same cohort.
      METHODS: Forty-three study patients with pathologically well-characterized,
      locally advanced bladder carcinoma, who were placed in a protocol incorporating
      surgery and chemotherapy, were studied for known clinical and pathological
      prognostic indicators as well as for their Rb status. Formalin-fixed and paraffin
      embedded archival primary tumor tissues were used for histological and
      immunohistochemical analyses. RESULTS: Altered Rb protein expression was
      documented in 37% of the tumor specimens. The high rate of altered Rb expression
      found in this cohort with advanced urothelial tumors strongly suggests that RB
      functional loss may be associated with tumor progression in this malignancy.
      Altered Rb protein expression was found to be independent of other known
      prognostic variables. A significantly poorer tumor-free survival rate also was
      noted for those patients who had a tumor with an altered Rb protein with or
      without vascular invasion. CONCLUSION: The high frequency of Rb alteration in
      locally advanced bladder carcinomas, plus the fact that a significant correlation
      could not be found between the Rb status and other known prognostic markers in
      this preliminary study, suggests that altered RB expression may be an independent
      prognostic marker of tumor progression in bladder cancer.

PMID- 1640486
TI  - Cigarette smoking and other risk factors for progression of precancerous stomach
      lesions.
AB  - BACKGROUND: Stomach cancer is generally thought to evolve through a series of
      gastric mucosal changes, but the determinants of the precancerous lesions are not
      well understood. PURPOSE: Our purpose was to assess risk factors for intestinal
      metaplasia and gastric dysplasia arising from chronic atrophic gastritis in a
      general population at high risk for stomach cancer. METHODS: A population-based
      gastroscopic screening of more than 3000 residents was conducted in a county in
      China with one of the world's highest rates of stomach cancer. Information on the
      lifestyle and other characteristics of the participants was obtained by
      interview, and responses were compared between those in whom the most advanced
      gastric lesion was dysplasia or intestinal metaplasia versus those with chronic
      atrophic gastritis. RESULTS: Cigarette smoking was found to nearly double the
      risk of transition to dysplasia and to be a mild risk factor for intestinal
      metaplasia. Smoking accounted almost entirely for the 55% higher prevalence of
      dysplasia among men than among women. Risk of transition to dysplasia had a weak
      association with several dietary factors and was increased among those
      participants with a family history of stomach cancer and with blood type A.
      CONCLUSIONS: The findings provide strong evidence for a role of tobacco
      consumption and offer clues to other environmental and genetic factors involved
      in the process of gastric carcinogenesis.

PMID- 1640487
TI  - Multiparametric prognostic evaluation of biological factors in primary breast
      cancer.
AB  - BACKGROUND: An array of biological features related to tumor cell differentiation
      status, growth rate, and invasive potential have been identified as potential
      prognostic factors in breast cancer. We were interested in determining their
      relative importance in predicting patient survival. PURPOSE: We evaluated the
      relative weight of the following four biological factors in predicting survival
      of patients with breast cancer: tumor cell DNA content (determined by flow
      cytometry), tumor cell proliferation rate (determined by thymidine kinase
      activity), expression levels of cathepsin D and urokinase plasminogen activator,
      and several "classical" clinical and histological factors. METHODS: Selected from
      a prospectively updated database, the study population consisted of 319 primary
      breast cancer patients who received treatment and follow-up care (median, 6
      years) in the Centre Rene Huguenin. To determine the profile of biological
      factors for each patient, we used frozen tumor specimens and (except for the flow
      cytometric DNA content assay) commercially available assay kits. We determined by
      Cox multivariate analysis the relationships of the biological factors to each
      other, to classical prognostic factors, and to disease-free and metastasis-free
      survival. RESULTS: In the overall population, disease-free survival was best
      predicted by node status (P = .004), clinical tumor size (P = .02), and cathepsin
      D expression (P = .01), whereas metastasis-free survival was best predicted by
      node status (P = .0004), clinical tumor size (P = .009), and urokinase
      plasminogen activator expression (P = .04). In node-negative patients, thymidine
      kinase activity was the only factor selected for disease-free (P = .04) and
      metastasis-free (P = .05) survival. In node-positive patients, the number of
      positive axillary lymph nodes was the only factor selected for disease-free (P =
      .0008) and metastasis-free (P = .00017) survival. CONCLUSIONS: Our retrospective
      analysis has identified protease expression and tumor cell proliferation rate as
      important biological prognostic factors in breast cancer. Prospective clinical
      trials should be undertaken to confirm these results.

PMID- 1640488
TI  - Evaluation of in vivo breast fine needle aspirates by flow cytometry: an efficacy
      study.
AB  - BACKGROUND: Malignancy of the breast is frequently diagnosed through fine needle
      aspiration. In the hands of a skilled aspirator and cytopathologist, this can be
      a highly accurate procedure. PURPOSE: This study was undertaken to evaluate
      whether sufficient residual cells in the bore of the needle could be harvested
      and analyzed efficiently by flow cytometry analysis. The goal was then to
      determine the value of routine flow cytometry as an adjunctive technology in the
      interpretation of breast fine needle aspirations. METHODS: Cells were rinsed from
      the needles of 83 consecutive diagnostic fine needle aspirates after preliminary
      inspection had confirmed adequate material was obtained for cytopathology. Cells
      were washed, and nuclei prepared by detergent treatment. After ribonuclease
      treatment, DNA was stained with the fluorescent marker propidium iodide. DNA
      content per cell was determined by flow cytometry by measurement of right-angle
      fluorescence. RESULTS: Less than 4% of the samples were rejected for inadequate
      cell numbers. Flow cytometry criteria for evidence of malignancy included the
      presence of a DNA aneuploid population or an elevated rate of proliferation (13%
      or higher) of a diploid population. Accuracy of flow cytometry was based on
      cytopathologic interpretation in all cases except two which were based on results
      of excisional biopsy. The sensitivity of the flow cytometry analysis was 76%; the
      specificity was 100%, with results from flow cytometry pivotal in the correct
      diagnoses for two patients whose cytopathologic results were equivocal. Analysis
      of histograms indicated acceptable coefficients of variation for all populations.
      Gating analysis indicated the suitability of the material for this type of study,
      with an average of 85% of the events selected, or "gated in." Low recoveries were
      associated with the presence of necrotic debris in the sample. CONCLUSION: Flow
      cytometry can be a valuable adjunctive technology, capable of providing the
      cytopathologist with additional information regarding the character of cells
      analyzed.

PMID- 1640489
TI  - Incidence of non-Hodgkin's lymphomas in Italy. Working Group on the Epidemiology
      of Hematolymphopoietic Malignancies in Italy.

PMID- 1640490
TI  - Antineoplastic drug screening.

PMID- 1640491
TI  - BNCT: looking for a few good molecules.

PMID- 1640492
TI  - Axonal regeneration of an identified Helisoma neuron depends on the site of
      axotomy.
AB  - Axotomy of molluscan neurons usually results in axonal regeneration. In this
      study, we tested the axotomy response of an identified neuron of the pond snail
      Helisoma trivolvis (buccal neuron 4, B4). This neuron has two primary axonal
      branches, the ipsilateral axon and the contralateral axon, each innervating one
      of the paired salivary glands. The ipsilateral axon projects via the ipsilateral
      esophageal nerve trunk whereas the contralateral axon crosses both buccal ganglia
      and projects via the contralateral esophageal nerve trunk. We tested various
      procedures of axotomy: injury to one axon or both axons, close to the ganglion or
      more distal. Surprisingly, we found that proximal axotomy of the ipsilateral axon
      was not usually followed by axonal regeneration. By contrast, all other
      procedures of axotomy (e.g., distal ipsilateral, or proximal bilateral) resulted
      in robust axonal regeneration and target reinnervation. Thus, in this
      preparation, axotomy may or may not result in axonal regeneration, depending on
      the site(s) of axotomy. To the best of our knowledge, such a differential result
      has not yet been found in any other preparation. We conclude that axotomy is not
      always a sufficient condition for axonal regeneration of molluscan neurons. We
      hypothesize that a damaged axonal stump may be a necessary condition for the
      initiation of regeneration. An alternative hypothesis is that neurite outgrowth
      is inhibited in normal mature neurons by a target-derived factor. This
      hypothetical factor would be transported retrogradely, but not anterogradely,
      along axons.

PMID- 1640493
TI  - Common sequence on distinct V beta genes defines a protective idiotope in
      experimental encephalomyelitis.
AB  - Synthetic TCR peptides expressed by encephalitogenic T cells can induce both
      cellular and humoral responses that protect against experimental
      encephalomyelitis. In the Lewis rat, encephalitogenic T cells predominantly
      express V beta 8.2, and a peptide in the CDR2 region representing residues 39-59
      could both protect against and treat experimental autoimmune encephalitis (EAE).
      Similarly, the homologous and cross reactive 39-59 peptide from V beta 8.6
      expressed by an EAE-protective clone also had protective and therapeutic activity
      against EAE. The consensus sequence between the V beta 8.2 and V beta 8.6
      peptides, which included residues 44-54, was postulated to contain the protective
      idiotope. In this report, we demonstrate that this peptide, designated V beta 8
      44-54, has comparable activity to the longer peptides for treating both active
      and passive EAE. Similar to the longer V beta 8.2-39-59 peptide, the V beta 8-44
      54 peptide stimulates protective TCR peptide-specific CD4+, CD8dim T cells
      restricted by MHC I. We also report for the first time the recovery of V beta 8
      44-54 reactive T cells that express a variety of V beta genes in their T-cell
      receptor (TCR), including V beta 4, 8, 10, 12, 15, 17, 19, and 20. Taken
      together, these data establish that the V beta 8-44-54 sequence constitutes an
      important autoregulatory idiotope in EAE.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640494
TI  - Transferrin receptor expression in myelin deficient (md) rats.
AB  - The question of iron regulation in the brain is the subject of increasing
      interest as the evidence continues to accumulate that a loss of brain iron
      homeostasis plays a significant role in some neurodegenerative diseases. Most
      cells acquire iron through a specific receptor mediated process involving
      transferrin, the iron mobilization protein. It appears that in the brain,
      endothelial cells, neurons, and oligodendrocytes express the transferrin
      receptor. This study uses a strain of rats (myelin deficient, md) in which
      oligodendrocytes fail to mature, and examines the consequences of this genetic
      defect on the expression of the transferrin receptor in the brain. The affinity
      of transferrin for its receptor is similar between the cerebral cortex and
      cerebellum in both the normal and myelin deficient rats (Kd = 7.8-10.6 nM). The
      transferrin receptor density is normally 2-3 times higher in the cerebellum than
      in the cerebral cortex. In the myelin deficient rat strain, the density of the
      transferrin receptor is decreased in both the cerebrum (56%) and cerebellum (70%)
      compared to the littermate control animals. Because oligodendrocytes are the only
      cell type affected in this mutant, the results suggest that these cells are
      responsible for a considerable amount of the transferrin receptors that are
      expressed in the brain (excluding the endothelial cell contributions). These
      observations are consistent with the existing literature stating that
      oligodendrocytes are responsible for the majority of transferrin and transferrin
      mRNA which is expressed in the brain, and support the working hypothesis that
      imbalances in brain iron homeostasis, particularly during development, are
      associated with myelin disorders.

PMID- 1640495
TI  - Immunohistochemical localization of beta-amyloid precursor protein sequences in
      Alzheimer and normal brain tissue by light and electron microscopy.
AB  - Immunohistochemical staining with antibodies directed against four segments of
      the amyloid precursor protein (APP) was studied by light and electron microscopy
      in normal and Alzheimer (AD) brain tissue. The segments according to the Kang et
      al. sequence were: 18-38 (T97); 527-540 (R36); 597-620 (1-24 of beta-amyloid
      protein [BAP], R17); and 681-695 (R37) (Kang et al. [1987]: Nature 325:733-736).
      The antibodies recognized full length APP in Western blots of extracts of APP
      transfected cells. They stained cytoplasmic granules in some pyramidal neurons in
      normal appearing tissue from control and AD cases. In AD affected tissue, the
      antibodies to amino terminal sections of APP stained tangled neurons and neuropil
      threads, and intensely stained dystrophic neurites in senile plaques. By electron
      microscopy, this staining was localized to abnormal filaments. The antibody to
      the carboxy terminal segment failed to stain neurofibrillary tangles or neuropil
      threads; it did stain some neurites with globular swellings. It also stained
      globular and elongated deposits in senile plaque areas. The antibody against the
      BAP intensely stained extracellular material in senile plaques and diffuse
      deposits. By electron microscopy, the antibodies all stained intramicroglial
      deposits. Some of the extracellular and intracellular BAP-positive deposits were
      fibrillary. Communication between intramicroglial and extracellular fibrils was
      detected in plaque areas. These data suggest the following sequence of events.
      APP is normally concentrated in intraneuronal granules. In AD, it accumulates in
      damaged neuronal fibers. The amino terminal portion binds to abnormal
      neurofilaments. Major fragments of APP are phagocytosed and processed by
      microglia with the BAP portion being preserved. The preserved BAP is then
      extruded and accumulates in extracellular tissue.

PMID- 1640496
TI  - Reactive microglia/macrophages phagocytose amyloid precursor protein produced by
      neurons following neural damage.
AB  - Kainic acid lesions of rat striatum caused an elevation of amyloid precursor
      protein (APP) immunoreactivity in neurons and neurites, some of which were then
      phagocytosed by reactive microglia/macrophages. Immunoexpression of APP was
      observed in neurites and neurons 1 day after the kainic injection. Four days
      after lesioning, immunoreactivity was still concentrated in thick and distorted
      neurites, but it began to appear in microglia/macrophages and in the tissue
      matrix. The cells were identified as microglia/macrophages by the phenotypic
      markers Ia (OX6), leukocyte common antigen (OX1), C3bi receptor (OX42), and
      macrophage marker (ED1). They were negative for the astrocytic marker glial
      fibrillary acidic protein (GFAP). APP immunoreactivity in these phagocytic cells
      was most prominent between 1 week and 1 month postlesioning. No extracellular
      amyloid fibrils were detectable. These results suggest that APP production is
      rapidly upregulated in damaged neurons and accumulates in degenerating axons.
      However, phagocytosis of APP by reactive microglia/macrophages in this rat model
      does not result in production of Alzheimer type amyloid deposits.

PMID- 1640497
TI  - Substratum-induced modulation of acetylcholinesterase activity in cultured dorsal
      root ganglion neurons.
AB  - Acetylcholinesterase (AChE) has been shown to be transiently expressed in the
      developing nervous system during periods of neuronal migration and axonal
      outgrowth. We are investigating the possible interaction of substratum with AChE
      activity in dorsal root ganglion neurons (DRGN) cultured on substrata with
      varying degrees of permissiveness for neurite outgrowth: (1) extracellular matrix
      substrata: reconstituted basal lamina Matrigel (MGEL), laminin (LAM) and type I
      collagen (COL), and (2) organotypic substrata: unfixed, frozen sections of
      sciatic nerve (SN) and spinal cord (SC). In group 1, histochemical staining for
      AChE in DRGN was lowest on MGEL where outgrowth was most vigorous, intermediate
      on LAM, and highest on COL where neurite outgrowth was reduced by 55% compared to
      Matrigel and highly fasciculated. A similar trend was seen when the cultures were
      assayed biochemically, 2.84 +/- 0.14 nmoles ACh hydrolyzed/ganglion/hr (MGEL),
      4.42 +/- 0.19 (LAM), 5.79 +/- 0.37 (COL). In group 2, SN supported an expansive
      outgrowth with lower AChE activity than in DRGN grown on SC where outgrowth was
      minimal. These studies show that the levels of AChE activity can be modulated by
      substratum, perhaps in proportion to the permissiveness of the substratum to
      neuritic outgrowth. These results are discussed in relation to possible non
      cholinergic roles of AChE.

PMID- 1640498
TI  - Effects of protein kinase inhibitors on regeneration in vitro of adult frog
      sciatic sensory axons.
AB  - The effects of protein kinase inhibitors on regeneration in vitro of adult frog
      sciatic sensory axons were tested. Regeneration of crush-injured nerves for 8
      days in serum-free medium was inhibited by staurosporine (100 nM) and H-7 (100
      microM), which are both known to inhibit protein kinase C. With the use of a
      compartmented culture system it could be shown that H-7 exerted both local
      (outgrowth region) and central (ganglia) effects, the latter being more
      pronounced. The local effects could be due to reduction of Schwann cell
      proliferation by H-7. Immunohistochemistry demonstrated the presence of protein
      kinase C in neuronal cell bodies but not in axonal processes. Proliferation of
      Schwann cells was accompanied by increased protein kinase C immunoreactivity at
      the site of injury. H-7 caused a selective inhibition in the incorporation of
      radioactive phosphate into one 74 kDa protein of both ganglia and nerve but also
      a more general decrease in protein labelling. The results show that protein
      phosphorylations, possibly mediated by protein kinase C, are involved in
      regeneration-related mechanisms operating at both local and central levels in the
      adult frog sciatic sensory axons.

PMID- 1640500
TI  - Focal, extracellular recording of slow miniature junctional potentials at the
      mouse neuromuscular junction.
AB  - Miniature endplate potentials (MEPPs) with slow rising phase can be attributed
      either to burst of transmitter releases or to distortion of conduction from
      remote releasing sites. The spontaneous activity of neuromuscular junctions
      recorded extracellularly at mouse diaphragms using sharp electrodes was analyzed
      to test these two hypotheses. The miniature junctional potentials (MEJPs)
      frequencies observed intracellularly as compared to MEPP frequency measured
      intracellularly in controls indicate that most events recorded extracellularly
      are induced by the presence of the electrode. All types of MEPPs (bell-MEPPs,
      skew-MEPPs, slow-, and giant MEPPs) previously described with intracellular
      recording methods (Vautrin and Kriebel, Neuroscience 41:71-88, 1991) were
      observed extracellularly and showed similar characteristics. This means that the
      presynaptic and postsynaptic zones that generate these synaptic events are
      restricted within areas of a few micrometers squared of synaptic contact. Long
      rise times of extracellularly recorded synaptic spontaneous events may be
      explained by multiple transmitter releases at intervals shorter than the rise
      time of individual events, which postsynaptic responses fuse into a single peak.

PMID- 1640499
TI  - Expression of multiple integrins and extracellular matrix components by C6 glioma
      cells.
AB  - We have investigated the expression of integrins in C6 glioma, a chemically
      induced glial tumor cell line from rat brain. Immunochemical analysis revealed
      that C6 cells express sets of integrin receptor complexes which immunologically
      and electrophoretically are indistinguishable from those expressed by normal rat
      skin fibroblasts. These include the well-characterized fibronectin (alpha 5 beta
      1) and the multi-specific laminin, collagen and fibronectin (alpha 3 beta 1)
      receptors. Assay of cell adhesion indicated that C6 cells adhere to fibronectin
      coated surfaces or matrix deposited by the C6 glioma cells (CGM) in an RGD- and
      divalent cation-dependent fashion. However, anti-fibronectin antibodies, which
      are able to inhibit fibroblast adhesion to fibronectin, did not inhibit adhesion
      of the C6 cells to fibronectin or CGM. This may reflect differences in functional
      properties and/or distribution patterns of integrins in C6 cells and normal
      fibroblasts.

PMID- 1640501
TI  - Alterations of 45Ca accumulation and [3H]inositol 1,4,5-trisphosphate binding
      using autoradiography in the exo-focal postischemic brain areas of the rat.
AB  - We studied the alterations of calcium accumulation and intracellular signal
      transduction using autoradiography of the second messenger system in order to
      clarify the mechanisms of the delayed neuronal changes in the remote areas of rat
      brain after transient focal ischemia. Chronological changes of 45Ca accumulation
      and [3H]inositol 1,4,5-trisphosphate (IP3) binding sites were determined after 90
      min of right middle cerebral artery (MCA) occlusion and after such occlusion
      followed by different periods of recirculation. After the ischemic insult, 45Ca
      accumulation extended to the lateral segment of the caudate putamen and to the
      cerebral cortex, both supplied by the occluded MCA. One day after the ischemia,
      [3H]IP3 binding sites decreased significantly compared with the control values in
      these ischemic areas. Moreover, 3 days after the ischemia, 45Ca accumulation was
      first detected in the ipsilateral thalamus and the substantia nigra, which lay
      outside the ischemic areas. In the substantia nigra, a significant decrease of
      [3H]IP3 binding sites and concurrent 45Ca accumulation were observed. In the
      thalamus, however, there was not alteration until 1 week after the ischemia, and
      then [3H]IP3 binding sites increased significantly 2 weeks (P less than 0.05) and
      4 weeks (P less than 0.01) after the ischemia. Based on the present study, we
      speculate that different mechanisms associated with signal transduction systems
      may be responsible for exo-focal postischemic delayed neuronal changes in the
      thalamus and the substantia nigra. The increase of [3H]IP3 binding sites of the
      thalamus in the chronic stage may be new evidence of plasticity related to
      neurotransmission.

PMID- 1640502
TI  - Hippocampal NCAM180 transiently increases sialylation during the acquisition and
      consolidation of a passive avoidance response in the adult rat.
AB  - Synaptic connectivity change is a consistent anatomical feature of memory
      formation and the possibility that this is mediated by a replay of
      neurodevelopmental events has been investigated by measuring change in neural
      cell adhesion molecule sialylation state during the acquisition and consolidation
      of a passive avoidance response in the adult rat. The avoidance response was
      always generated after two to three trials and the animals remained on the
      platform for the criterion time of 5 min. In all cases training was complete
      within 5-8 min. Change in sialylation state was monitored following
      intraventricular infusion of the 3H-ManNAc precursor at 4 hr prior to the
      reference point. No task-specific change in general glycoconjugate sialylation
      was apparent in hippocampal P2 pellets at increasing times following training.
      Increased sialylation state was observed only in neural cell adhesion molecule
      (NCAM) immunoprecipitates of hippocampal membrane fractions at 12 and 24 hr after
      training. Change in hippocampal sialylation state could not be attributed to an
      increased accumulation of NCAM as detected by an immunoabsorbent assay.
      Immunoblotting of antibody precipitated NCAM demonstrated the 3H-ManNAc to be
      incorporated into the synapse-specific, 180 kDa isoform of NCAM and a novel 210
      kDa isoform. Immunoprecipitation and immunoblotting procedures with an antibody
      specific for a2-8-polysialic acid showed the 180 and 210 kDa isoforms to be
      polysialylated. The role of NCAM180 sialylation as a mechanism for synapse
      selection in information storage is discussed.

PMID- 1640503
TI  - Implication of glucocorticoid receptors in the stimulation of human glioma cell
      proliferation by dexamethasone.
AB  - Dexamethasone is frequently used in the therapy of brain tumor patients. We
      investigated the effect of dexamethasone on the proliferation of three short-term
      and four established human glioma cell lines in vitro, using a microculture
      tetrazolium assay to determine growth rates. In one short-term culture and in one
      established cell line dexamethasone consistently stimulated the proliferation in
      a concentration-dependent way. The proliferation was maximally enhanced at a
      concentration of approximately 0.1 microM. In these two cell lines a relatively
      high level of glucocorticoid receptors was present, whereas low levels of
      glucocorticoid receptors were found in the other cell lines. In addition, we
      demonstrated that the stimulatory effects of dexamethasone on the proliferation
      of the glioma cell lines can be antagonized by the antiglucocorticoid RU38486.
      The results demonstrate unequivocally that the glucocorticoid receptor plays a
      role in the growth stimulating effect of dexamethasone.

PMID- 1640504
TI  - Peanut agglutinin binding glycoproteins in the chick retina: their presence in
      Muller glia cells.
AB  - The histological and cellular distribution and some biochemical characteristics
      of components that bind peanut agglutinin (PNA), a lectin that recognizes
      preferentially terminal galactose-beta (1-3) N-acetyl galactosamine disaccharide
      residues of glycoconjugates, were studied in chick retinal tissue and in
      dissociated retinal cells after their differentiation in culture. In sections of
      retinal tissue from animals 7 days after hatching (Rp7), in addition to the inner
      and outer segments of the photoreceptor layer, the plexiform and optic fiber
      layers were stained with rhodamine-labeled PNA, indicating that, besides
      photoreceptor cells, other cellular types contribute to the PNA staining. We
      present evidence indicating that at least part of this staining is provided by
      Muller glia cells. In cultures of dissociated cells from retinas at embryonic day
      7 (R7), photoreceptor-like cells and flat Muller glia-derived cells but not
      neurons were stained with rhodamine-labeled PNA. Furthermore, Muller glia cells
      isolated from Rp7 were also brightly stained with PNA. Western blot assays of
      extracts from R7 showed the presence of PNA binding glycoproteins of 31-33 kDa
      and a component that migrates at the dye front. In addition to the components
      detected in R7, extracts from R14 and Rp7 showed the presence of a major PNA
      binding glycoprotein of 175 kDa and a minor glycoprotein of 220 kDa. Extracts
      from the photoreceptor layer contain the 175 and 220 kDa glycoproteins,
      indicating their association with photoreceptor cells. The 31-33 kDa components
      were detected in extracts from the remnant inner retina, suggesting their
      association with the Muller glia cells. Supporting this view, these components
      and not those of 175 and 220 kDa were detected in cell cultures enriched in flat
      Muller glia-derived cells. Only the 31-33 kDa components and the component that
      migrates at the dye front were detected in extracts from cell cultures enriched
      in photoreceptor-like cells, suggesting the need of some environmental element
      for the expression of the 175 and 220 kDa components in the differentiated
      photoreceptor cells.

PMID- 1640505
TI  - Distribution of calcium-activated neutral protease inhibitor in the central
      nervous system of the rat.
AB  - The ubiquitous existence of calcium-activated neutral protease (CANP, calpain),
      an enzyme whose activity is regulated by calcium ions and a specific endogenous
      CANP inhibitor (calpastatin), is well known. Although there has been much
      investigation concerning the distribution and role of CANP, investigations of the
      distribution of the CANP inhibitor using immunohistochemical techniques are rare.
      We made antiserum against a 40K fragment of cDNA corresponding to two C-terminal
      repeats of rat liver CANP inhibitor expressed in Escherichia coli. Using this
      antiserum, we examined the distribution of CANP inhibitor in the rat central
      nervous system by the ABC technique and compared it with the distribution of
      CANP. Neurons and glias were stained, with the cytosol stained diffusely and the
      cell membranes stained clearly and strongly. Axons and myelin were stained
      faintly, but nuclei and vessels were not stained. The distribution of CANP
      inhibitor was thus found to be similar to that of CANP.

PMID- 1640506
TI  - Heptyl-physostigmine enhances basal forebrain control of cortical cerebral blood
      flow.
AB  - This study sought to determine the effect of heptylphysostigmine (H-PHY), a
      reversible cholinesterase (ChE) inhibitor with greater lipophilicity and longer
      duration of action than physostigmine, on resting and basal forebrain (BF)
      elicited increases in cortical cerebral blood flow (CBF). Laser-doppler flowmetry
      (LDF) was used to monitor changes in frontal cortical microvascular perfusion in
      urethane anesthetized rats. Responses were measured before, early after, and 1 hr
      following H-PHY, 3 mg/kg, i.m. Electrical stimulation (100 microA) of the BF
      elicited up to 220% increases in CBF at 50 Hz, an effect that was graded with
      frequency. At 15 min following H-PHY (3 mg/kg) resting cortical CBF was
      unchanged, whereas BF-elicited increases were potentiated 47% at 50 Hz. At 1
      hour, resting cortical CBF remained unchanged, and the BF-elicited responses were
      remarkably potentiated by 354% at 10 Hz and 67% at 50 Hz. Acetylcholinesterase
      (AChE) activity measured in the tissue directly beneath the LDF probe was
      decreased by 84% at a time when these CBF responses were enhanced. These data
      suggest that H-PHY substantially enhances the regulation of cortical CBF by the
      BF, an effect that may be linked to inhibition of cortical AChE activity. This
      enhancement of cortical CBF may contribute to the efficacy of H-PHY as a
      treatment for Alzheimer's disease.

PMID- 1640507
TI  - Transient, cyclic changes in mouse visual cell gene products during the light
      dark cycle.
AB  - Temporal and spatial changes in the cellular and subcellular concentrations of
      photoreceptor cell gene products appear to be important features of
      phototransduction in rod photoreceptor cells. The time course of the rapid, light
      dependent movement of S-antigen (S-Ag) (48k; Arrestin) from the inner segments to
      the outer segments was analyzed using polyclonal and monoclonal antibodies. The
      concentrations of mRNA change about threefold for rhodopsin and about sixfold for
      S-Ag in cyclic, independent modes during the normal light-dark cycle. Kinetic
      analysis indicates that the oscillations of S-Ag mRNA levels are due to changes
      in the transcriptional activity of the gene itself. An experimental model is
      presented summarizing the relationships between mRNA levels, protein
      localization, disc shedding, and phototransduction in the photoreceptors cells.

PMID- 1640508
TI  - The effect of obstruction on the developing bladder.
AB  - Congenital bladder obstruction causes significant immediate and long-term
      consequences yet its pathophysiology remains poorly understood. A model of early
      fetal bladder obstruction in sheep has been developed to study the response of
      the developing bladder to high grade obstruction, with particular emphasis on the
      regulation of growth and development. Congenital bladder obstruction was produced
      in fetal sheep at 60 days of gestation and studied at 95 days of gestation (14
      sheep) or term (12 sheep). A total of 24 age-matched normal sheep served as
      controls. Bladders were analyzed by total weight, stereological estimation of
      smooth muscle cell size, number and total mass, deoxyribonucleic acid
      concentration, muscarinic cholinergic receptor density, myosin isoform analysis
      and/or passive cystometrics. Congenital bladder obstruction caused a 4.6 times
      increase in bladder weight at term reflecting a 5.8 times increase in smooth
      muscle mass. This increase was predominantly that of cellular hypertrophy and
      less so of hyperplasia, based upon increased cell volume, increased protein-to
      deoxyribonucleic acid ratio, and no significant increase in total cell number.
      Muscarinic cholinergic receptor number per smooth muscle cell increased 3.2 times
      but it did not change relative to myosin content. The ratio of myosin heavy chain
      isoforms SM1:SM2 is developmentally regulated and was seen to change from 1.6 at
      100 days of gestation to 1.13 at term in normals. After 5 weeks of obstruction
      SM1:SM2 was 1.27 and it was 1.25 at term, indicating an effect on the
      developmental regulation of smooth muscle. Rapid fill cystometry in vivo measured
      the rate of stress relaxation to assess accommodative properties. The half-decay
      time was increased in all 3 obstructed bladders tested to greater than 15 seconds
      at 50% capacity (normal less than 5 seconds), suggesting reduced compliance. This
      study shows that an in utero model of bladder obstruction is feasible. Congenital
      bladder obstruction produces a variety of structural, biochemical and functional
      changes in the developing bladder indicative of alterations in the regulation of
      growth and differentiation.

PMID- 1640509
TI  - Papers presented at the annual meeting of the section of Urology, American
      Academy of Pediatrics. New Orleans, Louisiana, October 26-31, 1991.

PMID- 1640510
TI  - Acute hemodynamic and endocrinological effects of partial fetal bladder
      obstruction.
AB  - The pathophysiology of fetal urinary obstruction has not been elucidated. Using a
      unique, reproducible and easily reversible animal preparation, we studied the
      acute hemodynamic and endocrinological responses to partial fetal bladder
      obstruction in 16 ovine fetuses at 115 days of gestation (term 147 days). After
      partial obstruction blood pressure and renal weight increased significantly for
      at least 72 hours. Renal blood flow trended upwards, particularly from 24 to 72
      hours, although this change was not statistically significant. Plasma renin
      activity was significantly increased during the first 24 hours after obstruction
      but it returned to baseline thereafter. Plasma cortisol or catecholamine
      concentrations remained unchanged. The time course and pattern of hemodynamic
      changes in this fetal sheep preparation of partial urinary obstruction differ
      significantly from those reported in other preparations.

PMID- 1640511
TI  - The response of the fetal kidney to obstruction.
AB  - In a fetal ovine model the renal effects of different anatomic levels of fetal
      urinary obstruction were studied. Parameters of prenatal renal growth and
      differentiation were characterized and correlated with the patterns of renal
      response to in utero obstruction. Complete ureteral or urethral obstruction was
      produced in the sheep fetus at 55 to 60 days of gestation. Animals were delivered
      and sacrificed at near term (140 days), and the kidneys were removed and prepared
      for analysis. Parameters examined included weight, histology, glomerular number
      and total surface area, as well as urinary sodium, creatinine, osmolarity and N
      acetyl glucosaminidase. Three patterns of response were identified, producing
      hydronephrotic, cystic or dysgenetic kidneys. Hydronephrotic kidneys were usually
      the result of bladder outlet obstruction or ureteral obstruction with spontaneous
      urinary decompression. These kidneys were large (20.7 gm. versus normal 10.8 gm.,
      p less than 0.0001), with thinning of cortical parenchyma that was structurally
      intact. Glomerular number and surface area were normal. Cystic kidneys were large
      (14.2 gm., p less than 0.05) with grossly visible cysts and an effaced medulla.
      Cortical structure was distorted by cysts but basic elements were intact.
      Glomerular number and surface area were not reduced. Dysgenetic kidneys were
      small (3.9 gm., p less than 0.0001) with markedly abnormal cortical structure and
      little recognizable medulla. Histological elements similar to fetal structures
      were present, including cuboidal/columnar tubular epithelium and peritubular
      mesenchymal collars. Glomerular number and surface area were significantly less
      than normal (p less than 0.001). The kidneys contralateral to unilaterally
      obstructed kidneys were significantly larger than normal (16.2 gm., p less than
      0.0001), with normal histology, glomerular number and surface area, indicating in
      utero contralateral renal hypertrophy. Urinary sodium was variably affected in
      the hydronephrotic kidneys and was identical to plasma in the dysgenetic kidneys.
      These results indicate the technical feasibility of in utero models of urinary
      obstruction. Renal growth and patterns of differentiation were markedly affected
      by in utero obstruction. They should be a major focus in the investigation of
      congenital obstructive uropathy, since normal processes of renal growth and
      differentiation form the basis for postnatal function.

PMID- 1640512
TI  - Renal growth factor expression during the early phase of experimental
      hydronephrosis.
AB  - Unilateral ureteral obstruction in the rat leads to hydronephrosis of the
      affected kidney and renal cell deletion through the process of apoptosis. We
      studied this experimental model to determine whether acute alterations in renal
      growth factor expression might be involved in the initiation of the apoptotic
      response. Northern blot analysis of hydronephrotic, contralateral and sham
      operated kidney polyadenylated messenger ribonucleic acid (mRNA) was performed to
      quantitate the expression of mRNA encoding the growth factors epidermal growth
      factor, transforming growth factor-beta and insulin-like growth factor II during
      the first 48 hours following ureteral obstruction. Although the expression of the
      insulin-like growth factor II mRNA was unchanged by ureteral obstruction, the
      expression of epidermal growth factor mRNA rapidly declined in the obstructed
      kidney during this period. The loss of epidermal growth factor expression was
      further confirmed by an immunocytochemical staining procedure that demonstrated
      high concentrations of epidermal growth factor in control renal tubules and a
      drastic loss of this staining in obstructed renal tubules. In contrast,
      expression of transforming growth factor-beta mRNA increased in the obstructed
      kidney. We believe that the altered growth factor environment of the
      hydronephrotic kidney might be an initiating factor in the onset of renal
      apoptosis associated with this condition.

PMID- 1640513
TI  - Late onset severe oligohydramnios associated with genitourinary abnormalities.
AB  - We evaluated the diagnosis, gestational age at presentation, timing and mode of
      delivery, and ultimate outcome in those fetuses with third trimester onset of
      severe oligohydramnios who also had urinary tract abnormalities. A total of 8
      fetuses with obstructive uropathy or cystic renal disease was seen during a 2
      year period with the onset of severe oligohydramnios noted between 27 and 33
      weeks. Immediate and late postnatal pulmonary function was excellent in 5 of the
      8 subjects. Three neonates had respiratory distress but only 1 died at birth.
      Ultimate renal function varied in the 7 survivors. Those with supravesical
      obstructive uropathy achieved a normal serum creatinine, while the neonates with
      renal cystic disease and infravesical obstruction did not.

PMID- 1640514
TI  - Microanatomy and morphometry of the hydronephrotic "obstructed" renal pelvis in
      asymptomatic infants.
AB  - There has been limited histological study of the obstructed ureteropelvic
      junction in patients less than 1 year old. We present our prospective studies on
      the histomorphometry of the ureteropelvic junction complexes of 35 infants, of
      whom 23 underwent pyeloplasty for obstruction and 12 were age matched autopsy
      normals. Qualitatively, the major abnormalities of the pelvic microanatomy in the
      hydronephrotic obstructed kidneys included a lamina muscularis that was
      significantly thicker than normal and the presence of collagen fibers between
      muscle fascicles. Additionally, variable amounts of elastin were present in the
      adventitia and lamina muscularis. At the ureteropelvic junction the abnormalities
      were an increase in the number of inner longitudinal muscle bundles, collagen
      between muscle bundles (p less than 0.016) and elastin in the adventitia.
      Quantitatively, for the pelvis the lamina muscularis was significantly thicker in
      18 obstructed kidneys compared to 7 controls (1,075 +/- 79 mu. versus 420 +/- 63
      mu., mean +/- standard error of mean, p less than 0.001). The percentage area
      density of smooth muscle in the obstructed versus normals was increased (45.1%
      versus 35.2%, p less than 0.039). The percentage area density of collagen in the
      obstructed specimens versus normal showed an upward trend (38.6% versus 27.6%),
      which was not significant. In conclusion, the obstructed ureteropelvic junction
      complexes of kidneys in asymptomatic infants show significant qualitative and
      quantitative differences from normal.

PMID- 1640515
TI  - Nonoperative management of unilateral neonatal hydronephrosis.
AB  - We followed nonoperatively 45 neonates with unilateral hydronephrosis and
      suspected ureteropelvic junction obstruction for 30 months, regardless of the
      degree of hydronephrosis, shape of diuretic renogram washout curve or initial
      degree of functional impairment. Of the patients 30 had mild hydronephrosis and
      no renal deterioration, while 15 had severe hydronephrosis, an obstructed
      diuretic renogram and markedly decreased hydronephrotic kidney function. During
      followup percentage and absolute renal function rapidly increased in all
      patients, hydronephrosis improved in 7 and contralateral compensatory hypertrophy
      did not develop in any. These findings help to define the natural history of
      untreated hydronephrosis, suggest that many newborn kidneys with severe
      hydronephrosis are not obstructed despite even profound initial decreases in
      renal function and demonstrate that traditional tests for diagnosing obstruction
      are inaccurate in this age group. Therefore, the methods for assessing
      obstruction and the indications for surgical intervention in these patients
      require reexamination.

PMID- 1640516
TI  - Influence of initial therapy on progression of renal failure and body growth in
      children with posterior urethral valves.
AB  - Children with posterior urethral valves are at high risk for renal failure and
      growth retardation. It has been proposed that the type of initial surgical
      treatment (that is primary ablation versus high diversion) can affect the outcome
      of children with posterior urethral valves. We evaluated 43 children with
      posterior urethral valves treated and followed at our hospital from 1975 to 1990
      (17 since birth and 26 referred patients). A total of 19 patients was treated by
      a high urinary diversion, (high urinary diversion group), 19 were treated by
      primary fulguration and 2 by vesicostomy (fulguration and vesicostomy group), and
      3 underwent fulguration and unilateral diversion (mixed treatment group, excluded
      from study). The clinical outcome and body growth were compared for the high
      urinary diversion, and fulguration and vesicostomy groups. A normal stature
      (above the 25th percentile) was reached by 4 patients (21%) from the high urinary
      diversion group and 11 (52%) in the fulguration and vesicostomy group. This
      difference was not statistically significant. In contrast, renal function was
      predictive of body growth: 73% of the children with normal serum creatinine and
      20% of the children with renal failure achieved a normal stature (p less than
      0.05). One patient from the mixed treatment group died of pulmonary hypoplasia.
      We conclude that the type of primary surgical treatment (fulguration and
      vesicostomy or high urinary diversion) did not influence progression of renal
      failure or body growth in children with posterior urethral valves. Regardless of
      the surgical or medical treatment, which can greatly influence mortality, renal
      failure developed in almost 50% of the children with posterior urethral valves.

PMID- 1640517
TI  - The swing of the pendulum.

PMID- 1640518
TI  - Biodegradable pericardial implants for bladder augmentation: a 2.5-year study in
      dogs.
AB  - Bladder augmentation using biodegradable pericardial tissue was evaluated in
      canine bladders. Acetic acid and acetic anhydride treated pericardial tissue
      grafts were stored in 75% ethanol for 18 to 27 months before implant. Ten dogs
      weighing 20 to 25 kg. were subjected to a 50% partial cystectomy. After careful
      separation of the mucosa, bladder muscle and adventitial layers a pericardial
      graft volumetrically equivalent to the portion of the bladder removed was sutured
      to the bladder remnant in 2 layers. In 1 control dog the bladder was opened, 50%
      of the bladder was removed and the bladder was closed primarily. In another
      control dog the excised bladder was replaced with fresh chemically treated patch
      material that was never subjected to ethanol storage. Excretory urography and
      cystography were performed on all dogs. Urodynamics with filling pressures and
      bladder volumes measured before and after the operation at intervals of up to 36
      months confirmed that adequate bladder capacity was achieved. There were no
      operative complications. Postmortem histological evaluations revealed a smooth
      epithelialized inner surface with no traces of any surface irregularities or
      suture lines. The bladder apex showed an intact epithelium and the absence of a
      smooth muscle layer. The biodegradable acetylated tissue provides an intact
      structural reservoir for urine and serves as a template for epithelial
      regeneration. This permits volumetric bladder enlargement while the graft is
      progressively reabsorbed with time.

PMID- 1640519
TI  - Is lamina propria matrix responsible for normal bladder compliance?
AB  - Immunohistochemistry using monoclonal and polyclonal antibodies to extracellular
      matrix proteins is a highly sensitive tool for the characterization of matrix
      components. For the first time in the normal and noncompliant human bladder we
      have used antibodies to collagen types I, III and IV, and elastin to provide
      morphological correlation with mechanical properties noted clinically. In the
      normal bladder elastin and collagen types I and III showed intense localization
      in the lamina propria with modest localization in the detrusor layer. In
      contrast, lamina propria staining in the noncompliant bladder was essentially
      unchanged, while there was intense localization within the detrusor layer.
      Significantly, this intense localization consisted of collagen type III and
      elastin with little increase in type I. Type IV collagen is associated with
      basement membranes and individual smooth muscle cells, and shows commensurate
      increase in specimens with muscle hypertrophy and/or hyperplasia. These
      observations suggest that in the normal bladder the lamina propria may be a major
      structural capacitance layer with the smooth muscle covering it. The collagen
      fibers of the lamina propria may gradually unfold during filling, thus,
      accounting for normal compliance while in the noncompliant bladder the
      capacitance layer shifts outward to the infiltrated smooth muscle, thus,
      preventing the normal expansion of the lamina propria. The smooth muscle
      infiltration consists of a deposition of collagen type III and elastin with
      little increase of collagen type I, and it results in a loss of compliance. The
      pattern of localization would suggest that the smooth muscle is responsible for
      this accumulation.

PMID- 1640520
TI  - Transurethral intravesical electrotherapy for neurogenic bladder dysfunction in
      children with myelodysplasia: a prospective, randomized clinical trial.
AB  - Myelomeningocele is the most common cause of neurogenic bladder dysfunction in
      children. Urinary incontinence is socially disabling for many of these children
      and undetected elevations in detrusor pressure can lead to serious upper tract
      damage. Sensory receptors in the bladder mucosa and submucosa provide afferent
      information to the central nervous system regulating the micturition reflex.
      Since 1959 Katona and several other investigators have used intravesical
      electrotherapy for diagnosis and treatment of the neuropathic bladder. Our
      objective was to conduct a randomized, sham controlled and blinded clinical study
      on the efficacy of transurethral intravesical electrotherapy in treating urinary
      incontinence in the myelodysplastic child. A total of 36 children was enrolled in
      the study and 31 completed the entire protocol. Of the patients completing the
      study 13 were randomly selected to serve as an internal sham control having the
      electrocatheter placed without activating the stimulator. These patients were
      subsequently treated with a 3-week course of electrotherapy. The remaining 18
      patients completing the study were randomly selected to undergo 2, 3-week courses
      of intravesical bladder stimulation. Urodynamic studies were performed before and
      after each treatment series. Detailed daily questionnaires were submitted to each
      participant covering subjective improvement in urinary continence and any
      development of bladder sensory awareness. Analysis of the urodynamic data and
      questionnaires failed to reveal any statistically significant increase in bladder
      capacity, development of detrusor contractions, improvement in detrusor
      compliance or the acquisition of bladder sensation allowing timely intermittent
      catheterization preventing urinary incontinence.

PMID- 1640521
TI  - Expression of a Wilms tumor gene in porcine kidney during compensatory renal
      growth.
AB  - Expression of the putative Wilms tumor gene (WT-1) was studied to investigate its
      role in renal growth. Compensatory renal growth was induced in 35-day-old
      Yorkshire-swine by unilateral nephrectomy. The contralateral kidney was removed
      0.5 to 72 hours following the initial operation and analyzed for WT-1 gene
      expression by Northern analysis. Compensatory renal growth was detectable by wet
      weight measurements at 12 hours following contralateral nephrectomy. WT-1 gene
      expression was detectable in the contralateral kidney as early as 0.5 hours
      following unilateral nephrectomy. Expression of this gene was not detected in
      normal kidney from swine of this age group or from sham operated swine. In
      addition, we demonstrated the expression of this gene in newborn rat, pig and
      human kidneys, as well as human fetal kidney, indicating its role in
      nephrogenesis. These data suggest that expression of the WT-1 gene is involved in
      the regulatory mechanisms that control different types of renal growth.

PMID- 1640522
TI  - The effect of bacteriuria on bladder and renal pelvic pressures in the rat.
AB  - We investigated the effect of urinary tract infection on bladder and renal pelvic
      urodynamics in a rat model to examine the role of pressure during infection.
      Either an antibiotic solution (control group) or Escherichia coli with type 1
      pili (infected group) was instilled into the bladder. After 2 to 6 days
      simultaneous continuous bladder and renal pelvic pressures were measured during
      urinary flows from less than 2 to greater than 20 ml./kg. per hour while the
      bladder filled and emptied. Bladder pressures from 50 to 100% of maximum capacity
      and maximum voiding pressures were significantly higher in the infected group
      than the control group (36.7 +/- 6.79 cm. water versus 25.5 +/- 5.21 cm. water,
      respectively, p less than 0.0001). Renal pelvic pressures were significantly
      higher in the infected group during bladder filling at all urinary flows examined
      and actually exceeded bladder pressure for the highest flows. We conclude that
      elevated renal pelvic pressures may contribute to renal changes observed during
      urinary tract infection.

PMID- 1640523
TI  - The effects of ileocystoplasty on the development of renal failure in a rat model
      5/6 nephrectomy.
AB  - We examined the effects of ileocystoplasty on renal function and bone mineral
      content in 160 juvenile male Wistar-Furth rats with and without renal
      insufficiency induced by 5/6 nephrectomy. At intervals up to 20 weeks blood, bone
      and kidney samples were obtained with the animals under anesthesia and then they
      were sacrificed. Serum parameters of renal function and calcium metabolism were
      measured. Samples of bone were analyzed for calcium, magnesium and phosphorus
      content. At 20 weeks after 5/6 nephrectomy renal function was decreased by
      approximately half. The decrease in renal function and the changes in renal
      histology were identical in animals with and without ileocystoplasty. Bone
      mineral content in the animals with renal insufficiency with or without
      ileocystoplasty was not different from sham operated animals or from animals with
      an ileocystoplasty and normal renal function. These studies demonstrate that
      ileocystoplasty per se does not hasten the progression to renal failure or
      produce bone demineralization in rats having moderate renal insufficiency.

PMID- 1640524
TI  - The influence of urinary diversion on experimental gastrocystoplasty.
AB  - Gastrocystoplasty is used to augment the bladder of patients with decreased renal
      function to prevent development or worsening of metabolic acidosis. We recently
      observed a perforated peptic ulcer in the gastric portion of a defunctionalized
      gastrocystoplasty. We postulated that the lack of buffering action of urine
      precipitated peptic ulcer disease in the gastrocystoplasty. To explore this
      possibility further, we conducted an experiment. In 12 adult female mongrel dogs
      (weight 15 to 26 kg.) the bladder was divided into right and left segments. One
      kidney was removed and both hemibladders were capped with a vascularized segment
      of gastric body. Thus, 1 side (wet) remained exposed to urine, while the other
      side (dry) was drained to the abdominal wall with a cystostomy tube. The animals
      were divided into 2 groups: 9 in group 1 received no drugs to modify gastric
      secretion and 3 in group 2 received a hydrogen (H2) blocker. Three animals in
      group 1 had perforation of the vesical part of the dry gastrocystoplasty 2 to 3
      weeks postoperatively and were sacrificed. The others were sacrificed 3 to 6
      weeks postoperatively. Serum gastrin levels remained normal in all animals. Gross
      and histological examinations of the augmented bladders in group 1 revealed
      ulcerations of the bladder segment of the wet and dry gastrocystoplasties but the
      lesions were more numerous and prominent on the dry side in all animals,
      particularly those in which the perforations occurred. A peptic ulcer was noted
      in the gastric portion of the dry gastrocystoplasty in 1 animal. The bladder
      epithelium of the dry gastrocystoplasty showed glandular metaplasia in several
      animals in this group. In group 2 the wet gastrocystoplasty showed normal
      histology except in 1 dog that had mild inflammation and focal superficial
      ulceration in the vesical portion. On the other hand, the dry gastrocystoplasty
      showed severe inflammation and ulcerations in 2 animals, and mild inflammation of
      the vesical portion in 1. There were no perforations in this group. This
      experiment demonstrates that gastrocystoplasty produces cystitis but that these
      changes are more prominent in the absence of urine, as indicated by the severity
      of the lesions, perforations and metaplasia. Peptic ulcer disease occurred in the
      gastric portion of the dry gastrocystoplasty in 1 animal. The use of H2 blockers
      decreases the incidence of ulceration in wet gastrocystoplasty but it seems to
      have less influence on the ulceration of dry gastrocystoplasty. Clinicians must
      be alerted to the risk of perforation of dry gastrocystoplasty.

PMID- 1640525
TI  - Lithogenic properties of enterocystoplasty.
AB  - Calculi formed in 26 of 87 patients (30%) following augmentation
      enterocystoplasty, of which 23 formed within the reservoir, at a mean interval of
      25 months postoperatively. The calculi were composed principally of triple
      phosphates suggesting an important etiological role of bacteriuria and the urease
      reaction. Open cystolithotomy was the most successful means of removing the
      calculi.

PMID- 1640526
TI  - The urofacial (Ochoa) syndrome revisited.

PMID- 1640527
TI  - The value of urodynamic studies in infants less than 1 year old with congenital
      spinal dysraphism.
AB  - The role and timing of urodynamic studies in infants with congenital spinal
      dysraphism are controversial. We reviewed 64 consecutive infants with a mean
      followup of 28 months who underwent video urodynamic study when they were less
      than 1 year old (50 of the 64 patients were less than 3 months old). A previously
      reported video urodynamic "hostility score" from 0 (best) to 10 (worst) was given
      to each study and compared with the outcome of the upper urinary tract and
      subsequent urodynamic studies. A larger fraction of these children with high
      hostility scores (5 or greater) had upper tract deterioration (39%) compared to
      those with low hostility scores (9%). Moreover, 6 of 14 patients in the low
      hostility group who underwent repeat video urodynamic studies after age 1 year
      had high hostility lower urinary tracts. We conclude that urodynamic studies
      during and after the first year of life are useful in the appropriate urological
      evaluation and management of infants with spinal dysraphism.

PMID- 1640528
TI  - Pitfalls in determination of leak point pressure.
AB  - To evaluate the influence of the technical aspects of leak point pressure
      measurement we performed water cystometry and determined the leak point pressure
      in 23 patients 5 weeks to 21 years old with neurogenic bladders. We initially
      assessed the influence of catheter size on the leak point pressure and determined
      that the measured pressure varied in direct proportion to the catheter diameter.
      We further evaluated the effect of the method of infusion (gravity drip versus
      pump) and the infusion rate on pressures measured by a transducer in an in vitro
      setting. Using the gravity drip infusion technique pressure measurement was
      adversely affected by smaller catheter size and rapid infusion rate. With the
      pump infusion system neither catheter size nor infusion rate adversely affected
      pressure measurement. We conclude that the clinical measurement of the leak point
      pressure during water cystometry is influenced by the catheter size, and it is
      dependent upon the technique and rate of infusion. We believe that
      standardization of the technical aspects of leak point pressure determination
      would provide for reproducible results and facilitate comparisons of reports
      among different investigators.

PMID- 1640529
TI  - Bladder functional changes resulting from lipomyelomeningocele repair.
AB  - From 1986 to 1991, 12 boys and 23 girls underwent surgery for
      lipomyelomeningocele removal. Of these patients 29 were 15 months old or younger
      (average age 3 months), while 6 were 4.5 to 19 years old (average age 10 years).
      Preoperative and postoperative urodynamic studies, including external urethral
      sphincter electromyography, were done on everyone. All 29 infants had a cutaneous
      lesion overlying the lower back and 14 had an abnormal neurological examination.
      Preoperative urodynamic studies were abnormal in 11 patients, consisting of an
      upper motor neuron lesion in 6, and a mixed upper and lower motor neuron lesion
      in 5. Postoperatively, 10 of 14 children with an abnormal neurological
      examination improved, while 9 of 11 with abnormal lower urinary tract function
      normalized. In 1 of 18 children (6%) with normal preoperative urodynamic studies
      detrusor-sphincter dyssynergia developed postoperatively. In all 6 older children
      urinary incontinence developed, and this led to the diagnosis. Everyone had an
      abnormal neurological examination and abnormal preoperative urodynamic studies.
      One child had a lower motor neuron lesion, and 5 had a mixed upper and lower
      motor neuron lesion. Postoperatively, the neurological examination improved in
      only 1 patient (16%), and the urological symptoms and urodynamic findings
      improved in another child. Lipomyelomeningocele has a progressive effect on lower
      spinal cord function because infants tend to present with fewer urinary
      manifestations and physical findings than older children. Individuals who escape
      early detection tend to have a more subtle cutaneous abnormality. As a result,
      older children are more likely to present with urological and neurological
      complaints. Surgical correction in infancy provides a degree of reversibility not
      seen in older children. It is imperative that early identification, evaluation
      and treatment be undertaken to prevent this progression and permanency of
      neurological changes and urinary dysfunction.

PMID- 1640530
TI  - The pharmacokinetics of intravesical and oral oxybutynin chloride.
AB  - In 8 children with cystometric evidence of bladder instability and marked
      systemic side effects to oral oxybutynin we investigated the efficacy of
      intravesical instillation and compared the pharmacokinetics of both routes of
      delivery. In addition, 4 healthy dogs underwent intravesical instillation for
      pharmacokinetic studies. Intravesical oxybutynin was well tolerated, efficacious
      and rapidly absorbed, resulting in plasma concentrations markedly higher than
      after oral administration. In only 2 patients did this method of instillation
      result in side effects, and both had previously undergone bladder augmentation.
      This lack of significant systemic side effects despite high plasma concentrations
      suggests that a metabolite may be generated after oral administration that is
      responsible for the side effects. These studies demonstrate that the mode of
      administration affects the mechanism of action, side effects, pharmacokinetics
      and metabolism of oxybutynin, and that intravesical instillation is clinically
      effective and results in minimal side effects.

PMID- 1640531
TI  - Pronounced detrusor hypercontractility in infants with gross bilateral reflux.
AB  - In this study the prevalence of bladder dysfunction in 18 children with gross
      bilateral reflux was investigated via cystometric recordings. In all except 1
      infant maximal voiding detrusor pressure was 100 cm. or greater water (range 86
      to 244). Pronounced instability during filling (overt instability) with pressure
      waves above baseline (mean 65 cm. water, range 42 to 194) was found in 9 infants.
      Another 5 children had evidence to suggest an uninhibited bladder, not manifested
      as unstable contractions during filling but as covert instability, meaning that
      the first unstable contraction was transformed into a premature and forceful
      voiding contraction. The high detrusor pressures found in 18 children with gross
      bilateral reflux during the voiding phase but also during the filling phase in
      half of the children suggest that a hypercontractile detrusor may be a
      contributory factor for the development of reflux even in this age group.

PMID- 1640532
TI  - The efficiency of bladder emptying in the prune belly syndrome.
AB  - From 1956 to 1991, 49 cases of the prune belly syndrome were seen at our
      institution. Voiding information and/or 1 or more urodynamic studies were
      available in 30 male and 4 female patients. Analysis of multiple urodynamic
      studies during long-term followup periods ranging from 6 months to 19 years, with
      particular regard to any reconstructive procedures performed, revealed that
      voiding in the prune belly syndrome is variable, with 44% of the patients
      achieving spontaneous voiding and 56% requiring clean intermittent
      catheterization. The ability to void or need for clean intermittent
      catheterization was by no means permanent, indicating the need for meticulous
      followup. The 3 distinct voiding patterns observed included an approximately
      normal pattern, prolonged voiding with a low peak and an intermittent pattern.
      These 3 voiding patterns did not correlate with residual volumes. Comparison of
      urodynamic voiding parameters between reconstructed voiding patients and
      nonreconstructed voiding patients did not show significant differences.

PMID- 1640533
TI  - Postnatal ultrasound screening of urinary malformations.
AB  - We performed routine neonatal ultrasound screening on 3,454 neonates in the first
      week of life to establish the real incidence of congenital uropathy. Pronounced
      anomalies were found in 36 cases (1.04%) and mild renal pelvis dilatation in 159
      (4.60%). In the population study prenatal ultrasonography showed evidence of
      severe anomalies in only 7 fetuses (0.2%). Surgical correction was required in 14
      cases. Our results indicate that neonatal ultrasound screening has sufficient
      sensitivity and specificity for the early detection of the vast majority of
      urinary tract malformations. In 2 cases mild vesicoureteral reflux was not
      detected until a urinary tract infection was noted. Thus, neonatal sonography
      appears to be of limited value in detecting mild reflux.

PMID- 1640534
TI  - The sensitivity of renal scintigraphy and sonography in detecting nonobstructive
      acute pyelonephritis.
AB  - Recently it has been demonstrated that any child with proved acute pyelonephritis
      may be at risk for parenchymal scarring, whether or not reflux is present. Since
      cortical renal scintigraphy has been shown to detect accurately renal
      inflammation, we compared cortical scintigraphy with renal sonography in 46
      children with documented acute pyelonephritis to determine which modality is best
      to detect patients at risk for renal injury. Cortical scintigraphy was abnormal
      in 36 children (78%) and renal ultrasonography was abnormal in 5 (11%). Reflux
      was demonstrated in only 20 cases (43%). We conclude that cortical scintigraphy
      is the preferred imaging technique for diagnosing renal inflammation, and it
      should be used routinely in every child with suspected acute pyelonephritis. A
      new imaging protocol is proposed.

PMID- 1640535
TI  - Grading nephroureteral dilatation detected in the first year of life: correlation
      with obstruction.
AB  - To understand better the significance of pediatric idiopathic nephroureteral
      dilatation the renal ultrasound images of patients less than 1 year old with
      hydronephrosis or hydroureteronephrosis were graded and compared to the
      radiological diagnosis of obstruction as determined by diuresis renography and/or
      urography. The study included 73 boys and 30 girls with hydronephrosis (76
      patients) or hydroureteronephrosis (27). For hydronephrosis obstruction was
      diagnosed in 56 children (74%) and involved 61 of 97 kidneys (63%). For
      obstructed kidneys the mean grade of hydronephrosis (3.4 +/- 0.7 standard
      deviation) was statistically different from that of nonobstructed kidneys (1.6 +/
      0.8 standard deviation) (p less than 0.05). When the value to predict
      obstruction was set at grade 3 hydronephrosis or greater there was an 88%
      sensitivity and 95% specificity. For hydroureteronephrosis obstruction was
      diagnosed in 15 of 27 children (56%) and involved 17 of 34 kidneys (50%). The
      degree of dilatation was weighted as a score to assess the grades of
      hydronephrosis and ureteral dilatation, namely hydroureteronephrosis score equals
      grade of hydronephrosis plus grade of ureteral dilatation. In obstructed
      megaureters the mean hydroureteronephrosis score (5.8 +/- 1.0) was statistically
      different from that for nonobstructed megaureters (mean hydroureteronephrosis
      score 2.7 +/- 1.9) (p less than 0.001). When the value to predict obstruction was
      set at hydroureteronephrosis score of 5 or greater there was a 94% sensitivity
      and 80% specificity. Although ultrasound examination alone cannot be used to
      diagnose urinary obstruction, the radiological diagnosis of obstruction is linked
      with the grade of hydronephrosis or score of hydroureteronephrosis.

PMID- 1640536
TI  - The effect of polyethylene glycol-superoxide dismutase administration on
      histological damage following spermatic cord torsion.
AB  - Oxygen free radicals generated during the ischemic/reperfusion period have been
      suggested as a possible cause for tissue damage in different organs. In this
      study we address the question of whether administration of polyethylene glycol
      superoxide dismutase, an oxygen free radical scavenger, can alleviate
      histological damage associated with testicular torsion. The study included 67
      Sprague-Dawley rats. In 60 rats the left testicle was rotated 720 degrees
      clockwise through a scrotal incision. Torsion duration was 3 hours. Five minutes
      before and 5 minutes after detorsion the testicle color was evaluated and scored.
      The remaining 7 rats underwent a sham operation. After randomization 8,000 units
      per kg. polyethylene glycol-superoxide dismutase were injected intraperitoneally
      in the treated group 1 hour before detorsion. After 14 days histological
      evaluation was performed on both testicles of 58 rats (2 rats died before the
      evaluation). No statistically significant difference was demonstrated between the
      treatment (28 rats) and the control groups (30 rats). Testicular color after
      detorsion correlated with the histological damage.

PMID- 1640537
TI  - Injectable bioglass as a potential substitute for injectable
      polytetrafluoroethylene.
AB  - Injectable polytetrafluoroethylene (Teflon) and collagen have inherent problems
      that may prevent their long-term success. In search of a different injectable
      biomaterial we confirmed in rabbits the safety of injected Bioglass particles
      suspended in sodium hyaluronate. A second study was performed testing the ability
      of the Bioglass suspension to increase urethral resistance in pigs. Bioglass
      particles in suspension have the potential to substitute for
      polytetrafluoroethylene or collagen in the treatment of urinary incontinence or
      vesicoureteral reflux.

PMID- 1640538
TI  - Selective sacral rhizotomy in children with high pressure neurogenic bladders:
      preliminary results.
AB  - Recent successful introduction of selective rhizotomy in the management of lower
      extremity spasticity in patients with myelodysplasia has prompted us to use it as
      a means of managing high pressure neurogenic bladders occasionally encountered in
      myelodysplastic patients. During the last 1 1/2 years 8 children have undergone
      selective sacral rhizotomy in an attempt to avert urinary diversion or bladder
      augmentation. Patient age ranged from 6.5 to 18.5 years. The level of the
      respective lesions was evenly distributed throughout the spine. At spinal surgery
      each patient had an electrode placed in the detrusor of the bladder via a
      suprapubic approach, electromyography electrodes were placed in the perineum and
      slow fill water cystometry was performed throughout the procedure. Standard
      electrophysiological stimulation of the nerve roots was performed to identify the
      rootlets that would only affect the detrusor and spare the external sphincter.
      Postoperative followup has been obtained on all patients. Of the patients 4 have
      exhibited significant improvement and they have not required augmentation, 2 have
      not shown any further deterioration in bladder function, 1 has demonstrated
      deterioration and 1 still lacks urodynamic followup. Postoperative cystometric
      studies have revealed a bladder capacity increase of 69% for the group.
      Uninhibited bladder contractions were abated in all but 1 patient. No patient has
      been rendered incontinent of urine from the procedure and no patient has had a
      problem with stool continence as a result of the rhizotomy. It appears that
      selective rhizotomy of the sacral roots has been able to increase bladder
      capacity as well as compliance in patients who normally would have been relegated
      to either bladder augmentation or urinary diversion. While these are encouraging
      results, some further followup is required to ascertain if the early improvements
      will be long-lasting.

PMID- 1640539
TI  - Transurethral electrical bladder stimulation: initial results.
AB  - Transurethral electrical bladder stimulation to rehabilitate the neurogenic
      bladder initially proposed by Katona has been promoted in the United States by
      Kaplan and Richards since the mid 1980s. Encouraged by their results, 2 1/2 years
      ago we instituted a program patterned on their experience. Since January 1989 we
      performed transurethral electrical bladder stimulation in 21 patients ranging in
      age from 4 months to 26 years. The cause of the neurogenic bladder was
      myelomeningocele in 16 patients, lipomeningocele in 4 and an incomplete spinal
      cord injury in 1. The stimulation was performed using equipment supplied by
      Kaplan and Richards, and the stimulation protocol followed their recommendations.
      The treatments were delivered in daily sessions of 90 minutes with about 20
      sessions in a series. Of the patients 11 have undergone 1,6 have finished 2 and 4
      have completed 3 series of stimulation. The ultimate objective of the program is
      to achieve volitional voiding. To reach that goal the stimulation must engender a
      bladder contraction that must then be perceived and ultimately controlled. Of our
      patients 20 (95%) achieved bladder contractions during stimulation, including 12
      (60%) who had either a definite (7) or probable (5) sense of these contractions.
      To date, only 1 patient has started the biofeedback program to attempt to modify
      detrusor activity and he is presently wet on clean intermittent catheterization.
      Parents of 5 other children report minor positive changes in the child's
      perception of the bladder activity. Three patients noticed an improvement in the
      bowel program, although the effect only lasted during the month of stimulation in
      1. Cystometrograms were performed before each series of treatments. Of the 10
      patients with serial studies 2 had significant increases in bladder capacity and
      3 demonstrated a clinically significant decrease in the end filling pressures. We
      have seen limited encouraging results from transurethral electrical bladder
      stimulation. This is a time-consuming, labor intensive program, and the parents
      and patients need to be informed of the actual potential for dramatic
      improvements.

PMID- 1640540
TI  - Neuromodulation in the management of voiding dysfunction in children.

PMID- 1640541
TI  - Free bladder mucosal graft biology: unique engraftment characteristics in
      rabbits.
AB  - To study the biology of bladder mucosal grafts we developed an animal model using
      New Zealand white male rabbits. A 25 x 9 mm. segment of bladder mucosa was
      harvested and tubularized over an 8F catheter using 7-zero polyglactin sutures.
      An equivalent portion of rabbit urethra was then excised and the graft was
      anastomosed to this defect in an end-to-end fashion. A urethral catheter was left
      in place to provide bladder drainage and to stent the anastomosis. Animals were
      sacrificed on postoperative days 1 to 90. India ink was injected into the aorta
      at sacrifice to visualize the microvasculature. All 59 specimens were stained
      with hematoxylin and eosin, and studied using light microscopy. Our results
      demonstrated vascular ingrowth at 72 hours. Between postoperative days 8 and 10
      healthy viable epithelium first bridged the entire urethral defect. By
      postoperative day 12 the epithelial lining was complete. A poor outcome was
      observed in all animals whose stents were removed early. We conclude that the
      biology of bladder mucosal grafts is unique in that the graft initially undergoes
      partial degeneration followed by regeneration. Of concern are the results of
      those animals whose stents were removed early. In all such cases a poor outcome
      was observed.

PMID- 1640542
TI  - Hypospadias repair using laser welding of ventral skin flap in rabbits:
      comparison with sutured repair.
AB  - We tested the feasibility of laser welding in hypospadias repair. A total of 30
      New Zealand white rabbits (2 groups of 15) underwent creation of distal
      hypospadias. In the control group ventrally placed skin flaps were created and
      sutured to the urethra. In the experimental group the ventrally placed skin flaps
      were welded to the urethra using a continuous wave diode laser (808 plus or minus
      1 nm., 6.25 watts per cm.2). The welded anastomoses were strengthened by applying
      a solder of fibrinogen combined with a laser energy-absorbing dye. No stents were
      left indwelling. Operative time using laser welding was considerably less than
      that with sutured repair. No fistulas were seen in the welded urethras, and no
      significant foreign body reaction was identified in the laser welded repairs.
      Hypospadias repair in the rabbit using the laser welding technique seems to be a
      feasible alternative to suture repair. Topical energy-absorbing dyes that enhance
      thermosetting solders further increase weld strength while reducing collateral
      thermal damage to target tissues.

PMID- 1640543
TI  - True hermaphrodites: an experimental model in the mouse.
AB  - When the Y chromosome from the Mus musculus domesticus mouse strain is placed
      onto the C57BL/6J mouse background ovarian and testicular components develop in
      half of the XY progeny (B6.YDOM), providing an excellent model of true
      hermaphroditism. We examined the correlation between gonadal sex and development
      of the internal genital tract in the B6.YDOM mouse at puberty. Of 55 mice
      examined 20 had bilateral testes, 33 were true hermaphrodites and 2 had mixed
      gonadal dysgenesis. In all mice with bilateral testes male accessory sexual
      organs developed bilaterally. In the true hermaphrodites testes were found on
      either side but preferentially on the left side. When a male feature was present
      on the ipsilateral side of the ovary, the seminal vesicle was more frequently
      found than prostate or vas. Testicular mass was significantly different between
      the true hermaphrodites with and those without bilateral seminal vesicles.
      Similar difference was found in those with and without bilateral prostates. The
      serum testosterone level was not significantly different between these groups. We
      conclude that the testicular mass is a better discriminant than serum
      testosterone for the presence or absence of seminal vesicles and prostates at
      puberty.

PMID- 1640544
TI  - Vaginal replacement in children.
AB  - Between 1980 and 1990, 17 patients underwent total vaginal replacement at our
      hospital. The majority of these patients presented with mullerian failure or
      gender reassignment for intersex. Colon vaginal replacement was done in 15
      patients and small bowel was used in 2. Complications included prolapse in 2
      patients and stenosis in 2. Of the 17 patients 4 are married, 10 are sexually
      active, only 1 reports dyspareunia and 1 requires home self-dilation.

PMID- 1640546
TI  - Salvage pyeloplasty in nonvisualizing hydronephrotic kidney secondary to
      ureteropelvic junction obstruction.
AB  - The potential recoverability of an obstructed kidney detected by maternal
      antenatal ultrasound cannot be predicted by the currently available methods of
      investigation. Early repair in the presence of little parenchymal tissue may
      result in marked improvement in renal function. During the last 2 years 8 male
      and 2 female neonates with antenatal presentation of hydronephrosis were referred
      for postnatal evaluation. All patients had palpable renal masses clinically,
      which were unilateral (left side) in 9 and bilateral in 1. Blood urea nitrogen
      and creatinine were normal in all patients. Postnatal imaging included abdominal
      ultrasonography, voiding cystourethrography, excretory urography and quantitative
      functional evaluation with diuretic diethylenetriaminepentaacetic acid renal
      scan. Nonvisualization of a left hydronephrotic kidney was detected in all cases.
      Antegrade pyelography at surgical exploration (at age less than 2 months) was
      done to outline the anatomy. Stretched thinned out renal parenchymal tissue over
      a hugely distended renal pelvis was present and dismembered reduction
      pyeloureteroplasty was performed. A nephrostomy tube and ureteral stent were
      used. Followup ranged between 6 and 24 months. Remarkable recovery of renal
      function, more than 100% on renal scintigraphy, was noted postoperatively in all
      patients.

PMID- 1640545
TI  - Vaginal reconstruction after initial construction of the external genitalia in
      girls with salt-wasting adrenal hyperplasia.
AB  - A total of 28 patients with salt-wasting adrenal hyperplasia who underwent
      revision of the external genitalia at an early age (mean age 21.4 months) has
      been followed for 12 to 20 years (mean 16.3 years). The age at initial surgery
      ranged from 3 weeks to 5 years. Twenty-five patients had a low and 3 had a high
      takeoff of the vagina from the urogenital sinus. Of these children 22 (78.5%)
      required further vaginal reconstructive procedures to achieve a normal vaginal
      outlet. Of the 22 patients requiring further repair 18 have undergone vaginal
      reconstructive procedures with an initial success rate of 72.2%. These long-term
      data suggest that if vaginal reconstructive surgery is performed in infancy
      details, such as placement of the perineal flap well into the vagina and careful
      followup of the vaginal outlet, are mandatory for success. If there is evidence
      of outlet narrowing, periodic dilation will be needed to prevent vaginal stenosis
      and further vaginal surgery.

PMID- 1640547
TI  - Nonoperative management of major blunt renal trauma in children: in-hospital
      morbidity and long-term followup.
AB  - The management of 26 children with major renal injury secondary to blunt trauma
      was reviewed. Emergency computerized tomography (CT) was performed in all
      instances. Injury ranged from parenchymal laceration to vascular avulsion. Early
      surgical exploration was done in 5 children due to hemodynamic instability, renal
      pedicle injury or suspected malignancy. The remaining 21 children were observed.
      Of these children 5 had associated intra-abdominal organ injuries. The average
      length of hospitalization was 13.4 days and the average intensive care unit stay
      was 6.9 days. A third of the children were transfused with an average 10.8 cc/kg.
      of packed red cells. Ten patients (47.6%) had febrile episodes that lasted an
      average of 3 days. No foci of infection other than bladder urine were identified
      and there were no infected perirenal collections. In 2 children ureteral stents
      were placed cystoscopically. Exploration was performed in 1 child for delayed
      hemorrhage 2 months after hospital discharge. Followup CT was available in 15
      patients and all kidneys functioned, including 3 with residual focal scarring, 2
      with parenchymal calcifications and 1 with a cyst. Eleven patients were evaluated
      clinically at least 1 year after injury and all were asymptomatic, while 1 child
      had mild diastolic hypertension. In conclusion, nonoperative management results
      in an excellent long-term outcome in the majority of cases. In-hospital morbidity
      is minimal and early surgical exploration should be reserved for those with
      hemodynamic instability or renal pedicle injury. Immediate CT is an invaluable
      aid in categorizing and managing these patients.

PMID- 1640548
TI  - Results of varicocele surgery in adolescents: a comparison of techniques.
AB  - We report our experience using 3 different operative techniques for varicocele
      ligation in adolescents. Between August 1985 and April 1991 we performed 102
      varicocelectomies on 91 adolescents. Varicocele persistence rate was 16% with a
      modified Ivanissevich inguinal approach and 11% using a selective high
      retroperitoneal technique with preservation of the internal spermatic artery.
      Intraoperative post-ligation spermatic venography did not significantly improve
      the results with the artery sparing techniques. Palomo mass high retroperitoneal
      ligation of the internal spermatic vessels produced significantly better results
      compared to the artery sparing techniques. Testicular atrophy did not occur in
      any patient regardless of the surgical technique used. These data suggest that
      the Palomo technique results in a significant decrease in the operative failure
      rate compared to the artery sparing procedures and it should be the preferred
      technique for varicocele ligation in the adolescent.

PMID- 1640549
TI  - Significance of accessory ductal structures in hernia sacs.
AB  - The finding of ductal structures resembling a vas deferens during pathological
      examination of a hernia sac specimen has significant medical and legal
      implications. A method of distinguishing these accessory structures from an
      inadvertently transected vas has been lacking and is needed. Between July 1989
      and January 1990 we examined 147 hernia sacs from 105 consecutive prepubertal and
      adolescent boys to determine the incidence and salient histological features
      distinguishing these ductal structures from a true vas deferens. Luminal
      diameters of the ductal structures were compared with published normal age
      related established vas deferens diameters and with those measured during hernia
      repair in 10 of our youngest patients. Among the 147 specimens 6 hernia sacs
      (4.1%) contained ductal structures. We found that the mean ductal diameter (0.263
      mm.) was significantly smaller than that of a normal vas deferens (0.69 to 1.5
      mm.). Furthermore, the surrounding mantle of tissue of these ductal structures
      lacked muscle tissue when studied with Masson trichrome stain. We conclude that
      duct diameter and trichrome staining are simple ways of differentiating these
      structures from a true vas deferens.

PMID- 1640550
TI  - Perforation of the augmented bladder.
AB  - In 12 of 264 children treated with enterocystoplasty 15 spontaneous perforations
      occurred. Of the 12 children 9 had myelodysplasia. All segments of the
      gastrointestinal tract were used for the augmentation and most were
      detubularized. Surgery to increase bladder outlet resistance was done in 8 cases.
      At the time of each perforation 9 children had sterile cultures, however, 3 died
      of overwhelming sepsis. Presenting signs included abdominal pain in 8 cases,
      septic shock in 4 cases and shoulder pain in 4 older myelodysplastic children
      with diaphragmatic irritation from escaping urine. Cystography demonstrated a
      leak in 10 of 11 cases. Urodynamic studies revealed good compliance with low
      maximum filling pressure in 8 of 10 children. Hyperreflexia was noted in only 5
      cases and outlet resistance greater than 85 cm. water was demonstrated in 5.
      Histological analysis showed changes in the bowel wall consistent with ischemia
      but suture granulomas were present in areas adjacent to the perforation site or
      thinned areas in biopsy or autopsy specimens. In addition to the theory that
      overdistention may cause enterocystoplasty perforation, current detubularization
      techniques may produce areas of relative ischemia, which become accentuated when
      the augmented bladder is distended beyond a reasonable volume.

PMID- 1640551
TI  - Extravesical nondismembered ureteroplasty with detrusorrhaphy: a renewed
      technique to correct vesicoureteral reflux in children.
AB  - We performed an extravesical nondismembered reimplant to correct surgically
      primary vesicoureteral reflux in 45 patients (65 renal units) between April 1989
      and September 1990. Of the units 6 had grade I reflux, 16 grade II, 23 grade III,
      14 grade IV and 6 grade V. Only patients with primary reflux were included in
      this study. The success rate was 100% for grades I to III, 92.9% for grade IV and
      66.7% for grade V. Overall, the reflux was cured in 62 of the 65 operated renal
      units (95.4%) or 95.6% of the patients (43 of 45). Postoperative morbidity and
      complications were minimal. No cases of postoperative obstruction were detected
      on excretory urography 6 weeks postoperatively. Seven children (16%) suffered
      from transient inadequate bladder emptying as assessed by post-void ultrasound
      residual evaluations. This problem resolved spontaneously after a maximum of 4
      weeks of clean intermittent catheterization. Compared to conventional
      transvesical technique, the discomfort related to bladder spasms during the
      postoperative period was subjectively decreased and patients had no prolonged
      hematuria.

PMID- 1640552
TI  - Urethral healing in rabbits.
AB  - We studied urethral healing in New Zealand white rabbits by histological
      examination after insult (urethral catheter) or injury (urethrotomy) specifically
      for acute and chronic inflammation, fibrosis, fistulas, squamous metaplasia,
      foreign body giant cells and urethral dilatation. Urethral catheterization
      resulted in increased inflammation and fibrosis compared to noncatheterized
      animals. Skin closure techniques and materials resulted in an inflammatory
      response that may extend to and involve the urethra. Minor differences in suture
      size were not an important variable but the persistence of suture material may
      have a role in the degree of inflammation and the formation of foreign body giant
      cells. Transepithelial closure techniques drag epithelial cells into subcutaneous
      tissues and may predispose to fistula formation.

PMID- 1640553
TI  - Variations in practice among urologists and nephrologists treating children with
      vesicoureteral reflux.
AB  - To analyze the current management recommendations among physicians treating
      children with vesicoureteral reflux, the American Urological Association Reflux
      Practice Guidelines Panel surveyed 100 pediatric urologists, 100 general
      urologists and 100 pediatric nephrologists by questionnaire, and received a 60%
      response. In the evaluation of a 4-year-old girl with bilateral grade 2 reflux
      general urologists were more likely than the other 2 groups to recommend
      cystoscopy and urethral dilation. At followup nuclear cystography was recommended
      by 76% of pediatric urologists, 48% of general urologists and 71% of pediatric
      nephrologists, while the latter 2 groups were less likely to recommend any
      subsequent upper tract evaluation. Pediatric urologists were significantly more
      likely to recommend antireflux surgery if the child had 1 breakthrough febrile
      urinary tract infection, poor compliance with medical management or persistent
      reflux at age 11 years. In a 6-year-old girl with unilateral grade 4 reflux and
      detrusor instability 44% of pediatric urologists recommended antimicrobial
      prophylaxis and anticholinergic therapy compared to 12% of general urologists and
      6% of pediatric nephrologists. Antireflux surgery was recommended by 29% of
      pediatric urologists, 60% of general urologists and 59% of pediatric
      nephrologists. In older girls with persistent grade 2 or 3 reflux pediatric
      urologists were much more likely to recommend antireflux surgery. In contrast,
      they were less likely to recommend surgery in young girls and boys with newly
      diagnosed grade 4 reflux. These data demonstrate significant differences in
      therapeutic recommendations among pediatric urologists, general urologists and
      pediatric nephrologists, and suggest the need for outcomes research to determine
      the optimal management of children with vesicoureteral reflux.

PMID- 1640554
TI  - Subureteral collagen injection for the endoscopic treatment of vesicoureteral
      reflux in children. Followup study of 97 treated ureters and histological
      analysis of collagen implants.
AB  - Endoscopic subureteral injection has become an established alternative means for
      treating vesicoureteral reflux in select children. However, which injection
      material to use remains a controversy. Polytetrafluoroethylene (Teflon) has been
      injected in more than a thousand patients with few complications, although
      experimental and clinical studies have demonstrated migration of the injected
      particles into distant organs, such as the lungs and the brain, as well as local
      and metastatic granuloma formation. Therefore, we introduced, following
      experimental studies in the mini-pig model, glutaraldehyde cross-linked, highly
      purified bovine collagen for injection. Between June 1988 and October 1991, 97
      refluxing ureters in 66 children were treated by endoscopic subureteral collagen
      injection. In 58.8% of the ureters reflux was cured after 1 and in 77.3% after 2
      injections. Considering improvement to grades I and II reflux without further
      treatment as success, the success rate increased to 68.0% after 1 and to 89.7%
      after 2 injections. Mean followup was 18.5 months (range 3 to 39 months). After 2
      failed injections the patients either returned to antibiotic long-term
      prophylaxis or the reflux was operatively corrected. The operative procedure was
      never compromised by the preceding injection. A direct correlation between
      deficient length of the submucosal tunnel of the intravesical ureter and the
      iatrogenic malposition of the collagen deposits, and the failures could be
      demonstrated. Granuloma formation at the site of injection was not found. The
      results of the histological investigation of the collagen deposits removed at
      open ureteral reimplantation for failures are reported. It could be demonstrated
      that endogenous fibroblasts invade the bovine collagen implant and that these
      cells show active production of new human collagen, types I and III, replacing
      the implant.

PMID- 1640555
TI  - Endoscopic treatment of vesicoureteral reflux with a self-detachable balloon
      system.
AB  - There is controversy about the use of polytetrafluoroethylene (Teflon) paste in
      children for the endoscopic treatment of vesicoureteral reflux due to evidence of
      particle migration. However, there are definite advantages in treating patients
      endoscopically. It is evident that the ideal substance should be able to be
      delivered endoscopically, conserve its volume, and be nonmigratory and
      nonantigenic. Towards this goal we developed a catheter with an inflatable,
      detachable and self-sealing silicone balloon that would fit through a 19 gauge
      cystoscopic needle. Hydroxy-ethyl-methyl acrylate, a hydrophilic polymer that
      solidifies within 60 minutes after the addition of ferrous sulfate, was chosen as
      the filling material for the balloon. Conceptually, the sealed balloon would
      prevent the migration of hydroxy-ethyl-methyl acrylate and the solidified polymer
      would prevent volume loss. To test this system reflux was created in 6 Hanford
      mini-pigs by unroofing the ureters bilaterally. In 2 pigs a previously described
      method of open surgery was used and in the other 4 reflux was created
      endoscopically using the resectoscope and laparoscopic scissors. The presence of
      bilateral reflux was confirmed 4 weeks later with a cystogram and the balloon was
      implanted unilaterally through a cystoscope. The opposite ureter served as an
      internal control in all animals. A repeat cystogram was performed 2 to 4 weeks
      after implantation, demonstrating resolution of reflux in the treated side and
      persistence of reflux in the opposite untreated ureter. Serial cystograms,
      ultrasound and excretory urography showed no reflux on the implanted side nor any
      evidence of obstruction. Tissue sections from various organs showed no evidence
      of particle migration, granuloma formation or inflammatory reaction. Short-term
      results show that the balloon implants are able to correct reflux without
      evidence of obstruction.

PMID- 1640556
TI  - Enterocystoplasty and reflux nephropathy in the canine model.
AB  - Correction of vesicoureteral reflux at enterocystoplasty is often recommended to
      prevent the development of reflux nephropathy. Children with enterocystoplasty
      who require intermittent self-catheterization invariably have asymptomatic
      bacteriuria. In patients with persistent vesicoureteral reflux after
      enterocystoplasty the risk of renal damage from this asymptomatic bacteriuria is
      unknown. Detubularized ileocystoplasty was performed in 17 dogs with either
      direct nontunneled reimplantation or unroofing of the intramural tunnel and
      incision of the ipsilateral hemitrigone to create vesicoureteral reflux.
      Fluoroscopic urodynamic studies were performed 1 month later and unilateral
      vesicoureteral reflux was present in 6 dogs. All animals had low intravesical
      pressure and excretory urograms were performed to exclude obstruction. The 6 dogs
      with reflux were euthanized 3 months postoperatively and the kidneys were
      examined for histological evidence of pyelonephritis. In 5 of 6 dogs bacterial
      bladder colonization and subsequent renal pelvic colonization developed on the
      side of the vesicoureteral reflux. All of these animals had histological evidence
      of pyelonephritis in the refluxing kidney, whereas only 1 of 6 nonrefluxing
      control kidneys had any evidence of pyelonephritis (p = 0.031). Our results
      suggest that vesicoureteral reflux in association with enterocystoplasty leads to
      chronic upper tract infection and pyelonephritis in a majority of animals,
      despite creation of a low pressure urinary reservoir. Correction of
      vesicoureteral reflux at enterocystoplasty should be considered to prevent upper
      tract damage.

PMID- 1640557
TI  - Pyelonephritis in male infants: how important is the foreskin?
AB  - We investigated the association of the uncircumcised foreskin and pyelonephritis
      in male infants less than 6 months old. During a 21-month prospective study 94
      children (age range 2 weeks to 18.9 years) were hospitalized for febrile urinary
      tract infection. The male-to-female ratio for 35 patients less than 6 months old
      was 2.2:1. Of 59 patients older than 6 months the male-to-female ratio was
      reversed at 0.25:1 (p less than 0.001). In 13 of 24 infants (54%) less than 6
      months old and in 8 of 12 boys (67%) older than 6 months a dimercaptosuccinic
      acid renal scan documented acute parenchymal damage (p = 0.72). Vesicoureteral
      reflux or other genitourinary abnormalities were found in only 3 of 24 patients
      (12.5%) less than 6 months old compared with 6 of 12 boys (50%) older than 6
      months (p = 0.036). Of 24 infants less than 6 months old 22 (92%) were
      uncircumcised compared with 6 of 12 boys (50%) older than 6 months (p = 0.009).
      We then retrospectively compared the circumcision status of the infants who had
      febrile urinary tract infection with a control group of 63 infants matched for
      age, race and socioeconomic status hospitalized with febrile upper respiratory
      infection during a similar period. The frequency of uncircumcised infants in the
      control group with febrile upper respiratory infection was only 44% (28 of 63)
      compared with 91% of infants with febrile urinary tract infection (p less than
      0.001). Overall the findings of the male predominance among patients less than 6
      months old with febrile urinary tract infection, the disproportionately high
      frequency of infants with febrile urinary tract infection who were not
      circumcised, and the disproportionately low occurrence of vesicoureteral reflux
      and other genitourinary abnormalities in infants with febrile urinary tract
      infection strongly support an association between circumcision status and the
      risk for febrile urinary tract infection and pyelonephritis in male infants.

PMID- 1640558
TI  - Recombinant human tumor necrosis factor enhances radiosensitivity and improves
      animal survival in murine neuroblastoma.
AB  - An analysis of the potential of recombinant human tumor necrosis factor to
      enhance the radiosensitivity of C1300 murine neuroblastoma was undertaken. Female
      A/J mice bearing C1300 murine neuroblastoma (right hindlimb) underwent the
      following treatments: group 1-0.25 cc normal saline intraperitoneally times 2,
      group 2-0.5 mcg./gm. recombinant human tumor necrosis factor intraperitoneally
      times 2, group 3-400 cGy. right hindlimb, group 4-800 cGy. right hindlimb, group
      5-400 cGy. right hindlimb plus 0.5 mcg./gm. recombinant human tumor necrosis
      factor intraperitoneally times 2 and group 6-800 cGy. right hindlimb plus 0.5
      mcg./gm. recombinant human tumor necrosis factor intraperitoneally times 2. All
      animals were followed for 21 days after treatment initiation with interval
      measurements of tumor volume. All single modality treatments were more effective
      than normal saline in reducing average tumor volumes during the study period (800
      cGy. equals recombinant human tumor necrosis factor greater than 400 cGy. greater
      than normal saline). The addition of recombinant human tumor necrosis factor to
      radiotherapy moderately augmented antitumor response at radiation doses of 400
      cGy. but marked enhancement was attained at radiation doses of 800 cGy. (p less
      than 0.02). This enhancement was achieved without increased animal morbidity or
      mortality. Animals receiving recombinant human tumor necrosis factor in addition
      to 800 cGy. demonstrated increased survival when compared with animals receiving
      800 cGy. alone (p less than 0.02). Although statistical synergy was not proved,
      recombinant human tumor necrosis factor appears to augment significantly
      radiation-induced tumor regression at no toxic cost to the animal.

PMID- 1640559
TI  - Prognosis of children with solitary kidney after unilateral nephrectomy.
AB  - The clinical course of 138 children who underwent unilateral nephrectomy and had
      a normal contralateral kidney at the time of nephrectomy was reviewed. The
      diagnosis leading to nephrectomy included obstructive uropathy in 46% of the
      cases, reflux or pyelonephritis in 30%, Wilms tumor in 15%, hypertension in 4%,
      dysplastic kidney in 2% and trauma in 2%. Mean age at nephrectomy was 7.3 years
      and median followup was 24.7 years. Of the 138 patients 121 (88%) are well and 17
      died, including 14 secondary to metastatic Wilms tumor and 1 of renal failure.
      Survival of nonWilms tumor patients was similar to that of an age-matched control
      group. In 30 patients 24-hour creatinine clearance and 24-hour urinary protein
      excretion were measured. Proteinuria (greater than 150 mg./24 hours) was found in
      8 of the 30 patients (27%) (p less than 0.001), renal insufficiency developed in
      9 (30%) (p less than 0.0001) and hypertension occurred in 10% (p greater than
      0.10). Children with an acquired solitary kidney are at increased risk for
      proteinuria and renal insufficiency.

PMID- 1640560
TI  - Characterization of the upper urinary tract anatomy in the Danforth spontaneous
      murine mutation.
AB  - Absence or maldevelopment of the ureteral bud is thought to represent the final
      pathophysiological pathway resulting in renal anomalies ranging from agenesis to
      duplication. Little is known about the events preceding anomalous or absent
      ureteral bud formation. We describe the renal and ureteral anomalies found in a
      spontaneous murine mutation associated with a short tail: the Danforth or Sd
      mutation. Thirteen heterozygous pairs of mice were mated. Of 57 near-term progeny
      40 had short tails. Microdissection revealed both kidneys and ureters in 35%,
      neither kidneys nor ureters in 27.5%, absence of the left kidney and ureter in
      10%, absence of the right kidney and ureter in 7.5%, and absence of 1 or both
      kidneys associated with a blind-ending ureter in 20% of the mice. Scanning
      electron microscopy of gestational day 12 fetuses revealed unilateral or
      bilateral absence of the metanephros in some embryos, including some with a
      ureteral bud. Thus, primary absence of the metanephros may have a role in renal
      agenesis. Additional findings suggest that compensatory renal hypertrophy occurs
      in utero in the fetuses with unilateral renal agenesis. The morphological
      abnormalities involving the kidneys in the Sd mutation may represent an excellent
      model to study the pathophysiology of renal agenesis and mechanisms of normal
      renal development.

PMID- 1640561
TI  - A surgical model for normotensive chronic renal failure in the growing piglet.
AB  - Studying the effects of chronic uremia in children has been hindered by the lack
      of a suitable large mammalian animal model with normotensive renal failure. We
      performed nephrectomy with simultaneous contralateral partial nephrectomy using a
      stapling device and absorbable staples in 22 domestic piglets. Up to 93% of the
      total renal mass could be excised by this method. A chronic uremic state was
      reproducibly developed and correlated with the percentage of renal mass excised.
      There were no associated postoperative complications with the stapled partial
      nephrectomy. Pigs with moderate renal failure had a significant decrease in
      growth compared to those with mild renal failure, which represents the successful
      development of a normotensive large mammalian animal model that could be used to
      study the effects of chronic renal failure and hyperfiltration during a state of
      rapid growth. In addition, this study confirms the successful use of a stapling
      device to perform partial nephrectomy.

PMID- 1640562
TI  - Fetal nephrotoxicity.
AB  - Investigation of fetal nephrotoxicity by maternally administered nephrotoxins is
      hampered by many constraints, including the maternal effects of the nephrotoxin,
      the ability of the nephrotoxin to cross the placenta and the difficulties
      associated with direct fetal intervention. In the pouch young of the North
      American opossum, Didelphis virginiana, we describe the toxic effects of a heavy
      metal on the immature metanephric kidneys. Varying doses of uranyl nitrate, a
      heavy metal salt, were administered to opossum pups in the pouch approximately 20
      days after birth and the kidneys were harvested 3 to 12 days later for
      histological analysis. Group 1 consisted of 4 untreated and 5 saline treated
      pups. Group 2 (9 pups) received 10 to 15 mg./kg. intraperitoneal uranyl nitrate.
      Group 3 (6 pups) were given a uranyl nitrate dose of 25 mg./kg. Group 4, the high
      dose group, received either 58 mg./kg. (3 pups) or 87 mg./kg. (3 pups) of
      intraperitoneal uranyl nitrate. Group 1 kidneys demonstrated no pathological
      changes except for some mild renal tubular vacuolization seen in the saline
      treated animals. In group 2 tubular dilatation and necrosis were present 3 days
      after treatment; tubular regeneration could be seen by day 7. In group 3
      glomerular cystic changes, interstitial fibrosis and tubular regeneration were
      present by day 7. Some restoration of normal architecture occurred by day 12 with
      fibrosis apparent. Group 4 animals demonstrated much more pronounced cystic
      changes of glomeruli and tubules as early as day 5 with marked interstitial
      fibrosis and prominent tubular regeneration. By day 12 group 4 pups continued to
      demonstrate significant and severe glomerular and tubular cystic changes with
      marked interstitial fibrosis. Inflammation, although present in all groups
      (except control), was never prominent. This first description of the effect of
      heavy metal toxicity on the immature metanephric kidney could provide an insight
      into the mechanisms of disordered kidney growth.

PMID- 1640563
TI  - Transfusion medicine faces time of major 'challenges and changes'.

PMID- 1640564
TI  - As the blood supply gets safer, experts still call for ways to reduce the need
      for transfusions.

PMID- 1640565
TI  - Recommendations seek to prevent pressure sores.

PMID- 1640566
TI  - From the Centers for Disease Control. Accessibility of cigarettes to youths aged
      12-17.

PMID- 1640567
TI  - From the Centers for Disease Control. Scalping incidents involving hay balers-
      New York.

PMID- 1640569
TI  - From the Centers for Disease Control. Human rabies--California, 1992.

PMID- 1640568
TI  - From the Centers for Disease Control. Spina bifida incidence at birth--United
      States.

PMID- 1640570
TI  - From the Centers for Disease Control. Acquired immunodeficiency syndrome--1991.

PMID- 1640571
TI  - From the Centers for Disease Control. Penicillin-resistant pneumococcal disease-
      Spain.

PMID- 1640572
TI  - Pregnancy after embryo biopsy and coamplification of DNA from X and Y
      chromosomes.

PMID- 1640573
TI  - Surgical standby for coronary balloon angioplasty.
AB  - OBJECTIVE: To assess the predictability of need for emergency surgery after
      coronary balloon angioplasty. DESIGN: Nonrandomized intervention study. SETTING:
      Nonprofit university hospital. PATIENTS: Prior to balloon angioplasty, 1000
      consecutive patients were assigned to either the "standby" group (189 patients
      [19%]) or the "no-standby" group (811 patients [81%]). Patients in the standby
      group (intervention coordinated with cardiac surgery) included all operable
      patients undergoing angioplasty of their largest coronary arteries that were not
      currently or previously totally occluded or collateralized; the no-standby group
      consisted of the remainder of patients. INTERVENTION: Allocation to coronary
      angioplasty with or without surgical standby. MAIN OUTCOME MEASURES: Need for
      bypass surgery, occurrence of myocardial infarction, and mortality from
      complications of angioplasty. RESULTS: Bypass surgery immediately after
      angioplasty was done in one patient in each group (standby, 0.5%, vs no-standby,
      0.1%). The frequency of infarction was 5% vs 4%, respectively. All eight deaths
      occurred in the no-standby group (1.0%), but none of them were consequences of a
      lack of surgical standby. They occurred in situations in which bypass surgery
      would not have changed the outcome (two cardiac failures late after technically
      successful angioplasty for postinfarct cardiogenic shock, one in-laboratory
      rupture of an unrecognized ventricular pseudoaneurysm, and one protamine
      reaction), secondary to acute problems late after successful angioplasty (two
      sudden deaths and one vessel occlusion in an inoperable patient), or despite
      surgery (one patient with left main stem dissection). CONCLUSIONS: Performing
      roughly 80% of coronary angioplasties without surgical standby did not increase
      patient risk. Coronary angioplasty without surgical backup, albeit not an ideal
      setting, appears ethically feasible in selected patients if dictated by logistic
      considerations.

PMID- 1640574
TI  - Hip fractures and fluoridation in Utah's elderly population.
AB  - OBJECTIVE: To test the effect of water fluoridated to 1 ppm on the incidence of
      hip fractures in the elderly. DESIGN: Ecological cohort. SETTING: The incidence
      of femoral neck fractures in patients 65 years of age or older was compared in
      three communities in Utah, one with and two without water fluoridated to 1 ppm.
      PATIENTS: All patients with hip fractures who were 65 years of age and older over
      a 7-year period in the three communities, excluding (1) those with revisions of
      hip fractures, (2) those in whom the hip fracture was anything but a first
      diagnosis, (3) those in whom metastatic disease was present, or (4) those in whom
      the fracture was a second fracture (n = 246). OUTCOME MEASURE: Rate of hospital
      discharge for hip fracture. RESULTS: The relative risk for hip fracture for women
      in the fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to 1.46)
      and for men was 1.41 (95% CI = 1.00 to 1.81) relative to the nonfluoridated
      areas. CONCLUSIONS: We found a small but significant increase in the risk of hip
      fracture in both men and women exposed to artificial fluoridation at 1 ppm,
      suggesting that low levels of fluoride may increase the risk of hip fracture in
      the elderly.

PMID- 1640575
TI  - Protection from environmental tobacco smoke in California. The case for a smoke
      free workplace.
AB  - OBJECTIVE: To determine the extent of exposure of nonsmoking indoor workers to
      environmental tobacco smoke (ETS) according to type of work-site smoking policy,
      work area, workplace size, and demographic characteristics. DESIGN AND
      PARTICIPANTS: Participants included 7162 adult, nonsmoking, indoor workers who
      were interviewed as part of the 1990 California Tobacco Survey. Respondents were
      asked whether anyone had smoked in their work area within the past 2 weeks.
      RESULTS: An estimated 2.2 million California nonsmokers were exposed to tobacco
      smoke at indoor work sites in 1990. Nonsmoker exposure to ETS was 9.3% for those
      working in a smoke-free worksite, 23.2% for those working where there was only a
      work-area restriction, 46.7% for those working where there was a policy that did
      not include the work area, and 51.4% for those working where there was no work
      site smoking policy. After adjustment for type of work area (eg, office, open
      area), workplace size, and demographic factors, it was determined that nonsmokers
      working where there was only a work-area ban were 2.8 times more likely to be
      exposed to ETS than those working in a smoke-free work site. In workplaces with
      no policy or a policy not covering the work area, nonsmokers were over eight
      times more likely to be exposed to ETS than those who worked in a smoke-free work
      site. Nonsmokers who were 18 to 24 years of age, male, or Hispanic, and those
      with less than a high school education had more exposure to ETS. CONCLUSION:
      These results indicate that adequate protection of nonsmokers from ETS exposure
      requires a smoke-free work site.

PMID- 1640576
TI  - Trends in mortality, morbidity, and risk factor levels for stroke from 1960
      through 1990. The Minnesota Heart Survey.
AB  - OBJECTIVE: The Minnesota Heart Survey is a population-based study designed to
      monitor and explain trends in cardiovascular mortality, morbidity, and risk
      factors. DESIGN: Surveillance time-trends study. METHODS: The following trends
      were examined among men and women aged 25 to 74 years living in Minneapolis-St
      Paul, Minn: (1) stroke mortality from 1960 through 1990; (2) risk factors in
      population-based surveys conducted in 1973 through 1974, 1980 through 1982, and
      1985 through 1987; and (3) morbidity in a 50% sample of hospitalized discharges
      for acute-stroke in 1970, 1980, and 1985. RESULTS: Stroke mortality in
      Minneapolis-St Paul declined slowly from 1960 through 1972 (average fall, 2.4%
      per year), dropped sharply from 1972 through 1984 (average fall, 6.5% per year),
      but exhibited little change thereafter (average fall, 1.5% per year). The average
      level of cardiovascular disease risk factors fell from 1973-1974 to 1985-1987,
      with the exception of body mass index. In particular, hypertension diagnosis,
      treatment, and control levels improved substantially between 1973-1974 and 1980
      1982, although there was little improvement after 1980-1982. While discharge
      rates for hospital-coded acute stroke declined substantially between 1970 and
      1985 in both sexes, no clear trend was observed in definite stroke rates as
      validated using standard clinical criteria. Twenty-eight-day case fatality rates
      of definite stroke improved significantly from 1970 to 1985. CONCLUSIONS: The
      substantial decline in stroke mortality of more than 50% from 1960 through 1990
      appears to have been attributable to both primary and secondary prevention. These
      data suggest that the long decline in stroke mortality and morbidity in
      Minneapolis-St Paul has plateaued, although improved detection of stroke with
      computed tomography prevents an unequivocal conclusion.

PMID- 1640577
TI  - Elementary school students' performance with two ELISA test systems.
AB  - OBJECTIVE: To examine analytic performance by previously untrained and
      inexperienced subjects using enzyme-linked immunosorbent assay (ELISA) tests
      developed for decentralized laboratories. Performance variability between tests
      assigned to the "simple" and "moderately complex" Health Care Financing
      Administration laboratory levels was evaluated. DESIGN: A nonrandomized trial of
      the Surecell Strep-A chorionic gonadotropin ELISA tests. Each subject processed
      nine unknown specimens (three negative, three weakly positive, and three strongly
      positive) for each ELISA test. Subjects were blinded to expected test results.
      SETTING: An elementary school. SUBJECTS: A convenience sample of 52 students
      enrolled in the sixth and seventh grades. This age group was chosen because of
      their ability to generally comprehend instructions and remain attentive to the
      testing task. INTERVENTIONS: Subjects were either self-trained by reading package
      insert directions or trained by a manufacturer's sales representative. MAIN
      OUTCOME MEASURES: Performance was measured as the percentage of correct test
      results for the unknown specimens. The sensitivity and specificity for each test
      by operator group were calculated. RESULTS: Subjects demonstrated an overall
      sensitivity of 97.1% and specificity of 94.7% for human chorionic gonadotropin
      unknown specimens and a 95.9% sensitivity and 96.8% specificity for group A
      streptococcus unknown specimens. No significant differences between the self
      trained group and the representative-trained group were observed for either group
      A streptococcus or human chorionic gonadotropin tests. Performance was so high
      with the first specimen that improvement over time (ie, a "learning curve") could
      not be demonstrated. CONCLUSION: These ELISA test systems are able to achieve
      high levels of performance by subjects with no formal laboratory background, no
      previous method specific experience, and limited self-training.

PMID- 1640578
TI  - Drug allergy.

PMID- 1640579
TI  - Single-source financing systems. A solution for the United States?
AB  - Although tax-based and social insurance-based forms of single-source financing
      differ in how they raise funds, they share a common set of structural
      characteristics. In particular, they both enable publicly accountable authorities
      to control aggregate expenditure levels by creating a countervailing power to
      pressures for increased expenditures from providers. While major reform
      initiatives are under way in European single-source financing systems, these
      initiatives have so far sought to improve the efficiency, effectiveness, and/or
      responsiveness to patterns of service delivery without reducing their commitment
      to universal access to necessary care. The article concludes with a review of the
      advantages and disadvantages that could accompany the introduction of a single
      source financing system in the United States.

PMID- 1640580
TI  - Coronary angioplasty. Is surgical standby needed?

PMID- 1640581
TI  - 'Please pass the roach poison' again.

PMID- 1640582
TI  - Cigarette advertising and corporate responsibility.

PMID- 1640583
TI  - Cumulative trauma disorders of the upper extremities.

PMID- 1640584
TI  - The AMA and the Physicians Committee for Responsible Medicine.

PMID- 1640585
TI  - The resurgence of measles and herd immunity.

PMID- 1640586
TI  - Informed consent, deception, and discovering drug abuse.

PMID- 1640587
TI  - The letter from Utrecht.

PMID- 1640588
TI  - A piece of my mind. Diagnosis: V65.5.

PMID- 1640589
TI  - Bronchial reactivity: hyporesponsiveness vs hyperresponsiveness.

PMID- 1640590
TI  - Old age and hemochromatosis.

PMID- 1640591
TI  - A piece of my mind. Mary-go-round.

PMID- 1640592
TI  - Frequency, location of cases to be studied.

PMID- 1640593
TI  - Physicians urged to report moderate to severe immune deficiency cases without
      evidence of HIV infection.

PMID- 1640594
TI  - Federal health officials continue to reorganize offices for investigating
      scientific misconduct.

PMID- 1640595
TI  - NIH scientists retract published report.

PMID- 1640596
TI  - From the Alcohol, Drug Abuse, and Mental Health Administration.

PMID- 1640598
TI  - From the Centers for Disease Control. Sudden infant death syndrome--United
      States, 1980-1988.

PMID- 1640597
TI  - From the Centers for Disease Control. Transmission of multidrug-resistant
      tuberculosis among immunocompromised persons, correctional system--New York,
      1991.

PMID- 1640599
TI  - From the Centers for Disease Control, Cerebrovascular disease mortality and
      Medicare hospitalization--United States, 1980-1990.

PMID- 1640600
TI  - From the Centers for Disease Control. Congenital rubella syndrome among the Amish
      -Pennsylvania, 1991-1992.

PMID- 1640601
TI  - From the Centers for Disease Control. Shigellosis in child day care centers-
      Lexington-Fayette County, Kentucky, 1991.

PMID- 1640602
TI  - From the Centers for Disease Control. Primary amebic meningoencephalitis--North
      Carolina, 1991.

PMID- 1640603
TI  - Breast-conserving surgery and radiation therapy: are they underused?

PMID- 1640604
TI  - Variations in methadone treatment practices.

PMID- 1640605
TI  - Dads, docs, drugs, and decisions.

PMID- 1640606
TI  - A widow's grief: the language of the heart.

PMID- 1640607
TI  - Borrelia burgdorferi in the central nervous system.

PMID- 1640608
TI  - Borrelia burgdorferi in the central nervous system.

PMID- 1640609
TI  - Borrelia burgdorferi in the central nervous system.

PMID- 1640611
TI  - Commercial laboratory testing for chronic fatigue syndrome.

PMID- 1640610
TI  - Fat content of very low-calorie diets and gallstone formation.

PMID- 1640612
TI  - American Indians, African Americans: their common histories.

PMID- 1640613
TI  - Erythema migrans in Lyme disease: a correction.

PMID- 1640614
TI  - Poor response to rabies vaccination by the intradermal route.

PMID- 1640615
TI  - A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in
      US physicians.
AB  - OBJECTIVE: To assess prospectively the risk of coronary heart disease associated
      with elevated plasma levels of homocyst(e)ine. DESIGN: Nested case-control study
      using prospectively collected blood samples. SETTING: Participants in the
      Physicians' Health Study. PARTICIPANTS: A total of 14,916 male physicians, aged
      40 to 84 years, with no prior myocardial infarction (MI) or stroke provided
      plasma samples at baseline and were followed up for 5 years. Samples from 271 men
      who subsequently developed MI were analyzed for homocyst(e)ine levels together
      with paired controls, matched by age and smoking. MAIN OUTCOME MEASURE: Acute MI
      or death due to coronary disease. RESULTS: Levels of homocyst(e)ine were higher
      in cases than in controls (11.1 +/- 4.0 [SD] vs 10.5 +/- 2.8 nmol/mL; P = .03).
      The difference was attributable to an excess of high values among men who later
      had MIs. The relative risk for the highest 5% vs the bottom 90% of homocyst(e)ine
      levels was 3.1 (95% confidence interval, 1.4 to 6.9; P = .005). After additional
      adjustment for diabetes, hypertension, aspirin assignment, Quetelet's Index, and
      total/high-density lipoprotein cholesterol, this relative risk was 3.4 (95%
      confidence interval, 1.3 to 8.8) (P = .01). Thirteen controls and 31 cases (11%)
      had values above the 95th percentile of the controls. CONCLUSIONS: Moderately
      high levels of plasma homocyst(e)ine are associated with subsequent risk of MI
      independent of other coronary risk factors. Because high levels can often be
      easily treated with vitamin supplements, homocyst(e)ine may be an independent,
      modifiable risk factor.

PMID- 1640616
TI  - Maternal heat exposure and neural tube defects.
AB  - OBJECTIVE: To determine if exposure to hot tub, sauna, fever, or electric blanket
      during early pregnancy was associated with an increased risk for neural tube
      defects (NTDs). DESIGN: Prospective follow-up study. SETTING: Mostly private
      obstetric practices, primarily in New England. PARTICIPANTS: A cohort of 23,491
      women having serum alpha-fetoprotein screening or an amniocentesis were
      identified. Complete exposure and outcome information was available for 97% of
      these women. OUTCOME MEASURES: Relative risks (RRs) were used to compare
      incidence of NTD in those exposed to heat with those who were not exposed to any
      heat. Crude RRs were calculated directly from the data. Unconfounded RRs were
      calculated using logistic regression. RESULTS: Women reporting any heat exposure
      (sauna, hot tub, fever, or electric blanket) in early pregnancy had a crude risk
      of their fetuses developing NTD of 1.6 (95% CI [confidence interval], 0.9 to
      2.9). Women reporting exposure to sauna, hot tub, or fever in early pregnancy had
      a crude risk of their fetuses developing NTD 2.2 times that of women without heat
      exposure (95% CI, 1.2 to 4.1). For hot tub use, the crude RR was 2.9 (95% CI, 1.4
      to 6.3); for sauna, 2.6 (95% CI, 0.7 to 10.1); for fever, 1.9 (95% CI, 0.8 to
      4.1); and for electric blanket, 1.2 (95% CI, 0.5 to 2.6). Multivariate adjusted
      RRs for individual heat sources, after controlling for maternal age, folic acid
      supplements, family history of NTD, and exposure to other heat sources, were for
      hot tub use, 2.8 (95% CI, 1.2 to 6.5); sauna, 1.8 (95% CI, 0.4 to 7.9); fever,
      1.8 (95% CI, 0.8 to 4.1); and electric blanket, 1.2 (95% CI, 0.5 to 2.6). When
      only hot tub, sauna, and fever were considered and the women's exposure to each
      tallied, compared with no heat exposure, the RR for NTDs increased from 1.9 (95%
      CI, 0.9 to 3.7) after one type of heat exposure to 6.2 (95% CI, 2.2 to 17.2)
      after two types of heat exposure. CONCLUSIONS: Exposure to heat in the form of
      hot tub, sauna, or fever in the first trimester of pregnancy was associated with
      an increased risk for NTDs. Hot tub exposure appeared to have the strongest
      effect of any single heat exposure. Exposure to electric blanket was not
      materially associated with increased risk for NTDs.

PMID- 1640617
TI  - Delayed childbearing and risk of adverse perinatal outcome. A population-based
      study.
AB  - OBJECTIVE: To investigate the effect of advancing maternal age on pregnancy
      outcome among healthy nulliparous women, after adjustment for demographic
      characteristics, smoking, history of infertility, and other medical conditions.
      DESIGN: A population-based cohort study was conducted with prospectively
      collected data from the Swedish Medical Birth Register. PATIENTS: Nulliparous
      Nordic women (N = 173,715), aged 20 years and above, who delivered single births
      at Swedish hospitals from 1983 through 1987. OUTCOME MEASURES: Late fetal and
      early neonatal death rates; rates of very low birth weight (VLBW, less than 1500
      g), moderately low birth weight (MLBW, 1500 through 2499 g), very preterm
      delivery (less than or equal to 32 weeks), moderately preterm delivery (33
      through 36 weeks), and small-for-gestational-age (SGA) infants (less than -2
      SDs). RESULTS: Compared with women aged 20 to 24 years, women aged 30 to 34 years
      had significantly higher adjusted odds ratios (ORs) of late fetal deaths (OR =
      1.4); VLBW (OR = 1.2); MLBW (OR = 1.4); very preterm birth (OR = 1.2); and SGA
      infants (OR = 1.4). Among women aged 35 to 39 years, the adjusted OR was
      significantly higher for VLBW (OR = 1.9); MLBW (OR = 1.7); very preterm birth (OR
      = 1.7); moderately preterm birth (OR = 1.2); and SGA infants (OR = 1.7). Among
      women 40 years old and older, the adjusted OR was significantly higher for VLBW
      (OR = 1.8); MLBW (OR = 2.0); very preterm birth (OR = 1.9); moderately preterm
      birth (OR = 1.5); and SGA infants (OR = 1.4). CONCLUSIONS: Delayed childbearing
      is associated with an increased risk of poor pregnancy outcomes after adjustment
      for maternal complications and other risk factors.

PMID- 1640618
TI  - Performance of 45 laboratories participating in a proficiency testing program for
      Lyme disease serology.
AB  - OBJECTIVE: We show that significant interlaboratory and intralaboratory
      variations exist in Lyme disease proficiency testing. DESIGN: Six case-defined
      Lyme serum samples and three serum samples from individuals with no history of
      Lyme disease were randomized in four shipments and distributed to 45
      participating laboratories. RESULTS: Interlaboratory and intralaboratory
      performances were highly variable. Approximately 4% to 21% of laboratories failed
      to identify correctly positive serum samples with titers of 512 or more using
      polyvalent serum or immunoglobulin G conjugates. With lower levels of anti
      Borrelia burgdorferi antibody in the serum sample, approximately 55% of
      participating laboratories did not identify a case-defined serum. There was also
      a striking inability of many laboratories to reproduce their results on split
      samples from the same individual. In addition, 2% to 7% of laboratories
      identified serum samples from individuals with no known exposure to B burgdorferi
      as positive using polyvalent serum. The false positivity rate increased to 27%
      with the use of immunoglobulin G conjugate. CONCLUSIONS: Our results indicate
      that there is an urgent need for standardization of current testing
      methodologies. Until a national commitment is made, serological testing for Lyme
      disease will be of questionable value for the diagnosis of the disease.

PMID- 1640619
TI  - Medicare reimbursement accuracy under the prospective payment system, 1985 to
      1988.
AB  - BACKGROUND: Hospital reimbursement by Medicare's prospective payment system
      depends on accurate identification and coding of inpatients' diagnoses and
      procedures using the International Classification of Diseases, Ninth Revision,
      Clinical Modification (ICD-9-CM). A previous study showed that 20.8% +/- 0.5%
      (mean +/- SE) of hospital bills for 1985 contained errors that changed their
      diagnosis related group (DRG) and that a significant 61.6% +/- 1.3% of errors
      overreimbursed the hospitals. This DRG "creep" improperly increased net
      reimbursement by 1.9%, +308 million when projected nationally. The present study
      updated our previous study with 1988 data. METHODS: The Office of Inspector
      General, US Department of Health and Human Services, obtained a simple random
      sample of 2451 hospital charts for Medicare discharges from 1988. The American
      Medical Record Association reabstracted the ICD-9-CM codes on a blinded basis,
      grouped them to DRGs, and determined the reasons for discrepancies. RESULTS:
      Coding errors declined to 14.7% +/- 0.7% in 1988, and a nonsignificant 50.7% +/-
      2.6% of DRG errors overreimbursed the hospitals. Projected nationally, hospitals
      did not receive a significant overreimbursement. Physician misspecification of
      the narrative diagnoses underreimbursed the hospitals, while billing department
      resequencing overreimbursed them. CONCLUSIONS: The attestation requirement may
      have deterred DRG creep due to attending physician upcoding, but the peer review
      organizations' sentinel effect and educational activities have not eliminated
      hospital resequencing.

PMID- 1640620
TI  - The health care quality improvement initiative. A new approach to quality
      assurance in Medicare.

PMID- 1640621
TI  - Is syncope related to moderate altitude exposure?
AB  - STUDY OBJECTIVE: To investigate factors related to syncope occurring on recent
      ascent to moderate altitude. DESIGN: A 1-year retrospective case-control study,
      using local acclimatized residents as a control group. SETTING: The two main
      ambulance destinations for Summit County, Colorado (elevation, 2770 m). PATIENTS:
      All patients with a diagnosis of syncope, near-syncope, or fainting whose medical
      records were available for review. RESULTS: There was a significant relationship
      (P less than .05) between syncope of unknown origin and recent arrival at
      altitude (less than 24 hours), and a significant inverse relationship (P less
      than .05) between syncope of unknown origin and arterial oxygen saturation as
      measured by pulse oximetry. CONCLUSIONS: Short-term exposure to moderate altitude
      may be related to otherwise unexplained syncope in healthy young adults. We
      suggest the name high-altitude syncope for this entity and encourage further
      research in this area.

PMID- 1640622
TI  - Patient outcomes after lumbar spinal fusions.
AB  - OBJECTIVES: To determine success and complication rates for lumbar spinal fusion
      surgery, predictors of good outcomes, and whether fusion improves success rates
      of laminectomy for specific low back disorders. DATA SOURCES: English-language
      journal articles published from 1966 through April 1991, identified through
      MEDLINE searching (spinal fusion plus limiting terms), bibliography review, and
      expert consultation. STUDY SELECTION: Articles were selected only if they
      reported at least 1 year of follow-up data enabling the classification of
      clinical outcomes as satisfactory or unsatisfactory for at least 30 patients.
      DATA EXTRACTION: Two reviewers independently extracted data on patient
      characteristics, surgical methods, patient outcomes, and quality of study
      methods. DATA SYNTHESIS: Of 47 articles, there were no randomized trials. Four
      nonrandomized studies compared surgery with and without fusion for herniated
      disks; three found no advantage for fusion. On average, 68% of patients had a
      satisfactory outcome after fusion, but the range was wide (16% to 95%), and the
      satisfactory outcome rate was lower in prospective than in retrospective studies.
      The most frequently reported complications were pseudarthrosis (14%) and chronic
      pain at the bone graft donor site (9%). Clinical outcomes did not differ by
      diagnosis or fusion technique, but were worse in studies with a greater number of
      previously operated patients. CONCLUSIONS: For several low back disorders no
      advantage has been demonstrated for fusion over surgery without fusion, and
      complications of fusions are common. Randomized controlled trials are needed to
      compare fusion, surgery without fusion, and nonsurgical treatments in rigorously
      defined patient groups.

PMID- 1640623
TI  - The biology of developmental dyslexia.
AB  - Dyslexia is a relatively common disorder that, when severe, persists into
      adulthood. New evidence suggests that females are affected nearly as frequently
      as males. Neuropsychological studies characterize dyslexia as a language disorder
      that involves phonological deficits in particular. Educational therapies aimed at
      direct improvement of reading skill constitute the best available treatment.
      Variable genetic transmission leading to a final common pathway appears to
      involve deficits in phonological coding. Postmortem studies and in vivo
      anatomical imaging suggest altered asymmetry of structures in the temporal lobes,
      and neuroimaging with positron emission tomography indicates left temporoparietal
      dysfunction in particular. Neuromaging is providing a window into the brain that
      promises further insights into the biology of dyslexia.

PMID- 1640624
TI  - The best health care system in the world?

PMID- 1640625
TI  - Is the quality cart before the horse?

PMID- 1640626
TI  - A.S.P.E.N.--a precocious adolescent.

PMID- 1640627
TI  - Harry M. Vars Research Award. A new model to determine in vivo the relationship
      between amino acid transmembrane transport and protein kinetics in muscle.
AB  - The bidirectional transmembrane transport rates of leucine (Leu), valine (Val),
      phenylalanine (Phe), lysine (Lys), and alanine (Ala) were measured in vivo in the
      hindlimb muscle of five dogs and related to the rates of protein synthesis and
      degradation. The compartmental model was based on the systemic continuous
      infusion of stable isotopic tracers of the amino acids, and the measurement of
      the enrichment and concentration in the arterial and femoral vein plasma and the
      intracellular free water in muscle (obtained by biopsy). The transport rate from
      plasma to tissue (in micromoles per minute) was: Leu, 18.1 +/- 1.8; Val, 26.9 +/-
      3.5; Phe, 10.5 +/- 1.6 Lys; 12.2 +/- 1.8; and Ala, 10.7 +/- 3.4. The transport
      rate from tissue to plasma (in micromoles per minute) was: Leu, 25.5 +/- 2.5;
      Val, 32.4 +/- 2.8; Phe, 17.0 +/- 2.8; Lys, 24.9 +/- 3.4; Ala, 34.4 +/- 9.0. When
      the transmembrane transport rate was normalized per unit of amino acid
      concentration in the source pool, we found that the transport of Leu, Val, and
      Phe was significantly faster (p less than .05) than the transport of Lys and Ala.
      The calculated rates of incorporation into hindlimb muscle protein of Phe and Lys
      (in micromoles per minute) were 4.2 +/- 1.3 and 19.4 +/- 5.3, respectively, and
      the rates of intracellular appearance from breakdown were 10.7 +/- 1.9 and 32.1
      +/- 6.6, respectively. We concluded, therefore, that (1) the transmembrane amino
      acid transport rate can be measured in vivo in muscle with a relatively
      noninvasive technique, (2) in the dog hindlimb the equilibration between tissue
      and plasma free amino acid pool is different for each amino acid depending on the
      kinetics of the transmembrane transport systems, and (3) the transport rates of
      amino acids and their rate of appearance from protein breakdown are roughly
      comparable, suggesting that variations in transport rates could play a role in
      controlling the rate of protein synthesis.

PMID- 1640628
TI  - Effect of different dietary triglycerides on liver fatty acids and prostaglandin
      synthesis by mouse peritoneal cells.
AB  - The effect of dietary triglycerides varying in fatty acid composition on the
      tissue fatty acids and prostaglandin synthesis was studied in mice. The dietary
      fats were medium-chain triglycerides (rich in C8:0 and C10:0), structured lipids
      (rich in 12:0), high oleic sunflower oil (rich in 18:1), corn oil (rich in n-6
      polyunsaturated fatty acids), and menhaden oil (rich in n-3 polyunsaturated fatty
      acids) fed at 5% by weight in refined diets. The medium chain fatty acids C8 to
      C12 from medium-chain triglycerides and structured lipids did not accumulate in
      liver phospholipids. However, long-chain fatty acids from the dietary fats were
      incorporated into liver lipids, with n-3 polyunsaturated fatty acids replacing
      arachidonic acid. The synthesis of 6-keto-prostaglandin F1 alpha and
      prostaglandin E2 by peritoneal cells in response to intraperitoneal injection of
      zymosan decreased as the arachidonic acid levels were decreased. When the same
      dietary fats were added to the refined, fat-free diets, at 7.5 wt% levels,
      together with 2.5 wt% of safflower oil to provide essential fatty acids, only the
      long-chain fatty acids from the dietary fats were incorporated into the liver
      lipids. The arachidonic acid in liver lipids was enhanced after supplementation
      of diets with safflower oil. However, the reduction in prostaglandin synthesis by
      peritoneal cells in response to intraperitoneal injection of zymosan was similar
      to that observed when 5% fat was fed. The data suggest that dietary fats of
      defined composition, with or without added essential fatty acids, may be useful
      as alternate fat sources in parenteral nutrition in reducing inflammatory
      responses mediated via prostaglandins.

PMID- 1640629
TI  - Home parenteral nutrition--a 3-year analysis of clinical and laboratory
      monitoring.
AB  - We report a 3-year analysis (1986 to 1989) of the management of 63 home
      parenteral nutrition patients, 40 with short-bowel syndrome and 23 with chronic
      intestinal obstruction with or without intestinal resection. Intravenous fluid
      requirements varied from 0.9 to 6 L/day, and the content of glucose varied
      between 46 and 531 g/day, protein varied from .0 to 85 g/day, fat from .0 to 100
      g/day, sodium from 37 to 695 mEq/day, potassium from 30 to 220 mEq/day, chloride
      from 60 to 760 mEq/day, and acetate from 0 to 200 mEq/day. Body weight was
      normalized and well maintained in the majority of patients, but using the strict
      definition of deficiency as the presence of one abnormal value during 3 years,
      more than half had abnormal plasma chloride, glucose, alkaline phosphatase, serum
      glutamic oxaloacetic transaminase, total protein, albumin, selenium, and iron
      concentrations, and more than a third had low calcium, magnesium, vitamin D, and
      vitamin C levels. Normochromic anemia was seen in 73% and high blood creatinine
      associated with low urine volumes in 42%. Most (78%) returned to relatively
      normal lifestyles, but employability was occasionally impaired by loss of third
      party insurance coverage resulting from a therapy that may cost $100,000 per
      year. Overall mortality was low (5% per year), but 73% needed readmission to
      hospital, mainly for suspected catheter sepsis. The results indicate that home
      parenteral nutrition has allowed many patients to survive gut failure and return
      to work but problems with chronic fluid, electrolyte and micronutrient
      deficiencies, catheter sepsis, and insurance coverage often restrict optimal
      rehabilitation.

PMID- 1640630
TI  - Absence of hypermetabolism after operation in the newborn infant.
AB  - This study was designed to assess the effect of operative stress on resting
      energy expenditure (REE) in the newborn infant. In 13 neonates who had an
      uncomplicated abdominal, thoracic, or spinal operation, REE was measured both
      preoperatively and on the third postoperative day. The mean preoperative REE of
      43.19 +/- 7.95 kcal/kg per day was not significantly different from the mean
      postoperative REE of 41.70 +/- 7.94 kcal/kg per day. Sixteen neonates had REE
      measured on the first, second, and seventh postoperative days. The mean
      postoperative REE values of 43.12 +/- 6.92, 42.41 +/- 7.58, and 46.33 +/- 6.89
      kcal/kg per day at 1, 2, and 7 days, respectively, were not significantly
      different from the preoperative REE. There was no significant difference in
      oxygen consumption, carbon dioxide production, and respiratory quotient between
      the preoperative and postoperative groups. In this study, an uncomplicated
      operation did not increase REE in the neonate.

PMID- 1640631
TI  - Differentiating subtypes (hypoalbuminemic vs marasmic) of protein-calorie
      malnutrition: incidence and clinical significance in a university hospital
      setting.
AB  - Clinical nutrition assessment has identified two types of protein-calorie
      malnutrition (PCM), a stress-induced hypoalbuminemic form (HAF-PCM) and a
      marasmic form (MF-PCM) generated by adaptation to starvation. This study
      evaluated the differences between these two patterns of PCM with regard to
      precipitating factors and the clinical sequelae of mortality, cost of total
      parenteral nutrition, length of hospitalization, and rate of sepsis and
      nosocomial infection. Of 220 patients receiving total parenteral nutrition over a
      12-month period (0.7% of 30, 127 admissions), 180 were included in this study.
      HAF-PCM was diagnosed in 45% and MF-PCM in 25% of study patients. HAF-PCM was
      more common in older age groups. Women had PCM less often than did men (57% vs
      83%), but whereas men developed both forms of PCM equally, women were more likely
      to develop HAF-PCM. Prolonged mechanical ventilation increased the likelihood of
      both patterns, whereas the presence of malignancy, concomitant organ failure,
      trauma, burns, or surgery did not increase the likelihood of developing either
      pattern of PCM. HAF-PCM increased the length of hospitalization by 29% and the
      cost of total parenteral nutrition by 42%. The presence of HAF-PCM increased four
      fold the odds of dying, and the odds of developing nosocomial infection and
      sepsis almost 2.5 times above that seen in its absence. MF-PCM had no clinical
      effect of its own on any of the outcome parameters, but instead exerted only an
      interactive synergistic effect with HAF-PCM on length of hospitalization and cost
      of total parenteral nutrition.

PMID- 1640632
TI  - Short-term dietary lipid manipulation does not affect survival in two models of
      murine sepsis.
AB  - Dietary lipid manipulation has been shown to have various effects on the immune
      system, depending on the amount of fat, degree of saturation, and type of fat
      used. In this study we investigated the role of different sources of fat at
      different levels on the survival of mice in two models of peritonitis, one with
      Pseudomonas aeruginosa and the other with Salmonella typhimurium. CF1 mice were
      pair-fed diets with 5% or 40% of total calories as fat. The source of fat used
      was coconut oil, oleic acid, safflower oil, or fish oil. Three other diets were
      tested as well, one with no fat, one with only 0.5% of total calories linoleic
      acid as the only source of fat, and a control diet that had 12% of total calories
      as corn oil. At the end of 2 weeks of feeding the experimental diets, mice were
      challenged with Ps aeruginosa intraperitoneally and mortality was recorded over 1
      week. After 3 weeks of feeding the experimental diets, mice were challenged with
      S typhimurium and mortality was recorded over 2 weeks. No significant differences
      were seen on survival among groups fed different levels of fat, as well as
      different sources of fat. We conclude that, overall, 2- and 3-week manipulation
      of dietary fat does not affect outcome from infection in these models.

PMID- 1640633
TI  - Liver test alterations with total parenteral nutrition and nutritional status.
AB  - Liver test abnormalities are a well-recognized complication in the parenterally
      fed population. Numerous etiologies for the development of elevated liver tests
      have been suggested. However, the etiology and clinical significance remain
      unclear. The aim of this retrospective study was to determine the extent of liver
      associated test (LAT) abnormalities in patients receiving total parenteral
      nutrition (TPN) and to investigate whether the composition of TPN solutions and
      the magnitude of malnutrition could be used to predict subsequent LAT
      abnormalities. Medical records of 78 adult patients who received TPN for at least
      2 weeks were reviewed. All subjects had normal LAT results before TPN, were not
      receiving hepatotoxic drugs, and had no underlying liver disease. Aspartate
      aminotransferase peaked transiently during week 2 and returned to normal during
      week 4. Alkaline phosphatase and total bilirubin peaked during weeks 4 and 3,
      respectively. The average nonprotein kilocalorie distribution was approximately
      80% dextrose and 20% lipid. Caloric intake ranged from 7% to 23% above estimated
      needs. The mean nutritional status score was 22 +/- 15, with a possible range of
      0 to 75 (0 indicates no malnutrition). The composition of TPN solutions was not
      significantly associated with the changes in the three LATs during any week of
      the 4-week study. The nutritional status score was significantly associated (p
      less than .05) with the change in alkaline phosphatase during week 1. This study
      confirms that LAT abnormalities occur during TPN, but the composition of the
      solution has no significant ability to predict subsequent LAT
      abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640634
TI  - Adaptation to a fish oil diet before inducing sepsis in rats prevents fatty
      infiltration of the liver.
AB  - Hypertriglyceridemia and fatty liver are common lipid abnormalities associated
      with Gram-negative sepsis. Fish oils have been shown to have beneficial effects
      in reducing plasma triglycerides (TG). This study was designed to investigate
      whether fish oils would prevent the elevation of plasma TG and the accumulation
      of liver lipids during sepsis. One group of rats was fed a 10% menhaden oil diet
      and the other group was fed a 10% corn oil diet for 14 days. On the 14th day,
      sepsis was induced by injecting the rats with 8 x 10(7) live Escherichia coli
      colonies/100 g of body weight and the rats were fasted for 22 hours. The liver
      composition of total lipids and TG in the septic rats prefed the fish oil was
      lower than in the septic rats prefed the corn oil. In the rats adapted to the
      corn oil diet, lipids accumulated in the livers of the septic rats in comparison
      with the control rats. Hepatocytes isolated from the septic rats adapted to the
      corn oil diet showed an increased esterification of [1-14C]palmitate into TG and
      phospholipids than hepatocytes from the control rats. Feeding the fish oil diet
      instead of the corn oil diet before inducing sepsis reduced TG, cholesterol, and
      phospholipid synthesis by 58%, 79%, and 71%, respectively. The rise in TG
      synthesis in the septic rats prefed the corn oil diet was associated with an 89%
      increase in the activity of phosphatidate phosphohydrolase. There was no
      significant difference in the activities of glycerol-3-phosphate acyltransferase
      and phosphatidate phosphohydrolase between control and septic rats.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1640635
TI  - Measurement of resting energy expenditure in patients with chronic obstructive
      pulmonary disease in a clinical setting.
AB  - There is a growing tendency to estimate energy requirements by means of the
      assessment of resting energy expenditure (REE) by indirect calorimetry. In this
      study a computerized open-circuit ventilated hood system is described that was
      constructed for assessing REE in a clinical setting. Measurement error of the
      device, tested by ethanol combustion was +2% for VO2 and VCO2 and less than 1%
      for respiratory quotient. To assess the within-patient variability of REE
      measurements performed in a daily clinical routine, we studied the following
      aspects of the measurements in several groups of patients with chronic
      obstructive pulmonary disease: (1) reproducibility, (2) the influence of routine
      physical activities before the measurement, (3) measurement duration, and (4)
      difference between measurements using a ventilated hood or a mouthpiece.
      Reproducibility of measurements with a 2-month interval in 12 weight-stable
      patients was good (1415 +/- 128 and 1398 +/- 138 kcal/day). Variations due to
      limited activities and different measurement durations (between 10 and 30
      minutes) were not significant. Variations between measurements with a mouthpiece
      and ventilated hood were larger in patients than in healthy control subjects, but
      for both groups no systematic difference was established. REE can be assessed
      reliably by short-term measurements with a ventilated hood in stable chronic
      obstructive pulmonary disease patients on an outpatient basis, provided a short
      rest is taken before the measurement.

PMID- 1640636
TI  - Retrograde (ascending) bacterial contamination of enteral diet administration
      systems.
AB  - A prospective clinical study in three phases was performed to determine whether
      it was possible that enteral diet containers could become contaminated as a
      result of endogenous organisms ascending retrogradely from the enteral feeding
      tube via the giving set, and if this did occur whether the incidence could be
      altered by modifying enteral delivery systems. Each phase observed patients on
      enteral feeding over a 48-hour study period (phase I, n = 18; phase II, n = 17;
      phase III, n = 18). Each patient was prescribed an enteral diet of 2 L/24 h
      administered by continuous pump infusion from a closed 1-L sterile diet
      container. Four containers were used for each patient, and one giving set was
      used in the 48-hour period. Diet samples were taken at 12-hour intervals: two
      from the giving set before and after flushing with residual diet, and one from
      the diet container. Phases differed only in the design of the giving set: phase I
      had no drip chamber, phase II had a drip chamber, phase III had a drip chamber
      and an anti-reflux ball valve at the distal end. Both phase I and III had greater
      numbers of giving set samples colonized at 24, 36, and 48 hours. In phase I, 3 of
      14 sterile diet containers were colonized with greater than 10(4) colony-forming
      organisms/mL of diet at 48 hours. Only phase II had no organisms contaminating
      the containers at 48 hours. We conclude that the retrograde spread of organisms
      from patient to sterile diet container does occur in clinical practice, and that
      a drip chamber in the giving set may prevent the problem.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1640637
TI  - Safety and efficacy of glycerol and amino acids in combination with lipid
      emulsion for peripheral parenteral nutrition support.
AB  - The safety and efficacy of administering lipid emulsion with ProcalAmine, a
      glycerol-based parenteral nutrition solution, for peripheral nutrition has not
      been previously studied. Thirty-four patients recovering from major trauma or
      surgery were studied while receiving a peripheral parenteral nutrition regimen of
      either ProcalAmine with 10% lipid emulsion (group 1) or ProcalAmine with 20%
      lipid emulsion (group 2) for up to 5 days postinjury. Daily dose was 45 mL/kg
      ProcalAmine, providing 1.35 g of amino acids/kg and 1.35 g of glycero/kg, and 500
      mL/day lipid emulsion. The mean daily nitrogen balance was -0.3 g/day in group 1
      and -4.1 g/day in group 2. There was no progressive accumulation of circulating
      glycerol, and urinary glycerol excretion was minimal (less than 0.2 g/day),
      indicating effective utilization of glycerol as an energy substrate. Our finding
      that nitrogen balance was better with 10% fat emulsion suggests a limitation in
      fat utilization in this setting. Both regimens were well tolerated; there were no
      adverse clinical reactions and no occurrences of phlebitis in either group.

PMID- 1640638
TI  - Full protein alimentation and nitrogen equilibrium in a renal failure patient
      treated with continuous hemodiafiltration: a case report of 67 days of continuous
      hemodiafiltration.
AB  - Standard care for patients with renal failure while in an intensive care unit
      involves traditional hemodialysis or peritoneal dialysis and protein restriction.
      We present a case of a patient with renal failure supported with continuous
      arteriovenous hemofiltration with dialysis (CAVH-D) who was given full protein
      alimentation. Total daily urea clearance was measured from the CAVH-D output.
      Protein load was 196 +/- 34 g/day while receiving total parenteral nutrition and
      164 +/- 30 g/day while receiving enteral alimentation. Serum blood urea nitrogen
      was controlled between 40 and 75 mg/dL, except during septic episodes. Nitrogen
      balance was estimated based upon known alimentation protein load and measurable
      and estimated nitrogenous losses. The patient was potentially in nitrogen
      equilibrium during most of the dialysis period. The cumulative nitrogen balance
      was positive by 5.2 g after 67 days of dialysis. Volume of alimentation was 3.49
      +/- 0.7 liters/day. With CAVH-D, the renal failure patient can receive full
      alimentation without volume or protein load limitations. Furthermore, nitrogen
      balances can be estimated easily while the patient is on CAVH-D.

PMID- 1640639
TI  - Cuff Cath: an initial experience of cuffed polyurethane central venous catheters
      in children.
AB  - The tendency of medium- and long-term silicone central venous catheters (CVCs) to
      block, fracture, and become displaced has led to the evaluation of a polyurethane
      CVC, Cuff Cath (Viggo Spectramed, Swindon, Wilts, United Kingdom) as a possible
      alternative because polyurethane is smoother and stronger. We report the first
      prospective study of polyurethane cuffed CVCs in children. Sixty Cuff Caths were
      placed in 53 children, mean age 4.7 years (range, 4 days to 16.3 years), mean
      weight 15.6 kg (range, 3.1 to 58 kg). All CVCs were tunnelled (mean tunnel
      length, 12 cm; range, 5 to 20 cm) and inserted either into the subclavian vein (n
      = 28) or internal jugular vein (n = 32). In a total of 6363 catheter days (mean,
      111 days per patient; range, 15 to 364 days), three (5%) CVCs had to be removed
      because of sepsis and one (2%) because of blockage. All other Cuff Caths remained
      patent to infusion and blood sampling. No Cuff Caths were pulled or fell out,
      fractured, or migrated. This study demonstrates significant advantages of
      polyurethane compared with previous series using silicone CVCs with respect to
      blockage, fragmentation, and dislodgement. A prospective, randomized, controlled
      trial of Cuff Cath compared with a silicone CVCs in children is required.

PMID- 1640640
TI  - Parenteral nutrition-related bone disease.
AB  - Parenteral nutrition (PN)-related bone disease remains a problem in patients of
      all ages. Understanding of the pathogenesis of PN-related bone disease is
      complicated by the effect of underlying illnesses, therapeutic interventions, and
      pre-existing nutrition deficiencies before the initiation of PN therapy.
      Interrelation of various nutrients, for example, calcium, phosphorus, and vitamin
      D, in their effects on bone mineralization, demands simultaneous assessment of
      the role of multiple nutrients and increases the difficulty in defining the role
      of a single nutrient in the development of bone disease. However, recent reports
      indicate that there exist a number of factors important in the development of PN
      related bone disease and some factors such as increased mineral requirement are
      unique to growing infants whereas other factors such as aluminum toxicity may be
      common to both adult and pediatric populations. Nonnutritional factors, including
      chronic use of potent loop diuretics and altered acid-base status, can affect
      urine mineral loss, cell metabolism, and bone mineralization, particularly in
      small, preterm infants. Current evidence indicates that the cause of PN-related
      bone disease is multifactorial, and the prevention of PN-related bone disease
      awaits better delineation of the exact sequence of pathogenic events.

PMID- 1640641
TI  - Feeding jejunostomy for post operative nutritional support.

PMID- 1640642
TI  - Jejunal mucosal injury and restitution: role of hydrolytic products of food
      digestion.

PMID- 1640643
TI  - Depressed gut absorptive capacity early after trauma-hemorrhagic shock.

PMID- 1640644
TI  - Pathogenesis of hepatic steatosis.

PMID- 1640645
TI  - Nutrition-related bone disease.

PMID- 1640646
TI  - Resting energy expenditure in liver disease.

PMID- 1640647
TI  - Fatty acid-sensitive acid phosphatase activity of tubercle bacilli.
AB  - In a whole cell assay system with p-nitrophenyl phosphate as substrate, strains
      of Mycobacterium tuberculosis and M. bovis were identical in the pH-activity
      pattern of acid phosphatase. It was a one-peak curve with a pH optimum at 6.2 and
      sharp symmetrical slopes. The enzymatic activity did not reflect the virulence.
      When the cells were subjected to mechanical fractionation, the major part of the
      enzymatic activity was found in a particulate fraction and a minor portion in
      supernatant and cell walls, suggesting the location of the enzyme in the
      membrane. Exposure of the cells to free long-chain fatty acids, especially
      unsaturated ones, reduced the enzymatic activity in a dose-response manner with
      concomitant decrease in the viability. However, no causal relationship between
      these two effects was suggested from the collateral experiments.

PMID- 1640648
TI  - Different susceptibilities to attenuated poliovirus of cynomolgus monkeys from
      the Philippines and other Southeast Asian countries.
AB  - Susceptibilities to attenuated poliovirus of cynomolgus monkeys were assessed by
      the intraspinal inoculation method with the same single bulk lot as the reference
      for each of the three poliovirus types. The lesion-inducing virus dose in the
      spinal cord of 50% of monkeys inoculated (LID50) varied widely from 10(6.4) to
      lower than 10(2.5), the difference being as much as 10,000-fold, depending on the
      birth place of the monkey. The birth places of the monkeys used were traced and
      categorized into the following three districts; the peninsular region, Indonesia
      and the Philippines. The LID50 value of the attenuated poliovirus in the monkeys
      from the Philippines were much lower than those in the monkeys from the other two
      districts.

PMID- 1640649
TI  - [Platelet accumulation in abdominal aortic aneurysms and the effect of
      antiplatelet drugs: assessment by indium platelet scintigraphy].
AB  - A dual tracer technique using 111In labeled platelets and 99mTc labeled human
      serum albumin was applied to evaluate the in vivo thrombogenicity in 12 cases
      with abdominal aortic aneurysm (AAA) and the effect of antiplatelet drug on the
      thrombogenicity. The magnitude of platelet accumulation at AAA was expressed as
      the ratio of radioactivity of 111In platelets on the vascular wall to those in
      the blood pool (PAI; platelet accumulation index). Of the 12 patients with AAA,
      11 had positive studies on baseline imaging and 1 had equivocally positive image.
      The PAI value (Mean +/- SD) over the AAA was 53.8 +/- 34.1% as compared to -8.6
      +/- 4.4% in the control group (p less than 0.01). Seven patients with an AAA and
      positive baseline images were restudied during platelet active drug with 325 mg
      of aspirin. During treatment with aspirin, of 7 patients, 5 had positive images,
      of which 3 were decreased and others unchanged compared to baseline studies, 1
      equivocally positive one and one negative one. The PAI value during treatment
      (21.9 +/- 18.6%) was significantly decreased compared to those in baseline study
      (52.1 +/- 23.9%). Our results suggest that the method used for platelet imaging
      in the present study may be useful for studying the in vivo thrombogenicity and
      the effect of platelet active drugs in AAA.

PMID- 1640650
TI  - [Clinical evaluation of 99mTc ethyl cysteinate dimer SPECT in patients with
      spinocerebellar degeneration; comparison with cerebral blood flow determined by
      PET].
AB  - Technetium-99m ethyl cysteinate dimer (99mTc-ECD) is regarded as a promising
      radiopharmaceutical for imaging regional cerebral blood flow (rCBF). We evaluated
      99mTc-ECD SPECT comparing with rCBF images obtained by PET in 12 patients with
      spinocerebellar degeneration (SCD). SPECT images of 99mTc-ECD demonstrated
      characteristic findings of decreased rCBF in bilateral cerebellar hemisphere and
      almost identical with PET rCBF images in all patients based on the visual
      inspection. Semiquantitative analysis by drawing 14 intracranial regions of
      interest on SPECT and PET images revealed linear correlation between 99mTc-ECD
      count and rCBF measured by PET even in relatively high rCBF regions. In summary,
      99mTc-ECD is a promising tracer for evaluating rCBF in patients with SCD and
      distribution of it correlates well with rCBF measured by PET.

PMID- 1640651
TI  - [Radioisotope therapy of malignant pheochromocytoma with iodine-131
      metaiodobenzylguanidine--absorbed dose assessments using SPECT].
AB  - The correlation of absorbed doses D (rad) of tumors in 4 patients with malignant
      pheochromocytoma, who were treated by 131I-MIBG (3.7 GBq), with their clinical
      courses were analyzed and the clinical significance of determination of absorbed
      dose was discussed. Absorbed doses of 131I-MIBG in the tumors were measured by
      using SPECT at the time of therapy. Absorbed dose was calculated based on the
      MIRD (medical internal radiation dose committee) equation. Tumor volumes were
      ranged from 17 g-100 g (mean 40 g), effective half lives were ranged from 1.3
      days-5.9 days (mean 3.6 days), and tumor absorbed doses were varied between 5.4
      Gy-68 Gy (mean 40 Gy). When the absorbed doses of the tumor exceeded over 40 Gy,
      good clinical responses were obtained. The initial treatment seemed to be
      important for 131I-MIBG therapy, since the absorbed doses in the following
      therapy became reduced. These results indicate that the quantitative SPECT for
      radioisotope therapy is clinically valid and that the calculated absorbed doses
      correlate well with clinical responses.

PMID- 1640652
TI  - [Usefulness of vitamin A binding protein as a marker for capillary endothelial
      permeability].
AB  - We performed a preliminary study to assess the usefulness of Vitamin A binding
      protein (VABP) as a gamma-camera marker for capillary endothelial permeability.
      We used a guinea pig model of endotoxin (LPS) induced acute lung injury. We
      calculated the concentration ratio of either 125I-albumin or 125I-VABP in lung
      tissue to that in plasma (tissue plasma ratio; T/P) as a parameter of capillary
      endothelial permeability. 99mTc-diethylene triamine pentaacetic acid (DTPA) was
      used as a marker for pulmonary interstitial volume. We estimated wet to dry lung
      weight ratio as a parameter of lung water accumulation (W/D). LPS increased the
      T/P of 125I-albumin and W/D, suggesting the development of permeability edema.
      The T/P for 125I-VABP was also increased, indicating that 125I-VABP can be used
      to detect elevated capillary endothelial permeability. In both groups, LPS and
      saline, the T/P was higher for 125I-VABP than for 125I-albumin. These data
      suggest that the pulmonary capillary endothelium is more permeable to VABP than
      albumin.

PMID- 1640653
TI  - [Evaluation of gastroenterological disease by using 18F-FDG PET--differential
      diagnosis of malignancy from benignity].
AB  - In this study, we used 18F-FDG PET to differentiate gastroenterological
      malignancy from benignity. We investigated 122 patients with gastroenterological
      disease before treatment (with lesions exceeding 2.0 cm in diameter only). 60 min
      after injection of FDG, although 16 cases out of 17 benign disease did not reveal
      accumulation higher than normal tissue, 105 cases of malignant tumor except some
      of hepatocellular carcinoma revealed high accumulation of FDG. FDG uptake was
      expressed as the Ci/Cp ratio, calculated from radioactivity of the tumor (Ci) and
      the plasma (Cp). 89 cases out of 90 which show more than 2.0 of Ci/Cp ratio were
      malignant tumor. On the other hand, 32 cases which show less than 2.0 contained
      16 cases of benign disease and 15 of hepatocellular carcinoma. FDG PET is a
      useful tool for differential diagnosis of malignant tumor from benign disease
      except some of hepatocellular carcinoma.

PMID- 1640654
TI  - [123I-IMP SPECT study on patients with amnestic syndrome].
AB  - Regional cerebral blood flow was studied using single photon emission CT (SPECT)
      with 123I-IMP to elucidate the pathophysiology of amnesia. Four patients with
      amnestic syndrome diagnosed by DSM-III-R criteria were investigated. SPECT images
      demonstrated definite hypoperfusion of the temporoparietal lobe and relative
      sparing of motor-sensory and occipital cortices in two out of four patients.
      Since these abnormalities of regional cerebral blood flow have been considered to
      be characteristic findings in dementia of the Alzheimer type, two patients with
      temporoparietal hypoperfusion are suggested to manifest the early stage of
      dementia of the Alzheimer type. Our observations suggest that 123I-IMP SPECT is
      an useful modality in the diagnosis of the early stage of dementia of the
      Alzheimer type, especially in patients with only memory impairment.

PMID- 1640655
TI  - [Property of electrocardiogram gated single photon emission tomography by 99mTc
      methoxy isobutyl isonitrile].
AB  - 99mTc-methoxy isobutyl isonitrile (MIBI) is a new developed myocardial perfusion
      imaging agent. Because this compound has higher photon energy than thallium (Tl),
      electrocardiogram gated single photon emission tomography (SPECT): end-diastolic
      (ED) and end-systolic (ES) short axis (SA) images could be taken. To investigate
      property of gated MIBI SPECT, MIBI myocardial scintigraphy, Tl scintigraphy (TMS)
      and analysis of left ventricular wall motion were performed in 6 patients with
      myocardial infarction. Left ventricle was divided into 8 segments. Perfusion
      defect (PD) was scored: "0" (normal), "1" (hypo-perfusion), "2" (defect). Wall
      motion abnormality (WMA) was also scored: "0" (normokinesis), "1" (hypo-kinesis),
      "2" (a-, dys-kinesis). Severity and extent of PD and WMA were calculated.
      Severity of WMA was 3.0 +/- 2.0 (M +/- SD), severity of PD was 3.3 +/- 1.7 in
      TMS, 3.7 +/- 1.3 in no-gated MIBI, 5.0 +/- 0.6 in ES-MIBI, 7.3 +/- 2.0 in ED
      MIBI. Extent of WMA was 2.3 +/- 1.0. Extent of PD was 2.5 +/- 1.3 in TMS, 3.0 +/-
      1.6 in no-gated MIBI, 3.5 +/- 0.8 in ES-MIBI, 4.8 +/- 1.0 in ED-MIBI. Compared
      with wall motion abnormality, severity and extent of PD in ED-MIBI was larger.
      From our data, it is concluded that perfusion defect in ED-MIBI was overestimated
      significantly. When we evaluate gated MIBI image, we must consider this property.

PMID- 1640656
TI  - [Clinical use of serum erythropoietin determination by the recombigen EPO RIA
      kit].
AB  - Serum erythropoietin (EPO) levels were determined by the recombigen EPO RIA kit
      (DPC) in normal subjects and patients with renal dysfunction, diabetes mellitus,
      hypothyroidism and a variety of hematological disorders. Mean (+/- SD) serum EPO
      levels were 18.6 +/- 5.6 mU/ml in 180 normal subjects and no sex difference was
      obtained. Serum EPO levels in older subjects were slightly greater than those in
      younger subjects. There was a negative correlation between serum EPO levels and
      Ht values in anemic patients with normal renal function, whereas serum EPO levels
      were within the normal range in anemic patients with renal disorders, suggesting
      that serum EPO levels were relatively low in patients with chronic renal failure.
      Serum EPO levels were rather increased in patients with diabetes mellitus and
      hypothyroidism. High serum EPO levels were obtained in patients with a variety of
      hematological disorders such as acute leukemia, multiple myeloma, myelodysplasia
      syndrome, aplastic anemia and pure red cell aplasia. In a patient with pure red
      cell aplasia treated with glucocorticoids, serum EPO levels were lowered before
      anemia was recovered and reticulocytes were increased. These findings indicate
      that measurement of serum EPO levels are useful for not only differential
      diagnosis of anemia but also clinical evaluation of the treatment.

PMID- 1640657
TI  - [Three-dimensional display of 99mTc-MIBI myocardial scintigraphy].
AB  - One of 99mTc-hexakis, 99mTc-methoxyisobutyl isonitrile (MIBI), has been
      demonstrated to have a myocardial uptake proportional to regional coronary blood
      flow. In this study, 99mTc-MIBI myocardial scintigraphy were performed for 16
      patients with ischemic heart disease. After injection of 740 MBq of 99mTc-MIBI,
      64 projection images were collected during a 360-degree rotation. Three
      dimensional (3D) display of the left ventricle was reconstructed with depth
      shading method from 99mTc-MIBI SPECT images, which were reconstructed by filtered
      back projection method. In 9 of the patients, left ventricular cineangiography
      were performed as diagnostic gold standard. Four physicians blinded to patients'
      clinical informations interpreted 3D images and SPECT images on separate
      occasions. Diagnosis of hypoperfusion by 3D displays agreed with those of SPECT
      in 92.9% (104/112 segments), and disagreed in 7.1% (8 segments). Sensitivity and
      specificity of 3D images were 87.0 and 93.9%, which were not statistically
      different (p less than 0.05) from that of SPECT images (91.3, 97.0%). Receiver
      operating characteristic (ROC) analysis revealed nearly identical curves for the
      two. Although 3D display had nearly identical diagnostic ability with SPECT,
      observers reported that 3D images were easier to diagnose than SPECT images. An
      advantage of the 3D display is that the display gives a more realistic impression
      of the left ventricle to an observer than tomography or planar imaging. Another
      advantage is that 3D display can reduce the amount of data storage compared with
      that of SPECT. In conclusion, 3D images may be useful for diagnosis of
      hypoperfusion of left ventricle.

PMID- 1640658
TI  - Characteristics of the ambulation-increasing effect of the noncompetitive NMDA
      antagonist MK-801 in mice: assessment by the coadministration with central-acting
      drugs.
AB  - Characteristics of the ambulation-increasing effect of MK-801, a non-competitive
      NMDA antagonist, were assessed through the coadministration of MK-801 with
      various central-acting drugs in mice. The MK-801 (0.3 mg/kg, i.p.)-induced
      ambulation-increment with a slight ataxia was maximum at around 50 min, and
      ambulation returned to the control level at about 3 hr after the administration.
      At 1 mg/kg, the mouse's activity transiently increased, followed by a decrease
      due to a marked ataxia, which was due to neither stereotypy nor convulsion, for
      20-50 min, and then increased again; the ambulation-increment continued even at 4
      hr after the administration. Coadministration of MK-801 (0.3 mg/kg, i.p.) with
      either methamphetamine (2 mg/kg, s.c.), cocaine (20 mg/kg, s.c.), GBR-12909 (10
      mg/kg, i.p.), scopolamine (0.5 mg/kg, s.c.), caffeine (10 mg/kg, s.c.) or
      morphine (10 mg/kg, s.c.) produced a significant enhancement of the effect.
      However, 0.1 mg/kg of MK-801 had no effect on the interaction with these drugs.
      On the other hand, the ambulation-increasing effect of MK-801 (0.3 mg/kg) was
      significantly reduced by haloperidol (0.3 and 0.1 mg/kg, s.c.), ceruletide (0.01
      and 0.1 mg/kg, i.p.), reserpine (0.05 and 2 mg/kg, s.c., pretreatment 4 hr
      before) and nimodipine (1 and 3 mg/kg, i.p.), but it was scarcely modified by
      alpha-methyl-p-tyrosine (100 and 200 mg/kg, i.p., pretreatment 24 hr and 4 hr
      before), imipramine (20 mg/kg, i.p.), 6R-L-erythro-5,6,7,8-tetrahydro-biopterin
      (100 mg/kg, i.p.), pilocarpine (1 and 4 mg/kg, s.c.), N6-(L-2-phenylisopropyl)
      adenosine (0.03 and 0.1 mg/kg, s.c.) and naloxone (1 and 5 mg/kg, s.c.).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1640659
TI  - Reversing effect of anti-asthmatic drugs on bronchoconstriction induced by
      antigen challenge and histamine in anesthetized guinea pigs.
AB  - We performed an in vivo evaluation of bronchodilation using a model of antigen
      induced bronchoconstriction in anesthetized guinea pigs pretreated with
      indomethacin, pyrilamine and propranolol, and the results were compared with
      those for the histamine-induced response. Test drugs were administered
      intravenously when the antigen or histamine response reached its peak.
      Leukotriene (LT) D4 antagonists, FPL55712 and LY171883, gradually reduced the
      antigen-induced response, whereas the lipoxygenase inhibitor phenidone had no
      such effect. The bronchodilator theophylline rapidly reduced the antigen-induced
      response, and the adenylate cyclase activator forskolin had a similar effect. The
      following drugs also had no effect: nifedipine (calcium-channel antagonist),
      cromakalim (potassium-channel opener), amlexanox and disodium cromoglycate: DSCG
      (anti-allergic drugs), OKY-046 (thromboxane A2 synthetase inhibitor), and dapsone
      (anti-inflammatory drug). Theophylline, the beta-adrenoceptor agonist salbutamol
      and the histamine H1-blocker pyrilamine had only a small reversing effect on
      histamine-induced bronchoconstriction. These results suggest that antigen-, but
      not histamine-, induced bronchoconstriction in anesthetized guinea pigs is a
      useful in vivo model for evaluating the bronchodilating effect of anti-asthmatic
      drugs.

PMID- 1640660
TI  - Suppression by cyclosporin A of anti-GBM nephritis in rats.
AB  - The suppressive effect of cyclosporin A (CyA) on the development of
      glomerulonephritis was evaluated in rats with either original- or crescentic-type
      anti-glomerular basement membrane (GBM) nephritis. CyA (2.5, 10 or 20 mg/kg) was
      given p.o. daily to original-type anti-GBM nephritic rats for 10 days from the
      day after the injection of anti-GBM serum. The development of the nephritis was
      dose-dependently suppressed by CyA before the production of specific antibody
      against rabbit gamma-globulin (the heterologous phase). In addition, CyA
      suppressed glomerular infiltration of leukocyte subsets (leukocyte with common
      antigen, T cell, helper T cell, suppressor/cytotoxic T cell,
      macrophage/monocyte). CyA was given p.o. daily to crescentic-type anti-GBM
      nephritic rats for 10 days from the 10th day after the injection of anti-GBM
      serum. CyA-administration caused a distinct suppression of the deterioration of
      nephritis during the autologous phase. In addition, CyA markedly suppressed the
      antibody production. The above data indicate that CyA has a beneficial effect on
      anti-GBM nephritis, and the antinephritic action of this agent may be due to the
      inhibition of glomerular infiltration of leukocyte subsets as well as the
      suppression of the antibody production.

PMID- 1640661
TI  - A uniform alteration in serum lipid metabolism occurring during inflammation in
      mice.
AB  - The present study was designed to delineate changes in serum lipid levels
      following various kinds of tissue injury or inflammation such as contact
      sensitivity to picryl chloride, thermal burn, carrageenin-induced edema, the
      administration of turpentine oil, Freund's complete adjuvant (FCA), killed
      Bordetella pertussis (BP) or lipopolysaccharide (LPS). A uniform change in the
      serum lipid metabolism was observed in mice that received these inflammatory
      stimuli; that is, increases in total cholesterol, free cholesterol and
      phospholipid levels, a decrease in the ester ratio and a decline in lecithin:
      cholesterol acyltransferase activity as well as a decrease in albumin levels,
      which is an index of the acute-phase response. However, serum triglyceride levels
      were increased by treatment with the bacterial stimuli (FCA, BP and LPS) but
      decreased by treatment with the other stimuli. The serum free cholesterol and
      phospholipid levels were significantly correlated with the intensity of contact
      sensitivity, which was modified by treatment with cyclophosphamide. Indomethacin
      or dexamethasone suppressed carrageenin-induced edema and inhibited some of the
      alterations in lipid metabolism that developed during inflammation because each
      affected a part of the lipid metabolism. These findings suggest that, like the
      appearance of acute-phase proteins, the uniform change in serum lipid metabolism
      may be another sensitive index of the acute inflammatory response.

PMID- 1640662
TI  - Reversal of alpha-methyltyrosine-induced hypoactivity by 6-(R)-5,6,7,8-tetrahydro
      L-erythrobiopterin (R-THBP) in mice.
AB  - The effects of peripheral administration of 6-(R)-5,6,7,8-tetrahydro-L
      erythrobiopterin dihydrochloride (R-THBP), a natural cofactor for tyrosine and
      tryptophan hydroxylases, were investigated in mice treated with a competitive
      inhibitor of tyrosine hydroxylase, alpha-methyltyrosine (alpha-MT). A
      subcutaneous dose of 250 mg/kg of alpha-MT decreased markedly both ambulatory
      activity and cerebral contents of norepinephrine, dopamine and their metabolites
      in mice. An intraperitoneal dose of 100 mg/kg of R-THBP, which did not alter
      ambulatory activities in normal mice, improved the hypoactivity in alpha-MT
      treated mice. Moreover, R-THBP at intraperitoneal doses of 60 and 100 mg/kg
      inhibited the impairment of cerebral catecholamine metabolism induced by alpha-MT
      in mice. We suggest that the reversal of the alpha-MT effects by R-THBP might be
      due to reactivation of tyrosine hydroxylase in the central nervous system.

PMID- 1640663
TI  - Assessment of Ca(2+)-antagonistic effect of SM-6586 and its isomers, novel 1,4
      dihydropyridine derivatives, by radioligand binding assay.
AB  - The Ca(2+)-antagonistic effects of the 1,4-dihydropyridine derivative (+/-)SM
      6586 and its optical isomers were compared with those of its two derivatives ((+/
      )SM-7297 and (+/-)SM-7548) and other Ca(2+)-antagonists using a radioligand
      binding assay. The Ca(2+)-antagonistic effects of the optical isomers of SM-6586
      were in the order of (+) greater than (+/-) greater than (-)SM-6586 in both rat
      brain and heart. The pKi value of (+)SM-6586 was comparable to those of
      nimodipine, nicardipine, nifedipine and nitrendipine. The pA2 value for (+)SM
      6586 was the highest among the SM-6586 isomers, thus suggesting that (+)SM-6586
      has a potent Ca(2+)-antagonistic effect.

PMID- 1640664
TI  - [Confirmed and borderline hypertension found in 44% of men (aged 40-59 years)
      working at the H. Cegielski plant in Poznan].
AB  - Blood pressure was measured in 3317 men, aged 40-59, working in H. Cegielski
      Metal Works in Poznan. The average systolic pressure for the whole population was
      130.9 mmHg (SE = 17.90). The average diastolic pressure was 83.7 mmHg (SE =
      10.03). The systolic, diastolic and mixed systolic-diastolic hypertension was
      found in 539 men which makes 16.3% of the study group. The borderline systolic
      hypertension was found in 327 men i.e. 9.9%, borderline diastolic hypertension in
      267 men i.e. 8.0%. Both systolic and diastolic borderline hypertension displayed
      339 men i.e. 10.2% of the study group. So, borderline hypertension (systolic,
      diastolic and systolic-diastolic) was found in 933 men which makes 28.1% of the
      population under the study.

PMID- 1640665
TI  - [Hypertension, heart failure and angina pectoris. Diurnal rhythm of urinary
      excretion of catecholamines].
AB  - Adrenaline, noradrenaline and dopamine excretion was investigated in essential
      hypertension (n = 20), atherosclerotic heart failure (n = 20, NYHA class II and
      III), chronic angina (n = 10) and in healthy controls, in four time intervals:
      between 600-1200, 1200-1800, 1800-2400, 2400-600. Fluorimetric method of Anton
      and Sayre was employed. In patients with essential hypertension the circadian
      rhythm of adrenaline, noradrenaline and dopamine excretion was maintained but in
      all time intervals excretion of dopamine was decreased. In individuals with
      congestive heart failure due to atherosclerosis and in patients with ischemic
      heart disease, physiological circadian rhythm of adrenaline and noradrenaline
      excretion was found to be abolished. This was not the case with dopamine
      excretion which was undisturbed.

PMID- 1640666
TI  - [Tetralogy of Fallot. Physical work capacity after its total correction].
AB  - Results of exercise tests in 21 children after total correction of Fallot
      tetralogy (mean 5 years after surgery) are reviewed. Maximal exercise capacity
      recalculated for body mass and for total body area was approximately 60% of
      normal values. Maximal heart rate was lower than among healthy children. There
      was no statistical correlation between exercise capacity nad age while operated,
      nor time after surgery.

PMID- 1640667
TI  - [Long QT syndrome after organophosphate insecticide poisoning].
AB  - A case of prolonged QT syndrome (PQTS) caused by unintentional poisoning with
      organic phosphate pesticides is reported in a 73 year old farmer. PQTS developed
      and coexisted with other symptoms of poisoning such as low levels of
      cholinesterase, vomitus, diarrhoea, miosis, hypersalivation and occurred with
      typical symptoms. Despite concomitant with PQTS advanced ventricular
      extrasystoles the most dangerous form of them--ventricular tachycardia "torsades
      de pointes"--wasn't observed what was attributed among other things to scrupulous
      control and replenishment of potassium++ and magnesium and avoidance of typical
      antiarhytmic drugs in ventricular arrhythmia+ treatment. Acquired (most often
      after drug treatment, toxic and resulting from electrolytic disturbances) forms
      of PQTS are discussed stressing their heterogeneity and necessity of preventive
      treatment (different, dependent on etiology).

PMID- 1640668
TI  - [Cardiac rupture and tamponade in a pregnant woman with acute myocardial
      infarction].
AB  - A case is described of a 35-year old pregnant woman (38-th week, tertigravida)
      with an acute myocardial infarction (AMI). The diagnosis of anterolateral
      myocardial infarction was based on the clinical, biochemical, ecg and
      echocardiographical findings. Ventricular premature beats were observed in the
      tenth day of AMI: Delivery was accomplished by cesarean section without
      complications. In the second day after the cesarean section the patient died. On
      autopsy cardiac rupture, tamponade and fresh necrosis of the lateral wall was
      found.

PMID- 1640669
TI  - [Combined heart defects: tetralogy of Fallot, common atrium and a single
      atrioventricular valve diagnosed by echocardiography].
AB  - We present a case of the rare coincidence of three mechanisms leading to
      development of congenital heart disease in intrauterine life: intrinsic defect of
      the development of the cardiac loop (dextrocardia), failure of normal expansion
      of the subpulmonary infundibulum (Fallot syndrome) and endocardial cushion defect
      (common atrium and common atrioventricular valve ). It was associated with
      partial viscera inversion. A 31-year old man with congenital cyanotic heart
      disease, and Blalock-Taussig anastomosis was admitted to the hospital due to
      symptoms of severe cardiac failure. On physical examination: systolic murmur,
      hepatomegaly, ascites, leg's edema and cyanosis were found. In ECG--atrial
      fibrillation with 3-d degree a-v block. Standard echocardiography revealed:
      dextrocardia, a large single atrium with ostia of pulmonary and systemic veins,
      single atrio-ventricular valve , large ventricular, Fallot-like septal defect.
      The papillary muscles were not visible in the left ventricle. Aorta and pulmonary
      trunk arose from morphological right ventricle. The patient died on the 3-rd day
      of hospitalization in the course of cardiac and respiratory insufficiency.
      Postmorten examination confirmed the diagnosis.

PMID- 1640670
TI  - [Stenosis of the main trunk of the left coronary artery].

PMID- 1640671
TI  - [Emergency treatment of arterial hypertension].

PMID- 1640672
TI  - [Does fish consumption prevent arteriosclerosis?].

PMID- 1640673
TI  - [More about aspirin in cardiology].

PMID- 1640674
TI  - [Polymer ocular implants for controlled release of drugs. I. Animal testing of
      the materials].
AB  - Presented are the results of trials with hydrogel inserts received by radiation
      method and applied into the conjunctival sac of rabbits. In the future they can
      serve for incorporation of some definite drugs.

PMID- 1640675
TI  - [Polymer ocular implants with controlled release of drugs. II. Preliminary
      testing of implants with incorporated pilocarpine].

PMID- 1640676
TI  - [Vitreous body proteins. IV. Proteolytic activity of the vitreous body in
      pathological conditions of the eye].
AB  - Two groups of proteins are present in the vitreous: collagen and non-collagen,
      deriving probably from the blood serum. The authors examined the proteolytic
      activity against haemoglobin in the course of some ocular pathological
      conditions. It was demonstrated that the vitreous digests haemoglobin in the acid
      division of pH (optimum--3.0-4.5) with various activity dependent on the
      pathological condition of the eye.

PMID- 1640677
TI  - [Parasitic uveitis in children].
AB  - Seven children with an atypical parasitic uveitis were treated in the Department
      of Ophthalmology in Bialystok in the period 1985-1989. Parasitic background had
      been discovered in all the children: toxocara in 3, lambliasis in 2 and
      nematodiasis also in 2. Specific treatment achieved an improvement of the visual
      acuity and the inflammatory process abated.

PMID- 1640678
TI  - [Glaucoma in lens capsule pseudoexfoliation syndrome].
AB  - The authors observed 27 patients (39 eyes) with glaucoma in the course of the
      pseudoexfoliation of the lens capsule syndrome treated in the period of 1979
      1989. In all the patients the corneo-scleral angle was open with a considerable
      amount of pigment; 30 eyes exhibited opacification of the lens. The conservative
      anti-glaucomatous treatment was successful in only 2 patients. Control of the IOP
      was attained in 5 eyes after a laser trabeculoplasty and in 23 eyes after the
      Elliot-Fronimopoulos goniotrepanation. Discussed was the lesion of the visual
      function occurring in the presented syndrome.

PMID- 1640679
TI  - [Prognosis of the development of pathological conditions in open-angle glaucoma].
AB  - The authors prepared a matrix of probability of transition for each of the stages
      of the disease between the particular years of observation of such
      characteristics as: the visual acuity, visual field, intraocular pressure and the
      condition of the lens in 435 persons (854 eyes) with simple glaucoma. The
      greatest probability of an unchanged condition of the optic nerve and a normal
      visual field at the onset of treatment (0.45 and 0.74). For the severely damaged
      eyes the indexes amount respectively 0.07 and 0.34.

PMID- 1640680
TI  - [Analysis of the results of the treatment of patients with open-angle glaucoma].
AB  - Evaluated were the results of a conservative and surgical treatment in 478
      patients (870 eyes) after 5 and 10 years of observation. Taken into the account
      were: the visual acuity, visual field and the condition of the lens. The
      comparison of results of the conservative and surgical treatment showed that
      better results had been obtained in eyes treated surgically. The visual field did
      not indicated any statistically essential differences at any stage of
      observation. Much more advanced deterioration of the visual acuity was revealed
      in surgically treated eyes; this was probably caused by a progressive
      opacification of the lens.

PMID- 1640681
TI  - [Clinical evaluation of Ocuflur].
AB  - Presented is the initial clinical evaluation of Ocuflur, a compound of Allergan.
      The influence of the drug on the size of the pupil and the reaction of the pupil
      to a light flash was tested in volunteer subjects. The efficacy of the drug was
      tested intraoperatively.

PMID- 1640682
TI  - [Cronassial in the treatment of neuropathies and atrophy of the optic nerve].
AB  - The study presents the evaluation of treatment by Cronassial of 26 patients
      including 16 with post-inflammatory optic atrophy, 4 with optic neuritis and 6
      multiple sclerosis patients with optic neuropathy. One half of the patients
      showed an improvement of the visual acuity and visual field, and small
      improvement of the visual evoked potentials. No improvement of the conductivity
      of the impulses of the retino-cortical potentials has been observed. The best
      efficacy of the compound has been seen in the inflammatory conditions of the
      optic nerve.

PMID- 1640683
TI  - [Results of the treatment of ocular toxoplasmosis in personal experience].
AB  - Ocular toxoplasmosis manifested itself in following clinical forms: as central
      serous chorioretinitis, pars planitis, iritis, intrabulbar neuritis and central
      retinal degeneration. The diagnosis was based on the clinical picture,
      serological examinations, the course of the disease and the effect of the
      specific treatment. The authors used piridimide++ compounds, sulfonamides,
      steroids, folic acid and Tavegyl, Decaris as well as photo-coagulation. The
      efficacy of all these methods was compared.

PMID- 1640684
TI  - [Effect of complex treatment of retinitis pigmentosa on the results of
      pupillography].
AB  - Presented are the results of a 3 years long observation of the pupillary reaction
      in patients with pigmentary retinal dystrophy who have been subjected to a
      complex treatment. The authors discovered a consistency between the changes in
      the visual field and the amplitude of the pupillary reaction.

PMID- 1640685
TI  - [Peripheral photocoagulation of the retina in the treatment of early forms of
      diabetic retinopathy].
AB  - The authors present the results of a 5 years long observation of patients with an
      early form of diabetic retinopathy in whom one performed a photocoagulation of
      the retinal periphery. They observed the behavior of the visual function and the
      changes in the anterior chamber angle.

PMID- 1640686
TI  - [The role of vitrectomy in the treatment of retinal detachment with macular
      holes].
AB  - The authors discuss the pathogenesis and the method of treatment of a retinal
      detachment with a macular hole basing on personal material and a review of
      foreign literature. Personal material consists of 11 eyes in 10 patients operated
      upon in the University Ophthalmic Department in Munich in the period November
      1988--April 1990. In all the cases the primary method of treatment based on
      vitrectomy performed through the pars plana with a gas tamponade. In 4 cases a
      reoperation with silicon oil tamponade was necessary. Anatomical reattachment of
      the retina was achieved in 9 among 11 treated eyes. In 10 cases the visual acuity
      was 1/50 or better. Five among them showed the visual acuity at last 0.1.

PMID- 1640687
TI  - [Practical instructions for removal of ferromagnetic foreign bodies from the
      eye].
AB  - On basis of a several-years expertise in surgical extraction of ferromagnetic
      intraocular foreign bodies the authors are analysing the exact localization, the
      isoelectric magnetic lines and the position of the electromagnet. They present
      the most favourable method of a successful intervention in the course of the
      first extraction without causing any damage to the intraocular structures.

PMID- 1640688
TI  - [Use of the Foucault's test for determining the contrast sensitivity of the
      visual system].
AB  - The authors present the thesis that in apperception of the Foucault's test in
      condition of a threshold contrast only the first harmonic component is decisive;
      in connection with this one can replace the sinusoidal tests applied for the
      demarcation of the sensitivity curve of the visual system to contrast by
      Foucault's test. They point to the eventual possibility--if the influence of the
      following components would prove to be essential--of using the Foucault's test
      together with the sinusoidal test in order to make the diagnosis of pathological
      conditions more selective. The CSF function was designated by means of the
      sinusoidal and Foucault's tests seen on a monitor screen using the methods of
      contrast increase. In 8 subjects observing simultaneously one discovered that for
      the frequencies larger or equal to 1.5 stop-1 one can apply the Foucault's test
      instead of the sinusoidal test. Below the space frequency of 1.5 stop-1 one
      observed differences between the values of sensitivity to contrast demarcated by
      means of both tests; these differences result probably from the influence of the
      higher harmonics of the Foucault's test on the apperception of the test.

PMID- 1640689
TI  - [Glaucoma attacks in Weill-Marchesani syndrome].
AB  - Presented is a case of Weill-Marchesani syndrome complicated by acute attacks not
      responding to conservative treatment. The authors discuss a correct procedure in
      these cases and indications for a surgical intervention.

PMID- 1640690
TI  - [X-linked retinitis pigmentosa].
AB  - The study presents a case of a family whose members exhibit an X-linked retinal
      pigment dystrophy. The attention is called to the fact of an early onset of the
      disease, full development of the symptoms at an young age and a bed prognosis.
      The clinical characteristic of inheritance in X-linked retinal pigment dystrophy
      is discussed.

PMID- 1640691
TI  - Drugs of abuse in saliva: a review.
AB  - There has been substantial interest in the use of saliva as a diagnostic medium
      for drugs of abuse because it can be obtained noninvasively. Although drugs of
      abuse have been investigated in saliva for more than a decade, the role of saliva
      remains uncertain. A clear picture is difficult to obtain because of variations
      in (1) the analytical methods used; (2) the dose regimen of subjects, which was
      either unknown or differed between studies; and (3) the elapsed time between drug
      intake and sample collection. This communication summarizes the studies on the
      quantitative determination of different drugs of abuse in saliva to elucidate the
      current status in this area. Marijuana, cocaine, phencyclidine, opiates,
      barbiturates, amphetamines, and diazepines (or their metabolites) have all been
      detected in saliva by various analytical methods, including immunoassay, gas
      chromatography/mass spectrometry, and thin layer chromatography. Initial studies
      with cocaine and phencyclidine suggest a correlation between saliva and plasma
      concentrations of these drugs, indicating a dynamic equilibrium between saliva
      and blood. Tetrahydrocannabinol, the active component in marijuana, on the other
      hand, does not appear to be transferred from plasma to saliva. However,
      tetrahydrocannabinol is sequestered in the buccal cavity during smoking and can
      be detected in saliva. These findings point to the potential role of saliva in
      the analysis of many illicit drugs. To clearly identify the role of saliva as a
      diagnostic medium for drugs of abuse, research efforts should be directed towards
      (1) performing systematic studies on correlations between saliva, blood, and
      urine and (2) determining the concentrations of drugs and their metabolites in
      saliva as a function of dose and time after intake.

PMID- 1640692
TI  - N,N'-diethyl-m-toluamide (m-DET): analysis of an insect repellent in human urine
      and serum by high-performance liquid chromatography.
AB  - A procedure for monitoring m-DET in human urine and serum is described. m-DET is
      removed from the urine specimen by partitioning into diethyl ether, but solid
      phase extraction is used to remove it from human serum. The urine and serum m-DET
      values are determined by HPLC with a UV detector. The limit of detection was 0.09
      micrograms/mL in urine and 0.09 micrograms/g for serum. The percent of m-DET
      recovered from human urine spiked between 0.50 and 8.00 micrograms/mL was 90 +/-
      5.4%. For human serum spiked between 0.25 and 10.00, the percent recovered was 96
      +/- 5.9%. The pooled relative standard deviations (RSD) for spiked matrices were
      0.06 for urine and 0.06 for serum.

PMID- 1640693
TI  - The detection of danazol and its significance in doping analysis.
AB  - The use of anabolic steroids and related compounds in sport is forbidden by the
      International Olympic Committee (IOC). Because danazol (17 alpha-pregna-2,4-dien
      20-yno[2,3-D] isoxazol-17 beta-ol) is structurally related to the anabolic
      steroid stanozolol, its use should be questioned. Therefore, the detection and
      the significance of danazol in doping analysis are discussed. A urine specimen
      suspected of containing danazol metabolites was analyzed in order to characterize
      the metabolites. After isolation and conversion into three different derivatives,
      the metabolites were subjected to gas chromatography/mass spectrometry (GC/MS) in
      the electron impact (EI) mode. The structure assignment was based on the
      molecular ions, fragmentation patterns observed for the three different
      derivatives, and the possible metabolite structures given in the literature.
      Ethisterone was identified as a nonconjugated metabolite. 2
      Hydroxymethylethisterone was observed in two stereoisomeric forms. One
      stereoisomer was found mainly in the nonconjugated steroid fraction and the other
      in the conjugated fraction. The results were confirmed by analyzing urine
      specimens of a volunteer who was known to have taken danazol. Derivatization
      methods and GC/MS data are given to implement danazol detection in routine
      screening and confirmation procedures.

PMID- 1640694
TI  - Distinguishing sympathomimetic amines from amphetamine and methamphetamine in
      urine by gas chromatography/mass spectrometry.
AB  - Derivatives of seven commonly used sympathomimetic amines and two "designer
      amines" were isolated from urine, separated chromatographically from amphetamine
      and methamphetamine, and determined by mass spectrometry with selected ion
      monitoring. The drugs included ephedrine, propylhexedrine, pseudoephedrine,
      phenylpropanolamine, hydroxynorephedrine, phenylephrine, phentermine,
      methylenedioxyamphetamine (MDA), and methylenedioxy methamphetamine (MDMA). The
      drugs were liquid extracted from urine and derivatized by either
      heptafluorobutyric anhydride (HFBA) or 4-carbethoxyhexafluorobutyryl chloride (4
      CB). Because the base peak ions for ephedrine, pseudoephedrine, propylhexedrine,
      MDMA, and phentermine are identical to methamphetamine (e.g. 254 amu for HFBA)
      and those for phenylephrine, hydroxynorephedrine, phenylpropanolamine, and MDA
      are identical to amphetamine (e.g. 240 amu for HFBA), a table of selected ions
      was developed for all 11 drugs that distinguished amphetamine and methamphetamine
      from the sympathomimetic amines with either HFBA or 4-CB. The distinguishing ions
      rely on the ring structure of the different drugs and fragmentation associated
      with that structure. The 4-CB reagent partially derivatized the hydroxy
      containing sympathomimetic amines, while the HFBA completely derivatized all the
      sympathomimetic amines. Furthermore, false positive results for the 4-CB reagent
      were found only for methamphetamine (20-2250 ng/mL of methamphetamine) when high
      concentrations (greater than 5 micrograms) of ephedrine or pseudoephedrine were
      present in the specimen. These results are related to a combination of injection
      port temperature and cleanliness of the injection port sleeve.

PMID- 1640695
TI  - Confirmation of a carboxylic acid metabolite of polychlorotrifluoroethylene and a
      method for its GC-ECD analysis in biological matrices.
AB  - 3.1 Oil, referred to as polychlorotrifluoroethylene (pCTFE), is a polymeric
      mixture consisting primarily of trimers and tetramers of chlorotrifluoroethylene
      (CTFE) end-capped with chlorine. Inhalation studies have associated dose-related
      body weight loss, increased organ weights, and abnormal hepatic enzyme activities
      with exposure to pCTFE. The carboxylic acid metabolites of pCTFE have been shown
      to cause hepatotoxicity in rats, which is manifested by increased liver weights
      and the proliferation of hepatic peroxisomes. A method was developed to
      derivatize these carboxylic acid metabolites. Tissue homogenates and feces were
      extracted with methanol, and urinary metabolites were extracted on
      octadecylsilane (ODS) solid-phase extraction columns. Aliquots of the extracts
      and whole blood were methylated with 3N methanolic HCl to transesterify the
      carboxylic acid metabolites to volatile methyl esters. The pCTFE methyl esters
      were analyzed by gas chromatography (GC) with electron capture detection (ECD).
      The on-column limit of detection was 5 pg for each methyl ester. Solid-phase
      extraction of spiked urine gave extraction efficiencies of 90.4% for the trimer
      acid and 84.7% for the tetramer acid. This method was successfully applied to
      toxicity studies in rats and nonhuman primates. The identities of the derivatized
      metabolites were confirmed by GC/MS.

PMID- 1640696
TI  - Analysis and identification of azaperone and its metabolites in humans.
AB  - Azaperone, dihydroazaperone, and 4'[fluoro-4-(4-(2-pyridyl)-1
      piperazinyl]butyrophenone are identified in the urine of an intoxicated patient.
      The structures of the metabolites were confirmed by comparison of their TLC, GC,
      and GC/MS data with those of synthesized materials.

PMID- 1640697
TI  - Analysis of spleen specimens for carbon monoxide.
AB  - Crucial to the investigation of aircraft fatalities is the analysis of biological
      specimens for carbon monoxide (CO). In many cases, blood specimens are
      unavailable or unsuitable for analysis, and the testing of an alternate specimen
      for CO becomes necessary. Spleen specimens provide a rich source of red blood
      cells and hence can be a primary substitute for blood. To verify this, 40 paired
      blood and spleen specimens were analyzed for CO by using a gas chromatographic
      method. Ten specimens with a spleen CO saturation level (sat.) of less than 10%
      were associated with corresponding blood specimens with CO sat. less than 10%.
      Fifteen of the 18 spleen specimens with CO sat. greater than 29% were associated
      with blood specimens with greater than 48% sat. Results were inconclusive when
      the spleen CO sat. was between 10 and 29%. We concluded that spleen CO sat. can
      reflect blood CO sat. in certain situations, particularly when spleen CO sat. is
      high.

PMID- 1640698
TI  - Immunoassay method validation for a modified EMIT phencyclidine assay.
AB  - Immunoassay drug testing methods, that have been modified from the manufacturers'
      recommended procedure to be used for the analysis of federally regulated
      specimens or other forensic samples require evaluation to ensure their scientific
      validity. These validation studies must demonstrate the accuracy, precision, and
      linearity of the modified immunoassay around the cutoff concentration,
      substantiate adequate rate separation, and verify the ability of the assay to
      differentiate positive and negative samples. Modification of the EMIT d.a.u.
      phencyclidine assay in order to achieve the federally mandated cutoff
      concentration of 25 ng/mL is common. This study describes the validation of a
      modified EMIT phencyclidine assay and a protocol that allows for the evaluation
      of similarly modified immunoassays.

PMID- 1640699
TI  - Clozapine tissue concentrations following an apparent suicidal overdose of
      Clozaril.
AB  - Clozapine is a tricyclic dibenzodiazepine derivative that is classified as an
      "atypical" antipsychotic drug. A 25-year-old male was brought to a hospital
      emergency room following the ingestion of an estimated 20 100-mg tablets of
      clozapine. After several hours in the hospital, the patient died. The cause of
      death was listed as acute clozapine intoxication. It was also noted upon autopsy
      that the patient had an unusual eosinophilic myocarditis. The toxicological and
      pathological findings are presented in this report.

PMID- 1640700
TI  - Distribution of isoniazid in an overdose death.
AB  - A fatality due to the ingestion of isoniazid, a tuberculostatic agent, is
      presented. Isoniazid was extracted by a single step extraction procedure,
      derivatized with trifluoroacetic anhydride, and identified and quantified by gas
      chromatography/mass spectrometry (GC/MS). The distribution of isoniazid was as
      follows: heart blood 43 mg/L, subclavian blood 94 mg/L, urine 470 mg/L, bile 900
      mg/L, liver 650 mg/Kg, kidney 110 mg/Kg, and stomach contents 4 mg.

PMID- 1640701
TI  - Evaluation of reagent strips for the rapid diagnosis of nitrite poisoning.
AB  - Two commercial urine test strips based on the Griess nitrite-specific diazonium
      salt reaction, having sulfanilamide and para-arsanilic acid as substrates,
      respectively, were studied as qualitative tests in the rapid diagnosis of
      nitrite/nitrate poisoning. Their usefulness was compared to other rapid tests,
      such as the sulfanilic acid-1 naphthylamin and diphenylamine blue tests. The
      practical sensitivity limit to nitrites in plasma and in water of both the
      reagent strips and SA-1NA test was 0.50 micrograms NO2/mL, while the
      diphenylamine test, which is not nitrite specific, showed a positive reaction to
      nitrites in plasma and in water above 50 micrograms NO2/mL and 5 micrograms
      NO2/mL, respectively. The in vitro assays were evaluated in vivo by the sublethal
      intoxication of a sheep with nitrite, demonstrating that commercial urine test
      strips may be useful for the rapid diagnosis of nitrite/nitrate poisoning.

PMID- 1640702
TI  - Surgical complications of intraoperative radiation therapy: the Radiation Therapy
      Oncology Group experience.
AB  - Intraoperative radiotherapy (IORT) is being used with increasing frequency in
      many institutions in the United States but little is known about the surgical
      complication rates. The Radiation Therapy Oncology Group initiated three
      prospective studies in IORT in 1986 and we report here the experience in advanced
      malignancies of the stomach, pancreas, and rectum. The incidence and nature of
      major surgical complications were reviewed and presented with their implications
      in regard to future IORT trials. Two hundred twenty-seven patients were entered
      on three studies by 20 participating institutions between 1985 and 1989. One
      hundred twenty-nine patients received IORT while 98 patients were found to have
      too advanced disease to be benefited by IORT and underwent palliative surgical
      procedures only. IORT doses ranged from 12-22 Gy and bowel anastomoses were not
      irradiated. Wound infection in the IORT group was 6% vs. 2% in the non-IORT
      patients but this was not significant at the P = 0.05 level. Other complications
      included anastomotic leak (n = 5), operative bleeding (n = 10), pancreatitis (n =
      2), and were not statistically different in the IORT and non-IORT groups. The
      mortality rate for the IORT and non-IORT groups combined was 1.8%. This large
      multi-institutional experience in patients with advanced malignancy demonstrates
      that patients receiving IORT do not have a higher surgical complication rate than
      those not receiving IORT. Long-term survival data await the implementation of
      Phase III trials in advanced intra-abdominal malignancy.

PMID- 1640703
TI  - Retroperitoneal surgery in patients with nonseminomatous testicular cancer and
      minimal residual tumor.
AB  - In the period 1980-1991, 78 patients with advanced nonseminomatous testicular
      cancer underwent retroperitoneal lymphadenectomy for post-chemotherapy residual
      masses less than 2 cm. To decrease the frequency of "dry ejaculation" in these
      patients with no or limited residual disease, the extent of dissection was
      reduced during the period, with bilateral dissections (49 cases, 1980-1986) being
      initially replaced by unilateral procedures (19 cases, 1983-1990) and
      subsequently by nerve-sparing techniques (10 cases, 1990-1991). As expected, a
      higher total number of lymph nodes was found in the retroperitoneal specimens
      after bilateral (44 (13-100)) than after unilateral (21 (7-35)) and nerve-sparing
      (18 (7-60)) procedures. The number of lymph nodes with pathological changes was
      low, with 3 (1-16) after bilateral, 2 (1-9) after unilateral, and 2 (1-4) after
      nerve-sparing operations. Histological examination revealed only
      necrosis/fibrosis in 65% of the patients, elements of mature teratoma in 28%, and
      remnants of viable malignant tumor in 6%. There were no major postoperative
      complications. "Dry ejaculation" was reported by 84% of the patients with
      bilateral operations, but was generally avoided after the unilateral (16%) and
      nerve-sparing (nil) procedures. After a mean follow-up of 83 (5-138) months, 6
      patients have developed a recurrence, only one of them primarily in the
      retroperitoneal space. It is concluded that in patients with minimal residual
      retroperitoneal tumor, postchemotherapy lymphadenectomy using a unilateral or
      nerve-sparing technique seems to offer an effective therapeutic alternative with
      acceptable postoperative morbidity and preserved ejaculation.

PMID- 1640704
TI  - Postoperative atrial fibrillation in cancer surgery: preoperative risks and
      clinical outcome.
AB  - Postoperative atrial fibrillation (AF) is a recognized complication of cancer
      surgery. The purpose of this study was to define preoperative risk factors for
      AF, and to evaluate the clinical significance of the arrhythmia. We reviewed the
      medical records of 43 patients with postoperative AF admitted to the surgical
      intensive care unit (SICU). All patients were older than 60 years, 79% had a
      history of cigarette smoking, and 44% had hypertension. AF occurred an average of
      2.8 days following surgery, and lasted an average of 2.1 days. No significant
      complications developed, and there were no long-term sequelae. This study
      suggests that, in cancer patients, postoperative AF is a disease of elderly
      patients. In addition the arrhythmia appears to be a relatively transient and
      benign phenomenon. Prolonged monitoring in an intensive care setting may not be
      necessary for asymptomatic, hemodynamically stable patients.

PMID- 1640705
TI  - Regional DNA content heterogeneity in colonic adenocarcinoma: prognostic
      significance in patients with liver metastases.
AB  - We retrospectively examined by flow cytometry the DNA ploidy pattern in tissue
      blocks from 25 primary colon adenocarcinomas and their lymph node and liver
      metastases. Intratumoral heterogeneity was present in 22% of primary tumors and
      21% of metastatic liver deposits. Intertumoral heterogeneity, measured between
      the primary tumor and its lymph node and liver metastases, was 0% and 20%,
      respectively. Of 24 patients who underwent successful resection of their liver
      metastases, 8 neoplasms had uniformly diploid DNA content, while 16 tumors had
      aneuploid DNA pattern in either the primary tumor, the metastases, or both. Five
      year survival was better in the diploid group (38% vs. 7%, P = 0.10 by log rank
      analysis). Three of eight patients in the diploid group remain free of disease,
      while all 16 patients with aneuploid cell populations have died of recurrent
      disease.

PMID- 1640706
TI  - The hepatic artery--a guide to major upper abdominal resections.

PMID- 1640707
TI  - Malignant melanoma of the vulva: a clinicopathologic study of 18 cases.
AB  - In a study of 18 patients diagnosed with vulvar malignant melanoma between 1975
      and 1991, the effect of clinical and pathologic variables on the survival was
      evaluated. The overall 5-year survival rate was 28.6%. In 14 cases the tumor was
      retrospectively microstaged with use of Breslow depth and Chung levels.
      International Federation of Gynecology and Obstetrics (FIGO) stage and Breslow
      depth did not correlate well with survival. Positivity of groin lymph nodes at
      initial surgery was associated with an insignificant worsening in survival. An
      inverse correlation, although statistically not significant, was demonstrated
      between advancing Chung levels and survival. It is concluded that since the data
      with respect to microstaging of vulvar malignant melanoma is, as yet, still
      limited, great caution should be used in electing less aggressive surgery than
      radical vulvectomy and bilateral groin lymphadenectomy for patients with early
      microstage localized disease.

PMID- 1640708
TI  - Oncological aspect of immediate breast reconstruction in mastectomy patients.
AB  - In this study, we compared the relapse-free and overall survival of 83 patients
      who underwent mastectomy with immediate reconstruction (MIBR) using a
      musculocutaneous flap with or without silicone implant with those of 153 patients
      with breast cancer who underwent mastectomy without immediate reconstruction. In
      univariate analysis, the overall and/or relapse-free survival of reconstructed
      patients with four or more positive axillary lymph nodes or those with menopausal
      status were significantly inferior compared with those of nonreconstructed
      patients. In multivariate analysis, however, the immediate breast reconstruction
      did not appear to have a significant adverse influence on all patients, and on
      the subgroups stratified by menopausal status or axillary lymph node metastases.
      Therefore, it was concluded that MIBR using a musculocutaneous flap did not
      compromise the survival of patients with breast cancer.

PMID- 1640709
TI  - The role of fine needle aspiration in the diagnosis of thyroid nodules: analysis
      of 795 consecutive cases.
AB  - The utility of fine needle aspiration (FNA) and physical examination for
      selecting patients with palpable thyroid nodules for surgery was evaluated in 795
      consecutive cases. Surgery was performed in 216 patients based upon the
      cytological diagnosis and clinical criteria. Excluding 42 patients who were lost
      to follow-up, the remaining 537 were regularly followed up (range, 2-10 years).
      Cytological findings were classified as malignant, histologic control recommended
      (suspicious), follicular tumor, benign, and unsatisfactory. Thirty-six aspiration
      biopsies were positive for malignancy and the diagnosis was confirmed
      histologically in 34 of them. In 65 patients with final histological diagnosis of
      malignancy, cytology was positive in 34, suspicious in 20, benign in 3 cases, and
      unsatisfactory in 8. All patients with cytological diagnosis of follicular tumor
      had a benign lesion at histology. There were two false positive and three false
      negative cytological results among the 216 histologically confirmed cases.
      Excluding unsatisfactory specimen sensitivity, specificity and the predictive
      value for a positive and a negative result were respectively 95%, 97.5%, 94.5%,
      and 97%. We conclude that FNA is a very reliable diagnostic test in the
      evaluation of thyroid nodules and is the best guidance in addition to clinical
      criteria for selecting patients to be submitted to surgery.

PMID- 1640710
TI  - Cisplatin plus VP-16 combination chemotherapy in advanced refractory breast
      cancer.
AB  - Twenty-nine patients with advanced refractory breast cancer were treated with
      cisplatin 20 mg/m2/d and VP-16 100 mg/d for 5 days every 3-4 weeks. Ten patients
      received mitomycin C 10 mg/m2 every 6 weeks additionally. Partial response was
      obtained in 10 of 26 evaluable patients (38%). The response rates for the group
      treated with and without mitomycin C were 40% and 37.5%, respectively. Median
      response duration was 5.5 months in partial responders. Median survival was 9.5
      months for partial responders and 2 months for the rest of the patients.
      Cisplatin and VP-16 combination can be considered as a salvage treatment in
      heavily pretreated patients with advanced breast cancer.

PMID- 1640711
TI  - Primary oesophageal carcinoma in teens.
AB  - Seven teenaged patients with primary oesophageal carcinoma, treated at our
      hospital in the last 6 years are presented and their management discussed. Five
      patients had localised disease. Three of them underwent total oesophagectomy, one
      was given radical radiotherapy, and one was lost to follow-up. Two patients had
      metastatic disease at presentation. The primary oesophageal carcinoma in this age
      group may not be so rare as reported in the literature and must be considered in
      the differential diagnosis of dysphagia. Like their older counterparts, the
      outcome depends on the stage of the disease and is not influenced by age per se.

PMID- 1640712
TI  - Prognostic profile for patients with pheochromocytoma derived from clinical and
      pathological factors and DNA ploidy pattern.
AB  - Eighty-eight patients with pheochromocytoma and paraganglioma treated over a 28
      year period (1960-1987) were studied. Based on clinical course, they were divided
      into three prognostic groups: benign (n = 57); multiple (n = 12); and metastatic
      (n = 19). Using clinical data, histopathologic findings, and tumor nuclear DNA
      content a prognostic profile for each group was constructed. The following
      variables were studied: age, familial pheochromocytoma, associated endocrine or
      neoplastic disorders, number and location of the lesion at diagnosis, size of the
      tumor, and the nuclear DNA ploidy pattern. Of these prognostic factors the most
      significant to predict a future malignant clinical course were large size and
      local tumor extension at time of surgery. Family history of pheochromocytoma,
      associated endocrine disorders, and young age at presentation predicted
      multiplicity. Old age, absence of familial pheochromocytoma or related endocrine
      disorders and DNA diploid tumors seem to be favorable findings. Using these
      variables in combination may be helpful for early identification of patients with
      malignant, multiple, or benign pheochromocytoma and paraganglioma.

PMID- 1640713
TI  - A comparison of the clinical characteristics of second primary and single primary
      sarcoma: a population based study.
AB  - The clinical characteristics of 240 patients with sarcoma as a second
      metachronous primary neoplasm (SPN) were compared with those of 8,815 patients
      with sarcoma as a single tumor. The data were obtained from patients registered
      during the period 1973-1986 in the Surveillance, Epidemiology and End Results
      (SEER) Program in the United States. Seventy-four of the 240 SPN patients had
      postirradiation sarcoma (PIS) while the other 153 patients developed the sarcoma
      as a second tumor in an area which was not exposed to prior radiotherapy (non
      PIS). The stage of disease at diagnosis was more advanced in patients with PIS
      than in those with single sarcomas but the difference did not reach statistical
      significance. Overall, in comparable clinical stage localized and regional
      disease there was no statistically significant difference in survival between PIS
      and non-PIS sarcoma patients after adjusting for age. The survival of patients
      with localized or regionally advanced sarcoma as a second tumor was significantly
      worse than of those with single sarcomas with the same stage. There was no
      difference in survival between first or second sarcomas with metastatic disease.

PMID- 1640714
TI  - En bloc caudate lobe and partial vena cava resection using a Gott shunt for
      retrohepatic caval bypass.
AB  - A technique of retrohepatic inferior vena cava bypass is described, useful for
      resection of the hepatic caudate lobe. A 77 year old female developed a solitary
      metastatic tumor mass in the caudate lobe compressing the Inferior Vena Cava
      (IVC), with cavography showing the IVC to be compressed, but patent. Without
      evidence of other metastatic disease radical resection of this tumor was
      performed. Successful resection was accomplished using a Gott shunt and porta
      hepatus compression for hepatic vascular isolation. No pump was used to avoid
      heparinization. Postoperative imaging confirmed IVC patency. The serum
      carcinoembryonic antigen (CEA) level fell to normal and remained so for 18
      postoperative months. This introduces a new use of an atriocaval shunt for
      hepatic isolation during resection.

PMID- 1640715
TI  - Primary brain lymphoma after X-ray irradiation to the scalp for tinea capitis in
      childhood.
AB  - A 39-year-old male developed primary brain lymphoma 33 years after receiving
      scalp irradiation for tinea capitis. This is the first reported association
      between cranial irradiation during childhood and subsequent development of
      primary brain lymphoma.

PMID- 1640716
TI  - Adenocarcinoma arising within a gastric duplication cyst.
AB  - A rare case of carcinoma arising within a gastric duplication cyst in a 72 year
      old woman is presented. This is the oldest patient in whom neoplastic
      transformation of this usually benign developmental abnormality has been
      reported. The clinical and pathologic features of this patient are demonstrated
      and reviewed in the context of prior reported cases.

PMID- 1640717
TI  - Dynamics aspects of long distance functional interactions between membrane-bound
      enzymes.
AB  - The aim of this mini review is to study how an organized charged milieu, such as
      a membrane, may alter functional long-distance interactions between bound
      enzymes. Two questions are more specifically considered. The first is to know
      whether the overall response of a bound enzyme is dependent upon the degree of
      spatial order of fixed charges and enzymes molecules. The second is to determine
      whether electric interaction between the fixed charges of the matrix and the
      charged substrate may generate hysteresis loop of substrate concentration as well
      as oscillations of this concentration at the surface of the membranes. These
      effects that have been shown to occur at the surface of membranes, are not the
      result of intrinsic properties of enzymes. They appear as the consequence of the
      interplay between functional long-distance interactions between bound enzyme
      systems and electric repulsion effects of mobile ions. They may be viewed as
      supramolecular devices that allow storing information from the external milieu.

PMID- 1640718
TI  - Polynuclear ions in aluminum toxicity.

PMID- 1640719
TI  - Shape and length of myosin heads.
AB  - There is controversy concerning the shape and length of myosin heads. In the
      present paper we try to analyse the data and to draw clear conclusions in this
      field. When the myosin heads are isolated (S1) from the rest of the molecule,
      their length is approximately 12 nm and their shape is close to that of a prolate
      ellipsoid with an axial ratio approximately 2.3 (in solution) or close to that of
      a comma when attached to F-actin (with a length of 12-13 nm). When the myosin
      heads are observed on a whole molecule, their length is approximately 19 nm and
      they are pear-shaped. Here we suggest that all these observations are compatible.
      We believe that, for a whole myosin molecule, a large part of the head-rod joint
      (S1/S2 joint) is measured with the head, owing to a particularly heavy staining
      or shadowing of this joint. On the other hand, S1 is probably built up of a head
      part plus the S1/S2 joint, which is not revealed by the usual techniques
      (hydrodynamics, X-ray and neutron scattering). Finally, the comma shape would be
      related to a flexible part in the head region of S1, which is significantly bent
      when S1 is attached to F-actin, but which would be less bent for S1 in solution.
      A similar bending also occurs in crystalline S1.

PMID- 1640720
TI  - A model of heat-induced clonogenic cell death.
AB  - When cells are exposed to elevated temperatures, clonogenicity decreases in a
      temperature-dependent manner displaying non-linear kinetics. In this report we
      show that the survival of synchronized cell populations after heat exposure can
      be characterized by a parameter epsilon, which is normally-distributed throughout
      the population. Cells whose corresponding epsilon-value lies below an arbitrary
      threshold value epsilon min are unable to form a colony. Upon transfer of a cell
      culture to an elevated temperature, the mean value of the epsilon distribution
      decreases exponentially over time with a rate dependent upon the difference
      between the current and final mean value, until reaching a final value epsilon f
      dependent on the particular temperature used, thus representing a larger
      proportion of cells with epsilon less than epsilon min which are non-clonogenic.
      The analyses evaluate a temperature-independent parameter k which is presumed to
      be dependent upon the growth conditions of the cell population, and a temperature
      dependent parameter epsilon f, which is characteristic of the new temperature
      perturbed steady state. Comparison of the results of analysis of synchronized G1
      cell survival data to that for S phase cells obtained over a range of
      temperatures shows that it is sufficient to ascribe the increased thermal
      sensitivity of S phase cells to a different k value, the temperature-dependence
      of epsilon f being identical in the two cases. Linear regression analysis of the
      temperature-dependence of epsilon f, when expressed as 1n (-epsilon f) = a0 +
      a1/T demonstrated strong linearity (r2 = 0.99) for either the individual (G1 or
      S) or combined data sets. This description of heat-induced cytotoxicity may be of
      use as the basis for a dose concept for the clinical administration of
      hyperthermia.

PMID- 1640721
TI  - A mathematical model of the mechanism of vertebrate somitic segmentation.
AB  - A mathematical model for the mechanism of periodic pattern formation in the
      process of somitogenesis is proposed. It is assumed that the metameric
      arrangement first appears before somite formation at the stage of transition of
      mesodermal cells into a polarized state. The model is based on the assumption
      that besides the mechanism of contact cell polarization there exists a mechanism
      of polarization suppression due to excretion of some chemical substance by
      polarized cells. Periodicity appears as a result of interaction of a kinematic
      wave of somitogenic cell determination with the cell cycles of mesodermal cells.

PMID- 1640722
TI  - A bifurcating autoregression model for cell lineages with variable generation
      means.
AB  - The bifurcating autoregression model for cell lineage data is extended to allow
      for observations whose means vary from generation to generation. The maximum
      likelihood estimates of this extended model are found and used to estimate the
      generation means and overall variance. The model is also used to test for
      inherited effects as measured by mother-daughter correlation, and for
      environmental effects as measured by the sister-sister correlation, conditional
      on inherited effects. Applications to data sets on EMT6 cells and Escherichia
      coli are given.

PMID- 1640723
TI  - The continuous Sir Philip Sidney game: a simple model of biological signalling.
AB  - An analysis of Maynard Smith's two-player, ESS model of biological signalling,
      the "Sir Philip Sidney game", is presented. The stable strategies of the players
      in this game are shown to satisfy the conditions of Zahavi's handicap principle.
      At equilibrium, signals are honest, costly, and costly in a way that is related
      to the true quality revealed. Further analysis reveals that the level of cost
      required to maintain stability is inversely related to the degree of relatedness
      between the players. It therefore seems likely that stable biological signalling
      systems will feature lower signalling costs when communication occurs between
      relatives. A three-player, extended version of the model is investigated, in
      which signals are passed via an intermediate, or "messenger". It is shown that
      this destabilizes the signalling system, and leads to increased signalling costs.
      This result suggests that "kin conflict" theories of the evolution of the
      endosperm in flowering plants require further refinement. The introduction of a
      novel resource acquisition tissue, which mediates parent-offspring interaction
      during development, cannot be assumed to limit parent-offspring conflict simply
      because it carries an extra copy of the maternally inherited genes. The ability
      to add such complications to the Sir Philip Sidney game and still obtain
      solutions makes it a very useful modelling tool.

PMID- 1640724
TI  - Cell cycle studies in acute myelogenous leukemia.
AB  - Since the proliferative characteristics of leukemia cells play an important role
      in determining response to therapy, one may assume that an alteration of these
      characteristics could be therapeutically beneficial. To this end appropriate
      methods should be used to evaluate the effects of bioactive agents on leukemia
      cells in vivo in patients.

PMID- 1640725
TI  - Minimal residual disease in interferon-treated chronic myelogenous leukemia:
      results and pitfalls of analysis based on polymerase chain reaction.
AB  - Therapy with interferon-alpha results in complete cytogenetic remission in 15-20%
      of patients with chronic myelogenous leukemia. Even during prolonged clinical
      follow-up, most of these patients do not relapse. However, because of the limited
      sensitivity of cytogenetic techniques (approximately 5%) and Southern blots
      (approximately 1%), it is uncertain whether the residual malignant clone becomes
      extinct or persists below the limit of detection in these patients. We used
      polymerase chain reaction to amplify the chimeric BCR-ABL transcripts in 18
      patients with chronic myelogenous leukemia who became Ph1 chromosome negative
      while receiving treatment with interferon-alpha, either alone or in combination
      with interferon-gamma. At the time of study, these patients had been Ph1-negative
      for a median of 22+ months. Fifteen patients were positive for residual BCR-ABL
      transcripts. No residual BCR-ABL message was detected on analysis of multiple
      serial samples in three patients. In order to confirm these results, the samples
      from these three patients, along with positive and negative controls, were
      analyzed by two independent laboratories in a blinded fashion. In the first
      laboratory, RNA specimens from all three patients were considered negative using
      chemiluminescent acidinium-ester-labeled probes. In the second laboratory,
      samples from all three patients were also negative by conventional polymerase
      chain reaction (PCR). However, when a second round of amplification was carried
      out on the amplified samples using a different combination of primers, samples
      from two of the three patients were positive. The results confirm the presence of
      a small proportion of BCR-ABL-positive cells in the majority of patients who are
      in complete remission and highlight some of the potential problems of PCR-based
      analysis. There is a need to standardize PCR methodology and potential
      confounding factors need to be addressed before PCR can be generally applied to
      analysis of minimal residual disease in CML. The implications of BCR-ABL
      positivity for these patients are discussed.

PMID- 1640726
TI  - Childhood malignant non-Hodgkin lymphomas of uncommon histology.
AB  - Uncommon histologies were identified in 36 of 1336 cases (2.7%) of newly
      diagnosed childhood non-Hodgkin lymphoma (NHL). Seventeen cases were classified
      as follicular (six cases as mixed small and large cell, nine as large cell, and
      two as small non-cleaved cell) and 19 cases as diffuse (18 cases as mixed small
      and large cell, and one as small cell lymphocytic). The follicular pattern group
      included a preponderance of male patients; the median age at diagnosis was 11.7
      years. These children presented primarily with low-stage disease involving lymph
      nodes or tonsils. All patients except one achieved complete remission and remain
      disease-free for 11 months to 18.8 years (actuarial 5-year event-free survival,
      94%). The group with diffuse histologies was similar in sex ratio, age at
      diagnosis (median = 12.1 years), and nodal involvement, but tended to have more
      advanced-stage disease. Moreover, only 14 of 19 (74%) children with diffuse
      intermediate-grade histologies are alive in continuous complete remission
      (actuarial 5-year event-free survival, 70%). These results suggest that
      follicular pattern childhood NHL has an excellent prognosis, whereas cases with
      diffuse intermediate-grade histology are prognostically similar to those with
      diffuse high-grade histologies.

PMID- 1640727
TI  - Cytogenetic effects on cells derived from patients with myelodysplastic syndromes
      during treatment with hemopoietic growth factors.
AB  - Hemopoietic growth factors are used with increasing frequency in the treatment of
      patients with myelodysplastic syndromes (MDS). While a response occurs regularly,
      it has not been unequivocally resolved whether this effect is due to the
      stimulation of normal hemopoiesis or to induced maturation of the abnormal clone.
      To determine whether selective responses to colony-stimulating factors of normal
      versus abnormal clones occurred, cytogenetic analysis was performed on bone
      marrow cells of MDS patients before and during in vivo treatment with granulocyte
      macrophage colony-stimulating factor (GM-CSF) or recombinant human erythropoietin
      (rhEPO). A proliferation of additional clones could be demonstrated by karyotypic
      analysis in one patient during GM-CSF therapy and in two patients during rhEPO
      treatment. Two patients, initially with completely normal cytogenetics, developed
      a mixture of normal and abnormal metaphases during treatment. Two patients,
      initially with all abnormal metaphases, developed normal metaphases during
      treatment with GM-CSF. A mosaic of normal and abnormal metaphases was present in
      six patients. The percentage of abnormal metaphases increased in three patients
      during GM-CSF treatment, and in one patient during rhEPO therapy. The cytogenetic
      anomalies in one patient persisted after clinical response to treatment,
      suggesting that GM-CSF enhanced maturation of the abnormal clone. These data
      indicate that cytokine therapy in MDS may have diverse effects on hematopoiesis.

PMID- 1640728
TI  - Continuous-infusion daunorubicin and carboplatin for high-risk acute myeloid
      leukemia in the elderly.
AB  - Since continuous infusion of daunorubicin and of carboplatin have shown efficacy
      and reduced toxicity in early phase studies in acute myeloid leukemia (AML), 34
      elderly patients with high-risk AML were treated with continuous infusion
      daunorubicin, 30 mg/m2 per day, from day 1 to day 4, and carboplatin, 200 mg/m2
      per day from day 3 to day 7. Seven patients had therapy-related AML and/or AML
      following a myelodysplastic syndrome at diagnosis, 15 were in first and two in
      second relapse, and 10 were resistant to previous anthracycline and cytarabine
      therapy. Nine patients or 26%, with a 95% confidence interval (CI) ranging from
      18-67%, achieved complete remission, including one patient at diagnosis (14%, CI:
      0-58%), seven with relapsed AML (41%, CI: 18-67%), and one with resistant AML
      (10%, CI: 0-45%). Median durations of neutropenia below 0.5 x 10(9)/l and of
      thrombocytopenia below 20 x 10(9)/l were 24 and 20 days respectively. Severe
      toxicity included infections in 20 patients (59%), bleeding in two (6%), cardiac
      anomalies in two (6%), and vomiting in one (3%). Overall four patients (12%) died
      from chemotherapy related toxicity and 21 (62%) had resistant disease. Median
      overall survival was 4 months and median disease-free survival 8 months. We
      conclude that this regimen had efficacy with reduced toxicity in relapsed
      patients. Higher dosages for the same drugs could be tolerated by better risk
      patients for precise evaluation of cross reactivity with cytarabine-based
      regimens.

PMID- 1640729
TI  - Autologous bone marrow transplantation followed by interleukin-2 in children with
      advanced leukemia: a pilot study.
AB  - In an attempt to prolong disease-free survival in children with acute leukemia,
      we tested the feasibility of interleukin-2 (IL-2) administration after an
      autologous bone marrow transplantation (ABMT). We report the clinical and
      biological data obtained in three children with acute myelocytic leukemia (AML)
      in second complete remission (CR) and in seven children with acute lymphocytic
      leukemia (ALL) in second or subsequent CR, who received IL-2 at a median interval
      of 78 days (range 38-125) from ABMT. Patients were treated with 1-2 cycles of IL
      2 given by continuous infusion over a 5-day period using a daily escalating
      protocol, from 100 micrograms/m2 per day to the maximum tolerated dose, followed
      after 3 weeks by low-dose IL-2 for 5 days monthly over a 6-h infusion on an out
      patient basis. Side effects greater than grade 2 (WHO system), consisting of
      thrombocytopenia, fever, cutaneous rash, nausea and vomiting, diarrhoea were
      common during the high-dose IL-2 cycles, but resolved 24-48 h after stopping IL
      2. Only one patient developed liver toxicity (grade 3, WHO) on day +3 of the
      first cycle which prompted us to stop the administration of IL-2. An increase in
      lymphocytes and eosinophils was also observed. IL-2 treatment was followed by a
      normalization of NK function and by the generation of a high proportion of
      endogenous LAK cells. All seven ALL patients relapsed at a median of 5 months
      (range 1-23). Two AML patients relapsed at 1 and 11 months, while the other is
      still in continuous CR at 23 months after IL-2 treatment. Our IL-2 schedule for
      treatment of leukemia in children after ABMT is thus feasible but its efficacy
      requires further investigation.

PMID- 1640730
TI  - P190-type bcr/abl expressed in myeloid colonies in a patient with Ph1-positive
      acute lymphoblastic leukemia.
AB  - In Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukemia (ALL),
      some cytogenetic studies have suggested clonal derivation from a multipotential
      stem cell. The role of the product of the chimeric gene, P190, is not, however,
      well understood. We examined the expression of P190-type bcr/abl in single
      hematopoietic colonies obtained at various clinical stages of a patient with Ph1
      positive ALL, using the polymerase chain reaction (PCR). Seven out of 58 colonies
      examined expressed P190-type bcr/abl. Five out of seven colonies were
      granulocyte/macrophage (GM) colonies and two were erythroid colonies. The cell
      lineages of these colonies were confirmed by testing for the expressions of the
      myeloperoxidase (MPO) gene in the GM colonies and the beta-globin gene in the
      erythroid colonies. These results suggest transformation of multipotential stem
      cell in this patient and confirm that expression of the P190-type bcr/abl fusion
      gene permits stem cell differentiation leading to Ph1-positive ALL.

PMID- 1640731
TI  - Impaired degradation of Ca(2+)-regulating second messengers in myeloid leukemia
      cells. Implications for the regulation of leukemia cell proliferation.
AB  - Inositol 1,4,5-trisphosphate and inositol 1,3,4,5-tetrakisphosphate are Ca(2+)
      regulating second messenger molecules which are generated via the cleavage of
      inositol lipids. We have previously shown that these species are autonomously
      generated in HL60 myeloid leukemia cells and that they may play a role in
      signalling the continuous proliferation of this cell line. Here we show that the
      activity of the 5-phosphomonoesterase (5-PME) enzyme which cleaves and
      inactivates these second messengers was strikingly reduced in HL60 cells compared
      to normal granulocytes or macrophages. Induction of differentiation of HL60 cells
      along the monocyte/macrophage or granulocytic pathways did not result in a
      significant increase in 5-PME activity. The activity of this enzyme was also low
      in extracts of bone marrow mononuclear cells from four patients with myeloid
      leukemia. A lesion in the 5-PME pathway may therefore result in the conservation
      of Ca(2+)-regulating second messengers in the HL60 cell line and in some myeloid
      leukemia cells. It is plausible that this lesion may co-operate with the
      autonomous cleavage of inositol lipids in the signalling of leukemic cell
      proliferation.

PMID- 1640732
TI  - All-trans-retinoic acid induced enrichment of functionally normal neutrophils in
      vivo in a patient with acute promyelocytic leukemia.
AB  - A patient with resistant acute promyelocytic leukemia was treated with all-trans
      retinoic acid (45 mg/m2 per day for 42 days) and obtained complete remission at
      day 14. Analysis of the neutrophils from the patient at day 7 demonstrated that
      they were indistinguishable from neutrophils from normal individuals as far as
      this is assessed by presently available functional tests. Furthermore, the degree
      of peroxidase positivity of neutrophils obtained from the patient was similar to
      control values. Thus, taken together with the hematologic features, all-trans
      retinoic acid induces leukemic promyelocytes to become functionally normal
      neutrophils. This therapy is particularly suitable in obtaining complete
      remission in patients with acute promyelocytic leukemia with neutropenia with or
      without previous chemotherapy.

PMID- 1640733
TI  - Defective production of granulocyte-macrophage colony-stimulating factor and
      interleukin-1 by mononuclear cells from children treated for acute lymphoblastic
      leukemia.
AB  - The production of colony-stimulating activity (CSA) by phytohemagglutinin (PHA)
      stimulated peripheral blood mononuclear cells (PBMC) from patients receiving
      maintenance chemotherapy for acute lymphoblastic leukemia (ALL) was examined.
      Supernatants from only 14 of 22 patient PBMC cultures (64%), but all supernatants
      from normal PBMC cultures, supported myeloid colony growth. When present, colony
      stimulating activity always included granulocyte-macrophage colony-stimulating
      factor (GM-CSF). In addition, in nine of ten patient studies and in all control
      studies, stimulated PBMC produced interleukin-1 (IL-1). These results show that
      the chemotherapy administered to children with ALL can damage the cytokine
      production mechanisms in PBMC; the diminished ability to produce GM-CSF and IL-1
      may contribute to the increased risk of overwhelming infection in these patients.

PMID- 1640734
TI  - Effect of combined treatment with interleukin-3 and interleukin-6 on 4
      hydroperoxycyclophosphamide-mediated reduction of glutathione levels and
      cytotoxicity in normal and leukemic bone marrow progenitor cells.
AB  - 4-Hydroperoxycyclophosphamide (4-HC) is widely used as an ex vivo bone marrow
      purging agent for acute myeloid leukemia (AML) blasts. We have determined the
      effect of a combined treatment with interleukin 3 (IL-3) plus IL-6 on 4-HC
      cytotoxicity against normal (CFU-GEMM) versus AML (L-CFU) bone marrow progenitor
      cells. Following an 18 h exposure to IL-3 plus IL-6, treatment with 4-HC in
      conjunction with IL-3 and IL-6 for one hour resulted in a significantly greater
      inhibition of L-CFU versus CFU-GEMM colony growth. In addition, treatment with IL
      3 plus IL-6 reduced the inhibitory effects of higher concentrations of 4-HC on
      CFU-GEMM but not L-CFU growth. IL-3 and IL-6 did not protect the self-renewing,
      clonogenic, AML blast progenitor cells from the cytotoxic effects of 4-HC. While
      the total intracellular glutathione (GSH) levels were not significantly different
      between untreated normal bone marrow mononuclear cells (NBMMC) and AML blasts,
      greater intracellular GSH-S transferase activity was observed in the NBMMC. 4-HC
      produced a marked reduction in GSH levels in NBMMC as well as AML blasts. But
      treatment with IL-3 plus IL-6 in conjunction with 4-HC resulted in significantly
      higher GSH levels in NBMMC. These differences in intracellular GSH levels and GST
      activity may offer an explanation for the differential protective effects of IL-3
      plus IL-6 treatment against the cytotoxic effects of 4-HC on CFU-GEMM colony
      growth.

PMID- 1640736
TI  - Induction of differentiation in Friend-erythroleukemia cells by aclacinomycin A:
      early transient decrease in c-myc and c-myb mRNA levels.
AB  - Chemical inducers of the differentiation are known to cause an early transient
      decrease in c-myc and c-myb mRNA levels in Friend erythroleukemia cells preceding
      the down-regulation of c-myc and c-myb expression in the course of irreversible
      terminal differentiation. We therefore investigated the early effect of the
      potent differentiation-inducing anthracycline antitumor antibiotic, aclacinomycin
      A, on the c-myc and c-myb mRNA levels in the Friend cell line, F4-6, using
      Northern blot analysis. Aclacinomycin A induced a rapid decrease in the levels of
      c-myc and c-myb transcripts within 0.5-1 h and 2-3 h, respectively. The time
      course of decline in c-myc and c-myb expression was similar to that observed with
      dimethylsulfoxide or after transcription blockage brought about by a high
      concentration of actinomycin D. By 12 to 18 h after aclacinomycin A exposure, the
      c-myc and c-myb mRNA levels had returned to about pretreatment levels. When the
      cells were treated with adriamycin, an anthracycline that reduces cell
      proliferation in F4-6 cells without increasing differentiation, an early decrease
      in c-myc and c-myb expression was not observed. These results suggest that the
      transient decrease in c-myc and c-myb mRNA levels in F4-6 cells may be an early
      differentiation-related biochemical effect of aclacinomycin A.

PMID- 1640735
TI  - Accumulation of T-cell clones producing high levels of both granulocyte
      macrophage and macrophage colony-stimulating factors (CSF-1) in lymph nodes
      involved by Hodgkin's disease.
AB  - We have previously shown that total T cells derived from lymph nodes (LN)
      involved by Hodgkin's disease (HD) secrete higher levels of colony-stimulating
      activity than total T cells present within benign hyperplastic (BH) LN and B-non
      Hodgkin's lymphoma (B-NHL) LN, suggesting that T cells with particular properties
      accumulate in HD LN. To further characterize this T-cell population, we have
      quantified production of both granulocyte-macrophage colony-stimulating factor
      (GM-CSF) and macrophage colony-stimulating factor (M-CSF) production in a total
      of 98 T-cell clones (TCC) derived from CD25+ activated T cells present in HD LN;
      TCC derived from CD25+ T cells obtained from B-NHL LN(101 TCC), BH LN(95 TCC),
      and peripheral blood (PBL; 38 TCC) of healthy donors were used as controls. HD LN
      were characterized by the presence of an elevated number (44%) of TCC producing
      particularly high titers of both GM-CSF and M-CSF, whereas only a minority of
      such TCC was found in control groups (10% in B-NHL, 16% in BH, 8% in PBL). These
      observations support the hypothesis of a selection of T-cell families with
      particular properties occurring in contact with Reed-Sternberg (RS) cells.
      According to the biological properties of GM-CSF and M-CSF, it seems reasonable
      to suggest the involvement of this particular subset of T cells in the
      granulomatous process, the peripheral blood polynucleosis, and in the paracrine
      growth of RS cells.

PMID- 1640737
TI  - Glucose metabolism of hairy cells.
AB  - Hairy cell leukemia is a malignant B-cell disorder characterized by splenomegaly
      and pancytopenia. The malignant cell is morphologically unique and characterized
      by fine cytoplasmic projections. Although studies of the cell have revealed
      important information about its proliferative capacity, cell surface, and
      membrane composition, less is known about the metabolic characteristics of the
      cell. We have previously investigated the oxidative metabolism of the hairy cell
      and have suggested that hairy cells might have a unique glucose metabolism
      compared to normal lymphocytes. This is indicated by a high rate of [6
      14C]glucose oxidation in short-term culture consistent with an active Kreb's
      cycle and a high ratio of [6-14C]glucose oxidation to [1-14C] glucose oxidation.
      In this study, we evaluated an additional group of patients with hairy cell
      leukemia prior to or after treatment with the experimental drug 2'
      deoxycoformycin (dCF). We found that in seven of eight patients the leukemic
      cells had a pattern similar to that previously described and that all of these
      seven patients had a significant response to therapy. The cells of the eighth
      patient had minimal Kreb's cycle activity, and at the time of study the patient
      was resistant to therapy with dCF. The metabolic activity of hairy cells may
      distinguish them from other lymphoid populations and may be a marker for
      sensitivity to dCF.

PMID- 1640738
TI  - p53 in chronic myeloid leukemia cell lines.
AB  - Four human chronic myeloid leukemia (CML) cell lines, BV173, K562, KCL-22, and
      KYO-1, were studied for inactivation of human tumor suppressor gene p53. Southern
      blotting showed allele deletion in KCL-22 and cytogenetic studies showed a
      chromosome 17 deletion in KYO-1 but no gross structural abnormalities in the
      other two lines. Northern blotting showed increased amounts of normal size p53
      mRNA in BV-173 and KYO-1, trace amounts in KCL-22, and none in K562. Direct
      sequencing of p53 cDNA revealed a missense point mutation in KYO-1 and a single
      base pair deletion consistent with a coding frame shift in KCL-22. Both
      abnormalities in these myeloid cell lines were located in the highly conserved
      region of p53. Studies with two monoclonal antibodies showed that the three cell
      lines with p53 mRNA had readily detectable p53 proteins. In KYO-1 and BV173 cells
      the p53 protein was located mainly in the nuclei but KCL-22 cells had weak
      staining in the cytoplasm. Our data support the assumption that inactivation of
      p53 tumor suppressor function in myeloid blast transformation of CML may result
      from point mutations or deletions that produce mutant proteins.

PMID- 1640739
TI  - Concomitant chronic lymphocytic leukemia (CLL) and acute myeloid leukemia.
      Complete remission of CLL achieved with high-dose cytosine arabinoside.
AB  - The concomitant presentation of acute myeloid leukemia (AML) and chronic
      lymphocytic leukemia (CLL) is rare with so far only eleven cases reported. In
      addition, the achievement of complete remission (CR) in CLL is exceptional and
      generally not assessed by immunophenotypical investigations. We report a case
      with a simultaneous occurrence of AML and CLL in which, in addition to the
      complete remission of AML, an eradication of the CLL clone was obtained following
      high-dose cytosine arabinoside. The immunophenotypic investigation of minimal
      residual disease showed that less than 1 x 10(-3) CD19+/CD5+ B-cells remained in
      bone marrow.

PMID- 1640740
TI  - Can intensive chemotherapy cure chronic myelogenous leukemia?

PMID- 1640741
TI  - Steady-state point-source stimulation of a nerve containing axons with an
      arbitrary distribution of diameters.
AB  - The paper extends a mathematical model for point-source electrical stimulation of
      a nerve. In the original model, it was assumed that all the axons in the nerve
      have the same diameter. In this paper the model is extended to represent a nerve
      with an arbitrary distribution of axon diameters. It is shown that the assumption
      of identical axons is justified for a typical human nerve if the 'representative'
      axon diameter is taken as the area-weighted average of the diameter distribution.

PMID- 1640742
TI  - Damage in peripheral nerve from continuous electrical stimulation: comparison of
      two stimulus waveforms.
AB  - The propensity for two types of charge-balanced stimulus waveforms to induce
      injury during eight hours of continuous electrical stimulation of the cat sciatic
      nerve was investigated. One waveform was a biphasic, controlled-current pulse
      pair, each phase 50 microseconds in duration, with no delay between the phases
      ('short pulse', selected to excite primarily large axons), whereas in the second
      type each phase was 100 microseconds in duration, with a 400 microsecond delay
      between the phases (selected to excite axons of a broader spectrum of diameters).
      The sciatic nerve was examined for early axonal degeneration (EAD) seven days
      after the session of continuous stimulation. With both waveforms, the threshold
      stimulus current for axonal injury was greater than the current required to
      excite all of the nerve's large axons. The correlation between simple stimulus
      parameters and the amount of EAD was poor, especially with the 'short pulse'
      waveform, probably due to variability between animals. When the stimulus was
      normalised with respect to the current required to fully recruit the large axons,
      a good association between damage and stimulus amplitude emerged. The damage
      threshold was higher for the 'short pulse' waveform. The implications for
      clinical protocols are discussed.

PMID- 1640743
TI  - Tetrapolar electrode system for measuring physiological events by impedance.

PMID- 1640744
TI  - Laboratory assessment of Laerdal mouth tube mask prototype resuscitation device.

PMID- 1640745
TI  - Method for the fixation of optrodes in near-infra-red spectrophotometry.

PMID- 1640746
TI  - Intravascular oxygen sensor with polyetherurethane membrane: in vitro
      performance.

PMID- 1640748
TI  - Wavelets--new method of evoked potential analysis.

PMID- 1640747
TI  - Vortex mixing catheter.

PMID- 1640750
TI  - Personal computer system for ECG ST-segment recognition based on neural networks.
AB  - A personal computer system for electrocardiogram (ECG) ST-segment recognition is
      developed based on neural networks. The system consists of a preprocessor, neural
      networks and a recogniser. The adaptive resonance theory (ART) is employed to
      implement the neural networks in the system, which self-organise in response to
      the input ECG. Competitive and co-operative interaction among neurons in the
      neural networks makes the system robust to noise. The preprocessor detects the R
      points and divides the ECG into cardiac cycles. Each cardiac cycle is fed into
      the neural networks. The neural networks then address the approximate locations
      of the J point and the onset of the T-wave (T(on)). The recogniser determines the
      respective ranges in which the J and T(on) points lie, based on the locations
      addressed. Within those ranges, the recogniser finds the exact locations of the J
      and T(on) points either by a change in the sign of the slope of the ECG, a zero
      slope or a significant change in the slope. The ST-segment is thus recognised as
      the portion of the ECG between the J and T(on) points. Finally, the
      appropriateness of the length of the ST-segment is evaluated by an evaluation
      rule. As the process goes on, the neural networks self-organise and learn the
      characteristics of the ECG patterns which vary with each patient.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1640749
TI  - Conservation and characterisation of spatial features in a new method of data
      compression for body surface potential maps.
AB  - Body surface potential maps consist of a huge amount of data represented as a
      series of three-dimensional maps, which are time consuming to process and
      expensive to store. In spite of the continuous interest in body surface potential
      maps, their use has not become common and they are of no practical use in the
      clinics. This is due to the overwhelming amount of measured data required to
      generate the maps and the lack of quantitative methods to analyse them. Data
      compression or reduction may solve these deficiencies. Such a procedure must
      conserve the fine spatial details of the maps, which are usually extracted from
      low level surface potentials, as these are reported to be significant in
      diagnostic electrocardiography. A technique is presented for data reduction, that
      implements two-level thresholding and conserves the fine significant spatial
      features of each map. A sequence of annuli thus produced is shown to describe the
      dynamic nature of the underlying process. This sequence is further processed and
      characterised by features which quantify its dynamic behaviour: time of annuli
      sequence appearance, its duration, three-dimensional loci of centres of mass of
      the annuli, distances between successive centres of mass and cross-correlation
      coefficients between successive annuli. To test the data reduction procedure and
      the usefulness of the features, maps from 20 subjects are studied (both normal
      patients and those with various pathologies). It is found that the use of annuli
      instead of the whole measured information allows simple storage, display and
      calculations; the features, which vary in time, represent closely the changes in
      location of the annuli and their dynamic variations of shape. The features are
      also found to be grouped together for the maps of the normal patients and for
      each pathology. Thus, body surface potential maps may become more commonly used
      in clinics by being represented by a set of features, which conserve their
      dynamic and spatial nature, and which may serve for classification of cardiac
      pathologies.

PMID- 1640751
TI  - Classification of pathologies by reduced sequential potential maps.
AB  - Body surface potential mapping (BSPM) is an electrocardiographic measuring
      technique which produces the data as a series of three-dimensional maps. These
      maps are assumed to contain information which may help classify subjects for
      diagnostic purposes more effectively than standard ECGs. As quantitative
      classification of the complete sequences of maps is complex and cumbersome, the
      present study uses extracted features which characterise the data. The features,
      which have been presented and evaluated in a recent work, have been extracted
      after the maps were processed by a compression technique which conserved the
      spatial details of the maps. The compression by two-level thresholding converted
      the sequences of maps into sequences of annuli, from which the following features
      were extracted: time indices, velocity vector magnitude, loci in three
      dimensional space of the centres of mass and cross-correlation coefficients
      between successive annuli in the sequence. Here, three different classification
      methods are applied to these features: statistical methods, the Fisher linear
      discriminant method and visual inspection. BSPMs from 54 subjects are used: 25
      normal, 11 WPW syndrome and 18 CAD cases. It is found that by applying a decision
      role which comprises all features, the procedure offers a completely accurate
      classification of the subjects to their groups. The three-dimensional centre of
      mass is found to be the single best classifier; successfully categorising 20/25
      of the normals 17/18 of the CAD patients and 11/11 of the WPW patients.

PMID- 1640752
TI  - Measurement of human BAERs by the maximum length sequence technique.
AB  - The traditional brainstem auditory evoked response (BAER) measurement technique
      (ensemble averaging) is time-consuming and is not acceptable for some time
      critical clinical applications. In the paper the application of a pseudorandom
      binary sequence, the maximum length sequence, to human BAER measurements is
      examined. This technique permits a faster click rate to stimulate the test
      subject, and obtains a higher signal-to-noise ratio (SNR) response through
      deconvolution. When compared with conventional averaging, the method can result
      in an improved SNR or in faster measurement of BAER. The theory of the technique
      and the experimental setup are presented, and theoretical analysis on the SNR
      improvement by this technique against averaging is also given. Actual
      measurements of BAER on both humans and cats indicate that this technique is
      effective, especially when the measurement time is not too long, or the number of
      trials is not too large.

PMID- 1640753
TI  - In vivo measurement of bone quality in the horse: estimates of precision for
      ultrasound velocity measurement and single photon absorptiometry.
AB  - The in vivo precision of ultrasound velocity measurement and single photon
      absorptiometry for the assessment of equine bone quality is discussed. In vivo
      precisions for ultrasound velocity measurements were less than 0.5 per cent,
      whereas cortical cross-sectional area, compact bone density and modulus of
      elasticity were around 1 per cent, and bone mineral content and density were just
      over 2 per cent. Except for ultrasound velocity, substantial improvements could
      be achieved by taking the mean of five readings for each measurement. The long
      term precision of the techniques was also high, with all precision values being
      less than 3 per cent. The possible sources of variation in ultrasound velocity
      measurements were also investigated. The method for combining ultrasonic and
      photon absorptiometric data for equine bone quality assessment has been proven to
      be highly accurate and precise. There appears to be no reason why the same
      principles cannot be applied with equal success to the noninvasive assessment of
      bone quality in humans.

PMID- 1640754
TI  - Effect of pulsatile arterial diameter variations on blood flow estimated by
      Doppler ultrasound.
AB  - High-resolution measurements of common carotid and femoral arterial diameters
      have been performed by ultrasound echo devices. When combined with pulsed Doppler
      measurements of cross-sectional averaged velocity in the same vessels, exact
      calculations of flow were made possible. The median peak-to-peak pulsatile
      diameter variations were 0.19 mm (2.8 per cent) in the femoral artery and 0.49 mm
      (6.7 per cent) in the common carotid artery. Flow values were calculated either
      by taking the time-averaged diameter as a constant value, or by taking into
      account the dynamic variations in diameter. In comparing the two values, a
      quantification of the magnitude of error introduced by the averaging of the
      diameter was made possible. An error in the range 1.5-3.8 per cent was found for
      the femoral artery, whereas the error in the common carotid artery was in the
      range 0.4-3.6 per cent despite the larger amplitude of the pulsations in this
      vessel.

PMID- 1640755
TI  - Dynamic control of breathing during exercise and hypercapnia.
AB  - The dynamic influences of end-tidal CO2 and exercise on ventilation are compared
      when CO2 and exercise are imposed separately and when they are imposed
      simultaneously. Five human subjects are studied. The subjects performed three
      trials: random work rate forcing, random CO2 inhalation and their simultaneous
      loading. The work rate was varied between 20 and 80 W as a pseudorandom binary
      sequence. The concentration of inspired CO2 was varied randomly between 0 and 7
      per cent, adjusted so that it produced approximately the same amount of
      ventilatory fluctuations as the random work load. The relative contribution of
      each variable was analysed using multivariate autoregressive analysis at
      frequencies ranging from 0.1 to 1 cycle min-1. The results show that the dynamics
      of the response to CO2 inhalation, exercise and their combination are nonlinear
      and that the combination of CO2 inhalation and exercise magnifies the nonlinear
      behaviour. Ventilation is largely unaffected by either work rate or end-tidal CO2
      at 1 cycle min-1. During simultaneous CO2 and work rate forcing, ventilation
      tends to follow the change in the end-tidal CO2.

PMID- 1640756
TI  - Portable system for acquisition and transmission of ECG parameters.
AB  - A simple inexpensive bedside automatic ECG data-collection system is presented.
      The main parameter measured is the R-R interval length that can be used in the
      construction of a heart rate variability signal. Another parameter measured is
      the shape of the T-wave in the ECG signal. The collected data are transferred to
      a remote host computer through the public telephone network, by means of a modem.
      The system can function through the whole range of human heart rates. The
      described solution differs from most existing ones by utilising the existing ECG
      monitoring equipment in hospitals, which usually does not store any information.
      This equipment is connected by a portable, independent, special-purpose system to
      a remote host computer which can further analyse and store the data.

PMID- 1640757
TI  - Effect of the metallic seal of a hermetic enclosure on the induction of power to
      an implant.
AB  - Most neuroprostheses which use integrated circuits protect these chip components
      in a hermetic package. No satisfactory method of sealing such an enclosure has
      been found which does not use metals. Therefore, in general, the seal is an
      electrically conducting ring. If induction is used to supply power to this
      device, this ring will be a 'short-circuited turn' which will affect the
      performance of the inductive link. In the paper, theory is presented for a model
      in which the metallic seal is a tertiary inductance, coupled to the primary and
      secondary. The tertiary has finite Q. Equations for this model are given from
      which formulae for the gain and efficiency are derived for the particular
      condition of tuning that the carrier frequency equals the resonant frequency of
      both the primary and secondary circuits. From the formulae, gain curves are
      plotted which show how the seal affects the link. However, it is clear that
      general solutions to the problem are needed if the theory is to be of practical
      use.

PMID- 1640758
TI  - Class E driver for transcutaneous power and data link for implanted electronic
      devices.
AB  - Magnetic transcutaneous coupling is frequently used for power and data transfer
      to implanted electronic devices. The paper describes a transmitter/coil driver
      based on the class E topology. The development of a 'high-Q approximation'
      simplifies the design procedure. A method of data modulation using synchronous
      frequency shifting is described. The class E circuit shows great promise,
      especially for circuits with unusually low coefficients of coupling. Transmitter
      coil currents of several amperes, at radio frequencies, with relatively low
      active device power dissipation, can easily be obtained.

PMID- 1640759
TI  - Mechanical and optical anisotropy of bovine pericardium.
AB  - A Moire fringe method was used to determine the shape of inflated disks of fresh
      bovine pericardium. The results suggested that the tissue was anisotropic and
      allowed the identification of the directions of the axes of elastic symmetry.
      Quantitative biaxial inflation and simple tension tests confirmed the anisotropy.
      In the circumferential direction the tissue was more extensible and had greater
      mean strength (18 MPa against 2.5 MPa) and mean terminal modulus (46 MPa against
      14 MPa) than in the root-to-apex direction. The tissue was also optically
      anisotropic when viewed by transmitted polarised light and the directions of
      mechanical and optical anisotropy were related.

PMID- 1640760
TI  - Viscoelastic response of human hair cortex.
AB  - The present study describes a new methodological approach which allows the
      separate analysis and quantitative determination of the viscous and elastic
      components of human hair using a computerised experimental system. In a first
      series of experiments subsequent to the estimation of the cross-sectional surface
      area of the cuticle, the cortex and the medulla, the viscoelastic response of
      hair (considered as a homogeneous material) and of its cortex were determined in
      ten hair specimens derived from the same human subject. Statistically significant
      differences were found between hair and its cortex with regard to the values of
      the modulus of elasticity, limit of linearity and post-yield slope. In a second
      series of experiments the viscoelastic parameters of hair and its cortex were
      separately determined in 100 hair specimens derived from ten healthy human
      subjects (ten specimens from each subject). It was found that the dispersion of
      the values of modulus of elasticity, limit of linearity and post-yield slope of
      the cortex was significantly reduced compared with that of the hair. Our results
      indicate that the pattern of the viscoelastic parameters of human hair cortex,
      which strongly depends on its microstructural features, may be regarded as a more
      reliable and sensitive diagnostic marker than that of hair in various structural
      and functional hair disorders.

PMID- 1640761
TI  - Triaxial force transducer for investigating stresses at the stump/socket
      interface.
AB  - Although normal pressures at the stump socket interface of the lower-limb amputee
      have been investigated, little is known about the shear stresses that also occur.
      Studies suggest that the combination of both shear and normal stresses
      significantly exacerbates discomfort and vascular and tissue damage. A means of
      simultaneously measuring normal and shear stresses will aid in the investigation
      and improvement of prosthetic fit. A miniature triaxial force transducer (4.9 x
      16 mm diameter) has been developed which can be recessed into the socket wall.
      The principle of operation, construction, performance and limitations of the
      device are described. Preliminary measurements of the interface stress variations
      over the gait cycle in a supra-condylar PTB socket are presented. These show
      clear differences in the stress patterns present when two different prosthetic
      feet are used.

PMID- 1640762
TI  - Time series analysis of brain potentials preceding voluntary movements.
AB  - Brain potentials preceding voluntary movements, obtained after averaging single
      trial EEG records synchronised with the start of movement, consist of slow
      potentials shifts SPS in the negative direction mixed with faster components like
      ongoing EEG activity. Two hypotheses were tested: SPS could be presented by a sum
      of smooth function (trends) and weakly stationary processes (residuals); the
      residuals and the ongoing EEG activity preceding SPS could be described by the
      same class of autoregressive (AR) or autoregressive moving average (ARMA) models.
      The trend was estimated by comparing several approximating functions in the sense
      of least mean square error. The SPS residuals, after subtracting the trend and
      background EEG activity, were estimated using AR and ARMA models of different
      orders. These procedures were performed on brain potentials recorded from vertex
      to linked ear lobes of five subjects instructed to voluntarily press a button. As
      a result, the hypotheses were not rejected. The trend was best approximated by a
      hyperbolic function or Chebyshev's second order polynomial. AR models fitted both
      the SPS residuals and ongoing EEG activity well enough. In conclusion, SPS were
      characterised by three parameters of the smooth function plus a time parameter
      defined by the potential boundaries.

PMID- 1640763
TI  - Skin impedance measurements using simple and compound electrodes.
AB  - We have studied the effect of the electrode configuration on the measurement of
      body impedance and found that the electrode configuration greatly affects the
      impedance measurement using the four-electrode method. We studied the
      characteristics of the compound electrode and found that the compound electrode
      provides the four-electrode method in a compact form. A new method of measuring
      the skin impedance using simple electrodes at low frequencies was developed. At
      high frequencies where the effect of internal tissue impedance is not negligible,
      we used the compensation method using compound electrodes, because they measure
      the voltage right under the skin. At 50 kHz, we measured the real part of the
      skin impedance of less than 80 omega on the thorax. We propose a simple
      instrument which can measure accurate skin impedance at various frequencies.

PMID- 1640764
TI  - The structure of the Mental Health Inventory among Chinese in Taiwan.
AB  - This study attempted to ascertain the construct validity and external validity of
      the Mental Health Inventory in a Chinese population in Taiwan and contrast these
      results with results obtained from studies of several U.S. populations. In
      particular, a series of measurement models were specified and evaluated to
      address the issues of reliability and validity. Data were collected from personal
      interviews of a probability sample of 1,194 Chinese respondents 14 years of age
      and older in four townships in southwest Taiwan. The Mental Health Inventory was
      found to involve two major components: positive well-being and psychological
      distress. As a hierarchical structure, each component consists of one second
      order and two or three first-order factors. The relationships between well-being
      and distress can be characterized as substantially independent and modestly
      bipolar depending on the level and specification.

PMID- 1640766
TI  - The feasibility of a public-private long-term care financing plan.
AB  - In this study, the feasibility of a public-private long-term care (LTC) financing
      plan that would combine private LTC insurance with special Medicaid eligibility
      requirements was assessed. The plan would also raise the Medicaid asset limit
      from the current $2,000 to the value of an individual's insurance benefits. After
      using benefits the individual could enroll in Medicaid. Thus, insurance would
      substitute for asset spend-down, protecting individuals against catastrophic
      costs. This financing plan was analyzed through a computer model that simulated
      lifetime LTC use for a middle-income age cohort beginning at 65 years of age. LTC
      payments from Medicaid, personal income and assets, Medicare, and insurance were
      projected by the model. Assuming that LTC use and costs would not grow beyond
      current projections, the proposed plan would provide asset protection for the
      cohort without increasing Medicaid expenditures. In contrast, private insurance
      alone, with no change in Medicaid eligibility, would offer only limited asset
      protection. The results must be qualified, however, because even a modest
      increase in LTC cost growth or use of care (beyond current projections) could
      result in substantially higher Medicaid expenditures. Also, private insurance
      might increase personal LTC expenditures because of the added cost of insuring.

PMID- 1640765
TI  - The trade-off between hospital cost and quality of care. An exploratory empirical
      analysis.
AB  - The debate concerning quality of care in hospitals, its "value" and
      affordability, is increasingly of concern to providers, consumers, and purchasers
      in the United States and elsewhere. We undertook an exploratory study to estimate
      the impact on hospital-wide costs if quality-of-care levels were varied. To do
      so, we obtained costs and service output data regarding 300 U.S. hospitals,
      representing approximately a 5% cross section of all hospitals operating in 1983;
      both inpatient and outpatient services were included. The quality-of-care measure
      used for the exploratory analysis was the ratio of actual deaths in the hospital
      for the year in question to the forecasted number of deaths for the hospital; the
      hospital mortality forecaster had earlier (and elsewhere) been built from
      analyses of 6 million discharge abstracts, and took into account each hospital's
      actual individual admissions, including key patient descriptors for each
      admission. Such adjusted death rates have increasingly been used as potential
      indicators of quality, with recent research lending support for the viability of
      that linkage. The authors then utilized the economic construct of allocative
      efficiency relying on "best practices" concepts and peer groupings, built using
      the "envelopment" philosophy of Data Envelopment Analysis and Pareto efficiency.
      These analytical techniques estimated the efficiently delivered costs required to
      meet prespecified levels of quality of care. The marginal additional cost per
      each death deferred in 1983 was estimated to be approximately $29,000 (in 1990
      dollars) for the average efficient hospital. Also, over a feasible range, a 1%
      increase in the level of quality of care delivered was estimated to increase
      hospital cost by an average of 1.34%. This estimated elasticity of quality on
      cost also increased with the number of beds in the hospital.

PMID- 1640767
TI  - The protracted demise of medical technology. The case of intermittent positive
      pressure breathing.
AB  - In this study, the effects of hospital, staff, and patient characteristics on the
      rates of use and abandonment of an outmoded medical technology, intermittent
      positive pressure breathing (IPPB) are analyzed. The study focuses specifically
      on the use of IPPB to treat inpatients with chronic obstructive pulmonary disease
      in a national sample of more than 500 community hospitals from 1980 to 1987.
      Cross-sectionally, hospitals with shorter case-mix-adjusted lengths of stay,
      private nonprofit or investor-owned hospitals, and hospitals located outside of
      the north central United States were more likely to abandon IPPB by 1980.
      Teaching status, location, ownership, volume, and source of payment all appeared
      to affect rates of IPPB use in 1980. The longitudinal analysis examines both the
      probability a hospital abandoned IPPB and declines in rates of IPPB use over the
      study period, conditioned on the availability of IPPB in 1980. The results show
      that changes in the characteristics of hospitals, patients, and physicians all
      help to explain variations in the abandonment of IPPB. These findings contrast
      with previous studies of technological change, which find hospital size to be the
      most important variable. Size is important in explaining the rate of use in 1980,
      but it has no effect on the rate of decline in use or abandonment after 1980. In
      general, the analysis demonstrates that a combination of factors, economic
      incentives as well as information, contribute to the abandonment of outmoded
      medical technologies. Given the surprisingly long time periods required for this
      process to occur, the analysis underscores the need to strengthen financial
      incentives that encourage appropriate medical decisions and to disseminate
      information about the efficacy of specific procedures more widely and
      effectively.

PMID- 1640768
TI  - Duration and intensity of striking among participants in the Ontario, Canada
      doctors' strike.

PMID- 1640769
TI  - Correction and update on 'priority setting in medical technology assessment'.

PMID- 1640770
TI  - Coordinate-based mapping--a new method in health services research.
AB  - The Finnish national hospital discharge registers from 1985 and 1988 have been
      analysed by the National Board of Health. Results are provided for all the 21
      Finnish hospital districts and central communal organizations. The small area
      variation phenomenon in hospital utilization cannot be explained by demographic
      or epidemiological factors. Rather, the variations seem to be largely due to
      organizational factors. The project aims to develop a data processing system
      capable of handling information on one million patients rapidly and economically,
      and show the results in an intelligible form as a table with standard headers or
      as a map illustration. Maps are superior to traditional statistical tables in
      demonstrating regional variations in health care utilization and in mortality.
      Maps based on small administrative units are useful for many purposes. These maps
      are, however, relatively 'noisy' due to substantial random variation. Coordinate
      based mapping is a method to overcome some of these difficulties. It is based on
      linking hospital discharge and mortality data with exact address data. The method
      allows mapping independent of administrative boundaries. Several examples of
      coordinate-based maps are given. The method is used in Finland for annual
      analysis of hospital use.

PMID- 1640771
TI  - Visual knowledge processing in computer-assisted radiology: a consultation
      system.
AB  - This paper presents Visual Heuristics, a consultation system for diagnosis based
      on thorax radiograph recording. Visual Heuristics uses both prototypical
      representations of physiological and pathological states and reasoning aimed to
      infer conclusions from pathological or physiological conditions, establishing
      correspondences between pathological or physiological states and semantic
      descriptions of images. Images are assembled with groups of descriptors that
      guide the recognition process, achieving the possibility of comparisons with real
      images on the basis of 'expected' images. The system may be employed to generate
      a dynamic atlas that does not contain proper images, but generates them.

PMID- 1640772
TI  - A cooperative approach to decision support in the differential diagnosis of
      breast disease.
AB  - The problem of differential diagnosis in breast histopathology is described and
      areas in need of decision support identified. It is argued that the conventional
      role played by decision support systems, i.e. that of the 'autonomous problem
      solver', is unacceptable in this domain and that support must be given to the
      actual cognitive functions of potential system users. Decision-making processes
      of pathologists are examined with particular reference to Rector's category of
      'broad experts'. Pathologists possess a rich set of general diagnostic concepts
      for their domain, but their knowledge of detailed aspects of differential
      diagnosis may contain gaps and errors. A cooperative model of decision support,
      which utilizes the strengths and complements the weaknesses of pathologists'
      problem-solving skills, is described and the operation of this model within a
      functioning system illustrated.

PMID- 1640773
TI  - Decision support for patient management in oncology.
AB  - In this paper a novel approach to the development of the architecture of a
      knowledge-based decision support system for the management of patients with
      cancer of the breast is described. Its initial design and subsequent realization
      in a prototype version was facilitated by examining closely the overall clinical
      task and identifying its associated activities and related knowledge.
      Implementation in KEE highlights the value of rigorous conceptual modelling that
      leads to a design able to assess treatment response and disease progression as
      well as providing specific therapy advice. The approach is general and may be
      applied to the development of decision support systems for other areas of cancer
      and medicine.

PMID- 1640774
TI  - A pathology database system for autopsy diagnoses using free-text method.
AB  - Using natural language a computerized indexing and retrieval system was developed
      on a commercial database program, DATATRIEVE (Digital Equipment Corporation,
      Japan). Summarized anatomical diagnoses of nearly 4000 autopsy cases have been
      registered over a 13-year period at Tokyo Metropolitan Geriatric Hospital. There
      were 187,367 words in the pathological diagnoses with 4689 distinct words
      excluding articles, prepositions and conjunctions. 'Atrophy', 'congestion' and
      'metastasis' were the most frequent words with frequencies of 4335, 3377, and
      3373, respectively. Distinct clinical diagnoses were 2497, among which
      'pneumonia', 'hypertension' and 'DIC' predominated. Each step of retrieval by
      character strings from the sequential data file requires less than a minute.

PMID- 1640775
TI  - Using the proportional hazards model to study heart valve replacement data.
AB  - The proportional hazards model is used to study the effect of various concomitant
      variables on the time to valve failure, mortality, or other complications, for
      patients who have had artificial heart valves inserted. The data are from a
      database, which is still being assembled as more information is acquired, at
      Killingbeck Hospital. A suite of computer programs, not specifically developed
      with this application in mind, has been used to carry out the exploratory data
      analysis, the estimation of parameters and the validation of the model. These
      three elements of the analysis are all illustrated. The present report is seen as
      a preliminary study to assess the usefulness of the proportional hazards model in
      this area. Follow-up work as more data are accumulated is intended.

PMID- 1640776
TI  - Information technology training for health care: information support.
AB  - The teaching of information technology (IT) within health care applications is
      currently diffuse. The diversity of specializations in health care presents
      special challenges in relation to IT training. An integrating training model
      which reflects the level of IT expertise needed is presented.

PMID- 1640777
TI  - Competency of human-derived Mycobacterium leprae to use palmitic acid in the
      synthesis of phenolic glycolipid-I and phthiocerol dimycocerosate and to release
      CO2 in axenic culture.
AB  - Insufficient numbers of viable Mycobacterium leprae have hampered metabolic
      studies using human-derived M. leprae. In this study, sufficient numbers of M.
      leprae were obtained from an untreated lepromatous patient to titrate the effects
      of pH on the metabolism of 14C-palmitic acid by M. leprae. Catabolic metabolism
      (oxidation of 14C-palmitic acid and release of 14CO2) was maximal when M. leprae
      were incubated at 33 degrees C and suspended in Middlebrook 7H9, ADC supplemented
      medium that had been buffered to maintain a pH of 4.8. Anabolic metabolism
      (synthesis of 14C-phenolic glycolipid-I and its precursor, 14C-phthiocerol
      dimycocerosate) was maximal when the pH was maintained at 6.8.

PMID- 1640778
TI  - Evaluation of Mycobacterium leprae particle agglutination test, using eluates of
      filter paper blood spots.
AB  - A comparison of the ELISA test with the newly-developed MLPA test was carried
      out, using eluates of blood spots from filter paper for the detection of the anti
      PGL-I antibody. A very good positive correlation was observed between these two
      tests. The concordance rate was found to be 92.6%, ranging from 71.4% to 100%.
      This nonconcordance was not found when freshly-collected samples were used. The
      MLPA test is simple and reliable. The use of eluates from blood spots collected
      on filter paper further simplifies the test in the collection and transportation
      of blood samples. This accurate and rapid method makes the MLPA test logistically
      feasible for large-scale screening. With our modification of MLPA with eluates
      more samples can be screened with the kit than with sera.

PMID- 1640779
TI  - Double-blind evaluation of BACTEC and Buddemeyer-type radiorespirometric assays
      for in vitro screening of antileprosy agents.
AB  - Two radiorespirometric assays, the BACTEC 460 and Buddemeyer-type 14CO2 detection
      systems, were evaluated in a double-blind manner for their ability to
      discriminate between authentic antileprosy agents and inactive compounds. Freshly
      harvested, nude-mouse derived Mycobacterium leprae were incubated in axenic media
      in the presence of coded test solutions prepared in a remote laboratory. Activity
      was assessed by comparing the rate of 14CO2 evolution from [1-14C]palmitic acid
      to controls. Breaking the code revealed that both systems demonstrated a dose
      response to ethionamide, pefloxacin and rifampicin as well as sensitivity to
      dapsone. Most of the water, ethanol, sucrose, dabsyl chloride and riboflavin
      negative-control samples failed to effect a significant reduction in
      radiorespirometric activity. This study confirms the ability of the
      radiorespirometric assays to function as a primary drug screening system in
      leprosy.

PMID- 1640780
TI  - Clinical observations on leprosy patients with HIV1-infection in Zambia.
AB  - The clinical observations carried out on 10 leprosy patients with HIV1-infection,
      admitted between 1.1.1986 and 1.5.1988 to the Salvation Army Hospital at
      Chikankata, Mazabuka, Zambia are described. A total of 8 of this group were newly
      diagnosed borderline leprosy patients. Their clinical data were compared with
      those of 34 newly-diagnosed borderline leprosy patients, admitted in the same
      period--50% were men, 50% women. The clinical presentation, with respect to
      leprosy, on admission, did not differ very much in both groups. The incidence of
      neuritis in both groups was 50% (respectively 5 and 17). The outcome of specific
      therapy of neuritis was worse in the HIV1 patients than in the other group: only
      partial recovery in 4 out of 5 and no response in 1, compared with a complete
      recovery in 10 cases, and a partial recovery in 7 cases in the other group. A
      total of 6 patients of the HIV1-group admitted to have had multiple heterosexual
      contacts, 5 had a history of sexually transmitted disease, 7 had generalized
      lymphadenopathy and 4 presented with another disease in addition to leprosy.
      While in hospital the group of 10 HIV1-infected patients suffered 17 episodes of
      intercurrent disease against none in the other group; 1 patient (male) died with
      generalized dermatitis and sepsis; 1 woman died with fulminant hepatitis.

PMID- 1640781
TI  - Diagnostic exploration of enlarged peripheral nerves in suspected cases of
      leprosy. An analysis of 55 cases.
AB  - In 55 cases presenting with enlarged peripheral nerves without any skin lesions,
      a rice grain-sized biopsy of the nerve lesion was taken for histopathological
      examination. As a result definitive diagnoses could be established: leprosy was
      diagnosed in 32 cases. In 23 cases the cause of nerve enlargement was not
      leprosy: post-traumatic neuritis 9, cysts 5, hypertrophic neuritis 3, nonspecific
      4, neurofibroma 1, and amyloidosis 1. In all of these cases there was a deficit
      of the nerve function and postoperatively there were no complications. The
      authors, as a result of this experience, believe that surgical exploration and
      biopsy is a harmless diagnostic tool for establishing a definitive diagnosis of
      leprosy in cases presenting with enlarged peripheral nerves without any skin
      lesions. In 23 out of 55 such cases the nerve enlargement was proved to be other
      causes than leprosy.

PMID- 1640782
TI  - An application of the LePSA methodology for health education in leprosy.
AB  - This paper describes how the innovative LePSA technique can be used by community
      health workers to appropriately educate and increase compliance among leprosy
      patients. A lesson plan illustrating the interactive nature of the technique in a
      hypothetical Third World community is presented. The lesson plan, using MDT
      default, shows how the technique can elicit individual participation in a group
      setting and serve as both an educational and a behaviour change tool.

PMID- 1640783
TI  - Attitudes towards leprosy in the outpatient population of dermatology clinics in
      Trinidad.
AB  - We interviewed a total of 92 dermatology clinic patients using a brief
      questionnaire to determine their knowledge, attitudes and beliefs about leprosy.
      This small survey helped to confirm our suspicions that some knowledge of leprosy
      is lacking and that much stigma still remains.

PMID- 1640784
TI  - Attitudes of rural people in central Ethiopia towards leprosy and a brief
      comparison with observations on epilepsy.
AB  - To find out public attitudes toward leprosy a door-to-door survey was carried out
      in 1546 sampled households in the rural farming community of Meskan and Mareko in
      central Ethiopia, where the prevalence of leprosy is estimated to be 1:1000.
      Attitudes toward leprosy were compared with attitudes to epilepsy, studied in a
      previously performed survey in the same community. Eighty-seven per cent of the
      respondents were above the age of 25, and 59.5% were females. There were slightly
      more Muslims (54%) than Christians. The majority of the interviewees (87%) were
      farmers, with an illiteracy rate of 84%. Ninety-five per cent and 83%,
      respectively, were not willing to employ or work with a person having the
      disease. Seventy-five per cent would not allow their children to associate with a
      playmate suffering from leprosy. Comparative analysis of attitudes in the same
      community showed that negative attitudes toward leprosy were stronger than those
      toward epilepsy, particularly with regard to matrimonial associations, sharing of
      accommodation, and physical contact with an affected person. The reasons for
      these differences appear to be the community's deeply entrenched belief that
      leprosy is both hereditary and contagious, expressed respectively by 48% and 53%
      of the respondents. In order to minimize the perpetuation of negative attitudes,
      there is a need to educate and impress on the population that leprosy is a
      treatable infectious disease which is not congenitally acquired, and that it is
      even curable if detected early. The study reinforces previously proposed
      suggestions that, in developing countries such as Ethiopia, leprosy care should
      be integrated into the general health services.

PMID- 1640785
TI  - Appraisal of the knowledge and attitude of Nigerian nurses toward leprosy.
AB  - The attitudes of nurses toward leprosy are studied and in this paper. The
      findings show that their knowledge of leprosy is lacking and that they also fear
      leprosy. This study recommends that leprosy should be included in the basic
      nursing curriculum in order to increase awareness and to decrease the stigma of
      leprosy.

PMID- 1640786
TI  - Relationship problems between doctors and paramedical professionals working in
      leprosy with reference to a possible solution.
AB  - An empirical investigation was conducted on the in-group dynamics of health
      personnel working in leprosy. The sample populations were taken from the National
      Leprosy Eradication Programme (NLEP) employees of two state governments in India.
      They consisted of 21 doctors and 335 paramedicals, the former constituting a
      formal group and the latter a semiformal group. Two separate scales were
      developed for each of these groups to elicit information on five potential areas
      of intergroup relationships. The results indicated that there was very poor
      acceptance of the out-group and its roles, i.e. poor acceptance of the
      paramedicals by the doctors and vice versa. Three reasons were elicited from this
      study. First, doctors held their professional standing to be on a higher level
      than the paramedicals, leading to excessive social distancing between doctors and
      paramedicals. Second, multiprofessional involvement in NLEP work has increased
      the trend of professional overlapping, leading to a significant apprehension of
      the encroachment of skills. Third, there was a mutual lack of trust of each
      others professional skills. Despite these problems the otherwise more severe
      human relationship problems, such as domineering behaviour and prejudiced
      perception against the out-group were found to be significantly less in this
      study. In order to improve working relationships between these groups a method
      that has been used at Karigiri is recommended. The method has two parts. The
      first is aimed at intrapersonal understanding and the second at the development
      of interpersonal skills. Role play that mimics their original work situation and
      an analysis of case histories were the methods of teaching that were found to be
      more advantageous in internalizing these skills.

PMID- 1640787
TI  - A suggested new method to measure patch area in paucibacillary leprosy.

PMID- 1640788
TI  - Comment: Reversal reactions in leprosy and their management.

PMID- 1640789
TI  - Treatment of smear negative MB patients who had received previous dapsone
      monotherapy.

PMID- 1640790
TI  - '3 ps' in school surveys--'priming', privacy and a personalized approach.

PMID- 1640791
TI  - Second conference on AIDS in Asia and the Pacific.

PMID- 1640792
TI  - The serodiagnosis of leprosy.

PMID- 1640793
TI  - Endothelin and sarafotoxin: influence on steroid-regulated motility of rat
      uterus.
AB  - The sarafotoxins (SRTX) and endothelins (ET) were shown to influence the motility
      of the isolated rat uterus by inducing an increase in the rate and in the maximum
      tension of the spontaneous rhythmic contractions and a suppression of the
      relaxation phase of these contractions. Ovariectomized rats, 24 weeks post
      operation, show no spontaneous motility of their uteri and the SRTX/ET peptides
      induce only a slight tonic increase in the uterine tension. Treatment with 17
      beta estradiol restores spontaneous motility and sensitivity to the SRTX/ET
      peptides in all three contraction modes. It is concluded that the influence of
      the SRTXs and ETs on uterine motility depends on the hormonal status of the
      animal.

PMID- 1640794
TI  - Receptor regulation, competitive antagonism and pA2.
AB  - A growing body of evidence suggests that the number of drug receptors on cell
      surfaces is not fixed, but is dynamically regulated by circumstances that include
      exposure to the ligand itself. Because most traditional theories of drug action
      are based on the assumption of a fixed number of receptors, it is desirable to
      examine the importance of this regulatory process on the interpretation of dose
      effect data. Of special interest is the impact of a variable receptor number on
      the equation of competitive antagonism and associated pA2 which, in the
      traditional theory, is a quantitative measure of antagonist-receptor affinity.
      Using a simple model of drug-induced endocytosis or exocytosis, it is shown that
      if the rate of either is appreciable, the pA2 is no longer a simple measure of
      affinity.

PMID- 1640795
TI  - Low doses of urethane effectively inhibit spinal seizures evoked by sudden
      cooling of toad isolated spinal cord.
AB  - The effect of low doses of urethane on three phases of spinal seizures evoked by
      sudden cooling (SSSC) of toad isolated spinal cord was studied. In control toads,
      SSSC began with a latency of 91 +/- 3 sec (mean +/- S.E.M.) exhibiting brief
      tremors, followed by clonic muscle contractions and finally reaching a tonic
      contraction (tonic phase). The latency of onset of seizures was significantly
      enhanced. The tonic phase was markedly abolished in toads pretreated
      intralymphatically with 0.15 g/kg of urethane. Tremors were the only phase
      observed in 55% of toads that received doses of 0.2 g/kg, and a total blockade of
      seizures was seen after doses of 0.25 g/kg of urethane in 50% of the
      preparations. A possible depressant effect of urethane on transmission mediated
      by excitatory amino acids is suggested.

PMID- 1640796
TI  - Blood-brain barrier dysfunctions following systemic injection of kainic acid in
      the rat.
AB  - Changes in blood-brain barrier (BBB) permeability and cerebral metabolic activity
      following intravenous injection of kainic acid (KA; 6, 12 mg/Kg) in rats were
      assessed by calculating respectively a blood-to-brain transfer constant (Ki) for
      [14C]alpha-aminoisobutyric acid and local cerebral glucose utilization (LCGU)
      values, at different times (1 h, or acute seizures phase, and 48 h, or chronic
      pathology phase) after the induction of seizures. A significant increase in the
      local permeability of the BBB was observed 1 h after the injection of KA 6 mg/Kg
      (eliciting no significant changes in cerebral metabolic activity, except within
      the frontal cortex and the hippocampus) and 12 mg/Kg (which induced a marked and
      widespread enhancement of LCGU). On the contrary, during the pathology phase,
      persistent regional increases in Ki values were evidenced in rats treated with
      the lowest dose of the convulsant, but not in rats injected with KA 12 mg/Kg (a
      dose able to cause extensive neuronal damage). Thus one can speculate that: 1) KA
      induced regional changes in the permeability of the BBB are not correlated with
      changes in neuronal activity; 2) opening of the BBB is not reliably associated
      with neuronal injury.

PMID- 1640797
TI  - Effects of atropine on operant test battery performance in rhesus monkeys.
AB  - The acute behavioral effects of atropine sulfate were assessed using a battery of
      complex food-reinforced operant tasks that included: temporal response
      differentiation (TRD, n = 7); delayed matching-to-sample (DMTS, n = 6),
      progressive ratio (PR, n = 8), incremental repeated acquisition (IRA, n = 8), and
      conditioned position responding (CPR, n = 8). Performance in these tasks is
      thought to depend primarily upon specific brain functions such as time
      perception, short-term memory and attention, motivation, learning, and color and
      position discrimination, respectively. Atropine sulfate (0.01-0.56 mg/kg iv),
      given 15-min pretesting, produced significant dose-dependent decreases in the
      number of reinforcers obtained in all tasks. Response rates decreased
      significantly at greater than or equal to 0.03 mg/kg for the learning and
      discrimination tasks, at greater than or equal to 0.10 mg/kg for the motivation
      and short-term memory and attention tasks, and at greater than or equal to 0.30
      mg/kg for the time perception task. Response accuracies were significantly
      decreased at doses greater than or equal to 0.10 mg/kg for the learning,
      discrimination, and short-term memory and attention tasks, and at greater than or
      equal to 0.30 mg/kg for the time perception task. Thus, the order of task
      sensitivity to any disruption by atropine is learning = color and position
      discrimination greater than time perception = short-term memory and attention =
      motivation (IRA = CPR greater than TRD = DMTS = PR). Thus in monkeys, the rates
      of responding in operant tasks designed to model learning and color and position
      discrimination were the most sensitive measures to atropine's behavioral effects.
      Accuracy in these same task was also disrupted but at higher doses. These data
      support the hypothesis that cholinergic systems play a greater role in the speed
      (but not accuracy) of performance of our learning and discrimination tasks
      compared to all other tasks. Accuracy of responding in these and the short-term
      memory task, all of which involve the use of lights as visual stimuli, was more
      sensitive to disruption by atropine than those tasks which did not utilize such
      strong visual stimuli.

PMID- 1640798
TI  - Endothelin-3 modification of dopamine release in anaesthetised rat striatum; an
      in vivo microdialysis study.
AB  - Endothelin-3 (ET-3), a member of the vasoconstrictive peptide family, has
      recently been recognized as a neuropeptide. We used brain microdialysis and on
      line HPLC to examine the effect of ET-3 on the basal outflow of monoamines and
      their metabolites in the ketamine-anaesthetised rat striatum in vivo. Although
      intrastriatal infusion of ET-3 (40 pmol/rat) did not change basal dopamine (DA)
      release, after perfusion of DA releasing agent (5 x 10(-5) M ouabain or 120 mM
      KCl), ET-3 could increase the DA level. Further, these effects of ET-3 were
      attenuated by calcium-free Ringer. These data indicated that ET-3 may act by
      modifying the exocytosis from the striatum of rat brain to enhance DA release
      after depolarization induced by an agent such as KCl or ouabain.

PMID- 1640799
TI  - Effects of chronic morphine on biliary tract responses to cholecystokinin
      octapeptide in male guinea pigs.
AB  - Opioid peptides share the spasmogenic action of acutely administered morphine on
      the sphincter of Oddi. In this study, gallbladder function was assessed following
      chronic opioid administration. Implantation of morphine pellets (400 mg) in male
      guinea pigs depressed cholecystokinin-octapeptide(CCK)-induced emptying of
      gallbladder bile (monitored via a duodenal cannula). Gallbladder muscle strips,
      isolated from the morphine treated animals, showed depressed contractile
      responses to CCK. This antagonism was non-specific and indirectly mediated, as
      ACh contractions were also depressed, whereas CCK-induced contractions of
      gallbladder strips from untreated animals were unaffected by direct exposure to
      morphine (3 x 10(-6)M). The depression of CCK stimulation of bile flow by chronic
      morphine administration in male guinea pigs suggests that chronic exposure to
      opioids can impede gallbladder emptying.

PMID- 1640800
TI  - Chromogranin A correlates with norepinephrine release rate.
AB  - Chromogranin A (CgA) is an acidic protein co-released with catecholamines during
      exocytosis from sympathetic nerve terminals and chromaffin cells. Previous work
      has demonstrated that large scale perturbations in sympathetic nervous system
      (SNS) functioning result in corresponding changes in CgA levels in plasma. Little
      is known about the physiologic significance of CgA. We hypothesized that, since
      CgA and catecholamines are co-released from the same storage vesicles, and since
      CgA is not subject to reuptake or enzymatic metabolism, plasma CgA should reflect
      norepinephrine release from sympathetic terminals. We therefore measured venous
      CgA, norepinephrine levels, and norepinephrine release rate in 30 unmedicated
      subjects. Although the correlation of CgA with plasma norepinephrine was only
      modest (r = 0.37, p less than 0.05), its correlation with norepinephrine release
      rate was highly significant (r = 0.58, p less than 0.001). Thus, CgA may offer a
      novel perspective on peripheral sympathetic activity.

PMID- 1640801
TI  - Decreased glucose transporter 1 gene expression and glucose uptake in fetal brain
      exposed to ethanol.
AB  - Using pregnant rats fed equicaloric liquid diets (AF, and libitum-fed controls;
      PF, pair-fed controls; EF, ethanol-fed), we have previously shown that maternal
      alcoholism produces a specific and significant decrease of glucose in the fetal
      brain, which is accompanied by growth retardation. To further define the
      mechanisms of ethanol-induced perturbations in fetal fuel supply, we have
      examined (i) the uptake of 2-deoxyglucose (2-DG) by dissociated brain cells from
      fetal rats that were exposed to ethanol in utero and (ii) the steady-state levels
      of the glucose transporter-1 (GT-1) mRNA. A 9% decrease in brain weight (P less
      than 0.001) and a 54.8% reduction in 2-DG uptake into brain cells (P less than
      0.02) were found in offspring of EF mothers compared to the AF group. Brain
      weight correlated with the rate of 2-DG uptake (P less than 0.05). Northern blot
      analysis showed a 50% reduction of GT-1 mRNA in EF brain relative to that in the
      AF and PF groups. We conclude that glucose transport into the brain is an
      important parameter altered by maternal ethanol ingestion.

PMID- 1640802
TI  - Protamine induces autophosphorylation of protein kinase C: stimulation of protein
      kinase C-mediated protamine phosphorylation by histone.
AB  - Protein kinase C (PKC), a protein phosphorylating enzyme, is characterized by its
      need for an acidic phospholipid and for activators such as Ca2+ and
      diacylglycerol. The substrate commonly used in experiments with PKC is a basic
      protein, histone III-S, which needs the activators mentioned. However, protamine,
      a natural basic substrate for PKC, does not require the presence of
      cofactor/activator. We report here that protamine can induce the
      autophosphorylation of PKC in the absence of any PKC-cofactor or activator; this
      may represent a possible mechanism of cofactor-independent phosphorylation of
      this protein. It was investigated if protamine itself can act as a PKC-activator
      and stimulate histone phosphorylation in the manner of Ca2+ and phospholipids.
      Experiments however showed that protamine is not a general effector of PKC. On
      the contrary, histone stimulated PKC-mediated protamine phosphorylation and
      protamine-induced PKC-autophosphorylation. Histone alone did not induce PKC
      autophosphorylation. Kinetic studies suggest that histone increases the maximal
      velocity (Vmax) of protamine kinase activity of PKC without affecting the
      affinity (Km). Other polycationic proteins such as polyarginine serine and
      polyarginine tyrosine were not found to influence PKC-mediated protamine
      phosphorylation, indicating that the observed effects are specific to histone,
      and are not general for all polycationic proteins. These results suggest that
      histone can modulate the protamine kinase activity of PKC by stimulating
      protamine-induced PKC-autophosphorylation.

PMID- 1640803
TI  - Anomalous binding of [3H]N-methyl-quinuclidinyl benzilate methyl chloride to
      human lymphocyte muscarinic receptors.
AB  - Using the muscarinic cholinergic ligand [3H]N-methyl quinuclidinyl benzilate
      methyl chloride ([3H]NM-QNB), we demonstrated that intact, viable human
      lymphocytes possess specific muscarinic binding sites. Equilibrium binding
      studies show that muscarinic acetylcholine receptor are divided into two subtype;
      high affinity (Ms) and low affinity types (Mw) for the ligand.

PMID- 1640804
TI  - Excitotoxin induction of ornithine decarboxylase in cerebral cortex is reduced by
      phospholipase A2 inhibition.
AB  - The enzyme ornithine decarboxylase (ODC) has been shown to be induced by a number
      of conditions such as cold-injury, kindling, ischaemia and excitotoxin injection.
      In previous studies we have characterised the cortical response to kainate
      injection into the nucleus basalis and shown a substantial increase in both ODC
      mRNA and enzyme activity which reaches a maximum at 8h. This response is
      completely prevented by treatment with MK-801, indicating the involvement of NMDA
      receptors in mediating this response. Whilst NMDA receptors are known to gate a
      cation channel leading to increased calcium entry, an additional effect on the
      release of arachidonic acid has been reported. The possibility that NMDA receptor
      mediated activation of phospholipase A2 and release of arachidonic acid might
      mediate this ODC response was investigated in this study by treatment with the
      phospholipase inhibitors quinacrine and dexamethasone. Treatment of animals with
      quinacrine (100 mg/kg) at the time of injection of kainate into the nucleus
      basalis caused a significant attenuation of the induction of ODC in cerebral
      cortex of 43%. No further attenuation was seen at higher doses. A similar
      reduction in ODC induction was seen after treatment with dexamethasone (1 mg/kg)
      but a greater effect could be obtained (65% attenuation) at higher doses. The
      possible involvement of arachidonic acid derivatives in mediating ODC induction
      was further investigated by treatment with the cyclo-oxygenase inhibitor
      indomethacin and the lipoxygenase inhibitor nordihydroguaiaretic acid (NDGA).
      Indomethacin was able to significantly attenuate the induction of ODC (greater
      than 60%) whilst NDGA (30 mg/kg) was ineffective. These results indicate the
      possible role of arachidonic acid derivatives in the regulation of the expression
      of ODC in cerebral cortex after excitotoxin injection.

PMID- 1640805
TI  - Fura-2 handling in a polarized epithelial barrier: the toad urinary bladder.
AB  - Toad bladders sacs were placed inside quartz cuvettes. When fura-2 AM was added
      to the mucosal compartment, low temperature (4 degrees C) almost completely
      blocked the transepithelial transfer of fluorescence observed at 20 degrees C (20
      degrees C = 371 +/- 56, 4 degrees C = 29 +/- 29 fluorescence intensity in
      arbitrary units (FIAU), excitation at 340 nm, emission at 510 nm).
      Simultaneously, fluorescence accumulation inside the tissue was significantly
      higher (20 degrees C = 25 +/- 5, 4 degrees C = 91 +/- 24% increase on basal
      levels (%IBL)). When fura-2 AM was added to the serosal side, low temperature
      also reduced the serosal to mucosal transfer (20 degrees C = 149 +/- 36, 4
      degrees C = 61 +/- 35 FIAU). Nevertheless, in this situation tissue accumulation,
      that was significantly higher that the one observed when fura-2 AM was added to
      the mucosal side, was reduced at low temperature (20 degrees C = 300 +/- 30, 4
      degrees C = 48 +/- 7 %IBL). Spectral analysis of the mucosal and serosal
      compartments indicated that free fura-2 was transferred from the intracellular to
      the serosal compartment, but not to the mucosal one. These results indicate that
      fura-2 appears as a useful tool to evaluate the cellular distribution and traffic
      of polycyclic charged and non-charged molecules.

PMID- 1640806
TI  - Ethanol/cocaine interaction: cocaine and cocaethylene plasma concentrations and
      their relationship to subjective and cardiovascular effects.
AB  - To investigate the pharmacologic effects of the interaction between ethanol and
      cocaine, eleven male, paid volunteers familiar with the use of both ethanol and
      cocaine were tested in a dose-response, placebo-controlled, single-blind,
      randomly-assigned, cross-over design. Ethanol (0.85 g/kg) or placebo was
      administered in divided doses over a thirty minute period. Fifteen minutes after
      the termination of ethanol ingestion, cocaine HCl (1.25 and 1.9 mg/kg) or placebo
      (lidocaine and mannitol) was given by nasal insufflation (snorting). Cocaine and
      cocaethylene plasma concentrations, blood ethanol levels, subjective ratings of
      drug effects, and cardiovascular parameters were measured. Statistical analysis
      of the results indicate that: 1) cocaine administration did not alter blood
      ethanol concentrations nor the ratings of ethanol intoxication; 2) ethanol caused
      a significant increase in cocaine plasma concentrations, ratings of cocaine
      "high", and heart rate; 3) acute tolerance to the subjective and heart rate
      effects of cocaine was observed; 4) when combined with cocaine, ethanol led to
      the slow formation of cocaethylene in amounts much lower than those of its parent
      compound; and 5) the appearance of cocaethylene in plasma did not alter cocaine's
      subjective and cardiovascular effects.

PMID- 1640807
TI  - Effects of exercise on immune functions of undernourished mice.
AB  - Regular moderate exercise may modulate the response to a stressor and thus
      improve immune functions in conditions commonly associated with immunodepression
      and elevated levels of stress hormones. For example, anorexia nervosa patients,
      many of whom engage in regular aerobic exercise, generally have normal immune
      function and viral disease resistance in spite of their severe undernutrition. To
      test the hypothesis that exercise can prevent undernutrition-induced
      immunodepression, mice were fed a nutritionally complete, semi-purified diet,
      either ad libitum or in restricted quantities to induce 25% loss of initial
      weight over 3 weeks. Half the animals from each dietary group were run on a
      treadmill for 30 min/day, 5 days/week. Exercise had no effect on several measures
      of nutritional status. Spleen weight and blastogenic response to
      lipopolysaccharide were significantly increased by exercise in undernourished
      mice. In vivo antibody response to sheep red blood cells, and in vitro splenic
      responses to concanavalin A and phytohemagglutin were not significantly affected
      by exercise. Serum corticosterone level was increased by food restriction and
      significantly decreased by exercise in the undernourished mice. Within a
      treatment group there were no significant correlations between serum
      corticosterone level and any immune system measure. Hypothalamic concentration of
      uric acid was increased in food restriction groups and concentration of
      norepinephrine was increased in exercise groups. The results suggest that regular
      exercise may help prevent undernutrition-induced immunodepression, possibly
      through modulation of the stress response.

PMID- 1640808
TI  - In vitro oxidation of oxicam NSAIDS by a human liver cytochrome P450.
AB  - The nature of the enzyme(s) catalyzing the major metabolic pathway (5'
      hydroxylation) of oxicam NSAIDs was investigated in subcellular preparations of
      human liver tissue. Microsomal, but not cytosolic, fractions catalyzed the 5'
      hydroxylation of tenoxicam. This reaction required NADPH and was inhibited by
      various nonselective P450 inhibitors (CO, SKF-525A, ketoconazole), but not by the
      peroxidase inhibitor NaN3. Tenoxicam 5'-hydroxylation exhibited simple Michaelis
      menten kinetics compatible with catalysis by a single enzyme, but it strongly
      inhibited its own oxidation at concentrations higher than 100-150 microM.
      Piroxicam competitively inhibited tenoxicam 5'-hydroxylation and, conversely,
      tenoxicam competitively inhibited piroxicam 5'-hydroxylation. Tenoxicam 5'
      hydroxylation kinetics were similar in microsomes from one poor and five
      extensive metabolizers of debrisoquin (CYP2D6). Dextromethorphan (CYP2D6
      prototype substrate) and midazolam (CYP3A prototype substrate) had no influence
      on tenoxicam 5'-hydroxylation, whereas mephenytoin, tolbutamide and
      sulfaphenazole (Ki = 0.1 microM) inhibited it. This indicates that the 5'
      hydroxylation of both piroxicam and tenoxicam is predominantly catalyzed by at
      least one cytochrome P450 isozyme of the CYP2C subfamily.

PMID- 1640809
TI  - DAU 6285: a novel antagonist at the putative 5-HT4 receptor.
AB  - The antagonistic properties of DAU 6285, an azabicycloalkyl benzimidazolone
      derivative, at putative 5-hydroxytryptamine4 (5-HT4) receptors were investigated
      in in vitro preparations of guinea-pig ileum and human atrium, in comparison to
      ICS 205-930. DAU 6285 behaved as a competitive antagonist in all the preparations
      examined. Its affinity (pA2) ranged between 6.50 and 7.12 in the test models
      considered. The affinity of ICS 205-930 was 2-3 fold lower. At variance with ICS
      205-930, DAU 6285 displayed a weak affinity for 5-HT3 receptors (pKi = 6.1, rat
      cortex; pA2 less than 5, guinea-pig ileum). In the guinea-pig ileum, DAU 6285 (10
      microM) did not exert antimuscarinic, antihistaminic, antinicotinic or myolytic
      activity. Moreover, it did not bind to other 5-HT receptor subtypes, or to
      adrenergic, dopaminergic, benzodiazepine, nicotine, GABA receptors. DAU 6285 may
      represent a suitable tool for studies in the field of 5-HT4 receptors.

PMID- 1640810
TI  - In vivo binding of [11C]tetrabenazine to vesicular monoamine transporters in
      mouse brain.
AB  - The time course of regional mouse brain distribution of radioactivity after i.v.
      injection of a tracer dose of [11C]tetrabenazine ([11C]TBZ) has been determined.
      Radiotracer uptake into brain is rapid, with 3.2% injected dose in the brain at 2
      min. Egress from the brain is also very rapid, with only 0.21% of the injected
      dose still present in brain at 60 min. Radiotracer washout is slowest from the
      striatum and hypothalamus, consistent with binding to the higher numbers of
      vesicular monamine transporters in those brain regions. The rank order of
      radioligand binding at 10 min after injection is striatum greater than
      hypothalamus greater than hippocampus greater than cortex = cerebellum, similar
      to that found using in vitro assays of the vesicular monoamine transporters.
      Maximum ratios of striatum/cerebellum and hypothalamus/cerebellum were 2.85 +/-
      0.52 and 1.69 +/- 0.25, respectively, at 10 min after injection. Co-injection of
      unlabeled tetrabenazine (10 mg/kg) or pretreatment with reserpine (1 mg/kg i.p.,
      24 h prior) was used to demonstrate specific binding of radioligand in striatum,
      hypothalamus, cortex, hippocampus and cerebellum. Distribution of [11C]TBZ was
      unaffected by pretreatment with the neuronal dopamine uptake inhibitor GBR 12935
      (20 mg/kg i.p., 30 min prior). [11C]Tetrabenazine is thus a promising new
      radioligand for the in vivo study of monoaminergic neurons using Positron
      Emission Tomography.

PMID- 1640811
TI  - Effects of cyclosporin A on induced HIT cell alkalinization.
AB  - We studied whether therapeutic doses of cyclosporin A (CsA) modify the effects of
      nutrient and non-nutrient stimuli on pHi, in the insulin-secreting beta-cell line
      HIT-T15. Glucose caused a transient acidification, followed by alkalinization.
      CsA failed to block this alkalinization. PMA elicited a gradual alkalinization by
      a protein kinase C mediated mechanism which is not inhibited by CsA. The
      depolarization with high K+ was associated with a rise in pHi. CsA was able to
      completely block this increase in pHi. Ionomycin induced a rapid cytosolic
      alkalinization partially inhibited by CsA. We conclude that in HIT-T15 cells,
      therapeutical doses of CsA inhibit the Ca(2+)-dependent pathway of Na+/H+
      antiport activation but not protein kinase C activation of this exchanger.

PMID- 1640812
TI  - Effects of endothelin on microcirculation of the pancreas.
AB  - Endothelin, a newly described endothelial-derived peptide, has potent
      vasoconstrictive properties and has been speculated to play a physiological role
      in the regulation of blood flow in some organs. The present study was designed to
      evaluate the effects of endothelin-1, endothelin-2 and endothelin-3 on the
      pancreatic microcirculation. Pancreatic tissue blood flow was measured by a laser
      Doppler flow meter in anesthetized dogs and endothelin-1, endothelin-2 or
      endothelin-3 was injected intravenously in graduated doses. Endothelins induced
      dose-dependent decreases in pancreatic tissue blood flow. Endothelin-1,
      endothelin-2 and endothelin-3 at a dose of 100 pmol/kg reduced pancreatic blood
      flow by 45.4%, 19.6% and 51.9%, respectively, whereas systemic arterial blood
      pressure was not significantly affected. When endothelin-3 was administered at a
      dose of 1000 pmol/kg, pancreatic blood flow was decreased by 73.5% with a
      concomitant increase of systemic arterial blood pressure by 17.6%. Endothelins
      potently decreased pancreatic tissue blood flow, suggesting a possible role of
      these agents in regulating the pancreatic microcirculation.

PMID- 1640813
TI  - The use of microdialysis for studying the regional effects of pharmacological
      manipulation on extracellular levels of amino acids--some methodological aspects.
AB  - The purpose of this study was to examine and validate the use of microdialysis
      for sampling and pharmacologically manipulating extracellular amino acids in the
      brain. Repeated use of microdialysis probes in acute intracerebral experiments
      did not significantly alter the relative recovery in vitro for the amino acids
      quantitated (GABA, aspartate, glutamate, glycine, taurine, and alanine). Regional
      differences in basal levels of some of the amino acids were detected in
      dialysates collected from the dorsomedial hypothalamus, striatum, and frontal
      cortex. The percent in vitro recoveries for the amino acids from the probes used
      in the three regions were not significantly different suggesting that the
      regional differences in basal levels of amino acids were functionally derived and
      not a consequence of variations in probe recovery. Perfusion with nipecotic acid,
      an inhibitor of GABA uptake, resulted in selective elevations in extracellular
      GABA in the three regions studied. Conversely, perfusion with high-potassium, a
      depolarizing agent, resulted in significant elevations in not only extracellular
      GABA but also aspartate, glutamate, and taurine. Thus, microdialysis is a method
      which can be employed to assess and to pharmacologically manipulate extracellular
      amino acids in the rat brain.

PMID- 1640814
TI  - Congressional medical payments: then and now.

PMID- 1640815
TI  - Deeds, drugs, and dogs.

PMID- 1640816
TI  - University of Maryland Medical System: American medicine's first teaching
      facility reinvents the academic hospital.
AB  - The University of Maryland Medical School, established in 1807, focused on
      bedside teaching. This emphasis has continued and expanded through the growth of
      University Hospital and, ultimately, the University of Maryland Medical System,
      such that Maryland can now boast of a superb medical care system providing
      excellent medical education and research opportunities in a patient care setting.

PMID- 1640817
TI  - Aging and humoral immunity.
AB  - If human antibody responses undergo molecular shifts similar to those identified
      in mice, the appropriate immunization strategy for the elderly would be a passive
      administration of the protective antibody from young donors rather than an
      attempt to boost the individual's own response with a more potent vaccine,
      because the shifted immune system can no longer make the right kind of antibody.

PMID- 1640818
TI  - An overview of follicular development in the ovary: from embryo to the fertilized
      ovum in vitro.

PMID- 1640820
TI  - Pancreas transplants.

PMID- 1640819
TI  - Progress in understanding the nicotinic acetylcholine receptor function at
      central and peripheral nervous system synapses through toxin interactions.
AB  - The need to treat diseases affecting the nicotinic AChR is great, but therapeutic
      options are few. Through careful correlation of structure-activity relationships
      of AnTX analogs, we may ultimately be led to the development of diagnostic and
      therapeutic drugs with specific nicotinic agonist or antagonist activities in the
      central nervous system that would be of major importance in the treatment of
      Alzheimer's disease.

PMID- 1640822
TI  - MNA files comprehensive HIV legislation.

PMID- 1640821
TI  - Imaging case of the month. Alzheimer's disease.

PMID- 1640823
TI  - Do you know your responsibilities as a nurse?

PMID- 1640824
TI  - Lucy Lincoln Dworn Nursing History Society. Sister Amy: pediatric nurse,
      education, administrator, innovator.

PMID- 1640825
TI  - The staff nurses' guide for a JCAHO visit.

PMID- 1640826
TI  - Enabling professional nursing staff to conduct research.

PMID- 1640827
TI  - FDA safety alert: needlestick risks.

PMID- 1640828
TI  - Membrane-associated GTPases in bacteria.
AB  - Members of the GTPase superfamily are extremely important in regulating membrane
      signalling pathways in all cells. This review focuses on membrane-associated
      GTPases that have been described in prokaryotes. In bacteria, LepA and NodQ are
      very similar to protein synthesis elongation factors but apparently have membrane
      related functions. The amino acid sequences of FtsY and Ffh are clearly related
      to eukaryotic factors involved in protein secretion. Obg and Era are not closely
      related to any GTPase subgroup according to amino acid sequence comparisons, but
      they are essential for viability. In spite of similarities to well-studied
      eukaryotic proteins the signalling pathways of these cellular regulators, with
      the exception of NodQ, have not yet been elucidated.

PMID- 1640829
TI  - Inducible DNA repair and differentiation in Bacillus subtilis: interactions
      between global regulons.
AB  - The SOS response of Escherichia coli has become a paradigm for the study of
      inducible DNA repair and recombination processes in many different organisms.
      While these studies have demonstrated that the components of the SOS response
      appear to be highly conserved among bacterial species, as with most models, there
      are some significant variations. Perhaps the best example of this comes from an
      analysis of the SOS-like system of the developmental organism, Bacillus subtilis.
      Accordingly, the most striking difference is the complex developmental regulation
      of the SOS system as this organism differentiates into its competent state. In
      this review we have given an overview of the elements that comprise the SOS
      system of B. subtilis. Additionally, we have summarized our most recent findings
      regarding the regulation of this regulon. Using these results along with new
      findings from other laboratories we have provided provocative molecular models
      for the regulation of the B. subtilis SOS system in response to DNA damage and
      during competent cell formation.

PMID- 1640830
TI  - Cytotoxic activity of a recombinant chimaeric protein between Pseudomonas
      aeruginosa exotoxin A and Corynebacterium diphtheriae diphtheria toxin.
AB  - A segment of the exotoxin A gene of Pseudomonas aeruginosa, coding for the N
      terminal end of domain I and domain II of the toxin (ETA), was genetically fused
      to the diphtheria toxin gene of Corynebacterium diphtheriae, coding for the N
      terminal end of A fragment of diphtheria toxin (DT). The resulting hybrid protein
      (termed CED1) was produced in large amounts and exported to the periplasm in
      Escherichia coli. This chimaeric protein reacted with both anti-ETA and anti-DT
      antisera. Furthermore, the chimaeric protein displayed ADP-ribosylation activity
      and exhibited cytotoxicity to mouse 3T6 fibroblasts. These results demonstrated
      that the chimaeric protein is cytotoxic, and that the toxic potential of DTA can
      be selectively internalized and translocated via domains I and II of exotoxin A,
      which are thus sufficient to direct and translocate an enzymatically active
      heterologous polypeptide segment into the cytosol of sensitive cells.

PMID- 1640831
TI  - Transcriptional control of sex-pheromone-inducible genes on plasmid pAD1 of
      Enterococcus faecalis and sequence analysis of a third structural gene for (pPD1
      encoded) aggregation substance.
AB  - The expression of several neighbouring genes on plasmid pAD1 that are necessary
      for conjugation depend on induction with sex pheromone cAD1. Analyses of
      transcripts by Northern blot hybridization demonstrated that the genes sea1
      (encoding surface exclusion protein) and asa1 (encoding aggregation substance)
      are transcribed independently. Both genes are organized in different operons
      together with neighbouring open reading frames of unknown function. Several
      transcripts could be identified for sea1 and asa1. Their transcriptional start
      sites were determined by primer extension experiments, confirming the results of
      the Northern blot experiments. We also could identify sea1- and iad- (encoding an
      inhibitory peptide counteracting sex pheromone cAD1) specific transcripts which
      are expressed constitutively, but to a lower extent relative to induced
      conditions. In addition, we localized the asp1 gene coding for aggregation
      substance of sex pheromone plasmid pPD1 and determined its DNA sequence, which
      was found to be highly homologous to asa1 (aggregation substance gene of pAD1)
      and prgB (aggregation substance gene of pCF10). The structural genes were found
      to be organized more or less identically on the three sex-pheromone plasmids
      pAD1, pCF10, and pPD1, and to be highly conserved. Regions supposed to be of
      crucial importance for regulatory functions, however, were found to differ. We
      also could identify some conserved DNA motifs which might be potential target
      sites for transcriptional regulators. In combination these data allowed us to
      formulate a model for the regulation of sex-pheromone-inducible genes of plasmid
      pAD1. Its main statement is that only in the presence of cAD1 can the gene traE1
      be transcribed. The positive regulatory factor TraE1 then can trigger expression
      of the structural genes sea1 and asa1.

PMID- 1640832
TI  - Ferrioxamine uptake in Yersinia enterocolitica: characterization of the receptor
      protein FoxA.
AB  - The gene for the high-affinity outer membrane ferrioxamine receptor FoxA of
      Yersinia enterocolitica was cloned in Escherichia coli K-12. A foxA mutant of
      Yersinia could be complemented by the cloned DNA fragment. The FoxA encoding
      region was sequenced and an open reading frame encoding 710 amino acids,
      including a signal sequence of 26 amino acids, was deduced. The mature FoxA
      protein consisted of 684 amino acids and had a molecular mass of 75,768 Da. FoxA
      shared 33% amino acid sequence homology with FhuA, the ferrichrome receptor of
      Escherichia coli. Based on the homologies with FhuA and other TonB-dependent
      receptors a topological model of FoxA is presented.

PMID- 1640833
TI  - Outer membranes of gram-negative bacteria are permeable to steroid probes.
AB  - The permeability of bacterial outer membranes was assayed by coupling the influx
      of highly hydrophobic probes, 3-oxosteroids, with their subsequent oxidation
      catalysed by 3-oxosteroid delta 1-dehydrogenase, expressed from a gene cloned
      from Pseudomonas testosteroni. In Salmonella typhimurium producing wild-type
      lipopolysaccharide, the permeability coefficients for uncharged steroids were
      0.45 to 1 x 10(-5) cm s-1, and the diffusion appeared to occur mainly through the
      lipid bilayer domains of the outer membrane. These rates are one or two
      magnitudes lower than that expected for their diffusion through the usual
      biological membranes. The permeation rates were markedly increased (up to 100
      times) when the lipopolysaccharide leaflet was perturbed either by adding
      deacylpolymyxin or by introducing mutations leading to the production of deep
      rough lipopolysaccharides. An amphiphilic, negatively charged probe, testosterone
      hemisuccinate, penetrated much more slowly than the uncharged steroids. Study of
      various Gram-negative species revealed that P. testosteroni, Pseudomonas
      acidovorans, and Acinetobacter calcoaceticus showed higher outer membrane
      permeability to steroid probes and higher susceptibility to hydrophobic agents
      such as fusidic acid, novobiocin and crystal violet relative to S. typhimurium
      and Escherichia coli.

PMID- 1640834
TI  - Characterization of the Escherichia coli codBA operon encoding cytosine permease
      and cytosine deaminase.
AB  - The nucleotide sequence of a 3.1 kb segment carrying the cytosine deaminase gene
      (codA) from Escherichia coli was determined. The sequence revealed the presence
      of two open reading frames, the first (codB) specifying a highly hydrophobic
      polypeptide and the second specifying cytosine deaminase. A two-codon overlap
      between the two reading frames indicates that they constitute an operon.
      Transcription of the operon was found to be regulated by exogenous purines.
      Polypeptides specified by each of the two reading frames were expressed in
      minicells, and the codB gene product was found to be highly enriched in the
      membrane fraction. Uptake experiments showed that the CodB protein is required
      for cytosine transport into the cell and that the intracellular accumulation of
      cytosine correlated with the codB gene dose. A topological model for the cytosine
      permease in the cytoplasmic membrane is proposed.

PMID- 1640835
TI  - The amino acid sequence of a Bacillus subtilis phosphoprotein that matches an
      orfY-tsr coding sequence.
AB  - Bacillus subtilis contains a 30 kDa protein which was phosphorylated during late
      vegetative growth and sporulation. The sequence for the N-terminal 16 amino acids
      was found to be identical to the predicted sequence for the N-terminus of a small
      open reading frame, orfY, but diverged from the predicted sequence thereafter.
      The orfY region was resequenced and contained one less adenine residue than
      previously reported, resulting in an open reading frame from within orfY through
      the entire coding region for tsr which follows orfY. The predicted orfY-tsr amino
      acid sequence showed 24% identity to Escherichia coli fructose-1,6-bisphosphate
      aldolase. Two mutants in the tsr region had 2-5% of wild-type aldolase and the
      nucleotide sequences showed missense mutations. These results indicate that orfY
      tsr encodes aldolase and should be renamed fba1.

PMID- 1640836
TI  - The Aeromonas hydrophila exeE gene, required both for protein secretion and
      normal outer membrane biogenesis, is a member of a general secretion pathway.
AB  - The Aeromonas hydrophila Tn5-751 insertion mutant L1.97 is unable to secrete
      extracellular proteins, and is fragile because of defective assembly of its outer
      membrane. A KpnI 4.1 kb fragment, which complements this mutant when supplied
      with an exogenous promoter, was isolated and sequenced. It contains two complete
      genes, exeE and exeF, plus fragments of two others and may form part of an
      operon. The exeE and exeF open reading frames encode 501-residue M(r) 55,882 and
      388-residue M(r) 43,431 proteins, respectively. These genes were expressed in
      vitro and their initiation codons verified by deletion analysis. Tn5-751 had
      inserted near the centre of the exeE gene in the L1.97 strain. Subclones of the
      KpnI 4.1 kb fragment which contained only the exeE gene fully complemented the
      mutation, indicating that its function is required both for extracellular
      secretion and outer membrane assembly. ExeE and ExeF are highly similar to other
      proteins which have been shown to be involved in extracellular secretion,
      suggesting that an additional export apparatus beyond that required for inner
      membrane translocation may be part of the physiology of many Gram-negative
      bacteria.

PMID- 1640837
TI  - Expression of extracellular phospholipase from Serratia liquefaciens is growth
      phase-dependent, catabolite-repressed and regulated by anaerobiosis.
AB  - Many members of the genus Serratia synthesize and excrete a number of
      extracellular hydrolytic enzymes. One of these is the phospholipase A1 from
      Serratia liquefaciens, the expression of which is growth-phase-dependent. Through
      the use of gene fusions and primer extension analysis we show that the expression
      of phospholipase is subject to positive transcriptional regulation of a dual
      promoter system; one promoter positioned approximately 600bp upstream from the
      phlA gene is responsible for the induction of phospholipase expression under
      anaerobic conditions, and the other promoter positioned 50bp upstream from the
      phlA gene is subject to catabolite repression and induced during the transition
      from exponential to late log-phase of bacterial growth. On the basis of sequence
      homology and behaviour in the relevant Escherichia coli mutants, we suggest that
      distant promoter to be Fnr-controlled and the proximal phlA promoter to be a
      member of the FIbB-controlled flagellar-chemotaxis regulon.

PMID- 1640838
TI  - Compliance and quality in residential life. Rhetoric and realities in today's
      ICF/MR: control out of control.
AB  - Contrasts between the rhetoric of quality assurance and the realities of poor
      quality in today's ICFs/MR were explored. Comparative studies have shown that
      ICFs/MR provide the poorest quality of life for persons with mental retardation.
      The ICF/MR operational model was described here as paper-oriented, failure-based,
      and insensitive to the effects of its own practices. Recommendations, including
      the establishment of local control, a less-direct relation between funding and
      rule compliance, and alternate forms of program evaluation and monitoring, were
      made.

PMID- 1640839
TI  - Compliance and quality in residential life. From standards to compliance, to good
      services, to quality lives: is this how it works?
AB  - Licensing and certification of ICFs/MR can adversely affect individuals, distort
      the allocation of (and waste) scarce resources, and encourage community
      residences to become small institutions. At a home in Northern California, used
      as a case study, recent interest in active treatment has emphasized good paper
      rather than good service or quality lives. Several recommendations were offered
      to encourage responsive services in line with progressive values and the wants
      and needs of individuals with developmental disabilities.

PMID- 1640840
TI  - Compliance and quality in residential life. Analyzing the impact of regulations
      on residential ecology.
AB  - Viewed from a behavior analytic perspective as a form of verbal behavior,
      regulatory rules affect the behavior of service providers in residential programs
      directly and indirectly; they can facilitate habilitative services or exert a
      powerful counter-habilitative influence. Because regulations are written to apply
      to the general case, regulatory rules tend to become decontextualized, often
      failing to address (a) the needs of individuals and (b) specific environmental
      circumstances. Ecobehavioral analysis of rule-governed behavior in residential
      settings can provide a means of understanding and measuring the effects of
      regulatory rules. Feedback from field settings about the effects of regulatory
      rules on the behavior of people who live and work in residential settings would
      help to recontextualize the rule-making process and promote better correspondence
      between the intended effects of regulations and their actual effects.

PMID- 1640841
TI  - Compliance and quality in residential life. Limitations of regulations as a means
      of social reform in developmental services.
AB  - It has become obvious that community care systems for people with developmental
      disabilities are not fully realizing some of the stated goals toward which they
      are directed, despite great process. The foundations and processes by which state
      agencies regulate and whether the regulatory process can be directed to issues
      affecting the quality of life of people receiving developmental services were
      explored. Limitations and side effects of regulations were discussed with respect
      to the unpredictability of long-term effects, problems in measuring compliance,
      economic rather than social focus, the changing state of knowledge, and special
      considerations associated with the field of developmental services.

PMID- 1640842
TI  - Receptor-dependent and -independent catabolism of low-density lipoprotein in a
      kindred with familial hypobetalipoproteinemia.
AB  - Three affected members of a kindred with asymptomatic hypobetalipoproteinemia
      (HBL) were injected intravenously with 125I-labeled native low-density
      lipoproteins (LDL) and 131I-labeled cyclohexanedione (CHD)-treated LDL. Plasma
      and urine radioactivity data were collected for 15 days at regular intervals. A
      compartmental model using the SAAM program was built to fit simultaneously 125I
      and 131I plasma radioactivity decay and urine excretion data. This model allows
      precise calculation of the kinetic parameters of both receptor-independent (NR)
      and receptor-dependent (R) pathways. Compared with normal subjects, HBL patients
      show a 90% increased fractional catabolic rate (FCR) of LDL by both routes, more
      marked for the R pathway (215% increase), and an approximately 50% reduced
      production rate (PR). Structural analysis did not show significant abnormalities
      of apolipoprotein (apo) B in HBL patients compared with normal. These data
      suggest that the very reduced, LDL-apo B plasma levels result from a combination
      of two processes: (1) an increased activity of all catabolic routes, and (2) a
      reduced "synthesis" rate. The latter may result from a decreased conversion of
      very-low-density lipoprotein (VLDL) to LDL secondary to an increased direct
      removal of large VLDL, suggested by apo C-II and C-III turnover studies
      previously reported.

PMID- 1640843
TI  - beta-Endorphin and cortisol abnormalities in spinal cord-injured individuals.
AB  - Plasma beta-endorphin-like immunoreactivity (BEP-ir) and cortisol levels were
      measured by radioimmunoassay (RIA) in nine patients who were at least 12 months
      status post spinal cord injury (SCI). Plasma levels were obtained at 8:00 am and
      4:00 pm to determine circadian rhythm, and on the day following administration of
      1 mg dexamethasone, levels were again obtained at 8:00 am and 4:00 pm. The mean
      morning levels of plasma BEP-ir were significantly lower than control values for
      this laboratory (6.2 +/- 1.2 v 12.0 +/- 2.3 pg/mL). The morning BEP-ir values
      were lowest in patients who were closer to the time of injury (described by a
      second-order polynomial regression, R = .89; P less than .01). Mean morning
      cortisol levels were not significantly different from controls, but showed
      greater variability (mean, 15.1; range, 0.7 to 22.7 micrograms/dL v control,
      15.5; range, 7 to 35). Dexamethasone suppressed cortisol secretion in all
      patients and BEP-ir levels in six of nine patients. Failure to detect BEP-ir
      suppression occurred in patients whose BEP-ir levels were less than 4.5 pg/mL and
      close to the minimum detection limit of the assay. Depression was present in five
      of nine patients as measured by the Beck Depression Inventory (BDI) and in three
      of nine patients as measured by the Hamilton Depression Scale (HSRD). However,
      the depression indices did not correlate with the neuroendocrine measures.

PMID- 1640844
TI  - Thermic effect of epinephrine: a role for endogenous insulin.
AB  - The contribution of the basal insulin concentration to the metabolic response to
      epinephrine was measured in eight, postabsorptive, healthy volunteers before and
      during epinephrine (0.05 micrograms/kg fat-free mass [FFM] x min) and
      somatostatin (500 micrograms/h) infusion with and without insulin (0.1 mU/kg body
      weight [BW] x min) replacement. At basal plasma insulin concentrations,
      epinephrine increased oxygen consumption, heart rate, heart work, hepatic glucose
      production, glycogen breakdown in liver and muscle, and glucose oxidation, and
      the arterial plasma concentrations of glucose, lactate, and free fatty acids.
      Similar effects were observed during hypoinsulinemia, but epinephrine's actions
      on oxygen consumption and plasma concentrations of free fatty acids were
      disproportionally enhanced. We conclude that epinephrine-induced thermogenesis is
      partially inhibited by basal plasma insulin concentrations.

PMID- 1640845
TI  - Pravastatin lowers serum cholesterol, cholesterol-precursor sterols, fecal
      steroids, and cholesterol absorption in man.
AB  - Serum lipids, and absorption, intestinal fluxes, fecal elimination, and synthesis
      of cholesterol were studied before and during 4 weeks of pravastatin treatment at
      a dose of 40 mg/d in heterozygous familial hypercholesterolemic (FH) patients
      without (control group, n = 7) and with an ileal bypass (IBP group, n = 6). The
      drug reduced serum total and low-density lipoprotein (LDL) cholesterol and LDL
      apoprotein (apo)B levels up to 34%. Less-consistent decreases in intermediate
      density lipoprotein (IDL) and very-low-density lipoprotein (VLDL) cholesterol
      were also seen. None of the control patients and two of the IBP patients became
      normolipidemic (LDL less than 4 mmol/L). Marked transient reductions in serum
      free-methylated-cholesterol precursors, and more-constant decreases in the
      esterified and total fractions, suggested that cholesterol synthesis was reduced
      shortly after the start of treatment. The decreases in total lathosterol and
      methylsterols were more extensive in the IBP group than in the control group.
      Serum plant sterol levels were slightly increased, with inconsistent elevations
      of cholestanol. Reduced fecal elimination of cholesterol and its precursors
      suggests that decreased cholesterol synthesis was mainly due to lowered bile acid
      production, particularly in the IBP group with markedly enhanced basal bile acid
      and cholesterol synthesis. The serum and fecal levels of cholesterol precursors,
      lathosterol in particular, were related to each other and were proportionate to
      the serum level and fecal elimination of cholesterol.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1640846
TI  - Metabolism of very-low-density lipoprotein triglyceride by human placental cells:
      the role of lipoprotein lipase.
AB  - Several studies have shown lipoprotein lipase (LPL) activity in human placenta,
      but the quantitative significance and cellular specificity of LPL in this organ
      are unknown. The objective of this report is to investigate the metabolism of
      very-low-density lipoprotein triglycerides (VLDL-TG) by the placenta, the role of
      LPL in this process, and the types of cells involved. Placental cells were
      obtained by enzymatic digestion (collagenase, hyaluronidase, and DNA-ase) and
      separated on a 40% Percoll gradient. The trophoblasts were the predominant cell
      type (80% to 85% pure) isolated at d = 1.033 to 1.048 and macrophages were
      predominant at d = 1.077 to 1.100 (greater than 95% pure), as characterized by
      eight immunocytochemical assays using cell protein-specific monoclonal
      antibodies. Macrophages represented 50% to 60% of cells isolated, and
      trophoblasts, 40% to 50%. LPL activity was assessed by VLDL-TG hydrolysis in
      primary 3- to 4-day tissue culture. In a representative experiment, LPL activity
      (nmol fatty acids (FA)/mg protein/24 h) was 101.3 +/- 5.3 in macrophages and 29.9
      +/- 6.5 in the predominant trophoblast cell types, with approximately 20% of
      these amounts incorporated and reesterified. VLDL-TG hydrolysis and cell lipid
      uptake in both placental cell types was essentially abolished by a monoclonal
      anti-LPL antibody. When compared with a model of hepatocytes (Hep G2 cells), the
      hydrolysis of VLDL-TG was almost undetectable in these cells. In contrast, free
      fatty acids (FFA) uptake by Hep G2 cells was fourfold to sixfold greater than
      that by macrophages and trophoblasts, respectively. In conclusion, macrophages
      and trophoblasts are the two predominant placental cells isolated by enzymatic
      digestion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640847
TI  - Effects of morbid obesity on insulin clearance and insulin sensitivity in several
      aspects of metabolism as assessed by low-dose insulin infusion.
AB  - Obesity is associated with impaired insulin action in glucose disposal, but not
      necessarily in other aspects of intermediary metabolism or insulin clearance.
      Sixteen morbidly obese and 14 normal-weight subjects (body mass index, 51.2 +/-
      11.5 v 22.1 +/- 2.2 kg.m-2; mean +/- SD) were studied with sequential, low-dose,
      incremental insulin infusion with estimation of glucose turnover. In obese
      patients, basal plasma insulin was higher (10.5 +/- 3.8 v 2.4 +/- 3.0 mU.L-1, P
      less than .001) and remained elevated throughout infusion (F = 492, P less than
      .001), as did C-peptide (F = 22.7, P less than .001). Metabolic clearance rate
      for insulin (MCRI) at the highest infusion rate was similar (1,048 +/- 425 v
      1,018 +/- 357 mL.m-2.min-1, NS). Basal hepatic glucose production in obese
      subjects was less than in normal-weight subjects (270 +/- 108 v 444 +/- 68
      mumol.m-2.min-1, P less than .01), as was the basal metabolic clearance rate for
      glucose (MCRG, 77 +/- 26 v 108 +/- 31 mL.m-2.min-1, P less than .05). Insulin
      infusion caused blood glucose to decrease less in the obese patients (1.4 +/- 0.5
      v 1.9 +/- 0.5 mmol.L-1, P less than .05); hepatic glucose production was
      appropriately suppressed in them by hyperinsulinemia, but their insulin-mediated
      glucose disposal was reduced (1.67 [0.79] v 4.45 [2.13] mL.m-2.min-1/mU.L-1, P
      less than .01). Concentrations of nonesterified fatty acids (NEFA), glycerol, and
      ketones were elevated throughout the insulin infusions in obese patients, despite
      the higher insulin concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640848
TI  - Vitamin E restores reduced prostacyclin synthesis in aortic endothelial cells
      cultured with a high concentration of glucose.
AB  - Reduced prostacyclin (PGI2) production by the vascular wall may play an important
      role in the pathogenesis of vascular lesions such as atherosclerosis. The present
      study was undertaken to evaluate the effect of vitamin E on the production of
      PGI2 and other prostaglandins (prostaglandin E2 [PGE2], thromboxane A2 [TXA2],
      and 15-hydroxyeicosatetraenoic acid [15-HETE]) by bovine aortic endothelial cells
      cultured in a high concentration of glucose (300 mg/dL). Compared with
      endothelial cells cultured in 100 mg/dL glucose, the production of PGI2 and other
      prostaglandins, except 15-HETE, was significantly reduced in cultures containing
      300 mg/dL glucose when stimulated by histamine, the Ca2+ ionophore, A23187, or
      human plasma-derived serum (PDS). The addition of vitamin E to each stimulant
      significantly restored the production of PGI2, PGE2, and TXA2, products of the
      cyclo-oxygenase pathway, in aortic endothelial cells cultured in 300 mg/dL
      glucose. This effect of vitamin E on the stimulation of prostaglandin production
      was generally specific for D-alpha-tocopherol, but not for the other vitamin E
      analogs tested. However, vitamin E and the stimulants had no effect on the
      production of 15-HETE, a product of the lipoxygenase pathway. Moreover, vitamin E
      alone, without stimulants, did not affect prostaglandin production in cultured
      bovine aortic endothelial cells. These results suggest that vitamin E may restore
      reduced PGI2, PGE2, or TXA2 production by bovine aortic endothelial cells
      cultured in a high concentration of glucose. It seems likely that vitamin E may
      restore depressed PGI2 production by the vascular wall in hyperglycemic
      conditions such as those seen in patients with diabetes mellitus.

PMID- 1640849
TI  - Effect of chromium administration on glucose tolerance in stroke-prone
      spontaneously hypertensive rats with streptozotocin-induced diabetes.
AB  - The present study was conducted to assess the effect of chromium (Cr)
      administration on glucose tolerance in insulin-dependent diabetes that
      accompanies hypertension. Four rat groups were used: stroke-prone spontaneously
      hypertensive rats (SHRSP) and normotensive Wistar Kyoto rats (WKY) with and
      without streptozotocin (SZ, 40 mg/kg)-induced diabetes. Each group of rats was
      subdivided to the Cr-dose group and the control group. The Cr-dose group, which
      was intraperitoneally administered Cr solution (20 micrograms trivalent
      chromium/kg body weight/d for 4 weeks), and the control group (saline) were
      studied for plasma glucose and plasma insulin during intraperitoneal glucose
      tolerance test (IPGTT) and insulin action by isolated adipocytes. For diabetic
      SHRSP showing the highest plasma glucose and lowest plasma insulin among the four
      groups, Cr administration led to the greatest reduction in plasma glucose without
      a significant effect on plasma insulin during IPGTT. For each diabetic WKY and
      normal SHRSP and WKY, those given Cr showed lower levels of plasma glucose with
      lower levels of plasma insulin than the controls. For diabetic SHRSP, glucose
      uptake by isolated adipocytes in the Cr-dose group was higher than that in the
      control group. This effect of Cr administration involved enhancement of insulin
      responsiveness and sensitivity, attributed to enhanced affinity of the insulin
      receptor. A similar tendency was observed for diabetic WKY. However, for normal
      SHRSP and WKY, the increase in glucose uptake due to Cr administration coincided
      only with enhanced insulin responsiveness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640850
TI  - Effect of leucine on amino acid and glucose metabolism in humans.
AB  - Leucine has been reported to be an important regulator of protein metabolism. We
      investigated the effect of intravenous infusion of L-leucine versus saline on
      amino acid metabolism in eight healthy human subjects. Plasma concentrations of
      amino acids were measured and protein turnover was estimated using L-(1
      13C)lysine and L-(3,3,3,-2H3)leucine as tracers. Glucose kinetics were measured
      using D-(6,6-2H2)glucose as a tracer. Leucine infusion increased the plasma
      leucine concentration from 103 +/- 8 to 377 +/- 35 mumol/L (P less than .01).
      Plasma concentrations of essential amino acids, including threonine, methionine,
      isoleucine, valine, tyrosine, and phenylalanine were significantly decreased by
      leucine infusion. Leucine infusion did not change lysine flux significantly (108
      +/- 4 during saline v 101 +/- 4 mumol/kg/h-1 during leucine infusion), but
      decreased lysine oxidation (13.2 +/- 0.9 v 10.7 +/- 1 mumol/kg/h, P less than
      .05) and endogenous leucine flux (from 128 +/- 4 to 113 +/- 7 mumol/kg/h, P less
      than .05) when plasma (2H3) ketoisocaproate (KIC) was used for calculation.
      During leucine infusion, the (2H3) KIC to (2H3) leucine plasma enrichment ratio
      increased from 0.76 +/- 0.02 to 0.88 +/- 0.01 (P less than .001), while
      estimation of leucine flux using plasma (2H3) leucine showed no change in
      endogenous leucine flux. Leucine infusion decreased hepatic glucose production
      and metabolic clearance of glucose, but did not change plasma concentrations of
      glucose, insulin, C-peptide, glucagon, epinephrine, norepinephrine, or free fatty
      acids. We conclude that leucine spares glucose and lysine catabolism and
      decreases plasma concentrations of essential amino acids.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1640851
TI  - Effect of intensive endurance training on lipoprotein profiles in young and older
      men.
AB  - Although there are considerable data concerning the effects of endurance exercise
      training (ET) on plasma lipoproteins, the results have been quite inconsistent.
      The observed variability of response may be related to the age, sex, adiposity,
      or diet of the subjects tested, or to the type and intensity of the exercise
      intervention. Furthermore, there is relatively little such data in older
      individuals. Therefore, in the present study, we investigated the effects of
      intensive ET on lipoprotein profiles in healthy young (n = 12; 28.2 +/- 2.4
      years) and older (n = 15; 67.5 +/- 5.8 years) men. Unlike subjects in most
      similar studies, our subjects were weight-stabilized on a constant-composition
      diet for 21 days prior to determination of the lipoprotein profile before and
      after the ET program. At baseline, the two groups were not significantly
      different with respect to any individual component of their lipoprotein profiles,
      relative weight, or percent body fat, but the older men had a more central
      distribution of fat by both waist to hip ratio (WHR) and computed tomography
      (CT). Maximal aerobic power, expressed per kilogram of body weight (VO2 max), was
      33% lower (P less than .001) in the older men at baseline. Following the 6-month,
      walk/jog/bike ET program (5 d/wk), both the young (+18%, P less than .001) and
      the older (+22%, P less than .001) men increased their VO2 max. This was
      associated with small, but significant, decrements in weight, percent body fat,
      and WHR only in the older men.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640852
TI  - Age-related increase of collagen fluorescence in human subcutaneous tissue.
AB  - Nonenzymatic glycation produces compounds with characteristic fluorescence in
      long-lived proteins. We recently described the influence of age in rat collagen
      linked fluorescence. To examine the effect of age in humans, we studied the
      subcutaneous collagen-linked fluorescence in samples from 26 subjects of both
      sexes (age range, 42 to 78 years) who were undergoing vascular surgery. Intensity
      of fluorescence at 385 nm (upon excitation at 335 nm) and 440 nm (upon excitation
      at 370 nm) increased exponentially with age (r = .827, y = 114 + e0.038x, P less
      than .001; and r = .905, y = 36 + e0.039x, P less than 0.001, respectively). The
      two sets of data exhibited a high degree of correlation (r = .980, P less than
      .001, n = 26). Age-adjusted fluorescence data did not correlate with sex, body
      weight, or type of vascular pathology. The collagen fluorescence accumulation
      rate was 3.7% per year, and the characteristic time (CT) was 26 to 27 years. We
      conclude that the fluorescence measurement is a reliable methodology that can be
      used as a marker for biological age until new, more-specific tools are available.

PMID- 1640853
TI  - Metabolic changes during treatment with valproate in humans: implication for
      untoward weight gain.
AB  - This study was initiated to elucidate the mechanisms behind valproate-induced
      weight gain. Eight patients with epilepsy were studied with identical examination
      programs before and during the end of the first month of treatment with sodium
      valproate (VPA). The measurements included registration of food intake, indirect
      calorimetry, and determination of pancreatic and thyroid hormones,
      catecholamines, albumin, electrolytes, glycerol, and free fatty acids.
      Measurements were performed both at the basal condition and during a 3-hour oral
      glucose tolerance test (OGTT). After the start of VPA treatment, the mean levels
      during the OGTT of plasma glucose and catecholamines were significantly decreased
      by 7% and 25%, respectively (P less than .05). The mean ratio of insulin to
      glucagon decreased by 37% (P less than .01). During the glucose load, the
      decreases in free fatty acids were less pronounced after the start of VPA
      treatment, whereas the mean levels of glycerol were found to be unchanged. We
      detected no differences between the two periods with regard to total energy
      intake or macronutrient selection, energy expenditure, or thyroid hormones. As
      VPA is known to affect the concentration of carnitine in humans, it is
      hypothesized that a possible VPA-induced deficiency of the beta-oxidation of
      fatty acids is important for the development of obesity in epileptic patients in
      long-term treatment with VPA, but changes in catecholamines or other hormones
      might also be of importance.

PMID- 1640854
TI  - The effect of epinephrine on glucose-mediated and insulin-mediated glucose
      disposal in insulin-dependent diabetes.
AB  - The aim of this study was to determine the relative roles of changes in glucose
      mediated glucose disposal (SG) and insulin sensitivity (SI) on the impairment of
      glucose disposal caused by epinephrine (EPI) infusion in type I (insulin
      dependent) diabetes mellitus (IDDM). Seven non-obese young adult diabetics with
      minimal endogenous insulin secretion had EPI infusions at 25 ng/kg/min for 5.5
      hours, after a basal overnight insulin infusion (12 mU/kg/h), and glucose
      infusion as required to maintain euglycemia. The EPI infusion produced
      approximately an eightfold increase in plasma EPI. At 2.5 hours, an intravenous
      glucose tolerance test (IVGTT) was performed with supplemental exogenous insulin
      infusion to achieve an approximation of normal endogenous insulin secretion. In
      random order, each subject also had a control (CTR) infusion of basal insulin
      before the IVGTT. The results were analyzed according to a modification of the
      minimal model of Bergman et al. EPI infusion was associated with (1) elevated
      basal plasma glucose (EPI v CTR, 9.8 +/- 0.3 SE v 7.7 +/- 0.7 mmol/L, P less than
      .05); (2) elevated plasma nonesterified fatty acids (NEFA, 0.9 +/- 0.1 v 0.3 +/-
      0.1 mmol/L, P less than .05); and (3) profoundly reduced glucose disposal (KG
      0.59 +/- 0.1 v 1.91 +/- 0.33 min-1 x 10(2), P less than .02). Further analysis
      showed that the reduced glucose disposal was attributable to a marked decrease in
      SI (EPI 0.9 +/- 0.5 v CTR 7.03 +/- 3.2 min-1.mU-1.L x 10(4), P less than .05)
      with no significant change in SG (EPI 2.5 +/- 0.2 v CTR 3.1 +/- 0.5 min-1 x
      10(2), NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640855
TI  - Increased insulin sensitivity and increased rates of insulin clearance in men
      with human immunodeficiency virus (HIV) infection.

PMID- 1640856
TI  - Alterations in levels of plasma phenylalanine and its catabolism in the liver of
      stressed rats.
AB  - This study examined the relationship between elevation of blood phenylalanine
      (Phe) concentrations often observed in trauma or infected patients without
      hepatic dysfunction and alterations of liver Phe catabolism. Rats underwent
      pathophysiologically different stresses, either sepsis or scald injury. The
      catalytic activity of hepatic Phe hydroxylase (PH) in the septic rats, as
      measured after preincubation with Phe, decreased to 60% of the control values;
      this in vitro result suggests a reduction of enzyme species activated by its
      substrate. Phe was degraded in the septic rats to a similar extent to that in
      controls, when measured by pulse administration of [1-14C]-Phe. In the scalded
      rats whose plasma Phe level showed a comparable but transient increase, no
      significant alterations occurred in Phe catabolism and enzyme activities. The
      changes in plasma glucagon and catecholamine levels were consistent with those of
      the enzyme activities involved in Phe and tyrosine (Tyr) catabolism in the
      stressed groups. These results indicate that inadequate activation of native PH
      by regulatory mechanisms involving Phe in vivo was also associated with the
      accumulation of plasma Phe in infected rats during massive mobilization of amino
      acids from muscles under conditions of enhanced and sustained catabolism.

PMID- 1640857
TI  - Possible role of glycogen accumulation in B-cell glucotoxicity.
AB  - Rat pancreatic islets cultured for 1 to 5 days in the presence of 20 to 80 mmol/L
      D-glucose accumulate glycogen in a time- and concentration-dependent manner. When
      the glycogen-rich islets are incubated for 6 to 10 minutes in the absence of D
      glucose, the rate of glycogenolysis is grossly proportional to the glycogen
      content. Exogenous D-glucose (7 to 20 mmol/L) inhibits glycogenolysis. This
      inhibitory effect opposes the increase in glycolytic flux attributable to the
      utilization of exogenous glucose. Both the inhibitory effect of D-glucose on
      glycogenolysis and the utilization of exogenous hexose tend to be higher with
      alpha- than with beta-D-glucose. In light of these findings, it is proposed that
      the interference of D-glucose with glycogenolysis might play a role in the
      paradoxical changes in insulin output and its altered anomeric specificity in
      response to D-glucose administration, as is often encountered in non-insulin
      dependent diabetic subjects and experimental models of B-cell glucotoxicity.

PMID- 1640858
TI  - Characterization of unprocessed insulin proreceptors in COS 7 cells transfected
      with cDNA with Arg735----Ser735 point mutation at the cleavage site.
AB  - We previously reported on patients with severe insulin resistance due to
      unprocessed insulin proreceptors. A structural change of the cleavage site from
      Arg-Lys-Arg-Arg to Arg-Lys-Arg-Ser due to G----T point mutation appeared to be
      the cause for failure to process the proreceptors. To determine whether the
      mutation of insulin proreceptors at the cleavage site was responsible for
      unprocessed insulin receptors and to elucidate the structural and binding
      characteristics of the proreceptors, we transfected cDNA with the mutation in COS
      7 cells and examined the expressed insulin receptors. At 72 hours after
      transfection, insulin binding increased to the maximum in cells transfected with
      either normal or mutated cDNA, and insulin binding was 40 and 14 times higher
      than that of nontransfected cells, respectively. The declining rate of insulin
      binding after reaching the maximum was delayed in cells transfected with mutated
      cDNA. Affinity cross-linking and surface-labeling studies showed a 135-kilodalton
      (kD), normal alpha-subunit in the cells transfected with normal cDNA and a 210-kD
      proreceptor in the mutant cells. The proreceptors were cleaved by trypsin to
      yield normal-sized alpha- and beta-subunits. The sensitivity to trypsin was
      similar to that demonstrated in patients' cells, and the most effective
      concentration for the cleavage was 0.025%. Autophosphorylation resulted in
      decreased 32P incorporation into proreceptors of cells transfected with mutated
      cDNA at both basal and insulin-stimulated states, without a change in insulin
      sensitivity. Competitive binding studies with insulin, proinsulin, and
      miniproinsulin showed that the proreceptors had a lower relative affinity for
      proinsulin, but this characteristic disappeared after trypsin treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1640859
TI  - Ethanol stimulates apolipoprotein A-I secretion by human hepatocytes:
      implications for a mechanism for atherosclerosis protection.
AB  - Ethanol intake in humans has been shown to have a protective effect against
      coronary heart disease. The specific mechanism by which ethanol is
      cardioprotective has not been elucidated. Apolipoprotein (apo) A-I, the major
      protein of high-density lipoprotein (HDL), takes up cellular cholesterol, thus
      initiating reverse cholesterol transport whereby excess tissue cholesterol is
      eliminated. Using highly specific antibodies, we have found that ethanol
      increases apo A-I secretion and the incorporation of radiolabeled leucine into
      apo A-I by human hepatocytes (Hep-G2 cells). In addition, we have found that apo
      A-I molecules induced by ethanol have the ability to efflux cholesterol from
      human fibroblasts in vitro, and that apo A-I mass directly correlates with
      cholesterol efflux levels. At 10, 20, and 100 mmol/L, ethanol stimulated apo A-I
      secretion by 130%, 136%, and 162% of control, respectively (control, 3.71
      micrograms apo A-I/micrograms DNA), also stimulating the incorporation of 3H
      leucine into newly synthesized apo A-I by 115%, 131%, and 159% of control
      (control, 111 cpm/micrograms DNA/h). The ethanol-induced apo A-I from Hep-G2
      cells (incubated with 0, 10, 20, and 100 mmol/L ethanol) effluxed 2%, 14%, 16%,
      and 32% label (per h/mL incubation medium), respectively. Apo A-I mass correlated
      linearly with cholesterol efflux (r = .99, P less than .01). This data indicates
      that the cardioprotective role of moderate ethanol intake in humans is mediated
      by its stimulatory action on hepatic apo A-I secretion, thus defining the
      physiological basis for increased plasma apo A-I levels in vivo.

PMID- 1640860
TI  - Pulsatile activation of the hypothalamic-pituitary-adrenal axis during major
      surgery.
AB  - To examine the response of the hypothalamic-pituitary-adrenal (HPA) axis to
      severe surgical stress, we measured the immunoreactive plasma levels of
      corticotropin-releasing hormone (CRH), corticotropin, cortisol, arginine
      vasopressin (AVP), atrial natriuretic factor (ANF), neuropeptide Y (NPY),
      interleukin-1 (IL-1), IL-6, interferon gamma (INF), and tumor necrosis factor
      alpha (TNF-alpha) in eight patients with Zollinger-Ellison syndrome (ZES) or
      mediastinal parathyroid carcinoma, all undergoing major surgery with a
      standardized anesthetic technique. Blood samples were drawn the morning before
      surgery, every 10 to 30 minutes throughout surgery (average, 308.7 +/- 15
      minutes), and every morning for the next 4 postoperative days (POD). During
      surgery, plasma CRH concentrations were slightly but not significantly elevated
      compared with those before surgery and with those of the next 4 POD. However, the
      values were within the normal range (less than 2.2 pmol/L) and showed 8.9 +/- 0.6
      pulses (one pulse every 34.7 +/- 1.6 minutes). Plasma corticotropin, on the other
      hand, was quite elevated, but was also released in a pulsatile fashion during the
      surgical procedure (one pulse every 36.7 +/- 1.6 minutes). Most of these
      secretory episodes of corticotropin were temporally related to those of CRH.
      Corticotropin returned to basal levels on the first POD and remained so for all 4
      POD. Plasma cortisol concentrations increased steadily during surgery and
      remained elevated the first POD. Cortisol showed 6.2 +/- 1.1 pulses during the
      operative sampling period (one pulse every 71.8 +/- 13 minutes). Plasma AVP
      concentrations were also markedly elevated during surgery, but individual
      secretory pulses were not detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640861
TI  - A high-fat diet worsens metabolic control in streptozotocin-treated rats by
      increasing hepatic glucose production.
AB  - The aim of this study was to determine the mechanism by which a high-fat diet
      exacerbates the diabetes produced by a low dose of streptozotocin (STZ). The
      glucose clamp technique was used to determine hepatic glucose production (HGP)
      and the disappearance rate (Rd) of glucose, basally and during insulin infusions
      of 1.0 and 3.0 mU/kg/min in control of STZ-treated rats fed either a low-fat or
      high-fat diet. Fasting plasma glucose in the high fat-STZ (HFS) group was
      significantly higher than in any of the other groups: low fat-STZ (LFS), high-fat
      controls (HFC), or low-fat controls (LFC) (18.1 +/- 1.6 v 8.1 +/- 0.8 mmol/L, P
      less than .001; 6.0 +/- 0.2 mmol/L, P less than .001; 5.4 +/- 0.1 mmol/L, P less
      than .001, respectively). Basal HGP was markedly higher in the HFS group compared
      with each of the other three groups (98.8 +/- 5.9 v 61.4 +/- 3.7, P less than
      .001; 42.9 +/- 1.6, P less than .001; 39.6 +/- 1.3 mumol/kg/min, P less than
      .001; HFS v LFS, HFC, and LFC, respectively). Following insulin infusion, no
      differences were observed in HGP between the LFC and LFS groups at either insulin
      dose. However, HGP was not suppressed to control levels in either of the high-fat
      diet groups, and this defect was more marked in the HFS group. It is concluded
      that a high-fat diet exacerbates mild STZ diabetes primarily by increasing HGP.

PMID- 1640862
TI  - Racial differences in lipid and lipoprotein levels in diabetes.
AB  - Racial differences in plasma lipid and lipoprotein levels were investigated in
      145 patients with non-insulin-dependent diabetes mellitus (NIDDM). Black men had
      higher high-density lipoprotein (HDL) cholesterol levels, lower triglyceride
      levels, and an improved atherogenic index compared with white men. Premenopausal
      black women were also found to have higher HDL cholesterol levels, lower
      triglyceride levels, and a lower atherogenic index than their white counterparts.
      Adjustment for age, waist to hip ratio (WHR), hemoglobin A1c (HbA1c), and
      physical activity did not eliminate the significant differences found. There were
      no racial differences found regarding total and low-density lipoprotein (LDL)
      cholesterol. Metabolic control as measured by HbA1c was significantly correlated
      with the triglyceride level in black women. These data confirm that racial
      differences exist in plasma lipid levels among patients with NIDDM.

PMID- 1640863
TI  - Effect of a moderate alcohol intake on the lipoproteins of normotriglyceridemic
      obese subjects compared with normoponderal controls.
AB  - Moderate alcohol intake is frequently associated with an elevated concentration
      of high-density lipoprotein (HDL), which is one of the potential causes for the
      relative decrease in cardiovascular risk reported in moderate drinkers.
      Conversely, low HDL concentrations, particularly HDL2, in obese subjects may be a
      risk factor. The effect of 30 g alcohol daily (wine) during 14 days following a
      period of abstinence was studied in seven normolipidemic obese subjects (body
      mass index [BMI], 30 +/- 1.7 kg/m2) compared with seven normoponderal controls
      (BMI, 22 +/- 1.2 kg/m2). Alcohol caused apolipoprotein (apo) AI and apo AII
      concentrations to increase in all controls by 12% and 16% (P less than .05), but
      not in obese subjects. Lipoprotein (Lp) AI HDL particles (without AII) were
      initially in the same proportions in the two groups. Their increase in controls
      only (P less than .03) was not matched by an increase in HDL2 in all subjects. In
      obese subjects, neither Lp AI nor HDL2 were increased by alcohol, but their HDL
      triglyceride (TG) contents, initially elevated, were normalized. Cholesterol
      ester (CE) transfer activity was not different in controls and obese subjects
      during abstinence (105.7 +/- 40.8 v 104.8 +/- 34.5 mmol/mg protein/h). It was
      notably depressed by alcohol in controls (74.2 +/- 27.4, P less than .002), but
      not in obese subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640864
TI  - Estimation of plasma glucose fluctuation with a combination test of hemoglobin
      A1c and 1,5-anhydroglucitol.
AB  - We investigated the effect of plasma glucose fluctuation on hemoglobin A1c
      (HbA1c) and plasma 1,5-anhydroglucitol (AG) levels, especially in insulin
      dependent diabetes mellitus (IDDM). Plasma AG is a new marker that provides
      sensitive and analytical information on glycemic control. The basic mechanisms
      underlying both the reduction and recovery of the plasma AG level, ie, the
      excretion into urine with glucosuria and the amount supplied to the body, were
      presumed to be similar in IDDM and non-insulin-dependent diabetes mellitus
      (NIDDM) patients. The correlation coefficient for mean plasma glucose and AG was 
      .591, and it was .578 for mean plasma glucose and HbA1c in IDDM patients. In
      NIDDM, the correlation between mean plasma glucose and AG was -.869, and between
      mean plasma glucose and HbA1c, .875. The plasma AG levels in the IDDM group
      showed a lower range than in the NIDDM group, even with similar HbA1c levels. All
      the cases showing lower plasma AG levels among those with similar HbA1c levels
      manifested greater fluctuation of plasma glucose and a larger amount of urinary
      glucose. The lower AG level in IDDM patients was reversible to the level in NIDDM
      patients when the greater fluctuation of plasma glucose was corrected. Thus, it
      was suggested that because urinary glucose excretion is intermittently high in
      IDDM patients, plasma AG is frequently low, even though the mean plasma glucose
      and HbA1c levels suggest good control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640865
TI  - Postprandial thermogenesis at rest and postexercise before and after physical
      training in lean, obese, and mildly diabetic men.
AB  - To determine the independent impact of physical training on postprandial
      thermogenesis at rest and after 1 hour of cycling at 100 W, 10 lean (15% +/- 1%
      body fat), 10 obese (33% +/- 2% fat), and six obese diet-controlled, type II
      diabetic men (34% +/- 4% fat) underwent 12 weeks of vigorous cycle ergometer
      training (4 h/wk at approximately 70% of maximum oxygen consumption [VO2max])
      while maintaining body weight and composition. Body weight was held constant by
      refeeding the energy expended in each training session. Cardiorespiratory fitness
      increased by approximately 27%, but body weight and fat did not change. Before
      and at least 4 days after the last exercise session, energy expenditure was
      measured for 3 hours under four conditions: (1) rest, no meal; (2) rest, after a
      720-kcal mixed meal; (3) postexercise after 1 hour cycling, no meal; and (4)
      postexercise, meal after exercise. The thermic effect of food was calculated as
      postprandial minus postabsorptive energy expenditure at rest and postexercise
      (kcal/3 h). Before and after training, the thermic effect of food during rest was
      lower in obese than in lean men, and lower in diabetic than in obese men (P less
      than .05). Thermogenesis was improved after short-term exercise in obese and
      diabetic men compared with that at rest, but was not normalized (P less than .05
      for lean v obese, diabetic men). A significant effect of training on
      thermogenesis was due to a small but significant increase after training for
      diabetic men under the postexercise condition. Thus, while short-term exercise
      enhances but does not normalize thermogenesis in obese and diabetic men, long
      term exercise training leading to increased cardiorespiratory fitness, in the
      absence of changes in body composition, leads to a small increase in
      thermogenesis in diabetic men, which manifests only after a short period of
      exercise.

PMID- 1640866
TI  - Differences in metabolism of time-release and unmodified nicotinic acid:
      explanation of the differences in hypolipidemic action?
AB  - The possibility that differences in metabolism might underly the differences in
      efficacy and toxicity between time-release and unmodified formulations of
      nicotinic acid was investigated by measuring 24-hour urinary excretion of
      metabolites in 10 subjects who received both forms. Nicotinic acid has two
      metabolic fates: formation of nicotinamide adenine dinucleotide (NAD) and
      formation of nicotinuric acid, the glycine conjugate of nicotinic acid.
      Catabolism of NAD releases nicotinamide, which is subsequently methylated and/or
      oxidized to form a number of metabolites, with 2-pyridone predominating.
      Excretion of nicotinuric acid was more than four times greater when subjects took
      unmodified nicotinic acid than when they took time-release nicotinic acid (78.2
      and 18.8 mg, respectively). In contrast, excretion of 2-pyridone with unmodified
      nicotinic acid was only 30% more than with time-release nicotinic acid (171.0 and
      129.9 mg, respectively). These results demonstrate a marked difference in the
      metabolism of unmodified and time-release nicotinic acid. It is proposed that
      nicotinyl coenzyme A (CoA), the metabolic intermediate in the formation of
      nicotinuric acid, mediates some of the hypolipidemic actions of nicotinic acid,
      as the acyl-CoA esters of xenobiotics, including clofibrate, have been shown to
      interfere with lipid metabolism.

PMID- 1640867
TI  - Cortisol secretion in relation to body fat distribution in obese premenopausal
      women.
AB  - Urinary cortisol output and serum cortisol concentrations were measured in the
      steady state, under "field" conditions, and during standardized inhibitory and
      stimulatory tests in premenopausal, obese women, and were analyzed in relation to
      adipose tissue distribution. Urinary cortisol output was increased under field
      conditions in women with an elevated waist to hip circumference ratio (WHR) and,
      in particular, in women with a large abdominal sagittal diameter, indicating
      visceral fat accumulation. However, dexamethasone inhibition of cortisol
      secretion was normal. Stimulation with corticotropin analogue and with physical
      (cold-pressor test) or mental (color-word or mathematic) stress tests also showed
      elevated responses of serum cortisol, but not of prolactin or growth hormone
      concentrations. It is suggested that women with visceral fat accumulation have
      elevated cortisol secretion due to an increased sensitivity along the
      hypothalamic-pituitary-adrenal axis, and that this may be causing their abnormal
      fat depot distribution.

PMID- 1640868
TI  - Experimental study on Reye's syndrome: inhibitory effect of interferon alfa on
      acetylsalicylate-induced injury to rat liver mitochondria.
AB  - Viral infection and acetylsalicylate (ASA)-induced mitochondrial aberration have
      been reported to play important roles in the pathogenesis of Reye's syndrome. We
      report that increasing amounts of ASA (0 to 250 mumol/L) resulted in increases in
      state 4 respiration and decreases in state 3 respiration in rat liver
      mitochondria in vitro when using alpha-ketoglutarate and/or beta-hydroxybutyrate
      as respiratory substrates, but not when using succinate as substrate. Interferon
      alfa (IFN-alpha) (1.5 to 5 x 10(4)IU/mL, approximately 1/100 the therapeutic
      dosage for humans) and interleukin-1 (IL-1) (1.5 to 2 x 10(4)IU/mL, nearly
      equivalent to the therapeutic dosage) decreased the severity of the above effects
      via interaction with mitochondrial membranes. Interferon gamma (IFN-gamma) and
      interleukin-2 (IL-2) had no such protective effect. Electron microscopic
      observation indicated that IFN-alpha prevented the induction of mitochondrial
      swelling by ASA. These results suggest that IFN-alpha may prove to be effective
      for the treatment of Reye's syndrome.

PMID- 1640869
TI  - Generalized lipodystrophy: in vivo evidence for hypermetabolism and insulin
      resistant lipid, glucose, and amino acid kinetics.
AB  - Stable isotope tracers and indirect calorimetry were used to evaluate whole-body
      energy, glucose, lipid, and amino acid metabolism in a patient with generalized
      lipodystrophy during basal conditions and in response to insulin therapy. The
      results were compared with those obtained in previous studies in normal
      volunteers. The basal rate of glucose production (33.7 mumol/kg.min) was three
      times higher than normal. The basal rate of glycerol appearance in blood, an
      index of lipolysis, was 60% greater than normal when expressed per kilogram body
      weight (3.82 mumol/kg.min), but was more than 10 times normal when expressed per
      kilogram body fat mass (123.2 mumol/kg.min) because of the marked decrease in
      body fat in our patient (3% of total body weight). Leucine rate of appearance, an
      index of protein breakdown, and nonoxidative leucine disposal, an index of
      protein synthesis, were also greater than normal. Resting energy expenditure
      (REE) was 30% greater than normal. The effect of insulin infusion on these
      metabolic parameters was markedly blunted. These metabolic abnormalities help
      explain many of the clinical findings such as hyperglycemia,
      hypertriglyceridemia, fat depletion, hepatomegaly, and steatosis observed in
      patients with lipodystrophy. Ineffective insulin function in many tissues appears
      to be an important factor in the pathophysiology of lipodystrophy.

PMID- 1640870
TI  - Evidence that glucose transport is rate-limiting for in vivo glucose uptake.
AB  - To determine whether glucose transport or intracellular glucose metabolism is
      rate-limiting for in vivo glucose uptake, rates of glucose disposal were measured
      in a group of normal subjects at varying levels of hyperglycemia designed to
      attain saturating rates of glucose disposal at low and high physiological insulin
      concentrations. At insulin levels of approximately 200 pmol/L, glucose disposal
      rates were 2.9 +/- 0.4, 4.7 +/- 0.5, 6.4 +/- 0.6, and 6.5 +/- 0.8 mg/kg/min at
      plasma glucose concentrations of 5.55, 11.10, 13.88, and 19.43 mmol/L (or 100,
      200, 250, and 350 mg/dL, respectively). At insulin levels of approximately 750
      pmol/L, glucose disposal rates were 1.7 to 2.1-fold higher: 6.2 +/- 0.7, 9.2 +/-
      1.1, 11.0 +/- 1.1, and 12.3 +/- 1.4 mg/kg/min at glucose levels of 5.55, 11.10,
      13.88, and 19.43 mmol/L. Thus, during both the 15- and 40-mU/m2/min insulin
      infusions, glucose disposal increased in a linear fashion from 5.55 to 13.88
      mmol/L (r = .90) and then effectively plateaued at the same plasma glucose level.
      If the plateau of glucose disposal during the 40-mU/m2/min insulin infusion was
      due to saturation of the intracellular capacity to metabolize glucose, then when
      plasma glucose was increased from 13.88 to 19.43 mmol/L at the lower insulin
      level, the glucose disposal should have continued to increase and not plateau,
      since the rate of glucose disposal was only approximately 50% of that attained at
      the higher insulin infusion rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640871
TI  - Hyperinsulinemia and human chorionic gonadotropin synergistically promote the
      growth of ovarian follicular cysts in rats.
AB  - Tonically elevated serum luteinizing hormone (LH) and hyperinsulinemia are
      prominent features of polycystic ovary syndrome (PCO) in women, but the relative
      roles of LH and insulin in the pathogenesis of PCO is still unknown. The present
      study was undertaken to determine the effect(s) hyperinsulinemia might have on
      the induction of follicular cysts by LH/human chorionic gonadotropin (hCG) in the
      rat. Beginning on day 85 of age, adult female rats were given one of the
      following in vivo treatments: (1) vehicle alone; (2) a high-fat diet to control
      for the effects of weight-gain; (3) up to 6 U insulin per day; (4) 50 micrograms
      gonadotropin-releasing hormone (GnRH) antagonist (GnRHant) per day; (5) 1.5 IU
      hCG twice daily; (6) insulin + hCG; (7) insulin + GnRHant; (8) hCG + GnRHant; or
      (9) hCG + insulin + GnRHant. After 22 days of treatment, animals were killed on
      day 23, trunk blood was collected, and ovaries were excised for histological
      study. Regular cycles, assessed by vaginal smears, ceased after 10 days for most
      animals in treatment groups receiving hCG, but continued in all other treatment
      groups. All the animals in each hCG-treated group developed either unilateral or
      bilateral cystic ovaries, while no animals in the groups not receiving hCG
      developed follicular cysts. More animals from each group treated with both hCG
      and insulin possessed bilateral ovarian cysts than did rats treated with hCG
      alone: 80% and 60%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640872
TI  - Influence of aerobic capacity, body composition, and thyroid hormones on the age
      related decline in resting metabolic rate.
AB  - It has been suggested that changes in fat-free weight may not fully explain the
      decline of resting metabolic rate (RMR) that occurs with aging. We therefore
      examined the hypothesis that a reduction in maximal aerobic capacity (VO2max) may
      partially explain the lower RMR in older men, after accounting for differences in
      fat-free weight and fat weight. We also considered differences in energy intake
      and plasma thyroid hormones as possible modulators of the age-related decline in
      RMR in men. Three-hundred healthy men (aged 17 to 78 years) were characterized
      for: (1) RMR (kcal/min) from indirect calorimetry; (2) body composition from
      underwater weighing; (3) maximal aerobic capacity from a test of VO2max; (4)
      plasma thyroid hormones (total triiodothyronine [T3], free T3, total thyroxine
      [T4], and free T4); and (5) estimated energy intake (kcal/d) from a 3-day food
      diary. A curvilinear decline of RMR with age was found (P less than .01), in
      which no relationship was found in men less than 40 years of age (r = .10, slope
      = 0.002 kcal/min/yr), whereas in men older than 40 years, RMR was negatively
      related to age (r = -.52, slope = -0.008 kcal/min/yr). After statistical control
      for differences in fat-free weight and fat weight, a negative relationship
      between age and RMR persisted (partial r = -.30, P less than .01). It was only
      after control for fat-free weight, fat weight, and VO2max (partial r = -.10, P
      greater than .05) that no association between age and RMR was noted.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1640873
TI  - Obese (ob/ob) mice: are they hyperoxaluric?

PMID- 1640874
TI  - Distribution of red blood cell velocity in capillary network, and endothelial
      ultrastructure, in aged rat skeletal muscle.
AB  - Although age-related structural and functional changes in skeletal muscle have
      been described extensively, little is known about the accompanying hemodynamic
      and structural changes in the microvasculature. The objective of this study was
      to use the extensor digitorum longus muscle in mid-aged (12 months) and old (28
      months) Fisher 344 male rats to evaluate (1) the distribution of microvascular
      flow in the resting state, (2) the distribution response to a complete 30-min
      tourniquet ischemia, and (3) the extent of damage of capillary endothelium. Using
      intravital video microscopy, the mean resting velocity of red cells in
      capillaries was found to be 3x larger in old rats while the distribution of
      velocity within the microvascular bed was as heterogeneous as that in mid-aged
      rats. The postischemic response was characterized by the same mean peak velocity,
      but a slower return to velocity to the preischemic level. Within the
      microvascular bed, there was a less uniform postischemic response among
      capillaries. No long-term effect of ischemia was seen as velocity was already
      stable at the preischemic level 20 min after the tourniquet release. There were
      no differences in the pre- and postischemic densities of perfused capillaries,
      wet/dry weight ratios, or the occurrence of damaged capillaries. Thus, in this
      muscle model, aging was associated with an increased resting flow but a
      remarkably unaffected long-term flow response to a vasodilatory stimulus and
      endothelial ultrastructure.

PMID- 1640875
TI  - Arteriolar arcades and pressure distribution in cremaster muscle
      microcirculation.

PMID- 1640876
TI  - A simplified two-pore filtration model explains the effects of hypoproteinemia on
      lung and soft tissue lymph flux in awake sheep.
AB  - We used a simplified two-pore filtration model to examine the effects of
      hypoproteinemia on lung and soft tissue lymph flux in awake sheep (n = 7). To
      induce hypoproteinemia, we subjected each animal to 3 days of batch
      plasmapheresis (6 units per day). Data were collected in near steady-state
      conditions, 15-18 hr following completion of the last plasmapheresis episode. At
      this time, plasma protein concentration had fallen by 34%, while lung and soft
      tissue lymph protein concentrations had fallen by 55 and 62%, respectively. Lung
      and soft tissue lymph flows increased 52 and 87%, respectively. The plasma-to
      lymph osmotic pressure gradients for lung and soft tissue lymph were unchanged by
      protein depletion (soft tissue, 7.7 mm Hg; lung, 4.8 mm Hg). We applied these
      results to a heteropore model of the microvascular barrier that consisted of two
      types of pores: those which plasma proteins could not cross (sigma = 1) and those
      which proteins could cross without restriction (sigma = 0). We varied the
      proportion of small pores to large pores until the measured data fit a model in
      which the calculated microvascular hydrostatic pressures in normal and
      hypoproteinemic conditions were equal. This was based on the assumption that
      microvascular hydrostatic pressure did not change with plasma protein depletion.
      These conditions could be satisfied when the small pores accounted for 90% of
      total barrier porosity. According to the model, lymph flow increased in
      hypoproteinemia because of an increase in protein-free liquid flux through the
      large percentage of small pores; protein flux through the small percentage of
      large pores remained unchanged. The net result was an increase in lymph flow and
      a decrease in the lymph protein concentration. The model reproduced these changes
      even though the plasma-to-lymph osmotic pressure gradients were unchanged. We
      conclude that a simplified heteropore model can explain the effects of
      hypoproteinemia on lung and soft tissue lymph flux.

PMID- 1640877
TI  - Synchronous vasomotion in the human cutaneous microvasculature provides evidence
      for central modulation.

PMID- 1640878
TI  - Topographic mapping of the cutaneous microcirculation using two outputs of laser
      Doppler flowmetry: flux and the concentration of moving blood cells.
AB  - Using a "needle" probe in a template probe holder, we measured the flux and the
      concentration of moving red blood cell (CMBC) outputs from a Perimed (PF2B) laser
      Doppler instrument at 1-mm2 contiguous sites in a 8 x 8-mm area on the flexor
      forearm of three subjects. Using the means of the flux and CMBC recorded at each
      spot, a topographic contour map was constructed for each of these parameters.
      Viewing the two maps together, sites with four different combinations of flux and
      CMBC could be identified. Trephine biopsies (2 mm) of three representative sites
      in each subject were performed and the upper plexus was reconstructed in 3
      dimensions from serial sections. High flux/high-to-medium CMBC sites were found
      over the spot where the ascending arterioles entered the upper plexus. Medium
      flux/medium-to-low CMBC sites and low flux/medium CMBC sites were found in the
      peripheral part of the vascular unit that was fed by the ascending arteriole. The
      low flux/low CMBC sites were relatively avascular zones. Video imaging of the
      upper plexus in the forearm showed the same overall vascular pattern as the
      contour maps. The highest flux and CMBC signals were recorded when horizontally
      oriented vessels were present in the upper third of the plexus (400-650 microns
      below the stratum corneum). Topographic mapping will allow one to selectively
      identify different microvascular areas in the skin for physiological studies.

PMID- 1640879
TI  - A new mounting technique for perfusion of isolated small arteries: the effects of
      flow and oxygen on diameter.
AB  - There is at present no suitable technique available for performing pressure-flow
      studies in isolated small arteries (i.e., less than 500 microns), in which the
      effects of flow and pressure on artery dimensions can be studied independently. A
      new mounting technique is presented in which the ends of a vessel segment are
      cemented to the inner surface of two cannulae, with a tip diameter slightly
      larger than the outer diameter of the vessel, using two-component human fibrin
      glue. By means of this technique the pressure drop over the cannulae can be made
      small. First the effect of the glue on constrictive properties is studied. The
      glue used has no significant influence on the norepinephrine dose-response
      relation or on the relaxation in response to 1.0 microM acetylcholine. Small
      mesenteric arteries of the rabbit with outer passive diameters (at zero pressure)
      of 315 microns (+/- 22 microns SEM) are studied with this method. The effects of
      flow (shear stress) and oxygen are investigated (vessels are preconstricted (30%)
      with norepinephrine (1-2 microM)). The flow range used resulted in shear stresses
      between 0 and 290 dyn.cm-2, a range including values found in vivo. There is a
      significant (P less than 0.001) decrease in diameter when flow is increased, and
      hypoxia (pO2 less than 30 mm Hg) augmented the preconstriction with
      norepinephrine (P = 0.002). The flow effect and the oxygen influence are
      independent of each other. These results are similar to our previous findings in
      the femoral artery of the rabbit (diameter about 1200 microns).

PMID- 1640880
TI  - Spontaneous fluctuations in oxygen tension in the cat retina.
AB  - Oxygen tension was recorded with double-barreled microelectrodes in the retina of
      anesthetized cats and monkeys. The oxygen tension (PO2) was often observed to
      undergo spontaneous irregular fluctuations with peak-to-peak amplitudes of about
      3 to as much as 20 mm Hg. These fluctuations were observed only in the
      vascularized inner 40 to 50% of the retina, not in the avascular outer retina,
      and they were not correlated with the voltage recorded by the second barrel of
      the microelectrode. Oxygen records from the cat retina were subjected to Fourier
      analysis to determine their frequency content. The peak frequency was usually in
      the range of 3.5 to 10.5 c/min (0.06 to 0.18 Hz), considerably below the
      respiratory frequency of 20 to 30 c/min or the heart rate of 180 to 240 c/min.
      The power of the oxygen fluctuations fell gradually to less than 10% of the peak
      power by 60 c/min. It is suggested, based on the depth distribution and on
      comparison of these data with the literature on vasomotion, that the PO2
      fluctuations are the result of changes in oxygen supply caused by normal
      fluctuations of arteriolar diameter (vasomotion) and/or capillary perfusion.

PMID- 1640881
TI  - A three-dimensional junction-pore-matrix model for capillary permeability.
AB  - A three-dimensional model is presented for the hydraulic conductivity and
      diffusive permeability of capillary endothelial clefts with a junctional strand
      with discrete pores and a fiber matrix in its wide parts. The model attempts to
      provide new insight into long-standing issues concerning the relative importance
      of open junction discontinuities, restricted slit regions, and matrix components
      in determining the permeability and selectivity of the capillary wall. The
      predictions drawn from the model are used to formulate new experiments to test
      two hypotheses concerning the molecular organization of the junction strand and
      the location of matrix structures in the wide part of the cleft. Using the three
      dimensional theoretical approach recently developed by Tsay, Weinbaum, and
      Pfeffer (Chem. Eng. Comm. 82, 67-102, 1989), the model first explores the
      behavior of three different molecular models for the junctional strand
      discontinuities: (i) a more frequent circular pore of 5.5-nm radius formed by
      isolated missing junction proteins; (ii) a restricted rectangular slit of four to
      eight missing proteins and 8-nm gap height; and (iii) larger more infrequent
      breaks of four to eight missing proteins with a gap height of 22 nm, equal to the
      width of the wide part of the cleft. For the circular and 8-nm gap height pores
      the primary molecular sieve can be located at the level of the junction strand,
      whereas for the 22-nm gap height pores, matrix components must be present in at
      least some portion of the cleft to provide the molecular filter. The water flow
      through the cross-bridging fibers in the wide part of the cleft is described
      either by a new exact three-dimensional theory (Tsay and Weinbaum, J. Fluid Mech.
      226, 125-148, 1991) for an ordered periodic array or by a new approximate theory
      for a random array of perpendicular fibers. Both this theory and the new
      approximate theory for diffusion presented herein take into account for the first
      time the interaction between the fibers and plasmalemma boundaries. The principal
      predictions of the model are that (i) infrequent larger breaks are most likely
      required to account for small solute permeability; (ii) these larger breaks must
      be accompanied by a sieving matrix, but this matrix probably occupies only a
      small portion of the depth of the cleft and/or its entrance at the luminal
      surface; (iii) neither junctional pore, restricted slit, or fiber matrix models
      can by themselves satisfy permeability and selectivity data; and (iv) one
      dimensional models are a poor description of a cleft with infrequent larger
      breaks since the solute will be confined to small wakelike regions on the
      downstream side of the junction strand discontinuities and thus not fill the wide
      part of the cleft.

PMID- 1640882
TI  - Titration of immunotherapy by periodical nasal allergic challenges in the
      treatment of allergic rhinitis.
AB  - OBJECTIVE: To determine the benefits of nasal allergen challenge (NAC) in
      monitoring immunotherapy for allergic rhinitis in a clinical setting. DESIGN: Two
      hundred consecutive courses of immunotherapy, with pyridine-extracted alum
      precipitated allergen extracts (Allpyral), were personally carried out by the
      writer and analysed. Diagnosis before treatment was confirmed by NAC and the
      duration of treatment determined by periodical NAC. SETTING: Consultant
      allergist's clinical practice. PARTICIPANTS: Patients with allergic rhinitis who
      were referred for treatment; 79 patients were allergic to grass, 70 to the house
      dust mite, 30 to plantain and 21 to miscellaneous allergens. RESULTS: The mean
      protein nitrogen units (pnu) required to reverse an NAC was 145 467 pnu for
      grass, 93 771 pnu for mite, 103 137 pnu for plantain, and 121 030 pnu for
      miscellaneous allergen patients. The range of injections to obtain conversion to
      a negative NAC was wide. For grass it was 9-58 injections, for mite 6-47
      injections, for plantain 4-39 injections, and for miscellaneous allergens 10-79
      injections. Ten grass-sensitive patients who received an average of 477 807 pnu
      failed to convert to a negative NAC result. Similarly, two mite-sensitive
      patients who received 467 370 PNU, and one plantain-sensitive patient, one cat
      sensitive patient and one horse-sensitive patient, who had 389 240 pnu, 148 520
      pnu and 719 540 pnu respectively, failed to convert. One patient who was very
      sensitive to grass pollen developed urticaria which required an injection of
      adrenaline. CONCLUSION: Immunotherapy for allergic rhinitis with Allpyral is
      effective--as determined by the conversion of NAC results from positive to
      negative--providing a sufficient dose is given. The manufacturer's recommended
      dose is inadequate. The procedure is safe for mite, plantain and miscellaneous
      allergens, and only one reaction occurred with grass given in a high dosage
      protocol, which has subsequently been altered. Considering that the British
      Committee of Safety of Medicines reported no deaths from Allpyral injections, its
      recommendations appear over cautious for this make of extract.

PMID- 1640883
TI  - The Papanicolaou smear histories of 237 patients with cervical cancer.
AB  - OBJECTIVE: This study looks at the Papanicolaou (Pap) smear histories of patients
      presenting with invasive cervical cancer, to assess the problems associated with
      the cervical cancer screening program within New South Wales. DESIGN: Prospective
      collection of data concerning the Pap smear history, age, menopausal status and
      stage of disease of patients presenting with invasive cervical cancer. SETTING:
      All patients with primary invasive cervical cancer referred to the Gynaecological
      Oncology Department of the Royal Hospital for Women, Paddington, between November
      1986 and July 1990 were included in the analysis. RESULTS: Eighty-three out of
      237 patients (35%) reported never having had a Pap smear taken. These patients
      were on average older, more frequently postmenopausal and presented with more
      advanced stage of disease than the rest of the population. Fifty-one patients
      (21.5%) stated that they had had a "normal" smear within two years. Further
      analysis revealed that mistaken patient recall of the date of the last Pap smear
      and false-negative cytological reporting were the major factors explaining these
      latter cases. CONCLUSION: For voluntary screening to be more effective, quality
      control of cytology laboratories needs to be carefully evaluated and general
      practitioners need to take a more active role in cancer screening. In order to
      reach a greater proportion of the population, a national or State cytology
      register should be established.

PMID- 1640884
TI  - The present status of psychosurgery in Australia and New Zealand.
AB  - OBJECTIVES: To assess the extent and nature of psychosurgery currently being
      performed in Australia and New Zealand, and the present status of legislation
      regulating its practice. METHODS: Details of current legislation were obtained
      through inspection of statutes and direct communication with Departments of
      Health. All full and associate members of the Neurosurgical Society of
      Australasia were surveyed by postal questionnaire. Ninety-eight neurosurgeons
      were surveyed, of whom 72 (73%) replied. RESULTS: In the 1980s a mean of nine
      (SD, 5.9) operations were performed per year; about two were performed per year
      in the late 1980s. Ninety per cent of these operations were performed at one
      centre in Sydney. The most common indications were severe and medically
      intractable depression and obsessive-compulsive disorder. Surgery is now
      exclusively stereotactic and involves the creation of lesions in the orbitomedial
      frontal or cingulate tracts or a combination of the two. The nature and type of
      surgery are comparable to those in other centres in the Western world. Regulatory
      legislation is in place in most, but not all, States in Australia and in New
      Zealand. CONCLUSIONS: Further developments of other forms of psychiatric
      treatments may make psychosurgery, in its present form and at its present level
      of validation, redundant. If it is to have a resurgence, it would have to be
      based on a much sounder theoretical premise, and a stronger demonstration of
      efficacy and predictability of effect.

PMID- 1640885
TI  - Longitudinal study of quality of life and psychological adjustment after cardiac
      transplantation.
AB  - OBJECTIVE: To assess the psychological adjustment and quality of life of a sample
      of cardiac transplant recipients over time. DESIGN: The patients were consecutive
      recipients of new hearts which were transplanted between November 1984 and
      December 1986. Thirty-eight patients were entered into the study, but at final
      follow-up only 27 were assessed; six patients had died and five could not be
      contacted. Patients were seen before transplantation, at discharge, then at 4, 8
      and 12 months after transplantation and finally at a mean of 4.2 years after
      transplantation. They were assessed by means of standardised questionnaires. The
      results were compared across time and correlated with demographic data and
      medical data collected at the initial assessment. Only patients who were alive
      and responded at each point of follow-up were included in the study. SETTING: All
      patients were seen at St Vincent's Public Hospital and were tertiary care
      patients. MAIN OUTCOME MEASURES: The main outcome measures were anxiety,
      depression and well-being. These measures were assessed by means of the
      Spielberger State Trait Anxiety Scale, the Beck Depression Inventory and the
      Campbell Well-Being Scale. At the four year follow-up the Nottingham Health
      Profile was also used. RESULTS: Scores for anxiety, depression and well-being
      improved significantly after transplantation and did not deteriorate over time.
      No significant correlations were found between psychological measures and medical
      or demographic data. CONCLUSIONS: The results showed no evidence of mood disorder
      and a high level of well-being in this sample of cardiac transplant recipients up
      to four years after transplantation.

PMID- 1640886
TI  - Primary cerebral lymphoma: an association with craniopharyngioma or cadaveric
      growth hormone therapy?
AB  - OBJECTIVES: To present the first case of primary cerebral lymphoma associated
      with craniopharyngioma or previous cadaveric growth hormone therapy. CLINICAL
      FEATURES: A 22-year-old male shop assistant of European descent presented with
      unilateral uveitis and was found to have a high grade primary cerebral lymphoma.
      This occurred nine years after successful surgical resection of a
      craniopharyngioma without the administration of adjuvant radiotherapy.
      INTERVENTION AND OUTCOME: There was initial radiological resolution of cerebral
      lymphoma after cranial irradiation. Recurrence was noted 10 weeks later,
      resulting in the patient's death. CONCLUSION: The development of primary cerebral
      lymphoma following a craniopharyngioma is considered most likely a chance
      occurrence. Cadaveric growth hormone therapy may play a role in the genesis of
      lymphoma.

PMID- 1640887
TI  - A time of change in medical oncology. Problems created by the lack of coherence
      in Australia's health care system.

PMID- 1640888
TI  - Organ and tissue transplantation 1992.

PMID- 1640889
TI  - The teaching of multidisciplinary care.

PMID- 1640890
TI  - Depression in general practice.

PMID- 1640891
TI  - The impaired doctor.

PMID- 1640892
TI  - Transplantation in Australia--50 years of progress.
AB  - OBJECTIVE: To review the history of clinical transplantation practice in
      Australia. DATA SOURCES AND STUDY SELECTION: The first major source was published
      reports, chiefly in The Medical Journal of Australia (129 articles). The second
      source was personal communication with those involved in early and current
      transplantation programs. DATA EXTRACTION AND SYNTHESIS: The first known
      transplant of each organ in Australia and the results of current programs have
      been documented. CONCLUSIONS: Transplantation of the kidney, liver, heart, lung,
      pancreas, cornea, or bone marrow are available and accepted therapies for an
      increasing number of suitable patients, limited mainly by the number of donors.

PMID- 1640893
TI  - Neuropsychological functioning and sleep patterns in the elderly.
AB  - OBJECTIVE: To discover whether reported sleep-wake disturbances in the elderly
      (more frequent nocturnal awakenings, earlier waking and more day time naps) are
      associated with neuropsychological dysfunction. DESIGN AND SETTING: A sample of
      124 residents of a retirement village complex were interviewed about their sleep
      patterns and given neuropsychological assessments. Reported sleep-wake
      difficulties were combined to form two variables, "night sleep" and "day sleep".
      Additional sleep variables analysed were reported sleep duration and time of
      wakening. Principal components analysis of the neuropsychological test scores
      yielded four factors: "general ability", "memory", "motor", and "cerebral
      efficiency". MAIN OUTCOME MEASURES: A correlation analysis was performed for
      sleep variables, neuropsychological factors and age, mood scale and scores on
      indices of participation in physical and passive activities. RESULTS: There was
      no correlation between "night sleep" and the factor scores derived from the
      neuropsychological tests. "Day sleep" was correlated with "cerebral efficiency"
      only. Age was correlated with the "memory" and "motor" factors, the latter also
      being associated with participation in physical activities. CONCLUSION: Night
      sleep problems are not associated with neuropsychological deficits in a non
      clinic population.

PMID- 1640894
TI  - Cost effectiveness or catch 22?

PMID- 1640895
TI  - Letters to the editor 1991. An audit of the MJA's correspondence columns.
AB  - OBJECTIVE: To evaluate correspondence published in The Medical Journal of
      Australia, with particular emphasis on the level of post-publication peer review
      which it represented. METHOD: An audit of all letters submitted to the Journal
      for publication in 1991. RESULTS: Six hundred and forty-eight letters were
      received; 506 (78%) were published and 142 (22%) were not. Three hundred and
      twenty-nine of the published letters were written in response to material
      published in the Journal: 96 of these were related to other letters, 71 were
      replies to other letters by authors, 43 related to original articles, 42 to
      leading articles and 77 to other articles. Approximately 20% of all original
      articles published in the Journal attracted correspondence which was published.
      The commonest reasons for writing were concern about possible flaws in the design
      of a study, to add information of interest to the subject or to criticise the
      conclusions reached in the study. CONCLUSIONS: Readers are perhaps not taking
      full advantage of the opportunity for post-publication peer review provided by
      correspondence columns in the MJA.

PMID- 1640896
TI  - Rhabdomyolysis due to redback spider envenomation.

PMID- 1640897
TI  - Emergency transport of critically ill children.

PMID- 1640898
TI  - Doctors' advice to pregnant women regarding alcohol and tobacco consumption.

PMID- 1640899
TI  - Heart attacks and the Newcastle earthquake.

PMID- 1640900
TI  - Pesticides and other chemicals in cigarette tobacco.

PMID- 1640901
TI  - Cholera in Adelaide.

PMID- 1640902
TI  - Autopsy rates.

PMID- 1640903
TI  - Low risk of HIV-1 infection from blood donation: a test-based estimate.

PMID- 1640904
TI  - High dose nifedipine and fludrocortisone for intractable hiccups.

PMID- 1640905
TI  - Pap smear reminder systems.

PMID- 1640906
TI  - Combined ciprofloxacin/rifampicin therapy in methicillin-resistant Staphylococcus
      aureus (MRSA) infection.

PMID- 1640907
TI  - Convulsive syncope and the diagnosis of a first epileptic seizure.

PMID- 1640908
TI  - Adjuvant therapy for breast cancer.

PMID- 1640910
TI  - International Society of Pediatric Oncology, SIOP XXIV Meeting. Hannover, Federal
      Republic of Germany, October 12-16, 1992. Abstracts.

PMID- 1640909
TI  - Allergic rhinitis and immunotherapy.

PMID- 1640911
TI  - [Carious pathology in selective IgA deficit].
AB  - The relationship between levels of secretory IgA and incidence of dental caries
      has been the object of controversial studies. Selective IgA deficiency (SIgAD) is
      the commonest primary immunodeficiency and may be found in apparently healthy
      individuals but is also associated with a variety of diseases. In the present
      study the authors evaluated the prevalence [correction of incidence] of caries by
      means of caries indexes in a group of children with severe and partial SIgAD and
      in a group of children age-matched healthy control. Evaluated caries indexes were
      significantly higher in children with severe SIgAD as compared to control groups.

PMID- 1640912
TI  - [Lymphocyte subpopulations in inflammatory periapical lesions. A
      histopathological and immunohistochemical study in 10 cases].
AB  - The authors, thanks to the application of monoclonal antibodies, as well as the
      immunohistochemical technique of APAAP, have traced the qualitative and
      quantitative features of inflammatory cells implied in periapical lesions.
      Moreover ten patients, of whom 6 males and 4 females aged between 20 and 60 have
      been tested. The immunohistochemical reactions revealed a heterogeneous
      population of B and T (T4-T8) lymphocytes, together with myeloid trunk cells
      (granulocytes and histiocytes). The B lymphocytes form nearly 31.5% of all the
      inflammatory cell, whereas the T types form about 55.8. The granulo-histiocyte
      part implies 11.1% of all the inflammatory cells themselves. The average
      percentages of the roted inflammatory cells have been compared with two
      diagnostic categories of periapical granuloma and periapical cyst. However, by
      comparing the obtained results with the ones described by other authors, we
      notice agreement as for as qualitative analysis is concerned, while as for
      quantitative analysis, some differences are proved. Finally, this situation shows
      that the quantitative demonstration of inflammatory cell populations is only a
      moment in the development of immune reactions in the inflammatory tissue.

PMID- 1640913
TI  - [The importance of direct immunofluorescence in the diagnosis of oral lichen
      planus. A clinical study and proposal of new diagnostic criteria].
AB  - A series of 40 lesions of various kinds as lichen planus are examined using
      samples stained with trichromic test. HLA-DR expression with immunoperoxidase
      technique and direct immunofluorescence using the standard techniques. The aim of
      the study was to discover the usefulness for diagnosis of direct
      immunofluorescence, above all in histologically uncertain cases. The results
      suggest the view that direct immunofluorescence is essential for diagnosis of
      Lichen planus, in all clinical aspects. The author concludes with description of
      clinical proceeding for differential diagnosis between withe and erosive lesions
      of mouth.

PMID- 1640914
TI  - [Celiac disease and recurrent aphthous stomatitis. The clinical and immunogenetic
      aspects].
AB  - The frequency of HLA class II (DR and DQ) antigens is analyzed in 113 subjects
      affected by coeliac disease, nineteen of them suffering from recurrent aphthous
      stomatitis. A significant association was found between DRw10 and DQw1 HLA
      antigens and the two diseases in the 19 subjects suffering from both diseases.

PMID- 1640915
TI  - [Hemimandibular reconstruction via an autologous transplant of vascularized
      fibula. A report of a clinical case].
AB  - The authors illustrate the advantage of vascularised as opposed to conventional
      edges in the reconstruction of the jaw, focusing in particular on the use of a
      fibular autologous transplant. After a rapid description of the surgical
      technique used to remove the graft, they report a case of mandibular
      reconstruction in a young patient who had been involved in a shooting accident
      which had led to the loss of the left of this jaw.

PMID- 1640916
TI  - [Cervical trauma in the pathogenesis of cranio-cervico-mandibular dysfunctions].
AB  - A sudden cervical extension-flexion (whiplash) can cause a temporomandibular
      pathology with a direct and indirect mechanism of action. A total of 24 patients
      of both sexes who had undergone acute cervical trauma, which had led to
      masticatory dysfunction of a meniscal or algomyo-facial type, were examined. The
      most frequent signs and symptoms were regional pain, a qualitative and
      quantitative change in movements, cephalea, and articular noise. A complete
      condylo-meniscal block was observed in three cases. Concomitant radiographic
      tests using a trans-cranial projection confirmed clinical findings. A
      multidisciplinary individual therapeutic approach ensured complete functional
      recovery; prognosis varied with regard to cephalalgia which is related to the
      individual's psycho-behavioural substrate. The paper stresses the importance of
      early diagnosis and targeted treatment in order to prevent symptoms from becoming
      chronic thus making the disorder a disability which is difficult to treat.

PMID- 1640917
TI  - [A rare case of fibrous dysplasia in an elderly patient. The surgical
      intervention and prosthetic rehabilitation].
AB  - The authors report a rare case of fibrous dysplasia of the upper jaw bone in an
      elderly patient. Diagnostic iter, surgical therapy and rehabilitation are
      reported.

PMID- 1640918
TI  - [A clinical evaluation of the outcome of a bone graft from the iliac crest].
AB  - The paper examine 40 cases of bone graft from the iliac crest used in maxillo
      facial surgery. The immediate and late complications included pain with resulting
      difficulty of walking and, less frequently, hematoma, sensitivity disorders and
      dehiscence of the wound. Late complications were most frequently related to
      esthetic problems as well as a negligible number of persistent cases of difficult
      walking and neurological deficiencies. The results obtained were comparable to
      those most recently reported in the literature. The low incidence of immediate
      and late sequelae at the donor site and the characteristics of the bone graft
      confirm the suitability of iliac crest bone graft, in particular for use in
      reconstructive maxillo-facial surgery.

PMID- 1640919
TI  - [Condylar osteosynthesis after Krenkel's technic. The authors' personal
      experience].
AB  - The paper illustrates the authors' use of surgery to treat condylar fractures
      using Krenkel's technique which entails a cutaneous incision under the mandibular
      corner and the application of a clip screw in relation to the longitudinal axis
      of the upright branch of the jaw. This surgical technique, which is above all
      indicated in cases of low subcondylar fractures, provides a rigid internal
      fixation of the fracture stumps, thus preventing intermaxillary lock. Several
      stages in the operation are described in dental and the intrinsic advantages of
      this method are then outlined together with the results obtained.

PMID- 1640920
TI  - National action plan to combat multidrug-resistant tuberculosis.
AB  - At no time in recent history has tuberculosis (TB) been as great a concern as it
      is today. TB cases are on the increase, and the most serious aspect of the
      problem is the recent occurrence of outbreaks of multidrug-resistant (MDR) TB,
      which pose an urgent public health problem and require rapid intervention. A Task
      Force composed of representatives of many federal agencies has developed a
      National Action Plan for addressing this problem. The Task Force identified a
      number of objectives to be met if MDR-TB is to be successfully combatted. These
      objectives fall under the categories of a) surveillance and epidemiology-
      determining the magnitude and nature of the problem; b) laboratory diagnosis-
      improving the rapidity, sensitivity, and reliability of diagnostic methods for
      MDR-TB; c) patient management--effectively managing patients who have MDR-TB and
      preventing patients with drug-susceptible TB from developing drug-resistant
      disease; d) screening and preventive therapy--identifying persons who are
      infected with or at risk of developing MDR-TB and preventing them from developing
      clinically active TB; e) infection control--minimizing the risk of transmission
      of MDR-TB to patients, workers, and others in institutional settings; f) outbreak
      control; g) program evaluation--ensuring that TB programs are effective in
      managing patients and preventing MDR-TB; h) information dissemination/training
      and education; and i) research to provide new, more effective tools with which to
      combat MDR-TB. The Action Plan lays out a series of activities to be undertaken
      at the national level. For each category, the Plan presents statements of
      problems to be overcome, followed by a summary of the objective to be achieved
      and steps to be carried out. For each implementation step, responsibility is
      assigned to the appropriate organization and start-up dates are listed.

PMID- 1640921
TI  - Management of persons exposed to multidrug-resistant tuberculosis.
AB  - Recent outbreaks of multidrug-resistant tuberculosis (MDR-TB) have posed
      challenges for the management of exposed persons. This report offers suggestions
      for evaluating and managing persons (i.e., contacts) who have been exposed to
      patients with infectious MDR-TB (TB due to strains of Mycobacterium tuberculosis
      resistant to both isoniazid [INH] and rifampin [RIF]), provides background
      information on alternative preventive therapy regimens with drugs other than INH
      or RIF, and presents considerations relevant to making a decision to offer one of
      these alternative regimens.

PMID- 1640922
TI  - Counseling practices of primary-care physicians--North Carolina, 1991.
AB  - Because 80% of the U.S. population visits a physician each year (1), physicians
      are an important source for health education. In particular, physicians have
      unique opportunities to influence and modify health-risk behaviors of their
      patients. During 1991, the North Carolina Department of Environment, Health, and
      Natural Resources (DEHNR), the University of North Carolina at Chapel Hill, and
      CDC conducted a survey of nonmilitary primary-care physicians practicing in North
      Carolina regarding counseling and referral practices. This report summarizes
      results of this survey, including estimates of the proportion of primary-care
      physicians who counsel and/or refer for treatment patients who smoke, abuse drugs
      or alcohol, or have diet- or nutrition-related problems.

PMID- 1640923
TI  - Surgical sterilization among women and use of condoms--Baltimore, 1989-1990.
AB  - Since 1980, surgical sterilization among women has become the most common
      contraceptive method used among women aged greater than 30 years in the United
      States and is used by 28% of women aged 15-44 years. A previous report of women
      in drug treatment suggested that women who have been surgically sterilized were
      less likely to report condom use--an effective measure for prevention of human
      immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs)-
      than were nonsterilized women. This report summarizes a study of the relation
      between surgical sterilization, risk status for STDs and HIV, and use of condoms
      among women who reside in two inner-city, minority neighborhoods in Baltimore.

PMID- 1640924
TI  - Patient exposures to HIV during nuclear medicine procedures.
AB  - Although the potential for transmission of bloodborne pathogens to patients
      through transfusion of contaminated blood is well known, it is less widely
      recognized that such transmission can also occur during medical procedures
      involving withdrawal and reinjection of blood or blood products (e.g., nuclear
      medicine procedures). Since 1989, three patients (two in hospitals in the United
      States and one in the Netherlands) undergoing nuclear medicine procedures have
      been reported to have inadvertently received intravenous injections of blood or
      other material from patients infected with human immunodeficiency virus (HIV).
      Two of these patients are known to have become infected with HIV during these
      procedures; HIV test results are not available for the third patient. This report
      summarizes these three incidents and provides recommendations for preventive
      measures.

PMID- 1640925
TI  - Testing for HIV in the public and private sectors--Oregon, 1988-1991.
AB  - Counseling and testing persons for human immunodeficiency virus (HIV) infection
      is a key component of the public health strategy for reducing transmission of HIV
      in the United States (1,2). In 1991, the federal government allocated $100
      million to state and local health agencies to provide counseling and testing
      programs in public clinics for at-risk persons, including persons who may not
      otherwise use public health services. However, the relative contribution of HIV
      testing in public clinics to HIV testing in the private sector is unknown. To
      compare HIV testing in Oregon public clinics to overall HIV testing, the Health
      Division (HD) of the Oregon Department of Human Resources, in cooperation with
      CDC, reviewed data collected from September 1, 1988, through August 31, 1991, on
      public and private HIV testing in Oregon. This report summarizes findings for HIV
      testing rates and assesses the importance of publicly funded testing in
      identifying HIV-seropositive persons.

PMID- 1640926
TI  - Misclassification of infant deaths--Alaska, 1990-1991.
AB  - In June 1991, the Alaska Section of Vital Statistics reported that nine deaths of
      Alaskan Native infants occurred in seven villages in southwestern Alaska from
      January 1990 through June 1991. In comparison, seven Alaskan Native infant deaths
      occurred in these villages during 1986-1989. Two of the deaths during 1990-1991
      had been attributed to acute viral myocarditis (International Classification of
      Diseases, Ninth Revision [ICD-9], code 422.9) and three to viral or unspecified
      pneumonitis (ICD-9 codes 480.9 and 486), while from 1985 through 1989, one infant
      death in these villages had been attributed to either of these causes. An
      examination of the clinical histories of these nine infants by the Alaska
      Division of Public Health (ADPH) suggested some of the diagnoses might be
      inaccurate. This report summarizes an investigation by the ADPH to assess the
      accuracy of the immediate cause of death recorded on the death certificates for
      the nine infants.

PMID- 1640927
TI  - Ectopic pregnancy--United States, 1988-1989.
AB  - Although the number and rate of ectopic pregnancies in the United States
      increased from 1970 through 1987, they stabilized from 1987 through 1989 (1).
      This report presents data regarding the number and rate of ectopic pregnancies
      and ectopic pregnancy-related deaths in the United States from 1988 through 1989
      and compares those data with information reported since 1970.

PMID- 1640928
TI  - Effect of prolonged treatment with propionyl-L-carnitine on erucic acid-induced
      myocardial dysfunction in rats.
AB  - The aim of this study was to evaluate the ability of propionyl-L-carnitine to
      prevent cardiac damage induced by erucic acid. Rats were fed for 10 days with
      normal or 10% erucic acid-enriched diets with or without propionyl-L-carnitine
      intraperitoneally injected, (1 mM/kg daily, for 10 days). The erucic acid diet
      produced increases in triglycerides (from 5.6 to 12.4 mg/gww, P less than 0.01),
      and free fatty acids (from 2.0 to 5.1 mg/gww, P less than 0.01), but no changes
      in phospholipids. When the hearts were perfused aerobically with an isovolumic
      preparation there was no difference in mechanical activity. On the contrary, when
      pressure-volume curves were determined, the pressure developed by hearts from the
      erucic acid-treated rats were reduced. Independent of diet, propionyl-L-carnitine
      treatment always produced positive inotropy. This was concomitant with improved
      mitochondrial respiration (RCI 5.1 vs 9.3, P less than 0.01), higher tissue ATP
      content (10.3 vs 18.4 mumol/gdw P less than 0.01) and reduction of triglycerides
      (12.4 vs 8.0 mg/gww, P less than 0.01). These data suggest that propionyl-L
      carnitine, when given chronically, is able to prevent erucic acid-induced
      cardiotoxicity, probably by reducing triglyceride accumulation and improving
      energy metabolism.

PMID- 1640929
TI  - Characteristic induction of 70,000 da-heat shock protein and metallothionein by
      zinc in HeLa cells.
AB  - The synthesis of a 70,000 dalton-heat shock protein (hsp70) is one of several
      heat shock proteins induced in HeLa cells during the incubation in medium
      containing zinc sulphate. The synthesis of hsp70 was increased in the presence of
      200 microM zinc sulphate and above, but not at 100 microM zinc sulphate. On the
      other hand, the synthesis of metallothionein was activated in the presence of 100
      microM zinc sulphate and above. Uptake of zinc into the cells depended on the
      concentration of zinc sulphate in the medium. The separation of intracellular
      zinc into three fractions by gel filtration chromatography; high molecular,
      metallothionein, and low molecular fractions, showed that zinc in the low
      molecular weight and metallothionein fractions was elevated in the presence of
      100 microM zinc sulphate in the medium, whereas increase in the zinc content of
      the high molecular weight fraction occurred at 200 microM zinc sulphate and
      above. Inhibition of cell growth and cellular protein synthesis was also observed
      at 200 microM zinc sulphate and above, but not at 100 microM. From these
      findings, since the induction of hsp70 synthesis and inhibition of cell growth
      occurred concomitantly with the increase of zinc in the high and low molecular
      weight fractions, hsp70 seemed not to function in the detoxification of zinc, but
      it may participate in the repair of zinc-induced damage.

PMID- 1640930
TI  - Characterization of gastrin binding to colonic mucosal membranes of guinea pigs.
AB  - Gastrin has significant growth and metabolic effects on colonic mucosal cells. It
      is, however, not known if gastrin receptors are present on colonic mucosal cells
      that may directly mediate the reported biological effects of gastrin. In the
      present studies, the presence of specific gastrin binding sites on colonic
      mucosal membranes was investigated and the binding sites were further
      characterized. Crude membranes from colonic mucosa of guinea pigs were analyzed
      for specific binding to gastrin by our published procedures. A significant number
      (14.7 +/- 1.8 fmoles/mg protein) of high affinity gastrin binding sites (Kd =
      0.49 +/- 0.05 mM) were measured, that were specific for binding gastrin/CCK
      related peptides and demonstrated negligible binding affinity for all other
      unrelated peptides examined. In addition a large number of low-affinity (Kd =
      approximately 1 microM) binding sites were present. In order to further
      characterize the molecular size of gastrin binding proteins, we used the chemical
      cross-linking methods, and observed at least four bands of gastrin binding
      proteins (GBPs) (approximately 33, 45, 80 and 250 KDa), both under reducing and
      non-reducing conditions, indicating that these proteins were not sub-units of
      forms linked by disulfide bonds. Interestingly, majority of the specific gastrin
      binding sites (approximately 70%) were present on the 45 KDa protein, unlike
      other target cells of gastrin. The presence of N- and O-linked glycosylated
      moieties were indicated on the 45 KDa protein, based on enzymatic de
      glycosylation studies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1640931
TI  - Tyrosinated, detyrosinated and acetylated tubulin isotypes in rat brain
      membranes. Their proportions in comparison with those in cytosol.
AB  - The heterogeneity of alpha-tubulin and the relative proportions of the tubulin
      isotypes were investigated in brain membranes of rats of 1, 25 and 180 days of
      age by using four anti-alpha-tubulin antibodies: a) the monoclonal DM1A antibody,
      specific for alpha-tubulin; b) the monoclonal 6-11B-1 antibody, specific for
      acetylated tubulin; c) a polyclonal antibody (Glu antibody), specific for
      detyrosinated tubulin; and d) a polyclonal antibody (Tyr antibody), specific for
      tyrosinated tubulin. We found that rat brain membranes contain the three tubulin
      isotypes mentioned above. The proportions of tyrosinated and detyrosinated
      tubulin relative to total alpha-tubulin were somewhat lower in membrane than in
      cytosol in animals of 25 and 180 days of age. At day one of development, the
      proportions in membrane were similar to those found in cytosol. With respect to
      the acetylated form, it was about 20 times higher in membrane than in cytosol at
      the three ages studied. The proportion of acetylated tubulin was determined in
      different subcellular fractions: myelin, synaptic vesicles, mitochondria,
      microsomes, and plasma membrane. While the amount of total tubulin differed
      between the different subcellular fractions, the proportion of acetylated tubulin
      relative to total alpha-tubulin was constant and similar to that found in total
      membranes. The proportion of acetylated tubulin was also investigated in non
      neural tissues (kidney, liver and lung). Although values for cytosol were about
      10-fold higher than that found in brain cytosol, no detectable values for
      membranes could be obtained in these organs.

PMID- 1640932
TI  - Design of liposome to improve encapsulation efficiency of gelonin and its effect
      on immunoreactivity and ribosome inactivating property.
AB  - Gelonin, purified from the seeds of Gelonium multiflorum, using cation-exchange
      and gel-filtration chromatography was characterised for its purity, homogeneity
      and molecular weight by reverse-phase HPLC (RP-HPLC) and SDS-PAGE analysis. The
      HPLC purified gelonin was used for entrapment studies in the liposomes. Liposomes
      were prepared by reverse phase evaporation (REV) technique using three different
      types of lipid composition in the same molar ratio. The method resulted in 75-80%
      entrapment efficiency of gelonin in the liposomes. Entrapped and unentrapped
      gelonin was characterized for physico-chemical, immunochemical and biological
      properties. The immunoreactivity of entrapped gelonin was fully preserved but the
      ribosome-inactivating property was slightly inhibited. The method involved mild
      conditions, highly reproducible and the liposomes produced appeared to be stable
      for several months. It has important implications in the development of cell type
      specific cytotoxic agents where a chemical cross-linking is involved which
      significantly inhibits both immunoreactivity and ribosome-inactivating ability of
      the toxin.

PMID- 1640934
TI  - Role of the rat liver in the disposal of a glucose gavage.
AB  - An oral gavage of either 3, 1, or 0.1 mmoles of glucose was given to rats under
      standard feeding conditions or food deprived for 24 hr. The blood flow of the
      portal and suprahepatic veins as well as the hepatic balances for glucose,
      lactate, alanine and pyruvate were estimated. In fed rats, after the
      administration of an oral 3 mmoles load, the liver actually released 310 mumoles
      of glucose and 90 of lactate, amounts that could be accounted for by the uptake
      of alanine (148 mumoles) and small loss of glycogen (275 mumoles of glycosyl
      residues). In starved rats, however, the liver took a very high proportion (c.
      71%) of the glucose absorbed, both as glucose (780 mumoles), lactate and pyruvate
      (892 mumoles) or alanine (134 mumoles). The synthesis of glycogen was
      considerably limited, accounting for only 205 mumoles, and leaving practically
      one mmol of glucose equivalent energy available for liver function and the
      synthesis of other compounds. Practically all glycogen was synthesized directly
      from glucose, since the synthesis from 3 C carriers was less than a 5%. Smaller
      gavages (1 or 0.1 mmoles) resulted in a much lower liver uptake activity. The
      strikingly different activity of the liver with respect to the available glucose
      and 3 C fragments could not be explained alone by the circulating levels of these
      compounds, suggesting a very deep influence of the intestine in hepatic function.
      The liver plays a very passive role in fed animals, with a very small involvement
      in the disposal of a glucose load, whereas it takes on an important role when the
      overall availability of energy is diminished.

PMID- 1640933
TI  - Relevance of glutamine metabolism to tumor cell growth.

PMID- 1640935
TI  - Intestinal handling of a glucose gavage by the rat.
AB  - An oral gavage of either 3, 1 or 0.1 mmoles of 14C-labelled glucose was given to
      rats under standard feeding conditions or food deprived for 24 hr. The fate of
      the glucose label was determined at 10, 15, 30 and 60 min after gavage; at 60 min
      40% of the glucose was absorbed in fed rats (60% in food deprived). The portal
      vein blood flows were determined and the levels of glucose, lactate, alanine and
      pyruvate, and their radioactivity, as well as that of CO2 were measured in both
      portal and arterial blood. The net computed glucose and 3-carbon carriers
      (lactate, alanine and pyruvate) actually released into the portal system by the
      intestine was lower than the amount of glucose taken up from the intestinal lumen
      in one hour. Oxidation to 14CO2 accounted for a 12-15% of the absorbed glucose.
      The size of the gavage deeply affected the proportion of glucose released into
      the portal blood (c. 50% with a 3 mmoles gavage and practically nil with a 0.1
      mmoles gavage), but it affected much less the generation of lactate and other 3 C
      carriers. In fed rats, the net intestinal balance of non-radioactive glucose was
      negative, and that of lactate positive; when radioactive glucose was considered,
      the pattern was inverted. In starved rats, both glucose and lactate were released
      in large proportions by the intestine, but alanine efflux was lower. It can be
      concluded that the intestine consumes a considerable proportion of glucose in the
      fed state. Glucose handling by the intestine is compartmentalized in two
      functional circuits: glucose is taken up from the arterial blood and used for
      intestinal metabolism and lactate production, luminal glucose is absorbed mainly
      unaltered and transferred to the portal blood. Thus, the generation of lactate is
      mainly related to the availability of arterial glucose. In addition to the
      release of the ingested glucose as 3 C carriers or glucose, an extraportal
      pathway for glucose transfer into the bloodstream is postulated.

PMID- 1640936
TI  - High affinity DNA-microtubule associated protein interaction.
AB  - We have isolated the MAP/tau proteins from twice-cycled chick brain microtubule
      preparations and demonstrated that they are responsible for the nitrocellulose
      DNA binding activity we and others have measured. Using the isolated MAP/tau
      proteins we then measured the apparent affinity constant K(app) for the
      homologous chick DNA interaction and found evidence for two equilibrium affinity
      classes-a K(app) = 6 x 10(7) M-1, responsible for the bulk of the DNA binding
      activity and a small (less than 10%) higher affinity K(app) = 10(8) - 10(9) M-1,
      likely due to sequence specific binding protein species. Using the same chick
      brain MAP-tau protein, a heterologous interaction with D. melanogaster DNA, was
      found to possess just the lower affinity class-K(app) = 2 x 10(7) M-1. Under
      stringent binding conditions we carried out equilibrium nitrocellulose filter
      binding experiments in a ternary reaction mixture at constant MAP/tau protein and
      35S radiolabelled chick DNA concentration using increasing and excess
      concentrations of competitor DNAs of different sources. The order of competitor
      strengths found was-chick DNA greater than mouse DNA greater than D. melanogaster
      = E. coli. DNA. These data and specifically the homologous DNA: protein case
      being the strongest competitor corroborate our previous studies using total
      microtubule protein and provide new evidence for a conserved interaction of a
      small DNA sequence class with MAP/tau protein species. Moreover, these data allow
      us to conclude that the conserved DNA sequence: MAP/tau protein interactions do
      not critically depend upon any energetic feature co-involving tubulin for their
      properties since tubulin is absent from these preparations.

PMID- 1640937
TI  - Effect of calcium-binding protein regucalcin on Ca2+ transport system in rat
      liver nuclei: stimulation of Ca2+ release.
AB  - The effect of regucalcin, a calcium-binding protein isolated from rat liver
      cytosol, on Ca2+ transport in rat liver nuclei was investigated. Ca2+ uptake and
      release were determined with a Ca2+ electrode. Ca2+ uptake increased dependent on
      adenosine triphosphate (ATP; 0.5-2.0 mM), while the uptake was negligible in the
      presence of 2 mM ADP or AMP. Regucalcin (0.5-2.0 microM) had no effect on Ca2+
      uptake following addition of 2.0 mM ATP. Meanwhile, Ca2+, which accumulated in
      the nuclei during 10 min after ATP addition, was significantly released by the
      addition of regucalcin. This release was dose-dependent (0.1-2.0 microM).
      Vanadate (100 microM) and guanosine triphosphate (100 microM) did not cause a
      significant release of Ca2+ from the nuclei. Trifluoroperazine (TFP; 50 microM),
      an antagonist of calmodulin, significantly increased Ca2+ release from the
      nuclei. The presence of regucalcin (0.5 microM) further enhanced the TFP effect.
      These results indicate that regucalcin stimulates Ca2+ release from liver nuclei,
      and that the effect is not influenced by calmodulin antagonist. The finding
      suggests that regucalcin can regulate the Ca2+ transport system in rat liver
      nuclei.

PMID- 1640938
TI  - Decrease of myocardial infarct size with desferrioxamine: possible role of oxygen
      free radicals in its ameliorative effect.
AB  - The ability of an iron chelator, desferrioxamine, to inhibit the infarct size in
      in vivo rat heart was assessed. Anaesthetised rats were subjected to coronary
      artery ligation (CAL) for 72 hr and infarct size was measured macroscopically
      using TTC staining. Systolic blood pressure and ECG were monitored.
      Desferrioxamine (10 mg/kg and 20 mg/kg i.v.) administered half an hour after CAL
      markedly reduced the infarct size. However, drug treatment did not alter the
      systolic blood pressure of animals. In addition, desferrioxamine in vitro and in
      vivo demonstrated an inhibition of rat PMN-evoked and luminol-enhanced
      chemiluminescence. The capacity of desferrioxamine to impair the generation or to
      scavenge directly oxygen free radicals may be responsible for its beneficial
      effect on myocardial infarct size in rats.

PMID- 1640939
TI  - Demonstration of multiple forms of bovine brain myristoyl CoA:protein N-myristoyl
      transferase.
AB  - Four distinct N-myristoyl transferase (NMT) activity peaks, designated I, II,
      III, and IV, were separated from the cytosolic fraction of bovine brain by DEAE
      Sepharose column chromatography. Peaks I, II, III and IV were characterised
      biochemically with respect to substrate specificity: with cAMP-dependent protein
      kinase and pp60src derived peptides, and by their apparent molecular mass. The
      apparent molecular mass of peaks I, II, III and IV were 190 kDa, 224 kDa, 390 kDa
      and 76 kDa, respectively. These results indicate that bovine brain contains
      multiple forms of NMT.

PMID- 1640940
TI  - [Diagnosis and therapy of anemia in childhood. Part 2. Hemolytic anemia and
      anemia in the newborn infant].

PMID- 1640941
TI  - [Diseases involving the heart and kidney in children and adults].
AB  - An association of renal and cardiac manifestations can be observed in a variety
      of diseases. The pathogenetic factors may include, firstly, a disturbance of
      organ development due to chromosomal aberration or an underlying syndrome or,
      secondly, infectious, immunologic and metabolic factors. In addition, primarily
      isolated diseases of the heart or the kidney may lead to damage of the previously
      unaffected organ. The present article gives a review on renal diseases associated
      with heart diseases in children and adults.

PMID- 1640942
TI  - [How do parents adjust to a child with cancer? A clinical study of the
      psychosocial status of parents of children with cancer].
AB  - As chronic life-threatening diseases, cancer or leukemia in children generates an
      extreme situation for the family involved that can go on for years. Psychosocial
      care for all family members by a pediatric oncologist should be integrated into
      the treatment plan, as this is both helpful and necessary.

PMID- 1640943
TI  - [Farquhar disease. Reduced phagocyte function in a 9-year-old girl with
      erythrophagocytic lymphohistiocytosis].
AB  - We report phagocyte function tests in a female infant with familial
      hemophagozytotic lymphohistiocytosis. Chemiluminescence and killing of
      Saccharomyces cerevisiae by monocytes and granulocytes before chemotherapy and in
      remission were examined. Patients' monocytes and granulocytes showed a markedly
      reduced chemiluminescence and killing capacity irrespective of the stage of
      disease.

PMID- 1640944
TI  - [Killian-Teschler-Nicola syndrome (Pallister-Killian syndrome, mosaic tetrasomy
      12p)].

PMID- 1640945
TI  - [Townes-Brocks syndrome. Case report and review of the literature].
AB  - We report on a 14 months old Turkish girl with bilateral triphalangeal thumb and
      preaxial hexadaktyly on her left hand, bilaterally missing third toes and "Satyr
      ears" as typical features of Townes-Brocks Syndrome. Besides reviewing all
      previous publications we discuss frequency and significance of all features-
      especially of anorectal malformations and the third missing toe.

PMID- 1640946
TI  - [Anomalous origin of the left coronary artery from the pulmonary artery.
      Variability of clinical aspects, echocardiography and angiography findings].
AB  - OBJECTIVES: Analysis of symptoms, diagnostical difficulties and follow-up in
      infants and children with anomalous origin of the left coronary artery from the
      pulmonary artery. METHODS: Retrospective study; 12 children between 3 weeks and 2
      years old; time period: 1980-1991. RESULTS: Three infants were detected on
      routine examination because of a new cardiac murmur, the others presented with
      signs of cardiac failure. Cross sectional echocardiography and color Doppler flow
      mapping allowed to verify the suspected diagnosis. However, in one infant a false
      negative cross sectional echocardiographic result was obtained. In this case
      nuclear magnetic resonance imaging was able to delineate the exact anatomy. Mean
      preoperative left ventricular ejection fraction: 33 +/- 4%; percentage of infants
      below the age of 6 months: 92%; surgery related mortality: 66%; mean follow-up of
      the remaining 4 patients being in good clinical condition: 2.9 +/- 1 years.
      CONCLUSIONS: 1. An anomalous origin of the left coronary artery should be
      included into the differential diagnosis when a new cardiac murmur is detected.
      2. Possibility of false-negative echocardiographic results is emphasized. 3. With
      early symptoms and highly reduced left ventricular function, the mortality is
      still high.

PMID- 1640947
TI  - [Detection of drugs in meconium].
AB  - BACKGROUND: The number of newborn infants exposed to drugs in utero is on the
      increase in many European countries. As drug use reported by addicted pregnant
      women is unreliable there is a need for an accurate test to determine the drugs
      to which an infant has been exposed in utero. The purpose of this study was to
      evaluate the reliability of toxicology testing in meconium compared with
      traditional urine testing. METHODS: From twenty newborn infants born to drug
      dependent mothers, meconium and urine were collected as soon as possible after
      birth and tested for drugs with the same radioimmunoassay. Five neonates were
      premature (Gestational weeks less than 37), six were small and three
      microcephalic for gestational age. RESULTS: Meconium was positive for drugs in 19
      infants (95%) (Methadone 9, Morphine 9, Cocaine 6, Cannabis 4). Urine testing
      revealed the presence of drugs in 13 babies (65%) (Methadone 9, Morphine 6,
      Cocaine 4, Cannabis 1, Barbiturates 1). Five infants did not have any drug
      withdrawal, five had mild and ten severe withdrawal symptoms necessitating
      treatment with chlorpromazine and in four instances additional pethidine.
      CONCLUSIONS: Meconium is not only easier to collect but also at least as reliable
      as urine for drug detection in neonates.

PMID- 1640948
TI  - [Idiopathic hydrocephalus in adolescence].
AB  - BACKGROUND: Decompensation of chronic idiopathic hydrocephalus can occur at every
      age, but seems to be rather frequent in the middle of the second decade. From
      this observation, the question arises, whether or not in these cases a special
      manifestation of hydrocephalus occurs and, should the situation arise, whether
      this finding might influence the discussion about pathogenesis. METHODS: We give
      some casuistic material about six hydrocephalic patients who became symptomatic
      between their 12th and 16th year of life. RESULTS: All of these patients showed a
      tri-ventricular appearance of hydrocephalus as well as radiological signs of
      chronicly elevated intracranial pressure, while clinical signs and symptoms
      differed considerably. These findings are linked to the discussion of the
      pathogenesis of so-called aqueductal stenosis. CONCLUSIONS: Whenever, after
      normal development in childhood, symptoms like increasing headache, poor
      concentration, dizziness or disturbances of gait appear during puberty, X-ray
      diagnosis of the skull is recommended. If it shows the signs of chronic elevated
      intracranial pressure, further investigations are necessary.

PMID- 1640949
TI  - [Environmental chemoprevention of Haemophilus influenzae type B meningitis.
      Consequences of 2 indirectly related case pairs].
AB  - BACKGROUND: Within a few months we twice observed the following situation: In
      each of two different communities, a young child fell ill with meningitis caused
      by Haemophilus influenzae type B (HIB). One week later, a second case occurred in
      the same community. Both patients had had no direct contact with each other. But
      each had an asymptomatic older sibling. These siblings attended the same
      kindergarten and had close contact with each other. The isolated HIB strains were
      identical (capsular type b, biotype I, outer membrane protein subtype 1 and
      lipopolysaccharide serotype 1) and were beta-lactamase-negative. CONCLUSION:
      Since it must be assumed that the causative HIB strains circulated in the
      respective kindergartens and were transmitted to the patients by their healthy
      siblings, a rifampicin chemoprophylaxis was instituted which included all
      kindergarten children and their younger siblings. Since the current guidelines on
      chemoprophylaxis in HIB meningitis do not deal with a situation like the one
      encountered by us, a revision of the present guidelines was proposed and has been
      implemented in the meantime.

PMID- 1640950
TI  - [Perinatal hepatitis B virus transmission].
AB  - Using the highly sensitive Polymerase chain reaction (PCR) hepatitis B virus
      (HBV) DNA has already been detected in many patients negative for all other
      serological HBV markers [12]. But yet, the relevance of these findings as a
      marker of infectivity has not been determined. We therefore have used the PCR to
      examine the perinatal route of HBV transmission by testing sera from 109 mother
      child pairs in Yaounde, Cameroon. HBV-DNA was detected in 25 (23%) of the
      mother's sera from which only 5 were positive for HBsAg. At the age of 6 months
      only one baby out of 25 who could be retested had become positive for HBV-DNA,
      HBsAg, and HBeAg. Low serum HBV-DNA levels which are still detectable by the PCR
      therefore seem not to be associated with a high risk of perinatal HBV
      transmission.

PMID- 1640951
TI  - [Dioxins, furans and breast milk. Report of the Commission of Environmental
      Concerns of the Academy of Pediatrics and Adolescent Medicine and the Nutrition
      Commission of the German Society of Pediatrics].

PMID- 1640952
TI  - A randomized comparison of transcervical and transabdominal chorionic-villus
      sampling. The U.S. National Institute of Child Health and Human Development
      Chorionic-Villus Sampling and Amniocentesis Study Group.
AB  - BACKGROUND: Chorionic-villus sampling is done in early pregnancy to obtain fetal
      cells for the prenatal diagnosis of genetic and chromosomal defects.
      Transcervical chorionic-villus sampling has been shown to be safe and effective
      in national trials. Recently, an alternative transabdominal technique has been
      suggested as potentially easier and safer. METHODS: From April 1987 through
      September 1989, we prospectively compared transcervical and transabdominal
      chorionic-villus sampling in 3999 women with singleton pregnancies in whom the
      risk of a genetically abnormal fetus was increased. Women between 7 and 12 weeks
      of gestation underwent ultrasonographic evaluation of placental and uterine
      position. Those with active vaginal infections, active bleeding, or cervical
      polyps were excluded. If the obstetrician thought either sampling procedure was
      acceptable, the woman was asked to consent to random assignment to one of the two
      procedures. Both groups were followed to determine the outcome of pregnancy and
      the rate of spontaneous fetal loss after chorionic-villus sampling. RESULTS:
      Among the 3999 women who entered the study, sampling was attempted in 3873 (97
      percent), 1944 of whom had been assigned to undergo transcervical sampling and
      1929 to undergo transabdominal sampling. Of these 3873 women, sampling was
      eventually successful in 3863. Sampling was successful after a single insertion
      of the sampling instrument in 94 percent of the transabdominal procedures and 90
      percent of the transcervical procedures. Among the women with cytogenetically
      normal pregnancies who had sampling because of maternal age, the rate of
      spontaneous fetal loss through 28 weeks of pregnancy was 2.5 percent in the
      transcervical-sampling group and 2.3 percent in the transabdominal-sampling group
      (difference, 0.26 percent; 95 percent confidence interval, -0.5 to 1.0 percent).
      CONCLUSIONS: Transabdominal and transcervical chorionic-villus sampling appear to
      be equally safe procedures for first-trimester diagnosis of fetal abnormalities.

PMID- 1640953
TI  - Methylprednisolone plus chlorambucil as compared with methylprednisolone alone
      for the treatment of idiopathic membranous nephropathy. The Italian Idiopathic
      Membranous Nephropathy Treatment Study Group.
AB  - BACKGROUND AND METHODS: Treatment with methylprednisolone and chlorambucil may
      protect renal function and increase the chance of remission of the nephrotic
      syndrome in patients with idiopathic membranous nephropathy. To determine whether
      similar results might be obtained with methylprednisolone alone, we compared the
      effects of methylprednisolone and chlorambucil with those of methylprednisolone
      alone in 92 patients with the nephrotic syndrome caused by idiopathic membranous
      nephropathy. The patients were randomly assigned to receive either alternating
      one-month courses of methylprednisolone and then chlorambucil for a total of six
      months (group 1) or methylprednisolone alone for six months at the same
      cumulative dosage (group 2). RESULTS: Four of the 45 patients in group 1 (9
      percent) and 1 of the 47 in group 2 (2 percent) stopped treatment because of side
      effects. At one, two, and three years, the percentage of patients who did not
      have the nephrotic syndrome was significantly higher in group 1 than in group 2.
      It was 58, 54, and 66 percent, respectively, in group 1, as compared with 26, 32,
      and 40 percent in group 2 (P = 0.002, 0.029, and 0.011). By year 4, the
      difference was no longer statistically significant: 62 percent of the patients in
      group 1 and 42 percent of those in group 2 did not have the nephrotic syndrome (P
      = 0.102). The patients in group 1 were in remission longer than those in group 2
      (P = 0.008). CONCLUSIONS: In patients with the nephrotic syndrome caused by
      idiopathic membranous nephropathy, treatment with methylprednisolone and
      chlorambucil for six months induces an earlier remission of the nephrotic
      syndrome than methylprednisolone alone, but the difference may diminish with
      time.

PMID- 1640954
TI  - Abnormalities of the left temporal lobe and thought disorder in schizophrenia. A
      quantitative magnetic resonance imaging study.
AB  - BACKGROUND: Data from postmortem, CT, and magnetic resonance imaging (MRI)
      studies indicate that patients with schizophrenia may have anatomical
      abnormalities of the left temporal lobe, but it is unclear whether these
      abnormalities are related to the thought disorder characteristic of
      schizophrenia. METHODS: We used new MRI neuroimaging techniques to derive
      (without knowledge of the diagnosis) volume measurements and three-dimensional
      reconstructions of temporal-lobe structures in vivo in 15 right-handed men with
      chronic schizophrenia and 15 matched controls. RESULTS: As compared with the
      controls, the patients had significant reductions in the volume of gray matter in
      the left anterior hippocampus-amygdala (by 19 percent [95 percent confidence
      interval, 3 to 36 percent]), the left parahippocampal gyrus (by 13 percent [95
      percent confidence interval, 3 to 23 percent], vs. 8 percent on the right), and
      the left superior temporal gyrus (by 15 percent [95 percent confidence interval,
      5 to 25 percent]). The volume of the left posterior superior temporal gyrus
      correlated with the score on the thought-disorder index in the 13 patients
      evaluated (r = -0.81, P = 0.001). None of these regional volume decreases was
      accompanied by a decrease in the volume of the overall brain or temporal lobe.
      The volume of gray matter in a control region (the superior frontal gyrus) was
      essentially the same in the patients and controls. CONCLUSIONS: Schizophrenia
      involves localized reductions in the gray matter of the left temporal lobe. The
      degree of thought disorder is related to the size of the reduction in volume of
      the left posterior superior temporal gyrus.

PMID- 1640955
TI  - The prevention and treatment of osteoporosis.

PMID- 1640956
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 35-1992. An eight-month-old boy with diarrhea and failure to
      thrive.

PMID- 1640957
TI  - Membranous nephropathy--still a treatment dilemma.

PMID- 1640958
TI  - Nucleoside therapy for HIV infection--some answers, many questions.

PMID- 1640959
TI  - The Oregon Medicaid controversy.

PMID- 1640960
TI  - The Oregon Medicaid controversy.

PMID- 1640961
TI  - The Oregon Medicaid controversy.

PMID- 1640962
TI  - Prophylactic fluconazole and marrow transplantation.

PMID- 1640963
TI  - Prophylactic fluconazole and marrow transplantation.

PMID- 1640964
TI  - Prophylactic fluconazole and marrow transplantation.

PMID- 1640965
TI  - Pregnancy and HIV.

PMID- 1640966
TI  - Pregnancy and HIV.

PMID- 1640967
TI  - Preventing neonatal herpes.

PMID- 1640968
TI  - Preventing neonatal herpes.

PMID- 1640969
TI  - Demonstration of the transmissible agent in tissue from a pregnant woman with
      Creutzfeldt-Jakob disease.

PMID- 1640970
TI  - Pravastatin-associated inflammatory myopathy.

PMID- 1640971
TI  - The Supreme Court, liberty, and abortion.

PMID- 1640972
TI  - On gene patenting.

PMID- 1640973
TI  - Phylogeny of the genera Trichophyton using mitochondrial DNA analysis.
AB  - Diversity of mitochondrial DNA (mtDNA) was investigated in 92 Trichophyton rubrum
      strains, 2 T. mentagrophytes var. mentagrophytes, 2 T. m. var. interdigitale, 2
      T. m. var. goetzii, 1 T. m. var. erinacei, 2 T. quinckeanum, 2 T. schoenleinii, 1
      T. tonsurans, 2 T. verrucosum var. album, 2 T. v. var. discoides, 1 T. violaceum
      var. violaceum, 1 Arthroderma benhamiae, and 1 A. vanbreuseghemii using
      endonucleases, Hae III, Msp I, Hind III, Xba I, and Bgl II. Trichophyton species
      were divided into 7 groups, and a phylogenetic tree was produced based on
      sequence divergence within mtDNA. The following results were obtained: (1) T.
      rubrum was divided into 2 groups Type I and Type II, and was suggested to be a
      complex. (2) A. benhamiae was closely related to T. m. var. erinacei. (3) T.
      rubrum Type II, T. tonsurans, and A. vanbreuseghemii showed identical restriction
      profiles, and were suggested to be closely related to each other or identical.
      (4) T. quinckeanum and T. schoenlenii showed identical restriction profiles,
      which differed slightly from those of A. vanbreuseghemii. (5) mtDNA analysis was
      useful in identifying pleomorphic strains.

PMID- 1640974
TI  - Localized cutaneous nocardiosis in Japan. A new case.
AB  - We report a case of localized cutaneous nocardiosis due to Nocardia asteroides,
      appearing on the anterior surface of the right forearm of a 29-year-old woman.
      Examination of the skin revealed a firm subcutaneous nodule measuring 32 x 20 mm
      and accompanied with a small ulcer. The histology of the lesion showed
      granulomatous changes interspersed with large numbers of polymorphonuclear
      leukocytes. On Gram staining, a few bacillary bodies were found scattered through
      the lesion, but no grains were detected. The classification of the clinical types
      of cutaneous nocardiosis is discussed, and the Japanese literature on localized
      cutaneous nocardiosis is examined.

PMID- 1640975
TI  - Detection of cellular immunity with the soluble antigen of the fungus Sporothrix
      schenckii in the systemic form of the disease.
AB  - Sporothrix schenckii is the etiologic agent of sporotrichosis, a mycosis of world
      wide distribution more commonly occurring in tropical regions. The immunological
      mechanisms involved in the prevention and control of sporotrichosis are not fully
      understood but apparently include both the humoral and cellular responses. In the
      present investigation, cellular immunity was evaluated by in vivo and in vitro
      tests in mice infected with yeast-like forms of S. schenckii. The disease
      developed systemically and cellular immunity was evaluated for a period of 10
      weeks. The soluble antigen utilized in the tests was prepared from yeast form of
      the fungus through the sonication (20 min: 10 sonications at 50 W at 2-min
      intervals). Delayed hypersensitivity and lymphocyte transformation tests showed
      that the cellular immune response was depressed between the 4th and 6th week of
      infection when the animals were challenged with the soluble fungal antigen. This
      depression frequently indicates worsening of the disease, with greater
      involvement of the host. This is a promising field of research for a better
      understanding of the pathogeny of this mycosis.

PMID- 1640977
TI  - Ultrastructure of the concentric membrane system in Arthrinium aureum.
AB  - An ultrastructural study was performed on Arthrinium aureum. The fungi were
      treated with glutaraldehyde and osmium tetroxide fixation. The hypha and conidia
      has a concentric membrane system which consisted of multiple membranes of a
      myelinoid appearance, and continued to the conidia and hypha plasma membrane. The
      fungi were also treated with periodic acid-alkaline bismuth (PABi) staining after
      glutaraldehyde and osmium tetroxide fixation. PABi positive materials were found
      on the marginal glycogen granules, the concentric membrane system and the conidia
      plasma membrane.

PMID- 1640976
TI  - Pathogenicity of Sporotrichum pruninosum and Cladosporium oxysporum, isolated
      from the bronchial secretions of a patient, for laboratory mice.
AB  - In this study we have demonstrated the occurrence of Sporotrichum pruinosum and
      Cladosporium oxysporum in the bronchial secretions of a patient with a
      presumptive diagnosis of tuberculosis. This observation coupled with the ability
      of both fungi to cause infection and elicit tissue responses in experimentally
      infected mice supported a probable etiologic relationship with the patient which
      could not be confirmed in the absence of histologic evidence. In vitro some
      antimycotics were tested against S. pruinosum and C. oxysporum by the agar
      dilution method. Oxiconazole with a minimum inhibitory concentration of 0.1
      micrograms/ml-1 after 72 h and amorolfine at a concentration of 0.001
      micrograms/ml-1 after 72 h were the most active ones against S. pruinosum and C.
      oxysporum respectively. It is suggested that the isolation of S. pruinosum and C.
      oxysporum from patients with bronchopulmonary disorders should be viewed with
      caution. Clinical and laboratory evaluation of such patients should be done
      critically before arriving at a firm diagnosis.

PMID- 1640978
TI  - IMI descriptions of fungi and bacteria no. 1101. Penicillium aurantiogriseum.

PMID- 1640979
TI  - IMI descriptions of fungi and bacteria no. 1103. Penicillium camembertii.

PMID- 1640980
TI  - IMI descriptions of fungi and bacteria no. 1104. Penicillium citrinum.

PMID- 1640981
TI  - IMI descriptions of fungi and bacteria no. 1105. Penicillium glabrum.

PMID- 1640982
TI  - IMI descriptions of fungi and bacteria no. 1106. Penicillium islandicum.

PMID- 1640983
TI  - IMI descriptions of fungi and bacteria no. 1107. Penicillium oxalicum.

PMID- 1640984
TI  - IMI descriptions of fungi and bacteria no. 1108. Penicillium purpurogenum.

PMID- 1640985
TI  - IMI descriptions of fungi and bacteria no. 1109. Penicillium roquefortii.

PMID- 1640986
TI  - IMI descriptions of fungi and bacteria no. 1110. Penicillium viridicatum.

PMID- 1640988
TI  - Germany links biology centres.

PMID- 1640987
TI  - EMBL director quits after long fight over expansion.

PMID- 1640989
TI  - Burris appointed to head Woods Hole marine laboratory.

PMID- 1640990
TI  - Problems delay emergence of Moscow research centre.

PMID- 1640991
TI  - Fact and fiction in alignment.

PMID- 1640992
TI  - Mistaken view.

PMID- 1640993
TI  - Natural selection.

PMID- 1640994
TI  - Consciousness on the scientific agenda.

PMID- 1640995
TI  - Proteins. Folding in the egg white.

PMID- 1640996
TI  - Chemical kinetics. Probing the transition state.

PMID- 1640997
TI  - Quicker reaction by design.

PMID- 1640998
TI  - Signal transduction. Exchange rate mechanisms.

PMID- 1640999
TI  - How cells know their place.

PMID- 1641000
TI  - What's in a genome?

PMID- 1641001
TI  - Earliest Homo debate.

PMID- 1641002
TI  - Earliest Homo debate.

PMID- 1641003
TI  - The folding of hen lysozyme involves partially structured intermediates and
      multiple pathways.
AB  - Analysis of the folding of hen lysozyme shows that the protein does not become
      organized in a single cooperative event but that different parts of the structure
      become stabilized with very different kinetics. In particular, in most molecules
      the alpha-helical domain folds faster than the beta-sheet domain. Furthermore,
      different populations of molecules fold by kinetically distinct pathways. Thus,
      folding is not a simple sequential assembly process but involves parallel
      alternative pathways, some of which may involve substantial reorganization steps.

PMID- 1641004
TI  - Retinoblastoma gene product activates expression of the human TGF-beta 2 gene
      through transcription factor ATF-2.
AB  - The retinoblastoma susceptibility gene product (pRb) plays an important role in
      constraining cellular proliferation and in regulating the cell cycle. The pRb
      inhibits transcription of genes involved in growth control (reviewed in ref. 3)
      and can regulate transforming growth factor beta 1 (TGF-beta 1) gene expression.
      TGF-beta isoforms also down-regulate cellular proliferation. To determine whether
      pRb also regulates expression of other TGF-beta isoforms, we examined the effect
      of pRb on the expression of the human TGF-beta 2 gene. The human TGF-beta 2
      promoter contains multiple elements including an ATF site, which is essential for
      basal promoter activity. Here we report that pRb activates transcription of the
      human TGF-beta 2 gene. The promoter element responsible for pRb-mediated
      transcriptional regulation is a binding site for ATF proteins, an extensive
      transcription factor family. We provide evidence that implicates ATF-2 in pRb
      responsiveness. First, the ATF promoter element in the TGF-beta 2 gene is a high
      affinity ATF-2-binding site. Second, a GAL4-ATF2 fusion protein can support pRb
      mediated transcriptional activation of a promoter containing GAL4-binding sites.
      Third, ATF-2 in nuclear extracts can interact with pRb. Our results reveal a new
      mechanism by which pRb constrains cellular proliferation: by activating
      expression of the inhibitory growth factor, TGF-beta 2.

PMID- 1641005
TI  - A strategy tinged with chauvinism.

PMID- 1641006
TI  - NIH, under fire, freezes grant for conference on genetics and crime.

PMID- 1641007
TI  - Society asks Brazil's president to resign.

PMID- 1641008
TI  - British say Pasteur Institute slighted their help on AIDS test.

PMID- 1641009
TI  - Industry slows research gains in Portugal.

PMID- 1641010
TI  - British report real decline in spending on research.

PMID- 1641011
TI  - Japan prepares spending increase.

PMID- 1641012
TI  - Wellcome Trust to double spending after sale of shares.

PMID- 1641013
TI  - University officials dismiss quick payoff from research funds.

PMID- 1641014
TI  - How rare is rare?

PMID- 1641015
TI  - Humbling of world's AIDS researchers.

PMID- 1641016
TI  - Developmental biology. The germ of the issue.

PMID- 1641017
TI  - Marine biology. A phantom of the ocean.

PMID- 1641018
TI  - Transcriptional regulation. A closer look at E2F.

PMID- 1641019
TI  - Molecular mimicry in liver disease.

PMID- 1641020
TI  - Marine isotope evolution.

PMID- 1641021
TI  - Induction of germ cell formation by oskar.
AB  - The oskar gene directs germ plasm assembly and controls the number of germ cell
      precursors formed at the posterior pole of the Drosophila embryo. Mislocalization
      of oskar RNA to the anterior pole leads to induction of germ cells at the
      anterior. Of the eight genes necessary for germ cell formation at the posterior,
      only three, oskar, vasa and tudor, are essential at an ectopic site.

PMID- 1641022
TI  - New 'phantom' dinoflagellate is the causative agent of major estuarine fish
      kills.
AB  - A worldwide increase in toxic phytoplankton blooms over the past 20 years has
      coincided with increasing reports of fish diseases and deaths of unknown cause.
      Among estuaries that have been repeatedly associated with unexplained fish kills
      on the western Atlantic Coast are the Pamlico and Neuse Estuaries of the
      southeastern United States. Here we describe a new toxic dinoflagellate with
      'phantom-like' behaviour that has been identified as the causative agent of a
      significant portion of the fish kills in these estuaries, and which may also be
      active in other geographic regions. The alga requires live finfish or their fresh
      excreta for excystment and release of a potent toxin. Low cell densities cause
      neurotoxic signs and fish death, followed by rapid algal encystment and dormancy
      unless live fish are added. This dinoflagellate was abundant in the water during
      major fish kills in local estuaries, but only while fish were dying; within
      several hours of death where carcasses were still present, the flagellated
      vegetative algal population had encysted and settled back to the sediments.
      Isolates from each event were highly lethal to finfish and shellfish in
      laboratory bioassays. Given its broad temperature and salinity tolerance, and its
      stimulation by phosphate enrichment, this toxic phytoplankter may be a widespread
      but undetected source of fish mortality in nutrient-enriched estuaries.

PMID- 1641023
TI  - Physiological and behavioural thermoregulation in bigeye tuna (Thunnus obesus).
AB  - Tuna are unique among teleost fishes in being thermoconserving. Vascular counter
      current heat exchangers maintain body temperatures above ambient water
      temperature, thereby improving locomotor muscle efficiency, especially at burst
      speeds and when pursuing prey below the thermocline. Because tuna also
      occasionally swim rapidly in warm surface waters, it has been hypothesized that
      tuna thermoregulate to accommodate changing activity levels or ambient
      temperatures. But previous field experiments have been unable to demonstrate
      definitively short-latency, mammalian-type physiological thermoregulation. Here
      we show using telemetered data that free-ranging bigeye tuna (Thunnus obesus) can
      rapidly alter whole-body thermal conductivity by two orders of magnitude. The
      heat exchangers are disengaged to allow rapid warming as the tuna ascend from
      cold water into warmer surface waters, and are reactivated to conserve heat when
      they return into the depths. Combining physiological and behavioural
      thermoregulation expands the foraging space of bigeye tuna into otherwise
      prohibitively cold, deep water.

PMID- 1641024
TI  - Neural correlates of perceptual motion coherence.
AB  - The motions of overlapping contours in a visual scene may arise from the physical
      motion(s) of either a single or multiple surface(s). A central problem facing the
      visual motion system is that of assigning the most likely interpretation. The
      rules underlying this perceptual decision can be explored using a visual stimulus
      formed by superimposing two moving gratings. The resultant percept is either that
      of a single coherently moving 'plaid pattern' (coherent motion) or of the two
      component gratings sliding noncoherently across one another (noncoherent motion).
      When plaid patterns are configured to mimic one transparent grating overlying
      another, the percept of noncoherent motion dominates. We now report that neurons
      in the visual cortex of rhesus monkeys exhibit changes in direction tuning that
      parallel this perceptual phenomenon: sensitivity to the motions of the component
      gratings is enhanced under conditions that favour the perception of noncoherent
      motion. These results challenge models of cortical visual processing that fail to
      take into account the contribution of figural image segmentation cues to the
      analysis of visual motion.

PMID- 1641025
TI  - Specific binding of the transcription factor sigma-54 to promoter DNA.
AB  - A central event in transcription is the assembly on DNA of specific complexes
      near the initiation sites for RNA synthesis. Activation of transcription by one
      class of enhancer-binding proteins requires an RNA polymerase holoenzyme
      containing the specialized transcription factor, sigma-54 (sigma 54). We report
      here that sigma 54 alone specifically binds to promoter DNA and is responsible
      for many of the close contacts between RNA polymerase holoenzyme and promoter
      DNA, a property proposed for the major sigma 70 protein family. Binding of sigma
      54 to promoter DNA is not equivalent to that of holoenzyme suggesting that there
      is a constraint on sigma 54 conformation when bound with core RNA polymerase.
      Footprints indicate sigma 54 is at the leading edge of DNA-bound holoenzyme. Like
      the holoenzyme, sigma 54-binding to promoter DNA does not result in DNA strand
      separation. Instead the specific DNA-binding activity of sigma 54 assists
      assembly of a closed promoter complex. This complex can be isomerized to the open
      (DNA melted) complex by activator protein, but promoter-bound sigma 54 alone
      cannot be induced to melt DNA. The pathway leading to productive transcription is
      similar to that proposed for eukaryotic RNA polymerase II systems.

PMID- 1641026
TI  - Ectopic mesoderm formation in Xenopus embryos caused by widespread expression of
      a Brachyury homologue.
AB  - The Brachyrury (T) gene is required cell-autonomously for mesoderm formation in
      the posterior of the mouse embryo, and both is complementary DNA sequence and
      expression pattern closely resemble those of a Xenopus homologue (Xbra),
      suggesting that these genes have an evolutionarily conserved function in
      vertebrate development. Strong expression of Xbra messenger RNA is found in the
      ring of involuting mesoderm during Xenopus gastrulation, and the expression of
      Xbra is an immediate-early response of animal pole blastomeres to mesoderm
      inducing factors. To assess the role of Xbra in mesoderm formation, we increased
      its domain of expression in the embryo by microinjection of Xbra transcripts into
      the animal pole of Xenopus embryos at the one-cell stage. We show that expression
      of Xbra by cells of the early embryo is sufficient to direct their development
      into differentiated mesodermal tissues. At the molecular level this response
      shows a sharp threshold of sensitivity to the dose of Xbra RNA delivered, and we
      suggest that Xbra may act as a genetic switch initiating posterior mesodermal
      specification during embryogenesis.

PMID- 1641027
TI  - An unusual feature revealed by the crystal structure at 2.2 A resolution of human
      transforming growth factor-beta 2.
AB  - Transforming growth factor type beta 2 (TGF-beta 2) is a member of an expanding
      family of growth factors that regulate proliferation and differentiation of many
      different cell types. TGF-beta 2 binds to various receptors, one of which was
      shown to be a serine/threonine kinase. TGF-beta 2 is involved in wound healing,
      bone formation and modulation of immune functions. We report here the crystal
      structure of TGF-beta 2 at 2.2 A resolution, which reveals a novel monomer fold
      and dimer association. The monomer consists of two antiparallel pairs of beta
      strands forming a flat curved surface and a separate, long alpha-helix. The
      disulphide-rich core has one disulphide bone pointing through a ring formed by
      the sequence motifs Cys-Ala-Gly-Ala-Cys and Cys-Lys-Cys, which are themselves
      connected through the cysteines. Two monomers are connected through a single
      disulphide bridge and associate such that the helix of one subunit interacts with
      the concave beta-sheet surface of the other. Four exposed loop regions might
      determine receptor specificity. The structure provides a suitable model for the
      TGF-beta s and other members of the super-family and is the basis for the
      analysis of the TGF-beta 2 interactions with the receptor.

PMID- 1641029
TI  - Welcoming Wellcome.

PMID- 1641028
TI  - Cloning of cDNAs for Fanconi's anaemia by functional complementation.

PMID- 1641030
TI  - Healy attacks NASA's claims; bad news for research budgets.

PMID- 1641031
TI  - Bush delays new risk guidelines.

PMID- 1641032
TI  - AIDS causation.

PMID- 1641033
TI  - Sex testing at the Olympics.

PMID- 1641034
TI  - Developmental biology. Inducing concentric worm holes.

PMID- 1641035
TI  - Motor neuron diseases. High hopes of a trophic factor.

PMID- 1641036
TI  - Westhof's rule.

PMID- 1641037
TI  - The gene lin-3 encodes an inductive signal for vulval development in C. elegans.
AB  - The lin-3 gene is necessary for induction of the Caenorhabditis elegans vulva by
      the anchor cell. It encodes a molecule similar to epidermal growth factor and to
      transforming growth factor-alpha and acts through the epidermal growth factor
      receptor homologue let-23. Expression of lin-3 in the anchor cell stimulates
      vulval induction; lin-3 may encode the vulval inducing signal.

PMID- 1641038
TI  - Human infection by genetically diverse SIVSM-related HIV-2 in west Africa.
AB  - Our understanding of the biology and origins of human immunodeficiency virus type
      2 (HIV-2) derives from studies of cultured isolates from urban populations
      experiencing epidemic infection and disease. To test the hypothesis that such
      isolates might represent only a subset of a larger, genetically more diverse
      group of viruses, we used nested polymerase chain reactions to characterize HIV-2
      sequences in uncultured mononuclear blood cells of two healthy Liberian
      agricultural workers, from whom virus isolation was repeatedly unsuccessful, and
      from a culture-positive symptomatic urban dweller. Analysis of pol, env and long
      terminal repeat regions revealed the presence of three highly divergent HIV-2
      strains, one of which (from one of the healthy subjects) was significantly more
      closely related to simian immunodeficiency viruses infecting sooty mangabeys and
      rhesus macaques (SIVSM/SIVMAC) than to any virus of human derivation. This
      subject also harboured multiply defective viral genotypes that resulted from
      hypermutation of G to A bases. Our results indicate that HIV-2, SIVSM and SIVMAC
      comprise a single, highly diverse group of lentiviruses which cannot be separated
      into distinct phylogenetic lineages according to species of origin.

PMID- 1641039
TI  - Ciliary neurotrophic factor prevents degeneration of motor neurons in mouse
      mutant progressive motor neuronopathy.
AB  - Ciliary neurotrophic factor (CNTF) supports the survival of embryonic motor
      neurons in vitro and in vivo, and prevents lesion-mediated degeneration of rat
      motor neurons during early post-natal stages. Here we report that CNTF greatly
      reduces all the functional and morphological changes in pmn/pmn mice, an
      autosomal recessive mutant leading to progressive caudo-cranial motor neuron
      degeneration. The first manifestations of progressive motor neuronopathy in
      homozygous pmn/pmn mice become apparent in the hind limbs at the end of the third
      post-natal week, and all the mice die up to 6 or 7 weeks after birth from
      respiratory paralysis. Treatment with CNTF prolongs survival and greatly improves
      motor function of these mice. Moreover, morphological manifestations, such as
      loss of motor axons in the phrenic nerve and degeneration of facial motor
      neurons, were greatly reduced by CNTF, although the treatment did not start until
      the first symptoms of the disease had already become apparent and substantial
      degenerative changes were already present. The protective and restorative effects
      of CNTF in this mouse mutant give new perspectives for the treatment of human
      degenerative motor neuron diseases with CNTF.

PMID- 1641040
TI  - Retrograde transport of endocytosed Shiga toxin to the endoplasmic reticulum.
AB  - Shiga toxin and some other protein toxins that act on targets in the cytosol have
      previously been shown to enter the trans-Golgi network. Transport by this route
      may be necessary for translocation of the toxin to the cytosol and for
      intoxication, but it is not known whether the enzymatically active part of the
      toxins actually enters the cytosol from the trans-Golgi network. It has been
      suggested that such toxins are transported in a retrograde manner to the
      endoplasmic reticulum and that translocation occurs in this organelle, but
      retrograde transport of endocytosed material beyond the trans-Golgi network has
      never been demonstrated. Here we show that in butyric acid-treated A431 cells
      endocytosed Shiga toxin is not only transported to the trans-Golgi network, but
      also to all Golgi stacks, to the endoplasmic reticulum and to the nuclear
      envelope. Furthermore, butyric acid sensitizes the cells to Shiga toxin, which is
      consistent with the possibility that retrograde transport is required for
      translocation of the toxin to the cytosol.

PMID- 1641041
TI  - A role for ADP-ribosylation factor in nuclear vesicle dynamics.
AB  - Two distinct steps in nuclear envelope assembly can be assayed in vitro: the
      protein-mediated binding of nuclear-specific vesicles to chromatin, and the
      subsequent fusion of these vesicles to enclose the chromatin within a double
      nuclear membrane. Nuclear vesicle fusion, like fusion in the secretory pathway,
      requires ATP and cytosol and is inhibited by nonhydrolysable GTP analogues. The
      sensitivity of nuclear vesicle fusion to GTP-gamma S requires a GTP-dependent
      soluble factor, the properties of which are strikingly similar to a GTP-dependent
      Golgi binding factor (GGBF) that inhibits Golgi vesicle fusion in the presence of
      GTP-gamma S and belongs to the ADP-ribosylation factor (ARF) family of small
      GTPases. In the presence of GTP-gamma S, ARF proteins and alpha-, beta-, gamma-,
      delta-COP ('coatomer') subunits are associated with Golgi transport vesicles, but
      the exact roles of ARF proteins in secretion are not yet understood. We report
      here that purified ARF1 and GGBF have GTP-dependent soluble factor activity in
      the nuclear vesicle fusion assay. Our results show that the function of ARF is
      not limited to the Golgi apparatus, and indicate that there may be a link between
      the formation of nuclear vesicles during mitosis and proteins involved in
      secretion.

PMID- 1641042
TI  - Moving straight to the target.
AB  - Retroviral vectors for gene transfer experiments have their limitations--hence
      the attraction of using other viral vehicles to administer genes directly to
      affected organs.

PMID- 1641043
TI  - 32P, 33P and 35S: selecting a label for nucleic acid analysis.
AB  - The advent of 33P nucleotide triphosphates has widened the options available for
      labelling nucleic acids. Choosing the most appropriate label requires a careful
      consideration of experimental needs and circumstances.

PMID- 1641044
TI  - [Lumbar hernia nuclei pulposi; should not always initially treated
      conservatively].

PMID- 1641045
TI  - [Mother knows best; diagnosis of prelingual deafness].

PMID- 1641046
TI  - [Dutch sign language and communication by and with deaf subjects].

PMID- 1641047
TI  - [Secondary prevention of ischemic heart disease: a struggle on 2 fronts].

PMID- 1641048
TI  - [The provision of hearing aids to young children with congenital hearing
      impairment].
AB  - Early screening for hearing impairment in children is generally advised to
      prevent sensory deprivation and speech, language and learning problems. In the
      present study, the age at which 176 probably congenitally hearing impaired
      infants were referred to the Audiological Centre in Nijmegen between 1983 and
      1990 was examined. The mean age of fitting the hearing aids was 35 months. This
      was about 2 years after the auditory screening test (Ewing test) as performed in
      most baby health care centres. In general, if a screening test is positive, the
      child will be referred to the general practitioner, who can refer the child to
      either a general otolaryngologist or a ENT clinic with a (paedo-) audiological
      centre. Hearing aids can only be provided by an audiological centre. On average,
      hearing-impaired children who were directly referred to our clinic/audiological
      centre were provided with hearing aids 13 months earlier than children initially
      referred to a general otolaryngologist. It is concluded that young children who
      fail an auditory screening test should be thoroughly tested audiometrically after
      an otoscopic examination.

PMID- 1641049
TI  - [Results of cochlear implants in totally deaf subjects].
AB  - Cochlear implants have been applied on a limited scale in the Netherlands since
      1985. In a government sponsored health service trial the method was further
      explored from 1988 to 1991. During this period 20 persons were implanted, ten
      with a Vienna extracochlear system and ten with a 22-electrode Nucleus
      intracochlear system. The ages varied from 5 to 62, the duration of deafness from
      2 to 47 years. Some patients were congenitally deaf. The major cause of deafness
      was meningitis. The effect of the implantation was tested with the 'minimal
      auditory capability' test battery adapted for the Dutch language. 18 persons were
      wearing their system for more than 8 h a day; one person, a prelingually deaf did
      no longer use his implant while another one only used it occasionally. Except for
      two persons, all scored above chance level on several tests. The postlingually
      deaf persons with the Nucleus system all achieved a certain degree of open set
      speech understanding without lipreading. With the aim of achieving better
      selection criteria a new trial has started with the same financial sources in
      cooperation with the Utrecht University Hospital.

PMID- 1641050
TI  - [Prevention and control of pain in (adeno)tonsillectomy].
AB  - Pain prevention and analgesia in (adeno)tonsillectomy OBJECTIVE. To study the
      efficacy of three analgesia protocols in children subjected to
      (adeno)tonsillectomy. SETTING. Twenteborg District Hospital, Almelo, the
      Netherlands. PATIENTS AND METHODS. In 64 children with body weights ranging from
      15 to 25 kg (mean 20.4 kg) subjected to (adeno) tonsillectomy according to the
      procedure most current in the Netherlands (according to Sluder with
      administration of a volatile anaesthetic without intubation in day treatment),
      three protocols for preventing and treating postoperative pain were applied, with
      the analgetics most current in the Netherlands. Permission from the Medical
      Ethical Committee and written informed consent from the parents were obtained.
      According to protocol I 240 mg paracetamol was given, according to protocol II,
      500 mg paracetamol and according to protocol III, 500 mg paracetamol plus 10 mg
      codeine, in suppository form, every 4 hours always starting 60 minutes before
      operation. Initially, protocol I was carried out, subsequently randomization of
      protocols II and III. After a pilot study use of a control group was omitted for
      ethical reasons because of the severe pain in a placebo group. MEASUREMENTS. The
      efficacy of the analgesia was evaluated by means of pain assessments by the
      children themselves using the Oucher test, 1, 3 and 6 hours after operation. The
      statistical processing of the children's pain scores was performed primarily in a
      descriptive sense, with simultaneous comparison of the three groups using a
      single variance analysis for comparison of several groups. Multiple comparisons
      were carried out according to Ducans' multiple range test. The level of
      significance was put at p less than or equal to 0.05. RESULTS. One hour
      postoperatively there was no significant difference among the mean pain scores
      (0: no pain and 10: very bad pain) of the three groups, viz. 5.2 (SD 3.0), 4.7
      (SD 2.9) and 4.7 (SD 2.3), respectively; three hours postoperatively there was a
      significant difference between the mean pain scores of group I (4.5; SD 2.4) and
      group II (2.7; SD 2.4) but not between group I and group III (3.3; SD 1.5); six
      hours postoperatively there was a significant difference between the mean pain
      scores of group I (4.1; SD 2.1) on the one hand and of groups II (2.1; SD 1.5)
      and III (2.6; SD 1.6) on the other. CONCLUSION. The findings indicate existence
      of violent pain immediately after recovery from anaesthesia after
      (adeno)tonsillectomy as shown by the pain assessments by the children themselves
      one hour postoperatively, in spite of preventive administration of a high dose of
      a 'minor' analgetic according to each of the three protocols. Modification of the
      anaesthetic technique should be considered to effect adequate prevention or
      suppression of pain.

PMID- 1641051
TI  - [Prevention of blindness in developing countries].

PMID- 1641052
TI  - [IGF-1 and phosphate homeostasis during growth].
AB  - Inorganic phosphate (Pi) is an essential determinant of cellular growth and
      replication. IGF-1, a growth hormone dependent factor, enhances at the kidney
      level both the tubular reabsorption of inorganic phosphate (Pi) and the
      production of 1,25-dihydroxyvitamin D3. Through these two renal actions IGF-1
      increases the extracellular concentration of Pi. Consequently, the amount of Pi
      available for cellular growth and bone mineral deposition is maintained at a
      higher level as compared to the concentration prevailing during the adult life.
      Thus, IGF-1 appears to play a pivotal role in the control of Pi economy,
      particularly during growth.

PMID- 1641053
TI  - [Hypophosphatemia of a genetic origin].
AB  - Familial hypophosphatemia are either primitive disorders of renal phosphate
      handling, isolated as in X linked hypophosphatemic rickets (XLHR) or associated
      with alterations of renal handling of other solutes. They can also occur in the
      course of a number of other inherited diseases such as vitamin D dependent
      rickets type I or II and distal tubular acidosis. The molecular basis of most of
      these diseases are unknown. Chronic hypophosphatemia induces an alteration of
      bone mineralisation with rickets in children and osteomalacia in children and
      adults. Hypophosphatemia and the bone disease are most important in XLHR or VDDR.
      Treatment with oral phosphate and 1 alpha hydroxylated vitamin D metabolites, and
      in some cases calcium, tends to correct the hypophosphatemia and the bone
      disease. Treatment of the associated metabolic disorder in certain Fanconi
      syndromes can correct hypophosphatemia. In the forms associated with
      hypocalcemia, phosphate therapy is not indicated, but rather calcium therapy.

PMID- 1641054
TI  - [Parvovirus B19 infection revealed by acute renal insufficiency].
AB  - Human adult Parvovirus B19 infection is a well known disease most frequently seen
      in haematology and cancerology. To our knowledge, however, renal involvement in
      this context has never been reported. A case of severe infection caused by this
      virus is reported, where multiple organ involvement is associated with acute
      renal failure. The outcome was favourable with temporary dialysis and symptomatic
      treatment. Mechanisms of renal failure, presumably multifactorial, are discussed
      in the light of this case.

PMID- 1641055
TI  - [Post-catheterization venous stenosis in hemodialysis: comparative angiographic
      study of 50 subclavian and 50 internal jugular accesses].
AB  - From January 1986 to December 1990, we studied angiographically the subclavian
      brachiocephalic vein of 100 patients dialysed on subclavian catheter for 50
      (first group) and on internal jugular catheter for the 50 others (second group).
      These 2 groups are not statistically different for age: 61.6 +/- 11.3 years in
      the first and 61 +/- 11.1 in the second, for sex: respectively 48% and 56% of
      women, for time-length of catheter insertion: respectively 31 +/- 21.8 days and
      31.7 +/- 16, and for number of dialysis sessions: respectively 13.5 +/- 9.1 and
      13.6 +/- 7.1. The type of catheters, the frequency of removal for poor flow (16%
      in both groups) or for infections (6% in both groups) and the local nursing are
      similar in the 2 groups. Only the side of cannulation differs: the right side is
      used in 58% of cases in the first group and 78% in the second one. The
      angiographic study reveals a stenosis of the vein in 42% of the subclavian group
      and in 10% of the internal jugular group: a dramatic difference in favour of the
      internal jugular route, whose superiority on subclavian route is asserted in
      respect of venous access of dialysed patients.

PMID- 1641056
TI  - [AN 69 membrane and conversion enzyme inhibitors: prevention of anaphylactic
      shock by alkaline rinsing?].
AB  - Thirty-three anaphylactoid reactions occurring in 19 ACE inhibitors-treated
      patients dialyzed with AN 69 membrane--plate and hollow fibers--dialyzers are
      reported. A careful analyze of these observations strongly suggests the
      preventive role of alkaline rinsing of the membrane.

PMID- 1641057
TI  - [A new model of extramembranous glomerulonephritis in the mouse after a single
      injection of anti-aminopeptidase A monoclonal antibodies].

PMID- 1641058
TI  - Blood-brain exchange routes and distribution of 65Zn in rat brain.
AB  - Zinc is essential for normal development and function of the CNS although much is
      to be learned about brain Zn homeostasis. In these experiments adult male Wistar
      rats within the weight range 500-600 g were used. Ventriculo-cisternal perfusion
      was performed to allow the measurement of 65Zn fluxes between blood and csf
      across the choroid plexuses. Blood-brain or blood-cerebrospinal fluid barrier
      permeability to 65Zn has been determined by graphical analysis in experiments
      that lasted between 5 and 180 minutes. Cerebral capillary permeability to 65Zn
      was found to be low with a K(in) of about 5 x 10(-4)ml/min/g. Choroid plexus
      permeability to 65Zn was about 12 fold greater, although Zn influx to brain via
      this route was less than 5% that across cerebral capillaries. The
      autoradiographic distribution of 65Zn in brain showed regional variation with
      lowest levels in white matter and high levels in the dentate gyrus and
      hippocampus.

PMID- 1641059
TI  - A hypothalamic activator of calmodulin-dependent enzymes is thymosin beta 4 (1
      39).
AB  - A new class of stimulators of basal activity of a number of calmodulin-dependent
      enzymes have been previously isolated from bovine hypothalamus. One of these
      stimulators, denoted as C3, has been purified to homogeneity by reverse phase
      HPLC and tentatively identified as thymosin beta 4 (1-39) by mass spectrometry
      and Edman microsequence analysis. The stimulating effect of C3 on rabbit skeletal
      muscle MLCK basal activity was compared with that of thymosin alpha 1 and
      thymosin beta 4 (16-38). Evidence is presented that all the indicated compounds
      are Ca(2+)-independent high-affinity MLCK stimulators. The potency of the
      stimulators in activating the enzyme was: C3 greater than beta 4 greater than
      (CaM+Ca2+) greater than alpha 1.

PMID- 1641060
TI  - Age-related changes in acetylcholinesterase and its molecular forms in various
      brain areas of rats.
AB  - A previous study conducted in this laboratory revealed a decrease in total
      cholinesterase (total ChE) in the cerebral cortex, hippocampus and striatum in
      aged rats (24 months) of various strains, as compared with young animals (3
      months). The purpose of the present experiments was to extend the study to other
      brain areas (hypothalamus, medulla-pons and cerebellum) and to assess whether
      this decrease was dependent on the reduction of either specific
      acetylcholinesterase (AChE) or butyrylcholinesterase (BuChE) or both. By using
      ultracentrifugation on a sucrose gradient, the molecular forms of AChE were
      evaluated in all the brain areas of young and aged Sprague-Dawley rats. In young
      rats the regional distribution of total ChE and AChE varied considerably with
      respect to BuChE. The age-related loss of total ChE was seen in all areas.
      Although there was a reduction of AChE and, to somewhat lesser extent, of BuChE
      in the cerebral cortex, hippocampus, striatum, and hypothalamus (but not in the
      medulla-pons or the cerebellum), the ratio AChE/BuChE was not substantially
      modified by age. Two molecular forms of AChE, namely G4 (globular tetrameric) and
      G1 (monomeric), were detected in all the brain areas. Their distribution,
      expressed as G4/G1 ratio, varied in young rats from about 7.5 for the striatum to
      about 2.0 for the medulla-pons and cerebellum. The age-related changes consisted
      in a significant and selective loss of the enzymatic activity of G4 forms in the
      cerebral cortex, hippocampus, striatum, and hypothalamus, which resulted in a
      significant decrease of the G4/G1 ratio. No such changes were found in the
      medulla-pons or the cerebellum.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641061
TI  - Interactions of the neurotoxin MPTP and its demethylated derivative (PTP) with
      monoamine oxidase-B.
AB  - The kinetics of the interactions of MPTP and its N-des-methyl-derivative (PTP)
      have been studied. Both were mechanism-based inhibitors as well as substrates for
      the enzyme. Analysis of the reaction progress-curves for the formation of the
      corresponding dihydropyridine derivatives allowed the kinetic parameters for the
      process and the partition ratio, which corresponds to the number of mol. of
      product formed per mol. of enzyme inactivated, to be determined for both
      compounds. The conversion of MPTP to its corresponding pyridinium-ion derivative
      through the action of MAO-B is known to be essential for its neurotoxicity. PTP
      has been reported not to be neurotoxic, although it appears to be a relatively
      good substrate for MAO-B as well as acting as a mechanism-based inhibitor.
      Studies of the changes in absorbance spectra during the MAO-B catalysed oxidation
      were consistent with the formation of the corresponding pyridinium-ion derivative
      (MPP+), which is known to be the effective neurotoxin, as the end-product when
      MPTP was oxidized. In contrast the oxidation of PTP appeared to stop at the
      dihydropyridine stage with no significant further oxidation to the corresponding
      pyridine-derivative.

PMID- 1641062
TI  - Effects of detergents on Ca(2+)-activated neural proteinase activity (calpain) in
      neural and non-neural tissue: a comparative study.
AB  - Calcium activated neutral proteinase (mcalpain) activity was determined in brain
      and other tissue of rat. More than 60% of the brain mcalpain activity was present
      in the particulate fraction while only 30% was in cytosol. In contrast,
      particulate fractions of liver, kidney, muscle, and heart contained about 8-12%
      of tissue mcalpain activity while 88% was present in cytosol. Removal of the
      endogenous inhibitor calpastatin increased the tissue mcalpain activity
      severalfold. Triton X-100 and deoxycholate (DOC) stimulated the neural calpain
      activity by ten-fold while activity in non-neural tissue was unaffected.
      Incubation with other detergents, e.g. Triton N-57 and thioglucopyranoside,
      stimulated brain calpain activity five-fold while Brij-35 did not have any
      effect. Sodiumdodecylsulphate (SDS), on the other hand, inhibited the enzyme
      activity. Brain contained the lowest calpain activity compared to non-neural
      tissue. The calpain activity in muscle, kidney and heart was three-fold greater
      than liver. Immunoblot identification of the enzyme revealed that calpain was
      predominantly in the particulate fraction and less in cytosol of brain while it
      was present mainly in cytosol and less in the pellet fractions of non-neural
      tissue.

PMID- 1641063
TI  - Analysis of individual CNS protein synthesis.
AB  - A procedure for labeling rat CNS proteins in vivo which is useful for behavioral
      and pharmacological studies has been developed. Intraventricular administration
      of 35S-methionine through bilateral indwelling cannulae provided reproducible and
      highly specific radiolabeling of proteins from frontal cortex (FC), parietal
      cortex (PC), occipital cortex (OC), striatum (ST), septal nuclei (SN), amygdala
      (AM), hippocampus (HIP), thalamus (TH), brain stem (BS) and cerebellum (CB).
      Relative rates of synthesis of over 200 individual proteins were subsequently
      analyzed by 2DGE. Regional analysis demonstrated increased labeling of a protein
      of MW 28 kD and pI 6.4 in the hippocampus that was barely detectable in striatum
      of control rats. In heat-shocked animals, there was increased relative synthesis
      of the 74 kD Heat Shock Protein in both the septal nuclei and hippocampus.

PMID- 1641064
TI  - Dipeptidase activities in rat brain synaptosomes can be distinguished on the
      basis of inhibition by bestatin and amastatin: identification of a kyotorphin
      (Tyr-Arg)-degrading enzyme.
AB  - The neuropeptide kyotorphin (Tyr-Arg) was degraded by rat brain synaptosomes via
      a synaptic membrane-bound peptidase which was inhibited by bestatin but not by
      amastatin. The Km for kyotorphin was 8 x 10(-6) M and the Ki for bestatin was 1 x
      10(-7) M. The kyotorphin-degrading enzyme was distinguished from at least one
      other dipeptide-hydrolyzing activity in synaptosomes which was inhibited by both
      bestatin and amastatin. Gel permeation chromatography of detergent-extracted
      synaptosomes resulted in the separation of the dipeptide-hydrolyzing activities.
      A single kyotorphin-degrading enzyme peak was observed which had a M(r) = 52,000.
      The activity peak could degrade other dipeptides including Phe-Arg, a synaptic
      membrane-generated metabolic of bradykinin. The kyotorphin-degrading enzyme
      appears to be novel and can be distinguished from other known dipeptidases on the
      basis of substrate specificity, subcellular localization, and inhibition profile.

PMID- 1641065
TI  - Effects of taurine on the phosphorylation of specific proteins in subcellular
      fractions of the rat retina.
AB  - The effects of 20 mM taurine on the phosphorylation of specific proteins in
      mitochondrial and rod outer segment subcellular fractions of the rat retina were
      measured. A band of protein with an apparent molecular weight of approximately
      20K was consistently inhibited by taurine. Densitometry measurements performed on
      gel electrophoresis autoradiograms from the mitochondrial fraction demonstrated a
      42.7 +/- 8.3% decrease due to taurine (20 mM) in the area corresponding to
      radioactivity from the approximately 20K phosphoprotein. However, only a 21.2 +/-
      9.0% decrease was observed due to taurine in the rod outer segment preparation.
      These data suggest that taurine is exerting its primary effect on the
      phosphorylation of the approximately 20K molecular weight protein in the
      mitochondria of the retina. In addition, calmodulin and phorbol ester had no
      effect on the phosphorylation of the approximately 20K molecular weight protein.

PMID- 1641066
TI  - Membrane fluidity of platelets and erythrocytes in patients with Alzheimer's
      disease and the effect of small amounts of aluminium on platelet and erythrocyte
      membranes.
AB  - The membrane fluidity of platelet and erythrocyte membranes in 10 Alzheimer's
      disease patients and 9 age-matched controls was studied. The platelet membranes
      of patients with Alzheimer's disease were found to be significantly more fluid
      than those of controls (p less than 0.02). However, erythrocyte membranes of
      Alzheimer patients were less fluid (more viscous) than those of controls (p less
      than 0.05). On further investigation of platelet and erythrocyte membranes
      obtained from healthy volunteers, the fluidity was found to change with
      increasing aluminium concentrations. When aluminium ammonium sulphate (0.01-10
      microM) was added to membrane suspensions, the fluidity of platelet membranes was
      increased, whereas the fluidity of erythrocyte membranes was decreased (i.e. the
      microviscosity was increased).

PMID- 1641067
TI  - Short history of neuroendocrinology and the International Society of
      Neuroendocrinology.

PMID- 1641068
TI  - Noradrenergic innervation of the hypothalamus participates in adrenocortical
      responses to interleukin-1.
AB  - Stress and immune activation are associated with increases in plasma
      concentrations of corticosterone (CS). To determine whether the catecholaminergic
      innervation of neurons in the hypothalamic paraventricular nucleus (PVN) is
      involved in these responses, selective lesions were made using 6-hydroxydopamine
      (6-OHDA). Injection of 6-OHDA into the PVN depleted its norepinephrine (NE)
      content by 85% and reduced by 80-82% the increase in plasma CS concentrations
      following intraperitoneal injection of recombinant human interleukin-1 alpha (IL
      1), but did not affect the adrenocortical response to 20 min restraint. Injection
      of 6-OHDA into the ventral noradrenergic ascending bundle depleted PVN NE content
      by 77%. This lesion reduced the CS response to human IL-1 alpha by 82-86%, but
      did not alter that to 20 min restraint, although there was a nonsignificant
      decrease in the CS response following 3 min of restraint. These results suggest
      that the noradrenergic innervation of the PVN mediates the activation of the
      hypothalamic-pituitary-adrenal (HPA) axis by intraperitoneally injected IL-1.
      There may be a noradrenergic contribution to the HPA response to restraint, but
      other neural pathways probably also participate in this response.

PMID- 1641069
TI  - Plasma growth hormone and prolactin responses to graded levels of acute exercise
      and to a lactate infusion.
AB  - The effect of acute exercise at three graded intensities on plasma growth hormone
      (GH) and prolactin (PRL) concentrations was examined in three groups of healthy
      male volunteers. According to their training status these subjects were divided
      into untrained, moderately trained and highly trained. A clear response of GH to
      exercise was registered already at an intensity of 50% of maximal oxygen uptake
      (VO2max) with a maximal response at 70% VO2max and no further effect at 90%
      VO2max. In contrast, no PRL response was observed at 50% VO2max, a small PRL rise
      was seen at 70% VO2max and the highest response occurred at 90% VO2max. Basal and
      exercise-stimulated plasma GH and PRL concentrations were similar in the three
      groups tested at similar relative workloads, suggesting that physical training
      induces adaptive changes whereby higher absolute workloads induce similar
      hormonal and metabolic changes. To examine a potential causative role of lactate
      in inducing the GH and PRL responses, sodium L-lactate was infused intravenously
      to normal sedentary volunteers at doses producing plasma lactate concentrations
      within the range of those seen between 70 and 90% VO2max. This resulted in a
      significant elevation of plasma GH and PRL concentrations, which, however, were
      smaller than those obtained at an exercise-induced matched plasma lactate
      concentration. We conclude that physical training causes adaptive changes in
      highly trained runners so that identical GH and PRL responses to exercise are
      recorded at higher absolute workloads. Lactate may be involved in the exercise
      induced GH and PRL response; however, it does not appear to play an exclusive
      role.

PMID- 1641070
TI  - Stimulation and inhibition of growth hormone secretion by interleukin-1 beta: the
      involvement of growth hormone-releasing hormone.
AB  - The effects of intracerebroventricularly (i.c.v.) injected interleukin-1 beta (IL
      1 beta: 1, 2.5, 10, and 25 ng) were studied on plasma growth hormone (GH) and
      prolactin (PRL) concentrations in freely moving rats chronically implanted with
      i.c.v. cannulas and intracardial catheters. Significant changes in PRL secretion
      were not found. Small i.c.v. doses of IL-1 stimulated GH secretion 15 min
      postinjection (significant after 2.5 ng IL-1) whereas high doses of IL-1
      suppressed plasma GH concentrations. The stimulation of GH secretion by 2.5 ng IL
      1 was abolished when endogenous growth hormone-releasing hormone (GHRH) was
      immunoneutralized by pretreating the rats with GHRH antibodies. The results
      indicate that IL-1 elicits GH secretion by stimulating the release of
      hypothalamic GHRH. The inhibition of GH secretion after high doses of IL-1 is
      attributed to the previously reported corticotropin-releasing-hormone-releasing
      activity of IL-1.

PMID- 1641071
TI  - Divergent effects of glucocorticoid on the gene expression of vasoactive
      intestinal peptide in the rat cerebral cortex and pituitary.
AB  - We investigated the effects of glucocorticoid on the expression of the vasoactive
      intestinal peptide (VIP) gene, a neuropeptide and an established prolactin (PRL)
      releasing factor, in the rat brain and pituitary. The mRNA and peptide contents
      of VIP in the cerebral cortex, hypothalamus and anterior pituitary of male
      Sprague-Dawley rats were quantitated 4 weeks after adrenalectomy or sham
      operation. Following adrenalectomy, VIP mRNA content increased in the anterior
      pituitary but showed no significant change in the cerebral cortex and
      hypothalamus. Dexamethasone treatment for 10 days abolished the effect of
      adrenalectomy and decreased significantly pituitary VIP mRNA content in sham
      operated rats. In the cerebral cortex, however, dexamethasone treatment resulted
      in an enhancement in VIP mRNA levels in both sham-operated and adrenalectomized
      animals. Hypothalamic VIP mRNA content remained unchanged. These changes in VIP
      mRNA levels were accompanied by parallel changes in VIP concentrations in the
      tissues studied, suggesting that glucocorticoid regulates the synthesis of VIP in
      the cerebral cortex and anterior pituitary. On the other hand, serum PRL level
      increased after adrenalectomy but became suppressed following dexamethasone
      administration, in parallel with changes in pituitary VIP synthesis. These
      findings suggest that the effect of glucocorticoid on PRL secretion may be
      mediated, at least in part, via changes in VIP synthesis and secretion. We
      conclude that glucocorticoid regulates the expression of VIP in the rat brain,
      resulting in divergent changes in the cerebral cortex and pituitary. Changes in
      VIP synthesis and secretion may contribute to the disturbances in brain function
      and PRL secretion in conditions of glucocorticoid excess.

PMID- 1641072
TI  - Cytokines stimulate the CRH but not the vasopressin neuronal system: evidence for
      a median eminence site of interleukin-6 action.
AB  - Antigen-activated immune cells acutely release cytokines which, besides their
      effects on the immune system, increase hypothalamopituitary-adrenocortical (HPA)
      function to counteract the inflammatory process. The present study was designed
      to test, using in vitro paradigms, whether there exists a hypothalamic and/or a
      median eminence site of action, whereby different substances derived from the
      immune system could stimulate the CRH and/or the arginine-vasopressin (AVP)
      neuronal pathway. For this purpose, whole medial basal hypothalamus (containing
      the median eminence) were dissected from female rats and incubated in vitro with
      several concentrations of interleukin-1 (IL-1)beta, interleukin-6 (IL-6), tumor
      necrosis factor (TNF)-alpha, thymosin fraction 5 (TF5) or bacterial
      lipopolysaccharide (LPS). After a 40-min incubation period, the amounts of CRH
      and AVP released into the incubation medium were measured by specific
      radioimmunoassays (RIAs). Additional experiments were carried out by superfusing
      isolated rat median eminence fragments with the different test substances; CRH
      and AVP released into the medium were also measured by RIAs. The results
      indicated that IL-1 beta (10(-11) to 10(-7) M), IL-6 (0.06 x 10(-10) to 0.4 x 10(
      10) M), TNF-alpha (6 x 10(-9) to 6 x 10(-7) M) and TF5 (5-500 micrograms/ml) but
      not LPS (1-100 ng/ml) significantly enhanced hypothalamic CRH secretion above
      baseline in a concentration-related fashion. Additionally, superfusion
      experiments demonstrated that, among all test substances, only IL-6 possesses a
      direct and dose-dependent CRH-releasing activity at the median eminence level.
      Conversely, no preparation enhanced basal AVP release in either in vitro
      design.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641073
TI  - Proteolytic conversion of neurohypophyseal peptides by rat thymocytes:
      involvement of endopeptidases.
AB  - The proteolytic conversion of oxytocin and Arg8-vasopressin by purified rat
      thymocytes was studied at 37 degrees C and physiological pH 7.4. The formed
      peptide fragments were isolated by high performance liquid chromatography and
      characterized by amino acid analysis. When oxytocin was incubated with rat
      thymocytes, oxytocin 1-8 and oxytocin 1-7 were isolated. In contrast, only Arg8
      vasopressin 1-8 was found when Arg8-vasopressin was incubated with thymocytes.
      The formation of oxytocin 1-8, oxytocin 1-7 and Arg8-vasopressin 1-8 was
      prevented partially by 10(-3) M phenylmethylsulfonyl fluoride and iodoacetamide,
      and abolished by 0.5 x 10(-3) M Zn2+ and Hg2+ ions and 10(-3) M o-phenanthroline,
      but not by 10(-5) M leupeptin, lima bean trypsin inhibitor, trasylol, captopril
      and phosphoramidon. 0.5 x 10(-3) M EDTA was without effect on the formation of
      oxytocin 1-8 and Arg8-vasopressin 1-8 but increased by about 30% the formation of
      oxytocin 1-7. The results suggest that proteases capable of metabolizing oxytocin
      and Arg8-vasopressin are localized in the thymocyte surface membrane. Since
      oxytocin and vasopressin are synthetized by thymic epithelial cells and exert
      several actions on thymocytes, these proteases may play a physiological role in
      the inactivation of neurohypophyseal peptides at the thymocyte level.

PMID- 1641074
TI  - Interleukin-1 beta and interleukin-6 specifically increase the release of
      prostaglandin E2 from rat hypothalamic explants in vitro.
AB  - It has previously been shown that the cytokines interleukin-1 beta and
      interleukin-6 (IL-1 beta and IL-6) stimulate directly the release of
      corticotrophin-releasing-hormone-41 from the rat hypothalamus in vitro, while IL
      1 beta can also stimulate the release of somatostatin. These effects can be
      antagonized by drugs which block prostaglandin (PG) synthesis. PGs are also
      involved in the control of hypothalamic neuropeptides by other neurotransmitters.
      In the present study, we have characterized the production of PGs from the rat
      hypothalamus in vitro, and investigated the effects of IL-1 beta and IL-6, as
      well as the neurotransmitters norepinephrine, acetylcholine and 5
      hydroxytryptamine, on the acute release of PGs, using a well-validated acute
      hypothalamic incubation system. The rate of release of PGs [PGE2, PGF2 alpha, 6
      keto-PGF1 alpha (6KPGF1 alpha) and thromboxane B2 (TXB2) in the medium was found
      to stabilize after 60 min of preincubation and thereafter remain constant, with
      TXB2 being the predominant species. Twenty-minute incubation in the presence of
      human recombinant IL-1 beta or IL-6, in the dose range 1-100 U/ml, had no effect
      on the release of PGF2 alpha, 6KPGF1 alpha or TXB2; however, the release of PGE2
      was significantly increased by both IL-1 beta and IL-6. The effect of IL-1 beta
      was antagonized by both indomethacin and dexamethasone. None of the other
      neurotransmitters tested had any effect on the release of any of the
      PGs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641075
TI  - Identification of inositol 1,4,5-trisphosphate binding in human pheochromocytoma.
AB  - An attempt was made to identify a specific binding of inositol 1,4,5
      trisphosphate (IP3) to human chromaffin cell tumors. Crude microsomal fractions
      of pheochromocytomas possessed significant binding sites for [3H]IP3 with high-
      and low-affinity constants (Kd = 5.46 and 538 nM, respectively). The binding to
      these sites was rapid, saturable (reached equilibrium by 1 min at 0 degrees C)
      and reversible. Competition studies with other inositol phosphate analogs
      indicated the stereotypic specific binding for IP3. Although no significant
      difference was observed in the binding densities of IP3 between pheochromocytomas
      and adrenal nonfunctioning adenomas, the values of high-affinity constants were
      significantly lower in the former than the latter group (5.77 +/- 1.07, n = 5 vs.
      11.30 +/- 1.98 nM, n = 4, p less than 0.05). The present data indicate that
      characteristics of IP3 binding sites are congruous with their receptor functions
      and that changes in its binding sites may contribute to the biochemical
      dissimilitudes in pheochromocytomas.

PMID- 1641076
TI  - Behavioral action of estrogen in the male dove brain: area differences in
      codistribution of aromatase activity and estrogen receptors are steroid
      dependent.
AB  - Brain aromatization of androgen to estrogen (E) and presence of estrogen-receptor
      (ER) containing cells (ERC) are required for the control of E-dependent neural
      events under-lying male sexual behavior. We examined whether (a) numbers of ERC
      and steroid-inducible aromatase activity are codistributed and directly
      correlated in the same brain areas of individual sexually active male doves and
      whether, (b) distribution of ERC is altered by a change in E formation in
      preoptic areas known to be involved in control of male behavior. To allow spatial
      correlation between ERC and aromatase activity, a new approach was used that
      combined in vitro measurement of aromatase activity (stereospecific formation of
      3H2O from [1 beta-3H]-testosterone) in microdissected brain areas of one side of
      the brain and immunocytochemical localization of ERC (ER antibody H222Spy) in
      homologous contralateral areas of the same coronal brain section. The
      relationship between ERC and aromatase activity differs according to brain area
      in sexually active males: (a) large populations of ERC in preoptic areas, notably
      in nucleus preopticus medialis (6.5 +/- 0.8 ERC/5,000 microns2) and nucleus
      preopticus medialis, pars medianis (9.5 +/- 1 ERC/5,000 microns2) are
      codistributed with high steroid-dependent aromatase activity (greater than 100
      fmol/mg tissue); (b) areas containing the nucleus interstitialis and ventromedial
      hypothalamic nuclei also have relatively high aromatase activity, but lower ERC
      density than POA; (c) the anterior hypothalamic nuclei have few ERC, but steroid
      regulated aromatase activity; (d) the infundibular area contains elevated ERC and
      little steroid-inducible aromatase activity; (e) area basalis and neostriatum
      contain few or no ERC and no inducible aromatase activity. Castration of sexually
      active doves reduces aromatase activity in preoptic and posterior hypothalamic
      areas (by greater than 75%) to basal levels, but does not affect the distribution
      or number of ERC in brain areas containing steroid-regulated aromatase activity,
      notably in the preoptic area. The results show that steroid regulation of
      aromatase occurs in brain loci with high numbers of ERC. We suggest that steroid
      inducible aromatase occurs in brain loci with high numbers of ERC. We suggest
      that steroid-inducible aromatase activity and ERC are codistributed in areas
      controlling male sexual behavior; thus the formation and action of E may occur in
      the same area. Regulation of the aromatase activity and supply of E, but not of
      number of cells containing ER, is one mechanism which accounts for changes in
      action of testosterone on estrogen target sites in the male brain.

PMID- 1641077
TI  - Changes in follicle-stimulating hormone secretion in spontaneously hypertensive
      rats.
AB  - FSH and testosterone plasma levels, pituitary FSH content and concentration and
      the weight of testis, seminal vesicles and ventral prostate have been studied at
      the ages of 30, 60 and 90 days in spontaneously hypertensive rats (SHR) and
      normotensive control (WKY) rats. In vitro FSH secretion by pituitaries, and the
      response to orchidectomy and to exogenous administration of either LHRH (1
      microgram) or LHRH agonist (0.05, 0.1, 1, and 5 micrograms/kg) were analyzed in
      90-day-old SHR and WKY male rats. Ventral prostate weight and FSH plasma levels
      were determined in other groups of adult male rats castrated and castrated and
      implanted for 15 days with silastic capsules containing testosterone,
      dihydrotestosterone or estradiol. Also FSH plasma levels and pituitary FSH
      concentration were determined at the ages of 30, 60 and 90 days in SHR and WKY
      female rats. Male SHR showed increased plasma FSH levels and high testicular
      weight in all the cases, and enhanced testosterone levels in plasma and pituitary
      FSH content on days 60 and 90. Weight of seminal vesicles and ventral prostate
      was normal or reduced, depending on the animal age. Adult SHR had increased FSH
      secretion in vitro, normal response to orchidectomy and did not exhibit FSH
      increases after LHRH administration. The efficiency of testosterone to stimulate
      ventral prostate growth and the ability of estradiol to reduce FSH plasma levels
      were decreased in SHR. Female SHR showed a significant increase in the pituitary
      content of FSH on day 30 and on proestrus at the ages of days 60 and 90.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641078
TI  - CNS in congenital muscular dystrophy without mental retardation.
AB  - We have evaluated the CNS findings of 30 patients with congenital muscular
      dystrophy and normal mental development. The intelligence was estimated by
      psychological testing or school performance. There were more children of above
      average intelligence than expected. Neuroradiological examination was done to
      15/17 patients still alive. White matter changes were seen in five and cerebral
      atrophy in four patients. Three patients had epilepsy, two mild, one drug
      resistant. The EEG did not reveal any common pattern, though there were various
      abnormalities in several children.

PMID- 1641079
TI  - Immunotherapy with stimulated autologous lymphocytes in a case of a juvenile
      anaplastic glioma.
AB  - The effect of immunotherapy with stimulated autologous lymphocytes (SAL) in
      malignant gliomas is documented and discussed in a bioptical and autoptical case
      study. A five-year-old child with a recurrently operated and radiated right
      hemispheric anaplastic astrocytoma died six weeks after immunotherapy with
      mitogen-activated killer cells and recombinant Interleukin-2. The autopsy
      revealed a large butterfly glioma with partially necrotic gelatinous tissue at
      the site of the SAL reservoir. The tumor cell density on the right was less than
      on the left hemisphere, and T-lymphocyte content was higher on the right
      hemisphere. These results demonstrate a local effect of SAL therapy in vivo,
      although the tumor progression as a whole could not be stopped. They also
      demonstrate the need of a detailed neuropathological examination in all cases of
      immunotherapy of malignant gliomas.

PMID- 1641080
TI  - Acute changes in cerebral oxygenation and cerebral blood volume in preterm
      infants during surfactant treatment.
AB  - Following administration of surfactant a marked depression in aEEG activity
      occurs for about 10 minutes; the mechanism of this depression is unknown. In view
      of this, twenty-nine preterm infants were investigated with near infrared
      spectroscopy (NIRS) to evaluate rapid changes in total cerebral haemoglobin
      concentration and cerebral oxyhaemoglobin concentration during rescue treatment
      with natural surfactant. During surfactant instillation there was a short-lasting
      hypoxaemia as demonstrated by pulseoximetry as well as a considerable fall in
      arterial blood pressure. With NIRS, tissue hypoxia was demonstrated by a drop in
      cerebral oxyhaemoglobin concentration. The marked drop in arterial blood pressure
      occurring immediately following surfactant was not matched by a drop in total
      cerebral haemoglobin concentration. This suggests that cerebral blood volume and
      hence cerebral blood flow was maintained. In the following minutes there was an
      improvement in cerebral oxygenation as indicated by the rise in cerebral
      oxyhaemoglobin concentration in nearly all the infants.

PMID- 1641081
TI  - Mutism after cerebellar medulloblastoma surgery.
AB  - The case of a 9-year-old boy is presented, who developed transient mutism after
      removal of a medulloblastoma in the region of the cerebellar vermis. The mutism
      disappeared within 6 months. Neither reduction of consciousness nor disturbances
      of caudal cranial nerves or phonation ever appeared. The case is discussed with
      regard to its phenomenology, pathogenesis, and etiology, corresponding case
      reports are also taken into consideration.

PMID- 1641082
TI  - Leigh syndrome associated with a deficiency of the pyruvate dehydrogenase
      complex: results of treatment with a ketogenic diet.
AB  - A one-year-old boy suffering from intermittent lactic acidosis, muscular
      hypotonia, horizontal gaze paralysis and spasticity in both legs had low activity
      of the pyruvate dehydrogenase complex associated with low amounts of
      immunoreactive E 1 alpha and E 1 beta. Leigh syndrome was diagnosed on the basis
      of the clinical and biochemical abnormalities and the typical lesions observed on
      MRI of the brain. Treatment with a ketogenic diet was associated with clinical
      and biochemical amelioration. A striking improvement of the cerebral lesions was
      observed by neuro-imaging.

PMID- 1641083
TI  - Unilateral thalamic haemorrhage in the pre-term and full-term newborn.
AB  - One full-term and three premature newborns with a unilateral thalamic haemorrhage
      are reported. The lesion was diagnosed using cranial ultrasonography and
      confirmed in three using magnetic resonance imaging. Severe perinatal asphyxia
      occurred in all infants. The neonatal clinical history, subsequent neuro
      developmental outcome and neuroimaging findings are discussed. As the prognosis
      appears to be much better than for infants with bilateral thalamic densities, it
      is important that this type of lesion is recognised as a separate entity.

PMID- 1641084
TI  - Encephalopathy of infancy with intracerebral calcification and chronic spinal
      fluid lymphocytosis--another case of the Aicardi-Goutieres syndrome.
AB  - Another case of the Aicardi-Goutieres syndrome is presented. The female child was
      diagnosed at 4 months of age, when irritability, lack of fixation and dystonic
      movements were noted. Also, extensive intracerebral calcification was found on
      computed tomography. Nuclear magnetic resonance imaging confirmed extensive white
      matter disease. Repeated examination of the spinal fluid revealed chronic spinal
      fluid lymphocytosis. This condition belongs to the encephalopathies of infancy
      with intracranial calcification of genetic aetiology and unknown pathogenesis.
      Differentiation against other presumed entities in this group, as well as the
      wider differential diagnosis, are discussed.

PMID- 1641085
TI  - Early epileptic encephalopathy with suppression bursts and olivary-dentate
      dysplasia.
AB  - A case of neonatal epileptic encephalopathy with suppression-bursts associated
      with olivary dentate nuclei dysplasia is reported. This unusual association shows
      that the so-called Ohtahara syndrome could correspond to several different brain
      malformations sometimes disclosable only by neuropathological examination.

PMID- 1641086
TI  - Middle cerebral artery occlusion in rats: a neurological and pathological
      evaluation of a reproducible model.
AB  - Middle cerebral artery occlusion (MCAO) in rats produces an infarct of varying
      size. We examined three factors that may influence this variability: animal
      weight, vascular anatomy, and extent of occlusion in rats undergoing MCAO. We
      also developed a four-point neurological evaluation scale and validated its
      usefulness by comparing it with a four-grade pathological determination of the
      size of the infarct. Of 82 animals subjected to a standard MCAO, 34 developed
      small cortical infarcts (pathological grades I-II; infarct size less than 25 mm2,
      6-17% of the ipsilateral cortex surface area), and 48 large infarcts
      (pathological grades III-IV, infarct size greater than 25 mm2, 20-56% of surface
      area). We were able to predict the size of infarction from the neurological
      evaluation in 83% of the animals, and this accuracy reached 91% when grades I and
      II and III and IV were considered together (P less than 0.001). In 41 animals
      subjected to a more extensive vascular occlusion, 89% exhibited large infarcts.
      Four vascular patterns were identified but none played a significant role in the
      incidence or size of the cortical stroke. However, rats weighing less than 300 g
      showed a smaller lesion size than did rats greater than 300 g. Our proposed new
      MCAO technique appears useful in reproducing large-sized infarcts of the
      frontoparietal cortex.

PMID- 1641087
TI  - Histological comparison of autogenous canine fascia lata, Gore-Tex, lyophilized
      human fascia lata, and autogenous canine vein for vascular patch graft material
      in a canine arteriotomy model.
AB  - Autogenous fascia lata has found little clinical use as a vascular patch graft
      material. Previous experience, however, suggests that it possesses attributes
      that might make it useful in this regard. To assess its efficacy as a vascular
      patch graft, nine adult mongrel dogs each underwent four arteriotomies with
      placements of patch grafts. The four sites included both carotid arteries and
      both femoral arteries. In each animal, one of four patch graft materials
      (autogenous canine fascia lata, Gore-Tex, lyophilized human fascia lata, and
      autogenous canine vein) were placed as patch material at the arteriotomy site
      utilizing 7-0 running sutures and loop magnification. The site for placement of
      each graft material was rotated serially in the animals so that each site would
      have equal numbers of all four graft materials applied. The animals were killed
      at either 6 to 8 weeks or 11 to 12 weeks after angiography of all four vessels.
      The specimens were then evaluated histologically. No difference was observed
      among any of the patch graft materials with regard to myofibroblast plaque
      formation. Inflammatory responses were noted to be substantially less in the
      canine fascia lata group than in the other three groups. Granuloma formation,
      however, appeared to be most significant in the autogenous canine vein group.
      Only one vessel was occluded. Aneurysm or pseudoaneurysm formation was not noted
      in any specimen. It appears from the above results that autogenous fascia lata
      may be an appropriate alternative to currently utilized arterial patch graft
      materials and that it should be evaluated further for this purpose.

PMID- 1641088
TI  - Giant bilateral xanthogranulomas in a child: case report.
AB  - Symptomatic xanthogranulomas are rare lesions that most commonly occur in adults.
      A case of giant bilateral xanthogranulomas in a 6-year-old boy, who remains
      without tumor recurrence 9 years after resection, is presented. The operative
      management of these unusually large lesions is discussed. The pathogenesis of
      xanthogranulomas is reviewed as it relates to the presentation of these lesions
      in the pediatric population.

PMID- 1641089
TI  - Dural arteriovenous malformation in the cervical spine presenting with
      subarachnoid hemorrhage: case report.
AB  - Most spinal dural arteriovenous malformations are located in the thoracic and
      lumbar regions. The symptoms include pain, weakness, sensory disturbances, and
      sphincter dysfunction, which are usually gradual in onset. They are attributed to
      venous hypertension with a resultant ischemia of the cord, and hemorrhage from
      them is rare. The authors report an unusual case of a patient with a dural
      arteriovenous malformation in the cervical spine who was admitted with a sudden
      onset of severe headache and dysesthesia due to subarachnoid hemorrhage.

PMID- 1641090
TI  - Intramedullary epidermoid cyst of the cervical spinal cord associated with an
      extraspinal neuroenteric cyst: case report.
AB  - A 4-year-old girl presented with an intramedullary epidermoid cyst of the
      cervical spinal cord. The clinical, radiological, and surgical features and a
      brief critical review of the literature are included in this report. The cyst
      contents were removed totally in two operations. The child had a coexisting
      neuroenteric cyst in the posterior mediastinum. To our knowledge, this
      coexistence has not been previously reported. Contemporary imaging modes and
      prospects of the surgical treatment are discussed.

PMID- 1641091
TI  - Ectasia and fenestration of the anterior cerebral artery associated with
      persistent trigeminal artery: case report.
AB  - Multiple vascular anomalies in a 22-year-old patient who had signs and symptoms
      of vestibulocochlear dysfunction are reported. Angiography revealed a
      fenestration of the proximal segment of the left anterior cerebral artery, an
      ectasia of the left anterior and posterior cerebral arteries, and a persistence
      of the right trigeminal artery. The rarity of the association is documented, and
      the clinical significance is discussed.

PMID- 1641092
TI  - Acute subdural hematoma after aneurysmal rupture; evacuation with aneurysmal
      clipping after emergent infusion computed tomography: case report.
AB  - A 74-year-old woman sought treatment after an initial subarachnoid hemorrhage
      verified on computed tomographic scan with no focal neurological deficit. Shortly
      after admission, she sustained a second subarachnoid hemorrhage with acute
      neurological decompensation. A repeat computed tomographic scan revealed
      increased blood along the right medial temporal region, as well as in the
      interhemispheric fissure and bilateral sylvian cisterns. Also evident was a right
      hemispheric acute subdural hematoma. The patient's rapidly deteriorating
      neurological status precluded a cerebral angiogram; therefore, a double-dose
      infusion computed tomographic scan was performed. This revealed a cerebral artery
      aneurysm adjacent to the right medial temporal hematoma. She was taken to the
      operating room on the basis of this study. After evacuation of the right
      hemispheric subdural hematoma and clipping of the right posterior communicating
      artery aneurysm, the patient made a rapid, full neurological recovery.

PMID- 1641093
TI  - Sarcomatous transformation in cranial chordoma.
AB  - In a study of 52 patients with cranial chordoma treated at the Mayo Clinic over a
      19-year period (1966-1984), two tumors showed anaplastic features, both de novo,
      i.e., unassociated with prior irradiation. The incidence of anaplastic
      transformation was thus 4%. Immunohistochemistry showed the mixed mesenchymal
      epithelial phenotype typical of chordoma in portions of both tumors, but loss of
      reactivity for keratin and epithelial membrane antigen was noted in anaplastic
      components. The study indicates that sarcomatous change in chordoma is a rare
      event that may occur de novo and is associated with the loss of immunophenotypic
      features of epithelial differentiation.

PMID- 1641094
TI  - Multiple arteriovenous malformations located in the cerebellum, posterior fossa,
      spinal cord, dura, and scalp with associated port-wine stain and supratentorial
      venous anomaly.
AB  - Multiple arteriovenous malformations involving the left cerebellum and extra
      axial posterior fossa with associated calcified cyst, spinal cord, dura, and
      scalp were present in a 7-year-old girl, who became symptomatic after a
      cerebellar hemorrhage. A large port-wine stain was noted on the right
      temporoparietal scalp, consistent with the scalp arteriovenous malformation area,
      as demonstrated by angiogram. In addition to the multiple arteriovenous
      malformations, nonfilling of the superior sagittal sinus and tortuous, irregular
      cortical veins were recognized.

PMID- 1641095
TI  - Extracranial-intracranial arterial bypass after cerebral foreign body
      embolization: effective treatment of transient ischemic attacks.
AB  - A case of traumatic foreign body embolism into the right intracranial carotid
      artery with stenosis of the right middle cerebral artery in a 9-year-old boy is
      presented. Initial hemiparesis and a consecutive asymptomatic interval of 12
      months were followed by a period of frequent transient ischemic attacks. After an
      extracranial-intracranial arterial bypass had been performed 18 months later,
      symptoms ceased without relapse. A thorough review of the literature demonstrates
      the rare incidence of this entity.

PMID- 1641096
TI  - Pure motor hemiparesis with stable somatosensory evoked potential monitoring
      during aneurysm surgery: case report.
AB  - We report a patient who sought treatment for an acute subarachnoid hemorrhage as
      a result of an intracranial aneurysm. Management included early surgical repair
      and intraoperative monitoring of evoked potentials. Pan-angiography revealed
      berry aneurysms of the communicating anterior artery and right middle cerebral
      artery. Surgery was uneventful, and the somatosensory evoked potential monitoring
      did not show any abnormalities. Nevertheless, the patient showed a neurological
      deficit due to a clip-related infarct in the right middle cerebral artery
      territory characterized by a right hemiparesis with no sensory deficit. This case
      report supports the possibility of false-negative results in single-mode
      intraoperative monitoring during aneurysm surgery.

PMID- 1641097
TI  - Arteriovenous malformation of the pyriformis muscle manifesting as a sciatic
      nerve tumor.
AB  - We present a patient with an intramuscular pelvic arteriovenous malformation that
      was initially diagnosed as a tumor of the sciatic nerve sheath. Endovascular
      embolization, attempted as a preoperative maneuver, was complicated by diffuse
      pulmonary emboli and death. To our knowledge, this is the first such reported
      case. Its presentation here broadens the differential diagnosis of sciatic nerve
      sheath tumors, emphasizes the diagnostic and management issues of masses
      presenting as peripheral nerve tumors, and provides clinicopathological evidence
      regarding the cause of neurological symptoms.

PMID- 1641098
TI  - Patient positioning for the operative approach to midline intracerebral lesions:
      technical note.
AB  - Patients undergoing craniotomies for intracerebral lesions are generally
      positioned in such a way that the lesion is highest in the field. For midline
      lesions alongside the falx, patients are commonly positioned on their backs for
      an anatomically symmetrical approach. We propose positioning the patient in the
      lateral decubitus position ipsilateral to the lesion to take advantage of gravity
      by allowing the brain to fall away from the midline, thus obviating the need for
      retraction. We have used this position in 15 cases of falcine and parafalcine
      tumors to great advantage, without encountering untoward operative or anesthetic
      complications.

PMID- 1641099
TI  - Closure of posterior fossa dural defects using a dural substitute: technical
      note.

PMID- 1641100
TI  - Flow regulated suction tube: technical note.

PMID- 1641101
TI  - Modification of the standard myelography tray for universal precautions:
      technical note.

PMID- 1641102
TI  - Intracranial infection after missile injuries to the brain: report of 30 cases
      from the Lebanese Conflict.

PMID- 1641103
TI  - The effect of graded spinal cord injury on the extrapyramidal and pyramidal motor
      evoked potentials of the rat.

PMID- 1641104
TI  - Intraoperative angiography in the management of neurovascular disorders.

PMID- 1641105
TI  - Cerebral arteriovenous malformations associated with a straight sinus anomaly.
AB  - Nine cerebral arteriovenous malformations (AVM) associated with straight sinus
      anomaly were demonstrated on angiograms. All 10 AVM (1 patient had two AVM)
      occupied deep cerebral structures: Seven were totally or partially located in the
      basal ganglia or the corpus callosum, and 3 were in the medial occipital or
      temporal lobe. In 6 patients, almost no filling of the straight sinus was
      observed, although the AVM were located deeply and the main drainage was via the
      vein of Galen. All 6 patients showed retrograde flow in the deep cerebral veins
      or venous drainage through a persistent facial sinus. The other 3 patients had
      duplication or septal formation of the straight sinus. Straight sinus anomaly is
      extremely rare in the normal population but seems not uncommon in patients with
      deep-seated AVM.

PMID- 1641106
TI  - Factors affecting operative and excess long-term mortality in 935 patients with
      intracranial meningioma.
AB  - Between 1953 and 1980, a total of 935 patients underwent surgery for intracranial
      meningioma in the Department of Neurosurgery of the Helsinki University Hospital.
      The patients were followed up until death or the end of the year 1987. The
      cumulative observed survival rate was 91% at 3 months, 89% at 1 year, and 63% at
      15 years. The relative survival rate, that is, the ratio of the the observed and
      the expected rates, was 91% at 3 months, 89% at 1 year, and 78% at 15 years.
      Significant risk factors for operative mortality (7%) for the 652 patients
      operated on from 1966 to 1980 were poor preoperative clinical condition, absence
      of epilepsy, old age, incomplete tumor removal, pulmonary embolism, and an
      intracranial hematoma requiring evacuation. For those 828 patients who survived
      the first postoperative year, the factors predicting an excess risk of death for
      up to 15 years were incomplete tumor removal, poor pre- and postoperative
      clinical condition, anaplasia of the tumor, and hyperostosis. Patients whose
      tumors were not completely removed had a 4.2-fold relative excess risk of death
      as compared with patients whose tumors were completely removed, and patients who
      had malignant tumors had a 4.6-fold risk as compared with those who had benign
      tumors.

PMID- 1641107
TI  - Improved cerebral blood flow and CO2 reactivity after microvascular anastomosis
      in patients at high risk for recurrent stroke.
AB  - The medical community has not yet identified cerebrovascular pathophysiological
      factors that distinguish patients at high risk for stroke or aid in selecting
      patients for microvascular cerebral bypass. In this study, we describe the
      courses of 13 patients, all of whom suffered recurrent episodes of transient
      cerebral ischemia after previous cerebral infarction. These patients underwent
      regional cerebral blood flow studies using xenon inhalation with a CO2 challenge
      before and at various times after extracerebral-to-intracerebral microvascular
      anastomosis. Collateral circulation was assessed in all patients before surgery
      using four-vessel cerebral angiography. Patients were followed for a mean of 30
      months (range, 1-7 yr) after the anastomosis. Measurements of mean cortical
      cerebral blood flow, as measured using the initial Slope Index, and CO2
      cerebrovascular reactivity of these 13 patients were compared with those in a
      group of 20 patients designed as controls. Hemispheric cortical blood flow was
      significantly depressed in these patients before surgery compared with those in
      the control group (P less than 0.05). After the bypass, the mean resting Initial
      Slope Index in these patients increased 14% (P = 0.0005). Cerebral blood flow
      both before and after CO2 inhalation improved significantly in these patients
      after surgery (P = 0.001). Detectors bordering computed tomographic or magnetic
      resonance image documented infarctions, identified as peri-infarct regions, and
      demonstrated significant mean increases in both cerebral blood flow (38.8-43.2
      ml/min/100 g, P = 0.05) and CO2 cerebrovascular reactivity in these patients
      after bypass (1.71 + 1.91% to 4.00 + 2.38% change Initial Slope Index/mm Hg CO2,
      P = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641108
TI  - Rapid expansion of hypertensive intracerebral hemorrhage.
AB  - We report a series of 10 patients who had a rapid expansion of a hypertensive
      intracerebral hemorrhage (HICH). It occurred in approximately 3% of 320 patients
      who sought treatment for HICH during the past 2 years. The site of hemorrhage was
      the putamen in 6 patients and the thalamus in 4 patients. Neurological
      deterioration occurred in a mean time of 40 hours after the onset of symptoms
      (range, 5.5-109 h). Fifty percent of all patients deteriorated within 24 hours.
      Persistent hypertension was recorded in all patients. Repeat computed tomography
      showed an increase of hematoma volume that was twice as large in thalamic
      hemorrhage and about three times as large in putaminal hemorrhage. Six patients
      died, whereas 3 survived with severe disability and 1 survived with moderate
      disability. This study indicates that continued or subsequent bleeding can occur
      in HICH. If those lesions are not detected early and microsurgically evacuated,
      they are almost always fatal. Early stereotactic evacuation with urokinase
      irrigation is considered more dangerous than open craniotomy by microsurgical
      techniques. We stress the need for attention to this problem during the acute
      phase of HICH.

PMID- 1641109
TI  - Levels of catecholamine in plasma and cerebrospinal fluid in aneurysmal
      subarachnoid hemorrhage.
AB  - Despite intensive investigation into the cause of cerebral vasospasm (focal
      ischemic deficit) after subarachnoid hemorrhage, the morbidity and mortality
      associated with this condition remain high. Various studies have shown levels of
      catecholamine in plasma and cerebrospinal fluid (CSF) to be increased in
      subarachnoid hemorrhage, and it is possible that these vasoactive substances play
      an important role in the subsequent vasospasm. In an attempt to elucidate this
      possibility, the study presented here was undertaken to investigate the
      relationship between catecholamine levels in plasma and CSF and focal ischemic
      deficit (FID); the rupture of aneurysms on blood vessels supplying the
      hypothalamus as compared with the rupture of aneurysms on blood vessels supplying
      other areas of the brain; and the clinical outcome of the patients.
      Concentrations of adrenaline and noradrenaline in plasma and CSF samples obtained
      from 21 patients who had suffered aneurysmal subarachnoid hemorrhage were
      determined by a radioenzymatic technique. Significantly higher levels of
      adrenaline were found at the time of surgery in the CSF of patients with FID. A
      similar trend, though not statistically significant, was also observed for
      plasma. Patients with a rupture of aneurysms on blood vessels supplying the
      hypothalamus showed a tendency towards higher catecholamine levels in plasma and
      CSF. Subjects with a bad clinical outcome (i.e., those who were severely disabled
      or had died) had significantly higher levels of catecholamine in plasma than did
      those with a good clinical outcome (i.e., those with moderate or no disability).
      Further detailed analysis of the interrelationships showed that, within the group
      of patients with FID, those with rupture of aneurysms on blood vessels supplying
      the hypothalamus had significantly higher catecholamine levels in plasma than did
      those with rupture of aneurysms on other cerebral vessels. Furthermore, in the
      group of patients with rupture of aneurysms on blood vessels supplying the
      hypothalamus, those with a bad clinical outcome had significantly higher
      catecholamine levels in plasma than did those with a good clinical outcome. These
      findings lend support to the possibility that damage to the hypothalamus and
      subsequent elevations in catecholamine levels may be associated with FID and poor
      clinical outcome.

PMID- 1641110
TI  - External ventricular drainage for treatment of rapidly progressive
      posthemorrhagic hydrocephalus.
AB  - Twenty-seven newborn infants (birth weight, 1503 +/- 776 g; gestational age, 31
      +/- 3 wk) (mean +/- standard deviation) with rapidly progressive posthemorrhagic
      hydrocephalus and increased intracranial pressure were treated by external
      ventricular drainage. The progression of hydrocephalus was arrested during the
      drainage period in each patient. The drainage was kept in place for 23 +/- 9
      days, the longest drainage period being 48 days. In 16 of 23 surviving patients,
      progressive ventricular dilation recurred after removal of the drainage,
      requiring a definitive shunt implantation (nine ventriculoatrial, seven
      ventriculoperitoneal). For the remaining seven infants, no further therapy was
      necessary. Implantation of the permanent shunt was done days 28 to 88 (body
      weight, 2400 +/- 950 g). Bacterial cultures from cerebrospinal fluid and/or the
      tip of the ventriculostomy catheter were negative in 175 instances and positive
      in 11 instances (7 patients). No clinical or biochemical evidence of
      ventriculitis was noted. Four of the 27 patients died of causes unrelated to
      external ventricular drainage. Twenty-three infants survived. Seventeen of 23
      survivors suffered from intraventricular hemorrhage Grade 3; in 7, neurological
      and developmental outcomes were classified as normal; 9 patients experienced mild
      to moderate paresis and/or mild to moderate developmental delay; and only 1
      patient was severely retarded. Six patients with parenchymal lesions had severe
      motor and/or developmental handicaps. We consider external ventricular drainage
      an effective and safe therapy in newborn infants with rapidly progressive
      posthemorrhagic hydrocephalus and increased intracranial pressure. The ultimate
      outcome, however, depends mainly on the mode and the extent of the primary brain
      lesion.

PMID- 1641111
TI  - Motor and sensory cortex in humans: topography studied with chronic subdural
      stimulation.
AB  - Classic neurosurgical teaching holds that once the Rolandic fissure (Rf) has been
      located, there are distinct differentiated primary motor and sensory functional
      units confined within a narrow cortical strip: Brodmann's Areas 4 and 6 for
      primary motor units in front of the Rf and 3, 1, and 2 for sensory units behind
      the Rf. To test this assumption, we examined in detail the records of cortical
      mapping done by electrical stimulation of the cerebral cortex via implanted
      subdural electrode grids in 35 patients with seizure disorders. Of 1381
      stimulations of the electrode sites, 346 (25.1%) produced primary motor or motor
      arrest and sensory responses in contralateral body parts: 56.8% were primary
      motor responses; 16.2% were motor-arrest; 22.5% were sensory; and the remaining
      4.5% were mixed motor and sensory responses. Two-thirds (65.9%) of the primary
      motor responses were located within 10 mm of the Rf, and the remaining one-third
      (34.1%) were more than 10 mm anterior to the Rf or were posterior to the Rf.
      Furthermore, in the patient group with brain lesions, fewer than one-third
      (28.1%) of the responses were within the 10-mm narrow anterior strip. Our study
      reconfirmed that a significant number--at least one-third--of motor responses are
      distributed outside the classic narrow cortical strip. In patients with brain
      lesions, the motor representation is further displaced outside the narrow strip.
      This finding indicates that primary motor cortex may extend beyond the gyrus
      immediately anterior to the Rf.

PMID- 1641112
TI  - Facial nerve repair by interposition nerve graft: results in 22 patients.
AB  - Resection of tumors of the posterior cranial base may incorporate a segment of
      the facial nerve because of tumor infiltration, or may result in unplanned nerve
      injury. Immediate repair of the facial nerve by resuture or with an autogenous
      nerve graft is highly desirable to ensure optimal recovery of facial function.
      Twenty-four patients who underwent extensive surgery of the posterior skull base
      and facial nerve reconstruction were studied. Of these, 12 patients had
      preoperative facial weakness and 3 had facial palsy. All patients underwent graft
      reconstruction from the subarachnoid or labyrinthine portion of the facial nerve
      to the fallopian or extracranial segment. The greater auricular nerve was used as
      a graft in 14 patients, and the sural nerve in 10. Two patients died of their
      disease soon after surgery, and, therefore, were excluded from our follow-up. In
      the remaining 22 patients, the median follow-up time was 20 months. As evaluated
      by the House-Brackmann grading system, 45% (10/22) of the surviving patients
      achieved a good recovery of facial function, 36% (8/22) attained a fair recovery,
      and 18% (4/22) had minimal or no recovery. There was no statistical correlation
      between the length of the graft used and the degree or timing of clinical
      recovery. The surgical result obtained in all patients with complete preoperative
      facial palsy and in one patient with dense facial paresis was poor.

PMID- 1641113
TI  - Aggressive oligodendroglioma: a chemosensitive tumor.
AB  - Aggressive oligodendrogliomas, tumors that are symptomatic, enlarging, enhancing,
      and usually but not always anaplastic, respond to chemotherapy. We have observed
      responses to chemotherapy in 18 of 19 consecutively treated patients with newly
      diagnosed or recurrent aggressive oligodendrogliomas. A regimen of procarbazine,
      CCNU (lomustine), and vincristine (PCV) is predictably effective, but other drugs
      have antioligodendroglioma activity. Cooperative group trials will be necessary
      to determine the most effective drug, or combination of drugs, and to explore
      fully the role of chemotherapy in the treatment of this uncommon glioma.

PMID- 1641114
TI  - Cerebrovascular effects and tumor kinetics after a single intratumoral injection
      of human recombinant interleukin-2 alone or in combination with intravenous
      chemotherapy in a rat model of glioma.
AB  - It is well documented that drug delivery into experimental and human brain tumors
      is limited by the variably intact blood-brain barrier (BBB) at the growing edge.
      The aim of the present investigation was to examine the histopathological changes
      that occur after a single intralesional injection of human recombinant
      interleukin-2 (rIL-2) into a growing glioma and determine whether the injection
      improved delivery of cytotoxic drug into the neuropil surrounding the site of
      lymphokine injection. Because an intracerebral injection of rIL-2 causes a
      temporary breakdown in the BBB, we hoped to enhance drug penetration into
      peritumoral areas of brain with an intact BBB by using the novel biomodulating
      effect of rIL-2 on the cerebral endothelial cells. The results demonstrated that
      an intralesional injection of 7.2 x 10(4) National Units rIL-2 on Day 7 after
      tumor inoculation did not accentuate the already increased cerebrovascular
      permeability produced by the glioma nor did rIL-2 trigger additional or aggravate
      neurological deficits in glioma-bearing rats. Before the administration of
      chemotherapy in vivo, the RT-2 glioma cells were tested for in vitro sensitivity
      by colorimetric assay. At 24 hours after exposure to either methotrexate (MTX),
      vincristine (VIN), or doxorubicin (DOX), no significant inhibition of metabolic
      activity was observed. In contrast, a timed pulsed of any drug for 5 minutes
      caused significant dose-dependent inhibition of RT-2 glioma cells at 48 hours to
      5 days after drug administration. Animal models receiving an intralesional
      injection of rIL-2 followed 3 days later by an intravenous dose of 30 mg/kg MTX,
      0.23 mg/kg VIN, or 10 mg/kg DOX demonstrated that only MTX combined with
      intralesional rIL-2 significantly inhibited intracranial proliferation of RT-2
      glioma cells. Use of intralesional rIL-2 and intravenous chemotherapy, however,
      did not significantly increase survival in this animal model of glioma. These
      results show that the combination of cytotoxic drugs with intralesional rIL-2 can
      be safely applied in the management of glioma and may form a rational basis for
      additional pharmacological investigations of a wider assortment of chemotherapies
      in combination with rIL-2 for intracranial malignancies.

PMID- 1641115
TI  - Parallel and serial visual search after closed head injury: electrophysiological
      evidence for perceptual dysfunctions.
AB  - Event-related potentials (ERPs) were recorded from closed head injury (CHI)
      patients at least 2 years postinjury and from controls in order to assess their
      parallel and serial processing abilities during visual search. In Experiment 1,
      stimuli consisted of arrays of eight triangles; half of the arrays contained a
      target item. In the "feature-present" condition, the target item was a triangle
      with an additional horizontal line that could be detected automatically and in
      parallel, while in the "feature-absent" condition all items except for the target
      triangle had an additional horizontal line, thus requiring a serial search. In
      Experiment 2, stimuli consisted of eight solid bars (50%), seven solid bars and a
      vertical open bar (25%), and seven solid bars and a horizontal open bar (25%):
      the array containing the horizontal bar served as a target. By recording ERPs to
      the arrays containing vertical open bars, which were similar to the target items,
      parallel processing of "pop-out" stimuli could be studied in the absence of any
      overt response. ERP data were compared with the results of neuropsychological and
      neuroimaging (MRI, CAT) examination. Patient exhibited a decreased behavioral
      performance both in the parallel and in the serial processing mode. Furthermore,
      abnormalities of early and intermediate ERP components (P1, N1, P2, N2) were
      found, whereas the late component (P3) was less affected by CHI. The results were
      interpreted as an index of CHI-induced dysfunctions in perceptual processes such
      as simple feature registration and early target discrimination. It was suggested
      that these dysfunctions contribute to impairments of parallel as well as serial
      processes in visual search.

PMID- 1641116
TI  - To halve and to halve not: an analysis of line bisection judgements in normal
      subjects.
AB  - Normal adults were tested in a series of three experiments to examine the
      influences of spatial location and cueing upon line bisection judgements.
      Judgements in all three experiments were strongly influenced by cueing with a
      letter at one or other end of the line. The spatial location of the line (in
      left, central or right body space) also had a minor effect in Experiments 1 and
      2, where evidence was additionally found for a small constant error when lines
      were presented centrally. It is argued from the results of Experiments 2 and 3,
      where no explicit bisection response was required, that perceptual/attentional
      factors, rather than an orienting bias, play the major role in mediating the
      cueing effect. It is concluded that there is a substantial attentional effect
      upon judgements of extent, whereby paying less attention decreases perceived
      relative line length. However the constant error and the effect of spatial
      location, whilst mainly perceptual in nature, may also be partly determined by
      premotor orienting biases caused by differential hemispheric activation.

PMID- 1641117
TI  - The computation of perceptual structure from collinearity and closure: normality
      and pathology.
AB  - Three experiments tested how structural information affects the processing of
      fragmented forms, using evidence from both normal subjects and an agnosic
      patient. The stimuli were either (a) outline drawings of objects; (b) "well" or
      "poorly" structured fragmented forms derived from outline drawings (Experiments 1
      and 2) or (c) "well" or "poorly" structured fragmented forms derived from outline
      drawings of meaningless forms (Experiment 3). "Well" and "poorly" structured
      forms varied on the properties of collinearity and closure of the elements.
      Subjects decided if two simultaneously presented forms had the same orientation
      or were mirror-reversed. Three levels of discriminability were examined: (a) for
      "symmetrical" forms the decision had to be based on the detection of a small
      feature appearing on the same or the opposite side in the two forms; (b) for
      "asymmetrical" forms the decision had to be based on a large part located on the
      same or the opposite side of each object; and (c) for "oblique" forms, matching
      could be based on the global orientation of the shapes. Normal subjects performed
      equivalently on outline drawings and "well" structured fragmented forms and worse
      on "poorly" structured forms. This effect was strongest on "asymmetrical"
      stimuli, both with meaningful (Experiments 1 and 2) and meaningless forms
      (Experiment 3). This indicates that the segmentation of forms into parts, for
      judgements with "asymmetrical" stimuli, is affected by the structural properties
      of collinearity and closure. For the agnosic patient, performance was similar for
      "well" and "poorly" structured forms, and there was better performance in the
      "oblique" condition. This suggests that the patient could use global shape
      information, but that this coexists with a selective deficit in computing local
      perceptual structure, based on collinearity and closure between form elements.
      The implications of the results for understanding form perception and the
      clinical use of fragmented forms, are discussed.

PMID- 1641118
TI  - Ocular exploration in the dark by patients with visual neglect.
AB  - Eye-movements were recorded as patients with visual neglect searched in a
      completely darkened room to determine whether any light was present. Fixations
      were confined almost entirely to the right of the midline, and biased rightwards
      within that area. A control group with visual field defects searched equally to
      both sides. This shows that neglect patients have a bias to look to the right
      which is independent of the difficulty they also have in processing sensory
      information in the left visual field. Results are related to theories of the
      hemispheric control of attention and to the view that the representation of
      contralateral space is impaired in neglect.

PMID- 1641119
TI  - Spatio-motor cueing in unilateral left neglect: the role of hemispace, hand and
      motor activation.
AB  - Reported beneficial effects of left arm activation on neglect are experimentally
      examined. The present study of a subject with left visual neglect compared left
      hand finger movement with an instruction to visually anchor perception on the
      left arm during letter cancellation. Only the finger movements significantly
      reduced neglect. Another comparison was between "out of sight" finger movements
      of the left hand in left and right hemispace, respectively. Only left hemispace
      "blind" finger movements significantly reduced neglect compared to the standard
      condition. Thirdly, blind left finger movements in left hemispace were compared
      with passive visual cueing (reading a changing number) and again it was found
      that only the finger movements reduced neglect. Finally, right finger movements
      in left hemispace were compared with left finger movements in left hemispace:
      only the latter reduced neglect. The implications of these findings for theory
      and therapy of neglect are discussed.

PMID- 1641120
TI  - Different mental imagery abilities result in different regional cerebral blood
      flow activation patterns during cognitive tasks.
AB  - Using regional cerebral blood flow (rCBF) imaging, two populations having high
      and low imagery abilities were compared at rest and while performing two
      cognitive tasks: silent verb conjugation and mental imagery. The imagery task
      produced an rCBF increase in the left visual association and left frontal
      cortices in both groups. Differences between high and low imagers were observed
      on global and regional flow responses to cognitive tasks: low imagers showed a
      whole cortex CBF increase during both tasks; high imagers showed a right
      dominance in the visual association cortex in all conditions, and in the parietal
      association cortex at rest.

PMID- 1641121
TI  - Regional cerebral blood flow patterns related to verification of low- and high
      imagery sentences.
AB  - Although several SPECT studies have shown left inferior occipital activation with
      visual imagery, the reliability of this finding remains doubtful. The present
      study replicated two conditions of a previous SPECT-study exploring rCBF in
      subjects verifying the correctness of low- and high-imagery sentences. As in the
      previous study, verification of high-imagery sentences was associated with higher
      flow rates in the left inferior occipital region and lower flow rates in the
      right anterior frontal region. By contrast, a bilateral increase of thalamic flow
      rates with imagery was not replicated, and there was a higher flow rate in the
      left inferior temporal region with low-imagery sentences which had not been found
      in the original study.

PMID- 1641122
TI  - Abnormal eye movement behaviour during text reading in neglect syndrome: a case
      study.
AB  - The eye movement behaviour of a patient suffering from a right basal ganglia
      infarction with a left-sided hemineglect but without any visual field defects was
      investigated during reading. The eye movements were registered by means of an
      i.r. light technique (pupil-corneal reflection method). The main findings were
      abnormal return sweeps. Whereas in normal readers the end of one line of text is
      linked to the beginning of the new line by a long leftward saccade, the return
      sweeps of the hemineglect patient stereotypically ended in the middle of the next
      line. They were followed by sequences of short saccades indicating silent
      backward reading until a linguistically plausible continuation of sentences from
      the previous line was found, irrespective of the actual beginning of text. The
      shortened return sweeps could not be attributed to a general oculomotor
      disturbance. The spatial border for the occurrence of the patient's abnormal
      scanning pattern (left half of texts) clearly did not depend on a retinal
      coordinate frame of reference but rather has to be attributed to a different body
      centred reference system.

PMID- 1641123
TI  - A specific form of cognitive rigidity following excitotoxic lesions of the basal
      forebrain in marmosets.
AB  - The effects of N-methyl-D-aspartate-induced lesions of the basal forebrain were
      studied on performance of a series of visual discrimination tests that examined a
      range of cognitive functions in the marmoset. These included the ability to
      attend to the various dimensional properties of stimuli and to use just one of
      these properties in order to solve a discrimination (intra-dimensional shift); to
      switch attention from one dimension to another (extra-dimensional shift); to
      learn the reinforcement value of specific exemplars within a dimension (new
      learning); and to relearn their reinforcement value following reversal of the
      reward contingencies (serial reversals). Lesions of the basal forebrain did not
      impair the ability either to attend selectively to the dimensional properties of
      the stimuli or to switch attention from one dimension to the other. However, the
      lesion did affect various aspects of associative learning including a transient
      impairment of new learning and a marked disruption of serial reversal learning.
      The reversal deficit could be characterised as a tendency to perseverate on the
      previously correct stimulus and as a failure to to show the formation of a
      reversal learning set. In addition, the lesion prevented disruption of
      performance of a well-learned discrimination when novel exemplars from the
      irrelevant dimension were introduced (probe test). It is suggested that the
      functional effects of the basal forebrain lesion reflect impaired learning of
      stimulus-reward associations and behavioural rigidity. The finding, however, that
      there was no effect of the lesion on attentional set-shifting suggests that any
      loss of inhibitory control was specific to the level of stimulus-response or
      stimulus-reward associations, inhibitory control at the level of attentional
      selection remaining intact. The similarity of the effects of damage to the basal
      forebrain to those seen following damage to the orbitofrontal cortex and the
      amygdala are discussed in the context of the close anatomical and functional
      relationships that exist among these three structures.

PMID- 1641124
TI  - Various types of inhibitory postsynaptic potentials in anterior thalamic cells
      are differentially altered by stimulation of laterodorsal tegmental cholinergic
      nucleus.
AB  - The effects of stimulating the laterodorsal tegmental cholinergic nucleus upon
      inhibitory postsynaptic potentials recorded in relay cells of the anterior
      thalamic complex were studied in urethane-anesthetized cats. The inhibitory
      postsynaptic potentials induced in anterior thalamic relay cells by stimulating
      mammillary nuclei or retrosplenial cortex are generated by local-circuit
      inhibitory neurons since this nuclear complex is devoid of afferents from the
      other intrathalamic source of inhibition, the reticular thalamic nucleus. In a
      parallel study from this laboratory, it has been shown that cortical stimulation
      elicits a biphasic inhibitory postsynaptic potential consisting of two (A and B)
      components attributed to axonal firing of local interneurons, whereas mammillary
      stimulation elicits, in addition to the A-B sequence, an earlier component (a)
      presumably generated by presynaptic dendrites in thalamic glomeruli. In the
      present study, short pulse-trains applied to the laterodorsal tegmental nucleus
      diminished the amplitudes of A and B inhibitory components or completely
      suppressed them. The B component was more sensitive to the depressive effect. By
      contrast with the changes of the A and B components, the mammillary-evoked a
      inhibitory component was not reduced and, in many instances, was enhanced
      following laterodorsal tegmental stimulation. The effects of laterodorsal
      tegmental stimulation survived monoamine depletion by reserpine. We suggest that
      mesopontine cholinergic depressive actions on A and B inhibitory postsynaptic
      potentials may be due to an increased conductance in thalamocortical cells during
      the short-lasting nicotinic action combined with a somatic hyperpolarization of
      local-circuit cells, whereas the enhancement of the earliest (a) inhibitory
      postsynaptic potential reflects a concomitant potentiating action at the level of
      intraglomerular presynaptic dendrites.

PMID- 1641125
TI  - Regionally specific and rapid increases in brain-derived neurotrophic factor
      messenger RNA in the adult rat brain following seizures induced by systemic
      administration of kainic acid.
AB  - In situ hybridization techniques were used to analyse the spatiotemporal pattern
      of brain-derived neurotrophic factor messenger RNA elevation associated with
      kainic acid-induced seizure activity in the rat. Pronounced increases in
      hippocampal brain-derived neurotrophic factor messenger RNA levels were observed
      as early as 30 min following the onset of behavioral seizures. The greatest
      increase (10-fold) occurred in the dentate granule cell layer, while pyramidal
      layers CA1, CA3, and CA4 exhibited increases of two- to six-fold. Peak elevation
      of brain-derived neurotrophic factor messenger RNA in CA1 hippocampal region was
      evident at 4 h in CA3, and in the dentate granule layer at 30 min postseizure.
      Elevations persisted in the dentate and hilar regions to four days, while the
      increases in CA1 and CA3 returned to control levels by 16 h following seizure.
      Significant increases in brain-derived neurotrophic factor messenger RNA were
      also observed in the superficial layers of cortex (II and III) and in the
      piriform cortex which reached peak elevations by 8 h. No detectable changes were
      observed in the dorsomedial thalamus. Although histologically defined pyramidal
      and granule cell layers displayed relatively uniform increases in brain-derived
      neurotrophic factor messenger RNA in response to kainate, a closer examination of
      the labeling patterns using emulsion autoradiography revealed discrete areas of
      high grain densities overlapping uniform, moderate hybridization densities in the
      dentate granule cell layer and CA3, suggesting that the capacity to upregulate
      brain-derived neurotrophic factor messenger RNA in these regions may differ among
      individual neurons. In conclusion, our studies revealed that brain-derived
      neurotrophic factor messenger RNA induction in response to systemic kainate
      administration differs in hippocampal and cortical areas, in magnitude, time of
      onset and duration. The observed temperospatial pattern does not correspond in a
      simple way to increases in metabolic or electrical activity associated with
      seizures or neuronal vulnerability coincident with the seizures.

PMID- 1641126
TI  - Pertussis toxin administration increases the expression of proneurotensin and
      preproenkephalin A mRNAs in rat striatum.
AB  - The effect of a unilateral intrastriatal microinjection of pertussis toxin on the
      expression of proneurotensin and preproenkephalin A mRNAs in the adult rat
      neostriatum was investigated using a technique of non-radioactive in situ
      hybridization. Control sham microinjected animals received an equal volume of
      vehicle only and were processed in parallel with the pertussis toxin-treated
      rats. All rats were allowed to recover from the stereotaxic surgery for 22 h
      before being killed and their brains rapidly removed and processed for in situ
      hybridization using alkaline phosphatase-labelled oligonucleotide probes. In
      comparison to sham microinjected rats, a single intrastriatal microinjection of
      pertussis toxin (1 microgram) resulted in a significant increase in the amount of
      both proneurotensin and preproenkephalin A mRNAs in the ipsilateral neostriatum.
      For proneurotensin mRNA, this increase was reflected by a substantial increase in
      the number of mRNA-containing cells detected. Proneurotensin mRNA-containing
      cells detected in the nucleus accumbens appeared to be unaffected by the
      intrastriatal pertussis toxin microinjection. In contrast, the significant
      increase in preproenkephalin A mRNA, when compared to the contralateral
      uninjected striatum and the ipsilateral striatum of control sham injected rats,
      was reflected by an increase in the cellular amount of preproenkephalin A mRNA
      and not by an increase in the number of mRNA-containing cells detected. These
      results demonstrate that the expression of both proneurotensin mRNA and
      preproenkephalin A mRNA in the adult rat striatum are rapidly increased in vivo
      by an intrastriatal microinjection of pertussis toxin.

PMID- 1641127
TI  - Muscarinic antagonists attenuate neurotensin-stimulated accumbens and striatal
      dopamine metabolism.
AB  - The effect of scopolamine and atropine upon the increase in extracellular 3,4
      dihydroxyphenylacetic acid induced by central injection of neurotensin was
      examined in the nucleus accumbens and the striatum of anaesthetized rats using in
      vivo differential pulse voltammetry with carbon fibre electrodes. Scopolamine (1
      and 3 mg/kg, i.p.) and atropine (20 micrograms, i.c.v.) did not alter the 3,4
      dihydroxyphenylacetic acid level in the nucleus accumbens or the striatum,
      measured for 60 min after administration. Neurotensin (10 micrograms, i.c.v.)
      increased the 3,4-dihydroxyphenylacetic acid peak height in both regions.
      Pretreatment with scopolamine (1 mg/kg) 15 min before neurotensin injection
      blocked the increase in extracellular 3,4-dihydroxyphenylacetic acid in the
      striatum but not in the nucleus accumbens whilst scopolamine (3 mg/kg) partially
      attenuated the effect of neurotensin in the nucleus accumbens and blocked the
      increase in 3,4-dihydroxyphenylacetic acid in the striatum. Atropine partially
      attenuated the effect produced by neurotensin in the nucleus accumbens and
      blocked the increase in 3,4-dihydroxyphenylacetic acid induced by the peptide in
      the striatum. However, the increase in extracellular 3,4-dihydroxyphenylacetic
      acid induced by haloperidol (1 mg/kg, s.c.) was not altered by scopolamine (1
      mg/kg) or atropine. Also, the increase in dopamine metabolism in the nucleus
      accumbens and the striatum after centrally injected haloperidol (10 micrograms,
      i.c.v.) was not altered by atropine (20 micrograms, i.c.v.). Together, the
      results demonstrate a functional interaction between muscarinic antagonists and
      neurotensin on in vivo dopamine metabolism in the nucleus accumbens and the
      striatum but with a greater effect in the latter region.

PMID- 1641128
TI  - Virtual trajectories of single-joint movements performed under two basic
      strategies.
AB  - The framework of the equilibrium point hypothesis has been used to analyse motor
      control processes for single-joint movements. Virtual trajectories and joint
      stiffness were reconstructed for different movement speeds and distances when
      subjects were instructed either to move "as fast as possible" or to intentionally
      vary movement speed. These instructions are assumed to be associated with similar
      or different rates of change of hypothetical central control variables
      (corresponding to the speed-sensitive and speed-insensitive strategies). The
      subjects were trained to perform relatively slow, moderately fast and very fast
      (nominal movement times 800, 400 and 250 ms) single-joint elbow flexion movements
      against a constant extending torque bias. They were instructed to reproduce the
      motor command for a series of movements while ignoring possible changes in the
      external torque which could slowly and unpredictably increase, decrease, or
      remain constant. The total muscle torque was calculated as a sum of external and
      inertial components. Fast movements over different distances were made with the
      speed-insensitive strategy. They were characterized by an increase in joint
      stiffness near the midpoint of the movements which was relatively independent of
      movement amplitude. Their virtual trajectories had a non-monotonic N-shape. All
      three arms of the N-shape scaled with movement amplitude. Movements over one
      distance at different speeds were made with a speed-sensitive strategy. They
      demonstrated different patterns of virtual trajectories and joint stiffness that
      depended on movement speed. The N-shape became less apparent for moderately fast
      movements and virtually disappeared for the slow movements. Slow movements showed
      no visible increase in joint stiffness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641129
TI  - Muscarinic M2 receptor mRNA expression and receptor binding in cholinergic and
      non-cholinergic cells in the rat brain: a correlative study using in situ
      hybridization histochemistry and receptor autoradiography.
AB  - The goal of the present study was to identify the cells containing mRNA coding
      for the m2 subtype of muscarinic cholinergic receptors in the rat brain. In situ
      hybridization histochemistry was used, with oligonucleotides as hybridization
      probes. The distribution of cholinergic cells was examined in consecutive
      sections with probes complementary to choline acetyltransferase mRNA.
      Furthermore, the microscopic distribution of muscarinic cholinergic binding sites
      was examined with a non-selective ligand ([3H]N-methylscopolamine) and with
      ligands proposed to be M1-selective ([3H]pirenzepine) or M2-selective
      ([3H]oxotremorine-M). The majority of choline acetyltransferase mRNA-rich (i.e.
      cholinergic) cell groups (medial septum-diagonal band complex, nucleus basalis,
      pedunculopontine and laterodorsal tegmental nuclei, nucleus parabigeminalis,
      several motor nuclei of the brainstem, motoneurons of the spinal cord), also
      contained m2 mRNA, strongly suggesting that at least a fraction of these
      receptors may be presynaptic autoreceptors. A few groups of cholinergic cells
      were an exception to this fact: the medial habenula and some cranial nerve nuclei
      (principal oculomotor, trochlear, abducens, dorsal motor nucleus of the vagus).
      Furthermore, m2 mRNA was not restricted to cholinergic cells but was also present
      in many other cells throughout the rat brain. The distribution of m2 mRNA was in
      good, although not complete, agreement with that of binding sites for the M2
      preferential agonist [3H]oxotremorine-M, but not with [3H]pirenzepine binding
      sites. Regions where the presence of [3H]oxotremorine-M binding sites was not
      correlated with that of m2 mRNA are the caudate-putamen, nucleus accumbens,
      olfactory tubercle and islands of Calleja. The present results strongly suggest
      that the M2 receptor is expressed by a majority of cholinergic cells, where it
      probably plays a role as autoreceptor. However, many non-cholinergic neurons also
      express this receptor, which would be, presumably, postsynaptically located.
      Finally, comparison between the distribution of m2 mRNA and that of the proposed
      M2-selective ligand [3H]oxotremorine-M indicates that this ligand, in addition to
      M2 receptors, may also recognize in certain brain areas other muscarinic receptor
      populations, particularly M4.

PMID- 1641130
TI  - Evidence of GABA-immunopositive neurons in the dorsal part of the lateral
      geniculate nucleus of reptiles: morphological correlates with interneurons.
AB  - The distribution and staining pattern of gamma-aminobutyric acid immunoreactivity
      have been examined by both light and electron microscopy in the dorsal part of
      the lateral geniculate nucleus of three reptilian species: the turtle Chinemys
      reevesi, the lizard Ophisaurus apodus and the snake Vipera aspis. After perfusion
      of the animals with 1% paraformaldehyde and 1% glutaraldehyde and
      polyethyleneglycol embedding of the brains, the analysis of sections processed
      immunocytochemically with an anti-GABA antiserum has revealed a moderate-to-dense
      labeling of the neurons of the dorsal part of the lateral geniculate complex in
      these species. Labeled cell bodies are small-sized, either rounded or fusiform
      and the GABA-positive dendrites emerging from them are not preferentially
      oriented in any particular direction. Quantitative studies in Vipera indicate
      that GABA-positive neurons make up about 14% of the population of neurons of the
      dorsal part of the lateral geniculate nucleus. Electron microscopy of specimens
      treated by either pre- or post-embedding techniques has confirmed that these
      cells corresponded to neurons. No glial cells were ever observed to be
      immunopositive. These GABA-positive neurons, characterized by the presence of
      pleiomorphic synaptic vesicles localized either in their perikaryon or more often
      in presynaptic dendrites, established symmetrical synaptic contacts. In this
      case, the latter were involved both pre- and postsynaptically in serial and, more
      rarely, in triadic arrangements, a synaptic organization specific to
      interneurons. The involvement of such GABA-positive neurons in local circuits is
      discussed.

PMID- 1641131
TI  - A new monoclonal antibody against the GABA-protein conjugate shows
      immunoreactivity in sensory neurons of the rat.
AB  - A monoclonal antibody, 115AD5, was raised against GABA coupled to bovine serum
      albumin. The monoclonal antibody 115AD5 also reacted with other GABA-protein
      conjugates. The specificity of the monoclonal antibody was corroborated by enzyme
      linked immunoassay, dot-immunobinding experiments and immunostaining of rat
      cerebellum sections. The monoclonal antibody 115AD5 could successfully be applied
      on Vibratome and cryostat sections using either indirect immunofluorescence or
      peroxidase techniques. In rat cerebellar cortex the monoclonal antibody 115AD5
      gave an intense immunoreaction in stellate cells, in Golgi neurons, and in basket
      cells and their processes around Purkinje cell bodies. Purkinje cell dendrites
      showed GABA immunoreactivity while the cell bodies were non-reactive or only
      weakly reactive. There was labelling in some nuclei of Purkinje cells. GABA
      immunoreactivity was also found in dot-like structures in the granular layer. A
      large population of sensory neurons in rat thoracic and lumbar spinal dorsal root
      ganglia presented an intense immunoreactivity for the monoclonal antibody 115AD5.
      Nerve bundles immunoreactive for GABA were also seen in these ganglia. In the
      trigeminal ganglion, a major population of sensory neurons and some of their
      processes presented immunoreactivity for GABA. In the sensory nodose ganglion of
      the vagus nerve, many neuronal cell bodies and some fibres were immunoreactive
      for GABA. Ligation of the vagus nerve caudal to the ganglion resulted in an
      increased GABA immunoreactivity in neuronal somata of the ganglion, as well as in
      nerve fibres on the ganglionic side of the ligature. The present results suggest
      that in the rat, a population of sensory neurons in thoracic and lumbar spinal
      dorsal root ganglia, as well as in the trigeminal and nodose ganglia contain
      GABA. The presence of GABA immunoreactivity in these neurons raises the
      possibility of a neurotransmitter or modulator role.

PMID- 1641132
TI  - Oxytocin-containing pathway to the bed nuclei of the stria terminalis of the
      lactating rat brain: immunocytochemical and in vitro electrophysiological
      evidence.
AB  - Immunocytochemical staining within the forebrain of lactating rats revealed
      oxytocin-immunoreactive perikarya in a continuum running from the anterior
      parvocellular hypothalamic paraventricular nucleus through the anterior
      commissural nucleus and perifornical region. Beaded axons could be seen arising
      from these perikarya to enter the bed nuclei of the stria terminalis. In sections
      cut at a 45 degree angle to the parasagittal plane, much of this pathway could be
      maintained intact, and in vitro tissue slices prepared in this orientation were
      used for electrophysiological studies of oxytocinergic innervation of the bed
      nuclei. By extracellular recording, neurons of the bed nuclei of the stria
      terminalis were tested for their response to exogenous oxytocin and to
      stimulation of the paraventricular hypothalamus. Both short latency (3-40 ms)
      orthodromic excitation (26/78 neurons) and longer latency (greater than 100 ms)
      excitation (12/78 neurons) were observed following paraventricular hypothalamic
      stimulation, possibly representing mono- and polysynaptic inputs, respectively.
      Removal of extracellular Ca2+ blocked these orthodromic responses (n = 6).
      Antidromic invasion was seen in a further 11/78 neurons with characteristics of
      constant latency (mean = 5.9 +/- 0.7 ms), high frequency following (40-80 Hz) and
      persistence in Ca(2+)-free medium. When tested for the effect of oxytocin (10(-7)
      M), none (0/11) of the antidromically activated neurons were excited, but nine of
      34 of the orthodromically excited neurons (both short and long latency) responded
      with a marked increase in activity. In three of eight cases, the orthodromic
      synaptic excitation following hypothalamic stimulation could be reversibly
      attenuated by the receptor antagonist [d(CH2)5,D-Tyr(OEt)2,Val4,Cit8]-vasopressin
      (0.5 or 2.5 x 10(-6) M), further substantiating the involvement of oxytocin.
      These data provide anatomical and electrophysiological evidence for an
      oxytocinergic innervation of the bed nuclei of the stria terminalis. This pathway
      is discussed in terms of possible involvement in mediating the facilitatory
      effect of oxytocin on the milk-ejection reflex of lactating rats which has been
      suggested to act through this part of the limbic system.

PMID- 1641133
TI  - Interleukin-1 alpha expression is inducible by cholinergic stimulation in the rat
      adrenal gland.
AB  - Interleukin-1-like immunoreactivity has earlier been demonstrated by
      immunohistochemistry in the noradrenaline-containing chromaffin cells of the rat
      adrenal gland [Schultzberg et al. (1989) Neuroscience 30, 805-810; Schultzberg et
      al. (1987) J. Neurosci. Res. 18, 184-189]. In this study, we examine the
      regulation, upon cholinergic stimulation, of the expression of the cytokine
      interleukin-1 alpha in the rat adrenal gland. Interleukin-1 alpha and interleukin
      1 alpha mRNA levels in the adrenal gland are affected by systemic administration
      of the cholinergic agonists nicotine (0.5 mg/kg, i.p.) and carbachol (0.5 mg/kg,
      i.p.). Both drugs cause an increase in interleukin-1 alpha mRNA levels. In
      contrast to the increased mRNA levels, nicotine and carbachol reduce the
      interleukin-1 alpha protein level measured in the rat adrenal gland: nicotine by
      approximately 30%, 60 min after injection, and carbachol by approximately 55%, 30
      min after injection. The interleukin-1 alpha protein level returns to control
      level 90 min after nicotine injection, and 120 min after carbachol injection. We
      thus found a large, constitutively expressed and inducible pool of interleukin-1
      alpha in the rat adrenal gland, which appears to be sensitive to cholinergic
      stimulation and which may be responsible for some of the local and systemic
      effects of interleukin-1 alpha. Experiments with Escherichia coli
      lipopolysaccharide show that this substance, which induces interleukin-1
      expression and secretion in macrophages, is also able to induce the expression of
      interleukin-1 alpha mRNA and interleukin-1 alpha in the adrenal gland when
      injected at the dose of 2 mg/kg, i.p.

PMID- 1641134
TI  - Exercise therapy for positional vertigo.
AB  - We present a common cause of vertigo, benign positional paroxysmal vertigo
      (BPPV), and its history, diagnosis, and therapy. BPPV is suggested by history,
      readily diagnosed by office examination, and cured by appropriate exercise
      therapy. Since the condition is so common and often unrecognized, physicians are
      encouraged to consider BPPV as a possible cause of treatable dizziness.

PMID- 1641135
TI  - Parkinson's disease in twins.
AB  - Among nine monozygotic (MZ) and 12 dizygotic (DZ) twin pairs in which an index
      case had typical Parkinson's disease (PD) or PD with associated dementia, three
      MZ and three DZ pairs were concordant. Three of the six affected co-twins were
      first diagnosed during the study. Occurrence of PD in families of MZ and DZ index
      cases was more frequent than expected from population rates. The study underlines
      the need for personal examination using defined criteria in a cross-sectional
      twin study on PD. Although the study did not establish a major genetic impact in
      the etiology of PD, a genetic predisposition for the disease cannot be ruled out
      for some individuals.

PMID- 1641136
TI  - Asymmetric cortical degenerative syndromes: clinical and radiologic correlations.
AB  - Eight patients presented with slowly progressive focal neurologic syndromes that
      conformed to one of three clinically defined categories: progressive nonfluent
      aphasia (three patients), progressive perceptual-motor impairment (four
      patients), and progressive frontal lobe syndrome (one patient). Planar MRI and
      MRI-based surface or volume renderings demonstrated focal areas of atrophy that
      correlated well with clinical deficits. Single-photon emission computed
      tomography (SPECT) showed areas of cortical hypoperfusion that corresponded to
      focally atrophic regions revealed by MRI, but abnormal areas with SPECT were
      larger than those suggested by MRI. MRI and SPECT are useful in defining the
      regional structural and functional cerebral abnormalities that underlie slowly
      progressive focal neurologic syndromes caused by asymmetric cortical
      degeneration.

PMID- 1641137
TI  - A double-blind, randomized, crossover trial of pemoline in fatigue associated
      with multiple sclerosis.
AB  - Fatigue occurs in a majority of patients with MS and is generally independent of
      measurable neurologic disability. Few options for treatment are available. We
      conducted a double-blind, placebo-controlled, crossover trial for each of two 4
      week treatment periods. Forty-six eligible patients entered and five dropped out
      due to concurrent exacerbations. Nineteen patients (46.3%) experienced excellent
      or good relief of fatigue with pemoline, and eight patients (19.5%) with placebo
      (p = 0.06, Fisher's exact test). One-fourth of patients did not tolerate the drug
      well, and 7% had to discontinue pemoline during the study due to side effects.
      The most common side effects were anorexia, irritability, and insomnia. Pemoline
      may be an effective short-term treatment for fatigue associated with MS, but its
      adverse effects are not well tolerated by many patients.

PMID- 1641138
TI  - Epidemiology of human immunodeficiency virus encephalopathy in the United States.
AB  - To investigate the epidemiology of human immunodeficiency virus (HIV)
      encephalopathy, we analyzed cases of acquired immunodeficiency syndrome (AIDS)
      reported to the Centers for Disease Control (CDC) from September 1, 1987, through
      August 31, 1991. Of 144,184 persons with AIDS (PWAs), 10,553 (7.3%) were reported
      to have HIV encephalopathy. The proportion of PWAs with HIV encephalopathy was
      highest at the extremes of age: in PWAs less than 15 years old the proportion was
      13%, and in PWAs greater than or equal to 15 years old the proportion
      progressively increased with age, from 6% in PWAs 15 to 34 years old to 19% in
      PWAs greater than or equal to 75 years old (p = 0.00001, chi 2 test for linear
      trend in proportions). The reported annual incidence of HIV encephalopathy per
      100,000 population aged 20 to 59 years was 1.4 in 1988, 1.5 in 1989, and 1.9 in
      1990. This analysis best provides estimates for HIV encephalopathy as the initial
      manifestation of AIDS because the CDC AIDS reporting system often does not
      ascertain diagnoses after the initial AIDS report. These data suggest that age
      (very young or old) is associated with the development of HIV encephalopathy and
      that HIV encephalopathy is a common cause of dementia in adults less than 60
      years old in the United States.

PMID- 1641139
TI  - Adult-onset motor neuron disease and infantile Werdnig-Hoffmann disease (spinal
      muscular atrophy type 1) in the same family.
AB  - We describe a family in which infantile Werdnig-Hoffmann disease and adult-onset
      progressive muscular atrophy both occurred. The possibility of these two diseases
      developing within the same family by chance is unlikely, and several genetic
      hypotheses may be put forward to explain the association. We suggest that the
      molecular pathogenesis of these two subtypes of lower motor neuron degeneration
      may be linked. The genetic defect in the childhood spinal muscular atrophies has
      been mapped to chromosome 5q in close proximity to the microtubule-associated
      protein 1B locus. The association of diseases within this family suggests that
      chromosome 5q should also be studied in relation to adult-onset familial motor
      neuron disease.

PMID- 1641140
TI  - A case-control study of Alzheimer's disease in China.
AB  - We conducted a case-control study to assess possible factors associated with
      Alzheimer's disease (AD) with 70 clinically diagnosed AD patients and 140 age-
      and sex-matched nondemented neighborhood controls in China. Factors significantly
      associated with AD cases were family history of dementia in first-degree
      relatives, family history of psychotic disorders in first-degree relatives, and
      left-handedness/ambidexterity. A history of arthritis showed a significantly
      negative association with AD. Neither a family history for Down's syndrome,
      history of head trauma, nor other conditions that might support immune or viral
      hypotheses in AD were significantly associated with AD cases. These data support
      the role of familial/genetic factors in AD.

PMID- 1641141
TI  - Intrafamilial heterogeneity in hereditary motor neuron disease.
AB  - Although there are varied inheritance patterns in motor neuron disease (MND), the
      phenotype of MND is reported to be constant within these families, ie, cases of
      amyotrophic lateral sclerosis or primary lateral sclerosis do not occur in
      pedigrees with cases of spinal muscular atrophy. We describe four pedigrees whose
      members diverged in the phenotype of MND expressed. The intrafamilial variation
      of phenotype suggests a similar pathogenesis for some of the varied types of
      familial MND and the need for careful inquiry of family history in all patients
      with MND.

PMID- 1641142
TI  - Cognitive planning deficit in patients with cerebellar atrophy.
AB  - We compared the performance of 12 patients with cerebellar atrophy (CA) and 12
      normal controls matched for age and education on the Tower of Hanoi, a nine
      problem task that requires cognitive planning. CA patients performed
      significantly worse than controls on this task despite no difference in planning
      and between-move pause times. A reanalysis of the data using just the subgroup of
      patients with pure cerebellar cortical atrophy (CCA) (N = 9) replicated the above
      results and also showed that CCA patients had significantly increased planning
      times compared with controls. Neither age, sex, education level, severity of
      dementia, word fluency, response time, memory, nor visuomotor procedural learning
      predicted CA or CCA performance. This deficit in cognitive planning suggests a
      functional link between the cerebellum, basal ganglia, and the frontal lobe
      concerning specific cognitive processes. However, the exact role of the
      cerebellum in cognitive planning remains undetermined.

PMID- 1641143
TI  - Cerebrovascular complications of bacterial meningitis in adults.
AB  - We performed a prospective study of the type, frequency, temporal profile, and
      prognostic role of cerebrovascular complications in 86 adults with bacterial
      meningitis. Cerebral angiography was performed in 27 patients (31.4%) who had
      focal deficits either clinically, on cranial CT, or both, and in patients who had
      persistent coma without explained cause despite 3 days of antibiotic therapy.
      Alterations of the vessel systems, including involvement of major arteries at the
      base of the brain, medium-sized arteries, small vessels, and major sinuses and
      cortical veins, were present in 13 of the 27 patients who had angiography.
      Typical cerebrovascular complications were arterial narrowing of the supraclinoid
      portion of the internal carotid artery; vessel wall irregularities, focal
      dilatations, and occlusions of distal branches of the middle cerebral artery;
      focal abnormal parenchymal blush; and thrombosis of the sagittal superior sinus
      and cortical veins. Prognosis for those patients with cerebrovascular
      complications was unfavorable. Six patients died, one remained in a vegetative
      state, four were moderately or slightly disabled, and only two recovered
      completely. The study showed that angiographically documented cerebrovascular
      complications are the most frequent intracranial complications in bacterial
      meningitis of the adult (37.1%) and are major determinants in the prognosis of
      this disease.

PMID- 1641144
TI  - Embolism from vertebral artery origin occlusive disease.
AB  - We report 10 patients with severe occlusive disease of the vertebral artery (VA)
      origin in the neck with intra-arterial embolism to the posterior circulation. The
      VA lesions in seven patients were complete occlusions, and three patients had
      severe atherostenosis. All patients had strokes in the vertebrobasilar territory.
      The most frequent recipient sites of intra-arterial embolism were the
      intracranial VA-posterior inferior cerebellar artery region (8), and the distal
      basilar artery (BA) and its superior cerebellar and posterior cerebral artery
      branches (7). Two patients had pontine infarction due to BA embolism. The most
      common clinical signs were due to cerebellar infarction. Atherosclerotic disease
      of the VA origin has features in common with disease of the internal carotid
      artery origin. Both have similar risk factors and demography, and each can cause
      strokes by intracranial intra-arterial embolism.

PMID- 1641145
TI  - Characteristics of intractable seizures following meningitis and encephalitis.
AB  - We studied clinical seizure characteristics, seizure localization, and pathology
      in 38 patients who developed medically intractable partial seizures following
      meningitis (n = 16) or encephalitis (n = 22) and were evaluated for epilepsy
      surgery. Whereas meningitis in this group was commonly associated with mesial
      temporal sclerosis (MTS), most encephalitis patients had neocortical foci. The
      age of onset of the encephalitic illness was important in predicting mesial
      temporal or neocortical foci in that group: encephalitis before, but not after,
      age 4 years was associated with MTS. Since almost all meningitis occurred before
      age 4 years, these data support the hypothesis that the medial temporal lobe is
      particularly susceptible to early insults, establishing the initial pathologic
      entity of MTS and the subsequent cascade of partial seizures. Later-onset
      encephalitis produced extrahippocampal neocortical seizure foci, was rarely
      associated with MRI abnormality, and was difficult to localize precisely. In
      contrast, meningitis was commonly associated with MTS, aiding seizure
      localization and successful surgical intervention when seizures were medically
      uncontrolled.

PMID- 1641146
TI  - Headache in type I Chiari malformation.
AB  - We analyzed the headaches in 50 patients with type I Chiari malformation. Of the
      50, 14 (28%) had a rather specific, usually protracted, suboccipital-occipital
      headache of variable quality and duration that was aggravated by Valsalva's
      maneuver, effort, cough, or postural changes and relieved by occipital
      suboccipital craniectomy. Only the degree of tonsillar herniation significantly
      correlated with the presence of this pain. Both migraine and tension-type
      headache occurred with the expected frequency for the general population.

PMID- 1641147
TI  - Pendular pseudonystagmus arising as a combination of head tremor and vestibular
      failure.
AB  - We describe three patients with spontaneous pendular oscillation of the eye
      during funduscopy. All patients had blurred, shimmering vision or oscillopsia,
      exacerbated by concentration, reading, or trivial head movements, and had a
      history of unsteadiness. Examination revealed a fine head tremor, mild
      unsteadiness, absent vestibulo-ocular reflex (VOR), and otherwise normal
      neurologic and ocular motor findings. Rigid immobilization of the head abolished
      the retinal oscillations. Simultaneous precision recordings of head and eye
      movements showed that the eye movement was in the compensatory direction to the
      head tremor but that, in contrast to normal VOR, it was in phase error. We
      conclude that the essential head tremor was provoking oscillopsia and retinal
      oscillation because of the absence of VOR. Recognizing the association of head
      tremor with absent VOR is important since in all these patients the presence of
      this pendular pseudonystagmus on ophthalmoscopy raised the diagnostic possibility
      of brainstem disease.

PMID- 1641148
TI  - Elevated plasma glucagon in amyotrophic lateral sclerosis.
AB  - This study shown an abnormality in glucagon levels that may explain the glucose
      intolerance, abnormal insulin reactions, and abnormal plasma amino acid levels
      seen in amyotrophic lateral sclerosis (ALS). We randomly administered two test
      meals, differing only in protein source (soy versus casein) at least 1 week apart
      and measured fasting and postprandial bloods for glucagon, insulin, and glucose
      levels in 11 ALS patients. With the soy test meal, glucagon levels were elevated
      in all ALS patients compared with controls: at fasting (237 +/- 111 versus 108 +/
      46 pg/ml, p less than 0.01) and 1/2 hour (389 +/- 94 versus 133 +/- 68 pg/ml, p
      less than 0.001), and 2 hours postprandial (379 +/- 75 versus 108 +/- 53 pg/ml, p
      less than 0.001). Glucagon levels after the casein test meal were also
      significantly elevated. Insulin was elevated by both test meals. Casein produced
      significant glucose intolerance.

PMID- 1641149
TI  - Amyotrophic lateral sclerosis: increased solubility of skin collagen.
AB  - We studied the solubility of skin collagen from six patients with amyotrophic
      lateral sclerosis (ALS) and six controls. The amount of collagen extracted with
      neutral salt solution was significantly greater in patients with ALS than in
      controls. In addition, there was a statistically significant increase in the
      proportion of collagen extracted from ALS patients with increased duration of
      illness. The collagen solubilized by pepsin and cyanogen bromide treatments was
      significantly higher in ALS patients than in controls, and its proportion was
      positively and significantly associated with duration of illness in ALS patients.
      These results indicate that the metabolism of skin collagen may be affected in
      the disease process of ALS, causing an increase in immature soluble collagen in
      the tissue, which is the opposite to that which occurs in the normal aging
      process.

PMID- 1641150
TI  - Positron emission tomography demonstrates frontal cortex and basal ganglia
      hypometabolism in dystonia.
AB  - We studied 15 dystonic patients with positron emission tomography (PET) and (18F)
      2-fluoro-2-deoxy-D-glucose (FDG). The group comprised patients with focal (n =
      5), multifocal (n = 1), and generalized (n = 4) dystonia as well as patients with
      hemidystonia (n = 5). The age at onset was during childhood in four, during
      adolescence in two, and during adulthood in nine of the subjects. In dystonic
      patients, global cerebral glucose metabolism was unaltered when compared with
      normal controls, whereas the pattern of regional cerebral metabolic rate for
      glucose (rCMR[Glu]) was significantly different (p = 0.0001). rCMR(Glu) was
      significantly decreased in the caudate and lentiform nucleus and in the frontal
      projection field of the mediodorsal thalamic nucleus. The study confirms the
      concept that dystonia is caused by impaired connections between the basal
      ganglia, the thalamus, and frontal association areas.

PMID- 1641151
TI  - Linkage studies in progressive myoclonus epilepsy: Unverricht-Lundborg and
      Lafora's diseases.
AB  - The progressive myoclonus epilepsies (PME) are a heterogeneous group of rare
      genetic disorders. Unverricht-Lundborg disease and Lafora's disease are two major
      classic forms of PME. We recently assigned the gene for Unverricht-Lundborg
      disease (EPM1) to human chromosome 21 band q22.3. We have now refined the
      localization of EPM1 by linkage analysis between the disease phenotype and nine
      DNA markers in 13 Finnish families. Loci MX1 and CD18 flank the EPM1 interval,
      which spans a distance of about 3.5 megabases. In this 20-centimorgan interval,
      no recombinations were detected between EPM1 and marker loci BCEI, D21S19,
      D21S42, D21S113, D21S154, and PFKL. Within this interval a maximum multipoint lod
      score of 11.04 was reached at loci D21S154-PFKL. In two Swedish families with
      Unverricht-Lundborg disease no recombinations were detected. In three Italian
      families with Lafora's disease the linkage results suggested that EPM1 is not the
      locus for Lafora's disease.

PMID- 1641152
TI  - Effect of BAEP monitoring on hearing preservation during acoustic neuroma
      resection.
AB  - We measured the effect of brainstem auditory evoked potential (BAEP) monitoring
      on hearing preservation in acoustic neuroma resection in 90 consecutive patients
      with monitoring compared with 90 historical controls matched for tumor size and
      preoperative hearing status. In small tumors (less than 2 cm), BAEP monitoring
      was associated with a higher rate of hearing preservation and a greater chance
      that the hearing preserved was clinically useful. Changes in the BAEP
      intraoperatively showed a good correlation with postoperative hearing status.

PMID- 1641153
TI  - Isolated tremor and disruption of the nigrostriatal dopaminergic system: an 18F
      dopa PET study.
AB  - We measured striatal 18F-dopa influx constants (Ki) for 20 patients with
      isolated, predominantly postural, tremor (eight familial, 12 sporadic) and 11
      with predominantly rest tremor. Results were compared with 30 controls and 16
      Parkinson's disease (PD) patients. The eight familial essential tremor (ET)
      patients had normal striatal 18F-dopa uptake. Two of the 12 sporadic postural
      tremor patients had subnormal putamen 18F-dopa Ki, one (who later became
      akinetic) falling in the PD range. The mean putamen 18F-dopa uptake of the 11
      rest tremor patients was reduced to PD levels (51% of normal). Our findings argue
      against an association between ET and PD, but support the existence of a "benign"
      tremulous variant of PD. The presence of low-amplitude rest tremor, cogwheel
      rigidity, reduced arm swing, and short tremor duration was not a useful predictor
      of nigral dysfunction in patients with postural tremor. In contrast, patients
      with predominantly rest tremor, particularly with onset in the leg, consistently
      showed reduced putamen 18F-dopa uptake.

PMID- 1641154
TI  - Motor and nonmotor behavioral deficits in monkeys made hemiparkinsonian by
      intracarotid MPTP infusion.
AB  - We tested five monkeys (three Macaca mulatta, two Macaca nemistrina) made
      hemiparkinsonian by internal carotid artery infusion of 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine (MPTP) for lateralized motor function using a bar press task
      and a reaction time/movement time task and for hemispatial neglect or hemi
      inattention using a double simultaneous stimulation (DSS) task, a lateralized
      reward retrieval task, and a task that assessed response to lateralized moving
      stimuli. All monkeys had impaired bar press performance and prolonged reaction
      and movement times with the limb contralateral to the lesion. However, using the
      limb ipsilateral to the lesion, all animals showed extinction to DSS, that is,
      they responded to single stimuli presented on the impaired side (contralateral to
      the MPTP lesion) more often than to stimuli presented on the impaired side that
      were presented simultaneously with stimuli on the unimpaired side (ipsilateral to
      the lesion). There was a response bias toward the side ipsilateral to the lesion
      in the lateralized retrieval task and a deficit in the ability to direct
      attention toward the side contralateral to the lesion when moving stimuli were
      employed. These latter results could not be explained by primary motor or sensory
      impairments. We conclude that unilateral MPTP-induced dopamine depletion in
      monkeys causes a complex syndrome characterized by overt motor disturbances
      contralateral to the side of lesion and less overtly apparent sensorimotor
      integration deficits.

PMID- 1641155
TI  - In vivo 31P nuclear magnetic resonance spectroscopy of human temporal lobe
      epilepsy.
AB  - We performed localized 31P nuclear magnetic resonance (NMR) 1H-image-guided in
      vivo spectroscopy to study regional high-energy phosphate levels in the brains of
      normal controls and in patients with intractable unilateral temporal lobe
      epilepsy. We did not observe differences in intracellular pH between controls and
      patients. The phosphocreatine/inorganic phosphate ratio was reduced by 50% in the
      epileptogenic temporal lobe compared with controls (p less than 0.005) and by 35%
      when compared with the unaffected contralateral temporal lobe (p less than 0.05).
      We did not observe differences in the ratio of phosphomonoesters to
      phosphodiesters between controls and patients. These findings suggest that in
      vivo 31P NMR spectroscopy yields a distinctive interictal metabolic profile in
      patients with intractable unilateral temporal lobe epilepsy and may permit
      noninvasive lateralizing evidence of the seizure focus.

PMID- 1641156
TI  - Propriospinal myoclonus: a neurophysiologic analysis.
AB  - We are reporting a neurophysiologic analysis of two patients presenting with
      thoracoabdominal spontaneous muscle jerks. Polymyographic recordings showed
      myoclonic bursts with onset in the upper rectus abdominis or lower intercostal
      muscles followed by rostral propagation to the upper intercostal and caudal
      propagation to the abdominal muscles by slowly conducting pathways. Jerk-locked
      back-averaging did not show time-locked cortical or premovement potentials.
      Peroneal somatosensory evoked response, C-reflex, and intercostal nerve
      conduction were normal. These findings suggest a generator for the myoclonus in
      the midthoracic region of the spinal cord with up and down propagation by slowly
      conducting pathways, such as propriospinal fibers. This type of spinal myoclonus
      may thus be termed "propriospinal myoclonus," as suggested by Brown et al.

PMID- 1641157
TI  - Prospective serial analysis of interleukin-2 and soluble interleukin-2 receptor
      in relapsing-remitting multiple sclerosis.
AB  - We performed a longitudinal analysis of serum interleukin-2 (IL-2) and soluble IL
      2 (sIL-2R) concentrations in 60 patients with relapsing-remitting (R-R) multiple
      sclerosis (MS) as well as in 33 age- and sex-matched normal controls. Overall, we
      found that serum IL-2 levels remained low (less than 10 U/ml) and did not change
      appreciably over time; however, marked fluctuations in sIL-2R levels were
      observed in both the patient and control groups. Using patients as their own
      controls, we calculated an interrelapse (disease stable) mean sIL-2R
      concentration as a baseline for comparison with relapse values; sIL-2R levels
      greater than the 90th percentile of the Student's t distribution of stable values
      were defined as "peaks." There were a total of 27 sIL-2R peaks, eight (30%) of
      which correlated with clinical relapses but were potentially predictive of only
      18% (8/45) of all the recorded clinical relapses. There was no difference in
      disease severity (Expanded Disability Status Scale) score between peak-correlated
      and noncorrelated relapses. Our data suggest that despite reports of elevated
      levels of IL-2 and sIL-2R in MS, neither may be a useful marker for predicting
      clinical disease activity in R-R MS.

PMID- 1641158
TI  - Aortic plaque in patients with brain ischemia: diagnosis by transesophageal
      echocardiography.
AB  - We evaluated 183 patients with brain ischemia for an embolic source, using
      transesophageal echocardiography with extensive imaging of the thoracic aorta.
      There were mobile, frond-like projections of aortic plaque in seven (4%)
      patients. The plaque originated on a wide base on the posterior aspect of the
      ascending aorta at its junction with the transverse arch in six patients, and on
      the aortic root in one. The acute event was a cerebral infarction in five
      patients, and a transient ischemic attack in two. This type of aortic plaque
      could be a previously underdiagnosed source of cerebral embolism that is now
      easily visualized by transesophageal echocardiography.

PMID- 1641159
TI  - Interaction of random electromyographic activity with averaged sensory evoked
      potentials.
AB  - We averaged sensory nerve action potentials (SNAP) of the median nerve recorded
      at the wrist, forearm, and elbow with up to 6,000 trials in the presence of
      quantitated levels of background EMG activity in six normal volunteers. The SNAP
      could be recorded reproducibly with averaging when the EMG amplitude was up to 50
      times the SNAP amplitude. EMG amplitudes of greater than 100 times the SNAP
      amplitude produced continuous variation in the averaged waveform that did not
      stabilize, probably because of the quasi-random, large, triphasic potentials that
      make up the EMG. Monitoring and reduction of background EMG activity can improve
      reliability of somatosensory evoked potential recording.

PMID- 1641160
TI  - Vimentin and desmin in maturing skeletal muscle and developmental myopathies.
AB  - I studied vimentin and desmin immunoreactivities in the skeletal muscle of 30
      human fetuses and children ranging from 8 weeks' gestation to 2 years of age, and
      in 45 infants and children and five adults with developmental neuromuscular
      diseases. Acridine orange-RNA fluorescence also identified regenerating myofibers
      in Duchenne muscular dystrophy and dermatomyositis for comparison with congenital
      myopathies. Vimentin and desmin are both strongly expressed in fetal myotubes and
      their immunohistochemical demonstration persists until 36 weeks' gestation. These
      cytoskeletal proteins are uniformly expressed in myofibers of neonates with X
      linked recessive myotubular myopathy. Desmin but not vimentin is diffusely
      increased in infantile cases of myotonic dystrophy, in some cases of congenital
      muscle fiber-type disproportion, and in cerebrohepatorenal disease. In nemaline
      rod myopathy, desmin is focally increased in perinuclear zones and in regions of
      aggregated rods. The small myofibers in infantile spinal muscular atrophy show
      increased vimentin and desmin in the subsarcolemmal region. The demonstration of
      these intermediate filament proteins provides markers to enhance diagnostic
      precision in the interpretation of the infant muscle biopsy. Furthermore,
      persistently high fetal concentrations of vimentin/desmin may play a role in the
      pathogenesis of some developmental myopathies.

PMID- 1641161
TI  - The dropped head syndrome.
AB  - We describe four patients with a neuromuscular syndrome characterized by
      relatively isolated neck extensor weakness. EMG and muscle biopsies suggest a
      restrictive noninflammatory myopathy predominantly affecting the cervical
      paraspinal muscles.

PMID- 1641162
TI  - Spontaneous intracranial hypotension with pachymeningeal enhancement on MRI.
AB  - Spontaneous intracranial hypotension (SIH) is a rarely reported syndrome of
      spontaneously occurring postural cephalalgia associated with low CSF pressure. We
      report a case of SIH in which MRI of the brain revealed diffuse symmetric
      pachymeningeal enhancement that resolved without specific therapy.

PMID- 1641163
TI  - Olfactory function in essential tremor.
AB  - Olfactory function, assessed by the University of Pennsylvania Smell
      Identification Test, was normal in essential tremor (ET) patients and
      significantly reduced in patients with Parkinson's disease (PD). This finding
      further supports a lack of association between ET and PD.

PMID- 1641164
TI  - Upper arm radial nerve palsy after muscular effort: report of three cases.
AB  - Three healthy men were engaged in continuous repetitive arm exercise when a
      sudden forceful contraction and stretch of the arm muscles led to a delayed upper
      arm radial nerve palsy. Radial nerve "entrapment" at the lateral head of the
      triceps muscles is a recognizable occupational nerve injury.

PMID- 1641165
TI  - Vestibular evoked potentials in human neck muscles before and after unilateral
      vestibular deafferentation.

PMID- 1641166
TI  - Lotus neuropathy: report of a case.

PMID- 1641167
TI  - Recurrent aseptic meningitis complicating intravenous immunoglobulin therapy for
      chronic inflammatory demyelinating polyradiculoneuropathy.

PMID- 1641168
TI  - An open-label trial of bromocriptine in nonfluent aphasia.

PMID- 1641169
TI  - Supplements.

PMID- 1641170
TI  - Increased dystonia after intrathecal baclofen.

PMID- 1641171
TI  - L-dopa and narcolepsy.

PMID- 1641172
TI  - Celiac disease and vitamin E deficiency.

PMID- 1641173
TI  - Imaging and seizures.

PMID- 1641174
TI  - Epileptiform spikes.

PMID- 1641175
TI  - Paget's disease and hemifacial spasm.

PMID- 1641176
TI  - Selegiline and nigral neurons.

PMID- 1641177
TI  - Conjugal MS.

PMID- 1641178
TI  - How many neurologists?

PMID- 1641179
TI  - Hemispatial neglect.

PMID- 1641180
TI  - Serum lipid peroxides in patients with Parkinson's disease.
AB  - To elucidate whether high serum lipid peroxidation rates may increase the risk of
      developing Parkinson's disease (PD), we assessed serum levels of malondialdehyde
      (MDA), an intermediate in lipid peroxidation processes, in 37 PD patients, with
      their spouses as the control group. Serum MDA levels did not differ significantly
      between these two groups (8.7 +/- 0.51 and 8.8 +/- 0.48 nmol/ml, resp.), and were
      not influenced by antiparkinsonian therapy in the PD patients. Serum MDA levels
      were inversely correlated with age and age at onset (P less than 0.01) in the PD
      group, but they were not correlated with disease duration, Unified Parkinson's
      Disease Rating Scale scores or Hoehn and Yahr staging. In the control group there
      was no correlation between serum MDA and age. These results suggest that,
      although serum levels of lipid peroxides were similar in both the PD and control
      groups, high serum lipid peroxidation rates might constitute a risk factor for
      younger onset of PD in predisposed individuals.

PMID- 1641181
TI  - Presence of diadenosine polyphosphates--Ap4A and Ap5A--in rat brain synaptic
      terminals. Ca2+ dependent release evoked by 4-aminopyridine and veratridine.
AB  - The study of the adenine nucleotides in middle brain synaptosomes from rat showed
      the presence of two diadenosine polyphosphates, Ap4A and Ap5A. HPLC techniques
      and phosphodiesterase digestion were employed in order to characterize and
      quantify the dinucleotides. The Ap4A content per mg of protein was 169 +/- 25
      pmol and 159 +/- 22 pmol for Ap5A. The study of the exocytotic release of these
      compounds was carried out with 100 microM 4-aminopyridine or 10 microM
      veratridine in the presence and in the absence of calcium. 4-Aminopyridine
      released 14.5 +/- 3.0 pmol/mg protein of Ap4A and 11.6 +/- 2.4 pmol/mg protein of
      Ap5A in a calcium dependent process. Veratridine in the presence of calcium
      released 19.9 +/- 3.0 and 16.6 +/- 2.8 pmol/mg of protein of Ap4A and Ap5A
      respectively. The ratios of exocytosis were close to 7-9% and 10-12% of the total
      synaptosomal content in the presence of 4-aminopyridine and veratridine,
      respectively.

PMID- 1641182
TI  - Immunoreactivities for antisera to three putative neuropeptides of the rat
      melanin-concentrating hormone precursor are coexpressed in neurons of the rat
      lateral dorsal hypothalamus.
AB  - Antisera (AS) raised against rat melanin-concentrating hormone (rMCH) and against
      two additional peptides sequences derived from the rat MCH precursor
      (neuropeptide glutamic acid-isoleucineamide (NEI), and neuropeptide glycine
      glutamic acid (NGE)) exclusively stained the hypothalamic neurons previously
      described using AS to salmon MCH, human somatocrinin 1-37 (GRF37) and alpha-MSH.
      Liquid phase and dot-blot controls for specificity indicated that rMCH-, NEI- and
      NGE-AS bound epitopes recognized by sMCH-, alpha-MSH- and GRF-37-AS,
      respectively. The distinct intracellular patterns of immunoreactivity obtained in
      control animals with rMCH-, NGE- and NEI-AS, as well as the changes observed
      after intracerebroventricular injection of colchicine matched previous findings
      using sMCH-, GRF37- and alpha-MSH-AS.

PMID- 1641183
TI  - The effect of binocular lid suture on auditory responses in the guinea-pig
      superior colliculus.
AB  - Guinea-pigs were deprived of visual experience from soon after birth until the
      terminal auditory mapping experiment (performed between 57 and 96 days after
      birth). The visual deprivation was effectuated by binocular eyelid suture. Multi
      unit responses were obtained from the superior colliculus (SC) in response ot
      free field presentation of bursts of broad band noise. In lid sutured animals a
      topographically ordered auditory map of azimuthal space was demonstrated in the
      SC. The auditory responses were, however, not as precise or tuned when compared
      with normal animals. Nevertheless, lid sutured animals were not as severely
      affected as dark reared animals in which no auditory map is evident in the SC.
      This study thus highlights the difference between binocular lid suture and dark
      rearing as methods of visual deprivation.

PMID- 1641184
TI  - Estimation of neural architecture in human brain by means of the dipole tracing
      method.
AB  - The electric source locations of interictal spikes recorded with depth electrodes
      were estimated by the dipole tracing (DT) method. Three-dimensional coordinates
      of the active surfaces of the depth electrodes and head geometry of the patient
      were measured from frontal and sagittal X-ray images and by a special device,
      respectively. The estimated dipole locations were superimposed on MR images of
      the patients. The dipole locations estimated in the hippocampal or
      parahippocampal regions successively moved in a small limited region during the
      interictal spike's peak. It was suggested that an interictal spike is composed of
      summated equivalent dipoles generated by hypersynchronization of a cluster of
      neurons, and that the timing of such hyperexcitation is more or less delayed
      because of electrical propagation along neuronal clusters which might be
      separated by sclerotic tissues.

PMID- 1641185
TI  - Human circadian rhythm in serum melatonin in short winter days and in simulated
      artificial long days.
AB  - Serum melatonin rhythm was studied in 6 human subjects experiencing short winter
      days resembling light/dark (LD) 8:16 h and in 6 subjects exposed at the same time
      to a long, LD 16:8 h skeleton photoperiod, with 3 h of bright light in the
      evening and again in the morning; 4 out of the 6 subjects entrained to the
      simulated summer photoperiod within 3 days. In the synchronized subjects, the
      nocturnal melatonin signal was 3 h shorter than in those experiencing just winter
      days. The data indicate that humans are able to respond to environmental day
      length by forming a proper endogenous photoperiodic signal.

PMID- 1641186
TI  - Immunocytochemical localization of VIP-immunoreactive neurons in the hypothalamus
      of immature gilts.
AB  - Immunocytochemical study using avidin-biotin complex method and peroxidase
      antiperoxidase technique was carried out to determine the distribution and
      morphology of vasoactive intestinal polypeptide-immunoreactive (VIP-IR) neuronal
      structures in the hypothalamus of the immature female pig. VIP-IR neurons were
      found in the arcuate, paraventricular and supraoptic nuclei, as well as in the
      pituitary stalk. The median eminence disclosed an abundance of VIP-IR processes
      both in the internal and external layer. These results let us conclude that there
      exist convenient morphological conditions for the release of VIP into portal
      blood in the area of the porcine median eminence-pituitary stalk complex.

PMID- 1641187
TI  - In situ transformation of striatal glia into cerebellar-like glia after brain
      transplantation.
AB  - Transplants of striatum from rabbit embryo were implanted into the colliculus
      posterior of newborn mice. After 4 weeks, astroglial cells derived from the
      transplant had migrated into the cerebellum of the host. Whenever they had
      settled in the cerebellum they presented forms similar to local glia. Some
      migrated glial cells were found to transform into forms of glia, such as radial
      like glia, which are not present in the striatum. This observation confirms that
      glial precursor cells are highly plastic. It is an in vivo demonstration that
      local conditions alone define the morphology of glial cells. After grafting in an
      heterotopic location they take on forms that they were not destined to express in
      the region of origin.

PMID- 1641188
TI  - Early modification of neuropeptide Y but not of neurotensin in the
      suprachiasmatic nucleus of the obese Zucker rat.
AB  - Hyperphagia in the obese Zucker rat is characterized by the early modification of
      the dark/light (D/L) rhythm of food intake. This rhythm is mainly driven by the
      suprachiasmatic nucleus (SCN) and, more controversially, by the ventromedian
      nucleus (VMN). In the SCN of adult obese Zucker rat, the concentrations of
      neuropeptide Y (NPY), a potent stimulator of food intake, are increased whereas
      those of neurotensin (NT), an anorexigenic peptide, are decreased. However,
      nothing is actually known about the synchronicity of the dysregulation of the D/L
      rhythm and variations of these peptides. That is why we measured NPY and NT in
      the microdissected SCN and VMN of lean (n = 16) and obese (n = 15) Zucker rats
      before the occurrence of hyperphagia (day 16 of age) and a few days after weaning
      (day 30 of age) when the modifications are apparent. For NPY, there was a very
      significant effect of age (P less than 0.001) for both nuclei and a significant
      effect of genotype (P less than 0.02) for the SCN only. NPY concentrations
      increased between 16 and 30 days in both nuclei (+74% (SCN) and +70% (VMN) in the
      obese rat; +57% (SCN) and +67% (VMN) in the lean rat; P less than 0.001). NPY in
      the SCN was not different at 16 days of age between lean and obese rats but
      significantly increased at 30 days in the obese rat (22.6 +/- 1.2 vs. 18.6 +/-
      1.5 ng/mg protein; P less than 0.05). NT was not detected in the SCN of either
      group at 16 days or at 30 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641189
TI  - Localization of interleukin 6 mRNA and interleukin 6 receptor mRNA in rat brain.
AB  - The cytokine interleukin 6 (IL6) has several effects on the central nervous
      system in addition to the well established regulation of the acute phase
      inflammatory response. Therefore, the distribution of IL6- and IL6 receptor mRNA
      in the rat brain has been investigated by in situ hybridization using [35S]
      labeled oligonucleotides. The messages of both genes were found in the CA1-CA4
      regions as well as in the dentate gyrus of the hippocampus, in the habenulae, the
      dorsomedial and the ventromedial hypothalamus, in the internal capsule, the optic
      tract and in the piriform cortex. These data indicate both neuronal and glial
      localization of IL6 and IL6 receptor and their involvement in an autocrine or
      paracrine action of the cytokine in centrally regulated functions including
      neuroendocrine control.

PMID- 1641190
TI  - The neuropeptide schistosomin and haemolymph from parasitized snails induce
      similar changes in excitability in neuroendocrine cells controlling reproduction
      and growth in a freshwater snail.
AB  - Infection of the snail Lymnaea stagnalis with the schistosome parasite
      Trichobilharzia ocellata results in inhibition of reproduction and in giant
      growth. Parasite-related effects on the neuroendocrine centres that control these
      processes were studied electrophysiologically. Haemolymph from infected snails
      reduced the excitability of the caudodorsal cells, which control egg laying. In
      contrast, the excitability of the growth-controlling Light Green Cells was
      increased under these conditions. The endogenous anti-gonadotropic neuropeptide
      schistosomin, the presence of which is strongly enhanced in parasitized snails,
      induced similar effects. Schistosomin apparently plays an important role in the
      balance between reproduction and growth in Lymnaea. This balance is severely
      disturbed during parasitic infection, probably as a result of the release of the
      peptide.

PMID- 1641191
TI  - Effect of viscosity on neurite outgrowth and fractal dimension.
AB  - The growth mechanism by which neurons achieve their characteristic ramified
      morphology has long been of interest, but determining whether physical
      parameters, such as viscosity, are important has been difficult due to a lack of
      useful hypotheses and standard reproducible techniques. We have recently shown
      that neurons exhibit fractal behavior and that their fractal dimension (df) is
      consistent with a physical process called diffusion-limited aggregation (DLA). We
      suggested that this DLA behavior might stem from viscosity differences, chemical
      gradients or electrical fields (Caserta et al., Phys. Rev. Lett., 64 (1990) 95
      98). DLA is a model for a large family of growth processes. In order for a
      process to fit the DLA model, the growth rate must be proportional to the
      gradient of a field at a point on the growing structure (Feder, Plenum, New York,
      1988, Ch. 4). Chemical, electrical, or fluid pressure fields can fit the model
      depending on the particular physical system under study. Here, we studied growth
      of retinal neurons from chick embryos in culture media of various fluid
      viscosities. Thus, we test whether DLA in this system was based on a fluid
      pressure field. As viscosity was increased from 1 to 4.3 cps, the number of
      neurite branches decreased 98%. However, there was no effect on df. Over this
      range of viscosities, total cellular protein synthesis decreased only 17%. The
      results indicate that, while differences in viscosity between the interior and
      exterior of the cell affect neurite outgrowth, they do not affect the fractal
      behavior of neurons. Thus, viscosity differences are not the basis for the DLA
      pattern of neuronal arborization.

PMID- 1641193
TI  - Periodic amplitude modulation of EEG.
AB  - Time variation of the EEG spectral parameters was analyzed during a 10 min
      resting period in 40 healthy subjects. Spectral band powers over the theta and
      alpha bands were calculated for each non-overlapping 2.5 s long EEG segment. The
      time variation of the band powers was further analyzed by computing the power
      spectra. The results showed that both theta and alpha band powers oscillate at an
      average frequency 0.024 Hz and 0.057 Hz. This indicates, that the background EEG
      activity is modulated by periodical slow components. We hypothesize that this
      modulation reflects spontaneous periodic changes of cortical excitability with
      control at the brainstem level.

PMID- 1641192
TI  - Activation of basal forebrain cholinergic neurons differentially regulates brain
      derived neurotrophic factor mRNA expression in different projection areas.
AB  - Afferent cholinergic pathways from the basal forebrain were activated by
      injections of the glutamate analog quisqualate either into the nucleus basalis or
      into the medial septal nucleus. Nucleus basalis injections had no effect on the
      expression of brain-derived neurotrophic factor (BDNF) mRNA in its neocortical
      projection areas as measured by in situ hybridization. In contrast, 7 h after an
      injection into the septum the level of BDNF mRNA increased 3- to 5-fold in the
      dentate gyrus, throughout CA1 to CA3 in the hippocampus and in the piriform
      cortex.

PMID- 1641194
TI  - Axotomy induces fusimotor-free muscle spindles in neonatal rats.
AB  - Crushing the nerve to the medial gastrocnemius (MG) muscle at birth and
      administering nerve growth factor to rats afterwards results in a reinnervated
      muscle with supernumerary muscle spindles, some of which must have formed de
      novo. Structure and innervation of spindles in the reinnervated MG muscles were
      studied in serial 1 micron transverse sections. Two types of spindle-like
      encapsulations were observed. The prevalent type consisted of one to three small
      diameter intrafusal fibers with features of nuclear chain fibers or infrequently
      a nuclear bag fiber. The second type of encapsulation consisted of the small
      diameter fibers located in a compartment which abutted a compartment containing a
      large diameter extrafusal fiber. All intrafusal fibers in spindles of the
      experimental muscles were innervated by afferents, but most of them (85%) were
      devoid of efferent innervation. Thus, immature fusimotor neurons may be more
      susceptible than spindle afferents to cell death after axotomy at birth.

PMID- 1641195
TI  - Quantitative autoradiography of 5-CT-sensitive (5-HT1D) and 5-CT-insensitive (5
      HT1E) serotonin receptors in human brain.
AB  - Quantitative receptor autoradiography was used to determine the distribution
      patterns of 5-CT-sensitive and 5-CT-insensitive binding of [3H]5-HT to high
      affinity sites in human cortex, putamen, and globus pallidus. The binding of 3H-5
      HT was limited to 5-HT1D sites (5-CT-sensitive) by co-incubating pindolol and
      mesulergine with [3H]5-HT, and by using 10 microM 5-HT to determine non-specific
      binding. The difference in the levels of binding between tissues exposed to the 5
      CT-containing incubation media and tissue exposed to [3H]5-HT in the presence of
      100 nM 5-CT was defined as 5-CT-insensitive binding (5-HT1E). The 5-HT1D receptor
      density in the frontal cortex was 189 fmol/mg, 226 fmol/mg was present in the
      globus pallidus, while the density in the putamen was only 28 fmol/mg. The 5-HT1E
      receptor density was 146 fmol/mg in frontal cortex, 224 fmol/mg in putamen and
      140 fmol/mg in globus pallidus. The differential distribution patterns of the
      high-affinity, 5-CT-sensitive and 5-CT-insensitive [3H]5-HT binding sites
      indicate that these sites are expressed independently in human brain tissues.
      These data are supportive of and consistent with previous pharmacological data
      that led to the division of 5-HT1D receptors into 5-HT1D and 5-HT1E receptors and
      do not support the division of 5-HT1D receptors into 5-CT-sensitive and 5-CT
      insensitive states.

PMID- 1641196
TI  - Differential effects of platelet-derived growth factors on fetal hippocampal and
      cortical grafts: evidence from intraocular transplantation in rats.
AB  - Effects of platelet-derived growth factor-AA (PDGF-AA) and platelet-derived
      growth factor-BB (PDGF-BB) on developing parietal cortex (E16) and hippocampal
      (E18-E19) grafts were studied using the in vivo method of intraocular
      transplantation. Survival and growth of grafts in the anterior eye chamber of
      adult host rats under the influence of regular treatments with 0.5 ng (in a 100
      ng/ml concentration) PDGF-AA or PDGF-BB was followed and compared to those
      receiving vehicle solution alone (0.5 mg HSA/ml Hanks). Both PDGF-AA and PDGF-BB
      increased the volume of transplanted cortical grafts. PDGF-BB also exerted
      trophic effects on grafted hippocampal tissue whereas PDGF-AA seemed to inhibit
      hippocampal growth. Histological and immunohistochemical studies revealed an
      increase in the density of astroglial elements in PDGF-AA- and PDGF-BB-treated
      cortical grafts whereas the PDGF-AA- and PDGF-BB-treated hippocampal grafts
      maintained a cytoarchitecture closely resembling that of control grafts. These
      findings support in vitro experiments showing that developing glial cells are
      stimulated by PDGFs and we further propose regional differences of action of
      PDGFs in the developing central nervous system.

PMID- 1641197
TI  - Nutrition and health of elderly people in Europe: the EURONUT-SENECA Study.
AB  - In 1988 EURONUT, the umbrella European Community (EC) Concerted Action on
      Nutrition and Health, initiated a major European multicenter study, named
      SENECA,* to study cross-cultural differences in nutritional issues and life-style
      factors affecting health and performance of elderly people in Europe. According
      to a strictly standardized methodology, 2,586 elderly subjects--born between 1913
      and 1918--have been studied in 19 towns across Europe, using a mixed longitudinal
      design. Data regarding nutrient and food intakes, diet habits, diet awareness,
      nutritional status, health, and life-style factors were collected and are
      partially presented in this paper. There was considerable variability from site
      to site--even within countries--in dietary intake, in both quantity and
      composition; blood biochemistries; life-style factors; health; and performance.
      Implications of the observed wide variability will be studied longitudinally.

PMID- 1641198
TI  - How does fish oil lower plasma triglycerides?
AB  - Studies using dietary fish oil, safflower oil, and palm oil suggest that the
      decrease in plasma triacylglycerol due to dietary fish oils is somehow related to
      a decrease in the capacity of the liver to hydrolyze the phosphatidate, which
      then affects microsomal synthesis of triacylglycerol from diacylglycerol.

PMID- 1641199
TI  - Cellular retinol-binding protein functions in the regulation of retinoid
      metabolism.
AB  - A microsomal retinyl ester hydrolase from rat tissues is activated by apo
      cellular retinol-binding protein, which thus regulates the availability of
      retinol either for binding to serum retinol-binding protein or for metabolic
      oxidation. Microsomal retinal synthesis was found to occur in rat tissues with
      holo-cellular retinol-binding protein as substrate. Retinal could be further
      oxidized to retinoic acid by a cytosolic fraction.

PMID- 1641200
TI  - Growth-hormone therapy for short children without growth-hormone deficiency.
AB  - The daily subcutaneous injection of 0.3 U/kg of recombinant growth hormone (GH)
      for the two years prior to puberty in ten constitutionally growth-retarded
      children with normal pituitary function resulted in an average height gain of 10
      cm per year. No manifestations of GH excess were seen, and a transient alteration
      in glucose metabolism was resolved after treatment.

PMID- 1641201
TI  - Determinants of energy utilization in patients with cystic fibrosis.
AB  - Resting energy expenditure (REE) is increased in patients with cystic fibrosis, a
      consequence of the work of breathing and not related to the cystic fibrosis (CF)
      gene. CF patients compensate, however, with reduced energy expenditure for
      activity and thermogenesis, thereby maintaining total energy expenditure (TEE)
      equivalent to that of healthy peers.

PMID- 1641202
TI  - Treatment of patients with alcoholic liver disease with casein-based enteral
      nutrition.

PMID- 1641203
TI  - The data support a role for antioxidants in reducing cancer risk.

PMID- 1641204
TI  - The viable serotonin hypothesis.

PMID- 1641205
TI  - Common interests and shared objectives.

PMID- 1641206
TI  - Providing access to obstetric care in New York State.

PMID- 1641207
TI  - Professional liability reform and access to Medicaid obstetric care in New York
      State.
AB  - Professional liability costs and fear of lawsuits have made participation in
      Medicaid difficult for office-based physicians who provide prenatal care, both
      obstetricians and family physicians. We assessed the possible impact of changes
      in three liability policy reforms on expanding access of Medicaid-eligible
      pregnant women to these private physicians. We surveyed members of the New York
      State District of the American College of Obstetricians and Gynecologists and the
      New York Academy of Family Physicians to explore whether they would start,
      expand, or resume obstetric service to Medicaid patients in response to a ceiling
      on litigation awards, no-fault insurance and a subsidy for liability expenses. We
      then compared the reported increases in participation on the basis of liability
      reforms to those in response to changes in Medicaid policies. We found in general
      that the three liability reforms would have similar impacts on Medicaid
      participation, although a subsidy was indicated by fewer physicians than the
      ceiling or no-fault approaches. The support for the liability reforms was as
      effective as proposals of greater reimbursement rates. The proportion of
      obstetricians or family physicians increasing their participation depended more
      on whether they would be starting Medicaid participation, expanding existing
      Medicaid participation or resuming former Medicaid participation than on the
      particular liability policy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641208
TI  - Total serum cholesterol levels in Asians living in New York City: results of a
      self-referred cholesterol screening.
AB  - Asians historically have low total cholesterol levels and low incidence of
      coronary heart disease. In performing a coronary heart disease and total
      cholesterol screening in New York City's Chinatown, we obtained data supportive
      of previous studies, which focused on Japanese populations and described the
      influence of environment on total cholesterol. In the present study, Chinese
      living in Chinatown have higher levels of total cholesterol than would be
      expected from studies of Chinese living in Shanghai. For every age group
      examined, Asian-born Chinese living in Chinatown had higher total cholesterol
      levels than both urban and rural Chinese in Shanghai. In subjects less than or
      equal to 30 years of age, urban males in Shanghai had cholesterol levels of 160
      +/- 34 mg/dL, compared with 206 +/- 38 mg/dL for Asian-born males in Chinatown.
      For females in the same age category, cholesterol levels were 162 +/- 35 mg/dL vs
      224 +/- 45 mg/dL, respectively. Applying National Cholesterol Education Panel
      (NCEP) guidelines, the distribution of desirable, borderline-high, and high blood
      cholesterol levels for the Chinese in Chinatown (41%, 35%, and 23%, respectively)
      were similar to a group of Caucasians screened (42%, 32%, and 26%) and the group
      recently used to determine the prevalence of high blood cholesterol in American
      adults (43%, 30%, and 27%). Studies are needed to stratify the risk of coronary
      heart disease in other groups that traditionally have a low incidence of coronary
      heart disease, but which now have adopted Western lifestyles.

PMID- 1641209
TI  - The antihypertensive effects of exercise training.

PMID- 1641210
TI  - Skin changes associated with hematologic and oncologic diseases in children.

PMID- 1641211
TI  - The story of Lassa fever. Part II: Learning more about the disease.

PMID- 1641212
TI  - Low-dose vincristine-associated bilateral vocal cord paralysis.

PMID- 1641213
TI  - Tuberculous peritonitis as an initial manifestation of HIV infection.

PMID- 1641214
TI  - An unusual manifestation of testicular lymphoma.

PMID- 1641215
TI  - Intralymphatic immunotherapy of glioblastoma.

PMID- 1641216
TI  - Nocardia brasiliensis soft tissue infection in an immunocompromised host.

PMID- 1641217
TI  - Low technology and the prevention of nosocomial AIDS.

PMID- 1641219
TI  - Illegal drug use.

PMID- 1641218
TI  - Illegal drug use.

PMID- 1641220
TI  - Illegal drug use.

PMID- 1641221
TI  - Foveal photopigments.
AB  - The relative rates of absorption of quanta per unit of energy for the various
      wavelengths can be assessed for the human red, green, and blue photoreceptors by
      assuming that the responses generated by a photoreceptor are proportional to the
      rate of absorption of quanta. We start by selecting three points on the color
      mixture diagram to represent the fundamental colors. The mixture diagram is then
      transformed to a constant luminance diagram in which the fundamental colors serve
      as primaries. The V(lambda) values are then multiplied by the chromaticity
      coordinates (r, g, and b) to determine the response curves of red, green, and
      blue cones. The values of V(lambda)r, V(lambda)g, and V(lambda)b are divided by
      the transmittance of the ocular media and the wavelength to give the relative
      absorptions. No allowance has been made for self-screening or population
      densities. I have used the Judd (V(lambda) curve and the Wright-Guild mixture
      data. I have found three fundamental colors which yield predictions for the
      absorption curves of the photopigments of the foveal cones which conform well to
      the absorbance curves measured directly.

PMID- 1641222
TI  - Variation of the hyperacuity gap function with age.
AB  - Responses to hyperacuity stimuli are processed in quite a different manner by the
      central nervous system than many other stimuli such as resolution targets or
      increment threshold stimuli. With increased attention being paid to visual
      response in aging individuals, it is important to study how these response
      paradigms are affected by age. In this analysis, otherwise normal observers 20 to
      85 years of age were studied. The hyperacuity gap test was used. As defined, this
      is a vernier test using a two-point test array. This particular format was chosen
      because the resultant data are less distorted by image blur, scatter, and
      astigmatism than other designs we have studied. The gap or feature separation
      between the two small targets (which were aligned vertically) was increased
      logarithmically using octave steps and the hyperacuity threshold (setting
      variance) was measured for each step. No systematic variation of vernier
      hyperacuity threshold was found with increasing age within the range of ages or
      gaps tested. This is important because it can serve as a valuable control and
      reference for other clinical studies of aging.

PMID- 1641223
TI  - The Cardiff Test: a new visual acuity test for toddlers and children with
      intellectual impairment. A preliminary report.
AB  - We have developed a new test for acuity measurements specifically designed for
      the hard to test group of toddlers and children with intellectual impairment. The
      test uses vanishing optotypes and the preferential looking technique. Comparison
      studies with established acuity tests, Snellen, Cambridge and Teller cards show
      that the test provides a realistic acuity measure. It is highly successful for
      toddlers and children with intellectual impairment and quicker to administer for
      the toddler age group.

PMID- 1641224
TI  - Assessment of visual function in autistic children.
AB  - Children with autism demonstrate "atypical" gaze or social "looking" and
      frequently manifest such sterotypies as eye pressing, hand flicking, and light
      gazing. This study's purpose was to evaluate autistic children for visual
      dysfunction that may be related to the manifested visual signs and symptoms.
      Thirty-four autistic children, ages 2 to 11 years (median age = 7 years, 6
      months) were evaluated for ocular alignment, refractive error, visual acuity,
      oculomotility skills, and stereopsis. None of the children manifested ocular
      disease, known seizure disorders, or dysmorphic features. Their developmental
      levels ranged from average intelligence to severely retarded. Binocular visual
      acuity was measured with the acuity card procedure. Monocular visual acuity was
      not obtained. Refractive errors ranged from -4.25 to +3.25 D; the median was
      plano with the near retinoscopy technique. Of the 34 children, 21% were
      strabismic at far and 18% were strabismic at near. Lang stereo testing was
      attempted on all children and completed on 17. Of the 17, all but 3 exhibited 550
      sec arc. Only 14.7% of the children exhibited voluntary pursuit movements, and
      all the children demonstrated saccadic fixations. Thirty-one children had
      atypical optokinetic nystagmus (OKN) responses such as delayed onset, short
      duration, gaze avoidance, or stereotypic behavior. Repeated testing revealed
      consistent visual responses on OKN and visual acuity. Given these findings,
      research with this population should be pursued further.

PMID- 1641225
TI  - A new technique to measure contrast sensitivity in human infants.
AB  - We used a new time-efficient procedure to obtain binocular contrast sensitivity
      functions (CSFs) from 80 infants aged 1-, 3-, 6-, and 12-months-old. The test
      consisted of 5 sets of large (50 by 28 cm) cards constructed by mounting a 7.2
      degrees circular sine wave grating with 1 of 5 spatial frequencies (0.3, 0.6,
      1.2, 2.4, and 3.6 cpd at 60 cm) onto light gray matteboard. Each card also
      contained a second 7.2 degrees unpatterned patch of equal space-average
      luminance. Depending upon the set, the contrast within the gratings ranged from
      approximately 25 to 0.5%. To judge the subject's detection of each grating we
      used a rapid version of preferential looking (PL) similar to that developed for
      the Teller Acuity Cards. Results showed that compared to previous techniques, the
      card procedure allows one to estimate an infant's CSF much more simply, rapidly,
      and inexpensively.

PMID- 1641226
TI  - Refinement of an optical device that stabilizes vision in patients with
      nystagmus.
AB  - An optical device that produces partial stabilization of retinal images has been
      described. It consists of a high-plus spectacle lens used in combination with a
      large, high-minus, polymethyl methacrylate (PMMA) contact lens. This device is
      designed to provide more clear and stable vision in patients with acquired
      nystagmus due to neurological disease. We report success in using a smaller,
      rigid, gas permeable (RGP) contact lens that achieves the required degree of
      stabilization, but is more comfortable for patients than the PMMA contact lens
      originally described. We have confirmed that the degree of retinal image
      stabilization is similar to that achieved with the PMMA lens. We present a case
      report to illustrate its use.

PMID- 1641227
TI  - Effect of the use of artificial tears on the size of squamous cells of the rabbit
      corneal epithelium evaluated by scanning electron microscopy.
AB  - Female pigmented rabbits (2 to 2.3 kg) received 2 drops of a chlorobutanol 0.5%
      preserved, polyvinyl alcohol-based artificial tear at 21.00 h and 09.00 h for 1,
      2, 3, 6, or 12 days. The animals were euthanized at 15.00 h and the corneas fixed
      with 2.0% glutaraldehyde in 80 mM cacodylate buffer. Scanning electron
      micrographs were taken close to the corneal center at 500 x magnification and
      normal to the epithelial surface. The surface areas of the squamous cells were
      measured with a digitizer pad. As a result of the treatment, up to 9% of the
      cells were observed to be in the process of exfoliation with the effect being
      greatest after 3 days. Control (nontreated) corneas showed only 0.44% exfoliating
      cells. Over this time period there was a progressive shift of cell sizes to
      larger values followed by recovery back to control values by 12 days. The results
      confirm the lack of gross cytotoxic effect of chlorobutanol-preserved artificial
      tears and indicate that the corneal epithelium can adapt to the use of a polymer
      containing artificial tear.

PMID- 1641228
TI  - Flicker visual evoked potential differentiation of glaucoma.
AB  - We have been recording visual evoked potentials (VEP's) produced by a series of
      increasing rate flicker stimuli to find early neuronal loss in chronic open-angle
      glaucoma patients and suspects. This technique has demonstrated selective early
      signal losses in high flicker frequency responses (25 and 31 Hz). This signal
      loss can precede the characteristic arcuate losses found with automated
      perimetry. In this retrospective study, 428 visual fields were graded and grouped
      with their associated cup/disk ratios, peak recorded intraocular pressures
      (IOP's), and flicker VEP measures in a population of patients either diagnosed
      with glaucoma or at risk for glaucoma (glaucoma suspects). The correlation of
      selective high frequency (31 Hz) flicker VEP amplitude loss with visual field
      damage was confirmed. More severe VEP losses correlate well with optic cup size
      and visual field grade, but not with peak recorded IOP. Phase angle data did not
      differentiate between populations separated by visual field losses and VEP
      amplitude measurements.

PMID- 1641229
TI  - Color defective drivers and safety.
AB  - At least seven million drivers in North American cannot reliably identify red and
      green lights. The common assumption by traffic authorities that no serious
      problems exist is contradicted by the data on color vision, the testimonies of
      color defective drivers, studies under controlled conditions, and by reliable
      accident statistics. Color defective drivers can be provided with the same
      measure of traffic light safety as for normals. Brake lights on vehicles can be
      made equally effective for color defectives. Suggestions are provided to help
      those with color defective vision to compensate for their problems.

PMID- 1641230
TI  - Prevalence of myopia and myopic progression in a population of clinical
      microscopists.
AB  - The frequency of refractive errors in a population of clinical microscopists is
      presented. The prevalence of myopia in this population (N = 251) was found to be
      71%, with 49% of the population reporting onset or progression of myopia after
      entry into clinical microscopy (after 21 years of age). Of subjects undergoing
      renewed progression of an existing myopia since starting clinical microscopy, 56%
      reported no refractive change for the 5 years before entering their profession.
      Accuracy of reporting refractive changes was found to be high. No differences
      were found in task-related functions between those subjects reporting myopic
      change in adulthood from those who did not report myopic change.

PMID- 1641231
TI  - Comparative visual performance of three presbyopic contact lens corrections.
AB  - We compared the visual performance of a soft diffractive (DIFF) bifocal contact
      lens, a near center (CN) concentric bifocal design, and monovision (MV), using a
      comprehensive vision testing protocol. Fifteen presbyopic subjects who were
      successfully wearing DIFF bifocal contact lenses participated in the study. Of
      the three systems tested, MV provided best visual acuity at distance and near;
      less than one line of acuity was lost relative to best spectacle acuity under all
      lighting and contrast conditions, and there was less disturbance of a point
      source of light. Both bifocal corrections gave similar visual acuity performance,
      with more lines of acuity lost relative to spectacles at near compared to
      distance. However, the concentric bifocal induced more ghosting at near than the
      other two systems. Stereopsis was compromised at distance with MV correction, but
      all systems performed worse than spectacles at near. An understanding of the
      strengths and weaknesses of presbyopic contact lens options allows the clinician
      to improve management of the presbyope who wishes to wear contact lenses.

PMID- 1641232
TI  - Review of Horner's syndrome and a case report.
AB  - Sympathetic denervation of the eye [Horner's Syndrome (HS)] usually presents as
      ptosis, miosis, and facial anhydrosis. HS presents a challenge to the clinician
      because the causative lesion may involve a first, second, or third-order neuron.
      This paper reviews the literature regarding HS, the anatomy of the sympathetic
      pathway to the eye, the diagnosis, and the localization of the lesion. Our
      patient developed reversible HS after a migrainous episode which presumably
      caused "bruising" of the sympathetic plexus within the carotid canal.

PMID- 1641233
TI  - A case of monocular triplopia of lenticular origin.
AB  - A 70-year-old male experienced unilateral monocular triplopia of lenticular
      origin. The images formed a nearly equilateral triangle and were equally clear.
      It was noted that the images were formed by sections of the crystalline lens
      whose borders were parallel to the orientation of the anterior Y-sutures.

PMID- 1641235
TI  - Tools of the trade: enhancing teaching with computers.

PMID- 1641234
TI  - Is intraocular pressure a risk factor in contact lens wear?
AB  - Adherence of a rigid gas permeable (RGP) contact lens to the cornea is an
      unsolved clinical problem in extended wear. This communication proposes that
      intraocular pressure (IOP) is a cofactor of this phenomenon. Intradiem
      fluctuations in the IOP can additionally stress the corneal epithelium and affect
      its biomechanical properties. The corneal surface is then susceptible to lens
      imprinting and eventual lens immobilization. The prevalence of lens adherence in
      the morning correlates with the early morning peak in IOP that is known to occur
      in many normotensive patients. The possibility arises that lens immobilization
      during sleep is causally related to the peak in IOP.

PMID- 1641236
TI  - Binocular vision section.
AB  - The participants at the 1991 Meetings of the Section on Binocular Vision and
      Perception presented a substantial amount of valuable theoretical and clinical
      information. There was considerable and valuable interaction between the audience
      and panel, especially after the symposium concerned with new techniques and how
      to use them. The exchange of specialized knowledge through discussions at
      symposiums such as these represents one of the best features of Academy meetings.
      These symposiums reemphasize and remind us of the expertise of our Academy
      members in management of binocular vision anomalies.

PMID- 1641237
TI  - Plasmodium falciparum: isolation of intact and erythrocyte-free trophozoites from
      sorbitol lysates.
AB  - An in vitro culture of Plasmodium falciparum (isolate FCUP-1/RSA) was arrested in
      the trophozoite stage with alpha-difluoromethylornithine (DFMO), followed by
      sorbitol treatment to liberate intracellular parasites from infected
      erythrocytes. Most of the unlysed erythrocytes and ghost membranes were removed
      by filtration, after agglutination with anti-erythrocyte monoclonal antibodies or
      wheat-germ agglutinin. A highly purified parasite preparation was obtained after
      chromatography on an immuno-affinity column consisting of polystyrene particles
      to which anti-erythrocyte monoclonal antibodies had been adsorbed. Isolated
      parasites were free of surrounding erythrocyte membranes and structurally intact
      as assessed by transmission electron microscopy, SDS-PAGE and ELISA.

PMID- 1641238
TI  - Gametocyte sex ratios as indirect measures of outcrossing rates in malaria.
AB  - The frequency of recombination between unlike genotypes is central to
      understanding the generation of genetic diversity in natural populations of
      malaria. Here we suggest a way of investigating the problem which could
      complement conventional biochemical approaches to the population genetics of
      malaria. Sex allocation theory is one of the most successful areas of
      evolutionary biology. A well-supported prediction is that progressively less
      female-biased sex ratios are favoured with more outcrossing; equal numbers of
      males and females being evolutionarily stable in randomly mating outbred
      populations. We present a simple game theory model to support the idea that
      outcrossing rates in malaria will be correlated with the sex ratio of gametocytes
      in the peripheral blood of vertebrate hosts. Blood films from epidemiological
      surveys and culture-adapted isolates from Madang Province, Papua New Guinea, were
      used to estimate average gametocyte sex ratio of Plasmodium falciparum in the
      area. The geometric mean proportion of males in the population was 0.18 (95%
      confidence limits: 0.15-0.22). From our model, we estimate that, on average, 36%
      of zygotes are the result of outcrossing. This estimate assumes that most
      microgametes released following exflagellation are capable of fertilization. If,
      on average, fewer than about 70% of microgametes are capable of fertilization (as
      is the case in at least one other species of Plasmodium), the observed sex ratio
      would be consistent with between zero and 36% of zygotes being the result of
      outcrossing. These estimates suggest that there is usually a numerically dominant
      genotype in the gametocyte population in a blood meal, and that a considerable
      amount of selfing is occurring in P. falciparum populations in the Madang region,
      even though it is an area of intense year-round transmission.

PMID- 1641239
TI  - A gene associated with cell division and drug resistance in Giardia duodenalis.
AB  - A 3000 bp cDNA insert (G6/1) from Giardia duodenalis, cloned into Escherichia
      coli is located on chromosome 3 of Giardia stocks which have 3 chromosomes
      detectable by field-inversion gel electrophoresis in the range 650-800 kb and on
      chromosome 3 and/or 4 of stocks with 4 chromosomes in this size range. The loss
      of this sequence from chromosome 4 but not chromosome 3 was associated with the
      induction of drug resistance in a previously sensitive laboratory stock. G6/1
      appears to represent a single copy gene in Giardia as determined by hybridization
      of the probe to cleaved genomic DNA. Furthermore, the sequences flanking at least
      12 kb of G6/1 are the same when G6/1 appears on both chromosomes 3 and 4. The
      cDNA encodes a protein associated with the nuclei of trophozoites during some
      stages of growth of the parasite. In a non-dividing culture, the antigen is
      associated with the nuclei of about 30% of trophozoites and fewer in a dividing
      culture. Three Giardia stocks with obvious chromosome rearrangements, which grow
      poorly and fail to divide normally, apparently lack the DNA sequence G6/1.

PMID- 1641240
TI  - Repeated infection of cats with Brugia pahangi: parasitological observations.
AB  - Cats were repeatedly inoculated with infective larvae of Brugia pahangi. On
      parasitological grounds they could be divided into 5 groups. Group I--most cats
      (some 70%) became microfilaraemic (mf+) and retained high levels of microfilariae
      (mf) in their blood for over 2 years. In some Group I cats mf counts stabilized
      at high levels whilst in others mf counts continued to increase. Large numbers of
      fecund adult worms were recovered from their lymphatics. Adult counts were not
      made on the cats in the current experiments but over 100 adults have been
      recovered from 'super-susceptible' cats. Large amounts of B. pahangi adult
      antigen were consistently present in the serum of all Group I cats. About 30% of
      cats became amicrofilaraemic (mf-). In these cats the peak mf levels were seldom
      above 10,000 mf/ml. Group II--these cats had less than 10,000 mf/ml and low
      antigen levels. After more than 1 year of being repeatedly infected B. pahangi
      adult antigen slowly declined and eventually could no longer be detected in their
      serum and the number of mf declined very slowly after the fall in antigen levels.
      This shows that in Group II cats the adult worms die and as the cats are
      resistant to the development of the continuing weekly inoculation of L3 no new
      adults can develop. Group III--these cats became mf--during the first year of
      infection but remained B. pahangi antigen-positive for many weeks after this and,
      at autopsy, had living adults in their lymphatics.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1641241
TI  - Adaptation of a radioactive L. donovani complex DNA probe to a chemiluminescent
      detection system gives enhanced sensitivity for diagnostic and epidemiological
      applications.
AB  - The cDNA probe, Lmet2, was labelled with digoxigenin and used in a
      chemiluminescent system to detect fewer than 100 membrane-immobilized Leishmania
      parasites. The probe was found to hybridize primarily with members of the L.
      donovani complex but a slight cross-reaction was also observed with greater than
      5 x 10(4) L. major. This cross-reaction was reduced by hybridizations in 50%
      formamide at 37 degrees C. Formamide also significantly reduced non-specific
      binding of the digoxigenin-labelled probe to the membrane support which, in
      hybridizations without formamide, masked the specific hybridization signal. This
      background was not observed with the corresponding radio-isotope labelled probe.
      With hybridizations in formamide the sensitivity achieved by the chemiluminescent
      system after exposure to film for 3 h was greater than that achieved by the
      isotopic system even after autoradiography for 24 h.

PMID- 1641242
TI  - Naturally occurring immunoglobulin M antibodies: enhancement of phagocytic and
      microbicidal activities of human neutrophils against Toxoplasma gondii.
AB  - Naturally occurring immunoglobulin M antibodies to Toxoplasma gondii in human
      sera were examined for their ability to enhance toxoplasmacidal activities of
      human neutrophils to show a role of natural antibodies in immunity to the early
      stage of Toxoplasma infection in humans. Neutrophils were mixed with tachyzoites
      at a ratio of 1:5 in the presence or absence of antibodies and were cultured for
      1-18 h for microscopical examination. The count of tachyzoites phagocytosed in
      200 neutrophils within 1 h was significantly higher in the presence of sera with
      natural IgM antibody levels of greater than 0.8 than those of less than 0.1, with
      2.4- to 2.9-fold differences (P less than 0.02). The total tachyzoite counts at
      18 h decreased to 26-39% of those at 1 h in the presence of natural IgM antibody
      levels of greater than 0.8 (P less than 0.01), while the counts at 1 h
      consistently increased by 18 h in the absence of natural IgM antibodies. These
      results indicate that relatively high levels of natural IgM antibodies enhanced
      phagocytic and microbicidal activities of neutrophils against Toxoplasma. The
      enhancement was dose dependent, and was also weaker than that obtained with the
      same dilution of sera from individuals with chronic or acute infections. Live and
      dead tachyzoite counts in infected neutrophils suggested a quicker effect of
      natural IgM antibodies than IgG antibodies elicited by infection.

PMID- 1641243
TI  - Tryptophan metabolism and vitamin B6 nutritional status in patients with
      schistosomiasis mansoni and in infected mice.
AB  - Patients infected with Schistosoma mansoni showed an abnormal response to a test
      dose of tryptophan, with little increase in the urinary excretion of kynurenine,
      hydroxykynurenine, xanthurenic and kynurenic acids, N1-methyl nicotinamide,
      methyl pyridone carboxamide, 5-hydroxytryptamine or 5-hydroxyindoleacetic acid.
      In contrast to previous reports, this is different from the pattern of tryptophan
      metabolism seen in vitamin B6 deficiency. Furthermore, the patients' plasma
      concentrations of pyridoxal phosphate were within the reference range, and
      supplementation for 5 days with 20 mg vitamin B6/day did not affect tryptophan
      metabolism. Treatment with a single dose of Praziquantel resulted in a
      substantial restoration of normal tryptophan metabolism. In mice infected with S.
      mansoni there was a similar impairment of tryptophan metabolism, as shown by
      considerably reduced formation of 14CO2 after the administration of a tracer dose
      of [14C]tryptophan. Again, the administration of vitamin B6 supplements did not
      correct tryptophan metabolism in the mice. Treatment with Praziquantel resulted
      in substantial restoration of the production of 14CO2 from [14C]tryptophan. There
      was no evidence of vitamin B6 deficiency (as determined by erythrocyte aspartate
      aminotransferase activation coefficient) associated with infection in the mice,
      although there was a redistribution of pyridoxal phosphate between tissues, with
      a reduction in the concentration of liver, spleen and kidney, and an increase in
      skeletal muscle.

PMID- 1641244
TI  - A further model for temporal patterns in the epidemiology of schistosome
      infections of snails.
AB  - The prevalence of Schistosoma mansoni infections of Biomphalaria pfeifferi shows
      seasonal variation. Field data from Zimbabwe show annual ranges from 0 to 7%. In
      this paper a mathematical model of B. pfeifferi population dynamics and S.
      mansoni epidemiology is used as a framework for analysis of these patterns. Snail
      fecundity is a function of snail age and of temperature, and is apparently
      affected by other seasonal factors. The pre-patent period is dependent on
      temperature. Infection affects snail fecundity and mortality. Parameter values
      are derived from previous field and laboratory studies. The force-of-infection is
      estimated from the analysis of size-prevalence data. Using observed temperatures,
      model output agrees well with field data on snail abundance and prevalence of
      infection over a 14-month period. Seasonal variation in prevalence largely
      reflects variation in the pre-patent period and in snail population age
      structure. The possible role of seasonality in the force-of-infection is
      discussed. Prevalence patterns are not greatly affected by year-to-year
      differences in temperature. Significant seasonal variation in snail-man
      transmission rates is expected.

PMID- 1641245
TI  - A model for variations in single and repeated egg counts in Schistosoma mansoni
      infections.
AB  - Faecal egg counts are often used to measure Schistosoma mansoni infection, but
      the considerable variation between successive counts complicates their
      interpretation. The stochastic model described in this paper gives a description
      of observed egg counts in a population and can be used as a tool to gain an
      insight into the underlying worm load distribution. The model distinguishes
      between two sources of variation in egg counts: (1) variation caused by the
      difference in worm load between individuals, and (2) the variability of egg
      counts for an individual with a given worm load. Empirical data, single and
      repeated measurements, from surveys in five villages in Burundi and Zaire have
      been used to fit and validate the model. We have discussed possible mechanisms
      that explain the differences in estimated values between the villages. The model
      indicates that the expected number of eggs in a stool sample per S. mansoni worm
      pair is lower than suggested by autopsy data and that, possibly as a consequence
      of immunity, the inter-individual variation in worm loads decreases with age.

PMID- 1641246
TI  - Transport of isometamidium (Samorin) by drug-resistant and drug-sensitive
      Trypanosoma congolense.
AB  - The uptake kinetics of a 14C-labelled trypanocidal compound isometamidium
      chloride (Samorin, RMB Animal Health Ltd, UK) was measured in drug-resistant and
      drug-sensitive Trypanosoma congolense. It was established that drug uptake was
      significantly more rapid and quantitatively greater in drug-sensitive parasites.
      There was clear evidence that drug uptake in both the resistant and sensitive
      trypanosomes was by a specific, receptor-mediated process. This specific drug
      transport was energy-dependent, being sensitive to metabolic inhibition with
      SHAM/glycerol. Significant differences in drug transport were observed which
      could be correlated with resistance to isometamidium. The optimal pH for drug
      accumulation was lowered in the resistant trypanosomes; this finding, along with
      an observed change in specificity for the related compound homidium bromide,
      suggested that the specific receptor for isometamidium is altered in the
      resistant trypanosomes, possibly resulting in a reduction in drug uptake. In
      addition to these alterations in drug uptake, efflux of isometamidium also
      appears to occur in the resistant trypanosomes. Both a reduction in incubation
      temperature and metabolic inhibition increased the level of trypanosome
      associated isometamidium in the resistant parasites. This was in contrast to
      observations using drug-sensitive parasites. Furthermore, the addition of calcium
      flux-modulating agents to the incubation medium also resulted in an increase in
      accumulation by the resistant parasites.

PMID- 1641247
TI  - Preliminary characterization of the lipid and protein components of the
      protective surface membranes of a pentastomid Porocephalus crotali.
AB  - All instars of the pentastomid Porocephalus crotali, in the tissues of rat
      intermediate hosts and the lung of rattlesnake definitive hosts, are covered by a
      vesicular or stacked membranous secretory product which is synthesized in sub
      parietal cells (SPC) and channelled to the cuticle via multitudinous chitin-lined
      ducts. In rats this enveloping foam of vesicles survives for the duration of a
      cuticle. We have purified and partially characterized the lipid and protein
      composition of lamellate droplets from SPC of infective nymphs. Lipids in the
      droplets comprised a mixture of neutral and polar lipid classes with cholesterol
      being the major neutral lipid and phosphatidylcholine the dominant polar lipid.
      In addition, Triton X-114 phase separation of the protein component of droplets
      partitioned these into an aqueous phase (with a major band at 60 kDa), a
      detergent phase with two hydrophobic polypeptides (24 and 16 kDa) and an
      insoluble pellet containing several minor proteins and major bands at 31 and 107
      kDa. Western blotting, with rabbit anti-lamellate droplet antiserum, strongly
      label only the 60 kDa and the two hydrophobic proteins. Significantly no proteins
      at all label with serum from infected rats from 50-150 days post-infection, a
      finding endorsed by indirect fluorescent antibody tests on sectioned V-VII stage
      nymphs. Possible immunomodulatory functions of SPC-derived surface membranes are
      discussed and, in this regard, they are compared with pulmonary surfactant, a
      product of alveolar Type II cells which lines all vertebrate lungs.

PMID- 1641248
TI  - Ectoparasite impacts on Gerbillus andersoni allenbyi under natural conditions.
AB  - To assess ectoparasite impact on individuals and populations of Gerbillus
      andersoni allenbyi under natural conditions, I addressed the following questions.
      Do ectoparasites affect their host fitness and, if so, how? Do ectoparasites
      affect host population level? Does this parasite-host interaction support the
      traditional concept of parasite evolution towards avirulence? For this purpose,
      host infestation, infection, survival, haematological indices, and physical
      condition were recorded. A field experiment which included manipulating host
      infestation while recording host survival was conducted to determine the causal
      relations between these variables. G. a. allenbyi was infested by 2 fleas
      (Synosternus cleopatrae and Stenoponia tripectinata), 5 mesostigmatid mites
      (Androlaelaps centrocarpus, A. hirsti, A. insculptus, A. marshalli and
      Hirstionyssus carticulatus), 1 tick (Rhipicephalus sanguineus), and 1 louse
      (polyplax gerbilli). Ectoparasite burden significantly reduced host survival and
      red blood cell indices (red cell concentration, haemoglobin concentration and
      haematocrit). Ectoparasite burden did not significantly affect white blood cell
      concentration. Gerbils were not infected by haemoparasites or gut helminths which
      potentially could cause anaemia. The causal relationship between S. cleopatrae
      burden and host survival was established by manipulation of host infestation.
      Both ectoparasite removal and initial level of infestation significantly affected
      host survival. Ectoparasites that caused anaemia were not associated with host
      physical condition (PC), measured as weight/length3. None of the red blood cell
      indices was correlated with host PC. These results suggest both that host PC was
      not affected by ectoparasite burden and that exsanguination leading to anaemia
      was the main effect of the ectoparasites. Ectoparasite pressure on the host
      population (based on the ectoparasite effects as estimated by statistical models,
      combined with dispersion of the infestation within the host population) changed
      seasonally and was greatest when host density was the highest. A large segment of
      the gerbil population was affected by ectoparasites during the entire year. An
      explanation for the evolution of parasite virulence, contrasting parasites that
      evolve towards increased virulence with parasites that evolve towards avirulence
      is presented. This classification is primarily based on whether parasite impact
      is equated with a higher efficiency of host exploitation, or whether it is a
      'side effect' of parasite biology.

PMID- 1641249
TI  - Structure of the pinworm (Oxyurida: Nematoda) guild in the hindgut of the
      American cockroach, Periplaneta americana.
AB  - The pinworm (Oxyurida: Nematoda) guild in a laboratory colony of Periplaneta
      americana was investigated to answer the following questions. (1) Is guild
      structure stable with time? (2) Is there evidence of interaction among the
      species? (3) Is there evidence for niche diversification with respect to spatial
      distribution or developmental stage of host? Four species were found: Thelastoma
      periplaneticola, Thelastoma bulhoesi, Hammerschmidtiella diesingi and Leidynema
      appendiculatum; females of the first two could not be distinguished and they were
      lumped and referred to as Thelastoma sp.; 328 mid-instar hosts were dissected
      between September 1987 and February 1990, and the number of adult females of each
      pinworm species was recorded to investigate changes in guild structure through
      time. Seventy-five percent of hosts had Thelastoma sp., 62% had H. diesingi and
      40% had L. appendiculatum; mean intensities were 6.5 (Thelastoma), 2.9 (H.
      diesingi) and 1.9 (L. appendiculatum). Relative numbers were stable with time and
      intensities of the species were similar whether they occurred alone in the host
      or in conjunction with other species. Thelastoma sp. and L. appendiculatum
      occurred together less often than expected and their numbers in individual hosts
      were negatively correlated. Both species occurred alone more often than expected.
      Surprisingly, H. diesingi and L. appendiculatum occurred together more often than
      expected. Intestines of 44 roaches were frozen in liquid nitrogen and divided
      into 5 equal sections to study longitudinal distributions of the species in the
      gut. Most L. appendiculatum and H. diesingi were found in the first, whereas most
      Thelastoma sp. occurred in the second segment. However, Thelastoma sp. dominated
      all segments of the gut. Worms were counted in 192 hosts belonging to 4
      categories (early instar, late instar, adult male and adult female). Single
      species infections were more common in early instar hosts but there was no
      evidence that different species preferred different host stages. Modal
      distributions in male L. appendiculatum and T. bulhoesi suggest that these
      species may exhibit intraspecific interference competition similar to that
      observed in other pinworms. Such effects may be more important than interspecific
      effects in maintaining guild stability.

PMID- 1641250
TI  - Factors generating aggregation of Heligmosomoides polygyrus (Nematoda) in
      laboratory mice.
AB  - The importance of host heterogeneity in generating aggregation was investigated
      using Heligmosomoides polygyrus (Nematoda) in laboratory mice. Parameters of
      infection were compared between inbred and outbred mice, between primary and
      challenge infection protocols, and between gavage and natural exposure protocols,
      to investigate the relative effects of innate resistance, acquired resistance and
      behaviour, respectively. Heterogeneity in acquired resistance was identified as
      the most consistent factor leading to variability and aggregation of H. polygyrus
      numbers in mice. This hypothesis was supported in two experiments where groups of
      mice did not develop resistance to challenge infection (use of certain inbred
      strains of mice and immunosuppression with corticosteroids in the drinking water)
      and where variability in worm numbers after the challenge infection was
      comparable with that after the primary infection. Heterogeneity in host
      behaviour, particularly in behaviours enhancing skin contact with larvae, also
      was associated with increased heterogeneity in worm burden, though not as
      consistently as heterogeneity in acquired resistance. Surprisingly, worm burdens
      were not more variable in outbred compared with inbred mice. Our data suggest
      that the relative contributions of innate resistance, acquired resistance and
      behaviour in generating variable worm burdens are likely to vary spatially and
      temporally.

PMID- 1641251
TI  - Effects of cyclosporin A on the morphology and tegumentary ultrastructure of
      Hymenolepis microstoma in vivo.
AB  - Cyclosporin A (CsA) induced significant changes in parasite morphology when
      administered to mice infected with Hymenolepis microstoma. Gross morphological
      damage consisted of proglottis swelling and the formation of protuberances from
      the worm surface, visible with a low-power dissecting microscope, occurring most
      frequently in the posterior third of the strobila. Gross morphology and
      ultrastructure were examined further using scanning and transmission electron
      microscopy. Swollen proglottides exhibited areas covered in small pits and
      fissures (diameter approximately 1-2 microns) but it was not possible to
      establish the significance of this damage. The brush-border and distal cytoplasm
      appeared largely intact although some evidence of swelling of the basal membrane
      invaginations and possible fluid accumulation was seen in drug-treated TEM
      sections. The apparent oedematous condition of many of the proglottides from drug
      treated mice may indicate that CsA treatment mediates permeability changes in the
      worm surface membrane but the mechanisms by which this may occur remain to be
      elucidated. The effects of CsA on the morphology of H. microstoma correlate with
      the previously described anthelmintic activity of the drug against this parasite
      where CsA treatment dramatically reduces worm growth, retards migration into the
      bile duct and limits parasite survival.

PMID- 1641252
TI  - Moderate to heavy infections of Trichuris trichiura affect cognitive function in
      Jamaican school children.
AB  - A double-blind placebo trial was conducted to determine the effect of moderate to
      high loads of Trichuris trichiura (whipworm) infection on the cognitive functions
      of 159 school children (age 9-12 years) in Jamaica. Infected children were
      randomly assigned to Treatment or Placebo groups. A third group of randomly
      selected uninfected children were assigned to a Control for comparative purposes.
      The improvement in cognitive function was evaluated using a stepwise multiple
      linear regression, designed to control for any confounding variables. The
      expulsion of worms led to a significant improvement in tests of auditory short
      term memory (P less than 0.02; P less than 0.01), and a highly significant
      improvement in the scanning and retrieval of long-term memory (P less than
      0.001). After 9 weeks, treated children were no longer significantly different
      from an uninfected Control group in these three tests of cognitive function. The
      removal of T. trichiura was more important than Ascaris lumbricoides in
      determining this improvement. The results suggest that whipworm infection has an
      adverse effect on certain cognitive functions which is reversible by therapy.

PMID- 1641253
TI  - On the distribution of a fluorescent ivermectin probe (4" 5,7 dimethyl-bodipy
      proprionylivermectin) in Ascaris membranes.
AB  - The distribution of the fluorescent ivermectin derivative (4" 5,7 dimethyl bodipy
      proprionylivermectin, referred to here as bodipy ivermectin) was studied in
      muscle vesicle membranes from the parasite Ascaris suum. Incubation in bodipy
      ivermectin, at concentrations greater than 1 ng/ml, produced a dose-dependent
      fluorescence in the vesicles. The level of fluorescence was not depressed (but
      increased) by prior incubation with 1 microM unlabelled ivermectin. This
      observation suggested that most of the bodipy ivermectin was free in the lipid
      phase of the membrane and not associated with a receptor. The trypan blue
      quenching technique showed that the bodipy ivermectin did not cross the membrane
      bilayer but remained in the outer monolayer. Lateral mobility of the probe in the
      membrane was studied using the fluorescence recovery after photobleaching (FRAP)
      technique. The lateral diffusion coefficient (DL) was 14.0 x 10(-10) cm2/s which
      was nearly three times faster than the lipid probe octadecanoyl-aminofluorescein
      in membranes from the same preparations; only 46% of the probe was mobile,
      showing that within a 1.2 microns radius the distribution of the bodipy
      ivermectin in the membrane was not homogeneous. These observations are used to
      suggest that: the site of action of ivermectin is located in the outer monolayer
      of the membrane (possibly on the Cl- channel); and that the speed of onset of
      action in isolated membrane preparations may be limited by diffusion in the
      membrane.

PMID- 1641254
TI  - Detection of teichoic acid antibodies in Staphylococcus aureus infections.
AB  - A commercially available agar gel diffusion (AGD) assay was used to investigate
      the teichoic acid antibody (TAA) response in 183 patients with proven
      Staphylococcus aureus (SA) infections. Two control groups were also investigated.
      One consisted of 100 hospitalized patients with a variety of medical and surgical
      conditions other than SA infection and the other consisted of 116 healthy
      hospital staff members. The sensitivity of the AGD assay varied markedly
      depending on the site of infection in the patients with proven SA infections. All
      patients with SA endocarditis developed positive TAA titres (greater than or
      equal to 1:4), although more than one third of these were initially negative. In
      patients with chronic osteomyelitis or septic arthritis, 41% had positive TAA
      titres, whereas no positive titres were detected in patients with acute
      osteomyelitis or septic arthritis. Lower rates of positive TAA titres were found
      in patients with deep abscesses (27%), pneumonia (14%) and post-operative
      infections (9%), but no positive titres occurred in patients with acute
      uncomplicated bacteremia, cellulitis or meningitis. In 100 hospitalized control
      patients, no positive titres were detected, and only 1 of 116 (0.9%) healthy
      hospital staff controls was positive. Suggested guidelines for the use of the AGD
      assay are discussed.

PMID- 1641255
TI  - Concurrent zidovudine-induced myopathy and hepatoxicity in patients treated for
      human immunodeficiency virus (HIV) infection.
AB  - Myopathy and hepatic toxicity are important complications of zidovudine (3'-azido
      3'-deoxythymidine therapy) in patients infected with the human immunodeficiency
      virus (HIV) both may also occur in HIV infection in the absence of zidovudine
      therapy. We report 2 cases of myopathy caused by zidovudine, occurring within 16
      wks of initiation of therapy, and a case of concurrent hepatic and muscle
      toxicity. In one case, electron microscopy demonstrated characteristic enlarged
      mitochondria with paracrystalline inclusions. This technique can distinguish the
      myopathies caused by either HIV or zidovudine. Both zidovudine-induced myopathy
      and hepatoxicity require discontinuation of the drug if severe.

PMID- 1641256
TI  - White sponge nevus presenting in the esophagus--case report and literature
      review.
AB  - White sponge nevus (WSN) is a rare inherited disorder which usually presents as
      non-painful white plaques primarily involving the buccal mucosa, gingiva and
      palate. Extra-oral lesions most often occur in the esophagus or anogenital area
      but almost invariably follow the development of typical buccal lesions. We
      present a non-familial case in which the first manifestation of the disease was
      in the esophagus in the absence of oral lesions. This sequence of events has not
      previously been reported in the literature. The cytohistological and electron
      microscopical appearances which allow the recognition and differentiation of WSN
      from other conditions presenting as esophageal white lesions are discussed.

PMID- 1641257
TI  - A fatal case of Vibrio vulnificus septicemia.
AB  - A fatal case of Vibrio vulnificus septicemia in a 60 yr old man is described.
      This man displayed many of the classical features seen in fulminant infections
      with this organism. The epidemiology of V. vulnificus infections is discussed in
      this report.

PMID- 1641258
TI  - Guillain-Barre syndrome and Campylobacter jejuni/coli.

PMID- 1641259
TI  - The introduction of selective biochemical requesting in a teaching hospital.

PMID- 1641260
TI  - The perinatal autopsy: a contemporary approach.
AB  - As autopsy rates in general hospitals decline, interest in the perinatal autopsy
      continues to rise, reflecting the emergence of a vigorous specialty growing in
      parallel with fetal medicine, prenatal diagnosis and clinical genetics. Perinatal
      autopsies are best carried out in tertiary centres which provide these services.
      Meticulous documentation, flexibility of technique, intelligent use of laboratory
      tests and wide systematic histopathologic sampling are emphasized. Microbiologic
      examination is of particular value when carried out by a laboratory having a
      special interest in genital tract and perinatal pathogens. Karyotyping must be
      selective if resources are to be conserved and is most productive when there are
      multiple malformations. Perinatal autopsy is not complete without examination of
      the placenta and significant lesions should be clearly distinguished from
      curiosities and from changes secondary to fetal death. The pathologist's wider
      contribution to perinatal medicine includes providing high quality data to
      epidemiology units and auditing committees, contributing to the multidisciplinary
      management of prenatally diagnosed fetal abnormalities, monitoring iatrogenic
      disease patterns and supporting the process of perinatal grief management.
      Special problems and diagnostic challenges are to be found when investigating
      sudden, unexplained intrauterine fetal death, hydrops, bone dysplasias and
      complicated multiple pregnancies.

PMID- 1641261
TI  - Age, site and distribution of subepithelial neurosecretory cells in the appendix.
AB  - The appearance of subepithelial neurosecretory cells (SNC) was investigated by
      studying completely sampled appendices of 50 children, adolescents and adults.
      The cells were demonstrated using lead hematoxylin, a selective stain for
      neurosecretory cells. Additional routinely sampled specimens were also studied
      for comparison. In children up to the age of 9 yrs only occasional SNC were
      found. After this age, however, SNC were present in most appendices and in
      greater numbers. The majority of SNC were located in the distal portion of the
      appendix, with only small numbers of these cells being present in the proximal
      segment. Occasional SNC-like cells were identified in the appendiceal submucosa
      in all regions of the appendix at all ages. This lends support to the hypothesis
      that a correlation exists between the presence of increased numbers of SNC,
      patient age and the site distribution of both acute appendicitis and appendiceal
      carcinoid tumors.

PMID- 1641262
TI  - Histological grading in breast cancer: interobserver agreement, and relation to
      other prognostic factors including ploidy.
AB  - Sections of neoplasms from 76 female patients with primary operable carcinoma of
      the breast were independently assessed by 2 pathologists for histological
      features and assigned a grade score. Relative disagreement rates between
      pathologists were estimated by use of a log-linear model and found to be similar
      to those reported by many other groups, but higher than that reported by
      acknowledged experts. Tumor grade was related to nuclear DNA content as measured
      by static cytometry, inversely related to oestrogen receptor status and provided
      some additional prognostic information but, in this small series of patients, did
      not correlate with short-term survival as closely as other prognostic indicators
      such as ploidy, tumor size or the extent of lymph node involvement. Patients with
      Grade III tumors had a particularly poor prognosis, however, there were few
      patients allotted to Grade III (poorly differentiated tumors), and survival
      differences between Grades I and II were small; in short-term followup, used
      alone, grading separated out only a small proportion of patients into useful
      prognostic groups. This preliminary study emphasizes the need for a careful
      approach to the use of grading of breast carcinomas in the routine histopathology
      laboratory. Demonstration of higher levels of interobserver agreement, or
      concordance with experts in the field, will be necessary before our grading can
      be incorporated into a prognostic index useful for patient management.

PMID- 1641263
TI  - Automation of prothrombin time on the Cobas Fara II centrifugal analyser.
AB  - The automation of the prothrombin time using Low Turbidity Australian Reference
      Thromboplastin on the Cobas Fara II centrifugal analyser is described. Initially
      this test was programmed as a 2-step technique to mimic the reference manual
      method. However, the wide variation of Cobas Fara normal control values obtained
      with several different batches of the reagent was unacceptable. Investigation of
      1-step techniques resulted in dramatic changes in the normal control values.
      These changes would consequently alter reference values and affect International
      Sensitivity Index (ISI) and International Normalized Ratio (INR) determinations.
      This paper stresses the necessity to fully assess all methodology variables when
      evaluating new reagents.

PMID- 1641264
TI  - Test and teach. Number 67. Palisaded myofibroblastoma. (Intranodal hemorrhagic
      spindle cell tumor with "amianthoid" fibres).

PMID- 1641265
TI  - Post operative surveillance of human hydatidosis: evaluation of immunodiagnostic
      tests.
AB  - We investigated the kinetics of antibodies detected by indirect hemagglutination
      (IHA), IgE Elisa and immunoelectrophoresis (IEP) in patients with hydatid disease
      operated on and continuously followed in the pre-operative and post-operative
      periods. In the pre-operative phase the IgE Elisa test was found to be adequately
      sensitive (68.4%) compared with IHA (79%), with a ratio of IgE Elisa/IHA
      positivity of 87%, while IEP was positive in 55.3% of cases (IEP/IHA ratio =
      70%). During post-operative follow-up IHA became negative late in patients who
      were cured (7 out of 11 were still positive after 4 yrs), whereas IEP and IgE
      Elisa became negative within 2 yrs of operation (apart from 1 patient with a
      persisting positive IgE Elisa 3 yrs later). However, IgE Elisa appeared clearly
      more sensitive in revealing postoperative recurrences (13 out of 13 patients had
      positive IgE Elisa, vs. 6 out of 13 IEP).

PMID- 1641266
TI  - Two new anti-rat macrophage monoclonal antibodies.
AB  - There are relatively few monoclonal antibodies (MAbs) to rat monocyte/macrophages
      available. We describe here 2 new such antibodies. The first, 109.2, recognizes
      most rat monocyte/macrophages and all polymorphs. The antigen recognized by this
      antibody is upregulated by 15 mins exposure to PMA (Phorbol myristate acetate)
      but down regulated by overnight exposure to LPS (lipopolysaccharide). It is
      probably an adhesion molecule and is likely to represent the rat equivalent of
      CD11b. The second antibody, 112.1, recognizes lysozyme in rat macrophages,
      particularly alveolar macrophages. In addition it also recognizes lysozyme in
      hen, rabbit and human macrophages. It also recognizes lysozyme in other tissues
      such as Paneth cells and proximal renal tubular cells.

PMID- 1641267
TI  - Development of an enzyme immunoassay to detect antibody to Chlamydia pneumoniae
      strain TWAR and its application in a limited seroepidemiological survey.
AB  - A non-competitive enzyme immunoassay (EIA) was developed to detect IgG antibody
      to the recently-described species Chlamydia pneumoniae strain TWAR. Purified
      elementary bodies of the organism were used as capture antigen. Cross-reacting
      antibody to Chlamydia trachomatis was detected in the assay by running a parallel
      EIA for IgG antibody to C. trachomatis. The C. pneumoniae assay was validated by
      comparing the results on 60 selected sera with those obtained with the
      microimmunofluorescence test. The comparison indicated that the EIA had a
      sensitivity of 88%, specificity of 100% and overall correlation with micro
      immunofluorescence of 93%. The assay was applied to 352 sera from 3 populations
      within Australasia in a limited survey to determine the extent of exposure to
      this organism. Prevalence rates of up to 55% were found, suggesting that a
      significant amount of respiratory disease in the region may be due to C.
      pneumoniae strain TWAR.

PMID- 1641268
TI  - Comparison of Roche blood culture bottle with an in-house conventional blood
      culture system.
AB  - A comparison was made of the in-use performance of an in-house broth blood
      culture in a general hospital during 8 mths in 1988 with that of a commercial
      biphasic culture (BCB system, Roche Products Pty Ltd, Sydney) for the
      corresponding period in 1989. The clinical services and the number of blood
      samples tested were comparable. The yields of organisms after 48 hrs incubation
      were similar in both systems. Staphylococcus aureus showed up 3 times as often
      after 24 hrs incubation in the conventional system as in the BCB system.
      Agitation of the BCB facilitated macroscopic detection of growth in the initial
      24 hrs incubation.

PMID- 1641269
TI  - Variability of respiratory system compliance in mechanically ventilated infants.
AB  - We measured respiratory flow, volume by integrated flow, and airway pressure in
      four mechanically ventilated infants. Compliance of the respiratory system (Crs)
      was measured by the multiple occlusion method. Airway occlusion and release were
      achieved by a balloon in an occlusion valve between the endotracheal tube and a
      pneumotachometer, all connected in series with the respirator circuit. Values of
      Crs varied greatly due to changes in mean airway pressure (MAP). The Crs
      increased with the elevation of MAP on some occasions and decreased on others.
      Values of Crs also varied corresponding to different occlusion pressures for
      individual levels of MAP. Thus Crs changed continuously, even within a single
      respiratory cycle. The observed variability in Crs was explained by the following
      mechanism: a pressure-volume (P-V) loop of tidal ventilation moves its position
      within the pressure-volume diagram and changes shape due to variations of the
      ventilator settings. In some infants the lungs were ventilated in the range of
      the linear portion of the P-V diagram while in others they may have been
      ventilated on the flattened portion. Some patients had convex expiratory P-V
      curves even with low pressure swings during tidal ventilation.

PMID- 1641270
TI  - Nonlinear pressure/volume relationship and measurements of lung mechanics in
      infants.
AB  - We examined the effects of within-breath changes in compliance (C) upon the
      accuracy of measurements of compliance and resistance (R) by linear regression
      analysis and by Mead and Wittenberger's method. These effects were illustrated by
      a computer model and by lung models with linear and nonlinear pressure/volume
      relationships, and were also studied in 14 normal spontaneously breathing
      premature infants (mean +/- SD, BW 1,290 +/- 200 g, GA 29.9 +/- 2.7 weeks, age
      7.4 +/- 2.1 days). Flow was measured by pneumotachography and tidal volume was
      derived as digitally integrated flow, and transpulmonary pressure as airway minus
      esophageal pressure. We found that C and R calculated from the equation of motion
      is accurate only if C and R remain constant throughout the respiratory cycle.
      Calculated compliance depends more on C at the end than at the beginning of
      inspiration. A decreasing C leads to underestimation or R, while an increasing C
      leads to an overestimation of inspiratory R. Calculated total R may be accurate,
      but with low r values for measurement points. Mead and Wittenberger's method and
      the regression method are similarly affected by changing C; however, since the
      regression method is based on many more measurement points and therefore allows
      the detection and analysis of within-breath changes of C and R, it is less prone
      to erroneous results secondary to signal artifacts than Mead and Wittenberger's
      method.

PMID- 1641271
TI  - Estimation of arterial carbon dioxide by end-tidal and transcutaneous PCO2
      measurements in ventilated children.
AB  - Simultaneous measurements of arterial, end-tidal, and transcutaneous carbon
      dioxide (PaCO2, PetCO2, PtcCO2, respectively) were obtained in 134 children
      receiving mechanical ventilation (ages, 2 days to 16 years; mean, 2.5 years). The
      mean +/- SD PetCO2 bias (PaCO2 - PetCO2) was 3.4 +/- 6.6 mmHg. When the PetCO2
      bias was plotted against the PaO2/PAO2 ratio, a change in the scatter was obvious
      at about 0.3. The PetCO2 bias for patients with PaO2/PAO2 under 0.3 was 7.8 +/-
      7.3 mmHg compared to 0 +/- 3.4 in patients with PaO2/PAO2 above 0.3 (P less than
      0.001). PetCO2 differed significantly from PaCO2 (P less than 0.001) only for
      patients with PaO2/PAO2 under 0.3. The slope (PaCO2 versus PetCO2) for these
      patients was 1.59, while the slope for patients with PaO2/PAO2 above 0.3
      coincided with the line of identity (1.00). The mean +/- SD PtcCO2 bias (PaCO2 -
      PtcCO2) was -1.3 +/- 7.2 mmHg. Skin perfusion was recorded at the area close to
      the transcutaneous CO2 monitor electrode and was defined as normal when capillary
      refill was below 3 seconds. The PtcCO2 bias for patients with normal skin
      perfusion was -0.2 +/- 5.4 mmHg (P = 0.73) compared to -4.1 +/- 9.9 for patients
      with decreased skin perfusion (P = 0.01). The slope of PtcCO2 against PaCO2 was
      closer to identity in patients with normal skin perfusion (1.17) than in patients
      where it was decreased (slope, 1.40). We suggest that PaCO2 estimation by both
      PetCO2 and PtcCO2 is sufficiently precise and reliable for clinical use in
      critically ill children. Certain limitations stem from the nature of the
      techniques.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641272
TI  - Mucoid Pseudomonas aeruginosa is a marker of poor survival in cystic fibrosis.
AB  - The aim of this study was to assess the prognostic significance of mucoid and non
      mucoid isolates of Pseudomonas aeruginosa (muPs and non-muPs) from the sputa of
      patients with cystic fibrosis (CF). Eighty-one children with CF who coughed up
      sputum daily were recruited and followed over 12 months with frequent sputum
      cultures. At the end of this observation period they were classified to one of
      three age-matched groups. In 50 mPs was isolated on one or more occasions; 19
      grew non-muPs but not muPs, and 12 grew no isolates of Ps aeruginosa. These 81
      children and adolescents were followed for a further 8 years or until they died.
      Twenty-one (42%) of the muPs patients died compared with two (11%) of the non
      muPs and one (8%) of the no Ps patients (P less than 0.01). Stepwise regression
      indicated that forced expiratory volume in 1 second (FEV1) had the main
      predictive effect but that age, Shwachman score and muPs also had a predictive
      effect. Identification of mucoid forms of Ps aeruginosa is an unfavorable
      prognostic factor but the isolation of non-mucoid strains does not appear to be
      any more important than the isolation of other common respiratory pathogens.

PMID- 1641273
TI  - Dexamethasone therapy for bronchopulmonary dysplasia: improved respiratory
      mechanics without adrenal suppression.
AB  - The purpose of the present study was to examine the pattern of changes in
      respiratory system mechanics induced by dexamethasone (Dex) in infants with
      bronchopulmonary dysplasia (BPD) and to determine whether dosages that produce
      these changes induce adrenal suppression. We examined mechanics in seven
      ventilator-dependent premature infants (age, 33 +/- 4.8 days) with BPD, before
      and daily during Dex therapy. Dex (0.5 mg/kg/day) was given intravenously for 7
      days unless complications necessitated early termination. Respiratory system
      resistance (Rrs) and compliance (Crs) were measured by the passive expiratory
      flow-volume technique during the course of dexamethasone therapy or until
      extubation. Adrenocorticotrophic hormone (ACTH) stimulation tests were done at
      baseline and following Dex therapy to evaluate adrenal function. Dex therapy
      caused a 77 +/- 18% increase in Crs (from 0.97 +/- 0.09 SEM mL/cmH2O to 1.6 +/-
      0.16 mL/cmH2O; P less than 0.025) and a 33 +/- 5% decrease in Rrs (from 0.20 +/-
      0.02 cmH2O/mL/s to 0.14 +/- 0.01 cmH2O/mL/s; P less than 0.01). Concurrently,
      ventilator rate, mean airway pressure, and FIO2 all decreased significantly (P
      less than 0.025). Extubation occurred later in infants with the lowest Crs and
      highest Rrs at baseline. At extubation, all Crs values were greater than 1.33
      mL/cmH2O and Rrs values were less than 0.15 cmH2O/mL/s. Systolic blood pressure
      increased from 61 +/- 6.3 mmHg to 84 +/- 17 mmHg, 72-96 h after the start of Dex
      (P less than 0.025). There were no episodes of culture-positive sepsis. Neither
      basal nor ACTH-stimulated levels of cortisol were suppressed as a result of Dex
      therapy (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641274
TI  - Transfusion-induced changes in the breathing pattern of healthy preterm anemic
      infants.
AB  - In order to evaluate the effects of transfusion on breathing pattern in growing,
      otherwise healthy, anemic preterm infants, we studied 14 infants whose mean +/-
      SD birthweight was 1,212 +/- 294 grams, gestational age 29.28 +/- 2.23 weeks and
      hematocrit 25.86 +/- 2.24%. At a mean postnatal age of 41.35 +/- 19.45 days 12
      hour nocturnal (transthoracic impedance) pneumocardiograms were obtained 24 hours
      prior to and after transfusion with 10 mL/kg of packed red blood cells.
      Posttransfusion pneumocardiograms revealed significant reduction of periodic
      breathing, of apnea episodes with 11-15 second duration, of apnea density, and of
      heart rate. These findings indicate that transfusion with packed red blood cells
      significantly alters certain cardiorespiratory variables in anemic preterm
      infants.

PMID- 1641275
TI  - Measurement of bronchial responsiveness in young children: comparison of
      transcutaneous oxygen tension and functional residual capacity during induced
      bronchoconstriction and -dilatation.
AB  - Demonstration of an increased bronchial responsiveness in preschool children may
      support the diagnosis of asthma. Most young children cannot perform routine lung
      function tests. Transcutaneous PO2 (PtcO2) measurement has been applied
      successfully in young children, and changes in PtcO2 have been shown to correlate
      well with changes in forced expiratory volume in 1 second (FEV1) during
      bronchoprovocation testing with methacholine. PtcO2 is, however, an indirect
      measure of the effect of inhaled spasmogens. As functional residual capacity
      (FRC) can also be measured by helium dilution spirometry in preschool children,
      we compared PtcO2 and FRC during methacholine inhalation challenges and after
      inhaled terbutaline, in order to determine whether FRC is useful as a more direct
      measure of induced bronchoconstriction and -dilatation than PtcO2. We studied 41
      allergic asthmatic children (mean age, 5.2 years) who underwent a methacholine
      bronchoprovocation test; 38 children received terbutaline 1 h after the final
      methacholine dose. The provocative concentration of methacholine that caused a
      20% decrease of PtcO2 was determined, and changes in FRC and PtcO2 after each
      methacholine dose step were compared. Similarly, changes in PtcO2 and FRC before,
      and 15 and 30 min after, terbutaline were compared. All children had a drop in
      PtcO2 after increasing doses of methacholine; a 20% change was reached in 38
      patients. Mean FRC values increased significantly but variably with increasing
      doses of methacholine, and changes in PtcO2 and FRC did not correlate. After
      terbutaline, PtcO2 increased slightly but significantly, and FRC again varied
      unpredictably. In a separate group of 11 children, the effect of terbutaline was
      assessed directly after the final methacholine dose, when significant
      bronchoconstriction was still present.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641276
TI  - Hypersensitivity pneumonitis in an infant.

PMID- 1641277
TI  - William T. Grant Foundation. Faculty Scholars Awards 1992.

PMID- 1641278
TI  - Head injury in very young children: mechanisms, injury types, and ophthalmologic
      findings in 100 hospitalized patients younger than 2 years of age.
AB  - Head injury in the youngest age group is distinct from that occurring in older
      children or adults because of differences in mechanisms, injury thresholds, and
      the frequency with which the question of child abuse is encountered. To analyze
      some of these characteristics in very young children, the authors prospectively
      studied 100 consecutively admitted head-injured patients 24 months of age or
      younger who were drawn from three institutions. Mechanism of injury, injury type,
      and associated injuries were recorded. All patients underwent ophthalmologic
      examination to document the presence of retinal hemorrhages. An algorithm
      incorporating injury type, best history, and associated findings was used to
      classify each injury as inflicted or accidental. The results confirmed that most
      head injuries in children younger than 2 years of age occurred from falls, and
      while different fall heights were associated with different injury types, most
      household falls were neurologically benign. Using strict criteria, 24% of
      injuries were presumed inflicted, and an additional 32% were suspicious for
      abuse, neglect, or social or family problems. Intradural hemorrhage was much more
      likely to occur from motor vehicle accidents and inflicted injury than from any
      other mechanism, with the latter being the most common cause of mortality.
      Retinal hemorrhages were seen in serious accidental head injury but were most
      commonly encountered in inflicted injury. The presence of more serious injuries
      associated with particular mechanisms may be related to a predominance of
      rotational rather than translational forces acting on the head.

PMID- 1641280
TI  - Variability in head circumference growth rate during the first 2 years of life.
AB  - The head circumference (HC) curves were plotted for a group of 415 healthy full
      term babies over the first 2 years of life. Two hundred ten (51%) of the cohort
      demonstrated HC variability, defined as an HC acceleration or deceleration of at
      least 1 centile curve for at least 2 months. Of these, the deceleration pattern
      was predominant (80.9%), and also frequently permanent (87%). The HCs of 3
      (1.42%) of 210 infants with HC variability ended up with a deviation of 2
      standard deviations or more from the mean. The onset of HC transition occurred
      from the mean age of 1.3 months, and the new curve had stabilized by age 13
      months in 95% of the study group. Parallel changes occurred in body weight and
      body length in approximately 48% of the total cohort, but more frequently in the
      variable-HC group. The clinical interpretation of these findings is discussed.

PMID- 1641279
TI  - Neuroendocrine effects of toxic and low blood lead levels in children.
AB  - From 3 million to 4 million children in America have lead poisoning. This
      environmental toxin affects 1 in every 6 children younger than 6 years of age in
      the United States. The marked effects of lead toxicity on the central nervous
      system are well known, ie, lowering IQ and impairing memory, reaction time, and
      the ability to concentrate. Children are at greatest risk for the central nervous
      system effects of lead because the central nervous system is at its peak in
      development during the first few years of life. The negative correlation of
      stature and blood lead level (bPb) found in the National Health and Nutrition
      Examination Survey directed the authors to evaluate the possible neuroendocrine
      effects of this toxin in children. Twelve children were studied during toxic
      (greater than or equal to 40 micrograms/dL) and low bPb (less than 40
      micrograms/dL). Classic provocative stimuli, L-dopa (15 mg/kg by mouth) and
      insulin (0.1 U/kg given intravenously), were used to determine human growth
      hormone (hGH) responses during toxic bPb and after chelation therapy in six of
      the subjects. An additional four subjects were studied during low bPb. In two
      patients LGH levels were determined every 20 minutes for 24 hours during toxic
      bPb. Thyroid-stimulating hormone and prolactin responses to thyrotropin-releasing
      hormone were also determined. All children studied showed growth retardation
      during toxic bPb. Mean peak hGH responses to provocative stimuli were lower
      during toxic bPb, but the responses were all within normal limits.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641281
TI  - Capillary recruitment for preservation of cerebral glucose influx in
      hypoglycemic, preterm newborns: evidence for a glucose sensor?
AB  - Changes in cerebral blood volume (CBV) were investigated by means of near
      infrared spectroscopy in 18 preterm newborns during treatment with intravenous
      bolus glucose. All newborns were breathing spontaneously, and their postnatal age
      was 2 hours. Blood glucose concentration ranged between 0.3 and 2.2 mmol/L.
      Cerebral blood volume began to decrease shortly after the glucose infusion was
      terminated, and steady state was obtained after approximately 3 minutes. The
      decrease in CBV averaged 0.15 mL/100 g (range 0.02 to 0.40 mL/100 g). Thereafter,
      CBV remained constant. Individual reductions in CBV were inversely related to the
      pretreatment concentration of glucose, whereas there was no relation between
      changes in CBV and alterations in blood gas values or in mean arterial blood
      pressure. It is suggested that previously unperfused capillaries are recruited to
      maintain the glucose transport into neurons of hypoglycemic, preterm newborns.
      The rapidity whereby vessels adjust to alterations in glucose levels indicates
      the existence of a cerebral glucose sensor.

PMID- 1641282
TI  - Value of cranial ultrasound and magnetic resonance imaging in predicting
      neurodevelopmental outcome in preterm infants.
AB  - In this prospective study, cranial ultrasound was performed to detect
      periventricular-intraventricular hemorrhage and periventricular leukomalacia in
      33 preterm infants of less than 32 weeks' gestation. At 44 weeks postmenstrual
      age magnetic resonance imaging was performed to detect the stage of myelination.
      Neurodevelopmental outcome was assessed at 3 years of age in 31 children (2
      children died in the first year of life). Significant correlations were found
      between neurodevelopmental outcome and ultrasound findings (chi 2 = 32.8; P less
      than .0001) and stage of myelination (chi 2 = 20.5; P less than .0005). To
      establish the criterion with the best predictive factor, multiple regression
      analysis was performed with outcome as dependent variable and periventricular
      intraventricular hemorrhage, periventricular leukomalacia, and stage of
      myelination as independent variables. It appeared that the detection of
      periventricular leukomalacia with ultrasound showed the best predictive factor
      for neurodevelopmental outcome. Routine magnetic resonance imaging at 44 weeks
      postmenstrual age should not be performed just for the purpose of predicting
      neurodevelopmental outcome more reliably.

PMID- 1641284
TI  - Is there compensated hypothyroidism in infancy?
AB  - The state-mandated newborn thyroid screening program may uncover infants who
      exhibit normal thyroxine (T4) levels with various degrees of
      hyperthyrotropinemia. To elucidate further the thyroid status, the basal
      metabolic rate (BMR) of 10 infants (7 boys, 3 girls; aged 9 to 63 days) was
      studied by indirect calorimetry. They were clinically euthyroid and healthy with
      no evidence of overt biochemical hypothyroidism (low T4, high thyroid-stimulating
      hormone [TSH]). Confirmatory testing indicated that all infants had normal serum
      T4 levels for age (mean +/- SD: 10.3 +/- 3.2 micrograms/dL). However, serum TSH
      levels varied from 2.3 to 99.2 microU/mL. In 4 infants (2 boys, 2 girls) the BMR
      was low (38.1 +/- 4.1 kcal/kg per day), while the other 6 patients (5 boys, 1
      girl) demonstrated BMRs within the normal range (49.6 +/- 1.9 kcal/kg per day, P
      less than .001). The serum TSH levels were above 7.0 microU/mL among those
      infants with a low BMR, whereas the serum TSH levels were always below 6.0
      microU/mL among the normometabolic infants. All infants who had a low BMR
      received thyroid therapy and promptly became normometabolic (BMR: 48.7 +/- 1.0
      kcal/kg per day) with suppression of TSH levels (3.2 +/- 1.3 microU/mL) within 3
      weeks of therapy, while their serum T4 levels remained within the normal range.
      The observed normalization of BMR in parallel to reduction of TSH levels
      following thyroid replacement therapy strongly suggests that these patients
      demonstrated a hypometabolic state, despite normal serum T4 levels. Therefore,
      the assessment of BMR may help define subclinical hypothyroidism in infancy in
      conjunction with a close monitoring of TSH concentration.

PMID- 1641283
TI  - Effect of an exchange transfusion on plasma antioxidants in the newborn.
AB  - The effect of an exchange transfusion on antioxidants in the plasma of newborns
      with rhesus hemolytic disease was studied. The antioxidant concentrations in
      donor blood were similar to normal adult values except for the lower vitamin C
      concentrations. Exchange transfusion decreased the newborns' iron and ferritin
      levels and increased their ceruloplasmin and transferrin (primary antioxidants)
      concentrations and latent iron-binding capacity. The changes in secondary
      antioxidant concentrations were variable; uric acid and thiols were stable,
      vitamin C and bilirubin fell, and vitamin E rose. The total peroxyl-radical
      trapping capacity of the secondary antioxidants did not change significantly. The
      fall in levels of thiobarbituric acid reactive substances, an index of lipid
      peroxidation, was related to the lower levels present in the donor blood.
      Exchange transfusion rapidly produced variable changes in the concentrations of
      prooxidant and antioxidant substances in plasma and may thus influence free
      radical metabolism in the newborn.

PMID- 1641285
TI  - Postneonatal vitamin B6-dependent epilepsy.

PMID- 1641286
TI  - Attitudes of expectant fathers regarding breast-feeding.
AB  - Fathers participate in choosing the feeding method for their newborns. However
      they traditionally have not been included in most breast-feeding education
      programs. To examine expectant fathers' attitudes and knowledge regarding breast
      feeding, we surveyed 268 men during the first session of their childbirth
      education classes at five private hospitals in Houston, Texas. The study
      population was 81% white, 8% black, and 6% hispanic. Ninety-seven percent (n =
      259) of the total were married. Fifty-eight percent (n = 156) reported that their
      spouses planned to breast-feed exclusively; several significant differences
      existed between these men and those who reported plans for exclusive formula
      feeding. The breast-feeding group was more likely to believe breast-feeding is
      better for the baby (96% vs 62%; P less than .0001), helps with infant bonding
      (92% vs 53%; P less than .0001), and protects the infant from disease (79% vs 47%
      P less than .001). The breast-feeding group was also more likely to want their
      partner to breast-feed (90% vs 13%; P less than .0001) and to have respect for
      breast-feeding women (57% vs 16%; P less than .0001). Conversely, those in the
      formula feeding group were more likely to think breast-feeding is bad for breasts
      (52% vs 22%; P less than .01), makes breasts ugly (44% vs 23%; P less than .05),
      and interferes with sex (72% vs 24%; P less than .0001). The majority of both
      groups indicated breast-feeding was not acceptable in public (breast-feeding =
      71%, formula feeding = 78%, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641287
TI  - Passive smoking and middle ear effusion among children in day care.
AB  - One hundred thirty-two children who attended a research day-care center were
      studied to determine whether passive tobacco smoke exposure was associated with
      an increased rate of otitis media with effusion or with an increased number of
      days with otitis media with effusion during the first 3 years of life. Based on
      preliminary studies, a serum cotinine concentration of greater than or equal to
      2.5 ng/mL was considered indicative of exposure to tobacco smoke. Otitis media
      with effusion was diagnosed using pneumatic otoscopy by nurse practitioners and
      pediatricians who reviewed the children's health status each weekday. The 87
      children with serum cotinine concentrations greater than or equal to 2.5 ng/mL
      had a 38% higher rate of new episodes of otitis media with effusion during the
      first 3 years of life than the 45 children with lower or undetectable serum
      cotinine concentrations (incidence density ratio = 1.38, 95% confidence interval
      1.21 to 1.56). The average duration of an episode of otitis media with effusion
      was 28 days in the children with elevated cotinine concentrations and 19 days in
      the children with lower cotinine concentrations (P less than .01). It is
      estimated that 8% of the cases of otitis media with effusion in this population
      and 17.6% of the days with otitis media with effusion may be attributable to
      exposure to tobacco smoke.

PMID- 1641288
TI  - Effect of discharge samples on duration of breast-feeding.
AB  - The breast-feeding patterns of 146 women who initiated breast-feeding during
      their hospital stay were evaluated to determine whether those women who received
      a hospital discharge package containing a manual breast pump breast-fed their
      infants for a longer period of time than did women who received a discharge
      package containing an infant formula. Women were randomly assigned to receive
      either a specially prepared pack containing a manual breast pump but no infant
      formula or a commercially available infant formula package. The women were
      interviewed in the hospital and by computer-assisted telephone interviews at 2,
      4, 6, and 8 weeks postdischarge. Information obtained included infant-feeding
      practices, sociodemographic characteristics, and attitudinal data. Follow-up
      interviews were completed for nearly 85% of eligible women at each time period.
      Women who received a discharge pack containing a breast pump but no infant
      formula continued exclusive breast-feeding for a greater number of weeks (mean =
      4.18 weeks) than did women receiving infant formula in their discharge package
      (mean = 2.78 weeks) (P less than .05). Also, women who indicated that ease of
      nighttime feeding was an important consideration were more likely to breast-feed
      over the entire 8-week period if they received the breast pump rather than infant
      formula (P less than .05). The conclusion is that an easily implemented, low-cost
      intervention, the inclusion of a breast pump in discharge packages, may increase
      the duration of breast-feeding.

PMID- 1641289
TI  - Comparison of the causes and consequences of prematurity and intrauterine growth
      retardation: a longitudinal study in southern Brazil.
AB  - A cohort of 5914 liveborns (99% of the city births) was followed up to the age of
      4 years in Pelotas, southern Brazil. Besides the perinatal evaluation, the cohort
      children were examined again at mean ages of 11, 23, and 47 months. During each
      visit the children were weighed and measured and information on morbidity was
      collected. Also, multiple sources of information were used for monitoring
      mortality throughout the study. Of the babies with known gestational age, 9.0%
      were classified as intrauterine growth-retarded and 6.3% as preterm. Excluding
      those of unknown gestational age, 62% of low birth weight babies were
      intrauterine growth-retarded and 36% were preterm. Intrauterine growth
      retardation was statistically associated with maternal height, prepregnancy
      weight, birth interval, and smoking, whereas preterm births were associated with
      maternal prepregnancy weight and maternal age. Preterm babies had a perinatal
      mortality rate 13 times higher than that of babies of appropriate birth weight
      and gestational age and 2 times higher than that of intrauterine growth-retarded
      babies. Infant mortality rates presented a similar pattern, with the
      differentials being more pronounced during the neonatal than in the postneonatal
      period. In the first 2 years of life intrauterine growth-retarded children were
      at almost twice the risk of being hospitalized for diarrhea compared with
      appropriate birth weight, term children, while preterm children experienced only
      a slightly greater risk. For pneumonia, however, both groups of children were
      hospitalized significantly more than appropriate birth weight, term children. In
      terms of growth, despite their earlier disadvantage, preterm children gradually
      caught up with their appropriate birth weight, term counterparts.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641290
TI  - Maternal employment and the quality of young children's diets: empirical evidence
      based on the 1987-1988 Nationwide Food Consumption Survey.
AB  - Data from 442 children, aged 2 to 5, who were participants in the 1987-1988
      Nationwide Food Consumption Survey, were examined to determine the effect of
      maternal employment on the quality of their diets. Diet quality was assessed by
      examining nutrient adequacy and nutrient overconsumption using the 3-day average
      of one 24-hour recall and 2 days of written diet records. To assess dietary
      adequacy, a mean adequacy ratio of the four nutrients (zinc, vitamin E, iron, and
      calcium) for which 30% or more of the children fell below 77% of the Recommended
      Dietary Allowances was constructed. Percent calories from fat and saturated fat,
      and intake of cholesterol and sodium were examined to assess overconsumption.
      Multiple correlation regression analysis was used to control for household
      income, maternal education and age, child's age, race, number of siblings aged 5
      or younger, presence of male head of household, and number of meals eaten away
      from home. Maternal employment did not contribute significantly to the variation
      in any of the dietary variables. Although a number of dietary problems existed
      among the sample children, the variation in intakes of these nutrients was not
      directly related to maternal employment status.

PMID- 1641291
TI  - DNA diagnosis of central nervous system infection by Mycoplasma pneumoniae.
AB  - A nested polymerase chain reaction method for the detection of Mycoplasma
      pneumoniae was devised and applied to clinical samples. This system could detect
      5 to 50 fg of the DNA from M pneumoniae and did not amplify the DNA from
      Mycoplasma genitalium. With this method, the sequence of this organism was
      detected successfully in cerebrospinal fluid samples from four of six patients
      and in serum samples from three of four patients with clinically and
      serologically confirmed mycoplasmal central nervous system infection. This
      strongly suggested the direct invasion of this organism into the central nervous
      system and the concomitant occurrence of mycoplasmaremia. The nested
      amplification method is considered to be simple, rapid, and sensitive without the
      use of radioisotopes, thereby being highly applicable as a useful tool in routine
      clinical laboratories for the preliminary detection and diagnosis of mycoplasmal
      infections, particularly in extrapulmonary cases.

PMID- 1641292
TI  - Treatment with interferon gamma versus interferons alfa and gamma in children
      with chronic hepatitis B.
AB  - Thirty-five children with chronic hepatitis B were randomly assigned to three
      groups: group 1 (n = 12), untreated; group 2 (n = 11), treated with 1 million
      units of interferon gamma per square meter of body surface (MU/m2), three times a
      week for 24 weeks; and group 3 (n = 12), treated with interferon alfa at a dose
      of 5 MU/m2, three times a week for 12 weeks followed by 1 MU/m2 of interferon
      gamma with the same schedule. At the end of the treatment (6th month), hepatitis
      B virus DNA was negative in 16.5% of the control group, in 9% of the children
      treated with interferon gamma, and in 16.5% of those treated with interferons
      alfa and gamma. No child had lost the hepatitis B e antigen by this time. No
      basal differences in the serum hepatitis B virus DNA concentration among the
      groups were observed. At follow-up (15th month), viral genome was negative in 25%
      of the untreated children, in 36% of the group treated with interferon gamma, and
      in 41.5% of the children who had received interferons alfa and gamma. Hepatitis B
      e antigen was negative in 25% of the children who belonged to groups 1 and 3 and
      in 27% of the children treated with interferon gamma only. These data suggest
      that interferon gamma does not have a powerful antiviral effect on chronic
      hepatitis B in children. However, it is well tolerated.

PMID- 1641293
TI  - Pediatric dermatology update.

PMID- 1641295
TI  - Medical Education in Transition: the report of the Robert Wood Johnson Commission
      on Medical Education: the Sciences of Medical Practice.

PMID- 1641294
TI  - Concave hymenal variations in suspected child sexual abuse victims.
AB  - The purpose of this study was to describe and analyze the characteristics of, and
      the clinical correlates to, concave hymenal variations in a large number of
      suspected child sexual abuse victims. Thirteen hundred eighty-three female child
      and adolescent suspected sexual abuse victims were comprehensively evaluated.
      Photocolposcopy was used for the anogenital examinations. Concave hymenal
      variations were found in 174 patients (12.6%). Sixty-one (35.1%) were anterior.
      Of these, 40 (65.6%) were curved and smooth, and 21 (34.4%) were angular and/or
      irregular. One hundred (57.5%) were posterior/lateral. Of these, 33 (33%) were
      curved and smooth, and 67 (67%) were angular and/or irregular. Thirteen patients
      (7.5%) had multiple hymenal concavities. Posterior/lateral location was
      associated with penile-vaginal contact (P = .004), penetration (P = .006),
      stranger perpetrator (P = .032), hymenal rim narrowing (P less than .001), and
      posterior fourchette abnormality (P = .049). Angular and/or irregular features
      were associated with penile contact (P = .005), vaginal contact (P = .035),
      penile-vaginal contact specifically (P less than .001), penetration (P = .046),
      abnormal general physical examination (P = .018), and hymenal rim narrowing (P
      less than .001). Logistic regression analysis demonstrated that age-specific
      prevalence trends for posterior/lateral (P less than .001) and angular and/or
      irregular (P = .011) concavities were consistent with acquired anatomic findings.
      An interobserver exercise with five "blinded" raters evaluating photographs of 49
      patients showed significant agreement among observers in sorting
      posterior/lateral and angular concavities into the diagnostic categories
      "suggestive of trauma" and "trauma."(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641296
TI  - Managed care.

PMID- 1641297
TI  - Managed care.

PMID- 1641298
TI  - Serum enzyme monitoring in asthma patients.

PMID- 1641299
TI  - Serum enzyme monitoring in asthma patients.

PMID- 1641300
TI  - Baby's first spring water.

PMID- 1641301
TI  - Physicians' interactions with pharmaceutical companies.

PMID- 1641302
TI  - Recognizing the identifiers of child abuse as a syndrome.

PMID- 1641303
TI  - Faces of psychology.

PMID- 1641304
TI  - [MR imaging of intraocular lesions--a comparison with CT].
AB  - Thirty-two intraocular lesions were studied with magnetic resonance (MR) imaging
      and computed tomography (CT). These lesions included retinoblastoma (n = 11),
      uveal melanoma (n = 6), metastatic choroidal tumor (n = 3), choroidal hemangioma
      (n = 2), retinochoroiditis (n = 6) and Coats' disease (n = 4). MR imaging was
      superior to CT in the depiction of intraocular masses and retinal detachment. Gd
      DTPA enhanced MR imaging was more useful than contrast enhanced CT in evaluating
      the contrast enhancement of intraocular tumors. Differential diagnosis of
      intraocular tumors was difficult with both MR imaging and CT. Intratumoral
      calcification was noticed on CT in nine cases of retinoblastoma. It was concluded
      that MR imaging, including contrast enhancement study, is more useful than CT in
      the evaluation of intraocular lesions, except for calcification, and contrast
      enhanced CT may be unnecessary in the diagnosis of intraocular lesions.

PMID- 1641305
TI  - [Evaluation of cleft lip and palate by computed tomography with 2 mm thin slice
      scanning--Part 2].
AB  - Computed tomography was performed on 104 patients of cleft lip and palate with
      continuous 2 mm slice scanning. The type of hard palate was classified into 3
      groups, as normal, hypoplasia and aplasia, depending on its developmental degree.
      The shape of alveolus was also grouped into 3 groups as circular, triangular and
      asymmetric forms for the evaluation of the maxillary development. The hard palate
      development correlated with the shape of the alveolus, the diameter of maxillary
      and mandibular bone, and frequency of sinusitis and otitis media. Evaluation of
      the hard palate by thin slice scanning is useful in presumption of future facial
      development.

PMID- 1641306
TI  - [Evaluation of the internal mammary nodes by lymphoscintigraphy and
      ultrasonography in patients with breast cancer].
AB  - The efficacy of lymphoscintigraphy and ultrasonography was evaluated in the
      detection of internal mammary lymph node (IMN) metastases in patients with breast
      cancer. On histological examination of IMN, 10 patients had metastases (positive
      group) and 47 did not (negative group). On lymphoscintigraphy, lack of uptake in
      the parasternal region of the affected side was classified as abnormal. The
      frequency of this abnormal finding was not significantly different between both
      groups. On sonography, the thickness of the sonolucent internal mammary area was
      measured. The thickness of the affected side was 6 mm or more in two patients of
      the positive group and only one of the negative group. A thickness of over 6 mm
      on the affected side was statistically significant (p less than 0.05). The
      difference in thickness between the affected side and the healthy side was 3 mm
      or more in four patients of the positive group, and was less than 3 mm in all
      patients of the negative group. A difference in thickness of more than 3 mm
      between the two sides was extremely significant (p less than 0.001). In
      conclusion, sonography is valuable in detecting IMN metastases, while
      lymphoscintigraphy is not useful. Sonography is recommended as an efficient
      diagnostic modality for IMN metastases.

PMID- 1641307
TI  - [The biphasic response of hepatic arterial blood flow caused by vasoactive
      substances--an experimental study in dogs].
AB  - In ten male mongrel dogs, blood flow was measured in the common hepatic artery
      (CHA), portal vein (PV) and liver tissue before and after the injection of
      vasoactive substances: angiotensin II (1.0 micrograms/kg), prostaglandin F2 alpha
      (1.0 micrograms/kg) and vasopressin (0.1 Unit/kg), under observation of the
      systemic circulation. Each injection caused a biphasic response in CHA blood
      flow, an initial decrease followed by a marked increase, while PV blood flow
      decreased. Liver tissue blood flow was reduced just after injection, but soon
      returned to a normal level. The duration of action was the shortest with
      prostaglandin F2 alpha and the longest with vasopressin. In using vasoactive
      substances in pharmaco-angiography, it is important to consider the biphasic
      response in CHA blood flow as well as the duration of action of these substances.

PMID- 1641308
TI  - [A clinical study of biliary endoprosthesis using an expandable metallic stent-
      evaluation of early results].
AB  - Self-expandable metallic stents were used to relieve biliary obstruction in 58
      patients. Fifty-three of 57 patients with malignant obstruction were treated with
      EMS after radiotherapy. A percutaneous approach was employed in all patients
      without severe complications. Insertion of EMS was successful in all cases.
      Within one week of EMS placement, all stents expanded to at least 90% of their
      original diameter, with the caliber of the bile duct always smaller than that of
      the EMS due to ischemic edema of the mucosa. In fifty-one of 58 patients, the
      external biliary drainage catheter could be removed. Cholangioscopy revealed that
      epithelium covered the EMS from the early phase after placement, enabling the EMS
      to become a physiological endoprosthesis in the bile duct. Rapid re-obstruction
      after EMS placement had two mechanisms: reactive obstruction and rebound
      obstruction, to avoid which adequate therapy to reduce the volume of the tumor is
      required. Also it is necessary to continue external drainage for at least two
      weeks after EMS placement. For the management of biliary obstruction, EMBE
      combined with radiotherapy is a promising treatment modality, with encouraging
      early results obtained. Further studies will determine the role of EMS in the
      treatment of patients with non-operable biliary obstructions.

PMID- 1641309
TI  - [Radiation therapy of intracranial germinoma].
AB  - The appropriate radiation dose and field for the treatment of intracranial
      germinoma were investigated in 33 patients. Recurrences were observed in 4 cases
      treated with local field irradiation only, and all of them were recognized at the
      margin of the radiation field or under the dose (less than 25 Gy) area. This
      suggests that whole cranial irradiation (dose of 25 to 30 Gy) should be added
      even if the tumor is solitary. The effective dose for cerebrospinal dissemination
      appears to be 25-35 Gy, but prophylactic CNS irradiation seems unnecessary for
      patients who have not undergone surgical procedures. Changes in mental status
      were seen in 5 patients (26.3%). Doses of over 59 Gy may be related to this
      complication.

PMID- 1641310
TI  - [Combined treatment of invasive bladder cancer by intra-arterial infusion
      chemotherapy of cisplatin with or without other anticancer agents and concurrent
      radiotherapy--initial response and side effects].
AB  - Fourteen patients with invasive bladder cancer were treated by bilateral internal
      iliac artery infusion of cisplatin, with or without other anticancer agents, and
      concurrent radiotherapy. Angiotensin II was simultaneously infused in 10 cases.
      Of the 14 patients, complete response and partial response were achieved in 9
      (64%) and 3, respectively. Hematuria was controlled in all 8 patients, and pain
      was relieved in 3 of 4 patients. Side effects were observed in 8 patients:
      appetite loss in 8, nausea and/or vomiting in 7, and leukocytopenia in 6
      patients, in 3 of whom radiotherapy had to be intermittent because of severe
      leukocytopenia (less than 2000/mm3). However, restoration of leukocytopenia
      occurred one week later. Thus, intra-arterial anticancer agents including
      cisplatin together with concurrent radiation may be one of the most effective
      therapies for invasive bladder cancer.

PMID- 1641311
TI  - [Results of radiation therapy of extrahepatic bile duct carcinoma].
AB  - From January 1975 to August 1988, 40 patients with extrahepatic bile duct
      carcinoma were treated by external irradiation at Chiba University Hospital and
      the National Medical Center Hospital. Thirty-four patients (male: 20, female: 14)
      were evaluable. Eighteen patients were postoperative cases because the surgical
      margin was positive for tumor cells in the postoperative pathological
      examination; the other 16 were inoperable cases. Survival in postoperative and
      inoperable cases was not significantly different, with median survival times of
      13.8 and 8.1 months, respectively. Survival in the recanalization-positive and
      negative-groups was significantly different (p less than 0.05) after irradiation,
      with median survival times of 13.5 and 6.0 months, respectively. Complications of
      therapy were recognized in 68% of all cases. They were mainly gastrointestinal
      symptoms such as nausea, vomiting, erosive gastritis and loss of appetite, but
      they were not severe. Distant metastasis was recognized in only 4 patients (10%):
      three had bony metastasis and one had supraclavicular and pulmonary hilar lymph
      node metastasis. Ninety percent of all cases died from hepatic failure or
      peritonitis carcinomatosa due to failure to obtain local control by external
      irradiation. A more effective modality of treatment is necessary to cure these
      patients.

PMID- 1641312
TI  - [Radiation management of retinoblastoma].
AB  - Forty-five patients with retinoblastoma were treated at Keio University Hospital
      from 1970 to 1990. Thirty-two patients had unilateral lesions and 13 had
      bilateral lesions. Twenty-nine patients with unilateral and 12 with bilateral
      lesions underwent enucleation for advanced tumor. As a result, 3 patients with
      unilateral retinoblastoma and all patients with bilateral disease were treated
      with radiotherapy (40-50 Gy) combined with or without cryotherapy and/or
      photocoagulation. One patient with unilateral lesion treated with radiotherapy
      and chemotherapy had metastases at the first visit to our clinic and was excluded
      from this analysis. Among 16 eyes (15 patients) treated with radiotherapy, 6 eyes
      had recurrence and needed retreatment. Cataract occurred in 6 of 12 eyes and good
      vision was preserved in 5 of 10 eyes in which function could be evaluated.

PMID- 1641313
TI  - [Transcatheter embolization of the renal artery to treat massive retroperitoneal
      hemorrhage in long-term dialysis patients].
AB  - Acquired cystic kidney disease (ACKD) and renal tumors often develop in long-term
      dialysis patients. In addition, rupture of the cysts leading to hemorrhagic shock
      can be another serious complication. There are few reports on transcatheter
      arterial embolization for retroperitoneal hemorrhage caused by cyst rupture in
      chronic dialysis patients. We report here three cases of massive retroperitoneal
      hemorrhage, caused by cyst rupture in two patients with ACKD and another patient
      with polycystic kidney disease during long-term dialysis, which were successfully
      treated by transcatheter arterial embolization. Embolization of the renal artery
      was performed with absolute ethanol and/or stainless steel coils.

PMID- 1641314
TI  - [Clinical evaluation of hepatic scintigraphy using 99mTc-GSA].
AB  - Functional hepatic imaging was performed using 99mTc-DTPA-galactosyl human serum
      albumin (99mTc-GSA), a radiolabeled ligand that reacts specifically to the
      asialoglycoprotein receptor that resides at the plasma membrane of hepatocytes,
      in 21 patients: five with chronic active hepatitis (CAH), 14 with compensative
      liver cirrhosis (LC), one with chronic inactive hepatitis and one with acute
      hepatitis. The former two diseases were mainly investigated. Serial liver images
      were acquired at the rates of 10 sec/frame for 0-5 min and 2 min/frame for 6-30
      min after the injection of 99mTc-GSA, and the images were compared with 99mTc
      phytate images in 2 patients with CAH and 11 with LC, and those with portal
      scintigrams using 123I-iodoamphetamine (IMP) in 3 patients with LC. The images
      using 99mTc-GSA were in better agreement with hepatic function than those using
      99mTc-phytate, and with the findings of portal scintigraphy using 123I-IMP. LHL15
      (liver/liver and heart radioactivities at 15 min after the injection of 99mTc
      GSA) correlated with the hepaplastin test (r = 0.978 in CAH, and r = 0.544 in
      LC), indicators of hepatic reserve. These results suggest that liver scintigraphy
      using 99mTc-GSA might be a useful method for evaluating liver function.

PMID- 1641315
TI  - [Experimental studies on metastases from an irradiated tumor].
AB  - This study was carried out to determine the effect of irradiation of a tumor on
      the development of lung metastases. SANH, a spontaneous sarcoma, was
      isotransplanted in the right thighs of C3H mice which were either locally
      preirradiated (30 Gy: TBR) or non-irradiated. When the tumors had grown to 7 mm
      in diameter, they received 20-30 Gy of electron beams (RTx). The tumor-bearing
      legs were amputated at various tumor sizes, and the incidence of metastasis and
      number of lung nodules were compared in each treatment group. The incidences of
      metastases from 7 mm tumors in mice with regrowing tumors after RTx (30 Gy) and
      non-irradiated mice were 28% and 4%, respectively. When tumors grown in
      preirradiated legs were removed at 7 mm in diameter, the incidence of metastases
      (58%) was also enhanced by preirradiation of the tumor bed. Seven millimeter
      tumors that were growing in TBR legs and received RTx (20 Gy) developed a higher
      incidence (82%) and greater numbers of metastases than either the RTx or TBR
      groups. To determine the relationship between the interval of tumor bearing and
      development of metastases, tumors were removed at various intervals after tumor
      transplantation in 4 groups, namely, non-irradiated, TBR, RTx and TBR with 20
      GyRTx. Lung metastases came later but increased steeply in mice given either TBR
      or RTx, compared with non-irradiated mice. Tumors growing in TBR and receiving
      RTx (20 Gy) developed many more metastases than any other group.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641316
TI  - [Endobronchial intraluminal brachytherapy for patients with tracheobronchial
      carcinoma with high dose-rate 192-Iridium remote afterloading method].
AB  - Endobronchial intraluminal brachytherapy was conducted for 5 patients with
      tracheobronchial carcinoma using 192Iridium high dose-rate afterloading machine
      (microSelectron HDR) and guide tubes of 1.9 mm in outer diameter. Four patients
      with bronchial non-small cell carcinoma and one with tracheal adenocarcinoma were
      applied, and a dose of 6 Gy/Fr. at points 1 cm from the source once a week, and a
      cumulative dose of 18 Gy/3 Fr. was delivered. Guide tubes could be placed up to 3
      tubes via the vocal airway, and new computer planning system could afford to
      calculate dose from independent lining of the source into optimization. This
      could be done with safety, and no remarkable acute side effects were observed
      attributable to this method.

PMID- 1641317
TI  - Review of research on critical thinking in nursing education.

PMID- 1641318
TI  - A review of literature on changing answers on multiple-choice examinations.

PMID- 1641319
TI  - Nontraditional students in higher education: a review of the literature and
      implications for nursing education.

PMID- 1641320
TI  - Qualitative research in nursing education.

PMID- 1641321
TI  - Nursing research related to educational re-entry for the registered nurse.

PMID- 1641322
TI  - Phosphorothioate primers improve the amplification of DNA sequences by DNA
      polymerases with proofreading activity.
AB  - Two thermostable DNA polymerases with proofreading activity--Vent DNA polymerase
      and Pfu DNA polymerase--have attracted recent attention, mainly because of their
      enhanced fidelities during amplification of DNA sequences by the polymerase chain
      reaction. A severe disadvantage for their practical application, however, results
      from the observation that due to their 3' to 5' exonuclease activities these
      enzymes degrade the oligodeoxynucleotides serving as primers for the DNA
      synthesis. It is demonstrated that this exonucleolytic attack on the primer
      molecules can be efficiently prevented by the introduction of single
      phosphorothioate bonds at their 3' termini. This strategy, which can be easily
      accomplished using routine DNA synthesis methodology, may open the way to a
      widespread use of these novel enzymes in the polymerase chain reaction.

PMID- 1641323
TI  - A rapid method for the isolation of DNA-binding proteins from purified nuclei of
      tissues and cells in culture.
AB  - We describe a rapid and general method for isolating DNA-binding proteins in high
      yield from purified nuclei of animal cells. The method has been tested for the
      isolation of a series of different DNA-binding activities including those of
      transcription factors PTF1 and SP1. The rationale consists of first preparing
      purified nuclei from tissue or cells in culture by centrifugation over sucrose
      cushions. A synthetic, biotinylated oligonucleotide bearing the binding site for
      the protein of interest is then added directly to nuclei resuspended in binding
      buffer. At the end of the binding reaction, nuclei are removed by centrifugation;
      and protein-DNA complexes present in the postnuclear supernatant are attached to
      streptavidin-agarose. Two rounds of DNA-affinity chromatography are carried out
      to yield highly purified preparations of DNA-binding proteins.

PMID- 1641324
TI  - The molecular structure of a 4'-epiadriamycin complex with d(TGATCA) at 1.7A
      resolution: comparison with the structure of 4'-epiadriamycin d(TGTACA) and
      d(CGATCG) complexes.
AB  - The structure of the complex between d(TGATCA) and the anthracycline 4'
      epiadriamycin has been determined by crystallographic methods. The crystals are
      tetragonal, space group P4(1)2(1)2 with unit cell dimensions of a = 28.01, c =
      52.95A. The asymmetric unit consists of one strand of hexanucleotide, one
      molecule of 4'-epiadriamycin and 34 waters. The R-factor is 20.2% for 1694
      reflections with F greater than or equal to 2 sigma F to 1.7A. Two asymmetric
      units associate to generate a duplex complexed with two drug molecules at the
      d(TpG) steps of the duplex. The chromophore intercalates between these base pairs
      with the anthracycline amino-sugar positioned in the minor groove. The double
      helix is a distorted B-DNA type structure. Our structure determination of
      d(TGATCA) complexed to 4'-epiadriamycin allows for comparison with the previously
      reported structures of 4'-epiadriamycin bound to d(TGTACA) and to d(CGATCG). The
      three complexes are similar in gross features and the intercalation geometry is
      the same irrespective of whether a d(CpG) or d(TpG) sequence is involved.
      However, the orientation of the amino-sugar displays a dependence on the sequence
      adjacent to the intercalation site. The flexibility of this amino-sugar may help
      explain why this class of antibiotics displays a relative insensitivity to base
      sequence when they bind to DNA.

PMID- 1641325
TI  - Transcription by an immobilized RNA polymerase from bacteriophage T7 and the
      topology of transcription.
AB  - It is often assumed that a polymerase moves along the template as it synthesizes
      RNA. However, a polymerase that tracks along a helical strand will generate a
      transcript that is entwined about the template. No such interlocking results if
      the polymerase is immobile and the template moves past it. Therefore we
      investigated whether immobilization inhibits the RNA polymerase of T7
      bacteriophage using a hybrid protein, in which the polymerase is connected
      through a peptide linker to an immobilizing domain, which in turn was attached
      through an antibody to protein A covalently linked to plastic beads. Polymerase
      could be released by cleaving the linker with a protease, factor Xa. Comparison
      of the activity of the bound and free enzymes showed that immobilization reduced
      the rate of initiation about fivefold. However, when re-initiation was eliminated
      by removing excess template, immobilization was found to have little effect on
      the rate of elongation. Perhaps the untwining problem is sidestepped in vivo by
      immobilizing the polymerase.

PMID- 1641326
TI  - The Saccharomyces cerevisiae MGT1 DNA repair methyltransferase gene: its promoter
      and entire coding sequence, regulation and in vivo biological functions.
AB  - We previously cloned a yeast DNA fragment that, when fused with the bacterial
      lacZ promoter, produced O6-methylguanine DNA repair methyltransferase (MGT1)
      activity and alkylation resistance in Escherichia coli (Xiao et al., EMBO J.
      10,2179). Here we describe the isolation of the entire MGT1 gene and its promoter
      by sequence directed chromosome integration and walking. The MGT1 promoter was
      fused to a lacZ reporter gene to study how MGT1 expression is controlled. MGT1 is
      not induced by alkylating agents, nor is it induced by other DNA damaging agents
      such as UV light. However, deletion analysis defined an upstream repression
      sequence, whose removal dramatically increased basal level gene expression. The
      polypeptide deduced from the complete MGT1 sequence contained 18 more N-terminal
      amino acids than that previously determined; the role of these 18 amino acids,
      which harbored a potential nuclear localization signal, was explored. The MGT1
      gene was also cloned under the GAL1 promoter, so that MTase levels could be
      manipulated, and we examined MGT1 function in a MTase deficient yeast strain
      (mgt1). The extent of resistance to both alkylation-induced mutation and cell
      killing directly correlated with MTase levels. Finally we show that mgt1
      S.cerevisiae has a higher rate of spontaneous mutation than wild type cells,
      indicating that there is an endogenous source of DNA alkylation damage in these
      eukaryotic cells and that one of the in vivo roles of MGT1 is to limit
      spontaneous mutations.

PMID- 1641327
TI  - Expression of Escherichia coli dam gene in Bacillus subtilis provokes DNA damage
      response: N6-methyladenine is removed by two repair pathways.
AB  - The dam gene of Escherichia coli encodes a DNA methyltransferase that methylates
      the N6 position of adenine in the sequence GATC. It was stably expressed from a
      shuttle vector in a repair- and recombination-proficient strain of Bacillus
      subtilis. In this strain the majority of plasmid DNA molecules was modified at
      dam sites whereas most chromosomal DNA remained unmethylated during exponential
      growth. During stationary phase the amount of unmethylated DNA increased,
      suggesting that methylated bases were being removed. An ultraviolet damage repair
      deficient mutant (uvrB) contained highly methylated chromosomal and plasmid DNA.
      High levels of Dam methylation were detrimental to growth and viability of this
      mutant strain and some features of the SOS response were also induced. A mutant
      defective in the synthesis of adaptive DNA alkyltransferases and induction of the
      adaptive response (ada) also showed high methylation and properties similar to
      that of the dam gene expressing uvrB strain. When protein extracts from B.
      subtilis expressing the Dam methyltransferase or treated with N-methyl-N'-nitro-N
      nitroso-guanidine were incubated with [3H]-labelled Dam methylated DNA, the
      methyl label was bound to two proteins of 14 and 9 kD. Some free N6-methyladenine
      was also detected in the supernatant of the incubation mixture. We propose that
      N6-methyladenine residues are excised by proteins involved in both excision
      (uvrB) and the adaptive response (ada) DNA repair pathways in B. subtilis.

PMID- 1641328
TI  - A combination of upstream and proximal elements is required for efficient
      expression of the mouse renin promoter in cultured cells.
AB  - Renin, a key enzyme controlling blood pressure, is produced mainly in the kidney.
      To identify the transcriptional regulatory elements of the mouse Ren-1c gene, the
      promoter regions were fused to the CAT reporter gene and transfected into
      embryonic kidney-derived 293 cells and four extrarenal cell lines, HeLa, HepG2,
      HT1080 and NIH3T3 cells. Transient transfection assay showed that sequences from 
      365 to +16 of the renin gene could direct transcription of the CAT hybrid gene
      only in 293 cells. Deletion analysis identified two transcriptionally active
      regions; the renin upstream-promoter element (RU-1 element; position -224 to 
      138) and the renin proximal-promoter element (RP-2 element; position -75 to -47).
      Although the RU-1 element functioned as an activator, depending on its
      orientation, it failed to trans-activate the renin promoter when the RP-2 element
      was deleted. By contrast, the proximal element alone exhibited a weak trans
      activator property. Gel shift assay identified RU-1 element-binding factors in
      both 293 and HeLa cells, whereas 293 cell-dominant factors were shown to bind
      only to RP-2 element. Therefore, both RU-1 and RP-2 elements were found to be
      necessary for efficient CAT expression from the renin promoter in 293 cells,
      suggesting that activation of the Ren-1c promoter requires combined action
      between cell type-dominant and ubiquitous nuclear factors.

PMID- 1641329
TI  - A comparison of several similarity indices used in the classification of protein
      sequences: a multivariate analysis.
AB  - The present work describes an attempt to identify reliable criteria which could
      be used as distance indices between protein sequences. Seven different criteria
      have been tested: i and ii) the scores of the alignments as given by the BESTFIT
      and the FASTA programs; iii) the ratio parameter, i.e. the BESTFIT score divided
      by the length of the aligned peptides; iv and v) the statistical significance (Z
      scores) of the scores calculated by BESTFIT and FASTA, as obtained by comparison
      with shuffled sequences; vi) the Z-scores provided by the program RELATE which
      performs a segment-by-segment comparison of 2 sequences, and vii) an original
      distance index calculated by the program DOCMA from all the pairwise dotplots
      between the sequences. These 7 criteria have been tested against the aminoacid
      sequences of 39 globins and those of the 20 aminoacyl-tRNA synthetases from E.
      coli. The distances between the sequences were analyzed by the multivariate
      analysis techniques. The results show that the distances calculated from the
      scores of the pairwise alignments are not adequately sensitive. The Z-score from
      RELATE is not selective enough and too demanding in computer time. Three criteria
      gave a classification consistent with the known similarities between the
      sequences in the sets, namely the Z-scores from BESTFIT and FASTA and the
      multiple dotplot comparison distance index from DOCMA.

PMID- 1641330
TI  - The application of Markov chain analysis to oligonucleotide frequency prediction
      and physical mapping of Drosophila melanogaster.
AB  - Here we compare several methods for predicting oligonucleotide frequencies in 691
      kb of Drosophila melanogaster DNA. As in previous work on Escherichia coli and
      Saccharomyces cerevisiae, a relatively simple equation based on tetranucleotide
      frequencies can be used in predicting frequencies of higher order
      oligonucleotides. For example, the mean of observed/expected abundances of 4,096
      hexamers was 1.07 with a sample standard deviation of .55. This simple predictor
      arises by considering each base on the sense strand of D. melanogaster to depend
      only on the three bases 5' to it (a 3rd order Markov chain) and is more accurate
      than the random predictor. This equation is useful in predicting restriction
      enzyme fragment sizes, selecting restriction enzymes that cut preferentially in
      coding vs noncoding regions, and in selecting probes to fingerprint clones in
      contig mapping. Once again, this equation well predicts the occurrence of higher
      order oligonucleotides, supporting our hypothesis that this predictor holds in
      evolutionarily diverse organisms. When ranked from highest to lowest abundance,
      the observed frequencies of oligomers of a given length are closely tracked by
      the predicted abundances of a 3rd order Markov chain. Through use of the
      dependence of oligomer frequencies on base composition, we report a list of
      oligomers that will be useful for the completion of a cosmid physical map of D.
      melanogaster. Presently, the library is such that it will be possible to
      construct large contigs using only 30 oligonucleotide probes to fingerprint
      cosmids.

PMID- 1641331
TI  - Thiophosphates in yeast U6 snRNA specifically affect pre-mRNA splicing in vitro.
AB  - A thorough mutational analysis of U6 RNA in combination with a functional
      reconstitution assay, revealed that three domains are important for U6 function
      in pre-mRNA splicing. In order to further analyze why these regions are so
      critical for splicing, we make use of phosphorothioate substituted U6 RNAs. Wild
      type U6 RNA was transcribed in vitro with T7 RNA polymerase in the presence of
      either phosphorothiate (alpha-S) ATP, GTP, UTP or CTP. The functionality of the
      transcripts was monitored by in vitro reconstitution. While substitution with
      alpha-S ATP, GTP or UTP blocked splicing, substitution with alpha-S CTP had
      little or no effect on splicing. We made use of this alpha-S CTP effect in an
      attempt to elucidate which phosphates in the U6 RNA molecule play a role in the
      first or in the second step of splicing. U6 mutants in which a change of an A, G
      or U to C does not have any significant effect on splicing were transcribed in
      the presence of alpha-S CTP. Observed effects on splicing thus have to be
      attributed to the presence of the thio-substituted phosphate group rather than
      the nucleotide change. The results of in vitro reconstitution give a clear answer
      for at least three phosphates; two of them play a role in the first step, while
      one of them is involved in the second step of splicing.

PMID- 1641332
TI  - hnRNP I, the polypyrimidine tract-binding protein: distinct nuclear localization
      and association with hnRNAs.
AB  - Many hnRNP proteins and snRNPs interact with hnRNA in the nucleus of eukaryotic
      cells and affect the fate of hnRNA and its processing into mRNA. There are at
      least 20 abundant proteins in vertebrate cell hnRNP complexes and their structure
      and arrangement on specific hnRNAs is likely to be important for the processing
      of pre-mRNAs. hnRNP I, a basic protein of ca. 58,000 daltons by SDS-PAGE, is one
      of the abundant hnRNA-binding proteins. Monoclonal antibodies to hnRNP I were
      produced and full length cDNA clones for hnRNP I were isolated and sequenced. The
      sequence of hnRNP I (59,632 daltons and pI 9.86) demonstrates that it is
      identical to the previously described polypyrimidine tract-binding protein (PTB)
      and shows that it is highly related to hnRNP L. The sequences of these two
      proteins, I and L, define a new family of hnRNP proteins within the large
      superfamily of the RNP consensus RNA-binding proteins. Here we describe
      experiments which reveal new and unique properties on the association of hnRNP
      I/PTB with hnRNP complexes and on its cellular localization. Micrococcal nuclease
      digestions show that hnRNP I, along with hnRNP S and P, is released from hnRNP
      complexes by nuclease digestion more readily than most other hnRNP proteins. This
      nuclease hypersensitivity suggests that hnRNP I is bound to hnRNA regions that
      are particularly exposed in the complexes. Immunofluorescence microscopy shows
      that hnRNP I is found in the nucleoplasm but in addition high concentrations are
      detected in a discrete perinucleolar structure. Thus, the PTB is one of the major
      proteins that bind pre-mRNAs; it is bound to nuclease-hypersensitive regions of
      the hnRNA-protein complexes and shows a novel pattern of nuclear localization.

PMID- 1641333
TI  - Phenol-treatment and a homologous pairing-assay.
AB  - Homologous pairing is a key step in homologous genetic recombination. In the
      early stage of trials for the identification of homologous pairing-promoting
      proteins from a fission yeast, Schizosaccharomyces pombe, we treated DNA products
      with phenol in the presence of a salt for the removal of tightly bound proteins
      from DNA before the assay, but we found that this treatment caused very efficient
      protein-independent double-strand formation from complementary single-stranded
      DNAs. Using an assay including the phenol treatment, we detected another species
      of apparent homologous pairing-promoting proteins in the nuclei, in addition to a
      homologous pairing-promoting protein consisting of three components which we
      reported previously. However, studies involving the use of an assay without the
      phenol-treatments revealed that the second one was not really a homologous
      pairing-protein. Thus, the protein-independent double-strand formation by phenol
      treatment in the presence of a salt could cause the erroneous identification of
      homologous pairing-promoting proteins.

PMID- 1641335
TI  - Expression and characterisation of the korB gene product from the Streptomyces
      lividans plasmid pIJ101 in Escherichia coli and determination of its binding site
      on the korB and kilB promoters.
AB  - A 0.5kb Spel-BclI fragment containing the pIJ101 korB ORF was cloned into pUC8
      under the control of the lacZ promoter, creating pQR206. In vitro coupled
      transcription-translation of pQR206 identified a protein product of approximately
      10kDa, which corresponds to the predicted molecular weight deduced from the korB
      sequence. pQR206 was used to express the 10kDa KorB protein in vivo in E. coli.
      Crude E. coli protein extracts containing KorB were shown to bind to a 0.8kb kilB
      fragment and a 0.5kb korB fragment in gel retardation assays. DNasel footprinting
      indicated that the DNA recognition sequence of the KorB protein lies within a
      60bp protected region encompassing the kilB promoter and a 36bp region
      encompassing the korB promoter.

PMID- 1641334
TI  - Complex formation of nuclear proteins with the RNA polymerase I promoter and
      repeated elements in the external transcribed spacer of Cucumis sativus ribosomal
      DNA.
AB  - Complex repetitive structures are located downstream of the transcription
      initiation site in the intergenic spacer (IGS) of the rRNA genes in Cucumis
      sativus (cucumber). In order to show that these repetitive elements of the
      5'external transcribed spacer (ETS) are probably involved in transcriptional
      regulation as protein binding sites DNA-protein binding assays were carried out.
      The same proteins that recognize two binding sites in the promoter region
      analysed (upstream binding element between -164 and -105, and core promoter
      between -41 and +16) show binding affinity to the complex structures of the
      5'external transcribed spacer. These proteins also seem to interact with the
      single strands of the respective DNA regions suggesting an effect on
      transcriptional regulation while the DNA is transcribed and, therefore, is single
      stranded. Three proteins were isolated by affinity column chromatography; these
      proteins turned out to be much smaller (16, 22, and 24 kDa, respectively) than
      promoter and enhancer binding proteins in animal systems. Additionally, a 70-kDa
      protein could be characterized cooperating with a small segment of the repeated
      elements but not with the promoter.

PMID- 1641336
TI  - The cooperative interaction between two motifs of an enhancer element of the
      chicken alpha A-crystallin gene, alpha CE1 and alpha CE2, confers lens-specific
      expression.
AB  - An 84 bp element located between nucleotides -162 and -79 of the chicken alpha A
      crystallin gene exhibits lens-specific enhancer activity. Transient transfection
      experiments using 5' deletion and linker scanner mutants has indicated that the
      84 bp enhancer element is composed of three motifs, alpha CE1 (-162 to -134),
      alpha CE3 (-135 to -121) and alpha CE2 (-119 to -99). Neither alpha CE1 or alpha
      CE3 motif alone can exhibit enhancer activity even when trimerized, whereas
      together they can direct some degree of lens-specific expression. alpha CE2 alone
      shows low transcriptional activity when trimerized. A combination of alpha CE1
      with alpha CE2 exerts full lens-specific enhancer activity comparable with that
      of the 84 bp enhancer element, indicating that alpha CE1 and alpha CE2 motifs are
      sufficient to confer lens-specific expression. Transcriptional activation by
      these two motifs from a distance required the additional presence of either or
      both motifs adjacent to the beta-actin basal promoter. Gel shift experiments
      indicated that the alpha CE1, alpha CE2 and alpha CE3 motifs specifically bind
      nuclear proteins. alpha CE1 binds a protein predominantly present in lens cells,
      whereas alpha CE2- and alpha CE3-binding proteins differ between lens and lung
      cells. Mutations within the alpha CE1 and alpha CE2 motifs that failed to bind
      nuclear factors in vitro resulted in loss of transcriptional activation,
      indicating that these nuclear factors play a key role in controlling lens
      specific expression.

PMID- 1641337
TI  - Role of the conserved leucines in the leucine zipper dimerization motif of yeast
      GCN4.
AB  - Yeast GCN4 belongs to the class of eukaryotic transcription factors whose bZIP
      DNA-binding domains dimerize via a leucine zipper motif that structurally
      resembles a coiled coil. The leucine zipper contains 4-5 highly conserved leucine
      residues spaced exactly 7 residues apart that are located within the alpha
      helical hydrophobic interface between protein monomers. Here, we investigate the
      role of the four canonical leucines in the GCN4 leucine zipper by analyzing a
      series of mutated derivatives for their ability to activate transcription in vivo
      and to bind DNA in vitro. The GCN4 leucine zipper is surprisingly tolerant of
      mutations, with a wide variety of single substitutions at any of the four
      leucines including basic and acidic amino acids behaving indistinguishably from
      wild-type GCN4. Moreover, some derivatives containing two leucine substitutions
      display detectable though reduced function. These results indicate that other
      residues within the coiled coil are crucial for efficient dimerization, and they
      suggest that some eukaryotic transcriptional regulatory proteins lacking the
      conserved leucine repeat will dimerize through a structurally homologous motif.
      Interestingly, our results differ in several respects from those obtained by
      analyzing mutations in the GCN4 leucine zipper in the context of a lambda
      repressor-GCN4 zipper hybrid protein. These apparent differences may reflect a
      functional interrelationship between the leucine zipper and basic region
      subdomains for DNA-binding by bZIP proteins.

PMID- 1641339
TI  - Characterization of the spermidine-dependent, sequence-specific endoribonuclease
      that requires transfer RNA for its activity.
AB  - The spermidine-dependent, sequence-specific endoribonuclease (RNase 65) in mouse
      FM3A cells consists of protein and transfer RNA lacking its 3' terminus. In vitro
      properties of this enzyme were characterized using partially purified enzyme. The
      RNase 65 activity requires spermidine, which is not replaceable with spermine or
      Mg++. The enzyme cleaves an RNA substrate on the 3' side of the phosphodiester
      bond. The cleavage reaction has a temperature optimum around 50 degrees C and a
      pH optimum around 7.0. The optimum KCl concentration for the activity is around
      10 mM. Relative cleavage efficiency of two differently folded RNA substrates with
      the common target sequence was analyzed at 37 degrees C and 50 degrees C. The
      results of this analysis suggest that unfolding of the target sequence is
      critical for recognition by RNase 65. Furthermore, in experiments using several
      point-mutated RNA substrates designed to form basically the same secondary
      structure as the wild type, one to three nucleotide substitutions in the target
      sequence all reduced cleavage efficiency. The RNase 65 activity is found only in
      cytosolic extracts, not in nuclear ones. Gel filtration analysis suggests that
      the native size of the endoribonuclease is approximately 150 kDa.

PMID- 1641338
TI  - The PCF1-1 mutation increases the activity of the transcription factor (TF) IIIB
      fraction from Saccharomyces cerevisiae.
AB  - PCF1-1 is a dominant suppressor of a tRNA gene A block promoter mutation (A19) in
      Saccharomyces cerevisiae. Transcriptional activation by PCF1-1 was examined in
      vitro using whole-cell extracts and purified factors derived from mutant and wild
      type strains. These experiments show that PCF1 is a general activator of RNA
      polymerase III (pol III) gene transcription. The transcription of all pol III
      genes analyzed to date, including type I and numerous type II genes, is increased
      3-7 fold in mutant cell extracts. Single round transcription assays indicate that
      the PCF1-1 mutation increases the number of functional preinitiation complexes
      and suggest that this is achieved by increasing the intrinsic activity of the
      encoded product rather than its amount. Point mutations throughout the A block of
      the sup3-e gene and numerous B block mutations fail to abolish transcriptional
      activation suggesting that interactions between TFIIIC and the internal promoter
      are unaffected by PCF1-1. Moreover, TFIIIC purified from the mutant strain is
      incapable of conferring PCF1-1 transcriptional activity to a reaction in which
      the remaining components are wild-type. In contrast, the activity of the TFIIIB
      fraction is increased in PCF1-1 extracts and can reconstitute mutant levels of
      transcription when added to wild-type TFIIIC and polymerase. We conclude that
      PCF1 is a component or regulator of TFIIIB.

PMID- 1641340
TI  - Two promoter elements are necessary and sufficient for expression of the sea
      urchin U1 snRNA gene.
AB  - The essential elements of the sea urchin L. variegatus U1 snRNA promoter were
      mapped by microinjection of a U1 maxigene into sea urchin zygotes. Two elements
      are required for expression: a distal sequence element (DSE) located between -318
      and -300 and a proximal sequence element (PSE) centered at -55. Removal or
      alteration of other sequences conserved in different sea urchin snRNA U1 genes,
      including deletion of all sequence between -90 and -273, did not affect the
      expression. Sequences around the start site were not required for expression.
      Deletion of nucleotides between the PSE and the start site resulted in initiation
      inside the U1 coding region, suggesting that the PSE determines the start site of
      transcription. There is no obvious similarity between the sequences required for
      the sea urchin U1 snRNA expression and the sequences required for the expression
      of other sea urchin snRNAs.

PMID- 1641341
TI  - Sequence and variability of the 5.8S and 26S rRNA genes of Pneumocystis carinii.
AB  - The sequence of the coding region of the rRNA operon of rat-derived Pneumocystis
      carinii has been completed, including the genes for 5.8S and 26S rRNA. These
      genes show homology to the rRNA genes of yeast, and an apparent group I self
      splicing intron is present in the 26S rRNA gene. Like a similar intron in the 16S
      rRNA gene, this intron is in a phylogenetically conserved region. Variation in
      the 26S rRNA sequence was noted between P. carinii organisms isolated from two
      different sources.

PMID- 1641342
TI  - Transfer RNA genes in the mitochondrial genome from a liverwort, Marchantia
      polymorpha: the absence of chloroplast-like tRNAs.
AB  - Twenty-nine genes for 27 species of tRNAs were deduced from the complete
      nucleotide sequence of the mitochondrial genome from a liverwort, Marchantia
      polymorpha. One to three species of tRNA genes corresponded to each of 20 amino
      acids including three species for leucine and arginine, two species for serine
      and glycine, and one for the rest of the amino acids. Interestingly, all tRNA
      genes were located in the semicircle of the liverwort mitochondrial genome except
      for the trnY and trnR genes. The region containing these tRNA genes was
      originally duplicated, and two trnR genes have diverged from each other. On the
      other hand, trnY and trnfM are present as two identical copies. The G:U and U:N
      wobbling between the first nucleotide of the anticodon and the third nucleotide
      of the codon permit the 27 tRNA identified species to translate almost all
      codons. However, at least two additional tRNA genes, trnl-GAU for AUY codon and
      trnT-UGU for ACR codon, are required to read all codons used in the liverwort
      mitochondrial genome. All of the identified tRNA genes are 'native' in liverwort
      mitochondria, not 'chloroplast-like' tRNAs as are found in the mitochondria of
      higher plants. This result implies that the tRNA gene transfer from chloroplast
      to mitochondrial genome in higher plants has occurred after the divergence from
      bryophytes.

PMID- 1641343
TI  - Characterization of the elongation factor 1-alpha gene of Rhynchosciara
      americana.

PMID- 1641344
TI  - Isolation and characterization of a restriction enzyme BspO4I from an
      alkalophilic bacterium.

PMID- 1641345
TI  - AspEI, a novel Eam11051 isoschizomer from Aureobacterium species recognizing 5'
      GACnnn/nnGTC-3'.

PMID- 1641346
TI  - Caenorhabditis cDNA encodes an eIF-4A-like protein.

PMID- 1641347
TI  - The nucleotide sequence of a mouse cDNA encoding the 80 kDa subunit of the Ku
      (p70/p80) autoantigen.

PMID- 1641348
TI  - Nucleotide sequence of the Rickettsia prowazekii greA homolog.

PMID- 1641349
TI  - Complete nucleotide sequence of the cosmid vector pWE15A.

PMID- 1641350
TI  - Conserved structural motifs within the N-terminal domain of TFIID tau from
      Xenopus, mouse and human.

PMID- 1641351
TI  - A simple and highly efficient procedure for rescuing autonomous plasmids from
      yeast.

PMID- 1641352
TI  - A reliable method for amplifying cDNA using the anchored-polymerase chain
      reaction (A-PCR).

PMID- 1641353
TI  - A new mouse embryonic stem cell line with good germ line contribution and gene
      targeting frequency.

PMID- 1641355
TI  - [The radioiodine-concentrating oncocytic thyroid carcinoma: a case report].
AB  - A patient with radioiodine-positive metastases to bone and lung of an oncocytic
      thyroid cancer is reported. A left-sided thyroidectomy had been performed nine
      years earlier. Histologically it had been a large capsular Huerthle-cell adenoma
      with regressive changes without signs of malignancy. During a recent operation
      for a disc prolapse in the lumbar spine a metastasis of an oncocytic thyroid
      cancer was found. A radioiodine scan showed high accumulation of 131I in the
      thyroid region, the lung and the lumbar spine. The rare finding of radioiodine
      uptake in oncocytic cancer is discussed.

PMID- 1641354
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1641356
TI  - [Atypical scintigraphic appearance of an osteosarcoma. An explanation using x-ray
      and histologic findings].
AB  - In a 10-year old girl with a telangiectasic osteosarcoma of the proximal right
      tibia, sequential bone scintigraphy with 99mTc-DPD showed the tumor as an
      atypical photopenic lesion in the osseous phase. Considering conventional
      radiographs, angiographic features and histologic aspects, possible explanations
      for this unusual finding are discussed.

PMID- 1641357
TI  - [The detection of inflammation and the formation of HAMA following the
      administration of monoclonal antibody BW 250/183].
AB  - Experiences with the use of the 99mTc-labelled MAb BW 250/183 in the detection of
      inflammatory lesions are reported. In 160 of 354 investigated patients the
      results could be confirmed by other methods. The sensitivity (91%) and the
      specificity (82%) were very high for a diagnostic tool and were comparable with
      the results of other leukocyte scans as reported in the literature. The positive
      predictive value of the method was 93%. In 84 patients studied once and in 6
      patients studied twice only one case of the latter group showed a positive HAMA
      response. It may be concluded that the detection of foci of inflammation with the
      99mTc-labelled MAb BW 250/183 is of great diagnostic value and that its
      administration can be repeated without risk.

PMID- 1641358
TI  - [Radioimmunoscintigraphy and magnetic resonance tomography in the diagnosis of
      urinary bladder cancer].
AB  - Magnetic resonance tomography is a method which is sufficiently precise to
      demonstrate morphological changes for tumor staging of carcinoma of the urinary
      bladder. The stage of the tumor was correct in 68 resp. 86% of the patients. The
      RIS shows organ and lymph node metastases and has the capability to
      differentiating between scar and tumor after transurethral resection. The local
      spread, especially the infiltration depth of the tumor, is not visible. In 90% of
      the patients a primary tumor was detected, only in 5 cases a false-negative and
      in 2 cases a false-positive finding was made.

PMID- 1641359
TI  - Diagnostic accuracy of 99mTc-anti-CEA immunoscintigraphy in patients with liver
      metastases from colorectal carcinoma.
AB  - 17 patients with 43 liver metastases from colorectal carcinoma were studied by
      immunoscintigraphy (IS) using a 99mTc-labelled monoclonal anti-CEA antibody (BW
      431/26). Sensitivity and diagnostic accuracy were 21% for all liver lesions, but
      47% considering the number of patients (at least one positive finding out of
      multiple metastases) and 77% in patients with a single metastasis. SPECT imaging
      did not improve sensitivity markedly in this series. There was no correlation
      with CEA serum levels. Liver metastases of intermediate size with moderate tumour
      necrosis seem to be favourable to IS. Major reason for the low sensitivity is the
      poor tumour-to-background ratio caused by high unspecific uptake of 99mTc
      labelled antibodies in the RES of the liver. At the moment, IS seems be only a
      supplementary method to conventional diagnostic procedures.

PMID- 1641360
TI  - [Clinical value of the ultrafast gradient echo sequence "Quickflash"].
AB  - It is possible to develop faster sequences with 6 mT/m gradient field strength.
      However, the short gradient switch times which are advantageous for a better
      image contrast cannot be achieved. Using longer measurement times the influence
      of the preparation pulses is less dominant. The image quality of the quickflash
      is poorer than that of conventional SE and GE sequences. In some cases,
      especially for outline views and in the evaluation of Gd inflow into pathologic
      tissue or in restless patients, we use the quickflash in clinical routine.

PMID- 1641361
TI  - [Effect of intraperitoneal administration of sandoglobulin on peritoneal fluid
      IgG level in patients treated by standard peritoneal dialysis (SPD)].
AB  - In 6 patients (PTS) treated with SPD for 369 patient weeks (ptw) we evaluated the
      influence of three intraperitoneal SI on the IgG concentration in the PE. The
      concentration of IgG was checked before, on 1-st, 3-rd day 2-nd and 3-rd week
      after SI. In the course of the following 229 ptw, we observed three episodes of
      peritonitis (PN) in two pts, while in the control period of 140 ptw no PN
      occurred. The concentrations in PE of opsonins (IgG, C3 complement, fibronectin)
      at the start of SPD shoved enormous individual differences and did not correlate
      with occurrence of PN in the follow-up. Intraperitoneal SI caused significant
      increase of IgG in PE, but only to the third day after infusion. Our preliminary
      results do not confirm the protective effect of intraperitoneal SI on occurrence
      of PN in SPD patients.

PMID- 1641362
TI  - [Hormonal and hemodynamic changes caused by whole body cooling in patients with
      rheumatoid arthritis].
AB  - A limited number of experiments have shown that treatment of rheumatoid arthritis
      by means of cooling the entire body in cryogenic chamber reduces the pain in
      joints affected by inflammatory process and increases their mobility. The aim of
      the present thesis was to try explain the mechanisms responsible for the observed
      improvement of the patients' condition, and an investigation of the treatment's
      effect on selected hemodynamic indices. Tests were carried out on 63 patients
      with rheumatoid arthritis mainly in the 3rd and 4th stage of illness, all of whom
      had been treated for 14 days, once daily, by cooling the body for two-minute
      periods in cryogenic chamber with temperatures ranging from -110 degrees C to 
      160 degrees C, followed by kinesitherapy. It was demonstrated that after a single
      session in the cryogenic chamber, after 7 and 14 days the level of ACTH, cortisol
      and beta-endorphins in blood serum rises. The level of TSH, T4, T3, GH and 6-keto
      PGF1 alpha+, however, remains unchanged. The cryogenic chamber treatment does not
      affect the heart rate, arterial blood pressure nor the value of the left
      ventricle fractional shortening index and its ejection, neither does it cause of
      arrhythmias and ischemic changes of the heart.

PMID- 1641363
TI  - [Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi.
      I. Hypercalciuria].
AB  - In 1819 patients with active or non active respectively nephrolithiasis the
      following parameters were assessed: plasma level of calcium, phosphate, and uric
      acid and urinary excretion of calcium, phosphate, oxalate, uric acid and
      creatinine. These parameters were estimated after 5 days of diet containing 400
      mg of calcium, 800 mg of phosphate, 100 mg of purines and 40 g of proteins. In
      3/4 of all examined patients at least one lithogenic factor was present. More
      than 40% of patients showed presence of hypercalciuria. Among these patients in
      68% renal in 17% absorptive and in 15% undefined hypercalciuria was diagnosed.
      Patients with active nephrolithiasis showed a similar frequency of hypercalciuria
      but more profound abnormalities of Ca P metabolism than patients with non active
      renal stone disease.

PMID- 1641364
TI  - [Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi.
      II. Primary hyperparathyroidism].
AB  - Among 1819 patients with renal stone disease 44 cases with primary
      hyperparathyroidism (p.h.p.) were diagnosed. In all cases the diagnosis of php
      was confirmed by histomorphological examination. In 34 patients with php solitary
      adenoma was found, in 5 patients an adenoma with concomitant hyperplasia of the
      parathyroid glands, in 2 patients hyperplasia and in 3 patients carcinoma of the
      parathyroid glands. Hypercalcemia was found in 86% of patients, while elevated
      plasma levels of PTH in 90% of patients with php. Not in all patients PTH
      secretion was entirely autonomous. No significant correlation was found between
      plasma levels of PTH and kind of pathology of the parathyroid glands as well as
      clinical feature of php respectively.

PMID- 1641365
TI  - [Doppler ultrasonography of arteries of the lower extremities].
AB  - We examined 90 male nonsmokers aged 22 to 76, without any symptoms of arterial
      occlusive disease. They were in the I class of the NYHA classification. The
      subjects were divided into 2 groups according to age: group I 22-49, group II 50
      76. The study was performed using an Acuson 128 with linear probe 5 MHz. We
      examined arteries of the lower extremities from external iliac artery to
      popliteal artery. On the B-mode image the diameter of the artery and wall
      irregularities were evaluated. Doppler spectra were evaluated according to 3
      criteria. Doppler waveforms differed significantly between two groups. The third
      wave of spectrum (the diastolic wave toward the probe) was significantly lower in
      group II. This finding may be caused by decrease in vessel wall compliance in
      elderly patients. Moreover we found spectral broadening in the presence of
      atherosclerotic plaques (38% in group II). The authors' examination showed that
      Doppler sonography is useful in the evaluation of abnormality of an asymptomatic
      areas. Our study also indicated that subject's age has to be taken into
      consideration when Doppler waveforms are evaluated.

PMID- 1641366
TI  - [Personal experience with the diagnosis of peritonitis complicating a long-term
      program of peritoneal dialysis].
AB  - Among 37 patients (pts) with irreversible renal failure treated in years 1980
      1990 with chronic peritoneal dialysis there were 18 pts treated with continuous
      ambulatory peritoneal dialysis (CAPD) and 19 pts treated with standard
      intermitent peritoneal dialysis (SIPD). Mean incidence of peritonitis (P) was 1
      episode per 9.0 patients-months. The important symptoms for early diagnosis of P
      were as follows: opacity of the peritoneal effluent (PE) and high (more than 50%)
      percentage of polynuclear cells in the smear of PE sediment. Positive results of
      PE culture were obtained only in 50% of P episodes in years 1980-1985, mostly in
      pts treated with CAPD (17/21 pts). In the period of 1986-1990, in pts treated
      mostly with SIPD (15/16 pts), positive results were obtained in 80% of P.
      Improvements of bacteriological diagnosis of P, especially in pts treated with
      CAPD, were discussed. Prophylactic cultures of PE were found to be of no value.

PMID- 1641367
TI  - [Therapeutic use of the method of water immersion in a patient with ascites in
      uncompensated cirrhosis of the liver].
AB  - Water immersion was used as the treatment method in a patient with ascites caused
      by liver cirrhosis resistant to therapy. Application of water immersion caused
      only a short improvement; it was probably connected with the shortterm
      natriuretic effect. The joint effect of a diuretics and of the water immersion
      was beneficial.

PMID- 1641368
TI  - The development of vascular supply of normal rat prostate during the sexual
      maturation: an angiographic study.
AB  - Vascular distribution of small blood vessels and capillaries using India ink
      angiography was studied in normal rat prostate from puberty up to full sexual
      maturation. The study included both macroscopic observation of the lobular
      vascular irrigation and the histological assessment of the periacinar capillary
      network. The topographical distribution of the main prostate branches was found
      to be different among the rat prostate lobes. The ventral lobe seems to be better
      irrigated than the dorsal one. The former being supplied by two parallel vascular
      systems, one irrigating the median two-thirds of the ventral lobe, whereas the
      remaining external one-third was found to be conjointly irrigated from the
      pericapsular branches of the fat pads. The blood vessels of the dorsal and
      lateral lobes emerged radially from a periurethral circle, with the dorsal
      branches ending blindly in the connective tissue of the pelvic cavity, whereas
      the lateral prostate was also conjointly irrigated by a dual vascularization from
      the pericapsular fat pad and the periurethral circle branch. The histological
      study revealed quantitative differences between the periacinar capillaries of
      both ventral and dorsal lobes. The capillary density was found to be age
      dependent and directly proportional to the acinar size. Small acini were less
      well irrigated by capillaries than were the larger ones. The number of
      capillaries per acinar area increased progressively toward the maturation (day
      90); thereafter, their number remained constant. Both prostate lobes showed
      identical patterns. The heterogeneous vascular networks among the rat prostatic
      lobes might offer an additional clue for their distinctive morphophysiological
      characteristics, which most probably play a role in various pathogenetic
      processes.

PMID- 1641369
TI  - Response of rat and human prostatic cancers to the novel 5 alpha-reductase
      inhibitor, SK&F 105657.
AB  - The response of two androgen-responsive rat prostatic cancers (i.e., Dunning R
      3327 H and G sublines) and one androgen-responsive human prostatic cancer (i.e.,
      PC-82) to the 5 alpha-reductase inhibitor, SK&F 105657, was tested in vivo. SK&F
      105657 was administered orally twice a day at a dose of 25 or 50 mg/kg/dose. The
      rat R-3327 G tumor and the human PC-82 tumor have a low to undetectable level of
      tissue 5 alpha-reductase activity and both responded to SK&F 105657 treatment
      with a reproducible inhibition of tumor growth. Associated with this antitumor
      effect was a major decrease (i.e., greater than 70%) in tissue
      dihydrotestosterone (DHT) content in both tumors. By contrast, the rat R-3327 H
      prostatic cancer has a much higher level of tissue 5 alpha-reductase activity,
      and neither tumor DHT content nor growth of the tumor was inhibited by treatment
      with SK&F 105657. Drug treatment of rats bearing R-3227 H tumors resulted in a
      similar reduction in the DHT content, wet weight, and DNA content of the ventral
      prostate as that produced in R-3327 G tumor-bearing rats which experienced an
      antitumor response. These results suggest that SK&F 105657 can produce antitumor
      effects if a substantial reduction in tissue DHT is achieved. Such reduction in
      tissue DHT, secondary to inhibition of the tissue 5 alpha-reductase enzyme,
      appears to be more difficult to achieve in tumors than in the normal prostate. In
      order to achieve such a DHT reduction in tumor tissue, prostatic cancers with low
      5 alpha-reductase activity could be treated with SK&F 105657 on a dose regimen
      that lowers serum DHT to surgical castration levels, while concomitantly
      inhibiting the already low tumor tissue 5 alpha-reductase activity.

PMID- 1641370
TI  - The relationship between cardiovascular complications of estrogen therapy and
      fibrinolysis in patients with prostatic cancer.
AB  - To determine the relationship between cardiovascular complications of estrogen
      therapy and fibrinolysis, fibrinolysis parameters plasminogen, urokinase-type
      plasminogen activator (u-PA), tissue-type plasminogen activator (t-PA), and
      plasminogen activator inhibitor-1 (PAI-1), were assessed in 12 prostatic cancer
      patients before and 6 weeks after the onset of estrogen therapy. The levels of
      plasminogen, u-PA, and PAI-1 in the patients treated with the estrogen therapy
      were significantly higher than those in the patients before the therapy. The t-PA
      level in the patients during the therapy was significantly lower than that before
      the treatment. Cardiovascular complications were found in two patients (16.7%)
      during estrogen therapy. In the two patients, marked elevation of PAI-1 and
      decreased level of t-PA were observed during the therapy. These results indicate
      that cardiovascular complications of estrogen therapy in patients with prostatic
      cancer may be related to hypofibrinolysis resulting from changes of PAI-1 and t
      PA.

PMID- 1641371
TI  - The prognostic value of histological grading and mean nuclear volume in human
      prostatic cancer.
AB  - Fifty-eight consecutive patients diagnosed with prostatic cancer at transurethral
      resection in the period 1979-1983 were classified using histological grade
      according to Shelley, and using an unbiased estimate of mean nuclear volume. We
      find that both histological grade and mean nuclear volume appear to be
      significantly associated with survival. In eight of nine patients still alive
      after 89-130 months mean nuclear volume at diagnosis was in normal range and the
      histological grade showed a highly differentiated cancer in eight of the nine
      cases. These findings suggest highly differentiated cancer and normal range of
      mean nuclear volume may be important for long-term survival. In patients with
      advanced disease requiring endocrine treatment both histological grading and mean
      nuclear volume estimates failed to show any prognostic properties with regards to
      time to progression and time of survival. In patients not subjected to endocrine
      treatment histologic grade, but not mean nuclear volume, was found to be
      significantly associated with survival. Subtle changes in disease progression may
      be diagnosed early by repeated biopsies due to the accuracy and high
      reproducibility of mean nuclear volume measurements; however, a single estimate
      of mean nuclear volume has not been shown to offer advantage over histological
      grade with respect to prognostic properties.

PMID- 1641372
TI  - [Expression of cytochrome P-450 genes].
AB  - Cytochromes P-450 are important in the oxidative metabolism of many endogenous
      substrates, as well as innumerable drugs, chemical carcinogens, and environmental
      pollutants. Biochemical analyses of cytochrome P-450 have revealed multiple
      isoenzymes. Information for synthesis of these isoenzymes is contained in
      different genes. Based on the degree of relatedness in DNA sequence, the genes
      for cytochrome P-450 have been classified into different families, constituting
      cytochrome P-450 multigene superfamily. Particular chemicals induce expression of
      one or more genes belonging to definite cytochrome P-450 family. Expression of
      these genes may have served as a mechanism by which the cell respond to specific
      chemical signals (xenobiotic or hormonal).

PMID- 1641373
TI  - [Hypoxia and the development of liver damage].
AB  - Article presents some aspects of the role of hypoxia in the liver damage.
      Centrilobular injury, formation of the membranous blebs, release of enzymes are
      described. This cellular alterations may play an important role in the
      pathogenesis of the liver diseases.

PMID- 1641374
TI  - [Metabolism of liver proteins in ethanol poisoning].
AB  - The present paper reviews the literature on influence of ethanol and acetaldehyde
      on synthesis, export and degradation of liver proteins. Direction and
      intensification changes caused by ethanol and acetaldehyde depend on
      concentration, time of activity and the way of administration of these compounds,
      and the way of feeding.

PMID- 1641375
TI  - [Progress in biology and therapy of aplastic anemia and other conditions of bone
      marrow failure].
AB  - The new aspects in the pathogenesis of aplastic anaemia and others acquired
      states of bone marrow aplasia as well as congenital defects of the marrow stem
      cells have been reviewed. Role of immune mechanisms, viruses, chemical and
      irradiation exposure in the etiology and pathophysiology of bone marrow failure
      is presented. The new achievements in the treatment of aplastic anaemias
      including bone marrow transplantation, antilymphocyte globulin, cyclosporin A,
      high doses of 6-methyl prednisolone and recombinant haemopoietic growth factors
      are also discussed.

PMID- 1641376
TI  - [Fever as a homeostatic process accompanying infection].
AB  - After a survey of experimental data the author considers the notion that elevated
      (febrile) temperature acts as an adaptive factor buffering against the
      disordering of biomembrane homeostasis during infection. Impendance of the
      membrane homeostasis under infectious conditions occurs due to the certain
      disturbance of membrane structure caused by pyrogen-induced activation of
      phospholipases and liberation of arachidonic acid from phospholipid deposits. A
      consequence of liberation and oxygenation of the arachidonic acid is an outflow
      of double bonds from the overall pool embedded in the structure of membrane. This
      in turn leads to an increase of membrane bulk phase transition temperature and to
      depletion of membrane fluidity at normal (non-febrile) temperature.

PMID- 1641377
TI  - Toxicological evaluation of aflatoxin and cyclopiazonic acid in broiler chickens.
AB  - The individual and combined effects of aflatoxin (AF) and cyclopiazonic acid
      (CPA) were evaluated in day-old Petersen x Hubbard broiler chickens to 3 wk of
      age. Treatments were arranged in a 2 x 2 factorial with levels of 0 and 3.5 mg
      AF/kg of feed, and 0 and 50 mg CPA/kg of feed. Production performance, serum
      biochemistry, and gross pathological observations were evaluated. Body weight
      gain was significantly (P less than .05) reduced by AF, CPA, and the AF-CPA
      combination at the end of 3 wk. Aflatoxin significantly increased the relative
      weight of the kidney and serum concentration of blood urea nitrogen and decreased
      serum concentrations of protein, albumin, cholesterol, phosphorus, and the
      activity of lactate dehydrogenase. The toxicity of CPA was expressed through
      increased relative weights of the liver, kidney, and proventriculus, increased
      levels of uric acid and cholesterol, and decreased serum phosphorus. The activity
      of AF-CPA combination was characterized by increased relative weight of the
      liver, kidney, pancreas, and proventriculus, decreased concentrations of serum
      albumin and phosphorus, increased concentrations of serum glutamic oxalacetic
      transaminase and blood urea nitrogen, and decreases in the relative weight of the
      bursa of Fabricius. Post-mortem examination revealed that the chickens fed CPA
      and the AF-CPA combination had thickened mucosa and dilated proventricular
      lumens, hard fibrotic spleen, and atrophy of the gizzard. The data from the
      present study demonstrate that both AF and CPA alone and the AF-CPA combination
      can limit broiler performance and adversely affect broiler health. In most cases
      the effects of AF and CPA were additive.

PMID- 1641378
TI  - Barley inclusion and avoparcin supplementation in broiler diets. 2. Clinical,
      pathological, and bacteriological findings in a mild form of necrotic enteritis.
AB  - The clinical, pathological, and bacteriological findings of a mild form of
      necrotic enteritis (NE) in broiler chickens are presented. The term subclinical
      NE (SNE) is proposed for this condition. A diagnosis of SNE was based on the
      detection of macroscopically visible, focal necrotic lesions in the small
      intestinal mucosa. The ileal gut contents from SNE birds yielded increased
      numbers of Clostridium perfringens and reduced numbers of coliform bacteria.
      Reduced numbers of lactobacilli and streptococci were detected in birds from SNE
      pens and coccidial oocysts were not found in the rectal contents of SNE birds.
      Statistical analyses showed strong correlations between SNE and increased feed
      conversion ratio and retarded growth rate. An increased occurrence of SNE was
      observed in birds on a diet containing a large amount of barley.

PMID- 1641379
TI  - Stress measurements on beak-trimmed and untrimmed pullets.
AB  - Stress in poultry is difficult to define and measure. There is general agreement
      that some modern poultry production practices may exert a certain amount of
      stress on birds. Three experiments were conducted to explore possible measures of
      stress associated with beak trimming and rearing schemes. Experiments 1 and 2
      examined different degrees of beak trimming and rearing schemes of wire floor
      versus litter floor in pullet production. Experiment 3 examined the effect of
      beak trimming on feed consumption for 14 days after trimming. Adrenal glands of
      untrimmed birds were heavier (P less than .05) than those of trimmed birds at the
      end of the pullet growing period in Experiments 1 and 2, evidence that beak
      trimming reduced overall chronic stress levels. Hearts of untrimmed birds were
      heavier (P less than .05) than those of trimmed birds in Experiment 1. Hearts and
      spleens were not affected in Experiment 2. In comparisons of rearing schemes
      (litter versus wire), birds grown on litter floors had heavier adrenal glands and
      a greater incidence of cannibalism in the later weeks of Experiments 1 and 2.
      This indicated that a stressful interaction among penmates had occurred. Birds
      grown on litter floors consumed more feed than those grown on wire, and the
      untrimmed birds from both floor types consumed more total feed than trimmed
      birds. By the end of the growing period, body weights were not different in
      either study, indicating compensation for any early beak trimming stress. Beak
      trimming produced a decrease in feed intake in Experiment 3, consumption was
      reduced (P less than .05) in 5 of the first 8 days after trimming.

PMID- 1641380
TI  - Dietary zinc methionine effect on eggshell quality of hens drinking saline water.
AB  - In two experiments individually caged 60-wk-old laying hens were exposed to daily
      temperatures ranging between 18 and 35 C and given various dietary and drinking
      water treatments. In Experiment 1 these were: 1) basal diet and town water; 2)
      basal diet and town water supplemented with 2 g NaCl/L; 3) basal diet
      supplemented with .2 g zinc methionine (Zinpro-200)/kg diet and town water; or 4)
      basal diet supplemented with .2 g zinc methionine/kg and town water supplemented
      with 2 g NaCl/L. In Experiment 2, Treatments 1 and 2 were the same as in
      Experiment 1. Birds on Treatments 3 and 4 received the town water supplemented
      with 2 g NaCl/L and the basal diet supplemented with either .5 g zinc
      methionine/kg (Treatment 3) or .28 g ZnSO4H2O/kg to approximate the same dietary
      zinc concentration in Treatment 3 (Treatment 4). In both experiments, dietary
      zinc methionine plus 2 g NaCl/L in the drinking water significantly improved
      shell breaking strength over those birds on the 2 g NaCl/L with no zinc
      methionine supplementation. This same pattern occurred for shell weight, shell
      weight per unit of surface area, and percentage of shell defects. There were no
      improvements in the parameters measured from the supplementation of ZnSO4. The
      zinc methionine compound apparently was effective in overcoming the negative
      influence of the added 2 g NaCl/L of town water.

PMID- 1641381
TI  - Amino acid fortification of a low-protein corn and soybean meal diet for chicks.
AB  - Seven experiments were conducted to investigate whether a 19% CP corn and soybean
      meal (CS) diet could be fortified properly with amino acids (AA) to produce
      performance in 1- to 3-wk-old chicks equal to that obtained with a 23% CP, CS
      diet supplemented with Met. In one experiment, the assay was carried out to 6 wk
      of age. During 4- to 6-wk posthatching, the positive control was a 20% CP, CS
      diet with added Met and the low-protein diet was a 16% CP, CS diet fortified with
      limiting AA. The two most limiting AA in the low-protein diet (19% CP) were found
      to be Met and Lys. Arginine, Val, and Thr were observed to be limiting as well.
      Weight gain and feed efficiency were substantially increased and body fat content
      decreased when the low-protein diet was supplemented with the five limiting AA
      and amino nitrogen in the form of Glu. Addition of potassium had no effect on
      performance of chicks fed the AA-fortified, low-protein diet. With all trials
      considered together, chicks fed the low-protein diet fortified with the five
      limiting AA and Glu gained at the same rate with similar feed efficiency and had
      estimated body fat levels comparable to birds fed the 23% CP, positive control
      diet. From 3 to 6 wk of age, chicks fed the AA-fortified, 16% CP diet had growth
      performance similar to chicks fed the 20% CP, positive control diet.

PMID- 1641382
TI  - Effects of dietary aluminum and niacin on chick tibiae.
AB  - Effects of dietary aluminum chloride and niacin on bone mineral content and bone
      structural measurements were studied using young male Leghorn chicks. Standard
      chick rations containing .8% Ca and .4 or .5% available P were fed as control
      diets in three experiments. Experimental diets contained .05, .1, or .3% Al, or
      1.0 or 1.5% niacin, or both and were fed for 2 wk. Tibia weights were decreased
      by 1.5% niacin, .3% Al, and by .1% Al plus 1.5% niacin (P less than .05).
      Breaking strength of tibiae was decreased (P less than .05) by 1.5% niacin, .1%
      Al, and .1% Al plus 1.5% niacin. Ultimate stress, which is force per unit area,
      was decreased by .3% Al and .05% Al plus 1.5% niacin (P less than .05). Niacin
      had no significant effect on bone mineral content. In Experiment 3, .3% Al
      decreased P, Ca, Mg, and Zn content of the tibiae (P less than .05). These
      findings indicate that feeding high levels of supplemental niacin results in
      decreased bone strength in chicks with no change in mineral content of the
      tibiae. Aluminum fed at levels of .3% of the diet causes a decrease in bone
      strength with concomitant changes in bone mineral content.

PMID- 1641383
TI  - The effects of dietary protein level on the reproductive performance of bobwhite
      hens.
AB  - Two experiments were conducted to evaluate the protein requirement of adult
      bobwhite quail. Flight-type quail were used in one experiment and meat-type quail
      in the other. Corn and soybean meal diets containing 12, 15, 18, 21, and 24%
      protein were fed. Increasing the protein level of the diet from 12 to 15%
      significantly increased egg production with the flight-type bird. However, only a
      nonsignificant increase in egg production was obtained with the meat-type birds
      when the protein level was increased to 15%. Higher levels of protein did not
      result in further increases in egg production in either strain. Increasing the
      protein from 12 to 18% (flight) or 21% (meat) resulted in increased egg weight.
      Egg mass of flight-type hens receiving 18 and 21% protein was significantly
      greater than egg mass from hens receiving 12 and 15% protein. Hatch of fertile
      eggs, hatch of total eggs, chick weight, or weight of adult birds were not
      affected by protein level. Feeding the 12% protein diet resulted in significantly
      reduced fertility in the flight-type birds but not in the meat-type birds.

PMID- 1641384
TI  - Progeny performance when dams and chicks are fed supplemental zinc.
AB  - Three consecutive trials involving approximately 700 to 800 broilers (0 to 28
      days) were conducted to examine effects on growth and immunity of chicks after
      supplementing dams with inorganic Zn versus organic Zn. Offspring from hens fed a
      basal diet (72 mg Zn/kg) or diets with 152 mg Zn/kg supplemented with ZnO or
      organic Zn-Met were randomized across four battery brooders. Chicks were fed a
      starter diet without supplemental Zn containing 100 mg Zn/kg or diets
      supplemented with 40 mg/kg Zn from ZnO and DL-Met or Zn-Met containing 140 mg
      Zn/kg. No differences among treatments (P greater than .05) were found in feed
      conversion or average BW. Supplemental Zn-Met in hen diet increased (P less than
      .06) cellular immune response in progeny. Embryonic bone weights were higher (P
      less than .05) in progeny when dams were fed Zn-Met. Zinc as Zn-Met in diets of
      dams and progeny enhanced primary antibody titers to Salmonella pullorum antigen.

PMID- 1641385
TI  - Effects of dietary amino acid level and duration of finisher period on
      performance and carcass content of broilers forty-nine days of age.
AB  - Two studies were conducted to evaluate feeding reduced levels of amino acids (AA)
      to broilers during the finisher period. Birds grown to 42 days on nutritionally
      complete diets were fed diets formulated to contain a minimum of 70, 80, 90, 100,
      or 110% of recommended AA levels for periods of 3, 5, or 7 days prior to
      slaughter at 49 days of age. Body weight, feed intake, feed utilization, dressing
      percentage, and abdominal fat content were determined. For finisher periods of 3
      to 5 days, a reduction in recommended dietary AA levels may be utilized without
      impairment of body weight gains of broilers. Extending the finisher period to 7
      days resulted in significant (P less than .05) reduction of body weight gains on
      diets with AA levels less than 90% of recommended levels. Feed utilization was
      more sensitive to reduction in AA levels and may be affected adversely even by a
      5-day withdrawal period. Dressing percentage was reduced in some instances, and
      abdominal fat generally increased when reduced AA levels were fed. The economics
      of feeding reduced AA levels must be considered in evaluating the results of the
      present studies.

PMID- 1641386
TI  - Effect of progesterone in vitro on luteinizing hormone production in hen
      pituitary cells pretreated with estrogen.
AB  - Isolated cells from the pituitary gland of nonlaying hens were preincubated in
      vitro with or without estradiol-17 beta (E2), and then incubated with or without
      progesterone (P4), and luteinizing hormone (LH) in the cells and media was
      measured by a homologous radioimmunoassay. When the cells were preincubated with
      E2 for 2 h and then incubated with P4 for 4 h, cellular LH was increased, but LH
      in the medium remained unchanged. The increase in cellular LH in response to P4
      was dose-dependent. Protein synthesis inhibitors (cycloheximide, actinomycin-D,
      and alpha-amanitin) blocked the response of the cells to P4. The results suggest
      that LH production in estrogen-primed pituitary cells of the hen was stimulated
      by P4 through a protein-synthesizing pathway.

PMID- 1641387
TI  - Ultrastructure of the rat pancreas after experimental duct ligation. II. Duct and
      stromal cell proliferation, differentiation, and deletion.
AB  - Ligation of the pancreas in rats was followed by rapid atrophy of the distal part
      of the gland, where deletion of the acinar cells by apoptosis and simultaneous
      extensive proliferation of duct cells resulted in the lobules being converted
      into groups of closely packed small ducts within 5 days. We found no
      ultrastructural evidence that cells lining these small ducts arose from acinar
      cells by a process of dedifferentiation, as has been suggested by some
      investigators. During the succeeding weeks, some of the ductal lining cells
      developed islet cell or partial acinar cell differentiation. The latter soon died
      by apoptosis, and some ductlike and islet cells were also deleted by this means.
      Most of the apoptotic bodies formed in the ducts were phagocytosed by
      intraepithelial macrophages. In the longer term, continuing apoptosis eventually
      resulted in the disappearance of many ducts, only their thickened basal laminae
      remaining. Differentiation of stromal fibroblasts into contractile myofibroblasts
      may have contributed to shrinkage of the duct-obstructed glandular tissue, and
      apoptosis of endothelial cells probably accounted for the associated reduction of
      the capillary bed.

PMID- 1641388
TI  - The intestinal peptide PEC-60 inhibits insulin secretion in the mouse and the
      rat.
AB  - The newly discovered 60-amino-acid porcine intestinal peptide, PEC-60, shows a
      structural similarity to pancreatic secretory trypsin inhibitor. PEC-60 was
      recently demonstrated to inhibit glucose-stimulated insulin secretion from the
      perfused rat pancreas. We examined in this study whether the peptide affects
      basal and stimulated insulin secretion in vivo. Purified porcine PEC-60 was
      injected intravenously in mice at 1 or 8 nmol/kg alone or together with glucose
      (2.8 mmol/kg) or the cholinergic agonist carbachol (0.16 mumol/kg). PEC-60 was
      found to inhibit glucose- and carbachol-induced insulin secretion (p less than
      0.01 and p less than 0.05, respectively) at 8 nmol/kg, whereas at 1 nmol/kg, the
      peptide had no effect. In contrast, basal plasma insulin levels were not affected
      by PEC-60. In a second experimental series, PEC-60 was infused intravenously in
      rats at 17 or 68 pmol/min alone or together with glucose (56 mumol/min). At 68
      pmol/min (p less than 0.01), but not at 17 pmol/min, PEC-60 inhibited glucose
      stimulated insulin secretion. The peptide had no influence on basal plasma
      insulin levels. It is concluded that the newly isolated intestinal peptide, PEC
      60, inhibits stimulated insulin secretion under in vivo conditions both in the
      mouse and in the rat without affecting basal insulin secretion.

PMID- 1641389
TI  - Mitotic activity and DNA synthesis of rat islet cells following partial
      pancreatectomy.
AB  - The regenerative potential of the adult rat pancreas following a 50%
      pancreatectomy was investigated. Blood glucose values and body weight were
      unchanged by the procedure. The mitotic index (MI) of alpha, beta, and exocrine
      cells was examined in formalin-fixed sections of the pancreas stained for
      hormones and 5-bromo-2'-deoxyuridine (BrDU) after treating the animals with 2.5
      mg/kg colchicine and/or 50 mg/kg BrDU prior to sacrifice. The MI was unchanged
      within the control group. For pancreatectomized versus control animals, in beta
      cells after 5 days the MI was 0.84% versus 0.41% (p less than 0.05), while 7 days
      postoperatively it was 1.04% versus 0.57% (p less than 0.01); in alpha cells, the
      MI was 0.32% versus 0.17% (p less than 0.05) at 5 days and 0.47% versus 0.24% (p
      less than 0.05) at 7 days. The MI of exocrine cells rose transiently on day 3
      postoperatively to 0.74% in the pancreatectomized group but remained low at 0.15%
      (p less than 0.01) in the control group. The mean ratio of BrDU + ve beta cells
      was 1.19% in the pancreatectomy group and 0.45% in the control group on day 5
      postoperatively (p = 0.01). A highly significant (r = 0.97; p less than 0.001)
      correlation existed between BrDU + ve and mitotic cells. There was no difference
      between the two groups in the area occupied by insulin-positive cells in
      pancreatic sections, nor in the number of beta cells per islet.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641390
TI  - Inhibitory effect of islet amyloid polypeptide of glucose-induced proinsulin
      biosynthesis in rat insulinoma cells.
AB  - Islet amyloid polypeptide (IAPP) has been recently identified as the principal
      constituent of amyloid deposits in pancreatic islets of patients with type 2 (non
      insulin-dependent) diabetes mellitus and causes insulin resistance in some target
      cells. In addition, glucose-induced insulin secretion is inhibited by IAPP. We
      studied the effect of IAPP on proinsulin biosynthesis in rat insulinoma (RINr)
      cells. Glucose at concentrations of 0, 15, 30, 60, 100, and 300 mg/dl stimulated
      proinsulin biosynthesis in a dose-responsive and and actino-mycin D-inhibitable
      manner after 6 h of incubation. At a glucose concentration of 300 mg/dl, IAPP
      decreased the mean responses of proinsulin biosynthesis to 61.2 and 29% at
      concentrations of 0.1 and 1 microM, respectively, compared with the IAPP-free
      control. In conclusion, IAPP inhibits glucose-induced proinsulin biosynthesis in
      RINr cells. IAPP might play an important role in the pathogenesis of type 2
      diabetes mellitus.

PMID- 1641391
TI  - Effects of antioxidants and free radical scavengers in three different models of
      acute pancreatitis.
AB  - The present studies were done to evaluate the therapeutic potential of several
      antioxidants and free radical scavengers in three different models of acute
      pancreatitis. (a) Edematous pancreatitis with acinar cells necrosis was induced
      by seven hourly intraperitoneal injections of 50 micrograms of caerulein per kg
      in mice. (b) Hemorrhagic pancreatitis was induced by feeding a choline-deficient,
      ethionine-supplemented (CDE) diet in mice. (c) Hemorrhagic pancreatitis was
      induced by retrograde infusion of 0.6 ml of 5% sodium taurocholate into the
      pancreatic duct in rats. The following antioxidants and free radical scavengers
      were given at various doses intravenously, subcutaneously, or intraperitoneally
      before the onset of pancreatitis: Ebselen [2-phenyl-1,2-benzisoselenazol-3(2H)
      one], superoxide dismutase, catalase, deferoxamine (Desferal), dimethyl
      sulfoxide, or allopurinol. The severity of pancreatitis was assessed at various
      times after its onset by determination of serum amylase and pancreatic weight
      (edema), by grading of histological alterations, and by determination of survival
      (survival determined in models of hemorrhagic pancreatitis). In general, free
      radical scavengers and antioxidants ameliorated edema and inflammation to a
      greater degree than necrosis and the increase in serum amylase. Superoxide
      dismutase (as did Ebselen in previous studies) exerted beneficial effects on
      survival in diet-induced pancreatitis in the absence of marked effects on
      pancreatic necrosis, suggesting that these beneficial effects are due to
      amelioration of extrapancreatic complications that often contribute to mortality
      in acute pancreatitis. None of the antioxidants had major beneficial effects in
      taurocholate-induced hemorrhagic pancreatitis. Thus, formation of free radicals
      may be important for progression and outcome in diet-induced and, to a lesser
      degree, in caerulein-induced pancreatitis but not at all in taurocholate-induced
      pancreatitis. Different models of pancreatitis may, therefore, involve different
      degrees and mechanisms of free radical formation. Despite the amelioration of
      edema and the beneficial effects on mortality seen for some antioxidants in some
      of the models, antioxidants and free radical scavengers appear to have only a
      limited potential for treatment of acute pancreatitis.

PMID- 1641392
TI  - Clinical utility of the serum CA 19-9 test for diagnosing pancreatic carcinoma in
      symptomatic patients: a prospective study.
AB  - The diagnostic accuracy of the serum CA 19-9 determination was prospectively
      evaluated in patients selected for the presence of signs or symptoms highly
      suggestive for pancreatic cancer. Of 110 patients included in the study, 54 had a
      final diagnosis of pancreatic adenocarcinoma (49% prevalence). CA 19-9 values
      were higher than 40 U/ml in 45 patients with pancreatic carcinoma and in 18 of
      the 56 patients with other final diagnosis (sensitivity, 0.83; specificity, 0.68;
      positive predictive value [PPV], 0.71; negative predictive value [NPV], 0.81).
      The serum CA 19-9 determination was not capable of shortening the diagnostic
      workup of patients with strong clinical suspicion of pancreatic cancer since
      adequate imaging of the pancreas was required to confirm or exclude the
      diagnosis. However, values above 120 U/ml were strongly suggestive for pancreatic
      carcinoma in the overall population (PPV, 0.85) and they were diagnostic (PPV,
      1.0) in the anicteric portion. Combined with pancreatic imaging, the CA 19-9 was
      an excellent confirmatory test; a normal value in a patient with negative imaging
      ruled out pancreatic carcinoma as the cause of symptoms (NPV, 1.0), whereas a
      pathological result in the presence of positive or equivocal pancreatic radiology
      was highly suggestive for the presence of the disease (PPV, 0.93).

PMID- 1641393
TI  - Horseshoe anomaly of the pancreas.
AB  - A 72-year-old man with recurrent pancreatitis and a horseshoe-shaped anomaly of
      the pancreas is described. The diagnosis was made by endoscopic retrograde
      cholangiopancreatography (ERCP) and computed tomography scan; laparotomy was
      confirmatory. The abnormal duct branched to the lower left from an enlarged
      Santorini's duct; a thin Wirsung's duct was joined at its distal portion to the
      junction of the abnormal duct. The anomaly was associated with a cystic
      dilatation of the common bile duct with stone and cholecystolithiasis. This
      anomaly is considered to be a variation of the dominant dorsal duct syndrome.

PMID- 1641394
TI  - Detection of intrahepatic human islets following combined liver-islet
      allotransplantation.
AB  - This article describes the localization of intact insulin-containing intrahepatic
      islets after combined liver-islet allotransplantation. The patient was a 36-year
      old woman who underwent upper abdominal exenteration for neuroendocrine
      carcinoma; 289,000 islets were transplanted via portal vein infusion immediately
      after complete revascularization of the liver. Immunosuppression was with low
      dose FK-506. OKT3 and steroids were used to treat one rejection episode 2 weeks
      after transplantation, but the patient subsequently developed multiple infections
      and died 109 days after transplantation. At autopsy, the transplanted liver did
      not show any sign of rejection and well-preserved islets were present in portal
      triads sampled from the anterior inferior edge of the right lobe.
      Immunohistochemical labeling confirmed the presence of insulin-containing cells.
      This finding indicated that human islets can survive after intrahepatic
      allotransplantation, despite positive cross-match with no HLA antigen match,
      suggesting that upper abdominal exenteration and liver transplantation may
      constitute a protective factor for the survival of allogeneic human islets.

PMID- 1641395
TI  - The fatty acid chain elongation system of mammalian endoplasmic reticulum.
AB  - Much has been learned about FACES of the endoplasmic reticulum since its
      discovery in the early 1960s. FACES consists of four component reactions,
      requires the fatty acid to be activated in the form of a CoA derivative, utilizes
      reducing equivalents in the form of NADH or NADPH, is induced by a fat-free diet,
      resides on the cytoplasmic surface of the endoplasmic reticulum, appears to
      function in concert with the desaturase system and appears to exist in multiple
      forms (either multiple condensing enzymes connected to a single pathway or
      multiple pathways). FACES has been found in all tissues investigated, namely,
      liver, brain, kidney, lung, adrenals, retina, testis, small intestine, blood
      cells (lymphocytes and neutrophils) and fibroblasts, with one exception--the
      heart has no measurable activity. Yet, much more needs to be learned. The
      critical, inducible and rate-limiting condensing enzyme has resisted
      solubilization and purification; the purification of the other components has met
      with limited success. We know nothing about the site of synthesis of each
      component of FACES. How is each component enzyme integrated into the endoplasmic
      reticulum membrane? Is there a single mRNA directing synthesis of all four
      components or are there four separate mRNAs? How are elongation and desaturation
      coordinated? What is (are) the physiological regulator(s) of FACES--ADP, AMP,
      IP3, G-proteins, phosphorylation, CoA, Ca2+, cAMP, none of these? The molecular
      biology of FACES is only in the fetal stage of development. We are only
      scratching the surface--it is an undiscovered country.

PMID- 1641396
TI  - Inositol-containing lipids in higher plants.

PMID- 1641397
TI  - The role of transacylases in the metabolism of arachidonate and platelet
      activating factor.

PMID- 1641398
TI  - Chemistry and biochemistry of taurolipids.

PMID- 1641399
TI  - Idiosyncratic reactions to antidepressants: a review of the possible mechanisms
      and predisposing factors.
AB  - Antidepressants, a widely used group of drugs, are associated with a range of
      idiosyncratic reactions affecting in particular the liver, skin and both the
      hematological and central nervous systems. These reactions seem to be mediated by
      chemically reactive metabolites formed by the cytochrome P450 enzyme system, the
      toxicity occurring either directly or indirectly via an immune mechanism.
      Individual susceptibility is determined by factors, both genetic and
      environmental, which result in inadequate detoxication of the chemically reactive
      metabolite. Prevention of such reactions will depend on either the development of
      new compounds which are not converted to toxic metabolites or by prediction of
      individual susceptibility prior to drug administration.

PMID- 1641400
TI  - Carcinogen-mediated oxidant formation and oxidative DNA damage.
AB  - This article reviews the experimental data that points to formation of reactive
      oxygen species (ROS) and oxidative DNA base damage as being important
      contributors to cancer development. Particular emphasis is placed on the role
      they play in genetic changes occurring during tumor promotion. A number of
      structurally different anticarcinogenic agents inhibit ROS production and
      oxidative DNA damage as they inhibit inflammation and tumor promotion. This
      underlines the importance of ROS and oxidative genetic damage to the carcinogenic
      process. It also points to the possibility that some types of cancer may be
      preventable if the cycles of tumor promotion can be interrupted.

PMID- 1641401
TI  - Metal carcinogenesis: mechanistic implications.
AB  - Cancer epidemiology has identified several metal compounds as human carcinogens.
      Recent evidence suggests that carcinogenic metals induce genotoxicity in a
      multiplicity of ways, either alone or by enhancing the effects of other agents.
      This review summarizes current information on the genotoxicity of arsenic,
      chromium, nickel, beryllium and cadmium compounds and their possible roles in
      carcinogenesis. Each of these metals is distinct in its primary modes of action;
      yet there are several mechanisms induced by more than one metal, including: the
      induction of cellular immunity and oxidative stress, the inhibition of DNA
      metabolism and repair and the formation of DNA- and/or protein-crosslinks.

PMID- 1641402
TI  - Antihypertensive drugs: individualized analysis and clinical relevance of kinetic
      dynamic relationships.
AB  - Individualized approaches to antihypertensive therapy are being widely advocated.
      Ideally these should incorporate rational prospective methods for drug and dosage
      selection but progress has been hampered by the paucity of information about dose
      (and plasma concentration-) response relationships. However, in several recent
      clinical studies, concentration-effect analysis has been used to characterize
      kinetic-dynamic relationships in individual patients for a range of
      antihypertensive drugs. This approach provides an integrated mathematical
      description of drug response which has potential utility for quickly identifying
      poor or nonresponders and for determining individual dose requirements for
      optimum longterm blood pressure control.

PMID- 1641403
TI  - Fibrogenesis in cirrhosis. Potential for therapeutic intervention.
AB  - Liver cirrhosis is an end stage of several diseases that affect the liver
      chronically. It is characterized, among other things, by excess collagen
      deposition, distortion of liver architecture, tissue malfunction and hemodynamic
      alterations. Many of the complications of cirrhosis may result from excess matrix
      deposition. Therefore, prevention of collagen accumulation or removal of collagen
      deposits could ameliorate the disease. In this article we discuss the
      pathophysiology of liver fibrosis and we describe various compounds with
      antiinflammatory and antifibrogenic activity. We discuss their possible mechanism
      of action and we describe animal and clinical studies in which these compounds
      have been utilized.

PMID- 1641404
TI  - Pathophysiology and pharmacotherapy of cholelithiasis.
AB  - Several factors are involved in the development of gallstone formation: formation
      of supersaturated bile; nucleation; formation, retention and adhesion of
      cholesterol crystals and eventually stone growth. The dynamics of the gallbladder
      may play a key role in the overall process. The pathophysiologic theory of
      cholesterol gallstone formation and the knowledge of their physico-chemical
      properties support the modern concept of gallstone therapy. Chenodeoxycholic and
      ursodeoxycholic have been widely used as cholesterol gallstone dissolving agents
      and evaluated in terms of efficacy and safety.

PMID- 1641405
TI  - The clinical pharmacology of angiotensin converting enzyme inhibitors in chronic
      heart failure.
AB  - ACE inhibitors (ACEIs) have now been shown to improve symptoms and survival in
      patients with mild, moderate and severe chronic heart failure. Their mechanism of
      action is thought to be a combination of RAAS suppression and augmentation of
      bradykinin and prostaglandins. Although ACE inhibitors improve hemodynamics post
      myocardial infarction, we do not yet have consistent data on their effects on
      symptoms or survival in these particular patients. One other potential benefit is
      their effects on reperfusion injury and free radicals. As yet only minor
      differences have been found to exist between different ACEIs but increasing
      attention is now being focussed in this direction.

PMID- 1641406
TI  - Venomous mammals.
AB  - It is not widely appreciated that mammals can be venomous in the manner of snakes
      and lizards. However, it was first demonstrated scientifically 50 years ago in
      the case of the American short-tailed shrew. Subsequently, similar evidence has
      been obtained from European shrews and the Haitian solenodon, but research in
      this area has been almost completely neglected for the last 20 years. In complete
      contrast to what has been learned about other animal venoms, the identity and
      mode of action of mammal venom toxins are still unknown. This review draws
      attention once more to the pioneering work undertaken in the 1940s and 1950s,
      exploring in more detail than hitherto why the implications of mammal venom are
      just as important as the chemistry and pharmacology of the phenomenon itself.

PMID- 1641407
TI  - The use of pharmacogenetic techniques in drug abuse research.
AB  - Pharmacogenetics, the study of genetic factors underlying individual differences
      in response to drugs, has proven useful for demonstrating that there are large
      genetic differences in response to a number of abused drugs. Pharmacogenetics
      also provides a number of useful tools for studying mechanisms underlying the
      effects of drugs. This review discusses pharmacogenetic techniques with potential
      utility for drug abuse research and provides examples of their use in studies of
      the effects of acute and chronic nicotine, cocaine and opiate administration. The
      importance of using genetically standardized animal models in behavioral and
      pharmacological research is also discussed.

PMID- 1641408
TI  - Adhesive interactions in angiogenesis and metastasis.
AB  - A variety of adhesive interactions must take place between the tumor cell and the
      host vasculature in order to potentiate both tumor expansion and metastatic tumor
      spread. The study of tumor cell and blood vessel adhesive interactions becomes
      essential for our understanding of the malignant process, especially with regard
      to organ-specific tumor metastasis. In this article we will review recent
      progress made in our understanding of the nature of (i) receptor mediated
      adhesion of endothelial cells to extracellular matrix components and (ii)
      adhesion of tumor cells to endothelial adhesion molecules and to components of
      the subendothelial basement membrane.

PMID- 1641409
TI  - Xenobiotic metabolism by prostaglandin H synthase.
AB  - During the metabolism of arachidonic acid by prostaglandin H synthase many
      chemicals including carcinogens are metabolized. These chemicals are metabolized
      by either the peroxidase activity of prostaglandin H synthase, the peroxyl
      radicals generated during arachidonic acid oxygenation, or a combination of these
      two mechanisms. In many cases, the chemical metabolism results in the formation
      of reactive metabolites that have mutagenic activity and potential carcinogenic
      activity. In other cases, the chemicals are detoxified. Chemical metabolism that
      occurs during arachidonic acid oxygenation may be an important determinate of
      chemical toxicity in extra-hepatic tissues.

PMID- 1641410
TI  - Sympathetic nervous system and behavioral responses to stress following exercise
      training.
AB  - This study tests the hypothesis that a short-term (16 weeks) exercise program
      modifies sympathetic nervous system (SNS) and selected behavioral responses to
      acute psychological stress. Twenty-four previously sedentary middle-aged men with
      maximal aerobic capacity (VmaxO2) values less than 40 ml.kg-1.min-1 were assigned
      to experimental (n = 12) and control (n = 12) groups. All subjects performed a
      modified Stroop test (18 min) at pre- and postexercise training during which
      intravenous blood samples were drawn at three time intervals for plasma
      catecholamine (CA) determination. Motor performance was continuously recorded for
      assessment of premotor (PMT) and motor (MOT) components of reactions time. A set
      of anagrams were administered immediately following the modified Stroop to
      determine the level of cognitive fatigue induced. At both pre- and postexercise
      intervention, the total group (n = 24) manifested significant (p less than or
      equal to 0.05) elevations in state anxiety, heart rate, and plasma
      norepinephrine. No significant changes occurred over time on PMT or MOT. There
      were significantly (p less than or equal to 0.01) lengthened anagram performance
      scores poststress compared to nonstress values. The experimental group exercise
      trained 3 days/week for 16 weeks, resulting in a 20% increase in VO2max. However,
      there were no group differences on the CA or behavioral responses to the modified
      Stroop at pre- or postintervention. These findings do not support the hypothesis
      that short-term aerobic training significantly alters SNS activity or behavioral
      measures of central processing in middle-aged men exposed to an acute
      psychological challenge.

PMID- 1641411
TI  - Intraventricular neuropeptide Y injections stimulate food intake in lean, but not
      obese Zucker rats.
AB  - We examined the effect of acute third intraventricular (IVT) injections of either
      saline or NPY (0.95, 3.0, 9.5, or 30.0 micrograms in 1 microliter) on the 1-, 4-,
      and 22-hour postinjection food and water intake of female obese (fa/fa),
      heterozygous lean (Fa/fa), and homozygous lean (Fa/Fa) Zucker rats. None of the
      doses of NPY had an effect on either food or water intake of fa/fa rats. A
      significant increase of food intake was seen in Fa/Fa rats at 1 and 4 hours after
      the 3.0 micrograms injection of NPY and at 1, 4, and 22 hours after the 9.5
      micrograms injection of NPY. Both 3.0 and 9.5 micrograms of NPY also stimulated 1
      and 4-hour postinjection food intake of Fa/fa rats, although this effect was
      significant only at 4 hours after the 3.0 micrograms dose. NPY had a less
      reliable effect on water intake; 3.0 micrograms of NPY stimulated 1-hour
      postinjection water intake of Fa/fa rats and 4-hour postinjection water intake of
      Fa/Fa rats. These results indicate that lean, but not obese Zucker rats, respond
      by eating more to centrally administered NPY. This deficit is similar to the
      effects seen with IVT insulin injections and may be a result of a common receptor
      mediated mechanism.

PMID- 1641412
TI  - Emotivity, personality, and task-dependent EEG asymmetry.
AB  - In order to verify if task-dependent EEG asymmetry is related to emotivity or
      personality traits, the relationship between EEGraphic (EEG mapping) asymmetry,
      personality aspects, and emotional-affective state in 12 healthy volunteers was
      evaluated by means of standardized methods (SAD and CPI). Our subjects show an
      EEG asymmetry which is currently attributed in the literature to anxiety. In our
      subject the absence of anxiety and the presence of hyperthymic characteristics
      suggests that the different individual trends observed in various studies which
      have used methods similar to ours, could, at least partly, depend on interference
      on these variables.

PMID- 1641413
TI  - Diazepam facilitates acceptance of alien lambs by postparturient ewes.
AB  - The aim of this study was to determine the effect of diazepam on the behavior of
      parturient ewes towards alien lambs. There is evidence that benzodiazepines cause
      behavioral changes during the lactation period in rats. In two independent
      experiments, it was found that the ewes acceptance of alien lambs significantly
      increased following a single injection of the benzodiazepine, diazepam, given
      either 1 or 12 h after parturition. In a third experiment, in which the alien
      lamb was not permitted to suckle during a period of 2 h after the injection, the
      diazepam treatment did not provoke significant differences in maternal behavior
      of the ewes, although in the ewes treated with diazepam, suckling clearly tended
      to increase. At the dose employed (20 mg), administered 1 h after birth, diazepam
      caused no signs of sedation as assessed in an open-field test carried out 3 h
      after parturition. This doesn't eliminate the possibility of diazepam having a
      sedative effect in the period of 2 h immediately after its administration and
      before the test and, in this way, facilitating suckling which could be
      responsible for the maternal behavior observed after this period. As diazepam
      gives rise to an enhanced GABAergic activity in the brain, these observations
      suggest that a GABAergic mechanism could also play a role in the process whereby
      ewes form a selective bond with their own offspring.

PMID- 1641414
TI  - Changes in limbic neuronal function during hormonal induction of lordosis in
      behaving hamsters.
AB  - Several limbic structures influence copulatory behavior and contain receptors for
      estradiol and progesterone. In the present study, single neuron activity was
      recorded from septal, amygdaloid, and other limbic regions during the hormonal
      induction of lordosis in behaving golden hamsters. Limbic neurons had low firing
      rates and a small number showed firing associated with orienting, sniffing, and
      rearing. Progesterone administration to estradiol-primed hamsters produced the
      following neuronal effects: a reduction in the number of active neurons and
      narrowing of dynamic activity range; enhanced neuronal responsiveness to face
      stimulation; and lordosis-correlated firing, consisting of depressed activity
      during lordosis and increased firing at response onset or offset. Unlike
      previously studied midbrain and hypothalamic neurons, control progesterone
      injections that didn't produce lordosis were about as effective in altering
      limbic neuronal activity levels and sensory responsiveness as behaviorally
      effective injections. The progesterone effects on limbic neurons are consistent
      with previous evidence suggesting that these neurons tend to suppress lordosis.
      The significance of these results to hormone influences on epilepsy is discussed.

PMID- 1641415
TI  - Reaching behavior in the rat: absence of forelimb peripheral input.
AB  - In order to test whether peripheral input from a moving forelimb is essential for
      reaching in rats, the effects of dorsal rhizotomy C5-Th2 were examined. Rats were
      trained to reach for a food pellet in the horizontal tube or on a tray. Reaching
      attempts before and after bilateral forelimb deafferentation were monitored by
      continual recording using magnetic induction. Deafferented animals were able to
      initiate and generate the motor program of reaching, but modulation of its
      ongoing execution was lost. Peripheral input from moving forelimb was necessary
      for the effective performance of grasping; the duration of the manipulative part
      of reaching was significantly prolonged and the success of grasping was markedly
      decreased. Also, the aiming of forelimb was impaired, probably by disturbing of
      body forelimb postural coordination. No significant changes were found in the
      execution of forelimb protraction. It is concluded that somesthetic feedback is
      not required for execution of forelimb protraction, but it is necessary for
      grasping.

PMID- 1641416
TI  - Effects of various stressors on milk release in the rat.
AB  - This study investigated the effect of four stimuli on milk release (MR), namely,
      sound, nociception, novelty, and restraint. The role of the ensuing
      adrenocortical response in the suppression of MR was also evaluated. Plasma
      corticosterone (CORT) levels were measured at 0 (basal), 15, 30, and 60 min
      during the suckling sessions to determine whether elevated CORT normally
      associated with stress could be inhibitory to MR. Compared to nonstressed
      lactators, dams exposed to sound demonstrated no suppression in MR, but a
      significant increase in plasma CORT. Pain did not alter milk yield and elevated
      CORT only at the end of the first hour of exposure. During novelty, MR was
      suppressed and again CORT was only elevated at the end of the sampling period.
      Restraint decreased milk yield and increased CORT. During novelty, MR appeared to
      be regulated by an adrenal factor, which remains to be identified. The peripheral
      opiates seem to be partially involved during restraint. In conclusion, not all
      types of aversive stimuli interfere with MR. Of those which do, different
      mechanisms seem to be implicated depending upon the nature of the stressor.
      Furthermore, reduced MR during stress is not a direct consequence of increased
      CORT.

PMID- 1641417
TI  - Regulation of peripheral glucagon concentrations in cyclic, pregnant, and
      lactating rats.
AB  - In the rat, peripheral glucagon concentrations were studied throughout pregnancy
      and lactation. Basal glucose concentrations were decreased during late pregnancy
      and during lactation, but basal glucagon concentrations were not affected.
      Infusion of glucose (7.4 mg/min) caused an elevation of the glucose
      concentrations, which became lower in the course of lactation, and a suppression
      of the glucagon concentrations which was the same throughout pregnancy and
      lactation. Ingestion of 336 mg of glucose or 1 g of rat chow throughout pregnancy
      and lactation induced a transient increase of the glucose concentrations and a
      biphasic glucagon response: following a short-lasting elevation, the glucagon
      concentrations became suppressed. The glucagon responses to these tests did not
      change during pregnancy and lactation. It is concluded that the regulation of the
      peripheral glucagon concentration is not affected by pregnancy or lactation, and
      that the response of the glucagon concentration to a metabolic challenge varies
      with the kind of test (oral or intravenous) used.

PMID- 1641418
TI  - Neural androgen receptors and scent marking of male gerbils: modulation by
      females.
AB  - The involvement of brain cytosolic androgen receptors in the female-induced
      increase in scent-marking behavior of male Mongolian gerbils was studied. Scent
      marking activities and serum testosterone concentrations were measured in low
      marking control males and in males with increased scent-marking activities,
      stimulated by the presence of conspecific females in the same room. For every
      individual male the concentrations and affinities of androgen receptors were
      determined in four parts of the brain, which contained the hippocampus, septum,
      corpus striatum, amygdala, stria terminalis, and the hypothalamus. Compared to
      the basal unstimulated period, the marking activities of male gerbils
      significantly increased 58% during the presence of female conspecifics in their
      housing room. The serum testosterone concentrations did not change significantly
      during female presence. The association constants of the cytosolic androgen
      receptors were higher in the female-stimulated males compared to isolated control
      males. In contrast, the cytosolic receptor concentration was reduced. The
      difference reached significance in one of the brain parts. Individual levels in
      scent-marking activities could not be explained by correlation with individual
      androgen receptor parameters. The present results suggest that increased androgen
      binding in the brain may be involved in the elevation of scent-marking activities
      in male gerbils, caused by urinary chemical signals of female conspecifics.

PMID- 1641419
TI  - Effects of steroids on the olfactory function of the dog.
AB  - Twenty-four (24) mature, mixed breed, healthy dogs weighing from 14.6 kg to 27.6
      kg were used to study the effects of various steroids on the olfactory function
      of the dog using olfactory detection threshold as an index. Two odorants were
      used, viz; benzaldehyde and eugenol. Of the various steroids used, only
      dexamethasone produced classical signs of Cushing's syndrome in the dogs.
      However, all dogs that received either dexamethasone alone or hydrocortisone plus
      DOCA exhibited a significant elevation in the olfactory detection threshold for
      both odorants without any observable structural alteration of the olfactory
      tissue using light microscopy. On the other hand, neither DOCA, hydrocortisone
      alone, nor any of the vehicles used in the study significantly altered the
      olfactory function of the dogs. The results show that Cushing's syndrome can be
      experimentally produced in dogs using exogenous steroids and that this condition
      diminishes the olfactory capability of the dog without producing classical signs
      of the disease.

PMID- 1641420
TI  - Photoperiod modulates the effects of steroids on sociosexual behaviors of
      hamsters.
AB  - Female hamsters (Mesocricetus auratus) exposed to a short photoperiod for 8 weeks
      were ovariectomized, as were hamsters that were maintained in a long photoperiod.
      We then tested the effect of photoperiod on the ability of progesterone (P) to
      reduce aggression, as well as on the effects of estrogen (E), alone and with P,
      on the display of lordosis. Before hormone treatments, photoperiod did not affect
      the display of aggressive behaviors. When treated with steroids, short-day
      females were more aggressive than long-day housed animals, especially when tested
      using male intruders. Also, exposure to short days reduced the activational
      effects of E and E+P upon lordosis behavior. These findings confirm that
      photoperiod can modulate the behavioral effects of E and E+P in female hamsters.
      Furthermore, the results indicate that behavioral effects of P which do not
      depend upon E priming are also influenced by photoperiod.

PMID- 1641421
TI  - Effects of early postnatal malnutrition and chlordiazepoxide on experimental
      aversive situations.
AB  - In order to study the lasting consequences of brain changes caused by early
      malnutrition, rats were fed a protein-deficient diet from birth until 49 days of
      age and a balanced diet from day 50 to day 70. At 49 and 70 days of age,
      independent groups of animals were tested in the locomotor activity, step-down
      inhibitory avoidance, and flinch-jump nociceptive tests. Also, at 49 days of age,
      malnourished and control rats were sacrificed in order to evaluate the weight of
      brain regions. Malnourished rats had lower body and brain weights (telencephalon
      and brain stem) than control rats. Malnourished rats also showed less locomotor
      activity at the beginning of the test session, lower flinch and jump thresholds,
      and longer step-down latencies than control animals. Chlordiazepoxide (5 mg/kg,
      IP) shortened step-down latency of well-nourished rats, but was ineffective in
      malnourished rats. These and previously reported results indicate that early
      protein malnutrition causes long-lasting impairment of neuronal systems
      underlying emotional behavior.

PMID- 1641422
TI  - Paraventricular hypothalamic obesity in rats: role of corticosterone.
AB  - The role of adrenal glucocorticoid hormones in the weight gain produced by
      lesions of the paraventricular nuclei was explored in two experiments. In the
      first experiment, female rats with PVN lesions were found to have normal a.m.
      plasma corticosterone concentrations and blunted, albeit still elevated, p.m.
      concentrations. Nighttime corticosterone levels were moderately correlated with
      plasma insulin levels. In the second experiment, adrenalectomy markedly
      suppressed weight gain in animals with very large PVN lesions (mean weight gain
      of 33.0 g/20 days compared to 137.6 g/20 days for PVN rats with sham
      adrenalectomies). In the ADX-PVN group, there was a +0.90 correlation between
      plasma corticosterone levels and weight gain. Administration of corticosterone
      restored the abnormal weight gain in ADX-PVN animals. It is concluded that the
      steroid receptors mediating this effect of corticosterone lie outside the
      hypothalamus.

PMID- 1641423
TI  - Photostimulation of blackheaded bunting: subjective interpretation of day and
      night depends upon both photophase contrast and light intensity.
AB  - Blackheaded buntings were exposed to constant dim light (approximately 2 lux) for
      77 days and subsequently to 12:12 illumination, consisting of either dim
      light:complete darkness (dl:dk) (2:0 lux) or bright light:dim light (bl:dl) (10,
      35, and 90 lux:2, 10, and 35 lux, respectively, with 180 degrees bl:dl
      transitions) for 2-3 weeks each. Birds were unstimulated until day 100, under dim
      LL (dl:dl) and 12dl:12dk. Photostimulation with a significant increase (p less
      than 0.001) in average body weight and testis volume occurred on exposure to
      12bl:12dl (10:2 lux); birds remained fat and testes were enlarged until the end
      (day 173) of the experiment. Locomotor activity also did not have a discernible
      pattern under the nongonadostimulatory photoregimes. Birds became active in the
      bright photophase (subjective day) of 12bl:12dl (10:2 lux) on day 5 (day 105 of
      the experiment), but beginning on day 113 more intense perch-hopping was
      initiated in the dim photophase (subjective night), indicating the appearance of
      nocturnal migratory restlessness in the caged birds. A 180 degrees transition in
      the bl:dl photophases at this time for 2 weeks resulted in complete shift in the
      timing of daytime and nighttime activity. This trend is maintained under all
      subsequent 12bl:12dl exposures. These results suggest that the light intensity
      required for photostimulation in the blackheaded bunting is absolute, and that
      the subjective interpretation of day and night depends upon the photophase
      contrast, as well.

PMID- 1641424
TI  - Determinants of the slow acquisition of medical and sulcal prefrontal cortex self
      stimulation: an individual differences approach.
AB  - Stimulation-naive rats were tested for motor activity during noncontingent
      electrical stimulation of the medial prefrontal cortex (MPC) or sulcal prefrontal
      cortex (SPC). Defecation during stimulation was also measured. The rats were then
      tested using a conditioned taste aversion paradigm for aversion to a novel flavor
      (0.1% saccharin) paired with stimulation. Finally, the rats were trained to
      acquire self-stimulation over 26 days of training. Large individual differences
      were seen in motor activity, defecation, and conditioned taste aversion to
      initial stimulation and in the subsequent speed of self-stimulation acquisition.
      In the MPC-stimulated group, acquisition speed was positively correlated with
      motor activity to initial stimulation and negatively correlated with defecation
      to this stimulation. In the SPC-stimulated group, the same correlations were
      evident, but only when rats suffering seizures prior to self-stimulation
      acquisition were excluded from the analysis. Such preacquisition seizures, which
      were only found in the SPC-stimulated group, retarded self-stimulation
      acquisition. In most rats, MPC or SPC stimulation failed to condition a taste
      aversion to saccharin. These results suggest that the slow acquisition of MPC and
      SPC self-stimulation may be partly related to the motor suppressive, aversive,
      and convulsive properties of initial stimulation.

PMID- 1641425
TI  - Acceleration of tail pinch-induced feeding in rats by analgesic effect of
      neurotropin.
AB  - Mechanisms of tail pinch-induced feeding and effects of neurotropin (NSP), an
      extract from the inflamed skin of rabbit inoculated with vaccinia virus, on
      behavioral responses were investigated in rats. Treatment of a 5-min tail pinch
      (tail pinch I) induced feeding response. An intensified 15-min tail pinch (tail
      pinch II) provoked emotional reactions besides feeding behavior. The rate of food
      intake (food intake/tail pinch duration) during tail pinch II was less than that
      at tail pinch I. Intraperitoneal administration of NSP (100 mg/kg/day) by itself
      produced no remarkable change in feeding or emotional behavior. However, NSP
      treated rats increased eating size and prolonged eating duration during tail
      pinch I. Pretreatment of NSP increased feeding behavior more potently at tail
      pinch II than at tail pinch I and decreased the incidence of emotional reactions
      at tail pinch II. The results suggest that NSP, by its analgesic action, may
      modulate behavioral responses during tail pinch treatment through selective
      blockade of the nociceptive and feeding-inhibitory information, but not through
      the nonnociceptive and feeding-excitatory signals.

PMID- 1641426
TI  - Mimicking corticosterone's daily rhythm with specific receptor agonists: effects
      on food, water, and sodium intake.
AB  - The endogenous pattern of type I and II corticosteroid receptor stimulation was
      systematically assembled from specific agonists in order to detect any unique
      receptor interactions in the control of ingestive behavior. The type II agonists
      dexamethasone (0, 5, or 25 micrograms/kg) or RU28362 (0, 5, or 25 micrograms/kg)
      were injected daily in the final hour of the light phase of the illumination
      cycle of adrenalectomized rats. This was carried out in the presence or absence
      of continuous aldosterone (type I agonist) infusion. Additional comparisons were
      made with sham-operated groups and animals receiving type II agonists by
      continuous infusion. Type II agonists increased the intake of 2% saline and the
      proportion of food taken at night, but had negligible effects on total food
      intake. Type II agonists did not interact with the type I agonist. Type II
      effects were greatly potentiated by continuous infusion, though administered at
      the same doses as acute injection. When the effects of type II receptor
      stimulation emerged, they always consisted of an exacerbation of the
      adrenalectomy syndrome, not a return to normal quantities or patterns. In
      contrast, type I receptor stimulation restored both the quantities and unique day
      night patterns of saline, water, and food intake to values matching intact
      animals. The findings suggest that the behavioral significance of
      corticosterone's nocturnal peak of type II stimulation is small, and that its
      most important function may lie in the metabolic processes it instigates during
      its steady rise in the light phase.

PMID- 1641427
TI  - Neuropeptide Y paradoxically increases food intake yet causes conditioned flavor
      aversions.
AB  - Neuropeptides have been implicated in the short-term regulation of food intake
      and the long-term control of body weight. Previous studies have shown that
      central administration of neuropeptide Y (NPY), the most abundant of these
      peptides in the brain, produces robust increases of food intake. We now report
      that NPY, at doses that stimulate food intake when administered
      intraventricularly, also causes the formation of robust conditioned flavor
      aversions when given via the same cannula and at the same dose. This apparently
      paradoxical effect may be indicative of different populations of central NPY
      receptors having dissimilar effects on ingestive behaviors. The results also
      suggest that the use of conditioned aversions to investigate drug-induced malaise
      may not be appropriate when applied to ingestive behaviors.

PMID- 1641428
TI  - A possible genetic association between PROP-tasting and alcoholism.
AB  - Fifty-five young adult subjects and their parents were classified as alcoholic or
      nonalcoholic based on a standardized questionnaire (the MAST) filled out by the
      subjects. Subjects' thresholds for detection of 6-n-propylthiouracil (PROP; a PTC
      like compound) were determined with the experimenter blind to MAST responses.
      There was a significantly higher proportion of nontasters of PROP among children
      of alcoholics than among children of nonalcoholics. There was no relationship
      between the child's alcoholism status and ability to taste PROP. These results
      are inconsistent with the view that excessive use of alcohol causes the
      association between nontasting and alcoholism and are consistent with the view
      that there is a genetic association between PROP/PTC-tasting and alcoholism.

PMID- 1641429
TI  - Intraperitoneal administration of recombinant human interleukin-1 beta inhibits
      osmotic thirst in the rat.
AB  - Decrease in water intake after intraperitoneal injection of interleukin-1 beta
      (IL-1 beta) was studied in the rat. Administration of IL-1 beta at a dose of 20
      micrograms/kg attenuated osmotic thirst induced by intraperitoneal injection of
      hypertonic saline, but did not affect hypovolemic thirst induced by subcutaneous
      injection of either polyethylene glycol or angiotensin II. Interleukin-1 beta
      also decreased spontaneous intake of water but not that of 1.8% saline. The
      results suggest that the decrease in water intake by IL-1 beta is caused, at
      least in part, by suppression of osmotic thirst but not by general suppression of
      behavior. The effects of IL-1 beta were not secondary responses accompanied by
      feeding behavior, since food supply was removed during the experiments.
      Pretreatment with indomethacin blocked the decrease in water intake by IL-1 beta,
      suggesting the involvement of production of prostaglandins.

PMID- 1641430
TI  - Contribution of the amygdala to learning and performance of conditional fear.
AB  - The amygdaloid complex appears to be an essential component in the neural systems
      mediating some forms of aversive Pavlovian conditioning. The relative
      contribution of this structure to acquisition and performance during fear
      conditioning was assessed by making temporary lesions in the amygdala prior to
      training or retention testing in a single-trial Pavlovian conditioning
      preparation. Microinjection of lidocaine HCl (5.0%, 1.0 microliters) into the
      amygdala prior to the presentation of a CS signalling footshock resulted in a
      significant attenuation of the performance of conditional fear, as indexed by the
      amount of time rats spent engaged in defensive freezing behavior during the
      retention session. However, similar treatment with lidocaine prior to the
      training session, during which the CS and UCS were paired, resulted in only a
      weak reduction in subsequent responding. Thus, while both acquisition- and
      performance-related processes take place within the amygdala, it appears that the
      latter are more sensitive to disruption using the present procedures. These
      results are discussed in terms of the general role played by this structure in
      aversive learning and motivational processes.

PMID- 1641431
TI  - Oral estrogen retains potency as an aversion agent in eggs: implications to
      studies of community ecology and wildlife management.
AB  - The first of two experiments with laboratory rats demonstrated that oral estrogen
      (17 alpha-ethinylestradiol) can remain in the albumen of eggs at room temperature
      for up to 8 days with undiminished capacity to produce conditioned taste
      aversion. The second experiment showed that estrogen remains potent in the yolk
      of eggs for at least 4 days. There is now greater assurance that egg prey placed
      into the field will induce reliable CTA among mammalian predators. Community
      ecologists interested in such processes as competitive release and the responses
      of prey populations to reduced predation upon their eggs can selectively factor
      predation out of field experiments without the need for physically excluding
      predators. Wildlife biologists interested in reducing predation upon the eggs of
      endangered species now have greater assurance that estrogen-treated egg baits
      will suppress predation in a more cost-effective manner and with less likelihood
      of discrimination between treated eggs and those of endangered species.

PMID- 1641433
TI  - Cancer screening intervention among black women in inner-city Atlanta--design of
      a study.
AB  - This experimental study attempts to determine if an in-home educational
      intervention conducted by lay health workers (LHWs) can increase adherence among
      low-income, inner-city black women to schedules for screening for breast cancer
      and cervical cancer, as well as increase the women's knowledge and change their
      attitudes regarding these cancers. This paper is a description of the purposes,
      hypotheses, design, subject recruitment, intervention, and evaluation of the
      study conducted by Morehouse School of Medicine. Subjects were recruited from a
      variety of sources, including patients seen in a community health center, women
      referred by the National Black Women's Health Project (NBWHP), residents of
      public and senior citizen housing projects, and persons identified in various
      community settings. Fewer than half of those asked to participate agreed to do
      so. The 321 women who were recruited were demographically diverse. Overall, about
      half of these volunteer subjects self-reported at least one Papanicolaou (Pap)
      smear and one breast examination within a year before enrollment in the study.
      There was little variation by source of recruitment in compliance with screening
      recommendations, except that referrals from NBWHP were more likely (P less than
      0.01) to have had a Pap test and breast self-examination, while residents of
      public housing projects were somewhat less likely to have done so. About 35
      percent of participants ages 35 and older had a mammogram within an appropriate
      interval. Participants were randomly assigned to intervention and control groups.
      Women in the intervention group were visited in their homes by LHWs on three
      occasions; the LHWs provided education on cancer and reproductive health. The
      groups were comparable in their baseline sociodemographic status and previous
      screening history.

PMID- 1641432
TI  - Multistrategy health education program to increase mammography use among women
      ages 65 and older.
AB  - Mammography use decreases with age although the risk of breast cancer increases
      with age. Medicare now provides biennial coverage for screening mammography. This
      study was designed to simulate the Medicare condition by subsidizing mammography
      among women in eight retirement communities in the metropolitan Philadelphia
      area. The study also measured the impact of health education interventions and
      the presence of a mobile mammography van on increased use of mammography.
      Retirement communities were assigned randomly to the control (cost subsidy alone)
      or experimental group (cost subsidy, mammography van, and tailored health
      education interventions). A total of 412 women ages 65 and older who had not had
      mammograms in the previous year were surveyed at baseline and 3 months later.
      Analytic techniques reflected the cluster nature of the randomization. Women in
      the experimental group were significantly more likely than the control group
      women to have obtained mammograms. Forty-five percent of the experimental group
      women compared with 12 percent of the control group women subsequently had
      mammograms in the 3 months after the baseline interview (P less than .001).
      Logistic regression analysis for mammography use indicated an odds ratio of 6.1
      associated with being in the experimental group. For women in the experimental
      group, a separate logistic regression for mammography use showed an odds ratio of
      7.8 associated with attendance at the educational presentation. The results
      suggest that Medicare coverage alone will not increase mammography use
      sufficiently to achieve year 2000 objectives. However, the addition of access
      enhancing and health education interventions boosts utilization dramatically.

PMID- 1641434
TI  - Effects of migration on cancer incidence and resources for prevention and
      treatment in Florida.
AB  - Migration adds a complex dimension to the task of those who plan and allocate
      resources for health care. The authors offer a methodology for estimating the
      contribution of migration to the incidence of cancer, allow for age- and sex
      specific cancer risks, and estimate, by country, the impact of recent migration
      on the annual incidence of cancer in Florida. Cancer and migration data were used
      to develop estimates of the number of cancer cases for Florida counties that were
      attributable to recent migrants. A net gain and loss ratio was calculated for new
      cancer cases in 1980 resulting from the 1975-80 migration pattern. Florida data
      was used because that State has one of the highest crude cancer incidence rates
      in the nation, is one of the most populous States, and has a population growth
      from migration rather than from natural increase. Preliminary findings on the
      relationship between cancer health services resources and net cancer rates from
      migration are discussed. County cancer health services resources had a strong
      positive relationship to population size, but the impact of migration on cancer
      incidence was in a curvilinear relationship to population size.

PMID- 1641435
TI  - Accessing NCI's SEER cancer data base with SeerQuery and CD-ROM.
AB  - The National Cancer Institute operates the Surveillance, Epidemiology, and End
      Results (SEER) cancer data base. SEER data are obtained from participating
      population-based registries that monitor cancer incidence and patient survival in
      a representative 10 percent sample of the general population. The data cover all
      cancers (except superficial skin cancers) in the defined regional populations.
      SeerQuery is a personal computer program for accessing that data on IBM
      compatible personal computer compact diskettes in read-only memory (CD-ROM) form.
      SeerQuery facilitates rapid access to cancer data at minimal cost and effort to
      the user. SeerQuery is menu-driven, enabling physicians and other health care
      professionals to query the data base directly. They can use the data to determine
      cancer frequency, perform cross-tabulation, determine incidence, and calculate
      survival using such variables as primary cancer site, histologic type, stage,
      sex, age, and race. The comprehensive data base lacks many selection biases that
      are inherent in data reported from other sources. SeerQuery has applications in
      professional education and in cancer control program planning and resource
      allocation.

PMID- 1641436
TI  - Descriptive epidemiology of unintentional residential fire injuries in King
      County, WA, 1984 and 1985.
AB  - Although most studies have concentrated on fatal residential fire injuries, which
      are a leading cause of fatal injuries in the United States, few investigators
      have examined in detail nonfatal injuries as a consequence of residential fires.
      This population-based study used the Washington State Fire Incident Reporting
      System to assess the incidence and descriptive epidemiology of fatal and nonfatal
      burns or respiratory tract damage resulting from unintentional residential fires.
      For the 2-year period 1984-85 in King County, WA, the mortality rate due to
      injury in a residential fire was 0.7 per 100,000 per year, and the incidence of
      nonfatal injuries was 5.6 per 100,000 per year. Of 17 fatalities, 59 percent of
      the deaths occurred at the scene of the fire. Of 128 persons with nonfatal
      injuries, 19 percent were hospitalized; although the 55 percent seen as
      outpatients and the 26 percent treated by the fire department or paramedics at
      the fire scene usually had minor injuries, they would not have been captured if
      only traditional data sources had been employed. Those injured averaged 2.8 days
      of restricted activity, but the range was from less than 1 day to 1 year.
      Injuries were more common in the households with a low socioeconomic status and
      among nonwhites, especially American Indians. Variation in incidence by age, sex,
      and source of ignition for deaths and nonfatal injuries suggests appropriate
      targets for future fire injury prevention programs.

PMID- 1641437
TI  - Hospital and community characteristics in closures of urban hospitals, 1980-87.
AB  - Characteristics of 190 urban community hospitals that were closed during the
      period 1980-87 and characteristics of the communities that they served were
      analyzed and compared to a control group of 380 urban hospitals that remained
      open. A negative association was found between hospital closure and four hospital
      characteristics: the presence of a cancer program approved by the American
      College of Surgeons, the combined characteristics of for-profit status and
      membership in a multi-institutional chain, the number of admissions, and the
      number of facilities and services offered. A positive association was found
      between hospital closure and the percentage of black residents in the community.
      These findings are discussed in the context of political and economic trends in
      health care and urban development. Implications for future research are noted,
      including managerial strategy for hospital administrators and the socioeconomic
      implications of hospital survival in declining urban communities.

PMID- 1641438
TI  - Participant evaluation and cost of a community-based health promotion program for
      elders.
AB  - There is little information on how best to provide health promotion and disease
      prevention services to elderly persons. This paper reports participants'
      perceptions of the effectiveness of a health promotion program consisting of
      health education classes and case management services. A single-group, posttest
      only design was used for the county-wide program, which operated independent of
      participants' primary care physicians. Each person received a thorough screening
      evaluation, was invited to health education classes, and was assigned a case
      manager for a 2-year health promotion period. Community residents 64-71 years of
      age were recruited; 475 entered the study, and 378 (79.6 percent) completed the
      followup evaluation interview. Only one-third of the participants attended at
      least one class, but a majority of those attending each class rated it very or
      extremely effective in increasing knowledge. To determine the effectiveness of
      the case managers, each participant identified the three health problems that
      were of greatest concern to him or her and indicated which of these priority
      problems were discussed with the case manager. Discussion with the case manager
      was significantly associated with continuing to see a personal physician for the
      problem, following the physician's recommendations, the problem's being under
      control, and the problem's improving over the 2-year followup. The classes and
      case management services benefited the participants who used them. How to best
      deliver these services to the target group needs further study.

PMID- 1641439
TI  - Exploratory study of the relationship between hypertension and diet diversity
      among Saba Islanders.
AB  - The relationship between diet diversity and hypertension was examined in a cross
      sectional exploratory study of 82 randomly selected adult residents of Saba
      Island, Netherlands Antilles, in the eastern Caribbean Basin. Blood pressure
      measurements, taken over 4 years, and the appropriate use of antihypertensive
      medications, were used to identify chronic hypertensives. A 24-hour dietary
      recall, semi-quantitative food frequency interviews, and ethnographic
      confirmation techniques were used to calculate diet diversity, a measure of the
      overall dietary pattern. Results suggest hypertension is associated with lack of
      an overall balance of food groups in the daily diet beyond any imbalance of a
      particular dietary cation such as sodium, potassium, or calcium. Bivariate
      analyses found a significant association between a poorly diversified diet and
      hypertension (odds ratio [OR] = 4.25, 95 percent confidence intervals [CI] =
      1.47,12.30). Dietary intake of sodium, potassium, and calcium was also examined
      and found not to be associated with the presence of hypertension in bivariate
      analyses. Including these cations individually in logistic regression models,
      which also included diet diversity, did not diminish the diet diversity
      hypertension association. Multiple logistic regression models in which other
      potential confounding variables were individually entered as a control variable
      (body fat, skin color, age, sex, perceived stress, alcohol intake, aerobic
      activity, and socioeconomic status) did not alter this result. Analysis of the
      presence or absence of individual food groups indicate a lack of legumes in the
      daily diet is also associated with the diagnosis of hypertension (OR = 4.71, 95
      percent CI = [1.71,13.01]).

PMID- 1641440
TI  - The neglected health care needs of street youth.
AB  - Juveniles who live on the street are often the victims of physical and sexual
      abuse and family chaos. They have a multitude of health problems such as
      malnutrition, respiratory infections, sexually transmitted diseases, including
      human immunodeficiency virus, mental illness, and substance abuse. Health care,
      if available, is generally fragmented and often not relevant to their needs.
      Their high-risk existence leads to individual morbidity and has a negative effect
      on the health of the community. Presently, there is limited research on the
      health status and health care needs of street youth who are difficult to track
      and quantify. The findings of a project undertaken by Region IX of the Public
      Health Service in 1989 to provide technical assistance to three primary care
      clinics serving street youth in San Francisco are reviewed. Data were collected
      on demographics, overall health status, sex-related medical problems, mental
      health, and substance abuse and compared with another group of adolescents in the
      general population. Street youth were found to have a greater number of problems-
      both physical and psychological--than the general adolescent population. High
      risk behaviors, such as drug abuse and failure to use condoms during sex, make
      this population especially vulnerable to sexually transmitted diseases, including
      human immunodeficiency virus. The potential impact on public health is enormous.
      Adequate access to health services needs to be addressed legislatively.

PMID- 1641441
TI  - Cholesterol treatment practices of primary care physicians.
AB  - The active involvement of primary care physicians is necessary in the diagnosis
      and treatment of elevated blood cholesterol. Empirical evidence suggests that
      primary care physicians generally initiate dietary and pharmacological treatment
      at threshold values higher than is currently recommended. To determine current
      treatment thresholds and establish factors that distinguish physicians who are
      more likely to initiate therapy at lower cholesterol values, 119 primary care
      physicians in four northern California communities were surveyed. Data collection
      included their demographic factors, treatment of hypothetical patients, self
      efficacy regarding counseling patients about cholesterol reduction and personal
      health behaviors, outcome expectations, and cholesterol knowledge and attitudes.
      Results indicated that 59 percent of respondents would not start dietary
      treatment on a middle-aged female patient with a cholesterol of 215 milligrams
      per deciliter (mg per dl). Only 44 percent of respondents indicated that they
      would initiate pharmacological therapy for a middle-aged man with a cholesterol
      of 276 mg per dl. Logistic regression models were used to determine
      characteristics that influenced dietary and pharmacological treatment practices.
      Younger physicians, those who had had their own cholesterol checked, and those
      who personally ate a low-fat diet, were more likely to recommend diet therapy to
      patients with modest elevations of cholesterol. Willingness to use lipid lowering
      medications at more marked elevations was associated only with increased self
      efficacy regarding use of drugs to lower cholesterol. These results indicate that
      physicians' personal health behaviors and self-efficacy should be addressed in
      interventions to modify cholesterol-related practice behavior.

PMID- 1641442
TI  - Using the Behavioral Risk Factor Surveillance System to monitor year 2000
      objectives among American Indians.
AB  - The Behavioral Risk Factor Surveillance System, a data set based on telephone
      surveys that have been conducted by States in collaboration with the Centers for
      Disease Control, has been used to estimate the prevalence of behavioral risk
      factors for adults in the United States so health objectives can be set and
      progress towards accomplishing them measured. Data for adult American Indians in
      this regard have not been available generally. The use of these data to estimate
      behavioral risk prevalence for American Indians by geographic region was examined
      and the results compared with those for white Americans. In addition, data from
      the system were compared with other data sets, including the results of selected
      surveys in American Indian communities, to explore the validity of the system as
      a tool for evaluating the behavioral risks of Indians. Behavioral Risk Factor
      Surveillance System data for the period 1985 to 1988 were used. During this
      period, the 1,055 American Indian respondents constituted 0.63 percent of those
      responding under the system and 0.70 percent of the population of the
      participating States. Separate (sex-specific) behavioral risk prevalence
      estimates were derived for Indians and whites for four geographic regions-
      Southwest, Plains, West Coast, and Other States. The system's behavioral risk
      estimates for the Plains region were compared with available data from behavioral
      risk surveys done in three American Indian communities in Montana (Blackfeet,
      Fort Peck, and Great Falls) from 1987 to 1989. The behavioral risk factors
      compared include use of automobile seatbelts, current smoking, current use of
      smokeless tobacco, heavy drinking, drinking and driving, overweight,
      hypertension, and sedentary lifestyle. Although large regional differences in the
      prevalence of these risk factors were found, the magnitude and direction of the
      differences are frequently similar among American Indians and whites living in
      the same geographic regions. The findings from the Behavioral Risk Factor
      Surveillance System among American Indians are largely consistent within
      dependently collected data from more resource intensive household surveys, at
      least when surveys in Montana are compared with system data from the Plains.
      These data are generally consistent with other epidemiologic studies.When they
      are used in conjunction with community-specific surveys, the Behavioral Risk
      Factor Surveillance System data may be useful for monitoring the progress of
      American Indians towards the Year 2000 national health objectives. The value of
      the surveillance system for monitoring trends in behavioral risk factors among
      Indians would be enhanced if States attempted to over sample regions (such as
      Indian reservations) with a high proportion of Indian residents. It appears that
      aggressive health promotion and disease prevention efforts will be needed if
      these objectives are to be achieved.

PMID- 1641443
TI  - Life expectancy by employment status, income, and education in the National
      Longitudinal Mortality Study.
AB  - Based on data from the National Longitudinal Mortality Study for 1979-85, life
      expectancies are estimated for white men and white women by education, by family
      income, and by employment status. Life expectancy varies directly with amount of
      schooling and with family income. Differences in life expectancy at age 25
      between the highest and the lowest levels of education completed were about 6
      years for white men and about 5 years for white women. For family income,
      differences between the highest and the lowest income groups were about 10 years
      for white men and 4.3 years for white women. The largest differences in life
      expectancy were between employment categories. At age 25, white men in the labor
      force lived on average about 12 more years than those not in the labor force, and
      white women lived on average about 9 more years. For those who were unable to
      work compared with those in the labor force, the difference for white men was
      about 20 years; for white women, 29 years. Results in this study showed much the
      same differentials in life expectancy for education as the earlier Kitagawa
      Hauser study.

PMID- 1641444
TI  - HIV infection treatment costs under Medicaid in Michigan.
AB  - The Michigan Medicaid Program payment records generated in the period 1985-89 by
      783 persons were analyzed for services related to human immunodeficiency virus
      (HIV) infection. Other data from death records and the Michigan AIDS Surveillance
      Registry were available for a subset of those persons. The average monthly
      payment in 1989 dollars for HIV-related services was $1,302.57. Services
      determined to be unrelated to HIV infection accounted for 12.5 percent of the
      total amount for health care received and another 2.5 percent was questionable.
      The average monthly expenditure for men was roughly twice that for women. The
      discrepancy did not exist among persons identified in the AIDS Surveillance
      Registry. Sex differences ceased to exist when Medicaid eligibility (disability
      versus Aid to Families with Dependent Children) was controlled for by analysis of
      variance. There were no significant differences between payments to those
      infected through male-to-male sexual contact and those infected through
      intravenous drug use. Payments for HIV treatments rose with age to about 40
      years, and declined slightly among older adults. The sharpest rise was for those
      ages 19-25 years and 26-35 years. Large sex differences existed among those who
      received zidovudine (AZT), 61.4 percent of the men and 19.1 percent of the women.
      Controlling for Medicaid eligibility moderated those differences, but they
      remained statistically significant. Differences in zidovudine usage were not
      found between men and women in the subset identified in the AIDS Surveillance
      Registry nor among persons infected through male-to-male sexual contact and
      intravenous drug use.

PMID- 1641445
TI  - Inappropriate lubricant use with condoms by homosexual men.
AB  - Use of condoms has been advocated as an important method of reducing the risk of
      human immunodeficiency virus (HIV) transmission among high-risk groups such as
      homosexual and bisexual men, prostitutes, intravenous drug users, adolescents,
      and hemophiliacs. Despite risk-reduction education campaigns directed to gay men
      since the early 1980s, evidence shows continued deficits in condom-use skills and
      knowledge among gay men. Because most failures in the use of condoms are
      attributed to errors in use, increasing knowledge and skills in condom use is
      important in preventing HIV infection. Two groups of homosexual and bisexual men
      were sampled, those entering a risk-reduction education program and participants
      in a Gay Pride event. They were surveyed on their current sex practices and their
      efforts to reduce their risk of HIV infection. They were asked about their
      numbers of sex partners, specific sexual behaviors, use of condoms, types of
      condoms used, and lubricants used for genital-anal sex. The characteristics of
      those surveyed were similar to those of respondents in other studies of risk
      reduction among gay men. The use of an oil-based lubricant with condoms has been
      shown to weaken latex and to increase the likelihood of condom breakage, which
      use of water-based lubricants does not. Among respondents who reported having
      genital-anal sex, 60 percent reported use of an oil-based lubricant with a condom
      at least once during the year before the survey. Gay men in sexually exclusive
      relationships engaged in less consistent use of condoms for receptive genital
      anal sex than did single gay men. The duration of their relationship with a
      partner was unrelated to the consistency of risk reducing behaviors practiced by
      men in sexually exclusive relationships. Gay Pride participants engaged in sexual
      behavior that was relatively more risky for HIV transmission than did the other
      group. Gay Pride participants used condoms less consistently for genital-anal sex
      than did the risk-reduction program entrants.The findings indicate the need for
      better risk reduction education efforts directed to gay men. Continued
      improvement in these efforts will require assessing the effectiveness and
      consistency of risk reduction efforts, determining the potential for gay men to
      relapse into more risky behavior, and identifying gaps in the knowledge of risk
      reduction efforts among gay and bisexual men. Risk reduction programs need to
      emphasize motivational factors, provide basic information on how one determines
      the content of lubricants, explain why water-based lubricants only should be
      used, and teach how to use condoms properly. Active outreach is needed to gay and
      bisexual men who are unlikely to voluntarily enroll in risk-reduction programs.

PMID- 1641446
TI  - Timeliness of notification in infectious disease cases.
AB  - Records of notification in cases of eight infectious diseases in the "Servei
      Territorial de Salut Publica" of the Province of Barcelona, Spain, between 1982
      and 1986 were reviewed. Time from onset of symptoms to notification, time from
      notification to completion of data collection, and time from onset to completion
      of the case investigation were analyzed. For the period from onset to
      notification, the shortest mean was registered for meningococcal infection (6.31
      days) and the longest was for pulmonary tuberculosis (54.79 days). For time from
      notification to complete investigation, the shortest value was for pulmonary
      tuberculosis (12.20 days) and the longest for rickettsioses (35.79 days). Time
      from onset to completion of data collection was 22.87 days for meningococcal
      infection and 72.34 days for tuberculosis of other organs (probably because of
      the long period of time that elapses between the onset of the first symptoms and
      notification). It would appear that both physicians and the general population
      must be educated so that lay-men can identify early signs and symptoms of disease
      and physicians can realize that statutory notification of infectious diseases is
      strongly linked to community health care.

PMID- 1641447
TI  - An outbreak of Bacillus cereus food poisoning--are caterers supervised
      sufficiently.
AB  - Bacillus cereus is an uncommonly reported cause of foodborne illness in the
      United States. In May 1989, an outbreak of B. cereus gastroenteritis occurred
      among 140 guests who had attended a catered wedding reception in Napa, CA.
      Investigation established Cornish game hens served at the event as the vehicle
      for disease transmission (OR = 29, P = 0.0001). Although the spores of B. cereus
      are ubiquitous, large numbers of toxin-producing organisms (more than 10(5) per
      gram of food) are required for illness to occur. In the Napa outbreak, bacterial
      multiplication was facilitated at several points during the preparation and
      transportation of the food. While a licensed restaurant kitchen was used, the
      facilities were clearly inadequate for the event. At present, the California
      Health and Safety Code does not address the scope of catering operations. As
      caterers increase in number, there will be a growing need for governmental
      oversight to ensure that food production on a large scale is conducted safely.

PMID- 1641448
TI  - Use of death certificates for mesothelioma surveillance.
AB  - Data from the Massachusetts Cancer Registry and death certificates were linked
      for mesothelioma cases reported to the registry from 1982 through 1987 to
      determine the extent to which the cause of death information that is given on the
      death certificate is useful in identifying mesothelioma cases for disease
      surveillance. Only 12 percent of all persons reported with mesothelioma who had
      died were detected using underlying cause of death codes for cancers of the
      peritoneum and pleura, which are commonly used to identify mesothelioma cases.
      The rate increased to 83 percent when death certificates were reviewed manually
      for any mention of mesothelioma. Surveillance using only the coded cause of death
      data currently available will result in a large underascertainment of
      mesothelioma cases.

PMID- 1641449
TI  - Johnson Foundation booklet describes AIDS care projects in 11 communities.

PMID- 1641450
TI  - Cervical enamel projection with gingival fenestration in a maxillary central
      incisor: report of a case.
AB  - Bacterial plaque has been implicated as the primary etiologic factor in the
      initiation and progression of periodontal disease. Anatomic factors, such as
      cervical enamel projections, enamel pearls, and radicular grooves, are often
      associated with advanced localized periodontal destruction. Enamel projections
      and pearls are most often associated with molars, while radicular grooves are
      usually located on the palatal aspect of maxillary incisors. Gingival
      fenestrations are of uncertain etiology and have rarely been reported in the
      dental literature. An unusual case is presented of a cervical enamel projection
      located on the facial aspect of a maxillary central incisor in association with
      gingival fenestration. Rationale for therapy and likely healing results are
      discussed.

PMID- 1641451
TI  - Computer-designed inlays after 5 years in situ: clinical performance and scanning
      electron microscopic evaluation.
AB  - Eight mesio-occlusodistal adhesive inlays, fabricated from ceramic blocks using a
      computer-aided design/machining method, were reexamined after 5 years of clinical
      service. The inlays wre evaluated according to modified US Public Health Service
      criteria. The results indicated excellent clinical performance, with eight Alfa
      ratings for wear, recurrent caries, and color match, and five Alfa and three
      Bravo for marginal discoloration and marginal integrity. Under scanning electron
      microscope, 81.0% of the tooth-cement interfaces and 84.1% of the cement-inlay
      interfaces were rated continuous at the occlusal margin. Axially, 73.6% of the
      tooth-cement interfaces and 87.0% of the cement-inlay interfaces were rated
      continuous. Although this long-term investigation revealed good clinical
      performance of the inlays, improvements in the ceramic structure and its
      properties, the cavosurface design, and the luting composite resin were recently
      introduced to further optimize quality.

PMID- 1641452
TI  - Excimer lasers in dentistry: future possibilities with advanced technology.
AB  - The thermal side effects of carbon dioxide and neodymium:yttrium-aluminum-garnet
      lasers limit their clinical applications. These high-powered, infrared lasers
      result in zones of charring and carbonization even in soft tissues and the bone.
      In contrast, the pulsed, ultraviolet radiation emitted by excimer lasers causes
      limited thermal, denaturative damage to surrounding tissues. Therefore, treatment
      of dental tissues with the nonthermal process of photoablation with excimer
      lasers may present alternatives to traditional dental practice. Possible future
      applications of the excimer laser include selective caries removal, the
      conditioning of tooth surfaces, and cleaning of root surfaces; the zones of
      necrosis are small, so that there is no residual debris.

PMID- 1641453
TI  - The in vitro effect of glass-ionomer cement restoration on enamel subjected to a
      demineralization and remineralization model.
AB  - The purpose of this in vitro study was to evaluate differences in initiation and
      progression of carieslike lesions around restorations in enamel. A
      demineralization/remineralization cycling model was used to induce experimental
      secondary caries around cavities restored with glass-ionomer cement or composite
      resin. The effects of these materials were compared by microhardness profiles.
      The results indicated that glass-ionomer cement showed potential value as a
      restorative material for the prevention or reversal of caries in enamel adjacent
      to restorations, even in situations of high cariogenic challenge.

PMID- 1641454
TI  - Modified internal bleaching of severe tetracycline discoloration: a 6-year
      clinical evaluation.
AB  - Since 1985, 534 severely discolored teeth have been treated with intentional
      endodontics and internal bleaching; of these, 258 were treated with the
      conventional technique and 276 were treated with the modified technique. Six
      years of clinical and radiographic evaluation revealed that the results obtained
      with the first group (conventional technique) remain stable and that a very
      noticeable improvement has been achieved with the second group of teeth, treated
      with the modified technique.

PMID- 1641455
TI  - Improved esthetics with a combined bleaching technique: a case report.
AB  - This paper describes a clinical case in which a combination bleaching technique
      was used to improve the appearance of the patient's discolored anterior teeth.
      Enamel microabrasion was used first to remove superficial fluorosis stains. A
      home bleaching regimen was then used to lighten the overall shade of the teeth,
      which had appeared more yellow after microabrasion.

PMID- 1641456
TI  - Management of rampant caries in children.
AB  - Because research has resulted in a better understanding of the etiology of dental
      caries as well as the introduction of new techniques and materials in the
      practice of dentistry, approaches toward the management of rampant caries should
      be reevaluated. The development of the acid-etching technique and the
      improvements in the physical properties and clinical performance of composite
      resins and glass-ionomer cements have completely changed the concepts of
      prevention, conservative dentistry, and dental esthetics. Several methods for the
      treatment of rampant caries are described and management of two cases is
      documented.

PMID- 1641457
TI  - The rationale and indications for equilibration in the primary dentition.
AB  - One type of malocclusion in the primary dentition is posterior crossbite caused
      by premature deflective occlusal interferences. The primary canines are the teeth
      that most frequently contribute to a laterally guided centric occlusion that
      creates a functional malocclusion. Because this is not a self-correcting
      situation, these types of posterior crossbites should be identified early and
      evaluated for possible correction through occlusal equilibration. A case that
      illustrates early correction of a unilateral functional posterior crossbite by
      equilibration and the 5-year results are presented.

PMID- 1641458
TI  - Enamel microabrasion: a microscopic evaluation of the "abrosion effect".
AB  - Enamel surfaces have been found to acquire a glasslike luster and an
      exceptionally smooth texture following enamel microabrasion procedures. A
      commercially available enamel microabrasion compound containing abrasive
      particles and a mild concentration of hydrochloric acid, when applied by rotary
      compression, simultaneously abrades and erodes (abrosion) the enamel surface.
      Human enamel surfaces were evaluated microscopically after routine enamel
      microabrasion procedures. The results show distinct evidence of enamel surface
      changes that have been described as the abrosion effect.

PMID- 1641459
TI  - Clinical evaluation of a new pressed glass ceramic inlay material over 1.5 years.
AB  - Ten IPS/Empress pressed glass ceramic inlays were cemented in box-shaped, non
      beveled, Class II, posterior cavities. They were evaluated clinically according
      to modified US Public Health Service criteria after 1.5 years in vivo. In
      addition, quantitative marginal analysis was performed immediately after
      placement of the inlays and at the 1.5-year recall. Clinical evaluation revealed
      that the inlays performed well after 1.5 years; all inlays received scores of
      Alfa or Beta for all criteria evaluated. Scanning electron microscopic
      examination indicated that the excellent initial marginal adaptation decreased
      significantly over 1.5 years.

PMID- 1641460
TI  - The effectiveness of an enzyme-containing denture cleanser.
AB  - The purpose of this study was to test the effectiveness of an enzyme-containing
      denture cleanser. During a 3-week period, 13 patients used Enzydent only for
      soaking the denture; during another 3-week period, the patients were instructed
      first to soak and then to brush their denture. The effectiveness of the cleanser
      was measured by microbiologic procedures. The results showed that soaking the
      denture in the enzyme-containing cleanser alone was as effective as the patients'
      previous regimen of denture hygiene, but that when soaking was used in
      combination with brushing, the denture became significantly cleaner.

PMID- 1641461
TI  - Postoperative infections and tetracycline prophylaxis in periodontal surgery: a
      retrospective study.
AB  - The aims of this retrospective study were to assess the incidence of infection
      after periodontal surgery, in relation to the type of surgical procedure, and the
      effectiveness of prophylactic tetracycline administration. Nineteen (4.4%) of 445
      surgical procedures in patients who were given no tetracycline resulted in signs
      of infection, while two (3.8%) in patients who were treated with tetracycline
      resulted in signs of infection. There was no statistically significant difference
      between these incidences, suggesting that there is no reason for routine
      tetracycline prophylaxis in periodontal surgery. There was no statistically
      significant difference in the incidence of infection whether or not bone
      (ostectomy or osteoplasty) or tooth extraction was involved in the surgical
      procedure.

PMID- 1641462
TI  - Effect of protraction headgear on Class III malocclusion.
AB  - Ten patients with skeletal Class III malocclusion in the early mixed dentition
      who were treated with maxillary expansion appliance and protraction headgear were
      compared with reasonably matched controls. Significant orthopedic effects were
      found after as little as 6 months of treatment. Cephalometric analysis revealed
      that the correction of Class III malocclusion was primarily a result of forward
      and downward movement of the maxilla and backward rotation of the mandible. The
      clinical result of one patient treated with this appliance is used to demonstrate
      the importance of force magnitudes and directions, as well as the design of the
      appliance, to the success of the treatment.

PMID- 1641463
TI  - The effect of early water contact on glass-ionomer cements.
AB  - The purpose of this study was to observe the effect of immersion in water at 3,
      5, 7, and 10 minutes after mixing on the surface of three regular and one light
      curing glass-ionomer cements by measuring penetration of a methylene blue
      solution. Early solubility of these cements was also measured and compared with
      that of a zinc phosphate and a polycarboxylate cement. A blue-stained zone was
      observed in all glass-ionomer cements, but an inner, opaque zone was observed in
      only two of the regular glass-ionomer cements. Extending the time between start
      of mixing and immersion in water decreased the width of both zones in all cements
      and markedly lowered the loss of substance from the surface of regular glass
      ionomer cements. However, time after mixing had no or only a limited effect on
      the loss of substance from the light-curing glass-ionomer cement, the zinc
      phosphate cement, or the polycarboxylate cement.

PMID- 1641464
TI  - Influence of sterilization on the corrosion resistance of high-speed dental
      handpieces.
AB  - Ball bearings of high-speed dental handpieces were sterilized by various
      procedures and examined under scanning electron microscopy for evidence of
      corrosion. The metallic parts of ball bearings (rings and spheres), if not
      correctly lubricated, were dramatically corroded in chemical vapor and steam
      sterilizer. The nonmetallic parts (the retainers made of phenolic resins)
      appeared to be more sensitive to heat treatments, as revealed by the occurrence
      of darkening and embrittlement phenomena. In the absence of correct lubrication
      procedures, the performance of high-speed dental handpieces appears to be
      adversely influenced by sterilization, mostly in wet environments. On the other
      hand, daily maintenance that follows the manufacturer's instructions reduces and
      delays the damage to a great extent.

PMID- 1641465
TI  - Failla Memorial Lecture. Is radiation all bad? The search for adaptation.

PMID- 1641466
TI  - Transient thermal and mechanical response of water subject to ionizing radiation.
AB  - The ultrafast transient (10(-14) to 10(-12)S) thermal and mechanical response of
      water subject to ionizing radiations of different linear energy transfers has
      been investigated in order to understand the initial events which lead to cell
      mutation and lethality. Based on computational fluid dynamics, the production of
      a "thermal spike" around the trajectory of a charged particle and subsequent
      diffusion of deposited heart are calculated for particles with linear energy
      transfer (LET) of 4, 40, and 400 keV/microns. A radiation damage region (that is,
      the so-called "thermal core") is identified, and the transient behavior of the
      thermal core is studied. The local and transient environment has a dimension of
      nanometers, a scale which is of critical interest in understanding mechanisms of
      radiation damage in cells. The radius of the thermal core, Dd, at temperatures
      (or internal energy density) of up to 1,000 K, is observed to increase with LET,
      L, as Dd (in nanometers) = C4.L (in keV/microns)0.6, where, for example, C4 =
      0.50 for T = 800 degrees C.

PMID- 1641467
TI  - Hit rates and radiation doses to nuclei of bone lining cells from alpha-particle
      emitting radionuclides.
AB  - Factors relating the local concentration of a bone-seeking alpha-particle emitter
      to the mean hit rate have been determined for nuclei of bone lining cells using a
      Monte Carlo procedure. Cell nuclei were approximated by oblate spheroids with
      dimensions and location taken from a previous histomorphometric study. The Monte
      Carlo simulation is applicable for planar and diffuse labels at plane or
      cylindrical bone surfaces. Additionally, the mean nuclear dose per hit, the dose
      mean per hit, the mean track segment length and its second moment, the percentage
      of stoppers, and the frequency distribution of the dose have been determined.
      Some basic features of the hit statistics for bone lining cells have been
      outlined, and the consequences of existing standards of radiation protection with
      regard to the hit frequency to cell nuclei are discussed.

PMID- 1641468
TI  - Determination of the acid dissociation constants for WR-1065 by proton NMR
      spectroscopy.
AB  - The acid dissociation constants for N-(2-mercaptoethyl)-1,3-diaminopropane (WR
      1065) were determined in D2O by 360- and 500-MHz NMR spectroscopy. Results
      obtained at 0.21 M initial ionic strength and 26 degrees C were corrected to 25
      degrees C yielding pKD1 = 8.28 +/- 0.04, pKD2 = 9.88 +/- 0.07, and pKD3 = 11.58
      +/- 0.03. Correction of these values for the effect of the deuterium isotope upon
      the ionization reaction yielded dissociation constants in water of pKH1 = 7.69 +/
      0.09, pKH2 = 9.35 +/- 0.09, and pKH3 = 11.10 +/- 0.08. Analysis of the changes
      in chemical shift with pD indicated that the first ionization occurs largely
      through ionization of the thiol group (approximately 67%) and to a lesser extent
      the secondary ammonium group (approximately 30%), whereas the third ionization
      involves mainly the secondary ammonium group (approximately 65%) and to a lesser
      extent the primary ammonium group (approximately 30%). Estimates of the
      microscopic pK values for WR-1065 were also obtained from the results.

PMID- 1641469
TI  - Variations in pO2 and pH response to hyperthermia: dependence on transplant site
      and duration of treatment.
AB  - It has been clearly established that changes in intratumor pO2 and pH occur
      following hyperthermia, and it has been hypothesized that these changes may, in
      some way, be related to the ultimate response (i.e., cure) of the lesion. The
      purpose of this study was twofold: first, to examine the changes in intratumor pH
      during the course of a hyperthermia treatment at biologically related end point
      "doses"; second, to examine the response of pO2 after treatment in a different
      lesion transplant site. During hyperthermia treatment of the tumor transplanted
      in the leg, intratumor pH was found to drop from a control value of 6.74 +/- 0.17
      to 6.47 +/- 0.13 within 15 min following the start of treatment. The values then
      remained relatively constant throughout the remainder of the treatment (either 1
      or 2 h at 43.5 degrees C). Following the subcurative (10% tumor cures at 30 days;
      60 min at 43.5 degrees C) treatment the pH began to rise immediately, while after
      the higher dose (60% tumor cures at 30 days; 120 min at 43.5 degrees C) a slight
      rise in pH was followed by a continuous drop in pH for up to 4 h, as we have
      reported previously. Oxygen response in the two transplant sites (leg and flank)
      was found to be remarkably different even though the tumor cure rate was
      identical for a given hyperthermia "dose" in terms of time and temperature. In
      the leg, only very low levels of oxygen can be measured in the tumor 24 h after
      treatment with either "dose" studied (all measured pO2 values less than or equal
      to 5 mm Hg). In the flank, the tumor response is dependent on hyperthermia
      "dose." Only 28% of measured oxygen values are less than or equal to 5 mm Hg 24 h
      following a subcurative "dose," while 4 h following the higher "dose" there is a
      nonsignificant trend toward hypoxia (approximately 65% of values less than or
      equal to 5 mm Hg) with a subsequent shift toward reoxygenation. These latter
      observations are contrary to results reported previously and tend to contradict
      some current theories regarding the physiological mechanisms associated with
      hyperthermia treatment.

PMID- 1641470
TI  - Nonlinear survival curves for cells of solid tumors after large doses of fast
      neutrons and gamma rays.
AB  - We have previously proposed that survival curves for cells of murine NFSa
      fibrosarcomas after exposure to fast neutrons might demonstrate curvature when
      the neutron doses reach a level high enough to cure the fibrosarcomas. We report
      here that this is the case. Murine NFSa fibrosarcomas growing in the hind legs of
      syngeneic mice were exposed to either gamma rays or fast neutrons. The tumors
      were removed and retransplanted into fresh recipients to obtain 50% tumor cell
      doses, from which the dose-cell survival relationship was constructed. Survival
      curves showed continuous bending down to 10(-7), and were well fitted using the
      linear-quadratic model. The alpha and beta values for neutrons were larger than
      those for gamma rays. When the surviving fractions at experimental TCD50 doses
      were calculated using these values, comparable figures were obtained for neutrons
      and gamma rays. The RBEs for neutrons were comparable for the TCD50 and TD50
      assays. Neutron RBE was independent of dose within a range of 5-28 Gy. The
      capacity of the tumors to repair the damage caused by large doses of neutrons was
      identical to that for small doses of neutrons, indicating that cells retained the
      capacity to repair neutron damage irrespective of the size of the dose.

PMID- 1641471
TI  - Hypoxia and resistance to hydrogen peroxide confer resistance to tumor necrosis
      factor in murine L929 cells.
AB  - The mechanism whereby tumor necrosis factor (TNF) kills mammalian cells is not
      well understood, although oxidative damage has been suggested by several
      investigators. Further, it is not known why cells vary in their responsiveness to
      TNF. We show that the cytotoxic effect of TNF toward TNF-sensitive L929 cells is
      blocked under hypoxic conditions, suggesting a critical role of molecular oxygen
      and reactive oxygen species. To test whether cellular resistance to reactive
      oxygen species could provide resistance to TNF, we derived a variant strain from
      L929 cells by chronic exposure to an oxidizing agent, hydrogen peroxide (H2O2).
      These cells exhibit marked resistance to TNF as well as to H2O2. This cross
      protection provides additional evidence that mechanisms of resistance to
      oxidative damage are causally related to TNF-induced cell death. Scatchard
      analysis of TNF binding did not reveal significant differences between the H2O2
      resistant line and the wild-type L929 line. On the other hand, analyses of
      antioxidant enzymes and glutathione levels in cells of the wild-type and the H2O2
      resistant lines revealed several potentially important differences. Before
      exposure to TNF, the H2O2-resistant variants have elevated catalase activity,
      decreased activity of total glutathione-S-transferase (GST), and similar
      superoxide dismutase (SOD) activities. Exposure to TNF led to alteration in
      CuZnSOD activity, and much more so in the variants than in the wild-type L929
      cells. However, no significant change in MnSOD activities in cells of either cell
      line was observed. Total GST activity was not altered appreciably by TNF in
      either cell line, but Western analysis showed that the level of alpha GST isozyme
      was increased and mu GST isozyme decreased in the H2O2-resistant variants.
      Furthermore, alterations in total glutathione content were observed in both the
      control and the variant cells.

PMID- 1641472
TI  - Analysis of radiation-induced micronuclei by fluorescence in situ hybridization
      (FISH) simultaneously using telomeric and centromeric DNA probes.
AB  - Fluorescence in situ hybridization using simultaneously a combination of DNA
      probes for the telomeric hexamer repeat (TTAGGG) and the centromerically repeated
      murine gamma-satellite DNA was applied to analyze the nature of radiation-induced
      micronuclei in mouse NIH 3T3 fibroblasts. After subtraction of spontaneously
      occurring micronuclei independent from the dose and time after irradiation,
      approximately 22% of the radiation-induced micronuclei did not reveal any
      hybridization signal. Approximately 17% showed one centromeric hybridization
      signal and about four telomeric signals, suggesting their origin from whole
      chromosomes. Almost 60% of radiation-induced micronuclei had telomeric signals
      only, suggesting their origin from acentric fragments. A fraction of micronuclei
      were found to contain two or more acentric fragments. Micronuclei derived from
      whole chromosomes or from multiple acentric fragments might, together with DNA
      synthesis in micronuclei, explain the occurrence of radiation-induced micronuclei
      with DNA contents greater than the largest chromosome arm.

PMID- 1641473
TI  - Induction by H2O2 of DNA and interphase chromosome damage in plateau-phase
      Chinese hamster ovary cells.
AB  - The induction by H2O2 of DNA breaks, DNA double-strand breaks (DSBs), and
      interphase chromatin damage and their relationship to cytotoxicity were studied
      in plateau-phase Chinese hamster ovary (CHO) cells. Damage in interphase
      chromatin was assayed by means of premature chromosome condensation (PCC); DNA
      DSBs were assayed by nondenaturing filter elution (pH 9.6), and DNA breaks by
      hydroxyapatite chromatography. Cells were treated with H2O2 in suspension at 0
      degrees C for 30 min and treatment was terminated by the addition of catalase.
      Concentrations of H2O2 lower than 1 mM were not cytotoxic, whereas concentrations
      of 40 and 60 mM reduced cell survival to 0.1 and 0.004, respectively. An
      induction of DNA breaks that was dependent on H2O2 concentration was observed at
      low H2O2 concentrations that reached a maximum at approximately 1 mM; at higher
      H2O2 concentrations induction of DNA breaks either remained unchanged or
      decreased. Damage at the chromosome level was not evenly distributed among the
      cells, when compared to that expected based on a Poisson distribution. Three
      categories of cells were identified after exposure to H2O2: cells with intact,
      control-like chromosomes, cells showing chromosome fragmentation similar to that
      observed in cells exposed to ionizing radiation, and cells showing a loss in the
      ability of their chromatin to condense into chromosomes under the PCC reaction.
      The fraction of cells with fragmented chromosomes, as well as the number of
      excess chromosomes per cell, showed a dose response similar to that of DNA DSBs,
      reaching a maximum at 1 mM and decreasing at higher concentrations. The results
      indicate that induction of DNA and chromosome damage by H2O2 follows a complex
      dependence probably resulting from a depletion of reducing equivalents in the
      vicinity of the DNA. Reducing equivalents are required to recycle the transition
      metal ions that are needed to maintain a Fenton-type reaction. The absence of
      cell killing at H2O2 concentrations that yielded the maximum amount of DNA and
      chromosome damage suggests that this damage is nonlethal and repairable. It is
      suggested that lethal DNA and chromosome damage is induced at higher
      concentrations of H2O2 where cell killing is observed by an unidentified
      mechanism.

PMID- 1641474
TI  - Reduction of levels of nuclear-associated protein in heated cells by
      cycloheximide, D2O, and thermotolerance.
AB  - Hyperthermia increases levels of nuclear-associated proteins in a manner that
      correlates with cell killing. If the increase in nuclear-associated proteins
      represents a lethal lesion then treatments that protect against killing by heat
      should reduce and/or facilitate the recovery of levels of the proteins in heated
      cells. This hypothesis was tested using three heat protection treatments:
      cycloheximide, D2O, and thermotolerance. All three treatments reduced levels of
      the proteins measured immediately following hyperthermia at 43.0 or 45.5 degrees
      C, with the greatest reduction occurring at 43.0 degrees C. In addition to
      reducing the proteins, thermotolerance facilitated the recovery of the proteins
      to control levels following hyperthermia. Thus thermotolerance may protect cells
      by both reducing the initial heat damage and facilitating recovery from that
      damage. Cycloheximide and D2O did not facilitate recovery of nuclear-associated
      proteins, suggesting that their protection against cytotoxicity related to the
      proteins resulted solely from their reduction of increases in levels of the
      proteins. All three treatments have been shown to stabilize cellular proteins
      against thermal denaturation. The results of this study suggest that the increase
      in nuclear-associated proteins may result from thermally denatured proteins
      adhering to the nucleus and that it is the ability of cycloheximide, D2O, and
      thermotolerance to thermostabilize proteins that reduces the increase in levels
      of the proteins within heated cells.

PMID- 1641475
TI  - The contribution of DNA and chromosome repair deficiencies to the
      radiosensitivity of ataxia-telangiectasia.
AB  - Cells derived from individuals with ataxia-telangiectasia (AT) are more sensitive
      to ionizing radiation and radiomimetic drugs, as evidenced by decreased survival
      and increased chromosome aberrations at mitosis when compared with normal cell
      lines. Our previous studies showed that, despite similar initial levels of DNA
      double-strand breaks (DSBs), AT cells express higher initial chromosome damage
      than do normal cells as demonstrated by the technique of premature chromosome
      condensation. However, this finding accounted for only a portion of the increased
      sensitivity (T. K. Pandita and W. N. Hittelman, Radiat. Res. 130, 94-103, 1992).
      The purpose of the study reported here was to examine the contribution of DNA and
      chromosome repair to the radiosensitivity of AT cells. Exponentially growing AT
      and normal lymphoblastoid cells were fractionated into cell cycle phase-enriched
      populations by centrifugal elutriation, and their DNA and chromosome repair
      characteristics were evaluated by DNA neutral filter elution (for DNA DSBs) and
      by premature chromosome condensation, respectively. AT cells exhibited a reduced
      fast-repair component in both G1- and G2-phase cells, as observed at the level of
      both DNA DSBs and the chromosome; however, S-phase cells showed nearly normal DNA
      DSB repair. The findings that AT cells exhibit an increased level of chromosome
      damage and a deficiency in the fast component (but not the slow component) of
      repair suggest that chromatin organization might play a major role in the
      observed sensitivity of AT cells. When survival was plotted as a function of the
      residual amount of chromosome damage in G1- and G2- phase cells after 90 min of
      repair, the curves for normal and AT cells approached each other but did not
      overlap. These results suggest that, although higher initial levels of chromosome
      damage and reduced chromosome repair capability can explain much of the
      radiosensitivity of AT cells, other differences in AT cells must also contribute
      to their sensitivity phenotype.

PMID- 1641476
TI  - Point mutations, deletions, and radiation carcinogenesis.

PMID- 1641477
TI  - The radiography essentials: an evolutionary perspective.
AB  - A review of all the Radiography Essentials since their inception in 1944 provides
      an insightful look into the history and dynamics of entry-level educational
      standards in radiography. As successive Essentials have been revised, more
      attention has been given to the clinical environment, a broadened and
      strengthened curricula and due process. Additionally, radiographers have gained
      greater autonomy in delivering professional entry-level education in radiography.

PMID- 1641478
TI  - Factors affecting student program and career selection.
AB  - This study uses a national sample of freshman radiography students to examine
      demographic data and factors that affected career and program choice. The data
      are discussed in terms of implications for marketing and recruitment strategies.

PMID- 1641479
TI  - An overview of methods in stereotactic radiosurgery.
AB  - Stereotactic radiosurgery delivers a single high dose of ionizing radiation to a
      radiographically well-defined, small intracranial target without delivering a
      significant proportion of the prescribed dose to the surrounding brain tissue.
      Three methods of delivering the radiosurgical technique include the gamma knife,
      heavy charged particle beams and external high-energy photon beams from linear
      accelerators.

PMID- 1641480
TI  - Evolution of a degree program: the Australian example.
AB  - The progression of undergraduate radiography programs from diploma to bachelor's
      degree level has become a reality in Australia. This article outlines the
      evolution, underlying philosophy and structure of the bachelor of applied science
      in medical radiations program conducted by the Department of Medical Radiations
      Science at the Royal Melbourne Institute of Technology.

PMID- 1641481
TI  - Organ donation: a crisis with a cure.

PMID- 1641482
TI  - Evaluation of the high-risk patient.

PMID- 1641483
TI  - [Development and future perspectives of PET technology].
AB  - The physical principle of PET is discussed, and its advantages compared with
      SPECT are presented. Starting from the status of PET today, future developments
      are discussed with special reference to three-dimensional acquisition and
      reconstruction.

PMID- 1641484
TI  - [The integration of positron emission tomography into noninvasive cardiovascular
      diagnosis].
AB  - Cardiac positron emission tomography is a noninvasive imaging modality that can
      be used to assess regional myocardial blood flow and metabolism. This combined
      noninvasive approach to the evaluation of acute or chronic injury to the
      myocardium is superior to all other imaging modalities. With increasingly
      widespread use of positron emission tomography it is becoming evident that
      patients with impaired left ventricular ejection fraction (less than or equal to
      35%) resulting from congestive heart failure and patients soon (72-96 h) after
      acute myocardial infarction in particular may benefit from definition of
      metabolically active myocardium to stratify therapeutic assessment.

PMID- 1641485
TI  - [Preoperative localization diagnosis in focal epilepsy using PET].
AB  - We present results of studies in which positron emission tomography was applied
      to the presurgical evaluation of epileptics. Emphasis is placed on results of PET
      studies with various tracers in partial epilepsies and on the use of PET in age
      related epileptic syndromes in children.

PMID- 1641486
TI  - [Positron emission tomography of the thorax. The current clinical status].
AB  - The non-invasive diagnostic assessment of thoracic lesions has been greatly
      enhanced by the use of positron emission tomography with metabolic active radio
      compounds such as fluor-18 labeled deoxyglucose. Four clinical fields of use were
      established: differential diagnostic evaluation of lesions (T-staging);
      classification of adenopathy (N-staging); therapy response monitoring; diagnostic
      evaluation of recurrence. The upcoming challenges for clinical use are limited
      availability and necessary technical and qualitative standardizations.

PMID- 1641487
TI  - [Positron emission tomography (PET) in the evaluation of tumor proliferation and
      follow-up of therapy in ear, nose and throat tumors].
AB  - The uptake of 18F-Deoxyglucose (FDG) was studied in vivo in patients with head
      and neck tumors with positron emission tomography (PET) in relation to the
      proliferation rate of these tumors. The quantitative analysis of the
      radioactivity concentrations revealed two groups, showing a high or a lower FDG
      uptake pattern. In both groups the FDG uptake and the proliferation rate were
      correlated with a flat slope of the regression function. It is suggested that
      these differences in uptake in histologically identical tumor populations may
      correspond to differences at the molecular level, e.g. differences in the amount
      of the glucose carrier, perhaps caused by activated oncogenes. Furthermore PET
      was applied to evaluate therapeutic effects in patients with advanced head and
      neck cancer. We found that multiple lymph node metastases in the same patient can
      show a different baseline metabolism and also different changes following
      therapy. Tumors were more sensitive to therapy than lymph node metastases. The
      growth rate and the change in FDG uptake were highly correlated with different
      regression functions for tumors and lymph node metastases. These data demonstrate
      that PET with FDG can be used to assess early chemotherapeutic effects. The
      information gained with PET can be included in the treatment planning in patients
      undergoing systemic chemotherapy.

PMID- 1641488
TI  - [Hemangioma of the left ventricle].
AB  - The authors describe the case of a histologically proven hemangioma in the left
      coronary artery of the left ventricle of a 24-year-old woman. The results of the
      different medical imaging methods applied are described and the treatment of
      cardiac angiomas is discussed.

PMID- 1641489
TI  - [A retroperitoneal space-occupying lesion following tumor nephrectomy].

PMID- 1641490
TI  - The treatment and management of neuroleptic malignant syndrome.
AB  - 1. The neuroleptic malignant syndrome was initially described as a disorder
      specifically related to neuroleptic usage with frequent fatal outcome. The
      observations of variant or mild cases of this syndrome as well as case reports on
      neuroleptic-malignant-like syndromes in the absence of neuroleptics raises the
      issue of the usefulness of this terminology and highlights the potential for
      inappropriate management of this "malignant" syndrome. It has been suggested that
      hypothalamic thermoregulatory responses may involve an interplay among
      noradrenergic, cholinergic and serotonergic pathways. Out treatment strategy is
      based on the pharmacology of neuroleptics and empirical data, verified in our own
      clinical practice and considers that it is often difficult to determine whether
      certain physiologic states are a consequence to or specific triggering factors.
      2. If a patient's temperature is less than 101, we emphasize vigorous treatment
      with anticholinergic agents, while simultaneously assessing the psychiatric need
      for neuroleptics versus medical risks. Given that the severe rigidity of NMS
      represents severe extrapyramidal effects of dopamine blockade, there is no reason
      to withhold anticholinergics in the absence of higher temperatures. Neuroleptics
      can be stopped at the discretion of the clinician even during circumstances when
      there is fever below 101. 3. In cases of severe EPS with fever greater than or
      equal to 101, we recommend stopping neuroleptics, treating with anticholinergics
      and starting with dopamine agonists. In the event of a poor response to dopamine
      agonists, a brief trial of dantrolene and/or benzodiazepines is recommended.
      Dantrolene should not be introduced for prolonged periods, since abnormal liver
      function studies have been observed in approximately 1.8% of patients. 4. In
      cases of extreme hyperpyrexia (fever greater than 103), clinicians should
      consider transfer to an ICU or another medical support. Extreme temperatures have
      been associated with potentially irreversible cerebellar or other brain damage,
      if not aggressively treated. If neuroleptics are later indicated, a 2 week
      interval after resolution of symptoms should be maintained before reinstituting
      neuroleptics. 5. In patients with severe EPS without fever, we emphasize
      aggressive use of anticholinergic therapy, while simultaneously considering the
      psychiatric need for neuroleptics versus medical risks. In all cases where a
      patient's swallowing, respirations or physical mobility is severely compromised,
      we suggest stopping neuroleptics. Anticholinergic agents should be continued for
      7 days after neuroleptics are stopped. If anticholinergic agents are unsuccessful
      after 2-3 dosages, dopamine agonists may be added, while simultaneously
      monitoring vital signs. It should be emphasized that severe EPS sometimes takes
      days to improve even after neuroleptic cessation and the addition of
      anticholinergics.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1641491
TI  - MRI-SPECT and PET-EEG findings on brain dysfunction in schizophrenia.
AB  - 1. In this article the author reviews a series of investigations on brain
      dysfunction in untreated schizophrenics using manumotor and music listening tasks
      as activation paradigms. Methods involved were EEG mapping, Single Photon
      Emission Computerized Tomography (SPECT; Xenon-133 inhalation method), Magnetic
      Resonance Imaging (MRI) and Positron Emission Tomography (PET; 11-2-Deoxyglucose
      as tracer). 2. Major signs of brain dysfunction yielded a "nonreactivity" on both
      motor and music stimulation in patients displaying marked negative
      symptomatology, as shown consistently by EEG Mapping, SPECT and PET. In contrast,
      first-break patients with predominant "positive" and without underlying negative
      symptoms showed signs of "normal" to "diffuse hyperactivation" on such
      stimulations, as demonstrated by EEG and SPECT imaging methods. 3. Interestingly,
      MRI planimetry of the size of the corpus callosum (CC) corroborated the above
      findings, showing a significantly larger CC in "positive" than "negative"
      patients. 4. Together with functional imaging findings of other working groups
      and recent neuropathological theories we finally raise some speculative
      neurophysiological hypotheses on brain dysfunction in subgroups of
      schizophrenics, which might have direct implications for treatment and follow-up
      of these patients.

PMID- 1641492
TI  - Effects of tobacco smoking on the topographic EEG II.
AB  - 1. Tobacco smokers are well aware of the long term hazards of tobacco smoking,
      yet they continue to smoke. Presumably people smoke because of short term gains
      due to nicotine. 2. The mechanism by which nicotine is a drug reinforcer still
      needs a great deal of study. The specific aim of the present study was to
      determine the effects of tobacco smoking on the topographic EEG of 12 hr deprived
      heavy tobacco smokers. 3. Seven normal adult tobacco smokers of mixed sex were
      recruited into the study and compared with six normal nonsmokers of similar age
      and sex. 4. A Grass Model 8-24D EEG and 16 different scalp monopolar electrodes
      were used to record the EEG using both ears as reference before and after
      smoking. EKG lead II was recorded on channel 17. Blood pressure was measured by
      auscultation. Exhaled CO was measured using a CO detector. Computer analysis of
      the EEG data was run of line on a Zenith 386/25 microcomputer using RHYTHM 7.1.
      The same system was used to store the EEG in digitized form. The maximum number
      of 4 sec artifact free epochs in a 3 min recording period with eyes open and then
      closed was used before and after low and high nicotine tobacco or sham smoking.
      5. The hypothesis of this research was confirmed, i.e., that tobacco smoking of
      high nicotine cigarettes (about 2.0 mg/cigarette) would cause a shift in EEG
      alpha rhythm to higher frequencies in more diffuse midline cortical structures.
      In other studies an increase in alpha rhythm has been correlated with an awake
      relaxed behavioral state. 6. A heart rate increase was a more sensitive index of
      tobacco smoking than an increase in arterial blood pressure. Exhaled smoking CO
      levels correlated with the nicotine and tar content of the cigarette.

PMID- 1641493
TI  - The treatment of affective disorder with carbamazepine: prophylactic synergism of
      lithium and carbamazepine combination.
AB  - 1. In order to examine the prophylactic interaction between lithium and
      carbamazepine (CBZ), 18 patients who had been treated prophylactically with a
      combination of lithium and CBZ (combination therapy), lithium alone (Li-therapy),
      or CBZ alone (CBZ-therapy) were investigated in terms of episode occurrence. 2.
      The results revealed that the duration of symptoms and the frequency of
      hospitalization per year were significantly lower in the combination therapy than
      in both the Li-therapy and the CBZ-therapy. 3. In 7 out of 18 patients, the best
      prophylactic effect was obtained during combination therapy and none of the
      parameters measured was definitely inferior to those measured during the two
      single therapies. 4. During combination therapy, serum lithium level was
      significantly lower than during Li-therapy in the CBZ responders, and the
      combination of the two drugs enabled the required concentrations of lithium to be
      decreased. 5. It was concluded that synergistic action and a decrease in required
      concentrations of lithium can be expected with the combined use of lithium and
      CBZ, especially in responders to CBZ.

PMID- 1641494
TI  - Thyrotropin responses to TRH and MHPG excretion before and after an
      electroconvulsive therapeutic course in depressed patients.
AB  - 1. TSH response to TRH, and urinary MHPG were investigated before and after an
      ECT course in 12 female patients with endogenous depression. 2. The changes
      caused by ECT treatment on these parameters were not significant. 3. A positive
      correlation (r = 0.75, p = 0.005) was found between the changes in TSH response
      and the changes in urinary MHPG excretion.

PMID- 1641495
TI  - Effects of mianserin in chronic schizophrenia.
AB  - 1. The efficacy of mianserin as a supplement in treating chronic schizophrenia
      was tested by monitoring the BPRS and plasma monoamine metabolites. 2. Twenty
      inpatients with schizophrenia were administered fixed doses of neuroleptics
      throughout the study. 3. A control BPRS scoring and blood sampling were done
      before mianserin administration. 4. Fixed doses of 60 mg/day of mianserin for 2
      weeks and flexible doses for 4 weeks were given orally in an open study for 6
      consecutive weeks, and no treatment followed for 1 additional week. 5. BPRS
      scoring was carried out once weekly, and blood samples were obtained after
      mianserin treatment. 6. Both total BPRS scores and scores for negative symptoms
      were decreased by mianserin treatment as compared with the control values. 7. 5
      HIAA concentrations of both responding patients and nonresponding patients to
      mianserin were increased after medication; however, 5-HIAA values of responding
      patients were lower than those of nonresponding patients. 8. HVA concentrations
      of the responding group were slightly increased by mianserin administration. 9.
      There were no significant changes in MHPG levels between the two groups. 10.
      These results suggest that the negative symptoms of schizophrenia are partly
      improved by mianserin treatment.

PMID- 1641496
TI  - Daily activity and persistent sleep-wake schedule disorders.
AB  - 1. Patients with disorders of entrainment to external time cues such as delayed
      sleep phase syndrome (DSPS) and non-24-hour sleep-wake syndrome (HNS) were
      treated with non-pharmacological interventions and/or pharmacological agents. 2.
      Resetting the circadian clock with chronotherapy was easy in all DSPS patients,
      but it was not as easy to maintain the reset rhythm without additional therapy.
      Triazolam was effective in treating the phase delay that reappeared after
      chronotherapy. 3. Vitamin B12 (methylcobalamin) was strikingly effective in some
      patients with DSPS or HNS. 4. All the adolescent patients who complained of
      inability to attend school finally returned to their classes after treatment.
      Maintaining the reset rhythm in adolescent patients was easier than in adults.

PMID- 1641497
TI  - Adjunctive imipramine for dysphoric schizophrenic patients with past histories of
      cannabis abuse.
AB  - 1. Twenty-one schizophrenic or schizoaffective patients with histories of
      cannabis abuse and operationally-defined syndromes of post-psychotic depression
      completed a double-blind trial of adjunctive imipramine added to their on-going
      medication regimen of fluphenazine decanoate and benztropine. 2. The imipramine
      treated patients had superior global outcome. 3. Subscales suggested that
      specific improvement occurred in imipramine-treated patients in the domain of
      depression-like features. 4. Psychotic symptomatology was not found to be
      exacerbated by the imipramine.

PMID- 1641498
TI  - Differential behavioral response in LEW/N and F344/N rats: effects of
      corticotropin releasing hormone.
AB  - 1. Previous studies have documented that LEW/N rats exhibit an inflammatory
      response when challenged with a variety of stressful stimuli while
      histocompatible F344/N rats do not. These differences are thought to be regulated
      by the HPA axis. 2. In order to examine behavioral correlates of suspected
      differences in HPA activity in these strains, the baseline response to an open
      field as well as the effects of 3 micrograms/rat of CRH i.c.v. were compared
      across strains. 3. Significant differences in the pattern of activity in the open
      field, rearing, and grooming, as well as effects of CRH were found between
      strains. 4. The differences found are consistent with the notion that differences
      in endogenous CRH may form the basis for the differential susceptibility of these
      strains to autoimmune disease, and provide a model to study genetic determinants
      of CNS-immune system interactions.

PMID- 1641499
TI  - Postnatal development of regional binding of corticotropin-releasing factor and
      adenylate cyclase activity in the rat brain.
AB  - 1. Corticotropin-releasing factor (CRF) plays a major role in the endocrine,
      autonomic and behavioral responses to stress. The distribution of CRF and CRF
      receptors in hypothalamic and extra-hypothalamic brain regions is consistent with
      its stress-related functions. 2. In most brain regions, CRF acts primarily, if
      not exclusively, through activation of the adenylate cyclase systems. 3. While
      previous studies have demonstrated the prenatal presence of CRF receptors, in the
      early postnatal period the abundance of CRF receptors relative to the magnitude
      of CRF-stimulated cAMP production suggests that CRF receptors are not fully
      linked to adenylate cyclase. 4. Because of our interest in the possible
      involvement of CRF signal transduction in the development of the neonatal stress
      response, we have examined postnatal development of CRF receptors in relation to
      adenylate cyclase activity in the rat. 5. CRF binding decreased significantly in
      the hippocampus and striatum from postnatal days 7-21. Basal adenylate cyclase
      activity peaked in the second-third week of postnatal life in each brain region.
      Preliminary studies suggest that early stress can alter the maturation of second
      messenger systems in the frontal cortex.

PMID- 1641500
TI  - Role of oxygen-derived free radicals on rat splanchnic eicosanoid production
      during acute hemorrhage.
AB  - The effect of superoxide dismutase (SOD), an oxygen-derived free radical
      scavenger, on rat splanchnic eicosanoid synthesis was examined following
      hemorrhagic shock. Anesthetized male rats were hemorrhaged to 30 mm Hg for 30
      minutes (Shock), killed, or treated with the shed blood (Shock plus reperfusion).
      The Shock plus reperfusion group was treated with saline vehicle or SOD (2500,
      5000, 7500, 10,000 or 15,000 U/Kg, i.v.) 15 minutes prior to the reperfusion of
      the shed blood. The superior mesenteric artery was removed in continuity with the
      end organ intestine (SV+SI) and perfused in vitro with oxygenated Krebs-Henseleit
      buffer (3 ml/min at 37 degrees C). Venous effluent was measured for basal release
      of 6-keto-PGF1 alpha, PGE2 and thromboxane B2 at 15, 30, 60 and 90 minutes of
      perfusion. The SV+SI compensated for acute shock by increased release of 6-keto
      PGF1 alpha (300%) (and not PGE2 or thromboxane B2) which was abolished by
      reperfusion of the shed blood following shock. Prior treatment of the Shock plus
      reperfusion group with 7500 U/Kg or more of SOD restored the increased release of
      SV+SI 6-keto-PGF1 alpha found following shock alone (p less than 0.05). These
      data provided indirect evidence that ODFRs contributed to endogenous SV+SI
      regulation of PGI2 synthesis and release during hemorrhagic shock and reperfusion
      of shed blood.

PMID- 1641501
TI  - Ovarian and uterine prostaglandin E2-9-ketoreductase activity in cyclic and
      pregnant ewes.
AB  - The regulation of luteal function in sheep appears to be dependent in part upon
      relative utero-ovarian concentrations of PGE2 and PGF2 alpha. Prostaglandin E2-9
      ketoreductase converts PGE2 (a putative antiluteolysin) to PGF2 alpha. Enzymatic
      activity was measured in a cytosolic subcellular fraction of luteal and
      endometrial tissues collected on days 10, 13 and 16 of the estrous cycle or
      pregnancy. Respective days represented times before, during, and after the
      critical period for maternal recognition of pregnancy. Preparations of enzyme
      were incubated in the presence of tritiated PGE2. Radiolabeled PGF2 alpha (ie.,
      product) was separated from PGE2 by gel filtration chromatography and quantified
      by liquid scintillation spectrometry. There were no significant differences due
      to time of tissue collection or pregnancy status in enzymatic activity of luteal
      tissues. Prostaglandin E2-9-ketoreductase activity isolated from endometria of
      open ewes was greater than their pregnant counterparts on days 13 and 16. Thus,
      the potential capacity of the ovine uterus to generate luteolytic PGF2 alpha from
      PGE2 substrate is elevated during an infertile estrous cycle.

PMID- 1641502
TI  - Interleukin-1 beta stimulates decidual stromal cell cyclo-oxygenase enzyme and
      prostaglandin production.
AB  - The cytokine interleukin-1 (IL-1 beta) increased prostaglandin production by
      decidual stromal cells in culture in a time and dose dependent manner. Optimum
      conditions for stimulation were found to be for 24 hours at a concentration of
      100 pg IL-1 beta/ml. An apparent increase in cyclo-oxygenase enzyme synthesis
      accompanied the increase in prostaglandin production, and both changes were
      inhibited by the protein synthesis inhibitor cycloheximide. This implicates
      protein synthesis in the stimulatory effects of IL-1 beta, which may be mediated
      through the increase in cyclo-oxygenase enzyme. A pre-incubation period of 72
      hours was found to be necessary to observe the stimulatory effect of IL-1 beta on
      prostaglandin production, but this did not seem to be due to any change in the
      sensitivity of the cells to IL-1 beta; the increase in the number of cyclo
      oxygenase positive cells was the same if IL-1 beta was added on day 1, day 2 or
      day 3 of culture, even though prostaglandin production was not stimulated on day
      1 or day 2. Cycloheximide increased prostaglandin production on the first two
      days of culture and had no effect on the third day of culture. This was
      interpreted as indicating that a factor inhibiting cyclo-oxygenase activity was
      synthesised during the initial period of culture, which prevented any increase in
      prostaglandin production following the increase in enzyme synthesis.

PMID- 1641503
TI  - NADP-dependent 15-hydroxyprostaglandin dehydrogenase is homologous to NAD
      dependent 15-hydroxyprostaglandin dehydrogenase and other short-chain alcohol
      dehydrogenases.
AB  - Human tissues contain two enzymes that catalyze the oxidation of the 15-hydroxy
      group of prostaglandins: NAD-dependent 15-hydroxyprostaglandin dehydrogenase
      which is fairly specific for prostaglandins and NADP-dependent 15
      hydroxyprostaglandin dehydrogenase with low specificity for prostaglandins. The
      recent determination of the amino acid sequence of the NAD-dependent enzyme has
      revealed similarities with a number of oxidoreductases with distinct
      specificities that constitute the short-chain alcohol dehydrogenase family.
      Comparison of the amino acid sequence of NADP-dependent 15-hydroxyprostaglandin
      dehydrogenase with the sequences of the NAD-dependent enzyme and other short
      chain alcohol dehydrogenases revealed the same similarities, identifying the NADP
      dependent enzyme as a short-chain alcohol dehydrogenase. The degree of homology
      between the two 15-hydroxyprostaglandin dehydrogenases is similar to the one
      between each of the two enzymes and other members of the family indicating an
      early evolutionary divergence of the two proteins.

PMID- 1641504
TI  - A retrospective study of 932 second trimester terminations using gemeprost (16,16
      dimethyl-trans delta 2 PGE1 methyl ester).
AB  - A retrospective study of 932 second trimester terminations between 12-27 weeks
      gestation was carried out to determine the efficacy of gemeprost for second
      trimester termination. A single course of 5 x 1 mg gemeprost pessaries was
      administered every three hours. If abortion had not occurred after the first
      course of pessaries, a further course of 5 x 1 mg pessaries was administered.
      Intravenous oxytocin was administered after 36 hours if abortion had not
      occurred. Eighty per cent and ninety five per cent of patients aborted within 24
      and 48 hours respectively. Of the remaining 5 per cent of women, 3 per cent
      aborted with escalating doses of oxytocin. In the remaining 18 (2 per cent)
      women, the pregnancies were electively terminated with an alternative method. The
      median induction-abortion interval was 18.0 hours and 15.0 hours in nulliparous
      and parous women respectively (P less than 0.0001). The number of pessaries
      required to induce abortion was not influenced by parity. Significantly more
      parous women bled more than 500 ml. The incidence of pelvic sepsis (0.1 per cent)
      and cervical tear (0.1 per cent) was low. Twenty six per cent of women had
      diarrhoea and 23 per cent vomited following administration of prostaglandin. This
      study confirmed the efficacy of gemeprost for second trimester termination of
      pregnancy. This method of termination is safe, non-invasive, simple and has a low
      complication rate.

PMID- 1641505
TI  - Eicosanoid synthesis and Helicobacter pylori associated gastritis: increase in
      leukotriene C4 generation associated with H. pylori colonization.
AB  - The importance of pro-inflammatory leukotriene C4 in Helicobacter pylori (H.
      pylori) associated gastritis in man is unknown. Fresh gastric biopsy specimens
      from 28 dyspeptic patients were obtained: 10 showed normal antral histology with
      no evidence of H. pylori, the remaining 18 patients exhibited histological
      gastritis and were H. pylori positive as assessed by histology, culture and
      urease test. Twelve of these 18 patients received 240 mg twice daily colloidal
      bismuth subcitrate for four weeks before re-endoscopy. Gastric biopsies from H.
      pylori positive patients were incubated under basal and Ca(2+)-ionophore mediated
      conditions: Radioimmunoassay analysis of the supernatant showed basal release of
      prostaglandin E2 and leukotriene C4 was slightly but not significantly elevated
      in H. pylori positive mucosa. However in H. pylori positive mucosa there was an
      85% increase in leukotriene C4 synthesis when biopsies were incubated with
      ionophore, compared to only 13% increase in H. pylori negative mucosa (p less
      than 0.02). After eradication of H. pylori by colloidal bismuth subcitrate, there
      was a clearance of inflammatory cell infiltrate as assessed by histology and a
      significant reduction in ionophore-mediated leukotriene C4 formation compared
      with before treatment (p less than 0.02). These results suggest that H. pylori
      gastritis is associated with increased capacity to generate leukotriene C4, which
      may amplify the damaging effects of the bacteria on gastric mucosa.

PMID- 1641506
TI  - [Inability to mourn. Does the diagnosis hold up against an evaluation? On
      psychological processing of the Holocaust in Germany].
AB  - The book The Inability to Mourn by Alexander and Margarete Mitscherlich appeared
      in 1967 and claimed to provide a diagnosis of the era in which it was written.
      Superficially at least, its public impact was considerable. Rereading the work 25
      years later, Tilmann Moser has profound misgivings as to the accuracy of the
      Mitscherlichs' diagnosis. He characterises the authors' approach as a mixture of
      analytic-cum-therapeutic, political and pedagogical attitudes and suggests that
      this was largely inappropriate to the task of identifying the actual psychic
      condition of the "generation of culprits" and of encouraging self-recognition and
      a disposition for change. Moser posits the "tragic paradox" that the people
      implicated in this crime require empathy if they are to genuinely break with the
      past.

PMID- 1641507
TI  - [The (in)ability to mourn in East and West Germany. What mourning could mean].
AB  - Together, the fall of the Berlin Wall, the reunification of Germany and the
      public reactions to the war in the Gulf form a syndrome that poses anew the
      question of the specifically German "ability to mourn". On the one hand, the
      author registers a continuing rejection of the onerous task of facing up to the
      reality of the past via recollection and mourning. On the other, she sees
      indications both on the individual and collective level that this rejection is
      beginning to crumble, thus encouraging the emergence of attitudes that challenge
      the validity of German "ideals" to an increasing extent.

PMID- 1641508
TI  - [German unification influenced by an unfinished psychosocial history].
AB  - The critical form of social psychology presented here is concerned with the
      modalities and results of German reunification. It proceeds from Freud's
      insistence on the functional autonomy of psychic dispositions and unconscious
      forms of identification vis-a-vis the political and economic spheres. With
      reference to earlier historical experience of the Germans as an "economic nation"
      the authors suspect that German reunification with the avowed "economistic"
      priority of establishing the same life conditions in East and West is once again
      suppressing those problems that are bound up with the post-fascist syndrome
      handed down from one generation to the next. With a view to casting light on the
      reunification process and the collective psychic potentials it has released, the
      authors supplement Freud's mass-psychology approach with Julia Kristeva's outline
      of a social psychology that hinges on the relationship between cosmopolitanism
      and the national idea.

PMID- 1641509
TI  - Interrelationships between protein phosphorylation and oligomerization in
      transport and chemotaxis via the Escherichia coli mannitol phosphotransferase
      system.
AB  - The membrane-bound enzymes II of the bacterial carbohydrate phosphotransferase
      system (PTS) are multifunctional: they are required for the transport,
      phosphorylation and chemotactic sensing of their substrates. An oligomer
      (minimally a dimer) of at least one of these PTS permeases, the Escherichia coli
      mannitol permease, appears to be necessary for this protein to optimally carry
      out these functions. Much indirect evidence is consistent with this hypothesis,
      and recent experiments show that transport and phosphorylation of, and chemotaxis
      to, mannitol in E. coli involves an intersubunit phosphotransfer reaction, which
      can only occur in a protein oligomer. Membrane topological studies of the
      mannitol permease also argue in favour of an oligomeric structure in the membrane
      which may be necessary to form the hydrophilic channel through which mannitol
      must traverse the phospholipid bilayer. The possibility that the oligomerization
      state of the mannitol permease is a target for regulation of its activity in vivo
      is proposed, but has not yet been explored experimentally.

PMID- 1641510
TI  - Identification of a lacZ gene in Vibrio cholerae.
AB  - Plasmids that express an enzymatically active beta-galactosidase in an
      Escherichia coli delta lac strain were isolated from libraries of recombinant
      plasmids containing Vibrio cholerae chromosomal DNA. Deletion analysis localized
      the gene responsible for beta-galactosidase activity on a 3.1-kb DNA fragment,
      and the gene product was identified as a protein of approximately 110 kDa.
      Primary sequence comparisons indicated that this V. cholerae gene is homologous
      to the E. coli lacZ gene. In contrast to the lac loci of other bacteria, no gene
      that could specify a lactose transport system was detected in the vicinity of the
      V. cholerae lacZ gene, which may account for the inability of this species to use
      lactose. In V. cholerae, portions of open reading frames encoding proteins
      homologous to the Alcaligenes eutrophus chrA and E. coli galR gene products were
      detected upstream and downstream from the lacZ gene, respectively.

PMID- 1641511
TI  - Detection of intraspecific DNA polymorphism in Streptococcus salivarius subsp.
      thermophilus by a homologous rDNA probe.
AB  - Three ribosomal probes from Streptococcus salivarius subsp. thermophilus were
      cloned. Sequence data demonstrate that their juxtaposition corresponds to an
      entire operon. They were used in order to study ribosomal operon number and
      organization. rRNA genes were shown to be clustered in the order 5'-16S-23S-5S-3'
      and the number of rrn loci to vary within the subspecies. The smallest of the 3
      probes was used for strain characterization. Substantial variability in
      hybridization patterns was observed among strains, resulting not only from,
      restriction fragment length polymorphism (RFLP) but also from the variability of
      ribosomal operon number.

PMID- 1641512
TI  - N-unsubstituted glucosamine residues and other modifications in murein of the
      obligatory chemolithotroph Thiobacillus neapolitanus.
AB  - Purified murein from Thiobacillus neapolitanus was poorly digested by lysozyme.
      It's sensitivity to the enzyme greatly increased after N-acetylation. The murein
      was found to contain 30 to 35% glucosamine residues lacking N-acetyl groups. It
      also contained phosphomuramic acid. Further modifications included amidation of
      diaminopimelic acid in the peptide side chains and a low alanine content. None of
      these modifications were found in the murein of another sulphur bacterium,
      Thiobacillus versutus.

PMID- 1641513
TI  - Molecular typing of Brucella with cloned DNA probes.
AB  - Brucella constitutes a single genomic species (B. melitensis); however, for
      epidemiological studies, methods are needed for discriminating strains within
      this genomic species. DNA samples from 112 Brucella strains were cleaved by
      restriction endonucleases and the fragments separated by agarose gel
      electrophoresis and transferred to nylon membranes. When the DNA fragments on the
      membranes were probed with 32P-labelled 16 + 23 S rRNA from Escherichia coli, a
      single rRNA gene restriction pattern was obtained after cleavage with all
      endonucleases tested (HindIII, EcoRI, SmaI, and XhoI) except BamHI. This
      indicated high genomic homogeneity within the single Brucella species. Of 30
      probes consisting of random Brucella DNA fragments cloned into lambda EMBL3, 20
      yielded a single BamHI restriction pattern per probe when applied to 112 Brucella
      DNA tested. However, 7 probes yielded 3 to 12 different patterns among DNA
      tested. These patterns more-or-less correlated with the classification of strains
      into biogroups (Melitensis, Abortus, Suis, Neotomae, Ovis and Canis) and biovars
      (18 biovars represented). Probe A was capable of separating biogroup Melitensis
      from the other biogroups. Probe C separated the set of biogroups Melitensis
      Abortus-Ovis from the other biogroups. By reference to the patterns obtained
      using 1 to 7 probes, the most frequently occurring biovars (Melitensis 1,
      Melitensis 3, Abortus 1, Abortus 3, Suis 2 and Ovis) could be distinguished from
      each other. Eight biovars showed more than one pattern with 1 to 7 probes. The
      proposed typing system should be useful for epidemiological subtyping and does
      not pose safety problems once the DNA has been extracted.

PMID- 1641514
TI  - Mycobacterium paratuberculosis binds fibronectin.
AB  - Fibronectin, an adhesive glycoprotein which is present in plasma and on many host
      cell surfaces of many host organisms, binds to certain bacterial pathogens. This
      study demonstrates the ability of Mycobacterium paratuberculosis (M.ptb) to
      interact with 125I-labelled fibronectin purified from bovine and ovine plasma.
      Two M.ptb strains were tested: a clinical isolate and a commercially available
      vaccine strain. Both strains showed significant fibronectin-binding activities of
      22 and 41%, respectively, whereas non-pathogenic M.phlei had almost no affinity
      for fibronectin. Binding activities were similar for ovine and bovine
      fibronectin. We found that fibronectin binding by M.ptb was (1) time-dependent,
      reaching saturation within 90 min, (2) specific, since it was inhibited by an
      excess of unlabelled fibronectin but not by albumin, (3) saturable, with an
      apparent dissociation constant of 1.25 x 10(-9) M and a maximal number of 1,600
      binding sites per bacterium, and (4) sensitive to detergents, proteases and heat
      treatments, indicating the protein nature of the responsible binding
      component(s). Scatchard plot analysis gave a straight line suggesting the
      presence of a single type of fibronectin receptor on M.ptb.

PMID- 1641515
TI  - [Isolation and characterization of a flocculating mutant of Saccharomyces
      diastaticus].
AB  - A flocculating strain of Saccharomyces diastaticus NRRL2416 was isolated after
      ethidium bromide mutagenesis and density gradient separation. Flocculation did
      not change the general characteristics of the strain. Flocculation was better on
      maltodextrin-containing media than on others. It was found to be calcium
      dependent and sensitive to growth conditions. The deflocculating effects of some
      sugars suggested that mannose may be involved in the mechanism of flocculation,
      as for strains of the FLO1 phenotypic group.

PMID- 1641517
TI  - Amplification of a particular DNA sequence in Streptomyces ambofaciens RP181110
      reversibly prevents spiramycin production.
AB  - Streptomyces ambofaciens RP181110 produces the macrolide antibiotic spiramycin.
      After treatment with ethidium bromide, 7 strains presenting an amplified sequence
      of DNA (ADS) were found in its progeny. These ADS were localized within the same
      amplifiable region of the RP181110 genome. It has been established that these
      amplified strains were non-producers (Spi-) and that the loss of one particular
      ADS was correlated with restoration of spiramycin production. Genome
      rearrangements such as deletions were detected on the same side of the
      amplifiable region in both amplified and deamplified strains.

PMID- 1641516
TI  - High levels of anti-Campylobacter-flagellin IgA antibodies in breast milk.
AB  - Several studies have shown the beneficial role of immunity against enteric
      Campylobacter sp. Circulating antibodies against flagellin and possibly maternal
      antibodies seem to protect against intestinal colonization by Campylobacter. Milk
      from women in Central Africa (n = 120) and in France (n = 31) were investigated
      for the presence of anti-flagellin antibodies. Results showed that most French
      and all African milk possessed anti-flagellin IgA but not IgG. The titres of anti
      flagellin IgA were elevated in colostrum and decreased in later milk. Specific
      activities were constant during lactation, suggesting constant antigenic
      stimulation. The fact that IgA but not IgG are elicited against flagellin could
      be due to an infection limited to the mucosal surface.

PMID- 1641518
TI  - Social environment and health--a social epidemiological frame of reference.
AB  - Growing interest in epidemiological studies and prevention has led to increased
      awareness of the importance of the social environment to health. In this field of
      research, which might be designated social epidemiology, there is today extensive
      research into the possible association between different types of social factors
      and ill-health in the population. This article presents a social epidemiological
      frame of reference and some social factors of importance when one is studying the
      relationships between the social environment and health. Important social factors
      in the model are social stratification, social network, social support and life
      style factors. Two other main categories of social factors in the model are
      circumstances and events related to social stratification or occupation and
      social network respectively. These may be factors in the external or internal
      work environment and variables describing the general activity level of the
      individual or different types of stressful social network-related life events.
      Other important factors in the model are physiological and clinical factors and
      three different types of health indicator. In the field of social epidemiological
      research, there is an increasing need for the development of theoretical models
      and frameworks as support in the analysis of social factors and health. These
      could be based on experience and tradition in both epidemiological research and
      the social sciences.

PMID- 1641519
TI  - Traditional risk-factor profile fails to explain striking geographical
      differences in IHD mortality among middle-aged men. The project "myocardial
      infarction in mid-Sweden".
AB  - An east-west gradient in cardiovascular mortality has been reported from the
      region of mid-Sweden. Postal questionnaire studies found that the risk factor
      distributions among middle-aged men were similar in areas with striking
      differences in cardiovascular mortality. In this study, 120 randomly selected 50
      year-old men in two high mortality communities in the west and 120 men from two
      low mortality communities in the east were invited to a health survey in which
      serum lipids and other risk factors were analysed. Total serum cholesterol, LDL
      cholesterol, HDL-cholesterol, and triglyceride levels were similar. Among fatty
      acids, stearic acid was high and arachidonic acid was low in the high mortality
      area. The levels of other traditional risk factors were the same. After taking
      these differences into account, the mortality differences remain large.

PMID- 1641520
TI  - Morbidity in early childhood, sex differences, birth order and social class.
AB  - STUDY OBJECTIVE: The aim of the study was to investigate the relationship between
      morbidity in early childhood and gender, birth order, and social class. DESIGN:
      The study used data collected in the Nijmegen Continuous Morbidity Registration.
      All presented morbidity and a number of personal data were available. SETTING:
      The survey population was regional; four general practices in the east of The
      Netherlands. PARTICIPANTS: The study population included all children born in the
      four practices from 1971 to 1984. They were followed up till the age of five
      (1537 children). MEASUREMENTS AND MAIN RESULTS: Morbidity of children in the
      first five years was allocated to three degrees of seriousness and to 14
      diagnosis groups. The morbidity of all children was analysed for boys and girls,
      first-born, second-born, and later-born children, and low, middle, and high
      social class. Boys presented more morbidity than girls; in particular, nervous
      disorders, lower respiratory tract infections, and accidents. First-born children
      presented more morbidity than later-born children; in particular, non-serious
      diseases, nervous disorders, and colds. Lower social class children presented
      more moderately serious and non-serious morbidity, colds, lower respiratory tract
      infections, and skin diseases. Logistic regression analysis showed that high
      social class, being the first-born child, and male gender were the most important
      factors related to presented morbidity in general practice. CONCLUSIONS: High
      social class, low social class, gender, and being the first-born child were, in
      this sequence, related to morbidity in early childhood presented to the general
      practitioner in this study population.

PMID- 1641521
TI  - Follow-up appointments at consultation clinics: consultants fail in knowing their
      own practice.
AB  - In National Health Care Systems excessive reappointments at consultative clinics
      can result in over utilization of those services and/or too much retention of
      patients which frustrates family physicians in their interest for continuity of
      care for chronic patients. In order better to understand many consultants'
      complaints about overwork, we examined the proportion of patients who were given
      follow-up appointments by type of specialty in 2840 consecutive services
      requested in a multispecialist centre of a prepaid system in Israel, analysing as
      well the suspected disparity between this proportion and the consultants'
      perceptions on this subject. The results of this study show that 44.7% of
      patients at consultant clinics were given follow-up appointments, and that there
      was a marked disparity between the real and the subjectively estimated rates of
      follow-up in surgical specialties (rate-ratio 2.4). This suggests that a problem
      exists in the knowledge that consultants have of the structure of their own
      practices.

PMID- 1641522
TI  - Risk factors for admission to a nursing home. A study of elderly people receiving
      home nursing.
AB  - Risk factors for permanent admission to a nursing home were studied in a
      prospective study of persons 70 years and over who received home nursing.
      Demographic data and use of psychotropic drugs were registered, and mental
      capacity, behaviour, and performance of activities of daily living (ADL-function)
      estimated. 214 patients received home nursing. 166 patients were available for
      the follow-up study after 16 months, of whom 31 had been admitted to a nursing
      home. Senile dementia and stroke were the most frequent diagnoses of admitted
      patients. Mental impairment, age, and amount of home nursing were associated with
      permanent admission to a nursing home. The odds for being admitted were 10.2
      (C.I. 2.3-44.4) times higher in moderately and severely mentally impaired persons
      than in not mentally impaired persons. The odds for admittance for those 85 years
      and over, compared with those younger than 80, were 5.0 higher (C.I. 1.6-15.6);
      and those receiving home nursing three times weekly or more had 3.8 (C.I. 1.4
      9.8) times higher odds than those with less help.

PMID- 1641523
TI  - Age and sex: underestimated selection criteria for referral to x-ray examination
      of the colon?
AB  - An analysis was made of 2416 consecutive patients who underwent a double-contrast
      barium enema at the Central Roentgen Institute in Oslo. Age, sex, and
      radiological findings were registered. The age and sex distribution among
      patients consulting in general practice and in our study was surprisingly
      similar. This suggests that age as a risk factor for colorectal neoplasms did not
      play a prominent role among the referring doctors. Colorectal cancer was more
      frequent in males (4%) than females (2%) (p = 0.03). Odds ratio adjusted for age
      was 2.1 (1.3-3.8). This may be due to few examinations performed in old age, and
      different patient behaviour when experiencing colorectal symptoms. The overall
      polyp frequency was 11%. The frequency increased significantly from the age group
      40-49.

PMID- 1641524
TI  - Oestriol in the prophylactic treatment of recurrent urinary tract infections in
      postmenopausal women.
AB  - A block randomized, double-blind, group-comparative, placebo-controlled study was
      conducted to assess the effect of oestriol on recurrent urinary tract infections
      in postmenopausal women. 40 women, median age 78 years (66-91), 20 in each group,
      were treated with oestriol three mg p.o. per day or corresponding placebo for
      four weeks, followed by one mg per day for eight weeks. The main response
      parameter was the number of urinary tract infections per week in the two
      treatment periods. Both oestriol and placebo reduced the number of infections per
      week significantly in both periods, compared with the pretreatment period. There
      was no difference between oestriol and placebo treatment in the first period. In
      the second period, however, oestriol treatment was significantly more effective
      than placebo (p = 0.05). Correspondingly, there was a significant difference
      between the two groups in the vaginal pH at the end of the study (p less than
      0.05). We conclude that oestriol reduces recurrent urinary tract infections in
      postmenopausal women.

PMID- 1641525
TI  - Early detection of patients with fast progressive asthma or chronic bronchitis in
      general practice.
AB  - The morbidity and mortality due to asthma and chronic bronchitis are still rising
      in several countries. The aim of this study was to investigate whether early
      detection of patients with fast progressive asthma or chronic bronchitis in
      general practice was possible from a cross-sectional assessment of symptoms,
      smoking behaviour, quality of life, physical signs of the chest, allergy, and
      lung function. Data of 162 patients who had participated in a long-term
      randomized controlled intervention study in general practice were analysed. Fifty
      six out of the 162 patients showed fast progressive disease (FPD, a rapid annual
      decline in FEV1 in combination with a high exacerbation rate). Measurements at
      the start of the study were used in a logistic regression analysis in order to
      detect the patients at risk (with FPD). A lower maximal expiratory flow at 50% of
      expired volume (MEF50) was related to an increased risk of FPD in both asthma and
      chronic bronchitis (relative risks of 16.8 and 8.0 respectively, p less than
      0.05). Most lung function indices, but also quality of life and pack years, were
      significant predictors of FPD in chronic bronchitis (p less than 0.05). However,
      it was not possible to detect FPD reliably with these predictors separately or
      even with the combination of several relevant clinical variables; 18% of the
      patients with chronic bronchitis and 22% of the patients with asthma were still
      misclassified. It was concluded from this study that more than one measurement
      over time (monitoring) is necessary to detect the patients at risk. Monitoring
      should include assessments of objective ventilatory function indices (PEFR, FEV1
      or MEF50).

PMID- 1641526
TI  - Case-mix analyses in long-term care institutions in Stockholm.
AB  - In order to describe the patient case-mix in long-term care, several methods have
      been developed. One resource-based method, Resource Utilization Groups, RUGs,
      developed in New York and validated in several U.S. states, has also been
      validated in Stockholm and used there for studying various types of geriatric
      institutions. The variables used in this analysis, the distribution of the RUG
      categories, an ADL-index, and a case-mix index, show differences between
      geriatric departments, local nursing homes, mixed institutions, and private
      nursing homes. The geriatric departments show a high percentage of patients
      undergoing rehabilitation, a high case-mix index, and a relatively low ADL-index.
      In the local nursing homes, there is a majority of patients with behaviour
      problems and reduced physical functions. They show a low case-mix index but also
      a low ADL-index. Mixed institutions show results lying between these two types of
      institutions. The costs of the institutions, however, do not correlate well to
      the case-mix. This raises issues on efficiency and the need for new reimbursement
      models in geriatric care.

PMID- 1641527
TI  - Should we accept your article?

PMID- 1641528
TI  - Separation and distress--sickness absence and health screening in newly divorced
      middle-aged Swedish men.
AB  - The present study aimed at a description of the sickness absence pattern during
      1982-1989 in 32 men who divorced in 1984. Another purpose was to carry through a
      health screening of the men within six months after the marital disruption
      focusing on risk factors concerning cardio-vascular disease (smoking, overweight,
      hypertension) and high alcohol consumption (elevated GGT). The year of divorce
      and the successive three years (1984-1987) were characterized by high sickness
      rates (average 21,7 days/year, variation 19,4-26,6) compared to a reference group
      (average 16,6, variation 14,9-18,1). In the remaining four years (1982-1983 and
      1988-1989) the sickness absence was lower in the divorced group (average 12,2,
      variation 8,7-18,0, reference group: average 17,3, variation 14,8-20,0). The
      increase was mainly due to short absence periods (self-certifications). The
      health screening (health examination and record analysis) (n = 29) revealed high
      frequency of daily smoking and alcohol overconsumption. Overweight and
      hypertension were not overrepresented. The findings are discussed in relation to
      a supposed male reaction style to separation. The impact of social isolation is
      stressed.

PMID- 1641529
TI  - Health of the elderly with regard to sleep and nocturnal micturition.
AB  - A questionnaire study was carried out among pensioners in Jamtland County,
      Sweden. The questionnaire was answered by 1,115 persons, representing a response
      rate of 74%. It covered various aspects of health, with emphasis on sleep,
      fatigue, thirst, and other symptoms that may interfere with night-time sleep. The
      data were analysed with regard to the stated number of night-time disturbances
      due to urination. Nocturnal micturition was often associated with increased sleep
      disorders, a poorer quality of sleep, increased thirst, particularly at night,
      and increased fatigue in the daytime. All the relationships were clearer in women
      than in men. There was no relationship between reported enuresis in childhood and
      an increased frequency of voiding when the subject became older.

PMID- 1641530
TI  - The content of the oral daily reports at a long-term ward before and after staff
      training in integrity promoting care.
AB  - This study was based on the assumption that the daily report between different
      caregivers are of great importance for the quality of the care delivered and that
      they guide the content of it. The staff of a nursing home ward were given
      training in integrity promoting care and special training in reporting. After a
      three months' intervention period effects on patients and staff were evaluated
      and compared with a control ward. Positive patient outcomes have been reported
      earlier. The aim of this study was to describe the content of the oral daily
      reports between staff members in long-term care and investigate whether some
      changes occurred after training that might have contributed to the positive
      results for the patients. Another aim was to assess whether the staff regarded
      the reports as satisfactory. Oral reports were tape-recorded before and after
      staff training. A content analysis by a scheme based on Henderson's description
      of components of nursing care and a form analysis based on the nursing process
      were made. The reports were highly task oriented and the staff often discussed
      the patients' reaction in vague and general terms. The steps of the nursing
      process did not seem to be used. The answers to a questionnaire about the staff's
      satisfaction with the oral reports showed some increasing dissatisfaction and
      also comments about needs of more collaboration between different groups of
      personnel. More messages were given per report after the intervention compared to
      the control ward and the messages with psychosocial content had doubled.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641531
TI  - Risk factors responsible for patients' falls.
AB  - The study determined intrinsic factors which contributed to the falls of adults
      hospitalized in a general hospital during 1987-88. Two hundred and fourteen
      patients were studied in two groups. Group A consisted of 108 patients who fell
      during their hospitalization and control Group B consisted of 106 patients with
      the same characteristics also hospitalized during the same period who did not
      fall. Of the 23 variables which have been analyzed by the multivariate logistic
      regression method, seven present statistically significant incidence and
      increased risk of patients' falls: (1) gender: the number of accidents occurring
      among male patients was higher than that among females (p = 0.0022); (2) age: the
      majority of accidents occurred in the 65 greater than or equal to years old age
      group (p = 0.00426); (3) general pathological conditions: mostly patients with
      cardiac problems (p = 0.0062); (4) neoplasms (p = 0.0334); (5) anaemias (p =
      0.0128); (6) post-operative conditions (p = 0.0063); and the taking of
      hypnotic/tranquilizer drugs (p = 0.0486). Other significant findings were: the
      highest incidence of falls occurred during the first 4 days of the patients'
      admission to hospital and most during the early morning hours (5-6 am). Injuries
      incurred were bruises (32.4%), minor injuries (24%), major injuries (16.7%) and
      fractures (10.2%). The high correlation between patients' falls and (1) specific
      diseases, namely neoplasms, anaemias, cardiac and post-operative conditions and
      (2) the taking of hypnotic/tranquilizer drugs are risk factors in relation to
      patients' falls in general hospitals.

PMID- 1641533
TI  - The European Association of Science Editors.

PMID- 1641532
TI  - The alleviation of suffering--the idea of caring.
AB  - Caring science is seeking a basic category or the primary form of caring, the
      focus of caring science which includes the meaning of caring. Caring science does
      not deny the presence of suffering, even though it aims at soundness and health;
      suffering is the point from which it begins. Not until the patient has come to
      terms with his suffering can he hope to recover. Suffering is the most important
      basic category of all caring. It gives caring a unique quality and soundness and
      is something which all forms of caring aim to alleviate. Real caring is not just
      an abstract idea, philosophy or ideology, it is concrete work confronting
      suffering in real situations.

PMID- 1641534
TI  - Medical laboratory technologists' perception of professional self. A study of
      Swedish MLTs employed in clinical chemistry.
AB  - The subjective perception of professional self was studied for a sample of
      Medical Laboratory Technologists (MLTs) employed in Clinical Chemistry in Sweden.
      The sample (N = 488) consisted of a randomized tenth of members of their trade
      union. A mailed questionnaire with 21 items concerning self-description compared
      with peers in a seven-point Likert type scale was completed by 332 (68%). There
      was no significant overall difference concerning the four principal types of
      workplace: Clinical Chemistry, Blood Serology, Primary Care and Clinical
      Chemistry/Blood Serology. The main difference was found between those in
      managerial posts (N = 72) and the other MLTs (N = 260). Factor analysis showed
      three principal components, labelled Professionalism, Work Ethic, and Empathy,
      but also a different composition of variables of the components for the manager
      group compared with the non-manager group.

PMID- 1641535
TI  - Knowledge, expectations and experiences of patients receiving chemotherapy for
      breast cancer.
AB  - The experiences of a cohort of 60 women receiving chemotherapy in treatment of
      breast cancer were monitored in an in-depth prospective study. The purpose of the
      investigation was to identify ways in which nurses could improve the preparation
      and support of patients undergoing chemotherapy. It was found that patients'
      knowledge of chemotherapy was limited and that the side-effects they experienced,
      and their reactions to these, were rather different and more diverse than had
      been expected. The study illustrates the value of exploring patients' perceptions
      of their problems and needs for information and support.

PMID- 1641536
TI  - Variation in obstetric interventions by midwife.
AB  - This paper reports variation in birth interventions by 25 midwives among 2,135
      births in a Finnish hospital. The rate of cesarean sections varied from 0 to 18%,
      and that of instrumental deliveries from 0 to 8%. Mother's and infant's
      characteristics and rates of vaginal breeches suggest that a low rate of cesarean
      sections was not explained only by selection to easy births. This study suggests
      that the skills, attitudes and routines of midwives may explain part of the
      variation found in birth interventions.

PMID- 1641537
TI  - Patient involvement in decision-making in surgical and orthopaedic practice.
      Effects of outcome of operation and care process on patients' perception of their
      involvement in the decision-making process.
AB  - As part of the project Perioperative Risk,--an epidemiological study of
      complications associated with surgical and orthopaedic operations--the article
      reports a study of patients' perception of their involvement in decision-making
      in medical consultations, and how the outcomes of surgery and subsequent care
      determine patients' evaluation of the treatment. Patients' view of their
      involvement in the decision-making process was obtained before as well as after
      surgery. The results reveal that the more satisfied the patients were with the
      outcome of the operation, and the post-operative situation, the more they were
      inclined to assume responsibility for the decision to have surgery. The opposite
      response pattern, indicating a negative evaluation of either the operation or the
      post-operative care, resulted in an outcome where patients described others-
      especially the physician--as being responsible for the decision to have surgery.
      The results suggest that patients' evaluations of surgery are based upon a more
      global reaction to what happened during the entire care process. Dissatisfaction
      with either the operation or the post-operative care leads to a negative outcome
      in terms of patients' perceptions of their own involvement. This emphasizes the
      importance of all health care professionals seeing themselves as a team with
      complementary responsibilities for success in health care.

PMID- 1641538
TI  - Diagnostic reasoning in the care of a vocally disruptive severely demented
      patient. A case report.
AB  - In order to investigate the effect of nursing investigations based on diagnostic
      reasoning and research findings on vocally disruptive behaviour in a severely
      demented patient a single subject study was set up. The nursing diagnoses
      described problems that seemed connected with sensory deprivation and care that
      had not been adapted to the patient's abilities. The vocally disruptive behaviour
      decreased when the nursing treatment plan was followed. When the caregivers
      stopped following the care plan the disruptive behaviour increased. Another
      intervention was made and once again the disruptive behaviour decreased. In
      conclusion the study showed that nursing diagnoses and orders were not enough.
      The caregivers must also understand the importance of following the care plan and
      cope with the emotional reactions evoked by the care. Effective leadership,
      regular supervision of and support to the caregivers seem necessary.

PMID- 1641539
TI  - The role of massage in preparation for and recovery from exercise. An overview.

PMID- 1641540
TI  - Physiology applied to field hockey.
AB  - Field hockey is a sport with a long history that has undergone quite rapid and
      radical change within the past decade. The advent of the synthetic playing
      surface has changed the technical, tactical and physiological requirements of the
      game at all levels, but in particular at the elite level. In order to cope with
      the technical evolution within the game, the hockey player has also had to
      develop physiologically to meet the physical standards required at elite levels.
      Analysis of the physiological cost and energy expenditure of playing hockey has
      placed it in the category of 'heavy exercise', with reported VO2 values during a
      game of 2.26 L/min. Energy expenditure has been estimated to range from 36 to 50
      kJ/min. Physiological profiling of female hockey players has shown that
      somatotype tends towards 3.5/4.0/2.5. Figures for percentage body fat in female
      players range from 16 to 26%. Anaerobic power output has been shown to compare
      favourably with other groups of sportswomen and has also been shown to be a
      discriminating factor between elite and county level female players. Aerobic
      power amongst female players has been shown to range from 45 to 59 ml/kg/min. The
      reported somatotypes of male hockey players have shown considerable variation but
      there seems to be a trend away from ectomorphy towards mesomorphy. Anaerobic
      power output in male players has been shown to be the same as that of soccer
      players and better than other sports, e.g. basketball and also higher than
      reference norms. The range of aerobic power reported in the literature is 48 to
      65 ml/kg/min and it would appear that an aerobic power in excess of 60 ml/kg/min
      is required for elite level play. The physical strain of hockey play has been
      shown to be considerable, in particular with respect to spinal shrinkage. There
      is a greater injury risk inherent in playing on synthetic surfaces than on grass.

PMID- 1641542
TI  - Energy expenditure, aerodynamics and medical problems in cycling. An update.
AB  - The cyclist's ability to maintain an extremely high rate of energy expenditure
      for long durations at a high economy of effort is dependent upon such factors as
      the individual's anaerobic threshold, muscle fibre type, muscle myoglobin
      concentration, muscle capillary density and certain anthropometric dimensions.
      Although laboratory tests have had some success predicting cycling potential,
      their validity has yet to be established for trained cyclists. Even in analysing
      the forces producing propulsive torque, cycling effectiveness cannot be based
      solely on the orientation of applied forces. Innovations of shoe and pedal design
      continue to have a positive influence on the biomechanics of pedalling. Although
      muscle involvement during a complete pedal revolution may be similar, economical
      pedalling rate appears to differ significantly between the novice and racing
      cyclist. This difference emanates, perhaps, from long term adaptation. Air
      resistance is by far the greatest retarding force affecting cycling. The
      aerodynamics of the rider and the bicycle and its components are major
      contributors to cycling economy. Correct body posture and spacing between riders
      can significantly enhance speed and efficiency. Acute and chronic responses to
      cycling and training are complex. To protect the safety and health of the cyclist
      there must be close monitoring and cooperation between the cyclist, coach,
      exercise scientist and physician.

PMID- 1641541
TI  - Oxidation of carbohydrate ingested during prolonged endurance exercise.
AB  - Classic studies conducted in the 1920s and 1930s established that the consumption
      of a high carbohydrate (CHO) diet before exercise and the ingestion of glucose
      during exercise delayed the onset of fatigue, in part by preventing the
      development of hypoglycaemia. For the next 30 to 40 years, however, interest in
      CHO ingestion during exercise waned. Indeed, it was not until the reintroduction
      of the muscle biopsy technique into exercise physiology in the 1960s that a
      series of studies on CHO utilisation during exercise appeared. Investigations by
      Scandinavian physiologists showed that muscle glycogen depletion during prolonged
      exercise coincided with the development of fatigue. Despite this finding,
      attempts to delay fatigue during prolonged exercise focused principally on
      techniques that would increase muscle glycogen storage before exercise. The
      possibility that CHO ingestion during exercise might also delay the development
      of muscle glycogen depletion and hence, at least potentially, fatigue, was not
      extensively investigated. This, in part, can be explained by the popular belief
      that water replacement to prevent dehydration and hyperthermia was of greater
      importance than CHO replacement during prolonged exercise. This position was
      strengthened by studies in the early 1970s which showed that the ingestion of CHO
      solutions delayed gastric emptying compared with water, and might therefore
      exacerbate dehydration. As a result, athletes were actively discouraged from
      ingesting even mildly concentrated (greater than 5 g/100ml) CHO solutions during
      exercise. Only in the early 1980s, when commercial interest in the sale of CHO
      products to athletes was aroused, did exercise physiologists again begin to study
      the effects of CHO ingestion during exercise. These studies soon established that
      CHO ingestion during prolonged exercise could delay fatigue; this finding added
      urgency to the search for the optimum CHO type for ingestion during exercise.
      Whereas in the earlier studies, estimates of CHO oxidation were made using
      respiratory gas exchange measurements, investigations since the early 1970s have
      employed stable 13C and radioactive 14C isotope techniques to determine the
      amount of ingested CHO that is oxidised during exercise. Most of the early
      interest was in glucose ingestion during exercise. These studies showed that
      significant quantities of ingested glucose can be oxidised during exercise. Peak
      rates of glucose oxidation occur approximately 75 to 90 minutes after ingestion
      and are unaffected by the time of glucose ingestion during exercise. Rates of
      oxidation also appear not to be influenced to a major extent by the use of
      different feeding schedules.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1641544
TI  - Application of lasers in bladder cancer.
AB  - The Nd:YAG laser enables endoscopic destruction of bladder tumors under excellent
      viewing conditions in a specific and calculable way for induction of homogeneous
      necroses with simultaneous occlusion of blood and lymphatic vessels. The low
      local relapse rate, in contrast to that with TUR, is remarkable. By Nd:YAG laser
      application in combination with or without pelvic lymphadenectomy we were able to
      reduce the cystectomy rate significantly in recent years.

PMID- 1641543
TI  - Cerebral concussion in sport. Management and prevention.
AB  - This article explains the various stresses (tensile, compressive, and shearing)
      that can affect the brain, and how they may produce the different types of brain
      injury. The biomechanical forces and dynamics that produce coup versus contra
      coup injury are covered, as are the common intracranial athletic head injuries,
      i.e. concussion and the various intracranial haematomas (epidural, subdural,
      subarachnoid and intracerebral). Though less common in occurrence, because their
      outcome is so catastrophic, space is also devoted to the recognition, the
      treatment and (especially in the latter case) the prevention of the malignant
      brain oedema syndrome of the adolescent and the second impact syndrome of the
      adult. A major emphasis of this paper is the recognition of the 3 grades of
      cerebral concussion and the delineation of clear guidelines as to when it is safe
      to return to collision sports after sustaining such injuries, for the first,
      second or third time during a given season. Clear guidelines are also presented
      as to when to discontinue collision sport competition for the remainder of the
      season after multiple concussions. Because of the concern for the second impact
      syndrome, the requirement to never allow an athlete with postconcussion syndrome
      symptoms to return to competition is emphasised. Also covered is the prevention
      of head injuries, which sports are at greatest risk, and the need for additional
      research on the cumulative effects of concussion.

PMID- 1641545
TI  - Current status of lasers in neurosurgical oncology.
AB  - During the past decade and a half, the photothermal and photochemical effects of
      several medical lasers have been studied for the clinical treatment of benign and
      malignant, primary and secondary central nervous system tumors. Increased
      precision and hemostasis during tumor excision while limiting manipulation and
      retraction of nervous tissues are possible with the microsurgical carbon dioxide,
      argon, and frequency doubled neodymium:YAG lasers. Computerized tomography and
      magnetic resonance imaging-directed volumetric tumor removal by laser is feasible
      with computer-generated visual displays referenced to the patient's anatomy using
      stereotactic instrumentation. Photodynamic therapy with hematoporphyrin
      derivative as the photosensitizer and neodymium:YAG laser hyperthermia are
      currently under evaluation for the treatment of residual and recurrent malignant
      tumors. Encouraging results have been reported for each of these nonablative
      forms of laser use.

PMID- 1641546
TI  - Interstitial photoablative laser therapy guided by magnetic resonance imaging for
      the treatment of deep tumors.
AB  - The failure rate of cancer treatment remains unacceptably high, still being a
      leading cause of mortality in adults and children despite major advances over the
      past 50 years in the fields of surgery, radiation therapy, and, more recently,
      chemo and immunotherapy. In the United States, the 5-year survival rate for all
      cancers in the population has increased by only approximately 10% since 1960.
      Surgical access to some deep tumors of the head and neck and other areas often
      require extensive dissections with residual functional and cosmetic deformities.
      Repeated treatment is not possible after maximum dose radiotherapy and
      chemotherapy is still limited by its systemic toxicity. An attractive solution to
      these problems would be the development of a new adjunctive method combining the
      best features of interstitial laser phototherapy for selective tumor destruction
      via minimally invasive techniques for access and 3D-magnetic resonance imaging
      (MRI) as a monitoring system for laser-tissue interactions. Our experience with
      this new technique is reviewed.

PMID- 1641547
TI  - Interstitial laser hyperthermia.
AB  - Experimental studies have shown that once the appropriate laser parameters are
      defined, interstitial laser hyperthermia (ILH) can produce well-defined,
      predictable tissue necrosis in solid viscera which heal safely with little
      functional or structural sequelae. Preliminary clinical studies have illustrated
      that ILH is simple to perform, is well tolerated producing radiological and
      histological evidence of necrosis in liver, pancreatic, and breast cancer. Its
      future role in most cases will be palliative, controlling local tumour growth.
      Where the extent of necrosis can be matched accurately to tumour volume, the
      prospect for cure exists. Further research is necessary before ILH can be
      regarded as an established treatment and, in particular, its influence on patient
      survival is worthy of further evaluation.

PMID- 1641548
TI  - [Surveillance and control studies of nosocomial infection (I)].

PMID- 1641549
TI  - [The evaluation of the quality of care].

PMID- 1641550
TI  - [Professional risk, what does the law say?].

PMID- 1641551
TI  - [Hyperbaric oxygenation].

PMID- 1641552
TI  - [Fulguration. A new concept in the treatment of cardiac arrhythmias].

PMID- 1641553
TI  - [Skin allografts from cadavers].

PMID- 1641554
TI  - [The nursing consultation in dietetics and nutrition (II)].

PMID- 1641555
TI  - [Technics of continuous extrarenal purification].

PMID- 1641556
TI  - [New prohibitions for smokers].

PMID- 1641557
TI  - [Surveillance and control studies of nosocomial infection (II)].

PMID- 1641558
TI  - [Senile dementia].

PMID- 1641559
TI  - [Drugs that should not be triturated].

PMID- 1641560
TI  - [Medical care nurses are lacking, what is the solution?].

PMID- 1641561
TI  - [Bone marrow transplantation].

PMID- 1641562
TI  - [The principal motivating element is the relationship established between
      professionals].

PMID- 1641563
TI  - [The Ministry of Court Relations and of the Government Secretariate].

PMID- 1641564
TI  - [Life in Kimbau Hospital in Zaire].

PMID- 1641565
TI  - [Tobacco consumption in Spain. The economic determinants].

PMID- 1641566
TI  - [The education of midwives in the European Community].

PMID- 1641567
TI  - [The cardiology nurse expresses an opinion].

PMID- 1641568
TI  - [The dialysis disequilibrium syndrome].

PMID- 1641569
TI  - [The Port-A-Cath in pediatrics].

PMID- 1641570
TI  - [Some ills of the profession. The shortage of nurses and its possible solutions].

PMID- 1641571
TI  - Quantization error in clinical pure-tone audiometry.
AB  - The current clinical procedure for pure-tone audiometry was analysed for
      statistical measurement errors. Theoretically, the root-mean-square (RMS) error
      in a single threshold measurement is always greater than the standard deviation
      (SD) of measured intra-individual test-retest differences, divided by the square
      root of two. The RMS error includes an additional quantization component, caused
      by the finite step size between presented signal levels. In Monte-Carlo
      simulations with 2-dB and 5-dB steps the quantization error was negligible
      compared with other errors. Therefore, the single-test RMS error can be estimated
      with sufficient accuracy from the test-retest SD. The simulated single-test RMS
      error decreased from about 2.7 dB about 2.3 dB when the audiometric step size was
      reduced from 5 dB to 2 dB. Hearing thresholds appeared to be about 1.7 dB better
      with 2-dB steps than with 5-dB steps.

PMID- 1641572
TI  - Auditory and psychological factors in 'auditory disability with normal hearing'.
AB  - Patients who have 'Auditory Disability with Normal Hearing' (ADN) complain of
      hearing difficulties even although their hearing is audiometrically 'normal'. The
      auditory and psychological factors involved in ADN have been investigated by
      comparing 20 patients of employment age with 20 controls (matched for age, sex
      and socioeconomic group) on appropriate auditory tests and questionnaires. From
      the results it was concluded that both auditory and psychological factors are
      involved in ADN. The principal finding was that as a result of their problems
      with discriminating speech in noise, individuals with ADN have a tendency to
      anxiety, depression and loneliness. In addition the otological history of an
      individual was found to be important in the development of ADN. Finally, it was
      suggested that bad coping strategies may lead to increased anxiety in those with
      ADN.

PMID- 1641573
TI  - High-frequency audiometry. Masking of air- and bone-conduction signals.
AB  - Interaural attenuation has been investigated for both air-conduction and bone
      conduction signals in the frequency ranges 0.25-18 and 0.25-16 kHz respectively.
      Ear canal occlusion is recommended when using the Koss HV/1A earphone for BC
      masking, as acoustic transmission occurs through the headset in the high
      frequency range. Minimum masking levels for 1/3-octave filtered white noise were
      established for bone-conduction signals in the frequency range 8-16 kHz. Central
      masking of bone-conduction signals proved to be of the same order of magnitude in
      the conventional- and high-frequency ranges, while the cross-masking level was
      approximately 10-15 dB lower above 6 kHz. Recommendations are made for a masking
      procedure in the high frequency range.

PMID- 1641574
TI  - Speech recognition in noise when wearing amplitude-sensitive ear-muffs.
AB  - Speech recognition in background noise when wearing amplitude sensitive (non
      linear) ear muffs was studied in the laboratory in 15 young normal-hearing test
      subjects. Low-redundancy sentences were presented from a loudspeaker in a
      background noise level of 70 dB (A) and the speech-to-noise (S/N) ratio yielding
      50% correctly recognized words was determined. Three background noise spectra
      were tested: white noise, low-pass filtered noise (-12 dB/octave) and high-pass
      filtered noise (12 dB/octave). Five listening conditions were used: no
      protectors, a pair of normal ear-muffs, a passive amplitude-sensitive ear-muff
      and two types of electronic amplitude-sensitive ear-muffs. An ANOVA shows that
      speech recognition is significantly influenced by type of hearing protector and
      by noise spectrum. The interaction between these factors was not statistically
      significant. In general, the test subjects obtained somewhat better speech
      recognition thresholds in noise when wearing electronic amplitude-sensitive ear
      muffs than without muffs, whereas the opposite was true for the passive amplitude
      sensitive and the normal ear muffs.

PMID- 1641575
TI  - Coherence measurements in hearing instruments, using different broad-band
      signals.
AB  - In this investigation the effect of different broad-band test signals on non
      linear distortion in hearing instruments was examined using coherence
      measurements, and the interaction between different test signals and types of
      automatic signal processing is explored. It is concluded that the use of
      coherence measurements to quantify non-linear distortion in hearing instruments
      is only valid for instruments without automatic signal processing. This
      limitation arises because interaction between type of test signal and the
      automatic signal processing used causes system time-variations, which influences
      the measured coherence function in an uncontrollable way.

PMID- 1641576
TI  - Models for studying the progression of hearing loss caused by noise.
AB  - A computer-controlled fixed-frequency Bekesy audiometer has been used together
      with simplified mathematical models for hearing threshold measurements and
      analysis in 1,796 subjects from seven different noise environments with exposures
      varying from less than 80 dB(A) to greater than 95 dB(A). The methods of
      measurement and analysis have been used to determine hearing loss caused by noise
      for various age groups for men and women. It has also been possible to estimate
      the equivalent noise level to which workers are nowadays subjected under hearing
      protectors and the reduction in exposure level over the past 40 years. The
      results illustrate the effects of noise-reduction measures and the use of hearing
      protectors on the development of hearing loss suffered by workers in the actual
      Swedish industries.

PMID- 1641577
TI  - Perceived sound quality in a hearing aid with vented and closed earmould
      equalized in frequency response.
AB  - Nine normal-hearing subjects listened to speech and music in a hearing aid,
      either through a vented earmould or a closed earmould. The complex frequency
      responses of the two systems were made equal by compensating the aid and closed
      mould combination with a digital filter. The subjects rated the perceived sound
      quality of the systems on seven perceptual scales and a scale for overall
      impression. The results of the ratings support the hypothesis that there is no
      difference in perceived sound quality between vented and closed earmoulds that
      are equalized in frequency response, provided that the perceived loudness is the
      same in both cases.

PMID- 1641578
TI  - Patient performance with two types of multiple electrode intracochlear implant.
AB  - The functional results of 9 persons implanted with the Symbion Ineraid and 8
      persons implanted with the Nucleus cochlear implant with the F0, F1, F2 coding
      strategy are reported. All patients were postlingually totally deaf, the patients
      implanted with the Symbion Ineraid were all above 40 years of age, while the
      Nucleus patients were with one exception under 40 years of age. The CID Everyday
      Sentences Test, the Helen Test and the Speech Tracking Test showed that all
      patients improved their communication skills when sound through the implant was
      added to lip-reading. The patients' ability to understand without lip-reading was
      tested with the CID everyday sentences test, with the Helen test, with spondees,
      with three-choice vowels and with a consonant confusion test. These showed that
      all 9 Symbion Ineraid patients achieved some degree of open speech understanding.
      Four of the 8 Nucleus patients achieved some degree of open speech understanding.
      Difference limen tests for intensity and frequency indicated that 2 of the
      Nucleus patients who did not achieve open speech understanding probably had
      extensive cochlear nerve damage, while the remaining 2 Nucleus patients without
      open speech understanding had good frequency and intensity discrimination.

PMID- 1641579
TI  - Experimental colitis in animal models.
AB  - Colitis may be induced in animals by oral administration of sulfated
      polysaccharides (carrageenan, amylopectin sulfate, dextran sulfate), chemical
      irritation by rectal instillation of diluted acetic acid, delayed
      hypersensitivity reaction after sensitization to DNCB or after one single
      administration of TNBS, and Arthus reaction induced by intravenous injection of
      immune complexes after chemical irritation of the colon, and by chemoattractant
      peptides such as FMLP. It appears that all models of colon inflammation in the
      rat, mouse, or rabbit produce increased amounts of eicosanoids similar to that
      found in human colitis. Thus, animal studies provide useful information on the
      origin, regulation, and function of inflammatory mediators. However, with the
      possible exception of the cotton-top tamarin, no animal model of induced or
      spontaneous inflammation of the colon is analogous to human ulcerative colitis in
      etiology, course of disease activity, or histology (114). The observation that
      two different immune-mediated models gave similar results suggests that the
      colitis is not a specific response to delayed-type hypersensitivity or immune
      complex-mediated reactions but rather an unspecific, stereotype response (125).
      The original disturbance may not determine the nature of the lesions ultimately
      produced but may instead serve as an initiator of a final common immunologic
      pathway.

PMID- 1641580
TI  - Interdigestive gastroduodenal motility and cycling of putative regulatory
      hormones in severe obesity.
AB  - The aim of the present study was to evaluate interdigestive gastrointestinal
      motility and its coordination with plasma concentrations of motilin and
      pancreatic polypeptide (PP) in 14 patients with severe obesity and in 10 control
      subjects with normal body weight. Motor activity of the stomach, duodenum, and
      proximal jejunum was recorded by using an eight-lumen catheter. Blood samples
      were drawn for determination of interdigestive motilin and PP plasma
      concentrations. We observed no difference in total duration of the migrating
      motor complex (MMC) or of phases I, II, or III of the MMC. Gastric phase-III
      activity occurred less frequently in severely obese patients (only 15%
      originating in the stomach) than in controls (65%; p less than 0.01). Plasma
      motilin concentrations were decreased in obese patients in phase I (127 +/- 17
      pg/ml in controls versus 87 +/- 10 pg/ml in obese), in phase II (189 +/- 26 pg/ml
      controls versus 134 +/- 15 obese) and in phase III (195 +/- 29 pg/ml controls
      versus 153 +/- 28 pg/ml obese). Peak motilin release occurred in synchrony with
      phase-III activity and was greater in controls than in obese patients. Plasma PP
      concentrations did not differ from those of controls during any phase of the MMC.
      These results further suggest a potential role for motilin in regulating
      gastrointestinal motor activity and indicate a potential defect in this
      regulatory mechanism in severe obesity. Whether the relationship between
      disordered motor activity and motilin release is etiologic with regard to the
      pathophysiology of obesity remains to be determined.

PMID- 1641581
TI  - The colon in carbohydrate malabsorption: short-chain fatty acids, pH, and osmotic
      diarrhoea.
AB  - Short-chain (C2-C6) fatty acids (SCFA) are the major anions in colonic contents
      and the result of anaerobic fermentation of mainly saccharides. The effects and
      regulation of saccharide fermentation were studied in vitro and in vivo. In vitro
      faecal incubation was used to study the effects of lactose, glucose, and
      galactose and of pH on SCFA formation. Changing the pH to below 5 or above 11
      abolished SCFA formation in the faecal incubates; in the pH 5-9 interval SCFA
      production was high, with only minor pH dependence. Adding glucose, galactose, or
      lactose to the incubation system increased SCFA production, but at high
      saccharide concentrations (100-300 mmol/l) SCFA formation was inhibited by the pH
      change. In vivo disaccharide malabsorption with increasing doses of lactulose
      caused a decrease in faecal pH to less than 5, values inhibitory to fermentation,
      before the appearance of carbohydrate in faeces. In 6 of 12 volunteers diarrhoea
      occurred suddenly and was caused by malabsorbed non-fermented carbohydrate. The
      six other volunteers had a gradual increase in faecal output with lactulose dose
      and developed diarrhoea before the appearance of saccharide in faeces. The intake
      of lactulose tolerated before diarrhoea ensued varied between individuals, with
      the majority having diarrhoea of more than 11/day at 160 g lactulose per day. At
      this dose SCFA absorption was estimated to be in the range 550 to 1150 mmol/day.

PMID- 1641582
TI  - The importance of the centroacinar region in cerulein-induced mouse pancreatic
      growth.
AB  - Early proliferation events within different exocrine pancreatic cell compartments
      were studied in mice with or without cerulein administration. A technique with 3H
      thymidine labeling of DNA-synthesizing cells was used. Groups of five animals
      were given either cerulein (20 micrograms/kg/24 h) or saline subcutaneously twice
      daily. 3H-thymidine was given as a single injection, 300 microCi
      intraperitoneally, on the 3rd and 8th day of cerulein or saline administration,
      and the fraction of labeled cells in each cell compartment (3H-thymidine labeling
      index, TLI) was calculated on the basis of autoradiographic analyses of the
      tissue. In a second set of experiments the distribution of the tracer between
      cell compartments, when given on the 3rd day of cerulein (saline) administration,
      was followed over a 5-day period. The highest proliferative rate was observed in
      the centroacinar cell compartment (TLI, 6%), and newly formed cells were
      accumulated during the 5-day 'chase' period. During the same time the relative
      amount of labeled centroacinar cells increased and comprised 40% of all labeled
      exocrine cells. The relative size of the compartment did not increase, indicating
      increased cell turnover with loss of or possibly migration of centroacinar cells
      into other pancreatic cell compartments. Weak and no trophic effects of cerulein
      were seen on the acinar and ductal cell populations, respectively. In the control
      group labeled ductal cells were significantly reduced during the chase period.
      This was not observed in the cerulein group, indicating addition of labeled cells
      to this compartment from other sources. A significant non-cerulein-dependent
      relative increase and decrease of the ductal and acinar cell compartments,
      respectively, were observed during the chase period.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1641583
TI  - Incidence and pattern of peptic ulcer bleeding in a defined geographical area.
      DUSUK Study Group.
AB  - Despite the introduction of effective medical treatment for peptic ulcer disease,
      no decrease in the incidence of bleeding has been observed. Unfortunately, most
      incidence studies rely on a questionable case ascertainment and poor data. We
      therefore conducted a prospective study, to achieve an unbiased estimate of
      incidence and pattern of peptic ulcer bleeding in Dusseldorf (Germany). In a 1
      year period all patients with endoscopically verified peptic ulcer bleeding who
      were admitted to the departments of internal medicine or surgery in nine
      hospitals or seen by nine general practitioners offering endoscopic service were
      included in the study. Incidence rates were calculated in accordance with
      sociodemographic variables and expressed per 100,000 person-years of observation.
      The overall incidence of peptic ulcer bleeding was 51.4, with almost even rates
      for gastric (26.5) and duodenal (24.9) ulcer. Age was associated with an
      increased likelihood of bleeding in gastric ulcer patients of 19 per decade from
      about 40 years onwards (duodenal ulcer, 15). The incidence was about twice as
      high in men as in women (relative risk = 1.9). The pattern of peptic ulcer
      bleeding was similar in gastric and duodenal ulcers with regard to ulcer size,
      multiple lesions, and bleeding activity at endoscopy. However, patients with
      gastric ulcer bleeding had significantly more often accompanying or underlying
      diseases. No significant differences were observed between gastric and duodenal
      ulcer bleeding with regard to nonsteroidal antiinflammatory drug intake and ulcer
      history. The incidence rates in our study are in the upper range of the
      literature and comparable to rates from the USA and UK both before and after the
      introduction of H2 blockers. We hypothesize that the persistently high incidence
      rate is a superposition of two trends: higher incidences due to a more elderly
      and diseased population and more NSAID intake, and lower incidences due to
      effective medical treatment.

PMID- 1641584
TI  - Leucocyte scintigraphy to localize inflammatory activity in ulcerative colitis
      and Crohn's disease.
AB  - The validity of using autologous leucocytes labelled with technetium -99m
      hexamethyl-propyleneamine-oxine (Tc-HMPAO) for scintigraphy in inflammatory bowel
      disease was evaluated in 12 patients with clinically active ulcerative colitis
      (UC) and 10 with Crohn's disease (CD). Colonoscopy and biopsy were used as
      reference. Scintigrams taken 1 h and 3 h after leucocyte reinjection were
      evaluated blindly by two independent observer groups. Full agreement was found in
      11 of 12 UC patients when compared with colonoscopy but in only 3 of 10 CD
      patients. Segments with agreement in CD patients often showed neutrophilic
      granulocyte infiltration at biopsy. The judgements of clinicians and
      physiologists differed for only 2 of totally 70 UC segments but for 13 of 59 CD
      segments (kappa, 0.94 and 0.52). It is concluded that Tc-HMPAO scintigraphy might
      be an alternative to colonoscopy in the control of disease extent in UC. In CD
      patients the technique might warn about infections complications.

PMID- 1641586
TI  - Long-term treatment with 300 mg ranitidine once daily after dilatation of peptic
      oesophageal strictures.
AB  - This clinical, double-blind, multicentre trial evaluates the long-term effect of
      ranitidine in patients dilated for peptic oesophageal strictures. Seventy-one
      consecutive outpatients were dilated with hydrostatic balloons to a diameter of
      18-20 mm and randomized to a 1-year treatment with 300 mg ranitidine in the
      evening or with placebo. Endoscopies with measurement of the stricture size were
      performed before the initial dilatation, after 6 and 12 months, and in between
      when necessary. Symptoms and use of antacids were registered at inclusion and
      after 3, 6, 9, and 12 months. Thirteen patients were withdrawn before study end
      point. Fifteen of 30 (50%) in the ranitidine group and 11 of 28 (39.3%) in the
      placebo group were redilated. The difference in disfavour of ranitidine was 10.7%
      (95% confidence interval, -14.9; 36.2%). Nor were there any statistically
      significant differences between the treatment groups with regard to stricture
      size at end point, symptoms, or use of antacids. In conclusion, there is no
      evidence of any clinically significant effect of a 1-year treatment with 300 mg
      ranitidine once daily after dilatation of peptic oesophageal strictures.

PMID- 1641585
TI  - Allergen-induced mucosal exudation of plasma into rat ileum and its inhibition by
      budesonide.
AB  - Exudation of plasma across the airway mucosa is a specific defence/inflammatory
      response finely regulated by mediators and (in rodents) a capsaicin-sensitive
      innervation. This study examines plasma exudation responses to endointestinal
      challenges and effects of a glucocorticoid. The ileum of anesthetized rats was
      catheterized and ligated at two points 10 cm apart for mucosal challenge (0.5 ml)
      and repeated lavages (5 ml). Lavage fluid levels of the plasma tracer 125I
      albumin, previously injected intravenously, showed a stable, low base line
      greater than 2 h. Challenge with mediators (10(-5) M bradykinin, 10(-5)-10(-3) M
      serotonin, 10(-6)-10(-4) M histamine, 2.10(-9)-2.10(-7) M leukotriene D4 (LTD4),
      or 10(-5)-10(-3) M capsaicin did not increase luminal radioactivity. However,
      allergen (10(-6) M ovalbumin, in previously sensitized animals) produced prompt
      mucosal exudation of 125I-albumin, peaking within 30 min (p less than 0.001) and
      returning to base line within 90 min. Separate experiments suggested that
      absorption was not increased during the mucosal exudation. The glucocorticoid
      budesonide (10-1000 micrograms/kg given by gavage 24 h before challenge) dose
      dependently inhibited the allergen-induced exudation (p less than 0.01). The
      route of administration and the antiexudative versus the systemic potency
      (reduced thymus weight) suggest the possibility of a topical action of
      budesonide. We conclude that endointestinal allergen challenge produces
      reversible and glucocorticoid-inhibitable exudation of plasma across the mucosa.
      It appears less likely that bradykinin, serotonin, histamine, LTD4, or a
      capsaicin-sensitive innervation is involved in producing this exudative effect.

PMID- 1641587
TI  - Serodiagnosis of Helicobacter pylori-associated gastritis with a monoclonal
      antibody competitive enzyme-linked immunosorbent assay.
AB  - Forty-nine monoclonal antibodies against Helicobacter pylori were screened to
      investigate their capacity to be used in enzyme-linked immunosorbent assay
      (ELISA) competitive systems for the serodiagnosis of Helicobacter pylori
      infection. On the basis of the inhibition pattern showed by the sera of five
      infected patients, the antibodies were subdivided into five groups. The
      immunoblotting analysis showed that the antibodies recognized a total of nine
      different antigenic determinants. In a study of the reaction of the antibodies
      with 12 isolates of H. pylori a total of 9 antigenic profiles were identified.
      Two monoclonal antibodies, HpN44 and HpN45, which recognized a 64-kD protein,
      were inhibited by all 5 positive sera. Antibody HpN45 was labeled with
      horseradish peroxidase, and the competitive ELISA was compared with an ordinary
      indirect ELISA in a study of 102 patients undergoing gastroscopy. Seventy-three
      patients proved to be infected by H. pylori according to urease or histologic
      tests. The sensitivity and specificity were 90.4% and 89.6%, respectively, for
      the indirect ELISA and 100% and 89.6% for the HpN45 competitive assay. The three
      patients who were 'false seropositive' with both serologic tests had atrophic
      gastritis. The high diagnostic performance and simplicity of the HpN45 monoclonal
      competitive ELISA make it suitable for routine serodiagnosis of H. pylori
      infection.

PMID- 1641588
TI  - Does vagotomy affect the growth of the pancreas in the rat?
AB  - Vagotomy has been claimed to have a growth-promoting effect on the pancreas in
      the rat. The present study failed to show differences in total or relative
      pancreatic weight and DNA content between vagally intact and vagally denervated
      rats, whether normoCCKemic or hyperCCKemic after pancreaticobiliary diversion
      during 2-8 weeks. Contrary to the claims made in several recent reports, vagotomy
      does not seem to influence the growth of the rat pancreas.

PMID- 1641589
TI  - Incidence and prevalence of Crohn's disease in the county of Copenhagen, 1962-87:
      a sixfold increase in incidence.
AB  - The incidence of Crohn's disease increased sixfold from 1962 to 1987 in the
      county of Copenhagen. The mean annual incidence for 1979-87 was 4.1 per 10(5)
      inhabitants. The increase was found equally in both sexes, with an approximately
      40% higher incidence in women. The maximal incidence was found in the 15- to 24
      year age group, being 12.8 per 10(5) per year for women and 6.0 per 10(5) per
      year for men, as mean of the period 1979-87. The prevalence at the end of the
      study was 54 per 10(5) inhabitants, 46 per 10(5) in men and 63 per 10(5) in
      women. The clinical appearance of the disease at the time of diagnosis was
      remarkably similar during the study period with regard to both the localization
      of disease and the clinical symptoms and signs. A slightly higher percentage of
      the patients, however, were in high disease activity at diagnosis in the later
      years of the study.

PMID- 1641590
TI  - The effects of intravenous urea infusions on portal and arterial plasma ammonia
      and urea enrichment of jejunal and colonic infusions. Acute experiments with
      growing pigs.
AB  - Six pigs (49-69 kg) were anaesthetized and fitted with cannulas in the
      brachiocephalic artery and portal and jugular veins. In addition, inlet-outlet
      perfusion cannulas were placed in segments of the small and large intestine.
      Intravenous infusion of urea for 2 h increased arterial plasma urea from a base
      line level of 176 (SE, 51) mg/l up to 292 (SE, 67) mg/l after 5 h. During this
      rise portal ammonia levels remained fairly constant, with minimum and maximum
      values of 1.2 (SE, 0.3) and 1.7 (SE, 0.6) mg/l, respectively. The average amount
      of urea recovered in perfusates from small- and large-intestinal segments were
      141.4 and 43.8, respectively (p less than 0.001), when expressed as micrograms/g
      tissue/30 min. It thus appears as if the portal blood is not an important carrier
      of ammonia liberated from the hydrolysis of urea and that the gastrointestinal
      tract is differentially permeable to urea at different levels.

PMID- 1641591
TI  - The main five types of viral hepatitis: an alphabetical update.
AB  - The rapidly increasing knowledge in the field of viral hepatitis warrants regular
      updates. Clinical studies with new hepatitis A vaccines have shown that they are
      safe, well-tolerated, and effective. Several reports on hepatitis B virus (HBV)
      variants have appeared. Surface antigen mutants may have an important influence
      on vaccine prophylaxis because existing vaccines may not protect against
      infection with these variants. Hepatitis D virus is a circular RNA virus that
      requires the presence of HBV for successful infection. The requirements for the
      dual expression of these viruses are unknown and their relation is complex.
      Hepatitis C virus (HCV) is a RNA virus that has homology with the flaviviridae.
      This is a rather common agent in most populations studied and often causes
      chronic infection but little is known about its spread. Hepatitis E virus is a
      RNA virus which is usually spread by contaminated water in developing countries.
      The disease causes high mortality in pregnant women. The existence of further
      viral hepatitis agents have been suggested but hard data confirming this is so
      far lacking.

PMID- 1641592
TI  - Prevalence of Mycoplasma pneumoniae in subjectively healthy individuals.
AB  - Subjectively healthy persons were investigated for the presence of Mycoplasma
      pneumoniae in throat cultures. During a peak period of M. pneumoniae incidence,
      13.5% of 758 healthy volunteers were found to harbour the bacterium in the
      throat. The investigation was continued, and during a subsequent period of 11
      months, the incidence of M. pneumoniae isolated decreased to 4.6% of 499
      volunteers. All new blood donor sera 1990-1991 (422 sera) were screened for the
      presence of antibodies to M. pneumoniae; it was found that there was a
      fluctuating but significant number of individuals with positive serology based on
      a single test occasion.

PMID- 1641593
TI  - Preventing secondary cases of meningococcal disease by identifying and
      eradicating disease-causing strains in close contacts of patients.
AB  - In Norway, the use of chemoprophylaxis after cases of meningococcal disease is
      not recommended. Instead, household members less than 15 years are treated with
      penicillin for 7 days. Failures of this treatment have been reported. We
      therefore used DNA fingerprinting to identify the disease-causing strain in
      healthy contacts combined with selective rifampicin prophylaxis to these carriers
      to prevent secondary cases. During a 2-year period (1987-89) there were 13 cases
      of meningococcal disease in the County of Telemark (165000 inhabitants). 65
      (14.7%) out of 441 contacts to these 13 patients harbored meningococci in their
      throat; 16 (3.6%) carried the disease-causing strain. Only 1 carrier fulfilled
      the criteria for being treated with penicillin; 8 were adults and the remaining 7
      were not household members. No secondary cases of meningococcal disease occurred
      during the study period or the following 12 months. During the 4-year period
      (1984-87) preceding the study period there were 39 cases of meningococcal disease
      in Telemark; 7 of them were index cases for 12 bacteriologically verified and 4
      clinically suspected secondary cases of meningococcal disease. We conclude that
      selective prophylaxis with rifampicin seems to be more efficient that penicillin
      treatment of household members less than 15 to prevent secondary cases of
      meningococcal disease.

PMID- 1641594
TI  - Therapy of multidrug resistant typhoid in 58 children.
AB  - Treatment of children with infections caused by Salmonella typhi strains
      resistant to the commonly used oral antimicrobials is a special problem. As
      children cannot be treated with quinolones, there is no form of oral therapy.
      Third generation cephalosporins, which have been shown to be effective against
      typhoid caused by ampicillin sensitive strains of S. typhi were effective against
      typhoid caused by ampicillin, chloramphenicol and sulfamethoxazole/trimethoprim
      resistant strains. We treated 28 children with ceftriaxone and 8 with cefotaxime.
      We found ceftriaxone to be more effective than cefotaxime with significantly
      lower relapse rate. Antibiotic therapy of 19 other children, initially treated in
      a similar manner, was altered for ease of therapy or due to poor response to
      therapy. The high cost of this parenteral therapy and the problems in its
      delivery point to the need for safe, effective oral therapy.

PMID- 1641595
TI  - Molecular characterization of Borrelia burgdorferi isolated from Ixodes ricinus
      in northern Sweden.
AB  - Ixodes ricinus ticks, harbouring Borrelia burgdorferi, were found in an area in
      northern Sweden, not thought to be endemic for Lyme borreliosis. This
      investigation took place at Norrbyskar, an island situated in the Bothnian Gulf,
      63 degrees 33'N/19 degrees 52'E. One of 42 nymphal and 8/43 adult I. ricinus
      ticks collected carried spirochetes as seen by phase contrast microscopy. Pure
      bacterial cultures were obtained from 2 of the ticks. Western blot analysis using
      species-specific monoclonal antibodies showed that the isolated spirochetes were
      B. burgdorferi. The identity of the isolated spirochetes was confirmed by DNA
      amplification using B. burgdorferi OspA and flagellin gene specific
      oligonucleotides as well as partial DNA sequencing of the respective OspA and
      flagellin genes. The 2 isolated spirochaete populations were different as shown
      by their protein profiles in sodium dodecyl sulphate polyacrylamide gels.
      Moreover, the demonstration of Lyme borreliosis in a patient from the island of
      Norrbyskar indicates the need for clinical consideration of this disease in
      northern Sweden.

PMID- 1641596
TI  - Loss of erythrocyte complement receptors (CR1; CD35) in patients with acute
      episodes of septicaemia or bacterial meningitis.
AB  - 14 patients with septicaemia or bacterial meningitis were examined for serum
      levels of erythrocyte complement receptors CR1 (C3b/C4b; CD35) by an enzyme
      linked immunosorbent assay and levels of circulating immune complexes (IC) by a
      polyethylene glycol precipitation complement consumption method, and
      concentrations of complement C3d split products in plasma by intermediate gel
      rocket immunoelectrophoresis. The CR1 receptor levels were significantly lower on
      day 7-8 after admission than on day 1-2 (p = 0.01), and than the levels 3-4
      months later (p = 0.002). Both the levels of IC in serum and the C3d
      concentrations were significantly higher on day 7-8 than 3-4 months later (p =
      0.02 and p = 0.004). The mechanism behind a temporary decreased expression of CR1
      in patients with acute episodes of septicaemia or purulent meningitis is not
      fully known, and further investigations are needed to clarify whether this
      reduction in erythrocyte CR1 causes an impaired disposal of IC in patients with
      infections.

PMID- 1641597
TI  - Complement activation and the production of inflammatory mediators during the
      treatment of severe sepsis in humans.
AB  - Sepsis or septic shock is frequently associated with activation of the complement
      system, coagulation and fibrinolytic changes and the release of several
      cytokines. In this study we analyzed the relation of complement activation to the
      inflammatory mediators, hemodynamic and biochemical parameters and severity of
      illness and outcome in 20 consecutive patients with clinically defined sepsis.
      Levels of C3a and C3d were elevated in 90% of the patients (median levels 0.19
      mg/l and 8.6 mg/l respectively) in comparison to 14% and 42%, respectively of 7
      patients with non-septic shock. Levels of C4 were decreased in only 1 of the 20
      septic patients. Levels of TNF and IL-6 were elevated in 94% and 100% of the
      patients, Levels of TNF and IL-6 were elevated in 94% and 100% of the patients,
      respectively (median levels 122 ng/l and 1300 U/ml) and were clearly interrelated
      (r = 0.67, p less than 0.01). C3a levels correlated with the APACHE II score (r =
      0.57, p less than 0.05) and high C3a levels were associated with fatal outcome (p
      less than 0.05). C3a was also correlated inversely with mean arterial pressure (r
      = 0.50, p less than 0.01). Levels of complement C3a and C3d significantly
      correlated with levels of plasminogen activator inhibitor-1 (PAI) and correlated
      inversely with AT-III levels. We found no correlation between these complement
      products and leukocyte counts or lactate levels, nor was there a correlation
      between C3a or C3d and the cytokines TNF and IL-6. Levels of C3a and C3d did not
      decrease significantly during the first 24 h of treatment, in contrast to a clear
      decrease in IL-6 levels in all patients and a decrease in TNF in the surviving
      patients. TNF levels remained stable or increased in the non-survivors. We
      conclude that both the complement system and the cytokine system are involved in
      the pathogenesis of septic shock and may be involved in the development of some
      of the fatal complications like hypotension and disseminated intravascular
      coagulation.

PMID- 1641598
TI  - The differential leukocyte count in adults with acute gastroenteritis.
AB  - The total and differential leukocyte count of 4 groups of patients, admitted to
      the hospital because of acute gastroenteritis was evaluated. The 4 groups
      included: (a) 131 adult patients with positive stool culture for shigella; (b) 23
      children (age less than 15 years) with positive stool culture for shigella; (c)
      52 adult patients with positive stool culture for salmonella; (d) 43 adult
      patients with negative stool culture for bacterial pathogens. The total leukocyte
      count did not contribute to the differential diagnosis between shigella
      gastroenteritis and gastroenteritis of other etiology. However, the absolute band
      count was significantly higher in adults with shigella gastroenteritis. Moreover,
      a band to total neutrophil ratio further increased the diagnosis specificity. The
      differential leukocyte count can contribute to early diagnosis of shigellosis in
      adult patients.

PMID- 1641599
TI  - A comparison of aztreonam and ceftazidime in the treatment of respiratory
      infections in adults with cystic fibrosis.
AB  - A randomised double blind 2-week trial of monotherapy with ceftazidime and
      aztreonam was completed in 22 adults with cystic fibrosis. 26 courses of
      treatment were initiated and 22 courses were completed. Within groups, both
      ceftazidime and aztreonam demonstrated a significant improvement in FEV1 at 2
      weeks (ceftazidime p less than 0.05; aztreonam p less than 0.01) and a decline in
      sputum weight at 2 weeks (ceftazidime p less than 0.05; aztreonam p less than
      0.05). Between groups, for spirometry and sputum weight the only change was a
      slower decline in FEV1 in the aztreonam group at 42 days (p less than 0.05).

PMID- 1641601
TI  - Enterobacter endocarditis.
AB  - Endocarditis due to Enterobacter species is very rare. We recently cared for a
      patient who developed E. cloacae endocarditis following mitral valve replacement
      with a porcine heterograft, and was successfully treated with antibiotic therapy
      alone. A review of the literature disclosed an additional 17 well-described cases
      of enterobacter endocarditis. Two-thirds of the patients had underlying cardiac
      disease. The mitral valve was most frequently involved (10/16 cases) with 4 of
      the patients having concomitant aortic valve involvement. The overall mortality
      rate was 44.4%. Antibiotic therapy of enterobacter endocarditis should consist of
      the combination of a beta-lactam antibiotic and an aminoglycoside with careful
      monitoring of blood cultures to assure the adequacy of therapy. Resistance of
      enterobacter to previously susceptible antibiotics may occur during therapy due
      to induction of a chromosomally-mediated beta-lactamase, necessitating a change
      in antimicrobial therapy. Valvular surgery is indicated for patients failing
      medical management.

PMID- 1641600
TI  - Efficacy and tolerance of roxithromycin in comparison with erythromycin stearate
      in patients with lower respiratory tract infections.
AB  - The efficacy and tolerance of roxithromycin 150 mg b.i.d. were compared with
      those of erythromycin stearate 500 mg b.i.d. in patients with lower respiratory
      tract infections. Out of 86 patients recruited for the study, 79 were evaluable
      for tolerance and 76 for efficacy. These patients were evenly distributed among
      the 3 investigational clinics, with 26, 25 and 28 patients, respectively. The
      diagnosis of lower respiratory tract infections was based on clinical,
      laboratory, radiological and/or physical findings and, when available,
      bacteriological and serological findings. The duration of treatment was 10 days,
      with follow-up at post-treatment visits directly after treatment and 6 weeks
      thereafter. The clinical outcome was satisfactory with no significant difference
      between the drugs. More patients reporting adverse events were on erythromycin
      than on roxithromycin (51.3% vs 17.5%; p = 0.003). The results suggest that
      roxithromycin is as effective as erythromycin stearate in the treatment of lower
      respiratory tract infections and causes fewer adverse effects.

PMID- 1641602
TI  - Transfusion associated bacteremia and septic shock due to Erwinia herbicola.
AB  - We report a case of severe septicemia after blood transfusion to a 61-year-old
      man. The patient developed septic shock with signs of disseminated intravascular
      coagulation already during the blood transfusion. Blood culture from the patient
      showed growth of Erwinia herbicola and culture from the blood bag massive growth
      of the same microorganism. The bag had been stored in a refrigerator for 3 weeks
      after tapping. It is likely that contamination occurred during the tapping
      procedure.

PMID- 1641603
TI  - Successful surgical management of septic arthritis due to Trichosporon beigelii
      in a patient with acute myeloid leukaemia.
AB  - A Greek male with acute myeloid leukaemia (AML) developed a pyrexial illness
      while neutropenic and Trichosporon beigelii was isolated from his skin, blood and
      urine. This infection appeared to resolve with a rising neutrophil count, but
      recurred in the next episode of neutropenia. T. beigelii was isolated from an
      aspirate from an inflamed knee. Despite a rising neutrophil count resolution only
      occurred after surgical drainage and local irrigation with miconazole.

PMID- 1641604
TI  - Risk factors connected with hepatitis C infections in Finland.
AB  - Risk factors of 160 hepatitis C virus antibody (anti-HCV) positive patients,
      found in our serological routine, were analyzed. 89% of the patients had been
      exposed to blood (64% had a history of i.v. drug abuse, 24% had used whole blood
      or blood products, 0.6% had a profession connected with blood exposure). 8.1% of
      the patients had lived or travelled in Southern countries, notably in Africa and
      in the Eastern Mediterranean, 0.6% had an anti-HCV positive sex partner. 2.5% of
      the patients had no known risk factors.

PMID- 1641605
TI  - Swedish norms for completion of word stems and unique word fragments.
AB  - Swedish norms for completion of word stems and single-solution word fragments,
      with few or many letters specified, were obtained from Swedish students.
      Comparisons were made for completion rates between stems and fragments that were
      possible to complete with the same word. As expected, completion rates for
      fragments were generally superior to those of word stems since the word stems
      allowed alternative completions. Adding one letter to the word stems and
      fragments resulted in a significant increase in the probability of completion,
      for both stems and fragments. A stepwise regression analysis was conducted in
      order to partial out factors determining the completion probability for
      fragments. The ratio of specified letters to blank characters, and the
      familiarity of the solution was found to be the most important factors. Finally,
      the effect of number of given letters in the word stem on the number of generated
      words per stem was studied. The mean number of words generated per stem was found
      to be equal for both two- and three-letter word stems.

PMID- 1641606
TI  - Observational training improves adult womens' performance on Piaget's water-level
      task.
AB  - Among women university students who lacked conceptual understanding of the
      principle that the surface of still water is always horizontal, a specific task
      procedure designed to optimize self-discovery of the principle proved effective.
      Successful learning was reflected in more accurate responses on an adjustment
      task and by a significant increase (p less than .01) in the number of subjects
      able to verbalize a correct strategy. In contrast to previous research the
      results show that adult womens' performance on the water-level task can be
      improved by observational training, suggesting that the female lag in spatial
      skills may depend on experiential factors.

PMID- 1641607
TI  - Self-reported change in health behaviour after a mass media-based health
      education campaign.
AB  - A comprehensive short-term fund-raising campaign, was launched in 1987 by a
      health charity organization in cooperation with the only Norwegian TV-channel
      covering the whole country. The campaign which was extensively announced on TV
      and other media and which involved large proportions of the population, finished
      up with a six hour TV-show on the fund-raising day. Because a considerable amount
      of information on prevention of heart disease was presented in connection with
      the campaign, it is presently evaluated as a nationwide health education
      campaign. Twenty-two per cent of the population reported changes in one or more
      habits in connection with the campaign (one third of them took more exercise,
      while one quarter reduced/quit their smoking). Health behaviour change among
      family/friends, reported new knowledge of health and worry created by the
      campaign, were the factors most clearly associated with self-reported behaviour
      change. The paper discusses the magnitude of the effects of the campaign in
      relation to the study design, and the importance of social environment and fear
      arousal on health behaviour.

PMID- 1641608
TI  - Effectiveness of negative-thought-reduction, meditation and placebo training
      treatment in reducing anger.
AB  - Twenty-nine highly angry subjects who obtained high scores on Spielberger's Trait
      component of State-Trait Anger Scale went through a thought-listing procedure to
      determine their negative self-statements in response to high, medium, and low
      anger-arousing situations. It was found that subjects made more negative self
      statements in response to a high anger-arousing situation compared to the medium
      and low anger-arousing situations. The subjects were divided into four groups.
      Subjects in one group were trained to reduce their negative thoughts, subjects in
      a second group were trained to meditate, subjects in the third group were asked
      to imagine the high anger-arousing situations (placebo procedure), and subjects
      in the fourth group were given no treatment. It was found that the subjects in
      the Negative-thought-reduction, Meditation and Placebo groups showed improvement
      in trait anger, anger aroused through high-anger situations, anger scores across
      a wide variety of situations, unconstructive coping, and anger measured through
      physiological symptoms. The gains made through intervention were maintained at a
      6-week follow-up. The No-treatment Group showed no significant change in anger
      scores across a wide variety of situations, unconstructive coping, and
      physiological symptom scores but showed a small but significant improvement in
      trait anger and in anger aroused by high-anger situations.

PMID- 1641609
TI  - Perceptual and motor components of performance in three different reaction time
      experiments.
AB  - Three reaction time experiments were conducted to examine the effects of time of
      day, stimulus intensity, stimulus modality, and constant and variable foreperiod
      on the perceptual and motor components of performance. These variables are all
      supposed to generate changes in arousal level. All the independent variables
      affected the perceptual component, while the motor component was significantly
      influenced only by foreperiod and modality. The results are discussed in relation
      to aspects of dependency/independency of the perceptual and motor components of
      human performance in reaction time experiments.

PMID- 1641610
TI  - Reactions to DMT as related to psychotic and borderline personality organization.
AB  - Thirty-one inpatients in a psychiatric clinic were assessed with DMT and the
      Structural Interview. In order to assemble every relevant reaction that an
      individual might have to a percept-genesis, 130 DMT variables were formed. The
      results were first subjected to a quality control of the DMT-scores and then
      subjected to partial least squares in latent variables (PLS) discriminant
      analysis. The analysis showed that it is possible to separate patients with
      psychotic PO (PPO) from those with borderline PO (BPO) by means of the 130
      variables. The BPO group is characterized by aggressive manifestations,
      sensitivity to threat, identity lability and various transformations of the Hero
      gestalt. The PPO group, on the other hand, is characterized by high threshold
      values for perception, lack of identity, denial and repression of the peripheral
      person at a late-phase level. There are other perceptual reactions that are
      important predictors of PO than the defence categories of the manual. These
      perceptual reactions do not correspond to the traditional psychodynamic defence
      mechanisms. Our conclusion is that principal component analysis (PCA) and PLS are
      useful methods of finding discriminating patterns of perceptual reactions to the
      DMT for patients with different PO.

PMID- 1641611
TI  - A qualitative aspect of learning-sensitive open field ambulation in mice.
AB  - Maze training was shown to affect qualitative aspects of the learning-sensitive
      open-field (OF) ambulation in male Swiss albino mice. The changes in thigmotactic
      (wall-seeking) behaviour were most pronounced when significant signs of learning
      occurred, usually on the third day of training. Also daily changes in thigmotaxis
      from before to after training were found. Mice not subjected to maze training
      exhibited a different thigmotactic pattern of behaviour. The present series of
      experiments indicated that separate starting-points (centre or wall) influenced
      the thigmotactic behaviour as opposed to the shape of the OF (circular or
      square).

PMID- 1641612
TI  - [Liver transplantation: current aspects from the East].
AB  - The shortage of organs from cadaveric donors for liver transplantation has
      resulted in the development in Australia and the United States of the technique
      of partial hepatectomy on living related donors. As multi-organ harvesting from
      cadaveric donors is not accepted in Japan, procurement from living related donors
      is the only source of organs in this country, where active development in this
      field has been initiated.

PMID- 1641613
TI  - [Reoperation in colorectal carcinoma with curative intention].
AB  - From the surgical point of view it may be helpful to adopt the following
      guidelines in the treatment of patients with metastatic or locally recurrent
      colorectal cancer: 1. A gastroenterologist concerned with oncological patients
      should initiate adequate resectional treatment of the primary tumor. 2. In case
      of locoregional recurrences, every diagnostic effort (endoscopy, intraluminal
      ultrasound, angiogram, CT-scan, MRI) should be made to select patients with
      limited and resectable disease. 3. In patients with liver metastases amenable to
      surgical resection it is mandatory to rule out extrahepatic disease
      preoperatively as far as possible. 4. Prognostic factors deriving from tumor
      biological data, extent of recurrent disease, and laboratory findings (CEA) must
      be taken into consideration when the decision whether to operate is to be made.
      These arguments should also be used to support non-operative treatment in
      patients with a type of recurrence that cannot be cured by surgery. 5.
      Postoperatively, all information (intraoperatively detected extrahepatic disease,
      tumor infiltrated resection margins, CEA not returning to normal levels) should
      be combined to classify patients according to whether they carry a high risk for
      a second tumor recurrence and should thus undergo additional treatment. In a "low
      risk situation", further follow-up seems to be adequate.

PMID- 1641614
TI  - [Rhabdomyolysis, acute renal insufficiency and hypercalcemia].
AB  - Acute renal failure is a severe and frequent complication of rhabdomyolysis.
      During the early polyuric phase, hypercalcemia is observed in around 30% of
      cases. The principal mechanism is the liberation of calcium from areas of
      muscular necrosis. Two cases of toxic rhabdomyolysis with secondary hypercalcemia
      are described.

PMID- 1641615
TI  - [The long road to the fever chart].
AB  - Temperature and pulse measurement have a central position in the history of
      medicine in the 19th century as well as the medicine of today. Its beginnings can
      be traced back a long way; naturally, they are closely linked to the development
      of the thermometer and the watch, but their long paths also touch on the history
      of science and culture. Knowledge and teachings of pulse and fever certainly did
      not develop simultaneously and in mutual agreement, but crossed one another's
      paths on two occasions: in the work of Boerhaave in the early 18th century and
      with the introduction of thermometric analysis into the clinic from the middle of
      the 19th century. Individual milestones are selected and described.

PMID- 1641616
TI  - [Physiological basis of high milk production in cattle].
AB  - Milk yield is determined by number, size, synthetic and secretory capacity of
      mammary alveolar cells and low amounts of residual milk after milking. Initial
      milk yield and persistency of lactation are important. Important factors to
      achieve high milk yield are: optimal mammary development and preparation to
      lactation; maintenance and possibly increase in number and of synthetic capacity
      of alveolar cells during established lactation; sufficient availability of
      substrates for milk synthesis through high feed intake, readiness to mobilize
      body reserves (especially depot fat) and increased mammary blood flow; optimal
      milk let-down; regular and possibly more than twice milking/day. Favorable for a
      high milk yield are high circulating concentrations of somatotropin, possibly
      associated with increased production and levels of the insulin-like growth factor
      I, in the presence of low concentrations of and reduced sensitivity or
      responsiveness of target organs to insulin, reduced circulating levels of thyroid
      hormones and possibly enhanced conversion of thyroxine to triiodothyronine in the
      mammary gland. Enhanced sensitivity of depot fat to lipolytic hormones is
      favorable for high milk production.

PMID- 1641617
TI  - Ultrasonographic findings in a cow with ascites due to thrombosis of the caudal
      vena cava.
AB  - This case report describes a three-year-old Swiss Braunvieh cow with ascites due
      to thrombosis of the caudal vena cava. Ultrasonography verified the ascites and
      revealed dilatation of the abdominal portion of the caudal vena cava (4.8 cm). It
      was presumed that the caudal vena cava was occluded by a thrombus or by
      perivenous compression cranial to the dilatation. Post mortem findings included:
      a massive accumulation of fluid in the abdominal cavity; a 15 cm long thrombus in
      the subphrenic region of the caudal vena cava; multiple pulmonary abscesses;
      severe thrombosis of the pulmonary vasculature; hepatic congestion; oedematous
      abomasal folds; and severe thrombophlebitis of the left jugular vein and both
      udder veins, due to poor intravenous injection technique. Ascites caused by
      thrombosis of the caudal vena cava is rare because collateral routes of venous
      return, including the udder veins, are usually established. It was therefore
      concluded that the ascites was attributable to bilateral thrombosis of the udder
      veins.

PMID- 1641618
TI  - Material help.

PMID- 1641619
TI  - Biotechnology for sale, cheap.

PMID- 1641620
TI  - Doomsday diagnostic?

PMID- 1641621
TI  - Aborting research.

PMID- 1641622
TI  - East of Eden.

PMID- 1641623
TI  - Sea sick.

PMID- 1641624
TI  - Keeping it in the family.

PMID- 1641625
TI  - Bacterial endotoxins.
AB  - Endotoxins possess an intrinsic fascination that is nothing less than fabulous.
      They seem to have been endowed by nature with virtues and vices in the exact and
      glamorous proportions needed to render them irresistible to any investigator who
      comes to know them.

PMID- 1641626
TI  - Evolution comes to life.

PMID- 1641627
TI  - Paradoxes of musical pitch.

PMID- 1641628
TI  - Reference values for the study of low doses.
AB  - At present, the quantitative differences between environmental exposure and
      occupational exposure to toxic metals are steadily decreasing, it becomes
      important to establish reference values of the tests used for biological
      monitoring. However, the word 'reference values' is often used inappropriately
      and in particular its significance is often confused with that of 'limit values'
      or 'normal values'. The term reference values defines the levels of the
      biological indicators in the general population which are not occupationally
      exposed. It is necessary to refer to these values in order to compare the data
      obtained through biological monitoring programmes in workers and in groups of the
      general population which are presumed to be exposed. The most essential aspects
      for identifying reference values for toxic metals, using a rigorous methodology,
      are taken into consideration and in particular, the requisites needed for
      identifying the subjects which must be included in the reference groups are also
      examined. The modalities for using reference values for individual subjects as
      well as for groups are then discussed and the main points of research which must
      be faced in the near future regarding reference values are highlighted.

PMID- 1641629
TI  - Tentative reference values for some elements in broncho-alveolar lavage fluid.
AB  - The concentrations of Fe, Mn, Pb and Cr have been determined in broncho-alveolar
      lavage (BAL) fluid of 25 subjects without occupational or abnormal environmental
      exposure to metals, using the AAS method. The numerous factors which can
      interfere with the results in pre-analytical and in analytical phases are
      stressed. Metals concentrations in BAL are expressed in micrograms/l. They were
      not correlated with the volume of fluid recovered, the total cells, alveolar
      macrophages and erythrocytes. The results were not modified by stratification
      considering age and sex. Iron concentrations were higher than others, probably
      due to higher environmental exposure and partly to its essential role in humans.
      The diagnostic significance of element determination in BAL fluid and the
      relationship with exposure and lung load is discussed.

PMID- 1641630
TI  - Cadmium in blood and urine after cessation of exposure.
AB  - A plant for the synthesis and packaging of cadmium oxide was operated for 32
      months (1982-84) in a small chemical factory producing zinc and copper oxide. The
      cumulative exposure of 6 workers was from 12 to 190 days. Five years after
      cessation of exposure the blood cadmium levels in the exposed were, on average, 4
      10 times higher than those of a reference group and the urinary cadmium levels
      were 1-6-times higher. In view of the long half-life of cadmium in the human
      body, the choice of normal reference values requires particular care since brief
      and sometimes forgotten exposures to cadmium may be a confounding factor to set
      reference values.

PMID- 1641631
TI  - The microdose problem and the most commonly used metals.
AB  - On the basis of recent research a relationship may exist between microexposure to
      metals and certain diseases (e.g. neurological and cardiovascular diseases) which
      occur in the later stages of life. This fact must be kept firmly in mind in view
      of the implications for the quality of health, considering the increase in
      average life expectancy. Moreover, it will be necessary to re-identify the
      critical organ for each metal, bearing in mind that the effects are altered in
      low level exposure conditions.

PMID- 1641632
TI  - Is hypertension a confounding factor in the assessment of blood lead reference
      values?
AB  - In order to evaluate whether hypertension can be considered as a confounding
      factor in the setting up of reference values for blood lead, we examined the
      results of a cross sectional study which evaluated the relationship between lead
      in blood and hypertension in a sample of 254 males and 271 females of a general
      population not occupationally exposed to lead. The statistical analysis and in
      particular the multiple logistic regression showed that, even if some well-known
      confounding factors such as age, sex, overweight, smoking and alcohol are taken
      into account, blood lead levels are well correlated with hypertension. The
      results suggest that even modest lead absorption is able to influence the
      probability of being hypertensive. The relationship between blood lead and
      hypertension and their relationship with the main confounding factors involved in
      the determination of reference values of metals in blood are discussed.

PMID- 1641633
TI  - Reference values of tests for the assessment of mutagenic activity.
AB  - The determination of mutagenic activity in biological media aims at detecting the
      exposure to mutagenic chemicals, or to chemicals transformed by the organism into
      mutagenic metabolites. Mutagenic activity is detected by various short-term tests
      which rely upon the interaction of the chemical with the DNA of, bacteria,
      Drosophila or mammalian cells. The urinary fluctuation test has been particularly
      useful in determining mutagenic activity in the urine of subjects exposed to low
      concentrations of suspected genotoxic chemicals. The assay procedure itself is
      relatively simple, the data, however, should be carefully evaluated in relation
      to the attributes of the donor, bearing in mind the confounding variables related
      to life-style, diet, occupation and drug intake.

PMID- 1641634
TI  - Reference values for chromosome aberrations in human lymphocytes as indicators of
      genotoxic effects.
AB  - Increased chromosome aberrations (CA) in human cultured lymphocytes are an
      accepted indicator of early biological effects of exposure to genotoxic agents,
      which has also been investigated, with conflicting results, in several groups of
      subjects occupationally exposed to metals known or suspected to be carcinogenic.
      One of the problems with this indicator is the lack of universally accepted
      reference values. Difficulty in establishing absolute reference values for CA
      depends on individual variability in the reference groups (due to several
      environmental and genetic confounding factors) and on methodological variants at
      the different stages of the test (culture methods, scoring, classification and
      reporting of CA). Therefore, at present, CA studies in exposed groups should
      include proper 'control' groups, matched for the known confounders, investigated
      in the same laboratory, with the same methods in order to minimize factors of
      variation. The results of the studies should be statistically compared and
      evaluated mainly on a group basis.

PMID- 1641635
TI  - Statistical aspects of the estimation of reference limits.
AB  - This paper deals with some basic statistical issues arising from biological
      monitoring. Data description, Gaussianity tests, outlier identification,
      parametric and non-parametric estimates of fractiles and their standard errors,
      and parametric estimate of the one tail upper side tolerance interval are treated
      and exemplified using two data sets. Sample size and power determination are
      considered in terms of the cut-off point of the diagnostic quantitative test.

PMID- 1641636
TI  - The ICOH and IUPAC international programme for establishing reference values of
      metals.
AB  - In cooperation with the ICOH Scientific Committee on the Toxicology of metals and
      IUPAC Commission on Toxicology, we have developed evaluation criteria for
      derivation of reference values for metal concentrations in human tissues and
      fluids. In a first attempt to illustrate how these criteria may be used,
      tentative reference values for mercury in human blood were derived. For persons
      who do not eat fish, a mean value of 10 mumol/1 (2 micrograms/1) was suggested.
      It was pointed out, however, that this value was based on information that did
      not meet the desired quality requirements, which, unfortunately were not met by
      any of the published reports.

PMID- 1641637
TI  - Non-parametric age related centile curves for blood lead levels in blood donors
      from northern Italy.
AB  - Healy's non-parametric method, originally applied to growth data, provides an
      efficient and flexible tool for computing smoothed centile curves. We used this
      procedure to calculate reference curves for blood lead levels. A sample of 402
      blood donors living in Brescia and its surrounding area was used as a reference
      population. No exclusion criteria but occupational exposure to lead were adopted.
      The comparison between the reference values obtained with Healy's procedure and
      the tolerance limits, based on the normal approximation, computed within age
      strata is discussed.

PMID- 1641638
TI  - Criteria for the definition of reference values for toxic metals.
AB  - Two types of selection are used to identify subjects who make up reference
      groups: 'a posteriori' selection starting from a large number of subjects who are
      then subsequently selected and 'a priori' selection wherein the group to be
      examined is defined on the basis of preestablished criteria. The main variability
      factors are biological and those depending on the modalities of selection of
      groups and determination of the analysis. The nature of the element is also
      particularly important, i.e. whether an essential element must be considered only
      a micropollutant or whether it should be considered essential and at the same
      time a micropollutant. In addition two other factors which play an important role
      are the temporo-spatial modifications induced by natural or anthropogenic
      phenomena which influence the modality and degree of exposure in man. Two
      criteria are generally used in the production of reference groups:
      exclusion/inclusion and partitioning criteria. While in clinical chemistry the
      health status represents an important exclusion factor, in the case of metals,
      the environmental conditions and the function of organs and apparatuses involved
      in the toxicokinetics of metals can be considered as main criteria. All the other
      variables such as sex, age, life-style are partitioning criteria and enable us to
      obtain reference values for more and more homogeneous subgroups.

PMID- 1641639
TI  - Trace element reference values in tissues from inhabitants of the European
      Community. II. Examples of strategy adopted and trace element analysis of blood,
      lymph nodes and cerebrospinal fluid of Italian subjects.
AB  - The EURO TERVIHT (Trace Element Reference Values in Human Tissues), recently
      initiated, aims to establish and compare trace metal reference values in
      inhabitants from the different EC countries. The project anticipates
      international cooperation of specialized chemical and toxicological laboratories
      in Western Europe. In order to overcome the well known and intolerable high
      fluctuation in published trace metal concentrations in body fluids and tissues,
      which are mostly due to poor analysis, this paper gives recommendations and
      strategies for approaching 'background' values measurement practised in the EURO
      TERVIHT. The focus of the paper is more on quality rather than on quantity of
      data with particular aspects: (i) well-described protocol for the
      selection/composition of reference groups (extended epidemiological data plus
      clinical status); (ii) numerous pre-analytical factors, among which are of
      paramount importance are ultraclean laboratory air, container material, storage
      conditions at -20 degrees C; (iii) statistical treatment of the data and the
      expression of the analytical results (use of refined statistical analysis such as
      the Lilliefors test to define the type of distribution, normal or log-normal).
      Results reported here concern the determination of trace elements in whole blood
      of more than 350 Italian subjects which allowed the proposal of 'reference
      values' for 12 elements. In lymph nodes and cerebrospinal (CSF) the degree of
      information acquired is only sufficient to suggest 'indicative' of 'informative'
      values.

PMID- 1641640
TI  - Trace element reference values in tissues from inhabitants of the European
      Community. III. The control of preanalytical factors in the biomonitoring of
      trace elements in biological fluids.
AB  - In the context of a programme concerning the determination of trace elements in
      body fluids and tissues to establish trace element reference values, research has
      been undertaken on the control of preanalytical factors in order to develop
      sufficiently accurate and precise guidelines to be applied in routine work by
      using techniques such as graphite furnace atomic absorption spectroscopy (GFAAS).
      Aspects investigated are related to the risk of contamination during blood
      collection and the use of anticoagulants; the risk of losses during storage and
      freeze-drying as well as the possible risk of contamination arising from trace
      elements in airborne particulates of the laboratory environment. For the analysis
      of Al, Ba, Cd, Co, Cr, Mn, Mo, Ni, Sb, W, V and Zn in blood, Teflon cannula is
      the method of choice. The anticoagulants do not introduce disturbing
      contaminations of Rb, Se, Zn, while contaminations were observed for Co, Cr, Mn.
      Radiotracers in 'metabolized form' (radiolabelled rat or rabbit tissues from
      animals administered with radioisotopes) show that samples stored for 1 month at 
      20 degrees C have no significant trace metal losses. Strict ambient air quality
      standard has to be respected (continuous monitoring) due to the possibility of
      element contaminations inside the laboratory. The use of matrix modifiers could
      represent a toxicological risk to the operators. Critical factors should be
      considered ('metal sheets') for each element in each matrix. For instance 27
      factors for Cr in serum have been suggested.

PMID- 1641641
TI  - Reference values for early markers of renal damage.
AB  - In addition to the difficulties related to the definition of a reference
      population and hence of reference limits, special methodological problems have to
      be dealt with when early markers of renal damage are applied to monitor groups at
      risk. The urinary excretion of both high and low molecular weight proteins, as
      measured by sensitive immunoassays, is routinely applied in health surveillance
      programmes aimed at preventing the occurrence of adverse renal effects resulting
      from exposure to nephrotoxic chemicals, among which are several metals. Owing to
      the large intra-individual variability experimentally demonstrated for all
      indicators of renal impairment, carefully standardized sampling conditions must
      be adopted. At the individual level, repeated measurements should be performed
      before a diagnosis of renal disease or dysfunction is established. In fact,
      several physiological conditions may account for transient changes in renal
      function, leading to measured levels greatly exceeding reference limits.

PMID- 1641642
TI  - Inaccuracy quality control in the monitoring of trace metal concentrations in
      biological fluids.
AB  - Quality assurance in trace element analysis requires continual surveillance of
      the accuracy and precision of results. A review of difficulties encountered in
      performing quality control programs of trace metal analysis in biological fluids
      is presented. Examples to clarify the inadequacy of available biological
      reference materials for quality control in biological monitoring of environmental
      and occupational low level exposure to metals are reported.

PMID- 1641643
TI  - Exposure to metals that have recently come into use.
AB  - The possibility of deriving normal biological values for some rare metals is
      investigated. The metals under study are gallium, germanium, indium, niobium and
      tellurium, i.e. a group of metals with increasing utilization in the electronics
      industry. So far some data are unavailable for some of the elements, e.g. daily
      intake, oral absorption and half-life time for gallium, and body burden for
      gallium and germanium. Reliable values of blood concentration are available only
      for gallium, niobium and tellurium. The problem related to a proposed urinary
      biological limit value for tellurium is also discussed.

PMID- 1641644
TI  - Tentative reference values for gold, silver and platinum: literature data
      analysis.
AB  - Data available on biologic fluid content of therapeutic metals are uneven for
      silver, gold and platinum respectively. Tentative reference values may be
      proposed on the basis of the most representative studies for silver and gold. For
      silver it is suggested that the variability in normal subjects could range up to
      10 micrograms/l in whole blood and up to 1 microgram/l in urine. For gold 0.5
      microgram/l can be considered the upper limit for both whole blood and urine. For
      platinum there is no indication that concentration in either blood or urine could
      reach detectable amounts in normal subjects.

PMID- 1641645
TI  - Plasma selenium levels of the general population of an area in northern Italy.
AB  - Plasma selenium (Se) levels of 293 subjects (160 males and 133 females) living in
      Desio (a small town near Milan) were determined. Analyses were performed by
      graphite-furnace atomic absorption spectrophotometry with Zeeman background
      correction. Plasma samples were not subjected to any treatment before analysis
      and serum samples containing a certified Se content were used as reference
      materials to control the quality of the analytical determinations. Plasma Se
      levels were found to be distributed normally with an average value of 118.8
      micrograms/l and a S.D. of 27.2 (95% of the subjects lie between 64.4 and 173.2
      micrograms/l). No statistically significant difference was found between males
      and females, and no correlation was found between plasma Se levels and age or
      smoking habits.

PMID- 1641646
TI  - Clams as pollution bioindicators in Kuwait's marine environment: metal
      accumulation and depuration.
AB  - This study has developed and verified clam transplantation for marine pollution
      monitoring in Kuwait and has assessed its reliability for monitoring pollution by
      heavy metals through laboratory and field transplantation experiments. In field
      experiments, live specimens of the clam Circenita callipyga were transplanted,
      either suspended in seawater or buried in sand, to 11 coastal sites in Kuwait;
      subsamples of transplanted clams were recovered at intervals over a 6-month
      period. In laboratory experiments, heavy metal accumulation for 36 days and
      depuration (body's release of pollutants) for 60 days in small and big clams were
      investigated. Clams subsampled in laboratory and field experiments were analyzed
      for Hg, Cu, V, Cd and Pb. Results showed the ability of clams to survive under
      the transplantation conditions. Accumulation of biofouling materials was a
      problem at only two transplantation sites and was overcome by periodic cleaning.
      Statistical analysis of laboratory experimental data showed significant
      accumulation of all test metals and significant depuration of Hg, Cu, V and Cd.
      Rates of metal accumulation and depuration differed in relation to clam size
      class. Field experiments indicated statistically significant increases in Hg and
      Cu concentrations in the transplanted clams at most stations, no change in Cd
      concentrations and an increase or, occasionally, a decrease in V and Pb
      concentrations.

PMID- 1641647
TI  - Bioaccumulation of 137Cs and 60Co by a tropical marine teleost Epinephelus sp.
AB  - As part of a project on the behaviour of radionuclides released by the Angra
      Nuclear Power Station in the marine environment, laboratory experiments were
      performed to study cesium and cobalt accumulation by juvenile groupers
      (Epinephelus sp.). The fishes were kept in aquariums equipped with gravel-bed
      filters spiked with 60Co (150 KBq/l) and 137Cs (75 KBq/l). Uptake was only via
      water since the fishes received only non-radioactive food during the 4 months of
      experiment. Cesium accumulation in muscle was higher than in any other organ,
      reaching concentration factors (CFs) of 5 (fresh weight basis). Cobalt, in
      contrast, was concentrated mostly in the liver, gut and skin and scales. Cobalt
      CF in muscle tissue was 8 x 10(-2), lower than any previously reported figure.
      Chromatographic analysis of the water at the beginning and end of the experiment
      showed that cobalt had been completely converted from 60CoCl2 to non-cationic
      forms, most probably through complexation with organic ligands, mediated by the
      intense microbial activity of the filter bed. This conversion apparently enhanced
      cobalt bioavailability since a second experiment performed with this aged
      seawater yielded CFs for muscle tissue higher by a factor of 2.5.

PMID- 1641648
TI  - Mechanism of action of hydroxyurea.
AB  - Hydroxyurea is well absorbed after oral administration, converted to a free
      radical nitroxide in vivo, and transported by diffusion into cells where it
      quenches the tyrosyl free radical at the active site of the M2 protein subunit of
      ribonucleotide reductase, inactivating the enzyme. The entire replitase complex,
      including ribonucleotide reductase, is inactivated and DNA synthesis is
      selectively inhibited, producing cell death in S phase and synchronization of the
      fraction of cells that survive. Repair of DNA damaged by chemicals or irradiation
      is also inhibited by hydroxyurea, offering potential synergy between hydroxyurea
      and radiation or alkylating agents. Hydroxyurea renders cells sensitive to
      bleomycin because the quenched tyrosyl free radical no longer stabilizes the
      adjacent iron center, making it more susceptible to the chelating properties of
      bleomycin, which then produces active oxygen. Synergy has also been observed
      between hydroxyurea and a number of other chemotherapeutic agents, including
      cytarabine and etoposide. Recently, two new effects of hydroxyurea have been
      observed: hydroxyurea increases the level of fetal hemoglobin, leading to a
      reduction in the incidence of vasoocclusive crises in sickle cell anemia, and
      hydroxyurea selectively reduces the level of episomal DNA and thus potentially
      may reduce drug resistance associated with duplicated genes retained as episomes.
      Further exploration of the efficacy of hydroxyurea in combination with other
      therapeutic agents is warranted.

PMID- 1641649
TI  - Current advances in hydroxyurea therapy.

PMID- 1641650
TI  - Cytotoxic synergy of cisplatin with concurrent hydroxyurea and cytarabine:
      summary of an in vitro model and initial clinical pilot experience.
AB  - Cytarabine and hydroxyurea in combination are known to inhibit the DNA excision
      repair system. Given this system is responsible for repair of cisplatin-DNA
      adducts, we hypothesized that combining cytarabine, hydroxyurea, and cisplatin in
      an appropriate schedule might inhibit adduct repair, increase the number of DNA
      lesions, and produce synergistic cell kill. In vitro experiments using clinically
      achievable doses and schedules of these antimetabolites demonstrated cytotoxic
      synergy with the three-drug combination, but little or no such synergy with
      either antimetabolite plus cisplatin. The inclusion of hydroxyurea was necessary
      to achieve maximum synergy. Increased levels and persistence of cisplatin-induced
      DNA interstrand cross-links were observed, suggesting repair inhibition may have
      occurred. The dose of cisplatin required to inhibit colony formation by 90% was
      reduced approximately one third, even after normalization for the cytotoxic
      component(s) of hydroxyurea, cytarabine, and hydroxyurea plus cytarabine. Using
      one of the two optimal in vitro schedules for the three-drug combination, we
      performed a clinical pilot study in two patient cohorts (with and without prior
      systemic therapy). Administration of the program was feasible, and resulted in
      dose-limiting thrombocytopenia only in the cohort with prior chemotherapy.
      Azotemia was treatment-limiting in responding patients. Responses were observed
      in patients with a variety of solid tumors, including several patients who had
      previously failed cisplatin therapy. Modifications of this program are discussed,
      which have, to date, significantly decreased the toxicity concerns raised by the
      first trial. Phase II trials are planned in patients with a variety of cisplatin
      responsive and nonresponsive neoplasms.

PMID- 1641651
TI  - An overview of the clinical experience with hydroxyurea.
AB  - In the more than 30 years since hydroxyurea was first evaluated clinically, a
      number of diverse and unique applications have been identified for its use. Some
      of these applications were apparent to investigators almost from the beginning,
      while others are still evolving 3 decades later as a result of ongoing research.
      An overview of clinical experience with hydroxyurea provides an historical
      perspective on a period encompassing virtually the entire era in which anticancer
      chemotherapy has been a recognized discipline. The critical role of the
      ribonucleotide reductase reaction in the regulation of DNA synthesis makes this
      enzyme a particularly important target site for antineoplastic therapy. The
      sustained interest in hydroxyurea, however, has been the result of careful
      clinical observations as well as basic laboratory studies, which support current
      attempts to identify additional uses for the drug. This overview describes the
      clinical development of hydroxyurea, discusses current indications, and briefly
      describes areas of ongoing research that may expand the clinical indications for
      hydroxyurea.

PMID- 1641652
TI  - High-dose hydroxyurea in autologous bone marrow transplantation: a promising
      "new" agent.
AB  - Hydroxyurea is an antineoplastic drug with a broad spectrum of clinical activity
      and minimal nonhematopoietic toxicity. It potentiates the cytotoxicity of
      alkylating agents and topoisomerase II active drugs in vitro and in vivo. It is
      not susceptible to alkylating agent-specific or multidrug-type resistance. We
      have therefore added high-dose oral hydroxyurea to widely used autologous bone
      marrow transplantation combination chemotherapy regimens for large cell lymphoma
      and metastatic breast cancer. Seventeen patients with primary-refractory or
      refractory-relapse large cell lymphoma received oral hydroxyurea (1.5 g/m2 every
      6 hours for 12 doses) added to carmustine/cyclophosphamide/etoposide (BCV).
      Twelve patients with metastatic breast cancer received the same dose oral
      hydroxyurea added to cyclophosphamide and thiotepa. Mucositis severe enough to
      require parenteral narcotics was seen in over half of the patients, but none
      required intubation for airway maintenance. A thrombotic thrombocytopenic purpura
      like hemorrhagic syndrome occurred in six patients and was fatal for three. With
      the BCV/hydroxyurea regimen, this syndrome was seen with the same frequency as
      with BCV alone. Death from rapidly progressive disease or toxicity occurred in
      seven of 29 patients (24%). For patients with 6 months' minimum follow-up, four
      of 12 (33%) of the metastatic breast cancer patients remain in complete response
      (median follow-up, 15 months), and four of 17 (24%) refractory large cell
      lymphoma patients remain in complete response (median follow-up, 10 months). High
      dose hydroxyurea may increase the effectiveness of standard autologous bone
      marrow transplantation regimens without substantially increasing toxicity.

PMID- 1641653
TI  - The evolution of hydroxyurea therapy in chronic myelogenous leukemia.
AB  - The evolution of hydroxyurea as a chemotherapeutic agent has been unique.
      Hydroxyurea inhibits synthesis of DNA, has antitumor activity, and is
      myelosuppressive. It has attained a significant role in the management of chronic
      myelogenous leukemia. A nonrandomized comparison of busulfan and hydroxyurea
      concluded that hydroxyurea was the preferable agent in the treatment of chronic
      myelogenous leukemia and was associated with less life-threatening toxicity.
      Because of its systemic effects, hydroxyurea is also used in the treatment of
      polycythemia and psoriasis.

PMID- 1641654
TI  - A phase II pilot trial of high-dose hydroxyurea in chronic myelogenous leukemia.
AB  - Suppression or eradication of the Philadelphia (Ph1) chromosome has been a major
      goal in the therapy of chronic myelogenous leukemia (CML). Variable levels of Ph1
      chromosome negativity have been achieved using interferon-alfa, busulfan,
      combination chemotherapy, and allogeneic bone marrow transplantation. This study
      evaluated the effect of achieving a predetermined level of myelosuppression using
      hydroxyurea on bone marrow cytogenetics in CML. Fourteen patients with chronic
      phase CML received 25 cycles of therapy. Fourteen of the 25 cycles were
      associated with cytogenetic responses consisting of 25% or more Ph1 negative
      metaphases (range, 25% to 100%). Nine of the responses consisted of 50% or
      greater Ph1 negative metaphases. Toxicity was exclusively due to consequences of
      myelosuppression, including febrile neutropenia and thrombocytopenia. In chronic
      phase CML, hydroxyurea induces cytogenetic responses with tolerable toxicity and
      is an attractive agent for further study as a component of treatment strategies
      aimed at eradicating the Ph1 + population in CML.

PMID- 1641655
TI  - The place of hydroxyurea in the treatment of primary brain tumors.
AB  - Hydroxyurea has been used since the early 1970s to potentiate the effects of
      radiation in the treatment of primary gliomas. In the only randomized study, a
      statistically significant increase in time to tumor progression for glioblastoma
      patients was noted for those receiving hydroxyurea. In other studies, hydroxyurea
      has been used as a cell-cycle phase-specific agent to improve survival in
      patients with recurrent gliomas and, in combination with 5-fluorouracil, to
      increase cell kill and as a potential DNA polymerase inhibitor. Other protocols
      have used hydroxyurea during radiation therapy in medulloblastoma and in
      combination chemotherapy for metastatic brain tumors as well. While widely used
      in the treatment of primary and secondary brain tumors, hydroxyurea trials
      usually have not been randomized or otherwise controlled; most have been
      nonrandomized, phase II activity studies. With the conclusion of some current
      trials, it is conceivable that the use of hydroxyurea may be more clearly defined
      in the treatment of tumors affecting the nervous system.

PMID- 1641656
TI  - Radiosensitization and cell kinetics: clinical implications for S-phase-specific
      radiosensitizers.
AB  - Rapid repopulation of tumor cells during conventional radiation therapy has been
      recently recognized as a factor that might significantly impair tumor response in
      several different tumor sites. One clinical strategy to overcome rapid tumor
      proliferation is to use S-phase-specific radiosensitizers such as hydroxyurea and
      the halopyrimidines 5-iododeoxyuridine (IUDR), 5-bromo-2'-deoxyuridine (BUDR), 5
      fluoro-2'-deoxy-beta-uridine (FUDR), and 5-fluorouracil (5-FU). Indeed, several
      recent clinical trials have shown the positive antiproliferative effects of these
      radiosensitizers in various human tumors. In spite of this resurgence of clinical
      interest, the basic mechanism(s) of radiosensitization is not clearly understood.
      Although the halopyrimidines have similar biochemical pathways involving two key
      regulatory enzymes, thymidine kinase and thymidylate synthase, it appears that
      DNA-incorporation is important for radiosensitization by BUDR and IUDR but not
      for FUDR or 5-FU. Recent laboratory data suggest that biochemical modulation of
      the key regulatory enzymes can result in selective tumor radiosensitization with
      halopyrimidines. Hydroxyurea, like 5-FU, sensitizes cells when present prior to
      and following irradiation; this interaction may be related to cell
      synchronization as well as altered DNA damage repair. Exploiting differences in
      cell proliferation and cellular metabolism of these S-phase-specific
      radiosensitizers in tumors and normal tissues will be a major focus of clinical
      research in human tumor radiosensitization over the next few years.

PMID- 1641657
TI  - Experience with hydroxyurea as a radiosensitizer in carcinoma of the cervix.
AB  - Since 1968, hydroxyurea has been used as a radiosensitizer in combination
      modality treatments for carcinoma of the cervix. The drug has shown an advantage
      over placebo in several randomized trials. Although hydroxyurea is given orally
      on an outpatient basis, it has not gained widespread acceptance. Previous reports
      are reviewed and possible future uses are discussed.

PMID- 1641658
TI  - Hydroxyurea with concomitant radiotherapy for locally advanced head and neck
      cancer.
AB  - Hydroxyurea is an active single agent in squamous cell cancer of the head and
      neck. It has been used clinically, most frequently as a radiation-enhancing agent
      with concomitant radiotherapy. Pilot trials testing hydroxyurea in this setting
      reported encouraging results. Two randomized trials have been conducted with
      inconclusive results, possibly relating to study cohort size and short period of
      follow-up. More recently, hydroxyurea has been investigated with 5-fluorouracil
      and concomitant radiotherapy. A sound theoretic rationale can be made for this
      approach and data derived from a phase I/II study are presented. These support
      the further investigation of this regimen.

PMID- 1641659
TI  - Laboratory and clinical studies of biochemical modulation by hydroxyurea.
AB  - Hydroxyurea is a potent inhibitor of the enzyme ribonucleotide reductase. Due to
      its effects on cellular deoxyribonucleotide pools, hydroxyurea can modulate the
      activity of several pyrimidine and purine antimetabolites. As an inhibitor of DNA
      repair, it can potentially interact with DNA-damaging agents such as alkylating
      agents or inhibitors of topoisomerase II. Both cytokinetic and biochemical
      interactions occur between hydroxyurea and cytarabine (ara-C), which account for
      their synergistic cytotoxicity. Inhibition of ribonucleotide reductase by
      hydroxyurea depletes cellular deoxycytidine triphosphate pools, thereby enhancing
      ara-C uptake and phosphorylation to ara-C triphosphate. In a phase II clinical
      trial, the combination of hydroxyurea and ara-C produced a 43% response rate in
      patients with refractory malignant lymphoma. Studies in murine leukemia models
      have demonstrated therapeutic synergy when hydroxyurea is combined with
      fluoropyrimidines. High levels of deoxyuridine monophosphate that have been
      associated with resistance to 5-fluorouracil can be suppressed by hydroxyurea,
      leading to greater inhibition of thymidylate synthase. Despite the strong
      biochemical rationale for the use of hydroxyurea and 5-fluorouracil in
      combination, few clinical trials have been conducted thus far. Antimetabolites
      and topoisomerase II inhibitors have also been shown to be synergistic in vitro.
      Hydroxyurea has been shown to enhance the formation of DNA strand breaks produced
      by amsacrine and to produce synergistic cytotoxicity with etoposide. A phase I
      clinical trial of these drugs has demonstrated bone marrow suppression to be the
      major toxicity of the combination. In summary, hydroxyurea has been shown to
      undergo cytokinetic and biochemical interactions with a number of established
      antitumor agents. Clinical trials of hydroxyurea in combination with these agents
      have identified doses and schedules of administration that produce acceptable
      levels of clinical toxicity and appear feasible for further testing.

PMID- 1641660
TI  - Treatment of colon cancer based on biochemical modulation of fluoropyrimidines by
      hydroxyurea.
AB  - Preclinical studies have indicated that hydroxyurea leads to enhancement of 5
      fluorouracil (5-FU) activity when given after 5-FU. This is presumably due to
      hydroxyurea's actions resulting in maintaining low levels of deoxyuridine
      monophosphate pools. The combination of hydroxyurea and 5-FU has been tested in
      several inconclusive clinical trials in patients with advanced colorectal cancer.
      However, pharmacodynamic studies have been lacking, and the schedules tested have
      not usually tried to follow preclinical findings. With the current renewed
      interest in 5-FU, a role for hydroxyurea as part of its biochemical modulation is
      worthy of further study.

PMID- 1641661
TI  - Enhancement of the loss of multiple drug resistance by hydroxyurea.
AB  - Gene amplification is one mechanism whereby tumor cells can become resistant to
      antineoplastic agents. Unstably amplified genes occur either on submicroscopic
      circular pieces of extrachromosomal DNA called episomes or on small acentric
      chromosomes called double minutes. Double minutes are frequently associated with
      cells containing amplified drug-resistance genes. Human epidermoid carcinoma KBV1
      cells contain unstably amplified mdr1 genes and overexpress P glycoprotein,
      resulting in decreased intracellular drug accumulation. In this cell line, a
      nonlethal concentration of hydroxyurea accelerated the rate of loss of
      vinblastine resistance once vinblastine had been removed from the culture medium.
      After removal of vinblastine, KBV1 cells exposed to hydroxyurea for the time
      required to complete 12 cell doublings accumulated more vinblastine than control
      cells grown in the absence of hydroxyurea. In contrast, hydroxyurea had no effect
      on vinblastine sensitivity and accumulation in parental drug-sensitive KB-3-1
      cells. Hydroxyurea also had no effect on sensitivity to cisplatin in cisplatin
      resistant human ovarian carcinoma 2008/C13* cells, indicating that hydroxyurea's
      effect on drug sensitivity was specific for a drug-resistance phenotype
      associated with unstably amplified drug-resistance genes. These results indicate
      that, after removing selective pressure, hydroxyurea accelerates loss of
      resistance to vinblastine and increases accumulation of vinblastine in KBV1
      cells, presumably by accelerating loss of amplified mdr1 genes and thus P
      glycoprotein.

PMID- 1641662
TI  - The role of tissue factor pathway inhibitor in a revised coagulation cascade.

PMID- 1641663
TI  - The tissue factor pathway of blood coagulation.

PMID- 1641664
TI  - The roles of fibrinogen and fibrin in hemostasis and thrombosis.
AB  - Proteolytic conversion of fibrinogen to fibrin results in self-assembly to form a
      clot matrix that subsequently becomes cross-linked by fXIIIa to form the main
      structural element of the thrombus in vivo. Fibrin formation and assembly lead to
      new properties that regulate the rate and extent of clotting, cross-linking, and
      fibrinolysis. These are brought about by the ability of fibrin (1) to bind
      thrombin at a nonsubstrate site, thus limiting its diffusability but at the same
      time preserving its catalytic potential; (2) to bind fXIII, regulate its
      activation to fXIIIa, and limit further activation of fXIII once fibrin cross
      linking has occurred; and (3) to bind alpha 2-PI, t-PA, and plasminogen and
      regulate the initiation and propagation of fibrinolysis. Fibrinogen and fibrin
      contain several potential platelet binding sites that interact with platelet
      GPIIb/IIIa receptors, and thus promote their participation in the hemostatic
      process. Additional, less well-defined interactions, not covered in detail here,
      such as those between fibrinogen or fibrin and other plasma proteins, cells, or
      tissue matrix components, suggest other functions that, along with those detailed
      above, will further define its multiple roles in modulating hemostasis,
      inflammation, and the wound healing process.

PMID- 1641665
TI  - Factor XI: a renaissance.

PMID- 1641666
TI  - The role of leukocytes in the activation of blood coagulation.

PMID- 1641667
TI  - Surface-dependent hemostasis.

PMID- 1641668
TI  - The cultural logic of Indian medicine: prognosis and etiology in Rajasthani
      popular therapeutics.
AB  - This paper considers certain ways of describing and treating sickness in rural
      Rajasthan, and the representations of sickness and of the body on which they are
      based. Two indigenous medical or 'ethnomedical' perspectives on illness and its
      treatment emerge from the analysis of ethnographic material collected during
      field research in northern India. In the first part of the paper various
      characterizations of South Asian medicine are discussed, and I suggest that
      Western preconceptions about the nature and purpose of 'medicine' itself has led
      one of these perspectives to be highlighted in anthropological considerations at
      the expense of the other. A further dimension of ethnomedicine emerges through
      discussions of local therapeutic rituals and discourses about sickness and the
      body. This consideration of one domain of local therapeutics reveals its
      underlying cultural logic and highlights ethnomedical formulations that have
      heretofore been analytically neglected. It does not address the formal or
      textually based Indian medical traditions to any extent. It is concerned with the
      cultural construction of sickness and medicine among Hindu lay people and folk
      healers and employs folkloric material that, though rarely considered in
      anthropological writings on South Asia, may be fruitful guide to the meanings
      which sickness has for those experiencing and treating it.

PMID- 1641669
TI  - What can information systems do for primary health care? An international
      perspective.
AB  - The reform of health information systems has been made a priority by health
      managers, public health specialists and technocrats. While each of these groups
      has promised major benefits from improvements in information systems,
      insufficient attention has been paid to the limitations placed upon the
      theoretical possibilities of information technology by the characteristics of the
      health system of which the information system is but a part. Managers anticipate
      improved efficiency and rational allocation of resources, but rational decision
      making does not automatically follow from improvements in information.
      Epidemiologists and public health specialists seek more effective and equitable
      health systems but methodological problems and the expense of many conventional
      epidemiological approaches continue to limit the usefulness of disease
      surveillance, programme monitoring and evaluation. Both managers and
      epidemiologists are confronted with the conflicts which arise in seeking to
      create locally sensitive information systems within centralised health systems.
      Technocrats see microcomputers as essential for information systems to be truly
      effective and as a means of liberating health workers from the drudgery of form
      filling. However, the rate of organisational evolution in the health system has
      not kept pace with the rapid development of information technology. There are
      good prospects for considerable health gain to be wrought from reforms in health
      information systems but to realise these it is necessary that this process be
      'action-led' rather than, as is conventional, 'data-led'. The latter approach
      sees data as the end in itself; the 'action-led' approach, in contrast, regards
      information as needs to interventions with a focus on how information will
      influence decisions. For improvements in information to result in improved
      health, strategies must be adopted which will ensure that information routinely
      informs decisions and is seen as a means to the end of improving health.

PMID- 1641670
TI  - Community-based HIV/AIDS research--whither community participation? Unsolved
      problems in a research programme in rural Uganda.
AB  - Involvement of the study community in research on HIV/AIDS has presented the
      MRC/UVRI programme in rural Uganda with a multi-layered challenge. A typology
      developed in agricultural research which defines different levels of community
      participation in research is described where participation may be at 'contract',
      'consultative', 'collaborative' and 'collegiate' level (each level indicating an
      increasing degree of community participation). Community involvement in the
      MRC/UVRI Programme is then outlined and the typology applied. It is shown that
      the majority of community participation in the Programme is at the contract level
      since the nature of the research programme as a 'foreign imposition' with
      'foreign goals' has precluded the involvement of the community in much of the
      policy development and research planning. However, it is noted that as the
      Programme becomes more established in the area community influence grows and
      signs of community impact on policy and increased research inputs are beginning
      to be seen. The question is raised as to whether it is realistic to expect that
      externally imposed health research, particularly on sensitive topics, can ever be
      truly community participatory research.

PMID- 1641671
TI  - Quantitative and qualitative approaches to the evaluation of the medical
      dialogue.
AB  - Increasing availability of audio and videotape of medical encounters has drawn
      the attention of researchers from diverse disciplines and perspectives.
      Unfortunately, the result has more frequently been interdisciplinary competition
      than collaboration. Most striking are the differences in approach between
      researchers applying qualitative and quantitative methods. Advocates of each of
      these methods have not only argued their own relative merits, but have maintained
      unusually critical and intellectually isolated positions. The purpose of this
      paper is to demonstrate that the paradigmatic perspective which promotes mutual
      exclusivity is in error. We present several examples of research findings which
      demonstrate the rich potential for cross-method research. Examples have been
      taken from the areas of most fruitful qualitative and quantitative research-
      information gathering, patient disclosure, and information-giving.

PMID- 1641672
TI  - Yolmo aesthetics of body, health and 'soul loss'.
AB  - To date, little attention has been paid to the cultural philosophies of
      experience which shape human behavior. The present paper contends that culturally
      constituted 'aesthetics' of everyday life underlies moments of health, illness
      and healing among Yolmo Sherpa of Helambu, Nepal. The author examines cultural
      understandings of bodily and social experience to show how implicit aesthetics-
      from values of harmony and balance to fears of loss and decay--shape the ways in
      which Yolmo manage and evaluate their lives and how they construe and experience
      incidents of 'soul loss.' An analysis of shamanic ritual suggests, in turn, that
      while themes of imbalance, fragmentation and deficiency haunt the body in
      illness, healing works to reinstate a visceral sense of harmony, completion and
      vitality. These values reflect pressing political concerns. The paper concludes
      that a phenomenology of embodied aesthetics requires an analytic approach
      distinct from current semiotic, intellectualist, or psychological paradigms.

PMID- 1641673
TI  - Sexual behaviour related to psycho-social factors in a population of Danish
      homosexual and bisexual men.
AB  - An anonymous self-administered questionnaire was distributed to (1) male members
      of the Danish Gay and Lesbian Association (2) through a gay magazine and (3) to
      readers of a gay pornographic magazine. For the purpose of this study sexual
      practices were classified into three categories taking into account the HIV
      status of the respondent and his partner(s): safe sex (mutual masturbation, sex
      with condoms, sex without condoms between two HIV-positives), potentially safe
      sex (oral-genital sex without condoms irrespective of HIV-status, anal-genital
      sex without condoms between two HIV-negatives), unsafe sex (anal-genital sex
      without condoms between discordant partners or partners of unknown HIV status).
      Of the 2058 respondents 29.7% had had unsafe sex in the last 12 months.
      Multivariate analysis by recursive graphical models showed that sexual practice
      was directly related (that is conditionally dependent given the rest of the
      variables) to having a steady partner. Among men without a steady partner sexual
      practice was also directly related to age and number of partners showing an
      increase in unsafe sex with number of partners and a decrease with age. Thus of
      the men 16-19 years of age 43.5% had had unsafe sex irrespective of number of
      partners vs 5.7% of men older than 44 years and with one to two partners. Sexual
      practice was not directly related to any other demographic or psychosocial factor
      in the study. The adopted classification of sexual practice preclude that the
      high occurrence of unsafe sex could be explained by unsafe sex taking place among
      partners of concordant HIV status. The results emphasize the need for further
      preventive efforts to reduce transmission of HIV among homosexual men.

PMID- 1641674
TI  - Development and validation of the PCQ: a questionnaire to measure the
      psychological consequences of screening mammography.
AB  - We have developed a reliable and valid questionnaire to measure the psychological
      consequences of screening mammography. The questionnaire measures the effect of
      screening on an individual's functioning on emotional, social, and physical life
      domains. Content validity was ensured by extensive review of the relevant
      literature, discussion with professionals and interviews with attenders at a
      pilot Breast X-ray Screening Program in Melbourne, Australia. Discriminant
      validity was assessed by having expert judges sort items into dimensions which
      they appeared to be measuring. Acceptable levels of concordance (above 80%) with
      a priori classifications were found. Concurrent validity was demonstrated by
      comparison of subscale scores of 53 attenders at the Breast X-ray Program with an
      independent interview assessment of dysfunction on each of the emotional, social
      and physical dimensions. There was over 79% agreement between interview scores
      and questionnaire scores for each dimension. Construct validity was confirmed by
      showing that subscale scores varied in predicted ways. For women who were
      recalled for further investigation, scores on each subscale measuring negative
      consequences, were higher at the recall clinic than at screening clinic
      (emotional: t = -7.28; df = 70; P less than 0.001; physical: t = -2.53; df = 70;
      P = 0.014; social: t = -2.49; df = 70; P = 0.015). The internal consistency of
      all subscales was found to be acceptable. This questionnaire is potentially
      useful for assessing the psychological consequences of the screening process and
      should have wide application.

PMID- 1641675
TI  - The impact of road construction on the spatial characteristics of hospital
      utilization in the Meru district of Kenya.
AB  - This paper examines the effect of road construction on the catchment area of a
      church hospital. It is hypothesized that the new road will reduce the spatial and
      travel cost relationships for the hospital's patients. Analysis of the data
      suggests that the space-reducing effect of the new road is more important than
      its effect on travel costs. Reductions in the cost of travel have not
      significantly changed the spatial pattern of in-patient utilization. In contrast,
      out-patients show the hospital is attracting patients from further afield, though
      this involves a similar expenditure on fares to that prior to road construction.
      Institutional barriers, particularly the economic barrier of fee-paying
      treatment, are found to be the main explanation for this finding. The high cost
      of medical treatment also goes some way towards explaining the low level of child
      treatment apparent in the patient records.

PMID- 1641676
TI  - Determinants of perceived health status of medical outpatients.
AB  - The aim of this study was to examine the relative contributions made by medical
      morbidity, psychiatric disorder, functional status, and hypochondriacal attitudes
      to medical patients' opinions of their overall health status. The study was
      conducted in the general medical clinic of a large academic teaching hospital.
      Consecutive clinic visitors on randomly selected days were screened with a
      hypochondriasis self-report questionnaire, since the overall project was designed
      as a study of hypochondriasis. A random sample of the patients below a pre
      established cutoff (n = 100), along with all those exceeding the cutoff (n = 88),
      returned to undergo a research battery. For this analysis, a representative
      sample of the entire clinic was reconstituted by weighting the data from patients
      above and below the screening cutoff in proportion to their prevalence in the
      clinic. Measures of psychiatric disorder (the Diagnostic Interview Schedule),
      personality disorder, functional status and disability, medical morbidity (from
      physician ratings and medical record audit), and hypochondriacal attitudes were
      obtained. Patient self-ratings of global health status were significantly
      correlated with aggregate medical morbidity (r = 0.36; P less than 0.001);
      psychiatric morbidity (r = 0.48; P less than 0.001); functional disability (for
      intermediate activities of daily living, r = 0.62; P less than 0.001);
      hypochondriacal attitudes (r = 0.79; P less than 0.001); and with the tendency to
      somatize (r = 0.77; P less than 0.001). Using multiple regression analysis, the
      most powerful correlates of perceived global health were hypochondriasis,
      somatization and disability (model R2 = 0.762).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641677
TI  - Communicative styles and adaptations in physician-parent consultations.
AB  - This investigation compares the degree to which personal and interactive factors
      respectively account for variation in patterns of physician-parent communicative
      exchange. The analysis of audiorecordings of 115 pediatric consultations revealed
      several notable findings: (a) individual physicians differed in the degree to
      which each provided information, issued directives, exhibited positive
      socioemotional behavior, and engaged in partnership-building, (b) parents who
      asked more questions and expressed more negative affect (e.g. concerns,
      frustrations) received more information and directives from physicians, (c)
      parents who were more affectively expressive elicited a greater number of
      positive socioemotional comments from doctors, and (d) parents' question-asking
      and opinion-giving were related to the parents' level of education and the degree
      to which physicians' engaged in partnership-building. The results of this study
      suggest that, as are other forms of interpersonal communication, medical
      consultations are processes of personal and mutual influence that unfold
      according to the characteristics of the individuals and to interactive processes
      related to how interactants adapt their communication to one another.

PMID- 1641679
TI  - Planning health care in South Africa--is there a role for traditional healers?
AB  - Developing health policies for the 'post-apartheid' era has become an urgent task
      of the early 1990s in South Africa. A neglected policy issue thus far has been
      the question of whether traditional healers have a role to play in future health
      care, and if so what this should be. Rather than developing positions on these
      questions, this paper sets out the main debates which need the consideration of
      health care planners. Arguments for and against traditional healers in health
      care are presented, and alternatives which could be chosen are outlined. Options
      adopted by countries on South Africa's borders, Zimbabwe, Mozambique and
      Swaziland are briefly considered.

PMID- 1641678
TI  - Underreaction to AIDS in Sub-Saharan Africa.
AB  - In those parts of Sub-Saharan Africa most affected by the HIV/AIDS epidemic both
      public and private reaction to the seriousness of the epidemic have been less
      than might have been anticipated. This limited reaction weakens national,
      community and family responses to the epidemic and also reduces the pressure on
      international donors to provide adequate support. The paper first examines the
      reasons for underreaction by governments. These reasons include an assessment
      that successes will not be easily achieved, a reluctance to give leadership in
      areas of private sensitivity, an awareness of the fragility of the data base, a
      persistent feeling that it is a disease of foreign origin with a foreign
      overreaction to the situation in Africa, and the nature of the disease itself
      with a long latency period, obscure symptoms and an urban bias. Nevertheless, the
      paper argues that the more fundamental underreaction, shaping the reactions of
      governments, is that from the community itself. This arises partly from the
      demonstration that it is a sexually transmitted disease in societies where the
      discussion of sexual relations between the generations and the sexes has always
      been difficult and where new religions have in some societies reinforced older
      attitudes towards the shame of being discovered to have had illicit
      relationships. However, the main reasons lie in continuing aspects of the
      cultures which emphasize the multiple antecedents of misfortune and plural
      explanations of death, an element of predestination in when death takes place, a
      concept of good fortune--sometimes arising from or demonstrated by sexual
      activity--which renders misadventure unlikely, and a courage when facing death
      which is partly attributable to belief about survival beyond this event.

PMID- 1641681
TI  - Methodological issues and research strategies in the study of coping with cancer.
AB  - We explore methodological issues and research strategies and applications in the
      study of coping with cancer. The major points are addressed within the context of
      the transactional, or process, model of stress and coping offered by Lazarus and
      Folkman. Three features of this model are discussed: (a) a focus on what
      individuals are actually doing and thinking in stressful transactions as opposed
      to what they usually do or would do; (b) an emphasis on assessing coping behavior
      in relation to a specific context and; (c) attention to the dynamic nature of
      coping behavior. We outline each of these three features and discuss its
      implications for research on coping with cancer; particular attention is given to
      specific measurement strategies and substantive research questions. We also
      consider the utility of research on coping with cancer for the design and
      implementation of coping interventions for individuals with cancer.

PMID- 1641680
TI  - Suicide and unemployment in Italy: description, analysis and interpretation of
      recent trends.
AB  - This paper assesses the relationship between suicide and unemployment in Italy
      during the period 1977-1987, taking into account variations by gender and region.
      The first objective of the study is to provide descriptive longitudinal and cross
      sectional aggregate-level analyses and also trends in individual-level and
      population risks for suicide in relation to unemployment. Our second objective is
      to use the Italian data to help discriminate between rival interpretations of the
      unemployment-suicide link, i.e. the operation of health selection or causal
      (susceptibility) mechanisms. Evidence for an association between suicide and
      unemployment among women was not convincing. The annual rate of female
      unemployment was negatively correlated with the female suicide rate and unrelated
      to the suicide rate among the unemployed, the relative risk or population
      attributable risk. Individual-level analyses for each year confirmed that
      unemployed women were more likely to commit suicide than their employed
      counterparts, although the overall relative risk was low (1.5) and conference
      intervals for six of the eleven annual risk ratios included unity (1). Among men,
      the unemployment rate was positively correlated over time with the suicide rate.
      However, change in the suicide rate across 18 geographic regions of Italy was
      unrelated to change in the unemployment rate, a finding which did not appear to
      be invalidated by a regression to the mean effect. Unemployment was also
      positively related to the suicide rate among the employed and population
      attributable risk, but unrelated to the rate among the unemployed or the relative
      risk. Comparison of suicide rates among the employed and unemployed revealed an
      excess of suicide among the latter in each year, with an overall relative risk of
      3.4. On the basis of this contradictory and inconsistent evidence, we are
      cautious about offering definitive interpretations concerning the nature of the
      unemployment-suicide link among men. We conclude by suggesting the need for
      further individual-level studies using retrospective case-control methods.

PMID- 1641682
TI  - Patients' choices and perceptions after an invitation to participate in treatment
      decisions.
AB  - Previous search indicates that treatment outcomes may be improved if patients
      perceive greater control over their treatment, but the practical implications of
      encouraging patients to take more control have not been investigated. The present
      study investigated responses of 143 patients in a cardiovascular risk management
      clinic to an invitation to make a decision about their treatment. Subjects'
      choices of the target behaviour for their behaviour-change treatment were highly
      predictable from their state of health, reasons for coming to the clinic, what
      behaviours they were told they were at risk from, and contacts with health
      workers. The degree of control that subjects reported they had over the decision
      varied considerably, being negatively related to blood pressure and positively
      related to the degree of control that subjects believed they had over their
      health in general. Issues such as time-demands, the practitioner's job
      satisfaction, and ethical implications of patient participation are discussed.

PMID- 1641683
TI  - Perceived morbidity and health behaviour in a Dogon community.
AB  - The episodes of morbidity over a 6 month period were recorded at 179 households
      comprising 1715 people living in the district of Bandiagara (Mali). This
      population was subdivided into groups according to their distances from the
      nearest district health centre and educational services, their scholarization,
      socio-economic and hygiene levels. The subjects interviewed were asked to report
      illnesses using their vernacular names, the type of therapy selected, the
      decision process, the time-lapse between onset and remedial action, the treatment
      undergone and its effect. Subsequent analysis of the data recorded indicates that
      the frequency of morbidity episodes is inversely proportionate to the household's
      level of hygiene. It also appears that factors such as the household's hygienic,
      socio-economic and educational levels along with the type of illness and its
      duration, are more decisive when resorting (or not resorting) to treatment than
      is the proximity factor. This seems particularly true in the case of traditional
      medicine, chosen even where cosmopolitan resources are available and by people
      with a relatively high socio-economic, hygienic and educational level. In the
      specific situation under study this paper indicates those areas for further study
      with a view to improving public health education.

PMID- 1641684
TI  - The quality and quantity of social support: stroke recovery as psycho-social
      transition.
AB  - The impact of various types and amounts of social support is examined in the
      context of recovery from first stroke. We conceptualize the rehabilitation
      process as a psychosocial transition. In a longitudinal design, 44 patients were
      followed for 6 months following first stroke. Growth-curve analysis (repeated
      measures MANOVA) was utilized to examine the impact of three types of social
      support on changes in functional status during recovery. While all three types of
      support (emotional, instrumental and informational) were shown to be
      significantly related to recovery of functional capacity, substantial differences
      were found in the nature of those effects. The impact of social support does not
      appear during the first month of rehabilitation, indicating the importance of
      longitudinal designs and longer observation. Patients reporting high level of
      emotional support showed dramatic improvement despite having the lowest baseline
      functional status. Instrumental support is most closely related to positive
      outcomes when provided in moderate amounts. Unlike the other two types, the
      effect of informational support is mediated by disease severity.

PMID- 1641685
TI  - Genetic counselor attitudes towards fetal sex identification and selective
      abortion.
AB  - Thirty-four prenatal genetic counselors (all but one non-M.D.s) in seven American
      cities were interviewed on attitudes which might plausibly affect counselor
      client interchanges. They overwhelmingly endorse both non-directive counseling
      and the pro-choice ethos which supports a woman's absolute right to abortion in
      the early stages of pregnancy. However, they also overwhelmingly condemn using
      prenatal diagnosis for sex selection purposes. Therefore, counselors experience
      continual stress from clients who evoke the conflict inherent between these two
      stances. Counselors use a variety of coping mechanisms to minimize this cognitive
      dissonance. Avoidance through out-referral or invoking institutional policies
      forbidding prenatal diagnosis for sex selection purposes is a diminishing option
      and not possible with clients who have or offer a medical indication. More common
      is the use of psychological coping mechanisms. By elevating the ideals of non
      directiveness and female autonomy counselors better tolerate client values in
      conflict with their own. Some redefine the category of 'unwanted pregnancy' to
      include fetuses of the 'wrong sex'; others redefine the problem as their own
      ethnocentricism. Empowering counselors to set the protocols they use to screen
      applicants for prenatal diagnosis would not remove these conflicts. Many
      counselors believe a ban on releasing fetal sex information while abortion is
      still a legal option would be organizationally or legally unacceptable, or a
      violation of patient automony. A complicating factor is that 60% of the
      counselors interviewed would prefer to know fetal sex in their own pregnancies.
      Counselors reflect the ambivalence of American society in balancing conflicting
      social goals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641686
TI  - Mother's milk and pseudoscientific breastmilk testing in Pakistan.
AB  - In urban squatter settlements and rural villages of Pakistan, human breastmilk is
      regarded as a potential source of destruction as well as of nurturance. Though it
      is highly valued as crucial for infant survival, it is also thought susceptible
      to becoming tainted in many ways: by a 'shadow' from the spirit world; by 'evil
      eye' or black magic due to others' envy; by the effects of a new pregnancy; by
      the mother's illness or 'weakness'; by her exposure to excessive cold or heat; by
      her dietary indiscretions. In any of these circumstances, women may stop
      breastfeeding to prevent illness in the nursing child. Sometimes the stoppage is
      temporary, brief, and has no serious consequences. When the mother is pregnant,
      however, it is permanent. Further, if a child is sickly, cries a great deal, has
      prolonged diarrhea, or seems reluctant to suck, mothers frequently become alarmed
      and suspect irreversible breastmilk 'poisoning'. In the latter case, a folk
      healer has traditionally been consulted to test the milk's quality, but in recent
      years pathology laboratories have increasingly taken on this function in all of
      the major cities in Pakistan. Not only does the mother stop breastfeeding while
      the milk is being tested, but often she is unable or unwilling to resume nursing
      even if the milk is eventually pronounced safe to drink. This manifestation of
      inappropriate, child-endangering technology has gained acceptance partly because
      of maternal anxieties heightened by commercially-driven pressures to be 'modern'
      and partly because of its congruence with traditional ideas surrounding
      breastmilk, many of which have classical antecedents.

PMID- 1641687
TI  - Prevalence of smoking in secondary schools in the Greater Accra region of Ghana.
AB  - Tobacco smoking is fast becoming a public health problem in Ghana and the youth
      are at a greater risk of becoming victims of it. A survey of nine secondary
      (high) schools in the Greater Accra Region of Ghana showed that 31.1% of students
      have smoked before and that 10.3% smoke cigarettes regularly. A significant
      number of those who had ever smoked (32.6%) came from high socio-economic homes
      as exemplified by the level of education of the father. Advertising appears to be
      a factor as to why students start to smoke. Most students (59.4%) appear to know
      smoking is injurious to health. There is need to motivate secondary school
      students about not smoking. There is also need to legislate in Ghana to prevent
      the sale of tobacco products to young people and prohibit smoking in schools and
      in public places.

PMID- 1641688
TI  - Beri-beri: age-gender bias in The Gambia.
AB  - This paper investigates a suspected outbreak of beri-beri which occurred in The
      Gambia in 1988. The outbreak was spatially specific and had a distinct age and
      gender bias, with young men aged 15-49 being the group mainly affected. The age
      and gender bias of the outbreak is particularly interesting as women and children
      in the developing world are usually more susceptable to conditions associated
      with malnourishment, than men. The authors investigate the peculiar nature of the
      outbreak and find that they cannot easily explain the apparent age and gender
      bias. The authors note that at the time of the outbreak medical treatment took
      precedence over socio-economic investigations. This makes it difficult to
      ascertain why certain age and gender groups were affected and thus to target them
      for future preventative health education programmes. This case study therefore
      concludes, that where possible, medical investigations must be combined with
      socio-economic studies if future outbreaks of this kind are to be avoided.

PMID- 1641689
TI  - The impact of formal, informal, and societal support networks on the
      psychological well-being of black adolescent mothers.
AB  - Although several researchers argue that informal support systems provide economic
      and psychological resources for black families, little empirical research is
      available to inform policy and intervention programs. This article examines the
      impact of informal, formal, and societal support systems on the mental health of
      black adolescent mothers. Using the social work generalist theoretical framework,
      several types of resources are considered separately to determine whether they
      contribute similarly to psychological well-being. Data from a survey of black
      teenage mothers show that both lay and professional supports were important for
      the young mother's psychological well-being. Support from a male partner,
      caseworker contact, and membership in a support group decreased psychological
      distress and depression. Support from the male partner also enhanced
      psychological well-being. Support from friends, on the other hand, was associated
      with higher levels of psychological distress. A professional service plan that
      effectively incorporates informal and societal supports in a complementary manner
      offers the best possibility for reducing the distress of black teenage mothers.

PMID- 1641690
TI  - Legal requisites for social workers in child abuse and neglect situations.
AB  - Societal efforts to protect endangered children have resulted in increased
      responsibilities for social workers, who are expected to identify, report, and
      provide testimony in suspected cases of abuse and neglect. Their decisions in
      these cases may have profound consequences for children, families, and
      themselves. This article increases social workers' knowledge of legal requisites
      and system realities in child protection to help them make high-quality
      decisions.

PMID- 1641691
TI  - Therapeutic processes in professional and peer counseling of family caregivers of
      frail elderly people.

PMID- 1641692
TI  - Drug use and AIDS risks in a soup kitchen population.
AB  - Untreated substance users remain beyond the reach of most acquired immune
      deficiency syndrome (AIDS) prevention efforts. In an effort to describe the risk
      behavior and attitudes of this population, the authors conducted interviews with
      148 drug users in an urban soup kitchen. The study focused on subjects' risk
      taking and risk-reduction behavior related to injection drug use, perceived
      changes in risk behavior, perceived risk for contracting AIDS, and socioeconomic
      and attitudinal correlates of injecting and sharing needles. Study findings
      underscore the need for community-based AIDS prevention strategies to intervene
      with high-risk populations beyond the reach of drug treatment and AIDS prevention
      programs.

PMID- 1641693
TI  - [Comparison of administration of low doses of bromocriptine and levodopa in the
      early treatment of Parkinson disease].
AB  - Results og an open, controlled three-month clinical trial of therapeutical
      efficacy of a combination of a low doses of levodopa/carbidopa and bromocriptine
      in 20 de novo patients with Parkinson's disease (PD) are presented. All patients
      received the same daily doses of levodopa/carbidopa (250 mg), while daily dosage
      of bromocriptine was gradually increased from 1.25 mg to 30 mg. Owing to
      development of adverse effects 3 patients dropped out of the study, while in 70%
      of the patients who completed the protocol improvement of motor functioning
      exceeded 50%. Those with bradykinesia and rigidity responded most favorably. For
      all our patients the mean daily dose of bromocriptine was 26.25 mg. The most
      common adverse effects of the therapy were orthostatic hypotension (7 pts) and
      nausea (5 pts). The results of the study coincide with the hypothesis that
      comparative administration of low doses of bromocriptine and levodopa is the best
      approach to treatment of early phases of PD.

PMID- 1641694
TI  - [The effect of hyperprolactinemia on biohumoral parameters of bone metabolism in
      women of reproductive age on chronic hemodialysis].
AB  - The study was carried out on a group of 20 women in reproductive age on chronic
      haemodialysis and on a control group of 11 healthy women. The women on a regular
      haemodialysis were divided into two subgroups: normoprolactinaemic and
      hyperprolactinaemic. The following parameters of bone metabolic changes were
      studied: serum calcium, phosphorus, alkaline phosphatase, pharathormon,
      osteocalcin, calcitonin, and also LH, FSH, prolactin and estradiol. The values of
      serum Ca, P, AP, PTH, CTC, OS and of LH and FSH were significantly higher in
      women on haemodialysis. The hyperprolactinaemic women on haemodialysis had lower
      values of bone metabolic parameters than normoprolactinaemic women.
      Hyperprolactinaemia did not significantly contribute to acceleration of bone
      metabolic changes which were already very accelerated due of secondary
      hyperparathyroidism.

PMID- 1641695
TI  - [Intravenous loading doses of sodium phenobarbitone in the treatment of status
      epilepticus].
AB  - Over a period of nine months 14 adult patients with status epilecticus were
      treated with intravenous loading dose of phenobarbital-sodium. The initial dose
      was 9 to 12 mg/kg of body weight; it was increased to 36 mg/kg when seizures were
      stopped. The rate of infusion was 100 mg/min. In 11 of 14 patients (79%) this
      treatment was effective. The dose ranged from 9 to 14 mg/kg in ten patients and
      36 mg/kg in the remaining one. Seizures stopped during the first minute of
      infusion in nine patients. This treatment was unsuccessful in 3 patients. The
      rate of infusion was faster in the group where the therapy was successful. In
      this group higher plasma levels of phenobarbital were obtained with smaller
      loading doses than in the other patients. Side-effects were mild and transient;
      they comprised prolonged postical depression of consciousness. No respiratory or
      cardio-vascular side-effect were observed. There was no potentiation of side
      effect with subsequent application of intravenous diazepam. We conclude that
      intravenous phenobarbital-sodium is highly effective and safe in the treatment of
      status epilecticus.

PMID- 1641696
TI  - [Antimicrobial sensitivity of Haemophilus influenzae strains isolated from
      children].
AB  - Antibiotic susceptibility of 1308 Haemophilus sp. strains isolated in children
      was evaluated over a 6-year period. Based on their source and clinical
      presentation all strains were divided in three groups. The first group consisted
      of 1264 strains obtained by throat and nasal swab; the second of 30 mucosal
      strains isolated in children manifesting non-invasive infection and the third of
      14 invasive strains, Haemophilus influenzae(Hi)tip b, isolated from blood, CSF,
      pleural and synovial effusion. The isolates of the first and the second group
      demonstrated high susceptibility (90%) to chloramphenicol, erythromycin, and
      ceftriaxone, lower (70-90%) ampicillin and trimethoprim-sulfamethoxazole and low
      susceptibility (less than 25%) to penicillin, lincomycin and cefalexin. Invasive
      strains of Hi tip b were resistant to multiple drugs, showing susceptibility
      exclusively to chloramphenicol, erythromycin and ceftriaxone. Guidance for the
      treatment of the invasive and non-invasive infections and chemoprophylaxis are
      discussed.

PMID- 1641697
TI  - [Osteomyelitis after malleolar fractures].
AB  - Over a ten-year period, 485 patients suffering from malleous fracture were
      operated at the Department for Orthopaedic Surgery and Traumatology in Novi Sad.
      Postoperative infection appeared in ten cases (2.06%). Eight of these patients
      primarily had open fractures, and two of them had closed ones. Osteosynthesis of
      the lateral malleous had most frequently been treated by the use of panel and
      screws. Staphylococcus aureus was isolated as symptom of the infection in eight
      cases. In treatment of malleous osteomyelitis, the debridement of focus of
      infection together with fixation material extraction was the most frequently
      performed operative method. During a two-year period no exacerbation, seven
      patients was observed while at control examination three patients had secretion
      from fistula. Mobility of ankle joint was limited in most cases, while walking
      imposed no pain.

PMID- 1641698
TI  - [The effect of penicillamine in copper-processing workers].
AB  - Workers working in copper alloy factories (n = 40) who are professionally exposed
      to smoke and dust of copper, zinc, lead and cadmium and workers who are not
      exposed to toxic noxae (n = 15) were perorally administrated penicillamine for
      three days in order to evaluate deposits of these metals in their organisms. On
      the basis of the results obtained after penicillamine administration it was
      concluded that this substance can be useful in the evaluation of the presence of
      copper in workers. Penicillamine mobilisatory effect on lead and zinc in the
      organism was also proved. Because of competitive relations between copper and
      zinc (copper was a dominant noxa) it was not possible to evaluate the internal
      zinc presence. The mobilisatory effect of penicillamine on cadmium in the
      organism was not observed.

PMID- 1641699
TI  - [The intrathecal manometric lumbar infusion test (Katzman Test) in the diagnosis
      of normotensive hydrocephalus].
AB  - Over 12-months 17 patients were admitted to the hospital for the presumed
      diagnosis of normal pressure hydrocephalus (NPH). Four patients had cardinal
      signs of the syndrome: gait disturbance, dementia and urinary incontinence. Six
      patients had gait disturbance and dementia. Five patients had gait disturbance
      and ventricular enlargement on CT scans of the brain, while the last two patients
      had only urinary incontinence and dementia. All patients underwent neurological
      examination and CT scans. Clinical and radiological results of these patients
      were compared with the results of the Katzman's test. Katzman's test was
      performed in all patients. Physiologic solution of 0.9% NaCl was infused in the
      lumbal subarachnoid space. The rate of infusion was 1 ml/min during 60 minutes.
      Cerebrospinal fluid (CSF) pressure was recorded simultaneously using metal
      aneroid. The test was considered positive if either CSF pressure over 300 mm H2
      or undulating waves were recorded at any time of the test. Katzman's test was
      positive in 12 patients (9 of them with NPH). The undulating waves were recorded
      in 6 patients (5 with NPH). Four of them experienced tachycardia,
      hyperventilation, cephalea and mild confusion during the test. The test was
      positive in all 9 patients with NPH but also in 3 patients with different but
      pathophysiologically similar disorders. The test was positive in all 4 patients
      with the characteristic clinical triad of the syndrome and also in all 4 patients
      with periventricular hypodensity on their CT scans. No patient without gait
      disturbance had positive test. All except one patient with focal signs or
      pronounced cortical atrophy, besides with dramatic clinical improvement.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641700
TI  - [The importance of changes in the septal Q wave induced by exercise in the
      detection of ischemic heart disease].
AB  - Among the numerous variables measured by the electrocardiogram during exercise
      little attention has been paid to the "septal" Q wave. We examined changes of the
      "septal" Q wave amplitude during exercise in 43 patients with chest pain.
      Coronary arteriography showed significant changes in 23 patients and normal
      arteries in 20. The Q wave amplitude was measured in leads V4-V6 immediately
      before and at the peak of submaximal bicycle exercise. The amplitude of "septal"
      Q wave increased during exercise in 11 (55%) patients, and decreased or was not
      changed in 9 (45%) of the normal subjects (p greater than 0.05). However, the Q
      wave amplitude increased in 6 (26%) patients, and decreased or was not changed in
      17 (74%) patients with ischaemic heart disease (p less than 0.05). Thus, the
      sensitivity of Q wave analysis in the detection of coronary disease was 74% (p
      less than 0.05), but specificity was only 55% (p greater than 0.05).

PMID- 1641701
TI  - [Juvenile ankylosing spondylitis and the joint hypermobility syndrome].
AB  - The problem of correlation of rheumatic diseases with mobility of joints in
      children and young individuals was not frequently been considered. The first of a
      few authors was C.J. Sutro who was concerned with this problem in 1947. The goal
      of our treatment was to prevent as long as possible the onset of ankylosis in our
      patients. They were treated by NSAID as well as by intensive kinesi- and
      hydrotherapy. All these patients, besides HLA-B27 have also A2 antigen, a
      possible gen for hypermobility. A prospective study should explain the
      significance and role of A2 antigen in these patients.

PMID- 1641702
TI  - [The attitude toward persons with epilepsy].
AB  - The attitude of 50 employees and 50 students to epileptic patients was studied
      with the use of the classical scale of Likert's type. It was found that students
      were more tolerable then the employees. However, they all were humanistic only
      when general principles were in question i.e. that epileptic persons should not
      be avoided, but not also in personal contacts (emotional, close relation,
      professional). The obtained results confirmed the presumption that the problems
      related to the difficult employment and family-establishment of epileptic
      subjects was the consequence of negative attitude and prejudices of the
      environment to such persons. The secondary handicap due to illness frustrates the
      normal life of these individuals sometimes more than epileptic attacks. This is
      one of the reasons why physicians should pay additional attention to this problem
      during the treatment of epileptic patients.

PMID- 1641703
TI  - [Epidermoid cyst of the spleen].
AB  - A 33-year old woman with 6 x 6 cm splenic cyst of the lower pole of a moderately
      enlarged spleen, found during ultrasonographic examination for epigastric and
      left subcostal abdominal pain, is presented. At operation the spleen of 900 grams
      with a subcapsular cyst in pedunculated extension of the lower splenic pole, ie.
      accessory lobe, was removed. No other abdominal disease was found. Postoperative
      recovery was uneventful. Pathohistological examination revealed a cyst, 6 cm in
      diameter, with whitish wall filled with dark-red turbid fluid containing yellow
      flocules. The wall of the cyst consisted of the fibrous connective tissue with
      sclerotic and hyaline changes. The cyst was entirely lined by the stratified
      squamous epithelium, in some areas flattened, transformed into endothelium.
      Diagnosis of a very rare splenic epidermoid cyst in the "accessory lobe" of the
      lower pole, was confirmed.

PMID- 1641704
TI  - [Disseminated zygomycosis in patients with acute leukemia].
AB  - The authors present two patients with acute myeloid leukaemia and pulmonary
      disseminated form of zygomycosis developed during the period of bone marrow
      aplasia. Diagnosis was established on necropsy on the basic of the patho
      histological finding of wide, short and nonseptate hyphe with irregular
      branching. Hyphe were clearly recognized on Gomori methenamine Silver stained
      preparations. There were multiple haemorrhagic-necrotic infarcts of different
      organs due to the mycotic invasion of blood vessels. The authors discuss some
      some important diagnostic and therapeutic problems.

PMID- 1641705
TI  - [Perforated ulcer in Meckel's diverticulum].
AB  - Three cases, two women and one man, aged 27, 47 and 79 years with perforated
      peptic ulcer of Meckel's diverticulum are reported. All patients had diffuse
      peritonitis. The exact diagnosis of the cause of peritonitis has not been
      preoperatively established in any of them. In two patients cuneiform excision
      (diverticulectomy) was performed, and resection and anastomosis of the small
      intestine in the third. The female patients, aged 79, after an uneventful
      recovery suddenly died due to an acute heart failure on the eight day after
      surgery. In other patient suppuration of the wound occurred and convalescence was
      prolonged. In all cases microscopic examination revealed ectopic gastric mucosa
      on the top of the diverticulum with peptic ulcer.

PMID- 1641706
TI  - [Intra-arterial administration of prostaglandin E1 in occlusive arterial
      diseases].
AB  - The authors present their result of a two-year follow-up of 106 patients to whom
      an intra-arterial perfusion of prostaglandin E1 was administered, as limb salvage
      procedure. The patients were in the IIIrd and IVth stage of occlusive diseases by
      Fountain, and surgical reconstructions were not possible. All patients were
      divided into five groups: A--diabetic angiopathy (5), B--distal form of
      atherosclerosis (40), C--diabetic angiopathy and atherosclerosis (45), D--Burger
      disease (10) and E--adjuvant therapy in reconstruction with poor run-off (6). The
      Doppler sonographic and angiographic measurements were performed. After
      transcutaneous (16 cases), or intraoperative (90 cases) introduction of the
      catheter into superficial of profunda femoral artery, a continuous intraarterial
      administration of prostaglandin E1 was carried out in a dose of 10 nanograms/kg
      body weight/minute (total dosage 3000 nanograms). The patients were controlled
      immediately after the treatment, as well as 1, 3, 6, 12, 24 and 36 months after
      the treatment. In efficiency of the treatment was estimated on the following
      basis: elimination of rest pain, healing of trophic ulceration and demarcation of
      gangrenous processes. Our late results of intra-arterial administration of
      prostaglandin E1 proved to be a very successful limb salvage procedure. The
      treatment was more successful in a connections between the upper knee arterial
      net and pedal arterial arches were preserved.

PMID- 1641707
TI  - [Feasibility of use and limitations of the 3D-MR study technique. Results of 5
      years' clinical experience].

PMID- 1641708
TI  - [Plain and dynamic computed tomography in liver cirrhosis].

PMID- 1641709
TI  - [Ochronosis of the lumbar vertebrae].

PMID- 1641710
TI  - Cystic fibrosis. Part II. New developments in cystic fibrosis--implications for
      carrier detection and genetic counselling.
AB  - Cystic fibrosis (CF) is an autosomal recessive disorder found predominantly in
      people of European origin. Prenatal diagnosis for this disorder is now possible
      using the polymerase chain reaction technique to detect the most common CF
      causing mutation, delta F508. Case studies of prenatal diagnosis and carrier
      detection are presented and some of the genetic counselling issues related to
      these investigations are discussed.

PMID- 1641711
TI  - The frequency of the delta F508 mutation in the cystic fibrosis genes of 71
      unrelated South African cystic fibrosis patients.
AB  - The common delta F508 mutation is present in approximately 70% of mutant cystic
      fibrosis (CF) genes of European and North American populations. The frequency of
      the delta F508 mutation has been established for two groups of South African CF
      subjects. The mutation was found to be present in 82% and 53% of CF genes of
      white and coloured (i.e. of mixed ancestry) subjects respectively. These findings
      assist in providing appropriate counselling to individuals who have a family
      history of CF and in defining laboratory strategies for the establishment of an
      efficient genetic service for cystic fibrosis.

PMID- 1641712
TI  - Screening for syphilis and neurosyphilis in acute psychiatric admissions.
AB  - The value of blood screening for syphilis and cerebrospinal fluid (CSF) screening
      for neurosyphilis in acute psychiatric admissions is assessed. Of 1,296 patients,
      248 (19%) had evidence of previous or current syphilis as shown by a positive
      Treponema pallidum haemagglutination test, and 68 (5.2%) had potentially
      treatable syphilis as shown by a positive Venereal Disease Research Laboratory
      (VDRL) titre. CSF examination was performed on 169 patients with a positive blood
      test. Seventeen (i.e. 1.3% of all patients included in the study) met our
      criteria for neurosyphilis. The best predictor for neurosyphilis was the presence
      of a reactive serum VDRL. However, it is recommended that all patients with a
      positive blood test and symptoms that could possibly be ascribed to neurosyphilis
      undergo CSF examination.

PMID- 1641713
TI  - Frequency of mutant cystic fibrosis genes in South Africa.

PMID- 1641715
TI  - Speech and hearing problems in a high-risk population.
AB  - A retrospective study was conducted on 85 neonatal intensive care unit (NICU)
      survivors, all of whom had been mechanically ventilated. Mean birth weight was
      1,726 +/- 778 g and mean gestational age was 32.3 +/- 3.8 weeks. Infants were
      evaluated for various risk factors previously reported to cause hearing loss.
      Language development was assessed using the Early Language Milestone (ELM) scale
      and hearing was tested by free field responses (FFR). Twenty-four children
      (28.2%) had an abnormal ELM or FFR result. Seventeen children failed an FFR; 14
      of these were normal on follow-up and 3 defaulted. There was thus no permanent
      sensorineural hearing loss in the sample assessed. Eleven children failed an ELM,
      of whom 5 had speech problems on long-term follow-up. There was a significant
      correlation between the ELM and neurodevelopmental scores (P = 0.045).
      Intraventricular haemorrhage also correlated significantly with the ELM score (P
      = 0.0016). Thus the overall incidence of hearing loss in this NICU population was
      low, but there was a significant occurrence of speech problems, which correlated
      with neurological damage.

PMID- 1641714
TI  - Flunarizine--effective add-on therapy in reading epilepsy.
AB  - Since it was first described in 1956, reading epilepsy, an uncommon disorder, has
      engendered great interest among neurologists, the reason being that it is
      probably one of the most complex of the sensory-evoked reflex epilepsies and one
      in which the mechanism of seizure production is as yet unresolved. Unfortunately,
      it often defies the standard medications useful in the treatment of other forms
      of epilepsy. A patient with typical reading epilepsy, preceded by jaw-jerking, is
      described in this report. An additional feature of this case is the presence of a
      stutter from early childhood. Therapy with phenytoin, carbamazepine and sodium
      valproate failed to provide satisfactory control. Flunarizine, as add-on therapy
      to sodium valproate, produced an excellent therapeutic response.

PMID- 1641716
TI  - A safer anaesthetic airway for paediatric adenotonsillectomy.

PMID- 1641717
TI  - No need for needs norms--why central planning cannot work for health care.
AB  - It is widely recognised that South Africa, like other countries, has inequities
      in health and in access to health care. Centralised formal planning is used by
      the Department of National Health and Population Development and advocated by
      others as the approach to social justice and equitable distribution of health
      care resources. This approach is typical of the central planning of command
      economies. The reasons why central planning cannot work for health care are
      explained and an alternative approach is suggested which emphasises decentralised
      management. This is in line with recent policy statements by the Minister of
      Health that place a high priority on decentralisation and democratisation. The
      proposal has important implications for the way in which information systems are
      developed and used. Much information that central planners say they need is also
      required for effective management, but with some crucial differences. Planners
      use ad hoc historical information with little understanding of the local context.
      Managers, in contrast, regularly need current information for use within the
      local context. It is therefore recommended that efforts by central planners to
      acquire information be redirected towards building the capabilities of the health
      care services to provide and use information for management at all levels.

PMID- 1641718
TI  - Tetracyclines in myalgic encephalomyelitis--fad or fact?

PMID- 1641719
TI  - Ethical issues in the transformation of health policy in South Africa.
AB  - There have, of late, been repeated calls for the transformation of the South
      African health care system. While there are political and economic consequences
      involved, there are also bio-ethical sequelae. This paper attempts to explore
      some of the bio-ethical dilemmas that confront both the 'consumers' and the
      architects of a new health policy (including the State; professional health
      groupings, e.g. the Medical Association of South Africa; and the so-called
      progressive health organisations, e.g. the National Medical and Dental
      Association and the South African Health Workers' Congress). While the literature
      has focused on libertarian and utilitarian ethical theories, communitarian
      perspectives are not often mentioned. This paper attempts to redress this
      perceived deficit.

PMID- 1641720
TI  - Dying and 'euthanasia'.
AB  - Medical progress, secularisation of life, growing acceptance of individual human
      rights (including the right to refuse medical treatment) and of shared decision
      making in medicine have focused public attention on the ways in which life may,
      and perhaps even ought to, be allowed to end in our complex modern era. Intense
      and thoughtful bio-ethical debate over many years has 'unpacked' the many
      different understandings and interpretations of the word euthanasia. The
      consequent conceptual clarification together with recognition and acknowledgement
      of psychological implications has facilitated a growing rational consensus on
      openly accepting the withholding and withdrawing of treatment (under defined
      conditions) within the realm of sound medical practice. This is clearly distinct
      from assisted suicide and active euthanasia which are generally considered
      unacceptable perversions of medical practice. Given the ability to sustain life
      for prolonged periods, often in a permanent state of unconsciousness, the
      unrealistic expectations of some medical personnel and the lay public, the severe
      constraints on health care facilities in South Africa and the totally inadequate
      allocation of resources for highly effective medical treatments, it is
      appropriate to re-open public debate on the limits of 'striving officiously to
      keep alive' and on the distinction between 'allowing to die' and 'killing'.
      Concern that 'rational' arguments reflect moral decay rather than moral progress
      keeps the debate open and focuses attention on some 'slippery slope'
      consequences.

PMID- 1641721
TI  - Cystic fibrosis--controversial issues.

PMID- 1641722
TI  - Myelopathy in a patient dually infected with HIV-1 and HTLV-I.

PMID- 1641723
TI  - Allergy genes--how far are we?

PMID- 1641724
TI  - AIDS--no joke.

PMID- 1641725
TI  - Pseudopneumothorax or pneumothorax simulated by a skin fold.

PMID- 1641726
TI  - Strange neonatal scalp skin lesions.

PMID- 1641727
TI  - [Midazolam for preoperative sedation].

PMID- 1641728
TI  - Anthropometry and maximum oxygen consumption of rural black schoolboys.

PMID- 1641729
TI  - The challenge of AIDS to the medical profession.

PMID- 1641730
TI  - Botshabelo's vaccination survey.

PMID- 1641731
TI  - Chemotherapy, medical oncology and nomenclature.

PMID- 1641732
TI  - Cystic fibrosis. Part I. Frequency of the delta F508 mutation in South African
      families with cystic fibrosis.
AB  - Cystic fibrosis (CF) is a common autosomal recessive disorder among people of
      European origin. With the localisation of the gene locus to chromosome 7q31 and
      the identification of closely linked polymorphic markers in 1985, it became
      possible to offer prenatal testing to couples at risk of having CF children,
      provided a live affected individual from that family was available for
      investigation. The CF gene, named CFTR, was cloned and sequenced in 1989 and the
      most common CF-causing mutation, delta F508, identified. A search for this
      mutation has been carried out in 81 South African white CF families of European
      origin. Using the polymerase chain reaction (PCR) technique the frequency of
      delta F508 was found to be 0.81. This mutation was not found in the 1 negroid and
      the 1 Indian CF family investigated.

PMID- 1641733
TI  - The vascular blood supply of the second metacarpal bone: anatomic basis for a new
      vascularized bone graft in hand surgery. An anatomical study in cadavers.
AB  - After traumatic loss of the index finger the second metacarpal bone is often used
      as a free graft to reconstruct bony defects of the thumb. Since clinical
      experience has shown numerous advantages of using a blood supplied bone graft, an
      anatomical study was performed in 104 cadaveric hands to investigate the
      vascularization supply of this bone. After dye injections into the arterial
      system the vascular situation of the second metacarpal was studied and a
      classification was made. Six variations in arterial vascularization were found.
      The nutrient vessels to the bone originate from the radial artery or from the
      deep palmar arch and correspond to variable metacarpal arteries. Selective
      injection studies via the respective pedicles showed sufficient perfusion and
      complete dye distribution in the bone. Further dissections could demonstrate the
      feasibility of raising a pedicled bone graft only partially with preservation of
      the index finger. The second metacarpal as a vascularized graft may be harvested
      entirely in serious injuries with destruction of the index finger in emergency
      cases of skeletal thumb reconstruction or partially as an elective procedure. All
      types have a useful arc of rotation and their pedicles allow transpositions
      within the radial side of the hand, especially for applications in the thumb and
      carpus. The clinical application of these procedures could be shown in five
      cases. The results of this study therefore provide the anatomical basis for
      transposition or free microvascular transplantation of the second metacarpal as a
      vascularized bone graft for a variety of indications in hand surgery.

PMID- 1641734
TI  - Renal arteries: anatomic study for surgical and radiological practice.
AB  - The renal arterial supply was analyzed in 266 kidneys dissected from 133 fixed
      adults subjects. The anatomical findings are presented: 1 hilar artery in 53.3%
      of the cases, 1 hilar artery with 1 superior pole extra-hilar branch in 14.3%, 2
      hilar arteries in 7.9%, 3 hilar arteries in 1.9%, superior polar artery in 6.8%,
      inferior polar artery in 5.3% and other variations in 8.5%. The urological and
      radiological implications of these findings in kidney transplantation,
      renovascular hypertension, renal trauma, interventional radiology, conservative
      surgery and oncologic surgery are discussed.

PMID- 1641735
TI  - Frequency and size of ossifications in the caudal attachments of the ligamentum
      flavum of the thoracic spine. Role of rotatory strains in their development. An
      anatomic study of 121 spines.
AB  - Ossifications in the caudal attachments of the ligamentum flavum were studied on
      121 dried thoracic spines. Most of them were aged. Frequency increased in a
      caudal direction. At T12, frequency depended on the orientation of the
      zygapophyseal joints of T11-12 which determined the range of rotation. When they
      were of thoracic orientation, allowing large range of rotation, ossifications
      were present in 83% of cases. If orientation was lumbar, allowing poor range of
      rotation, ossifications became much less frequent:33%. The size of ossifications
      was also studied. The smaller were in T1 and T2. In T11 and T12, size also
      depended on the orientation of the zygapophyseal joints of T11-12. If it allowed
      important range of rotation, ossifications were large sized. In the opposite
      case, they were small sized. Ossifications of caudal attachments of ligamentum
      flavum appear to be a normal feature of the aged lower thoracic spine. Their
      frequency in a given motion segment seems to be influenced by rotational strains.

PMID- 1641736
TI  - Growth of the cranial bones in human fetuses (2nd and 3rd trimesters).
AB  - The increase of the weight of some cranial bones was studied in 30 human fetuses
      (from 17 to 41 weeks of gestation, both sexes together) by multivariate
      allometry. The study was performed with a covariance matrix of the log
      transformed bony weights and the Principal Components Analysis (PCA). The first
      principal component in PCA accounted for 92.12% of the total variance, and all
      characters were positively correlated with this component. PCA scaled the growth
      of the bones in the following sequence: a) with negative allometry: vomer,
      palatine, mandible and maxillae; b) with isometry (p less than 0.05): zygomatic
      bone; c) with positive allometry: sphenoid, ethmoid, frontal, occipital, temporal
      and parietal. During the 2nd and 3rd trimesters of gestation the skull exhibited
      two different growth rates, i.e., the bony group of the facial skeleton presented
      lower eigenvalues than the bony group of the calvaria, including the base of the
      skull. These bones of the calvaria certainly are affected by the high increase in
      volume of the fetal brain during the prenatal life. The knowledge of the cranial
      growth is a useful information for the anatomy, anthropology, orthodontics, and
      several medical specialties: radiology, obstetrics, pediatrics, orthopedics and
      reconstructive surgery.

PMID- 1641737
TI  - Anatomical study of the accessory axillary vein.
AB  - The Accessory Axillary Vein (AAV) was studied in 60 axillae of adult cadavers
      after fixation in 10% formaldehyde solution. The AAV had an incidence of 56.7%
      originating in 55.9% from the lateral brachial vein, in 32.4% from the common
      brachial and in 11.8% from the deep brachial vein. After running upward laterally
      to the axillary artery and the brachial plexus it ended usually (79.4%) in the
      suprapectoral portion of the AV. The tributaries of the AAV are the circumflex
      humeral and muscular veins and rarely the thoraco-acromial and the cephalic
      veins. The AAV can replace the AV in cases of obliteration of the latter.

PMID- 1641738
TI  - The relationship between the directions of myocardial bridges and of the branches
      of the coronary arteries in the human heart.
AB  - The variations of the direction of the myocardial bundles of the bridges over
      coronary arteries and branches were studied in relation to the direction of the
      vessels over which they are found. The investigation was performed on 82 hearts
      of individuals whose death was accidental and unrelated to cardiac disease. The
      hearts were obtained from cadavers of individuals of either sex and different
      racial groups, whose age ranged from 7 to 68 years. The angle between the
      direction of the musculature and of the vessels may explain why in some cases
      there is no change in the structure of the "pontine portion" of the wall.

PMID- 1641739
TI  - Morphologic variants of the proximal knee-joint cavity. An anatomical and
      radiological study.
AB  - To study the shapes of the suprapatellar bursa and the suprapatellar septum, 210
      specimens were examined anatomically and 2056 patients radiologically. It is
      possible to classify the variants of the suprapatellar septum into four types on
      the bases of anatomical aspects. The type of suprapatellar septum determines the
      communication between the suprapatellar bursa and the knee-joint cavity and
      influences the proximal extension of the knee-joint cavity. A suprapatellar
      lateral recess shaped like a saccular space was found on the lateral side of the
      suprapatellar bursa in just under 20% of the knee joints. There was no
      corresponding suprapatellar recess on the medial side. Pneumoarthrography is an
      effective tool for demonstrating the variable structures and spaces of the
      synovial cavity of the knee joint. The radiological findings correlate with the
      results of the anatomical studies.

PMID- 1641740
TI  - Contribution of imaging to the understanding of the female pelvic fasciae.
AB  - According to the ultrasound and MRI findings, supported by planned dissections,
      the female perineum is organised around the musculofascial system converging
      towards the fibrous structure of the central perineal tendon (CPT). Behind the
      CPT the fascial layers form part of a fibrous assembly extending from the ventral
      surface of the sacrum to the anal complex, prolonging the direction of the sacral
      concavity downwards and forwards. On the other hand, in front of the CPT the
      fasciae fuse to form two aponeurotic bands circumscribing the urogenital fossa.
      The fascial system is reinforced cranially by the structures of the hypogastric
      sheath and the uterosacral ligaments. The weak point of the urogenital fossa is
      partly filled by the urethral-clitoridal-vulvar complex. The perineum so formed
      plays a cardinal role in stabilising the pelvic viscera. Stress is placed on the
      firmness of the posterior perineum, a key element in pelvic stability. The
      posterior perineum is often involved in pathological conditions and a good
      acquaintance with these structures is essential in defining therapeutic
      indications.

PMID- 1641741
TI  - Structural analysis of the mandible by quantitative computed tomography.
AB  - The study presents quantitative computed tomography (QCT) as a noninvasive method
      for analyzing the inner bone structure. Randomly selected mandibles from the
      osteological collection of the "Drago Perovic" Institute of Anatomy, School of
      Medicine, Zagreb were CT-scanned in five bone areas. Analyzing the densitometry
      curve in two horizontal levels the relation between the compact and spongy bone
      and the total amount of bone substance in each area were determined. The smallest
      bone quantity was found in the area of the neck and angle of the mandible, the
      areas of most frequent bone fractures. The alveolar part of the bone, apart from
      the area of the angle, was considerably less thick than the base of the mandible.
      The compact bone was predominant in all CT-scans.

PMID- 1641742
TI  - Magnetic resonance imaging of the liver by oblique sections.
AB  - The authors have applied magnetic resonance imaging (MRI) to the anatomic study
      of the liver by comparing cadaveric sections with those obtained with MRI. This
      study deals with sections oblique in relation to a sagittal or frontal plane,
      whose orientation is determined from landmarks visible on transverse sections.
      Oblique sections were made in 10 cadavers using an original method. First,
      adjacent transverse sections were made of the frozen trunk and two landmarks were
      located in these sections: the course of the middle hepatic v. and the direction
      of the division of the portal venous trunk. The transverse sections were then
      stacked and the block so reconstituted was refrozen and then cut in adjacent
      oblique sections oriented either along the plane of the middle hepatic v.
      (sagittal oblique sections) or along the plane of division of the portal venous
      trunk (frontal oblique sections). Oblique MRI sections were made in 15 healthy
      volunteers, mainly based on the same venous landmarks but sometimes on other
      landmarks visible on the transverse sections. Oblique MRI sections can be made in
      the plane of any anatomic structure located in the transverse sections in order
      to define its position. Sections based on identical landmarks differently
      oriented in different subjects allow for definition of the individual anatomy of
      the liver investigated. The frontal oblique sections clearly show the course of
      the trunk of the portal v. and the junctions of the hepatic vv. with the inferior
      vena cava. The sagittal oblique sections are particularly useful for
      investigating the thinnest part of the left side of the liver and also the
      caudate lobe.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641743
TI  - Evaluation of the temporal bone by anatomic sections and computed tomography.
AB  - Serial Computed Tomography (CT) scans of isolated temporal bones have been
      obtained in transverse planes at 1.5 mm intervals. Then gross anatomic sections
      of same temporal bones were taken at 3 mm. intervals in planes parallel to the CT
      scans. These CT and anatomic sections were evaluated comparatively.

PMID- 1641744
TI  - Supernumerary head of biceps brachii and branching pattern of the musculocutaneus
      nerve in Japanese.
AB  - Out of 546 upper limbs (273 cadavers), supernumerary heads of the biceps brachii
      were found in 75 limbs (13.7%) of 58 cadavers (21.3%). The form, origin, and
      insertion of the supernumerary heads, and branching pattern of the
      musculocutaneus nerve were studied. In addition, the dimensions of the heads were
      measured. In many cases, the supernumerary head arose from the humerus, between
      the insertion of the coracobrachialis and the upper part of the origin of the
      brachialis, and/or from the medial intermuscular septum. In a few cases, a
      supernumerary head arose from the tendon of the pectoralis major or the deltoid,
      or from the articular capsule, or from the crest of the greater tubercle. The
      supernumerary heads typically joined the common belly, or the aponeurosis of the
      biceps brachii. Some heads joined the belly of the long head or that of the short
      head. In the examination of the branching pattern of the musculocutaneus nerve,
      communication between the musculocutaneus nerve and the median nerve was found in
      43 out of the 75 limbs (57.3%). The communicating branch ran from the
      musculocutaneus nerve to the median nerve in 24, from the median nerve to the
      musculocutaneus nerve in 12, in both directions in 5, or in another type of
      pattern in 2 out of 43 limbs. Sometimes a branch of the musculocutaneus nerve ran
      around a supernumerary head and then fused with the present trunk. The presence
      of a supernumerary head seemed to affect the course and branching of the
      musculocutaneus nerve.

PMID- 1641745
TI  - The saphenous postero-medial cutaneous island thigh flap and the saphenous supero
      medial cutaneous island leg flap (25.10.91).

PMID- 1641746
TI  - The medial septumcutaneous island thigh flap (25.10.91).

PMID- 1641747
TI  - Clinical anatomy: the new spirit in anatomy.

PMID- 1641748
TI  - The surgical anatomy of the dorsal carpal branch of the ulnar artery: basis for a
      neurovascular dorso-ulnar pedicled flap.
AB  - In order to design a neurovascular flap from the dorso-ulnar aspect of the
      midhand for pedicled transfer to adjacent or distant locations, the surgical
      anatomy of the dorsal carpal branch of the ulnar artery (DCBUA) was studied in 12
      cadavers. The DCBUA was identified in all specimens. It originates from the ulnar
      artery 1.6 to 4.4 centimeters proximal to the ulnar styloid, passing deep to the
      flexor carpi ulnaris tendon, and spirals superficially to the extensor
      retinaculum around the ulnar border of the wrist. Its terminal branches supply an
      undetermined area of skin overlying the ulnar metacarpals and the ulnar
      hypothenar region, either by direct cutaneous supply (3/12 specimens) or by septo
      cutaneous perforators (8/12 specimens). The DCBUA is closely related to the
      dorsal sensory branch of the ulnar nerve, with which it supplies a common
      neurovascular territory.

PMID- 1641749
TI  - [Etiopathogenetic aspects of medial osteochondrosis dissecans tali].
AB  - In a cadaveric biostatic model the pressure distribution at the weightbearing
      ankle has been investigated under different joint positions and stages of
      artificial lateral ligament dissection mimicking a supination trauma. The
      location of the transduced contact area, the size of these areas and amount of
      pressure were evaluated after application of axial load. The results showed that
      the location, size of contact area and the maximum transduced pressure were
      depending on the joint position and stage of ligament dissection. Interestingly
      the peak pressure was located at the medial talar rim even without lateral
      ligament dissection. The transduced pressure areas were located at that locations
      were osteochondral lesions are mostly observed. In regard to these results the
      etiology and pathogenesis of osteochondritis dissecans tali is discussed. It is
      thought that supination traumas as well as other biomechanical factors such as
      overweight and lax ankle ligaments have an important influence on the development
      of osteochondritis dissecans at least at the medial rim of the talus.

PMID- 1641750
TI  - [Stress on the upper ankle joint in tennis-specific forms of movement].
AB  - The permanently increasing number of injuries in tennis, which are mainly located
      at the lower extremity, indicates that the internal load e.g. applicated to the
      ankle during certain movements might be a critical factor. In the present study
      the relationship between calculated ankle load and muscle forces appearing during
      tennis techniques performed in a laboratorial setup and some varying parameters
      such as playing surface, footwear and individual differences in movement
      structure were investigated. It could be shown that on a felt tennis floor due to
      its frictional characteristics the midfootstriking subject produced the highest
      ankle load, while the heelstriking technique reduces the load as well as the
      change of the playing surface to a floor with loose granulate. In addition it
      should be considered that external forces (e.g. gained from a force plate) must
      not be used as predictors for internal load. The presented data show that the
      model-aided load calculation (MALC) from two trials with similar ground reaction
      forces leads to completely different values of e.g. the ankle-joint force.

PMID- 1641751
TI  - [Measuring the cartilage thickness in the patellar gliding articulation with
      ultrasound--method and value].
AB  - An ultrasonographic method for standardized measurement of cartilage thickness in
      the patellar gilding articulation is presented. A total of 778 kneejoints was
      investigated. The measurements from 438 healthy kneejoints were analysed with
      regard to their correlation with sex, age, height and weight, and norm values wer
      calculated. These were compared with the measurements from 130 kneejoints with
      "retropatellar pain syndrome". It could be demonstrated that the cartilaginous
      covering of the patellar facies in "retropatellar pain syndrome" is significantly
      thinner on the whole (but in particular at the medial facet) than in the healthy
      kneejoint; after intra-articular chondroprotective treatment, this difference
      could no longer be demonstrated in 71 kneejoints which were followed up
      sonographically. The precision and the reliability of the measurement could be
      verified statistically, so that it is feasible to make a contribution not only to
      noninvasive diagnosis of retropatellar symptoms, but possible also to better
      appraisal of the efficiency of therapy measures.

PMID- 1641752
TI  - [The value of dynamic examination methods in instability of the shoulder joint].
AB  - We prospectively examined 25 patients with shoulder instability by clinical
      examination and by fluoroscopic and sonographic imaging. 14 patients were
      classified as recurrent, posttraumatic instabilities, 12 of these anterior and
      two posterior. Clinical examination revealed the direction of instability in 5
      patients, fluoroscopy in 5 and sonography in 3 patients. 11 patients had non
      traumatic recurrent instabilities. Of these, clinical examination and fluoroscopy
      demonstrated identical directions of laxity in 8. Sonography concurred with the
      other techniques in only three cases. We recommend manual instability testing
      followed by fluoroscopy for evaluation and documentation of patients with non
      traumatic, recurrent shoulder instability. Posttraumatic instabilities should be
      diagnosed with other, static procedures.

PMID- 1641753
TI  - [Supinator tunnel syndrome--a differential diagnosis of so-called tennis elbow].
AB  - The increasing activity in sport lead especially in untrained persons to
      overstress of the elbow joint. Often one tends to diagnose a epicondlylits humeri
      radialis i.E. tennis elbow. In 1873, Runge (16) first described what we now call
      epicondylitis humeri radialis, i.e. what Morris (10) 1882 called "Tennis elbow."
      Its etiology is still under discussion, and the diagnosis of tennis elbow
      necessitates exact and detailed differential diagnostic efforts. In the work
      presented, we describe one major differential diagnosis, the posterior
      interosseous nerve syndrome or supinator entrapment syndrome. With sketches and
      anatomical preparations we describe the course of the radial nerve around the
      elbow joint and of its ramus profundus within the supinator muscle pouch. Listing
      representative causes of this syndrome, we also comment on clinical aspects and
      our surgical method of choice. We have interviewed and reexamined 6 of our
      patients suffering from a so called therapy-resistant epicondylitis humeri
      radialis. Due to their clinical picture all six had been operated for posterior
      interosseous nerve syndrome/supinator muscle entrapment syndrome. We present our
      results including neurophysiological evaluations. In relapsing, therapy resistant
      and diagnostically untypical humeral radial epicondylitis, a posterior
      interosseous nerve syndrome should be considered. After clinical and
      electromyographic examination a revision of the supinator channel is justified in
      selected cases.

PMID- 1641754
TI  - [Diagnosis and therapy of tendinitis exemplified by the athletic horse].
AB  - This paper reviews the literature and describes our experiences in the diagnosis
      and treatment of tendinitis in horses. Ultrasonography provides a sensitive tool
      to diagnose tendinitis and quantitate the degree of damage to the tendon; as well
      as provide differential diagnoses such as peritendinitis. The principles in
      therapy of acute tendinitis are: Immediate reduced exercise or rest, physical
      therapy to reduce inflammation and administration of local and systemic
      antiinflammatory drugs. The goal is restoration of the tensile strength of the
      tendon without peritendinous granulation tissue and adhesions. To achieve this
      goal it is important to maximize the intrinsic healing and to minimize the
      extrinsic healing. Any form of counterirritation is forbidden because of increase
      of inflammation. Passive motion and massage will help to increase blood flow and
      to decrease adhesions. Local injection (peritendinous and intratendinous) of
      hyaluronic acid seems to increase the intrinsic healing and to decrease adhesions
      without side effects. Depending on the extent of the tendon damage, which tendon
      is involved and the progress toward healing controlled ultrasonographically, the
      healing period can be divided in 4 phases: 1. Immobilisation (Cast), only in
      severe cases (for 1-2 weeks). 2. Passive motion and massage (starting as soon as
      possible, usually at once during bandage change). 3. Careful exercise, hand walk
      or walk under saddle (for 1-6 months, starting as soon as possible, usually about
      5 days after initial treatment). 4. Controlled slow and gradual training, no
      turnout, long or pasture (for 1-6 months, after phase 3). Chronic tendinitis is
      often caused when the severity of the initial injury is underestimated and the
      treatment inappropriate. Chronic tendinitis is treated using similar principles
      starting with phase 2. Tendon splitting and other surgical approaches have been
      used in selected cases to enhance the prognosis.

PMID- 1641755
TI  - To be or not to be?

PMID- 1641756
TI  - Spin trap salvage from endotoxemia: the role of cytokine down-regulation.
AB  - BACKGROUND: The spin trap alpha-phenyl-N-tert-butyl-nitrone (PBN) affords
      protection from the lethality of septic (lipopolysaccharide) shock. We
      hypothesized that PBN may work through down-regulation of the sepsis-induced
      cytokine cascade. METHODS: C3H/HEN mice received 30 mg/kg lipopolysaccharide 15
      minutes after pretreatment with PBN or vehicle. Animals were monitored for
      differences in behavior, histopathologic studies, survival, and serum levels of
      tumor necrosis factor (TNF-alpha), interferon-gamma (IFN-gamma), and interleukin
      6 (IL-6) after lipopolysaccharide. Northern blot analyses of TNF, IFN-gamma, c
      fos, and IL-6 transcripts were also performed. RESULTS: Seventy-two-hour survival
      was significantly higher in the PBN-treated (59/60) compared with the saline
      treated animals (13/60; p2 less than 0.005), and the PBN group exhibited a
      blunted endotoxemic response. TNF levels were significantly lower in the PBN
      treated animals at 1 to 6 hours, whereas IFN-gamma levels were depressed at 8
      hours. PBN down-regulated TNF transcription at 30 minutes, with maximum lowering
      of all cytokine transcripts at 6 hours. PBN depressed c-fos transcription within
      15 minutes of lipopolysaccharide injection. CONCLUSIONS: Spin trap protection
      from endotoxemia may be related to interruption of the cytokine network, with
      profound effects on transcription and protein elaboration. Such compounds may
      prove useful in not only sepsis but also other cytokine-free radical-related
      pathophysiologic alterations.

PMID- 1641757
TI  - Glutathione deficiency increases organ dysfunction after hemorrhagic shock.
AB  - BACKGROUND: Reactive oxygen metabolites contribute to tissue destruction in a
      wide variety of diseases. Glutathione, a potent endogenous antioxidant,
      neutralizes the destructive potential of free radicals, but this tripeptide may
      be depleted during illness. We hypothesized that glutathione deficiency would
      amplify organ dysfunction after shock in rats. METHODS: Rats received either
      diethyl maleate to deplete tissue glutathione or a control solution
      intraperitoneally. The animals were subsequently bled to and maintained at a mean
      arterial pressure of 40 mm Hg for 30 minutes and then fully resuscitated. Sham
      animals underwent blood pressure monitoring only. Tissue glutathione, liver and
      renal function tests, organ bacterial content, and mortality rates were
      determined 4 and 24 hours after shock. RESULTS: Normal rats subjected to shock
      and sham animals had similar laboratory chemistry results, organ culture results,
      and mortality rates. However, glutathione-depleted animals subjected to shock had
      elevated liver and renal function tests, increased organ bacteria, and a dramatic
      increase in mortality rates compared with control shock and sham animals.
      CONCLUSIONS: We conclude that glutathione deficiency predisposes animals to organ
      failure and death after an otherwise nonlethal period of hypotension. Because
      glutathione deficiency is associated with severe injury and sepsis, treatment
      strategies that maintain glutathione stores may decrease the incidence of
      multisystem organ failure.

PMID- 1641758
TI  - Energetics of defective macrophage antigen presentation after hemorrhage as
      determined by ultraresolution 31P nuclear magnetic resonance spectrometry:
      restoration with adenosine triphosphate-MgCl2.
AB  - BACKGROUND: The purpose of this study was to determine whether a decrease in
      macrophage energetics contributes to the profound immune dysfunction that occurs
      after hemorrhage and, if so, whether adenosine triphosphate (ATP)-MgCl2 treatment
      has any beneficial effects on the above parameters. METHODS: C3H/HeN mice were
      bled to a mean blood pressure of 35 mm Hg, maintained at that pressure for 60
      minutes, resuscitated with their own shed blood and Ringer's lactate, and treated
      with ATP-MgCl2 (80 mumol/kg body weight) or saline solution (vehicle). Peritoneal
      macrophages were harvested 1 hour after resuscitation and ATP levels were
      determined by 31P nuclear magnetic resonance spectrometry. In addition,
      macrophage functions were determined by measuring antigen presentation capacity
      (AP), as well as interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis
      factor (TNF) synthesis. RESULTS: Hemorrhage caused a significant decrease in
      peritoneal macrophage AP function, as well as IL-1, IL-6, and TNF synthesis, by
      52% +/- 14%, 91% +/- 12%, 78% +/- 8%, and 89% +/- 8%, respectively, which was
      correlated with a 78% +/- 6% decrease in macrophage ATP levels (p less than
      0.05). Treatment with ATP-MgCl2 after hemorrhage restored macrophage ATP levels
      (p less than 0.05) and significantly increased (p less than 0.05) macrophage AP,
      IL-1, IL-6, and TNF release by 110% +/- 21%, 130% +/- 38%, 124% +/- 17%, and 66%
      +/- 24%, respectively. CONCLUSIONS: The decreased macrophage ATP levels may be
      the cause of defective macrophage AP and cytokine release after hemorrhage, and
      both macrophage ATP levels and macrophage immune functions can be restored with
      adjuvant ATP-MgCl2 treatment after hemorrhage.

PMID- 1641759
TI  - The role of magnesium in postischemic cardiac dysfunction.
AB  - BACKGROUND: The biochemical basis for postischemic myocardial stunning is not
      fully elucidated. Magnesium is an important regulator of cellular energetic
      processes and excitation-contraction coupling. We hypothesized that the decrease
      in function in the postischemic period may be the result of an alteration in
      magnesium regulation. METHODS: In a Langendorf perfused rabbit heart model, we
      used 31P nuclear magnetic resonance spectroscopy to noninvasively determine
      intracellular Mg2+ and high-energy phosphate levels in the preischemic period and
      after a 30-minute period of normothermic ischemia. We measured adenosine
      triphosphate (ATP), phosphocreatine, and the phosphocreatine/inorganic phosphate
      ratio and calculated the free energy of ATP hydrolysis (delta GATP). On
      reperfusion, hearts were divided into three groups (n = 7 per group)--those
      receiving unmodified Krebs-Henseleit (control), 192 ng/ml dobutamine, or 5 mmol/L
      pyruvate. RESULTS: Function (expressed as the rate-pressure product) was
      approximately 77% of preischemic values in the control group, whereas in both
      dobutamine and pyruvate groups it returned to preischemic levels. ATP was
      decreased similarly in all groups in the postischemic period.
      Phosphocreatine/inorganic phosphate ratio and delta GATP were higher in the
      pyruvate group compared with the other groups. Intracellular Mg2+ was elevated
      significantly in the unmodified control postischemic group compared with
      preischemic, postischemic dobutamine, and pyruvate groups (1.0 +/- 0.12 vs 0.80
      +/- 0.08, 0.64 +/- 0.08, and 0.70 +/- 0.05 mmol/L, respectively; p less than
      0.05). CONCLUSIONS: We conclude that (1) postischemic "stunned" hearts have
      elevated Mg2+ levels in association with impaired contractile function, (2)
      inotropic agents improve contractile function in association with a decline in
      Mg2+ to preischemic levels despite differing effects on intracellular energetics,
      and (3) Mg2+ may play an important regulatory role in the heart after ischemia.

PMID- 1641760
TI  - Growth hormone attenuates the abnormal distribution of body water in critically
      ill surgical patients.
AB  - BACKGROUND: Catabolic illness is associated with fluid retention and
      extracellular space expansion. To determine the effect of human growth hormone
      (GH) on body water compartments, critically ill surgical patients were studied
      for a 2-week period during which they either continued to receive standard
      intensive care unit support, or in addition, received GH, 10 mg/day. METHODS:
      Body water compartments were measured at the beginning and end of the period by
      the indicator dilution technique with sodium bromide and heavy water used as the
      indicators of extracellular (ECW) and total body water (TBW), respectively;
      intracellular water (ICW) was calculated by subtraction. RESULTS: Neither group
      lost significant amounts of weight or TBW. A marked ECW expansion and disturbance
      of the ECW/TBW ratio occurred in the patients receiving standard care, which was
      associated with a dramatic reduction in ICW, a critical component of the body
      cell mass (BCM). In contrast, GH-treated patients maintained ECW and ICW,
      indicating a preservation of BCM, and their ECW/TBW ratio normalized.
      CONCLUSIONS: GH administration prevents ECW retention and stabilizes or
      normalizes fluid distribution during critical illness. Taken together with its
      known anabolic effects under these conditions, the maintenance of ICW
      demonstrates that GH can be used to preserve BCM in complex surgical patients.

PMID- 1641761
TI  - The influence of ethanol on pancreatic blood flow in cats with chronic
      pancreatitis.
AB  - BACKGROUND: The mechanism by which ethanol predisposes to acute pancreatitis,
      especially in established chronic pancreatitis, is not known. Here we studied the
      effects of acute ethanol ingestion on pancreatic blood flow in chronic
      pancreatitis, a setting characterized by diminished basal blood flow to the
      pancreas. METHODS: Obstructive pancreatitis was created by partial duct ligation
      for 3 weeks in nine cats. Controls (n = 8) were not operated on. Blood flow was
      measured in anesthetized animals with a hydrogen gas clearance technique and an
      intraductal electrode. Pancreatic interstitial pressure, systemic and portal
      blood pressures, and serum ethanol levels were recorded, and pancreatic vascular
      resistance was calculated. Measurements were made before and for 2 hours after 20
      cc of 40% (wt/vol) ethanol was instilled into the stomach. RESULTS: Basal flow
      was reduced in the obstructed pancreas to 51% of normal. Both groups showed an
      acute decrease in blood flow when ethanol was given. A more steep (50% of
      baseline) and a more prolonged (120 minutes) fall was observed in the
      pancreatitis group than in controls (31% and 60 minutes, respectively). The
      decline in blood flow correlated with increases in interstitial pressure and
      vascular resistance. CONCLUSIONS: Acute ethanol ingestion sharply reduces
      pancreatic blood flow, especially in glands with chronic pancreatitis.

PMID- 1641762
TI  - Neuropeptide release from the isolated, perfused, lower esophageal sphincter
      region of the rabbit and the effect of vasoactive intestinal peptide on the
      sphincter.
AB  - BACKGROUND: The aim was to evaluate the isolated, vascularly perfused, lower
      esophageal sphincter (LES) as a model for investigating the functional role of
      neuropeptides such as vasoactive intestinal peptide (VIP). METHODS: At laparotomy
      the LES was removed along with the distal esophagus, stomach, and left gastric
      artery and vein. The LES area, isolated from the body of the stomach by a custom
      made clamp, was perfused with oxygenated Krebs-Ringer bicarbonate solution (pH
      7.4, 38 degrees C) via the left gastric artery. The LES pressure was monitored
      continuously with a custom-made Dent sleeve catheter. LES pressure and release of
      neuropeptides were investigated after carbachol and VIP were administered alone
      or in combination. VIP, calcitonin gene-related peptide (CGRP), and somatostatin
      were measured in the venous perfusate collected from the left gastric vein.
      RESULTS: LES tone and contraction frequency were similarly increased by 10 and
      100 nmol/L carbachol (increment, 4.0 +/- 0.26 mm Hg with 10 nmol/L carbachol; p
      less than 0.0003). Perfusion with 10 nmol/L VIP decreased basal tone and
      completely abolished the contraction induced by 100 nmol/L carbachol. VIP, CGRP,
      and somatostatin were released from the LES in response to 10 nmol/L carbachol
      (VIP rose from 55 +/- 13 to 179 +/- 24 pmol/L, CGRP, from 114 +/- 30 to 239 +/-
      33 pmol/L, and somatostatin from 15 +/- 2 to 27 +/- 4 pmol/L; all p less than
      0.001). CONCLUSIONS: These findings support a role for VIP in the inhibitory
      reflex of the LES but suggest that other neuropeptides may also be involved. The
      isolated, perfused LES provides a new tool for investigating neuropeptide
      interactions.

PMID- 1641763
TI  - Quantitative increases in surgical house officer clinical activity as the basis
      for increased work loads in a university hospital.
AB  - BACKGROUND: House officer (HO) work loads, particularly work hours, have been the
      subject of considerable controversy. The hypothesis of this study was that a
      disproportionate work burden has been placed on HOs in teaching hospitals because
      of increased obligatory clinical activities and increased educational
      expectations. METHODS: Factors directly and indirectly affecting care of surgical
      patients were related to individual HO efforts at the University of Michigan from
      1981 to 1991. Data regarding clinical activity and support services were
      abstracted for analysis from hospital year-end reports, personnel rosters, and
      educational logs and correlated with the number of surgical HOs. RESULTS: The
      total numbers of HOs in the Department of Surgery were relatively constant (122
      +/- 4) throughout the study interval. Increases that occurred in annual hospital
      admissions (7615 to 10,651), discharges (7909 to 11,176), clinic visits (53,251
      to 86,111), total operations (6789 to 16,526), and operating room hours (24,175
      to 62,429) were significant (r greater than 0.9; p less than 0.001 in each
      category). The acuity of inpatient hospital care increased twofold, as measured
      by a case mix index, and was accompanied by a 125% increase in the number of
      surgical intensive care unit beds. During the study period, department of surgery
      faculty increased 49% (59 to 88), clinical nursing staff increased 118% (821 to
      1794), hospital administrative staff increased 59% (2086 to 3320), and hospital
      support staff increased 53% (4134 to 6342). The number of students in each
      University of Michigan Medical School class, a group that might defray certain HO
      work loads, decreased significantly by 16% (226 to 189) during this time (r = 
      0.76; p less than 0.02). CONCLUSIONS: Disproportionate increases in work demands
      have been placed on surgical HOs compared with other health care team members
      during the past decade. Calculated work loads increased from 91.2 hr/wk/HO in
      1981 to 110.9 hr/wk/HO in 1991. Balancing the increasing service activities with
      educational needs of surgical HOs remains a substantial challenge to be addressed
      by educators.

PMID- 1641764
TI  - Enhanced endothelialization of expanded polytetrafluoroethylene grafts by
      fibroblast growth factor type 1 pretreatment.
AB  - BACKGROUND: Biomaterial pretreatment with endothelial cell mitogens may enhance
      endothelialization. METHODS: Modified fibrin glue (FG) containing 1 ng/cm2
      recombinant 125I-labeled fibroblast growth factor type 1 (125I-FGF-1), 20
      micrograms/cm2 heparin, 2.86 mg/cm2 fibrinogen, and 2.86 x 10(-2) units/cm2
      thrombin was pressure perfused into expanded polytetrafluoroethylene (ePTFE)
      grafts. Grafts were interposed into infrarenal aortas of 24 New Zealand white
      rabbits and explanted after 0, 5, 30, and 60 minutes and 1, 7, 14, and 30 days.
      Residual radioactivity was determined by gamma-counting. Remaining 125I-FGF-1 is
      expressed as percent of value at time 0. To determine the effect of the FG/FGF-1
      on graft healing, three groups of 50 x 4 mm 60 microns internodal-distance
      nonreinforced ePTFE grafts were implanted in the aortoiliac position of 12 dogs.
      Group I (n = 12) contained the complete modified FG, group II (n = 6) contained
      FG with heparin but no FGF-1, and group III (n = 6) contained untreated identical
      ePTFE. Tritiated thymidine (0.5 microCi/kg) was injected intramuscularly 10 hours
      before explantation after 7 and 28 days for light and electron microscopy and en
      face autoradiography. RESULTS: Retention of 125I-FGF-1 showed rapid initial loss
      (delta %/delta min = -24.1) followed by slow loss after 1 hour (delta %/delta min
      = -0.03), with 13.4% +/- 6.9% remaining at 1 week and 3.8% +/- 1.1% at 30 days.
      Every FG/FGF-1 graft at 28 days showed extensive capillary ingrowth and confluent
      endothelialized luminal surfaces, not seen in any specimen of the other two
      groups. Autoradiography revealed a significant increase (p less than 0.05) in 3H
      thymidine incorporation in the FG/FGF-1 grafts at 28 days versus all groups as a
      function of time and graft treatment. CONCLUSIONS: Pressure perfusion of an FGF
      1/FG suspension into 60 microns internodal-distance ePTFE grafts promotes
      endothelialization through capillary ingrowth and increased endothelial cell
      proliferation.

PMID- 1641765
TI  - Collagen and elastin gene expression in aortic aneurysms.
AB  - BACKGROUND: The decreased elastin concentration found in abdominal aortic
      aneurysms (AAAs) may result from a differential synthetic response wherein
      elastin gene expression fails to increase in parallel with type I procollagen
      (COL I) gene expression. The purpose of this study is to determine tissue mRNA
      levels for elastin and COL I in AAAs compared with levels in normal, age-matched
      aorta and to determine the relationship between aging and COL I gene expression.
      METHODS: Total RNA exacted from normal infrarenal aortic tissue (n = 7) and AAA
      (n = 10) tissue was subjected to Northern analysis. Mean values for COL I,
      elastin, and alpha-tubulin mRNA levels were compared by use of the Student t
      test. Age and COL I mRNA levels were analyzed by regression analysis. RESULTS:
      COL I mRNA was increased significantly in AAAs (1.18 +/- 0.13) compared with
      normal aortas (0.14 +/- 0.05). A commensurate increase in elastin mRNA (AAAs,
      0.11 +/- 0.02, vs normal aortas, 0.39 +/- 0.2) was absent. There was no
      correlation between age and COL gene expression. CONCLUSIONS: The decreased
      elastin concentration relative to collagen in AAAs may be explained, in part, by
      the changes in message level of elastin and collagen. The enhanced COL I gene
      expression in AAAs is unrelated to age.

PMID- 1641766
TI  - Glucocorticoids regulate intestinal glutaminase expression.
AB  - BACKGROUND: The metabolism of glutamine by the small intestinal mucosal cells is
      highly dependent on the glutaminase enzyme. Because mucosal glutamine utilization
      is increased after operation, we hypothesized that the elevated glucocorticoid
      hormones that occur after surgical stress regulate expression of mucosal
      glutaminase at the molecular level. METHODS: Adult rats received saline solution
      or dexamethasone (0.5 mg/kg, one dose) and were sacrificed at various times after
      treatment. Jejunal mucosal total RNA was extracted for Northern hybridization
      with an alpha-32P-labeled rat glutaminase cDNA. The mRNA of the constitutively
      expressed gene beta-actin was the control for RNA loading. Quantitation of
      glutaminase transcripts was determined by densitometric scanning and normalized
      to actin. Glutaminase activity (micromoles per milligram of protein per hour) and
      its kinetic parameters, maximal transport velocity (micromoles per milligram of
      protein per hour) and Michaelis-Menten constant (micromoles per liter), were also
      determined. RESULTS: Dexamethasone increased glutaminase mRNA (twofold at 4
      hours, sixfold at 12 hours; p less than 0.01) and glutaminase-specific activity.
      The increase in message preceded the increase in activity by 4 hours, consistent
      with de novo RNA synthesis followed by protein synthesis. The increase in
      glutaminase activity was the result of a 21% increase in the maximal enzyme
      capacity (maximal transport velocity = 8.6 +/- 0.5 mumol/mg protein/hr in control
      rats vs 10.4 +/- 0.3 mumol/mg protein/hr in rats treated with dexamethasone; p
      less than 0.01) rather than a change in enzyme affinity (Michaelis-Menten
      constant). CONCLUSION: Glucocorticoids may accelerate intestinal glutamine
      utilization by increasing glutaminase expression, an adaptive response that could
      provide more energy for mucosal cells in stress states.

PMID- 1641767
TI  - Growth hormone and insulin combine to improve whole-body and skeletal muscle
      protein kinetics.
AB  - BACKGROUND: A cooperative effect of exogenous insulin and recombinant human
      growth hormone (r-hGH) with respect to whole-body and skeletal muscle protein
      metabolism has not been demonstrated previously. This study examined the effect
      of r-hGH and insulin administration during euglycemic clamping and concurrent
      amino acid supplementation. METHODS: Twenty-three normal volunteers in the
      postabsorptive state were either treated with r-hGH for 3 consecutive days before
      a metabolic study (GH group; n = 10) or not treated (CTRL group; n = 13). The r
      hGH dose was 0.2 mg/kg/day (n = 5) or 0.1 mg/kg/day (n = 5). All subjects then
      received an infusion of 14C-labeled leucine and tritiated phenylalanine, followed
      by measurement of baseline protein kinetics (GH and CTRL). Subsequently a
      euglycemic insulin infusion (1 mU/kg/min) with concurrent amino acid infusion was
      administered, and protein kinetic measurements were repeated at steady state.
      RESULTS: GH and insulin separately produced an increase in whole-body and
      skeletal muscle protein net balance. GH plus insulin was associated with a higher
      net balance of protein than was insulin alone. CONCLUSIONS: r-hGH and insulin in
      the presence of amino acids and glucose combine to improve whole-body and
      skeletal muscle protein kinetics.

PMID- 1641768
TI  - Effect of age on wound healing in healthy human beings.
AB  - BACKGROUND: Although the elderly clinically have a higher rate of wound
      complications, the physiologic effect of age on wound healing in human beings is
      unknown. METHODS: Healthy young (18 to 55 years of age) and elderly (more than 65
      years of age) human volunteers had a 2 x 2 cm, superficial, split-thickness wound
      created on the anterior aspect of the thigh, and the rate of epithelialization
      was assessed. For studies of fibroplasia, similar groups underwent subcutaneous
      implantation of polytetrafluoroethylene catheters, which were removed after 14
      days. Biochemical analyses of the catheters included determinations of
      hydroxyproline, total alpha-amino nitrogen, and DNA. RESULTS: The elderly
      volunteers had a significant delay of 1.9 days in epithelialization. Analyses of
      the subcutaneously implanted catheters showed no difference in DNA content or
      hydroxyproline-accumulation; however, the young volunteers had a significantly
      higher amount of total alpha-amino nitrogen. CONCLUSIONS: In healthy humans,
      aging leads to delayed epithelialization. No effect of age on collagen synthesis
      was noted, although accumulation of wound noncollagenous protein was decreased.
      This decrease may impair the mechanical properties of scarring in aged human
      beings.

PMID- 1641769
TI  - Beneficial effect of syngeneic pancreatic islet transplantation on liver atrophy
      and hepatocellular function after portacaval shunt.
AB  - BACKGROUND: Hepatic insufficiency, which continues to be a source of morbidity
      after portacaval shunt (PCS), can be prevented by syngeneic pancreatic islet
      transplantation into the portal vein before PCS. This study investigated the
      ability of syngeneic pancreatic islet transplantation after PCS to prevent
      hepatic atrophy and rescue hepatocellular function. METHODS: Approximately 1200
      to 1400 syngeneic rat pancreatic islets were transplanted through a heparinized
      catheter into the left lobes of the liver 3, 7, and 21 days after end-to-side
      PCS. Normal rats received no treatment, and PCS control rats received PCS only,
      without islet transplantation. Hepatocellular function (caffeine clearance) and
      hepatic blood flow (indocyanine green clearance) were analyzed at 42 and 49 days
      after PCS. On day 51 after PCS, the left and right lobes of the liver were
      divided, weighed, and sectioned for histologic studies. RESULTS: Caffeine
      clearance in the animals at 3 days (p less than 0.05) and at 7 days (p less than
      0.05) after end-to-side PCS was significantly improved versus control PCS
      animals, indicating that hepatocellular function could be rescued after creation
      of a PCS. Indocyanine green clearance of all groups with PCS was significantly (p
      less than 0.001) decreased versus normal animals, showing that hepatic blood flow
      was uniformly decreased by PCS in all groups. The weight of the transplanted left
      lobes was significantly greater than the untransplanted right lobes of the groups
      at 3 days (p less than 0.01) and at 7 days (p less than 0.05) after end-to-side
      PCS compared with control animals, indicating that liver atrophy was prevented in
      the islet-transplanted lobes but not in those lobes without a transplant.
      CONCLUSIONS: Islet transplantation early after PCS can prevent liver atrophy and
      significantly improve hepatocellular function.

PMID- 1641770
TI  - Evaluation of intrathymic islet transplantation in the prediabetic period.
AB  - BACKGROUND: Beta-cell destruction in type I diabetes mellitus results from a
      chronic autoimmune process. Exposure of thymic T cells to islet antigens during
      the prehyperglycemic phase of diabetes may alter the likelihood of autoimmune
      damage to beta cells in the native pancreas. Thus we evaluated whether
      prophylactic major histocompatibility complex (MHC)-incompatible intrathymic
      islet allografts could prevent hyperglycemia and native pancreatic beta-cell
      destruction. METHODS: At 4 to 6 weeks of age, diabetes-prone BioBreeding rats
      received intrathymic injection of 1500 to 2000 noncultured MHC-incompatible Lewis
      islets. No immunosuppression was administered. Age-matched littermates underwent
      intrathymic injection of saline solution. RESULTS: None of 13 BioBreeding rat
      recipients of prophylactic intrathymic Lewis islet allografts became
      hyperglycemic versus 13 of 13 control rats (p less than 0.001). The age at onset
      of diabetes in the control group ranged from 77 to 104 days (mean, 86 days).
      Normoglycemia in recipients of intrathymic islet allografts persisted for greater
      than 8 months after transplantation, and thymectomy (graft removal) did not
      precipitate hyperglycemia. CONCLUSIONS: Prophylactic intrathymic MHC-incompatible
      islet allografts effectively prevent hyperglycemia and native beta-cell
      destruction in an animal model of autoimmune diabetes. Rejection and autoimmune
      destruction of intrathymic MHC-incompatible islet allografts were not seen after
      transplantation in the prediabetic (prehyperglycemic) period. Intrathymic islet
      allografts at an early age (before puberty) preserve native beta-cell function
      and may prevent or retard thymic atrophy.

PMID- 1641772
TI  - Retroviral-mediated gene transfer in human hepatocytes.
AB  - BACKGROUND: The ability to modify human hepatocytes genetically is an essential
      first step in the development of liver-directed ex vivo gene therapy for
      inherited metabolic disease. The purpose of these studies was to prove that the
      genome of human hepatocytes can be altered successfully to express foreign
      genetic material. METHODS: Human hepatocytes were plated at 2 or 4 x 10(6)
      cells/10 cm Primaria (Falcon, Oxnard, Calif.) plates. Fresh virus from the
      amphotropic viral producer cell line BAG, containing the Escherichia coli beta
      galactosidase gene lacZ, was placed directly onto hepatocyte cultures and
      quantitative analysis of cells staining positive for the lacZ gene was
      undertaken. In a different human liver, a variety of viruses from producer cell
      lines containing clones of the human low-density lipoprotein (LDL) receptor were
      plated directly on cultures of human hepatocytes, and gene transfer was
      demonstrated by increased uptake of fluorescent-labeled LDL. RESULTS: Beta
      galactosidase production in hepatocytes was assayed histochemically with the
      chromogenic substrate X-gal. The highest percentage of cells staining positive
      for expression of enzyme was seen at 4 x 10(6) cells/plate (43.66% +/- 1.02% vs
      27.99% +/- 2.31%). Gene transfer was also documented by the uptake of fluorescent
      labeled LDL with a variety of different vectors containing the human LDL
      receptor. CONCLUSIONS: (1) Human hepatocytes can be cultured in vitro and are
      susceptible to retroviral infection, (2) functional gene transfer is demonstrated
      by intracellular function of foreign genes, and (3) the level of expression
      appears dependent on plating density. We conclude that human hepatocytes are
      suitable targets for genetic manipulation and may play an important role in human
      gene therapy trials.

PMID- 1641771
TI  - Islet xenografts in fully xenogeneic (rat----mouse) chimeras: evidence for normal
      regulation of function in a xenogeneic mouse environment.
AB  - BACKGROUND: Transplantation of untreated rat bone marrow into mouse recipients
      conditioned by total-body irradiation results in fully xenogeneic chimerism (rat-
      --mouse). The chimerism is stable for up to 10 months, survival is excellent, and
      there is no evidence for graft-versus-host disease. We recently reported the long
      term survival (greater than 180 days) of donor-specific pancreatic islet
      xenografts in these fully xenogeneic chimeras. METHODS: Chimeras were prepared
      and typed for chimerism at 6 weeks, and diabetes was induced by streptozocin
      injection. Donor-specific pancreatic islets were placed under the renal capsule
      and recipient blood glucose levels were followed biweekly. The aim of this study
      was to examine whether the transplanted pancreatic islets exhibited normal
      function in a xenogeneic environment and assess whether the islet xenografts were
      not only sufficient to support euglycemia but also regulated in function in
      response to a glucose challenge. RESULTS: We report for the first time that donor
      specific rat islet xenografts were capable of producing normal basal and peak
      levels of insulin and responding to a glucose challenge in a manner similar to
      that of normal mouse islets. CONCLUSIONS: These data indicate that donor-specific
      rat islet xenografts are functional and regulated normally in fully xenogeneic
      (rat----mouse) chimeras.

PMID- 1641773
TI  - Epidermal growth factor protects portal hypertensive gastric mucosa in
      ischemia/reperfusion: the role of capillary endothelia and prostaglandins.
AB  - BACKGROUND: Epidermal growth factor (EGF) protects gastric mucosa against a
      variety of injurious agents, but the mechanism is unclear. Because the abnormal
      microvasculature of portal hypertensive (PHT) gastric mucosa is a major target of
      ischemia/reperfusion (I/R) injury, we used this model to assess EGF's protective
      role at the microvascular level. METHODS: Rats with PHT (staged portal vein
      ligation) received either EGF, 20 micrograms/kg, or saline solution
      intravenously, with or without indomethacin pretreatment (20 mg/kg
      subcutaneously). I/R was produced by withdrawing blood to systemic pressures of
      30 mm Hg for 20 minutes and reinfusing it. Stomachs were excised 20 minutes later
      and evaluated for gross and histologic necrosis, microvascular permeability,
      mucosal ultrastructure and vimentin, and cyclooxygenase immunofluorescence.
      RESULTS: In saline-treated rats, gross and histologic damage involved 46% +/- 3%
      of glandular mucosa and 23% +/- 3% of mucosal sections, respectively.
      Microvascular permeability was increased 43-fold over that of normal control
      rats. Vimentin immunofluorescence intensity was reduced to 36% +/- 4% that of
      normal control rats. EGF pretreatment reduced histologic necrosis to 2% +/- 1% (p
      less than 0.01). Microvascular permeability and vimentin intensity were almost
      normalized. Indomethacin partially reversed the mucosal protection induced by
      EGF. CONCLUSIONS: EGF significantly reduces I/R injury to PHT gastric mucosa.
      Microvascular endothelia of PHT gastric mucosa are the major target of I/R injury
      and the site of EGF's protective action. Prostaglandins in part mediate EGF's
      protective action.

PMID- 1641774
TI  - Oxygen free radical regulation of rat splanchnic blood flow.
AB  - BACKGROUND: The role of oxygen-derived free radicals on splanchnic prostaglandin
      (PGI2) synthesis and superior mesenteric artery (SMA) blood flow was examined
      during acute hemorrhage. METHODS: Sprague-Dawley rats were hemorrhaged to 30 mm
      Hg for 5, 30, or 45 minutes without (SK5, SK30, and SK45) or with (SK5 + R, SK30
      + R, and SK45 + R) blood reperfusion. The SK30 + R and SK45 + R groups were
      treated with or without superoxide dismutase (10,000 units/kg intravenously). In
      vivo SMA blood flow was measured continuously for 100 minutes by a transonic flow
      probe, or in other groups the in vitro-perfused SMA and its end-organ intestine
      (SV+SI) were assayed for release of PGI2 by radioimmunoassay after 15 and 30
      minutes of perfusion. RESULTS: Acute hemorrhage at all time periods increased
      SV+SI PGI2 release twofold to threefold compared with sham animals (p less than
      0.01), which was abolished after blood reperfusion. SMA blood flow was decreased
      by 79.6% +/- 3.3% and 88.2% +/- 1.4% in the SK30 + R and SK45 + R groups compared
      with the sham animals (p less than 0.01). Superoxide dismutase treatment restored
      both SV+SI release of PGI2 after SK and SMA blood flow to control levels.
      CONCLUSION: Oxygen-derived free radicals locally produced during SK30 + R and
      SK45 + R inhibited splanchnic PGI2 synthesis, which contributed to decreased
      splanchnic blood flow.

PMID- 1641775
TI  - Cytokine regulation of gut ornithine decarboxylase gene expression and enzyme
      activity.
AB  - BACKGROUND: The enzyme ornithine decarboxylase (ODC) catalyzes the rate-limiting
      step in polyamine biosynthesis and is important for gut mucosal repair after
      systemic injury (e.g., burns); however, the mechanisms responsible for the injury
      mediated induction of ODC are not known. The purpose of this study was to
      determine whether interleukin-1 (IL-1) or tumor necrosis factor (TNF), which are
      released immediately after injury, regulates gut mucosal ODC enzyme activity and
      gene expression. METHODS: In vivo: In experiment 1, 64 male BALB/c mice received
      either recombinant IL-1 beta (2 x 10(4) units/kg administered intraperitoneally)
      or saline solution. In experiment 2, 64 mice received either recombinant TNF
      alpha (100 micrograms/kg administered intraperitoneally) or saline solution. We
      determined ODC enzyme activity and ODC mRNA levels in small intestine and kidneys
      at 2, 4, 12, and 24 hours after injection. In vitro: We also determined the ODC
      enzyme activity in intestinal epithelial crypt cells after either IL-1 beta or
      TNF-alpha treatment. RESULTS: IL-1, but not TNF, increased small intestinal ODC
      enzyme activity. In addition, IL-1 increased ODC enzyme activity in intestinal
      epithelial crypt cells at 5 and 6 hours after treatment. Both IL-1 and TNF
      increased small intestinal ODC mRNA levels. Neither agent affected ODC enzyme
      activity or ODC mRNA levels in the kidney. CONCLUSIONS: These results suggest
      that the cytokine-mediated induction of ODC in the small intestine is tissue
      specific, that the induction occurs at multiple cellular levels, and that ODC may
      play a vital role in the restoration of gut mucosa that occurs after injury.

PMID- 1641776
TI  - Induction of donor-specific tolerance to rat cardiac allografts by intrathymic
      inoculation of bone marrow.
AB  - BACKGROUND: Induction of donor-specific tolerance to tissue or organ allografts
      can readily be achieved by administration of allogeneic bone marrow to neonatal
      rodents; however, in adult recipients induction of transplantation tolerance by
      this strategy generally requires intensive cytoablative conditioning. Described
      here is a novel method of promoting transplantation tolerance that involves
      inoculation of donor bone marrow into the thymus of transiently immunosuppressed
      adult recipients. METHODS: Prospective Wistar-Furth recipients were inoculated
      with allogeneic Lewis bone marrow cells (BMCs) either intrathymically or
      intravenously in conjunction with a single dose of antilymphocyte serum 2 to 3
      weeks before receiving donor-strain cardiac allografts. Recipients were monitored
      for graft survival and examined for presence of hematopoietic chimerism. RESULTS:
      Intrathymic but not intravenous inoculation of donor BMCs led to permanent
      survival of donor-strain cardiac allografts, whereas third-party Dark agouti
      cardiac allografts were rejected promptly. Persistence of donor chimerism was
      demonstrated in the thymus of Wistar-Furth recipients of intrathymic Lewis BMCs
      for as long as 3 weeks after BMC inoculation. CONCLUSIONS: Intrathymic
      inoculation of BMCs concurrently with a single dose of antilymphocyte serum
      induces donor-specific unresponsiveness to rat cardiac allografts. The
      unresponsiveness may be the result of deletion or functional inactivation of
      alloreactive clones maturing in a thymus bearing donor alloantigen. Intrathymic
      inoculation of BMCs deserves further evaluation as a possible clinical strategy
      for the induction of transplantation tolerance.

PMID- 1641777
TI  - Stimulation of hepatocyte System y(+)-mediated L-arginine transport by an
      inflammatory agent.
AB  - BACKGROUND: Arginine participates in several distinct metabolic pathways,
      including polyamine and nitric oxide biosynthesis. Normally, arginine is
      effectively sequestered from the hepatocyte intracellular space by the low basal
      activity of membrane transport system y+. This has implications for the
      subsequent metabolism of arginine and for hepatic arginine requirements during a
      septic insult. We investigated the influence of tumor necrosis factor (TNF) on
      the activity of System y(+)-mediated hepatocyte arginine transport employing
      hepatic plasma membrane vesicles (HPMVs). METHODS: Rats were treated with a
      single intraperitoneal injection of TNF (50 or 150 micrograms/kg body weight) for
      2, 4, or 24 hours, and HPMVs were prepared by Percoll density gradient
      centrifugation. Vesicle purity was established by assay of enzyme markers.
      Vesicle arginine transport activity was evaluated by measurement of tritiated
      arginine uptake employing a rapid mixing-filtration technique. RESULTS: Arginine
      transport by HPMVs was entirely independent of sodium and consisted of saturable
      and nonsaturable components. Prior treatment with TNF resulted in a time- and
      dose-dependent stimulation of saturable transport within 2 hours and a return to
      basal levels after 24 hours. Nonsaturable uptake was unchanged. Inhibition
      analysis indicated that the TNF-induced increase in saturable arginine transport
      activity was mediated by an increase in System y+. Kinetic analysis revealed that
      accelerated transport was caused by a 78% increase in the maximal velocity of
      transport without alteration in transport affinity. CONCLUSIONS: In vivo
      treatment with TNF results in a rapid stimulation of saturable, System y(+)
      mediated arginine transport in the liver. This TNF-induced stimulation of hepatic
      arginine transport may serve to increase the normally restricted availability of
      extrahepatic arginine to the hepatocyte intracellular space during a septic
      insult to support important arginine-dependent pathways in the liver.

PMID- 1641778
TI  - Experience as a surgeon determines resident knowledge.
AB  - BACKGROUND: This is a prospective study that compares operative experience with
      performance on the American Board of Surgery Inservice Training Examination
      (ABSITE) to establish the primacy of procedural experience in the graduate
      training environment. METHODS: Operative experience was determined from a
      computerized log of surgical procedures. The Report D of the 1991 ABSITE was used
      to assign each test item to specific operative procedures and to determine the
      frequency of the correct response (Fcr) for each item. The fraction of operative
      procedures (Fs) was determined for each category of surgical procedures (Fs =
      Number of procedures as surgeon/Total number of procedures). The Fcr was compared
      to the Fs by use of the Pearson correlation coefficient with significance at 95%
      confidence. RESULTS: Forty-two residents reported doing 8357 surgical procedures
      as surgeon in 12 months. Report D contained 209 test items. Of these, 162 items
      could be assigned to 26 categories of surgical procedures. The Fcr correlated
      directly with the Fs (p = 0.002, r = 0.605). CONCLUSIONS: A significant
      correlation exists between the experience of surgical residents as surgeon and
      their performance on the ABSITE:

PMID- 1641779
TI  - The effect of erythropoietin in normal healthy volunteers and pediatric patients
      with burn injuries.
AB  - BACKGROUND: Surgical procedures result in blood loss that can require replacement
      transfusions. Such therapy may result in multiple adverse sequelae, including
      transmission of infectious diseases and immune impairment. Alternative therapies
      are therefore desirable. METHODS: We evaluated the ability of recombinant human
      erythropoietin (rEPO) to increase red blood cell production in both normal
      healthy volunteers and patients with burn injuries. The effect of rEPO on immune
      function in the volunteers was also evaluated. The volunteers received 150
      units/kg rEPO daily for 7 days, with immune function and hematopoiesis assayed on
      days 0, 7, and 14. The patients with burn injuries received either 500
      units/kg/day rEPO with iron supplementation or merely the iron. RESULTS: rEPO
      increased erythropoiesis in both the volunteers and the patients with burn
      injuries. Failure to provide iron supplementation to the volunteers resulted in
      significant depletion of iron stores with a concomitant impairment in immune
      function that paralleled the iron depletion. CONCLUSIONS: rEPO therapy offers the
      potential to increase red blood cell production in surgical patients. Failure to
      provide iron supplementation in patients receiving rEPO can lead to a rapid
      depletion of iron stores and may contribute to an immune dysfunction.

PMID- 1641780
TI  - Antihemostatic and antithrombotic effects of monoclonal antibodies against von
      Willebrand factor in nonhuman primates.
AB  - BACKGROUND: Because the adhesive glycoprotein von Willebrand Factor (vWF)
      mediates initial platelet attachment at sites of vascular injury and may also
      contribute to shear-dependent platelet thrombus formation, we have determined in
      vivo the relative antithrombotic efficacy and hemostatic safety of infusing
      murine monoclonal antibodies against vWF. METHODS: In baboons with chronic
      arteriovenous shunts, thrombus formation was initiated by interposition of
      thrombogenic Dacron vascular grafts (VG) and endarterectomized baboon aortic
      segments (EAS). Thrombus formation on VG and EAS was assessed by use of real-time
      scintillation camera imaging of indium 111-labeled platelet deposition. In
      control and treated animals (anti-vWF antibody) platelet hemostatic competence
      was evaluated by means of serial measurements of platelet count, bleeding time,
      and ex vivo platelet aggregation in response to adenosine diphosphate and
      ristocetin. RESULTS: Although bolus antibody infusions did not affect circulating
      platelet counts, bleeding times were immediately prolonged to 28 +/- 4 minutes
      (vs 4.7 +/- 0.4 minutes before treatment, p = 0.01). Bleeding times normalized
      within 24 hours after antibody administration. Platelet aggregation in response
      to adenosine diphosphate was unchanged by antibody therapy, whereas ristocetin
      induced platelet aggregation was abolished acutely and remained impaired for 24
      hours. Platelet deposition on VG after 60 minutes of exposure to flowing blood
      was 2.95 +/- 0.74 x 10(9) platelets/cm in six control animals as compared to 1.86
      +/- 0.16 x 10(9) platelets/cm in five treated animals (p = 0.04). Similarly,
      platelet deposition on EAS averaged 4.40 +/- 0.89 x 10(9) platelets/cm in control
      studies and was reduced significantly by antibody therapy (1.52 +/- 0.50 x 10(9)
      platelets/cm, p = 0.02). CONCLUSIONS: Despite profound interruption of platelet
      hemostatic functions, therapeutic targeting of vWF modestly inhibits platelet
      dependent thrombosis.

PMID- 1641781
TI  - Oral vitamin E prophylaxis in the protection of newborn myocardium from global
      ischemia.
AB  - BACKGROUND: Oxygen-derived free radicals have been implicated in the
      pathophysiology of myocardial reperfusion injury after ischemic insult. Recent
      studies have demonstrated that free radical scavengers could afford protection to
      the mature myocardium from these injuries. The purpose of this study was to
      investigate whether oral vitamin E pretreatment could improve the tolerance of
      newborn hearts to ischemia. METHODS: Two groups of six newborn piglet hearts were
      randomly studied in an isolated, perfused Langendorff heart model. Group I
      control hearts were subjected to 30 minutes of cold perfusion at 15 degrees C, in
      which profound hypothermia was achieved over a period of 10 minutes. This was
      followed by 90 minutes of global ischemia arrest and 30 minutes of normothermic
      reperfusion. Group II piglets were pretreated with d-alpha-tocopherol (vitamin E)
      given by oral gavage for 4 days before similar experimentation. Baseline
      functional parameters were recorded before cold perfusion by a left
      intraventricular balloon inflated to a diastolic pressure of 11 to 14 mm Hg and
      repeated at the end of 30 minutes of normothermic reperfusion. Creatine
      phosphokinase leakage in the perfusate was analyzed immediately after reperfusion
      and the pressure/volume ratio was obtained at the conclusion of each experiment.
      RESULTS: Postischemic functional recovery of vitamin E-pretreated group II hearts
      was improved significantly compared with the control hearts (group I). Left
      ventricular diastolic pressure was 87.5% +/- 2.3% versus 66.1% +/- 2.3%, +dp/dt
      was 94.5% +/- 2.2% versus 68.0% +/- 5.6%, -dp/dt was 93.0% +/- 2.4% versus 69.6%
      +/- 6.0%, mean left ventricular end-diastolic pressure was 13.0 +/- 0.8 versus
      22.0 +/- 3.5 mm Hg, and pressure/volume ratio was 29.2 +/- 2.3 versus 41.8 +/-
      4.3 mm Hg/ml, respectively (p less than 0.05). Perfusate creatine phosphokinase
      leakage was also reduced significantly from 112.5 +/- 17.9 to 56.2 +/- 4.0 IU/L
      (p less than 0.05) in group II. CONCLUSIONS: Oral vitamin E pretreatment improved
      the ischemic tolerance of newborn myocardium and therefore might be considered a
      valuable, effective, and inexpensive method of myocardial protection.

PMID- 1641782
TI  - Mechanism of the beneficial effects of pentoxifylline on hepatocellular function
      after trauma hemorrhage and resuscitation.
AB  - BACKGROUND: The purpose of this study was to determine whether pentoxifylline
      administration restores the depressed hepatocellular function after trauma
      hemorrhage and crystalloid resuscitation and, if so, whether this is the result
      of the down-regulation of inflammatory cytokines, tumor necrosis factor (TNF) and
      interleukin-6 (IL-6). METHODS: After laparotomy rats were bled to and maintained
      at a mean arterial pressure of 40 mm Hg until 40% of maximum shed blood volume
      was returned in the form of Ringer's lactate. They were then resuscitated with
      Ringer's lactate to four times the shed blood volume. Pentoxifylline (50 mg/kg
      body weight) or saline solution was infused intravenously for 95 minutes during
      and after resuscitation. One and a half hours and 4 hours after resuscitation,
      hepatocellular function (maximal velocity [Vmax] and the efficiency of the active
      transport [Km] of indocyanine green clearance) and plasma. TNF and IL-6 levels
      were determined with in vivo hemoreflectometer and cellular assays, respectively.
      RESULTS: Circulating TNF and IL-6 levels increased significantly after hemorrhage
      and resuscitation. Pentoxifylline treatment, however, markedly decreased the
      levels of these cytokines, and the values were similar to those of sham rats. The
      decreased Vmax and Km values were also restored by pentoxifylline treatment.
      Moreover, there was a significant correlation between Vmax and TNF or IL-6
      levels. CONCLUSIONS: The down-regulation of inflammatory cytokines by
      pentoxifylline may be the mechanism by which this agent restores the depressed
      hepatocellular function after trauma hemorrhage and resuscitation.

PMID- 1641783
TI  - Triiodothyronine treatment maintains surfactant synthesis during sepsis.
AB  - BACKGROUND: Pulmonary compromise with altered surfactant metabolism is frequently
      noted during sepsis; triiodothyronine is necessary for normal surfactant
      synthesis. We evaluated the role of physiologic replacement of triiodothyronine
      during sepsis-induced hypothyroidism on surfactant synthesis and lung structural
      integrity. METHODS: Male Sprague Dawley rats (average weight, 330 gm) underwent
      sham laparotomy or cecal ligation and puncture; treatment was administered to
      rats that underwent cecal ligation and puncture by Alzet osmotic pump consisting
      of triiodothyronine (3 ng/hr) or saline control. The rats were killed 24 hours
      after serum triiodothyronine determination by radioimmunoassay (normal, 60 to 160
      ng/dl). Surfactant was obtained by saline lavage. Lipid content was determined by
      Folch extraction; phospholipid content was verified by chromatography. Blinded
      histologic analysis of lung confluence and alveolar sparing was done in separate
      subgroups. Results are +/- SE. RESULTS: Control rats with sepsis were hypothyroid
      at 24 hours; rats given triiodothyronine were euthyroid (rats that underwent sham
      laparotomy, 67.7 +/- 4.9 ng/dl; control rats, 37.6 +/- 5.7 ng/dl; and
      triiodothyronine, 85.7 +/- 19 ng/dl; p less than 0.05 compared with
      triiodothyronine by analysis of variance). Surfactant production was
      significantly improved by triiodothyronine compared with control (60.7 +/- 22.6
      mg vs 23.2 +/- 11.3 mg; p less than 0.05 by analysis of variance). Lung
      histologic integrity was maintained by triiodothyronine treatment during sepsis.
      CONCLUSIONS: Triiodothyronine supplementation may be beneficial in septic-induced
      pulmonary dysfunction.

PMID- 1641784
TI  - Passive immunization against tumor necrosis factor inhibits interleukin-2-induced
      microvascular alterations and reduces toxicity.
AB  - BACKGROUND: Antineoplastic therapy with interleukin-2 (IL-2) has been limited by
      dose-dependent systemic toxicities. Previous studies suggest that the hemodynamic
      instability and "vascular leak syndrome" that develop immediately after IL-2
      administration occur secondary to neutrophil-mediated events in the
      microcirculation. Because IL-2 has limited direct effects on neutrophils and
      acutely induces the production of tumor necrosis factor-alpha (TNF), we
      hypothesized that the acute microvascular alterations and hemodynamic instability
      induced by IL-2 were mediated by TNF. METHODS: The cremaster muscles of
      anesthetized rats were prepared for intravital microscopy. All animals were
      injected with fluorescein isothiocyanate conjugated to bovine serum albumin, and
      relative interstitial fluorescence was quantitated as an index of macromolecular
      leakage. Vital signs, leukocyte-endothelial interactions, and interstitial
      fluorescence were quantitated every 30 minutes for 2 hours after intravenous
      injections of IL-2, TNF, and IL-2 with polyclonal antibody to TNF. RESULTS: Both
      IL-2 and TNF acutely induced hypotension, tachycardia, increased macromolecular
      leakage, and increased leukocyte-endothelial adherence. Polyclonal antibody to
      TNF effectively inhibited IL-2-induced leukocyte-endothelial adherence,
      macromolecular leakage, and hypotension. CONCLUSIONS: These data suggest that the
      acute microvascular alterations and hypotension induced by IL-2 are mediated by
      TNF.

PMID- 1641785
TI  - [WHO: support program to Eastern countries].

PMID- 1641786
TI  - [Open your eyes!].

PMID- 1641787
TI  - [Women's Day--infant girls in danger of dying].

PMID- 1641788
TI  - [SEF (Joint Council of Student Nurses)--we need illness days compensation].

PMID- 1641789
TI  - [SEF--70 percent fail. Interview by Lars Peter Bergqvist].

PMID- 1641790
TI  - [Substance abuse--it is also the responsibility of the place of work].

PMID- 1641791
TI  - [Substance abuse--confrontation, contract and professional support. Interview by
      Mette Fjordbo].

PMID- 1641792
TI  - [Substance abuse: alcohol policy--a personnel benefit].

PMID- 1641793
TI  - [Child psychiatry--the necessary daily routine].

PMID- 1641794
TI  - [Child psychiatry--it involves the entire family].

PMID- 1641795
TI  - [Child psychiatry--act punctually and honestly].

PMID- 1641796
TI  - [Child psychiatry--to understand Kim].

PMID- 1641797
TI  - [Child psychiatry--when Uffe stopped eating].

PMID- 1641799
TI  - [Child psychiatry--force feeding].

PMID- 1641798
TI  - [Child psychiatry--my daughter is trying to starve herself to death].

PMID- 1641800
TI  - [Child psychiatry--nurses get emotionally involved].

PMID- 1641801
TI  - [Terminal care at home].

PMID- 1641802
TI  - [Greenland--health project in a waiting position].

PMID- 1641803
TI  - [Greenland--more services for half the money. Interview by Soren Palsbo].

PMID- 1641804
TI  - [Child psychiatry--what is going on in their heads?].

PMID- 1641805
TI  - [Child psychiatry--disturbed contact].

PMID- 1641806
TI  - Maternal factors affecting teratogenic response: a need for assessment.
AB  - A review of current literature suggests that maternal nutritional status can be
      an important modulator of the developmental toxicity of a number of agents in the
      environment. While the provision of multivitamin/multimineral supplements during
      the periconceptional period is often associated with improved pregnancy outcome,
      it has been difficult to identify specific nutrient deficiencies as causative
      factors of abnormal development in humans. One explanation for this is that
      nutrient deficiencies can arise through a number of means in addition to a simple
      dietary deficit of the nutrient. The hypothesis is proposed that one mechanism
      contributing to the embryotoxicity of a diverse group of insults is an alteration
      in the metabolism of select nutrients. Evidence is presented that zinc is one
      nutrient whose metabolism can be markedly influenced by a variety of insults. One
      consequence of this alteration can be a reduction in embryonic zinc uptake, the
      development of embryonic zinc deficiency and abnormal development.

PMID- 1641807
TI  - Diagnosis of abnormalities of the human fetus during the first, second, and third
      trimesters.
AB  - Clinical teratologists will have new challenges during the 1990s as birth defects
      are diagnosed more frequently than in previous decades. Malformations and genetic
      disorders will be diagnosed in utero during all three trimesters of pregnancy.
      The teratologist may participate in or lead a multispecialty group to give the
      involved family optimal interpretation of test results, counseling, and
      recommendations regarding subsequent clinical management.

PMID- 1641808
TI  - In vitro approaches to the elucidation of mechanisms of chemical teratogenesis.
AB  - This article describes some of the contributions that in vitro methods have made
      to our progress, albeit slow, toward understanding mechanisms of chemical
      teratogenesis. Emphasis is given to the painstaking and time consuming nature of
      approaches required to elucidate mechanisms. The examples considered are
      cyclophosphamide, 2-methoxyethanol, and retinoids. Some of the newer methods that
      take advantage of the recent advances in molecular biology and analytical
      chemistry have already been applied to studies on teratogenic mechanisms.
      Prospects for the 1990s are excellent and promise more rapid progress than during
      the past decade toward unraveling the mysteries of normal developmental biology.
      That knowledge in turn should be immediately applicable for investigations on
      developmental toxicant-induced abnormal development.

PMID- 1641809
TI  - Clinical teratology counseling and consultation case report: exposure to
      diagnostic radiation early in pregnancy.

PMID- 1641810
TI  - Teratogenic Agent Information Centre: fifteen years of counseling and pregnancy
      follow-up.
AB  - The Teratogenic Agent Information Centre was set up 15 years ago in response to a
      growing demand from a medical profession struggling to cope with the problem of
      teratogenic risk. Our goal was to provide information on the real nature of the
      risk and to monitor all at-risk pregnancies so as to obtain data in a field where
      there are still, unfortunately, many gaps in our knowledge. The results of these
      15 years have been most encouraging, in that physicians have been provided with
      specialized information and the follow-up of gestations had provided considerable
      clinical data, which has contributed to advancing our understanding in this
      domain.

PMID- 1641811
TI  - Fetal dexamethasone exposure alters macromolecular characteristics of rat brain
      development: a critical period for regionally selective alterations?
AB  - Fetal glucocorticoid exposure retards postnatal growth and evokes abnormalities
      of nervous system structure and function. To examine the underlying mechanisms,
      we administered 0.2 or 0.8 mg/kg of dexamethasone to pregnant rats on gestational
      days 17, 18, and 19 and assessed brain region cell development with indices of
      DNA content (total cell numbers), DNA concentration (cell packing density), and
      protein/DNA ratio (relative cell size). Dexamethasone evoked deficits of pup body
      and brain region weights, but the brain regions displayed growth-sparing
      associated initially with preservation of cell numbers (normal or elevated DNA
      content and concentration), at the expense of relative cell size (decreased
      protein/DNA). Subsequently, brain cell acquisition lagged behind that of
      controls, with deficits in DNA and elevations of protein/DNA. In midbrain +
      brainstem and in cerebellum, cell markers returned to normal by weaning. However,
      the forebrain showed persistent elevations of DNA and reduced protein/DNA,
      indicative of replacement of neurons with glia. Because the treatment period
      coincided with the timing of neuronal cell replication in the forebrain, but not
      in the other regions, these results suggest that the critical period for lasting
      deficits of dexamethasone coincides with the peak of neuronal mitosis.

PMID- 1641812
TI  - Toxicity of the methyl isocyanate metabolite S-(N-methylcarbamoyl)GSH on mouse
      embryos in culture.
AB  - Methyl isocyanate, the chemical involved in the 1984 accident at Bhopal, India,
      forms a labile conjugate, S-(N-methylcarbamoyl)GSH (SMG), by way of a reversible
      reaction with GSH. We studied the toxicity of SMG on mouse embryos explanted on
      day 8 of gestation and cultured in rat serum for 42 hr. SMG caused concentration
      dependent decreases in growth and development over the range 0.1-2 mM, without
      causing significant mortality. At a concentration of 2 mM, SMG completely
      arrested embryo development, but heartbeat was absent in only one of nine embryos
      at 42 hr. At a concentration of 0.25 mM, SMG reduced embryo size to 75% and
      protein content to 63% of the control; 18% of embryos failed to rotate. At this
      concentration (0.25 mM), which was selected for all other studies, spinal kinks
      and somite pair distortion in the region of the forelimb were evident in 38% of
      embryos; no other abnormalities were noted. DNA content of and thymidine
      incorporation by embryos and yolk sacs was reduced by SMG, although this was more
      pronounced in the yolk sac than in embryos. At subtoxic concentrations, the L
      cysteine precursor (-)-2-oxo-4-thiazolidine-carboxylic acid did not, but GSH did,
      inhibit embryotoxicity of SMG. It is concluded that SMG exerts embryotoxic and
      dysmorphogenic effects and may contribute to systemic toxicity of methyl
      isocyanate.

PMID- 1641813
TI  - Interpretation of recurring weak associations obtained from epidemiologic studies
      of suspected human teratogens.
AB  - Epidemiological studies of suspected human teratogens not infrequently lead to
      recurring weak or moderate associations (relative risks or odds ratios ranging
      from greater than 1 to 3 for adverse effects and from 1/3 to less than 1 for
      protective effects) between specific defects and prenatal exposures. Examples of
      such associations include cigarette smoking and oral clefts (odds ratios between
      1 and 2) and periconceptional multivitamin/folic acid supplementation and neural
      tube defects (odds ratios from 1/3 to 1). In this paper, we illustrate that low
      relative risk recurring in well-designed studies may reflect underlying biologic
      mechanisms and should not be readily dismissed. Low relative risks could be the
      result of a combination of the following factors: 1) unmeasured confounding, 2)
      exposure misclassification (often related to the inability to pinpoint relevant
      dose and timing), 3) outcome misclassification (related to the etiologic
      heterogeneity of birth defects), 4) biologic interactions (related to teratogenic
      effects in population subgroups defined by genetic susceptibility or the presence
      of other exposures), and 5) differential prenatal survival (related to the
      combined impact of the exposure and the defect on prenatal survival). These
      issues can be addressed in epidemiologic studies by using biological markers of
      exposure and susceptibility, dysmorphologic evaluation of affected infants,
      subgroup analysis for etiologic heterogeneity, a search for biologic
      interactions, and the use of prospective cohort studies. Finally, low relative
      risks in the face of common exposures can reflect an important public health
      contribution of the exposure to the occurrence of the defect in the population.

PMID- 1641814
TI  - Long bone development in extrinsic fetal akinesia: an experimental study in rat
      fetuses subjected to oligohydramnios.
AB  - The transverse growth of long bones during intrauterine development was studied
      in rat fetuses subjected to experimental oligohydramnios in order to determine
      whether the skeletal changes, if any, in extrinsic fetal akinesia were similar to
      those observed in curarized rat fetuses with the fetal akinesia deformation
      sequence. Oligohydramnios was induced by daily extraction of amniotic fluid from
      day 17 of gestation until term. Experimental fetuses were compared with a sham
      operated control group. The total area and perimeter, the absolute and relative
      amount of periosteum and bone trabeculae, the major and minor axes, and the
      elongation factor were measured in histological cross sections of the femoral
      metaphysis and diaphysis with an IBAS 1 image analysis system. Rat fetuses in the
      experimental group showed multiple articular contractures, redundant skin, and
      lung hypoplasia, a phenotype consistent with the oligohydramnios sequence. No
      alterations in femoral shape and transverse growth of the metaphysis and
      diaphysis were noted in these fetuses. These results suggest that the main
      mechanical factor related to fetal bone modeling is muscular strength, while
      motion would be mainly involved in fetal joint development.

PMID- 1641815
TI  - In vitro exposure of preimplantation mouse embryos to cocaine and benzoylecgonine
      inhibits subsequent development.
AB  - Cocaine is used by over 20% of women of reproductive age. Although there have
      been numerous studies focusing on its effects on reproductive processes, none has
      evaluated its direct effect on preimplantation development. We have investigated
      the effect of cocaine and its major metabolite, benzoylecgonine, on in vitro
      preimplantation mouse embryogenesis. One-cell embryos were exposed at the one-,
      two-, four-, or eight-cell stage for 24 hr to medium containing 0-400
      micrograms/ml cocaine or benzoylecgonine and then cultured to the blastocyst
      stage. Cocaine had its strongest inhibitory effect at the earliest stages of
      development. At the one- and two-cell stages, there was a significant inhibition
      of blastocyst formation following exposure to cocaine concentrations of 25-400
      micrograms/ml, and at the four-cell stage there was an inhibitory effect at 100
      and 400 micrograms/ml cocaine. Benzoylecgonine inhibited the development of
      embryos to blastocyst only at the one- and two-cell stages, at concentrations of
      100-400 micrograms/ml. These findings suggest that cocaine is capable of blocking
      preimplantation embryogenesis, particularly following exposure at the earliest
      stages, and that this toxicity may abate as cocaine is biotransformed to
      benzoylecgonine.

PMID- 1641816
TI  - Morphological and physiological correlates of unilateral agenesis of the
      urogenital system in young ovariectomized ACI rats.
AB  - ACI rats are distinguished by a polygenic trait resulting in unilateral agenesis
      of the urogenital system in 20-30% of animals of both sexes. This report details
      additional features, both morphological and physiological, which distinguish ACI
      rats with unilateral agenesis of the reproductive and urinary tracts from the
      majority of ACI rats that have intact urogenital systems. Young female ACI rats
      were ovariectomized at 34 days of age and sacrificed 19 days later. A preliminary
      determination of the urogenital morphology was made at the time of ovariectomy
      and then confirmed by careful abdominal inspection at necropsy. Data on the time
      of vaginal opening were obtained at selected intervals prior to sacrifice. At
      necropsy, the mammary glands were removed and were prepared as stained whole
      mounts for morphological evaluation; the remaining portions of the reproductive
      tracts were excised, weighed, fixed, and sectioned for microscopic examination. A
      majority of animals with unilateral agenesis had mammary glands that had higher
      degrees of glandular proliferation than the mammary glands of intact rats.
      Unilateral agenesis animals also possessed significantly thicker and heavier
      uterine horns, despite having been ovariectomized. Furthermore, rats with
      unilateral agenesis were found to have an earlier time of vaginal opening than
      that of their intact counterparts. These features of ovariectomized ACI rats with
      unilateral agenesis are consistent with an active, extra-ovarian source of
      endogenous estrogen. Further investigation of the endocrinological state of
      animals with unilateral agenesis of the urogenital tract is warranted.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641817
TI  - Hirudin C-terminal fragments inhibit thrombin induced neutrophil chemotaxis.
AB  - Since native hirudin blocks the thrombin induced chemotaxis response of
      neutrophils, we examined whether hirudin C-terminal peptides were also capable of
      this inhibition. The studies showed that thrombin induced human neutrophil
      chemotaxis was effectively blocked by the C-terminal hirudin peptide analogs, Gly
      Asp-Phe-Glu-Glu-Ile-Pro-Glu-Glu-Tyr-Leu-Gln (12-mer[54-65]) and Thr-Pro-Lys-Pro
      Gln-Ser-His-Asn-Asp-Gly-Asp-Phe-Glu-Glu-Ile-Pro-Glu-Glu- Tyr- Leu-Gln (21-mer[45
      65]). Furthermore, neither peptide had an effect on formyl-L-methionyl-L-leucyl-L
      phenylalanine induced chemotaxis. The results suggest that binding of the hirudin
      C-terminal peptides block the thrombin chemotactic domain.

PMID- 1641818
TI  - Hematological causes of venous thrombosis in young people: high incidence of
      myeloproliferative disorder as underlying disease in patients with splanchnic
      venous thrombosis.
AB  - Thrombotic events occur frequently in myeloproliferative disorders, namely
      polycythaemia vera and essential thrombocythaemia. Standard diagnostic criteria
      are designed quite stringent, so that a number of patients could be
      underdiagnosed. Spontaneous erythroid colonies formation from bone marrow or
      peripheral blood in the absence of exogenous erythropoietin is considered a
      reliable index of myeloproliferative disorder even at early stages. Endogenous
      erythroid colonies (EECs) formation was assessed in 43 patients having recently
      suffered from venous thrombosis prior to 45 years and without a previous
      diagnosis of hematological disease favouring thrombosis. A screening for
      coagulative abnormalities associated with thrombophilia was also carried out: in
      5 patients (11.6%) a plasmatic thrombogenic defect was found (quantitative
      deficiency of antithrombin III, 1 case, protein C, 2 cases, protein S, 1 case,
      and plasminogen, 1 case). In 10 patients (2 males and 8 females) (23.2%) EECs
      assay was positive, allowing diagnosis of myeloproliferative disease even though
      7 of them did not fulfill standard diagnostic criteria. In the other 3 patients
      who met the criteria for diagnosis of overt myeloproliferative disease the
      thrombotic event was the inaugural manifestation. In all these EECs-positive
      patients thrombosis involved mesenteric and portal veins (n = 4), hepatic veins
      (n = 3), portal vein (n = 2), mesenteric vein (n = 1). One of them was
      simultaneously affected from congenital protein C deficiency. Thus latent or
      atypical forms of myeloproliferative disease as well as the overt stages were the
      most frequent recognized cause of splanchnic venous thrombosis, accounting for
      55% of the cases of our series. On the contrary no EECs-positive subject was
      found among the 25 patients with other sites of thrombosis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1641819
TI  - Experimental carotid stenosis and endothelial injury in the rabbit: an in vivo
      model to study intravascular platelet aggregation.
AB  - Previous studies have shown that experimental canine coronary artery stenosis
      associated with endothelial injury results in a typical pattern of coronary flow
      characterized by gradual decreases in coronary flow to almost zero values
      followed by restorations of flow to normal values. This pattern of flow, called
      cyclic flow reductions (CFRs), is the consequence of recurrent platelet
      aggregation at the site of the stenosis and endothelial injury and subsequent
      dislodgement of the thrombus. In the present study, platelet activation and
      aggregation in vivo was induced by placing an external constrictor around carotid
      arteries with endothelial injury in anesthetized rabbits. Carotid blood flow
      velocity was measured continuously with a Doppler flow probe positioned
      proximally to the constrictor. After placement of the constrictor, CFRs developed
      in 14 of 14 rabbits with a mean frequency of 16.5 +/- 2.3 cycles/h. CFRs were
      observed for 30 min, and the animals were treated with either an i.v. bolus of
      aspirin (10 mg/kg) or R 68070 (20 mg/kg), a drug with simultaneous TxA2 synthase
      and TxA2/PGH2 receptor blocking properties. Aspirin completely inhibited CFRs in
      4 of 7 rabbits, whereas R 68070 eliminated CFRs in 7 of 7 animals. In the 3
      animals that did not respond to aspirin, administration of ketanserin (0.25 mg/kg
      i.v.), a selective serotonin S2 receptor antagonist, completely abolished CFRs.
      Both aspirin and R 68070 resulted in a marked reduction in serum TxB2 formation
      and in a complete inhibition of ex vivo platelet aggregation in response to
      arachidonic acid, whereas aggregation in response to U46619, a TxA2 mimetic, was
      inhibited only in R 68070-treated rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641820
TI  - Double-blind, randomized comparison of systemic continuous infusion of 0.25
      versus 0.50 mg/kg/24 h of alteplase over 3 to 7 days for treatment of deep venous
      thrombosis in heparinized patients: results of the European Thrombolysis with rt
      PA in Venous Thrombosis (ETTT) trial.
AB  - Thirty-two patients with acute, proximal-vein thrombosis were treated with
      heparin and alteplase (0.25 versus 0.5 mg/kg/24 h during 3-7 days) in a
      randomized, double-blind, multicenter, European (ETTT) trial. The treatment
      resulted in a decrease of the venographic Marder's score from 18 (6-25) to 13 (2
      24) units (median, range) in Group I (0.25 mg/kg/24 h, n = 15, median decrease
      3.0, p = 0.32) and from 17.5 (3-33) to 15.5 (0-27) in Group II (0.5 mg/kg/24 h, n
      = 16, median decrease 4.0, p = 0.23). Comparison of the sequential venograms
      could be performed in 14 cases of Group I and in 15 cases in Group II. A minority
      of patients showed substantial partial recanalization of the initially obstructed
      veins on the control venogram (one in each treatment group) and most of the
      control venograms showed either thrombus size reductions (5 in Group I, 7 in
      Group II) or no change or even deterioration (8 in Group I, 7 in Group II). Major
      bleedings were observed in 7 patients (7/32, 22%), 5 of them occurring in Group
      II (5/17, 29%). Thus, the results of the ETTT trial show that the used low
      dosages of alteplase administered intravenously over 3-7 days in heparinized
      patients cannot be recommended as a treatment for patients with deep venous
      thrombosis of lower limbs and/or pelvis. Further studies are needed to define a
      more suitable dosage regimen of alteplase in this indication.

PMID- 1641821
TI  - Production and therapeutic use of a factor XI concentrate from plasma.
AB  - Factor XI deficiency is an uncommon bleeding disorder usually manifested by
      excessive bleeding after surgery or trauma. Until recently the only effective
      therapy has been fresh-frozen plasma (FFP) infusion. We describe the efficacy and
      safety of a new factor XI concentrate produced from human donor plasma by a
      modification of the method used for antithrombin III concentrate. The mean
      recovery of factor XI in the circulation measured on 62 occasions was
      approximately 91% of the injected dose, and the mean half-disappearance-time was
      52 h. The concentrate was used for 31 invasive procedures in 30 patients,
      including 16 patients who had a definite bleeding tendency on previous occasions,
      with normal haemostasis being achieved in all but 1. Only 1 patient (previously
      experiencing allergy to FFP) experienced adverse effects during infusion.
      Monitoring of liver function tests and viral antibody status in suitable patients
      has shown no evidence of transmission of hepatitis viruses, HIV-1 or parvovirus
      B19. We conclude that this concentrate provides effective treatment for patients
      with factor XI deficiency. Preliminary results suggest safety from virus
      transmission, but this needs to be established in further studies of previously
      untreated patients.

PMID- 1641822
TI  - Absence of the largest platelet-von Willebrand multimers in a patient with
      lactoferrin deficiency and a bleeding tendency.
AB  - We have studied a young male with lactoferrin deficiency and a bleeding tendency
      responsive to cryoprecipitate. This child has had increased bleeding following
      surgical procedures and a variably prolonged template bleeding time. The patient
      has a normal platelet count, normal in vitro platelet ATP secretion and
      aggregation in response to a variety of agonists, and normal concentration of
      plasma-von Willebrand factor ristocetin cofactor activity and antigen. Analysis
      of plasma-vWf multimers by agarose gel electrophoresis consistently demonstrated
      a subtle decrease in the largest vWf multimers. In contrast, analysis of the
      patient's platelet-vWf revealed normal vWf:Ag, decreased vWf ristocetin cofactor
      activity, and a striking absence of the high and intermediate size molecular
      weight vWf multimers. Analysis of surface bound platelet-vWf demonstrated normal
      amounts on the surface of unstimulated platelets, but after thrombin stimulation
      the platelet-vWf surface expression did not increase. This lack of increased
      platelet-vWf surface expression resulted from decreased binding of secreted
      platelet-vWf to be surface of stimulated platelets. These data suggest that the
      patient's bleeding tendency may be related to a defect in his platelet-vWf
      structure and/or mobilization. This case represents a unique demonstration of an
      abnormality of platelet-vWf in the presence of normal plasma-vWf, and supports
      the data indicating an important role for platelet-vWf in primary hemostasis.

PMID- 1641823
TI  - In vitro inhibition of blood coagulation by tripeptide aldehydes--a retrospective
      screening study focused on the stable D-MePhe-Pro-Arg-H.H2SO4.
AB  - A series of peptide aldehydes synthetized in our institute during the last 15
      years were screened to detect their inhibitory effect on blood coagulation.
      Simple conventional clotting assays, platelet function tests and fibrinolytic
      methods were used to evaluate the inhibitory potency of the compounds in complex
      clotting systems as well as their supposed antifibrinolytic effect in vitro.
      Special attention was paid to the possible interactions with blood cells and
      plasma proteins, and to the functional stability of the inhibitors in several
      tissue homogenates. D-Phe-Pro-Arg-H (GYKI-14166, RGH-2958), Boc-D-Phe-Pro-Arg-H
      (GYKI-14451) and D-MePhe-Pro-Arg-H (GYKI-14766) were found to be the most potent
      inhibitors. The peptide aldehydes via formation of reversible complexes with
      thrombin impede the enzyme to react with the coagulation factors, platelet
      membrane and vessel wall. The compounds inhibit platelet aggregation induced by
      thrombin specifically without changing the sensitivity of platelets to other
      inducers. D-Phe-Pro-Arg-H and D-MePhe-Pro-Arg-H showed no antifibrinolytic
      effect. D-MePhe-Pro-Arg-H and Boc-D-Phe-Pro-Arg-H proved to be stable in dry
      state for years and in solution at room temperature for several days. The
      anticoagulant activity of the compounds was declared in NIH antithrombin units.

PMID- 1641824
TI  - Cell shape change and cytosolic Ca2+ in human umbilical-vein endothelial cells
      stimulated with thrombin.
AB  - We quantified thrombin-induced endothelial cells shape change and investigated
      the role of Ca2+ in such shape change. We used the fluorescent Ca2+ indicator,
      fura2, to measure both shape change as cell size and intracellular free Ca2+
      ([Ca2+]i), in cultured human umbilical-vein endothelial cells (HUVEC). Thrombin
      induced concentration-dependent decreases in cell size (percentage of cell size
      at 6 min after stimulation with 0.01 U/ml, 0.1 U/ml, or 1 U/ml thrombin) was 90.1
      +/- 1.5%, 78.1 +/- 2.4%, and 40.9 +/- 2.4%, respectively. Thrombin also increased
      [Ca2+]i in a concentration-dependent manner. Both depletion of extracellular
      Ca2+, and also the addition of W5, a calmodulin antagonist, inhibited thrombin
      induced size reduction. These results indicate an association between shape
      change and [Ca2+]i mobilization in human endothelial cells stimulated by
      thrombin.

PMID- 1641825
TI  - Toward gene therapy in haemophilia A: retrovirus-mediated transfer of a factor
      VIII gene into murine haematopoietic progenitor cells.
AB  - To study and evaluate the potential of the haematopoietic system as a target for
      gene therapy in haemophilia A, we have infected murine bone-marrow cells with a
      recombinant retrovirus encoding blood-coagulation factor VIII and the bacterial
      enzyme neomycin-phosphotransferase. After transplantation of the infected bone
      marrow into lethally irradiated mice, the presence of intact vector could be
      demonstrated in DNA isolated from individual haematopoietic progenitor-cell
      derived spleen colonies. About 8% of the spleen colonies were shown to contain
      the intact vector. Selection for resistance to the neomycin analogue G418 prior
      to transplantation specifically killed the uninfected bone-marrow cells and, as a
      result, over 90% of the spleen colonies contained the factor VIII vector.
      However, expression of factor VIII in vivo, either at the RNA or at the protein
      level could not be demonstrated. From these data we conclude that: 1) retroviral
      vectors can be used to transfer factor-VIII cDNA into haematopoietic progenitor
      cells; 2) the vector sequences are expressed immediately after integration; and
      3) transcription of the vector is repressed in the progenitor-cell-derived cells.

PMID- 1641826
TI  - Rapeseed oil and sunflower oil diets enhance platelet in vitro aggregation and
      thromboxane production in healthy men when compared with milk fat or habitual
      diets.
AB  - In this highly controlled trial, 26 normolipidemic men (average age 28 years,
      range 18 to 60) were fed a baseline diet high in milk fat (MF) (fat 36% of
      energy, saturates 19%, monounsaturates 11%, polyunsaturates 4%), followed by a
      diet high in sunflower oil (SO) (fat 38% of energy, saturates 13%,
      monounsaturates 10%, polyunsaturates 13%) and another diet high in low erucic
      acid rapeseed oil (RO) (fat 38% of energy, saturates 12%, monounsaturates 16%,
      polyunsaturates 8%). All diets were mixed natural diets with the same cholesterol
      contents. The baseline milk fat diet was given for 14 days and the oil diets for
      24 days in a blind cross-over design. The platelet in vitro aggregation (slope
      %/min) induced by 1, 2 and 3 microM ADP and collagen (25 micrograms/ml PRP) was
      highly significantly (p less than 0.001) increased after both oil diets when
      compared with the results from the milk fat diet. The aggregation pattern
      determined by threshold collagen concentration confirmed increased collagen
      sensitivity of the platelets after the rapeseed oil diet (p less than 0.001). The
      enhancement of platelet aggregation was associated with increased in vitro
      platelet thromboxane production after the oil diets vs. the milk fat diet (p less
      than 0.05 after the sunflower oil diet and p less than 0.001 after the rapeseed
      oil diet).

PMID- 1641827
TI  - In vivo anticoagulant and antiplatelet effect of D-Phe-Pro-Arg-H and D-MePhe-Pro
      Arg-H.
AB  - D-Phe-Pro-Arg-H and D-MePhe-Pro-Arg-H synthetized in our institute were
      administered to mice, rats, rabbits and beagle dogs. The kinetics of the
      anticoagulant and antiplatelet effect was recorded by measuring various clotting
      parameters, platelet count and aggregation, and evaluated as proposed by
      Verstraete and Verwilghen. The minimum effective doses were found to be 0.25-0.5
      mg kg-1h-1 by intravenous continuous infusions and 0.5-1.0 mg/kg by single
      injections. The dose-dependent prolongation of clotting times appeared after
      application within minutes and returned to baseline values as a function of dose.
      Blood level of the inhibitors was determined by a bioassay. Unlike heparin, no
      higher starting dose was required to reach the anticoagulant threshold level,
      i.e. 0.03-0.1 microgram/ml whole blood. The peptides did not cause significant
      changes in platelet count and function or in hemodynamic parameters (blood
      pressure, heart rate and ECG) and in respiration. They blocked platelet
      aggregation induced by thrombin ex vivo specifically. No rebound effect or
      bleeding could be demonstrated even after subtoxic doses of the compounds. The
      onset of the anticoagulant and antithrombotic effect appeared within 60 min after
      single oral doses and lasted for 3-6 h. In close correlation with the
      anticoagulant effect a complete or significant inhibition of platelet aggregation
      induced by thrombin ex vivo could also be recorded by using 5-10 mg/kg doses.

PMID- 1641829
TI  - Thrombin activity by intrinsic activation of plasma in-vitro accelerates with
      increasing age of the donor.
AB  - Thrombotic diseases increase in incidence with advancing years and this might be
      partly due to an increased propensity for fibrin formation in older individuals.
      Accordingly we decided to investigate whether the time taken to generate 50%
      thrombin activity in vitro varied with the age of the plasma donor. Coagulation
      was initiated in defibrinated, diluted plasma by contact activation and thrombin
      activity measured using the chromogenic substrate, S2238. The rate of thrombin
      generation was assessed by measuring the time taken to reach 50% maximal activity
      (T50/s). There was a highly significant negative correlation between T50 and age,
      T50 declining from 93 s at 19 years to 71 s at 65 years (r = -0.637, p less than
      0.0001). A strong negative correlation was demonstrated between T50 and FVII
      level (r = -0.415, p = 0.0007) and FVIII:C level (r = -0.465, p = 0.0001).
      Although FVII concentration correlated with age (r = 0.307, p = 0.014) no
      relationship was seen between age and FVIII:C. These data suggest that
      coagulation rates in plasma accelerate with age.

PMID- 1641828
TI  - Anticoagulant efficacy and immunogenicity of the selective factor Xa inhibitor
      antistasin following subcutaneous administration in the rhesus monkey.
AB  - The antithrombotic efficacy and duration of action of a single subcutaneous
      administration of the selective factor Xa inhibitor recombinant antistasin (rATS)
      was evaluated in a rhesus monkey model of mild disseminated intravascular
      coagulation. rATS (1 mg/kg) was shown to be fully effective and comparable to
      standard heparin (1,000 U/kg) in the suppression of thromboplastin-induced
      fibrinopeptide A generation for at least 5 h following a single subcutaneous
      administration. The absorption rate of rATS, as measured by ex vivo activated
      partial thromboplastin times (aPTT), mirrored that of standard heparin exhibiting
      peak anticoagulant activity between 1 and 2 h post administration. The
      anticoagulant effects of a single rATS dose lasted for longer than 30 h
      maintaining an aPTT value at least 2-fold higher than baseline. Repeated
      subcutaneous administrations of rATS resulted in the generation of fully
      neutralizing antibodies. These results suggest that specific factor Xa inhibition
      may be as effective as standard heparin in the treatment of venous thrombosis.
      Due to its antigenicity however, rATS is probably not suitable for chronic
      subcutaneous anticoagulant therapy.

PMID- 1641830
TI  - Report of Scientific and Standardization Subcommittee on Neonatal Hemostasis
      Diagnosis and Treatment of Neonatal Thrombosis.

PMID- 1641831
TI  - Changes in von Willebrand factor antigen levels in venous occlusion.

PMID- 1641832
TI  - Increased levels of beta 2-glycoprotein I (aca-Cofactor) in patients with lupus
      anticoagulant.

PMID- 1641833
TI  - Acquired von Willebrand's disease in myeloproliferative syndrome: spontaneous
      remission during pregnancy.

PMID- 1641834
TI  - [Feline haemobartonellosis (feline infectious anemia): current knowledge].
AB  - Fifty years after it was first reported in South Africa (1) and thirty-five years
      after Haemobartonella felis was detected in the USA (2), we still do not know
      enough about certain aspects of feline haemobartonellosis (feline infectious
      anaemia). This overview covers these and known aspects, with the aim of bringing
      these aspects to the attention of people working in the field of feline medicine.

PMID- 1641835
TI  - [Felinfo glossarium. Mad cow disease in the cat].

PMID- 1641836
TI  - [Mycotic mastitis in cattle].
AB  - The literature on aetiology, diagnosis, symptoms, therapy and prognosis of
      mycotic mastitis in cows is reviewed. The importance of identification of the
      causative agent for the prognosis is discussed. Some cases of (candida) mastitis
      recover spontaneously: however, spontaneous recovery or recovery after therapy
      for mastitis caused by Cryptococcus or Prototheca is rare. Frequent milking of
      infected teats is important during treatment of mycotic mastitis. If supportive
      pharmacotherapy is desired, antimycotic drugs could be appropriate, however there
      is no clear evidence of the effectiveness of this therapy.

PMID- 1641837
TI  - [Revolutionary discovery].

PMID- 1641838
TI  - [Veterinary guidelines for preparation for export of breeding and commercial
      cattle. Government Department for Inspection of Cattle and Meat 1992].

PMID- 1641839
TI  - [What went wrong with the magnesium provision?].

PMID- 1641840
TI  - [Veterinarian on the way to a unified Europe].

PMID- 1641841
TI  - [Stress in newborn infants: a literature review].
AB  - All kinds of handling of sick newborn, especially premature babies, are thought
      to be stressful events. In order to develop stress reducing programs for those
      infants, a study was carried out into the reports of stress parameters for
      newborns in the current literature. B-endorphin answers the best to the needs for
      a reliable parameter in stress studies.

PMID- 1641842
TI  - [IgA deficiency: clinical ans immunological evaluation of 28 patients].
AB  - Seventeen patients with total IgA deficiency and II with partial IgA deficiency
      were investigated. Symptoms associated with IgA deficiency were retrospectively
      studied, and the levels of other immunoglobulins were measured in blood and in
      saliva. The most important associated complaints were recurrent upper respiratory
      infections. More than 50% of the symptomatic patients recovered clinically,
      associated with a recovery of the IgA level or with compensatory humoral
      immunological mechanisms (such as elevated IgG subclasses or strongly positive
      secretory IgM). The necessary diagnostic procedures, follow-up of patients and
      families are described.

PMID- 1641844
TI  - [Pulmonary artery loop: a cause of life-threatening stridor in the young infant].
AB  - Four clinical cases of pulmonary artery sling are reported. As an early
      recognition of this congenital anomaly can be life-saving for many infants, the
      most important elements in diagnosis and therapy are described.

PMID- 1641843
TI  - [Helicobacter pylori infections in children].
AB  - In our patient population with chronic aspecific abdominal complaints
      Helicobacter pylori gastritis is no rarity. This entity has been diagnosed in 10
      children out of 48 (mean age: 8 years 11 months) who underwent an endoscopy of
      the upper gastrointestinal tract. After treatment with amoxicillin and colloidal
      bismuth subcitrate during a period of 2 weeks the complaints disappeared and an
      eradication was obtained in 7. Histology of the antral mucosa demonstrated a type
      B chronic active gastritis in all patients. A Helicobacter pylori specific
      serology was positive in all 10 patients. This test was also positive in 17 out
      of 35 asymptomatic first degree family members; this is an illustration for the
      high family prevalence of Helicobacter pylori.

PMID- 1641845
TI  - [Symptomatology and treatment of neonatal hypertension].
AB  - A newborn child of a diabetic mother is described, who developed neonatal
      hypertension after birth. Clinical signs were not specific and the diagnosis
      would have been missed if blood pressure had not been measured. The cause of the
      neonatal hypertension appeared to be a thrombus in the left renal artery,
      probably originating from the ductus arteriosus Botalli. Control of the neonatal
      hypertension according to a stepwise treatment regime was very difficult. Based
      on our experience and on study of the literature it is advised to start treatment
      in the acute stage with nifedipine orally or with sodium nitroprusside
      intravenously.

PMID- 1641846
TI  - [Lidocaine poisoning in a newborn infant following perineal infiltration for
      episiotomy].
AB  - Intoxication of the newborn by a local anesthetic is a relatively unknown
      disease. A newborn born alive after being accidentally injected with lidocaine
      during perineal infiltration for episiotomy is described and the pharmacokinetics
      and possible therapies are discussed.

PMID- 1641847
TI  - [A child with Wegener's granulomatosis].
AB  - A 13-year old boy is described with painful joints, papular skinlaesions, malaise
      and haematuria. Impaired renal function and hypertension were found. In the past
      he frequently suffered of otitis media. Biopsies of kidney and skin lesions
      showed a vasculitis, furthermore the C-ANCA-titer (anti-neutrophil cytoplasm
      antibodies) was strongly elevated which justified the diagnosis Wegener's
      granulomatosis (WG). This disease is seldom seen in childhood. It is a
      necrotizing vasculitis with granulomas of mostly the respiratory tract and
      kidneys. Autoantibodies directed against intracellular antigens of neutrophils
      were first associated with vasculitis in 1982. Since 1988 two ANCA-subtypes have
      been recognized: C-ANCA and P-ANCA. The C-ANCA appear to be highly specific for
      diagnosis and follow-up of WG, and to differentiate of other forms of vasculitis
      (with P-ANCA). If children present with frequent and serious upper respiratory
      tract infections, with suspicion of a systemic disease it is important to perform
      the ANCA-test to differentiate between WG and other forms of vasculitis. The
      patient was treated with prednisone and cyclophosphamide, after which the
      symptoms and the ANCA-titer decreased.

PMID- 1641848
TI  - A novel cytotoxicity screening assay using a multiwell fluorescence scanner.
AB  - A new assay using a multiwell fluorescence scanner was developed for screening
      cytotoxicity to cells cultured in 96-well microtiter plates. The assay is based
      on binding of propidium iodide to nuclei of cells whose plasma membranes have
      become permeable due to cell death. Fluorescence of propidium iodide measured
      with a multiwell fluorescence scanner increased in proportion to the number of
      permeabilized cells. After ATP depletion of hepatocytes and neonatal cardiac
      myocytes with metabolic inhibitors ("chemical hypoxia"), and exposure of Madine
      Darby canine kidney cells to the toxic chemical, HgCl2, propidium iodide
      fluorescence progressively increased. Increases of fluorescence were linearly
      proportional with release of lactate dehydrogenase into the culture medium.
      Employing this cytotoxicity screening assay, protection by various agents against
      lethal injury was evaluated in cultured hepatocytes during chemical hypoxia.
      Inhibitors of cysteine proteases (i.e., antipain, leupeptin, E-64), serine
      proteases (i.e., PMSF), and aspartic acid proteases (i.e., pepstatin A) did not
      protect against chemical hypoxia. In contrast, 1,10-phenanthroline, an inhibitor
      of metalloprotease, markedly protected against the onset of cell death during
      chemical hypoxia. Half-maximal protection after 60 min occurred at 0.5 microM.
      Phospholipase inhibitors, chlorpromazine (50 microM) and mepacrine (50 microM),
      also substantially retarded cell killing. U74006F, an inhibitor of lipid
      peroxidation, slowed cell killing to a lesser extent during chemical hypoxia and
      after oxidative stress with t-butyl hydroperoxide. Calciphor, a dimer of
      prostaglandin B1, did not protect against cell killing during chemical hypoxia or
      t-butyl hydroperoxide toxicity. In conclusion, this high capacity cytotoxicity
      assay for cells cultured in 96-well microtiter plates is suitable for rapid
      screening of potential cytoprotective agents in a variety of cell types.

PMID- 1641849
TI  - Oxidative DNA damage levels in rats fed low-fat, high-fat, or calorie-restricted
      diets.
AB  - Increased fat and caloric content of the diet has been associated with increased
      mammary tumor incidence. The dietary modulation of cellular redox state may be
      one mechanism behind this association. We have examined the effects of changes in
      dietary fat and caloric intake on the levels of 5-hydroxymethyluracil in DNA from
      rat liver and mammary gland. Female Fischer 344 rats, 40 days old, were
      maintained on 3% (low-fat), 5% (control), or 20% (high-fat) corn oil diets for 2
      weeks. A fourth group of rats had the same daily fat intake as the control group,
      but total caloric intake was restricted by 40%. As a measure of oxidative DNA
      damage, 5-hydroxymethyluracil levels were measured in the DNA extracted from
      liver and mammary gland by gas chromatography-mass spectrometry. 5
      Hydroxymethyluracil levels in the liver DNA of the low-fat, high-fat, and calorie
      restricted groups were decreased relative to that of control, but the only
      significant decrease was in the calorie-restricted group (p less than 0.01). In
      the mammary gland DNA, statistically significant decreases in damage were found
      in each group relative to control (p less than 0.05). The relationship between
      fat in the diet and oxidative stress is thus complex. These results show that
      changes in dietary intake of both fat and calories can modulate oxidative DNA
      damage levels, and the effect of diet was more clearly evident in the DNA from
      mammary gland than in DNA from liver.

PMID- 1641850
TI  - Lung mitochondrial function following oxygen exposure and diethyl maleate-induced
      depletion of glutathione.
AB  - Diethyl maleate (DEM) pretreatment has previously been shown to result in a
      transient depletion of lung glutathione and an associated decrease of the time to
      the onset of rat mortality resulting from exposures to 100% oxygen in vivo. The
      effects of oxygen exposure on mitochondrial energy metabolism were assessed by
      measurements of ADP-stimulated rates of O2 utilization by lung homogenates
      prepared from untreated and DEM-treated rats following 4 and 24 hr of exposure to
      either air or 100% oxygen. Twenty-four hours of oxygen exposure of untreated rats
      resulted in significant decreases in lung homogenate ADP-stimulated rates of
      respiration supported by the substrates, pyruvate, isocitrate, and alpha
      ketoglutarate. No changes were observed in succinate-supported respiration,
      indicating that oxygen exposure appears to adversely affect NAD-linked rather
      than FAD-linked pathways of mitochondrial energy metabolism. The decreased lung
      mitochondrial glutathione, observed 4 hr following DEM treatment, returned to
      normal levels following 24 hr of air and oxygen exposure. No effects of
      glutathione depletion were observed on ADP-stimulated rates of respiratory
      activity 4 hr following DEM treatment. The DEM-induced transient depletion of
      glutathione also did not result in any additional detrimental effects on
      mitochondrial respiratory activity following 24 hr of oxygen exposure in vivo.
      These results suggested that transient mitochondrial depletion of glutathione
      does not accelerate the oxygen-induced impairment of mitochondrial energy
      metabolism. The onset of mortality associated with DEM-pretreatment might
      therefore result from a failure of glutathione-dependent cytosolic protective
      mechanisms, rather than from an increased rate of oxygen-induced mitochondrial
      damage.

PMID- 1641851
TI  - Detection of a reactive pyrrole in the hepatic metabolism of the pyrrolizidine
      alkaloid, monocrotaline.
AB  - Pyrrolizidine alkaloids such as monocrotaline are bioactivated in the liver,
      resulting in veno-occlusive disease of the liver, pulmonary arterial
      hypertension, and right ventricular hypertrophy. We have searched for the
      formation of a reactive, alkylating pyrrole intermediate in the metabolism of
      monocrotaline by isolated rat liver microsomes, using the sulfhydryl-containing
      resin, thiopropyl sepharose 6B, as a trapping agent. Control experiments show
      that a toxic, chemically reactive, alkylating pyrrole such as
      dehydromonocrotaline binds covalently to the resin via a thioether bond, but that
      a less toxic, poorly alkylating pyrrole, such as dehydroretronecine, does not.
      Isolated hepatic microsomes metabolize monocrotaline to produce a pyrrole that
      binds to the resin, and that can be detected by means of the Ehrlich color
      reagent (p-dimethylaminobenzaldehyde). The pyrrole is releasable by silver
      nitrate treatment, thereby establishing it to be bound via a thioether linkage.
      In buffered ethanolic silver nitrate the major product is 7-ethoxy-1
      hydroxymethyl-6,7-dihydro-5H-pyrrolizine (O7-ethyldehydroretronecine). This
      establishes that the thioether linkage is at the 7-position. The same product is
      obtained on release of the resin-bound pyrrole formed from the reaction of
      dehydromonocrotaline with the resin, thereby establishing the intermediacy of
      dehydromonocrotaline in the metabolism of monocrotaline.

PMID- 1641852
TI  - Altered intrarenal accumulation of mercury in uninephrectomized rats treated with
      methylmercury chloride.
AB  - We tested the hypothesis that the intrarenal accumulation of mercury in rats
      treated with methylmercury is altered significantly as a result of unilateral
      nephrectomy and compensatory renal growth. Renal accumulation of mercury was
      evaluated by radioisotopic techniques in both uninephrectomized (NPX) and sham
      operated (SO) rats 1, 2, and 7 days after the animals received a nonnephrotoxic
      intravenous dose of methylmercury chloride (5 mg/kg Hg). At all times studied
      after the injection of the dose of methylmercury, the renal accumulation of
      mercury (on a per gram kidney basis) was significantly greater in the NPX rats
      than that in the SO rats. The increased accumulation was due to a specific
      increase in the accumulation of mercury in the outer stripe of the outer medulla.
      Renal cortical accumulation of mercury was similar in both the NPX and SO rats.
      The percentage of the administered dose of mercury that was present in the total
      renal mass of the NPX and SO rats ranged between 5 and 15, depending on the day
      that the renal accumulation was studied. Approximately 40-50% of the total renal
      burden of mercury in both the NPX and SO rats was in the inorganic form. However,
      only less than 1% of the mercury in blood was in the inorganic form at the three
      times accumulation was studied. Very little mercury was excreted in the urine by
      either the NPX or SO rats. Only about 2 to 3% of the administered dose of mercury
      was excreted in the urine in 7 days. By contrast, the cumulative fecal excretion
      of mercury over 7 days was substantial in the NPX and SO rats, and significantly
      more mercury was excreted in the feces by the NPX rats (about 19% of the dose)
      than by that in the SO rats (about 16% of the dose). In conclusion, our findings
      indicate that unilateral nephrectomy and compensatory renal growth cause a
      significant increase in the accumulation of mercury in the renal outer stripe of
      the outer medulla in rats exposed to methylmercury. In addition, the findings
      indicate that the fecal excretion of mercury is also significantly increased.

PMID- 1641853
TI  - Effect of pregnenolone-16 alpha-carbonitrile and dexamethasone on acetaminophen
      induced hepatotoxicity in mice.
AB  - Recently, we demonstrated that a microsomal enzyme inducer with a steroidal
      structure, pregnenolone-16 alpha-carbonitrile (PCN), markedly decreased the
      hepatotoxicity of acetaminophen (AA) in hamsters. Therefore, it was of interest
      to determine if PCN, as well as another steroid microsomal enzyme inducer,
      dexamethasone (DEX), would decrease the toxicity of AA in mice, another species
      sensitive to AA hepatotoxicity. Mice were pretreated with PCN or DEX (100 and 75
      mg/kg, ip, for 4 days, respectively) and were given AA (300-500 mg/kg, ip).
      Twenty-four hours after AA administration, liver injury was assessed by measuring
      serum activities of sorbitol dehydrogenase and alanine aminotransferase and by
      histopathological examination. Neither PCN nor DEX protected markedly against AA
      hepatotoxicity in mice; PCN tended to decrease AA-induced hepatotoxicity, whereas
      DEX was found to enhance AA-induced hepatotoxicity and it produced some
      hepatotoxicity itself. DEX decreased the glutathione concentration (36%) in liver
      and increased the biliary excretion of AA-GSH, which reflects the activation of
      AA, whereas PCN produced neither effect. Thus, whereas PCN has been shown to
      markedly decrease the hepatotoxicity of AA in hamsters, apparently by decreasing
      the isoform of P450 responsible for activating AA to N-acetyl-p
      benzoquinoneimine, this does not occur in mice after induction with either PCN or
      DEX. In contrast, DEX enhances AA hepatotoxicity apparently by decreasing liver
      GSH levels and increasing the activation of AA to a cytotoxic metabolite.

PMID- 1641854
TI  - Blood pressure changes and sympathetic function in rats given cyclohexylamine by
      intravenous infusion.
AB  - Intravenous infusion of cyclohexylamine (30-120 mg/kg) caused a dose-dependent
      increase in blood pressure in urethane-anesthetized rats. The increase in blood
      pressure was inversely related to the duration of the infusion. The blood
      pressure returned to baseline values (+/- 5 mm Hg) within 60 min of the end of
      the infusion after doses of 30 and 60 mg/kg were administered over 20 and 40 min.
      The plasma concentrations of cyclohexylamine were related linearly to the
      administered dose and decreased only 27% between the end of the infusion and 60
      min later. The concentration-effect relationship showed clockwise hysteresis,
      indicative of tachyphylaxis, as has been reported in humans (Eichelbaum et al.,
      1974). Administration of bolus doses of tyramine at the end of the infusion or 60
      min later demonstrated the presence of an indirect sympathomimetic response,
      although this was attenuated to a greater extent by high doses and more rapid
      infusions of cyclohexylamine. An almost complete loss of response to tyramine was
      found only in animals given 120 mg/kg over 40 min. The presence of a tyramine
      response 60 min after the infusion of 60 mg/kg occurred when there was an
      essentially complete reversal of the hypertensive effect of cyclohexylamine.
      These data indicate that the hypertensive effect of the indirectly acting
      sympathomimetic amine cyclohexylamine occurs primarily during rapid increases in
      plasma concentrations. Tachyphylaxis develops rapidly after the cessation of the
      infusion which is probably due largely to reuptake of released noradrenaline at
      low doses and depletion of releasable noradrenaline at high doses.

PMID- 1641855
TI  - Percutaneous absorption and metabolism of pyrene, benzo[a]pyrene, and di(2
      ethylhexyl) phthalate: comparison of in vitro and in vivo results in the hairless
      guinea pig.
AB  - The in vitro and in vivo absorption and metabolism of pyrene, benzo[a]pyrene, and
      di(2-ethylhexyl) phthalate (DEHP) were investigated in the hairless guinea pig.
      The in vitro method, which involved the use of flow-through diffusion cells and
      Hepes-buffered Hanks' balanced salt solution containing 4% bovine serum albumin
      as perfusate, was demonstrated to be a suitable system for predicting in vivo
      absorption of the above lipophilic compounds. The successful application of the
      in vitro technique for these compounds is significant because no satisfactory in
      vitro method has hitherto been developed to predict in vivo absorption of highly
      lipophilic chemicals. Quantification of parent compounds and metabolites that
      permeated into perfusates and those that remained in skin discs provided insight
      into the process by which the chemicals penetrated through the skin. Pyrene was
      absorbed primarily by a passive diffusion process, although a small fraction of
      the administered dose was biotransformed into metabolites in the skin and
      partitioned into the receptor fluid. Absorption of benzo[a]pyrene was mediated by
      biotransformation processes. A metabolite derived from the ultimate carcinogen of
      this compound, benzo[a]pyrene r-7, t-8,9,10-tetrahydrotetrol, was identified in
      the receptor fluid. Most of the administered DEHP remained in the skin and only a
      very small fraction of the dose partitioned into the receptor fluid in either
      viable or nonviable skin. Data from the present study led to the conclusion that
      the in vitro method can be utilized to predict in vivo absorption for compounds
      of high lipophilicity and that dermal metabolism facilitates partitioning of
      metabolites into the receptor fluid and hence may affect the biological
      activities of dermally applied compounds.

PMID- 1641856
TI  - Exposure to bleached kraft pulp mill effluent disrupts the pituitary-gonadal axis
      of white sucker at multiple sites.
AB  - Our recent studies have demonstrated reproductive problems in white sucker
      (Catostomus commersoni) exposed to bleached kraft pulp mill effluent (BKME) at
      Jackfish Bay on Lake Superior. These fish exhibit delayed sexual maturity,
      reduced gonadal size, reduced secondary sexual characteristics, and circulating
      steroid levels depressed relative to those of reference populations. The present
      studies were designed to evaluate sites in the pituitary-gonadal axis of
      prespawning white sucker affected by BKME exposure. At the time of entry to the
      spawning stream, plasma levels of immunoreactive gonadotropin (GtH)-II (LH-type
      GtH) in male and female white sucker were 30- and 50-fold lower, respectively,
      than the levels in fish from a reference site. A single intraperitoneal injection
      of D-Arg6, Pro9N-Et sGnRH (sGnRH-A, 0.1 mg/kg) increased plasma GtH levels in
      male and female fish at both sites, although the magnitude of the response was
      greatly reduced in BKME-exposed fish. Fish at the BKME site did not ovulate in
      response to sGnRH-A, while 10 of 10 fish from the reference site ovulated within
      6 hr. Plasma 17 alpha,20 beta-dihydroxy-4-pregnen-3-one (17,20 beta-P) levels
      were depressed in BKME-exposed fish and unlike fish at the reference site, failed
      to increase in response to sGnRH-A. Testosterone levels in both sexes and 11
      ketostestosterone levels in males were elevated in fish from the reference site
      but were not further increased by GnRH treatment. In contrast, BKME-exposed fish
      exhibit a transitory increase in testosterone levels in response to the GnRH
      analog. In vitro incubations of ovarian follicles obtained from fish at the BKME
      site revealed depressed basal secretion of testosterone and 17,20 beta-P and
      reduced responsiveness to the GtH analog human chorionic gonadotropin and to
      forskolin, a direct activator of adenylate cyclase. By comparison, ovarian
      follicles from fish collected at BKME and reference sites produced similar levels
      of prostaglandin E basally and in response to a phorbol ester and calcium
      ionophore A23187, suggesting that BKME effects on ovarian function are selective
      and do not reflect a general impairment of ovarian function. BKME-exposed fish
      had plasma levels of testosterone glucuronide proportionately lower than those of
      reference fish, suggesting that there are site differences in the peripheral
      metabolism of steroids. These studies demonstrate that BKME exposure affects
      reproduction by acting at multiple sites in the pituitary-gonadal axis.

PMID- 1641857
TI  - Galactosamine hepatotoxicity: effect of galactosamine on glutathione resynthesis
      in rat primary hepatocyte cultures.
AB  - The effect of galactosamine on the resynthesis of glutathione in rat primary
      hepatocyte cultures was investigated. Cultured rat hepatocytes were treated with
      galactosamine (4 mM) 1.5 hr prior to concurrent with, or 1.5 hr after cell
      attachment; total cellular glutathione was then measured over time. Addition of
      galactosamine at any of these times suppressed methionine-enhanced glutathione
      resynthesis in the cultures after a lag period of about 120 min. The lag period
      was not due to slow uptake of galactosamine by the cultured cells, since cellular
      UTP levels fell to less than 10% of controls within 60 min, a time frame
      comparable to that observed in vivo. Neither was the lag period a result of
      interference with cellular uptake of methionine or with conversion of methionine
      to cysteine, since the phenomenon was observed regardless of whether methionine
      or cysteine was used to promote glutathione resynthesis. Addition of uridine,
      which protects against galactosamine hepatotoxicity in vivo by replenishing
      hepatic UTP levels, did not prevent the suppression of glutathione resynthesis.
      The data indicate that (a) galactosamine inhibits the time-dependent resynthesis
      of glutathione in primary hepatocyte cultures, (b) a lag period exists for this
      response, and (c) this effect is not directly related to depletion of cellular
      UTP stores.

PMID- 1641858
TI  - Epithelial injury and interstitial fibrosis in the proximal alveolar regions of
      rats chronically exposed to a simulated pattern of urban ambient ozone.
AB  - Electron microscopic morphometry was used to study the development of lung injury
      during and after chronic (78 weeks) exposure to a pattern of ozone (O3) designed
      to simulate high urban ambient concentrations that occur in some environments.
      The daily exposure regimen consisted of a 13-hr background of 0.06 ppm, an
      exposure peak that rose from 0.06 to 0.25 ppm, and returned to the background
      level over a 9-hr period, and 2-hr downtime for maintenance. Rats were exposed
      for 1, 3, 13, and 78 weeks. Additional groups of rats exposed for 13 or 78 weeks
      were allowed to recover in filtered clean air for 6 or 17 weeks, respectively.
      Rats exposed to filtered air for the same lengths of time were used as controls.
      Samples from proximal alveolar regions and terminal bronchioles were obtained by
      microdissection. Analysis of the proximal alveolar region revealed a biphasic
      response. Acute tissue reactions after 1 week of exposure included epithelial
      inflammation, interstitial edema, interstitial cell hypertrophy, and influx of
      macrophages. These responses subsided after 3 weeks of exposure. Progressive
      epithelial and interstitial tissue responses developed with prolonged exposure
      and included epithelial hyperplasia, fibroblast proliferation, and interstitial
      matrix accumulation. The epithelial responses involved both type I and type II
      epithelial cells. Alveolar type I cells increased in number, became thicker, and
      covered a smaller average surface area. These changes persisted throughout the
      entire exposure and did not change during the recovery period, indicating the
      sensitivity of these cells to injury. The main response of type II epithelial
      cells was cell proliferation. The accumulation of interstitial matrix after
      chronic exposure consisted of deposition of both increased amounts of basement
      membrane and collagen fibers. Interstitial matrix accumulation underwent partial
      recovery during follow-up periods in air; however, the thickening of the basement
      membrane did not resolve. Analysis of terminal bronchioles showed that short-term
      exposure to O3 caused a loss of ciliated cells and differentiation of preciliated
      and Clara cells. The bronchiolar cell population stabilized on continued
      exposure; however, chronic exposure resulted in structural changes, suggesting
      injury to both ciliated and Clara cells. We conclude that chronic exposure to low
      levels of O3 causes epithelial inflammation and interstitial fibrosis in the
      proximal alveolar region and bronchiolar epithelial cell injury.

PMID- 1641859
TI  - Rat liver microsomal UDP-glucuronosyltransferase activity toward thyroxine:
      characterization, induction, and form specificity.
AB  - Glucuronidation of thyroxine (T4) by liver microsomal UDP-glucuronosyltransferase
      (UDP-GT) is a predominant pathway by which T4 is deactivated. This study was
      conducted to characterize in vitro T4 UDP-GT activity in rat liver microsomal
      preparations, to determine if T4 glucuronidation is mediated by a particular form
      of UDP-GT, and to determine if T4 glucuronidation can be increased by microsomal
      enzyme inducers. Characterization of microsomal T4 UDP-GT activity led to the
      establishment of optimal assay conditions. UDP-GT activity toward T4 was
      determined in hepatic microsomal preparations from Wistar and Gunn rats, a mutant
      strain of Wistar rats deficient in several forms of UDP-GT. Hepatic microsomal
      preparations from Gunn rats glucuronidated T4 at one-third the rate catalyzed by
      microsomal preparations from Wistar rats. To determine the effect of four
      inducers that each increase a separate class of UDP-GT, phenobarbital (PB), 3
      methylcholanthrene (3MC), pregnenolone-16 alpha-carbonitrile (PCN), clofibrate
      (CLO), saline, or corn oil was administered to male Sprague-Dawley rats ip for 4
      days. T4 UDP-GT activity was increased by PB, 3MC, PCN, and CLO 88, 150, 100, and
      160%, respectively on a per-milligram-microsomal-protein basis and 138, 125, 100,
      and 145% on a per-kilogram-body-weight basis, respectively. Therefore, all four
      classes of UDP-GT inducers increase T4 glucuronidation, suggesting that T4 is not
      a selective substrate for a particular form of UDP-GT.

PMID- 1641860
TI  - Metabolism and lipoperoxidative activity of trichloroacetate and dichloroacetate
      in rats and mice.
AB  - Trichloroacetate (TCA) and dichloroacetate (DCA) have been shown to be
      hepatocarcinogenic in mice when administered in drinking water. However, DCA
      produces pathological effects in the liver that are much more severe than those
      observed following TCA treatment in both rats and mice. To identify potential
      mechanisms involved in the liver pathology, the biotransformation of TCA and DCA
      was investigated in male Fischer 344 rats and B6C3F1 mice. Rodents were
      administered 5, 20, or 100 mg/kg [14C]TCA or [14C]DCA as a single oral dose in
      water. Elimination was examined by counting radioactivity in urine, feces,
      exhaled air, and carcass. Blood concentration over time curves were constructed
      for both TCA and DCA at the 20 and 100 mg/kg doses. Analysis of the data reveals
      two significant differences in the systemic clearance of TCA relative to DCA.
      First, DCA was much more extensively metabolized than TCA. More than 50% of any
      single dose of TCA was excreted unchanged in the urine of both rats and mice. In
      contrast, less than 2% of any dose of DCA was recovered in the urine as the
      parent compound. Second, while the blood concentration over time curves for TCA
      were similar in rats and mice, the blood concentrations of DCA were markedly
      greater in rats compared to those in mice, both when DCA was administered and
      when DCA resulted from metabolism of TCA. DCA was detected in the urine of TCA
      treated animals and chloroacetate was found in the urine of DCA-treated animals.
      These metabolic products would be expected to arise from a free radical
      generating, reductive dechlorination pathway. To evaluate the ability of acute
      doses of TCA and DCA to elicit a lipoperoxidative response, additional groups of
      mice were administered 0, 100, 300, 1000, and 2000 mg/kg TCA or DCA and
      thiobarbituric acid-reactive substances (TBARS) measured in liver homogenates.
      Both TCA and DCA enhanced the formation of TBARS in a dose-dependent manner,
      thereby providing further evidence of a reductive metabolic pathway. DCA was
      found to be the more potent of the chlorinated acetates in increasing TBARS
      formation in the livers of both rats and mice. In view of these data, it appears
      that the more extensive metabolism and rapid rate of elimination of DCA relative
      to TCA and the more potent lipoperoxidative activity of DCA may be important
      factors in the pathological effects associated with DCA treatment.

PMID- 1641861
TI  - Species differences in the metabolism of trichloroethylene to the carcinogenic
      metabolites trichloroacetate and dichloroacetate.
AB  - Differing rates and extent of trichloroethylene (TCE) metabolism have been
      implicated as being responsible for varying sensitivities of mice and rats to the
      hepatocarcinogenic effects of TCE. Recent data indicate that the induction of
      hepatic tumors in mice may be attributed to the metabolites trichloroacetate
      (TCA) and/or dichloroacetate (DCA). The present study was directed at determining
      whether mice and rats varied in (1) the peak blood concentrations, (2) the area
      under the blood concentration over time curves (AUC) for TCE and metabolites in
      blood, and (3) the net excretion of TCE to these metabolites in urine in the dose
      range used in the cancer bioassays of TCE, and to contrast the kinetic parameters
      observed for TCE-derived TCA and DCA with those obtained following direct
      administration of TCA and DCA. Blood and urine samples were collected over 72 hr
      from rats and mice after a single oral dose of TCE of 1.5 to 23 mmol/kg. The AUC
      values from the blood concentration with time profiles of TCE, TCA, and
      trichloroethanol (TCOH) were similar for Sprague-Dawley rats and B6C3F1 mice.
      Likewise, the percentages of initial TCE dose recovered as the urinary
      metabolites TCA and TCOH were comparable. Nevertheless, the peak blood
      concentrations of TCE, TCA, and TCOH observed in mice were much greater than
      those in rats, while the residence time of TCE and metabolites was prolonged in
      rats relative to that of mice. DCA was detected in the blood of mice but not in
      rats. The blood concentrations of DCA observed in mice given a carcinogenic dose
      of TCE (15 mmol/kg) were of the same magnitude as those observed with
      carcinogenic doses of DCA. In conclusion, the net metabolism of TCE to TCA and
      TCOH was similar in rats and mice. The initial rates of metabolism of TCE to TCA,
      however, were much higher in mice, especially as the TCE dose was increased,
      leading to greater concentrations of TCA and DCA in mice approximated those
      produced by carcinogenic doses of the chlorinated acetates makes it highly likely
      that both compounds play a role in the induction of hepatic tumors in mice by
      TCE.

PMID- 1641862
TI  - Propane 2-nitronate is more rapidly denitrified and is more genotoxic than 2
      nitropropane in cultured rat hepatoma cells.
AB  - We have investigated the importance of nitronate formation from 2-nitropropane (2
      NP) for the oxidative metabolism and the genotoxicity of 2-NP in 2sFou rat
      hepatoma cells. Treatment of the cells with 2-NP for up to 3 h resulted in the
      time-dependent appearance of nitrite in the culture medium and in a weak
      induction of DNA repair synthesis. Both nitrite formation and repair induction
      were markedly enhanced in cells exposed to the anionic form of 2-NP, propane 2
      nitronate. These observations suggest that propane 2-nitronate, rather than 2-NP
      itself, is oxidized by the liver cells to yield a DNA-damaging product. The
      results also indicate that the nitro/nitronate equilibration in intact liver
      cells is slow, suggesting that nitronate formation represents the rate-limiting
      step in the metabolic activation of 2-NP.

PMID- 1641863
TI  - Synergism between aflatoxin B1 and oxytetracycline on fatty acid esterification
      in isolated rat hepatocytes.
AB  - The individual and combined effects of aflatoxin B1 (AFB1) and oxytetracycline
      (OXT) on the synthesis and secretion of triacylglycerols in isolated rat
      hepatocytes maintained in suspension during 2.5 h were studied. Secretion of
      triacylglycerols was inhibited by both drugs when administered separately. This
      inhibition was accompanied by a concomitant elevation of intracellular
      triacylglycerols only at the highest AFB1 dose tested. Total synthesis of
      triacylglycerols was not inhibited by AFB1 or by OXT. When the two drugs were
      simultaneously added to the incubation medium, the AFB1-induced accumulation of
      intracellular triacylglycerols was no longer observed; the inhibition of
      secretion was nevertheless identical to that observed with AFB1 alone. Finally,
      total esterification of palmitate was inhibited by 20% compared to the AFB1
      treated cells. These data suggest that OXT inhibits lipid accumulation induced by
      AFB1 but that this effect is due to an inhibition of total synthesis of
      triacylglycerols. The mechanism of AFB1's effect and of the interaction between
      both molecules is discussed.

PMID- 1641864
TI  - Modulation of hexachlorobenzene-induced hepatic porphyria by methyl isobutyl
      ketone in the rat.
AB  - Potential toxic interaction between hexachlorobenzene (HCB) and methyl isobutyl
      ketone (MiBK) was investigated using two different schedules of toxicant
      administration. The first schedule involved simultaneous administration of HCB
      (50 mg/kg/d, p.o. in 10 ml/kg corn oil at 10.00 a.m. for 5 d/wk) and MiBK (7.5
      mmol/kg/d, p.o. in 10 ml/kg corn oil at 4.00 p.m. for 3 d/wk) for 6 weeks. The
      second schedule involved an initial dosing of 25 or 50 mg HCB/kg/d for 12
      consecutive days, followed by the administration of 7.5 mmol MiBK/kg every other
      day for 27 days. When administered simultaneously, MiBK reduced the severity of
      HCB-induced porphyria, but when given sequentially after HCB accumulation, it
      enhanced the porphyrinogenic response. These results suggest that the effect of
      combined exposure to HCB and MiBK on hepatic porphyria depends on the sequence of
      the administration of both chemicals, and that the mechanism involved in this
      interaction may invoke both the induction and inhibition of specific hepatic
      isoenzymes by MiBK.

PMID- 1641865
TI  - The role of propranolol and atropine in mitigating the toxic effects of scorpion
      venom on rat electrocardiogram.
AB  - The effects of the scorpion Leiurus quinquestriatus (H.&E.) venom on
      electrocardiogram (ECG) parameters such as P-R and Q-T intervals and R and T wave
      amplitudes were investigated in anesthetized rats. Venom was administered
      intramuscularly (i.m.) at three doses (100, 200 and 400 micrograms/kg). ECG limb
      lead II was recorded for 4-h sessions. Because autonomic nervous system tone
      plays an important role in influencing ECG findings, another study was completed
      with concomitant pharmacologic autonomic nervous system blockade. Propranolol or
      atropine was injected 20 min before venom administration in two groups of rats.
      The results indicated that the venom has drastic effects on the electrical
      activity of the heart. The Q-T interval developed a dose-response relationship
      after venom administration. Propranolol abolished the toxic effects of the venom
      on P-R and Q-T intervals as well as on R wave amplitude, while atropine had no
      effect on the ECG changes produced by the venom.

PMID- 1641866
TI  - Toxic neurofilamentous axonopathies and fast anterograde axonal transport. IV. In
      vitro analysis of transport following acrylamide and 2,5-hexanedione.
AB  - Recent investigations into the mechanisms of neurotoxicity of acrylamide and
      gamma-diketones have demonstrated reductions in the delivery of radiolabelled
      proteins to the distal axon. To differentiate a toxicant-induced compromise in
      the capacity of the fast anterograde axonal transport system from a neuron cell
      body processing effect, selective exposure of either the L5 dorsal root ganglion
      or sciatic nerve to 0.7 mM acrylamide (ACR) or 4 mM 2,5-hexanedione (2,5-HD) was
      performed during in vitro transport. Nerve exposure to ACR decreased the quantity
      of transport by 32%, 2,5-HD reduced the quantity by 44%. Ganglion exposure
      produced no significant changes. We conclude that both toxicants penetrate the
      nerve barriers and act directly and/or indirectly on the axonal transport
      mechanisms to cause the reductions in transport.

PMID- 1641867
TI  - The renal handling of sodium and potassium in environmental cadmium-exposed
      subjects with renal dysfunction.
AB  - To clarify using clearance methods the renal handling of sodium and potassium in
      a population with environmental cadmium (Cd)-induced renal dysfunction, 76 Cd
      exposed subjects (32 men and 44 women) and 36 non-exposed subjects (18 men and 18
      women) were selected. Fractional excretions of potassium and beta 2-microglobulin
      were higher in the Cd-exposed subjects than in the non-exposed subjects, while
      the fractional excretion of sodium in the Cd-exposed subjects was equal to that
      of the non-exposed subjects. The urinary excretion rate of sodium was
      significantly lower in the Cd-exposed subjects than in the non-exposed subjects,
      while no significant difference was found in the urinary potassium excretion
      rate. Fractional excretion of sodium showed a significant correlation with age in
      all the subjects, while that of potassium significantly correlated with serum
      beta 2-microglobulin. These results indicate that increases in the fractional
      excretion of sodium or potassium do not directly signify increased urinary
      excretion of sodium or potassium in Cd-induced renal tubular dysfunction. The
      fractional excretion of potassium may be more affected by Cd-induced renal
      dysfunction, while that of sodium appears to be more related to age.

PMID- 1641868
TI  - Effect of phenobarbital treatment on carbon tetrachloride-mediated cytochrome P
      450 loss and diene conjugate formation.
AB  - The effect of phenobarbital treatment on the linkage between carbon tetrachloride
      mediated cytochrome P-450 loss and lipid peroxidation in rat liver microsomes was
      studied. Male Sprague-Dawley rats, pretreated with 3 daily i.p. doses of
      phenobarbital (50 mg/kg) or saline, were orally dosed with carbon tetrachloride
      (0.01-2.5 ml/kg), with liver microsomes prepared at 7.5-180 min after carbon
      tetrachloride treatment. In vivo cytochrome P-450 loss displayed pseudo-first
      order kinetics, and the initial rates of diene conjugate formation were saturable
      with dose. Phenobarbital pretreatment decreased the in vivo t0.5,max from 27.0 to
      15.6 min, and increased the Kd,app from 0.78 to 1.30 ml/kg for carbon
      tetrachloride mediated cytochrome P-450 loss. Phenobarbital had no effect on the
      in vivo Vmax (1.03 to 1.04 delta OD232 nm/min/mg phospholipid) for carbon
      tetrachloride mediated diene conjugate formation, but decreased the Km,app from
      0.22 to 0.10 ml/kg. These results are consistent with destruction of cytochrome P
      450 heme resulting from a metabolite which does not leave the site of generation,
      and with phenobarbital pretreatment enhancing the initiation of lipid
      peroxidation.

PMID- 1641870
TI  - Effect of caloric restriction on hepatic nuclear DNA damage in male Fischer 344
      rats treated with aflatoxin B1.
AB  - Caloric restriction is known to reduce chemically-induced tumor incidence in
      laboratory animals. The effect is believed to be mediated in part by modification
      of hepatic drug metabolism, including both phase I and phase II enzymes. Using
      aflatoxin B1 (AFB1) as a model carcinogen, we studied the effect of caloric
      restriction on the modification of rat liver nuclear DNA by AFB1 and DNA damage
      due to the formation of apurinic sites from the AFB1-DNA adduct removal process.
      Caloric restriction reduced the metabolic activation of AFB1 which resulted in a
      decrease of AFB1-DNA binding by more than 50%. The results of the study of the
      effect of caloric restriction on the AFB1-induced DNA strand breakage assayed by
      the alkaline unwinding technique showed that caloric restriction protected the
      formation of apurinic sites from the AFB1-DNA adducts and reduced the double
      strand DNA breakages by 1.3-2.5-fold. Thus, the lower initial AFB1-DNA binding
      and less DNA damage, presumably by the less apurinic sites formed during the
      depurination process of AFB1-DNA adducts, contributed to the protective effect of
      caloric restriction.

PMID- 1641869
TI  - The effects of aluminum ingestion on intestinal cadmium absorption, lipid
      peroxidation and alkaline phosphatase activity.
AB  - Consumption of dietary aluminum (A1, 2000 or 4000 ppm) for 1 month did not
      influence mouse body weight. In order to estimate an absorption of cadmium (Cd)
      from the gastrointestinal tract, mice were intubated twice every 24 h with Cd
      (CdCl2). In the A1-supplemented mice, Cd absorption increased rather than
      decreased. Intestinal Cd and metallothionein concentrations were increased by the
      A1 supplement. Intestinal alkaline phosphatase activity and lipoperoxide
      concentrations were also enhanced by A1 ingestion. Of course, intestinal A1
      concentration was at a high level in the A1-supplemented groups. However, A1
      accumulation was not observed in the liver. The increase of Cd absorption may be
      due to an abnormality of the gut wall caused by the A1. Our results suggest that
      A1 is not inert for animals, even though A1 absorption is poor.

PMID- 1641871
TI  - Cardiovascular, metabolic and neurologic effects of carbon monoxide and cyanide
      in the rat.
AB  - Levine-prepared, female Sprague-Dawley rats were used to investigate the effects
      of carbon monoxide (CO) and cyanide (CN) on heart rate, blood pressure,
      hematocrit, body temperature, blood glucose, lactate, and neurologic function.
      Rats were exposed to either 2400 ppm CO, 1500 ppm CO, 4 mg/kg NaCN, or both 1500
      ppm CO and 4 mg/kg NaCN for 90 min, followed by 4 h of room air recovery.
      Following exposure to 2400 ppm CO, rats exhibited a significant bradycardia which
      normalized by 2 h of recovery. All groups exhibited an initial hypotension which
      was either maintained or exaggerated during exposure in all but the rats exposed
      to CN, and which returned to pre-exposure values by 90 min. All groups
      experienced a significant hypothermia during the exposure period, with those in
      the 1500 ppm CO or the CN returning to initial values over the recovery period.
      The only significant change in hematocrit was due to 2400 ppm CO (4.1% increase).
      During exposure, all groups experienced an initial surge in glucose concentration
      which was maintained in all but rats exposed to 2400 ppm CO. The greatest
      hyperglycemic response resulted from the combination of CO and CN, whereas 2400
      ppm CO produced the smallest. CN alone produced no significant rise in lactate
      concentration. However, lactate concentration in all other groups was
      significantly elevated during the exposure period, returning to initial values by
      4 h of recovery. Lactate concentrations and neurologic deficit in rats exposed to
      1500 ppm CO, when added to those rats treated with CN, closely approximated the
      lactate and neurologic deficit of the combination treatment. Neurologic deficit
      was greatest in rats exposed to 2400 ppm CO. While in most cases the responses of
      the rats to CO and CN differed whether the substances were administered alone or
      in combination, a synergistic relationship is not suggested. An additive or less
      than additive relationship is more likely.

PMID- 1641872
TI  - Do intracellular Ca2+ activity and hepatic glutathione play a role in the
      pathogenesis of lithocholic acid-induced cholestasis?
AB  - The possible relevance of alterations in intracellular Ca2+ and hepatic
      glutathione levels (GSH) in the pathogenesis of cholestasis induced by
      lithocholic acid (LCA) was examined by comparing effects of LCA and acetaminophen
      on these parameters and bile flow (BF) in rats. Intracellular Ca2+ activity was
      measured via glycogen phosphorylase a determination in rats given an intravenous
      bolus injection of either LCA (12 mumol/100 g body wt.), acetaminophen (60 mg/100
      g body wt.), or a mixed solution of LCA and acetaminophen. BF was reduced
      immediately after LCA administration, with a maximum decrease occurring at 60 min
      followed by an increase to normal values at 210 min. On the other hand, glycogen
      phosphorylase a activity was elevated during all time periods after LCA
      treatment. Hepatic glutathione followed the BF curves being markedly depleted at
      the peak of cholestasis (60 min) and normal in the total recovery period (210
      min). In contrast, acetaminophen had no effect on BF but significantly increased
      glycogen phosphorylase a activity and depleted hepatic glutathione levels. These
      results suggest that cholestatic effect of LCA is not due to changes in
      intracellular Ca2+ or hepatic glutathione levels.

PMID- 1641873
TI  - Induction of cytochrome P-450 by dimethyl sulfoxide in primary cultures of adult
      rat hepatocytes.
AB  - Treatment of hepatocyte cultures with dimethyl sulfoxide (DMSO) induced P-450IIE1
      specific aniline 4-hydroxylase activity and P-450IA1-specific ethoxyresorufin O
      deethylase activity at a concentration of 0.1% (v/v). The P-450IIB-specific
      pentoxyresorufin O-deethylase activity was induced only at the 2% (v/v) level.
      Dot blot analysis of the total cellular RNA and cycloheximide treatment of the
      culture suggested that induction of ethoxyresorufin O-deethylase activity by DMSO
      may be due to the increase of de novo synthesis of the P-450IA1 protein, not to
      accumulation of mRNA in the hepatocyte culture.

PMID- 1641874
TI  - No evidence of intracellular oxidative stress during ischemia-reperfusion damage
      in rat liver in vivo.
AB  - The role of the intracellular generation of reactive oxygen species in the
      pathogenesis of ischemia-reperfusion damage of the liver was investigated in two
      in vivo rat models. Global hepatic ischemia was produced in the left and median
      lobes for 90 min followed by 60 min reperfusion to the total organ (model A) or
      only to the ischemic lobes (model B). Although both regimens caused significant
      rises in serum transaminases, this rise was higher in model B. In neither model
      was intracellular hydrogen peroxide production nor increased glutathione
      disulfide in bile found. The activities of various antioxidant enzymes were not
      affected by ischemia or ischemia-reperfusion. In conclusion, oxygen-free radicals
      are unlikely to be produced in the cells of rat liver during ischemia
      reperfusion.

PMID- 1641875
TI  - Comparative hepatotoxicity of cholic acid, deoxycholic acid and lithocholic acid
      in the rat: in vivo and in vitro studies.
AB  - Until now, the cytotoxicity of the bile acids was mostly seen as being inversely
      associated with their degree of lipophilicity. The present study aimed at
      comparing the hepatotoxicity of cholic acid (CA), deoxycholic acid (DCA) and
      lithocholic acid (LCA), which are respectively, tri-, di- and monohydroxylated
      bile acids. For in vivo studies, the bile acids have been given at the dose of
      0.5% or 1% in the diet of male Wistar rats for 2 weeks. The histological analysis
      of the liver, and the measurement of serum parameters of cytotoxicity and
      cholestasis (aminotransferases activity, bilirubin and total bile acids
      concentration), indicate that, among the bile acids tested, DCA is the most
      hepatotoxic, at both doses, while CA is the least hepatotoxic and cholestatic
      compound. Moreover, DCA is the only bile acid which, when given at the dose of
      0.5%, induces lipid peroxidation in the liver, as evidenced by the measurement of
      thiobarbituric reactive substances in liver homogenates. The analysis of bile
      acids in liver homogenates by gas liquid chromatography revealed that feeding the
      animals with DCA results in its hepatic accumulation. Feeding rats with LCA or CA
      only slightly modifies the proportion of tri-, di- and monohydroxylated bile
      acids in the liver, as compared to controls. An in vitro experiment aimed at
      studying the hepatocellular lysis induced in vitro by the three bile acids by
      measuring the release of lactate dehydrogenase in the incubation medium of
      surviving hepatocytes in suspension. At a concentration of 1 mM, only DCA induces
      a significant cellular lysis, while at this concentration the lytic effects of CA
      and LCA are progressive and time-dependent. From this study, we gather that the
      hepatotoxicity of bile acids does not necessarily depend on their degree of
      hydroxylation. Our results are in accordance with some studies in rat
      hepatocarcinogenesis, showing a predominant initiating and promoting effects of
      DCA, as compared to LCA.

PMID- 1641876
TI  - Evaluation of the interaction of benzene and toluene on the urinary excretion of
      t,t-muconic acid in rats.
AB  - The influence of simultaneous exposure to benzene and toluene on the urine
      excretion of t,t-muconic acid (t,t-MA) was examined in rats. t,t-MA was measured
      from 24-h urine of rats subjected to a single 4-h exposure to 5 or 20 ppm benzene
      and/or 50, 100, 200 or 1000 ppm toluene. Coexposure lowered t,t-MA excretion in a
      concentration-dependent manner, especially in the 20 ppm benzene group where the
      decrease averaged 28, 44 and 85% after exposure to 100, 200 and 1000 ppm toluene,
      respectively, as compared to benzene-exposed groups alone. The data confirm the
      sensitivity of t,t-MA as an indicator of benzene exposure and point out that
      measurement of t,t-MA may underestimate the exposure to benzene in the presence
      of toluene.

PMID- 1641878
TI  - Clinical manifestations of filariasis in Fujian, China.

PMID- 1641877
TI  - Primary medical care in Seychelles.
AB  - This paper describes some of the current health problems faced by a tropical
      country whose standard of living and lifestyle is approaching that of many
      countries in Western Europe. Long-term health problems such as cardiovascular
      diseases and diabetes have become at least as important as infectious diseases. A
      change in approach to a more proactive style of primary care is needed to allow
      the contribution of community doctors to be effective. The system of primary care
      in the Republic of Seychelles is based on the UK model of general practice where
      recent improvements in education and organization are raising standards. How some
      of these improvements might be transferred elsewhere is discussed.

PMID- 1641879
TI  - The bioavailability of a novel taste-masked formulation of quinine.

PMID- 1641880
TI  - Podoconiosis (endemic non-filarial elephantiasis) in two resettlement schemes in
      western Ethiopia.
AB  - In a population-based study of podoconiosis in two resettlement schemes in
      western Ethiopia, we found that 5% of 194 settlers and 9% of 222 indigenous
      people were affected. Prevalence rates were generally higher in males than
      females and increased with age, indicating sex differences in occupationally
      linked trauma to the feet and the cumulative effect of long-term exposure to
      volcanic soils. Persons wearing shoes had significantly lower rates than those
      usually walking barefoot. Suggestions are made for the control of podoconiosis.

PMID- 1641881
TI  - Antisnakevenom: an over-used medication.
AB  - Fifty-five cases of snakebite were retrospectively analysed for the indications
      for the use of anti-snakevenom (ASV). Sixty-seven per cent of patients received
      treatment with ASV. Of these, 47% had features of systemic envenoming, 30% had
      features of local envenoming and 22% had no features of envenoming, either
      systemic or local. When WHO guidelines were strictly applied, it was found that
      in 44% of cases, ASV was used without adequate indication.

PMID- 1641882
TI  - The International Federation of Red Cross and Red Crescent Societies.

PMID- 1641883
TI  - Neoplastic transformation of chronic ulcers in leprosy.

PMID- 1641884
TI  - Appropriate orthopaedic care in the Third World.

PMID- 1641885
TI  - Traditional health workers.

PMID- 1641886
TI  - Could the law governing the use of 'prescription-only' medicines be extended to
      traditional medicines?

PMID- 1641887
TI  - Taylor Pressure-Reducer in cataract surgery.

PMID- 1641888
TI  - Malnutrition and malaria gave him anaemia, then the blood transfusion gave him
      HIV.

PMID- 1641889
TI  - New emergency health kit: disasters supplement.

PMID- 1641890
TI  - Acute suppurative thyroiditis: increased incidence in Zambia.

PMID- 1641891
TI  - Sutureless circumcision.

PMID- 1641892
TI  - The problem of under-registration of infant deaths in Jamaica.

PMID- 1641893
TI  - Dental treatment needs in an African obstetric population.

PMID- 1641894
TI  - Colostomy: indications, complications and management: the Zaria experience.

PMID- 1641895
TI  - Clinical characteristics of tuberculous lymphadenitis in Tanzania.

PMID- 1641896
TI  - An unusual presentation of gastro-oesophageal reflux--Sandifer's syndrome.

PMID- 1641897
TI  - Tuberculosis of the stomach.

PMID- 1641898
TI  - Visceral leishmaniasis in a 6-week-old infant: possible congenital transmission.

PMID- 1641899
TI  - Postoperative tetanus following cryosurgery for haemorrhoids.

PMID- 1641900
TI  - Mebendazole with levamisole in tropical pulmonary eosinophilia: an alternative in
      diethylcarbamazine allergy.

PMID- 1641901
TI  - A simple method for the re-tightening of loose cervical cerclage stitch.

PMID- 1641902
TI  - Traditional healers.

PMID- 1641903
TI  - Letter from Denis Burkitt.

PMID- 1641904
TI  - [The morphological and functional characteristics of human aortic endothelium.
      II. Cellular polymorphism and the incorporation of 3H-thymidine in a culture].
AB  - The content of multinuclear endothelial cells and the ability of cells to
      incorporate 3H-thymidine were studied in primary cultures isolated from zones of
      low (LP) and high (HP) probability of atherosclerosis of adult human aortas. It
      was found that the percentage of multinuclear EC was at mean 2-fold higher in
      cultures from HP zones compared to LP zones of the same vessels. In primary
      cultures and in the first passage cultures only small mononuclear EC were able to
      incorporate 3H-thymidine. A significant decrease in the thymidine index (TI) was
      found only in cultures from HP zones of atherosclerotic aortas. In cultures of EC
      from the LP zones of these aortas the TI was as high as in cultures from the LP
      and HP zones from grossly normal vessels.

PMID- 1641905
TI  - [The role of satellite DNA in chromatin spatial organization in the interphase
      nucleus].
AB  - Problem of three-dimensional structure of chromatin is reviewed. Data concerning
      ranged distribution of chromosomes in nucleoplasm are shown. Special attention
      being paid to the role of nuclear matrix in maintenance of nucleus topology.
      Possible role of satellite sequences and DNA-binding proteins is discussed.

PMID- 1641906
TI  - [The programmed cell death of murine BW5147 thymoma under the action of
      dexamethasone].
AB  - By flow cytometry, imitation modelling and biochemical analysis, the mode and
      kinetics of dexamethasone-treated T-lymphoma cell death were studied. The hormone
      was shown to induce delays in pre- and postsynthetic phases of the cell cycle and
      the death of part of cells. A short exposure to dexamethasone reveals its
      cytostatic rather than cytolytic effect. Following G2/M delay and cytokinesis,
      part of cells dies. A reduced serum concentration (2%) causes shorter delays in
      the cell cycle and a more rapid cell death. Dexamethasone stimulates apoptosis
      which is indicated by internucleosomal DNA fragmentation, and by a coincidence in
      time of the processes of DNA degradation and increase in the other membrane
      permeability. These results are discussed in relation to the cell death and
      proliferation.

PMID- 1641907
TI  - [The cellular apoptosis of murine BW5147 thymoma during cold shock].
AB  - The mode of T-lymphoma cell death induced by cold shock was studied. The
      rewarming of cells at 37 degrees C following a brief period of cold (0 degrees C)
      resulted in internucleosomal DNA fragmentation. The cells underwent cold shock
      mediated apoptosis only at a reduced (2%) serum concentration. The apoptosis was
      not blocked by macromolecular synthesis inhibitors such as cycloheximide and
      antinomycin D, or by Quin-2. EGTA per se was responsible for the initiation of
      cell death. Colchicine also induced internucleosomal fragmentation of DNA. Our
      findings suggest that cold shock induced apoptosis is associated with low
      temperature mediated disruption of microtubules. The role of Ca2+ and growth
      factors in cold shock induced cell death is discussed.

PMID- 1641908
TI  - [The effect of the UV microirradiation of the centrosome on cell behavior. III.
      The ultrastructure of the centrosome after irradiation].
AB  - One of the spindle poles of mitotic PK cells was irradiated with UV microbeam in
      metaphase or in anaphase. Electron microscopy showed that immediately after
      irradiation the microtubules around the centrosome were maintained, and that the
      ultrastructure of both irradiated and nonirradiated poles was similar. After
      microirradiation of the centrosome in metaphase, the mitotic halo around this
      centrosome was retained, but in due time the number of microtubules was getting
      less compared to that around the nonirradiated centrosome. When daughter cells
      with irradiated centrosomes are passing into the interphase, their centrioles are
      not separated from each other, no primary cilia are formed, and no replication of
      centrioles occurs. In the interphase cells with irradiated centrosomes,
      satellites are formed on the active centriole, but centrosome-attached
      microtubules are practically absent.

PMID- 1641909
TI  - [The radiomodification of ion-transporting membrane enzymes in an experimental
      CNS syndrome].
AB  - A study was made of the radiomodified action of adenylic junction on the rat's
      brain plasmatic membranes during experimental CNS-syndrome, after a 24 h
      postirradiation, according to the test of enzyme activity changes of membrane
      bound enzymes. Among ATP, ADP, AMP and adenosine--only the latter shows a
      radioprotective effect in later periods of irradiation.

PMID- 1641910
TI  - [Balanced translocation t(17p--; 23p+) in the chimpanzee].
AB  - A chimpanzee family was studied, in which the father had a balanced translocation
      t(17p--; 23p+). The mother showed the normal female chromosome complement. Their
      daughter had also the normal female karyotype, but with heteromorphic chromosomes
      23. A cytogenetic analysis was made using G- and Q-banding techniques and in
      addition an alkaline silver method for NOR staining. A mechanism of the
      translocation inheritance is discussed.

PMID- 1641911
TI  - [The cytochemical demonstration of glycoproteins and glycolipids in Sarcocystis
      muris sarcocysts].
AB  - An electron cytochemical study of glycoproteins and glycolipids was made for the
      mature sarcocysts of Sarcocystis muris. Glycoprotein structures as branched
      fibrilles were seen on the surface of the sarcocyst wall. The fibrillar and
      granular glycoprotein structures were found in the ground substance of sarcocysts
      near the cyst wall and in the septae. In the plasmalemma of two types of cyst
      stages (merozoites and intermediate cells), glycoprotein fibrillar structures
      were revealed connecting these two cell types with each other. The third type
      cyst stages, i.e. the metrocytes, are situated separately without any fibrillar
      connections between them and other cyst stages being observed. This question is
      discussed in terms of the problem of cytodifferentiation. The fibrillar and
      granular glycoprotein material is scattered over the cytoplasm of the cyst
      stages, being especially concentrated in micronemes, rhoptries and around
      amylopectin granules. The control ultrathin sections were treated with saliva or
      pronase for the aims of protein identification in the material under study. In
      addition to glycoprotein, some glycolipids material was detected in the
      sarcocysts in the form of drops surrounded with thin glycoproteinaceous layers.
      Glycolipids were found in the ground substance of sarcocysts near the cyst stages
      and in the parasite cell cytoplasm around the micronemes and rhoptries. The data
      obtained are discussed in connection with the functional role glycoproteins and
      glycolipids play in S. muris.

PMID- 1641912
TI  - Optimization of quantitative electron energy loss spectroscopy in the low loss
      region: phosphorus L-edge.
AB  - The purpose of this study was to optimize quantitative electron energy loss
      spectroscopy (EELS) of elements that have characteristic edges in the low energy
      loss region and are components of organic matrices. The optimum parameters for
      phosphorus L2,3-edge (at 135 eV) detection were determined by numerical analysis
      of computer-generated, Poisson-noisy spectra and by experimental measurements (at
      80 keV) of films of the phosphoprotein, phosvitin. When the first, second and
      third valence electron/plasmon scatterings are included in the multiple least
      squares (MLS) fit, the background subtraction of (first-difference) spectra is
      significantly more accurate than that obtained with the "inverse power law"
      method, even for a specimen thickness of only 0.25 lambda. Taking into account
      the effects of plural scattering, the optimal thickness for P quantitation is
      approximately 0.3 lambda. Signal-to-noise (S/N) ratio decreases rapidly with
      thickness, and at 1.0 lambda, it is only about 60% of the optimum S/N. The
      combined effects of the statistical uncertainty of measurements and of the
      systematic error due to gain variations of the parallel detector were evaluated,
      and the relative sensitivities of the no-difference (raw spectrum), first
      difference and second-difference methods were compared. For channel-to-channel
      gain variations greater than 0.1% and up to 0.8%, the first-difference method
      results in the lowest uncertainty of P measurements. In the absence of gain
      variations, direct fitting provides the greatest sensitivity (least uncertainty),
      whereas at larger gain variations it may be necessary to use the second
      difference method. The optimum energy shift for collecting a first-difference
      spectrum, approximately 15 eV, did not show any great variation between 5 and 25
      eV, and is, in general, specimen dependent. Quantitation with EELS showed
      excellent correlation with simultaneous electron probe X-ray microanalysis, but,
      for the detection of P in a 0.25 lambda thick specimen, EELS was approximately
      five to six times more sensitive than X-ray. The minimal detectable P
      concentration, with 0.5 nA beam current for 100 s in a 0.25 lambda thick
      specimen, was 8.4 mmol/kg (0.01 at%) at the 99% confidence level, equivalent to
      34 phosphorus atoms for a 15 nm probe. This value is close to the theoretical
      prediction of 7.5 mmol/kg, and can be improved only by further reducing the gain
      variation and directly fitting the non-difference spectrum. Appropriate reduction
      of the gain variations to less than 0.1% would result in a further, approximately
      two-fold, improvement in the parallel EELS detection system.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1641913
TI  - 3D reconstruction from the Fourier transform of a single superlattice image of an
      oblique section.
AB  - An image of a thin oblique section through a 3D crystal exhibits superlattice
      periods much larger than the unit cell dimensions of the crystal. Within a
      superlattice period the contents of the unit cell of the 3D crystal are sampled
      at different levels, so that a 2D image of the section contains 3D information
      about the crystal. The 2D Fourier transform of an electron micrograph of such an
      oblique section thus exhibits superlattice spots, which provide an estimate of
      the 3D transform of the original crystal. The strengths of the observed spots are
      reduced from their true values by convolution with a weighting function that
      depends on section thickness. A method is described that uses phase relationships
      among symmetry-related structure factors to determine the section thickness and
      hence the weighting function. Wiener filter deconvolution of the section
      thickness is performed, in which the filter level is set by the ratio of
      diffraction spot intensity to background intensity. From the deconvoluted set of
      structure factors a 3D map of the unit cell can be computed by a standard
      crystallographic Fourier program. The approach is illustrated with images of
      oblique sections through rigor insect flight muscle.

PMID- 1641914
TI  - Fibrocartilaginous emboli.
AB  - Fibrocartilaginous embolism (FCE) is an acute ischemic myelopathy, primarily of
      large or giant breed dogs, which results from occlusion of blood vessels within
      the spinal cord parenchyma or the adjacent leptomeninges by masses of
      fibrocartilage. Lateralizing and asymmetric neurologic deficits are very
      suggestive of spinal cord infarction. The diagnosis of FCE is made by eliminating
      causes of acute compressive myelopathy such as trauma and intervertebral disc
      herniation. Patients with lower motor neuron deficits secondary to FCE have a
      more guarded prognosis than those with upper motor neuron deficits. In most
      instances, if recovery is to occur, improvement will be evident within the first
      10 days after the onset of clinical signs.

PMID- 1641916
TI  - Diseases of the spine.

PMID- 1641915
TI  - Discospondylitis.
AB  - The etiopathogenesis and diagnosis of discospondylitis are reviewed. Various
      therapy options are described. Also included is a discussion of the appropriate
      usage of specific antimicrobial agents.

PMID- 1641917
TI  - Approach to the patient with spinal disease.
AB  - The approach to the patient suspected of having spinal disease should be
      methodical to assure an accurate diagnosis that is cost-effective with minimal
      risk to the patient. Using a problem-oriented approach will facilitate attaining
      this goal. A neurologic examination should enable the veterinarian to localize to
      one of four spinal cord segments or the cauda equina.

PMID- 1641918
TI  - Cerebrospinal fluid analysis.
AB  - Accurate interpretation of cerebrospinal fluid (CSF) changes can only be made in
      the context of the differential diagnosis for each case. The routine analysis of
      CSF cell number and type as well as CSF total protein can provide information
      that suggests a specific mechanism or disease, but is often inconclusive. Further
      information obtained from CSF protein electrophoresis and immunoglobulin
      determination and calculation of an albumin quota and IgG index can lend
      additional support for the suspected mechanism of disease. Paired serum and CSF
      antibody titers for specific organisms can be useful to confirm the presence of a
      systemic or nervous system infection. Current research on detecting antibodies
      against nervous tissue components in CSF should result in better diagnostic
      capabilities and understanding of the pathophysiology of certain disorders in the
      future.

PMID- 1641919
TI  - Radiography, myelography, computed tomography, and magnetic resonance imaging of
      the spine.
AB  - Various methods of documenting pathologic change in the spine and spinal cord are
      available to the veterinary practitioner. Intimidation caused by the imaging
      modality and the fear that one will not be able to recognize or diagnose a lesion
      are the factors that limit the use of diagnostic imaging. One needs only to be
      able to recognize the variations of normal anatomy to be successful. Once an
      abnormal area has been identified, the diagnosis is soon to follow. Therefore one
      should concentrate on improving the simple skills associated with image
      interpretation and normal anatomy. Lesion identification and definitive diagnoses
      will follow by natural progression.

PMID- 1641920
TI  - Electrodiagnostic examination. Somatosensory evoked potentials and
      electromyography.
AB  - The anatomic/physiologic basis and uses of somatosensory evoked potential
      recordings are presented. A brief summary of the use of electromyography in
      spinal cord diseases is included.

PMID- 1641921
TI  - Spinal trauma. Pathophysiology and management of traumatic spinal injuries.
AB  - Spinal trauma can originate from internal or external sources. Injuries to the
      spinal cord can be classified as either concussive or compressive and concussive.
      The pathophysiologic events surrounding spinal cord injury include the primary
      injury (compression, concussion) and numerous secondary injury mechanisms
      (vascular, biochemical, electrolyte), which are mediated by excessive oxygen free
      radicles, neurotransmitter and electrolyte alterations in cell membrane
      permeability, excitotoxic amino acids, and various other biochemical factors that
      collectively result in reduced SCBF, ischemia, and eventual necrosis of the gray
      and white matter. Management of acute spinal cord injuries includes the use of a
      high-dose corticosteroid regimen within the initial 8 hours after trauma. Sodium
      prednisolone and methylprednisolone, at recommended doses, act as oxygen radical
      scavengers and are anti-inflammatory. Additional considerations are the stability
      of the vertebral column, other conditions associated with trauma (i.e.,
      pneumothorax), and the presence or absence of spinal cord compression, which may
      warrant surgical therapy. Vertebral fractures or luxations can occur in any area
      of the spine but most commonly occur at the junction of mobile and immobile
      segments. Dorsal and dorsolateral surgical approaches are applicable to the
      lumbosacral and thoracolumbar spine and dorsal and ventral approaches to the
      cervical spine. Indications for surgical intervention include spinal cord
      compression and vertebral instability. Instability can be determined from the
      type of fracture, how many of the three compartments of the vertebrae are
      disrupted, and on occasion, by carefully positioned stress studies of
      fluoroscopy. Decompression (dorsal laminectomy, hemilaminectomy, or ventral
      cervical slot) is employed when compression of the spinal cord exists. The
      hemilaminectomy (unilateral or bilateral) causes less instability than dorsal
      laminectomy and therefore should be used when practical. The preferred approach
      for atlantoaxial subluxation is ventral, and the cross pinning, vertebral fusion
      technique is used for stabilization. Fracture luxations of C-2 are repaired with
      small plates on the ventral vertebral body. The thoracic and upper lumbar spine
      is stabilized with dorsal fixation techniques or combined dorsal spinal
      plate/vertebral body plate fixation. Several methods of fixation can be used with
      lower lumbar or lumbosacral fractures, including the modified segmental technique
      and the combined dorsal spinal plate/Kirschner-Ehmer technique.

PMID- 1641922
TI  - Intervertebral disc disease.
AB  - This article describes the functional anatomy of intervertebral discs and their
      relationship to the vertebrae and spinal cord. The pathologic events and clinical
      complications of intervertebral disc disease are described. A discussion of
      proper staging of disc disease and appropriate conservative management of
      degenerative disc disease is included.

PMID- 1641923
TI  - Surgical treatments for intervertebral disc disease.
AB  - Surgical treatments for intervertebral disc disease are useful for animals with
      gradually progressive, severely acute, or recurrent lesions. Surgical patients
      require a diligent neuroradiographic evaluation to confirm location and severity
      of the discopathy and rule out conditions unrelated to disc disease. Although
      controversial, some surgeons advocate fenestration for recurrent pain or mild
      ataxia associated with a noncompressive lesion. Decompressive procedures are
      recommended for treatment and prognostication of compressive disc-associated
      myelopathy. Foraminotomy is reserved for patients with lateralizing extrusions
      confirmed with myelography or newer imaging modalities (CT, MRI). Future
      treatments for animals may include chemonucleolysis or various discectomy
      procedures currently performed in humans with symptomatic disc disease.

PMID- 1641924
TI  - Decompressive procedures. Indications and techniques.
AB  - Hemilaminectomy and dorsal laminectomy are the surgical techniques most suited
      for decompression of the thoracic, thoracolumbar, lumbar, and lumbosacral spine.
      Hemilaminectomy is preferred for decompressing the spinal cord before applying
      fixation devices for fractures/luxations. Dorsal laminectomy is the method of
      choice for exploration of the spinal canal and for decompression of the
      lumbosacral region. Either method is applicable to removal of herniated
      intervertebral disc material and fenestration of other disc spaces.

PMID- 1641925
TI  - Cervical vertebral malformation/malarticulation syndrome in large dogs.
AB  - To anticipate improvement of a chronically affected animal may be expecting too
      much because reserve or functional spinal cord tissue may be minimal. An accurate
      prognosis is sometimes impossible to formulate because the extent of spinal cord
      damage is not known. Treatment may result only in halting progression of the
      disease, and even with total relief of spinal cord compression, recovery may be
      minimal. Animals with minimal neurologic deficits treated early in the course of
      the disease with adequate decompression and stabilization are more likely to
      return to function. The goals of treatment for cervical spinal cord compression
      are decompression and stabilization of the affected area. Adequate stabilization
      may result in atrophy of the soft tissues and further decompression once
      stabilization is achieved (see Fig. 3). If stabilization is not provided,
      adequate decompression of the spinal cord and the nerve roots is essential.

PMID- 1641926
TI  - Lumbosacral disease.
AB  - Careful clinical and neurologic evaluations are the foundation on which a
      diagnosis of lumbosacral disease is based. Appropriate use of ancillary
      diagnostic aids will confirm the diagnosis and allow appropriate treatment to be
      instituted.

PMID- 1641927
TI  - Myelitis and meningitis.
AB  - Animals with meningomyelitis have clinical neurologic signs that typically range
      from paraspinal discomfort to tetraplegia; however, most affected animals also
      show evidence of multifocal CNS involvement with brain stem and cerebral cortical
      structures being affected most commonly. The cause, duration, and host response
      to the disease process will determine the clinical signs in individual animals.
      Confirmation of a specific causative agent is difficult, but CSF analysis and
      immunotesting of serum and CSF yield the most rewarding diagnostic results.
      Successful treatment is based on formulation of an appropriate and aggressive
      therapeutic regimen. In some diseases, no effective treatment is available, and
      some animals may develop permanent neurologic disabilities.

PMID- 1641928
TI  - Degenerative myelopathy.
AB  - DM in the German Shepherd is an immune-related disorder whose clinical signs are
      explained by a widespread degeneration of the white matter pathways in the
      thoracolumbar spinal cord. Therapy includes exercise, vitamin supplementation,
      and EACA medication. Avoiding unnecessary surgical procedures is also important
      to preclude permanent deterioration that can result following surgery in DM
      patients. In dogs other than German Shepherds, other identifiable causes should
      be treated. Additional confirmation of the diagnosis of DM may be assisted by
      performing cell-mediated immune studies or other serodiagnostic tests as they
      become available.

PMID- 1641929
TI  - Neoplasms of the spine.
AB  - Although the treatment of central nervous system neoplasms generally is
      unrewarding, some animals with spinal neoplasia may, for a variety of reasons, be
      successfully managed for extended periods of time. The veterinary profession has
      greater experience with spinal surgery than with intracranial surgery. As a
      result, surgeons are more willing to attempt and more successful at removing or
      debulking spinal neoplasms. Additionally, there are more affordable and
      accessible diagnostic procedures available to evaluate the spinal cord than there
      are to evaluate the brain. Finally, the majority of tumors that affect the spinal
      cord are extramedullary and are therefore amenable to attempts to remove them
      surgically.

PMID- 1641930
TI  - Congenital spinal malformations.
AB  - When presented with an animal that has a congenital spinal malformation, the
      veterinarian needs to consider the clinical significance of the malformation, the
      possible presence of other anomalies--spinal and nonspinal, the heritability of
      the malformation, and potentially innovative treatment options. This article
      includes explanations of the conditions and information regarding diagnosis and
      treatment of hemivertebrae and block vertebrae, malformations at the cranial
      vertebral junction, osteocartilaginous exostoses, spinal bifida, and spinal
      stenosis.

PMID- 1641931
TI  - [Morphologic and cytochemical study of Sertoli cell nuclei in ruminants].
AB  - Nuclei and nucleoli were examined at an ultrastructural level in the testicular
      tissue of bulls and rams. In the two species there occurs a morphologically
      interesting so called multivesicular nuclear body; the interpretation of its
      function is not quite clear. The tissue was processed by a routine electron
      microscope technique and than a cytochemical demonstration of several types of
      proteins was used. Acidic argyrophilic proteins were demonstrated by a silver
      staining technique, basic lysine-rich proteins by means of ethanolic PTA, and
      ribonucleoproteins (RNP) by the method of Bernhard's regressive preferential
      staining. Multivesicular nuclear bodies in bull Sertoli's cells are composed of a
      greater number of membrane bound vesicles with granules on the outer surface
      (Fig. 1). The results of cytochemistry reactions show that the granules contain
      acidic argyrophilic proteins (Fig. 3) and RNP (Fig. 7). The intervesicular
      material is an analogy of the dense fibrillar component of normal nucleoli of
      somatic cells. This component contains the three types of investigated proteins
      (Figs. 2, 3, 5, 7). In the nuclear bodies of ram Sertoli's cells the number of
      vesicles is much lower, the fibrillar component is prevailing, in form of
      clusters and striae of filamentous material around the vesicles. The
      cytochemistry reactions proved that this material contains acidic argyrophilic
      proteins (Fig. 4) and basic PTA positive (Fig. 6) proteins. The presence of
      acidic and basic regulatory proteins in the fibrillar component of multivesicular
      nuclear bodies indicates the active synthesis of RNA occurring in this material.
      It is therefore possible to consider this special type of nuclear bodies as a
      full equivalent of nucleoli of somatic cells as to the function.

PMID- 1641932
TI  - [Effect of monensin (USA, Czechoslovakia, Bulgaria) on fermentation of animal
      feed in an artificial rumen (Rusitec)].
AB  - An experiment was made with the Rumen Simulation Technique (Rusitec) in which the
      fermentation of a mixed ration of hay (12.8 g/d) and bruised barley (3.2 g/d) was
      compared with the fermentation of the same diet in the presence of 5 mg
      monensin/d from the USA, CSFR and Bulgaria. The fermentation of the mixed ration
      was significantly affected by all three kinds of monensin. The digestibility of
      dry matter (DM) in the rations declined in the presence of monensin from 48% to
      40% (tab. I). The digestibility of detergent fibre, cellulose and hemicellulose
      also declined in the presence of monensin (tab. I). The production of methane
      decreased (-70%) and CO2 production dropped too, but this decrease could be
      accounted for by the changes in the production of volatile fatty acids and
      redistribution of metabolic hydrogen (tab. I). Monensin decreased the production
      of total volatile fatty acids (-21%), the production of acetic (-35%), n-butyric,
      n-valeric and isovaleric acids (tab. II) and increased the production of
      propionic acid (+60%). The production, utilization and recovery of metabolic
      hydrogen were significantly increased in the presence of all three kinds of
      monensin (tab. IV). The end products of fermentation were affected by an addition
      of monensin to the mixed ration. All three kinds of monensin increased energic
      efficiency of volatile fatty acids, decreased adenosinetriphosphate (ATP)
      production, the amounts of fermented hexose, organic matter fermented and
      utilization of glucose (tab. III).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641933
TI  - [Tests of Milkofix, a new preservative preparation for milk samples used for
      infrared analysis of milk components. I. Verification of its bacteriostatic and
      bacteriocidal effects and its interference effects].
AB  - Hygienic, ecological and health problems of sample preservation for an analysis
      of basic milk components make us continually to develop a safer chemical
      preservative substance which will preserve the original sample composition for
      the time required and which will not influence the analyses. Trzicky (1990)
      proposed Milkofix (M), a preservative substance on the basis of silver compound.
      The author reports on minimum risks of the use of this preparation, in comparison
      with traditional preservatives. Preservative efficiency of Milkofix was compared
      with other preservatives: K2Cr2O7 (C), NaN3 (A) and bronopol (B). The following
      concentrations were used: A--0.0085 g NaN3 and 0.0630 g NaCl, B--0.0050 g
      bronopol and 0.0500 g NaCl, C--0.0330 g K2Cr2O7 and 0.0670 g KCl in tablet, M-
      0.1250 g of the mixture, all amounts are per 25 ml milk. The observed
      antibacterial efficiency of M could be seen in a slower decrease in actual
      acidity, and/or in an increase in titratable acidity in M-treated samples unlike
      untreated ones (N). From the starting value pH 6.3 (Fig. 1), the value of N
      treatment dropped to 3.8 after two days, the values of M and A treatments dropped
      to 4.9 after nine days and to 5.7 after twelve days, respectively. As for SH, the
      values increased within the same interval from 6.5 (2.5 mmol/l) to 28.6 in N, and
      to 22.3 in M and 9.4 in A (Fig. 3). There was a similar trend when the milk
      samples were stored at a temperature of 4 degrees C, but the differences between
      the preservation methods were not so clear in comparison with storage at a
      temperature of 20 degrees C (Figs. 1 and 3). The standardized SH value of 9.0
      (2.5 mmol) for infraanalyzer measurements was exceeded after 24 hours in N
      samples, after four days in M samples and after 12 days in A samples at a
      temperature of 20 degrees C. The observation of the growth of microorganism
      counts (CPM) showed that this growth was slower in M than in N, but faster in the
      samples of C treatment (Fig. 5). The generative time of CPM in N made 1.6 hours,
      in M 2.4 hours and in C 7.9 hours. The lag phase of these mixed cultures was 24
      hours in M, 60 hours in C and in N treatment the lag phase was zero.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1641934
TI  - [Testing Milkofix, a new preservative preparation for milk samples used for
      infrared analysis of milk components. II. Verification of its preservative
      effects in relation to infrared analysis].
AB  - For the purposes of the infrared analysis of the basic milk composition,
      Milkofix, an ecologically friendly preparation used for milk sample preservation
      (Trzicky, 1990), was compared with untreated samples (N) and with samples
      preserved with sodium azide (A), bronopol (B) and potassium dichromate (C) at a
      storage temperature of 20 degrees C (I) and 4 degrees C (II) in samples kept for
      14 and 18 days. Pursuant to the recommendations cited in literature, the
      preservatives had these concentrations: A = 0.0085 g NaN3 and 0.0630 g NaCl; B =
      0.0050 g bronopol and 0.0500 g NaCl; C = 0.0330 g K2Cr2O7 and 0.0670 g KCl; M =
      0.1250 g, all amounts are per 25 ml milk. Three bulk milk samples were used which
      were analyzed on an automatic Milko-Scan 133 B infraanalyzer (Foss Electric,
      Denmark) every day. On the basis of a graphical evaluation of the results by IDF
      recommendations (1985) the times within which the applicable results could be
      obtained were determined for the various methods of milk sample treatment (Figs.
      1 to 6): N I--0 days; A I--9; B I--10; C I--13; M I--4; N II--10; A II--5; B II-
      11; C II--15; M II--10 (Tab. I). The results recorded for Milkofix are in
      agreement with the conclusions drawn in the previous study, where the intervals
      of four and nine days were determined. The days to milk sample coagulation were
      as follows: N I--1 day, M I--10 days. The coagulation in A I, B I, C I and N II
      samples was not observed even after 13-day storage and in A II, B II, C II and M
      II samples not even after 17 days of storage. The results for particular
      components (fat, proteins, lactose) of milk samples differently treated in time
      are presented in Tabs. II, III and IV. A system of evaluating criteria (Tab. V)
      was used to determine the order beginning from the most convenient method of milk
      sample treatment for the given purpose: 1. C II, 2. C I, 3. B II and A I, 4. B I,
      5. M II, 6. N II, 7. A II, 8. M I and 9. N I.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1641935
TI  - [Ultrastructure of boar sperm membranes prepared by freeze-fracturing].
AB  - The objective of the present paper was to describe the topographic orientation of
      intramembraneous particles (IMP) in the membranes of freshly ejaculated boar
      spermatozoa applying the method of freeze fracturing. Disc clusters of IMP's
      could be distinguished in the acrosome-covering plasma membrane (PF). The border
      of the head to a distance of about 0.3 micron seemed to contain no IMP's (Figs.
      1, 2). In the postacrosomal region in an anterior direction from the posterior
      ring the IMP's were found to be arranged in palissade slant rows. Statistical
      measurements of 20 spermatozoa (Tab. I) indicated that the slant rows extended to
      the greatest distance in the lateral part of the head, up to 0.67 micron (+/-
      1.45-0.39) from the posterior ring. In the middle of the head the rows extended
      to a distance of 0.18 micron (+/- 0.10-0.42). The transition spot between the
      zone of sparse IMP's and the zone of densely arranged IMP's was at a distance of
      1.63 microns (+/- 1.87-0.69) in an anterior direction from the posterior ring
      (Figs. 3, 4). In the flagellum in the plasma membrane (PF) the first spot of an
      ample occurrence of IMP's is located in the first mitochondrion in the spiral.
      The IMP clusters follow the cicumferential orientation of mitochondria in the
      mitochondrial spiral. The IMP's were missing in the spaces between the spiral
      coils (Fig. 5). The membranes of the mitochondria contain a large amount of
      IMP's. This activity is transferred to the clinging part of the plasma membrane
      (Fig. 6). A larger accumulation of IMP's can be seen at the spot where the plasma
      membrane covers the annulus (Fig. 7). In the plasma membrane of the main segment
      of the flagellum the IMP's are distributed irregularly in PF, and also in EF
      (Fig. 8). The EF surfaces of the plasma membrane had in general an indistinct
      structural organisation of IMP's. The distribution of IMP's in acrosomal
      membranes was found to be irregular. The postacrosomal lamina in the freeze
      fracturing did not look like a morphologically identifiable structure. In the
      nuclear envelope delimiting the posterior nuclear space, nuclear pores could be
      identified (Fig. 9). No nuclear pores could be seen in the nuclear envelope
      clinging to the posterior part of the nucleus. At this spot smaller IMP's were
      observed which could be a part of the proteins of the filaments connecting the
      concave surface of the head with the convex articular surface of the flagellum.
      These filaments connect the head and the flagellum (Fig. 10).(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1641936
TI  - [Diagnosis of sarcocystosis in sheep using the indirect fluorescence test and
      ELISA].
AB  - The indirect fluorescent antibody test (IFAT) was compared with the enzyme-linked
      immunosorbent assay (ELISA) for the detection of specific antibodies to
      Sarcocystis sp. A set of 275 ovine blood samples was examined by both reactions.
      Cystozoites of Sarcocystis gigantea were used as the corpuscular antigen for the
      IFAT. For the diagnostics of sarcocystosis by the ELISA technique used the
      sandwich test of the antibody titration with a soluble antigen which was also
      prepared from S. gigantea macrocysts. Our studies confirmed that this antigen did
      not cross-react with Toxoplasma gondii. Titre 40 was determined as the limit one
      for the IFAT and titre 80 for the ELISA; which was confirmed by the direct
      detection of cysts in the muscles (Svobodova, 1989). The results of both methods
      are shown in Table I. 76.7% of the blood samples reacted positively in the IFAT
      and 83.6% in the ELISA. These methods were found to be suitable and can be
      utilized for the intravital routine diagnostics.

PMID- 1641937
TI  - [Metabolic indicators in large-scale breeding of goats during various seasons].
AB  - Thirty-five biochemical parameters were investigated in 144 clinically healthy
      goats throughout the seasons of the year from March 1984 to April 1986. The
      average values and standard deviations of the investigated parameters of
      metabolic profile which are presented in this paper were obtained from
      examinations performed throughout the whole period of investigation. The average
      values of biochemical parameters are presented in Tabs. I and II. Our study of
      the values of the given parameters in the large-scale breeding of goats
      throughout the seasons of the year did not show a clear seasonal dependence of
      any of the investigated parameters with the exception of vitamin A and beta
      carotene contents. The average values and standard deviations of vitamin A and
      beta-carotene contents recorded throughout the year seasons are shown in Tab.
      III. Based on the average, and also individual values, it can be seen that the
      lowest levels of vitamin A were recorded at the beginning of the spring season
      (before the goats began to graze). In the winter seasons of 1984 and 1985 there
      were only traces of beta-carotene in the blood serum. A relatively great variance
      of the values mentioned by different authors demonstrates their great
      variability, which is influenced particularly by different environmental
      conditions, various methods of investigation, different nutrition and
      exploitation of the animals.

PMID- 1641938
TI  - [The effect of estrogens on phagocytic activity of blood leukocytes in heifers
      and cows].
AB  - Phagocytic activity of peripheral leucocytes (PA) was measured in heifers during
      the luteal phase and oestrus and after administration of various doses of
      oestradiol, in ovariectomized heifers and cows in the early post-partum period.
      PA was demonstrated in 22.63 +/- 2.49% and 50.61 +/- 3.76% of phagocytes in the
      luteal phase and oestrus respectively (P less than 0.01, Fig. 1). The phagocytic
      index (PI) rose parallelly from 2.26 +/- 0.31 to 6.55 +/- 0.64 particles per cell
      (Fig. 2). Intramuscular administration of a single dose 3 mg of oestradiol
      dipropionate resulted in an increase of PA from 28.93 +/- 3.34 to 69.60 +/- 3.32
      on post-treatment day 3 (P less than 0.05, Fig. 3). A nonsignificant increase of
      PA was observed in heifers treated with 10 mg oestradiol. Increases of PA and PI
      in postparturient cows, treated with various doses of oestradiol, were
      nonsignificant (Fig. 5, 6) owing to a wide variance of the values obtained, which
      might be due to individual differences in endocrine and metabolic status or to
      uterine bacterial contamination. The most marked of haematological changes was
      the increase of eosinophil counts from 317 to 525.10(6).l-1 in a group of cows
      treated with 10 mg oestradiol and a decrease of the lymphocyte: neutrophil ratio
      (Tab. I). Both endogenous and exogenous oestrogens stimulate PA of peripheral
      leucocytes and 3 mg of oestradiol is a sufficient dose to obtain the effect.

PMID- 1641939
TI  - [Development of rumen fermentation in calves during milk feeding].
AB  - The concentration of total volatile fatty acids (VFA) in the rumen fluid were
      increasing with the age of the animals (Fig. 1). A significant increase in the
      concentrations of total VFA (P less than 0.01) from 70.93 to 90.71 mmol/l was
      observed in the age period of 5-7 weeks and a highly significant increase (P less
      than 0.001) in the age period of 9-11 age. At the average age of seven weeks the
      lower boundary of the reference value range (80-120 mmol) of the total VFA
      concentrations in the rumen fluid as mentioned for adult animals was exceeded in
      the experimental calves. As to this parameter in individual calves, the level of
      the total VFA concentrations in the rumen fluid of adult animals was not reached
      in 50% of calves at the age of three weeks, in 80% of calves at the age of five
      weeks, in 20% of calves at the age of seven weeks and in 10% calves at the age of
      nine weeks. At the age of 11 weeks the concentrations of total VFA reached the
      level of adult animals in all experimental animals (Fig. 2). The molar proportion
      of acetate (Fig 3) decreased from 74.04 mol% at the age of three weeks to 67.54
      mol% at the age of 11 weeks, and the propionate proportion increased from 16.73
      to 19.53 mol% within the same interval.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641940
TI  - [Levels of insulin and glucose in calves during the first 6 months of life].
AB  - Twenty-four calves of the Holstein-Friesian breed were included into a trial. The
      trial was performed from April (when the calves were born) to October. The
      objective of the study was to investigate variations in insulin and glucose
      levels over a longer time period of the postnatal development of calves. The
      blood was sampled by the jugular vein puncture at the age of 1, 2, 3, 5, 14, 21,
      28, 35, 49, 63, 91, 118, 147 and 175 days. The calves were housed in a
      prophylactorium calf-house till the age of 21 days: till the age of 14 days they
      were housed individually and then in groups of 2-3 calves in a small pen. The
      calves were fed milk till the age of 26 or 28 days, after a fortnight the feed
      intake was increased from the previous 3 litres to 5-6 litres per head/day. At
      the age of 21 days the calves were transferred to pens in the calving room. At
      the age of 26 days twelve calves were transferred to a barn for young cattle
      rearing, the remaining twelve calves were transferred at the age of 28 days; here
      they were housed by 10-12 head per pen and they were fed a commercial milk
      replacer diluted at a 1:10 ratio, the feed intake being 6-8 litres a day, and a
      commercial pelleted calf starter TKS at the amount of 1.0-1.1 kg.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641941
TI  - [Comparison of the effectiveness of Milkofix, a preservative preparation, with
      traditional preservative agents in the determination of somatic cell count in
      milk samples using a fluoro-optic-electronic method].
AB  - Milkofix (M), a health friendly preservative substance, to be used for milk
      sample preservation (Trzicky, 1990), was compared with other preservatives.
      Untreated milk samples (N) were tested against samples treated with sodium azide
      (A; 0.0085 g NaN3 and 0.0630 g NaCl), bronopol (B; 0.0100 g bronopol and 0.090 g
      NaCl), potassium dichromate (C; 0.0330 g K2Cr2O7 and 0.0670 g KCl) and Milkofix
      (M; 0.1250 g). The doses of the preservatives A, B, C and M are per 25 ml milk.
      The somatic cell counts (SB) were determined on a FOSSOMATIC 90 apparatus (FOSS
      ELECTRIC, DENMARK). In the treated milk samples taken from individual cows the
      values of SB counts were significantly higher than in N samples if determined
      within eight hours after sampling (Tab. I): in A higher by 18.6%, B by 26.3%, C
      by 26.4% and M by 24.3% (P less than 0.05). The significantly higher values of SB
      counts were recorded in bulk milk samples treated with preservatives in
      comparison with N samples immediately after sampling: in A by 6.0%, in B, C and M
      by 12.9% (P less than 0.01; Tab. II). After one-day storage of N samples at a
      temperature of 4 degrees C these differences are insignificant (P greater than
      0.05), thus the results of N, A, B, C and M samples obtained after one-day
      storage at 4 degrees C can be taken as actual and mutually comparable.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641942
TI  - [The ovarian response and fertility in cows with acidosis induced by acetic
      acid].
AB  - The effects of acetic acid administered at an amount of 300 to 600 g (5 to 10
      mol) to the rumen of breeding cows, were investigated on ovulation, conception
      and progesterone levels in the blood and milk of cows with cloprostenol-induced
      (Oestrophan Spofa) oestrus at a dose of 500 micrograms i.m. In the group of 15
      cows exposed to the acetic acid load five cows got in calf after the first
      insemination (33.3%), and 12 cows (80.0%) after all inseminations in 37.6 days
      after cloprostenol administration, with the insemination index 1.67 (Tab. I). In
      the control group (five cows) four cows (80.0%) got in calf after the first
      insemination, in total all five breeding cows got in calf in 20.6 days after
      cloprostenol administration, with the insemination index 1.2. In the experimental
      group of 15 cows a clinical examination of ovaries on day 7 after insemination
      revealed ovulation disorders in eight cows, that means in 53.3% of the animals
      (Tab. II). No ovulation disorders were observed in the control group of five
      cows. Progesterone levels in the blood showed high variability (Tab. III). In the
      group of cows administered acetic acid they were by more than a half lower (1.49;
      0.67; 1.53 per ml) on days 7, 14 and 21 after insemination in comparison with the
      control group (3.35; 2.5; 3.38 ng per ml). The average progesterone levels in
      milk (Tab. IV) were 1.27 and 1.53 on day 7, 6.74 and 7.27 on day 14 and 3.52 and
      11.85 ng per ml on day 21, respectively, the higher values apply to the control.
      It was not possible to evaluate reliably from the progesterone levels in the
      blood and milk if ovulation took place and if the corpus luteum was developing
      (Tab. V and VI). The clinical control of ovaries on days 7 and 8 after oestrus
      and insemination was more reliable to determine the ovulation disorders than the
      progesterone determination in the blood and milk of cows.

PMID- 1641943
TI  - [Characteristics of the cumulus-oocyte complex during the preovulatory period in
      superovulated heifers].
AB  - The nature of cumulus--oocyte complexes was examined in PMSG (group 1, n = 18)
      and FSH (group 2, n = 30) stimulated heifers. Laparoscopy was performed 65 h
      after cloprostenol application. The number of follicles was 13.67 +/- 0.75 and
      12.67 +/- 0.81 (P greater than 0.05) in group 1 and 2, respectively (Tab. I). The
      recovery rate of oocytes was 56% in the first and 67% in the second group (Tab.
      I). The cumulus oophorus was divided into three groups: compact, expanded and
      partial (Tab. II). Most oocytes (65 and 75% in the first and second group,
      respectively) exhibited an expanded cumulus (P greater than 0.05). In the first
      and second group 11 and 26% (P less than 0.01) of oocytes with the extruded first
      polar body were aspirated (Tab. III). As judged from the pool of visible
      follicles, the superovulation response to stimulatory treatment and recovery rate
      of oocytes in the present experiment were not different from the results
      published earlier. The degree of the cumulus oophorus expansion is an indicator
      for the evaluation of cumulus--oocyte complexes. After the preovulatory LH peak
      the disintegration of cumulus oophorus proceeds from glycosaminoglycan
      accumulation. In our experiment this effect resulted in a significantly higher
      number of oocytes with expanded cumulus in both treatments. The enlargement of
      perivitelline space is related to a subsequent release of the first polar body in
      the preovulatory period. It can be seen from our results that after FSH treatment
      it is possible to reach the high number of oocytes with the extruded polar
      body.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641944
TI  - [The effect of aging of milk samples on the accuracy of infrared analysis of milk
      composition].
AB  - The effect of a decrease (and/or fermentation) in the lactose content during milk
      storage under different conditions was investigated on the accuracy of the
      results obtained on a Milko-Scan apparatus to contribute to the present knowledge
      of this problem. The results were in agreement with some results cited in the
      literature. These wavelengths are used for infrared spectrophotometry on the
      above apparatus: for fat 3.48 microns, for proteins 6.46 microns and for lactose
      9.60 microns. Bulk milk samples used for the tests were untreated or treated with
      potassium dichromate, bronopol, sodium azide and Milkofix at the temperatures of
      storage in darkness 20 degrees C and 4 degrees C. The differences against the
      reference values (measured on the first day) were determined and evaluated in
      milk composition and characteristics as arising during milk storage. These
      differences were used in form of either cumulative means of differences (Figs. 1
      to 5) or individual differences (Fig. 8). In the first part significant
      correlation coefficients (P less than 0.001) were calculated for the relationship
      between the variations of lactose content and the fat and protein contents: r = 
      0.59 and/or -0.73 (Figs. 6 and 7). This suggests that the decrease in the lactose
      content by 0.10% recorded by the infrared analysis and caused by lactose
      decomposition is accompanied by a "seeming" increase in the fat and protein
      content by about 0.04%. In the second part the correlation coefficients for the
      fat and protein contents r = -0.96 and -0.96 (P less than 0.001; Figs. 9 and 10;
      Tab. II) were calculated on the basis of an observation of the lactose decrease
      in an untreated milk sample (20 degrees C for 28 hours). These coefficients are
      somewhat different from the preceding ones; this is due to the lower homogeneity
      of the first set where the milk samples were treated in a different way, but the
      coefficients confirm the same conclusions. The values of the correlation
      coefficients for the dependence between the development of the acquired
      titratable acidity (SH) and the variations of fat (F), protein (P) and lactose
      (L) contents were as follows: r = 0.95; 0.95; -0.99 (P less than 0.001; Figs. 12,
      13; Tab. II). Thus the above-mentioned "seeming" increase in the F and P contents
      can be explained to the extent of 92.2% from the decrease in the L content, which
      also causes the increase in titratable acidity to the extent of 98.0%.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1641945
TI  - [The effect of Bentazone, a Czechoslovak developmental herbicide, on health
      status indicators in sheep during subchronic poisoning].
AB  - A three-month feeding trial was conducted with sheep of the Slovak Merino breed
      (13-14 months of age, males and females) as a part of the obligatory
      toxicological tests of the Czechoslovak developmental herbicide bentazone
      (Research Institute for Chemical Technology, Bratislava). Partial results are
      shown describing the action of this herbicide on the overall health of sheep with
      respect to weight gains, trias values and intrauterine foetus development. The
      sheep of the first experimental group were fed bentazone as an additive to
      molasses feed M at a daily rate of 195 mg/kg lwt. (1/10 from LD50), and the sheep
      of the second group were fed a rate of 97.5 mg/kg lwt. (1/20 from LD50). No
      symptoms of the toxic effects of bentazone were observed in the course of the
      experiment. There were no differences between the experimental and test animals
      in the dynamics of pulse value changes (Fig. 1), breathing value changes (Fig. 2)
      and body temperature value changes (Fig. 3) from the beginning till the end of
      the trial. A slight increase in the pulse and breathing values above the upper
      reference value observed in the experimental groups in the last two to three
      weeks of the trial cannot be associated with the bentazone action. This increase
      reflects the physiological condition of the animals in the given conditions
      because the identical changes were also found in the control group. We assume
      that the changes were evoked by the elevated temperature of the external
      environment due to the fact that the sheep were not sheared.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1641946
TI  - [Surveillance of Francisella tularensis infection in dogs in Bratislava].
AB  - Out of 548 serologically investigated dogs from Bratislava and other regions of
      Slovakia and Moravia, antibodies to F. tularensis were found in 16.4% (Tabs. I,
      II). In all the investigated groups of dogs from the region of Bratislava the
      highest seroprevalence by F. tularensis was recorded in watch dogs kept on farms
      and in cooperatives--37.5% and in rambling dogs--20.7% (Tab. I). The highest
      seropositivity was found in one to three year old dogs--22.2% (Tab. III). A
      similar degree of seroprevalence was also observed in one to three years old
      police dogs which came from the endemic region of tularemia--West Slovakia
      (19.3%) and East Slovakia (25.6%)--Tab. IV. These facts indicate the persistence
      of active natural foci in these regions. Serological investigations of the
      relatively great number of dogs from different regions of Slovakia showed that
      the presence of F. tularensis antibodies in this animal species, mainly in the
      watch dogs group, can be taken as a convenient marker or indicator of the
      existence of active natural foci of tularemia and as a suitable component for
      surveillance of this diseases.

PMID- 1641947
TI  - [Coxiella burnetii and Chlamydia psittaci infection in dogs].
AB  - The prevalence of Coxiella burnetii and Chlamydia psittaci antibodies was
      investigated in 530 dog specimens divided into six groups, i. e. A = private
      watch dogs, B1 = service dogs from Bratislava, B2 = service dogs from other
      localities of Slovakia and Moravia, C = watch dogs from farms, I = household
      dogs, T = stray dogs. The dogs demonstrated the higher seropositivity to C.
      burnetii (11.7%) than to Ch. psittaci (5.5%). The highest percentage of
      antibodies to C. burnetii was found in stray dogs (23.7%), less prevalence of
      antibodies was observed in the animals in group C (13.6%), almost the same
      positivity was proved in the dogs of group B1 and B2 (10.5 and 10.6%). The
      highest positivity to Ch. psittaci was demonstrated in the dogs of group A
      (8.7%), less in group B2 (6.6%) and the least number in group B1 (1.9%). The
      stray dogs occupied the intermediate position in this data (Tab. I). Ninety four
      localities were tested, from which 38 were seropositive. Neither acute
      coxiellosis nor chlamydiosis were proved in any animals examined. Ninety per cent
      of dogs were found healthy, but 10% of dogs demonstrated hepatopathia and
      gastroenteritis. Two of them (category A and I) were seropositive to C. burnetii
      (titer 1:8 to 1:16) and one to Ch. psittaci (titer 1:16). Both C. burnetii and
      Ch. psittaci attack dogs parallely with the agents of other zoonoses, of which
      the most common is Toxoplasma gondii (Tab. II). Several dogs demonstrated
      seropositivity to three up to five zoonotic agents (Tab. III).

PMID- 1641948
TI  - [Leptospirosis in dogs in Slovakia].
AB  - Out of 571 serologically investigated dogs from Bratislava and all regions of
      Slovakia and Moravia, 26.1% presented antibodies reacting with leptospiral
      antigens. The lowing seropositivity in dogs from Bratislava was found in lap dogs
      -11.1%, the highest one in farm dogs--35.3% (Tab. I). The seropositivity of
      police dogs from different regions of Slovakia and Moravia varied from 24.0% to
      47.6% (Tab. II). The age of dogs progressing, their seropositivity rose from 3.1%
      in animals younger than one year to 33.3% in those aged seven years and in older
      ones (Tab. III). The predominant serovars causing infections of dogs were L.
      grippotyphosa (58.9% of infections) and serovars of both Sejroe (21.0%) and
      Icterohaemorrhagiae groups (15.3%). The serovars bratislava/jalna, pomond/mozdok
      and tarassovi were only rarely involved in these infections, canicola and arborea
      only exceptionally (Tab. IV). At present, in the Czechoslovak conditions the dogs
      do not play a significant role as reservoirs of human leptospirosis, and the
      predominant serovars may only cause irregular and short-time lasting
      leptospiruria. This is why the reasonableness of actual vaccination of dogs,
      possibly with the exception of the vaccination against Weil's disease, is
      doubtful. Dog is a good indicator of the distribution of different leptospiral
      serovars in its environment. It seems reasonable to practice occasionally
      serological investigations of these animals in order to detect possible changes
      in infecting leptospiral serovars. Consequently, adequate epizootological
      measures could be taken (e. g. modification of the composition of a leptospiral
      vaccine for dogs).

PMID- 1641949
TI  - [The physiology of natural parturition in cows].
AB  - In the year 1990 free parturitions of 339 cows were followed on three farms;
      these parturitions were compared with the last parturitions of these cows when
      the tender's assistance was available. The spontaneous free parturitions were
      followed in the open air in litter boxes which were located outside the barns
      where the groups of about twenty highly pregnant cows and heifers were housed for
      two months before their parturitions all the year round irrespective of the
      weather conditions. In addition to direct continuous observations, a host of
      zooveterinary data filed for these groups of animals were evaluated, concerning
      particularly those animals which could not be directly followed for the time
      reasons. Through direct observations the time schedule of the given parturition
      was evaluated and recorded above all, including all changes in the behaviour of
      the cow itself, and also behavioural changes in the group of animals or the
      behaviour of particular groups of animals toward each other. Applying the same
      criteria, the behaviour of born calves toward the mother, behaviour of calves
      toward each other and their behaviour toward other breeding cows was evaluated.
      The method of disinterested observation was used, this means the principle of
      noninterference with the most actions observed, with the exception of such
      situations that could result in the calf death. Another principle was to minimize
      through these observations all negative effects that could influence the
      behaviour of individual animals and also the behaviour of the whole
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641950
TI  - [Use of the skin test in the evaluation of true levels of cellular immunity and
      levels after experimental administration of glucan and levamisole in feed-lot
      bulls].
AB  - Applicability of a skin test induced by dinitrofluorobenzene (DNFB) to
      quantification of the actual level of cellular immunity (CI) in vivo and its
      level after an experimental immunomodulation intervention were evaluated in two
      breeds (40 animals in each) of fattening bulls (10-11 months old). At the
      selected methodical procedure of intensity determination of the delayed type of
      hypersensitivity (DTH), its average value reached 4.5 +/- 1.5 mm in 80 animals,
      while in 77.5% of bulls its level ranged from 3.6 to 9.6 mm, in 18.7% from 2.0 to
      3.5 mm and in 3.8% remained less than 2.0 mm. Evident expression of the reaction
      points to the possibility of application of the used methodical procedure of the
      skin test using DNFB to quantify the level of CI response in vivo in cattle.
      Percentual representation of animals according to the intensity of skin reaction
      (Tab. I) and concentration of total serum immunoglobulins (Cs-Ig) and serum IgG
      (Tab. II) indicates the different cellular and humoral state of animals in
      investigated breeds. This is also confirmed by the recorded average values of
      mentioned parameters which were significantly lower (P less than 0.01; or 0.05)
      in animals of the first breed (4.0 +/- 1.3 mm; 28.3 +/- 4.4 U ZST, 18.4 +/- 3.5
      g.l-1) than in breed 2 (4.9 +/- 1.6 mm; 32.5 +/- 3.8 U ZST; 20.3 +/- 3.5 g.l-1).
      The animals of each breed were divided into four experimental groups with the
      approximately equal actual levels of DTH (Tab. III).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1641951
TI  - [Isolation and control of the functional quality of mRNA of bovine leukocyte
      interferon].
AB  - For the construction of the cDNA library total cellular RNA was separated from
      bovine leucocytes induced with NDV (inductor of interferons) for five hours.
      Guanidinisothiocyanate and ultracentrifugation in the gradient of CsCl were used
      for the separation of the total RNA (Chirgwin et al., 1979). Bands 18S and 28S
      were detected in the samples of RNA by electrophoresis in an MOPS buffer (Fig.
      1). mRNA was separated from the mixture of RNA via affinity chromatography on
      oligo(dT)-cellulose (Aviv and Leder, 1972). The function quality of mRNA BoIFN
      alpha was verified by microinjection into the oocytes of Xenopus laevis using a
      microinjector of our own construction (Fig. 2). The microinjector was calibrated
      by injection of a radioactive 51Cr solution (Fig. 3). It was found out on the
      basis of CPE inhibition measurements that the injected oocytes synthesized 320
      640 U/ml BoIFN-alpha (16-32 U/50 microliters; Tab. I).

PMID- 1641952
TI  - [The effect of copper and cobalt supplementation on the digestibility of fibrous
      feed in sheep].
AB  - The effects of an addition of copper, cobalt, and copper + cobalt on the in vitro
      digestibility of hay, treated beech sawdust and cellulose by the rumen fluid of
      sheep fed a complete food ration, complete food ration with 15% treated beech
      sawdust and a diet consisting of 80% hay and 20% barley were investigated,
      respectively. The rumen fluid obtained from animals fed a complete food ration
      showed the significantly higher digestibility of hay (Tab. I) when Cu (P less
      than 0.05), Co, or Cu + Co (P less than 0.001) had been added into the rumen. The
      cellulose digestibility increased only after Co application (P less than 0.05).
      The microelements supplementation in all three forms had a very significant
      effect on the digestibility of treated beech sawdust by the rumen fluid of sheep
      fed a diet with 15% sawdust content, although the initial digestibility by the
      rumen fluid in the control animals (without microelements) was only 44.9%. A
      similar trend was also observed in the cellulose digestibility, but after Co
      application this increase was not significant. The rumen fluid of animals fed hay
      (80%) and barley (20%) showed the highest digestibility. The digestibility of
      sawdust reached 60% and the of cellulose 95.9% without microelements
      supplementation (control). In this case the effect of microelement
      supplementation on the sawdust digestibility was manifested only in the case of
      cobalt by the digestibility decrease (P less than 0.001). The cellulose
      digestibility also decreased after administration of Cu (P less than 0.01) and Co
      (P less than 0.05). The Cu + Co supplementation did not influence its
      digestibility.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641953
TI  - [Levels of mercury in the organs and tissues of sheep after administration of
      very low doses].
AB  - Experiments were carried out with six sheep of the Slovak Merino breed, weighing
      22-28 kg. For 28 days the animals were given 4 mg inorganic Hg2+ in the feed per
      animal/day. In contrast with the controls, the following residual mercury
      concentrations were determined in the single organs and tissues: liver 1.580 +/-
      0.326 mg.kg-1 Hg2+ and 0.091 +/- 0.014 mg.kg-1 Hg2+, respectively muscle 0.064 +/
      0.009 mg.kg-1 Hg2+, and 0.026 +/- 0.006 mg.kg-1 Hg2+, resp. spleen 0.142 +/-
      0.025 mg.kg-1 Hg2+, and 0.022 +/- 0.010 mg.kg-1 Hg2+, resp. kidney 9.054 +/-
      3.794 mg.kg-1 Hg2+, and 0.128 +/- 0.080 mg.kg-1 Hg2+, resp. (Fig. 1), abomasal
      contents 0.309 +/- 0.069 mg.kg-1 Hg2+, and 0.021 +/- 0.007 mg.kg-1 Hg2+, resp.
      large intestinal contents 0.267 +/- 0.058 mg.kg-1 Hg2+, and 0.043 +/- 0.004 mg.kg
      1 Hg2+, resp. The results suggest that the long-term ingestion of mercury with
      feed leads to a pronounced Hg accumulation in the kidneys and liver. Much lower
      levels were observed in the muscle tissue and spleen. The affinity of mercury to
      the kidney and liver is probably related to the preferential bonds of organic
      mercury compounds to the SH- groups of the plasma proteins in these organs. It is
      the bond to the sulphydryl groups of proteins that results in the inhibition of
      proteosynthesis and thus enzyme and antibody inhibition. Under the conditions of
      continuing chemical contamination of the environment, a permanent supply of low
      concentrations of heavy metals the animal organism is observed.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1641954
TI  - [Clinical effects and morphological changes after administration of low doses of
      ochratoxin A to broiler chicks].
AB  - Ochratoxin A (OA) was fed to HYBRO broiler chicks at a relatively low levels of
      850 micrograms/kg up age 42 days. The effects of OA on chick development, health
      state and the patho-morphological lesions in internal organs were investigated in
      this experiment. The chicks exposed to the relatively low OA levels were observed
      to lag behind in their growth; this was confirmed by their regular weekly
      weighing when the lower liveweight in comparison with the control group was
      recorded from the age of 14 days. A decrease in the liveweight was statistically
      significant at the age of 21, 28 and 35 days. The patho-anatomic finding was
      negative. A histological examination of kidneys and liver revealed the
      pathological lesions typical for ochratoxicosis. The lesions observed included
      the dystrophy of the tubular epithelial cells (Fig. 1), eosinophil granules in
      the tubulus lumen (Fig. 3), dystrophic lesions in the glomerules (Fig. 2) and
      cellulization of the connective tissue of intertubular spaces (Fig. 1). The
      lesions of liver (Fig. 4) show to allergic responses and defense reactions of the
      organism to the OA action. On the basis of results it can be concluded that the
      relatively low ochratoxin levels cause histopathological lesions in the kidneys
      and liver of chicks, and in this way they can negatively influence their
      development and performance.

PMID- 1641955
TI  - [Use of xylazine and ketamine in the induction of halothane anesthesia in dogs].
AB  - Our experience of the administration of xylazine and ketamine for an induction of
      halothane inhalation anaesthesia in dogs is described in this paper. After this
      procedure had been evaluated in 10 test dogs, the xylazine-ketamine induction was
      used for different surgical interventions in 160 patients. After joint i.m.
      atropine (0.05 mg/kg) and xylazine (1.5-2 mg/kg) pre-medication general
      anaesthesia of the dogs was induced by an i.v. administration of 1% ketamine (2
      mg/kg). After intubation and anaesthetizer connection halothane vapours had to be
      applied for 2 to 8 minutes at a 2.5% to 3.5% concentration to induce the
      tolerance stage of anaesthesia. Then the anaesthesia level was maintained by an
      application of halothane vapours at a 0.5 to 1.5% concentration (Tab. I). In
      addition to an evaluation of the anaesthesia proper, breathing-rate, inspiratory
      and expiratory volumes, internal body temperature were recorded, ECG was made and
      venous blood samples were taken to evaluate acid-base balance changes. The
      processing of the obtained data (Figs. 1 to 5, Tab. II) revealed a transient
      breathing attenuation after the xylazine-ketamine induction and partly
      compensated respiratory acidosis. On the basis of our results this tested method
      can replace the traditional thiopental induction associated with the risks of
      cardiopulmonary depression, or even blood circulation stoppage.

PMID- 1641956
TI  - [Focal changes in the lungs of wild hares caused by the parasite Protostrongylus
      commutatus (Diesing, 1851)].
AB  - The pathomorphological changes in the lungs of hare (Lepus europaeus Pallas,
      1778) provoked by the parasite P. commutatus (Diesing, 1851) are macroscopically
      manifested as layer and nodular changes. With regard to the fact that the layer
      changes are suggesting the hatching nodules of protostronglyoses of small
      domestic ruminants, we have decided to rate them separately because of the
      differentiation. The layer changes on the surface of hare's lungs become evident
      as areas of emphysema, inflammation and induration. The emphysematous changes are
      macroscopically evident in the form of lobular formation (Fig. 1).
      Histologically, it was found out that the emphysematous effect was limited by an
      area of compressed lungs structures without perspicuous signs of the development
      of atelectatic changes (Fig. 2). The emphysematous changes are causing prominent
      exudative inflammatory processes in the bronchi and bronchioli provoked by
      unfertilized and disintegrating eggs of parasites. Inflammatory layers are
      macroscopically evident as solid brown-reddish areas (Fig. 3). Their macroscopic
      manifestation is transient. It is qualified by the stages of the inflammation
      itself. It is possible to put down the stage of manifestative development of the
      changes in the inflammatory areas only by continual examinations of hare's lungs
      all year round. Unfertilized eggs and grounded, disintegrating larvae of
      protostrongylus are provoking the inflammatory reactions which may lead in the
      layer changes to the obliteration of bronchioli (Fig. 6), which is
      macroscopically evident as induration (Fig. 7). The bronchioli are obliterated so
      that the phagocytic ability of monocytes is transformed to a reparative
      ability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1641957
TI  - Chronic tracheobronchial syndrome in eight dogs.
AB  - Chronic tracheobronchial syndrome was diagnosed in eight dogs which had had a
      chronic mild cough for two to 13 months but were otherwise clinically normal. In
      five of them there was evidence of contact with other coughing dogs before the
      appearance of clinical signs and the majority at first responded favourably to
      antibacterial therapy. The coughing occurred mainly when the dogs pulled on their
      leads or became excited. Three cases had bronchoscopic evidence of active airway
      inflammation, and five had varying numbers of inflammatory cells (neutrophils) in
      bronchial aspirates. There was no evidence of excessive production of mucus in
      the airways of any of the dogs. Seven had an increased bronchial pattern on
      radiographs but only one of the dogs has developed chronic bronchitis.

PMID- 1641958
TI  - Bovine spongiform encephalopathy: recent observations on the age-specific
      incidences.

PMID- 1641959
TI  - Retractile mesenteritis in a cat.

PMID- 1641960
TI  - Tests of four baits for oral vaccination of dogs against rabies in Tunisia.

PMID- 1641961
TI  - Mycotoxicosis associated with Penicillium purpurogenum in horses in Nigeria.

PMID- 1641962
TI  - Feline vaccination.

PMID- 1641963
TI  - Carcinoid in canine large intestine.

PMID- 1641964
TI  - Mare scanning--possible ectopic pregnancy.

PMID- 1641965
TI  - Clinical teaching: a case for treatment.

PMID- 1641966
TI  - Slowing the spread of anthelmintic resistant nematodes of sheep and goats in the
      United Kingdom.
AB  - Anthelmintic resistant nematodes pose an increasing threat to animal welfare and
      lamb production on lowland sheep farms in the United Kingdom. Based on published
      information on anthelmintic resistance in nematodes and insecticide resistance in
      arthropods, seven recommendations are made for reducing the development and
      spread of anthelmintic resistant nematodes. The two most important are probably
      to prevent the introduction of resistant worms through the purchase of stock and
      to reduce the reliance on frequent anthelmintic treatments by using
      epidemiological principles of nematode control.

PMID- 1641967
TI  - Pharmacokinetics and bioavailability of spiramycin in pigs.
AB  - The pharmacokinetics of spiramycin in pigs were investigated after intravenous
      and oral administration. The potential therapeutically effective blood level was
      established after a single administration and examined in a subsidiary five day
      study. The rapid intravenous injection of 25 mg spiramycin/kg bodyweight produced
      marked salivation in all the test animals. The elimination half-life (2.3 +/- 1.2
      hours) was relatively short, in accordance with the total body clearance rate
      (27.3 +/- 10.1 ml/minute/kg). The high volume of distribution (5.2 +/- 2.2
      litres/kg) was due to the accumulation of the drug in the body tissues. The
      maximum plasma concentration (4.1 +/- 1.7 micrograms/ml) after oral
      administration of 85 to 100 mg spiramycin/kg bodyweight was reached after 3.7 +/-
      0.8 hours and the half-life of the elimination phase was 6.0 +/- 2.4 hours. The
      oral bioavailability was 45.4 +/- 23.4 per cent. Ad libitum feeding of a diet
      containing 2550 mg spiramycin/kg produced a steady state concentration of 0.96 +/
      0.27 micrograms/ml. This plasma concentration would provide a potentially
      therapeutically effective blood concentration against Mycoplasma species,
      Streptococcus species and Staphylococcus species.

PMID- 1641968
TI  - Effects of blue-eared pig disease on a breeding and fattening unit.

PMID- 1641969
TI  - Antibodies to phocine distemper virus in Canadian seals.

PMID- 1641970
TI  - Coronal cemental hyperplasia in a cow.

PMID- 1641971
TI  - Availability of medicines.

PMID- 1641972
TI  - Docking of dogs.

PMID- 1641973
TI  - Ewe deaths.

PMID- 1641974
TI  - Correlation of RNA secondary structure and attenuation of Sabin vaccine strains
      of poliovirus in tissue culture.
AB  - Part of the 5' noncoding regions of all three Sabin vaccine strains of poliovirus
      contains determinants of attenuation that are shown here to influence the ability
      of these strains to grow at elevated temperatures in BGM cells. The predicted RNA
      secondary structure of this region (nt 464-542 in P3/Sabin) suggests that both
      phenotypes are due to perturbation of base-paired stems. Ts phenotypes of site
      directed mutants with defined changes in this region correlated well with
      predicted secondary structure stabilities. Reversal of base-pair orientation had
      little effect whereas stem disruption led to marked increases in temperature
      sensitivity. Phenotypic revertants of such viruses displayed mutations on either
      side of the stem. Mutations destabilizing stems led to intermediate phenotypes.
      These results provided evidence for the biological significance of the predicted
      RNA secondary structure.

PMID- 1641975
TI  - Transcriptional activation of the tat-defective human immunodeficiency virus type
      1 provirus: effect of interferon.
AB  - The effect of human interferon-alpha 2 (HuIFN-alpha 2) on the activation of HIV-1
      provirus was studied in cell lines containing either an integrated tat-defective
      HIV-1 provirus (HIV-1 (-tat)) (HNHIVdt4 cells) or the HIV-1 (-tat) provirus and a
      plasmid in which the expression of HuIFN-alpha 2 was under the control of HIV LTR
      (HNHIV alpha 1 cells). In both cell lines, the expression of HIV-1 RNA was below
      the limit of detection, but transcription of the HIV-1 (-tat) provirus could be
      induced either by transfection with Tat-expressing plasmid or by treatment with
      TPA and cycloheximide (CHX). By contrast, stimulation with TPA alone induced HIV
      1 transcription only in HNHIVdt4 cells, but not in HNHIV alpha 1 cells that
      produced low levels of IFN-alpha constitutively. Similarly in a transient
      expression assay, TPA upregulated transcription of the transfected HIV-1 CAT
      plasmid only in HNHIVdt4 cells, but not in HNHIV alpha 1 cells. UV-crosslinking
      analysis of NF-kappa B-specific proteins induced in TPA-treated cells showed the
      presence of 45 and 55 kDa NF-kappa B-binding protein in TPA-induced HNHIVdt4
      cells while, in HNHIV alpha 1 cells, we detected only 55-, 110-, and 200-kDa
      proteins, but no 45-kDa protein. The transcriptional effects of IFN could not,
      however, be seen in the presence of Tat protein, suggesting that the virus
      developed a mechanism to overcome the IFN-mediated restrictions.

PMID- 1641976
TI  - Increased E6/E7 transcription in HPV 18-immortalized human keratinocytes results
      from inactivation of E2 and additional cellular events.
AB  - We characterized the state of the viral genome and transcription of human
      papillomavirus 18 oncogenes, E6 and E7, in immortalized human keratinocytes. At
      passage 9 after transfection with HPV 18 a homogeneous population of immortal
      clones was present. These cells have the viral DNA integrated within the E2 orf,
      accompanied by its partial deletion, similarly to what has been found in cervical
      carcinoma specimens. Transcription of the E6 and E7 oncogenes is mediated by the
      major viral early promoter (P105). Interestingly, transcriptional activity from
      this promoter increased upon continued in vitro passage of the cells. This event
      is concomitant with an increase in the proliferation rate of the cells.
      Reintroduction of the HPV 18 E2 gene into these cells resulted in repression of
      P105. However, the amount of E2 was limited in the HPV 18-immortalized cells.
      These data suggest that both viral and cellular factors play a role in increasing
      levels of E6 and E7 transcription providing the host cell with a proliferation
      advantage necessary for tumor growth.

PMID- 1641977
TI  - Parvovirus B19 replication in human umbilical cord blood cells.
AB  - The human parvovirus B19 is now known to be one of the causative agents of
      nonimmune hydrops fetalis and spontaneous abortions in pregnant women. The
      presence of the viral proteins and antibodies in fetuses of B19-infected women
      suggests that the virus can cross the placental barrier. In order to gain an
      insight into the mechanism of intrauterine fetal infection and the virus-induced
      hydrops fetalis, we examined whether human umbilical cord blood cells were
      permissive for B19 replication. Cord blood cells were infected with B19 in vitro,
      and Southern blot analyses of low M(r) DNA isolated from these cells revealed the
      presence of the characteristic replicative intermediates of B19 DNA. In addition,
      B19 genome expression in cord blood cells was detected by Northern blot analysis.
      Quantitative DNA dot blot analysis of culture supernatants documented complete
      assembly and release of B19 progeny virions in these cells. The progeny virions
      were biologically active in secondary infections of normal human bone marrow
      cells. The human umbilical cord blood cells may be a useful alternative to bone
      marrow and fetal liver culture systems for further studies on B19 since the need
      for bone marrow donors is obviated and, unlike fetal tissues, there are no
      ethical questions associated with the experimental use of cord blood because it
      is normally discarded. These studies also suggest that the umbilical cord blood
      may be a site for active replication of parvovirus B19 in vivo and may thus
      provide a means for transmission of the virus during intrauterine fetal
      infections.

PMID- 1641978
TI  - Bacteriophage T4 gene 21 encodes two proteins essential for phage maturation.
AB  - The T4 prohead protease (T4 PPase) is the key enzyme in the morphopoietic pathway
      of the T4 phage head. It is responsible for the proteolytic processing of all
      head proteins allowing protein rearrangement and head expansion. To study its
      biochemistry and gene regulation, T4 gene 21 was cloned into an expression vector
      under the control of the inducible tac promoter. Two proteins of apparent
      molecular weights of 21.5 and 27.5 kDa were detected after induction. These
      proteins are synthesized using two different start codons in the same reading
      frame. Destruction of either start codon resulted in the loss of the respective
      protein. Complementation experiments with bacteriophage T4 21(-)-infected cells
      showed that both proteins are functional in vivo and essential for T4 phage
      assembly.

PMID- 1641980
TI  - Monoclonal antibodies recognizing normal and retrovirus-transformed chicken
      hematopoietic cells.
AB  - The avian hematopoietic system has long been an invaluable model to study the
      mechanisms of cell growth and differentiation. We have developed six MAbs against
      either chicken embryonic hematopoietic precursor cells or retrovirus-transformed
      cells. MAbs Mo1, Mo2, and Mo3 recognized transformation-associated markers
      expressed in AMV-transformed nonproducer cell line-BM2. Not only were these
      markers expressed 7 to 10 folds higher on BM2 than on normal monocytic cells, but
      their expression was drastically reduced when BM2 cells were induced to
      differentiate into macrophages by PMA. The control of marker expression is
      associated with v-myb-transforming cascade, since another monocytic lineage
      specific oncogene, v-myc, did not enhance the expression of these markers. MAb
      Em1 detected a marker that is normally present in 20% of the cells from the
      30/50% interface of a discontinuous percoll gradient of normal 4-day-embryo yolk
      sac. Its expression is also found in AEV-transformed cells and MSB1 cells. The
      epitope for Em1 was exposed after neuraminidase treatment on erythroleukemia cell
      line 6C2, which suggested that sialylation and/or glycosylation is pivotal in
      regulating the expression of specific markers in differentiation pathways during
      embryogenesis and tumorigenesis. MAb Em2 recognized proliferating hematopoietic
      cells after the fourth day of embryogenesis. MAb Em3, on the other hand, is
      presumed to be specific for an oncofetal antigen expressed in various transformed
      cells but only in 10% of the cells from 30/50% interface of a discontinuous
      percoll gradient of normal 4-day-embryo yolk sac. These MAbs will be useful for
      dissecting the expression of differentiation markers within normal versus
      abnormal differentiation pathways in molecular terms.

PMID- 1641979
TI  - Proton nuclear magnetic resonance studies of the binding of sialosides to intact
      influenza virus.
AB  - The dissociation constants for binding of sialic acid derivatives to the
      hemagglutinin on intact influenza virus were determined using nuclear magnetic
      resonance (NMR) spectroscopy. The dissociation constants determined with whole
      virus are similar to, but slightly higher than, those determined with BHA
      (hemagglutinin released from virus by treatment with the protease bromelain;
      Sauter et al., 1989, Biochemistry 28, 8388-8396), indicating that the sialic acid
      binding site is not significantly altered when hemagglutinin is released from
      virus. Binding was quantified by observing the concentration-dependent broadening
      of the sialoside resonances in the presence of X-31 virus or alternatively by
      observing the effect of the sialoside on the resonances of a competitive
      "reporter" ligand. The glycosidic substituent attached to the sialic acid makes
      relatively little difference in the affinity of the sialoside for virus:
      alpha(2,6)-sialyllactose (KD = 2.7 mM) binds only slightly more tightly than
      alpha(2,3)-sialyllactose (KD = 3.5 mM). However, inversion of the glycosidic
      center produces a dramatic change in affinity: the dissociation constant for the
      alpha-methyl glycoside of sialic acid is 4.2 mM, but not binding is observed with
      the beta-methyl glycoside.

PMID- 1641982
TI  - The role of the tnv protein and tnv RNA splicing signals in replication of HIV-1
      IIIB isolates.
AB  - The requirement for tnv, a tat-env-rev fusion protein expressed by the IIIB
      strain of HIV-1, was tested. The expression of tnv was prevented by altering the
      5' splice site that flanks the central coding exon of tnv. Mutants that carry
      such an altered 5' splice site replicate normally in an established T-cell line
      and in peripheral blood lymphocytes, demonstrating that tnv has no effect on
      virus replication. However, two mutants that carry an alteration in the 3' splice
      site of the same exon are replication defective. The 3' splice site mutations
      result in significant reduction in the expression of the 16-kDa tat protein and
      induce the expression of large amounts of a 19-kDa rev-related protein that
      initiates within the central coding exon of tnv. S1 nuclease analysis reveals
      that splicing to the central tnv exon occurs with substantially increased
      efficiency via the use of an alternate 3' splice site six nucleotides 3' from the
      mutated site. The effect of the 3' splice site mutations on viral protein
      expression and replication are fully reversed by a second site mutation that
      eliminates the alternate splice site.

PMID- 1641981
TI  - Molecular analysis of a resistance-breaking strain of potato virus X.
AB  - Full-length cDNA clones of potato virus X (PVX) strains PVXUK3 and PVXHB have
      been constructed in plasmid vectors to allow in vitro transcription of infectious
      PVX RNA. In both instances the transcript-derived virus infected tobacco and
      potato identically to the respective progenitor strains: in tobacco and
      susceptible potato cultivars both strains infected systemically, producing
      symptomless or mild mosaic symptoms. In potato carrying the Rx or Nx resistance
      genes, the virus derived from the PVXHB cDNA infected systemically, whereas the
      virus derived from the PVXUK3 cDNA failed to infect the Rx plants or induced
      apical necrosis, characteristic of a hypersensitive response of the Nx gene.
      Three hybrid viral genomes were constructed at the cDNA level to localize the
      resistance breaking determinants of PVXHB. Transcripts of all three hybrids were
      infectious on tobacco. On potato cultivars with either the Rx or Nx resistance
      genes, the hybrid viruses infected in the same way as PVXHB, rather than PVXUK3.
      The common feature of these hybrid viruses, the coat protein gene, is therefore
      the determinant of Nx and Rx resistance breaking of PVXHB.

PMID- 1641983
TI  - Deoxyuridylate-hydroxymethylase of bacteriophage SPO1.
AB  - Phage SPO1 of Bacillus subtilis carries hydroxymethyl-deoxyuridylate in place of
      thymidylate in its DNA. The enzyme, responsible for the conversion of dUMP to
      HmdUMP, is a dUMP hydroxymethylase, encoded by the SPO1 gene 29. Here we describe
      the cloning and sequencing of the gene and the overexpression of the gene
      product. DNA hybridization using the DNA of bacteriophage T4 dCMP
      hydroxymethylase gene as a probe, allowed us to identify and map g29 on a 3.9-kb
      restriction fragment, EcoRI*11. We determined the nucleotide sequence. One of the
      open reading frames detected, coding for a putative 44.6-kDa protein, showed
      significant amino acid homologies with all known thymidylate synthases. Gp29 was
      overexpressed in the pT7 system. Extracts prepared from induced cells show
      hydroxymethylase activity in a tritium release assay.

PMID- 1641984
TI  - Peanut stunt virus satellite RNA: analysis of sequences that affect symptom
      attenuation in tobacco.
AB  - The V-satellite RNA (V-satRNA) of peanut stunt virus (PSV) has no effect on
      symptoms produced in tobacco by PSV. In contast, the G-satRNA induced complete or
      nearly complete suppression of systemic symptom development. Because G-satRNA
      differs from V-satRNA in only five nucleotide positions, these two satRNAs
      provide excellent material for investigating the molecular basis of satRNA
      mediated symptom attenuation. For this purpose, we constructed transcription
      vectors containing full-length cDNA clones from which infectious RNA transcripts
      can be synthesized in vitro, and produced chimeric and mutant satRNA molecules.
      Although an A----C substitution at position 362 of the V-satRNA molecule delayed
      systemic symptom development and reduced symptom severity, changes at both
      nucleotide positions 226 (C----U) and 362 (A----C) of V-satRNA were required for
      suppression of systemic symptom development. Our results are consistent with the
      idea that PSV satRNAs are noncoding molecules that exert their biological
      activities by directly interacting with host/viral components.

PMID- 1641985
TI  - The vaccinia virus K2L gene encodes a serine protease inhibitor which inhibits
      cell-cell fusion.
AB  - In certain circumstances, cells infected with vaccinia virus (VV) undergo fusion,
      but this does not occur in tissue cultures infected with wild-type VV. The VV
      genome includes three genes (B24R, B13R, and K2L) encoding polypeptides that are
      structurally related to members of the plasma serine proteases inhibitor (SPI)
      superfamily. In this study, we demonstrate by deleting these genes singly or in
      combination that the K2L gene encoding SPI-3, but not the B24R or B13R genes
      encoding SPI-1 and SPI-2, inhibits cell-cell fusion in VV-infected cells. A VV
      encoded hemagglutinin (HA) has previously been demonstrated to inhibit cell-cell
      fusion, but fusion-promoting VVs with K2L gene deletions had normal expression
      and cellular location of the VV HA. As both HA and SPI-3 independently inhibit
      cell-cell fusion in VV-infected cells, there must be at least two fusion
      promoting mechanisms encoded by VV. These may play different roles in virus-cell
      fusion and in cell-cell fusion after VV infection.

PMID- 1641986
TI  - Untranslatable transcripts of the tobacco etch virus coat protein gene sequence
      can interfere with tobacco etch virus replication in transgenic plants and
      protoplasts.
AB  - Transgenic tobacco plants which express untranslatable sense or antisense forms
      of the tobacco etch virus potyvirus (TEV) coat protein (CP) gene sequence have
      been generated. One of seven transgenic plant lines expressing a CP gene
      antisense transcript showed an attenuation of symptoms when inoculated with TEV.
      Three of ten transgenic plant lines expressing untranslatable sense transcripts
      did not develop symptoms when inoculated with TEV. These lines were resistant to
      either aphid or mechanically transmitted TEV. In contrast to CP-mediated
      resistance reported for other viruses, resistance was (1) mediated by an RNA
      molecule; (2) TEV-specific (i.e., "broad-spectrum resistance" was not observed);
      (3) independent of inoculum levels; (4) not dependent on plant size and; (5) due
      to decreased levels of virus replication. Protoplast experiments were used to
      demonstrate that resistant plant lines did not support the production of virus
      protein and progeny virus at wild-type levels.

PMID- 1641987
TI  - Selection of antigenically distinct variants of influenza C viruses by the host
      cell.
AB  - Five strains of influenza C virus were isolated and passaged in the amniotic sacs
      of embryonated hens' eggs, or in the HMV-II line of human malignant melanoma
      cells, and were tested for reactivity with a panel of monoclonal antibodies to
      the hemagglutinin-esterase (HE) glycoprotein. It was observed with two strains
      (C/Yamagata/4/88, C/Yamagata/7/88) that the HE of virus passaged in HMV-II cells
      was antigenically distinguishable from that of virus cultivated in eggs. Virus
      clones obtained after repeated passages of these two strains in HMV-II cells all
      showed a significant increase in the ability to replicate in the cell culture
      compared to clones derived from viruses grown in eggs. No difference was seen, by
      contrast, in the ability to grow in eggs between HMV-II- and egg-derived virus
      clones. It was also found that HMV-II-grown viruses but not egg-grown viruses
      could agglutinate glutaraldehyde-fixed chicken erythrocytes at 23 degrees. These
      observations, taken together, suggest that isolation and passage of influenza C
      virus in HMV-II cells sometimes result in selection of antigenically distinct
      variants which have an advantage in binding to the cell surface receptors.
      Sequence analyses of the HE genes revealed that compared to egg-grown viruses,
      HMV-II-adapted variant of the Yamagata/4/88 strain had a single amino acid
      substitution in the HE molecule at position 283 (Asp----Asn) and that of the
      Yamagata/7/88 strain had two substitutions at positions 212 (Glu----Lys) and 519
      (Asn----Asp).

PMID- 1641988
TI  - Adenovirus helper function activity of simian virus 40 T antigen mutants.
AB  - The SV40 large T antigen provides a helper function that permits human adenovirus
      yields in monkey cells to approach those obtained in human cells. The carboxy
      terminus of large T antigen is involved in providing this activity. The ability
      of a large number of SV40 mutants affecting T antigen to enhance the growth of
      adenovirus type 2 in the CV-1 line of African green monkey kidney cells was
      examined. Mutation of those serines and threonines at the carboxy terminus which
      are normally phosphorylated had no effect on adenovirus helper function. A
      cytoplasmic T antigen was very effective in providing adenovirus helper function.
      Mutants that produce unstable T antigens provided helper function, but to a
      reduced degree. Finally, mutations in T antigen which permit it to interfere
      trans-dominantly with replication catalyzed by wildtype T antigen provided
      adenovirus helper function at wildtype levels.

PMID- 1641989
TI  - Baculovirus-expressed rabies virus M1 protein is not phosphorylated: it forms
      multiple complexes with expressed rabies N protein.
AB  - The rabies N, M1, M2, and G antigens have been expressed in Spodoptera frugiperda
      cells from single gene expression vectors or dual gene vectors (N/M1 or M2/G)
      using the baculovirus system. Although N protein was phosphorylated, no evidence
      for M1 phosphorylation was obtained. N-M1 complexes were formed in vivo using
      dual infections or the coexpression vectors, as well as in vitro in mixing
      experiments. The free or complexed rabies N and M1 proteins reacted with
      available monoclonal and polyclonal antibodies. By sedimentation analyses the N
      M1 complexes were shown to exist in multiple configurations.

PMID- 1641990
TI  - A single amino acid substitution in the hemagglutinin-neuraminidase of Newcastle
      disease virus results in a protein deficient in both functions.
AB  - Sequence determinations of the hemagglutinin-neuraminidase (HN) glycoproteins of
      a temperature-sensitive mutant of Newcastle disease virus and two sequentially
      selected revertants had previously shown that substitution at a pair of residues,
      129 and 175, resulted in a deficiency in neuraminidase (NA) activity, which was
      partially restored by a third substitution at residue 193. To evaluate the role
      of the substitution at residue 175 in diminished NA activity, the mutation was
      introduced into HN and the protein expressed in COS cells. The mutated HN not
      only had minimal NA activity but also was unable to absorb chicken erythrocytes,
      even though it was transported to the cell surface in normal amounts, in an
      apparently antigenic form. Attachment function was restored to the protein by the
      introduction of the additional substitution(s) at 129 and/or 193. These results
      indicate that residue 175 influences not only NA activity but also receptor
      recognition.

PMID- 1641991
TI  - Comparison of the S RNA segments and nucleoprotein sequences of Crimean-Congo
      hemorrhagic fever, Hazara, and Dugbe viruses.
AB  - The S RNA segments of the nairoviruses Crimean-Congo hemorrhagic fever (CCHF)
      virus (Chinese isolate) and Hazara (HAZ) virus were cloned and sequenced from PCR
      products. The RNAs comprise 1672 and 1677 nucleotides, respectively, and each
      encodes a protein in the viral complementary strand (54.0 and 54.2 kDa,
      respectively). The deduced protein sequences show homology to each other and to
      the nucleoprotein of Dugbe (DUG) nairovirus, although both the CCHF and HAZ viral
      proteins are larger. Alignment of the nucleoprotein sequences of CCHF, HAZ, and
      DUG viruses show that the CCHF and HAZ sequences are somewhat more closely
      related to each other (60.0% identity) than either is to the DUG sequence (55.4
      and 53.0% identity, respectively); 39.5% of residues are identical across all
      three proteins. The carboxyl-terminus of DUG N protein shows a 40-residue
      deletion relative to the N proteins of the other two viruses.

PMID- 1641992
TI  - Abutilon mosaic geminivirus double-stranded DNA is packed into minichromosomes.
AB  - An intermediate form of Abutilon mosaic geminivirus, a complex of viral double
      stranded DNA (dsDNA) and protein, was characterized by two different techniques.
      Cesium sulphate gradient centrifugation was used to show that the majority of
      this form comigrates with host chromatin. Micrococcus nuclease digestion
      experiments with isolated nuclei demonstrated that the viral dsDNA is organized
      in a manner comparable to that of host nucleosomes. Results from a previous
      electron microscopical work (Abouzid, A. M., Frischmuth, T., and H. Jeske, 1988,
      Mol. Gen. Genet. 212, 252-258) suggested to us that a part of the viral dsDNA
      must be free of nucleosomes. Whether this nucleosome-free space corresponds to
      the intergenic region which contains most of the promotor sequences and the
      putative origin of replication is discussed.

PMID- 1641993
TI  - Characterization of beet curly top virus subgenomic DNA localizes sequences
      required for replication.
AB  - Subgenomic viral DNA is accumulated in Nicotiana benthamiana and Beta vulgaris
      plants agroinoculated with the geminivirus beet curly top virus. The subgenomic
      DNA is more abundant in N. benthamiana and is distributed between two broad size
      groups in this host. Six unique examples, ranging in size from 887 to 1311
      nucleotides, have been cloned from viral double-stranded DNA purified from N.
      benthamiana and analyzed by sequence determination. Deletions are distributed
      throughout most of the genome and only nucleotides 2946-410 are represented in
      all subgenomic DNAs. Comparison with a previously characterized subgenomic DNA
      suggests that cis-acting signals necessary for viral DNA replication are located
      in a predominantly intergenic region between nucleotides 2946-308.

PMID- 1641994
TI  - Mutagenesis of a hexanucleotide sequence conserved in potexvirus RNAs.
AB  - Biologically active in vitro transcripts were synthesized from a cloned cDNA of a
      defective RNA (D RNA) of clover yellow mosaic virus (CYMV) and were used to
      determine if a hexanucleotide motif (5'-ACUUAA) conserved in the 3' noncoding
      region of potexvirus RNAs is essential for accumulation of progeny D RNA in
      planta. Deletion of rearrangement of the entire hexanucleotide sequence in the D
      RNA resulted in no detectable accumulation of progeny D RNA when coinoculated
      with helper CYMV RNA. Single-base substitutions of the four central nucleotides
      of the hexanucleotide sequence revealed that viable D RNAs can tolerate single
      residue changes at positions 3 and 5 only. These results suggest that the hexamer
      motif is involved in the process of D RNA propagation. The hexanucleotide
      sequence was also identified in the negative strand of potexvirus RNAs in the
      regions proposed to represent subgenomic RNA (sgRNA) promoters. In addition, the
      hexamer motif is present in similar regions in carlavirus RNAs. The conservation
      of this hexanucleotide (in orientation and position) in potexvirus and carlavirus
      RNAs, which serve as templates for full-length negative-strand synthesis and
      sgRNA production, strongly suggests that it plays a functional role in the
      synthesis of viral RNAs. Taken together, our data support our previous proposal
      (Bancroft et al., 1991. J. Gen. Virol. 72, 2173-2181) that the hexanucleotide
      sequence acts as a cis element involved in synthesis of full-length negative
      sense viral RNA and further implicate the sequence in a similar role in
      production of positive-sense sgRNA.

PMID- 1641995
TI  - Management of injured in combats in Yugoslavia from June 1991 to February 1992.

PMID- 1641996
TI  - Management of the diseased during combat operations in Yugoslavia 1991-1992.

PMID- 1641997
TI  - Posttraumatic stress disorders and psychotherapeutic approach.
AB  - The paper deals with the problem of the posttraumatic stress reaction of the
      young members of the Yugoslav People's Army (18-26 years old) who took part in
      the war of 1991. This paper is based on the explorative research of 43 subjects
      who were exposed to traumatic events in Croatia and Slovenia. The following
      variables have been treated in the research: the features of traumatized persons,
      the level of the posttraumatic personality integration, symptoms, plans for
      future and interpersonal consequences of the traumatic experience. The results
      have shown that the basic problem of all the psychotraumatized persons is the
      split between the experience of destructive reality that exceeds the death itself
      and outwar reality ruled by the laws that affirm life. On the basis of these
      experiences, the psychotherapeutic approach has been established and named "The
      Construction of the Peer Supporting Network" the essence of which is to overcome
      the gap between the two experienced but opposite realities.

PMID- 1641998
TI  - Psycho-social causes and consequences of refugee military families.

PMID- 1641999
TI  - Health status evaluation of the reserve forces under normal and emergency
      conditions.

PMID- 1642000
TI  - Forensic-medical expertise of twenty four murdered citizens from Gospic and its
      surroundings.
AB  - The forensic-medical expertise of 24 predominantly carbonized bodies, that were
      found at Kukin Do was reported. The victims were from Gospic and its
      surroundings, who disappeared between October 16-18, 1991. The expertise involved
      the identification of bodies, injury classification, determination of tools by
      which injuries were inflicted as well as time when injuries were inflicted, and
      whether it was when the victims were alive or dead. At the time of expertise all
      bodies were in the state of advanced putrification, frozen and burned. In 18
      cases, the larger or smaller parts of bodies lacked as the consequence of fire.
      Eleven persons were identified as the Serbs from Gospic and for thirteen persons
      the procedure of identification is still in process. In 21 persons while they
      were alive, injuries were done with: bullets, blade, pointed and blunt mechanical
      tools. In three persons, injuries were not found due to missing of the larger
      parts of bodies. After their death all corpses were burned, and in two persons
      bites of rodents were evident.

PMID- 1642001
TI  - Preventive medical protection in the Armed Forces of Yugoslavia during military
      conflicts.
AB  - Some experiences in preventive medical protection in the Armed Forces of the
      Yugoslav People's Army (Y.P.A.) in the blockade and combat operations in 1991 are
      presented. In garrisons which were in the total blockade the basic life-needs
      were threatened and in the same time personnel was exposed to combat operations
      of enemy forces. Owing to alterness and discipline of the whole staff the basic
      hygienic measures of health protection were maintained. In units which were
      engaged in combat operations the hygienic prophylactic measures were conducted
      based on our doctrinal principles in preventive medical protection. The decrease
      in the incidence of infectious diseases and lack of epidemics point to the
      successfully applied protection. The health service provided protection both of
      people and refugees and also a significant help was extended to the units of the
      Armed Forces.

PMID- 1642002
TI  - Replacement therapy with virus-inactivated plasma concentrates in von Willebrand
      disease.
AB  - In von Willebrand disease, the goal of treatment is to correct the two laboratory
      hallmarks of abnormal hemostasis, i.e. the deficiency of factor VIII (FVIII) and
      the prolonged bleeding time (BT). Since desmopressin (DDAVP) is able to achieve
      both these goals in the majority of patients, it is the treatment of choice. Some
      patients, however, are not responsive or become refractory to DDAVP. In these,
      blood products maintain an important therapeutic role, and there is a need to
      assess the efficacy of the recently available virus-inactivated plasma
      concentrates, which contain both FVIII and von Willebrand factor and carry a low
      risk of transmitting blood-borne viruses. Our survey of the data reported in the
      literature indicates that all available concentrates are similarly effective in
      attaining high and sustained levels of FVIII after infusion. Although they often
      shorten or normalize the prolonged BT, that effect is less uniform. Since
      concentrates appear efficacious in the majority of clinical situations that
      require the use of blood products, they should be preferred, because of their
      greater safety, to cryoprecipitate produced by blood banks, which cannot be virus
      inactivated.

PMID- 1642003
TI  - Anti-IgG autoantibodies in HIV-infected hemophilia patients.
AB  - Sera of 76 HIV-negative hemophilia patients, 103 HIV-positive (HIV+) hemophilia
      patients free of AIDS or AIDS related complex (ARC), and 32 HIV+ hemophilia
      patients with AIDS/ARC were tested for four different anti-IgG activities. IgG
      anti-F(ab')2 gamma, IgM-anti-F(ab')2 gamma, and IgG-anti-Fc gamma serum
      activities were significantly associated with the clinical stage of HIV
      infection, whereas IgM-anti-Fc gamma was not. IgG-anti-F(ab')2 gamma activity was
      found to be caused by cross-reaction of anti-HIV antibody with an epitope within
      the constant CH1 domain of human IgG. HIV+ hemophilia patients with severe
      thrombocytopenia (less than 50,000/microliters platelet counts) had significantly
      higher IgM-anti-IgG activity than patients with greater than 50,000/microliters
      platelets. Because anti-IgG antibodies possess immunoregulatory properties, our
      results may serve as a possible explanation for the frequent B cell disorders
      encountered in HIV-infected patients.

PMID- 1642004
TI  - Leukocyte depletion of red cell concentrates by filtration: influence of blood
      product temperature.

PMID- 1642005
TI  - HIV-2 infection in high-risk individuals with indeterminate HIV-1 western blot
      analysis: a serologic surveillance.

PMID- 1642006
TI  - Note on the measurement of alanine aminotransferase in the screening of blood
      donors.

PMID- 1642007
TI  - Disasters in health. Typhoid epidemic in Jamaica, 1990.

PMID- 1642008
TI  - [Brief definitions of medical ethics concepts. 20. Potentiality].

PMID- 1642009
TI  - [Psychotherapy in advanced age].
AB  - The ageing patient, especially in rehabilitation, faces an unknown and sometimes
      critical situation, in which he is as much in need of psychotherapy as he can
      benefit by it. Combinations of hypnoid techniques together with group
      interactions and analytically orientated verbal therapy have proved to be most
      suitable, bringing into action the somatotropic as well as the psychotropic
      effects of psychotherapy. Pleasure-orientation, variety and imagination as
      psychotherapeutic dimensions have to be integrated into rehabilitation, which
      otherwise would remain incomplete patchwork. We need a renaissance of general
      communicative culture in the first place, additionally specific verbal techniques
      for special (critical) situations, e.g. when talking to the incurably diseased,
      to his family, etc. Psychotherapeutic reasoning and acting must become part of
      the training and a permanent concomitant factor in all health professions. The
      same must hold good for public life, politics and society, if we strive for
      generally effective achievements for the ever-increasing number of elderly
      patients. It opens vast new fields of action for a new generation of
      psychotherapists who will be prepared to shed antiquated prejudiced stereotypes.

PMID- 1642010
TI  - [Concomitant depression and its treatment].
AB  - Accompanying depression is especially common in elderly, chronically ill patients
      and rehabilitation patients, where a physical illness and/or disablement is
      accompanied by depression. Treatment should always be focussed in a
      "polypragmatic" manner on both physical or psychic symptoms. In particular
      psychotherapy (see article by Barolin), pharmacotherapy (referred to in this
      article) and physiotherapy (described further in other literature) are of
      importance here. Advantage is to be taken of the polar dimensions of different
      types of antidepressant drugs, namely the increase in drive or sedating effects.
      However, the increased rate of side effects from some drugs among elderly
      patients is not to be ignored. Taking the above into consideration, the new
      antidepressant, Fluctine (Fluoxetine), has proved to be effective among our
      randomly selected patients. This is on account of its relatively fast onset of
      action, minimal side effects and its slight increase in drive. The group of non
      responders (one third of the patients) showed no decrease in depressive symptoms
      when other antidepressants were substituted. As expected those patients suffering
      organic-brain illness responded worse and represent a large percentage of the non
      responders. These data prove the results of previous findings that patients with
      organic-brain illness generally respond worse to antidepressant medication. Thus
      Fluctine can be recommended for elderly patients with accompanying depression.

PMID- 1642011
TI  - [Abortion from the Catholic perspective].
AB  - The embryo possesses the right to life. Therefore abortion is an forbidden act of
      killing. There is no sufficient reason to justify it. Especially the burden of
      pregnancy in situations of social conflicts and change of carriere-plans cannot
      justify abortion. Also there can be no demand of conscience to legitimate an
      abortion. The Catholic Church itself offers support for women in conflict
      situations. The Church condemns abortion, not the person, who needs a special
      attention in such a situation.

PMID- 1642012
TI  - [Abortion: interviews and discussions].
AB  - The paper focuses on the high number of annual induced abortions and is
      discussing alternative ways to cope with this problem. 151 women were interviewed
      on the day of abortion. 39 women were interviewed with more detail on the
      psychological consequences of their abortion carried out 7 to 8 years ago. Main
      topics of the questionnaire in the first group concerned on the background of
      conflicts arising from pregnancy, on the information provided by physicians and
      social advisory boards, and on the question under what circumstances abortion
      could have been avoided. In the second group 50% of the individuals carried out
      multiple abortions (up to 5 times). In the conversations it was tried to get more
      detailed informations on the present well-being, on severe life-events which had
      taken place in the past years history and on the present point of view to the
      abortion in 1981.

PMID- 1642013
TI  - [Theses on the ethics and legal ethics of abortion].
AB  - The author subjects the principal ethical and pragmatic arguments for the moral
      and legal rejection of abortion to critical scrutiny. He concludes that a
      prohibition of abortion can be justified neither by considerations of individual
      and social consequences nor by the standard arguments intended to show that
      abortion is intrinsically wrong as a form of killing specifically human life.

PMID- 1642014
TI  - Recent advances in medically assisted conception. Report of a WHO Scientific
      Group.

PMID- 1642015
TI  - [Asbestos and tumors].

PMID- 1642016
TI  - [Epidemiology and clinical aspects of pancreatic cancer].

PMID- 1642017
TI  - [Endocrine-active pancreatic tumors].

PMID- 1642018
TI  - [Some new aspects of vaginal candidosis in the female].

PMID- 1642019
TI  - [Myopathy with carnitine deficiency and lactic acidosis. A contribution to
      differential diagnosis of carnitine deficiency myopathies and mitochondrial
      myopathies].

PMID- 1642020
TI  - [Ludwig Aschoff (10 January 1866 to 24 June 1942)].

PMID- 1642021
TI  - [Chemical structure, biotechnical production and clinical use of recombinant
      erythropoietin].
AB  - The renal glycoprotein hormone erythropoietin is an essential growth factor for
      the erythrocytic progenitors in the bone marrow. Erythropoietin deficiency is the
      main cause of the anemia in chronic renal failure. Genetical engineering has made
      it possible to produce recombinant human erythropoietin (rhu-Epo) in CHO cell
      cultures as a pharmaceutical compound. Endogenous and recombinant erythropoietin
      are similar with respect to their biological and chemical properties (M(r) 30,400
      Da, protein content 60%, 165 amino acids, 4 carbohydrate side chains). With few
      side-effects, rhu-Epo corrects the anemia of predialysis and dialysis renal
      failure patients. In addition, rhu-Epo treatment may reduce the need for blood
      transfusion in other types of anemias, including those of rheumatoid arthritis,
      AIDS, malignant diseases and major surgical procedures. However, rhu-Epo has not
      been approved as yet for treatment of non-renal anemias in Germany.

PMID- 1642022
TI  - [Anti-oxidative therapy of pancreatitis--an 18-month interim evaluation].
AB  - 99 patients affected with acute pancreatitis of different genesis were treated in
      hospital (necrotizing n = 38, mild form n = 61) from May 1990 to November 1991.
      Nearly 80% of these illnesses were ethanol-induced, 12% were of biliary origin.
      90 patients were submitted to an adjuvant antioxidant therapy with selenium and D
      alpha-tocopherol (necrotizing form n = 29, mild form n = 61). The average
      lethality rate of 34% (1982-1989) fell to 1.1% (1 female patient with biliarily
      induced pancreatitis). No lethal courses were observed in alcohol-induced,
      idiopathic, post-traumatic, and post-operative forms. Clinical courses proceeded
      more easily under adjuvant antioxidant therapy, surgical treatment was not
      necessary. A treatment at reasonable costs can be made in all general internal
      wards.

PMID- 1642023
TI  - [Coronary heart disease and insulin concentration in type II diabetic patients-
      results of a diabetes intervention study].
AB  - There is experimental, clinical and epidemiological evidence that elevated
      insulin levels are associated with development of atherosclerosis. Early results
      came from studies in non-diabetics, but the situation with respect to diabetes is
      more complex and not so clear. The Diabetes Intervention Study is a population
      based follow-up study in newly detected type II diabetics (30- to 55-yr-old).
      After 5 years 431 men and 320 women received a complex check up with oral glucose
      tolerance tests and measurements of plasma insulin and glucose levels, fasting
      and 2h post-load. Regarding the metabolic parameters, the fasting and
      postprandial insulin levels were higher among the patients having coronary heart
      disease (15% of men, 36% of women), as compared to patients without this disease.
      In multivariate analysis sex, age, antihypertensive treatment, blood pressure,
      body mass index, and fasting insulin levels were independently associated with
      the prevalence of coronary heart disease in patients with non-insulin dependent
      diabetes mellitus (NIDDM) treated with diet and/or oral antidiabetics. Body mass
      index and triglycerides were the only variables that independently correlated to
      insulin: fasting insulin = 0.4 (body mass index) + 0.1 (triglycerides) - 4,2. In
      future prospective studies of diabetics relating insulin concentrations to the
      development of vascular disease are of particular interest and necessity. Because
      hyperinsulinemia may contribute to accelerated atherosclerosis in NIDDM-patients,
      the aim of the treatment of type II-diabetes should be to correct hyperglycemia
      without aggravating insulin levels and other cardiovascular risk factors.

PMID- 1642024
TI  - [Do piroxicam and diclofenac impair reaction performance?].
AB  - The non-steroid agents diclofenac (1 mg/kg) and piroxicam (0.3 mg/kg) were
      studied for their performance-influencing effect in an acute placebo controlled
      cross-over trial involving 11 normal subjects in intraindividual comparison.
      Various cognitive tests (vigilance measurement, d2-test, concentration
      performance test), a determination test, and a flicker frequency test did not
      reveal verum effects when compared to placebo. In contrast, for subjects
      administered piroxicam, the self-state questionnaire according to Nitsch showed
      marked positive effects on the motivation and activation on the subjects.
      Numerical improvements (without being statistically significant) were also seen
      with respect to outgoingness and exertion increase. Moreover, subjects
      administered piroxicam were observed to be more concentrated and relaxed, whereas
      diclofenac exerted no influence on performance and the state of mind.

PMID- 1642025
TI  - [Activated circulating lymphocytes as a parameter for clinical activity in
      patients with Crohn disease].
AB  - Patients with Crohn's disease exhibit peripheral lymphocytes during exacerbation
      which express activation associated epitopes on their cell surface. We have
      therefore enumerated circulating lymphocytes in 36 patients with Crohn's disease
      by immunofluorescent staining using monoclonal antibodies directed against
      activation associated antigens (CD 25, CD 71, CD 38 and MHC-class II-antigens,
      respectively). We found a highly significant correlation between the percentage
      of activated lymphocytes and the clinical activity. Thus in our experience
      measuring of activated peripheral lymphocytes proved as a valuable parameter in
      assessing the clinical activity of Crohn's disease for a well-timed medication.

PMID- 1642026
TI  - [Malondialdehyde concentration in blood plasma of patients with liver diseases].
AB  - Malondialdehyde (MDA) level was determined spectrophotometrically with
      thiobarbituric acid method on 50 healthy persons and 160 patients with alcoholic
      and nonalcoholic liver diseases. Alcoholics without liver damage show normal
      plasma MDA values. Alcoholic fatty liver, alcoholic hepatitis and alcoholic liver
      cirrhosis cause an increase of MDA values. The highest concentrations of MDA were
      found on patients with acute virus hepatitis. Also noninfectional hepatitis and
      nonalcoholic liver cirrhosis showed an elevated MDA-Level. Liver damage and lipid
      peroxidation are considered as closely connected processes.

PMID- 1642027
TI  - [How painful is intensive insulin therapy?].
AB  - Injection-pain was assessed in 39 type-1 diabetic patients in relation to an
      insulin injection (with an insulin-pen) into the upper arm, the abdomen, and the
      thigh and in another 10 patients, pain associated with finger-pricking for blood
      glucose self-monitoring was assessed. Pain perception was recorded on a visual
      analogue scale. According to the results, injections were relatively painless
      with an average (median) pain-score of less than 10% of maximum pain. Injection
      pains varied in relation to the injection sites (upper arm greater than thigh
      greater than abdomen). Least painful (n = 44) versus most painful (n = 39)
      injections were distributed as follows: upper arm 20% vs. 46%, abdomen 43% vs.
      23%, thigh 36% vs. 31% (chi 2 7.26, df2, p less than 0.05). Finger-pricking was
      no more painful than injecting insulin. It is concluded that insulin injecting
      (e.g. with insulin pens) and blood glucose self-monitoring in general is not very
      painful. However, if this positive conclusion also applies to long-term
      performance of intensive insulin therapy remains to be proven.

PMID- 1642028
TI  - [Appointment modalities in the history of the medical faculty of the Halle
      University. I. The 18th century].
AB  - Modalities of appointment to medical professorships and readerships were quite
      differently managed in the period of the first century of Halle University opened
      in 1694. The appointments of the initial era secured a top position to Halle
      University (Faculty of Medicine). Then followed decades of decline which not at
      last resulted from a personal policy being not clear-sighted enough. Nearly from
      about 1780 new conceptions in the modalities of appointment referred to the bloom
      of the decades of foundation.

PMID- 1642029
TI  - [Occupational rights in medical practice. II].

PMID- 1642030
TI  - [Pollex flexus congenitus].
AB  - The authors report on the incidence, clinical picture, etiology, pathogenesis and
      treatment of congenital pollex flexus, and communicate the results of surgery on
      52 thumbs. The permanent flexion anomaly in the interphalangeal joint and a hard,
      palpable knot in the long flexor tendon of the thumb over the metacarpophalangeal
      joint are typical for the deformity. Although these changes are sometimes
      observed immediately post partum, delayed diagnosis and treatment are more
      common. The hypothesis that it is a hereditary, endogenous condition is supported
      by observations in twins, relatively frequent bilateral occurrence and a high
      familial incidence. Constriction of the synovial sheath over the basal joint of
      the thumb is a key pathogenetic factor, although little is known about its
      causes; anatomical factors, influences affecting the growth of the sesamoid
      bones, and mechanical causes have been postulated. A more plausible hypothesis
      was first advanced by Jeannin. Like Hueston and Wilson 100 years later, he
      compared the tendon to a thick thread which had to be passed through a narrow eye
      of a needle: as a result, the "thread" would be frayed and compressed. The knot
      in the tendon is held to be a secondary phenomenon. The pathologicoanatomical
      picture varies. Lymphocyte and monocyte infiltration, and metaplasias to fiber
      cartilage have been detected in specimens excised from the tendon and the
      synovial sheath. However, pathologic changes have not been found in all cases. In
      the first year of life conservative therapy may be attempted, with temporary
      splinting of the thumb following manual correction of the flexion anomaly in the
      interphalangeal joint.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642031
TI  - [Indications and technique of partial arthrodesis of the carpus].
AB  - Partial arthrodesis of the carpus has again become a topical method. The
      technique has been improved and the range of indications has been extended.
      Fusion of certain areas has indeed been propagated as first-line therapy, for
      example in lunatum necrosis or as an important additional operation in
      substitution plastic surgery. Partial arthrodesis of the carpus is intended to
      eliminate mechanisms which has become pathological whilst preserving the best
      possible mobility. Partial arthrodesis alters the movement pattern of the
      individual ossae carpi. Moreover, the pressure in the adjacent joints also rises.
      The risk of a new pathological process is considerable. Recent publications
      report on a rapid development of impingement and symptoms. The most frequent
      partial arthrodeses are discussed. The indications and the direct consequences
      are critically analysed and explained with reference to examples. Technical
      details and potential dangers are described. An STT-arthrodesis is indicated for
      osteoarthritis of these bones. The radio-lunar arthrodesis is recommended for
      ulnar drifting of the carpus in cases of rheumatoid arthritis. Reconstruction of
      the central axis with arthrodesis of the capitate-lunate is indicated for
      pseudarthrosis of the scaphoid with carpal collapse. Other combinations are
      possible, they cause however greater functional deficits. We recommend a critical
      analysis of the function of the entire carpus before the operation. Caution is
      called for when an incipient arthrosis is present in the adjacent joint. Partial
      arthrodesis of the carpus is rather a temporary solution, since it enables time
      to be gained. Total arthrodesis is the ultimate resort.

PMID- 1642032
TI  - [Results of resection of the head of the ulna].
AB  - A follow up of 57 wrists with resection of caput ulnae shows different value to
      different groups of patients. The painful arthrosis of distal radioulnar joint
      gives indication in posttraumatic cases. Release of pain and improvement of range
      of motion will be achieved; loss of strength is the most impairing problem for
      younger patients. 13 patients out of 21 with posttraumatic deformities were
      satisfied with the post-operative outcome; 13 patients showed significant loss of
      strength, too. In case of rheumatoid arthritis with caput-ulnae-syndrome the
      resection is without alternative, needs to be combined with the arthrodesis of
      radiolunar-joint, if necessary. 20 of 34 rheumatics were satisfied with the
      outcome after resection of caput ulnae; in 6 cases an ulnar drift was evident,
      which implied simultaneous or later partial arthrodesis of the wrist. For all
      patients release of pain decided on their satisfaction with surgery.

PMID- 1642033
TI  - [Arthroscopy and MRT of the shoulder--a comparative retrospective analysis].
AB  - MR Imaging is proving to an effective means for evaluating the shoulder. The use
      of a surface coil and high resolution scanning techniques have allowed detailed
      analysis of normal anatomy and suspected pathology of the shoulder. On the other
      way arthroscopic inspection provides a more extensive visualization of the joint
      in different positions. 31 patients, well documented, were studied with MR
      Imaging and correlated with findings in arthroscopy and open revision in some
      cases. The MR studies were retrospective interpreted without the knowledge of the
      results of other diagnostic procedures. For the evaluation of rotator cuff tears
      MRI proved to have a sensitivity of 83.3% and an accuracy of 90.3%. When
      Arthroscopy was correlated with open revision the sensitivity was 61.8% and the
      accuracy 78%. Labral pathology and Hill-Sachs lesions will be better evaluated in
      arthroscopy as in MRI (sensitivity of arthroscopy 100% and of MRI 69%, accuracy
      of arthroscopy 100% and of MRI 87.1%). With the high resolution scanning
      technique and a surface coil MRI has been shown to be useful in the evaluation of
      rotator cuff tears and impingement syndrome but not in diagnosis of labral
      pathology and Hill-Sachs lesions.

PMID- 1642034
TI  - [Clavicula pro humero--a new surgical method for malignant tumors of the proximal
      humerus].
AB  - In the majority of cases with malignant tumors in the proximal part of the
      humerus a limb saving tumor resection is possible. Reconstruction of the defect
      is necessary to maintain the length of the arm and to create a fulcrum for elbow
      flexion and extension. Several methods of reconstruction have been described in
      the literature including the fixation of distal humerus to the second rib or to
      the clavicle by means of Kuntscher-nails, the implantation of a proximal humerus
      prosthesis without or with accompanying bone transplantation, a bridging of the
      defect using an allograft or an arthrodesis of the shoulder joint using free or
      vascularized bone transplants. The following paper describes a new surgical
      procedure whereby the vascularization of the clavicle is preserved and the
      clavicle used to bridge the defect. Although the follow-up period of the patients
      operated on so far in this way is relatively short, the functional advantages of
      this operation over the other forms of reconstruction can already be observed.

PMID- 1642035
TI  - [Surgical therapy of metastases of the pelvis and sacrum].
AB  - We are reporting on 42 surgical and 5 conservative treatment approaches in
      metastases of the pelvis and sacrum. With an average disease-free survival of
      14.4 months the majority of the lesions were resected intralesionally. In the
      area of the ischium and the pubis resection alone was done without further
      stabilizing measures. If the resection was in the area of the iliac wings,
      stabilization was achieved by means of osteosynthesis in 50% of the cases.
      Periacetabular resections required reconstruction with endoprotheses in all
      cases. In patients with good prognosis and solitary metastases also extralesional
      resections were performed. Reoperated embolization was used in advanced stages of
      the disease or if the metastases were not easily accessible surgically. Because
      of the complexity of pelvic resections and the often considerable loss of
      function, patients with metastases are often treated with intralesional resection
      and osteosynthesis. In exceptional cases, if radiotherapy had failed or multiple
      intralesional resections were followed by recurrences, we feel however that
      extralesional resection should be attempted with good prognosis for the patient.

PMID- 1642036
TI  - [Results of surgical therapy of knee flexion contractures in patients with
      myelomeningocele].
AB  - This study reports the results of 98 operations for correcting knee-flexion
      contractures, which were performed between 1972 and 1989 in 60 patients with
      myelomeningocele. 13 knees had hamstring lengthening and 85 knees had radical
      flexor release. In 4 patients, who had flexion-contractures of more than 50
      degrees, the soft tissue release was combined with supracondylar extension
      osteotomy. 58 patients had additional hip-flexion-contractures and 39 patients
      had feet deformities. The average age at time of surgery was 8 years, 3 months.
      The average follow-up-period was 65 months with a minimum of 1 year and a maximum
      of 13 years. In 92 knees a permanent extension ability could be achieved. In 6
      knees a recurrence of flexion-contracture occurred making a second surgery
      necessary. The main problem in the postoperative period were 13 skin necroses,
      which were seen mainly after an s-shaped incision. As a conclusion a
      perpendicular midline incision is recommended. After surgery 11 patients could be
      provided for the first time with an orthoses. In the remaining the upright body
      position or the erection of the orthoses could be improved.

PMID- 1642037
TI  - [Effect of constitutional ligament laxity and physical stress on development of
      patellar tip syndrome].
AB  - Studies were performed in order to obtain information on the pathogenesis of
      patellar tip syndrome (PTS). Using a finger hyperextensiometer, ligamental laxity
      tests were performed on athletes, non-athletes and controls. Ninety-eight PTS
      patients who did not indulge regularly in sports, 39 patients from the German
      federal volleyball league, and 400 healthy controls were examined. No difference
      in the extensibility of ligaments was found between the patients from the group
      of competitive athletes and the controls. However, a significantly increased
      extensibility of the finger joints was found in all age and sex groups with
      "spontaneous" PTS. The authors conclude that 1) constitutional laxity of the
      ligaments is a key predisposing factor for PTS, and 2) PTS is triggered by
      physical stress. Susceptibility to microtrauma at the insertion of the patellar
      ligament is a function of the constitutional strength of the ligaments.

PMID- 1642038
TI  - [Results of isolated lateral retinaculum release as a treatment method in patello
      femoral dysfunction].
AB  - The results of lateral retinaculum-release by arthroscopic, subcutaneous and open
      technique on 122 patients are presented. Within a follow-up period of 3.68 years
      in average the postoperative success rate was 56%. The results of surgery if the
      cartilage of the patella was unchanged--as well as with isolated medial or
      lateral chondromalacia--were good. If there was medial and lateral chondromalacia
      the isolated retinaculum-release is insufficient. The rate of postoperative
      complications (effusion, haemorrhage) by arthroscopic surgery technique is with
      11.1% distinctly above the results by the subcutaneous technique, which amounts
      to a mere 3%. The 30 degrees degree-tangential x-ray technique combined with
      external rotation of the lower leg and simultaneous tension of the quadriceps
      gives much better information of the position of the patella than the 30 degrees
      degree x-ray without quadriceps tension.

PMID- 1642039
TI  - [Comments on the use of the "life-table method" in orthopedics].
AB  - In the description of long term results, e.g. of joint replacements, survivorship
      analysis is used increasingly in orthopaedic surgery. The survivorship analysis
      is more useful to describe the frequency of failure rather than global statements
      in percentage. The relative probability of failure for fixed intervals is drawn
      from the number of controlled patients and the frequency of failure. The
      complementary probabilities of success are linked in their temporal sequence thus
      representing the probability of survival at a fixed endpoint. Necessary condition
      for the use of this procedure is the exact definition of moment and manner of
      failure. It is described how to establish survivorship tables.

PMID- 1642040
TI  - [Effect of surgical draping on bacterial contamination in the surgical field].
AB  - Standardized samples were taken from the skin of 100 patients immediately before
      and after their hip operation. 50 patients were operated with and 50 patients
      without use of plastic drapes. The samples were evaluated quantitatively and
      qualitatively by the employment of usual microbiological methods. The statistical
      analysis revealed that at the end of the operations there were a) as many
      microbes on the drape as on the skin where no drape had been used and b) many
      more microbes under the drapes than either on them or on undraped skin. The value
      of the plastic drape as a means of preventing infections has to be doubted.
      Discontinuing the use of plastic drapes seems to be justified.

PMID- 1642041
TI  - [Effect of shock waves on the strength of connection between bone and
      polymethylmethacrylate. An in vitro study of human femur segments].
AB  - The increasing number of revision surgery for failed total arthroplasty including
      the most difficult aspects of cement removal has lead to various developments of
      new instruments and techniques to facilitate this procedure. In this in vitro
      study the effect of extracorporeal shockwaves on the bone-cement interface under
      this view was investigated. At first the pressure reduction of bounding
      shockwaves in their progress through compounds consisting of cortical bone-PMMA
      and cancellous bone-PMMA by means of a needle pressure probe was measured. In the
      second part of the experiments the mechanical and morphological effects of ESW on
      the PMMA-Bone-Interface of human femoral segments was tested. Using bone cement
      cadaveric femoral segments were implanted with stainless steel rods within the
      medullary canal and the PMMA-Bone-interface was treated with ESW. After treatment
      the segments were examined mechanically, radiologically and by microscopy.
      Between the treated and the control group no difference was found which could
      give any a reference to the disruption of the Cement-Bone-Interface caused by
      ESW. However, there were observations which indicated that ESW induces a
      increasing risk of intravasation of bone marrow. Considering these facts ESW
      seems not to be a good clinical adjunct in revision surgery.

PMID- 1642042
TI  - [Induction of sarcoma by resorbable osteosynthesis material in the rat. A
      preliminary report].
AB  - In an experiment testing the resorption of Poly-l-lactate in the back muscles of
      Cara rats a foreign body sarcoma occurred in two rats. 20 months after
      implantation of a body of high molecular weight poly-l-lactate a malignant
      fibrous histiocytoma developed in one rat. A soft tissue tumor, which was
      classified according to the immune-histiochemical analysis as a neurogenic
      sarcoma, developed 23 months after the implantation of a body of injection-casted
      poly-l-lactate of high molecular weight in a second rat.

PMID- 1642043
TI  - [Case report of transcondylar stress fracture of the distal femur in the
      elderly].
AB  - We report the case of a 67-year-old woman with a transcondylar stress fracture of
      the femur. Problems in diagnosis and treatment of elderly patients with stress
      fractures around the knee joint are illustrated.

PMID- 1642044
TI  - [Comments on the contribution: F. Grill and B. Frischhut: "Results of treatment
      of chronic congenital hip dislocation after learning to walk].

PMID- 1642045
TI  - [Surgical indications and technique of persistent and recurrent spontaneous
      pneumothorax].
AB  - The thoracotomy is the most invasive and most effective method for treatment of
      spontaneous pneumothorax. This method is indicated not only for recurrent
      pneumothoraces but also if conservative treatment does not induce expansion of
      lung. The primary operation is indicated absolutely in only some cases
      (spontaneous hemopneumothorax, pneumothorax in pregnancy). Today it is possible
      to operate for relative indications: Surgery has a small rate of complications,
      mortality and relapse (below 1%). The operation removes the causes of
      pneumothorax and protect for relapse of the pneumothorax via pleurodesis with
      mechanical irritation of the pleural surface.

PMID- 1642046
TI  - [Symptom: spontaneous pneumothorax. Indications for drainage therapy?].
AB  - Spontaneous pneumothoraces follow lesions of pleuropulmonary tissues.
      Improvements of diagnostical and therapeutical management seem to change the
      traditional way by using thoracic drainage-systems. What value does drainage
      therapy still have?

PMID- 1642047
TI  - [Thoracoscopic pleurodesis in persistent and recurrent pneumothorax].
AB  - 103 patients with recurrent or persistent pneumothorax have been treated with
      local application of fibrin and talcum by a thoracoscopic procedure. The method
      was successful in 97 patients (94.2%) and lead to a stable and complete
      reexpansion of the lung within 6.3 days. As a direct consequence of the procedure
      itself only a few and minor complications occurred during a mean hospitalization
      time of 10.4 days. The longterm followup over a mean period of 6.4 years revealed
      a recurrence rate of 15%, although half of the episodes occurred early during the
      first three months. After 6 years, 80% of the patients were completely
      asymptomatic and spirometric lung function was restored to normal values. We
      therefore consider thoracoscopic pleurodesis to be a successful and safe method
      for treating complicated pneumothorax.

PMID- 1642049
TI  - [The treatment concept of chylothorax including surgical procedures using fibrin
      glue].

PMID- 1642048
TI  - [Thoracoscopic treatment of spontaneous pneumothorax using fibrin pleurodesis].
AB  - In 33 patients with a recurrent spontaneous pneumothorax, a thoracoscopic
      pleurodesis with fibrin glue was performed under local anesthesia. During an
      average postoperative observation period of 4 years the relapse frequency was 39%
      (13 cases). In these cases thoracotomy was performed and a new relapse of
      pneumothorax occurred in 3 patients (23%): Application of thoracoscopy with
      fibrin glue pleurodesis should only be applied in those patients without large
      emphysema vesicles and without large coalescences. Under these conditions the
      relapse frequency could be reduced to 26%. The thoracoscopic treatment of
      recurrent pneumothorax by using fibrin glue and local anesthesia in well selected
      patients is an alternative procedure to thoracotomy.

PMID- 1642050
TI  - [Morphology and therapy of tracheal cysts].
AB  - Following a short representation of etiology, morphology and classification of
      cysts of trachea the symptoms, diagnosis and therapy were described. 7 cases of
      the own patients material in 27 years are presented extensively.

PMID- 1642051
TI  - [Experiences with surgical therapy of Budd-Chiari syndrome].
AB  - The obstruction of the hepatic venous outflow tract with or without involvement
      of the inferior vena cava results in the Budd-Chiari syndrome (BCS). With its
      very heterogenous etiology and variable epidemiology the rare disease either
      takes a chronic or an acute foudroyant clinical course. In general the prognosis
      is poor. Together with the clinical signs the diagnosis is based on radiological
      measures and the histology of the hepatic parenchyma. The exact etiological
      investigation of the BCS is of great significance. Typical findings are discussed
      and a diagnostic scheme is developed. Between 1979 and 1991, altogether 16
      operations were carried out in 13 patients with a BCS. Predominantly there were
      undertaken a porto-systemic shunt procedure or an orthotopic liver
      transplantation, respectively, in 6 cases each. The need for an always
      individually tailored therapeutic strategy of the BCS is underlined by a case
      history. An overview analyzes the different therapeutic modalities of the BCS and
      their differential indications.

PMID- 1642052
TI  - [Isolated pulmonary coin lesion as an indication of Wegener's granulomatosis].

PMID- 1642053
TI  - [Left-sided diaphragmatic rupture with intrathoracic migration of the ruptured
      spleen. A rare cause of hemothorax].

PMID- 1642054
TI  - [Our surgical heritage. On the history of clinical liver transplantation in
      Germany].

PMID- 1642055
TI  - [Ultrasound biometry of the fetal heart].
AB  - We report on biometric measurements of the fetal heart with the TM-technique;
      these measurements were carried out between the 20th and 40th gestational week.
      The right and left endsystolic atrial and ventricular diameters were, measured,
      as well as the diameters of the large vessels, i.e. aorta and pulmonary artery;
      finally, the septal thickness was determined. Our measurements show a linear
      progression of the diameters in question, the right-left ratio of the atria and
      ventricles was close to one, so was the ratio between aorta and pulmonary artery.
      Our results are compared, as far as possible, to the literature.

PMID- 1642056
TI  - [Ovarian stimulation with clomiphene is not a risk factor for extrauterine
      pregnancy].
AB  - In a retrospective cohort study of 252 patients with ectopic pregnancies the
      possible association between use of clomiphene citrate and the occurrence of an
      ectopic pregnancy was examined. Seventeen out of 252 patients had been treated
      with clomiphene. Epidemiologic data and animal experiments suggest, that there
      may be a role of clomiphene in the etiology of ectopic pregnancy. Marchbanks et
      al. [6] reported that patients who used clomiphene were found to have a relative
      risk of 10.0 for ectopic pregnancy. The analysis of our own data show an
      accumulation of classic risk factors as history of pelvic inflammatory disease or
      of microsurgery for treatment of tubal disease in the clomiphene group. The
      higher rate of ectopic pregnancies in patients who have been treated with
      clomiphene is more likely associated with the diagnosis of infertility than with
      the use of ovulatory-inducing agents. Clomiphene treatment is no independent risk
      factor in the etiology of ectopic pregnancy.

PMID- 1642057
TI  - New criterion of placental barrier maturity.
AB  - In 120 full term pregnancies and 20 premature deliveries number of plates
      thickness of epithelial plate and number of vili in 1 mm2 placenta have been
      determined by histological investigation. These morphometric studies lead to the
      following conclusion: the increase of placental transport ability corresponds
      with fetal age and weight. The ratio between number of plates to their thickness
      is introduced as transportation index. There is a correlation between placental
      morphology and fetal maturity.

PMID- 1642058
TI  - [The antibacterial effectiveness of hexetidine vaginal tablets on pathogen flora
      of the cervix and vagina].

PMID- 1642059
TI  - [Disinfection in gynecologic practice].
AB  - It will be pointed to the necessity of the demand according to a standardize
      sanitary regime which concerns ambulant practicing gynaecologists. A sanitary
      pattern scheme is introduced.

PMID- 1642060
TI  - [Clinical use of photodynamic therapy in gynecologic tumor patients--antibody
      targeted photodynamic laser therapy as a new oncologic treatment procedure].
AB  - The clinical report addresses the first application of a antibody-targeted
      photodynamic laser therapy with Phthalocyanines. Photodynamic therapy (PDT) has
      been proposed as a further treatment modality in oncology. The concept of PDT is
      based on the interaction between a dye which is accumulated in the target and
      laserlight. The phototoxic effect is achieved by the augmentation of oxygen
      radicals. The improvement of the selectivity and the reduction of side-effects is
      achieved by our concept of using an antibody-targeted phthalocyane induced PDT.
      The clinical application of the antibody-targeted Phthalocyanine was performed in
      3 patients suffering from an advanced ovarian carcinoma (FIGO III). By means of
      an ultramicroscopical analysis a selective devitalisation of tumor cells was
      demonstrated. The perspective of PDT reaches far beyond the application for the
      ovarian carcinomas and relates to all tumor types, where the presence of tumor
      associated antigens implicates a treatment in a similar way.

PMID- 1642061
TI  - [Compliance in gynecologic screening and causes for delayed tumor diagnosis in
      East Thuringen].
AB  - The public health service of the former GDR paid special attention to early
      recognition and the registration of malignancies. Due to this efforts the staging
      of cervical cancer moved to more low-staged tumours admitted to our hospital from
      the eastthuringian region. In spite of this around 35% of our patients with
      malignant diseases had stage II or higher staged tumours ad admission. The causes
      for delayed perception were analysed. Campaign-like preventive actions formerly
      supported by factories and public health service will not take place again. The
      responsibility for secondary prevention has to be taken over by practicing
      gynaecologist in cooperation with the general practitioner. A pilot study
      revealed that only 11% of the women followed a written invitation for a
      preventive gynaecological examination. But a general practitioner concerning the
      patients individuality persuaded 75% of his patients letting perform such a check
      up. The family doctors direct advice to consult a gynaecologist is the most
      effective way to get the patients compliance for a preventive examination. The
      epidemiology and results of therapy will become evident by duty of notification
      and central registration of malignancies. Relatively centralized therapy and
      obligatory follow up under the responsibility of the treatment center for about
      five years enhance the therapeutic results. The positive experience of
      gynaecological oncology of the eastern part of the Federal Republic of Germany
      ought to be maintained and should be developed.

PMID- 1642062
TI  - [A case of full term ovarian pregnancy].
AB  - A term ovarian pregnancy with a stillborn infant, weighting 3,100 g is reported.
      The authors believe, that in case of an advanced ectopic pregnancy only the
      extrauterine, but not the precise origin could be diagnosed ultrasonographi-caly.

PMID- 1642063
TI  - [Malignant teratoma of the ovary in childhood and adolescence--a case report].
AB  - This is a report on a 15 year old patient with malignant teratoma grade III of
      the right ovary in stage Ia (FIGO). The adequate treatment of this rare tumors
      which occurs preponderant in children and adolescents supposes an accurate and
      thorough histologic analysis. Our patient was treated initially by unilateral
      oophorectomy followed by an polychemotherapy with Vincristine, Actinomycin D and
      Cyclophosphamide. Regular monitoring of the tumor markers AFP and beta-HCG before
      and after surgery is indispensable to control the development.

PMID- 1642064
TI  - [Our gynecologic history. Karl Schuchardt on the 90th anniversary of his death].
AB  - The surgeon Karl Schuchardt dedicated most of his life to the surgical treatment
      of cervical carcinoma. He improved the surgical access by enlarging the introitus
      with a particular perineotomy bearing his name today. Dr. Schuchard died ninety
      years ago in Stettin.

PMID- 1642065
TI  - Effect of operation theatre environment on laparotomy wound infection in bovines.
AB  - Right flank laparotomies were performed on five clinically healthy cross-bred
      calves. A significant (P less than 0.05) increase of 22.1 and 2.7 times in
      bacterial count in subcutaneous tissue and incised skin edges, respectively, and
      a non-significant increase (1.1 times) in muscles and peritoneum had occurred
      during 15 minutes exposure to the operation theatre environment. Poly
      morphonuclear cells and Gram-positive and Gram-negative bacterial infiltration
      was also demonstrated histopathologically in muscles and peritoneum. Organisms
      isolated from operation theatre air were Staphylococcus aureus, other
      Staphylococcus spp., Bacillus spp., Micrococcus spp., and yeast. Usually similar
      organisms were also found on the laparotomy wound, just before closure of
      abdomen. Operation theatre environment is concluded to be a significant source of
      operative wound contamination. Provision of separate operation theatres for
      different types of surgery in different species is recommended and the necessity
      for their regular disinfection is stressed.

PMID- 1642066
TI  - Electron microscopy of the endometrium of camels in normal and some diseased
      conditions.
AB  - Ultrastructure of the camel's endometrium in normal and diseased conditions, was
      studied using the electron microscope. The samples were obtained from 6 normal
      uteri and 10 uteri with inflammatory lesions. Three ovaries of the latter 10
      uteri showed ovarian cysts. All the animals were non-pregnant. No cyclic changes
      were taken in consideration because the camel is an induced ovulator animal. The
      surface and the glandular epithelium of the normal uteri consisted of one layer
      of tall columnar cells, resting on an undulating membrane. The free borders of
      cells showed microvilli, motile cilia and zeiotic blebs. Desmosomes and gap
      junctions were seen as means of connections between the neighboring cells. The
      nuclei were large, oval and situated in the lower half of the cells. Two types of
      mitochondria were seen. One type was small, rounded and dilated, and the other
      was large and elongated. Many lipid droplets and scanty glycogen granules were
      common findings in the normal cells. Granulated bodies similar to those described
      in the epithelium of the human uterus and containing acid phosphatase were found.
      Many other cytoplasmic organelles and granules were seen. The endometrial stroma
      consisted mainly of stromal cells of irregular shape, and collagen fibres. The
      collagen fibres were present in amounts larger than many other species. In the
      diseased uteri, the changes in the epithelium consisted mainly of hyperplasia of
      the cells and marked increase of all cytoplasmic inclusions and vacuoles. There
      was also marked increase in the number of the crossing lymphocytes through the
      epithelial layer. The collagen fibres of the stroma increased in amount and the
      stromal cells became similar in shape to the fibroblasts. A large number of mast
      cells as well as other types of inflammatory cells infiltrated the stroma. Non
      specific bacterial infections were detected on bacteriological examination of the
      inflamed uteri. Neither bacteria nor other microbial agents could be seen
      ultrastructurally. In an uterus associated with ovarian cysts, the microvilli of
      its epithelium showed marked changes in their shape and length.

PMID- 1642067
TI  - Teat reactions in cows associated with machine milking.
AB  - In the present investigations, referring to conventional milking machines and
      conventional milking technique, teat ends were transversally compressed for a
      short moment by means of a cutimeter before, during and after milking (main
      series), or before and after milking (additional series). The thickness of the
      teat ends between the jaw plates of the instrument decreased during the high flow
      rate phase, increased during the low flow-rate and overmilking phases, and
      started decreasing as soon as milking was finished. The decreased values in the
      beginning of the milking process reflect the thinning of the teat wall following
      the vacuum-induced teat elongation that occurs when the teat cups are attached.
      The subsequent increased values are due to active, i.e., functionally significant
      hyperaemia in the teat wall, especially in the specific teat venous system, and
      locally elevated vascular pressure. Both the thinning and the thickening seem to
      occur within physiologically tolerable limits. The diagnosis, proposed in the
      literature, of teat congestion (passive hyperaemia) and/or oedema involving risks
      of impaired teat and udder health has no support in our investigations.

PMID- 1642068
TI  - [Histological studies of a tongue-shaped formation at the intertubercular groove
      in the shoulder joint of the dog].
AB  - Radiologically apparent unilateral changes at the intertubercular groove of the
      humerus were investigated histologically in three dogs and compared with the
      findings in an unaltered shoulder joint of a dog. Polymethylmethacrylate
      embedded, undecalcified sections were cut through the sulcus area at the head of
      humerus and through the biceps tendon, its synovial sheet and the transverse
      ligament, and were evaluated by light microscopy. While the tendon and soft
      tissue features were for the most part typical for a normal "gliding" tendon, the
      respective groove exhibited an again groove-like, 10-12 mm wide and up to 2 mm
      high exostosis consisting mainly of lamellar bone, filled with hemopoietic and
      fatty marrow. The normal fibrocartilaginous lining of the groove showed
      degenerative arthrotic changes in the altered grooves, pointing to mechanical
      overloading. The possible mechanisms of these ossifications are discussed.

PMID- 1642069
TI  - Inhibition of food intake and reticulo-rumen motility of sheep by the alpha-2
      adrenoreceptor agonist clonidine.
AB  - The investigation of the effect of intravenous clonidine, an alpha-2
      adrenoreceptor agonist, was carried out in sheep with recording of forestomach
      motility for 3 h and intake of chopped hay for 8 h after drug administration.
      Motility and food intake were inhibited by clonidine at 2 micrograms.kg-1 and at
      5 micrograms.kg-1. The effects of the lower dose were prevented by idazoxan, an
      alpha-2 antagonist, at 0.1 mg.kg-1 but not by prazosin, an alpha-1 antagonist, at
      0.1 mg.kg-1. Minor effects of the antagonists alone were noted. Blood glucose
      concentration was measured in all the experiments and the possibility discussed
      that changes in concentration, not absolute values, may have contributed to
      inhibitory effects. Vagal stimulation in anaesthetised sheep indicated that
      inhibition of motility was a central neural effect, not an effect on forestomach
      muscle.

PMID- 1642070
TI  - Selenium content and distribution in bovine and human milk from different regions
      of Poland.
AB  - Human milk and bulk cow's milk samples from 3 different areas of central Poland
      were analyzed for their Se content. Cow's milk specimens were also analyzed for
      Se distribution and GSH-Px activity. Mature human milk contained 34-68% more Se
      than bulk cow's milk obtained from analogous areas of central Poland. Comparison
      of literature values suggest, that human and cow's milk from vicinity of Warsaw
      and Piotrkow Trubunalski were Se-adequate but milk from Siedlce area was Se
      deficient. Glutathione peroxidase activity accounted for 25-31% of the total
      peroxidase activity of cow's milk. The majority of the Se was found in the whey
      fraction. It was suggested that the participation of the casein fraction in total
      milk selenium increased faster than milk Se content. Cow's milk obtained near
      Warsaw had a 2-times higher concentration of Se than in milk from Siedlce but the
      content of this microelement in the casein fraction (pellet) was 3-times higher.

PMID- 1642071
TI  - Avian paramyxovirus serotype 1 (Newcastle disease virus)--infections in falcons.
AB  - From eight falcons and one pigeon which died from NDV over a period of 15 months
      in Dubai, United Arab Emirates, PMV-1 viruses were isolated on quail embryo cell
      cultures. The identification of all 9 strains were achieved with the
      haemagglutination inhibition test against polyclonal chicken PMV-1 antiserum,
      against mouse monoclonal antibodies as well as with the immunoperoxidase test.
      Intracerebral pathogenicity index and intravenous pathogenicity index tests were
      also carried out. Although the virus isolates in this study fell into two
      distinct groups, the overall clinical symptoms displayed by the falcons tailed to
      demonstrate any trends or specificity unique to a group. The isolate obtained
      from a pigeon was similar to the isolates from one group of the falcons and
      showed no identity with the pigeon variant virus.

PMID- 1642072
TI  - Immunoglobulins, lysozyme and lactoferrin in the teat and udder of the dry cow
      during endotoxin-induced inflammation.
AB  - Immunoglobulins (Ig) and antibacterial proteins like lysozyme and lactoferrin are
      components of the humoral defence against infections. Changes in Ig, lysozyme and
      lactoferrin concentrations during endotoxin-induced inflammation in the test
      cistern and udder quarter of the dry cow were studied. Surgical closure of the
      passage between teat and udder cisterns enabled studies of reactions in the teat
      cistern without interference of the mammary gland. After endotoxin infusion,
      IgG1, IgG2, lysozyme, and to some extent IgM, increased in the teats and udder
      quarters, and were positively correlated with changes in somatic cell counts. No
      significant changes were observed in IgA or lactoferrin. The origin and
      significance of Ig, lysozyme and lactoferrin in the bovine teat and udder are
      discussed. Ig probably originated both from serum and from local plasma cells,
      while leukocytes appeared to be the source of lysozyme during inflammation.
      Secretory epithelium appeared to be the source of lactoferrin. Support for this
      theory was the almost total absence of lactoferrin in teat cistern samples.

PMID- 1642073
TI  - Comparison of Campylobacter carriage rates in diarrheic and healthy pet animals.
AB  - To explore the clinical significance of campylobacter infections for dogs and
      cats we compared intestinal carriage rates for Campylobacter sp. between animals
      with gastroenteritis and healthy controls. We cultured fecal specimens of 405
      diarrheic dogs and 203 cats as well as 71 asymptomatic dogs and 35 cats using a
      selective medium in addition to filtration on a non-selective blood agar plate.
      We identified 224 campylobacter isolates using conventional phenotypic tests and
      DNA hybridization. There were 112 isolates, of C. upsaliensis, 43 C. jejuni and
      69 other Campylobacter sp. For cats, there was no association between
      campylobacter carriage and disease, irrespective of the animals age. For dogs
      older than 12 months there was also no difference in campylobacter carriage rates
      between diarrheic and healthy animals. However, in younger dogs 44% of animals
      with diarrhea shed campylobacters in their feces, more than twice the rate in
      asymptomatic controls (21%), a significant difference. C. jejuni and C.
      upsaliensis contributed equally to this association between diarrhea and
      campylobacter prevalence. The parallel use of two culture methods enabled us to
      show that the recovery of Campylobacter sp. by filtration may be less than
      optimal and that filtering is probably unsuitable as a reference method for
      culturing C. upsaliensis. Finally we found that almost half of the campylobacter
      isolates from cats belong to a phenotypically homogeneous group of strains
      closely resembling C. upsaliensis but hybridizing only weakly with C. upsaliensis
      DNA.

PMID- 1642074
TI  - Microbiological study of foot-rot in lambs: isolation, elastolytic activity and
      antimicrobial susceptibility.
AB  - A microbiological study was made of an outbreak of foot-rot in lambs. Elastolytic
      activity was detected in all 10 Bacteroides nodosus strains isolated from the
      hooves of 9 affected animals. Among 14 other isolated strictly anaerobic
      microorganisms belonging to different species or genera only 4 strains showed a
      low degree of elastolysis. The 14 antimicrobial agents studied effectively
      inhibited "in vitro" growth of B. nodosus.

PMID- 1642075
TI  - Diagnostic value of gastrin for clinical bovine ostertagiosis.
AB  - Gastrin values were evaluated in 130 parasite naive calves, in 61 first season
      grazing calves during six field trials and in 8 experimentally infected adult
      immune cows. The gastrin values were linked to pepsinogen levels and daily weight
      gain. Also the influence of an anthelmintic treatment on pepsinogen and gastrin
      values was assessed during a clinical outbreak of ostertagiosis in a group of
      first season grazing calves. Mean gastrin levels in parasite naive calves were
      106 pg/ml. Results show that a group mean of 400 pg/ml gastrin in first season
      grazing calves indicates a reduced daily weight gain but with no obvious clinical
      signs. During clinical outbreaks mean gastrin levels frequently reached 1,000
      pg/ml with a severe weight loss and a mean pepsinogen level of 5,000 mU tyr. The
      serum gastrin concentration was strongly reduced 4 days post treatment. No
      gastrin response was noted following an Ostertagia challenge in adult immune
      cows. The value of gastrin as a diagnostic aid for ostertagiosis is discussed in
      relation to pepsinogen, the adult worm burden, larval inhibition and the
      technique involved in assessing gastrin.

PMID- 1642076
TI  - A spontaneous Yersinia pseudotuberculosis-infection in a monkey-colony.
AB  - A spontaneous Yersinia pseudotuberculosis (Y.p.) infection in one African Green
      Monkey (Cercopithecus aethiops), and nine Squirrel Monkeys (Saimiri sciureus), is
      reported. The clinical findings, laboratory results and pathological findings are
      presented. The digestive system was the most affected organ in the acute phase of
      the Y.p. infection, while in the subacute and chronic phases, the alterations of
      the lymphatic tissues, spleen or liver were severe.

PMID- 1642077
TI  - [Infections with original cowpox virus and cowpox-like agents in humans and
      animals: a literature review].
AB  - In an evaluation of literature the biological, physical-chemical and antigenic
      characteristics of cowpoxviruses and cowpox-like agents are presented, the
      according diseases following a natural and experimental infection are described
      and their epizootiological and epidemiological aspects discussed.

PMID- 1642078
TI  - Detection of rabies antibody by ELISA and RFFIT in unvaccinated dogs and in the
      endangered Simien jackal (Canis simensis) of Ethiopia.
AB  - Varying levels of rabies antibody have been detected both by Enzyme Linked
      Immunosorbent Assay (ELISA) and Rapid Fluorescent Focus Inhibition Test (RFFIT)
      in the sera collected from wild and domestic canids in the Bale Mountains
      National Park (BMNP) of Southern Ethiopia. Rabies antibody was detected in 80% (8
      out of 10) of domestic dog samples, 13.3% (2 out of 15) of Simien jackal samples
      and in one common jackal. Rabies virus was isolated from one dog in an area where
      contact with the Simien jackal could possibly occur. All samples examined from
      wild rodents as possible reservoir hosts for rabies were found negative. The
      presence of large proportion of susceptible Simien jackals in the population
      should be a cause of great concern in saving this endangered species from the
      ravages of rabies.

PMID- 1642079
TI  - C-peptide profiles in patients with non-insulin-dependent diabetes mellitus
      before and during insulin treatment.
AB  - The objective of the study was to evaluate the effect of insulin treatment on
      insulin secretion in patients with non-insulin-dependent diabetes mellitus
      (NIDDM). Ten patients with NIDDM were first investigated while still taking oral
      hypoglycemic agents, and then randomized to a crossover study with two eight-week
      periods of insulin treatment (oral treatment having been stopped) given either as
      mainly intermediate-acting insulin twice daily (2-dose) or as preprandial regular
      insulin and intermediate-acting insulin at bedtime (4-dose). In the patients
      treated with oral agents the 24-h C-peptide area under the curve was similar to
      that in the controls, but the profile was different with a rise at breakfast but
      with almost absent meal peaks during the rest of the day. Insulin treatment
      improved glycemic control markedly, lowered urinary C-peptide excretion and the
      serum C-peptide concentrations being reduced by more than 50%. The shape of the C
      peptide profiles was unaltered and there were no significant differences between
      the two insulin regimens. The decrease in serum C-peptide concentration during
      insulin treatment correlated with the change in blood glucose. Fasting serum C
      peptide concentrations correlated closely with the 24-h C-peptide area under the
      curve. In conclusion, insulin treatment of NIDDM patients with secondary failure
      to oral agents greatly reduces the insulin secretion, probably owing to the
      reduction in blood glucose.

PMID- 1642080
TI  - Urinary excretion of 19-noraldosterone, 18, 19-dihydroxycorticosterone and 18
      hydroxy-19-norcorticosterone in patients with aldosterone-producing adenoma or
      idiopathic hyperaldosteronism.
AB  - Urinary excretion of 19-noraldosterone, 18. 19-dihydroxycorticosterone (18,
      19(OH)2-B), 18-hydroxy-19-norcorticosterone (18-OH-19-nor-B), 18
      hydroxycorticosterone (18-OH-B), 18-hydroxycortisol (18-OH-F) and aldosterone
      were measured in 25 patients with primary aldosteronism, 16 with an aldosterone
      producing adenoma and 9 with idiopathic hyperaldosteronism. In patients with
      idiopathic hyperaldosteronism, urinary 19-noraldosterone (207 +/- 51 pmol/day),
      18, 19(OH)2-B (21 +/- 4.2 nmol/day) and 18-OH-19-nor-B (879 +/- 213 pmol/day)
      levels were lower but not significantly different from 19-noraldosterone (263 +/-
      56 pmol/day), 18, 19(OH)2-B (40 +/- 8.7 nmol/day) and 18-OH-19-nor-B (1322 +/-
      267 pmol/day) seen in patients with aldosterone-producing adenoma. Urinary
      aldosterone did not differ significantly between patients with idiopathic
      hyperaldosteronism and those with aldosterone-producing adenoma. Both urinary 18
      OH-B and 18-OH-F excretion were significantly higher in aldosterone-producing
      adenoma (39 +/- 5.2 nmol/day, 1660 +/- 318 nmol/day, respectively) compared with
      patients with idiopathic hyperaldosteronism (19 +/- 3.3 nmol/day, 541 +/- 93
      nmol/day, respectively) (p less than 0.05). Though urinary 18-OH-F and 18-OH-B
      concentrations were useful markers, the mineralocorticoid steroids which we can
      only now measure, 19-noraldosterone, 18, 19(OH)2-B and 18-OH-19-nor-B, could not
      be used to distinguish the two subsets of primary aldosteronism.

PMID- 1642081
TI  - Cabergoline in the long-term therapy of hyperprolactinemic disorders.
AB  - The efficacy and safety of the new long-acting dopamine agonist cabergoline were
      evaluated in 127 hyperprolactinemic patients (124F and 3M; 71 with
      microprolactinoma, 14 with macroprolactinoma, 5 with operated macroprolactinoma
      and 37 with idiopathic disorder) who were treated with the drug for from 3 to 52
      months (median, 14 months). Cabergoline was administered orally at dose levels
      ranging between 0.2 and 3.5 mg per week, given once weekly in 92 patients, twice
      weekly in 22, thrice weekly in 9 and daily in 4. Serum prolactin and progesterone
      levels, hematology, blood chemistry and electrocardiograms were frequently
      evaluated throughout treatment. CT or MR imaging of the pituitary was repeated
      during treatment in patients with macroprolactinoma and in 38 with
      microprolactinoma. After drug discontinuation, serum prolactin and gonadal
      function were evaluated monthly for three months in 65 patients and for up to two
      years in 12. Serum prolactin levels were normalized in 114 patients (90%). Of 56
      women with amenorrhea, 52 resumed menses (with presumptive evidence of ovulation
      in 49); 17 women became pregnant; and sexual potency was restored in the 3 men.
      Evidence of tumor shrinkage was obtained in 13 of the 14 patients with
      macroprolactinoma and in 28 of 38 with microprolactinoma; complete disappearance
      of the tumor image was achieved in 2 macro and 14 microprolactinomas. A total of
      48 adverse events was reported by 29 patients (23%), almost all typical of the
      pharmacological class and mild to moderate; no patient withdrew from treatment
      due to adverse events. Safety parameters did not change. Following cabergoline
      discontinuation, prolactin levels increased slowly, being still markedly lower
      than pretreatment values after three months; 10 patients out of 32 had
      persistently normal prolactin levels during one year of follow-up.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642082
TI  - Development of Graves' disease after subacute thyroiditis: two unusual cases.
AB  - This report describes two unusual cases of subacute thyroiditis from which
      Graves' disease with hyperthyroidism developed seven to eight years after
      complete recovery. The first case is a 45-year-old woman who developed
      hyperthyroidism seven years after recovering from subacute thyroiditis. This
      patient had a genetic predisposition to both subacute thyroiditis HLA-BW35 and
      Graves' disease (HLA-BW46). The second case is a 60-year-old woman who developed
      hyperthyroidism eight years after the episode of subacute thyroiditis; her HLA
      showed neither BW 35 nor BW 46. It has been reported that if hyperthyroidism is
      to develop following subacute thyroiditis it occurs within one year. Our
      observation indicates that it may occur seven or eight years later.

PMID- 1642083
TI  - A normal ovulatory woman with hyperprolactinemia: presence of anti-prolactin
      autoantibody and the regulation of prolactin secretion.
AB  - We present the case of a normal ovulatory woman with marked hyperprolactinemia
      and no evidence of a pituitary adenoma on CT and MRI. Gel filtration studies
      showed that most immunoreactive PRL was eluted as 150K-170K macroprolactin. Anti
      PRL autoantibody was detected and Scatchard analysis revealed a low-affinity (the
      association constant: 1.29 x 10(7) l/mol), high-capacity (the maximal binding
      capacity: 1174 micrograms/l) antibody. Dopamine had little suppressive effect on
      PRL levels and an antidopaminergic agent elicited an augmented response of PRL
      secretion. These results suggest that the presence of anti-PRL autoantibody may
      delay the clearance of PRL and/or may alter the central regulation of PRL
      secretion.

PMID- 1642084
TI  - Presence of aldosterone-like immunoreactivity in cerebrospinal fluid in
      normotensive subjects.
AB  - Accumulating evidence, including a wide distribution of specific receptors for
      aldosterone in the brain, has revealed a potential role of aldosterone in the
      central nervous system. However, whether or not aldosterone is present in
      cerebrospinal fluid remains unclear. We attempted to detect aldosterone in
      cerebrospinal fluid in 14 normotensive subjects. Cerebrospinal fluid was obtained
      by lumbar puncture. Aldosterone-like immunoreactivity was detected in
      cerebrospinal fluid (163 +/- 5 pmol/l, range 139-211 pmol/l) and was found to
      significantly correlate to both plasma aldosterone (r = 0.70, p less than 0.01)
      and plasma renin activity (r = 0.68, p less than 0.01). However, no significant
      relationship was found between aldosterone-like immunoreactivity in cerebrospinal
      fluid and the level of sodium or potassium in cerebrospinal fluid or mean blood
      pressure. Although we confirmed the presence of aldosterone-like immunoreactivity
      in cerebrospinal fluid of normotensive subjects, the physiological role of
      aldosterone in cerebrospinal fluid has yet to be elucidated. Further study will
      thus be needed to determine the role of cerebrospinal fluid aldosterone.

PMID- 1642086
TI  - Effect of testosterone on bone mineralization of the hypophosphataemic rat.
AB  - Clinical observations in patients with X-linked hypophosphataemic rickets, that
      bone changes can be corrected during puberty, suggest that androgen can
      participate actively in the process of bone mineralization. In the present study
      we investigated the role of testosterone on the bone mineralization of male rats
      placed on a low phosphorus and vitamin D diet and kept in complete darkness after
      weaning. After 15 days the animals presented hypophosphataemia, rickets and
      osteomalacia, as assessed by histomorphometry of the tibia and seventh caudal
      vertebra calcification fronts respectively. Testosterone propionate
      administration for five days, while the animals were kept on the same
      rachitogenic diet, induced an improvement in the bone mineralization process of
      the hypophosphataemic rat independently of serum phosphate levels. Testosterone
      treated rats were cured of rickets but not of osteomalacia, despite the reduction
      in osteoid seam area.

PMID- 1642085
TI  - Regulation of parathyroid hormone release in normal and pathological parathyroid
      cells exposed to modulators of protein kinase C.
AB  - Effects of the protein kinase C activating phorbol ester 12-O-tetradecanoyl
      phorbol 13-acetate and the inhibitor 1-(5-isoquinolinyl-sulfonyl)-2
      methylpiperazine (H-7) on parathyroid hormone (PTH) release were studied in
      normal bovine and pathological human parathyroid cells. An increase of
      extracellular Ca2+ from 0.5 to 3.0 mmol/l inhibited PTH release by 60% in the
      bovine cells with half maximal effect (ED50) at 1.31 mmol/l. This inhibition
      reached less than 50% in the cells from patients with primary and uremic
      hyperparathyroidism, and the ED50 values were 1.49 and 1.42 mmol/l, respectively.
      The phorbol ester (0.1 mumol/l) made secretion insensitive to changes of
      extracellular Ca2+, an action counteracted by H-7 (50 mumol/l) in the bovine
      cells, whereas H-7 alone had no effects. The phorbol ester and H-7 had opposite
      actions on regulation of PTH release also from cells from patients with
      hyperparathyroidism. However, in pathological cells H-7 alone improved Ca2+
      inhibition of secretion by stimulating release in low Ca2+ concentrations and
      decreasing the ED50 values. The magnitude of changes in ED50 values by H-7
      increased with the severity of the secretory disturbance of the pathological
      cells. The results indicate that increased protein kinase C activity may be a
      factor of importance in the pathophysiology of hyperparathyroidism.

PMID- 1642087
TI  - The effects of goitrogenesis, involution, and goitrogenic rechallenge on the
      clonogenic cell content of the rat thyroid.
AB  - A fraction of enzymatically monodispersed rat thyrocytes from untreated animals
      clonally proliferate into thyroid follicular units following transplantation into
      the subcutaneous fat pads of syngeneic recipients. During the induction of
      experimental goiters in rats either with 3-amino-1,2,4-triazole/iodine sufficient
      diet or KClO4/Remington low iodine diet, the clonogenic fractions of cells from
      aminotriazole goiters decreased to 1.9 x 10(-4) and KClO4 goiters to 9.8 x 10(-5)
      as compared to 5.8 x 10(-3) for cells from age-matched controls during the growth
      phase of goitrogenesis. With continued aminotriazole treatment after thyroid
      hyperplasia had ceased, the clonogenic fraction increased to 2.0 x 10(-3) while
      continued KClO4 treatment had little further effect. The changes in the
      clonogenic fraction induced by both regimens were reversed during involution;
      goitrogenic rechallenge of involuted glands led to changes in the clonogenic
      fraction similar to that noted during the initial challenge. The clonogenic
      fractions of cells from aminotriazole goiters were greater than that of cells
      from KClO4 goiters at all time points examined despite similar TSH levels in
      situ. We conclude that the rat thyroid contains a hierarchy of cells with
      different proliferative capacities and that the clonogenic thyrocytes possess
      many of the attributes of a stem-cell.

PMID- 1642088
TI  - Recombinant human growth hormone stimulates B cell immunoglobulin synthesis and
      proliferation in serum-free medium.
AB  - In order to investigate the effects of growth hormone on human B cells, we
      studied immunoglobulin synthesis and [3H]-thymidine uptake by B cell lines, IM-9,
      GM-1056 and CBL, and purified tonsil B cells. Cells were cultured in a serum- and
      albumin-free medium, Cosmedium-001 to exclude interaction between a certain
      growth-promoting substance and any unknown substances that serum may contain. GH
      enhanced IgG synthesis and [3H]-thymidine uptake by IM-9 cells, IgA synthesis by
      GM-1056 cells and IgM synthesis by CBL cells in a dose-dependent fashion. This
      was not a non-specific effect of protein in GH, since equivalent or higher
      concentrations of proteins such as bovine serum albumin, interleukin-2,
      interleukin-5, granulocyte/macrophage colony-stimulating factor, or
      erythropoietin did not stimulate B cell lines. Moreover, the rabbit anti-GH
      antibody blocked the enhancing effect of GH, while normal rabbit antibody failed
      to do so. GH also enhanced immunoglobulin synthesis (IgG and IgM) and thymidine
      uptake by Staphylococcus aureus Cowan strain I-activated tonsil B cells. These
      results indicate that GH has a direct stimulating effect on B cells, and, in
      addition to its endocrinological function, GH may also act as an immunoregulatory
      cytokine.

PMID- 1642089
TI  - Ovarian and circulating levels of oxytocin and arginine vasopressin during the
      estrous cycle in the rat.
AB  - Ovarian extracts of Long-Evans rats separated using high performance liquid
      chromatography (HPLC) were measured by radioimmunoassays (RIAs) for the presence
      of oxytocin and arginine vasopressin (AVP). The results showed that the ovary
      contains both, and that they are indistinguishable from the respective standard
      synthetic peptides. During the estrous cycle, the ovarian content of oxytocin was
      10-fold higher (p less than 0.01) in estrus than in the other phases, while AVP
      was 16- and 25-fold higher (p less than 0.01) in metestrus than in the other
      phases. In contrast, the plasma levels of oxytocin showed no significant
      difference among the various phases of the estrous cycle. However, the plasma
      level of AVP level was significantly higher (p less than 0.01) in diestrus than
      in other phases. The present study thus strongly supports the hypothesis that
      both oxytocin and AVP can be produced by the ovary itself in the rat. The
      possible roles of oxytocin and AVP in the reproductive cycle are discussed.

PMID- 1642090
TI  - Effect of growth factors on hyaluronan and proteoglycan synthesis by retroocular
      tissue fibroblasts of Graves' ophthalmopathy in culture.
AB  - One of the pathological changes seen in Graves' ophthalmopathy is the deposition
      of glycosaminoglycans such as hyaluronan and proteoglycan in retroocular
      connective tissue. We analyzed glycosaminoglycans synthesized by retroocular
      tissue fibroblasts in culture derived from an individual not suffering from
      thyroid disease and from three patients with Graves' ophthalmopathy. Retroocular
      tissue fibroblasts synthesized both hyaluronan and proteoglycan, the latter
      composed mainly of chondroitin sulfate. This contrasts with the proteoglycan
      synthesized by adult skin fibroblasts which was composed of dermatan sulfate and
      heparan sulfate proteoglycan. Chondroitin sulfate proteoglycan secreted by
      retroocular tissue fibroblasts consisted of large and small chondroitin sulfate
      proteoglycans (CS-PG), their size being determined by the Sepharose CL-6B column.
      The effects of IGF-1 and PDGF on hyaluronan and proteoglycan synthesis were
      studied separately and in combination. Both IGF-1 and PDGF increased the
      synthesis of hyaluronan and proteoglycan in a dose-dependent manner. IGF-1
      predominantly stimulated secretion of small CS-PG, while PDGF increased large CS
      PG markedly when studied in retroocular tissue fibroblasts. In contrast, IGF-1
      stimulated secretion of small proteoglycan while PDGF had little effect on
      proteoglycan synthesis in skin fibroblasts. Thus, glycosaminoglycan synthesized
      by retroocular tissue fibroblasts has a unique composition and each component is
      regulated independently, at least in part.

PMID- 1642091
TI  - Prognostic relevance of morphological classification in multiple myeloma.
AB  - One hundred and twenty-two patients with multiple myeloma were classified as
      mature, intermediate, immature, or plasmablastic subtype according to Greipp's
      criteria. Contrary to Greipp's report, the survival time of plasmablastic myeloma
      was not significantly shorter than other subtypes, nor was the plasmablastic
      subtype identified as a poor prognostic factor. The survival time of mature plus
      intermediate myeloma was significantly longer than that of immature plus
      plasmablastic myeloma. Between the former and latter, significant differences
      were found for sex, clinical stage, thrombocytopenia, bone marrow plasmacytosis,
      renal insufficiency, bone destruction, and response rate to treatment. Therefore,
      it was suspected that the immature and plasmablastic subtypes were unfavorable
      prognostic factors in patients with multiple myeloma.

PMID- 1642092
TI  - Recurrence of Hodgkin's disease after 10 years: observation of 5 cases.
AB  - Five patients whose Hodgkin's disease recurred 10 years or more after the
      achievement of complete remission are reported. Four out of 5 patients had shown
      an advanced stage at the onset of disease and therefore had received combination
      chemotherapy (ABVD or MOPP-like) as primary treatment. Involved-field irradiation
      was delivered as consolidation therapy in 1 patient only. All pathologically
      proven relapses occurred in a previously affected area and the histologic subtype
      differed from the primary subtype. The time interval between the achievement of
      the first complete remission and the relapse was 120, 170 and 190 months in 3, 1,
      and 1 patient, respectively. All 5 patients are alive in second complete
      remission. This paper emphasizes the risk of late relapse even after a prolonged
      disease-free interval for patients with Hodgkin's disease. Close follow-up is
      therefore recommended also in this clinical setting.

PMID- 1642093
TI  - Normal fluctuations of leucocyte counts and the response to infection in benign
      familial leucopenia.
AB  - In a long-term follow-up of 47 Yemenite patients with benign familial leucopenia,
      the mean white-cell count was 4,578 with a standard deviation of 940. During
      bacterial infections, the average leucocyte increment was the same in leucopenic
      as in non-leucopenic subjects, leading to total leucocyte counts in the normal
      range in previously leucopenic subjects. The marked degree of variability makes
      clinical interpretation difficult when leucocyte counts are found between levels
      standardised as normal in sick patients previously known to be leucopenic.

PMID- 1642095
TI  - HbH disease associated with the (--MED) deletion in a Brazilian black woman.
AB  - Clinical, laboratory features and restriction enzyme DNA analysis are reported
      for a black Brazilian woman with HbH disease. The patient presented a thalassemic
      blood picture with HbH and Hb Bart's. Gene mapping demonstrated the compound
      heterozygous state for the --MED and -alpha 3.7 deletions.

PMID- 1642094
TI  - Identification of GATA-1 and NF-E2 binding sites in the flanking regions of the
      human alpha-globin genes.
AB  - Some of the elements involved in the erythroid-specific transcriptional
      regulation of the human gamma- and beta-globin genes and located inside or in the
      immediate proximity of these genes have been identified as sequences which bind
      erythroid-specific factors. In the present study, we found two regions located
      within 1 kb in 5' to the alpha 2- and in 3' to the alpha 1-globin genes which
      contribute to the induction of human alpha-globin genes following erythroid
      differentiation in stable MEL transformants. By DNAse I footprinting and gel
      mobility shift assays, we identified several GATA-1 and one AP-1/NF-E2-binding
      sites located inside these regions. These results strengthen the idea that, like
      for all other globin genes, flanking regions contribute in vivo to the regulation
      of human alpha-globin gene expression.

PMID- 1642096
TI  - Treatment of methimazole-induced severe aplastic anemia with recombinant human
      granulocyte-monocyte colony-stimulating factor and glucocorticosteroids.
AB  - The in vivo response to recombinant human granulocyte-monocyte colony-stimulating
      factor (rHu GM-CSF) in facilitating the reconstitution of granulomonopoiesis was
      evaluated in a patient with Graves' disease who developed severe aplastic anemia
      during methimazole therapy. After 10 days of treatment with rHu GM-CSF, the
      neutrophil and monocyte counts rose to 1.65 x 10(9)/l and 0.41 x 10(9)/l,
      respectively. However, the patient was still dependent on erythrocyte and
      platelet transfusions. Two days after rHu GM-CSF withdrawal, the neutrophil count
      dropped off to 0.41 x 10(9)/l.rHu GM-CSF was reinitiated for 2 days along with
      glucocorticosteroids. With this combined therapeutic approach, the neutrophil
      count returned to normal and remained stable, and both Hb and platelet values
      began to improve. It is concluded that the combination of rHu GM-CSF and
      glucocorticosteroids can be used as a therapeutic option that may lead to
      beneficial results in drug-induced aplastic anemia.

PMID- 1642098
TI  - Central nervous system involvement in prolymphocytic transformation of chronic
      lymphocytic leukemia.

PMID- 1642099
TI  - A case of adult T cell leukemia complicated by monoclonal gammopathy in the
      course of chemotherapy.

PMID- 1642097
TI  - Neonatal alloimmune thrombocytopenia due to HLA-A2 antibody.
AB  - A male, full-term baby with thrombocytopenia was born by a G3P2A1 mother who was
      not associated with autoimmune disease. Platelet antibody screening was positive
      by using lymphocytotoxicity test, platelet suspension immunofluorescence test and
      solid-phase red cell adherence test. The identified HLA antibody was of A2
      specificity. It was confirmed by testing the mother's and the baby's sera against
      the lymphocytes and platelets of 10 HLA-A2-positive donors. The possibility of
      platelet-specific antibody as the cause of neonatal alloimmune thrombocytopenia
      was ruled out by testing against platelets of 10 HLA-A2-negative donors and the
      known platelet-specific antigens utilizing immobilized, purified platelet
      glycoprotein as targets. The mother's serum reacted strongly with both the
      father's and the baby's platelets and lymphocytes. This neonatal thrombocytopenia
      was most likely due to the maternal HLA antibody, which was induced by her
      antecedent gestations.

PMID- 1642100
TI  - Chemotherapy-induced neutrophilic eccrine hidradenitis in acute myeloid leukemia.

PMID- 1642101
TI  - [Histochemical light and electron microscopic investigations on an eosinophilic
      granuloma].
AB  - An eosinophilic granuloma has been investigated by means of histochemical proofs
      for enzymes and tissue elements and common staining methods. The best method was
      be found the proof for the enzyme phenol oxidase (EC 1.14.18.1). In this way it
      is possible to determine eosinophils rapidly and surely and to receive an
      overview on the frequency and distribution of these cells. The histiocytic-like
      cells was identified electron microscopical as Langerhans' cells. This cells are
      in narrow contact to many eosinophilic granulocytes. Their granula have manifold
      changes in their structure. The granula are possibly able to produce new
      structures of the cell. The eosinophilic granuloma correspond to a cell mediating
      immunological defence reaction approximate to the type of a delayed
      hypersensitivity.

PMID- 1642102
TI  - Histochemical detection of sugar residues in chick embryo developing lingual
      glands with horseradish-peroxidase conjugated lectins.
AB  - Tongue anlage were taken in chick embryos from the 7th to the 21st d of
      incubation and in 3 d old chicken. A battery of 7 different horseradish
      peroxidase-conjugated lectins (PNA, ConA, DBA, SBA, LTA, WGA, UEA I) was used to
      study the carbohydrate residues of glycoconjugates at the epithelial cells of the
      anterior and posterior lingual glands. Some sugar residues, detected at the
      surface of the epithelial cells in early developmental stages of glandular
      primordia, seemed to play a role in inducing and regulating the first
      differentiative steps of the glands. Differences in type, amount, time of
      appearance and cellular localization between the 2 groups of glands were
      detected. The group of the anterior lingual glands, adjacent to the entoglossal
      cartilage (paraentoglossal glands), showed some peculiar histochemical
      characteristics.

PMID- 1642103
TI  - [Histochemical investigations on the localization of acetylcholinesterase in the
      kidney of selected vertebrates].
AB  - The light and electron microscopical localization of AChE activity in the kidney
      of selected vertebrates was studied using the method of Karnovsky and Roots
      (1964) for light microscopy and the modification of the Koelle and Friedenwald's
      technique according to Tsuji (1974, 1984) for electron microscopy. AChE activity
      could be demonstrated light microscopically mainly within the glomeruli of some
      mammals (golden hamster, mouse, rat) and non-mammalian vertebrates (carp, frog).
      No activity was found in the glomeruli of guinea pig, of chicken and tortoise. In
      the mammalians, the strongest AChE activity could be demonstrated in the guinea
      pig, the lowest in the rat. A strong AChE enzyme activity was also detected
      within the interlobular arteries and the cells of Bowman's capsule. With the
      electron microscopical method AChE activity was demonstrated in mesangial cells
      and endothelial cells of the glomeruli (golden hamster and carp) and in the cells
      of Bowman's capsule (carp). Reaction product was localized within the cisterns of
      endoplasmic reticulum and the perinuclear space (nuclear envelope). A high amount
      of electron opaque material could be observed in the cells of Bowman's capsule
      and their lamina basalis. The functional significance of the localization of AChE
      activity in the glomeruli will be discussed.

PMID- 1642104
TI  - [Histochemical and immunohistochemical investigations of the perivascular nerves
      in rat colonic mucosa].
AB  - Using histo- and immunohistochemical methods and conventional transmission
      electron microscopy (TEM), perivascular nerves of the rat colonic mucosa were
      investigated. We found that the nerve endings and varicosities operate with
      various transmitter substances. The morphological findings show that cholinergic
      and peptidergic nerves are localized around all kinds of terminal
      microcirculation vessels, while noradrenergic nerves are encountered only near
      arterioles and venules.

PMID- 1642106
TI  - Pitfalls in the histochemical demonstration of alpha-glucan phosphorylase
      activity in glycogen-depleted skeletal muscle fibres.
AB  - In the present communication, an investigation is described into the reliability
      of histochemical methods for the demonstration of alpha-glucan phosphorylase
      activity in glycogen-depleted skeletal muscle fibres. Human skeletal muscles with
      glycogen-depleted fibres from patients with diseases of the neuromuscular system
      and from subjects who had suffered from malignant hyperthermia were used for the
      study. The location of phosphorylase activity and glycogen was demonstrated with
      histochemical techniques. Biochemical techniques were used to assay the activity
      of phosphorylase and the content of glycogen. Biochemical determinations of
      phosphorylase activity did frequently not reveal significant differences between
      glycogen-depleted and non-depleted skeletal muscle fibres. In contrast, all
      histochemical methods investigated, showed little or no phosphorylase activity in
      the glycogen depleted fibres, indicating that none of the existing histochemical
      methods revealed reliable staining results in these fibres. Owing to the invalid
      staining results of the histochemical methods for glycogen-depleted muscle
      fibres, it is necessary that for metabolic studies a biochemical assay for
      phosphorylase activity is also to be performed.

PMID- 1642105
TI  - Developmental regulation of lectin-binding patterns in Paracentrotus lividus
      gonads, gametes, and early embryos.
AB  - By use of several lectins (ConA, WGA, SBA, GS I, PNA), a study was carried on
      gametes and developing embryos of the sea urchin Paracentrotus lividus, to
      investigate developmental changes in cell surface, leading to changements in cell
      environment interactions. ConA, WGA, and SBA, with high affinity, bind to the
      vitelline membrane of unfertilized eggs, while PNA labelling at the same site is
      weak; GS I-binding is only present in the cytoplasm and cortical region of the
      unfertilized eggs. Immediately after fertilization, no ConA-binding is present in
      the membrane, while WGA- and SBA-binding molecules are located in the
      fertilization layer. In zygotes, 40 min after fertilization, ConA affinity sites
      were again present in both cytoplasm and cortical region. During cleavages and
      gastrulation, ConA binds to the blastomere cytoplasm and cortical region, to the
      intercellular matrix, and to the cytoplasm of mesenchyme cells. WGA binds to the
      cortical region of cleaving blastomeres, including the hyaline layer, up to the
      unhatched blastula. Then it labels the gastrula inner and outer surfaces. SBA
      binds to the blastomere membranes; no GS I- and PNA-binding was detected during
      embryonic development. Sperms are bound by all the lectins, except GS I. Mannose
      and glucose conjugates are the most represented throughout the whole development
      of P. lividus, and their origin and locations are developmentally regulated.
      Galacto-residues are scarcely represented or are masked by other terminal sugars
      (e.g. sialic acid), and become functional during particular developmental events
      (cell movements).

PMID- 1642107
TI  - Histomorphological and cytochemical changes induced in the liver of goldfish
      Carassius carassius var. auratus by short-term exposure to lead.
AB  - The cellular and molecular effects of experimental lead intoxication (5 mg l-1/24
      h and 48 h) were studied in hepatocytes of Carassius carassius var. auratus.
      Significant lead storage was not detected by atomic absorbance spectroscopy after
      treatment. Cell morphology appeared only poorly impaired. A decrease of glycogen
      content was observed. Glycolysis, Krebs cycle and pentose shunt were altered in
      their enzymatic activities. Lysosomal activities were strongly increased. All
      enzymatic activities tested were altered 24 h after lead treatment.

PMID- 1642108
TI  - Differential diagnosis between dementia and depression: a study of efficiency
      increment.
AB  - A battery of neuropsychological tests was examined to establish its value in
      differentiating mild dementia from depression. The battery was applied to 84
      subjects: 31 dementia patients of several etiologies, 31 patients with major
      depression and 22 volunteers whose age and educational level was similar to that
      of the patients. The battery consisted of tests for immediate, recent and remote
      memory, the Mini Mental State examination, a screening test for language
      disorders, and tests measuring abstraction, calculation, judgement, praxic and
      gnosic functions. The results showed significant differences among the three
      groups in all memory tests. Deficits of abstraction, calculation, praxis and
      language functions were strongly associated with dementia. The epidemiological
      analysis of efficiency increment, with determination of sensitivity and
      specificity, showed a highly significant enhancement of efficiency for diagnostic
      purposes when the results of the tests were combined. These findings suggest that
      the entire battery of neuropsychological tests should be applied, and their
      results compared using the efficiency increment procedure, in order to establish
      a firm differential diagnosis between dementia and depression, and/or to detect
      the former when it is at a mild early stage.

PMID- 1642109
TI  - Correction for age, education and other demographic variables in the use of the
      Mini Mental State Examination in Finland.
AB  - The population-based Helsinki Aging Study was comprised of three age groups: 75-,
      80- and 85-year-olds. A random sample of 511 subjects completed the Mini Mental
      State Examination (MMSE) and were assessed on the Clinical Dementia Rating-scale
      (CDR). According to the CDR results 446 subjects were screened as non-demented.
      Of these subjects 30% scored below or at 24 MMSE points. Age, education and
      social group had a significant effect on the MMSE scores, even after excluding
      the demented cases. Together they explained 10% of the total variance within the
      MMSE. Social group correlated with education. The MMSE scores were corrected
      according to age and education. Adjustment of the originally used cutpoint of 24
      resulted in cutpoints of 25 and 26 among the 75-year-olds, in the low and high
      education groups respectively; 23 and 26 in the 80-year-olds; 22 and 23 in the 85
      year-olds.

PMID- 1642110
TI  - Benign monomelic amyotrophy of lower limb: report of three cases.
AB  - Three patients with wasting confined to a single lower limb are reported. The
      characteristic features were: sporadic occurrence, insidious onset with slow
      progression and in 2 cases arrested course for at least 4 years, wasting out of
      proportion with disability, absence of sensory, pyramidal tract or bulbar signs.
      CK, motor and sensory conductions, and lumbar MRI were normal. Muscle CT showed
      selective loss of muscle tissue and fat replacement in posterior leg muscles.
      Quantitative electromyography and histologic findings revealed neurogenic
      features not only in the affected legs, but also in clinically uninvolved limbs.
      Monomelic amyotrophy of lower limb is a variant of spinal muscular atrophy with a
      benign course. However, as in the early stages of the disease there are no
      distinctive clinical or laboratory findings with other motor neuron diseases, the
      diagnosis of monomelic amyotrophy may be made only retrospectively after a
      prolonged observation.

PMID- 1642111
TI  - Primary intranasal encephalocele: a rare cause of bacterial meningitis.
AB  - In four patients with bacterial meningitis a primary intranasal encephalocele was
      found as portal of entry. In two of the cases the malformation had been
      misdiagnosed as a nasal polyp and operated upon. In two patients a cerebrospinal
      fluid fistula developed spontaneously at the age of 54 years. None of the
      patients had associated symptoms indicating the presence of a cleft.
      Encephaloceles can be readily visualized by computed tomography particularly in
      coronal sections. The treatment of choice is transcranial surgical repair.

PMID- 1642112
TI  - Migration and age at onset of multiple sclerosis: some pitfalls of migrant
      studies.
AB  - The aim of this study was to compare age at onset of multiple sclerosis (MS) in
      North African-born and French-born patients. The migrant group consisted of 246
      patients who arrived in France during the period 1960-1965. Among these migrants,
      27 (11%) had first symptoms before migration. The French-born group consisted of
      MS patients of same sex and age at the time of the study as migrants who were
      randomly selected from a large national sample. After controlling for various
      biases which could explain differences between migrants and French-born patients,
      we found no differences in mean age at MS onset between the two groups.
      Therefore, it is likely that MS was acquired by the same age in migrants as in
      French-born patients. This finding may constitute an indirect support for the
      hypothesis that the unknown causative factors of MS are equally frequent whatever
      the latitude of origin.

PMID- 1642113
TI  - Cerebral ischemia associated with anticardiolipin antibodies.
AB  - Eight patients, 3 with systemic lupus erythematosus (SLE) or "SLE-like" disease,
      1 with sarcoidosis, and 4 with no connective tissue disease had transient
      ischemic attacks (TIA) or cerebral infarctions associated with high levels of
      anticardiolipin antibodies (ACA). Cerebral ischemic events included amaurosis
      fugax, recurrent hemispheric TIA, cerebral infarction, and multi-infarction
      dementia. Treatment with acetylsalicylic acid was ineffective in 3 patients.
      Warfarin, alone or in combination with dipyridamole or steroids, may reduce the
      risk of further cerebrovascular events.

PMID- 1642114
TI  - Effects of oxcarbazepine and carbamazepine on the central nervous system:
      computerised analysis of saccadic and smooth-pursuit eye movements.
AB  - Oxcarbazepine (OXC) is a new anti-epileptic agent structurally related to
      carbamazepine (CBZ). OXC seems to have a similar efficacy and a better
      tolerability profile than CBZ. In the present study we compared the subclinical
      side-effects on the CNS of OXC and CBZ using a computerised analysis of saccadic
      and smooth-pursuit eye movements. Six healthy male volunteers (mean age 29 yrs)
      participated in the study, which was conducted by a double-blind cross-over
      design. Each subject was given a single dose of either CBZ 400 mg or OXC 600 mg
      (according to the random assignment) after which the drug effects on eye
      movements were evaluated. One week later, the trial was repeated using the other
      drug. The parametrisation of both saccadic and smooth-pursuit eye movements was
      carried out by measuring a series of performance parameters [e.g. the maximum
      saccade peak velocity (MSPV) and the typical target velocity (TTV)]. OXC was
      found to induce a lesser degree of alteration on the values of both MSPV (p =
      0.07) and TTV (p less than 0.03) than CBZ. In particular, the TTV values were
      virtually unaffected by OXC administration, while the effects of CBZ on both
      variables were particularly evident at 8 and 10 h after dosing which correspond
      to the time at which the plasma concentrations of CBZ and of its 10,11-epoxide
      reach the peak. In conclusion, our preliminary results indicate that OXC induces
      negligible alterations, if any, on the eye movement parameters evaluated in our
      study.

PMID- 1642115
TI  - Mobius syndrome with basal ganglia calcification.
AB  - Basal ganglia calcification has not been described in Mobius syndrome. A family
      with two children with Mobius syndrome are reported. Bilateral basal ganglia
      calcification was seen on computed tomography in both. This is the first family
      where cerebral involvement has been clearly documented in this syndrome.

PMID- 1642116
TI  - Diagnosis of sympathetic pupilomotor dysfunction (Horner's syndrome)

PMID- 1642117
TI  - Progressive senile dementia Alzheimer type (SDAT)

PMID- 1642118
TI  - [Otorhinolaryngologic surgery in Flanders from the Renaissance to the 18th
      century. A brief overview].

PMID- 1642119
TI  - [The beginnings of otorhinolaryngology in Belgium in the 19th century].

PMID- 1642121
TI  - A community-based study of survival in dementia.
AB  - The objective of this study was to compare the mortality rate of demented and
      nondemented subjects in a single cohort. We followed up a cohort of subjects
      comprising all 1259 inhabitants of Leiden aged 85 years and over, evaluated
      earlier for the presence of dementia, and including institutionalized subjects.
      The main outcome measure was the mortality rate ratio of the demented and
      nondemented groups adjusted for age and sex. The mortality rate ratio of the
      demented vs the nondemented group was 1.9 (95% confidence interval: 1.7-2.2). No
      difference in mortality rate was found between those with mild vs moderate to
      severe dementia. The mortality rate in dementia patients is higher than in
      nondemented subjects.

PMID- 1642120
TI  - The psychological management of depression.
AB  - This article reviews the effects of psychological treatments specifically
      developed for depression. Promising and durable results have been reported for
      cognitive and interpersonal psychotherapies but also for behavioral
      psychotherapy, which has generated less research interest so far. The therapeutic
      effects seem to be equivalent and at least comparable to pharmacotherapy in mild
      to moderate depression.

PMID- 1642122
TI  - Specific skills and social competence in schizophrenia.
AB  - Generalization of skills is a major problem in social skills training for
      schizophrenic patients. Assessment of skills is mostly not based on objective
      indices of specific skill deficits. The results of this study show that global
      competence of schizophrenics can be differentiated from specific competence.
      Global competence was found to be related to symptoms, whereas specific
      competence was not. No support was found for the assumption that social
      dysfunctions are caused by negative symptoms. Social perception and positive
      symptoms did explain a substantial part of the variance of global competence. It
      is therefore concluded that neither global incompetence nor negative symptoms
      should be used as an indication for social skills training.

PMID- 1642124
TI  - Bright dawn simulation compared with bright morning light in the treatment of
      winter depression.
AB  - In a randomized cross-over design, 7 patients with winter depression were treated
      with a week of a bright (1700 lx) dawn simulation (0400 to 0600) and a week of
      standard bright (1700 lx) morning (0600 to 0800) light therapy. The Hamilton
      Rating Scale for Depression scores decreased significantly for the standard light
      therapy (18.9 to 6.6) but not for the bright dawn therapy (18.0 to 11.3). Early
      morning awakening was a frequent side effect with the bright dawn simulation.
      Although dawn simulation at a lower illuminance may be an effective treatment,
      the bright dawn used in this study showed only a nonsignificant trend to lower
      depression ratings. The illuminance of dawn simulation should be adjusted to
      minimize side effects.

PMID- 1642123
TI  - Genetic epidemiological study of schizophrenia: reproduction behaviour.
AB  - Data from the Tomsk Epidemiological Register and epidemiological family sample
      were used to study the relationship between schizophrenics' reproductive
      behaviour (marital status and fertility rate), severity of ICD-9 schizophrenia
      and risk of illness among relatives of probands. The results are interpreted in
      terms of multifactorial threshold and single monolocus models. Their importance
      for the interpretation of epidemiological data (a change of prevalence rate,
      cohort effect and clinical polymorphism) is discussed.

PMID- 1642125
TI  - Sex differences in problem drinking among 42-year-old residents of Malmo, Sweden.
AB  - The main objective was to describe sex-related differences in rates of
      nonidentified vs identified problem drinking in 42-year-old Malmo residents. All
      1264 women and 1368 men born in 1941 were invited to a health screening at the
      Preventive Medicine Section, Malmo General Hospital. Individuals registered at
      the Department of Alcohol Diseases because of problem drinking prior to screening
      (identified problem drinkers) were excluded and analyzed separately. Intervention
      in the remaining subjects was made if any of 3 sets of inclusion criteria was
      met. The sex ratios (female:male) of identified and nonidentified problem
      drinking were 1:4.1 and 1:2.8 respectively. Thus, nonidentified problem drinking
      is by and large proportional to identified problem drinking in both sexes,
      arguing against hidden drinking being and exclusively female phenomenon.

PMID- 1642126
TI  - Comparison of Composite International Diagnostic Interview and clinical DSM-III-R
      criteria checklist diagnoses.
AB  - This article describes a comparison of Composite International Diagnostic
      Interview (CIDI) diagnostic results and results based on clinicians' observation
      of CIDI assessments. Psychiatrists scored a DSM-III-R criteria checklist either
      while observing or after administering 20 CIDI interviews. Overall diagnostic
      concordance between the checklist and CIDI diagnoses was found to be good (kappa
      = 0.78). Good diagnostic agreement was also found for 3 groups of DSM-III-R
      disorders: depressive disorders (kappa = 0.84), psychoactive substance use
      disorders (kappa = 0.83) and anxiety phobic disorders (kappa = 0.76). These
      results are consistent with the results from a similar comparison between the
      CIDI and checklist results for ICD-10 diagnoses.

PMID- 1642127
TI  - Low level of antidepressant prescription for people who later commit suicide: 15
      years of experience from a population-based drug database in Sweden.
AB  - The use of antidepressants has been low in Jamtland County for many years, while
      the suicide rate has been among the highest in Sweden. A continuous outpatient
      prescription recording system has been in operation in Jamtland since 1970.
      Through this system we traced the prescription pattern of 80 individuals who
      committed suicide from 1970 to 1984. Suicide patients obtained 1.5 times more
      prescription drugs than 80 matched controls, mainly psychotropics and vitamins.
      During the 3 months prior to the suicide, half of the patients had received
      medical attention and 73% of the women and 40% of the men had obtained
      prescription drugs, in one-third from the psychiatric department. While 53% and
      29%, respectively, obtained psychotropic drugs, only 13% and 9% respectively were
      prescribed antidepressants, often in low doses. People who will commit suicide
      often seek medical help. The low rate of antidepressant prescription in patients
      committing suicide probably reflects insufficient diagnosis and treatment of
      depressive disorders. It is urgent--for the individual as well as for society-
      that diagnostic and pharmacotherapeutic routines be improved.

PMID- 1642128
TI  - Projective identification and suicide contagion.
AB  - The effect of suggestion on suicide is well established. However, the
      intrapsychic mechanisms of the contagion of suicides are poorly understood. In
      this article I first present the literature about suicide clustering and about
      projective identification. In the following clinical vignette I try to understand
      a patient's suicidal behaviour, referring to William Goldstein's clarifying model
      of projective identification. I aim to illustrate that his model has heuristic
      value in the treatment of suicidal patients when the effect of suggestion or
      identification is suspected.

PMID- 1642129
TI  - Fluvoxamine in the treatment of demented elderly patients: a double-blind,
      placebo-controlled study.
AB  - The efficacy of fluvoxamine on cognitive functioning and behavioral changes was
      evaluated in a double-blind, placebo-controlled study of 46 elderly demented
      patients. The patients had a DSM-III diagnosis of primary degenerative dementia
      or multi-infarct dementia and were aged greater than or equal to 65 years. Twenty
      two patients were given 150 mg fluvoxamine per day and 24 received placebo
      tablets; 14 and 15 patients, respectively, completed 6 weeks of treatment. Within
      treatments, there were no significant changes in median scores on
      neuropsychological tests (picture recall and recognition, trail making and finger
      tapping) or the GBS scale scores (degrees of dementia) or GBS subscale score
      (clinical profiles, including symptoms common in dementia, motor, emotional and
      intellectual functioning). Between treatments, the median changes in psychometric
      test scores did not differ significantly. However, within and between treatments,
      there were trends favoring fluvoxamine on symptoms common in dementia (confusion,
      irritability, anxiety, fear-panic, mood level and restlessness). In conclusion,
      the study does not support the hypothesis that fluvoxamine improves cognitive
      functioning or behavioral changes in elderly dementia patients.

PMID- 1642130
TI  - Cost-benefit analysis of an educational program for general practitioners by the
      Swedish Committee for the Prevention and Treatment of Depression.
AB  - In 1983-1984 the Swedish Committee for the Prevention and Treatment of Depression
      launched an educational program on the diagnosis and treatment of depressive
      disorders for all general practitioners on the island of Gotland. The baseline
      year chosen was 1982 and the immediate effects were evaluated in 1985. In 1988
      the long-term effects were evaluated. These two evaluations indicated strictly
      time-related beneficial effects on the frequency of sick leave and inpatient care
      for depressive disorders, the pattern of prescription of psychopharmacologic
      drugs and the frequency of suicide. This article describes a cost-benefit
      analysis of the program. The cost of the educational program, changes in drug
      prescription and inpatient care were calculated as well as indirect costs
      concerning changes in morbidity and mortality. The calculation of the savings to
      society was subject to a sensitivity analysis. This shows that the educational
      program resulted in savings to society on the order of about SEK 155 million (USD
      26 million). It is concluded that educational programs of this kind should be
      repeated every second to third year.

PMID- 1642131
TI  - Social conditions in a total population with long-term functional psychosis in
      three different areas of Stockholm County.
AB  - A number of social conditions regarding interpersonal relations, housing and
      employment were studied in a total population of individuals with long-term
      functional psychosis (n = 341) drawn from the population aged 18-64 years
      inhabiting three different areas of Stockholm County, altogether about 57,000
      inhabitants. Individuals were included irrespective of whether they had a
      psychiatric treatment contact or not. They were mostly unmarried (57%) and living
      alone (64%). Most were unemployed (69%) and over half received a disability
      pension. However, 76% had their own flat and a reasonable financial standard, not
      deteriorating with illness duration. The diagnosis of schizophrenia led to poorer
      social conditions, as did early age at onset, male sex and co-morbidity of
      substance abuse. A larger number of individuals lived in an institution in the
      urban area while a greater number lived with relatives in the rural area.

PMID- 1642132
TI  - Posterior fossa abnormalities in major depression: a controlled magnetic
      resonance imaging study.
AB  - High-field magnetic resonance (MR) images were used to study posterior fossa
      morphology in 27 patients with major depression and 36 normal control subjects.
      Depressed patients demonstrated smaller brain stem and cerebellar vermis than
      controls. These differences were highly significant for the anterior cerebellar
      vermis and medulla. There was also a striking age-related decline in midbrain
      size in depressed patients as well as in controls. Our results are consistent
      with several lines of evidence implicating a role for the cerebellar vermis in
      affective disorders and, in addition, provide the first MR documentation of the
      differential effects of aging on posterior fossa morphology in normal subjects
      compared with patients with major depression.

PMID- 1642133
TI  - Urinary excretion of albumin and retinol-binding protein in lithium-treated
      patients: a longitudinal study.
AB  - The urinary excretion of albumin and retinol-binding protein was determined by
      means of sensitive immunochemical methods in a 2-year longitudinal study of 22
      lithium-treated patients. During lithium treatment, there were no significant
      changes in the median albumin:creatinine ratios or retinol-binding
      protein:creatinine ratios. However, the median albumin:creatinine ratios were
      significantly higher in lithium-treated patients than in 22 normal subjects,
      which indicates that glomerular permeability is increased; no correlation with
      serum lithium level or duration of lithium treatment could be shown. In patients
      treated with slow-release tablets, the urinary excretion of albumin was
      significantly higher after 2 years than in patients given lithium carbonate. The
      median retinol-binding protein:creatinine ratios did not differ significantly
      between lithium-treated patients and normal subjects, suggesting that lithium
      does not affect the catabolism of low-molecular-weight proteins in the proximal
      tubules. In conclusion, the study supports the hypothesis that lithium treatment
      produces a small but significant and nonprogressive elevation of the urinary
      excretion of albumin.

PMID- 1642135
TI  - Can certain stimulus characteristics influence the hemispheric differences in
      global and local processing?
AB  - Hemispheric processing of global and local form was examined in two experiments
      in which the size of hierarchical visual stimuli was manipulated in divided
      attention tasks. In experiment 1, the subjects were instructed to decide whether
      or not a symmetrical target (T) was in the visual object presented. In experiment
      2, the target to be detected was nonsymmetrical (L). In both studies, global
      precedence was found depending on stimulus size. When the stimuli subtended about
      3 degrees vertically, global dominance was found, but it was not detected when
      the stimuli subtended about 10 degrees. Experiments 1 and 2 provided evidence
      against the analytic/holistic dichotomy, presenting the same performance for both
      hemispheres: the global analysis was much better than the local analysis. When
      the target was in the global form, both the LH and the RH analyzed the 3 degrees
      stimuli more efficiently, while both analyzed the 10 degrees stimuli with greater
      efficiency when the target was in the local form.

PMID- 1642134
TI  - Neuropsychological and clinical correlates of temporal lobe anatomy in
      schizophrenia.
AB  - Twenty-five DSM-III schizophrenic patients were assessed neuromorphologically and
      neuropsychologically. Reduced temporal lobes were found through magnetic
      resonance imaging (MRI) evaluation. In addition, in order to look for the
      neuropsychological correlates of temporal anatomy in schizophrenia, patients were
      divided into cognitive normal and abnormal schizophrenics, according to their
      Luria Nebraska Neuropsychological Battery profile. The latter group had
      statistically significant temporal lobe abnormalities as assessed by MRI,
      irrespective of medication, clinical picture or any other relevant variables. The
      implication of such findings in the light of the diaschisis model is discussed.

PMID- 1642136
TI  - Line bisecting as a predictor of personal optimism and desirability of risky
      behaviors.
AB  - Our goal was to test whether current hemisphere predominance is a predictor of
      scores on standardized measures of personal optimism and preference for risk. In
      two between-subject experiments, current hemisphere predominance was measured by
      the direction and extent of line bisecting errors. Pearson correlations and
      median splits of the line bisecting errors showed significantly greater personal
      optimism and preference for risk with left hemisphere predominance. These results
      support previous research in which manipulation of hemisphere predominance
      produced similar effects on personal optimism in normal individuals and on risk
      taking in lesioned and normal samples. We conclude that the association of
      optimism and risk with left hemisphere predominance can be observed in resting as
      well as in manipulated situations.

PMID- 1642137
TI  - Follow-ups of children with attention deficit hyperactivity disorder (ADHD).
      Review of literature.
AB  - The purpose of this review has been to examine the hypothesis that the Attention
      Deficit Hyperactivity Disorder (ADHD), formerly also referred to as the
      Hyperactive Syndrome or Minimal Brain Dysfunction (MBD), is a precursor of
      criminality and abuse of alcohol and illicit drugs. This has been done by
      reviewing findings from follow-ups. Most reviewed projects suffer from
      methodological weakness. In most materials, few if any of the cases had ADHD
      according to present criteria. Some had ADHD and conduct problems. Many probably
      had exclusively conduct problems, but were too young to fulfill the criteria of
      Conduct Disorder (CD). Methodological limitations of the examined projects have
      been pointed out. It has been discussed how weaknesses regarding research design
      might have influenced the results. As a consequence of methodological
      shortcomings of most projects, the reviewed studies do not give definite answers.
      However, they show some rather convincing trends. By early adulthood, ADHD
      appears to remain present in at least one third of the subjects. Subjects with
      prior ADHD did not have more mental problems than controls in adolescence and
      early adulthood, provided they had normal intelligence, and no additional
      disabilities or mental disorders. Those with mental retardation, cerebral
      dysfunction or psychosis in addition to ADHD have a poor prognosis. A high
      percent become psychotic, and some end up in institutions. Although there seems
      to be an increased rate of delinquency and lawbreaking in prior hyperactives
      compared to controls, these differences disappear when the results are analyzed.
      The initially impressive differences between cases and controls are probably
      consequences of bias. Cases with a childhood history of conduct and educational
      problems have been compared to controls without a history of such problems. Thus,
      the reported differences are not related to ADHD. Hyperactives without conduct
      problems do not have an increased frequency of delinquency. Problems of conduct,
      CD and Antisocial Personality Disorder, but not psychosis characterize cases with
      a childhood history of conduct problems (with or without ADHD). In subjects with
      ADHD as well as conduct problems in childhood, conduct problems and not ADHD
      predict the prognosis, which is worse than for those with CD without ADHD. ADHD
      combined with delinquency indicates a high rate of subsequent lawbreaking.
      Usually, cases have more problems than controls with alcohol and illicit drugs,
      but this might be the consequence of selection of cases (subjects with school and
      conduct problems) and controls (subjects without such problems).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1642139
TI  - Excited carbonyl formation in the combination and disproportionation of free
      radicals.
AB  - The pyrolyisis of di-tert-butyl peroxyoxalate in the presence of para-substituted
      benzaldehydes produces almost quantitatively the corresponding p,p'-disubstituted
      benzils. The formation of these products is accompanied by chemiluminescence
      arising from excited triplets. From the quantum yield of excited triplet
      generation and the rate constants for the triplet photocleavage it is possible to
      obtain the change in Gibbs free energy associated with triplet formation. The
      values obtained are -5.6, -5.7 and -8.1 kcal/mol for benzil, p,p'-dimethylbenzil
      and p,p'-dimethoxybenzil, respectively. The pyrolysis of di-tert-butyl
      peroxyoxalate in the presence of isopropanol or benzoin leads to the formation of
      acetone and benzil. These products are generated in disproportionation processes
      involving the alpha-hydroxy radical produced by hydrogen abstraction. The
      luminescence observed in these reactions constitutes the first experimental
      indication of excited species generation in the disproportionation of
      uncorrelated free radicals.

PMID- 1642138
TI  - Enhanced chemiluminescence in the oxidation of luminol and an isoluminol cortisol
      conjugate by hydrogen peroxide in reversed micelles.
AB  - The chemiluminescent oxidation of luminol and an isoluminol cortisol conjugate
      (ABI-COR) by hydrogen peroxide has been studied in cetyltrimethylammonium bromide
      (CTAB) reversed micelles in octane-chloroform (1:1). The maximum
      chemiluminescence intensity of both compounds is dependent on the initial
      concentrations of the H2O2 and substrates, the pH value of the micelle polar
      phase and the H2O/CTAB ratio. The optimum pH ranged from 8.5 to 9.5. Under
      comparable conditions, the chemiluminescence intensity for luminol was 15-fold
      higher than for the ABI-COR conjugate. A mechanism of oxidation of the substrates
      in reversed micelles is proposed and the possible mechanisms of inhibition by the
      substrate and oxidant is discussed.

PMID- 1642140
TI  - The effect of serine and thiol protease inhibitors on the chemiluminescence of
      human neutrophils in investigations in vitro.
AB  - We have studied an indirect role of serine and thiol proteases in the activation
      of human neutrophils in vitro. Stimulation was evaluated using a
      chemiluminescence (CL) generation system. Receptor-dependent and receptor
      independent stimuli were studied, e.g. opsonized zymosan, formyl-methionyl-leucyl
      phenylalanine, platelet activating factor, phorbol myristate acetate, and calcium
      ionophore A23187. The serine protease inhibitors TPCK and TLCK, and thiol
      protease inhibitor PHMB, diminished the CL with different potencies and in a dose
      dependent manner after treatment of cells with the various stimuli. Non-specific
      serine protease inhibitor, PMSF, and trypsin substrate TAME, showed a low
      inhibitory potency with respect to CL generation. Synthetic substrates for
      chymotrypsin (BTEE, ATEE) significantly inhibited CL with the various stimuli
      used with some differences in susceptibility to their inhibition. Specific
      chymotrypsin inhibitors diminished both the resting and activator-induced CL. We
      suggest that cell-bound chymotrypsin-like protease(s) is involved in the
      activation of signal transduction in human neutrophils after both receptor
      dependent and receptor-independent stimulation.

PMID- 1642141
TI  - Relationship between bone mass and rates of bone change at appendicular
      measurement sites.
AB  - The rate of bone change among postmenopausal women may vary depending upon the
      initial bone mass. Examining this possibility is difficult, however, because of a
      negative statistical bias that occurs when change is regressed against the
      initial value of the same variable. In this article, four statistical methods
      were applied to measure the association between bone mass and the rate of bone
      change. The study population was Japanese-American women, who were monitored for
      approximately 5 years. Bone changes were determined for the calcaneus and the
      distal and proximal radius. The results were consistent across the bone sites but
      differed between statistical methods. Three of the four methods indicated that
      the women with the greater bone mass had the greater loss rates. The fourth
      method did not support this association. Possible reasons for the discordant
      results are discussed. Using the "best" estimate of the relationship, a gradual
      convergence of bone mass was projected over time toward the population mean. The
      convergence occurred because women with higher bone mass had a somewhat faster
      loss rate than women with lower bone mass. Overall, however, the variation in
      bone mass between individuals was large compared to the rate of convergence.

PMID- 1642142
TI  - Factors influencing synthesis and mineralization of bone matrix from fetal bovine
      bone cells grown in vitro.
AB  - This study of the in vitro synthesis and mineralization of bovine bone
      demonstrates that sheets of mineralized matrix can be produced consistently
      within 18-24 days of cell isolation. Mineralization surpasses that achieved by
      other systems with other species: The deposition of mineral extends beyond
      nodules to form branching trabeculae and then solid wafers of bone. Comparison of
      the fetal age of the bone source, enzyme digestion methods, seeding density,
      culture surface, nutritive media, and concentration of fetal calf serum and other
      additives, including insulin and ascorbic acid, has yielded a set of optimal
      culture conditions. In the presence of ascorbic acid and beta-glycerol phosphate,
      insulin has a dose-dependent effect on the morphology of the mineralized bone
      matrix produced. Quantitative analysis shows that in these cultures calcium
      accumulates most rapidly between days 6 and 10 after the introduction of
      mineralization medium but that mineral accretion continues throughout 14-16 days
      of culture. Alkaline phosphatase levels rise up to 200-fold, concomitant with a
      rapid increase in the number of cells per culture during the early mineralization
      phases; both fall as mineralization proceeds. This system has been used to study
      the induction of mRNA of type I collagen, alkaline phosphatase, and several
      noncollagenous bone proteins during the course of mineralization. Because of the
      degree of mineralization achieved with this system, it has many potential
      applications.

PMID- 1642143
TI  - Bone matrix mRNA expression in differentiating fetal bovine osteoblasts.
AB  - In the accompanying study, we report an in vitro culture system from bovine bone
      cells that can be applied to investigate bone cell growth and differentiation. In
      this system, bovine bone cells placed in mineralization medium formed multilayers
      (days 2-3), began deposition of mineral (days 5-6), and eventually acquired a
      mineralized matrix sheet (days 14-20) through the stages of mineralizing nodules
      and trabecular-like structure. In the current study we used this system to
      investigate the relative expression of bone matrix genes that may play an
      important role in bone development and metabolism. alpha 1(I)-collagen, alkaline
      phosphatase, osteonectin, biglycan (PgI), decorin (PgII), osteopontin, and bone
      sialoprotein mRNA gene expression were measured on days 0, 2, 6, 10, and 20 (date
      when the cells were placed in mineralization medium as day 0). Total RNA was
      purified and analyzed by northern blot using radiolabeled cDNA encoding these
      genes. To comprehend the relationship between gene expression and mineralization,
      total calcium content in the cultures was also measured. During the culture
      period we observed several very different gene expression profiles. The
      expression of both alpha 1(I)-collagen and biglycan increased 3- to 4-fold by day
      6 and then returned to basal levels by day 20. The osteonectin gene was highly
      expressed throughout the culture, with no significant increase in induction found
      during any time of culture. A significant induction of alkaline phosphatase (13.8
      fold) gene expression was observed by day 6. Osteopontin showed a similar profile
      to that of alkaline phosphatase but had a much greater level of relative
      expression (26-fold) compared to day 0. Interestingly, downregulation during
      mineral accumulation seemed a common occurrence among many of the genes measured.
      In contrast, the bone sialoprotein gene showed a significant and distinct
      expression pattern, increasing rapidly after the onset of mineralization on day 6
      and ultimately reaching 140-fold that of day 0. Decorin (Pg II) showed an
      increasing pattern, with the final relative level of induction 5-fold on day 20.
      These data suggest that the development of the mature osteoblastic phenotype,
      complete with the ability to produce a thick mineralized matrix, requires the
      differential regulation of a series of genes and their gene products over the
      culture period.

PMID- 1642144
TI  - Bone mineral density in the proximal femur and hip fracture type in the elderly.
AB  - Bone mineral density (BMD) in the contralateral proximal femur in 100 female
      elderly patients with hip fracture and the 35 controls without hip fracture were
      investigated using dual-photon absorptiometry. The hip fracture patients were
      divided into intracapsular fracture (n = 53) and extracapsular fracture (n = 47)
      groups, and these two groups were further divided into five subgroups according
      to fracture site: intracapsular fracture type 1 (transcervical fracture, n = 29)
      and type 2 (subcapital fracture, n = 24); extracapsular fracture type 1
      (intertrochanteric line fracture, n = 13), type 2 (pertrochanteric fracture, n =
      28), and type 3 (combined type of pertrochanteric and subtrochanteric fracture, n
      = 6). The intracapsular fracture group showed BMD values similar to those of
      controls; the extracapsular fracture group showed significantly lower BMD values
      than controls. When these two were subclassified into five subgroups, different
      results were seen in terms of BMD value in the proximal femur and fracture types;
      intracapsular fracture type 1 showed BMD values equivalent to those of controls;
      on the other hand, type 2 showed significantly lower BMD value than controls, and
      the BMD distribution in the proximal femur among the extracapsular fracture
      subgroups 1-3 differed, although all of them showed significantly lower BMD
      values than controls. The degree of trauma causing the fractures was also
      assessed according to available anamnestic data, but no significant difference
      was found in trauma tendency between the intra- and the extracapsular fracture
      group or among the subgroups in each group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642145
TI  - Effects of resistance and endurance exercise on bone mineral status of young
      women: a randomized exercise intervention trial.
AB  - A substantial body of cross-sectional data and a smaller number of intervention
      trials generally justify optimism that regular physical activity benefits the
      skeleton. We conducted an 8 month controlled exercise trial in a group of healthy
      college women (mean age = 19.9 years) who were randomly assigned to a control
      group or to progressive training in jogging or weight lifting. We measured the
      following variables: bone mineral density (BMD) of the spine (L2-4) and right
      proximal femur using dual-energy x-ray absorptiometry, dynamic muscle strength
      using the 1-RM method, and endurance performance using the 1.5 mile walk/run
      field test. A total of 31 women completed the 8 month study. For women completing
      the study, compliance, defined as the percentage of workout sessions attended,
      was 97% for the runners (range 90-100%) and 92% (range 88-100%) for the weight
      trainers. Body weight increased by approximately 2 kg in all groups (p less than
      0.05). Weight training was associated with significant increases (p less than
      0.01) in muscle strength in all muscle groups. Improvement ranged from 10% for
      the deep back to 54% for the leg. No significant changes in strength scores were
      observed in the control or running groups. Aerobic performance improved only in
      the running group (16%, p less than 0.01). Lumbar BMD increased (p less than
      0.05) in both runners (1.3 +/- 1.6%) and weight trainers (1.2 +/- 1.8%). These
      results did not differ from each other but were both significantly greater than
      results in control subjects, in whom bone mineral did not change.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642146
TI  - Effects of heparin on osteoclast activity.
AB  - The effect of heparin on osteoclastic bone resorption was studied in vitro using
      the disaggregated osteoclast resorption assay. Bone resorption was assessed by
      counting the resorption lacunae on bone slices by light microscopy. Low
      concentrations of heparin (5 micrograms/ml) increased bone resorption by isolated
      chick and rat osteoclasts. Among other glycosaminoglycans tested at 5
      micrograms/ml, only dextran sulfate showed a small but significant stimulation of
      resorption. Chondroitin sulfates A, B, and C were without effect at 25 and 100
      micrograms/ml, whereas resorption was increased by 100 micrograms/ml of heparan
      sulfate. With chick osteoclasts, which could be maintained in serum-free
      conditions, a stimulatory effect of heparin was found both in the presence of 5%
      fetal calf serum and in serum-free media containing insulin, transferrin, and
      selenium. The magnitude of the heparin-induced increase in resorption was similar
      in the presence or absence of serum. The stimulation of resorption was associated
      with an increase in the number of osteoclasts on bone slices. Pretreatment of the
      bone slices with heparin also enhanced resorption. In time course experiments, 5
      micrograms/ml of heparin caused a doubling of chick osteoclast activity index
      (number of resorption pits per number of osteoclasts) at 12 and 24 h. In 24 h
      cultures, treatment with 10 micrograms/ml of the arginine-rich basic protein,
      protamine, 1 microgram/ml of the immunosuppressant, cyclosporine A, or 5
      micrograms/ml of the cysteine-proteinase inhibitor, leupeptin, negated the
      heparin effect on bone resorption. Leupeptin also inhibited basal
      resorption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642147
TI  - Quantitation of skeletal alkaline phosphatase isoenzyme activity in canine serum.
AB  - Pursuing the hypothesis that quantitation of skeletal alkaline phosphatase (ALP)
      activity in canine serum would provide an index of the rate of bone formation, we
      compared three methods for isoenzyme-specific identification of skeletal ALP
      activity in canine serum: heat inactivation, wheat germ agglutinin (WGA)
      precipitation, and concanavalin A (ConA) precipitation. ALP isoenzyme activities
      were extracted from canine bone, intestine, and liver, diluted into heat
      inactivated canine serum (i.e., serum without ALP activity), and used as
      calibrators of ALP isoenzyme activities. Differential sensitivity to inhibition
      by 10 mM L-homoarginine was used to distinguish intestinal ALP activity from
      hepatic and skeletal ALP activities (i.e., 9, 80, and 72% inhibition,
      respectively). To allow resolution of skeletal ALP activity from hepatic ALP
      activity, we tested two established methods (heat inactivation and WGA
      precipitation) and a novel method, ConA precipitation. The organ-derived skeletal
      and hepatic ALP isoenzyme activities were used to compare these three methods
      with respect to linearity, isoenzyme separation, and precision. All three methods
      were linear, but the WGA and ConA methods afforded greater isoenzyme separation
      and precision. The relative extent of isoenzyme separation (i.e., the difference
      in percentage remaining skeletal and hepatic ALP isoenzyme activities) averaged
      23, 40, and 47% remaining ALP activity for the heat, WGA, and ConA methods,
      respectively. However, when these methods were applied to the quantitation of
      skeletal ALP activity in sera from 10 young and 10 adult beagles, the WGA method
      was found to be unacceptable because most of the results fell outside the range
      of the WGA assay calibrators (i.e., greater than 100% skeletal ALP activity). The
      heat and ConA methods showed that the amount of skeletal ALP activity in the
      beagle sera decreased with age, both as ALP activity per liter and as percentage
      of total serum ALP activity (p less than 0.001 for each). Skeletal ALP activity
      levels determined by ConA were correlated with values determined by heat
      inactivation (r = 0.87, p less than 0.001) but not with WGA-determined levels (r
      = 0.26). Intestinal ALP activity was detected in only 1 of these 20 sera. We
      conclude that ConA precipitation can be used for quantitation of skeletal ALP
      activity in beagle serum.

PMID- 1642148
TI  - Expression of mutant alpha (I)-procollagen in osteoblast and fibroblast cultures
      from a proband with osteogenesis imperfecta type IV.
AB  - This study compares the synthesis of mutant type I collagen in cultured dermal
      fibroblasts and trabecular osteoblasts that were isolated from a patient with
      moderately severe osteogenesis imperfecta (type IV). Previous study of this
      patient's dermal fibroblasts revealed a 2000 dalton deletion located in cyanogen
      bromide peptide 4 of alpha 2(I)-collagen. The phenotype of the bone cell cultures
      was defined by a 3-4 day logarithmic phase doubling time, predominantly type I
      collagen production over type III and alkaline phosphatase activity 13.5 times
      dermal fibroblast levels. The current study revealed that both fibroblasts and
      osteoblasts synthesized a normal and a shortened alpha 2(I) chain, each as the
      product of separate alleles. Following pepsin treatment of the procollagens, a
      shortened alpha 1(I) chain was also seen in both cell types. Cyanogen bromide
      peptide mapping of osteoblast alpha-chains demonstrated the same deletions in the
      cyanogen bromide peptide 4 as observed in the fibroblast cyanogen bromide maps.
      PAGE analysis of oligonucleotide-specific cDNA that was reverse transcribed from
      RNA isolated from fibroblasts and osteoblasts also demonstrated the presence of
      two bands, one the normal size of alpha 2(I) cDNA and a second species that was
      smaller by 54 base pairs. Sequencing of polymerase chain reaction-amplified cDNA
      fragments revealed an in-frame deletion of exon 12. This finding was confirmed by
      the RNase protection method. Genomic DNA sequencing detected a T----G point
      mutation in the second position of the 5' splice donor site of intron 12.
      Therefore, in this patient with osteogenesis imperfecta there was no qualitative
      alteration in the osteoblast-specific expression of this mutant alpha 2(I)
      collagen allele compared to dermal fibroblasts.

PMID- 1642149
TI  - Impact of short-term estrogen administration on growth hormone secretion and
      action: distinct route-dependent effects on connective and bone tissue
      metabolism.
AB  - We recently reported that estrogen exerts distinct effects on the GH/IGF-1 axis
      that are dependent on the route of delivery, probably reflecting a first-pass
      effect on hepatic IGF-1 production. Oral administration reduces IGF-1 and
      increases GH levels; transdermal administration elevates IGF-1 without changing
      GH concentrations. Since mesenchymal tissue is a target for GH and IGF-1 action,
      we studied changes in the GH/IGF-1 axis following oral (ethinyl estradiol, 20
      micrograms/day) versus transdermal (Estraderm 100 TTS, Ciba Geigy, 100 micrograms
      17 beta-estradiol per day) estrogen delivery and compared corresponding effects
      on connective and bone tissue metabolism. Mean 24 h GH levels, IGF-1, markers of
      fibroblast (procollagen III) and osteoblast (procollagen I, osteocalcin)
      function, and indices of bone turnover (fasting urinary hydroxyproline and
      calcium to creatinine ratios, UOHPr/Cr and UCa/Cr) were measured before and after
      2 months of either oral or transdermal therapy in two groups of postmenopausal
      women. Transdermal estrogen administration significantly (p less than 0.05)
      increased IGF-1, procollagen III, procollagen I, osteocalcin, and UOHPr/Cr. In
      contrast, oral estrogen administration had a suppressive effect; the levels of
      IGF-1 (p = 0.001), procollagen III (p = 0.018), procollagen I (p = 0.002),
      osteocalcin (p = 0.015), and UOHPr/Cr (p = 0.004) were significantly different
      from those measured during transdermal administration. Both treatments
      significantly reduced UCa/Cr (p less than 0.015). IGF-1 changes during estrogen
      therapy were significantly related (p less than 0.05) to changes in procollagen
      III, procollagen I, osteocalcin, and UOHPr/Cr. Transdermally delivered estrogen
      stimulates IGF-1 production, increases osteoblastic function, and stimulates bone
      and nonbone collagen synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642150
TI  - Detection of canine distemper virus in bone cells in the metaphyses of distemper
      infected dogs.
AB  - In the light of recent evidence implicating canine distemper virus (CDV) as a
      possible etiologic agent in Paget's disease of bone, we thought that it would be
      of interest to examine distemper-infected bone in the natural host. Samples from
      the long bones, spleen, and bladder of four distemper-infected and three
      uninfected dogs were examined for the presence of CDV nucleocapsid and
      phosphoprotein genes and the measles virus (MV) nucleocapsid gene using the
      technique of in situ hybridization with radioactively labeled riboprobes. Two of
      the four distemper-infected dogs showed strongly positive hybridization with both
      of the CDV probes. The signal was present in marrow cells, in osteoblasts, in
      osteocytes, and particularly in osteoclasts. No hybridization was seen over the
      cartilage cells of the growth plate, and there was a clear line of demarcation at
      the point of invasion of osteoclasts and vascularization. The spleen and bladder
      samples from infected dogs also showed positive hybridization. There was no
      hybridization with the MV probe in any of the distemper-infected tissue. Samples
      from the uninfected dogs showed no evidence of hybridization with either the CDV
      or MV probes. These results show that CDV can infect bone cells of the natural
      host and provide further support for the theory that CDV may play a role in human
      Paget's disease of bone.

PMID- 1642151
TI  - Suppression of PTH and decreased action on bone are partially responsible for the
      low calcemic activity of 22-oxacalcitriol relative to 1,25-(OH)2D3.
AB  - We previously showed that OCT, an analog of 1,25-(OH)2D3 with little calcemic
      activity, can decrease PTH mRNA levels in normal rats and inhibit PTH secretion
      in cultured bovine parathyroid cells with the same potency as 1,25-(OH)2D3 and
      that in normal rats fed a normal calcium diet, administration of OCT (500 ng) for
      5 days did not increase plasma Ca. Thus, to determine if PTH suppression by OCT
      contributes to its lack of calcemic activity and to further characterize the
      effects of OCT on Ca metabolism, we performed several studies in
      parathyroidectomized (PTX) rats. PTX rats, maintained on a normal diet (0.9% Ca),
      received daily injections of vehicle, 1,25-(OH)2D3 (200 ng/day), or OCT (200
      ng/day) for 6 days. Plasma Ca was measured daily. Plasma Ca in control rats
      stayed between 6.60 and 7.40 mg/dl, whereas Ca increased to 12.9 +/- 0.42 mg/dl
      in 1,25-(OH)2D3-treated rats and to 9.53 +/- 0.35 mg/dl in OCT-treated rats after
      6 days. With a Ca-deficient diet, control rats maintained a plasma Ca between
      4.25 and 4.60 mg/dl, but Ca increased to 13.7 +/- 0.24 mg/dl with 1,25-(OH)2D3
      and to 7.29 +/- 0.17 mg/dl with OCT. Since the elevation in Ca by OCT was similar
      with both diets, OCT appears to act primarily on bone. PTX rats were infused with
      PTH (1.84 micrograms/kg/day) via an Alzet pump to achieve normal plasma Ca and
      then treated daily with either vehicle or OCT (200 ng/day). After 6 days, OCT
      increased serum Ca to 10.7 +/- 0.21 mg/dl over a control value of 8.58 +/- 0.29
      mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642152
TI  - Dual-energy x-ray absorptiometry of the forearm: reproducibility and correlation
      with single-photon absorptiometry.
AB  - Although single-photon absorptiometry (SPA) has been the predominant tool used to
      assess bone mineral density (BMD) in the forearm, the development of dual-energy
      x-ray absorptiometry (DEXA) provides the benefits of greater source stability,
      reduced scanning time, and improved image resolution compared to SPA. In the
      present study we used the DEXA bone densitometer (Hologic, Inc., Waltham, MA) to
      (1) measure BMD in the one-third radius and ultradistal radius; (2) examine the
      reproducibility of these BMD measurements; and (3) compare the BMD at the one
      third radius with SPA (SP2, Lunar Corp., Madison, WI). In 65 normal women (ages
      22-74 years) we examined changes in the forearm DEXA BMD with age, revealing
      significant quadratic regression equations. The reproducibility of DEXA BMD (mean
      +/- SEM) in 7 normal subjects aged 22-50 years is 0.85 +/- 0.16% for the
      predominantly cortical one-third radius site and 0.97 +/- 0.15% for the more
      trabecular ultradistal site. The regression relationship between DEXA and SPA of
      the one-third radius in 26 subjects (ages 22-68 years) is DEXA BMD = 0.105 +
      0.826 (SPA BMD); R = 0.97, R2 = 0.94, p less than 0.0001. Bone densitometry of
      the forearm using DEXA may be performed relatively rapidly, providing
      reproducibility and image resolution that are generally superior to those
      observed with SPA.

PMID- 1642154
TI  - Microbial degradation of nitroaromatic compounds.

PMID- 1642153
TI  - Expression of human transforming growth factor alpha by Chinese hamster ovarian
      tumors in nude mice causes hypercalcemia and increased osteoclastic bone
      resorption.
AB  - Transforming growth factor alpha (TGF-alpha) is a polypeptide regulator of cell
      growth produced by many malignant tumors. It stimulates osteoclastic resorption
      in bone organ culture and osteoclast-like cell formation in marrow culture. To
      determine whether tumor production of TGF-alpha can cause hypercalcemia in vivo,
      we used Chinese hamster ovarian (CHO) cells transfected with the human TGF-alpha
      gene (TCHO), which stably express and secrete TGF-alpha. We used nontransfected
      CHO cells as controls (CCHO). TCHO and CCHO were inoculated intramuscularly into
      one hindlimb of nude mice and grew as local solid tumors. After 4 weeks of TCHO
      tumor growth, plasma ionized calcium (Ca2+) increased to reach 1.48 +/- 0.03 mM
      (mean +/- SEM), whereas mice bearing similarly sized CCHO tumors and non-tumor
      bearing mice (NTB) remained normocalcemic (normal range for Ca2+, 1.15-1.30 mM).
      Plasma TGF-alpha was undetectable by an ELIFA assay in all NTB mice, was markedly
      increased in all TCHO mice (5.75 +/- 0.78 ng/ml), and was slightly increased in
      CCHO mice (0.50 +/- 0.22 ng/ml). Quantitative bone histomorphometry showed a
      prominent increase in osteoclastic bone resorption in TCHO mice. These data
      suggest that TGF-alpha is a mediator of hypercalcemia and increased osteoclastic
      bone resorption in tumors that produce it in sufficient quantity.

PMID- 1642155
TI  - Medicinal benefits of the mushroom Ganoderma.

PMID- 1642156
TI  - Microbial degradation of biphenyl and its derivatives.

PMID- 1642157
TI  - An evaluation of bacterial standards and disinfection practices used for the
      assessment and treatment of stormwater.

PMID- 1642158
TI  - Biopotentialities of the basidiomacromycetes.

PMID- 1642160
TI  - Complete prescription orders reduce medication errors.

PMID- 1642159
TI  - Pharmacist with AIDS wins right to practice.

PMID- 1642161
TI  - Ancient antidote ignored.

PMID- 1642162
TI  - Inside a poison center.

PMID- 1642164
TI  - Create value-added services to meet patient needs.

PMID- 1642163
TI  - The tuberculosis epidemic and the pharmacist's role.

PMID- 1642166
TI  - Expiration dating.

PMID- 1642165
TI  - The effect of new clinical lab rules on your pharmacy.

PMID- 1642167
TI  - Design and evaluation of a solid sampler for the monitoring of airborne 1,6
      hexamethylene diisocyanate (HDI) and its prepolymers in two-component spray
      painting.
AB  - An active, solvent-free solid sampler was developed for the collection of 1,6
      hexamethylene diisocyanate (HDI) aerosol and prepolymers. The sampler was made of
      a filter impregnated with 1-(2-methoxyphenyl)piperazine contained in a filter
      holder. Interferences with HDI were observed when a set of cellulose acetate
      filters and a polystyrene filter holder were used; a glass fiber filter and
      polypropylene filter cassette gave better results. The applicability of the
      sampling and analytical procedure was validated with a test chamber, constructed
      for the dynamic generation of HDI aerosol and prepolymers in commercial two
      component spray paints (Desmodur N75) used in car refinishing. The particle size
      distribution, temporal stability, and spatial uniformity of the simulated aerosol
      were established in order to test the sampler. The monitoring of aerosol
      concentrations was conducted with the solid sampler paired to the reference
      impinger technique (impinger flasks contained 10 mL of 0.5 mg/mL 1-(2
      methoxyphenyl)piperazine in toluene) under a controlled atmosphere in the test
      chamber. Analyses of derivatized HDI and prepolymers were carried out by using
      high-performance liquid chromatography and ultraviolet detection. The correlation
      between the solvent-free and the impinger techniques appeared fairly good (Y =
      0.979X-0.161; R = 0.978), when the tests were conducted in the range of 0.1 to 10
      times the threshold limit value (TLV) for HDI monomer and up to 60 micrograms/m3
      (3 U.K. TLVs) for total -N=C=O groups.

PMID- 1642168
TI  - The acute toxicity evaluation of a low-temperature hydraulic fluid.
AB  - A low-temperature version of MIL-H-83282 (LT 83282) is a candidate hydraulic
      fluid to be used as a replacement for the current low-temperature fluid used on
      Strategic Air Command aircraft. A single neat dose of 0.1 mL LT 83282 into New
      Zealand White (NZW) rabbit eyes resulted in slight conjunctival irritation for up
      to 24 hr after treatment in two of nine rabbits. Rinsing the eyes after treatment
      appeared beneficial. A single treatment of 0.5 mL neat LT 83282 to rabbit skin
      produced no irritation. A total of 40% of the guinea pigs receiving repeated
      dermal application of the fluid demonstrated a positive sensitization response. A
      single oral dose of 5 g LT 83282/kg body weight given to five male and five
      female Fischer 344 (F-344) rats and a single dermal application of 2 g LT
      83282/kg body weight applied to five male and five female NZW rabbits resulted in
      no deaths. Inhalation exposures to aerosol concentrations of LT 83282 resulted in
      an LC50 of 2.13 and 1.50 mg/L for male and female F-344 rats, respectively. No
      clinical signs of acute delayed neurotoxicity were observed in hens twice dosed
      at limit levels (5 g/kg) and observed for 21 days.

PMID- 1642169
TI  - Subchronic rat inhalation study with Skydrol 500B-4 fire resistant hydraulic
      fluid.
AB  - Skydrol 500B-4 fire resistant hydraulic fluid, a proprietary phosphate ester
      mixture composed principally of dibutyl phenyl phosphate (DBPP) and tributyl
      phosphate (TBP) and used as a commercial airline hydraulic fluid, was evaluated
      in an inhalation toxicity study of Sprague-Dawley rats. Target exposure levels
      used in the study were 0, 5, 100, and 300 mg/m3, and exposures were maintained
      for 6 hr/day, 5 days/week. Mass median aerodynamic diameters determined for
      particles in the mid- and high-exposure inhalation chambers were 2.85 microns and
      3.31 microns, with geometric standard deviations of 1.99 microns and 1.92
      microns, respectively. The percentage of particles less than 10 microns in
      diameter were 96.4% in the mid-exposure chamber and 95.5% in the high-exposure
      chamber. After 6 weeks of Skydrol exposure, 10 rats/sex/group were euthanized and
      then assessed for indications of possible chemical toxicity. Another 15
      rats/sex/group were studied for a total of 13 weeks of exposure. The only
      clinical sign of chemical toxicity was the observation of a reddish nasal
      discharge with accompanying oral salivation in mid- and high-exposure animals of
      both sexes, indicative of an irritant response. Statistically significant reduced
      body weights; increased absolute and relative liver weights; and decreased
      erythrocyte counts, hemoglobin levels, and hematocrit values were observed in
      high-exposure female rats euthanized after 13 weeks of Skydrol exposure. High
      exposure male rats also had increased absolute and relative liver weights and
      decreased hematocrit values after 13 weeks. Plasma cholinesterase levels were
      decreased in high-exposure female rats both 6 and 13 weeks after the study was
      initiated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642170
TI  - Inhalation of diethylamine--acute nasal effects and subjective response.
AB  - Adult volunteers were exposed to 25 ppm (75 mg/m3) diethylamine in a climate
      chamber for 15 min in order to study the acute nasal reactions to an exposure
      equivalent to the present threshold limit value-short-term exposure limit.
      Changes in nasal volume and nasal resistance were measured by acoustic rhinometry
      and by rhinomanometry. Acute change in nasal volume, usually seen as acute nasal
      mucosa response to thermal stimuli, was not observed, nor was an acute change in
      nasal airway resistance. In a subsequent experiment, the aim was to measure acute
      sensory effects. Exposure to a concentration increasing from 0 to 12 ppm took
      place for 60 min, equal to an average concentration of 10 ppm (30 mg/m3). A
      moderate to strong olfactory response and distinct nasal and eye irritation were
      observed. In spite of considerable individual variation, the results were in
      agreement with sensory effect estimates obtained from animal studies.

PMID- 1642171
TI  - Cobalt exposure in a carbide tip grinding process.
AB  - Reports relating hard metal disease or nonspecific respiratory symptoms to
      tungsten or cobalt exposure have been published in the past 20 yr. This report
      discusses a work site investigation of a small company, employing approximately
      50 workers, producing carbide tip saw blades for the woodworking industry. Cobalt
      exposure was characterized by ambient air monitoring (area and personnel),
      particle size determination, and biological monitoring. Area sampling for
      cadmium, cobalt, and tungsten indicated low ambient air levels in all
      manufacturing areas except the grinding department, which had cobalt air levels
      approaching the threshold limit value of 0.05 mg/m3. Area airborne cobalt
      exposure levels measured over six shifts in the grinding department ranged from
      0.017 to 0.12 mg/m3 for the total collection method and 0.002 to 0.028 mg/m3 for
      the method collecting respirable particles. Cobalt content in the total and
      respirable fractions was similar. Urine monitoring indicated production workers
      have elevated cobalt levels, and the grinders' levels were higher than other
      production workers. The grinding coolant was found to have elevated cobalt
      concentrations. A survey of coolants from nine carbide grinding shops indicated
      the elevated cobalt concentrations may be common.

PMID- 1642172
TI  - Respirator performance rating table for mask design.
AB  - The ultimate goal for respirator mask designers is computer-aided design. Mask
      design, however, is a very complex operation, with many different
      interrelationships. Current knowledge does not allow significant incorporation of
      physiological information into mask design. Rather, physiological information is
      usually gathered during mask evaluation, after the design process has been
      completed. The Performance Rating Table (PRT) is a beginning step to formulating
      physiological knowledge in a way that can be useful for design. The PRT organizes
      physiological knowledge to assign performance data to various mask and level of
      work causes. Best estimates of tabled values were obtained from the literature.

PMID- 1642173
TI  - Exposure of hospital operating room personnel to potentially harmful
      environmental agents.
AB  - Epidemiologic studies of risk to reproductive health arising from the operating
      room environment have been inconclusive and lack quantitative exposure
      information. This study was undertaken to quantify exposure of operating room
      (OR) personnel to anesthetic agents, x-radiation, methyl methacrylate, and
      ethylene oxide and to determine how exposure varies with different operating room
      factors. Exposures of anesthetists and nurses to these agents were determined in
      selected operating rooms over three consecutive days. Each subject was asked to
      wear an x-radiation dosimeter for 1 month. Exposure to anesthetic agents was
      found to be influenced by the age of the OR facility, type of surgical service,
      number of procedures carried out during the day, type of anesthetic circuitry,
      and method of anesthesia delivery. Anesthetists were found to have significantly
      greater exposures than OR nurses. Exposure of OR personnel to ethylene oxide,
      methyl methacrylate, and x-radiation were well within existing standards.
      Exposure of anesthetists and nurses to anesthetic agents, at times, was in excess
      of Ontario exposure guidelines, despite improvements in the control of anesthetic
      pollution.

PMID- 1642174
TI  - Evaluation of OSHA method 5 for measuring chloroform in pulp and paper industry
      workplace and ambient atmospheres.
AB  - As a result of the recent lowering of the Occupational Safety and Health
      Administration's (OSHA's) permissible exposure limit (PEL) for chloroform from 50
      ppm to 2 ppm, interest has increased in measuring chloroform in pulp and paper
      industry workplace atmospheres. OSHA suggested that its Method 5 should be used
      for measuring chloroform concentrations in the range of the new PEL. There are
      some potential problems with using Method 5 for this purpose. Pulp and paper
      industry atmospheres may interfere with the measurement because of high
      temperature, high humidity, and the presence of chlorine. The charcoal sorbent
      tubes specified in OSHA Method 5 were challenged in the laboratory with a test
      gas containing 0.1, 0.5, 1, and 2 times the PEL of chloroform at 38 degrees C
      with 80% to 93% relative humidity and ca. 0.5 ppm chlorine. Application of the
      National Institute for Occupational Safety and Health (NIOSH) validation protocol
      to the results indicated a bias of -8.2% and a pooled coefficient of variation
      (CV) of 0.0274. The method CV is less than the critical CV; thus, the method is
      acceptable by the NIOSH validation protocol under these conditions. Field testing
      of OSHA Method 5 was successful and did not reveal any unexpected problems.
      Additional tests showed that with some modification, OSHA Method 5 can be used to
      measure chloroform concentrations in ambient atmospheres down to 0.1 ppb.

PMID- 1642175
TI  - Limitations of ambient air quality standards in evaluating indoor environments.
AB  - Analysis of the kinds of data used for the derivation of ambient air quality
      standards (AAQSs) for carbon monoxide and ozone shows that these values are based
      on the toxicology of the materials and thus are suitable for evaluating potential
      health effects of indoor environments, especially on the very young, the aged,
      and the infirm. A similar analysis shows that the AAQSs for suspended particulate
      matter, nitrogen dioxide, and sulfur dioxide are strictly empirical and that they
      should not be used for any but their first, intended purpose. The AAQSs for non
      methane hydrocarbons are based on photochemical smog production, not injury of
      any kind, and have no utility for indoor environment evaluation.

PMID- 1642176
TI  - Efficiency of a physician-operated mobile intensive care unit for prehospital
      thrombolysis in acute myocardial infarction.
AB  - The efficiency of an emergency medical system for routinely performed prehospital
      thrombolysis is evaluated for 1 of the 7 physician-staffed mobile intensive care
      units (MICU) in former West Berlin. During 19 consecutive months the MICU had
      4,920 missions, and 1,226 patients had chest pain of presumed cardiac origin. The
      diagnosis at hospital discharge was acute myocardial infarction (AMI) in 406
      patients and "interrupted" infarction in 11 patients (total 417). Correct on
      scene electrocardiographic diagnosis of acute injury was made in 268 patients
      (64%) and was false-positive in 4 patients (1%). In 8%, present ST elevations
      were not recognized. In 27%, the electrocardiogram on scene was nondiagnostic
      (16% with no ST elevation, 11% with bundle branch block). Of all 417 patients
      with later hospital evidence of AMI, 317 (76%) were seen by the MICU physician
      within 4 hours, and 173 (41%) within the first hour from symptom onset. Two
      hundred three patients seen within 4 hours had diagnostic ST elevation on the
      scene, of whom 124 (61%) received prehospital thrombolysis (74 patients [36%]
      within the first hour). There was no prehospital death; hospital mortality was
      6.3%. Because greater than 50% of all patients in the community, hospitalized
      because of AMI, made use of the MICU and 3/4 of them had called within 4 hours
      from symptom onset, a large proportion of all patients with AMI were candidates
      for the actually received prehospital thrombolysis.

PMID- 1642177
TI  - Patient delay and receipt of thrombolytic therapy among patients with acute
      myocardial infarction from a community-wide perspective.
AB  - The duration of patient delay from the time of onset of symptoms of acute
      myocardial infarction (AMI) to hospital presentation, and the relation of delay
      time and various patient characteristics to receipt of thrombolytic therapy were
      examined as part of a community-based study of patients hospitalized with AMI in
      the Worcester, Massachusetts, metropolitan area. In all, 800 patients with
      validated AMI hospitalized at 16 hospitals in the Worcester metropolitan area in
      1986 and 1988 constituted the study sample. Patients delayed on average 4 hours
      between noting symptoms suggestive of AMI and presenting to area-wide emergency
      departments with no significant change observed between 1986 and 1988. The
      shorter the time interval of delay, the greater the likelihood of receiving
      thrombolytic therapy; patients arriving at the emergency department within 1 hour
      of the onset of acute symptoms were approximately 2.5 and 6.5 times more likely
      to receive thrombolytic agents than were those presenting to the hospital between
      4 and 6, and greater than 6 hours, respectively, after the onset of symptoms.
      Results of a multivariate analysis showed increasing length of delay, older age,
      history of hypertension or AMI and non-Q-wave AMI to be significantly associated
      with failure to receive thrombolytic therapy.

PMID- 1642178
TI  - Diagnosis of right ventricular acute myocardial infarction by dual isotope
      thallium-201 and indium-111 antimyosin SPECT imaging.
AB  - To assess the diagnostic value of indium-111 antimyosin for detecting right
      ventricular (RV) wall acute infarction, 30 patients with electrocardiographic
      documented left ventricular inferior (posterior) wall acute myocardial infarction
      underwent simultaneous dual isotope indium-111 antimyosin and thallium-201 single
      photon emission computed tomography (SPECT) within 2 days of admission. RV
      necrosis was defined as uptake of indium-111 antimyosin anterior and to the right
      of septal thallium uptake. Twenty-nine of the 30 patients (97%) had indium-111
      antimyosin uptake in the inferior, posterior or lateral walls of the left
      ventricle and 14 of 30 (47%) had additional RV antimyosin uptake. Three different
      patterns of RV uptake of indium-111 antimyosin were observed: crescent-shaped,
      focal and apical. Twenty-seven patients underwent gated blood pool scanning
      before hospital discharge. Twelve of the 14 patients with RV antimyosin uptake
      had gated blood pool scintigraphy and 7 of 12 had RV dysfunction; 5 had normal RV
      function. Except for 1 patient who had questionable RV antimyosin uptake and had
      RV dysfunction, no patient without RV antimyosin uptake had RV dysfunction. In
      summary, right and left ventricular necrosis can be detected on tomographic
      images of indium-111 antimyosin uptake in patients with inferior infarctions when
      simultaneous uptake of a perfusion tracer, thallium-201, is imaged and used as an
      aid to reconstruction and anatomic localization.

PMID- 1642179
TI  - Frequency of late potentials on signal-averaged electrocardiograms during
      thallium stress testing in coronary artery disease.
AB  - Late potentials detected by signal-averaged electrocardiography (SAECG) are an
      important noninvasive indicator identifying patients with previous myocardial
      infarction at risk for developing ventricular tachycardia. The role of myocardial
      ischemia in the development of late potentials is undefined. This study attempts
      to determine if late potentials on SAECG can be produced during scintigraphically
      proven ischemia. A signal-averaged electrocardiogram was obtained before and
      immediately after single-photon emission computed tomography thallium exercise
      testing in 51 patients. Reversible ischemia was documented in 25 cases with no
      significant changes in the parameters of SAECG; patients with previous myocardial
      infarction (n = 10) also had no significant changes from baseline. Multivariate
      analysis with respect to reversible ischemia and previous myocardial infarction
      was unrevealing. Patients with late potentials at baseline (n = 10) who developed
      reversible ischemia (n = 5) had a shorter QRS duration than those with late
      potentials at baseline and no reversible ischemia. The data indicate that
      exercise-induced scintigraphically proven ischemia does not alter SAECG even in
      the presence of previous myocardial infarction. Patients with late potentials at
      baseline may actually have a shortened QRS duration during reversible ischemia as
      opposed to the expected lengthening of the QRS.

PMID- 1642180
TI  - Relation of the level of high-density lipoprotein subfractions to the presence
      and extent of coronary artery disease.
AB  - Plasma lipid profiles, including high-density lipoprotein (HDL) subfractions HDL2
      and HDL3, were obtained in 115 men undergoing coronary angiography to assess the
      relation of lipid levels to coronary artery disease (CAD). CAD was present in 87
      patients (76%) and absent in 28 (24%). The largest difference between the 2
      groups were observed for HDL2 cholesterol, with a mean of 0.13 mmol/liter (5
      mg/dl) in patients with CAD compared with 0.25 mmol/liter (10 mg/dl) in those
      without CAD (p less than 0.005). Smaller differences were found for HDL3 (1.02
      mmol/liter [39 mg/dl] vs 1.19 mmol/liter [46 mg/dl]; p less than 0.005) and HDL
      (1.15 vs 1.42 mmol/liter [45 vs 55 mg/dl]; p less than 0.001) cholesterol, and
      apolipoprotein A-1 (1.37 vs 1.50 g/liter; p less than 0.01) and plasma
      triglycerides (1.79 vs 1.38 mmol/liter [159 vs 122 mg/dl]; p less than 0.05). No
      significant difference was found for plasma and low-density lipoprotein
      cholesterol, and apolipoprotein B levels. Simple regression analysis revealed
      that the most powerful independent variable associated with the extent of CAD was
      HDL2 cholesterol (Spearman rho = 0.311; p less than 0.001). Stepwise multiple
      regression analysis proved HDL2 cholesterol and age to be the strongest
      predictors of extent of CAD. The level of HDL2 cholesterol was reasonably well
      correlated with HDL cholesterol (r2 = 0.6; p less than 0.0001), but less so with
      plasma apolipoprotein A-1 (r2 = 0.4; p less than 0.0001). The data add to the
      growing body of information demonstrating an important association of HDL (and
      more specifically HDL2) with CAD in men.

PMID- 1642182
TI  - Intravascular ultrasound to assess aortocoronary venous bypass grafts in vivo.
AB  - In 20 consecutive patients (18 men and 2 women, aged 42 to 72 years) undergoing
      repeat coronary angiography because of new onset of angina pectoris 4 months to
      11 years (mean 53 months) after aortocoronary saphenous venous bypass operation,
      the graft to the left anterior descending (n = 12), left circumflex (n = 4) or
      right coronary (n = 2) artery, or a diagonal branch (n = 2) was studied by both
      intravascular ultrasound and angiography. Sonographic images were obtained using
      a 4.8Fr catheter with a crystal mechanically rotated at 900 rpm; quantitative
      coronary angiograms were recorded in biplane projections. In 18 patients,
      qualitatively as well as quantitatively evaluable images could be recorded; no
      complications occurred. The venous wall in general appeared to be homogenous;
      there were no separate layers identifiable. Simultaneous ultrasound and
      angiographic measurements were performed at a total of 75 sites (2 to 6 per
      bypass). In 4 of these patients (10 of 75 sites), neither intravascular
      ultrasound nor angiography revealed any pathologic changes; these bypasses were
      classified as normal. At the remaining 65 sites, arteriosclerotic lesions were
      detected in each case by ultrasound, but at only 33 sites by angiography. Median
      wall thickness was 0.59 mm (95% confidence interval 0.54 to 0.63) in normal
      grafts and 1.02 mm (0.99 to 1.07; p less than 0.001) in diseased grafts. The
      cross-sectional luminal area determined by ultrasound correlated well with the
      angiographic assessment (r = 0.90; p less than 0.001), but the measured values
      were significantly higher (17 +/- 4 vs 14 +/- 4 mm2; p less than 0.001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642181
TI  - Comparison of heart rate variability in survivors and nonsurvivors of sudden
      cardiac arrest.
AB  - Imbalances in autonomic nervous system function have been posed as a possible
      mechanism that produces ventricular fibrillation and sudden cardiac arrest in
      patients with cardiovascular disease. Heart rate (HR) variability is described in
      survivors and nonsurvivors of sudden cardiac arrest within 48 hours after
      resuscitation using time and frequency domain analytic approaches. HR data were
      collected using 24-hour ambulatory electro-cardiograms in 16 survivors and 5
      nonsurvivors of sudden cardiac arrest, and 5 control subjects. Survivors of
      sudden cardiac arrest were followed for 1 year, with recurrent cardiac events
      occurring in 4 patients who died within that year. Analysis of 24-hour
      electrocardiograms demonstrated that control subjects had the highest HR
      variability (standard deviation of all RR intervals = 155.2 +/- 54 ms), with
      nonsurvivors demonstrating the lowest HR variability (standard deviation of all
      RR intervals = 52.3 +/- 6.1 ms) and survivors of sudden cardiac arrest falling
      between the other 2 groups (standard deviation of all RR intervals = 78 +/- 25.5
      ms, p less than or equal to 0.0000). Two other indexes of HR variability (mean
      number of beat to beat differences in RR intervals greater than 50 ms/hour and
      root-mean-square of successive differences in RR intervals) did not demonstrate
      the expected pattern in this sample, indicating that perhaps patterns of HR
      variability differ between groups of patients with cardiovascular disorders.
      Spectral analytic methods demonstrated that survivors of sudden cardiac arrest
      had reduced low- and high-frequency spectral power, whereas nonsurvivors
      demonstrated a loss of both low- and high-frequency spectral power.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642183
TI  - Ventricular tachycardia in Chagas' disease.
AB  - This study examined the usefulness of the electrophysiologic approach for
      selecting antiarrhythmic drug therapy to improve survival in patients with
      ventricular tachycardia (VT) and Chagas' disease. A total of 71 consecutive
      chagasic patients undergoing treatment and evaluation of VT were analyzed.
      Programmed electrical stimulation (PES) was performed in 45 patients, sustained
      VT was induced in 18 of these 45 (40%); nonsustained VT was induced in 17 (38%),
      and in 10 patients (22%) VT was not induced at all. An average of 3 drugs per
      patient were tested, including mexiletine, flecainide and propafenone. At least 1
      effective drug preventing VT induction was identified in 13 of 18 patients with
      induced sustained VT, whose outcome resulted in 2 nonsudden but cardiac deaths
      (15%). Eight patients received no drug therapy because the induced arrhythmia was
      asymptomatic nonsustained VT; none of these died. The remaining 24 patients from
      the PES group were empirically treated with amiodarone; 7 died (4 suddenly)
      during follow-up (29%). A group of 26 patients (non-PES group) did not undergo
      electrophysiologic evaluation. In these patients, the therapy chosen was
      amiodarone alone or associated with mexiletine, and the incidence of death was 7
      of 26 patients (27%), 3 suddenly (p less than 0.05 at 10-year survival and p =
      not significant at 5-year survival). It is concluded that the electrophysiologic
      approach improves survival in this study population, but only 29% were eligible
      for guided therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642184
TI  - Comparison of atrial overdrive pacing with and without extrastimuli for
      termination of atrial flutter.
AB  - Atrial overdrive pacing has been successfully used to terminate atrial flutter.
      This study compared the efficacy of atrial extrastimuli following a rapid pacing
      train to overdrive pacing without atrial extrastimuli for the termination of
      atrial flutter. Patients were randomized to treatments of short or long burst
      atrial overdrive pacing or atrial overdrive pacing followed by atrial
      extrastimuli in a crossover study design. A total of 22 patients (73%) had
      successful conversion of atrial flutter to sinus rhythm. The success rates in
      patients exposed to each therapy, including crossover therapies, were 62% with
      the atrial extrastimuli method, 8% with the short burst pacing method, and 8%
      with the long burst pacing method (p less than 0.001). Transient atrial
      fibrillation developed in 15 patients and in 9 of these this arrhythmia preceded
      conversion to sinus rhythm. Sustained atrial fibrillation was induced in 3
      additional patients but never with the atrial extrastimuli method. In conclusion,
      the method of delivering atrial extrastimuli after a rapid pacing train is highly
      efficacious for the termination of atrial flutter. Furthermore, this method is
      more effective than atrial overdrive pacing methods delivered at the same pacing
      cycle length. These observations have important implications for the programming
      of antitachycardia pacemakers.

PMID- 1642185
TI  - Effects of long-acting nifedipine on casual office blood pressure measurements,
      24-hour ambulatory blood pressure profiles, exercise parameters and left
      ventricular mass and function in black patients with mild to moderate systemic
      hypertension.
AB  - Thirty-nine black patients with mild to moderate hypertension were treated for 1
      year with various long-acting preparations of nifedipine, during which time
      serial changes in 24-hour ambulatory blood pressure (BP), exercise performance,
      left ventricular (LV) mass index and LV systolic function were evaluated. Mean 24
      hour ambulatory BP decreased from 156 +/- 15/99 +/- 8 to 125 +/- 10/79 +/- 6 mm
      Hg at 1 year (p less than 0.0001). LV mass index decreased from 130 +/- 40 to 114
      +/- 39 g/m2 at 6 weeks (p less than 0.005) and to 95 +/- 32 at 1 year (p less
      than 0.0001). There was a significant reduction in septal and posterior wall
      thickness from 11.0 +/- 2.0 to 9.3 +/- 2.0 mm (p less than 0.0001) and from 10.9
      +/- 2.0 to 9.3 +/- 2.0 mm (p less than 0.005), respectively. Cardiac index and
      fractional shortening changed insignificantly from 2.9 +/- 0.7 to 2.9 +/- 0.6
      liters/min/m2, and from 35 +/- 5 to 36 +/- 6%, respectively. At 1 year, using a
      modified Bruce protocol, exercise time increased from 691 +/- 138 to 845 +/- 183
      seconds (p less than 0.05); peak exercise and 1 minute post-effort systolic BP
      decreased from 240 +/- 26 to 200 +/- 21 mm Hg and from 221 +/- 27 to 169 +/- 32
      mm Hg (p less than 0.05), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642188
TI  - Clinical significance of coronary artery disease in hypertrophic cardiomyopathy.
AB  - The role of coronary artery disease (CAD) in hypertrophic cardiomyopathy (HC) has
      not been thoroughly clarified. To assess the clinical and prognostic significance
      of these 2 coexistent diseases, 96 patients with HC (62 men, mean age 45 years)
      who underwent coronary arteriography and 2-dimensional echocardiography were
      studied. Significant stenosis (greater than 70%) of 1 or more coronary arteries
      was detected in 11 patients, all aged greater than 45 years. This group, compared
      with the other group without significant CAD (n = 85), was characterized by an
      older age (59 +/- 7 vs 42 +/- 15 years; p less than 0.05), a greater prevalence
      of previous myocardial infarction (24 vs 0%; p less than 0.001), complex
      ventricular arrhythmias (100 vs 50%; p less than 0.05), non-obstructive forms (82
      vs 46%; p less than 0.05), dilated (45 vs 7%; p less than 0.02) and
      hypocontractile left ventricle (36 vs 6%; p less than 0.01) and higher mortality
      (36 vs 8%; p less than 0.05) during a mean follow-up of 3.6 years. It is
      concluded that CAD associated with HC is a complex clinical syndrome, difficult
      to diagnose clinically, that can reliably be recognized by coronary angiography.
      CAD seems to play an important role in modifying the pathophysiology, the natural
      history and the prognosis of HC.

PMID- 1642186
TI  - Renal function in severe congestive heart failure during treatment with enalapril
      (the Cooperative North Scandinavian Enalapril Survival Study [CONSENSUS] Trial).
AB  - The effect on renal function of long-term treatment with either enalapril (n =
      123) or placebo (n = 120) in addition to conventional therapy was studied in a
      randomized trial in patients with severe congestive heart failure (New York Heart
      Association functional class IV; the Cooperative North Scandinavian Enalapril
      Survival Study). Enalapril was administered in a dose of 2.5 to 40 mg/day. The
      analysis was restricted to the first 6 months of treatment. There was an average
      initial increase of 10 to 15% (10 to 20 mumol/liter) irrespective of baseline
      serum creatinine within the first 3 weeks of enalapril treatment, whereafter mean
      serum creatinine remained on a similar level during the first 6 months. Enalapril
      was well-tolerated by most patients, and serum creatinine was reduced in 24%.
      Serum creatinine increased by greater than 100% in 13 patients (11%) in the
      enalapril group (mainly as a consequence of intercurrent disease or severe
      hypotension, and usually transiently) and in 4 (3%) in the placebo group. The
      maximal increase in serum creatinine in the enalapril group was inversely
      correlated to the diastolic blood pressure (p = 0.008) at baseline and to the
      mean diastolic and systolic blood pressures measured at the time of the maximal
      increase in serum creatinine (p = 0.0001). According to multivariate regression
      analysis, the maximal increase in serum creatinine was also slightly influenced
      by the dose of furosemide taken. The development of hypotension emerged as the
      strongest factor explaining an abnormal increase in serum creatinine.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642187
TI  - Detection of skeletal muscle fatigue in patients with heart failure using
      electromyography.
AB  - Patients with heart failure frequently report that leg fatigue limits maximal
      exercise capacity. However, objective documentation of muscle fatigue has not
      been obtained in such patients. In normal subjects, muscle fatigue during
      constant work load exercise is associated with an increase in electrical activity
      generated per contraction due to use of additional muscle fibers to compensate
      for fiber fatigue. The present study was performed to determine if this approach
      can be used to document muscle fatigue in patients with heart failure. Vastus
      lateralis surface electromyograms were monitored in 8 ambulatory patients with
      nonedematous heart failure and 6 normal subjects during maximal bicycle exercise
      (20 W increments every 2 minutes). The electromyogram was stored on tape and
      subsequently analyzed for integrated root-mean-square voltage/contraction
      (iRMSV). At each work load, the iRMSV of the first and last 30 seconds of the
      work load were compared. The maximal work load achieved by patients with heart
      failure was significantly lower (73 +/- 22 W) than that by normal subjects (150
      +/- 15 W; p less than 0.01). Both groups had no significant difference between
      the initial and final iRMSV at submaximal work loads. However, during the 2
      highest work loads, both groups reported leg fatigue and had significant
      increases in iRMSV, consistent with muscle fiber fatigue (maximal work load: 259
      +/- 59 to 279 +/- 58 mv.ms [normals] vs 258 +/- 94 to 283 +/- 93 mv.ms [heart
      failure]; p less than 0.03). The data indicate that the surface electromyogram
      can be used to detect skeletal muscle fatigue in patients with heart
      failure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642189
TI  - The "adult" form of the scimitar syndrome.
AB  - One hundred twenty-two cases of the adult form of the scimitar syndrome were
      collected from different cardiologic centers. The clinical, radiographic and
      hemodynamic findings are described. The scimitar syndrome is defined as an
      anomalous right pulmonary venous drainage, partial or complete, to the inferior
      vena cava. Additional characteristics of this syndrome such as hypoplasia and
      abnormalities of the vascular supply to the right lung, dextrocardia and
      abnormalities of the bronchial segmentation are common; bronchiectases are rare.
      The left to right shunt was less than 50% in 100 of the 122 patients. The
      pulmonary arterial pressures were normal in 94 patients and slightly elevated in
      28. A follow-up study of these patients showed that, without surgical correction,
      they lead a normal life. An awareness of this syndrome may avoid unnecessary
      invasive diagnostic procedures and surgical treatment for most patients.

PMID- 1642190
TI  - Determinants of Doppler indexes of left ventricular diastolic function in normal
      subjects (the Framingham Heart Study).
AB  - Normative Doppler values and determinants of left ventricular (LV) diastolic
      function in healthy subjects have not been fully elucidated. Subjects from the
      Framingham Heart Study were examined to describe reference values and
      determinants of echocardiographic Doppler indexes of diastolic function. One
      hundred twenty-seven randomly selected, rigorously defined, normal subjects,
      approximately evenly distributed by sex and age from the third through the eighth
      decades were studied by Doppler echocardiography. Normative values for 7
      frequently used Doppler indexes of LV diastolic function are presented. Doppler
      indexes of LV diastolic function change dramatically with age; the peak velocity
      of early filling divided by late filling (peak velocity E/A) ranges from a mean
      of 2.08 +/- 0.55 for subjects in their third decade to 0.84 +/- 0.29 for those in
      their eighth decade. A peak velocity E/A ratio less than 1 is abnormal in
      subjects aged less than 40 years, but occurs in most subjects aged greater than
      or equal to 70 years. The high correlations between age and Doppler indexes of LV
      diastolic function are not greatly attenuated after adjustment for other clinical
      parameters associated with diastolic function; the multivariate partial
      correlation coefficient between age and peak velocity E/A is -0.80 (p less than
      0.0001). Heart rate, PR interval, LV systolic function, sex and systolic blood
      pressure are minor determinants of Doppler indexes of diastolic function. Body
      mass index, left atrial diameter, and LV wall thickness, internal dimension and
      mass have little or no association with Doppler indexes in healthy
      subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642191
TI  - Frequency and significance of intrapulmonary right-to-left shunting in end-stage
      hepatic disease.
AB  - Intrapulmonary vascular abnormalities consisting of arteriovenous malformations
      and capillary dilatations have been described in patients with severe liver
      disease. These intrapulmonary vascular abnormalities can result in intrapulmonary
      right-to-left shunting and hypoxemia. Twenty-five of 53 patients (47%) with end
      stage hepatic disease were found to have contrast echocardiographic evidence of
      intrapulmonary right-to-left shunting. There was no difference in mean age,
      gender distribution, or severity of hepatic disease in those with and without
      evidence of such shunting. Although there was no difference in mean partial
      arterial oxygen pressure (PaO2) values in the 2 groups (82 +/- 11 vs 76 +/- 11 mm
      Hg), the mean PaO2 value of those with at least 2+ left ventricular opacification
      (2 to 4+) was significantly lower (66 +/- 3 mm Hg, n = 8; p less than 0.01).
      Unexpectedly, patients with evidence of intrapulmonary shunting had a lower
      mortality rate before transplantation (3 of 25, 12%) than those without evidence
      of shunting (10 of 28, 36%) resulting in a significant difference in actuarial
      survival (p less than 0.05) by the end of the follow-up period. It is concluded
      that intrapulmonary right-to-left shunting occurs frequently in patients with end
      stage liver disease and may be a marker of a positive biologic process that, in
      some way, leads to improved short-term survival.

PMID- 1642192
TI  - Factors influencing the development of hypercholesterolemia after cardiac
      transplantation.
AB  - Although hypercholesterolemia is a frequent complication in cardiac transplant
      recipients, the exact mechanisms contributing to its development are not known.
      Cholesterol levels in 151 thoracic transplant patients treated with cyclosporine,
      azathioprine and prednisone were retrospectively examined to evaluate the factors
      influencing the heterogeneity of changes after the first year after
      transplantation in patients on a standard 3-drug immunosuppression regimen. Three
      groups were compared including ischemic heart transplant (n = 72), nonischemic
      heart transplant (n = 64) and heart-lung/lung transplant (n = 15) recipients.
      After the first year, 64 patients (43%) developed consistent hypercholesterolemia
      (greater than 240 mg/dl) for which pharmacologic treatment was initiated. Forty
      eight patients (67%) in the ischemic heart transplant group required treatment,
      significantly (p less than 0.001) greater than both the nonischemic (n = 14; 22%)
      and heart-lung/lung transplant (n = 2; 13%) group. Univariate and forward
      stepwise multivariate regression analysis identified 4 factors that were all
      significantly and independently correlated with follow-up cholesterol including
      prednisone dose (p less than 0.001), baseline cholesterol (p less than 0.001),
      glucose (p less than 0.001) and weight gain (p less than 0.01). Changes in
      triglycerides in the 3 groups of patients were similar to changes in cholesterol.
      Furthermore, the increase in cholesterol in patients requiring treatment was
      primarily due to an increase in low-density lipoprotein cholesterol. These data
      demonstrate that hypercholesterolemia is common in heart transplant recipients
      treated with standard 3-drug immunosuppression and generally develops within the
      first 2 years after transplantation. However, this complication is not uniform
      and appears to be most strongly related to previous coronary artery
      disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642193
TI  - Error rates with which endomyocardial biopsy specimens are graded for rejection
      after cardiac transplantation.
AB  - Control of the immune response to the transplanted organ is fundamental to the
      success of transplantation. Endomyocardial biopsy to diagnose and grade rejection
      is the mainstay in achieving this control. As rejection tends to be a patchy
      process, accurate diagnosis depends on adequate sampling from the myocardium.
      This study estimates the error rates with which biopsy specimens are graded. The
      results of 459 biopsy sets, in which at least 4 fragments were graded, were
      analyzed. Combinations of grades observed at the same biopsy session were used to
      estimate error rates. An E-M algorithm was used to estimate error rates.
      Predictive probabilities of true grades, given a set of 4 graded fragments, were
      calculated using Bayes theorem. If 4 fragments at a biopsy session were negative
      there was a 0.02% chance of missing clinically significant rejection (moderate or
      severe). Similarly, if minimal rejection was the highest grade observed, the
      probability of missing moderate-severe rejection was negligible, between 0.06 and
      0.09%. However, where mild rejection is the highest observed on the 4 fragments,
      there is between a 2% (1 mild fragment) and 28% (4 mild fragments) chance of
      moderate-severe rejection being the underlying grade. This study concludes that 4
      fragments are adequate as a minimum in most cases. However, if only 4 fragments
      are available, and greater than or equal to 3 are graded mild, the risk of
      missing moderate-severe rejection is unacceptably high, and repeat biopsy or
      treatment may be indicated.

PMID- 1642194
TI  - Peak exercise left ventricular performance in normal subjects and in athletes
      assessed by first-pass radionuclide angiography.
AB  - The role of Frank-Starling law of the heart in determining the increase in
      cardiac output during exercise in humans is still controversial (e.g., the
      mechanisms responsible for the enhancement of left ventricular [LV] filling
      during the shortened diastolic interval). Ten weight lifters, 12 swimmers and 12
      sedentary subjects who underwent maximal upright bicycle exercise testing were
      studied. First-pass radionuclide angiography was performed both at rest and at
      peak exercise using a multicrystal gamma camera. Compared with resting values,
      heart rate and cardiac index at peak exercise increased by 101 +/- 16 beats/min
      (p less than 0.001) and 6.7 +/- 2.8 liters/min/m2 (p less than 0.001) in weight
      lifters, by 96 +/- 9 beats/min (p less than 0.001) and 9.5 +/- 2 liters/min/m2 (p
      less than 0.001) in swimmers, and by 103 +/- 9 beats/min (p less than 0.001) and
      7.3 +/- 1.8 liters/min/m2 (p less than 0.001) in sedentary subjects. Stroke
      volume increased by 20.5 +/- 9.8 ml/m2 (p less than 0.001) in swimmers only. End
      diastolic volume at peak exercise did not change in weight lifters and in
      swimmers; it decreased by 8.2 +/- 8.6 ml/m2 (p less than 0.01) in sedentary
      subjects. A significant correlation was found between the decrease in end
      systolic volume and the increase in peak rapid filling rate at peak exercise in
      all 3 groups (r = 0.65, p less than 0.05 in weight lifters; r = 0.59, p less than
      0.05 in swimmers; r = 0.67, p less than 0.05 in sedentary subjects.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642195
TI  - Doppler echocardiographic assessment of aortic stenosis using the peak velocity
      ratio.

PMID- 1642196
TI  - Comparison of thermodilution and Fick methods for measurement of cardiac output
      in tricuspid regurgitation.

PMID- 1642197
TI  - Reported frequency of coronary arterial narrowing by angiogram in patients with
      valvular aortic stenosis.

PMID- 1642198
TI  - Specificity of electrocardiographic stress test in women versus men.

PMID- 1642199
TI  - Assessment of rate smoothing in dual-chamber pacemakers.

PMID- 1642200
TI  - Intraoperative percutaneous double-balloon valvuloplasty versus surgical
      commissurotomy for mitral valve stenosis.

PMID- 1642201
TI  - Is tropical pancreatitis premalignant?
AB  - Pancreatic adenocarcinoma occurred in 22 of 266 patients with tropical
      pancreatitis presenting over an 8-yr period (8.3%). We compared the data on three
      groups: group 1, patients with tropical pancreatitis (benign, n = 82); group 2,
      tropical pancreatitis with super-imposed malignancy (n = 22), and group 3, those
      with de novo cancer (n = 76). Factors associated with high risk for cancer in
      tropical pancreatitis were age greater than 40 yr, short symptom duration, weight
      loss, mass on ultrasound, and ductal block on endoscopic retrograde
      cholangiopancreatography. Tropical pancreatic cancers had distinct differences
      from de novo cancers: younger mean age (47 vs. 61 yr), calculi in all (vs. none
      in group 3), diabetes in 16 of 22 (73%) versus 18 of 76 (24%), and tumors in body
      and tail in 16 of 22 (73%) versus 26 of 76 patients (34%). In group 2, survival
      was poorer (10 vs. 17 months, p less than 0.01) than in group 3 (those with de
      novo cancer). Two of five resected specimens in group 2 showed features of
      dysplasia, in addition to cancer. Tropical pancreatitis has a high association
      with cancer. Malignancy occurring in tropical pancreatitis is distinct from de
      novo cancer. When considered in the light of the low incidence of pancreatic
      cancer in southern India, the above evidence suggests a possible etiological
      relationship.

PMID- 1642202
TI  - A comparative study of once-a-day morning and once-a-day bedtime administration
      of 40 mg famotidine in treating gastric ulcers.
AB  - A randomized controlled study comparing once-a-day morning and once-a-day bedtime
      administration of 40 mg famotidine in treating gastric ulcers was carried out in
      179 Japanese patients. Endoscopic examinations were performed at the baseline and
      repeated at 4-wk intervals until healing was confirmed. One hundred and sixty
      four patients fulfilled the evaluation criteria (81 in the morning group and 83
      in the bedtime group). The healing rates were 50.7% after 4 wk and 88.9% after 8
      wk in the morning group and 46.5% after 4 wk and 74.7% after 8 wk in the bedtime
      group. The difference was statistically significant after 8 wk. Significant
      reductions from baseline for overall pain, beginning during the first 3 days,
      were likewise found in the two treatment groups. However, the pain severity in
      hunger state 1 wk after treatment was significantly higher in the bedtime group
      than in the morning group. Thus, once-a-day morning administration of 40 mg
      famotidine seems to be superior to once-a-day bedtime administration of 40 mg
      famotidine in treating gastric ulcers.

PMID- 1642203
TI  - Historical case report of Sir William Johnson, the Mohawk Baronet.

PMID- 1642204
TI  - Cullen's sign: it doesn't always mean hemorrhagic pancreatitis.
AB  - Periumbilical ecchymosis, Cullen's sign, is most often considered a sign of
      hemorrhagic pancreatitis. We present a case of splenic rupture secondary to
      infectious mononucleosis in a middle-aged patient whose presenting complaint was
      the presence of Cullen's sign, secondary to the hemoperitoneum. The splenic
      rupture was managed conservatively, and the Cullen's sign resolved within 14 days
      of presentation.

PMID- 1642205
TI  - Crohn's disease of the duodenum complicated by pancreatitis and common bile duct
      obstruction.
AB  - It is well known that Crohn's disease can involve the duodenum, but isolated
      secondary complications such as pancreatitis or common bile duct obstruction have
      only rarely been reported, and never in the same patient. Herein, we describe a
      patient with duodenal Crohn's disease and both pancreatitis and calculous common
      bile obstruction. This unusual constellation of findings was managed with
      percutaneous techniques in which transhepatic catheterization of the bile duct
      permitted balloon dilatation of the ampulla of Vater, as well as a duodenal
      stricture. These maneuvers resulted in passage of the biliary stone and relief of
      the patient's symptoms. The management of this patient may serve as a guide
      possibly to delay or even prevent surgical intervention in similar cases of
      benign enteric strictures.

PMID- 1642206
TI  - Acute onset of celiac disease in the puerperium.
AB  - An acute, severe onset of celiac disease is very unusual in adults. We describe
      its occurrence postpartum in two patients. These, together with two similar cases
      previously reported, suggest a causal association with the puerperium. Possible
      causes include potentiation of a pathogenetic immune reaction and hormonal
      mechanisms.

PMID- 1642207
TI  - Endoscopic detection and therapy of colonic actinomycosis.
AB  - Abdominal actinomycosis is a disease that is difficult to diagnose
      nonoperatively. Usual manifestations are abscesses and draining sinus tracts.
      Treatment is typically surgical and requires prolonged intravenous antibiotics.
      Presented is a patient who underwent surveillance colonoscopy after resection for
      colon carcinoma. Diagnosis of colonic actinomycosis and subsequent resolution was
      demonstrated endoscopically after lengthy oral penicillin therapy (2 g/day for 1
      yr). This case documents that resection may not be necessary to effect cure of
      abdominal actinomycosis.

PMID- 1642208
TI  - Diffuse-type gastric cancer in a young adult presenting with neurological
      symptoms and liver rupture.
AB  - A 27-yr-old man presented with neurological symptoms and subsequent painful liver
      enlargement. Cranial computerized tomographic scans and gastroscopy were
      negative. Ultrasound examination revealed nonhomogeneous echo pattern of the
      enlarged liver; a guided biopsy specimen suggested hepatoma. The patient died of
      hemorrhagic shock 5 days after liver biopsy and 4 wk after the initial
      presentation. Autopsy revealed diffuse-type gastric carcinoma as the primary
      lesion, liver ruptures at sites distant from the biopsy, thrombosis of the
      sagittal sinus, and widespread permeation of blood and lymphatic vessels with
      anaplastic carcinoma cells. The incidence of gastric cancer in young adults from
      the Cancer Registry of Slovenia is presented for the period from 1979 to 1987.
      Our case corroborates the importance of considering this malignancy early in the
      evaluation of young symptomatic patients.

PMID- 1642209
TI  - Carcinoma of the uncinate process of the pancreas with a peculiar clinical
      manifestation.
AB  - A total of 119 Japanese patients with pancreas head carcinoma were treated in the
      Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka, Japan,
      from January 1976 to December 1991. Three of the 119 patients had carcinoma in
      the uncinate process, with a 2.5% incidence of pancreas head carcinoma. Those
      three cases consisted of two men, one 55 and one 72 yr old, and one 62-yr-old
      woman. Two patients developed abdominal pain, whereas another was vomiting; no
      patients were icteric. Hypotonic duodenography showed an irregular mucosa of the
      inner area of the third portion of the duodenum in two and an obstruction of the
      duodenum in one. Drip infusion cholangiography and/or endoscopic retrograde
      cholangiopancreatography revealed no abnormality of the biliary tract or
      pancreatic ducts in any of the three. Ultrasonography showed a hypoechoic mass in
      the uncinate process in three, and computed tomography showed a low-density mass
      in the uncinate process in two with a displacement of the superior mesenteric
      vessels toward the anterior. Angiography showed encasement of the
      pancreatoduodenal arcade in three, the dorsal pancreatic artery in two, and the
      middle colic artery in two. No neovascularity or tumor staining was present. Two
      patients underwent a pancreatoduodenectomy, and the other had a bypass operation
      (gastrojejunostomy). The histopathologic diagnosis was well-differentiated
      adenocarcinoma, mucinous carcinoma, and adenosquamous carcinoma, respectively.
      Two patients died from local recurrence and/or distant metastasis 5 and 6 months
      after a radical resection, and the other died 3 months after clinical diagnosis.
      Peculiar clinicopathologic features of these patients with pancreas carcinoma
      arising in the uncinate process are reported herein, and the clinical problems of
      this disorder are briefly discussed.

PMID- 1642210
TI  - Copper deficiency and microcytic anemia resulting from prolonged ingestion of
      over-the-counter zinc.
AB  - Isolated copper deficiency occurred in a 57-yr-old man who had ingested massive
      quantities of zinc for more than 18 months. The patient presented with microcytic
      anemia and had normal gastrointestinal function with no evidence of occult blood
      loss. Dietary zinc in large doses leads to copper deficiency by antagonizing
      copper absorption. With discontinuance of zinc, the anemia and hypocupremia
      promptly corrected. The relationship between zinc, copper deficiency, and iron
      metabolism is reviewed.

PMID- 1642211
TI  - Biofeedback in anismus: the truth be known?

PMID- 1642212
TI  - Autoimmune hepatitis, hepatitis C, and interferon: look before you leap.

PMID- 1642213
TI  - Experimental pancreatolithiasis: association with chronic alcoholic pancreatitis.

PMID- 1642214
TI  - Chronic non-B, non-C hepatitis: report from Pakistan.

PMID- 1642215
TI  - Hepatic dysfunction induced by streptokinase.

PMID- 1642216
TI  - Visual endoscopic indicator of Helicobacter pylori infection.

PMID- 1642217
TI  - Portal hypertensive intestinal vasculopathy: a review of the clinical,
      endoscopic, and histopathologic features.
AB  - Over the past decade, awareness of the association between portal hypertension
      and changes in the intestinal circulation has increased. Most of the observations
      have been made by endoscopic examination and biopsy of the mucosa. The
      fundamental pathologic change is a vasculopathy. Portal hypertensive intestinal
      vasculopathy (PHIV) most often involves the stomach (gastropathy) and can be a
      common source of bleeding. The significance of small bowel involvement
      (enteropathy) is unknown. Colon involvement (colopathy) has been associated with
      bleeding, and mimics inflammatory bowel disease. The reliability of endoscopic
      appearances and histologic examination in establishing the diagnosis is
      questionable. Recent observations of other diagnostic modalities and associated
      physiologic alterations and treatment options are discussed. Further prospective
      evaluations that use uniform terminology for endoscopic and histologic
      descriptions are needed to establish criteria for accurate diagnosis and
      assessment of response to treatment.

PMID- 1642218
TI  - Role of endoscopic retrograde cholangiopancreatography after orthotopic liver
      transplantation.
AB  - We reviewed the records of 20 liver transplant patients who underwent 28
      procedures [endoscopic retrograde cholangiopancreatography (ERCP)] to rule out
      biliary obstruction, treat bile leaks, dilate and/or stent strictures, or remove
      stones and debris. Three patients (two with abnormal T-tube cholangiograms and
      one with hyperbilirubinemia) underwent ERCP to rule out obstruction. Therapeutic
      ERCP (sphincterotomy with balloon dilatation or stone extraction) was successful
      in 16 of 17 patients, including seven of nine in whom there was resolution of
      bile leaks without the use of stents or surgery. Mild pancreatitis occurring in
      one patient was the only complication experienced that was related to ERCP. We
      conclude that ERCP is a safe and important modality in the medical management of
      biliary tract complications after orthotopic liver transplantation.

PMID- 1642219
TI  - The LES locator: accurate placement of an electrode for 24-hour pH measurement
      with a combined solid state pressure transducer.
AB  - Twenty-four-hour esophageal pH monitoring is the gold standard for diagnosing
      gastroesophageal reflux disease. A possible limitation to the widespread use of
      this test is that manometry is required for accurate placement of the pH
      electrode 5 cm above the lower esophageal sphincter. We compared the accuracy of
      a single solid state pressure transducer, combined with a pH electrode, in
      determining the proximal border of the lower esophageal sphincter (LES) with the
      values obtained from stationary manometry in 40 patients referred to our
      laboratory for 24-h pH studies. Not only was there a strong correlation (r = 0.9)
      between LES values obtained by the two techniques, but none of the values
      obtained by the single solid state transducer were outside the clinically
      accepted range of greater than +/- 3 cm. The presence of a hiatal hernia or low
      sphincter pressure did not affect these measurements. The larger probe was
      tolerated somewhat less well (p = 0.02) than a standard antimony electrode during
      the prolonged pH studies. In conclusion, a single solid state pressure transducer
      on a pH probe with the help of a LES locator accurately identifies the proximal
      border of the LES. Therefore, stationary esophageal manometry is no longer needed
      prior to 24-h pH monitoring, potentially making this important clinical tool
      available to a wider variety of clinicians at all levels of the health care
      system, in investigating gastroesophageal reflux and its protean clinical
      presentations.

PMID- 1642220
TI  - An index of disease activity in patients with ulcerative colitis.
AB  - Quantification of disease severity was studied in 72 patients with ulcerative
      colitis, who had undergone total 85 clinical courses. We performed a multiple
      stepwise regression analysis, according to Truelove and Witts' classification,
      with disease severity as a dependent variable, and with 18 clinical, laboratory,
      and endoscopic parameters as independent variables. Results showed that disease
      severity in patients with ulcerative colitis is significantly influenced by five
      factors, namely, bloody stool, bowel movements, erythrocyte sedimentation rate
      (ESR), hemoglobin (Hb), and serum albumin. The activity index (AI) developed for
      ulcerative colitis is expressed as follows: AI = 60 x blood stool + 13 x bowel
      movements + 0.5 x ESR - 4 x HB - 15 x albumin + 200. Index values below 150,
      values between 150 and 220, and values above 220 nearly corresponded to mild,
      moderate, and severe disease, respectively, in Truelove and Witts'
      classification. We believe that the activity index is useful in evaluation of the
      effect of medical treatment in patients with ulcerative colitis. Its most
      important value will be in therapeutic trials.

PMID- 1642221
TI  - Psychological evaluation of patients with severe idiopathic constipation: which
      instrument to use.
AB  - We prospectively evaluated 38 patients with chronic severe idiopathic
      constipation who failed to respond to conventional therapy. Colonic transit
      studies, the Hopkins Symptom Checklist (SCL-90-R), and the Minnesota Multiphasic
      Personality Inventory (MMPI) were completed. Colonic transit studies identified
      23 patients with slow transit and 15 with normal transit. Patients with normal
      transit constipation scored higher than those with slow transit on every scale of
      both the SCL-90-R and MMPI, but the SCL-90-R appeared to detect greater
      differences between the two groups. We conclude that the SCL-90-R is the
      preferred psychological instrument to evaluate patients with chronic severe
      constipation who fail to respond to conventional therapy. It provides information
      similar to the MMPI with which to measure behavioral profiles of patients in an
      office setting, and it can be completed and scored more rapidly.

PMID- 1642223
TI  - Endoscopic stent placement for obstructive jaundice secondary to metastatic
      malignancy.
AB  - In patients with malignancy, jaundice may result from hepatic infiltration or
      metastatic lymph nodal compression along the bile duct. We attempted endoscopic
      stent placement on 31 consecutive patients with biliary obstruction from
      malignant adenopathy, with and without computerized tomographic (CT) scan
      evidence of hepatic parenchymal metastases. Endoscopic or combined endoscopic
      percutaneous decompression was accomplished in 28 patients. Fifteen patients
      (53.6%) had CT evidence of concomitant metastatic disease to the liver. Thirteen
      patients had obstructing adenopathy only. Mean survival for patients with hepatic
      metastases after relief of extrahepatic obstruction was 117.4 days (range 9-386
      days). Mean survival after biliary decompression in patients without hepatic
      involvement was significantly longer at 364.3 days (range 52-1098 days; p =
      0.0087). Bilirubin levels fell in all patients in this group. No patient died
      from complications of obstruction or stent placement. Our data support the
      conclusion that patients with extrahepatic metastatic biliary obstruction without
      hepatic metastases have improved survival, compared with patients with both
      obstruction and hepatic involvement. In the absence of hepatic parenchymal
      involvement, endoscopic stent placement can safely and effectively palliate
      metastatic extrahepatic obstruction. Controlled trials are needed to assess the
      effect of such stenting on survival.

PMID- 1642222
TI  - Enteric-coated charcoal as a means of blinding studies comparing bismuth and H2
      receptor antagonists.
AB  - Clinical trials comparing H2-receptor antagonists and bismuth-containing regimens
      in ulcer healing, ulcer relapse, or dyspepsia have not been double-blind, because
      bismuth darkens stools. This study was designed to determine whether enteric
      coated charcoal could darken stools of subjects taking an H2-receptor antagonist
      without interfering with absorption of the drug. Twelve healthy volunteers
      participated in a randomized, double-blind, crossover trial of oral ranitidine
      (300 mg at bedtime) alone, ranitidine plus bismuth (30 ml Pepto-Bismol four times
      daily), and ranitidine plus enteric-coated charcoal (four tablets daily). Mean
      stool colors both with ranitidine plus charcoal and with ranitidine plus bismuth
      were significantly darker than with ranitidine alone, but were not significantly
      different from each other. Blood levels of ranitidine during the 10 h after its
      administration did not differ significantly among the three regimens. We conclude
      that enteric-coated charcoal can be used to blind clinical trials comparing an H2
      receptor antagonist (e.g., ranitidine) and a bismuth regimen.

PMID- 1642224
TI  - A prospective randomized study of the injurious effects of aspirin and naproxen
      on the gastroduodenal mucosa in patients with rheumatoid arthritis.
AB  - A prospective double-blind randomized placebo-controlled study was conducted to
      compare the injurious effects of aspirin and naproxen on the gastroduodenal
      mucosa. Patients with rheumatoid arthritis attending the immunology clinic of a
      tertiary care center were included in the study. Ninety consecutive patients were
      randomized to receive aspirin, naproxen, or placebo. Clinical evaluation was done
      every 2 wk. Upper gastrointestinal endoscopy, biopsies from the gastric antrum
      and duodenum for histological examination, and Helicobacter pylori studies were
      done at entry and after 2 months. The number of patients with dyspeptic symptoms
      was similar in the aspirin (12) and naproxen (9) groups. In both cases, however,
      it was higher (p less than 0.01) than in the placebo group (none). Naproxen was
      associated with a higher score of endoscopic abnormalities in the gastric body
      (0.6 +/- 1.3) than aspirin (0.2 +/- 0.6) or placebo (0.03 +/- 0.18). H. pylori
      was present in a similar proportion of patients in the three groups (33-43%). A
      greater fall in hemoglobin was observed with aspirin (0.35 +/- 0.48 g%) and
      naproxen (0.44 +/- 0.53 g%) than with placebo (0.09 +/- 0.4 g%). The present
      study suggests that aspirin and naproxen produce a similar degree of injury to
      the gastroduodenal mucosa.

PMID- 1642225
TI  - Organized medical genetics at a crossroad.

PMID- 1642226
TI  - Human dermatosparaxis: a form of Ehlers-Danlos syndrome that results from failure
      to remove the amino-terminal propeptide of type I procollagen.
AB  - Dermatosparaxis is a recessively inherited connective-tissue disorder that
      results from lack of the activity of type I procollagen N-proteinase, the enzyme
      that removes the amino-terminal propeptides from type I procollagen. Initially
      identified in cattle more than 20 years ago, the disorder was subsequently
      characterized in sheep, cats, and dogs. Affected animals have fragile skin, lax
      joints, and often die prematurely because of sepsis following avulsion of
      portions of skin. We recently identified two children with soft, lax, and fragile
      skin, which, when examined by transmission electron microscopy, contained the
      twisted, ribbon-like collagen fibrils characteristic of dermatosparaxis. Skin
      extracts from one child contained collagen precursors with amino-terminal
      extensions. Cultured fibroblasts from both children failed to cleave the amino
      terminal propeptides from the pro alpha 1(I) and pro alpha 2(I) chains in type I
      procollagen molecules. Extracts of normal cells cleaved to collagen, the type I
      procollagen synthesized by cells from both children, demonstrating that the
      enzyme, not the substrate, was defective. These findings distinguish
      dermatosparaxis from Ehlers-Danlos syndrome type VII, which results from
      substrate mutations that prevent proteolytic processing of type I procollagen
      molecules.

PMID- 1642227
TI  - Isolation, characterization, and regional mapping of microclones from a human
      chromosome 21 microdissection library.
AB  - Thirty-four unique-sequence microclones were isolated from a previously described
      microdissection library of human chromosome 21 and were regionally mapped using a
      cell hybrid mapping panel which consists of six cell hybrids and divides
      chromosome 21 into eight regions. The mapping results showed that the microclones
      were unevenly distributed along chromosome 21, with the majority of microclones
      located in the distal half portion of the long arm, between 21q21.3 and 21qter.
      The number of unique-sequence clones began to decrease significantly from 21q21.2
      to centromere and extending to the short arm. This finding is consistent with
      those reported in other chromosome 21 libraries. Thus, it may be inferred that
      the proximal portion of the long arm of chromosome 21 contains higher proportions
      of repetitive sequences, rather than unique sequences or genes. The microclones
      were also characterized for insert size and were used to identify the
      corresponding genomic fragments generated by HindIII. In addition, we
      demonstrated that the microclones with short inserts can be efficiently used to
      identify YAC (yeast artificial chromosome) clones with large inserts, for
      increased genomic coverage for high-resolution physical mapping. We also used 200
      unique-sequence microclones to screen a human liver cDNA library and identified
      two cDNA clones which were regionally assigned to the 21q21.3-q22.1 region. Thus,
      generation of unique-sequence microclones from chromosome 21 appears to be useful
      to isolate and regionally map many cDNA clones, among which will be candidate
      genes for important diseases on chromosome 21, including Down syndrome, Alzheimer
      disease, amyotrophic lateral sclerosis, and one form of epilepsy.

PMID- 1642228
TI  - Assessment of amyloid beta-protein precursor gene mutations in a large set of
      familial and sporadic Alzheimer disease cases.
AB  - A genetic locus associated with familial Alzheimer disease (FAD) and a candidate
      gene, APP, encoding the amyloid protein precursor have both been assigned
      previously to chromosome 21, and, in a few FAD families, mutations of APP have
      been detected. However, obligate crossovers between APP and FAD have also been
      reported in several FAD pedigrees, including FAD4, a large kindred showing highly
      suggestive evidence for linkage of the disorder to chromosome 21. In case the
      apparent APP crossover in FAD4 actually represented an intragenic recombination
      event or segregation of different mutations in different family branches, we have
      performed a more detailed assessment of APP as a candidate gene in this family.
      The entire coding region of the APP gene was sequenced for FAD4 and for FAD1, a
      second large kindred. No mutations were found, indicating that, in at least one
      chromosome 21-linked FAD pedigree, the gene defect is not accounted for by a
      mutation in the known coding region of the APP gene. A total of 25 well
      characterized early- and late-onset FAD pedigrees were typed for genetic linkage
      to APP, to assess the percentage of FAD families predicted to carry mutations in
      the APP gene. None of the FAD families yielded positive lod scores at a
      recombination fraction of 0.0. To estimate the overall prevalence of FAD
      associated mutations in the beta A4 domain of APP, we sequenced exons 16 and 17
      in 30 (20 early- and 10 late-onset) FAD kindreds and in 11 sporadic AD cases, and
      we screened 56 FAD kindreds and 81 cases of sporadic AD for the presence of the
      originally reported FAD-associated mutation, APP717 Val----Ile (by BclI
      digestion). No APP gene mutations were found in any of the FAD families or
      sporadic-AD samples examined in this study, suggesting that the mutations in
      exons 16 and 17 are a rare cause of FAD. Overall, these data suggest that APP
      gene mutations account for a very small portion of FAD.

PMID- 1642229
TI  - Strategies for characterizing highly polymorphic markers in human gene mapping.
AB  - Before new markers are thoroughly characterized, they are usually screened for
      high polymorphism on the basis of a small panel of individuals. Four commonly
      used screening strategies are compared in terms of their power to correctly
      classify a marker as having heterozygosity of 70% or higher. A small number of
      typed individuals (10, say) are shown to provide good discrimination power
      between low- and high-heterozygosity markers when the markers have a small number
      of alleles. Characterizing markers in more detail requires larger sample sizes
      (e.g., at least 80-100 individuals) if there is to be a high probability of
      detecting most or all alleles. For linkage analyses involving highly polymorphic
      markers, the practice of arbitrarily assuming equal gene frequencies can cause
      serious trouble. In the presence of untyped individuals, when gene frequencies
      are unequal but are assumed to be equal in the analysis, recombination-fraction
      estimates tend to be badly biased, leading to strong false-positive evidence for
      linkage.

PMID- 1642230
TI  - Different patterns of X inactivation in MZ twins discordant for red-green color
      vision deficiency.
AB  - Two female identical twins who were clinically normal were obligatory
      heterozygotes for X-linked deuteranomaly associated with a green-red fusion gene
      derived from their deuteranomalous father. On anomaloscopy, one of the twins was
      phenotypically deuteranomalous while the other had normal color vision. The color
      vision-defective twin had two sons with normal color vision and one
      deuteranomalous son. X-inactivation analysis was done with the highly informative
      probe M27 beta. This probe detects a locus (DXS255) which contains a VNTR and
      which is somewhat differentially methylated on the active and inactive X
      chromosomes. In skin cells of the color vision-defective twin, almost all
      paternal X chromosomes with the abnormal color-vision genes were active, thereby
      explaining her color-vision defect. In contrast, a different pattern was observed
      in skin cells from the woman with normal color vision; her maternal X chromosome
      was mostly active. However, in blood lymphocytes, both twins showed identical
      patterns with mixtures of inactivated maternal and paternal X chromosomes.
      Deuteranomaly in one of the twins is explained by extremely skewed X
      inactivation, as shown in skin cells. Failure to find this skewed pattern in
      blood cells is explained by the sharing of fetal circulation and exchange of
      hematopoietic precursor cells between twins. These data give evidence for X
      inactivation of the color-vision locus and add another MZ twin pair with markedly
      different X-inactivation patterns for X-linked traits.

PMID- 1642231
TI  - A microdeletion of less than 250 kb, including the proximal part of the FMR-I
      gene and the fragile-X site, in a male with the clinical phenotype of fragile-X
      syndrome.
AB  - A gene designated "FMR-1" has been isolated at the fragile-X locus. One exon of
      this gene is carried on a 5.1-kb EcoRI fragment that exhibits length variation in
      fragile-X patients because of amplification of or insertion into a CGG-repeat
      sequence. This repeat probably represents the fragile site. The EcoRI fragment
      also includes an HTF island that is hypermethylated in fragile-X patients showing
      absence of FMR-1 mRNA. In this paper, we present further evidence that the FMR-1
      gene is involved in the clinical manifestation of the fragile-X syndrome and also
      in the expression of the cellular phenotype. A deletion including the HTF island
      and exons of the FMR-1 gene was detected in a fragile X-negative mentally
      retarded male who presented the clinical phenotype of the fragile-X syndrome. The
      deletion involves less than 250 kb of genomic DNA, including DXS548 and at least
      five exons of the FMR-1 gene. These data support the hypothesis that loss of
      function of the FMR-1 gene leads to the clinical phenotype of the fragile-X
      syndrome. In the fragile-X syndrome, there are pathogenetic mechanisms other than
      amplification of the CGG repeat that do have the same phenotypic consequences.

PMID- 1642232
TI  - Further localization of X-linked hydrocephalus in the chromosomal region Xq28.
AB  - X-linked hydrocephalus (HSAS) is the most frequent genetic form of hydrocephalus.
      Clinical symptoms of HSAS include hydrocephalus, mental retardation, clasped
      thumbs, and spastic paraparesis. Recently we have assigned the HSAS gene to Xq28
      by linkage analysis. In the present study we used a panel of 18 Xq27-q28 marker
      loci to further localize the HSAS gene in 13 HSAS families of different ethnic
      origins. Among the Xq27-q28 marker loci used, DXS52, DXS15, and F8C gave the
      highest combined lod scores, of 14.64, 6.53 and 6.33, respectively, at
      recombination fractions of .04, 0, and .05, respectively. Multipoint linkage
      analysis localizes the HSAS gene in the telomeric part of the Xq28 region, with a
      maximal lod score of 20.91 at 0.5 cM distal to DXS52. Several recombinations
      between the HSAS gene and the Xq28 markers DXS455, DXS304, DXS305, and DXS52
      confirm that the HSAS locus is distal to DXS52. One crossover between HSAS and
      F8C suggests that HSAS gene to be proximal to F8C. Therefore, data from
      multipoint linkage analysis and the localization of key crossovers indicate that
      the HSAS gene is most likely located between DXS52 and F8C. This high-resolution
      genetic mapping places the HSAS locus within a region of less than 2 Mb in
      length, which is now amenable to positional cloning.

PMID- 1642233
TI  - Characterization of a deletion at Xq27-q28 associated with unbalanced
      inactivation of the nonmutant X chromosome.
AB  - We report the results of studies on the characterization of the mutation
      associated with marked unbalanced expression of the mutant X chromosome in a
      karyotypically normal girl with Hunter disease (mucopolysaccharidosis type II).
      Southern analysis of DNA extracted from somatic cell hybrids containing only the
      mutant X chromosome showed deletion of the Xq27.3-q28 loci: DXS297 (VK23AC),
      DXS293 (VK16), FRAXA (pfxa3), DXS296 (VK21A), and the 3' end of the
      iduronatesulfatase (IDS) gene. The flanking loci--DXS52 (St14-1), DXS304 (U6.2),
      and DXS369 (RN1)--were intact. On the basis of these results, we concluded that
      the mutation was a simple deletion extending a maximum of 3-5 cM to the
      centromeric side of the IDS gene. Both Southern analysis of DNA from somatic cell
      hybrids, using short segments of IDS cDNA, and PCR of reverse-transcribed RNA
      from cultured skin fibroblasts indicated that the telomeric terminus of the
      deletion was localized to a region near the middle of the coding sequences of the
      gene.

PMID- 1642234
TI  - Mode of inheritance of nonsyndromic cleft lip with or without cleft palate: a
      reanalysis.
AB  - Nonsyndromic cleft lip with or without cleft palate (CL +/- P) is traditionally
      recognized as a multifactorial threshold trait (MFT). Recently, however, evidence
      for the involvement of a major gene in the etiology of CL +/- P has been
      reported. To assess the potential for major-gene involvement in the etiology of
      this trait, familial recurrence patterns from several family studies of CL +/- P
      were reanalyzed. The recurrence patterns in first-degree relatives of CL +/- P
      probands were found to be compatible with the expectations for either an MFT or a
      generalized single-major-locus (gSML) trait. The use of multiple thresholds based
      on proband sex, defect bilaterality, or palatal involvement did not help to
      discriminate between these models. However, the pattern of recurrence among MZ
      twins and more remote relatives of CL +/- P probands is not consistent with gSML
      inheritance but is compatible with either an MFT model or a model specifying
      multiple interacting loci. For such a model, no single locus can account for more
      than a sixfold increase in risk to first-degree relatives. These findings have
      important implications with regard to the feasibility of detecting linkage to
      loci conferring susceptibility to CL +/- P.

PMID- 1642235
TI  - Segregation analysis of cancer in families of childhood soft-tissue-sarcoma
      patients.
AB  - This paper presents the analysis of familial cancer data collected in a hospital
      based study of 159 childhood soft-tissue-sarcoma patients. Two different
      statistical models detected excess aggregation of cancer, which could be
      explained by a rare dominant gene. For each kindred, we estimated the probability
      of the observed cancer distribution under the dominant-gene model and identified
      12 families that are the most likely to be segregating the gene. Two of those
      families have confirmed germ-line mutations in the p53 tumor-suppressor gene. The
      relative risk of affection for children who are gene carriers was estimated to be
      100 times the background rate. Females were found to have a slightly higher age
      specific penetrance, but maternal and paternal lineages made equal contributions
      to the evidence in favor of the dominant gene. The proband's histology,
      ethnicity, and age at diagnosis were evaluated to determine whether any of these
      altered the probability of affection in family members. Only embryonal
      rhabdomyosarcoma was found to be a significant covariate under the dominant-gene
      model. While molecular genetic studies of familial cancer will eventually provide
      answers to the questions of genetic heterogeneity, age- and site-specific
      penetrance, mutation rates, and gene frequency, information from statistical
      models is useful for setting priorities and defining hypotheses.

PMID- 1642236
TI  - Functional profile of the human fetal gamma-globin gene upstream promoter region.
AB  - We performed a systematic functional analysis of the human gamma-globin promoter
      to identify its activator domains. We used a panel of truncation and scanning
      mutants as well as transfection in human K562 fetal erythroid cells. The various
      mutations produced relatively small changes in promoter function in both
      transient and stable transfection assays. The CACCC region and the region
      containing the binding sites for protein GATA-1 behaved as activator domains. We
      also obtained evidence for a minor activator site in the - 200 to - 190 region.
      The results are consistent with the interpretation that gamma-globin gene
      regulation may occur in part through multiple small effects of promoter elements.

PMID- 1642237
TI  - Regional mapping of facioscapulohumeral muscular dystrophy gene on 4q35: combined
      analysis of an international consortium.
AB  - Members of an international consortium for linkage analysis of the
      facioscapulohumeral muscular dystrophy (FSHD) gene have pooled data for joint
      analyses, in an attempt to determine the precise location of the FSHD gene and
      the order of four DNA markers on 4q35 region. Six laboratories determined a total
      of 3,078 genotypes in 65 families, consisting of a total of 504 affected subjects
      and 559 unaffected subjects. For each marker, a mean of 648 meioses were
      informative. D4S139 and D4S163 were identified as the closest linked markers to
      the FSHD locus, with 99% upper confidence intervals of recombination fractions of
      .08 and .10, respectively. We have used the CRI-MAP program to construct the most
      likely order of cen-D4S171-F11-D4S163-D4S139-FSHD-tel, with favorable odds of
      10(8)-10(114) over all other orders except that in which F11 and D4S171 are
      reversed, for which the odds ratio was 191:1. With this order, the genetic map of
      this region extends 25.5 cM in males and 13.8 cM in females (averaging 19.5 cM
      for sexes combined); the sex difference was statistically significant (P =
      .0013). Comparison between families for the two-point and multipoint lod scores
      involving FSHD showed no evidence for heterogeneity of this disorder. However,
      after the completion of this analysis, one large family which might show
      heterogeneity was identified. In view of this and the fact that all of the linked
      markers reside on the same side of the FSHD locus, the clinical application of
      these markers is not recommended at this time.

PMID- 1642238
TI  - The mapping of chromosome 4q markers in relation to facioscapulohumeral muscular
      dystrophy (FSHD).
AB  - Four DNA markers on the distal long arm of chromosome 4 have been analyzed for
      their linkage relationship to facioscapulohumeral muscular dystrophy (FSHD) in a
      series of 23 families with this disease. Two hypervariable markers, pH30 (D4S139)
      and EFD 139.1 (D4S184), both show close linkage with the disorder, with a maximum
      recombination fraction (theta max) of .02 and a maximum lod score (Zmax) of 36.77
      and 34.50, respectively; two other markers, the locus for factor XI (F11) and the
      microsatellite marker Mfd22 (D4S171), both show less close linkage, with
      respective theta max of .16 (Zmax = 3.40) for F11 and .24 (Zmax = 1.61) for
      D4S171. While the relative ordering and orientation of the loci on the chromosome
      remain provisional, analysis of 15 individual recombination events in seven
      families supports the order D4S171-F11-D4S184-D4S139-FSHD, with the disease locus
      telomeric to all four markers.

PMID- 1642239
TI  - Genetic linkage map of facioscapulohumeral muscular dystrophy and five
      polymorphic loci on chromosome 4q35-qter.
AB  - A genetic map of five polymorphic markers in the area of the facioscapulohumeral
      muscular dystrophy (FSHD) gene on chromosome 4q35-qter has been constructed. With
      these five markers, a number of recombinants have been identified that allow
      ordering of the marker and the disease loci. The most likely locus order and the
      relative position of the FSHD gene supported by the recombinants is centromere
      D4S171-F11-D4S187-D4S163-D4S139-FS HD-telomere. However, at least one
      recombination event appears to be inconsistent with this order and suggests a
      location of FSHD proximal to D4S139.

PMID- 1642240
TI  - Linkage analyses of five chromosome 4 markers localizes the facioscapulohumeral
      muscular dystrophy (FSHD) gene to distal 4q35.
AB  - The genetic locus for facioscapulohumeral muscular dystrophy (FSHD) has been
      mapped to chromosome 4. We have examined linkage to five chromosome 4q DNA
      markers in 22 multigenerational FSHD families. Multipoint linkage analyses of the
      segregation of four markers in the FSHD families and in 40 multigenerational
      mapping families from the Centre d'Etude du Polymorphisme Humaine enabled these
      loci and FSHD to be placed in the following order: cen-D4S171-factor XI-D4S163
      D4S139-FSHD-qter. One interval, D4S171-FSHD, showed significant sex-specific
      differences in recombination. Homogeneity tests supported linkage of FSHD to
      these 4q DNA markers in all of the families we studied. The position of FSHD is
      consistent with that generated by other groups as members of an international
      FSHD consortium.

PMID- 1642241
TI  - Linkage studies in facioscapulohumeral muscular dystrophy (FSHD).
AB  - Facioscapulohumeral muscular dystrophy (FSHD) has been localized to the 4q35-qter
      region of chromosome 4. Linkage analyses of two polymorphic markers from the
      region, D4S139 and D4S163, have been carried out using four large
      multigenerational FSHD families. The results indicate that both markers are
      closely linked to FSHD, with D4S139 being the closest proximal marker to FSHD.

PMID- 1642242
TI  - Linkage localization of facioscapulohumeral muscular dystrophy (FSHD) in 4q35.
AB  - Fasioscapulohumeral muscular dystrophy (FSHD) has recently been localized to
      4q35. We have studied four families with FSHD. Linkage to the 4q35 probes D4S163,
      D4S139, and D4S171 was confirmed. We found no recombinants helpful in detailed
      localization of the FSHD gene. Two of our families include males with a rapidly
      progressive muscle disease that had been diagnosed, on the basis of clinical
      features, as Duchenne muscular dystrophy. One of these males is available for
      linkage study and shares the haplotype of his FSHD-affected aunt and cousin.

PMID- 1642243
TI  - Genetic and physical mapping on chromosome 4 narrows the localization of the gene
      for facioscapulohumeral muscular dystrophy (FSHD).
AB  - We have used a combination of classical RFLPs and PCR-based polymorphisms
      including CA repeats and single-strand conformation polymorphisms to generate a
      fine-structure genetic map of the distal long arm of chromosome 4q. This map is
      now genetically linked to the pre-existing anchor map of 4pter-4q31 and
      generates, for the first time, a complete linkage map of this chromosome. The map
      consists of 32 anchor loci placed with odds of greater than 1,000:1. The high
      resolution map in the cytogenetic region surrounding 4q35 provides the order 4cen
      D4S171-F11-D4S187-D4S163-D4S139-4q ter. When we used somatic cell hybrids from a
      t(X;4)(p21;q35) translocation, these five markers fell into three groups
      consistent with the genetic map-D4S171 and F11 in 4pter-4q35, D4S163 and D4S139
      in 4q35-4qter, and D4S187 as a junction fragment between these two regions. These
      markers are in tight linkage to the gene for facioscapulo-humeral muscular
      dystrophy (FSHD) mapped to this region by several collaborating investigators and
      provide a framework for further detailed analysis of this region.

PMID- 1642244
TI  - Fast screening methods to detect mutations of spectrin in subjects with
      hereditary elliptocytosis.

PMID- 1642245
TI  - Van der Woude syndrome and nonsyndromic cleft lip and palate.

PMID- 1642246
TI  - Presentation of the Southern Society for Clinical Investigation Founder's Medal
      to Dr. Daniel W. Foster.

PMID- 1642247
TI  - Cicletanine blunts the pulmonary pressor response to acute hypoxia in rats.
AB  - Cicletanine (CIC) recently has been shown to lower systemic arterial pressure in
      hypertensive animals and man by a mechanism that may involve potentiation of the
      vasodilator effect of atrial natriuretic peptide (ANP). We previously have shown
      that ANP prevents acute hypoxia-induced pulmonary vasoconstriction and modulates
      the severity of chronic hypoxic pulmonary hypertension. The current study tested
      the hypothesis that CIC inhibits the pulmonary pressor response to acute hypoxia
      by a cyclic guanosine monophosphate (cGMP)-dependent mechanism. Catheters were
      placed in the pulmonary arteries of Sprague-Dawley rats through the right jugular
      vein using a closed chest technique, and in the aorta through the right femoral
      artery. After a 24 hour recovery, CIC (600 mg/kg) or vehicle was administered
      orally by gavage to conscious rats 4 hours prior to exposure to 10% oxygen at
      ambient pressure or to room air. Mean pulmonary arterial pressure (MPAP) and mean
      systemic arterial pressure (MSAP) and heart rate (HR) were monitored for 3 hours.
      CIC attenuated the acute pulmonary pressor response to hypoxia (MPAP = 24.5 +/-
      1.0 mm Hg in the "hypoxic+CIC" group vs. 29.9 +/- 1.0 mm Hg in the
      "hypoxic+vehicle" group; p less than 0.05 at 3 hours of hypoxic exposure), but
      had no significant effect on MSAP or HR. CIC had no effect on MPAP, MSAP, or HR
      in air control rats. Acute hypoxia caused significant increases in plasma ANP and
      cGMP and in kidney cGMP content, but CIC administration did not alter these
      parameters further. This is the first demonstration that acute administration of
      CIC attenuates the pulmonary pressor response to acute hypoxia in conscious rats.

PMID- 1642249
TI  - Effect of occlusive dressings on the stratum corneum water holding capacity.
AB  - Occlusion of the skin is used in clinical dermatology to promote wound healing
      and to increase the transcutaneous penetration of topically applied drugs. These
      effects are related to the degree of occlusion exerted and depend on the
      physicochemical nature of the dressing. We have evaluated the effects of four
      different materials on the skin barrier and the stratum corneum water holding
      capacity (WHC) using the Plastic Occlusion Stress Test (POST). The following
      materials were compared: hydrocolloid dressing, polyurethane film, polyethylene
      film, and a plastic chamber. These devices were applied on the volar forearm for
      24 hours in 10 healthy volunteers (mean age 32 +/- 4 years). Upon their removal,
      the stratum corneum WHC, measured as skin surface water loss (SSWL), was recorded
      continuously for 25 minutes using an Evaporimeter. SSWL decay curves showed
      significant differences between the occlusive materials (analysis of variance, p
      less than 0.01). Higher SSWL values were recorded in sites occluded with the
      plastic chamber, whereas the polyurethane film resulted in poor occlusive
      capacity. Hydrocolloid dressing and polyethylene gave similar responses with
      higher WHC values compared to polyurethane (p less than 0.05). The relevance of
      these findings to clinical dermatology in terms of wound healing and drug
      absorption is discussed.

PMID- 1642248
TI  - Vitamin A in hypercholesterolemia.
AB  - This study evaluated the relationship between plasma vitamin A and cholesterol in
      48 patients with hypercholesterolemia studied before and after treatment with a
      cholesterol-lowering diet, with or without lipid-lowering medication. Plasma
      vitamin A levels were higher in hypercholesterolemic subjects than in healthy
      controls (2.58 +/- 0.15 vs. 1.82 +/- 0.14 mmol/L, p = 0.025) despite similar
      values for retinol binding protein (RBP). Successful cholesterol lowering,
      defined as greater than 25% reduction in low density lipoprotein cholesterol, was
      achieved in 16 patients. In this subset, plasma vitamin A declined from 3.00 +/-
      0.32 (pretreatment) to 2.34 +/- 0.15 mmol/L (post treatment; p = 0.018). A
      nonsignificant increase in RBP was observed, resulting in a significant decrease
      in the molar ratio of vitamin A to RBP (1.05 +/- 0.06 vs. 0.80 +/- 0.05, p =
      0.013). These data suggest an interaction between vitamin A and cholesterol that
      is independent of the transport mechanisms for vitamin A in association with
      chylomicrons (post absorptive) and with RBP. Further examinations of the form or
      forms of vitamin A (retinol, retinyl ester), its distribution within the plasma
      lipoproteins, and the mechanisms of origin and removal are warranted to explain
      these findings.

PMID- 1642250
TI  - Case report: severe pyoderma associated with familial Mediterranean fever-
      favorable response to colchicine in three patients.
AB  - Familial Mediterranean fever (FMF) is an autosomal recessive disorder that occurs
      most frequently among Sephardic Jews and Armenians. It is characterized by
      recurrent episodes of fever, peritonitis, pleuritis, and arthritis. Skin lesions
      are seen in some patients. Diagnosis of FMF usually is made on clinical grounds
      only, typically when recurrent attacks of abdominal pain, fever, and arthritis
      are observed in a patient with an appropriate ethnic background and family
      history. To date, there are no specific diagnostic laboratory tests for FMF.
      Three patients with severe recurrent Pyoderma are covered in this report. In all
      three cases, the cutaneous lesions were associated with clinical manifestations
      of FMF and responded to colchicine therapy favorably. The importance of such an
      association and its therapeutic consequences are emphasized.

PMID- 1642251
TI  - Case report: hypoparathyroidism with menses-associated hypocalcemia.
AB  - For 18 years, a patient with idiopathic hypoparathyroidism has experienced
      stiffness or tetany chiefly at the time of menses. A significant decline (0.2
      mmol/L) in her serum total and ionized calcium values was observed after the
      withdrawal of oral contraceptive and after spontaneous onset of menses. No
      increase in urinary calcium excretion or decline in serum magnesium or calcitriol
      occurred to explain the fall in serum calcium. In two hypoparathyroid women
      without the history of menses-associated tetany, serum calcium remained stable
      after withdrawal of oral contraceptive or conjugated estrogen. Serum calcitriol
      levels unexpectedly increased in these controls, possibly helping sustain serum
      calcium. The author concludes the following: (1) some hypoparathyroid women show
      a significant and symptomatic decline in serum calcium at the time of menses; (2)
      serum calcium values obtained at the time of menses may not be a reliable guide
      to adjusting medication dosage for hypoparathyroidism; and (3) further
      investigation will be needed to determine the mechanism of the decline in serum
      calcium values and whether the effect of estrogens on serum calcitriol might be
      altered in the absence of the parathyroid glands.

PMID- 1642252
TI  - Case report: coronary vasospasm--relation to the hyperthyroid state.
AB  - While angina is not uncommonly seen in association with hyperthyroidism, only
      rare case reports have suggested that myocardial ischemia in this state may be
      due to coronary artery spasm. The authors review the literature and describe a
      case in which the repetitive occurrence of episodes of myocardial ischemia due to
      coronary spasm correlated with repeated transient elevations in thyroid hormone
      levels, thus clarifying this relationship. The importance of defining thyroid
      status in patients presenting with coronary vasospasm is emphasized and the
      effects of thyroid hormone on the heart are reviewed.

PMID- 1642253
TI  - Testosterone deficiency as a risk factor for hip fractures in men: a case-control
      study.
AB  - The objective of this study was to determine whether decreased gonadal function
      is a risk factor for hip fracture in elderly men. The study was a matched case
      control study performed at an in-hospital orthopedic service at a semi-rural and
      academic tertiary care center. The patients were seventeen men who presented with
      hip fractures after simple falls over a 10-month period, 11 men with a history of
      hip fractures in the preceding 25 months, and 28 randomly selected age-, race-,
      and living status-matched control subjects (mean age 73 years). Serum pooled
      total testosterone (9.2 +/- 5.5 nmol/L vs. 12.8 +/- 5.4 nmol/L; p less than 0.02)
      and free testosterone (37.9 +/- 18.8 pmol/L vs. 48.4 +/- 20.6 pmol/L; p less than
      0.03) were significantly lower in hip fracture vs. control patients. Testosterone
      deficiency was found in 20 (71%) hip fracture men vs. 9 (32%) of the controls (p
      = 0.003; odds ratio 5.3). Analysis of testosterone values within the stratum of
      absence of any chronic disorder revealed similar results. Serum 25-hydroxyvitamin
      D levels were significantly lower in the hip fracture group than in control men
      (p less than 0.001). The conclusion is that gonadal deficiency appears to be an
      important and heretofore understudied risk factor for hip fractures in men.
      Prevention of hip fractures in men may involve early recognition and treatment of
      testosterone deficiency.

PMID- 1642254
TI  - Case report: recurrent Salmonella typhi chest wall abscess associated with a
      pituitary macroadenoma.
AB  - An unusual manifestation of a Salmonella typhi infection is presented in a
      patient with a growth hormone producing tumor. Growth hormone may effect cell
      mediated immunity and predispose to localized or disseminated intracellular
      infections.

PMID- 1642255
TI  - Propofol: a review of the pharmacology and applications of an intravenous
      anesthetic agent.

PMID- 1642256
TI  - AFCR public policy forum.

PMID- 1642257
TI  - Current concepts in renovascular hypertension.
AB  - Renovascular disease represents an important dimension of hypertension. Although
      estimates vary regarding the exact prevalence of renovascular hypertension, it is
      being diagnosed with increasing frequency because of refined criteria for the
      workup and the availability of sensitive diagnostic tests. Two major pathologic
      entities--atherosclerosis and fibromuscular dysplasia--account for most cases of
      renovascular hypertension. Once the diagnosis and clinical significance of renal
      artery stenosis in a hypertensive patient are established, appropriate and
      specific therapy should be considered. The goal is not only to treat
      hypertension, but to preserve and restore renal function. Although
      antihypertensive drug therapy may lower the blood pressure, reperfusion of the
      kidney (surgical, angioplasty) is a desirable long-term objective in the
      management of patients with renovascular hypertension. With careful selection of
      therapeutic choices, we are now able to render optimal care to patients with
      renovascular hypertension.

PMID- 1642258
TI  - Is steroid receptor data useful in patients with metastatic breast cancer?
AB  - Optimal therapy for patients with metastatic breast cancer is unknown. For those
      with rapidly progressive disease or liver metastases, combination chemotherapy is
      believed to be the treatment of choice. However, most patients do not fall into
      that category. For them, two treatment approaches can be considered: (1) ignore
      estrogen receptor/progesterone receptor (ER/PR) data and treat all patients with
      hormonal therapy or (2) use ER/PR data and treat patients with ER-/PR- tumors
      with combination chemotherapy and treat all other patients with hormonal therapy.
      This report presents a decision analysis for assessing the usefulness of ER/PR
      data in this situation. The probabilities of response to hormonal therapy were
      obtained from literature reviews. Patients' utilities or preferences for the
      various outcomes were estimated by using physicians as patient surrogates. The
      baseline analysis favored ignoring ER/PR data and treating all patients with
      hormonal therapy. Extensive sensitivity analyses showed that the decision was
      most affected by patients' utilities for the various outcomes. The conclusion is
      that patients' utilities are most important in deciding the usefulness of ER/PR
      data in metastatic breast cancer.

PMID- 1642259
TI  - Consanguineous marriage in Jordan.
AB  - We conducted a population-based study of consanguineous marriages in Jordan.
      About two thousand households were interviewed. First cousin marriages were
      encountered in 32.03%, second cousin in 6.8%, distant relation in 10.5%, and no
      relation in 50% of all marriages, respectively. Inbreeding coefficients were
      compared with those of other countries. The most important variables affecting
      inbreeding were social tradition, religion, education, and place of residence-
      urban vs. rural. Secular trends appear rather stable since the early decades of
      the twentieth century, especially for first cousin marriages. Jordan society
      showed a deeply rooted traditional behavioral pattern when inbreeding is
      considered.

PMID- 1642260
TI  - Late-onset localized junctional epidermolysis bullosa and mental retardation: a
      distinct autosomal recessive syndrome.
AB  - We present 2 sibs with a local junctional type of epidermolysis bullosa
      associated with enamel defect of the teeth, dystrophic nails of the feet, and
      mental retardation. Subluxation of the lenses was evident in 1 of them. This
      combination found in a brother and a sister seems to represent a distinct
      autosomal recessive type of epidermolysis bullosa.

PMID- 1642261
TI  - Poland anomaly with a limb body wall disruption defect: case report and review.
AB  - We describe a female infant with apparent Poland anomaly (PA) and limb body wall
      defect. Analysis of the defects suggest that a disruption of the lateral
      embryonic plate mesoderm may have been responsible for the observed lesions.
      Because of the overlap of this case with PA, we re-examined previous reports of
      this syndrome. We think that the lesions could be equally well explained as a
      mesodermal disruption, and point out a previously unrecognised discrepancy
      between sex and affected side in sporadic PA and inherited PA which supports this
      view.

PMID- 1642262
TI  - Dominant syndrome with isolated cryptophthalmos and ocular anomalies.
AB  - We report on a mother and daughter with nonsyndromal cryptophthalmos. Both
      patients have additional ocular anomalies, including microphthalmia, retinal
      dysplasia, and Peters anomaly. The periocular and lid changes seen in these
      individuals are distinct from those seen in typical cryptophthalmos. The apparent
      dominant mode of inheritance in this family distinguishes this condition from
      autosomal recessive isolated cryptophthalmos and from the Fraser or
      cryptophthalmos syndrome.

PMID- 1642263
TI  - Pericentric inversion of chromosome 16 in a large kindred: spectrum of morbidity
      and mortality in offspring.
AB  - Constitutional pericentric inversions of chromosome 16 are rare in the general
      population. We report here a large kindred who carry an inv(16)(p13q22)
      rearrangement. In general, individuals with the inv(16) are in good health but
      prone to reproductive loss. Two different types of recombinant offspring were
      identified in this family and analyzed at the molecular level using probes from
      the alpha-globin and polycystic kidney disease loci. Both were associated with
      serious major malformations.

PMID- 1642264
TI  - Platelet dysfunction in a patient with the Opitz (BBBG) syndrome.
AB  - An 11-year-old girl with Opitz (BBBG) syndrome presented with a bleeding
      disorder. Studies showed an immune-mediated qualitative platelet dysfunction in
      the absence of thrombocytopenia. This is the first report of hemostatic
      dysfunction in a patient with the Opitz (BBBG) syndrome. This report considers
      the possible relationship of the platelet dysfunction to the Opitz (BBBG)
      syndrome and its treatment.

PMID- 1642265
TI  - Basal cell carcinomas, coarse sparse hair, and milia.

PMID- 1642266
TI  - TAR-like syndrome in a consanguineous Mayan girl.
AB  - We report on a 3-month-old girl with a TAR-like syndrome. Her older brother died
      with a similar disorder at 3 months of unknown causes. The parents are second
      cousins of Mayan ancestry. The infant also had, in addition to the usual
      abnormalities of TAR syndrome, depressed nasal bridge, cataracts, glaucoma,
      megalocorneae, and blue sclerae.

PMID- 1642267
TI  - Aarskog syndrome in a Brazilian boy born to consanguineous parents.
AB  - We report on a Brazilian boy (F = 1/16) born to consanguineous parents and
      presenting with typical Aarskog syndrome. Genetic aspects and phenotypic
      manifestations of this patient are compared with those of the (X-linked) Aarskog
      syndrome and with the autosomal recessive faciodigitogenital syndrome.

PMID- 1642268
TI  - Renal tubular dysgenesis: a not uncommon autosomal recessive syndrome: a review.
AB  - Renal tubular dysgenesis is a recently recognized autosomal recessive condition
      characterized by short and poorly developed proximal convoluted tubules, leading
      to oligohydramnios, Potter sequence, and neonatal respiratory failure. We report
      an additional 9 cases from one pediatric center, suggesting that this syndrome is
      not as rare as was previously thought. Normal amniotic fluid volumes in affected
      pregnancies prior to the 22nd week of gestation have been documented,
      compromising early prenatal diagnosis. Late second trimester sonographic
      demonstration of oligohydramnios, with structurally normal kidneys, should
      suggest this diagnosis and the need for detailed post-mortem pathological
      examination.

PMID- 1642269
TI  - Neurofibromatosis 1 and osseous fibrous dysplasia in a family.
AB  - We report on the cosegregation of neurofibromatosis 1 (NF 1) and osseous fibrous
      dysplasia in a family. The father and 3 children by 2 women are affected. A
      fourth child had neither NF 1 nor osseous fibrous dysplasia. All 4 affected
      individuals had NF 1, i.e., cafe-au-lait spots in 4, neurofibromata in 4, Lisch
      nodules in 3, macrocrania in 3, scoliosis in 2, and curvature of the long bones
      in 2. Each demonstrated various fibroosseous lesions of the skeleton including
      non-ossifying fibromas in 3 and both non-ossifying fibromas and fibrous dysplasia
      in one. This pattern suggests that the fibrous bony lesions are a component of NF
      1 in this family. Alternatively, a mutant gene resulting in the fibrous changes
      in bone could be linked to the gene for NF 1. Another possibility is the
      coincidence of the 2 non-linked traits segregating in the same family.

PMID- 1642270
TI  - Chondrodysplasia punctata: a boy with X-linked recessive chondrodysplasia
      punctata due to an inherited X-Y translocation with a current classification of
      these disorders.
AB  - Chondrodysplasia punctata (CDP) is a heterogeneous group of rare bone dysplasias
      characterized by punctate calcification of cartilage. The punctate calcifications
      are non-specific and have been seen in a wide variety of disorders including the
      Zellweger syndrome, warfarin, dilantin, alcohol and rubella embryopathies,
      vitamin-K-epoxide-reductase deficiency, chromosome trisomies 18 and 21, the Smith
      Lemli-Opitz syndrome, prenatal infectious chondritis, hypothyroidism, and other
      rare disorders. We report on a boy with short stature, developmental delay, nasal
      hypoplasia, telebrachydactyly, hypoplastic genitalia, CDP, ichthyosis,
      hypoplastic genitalia, and a 46-X,+der(X),t(X;Y)(p22.31;q11.21), Y karyotype.
      Genomic DNA probe analysis was interpreted as showing that the translocation
      breakpoint was within the X-linked Kallmann syndrome gene. We review a current
      classification of these disorders that includes 3 well-defined single gene
      disorders. These include an autosomal recessive rhizomelic type with early
      lethality, an X-linked dominant type with presumed male lethality, and an X
      linked recessive type that has only been described as part of a contiguous gene
      deletion syndrome.

PMID- 1642271
TI  - Sparse hair and multiple endocrine disorders in two women heterozygous for
      adrenoleukodystrophy.
AB  - We describe two sisters (40 and 42 years old) heterozygous for
      adrenoleukodystrophy who have multiple endocrine disorders. In addition to the
      characteristic neurological symptoms, the younger patient has Addison disease and
      primary hypothyroidism attributable to autoimmune thyroiditis, and the older one
      has Graves disease. Both patients have loss of body hair and sparse scalp hair,
      which have not been reported previously in women heterozygous for
      adrenoleukodystrophy. After the institution of glucocorticoid replacement
      therapy, the younger sister, who has adrenal insufficiency, has shown unexpected
      neurological improvement.

PMID- 1642272
TI  - Combined Goltz and Aicardi syndromes in a terminal Xp deletion: are they a
      contiguous gene syndrome?
AB  - We report on 2 girls with a terminal deletion of the short arm of chromosome X.
      They had microphthalmia, cloudy corneae, mild linear skin lesions, and agenesis
      of corpus callosum. A comparison of clinical and cytogenetic findings in similar
      cases suggested that the critical genes for the Goltz and Aicardi syndromes might
      be contiguous in the region Xp22.31.

PMID- 1642273
TI  - New mental retardation syndrome with hearing impairment, distinct facial
      appearance, and skeletal anomalies.
AB  - We present 2 unrelated children with a distinct pattern of anomalies, including
      mental retardation, hearing impairment, unusual facial appearance, and skeletal
      defects. Both children have severe behavior disturbance and hyperactivity. The
      characteristic facial findings include a broad mouth, broad nasal bridge, mildly
      anteverted nares with a fleshy nasal tip, and deep nasolabial folds. Skeletal
      findings include mild to moderate short stature, dysharmonic maturation of
      epiphyseal ossification centers in the hands, and mild scoliosis.

PMID- 1642275
TI  - Analysis of sperm chromosome complements from a man heterozygous for a
      robertsonian translocation 45,XY,t(15q;22q).
AB  - Chromosome complements were studied in 118 sperm from a man heterozygous for a
      15;22 Robertsonian translocation using the human sperm/hamster oocyte fusion
      technique. Alternate segregation occurred in most spreads (89.6%) and the
      proportion of normal (42.6%) and balanced complements (47%) was approximately
      equal. The frequency of sperm that were unbalanced with respect to the
      translocation was 10.4% and all categories of unbalanced sperm were observed (
      15, -22, +15, +22). The frequency of chromosome abnormalities unrelated to the
      translocation was 7.6%. Since the frequencies of both numerical (3.4%) and
      structural abnormalities (3.4%) were within the normal range of control donors,
      there was no evidence for an interchromosomal effect. The frequencies of X
      chromosome bearing (48%) and Y-chromosome bearing (52%) sperm were not
      significantly different from 50%. Data on this translocation were compared to the
      4 other reports of cytogenetic analysis in sperm of Robertsonian translocation
      carriers.

PMID- 1642274
TI  - Prenatal diagnosis with repetitive in situ hybridization probes.
AB  - We have used chromosome-specific repetitive sequences to detect the most common
      human aneuploidies prenatally. Together chromosome 21, 13, 18, X, and Y
      aneuploidy comprises 95% of the chromosome abnormalities that result in a high
      risk of abnormal phenotypes at birth. The X, Y, and 18 repetitive probes work
      reliably in multiple tissue types including directly examined and cultured
      amniocytes, chorionic villus cells, lymphocytes, and cultured fibroblasts. The
      probe that detects both chromosomes 13 and 21 routinely gives results in each
      cell type tested except directly studied amniocytes which can be interpreted in
      seven-ninths of the cases with protocol 1 and all tested samples with protocol 2.
      Our protocols diagnosed trisomy 21 in a 23-week fetus with low maternal serum AFP
      and a trisomy 18 in a direct chorionic villus sample 2 working days after the
      samples were obtained. Trisomy 21 also has been ruled out in a CVS karyotype
      first thought to be 47,XY, +21. These studies reflect the potential value of in
      situ hybridization to provide a more rapid, less expensive means to screen most
      at-risk fetal populations with less effort in first world cytogenetic
      laboratories, and to provide economical cytogenetic services in less developed
      countries.

PMID- 1642276
TI  - Membranoproliferative glomerulonephritis in a child with Prader-Willi syndrome.
AB  - We describe a girl with Prader-Willi syndrome and membranoproliferative
      glomerulonephritis. She had a deletion at 15q11-13. The deletion may have made
      the child susceptible to renal disease.

PMID- 1642277
TI  - New distinct lethal osteosclerotic bone dysplasia (Raine syndrome).
AB  - We report a third case of a rare neonatal lethal sclerotic bone disorder with
      distinct craniofacial anomalies and striking radiographic and hitherto
      undescribed histopathologic features. The remarkable similarity between our
      patient and 2 recently reported infants suggests strongly a distinct entity. We
      propose the term Raine syndrome as a convenient identification of this disorder.

PMID- 1642278
TI  - Tyrosinase gene mutations in type I (tyrosinase-deficient) oculocutaneous
      albinism define two clusters of missense substitutions.
AB  - Type I (tyrosinase-deficient) oculocutaneous albinism (OCA) results from
      mutations of the gene encoding tyrosinase, the enzyme that catalyzes the first 2
      steps of melanin pigment biosynthesis. In type IA (tyrosinase-negative) OCA
      tyrosinase enzymatic activity is completely absent, and in type IB ("yellow") OCA
      tyrosinase activity is greatly reduced. Here, we describe 11 novel mutations of
      the tyrosinase gene in Caucasian patients with these 2 forms of type I OCA. Type
      I OCA in Caucasians appears to result from a great variety of different uncommon
      alleles. More than 80% of the known missense substitutions associated with type I
      OCA cluster within 2 relatively small regions of the tyrosinase polypeptide,
      suggesting that these may correspond to functionally important sites within the
      enzyme.

PMID- 1642279
TI  - A severe case of mandibuloacral dysplasia in a girl.
AB  - We report on a 16-year-old girl with mandibuloacral dysplasia, a rare progeroid
      syndrome. She presented at age 2 years with thin skin on the limbs,
      characteristic face with prominent eyes, a pinched nose, micrognathia, and small
      mouth. Hair was sparse and brittle. The terminal phalanges were hypoplastic and
      showed acroosteolysis. On follow-up, hands and feet showed progressive
      camptodactyly of fingers and toes with total loss of subcutaneous tissue. The
      clavicles were hypoplastic. Intelligence was normal. We review the literature on
      the subject and discuss differential diagnosis.

PMID- 1642280
TI  - Hypoglossia-hypodactylia syndrome with jejunal atresia in an infant of a diabetic
      mother.
AB  - Despite advances in therapy for maternal diabetes, pregnancies of diabetic women
      remained at an increased risk of spontaneous abortion or delivery of an infant
      with major malformation. We report on an infant of a diabetic mother with
      hypoglossia-hypodactylia associated with complete jejunal atresia. A common
      pathogenesis for these 2 malformations could be a vascular disruptive mechanism
      with in utero arterial thrombosis.

PMID- 1642281
TI  - Carrier detection and prenatal diagnosis of X-linked agammaglobulinemia.
AB  - We investigated the pregnant mother of a boy with X-linked agammaglobulinemia
      (XLA) but with no family history of immune disease. The X-inactivation pattern
      was found, using a methylation-sensitive probe, to be skewed in the maternal B
      cells but random in the polymorphonuclear cells, indicating carrier status and a
      50% risk of inheritance for her male fetus. Using probes assigned to regions on
      either side of the XLA locus and defining RFL polymorphism, we excluded for the
      first time a diagnosis of XLA on a chorionic villus sample, with a risk of error
      less than 0.003. Immunological studies performed at the 19th week of gestation
      and 3 days after birth confirmed normality. Carrier detection based on the X
      chromosome inactivation pattern, together with prenatal studies using probes
      close to the disease locus, thus permits prenatal diagnosis in families with
      isolated cases of XLA.

PMID- 1642282
TI  - History of C-patient with SC-Roberts/pseudothalidamide syndrome.

PMID- 1642283
TI  - Congenital heart defect in a Japanese girl with Adams-Oliver syndrome: one of the
      most important complications.

PMID- 1642284
TI  - Orofaciodigital syndrome type IV: report of a patient.

PMID- 1642286
TI  - Uveitis associated with human T-cell lymphotropic virus type I.
AB  - Seroepidemiologic, clinical, and virologic studies were performed to determine
      whether human T-cell lymphotropic virus type I was closely associated with
      uveitis in two hospitals. One hospital was in an endemic area of the virus
      (Miyakonojo, Miyazaki) and the other hospital was in a less endemic area
      (Kurume). In the endemic area, the seroprevalence of the virus in patients with
      uveitis without defined causes (35.4%, 62 of 175 patients) was significantly
      higher than that in patients with nonuveitic ocular diseases (16.1%, 42 of 261
      patients), or in patients with uveitis with defined causes (10.3%, eight of 78
      patients). The seroprevalence in younger patients (20 to 49 years of age) with
      uveitis without defined causes in the area was 44.8% (30 of 67 patients), whereas
      it was only 9.3% (ten of 107 patients) in the other two groups. A similar
      observation was recorded even in the less endemic area (Kurume). Because the
      seroprevalence of the virus in the general population is known to be low in
      younger patients and to increase with age, these findings were interpreted to
      indicate that the association of human T-cell lymphotropic virus type I with
      uveitis was significant. Most patients, particularly those aged 20 through 49
      years, had an intermediate uveitis characterized by a moderate inflammation in
      the vitreous body accompanied by an iritis and retinal vasculitis. The ocular
      symptoms in the patients differed from those of other types of uveitis common in
      Japan (Behcet's disease, Vogt-Koyanagi-Harada's disease, and toxoplasmosis, for
      example).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642287
TI  - An unusually high prevalence of ocular toxoplasmosis in southern Brazil.
AB  - Because of the frequency of ocular toxoplasmosis and its occurrence in multiple
      siblings in southern Brazil, a population-based household survey was performed to
      better understand the epidemiologic characteristics of the disease in this
      region. Of 1,042 individuals examined, 184 (17.7%) were deemed to have ocular
      toxoplasmosis on the basis of conservative assessment of ophthalmic findings. Of
      those with ocular toxoplasmosis, 183 (99.5%) had specific IgG antibodies,
      compared with only 140 of 181 age-matched control subjects (77.4%; P less than
      .001). The prevalence of ocular toxoplasmosis was 0.9% in 1- to 8-year-olds, 4.3%
      in 9- to 12-year-olds, 14.3% in 13- to 16-year-olds, and 21.3% (95% confidence
      interval, 18.6% to 24.2%) in all individuals 13 years or older. The prevalence of
      ocular toxoplasmosis in this population was more than 30 times higher than
      previous estimates for the same condition elsewhere. The low prevalence in the
      young children we studied supplements previous data suggesting that, in this
      population, ocular toxoplasmosis is a sequela of postnatal rather than congenital
      infection.

PMID- 1642285
TI  - A reinvestigation of thirty three fragile(X) families using probe StB12.3.
AB  - We have reinvestigated 33 fragile X families using probe StB12.3. In 31 families
      the affected individual showed an insert while in 2 families no insert was
      detected. The insert fell into two size categories: small (less than 0.5 kb); and
      large (greater than 0.6 kb) accompanied by methylation of an EagI site. All
      individuals of either sex having a small insert were fra(X) negative and
      intellectually normal, while all males having a large insert were fra(X) positive
      and intellectually impaired. Females having a large insert were either fra(X)
      positive or negative and either intellectually normal or impaired. No new
      mutation was found. All daughters of males with a small insert had a small
      insert; females with a large insert produced males and females who had a large
      insert, while females with a small insert had offspring with either a large or a
      small insert. However, females with a small insert tended to fall into one of two
      categories: either they had only children with a small insert or only children
      with a large insert, there being only one exception to this rule. We found four
      unexpected small inserts, two in unrelated spouses and two in female carriers who
      proved to be compound heterozygotes, indicating that they had inherited an insert
      from both their parents. These observations suggest that individuals with a small
      insert must be not uncommon in the general population.

PMID- 1642288
TI  - X-linked recessive familial exudative vitreoretinopathy.
AB  - Familial exudative vitreoretinopathy is an inherited disorder characterized by
      retinal traction, peripheral vitreous opacities, and subretinal and intraretinal
      exudates. We observed a family in which four boys (the children of three sisters)
      were affected with this disorder and an X-linked recessive inheritance was
      apparent. The differential diagnosis includes retinopathy of prematurity, primary
      hyperplastic primary vitreous, Coats' disease, peripheral uveitis,
      retinoblastoma, and Norrie's disease, but this differentiation can usually be
      made on the basis of clinical findings alone. Knowledge of X-linked recessive
      transmission is important for correct diagnosis and for genetic counseling.

PMID- 1642289
TI  - Foveal densitometry in adult-onset diffuse drusen.
AB  - We compared the results of foveal densitometry with results of other retinal
      function tests in five asymptomatic subjects with adult-onset diffuse drusen. All
      results of routine retinal function tests, including visual acuity, Rayleigh
      equation color matches, multiple static perimetry, electroretinography, and
      electro-oculography, were normal. All five subjects had decreased foveal cone
      photopigment density with densitometry, indicating an early dysfunction at the
      level of the foveal cone photoreceptors. Several functional defects may be
      responsible for the densitometric results in adult-onset diffuse drusen,
      including retinal pigment epithelium dysfunction, foveal cone photoreceptor
      misalignment, and a reduction of the in situ foveal cone photopigment.

PMID- 1642290
TI  - Sudden retinal manifestations of intranasal cocaine and methamphetamine abuse.
AB  - We examined two patients who had sudden decrease in vision after intranasal
      cocaine or methamphetamine abuse. A 38-year-old woman with a history of systemic
      arterial hypertension developed a central retinal artery occlusion four hours
      after intranasal use of cocaine. A 26-year-old woman had blurred vision and
      intraretinal hemorrhages shortly after using methamphetamine nasally. The
      adrenomimetic response and sudden increase in blood pressure associated with the
      intranasal use of these drugs may have contributed to the retinal vascular
      manifestations observed in these patients.

PMID- 1642291
TI  - Clinical and histopathologic changes in the host cornea after epikeratoplasty for
      keratoconus.
AB  - Five consecutive patients underwent epikeratoplasty for keratoconus.
      Postoperatively, four patients had poor visual acuity (average, 20/200) secondary
      to folds in Descemet's membrane and interface scarring. Two underwent penetrating
      keratoplasty eight months later. Histopathologic examination of the host corneas
      and the overlying lenticules disclosed epithelial irregularity and subepithelial
      fibrosis. The host corneas showed folds in Descemet's membrane and focal
      posterior stromal fibrosis. Electron microscopy disclosed breaks in Bowman's
      membrane with irregular collagen, posterior aggregates of amorphous material, and
      focal endothelial degeneration. The fifth patient had graft ulceration and
      vascularization that required removal of the lenticule. She underwent a
      penetrating keratoplasty five months later and histopathologic examination
      demonstrated persistent folds in Descemet's membrane. Immunostaining of specimens
      from three cases disclosed a reduced expression of sulfated epitopes of keratan
      sulfate and an increase in sulfated dermatan sulfate in the lenticule and host
      corneal tissues. These alterations in stromal proteoglycans are characteristic of
      stromal scars and keratoconus and provide evidence of pathologic processes in the
      graft tissue. Because of potential complications, epikeratoplasty should be
      considered only for those patients who are unsuitable candidates for contact
      lenses or penetrating keratoplasty.

PMID- 1642292
TI  - Progression and regression of partial corneal involvement in the iridocorneal
      endothelial syndrome.
AB  - We observed three women with partial corneal involvement in the iridocorneal
      endothelial syndrome for more than ten years. During this time, the peripheral
      anterior synechiae progressed in all three, with one patient developing glaucoma.
      In two patients, the abnormal endothelial cells spread to cover the entire
      posterior corneal surface; in the third, they disappeared almost entirely. The
      endothelial permeability to fluorescein remained abnormally low only in the two
      eyes with diffusely abnormal endothelium, and increased to normal in the third
      eye as the abnormal endothelium disappeared. The permeability in the third eye
      had been abnormally low only in the superior half of the cornea, where the
      abnormal endothelium was located. As the abnormal endothelium regressed, it was
      replaced by normal endothelium with a normal cell density similar to that of the
      unaffected fellow eye. Thus, for more than ten years, the partial endothelial
      involvement associated with the iridocorneal endothelial syndrome progressed
      substantially in two patients and regressed dramatically in a third.

PMID- 1642293
TI  - Penetrating keratoplasty and transscleral fixation of posterior chamber lens.
AB  - We reviewed the outcome in 115 patients who underwent penetrating keratoplasty
      and transscleral fixation of a posterior chamber lens. One patient died soon
      after surgical procedures, and nine patients were lost to follow-up, leaving a
      cohort of 105 patients. Mean follow-up time was 26.8 months (range, six to 43
      months). Visual acuity of 20/40 or better was found in 29 patients (27.6%) and
      20/50 to 20/200 in 37 patients (35.2%). Reasons for poor visual outcome included
      cystoid macular edema in ten patients (9.5%), age-related macular degeneration in
      six patients (5.7%), and retinal detachment in four patients (3.8%). None of the
      patients developed lens decentration. There were no instances of hyphema and only
      one patient had a perioperative limited suprachoroidal hemorrhage. New-onset
      increase in intraocular pressure developed in 20 of 66 patients (30.3%). Analysis
      of the 39 patients with preoperative increase in intraocular pressure that
      required medical treatment demonstrated an improvement in 13 patients (33.3%),
      worsening in 12 patients (30.8%), and unchanged status in 14 patients (35.9%).
      The exposed haptic suture was covered by using one of the following three
      alternative methods: a conjunctival flap, a scleral flap, or a corneal tissue
      button. Exposure of the haptic suture through the conjunctiva was a complication
      in 21 patients (20%). Of these 16 (76.1%) occurred in the group with a
      conjunctival covering, five (23.8%) occurred in the group with a scleral flap,
      and none occurred in the corneal tissue button group. This study demonstrated
      that transscleral fixation of a posterior chamber lens is a viable option in the
      treatment of patients undergoing penetrating keratoplasty and intraocular lens
      implantation with absent capsular support.

PMID- 1642294
TI  - Meibomian gland function and giant papillary conjunctivitis.
AB  - We examined 42 contact lens-wearing patients for clinical evidence of giant
      papillary conjunctivitis and for meibomian gland dysfunction with gland dropout.
      Fifteen patients were free of clinical signs and symptoms of giant papillary
      conjunctivitis, whereas 27 had clinical symptoms and evidence of giant papillary
      conjunctivitis. Patients with giant papillary conjunctivitis had significantly
      more gland dropout with an average of 0.6 +/- 1.2 gland absent in both lower
      eyelids compared with 0.2 +/- 0.4 gland absent in patients without giant
      papillary conjunctivitis. Additionally, the viscosity of meibomian gland excreta
      was greater in the giant papillary conjunctivitis group. There was no difference
      in tear osmolarity or in the Schirmer test results between the two groups. These
      results indicated patients with giant papillary conjunctivitis were more likely
      to have meibomian gland dysfunction with gland dropout than patients without
      giant papillary conjunctivitis.

PMID- 1642295
TI  - Spontaneous visual improvement in chiasmal gliomas.
AB  - Three untreated patients with presumed chiasmal gliomas had spontaneous visual
      improvement, although serial magnetic resonance imaging in two of the patients
      showed the lesions to be unchanged. Two patients had evidence of
      neurofibromatosis. Three other patients with similar disease courses have been
      documented in the medical literature. These cases demonstrate that conservative
      management of optic chiasmal gliomas may sometimes be associated with favorable
      outcomes.

PMID- 1642296
TI  - Nucleolar organizer regions in iris nevi and melanomas.
AB  - The silver staining of nucleolar organizer region-associated proteins is an
      objective method that has been used to differentiate benign from malignant
      neoplasms. Recently this method was used to distinguish benign choroidal nevi
      from malignant choroidal melanomas. We studied 24 iris melanocytic lesions to
      assess the applicability of this technique for differentiating benign from
      neoplastic iris tumors. Masked observers determined the number of silver-stained
      nucleolar organizer region dots per cell for silver-stained specimens. Iris nevi
      contained a mean of 1.6 silver-stained nucleolar organizer region dots per cell,
      whereas iris (spindle A and B, spindle B, epithelioid, mixed cell) malignant
      melanomas contained a mean of at least 3.5 silver-stained nucleolar organizer
      region dots per cell (P less than .0001). All iris nevi demonstrated counts lower
      than 1.9, whereas all iris melanomas demonstrated counts greater than 2.8. Silver
      stained nucleolar organizer region counts were also compared with the
      clinicopathologic variables of gender, age, and largest specimen dimension. Only
      the largest specimen dimension correlated with silver-stained nucleolar organizer
      region counts (P less than .0029). The silver-stained nucleolar organizer region
      method is a simple technique for differentiating iris nevi from iris melanomas.
      The silver-stained nucleolar organizer region technique may aid in the assessment
      and treatment of iris lesions by confirming the malignancy of biopsy specimens.

PMID- 1642297
TI  - Adjunctive hyperbaric oxygen in the treatment of bilateral cerebro-rhino-orbital
      mucormycosis.
AB  - Survival is uncommon in bilateral cerebro-rhino-orbital mucormycosis treated
      surgically and medically. A 66-year-old man in previously good health had
      bilateral cerebro-rhino-orbital mucormycosis and newly diagnosed nonketotic
      diabetes mellitus at initial examination. Total loss of vision, proptosis, and
      ophthalmoplegia of both eyes were present. The patient was treated with
      aggressive surgical and medical therapies that included bilateral orbital
      exenteration, intravenous and local amphotericin B, hyperbaric oxygen, and
      control of the diabetes mellitus. One and one-half years after onset of the
      illness, the patient is alert and clinically stable. The importance of prompt
      diagnosis and aggressive treatment of this disease is emphasized by this case.
      Additionally, we suggest that adjunctive hyperbaric oxygen is a reasonable
      modality in the treatment of this often fatal disease.

PMID- 1642298
TI  - The solubility of antibiotic and corticosteroid combinations.
AB  - The use of collagen shields soaked in various combinations of medications has
      been advocated to enhance drug delivery to the cornea. Recently, severe corneal
      toxicity associated with aggregate formation in mixtures of gentamicin and
      methylprednisolone prompted our study of the effect of drug concentration, pH,
      and temperature on the solubility of several antibiotic and corticosteroid
      formulations commonly used to treat ocular disease. Selected combinations of
      cefazolin, vancomycin, tobramycin, gentamicin, methylprednisolone, and
      dexamethasone were evaluated. Mixtures of tobramycin and vancomycin produced no
      precipitates, but many spheroid aggregates were seen when methylprednisolone and
      gentamicin were combined. Although the effects of precipitate formation on drug
      bioavailability and toxicity have not been fully determined, until such
      information is available, the use of combinations of drugs that remain in
      solution during administration is recommended.

PMID- 1642299
TI  - Histologic study of healing after ab interno laser sclerostomy.
AB  - We examined the histologic characteristics of healing after ab interno laser
      sclerostomy in a human eye. A KTP 532 green laser coupled to a 300-microns quartz
      fiberoptic probe was used to create an ab interno sclerostomy in a terminally ill
      patient with pigmentary glaucoma. The intraocular pressure increased five days
      postoperatively and did not respond to medical treatment. The patient died six
      weeks postoperatively of metastatic lung cancer. Histopathologic analysis showed
      a patent 150-microns scleral lumen from the anterior chamber to the episclera,
      surrounded by a 300-microns zone of acellular thermal damage. There was no
      healing of the lumen. The subconjunctival end of the lumen was capped with a
      thick episcleral scar, which caused the failure of the operation.

PMID- 1642300
TI  - The obligation of ophthalmic organizations to report their actions.

PMID- 1642301
TI  - Closure of fornix-based posttrabeculectomy conjunctival wound leaks with
      autologous fibrin glue.

PMID- 1642302
TI  - Mucogenic glaucoma caused by an epithelial cyst of the iris stroma.

PMID- 1642303
TI  - Central retinal artery occlusion after neck irradiation.

PMID- 1642304
TI  - Traumatic rupture of a persistent hyaloid artery.

PMID- 1642305
TI  - Calcified intraocular abscess simulating retinoblastoma.

PMID- 1642306
TI  - Use of a transparent film dressing to enhance compliance with occlusion therapy
      for amblyopia.

PMID- 1642307
TI  - Ocular complications in Sweet's syndrome.

PMID- 1642308
TI  - Recurrence of herpetic stromal keratitis after a conjunctival flap surgical
      procedure.

PMID- 1642309
TI  - Enterococcus faecalis infection in a corneal graft.

PMID- 1642310
TI  - Keratoconjunctivitis sicca in a patient with a Jones tube to treat sleep apnea.

PMID- 1642311
TI  - Central retinal artery occlusion after varicella.

PMID- 1642312
TI  - Controversies in the management of retinopathy of prematurity.

PMID- 1642313
TI  - Torsional diplopia after transantral orbital decompression and extraocular muscle
      surgery associated with Graves' orbitopathy.

PMID- 1642314
TI  - Running nylon suture dissolution after penetrating keratoplasty.

PMID- 1642315
TI  - Positional behavior and body size of arboreal primates: a theoretical framework
      for field studies and an illustration of its application.
AB  - The rationale for most field studies of the positional behavior of arboreal
      primates has been the need to document natural behaviors quantitatively in order
      to infer the functional significance of morphological configurations. This focus
      on interactions of morphology with behavior is justifiable, but there exists
      another important level of biological relationships, that of the animal with its
      structural habitat, which it must negotiate to find food and avoid being preyed
      on. Recently it has become apparent that body size is likely to affect
      relationships of positional behavior with habitat structure, as well as with
      morphology. Here I offer a framework for research on functional relationships of
      positional behavior, body size, and habitat structure, with the ultimate
      objective of elucidating the aptive significance of the great diversity exhibited
      by arboreal primates. This approach specifies several distinct problems that
      animals solve, and indicates how research might be directed at revealing the
      relative effectiveness with which different primates solve them. A preliminary
      application of the framework examines sympatric north Sumatran primates.

PMID- 1642316
TI  - Genetic and environmental contributions to the variance of body height in a
      sample of first and second degree relatives.
AB  - Height was measured in a health screening of the population in Nord-Trondelag,
      Norway. Correlations were computed for 24,281 pairs of spouses, 43,613 pairs of
      parents and offspring, 19,168 pairs of siblings, 1,318 pairs of grandparents and
      grandchildren, 1,218 cognate avuncular pairs, 849 noncognate avuncular pairs, 175
      pairs of same-sexed twins, and smaller groups of other types of relatives.
      Fitting of structural equation models showed proportions of additive genetic
      variance of approximately 0.8 for both sexes and small sex-specific effects that
      probably reflect genetic dominance or environmental sibling effects. The
      correlations between parents and offspring were significantly lower in old than
      young cohorts, seeming to imply some kind of interaction effect between genes and
      environment.

PMID- 1642317
TI  - Bantu beta s cluster haplotype predominates among Brazilian blacks.
AB  - We describe the combination of polymorphic restriction-enzyme sites in the beta
      globin gene cluster (haplotypes) for 74 chromosomes from Brazilian Blacks bearing
      the sickle hemoglobin gene (beta s). The three most common African beta s
      haplotypes account for 67 chromosomes: 49/74 (66.2%) were identified as Central
      African Republic (CAR or Bantu) type, 17 (23.0%) as Benin, and one as Senegal;
      seven chromosomes (9.5%) had minor atypical haplotypes. This distribution is
      different from that observed in the United States or Jamaica, where the Benin
      haplotype predominates, and results from different patterns of slave trades to
      North and South Americas. Since the beta s gene cluster polymorphisms modulate
      the severity of sickle cell anemia, this heterogeneity may explain differences of
      the clinical behavior of the disease in the United States and South America, and
      should also be considered in relation to other features and diseases.

PMID- 1642318
TI  - Effects of demographic and ethnohistorical factors on average heterozygosities of
      South Amerindians.
AB  - Recent investigations have shown that average within-Tupi genetic distances
      differ from within-Carib distances, which is possibly due to differences in
      effective size of the populations belonging to these two linguistic stocks of
      South American tribes. The aim of this paper is to verify the influence of
      demographic factors and of interpopulation contacts on the degree of intragroup
      genetic variability of 18 South American native groups (eight Carib, seven Tupi,
      and three Ge). The mean per locus per individual heterozygosity (Hm) was studied
      for seven polymorphic systems and the distance from the centroid rii on Hm was
      evaluated with regression analysis according to Harpending and Ward's model. Data
      on intergroup contacts among the populations since the end of the eighteenth
      century were collected from an extensive review of the ethnohistorical
      literature. The level of Hm of the three linguistic stocks did not differ, which
      suggests a homogeneous within-group variation for these groups. In addition,
      there was no association between gene diversity and population size. On the other
      hand, demographic size correlated with rii, which suggest that gene frequencies
      in groups of larger populations more closely resemble the average gene
      frequencies of native South Americans. Values of rii differed between the stocks,
      and the average distance from the centroid of the Carib was about 2.6 times
      greater than that of the Tupi, in accordance with previous genetic distance
      analysis. It should also be emphasized that there was an important correlation
      between mean heterozygosity and the degree of historical intertribal contacts.
      This constitutes a particularly significant finding, suggesting the basic role of
      intertribal gene flow of the past two centuries on the level of present genetic
      variability of South American tribes.

PMID- 1642319
TI  - Nutritional status of adults in rural Mali.
AB  - An anthropometric assessment was conducted of 441 adults from six rural villages
      in southern Mali. As is typical for human populations, females are shorter and
      lighter than males. Both females (N = 320) and males (N = 121) are shorter and
      lighter than their U.S. counterparts. Mean weight in the sample is 53.4 +/- 8.5
      kilos for females and 58.8 +/- 6.5 kilos for males. Mean height is 160.4 +/- 5.7
      cm for females and 171.3 +/- 6.6 cm for males. The data for height in males are
      very similar to those reported from other surveys in Mali, and show no evidence
      for a positive secular trend in height. Mean body mass index (BMI) is 20.8 for
      females and 20.0 for males. These are lower than U.S. averages, but well above
      suggested cutoff points for malnutrition in adults. Average arm circumference is
      26.5 cm for females and 26.4 cm for males. Females have relatively large arm
      circumferences due, in part, to the heavy manual labor they perform. Average head
      circumference is 53.0 cm for females and 54.8 cm for males. For both sexes, these
      values are more than 1 standard deviation (SD) below the U.S. means. Adult values
      for anthropometric measurements reflect childhood stresses of malnutrition and
      disease, and a lifetime of accommodation to a high-carbohydrate, low-protein
      diet, and hard physical labor. Females are significantly closer to the U.S.
      standards than males for weight, height, BMI, and arm circumference; these
      findings support the idea that females are buffered from environmental stresses
      relative to males. In addition, females exhibit significantly more variability
      than males for weight, arm circumference, and head circumference, but not for
      height, suggesting that variability in adult height does not reflect the presence
      or absence of female buffering or the level of environmental adversity.

PMID- 1642320
TI  - Effects of fronto-occipital artificial cranial vault modification on the cranial
      base and face.
AB  - Artificial reshaping of the cranial vault has been practiced by many human groups
      and provides a natural experiment in which the relationships of neurocranial,
      cranial base, and facial growth can be investigated. We test the hypothesis that
      fronto-occipital artificial reshaping of the neurocranial vault results in
      specific changes in the cranial base and face. Fronto-occipital reshaping results
      from the application of pads or a cradle board which constrains cranial vault
      growth, limiting growth between the frontal and occipital and allowing
      compensatory growth of the parietals in a mediolateral direction. Two skeletal
      series including both normal and artificially modified crania are analyzed, a
      prehistoric Peruvian Ancon sample (47 normal, 64 modified crania) and a Songish
      Indian sample from British Columbia (6 normal, 4 modified). Three-dimensional
      coordinates of 53 landmarks were measured with a diagraph and used to form 9
      finite elements as a prelude to finite element scaling analysis. Finite element
      scaling was used to compare average normal and modified crania and the results
      were evaluated for statistical significance using a bootstrap test. Fronto
      occipitally reshaped Ancon crania are significantly different from normal in the
      vault, cranial base, and face. The vault is compressed along an anterior-superior
      to posterior-inferior axis and expanded along a mediolateral axis in modified
      individuals. The cranial base is wider and shallower in the modified crania and
      the face is foreshortened and wider with the anterior orbital rim moving inferior
      and posterior towards the cranial base. The Songish crania display a different
      modification of the vault and face, indicating that important differences may
      exist in the morphological effects of fronto-occipital reshaping from one group
      to another.

PMID- 1642321
TI  - Dental microwear and diet in Venezuelan primates.
AB  - Recent microwear analyses have demonstrated that wear patterns can be correlated
      with dietary differences. However, much of this work has been based on analyses
      of museum material where dates and locations of collection are not well known. In
      view of these difficulties, it would be desirable to compare microwear patterns
      for different genera collected from the same area at the same time. The
      opportunity to do this was provided by the collections of the Smithsonian
      Venezuelan Project (Handley, 1976), in which multiple primate genera were
      collected from the same humid tropical forest sites within the same month. The
      monkeys represent a wide range of dietary preferences, and include Saimiri,
      Cebus, Chiropotes, Ateles, Aotus, Pithecia, and Alouatta. As in previous
      microwear analyses, epoxy replicas were prepared from dental impressions, as
      described by Rose (1983) and Teaford and Oyen (1989). Two micrographs were taken
      of facet 9 on an upper second molar of each specimen. Computations and analyses
      were the same as described by Teaford and Robinson (1989). Results reaffirm
      previously documented differences in dental microwear between primates that feed
      on hard objects versus those that do not--with Pithecia and Alouatta at the
      extremes of a range of microwear patterns including more subtle differences
      between species with intermediate diets. The subtle microwear differences are by
      no means easy to document in museum samples. However, additional results suggest
      that 1) the width of microscopic scratches may be a poor indicator of dietary
      differences, 2) large and small pits may be formed differently, and 3) there are
      very few seasonal differences in dental microwear in the primates at these humid
      tropical forest sites.

PMID- 1642322
TI  - Muscle force recruitment and biomechanical modeling: an analysis of masseter
      muscle function during mastication in Macaca fascicularis.
AB  - The main purpose of this study is to test the hypothesis that as subjects chew
      with increasing levels of force, the ratio of the working- to balancing-side jaw
      muscle force (W/B) decreases and begins to approach 1.0. We did this by analyzing
      relative masseter force in Macaca fascicularis using both strain gage and surface
      electromyographic (EMG) techniques. In addition, we also analyzed: 1) the
      relationship between jaw position using cineradiographic techniques and relative
      masseter force, 2) the timing differences between relative masseter force from
      the working and balancing sides, and 3) the loading and unloading characteristics
      of the masseter muscle. Our findings indicate that when macaques increase the
      amount of overall masticatory force during chewing, the W/B ratio for masseter
      force frequently (but not always) decreases and begins to approach 1.0.
      Therefore, our working hypothesis is not completely supported because the W/B
      ratio does not decrease with increasing levels of force in all subjects. The data
      also demonstrate timing differences in masseter force. During apple-skin
      mastication, the average peak masseter force on the working side occurs
      immediately at or slightly after the initial occurrence of maximum
      intercuspation, whereas the average peak masseter force on the balancing side
      occurs well before maximum intercuspation. On average, we found that peak force
      from the balancing-side masseter precedes the working-side masseter by about 26
      msec. The greater the asynchrony between working- and balancing-side masseter
      force, the greater the difference in the relative magnitude of these forces. For
      example, in the subject with the greatest asynchrony, the balancing-side masseter
      had already fallen to about one-half of peak force when the working-side masseter
      reached peak force. Our data also indicate that the loading and unloading
      characteristics of the masseter differ between the working and balancing sides.
      Loading (from 50 to 100% of peak force) and unloading (from 100 to 50% of peak
      force) for the balancing-side masseter tends to be rather symmetrical. In
      contrast, the working-side masseter takes much longer to load from 50 to 100% of
      peak force than it does to unload from 100 to 50% of peak force. Finally, it
      takes on average about 35 msec for the working-side zygoma and 42 msec for the
      balancing-side zygoma to unload from 100 to 50% of peak force during apple-skin
      mastication, indicating that the unloading characteristics of the macaque
      masseter during mastication closely approximates its relaxation characteristics
      (as determined by muscle stimulation).

PMID- 1642323
TI  - Erosive arthritis and spondyloarthropathy in Old World primates.
AB  - Presence of spine and sacroiliac involvement and the nature and distribution of
      the erosive lesions allow definitive diagnosis of spondyloarthropathy. Thus,
      spondyloarthropathy was identified in Theropithecus, Papio, Cercopithecus,
      Macaca, Colobus, Presbytis, and Hylobates. Only monarticular erosive disease was
      present in prosimians, precluding a diagnosis of spondyloarthropathy for that
      group. The distribution of erosive disease and axial joint involvement in 1,349
      non-prosimian Old World primates is quite characteristic of that noted in human
      psoriatic arthritis. While Reiter's syndrome must also be considered, the
      histologic appearance of skin lesions in Macaca is characteristic of psoriasis.
      Evidence of spondyloarthropathy abounds in the literature of primate skeletal
      disease. Environmentally based contagions may be important in the pathophysiology
      of spondyloarthropathy. The wide geographic distribution of the phenomena in
      monkeys suggests a "panendemic," with limited individual susceptibility (compared
      to that noted in gorillas and chimpanzees). Identical occurrence of erosive
      arthritis/spondyloarthropathy in free-ranging and artificially restrained animals
      suggests that spondyloarthropathy can validly be studied in artificially
      restrained populations. This perspective should allow application of human
      therapeutic approaches to and perhaps improve the quality of life for
      artificially restrained, afflicted individuals.

PMID- 1642324
TI  - Laryngeal edema induced by neck dissection and catheter thrombosis.
AB  - PURPOSE: There are many possible causes of airway edema in a patient being
      treated for squamous cell carcinoma of the head and neck. The differential
      diagnosis includes radiation changes, anaphylaxis, and venous or lymphatic
      obstruction secondary to mechanical compromise resulting from infection,
      recurrent tumor, or anatomic distortion. METHODS: A 60-year-old man underwent
      partial glossectomy and right radical neck dissection for squamous cell carcinoma
      of the tongue. He subsequently required insertion of a Hickman catheter for
      administration of chemotherapy to treat recurrent disease. Edema of the left
      neck, shoulder, and arm was noted to accompany the onset of laryngeal obstruction
      secondary to supraglottic edema. RESULTS: Catheter-induced thrombosis of the left
      brachycephalic vein obstructed the only residual jugular vein and was responsible
      for the sudden airway obstruction. CONCLUSION: Acute laryngeal edema may be
      caused by obstruction of venous outflow. Invasive catheters should be placed with
      caution in patients who have undergone surgical sacrifice of the contralateral
      internal jugular vein.

PMID- 1642325
TI  - Augmentation genioplasty: when bone is not enough.
AB  - PURPOSE: Augmentation genioplasty is indicated to correct microgenia. When a
      large defect must be corrected, the additional use of a soft alloplastic implant
      may be indicated. METHODS: A 22-year-old patient is presented who required
      correction of microgenia. A 15-mm advancement of the chin was required to obtain
      an acceptable cosmetic result. RESULTS: An augmentation genioplasty achieved an 8
      mm correction. This was supplemented by a silicone gel-filled implant inserted
      subperiosteally. This resulted in an outstanding cosmetic result. CONCLUSIONS:
      Chin contour is an important aspect of facial aesthetics. The sliding genioplasty
      is ideally suited for correcting most chin deformities; however, the insertion of
      an alloplast may augment patients with severe microgenia. Avoidance of the donor
      site morbidity associated with the use of autogenous bone is a major benefit of
      this procedure.

PMID- 1642327
TI  - Pneumolabyrinth: a computed tomographic sign of temporal bone fracture.

PMID- 1642326
TI  - Malignant salivary gland tumors: squamous cell carcinoma of the submandibular
      gland in a child.
AB  - PURPOSE: Malignant neoplasms of the salivary glands are extremely unusual in the
      pediatric age group. METHODS: We report an 11-year-old boy who presented with a
      mass in the left submandibular region and a second mass in the jugularfacial
      venous angle. RESULTS: Histologic evaluation determined that this was a squamous
      cell carcinoma of the submandibular gland with metastasis to a cervical node.
      Review of the literature was undertaken to identify the rate of malignant
      salivary gland tumors in children. Malignant salivary gland tumors are extremely
      rare in children. When malignancy does occur, nearly 90% are present in the
      parotid gland. The submandibular gland is effected in 7.7% of cases. The most
      common malignancy in salivary glands of children is the mucoepidermoid carcinoma.
      Squamous cell carcinoma occurs in less than 2% of cases. CONCLUSIONS: Salivary
      gland tumors are very rare in children in contrast to adults. The proportion of
      malignant tumors in children is higher than that observed in adults; however, it
      is not possible to draw conclusions concerning treatment from the few case
      reports that exist. A higher rate of local recurrence and cervical lymph node
      metastasis may be expected in children.

PMID- 1642328
TI  - Pediatric tracheotomy: a review of technique.

PMID- 1642329
TI  - Subjective idiopathic tinnitus: a unified plan of management.

PMID- 1642330
TI  - Laryngeal transplantation: ethical considerations.

PMID- 1642331
TI  - The management of congenital neck masses.

PMID- 1642332
TI  - Developmental anatomy of the eustachian tube and middle ear in mice.
AB  - PURPOSE: It is generally accepted that the development of the tubotympanum has
      significant bearing on the susceptibility to ear infection. A detailed study of
      the differentiation of ciliated cells in secretory elements will be useful in
      understanding both the normal physiology and the pathology of the tubotympanum.
      METHOD: Serially sectioned temporal bones of 76 mice ranging from gestational age
      day 11 to postnatal day 21 were examined microscopically. RESULTS: During the
      period of gestation, the tubotympanic recess was formed at the 12th day and began
      to extend to form the middle ear between the 13th and 14th days. A rapid increase
      in the volume of the tubotympanic recess was observed between the 15th and 16th
      days when a definitive division of the tubotympanic recess into the eustachian
      tube and middle ear cavity was observed. Postnatally the tubotympanum attained an
      adult form around day 9, and the maximum change of middle ear volume was noted on
      day 11, when the mesenchymal tissue in the middle ear cavity disappeared
      completely. Development of the ciliated cells was observed concurrently in both
      the eustachian tube and middle ear on the 16th gestational day, one day earlier
      than the appearance of the epithelial secretory cells in both the eustachian tube
      and middle ear. The number of ciliated cells and secretory cells increased
      rapidly after birth. Tubal glands were well developed with evidence of secretory
      activity around the time of birth. CONCLUSIONS: Based on these findings, one can
      conclude that the mucociliary defense system starts to develop during the fetal
      stage and is well established immediately after birth.

PMID- 1642333
TI  - Morphology and functions of the human seminal vesicle.
AB  - The seminal vesicles originate in embryos of about 58 mm crown-rump-length from
      the Wolffian duct under the influence of testosterone. Along with the ampulla of
      the vas deferens and the ejaculatory duct, they form a functional unit that
      develops slowly until the onset of puberty. Developmental malformations occur as
      uni- or bilateral agenesis, aplasia, cysts, or ureterovesicular fistules. After
      puberty, the glands form sac-like structures which have a capacity of about 3.4
      4.5 ccm and contribute about 70% of the seminal fluid. In addition to secretion,
      they are capable of reabsorption of fluids or dissolved substances, and of
      spermatophagy (ingestion and degradation of damaged spermatozoa by epithelial
      cells). Secretory activity of the glands is a measure of testosterone
      supplementation to the epithelium. Nervous regulation of secretion is realized by
      cholinergic post-ganglionic, sympathetic (and perhaps parasympathetic) fibres,
      derived from pelvic plexus. Contraction of the muscular wall occurs under the
      influence of excitatory adrenergic and modulatory NPY-encephalin-peptidergic
      nerve fibres. The secretory products of the seminal vesicles encompass (1) ions
      (K+: 1.1 mM ml-1) (2) low molecular weight substances (fructose: above 1.2 mg ml
      1; prostaglandins above 250 microliters ml-1, (3) peptides (endorphin: 330 pg ml
      1), and (4) proteins. In addition to plasma protein related forms such as
      transferrin, lactoferrin, and fibronectin, specific proteins such as semenogelin
      (52 kDa) are synthesized, the scaffold protein of semen coagulate forming the
      substrate for PSA (prostate specific antigen), sperm motility inhibitor (ca. 18
      kDa), and others (placental protein 5, protein kinase inhibitor, carboanhydrase,
      5'-nucleotidase), some of which are immunosuppressive. Therefore, functions of
      the seminal vesicles concern (a) formation of seminal coagulum, (b) modification
      of sperm functions (motility, capacitation), and (c) immunosuppression.
      Additional functions within the female genital system, perhaps during pre
      implantation period, are likely, but remain to be proven experimentally.

PMID- 1642334
TI  - Leucocyte populations in semen and male accessory gland function: relationship
      with antisperm antibodies and seminal quality.
AB  - Semen samples from 279 infertility patients attending an Immunological Centre
      were analysed to evaluate the relationship between the populations of leucocytes,
      seminal quality, antisperm antibodies, and seminal vesicle function. The most
      frequent finding between leucocytospermic samples was asthenozoospermia (57%),
      whereas in non-leucocytospermic samples normozoospermia was the most frequent
      finding (47%). In the samples with asthenozoospermia, granulocytes predominated,
      whereas in those with oligozoospermia and azoospermia a reduction in the number
      of macrophages and lymphocytes was observed, suggesting an obstructive process at
      the level of epididymis and/or vas deferens where these leucocytes are mostly
      produced. In the case of hypofunction of the seminal vesicles there was a
      predominance in granulocytes. The increased levels of each type of leucocytes
      affected seminal quality only when seminal vesicles were affected. Only the
      elevated granulocytes count was related to a decrease in sperm motility. In those
      samples with leucocytospermia, positive antisperm antibodies (ASA) were
      associated with low sperm motility, low sperm normal morphology, and low value of
      seminal corrected fructose, whereas, in the absence of leucocytospermia, ASA,
      were more related to low sperm counts. These data suggest that granulocytes were
      more related to seminal vesicles dysfunction and sperm motility changes, and that
      ASA may be observed in the presence or absence of leucocytospermia.

PMID- 1642335
TI  - The concentration pattern of laminin, hyaluronan, and aminoterminal propeptide of
      type III procollagen in seminal fluid.
AB  - The extracellular matrix components laminin, N-terminal propeptide of type III
      procollagen (PIIINP) and hyaluronan (HA) were determined in seminal fluids of 119
      patients submitted for diagnosis of infertility. The concentrations of laminin
      and HA, but not those of PIIINP, were elevated in seminal fluid in comparison to
      their ranges of concentration in normal sera. Only weak correlations were
      observed between the concentrations of the three matrix components. The
      concentration of HA was negatively correlated with sperm count and ejaculate
      volume. Laminin was positively correlated with sperm count, the age of patients,
      and highly significantly with the concentrations of acrosin. A highly significant
      positive correlation was also found between PIIINP and fructose. By analysis of
      variance it could be shown that patients with azoospermia and oligozoospermia
      have significantly higher levels of HA than those with normospermia. Patients
      with terato- and asthenozoospermia showed no characteristic pattern of the matrix
      components.

PMID- 1642336
TI  - Evaluation of the hypo-osmotic swelling test in relation with advanced methods of
      semen analysis.
AB  - The hypo-osmotic swelling test was claimed to assess an independent functional
      characteristic of human spermatozoa bearing relevance to their fertilizing
      capacity. To test this claim, we have studied the relationship between the result
      of the hypo-osmotic swelling test with that of conventional semen analysis and
      sperm motility patterns, the semen content of adenosine triphosphate, the
      staining pattern to acidified aniline blue, and the zona-free hamster oocyte
      test. The result of the HOS test is significantly correlated with all sperm
      characteristics except for the aniline blue stainability and the hamster oocyte
      test. The capacity of spermatozoa to react in a hypo-osmotic environment
      expresses the same functional information as the viability test using eosine
      staining. It is concluded that the hypo-osmotic swelling test does not add
      relevant information to that obtained by routine sperm analysis with regards to
      the fertilizing potential of semen.

PMID- 1642337
TI  - S-100 protein immunoreactivity in bovine testis.
AB  - The present study deals with immunohistochemical localization of S-100 protein in
      the bovine testis. Immunoreactivity for the protein was seen in Sertoli cells of
      the seminiferous tubules and as a particularly intense staining in the terminal
      tubular segment (transitional region, middle portion, and terminal plug), which
      is mainly composed of modified Sertoli cells. Immunoreactivity was also found in
      epithelial cells of the straight testicular tubules and rete testis, and in the
      endothelium of capillaries, veins and lymphatic vessels. Although the functional
      significance of S-100 protein immunoreactivity in the Sertoli cells remains
      unclear, the present results suggest that it may be involved in the microtubule
      assembly-disassembly system. The specificity of the immunolabelling observed
      should enable the antigen and/or antibody to S-100 to be used as an investigative
      and diagnostic tool in the study of bovine Sertoli cell function.

PMID- 1642338
TI  - Fluorescence body of bovine spermatozoa represents Y-chromosome.
AB  - The fluorescence body test would be an inexpensive method of quantifying the Y
      chromosomes of mammalian spermatozoa, and could be used to monitor the enrichment
      of X- and Y-spermatozoa. However, a definitive proof that the fluorescence bodies
      are markers of the Y-chromosome, is available only for humans and gorillas. In
      the study described here it is demonstrated for the first time in cattle that the
      fluorescence bodies of spermatozoa represent the Y-chromosomes. The evidence is
      furnished by a combination of the fluorescence staining (quinacrine mustard) with
      the in-situ-hybridization using bovine male-specific DNA fragments. The incidence
      of f-bodies corresponded with autoradiographic grains caused by the tritiated Y
      specific DNA in the examined 144 single cells (75, 5, and 88% agreement).

PMID- 1642339
TI  - Latex anaphylaxis.

PMID- 1642340
TI  - Thiopental pharmacodynamics. I. Defining the pseudo-steady-state serum
      concentration-EEG effect relationship.
AB  - To assess depth of anesthesia for intravenous anesthetics using clinical stimuli
      and observed responses, it is necessary to achieve constant serum concentrations
      of drug that result in constant biophase or central nervous system
      concentrations. The goal of this investigation was to use a computer-controlled
      infusion pump (CCIP) to obtain constant serum thiopental concentrations and use
      the electroencephalogram (EEG) as a measure of thiopental's central nervous
      system drug effect. The number of waves per second obtained from aperiodic
      waveform analysis was used as the EEG measure. A CCIP was used in six male
      volunteers to attain rapidly and then maintain for 6-min time periods the
      following pseudo-steady-state constant serum thiopental target concentrations:
      10, 20, 30, and 40 micrograms/ml. The median performance error (bias) of the CCIP
      using 149 measurements of thiopental serum concentrations in six subjects was
      +5%, and the median absolute performance error (accuracy) was 16%. Following the
      step change in serum thiopental concentration, the EEG number of waves per second
      stabilized within 2-3 min and the remained constant until the target serum
      thiopental concentration was changed. When the constant serum thiopental
      concentration was plotted against the number of waves per second for each
      subject, a biphasic serum concentration versus EEG effect relationship was seen.
      This biphasic concentration:response relationship was characterized with a
      nonparametric pharmacodynamic model. The awake, baseline EEG was 10.6 waves/s; at
      peak activation the EEG was 19.1 waves/s and occurred at a serum thiopental
      concentration of 13.3 micrograms/ml. At a serum thiopental concentration of 31.2
      micrograms/ml the EEG had slowed to 10.6 waves/s (back to baseline) and at 41.2
      micrograms/ml was 50% below the baseline, awake value. Zero waves per second
      occurred at serum thiopental concentrations greater than 50 micrograms/ml. Using
      a CCIP it is possible to establish constant serum thiopental concentration
      rapidly and characterize the concentration versus EEG drug effect relationship.

PMID- 1642341
TI  - Thiopental pharmacodynamics. II. Quantitation of clinical and
      electroencephalographic depth of anesthesia.
AB  - This study examined the relationship among pseudo-steady-state (constant) serum
      thiopental concentrations, clinical anesthetic depth as assessed by several
      perioperative stimuli, and the electroencephalogram (EEG). Twenty-six ASA
      physical status 1 or 2 patients participated in the study. Two constant serum
      thiopental concentrations were maintained in each patient using a computer
      controlled infusion pump. The first randomly assigned target serum concentration
      of 10-30 micrograms/ml was maintained for 5 min to allow serum:brain
      equilibration. Then the following stimuli were applied at 1-min intervals: verbal
      command, tetanic nerve stimulation, trapezius muscle squeeze, and laryngoscopy. A
      second, higher, randomly assigned target serum concentration of 40-90
      micrograms/ml was then achieved and maintained by the computer-controlled
      infusion pump. The previously described stimuli were reapplied, after which
      laryngoscopy and intubation was performed. A positive response was recorded if
      purposeful extremity movement or coughing was observed. Using the quantal
      movement or cough response and the measured constant serum thiopental
      concentration, the probability of no movement to each stimulus was characterized
      using logistic regression. The serum thiopental concentrations that produced a
      50% probability of no movement response for the clinical stimuli were as follows:
      15.6 micrograms/ml for verbal command, 30.3 micrograms/ml for tetanic nerve
      stimulation, 39.8 micrograms/ml for trapezius muscle squeeze, 50.7 micrograms/ml
      for laryngoscopy, and 78.8 micrograms/ml for laryngoscopy followed by intubation.
      The EEG was analyzed using aperiodic waveform analysis to derive the number of
      waves per second. A biphasic relationship between constant serum thiopental
      concentration and the EEG number of waves per second was observed. Loss of
      responsiveness to verbal stimulation occurred when the EEG was activated at 15-18
      waves/s.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642342
TI  - Evaluation of risk factors for laryngeal edema after tracheal extubation in
      adults and its prevention by dexamethasone. A placebo-controlled, double-blind,
      multicenter study.
AB  - Because laryngeal edema (LE) after tracheal extubation is likely to result from
      an exudative response, corticosteroids often are given routinely as a preventive
      treatment. No adequate controlled study supports this strategy, however. A
      prospective, randomized, placebo-controlled, double-blind, multicenter trial that
      included 700 consecutive patients requiring tracheal intubation and mechanical
      ventilation was conducted to determine risk factors for LE occurrence after
      tracheal extubation in adults and to evaluate the efficacy of corticosteroids in
      its prevention. One hour before extubation, patients were given either an
      intravenous bolus of 8 mg dexamethasone or a placebo. Patients were divided into
      two groups: 1) those in whom short-duration intubation (SDI, less than 36 h) was
      administered; and 2) those in whom long-duration intubation (LDI, more than 36 h)
      was administered. Minor LE was diagnosed when either stridor or laryngeal
      dyspnea, or both, occurred; major LE was diagnosed when reintubation due to LE
      was required, with LE evidenced during direct laryngoscopy. The overall incidence
      of LE was 4.2% and varied among the six participating centers from 2.3 to 6.9%
      (not significant). In only seven patients (1%), all with LDI, was tracheal
      reintubation required for LE. Laryngeal edema occurred more frequently after LDI
      than after SDI (7.2 vs. 0.9%; P less than 0.001). It also was more frequent in
      female than in male patients (20/284 vs. 8/379; P less than 0.05), irrespective
      of intubation duration and treatment. There was no association between LE and
      either difficulty/route of intubation or admission diagnosis.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1642343
TI  - Epidural versus general anesthesia, ambient operating room temperature, and
      patient age as predictors of inadvertent hypothermia.
AB  - To elucidate the multifactorial nature of perioperative changes in body
      temperature, the influence of several clinical variables, including anesthetic
      technique, ambient operating room temperature, and age, were evaluated.
      Perioperative oral sublingual temperatures were measured in 97 patients
      undergoing lower extremity vascular surgery randomized to receive either general
      (GA) or epidural (EA) anesthesia. Surgery and anesthesia were performed in
      operating rooms (OR) with a relatively warm mean ambient temperature (24.5 +/-
      0.4 degrees C) (GA, n = 30; EA, n = 33) or relatively cold mean ambient
      temperature (21.3 +/- 0.3 degrees C) (GA, n = 21; EA, n = 13). Patients were 35
      94 yr old, with a mean age of 64.5 +/- 1.1 yr. A regression analysis was
      performed to determine the variables that correlated with intraoperative decrease
      in temperature and postoperative rewarming rate. The major correlates of greater
      intraoperative decrease in temperature were 1) GA (P = 0.003); 2) cold ambient OR
      temperature (P = 0.07); and 3) advancing patient age (P = 0.03). There was
      significant interaction between ambient OR temperature and type of anesthesia (P
      = 0.03): there was a greater intraoperative decrease in temperature with GA
      compared to EA in a cold OR but a similar decrease with GA and EA in a warm OR.
      The data also suggest an interaction between type of anesthesia and patient age
      (P = 0.06), showing a greater decrease in temperature with GA compared to EA in
      the younger patients, but a similar decrease between GA and EA in older
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642344
TI  - Transcutaneous cardiac pacing in patients with automatic implantable cardioverter
      defibrillators and epicardial patch electrodes.
AB  - In patients with automatic implantable cardioverter defibrillators, insulation of
      the epicardial patch electrodes (patches) prevents externally applied current
      from passing through the electrode to the cardiac muscle so that external
      transthoracic and even internal defibrillation can be unsuccessful. Because
      emergency cardiac pacing may be required in such a case, a study was performed to
      evaluate whether, and at what threshold and electrode orientation, transcutaneous
      pacing is possible in patients with implanted patches. Thresholds for
      transcutaneous pacing were determined during general anesthesia in nine patients
      with patches sewn across the heart (anterior right and posterior left ventricles)
      either before or after surgery, or at both times (automatic implantable
      cardioverter defibrillator implantation/exchange with or without coronary artery
      bypass grafting). Because surgery per se can increase the pacing threshold, nine
      patients of similar body size and weight undergoing routine coronary artery
      bypass grafting also were evaluated and served as a control group. Pacing
      thresholds (stimulus duration: 50 ms) were determined during normothermia with a
      transportable transcutaneous pacer, and adult cutaneous electrodes were placed
      across the patients' chest in the standard anteroposterior and right-to-left
      orientations. In all patients with patch electrodes, antero-posterior pacing was
      possible at a mean threshold of 73 +/- 30 mA standard deviation (range: 40-140
      mA). This threshold was not significantly different (Mann-Whitney test) from that
      in control patients before (57 +/- 20 mA; range: 30-90 mA) or after (94 +/- 24
      mA; range: 40-120 mA) coronary artery-bypass grafting. The surgical procedure per
      se significantly increased the threshold (Wilcoxon test, P less than
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642345
TI  - Intraarticular morphine, bupivacaine, and morphine/bupivacaine for pain control
      after knee videoarthroscopy.
AB  - Evidence has accumulated that opioids can produce potent antinociceptive effects
      by interacting with opioid receptors in peripheral tissues. This study sought to
      compare the effects of morphine with those of bupivacaine administered
      intraarticularly upon pain following arthroscopic knee surgery. In a double
      blind, randomized manner, 33 patients received either morphine (1 mg in 20 ml
      NaCl; n = 11), bupivacaine (20 ml, 0.25%; n = 11), or a combination of the two (n
      = 11) intraarticularly at the completion of surgery. After 1, 2, 3, and 4 h and
      at the end of the 1st and 2nd postoperative days, pain was assessed by a visual
      analogue scale, and supplemental analgesic requirements were recorded. Pain
      scores were significantly greater in the morphine group than in the other two
      groups at 1 h. There were no significant differences at 2 and 3 h. From 4 h until
      the end of the study period, pain scores were significantly greater in the
      bupivacaine group than in the other two groups. Analgesic requirements were
      significantly greater in the morphine group than in the other groups at 1 h but
      were significantly greater in the bupivacaine group than in the other groups
      throughout the remainder of the study period. We conclude that intraarticular
      morphine produces an analgesic effect of delayed onset but of remarkably long
      duration. The combination of these two drugs results in satisfactory analgesia
      throughout the entire observation period.

PMID- 1642346
TI  - Intrathecal clonidine as a sole analgesic for pain relief after cesarean section.
AB  - In a small number of studies and isolated case reports, intrathecally
      administered clonidine has been reported to relieve intractable cancer pain and
      to prolong spinal anesthesia induced by various local anesthetics. A double-blind
      placebo-controlled clinical trial was carried out in order to evaluate the effect
      of intrathecal clonidine on pain following cesarean section. Twenty patients who
      underwent elective cesarean section received, 45 min after general anesthesia,
      either 150 micrograms (n = 10) clonidine or saline (control group, n = 10)
      intrathecally. Pain scores were lower in clonidine- than saline-treated patients
      from 20 to 120 min after intrathecal injection, as measured by a visual pain
      linear analog scale (P less than 0.05). Pain relief, in terms of the first
      supplemental analgesic request by patients, lasted 414 +/- 128 min after
      intrathecal clonidine and 181 +/- 169 min (mean +/- SD) (P less than 0.01) after
      saline. Clonidine decreased systolic, diastolic, and mean arterial pressures
      compared to baseline values (P less than 0.05), but heart rate and central venous
      pressure were unaffected (difference not significant). Maximal reduction of
      systolic arterial pressure was 15 +/- 9%, of diastolic arterial pressure 22 +/-
      12%, and of mean arterial pressure 18 +/- 12%. Clonidine did not affect arterial
      hemoglobin oxygen saturation or PaCO2. Patients in the clonidine group were
      significantly more sedated (P less than 0.05) and more frequently reported a dry
      mouth (P less than 0.01) compared to the normal saline group.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1642347
TI  - Postoperative pain management by intranasal demand-adapted fentanyl titration.
AB  - The aim of the present study was to investigate whether intranasal administration
      of fentanyl allows a demand-adapted postoperative opioid titration. Forty-two
      patients who had undergone surgery for lumbar intervertebral disk protrusion were
      included in a prospective randomized double-blind study. When complaining about
      intense pain, 22 patients received six sprays of fentanyl (0.027 mg) intranasally
      and 6 ml sodium chloride 0.9% intravenously and 20 patients received six sprays
      of sodium chloride 0.9% intranasally and 6 ml of a diluted fentanyl solution
      (0.027 mg) intravenously. In both groups, these doses were repeated every 5 min
      until the patients were free of pain or refused further analgesic. Before the
      beginning of opioid titration and then every 10 min for at least 1 h, pain was
      evaluated with the aid of a 101-point numerical rating scale and a verbal rating
      scale. Blood pressure, heart rate, arterial hemoglobin oxygen saturation,
      respiratory rate, and side effects were recorded. All patients were satisfied
      with the pain reduction achieved. The total fentanyl dose was 0.073 mg (range
      0.027-0.162) in the intravenous group and 0.11 mg (range 0.027-0.243) in the
      intranasal group. The onset of action after intranasal application was nearly as
      fast as after intravenous titration. The pain reduction achieved was comparable
      in both groups. Only at the (10-), 20- and 30-min measurement points was the pain
      intensity significantly lower in the intravenous than in the intranasal group.
      One patient of the intravenous group showed a decrease in arterial hemoglobin
      oxygen saturation to less than 90%. Other serious side effects were not
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642348
TI  - Painful stimulation minimally increases the thermoregulatory threshold for
      vasoconstriction during enflurane anesthesia in humans.
AB  - Generalized autonomic stimulation enhances hemodynamic responses and may, in a
      similar fashion, facilitate thermoregulatory responses. We thus tested the
      hypothesis that painful stimulation increases the central temperature threshold
      for vasoconstriction during general anesthesia. Healthy volunteers were
      anesthetized with 1.3% end-tidal enflurane on 2 separate days. On 1 day (randomly
      assigned), painful stimulation was produced by tetanic electrical stimulation. On
      the other day, electrical stimulation was not given. Significant thermoregulatory
      vasoconstriction was defined as a forearm-fingertip skin-surface temperature
      gradient exceeding 4 degrees C. The distal esophageal temperature triggering
      significant vasoconstriction was considered the thermoregulatory threshold. The
      threshold was 35.5 +/- 0.8 degrees C during electrical stimulation and 35.1 +/-
      0.6 degrees C without stimulation (P = 0.050, 95% confidence interval for the
      difference = 0-0.7 degree C). These data suggest that thresholds determined in
      nonsurgical volunteers will be slightly (but not clinically significantly) less
      than those in operative patients. Similarly, intraoperative vasoconstriction
      thresholds likely will be slightly less when surgical pain is prevented by
      simultaneous regional or local analgesia.

PMID- 1642349
TI  - Successful transplantation after long-term preservation of dog hearts.
AB  - Nucleoside transport inhibition is a new approach to long-term preservation of
      donor hearts. To evaluate its effectiveness, the following were tested: 1) the
      effect of nucleoside transport inhibition on high-energy phosphate content after
      cardioplegic arrest and during long-term cold storage (group I: cardioplegia,
      control ]n = 18]; group II: cardioplegia plus nucleoside transport inhibitor [n =
      18]); 2) the effect of nucleoside transport inhibition on high-energy phosphates
      and hemodynamic recovery in a modified blood-perfused Langendorff system (group
      III: 24-h cold storage followed by reperfusion [n = 6]; group IV: addition of
      nucleoside transport inhibition to cardioplegia but not during reperfusion [n =
      6]; group V: addition of nucleoside transport inhibition during reperfusion [n =
      6]; group VI: addition of nucleoside transport inhibition to cardioplegia and
      during reperfusion [n = 6]); and 3) the effect of nucleoside transport inhibition
      added to cardioplegia and during reperfusion on high-energy phosphate content and
      outcome after heart transplantation (group VII: no nucleoside transport inhibitor
      in cardioplegia and during reperfusion [n = 8]; group VIII: addition of
      nucleoside transport inhibition to cardioplegia and during reperfusion [n = 8]).
      The following results were obtained: 1) addition of nucleoside transport
      inhibition prevented high-energy phosphate depletion during cold storage: after
      24 h, adenosine triphosphate content in group I was 9.4 +/- 3.1 mumol/g versus
      17.7 +/- 3.6 mumol/g dry weight in group II (P less than 0.05); 2) addition of
      nucleoside transport inhibition to cardioplegia and during reperfusion resulted
      in greater high-energy phosphate content (adenosine triphosphate in group III was
      7.9 +/- 3.5 mumol/g vs. 17.8 +/- 2.8 mumol/g in group VI [P less than 0.05]) and
      improved hemodynamics upon reperfusion (hearts in group III did not recover,
      maximum isometric left ventricular pressure development was 1,635 +/- 577
      mmHg/sec in group IV, 1,915 +/- 423 mmHg/sec in group V, and 2,437 +/- 201
      mmHg/sec in group VI [P less than 0.05, group VI vs. groups IV and V]); and 3)
      hearts treated with nucleoside transport inhibition in cardioplegia and during
      reperfusion (group VIII) could be transplanted successfully in contrast to group
      VII hearts. These data indicate that nucleoside transport inhibition in dogs is
      highly effective in long-term preservation of donor hearts.

PMID- 1642350
TI  - Insufflated halothane increases venous admixture less than nitroprusside in
      canine atelectasis.
AB  - Although it generally is agreed that halothane is a pulmonary vasodilator, its
      effect on venous admixture and hypoxic pulmonary vasoconstriction are more
      controversial. The effects of 2.4% halothane on pulmonary vascular resistance and
      venous admixture were investigated in an isolated canine lobe made atelectatic.
      Halothane was administered by three different methods: insufflation, addition to
      the pulmonary artery blood through a bubble deoxygenator, or a combination of
      both techniques. Pulmonary vascular resistance was divided into arterial, venous,
      and middle segmental resistance by a vascular occlusion technique. Middle
      resistance increased with 3% O2 ventilation (0.0238 +/- 0.0092 cmH2O.ml-1.min-1)
      or after production of atelectasis (0.0225 +/- 0.0074 cmH2O.ml-1.min-1), compared
      to control ventilation in the nonatelectatic lung 0.01 +/- 0.0067 cmH2O.ml-1.min
      1). Halothane by any delivery method variably decreased middle resistance, with
      increasing potency from addition of halothane through the bubble deoxygenator
      (0.0118 +/- 0.0047 cmH2O.ml-1.min-1) to halothane insufflation (0.0072 +/- 0.0058
      cmH2O.ml-1.min-1), and finally to a combination of both techniques (0.0026 +/-
      0.0041 cmH2O.ml-1.min-1). In contrast to vascular resistance, venous admixture in
      the atelectatic (8 +/- 5%) and nonatelectatic lobes (7 +/- 4%) was increased with
      halothane insufflation (11 +/- 4%), addition of halothane through the bubble
      deoxygenator (26 +/- 16%), and a combination of both techniques (22 +/- 13%).
      Compared to intravenous nitroprusside (26 +/- 12%), halothane insufflation was
      less potent in increasing venous admixture when total pulmonary vascular
      resistances were of similar magnitude (0.0526 +/- 0.0112 and 0.0484 +/- 0.0088
      cmH2O.ml-1.min-1, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642351
TI  - The effect of amrinone on recovery from severe bupivacaine intoxication in pigs.
AB  - Cardiovascular collapse following intravascular bupivacaine may be resistant to
      treatment. The effect of amrinone on recovery from bupivacaine-induced severe
      cardiovascular depression was evaluated in 20 pigs (13-26 kg) in a placebo
      controlled randomized double-blind study. Under 0.7% isoflurane anesthesia at
      FIO2 0.21, 0.5% bupivacaine 2 mg.kg-1.min-1 was infused until mean arterial
      pressure was 40% of the baseline. Cardiac output and heart rate decreased 75% and
      50% from the baseline, respectively. The total dose of bupivacaine was 17 +/- 6
      (SD) mg.kg-1 in the control and 19 +/- 5 mg.kg-1 in the amrinone group, resulting
      in mean plasma concentrations of 42 +/- 6 and 53 +/- 19 micrograms.ml-1,
      respectively. A bolus of amrinone 4 mg.kg-1 (n = 10) was given immediately after
      cardiovascular depression, followed by an infusion of 0.6 mg.kg-1.min-1. The
      control animals received corresponding volumes of physiologic saline (n = 10).
      After cardiovascular depression, the lungs were ventilated with FIO2 1.0 without
      anaesthetics or sympathomimetic support. Electric activity of the heart ceased in
      all control animals in 3.9 +/- 2 min after cardiovascular depression despite
      atropine and external cardiac compression. All animals in the control group and 5
      of 10 animals in the amrinone group were given atropine (P less than 0.01). The
      animals receiving amrinone survived without cardiac compression (P less than
      0.0001). During bupivacaine infusion, all animals developed burst suppression in
      the electroencephalogram. At the time of cardiovascular depression, in 8 of 10
      control and in 6 of 10 amrinone animals, the electroencephalogram was
      isoelectric.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642352
TI  - Mechanism underlying the changes in plasma potassium concentration during
      infusion of isosmotic nonelectrolyte solution.
AB  - Generally, during infusion of an isosmotic nonelectrolyte solution that permeates
      the cell membrane, plasma K+ concentration ([K+]pl) either does not change or it
      increases slightly. The mechanism underlying this [K+]pl change has not been
      clarified. We continuously monitored the [K+]pl and plasma Na+ concentration
      ([Na+]pl) for 10 min during isosmotic mannitol infusion of 1.6 ml/100 g body
      weight in rats with intact kidney function (intact mannitol group). In addition,
      in nephrectomized rats, we compared the [K+]pl change during infusion with
      isosmotic mannitol (which permeates the cell membrane; mannitol nephrectomized
      group) with that during infusion with isosmotic sucrose (which does not permeate
      the cell membrane; sucrose nephrectomized group) to evaluate the effect of cell
      volume regulation. In the intact mannitol group, [Na+]pl decreased with dilution,
      and [K+]pl remained relatively constant. In the sucrose nephrectomized group,
      [K+]pl decreased by the same percentage as [Na+]pl and gradually increased to
      greater than the control level. In the mannitol nephrectomized group, however,
      [K+]pl increased immediately after the beginning of the infusion and reached the
      same level as that in the sucrose nephrectomized group. To confirm that the
      difference in [K+]pl between the mannitol and sucrose nephrectomized groups was
      dependent on cell volume regulation, we investigated the changes in mean
      corpuscular volume of red blood cells, using a Coulter counter. This value
      remained constant during isosmotic sucrose infusion but increased during
      isosmotic mannitol infusion, returning to the original volume after the infusion.
      We kept [HCO3-] and pH constant throughout the experiments.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1642353
TI  - Brain blood flow and metabolism do not decrease at stable brain temperature
      during cardiopulmonary bypass in rabbits.
AB  - Cerebral blood flow (CBF) during human hypothermic cardiopulmonary bypass has
      been reported to decrease with time, suggesting that progressive cerebral
      vasoconstriction or embolic obstruction may occur. We tested the hypotheses: 1)
      that observed CBF reductions were due to continued undetected brain cooling and
      2) that CBF during cardiopulmonary bypass would be stable after achievement of
      constant brain temperature. Anesthetized New Zealand White rabbits underwent
      cardiopulmonary bypass (membrane oxygenator, centrifugal pump, bifemoral arterial
      perfusion) and were assigned to one of three bypass management groups based on
      perfusate temperature and PaCO2 management: group 1 (37 degrees C, n = 8); group
      2 (27 degrees C, pH-stat, n = 9); and group 3 (27 degrees C, alpha-stat, n = 8).
      Systemic hemodynamics, and cerebral cortical, esophageal, and arterial perfusate
      temperatures were recorded every 10 min for the first hour of bypass and again at
      90 min. CBF and masseter blood flow (radiolabeled microspheres) were determined
      at 30, 60, and 90 min of bypass, while the cerebral metabolic rate for oxygen
      (CMRO2) was determined at 60 and 90 min. Groups were comparable with respect to
      mean arterial pressure, central venous pressure, hematocrit, and arterial oxygen
      content throughout bypass. Cortical temperature was stable in normothermic (group
      1) animals, and there was no significant change in CBF between 30 and 90 min of
      bypass: 68 +/- 18 versus 73 +/- 20 ml.100 g-1.min-1 (mean +/- SD). In the
      hypothermic groups (2 and 3), cortical temperature equilibration (95% of the
      total change) required 41 +/- 6 min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642354
TI  - Treatment of proximal aortic hypertension after thoracic aortic cross-clamping in
      dogs. Phlebotomy versus sodium nitroprusside/isoflurane.
AB  - Thoracic aortic cross-clamping causes proximal aortic hypertension.
      Theoretically, the method used to treat hypertension can influence spinal cord
      perfusion pressure and neurologic outcome. Phlebotomy was compared to sodium
      nitroprusside/isoflurane in terms of ability to treat increased proximal mean
      aortic pressure (MAPp) after thoracic aortic cross-clamping in dogs. Dogs were
      assigned randomly to one of three groups depending on the method used to treat
      hypertension after cross clamping: 1) phlebotomy (n = 10); 2) sodium
      nitroprusside/isoflurane (n = 11); and 3) control (no treatment) (n = 8). In each
      dog, anesthesia was maintained with isoflurane in oxygen, 1.4% end-tidal. The
      thoracic aorta was occluded 2.5 cm distal to the left subclavian artery for 50
      min and then was released. Hemodynamics, cerebrospinal fluid pressure (CSFP), and
      regional blood flows by the radioactive microsphere technique, were measured at
      1) baseline; 2) 2 min after aortic cross-clamping; 3) after treatment of proximal
      aortic hypertension; 4) 5 min after aortic unclamping; and 5) 30 min after
      resuscitation. At 24 h, a neurologic assessment was performed. Thoracic aortic
      cross-clamping increased MAPp, decreased distal MAP (MAPd), and reduced lumbar
      spinal cord perfusion pressure (SCPPl), [SCPPl = MAPd - CSFP], in all three
      groups. Control of increased MAPp necessitated removal of 36 +/- 9 ml/kg of blood
      in the phlebotomy group. In the sodium nitroprusside/isoflurane group, sodium
      nitroprusside (16 micrograms.kg-1.min-1) was infused and end-tidal isoflurane
      concentration increased to 2.5 +/- 0.7%, restoring MAPp to baseline
      level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642355
TI  - Selective effects of pentobarbital and halothane on c-fos and jun-B gene
      expression in rat brain.
AB  - The effects of pentobarbital and halothane anesthesia on the expression in brain
      of the immediate-early genes c-fos and jun-B were investigated. Pentobarbital
      anesthetized rats (n = 10) received a single intraperitoneal injection of
      pentobarbital 65 mg/kg in a vehicle of 40% propylene glycol and 10% ethanol and
      then were placed in a plexiglass box flushed continously with 100% oxygen at 5
      l/min. Halothane-anesthetized rats (n = 10) received an intraperitoneal injection
      of vehicle only and were transferred to a box flushed continuously with oxygen
      plus 1.5% halothane. Unanesthetized control rats (n = 10) received an
      intraperitoneal injection of vehicle and were placed in a box flushed
      continuously with 100% oxygen. Four additional rats received no intraperitoneal
      injection but were handled and otherwise treated identically to the control
      group, and six others had a femoral arterial catheter inserted for blood pressure
      and blood gas measurements. Five animals from the control and both anesthetized
      groups were killed at 30 and 120 min postinjection and their brains rapidly
      removed and frozen. The messenger ribonucleic acid transcription products of the
      genes c-fos, jun-B, and beta-actin from whole cerebral hemispheres were analyzed
      autoradiographically after Northern blot hybridization with 32P-labeled
      deoxyribonucleic acid probes. Relative levels of c-fos and jun-B messenger
      ribonucleic acid were determined from optical density measurements of the
      autoradiographic bands, with beta-actin measurements being used to correct for
      sample-to-sample variation. Rats became immobile within minutes of drug
      administration and remained anesthetized until they were killed.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642356
TI  - Latex anaphylaxis in a child with a history of multiple anesthetic drug
      allergies.

PMID- 1642357
TI  - Anesthetic management of patients undergoing cardiomyoplasty.

PMID- 1642358
TI  - The institution of veno-venobypass by peripheral cannulation under emergent
      intraoperative conditions.

PMID- 1642359
TI  - Anaphylaxis due to propofol.

PMID- 1642360
TI  - Kartagener's syndrome: anesthetic considerations.

PMID- 1642361
TI  - Pulmonary artery hypertension complicating anesthesia for liver transplantation.

PMID- 1642362
TI  - Fewer failed spinal anesthetics with the Sprotte needle.

PMID- 1642363
TI  - Adverse outcomes and the multicenter study of general anesthesia: I.

PMID- 1642364
TI  - Adverse outcomes and the multicenter study of general anesthesia: II.

PMID- 1642365
TI  - A few details regarding tonometric measurement of blood pressure.

PMID- 1642366
TI  - When the endotracheal tube will not pass over the flexible fiberoptic
      bronchoscope.

PMID- 1642367
TI  - Machine wars: another cause of pressure loss in the anesthesia machine.

PMID- 1642368
TI  - Design flaw in an anesthesia machine.

PMID- 1642369
TI  - A simple alternate technique for the application of the pulse oximeter probe to
      infants.

PMID- 1642370
TI  - Intubation and extubation of the patient with Pierre-Robin syndrome.

PMID- 1642371
TI  - Position of the laryngeal mask airway.

PMID- 1642372
TI  - Intracranial elastance versus intracranial compliance: terminology should agree
      with that of other disciplines.

PMID- 1642373
TI  - Data management and accountability in behavioral and biomedical research.
AB  - Regulations recently enacted by the Public Health Service and the National
      Science Foundation to address misconduct in scientific research were designed
      primarily to curtail deliberate forms of misconduct, such as fabrication or
      falsification of findings; however, researchers may also be held accountable for
      inadvertent deficiencies in data management. This article examines some of the
      problems in data quality control, documentation, and data retention that can
      occur when computers are used in scientific research. It focuses on deficiencies
      that could make it difficult to verify the integrity of research data or to
      reproduce statistical analyses. Strategies for prevention of data management
      problems are recommended.

PMID- 1642374
TI  - Why the gap? Practice and policy in civil commitment hearings.
AB  - The failure of civil commitment procedures to meet statutory requirements is one
      of the more reliable findings in the applied social sciences. Most states now
      require specific legal procedures and behavioral standards for involuntary
      hospitalization. Nonetheless, empirical studies have demonstrated that commitment
      hearings are rarely adversarial and clinical concerns continue to take precedence
      over legal issues. These findings are analyzed in the context of three related
      issues: the grounds for commitment that are used in civil commitment hearings,
      the particular difficulties of recommitment hearings, and the shortcomings of the
      national policy of deinstitutionalization. The authors conclude that a primary
      cause of the gap between legal standards and actual practice is the absence of
      viable, less restrictive alternatives to inpatient treatment.

PMID- 1642375
TI  - Where's poppa? The relative lack of attention to the role of fathers in child and
      adolescent psychopathology.
AB  - Compared with mothers, fathers are dramatically underrepresented in clinical
      child and adolescent research. The author reviewed empirical and theoretical
      clinical child and adolescent literature to ascertain the reasons for this
      underrepresentation. Four somewhat interrelated factors are discussed: practical
      issues in participant recruitment, differential base rates of paternal vs.
      maternal psychopathology, theory-driven research based on sexist theories, and
      research assumptions based on outdated societal norms. Suggestions for future
      research are discussed, including parallel investigations of paternal
      characteristics whenever maternal characteristics are investigated, assessment of
      both similarities and differences in the role of fathers and mothers in child and
      adolescent psychopathology, and investigation of parenting factors for both
      fathers and mothers (e.g., time spent in actual caretaking, career vs. family
      orientation) in relation to child and adolescent psychopathology.

PMID- 1642376
TI  - Prospective evaluation of a double-lumen subclavian dialysis catheter for acute
      vascular access.
AB  - The safety and efficacy of a parallel, double-lumen hemodialysis catheter used to
      achieve acute, temporary vascular access were evaluated prospectively in 134
      hospitalized adult patients in whom 162 catheters were placed. The arterial flow
      rates and venous resistance were such that 84 per cent of the catheters provided
      satisfactory access for dialysis. Minor manipulations of the catheter were
      frequently required to maximize function. Three serious complications occurred,
      including one instance each of pneumothorax, hemorrhage, and nonfatal pericardial
      tamponade.

PMID- 1642377
TI  - Carotid arterial surgery using local anesthesia: a private practice retrospective
      study.
AB  - Carotid endarterectomy has recently become one of the more controversial
      operations. The tremendous increase in the number of endarterectomies performed,
      coupled with the apparent increase in morbidity and mortality associated with
      this operation in some studies, have brought into question the indications and
      results of the procedure. The potential for complications from the procedure
      itself, as well as increased morbidity and mortality from surgery on the elderly,
      make carotid endarterectomy a dangerous operation that must be done carefully and
      thoughtfully. The authors have performed carotid endarterectomies exclusively
      under local anesthesia to more closely evaluate the neurologic status of the
      patient. They believe that the operation performed in this manner obviates the
      use of a shunt and its inherent complications in greater than 80 per cent of the
      patients. This, coupled with the fact that many of the patients also have severe
      cardiac disease and the use of local anesthesia causes less hemodynamic changes
      and stress, should make carotid endarterectomy under local anesthesia the
      preferred approach.

PMID- 1642378
TI  - Post-traumatic pseudoaneurysm of the left hepatic artery initially appearing as
      upper gastrointestinal hemorrhage secondary to hepatic artery-duodenal fistula. A
      case study.
AB  - Post-traumatic hepatic artery pseudoaneurysm initially appearing as upper
      gastrointestinal hemorrhage secondary to rupture in the duodenum is rare.
      Diagnosis was made on selective arteriogram and the patient was managed
      successfully by ligating the feeding vessel to the aneurysm.

PMID- 1642379
TI  - An unusual case of intermittent venous obstruction of the upper extremity.
AB  - The axillary vein can be subject to intermittent obstruction from numerous
      anatomic structures such as the pectoralis minor and the scalenus anterior
      muscles. The diagnosis can be readily made on history and physical examination of
      the upper extremity, but it can be difficult to confirm by routine venogram done
      with the arm in the standard position at the side with full extension at the
      antecubital fossa. Positional venography with the arm fully abducted and flexion
      of that antecubital fossa allows for better definition of this extrinsic
      compression. In the case presented, a fascial band arising from the medial head
      of the biceps was compressing the axillary vein and was suspected on history and
      physical examination; it was confirmed with positional venography as noted. As in
      this case, it is important to make the diagnosis early, before thrombosis of the
      vein occurs, to minimize the associated morbidity. Transaxillary exploration was
      performed with excision of the band and complete resolution of the symptoms.
      Subsequent noninvasive studies were performed that showed complete resolution of
      the extrinsic axillary vein compression. Having a high suspicion of intermittent
      venous obstruction with early diagnosis and surgical correction of any extrinsic
      compression are the keys to a successful outcome in these patients.

PMID- 1642380
TI  - A new, compound-curved needle for vascular surgery.
AB  - A new, compound-curved needle has been designed and developed for vascular
      surgery from a unique stainless steel alloy, American Society for Testing
      Materials (ASTM) 45500. This needle has two different radii of curvature and a
      relatively straight body followed by a short, curved tapered point. Despite its
      geometry, it exhibits a similar sharpness, as well as resistance to bending and
      breakage, as did a curved needle with a single radius of curvature manufactured
      from the same alloy. The design of this new needle enabled the surgeon to pass it
      through the vessel wall with greater accuracy to a controlled depth and length of
      bite than the curved cutting edge needle with a single radius of curvature.

PMID- 1642381
TI  - The influence of vascular certification on lower extremity revascularization at
      one institution.
AB  - The potential impact of vascular certification on the practice of vascular
      surgery at Maricopa Medical Center (Phoenix, AZ) was analyzed by comparison of
      lower extremity revascularization results over consecutive 2-year periods before
      (Period I) and after (Period II) institution of vascular surgery service. The
      overall setting (county hospital, surgical residency) and ancillary services
      (Anesthesia, Intensive Care Unit, Radiology) were unchanged, except for the
      authors' use of invasive hemodynamic support. In Period I, there were 49 cases
      (30 inflow, 19 outflow) with 14 per cent (7/49) mortality, 32 per cent (21/67)
      limb thrombosis or embolus, and 10 per cent (5/49) graft infection; 80 per cent
      (39/49) of operations were done for claudication; 20 per cent (10/49) were done
      for inappropriate indications (P less than 0.005). In Period II, there were 110
      cases (47 inflow, 63 outflow). The increase in cases was predominantly due to
      increased use of extra-anatomic inflow and complex infrapopliteal outflow
      reconstructions. Seventy per cent (77/110) of operations were done for limb
      salvage; of 17 aortic cases, 3 were "re-do's" and 5 underwent simultaneous renal
      revascularization. There was a 3 per cent (4/110) mortality (P less than 0.025),
      11 per cent (13/137) limb thrombosis or embolus (P less than 0.005), and no graft
      infections (P less than 0.001). Lower extremity revascularization delivered by
      certified vascular surgeons was offered to more patients with lower overall
      mortality and morbidity rates after more thorough diagnostic work-up and for more
      appropriate indications, with concomitant use of more refined vascular
      techniques/procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642382
TI  - The use of epidural anesthesia and analgesia in aortic surgery.
AB  - During a 3-year period, sixty-four consecutive patients, who had elective aortic
      reconstruction were investigated to determine whether epidural anesthesia and
      analgesia, combined with light general anesthesia, would lower the rate of
      perioperative complications in this high-risk group of patients. The epidural
      group comprised 32 consecutive patients who had surgery during the 20-month
      period from July 1986 to December 1987. These patients were compared with the
      previous 32 patients who had aortic reconstruction at Huntington Memorial
      Hospital (Pasadena, CA) using conventional general anesthetic techniques.
      Cardiovascular and respiratory morbidity, length of hospital stay, length of
      intensive care unit stay, and duration of endotracheal intubation were compared.
      There was no statistically significant difference in cardiovascular morbidity,
      length of hospital stay, or intensive care unit stay between the two groups.
      There was however, a striking decrease in respiratory complications and length of
      intubation in the epidural anesthesia group (P less than 0.005). The authors
      conclude that epidural anesthesia and analgesia, combined with a light general
      anesthetic may confer benefits over conventional general anesthesia in patients
      undergoing aortic surgery.

PMID- 1642383
TI  - Changing patterns in the predisposition for amputation of the lower extremities.
AB  - The purpose of this study was to evaluate and determine the role of diabetes and
      other common predisposing factors in amputation of the lower extremities. A
      retrospective review of 110 patients with peripheral vascular disease who
      underwent amputation between 1987 and 1990 at Hahnemann University Hospital
      (Philadelphia, PA) was performed. Patients who underwent amputations for trauma
      or cancer were excluded from this analysis. The patients were divided into four
      groups according to the site of amputation: Above Knee (n = 43), Below Knee (n =
      26), Foot (n = 7) and Transmetatarsal (n = 34). The mean age was 60 years. Fifty
      five patients (51%) were white. Sixty-four patients (58%) were men. Twenty-nine
      patients (26%) were cigarette smokers; sixteen smokers (55%) had above-knee
      amputation. Thirty-five patients (32%) had previous vascular surgery of the lower
      extremities. The combination of diabetes and hypertension was present in 40
      patients (36%). When either diabetes or hypertension alone was present in a
      patient, hypertension, not diabetes, was more commonly the dominant underlying
      medical condition in patients with amputation (32 hypertension-alone patients vs.
      10 diabetes-alone patients). The high frequency of hypertension suggests that
      enhanced control of this disease may affect peripheral vascular disease and
      related amputations in the future.

PMID- 1642384
TI  - Risk factors for myocardial infarction after distal arterial reconstructive
      procedures.
AB  - This study identifies the preoperative, intraoperative, and postoperative factors
      associated with perioperative myocardial infarction (MI). The records of all
      patients who had distal vascular reconstructive procedures who sustained a
      perioperative MI were retrospectively reviewed from 1977 to 1990. From a total of
      767 procedures, 18 (2.3%) patients suffered a MI. The mean time to MI after
      surgery was 1.8 days. Diabetes, heart murmur, and previous major amputations were
      identified as significant risk factors for the development of a perioperative MI.
      No laboratory or cardiographic data correlated with an increased risk, and the
      Goldman Index was inadequate in predicting perioperative MI risk.

PMID- 1642385
TI  - Simple modification for a more secure vascular clamp.
AB  - Large, atraumatic vascular clamps can be prone to slippage, especially at the
      toe. A simple modification of the clamp is described along with an illustration.

PMID- 1642386
TI  - Prevalence of ischemic nephropathy in patients with renal insufficiency.
AB  - To estimate its clinically unsuspected prevalence among patients with renal
      insufficiency, renal duplex sonography (RDS) was used to estimate the presence of
      critical renal artery stenosis (RAS) in that population. Patients, aged 45 to 75
      years, with a serum creatinine of greater than or equal to 2.0 mg% but without
      dialysis dependence, prior renal transplantation, or prior renal artery surgery
      were considered for RDS. Fifty-three patients who met criteria for study were
      randomly selected from the Section of Nephrology clinic files and each patient
      was contacted both by mail and by telephone. Twenty-five patients agreed to RDS,
      and renal artery anatomy was determined in 21 patients using standardized RDS
      techniques. These techniques have demonstrated an overall accuracy of 96 and 97
      per cent when compared prospectively to conventional angiography during validity
      analyses in the authors' center. Results of RDS revealed significant findings in
      5 of 21 patients (24%). Three patients demonstrated criteria for ischemic
      nephropathy (IN): one patient had RAS with contralateral renal artery occlusion
      confirmed by angiography, while 2 patients demonstrated unilateral RAS. An
      abdominal aortic aneurysm and unilateral hydronephrosis were discovered in the
      fourth and fifth patients. Evaluation of patient demographic data and functional
      parameters as predictors of IN revealed that the duration of renal insufficiency
      at the time of RDS and extra-renal organ-specific atherosclerotic damage were
      significantly different between the groups with and without IN. The authors
      preliminary findings suggest that unsuspected ischemic nephropathy may exist in a
      significant minority of patients with renal insufficiency.

PMID- 1642387
TI  - Preoperative spirometry predicts perioperative pulmonary complications after
      major vascular surgery.
AB  - This study determined utility of preoperative spirometry for prediction of
      postoperative pulmonary complications (PPC) defined as pneumonia, ventilator
      dependence greater than 48 hours, and adult respiratory distress syndrome in 147
      patients undergoing vascular surgery from June 1988 through March 1990 [39 aortic
      aneurysm repairs, 21 carotid procedures, and 87 operations for occlusive disease
      including aorto-ileofemoral, infra-inguinal, and visceral]. The incidence of PPC
      was 12.9 per cent, while cardiac complications (myocardial infarction, congestive
      heart failure, and ventricular arrhythmias) were present in 9.8 per cent. Prior
      or current smoking, which was present in 80 per cent, was not predictive of PPC.
      FEV1 was 2.2 +/- 0.7 L/s (mean +/- 1 SD). Abnormal FEV1 (2.0 or less L/s) was
      present in 42 per cent (n = 62). For FEV1 of 2.0 or less, PPC rate was 22.5 per
      cent versus 5.8 per cent for FEV1 greater than 2.0 L/s (P less than 0.005, Fisher
      exact). The incidence of PPC was 30.7 per cent for aortic aneurysm repair, 8.0
      per cent for occlusive disease, and 4.7 per cent for carotid procedures.
      Abdominal aortic procedures (performed in 67 patients: 39 for aortic aneurysm
      repair and 28 for aortoiliac occlusive disease) were associated with a PPC rate
      of 22.4 per cent versus 5.0 per cent for "nonabdominal" procedures (P less than
      0.002, Fisher exact). Life table analysis after surgery demonstrated decreased
      survival for patients with PPC (P = 0.031, Mantel-Haensel) during follow-up (250
      +/- 165 days). PPC are associated with abnormal FEV1 and abdominal vascular
      procedures. In conclusion, preoperative spirometry is useful for the prediction
      of PPC after vascular surgery.

PMID- 1642388
TI  - The ruptured abdominal aortic aneurysm in a community hospital. A 5-year study.
AB  - The authors report on a recent 5-year experience with the treatment of ruptured
      abdominal aortic aneurysms in a community hospital located in a frequently
      visited tourist center. Their mortality rate of 43 per cent compares favorably
      with accepted mortality rates from large teaching institutions. Several known
      complications of this condition occurred in the authors' series. The most ominous
      complications that carried the highest associated mortality rates, if the patient
      did not succumb in the operating room, were acute tubular necrosis (75%
      associated mortality) and bowel infarction (100% associated mortality). Most
      important, physicians must have a high index of suspicion to make the diagnosis
      early. As reported in other series, prolonged hypotension and blood loss has a
      direct correlation with high mortality.

PMID- 1642389
TI  - A note on the historical aspects of dysphagia lusoria.
AB  - There is a lack of appreciation for the fact that, in less than 1 per cent of the
      general population, the right subclavian artery has an anomalous origin and
      course. Fortunately, most of these persons do not have symptoms; however, if they
      should have neck surgery, they may be at increased risk for damage to the right
      inferior laryngram nerve. The earliest reported description of an anomalous right
      subclavian artery was that of Hunald in 1735; 52 years passed before the clinical
      syndrome of dysphagia lusoria was published by Bayford in 1787. Bayford did not
      mention the associated displacement of the right inferior laryngeal nerve. In
      1823, Stedman described the entire anatomical picture.

PMID- 1642390
TI  - Splenic artery stump back pressure.
AB  - Splenic arterial collateral hemodynamics were measured during splenic artery
      occlusion in 15 patients who had splenic to left renal artery bypass. The mean
      splenic artery stump back pressure during proximal splenic artery clamping was
      48.0 +/- 9.8 mmHg (mean +/- ISD) and the mean collateral splenic perfusion
      pressure was 34.3 +/- 9.4 mmHg. The lowest measured back pressure was 39 mmHg and
      the lowest perfusion pressure was 30 mmHg. There were no spleen complications
      after operation. These measurements establish a normal range for collateral
      splenic perfusion pressure. These results may be helpful in clinical decisions
      about the adequacy of splenic circulation in operations that require division of
      the splenic artery or the short gastric arteries when there is celiac axis or
      splenic artery occlusive disease.

PMID- 1642391
TI  - Clinical experience with polytetrafluoroethylene (PTFE) in the aortobifemoral
      position.
AB  - Between 1981 and 1990, 18 patients (mean age 66.0 years) had aortobifemoral
      bypass with polytetrafluoroethylene (PTFE) bifurcated grafts. Twelve patients
      (66.7%) were treated for aortoiliac occlusive disease, 5 patients (27.8%) for
      abdominal aortic aneurysms and one patient (5.6%) had surgery for hypoplastic
      aortic syndrome. The authors' overall complication rate was 16.7 per cent and
      included formation of an anastomotic pseudoaneurysm (1/18, 5.6%), graft infection
      (1/18, 5.6%), and graft thrombosis (1/18, 5.6%). Sixteen patients were followed
      for a mean period of 41.4 months. In this subgroup of patients the patency rate
      was 93.8 per cent. The authors conclude that the PTFE bifurcated graft is a
      suitable conduit for use in aortobifemoral bypass surgery.

PMID- 1642392
TI  - Hemicorporectomy for acute aortic occlusion: a case study.
AB  - Hemicorporectomy has been done for potentially curable pelvic malignancy and for
      intractable pelvic sepsis with bone involvement. In this report, the authors
      describe the first use of hemicorporectomy to treat ischemic gangrene of the
      limbs and pelvic soft tissues secondary to acute aortic occlusion.

PMID- 1642393
TI  - [Isolation of Leishmania major in Phlebotomus papatasi in Biskra (Algeria). The
      end of an ecoepidemiological saga].
AB  - Out of 1,167 females of sandflies dissected, one specimen of Phlebotomus papatasi
      captured at a transmission site near Biskra, a well known Algerian focus of
      zoonotic cutaneous leishmaniasis, was found naturally infected with Leishmania
      major zymodeme MON-25. This supports classical observations of Sergent and al. P.
      papatasi as vector in this focus in 1921.

PMID- 1642394
TI  - The current management and prognosis of acral lentiginous melanoma.
AB  - A computer-aided retrospective analysis was performed on 359 patients with stage
      I and II melanoma at the time of diagnosis (disease confined to the primary
      melanoma), at the University of South Florida (Tampa, FL). Eighteen patients were
      identified with primary melanoma in acral locations, most being acral lentiginous
      melanoma. A comparison of actuarial survival curves of patients with melanoma in
      four different locations (acral, head and neck, trunk, and other extremity site)
      was performed. The patients with melanoma in acral locations did not have a
      statistically different actuarial survival than those with primary melanoma in
      other sites. When actuarial disease-free survival curves were constructed,
      however, acral primary melanoma had a shorter interval to recurrence than those
      located on the trunk or other extremity sites. Differences between actuarial
      disease-free survival for the head and neck and for acral primary sites were not
      significant. To identify prognostic factors responsible for the decreased disease
      free survival of the acral lentiginous population, a regression analysis was
      performed. Three prognostic factors were analyzed for stage I and II melanoma,
      including Breslow tumor thickness, ulceration of the primary lesion, and primary
      site location. In the univariate analysis, with each prognostic factor acting
      independently, tumor thickness (p less than 0.01) and ulceration (p = 0.02) were
      significant variables influencing the disease-free interval. Primary site did
      not, however, add prognostic information to the model (p = 0.54). A stepwise
      multivariate analysis confirmed this finding.

PMID- 1642395
TI  - Immunotherapy for malignant melanoma with a tumor cell vaccine.
AB  - Specific active immunotherapy for melanoma has been administered to several
      thousand patients since 1972, using an irradiated whole-cell preparation. A
      humoral response to vaccination can be demonstrated in a large percentage of
      patients. This response increases while immunizations are continued and decreases
      after cessation of therapy. The vaccinations are well tolerated; however, the
      therapeutic impact of this whole-cell vaccine awaits a randomized trial for
      definitive evaluation.

PMID- 1642397
TI  - The genetics of malignant melanomas.
AB  - A review of the hereditary aspects of the malignant melanomas showed causal
      heterogeneity and similar pathogenesis based on the dysregulation of the
      paracrine/autocrine growth mechanisms. The genetically different malignant
      melanomas have a range of recurrence risks from 1% for the nonfamilial, solitary,
      malignant melanoma to a risk exceeding 70% for the syndromic melanomas of
      neurocutaneous melanosis and the nine types of xeroderma pigmentosum. A
      recurrence risk of 6% is relevant to the members of dysplastic nevus syndrome
      families without malignant melanomas and the risk increases in excess of 50% for
      the individuals of families with dysplastic nevi and more than one malignant
      melanoma.

PMID- 1642396
TI  - Active specific adjuvant immunotherapy with vaccinia melanoma oncolysate.
AB  - Vaccinia melanoma oncolysate is an investigative agent for active specific
      adjuvant immunotherapy. Viral oncolysate work in animals has led to application
      of this treatment in humans. Success of initial trials in treatment of melanoma
      has led to a phase III randomized, prospective, double-blind, multi-institutional
      trial, which is currently under way.

PMID- 1642398
TI  - Prospects for cellular immunotherapy for metastatic melanoma.
AB  - Systemic therapy for metastatic malignant melanoma has been disappointing. The
      search for alternate therapeutic methods includes investigation of the
      interaction between melanoma and the human immune system. A cellular immune
      response to melanoma has been documented in vitro and in vivo. In most patients
      with disseminated disease, however, immune T cells fail to eradicate the tumor.
      While this phenomenon is poorly understood, the occasional occurrence of
      spontaneous regression provides some indication that the immune response may, in
      fact, be capable of eradicating established tumor in vivo. Current efforts to
      augment and to direct the immune response to melanoma include investigation of
      specific and nonspecific adoptive immunotherapy. Specific therapy includes the
      generation of tumor-activated specific killer cells from peripheral blood,
      draining nodes, or metastatic tumor deposits. An increasing understanding of
      antigen recognition and improved methodology for T-cell culture are contributing
      toward the application of cellular immunotherapy to patients with melanoma.

PMID- 1642399
TI  - Prospects for gene therapy and lymphokine therapy for metastatic melanoma.
AB  - Conventional treatment of cancer, especially for patients with metastatic
      melanoma tumor, is often ineffective. Immunotherapy and recently introduced gene
      therapy have revolutionized the treatments of patients with metastatic melanoma
      tumor. Use of biological response modifiers, such as interleukins and
      interferons, have been found to enhance therapeutic benefits to patients with
      malignant melanoma. Initial studies with a high-dose interleukin-2 (IL-2) therapy
      have proved effective in patients with melanoma tumor, although a variety of
      systemic toxicities were observed. A low-dose IL-2 continuous infusion has shown
      a similar response in patients with melanoma tumor, but produced lesser toxicity.
      The low-dose IL-2 therapy has been studied with an adoptive transfer combined
      with either autologous lymphokine activated killer cells or autologous tumor
      infiltrating lymphocytes (TIL). IL-2 in combination with chemotherapeutic agents
      such as flavone acetic acid, dacarbazine, and cyclophosphamide have also been
      studied in patients with metastatic melanoma. Results have shown a moderate
      response in patients with metastatic melanoma. TIL therapy, however, has been
      shown to result in higher objective regression due to potent tumor-specific
      killing and tumor-specific targeting characters of the TIL. The tumor targeting
      nature of the TIL creates the possibility of using TIL as a vehicle to deliver
      gene product specifically to tumor tissue. Safety and toxicity of gene-transduced
      TIL were addressed by the use of neomycin-resistant, gene-transduced TIL in
      patients with metastatic melanoma. We also investigated the use of vaccinia
      oncolysate therapy by using the viral oncolysate prepared with IL-2 gene encoded
      vaccinia virus. Preliminary studies with murine hepatic metastases colon model
      have shown encouraging results.

PMID- 1642400
TI  - Psychosocial aspects of melanoma.
AB  - Seventy-five patients with melanoma were surveyed for recent history of major
      stress, coping styles, and psychiatric disturbance. Recurrence of disease was
      strongly related to biological variables (stage and Breslow depths) but not to
      psychological measures. Major life stress was not related to stage, Breslow,
      Clark level, or estimates of lymphocytic infiltration of tumor. Coping styles
      were paradoxically related to major life stress such that history of major
      stresses was associated with greater confrontation of the melanoma diagnosis,
      greater will to fight the disease, and less avoidance of its frightening aspects.
      Experience with fewer major life stresses was associated with a defeatist
      attitude characterized by an expectation of a poor prognosis and little control
      over outcomes. More than 50% of the sample had experienced at least one major
      life stress in the past 5 years. This figure is consistent with prior work and
      indicative of a higher than normal rate of major life stress in the years before
      diagnosis.

PMID- 1642401
TI  - Treatment of the primary in malignant melanoma of the skin.
AB  - Surgical excisional therapy of malignant melanoma is the primary method of
      treatment for malignant melanoma. The exact size of the excisional therapy
      depends on the depth and location of the tumor. At the University of South
      Florida (Tampa, FL), tumors less than 0.76 mm in depth are resected with a 1-cm
      margin and tumors greater than 0.76 mm in depth are resected with a 3-cm margin.
      The location of the tumor also determines the exact margin of excision. Maximal
      reconstructive efforts following general principles of plastic and reconstructive
      surgery are noted and used for producing an optimal functional and aesthetic
      result.

PMID- 1642402
TI  - Etiology and prognosis of local recurrence in malignant melanoma of the skin.
AB  - All patients with stage I and stage II malignant melanoma of the skin were
      analyzed for stage; time of local, regional, or systemic recurrence, or two or
      more of these events; presence or absence of ulceration of the primary tumor;
      thickness of the primary tumor; level of invasion according to Clark; and margins
      of resection. Local recurrence had a significant negative impact on the long-term
      survival of patients. Our data revealed that local recurrence had the same poor
      prognostic effect as regional or systemic recurrence, or both. Factors
      significant in predicting local recurrence included the primary tumor
      characteristics of ulceration of the primary tumor and thickness of the primary
      tumor. Margins of resection and level of invasion were not noted significant in
      predicting local recurrence.

PMID- 1642403
TI  - Lymphoscintigraphy in malignant melanoma.
AB  - The development and rationale for the use of lymphoscintigraphy in the
      preoperative evaluation of patients with malignant melanoma being considered for
      elective lymph node dissection is reviewed. This overview is updated by an
      analysis of 135 patients with early stage malignant melanoma involving the head,
      neck, shoulders, and trunk at Moffitt Cancer Center and Research Institute at the
      University of South Florida (Tampa, FL). High discordancy rates (overall, 41%)
      were seen between drainage patterns predicted from historical anatomical
      guidelines and those revealed by the lymphoscintigraphic examination. The high
      discordancy rate was most pronounced in the head (64%) and the neck (73%).
      Surgical management was changed in 33% of the patients, overall. A preoperative
      lymphoscintigram is recommended for all patients with melanoma with head, neck,
      and truncal lesions evaluated for elective lymph node dissection as the lymphatic
      drainage patterns are often unpredictable and variable.

PMID- 1642404
TI  - The concept of lymph node dissections in patients with malignant melanoma.
AB  - Therapeutic lymph node dissections in patients with grossly palpable metastatic
      melanoma are performed to control regional disease, to salvage a small percentage
      of patients, and to obtain staging information. Patients with malignant melanoma
      may undergo elective lymph node dissections, when the basin is clinically
      negative, for three reasons. There is some evidence based on large retrospective
      studies that survival is increased in patients with intermediate thickness
      melanoma if elective lymph node dissections are performed as part of the initial
      treatment of the primary melanoma. Second, in a small percentage of patients, a
      previous elective lymph node dissection may have helped control disease in the
      regional lymphatics, so that more extensive procedures, including amputations,
      are not necessary. Another important reason is to obtain staging and prognostic
      information for the patient because most adjuvant protocols are based on the
      presence or absence of disease in the regional basin. During a 3-year period, 115
      patients have undergone a regional nodal dissection at the Moffitt Cancer Center
      and James Haley VA Hospital as part of their surgical treatment. With a follow-up
      of 3 years, patients with 1 node positive do significantly better than those with
      more than 1 node positive in their dissection (p = 0.06). The percentage of nodes
      positive is also important. Those patients who have less than 10% of their nodes
      involved with metastatic melanoma have a better survival than those patients
      whose percentage is greater than 10% (p = 0.07).

PMID- 1642405
TI  - Recurrent malignant melanoma: the identification of prognostic factors to predict
      survival.
AB  - The prognostic factors for stage 1, 2 melanoma have been elucidated. Tumor
      thickness, ulceration of the primary melanoma, and perhaps, primary site may be
      used to predict the percentage of patients with regional nodal disease or
      systemic metastases and the prognosis of patients who have only cutaneous disease
      at diagnosis. Very little is known about prognosis once there is a recurrence. A
      retrospective, computer-aided chart review identified 4,185 patients registered
      at the Duke University Melanoma Database who had stage 1, 2 disease at diagnosis.
      During a mean follow-up period of 7 years, 35.9% experienced a recurrence. Local
      regional recurrences explained 62.5% to 85.5% of the recurrences. Even after
      elective node dissections, local regional recurrences explained most relapses
      (58.1%). Sixty-five percent of the recurrences occurred within the first 3 years
      of of follow-up. There was a pronounced difference in 5-year survival in those
      patients who suffered a recurrence sometime during their clinical course compared
      with those who never relapsed (p = 0.00001, for trunk primary melanoma). Patients
      with local or regional recurrence have a better prognosis than patients who
      relapse systemically, with 5-year survivals from the time of recurrence of 55%
      for a patient with a local recurrence, 51% for a patient with a regional nodal
      recurrence, and 20% for a patient with a systemic recurrence. A multivariate
      regression analysis identified thickness, ulceration of the primary melanoma, and
      age and location of the primary melanoma on the extremity as variables that
      predicted prognosis. The only factors concerning the recurrent state that added
      prognostic information was the disease-free interval and the presence of systemic
      metastases as the initial recurrence.

PMID- 1642406
TI  - Isolated limb perfusion for recurrent melanoma of the extremity.
AB  - Recent reports in the literature suggest that hyperthermic isolated limb
      perfusion (HILP) may be effective in preventing local recurrence in patients with
      deeply invasive melanoma or in patients with recurrent disease confined to the
      extremity. It has been used in the past as an adjuvant treatment after resection
      of the primary melanoma or recurrence, or as a therapeutic measure if all the
      disease on the extremity cannot be resected. A prospective, nonrandomized trial
      of 16 patients with melanoma with recurrent disease confined to the extremity
      underwent HILP. The protocol involved the wide local excision of all recurrent
      disease when possible, elective or therapeutic node dissection when indicated,
      and HILP using cisplatin. In 11 patients in whom all recurrent disease could be
      resected and the HILP was considered prophylactic, only 1 patient's disease has
      recurred in the perfusion circuit. Before the perfusion, the 11 patients had a
      total of 19 local or intransit recurrences. Of the 5 patients in whom all
      recurrent disease could not be resected, disease persisted in 4 patients. When
      compared with a concurrent control population of patients with extremity melanoma
      who had a local recurrence and were not perfused, the patients with melanoma who
      underwent HILP had a significant prolongation of disease-free survival (p less
      than 0.05), but a similar actuarial survival. In this study, we demonstrate that
      HILP can prevent local regional recurrences in patients with metastatic melanoma
      who are at high risk for further recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642407
TI  - The evaluation of putative tumor markers for malignant melanoma.
AB  - Biomarkers have long held out the promise that malignancies might be diagnosed
      early and that patients could be monitored more confidently during their clinical
      course to more reliably predict recurrence and the effect of therapy. Reliable
      tumor markers have been described for colon carcinoma, hepatomas, and other
      tumors, but no reliable marker has been identified to monitor the course of
      malignant melanoma. Recently, the plasma level of lipid-bound sialic acid (LASA
      P) has been described as reflecting an alteration in the surface membrane of
      cancer cells. An attempt was made to correlate the LASA-P level, along with the
      serum level of neuron-specific enolase, a glycolytic enzyme specific to cells of
      neuroectoderm origin including melanocytes, with clinical disease activity with a
      follow-up to at least 2 years. Two hundred seventy patients had blood samples
      drawn at various times during their clinical course for assay of LASA-P and
      neuron-specific enolase. Eighty of the patients (30%) sampled developed a
      recurrence sometime during their clinical course, whereas another 10 patients had
      active disease noted at diagnosis with evaluative tumor markers. The sensitivity
      and specificity of neuron-specific enolase was 27% and 77%, respectively, and
      cannot be recommended as a marker for melanoma. LASA-P showed a sensitivity of
      65%, with 55 patients recurring and having active disease with abnormally high
      markers and 35 patients recurring or having active disease with normal markers.
      Specificity of the LASA-P test was 76%. When recurrence was associated with
      elevated LASA-P levels, the elevated level preceded recurrence by a median of 9.3
      months. LASA-P may be a useful marker to follow patients with malignant melanoma.

PMID- 1642408
TI  - Adjuvant chemotherapy in malignant melanoma using dacarbazine, carmustine,
      cisplatin, and tamoxifen: a University of South Florida and H. Lee Moffitt
      Melanoma Center Study.
AB  - A prospective, nonrandomized trial was performed of the four-drug chemotherapy
      protocol consisting of dacarbazine, carmustine, cisplatin, and tamoxifen citrate
      given to high-risk patients for recurrence of melanoma after local regional
      treatment. The treated patients were consecutively registered and 6 patients who
      did not elect to be treated served as the control population. Criteria for
      inclusion in the trial were the presence of four or more lymph nodes positive for
      metastatic melanoma on regional modal dissection, the presence of metastatic
      disease in second station lymph node areas such as the iliac basin, greater than
      5 cm in maximal diameter tumor burden in the nodal basin, and patients who had
      resected stage 4 (systemic metastases) disease with clear margins and were
      rendered free of disease. Actuarial survival curves for the treated group and the
      control subjects were similar (p = 0.91). There was a definite trend toward an
      increased disease-free survival for the group receiving adjuvant chemotherapy (p
      = 0.09). The mean disease-free survival for the control population was 200 days
      and for the treated group, 600 days. The study suggests a therapeutic benefit for
      adjuvant chemotherapy treatment of patients with metastatic melanoma who have
      been rendered free of disease but are at high risk for recurrence.

PMID- 1642410
TI  - Epidemiology and prognostic factors in malignant melanoma.
AB  - The rising rate of MM reflects damage to the skin that has been done in the past.
      If a difference is to be seen prospectively, we must use protection (sunscreens)
      and have suspicious areas evaluated early in their course so that MM can be
      treated when curable. Until further research yields a cure for advanced MM, the
      above approach remains the first line of defense in the fight against this
      cancer.

PMID- 1642409
TI  - Treatment of stage IV malignant melanoma with dacarbazine, carmustine, cisplatin,
      and tamoxifen regimens: a University of South Florida and H. Lee Moffitt Melanoma
      Center Study.
AB  - Fourteen consecutive patients with stage IV metastatic melanoma with measurable
      disease were treated between January 1989 and August 1990 with combination
      chemotherapy. The chemotherapy regimen (DBPT) included dacarbazine (DTIC) 200
      mg/m2/i.v. on days 1 through 3, carmustine (BCNU) 150 mg/m2/i.v. on day 1,
      cisplatin 25 mg/m2/i.v. on days 1 through 3, and tamoxifen citrate 10 mg p.o.
      twice daily. This cycle was repeated every 4 weeks. BCNU was given every other
      cycle. A total of six cycles of chemotherapy were delivered. Patients were then
      restaged to assess the response. Six concurrent patients during the study period
      did not elect to undergo chemotherapeutic approach and served as control
      subjects. When evaluated at 300 days of follow-up, 4 patients had response (3
      complete response and 1 partial response), 3 had stable disease, and 7 showed
      progression. At 300 days of evaluation after chemotherapy, survival appeared
      significantly increased between treated and nontreated groups, that is, 48% in
      the chemotherapy group versus 27% in the control group (p = 0.03). Actuarial
      survival was significantly increased between those who responded to chemotherapy
      versus the nonresponders. At 300 days follow-up, survival was at 83% in the
      responders and 22% in nonresponders (p = 0.0002). This study shows that in stage
      IV disease, systemic chemotherapy appears to make a difference in survival.
      Attempts to discover better chemotherapy regimens to improve response in patients
      with stage IV malignant melanoma should continue to be rewarded.

PMID- 1642411
TI  - Autologous bone marrow transplantation and melanoma: a focused review of the
      literature.
AB  - Metastatic malignant melanoma has been regarded traditionally as an aggressive
      cancer highly refractory to standard doses of chemotherapy. Complete responses to
      standard chemotherapy are less than 5%. To overcome resistance, autologous bone
      marrow transplantation has been employed in the treatment of this disease. High
      dose chemotherapy followed by autologous bone marrow rescue has been associated
      with increased response rates when compared with standard chemotherapy. A recent
      survey indicates that at least 283 patients with metastatic melanoma have been
      treated with this form of therapy thus far. Evaluation of the literature
      indicates that overall response rates for melanoma patients undergoing autologous
      bone marrow transplantation range from 46 to 65%, with complete response rates as
      high as 16%. Although few patients are long-term responders, several patients
      remain in complete remission for periods of more than one year. Multiple centers
      are evaluating the utility of high-dose therapy in the high-risk adjuvant setting
      for patients who present with poor prognosis disease. Data concerning the long
      term outcome of this therapy are not available. This article reviews the concepts
      of high-dose therapy followed by autologous bone marrow transplantation, and the
      outcomes of patients with malignant melanoma who are treated in this manner.

PMID- 1642412
TI  - Detection of occult lymph node metastases in malignant melanoma.
AB  - An accurate prediction of the prognosis of melanoma is dependent on the ability
      to determine the presence or absence of malignant cells in lymph nodes. Our
      laboratory has developed a method for screening lymph node sections for the
      presence of micrometastatic disease. The nodes obtained from regional
      lymphadenectomies are dissected free from surrounding tissue and divided into
      halves. One-half is subjected to routine histopathological evaluation and the
      other one-half is disrupted into a single cell suspension and placed into cell
      culture. Lymph nodes from 19 patients with malignant melanoma were evaluated by
      tissue culture. Tumor cells were isolated in 125 of the 173 nodes examined. In
      contrast, only 14 of these nodes were initially found positive for melanoma by
      routine pathological evaluation. All lymph nodes positive for melanoma by
      pathological evaluation were also culture positive. Examination by cell culture
      has led to an upgrade in the stage of disease in 58% of the histologically node
      negative patients. In addition, 43% of the patients who were histologically node
      negative but culture positive have recurred, suggesting some clinical
      correlation. These results indicate that the tissue culture method for detecting
      micrometastatic lymph node disease may prove more reliable and sensitive than
      current techniques for determining the presence of occult melanoma.

PMID- 1642413
TI  - Therapeutic and prognostic considerations of head and neck melanoma.
AB  - Therapeutic considerations are discussed based on recurrence and survival
      statistics of 900 patients treated at Duke University Medical Center (Durham,
      NC). Approximately one-third of all patients developed recurrence. Factors
      affecting recurrence include tumor thickness, presence of positive regional nodes
      at diagnosis, and advanced Clark level. Patients with more than one adverse index
      had even higher rates of recurrence than with one alone. The 5-year survival of
      all patients after recurrence was 32%. Therapeutic decisions should include
      considerations that relate to patients' recurrence patterns and survival curves.

PMID- 1642414
TI  - Metastatic melanoma with an unknown primary.
AB  - An infrequent initial presentation for malignant melanoma is the diagnosis of
      metastatic disease without a history of an obvious primary lesion. Confusion
      exists in the literature concerning the workup, treatment, and prognosis of the
      unknown primary melanoma. A retrospective, computer-aided chart review of 580
      consecutively registered patients with melanoma at the University Treatment
      Center (Tampa, FL), identified 18 patients with an unknown primary presentation.
      There were 10 males and 8 females with a mean age of 38.4 years. Ninety-four
      percent of the patients were diagnosed with metastatic disease in a nodal basin,
      whereas 1 patient had a resected isolated lung mass as the initial presentation.
      In the patients who presented after having a biopsy of a single positive node for
      diagnosis, more disease was recovered in the nodal basin with a formal node
      dissection in 59% of the patients. Actuarial survival curves were constructed for
      the group with unknown primary melanoma. As a control population, survival curves
      were constructed of the subpopulation of patients with melanoma who had a known
      primary and had stage III (regional nodal disease) at diagnosis. There was no
      difference in survival between those with known and unknown primary melanoma (p =
      0.96).

PMID- 1642416
TI  - "Thin" malignant melanoma: risk factors and clinical management.
AB  - Thin melanomas can metastasize and can be lethal. Six hundred eighty-one patients
      with melanomas less than 0.76 mm thick have been evaluated, and are reviewed in
      this study and discussed in the context of a literature review. Among those
      referred without metastatic disease (583 patients), 4.8% metastasized after a
      mean follow-up of 3.6 years. Among those referred with metastatic disease (98
      patients), mortality was 35% after a mean follow-up of 5.9 years. Male patients
      (p less than 0.04) and patients with axial primary lesions (p less than 0.05) had
      increased risk of metastasis. Severe histological regression was present in 40%
      of primary lesions that metastasized and only 17% of similar lesions that did not
      (p less than 0.001). Increased age was associated with increased local skin
      metastases, but not with increased nodal or distant metastases. A prognostic
      model was designed that identifies a low-risk population with an actuarial risk
      of metastasis at 10 years that is less than 3%. High-risk patients have an
      actuarial risk of metastasis of 11% at 5 years and 22% at 10 years (p = 0.0084).
      Identifying high-risk and low-risk patients with thin melanomas may improve
      guidelines for the application of adjuvant therapies to this population. New
      approaches to this problem include use of molecular biology techniques,
      immunohistochemistry, and varied methods of histological sectioning.

PMID- 1642415
TI  - Anorectal melanoma: clinical characteristics and the role of abdominoperineal
      resection.
AB  - Twenty-four patients with primary anorectal melanoma diagnosed since 1974 have
      been retrospectively studied. The most common presenting symptom was rectal
      bleeding, typically misdiagnosed as hemorrhoids. Progressive disease most
      commonly presented as a large pelvic mass, diffuse bilateral pulmonary nodules,
      or diffuse liver metastases. Twenty-one patients (88%) died of their disease;
      none survived more than 6 years. Among the patients who have died of their
      disease, mean survival was 2.2 years. Among assessable stage I patients initially
      managed with abdominoperineal resection (APR), 50% developed recurrent local
      regional disease (mean disease-free interval = 23 months), compared with 100% of
      those managed with more limited surgery (mean disease-free interval = 16 months).
      Even after APR, however, distant metastases were common, and there was no
      prolongation of survival for patients treated with APR. Primary melanoma of the
      anorectum has a high metastatic potential and carries a grave prognosis. APR
      appears to have some effect in controlling local and regional disease, but
      prolongation of survival will depend both on earlier diagnosis and on development
      of more successful therapeutic approaches.

PMID- 1642417
TI  - The dilemma of the dysplastic nevus.

PMID- 1642419
TI  - [Radiological aspects of acoustic neurinoma].
AB  - For a long time CT constituted the technique of choice for the investigation and
      pretreatment staging of acoustic neuroma. It is sometimes inadequate especially
      for defining the extra-axial site of a tumour or for identifying small lesions.
      Today, any case of suspected acoustic neuroma should undergo first-line MR
      studies. MR identifies almost all extra-axial lesions, clearly visualises small
      lesions and provides a satisfactory pretreatment staging in the majority of
      cases, acoustic neuroma presents a signal intensity identical to or lower than
      that of the brainstem with a high intensity signal on T2-weighted SE sequences
      and post-gadolinium T1-weighted SE sequences, generally with a mixed intra- and
      extra-meatal location and eccentric in relation to the anterior border of the
      porus.

PMID- 1642418
TI  - Malignant melanoma and pregnancy.
AB  - Among 100 patients diagnosed with melanoma during pregnancy and followed a mean
      of 6.8 years, when compared with a nonpregnant female population, there was a
      significantly shorter disease-free interval for the pregnant group. Median
      disease-free intervals were 5.8 and 11.9 years, respectively. The time to
      development of lymph node metastases was shorter in the pregnant patients (p =
      0.015). Nodal metastases developed in 48% of the pregnant patients and only 26%
      of the nonpregnant patients, at 10 years. Multivariate analysis demonstrated that
      pregnancy at diagnosis was significantly associated with the development of
      metastatic disease (p = 0.008), when controlling for tumor site, thickness, and
      Clark level. Pregnancy, however, was not a risk factor for patient mortality. The
      literature continues to be split on the role of pregnancy in melanoma; however,
      most recent series show no difference in survival. Multiple studies have failed
      to show significant effects of female hormones on melanoma cells or on the
      incidence or progression of melanoma.

PMID- 1642420
TI  - [Auditory evoked potentials and tumor of the cerebellopontine angle].
AB  - The technique of auditory evoked potentials evaluates the auditory pathways along
      the vestibulocochlear nerve and in the brainstem. The authors stress the
      importance of this examination in the diagnosis of tumours of the
      cerebellopontine angle and they discuss its place in relation to radiological
      investigations.

PMID- 1642421
TI  - [Vestibular studies: current status, prospects].
AB  - Equilibrium is based on gaze stabilization. Clinical examinations currently test,
      individually the three components involved in equilibrium: vestibular, visual and
      proprioception. New investigations are being developed to test equilibrium
      dynamic conditions. After briefly reviewing vestibular physiology, under the
      authors discuss the various tests of vestibular function and equilibrium.

PMID- 1642422
TI  - [Rare tumors of the cerebellopontine angle].
AB  - Tumours of the cerebellopontine angle are essentially benign in adults, are
      generally treated surgically and require a preoperative assessment as precise as
      possible. MRI simplifies the diagnostic assessment; it is indicated as the first
      line investigation and is usually sufficient whenever a tumour of the posterior
      cranial fossa is suspected. Acoustic neuromas represent 75% of all tumours of the
      cerebellopontine angle. Other tumours are rare and essentially consist of
      meningioma, detected in 10 to 14% of cases and cholesteatoma in 1 to 5% of cases.
      Cholesteatoma, with a pathognomonic appearance, must be distinguished from
      arachnoid cyst. Other tumours are exceptional. The authors define the diagnostic
      criteria based on their experience and present a recent review of the literature.

PMID- 1642423
TI  - [3D imaging of the labyrinth: application to candidates for cochlear implant].
AB  - Cochlear implantation is a treatment for profound bilateral cochlear hearing
      loss. Two broad varieties of cochlear implants are used: single or multichannel
      device (22- channel) inserted either into the cochlea (tympanic ramp) or on the
      promontory on round window Imaging modalities have to predict cochlear patency
      prior surgery, an essential factor for choosing between intra or extra cochlear
      implant. Since March 1991, we have investigated 23 implant candidates to evaluate
      cochlear patency prior surgery, 6 patients underwent surgery: 4 had a
      multichannel and 2 had a monochannel electrode. Both CT and MRI play a role in
      pre operative study. CT easily predicts cochlear ossification and labyrinthine
      malformations MRI (3 D applications) with T 2 Weighted images, one millimeter
      thick, more clearly depicts labyrinthine liquid and can predict cochlear fibrosis
      before ossification.

PMID- 1642424
TI  - [Petrous surgical approaches in tumors of the cerebellopontine angle].
AB  - Three petrous incisions, performed by an ENT-neurosurgery team, can be used for
      the resection of tumours of the cerebellopontine angle: transpetrosal incisions
      (posterior translabyrinthine and transcochlear) which provide large access to the
      IAM and the posterior surface of the petrous bone, but they sacrifice hearing.
      The suprapetrosal incision (reserved for tumours in the meatus) and the
      mastoidoretrosigmoid incision (for tumours less than or equal to 20 mm) preserve
      the labyrinth in an attempt to preserve hearing. The principal objectives of
      surgical resection of tumours of the cerebellopontine angle (85% of which are
      acoustic neuromas) are total resection (to preserve the vital prognosis) and
      preservation of facial nerve function. Attempts to preserve hearing must be
      confined to cases selected by a complete clinical otological and audiometric
      examination.

PMID- 1642425
TI  - [MRI techniques for the study of the temporal lobe and its environment].
AB  - The MR study of the temporal lobe and its environment requires a good knowledge
      of the anatomy in order to select the views adapted to the disease investigated.
      The authors propose a series of protocols according to the region examined. An
      understanding of the principles of MR sequences is also essential to avoid the
      problems of investigation associated with this complex anatomical region. The
      principal sequences are reviewed together with their advantages and
      disadvantages.

PMID- 1642426
TI  - [Mycotic sinusitis. Contribution of x-ray computed tomography].
AB  - The authors present three cases of fungal sinusitis. Fungal sinusitis is a
      relatively rare disease that affects more commonly immunosuppressed and diabetic
      individuals. The radiographic signs are non-specific. Nevertheless, some CT
      findings are highly suspicious: unilateral lesions of one or more sinuses;
      nodular mucoperiosteal thickening, and, or focal areas of bone destruction; very
      dense, intrasinus concretions. Air-fluid levels are very uncommon, and when
      present suggest a nonfungal bacterial infection. In most cases, a combination of
      these findings suggests fungal disease. The clinical hallmark is chronic
      sinusitis that fails to respond to antibiotic therapy.

PMID- 1642427
TI  - [Subcondylar mandibular fracture].
AB  - Mandibular fractures are frequent lesions which are classified into 6 groups
      according to the site of the fracture. Condylar fractures are primarily due to a
      direct blow to the symphysis menti. Medical imaging must be able to identify the
      type of fracture, its intra- or extra-articular site and the associated
      displacement of the condyle, the fundamental element in deciding treatment. The
      action of the masticatory muscles on one of the bone fragments may be responsible
      for an unstable fracture, leading to disturbances of consolidation
      (pseudarthrosis). Anterior bilateral fractures can be life-threatening due to
      ptosis of the tongue.

PMID- 1642428
TI  - [Cholesterol granuloma. Review of the literature apropos of a case].
AB  - MRI allows the diagnosis of cholesterol granuloma in the presence of a non
      contrast-enhanced, erosive solid mass of the apex of the petrous bone or middle
      ear. Cholesterol granuloma has a suggestive low signal intensity on T1 and T2
      weighted sequences (cholesterol crystals, haemoglobin degradation products).
      These specific features eliminate the principal CT differential diagnoses,
      particularly cholesteatoma. MRI is also useful for follow-up of treatment.

PMID- 1642429
TI  - [Symptomatic trigeminal neuralgia caused by venous angioma of the posterior
      fossa].
AB  - Any atypical trigeminal neuralgia requires etiological investigation. The authors
      report a case of a trigeminal neuralgia (V2) due to an angioma associated with
      two cavernomas.

PMID- 1642430
TI  - [Biological roles of free radicals: introduction].
AB  - Free radicals are produced during cellular oxidations. The primary ones are
      superoxide anions (O2-) and hydroxyl radicals (OH). They generate in vivo various
      secondary radicals. Radical mechanisms are invoked in a number of biological
      processes including, phagocytosis, ischemia or ageing.

PMID- 1642431
TI  - [Extracellular matrix and vascular pathologies. Role of proteases and oxygenated
      free radicals].
AB  - Vessel walls contain several types of mesenchymatous cells and many
      representatives of the 4 groups of macromolecules of the extracellular matrix
      secreted by those cells. Under normal conditions, a proportion of the
      macromolecules of the vascular wall is broken down by the neosynthesis of an
      equivalent amount of the same macromolecules which are then integrated into
      functional structures. Under pathological conditions, an excessive amount of
      macromolecules is broken down by proteases and free radicals, without any
      compensatory increase in biosynthesis and without the integration of
      biosynthesised compounds into functional structures. Thus, for example, a
      varicose saphenous vein may lose as much as 60 per cent of the collagen of its
      wall. Attempts at symptomatic treatment designed to combat this loss of
      substance, a notable cause of weakening of he vessel wall, are based upon three
      principles: inhibition of catabolic enzymes, chiefly proteases (e.g. leucocyte
      elastase), responsible for excessive breakdown; uptake of oxygenated free
      radicals; "substrate protection" designed to preserve undamaged fibrous proteins
      and to help the integration of neosynthesized compounds into functional
      structures. Only medications which act as "substrate protectors" are capable of
      coping at one and the same time with the effects of proteases and those of
      oxygenated free radicals.

PMID- 1642432
TI  - [Oxygenated free radicals and vascular pathology].
AB  - Oxygen free radicals are used as a weapon by neutrophil morphopolynuclear cells,
      monocytes and macrophages against bacterial attacks. They do interact with
      arachidonic acid cascade catabolism that means they stimulate too, platelet cells
      and endothelial cells activity (EDRF is indeed "NO"). They prime all along
      inflammatory process and thrombosis which are main items of the pathology of
      vessels.

PMID- 1642433
TI  - [Myxoma of the right atrium. Apropos of 10 surgically treated cases].
AB  - In a series of 100 patients with intracardiac myxoma, the lesion was in the right
      atrium in 10 cases. The authors attempt to define the particular features of
      right atrial myxoma in terms of clinical aspects, outcome and pathology. The
      diagnostic difficulty raised by complex clinical pictures (including right
      ventricular failure, pseudopericardial forms and forms with a predominance of
      systemic problems) has now been resolved by imaging and, above all
      echocardiography. Consequences for the right side of the heart may involve the
      pulmonary artery with myxomatous emboli causing multiple fusiform aneurysms and
      pulmonary hypertension, or, more rarely, the tricuspid (with need for valve
      replacement), vena cava (Budd-Chiari syndrome) or atrial septum (right/left
      shunt). Alongside systemic problems due to interleukin 6, erythrocyte
      abnormalities are a new feature. Frequent etiological inclusion in a Carney
      complex explains recurrences and multi-cavity forms. The dominant pathological
      feature is tumor calcifications, no doubt as a result of the long presymptomatic
      phase of myxoma.

PMID- 1642434
TI  - [Clinical and angiographic results of delayed revascularization by angioplasty or
      bypass after intravenous thrombolysis in myocardial infarction].
AB  - Between 1988 and 1990, 150 patients treated for an infarction by intravenous
      thrombolysis underwent coronary arteriography. Sixty seven were managed by
      revascularisation by angioplasty (n = 49) or bypass (n = 18) more than 48 hours
      after thrombolysis. In this delayed revascularisation group, the time before
      initial fibrinolysis was 114 +/- 55 minutes. The artery responsible for the
      infarction was patent in 88 per cent of cases at 12 +/- 9 days, with ejection
      fraction being 56 +/- 12 per cent. Indications for revascularisation were:
      recurrence of angina, Thallium stress test showing redistribution (n = 9),
      diffuse lesions (n = 11) or tight (greater than 75 per cent) proximal stenosis
      without vessel wall sequelae (n = 10). Comparison of the bypass and angioplasty
      groups showed a lower ejection fraction in the former than the latter (47% VS
      58%, p less than 0.01), more frequent three-vessel disease (50% VS 6%, p less
      than 0.01) and more frequent revascularisation of the anterior interventricular
      (100% VS 37%, p less than 0.01). There were 2 deaths and 5 recurrences of
      infarction at one year. Follow-up arteriography was performed between at 2 and 6
      months in 72% of the patients: 16 had restenosis after angioplasty and 4
      occlusion of the graft after bypass. A second revascularisation procedure was
      necessary 15 times (14 angioplasties, 1 bypass). The outcome after bypass or
      angioplasty was favourable in 90% of cases in this group of patients exposed to a
      recurrence of infarction.

PMID- 1642435
TI  - [Cardiac toxicity of fluoro-uracil. Typical and atypical aspects. Apropos of 8
      cases].
AB  - The cardiac toxicity of 5 fluoro-uracil, an antimitotic agent widely used in
      various protocols, has been known for 16 years. Several cases have been reported
      in the literature, leading to the suggestion, without formal evidence, that the
      chief mechanism responsible for this cardiac toxicity is "classical" coronary
      spasm. However, certain clinical aspects already described may shed doubt on this
      theory. On the basis of 8 cases, the authors report different clinical pictures
      all caused by cardiac toxicity of 5FU. It is of interest to note that chest pain
      with the classically described electrocardiographic changes did not apply in the
      majority of cases. The commonest pattern was asymptomatic electrocardiographic
      abnormalities and/or arrhythmias without angina. Among the reported cases, one
      patient had pain with electrocardiographic abnormalities, recurrent after the
      withdrawal of 5FU and resistant to maximal medical treatment, despite the absence
      of any coronary disease or signs of spasm. One patient had a first myocardial
      infarction, later rechallenge with the drug resulting in failure. In another
      patient, with known coronary disease, 5FU probably cause cardiogenic shock. In
      total, some of our cases, as well as other features described in the literature,
      raise questions as to the pathophysiology of the cardiac toxicity of 5FU.

PMID- 1642436
TI  - [Leg muscle bed syndrome: medical aspects of chronic forms].
AB  - Ninety two patients with lower leg pain of unknown cause underwent intramuscular
      pressure measurements by the needle technique described by Whitesides. Fifty four
      patients (59%) were found to have a chronic compartment syndrome. In these
      patients the intramuscular pressure was significantly increased at rest and after
      exercise as compared with normal subjects (13) and patients without the syndrome
      (38). Increased pressure at rest after exercise and a prolonged time for
      normalisation are the most commonly parameters in diagnosing chronic compartment
      syndrome. Tissue pressure measurement remains the basis of diagnosis for patients
      suffering from chronic compartment syndrome, indeed the clinical findings alone
      were found to be insufficient. Effective treatment consists of reduction of
      exertional activities or decompression by fasciotomy. The clinical results after
      fasciotomy were good and consistent with the findings of others.

PMID- 1642437
TI  - [The single coronary artery].
AB  - Single coronary artery is a fairly rare entity which may nevertheless be found in
      0.4 per cent of coronary arteriograms. The authors report 3 cases seen in 2
      departments of cardiology. In each patient, despite the existence of definite
      cardiovascular risk factors, this distribution was a factor worsening coronary
      ischemia, leading to complete thrombosis in one case. Although most often a
      chance discovery, a review of the literature justifies the attribution to this
      anomaly of the onset of angina, infarction or even sudden death.

PMID- 1642438
TI  - [Negativity of the exercise thallium test despite tight stenosis of the common
      trunk of the left coronary artery].
AB  - The authors report a case of severe angina linked to subocclusive ostial stenosis
      of the common trunk of the left coronary, characterised by the contrast between a
      very positive stress test on the basis of clinical and electrocardiographic
      parameters and a negative Thallium stress test. The occasion is taken to review
      the sensitivity of Thallium stress testing in lesions of the common trunk.

PMID- 1642439
TI  - [Spontaneous complete rupture of the thoracic aorta. Apropos of a case surgically
      treated with success].
AB  - The authors report the case of a 74-year-old hypertensive man hospitalised with
      chest pain accompanied by shock and hemo-mediastinum. The diagnosis of
      spontaneous rupture of the thoracic aorta, suspected by aortic arteriography, was
      confirmed by thoracic CT scan with injection of contrast medium. Emergency
      surgery revealed a 4 cm longitudinal linear tear of the horizontal aorta, with
      neither dissection nor aneurysm. Simple suture during extra-corporeal circulation
      with normothermia and the heart beating, was successful after prolonged
      postoperative intensive care. This case of complete and spontaneous acute rupture
      of the horizontal thoracic aorta appears to be the first to have been
      successfully treated surgically.

PMID- 1642440
TI  - [Adjustment of double-chamber pacemakers in VDD mode by measurement of thoracic
      electric bio-impedance].
AB  - An optimal atrioventricular interval (AVI) was sought in 6 patients with a double
      chamber pacemaker by an non-invasive technique: measurement of stroke volume by
      thoracic bioimpedance. This method proved to be easy and reliable in practice
      when there was only one pacing spike (VDD mode). It confirmed the existence of a
      variable optimal AVI according to individual patients: 250 ms (3 patients), 200
      250 ms (1 patient), 150 ms (1 patient), 75-100 ms (1 patient). The value of
      optimal AVI is unpredictable since it depends upon individual
      electrophysiological and hemodynamic parameters. In a patient with severe mitral
      incompetence, Echo-Doppler provided evidence of end-diastolic ventriculo-atrial
      regurgitation at middle and long AVI, while a short AVI enabled elimination of
      end-diastolic regurgitation and a 15.45 per cent improvement in stroke volume. In
      two patients with a long optimal AVI (250 ms), a programmed short AVI (75 ms)
      paradoxically appeared to be more favourable than a middle AVI (150 ms).

PMID- 1642441
TI  - [Comparison of the efficacy/tolerability ratio of cibenzoline and propafenone in
      the treatment of ventricular arrhythmia].
AB  - Cibenzoline (C) was compared with propafenone (P) in 18 adult patients (7 women
      and 11 men) aged 50 +/- 7 in double-blind, placebo-controlled crossover trial.
      After a therapeutic wash-out period corresponding to 5 times the half-life of
      previous anti-arrhythmic drugs, patients with more than 100 premature ventricular
      contractions (PVC) per hour in two 24 hour Holter records obtained at an interval
      of 7 days were treated in succession and after randomised by C (390 mg/day in 3
      divided doses) and P (900 mg/day in 3 divided doses) for a period of two weeks,
      each active sequence being followed by a two week wash-out period. Efficacy
      (based upon the decrease in PVC/hour in a 24 hour Holter) and tolerability were
      evaluated at the end of each sequence, with samples drawn at the same times for
      assay of the study drugs. Three patients dropped out of the trial, 1 with each
      active drug (for epigastric pain) and 1 with dummy. No significant difference was
      seen between the two drugs regarding the decrease in the total number of PVC/hour
      in the 15 patients completing the cross-over protocol. A reduction in PVC/hour of
      more than 70 per cent was seen in 7 patients with C and in 9 patients with P. C
      was better tolerated than P on the basis of both clinical and
      electrocardiographic parameters. One patient developed troublesome adverse
      reactions with C as compared with 4 patients in the case of P. A more than 20 per
      cent increase in QRS was seen in 7 patients with C and in 10 patients with P, the
      figures for PR being 2 and 6 patients respectively. One patient showed a
      proarrhythmic effect with P. Plasma levels of C were significantly higher in
      responders (328 +/- 149 ng/ml) than in non-responders (137 +/- 41 ng/ml, p less
      than 0.05). No significant difference was found concerning plasma levels of P
      (578 +/- 477 ng/ml compared with 646 +/- 457 ng/ml, p greater than 0.05). In
      conclusion, the efficacy/tolerability ratio in this population with a low risk of
      serious rhythm events appeared to be better with C than with P.

PMID- 1642442
TI  - The neonatal detection of cystic fibrosis by measurement of immunoreactive
      trypsin in blood.

PMID- 1642443
TI  - Measurement of aluminium in clinical samples.
AB  - Measurement of aluminium in clinical samples is important for the protection of
      patients with chronic renal failure, and for investigations of dementia. The
      types of specimen that need to be analysed include body fluids and tissues,
      dialysis fluids, water and foods and the concentrations that may be found can
      range from around 1 microgram/L to several mg/L. Although techniques must afford
      exceptional sensitivity they will also be susceptible to the effects of external
      contamination and it is imperative that those involved with the analysis, from
      sample collection through to the determination, ensure that precautions are taken
      to prevent undue addition of the metal. Of the methods that may be used ETAAS is
      clearly the most appropriate. Great care is required to achieve reliable
      performance but with experienced personnel very good results can be obtained.
      Regular reviews of recent analytical developments are presented in the Atomic
      Spectrometry Updates series and these are recommended to those who may wish to
      look for further information.

PMID- 1642444
TI  - Abnormal endogenous carbon monoxide production in children with ineffective
      erythropoiesis.
AB  - The aim of this study was to evaluate the extent of endogenous carbon monoxide
      production in subjects with ineffective erythropoiesis. Carboxyhaemoglobin
      concentrations were measured in eight transfused and eight nontransfused
      thalassemic patients. Measurements were made on venous blood collected under
      controlled conditions and were corrected by simultaneous measurement of HbF
      levels. Nontransfused thalassaemic patients with abnormal erythropoiesis were
      found to have elevated levels of carboxyhaemoglobin, significantly higher than
      those found in transfused subjects, as well as decreased cardiac performance. It
      is important to consider carboxyhaemoglobin levels in planning transfusion
      programmes.

PMID- 1642445
TI  - Reference values for urinary HMMA, HVA, noradrenaline, adrenaline, and dopamine
      excretion in children using random urine samples and HPLC with electrochemical
      detection.
AB  - Random urine samples were collected from 305 children aged from birth to 14 years
      and the values of hydroxymethoxymandelic acid, homovanillic acid, noradrenaline,
      adrenaline, and dopamine were measured by high-performance liquid chromatography
      with electrochemical detection. The results were reported relative to the urinary
      creatinine concentration and the values declined progressively with increasing
      age for each analyte with the exception of adrenaline. The results for each age
      group were not normally distributed and all values except outliers were retained
      in determining the upper reference limits.

PMID- 1642446
TI  - Comparison of seven formulae and isoelectrofocusing for determination of
      intrathecally produced IgG in neurological diseases.
AB  - Seven different formulae and agarose isoelectrofocusing (AIF) using
      immunolabelling for IgG were compared for their ability to discriminate between
      intrathecally produced IgG and transudated IgG in cerebrospinal fluid. All
      reference limits were set to a specificity of 97.5% (reference group, n = 211).
      The probability of a positive test (p+) was evaluated for 112 patients with
      multiple sclerosis (MS), 42 with meningitis, 114 with noninflammatory diseases
      affecting the central nervous system (CNS), 23 with Guillain-Barre syndrome, and
      56 with various diseases not affecting the CNS. Agarose isoelectrofocusing had
      the best diagnostic sensitivity (93%) for MS, combined with a low p+ (0-19%) for
      other diseases. Among the formulae, the IgG extended index and Reiber's
      hyperbolic formula were equivalent, giving high (75-79%) diagnostic sensitivity
      for MS combined with low p+ (4-22%) for other diseases. All other formulae,
      although sensitive for MS, had a higher rate of false positive results.

PMID- 1642447
TI  - Nephelometric determination of total protein in cerebrospinal fluid and urine
      using benzalkonium chloride as precipitation reagent.
AB  - Four different protein precipitants, namely trichloroacetic acid, sulphosalicylic
      acid, benzethonium chloride and benzalkonium chloride, were used to estimate the
      total protein concentration in cerebrospinal fluid and urine by nephelometry.
      Protein determinations for 50 cerebrospinal fluid samples and 100 urine samples
      were compared with values obtained by a trichloroacetic acid-Ponceau S
      spectrophotometric method. All methods were correlated well, but total protein
      results using acid precipitants were usually lower, while results obtained using
      benzethonium chloride were generally higher, than results obtained by the
      trichloroacetic acid-Ponceau S method. Anomalous results were obtained for some
      urine samples with benzethonium chloride, but not with benzalkonium chloride.
      Assays using benzalkonium chloride as precipitating reagent showed good precision
      and closest agreement with the trichloroacetic acid-Ponceau S dye-binding method.
      The use of benzalkonium chloride as precipitant is recommended for automated
      cerebrospinal fluid and urine protein estimations by nephelometry.

PMID- 1642448
TI  - A simple method for the measurement of different forms of alpha 1 proteinase
      inhibitor in the faeces of patients with Crohn's disease.
AB  - Alpha-1 proteinase inhibitor (alpha 1PI), formerly named alpha 1-antitrypsin, is
      excreted in the faeces of patients with Crohn's disease as isoforms clearly
      separated by SDS-PAGE and immunoblot analysis. Relapses in Crohn's disease are
      generally associated with the appearance in faeces of M(rs) 51,000 and 45,000
      glycosylated forms of alpha 1PI, as compared with normal subjects and most of the
      patients in quiescent phases of their disease who excrete an M(r) 38,000
      unglycosylated form of alpha 1PI. We used their differential Concanavalin-A
      reactivity to design a specific test. The proposed assay is potentially helpful
      for the follow-up of patients under therapy and for early recognition of attacks
      of Crohn's disease.

PMID- 1642449
TI  - Within-subject and between-subject biological variation of prothrombin time and
      activated partial thromboplastin time.
AB  - The within-subject and between-subject biological variation of prothrombin time
      (PT) and activated partial thromboplastin time (APTT) have been studied in a
      group of 19 women and 20 men over a period of 9 months. All measurements were
      performed with a mechanical coagulometer. The between-subject coefficients of
      variation were 6.8% for PT and 8.9% for APTT. The medians and the 90th
      percentiles of within-subject coefficients of variation were 1.7% and 5.9%,
      respectively, for PT, and 0.0% and 6.1% for APTT. These data were used to
      calculate the critical difference for significant change detection and the
      desirable between-day imprecision.

PMID- 1642450
TI  - Prevalence of haemoglobin variants in a diabetic population and their effect on
      glycated haemoglobin measurement.
AB  - The measurement of glycated haemoglobin (glycated Hb) by automated high pressure
      liquid chromatography enabled the prevalence of haemoglobin variants (Hb variant)
      to be determined in a large diabetic population within Leeds, UK. There were 16
      patients showing a Hb variant amongst a total of 5300 diabetics, the majority of
      the variants being HbA/S traits. There were also 13 patients showing a slightly
      raised HbF in the range of 2% to 5%. A multi-centre study was carried out by
      distributing blood specimens from some of the patients with Hb traits.
      Significant differences in the percentage of glycated Hb were observed relating
      to the methodology used. However, glycated Hb is used to monitor glycaemic
      control and laboratories must be aware of Hb variant interferences on their
      methods. Also, screening for Hb variants should be considered for the at risk
      groups of diabetic patients.

PMID- 1642451
TI  - Defective collagen metabolism in Saudi patients with hernia.
AB  - Fibroblastic cell cultures were derived from the hernial sac and some of the
      surrounding muscles (rectus sheath, internal oblique, and/or cremasteric muscle)
      of 130 Saudi patients with different types of herniation, and from 21 control
      subjects. The rates of cell proliferation were studied for 39 days. Results
      suggested decreased rates of proliferation of cells derived from patients
      compared to controls. In vitro studies of the rates of incorporation of 14C
      proline into the muscle biopsies revealed decreased rates of label incorporation
      in the samples derived from patients compared to controls. However, no
      differences were detected between rates of collagenase activities of the biopsies
      obtained from patients compared to those of controls. These findings suggest that
      collagen synthesis is probably defective in the studied group of Saudi patients
      with hernia.

PMID- 1642452
TI  - Serum fructosamine concentration in patients with nephrotic syndrome and with
      cirrhosis of the liver: the influence of hypoalbuminaemia and
      hypergammaglobulinaemia.
AB  - We have investigated the influence of variation of the concentrations of serum
      albumin and immunoglobulins on serum fructosamine concentration in 33 patients
      with nephrotic syndrome, and 18 patients with cirrhosis of the liver. Protein
      alterations were evident in these patients and they were compared with 109 normal
      subjects, 43 patients with type II diabetes mellitus and nine diabetic patients
      with nephrotic syndrome. The mean serum fructosamine concentration in diabetic
      patients (2.76 +/- 0.53 mmol/L) was significantly increased (P less than 0.001)
      by comparison with normal subjects (1.93 +/- 0.20 mmol/L) and the other patients
      studied. Patients with diabetic nephropathy had higher (P less than 0.01) serum
      fructosamine concentrations (2.23 +/- 0.54 mmol/L) than non-diabetic patients
      with the nephrotic syndrome (1.57 +/- 0.37 mmol/L) but remained with the normal
      range. Positive correlations were observed between fructosamine and
      immunoglobulins G and M in nephrotic and cirrhotic patients. Serum immunoglobulin
      A was also directly correlated with serum fructosamine in patients with cirrhosis
      of the liver. An inverse correlation between albumin and fructosamine in serum of
      patients with cirrhosis of the liver was also noted. We conclude that the
      fructosamine assay is not useful in the assessment of glycemic control in
      patients with cirrhosis of the liver, nephrotic syndrome or in any other clinical
      situation in which protein metabolism is altered.

PMID- 1642453
TI  - Dependence of measured ionized calcium on protein concentration as measured by
      three ion-selective electrodes.
AB  - A positive effect of protein on the measurement of ionized calcium in serum by
      ion-selective electrodes (ISEs) has been previously reported and the present
      study confirms this finding. Ionized calcium in serum was measured in the
      presence of increasing protein concentrations induced by venous stasis in 17
      healthy volunteer subjects. Ionized calcium was measured using two commercial
      analysers, a Radiometer ICA2 analyser and a Baker Analyte+2 analyser, and a
      calcium cell devised by Covington for the calcium reference method (CRM). Both
      commercial analysers used charged ionophores and the CRM used a neutral carrier
      ionophore in the selective membrane. A small but significant rise in ionized
      calcium with increasing protein was measured on all analysers. Substitution of
      isotonic KCl for saturated KCl in the reference electrode of the CRM resulted in
      significantly reduced values for ionized calcium in paired serum samples when
      measured using the isotonic salt bridge. This study supports the premise that the
      positive effect of protein is related to the salt bridge concentration of the
      reference electrode rather than the ISE membrane composition.

PMID- 1642454
TI  - Auditing quality control procedures in a chemical pathology laboratory--a
      multiple regression analysis.
AB  - We undertook a retrospective analysis of the monthly test rejection rates and the
      monthly external quality assessment scheme performance indices for our
      laboratory's two automated analysers, and examined the association of these
      variables with measures of laboratory workload, manpower, staff training,
      instrument servicing, seasonal and temporal factors and changes of calibration,
      method and assigned internal quality control values. Using multiple linear
      regression and stepwise multiple linear regression, we found that test rejection
      rates differed significantly between instruments, and were highest on the
      instrument performing the widest variety and lowest volume of tests. On that
      instrument, rejection rates were significantly associated with the introduction
      of new staff and laboratory manpower levels, and also showed a highly significant
      trend upwards over the study period, independent of the effects of the other
      variables examined. External quality assessment scheme performance indices showed
      small trends over the study period. They were not related to the test rejection
      rates on either analyser but also showed a significant association with the
      introduction of new staff and a small but significant association with laboratory
      workload. We conclude that the training and introduction of new staff and
      decreased laboratory manpower levels may significantly increase the level of test
      rejection, and adherence to appropriate quality control protocols effectively
      maintains the quality of the laboratory's results, but may not be completely
      successful in filtering out the effects of some assignable causes of variation in
      test results. It is suggested that clinical laboratories use the statistical
      approach adopted here to identify factors which may be adversely affecting
      quality performance and running costs and to provide evidence that quality
      control procedures are both cost- and quality-effective.

PMID- 1642455
TI  - Human cardiac muscle magnesium and potassium concentrations: can skeletal muscle,
      mononuclear blood cells, erythrocyte and plasma concentrations provide a
      surrogate measure?

PMID- 1642456
TI  - Failure of an immunometric assay to detect elevated creatine kinase MB isoenzyme.

PMID- 1642457
TI  - The use of C-reactive protein in the evaluation of chest pain of cardiac origin.

PMID- 1642458
TI  - Hyperparathyroidism in pregnancy: three case reports.

PMID- 1642459
TI  - The measurement of parathyroid hormone.

PMID- 1642460
TI  - Antibody interference in free thyroxine assays.

PMID- 1642461
TI  - Spontaneous remission of a third-nerve palsy in meningeal lymphoma.
AB  - We report on a patient with spontaneous remission of a third-nerve palsy who was
      subsequently found to have meningeal lymphoma. Initial magnetic resonance images
      (MRI) showed bilateral enhancement of the third nerves. Follow-up MRI 7 months
      later, without treatment, showed complete resolution. One year after initial
      presentation, the patient developed multiple lumbosacral radiculopathies and
      examination of a nerve root biopsy specimen disclosed a B-cell lymphoma. Serial
      cerebrospinal fluid analyses over the previous year showed occasional atypical
      cells, later found to resemble closely the biopsy cell type. We conclude that
      meningeal lymphoma may have a protracted course, with spontaneous remission of
      both clinical and neuroimaging findings.

PMID- 1642462
TI  - Dystonia induced by combined treatment with L-dopa and MK-801 in parkinsonian
      monkeys.
AB  - We examined whether the N-methyl-D-aspartate antagonist MK-801 (dizocilpine)
      would reverse parkinsonism or potentiate the effects of L-dopa in primates
      treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). In contrast to
      its effect in rodent models, treatment with MK-801 (0.1 mg/kg) caused
      bradykinesia and ataxia in parkinsonian primates, but no locomotor stimulation.
      Coadministration of MK-801 (0.1 mg/kg) with L-dopa (20 mg/kg) induced marked
      dystonia accompanied by bradykinesia and ataxia. Dystonia was not induced by
      either treatment given alone. These findings indicate that MK-801 should not be
      advocated as an adjunct to dopamine agonist therapy in Parkinson's disease.

PMID- 1642463
TI  - Magnetoencephalographic localization of epileptic cortex--impact on surgical
      treatment.
AB  - A 24-channel, planar, superconducting quantum interference device gradiometer,
      sampling a fourth of the head surface over brain tissue, was used to determine
      the site of an epileptic focus in a 36-year-old woman with intractable complex
      partial epilepsy. The other presurgical findings appeared divergent: a large
      arachnoid cyst over the right parietal convexity, dissimilar interictal
      electroencephalographic patterns, and several neuropsychological dysfunctions.
      The equivalent current sources of magnetoencephalographic spikes were in the
      right posterior temporal region of the cortex, 4 cm apart from the cyst. Surgical
      exploration of the area pinpointed by magnetoencephalography revealed a
      pachygyric patch of cortex displaying focal discharges on the electrocorticogram.
      After resection, a dramatic reduction of seizures occurred. The good agreement
      between electrocorticography and magnetoencephalography warrants future
      investigation of multichannel magnetoencephalography as a potential alternative
      to invasive presurgical recordings.

PMID- 1642464
TI  - Parkinsonism-inducing neurotoxin MPP+: uptake and toxicity in nonneuronal COS
      cells expressing dopamine transporter cDNA.
AB  - Expression of a cloned dopamine transporter complementary DNA in COS cells allows
      these primate kidney cells to accumulate the parkinsonism-inducing neurotoxin
      metabolite MPP+ (1-methyl-4-phenylpyridinium) avidly, and MPP+ toxicity results.
      By documenting that the dopamine transporter can confer MPP+ sensitivity to
      nonneural cells, these results highlight the key role that this transporter could
      play in mechanisms underlying parkinsonism.

PMID- 1642465
TI  - Treatment strategy for the corticocortical neuron pathology of Alzheimer's
      disease.

PMID- 1642466
TI  - Lhermitte-Duclos disease and Cowden disease: a third case.

PMID- 1642467
TI  - Mitochondrial oxidative phosphorylation defects in Parkinson's disease.

PMID- 1642468
TI  - Increased signal in basal ganglia and white matter on magnetic resonance imaging
      in Creutzfeldt-Jakob disease.

PMID- 1642469
TI  - Motor dyscontrol in narcolepsy: rapid-eye-movement (REM) sleep without atonia and
      REM sleep behavior disorder.
AB  - Narcolepsy involves abnormalities of rapid-eye-movement (REM) sleep, including a
      short latency to the onset of REM sleep, hypnagogic hallucinations, and sleep
      paralysis. In addition, persistence of muscle tone by electromyographic criteria
      or excessive muscle twitching during REM sleep or both have been reported in
      treated and untreated narcoleptic patients. We report that another previously
      described abnormality of REM sleep, REM sleep behavior disorder, may also be a
      symptom of narcolepsy. This disorder was found in 10 narcoleptic patients during
      routine clinical evaluations involving polysomnography and multiple sleep latency
      tests. During REM sleep, 7 additional narcoleptic patients displayed persistent
      muscle tone and/or excessive twitching, which we believe to be subclinical
      components of REM sleep behavior disorder. These 17 patients, diagnosed by
      established criteria for narcolepsy and for REM sleep behavior disorder, ranged
      in age from 8 to 74 years. Seventy-one percent were male. Narcolepsy and REM
      sleep behavior disorder most commonly emerged in tandem. In 3 patients, treatment
      of narcolepsy-cataplexy with stimulants and tricyclics either induced or
      exacerbated REM sleep behavior disorder.

PMID- 1642470
TI  - Morphometry, histopathology, and tomography of cerebral atrophy in the acquired
      immunodeficiency syndrome.
AB  - Patients with the acquired immunodeficiency syndrome (AIDS) commonly display
      evidence of gross cerebral atrophy, but its true incidence and pathophysiology in
      the general AIDS population are unknown. In this study, we measured cerebrospinal
      fluid (CSF) spaces in 64 consecutively autopsied patients with AIDS, compared
      them with age-matched non-AIDS subjects, and correlated them with the microscopic
      neuropathology at autopsy. Thirty-seven of the patients with AIDS (58%) had a CSF
      space index greater than two standard deviations above the mean of the age
      matched control subjects. CSF spaces were expanded the most in frontal and
      temporal lobes; ventricular spaces were expanded more than sulcal spaces.
      Regression analysis between age and the measured CSF indexes showed that
      practically none of the deviation in patients with AIDS could be explained by age
      related atrophy. Patients with atrophy were much more likely to have human
      immunodeficiency virus type 1-associated histopathological changes in their
      brains, but the relationships were too weak to establish the microscopic cause of
      the atrophy. Measurement of CSF spaces in antemortem computed tomographic (CT)
      scans from 47 of the patients with AIDS revealed the same regional pattern of
      brain wasting. CT diagnosis of cerebral atrophy was strongly concordant with the
      postmortem diagnosis, but its severity was diagnosed slightly more conservatively
      at autopsy. Thus, quantitative analysis of CSF spaces in a robust sampling of
      patients with AIDS confirms that cerebral atrophy is a sensitive, common, and
      frequently subtle indication of central nervous system human immunodeficiency
      virus type 1 infection that may occur independently from any single specific
      microscopic abnormality. Its presence, severity, and regional pattern are
      detected with reasonable consistency using CT scanning.

PMID- 1642471
TI  - Physiological abnormalities in hereditary hyperekplexia.
AB  - Five patients from a kindred with hereditary hyperekplexia had physiological
      testing. The surface-recorded electromyographic pattern of audiogenic muscle
      jerks was identical to that of the normal acoustic startle reflex. Testing at
      graded stimulus intensities indicated an increase in the gain of the acoustic
      startle reflex. Nose-tap stimuli resulted in short-latency generalized
      electromyographic bursts that were similar to the R1 component of the blink
      reflex. Electrical stimulation of peripheral nerves elicited a pattern of
      generalized muscle jerks that was similar to that of the acoustic startle reflex.
      Somatosensory evoked potentials, brainstem auditory evoked potentials, and
      cortical auditory evoked potentials were normal. The primary physiological
      abnormality in hereditary hyperekplexia is widespread elevated gain of vestigial
      withdrawal reflexes in the brainstem and possibly the spinal cord, most likely
      resulting from increased excitability of reticular neurons.

PMID- 1642472
TI  - Neonatal idiopathic cerebral venous thrombosis: an unrecognized cause of
      transient seizures or lethargy.
AB  - Seven neonates who presented with either lethargy (four infants) or seizures
      (three infants) were found by magnetic resonance (MR) phase imaging to have
      idiopathic cerebral venous thrombosis (CVT). Examination showed only hypotonia or
      hyperreflexia. The presence of CVT was suggested by unenhanced cranial computed
      tomographic (CT) scans. Conventional MR T1- and T2-weighted images often
      indicated more extensive thromboses than were suggested by cranial CT. In all
      infants, MR phase imaging confirmed thromboses by establishing absence of blood
      flow in cerebral veins or sinuses. No infant received anticoagulation. Lethargy
      slowly resolved and seizures did not recur. Normal development has been observed
      thus far in brief follow-up. The occurrence of seven infants with idiopathic
      neonatal CVT within a 3-month period indicates that CVT may be a cause of
      neonatal seizures or lethargy of unclear cause. MR phase imaging provides a
      powerful, noninvasive means of confirming the diagnosis. Treatment with
      anticoagulants does not appear necessary.

PMID- 1642473
TI  - An abnormality of plasma amyloid protein precursor in Alzheimer's disease.
AB  - beta A4 amyloid deposition in the brain, which is characteristic of Alzheimer's
      disease (AD), may result from either overexpression of the amyloid protein
      precursor (APP) or failure of APP to be correctly processed. A blood marker
      reflecting this abnormal metabolism would be of diagnostic value and would
      provide a means of monitoring the efficacy of therapeutic interventions. We
      analyzed immunoblots of plasma APP enriched by heparin-Sepharose chromatography
      from patients with moderate to severe AD dementia (n = 34) and control subjects
      (n = 77) and found an approximately 50% increase in the proportion of 130-kd APP
      species in patients with AD (p less than 0.001), no difference in the 110-kd
      form, a 15 to 30% decrease in the 65-kd form (p less than 0.001), and a 20 to 35%
      decrease in the proportion of 42-kd APP (p less than 0.001). These species of APP
      were soluble, lacked the carboxyl terminus, and the 110- and 42-kd species were
      shown to be consistent with degradation products derived from the 130-kd species.
      A comparison of levels of 130-kd plasma APP from moderately to severely demented
      patients with AD and control subjects distinguished the two groups with a
      specificity of 87.0% and a sensitivity of 79.4%.

PMID- 1642474
TI  - L-2-hydroxyglutaric acidemia: a novel inherited neurometabolic disease.
AB  - Routine screening for organic acids revealed increased and isolated urinary
      excretion of L-2-hydroxyglutaric acid in 8 mentally retarded patients from five
      unrelated families, including three pairs of siblings. L-2-Hydroxyglutaric acid
      concentration was also found to be increased in the cerebrospinal fluid (CSF) and
      to a lesser extent in plasma. The only other biochemical abnormality was an
      increased concentration of lysine, both in plasma and in CSF. No organic acid
      abnormality was found on screening of asymptomatic family members. Patients were
      of either sex, and became symptomatic during childhood, with moderate to severe
      mental deficiency in all and definite cerebellar dysfunction in 7. Magnetic
      resonance imaging revealed an identical abnormal pattern with subcortical
      leukoencephalopathy, cerebellar atrophy, and signal changes in the putamina and
      dentate nuclei, in all patients. No specific biochemical function or catabolic
      pathway involving L-2-hydroxyglutaric acid is known in mammals, including humans.
      Preliminary loading and dietary studies failed to reveal the origin of the
      compound. The elevated CSF/plasma ratio suggests that it is in part generated
      within the central nervous system. This report describes a novel inherited
      neurometabolic disease, probably autosomal recessive, with distinct clinical,
      biochemical, and neuroimaging features.

PMID- 1642476
TI  - Neurology research: a journal survey, 1980-1990.
AB  - There have been major changes in neurology research during the past decade, but
      no systematic examination of the content, methods, funding, and research
      personnel. All scientific articles in the journals Annals of Neurology, Archives
      of Neurology, and Neurology were categorized by article type, number of authors,
      highest degree of first author, institution, disease area, research field, and
      source of support for the years 1980 and 1990. Original articles grew by 54% over
      the decade. The average number of authors increased by 1.3 to 5 (p greater than
      0.0001). Groups of MDs and PhDs wrote 39% of articles in 1990 (24% in 1980).
      Contributions with a diagnostic or therapeutic focus rose from 7 to 14%, whereas
      there was a pronounced drop in case reports from nearly 40% to just under 20%.
      Articles on movement disorders and neurodegenerative diseases increased more than
      100% and now together comprise more than 25% of original articles. Molecular
      biology increased by 1,600%, and there was significant growth in epidemiology,
      neuro-imaging, neurochemistry, and neuropsychology. The top 20 publishing
      institutions accounted for 40% of all original articles and 60% of US original
      articles. Foreign contributions doubled over the decade. The National Institutes
      of Health funded 46% of US articles in 1990 (35.5% in 1980). More than 80% of
      articles in 1990 on neurodegenerative disease were supported by the National
      Institutes of Health. The complexity of neurological research has driven greater
      collaboration between basic and clinical scientists. New areas of clinical and
      basic knowledge are rapidly emerging in neurology.

PMID- 1642475
TI  - Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke.
AB  - An open angiography-based, dose rate escalation study on the effect of
      intravenous infusion of recombinant tissue plasminogen activator (rt-PA) on
      cerebral arterial recanalization in patients with acute focal cerebral ischemia
      was performed at 16 centers. Arterial occlusions consistent with acute ischemia
      in the carotid or vertebrobasilar territory in the absence of detectable
      intracerebral hemorrhage were prerequisites for treatment. After the 60-minute rt
      PA infusion, arterial perfusion was assessed by repeat angiography and computed
      tomography scans were performed at 24 hours to assess hemorrhagic transformation.
      Of 139 patients with symptoms of focal ischemia, 80.6% (112) had complete
      occlusion of the primary vessel at a mean of 5.4 +/- 1.7 hours after symptom
      onset. No dose rate response of cerebral arterial recanalization was observed in
      93 patients who completed the rt-PA infusion. Middle cerebral artery division
      (M2) and branch (M3) occlusions were more likely to undergo recanalization by 60
      minutes than were internal carotid artery occlusions. Hemorrhagic infarction
      occurred in 20.2% and parenchymatous hematoma in 10.6% of patients over all dose
      rates, while neurological worsening accompanied hemorrhagic transformation
      (hemorrhagic infarction and parenchymatous hematoma) in 9.6% of patients. All
      findings were within prospective safety guidelines. No dose rate correlation with
      hemorrhagic infarction, parenchymatous hematoma, or both was seen. Hemorrhagic
      transformation occurred significantly more frequently in patients receiving
      treatment at least 6 hours after symptom onset. No relationship between
      hemorrhagic transformation and recanalization was observed. This study indicates
      that site of occlusion, time to recanalization, and time to treatment are
      important variables in acute stroke intervention with this agent.

PMID- 1642477
TI  - Plasma exchange in Guillain-Barre syndrome: one-year follow-up. French
      Cooperative Group on Plasma Exchange in Guillain-Barre Syndrome.
AB  - We report the one-year assessment of plasma exchange (PE) versus control in
      Guillain-Barre syndrome (GBS), based on a randomized multicenter clinical trial
      of 220 patients with GBS. Treated patients received four PEs, with either albumin
      or fresh frozen plasma (FFP) as replacement fluid. This study completes the short
      term analysis previously published (Ann Neurol 1987;22: 753-761). Long-term
      benefit from PE was observed, as demonstrated by full muscular strength recovery
      at one year: 71% in the PE group versus 52% in the control group (p = 0.007),
      confirmed after adjustment for four prognostic factors. FFP showed no additional
      benefit compared with albumin (77% full recovery in the FFP group versus 65% in
      the albumin group; p = 0.22). PE did not affect the incidence of severe motor
      disability (11% in both groups).

PMID- 1642478
TI  - Lack of major olfactory dysfunction in MPTP-induced parkinsonism.
AB  - The olfactory function of 6 patients whose parkinsonism was the result of
      intravenous administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)
      was compared to that of 12 age-matched patients with idiopathic Parkinson's
      disease (PD) and 10 age-matched normal control subjects. Unlike their PD
      counterparts, the olfactory test scores of patients with MPTP-induced
      parkinsonism did not differ significantly from those of control subjects. These
      findings suggest that MPTP-induced parkinsonism, unlike idiopathic PD, is
      unaccompanied, on average, by major alterations in the ability to smell.

PMID- 1642479
TI  - Recent advances in the design of HIV proteinase inhibitors.
AB  - Inhibition of HIV proteinase is currently one of the most widely studied
      approaches for chemotherapeutic intervention in the treatment of AIDS. A range of
      inhibitors of this essential enzyme has been designed from detailed knowledge of
      its mechanism of action and cleavage sites. These inhibitors have been classified
      according to their derivation. All are transition-state analogues and contain a
      hydroxyethylene, hydroxyethylamine, phosphinate or symmetrical moiety. Many of
      these inhibitors have high selectivity for the viral enzyme and significant
      antiviral activity. Advances in the design of HIV proteinase inhibitors that have
      been reported in the past year are reviewed.

PMID- 1642480
TI  - Antisense inhibitors of HIV: problems and perspectives.

PMID- 1642481
TI  - Challenges in the clinical development of antiretroviral drugs.

PMID- 1642482
TI  - Aryl phosphate derivatives of AZT retain activity against HIV1 in cell lines
      which are resistant to the action of AZT.
AB  - Novel aryl phosphate derivatives of the anti-HIV nucleoside analogue AZT have
      been prepared by phosphorochloridate chemistry. These materials are designed to
      act as membrane-soluble pro-drugs of the bio-active free nucleotides. In vitro
      evaluation revealed the compounds to have a pronounced, selective antiviral
      activity, which, in one case, was more potent than the parent nucleoside AZT. The
      magnitude of the biological effect varied considerably with the nature of the
      phosphate-blocking group. Moreover, one of the compounds, a phosphoramidate, is
      particularly active in a cell line restrictive to the activity of AZT, due to
      poor phosphorylation therein. These data support the suggestion that the
      phosphate derivatives exert their biological effects via intracellular release of
      the nucleotide forms.

PMID- 1642483
TI  - Clinical assessment of confusion in long-term care.

PMID- 1642484
TI  - A researcher as resource, mentor, and preceptor.

PMID- 1642485
TI  - How to behave at a research meeting.

PMID- 1642486
TI  - Predictors of general activity 8 weeks after cardiac surgery.
AB  - In this secondary analysis, the influence of mood states and self-efficacy
      beliefs on recovery of general activities 8 weeks after cardiac surgery were
      investigated. Study data were taken from a randomized clinical trial with 156
      subjects who were either in an efficacy enhancement nursing care group (n = 75)
      or in a routine care group (n = 81). It was found that self-efficacy beliefs at
      time of hospitalization regarding ability to resume general activities after
      discharge, measured tension/anxiety at 4 weeks after surgery, and experimental
      group status explained 21% of the variation in self-reported recovery at 8 weeks.

PMID- 1642487
TI  - Comparing two models of discharge planning rounds in acute care.
AB  - Rounds are a primary part of the discharge planning process in acute care
      hospitals. The multidisciplinary aspect of rounds has been accepted as a given,
      but the differences resulting from differently composed interdisciplinary groups
      functioning in rounds has not been investigated. This experimental study examined
      two models of discharge planning rounds and compared their effects on the process
      of probing, identifying, planning for, and following through on patient discharge
      needs.

PMID- 1642488
TI  - Uninsured maternity clients: a concern for quality.
AB  - Differences among demographic characteristics, health status indicators, and
      resource use of maternity clients privately insured, insured through public
      entitlement funds, or uninsured were examined in a public hospital. The uninsured
      were in their early twenties, black (44%), single (52%), lived in the central
      city area, employed in service occupations without health care benefits, and
      either sought prenatal care later in the pregnancy or not at all. Compared with
      the privately insured, the uninsured had more lifestyle risks. The uninsured
      women had a shorter hospital stay with more maternal complications. Insurance
      coverage and prenatal care were positive predictors of birth weight and lifestyle
      risk factors detracted. Length of stay was not influenced by insurance coverage
      but rather by health problems before delivery. Earlier discharge of the uninsured
      patients suggest the need for quality of care monitoring and outreach programs.

PMID- 1642489
TI  - Relationship between body image and chronic obstructive pulmonary disease.

PMID- 1642490
TI  - Effect of nitropaste administration times on sleep and nocturnal angina.

PMID- 1642491
TI  - Nurses' perceptions of reportable medication errors and factors that contribute
      to their occurrence.

PMID- 1642492
TI  - Motivation of subjects to participate in a research trial.

PMID- 1642493
TI  - Practice-based research in maternity nursing: issues and examples from studies of
      labor and birth.

PMID- 1642494
TI  - [How extensive can injury of the larynx in self-choking be?].
AB  - Is it possible to distinguish between suicidal and homicidal strangulation by the
      extent of the injuries of the larynx if the results of the police investigations
      are uncertain? Therefore evaluation of the German publications (115 reported
      cases of suicidal strangulation) and our own cases (17 cases). Hereafter more
      intensive injuries of the neck are extremely rare in cases of self-strangulation.
      Casuistic: Body of a 40 years old woman with signs of strangulation. The husband
      declared his wife strangulated herself in the bathtub with the belt of a
      bathrobe. Autopsy: Typical findings of drowning, intensive injuries of the neck
      tissues and the larynx. Kind and extent of the findings are speaking well for an
      assault mainly by manual strangulation. Undepending of the medical findings the
      police investigations are almost excluding a suicide. Condemnation of the
      husband.

PMID- 1642495
TI  - [An unusual case of suicide caused by electric current].
AB  - The authors describe a suicide case of a 37 year old master joiner caused by
      electricity. One wire was put around a neck and the other around the left wrist.

PMID- 1642496
TI  - [Unusual fatalities caused by glass splinter injury].
AB  - In the case of a thorax stab wound and an intrapulmonal position of the glass
      fragment (fall from a ladder into a glass door) an extrathoracic cardiac massage
      had been carried out. The result of which, an extremely unusual
      "reanimationtrauma" and the problems connected with it are discussed. In another
      case of a stab wound of the right iliacal vessels and the position of the glass
      fragment in the minor pelvis (jump through a thermopane glass of a door, followed
      by a fight) investigations were first conducted because of the suspicion of
      manslaughter. The autopsy, however, completely excluded death through fault of
      another. Further an unusual figured glass cut wound on the left side of the head
      (fall into a glass brick wall) led to death through gradual bleeding. The
      question arose whether death was caused by failure to give assistance.

PMID- 1642497
TI  - [Separation of stomach contents using the sieve-tower technique].
AB  - The authors present a method to separate and preserve stomach contents for
      forensic purpose. Analysis by "sieve tower" technique is simple and quickly done
      during autopsy. Solid phases of stomach content are arranged size up and can be
      stored for subsequent examinations. With the fluid phase drug analysis or
      microscopic analysis to confirm identy of the foodstuffs may be done. By adding
      alcohol (70%) enzymatic digestion and bacterial degradation of the stomach
      content are stopped.

PMID- 1642499
TI  - [Significance of tachycardia induced by atrial stimulation in Wolff-Parkinson
      White syndrome].
AB  - Increased atrial vulnerability is one of the criteria of malignant Wolff
      Parkinson-White syndrome. The aim of this study was to try to define the methods
      of induction of atrial tachycardias (tachycardia, flutter, fibrillation) by
      endocavitary and oesophageal stimulation characterising an increased
      vulnerability. The incidence of induced sustained tachycardia by fixed atrial
      stimulation at incremental rates until the Wenckebach point is attained and
      programmed atrial stimulation using 1 and 2 extrastimuli under basal conditions
      and then with isoproterenol was compared in subjects without cardiac disease,
      Wolff-Parkinson-White or spontaneous tachycardia (Group I) and patients with
      Wolff-Parkinson-White and spontaneous tachycardias (Group II). Atrial stimulation
      only induced tachycardia in 2.5% of normal subjects under basal conditions or
      with isoproterenol, by the endocavitary or oesophageal approaches. Programmed
      stimulation induced tachycardia in 15% of normal subjects under basal conditions
      or with isoproterenol by the endocavitary approach alone. In Group II,
      tachycardia was reproduced under basal conditions or with isoproterenol by atrial
      stimulation or programmed stimulation in all patients. In conclusion, the
      induction of a tachyarrhythmia by incremental atrial stimulation up to the
      Wenckebach point is always pathological even with isoproterenol. Programmed
      atrial stimulation is less specific except by the oesophageal approach. The use
      of bursts of very rapid stimuli in the Wolff-Parkinson-White syndrome is of no
      value as tachycardia can be induced by classical methods in all subjects at risk.

PMID- 1642498
TI  - [Multi-locus DNA fingerprints using oligonucleotide probe (CAC)5/(GTG)5 in the
      Chinese population].
AB  - In order to test the practical applicability of oligonucleotide fingerprinting in
      China we have investigated unrelated individuals, family members and a pair of
      twins from the Beijing area using the probe (CAC)5/(GTG)5. Except for the
      monozygotic twins highly variable banding patterns were demonstrated as expected
      for the randomly selected individuals but also for the relatives. On the basis of
      an initial survey of 50 unrelated individuals the calculated probability for
      obtaining by chance two identical multilocus patterns is very small (less than
      1.93 x 10(-13). Therefore it seems reasonable to conclude that like in
      caucasians, (CAC)5/(GTG)5 fingerprints are completely individual-specific also in
      this population. Therefore they have already been used successfully for
      identification purposes and paternity tests in many actual cases.

PMID- 1642500
TI  - [Transesophageal echography and peripheral arterial embolism. A new etiologic
      approach. Apropos of 87 cases].
AB  - This prospective study (September 1989 to November 1990) was undertaken to
      evaluate the utility of transesophageal echocardiography in acute peripheral
      ischaemic syndromes. After embolectomy or thrombolysis, 87 patients with an
      average age of 69.7 years underwent not only the usual investigations
      (conventional echocardiography, abdominal ultrasonography and Holter monitoring)
      but also transesophageal echocardiography within 2 days of the ischaemic events
      (lower limb 84%, multiple embolism 11%, recurrent embolism 13%). Atrial
      fibrillation was documented in 44 patients (50.5%), 19 patients had chronic
      arterial disease (22%), 8 patients had valvular heart disease (9%) and 2 patients
      had a blood disorder (2%). Transthoracic echocardiography only demonstrated one
      left ventricular apical thrombus whereas transesophageal echocardiography showed
      residual thrombus in 22 patients (25%) mainly in the left auricle but also in the
      descending thoracic aorta (8 patients) as a mobile, pediculated thrombus or
      lining an aortic aneurysm, thereby opening up new therapeutic possibilities. In
      addition, double aortic dissection was diagnosed in a patient who was not
      echogenic, isolated spontaneous contrast in 20 patients (23%) and other
      abnormalities in 7 patients (8%). Statistical analysis showed a significant
      relationship between the presence of thrombus and/or spontaneous contrast in the
      left atrium and/or left auricle and the size of the left atrium (Fisher test - p
      = 0.0073), and the presence of a supraventricular arrhythmia (chi 2 test).

PMID- 1642501
TI  - [Etiologic course of heart valve diseases surgically treated during 20 years in
      France].
AB  - The aim of this study was to analyse the evolution of the aetiologies of operated
      valvular heart disease over a 20 year period and to assess the consequences. Two
      thousand five hundred and ninety eight patients who underwent conservative
      surgery or valve replacement were included. This population was classified
      according to the date of surgery into 4 groups, each corresponding to a 5 year
      period. Analysis of these results, especially in the groups operated between 1970
      and 1974 and between 1985 and 1989 shows: 1) a change in aetiology: decreased
      incidence of rheumatic valvular disease (36 versus 61%) and an increased
      incidence of degenerative lesions (43 versus 23%) (p less than 0.0001); 2) a
      change in the valvular lesions operated, aortic stenosis has become the commonest
      operated condition (43 versus 27%) (less than 0.001); 3) an increased age (59 +/-
      14 versus 49 +/- 13 years, p less than 0.0001) with a higher proportion of
      patients over 70 years of age (22 versus 1%, p less than 0.001); 4) a higher
      incidence of mixed coronary and valvular surgery (11 versus 2%, p less than
      0.001).

PMID- 1642502
TI  - [Myocardial dissection in infarction of the right ventricle. Clinical
      echocardiographic and pathological aspects].
AB  - Dissection of the inferior wall of the right ventricle during the acute phase of
      myocardial infarction with right ventricular involvement is a mechanical
      complication which has been recently identified, the diagnosis being almost
      exclusively post-mortem. The authors report the clinical, echocardiographic and
      pathological features of myocardial dissection in four patients. Between 1985 and
      1988, the diagnosis of myocardial dissection was made by echocardiography in 4
      patients aged 77 to 80 years, admitted to hospital for an acute inferior wall
      myocardial infarction. All 4 patients had signs of acute right ventricular
      failure indicating right ventricular necrosis and a loud systolic murmur at the
      left sternal border; 2 patients were in shock. The ECG showed signs of inferior
      wall infarction with, in 2 patients, electrical changes suggestive of right
      ventricular involvement. Echocardiography showed dissection of the inferior wall
      of the right ventricle as a pulsatile, echo-free space in the diaphragmatic wall
      of the right ventricle which appeared to obstruct right ventricular ejection in
      end systole to a variable degree. The outcome was fatal in all cases with death
      resulting from refractory myocardial failure. Pathological analysis confirmed
      biventricular inferior wall infarction also involving the posterior part of the
      interventricular system, the site of a small tear on the left side which
      communicated with a neo-cavity dissecting the RV posterior wall. The right
      coronary artery was totally occluded in all cases. The anatomical lesions were
      fully concordant with the echocardiographic data: the dissection filled with
      blood from the left ventricle at each systole creating a pulsatile space in the
      diaphragmatic wall of the ventricle obstructing ejection.

PMID- 1642503
TI  - [Technical problems during coronary revascularization in case of massive
      calcified aorta].
AB  - A massively calcified ascending aorta which may make aortic clamping impossible,
      is a major obstacle to coronary revascularisation surgery. The aim of this study
      was to demonstrate that by the use of certain technical modifications, these
      patients can be treated even in multivessel disease. In the author's experience,
      two patients with this condition underwent complete revascularisation with a good
      surgical result controlled by angiography. The sites of arterial cannulation were
      the aortic arch in one case, the brachiocephalic artery and the common femoral
      artery in the other case. The ascending aorta was not clamped in either patient
      or used as the origin of the coronary bypass grafts. Myocardial protection was
      performed by systemic cooling with ventricular fibrillation without cardioplegia.
      The feasibility of these methods has led to the suggestion of a classification of
      the aortic wall according to peroperative palpation. This classification would
      provide indications for the use of technical modifications not only in extreme
      cases of aortic calcification but also in patients with severe atherosclerotic
      changes at high neurological risk; it would not, however, interfere with the
      classical technique of revascularisation.

PMID- 1642504
TI  - [Immediate and mid-term results of percutaneous pulmonary valvotomy in adults.
      Apropos of 10 cases].
AB  - Percutaneous pulmonary valvulotomy (PPV) is the treatment of choice for isolated
      congenital pulmonary stenosis of infancy. However, experience with this technique
      in the adult is much more limited. From November 1983 to November 1990, PPV was
      performed in 10 adults in our Institute. The mean age was 40 +/- 19 years (range
      21 to 71 years). Before PPV, 4 patients were in functional Class II and 6 in
      functional Class III of the NYHA classification. All procedures were successful
      with no complications. The right ventricular systolic pressure decreased from 98
      +/- 35 to 57 +/- 30 mmHg (p less than 0.01) and the mean pulmonary gradient
      decreased from 57 +/- 30 to 23 +/- 15 mmHg (p less than 0.01). The cardiac output
      was unchanged: 5.3 +/- 2.8 and 5.9 +/- 2.6 l/mn (not significant). Pulmonary
      valve area increased from 0.59 +/- 0.3 to 1.15 +/- 0.5 cm2 (p less than 0.01).
      The post-dilatation infundibular gradient was less than 10 mmHg in all patients.
      After an mean follow-up period of 29 +/- 26 months all but one patient (Class II)
      were in functional Class I. Exercise capacity was 6.9 +/- 2 Mets. Doppler
      echocardiography indicated a stable mean pulmonary gradient of 16.5 +/- 6.8 mmHg
      after PPV and 15.0 +/- 7.0 mmHg during follow-up. Pulmonary regurgitation was
      less than Grade I in all cases. In conclusion, PPV is an effective treatment for
      adult pulmonary stenosis and carries a low risk. The mid term results are
      excellent.

PMID- 1642505
TI  - [Oxygen free radicals in cardiology].
AB  - Oxygen free radicals are extremely toxic chemical entities derived from oxygen
      metabolism. This is a physiological process which explains a great deal of the
      phenomenon of phagocytosis. Under normal conditions, the body's natural defense
      mechanism neutralise the oxygen-free radicals as they are produced. In certain
      pathological situations, a disequilibrium is observed between the free radical
      aggression and the defense systems which creates an oxidative stress and organ
      damage. In cardiology, the oxidative stress occurs essentially in the phenomenon
      of reperfusion ischaemia. It is partially responsible for the reperfusion
      arrhythmias and myocardial stunning. An irreversible myocardial disease such as
      myocardial infarction, the responsibility of the oxidative stress is more
      uncertain. In myocardial protection during cardiac surgery the radical-induced
      damage occurs without it being possible to demonstrate the phenomenon in
      irreversible myocardial disease. The role of oxidative stress is unquestionable
      in myocardial reperfusion ischaemia. The detection of sensitive biological
      markers and a better understanding of the physiopathology should increase our
      knowledge of oxygen free radicals and enable effective treatment of their
      complications.

PMID- 1642506
TI  - [Should inferior myocardial infarction be thrombolysed?].
AB  - Recent randomised studies have demonstrated the benefits of administration of
      intravenous thrombolytic agents in the acute phase of myocardial infarction.
      Though the benefits are generally acknowledged in cases of anterior wall
      necrosis, the results in inferior infarction have been discordant. The early
      patency rate at 90 minutes after thrombolysis is lower in the right coronary and
      left circumflex than in the left anterior descending artery. The secondary
      reocclusion rate is twice as high on the right coronary artery. The significant
      increase in ejection fraction after thrombolysis has only been demonstrated in 2
      of the 8 studies in the literature. The benefits in terms of early mortality were
      not significant in the GISSI study. A significant decrease in early mortality
      (7.2% vs 8.8%) was observed only in the ISIS 2 study with streptokinase. The
      reinfarction rate at 1 year was twice as high when the initial infarct was on the
      inferior wall. Analysis of the results in the literature shows that the benefits
      of intravenous thrombolysis was clearcut in certain subgroups of inferior
      infarction: ST elevation in over 3 leads, mirror-image anterior lead changes,
      very early treatment (before the 3rd hour), complicated infarcts
      (atrioventricular block, right ventricular extension, hypotension) or in inferior
      infarcts occurring after previous anterior infarction.

PMID- 1642507
TI  - [Angiosarcoma of the aorta disclosed by intestinal metastasis].
AB  - The authors report a case of angiosarcoma of the descending thoracic aorta
      presenting with a metastasis of the small intestine. This is a very rare tumour
      in this localisation, two cases having been described among the 28 cases of
      aortic tumour reported in the literature.

PMID- 1642508
TI  - [Left coronaro-ventricular fistula after septal myectomy].
AB  - The authors report the case of a 17 year old patient operated for valvular aortic
      stenosis associated with severe hypertrophy of the interventricular septum. The
      operation consisted of aortic valve replacement and septal myectomy. Color-flow
      imaging in the postoperative period showed a coronary artery--left ventricular
      fistula in the region of the septal myectomy. In view of the small size of the
      fistula on echocardiographic examination and the absence of a codified strategy
      of management of acquired coronary left ventricular fistula after surgery, a
      simple Doppler echocardiographic follow-up was proposed in this case.

PMID- 1642509
TI  - [An unusual pericardial tumor: bronchogenic cyst].
AB  - The authors report the case of an intrapericardial bronchogenic cyst in a 42 year
      old woman with no cardiac symptoms. Despite extensive investigation, the final
      diagnosis was made only at anatomopathological examination. A pericardial
      localisation of this embryological tumour is very rare and a number of features
      of the condition are described. In this case, the carbohydrate antigen (CA 19-9)
      was a veritable marker of this tumour. This association, described for the first
      time, between a simple biological marker and an intrapericardial bronchogenic
      cyst, could be a valuable diagnostic aid in a pathology in which surgery could
      reasonably be deferred should the diagnosis of bronchogenic cyst be certain.

PMID- 1642510
TI  - [Function and pharmacology of potassium channels in heart and vessels].
AB  - The variability of the potassium channels in the cardiac tissues is remarkable.
      There are two main classes: voltage-operated channels and ligand-operated
      channels. The voltage-operated channels play a dominant role in the genesis of
      the resting potential (iK1) and the different phases of the action potential, the
      transient current ito during the initial phase of repolarisation, the iKp current
      and the slow current iK during the plateau phase. This class also includes the
      acetylcholine activated channel, iK(Ach). The ligand-operated channels seem to
      play a role in pathological situations such as ischaemia and anoxia: these
      channels are activated by a reduction in intracellular ATP or an increase in
      intracellular fatty acids or Na+. Substances blocking the iK and ito potassium
      channels have an anti-ischaemic effect. The agonists of ATP channels have a great
      therapeutic potential in vascular pathology, especially in the treatment of
      hypertension.

PMID- 1642511
TI  - [Structure and family of proteins, a puzzle].
AB  - It now seems quite clear that the number of modes of three-dimensional
      arrangement of peptide chains of globular proteins is much smaller than the great
      sequential variability would suggest. Structural families and super families are
      formed with members which show little if any sequential identity (in the
      statistical sense) with older members of these families. In addition, it is
      evident that many proteins are formed like puzzles, by the juxtaposition of
      domains and sub-domains. Each brick usually has a well-defined intrinsic
      biological function. The components of these macro molecular puzzles have very
      different sizes, from a few amino acids to complete protein globules of several
      hundreds of amino acids, via intermediary local secondary ans super-secondary
      structures. This building system, the result of a long evolution after
      duplication or replication of genes, offers banks (sequences and three
      dimensional structures) while limiting the complexity of the protein world.

PMID- 1642512
TI  - [Charles Dubost. 1914-1991].

PMID- 1642513
TI  - Activated species of oxygen: a challenge to modern pharmaceutical chemistry.

PMID- 1642514
TI  - [Cardenolide glycosides in Digitalis crossbreeds. Reciprocal crossbreeds of
      Digitalis lanata with other Digitalis species].

PMID- 1642515
TI  - Synthesis and antihypertensive properties of some dopamino-pyridazin-3(2H)-one
      derivatives.

PMID- 1642516
TI  - Bimanual skill development in pediatric below-elbow amputation: a multicenter,
      cross-sectional study.
AB  - The purpose of this study was to investigate the following in children with
      unilateral below-elbow amputation: (1) development of bimanual functional skills,
      (2) development patterns relative to able-bodied children, and (3) the
      relationship between duration of prosthetic wear and bimanual functional
      performance. Sixty-nine children with unilateral below-elbow amputation, all less
      than ten years old, were assessed on 14 prosthesis-assisted bimanual ADL,
      including play, feeding, dressing, and hygiene activities, which have been
      studied previously in able-bodied children. Bimanual ADL skill development was
      not delayed in five of the 14 comparisons to previously published standards, but
      most development patterns had multimodal, nonmonotonic performance profiles.
      Duration of prosthetic wear and other factors previously believed to contribute
      to good prosthetic function were not well correlated to ADL skills (r less than
      .52). Although these children had no CNS dysfunction, it is apparent that below
      elbow amputation impedes pediatric ADL skill development. The cause of these
      delays appears to be complex and is not expressed uniformly among all children;
      thus, the delays observed are not simply due to mechanical deficiencies of the
      prosthetic restoration.

PMID- 1642517
TI  - The team approach to treatment of the dizzy patient.
AB  - This report describes how a rehabilitation team treats dizziness and vestibular
      disorders. Team members include a nurse, physician, audiologist, physical
      therapist, occupational therapist, and a research scientist. Although unusual,
      this multidisciplinary approach, involving a close-knit group of professionals,
      is of great benefit in the treatment of vestibular and balance disorders.

PMID- 1642518
TI  - Muscular endurance and wheelchair propulsion in children with cerebral palsy or
      myelomeningocele.
AB  - Bivariate correlations between muscular endurance or resistance used during six
      repetition maximum (6-RM) for eight upper body exercises (shoulder flexion,
      extension, abduction, internal and external rotation, elbow flexion, extension
      and shoulder flexion/elbow extension (bench press), 50-meter dash, and 12-minute
      wheelchair propulsion tests were examined in six children with diagnoses of
      cerebral palsy or myelomeningocele. Correlations were determined before and after
      resistance training. Before training, only elbow extension correlated
      significantly with the 12-minute test. Following training, significant
      correlations (p less than or equal to 0.05) were found between all 6-RM exercises
      and 12-minute test scores. Additionally, significant correlations were found
      between all 6-RM exercises (except elbow flexion, which approached significance)
      and 50-meter dash scores. The results of this clinical case investigation
      indicate that the relationship between muscular endurance (6-RM) and wheelchair
      propulsion improves as muscular endurance increases.

PMID- 1642519
TI  - Venous thromboembolism in patients undergoing rehabilitation for stroke.
AB  - OBJECTIVE: To determine the incidence of venous thromboembolism during
      rehabilitation for stroke and to identify factors that alter its risk. DESIGN:
      Cohort. SETTING: Tertiary care stroke rehabilitation program. PATIENTS: 102
      consecutive patients undergoing rehabilitation for stroke. INTERVENTIONS:
      Impedance plethysmography (IPG) as routine screening and in patients with
      symptoms of deep venous thrombosis (DVT). MAIN OUTCOME MEASURES: DVT, pulmonary
      embolism (PE), death from PE. RESULTS: Venous thromboembolism was documented in
      11 patients (11%) an average of 60 days after stroke onset (range 14-138 days); 2
      patients (2%) died from PE. DVT was found on routine IPG screening in six
      patients and verified by IPG in two clinically symptomatic patients. The odds of
      developing venous thromboembolism was 17.6 (95% confidence interval: 2.2-143.5)
      in patients who were bedridden or wheelchair-bound at the time of admission.
      CONCLUSIONS: The incidence of venous thromboembolism is high and greatest in
      bedridden or wheelchair-bound patients undergoing stroke rehabilitation;
      randomized trials evaluating the safety and efficacy of screening and/or
      prophylaxis in such patients are required.

PMID- 1642520
TI  - Deep diaphragmatic breathing: rehabilitation exercises for the asthmatic patient.
AB  - A new diaphragmatic breathing technique practiced without the aid of a physical
      corset is outlined, and the findings from a study of its application in the
      respiratory rehabilitation of asthmatic patients are presented. Sixty-seven
      asthmatic adults randomly assigned to either deep diaphragmatic breathing
      training, physical exercise training, or a waiting list control group
      participated in a 16-week program. Deep diaphragmatic training resulted in
      significant reductions in medication use and in the intensity of asthmatic
      symptoms. Importantly, a nearly 300% increase in time spent in physical
      activities also resulted from deep diaphragmatic training. A follow-up at two
      months found many patients had returned to earlier medication levels and
      sedentary habits. A strengthened musculature can replace the need for a physical
      aid in this respiratory habilitation; adherence to its use may require
      individually-tailored encouragement.

PMID- 1642521
TI  - Nature, reliability, and predictive value of muscle performance measures in
      patients with hemiparesis following stroke.
AB  - The purposes of this investigation were to examine among a sample of hemiparetic
      stroke patients the nature and reliability of selected muscle performance
      measures and the correlation between the measures and gait speed. Fourteen
      subjects who met specific entry criteria participated. The Lido Active
      Rehabilitation System was used to obtain bilaterally all muscle performance
      measures of knee extension (velocity, isometric torque-peak and time specific,
      and time to peak torque and 90% peak torque). Gait speed was measured under both
      "comfortable" and "maximum safe" conditions. In addition to lower torques, the
      subjects demonstrated slower knee extension speeds and longer times to peak
      torque and 90% peak torque on the paretic than on the nonparetic side. High
      intrasession reliabilities were demonstrated for all muscle performance measures
      except the torque at 0.1 sec on the nonparetic side and the time to peak torque
      and 90% peak torque measures. Significant correlations were demonstrated between
      both gait speeds and paretic knee extension torque (except at 0.1 sec),
      nonparetic knee extension torque at 0.1 sec and 0.2 sec, and time to nonparetic
      peak torque. Muscle performance measures other than peak torque appeared to offer
      little advantage (alone) over paretic peak torque for predicting gait speed. Over
      74% of the variance in gait speed, however, could be predicted by the peak
      isometric peak torque of the paretic side and the time to peak torque on the
      nonparetic side, together. Thus, there may be benefits to testing the muscle
      performance of both lower extremities when examining patients with stroke.

PMID- 1642522
TI  - Assessment of aerobic power in chronic pain patients before and after a multi
      disciplinary treatment program.
AB  - Physical exercise is widely used in the treatment of chronic pain patients, and
      direct measurement of physical capabilities is needed to objectively document
      change. In this study, 46 residential chronic pain patients undergoing treatment
      at a multidisciplinary rehabilitation center were administered a cycle ergometer
      graded exercise test, using a Medical Graphics CAD/NET exercise system, to
      measure aerobic fitness and other physiological parameters before and after the
      four-week treatment program. Patients evinced highly statistically significant
      changes in all major indices of cardiopulmonary functioning, including MAXVO2 and
      METS, and a measure of lower body power (WATTS). Possible mechanisms underlying
      such dramatic changes in this short time period include improved physical
      fitness, learning or desensitization to symptoms associated with exertion, and
      improved effort. Documenting treatment-related changes is important, and
      metabolic exercise testing provides an objective method for assessing changes in
      functional capacities. Such changes may have important practical implications for
      these individuals. The importance of assessing and improving aerobic fitness in
      chronic pain populations is discussed.

PMID- 1642524
TI  - Cervical rotation lateral flexion test in brachialgia.
AB  - The cervical rotation lateral flexion test (CRLF test), developed earlier, was
      used to examine patients with brachialgia and thoracic outlet syndrome (TOS)
      symptoms to detect possible restriction of the movement of the first rib. The
      test was performed for 23 patients, five of them both before and after treatment.
      The patients were assessed independently by two clinicians to analyze the
      interobserver reliability. A cineradiographic examination was performed so that
      any restriction of the movement of the first rib during expiration and
      inspiration could be detected objectively. The interobserver repeatability of the
      test was excellent, thus making the cineradiographic examination unnecessary. It
      is recommended that this test be included in the clinical investigation of all
      patients with brachialgia with or without radicular pain.

PMID- 1642523
TI  - Silent ischemia in rehabilitation patients: limited clinical utility of
      electrocardiographic monitoring.
AB  - In a prospective blinded trial, 24-hour continuous electrocardiographic
      monitoring for silent ischemia was used to try to identify rehabilitation
      patients at risk for cardiac complications. Five of 42 patients had episodes of
      silent ischemia, none of which occurred during physical therapy sessions. One of
      these patients had syncope while wearing the Holter; none of the other four
      patients had significant cardiac complications during their rehabilitation, and
      all were discharged home. None of the patients without ischemia on the monitor
      had complications, but two patients of 14 whose ECGs precluded monitoring for
      ischemia had complications. In addition, six patients had episodes of
      nonsustained asymptomatic ventricular tachycardia, 12 had episodes of
      supraventricular tachycardia, and four had significant ventricular ectopy, all
      without clinical significance. Despite the apparent high sensitivity and
      specificity of the technique, the positive predictive value of monitoring
      eligible patients for silent ischemia was 20%. We conclude that ambulatory
      electrocardiographic monitoring for silent ischemia or ectopy has limited
      clinical utility in the rehabilitation population.

PMID- 1642525
TI  - Training effects during repeated therapy sessions of balance training using
      visual feedback.
AB  - Visual biofeedback of postural sway is currently being investigated as a
      therapeutic technique to reduce postural instability in selected patient
      populations. Before the efficacy of this type of therapy can be determined in a
      clinical setting, the performance curves of a normal population doing the static
      and dynamic balance training exercises have to be delineated. Two groups of
      normal subjects were evaluated during a daily and weekly protocol of dynamic
      balance exercises using visual feedback of their center of gravity (COG) and
      theoretical limits of stability. Static stability in a central position was
      measured with eyes open, eyes closed, and with visual feedback of the COG in a
      pre-therapy to post-therapy assessment. No significant change was observed in any
      of these variables from the pre-therapy to the post-therapy evaluation; as well
      there was no difference between the scores of both groups. Dynamic variables were
      evaluated in both a pre-therapy to post-therapy assessment, and over the course
      of therapy. Each of these protocols required the subjects to track targets
      representing 75% of their limits of stability on a computer screen with their
      COG. The time taken and the accuracy to move the COG cursor from target to
      target, as well as the body sway upon reaching the target were evaluated.
      Transition time and sway area both decreased significantly (p less than 0.01)
      from the pre-therapy to the post-therapy assessment for both groups, with path
      error decreasing significantly for the daily therapy group only. No significant
      difference was demonstrated between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642526
TI  - Spinal mobility and muscular strength: effects of supine- and prone-lying back
      extension exercise training.
AB  - This study compared the effectiveness of supine-lying back extension (SBE)
      exercise and prone-lying back extension (PBE) exercise on spinal mobility and
      muscular strength. A 3 (groups) x 4 (time frames) experimental design was used.
      Thirty-four healthy men (mean age, 23.1 +/- 2.1 years) were randomly assigned to
      three groups. Subjects in group 1 (n = 11) were trained using the SBE protocol,
      whereas those assigned to group 2 (n = 12) performed the PBE program. Subjects in
      group 3 (n = 11) received no exercise training and served as controls. The
      exercise programs were standardized and administered three times a week for 6
      weeks. The spinal range of motion (ROM) and back extension isometric force of all
      the subjects was evaluated before training, at the end of the third and sixth
      weeks of the study, and 9 weeks after the end of the exercise training. A two
      factor (group and time frame), repeated-measures ANOVA was used to determine
      significant differences in spinal ROM and back extension isometric force among
      the groups at the different time frames. The results of the statistical analyses
      showed progressive increases (p less than .05) in spinal ROM and isometric force
      after the exercise training; they had increased by 12.6% and 19.2%, respectively,
      at the end of the sixth week of training. The gain in spinal mobility was
      completely obliterated nine weeks posttraining. However, the improvement in
      muscular strength was sustained 9 weeks after the end of physical training. The
      SBE method was better for improving the spinal ROM, whereas the PBE method was
      more effective in augmenting muscular strength of the back.

PMID- 1642527
TI  - Hospitalizations for hip fractures among elderly persons in Hawaii, 1986-1990.
AB  - Hawaii differs ethnically, geographically, and culturally from other states;
      therefore, United States hip fracture data cannot be assumed to apply to Hawaii.
      The purpose of this research was to gain new knowledge about hip fracture in
      Hawaii to plan and target appropriate services and design preventive measures.
      Peer Review Organization Medicare data were analyzed for persons age 65+ over a 4
      year period. Average length of hospital stay was 20 days resulting in an average
      estimated charge per hospitalization of $20,000. Of those with E-Codes, 94%
      sustained falls. Fifty-five percent had one or more complicating illness.
      Unexpected significant differences were found among the islands: the average
      annual hospitalization incidence rate/1,000 on Kauai (8.4) was almost twice that
      of the Island of Hawaii (4.4), and Maui (3.9), and significantly greater than
      Oahu (5.4), primarily in women over 85. The island differences raise important
      questions in need of investigation, and suggest target populations and locations
      for prevention.

PMID- 1642528
TI  - Recovery from diffuse traumatic brain injury in Johannesburg: a concurrent
      prospective study.
AB  - Three hundred and twenty-six persons with light, moderate, or severe diffuse
      traumatic brain injury (TBI) were assessed during initial hospitalization in
      Johannesburg. One hundred and forty-four were followed up at approximately six
      months, 83 at 12 months, and 71 at 24 months posttrauma. The sample attrition
      rate was high. When patients could not be found, data were obtained from their
      caregivers. Recovery was measured in five different areas of functioning: family
      relationships, psychologic problems, activities of daily living (ADL), employment
      status, and physical status. Psychologic problems and family relationships
      worsened with time, but proficiency in ADL improved; physical and employment
      status remained relatively stable during the survey period. Severity of injury
      was significantly correlated with outcome in each functional area at some point
      in the follow-up period. Discrepancies between patients' and caregivers'
      perceptions of outcome were noted, particularly in the area of psychologic
      functioning. Caregivers tended to rate the recovery made by the patient as better
      than the outcome patients perceived themselves to have made. These differences in
      perception diminished with time. The multifactorial nature of recovery after TBI
      is indicated by the improvements seen in some functional areas and the worsening
      of outcome in other areas. These findings suggest that rehabilitation programs
      for persons with TBI should (1) include caregivers, (2) focus on the adjustment
      of both parties to their new circumstances, and (3) facilitate a convergence in
      their perceptions. Adequately defining recovery is a first step to estimating the
      prevalence of TBI, but necessitates further work. Epidemiology awaits a better
      understanding of the recovery process after TBI.

PMID- 1642529
TI  - Traumatic brain injury: family response and outcome.
AB  - Family outcome following traumatic brain injury has been the subject of
      investigation for nearly two decades. Researchers have reported on samples from
      Israel, Scotland, Denmark, England, and the United States. Cultural diversity as
      well as differences in design, assessment methods, injury characteristics, and
      definitions have contributed to difficulties establishing definitive conclusions.
      Findings indicate that patients' levels of emotional and personality disturbances
      are associated with levels of family disturbance, and are relatively more
      significant than physical disability. Undeniably, the long-term sequelae of
      injury have a long-term negative impact on families. Unfortunately, little has
      been done to establish the nature of family outcomes for patients younger than
      age 17, siblings, and less than severe injuries. Recent advances including
      development of valid measurement tools, definitions established through
      consensus, and multi-center collaborative research networks are promising and
      contribute to the likelihood of imminent progress.

PMID- 1642530
TI  - Independent insulin administration by the hemiplegic patient: stabilization of an
      insulin pen with a new device.
AB  - Diabetes mellitus is an independent risk factor for stroke, and the incidence of
      diabetes in patients presenting with stroke is 16% to 20%. Administration of
      insulin is an important activity of daily living that should be addressed in
      hemiplegic patients with diabetes. Presented here is a table-top clamp that can
      be used with an insulin pen allowing independent insulin dosing and subcutaneous
      administration with one hand. The clamp is built on a wood block base that is
      mounted to a smooth table surface by suction cups. Construction of the device is
      simple, inexpensive, and can be incorporated as a therapeutic project for the
      patient during the rehabilitation stay. A diabetic patient with a left hemiplegia
      is presented who demonstrated independence with the device prior to her discharge
      home.

PMID- 1642531
TI  - Diagnosis of myocardial contusion. Quantitative analysis of single photon
      emission computed tomographic scans.
AB  - Prior studies from our institution have shown that single photon emission
      computed tomography is sensitive (100%) in predicting patients at risk for
      serious arrhythmias. However, the positive predictive value is low (15% to 20%).
      The purpose of this study was to determine if quantitative analysis of single
      photon emission computed tomographic defects could improve predictive value. One
      hundred seventy-five patients with positive single photon emission computed
      tomographic scans were studied. One hundred two patients developed arrhythmias,
      42 of which were ventricular. Arrhythmias were associated with all defect loci
      and all defect sizes. The incidence of arrhythmias did increase with increasing
      size. Patients were at risk for arrhythmias up to 72 hours after trauma. The
      value of single photon emission computed tomography is its ability to predict
      patients at risk for arrhythmias. This study shows that any single photon
      emission computed tomographic defect, regardless of location or size, is a
      significant predictor of arrhythmias.

PMID- 1642532
TI  - Postinjury shock and early bacteremia. A lethal combination.
AB  - Gut bacteria translocation has been invoked as a prime cause of early postinjury
      death. To examine this hypothesis, we obtained emergency department blood
      cultures in 132 acutely injured patients requiring urgent laparotomy for trauma.
      In the latter half of these patients, mesenteric lymph node and liver biopsy
      cultures were also performed. The incidence of early bacteremia was 11% (10/94)
      in the patients without shock compared with 32% (12/38) in the group with shock.
      The majority (73%) were gram-positive bacteremias. Most notably, Staphylococcus
      was isolated in 13% (5/38) of the patients with shock, but these isolates were of
      no apparent clinical significance. In contrast, 18% (7/38) of the patients with
      shock had enteric bacteremias, and all of these patients died. Cultures were
      positive in 11% of the liver samples and 15% of the mesenteric lymph nodes. With
      the exception of two patients with concurrent enteric bacteremias, these hepatic
      and mesenteric lymph node bacteria were of no clinical significance. In
      conclusion, bacterial translocation occurs infrequently, and virtually all
      enteric bacteria were found in dying patients; the cause or effect remains to be
      defined.

PMID- 1642533
TI  - The catecholamine response to multisystem trauma.
AB  - We studied the catecholamine response in two groups of patients with multisystem
      injuries according to the presence (group 1, N = 124) or absence (group 2, N =
      82) of head injury. Markers of injury severity included the injury Severity
      Score, the Glasgow Coma Scale, the need for intubation, admission hypotension,
      the amount of blood products and fluid expanders administered during the first 24
      hours, and patient outcome. In group 1, higher norepinephrine levels always and
      epinephrine concentrations usually were associated with worsening indexes of
      injury severity. The best correlations were between the Injury Severity Score and
      the Glasgow Coma Scale and norepinephrine concentrations. In group 2, despite
      elevated catecholamine levels, such associations were seldom present. Thus,
      circulating catecholamine levels, especially norepinephrine levels, significantly
      correlated with the severity of injury in patients who had suffered multisystem
      injury, but only if the injury included the brain.

PMID- 1642534
TI  - The continuing dilemma of lobular carcinoma in situ.
AB  - We reviewed the courses of 250 consecutive women with lobular carcinoma in situ
      of the breast entered into the Surveillance, Epidemiology, and End Results
      program of the Michigan Cancer Foundation, Detroit, Mich, between 1973 and 1986.
      No patient had known invasive cancer at the time of initial entry. The average
      follow-up was 93.1 months; 212 patients had mastectomy for the initial lesion and
      65 patients had less than mastectomy, of whom one developed a new lesion in the
      ipsilateral breast. Thirty-seven patients (14.8%) were later found to have
      lesions in the contralateral breast, 25 within the first year. Thirteen of the 38
      lesions (5.2% of the total series) were invasive, and 11 were primarily ductal.
      Seventeen patients died, two of breast cancer, two of unknown causes, and 13 of
      non-breast-related causes. The maximum mortality from breast cancer is 1.6% to
      this point. The frequency of mastectomy fell from 78.1% in the years 1973 through
      1983 to 52% in 1984 through 1986, reflecting a change in surgical philosophy.
      Although no guarantees can be given to any individual patient, the great majority
      of patients with LCIS unassociated with a proved invasive cancer can be safely
      treated with less than mastectomy.

PMID- 1642535
TI  - Primary tumor size. Relevance to breast cancer survival.
AB  - In view of current emphasis on identifying prognostic factors for patients with
      early breast cancer, we studied the importance of tumor size to survival among
      1392 patients with primary operable breast cancer who were followed up
      prospectively. All patients had modified radical mastectomies. Nine hundred
      seventeen patients had negative nodes and did not receive postoperative adjuvant
      therapy. Four hundred seventy-five patients had node involvement and received
      combination chemoendocrine therapy. In a Cox's proportional hazards model, tumor
      size was a significant predictor of disease-free and overall survival when the
      number of positive nodes, estrogen receptor status, menopausal status, and race
      were considered. Among the node-negative group, tumor size explained considerable
      variation in disease-free and overall survival, varying from a 10-year disease
      free and overall survival of 80% and 99% for patients with estrogen receptor
      positive tumors measuring 1 cm or less to a 10-year disease-free and overall
      survival of 51% and 59% for patients with tumors larger than 5 cm.

PMID- 1642536
TI  - Hirschsprung's disease. Evaluation of mortality and long-term function in 260
      cases.
AB  - This report describes 260 patients treated for Hirschsprung's disease. There were
      213 boys (82%) and 47 girls (18%). Age at diagnosis was younger than 30 days in
      106 patients (41%), 1 month to 1 year in 90 patients (35%), and older than 1 year
      in 64 patients (25%). Diagnosis was achieved with barium enema and rectal biopsy.
      Aganglionosis involved the rectum or rectosigmoid in 174 patients (67%), the left
      colon in 38 patients (15%), and the proximal colon in 23 patients (9%); 25
      patients (9%) had total colonic aganglionosis. Enterocolitis occurred in 47 cases
      (18%). Following an initial colostomy or ileostomy, a definitive pull-through
      procedure was performed in 247 patients (95%) (modified Duhamel in 185, Soave in
      25, Swenson procedure in 15, and anomyectomy/sphincterotomy in 22); the overall
      survival rate was 93.8% (244 of 260 patients). An increased mortality was
      associated with Down syndrome, total colonic aganglionosis, and enterocolitis.
      Long-term follow-up (mean, 6 years 10 months) was available in 103 patients who
      underwent a Duhamel procedure. Sixty-seven (65%) had normal bowel function, 28
      (27%) occasionally used enemas or stool softeners, and eight (8%) had severe
      constipation or soiling. Bowel habits improved with time and were considered
      normal in 58% of patients at less than 5 years of follow-up and in 88% of
      patients at more than 15 years of follow-up. The Duhamel operation is a very
      effective definitive procedure for Hirschsprung's disease. Long-term follow-up is
      an important component of patient care.

PMID- 1642537
TI  - Transhiatal and transthoracic esophagectomy for adenocarcinoma of the esophagus.
AB  - Adenocarcinoma of the esophagus is no longer rare and is treated by resection. To
      determine whether the approach used for resection influences outcome, we studied
      88 patients who underwent resection; 14 had stage I or II disease, 74 had stage
      III, and 40 had stage IV. One third of those with Barrett's esophagus were noted
      on screening endoscopy to have potentially curable disease; the others were
      diagnosed with stage III or IV disease. Transhiatal esophagectomy was performed
      in 63 patients; 24 patients underwent transthoracic esophagectomy. We found no
      difference in survival or morbidity between transhiatal and transthoracic
      esophagectomy. Overall 5-year survival for stage I and II disease was 86%. For
      stage III and IV disease, 5-year survival was 14.5%. Aggressive surveillance of
      Barrett's esophagus facilitates the discovery of early disease. Esophagectomy for
      adenocarcinoma can result in cure of early cancers and improved palliation of
      more advanced disease.

PMID- 1642538
TI  - Effect of helium and oxygen on airflow in a narrowed airway.
AB  - A mixture of 80% helium and 20% oxygen has physical properties that increase
      airflow and decrease resistance in the airway when used as a portion of inspired
      gas. This study was designed to demonstrate and quantify the effects of a helium
      oxygen mixture in a normal airway and when airway resistance is increased. Thirty
      healthy volunteers were studied breathing room air and the helium-oxygen mixture
      through a normal airway and an airway that included a resistor. Pulmonary
      function tests, directed by a registered respiratory therapist, were performed on
      all subjects using a computerized spirometer. The functional vital capacity, one
      second forced expiratory volume, half-second forced expiratory volume, and peak
      inspiratory flow rate were analyzed. There was a statistically significant
      increase in 1-second forced expiratory volume using a helium-oxygen mixture in a
      normal airway. All pulmonary function test scores statistically improved when
      volunteers inspired helium and oxygen through the restricted airway,
      demonstrating that helium and oxygen can increase airflow in the presence of an
      increased airway resistance. This substantiates a role for helium and oxygen in
      treating conditions associated with decreased airway size and increased airway
      resistance.

PMID- 1642539
TI  - Carotid body tumor.
AB  - To better define the management and behavior of carotid body tumors, a 34-year
      surgical experience with 33 tumors in 30 patients was reviewed. There were 20
      women and 10 men with an age range of 20 to 78 years. All but one presented with
      a neck mass. Arteriography was performed on 21 patients and was diagnostic in
      every case. There was no surgical mortality. Complications occurred in eight
      patients (27%), and one long-term neurologic deficit occurred. Three of 33 tumors
      were malignant, and aggressive resection of all approachable disease with
      radiotherapy for unresectable metastases led to prolonged survival in each case.
      Carotid body tumors present with neck mass. Arteriography is diagnostic and
      surgery is indicated. Even for malignant tumors and metastases, aggressive
      resection and radiotherapy are indicated.

PMID- 1642540
TI  - Late results of suprarenal Greenfield vena cava filter placement.
AB  - Placement of the Greenfield filter above the renal veins was necessary in 71 (9%)
      of 821 total patients in the filter registries of two institutions. The status of
      60 patients (85%) could be verified, with follow-up data ranging from 18 months
      to 16 years (average, 53 months). Of 24 deaths (34%), none was from recurrent
      embolism or renal failure; death was most commonly associated with a malignant
      neoplasm. The recurrent embolism rate was 4%, identical to the infrarenal
      experience. Duplex evaluation of the filters in 22 patients, representing the
      majority (61%) of living patients, showed that all the filters were patent.
      Sixteen patients (41%) had lower-extremity edema that predated filter insertion,
      and in no patient did the results of noninvasive venous studies worsen. Filter
      fracture (two patients) or distal migration (two patients) had no clinical
      sequelae, and there was no evidence of renal dysfunction. For thrombus extending
      to the level of the renal veins or within them and for pregnant patients or women
      of childbearing age, suprarenal placement of the Greenfield filter is safe and
      effective, with no filter obstruction seen in follow-up extending to 16 years.

PMID- 1642541
TI  - Axillary-popliteal artery bypass provides successful limb salvage after removal
      of infected aortofemoral grafts.
AB  - Axillary-popliteal artery bypasses were placed to revascularize 28 extremities
      for 17 patients who were undergoing removal of infected aortofemoral grafts.
      Polytetrafluoroethylene (PTFE [polytef]) material was anastomosed to the above
      knee popliteal artery in 22 cases and to the below-knee popliteal artery in six
      limbs. All but one patient had axillary-popliteal grafts in place before excision
      of the aortic graft. In 12 groins, vein-patch angioplasty was performed after
      removal of the infected aortic graft to provide retrograde pelvic perfusion and
      maintain femoral patency for future reconstruction. Three patients (18%) died of
      septic-related, multisystem organ failure. With a mean follow-up of 25 months,
      primary patency was 75% at 1 year and 43% at 2 years. Secondary patency,
      maintained by thrombectomy (n = 7), revision (n = 3), and conversion to warfarin
      sodium (Coumadin) therapy (n = 6) was 100% at 2 years, and limb salvage was
      achieved for all surviving patients.

PMID- 1642542
TI  - Colon infarction after ruptured abdominal aortic aneurysm.
AB  - Colon infarction is a lethal complication of ruptured abdominal aortic aneurysm.
      We compared multiple anatomic, hemodynamic, and clinical features in 25 patients
      with ruptured abdominal aortic aneurysm who suffered colon ischemia and 25
      initial survivors of ruptured abdominal aortic aneurysm in whom this complication
      did not develop. Prior impressions notwithstanding, preoperative shock or volume
      administration did not correlate with the development of colon ischemia, nor did
      aneurysm location, cross-clamp site, graft type, or inferior mesenteric artery
      patency. However, patients with colon ischemia had a significantly lower
      perioperative cardiac output and were significantly more likely to have received
      alpha-adrenergic vasoconstrictor agents. Seventeen patients (68%) with colon
      ischemia died compared with nine patients (36%) without colon ischemia.
      Perioperative maintenance of cardiac output and avoidance of alpha-adrenergic
      vasopressor agents are critical elements in prevention of this lethal
      complication.

PMID- 1642543
TI  - Aortic aneurysmal disease. A generalized dilating diathesis.
AB  - The association of dilated peripheral arteries with aortic aneurysmal disease has
      previously been suspected, but is not well documented. To test this association,
      the diameters of the common femoral, popliteal, brachial, common carotid,
      internal carotid, and external carotid arteries were measured with a color-flow
      duplex scan in 30 control subjects and 36 patients with aortic aneurysm matched
      for age, sex, smoking habits, and hypertension. Mean peripheral artery diameter
      was significantly greater in patients with aortic aneurysm than in controls at
      all measurement sites. Peripheral artery dilatation was identified at sites that
      are seldom, if ever, involved in atherosclerosis. These findings lend support to
      the view that there is a generalized dilating diathesis in aortic aneurysmal
      disease that may be unrelated to atherosclerosis.

PMID- 1642544
TI  - The 'absent' appendix.
AB  - During an operation for suspected appendicitis, the surgeon concluded that the
      appendix was absent. The causes of this situation are presented and a guide to
      its management is suggested.

PMID- 1642545
TI  - Safety of surgical procedures.

PMID- 1642546
TI  - What is the meaning of labels on trauma care?

PMID- 1642547
TI  - Genetic characterization of simian immunodeficiency virus isolated from an
      African mandrill.
AB  - We constructed an infectious molecular clone of simian immunodeficiency virus
      from an African mandrill (SIVMND). Upon transfection, this clone directed the
      production of progeny virus particles infectious to and cytopathic for CD4+ human
      leukemia cells. Thirteen frameshift proviral mutants with an alteration in the
      eight open reading frames of SIVMND were generated by recombinant DNA techniques,
      and were analyzed biologically and biochemically. While mutations in the
      structural genes gag, pol, and env abolished viral growth and induction of
      cytopathology, mutants of the vif, vpr, and nef genes were fully biologically
      active. Of the tat and rev mutants, only one rev mutant grew in CD4+ cells with
      delayed kinetics. In reporter-based transient expression systems, transactivation
      potentials of the tat and rev mutants were evaluated. A mutant lacking 2nd coding
      exon of tat gene exhibited tat activity similar to that of the wild type clone.
      The infectious rev mutant was partially defective for rev gene activity.

PMID- 1642548
TI  - Transient expression of the coat protein of sugarcane mosaic virus in sugarcane
      protoplasts and expression in Escherichia coli.
AB  - The coat protein (CP) of strain SC of sugarcane mosaic virus (SCMV-SC) was
      expressed transiently in sugarcane protoplasts after electroporation with one of
      two plasmids encoding the CP gene. The CP gene was fused with either the
      cauliflower mosaic virus 35S promoter or the synthetic monocotyledon promoter
      "Emu". The coat protein gene was also inducibly expressed in Escherichia coli
      when fused to the trc promoter. The protein expressed in both systems had the
      same electrophoretic mobility and antigenic specificity as purified SCMV-SC coat
      protein. Transient expression of the 35S-CP gene in protoplasts could only be
      demonstrated in Western blots developed with the chemiluminescence enzyme
      substrate luminol.

PMID- 1642549
TI  - Expression of nef, vpu, CA and CD4 during the infection of lymphoid and monocytic
      cell lines with HIV-1.
AB  - The expression of the capsid antigen (CA) and the two regulatory proteins nef and
      vpu as well as the CD4 cell surface receptor was followed in HIV-infected
      lymphoid and promonocytic cells. In the lytic phase of infection all three viral
      proteins were expressed; production of these proteins coincided with the increase
      of CA antigen and infectious virus in culture supernatants and with prominent
      cytopathic effects. After selection of persistently infected cells, the number of
      lymphoid cells expressing detectable levels of nef decreased to zero; the number
      of cells positive for CA ranged between 40 to 70%. In chronically infected
      promonocytic cells nef and vpu expression was reduced to undetectable levels,
      whereas most of the cells accumulated CA intracellularly. Infectious cell free
      virus and CA in the supernatant of promonocytic cells had low titers. CD4 surface
      expression declined in all cell lines investigated before cell free virus was
      detectable.

PMID- 1642550
TI  - Comparison of hemagglutinating, receptor-destroying, and acetylesterase
      activities of avirulent and virulent bovine coronavirus strains.
AB  - Hemagglutinating and acetylesterase functions as well as the 124 kDa glycoprotein
      were present in the highly cell-culture adapted, avirulent bovine coronavirus
      strain BCV-L9, in the Norden vaccine strain derived from it, and in 5 wild-type,
      virulent strains that multiplied in HRT-18 cells but were restricted in several
      types of cultured bovine cells. The BCV-L9 and the wild-type strain BCV-LY-138
      agglutinated chicken and mouse erythrocytes. The acetylesterase facilitated break
      down of the BCV-erythrocyte complex with chicken but only to a minimal extent
      with mouse erythrocytes in the receptor-destroying enzyme test. Purified
      preparations of the vaccine and the wild-type strains agglutinated chicken
      erythrocytes at low titers and mouse erythrocytes at 128 to 256 times higher
      titers whereas receptor destroying enzyme activity was detectable only with
      chicken erythrocytes. When wild-type strains were propagated in HRT cells at low
      passage levels, they produced 5 x 10(5) to 4.5 x 10(6) plaque forming units per
      50 microliters which agglutinated erythrocytes from mice but not from chickens.
      Diisopropylfluoro-phosphate moderately increased the hemagglutination titers, but
      completely inhibited the receptor destroying enzyme of purified virus of all
      strains. It had virtually no influence on the plaque-forming infectivity of the
      different BCV strains. The acetylesterase of strain BCV-L9 reacting in the
      receptor-destroying enzyme test was stable for 3 h at 37 and 42 degrees C. It was
      inactivated within 30 min at 56 degrees C while the hemagglutinin function of
      this strain was stable for 3 h at 37, 42, and 56 degrees C, but it was
      inactivated at 65 degrees C within 1 h.

PMID- 1642551
TI  - Ultrastructure of lymphocystis disease virus (LDV) as compared to frog virus 3
      (FV3) and chilo iridescent virus (CIV): effects of enzymatic digestions and
      detergent degradations.
AB  - Ultrastructure of fish lymphocystis disease virus (LDV), the largest of all known
      icosahedral viruses, has been studied under electron microscopy using enzymatic
      digestions and detergent degradations. LDV structure appeared roughly the same as
      those of frog virus 3 (FV3) and chilo iridescent virus (CIV), two other well
      known viruses of the family Iridoviridae, although the great flexibility of its
      capsid as observed on negatively stained and shadow cast particles, and its three
      electron dense layers visualized in ultrathin sections, differed from
      observations made with the two other viruses. Specific degradation of the virions
      with enzymes or detergents revealed that the composition of the three
      iridoviruses was very much alike. In fact, their capsid was composed of two
      layers as observed in negative staining: an external one, which was removed
      following digestion with proteinase K, and an internal one which could be
      digested with phospholipase A2. Thus, the outermost layer is probably made of
      surface protein units, more or less tightly bound to each other, while the
      internal one would be a lipoprotein membrane. Consequently, these three
      iridoviruses appeared structurally related.

PMID- 1642552
TI  - The synergistic neutralization of Rift Valley fever virus by monoclonal
      antibodies to the envelope glycoproteins.
AB  - A panel of monoclonal antibodies (MAbs) mapping to different antigenic sites on
      the RVFV G1 and G2 proteins were used to examine the mechanisms involved in
      neutralization of the virus. Three types of synergistic neutralization of RVFV
      were observed on mixing various pairs of MAbs. Firstly, enhanced neutralization
      occurred for two MAb pairs that showed augmented binding for G2. These comprised
      a combination of a neutralizing MAb with a non-neutralizing antibody, as well as
      two antibodies which were non-neutralizing individually. In the second category,
      synergistic neutralization was observed between combinations of MAbs for which
      increased binding had not been detected. Lastly, mixtures of G1 and G2-specific
      MAbs were also capable of enhancing neutralization. Post-adsorption
      neutralization assays revealed that some MAbs neutralized cell-attached virus
      efficiently, indicating that they can neutralize by inhibiting the infection
      process after virus attachment. MAbs mapping to G1 IIe, G2I b and G2I c were
      unable to neutralize adsorbed virus and thus probably neutralize by preventing
      virus attachment to cells. Several G1-reactive MAbs displayed low level post
      adsorption activity, suggesting they may be capable of inhibiting RVFV
      infectivity at different stages of the replication cycle.

PMID- 1642553
TI  - Radioactive and enzymatic cloned cDNA probes for bovine enteric coronavirus
      detection by molecular hybridization.
AB  - Genomic RNA of F15 strain bovine enteric coronavirus (BECV) was cloned in E.
      coli. Three clones (174, 160, PG78), selected in the cDNA library, including a
      large portion of the nucleocapsid (N), matrix (M) and peplomeric (S) protein
      genes, were used as probes for a slot blot hybridization assay. Two probe
      labelling techniques were compared, radiolabelling with 32P and enzymatic
      labelling through covalent linkage to peroxidase and chemiluminescence detection.
      The radioactive probe 174 detected as little as 1 to 3 pg of viral RNA, while the
      less sensitive enzymatic probe could not reveal more than 100 pg of RNA. No
      significant detection amplification was achieved when a mixture of the three
      probes was used. Probe 174 allowed specific identification for BECV. No
      hybridization was noticed either with rotaviruses or even with other
      antigenically unrelated members of the family Coronaviridae such as transmissible
      gastroenteritis virus. The test proved valid for detection of BECV in the
      supernatant of infected HRT-18 cells: genomic RNA could be detected after direct
      spotting of samples, but prior nucleic acid extraction after proteinase K
      treatment improved virus detection. BECV diagnosis in faecal samples using
      enzymatic probe was compared with conventional diagnostic methods.

PMID- 1642554
TI  - Structural variability of env and gag gene products from a highly cytopathic
      strain of HIV-1.
AB  - The glycoprotein precursor of the highly cytopathic Zairian virus HIV1-NDK
      synthesized in CEM leukemic cells displayed a molecular mass of 140 kDa (gp140)
      as compared to the 160 kDa of gp160 of HIV1-LAV prototype strain. This precursor
      was cleaved to produce a smaller than prototype extra-cellular envelope
      glycoprotein (gp100) and a transmembrane component with a usual size (gp41).
      Immunoprecipitates from tunicamycin-treated infected cells demonstrated the
      presence of a non-glycosylated precursor of 100 kDa for HIV1-LAV prototype strain
      and 90 kDa for HIV1-NDK. Digestion of labeled precipitates with a mixture of
      endoglycosidase F and glycopeptidase F reduced the size of HIV1-LAV gp160 and
      gp120 to 100 and 60 kDa, respectively, while HIV1-NDK gp140 and gp100, after
      treatment with the same enzymes, displayed an apparent molecular mass of 90 kDa
      and 55 kDa, respectively. From these data we conclude that HIV1-LAV gp120 and
      HIV1-NDK gp100 differ both in their proteic moiety (60 kDa and 55 kDa,
      respectively) and in their carbohydrate moiety (60 kDa and 45 kDa, respectively).
      These differences could not be deduced from the available gene sequences of the
      two viruses. A chimeric virus containing the first 124 amino acid residues of the
      envelope glycoprotein coded by HIV1-LAV sequence and the rest by HIV1-NDK
      displayed normal size envelope glycoproteins, demonstrating the involvement of
      this N-terminal sequence in the alteration of the molecular mass characteristic
      of HIV1-NDK gp140 and gp100. Finally, characterization of the gag gene products
      from both strains demonstrated that HIV1-NDK p18 and p15 have a slower
      electrophoretic mobility as compared to its HIV1-LAV counterparts. Therefore,
      structural properties of HIV1-NDK env and gag products, reflected by their
      unusual electrophoretic mobilities, may be responsible for HIV1-NDK biological
      properties.

PMID- 1642555
TI  - Detection of a hepatitis B virus variant with a truncated X gene and enhancer II.

PMID- 1642556
TI  - Characteristics of a cetacean morbillivirus isolated from a porpoise (Phocoena
      phocoena).
AB  - A virus isolated from a porpoise during the 1988 seal epizootic was shown to be a
      morbillivirus. In order to determine the relationship of the virus to phocine
      distemper virus (PDV) a battery of monoclonal antibodies raised against canine
      distemper virus (CDV), PDV or the porpoise isolate were assessed for their
      ability to bind to CDV, PDV or porpoise virus epitopes in indirect
      immunofluorescence assays and ELISAs. The porpoise isolate contained several
      unique epitopes and several epitopes present on CDV and PDV were absent on the
      porpoise isolate. The data presented in this study indicate that the porpoise
      virus is an antigenically distinct morbillivirus and as such has been tentatively
      named as delphinoid distemper virus (DDV).

PMID- 1642557
TI  - PCR-amplification of influenza A virus specific sequences.
AB  - The possibilities of PCR-technique for rapid influenza virus A diagnostic using
      universal and M- or NS- gene specific primers were demonstrated. The results of
      PCR-analyses of specimens from people correlated with virological, serological
      and immunochemical data and the results of spot-hybridization test.

PMID- 1642558
TI  - An epidemic of non-A, non-B hepatitis in south Delhi: epidemiological studies and
      transmission of the disease to rhesus monkeys.
AB  - In November 1987 an epidemic of NANB-hepatitis broke out in a residential colony
      of South Delhi which lasted for nearly two months. The epidemic was caused due to
      the sewage contamination of the drinking water supply. Analysis of the
      epidemiological data showed that the disease was more common in the younger age
      group of 11-20 years and that both sexes were equally prone to the disease. The
      disease could be transmitted to rhesus monkeys by intravenous inoculation of the
      stool extracts from the patients. Experimentally infected monkeys showed elevated
      levels of serum aminotransferases and excreted the infectious agent in the
      stools. Hepatic lesions characteristic of enteric non-A, non-B hepatitis were
      observed in an infected monkey.

PMID- 1642559
TI  - Increased HIV-1 production in chronically infected H9 cells grown in protein-free
      medium.
AB  - Human T cell line H9 was established in a protein-free 1:1 mixture of Ham's F-12
      and IMDM. After 230 passages (3 years) in protein-free medium, the cells
      designated H9-PF were infected with HIV-1. The infectivity titers of HIV-1 in
      cell culture medium were monitored by determining the median tissue culture
      infectious doses (TCID50). Additionally, the production of viral antigen in cells
      was measured by an immunoenzymatical alkaline phosphatase anti-alkaline
      phosphatase (APAAP) method using a monoclonal antibody against HIV-1-p24 antigen.
      In acutely infected H9-PF and H9 cultures similar TCID50 values and percentage of
      cells positive for p24 antigen were found. In contrast, both TCID50 values and
      percentage of cells positive for p24 antigen were by far greater in chronically
      infected H9-PF than in H9 cultures.

PMID- 1642560
TI  - In vitro expressed HPV 8 E6 protein does not bind p53.
AB  - The oncogene E6 of human papillomavirus 8, which is associated with skin cancers
      in epidermodysplasia verruciformis, was transcribed and translated in vitro. The
      resulting 17 kDa protein did not bind to the cellular p53 in contrast to E6 of
      HPV16.

PMID- 1642561
TI  - The IgA and subclass IgG responses and protection in mice immunised with
      influenza antigens administered as ISCOMS, with FCA, ALH or as infectious virus.
AB  - Comparative studies on the local IgA, and circulating IgG subclass antibody
      responses of mice to A/Sichuan/2/87 (H3N2) influenza virus surface antigens
      administered with different carrier or delivery systems by the parenteral route,
      were carried out. The results obtained were compared with the responses observed
      following live influenza virus infection, and the protection afforded to these
      animals by these various preparations determined. Infection with live virus
      elicited early and high levels of protection against homologous virus challenge
      and this correlated with both local IgA and circulating IgG2a antibody levels.
      When incorporated into immunostimulating complexes (ISCOMS), A/Sichuan surface
      antigens promoted high levels of local IgA and circulating IgG1 antibody, and
      achieved a more rapid and more solid immunity against homologous virus challenge
      infection, than that elicited by the same surface antigens administered alone or
      together with Freund's complete adjuvant or alhydrogel.

PMID- 1642563
TI  - Fitting multichannel-compression hearing aids.
AB  - Multichannel hearing aids have been introduced recently in clinical practice. In
      this paper, some advantages and disadvantages of multichannel hearing aids are
      discussed. The advantages include an improved use of compression. However, the
      number of settings will be larger in multichannel hearing aids and exact
      knowledge of the goal to be pursued by compression is more necessary than ever.
      Inexactness of the definitions of these goals may have been a reason for the
      contradictory results in the studies on multichannel compression. A number of
      requirements must be fulfilled for a successful application of multichannel
      compression. One of these is detailed knowledge about the perception of
      suprathreshold signals. For that reason, an extension of the battery of tests
      commonly used in rehabilitative audiology is necessary. Another requirement is
      that the fitting strategy is determined by the purpose of applying compression.
      The objectives will be different for compression limiting and syllabic
      compression. A fitting procedure used in clinical practice has to take into
      account some limitations in the fitting time available. A number of possible
      fitting tools are discussed. Two strongly different fitting strategies for the
      same commercially available three-channel compression aid illustrate fundamental
      differences in fitting philosophy.

PMID- 1642562
TI  - Acute and latent infection of mice immunised with HSV-1 ISCOM vaccine.
AB  - The effect of immunisation with an HSV-1 antigen preparation (containing at least
      6 viral glycoproteins) on primary infection with HSV and the establishment of
      latency, was assessed in two mouse models (involving either skin or corneal
      challenge with virus). The vaccine preparation, given either with Freund's
      complete adjuvant or aluminium hydroxide gel or in the form of immunostimulating
      complexes (ISCOMS), induced high ELISA antibody responses (highest with HSV as
      the ISCOM preparation) and low levels of neutralising antibody. In both models,
      immunisation with the HSV ISCOM preparation significantly reduced the incidence
      of zosteriform spread of virus and the severity of disease and, in some cases,
      the incidence of latent infection in sensory ganglia. In the eye model it was
      possible to show that immunisation with the HSV ISCOMS restricted the
      establishment of latency almost entirely to the ophthalmic part of the trigeminal
      ganglion. Protection from establishment of latency correlated with prechallenge
      antibody levels.

PMID- 1642564
TI  - Diagnosis of middle ear disease with eardrum perforation by a newly developed
      sweep frequency measuring apparatus.
AB  - Dynamic characteristics of an artificial middle ear model with and without
      eardrum perforations were measured with our newly developed sweep frequency
      measuring apparatus. Then, the dynamic characteristics of patients with chronic
      otitis media having eardrum perforations and with traumatic perforations were
      measured with this apparatus, and the results were compared with those of the
      artificial middle ear model with an eardrum perforation. The comparison leads to
      the conclusion that the middle ear condition of patients with eardrum
      perforations can be distinguished on the basis of their measurement results.
      Furthermore, the ossicular chain conditions of patients with eardrum perforations
      can be diagnosed after putting a paper patch on the eardrum perforation.
      Therefore, this apparatus seems to be highly useful in the diagnosis of both
      ossicular chain disorders and eardrum perforations.

PMID- 1642565
TI  - Growth of evoked otoacoustic emissions during the first days postpartum. A
      preliminary report.
AB  - Evoked otoacoustic emissions (EOAEs) were recorded twice in 20 ears of 15
      newborns. The recordings were performed in a room of the well baby ward, using
      the ILO88 in its default setting, i.e. with click stimulation. On the first test
      occasion, the infants were between 3 and 51 h of age, and EOAEs were identified
      in 10 ears. On the second test occasion, while the infants were at least 1 day
      older (range 42-107 h), EOAEs were present in all ears. The second EOAE was
      stronger, so the EOAE appeared to grow in the first days postpartum. This might
      be due to middle ear clearance of amniotic fluid, shortly after birth. The
      results of the EOAEs of the second examination were compared with 10 EOAEs in
      adult ears. The response levels of the newborns were significantly higher than in
      the adults. The (cross)-correlation peak value of the two tests' waveforms is
      over 0.75, however sometimes only after filtering around the most pronounced
      emission frequencies. The study proves that newborns failing the EOAE screen in
      the first 24 h after birth can pass if retested 1 day later, simply because of
      growth of EOAE strength.

PMID- 1642566
TI  - Left-right asymmetries in hearing threshold levels in three age groups of a
      random population.
AB  - The average asymmetry between the hearing threshold levels in the left and right
      ears was analyzed in a random population (n = 3487) representing a normal
      population. Males and females of age groups 5-10 years, 15-50 years and over 50
      years were analyzed separately. A significant average inferiority of the hearing
      in the left ear was found at high frequencies, especially at 3-6 kHz, among adult
      males and females but not among children. A slight but statistically significant
      average superiority of the left ear at low frequencies was noted in all age
      groups. At corresponding hearing threshold levels at 4 kHz, the average
      inferiority of the left ear in the male population was significantly greater
      among subjects aged 15-50 years than among older subjects. In conclusion, the
      inferiority of hearing in the left ear at 4 kHz seems to be associated more with
      noise damage than with presbyacusis. The average interaural difference at 4 kHz
      was significantly more marked among subjects aged 15-50 years than among older
      subjects when analyzed at the corresponding threshold levels. These findings
      indicate a pathophysiological difference between noise damage and presbyacusis.

PMID- 1642567
TI  - Support for Corso's hearing loss model. Relating aging and noise exposure.
AB  - A brief review is provided of the variable ratio model [Corso, Audiology
      1980;19:221-232] for partitioning the effects of age and noise exposure in cases
      of occupational hearing loss. Data are presented from Rosenhall, Pedersen, and
      Svanborg [Ear Hear 1990;11:257-263] which support the variable-ratio model.
      Suggestions are offered for the application of the model in medico-legal cases of
      permanent hearing damage due to excessive noise exposure.

PMID- 1642568
TI  - Psychological and audiological correlates of perceived tinnitus severity.
AB  - Beliefs and attitudes towards tinnitus have been found to play an important role
      in the process of rehabilitation. The relationship between audiological,
      psychological and psychosomatic factors (self-assessment of vertigo and headache
      and the perceived severity of tinnitus) was investigated in a clinical population
      of 163 subjects. Audiological descriptives comprised pure-tone average (dB HL),
      etiology of hearing loss, duration of tinnitus and tinnitus localisation.
      Perceived severity of tinnitus was assessed with a questionnaire focusing on
      tinnitus impact on aspects of quality of life, concentration and sleep. A 28-item
      handicap and support questionnaire was used and factor analysed, resulting in
      three factors: perceived attitudes, social support and disability/handicap.
      Tinnitus severity was significantly related to perceived attitudes. The influence
      of social support on tinnitus severity did not seem to be crucial. The results
      showed that significantly more women than men complained about vertigo.
      Unilateral tinnitus localisation was also more prevalent in females. The subjects
      with multiple tinnitus localisations were older and had significantly more sleep
      disturbance than subjects with tinnitus localized to the ears only. In accordance
      with previously reported observations, the frequency of headaches was strongly
      correlated with the severity of tinnitus.

PMID- 1642569
TI  - The use of a BF3 remmeter to calibrate neutron activation foils in the medical
      linear accelerator environment.
AB  - A technique has been developed for radiation protection purposes whereby it is
      possible to measure the dose-equivalent due to neutrons from a dual energy
      medical linear accelerator using a conventional BF3 neutron remmeter to calibrate
      gold foils. This technique has been applied to measuring the neutron dose
      equivalent from a Philips SL75-20 medical linear accelerator. The tenth value
      distance for the entrance maze is 3.3 +/- 0.5m compared to a typically quoted
      value of 5m. This suggests that the use of wood and boron tiles in the
      construction of the entrance maze can reduce neutron propagation down the maze.

PMID- 1642571
TI  - X-ray field misalignment in screening mammography.

PMID- 1642570
TI  - Automatic counting of nuclear tracks.
AB  - Two software packages designed for automatic counting nuclear tracks are tested
      and compared. The image processing in the first package is divided into three
      parts segmentation, speckle elimination and removal of ill-formed track holes.
      The second package is also divided into three parts but the last part is modified
      such that the track holes with white centres are filled by the program. The
      processes in the second package are done by the use of mathematical morphology.
      From the test, it was found that the first package has severe limitations for the
      working range. The second package provides a greater working range but the
      running time of the program is longer than that of the first package.

PMID- 1642572
TI  - Do changes in transcardiac impedance modulation correlate with haemodynamic
      status?
AB  - Implantable cardiac pacemakers and defibrillators have the ability to revert a
      variety of arrhythmias to normal sinus rhythm. For correct operation, such
      devices require accurate arrhythmia classification. Arrhythmia classification by
      these devices could be improved with the addition of a suitable haemodynamic
      sensor. This study investigated the use of transcardiac impedance for
      haemodynamic sensing. Ventricular fibrillation, ventricular tachycardia, electro
      mechanical dissociation and five rates of ventricular pacing, each having a
      different associated level of haemodynamic compromise, were induced in each of
      seven mongrel dogs. The amplitude responses of the modulations of transcardiac
      impedance were compared with those of arterial pulse pressure (an established
      measure of haemodynamic status), and changes in cycle length. The correlation
      coefficient for changes in transcardiac impedance modulation amplitude and
      arterial pulse pressure was found to be 0.89. For transcardiac impedance
      modulation amplitude and cycle length, the correlation coefficient was 0.77, and
      for arterial pulse pressure and cycle length, the correlation coefficient was
      0.85. In the acute anaesthetised dog, changes in the amplitude of transcardiac
      impedance modulations were shown to reflect different levels of haemodynamic
      status.

PMID- 1642573
TI  - Auditory P300 studies in schizophrenic subjects and their first degree relatives.
AB  - Nineteen subjects with schizophrenia, 6 subjects with related disorders
      (schizophrenic spectrum disorders (S.S.D.)), and 20 unaffected first degree
      relatives from a sample of schizophrenic pedigrees, together with 35 normal
      control subjects, had auditory P300 evoked responses measured, using the "odd
      ball" paradigm for stimulation. Bipolar recording on the midline (CZOZ) and two
      contralateral sites (CZ-mastoid) was carried out. It was found that approximately
      40% of schizophrenics/S.S.D.'s had abnormal P300 responses. Abnormalities were
      seen in latency, RMS response voltage and in the left side response--right side
      response cross correlation coefficient. Schizophrenics/S.S.D.s showed responses
      which were topographically different than those of normal controls. Significant
      left-side/right-side response voltage asymmetry was not observed. In our study,
      only 10% of unaffected relatives of schizophrenics/S.S.D.'s showed abnormal P300
      responses.

PMID- 1642574
TI  - Tissue analysis using dual energy CT.
AB  - A new dual-energy x-ray CT algorithm is presented which makes use of both pre-
      and post-reconstruction data in an iterative manner to achieve accurate beam
      hardening correction and decomposition into basis materials. The technique does
      not require a calibration phantom and also does not require accurate estimation
      of the effective energies of the polyenergetic x-ray beams. It does however,
      require a knowledge of the incident x-ray spectra. For the situation where the
      incident spectra are unknown, a method is given whereby sufficiently accurate
      approximations to the spectra can be determined from attenuation measurements.
      Decomposition into basis materials makes use of spatial and energy information
      and an 'a priori' knowledge of the composition and attenuating properties of
      various tissue types. Any total number of basis materials may be used within the
      limitation that a subset containing a maximum of three materials is used for any
      individual pixel. Results of a computer simulation show that the algorithm
      produces accurate measurements of the concentrations of both high and low atomic
      number materials such as bone mineral, collagen, fat and air. However the results
      of a phantom study show that the measurement of the concentrations of low atomic
      number basis materials may be subject to systematic errors arising from
      uncertainties in the published values of linear attenuation coefficients.

PMID- 1642575
TI  - A visual evoked response simulator.
AB  - A Visual Evoked Response (VER) phantom, simulating a normal waveform response,
      has been designed to assist with calibration and quality assurance of ophthalmic
      electrophysiological instrumentation. This VER SIMulator (VERSIM) is based on a
      simple microprocessor design with a digitised waveform stored as an array in
      memory and converted to an analog signal when output. Frequency is controlled by
      a software delay between each byte of data output and a voltage divider network
      defines the range of voltages. To simulate a subject isolated from the electrical
      mains supply the VERSIM is battery powered.

PMID- 1642576
TI  - Optimization of a cord shielding technique for electrons.
AB  - Large anterior electron fields are sometimes used to irradiate the neck when
      treating head & neck tumors. To offer a degree of spinal cord shielding, wax
      bolus, approximately the width of the vertebral bodies, is placed on the
      immobilization shell. The thickness of the bolus is adjusted so that the
      radiological depth of the anterior edge of the vertebral bodies is equal to the
      R80 depth for the energy used. This approach ignores electron scattering. Using a
      CT study of a thyroid cancer patient, neck contours were generated at 0.5 cm
      intervals and entered into the Alberta Treatment Planning system. Internal
      contours for the trachea and vertebral bodies were added and CT information was
      used for treatment planning purposes. The bolus outline was added as described
      above, and the dose calculated using a 3D implementation of the M.D. Anderson
      (Hogstrom) algorithm. The calculation shows that the simple bolus technique
      described above is inappropriate. The spinal cord is adequately shielded, but the
      target volume is not covered by the 80% isodose line. Qualitatively, the results
      can be explained by the lateral scatter non-equilibrium introduced by the bolus.
      By iteratively adjusting the shape and thickness of the wax bolus and
      recalculating the dose distribution, we were able to better fulfill the dose
      prescription. Comparison with measured data shows reasonable, but not perfect
      agreement. In conclusion, electron beam treatments must be examined closely to
      ensure that the treatment goals are met. In some cases, treatment integrity may
      be compromised by incorrect assumptions regarding the nature of the electron
      transport and dose deposition.

PMID- 1642577
TI  - A contrast-detail study of interpolated scatter and glare correction of digital
      fluoroscopic images.
AB  - A scheme to correct for the effects of scattered radiation and veiling glare on
      the contrast of digital fluoroscopic images was investigated. The correction
      scheme is based on using spatial interpolation of signals generated in the
      shadows of a lead disk array, placed in the radiation beam. Contrast-detail plots
      obtained using the Leeds TO.10 test object, for corrected images were compared
      with those for unprocessed images, for images processed using digital contrast
      enhancement and for images acquired using a grid. It was found that substantial
      improvements in image contrast were obtained using the correction scheme.

PMID- 1642578
TI  - Deep vein thrombosis: aetiology, prevention and management.

PMID- 1642579
TI  - Deep vein thrombosis prophylaxis: a survey of current practice in Australia and
      New Zealand.
AB  - A survey of current practice for deep vein thrombosis (DVT) prophylaxis was
      undertaken in Australia and New Zealand. The most common indications for
      prophylaxis were a history of thrombo-embolism, the type and length of surgery
      and obesity. Prophylaxis was used in 65% of patients having hip surgery and in
      39% undergoing knee surgery. In general surgery the corresponding rate was around
      67% for colorectal surgery, hepatobiliary, upper gastrointestinal and major
      abdominal vascular surgery. Apart from open-heart cardiothoracic surgery (66%),
      use in other specialties was less than 50%. Physical methods (anti-embolism
      stockings, calf stimulation and calf compression devices) were most commonly used
      for prophylaxis (46%) with heparin being used by 40%. The main side effect
      reported with heparin was bleeding (18%). The estimated incidence of DVT and
      pulmonary embolus (PE) was 2.8 and 0.4% for general surgery, 2.7 and 0.7% for
      orthopaedic surgery and 6.6 and 1.3% for hip surgery. Intravenous heparin
      followed by oral anticoagulants was the most commonly used treatment for
      established DVT and nearly all respondents used intravenous heparin and oral
      anticoagulants for treatment of PE. Venography was the favoured objective test
      for diagnosing DVT. The principal reason for considering a change in prophylactic
      policy was the potential availability of an agent with increased efficacy and a
      reduced incidence of haemorrhagic complications.

PMID- 1642580
TI  - Prophylaxis against venous thrombosis after total hip arthroplasty.
AB  - Venous thrombosis rates were compared in 200 patients undergoing total hip
      arthroplasty and randomized to receive either fixed mini-dose warfarin (1 mg
      daily) or adjusted-dose warfarin to maintain an international normalized
      prothrombin ratio (INR) of 2.0-4.0. Bilateral lower limb venography was performed
      between days 11 and 13 inclusive. Fixed mini-dose warfarin was associated with a
      significantly higher rate of total thrombosis (P less than 0.05). General
      anaesthesia was associated with a significantly higher rate of thrombosis than
      spinal anaesthesia (P less than 0.05). Adjusted-dose warfarin was associated with
      more bleeding complications than mini-dose warfarin although these were not
      attributable to excessive anticoagulation. A single death from pulmonary embolus
      occurred in the early postoperative period in a patient receiving adjusted-dose
      warfarin.

PMID- 1642581
TI  - Duplex scan surveillance of infra-inguinal bypass grafts: the case for
      selectivity.
AB  - A consecutive series of 270 non-reversed infra-inguinal saphenous vein bypass
      grafts performed by the same surgeon between January 1986 and January 1991 was
      reviewed. The series included 250 in situ and 20 translocated non-reversed
      grafts. The aims were to calculate the number of duplex scans that would have
      been required for surveillance, to determine the value of a non-selective
      prolonged scanning regimen and to identify subgroups requiring more (or less)
      intensive surveillance. Indications were for critical ischaemia in 194 patients,
      popliteal aneurysms in seven patients and incapacitating claudication in 69
      patients. Patients were reviewed at 1 month and then at approximate 6 month
      intervals for symptoms and with resting and post-exercise ankle pressures.
      Primary patency of grafts placed to a popliteal distal anastomosis for critical
      ischaemia was 85% (s.e.m. 9.1%) at 3 years while secondary patency was 94%
      (s.e.m. 8.1%) at 4 years. Primary patency of grafts placed to a tibial artery or
      isolated popliteal segment was 68% (s.e.m. 8.4%) at 2 years while secondary
      patency was 76% (s.e.m. 9.9%) at 2.5 years. The difference in secondary patency
      between popliteal and tibial grafts was highly significant (P = 0.003). Tibial
      grafts required significantly more secondary early intervention than popliteal
      grafts. If recommended protocols for serial duplex scan (DS) surveillance had
      been followed, a minimum of 960 scans would have been required. If the tibial
      bypass group only had been monitored, 702 of these scans would have been avoided
      with a maximum loss of one popliteal graft and no limbs.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1642582
TI  - Coronary artery bypass surgery in young patients.
AB  - Coronary atherosclerosis is being increasingly observed in young patients.
      However results of surgery in such patients have so far been disappointing both
      in terms of operative mortality, symptomatic relief and long-term survival.
      Reasons given for this include the increased prevalence of risk factors in young
      patients and a higher incidence of graft occlusion. In the treatment of Asian
      patients, a further negative factor is the belief that coronary artery disease is
      more often diffuse and the vessels smaller. Between January 1987 and May 1991, a
      total of 66 patients under the age of 45 years at the time of surgery had
      coronary artery bypass grafting performed. The demographic, clinical,
      angiographic and operative data were analysed. Eighty-nine per cent of the
      patients were male and their racial distribution was 63% Chinese, 8% Malays, 26%
      Indians and 3% Others. Their mean age was 40.8 years. The presence of risk
      factors was high: 45.6% had hypertension; 34.8% were smokers; 21.2% had diabetes
      mellitus; and 12.1% had hyperlipidaemia. The main indication in these patients
      was either angina or a previous myocardial infarction (53%). There were no
      patients with perioperative infarction diagnosed by the presence of new Q wave.
      There was no hospital death. The stay of the patients ranged from 6 to 28 days
      with a mean of 10 days. Follow-up ranged from 3 to 54 months. There were no late
      deaths. It was concluded that there is a high incidence of risk factors among
      young patients with coronary artery disease, which follows the pattern of many
      other studies. The operative risk in these patients is low and morbidity is
      minimal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642583
TI  - Radiation therapy of glottic carcinoma: Peter MacCallum Cancer Institute
      experience.
AB  - The medical records of patients with T1N0, T2N0 and T3N0 squamous cell carcinomas
      of the glottis treated at the Peter MacCallum Cancer Institute between January
      1983 and October 1988 were retrospectively reviewed. One hundred and twenty-seven
      patients were identified. There were 93 T1, 26 T2 and eight T3 tumours. These
      patients were treated with curative radiotherapy (60-70 Gy). The survival from
      glottic cancer of patients with T1, T2 and T3 tumours at 5 years was estimated to
      be 97, 62 and 100% respectively. The local disease free survival for T1 and T2
      disease at 5 years was estimated to be 82 and 65% respectively. The local disease
      free survival for T3 tumours at 2 years was estimated to be 63% with 5 year
      survival not yet reached. The surgical salvage rates for 24 radiotherapy failures
      were 77, 25 and 66% for T1, T2 and T3 tumours respectively. Radiotherapy remains
      the treatment of choice for T1 tumours and a viable alternative to primary
      laryngectomy in more advanced glottic tumours, with salvage surgery in reserve.

PMID- 1642584
TI  - The abdominal cocoon.
AB  - Since it was first described in 1978 the abdominal cocoon continues to be a rare
      cause of intestinal obstruction. So far this rare condition where the small
      intestine is encased in a fibrous membrane has been reported only in females.
      Diagnosis is usually made at laparotomy and the treatment of choice is lysis of
      adhesions. Proper recognition of this benign condition will result in the correct
      management of it and prevent unnecessary bowel resections. Five new cases
      including one male patient, together with a review of previous reports in the
      English literature, are presented.

PMID- 1642585
TI  - Photodynamic therapy in the treatment of subcutaneously implanted human bladder
      tumour.
AB  - Photodynamic therapy (PDT) is an experimental treatment modality for malignant
      tumours. The effect of PDT with haematoporphyrin derivative (HpD) was studied
      using a human bladder tumour (BL-17) which was implanted subcutaneously (s.c.)
      into immunodeficient Balb/c nude mice. This model is only suitable for short-term
      investigation of PDT because of the high mortality that arises due to the immune
      deficiency of the animals. In a short-term observation (2 weeks post-treatment),
      HpD sensitized PDT was effective in the control of tumour growth, with 71% of
      tumours cured. The effect of PDT was found to be highly dependent on doses of HpD
      and/or the activating laser light. The comparison of PDT effects of the gold
      metal vapour laser (GMVL) and argon ion pumped dye laser (AIPDL) indicated that
      no significant difference exists between these two different laser sources for
      PDT. The irradiation with laser light alone and the administration of HpD alone
      had no significant effect on tumour growth.

PMID- 1642586
TI  - Management of the airway in oral and oropharyngeal resections.
AB  - A tracheostomy is the traditional method of maintaining an airway after major
      oral and oropharyngeal resections. Postoperative endotracheal intubation was used
      for 19 patients who underwent major oral and oropharyngeal resections over a 3
      year period at the Royal Adelaide Hospital. This appears to be a safe alternative
      to tracheostomy if intensive care facilities are available.

PMID- 1642587
TI  - Linitis plastica carcinoma of the colon mimicking Crohn's colitis.
AB  - Primary linitis plastica carcinoma of the colon is an uncommon morphological type
      of colorectal carcinoma. Linitis plastica of the stomach may spread to the colon
      producing a similar lesion to primary colonic linitis plastica. This case report
      describes a case of linitis plastica of the colon that had many of the clinical,
      endoscopic, radiological and operative features of Crohn's colitis. The precise
      origin of the linitis plastica carcinoma was not clear: it may have been clonic
      or gastric, although the former is favoured. This case illustrates a number of
      facets of this unusual colonic carcinoma.

PMID- 1642588
TI  - Major gastrointestinal haemorrhage from a metastatic testicular teratoma.

PMID- 1642589
TI  - Life-threatening glossopharyngeal neuralgia.
AB  - Glossopharyngeal neuralgia is a rare condition that, on occasions, may be
      associated with cardiac dysrhythmia. This case report describes the case of an 86
      year-old woman whose glossopharyngeal neuralgia was complicated by life
      threatening dysrhythmias and who was cured by posterior fossa rhizotomy.

PMID- 1642590
TI  - Psoas abscess following ingestion of psoas.
AB  - A case of right psoas abscess that was caused by duodenal perforation following
      the ingestion of a wooden skewer from a filet mignon is presented. Surgical
      repair of the perforation, drainage of the abscess and 5 days of intravenous
      antibiotics resulted in prompt recovery.

PMID- 1642591
TI  - Spontaneous rupture of a splenic artery aneurysm.

PMID- 1642592
TI  - Two difficult cases of craniocervical instability.

PMID- 1642593
TI  - Mucinous cystadenoma of the appendix: an unusual cause of recurrent
      intussusception in an adult.

PMID- 1642594
TI  - Veterinary education--the three-fold path to reform.

PMID- 1642595
TI  - Efficacy and safety of ivermectin applied topically to cattle under field
      conditions in Australia.
AB  - Fifteen controlled field trials were conducted to evaluate the efficacy against
      gastrointestinal nematodes and safety of ivermectin when applied topically to
      cattle in Australia. Three hundred and fifty-one cattle received ivermectin, and
      88 were untreated controls. The trials were conducted in 3 States and included a
      variety of cattle breeds and environmental conditions. Faecal samples were
      collected before treatment and 11 to 14 days after treatment for nematode egg
      counts. Data from these trials show that under Australian conditions, ivermectin
      applied along the mid line of the back from the withers to the sacral region at a
      dose rate of 500 mcg/kg body weight, effectively controlled gastrointestinal
      nematode infections, and did not produce unacceptable adverse reactions in the
      animals.

PMID- 1642596
TI  - Cryptococcosis in seven horses.
AB  - The clinical, radiographic and post-mortem findings in 6 horses with cryptococcal
      pneumonia and one horse with an abdominal cryptococcal granuloma are described.
      In pulmonary cryptococcosis, the lesions were either diffuse and multiple, with
      bilateral lung involvement, or localised mainly to the dorsocaudal region of one
      lung. The cases of diffuse multiple cryptococcosis were thought to be associated
      with haematogenous spread of the fungus after gastrointestinal infection and
      dissemination from regional lymph nodes. The localised form of the disease was
      thought to have been associated with inhalation of cryptococci. In all cases of
      pulmonary cryptococcosis, encapsulated yeast-like organisms were demonstrated in
      Wright's-stained sediment of tracheal washes. In the horse with the abdominal
      granuloma, cryptococci were present in a fine needle aspirate sample. Isolates of
      Cryptococcus neoformans var gattii were recovered from 2 of the 5 horses in which
      cultures were attempted. In addition to a history of previous illness that may
      have predisposed to infection, most horses in this report had been in areas in
      which Eucalyptus camaldulensis, or the closely related E rudis, were growing. In
      humans, an epidemiological relationship between E camaldulensis and infection
      with C neoformans var gattii has been suggested. Cases of equine cryptococcosis
      carry a poor prognosis and treatment was not attempted in any of these cases.

PMID- 1642597
TI  - Molecular pathotyping of two avian influenza viruses isolated during the Victoria
      1976 outbreak.

PMID- 1642598
TI  - Losses of sheep following adverse weather after shearing.

PMID- 1642599
TI  - Maple syrup urine disease in Poll Shorthorn calves.

PMID- 1642600
TI  - Protoporphyria in Limousin cattle.

PMID- 1642601
TI  - Beta-mannosidosis in Salers calves in Australia.

PMID- 1642602
TI  - Congenital hypotrichosis in Poll Dorset sheep.

PMID- 1642603
TI  - Pseudomonas pseudomallei infection in camels.

PMID- 1642604
TI  - Psychomotor change as a feature of depressive disorders: an historical overview.
AB  - Psychomotor disturbance has generally been viewed as a feature of all depressive
      disorders, merely varying in severity as a consequence of the mood state. As we
      have elsewhere argued for psychomotor change being specific to melancholia, its
      definition, measurement and capacity to sub-type depressive disorders may benefit
      from close consideration. Here we overview historical views and contemporary
      measures of psychomotor change, noting variable interest in behavioural
      manifestations of depression, as against symptoms, over time.

PMID- 1642605
TI  - Interpersonal sensitivity and the one-year outcome of a depressive episode.
AB  - Previous studies have demonstrated that abnormalities of personality can
      contribute to a poor prognosis following a depressive episode. In this study the
      relevance of a specific personality trait, interpersonal sensitivity, to poor
      outcome was examined. One hundred and eleven depressives completed the
      Interpersonal Sensitivity Measure (IPSM) twenty weeks after a baseline
      assessment. High scores on the IPSM were associated with a poor outcome at one
      year following the baseline assessment, judged according to whether they had
      remitted clinically or not and by the degree of change in depression severity
      measured using the Hamilton and Zung Depression Rating Scales. The relevance of
      this personality trait to the course and treatment of depression is discussed.

PMID- 1642606
TI  - Staff response to inpatient and outpatient suicide: what happened and what do we
      do?
AB  - Inpatient or outpatient suicide may have a marked effect on the staff or
      therapist. After reviewing the literature, a practical, clinically-based protocol
      for managing such an event is described. Additionally, it places one event, the
      psychological autopsy, within the general context of post-suicide management.

PMID- 1642607
TI  - General practitioners' reported knowledge about depression and dementia in
      elderly patients.
AB  - Previous studies have shown that general practitioners often fail to detect
      dementia and depression in their elderly patients. The present study aimed to
      find out how much knowledge general practitioners have of these disorders. The
      knowledge of 36 general practitioners was assessed and it was found that they had
      a limited knowledge of the symptoms and signs of dementia and depression.
      Furthermore, almost 60% of the general practitioners did not know that
      Alzheimer's disease is the most common dementing disorder.

PMID- 1642608
TI  - Alcohol-related problems in New Zealand women.
AB  - As total alcohol consumption has increased this half century in most developed
      countries, alcohol-related problems have become more frequent. Most research has
      either studied only men or failed to mention gender. This study examined the
      prevalence of alcohol problems and their socio-demographic associations in a
      random sample of New Zealand women. Women of younger age, who were unmarried,
      well educated, in employment, with child care support and who lived in rural
      communities saw themselves as having more problems with alcohol. Women who had
      experienced physical or sexual abuse as adults had increased rates of alcohol
      problems as did those with more psychiatric morbidity as assessed by the General
      Health Questionnaire and the short Present State Examination. However, women with
      multiple social roles, particularly caring responsibilities, were less likely
      than women with one or two social roles to view themselves as having alcohol
      problems. The data provided no support for the role strain hypothesis of alcohol
      abuse. It is argued that the findings support a social explanation for alcohol
      problems based on varying social sanctions on drinking and alcohol availability
      rather than a psychoanalytic one of unconscious conflicts over femininity,
      sexuality or female social roles.

PMID- 1642609
TI  - Psychiatric morbidity among Dunedin Chinese women.
AB  - A community postal survey of minor psychiatric morbidity among Chinese women
      living in Dunedin was conducted. The 28-item version of the General Health
      Questionnaire (GHQ-28) was used as the case identification instrument. The
      overall rate of psychiatric morbidity of Dunedin Chinese women did not differ
      from their European counterparts. The sociodemographic factors found to be
      associated with minor psychiatric morbidity included having no children, and
      being either very well or very poorly educated. Among (foreign born) migrants,
      those who were born in China, whose reason for migration was "follow the lead of
      their family" or "family reunion", had resided in New Zealand for ten years or
      more and spoke English infrequently tended to have higher psychiatric morbidity.

PMID- 1642610
TI  - Bush psychiatric services.
AB  - This is a description of the psychiatric services at present provided to the Far
      West Region of New South Wales. On account of the isolation of the region, and
      noting that the area probably has a higher than normal rate of psychiatric and
      psycho-social morbidity, there are special problems involved in the provision of
      comprehensive treatment services. I am the only resident psychiatrist within the
      region, and work as both a Visiting Medical Officer to the Broken Hill Base
      Hospital, to Wilcannia Hospital, and to the Prison Medical Service, as well as
      half time in private practice. The Mental Health Services to the area are at
      present being considerably expanded, and in this paper their structure and
      function will be described, and the special problems of providing a comprehensive
      service to an isolated area of the bush will be discussed. The inequity of
      service allocation to the region will be highlighted. It is noted that the
      region's total share of the financial mental health cake has dropped by about 40%
      in the last ten years as a result of the setting up of local community services
      and dramatically reduced in-patient hospitalisation costs in Sydney and Adelaide.

PMID- 1642611
TI  - The Broken Hill Psychopathology Project.
AB  - The main objective of this study was to describe the psychiatric disorders seen
      in patients presenting for treatment in rural New South Wales. The patients were
      seen primarily in the community, in both public and private practice, but also in
      the local base hospital and prison. Seven hundred and seven patients were
      consecutively examined during the study period. The results of this study were
      compared with a previous Australia-wide study to identify specific disorders that
      were more prevalent in rural areas. Alcohol abuse and dependence stood out as
      being much more prevalent. Life problems such as domestic violence, sexual
      assault, and incest occurred commonly in women referred for psychiatric
      assessment. More than ten percent of the study patients were children aged under
      17, who had similar prevalence rates of the various psychiatric disorders to a
      national comparison. It is concluded that alcohol abuse is very common in rural
      New South Wales, particularly in men, although there are also high rates in
      women, and this is probably related, in part at least, to the high rates of
      domestic violence, sexual assault and incest. It appears probable that there is a
      cycle of alcohol abuse in men leading to domestic violence and sexual abuse in
      women and children. This may contribute to the latter becoming anxious and
      depressed. The rates of the major functional psychiatric disorders were similar
      to those seen nationally. There is a great need for the maldistribution of
      psychiatrists between metropolitan and rural areas to be addressed.

PMID- 1642612
TI  - The relationship between risk factors for affective disorder and poststroke
      depression in hospitalised stroke patients.
AB  - The influence of psychiatric risk factors on the development of depression
      following stroke was examined in 88 patients undergoing inpatient rehabilitation.
      In this sample, 34 patients (38%) had a diagnosis of major or minor depression.
      Older age and a personal or family history of affective or anxiety disorder were
      associated significantly with major depression. Minor depression was more common
      among males and those patients with greater physical disability. Severity of
      depressive symptoms was associated with a personal or family history of affective
      or anxiety disorder and higher pre-stroke personality neuroticism. We conclude
      that certain psychiatric risk factors for affective disorder are strongly
      associated with poststroke depression. The implications of these findings for
      anticipating and managing poststroke depression are discussed.

PMID- 1642613
TI  - Psychiatric consultation in a spinal injuries unit.
AB  - The function of a consultation liaison service to a spinal injuries unit is
      described. Within this context, a study was conducted in which sociodemographic
      and clinical data were collected over a 4 year period for consecutive admissions
      to the unit. Data are presented for 227 patients admitted during this period.
      Forty-seven patients were found to have discrete psychiatric disorders (DSM III)
      which required treatment during the course of their inpatient care. For forty-two
      of these patients the psychiatric disorder first developed following spinal cord
      injury.

PMID- 1642614
TI  - The effect of computer-assisted interviewing on the clinical assessment of
      children.
AB  - This study investigated the effect of providing clinicians with a report from a
      computer-assisted interview conducted prior to the clinical assessment of
      children referred to a mental health service. The results suggest that the
      availability of reports from computer-assisted interviews influenced the type of
      problems identified by clinicians and the services that they recommended to
      manage the children's problems. It is suggested that reports from computer
      assisted interviews could assist clinicians by collecting a broad range of
      clinical information describing the problems of clinic-referred children. It is
      also suggested that considerably more research is needed into the possible
      benefits of computer technology in child and adolescent mental health services.

PMID- 1642615
TI  - Psychological adjustment of relinquishing mothers before and after reunion with
      their children.
AB  - A main objective of this study was to compare the emotional well-being of mothers
      who had already experienced a reunion with children relinquished two to four
      decades ago, with that of mothers who were still awaiting the possibility of such
      re-contact. A nationwide postal survey was carried out in New Zealand of the
      relinquishment experiences and subsequent adjustment of 238 women who had been
      able to re-contact their children and of 206 women who had not as yet made
      contact. The two subgroups did not differ on two standardised measures of
      psychological well-being (GHQ-28 and global self esteem). However, the post
      reunion women reported significantly greater improvements in their feelings
      connected with "adoption events", and also reported higher levels of perceived
      social support than did the pre-reunion women. Women who still lacked any
      information about their relinquished child showed significantly more negative
      affect and poorer psychological well-being than those who had at least obtained
      some non-identifying information.

PMID- 1642616
TI  - Immunological and psychological dysfunction in patients receiving immunotherapy
      for chronic fatigue syndrome.
AB  - Associations between immunological and psychological dysfunction in 33 patients
      with Chronic Fatigue Syndrome (CFS) were examined before and in response to
      treatment in a double blind, placebo-controlled trial of high dose intravenous
      immunoglobulin. Only those patients who received active immunotherapy
      demonstrated a consistent pattern of correlations between improvement in
      depressive symptoms and markers of cell-mediated immunity (CMI). This finding
      lends some support to the hypothesis that depressive symptoms in patients with
      CFS occur secondary to, or share a common pathophysiology with, immunological
      dysfunction. This pattern and the lack of strong associations between depression
      and immunological disturbance prior to treatment are less supportive of the view
      that CFS is primarily a form of depressive disorder or that immunological
      dysfunction in patients with CFS is secondary to concurrent depression.

PMID- 1642617
TI  - Predicting the outcome of schizophrenia ten years later.
AB  - A total of 407 new admissions to Woodbridge Hospital, Singapore in 1975 with a
      diagnosis of schizophrenia were examined 10 years later to determine which
      variables were predictive of outcome. Useful predictors were marital status,
      duration of illness and Feighner's diagnostic criteria. Fairly useful predictors
      were age, sex and educational status. Race, family history, suicidal behaviour,
      thought disorder, affective blunting, delusions and hallucinations were not
      useful for predicting long term prognosis.

PMID- 1642618
TI  - Looking beyond the 1:10,000 ratio of psychiatrists to population.
AB  - The frequently quoted ratio of 1:10,000 psychiatrists to population originated in
      Canada in 1962 and was later adopted as the minimum by the American Psychiatric
      Association. Since then both Canada and the United States have found this ratio
      to be inadequate. Canada has since advocated an optimal target ratio of 1:6,500,
      but recommended a more attainable pragmatic ratio of 1:8,000 for the foreseeable
      future. The Royal Australian and New Zealand College of Psychiatrists' recently
      recommended range of 1:7,500 to 1:10,000 is applauded. Reasons are given why a
      reasonable upper limit to the ratio of psychiatrists to population is desirable.

PMID- 1642619
TI  - Is mental disease just brain disease? The limits to biological psychiatry.
AB  - As a process of rational enquiry into an empirical field, psychiatry must submit
      itself to the same discipline as other areas of science. Effectively, it must
      show that its fundamental premises are both internally and externally consistent,
      and that its methods of investigation satisfy prevailing criteria of scientific
      methodology. When psychoanalytic psychology (and hence all psychodynamic models)
      and behaviourism were analysed from these points of view, they were found
      wanting. To date, there has been little or no meta-analysis of the third great
      school of psychiatric theorizing, biological psychiatry. A preliminary analysis
      establishes sharp limits to the notion that biological psychiatry is the "wave of
      the future". Like psychoanalysis and behaviourism, it cannot form the basis of a
      general theory of psychiatry. Since it lacks an adequate theoretical framework,
      the inescapable conclusion is that psychiatry is nothing more than protoscience.

PMID- 1642620
TI  - Encounter with neurophilosophy.

PMID- 1642621
TI  - Chance: a major factor in the causation of mental illness.
AB  - This paper questions the adequacy of traditional models of human behaviour,
      including models of functional mental illness. It is proposed that random
      (chance) variation is an invariable rule of nature which must apply to
      neurophysiological processes. Because of this, internal chance (random variation
      in neurophysiological processes) must be an important factor in determining the
      course and onset of mental illness. It is proposed that external chance-
      fortuitous changes in the complex pattern of interaction between physical and
      functional factors influencing behaviour--is also an important determinant of
      mental illness. It is proposed that many of the key characteristics of mental
      illness are explicable in terms of the properties of complex interactional
      systems.

PMID- 1642622
TI  - The quantum of meaning: an approach to the paradox of self-observation.
AB  - Self-observation contains a paradox largely unaddressed in current psychiatric
      theory. It is impossible to make "objective" observations of the meaning of our
      own thoughts and feelings because we use those very same thoughts and feelings to
      make our observations. Nevertheless most psychiatric theory assumes a clear
      separation between the internal part of ourselves which observes and that part
      which forms the object of our observations. Analogies from quantum physics can be
      used to elucidate this paradox. Once the complexities of self-observation are
      understood, so are many of the enigmas of psychotherapy.

PMID- 1642623
TI  - The evolution of community psychiatry.
AB  - Community Psychiatry is sometimes regarded as a separate and even as a recent
      study. The history of its evolution in Australia shows it to have resulted from a
      logical progression since the earliest days of the psychiatric services. The
      demand for care completely outstripped the accommodation available so two
      separate but parallel methods of dealing with this problem were evolved. The
      first explored how the numbers in the overcrowded hospitals could be reduced, and
      the second, the ways in which admission could be avoided. Both methods resulted
      in the expansion of community services. Present day activities must be viewed in
      this light and community services recognised to be an indivisible portion of a
      professionally organised total mental health organisation.

PMID- 1642624
TI  - Julius Wagner von Jauregg: a reappraisal.
AB  - A little more than half a century has passed since the death of Julius Wagner von
      Jauregg, a significant figure in the history of modern psychiatry. We believe
      that after this passage of time the life and work of Wagner von Jauregg deserve
      reappraisal.

PMID- 1642625
TI  - A history of the Lunatic Reception House, Darlinghurst.
AB  - The Lunatic Reception House at Darlinghurst operated between 1868 and 1961.
      Established to remove the stigma of criminality from the care of the insane, it
      operated as an observation ward and was for most of its time the sole portal of
      entry into metropolitan psychiatric hospitals in Sydney. An account of its
      inception and notable aspects of its history, with particular reference to lunacy
      legislation, is presented.

PMID- 1642626
TI  - Carbon monoxide, amnesia and hyperbaric oxygen therapy.
AB  - A case of carbon monoxide poisoning, initially misdiagnosed as conversion
      disorder, is presented. Cognitive deficits demonstrated at the time of
      psychiatric assessment were successfully reversed by hyperbaric oxygen therapy
      despite the 1 week delay. The clinical manifestations of carbon monoxide
      poisoning and the rationale for and timing of hyperbaric oxygen therapy are
      discussed. Emphasis is placed on the need for a high index of suspicion for
      carbon monoxide poisoning in the clinical situation of profound memory
      disturbance.

PMID- 1642627
TI  - Triazolam-induced nocturnal bingeing with amnesia.
AB  - A combination of behavioural and cognitive adverse effects is illustrated in this
      case report of a recurrent triazolam-induced eating disorder. The co-occurrence
      of bingeing, irritability and anterograde amnesia is suggestive of a drug-induced
      Kleine-Levin Syndrome.

PMID- 1642628
TI  - Sturge-Weber syndrome--a forgotten condition.

PMID- 1642629
TI  - The changing nature of psychiatry.

PMID- 1642630
TI  - The changing nature of psychiatry.

PMID- 1642631
TI  - Potentially reversible dementia.

PMID- 1642632
TI  - Monoamine oxidase inhibitors (MAOI) or reversible inhibitors of monoamine oxidase
      (RIMA)/tricyclic antidepressant (TCA) combination therapy.

PMID- 1642633
TI  - Chronic fatigue syndrome.

PMID- 1642634
TI  - Consent for ECT.

PMID- 1642635
TI  - Ethics and advertising.

PMID- 1642636
TI  - Psychiatrist-patient relationships.

PMID- 1642637
TI  - Quinone-induced DNA single strand breaks in rat hepatocytes and human chronic
      myelogenous leukaemic K562 cells.
AB  - In rat hepatocytes exposed to the quinones menadione and 2,3-dimethoxy-1,4
      naphthoquinone (2,3-diOMe-1,4-NQ) a decrease in NAD+ is observed. DNA damage and
      activation of poly(ADP-ribose)polymerase are often associated with a decrease in
      NAD+. Using rat hepatocytes and human myeloid leukaemic cells (K562), we examined
      the extent of DNA damage induced by these quinones at non-toxic concentrations,
      i.e. at concentrations at which the cells completely exclude the dye trypan blue.
      Both quinones caused significant DNA damage at very low concentrations (5-100
      microM). With 2,3-diOME-1,4-NQ (15 microM) or menadione (15 microM) single strand
      breaks (SSB) were observed at very early time points (less than 5 min), reaching
      a maximum between 20 and 30 min. Most SSB were repaired within 45 min of the
      removal of the quinones. Whilst extensive repair was observed within 4 hr of the
      removal of 2,3-diOMe-1,4-NQ (15 microM), only partial repair was observed
      following exposure to menadione (15 microM). SSB induced by 2,3-diOMe-1,4-NQ (15
      microM) were completely inhibited by the iron chelator 1,10-phenanthroline (25
      microM), whereas in cells exposed to menadione (15 microM) they were only
      partially inhibited. Finally, although the membrane integrity of K562 cells was
      unaffected by exposure to high concentrations of both quinones (less than or
      equal to 400 microM), cytostasis was observed at much lower concentrations (50
      microM). Our results demonstrate that at very low concentrations these quinones
      induce extensive DNA damage possibly caused by hydroxyl radicals. The DNA damage
      was accompanied by an early cytostasis but no loss of membrane integrity.

PMID- 1642638
TI  - Studies on the biochemical effects of the aldose reductase inhibitor 2,7
      difluorospirofluorene-9,5'-imidazolidine-2',4'-dione (Al 1576, HOE 843).
      Detection of D-glucaric and D-glucuronic acid excretion by high resolution 1H and
      13C NMR spectroscopy.
AB  - The effects of two aldose reductase inhibitors on the biochemical composition of
      rat urine were investigated using high resolution 1H and 13C NMR spectroscopy. We
      report the elevated excretion of D-glucaric acid (DGA) and D-glucuronic acid
      (GCA) following treatment with 2,7-difluorospirofluorene-9,5'-imidazolidine-2'4'
      dione (Imirestat, IM, Al 1576, HOE 843) at 50 mg/kg/day for 1 month, but not with
      3-4-bromo-2-fluorobenzyl-4-oxo-3-phthalazine-1-ylacetic acid (Ponalrestat,
      Statil), dosed at 50 mg/kg/day for 2 weeks. Sugar aciduria was also detected
      following treatment with the cytochrome P450 inducer phenobarbitone (PB) at 45
      mg/kg/day for 1 month, although the qualitative and quantitative pattern of
      excretion of sugar acids differed greatly between the IM and PB treatment groups.
      The levels of GCA excreted are elevated 11-fold by IM treatment from 19.0 to
      210.0 mumol/24 hr, but only 2.5-fold by PB, from 9.7 to 23.9 mumol/24 hr. DGA was
      not detectable in control urine, although levels did increase by 30% during the
      study from 7.5 to 10.9 mumol/24 hr, between day 8 and day 29, with IM treatment,
      and by 60% from 1.7 to 4.9 mumol/24 hr following PB administration for the same
      time period. This predominant elevation of DGA and GCA caused by IM treatment far
      exceeds previous records. In contrast, PB treatment resulted in an increase in
      intensity of a number of partially resolved sugar resonances, but at a much lower
      level than resulted from IM treatment. A raised level of DGA and GCA is usually
      associated with hepatic P450 induction; however, we report here profound DGA and
      GCA uria as a result of the inhibition of the aldehyde reductase, hexonate
      dehydrogenase (EC 1.1.1.19, EC 1.1.1.20). This mechanism is not closely linked to
      P450 induction, corroborating the current view that elevated excretion of DGA is
      not a reliable indicator of hepatic enzyme induction. This study further
      demonstrates the use of high resolution NMR spectroscopy in the detection of a
      novel biochemical effect which may go unnoticed during routine clinical chemistry
      tests.

PMID- 1642639
TI  - Inhibition of Trichomonas vaginalis ornithine decarboxylase by amino acid
      analogs.
AB  - Ornithine decarboxylase (ODC) from Trichomonas vaginalis was inhibited
      irreversibly by several substrate analogs. Of these, DL-alpha
      monofluoromethyldehydroornithine (MFMDO) and DL-alpha-monofluoromethylornithine
      (MFMO) were the most potent. The enzyme was unaffected by putrescine analogs
      suggesting that differences exist between the regulation of the trichomonad
      enzyme and that in other eukaryotes. In culture the ornithine analogs strongly
      inhibited putrescine synthesis and increased the generation time after 24 hr of
      exposure. In a semi-defined growth medium MFMDO methyl and ethyl esters increased
      the generation time from 4.5 hr to 9.0 and 8.2 hr, respectively. In standard
      undefined growth medium the trichomonad ODC was fully induced only after 15 hr
      (late log) and had an extended half-life of greater than 8 hr.

PMID- 1642640
TI  - The role of cytochrome P450 and cytochrome P450 reductase in the reductive
      bioactivation of the novel benzotriazine di-N-oxide hypoxic cytotoxin 3-amino
      1,2,4-benzotriazine-1,4-dioxide (SR 4233, WIN 59075) by mouse liver.
AB  - SR 4233 or WIN 59075 (3-amino-1,2,4-benzotriazine-1,4-dioxide) is a novel and
      highly selective hypoxic cell cytotoxin requiring reductive bioactivation for its
      impressive antitumour effects. Expression of appropriate reductases will
      contribute to therapeutic selectivity. Here we provide more detailed information
      on the role of cytochrome P450 and cytochrome P450 reductase in SR 4233 reduction
      by mouse liver microsomes. Reduction of SR 4233 to the mono-N-oxide SR 4317 (3
      amino-1,2,4-benzotriazine-1-oxide) is NADPH, enzyme and hypoxia dependent. An
      inhibitory antibody to cytochrome P450 reductase decreased the microsomal SR 4233
      reduction rate by around 20%. Moreover, studies with purified rat cytochrome P450
      reductase showed unequivocally that this enzyme was able to catalyse SR 4233
      reduction at a rate of 20-30% of that for microsomes with equivalent P450
      reductase activity. Exposure to the specific cytochrome P450 inhibitor carbon
      monoxide (CO) inhibited microsomal reduction by around 70% and CO plus reductase
      antibody blocked essentially all activity. Additional confirmation of cytochrome
      P450 involvement was provided by the use of other P450 ligands: beta
      diethylaminoethyl diphenylpropylacetate hydrochloride gave a slight stimulation
      while aminopyrine, n-octylamine and 2,4-dichloro-6-phenylphenoxyethylamine were
      inhibitory. Induction of SR 4233 reduction was seen with phenobarbitone,
      pregnenalone-16-alpha-carbonitrile and beta-napthoflavone, suggesting that
      cytochrome P450 subfamilies IIB, IIC and IIIA may be involved. Since cytochrome
      P450 and P450 reductase catalyse roughly 70 and 30%, of mouse liver microsomal SR
      4233 reduction respectively, we propose that expression of these and other
      reductases in normal and tumour tissue is likely to be a major factor governing
      the toxicity and antitumour activity of the drug.

PMID- 1642642
TI  - Inactivation of brain cortex muscarinic receptors by 4-diphenylacetoxy-1-(2
      chloroethyl) piperidine mustard.
AB  - We demonstrated in this study that 4-DAMP [4-diphenylacetoxy-1-(2- chloroethyl)
      piperidine] mustard, which cyclizes to the aziridinium ion, behaved as a non
      selective, non-competitive inhibitor of muscarinic receptors in rat brain cortex.
      It inactivated to the same extent the M1, M2 and M4 muscarinic receptors present
      in this tissue, as well as receptors accessible or not accessible to quaternary
      antimuscarinic drugs. Under mild incubation conditions, the muscarinic receptors
      in a state with super high affinity for agonists (SH receptors) were less
      affected by preactivated 4-DAMP mustard than the receptors in the states with
      lower affinity for agonists (H and L receptors).

PMID- 1642641
TI  - Effect of age and gender on the activity of human hepatic CYP3A.
AB  - Many pharmacokinetic investigations in the elderly population reveal decreased
      clearance of lipophilic drugs metabolized by the cytochrome P450 enzymes;
      however, few studies have evaluated aging-dependent or gender-related changes in
      specific cytochrome P450 enzymes. The clearance of quinidine, midazolam,
      triazolam, erythromycin, and lidocaine declines with age; these drugs are
      metabolized by the isoform, CYP3A. To determine whether these metabolic effects
      are due to changes in CYP3A, the effects of age and gender on CYP3A activity were
      examined. The activity of the human hepatic cytochrome P450, CYP3A, was
      quantified in vitro as erythromycin N-demethylation in microsomes prepared from
      forty-three resected human liver specimens obtained from patients, age 27 to 83,
      with normal liver function. Erythromycin N-demethylation varied 5-fold in human
      liver microsomes. CYP3A activity was 24% higher in females than males (P =
      0.027). CYP3A activity did not correlate with age, smoking status, ethanol
      consumption or percent ideal body weight. Large interindividual differences and a
      small female-specific increase in CYP3A activity were obtained. However, CYP3A
      activity was unaffected by age over the range of 27-83 years, suggesting that the
      aging-related alteration in the clearance of CYP3A substrates is secondary to
      changes in liver blood flow, size, or drug binding and distribution with aging.

PMID- 1642643
TI  - Stereoselective interactions of ketoprofen glucuronides with human plasma protein
      and serum albumin.
AB  - A clearance pathway common to many aryl alkanoic acids is the generation of
      renally eliminated ester glucuronides. These metabolites are susceptible to
      systemic hydrolysis which generates the parent aglycone. We have conducted in
      vitro studies with biosynthetic R- and S-ketoprofen glucuronides to elucidate the
      mechanism of this phenomenon. These conjugates were incubated in human plasma,
      various concentrations of human serum albumin (HSA) and protein-free buffer. It
      was apparent that albumin, rather than plasma esterases, catalysed the hydrolysis
      of the glucuronides. The albumin-catalysed hydrolysis of ketoprofen glucuronides
      was highly stereoselective. The mean (+/- SD) hydrolysis half-life of R
      ketoprofen glucuronide in plasma (N = 4) at physiological pH and temperature was
      1.37 (+/- 0.30) hr. The corresponding value for S-ketoprofen glucuronide, 3.46
      (+/- 0.84) hr, was significantly different (P less than 0.005). In contrast,
      synthetic ethyl esters of R- and S-ketoprofen were hydrolysed by plasma
      esterases, but not by HSA, and with little stereoselectivity. The reversible
      protein binding of ketoprofen glucuronides was determined at physiological pH and
      temperature by a rapid ultra-filtration method. The binding of R- and S
      ketoprofen glucuronide to human plasma protein was independent of concentration
      (P greater than 0.05) over the range of 1-20 micrograms/mL. The mean (+/- SD)
      percentage unbound in plasma (N = 4) of R-ketoprofen glucuronide was 12.6 (+/-
      1.4)%. The corresponding value for S-ketoprofen glucuronide, 9.12 (+/- 0.54)%,
      was significantly different (P less than 0.005). S-Ketoprofen glucuronide was
      also more avidly protein bound in physiological concentrations of HSA. However,
      this stereoselectivity decreased in more dilute HSA solutions. Based on the
      hydrolysis and protein binding data for ketoprofen glucuronides, we propose the
      existence of separate binding and catalytic sites on the albumin molecule for
      these metabolites.

PMID- 1642644
TI  - Effect of depolarizing agents on the Ca(2+)-independent and Ca(2+)-dependent
      release of [3H]GABA from sheep brain synaptosomes.
AB  - The purpose of the present study was to compare the effects of several
      depolarizing agents on both the membrane potential and on the release of [3H]
      gamma-aminobutyric acid (GABA) from sheep brain cortex synaptosomes. We examined
      the effects of KCl, 4-aminopyridine (4-AP), veratridine, ouabain and
      tetraphenylphosphonium cation (TPP+) on Ca(2+)-independent (carrier-mediated) and
      Ca(2+)-dependent (exocytotic) release. We found that, in the absence of Ca2+, KCl
      at 40 mM releases 7.57 +/- 0.65%, veratridine at 50 microM releases 45.85 +/-
      2.48%, ouabain at 1 mM releases 8.62 +/- 0.93% and TPP+ at 1 mM releases 4.09 +/-
      0.37% of the total accumulated neurotransmitter, provided that the external
      medium contains Na+. These are about the maximal values of release obtained with
      each depolarizing agent in a Na+ medium and in the absence of Ca2+. Replacing
      external Na+ with choline blocks the release observed in the presence of the
      depolarizing agents in the absence of Ca2+, and this divalent ion can increase
      [3H]GABA release only for K+ or 4-AP. Synaptosomal depolarization requires Na+
      except for K+ depolarization. Furthermore, although Ca2+ stimulates the release
      of [3H]GABA due to K+ depolarization (13.56 +/- 0.44%) or due to 4-AP (4.26 +/-
      0.51%), it inhibits the release due to the other depolarizing agents. The amount
      of [3H]GABA released by 4-AP in Na+ medium (4.26 +/- 0.51%) is similar to that
      induced by KCl in the presence of Ca2+ in the absence of Na+ (3.39 +/- 0.29%)
      which represents only exocytotic release. This suggests that the Ca(2+)-dependent
      exocytotic release of [3H]GABA can be specifically induced by 4-AP in a Na+
      medium, or by KCl in the absence of Na+, as reported by us earlier. The
      observation that Ca2+ inhibits the Ca(2+)-independent release is of interest
      because it suggests that Ca2+ may modulate the release of cytoplasmic GABA
      probably by inhibiting the carrier-mediated release of GABA. It is of interest as
      to whether Ca2+ regulation depends on intracellular Ca2+.

PMID- 1642645
TI  - Characterization of cryopreserved rat liver parenchymal cells by metabolism of
      diagnostic substrates and activities of related enzymes.
AB  - The metabolism of testosterone and benzo(a)pyrene (BaP) which is mediated by
      diverse enzymes was determined in cryopreserved rat liver parenchymal cells and
      compared with that found in freshly isolated cells. In addition, the activities
      of single xenobiotic-metabolizing enzymes were measured by using specific
      substrates. The cytochrome P450 (P450)-mediated total metabolic conversion of
      testosterone was reduced to 55% in cryopreserved cells. The metabolite profile,
      i.e. the formation of single metabolites compared with total metabolic
      conversion, was however unchanged when compared with freshly isolated cells. A
      concomitant reduction in the activities of the involved P450 isoenzymes can
      therefore be postulated. The amount of detected phase I-metabolites of BaP was
      unaffected by the cryopreservation method. The formation of phase II-metabolites
      and total metabolic conversion of BaP in cryopreserved cells was however reduced
      to about 50-60%. The reduced glutathione S-transferase and more obviously phenol
      sulfotransferase activities measured in cryopreserved cells, may explain the
      impaired conjugation of BaP. The ratio between phase I- and phase II-metabolites
      was thus changed by cryopreservation. Density separation on Percoll yielded
      cryopreserved cells with a viability and metabolic capacity not measurably
      different from freshly isolated cells. To this extent, cryopreserved, Percoll
      purified liver parenchymal cells are a useful in vitro system for drug metabolism
      studies. However due to the extensive loss in cell number during this procedure
      (recovery = 22% of freshly isolated cells) the application of this system is
      limited.

PMID- 1642646
TI  - Schizophrenic patients treated with high dose phenothiazine or thioxanthene
      become deficient in polyunsaturated fatty acids in their thrombocytes.
AB  - Total fatty acids were analysed in thrombocytes of schizophrenic patients treated
      with a "high dose" or "low dose" monotherapy of neuroleptic drugs phenothiazine
      or thioxanthene. The ratio of the very long chain fatty acid hexacosanoic acid to
      the long chain fatty acid docosanoic acid (C26:0/C22:0) increased in the "high
      dose" and "low dose" groups as compared to healthy untreated controls (P less
      than 0.05). The polyunsaturated fatty acid arachidonic acid decreased in the
      "high" and "low dose" groups (P less than 0.01 and P less than 0.05). The
      polyunsaturated fatty acids alpha-linolenic acid, eicosapentaenoic acid and
      docosahexaenoic acid were not detectable in most of the "high dose" schizophrenic
      patients, however, they were found in the "low dose" group and in the controls.
      There was a negative correlation between the daily dosage of phenothiazine and
      the percentages of the polyunsaturated fatty acids arachidonic acid and alpha
      linolenic acid+eicosapentaenoic acid+docosahexaenoic acid in thrombocytes (r = 
      0.87, P less than 0.01 and r = -0.81, P less than 0.01). Two patients of the
      "high dose" group with an especially high and long lasting monotherapy of
      neuroleptics were nearly devoid of polyunsaturated fatty acids in their
      thrombocytes. Untreated schizophrenic patients exhibited a fatty acid pattern in
      their thrombocytes not markedly different from that of the healthy untreated
      control group. We conclude that neuroleptic drugs phenothiazine or thioxanthene
      can alter the fatty acid pattern of thrombocytes.

PMID- 1642647
TI  - Effect of dietary lipids on levels of UDP-glucuronosyltransferase in liver.
AB  - Others have shown recently that dietary fish oil protects against acetaminophen
      induced liver injury in vivo. Fish oil was protective because it increased the
      clearance of acetaminophen via glucuronidation. This work left unresolved the
      basis for increased rates of glucuronidation in animals fed fish oil. We
      therefore have determined how the amount and type of lipid in the diet affect the
      activity of liver microsomal UDP-glucuronosyltransferase activity. Male Wistar
      rats were fed a fat-free diet or isocaloric diets containing 5% corn oil, olive
      oil or fish oil for 4 weeks. The activity of UDP-glucuronosyltransferase was
      highest in rats fed fish oil and lowest in rats fed the fat-free diet. Treatment
      with corn oil and olive oil resulted in intermediate levels of activity. Diet
      induced differences in amounts of UDP-glucuronosyltransferase were shown by
      immunoblotting and kinetic measurements. Treatment with fish oil resulted in a 3
      fold increase in the amount of UDP-glucuronosyltransferase versus the fat-free
      diet. Corn oil and olive oil diets caused 2-fold increases in the amount of UDP
      glucuronosyltransferase versus the fat-free diet. Fatty acid analysis of
      microsomal lipids showed that the fat-free diet was associated with decreased
      levels of arachidonic acid versus the corn oil or olive oil diets. The fish oil
      diet resulted in increased levels of omega-3 fatty acids versus the other diets.

PMID- 1642649
TI  - Acute effect of benfluorex on glucose metabolism.
AB  - The antihyperlipidaemic agent benfluorex [1-(3-trifluoromethylphenyl)-2-(2
      benzoyl-oxyethyl)-aminopropane] and its metabolite S422 [1-(3
      trifluoromethylphenyl)-2-(2-hydroxyethyl)-aminopropane] were examined for an
      acute (after 1-2 hr) effect on glucose metabolism in normal rats. Enteral
      administration of benfluorex (25 mg/kg) did not affect basal plasma glucose and
      insulin concentrations. However, enteral and intravenous glucose tolerance were
      modestly improved without enhancing the insulin response to glucose. Hepatic
      gluconeogenesis from lactate was not acutely altered by benfluorex (25 mg/kg) in
      vivo or by S422 (1 mM) in vitro, but S422 (1 mM) slightly reduced (by 11%)
      hepatic glycogen mobilization in vitro after 2 hr. S422 (1 mM) increased (by 47%)
      glucose oxidation by diaphragm muscle in vitro. The effect was additive to that
      of insulin. Anaerobic glucose metabolism and glycogenesis of diaphragm muscle
      were not affected by S422. The results suggest that benfluorex can acutely
      improve glucose tolerance associated with increased glucose oxidation by muscle.

PMID- 1642648
TI  - Quinone reduction and redox cycling catalysed by purified rat liver dihydrodiol/3
      alpha-hydroxysteroid dehydrogenase.
AB  - A highly active preparation of rat liver dihydrodiol/3 alpha-hydroxysteroid
      dehydrogenase was obtained using a newly developed, rapid purification scheme
      involving affinity chromatography on Red Sepharose. Depending on the coenzyme
      present, the purified enzyme was found to catalyse the oxidation of dihydrodiols
      and steroids or the reduction of substrates with carbonyl or quinone moieties.
      Using a wide range of synthetic quinones derived from polycyclic aromatic
      hydrocarbons (PAHs), we observed a pronounced regioselectivity of the quinone
      reductase activity. Good substrates were the o-quinones of phenanthrene,
      benz(a)anthracene, chrysene and benzo(a)pyrene with the quinonoid moiety in the K
      region which were reduced at rates of 1-10 mumol/min.mg enzyme. 1,4-Benzoquinone,
      naphthalene-1,2-quinone and benz(a)anthracene-8,9-quinone were also reduced at
      high rates. In contrast, alkyl-substituted quinones such as duroquinone and
      menadione were poor substrates for the enzyme. During the enzymatic reduction of
      several o-quinones, but not 1,4-benzoquinone, we observed the oxidation of large
      amounts of NADPH and the consumption of molecular oxygen which is indicative of a
      redox-cycling process. Thus, the reduction of quinones of PAHs may lead to a
      facilitated conjugation and excretion of these highly lipophilic compounds, but
      may also initiate toxic processes due to the formation of reactive oxygen
      species.

PMID- 1642650
TI  - The influence of ebselen on the toxicity of cisplatin in LLC-PK1 cells.
AB  - LLC-PK1 cells have been used as an in vitro model to study the nephrotoxicity of
      the antitumor drug cisplatin. A concentration-dependent cytotoxicity of
      cisplatin, measured as lactate dehydrogenase leakage and amount of protein
      remaining attached to the culture plate, was observed. At a cisplatin
      concentration of 0.4 mM cell viability was reduced to 21% after 72 hr. Ebselen, a
      seleno-organic compound capable of forming selenol intermediates through reaction
      with thiols, was found to protect LLC-PK1 cells against cisplatin-induced
      toxicity at low concentrations (5-15 microM). The ebselen-induced protection
      against cisplatin toxicity in this in vitro test system apparently correlates
      well with a similar protection previously observed in vivo in mice and rats.

PMID- 1642651
TI  - Reduced drug accumulation in a newly established human lung squamous-carcinoma
      cell line resistant to cis-diamminedichloroplatinum(II).
AB  - A human lung squamous-carcinoma cell line resistant to cis
      diamminedichloroplatinum(II) (CDDP), designated PC10-B3, has been established
      from the original cell line PC10 by a stepwise increment of the CDDP
      concentration. This is the first report, to our knowledge, to establish a CDDP
      resistant lung squamous-carcinoma cell line. PC10-B3 has continued to proliferate
      in the presence of 0.5 micrograms/mL CDDP, whereas PC10 could not survive. A 3
      (4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay revealed
      that PC10-B3 was 11.4-fold more resistant to CDDP than PC10 and cross-resistant
      to diammine(1,1-cyclobutanecarboxylate)platinum(II) (CBDCA) and 254-S, but not to
      doxorubicin or etoposide. PC10-B3 was characterized by a smaller DNA index and a
      larger cell size compared to PC10. The level of intracellular platinum
      accumulation was reduced by about 5- to 8-fold in PC10-B3 when compared with
      PC10, suggesting that reduced drug accumulation may be one of the important
      factors in contributing to CDDP resistance in PC10-B3.

PMID- 1642652
TI  - Comparison of azathioprine, methotrexate, and the combination of both in the
      treatment of rheumatoid arthritis. A controlled clinical trial.
AB  - OBJECTIVE: To compare the relative safety and efficacy of azathioprine (AZA),
      methotrexate (MTX), and the combination of both in the treatment of active
      rheumatoid arthritis (RA). METHODS: Two hundred twelve patients with active RA
      were entered into a 24-week prospective, controlled, double-blind, multicenter
      trial and were randomly assigned to 1 of 3 treatment groups. RESULTS: One hundred
      fifty-eight patients finished 24 weeks of the study. There were no remissions
      seen but response rates were greater than 30% for all outcome measures.
      Combination therapy was not statistically superior to MTX therapy alone, but both
      combination therapy and MTX alone were superior to AZA alone when patients were
      analyzed by intent-to-treat and with withdrawals treated as therapy failures. If
      only patients who continued taking the therapy were analyzed, the mean
      improvement was greater for AZA therapy than for MTX, while the combination
      remained the most active. Adverse effects on the gastrointestinal tract and
      elevations of liver enzyme levels were the most frequent causes for
      discontinuations. CONCLUSION: Both combination therapy and MTX alone were
      superior to therapy with AZA alone for active RA but were not statistically
      different in their effect on outcome assessment.

PMID- 1642653
TI  - Effect of gold compounds on the activity of adenylyl cyclase in human lymphocyte
      membranes.
AB  - OBJECTIVE: To determine the effects of aurothioglucose, aurothiomalate, and
      auranofin on basal and forskolin-activated adenylyl cyclase activity in human
      total lymphocyte membranes, and in membranes of T and B lymphocyte subsets.
      METHODS: Membranes were isolated from human total lymphocytes and T and B cell
      subsets. The effects of gold compounds on basal and forskolin-stimulated activity
      of adenylyl cyclase were measured by radioassay. RESULTS: The gold compounds
      inhibited adenylyl cyclase activity. This inhibitory effect required the presence
      of both the sulfhydryl ligands and aurous cation. CONCLUSION: Regulation of
      lymphocyte adenylyl cyclase by gold compounds represents a potential mode of
      action of these drugs in rheumatic diseases.

PMID- 1642654
TI  - Inhibition of the production of proinflammatory cytokines and immunoglobulins by
      interleukin-4 in an ex vivo model of rheumatoid synovitis.
AB  - OBJECTIVE: To assess the spontaneous production of proinflammatory cytokines and
      immunoglobulins in rheumatoid arthritis (RA) synovitis and modulation by
      interleukin-4 (IL-4). METHODS: We developed an ex vivo model of RA synovitis
      using pieces of RA synovium, and have studied the regulation of the production of
      IL-1 beta, IL-6, tumor necrosis factor alpha (TNF alpha), IgM, and IgG. RESULTS:
      Spontaneous production of proinflammatory cytokines in vitro was active, with
      prolonged cytokine gene transcription and translation. IL-6 was produced at
      higher levels than either IL-1 beta or TNF alpha, and explants produced more IgG
      than IgM. In contrast, IL-4 and interferon-gamma were undetectable. When pieces
      of synovium were incubated in the presence of IL-4, reduction of spontaneous
      proinflammatory cytokine and Ig production was observed. CONCLUSION: These
      results extend the observations of the antiinflammatory properties of IL-4 to an
      ex vivo situation, and provide the rationale for the clinical use of IL-4 in RA.

PMID- 1642655
TI  - Autoradiographic localization and analysis of endothelin-1 binding sites in human
      synovial tissue.
AB  - OBJECTIVE: To determine the localization of endothelin binding sites and
      immunoreactivity in human synovial tissues. METHODS: Quantitative in vitro
      autoradiographic and immunohistochemical techniques were used to localize and
      characterize 125I-labeled endothelin-1 (125I-ET-1) binding sites and endothelin
      like immunoreactivity in sections of rheumatoid, osteoarthritic, and normal
      synovium. RESULTS: Specific 125I-ET-1-binding sites, characteristic of the ETA
      receptor, were localized to the media of synovial blood vessels in all 3 groups.
      No difference was found in vascular binding site density in rheumatoid and
      osteoarthritic synovium. Endothelin-like immunoreactivity was localized to
      endothelial cells in blood vessels displaying 125I-ET-1 binding sites.
      CONCLUSION: We conclude that endothelin may act locally, modulating synovial
      perfusion and exacerbating hypoxia in chronic arthritis.

PMID- 1642656
TI  - The immunoglobulin kappa light chain repertoire expressed in the synovium of a
      patient with rheumatoid arthritis.
AB  - OBJECTIVE: To analyze the nature of the B cell response in the synovial tissue of
      a patient with rheumatoid arthritis (RA). Specifically, we sought to determine if
      the pattern of immunoglobulin expression was consistent with polyclonal
      stimulation of B cells or an antigen-driven response. METHODS: We generated an
      unrestricted complementary DNA (cDNA) library from the diseased synovium of a
      rheumatoid factor (RF)-positive patient with an 18-year history of RA. A random
      sample of kappa light chain recombinants was identified, and sequence analysis
      was performed. The variable domains were compared with an extensive database of
      germline and cDNA kappa sequences. RESULTS: We found a light chain repertoire
      enriched for kappa transcripts containing 2 V kappa gene segments (Humkv325 and
      Humkv328) that are frequently associated with paraproteins expressing RF
      activity. Kappa variable domains from synovium contained numerous somatic
      mutations which resulted in frequent replacement of amino acids that encode the
      classic antigen-binding site. Unexpectedly, many of these kappa transcripts
      contained non-germline-encoded nucleotides (N regions) at the site of V kappa-J
      kappa joining. The combination of N-region addition and variation in the sites of
      V kappa-J kappa splicing generated unusually long complementarity-determining
      region 3 regions and charged amino acids near the V kappa-J kappa splice site.
      CONCLUSION: The pattern of somatic mutations found in this patient sample
      supports the hypothesis that these synovium-derived plasma cells are the product
      of immunoglobulin receptor-dependent (i.e., antigen-driven) selection. The extent
      of N-region addition raised the additional possibility that these antibodies
      derive from an unusual set of B lymphocytes that have escaped normal regulation.

PMID- 1642657
TI  - Utility of high-resolution ultrasound for the diagnosis of dialysis-related
      amyloidosis.
AB  - OBJECTIVE: To evaluate the utility of real-time, high-resolution ultrasound of
      the shoulder in the diagnosis of dialysis-related amyloidosis. METHODS: We
      performed a case series study of 2 groups of patients seen at a referral-based
      clinic in a tertiary care hospital. The shoulders of 13 patients with normal
      renal function and of 38 patients receiving long-term hemodialysis were studied
      by real-time, high-resolution ultrasound. All hemodialysis patients were
      evaluated clinically for the presence of dialysis-related amyloidosis. Surgical
      specimens of joints were available for all 13 patients with normal renal function
      and for 17 of the 38 hemodialysis patients. These specimens were evaluated for
      the presence of beta 2-microglobulin (beta 2m) amyloid by Congo red and
      immunohistochemical staining. RESULTS: Two ultrasonographic findings were
      selectively observed in the dialysis patients with clinical and histologic
      evidence of beta 2m amyloid in comparison with patients with normal renal
      function and no evidence of amyloid: rotator cuffs greater than 8 mm in thickness
      and echogenic pads between muscle groups of the rotator cuff. The presence of at
      least 1 of these 2 findings corresponded to the presence of clinically and
      histologically evident beta 2m amyloid with a sensitivity of 79% and a
      specificity of 100%. When additional patients without surgical specimens for
      histologic confirmation of amyloidosis were included, the sensitivity of these 2
      sonographic findings was 72% and the specificity was 97%. CONCLUSION: Real-time,
      high-resolution ultrasound is a relatively sensitive and highly specific
      noninvasive adjunct to the clinical diagnosis of beta 2m amyloidosis in patients
      receiving long-term hemodialysis.

PMID- 1642658
TI  - Mast cell changes in scleroderma. Presence of MCT cells in the skin and evidence
      of mast cell activation.
AB  - OBJECTIVE: To analyze the concentration and distribution of the MCT (tryptase
      positive, chymase-negative) and MCTC (tryptase-positive, chymase-positive) types
      of mast cell in cutaneous lesions of scleroderma. METHODS: Biopsy specimens were
      obtained from skin lesions in 24 patients with scleroderma, and subjected to
      double immunohistochemical analysis using mouse monoclonal anti-tryptase and anti
      chymase antibodies. RESULTS: Dermal mast cell concentrations were below the
      normal range in 12 of the specimens, most of which were obtained between 1 and 4
      years after disease onset. All other specimens contained normal concentrations of
      mast cells. MCT cells were present in 12 specimens and comprised between 8% and
      100% of the total mast cells. Extracellular tissue deposits of tryptase-positive
      and/or chymase-positive granular material were observed in 8 specimens,
      suggesting possible mast cell degranulation. CONCLUSION: These findings are in
      contrast to those in normal skin, where MCTC cells are essentially the only type
      of mast cell present in the dermis. The results suggest that mast cells are
      involved in the pathogenesis of cutaneous lesions in scleroderma.

PMID- 1642659
TI  - Anti-interleukin-6 autoantibodies in rheumatic diseases. Increased frequency in
      the sera of patients with systemic sclerosis.
AB  - OBJECTIVE: To investigate the presence and the roles of anti-interleukin-6 (anti
      IL-6) autoantibodies in rheumatic diseases, and to further elucidate clinical and
      pathophysiologic significance of anticytokine autoantibodies. METHODS: Anti-IL-6
      IgG autoantibodies were measured by the 125I-IL-6 binding activity of IgG, which
      was isolated from serum by protein A-Sepharose. RESULTS: Nine of 52 sera (17.3%)
      from patients with systemic sclerosis (SSc) contained anti-IL-6 antibodies,
      whereas only 1.9% of sera from normal subjects and 0-5% of sera from patients
      with other rheumatic diseases were positive for the antibodies. Moreover, anti-IL
      6 autoantibodies were found predominantly among patients with the limited form of
      SSc (42.9%), compared with those with the diffuse form (7.9%). CONCLUSION: Anti
      IL-6 IgG autoantibodies were detected in patients with SSc, particularly those
      with the limited form of the disease, at a significantly increased frequency
      compared with normal subjects and patients with other rheumatic diseases. These
      results suggest that the development of anti-IL-6 autoantibodies and IL-6 may
      have a role in the pathophysiology of SSc.

PMID- 1642660
TI  - Fluorescent light photosensitivity in patients with systemic lupus erythematosus.
AB  - OBJECTIVE: To determine the prevalence of fluorescent light toxicity in patients
      with systemic lupus erythematosus (SLE). METHODS: SLE patients were polled about
      their symptomatic responses to sunlight and cool white fluorescent light.
      Photometry was used to determine the levels of ultraviolet (UV) emissions from
      fluorescent lamps. RESULTS: Thirteen of 30 photosensitive SLE patients described
      increases in disease activity following exposure to unshielded fluorescent lamps.
      Photometry indicated that these lamps emit substantial levels of UV-B (280-320
      nm) radiation, which is toxic to patients with SLE. Standard acrylic diffusers
      absorbed this radiation, and their use was associated with almost no patient
      reported problems. CONCLUSION: Fluorescent lamps, emitting UV-B radiation, induce
      disease activity in photosensitive SLE patients. Standard acrylic diffusers
      absorb UV-B radiation and appear to be protective against induction of disease
      activity with the use of fluorescent lamps.

PMID- 1642661
TI  - Anti-Ro/SS-A and anti-La/SS-B autoantibody levels in relation to systemic lupus
      erythematosus disease activity and congenital heart block. A longitudinal study
      comprising two consecutive pregnancies in a patient with systemic lupus
      erythematosus.
AB  - OBJECTIVE: To analyze the anti-Ro/SS-A and anti-La/SS-B autoantibody responses,
      both quantitatively and qualitatively, in relation to the occurrence of
      congenital heart block (CHB) and disease activity in a patient with systemic
      lupus erythematosus. METHODS: The patient's course was carefully documented for a
      period of 80 months. Specific enzyme-linked immunosorbent assays, a HeLa cell
      immunoblotting test, and an RNA precipitation assay were used to determine
      autoantibody levels and fine specificities. RESULTS: Anti-Ro/SS-A and anti-La/SS
      B antibody did not disappear. Levels of anti-Ro/SS-A appeared to fluctuate more
      frequently than levels of anti-La/SS-B. Fluctuations were unrelated to disease
      activity or immunosuppressive treatment. There was no characteristic relationship
      between levels of these antibodies and the occurrence of CHB. CONCLUSION: The
      occurrence of CHB cannot be predicted by frequent measurement of anti-Ro/SS-A and
      anti-La/SS-B levels. The immunoregulatory control of anti-Ro/SS-A and anti-La/SS
      B antibodies differs from that of anti-DNA and anti-tetanus toxoid antibodies.

PMID- 1642662
TI  - Evaluation of the efficacy and safety of oral tiludronate in Paget's disease of
      bone. A double-blind, multiple-dosage, placebo-controlled study.
AB  - OBJECTIVE: To assess the optimal dosage of oral tiludronate in Paget's disease of
      bone. METHODS: We studied 149 patients with Paget's disease, in a double-blind,
      randomized, placebo-controlled trial. Patients were randomly assigned to 1 of 5
      therapeutic groups: a daily dose of 100 mg, 200 mg, 400 mg, or 800 mg of oral
      tiludronate, or a placebo. Treatment was for 3 months, followed by 3 months of
      placebo-controlled followup. Serum alkaline phosphatase activity (SAP) and
      fasting urinary excretion of hydroxyproline/creatinine (OH/Cr) were measured
      monthly, as were biochemical parameters reflecting renal, hepatic, and
      hematologic functions. Analgesic efficacy was self-evaluated from a visual analog
      scale and a global pain index. RESULTS: Statistical analysis revealed that
      beginning at a dosage of 200 mg/day, there was a direct dose-dependent effect on
      the reduction of SAP and OH/Cr levels. Reduction of SAP levels was clinically
      significant at a dosage of 400 mg (44.9 +/- 4.2% reduction at 90 days and 49.2 +/
      4.5% at 180 days, mean +/- SEM) and at 800 mg (53.4 +/- 5% at 90 days and 59.3
      +/- 4.6% at 180 days). There was a significant reduction in pain in all groups,
      including the group taking placebo. In only those taking 800 mg/day of
      tiludronate was there a significant frequency of complete resolution of pain
      (versus placebo). Aside from mild gastrointestinal disturbances, as experienced
      with other oral bisphosphonates, clinical tolerance of all 5 regimens was good.
      Exhaustive biochemical investigations failed to reveal significant toxicity of
      tiludronate up to the 800-mg daily dose investigated. CONCLUSION: Because of its
      significantly better antiresorptive effects and greater analgesic properties
      (compared with lower dosages), combined with the excellent clinical and
      biochemical tolerance, the 800-mg daily dose of tiludronate appears to be optimal
      for the treatment of Paget's disease of bone.

PMID- 1642663
TI  - Selective inhibition of granulopoiesis with severe neutropenia in systemic lupus
      erythematosus.

PMID- 1642664
TI  - C-reactive protein levels as a direct indicator of interleukin-6 levels in humans
      in vivo.

PMID- 1642665
TI  - Increase of survival time in experimental hypoxia by cytidine diphosphate
      choline.
AB  - 36 Wistar rats were kept in chronic hypoxic hypoxia of 7 vol % of oxygen in 2
      experiments over a period of 6 months, other 36 served as controls. Half of the
      animals of each group received cytidine diphosphate choline (CDP-choline,
      citicoline, Somazina; CAS 987-78-0) at a dose of 100 mg/kg body weight in the
      liquid food. Animals in chronic hypoxia without application of CDP-choline
      developed pathological symptoms and began to die after 19 to 23 weeks in hypoxia.
      Rats that received CDP-choline developed less prominent pathological symptoms and
      died later or remained alive until the end of the experiment. Under conditions of
      extreme hypoxia CDP-choline exhibited a life-prolonging effect.

PMID- 1642666
TI  - Effect of vinpocetine on red blood cell deformability in stroke patients.
AB  - Reduction in red blood cell deformability is a contributory factor in stroke
      disease, and it has been postulated that red blood cell rigidification may be
      improved by drug treatment. In this paper the effect of vinpocetine (CAS 42971-09
      5) on the deformability of red blood cells from patients with chronic ischemic
      cerebrovascular disease has been examined. During the administration of
      vinpocetine for 3 months a significant improvement in red blood cell
      deformability was observed without adverse effect.

PMID- 1642667
TI  - Effects of the new angiotensin-I-converting enzyme inhibitor imidapril on the
      responses of isolated vascular preparations to various agonists.
AB  - Effects of imidapril hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1- ethoxycarbonyl-3
      phenylpropyl]amino]propionyl]-1-methyl-2- oxoimidazolidine-4-carboxylic acid
      hydrochloride, imidapril, TA-6366, CAS 89396-94-1), a new prodrug type
      angiotensin converting enzyme (ACE) inhibitor, and 6366 A (CAS 89371-44-8), an
      active metabolite of imidapril, on isolated vascular preparations were studied.
      6366 A inhibited angiotensin I (AT-I)-induced contraction of the rabbit thoracic
      aorta at 3 x 10(-10) mol/l or more and augmented bradykinin (BK)-induced
      relaxation of the dog renal artery precontracted with prostaglandin F2 alpha PGF2
      alpha at 10(-9) mol/l or more, whereas imidapril at 10(-7) mol/l did not affect
      these responses. However, 6366 A, like imidapril, had no effect on angiotensin II
      (AT-II), norepinephrine, serotonin-, KCl- and PGF2 alpha-induced contractions.
      The inhibitory effect of 6366 A on AT-I-induced contraction was attenuated by
      denudation of the endothelium, but it was still maintained even after washing out
      the aorta that had been previously exposed to the medium containing 6366 A. This
      suggests that 6366 A persistently inhibits the angiotensin I converting enzyme
      located preferentially in the endothelium. Therefore, the antihypertensive action
      of imidapril is mainly attributable to the vasodilation through the inhibitory
      effects of 6366 A on AT-II synthesis and BK degradation in the vasculature.

PMID- 1642668
TI  - Metabolic fate of the new angiotensin-converting enzyme inhibitor imidapril in
      animals. 1st communication: absorption, pharmacokinetics and excretion in rats
      and dogs.
AB  - Imidapril hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1-ethoxycarbonyl-3-
      phenylpropyl]amino]propionyl]-1-methyl-2-oxoimidazolidine-4-carboxylic acid
      hydrochloride, imidapril, TA-6366, CAS 89396-94-1) is an ester prodrug of the
      angiotensin-converting enzyme (ACE) inhibitor, 6366 A (CAS 89371-44-8).
      Absorption, pharmacokinetics and excretion of imidapril were studied in rats and
      dogs after oral and intravenous administration of [N-methyl-14C]-imidapril and [N
      methyl-14C]-6366 A (1 mg/kg). Following oral administration of 14C-labeled
      imidapril and 6366 A to rats, plasma concentrations of radioactivity were much
      higher after [N-methyl-14C]-imidapril dosing than after [N-methyl-14C]-6366 A
      dosing at all time points. Imidapril was relatively rapidly absorbed from the
      digestive tract and easily metabolized to the pharmacologically active 6366 A
      after oral dosing in the rats and dogs. Thus, imidapril proved to be an orally
      usable 6366 A prodrug. More than 62% and 38% of the dose were assumed to be
      absorbed from the gastrointestinal tract in the rats and dogs, respectively. The
      in situ absorption study showed that [N-methyl-14C]-imidapril was absorbed from
      nearly the entire rat small intestine, especially from the jejunum, but hardly
      absorbed from the stomach. After oral administration, peak levels of
      radioactivity in the plasma occurred at 1 h in rats and 30 min to 2 h in dogs.
      The disappearance of unchanged drug from the plasma was much faster in rats than
      in dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642669
TI  - Metabolic fate of the new angiotensin-converting enzyme inhibitor imidapril in
      animals. 2nd communication: tissue distribution and whole-body autoradiography of
      imidapril in rats.
AB  - Tissue distribution, whole-body autoradiography and metabolic profiles in
      selected tissues of imidapril hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1
      ethoxycarbonyl-3- phenylpropyl]amino]propionyl]-1-methyl-2-oxoimidazolidine-4
      carboxylic acid hydrochloride, imidapril, TA-6366, CAS 89396-94-1) were studied
      in male and female rats after oral and intravenous administration of [N-methyl
      14C]-imidapril (1 and 5 mg/kg) or [alanine-3-14C]-imidapril (1 mg/kg). After oral
      administration of [N-methyl-14C]-imidapril, radioactivity was distributed
      relatively rapidly to all tissues, except for the central nervous system. Maximum
      concentrations in most tissues were observed at 30 min to 1 h after dosing.
      Concentrations greater than those in the plasma were found in the liver, kidney
      and particularly in the lung except for the gastrointestinal contents. The
      elimination from the lung was relatively slow (t1/2: ca. 28 h). At 96 h after
      dosing, there was no evidence of remaining radioactivity in any tissues, except
      for the lung and kidney. No gender-related differences in the tissue distribution
      profile of radioactivity were observed in the whole-body autoradiogram. After
      intravenous administration, the distribution pattern of radioactivity was similar
      to the results of oral administration, except for the gastrointestinal contents.
      There was no specific binding of drug-related compounds to melanin-containing
      tissues such as the hair follicles and the uveal tract of the eye in the
      pigmented rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642670
TI  - Metabolic fate of the new angiotensin-converting enzyme inhibitor imidapril in
      animals. 3rd communication: tissue accumulation after consecutive oral
      administration of [N-methyl-14C]-imidapril in rats.
AB  - Accumulation characteristics of radioactivity in the organs and tissues,
      metabolism, and excretion of imidapril hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1
      ethoxycarbonyl-3- phenylpropyl]amino]propionyl]-1-methyl-2-oxoimidazolidine-4
      carboxylic acid hydrochloride, imidapril, TA-6366, CAS 89396-94-1), an oral
      angiotensin-converting enzyme inhibitor, were investigated after consecutive oral
      administration of [N-methyl-14C]-imidapril at a once-daily dose of 1 mg/kg to
      male rats for 14 days. During the consecutive oral administration, the plasma
      radioactivity levels at 1 h after each dose reached steady-state following the
      3rd to 4th administered dose; this was about 1.4 times higher than the
      corresponding plasma levels of the first dose. At 24 h after each administration,
      the plasma levels attained a steady-state at 3-4 days after the beginning of the
      consecutive dosing. Examination of the time course of plasma radioactivity after
      the single and multiple (7 and 14 times) oral administration revealed that the
      Cmax and AUCO-24 h values slightly, but significantly, increased according to
      repeated dosing and the beta-phase of the t1/2 of disappearance became longer
      after consecutive dosing. However, these values were not markedly different among
      consecutive dosing groups. The extent and rate of excretion of radioactivity in
      the urine and feces were nearly constant during the periods of consecutive oral
      administration, and were also similar to those after the single oral
      administration. Total recovery of radioactivity from urine and feces within 96 h
      after the final dosing was more than 98% of the total dose.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1642671
TI  - Metabolic fate of the new angiotensin-converting enzyme inhibitor imidapril in
      animals. 4th communication: placental transfer and secretion into milk in rats.
AB  - Imidapril hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1-ethoxycarbonyl-3-
      phenylproply]amino]propionyl]-1-methyl-2-oxoimidazolidine-4-car box ylic acid
      hydrochloride, imidapril, TA-6366, CAS 89396-94-1) labeled with 14C was
      administered orally or intravenously to pregnant rats on the 13th or 19th day of
      pregnancy, and lactating rats on the 7th or 13th day after delivery at a dose of
      1 or 5 mg/kg. The placental transfer and the secretion into milk were studied
      using whole-body autoradiographic methods and/or quantitative determination of
      total radioactivity after autopsy. Irrespective of the stages of pregnancy, the
      placental transfer of imidapril was low in the rats after oral administration.
      The transfer of total radioactivity per fetus on the 13th and 19th day of
      pregnancy was below 0.001 and 0.07%, respectively, of the dose to their dams
      during the observation periods. This indicates that the substance-associated
      radioactivity penetrates the placental barrier to a low extent. After oral
      administration of [N-methyl-14C]-imidapril to lactating rats on the 7th day after
      delivery, the concentration of radioactivity in the milk attained a peak at 4 h
      after administration (0.05 microgram equivalents of imidapril/g), which was about
      1/3 of Cmax in the blood. The transfer of imidapril and/or its radioactive
      metabolites to each suckling via milk after oral dosing was only below 0.03% of
      the dose to the dams on the 13th day after delivery during the observation
      periods. The present autoradiographic findings confirmed the above results of
      tissue distribution studies.

PMID- 1642672
TI  - Metabolic fate of the new angiotensin-converting enzyme inhibitor imidapril in
      animals. 5th communication: isolation and identification of metabolites of
      imidapril in rats, dogs, and monkeys.
AB  - The metabolism of imidapril hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1
      ethoxycarbonyl-3-phenylpropyl]amino] propionyl]-1-methyl-2-oxoimidazolidine-4
      carboxylic acid hydrochloride, imidapril, TA-6366, CAS 89396-94-1) was studied in
      rats and dogs after oral or intravenous administration of [N-methyl-14C]
      imidapril or [alanine-3-14C]-imidapril, and in monkeys after oral administration
      of [alanine-3-14C]-imidapril. Radio-chromatographic analysis of the metabolites
      of imidapril from the plasma, urine, and bile of rats, dogs, or monkeys resulted
      in the detection of at least four metabolites. These four metabolites were
      isolated and characterized by high performance liquid chromatography (HPLC) and
      gas chromatography-mass spectrometry(GC-MS). Of these metabolites, M1 (6366 A,
      CAS 89371-44-8) was pharmacologically active; however, M2, M3, and M4 were
      inactive. There was no evidence of any glucuronides or sulfates of drug-related
      compounds, or of the piperazine-dione lactam type metabolites of imidapril or
      6366 A in the urine of the animals used. Imidapril was metabolized by hydrolysis
      at the carboxylic ethyl ester side-chain to give M1, and by cleavage of the amide
      bond to form M2 and M3. M4 was formed by hydrolysis of M3 and/or cleavage of the
      amide bond of M1. Qualitatively, the same metabolites were found in all animal
      species tested; however, quantitatively, there were differences in the amounts of
      metabolites formed depending on the species.

PMID- 1642673
TI  - Metabolic fate of the new angiotensin-converting enzyme inhibitor imidapril in
      animals. 6th communication: interspecies comparison of pharmacokinetics and
      excretion of imidapril metabolites in rats, dogs, and monkeys.
AB  - The pharmacokinetics and excretion of the main metabolites of imidapril
      hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1-ethoxycarbonyl-3-
      phenylpropyl]amino]propionyl]-1-methyl-2-oxoimidazolidine-4-carboxylic acid
      hydrochloride, imidapril, TA-6366, CAS 89396-94-1) were investigated in rats,
      dogs, and monkeys after oral or intravenous administration of [N-methyl-14C]
      imidapril and [alanine-3-14C]-imidapril. After oral administration of 14C-labeled
      imidapril to rats and dogs, the plasma concentrations of the pharmacologically
      active metabolite, 6366 A (M1, CAS 89371-44-8), reached a peak at 1-2 h in rats
      and at 2-6 h in dogs. The disappearance half-lives of M1 from plasma were much
      longer in dogs (6.3-9.3 h) than in rats (0.9-2.3 h). At the point of peak plasma
      radioactivity, the major radioactive metabolites in the plasma were M2, followed
      by M3, M4 greater than M1 in rats; in dogs, M2 and M3 followed by M1 greater than
      M4. After intravenous administration of [N-methyl-14C]-imidapril to rats and
      dogs, plasma levels of M1 reached a peak at the first measuring time of 5 min in
      rats and at about 2 h in dogs. The half-lives of plasma M1 levels were similar to
      those after oral dosing. At 1 h after dosing, the major metabolites in plasma
      were M1 followed by M2 in both rats and dogs. Irrespective of the route of
      administration, unchanged imidapril disappeared more rapidly from the plasma in
      rats than in dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642674
TI  - Metabolic fate of the new angiotensin-converting enzyme inhibitor imidapril in
      animals. 7th communication: in vitro metabolism.
AB  - In order to clarify the sites of metabolism and the metabolizing enzymes of
      imidapril hydrochloride ((-)-(4S)-3-[(2S)-2-[[(1S)-1- ethoxycarbonyl-3
      phenylpropyl]amino]propionyl]-1-methyl-2- oxoimidazolidine-4-carboxylic acid
      hydrochloride, imidapril, TA-6366, CAS 89396-94-1), metabolism studies were
      carried out using rat, dog, monkey, and human plasma and rat tissue homogenates.
      After incubating with the various plasma samples, imidapril was mainly
      metabolized to the pharmacologically active metabolite, 6366 A (M1, CAS 89371-44
      8), in rat plasma; on the other hand, the ester bond of imidapril was not
      hydrolyzed in dog, monkey, and human plasma. Imidapril was metabolized to M1, M2,
      M3, and M4 in all rat tissue homogenates tested. Aside from the above
      metabolites, no other metabolites were detected. The metabolic activity of
      imidapril to M1 was the highest in the liver, followed by the kidney and lung;
      however, it was low in other tissue homogenates. From the results of experiments
      using certain esterase inhibitors, it has been concluded that the metabolic
      conversion of imidapril to M1 is mainly due to a carboxylesterase (B-esterase).
      In contrast, the metabolic activity of imidapril to M2 and M3 (or M4) was highest
      in the kidney and small intestine while low in other tissues. From the
      experiments using certain enzyme inhibitors, it has been found that an
      acetylesterase (C-esterase) is largely involved in the metabolism of imidapril
      into M2 and M3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642675
TI  - Antihypertensive effect of the new dihydropyridine calcium antagonist (+-)-3
      (benzylmethylamino)-2,2-dimethylpropyl methyl 4-(2-fluoro-5-nitrophenyl)-1,4
      dihydro-2,6-dimethyl-3,5-pyridinedica rbo xylate hydrochloride in dogs.
AB  - The antihypertensive effect of TC-81 ((+-)-3-(benzylmethylamino)-2,2
      dimethylpropyl methyl 4-(2-fluoro-5-nitrophenyl)-1,4-dihydro-2,6-dimethyl-3,5
      pyridine dicarboxylate hydrochloride, CAS 96515-74-1), a new calcium antagonist,
      was investigated in normotensive dogs (NTD) and renal hypertensive dogs (RHD). By
      oral administration, the antihypertensive activity of TC-81 (ED20% was 0.09 mg/kg
      p.o.) was about 18 times more potent in conscious RHD in comparison with
      nicardipine (ED20% was 1.65 mg/kg p.o.). 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 equipotent dose. Similar results
      were observed more clearly by intravenous injection, but the potency of TC-81 was
      only 3 times higher than that of nicardipine in anesthetized dogs. Tolerance of
      the antihypertensive effect of TC-81 in daily dosing for 2 weeks and the rebound
      phenomena after discontinuance of the treatment were not observed in RHD. TC-81
      at a concentration of 10(10)-3 x 10(-9) mol/l inhibited the KCl- or
      norepinephrine-induced contraction of isolated dog femoral artery. 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- 1642676
TI  - Absorption, plasma concentration, and excretion after single administration of
      14C-(+-)-3-(benzylmethylamino)-2,2-dimethylpropyl methyl 4-(2-fluoro-5-
      nitrophenyl)-1,4-dihydro-2,6-dimethyl-3,5-pyridinedicarboxylate hydrochloride in
      rats and dogs.
AB  - The absorption, plasma concentrations, and excretion of a newly synthesized
      calcium antagonist, TC-81 ((+-)-3-(benzylmethylamino)-2,2-dimethylpropyl methyl 4
      (2-fluoro-5-nitrophenyl)-1,4-dihydro-2,6-dimethyl-3,5- pyridinedicarboxylate
      hydrochloride, CAS 96515-74-1) were studied following a single oral or
      intravenous administration of 14C-labelled compound. After oral administration,
      14C-TC-81 was rapidly and well absorbed from the gastrointestinal tract. The peak
      plasma concentrations of radioactivity were observed at 0.5-1 h (rats) and 1-2 h
      (dogs) h after dosing. The elimination of the radioactivity in plasma was
      biphasic with a half-life of 3.8-5.2 h (a phase) and 42.9-56.2 h (beta phase) in
      the rats or 3.2 h (a phase) and 61.5 h (beta phase) in dogs. Maximum plasma
      concentrations of unchanged drug after oral administration of TC-81 to male rats
      at the doses of 0.5, 1.0, and 3.0 mg/kg were 1.7, 7.3 and 15.6 ng/ml,
      respectively. They were attained at 0.5 h after dosing in every dose examined.
      Plasma levels of unchanged drug declined with a half-life of 0.39-1.15 h. When TC
      81 was orally administered to male dogs at the doses of 0.1, 0.2 and 0.5 mg/kg,
      plasma concentrations of unchanged drug reached the maximum level at 0.5 h after
      dosing and the values were 0.8, 3.3 and 9.6 ng/ml, respectively. They were
      eliminated with a half-life of 2.4-2.8 h. The absolute bioavailability of
      unchanged drug was estimated to be 2.6-7.0% (rats) and 5.3-15.5% (dogs) of the
      dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642677
TI  - Distribution to and elimination from tissues following a single or repeated
      administration of 14C-(+-)-3-(benzyl-methylamino)-2,2-dimethylpropyl methyl 4-(2
      fluoro-5-nitrophenyl)-1,4-dihydro-2,6-dimethyl-3,5-pyridinedica rbo xylate
      hydrochloride in rats.
AB  - A newly synthesized calcium antagonist, TC-81((+-)-3-benzylmethylamino)-2,2
      dimethylpropyl methyl-4-(2-fluoro-5-nitrophenyl)-1,4-dihydro-2,6-dimethyl-3,5-
      pyridinedicarboxylate hydrochloride, CAS 96515-74-1) was administered to adult
      male rats, pregnant and lactating rats with a single oral dose or with repeated
      doses of 0.3 mg/kg for 2 weeks. The distribution to tissues, placental transfer
      and secretion of the radioactive drug into milk was studied using whole body
      autoradiography methods and quantitative determination of total radioactivity
      after autopsy. 14C-TC-81 was distributed rapidly but disproportionately to the
      tissues after single administration. The highest concentration of radioactivity
      was observed in the liver. The radioactivity in the various tissues declined
      slowly comparing to the plasma but at 96 h after dosing the radioactivity was
      detected only in the liver. The radioactivity penetrated the blood-placental
      barrier to a low extent after oral administration of 14C-TC-81 to pregnant rats.
      When 14C-TC-81 was administered to lactating rats, the radioactivity was secreted
      into the milk with the maximum concentration of radioactivity, 86% of the
      corresponding plasma concentration. Following 14-day oral treatments of male rats
      the equivalent concentration in the plasma was increased 1.5 fold as compared to
      the single treatment. In all tissues, the AUC0-24 h after 1, 7, and 14 days
      treatment were gradually increased, but these increases were almost the same as
      or even less than the rise observed in the plasma. After the last dosing, the
      radioactivity declined slowly with time in most of the tissues.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642678
TI  - Analysis of the daily variation in blood pressure and pharmacokinetics after
      single or repeated administration of clentiazem to patients with essential
      hypertension.
AB  - Clentiazem (TA-3090, CAS 96125-53-0), a new benzothiazepine Ca++ antagonist, was
      orally administered to inpatients with essential hypertension at a dose of 30 mg
      at 8:00 a.m. once (n = 5) or daily for 2 weeks (n = 22). After administration of
      the medication, the daily variations in blood pressure and pulse rate were
      monitored using a portable blood pressure recorder, and plasma concentrations of
      clentiazem were determined by HPLC. 1. In the single administration study, an
      antihypertensive effect was observed between 4 and 12 h with a peak approximately
      8 h after administration. After the single dose, the diurnal pulse rate was
      higher than the pretreatment level, but it was not correlated with the
      antihypertensive effect. 2. In the repeated administration study, both the
      systolic and diastolic blood pressures showed significant decreases after
      administration throughout the day (p less than 0.01). The nocturnal
      antihypertensive effect was weaker than the diurnal effect, and the minimum
      decrease/maximum decrease ratio in a day was 0.52 for both systolic and diastolic
      pressures. The pulse rate decreased slightly during certain time intervals after
      administration (p less than 0.01 or p less than 0.05), but those were slight
      changes. 3. As to the pharmacokinetic profile clentiazem showed a long-lasting
      plasma level, the tmax was 6.8 +/- 1.1 h for the single treatment and 6.9 +/- 1.6
      h for the repeated treatment; the Cmax was 16.9 +/- 6.1 ng/ml and 19.3 +/- 8.8
      ng/ml, respectively; and the t1/2 was 6.6 +/- 1.5 h and 12.5 +/- 5.4 h,
      respectively. The plasma level profiles for single and repeated administrations
      were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642679
TI  - Hemodynamic effects of cilostazol on peripheral artery in patients with diabetic
      neuropathy.
AB  - On the basis of vascular involvement, an open clinical trial was performed to
      determine whether or not the antithrombotic drug cilostazol (6-[4-(1-cyclohexyl
      1H-tetrazol-5-yl) butoxy]-3,4-dihydro-2(1H)-quinolinone, OPC-13013, Pletaal, CAS
      73963-72-1) applied as a single 100 mg tablet increases peripheral blood flow and
      prevents diabetic neuropathy in 30 patients with non-insulin dependent diabetes
      mellitus. The hemodynamic effects of this drug on the a. dorsalis pedis were
      examined using a new real-time two-dimensional Doppler echography. 1 h after oral
      administration of cilostazol, the cross-sectional area of the a. dorsalis pedis
      significantly increased from 2.2 +/- 0.2 to 2.9 +/- 0.3 mm2 (p less than 0.05).
      Also, the a. dorsalis pedis blood flow index significantly increased from 16 +/-
      1 to 31 +/- 4 (p less than 0.05). Cilostazol did not affect plasma glucose level
      (from 213 +/- 14 to 198 +/- 15 mg/dl), but slightly plasma ratio of 6-keto PGF1a
      to TXB2 (from 0.71 +/- 0.09 to 0.83 +/- 0.12). These effects of cilostazol might
      ameliorate diabetic neuropathy by improving blood flow and preventing nerve
      tissue ischemia.

PMID- 1642680
TI  - [Anti-inflammatory activity of sabal fruit extracts prepared with supercritical
      carbon dioxide. In vitro antagonists of cyclooxygenase and 5-lipoxygenase
      metabolism].
AB  - The extract SG 291 (Talso, Talso uno) from the fruits of Sabal serrulata (syn.:
      Serenoa repens) prepared by supercritical fluid extraction with carbon dioxide is
      used for the treatment of benign prostatic hyperplasia (BPH) and non bacterial
      prostatitis. In the present work, the Sabal extract SG 291 was analyzed by gas
      chromatography and investigated for its inhibitory influence on the biosynthesis
      of inflammatory arachidonic acid metabolites. The extract SG 291 was found in
      vitro to be a dual inhibitor of the cyclooxygenase (IC50-value: 28.1
      micrograms/ml) and 5-lipoxygenase pathway (IC50-value: 18.0 micrograms/ml). By
      alkaline hydrolysis, ether extraction and preparative thin layer chromatography
      the extract SG 291 was separated in three fractions containing acid lipophilic
      compounds (A), fatty alcohols (B) and sterols (C) as main components. Fraction A
      inhibited the biosynthesis of cyclooxygenase (CO) and 5-lipoxygenase (5-LO)
      metabolites in the same intensity as the native extract SG 291, while the
      fractions B, C and beta-sitosterol showed no inhibitory effect on both enzymes of
      the arachidonic acid pathways. Therefore, the CO and 5-LO inhibiting principle of
      Sabal serrulata extract SG 291 must be localized in the acidic lipophilic
      fraction (SLF). The CO and 5-LO inhibitory effects may give an explanation for
      the in vivo observed antiphlogistic and antiedematous activity of the lipophilic
      Sabal serrulata extract SG 291.

PMID- 1642681
TI  - [Pharmacokinetic aspects of a combination of metoclopramide and paracetamol.
      Results of a human kinetic study and consequences for migraine patients].
AB  - An open trial was carried out in eight healthy male and female volunteers to
      examine the bioavailability as well as the main kinetic parameters of Migranerton
      (metoclopramide and paracetamol; CAS 364-64-5 and CAS 103-90-2, resp). in
      comparison with reliable literature data. The results reported here clearly show
      that the absorption of both active ingredients from the fixed combination is
      complete and that therapeutically relevant plasma concentrations are achieved
      within 30 min. Bioavailability as well as tmax, t1/2, and time-lag are comparable
      with data resulting from reliable and internationally acknowledged kinetic
      studies. The fixed combination was shown to be kinetically compatible with regard
      to all parameters determined for metoclopramide and paracetamol.

PMID- 1642682
TI  - Activity and pharmacokinetics of a new oral dosage form of soluble ibuprofen.
AB  - The pharmacokinetics and the relative bioavailability of a soluble granular form
      (sachets) of a pharmaceutical formulation containing ibuprofen (CAS 15687-27-1)
      and 1-arginine were investigated in healthy volunteers. Two granular dosage forms
      were evaluated, 200 and 400 mg, in comparison with the commercial equivalents
      (tablets). After the oral administration of both granular dosage forms, a quicker
      absorption and a significantly higher plasma bioavailability of ibuprofen in the
      first hour following the treatment than after tablets administration were
      observed. The mean values of peak plasma concentration (microgram/ml) were 26.1
      and 56.4 after treatment with 200 and 400 mg sachets respectively vs. 16.3 and
      43.0 after treatment with 200 and 400 mg tablets. The mean values of peak time
      were 16.9 and 24.4 min after treatment with 200 and 400 mg sachets respectively
      vs. 90.0 and 63.7 min after treatment with 200 and 400 mg tablets. The shortening
      in the absorption time and the increase in the plasma concentrations did not
      involve a quicker drug elimination nor cause any changes in the bioavailability
      (mean values of the relative bioavailability indexes of 0.98 for 200 mg dosage
      form and 1.02 for the 400 mg one). The analgesic activity of soluble ibuprofen
      400 mg was compared with that of ibuprofen 400 mg tablets in patients with osteo
      articular pain, according to a single dose, double-blind cross-over balanced
      design. The results showed that the soluble granular form is able to determine an
      analgesic effect significantly quicker and higher than that of tablets.

PMID- 1642683
TI  - Osteopenia in rats with drug-induced mucopolysaccharidosis.
AB  - The immunostimulatory drug tilorone (CAS 27591-97-5) induces generalized
      lysosomal storage of sulfated glycosaminoglycans, i.e., mucopolysaccharidosis
      (MPS) in rats. Since inherited MPS of man is often associated with skeletal
      lesions the present study was performed to investigate whether the tilorone
      induced MPS is also accompanied by bone alterations. The answer is yes. Rats
      (initial age 4 weeks) were orally treated with tilorone (60-80 mg/kg; 6-25
      weeks). The proximal tibial metaphysis was examined by radiography and by light
      and electron microscopy. The tibiae of drug-treated rats remained smaller than
      those of pair-fed control rats. The primary bone trabecules in drug-treated rats
      became increasingly shorter, and the cortical bone became thinner. The general
      organization of the cartilaginous growth plate and the zones of vascular invasion
      and primary trabecule formation appeared similar as in control rats. Increased
      numbers of active osteoclasts were found at the free ends of the primary
      trabecules. Ultrastructurally, MPS-like alterations were observed in all types of
      bone cells. The osteopenia was partly reversible during recovery periods of more
      than 6 months after discontinuance of drug treatment. At present, the causal
      relationship between drug-induced MPS and osteopenia, as well as the mechanisms
      responsible for osteopenia are unknown. It is suggested that the principal
      factors are stimulation of osteoclasts and retardation, though not profound
      distortion, of the events involved in enchondral ossification.

PMID- 1642684
TI  - Effect of cefodizime on parameters of cell-mediated immunity in vitro.
AB  - A positive effect of cefodizime (CAS 69739-16-8), a new aminothiazolyl
      cephalosporin, on a number of immunological variables, and in particular
      phagocytosis, was demonstrated in several test systems. The aim of the present
      investigation was to establish whether clinically relevant concentrations of
      cefodizime affect cell-mediated immune variables. Peripheral lymphocytes from
      healthy subjects were isolated and incubated with cefodizime in increasing
      concentrations from 0 to 200 mg/l. The effects of cefodizime on membrane-bound
      antigenic determinants of the lymphocytes were determined in the rosette
      inhibition test, and its effects on the proliferative capacity of lymphocytes
      after stimulation with phytohaemagglutinin, concanavalin A and pokeweed mitogen
      were determined in the lymphocyte transformation test. Cefodizime inhibited
      rosette formation in a concentration dependent manner. A direct inhibitory effect
      on proliferation was not, however, demonstrated in the lymphocyte transformation
      test. Indeed, stimulation of mitogen-induced lymphocyte transformation,
      particularly of concanavalin A-sensitive cells was observed at concentrations
      higher than 100 mg/l. The findings in healthy volunteers were reproduced in
      samples from three female patients with impaired host-defence. These results may
      suggest a positive effect of cefodizime on the proliferative capacity of the
      cellular immune system. However, no conclusions can be drawn on the clinical
      relevance of these findings until the results of in vivo investigations are
      available.

PMID- 1642685
TI  - [Structural characterization of an unknown metabolite of ciprofloxacin].
AB  - The chemical structure of an unknown metabolite of ciprofloxacin (CAS 85721-33-1)
      is characterized by means of reversed phase ion pair liquid chromatography,
      absorption and fluorescence spectroscopy, partition coefficients as well as
      chemical and enzymatic hydrolytic degradation. A chemical structure of the
      unknown metabolite is proposed: N-formyl-desethylen-ciprofloxacin. It can be
      formed as an intermediate in the oxidative degradation of ciprofloxacin via
      oxociprofloxacin to desethylen-ciprofloxacin, or it may be formed by conjugation
      of desethylen-ciprofloxacin with formic acid. The amounts found in plasma and
      urine of patients were in the range of desethylen-ciprofloxacin, i.e. about 1% of
      the parent compound.

PMID- 1642686
TI  - Distribution of recombinant human erythropoietin following multiple intravenous
      administration and effects of age on the distribution in rats.
AB  - Multiple administration of 125I-recombinant human erythropoietin (125I-rh-EPO)
      did not cause an accumulation of intact EPO in tissue. The gel filtration profile
      of tissue from rats given multiple doses of 125I-rh-EPO was very similar to that
      for rats given single doses of 125I-rh-EPO, suggesting that intact rh-EPO (CAS
      11096-26-7) does not accumulate. Pretreatment of rats with non-labeled rh-EPO did
      not cause a change in the ratio of metabolites to intact rh-EPO, as judged by the
      gel filtration data. This indicates that multiple administrations do not cause a
      change in metabolic pathways in the tissues. The tissue to plasma concentration
      ratio (t/p ratio) of rh-EPO in the target organ, i.e., the bone marrow and
      spleen, decreased with increase of age; the spleen showed a marked decrease in
      t/p ratio as compared to the bone marrow. On the other hand, t/p ratios in the
      kidney and liver did not change for periods of 4 to 31 weeks.

PMID- 1642687
TI  - Regression of coronary atherosclerosis by combined LDL-apheresis and lipid
      lowering drug therapy in patients with familial hypercholesterolemia: a
      multicenter study. The LARS Investigators.
AB  - The purpose of the LDL-Apheresis Regression Study (LARS) group, which included 13
      institutions in Japan, was to investigate the effects on coronary atherosclerosis
      of LDL-apheresis combined with cholesterol-lowering drugs. Changes in coronary
      artery stenosis were assessed angiographically in 37 patients with familial
      hypercholesterolemia (7 homozygotes and 25 heterozygotes) and
      hypercholesterolemia which had not been defined as familial hypercholesterolemia
      (5 patients) by visual judgement and computer analysis. Definite regression was
      observed in 14 cases, including 4 homozygotes and 10 heterozygotes and others.
      Regression occurred as often in patients with severe coronary artery disease (2
      or more vessel disease) as in those having less severe disease. Our results
      encourage initiation of aggressive cholesterol-lowering therapy to produce
      regression of coronary atherosclerosis in FH patients at high risk for
      cardiovascular events.

PMID- 1642688
TI  - Seasonal variation in serum cholesterol levels--evidence from the UK and Japan.
AB  - Using data from 140,000 men and 32,000 women in the UK and 30,000 men and 12,000
      women in Japan, we performed spectral analyses to test for seasonal variation in
      serum cholesterol levels. In both countries and both sexes we found a strong
      seasonal effect, cholesterol levels being some 3-5% higher in winter than in
      summer. This was independent of seasonal changes in body mass. Mean monthly
      cholesterol levels were negatively correlated with mean monthly air temperatures
      (r = -0.60 to -0.71). The observed seasonal differences were larger than the
      inter-assay coefficient of variation for the cholesterol determination method
      employed and have important consequences for long-term epidemiological or
      intervention studies.

PMID- 1642689
TI  - Non-cholesterol sterols, absorption and synthesis of cholesterol and
      apolipoprotein A-I kinetics in a Finnish lecithin-cholesterol acyltransferase
      deficient family.
AB  - We describe the first Finnish LCAT-deficient family with two affected, one
      questionably affected and one healthy family member. The affected family members
      presented stomatocytes in the peripheral blood, exhibited low serum levels of
      total, LDL and HDL cholesterol, triglycerides, phospholipids and apolipoprotein A
      I and especially A-II. Apolipoprotein A-I catabolism was accelerated to
      moderately high and very high levels in the two affected subjects. Cholesterol
      esterification percentage was low in all lipoprotein fractions. The intestinal
      cholesterol absorption efficiency and cholesterol and bile acid synthesis were
      within normal limits. The esterification percentage of demethylated cholesterol
      precursor sterols, cholestanol and plant sterols resembled mostly that of
      cholesterol, while those of VLDL and LDL methostenols, precursor sterols
      esterified by acyl-CoA:cholesterol acyltransferase (ACAT), suggested normal ACAT
      activity. In HDL all sterols were poorly esterified. The observations on
      stomatocytes, normal absorption and synthesis of cholesterol and bile acids,
      abnormal kinetics of apolipoprotein A-I, evidence of normal ACAT activity and
      abnormal esterification of non-cholesterol sterols are findings presented for the
      first time in LCAT deficiency.

PMID- 1642690
TI  - Effect of gemfibrozil on composition of lipoproteins and distribution of LDL
      subspecies.
AB  - We studied the effect of gemfibrozil on the compositions of VLDL, LDL and
      distribution of LDL subspecies in type II hyperlipidemic patients. Gemfibrozil
      significantly lowered serum triglyceride levels in this group of patients who had
      normal to moderately elevated triglyceride prior to therapy. Gemfibrozil also
      changed the composition of VLDL by lowering its free cholesterol, cholesterol
      ester and raising the protein content. In contrast, no measurable changes in LDL
      chemical composition were found following gemfibrozil therapy. Changes in LDL,
      however, can be detected using ultracentrifugal and electrophoretic methods. Peak
      densities of LDL were lowered and LDL subspecies shifted to larger, slower-moving
      bands on gradient gel electrophoresis in patients receiving gemfibrozil
      treatment. These results suggest that gemfibrozil treatment resulted in
      qualitative changes in both VLDL and LDL even in patients with moderately
      elevated baseline serum triglyceride levels.

PMID- 1642691
TI  - Poland-US collaborative study on cardiovascular epidemiology: classification
      agreement between US National Cholesterol Education Program and European
      Atherosclerosis Society hyperlipidemia guidelines in selected Polish and US
      populations.
AB  - Data from two epidemiological studies are used to measure the degree to which two
      well-known guidelines agree in measuring hyperlipidemia in population samples in
      the US and Poland. The epidemiological studies are the US Lipid Research Clinics
      Program Prevalence Study and the Pol-MONICA project in Poland and the guidelines
      are those adopted by the US National Cholesterol Program (USNCEP) and by the
      European Atherosclerosis Society (EAS). EAS guidelines were analyzed in two ways:
      Method 1 used triglycerides and total cholesterol only in classifying persons as
      hyperlipidemics or non-hyperlipidemics; Method 2 used triglycerides, total
      cholesterol and nine additional risk factors in the classification process.
      USNCEP guidelines used total cholesterol, low density lipoprotein cholesterol and
      the same additional nine risk factors used in EAS Method 2 in classifying
      hyperlipidemics. Classification differences between the two sets of guidelines
      were high when EAS Method 1 guidelines were compared with USNCEP guidelines.
      However, EAS Method 2 which included risk factors, compared favorably with USNCEP
      guidelines in all three populations under study.

PMID- 1642692
TI  - Priming effect of adrenic acid (22:4(n-6)) on tissue factor activity expressed by
      thrombin-stimulated endothelial cells.
AB  - Tissue factor (TF) which initiates clotting process can be expressed by
      stimulated endothelial cells (EC). TF is an apolipoprotein requiring an
      association with phospholipids (PL) in order to become active. Also PL constitute
      an important storage pool of polyunsaturated fatty acids (PUFAs) in EC which can
      be modulated by diet or cell medium supplementation. In order to test the effect
      of such manipulation upon TF activity, we have pre-enriched human EC cultures
      with different fatty acids of nutritional interest. TF was evaluated after 4 h of
      thrombin stimulation by using a chromogenic method. Without additional
      stimulating agents, these acids have no effect on the basal level of TF.
      Eicosapentaenoic and docosapentaenoic acids appeared to be ineffective at the
      stimulated TF level. Only adrenic acid (22:4(n-6)) has been found to
      significantly enhance TF activity of thrombin-stimulated endothelial cells. Other
      TF inducers were also tested after 22:4(n-6) enrichment. An increase tendency of
      TF expression was found only with tumor necrosis factor, whereas interleukin-1
      beta, lipopolysaccharide and especially phorbol myristate acetate stimulations
      were not significantly modified. The priming effect of adrenic acid on thrombin
      stimulated TF expression might involve alterations of signal transduction
      pathways rather than modifications of apolipoprotein III environment. Adrenic
      acid, which is a prostacyclin inhibitor, appears to be potential prothrombotic
      agent.

PMID- 1642693
TI  - Enhanced incorporation of [14C]glucosamine into glycosaminoglycans of aortic
      neointima of balloon-injured and cholesterol-fed rabbits in vitro.
AB  - Glycosaminoglycans (GAG), which form the elementary constituent of extracellular
      matrix proteoglycans (PG), are implicated in the pathogenesis of atherosclerosis,
      mainly due to their lipoprotein binding capability and their abundance in a
      developing lesion during atherogenesis. However, the reasons for the increment of
      GAG content are poorly understood. In the present study, the influence of two
      well known atherogenic factors on arterial GAG synthesis were examined by
      estimating the incorporation of [14C]glucosamine into aortic GAG in an in vitro
      incubation system. Radioactivity associated with GAG was taken to represent their
      synthesis. GAG synthesis by neointimal tissue of rabbit aortas, 12 weeks
      following balloon catheter deendothelialization was measured and compared in
      rabbits fed a normal or 0.25% cholesterol supplemented diet for the preceding 6
      weeks. In normolipaemic rabbits synthesis was found to be 12,438 +/- 173, 17,884
      +/- 1390 and 15,960 +/- 1355 dpm/mg dry defatted tissue from uninjured (control),
      deendothelialized (DEA) and reendothelialized (REA) areas of rabbit aortas,
      respectively. This incorporation of radioactivity was significantly greater in
      hypercholesterolaemic rabbits corresponding to 13,426 +/- 239, 32,670 +/- 3077
      and 27,496 +/- 3287 in the control, DEA and REA, respectively. The results
      demonstrated a synergistic effect of cholesterol feeding and arterial endothelial
      denudation in stimulating GAG synthesis. Although GAG synthesis was found to be
      stimulated by either cholesterol feeding or arterial injury, the stimulation by
      cholesterol feeding alone was only marginal. Further, results show a much higher
      retention of newly synthesized GAG by the tissue from REA. This study provided a
      possible explanation for increased GAG content in a developing proliferative
      lesion.

PMID- 1642694
TI  - Differential effects of nicotinic acid in subjects with different LDL subclass
      patterns.
AB  - Twenty-six subjects (20 male, 6 female) at high risk for CAD events were treated
      with moderate doses of nicotinic acid to investigate whether there was a
      differential lipoprotein response in patients with different LDL subclass
      patterns. Subjects were selected to have either pattern A (predominance of large
      LDL, peak particle diameter greater than 262 A, n = 9) or pattern B (predominance
      of small LDL, peak particle diameter less than 255 A, n = 17) as assessed by 2
      16% gradient gel electrophoresis of plasma. Nicotinic acid dose was similar in
      pattern A (2111 +/- 651 mg/day) and pattern B subjects (1875 +/- 698 mg/day).
      Total cholesterol and LDL cholesterol decreased by similar amounts in pattern A (
      41 +/- 26 mg/dl and -37 +/- 18 mg/dl) and pattern B (-51 +/- 44 mg/dl and -44 +/-
      45 mg/dl) subjects. Triglycerides tended to be reduced more in pattern B subjects
      (-100 +/- 175 mg/dl) compared to pattern A subjects (-23 +/- 34 mg/dl) although
      this difference was not statistically significant (P = 0.08 for triglycerides log
      transformed). HDL cholesterol increased significantly more in the pattern B group
      (11.9 +/- 14.2 mg/dl) compared to pattern A subjects (0.7 +/- 8.5 mg/dl), (P less
      than 0.04). Similarly, LDL particle diameter increased significantly more in the
      pattern B subjects (9.8 +/- 6.9 A) compared to the pattern A subjects (3.6 +/-
      3.0 A), (P less than 0.02). All pattern B subjects who achieved a plasma
      triglyceride less than 140 mg/dl converted to pattern A.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1642695
TI  - Inhibition of cultured vascular smooth muscle cell migration by simvastatin (MK
      733).
AB  - The effect of simvastatin (MK-733), a potent 3-hydroxy-3-methylglutaryl coenzyme
      A (HMG-CoA) reductase inhibitor, on the migration of cultured porcine smooth
      muscle cells (SMCs) was investigated in modified Boyden chambers. Platelet
      derived growth factor (PDGF) stimulated the SMC migration dose dependently. MK
      733 inhibited the migration response induced by PDGF with an IC50 value of 2
      microM. Supplementation with mevalonate restored the migration response inhibited
      by MK-733 but the addition of low-density-lipoprotein (LDL) did not change the
      response. Another HMG-CoA reductase inhibitor, pravastatin (CS-514), also reduced
      the migration response. However its potency was far less than that of MK-733. MK
      733 also inhibited the SMC migration stimulated by fibrinogen. These results
      suggest that non-sterol metabolite(s) of mevalonate, possibly prenylated
      proteins, are involved in a migration signaling pathway and that HMG-CoA
      reductase inhibitors are effective in the prevention of the formation of intimal
      hyperplasia in atherosclerosis.

PMID- 1642696
TI  - Hypercholesterolemia induces differential expression of rabbit apolipoprotein A
      and C genes.
AB  - We have compared steady-state mRNA levels of apolipoproteins AI, AII, AIV, CI,
      CII and CIII in liver and small intestine of rabbits fed on a cholesterol-rich
      diet for up to 16 weeks. Apolipoprotein (apo) AIV mRNA was detected in both liver
      and small intestine, while apo AII was not detected in either organ. Apo CI, apo
      CII and apo CIII were expressed only in liver and apo AI mRNA was detected only
      in small intestine. In small intestine, apo AIV and apo AI mRNA levels increased
      to a maximum at the 4th and 12th week of treatment, respectively. In liver there
      was a parallel increase in the mRNA levels of apo AIV, apo CI, apo CII and apo
      CIII, with maximum levels after 4 weeks of treatment. A 3-fold increase was found
      in apo CII and apo CIII hepatic transcription rates between hypercholesterolemic
      and control rabbits after 4 weeks of treatment, no longer detectable after 8
      weeks. However, no changes were found in apo AIV and apo CI transcription rates.
      Changes in apolipoprotein mRNA levels were accompanied by changes in plasma
      lipoprotein levels. Overall, these changes correlate well with the variations
      detected in the expression of the different apolipoprotein genes. Our results
      indicate that dietary cholesterol plays an important role in the regulation of
      these genes and that this regulation is tissue dependent.

PMID- 1642697
TI  - 'HIV transmission via blood and saliva splashes to the face'.

PMID- 1642698
TI  - Junior doctors on the warpath.

PMID- 1642699
TI  - Psoriatic arthritis precipitated by physical trauma: destructive arthritis or
      associated with reflex sympathetic dystrophy?

PMID- 1642701
TI  - The incidence of ethanol-induced hypoglycemia.
AB  - The purpose of the study was to determine the incidence of ethanol-induced
      hypoglycemia. All nondiabetic patients who had blood alcohol levels above 0.10%
      and a random serum chemistry drawn (including glucose) were included. Over a 6
      month study period, 378 patients were included in the study. Fifteen patients
      (4%) presented with hypoglycemia (glucose less than 67 mg%). Of these, four (1%)
      were profoundly hypoglycemic (glucose less than 50 mg%). Two hundred and fifty
      three patients (67%) patients were normoglycemic (glucose 67-106 mg%) and 110
      patients (29%) were hyperglycemic (glucose greater than 106 mg%). Nonfasting
      glucose measurements from a control group of 96 nondiabetic, nonintoxicated
      patients were compared with those of the study group. Two patients (2%) presented
      with hypoglycemia and none (0%) presented with profound hypoglycemia. Forty-five
      patients (47%) presented with normoglycemia, and 49 (51%) with hyperglycemia.
      There were no statistically significant differences found in the hypoglycemia
      rate between the intoxicated patients and nonintoxicated control population (odds
      ratio of 0.75; P greater than .05). Four of 378 intoxicated patients (1%) had
      profound hypoglycemia (less than 50 mg/dL) compared with none (0%) of the 96
      nonintoxicated patients. Intoxicated patients had a statistically significant
      lower rate of hyperglycemia in comparison with the nonintoxicated control group
      (29% versus 51%; P less than .0001). Age, sex, race, ethanol level, and serum
      electrolyte measurement had no predictive value for hypoglycemia in intoxicated
      patients. The anion gap was consistently elevated in hypoglycemic patients in
      comparison with normoglycemic patients (P less than .05). Hypoglycemia appears to
      occur as frequently in an ethanol-intoxicated population as in a population
      without elevated ethanol levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642700
TI  - Effect of administration of thyroxine on the risk of postpartum recurrence of
      hyperthyroid Graves' disease.
AB  - In our previous study, we reported that the administration of T4 to patients with
      Graves' disease who were under treatment with methimazole (MMI) decreased the
      level of antibodies to thyroid-stimulating hormone (TSH) receptors and the rate
      of recurrence of hyperthyroidism. In this study, the effect of T4 administration
      on the rate of postpartum recurrence of hyperthyroidism was examined. Seventy
      eight patients with Graves' disease had been treated with MMI for 1-3 yr before
      pregnancy, and MMI was discontinued 5-6 months after the onset of pregnancy
      because the levels of antibodies to TSH receptors decreased during early
      pregnancy. The patients were then divided into two groups. Group A (n = 40) was
      given T4 (100 micrograms/day) and group B (n = 38) was not given any drugs from 5
      months after the onset of pregnancy until 1 yr after delivery. The levels of the
      antibodies to TSH receptors and serum concentrations of thyroxine-binding
      globulin (TBG) and T4 were not different between the two groups before and during
      pregnancy, although a transient increase in serum T4 and TBG concentrations were
      observed during the pregnancy in both groups. After delivery, levels of
      antibodies to TSH receptors increased in both groups. The rate of increase,
      however, was more rapid in group B than in group A. The levels were significantly
      higher in group B than A at 3, 6, 9, and 12 months after delivery. Serum T4 and
      TBG concentrations decreased after delivery in both groups. Serum concentrations
      of T4 increased after delivery in group B but not in group A. The concentration
      of T4 was significantly higher in group B than in group A at 9 and 12 months
      after delivery. Postpartum recurrence of hyperthyroidism was 5.0% in group A and
      31.6% in group B, respectively, during the first year after delivery. These
      results suggest that administration of T4 during pregnancy and after delivery is
      effective in decreasing the level of antibodies to TSH receptors and to prevent
      the postpartum recurrence of hyperthyroidism.

PMID- 1642702
TI  - Early identification of acute myocardial infarction and prognosis in relation to
      mode of transport to hospital.
AB  - Of 2,840 consecutive patients who were admitted to the emergency department of a
      Swedish university hospital due to suspected acute myocardial infarction (AMI),
      only 25% were reached by the mobile coronary care unit (MCCU), and only 4%
      simultaneously fulfilled traditional criteria for prehospital thrombolysis (ie,
      had ST-segment elevation on admission electrocardiogram and a delay time of less
      than 6 hours). In the subset of patients who fulfilled criteria for a confirmed
      AMI, 31% were reached by an MCCU and 11% fulfilled criteria for prehospital
      thrombolysis. Among patients with confirmed AMI, the hospital mortality rate was
      highest in patients transported by standard ambulance (19%) versus 15% in those
      transported by an MCCU and 8% in those transported by other means. The authors
      conclude that AMI patients transported by ambulance are high-risk patients for
      early death. Prehospital thrombolysis might reduce their rate of mortality.
      However, according to the authors' experience only a minor fraction of patients
      are available for prehospital thrombolysis.

PMID- 1642703
TI  - Compliance with emergency department patient referral.
AB  - This study evaluated the nature and efficacy of compliance with emergency
      department (ED) patient referral recommendations. This was a prospective,
      nonrandomized, descriptive analysis of all ED patients referred mandatorily to an
      established urban hospital follow-up network. Compliance was measured by analysis
      of hospital records determined as appointment completion. Patient demographics,
      urgency of complaint, hospital relationship (new versus established), diagnosis
      (International Classification of Diseases-9CM), specialty, and method of payment,
      defined as clinic or private referral, were determined. Comparisons between
      groups used Fisher's exact test and chi 2 analysis (alpha = 0.05). There were
      2,185 patients encountered with 1,443 (66%) discharged for referral, and an
      overall compliance rate of 27.8% (401 patients). Patients had a mean age of 36.9
      years; 50.6% were male, 94.4% were established patients, 51.1% were clinic cases,
      and 96.7% had nonurgent complaints. Patients encountered had higher rates of
      compliance if female (33.9%), greater than 40 years of age (43.4%), with urgent
      complaints (46.8%), and if referred to private physicians (37.0%) (P less than
      .001). Compliance also correlated with the diagnosis of fracture (63.3%) or
      laceration (45.6%); and specialty referral to obstetrics-gynecology (28.4%) and
      general surgery (22.4%) consultants (P less than .01). Most patients demonstrate
      low compliance (28%) with follow-up recommendations, even with a directed ED
      referral system.

PMID- 1642704
TI  - Paramedic intubation training in a pediatric operating room.
AB  - The authors conducted a prospective study to assess the performance of paramedics
      with prior adult endotracheal intubation experience in pediatric intubation in
      the operating room of a teaching hospital. Nineteen paramedic students were
      observed attempting endotracheal intubation on a total of 57 anesthetized
      pediatric patients undergoing scheduled surgical procedures. The average age of
      patients was 5.1 years (range, 6 months to 15.2 years). Average duration of
      intubation attempts was 22.7 +/- 10.7 seconds, with a success rate on first
      attempt of 74%. Only minor complications occurred, and were limited to intubation
      attempts of greater than 45 seconds duration in four cases (6%), and patient
      oxygen saturation less than 90% in one case (2%). The study suggests that
      paramedics may be successfully incorporated into a hospital's clinical training
      program, and can receive closely supervised experience in pediatric endotracheal
      intubation without compromising patient care. Such training may increase the
      willingness of paramedics to attempt emergent prehospital endotracheal intubation
      of children, as well as increase their success with this potentially life-saving
      procedure.

PMID- 1642705
TI  - Steroids for the treatment of corrosive esophageal injury: a statistical analysis
      of past studies.
AB  - Caustic esophageal injury causes substantial morbidity and mortality. However,
      the use of corticosteroids to treat this problem has been evaluated in a limited
      number of studies because adequate sample size is difficult to obtain. We
      analyzed 361 subjects with corrosive esophageal injury derived from 10
      retrospective and three prospective publications. We divided cases into those
      treated with corticosteroids and antibiotics (T) and those that received neither
      modality (NT) based on inclusion and exclusion criteria. Forty-one percent of NT
      cases developed esophageal stricture and 19% of T cases developed this
      complication (P less than .01). There were no reported strictures among 72 first
      degree esophageal burns (combined T and NT cases). The T group contained 54
      strictures among 228 patients (24%) with either second- or third-degree burns.
      The NT group of 25 patients with the same burn severity suffered 13 strictures
      (52%) (P less than .01). Reports of death and gastrointestinal hemorrhage did not
      increase among steroid-treated patients. We do not recommend corticosteroid
      therapy for first-degree esophageal injuries. However, this therapy may be useful
      in preventing strictures among patients with second- or third-degree corrosive
      esophageal burns.

PMID- 1642706
TI  - Acute nutmeg intoxication.
AB  - Nutmeg is a common household spice sometimes abused for its hallucinogenic
      properties. This abuse is well reported in the medical literature over the last
      century. Ingestion of less than one tablespoon can produce symptoms similar to
      those of an anticholinergic toxic episode. Common presenting complaints are
      hallucinations, palpitations, and feelings of impending doom. We report a case of
      intentional nutmeg intoxication in a 23-year-old college student. As laboratory
      tests are usually normal, this diagnosis should be considered in patients
      presenting with an acute psychotic break accompanied by symptoms resembling an
      anticholinergic toxic episode. Treatment is primarily supportive once other life
      threatening conditions have been ruled out.

PMID- 1642707
TI  - "Pneumo-ptosis" in the emergency department.
AB  - The authors report the case of a 16-year-old female who presented with a left
      tension pneumothorax and a left Horner's syndrome. Chest tube thoracostomy
      performed to relieve the tension pneumothorax also resulted in the immediate
      resolution of the patient's ptosis and miosis. The probable mechanism for the
      patient's focal neurologic signs was traction upon the cervical sympathetic chain
      secondary to the mediastinal shift of the tension pneumothorax. This case
      demonstrates that unequal pupils in the presence of a pneumothorax could
      represent Horner's syndrome.

PMID- 1642708
TI  - Bedside visual colorimetry of peritoneal lavage fluid in abdominal trauma
      patients.

PMID- 1642709
TI  - Tetanus.
AB  - Tetanus is a preventable disease with proper immunization. The marked decline in
      the incidence over the past several decades has resulted from widespread use of
      tetanus prophylaxis and improved wound management in the emergency department.
      Emergency physicians are among the most frequent providers of tetanus
      vaccination. We can stress the importance of proper immunization and encourage
      patients to keep accurate immunization records. This can maximize protection of
      patients from tetanus, and minimize adverse reactions from excessive
      administration of booster. Tetanus can be fatal even with proper treatment. Vital
      treatment measures can easily be completed in the emergency department.

PMID- 1642710
TI  - Cases in electrocardiography.

PMID- 1642711
TI  - 1991 annual report of the American Association of Poison Control Centers National
      Data Collection System.

PMID- 1642712
TI  - Intubation of patients with cervical spine injuries.

PMID- 1642713
TI  - Threefold increase in theophylline serum concentration after addition of
      mexiletine.

PMID- 1642714
TI  - Ultraviolet light-induced keratitis secondary to germicidal lamp exposure
      resulting in corneal epithelial sloughing.

PMID- 1642715
TI  - Breathing pattern and subjective responses to small inspiratory resistance during
      submaximal exercise.
AB  - Breathing patterns and subjective responses to small resistances were
      investigated in seven subjects during moderate exercise. Inspiratory resistances
      of 0.15 (R1), 0.25 (R2) and 0.30 (R3) kPa.l-1.s were tested against control of
      0.06 kPa.l-1.s with no added resistance. Subjective responses to small
      inspiratory resistances were evaluated through whole experiments including
      periods before and after exercise, herein called SNS. Average SNS significantly
      increased above the R2 condition. Above the R2 condition, significant changes in
      the breathing components of volume, flow and timing were also observed during
      exercise. SNS grew as a power function of peak inspiratory pressure (P(imax))
      measured during exercise within such small range of stimulation less than the R3
      condition and individual differences in the relationship between SNS and P(imax)
      were observed. All subjects felt at least some discomfort below the resistance of
      R3 and two subjects felt it below around R1 condition. It was suggested that
      breathing pattern was selected to limit peak pressure at the R3 condition by
      further increasing inspiratory work for a breath and this tendency was reinforced
      in load-sensitive subjects with longer inspiratory time and lower peak flow rate.
      We concluded that breathing patterns depend mainly on peak work, especially in
      load-sensitive individuals, which is likely to be one of the primary determinants
      of a worker's tolerance to respirators.

PMID- 1642716
TI  - Pulmonary gas exchange dynamics and the tolerance to muscular exercise: effects
      of fitness and training.
AB  - Oxygen uptake (VO2) kinetics are generally agreed to be first-order for moderate
      work rates with a time constant (tau VO2) that is thought to reflect the kinetics
      of intramuscular creatine phosphate depletion. However, when there is a
      concomitant lactic acidosis, tau VO2 is appreciably longer, reflecting an
      additional, delayed and slowed component that leads to VO2S greater than the
      aerobic equivalent of that work rate and which therefore invalidates current
      techniques for O2 deficit estimation. This "excess" VO2 is no more than
      approximately 250-300 ml/min at work rates for which [lactate] and [H+]a can be
      stabilized. At higher work rates which demand sustained and progressive increases
      in [lactate] and [H+]a, however, VO2 also continues to increase progressively,
      yielding excess VO2S greater than 11/min at exhaustion. The trajectory of excess
      VO2 therefore is to the maximum VO2: the resulting exercise limitation becomes
      progressively more pronounced the higher the work rate, which accounts for the
      hyperbolic character of the power-duration curve. Factors which speed VO2
      kinetics in this domain reduce the excess VO2 mechanism and lead to improved
      exercise performance. We have demonstrated that, in addition to appropriately
      designed training regimens, induction of a metabolic acidosis prior to exercise
      speeds VO2 kinetics at high work rates, reducing the increase in both [lactate]
      and [H+]a and reducing the CO2 load to ventilation during the transient phase of
      the work. The optimum procedure for inducing these improved pulmonary gas
      exchange kinetics, however, remains to be determined.

PMID- 1642717
TI  - Possible mechanisms of oxygen uptake kinetics.
AB  - The VO2 response to a step change in work rate resembles a first order
      exponential function. This suggests that a single site of the many which link ATP
      demand to VO2 is limiting. The location of this site is controversial. Some
      authors suggest that O2 delivery regulates the VO2 response. Others have
      suggested that peripheral mechanisms within the active muscle regulate O2
      consumption. The evidence supporting each hypothesis is reviewed. It is concluded
      that O2 delivery sets the initial parameters and peripheral mechanisms then
      regulate O2 utilization within the bounds initially established by delivery
      mechanisms.

PMID- 1642718
TI  - Behavior of cardiac output during progressive exercise tests: a preliminary
      report.
AB  - The behavior of cardiac output (Q) during progressive incremental exercise tests
      was studied in young healthy men. Q approached a plateau and leveled off at
      almost the same work rate at which oxygen uptake (VO2) attained its maxima, while
      heart rate (HR) still continued to rise. This suggests that the limiting factor
      for maximal aerobic capacity in healthy subjects is Q. The rate of increase in Q
      and HR accelerated from a work rate which is close to the ventilatory anaerobic
      threshold (AT). The prime cause of the progressive augmentation in cardiac
      activity is probably an accelerated release of plasma catecholamine and/or
      potassium. There is a possibility that these substances might also affect the AT.

PMID- 1642719
TI  - Transient responses of heart rate, skin and muscle sympathetic nerve activity
      before and after anticipatory muscle contraction.
AB  - Sympathetic nerve activity leading to skin (SSA) and skeletal muscle (MSA) and
      heart rate were measured before and during two-minute static handgrip (SHG) in
      seven healthy volunteers. Two different situations were set before commencement
      of the exercise; one was that a preparation time of between 4 and 6 minutes was
      set prior to SHG while no information of starting time for exercise was given to
      the subjects (Cond. 1). Another was that after two minutes of control rest,
      countdown was started two minutes before SHG and then the handgrip was started
      (Cond. 2). Heart rate for 10-s before SHG in Cond. 2 increased significantly from
      the control value, while there was no significant change in Cond. 1. The
      magnitude of heart rate response to SHG was the same in either condition.
      Although SSA for 10 seconds just before the exercise did not show any change from
      the control value in Cond. 1, it increased in Cond. 2. There was no difference in
      SSA response patterns during SHG in either condition. Before commencement of SHG,
      MSA was suppressed at 10-s before exercise from the control value in Cond. 2, but
      there was no significant change in Cond. 1. After onset of contraction, MSA was
      suppressed in the brief initial period regardless of countdown, thereafter MSA
      increased time-dependently. The MSA response pattern to SHG was almost identical
      in both conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642720
TI  - Muscle metabolism during repeated exercise studied by 31P-MRS.
AB  - We studied 31P-nuclear magnetic resonance spectroscopy (31P-MRS) for repeated non
      invasive measurement of changes in the muscle metabolites, i.e., creatine
      phosphate (PCr) and inorganic phosphate (Pi), and changes in intramuscular pH,
      during repeated exercise and intervening rest periods. Six healthy male subjects
      performed 2 min of femoral flexion exercise at 20 kgm/min in a 2.1 Tesla
      superconducting magnet with a 67 cm bore. This exercise was repeated 4 times with
      2-min rest periods between bouts. During this time 31P-MRS data was collected
      with 32 scans per spectrum, requiring 12.8 sec. During exercise, the PCr
      decreased to 30.3 +/- 7.0% (mean +/- SD) of the pre-exercise level, and it did
      not completely recover during the rest period (79.0 +/- 1.3% of the pre-exercise
      level). Thereafter, when the exercise was repeated, the lowest PCr value during
      exercise decreased gradually (2nd bout, 22.1 +/- 3.9%; 3rd bout, 16.7 +/- 3.2%,
      and 4th bout 14.9 +/- 3.5%). The Pi increased by 705-740% during exercise and
      there were no significant differences in maximum Pi among the 4 bouts. During the
      rest period after the first bout, Pi fell to about 10% below the pre-exercise
      level in four of the six subjects. With repeated exercise, this undershoot was
      less common. The Pi/PCr ratio during exercise increased linearly over time.
      Furthermore, the maximum Pi/PCr ratio during exercise increased significantly
      with repeated exercises. We conclude that as exercise is repeated PCr gradually
      decreases, but there is no cumulative increase in Pi. Thus, the Pi/PCr ratio, an
      indicator of free ADP, increased with repeated exercise.

PMID- 1642721
TI  - Blood flow during muscle contraction and relaxation in rhythmic exercise at
      different intensities.
AB  - Effect of contraction force on blood flow during the contraction and relaxation
      phase of rhythmic handgrip exercise was studied on 6 healthy women. Velocity of
      blood flow in the brachial artery and the diameter of the artery were studied by
      Doppler-ultrasound method. Both the peak and mean velocity of the blood flow were
      significantly higher during the relaxation period than during contraction, and
      the velocity during the relaxation period was significantly higher in 30% MVC
      exercise than in 10% MVC exercise. However, no significant differences were found
      in the diameter of the artery between resting and exercise conditions, nor
      between exercises at different intensities. Thus blood flow during the relaxation
      phase was significantly increased from 135.7 +/- 18.2 ml.min-1 (10% MVC) to 182.5
      +/- 19.6 ml.min-1 (30% MVC) by an increased contraction force, whereas blood flow
      during the contraction phase was hardly affected by increased contraction force.

PMID- 1642722
TI  - Increase in neuromuscular activity and oxygen uptake during heavy exercise.
AB  - In order to examine the contribution of neuromuscular activity to the slow
      increase in VO2 during heavy exercise, integrated electromyogram (iEMG) of
      dominant working muscle and VO2 was compared in seven subjects during constant
      load cycling exercise at the intensity of 10% below and 30% above ventilatory
      threshold (VT) for seven minutes. VO2 and iEMG after 4th min in above VT test was
      significantly correlated (r = 0.53, p less than 0.01) and VO2/iEMG was constant
      after 4th min, indicating coupling of iEMG with VO2. The results suggested that
      the slow increase in VO2 during heavy exercise may result from the changes in the
      recruitment pattern of motor units.

PMID- 1642723
TI  - Ventilatory capacity and exercise-induced arterial desaturation of highly trained
      endurance athletes.
AB  - Recent evidence suggested that exercise-induced arterial O2 desaturation may
      occur in highly trained endurance athletes. So, Dempsey brought the hypothesis
      that the pulmonary capacity for oxygen transport cannot meet superior demands
      imposed by cardiovascular system in highly trained endurance athletes, and
      endurance training primarily causes adaptation in the skeletal muscles and in the
      systemic cardiovascular system, with little change in the pulmonary system. In
      the present study, we determined the propriety of the hypothesis due to measure
      the ventilatory capacity of endurance athletes. Sixteen highly trained endurance
      athletes (ET) and thirteen untrained subjects (UT) volunteered to participate in
      these experiments. All subjects performed the four experiments, 1) the highest
      oxygen uptake (peak VO2) during incremental cycle exercise and ventilation (VE),
      ventilatory equivalent for O2 (VE/VO2) and arterial O2 saturation (SaO2) at which
      peak VO2 was observed, 2) the maximal voluntary ventilation for 30 sec at rest
      (MVV), 3) the pulmonary diffusing capacity for CO (DLCO) and expressed per unit
      of alveolar lung volume (KCO) at rest by the single breath method, and 4) the
      ventilatory response to hypercapnia (S) at rest by rebreathing method, were
      measured. The peak VO2 of ET (66.7 ml.min-1.kg-1) was significantly (30.8%)
      higher than UT (52.4 ml.min-1.kg-1), and VE/VO2 and SaO2 of ET (29.3 and 93.7%,
      respectively) were significantly lower than UT (34.6 and 95.8%). There were no
      differences in VE, MVV, DLCO, and S between two groups.

PMID- 1642724
TI  - Swimming physiology.
AB  - Swimming takes place in a medium, that presents different gravitational and
      resistive forces, respiratory conditions and thermal stress compared to air. The
      energy cost of propulsion in swimming is high, but a considerable reduction
      occurs at a given velocity as result of regular swim training. In medley swimmers
      the energy cost is lowest for front crawl, followed by backstroke, butterfly and
      breast-stroke. Cardiac output is probably not limiting for performance since
      swimmers easily achieve higher values during running. Maximal heart rate,
      however, is lowered by approx. 10 beats/min during swimming compared to running.
      Most likely active muscle mass is smaller and rate of power production lesser in
      swimming. Local factors, such as peripheral circulation, capillary density,
      perfusion pressure and metabolic capacity of active muscles, are important
      determinants of the power production capacity and emphasize the role of swim
      specific training movements. Improved swimming technique and efficiency are
      likely to explain much of the continuous progress in performance. Rational
      principles based on improved understanding of the biomechanics and physiology of
      swimming should be guidelines for swimmers and coaches in their efforts to
      explore the limits of human performance.

PMID- 1642725
TI  - Validity of ratings of perceived exertion as an index of exercise intensity in
      swimming training.
AB  - The validity of ratings of perceived exertion (RPE), proposed by Borg (1962), as
      an index of exercise intensity in swimming training was discussed based on the
      following four experiments. Experiment I: VO2 and heart rate (HR) were measured
      and RPE was asked in ten female and seven male physical education students with
      different levels of swimming skill performing submaximal and maximal work in
      tethered swimming. The increases in HR and RPE with increase in %VO2max were
      fitted well by straight lines with high correlation coefficients of r = 0.957
      0.999 and r = 0.893-0.988, respectively. RPE was increased in a linear fashion
      with increase in HR except for a few subjects. The correlation coefficients for
      linear regression for individuals were 0.862-0.987. Experiment II: Swimming
      velocity and HR were measured in four groups with different levels of swimming
      skill. The breast stroke in a 50-m pool for 5 min at three RPE ratings, i.e.,
      very light (RPE 9), somewhat hard (RPE 13) and very hard (RPE 17) was requested
      of these groups. In good skilled well trained college swimmers, %HRmax was fairly
      higher than the RPE at the RPE 9 and RPE 13 levels but coincided with the RPE at
      the RPE 17 level. In skilled trained physical education students, the HR
      increased with a corresponding increase in RPE. But in the group with low or
      lower levels of swimming skill, the HR kept about the same values in spite of the
      increase in RPE. Experiment III: Two male and six female low skilled physical
      education students took the swimming training in the swimming pool for 2.0-2.5
      hours a day, 6 days a week, for 2 weeks. The students also received the swimming
      training in the sea which lasted for 2 hours each in the morning and in the
      afternoon for 6 days. The same RPE test, as mentioned in Experiment II, was done
      before, during and after swimming training. Mean swimming velocity during and
      after training was slightly higher than that before training at the RPE 9 and RPE
      13 levels, and was much higher at the RPE 17 level. Before training, the HR was
      fairly higher than the RPE at the RPE 9 and RPE 13 level. But during and after
      training, the HR was much closer to the RPE at the RPE 9 and RPE 13 levels.
      Experiment IV: Two male and three female lower skilled middle-aged swimmers
      performed the same RPE test as mentioned in Experiment II.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1642726
TI  - Peak oxygen uptake during arm stroke under a hypobaric hypoxic condition.
AB  - The purpose of this study was to examine the limiting factor for swimming by
      measuring peak oxygen uptake (peak VO2) during front crawl (C) and arm stroke (A)
      under a hypobaric hypoxic condition. Seven-trained swimmers (age; 19-21 yrs, 100
      m free style event; 57.2 +/- 2.5 secs) were measured twice under a normal (N)
      (751 mmHg) and a hypobaric hypoxic (H) (602 mmHg) condition in a chamber where
      atmospheric pressure was regulated. Water flow rate started at 0.80 m.sec-1 and
      was increased by 0.05 m.sec-1 every 2 min up to 1.00 m.sec-1. Subsequently, flow
      rate was increased by 0.05 m.sec-1 every minute until exhaustion. VO2 was
      measured with an automatic analyzer. The peak heart rate under N was not
      significantly different from that under H in both C (N; 190 +/- 9, H; 184 +/- 6
      beats.min-1) and A (N; 180 +/- 6, H; 181 +/- 6 beats.min-1). Peak VO2 values
      during A (N; 3.42 +/- 0.27, H; 3.08 +/- 0.19 l.min-1) were significantly lower by
      15-20% than those during C (N; 4.18 +/- 0.18, H; 3.65 +/- 0.11 l.min-1) for both
      N and H (p less than 0.01). Peak VO2 values under H were significantly lower than
      those under N during both C and A (p less than 0.01). There was no significant
      difference in the magnitude of decrease in peak VO2 between C (12.0 +/- 3.4%) and
      A (9.8 +/- 3.8%) under H. This ratio of decrease agrees with previous
      investigations that studied centrally limited exercise, such as running and
      cycling, under similar levels of hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642727
TI  - Difference of physiological responses to swimming and running.
AB  - The purpose of this research is to investigate the range of response to the
      treadmill running and swimming. Cardiovascular changes and substrates changes in
      blood were examined before and after healthy male subjects (swimming group (SG)
      has swimming habits and running group (RG) has practiced basketball or baseball
      or running more than four days a week) swam and ran for 10 to 15 minutes
      voluntarily. Average heart rate was recovered more quickly in case of running
      than swimming in the RG, but in the SG there was no difference. Diastolic blood
      pressure recovered to the rest condition faster in the SG than RG. In case that
      subjects have done familiar exercise, free fatty acids increased a little more
      after 10 minutes than in case of unfamiliar exercise. These results suggest that
      response of habitual exercise showed lesser change of diastolic blood pressure
      and more increase of free fatty acids. There might be a difference in
      physiological responses between usual sports and other kinds, so that we had to
      be careful when we apply different styles of activity to use training.

PMID- 1642728
TI  - Validity of critical velocity as swimming fatigue threshold in the competitive
      swimmer.
AB  - The purpose of this investigation was to determine whether the critical velocity
      (CV) as the swimming speed which can be theoretically maintained for a very long
      time without exhaustion could be applied to estimate the swimmer's endurance
      performance. CV was based on the concept of critical power originality
      established by Monod and Scherrer (1965) and extended by Moritani et al. (1981),
      and expressed as the slope of a regression line between swimming distance (D) at
      each velocity and its sustained time (T). Seventeen highly trained swimmers were
      instructed to swim the four different swimming distances (50 m, 100 m, 200 m and
      400 m) at maximal effort using the swimming pool. In the results of CV, the
      regression relations between D and T were expressed in the general form, D = a +
      bxT, with r2 showing higher than 0.997 (p less than 0.001). These results
      indicate extremely good lineality. Furthermore, VO2max during incremental
      exercise test, swimming speed corresponding 4 mM of blood lactate concentration
      (V-OBLA) and mean velocity in the 200 m and 400 m freestyle (V-200 and V-400)
      were measured on nine subjects. Significant correlations were found between CV
      and V-OBLA (r = 0.862, p less than 0.01), CV and V-200 (r = 0.781, p less than
      0.01), CV and V-400 (r = 0.999, p less than 0.001), V-OBLA and V-400 (r = 0.869,
      p less than 0.01) and V-200 and V-400 (r = 0.776, p less than 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1642729
TI  - The physiology of cycling with reference to power output and muscularity.
AB  - The maximal average power output (Wmax) and capacity (Wcap) of the short-term
      (anaerobic) energy processes are examined in cyclists and young adults with
      respect to body size and muscularity. The results show that when Wmax and Wcap
      are standardized for muscle size the power and capacity of the anaerobic
      mechanisms are similar between trained sprint and pursuit cyclists and untrained
      young healthy adults. Thus the efficiency of anaerobiosis appears to a function
      of muscularity in man over the range of subjects studies. From the data it is
      estimated that the probable efficiency of supra maximal cycling is of the same
      order (0.22) as found for steady state submaximal (aerobic) exercise.

PMID- 1642730
TI  - Muscle energetics during exercise by 31P NMR.
AB  - Previous studies have shown that a decrease in muscle tension is not proportional
      to decrease in the ATP concentration and free energy for ATP degradation but is
      proportional to the decrease in ATP consumption during muscle contraction, and
      that the free ADP concentration in the cell can be estimated using the Pi/PCr
      ratio obtained by 31P NMR. From this view, we discuss findings on muscle
      energetics during exercise that have been clarified by 31P NMR and its future
      problems.

PMID- 1642731
TI  - Muscle metabolism during exercise: anaerobic threshold does not exist.
AB  - Blood lactate level begins to increase at a certain work load or oxygen
      consumption which is called as anaerobic threshold (AT). However, numerous
      studies showed that anaerobic glycolysis is not the cause of the enhanced
      accumulation of blood lactate during exercise. Increased lactate production is
      seen even in fully aerobic muscles. Some studies suggest that elevation of
      lactate is due to a temporary imbalance between the rates of pyruvate formation
      by aerobic glycolysis and pyruvate utilization in the Krebs cycle. These results
      clearly suggest that AT does not exist.

PMID- 1642732
TI  - Relationship between power spectral densities of P-P and R-R intervals.
AB  - To investigate the role of the peripheral effector for the generation of heart
      rate variability, the relationship among the P-P, R-R, P-R, and R-P intervals
      were compared on five healthy male subject in the supine position. During supine
      rest, electrocardiogram was monitored, and P-P, R-R, P-R, and R-P intervals were
      measured. Power spectral densities (PSD) were estimated by using direct method
      for successive 256 intervals. PSDs were integrated at the low (PSDLF; 0.05-0.15
      cycle/beat) and high (PSDHF; 0.20-0.40 cycle/beat) frequency bands. Mean interval
      times of P-P, R-R, R-P, and P-R intervals were 827 +/- 40, 827 +/- 40, 357 +/-
      34, 170 +/- 19 msec, respectively. PSDLFS of P-P, R-R, R-P, and P-R intervals
      were 15677 +/- 2771, 15566 +/- 2815, 15345 +/- 2767, 1491 +/- 255 msec2/c/b,
      respectively. PSDHFS of P-P, R-R, R-P, and P-R intervals were 13289 +/- 3602,
      12918 +/- 3897, 12558 +/- 3630, 2758 +/- 517 msec2/c/b, respectively. The PSD of
      P-R intervals showed white noise. These results might suggest that the periodic
      fluctuation would be formed at or above the sinoatrial node.

PMID- 1642733
TI  - Cardiac autonomic regulation after moderate and exhaustive exercises.
AB  - The purpose of this study was to investigate the recovery kinetics of cardiac
      autonomic regulation after acute exercises related to exercise intensity.
      Firstly, eight healthy subjects performed two kinds of constant load exercises at
      the work rate corresponding to 20% and 100% of the individual ventilatory
      threshold (VT) in addition to the exhaustive incremental exercise using a cycle
      ergometer. Blood pressure (BP) and oxygen uptake (VO2) were measured during 9 to
      10 min after the exercises as well as the beat-by-beat recording of R-R
      intervals. Coarse graining spectral analysis (CGSA) was applied to heart rate
      variability (HRV) data sets of 5 min before exercise, last 5 min during exercise,
      and 8 to 10 min after exercise. The low frequency (0-0.15 Hz; LO) and the high
      frequency (0.15-0.5 Hz: HI) areas under power spectra were calculated for
      evaluating sympathetic (LO/HI) and vagal (HI) activities. The recovery for 10 min
      was sufficient to settle both VO2 and BP even after the exhaustion. Comparing to
      the pre-exercise value, however, HI was still suppressed until 10 min after the
      100% VT exercise (522 +/- 300 vs. 122 +/- 63 msec2, p less than 0.05) while it
      was recovered at 10 min after the 20% VT one (353 +/- 122 vs. 487 +/- 159msec2).
      Secondly, six healthy subjects performed an incremental cycle exercise until
      exhaustion. The R-R intervals were monitored beat-by-beat during 30 min after
      exercise. The CGSA was applied to every five min data set of HRV during recovery
      phase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642734
TI  - Effect of DCA administration or endurance training on lactate metabolism in mice
      during and after exercise.
AB  - The purpose of this study was to investigate the effect of the activation of
      tissue oxidative capacity by dichloroacetate (DCA) administration or endurance
      training on oxidative removal of lactate, which is the major pathway of lactate
      metabolism, in mice during prolonged exercise and after supramaximal exercise.
      DCA administration significantly decreased the blood lactate concentration and
      activated the oxidative removal of lactate during prolonged exercise. DCA
      administration did not change lactate metabolism in mice after supramaximal
      exercise. Endurance training significantly decreased the blood lactate
      concentration during prolonged exercise and also activated the oxidative removal
      of lactate. Endurance training significantly increased the recovery of the blood
      lactate concentration after supramaximal exercise, while it did not activate the
      oxidative removal of lactate. These results suggest that the activation of the
      tissue oxidative capacity decreases the blood lactate concentration and also can
      activate the oxidative removal of lactate during prolonged exercise, while it
      does not activate the oxidative removal of lactate after supramaximal exercise.

PMID- 1642735
TI  - Dose/response effects of exercise modeled from training: physical and biochemical
      measures.
AB  - This study has measured the pattern of elevated serum enzyme activity (ESEA)
      during extended daily training in a dose-response manner and compared ESEA to the
      pattern of accumulated fitness and fatigue predicted from a mathematical model
      previously described. Blood samples were taken regularly during the study from
      each subject and the activity of lactate dehydrogenase (LDH), creatine kinase
      (CK), and aspartate aminotransferase (AST) in the serum was measured. Although no
      single physiological/biochemical correlate of the hypothesized fatigue
      compartment of performance is firmly identified it is significant that the
      pattern of variation of model fatigue and ESEA throughout training were similar
      although slightly out of phase. With continued hard training, model fatigue began
      to plateau and concomitantly ESEA declined exponentially from its initial high
      value in early training. During relative rest throughout a tapering period
      following training both ESEA and fatigue reverted quickly towards baseline and
      follow the similar but earlier time course in blood of a degradative membrane
      enzyme phospholipase A2 observed in clinical studies.

PMID- 1642736
TI  - The effects of resistance training on muscle area and strength in prepubescent
      age.
AB  - The purpose of this study was to determine the effect of strength training in
      prepubescent boys and girls on muscle strength and cross-sectional area of upper
      arm. Subjects were ninety-nine healthy elementary school children who belonged to
      1st, 3rd and 5th grades and they were assigned to two groups of training (N = 52)
      and control (N = 47). Training group participated in strength training program
      for 12 weeks which consisted of maximum sustained isometric contraction of elbow
      flexion for ten sec, whereas control group did not participate in special
      training program in this period. In orger to determine the changes due to
      training, cross-sectional areas of the tissues in upper arm, such as muscle, fat
      and bone, were measured by the ultrasonic method. Maximum isometric and
      isokinetic muscle strength of elbow flexion and extension were measured by means
      of isokinetic cybex dynamometer. In order to assess the development of
      physiological maturity, TW2 method was used to estimate the skeletal age in each
      subject by taking the hand-wrist X-ray photograph. After 12-week training period,
      the whole cross-sectional areas increased in both training and control groups.
      This increment was due to significant increases in muscle and bone area in the
      training group and, on the other hand, due to the increase in fat area in the
      control. The increment of muscle area of training group was about 50% of that
      derived from the study on adults (Fukunaga, T., 1978). The increment in cross
      sectional area of muscle with training was significantly correlated with the
      skeletal age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642737
TI  - The benefits of the low intensity training.
AB  - This presentation addressed the researches concerning the effects of the low
      intensity training on health promotion done in our laboratory. Supervised
      physical training performed at 50% VO2max or lactate threshold for 60 minutes, 3
      or 5 times a week for 30 sessions could induce the improvement in VO2max, lipid
      profiles, and augment in cardio-pulmonary baroreflex. This training was also
      applied for patients in ischemic heart disease, hypertension, and obesity. These
      patients could improve their aerobic work capacity. Hypertensive patients could
      reduce their blood pressure in association with modulating in humoral factors
      without changes in body weight and diet. The obese patients succeeded in
      significant body reduction with mild food reduction. We also found the existence
      of break-point of double product (BPDP) during graded exercise test corresponding
      to lactate threshold. BPDP will be able to use for estimating lactate threshold.
      This low intensity training, which is easier and safer, can be recommended to the
      wide-variety of persons including older person to promote health.

PMID- 1642738
TI  - The clearance rate of exercise-elevated blood lactate following physical
      training.
AB  - In this paper, previous studies regarding the effect of physical training on the
      disappearance rate of blood La during recovery after strenuous exercise have been
      briefly summarized. The results of our own recent study of this problem have also
      been added. It may be concluded that there is some evidence for an improved
      lactate metabolic clearance rate resulting from physical training in human
      subjects, when the degradation rate is estimated from serial blood samples taken
      during a standard ramp ergometer test to exhaustion during each week of a
      training/detraining sequence. This beneficial effect of training, however, may
      also be influenced by the initial physical status of the subject and the nature
      of the training program.

PMID- 1642739
TI  - Changes in intracellular pH of muscle during dynamic contraction.

PMID- 1642740
TI  - Liberal arts in the surgery residency.

PMID- 1642741
TI  - [Therapeutic possibilities of sympathoadrenergic reactions during general
      anesthesia using sublingual application of glycerol trinitrate].
AB  - Strong surgical stimulation (for e. g. sternotomy, mediastinal preparation and
      aortic dissection in heart surgery) leads to an adrenergic reaction with the so
      called haemodynamic break-through phenomenon. The inhibition of this reaction by
      means of narcotics is always connected with a dangerous decrease of cardiac
      index. Therefore, the sublingual application of nitroglycerin (GTN: 7
      micrograms/kg), well established in the therapy of angina pectoris, was used as a
      rapidly applicable alternative. Patients with coronary heart disease under
      neuroleptanaesthesia (n = 10) were investigated in comparison to volunteers (n =
      5). Beside the registration of haemodynamic parameters by invasive monitoring,
      the determination of arterial plasma concentrations of GTN and its metabolites
      1.2- and 1.3-glyceryl dinitrate (GDN) were performed using gas-chromatographic
      technique. Using the same doses the haemodynamic changes are more marked and of
      longer duration in the anaesthetised patients than in the awake volunteers. The
      cause seems to be the higher and longer detectable active concentrations of GTN
      and GDN (the average maximum GTN concentrations greater than 0.5 ng/ml still
      after 12 minutes in contrast to 7 minutes). After discussing various different
      pharmacokinetic possibilities this effect is probably related to the simple fact
      of an improved resorption of the drug in the anaesthetised patient (no
      salivation, no swallow movements). On the basis of this investigation the
      sublingual application of GTN is a very useful therapy for the blockade of
      sympathoadrenergic reactions under anaesthesia, but the commonly used doses of
      GTN has to be reduced by half (3-4 micrograms/kg).

PMID- 1642742
TI  - Automated anaesthesia recording system. Statement regarding the article by J.S.
      Gravenstein.

PMID- 1642744
TI  - Toxic oil syndrome. Current knowledge and future perspectives. Introduction.

PMID- 1642743
TI  - Physiology, pathophysiology and pharmacology of the coronary circulation with
      particular emphasis on anesthetics.
AB  - The normal control of coronary blood flow is through alterations in the
      resistance of the intramyocardial arterioles (R2). Myocardial cellular hypoxia
      causes increased breakdown of ATP (or decreases synthesis) resulting in increased
      concentrations of the purine metabolite, adenosine. This potent endogenous,
      vascular smooth muscle relaxant vasodilates the R2 arterioles increasing coronary
      blood flow and myocardial O2 delivery. This mechanism autoregulates coronary
      blood flow according to myocardial O2 needs. Myocardial hypertrophy (from chronic
      hypertension) or coronary atherosclerosis interfere with this process and result
      in myocardial ischemia which may cause symptoms (angina), signs (ECG changes,
      regional muscle dysfunction) or tissue death (myocardial infarction). In
      addition, coronary atheroma disrupt endothelial function in the large R1 coronary
      arteries predisposing to vasoconstriction, platelet aggregation and thrombosis.
      Therapeutic measures for controlling ischemia may include decreasing oxygen
      demand (especially heart rate) and maintaining supply (R1 vasodilators and anti
      thrombotic drugs such as non-steroidal anti-inflammatories). Intravenous, most
      inhalational and regional anesthesia appear to interfere minimally in the control
      of both the normal and ischemic coronary circulation. Thus optimizing myocardial
      oxygen balance (maintaining supply and decreasing demand) during anesthesia
      protects the ischemic myocardium. High doses of isoflurane, sevoflurane or
      desflurane are potent R2 coronary vasodilators which may cause redistribution of
      collateral blood flow away from ischemic regions (coronary steal). However, if
      tachycardia and hypotension are avoided, such an effect has not been shown
      experimentally or clinically. Preliminary evidence suggests that halothane may
      preferentially dilate R1 arteries and/or interfere with platelet aggregation. If
      these effects are confirmed, then halothane may prove to be the anesthetic of
      choice in the non-failing ischemic heart.

PMID- 1642745
TI  - Immunology.

PMID- 1642746
TI  - Future research.

PMID- 1642747
TI  - Clinical findings.

PMID- 1642748
TI  - Pathology.

PMID- 1642749
TI  - Epidemiological studies.

PMID- 1642750
TI  - Experimental studies.

PMID- 1642751
TI  - Chemical composition of TOS-related oils.

PMID- 1642752
TI  - Histamine: an early messenger in inflammatory and immune reactions.
AB  - The local concentration of histamine at sites of inflammation and immune
      responses is invariably high. Recent studies suggest that the biological
      relevance of this accumulation of histamine extends beyond its well-characterized
      role in mediating allergic reactions. In this article, Andras Falus and Katherine
      Meretey describe a possible function for histamine in cytokine-governed
      regulation of inflammatory and immune cascades.

PMID- 1642753
TI  - Slow bacterial infections or autoimmunity?
AB  - In this article, Graham Rook and John Stanford propose that a group of idiopathic
      diseases that are often associated with a degree of autoimmunity and arthritis,
      including rheumatoid arthritis, inflammatory bowel disease, sarcoidosis and
      psoriasis, are caused by extremely slow-growing bacteria. They suggest that these
      diseases are one end of a continuous spectrum caused by related slow-growing
      genera, which ranges from rheumatoid arthritis, through Takayasu's arteritis and
      Whipple's disease, to reach the conventional mycobacterioses such as tuberculosis
      and leprosy.

PMID- 1642754
TI  - Intermolecular cooperativity: a clue to why mice have IgG3?
AB  - Mouse IgG3 subclass antibodies predominate in humoral responses to bacterial
      polysaccharide antigens. The reasons for this isotype restriction are not fully
      understood. Here, Neil Greenspan and Laurence Cooper propose that intermolecular
      cooperativity, a novel mechanism of antibody binding, may help to explain the
      preferential expression of IgG3 antibodies in these responses.

PMID- 1642755
TI  - Poly's lament: the neglected role of the polymorphonuclear neutrophil in the
      afferent limb of the immune response.
AB  - The polymorphonuclear leucocyte (PMN) has traditionally been thought to
      participate in the inflammatory response only as an effector cell. However,
      recent data demonstrate that PMNs can synthesize and release cytokines, such as
      IL-1, TNF-alpha and IL-6, and hence modulate both T- and B-cell activities in the
      evolution of an immune response.

PMID- 1642756
TI  - Intracellular transport of MHC class II molecules.
AB  - MHC class II molecules associate, during biosynthesis, with peptides derived from
      endocytosed antigen. Here, Jacques Neefjes and Hidde Ploegh describe the
      intracellular transport of MHC class II molecules and its relationship to the
      binding of peptides in endosomal compartments. They discuss alternative routes
      for the delivery of antigen to sites at which peptides associate with MHC class
      II molecules and raise the possibility of cell type-specific differences in the
      handling of MHC class II molecules, and hence in antigen presentation.

PMID- 1642757
TI  - Observations on constitutional resistance to infection.
AB  - The attention of most immunologists is held by the elaborate nonspecific and
      antigen-specific mechanisms of reactive immunity. There is, however, a more
      fundamental level of immunity to infection that is shared by all forms of life:
      constitutional resistance to infection. In this article, the nature and
      importance of constitutional immunity is illustrated using examples from
      population, cell and molecular biology.

PMID- 1642758
TI  - Behring's discovery of diphtheria and tetanus antitoxins.

PMID- 1642759
TI  - Tat and Kawasaki disease.

PMID- 1642760
TI  - The rheumatoid synovium: a model for T-cell anergy?

PMID- 1642761
TI  - [Role of the HLA system in the functioning of the immune system].
AB  - HLA molecules share a particular architecture that allow them to present various
      peptides. They belong to 2 different subfamilies (class I and class II) working
      in parallel: each class restricts the presentation of potentially immunogenic
      peptides to a peculiar T cells subpopulation. This lead HLA system to be one of
      the possible components of the allergic background.

PMID- 1642762
TI  - [Diversity of antigenic fractions of allergenic extracts and importance of the
      Western blot technique].
AB  - The Phast-system groups together the techniques of electrophoresis and transfer.
      When applied to allergen extracts it allows identification of the allergenic
      protein fractions and shows their reactivity against sera from allergic patients.
      The Phast-system is indicated for the choice of the appropriate allergen for
      specific immunotherapy. If it is not possible to do it systematically, it should
      be done whenever there is a check to specific immunotherapy.

PMID- 1642763
TI  - Do burn patients have a silver lining?
AB  - Silver-containing pharmacological preparations have been used for many years in
      the prophylaxis and management of burn wound sepsis and, more recently, 1 per
      cent silver sulphadiazine cream (SSD) has been the treatment of choice for such
      problems. A prospective clinical study has been undertaken to determine the
      absorption and effects of the silver ion from SSD, with particular reference to
      hepatic and renal function. Twenty-two patients were studied. The silver assay
      was done by atomic absorption spectrophotometry with an attached graphite
      furnace. The detection level was 0.5 micrograms/l. The precision at 3.5
      micrograms/l was 4.8 per cent and at 8.5 micrograms/l was 2.8 per cent. Silver
      was rapidly absorbed through the burn wound and serum silver levels were elevated
      in 20 patients. Silver was found to be deposited biochemically and
      electronmicrographically in the liver and kidneys of the only patient who died in
      the study group. Early hepatic dysfunction was present in all burns greater than
      10 per cent total body surface area. Liver and renal function tests did not
      correlate with serum silver levels. A urinary threshold to silver excretion was
      seen at a serum silver level of 100 micrograms/l. This study demonstrates that
      silver is rapidly absorbed through burn wounds, is deposited in large amounts
      throughout the body but appears safe when used in the treatment of moderate
      burns. Whether the very high levels recorded in the subject who died were
      inherently detrimental will remain a matter for speculation.

PMID- 1642764
TI  - Neopterin plasma levels in burn patients.
AB  - Burn victims have severely depressed cellular immunity and despite careful
      hygiene, antibiotics and early surgical therapy the infection rate remains high.
      The assessment of plasma neopterin levels can be considered as an indirect
      measurement of macrophage function, because activation of macrophages is
      accompanied by the release of D-erythro-neopterin. The influence of burn trauma
      on neopterin levels was investigated to determine whether neopterin estimations
      might have a prognostic or diagnostic value. Twenty patients with a mean age of
      36 +/- 16 years and a TBSA of 45.5 per cent +/- 23 were studied. During the whole
      hospital treatment daily blood samples were analysed for neopterin levels using
      radioimmunoassay. Starting from normal levels (9 +/- 1.6 nmol/l), neopterin
      content increased continuously until day 10 (30-40 nmol/l), then fluctuated
      around these high levels for several weeks. There were no differences between
      patients with TBSA less than 35 per cent or greater than 35 per cent, and between
      survivors and non-survivors. Burn injury caused a constant increase of plasma
      neopterin indicating an intact reaction by macrophages. It can be used as an
      additional parameter for the diagnosis of sepsis: high values being a sign of
      adequate reaction by macrophages, whereas low neopterin values in the presence of
      bacteraemia and clinical symptoms of sepsis show a deleterious impairment of
      immune functions.

PMID- 1642765
TI  - The psychological problems of burned patients. The Rudy Hermans Lecture 1991.

PMID- 1642766
TI  - An algorithmic approach to the management of cutaneous burns.
AB  - An algorithm of fluid resuscitation for cutaneous burns is presented. The
      management of these cases entails an initial process of evaluation followed, when
      appropriate, by the administration of intravenous fluids. The fluid requirements
      are prospectively calculated and subsequently modified by using closed loop
      feedback with monitoring of urine output, plasma deficit, osmolality and vital
      signs. Three 'problem boxes' have been incorporated into the algorithm to outline
      the management of: 1. fluid deficit and excess; 2. acute renal failure; 3. the
      critically ill patient. An algorithm such as this can never be complete, but in
      its present form it provides both a teaching tool for junior staff as well as a
      valuable clinical aid for those involved in the acute management of burns
      patients.

PMID- 1642767
TI  - Factors involved in burn mortality: a multivariate statistical approach based on
      discriminant analysis.
AB  - This article suggests an alternative statistical model for studying the mortality
      of burned patients: discriminant analysis. This model was applied to our
      population of 532 patients among whom 71 died. It is not the first time that this
      model has been applied to assess burn mortality, although it is not frequently
      used for that application. We found four factors that are statistically
      significant: age, TBSA, inhalation injury and sex (female). Discriminant analysis
      allowed us to demonstrate an impressive correlation between death, age and TBSA;
      inhalation injury by itself and sex, the two other significant factors in our
      study, seem to have a minor influence on the final outcome of the burned patients
      and their predictive value is virtually nil. The advantages of this statistical
      model are compared with logistic regression, the commonly chosen statistical
      method.

PMID- 1642768
TI  - Incidence of HIV seroconversion in paediatric burn patients.
AB  - A retrospective review of paediatric patients treated for acute burn injuries and
      receiving blood/blood products between 1978 and 1985, identified 52 patients at
      risk for HIV infection. Over 50 per cent of the identified population had
      received 3 or more units of blood/blood products during their acute hospital
      stay. A total of 214 patients (36.8 per cent) have been tested for HIV
      seroconversions: five tested HIV positive by ELISA and four were confirmed by
      Western Blot, yielding a 1.9 per cent incidence. The four confirmed patients
      received 2-9 total body blood volume turnovers during their postburn period in
      hospital. At 4 years post-exposure, two patients show active disease, one is
      currently asymptomatic and one has died from AIDS-related sepsis.

PMID- 1642769
TI  - Operative treatment of deep burns of the scalp and skull.
AB  - Traditional surgical treatment of deep burns of the scalp and skull involve the
      excision of necrotic bone and soft tissues with trephanation of the bone to
      permit granulation tissue formation and subsequent grafting. This approach
      prolongs wound time, adds additional trauma and, even after initial healing,
      necessitates secondary soft tissue and bone reconstruction. The treatment
      described here is an alternate and more aggressive one involving early excision
      of necrotic soft tissue without bone resection followed by immediate coverage
      with well-vascularized axial flaps from adjacent intact scalp. This method
      provides an optimal environment for healing and regeneration of areas of
      destruction to the skull. This surgical method was used in the treatment of 22
      patients with deep burns of the scalp with satisfactory clinical results. Bone
      regeneration was confirmed by roentgenological investigations.

PMID- 1642770
TI  - An analysis of childhood burns in Kuwait.
AB  - A prospective study of 394 burned children (in-patients) up to the age of 12
      years old was carried out for the period from January 1984 to December 1986. They
      were categorized into three age groups, the infants and toddlers 0-2 years, early
      childhood 3-6 years and late childhood 7-12 years. In the first two groups
      scalding was the predominant cause of injury, while in late childhood there were
      many more flame burns. Ninety-five per cent of the accidents occurred at home and
      the majority happened in the presence of parents. The presence of parents was not
      a deterrent to the accident but ensured speedy transport to the hospital. In our
      review 3 per cent of patients sustained more than 50 per cent BSA burns, there
      were 12 deaths with a mortality rate of 3 per cent. An intense campaign to make
      parents aware of the risk factors and their avoidance is required to reduce the
      number of burn accidents.

PMID- 1642771
TI  - Burn injuries in the Dong Bei area of China: a study of 12,606 cases.
AB  - This survey analyses data from nine Chinese burn units with respect to age,
      causes, severity of burn injury, and survival or death of patients admitted to
      hospital during the past 10 years (from January 1980 to December 1989). Of 12,606
      burned patients treated, 3391 were children (26.9 per cent) and over half the
      children (52.3 per cent) were up to 4 years old. Almost 60 per cent of the 12,606
      patients treated were in the young adult group (15-44 years), and 86.9 per cent
      of 12,606 patients sustained thermal injuries mainly from fire flames followed by
      scald injuries (40.7 per cent). About 93 per cent of the patients had burns
      covering less than 50 per cent of the body surface area. The overall mortality
      rate was 1.24 per cent. The LD50 for the 12,112 patients less than 60 years old
      was a burned surface area exceeding 80 per cent of the total body surface area.

PMID- 1642772
TI  - Benefits of silicone cream occlusive dressing for treatment of meshed skin
      grafts.
AB  - A side-by-side evaluation of a silicone cream occlusive dressing technique for
      grafted meshed skin on the extremities of 10 patients is described. The site
      treated by silicone cream showed less congestion in the interstices of the mesh,
      less visible diamond pattern, and less hardness of the skin in all patients
      compared with the control site, which was treated by application of petroleum
      jelly ointment. The general appearance of the silicone cream-treated site showed
      better cosmetic results when compared with the control site.

PMID- 1642773
TI  - In vitro antimicrobial effects of fresh split skin, homologous-cultured
      epithelium and porcine split skin grafts for wound coverage.
AB  - Various biological dressings, for example, human fresh and cadaver skin grafts,
      homologous cultured human epithelium and deep frozen porcine split skin
      (Lyocutis), have been used to treat skin loss. Each of these biological dressings
      has its advantages and disadvantages. The antimicrobial properties of each
      dressing type are important since bactericidal activity influences the lifespan
      of the transplanted tissue. In the present study the in vitro antimicrobial
      effects of human fresh skin, homologous cultured epithelium and Lyocutis were
      compared to in vivo bactericidal activity of these dressings and possible
      clinical applications are recommended.

PMID- 1642774
TI  - Prevention of dressing slippage under an elastic bandage.
AB  - A technique is described to prevent the shift in position of dressing materials
      by applying a double-sided adhesive tape between the skin and the elastic
      bandage. This technique also prevents a shift in position of a pressure garment,
      especially when applied around joints on the extremities.

PMID- 1642775
TI  - Burns from electric fire-guards.
AB  - Nine children with burns caused by contact with electric fire-guards are
      presented. A method of preventing such injuries is recommended.

PMID- 1642776
TI  - Enteral hyperalimentation of burned patients: the possibility of correcting
      metabolic disorders by the early administration of prolonged high calorie evenly
      distributed tube feeds.
AB  - Metabolic processes and the ways they may be treated were investigated in
      severely burned patients receiving prolonged high calorie evenly distributed tube
      feedings. It was shown that in critically ill patients the absorption of
      nutrients in the upper regions of the intestine was slightly impaired but the
      ability to absorb was preserved, which made it possible to provide prolonged
      evenly distributed tube feeding. For these purposes we used the nutrient mixture
      'Combustal'. Restoration of nitrogen balance could be reached within about 10
      days after starting tube feeding. However, the creatine excretion remained high,
      a manifestation of increased dystrophy of muscle tissue. Pseudocholinesterase
      activity in serum was also decreased, suggesting subnormal biosynthetic
      processes. To provide the full correction to normal of the metabolic processes
      the tube feeding with 'Combustal' should be given for at least a month.

PMID- 1642777
TI  - Chemical burns: our 10-year experience.
AB  - A review of 173 patients with chemical burns admitted to our burn unit was
      carried out during the years 1976-85. Most burns were work related (83 per cent).
      The majority of patients were men aged 21-50 years (mean age = 29.6 years). The
      mean total body surface area involved was 3.6 per cent (range = 1-30 per cent).
      The mean length of stay in hospital was 6.3 days (range = 1-52 days). The
      extremities were involved in 68 per cent of the patients. The more common
      aetiological agents were bromine and its compounds (36 per cent), then acids (21
      per cent), alkalis and organic substances (14.5 per cent each). The severest
      burns were caused by the inorganic substances. Delayed admission was most
      characteristic of the bromine and alkali burns. Complications included local
      infection (19 cases), systemic infection (two cases), inhalation injury (two
      cases), tissue necrosis (one case) and corneal erosion (one case). There were no
      deaths. Increased awareness of the hazardous potential of chemicals should help
      reduce the incidence of chemical burns.

PMID- 1642778
TI  - Management of electrical injuries of the abdomen.
AB  - High voltage electrical burns may involve intra-abdominal viscera with or without
      an abdominal wound. The risk of such an involvement is much higher when a wound
      is present. Depending upon the amount of heat produced vapourization of tissues
      may occur. If it includes part of the peritoneum, visceral damage is revealed
      immediately. If it does not occur to that extent, necrosed tissues remain in
      continuity and visceral involvement remains concealed until slough separates. The
      prognosis is related to early diagnosis of the associated visceral injury. It is
      recommended that the debridement should be undertaken at 2-3 days postburn.
      Laparotomy is indicated if part of the peritoneum is also debrided.
      Reconstruction of the abdominal wall may be a formidable task. Among the options
      available, pedicled muscle and musculocutaneous flaps seem to be ideally suited
      for the purpose.

PMID- 1642779
TI  - Hot tap water burns.

PMID- 1642780
TI  - Role of a two-chain IL-6 receptor system in immune and hematopoietic cell
      regulation.
AB  - Three factors with distinct function are involved in the regulation of the B-cell
      response into antibody-producing cells: (1) a factor for the activation of
      resting B cells (BSF1/IL-4), (2) a factor for the growth of activated B cells
      (BCGFII/IL-5), and (3) a factor for the final maturation of B cells into antibody
      producing cells (BSF2/IL-6). The cDNAs for these three molecules have been
      cloned, and studies with recombinant molecules demonstrated that their individual
      functions were not confined to the B-lineage cells; they were found to have a
      wide variety of biological functions. A typical example of a pleiotropic function
      of such interleukins is BSF2/IL-6. BSF2/IL-6 is not only a B-cell-differentiation
      factor, but also is a potent growth factor for myeloma cells. Moreover, BSF2/IL-6
      acts as hepatocyte-stimulating factor to induce acute-phase proteins and
      multicolony-stimulating factor to activate hematopoietic stem cells. It appears
      that BSF2/IL-6 plays an essential role in the host defense mechanisms against
      infections, inflammation, and injury. Receptors for BSFs have not yet been
      molecularly cloned because of the low density of receptor molecules. Recently,
      the cloning of the cDNA for BSF2/IL-6 receptor has been achieved and its
      molecular structure and the signals transduced through it are described herein.

PMID- 1642781
TI  - [Serological screening for Trypanosoma cruzi among blood donors in central
      Brazil].
AB  - The present study compares the results of serological screening for Trypanosoma
      cruzi infection done at blood banks with results obtained in Chagas' disease
      studies undertaken by the Reference Laboratory of the Federal University of Goias
      (UFG) and evaluates the use of the enzyme-linked immunosorbent assay (ELISA) for
      this purpose. The study was conducted with data from six of the eight blood banks
      in the city of Goiania in central Brazil, an urban area in which this infection
      is highly endemic. The population studied consisted of 1,513 volunteers who had
      donated blood for the first time between October 1988 and April 1989. The sample
      represented 50% of all first-time blood donors during the period. Of these
      donors, 94% were residents of urban areas, and of these, approximately 26% had
      migrated from the countryside. Nearly 90% of the blood donations in the city are
      received at these banks, which normally use the indirect hemagglutination and
      complement-fixation tests. The samples selected for the study of T. cruzi
      antibody in first-time blood donors were assayed at the Reference Laboratory of
      the Federal University of Goias using the indirect hemagglutination (IH),
      indirect immunofluorescence (IF), and enzyme-linked immunosorbent assay (ELISA)
      tests, independently of the serological classification performed by the blood
      banks. Comparison of the results provided by the latter with the positivity
      pattern established in the study (IH and IF yielded simultaneous positive results
      in the Reference Laboratory) revealed a relative sensitivity of 77%, with
      extremes ranging between 50% and 100%, depending on the blood bank
      studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642782
TI  - [Psychiatric disorders among victims of disasters 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- 1642783
TI  - Fluorescence spectroscopy studies of the effects of pyrethroids on the DPPC
      vesicles.
AB  - The interactions of pyrethroids with membrane lipids have been studied by means
      of fluorescent membrane probe DPH. Pyrethroids located in the interior
      hydrophobic regions of the lipid bilayer, differed in their effectiveness of
      lowering the phase transition temperature and in their ability to broaden the
      temperature range of this transition. With the increase in the concentrations of
      pyrethroids, the effects of disordering hydrocarbon packing were increased by
      pyrethroids. Fluorescence polarizations (P) were decreased in gel state, but not
      changed in fluid state by permethrin. The pyrethroids containing a cyano
      substituent could not only disturb the hydrocarbon packing in the bilayer core,
      but also cause collisional quenching of DPH fluorescence in gel state, P were
      decreased, then were increased and at last were decreased slightly again as the
      concentrations were increased, in fluid state P were not changed substantially at
      low concentrations and were increased obviously when the concentrations were
      higher.

PMID- 1642784
TI  - An outbreak of poisoning from Penicillium cyclopium contaminated dried persimmon.
AB  - It is the first report of an outbreak of 114 food-poisoning cases due to
      consumption of Penicillium cyclopium contaminated dried persimmon. Gastralgia,
      diarrhea, dizziness and general malaise are chief symptoms of the poisoning, with
      incubation period of 2-6 hrs generally and a short disease period (generally
      recovered within 2-3 days). No enteropathogenic organism, pathogenic coccus and
      Campylobacter jejuni were detected. Surface fungi counts were 49,000/g, 21.3
      times of that discovered in the marketed dried persimmon. Penicillium cyclopium
      Westling was the dominant fungus isolated. Mouse toxicity tests were carried out
      with the crude extracts of the fungus culture. Diarrhea, tremor and convulsion
      were observed before death. During autopsy, necrosis and hemorrhagic foci were
      observed in G.I. tract after intra-peritoneal injection and intubation. In histo
      pathological examination, different degree of necrosis and scaling of gastro
      intestinal mucous membrane, lymphocyte infiltration, and necrosis of liver cells
      and renal tubule epithelial cells could be seen.

PMID- 1642785
TI  - Effect of vitamin C supplementations on iron deficiency anemia in Chinese
      children.
AB  - A total of 65 children with mild iron deficiency anemia (IDA) were divided into 5
      groups, and received 0, 25, 50, 100 and 150 mg/day of vitamin C (VC) respectively
      every day for 8 weeks. Hemoglobin, serum ferritin, free erythrocyte and
      hematocrit were determined every week. At a daily average intake of about 30 mg
      of VC and 7.5 mg of Fe, the results of the study indicate that: (1) VC supplement
      alone could effectively control children's IDA, and a dose-dependent relationship
      was observed. (2) 50 mg/day of VC is the most efficient dosage and 6 weeks is the
      shortest time for an effective therapy. (3) With a diet predominantly comprised
      of plant foods, it is suggested that appropriate dose of VC should be
      supplemented for the children during winter and spring in northeastern areas of
      China.

PMID- 1642786
TI  - A judgment of attribution of increase in urine beta 2-microglobulin after
      environmental cadmium exposure.
AB  - Urine beta 2-microglobulin (beta 2-m) was measured in 433 persons with low-level,
      long-term environmental exposure to Cd, and in 124 control persons from
      unpolluted area. In 152 of the exposed persons, and some of the controls, the
      urine beta 2-m exceeded the limit. Of the 433 exposed persons, 74 cases with both
      urine Cd and beta 2-m exceeding the limit were matched by the control. This study
      suggests that after the stratification of the degrees of renal tubular injury
      according to the fractional beta 2-m excretion (FE beta 2-m) and coordination of
      clinical examination, FE beta 2-m could contribute to identifying renal tubular
      dysfunction due to Cd exposure and kidney lesion when both Cd exposure and
      original nephropathy exist.

PMID- 1642788
TI  - Altered host resistance to Listeria monocytogenes in mice exposed to 1
      chloroacetophenone (CN) vapours.
AB  - Short term repeated exposure of 1-chloroacetophenone (CN) vapours at a
      concentration of 0.153 mg per litre for 15 minutes daily on 10 consecutive days
      in Swiss albino male mice resulted in increased mortality to Listeria
      monocytogenes. Significantly elevated bacterial growth was observed in the spleen
      and liver of the CN exposed animals. The increased bacterial count in these
      organs was evident within 4-6 days post challenge as compared to vehicle exposed
      infected and unexposed infected animals. Increased susceptibility to infection
      has been considered to be the function of immune alteration due to cumulative
      short term effects of CN vapour inhalation. This may be attributed to immunotoxic
      effects of CN on T-cells mediated macrophage functions.

PMID- 1642787
TI  - Indoor air pollution and pulmonary function in children.
AB  - Pulmonary function in winter time in 1,343 school children aged 10-13 years was
      measured in four cities located in northern and southern part of China. The
      results showed that FVC, FEV1, PEF, V75, V50 and V25 in children living in homes
      with coal stoves were decreased by 1.5-10.7% compared with children living in
      homes with gas or LPG stoves in Chengde and Shanghai. In contrast to this, no
      significant difference in pulmonary function was found in Shenyang and Wuhan. It
      suggested that this phenomenon was related to indoor air pollution, and partly
      related to passive smoking or outdoor air pollution.

PMID- 1642789
TI  - Development of the new antimalarial drug pyronaridine: a review.
AB  - This report outlines the structure scheme and development of a new antimalarial
      drug pyronaridine, which was synthesized from either 2-aminopyridine or pyridine.
      A series of in vivo and in vitro experimental studies and the assessment of
      toxicity revealed pyronaridine to be a promising agent against erythrocytic stage
      of malaria parasites. It exhibited low toxicity and had no cross-resistance to
      chloroquine. Clinical administration in malaria cases showed high efficacy and
      mild side-effects. In order to retard the development of resistance of Plasmodium
      falciparum to pyronaridine, a combination of
      pyronaridine/sulfadoxine/pyrimethamine was used in the treatment of chloroquine
      resistant falciparum malaria in Hainan Province. Further in vivo test was carried
      out to monitor the sensitivity of P. falciparum to this combined formula for 5
      years (1986-1990) in Diaoluo area where chloquine-resistant falciparum malaria
      was prevalent. Drug resistance was not demonstrated in this field study.

PMID- 1642790
TI  - Studies on the epidemiology and etiology of moldy sugarcane poisoning in China.
AB  - Moldy sugarcane poisoning, an acute fatal food poisoning of unknown etiology, has
      occurred in 13 provinces in China. The epidemiological characteristics and
      clinical features were described. Evidence from laboratory studies indicates that
      3-nitropropionic acid produced by the fungus Arthrinium Spp. is the etiological
      factor of this food poisoning.

PMID- 1642791
TI  - Acetylcholinesterase characteristics of termite queen exposed to
      anticholinesterase compounds.
AB  - A regional profile of AChE activity was noted in the Indian termite queen
      Odontotermes redemanni with the head recording the higher and body the lower
      range of activity. The enzyme characteristics such as substrate and temperature
      optima were more or less similar while pH requirement for optimum AChE activity
      varied from 7.0 to 7.6 In vitro inhibition of head and body AChE was studied
      using pure and commercial anticholinesterase compounds. Interestingly, the
      commercial formulations like Metacid-50 and Carbaryl are potent enough at 1 x 10(
      8) M to produce 50% in vitro inhibition of AChE of head and body regions within
      15 min of preincubation. A 20 min of preincubation (t0.5) was necessary to record
      50% in vitro inhibition of AChE with known and pure anticholinesterase compounds
      such as DFP (3.5 x 10(-10) M) and physostigmine (3.6 x 10(-10) M). It is surmised
      that (a) the response of the head and body AChE to the commercial formulations of
      the insecticides may be used as a reliable and sensitive bioindicator of
      pesticidal contamination of the terrestrial environment and (b) termite control
      may be successfully done with the application of organophosphate or carbamate
      compounds.

PMID- 1642792
TI  - Role of soluble factors in immune and normal sera in the control of giardiasis
      due to Giardia lamblia.
AB  - Hyperimmune sera (HIS), raised against crude giardia antigen, on in vitro
      interaction, caused more agglutination of Giardia lamblia trophozoites. Heat
      inactivated HIS possessed a comparable agglutinating activity as the non
      inactivated controls. Non-inactivated normal (unimmunized) serum caused
      immobilization of Giardia trophozoite, which was checked on heat inactivation.
      Antibodies in immune sera are mainly responsible for agglutination, whereas the
      heat labile non-immune components control the mobility of the intestinal
      parasite.

PMID- 1642794
TI  - Removal of Cu and Ni by free and immobilized microalgae.
AB  - The present investigation evaluated the effectiveness of Chlorella cells in
      concentrating Cu and Ni in their cells and thereby removing the two metals from
      solution. The removal efficiency of the two metals by free and immobilized algal
      cells were further studied. (1) Four types of Chlorella cells, namely Chlorella
      pyrenoidosa (26) (from Carolina Biological Supplies Company), Chlorella HKBC-1
      and-2 (isolated from a polluted stream receiving wastewater from several
      electroplating factories) and Chlorella HKBC-3 (from a clean water pond) were
      subjected to different concentrations of Cu and Ni accordingly. It was revealed
      that Chlorella HKBC-1 was the most tolerant species to Cu and Ni as reflected by
      their highest values of 48 h and 96 h "Highest no effect concentrations" (The
      highest concentration of the tested substance that does not inhibit the growth
      rate of the alga: Cu 2 and Ni 10 mg/l at 48 h, Cu 2 and Ni 5 at 96 h). This was
      followed by C. pyrenoidosa (26) and then C. HKBC-2 while C. HKBC-3 had the lowest
      tolerance to the two metals (Cu 0.5 and Ni 2 at 48 h; Cu 0.5 and Ni 1 mg/l at 96
      h). (2) It was further revealed that C. HKBC-1 had higher concentration factors
      and removal efficiencies of Ni (734-963 mg/l, 16.3-18.7%) and C. HKBC-2 had
      higher concentration factors and removal efficiencies of Cu (2316-2839 mg/l, 53.7
      66%) when exposed to lower concentrations of Cu (0.5, 1 and 2 mg/l) and Ni (5, 10
      and 13 mg/l). (3) By treating the free and immobilized algal cells (algal cells
      entrapped in alginate beads) with different concentrations of Cu and Ni, it was
      observed that free cells had higher concentration factors and removal
      efficiencies when compared with immobilized cells (free cells: Cu 1577-3056 mg/l,
      24.2-71.4%; Ni 355-849 mg/l, 4.8-18.7%; immobilized cells: Cu 453-935 mg/l, 13.9
      53.2%; Ni 244-486 mg/l, 3.2-11.9%).

PMID- 1642793
TI  - Effect of certain toxicants on gonadotropin-induced ovarian non-esterified
      cholesterol depletion and steroidogenic enzyme stimulation of the common carp
      Cyprinus carpio in vitro.
AB  - Isolated ovarian tissues from the common carp, Cyprinus carpio were incubated in
      vitro to obtain a discrete effect of four common toxicants of industrial origin,
      namely phenol, sulfide, mercuric chloride and cadmium chloride, on gonadotropin
      induced alteration of nonesterified and esterified cholesterol and steroidogenic
      enzymes, delta 5-3 beta-HSD and 17 beta-HSD activity. Stage II ovarian tissue
      containing 30-40% mature oocytes were shown to be most responsive to
      gonadotropins in depleting only nonesterified cholesterol moiety and stimulating
      the activity of both. Safe doses of above mentioned toxicants when added
      separately to stage II ovarian tissue with oLH (1 microgram/incubation)
      gonadotropin-induced depletion of nonesterified cholesterol and gonadotropin
      induced stimulation of the activity of both enzymes was significantly inhibited.
      Esterified cholesterol remained almost unaltered. Findings clearly indicate the
      impairment of gonadotropin induced fish ovarian steroidogenesis by the four
      toxicants separately.

PMID- 1642795
TI  - Viral aseptic meningitis in the United States: clinical features, viral
      etiologies, and differential diagnosis.

PMID- 1642796
TI  - Pancreatic abscess and infected pancreatic pseudocyst: diagnosis and treatment.

PMID- 1642797
TI  - Approach to the febrile traveler returning from Southeast Asia and Oceania.

PMID- 1642798
TI  - Management of septic shock: new approaches.

PMID- 1642799
TI  - The increasing prevalence of resistance to antituberculosis chemotherapeutic
      agents: implications for global tuberculosis control.

PMID- 1642800
TI  - Use of immune globulins in the prevention and treatment of infections.

PMID- 1642801
TI  - Mycobacterium avium complex in AIDS.

PMID- 1642802
TI  - Aeromonas species: role as human pathogens.

PMID- 1642803
TI  - Evaluation of cryptic fever in a traveler to Africa.

PMID- 1642804
TI  - Purulent pericarditis.

PMID- 1642805
TI  - Diagnosis and management of infections of implantable devices used for prolonged
      venous access.

PMID- 1642806
TI  - Familial occurrence of Summitt syndrome or a variant example of Carpenter
      syndrome?
AB  - In this report, we describe three sibs presenting an identical malformation
      syndrome i.e.: acrocephaly, brachydactyly, prominent metopic ridge, broad
      depressed nasal bridge, narrow maxillae, obesity and normal intelligence. We
      discuss the relationship between this combination of clinical signs and symptoms
      most compatible with the diagnosis of Summitt syndrome and the Carpenter
      syndrome.

PMID- 1642807
TI  - Apert syndrome with partial preaxial polydactyly.
AB  - Acrocephalosyndactyly type I or Apert syndrome is characterized by
      craniosynostosis, particular dysmorphic features and abnormalities of the hands
      and feet. Rarely, polydactyly of the toes has been reported, and in this event
      the diagnosis of Carpenter syndrome must be discussed. A case of atypical
      Acrocephalosyndactyly type I syndrome with partial preaxial polydactyly is
      reported. Despite this preaxial polydactyly a diagnosis of Apert syndrome
      consecutive to a new mutation was made, and the possibility of recurrence
      considered to be highly improbable.

PMID- 1642808
TI  - Extreme growth failure and kyphoscoliosis as complications of the distal trisomy
      10q syndrome.
AB  - The patient was diagnosed in infancy. Clinical findings and results of re
      evaluation 13 years after diagnosis are presented.

PMID- 1642810
TI  - A new syndrome with ptosis, coloboma and mental retardation.

PMID- 1642809
TI  - A syndrome of mental retardation, short stature, craniofacial anomalies with
      palpebral ptosis and pulmonary stenosis in three siblings with normal parents. An
      example of autosomal recessive inheritance of the Noonan phenotype?
AB  - We present a family with four children in which three, a girl and two boys,
      present a similar MR/MCA syndrome with slight to moderate mental retardation,
      short stature, peculiar facies with palpebral ptosis, pectus excavatum and
      pulmonary stenosis. As both parents are mentally and physically normal, autosomal
      recessive inheritance of this Noonan-like phenotype is most likely. The findings
      in the present family confirm that the Noonan phenotype may be caused by
      different etiologies with different types of genetic transmission.

PMID- 1642811
TI  - Lethal malformation syndrome in three siblings. A variable expression of the same
      entity?

PMID- 1642812
TI  - The check-up of reproductive health and genetic counseling.
AB  - The Hungarian Family Planning Program was a feasibility study on combining
      methods of periconceptional care. The first step was the check-up of reproductive
      health, including family history of the couples, case history of females, pre
      pregnancy examination (vaginal and cervical smears), and the measurement of basal
      body temperature, sperm examination, psycho-sexual exploration and exclusion of
      some risk factors. This preconception screening program was carried out by
      graduate trainee nurses to identify those participants secondary health services.
      The data of 4,240 couples attending in the Budapest Center indicated a useful
      relationship between the check-up of reproductive health and genetic counseling
      clinics, by selecting couples requiring genetic counseling and preventing other
      couples making unnecessary visits.

PMID- 1642813
TI  - Wiedemann-Beckwith syndrome: clinical, cytogenetical and radiological
      observations in 39 new cases.
AB  - Thirty-nine patients (82% under 1 year of age) with Wiedemann-Beckwith syndrome
      (WBS) were prospectively studied. To evaluate the somatometric data the normal
      range was set out at mean +/- 2 SD. The relevant physical findings were a
      characteristic face, non increased mean height and weight, normal head
      circumference, defective abdominal wall, a predominance of the upper segment, and
      tibial bowing. Mental retardation was documented in 5 cases but in only 1 it was
      related to hypoglycemia. The 32 cases karyotyped were normal. Since neonatal
      hypoglycemia is frequent (34.3% in our series) and potentially deleterious for
      the CNS we propose to monitor the glycemia every 6 h during the first 3 days in
      WBS newborns in order to correct glycemia below of 2.6 mmol/l (46.8 mg/dl)
      according to recent studies. The comparison with previous large series enabled us
      to precise the frequency, onset and evolution of the main stigmata.

PMID- 1642814
TI  - Smith-Lemli-Opitz syndrome: the changing phenotype with age.
AB  - In this report we present follow up data of two brothers with Smith-Lemli-Opitz
      syndrome. The changes with ageing are striking and few of the typical SLO traits
      are still present, which makes it extremely difficult to make the diagnosis Smith
      Lemli-Opitz syndrome at adult age.

PMID- 1642815
TI  - Partial monosomy 8p and partial trisomy 8p with moderate mental retardation.
AB  - A female patient with mosaicism for partial monosomy 8p and partial trisomy 8p is
      presented. Her karyotype is 46,XX, del(8)(p21)/46,XX, dup(8)(p21----pter). She
      showed minimal dysmorphic features, agenesis of the corpus callosum and moderate
      developmental delay. There is no previous report of mosaicism for partial
      monosomy and partial trisomy 8p. The clinical findings in the presently described
      patient are less severe than those reported in cases with only monosomy or
      trisomy of the distal part of chromosome 8.

PMID- 1642816
TI  - Tetraphocomelia and bilateral femorotibial synostosis. A severe variant of the
      thrombocytopenia-absent radii (TAR) syndrome?
AB  - In this report we describe severe tetraphocomelia with complete femorotibial
      fusion in a second trimester male fetus. The association of severe
      tetraphocomelia-femorotibial synostosis has previously been reported in three
      patients as examples of a severe variant of the thrombocytopenia-absent radii
      (TAR) syndrome. In the present fetus no morphological abnormalities of the
      megakaryocytes were detected. This observation is not in favour of the hypothesis
      that abnormalities of the primordial megakaryocytes may be causally related with
      the pathogenesis of the limb malformations as present in this syndrome.

PMID- 1642818
TI  - Outcome measures ... a chimera?

PMID- 1642817
TI  - Radial ray deficiency and ulnar ray deficiency in two sibs.
AB  - A kindred with a diabetic mother is described with one sibling with a radial
      deficiency (type 1 radial dysplasia (Bayne) with a hypoplastic thumb type 3 of
      Blauth) and one with an ulnar ray deficiency (type 2 of Ogden or type 1 of
      Swanson). A metabolic cause is probable, although the diabetes was well
      controlled during pregnancy.

PMID- 1642819
TI  - Analysis of data in idiographic research. Issues and methods.
AB  - Time-series and single-subject designs are being advocated for use in
      rehabilitation research to document the effectiveness of therapeutic intervention
      procedures. The argument is made that these designs are practitioner-oriented and
      practice-based. Acceptance and application of single-subject procedures by
      rehabilitation researchers will depend on the development of reliable and
      accurate methods of data analysis. Previous research suggests that traditional
      visual analysis of graphed data is unreliable and that quantitative supplements
      to visual analysis should be included in single-subject investigations. The
      advantages and limitations of two commonly advocated supplements to visual
      analysis are examined. The two supplemental procedures are the split-middle
      method of trend estimation and the resistant trend line. One advantage of the
      resistant trend line is that it does not make the assumption of a linear pattern
      in single-subject data. The argument is made that the resistant trend line is the
      preferred method and should be selected over the more commonly used split-middle
      method of trend estimation. The advantages and limitations of other quantitative
      procedures are briefly examined.

PMID- 1642820
TI  - Insights into amputee running. A muscle work analysis.
AB  - Five young, active, unilateral below knee amputees wearing the SACH prosthetic
      foot, and six normal subjects participated in the study. Subjects ran at a
      controlled velocity of 2.8 m/s +/- 10% over a ground reaction force plate while
      being filmed with a video camera. Joint moments, power outputs and mechanical
      work characteristics were then calculated. During stance phase the amputee
      prosthetic limb exhibited a marked reduction in total work. There was a reduction
      in the mechanical work at the knee and the prosthetic foot/ankle with a
      compensatory increase in mechanical work by the hip musculature. The intact
      stance phase limb mechanical work characteristics were not significantly
      different from normal. The hip flexors were the only muscle group in the swing
      phase prosthetic limb with a significant increase in muscle work compared with
      normal subjects. The intact swing phase limb in contrast exhibited a marked
      increase in concentric muscle work by the hip flexors and eccentric muscle work
      by the knee flexors in early swing phase, and an increase in concentric hip
      extensor and eccentric knee flexor muscle work in late swing phase. The major
      compensatory patterns, therefore, that allow below knee amputees to run appear to
      be an increase in stance phase hip muscle work on the prosthetic limb and
      increased hip and knee muscle work on the intact limb during swing phase.

PMID- 1642821
TI  - Estimation of normal lumbar flexion with surface inclinometry. A comparison of
      three methods.
AB  - The purpose of this study was to determine the magnitude and clinical
      significance of surface measurement error in the determination of lumbar spinal
      flexion. Intrarater, inter-rater and intermethod reliability estimates were
      obtained using single inclinometry, double inclinometry and back range-of-motion
      inclinometry methods. Eight healthy subjects were examined independently by two
      experienced observers and three replicates of each measurement were obtained by
      each observer in a random sequence. In addition, three replicates of lumbar
      flexion angles were obtained for each subject by a single observer using the B
      200. Reliability estimates were determined by intraclass correlation coefficients
      and were further compared by paired t tests between observation series. The
      median range of error was 8.5 degrees using the single inclinometer, 10.5 degrees
      using the double inclinometer and 16 degrees using the back range-of-motion. The
      intrarater reliability was generally higher than inter-rater reliability and
      intermethod reliability was low in most cases reflecting the poor cross-validity
      across inclinometry methods and between each inclinometry method and the B-200.
      In conclusion, significant measurement error in estimating lumbar flexion by
      inclinometry may be expected to occur even in a "controlled" setting using
      experienced observers, standard examination techniques and asymptomatic healthy
      subjects. These findings appear to undermine the expectation that the clinician
      can reliably apply surface inclinometry to estimate loss of spinal mobility for
      purposes of impairment determination.

PMID- 1642822
TI  - Sexual activities, concerns and interests of men with spinal cord injury.
AB  - A representative sample of 79 men with spinal cord injury, drawn from a sampling
      frame of 661 women and men who reside in the community, was studied in terms of
      sexual activity, concerns and interests. Participants responded to a
      questionnaire and rating scales and were physically examined to establish their
      neurologic status. With respect to eleven other areas of life, sex life ranked
      the lowest in terms of satisfaction and fifth in terms of importance. Of the
      sample, 67% reported having had a physical relationship (not necessarily
      including intercourse) in the past 12 months. Areas of sexual activity about
      which respondents were most concerned were not satisfying a partner, getting or
      giving a sexual disease, urinary accidents, and not getting enough personal
      satisfaction. From among seven topics related to sexuality, the three in which
      there was greatest interest were methods and techniques to achieve sexual
      satisfaction, helping a partner cope emotionally with limitations on sexual
      activity and ability to have children.

PMID- 1642823
TI  - Outcomes following cardiopulmonary resuscitation in an acute rehabilitation
      hospital. Clinical and ethical implications.
AB  - This retrospective study examines cases of cardiac arrest requiring
      cardiopulmonary resuscitation (CPR) in an acute rehabilitation hospital. All
      admissions to the Center for Rehabilitation Medicine at Emory University, a 56
      bed facility, are reviewed. Seventeen cases of true cardiac arrest are identified
      for analysis of ultimate disposition over a 10-yr period. Only one patient (5.9%)
      survived CPR to discharge from the rehabilitation hospital, but he died
      subsequent to his transfer to the acute hospital. Though the sample size is
      small, it reflects the total population of patients eligible for CPR who suffered
      a cardiac arrest. We conclude that CPR is generally not successful in the elderly
      inpatient rehabilitation population. The growing clinical complexity of the
      rehabilitation patient demands that health-care providers and their patients more
      regularly address decision-making issues pertinent to CPR.

PMID- 1642824
TI  - Use of a polyethylene body jacket to prevent feeding tube removal in an agitated
      patient with anoxic encephalopathy.
AB  - Maintaining a feeding tube in place in the agitated patient following a traumatic
      brain injury or anoxic encephalopathy is a familiar problem. However, a survey of
      the literature employing the MEDLINE system provided no solutions. This case
      study of a 36-yr-old patient with anoxic encephalopathy illustrates a new method
      of preventing feeding tube removal using a modified polyethylene body jacket. The
      patient had repeatedly pulled out his gastrostomy tube despite the use of four
      way restraints, a posey, behavior modification and anti-psychotic medications at
      levels near sedation. A polyethylene jacket with an S-shaped tunnel for feeding
      tube exit was constructed to cover the abdomen. FINDINGS: 1) The patient was
      unable to disturb the feeding tube. 2) The recessed design of the jacket's tunnel
      did not traumatize the feeding tube or obstruct fluid flow. 3) Nursing staff
      encountered no problems in placing or removing the orthosis. 4) Skin integrity
      was maintained. 5) The orthosis did not interfere with therapies.

PMID- 1642825
TI  - Methylphenidate in stroke patients with depression.
AB  - The treatment of depression after stroke is a difficult clinical problem. Many of
      the medications used to treat patients with depression in the general population
      have significant potential side effects that are of particular concern in elderly
      patients. We reviewed the records of ten patients with stroke treated with
      methylphenidate for depression during an inpatient rehabilitation program.
      Improvement was noted in seven patients. This suggests that methylphenidate in
      the treatment of post-stroke depression merits further study.

PMID- 1642826
TI  - Liver transplant rehabilitation.

PMID- 1642827
TI  - Nasal and oral airflow resistors. Site, function, and assessment.
AB  - Major respiratory resistors situated at the nasal and oral portals are described,
      and the part they play in disrupting laminar flow of inspiratory air and
      facilitating the mucosal contact and mixing essential for effective cleansing,
      warming, and humidification is discussed. The resistors also determine the
      distribution of oronasal airflow. The contribution of structural and mucovascular
      elements to nasal airflow resistance is examined and the place of history,
      rhinoscopy, and rhinomanometry in clinical assessment of nasal patency and its
      variation in health and with age, race, and disease, is discussed.

PMID- 1642828
TI  - Serous otitis media. An opportunity for early recognition of nasopharyngeal
      carcinoma.
AB  - In a prospective study of 271 new patients with nasopharyngeal carcinoma, 36
      (13.3%) were found to have cranial nerve involvement. Serous otitis media (SOM)
      was found in 98 (41.4%) of 237 patients who had undergone complete otologic
      assessment. The local control of tumor and actuarial survival of three subgroups
      of patients, namely, 80 patients with SOM only, 11 patients with cranial nerve
      palsy only, and 18 patients with both SOM and cranial nerve palsy, were analyzed.
      The local control of tumor was better in patients with SOM alone than in those
      with cranial nerve palsy alone; those patients with both SOM and cranial nerve
      involvement had worse local control as well as survival. As SOM is not uncommon
      in the diagnosis of nasopharyngeal carcinoma, and adult-onset SOM is otherwise
      distinctly uncommon, this provides a good opportunity for early recognition and,
      perhaps, better control of nasopharyngeal carcinoma.

PMID- 1642829
TI  - Primary squamous cell carcinoma of the parotid gland.
AB  - We reviewed all cases of possible primary squamous cell carcinoma of the parotid
      gland treated at Mayo Clinic, Rochester, Minn, from 1960 through 1988. Eighteen
      cases of primary squamous cell carcinoma of the parotid gland were identified. We
      report the clinical behavior and results of treatment of these rare parotid gland
      neoplasms. The age at diagnosis ranged from 48 to 86 years; the majority of
      patients were aged 65 years or older. Half of the patients presented with an
      asymptomatic parotid gland mass; a painful mass occurred in 33% of patients.
      Facial paralysis was noted in 17%, and a neck was the presenting symptom in 11%
      of patients. All patients underwent parotidectomy, and all or part of the facial
      nerve was sacrificed in 66% of patients. A neck dissection was performed in 12
      patients, five of whom had pathologic confirmation of neck metastasis. Adjunctive
      radiation therapy was performed in 55% of patients. The overall survival at 5
      years was 50%. Deep fixation and facial nerve paralysis were associated with a
      poor prognosis. Most recurrences developed within 1 year of initial treatment.
      Regional recurrence was always associated with a rapid death. Our data suggest
      that aggressive treatment and early detection may result in a better prognosis
      than is commonly associated with these tumors.

PMID- 1642830
TI  - The lack of utility of a tumor marker panel in head and neck carcinoma. Squamous
      cell carcinoma antigen, carcinoembryonic antigen, lipid-associated sialic acid,
      and CA-125.
AB  - An ideal tumor marker should be sensitive in tumor-bearing patients while having
      adequate specificity so that controls do not demonstrate the marker. To date, a
      single circulating marker has not been identified for squamous cell carcinoma of
      the head and neck. This study evaluates a panel including squamous cell carcinoma
      radioimmunoassay, lipid-associated sialic acid, carcinoembryonic antigen, and CA
      125. In this population of patients with cancer, serum samples from 101 patients
      and 88 controls were evaluated. The squamous cell carcinoma radioimmunoassay was
      the most sensitive marker identified (47.5%), while carcinoembryonic antigen
      level was elevated in 40.6%, lipid-associated sialic acid level in only 16.8%,
      and CA-125 level in 7.9%. False-positive results were found with all markers,
      including squamous cell carcinoma radioimmunoassay (18.2%), carcinoembryonic
      antigen (18.2%), lipid-associated sialic acid (10.2%), and CA-125 (15.9%).
      Various combinations of markers did not significantly improve either specificity
      or sensitivity. Available tumor markers are inadequate for diagnostic purposes in
      patients with squamous cell carcinoma of the head and neck.

PMID- 1642831
TI  - Simultaneous chemoradiation in the treatment of advanced head and neck cancer.
AB  - Fifty-eight patients with either advanced or unresectable squamous cell carcinoma
      of the head and neck were randomly selected to receive either twice daily
      radiation alone or twice daily radiation plus concomitant chemotherapy with
      cisplatin and fluorouracil (5-fluorouracil). There was no advantage in survival
      or time to progression with the addition of chemotherapy to twice daily radiation
      for patients with advanced resectable cancers. In the group of patients with
      unresectable cancers, however, there was a statistically significant advantage to
      the addition of chemotherapy, both in terms of disease-free survival and date to
      progression.

PMID- 1642832
TI  - Defining and predicting tracheoesophageal puncture success.
AB  - There is considerable variability in the reported success rates of
      tracheoesophageal puncture due, in part, to the lack of a clear definition of
      success and a paucity of knowledge about factors that determine success. In this
      article, we define success on a continuum with the use of a 15-point rating scale
      that incorporates aspects of use and quality of speech and ability to care for
      the fistula and prosthesis. We suggest a cutoff score for functional and
      nonfunctional speakers. We define immediate and short- and long-term success.
      Variables related to the patient, clinician, surgical procedure, and extent of
      disease were subjected to a multiple regression analysis to determine which
      predicted success. Overall success was predicted by greater clinician expertise,
      younger patient age, and better patient health. We discuss the use of the rating
      scale and an equation to predict success.

PMID- 1642833
TI  - Tinnitus and vertigo in patients with temporomandibular disorder.
AB  - The association of tinnitus and vertigo with temporomandibular disorder (TMD) has
      been debated for many years. The observation that patients with TMD have otologic
      symptoms is confounded because tinnitus and vertigo are common symptoms in the
      normal population. The present study was conducted to determine if tinnitus and
      vertigo are actually more prevalent in patients with TMD than in appropriate age
      matched controls. One control group was recruited from patients seeking care for
      health maintenance and the other from patients seeking routine dental care. We
      surveyed 1032 patients: 338 had TMD and 694 served as two age-matched control
      groups. Tinnitus and vertigo symptoms were significantly more prevalent in the
      TMD group than in either of the control groups. The mechanism of the association
      of TMD and otologic symptoms is unknown.

PMID- 1642834
TI  - Extensive defects of the sino-orbital region. Results with microvascular
      reconstruction.
AB  - We performed microvascular free-tissue reconstruction of extensive defects in the
      sino-orbital region in 11 patients. Reconstructions were immediate in 10 patients
      and delayed in one patient. There was loss of orbit in eight patients, maxilla in
      eight patients, cranial base in two patients, and skin and soft tissue of the
      face in six patients. Nine rectus abdominis flaps, one radial forearm flap, and
      one lateral arm flap were used. Palatal reconstruction with autologous tissue was
      successful in all patients. Cranial base repairs healed without sequelae or
      evidence of meningitis. Cosmetically, soft-tissue repair of facial skin was only
      satisfactory. For large defects, it was difficult to reconstruct the palate and
      facial soft tissue and to maintain nasal airway patency with a single
      microvascular procedure. Free-tissue transfers remain the safest and most
      versatile reconstructive procedure for massive sino-orbital defects after
      ablation of a tumor.

PMID- 1642835
TI  - Aesthetic reconstruction of the platyrrhine nose.
AB  - The platyrrhine nose is characterized by a hypoplastic nonprojected nasal tip,
      wide flaring alae, underdeveloped premaxilla, and lack of nasal dorsal support.
      Aesthetic nasal reconstruction is performed utilizing the external rhinoplasty
      technique. Precise placement of nasal augmentation grafts is facilitated by this
      technique. The harvesting and utilization of a large autogenous nasal fibrofatty
      graft for finesse dorsal contouring is described. Seventy-five patients underwent
      aesthetic reconstruction of the platyrrhine nose. Follow-up ranged from 2 to 7
      years. No major complications, including extrusion or significant resorption of
      augmentation grafts, have been observed. Minor complications included notching of
      the transverse columella incision in 5% (4/75) of cases, observable suture tract
      marks along the alar closure incision in 4% (3/75) of cases, and alar incision
      granuloma in 1% (1/75). A modification of our technique, utilizing a two-layer
      tension-free closure of the columella and alar incisions, has alleviated these
      complications.

PMID- 1642836
TI  - Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media.
AB  - Clinical and bacteriological efficacy of topical ciprofloxacin hydrochloride was
      compared with that of intramuscular gentamicin sulfate in two groups composed of
      30 patients each, all of whom were affected by chronic otitis media in the acute
      stage. Antibiotics were randomly given for 5 to 10 days according to the
      following schedules: ciprofloxacin hydrochloride, four drops (250 mg/mL in saline
      solution) administered locally twice a day, or gentamicin sulfate, 80 mg
      administered intramuscularly twice a day. We admitted to the study only adult
      patients affected by chronic otitis media in the acute stage with perforation of
      the tympanic membrane, without cholesteatoma, whose bacteriological culture was
      positive for Pseudomonas susceptible in vitro to ciprofloxacin and gentamicin.
      The clinical and bacteriological response was stated 12 hours after the
      interruption of the treatment, and 2 and 3 weeks later (follow-up). A favorable
      clinical result was observed in 26 (87%) of 30 patients under ciprofloxacin
      treatment; in 30 patients receiving gentamicin, a favorable clinical response was
      observed in 20 (66%) and bacteriological eradication in 13 (43%). No relapse at
      the follow-up was observed. Topical ciprofloxacin seems to be more effective than
      intramuscular gentamicin in curing Pseudomonas-caused chronic otitis media in the
      acute stage.

PMID- 1642837
TI  - Severe orbital infection as a complication of orbital fracture.
AB  - Orbital fractures secondary to blunt trauma, and their complications, have been
      the subject of numerous reports, with little mention of an association with
      severe orbital infection. Conversely, studies of severe (postseptal) orbital
      infections rarely make reference to orbital fractures as being a significant
      pathogenetic factor. In a retrospective study of 130 orbital infections, three
      cases of severe orbital infection were identified as being associated with an
      orbital fracture, and are thus presented. In the literature, only anecdotal
      reports and inconclusive studies address this problem, and its possible
      prevention. The consequences of a pathologic communication between the paranasal
      sinuses and the orbit secondary to blunt facial trauma are discussed, along with
      recommendations for prophylactic management.

PMID- 1642838
TI  - Mycosis fungoides of the larynx. Report of two cases and review of the
      literature.
AB  - Involvement of the larynx by mycosis fungoides is extremely rare with only three
      reported clinical cases in the English-language literature. We present two
      patients with laryngeal mycosis fungoides, one of whom presented with vocal cord
      paresis (progressing to paralysis) as the initial clinical manifestation of
      laryngeal involvement. Our clinical findings and the observations from the three
      previous case reports suggest that laryngeal mycosis fungoides has a predilection
      for the arytenoids, aryepiglottic folds, and the laryngeal surface of the
      epiglottis. Laryngeal involvement, like other forms of visceral dissemination,
      appears to manifest clinically in the terminal stages of the disease. The natural
      history, clinical features, histopathology, and treatment of mycosis fungoides
      are reviewed and the etiopathology of the vocal cord paralysis is described.

PMID- 1642839
TI  - Ameloblastoma of the mandible with intracranial metastasis. A case study.
AB  - Ameloblastoma is an aggressive locally recurring neoplasm of odontogenic
      epithelium. We describe a case of a mandibular ameloblastoma with a 17-year
      history of local recurrences followed by two metachronous intracranial
      metastases. Central nervous system metastasis without pulmonary involvement is
      previously unreported in a living patient with ameloblastoma. The behavior of
      this tumor qualifies it as a malignant ameloblastoma.

PMID- 1642840
TI  - Pulmonary artery sling associated with tracheobronchial malformations.
AB  - We describe three cases of pulmonary artery slings associated with tracheal
      stenoses by complete cartilaginous rings and abnormalities in the
      tracheobronchial branching pattern. This association implicates special problems
      of management that are different from the simple pulmonary artery sling.
      Pathologic anatomy, symptoms, diagnostic procedures, and the problems of therapy
      are described. Considering similar cases in the literature, we conclude that
      thorough diagnostic evaluation of the tracheobronchial and the cardial system
      should be carried out in all cases of pulmonary artery sling. Simple correction
      of the aberrant vessel without correcting the tracheal stenosis is of no value in
      these cases. In some milder cases, a conservative approach is possible and
      probably less harmful than an operation.

PMID- 1642841
TI  - Management of tracheocutaneous fistula.
AB  - Management of large tracheocutaneous fistulas is not well described in the
      otolaryngology literature. Some authors have focused on the excision of the
      fistula tract with or without the use of a strap muscle or sternocleidomastoid
      flap. Others have proposed staged closures over a period of months to allow
      secondary healing to occur in order to avoid complications of dehiscence,
      pneumomediastinum, and infection. We describe a simple technique that utilizes
      the fistula tract to facilitate closure of a large tracheocutaneous fistula. By
      using this technique, the surgeon avoids the complications generally associated
      with the closure of such defects and also the morbidity of waiting for secondary
      closure to occur.

PMID- 1642842
TI  - Continuous positive airway pressure. Use in bilateral vocal cord paralysis.
AB  - Continuous positive airway pressure has been used in the management of a number
      of upper airway problems, and has become well established as a treatment option
      for obstructive sleep apnea. The therapeutic value is achieved by an internal
      splinting effect on the compromised airway. Airway compromise from bilateral
      recurrent laryngeal nerve trauma can occur with surgical procedures associated
      with extensive dissection of these nerves. The use of continuous positive airway
      pressure for the management of bilateral vocal cord paralysis, although not
      previously described, to my knowledge, is outlined in this article.

PMID- 1642843
TI  - Pathologic quiz case 2. Laryngeal tuberculosis.

PMID- 1642844
TI  - Lysozyme localization in normal and diseased human gastric and colonic mucosa. A
      correlative histochemical, immunohistochemical and immunoelectron microscopic
      investigation.
AB  - The distribution of lysozyme in normal and pathological human gastric and colonic
      mucosa was studied by light and electron microscopic immunocytochemical
      techniques and compared with histological and histochemical features. Lysozyme
      was localized in pyloric glandular epithelial cells, mucous neck cells of fundic
      glands, Paneth cells and some crypt cells of the mature colonic mucosa. In
      addition, lysozyme was detected in a large spectrum of "immature" or
      "regenerative" epithelium: neck cells of the gastric regenerative zone,
      undifferentiated columnar cells of surface and hyperplastic interfoveolar crests
      of the stomach, regenerative cells in a healed gastric ulcer, some goblet cells
      in incomplete intestinal metaplasia, cells of the regenerative zone at the bottom
      of colonic crypts and, finally, fetal intestinal epithelium. Electron
      microscopically, we localized lysozyme in the central core of mucous granules in
      the pyloric gastric glandular epithelium and in the dense mucous granules in
      gastric mucous neck cells. Lysozyme was also detected in some immature mucin
      producing cells of the gastric regenerative zone and in the rough endoplasmic
      reticulum of surface hyperplastic columnar gastric cells. At the electron
      microscopic level, a peculiar correlation between the immunopattern of lysozyme
      and the morphology of mucous granules has been postulated. All our data support
      and extend the view that the presence of lysozyme may be related to cell
      immaturity as well as to a regenerative state of the cell. Finally, the lysozyme
      distribution and its relation to mucosubstances in gastric and colonic carcinoma
      suggest that lysozyme should not be considered an exclusive marker of cells of
      gastric derivation.

PMID- 1642845
TI  - Disseminated histoplasmosis in a badger (Meles meles) in Denmark.
AB  - We report the first case of disseminated histoplasmosis in an animal in
      Scandinavia. Yeast cells compatible with those of Histoplasma capsulatum var.
      capsulatum were found in the skin, liver, spleen, a kidney, and a lymph node of a
      wild badger (Meles meles). The diagnosis was confirmed by electron microscopy and
      immunofluorescence staining of the yeast cells in tissue sections.

PMID- 1642846
TI  - The redistribution of lymphocytes during adrenaline infusion. An in vivo study
      with radiolabelled cells.
AB  - Adrenergic activation is known to occur in sepsis and after major surgery or
      trauma. An elevated serum concentration of adrenaline is followed by
      lymphocytosis in peripheral blood even in splenectomized patients. The purpose of
      the present study was to clarify the redistribution of lymphocytes in the tissues
      during adrenaline infusion. Lymphocytes were isolated from 24 rabbits, labelled
      with indium-111-tropolone and reinjected into the rabbits. The next day the
      rabbits were anaesthetized. Eight rabbits received 3 micrograms of adrenaline
      i.v. followed by 0.2 micrograms/min, eight received 300 micrograms of adrenaline
      i.v. followed by 20 micrograms/min, while eight received a saline infusion and
      served as a control group. The activity of labelled cells was imaged with a gamma
      camera and computer before, during and after adrenaline infusion. The activity of
      the spleen decreased to 90% and 94% of initial values during low and high doses
      of adrenaline. The activity of the bone marrow decreased to 91% and 96%,
      respectively, while the activity of the heart/lung and the liver increased to
      107% and 106% with the high dose of adrenaline. In peripheral blood the
      lymphocytes increased 10%. It is concluded that lymphocytes are redistributed
      from spleen and bone marrow to peripheral blood, lungs and liver during
      adrenaline infusion in this animal model.

PMID- 1642847
TI  - Aspergillus fumigatus fungaemia and myocarditis in a patient with acquired
      immunodeficiency syndrome.
AB  - Necrotizing myocarditis due to Aspergillus fumigatus was a contributory cause of
      death in a patient with acquired immunodeficiency syndrome and non-Hodgkin
      lymphoblastic malignant lymphoma of the Burkitt type. A transient remission of
      the lymphoma had been obtained by cytostatic treatment. A. fumigatus was isolated
      from blood two weeks before death, but myocarditis was not diagnosed until
      autopsy.

PMID- 1642848
TI  - Detection of mycobacteria from blood and bone marrow: a decade of experience.
AB  - This study reports our experience with methods used at our department from 1981
      through 1990 for detection of mycobacteria in blood and bone marrow specimens.
      Direct inoculation on Lowenstein Jensen media was replaced by Isolator lysis
      centrifugation followed by inoculation on conventional solid media, and the
      Bactec 12B and Bactec 13A systems. A total of 3033 specimens were analyzed. A
      total of 137 mycobacterial isolates were obtained from 42 patients, all HIV
      positive except one. Mycobacteremia caused by M. avium-intracellulare (83%), M.
      tuberculosis, M. scrofulaceum and M. kansasii was found. Of 680 blood specimens
      tested by the last three methods, 7.6% were found to be positive by at least one
      method and revealed recovery rates of 6.8% for the Isolator-solid media system,
      3.4% for the Isolator-12B system and 6.9% for the 13A system (all isolates MOTT).
      Mean detection times for 21 cultures found positive by all three methods were
      23.6, 23.3 and 17.7 days for the Isolator-solid media, Isolator-12B and 13A
      systems, respectively, with a significantly shorter detection time for the 13A
      system. Low degree (less than 1 cfu/ml) mycobacteremia (MOTT) caused delay in the
      Isolator-solid media and the 13A systems and no detection in the Isolator-12B
      system. Antituberculous therapy significantly prolonged the detection times for
      MOTT in the 13A system in contrast to the other systems.

PMID- 1642849
TI  - Evaluation of a Salmonella-specific DNA probe by colony hybridization using non
      isotopic and isotopic labeling.
AB  - A 2.3 kilobase (kb) Salmonella probe, JEO402-1, and two subfragments, F1214 (1.3
      kb) and F1217 (0.8 kb), have been evaluated by colony hybridization using pure
      cultures of Salmonella serovars and non-salmonella bacteria. JEO402-1, and its
      subfragments, F1214 and F1217, hybridized to all of 156 different Salmonella
      serovars tested, while there was no reaction to 112 non-salmonella strains
      belonging to 19 genera and 37 species of Enterobacteriaceae. Together with
      previously published results, the JEO402-1 probe has now been shown to detect a
      total of 396 Salmonella strains belonging to 214 serovars of Salmonella
      subspecies I-VI. A total of 178 non-salmonella strains representing 23 genera and
      51 species of Enterobacteriaceae have all tested negative with JEO402-1. The
      hybridization results obtained using a digoxigenin-labeled probe were similar to
      those obtained with 35S isotopic labeling when complete colony lysis was ensured.

PMID- 1642850
TI  - Tetracycline resistance genes in Kenyan hospital isolates of Salmonella
      typhimurium.
AB  - All 97 strains of Salmonella typhimurium isolated from patients at a hospital in
      Nairobi, Kenya, during 1988-90 were resistant to tetracycline. The minimum
      inhibitory concentration (MIC) showed a large distribution range from 1
      microgram/ml to 128 micrograms/ml. The strains were heterogeneous with respect to
      plasmid content, but initially all strains possessed, in addition to other
      plasmids, a large 60-, 63- or 65-MDa plasmid. The tetracycline resistance genes
      were characterized using oligonucleotide probes, and 20% of the resistant strains
      possessed tetracycline type A (tetr A), 6% tetr B, and 4% tetrC genes. Three
      strains possessed both type A and B tetracycline resistance determinants, which
      were shown to be located on the large 65-MDa plasmid. There was no correlation
      between strains isolated from stools, blood, cerebrospinal or epidural fluids,
      pus, or urine, with respect to the tetracycline genotypes, MIC values or plasmid
      content.

PMID- 1642851
TI  - Utility of an internal control for the polymerase chain reaction. Application to
      detection of Mycoplasma pneumoniae in clinical specimens.
AB  - The polymerase chain reaction (PCR) was used to amplify a 209 base-pair fragment
      of Mycoplasma pneumoniae DNA. The amplicon was transferred into a plasmid and a
      680 base-pair piece of foreign DNA was inserted between the two amplimer sites.
      Plasmid DNA was added to the reaction mixture as an internal control for the
      polymerase chain reaction. Since the original hybridization target sites were
      included in this construction, one pair of amplimers could be used to amplify
      both the target DNA and the internal control DNA. Separation of internal control
      from target DNA after amplification was easily obtained on agarose gel
      electrophoresis. For the analysis of clinical samples with the polymerase chain
      reaction, the addition of internal control DNA allowed monitoring of the overall
      effectiveness of the amplification in each tube. With this technique
      approximately one-third of the tests were shown to be unsatisfactory due to
      technical errors or contaminating inhibitors. Adequate internal controls are
      necessary to avoid false-negative results with the polymerase chain reaction.

PMID- 1642852
TI  - DNA content in primary tumours and lymph node metastases in colorectal
      adenocarcinoma.
AB  - In 18 consecutive patients operated on for colorectal carcinoma of Dukes' stage
      C, the DNA patterns were determined in multiple samples of the primary tumours
      and in all detected lymph node metastases. Single-cell microspectrophotometry on
      Feulgen-stained smears of fine-needle aspirates was used. When the most
      aggressive DNA pattern was considered representative, 12 primary tumours (67%)
      were designated as aneuploid. The frequency of aneuploidy among the metastases
      was almost the same (63%). In 15 cases (83%) the DNA patterns displayed by the
      metastatic lymph nodes were also found in the corresponding primary tumour, while
      in the remaining three cases (17%) the DNA pattern in the lymph node metastases
      was not seen in any of the multiple samples from the primary tumour. The observed
      tumour DNA heterogeneity may reflect either the multicellular origin of the
      tumour cells or the continuous evolution and progression of a neoplasm of
      unicellular origin, and may partly explain the dissimilarities between the DNA
      patterns of the primary tumour and the lymph node metastases. Biopsy samples from
      a number of metastatic lymph nodes are therefore required to ensure
      representativeness and to permit an adequate analysis of the prognostic role of
      the DNA ploidy status in lymph node metastases from colorectal cancer.

PMID- 1642853
TI  - Detection of Chlamydia trachomatis antigens in first-void urine to identify
      asymptomatic male carriers.
AB  - Early morning first-void urine collected from 279 sexually active Swedish male
      recruits (mean age 19.5 years) was tested by two commercial enzyme immunoassay
      (EIA) kits, MicroTrak and IDEIA III, and by MicroTrak direct fluorescence assay
      (DFA), to detect Chlamydia trachomatis antigens. A result was assumed to be true
      positive when any of the two non-culture tests were positive for the same
      specimen. In one case where only DFA was positive, confirmatory chlamydial
      testing was performed by isolating the organism from a urethral swab. On these
      premises, the number of true-positive men was 26 (9.3% of all men studied). The
      sensitivity, specificity, positive predictive value and negative predictive value
      for MicroTrak EIA were 85%, 98%, 85%, and 98%, respectively. IDEIA III was less
      sensitive than MicroTrak EIA (42% vs 85%). In conclusion, the diagnosis of
      asymptomatic chlamydial infections in men can be established with reasonable
      accuracy by the detection of Chlamydia antigens in urine samples using MicroTrak
      EIA.

PMID- 1642854
TI  - Detection and identification of Mobiluncus species by direct filter hybridization
      with an oligonucleotide probe complementary to rRNA.
AB  - A hybridization assay for direct detection and identification of Mobiluncus
      species has been developed and tested. A [32P]-labelled synthetic oligonucleotide
      probe, complementary to a nucleotide sequence in the variable region V8 of
      Mobiluncus 16S ribosomal RNA, was utilized. One of the advantages of using rRNA
      as target molecule for the hybridization assays is the copy number of rRNA, which
      can be as high as 10(4), and that additionally three to six sites on the minus
      strand of the DNA gene can be utilized. This probe was found to be sensitive and
      to react with 62 of 68 tested typical or atypical Mobiluncus isolates. It was
      also specific, and was shown not to react with 96 tested unrelated bacterial
      species and isolates, including taxonomically closely related species like
      Actinomyces or Bifidobacterium spp., or with bacteria isolated from the vagina of
      both healthy persons with an undisturbed flora, as well as from patients
      suffering from the bacterial vaginosis syndrome (BV).

PMID- 1642855
TI  - Susceptibility of strains of the Mycobacterium tuberculosis complex to fusidic
      acid.
AB  - The activity of fusidic acid was studied in 40 strains of M. tuberculosis (of
      which 20 strains were mono- or multiresistant to standard antituberculosis drugs)
      and 10 strains of M. bovis. Minimum inhibitory concentration (MIC) was determined
      by the radiometric (BACTEC) broth method. The MIC for the 50 strains varied
      between 8 and 32 mg/l, with a MIC90 of 16 mg/l for M. tuberculosis and a MIC90 of
      32 mg/l for M. bovis. Minimal bactericidal concentration (MBC, defined as the
      lowest concentration of fusidic acid which killed 99% or more of the population)
      varied between 32 mg/l and 500 mg/l, with a MBC90 of 250 mg/l for M. tuberculosis
      and 500 mg/l for M. bovis. No cross-resistance to other antituberculosis drugs
      (ethambutol, isoniazid, rifampicin, streptomycin, pyrazinamide, ofloxacin,
      ciprofloxacin) was observed as strains resistant to one or more standard
      antituberculosis drugs were as susceptible to fusidin as sensitive strains of M.
      tuberculosis. No synergism or antagonism could be demonstrated when fusidic acid
      was combined with either ethambutol, isoniazid, rifampicin or streptomycin
      against strains of M. tuberculosis resistant to one or more standard
      antituberculosis drugs. Addition of pooled human serum to the medium increased
      both MIC and MBC by factors of 4 and 8 at serum concentrations of 10% and 50%,
      respectively. Single-step mutation to high-level resistance to fusidic acid at a
      frequency of less than 1.7 x 10(-8) could be readily selected at four times the
      MIC. These fusidic acid-resistant organisms had a generation time 2.0-2.7 x
      longer than their parent organisms.

PMID- 1642856
TI  - Information processing in the separated hemispheres of callosotomy patients: does
      the analytic-holistic dichotomy hold?
AB  - The characterization of the left and right cerebral hemispheres as analytic and
      holistic, respectively, was evaluated with callosotomy patients. This distinction
      was operationalized by reference to the work of Garner, Kemler Nelson, and their
      colleagues on separable (analytic) and integral (holistic) dimensions of
      cognition. In one experiment, patients were asked to make similarity judgments
      when faced with triads of stimuli such that one pair matched on a criterial
      attribute (analytic) and another pair showed a family resemblance (holistic). The
      right hemisphere showed a stronger bias to judge on the basis of the criterial
      attribute. In a second experiment, each hemisphere was engaged separately in a
      concept formation task. Depending on the exemplars in a particular set, analytic
      or holistic processing was seen in either hemisphere. However, the left
      hemisphere was more likely to engage in analytic processing. The results suggest
      that both hemispheres are capable of either type of processing and may use either
      mode, depending on the nature of the task and stimulus material. Thus, the
      analytic/holistic distinction may not provide a simple, generalizable description
      of information processing differences between the two hemispheres.

PMID- 1642857
TI  - Clarification of the dual task dilemma: lateralized effects for perfunctory and
      purposeful tasks in left- and right-handed males.
AB  - The hypothesis that behavioral asymmetries with the dual task paradigm represent
      manual dominance was investigated with right- and left-handed males performing
      verbal and spatial tasks ordered by complexity. Lateralization was assessed for
      nonideational (perfunctory) and ideational (purposeful) components of tasks with
      multivariate and ANCOVA procedures. The outcomes of prerequisite tests showed the
      assumptions for conducting ANCOVA procedures were not satisfied with different
      handedness groups in the same design. However, results of the multivariate
      analyses suggest lateralized effects are more likely to represent the cognitive
      task when interference is high and may represent manual dominance when
      interference is low.

PMID- 1642858
TI  - Confabulation in Alzheimer's disease.
AB  - Confabulation is present when memory is disturbed, but does it occur in
      Alzheimer's disease (AD) where memory abnormalities are often severe? In this
      study, confabulation was assessed prospectively in 26 AD patients and 15 normal
      elderly (NE) controls using a neuropsychological battery specifically designed to
      assess different types of memory errors. The results indicated that the AD group
      made significantly more verbal intrusions than the NE group. These findings
      provide evidence for the feasibility of eliciting confabulatory-type behavior
      during clinical assessment and support previous reports which have documented
      verbal intrusions as a common accompaniment of the memory impairment manifested
      by AD patients.

PMID- 1642859
TI  - Manipulations of subjects' level of arousal in dichotic listening.
AB  - The effects of manipulation of the subject's level of arousal on the right ear
      advantage (REA) in dichotic listening to CV-syllables were investigated. There
      were three different arousal manipulations under high and low incentive levels.
      Negative manipulations involved threat of electric shock (high incentive) or
      noise (low incentive) for incorrect answers. Positive manipulations involved the
      possibility to earn a substantial (high incentive) or small (low incentive) sum
      of money for correct answers. A third, neutral, condition involved no specific
      instructions about consequences for correct or incorrect answers. Thirty-six
      females participated in the study. Heart rate was recorded as an independent
      measure of change in level of arousal as a function of the experimental
      instructions. The results showed that the high negative condition abolished the
      REA effect, with a non-significant difference between ears. This was caused by
      both an increase in correct left ear reports and a decrease in correct right ear
      reports. The other arousal conditions had no effect on the REA. The results are
      discussed in terms of right hemisphere dominance for aversive emotional
      processing in dichotic listening.

PMID- 1642860
TI  - Visual field differences in an object decision task.
AB  - Two experiments are reported which investigate hemispheric processing in an
      object decision task. Experiment 1 used 40 pictures of objects, and 40 pictures
      of nonobjects, and subjects decided manually whether each lateralized stimulus
      represented an object. Results indicated an interaction between visual field and
      response (yes versus no). There was a right visual field advantage for positive
      responses, but no difference between visual field for negative responses.
      Positive responses were faster than negative responses, and this effect was more
      marked for right visual field presentations. These results were replicated in a
      second experiment. The results are interpreted as reflecting a left hemisphere
      superiority at accessing stored structural descriptions of known objects. The
      possibility that left and right hemispheres use different methods of carrying out
      the task is also discussed.

PMID- 1642861
TI  - Mathematics performance in left and right brain-lesioned children and
      adolescents.
AB  - Children and adolescents with unilateral left- or right-hemisphere lesions were
      administered a standardized test of mathematics ability and a battery of
      experimental tests that examined the components of numerical and arithmetic
      processing. All lesioned groups showed at least marginally lower scores on the
      standardized test than the controls. More importantly, lesion-related deficits in
      performance were observed, especially for younger left-lesioned subjects (ages 7
      12), on the verbal counting, digit matching, speeded addition, and written
      subtraction tasks; deficits among younger right-lesioned subjects were similar in
      nature, yet less pronounced than in the left-hemisphere group. Older left
      lesioned subjects showed differences from their controls only on complex verbal
      counting and speeded addition. Correlations among the various measures indicated
      two further points. First, earlier onset of left-hemisphere lesion is associated
      with more serious disruption of mathematical processing. Second, these
      disruptions are not well assessed by a typical standardized test of mathematical
      performance, but are clearly in evidence with more precise, focused tasks.

PMID- 1642862
TI  - Perceptual closure and object identification: electrophysiological responses to
      incomplete pictures.
AB  - Event-related potentials were recorded during the naming of pictures of concrete
      objects. The pictures were presented at three levels of completeness: 10, 30, and
      60%. The ERP waveforms were evaluated according to the level of picture
      completeness and the correctness of naming. A negative wave in the latency range
      of 250-550 ms was significantly more negative when the pictures were more
      incomplete, regardless of the correctness of response. This N400 wave is proposed
      as being related to hypotheses about the identity of the object. A late positive
      wave in the latency range of 550-650 ms followed the negativity, but only when
      the response was correct. This may reflect the subject's certainty about the
      perceptual analysis, a verification of the identity of the object. A slow
      parietal negativity lasting up to 2 sec was largest for the least complete
      picture. This therefore varied with the perceptual difficulty.

PMID- 1642863
TI  - Preoperative ultrasonographic verification of peritonsillar abscesses in patients
      with severe tonsillitis.
AB  - Infection around the tonsillar region does not always mean the presence of a
      peritonsillar abscess although the condition of peritonsillitis without abscess
      formation may clinically present similarly. It is, however, of therapeutic
      importance to distinguish between the two conditions. Treatment for abscess is
      surgical: aspiration, incision and drainage or immediate tonsillectomy. In
      contrast, phlegmonous peritonsillitis only requires antibiotics. In order to
      evaluate the diagnostic implications of preoperative ultrasonography in patients
      referred for treatment of peritonsillar abscess, 27 consecutive patients were
      subjected to bilateral ultrasound examination to visualize the tonsillar region.
      The transducer used was placed just below the mandibular angle, pointing
      posteriorly and cranially. The results of this study showed that it was possible
      to verify the presence of an abscess in approximately 90% of the cases. We
      suggest that this examination be performed whenever the normal clinical
      examination is insufficient due to trismus, lack of patient cooperation, etc.

PMID- 1642864
TI  - Expression of glycoconjugates in the mouse inner ear after prenatal irradiation.
AB  - Irradiation of the murine fetal inner ear is known to produce damage both to the
      vestibular and cochlear parts in the adult mouse. Fluorescein-labelled lectins
      were used to reveal possible differences in the glycoconjugate content between
      normal and irradiated inner ears. In the vestibular part, the otoconia showed the
      highest uptake of labelled sugars. This uptake was weaker after irradiation when
      compared to non-irradiated specimens. The type I hair cells in the ampulla and in
      the utricle showed a weaker uptake, but no labelling was demonstrated in the type
      II hair cells compared to the non-irradiated controls. In the cochlear part of
      the inner ear almost no uptake of fluorescent-binding lectins could be
      demonstrated in the irradiated groups except for in the tectorial membrane. In
      the endolymphatic sac no uptake was shown after prenatal irradiation. These
      findings are discussed and correlated to the already known damage of the inner
      ear following prenatal irradiation.

PMID- 1642865
TI  - DNA-flow cytometry of head and neck carcinoma: the importance of uniform tissue
      sampling and tumor sites.
AB  - Flow cytometric DNA ploidy measurements using deparaffinized tumor specimens were
      performed on 46 squamous cell carcinomas of the head and neck, including 22
      carcinomas of the oropharynx, 18 carcinomas of the larynx and six carcinomas of
      the oral cavity. Aneuploidy was found in 14 of these tumors with carcinomas of
      the larynx and oral cavity showing almost equal percentages of DNA aneuploidy
      (10/18 and 3/6, respectively). In contrast, only 1 of the oropharyngeal
      carcinomas was aneuploid. Accurate microscopy-controlled sampling of tumor tissue
      from the histological tissue blocks was found to be mandatory in order to obtain
      reliable ploidy measurements.

PMID- 1642866
TI  - Value of the supraomohyoid neck dissection with frozen section analysis as a
      staging procedure in the clinically negative neck in squamous cell carcinoma of
      the oral cavity.
AB  - A retrospective analysis was performed to evaluate with the efficacy of elective
      supraomohyoid neck dissection (SOND) with frozen section (FS) analysis in 57
      newly diagnosed patients (62 SONDs) with squamous cell carcinoma of the oral
      cavity. The protocol included sampling of both the most suspect and largest node
      in the jugulodigastric region (if present) and the most distal jugulo-omohyoid
      lymph node (if present). These nodes were then studied with FS histological
      examination. In the absence of evident nodes for FS analysis during surgery,
      histological examination uncovered occult metastatic disease in 3 of 11 SOND
      specimens. Among the remaining patients FS analysis revealed occult metastatic
      disease in 10 of the 51 samples (19.6%). In these latter cases surgery was
      continued using standard or modified radical neck dissection en bloc with the
      primary tumor. In 1 specimen only a single metastasis was found outside the
      original extent of the SOND. Among 41 FS analysis reports stating the absence of
      metastatic disease, histological examination of the SOND specimens demonstrated
      occult nodal disease in 7 (17%). All of the cervical metastases appeared in the
      ipsilateral side of the neck. False FS reports did not occur. In the
      histologically proven absence of metastatic disease in the SOND specimens,
      disease recurrence in the neck occurred only in 3 cases (7%), all in the presence
      of local failure: once in the previous SOND area, once in the ipsilateral
      supraclavicular region and once on the contralateral side.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1642867
TI  - Changes in the electrochemical composition of cochlear fluids after
      intracisternal application of doxorubicin in the rat.
AB  - Since doxorubicin (Adriamycin) is known to bind on membranous negative surface
      charges, its effect on the electrochemical composition of the cochlear fluids was
      studied in rats. Doxorubicin was infused into the cerebrospinal fluid via the
      lateral cerebral ventricle. The endocochlear resting potential was recorded, and
      endolymph and perilymph of the scala vestibuli were collected from the basal
      cochlear turn before and 1, 2, and 4 h after the drug application. Na+, K+, and
      Cl- concentrations and osmolality of the endolymph and perilymph were measured in
      1 nl aliquots. In perilymph, Cl- concentration increased 4 h after doxorubicin
      treatment to reach a concentration 8 mM higher than recorded initially. In
      endolymph, the endocochlear potential decreased by 5 mV/h while its K+
      concentration and osmolality increased by about 3 mM/h and 4 mosmol/kg H2O per
      hour, respectively. These results suggest that the negative surface charges
      demonstrated on Reissner's membrane may play a role in the homeostasis of
      endolymph.

PMID- 1642868
TI  - The relationship between smooth and saccadic components in smooth pursuit.
AB  - Eye movements in smooth and pathological (saccadic and ataxic) pursuit patterns
      were separated by the use of the inverse fast Fourier transform. Results showed
      that the smooth component was significantly smaller while the saccadic component
      was significantly greater in the pathological pursuit patterns than in the smooth
      pursuit pattern. In addition, the smooth and saccadic components showed a linear
      relationship. These findings give some support to the threshold theory in
      explaining the relationship between smooth pursuit and saccades.

PMID- 1642869
TI  - Tetramethylammonium for in vivo marking of the cross-sectional area of the scala
      media in the guinea pig cochlea.
AB  - A physiologic technique was developed to measure endolymphatic cross-sectional
      area in vivo using tetramethylammonium (TMA) as a volume marker. The technique
      was evaluated in guinea pigs as an animal model. In the method, the cochlea was
      exposed surgically and TMA was injected into endolymph of the second turn at a
      constant rate by iontophoresis. The concentration of TMA was monitored during and
      after the injection using ion-selective electrodes. Cross-section estimates
      derived from the TMA concentration measurements were compared in normal animals
      and animals in which endolymphatic hydrops had been induced by ablation of the
      endolymphatic duct and sac 8 weeks earlier. The method demonstrated a mean
      increase in cross-sectional area of 258% in the hydropic group. Individually
      measured area values were compared with action potential threshold shifts and the
      magnitude of the endocochlear potential (EP). Hydropic animals typically showed
      an increase in threshold to 2 kHz stimuli and a decrease in EP. However, the
      degree of threshold shift or EP decrease did not correlate well with the degree
      of hydrops present.

PMID- 1642870
TI  - Primary cultures of middle ear epithelial cells from chinchillas.
AB  - A reproducible method is presented for primary cultures of middle ear epithelial
      cells (MEEC) from chinchillas. The MEEC were first dissociated with protease and
      grown on collagen-coated membrane using a culture medium containing equal volumes
      of Dulbecco's modified Eagle medium and Ham's F12 supplemented with 0.5% fetal
      bovine serum. Outgrowth of cells was first noted within 24 h, reaching confluency
      in 6-7 days. These cells grew in a monolayer and appeared to be ovoid or
      polygonal. By immunofluorescence microscopy, these cells stained for cytokeratin,
      but not for type III collagen. In contrast, fibroblasts stained for type III
      collagen, but not for cytokeratin. Based on growth characteristics, morphology,
      and immunofluorescent findings, these cells were determined to be epithelial
      cells. To retard the outgrowth of fibroblasts, 5 mM putrescine was added to the
      culture medium on the 2nd day of explant. Contamination with fibroblasts was
      consistently less than 5% when defined as type III collagen-positive cells.
      Establishment of a method for the primary culture of MEEC will provide a new
      approach for studying the role of epithelial cells in the pathogenesis of various
      types of otitis media.

PMID- 1642872
TI  - Stapedius reflexes to electrical stimulation in the rabbit for the assessment of
      hearing.
AB  - The possibility of using electrically induced stapedius reflexes as a means of
      objective hearing evaluation was investigated in the rabbit as an animal model.
      The contralateral stapedius reflex to acoustic and electrical stimulation was
      measured in anesthetized rabbits. For electrical stimulation, the middle ear was
      opened surgically and stimulation was applied by a monopolar electrode placed at
      or into the round window. Contraction of the middle ear muscle was monitored by
      digital sampling and averaging of the impedance changes in the contralateral ear.
      Acoustically evoked reflexes were recorded within expected limits despite
      anesthesia. The level of the electrical stimulus was raised until mass reflexes
      of the neck muscles were observed. A contralateral stapedius reflex to electrical
      stimulation could not be demonstrated. In our experiment, monopolar electrical
      stimulation at the round window could not elicit contralateral stapedius
      reflexes.

PMID- 1642871
TI  - Effects of organic acids on stria vascularis ultrastructure and function in the
      chinchilla.
AB  - The purpose of this study was to compare the effects of several organic acids
      (probenecid, sodium salicylate and penicillin G) on the endocochlear potential
      (EP) and the ultrastructure of the stria vascularis of the chinchilla with the
      effects of furosemide on these parameters. Chinchillas received 50 mg/kg i.v.
      doses of probenecid, sodium salicylate or penicillin G, or 25 mg/kg i.v.
      furosemide. The EP was monitored continuously before and for 60 min afterwards.
      The stria vascularis was removed at 10-min intervals from animals and from 10 to
      60 min after the injection of these agents. Specimens were then processed for
      transmission electron microscopy. Only furosemide had an effect on the EP,
      causing a reversible reduction. The reduction of the EP was accompanied by the
      appearance of edema in the intercellular spaces of the stria vascularis. No
      significant edema was found after probenecid, sodium salicylate or penicillin G.
      This was consistent with the finding that none of these latter three agents
      affected the endocochlear potential.

PMID- 1642873
TI  - Caloric irregularity in experimentally induced perilymphatic fistula.
AB  - The term "caloric irregularity" was coined to refer to a gross irregularity in
      the amplitude and/or frequency of a caloric-induced nystagmus, having a variable
      slow-phase velocity and prolonged duration. Twelve of 46 guinea pigs with
      experimentally induced perilymphatic fistula had irregular responses to the ice
      water caloric test 1 week after creation of a fistula. The long-term vestibular
      consequences in animals with caloric irregularities were either resolution and
      return to normal function (i.e. caloric return) or continuing deterioration to
      canal paresis. Morphological examination of ears with caloric irregularity
      revealed that there had been partial collapse of the membranous labyrinth and the
      creation of a floating labyrinth.

PMID- 1642874
TI  - Management of cervical lymph nodes in patients with head and neck cancer.
AB  - The status of the cervical lymph nodes is the single most important prognostic
      factor in head and neck cancer. Unfortunately, clinical assessment of the neck is
      not very accurate, although newer imaging techniques such as CT, MRI and
      ultrasound-guided fine needle aspiration cytology can be used to improve upon the
      results of clinical palpation alone. While diagnostic techniques remain less than
      100% accurate, the risk of occult disease in the neck will remain. If this
      occurrence is judged to be greater than 15-20%, elective treatment to the neck
      may then be justified. When the neck is treated surgically, histological
      information can be gained which has both prognostic and therapeutic implications.
      Indications for the use of surgery and radiotherapy for the elective and
      therapeutic management of the neck and the results of such treatment are
      discussed.

PMID- 1642875
TI  - Pitfalls in the histopathologic diagnosis of pyogenic granuloma.
AB  - The term pyogenic granuloma (PG) is a misnomer. The histopathologic appearance is
      fairly characteristic, the lesion being in fact a lobular capillary hemangioma.
      The recognition of PG as a clinically polypoid or exophytic, circumscribed lesion
      is of importance to both the clinician and the pathologist, as this feature
      distinguishes PG from most malignant vascular tumors. Although PG may be
      multiple, especially on the skin, and necrosis is not uncommon, invasion of
      adjacent structures is not seen. Diagnostic pitfalls occur histologically when
      the characteristic lobular configuration of PG is not recognized because of a
      solid growth pattern of endothelial proliferation, the presence of brisk mitosis,
      intervascular stromal fibrosis or spindle cell proliferation, and occasionally an
      epithelioid appearance of endothelial cells. The different vascular neoplasms
      that may be confused with PG are discussed, and the clinical and histopathologic
      features of PG are emphasized.

PMID- 1642876
TI  - Distribution and co-localization of immunoreactive helospectin with vasoactive
      intestinal polypeptide and peptide histidine methionine in human nasal mucosa,
      soft palate and larynx.
AB  - Regulatory peptide immunoreactivities reported in the upper respiratory system of
      man include vasoactive intestinal polypeptide (VIP) and peptide histidine
      methionine (PHM), which are co-localized in a network of fine varicose nerve
      fibers. The present study was undertaken to examine the possible occurrence and
      distribution of the recently described VIP-like peptide helospectin. Double
      immunofluorescence labelling showed that helospectin is co-localized with VIP and
      PHM. In addition to nerve fibers containing all three peptides, scattered nerve
      fibers were detected that were only immunoreactive to helospectin but not to VIP
      and/or PHM. The distribution of helospectin/VIP/PHM immunoreactive nerve fibers
      around blood vessels and in close relationship to seromucous glands indicates
      their possible involvement in the regulation of blood flow and secretion.

PMID- 1642877
TI  - Eustachian tube dysfunction in patients with nasopharyngeal carcinoma, pre- and
      post-irradiation.
AB  - Eustachian tube function tests were performed in 34 patients with nasopharyngeal
      carcinoma before and after irradiation. Tubal dysfunction prior to irradiation in
      these patients was due to functional impairment. However, tubal dysfunction after
      irradiation was due to both organic obstruction and functional impairment.
      Organic obstruction of the tube was found to be severe with higher dosages of
      irradiation (to 80 Gy) resulting in subsequent otitis media. In our experience,
      higher doses of irradiation should be avoided if possible, but insertion of a
      ventilation tube should be done if a high dose of irradiation is planned.

PMID- 1642878
TI  - Magnesium levels in middle ear fluids and sera in otitis media with effusion.
AB  - Middle ear fluids (MEE) and matched sera (S) were obtained from 50 patients with
      serous otitis media and magnesium levels were measured to determine if magnesium
      concentration was distinctly varied in otitis media with effusion (OME). The
      MEE/S ratio was considerably raised along with transient sensory hearing loss in
      chronic OME when compared with acute OME. The higher magnesium level found in the
      MEE implies that it is probably produced locally by the middle ear mucosa and may
      contribute to the hearing loss found. We also regard the MEE/S ratio as a
      prognostic factor in OME.

PMID- 1642879
TI  - A randomized trial of neoadjuvant vs concomitant chemotherapy vs radiotherapy
      alone in the treatment of stage IV head and neck squamous cell carcinoma.
AB  - Treatment results of irradiation as a single treatment for advanced stage IV
      unresectable head and neck cancer remains uniformly poor and apparently has not
      changed with the most recent improvements in oncological care. Despite several
      negative results of randomized studies, neoadjuvant or concomitant chemotherapy
      and radiotherapy seems to improve the number of complete responses and also the
      duration of disease-free survival. The present study was designed to determine
      the feasibility, potential risks and benefits of the two methods of combined
      treatment and radiotherapy alone on the management of advanced unresectable
      squamous cell carcinoma of the upper respiratory and digestive system. From 1983
      to 1986, 90 patients entered the trial. Thirty patients were randomized to each
      study group: radiotherapy alone (70 Gy); neoadjuvant chemotherapy (vinblastine,
      mitomycin, cisplatin, and bleomycin) and radiotherapy; concomitant chemotherapy
      (cisplatin and bleomycin) and radiotherapy. An increased frequency of complete
      responses (33%) was seen in patients treated with the two different combinations
      of chemotherapy and irradiation compared to irradiation alone (10%). However,
      toxicity was more common in patients treated with the two modalities of combined
      treatment and there were no differences in overall survival rates (P = 0.706).

PMID- 1642881
TI  - Malignancy of a cystadenolymphoma of the parotid gland.
AB  - The authors describe malignant degeneration of the epithelial component of a
      cystadenolymphoma (CAL) of the parotid gland in a 79-year-old man. This
      development of carcinoma in CAL is a very rare occurrence, with only eight cases
      described thus far in the literature.

PMID- 1642880
TI  - Extracellular matrix in the rat spiral limbus.
AB  - The matrix of the spiral limbus is obviously a special form of the intercellular
      substance. In the present study, the rat's spiral limbus was investigated by
      electron microscopy after fixation with ruthenium red and tannic acid and
      immunofluorescence to demonstrate matrix components. Collagen types I, II, V, VI,
      VII, IX and XI and fibronectin were not observed. Collagen type II and cartilage
      specific proteoglycans, however, occurred in large quantities. The basal lamina
      of interdental cells and inner sulcus cells did not contain any collagen type IV,
      while the basal lamina of the capillaries had only minor amounts. Laminin and
      nidogen appeared in large amounts in the basal lamina. After fixation with tannic
      acid, the matrix between the interdental cells and the capillaries contained 20-
      to 22-nm-thick single and irregularly running fibrils as well as plaques of a
      fine granular material. After fixation with ruthenium red, 30- to 60-nm-thick,
      electron-dense granules occurred and most probably consisted of proteoglycans.
      These findings indicate that the composition of the matrix of the spiral limbus
      is similar to that of cartilage but not identical.

PMID- 1642882
TI  - High-efficiency cDNA cloning: a comparison of electroporation and in vitro
      packaging.
AB  - The production of complete cDNA libraries from minimal amounts of starting
      material (i.e., mRNA) is a major challenge for cDNA cloning technology. This
      paper reports the cDNA cloning efficiencies of electroporation and in vitro
      packaging. These two methods produce a tremendous number of recombinant clones
      (greater than or equal to 1 x 10(8) clones/micrograms cDNA) although
      electroporation generates more clones at nearly all cDNA concentrations used in a
      ligation reaction.

PMID- 1642883
TI  - PCR libraries of ancient DNA using a generalized PCR method.
AB  - We describe a generalized PCR method that will amplify fragments of DNA without
      any knowledge of sequence using a single primer. Although we are presently using
      this method to amplify DNA fragments isolated from ancient preserved tissues, in
      effect, producing PCR libraries, it may prove to have other applications.

PMID- 1642884
TI  - Spontaneous hazardous chemical explosion of unopened bottles of diethyl
      pyrocarbonate (DEPC).

PMID- 1642885
TI  - Colony-hybridization apparatus with batch-processing capacity.

PMID- 1642886
TI  - Purification of BrdUrd-substituted DNA by immunoaffinity chromatography with anti
      BrdUrd antibodies.

PMID- 1642887
TI  - Effect of dimethyl sulfoxide concentration on specificity of primer matching in
      PCR.

PMID- 1642888
TI  - Use of petroleum jelly for sealing coverslips in crystallization trials.

PMID- 1642889
TI  - A simple and rapid method for the preparation of phage DNA suitable for Southern
      analysis.

PMID- 1642890
TI  - Detection of DNA in Southern blots by chemiluminescence is a sensitive and rapid
      technique.

PMID- 1642891
TI  - Random primer labeling of DNA in high melting point agarose gel slices for
      chemiluminescent detection.

PMID- 1642892
TI  - Subtractive immunization techniques for the production of monoclonal antibodies
      to rare antigens.
AB  - Traditional techniques for the production of monoclonal antibodies usually result
      in generation of monoclonal antibodies to immunodominant molecules. To enhance
      the production of monoclonal antibodies to rare or less immunodominant antigens,
      subtractive immunization techniques have been employed. This study compared the
      ability of several subtractive immunization techniques to suppress the immune
      system to a given antigen. Neonatal tolerization, chemical immunosuppression with
      cyclophosphamide, a combination of the two and various permutations of these
      techniques were compared. The results from this study indicated that chemical
      immunosuppression with cyclophosphamide was the most effective subtractive
      immunization technique and that the cyclophosphamide regime employed was a
      critical determinant in the success of chemical immunosuppression.

PMID- 1642893
TI  - Serum-free, defined medium for the growth and differentiation of murine
      erythroleukemia cells.
AB  - Murine erythroleukemia (MEL) cells are frequently employed to study both cell
      growth and erythroid differentiation. Although these cells are easily cultured
      and induced to differentiate, they are routinely maintained in a medium that
      contains 10%-15% fetal bovine serum. Because of the variability between different
      lots and the cost of serum, it was desirable to define a serum-free medium in
      which to culture MEL cells. In the present work, a totally serum-free, defined
      medium is described that supports both normal cell growth and dimethyl sulfoxide
      induced differentiation in the two MEL cell lines examined (DS-19 and 270). A
      variety of hormones and biological compounds are examined in this medium to
      determine their effects on growth and differentiation. This medium does not
      support the growth of the mouse hepatoma cell line.

PMID- 1642894
TI  - Expression of a heterodimeric Fab antibody protein in one cloning step.
AB  - A new method is presented for creating antibody expression libraries in
      Escherichia coli. Rather than perform two cloning steps to express the heavy and
      light chains of the antigen binding domain, we have used a fusion-PCR method to
      link the coding regions for heavy and light chain sequences in a single DNA
      molecule prior to vector ligation. This greatly simplifies the construction of
      antibody expression clones.

PMID- 1642895
TI  - CHELATOR: an improved method for computing metal ion concentrations in
      physiological solutions.
AB  - An algorithm is presented for the calculation of metal ion concentrations from
      given total metal concentrations (and vice versa) in physiological media
      containing metal-chelating compounds. In such media, conditions differ from those
      used for stability constant determination of metal-chelator equilibria; therefore
      calculated metal ion concentrations are incorrect. We recompute stability
      constants to reflect the effects of ionic strength and temperature of
      physiological solutions. Twelve different equilibria can be considered per metal
      chelator pair. The computer program also calculates the contribution of ionized
      species of metals, chelator, complexes and pH buffers to ionic strength.
      Measurements with a Ca-selective electrode and with fura-2 show that calculated
      ionic Ca2+ concentrations are correct from 10 nM up to the millimolar range. The
      importance of the correct calculation of metal ion concentrations in
      physiological experiments is demonstrated by data, and derived kinetic
      parameters, on Na+/Ca2+ exchange and the ATP-dependent Ca2+ pump of enterocyte
      plasma membrane vesicles. The program is written in Turbo Pascal and will run on
      IBM-compatible computers. It is menu-driven and supports the use of a Microsoft
      mouse.

PMID- 1642896
TI  - A BASIC computer program for analyzing endpoint assays.
AB  - We present a computer program that is based on Karber's approximation of endpoint
      titers, written in GW-BASIC and provides an easy means for analyzing the results
      of dilution endpoint assays. The program provides estimates of standard error
      that are not possible from other statistical procedures for this type of data.

PMID- 1642897
TI  - Convenient methods for the display, comparison and interpretation of amino acid
      composition data.

PMID- 1642898
TI  - A graphical user interface for quantitative imaging and analysis of
      electrophoretic gels and autoradiograms.
AB  - DNA/GUI (DNA Graphical User Interface) is an interactive software system for
      rapid and efficient analysis of images of the types used in genome mapping, such
      as autoradiograms and electrophoretic gels. Images are digitized using a
      commercially available charge-coupled-device (CCD) camera system and analyzed on
      a graphics workstation using a menu-driven user interface. DNA/GUI features
      automatic lane and band detection, simultaneous display of multiple images and a
      unique spatial-normalization algorithm. Images and their associated data are
      archived and easily available for later recall. Preliminary results indicate that
      DNA/GUI is a useful tool in the analysis and comparison of images used in a
      variety of applications such as genetic-linkage analysis and DNA restriction
      mapping. The interactive display software is based on the X Window System and is
      therefore readily portable to a variety of graphics workstations.

PMID- 1642899
TI  - High sensitivity quantification of RNA from gels and autoradiograms with
      affordable optical scanning.
AB  - To increase sensitivity and to improve normalization of RNA levels in Northern
      blot analysis, a comparatively inexpensive optical scanner was utilized for
      digitizing photonegatives of ethidium bromide stained gels and autoradiograms.
      The optical scanner captures the image with a maximum resolution of 300 dots per
      inch by assigning one of 256 gray levels (8-bit) to each dot in the image. With
      the use of the public domain NIH Image program (requires a Macintosh II and an 8
      bit video card), gel or autoradiogram bands in the digitized image are selected
      and their average gray scale density measured. We found that the digitized image
      of a photonegative of a TAE (Tris-acetate/EDTA) agarose gel, loaded incrementally
      with 50-1500 ng total RNA, produced a linear response over a 4-fold range down to
      100 ng (R2 greater than 0.950). In utilizing "quantification" gels like this, RNA
      samples that are too dilute or too small for traditional spectrophotometric
      techniques can be normalized and loaded uniformly onto subsequent Northern gels.
      Results from autoradiogram scans demonstrate highly linear gray scale responses
      over a 4-fold range of total RNA (R2 greater than 0.950) that are reproducible
      with different blots and probe types (e.g., riboprobe, cDNA and oligonucleotide).
      In addition, we describe a normalization technique using a 30-mer oligonucleotide
      probe for rat 28S ribosomal RNA as a measure of total RNA loaded per gel lane.
      Altogether, this scanning, ribosomal RNA normalization system allows the
      measurement of relative changes between 20% and 400% using standard
      autoradiographic methods.

PMID- 1642900
TI  - The maternal-fetal relationship in human pregnancy: an immunogenetic perspective.
AB  - Although the mechanisms by which the fetal allograft escapes rejection are still
      poorly understood, abundant evidence has accumulated suggesting multiple roles
      for major histocompatibility complex (MHC) genes in pregnancy. Specific maternal
      MHC genotypes and maternal-fetal histocompatibility have been associated with
      recurrent spontaneous abortion, decreased fecundity, segregation distortions,
      altered sex ratios, fetal growth rates, and maternal autoimmune disease
      progression. In this review, the evidence for a variety of MHC gene effects in
      human pregnancy is considered.

PMID- 1642901
TI  - Distribution of GM allotypes and deleted IGHG1 haplotypes in the Sel'kups in
      comparison to the Forest Nentsi of northwestern Siberia.
AB  - Northern Sel'kup people residing in the upper Taz and the tributaries of Turukhan
      Rivers were typed for immunoglobulin heavy chain (GM) allotypes. The Sel'kups
      exhibited a unique GM*-G haplotype circulating within the tribe in low but almost
      polymorphic frequency along with common GM*F B and GM*A T haplotypes, the former
      a Caucasian marker and the latter a northern Oriental population's marker.
      Contemporary Sel'kups show a higher frequency of GM*A T than the westwardly
      situated Forest Nentsi, reflecting recent historical events in the region such as
      admixture with the Evenki of Middle Siberia. Within the area located between
      lower Ob and Yenisey rivers, the unique GM*-N B haplotype, restricted to the
      Forest Nentsi, and the unique GM*-N' G haplotype, restricted to the Sel'kups,
      serve as GM markers discriminating between these two adjacent tribes.

PMID- 1642902
TI  - Genetic polymorphism of IgG in the mink. VIII. A quantitative study of the
      expression of C gamma-allotypes (H3, H4, H6, H8) in sera.
AB  - The results of a quantitative study of the expression of mink C gamma-allotypes
      (H3, H4, H6, and H8) in sera are presented. H6 and H8 were found to be stably
      expressed, and the individual concentrations of the allotypes varied within one
      order of magnitude. Gene dosage effects were observed for H6 and H8: average sera
      allotype concentrations in homozygotes were twice those in heterozygotes. In
      contrast, the serum concentrations of H3 and H4 varied by three orders of
      magnitude, ranging from minor (2-200 micrograms/ml) to high (1-10 mg/ml). No gene
      dosage effects were observed for the expression of H3 and H4. Histograms for the
      population of H3 concentrations showed three peaks, sharply differing from those
      of H4, H6, and H8. There was no association between the minor expression of H3
      and H4. The data obtained indicate that the expression of mink C gamma-allotypes
      is regulated by different allotype-specific mechanisms.

PMID- 1642903
TI  - Complement-mediated killing of susceptible gram-negative bacteria: an elusive
      mechanism.
AB  - Exposure of gram-negative bacteria to a source of antibody and complement
      frequently results in efficient cell killing; this effect follows the deposition
      of C5b-9 membrane attack complexes onto the bacterial surface. This review
      examines the molecular and physiological events culminating in C5b-9 deposition
      and cell death and advances an hypothesis that may account for cytoplasmic
      membrane damage following complement-mediated perturbation of the outer membrane.

PMID- 1642904
TI  - Magnetic resonance imaging of meningiomas.
AB  - MRI with gadolinium enhancement is the imaging modality of choice in the
      diagnosis of meningiomas. Various MRI features are described. MRI signal
      intensity characteristics in meningiomas contain information that could be
      correlated with the histopathology of the tumor. Hyperintensity on T2-weighted
      images indicates soft tumor consistency and microhypervascularity and is more
      often seen in aggressive, angioblastic, or meningothelial meningiomas. MRI is
      useful in demonstrating dural sinus involvement. Meningiomas in unusual locations
      and their mimics are also presented.

PMID- 1642905
TI  - Posterior fossa neoplasms: multiplanar imaging.
AB  - Multiplanar imaging capabilities and increased tissue contrast inherent to MR
      permit inimitable evaluation of the normal and abnormal structures of the
      posterior fossa. A review of common posterior fossa neoplasms in adults and
      children is presented with emphasis on the MR characteristics.

PMID- 1642906
TI  - Imaging of pituitary gland tumors.
AB  - MRI has clearly improved the visualization of the perisellar region. Its full
      role in the diagnosis of pituitary adenomas remains to be defined. It is likely
      that three-dimensional Fourier transform thin-section imaging of the gland will
      further refine the diagnosis of adenoma, allowing not only for the visualization
      of tiny adenomas, but possibly helping to distinguish them from other
      nonadenomatous intraglandular abnormalities.

PMID- 1642907
TI  - The development and safe use of patient-controlled analgesia.

PMID- 1642908
TI  - Fresh gas requirements of an enclosed afferent reservoir breathing system in
      anaesthetized, spontaneously ventilating children.
AB  - We have determined the minimum fresh gas flow rate (VF) for use with the Ohmeda
      enclosed afferent reservoir breathing system (EAR) in 10 anaesthetized children
      breathing spontaneously. First, we determined the VF required to prevent
      rebreathing as detected by increased total ventilation (VE) and end-tidal carbon
      dioxide partial pressure. Second, we used a mathematical model to calculate the
      degree of rebreathing occurring at each VF. A VF equal to the predicted alveolar
      ventilation was sufficient to prevent clinically detectable rebreathing in all
      patients. From the model, no rebreathing occurred when VF/VE was 0.78 or more. We
      have shown previously that the EAR functions efficiently during controlled
      ventilation with a VF = 0.6 x weight 0.5. As this VF is slightly greater than the
      predicted alveolar ventilation, we suggest that the EAR may be used with a VF =
      0.6 x weight 0.5 regardless of the mode of ventilation.

PMID- 1642909
TI  - Extradural clonidine infusions for analgesia after total hip replacement.
AB  - We have examined the effectiveness of extradural clonidine infusions for
      postoperative analgesia and the effect of clonidine on extradural morphine. In a
      double-blind, controlled study, patients, undergoing total hip replacement were
      allocated randomly to receive one of two doses of extradural clonidine (25
      micrograms h-1 or 50 micrograms h-1), low dose extradural morphine or a
      combination of morphine and clonidine. Pain scores in the morphine group were
      significantly greater than in the clonidine groups (P less than 0.01) and the
      combination group (P less than 0.05) during the first 1 h after surgery. The
      requirements for systemic analgesia were least in the combination and larger dose
      clonidine group, and the duration of effect of the initial bolus dose was
      significantly longer compared with the morphine and low dose clonidine groups (P
      less than 0.05). Arterial pressure was reduced in the clonidine groups, although
      the incidence of clinical hypotension was low. There were no significant
      differences between the groups in emetic symptoms or urinary retention.

PMID- 1642910
TI  - Effect of pre- vs postoperative inguinal field block on postoperative pain after
      herniorrhaphy.
AB  - The analgesic effects of an identical inguinal field block, performed before or
      immediately after inguinal herniorrhaphy, were evaluated in 32 healthy patients
      in a double-blind, randomized study. During surgery, all patients received a
      light general anaesthesia with thiopentone, alfentanil and nitrous oxide in
      oxygen. After induction of general anaesthesia, patients were allocated randomly
      to receive an inguinal field block with lignocaine, either 15 min before
      operation or immediately after operation, after closure of the surgical wound,
      but before the patients were awake. Pain score on a visual analogue scale and on
      a verbal scale at rest, during mobilization from supine into sitting position and
      during cough was assessed 1, 2, 4, 6, 8 and 24 h, and 7 days after operation. No
      significant differences between the groups were observed in VAS scores or verbal
      pain scores during rest or ambulation at any time. There was no significant
      difference in time to first request for morphine or total morphine consumption.
      These results do not show pre-emptive analgesia with a conventional inguinal
      field block to be of clinical importance compared with a similar block
      administered after operation.

PMID- 1642911
TI  - Effect of physiotherapy on the auditory evoked response of paralysed, sedated
      patients in the intensive care unit.
AB  - Auditory evoked response (AER) was recorded before, during and after
      physiotherapy in 11 paralysed (atracurium 0.56 (SD) 0.13 mg kg-1 h-1), sedated
      (propofol 2.2 (1.0) mg kg-1 h-1; fentanyl 4.4 (2.3) micrograms kg-1 h-1) and
      critically ill patients undergoing ventilation in the intensive care unit (ICU).
      The latency of the negative wave, NB, was reduced by physiotherapy (mean 44.8
      (SD) 7.9 ms before, 41.0 (6.8) ms during (P less than 0.01, non-parametric
      Friedman test) and 45.6 (6.3) ms after physiotherapy); NB amplitude showed no
      consistent change (-0.81 (1.4) microV, -0.81 (1.5) microV and -0.71 (1.3) microV,
      respectively). NB latency responded to patient arousal at constant levels of
      sedation and this requires further evaluation as a means of monitoring sedation
      in paralysed patients in the ICU.

PMID- 1642912
TI  - Recovery from day-case anaesthesia: comparison of total i.v. anaesthesia using
      propofol with an inhalation technique.
AB  - A prospective, double-blind study was conducted to compare postoperative recovery
      after either total i.v. anaesthesia (TIVA: propofol and alfentanil) or an
      inhalation technique (propofol and alfentanil followed by nitrous oxide and
      isoflurane) in 50 patients undergoing day-case gynaecological surgery.
      Psychomotor performance was assessed at 1 and 2 h after surgery using the
      Critical Flicker Fusion Threshold (CFFT), Simple Reaction Time (SRT) and Choice
      Reaction Time (CRT). Subjective recovery and side effects after discharge from
      hospital were assessed using a postal questionnaire. Recovery occurred
      significantly earlier in the TIVA group as assessed by CFFT and SRT (P less than
      0.01); there were no significant differences (P greater than 0.05) between the
      two groups in CRT, subjective duration of recovery or side effects.

PMID- 1642913
TI  - Heart rate periodicities during induction of propofol-nitrous oxide-isoflurane
      anaesthesia.
AB  - This study examined the variation in cardiac inter-beat interval during induction
      of anaesthesia with propofol and subsequent inhalation anaesthesia with nitrous
      oxide and isoflurane. In comparison with preoperative control values, heart rate
      variability was reduced by anaesthesia and there was a complex, but consistent,
      pattern of R-R interval change during induction. Immediately after propofol 2 mg
      kg-1, high frequency heart rate oscillations were replaced by low frequency
      oscillations (0.05 Hz). Subsequently, with decreasing propofol and deepening
      nitrous oxide-isoflurane anaesthesia, high frequency components returned towards,
      although not reaching, control values; low and, to a greater extent, mid range
      (0.1-Hz) frequency components remained reduced. We postulate that these
      alterations are consistent with an immediate but transient post-induction
      ventilatory depression, subsequent decrease in efferent sympathetic activity and
      reduction in baroreflex responsiveness. R-R interval analysis is suggested to be
      a useful tool in the evaluation of autonomic function during anaesthesia.

PMID- 1642914
TI  - Response of 10 pulse oximeters to an in vitro test system.
AB  - Pulse oximeters are often used in situations in which severe hypoxaemia may
      occur. We have developed an in vitro system to test the accuracy of pulse
      oximeter calibration. The probe of 10 different oximeters was attached to a model
      finger in an in vitro blood circuit, and pulse oximeter readings (SpO2) were
      compared with multi-wavelength in vitro oximeter readings (SO2) over a range of
      SO2 values from 50 to 100%. The oximeters tested varied widely in their accuracy
      and linearity. We conclude that the system can test the accuracy, reproducibility
      and linearity of response of pulse oximeter readings at low oxyhaemoglobin
      saturations.

PMID- 1642915
TI  - Vasodilator properties of nitroglycerin and isosorbide dinitrate during
      cardiopulmonary bypass.
AB  - In a placebo-controlled trial, we have studied the vasodilator properties of
      bolus doses of nitroglycerin (TNG) and isosorbide dinitrate (ISDN) in 32 patients
      during cardiopulmonary bypass with a constant pump flow. Blood volume of the
      venous reservoir and mean arterial pressure were recorded for 10 min after drug
      administration to detect changes in venous capacitance and arteriolar resistance,
      respectively. The venous capacitance-increasing effects of TNG 200 micrograms and
      ISDN 1,600 micrograms were initially identical and significant at 2 and 3 min
      after the bolus. Thereafter, the effect of TNG began to decline, while that of
      ISDN remained significant until the end of the study. TNG 200 micrograms
      decreased arterial pressure slightly more than ISDN 1,600 micrograms, but the
      effect of both drugs lasted for only 1-2 min. TNG and ISDN were equipotent in
      increasing venous capacitance when administered in a bolus dose ratio of 1:8
      during CPB, but the venodilator effect of ISDN lasted longer than that of TNG.
      The duration of the arteriolar dilator effect was very short with both drugs.

PMID- 1642916
TI  - Accuracy of text entries within a manually compiled anaesthetic record.
AB  - We have examined the accuracy of text entries within a manually compiled
      anaesthetic record by comparing the record of the anaesthetist with that of an
      observer, present throughout the procedure but whose sole purpose was the
      documentation of perioperative events. Eighty-six items of information were
      analysed for accuracy from 197 records. The mean proportion of omissions was 35%
      and the mean proportion of incorrect entries was 3.4%. Where no entry should have
      been made, the mean proportion of unwarranted entries was 1%. Accuracy varied
      according to the information contained; however, omissions were common for
      preoperative status, fluids, tourniquet use, aspects of monitoring, local
      anaesthesia and intraoperative problems. The most consistently accurate
      information was the description of the patient and that relating to
      intraoperative i.v. drug use. Inaccuracy was common for the majority of sites on
      the record, irrespective of their reflecting on the anaesthetist's performance.
      We suggest, therefore, that the reason for this inaccuracy of data was not
      related principally to anaesthetists' defensiveness, but may reflect their
      attitudes to the record's value and response to inadequacies in its design. The
      observed deficiencies in recording accuracy may affect patient safety during
      future anaesthesia and has relevance to medico-legal and epidemiological
      research.

PMID- 1642917
TI  - Transcranial Doppler sonography: effects of halothane, enflurane and isoflurane
      on blood flow velocity in the middle cerebral artery.
AB  - Systolic, diastolic, and mean blood flow velocity in the middle cerebral artery
      (Vs,mca; Vd,mca; Vm,mca) and pulsatility (Vs-Vd)/Vm of the waveform obtained were
      recorded in 51 patients before, during and after general anaesthesia.
      Transcranial Doppler (TCD) sonographic variables were measured in the awake
      patient and after induction of anaesthesia with thiopentone 5-6 mg kg-1. After
      tracheal intubation, 17 patients received 0.8% halothane and 66% nitrous oxide in
      oxygen for 30 min (15 min normoventilation; 15 min hyperventilation). The
      inspired halothane concentration was then increased to 1.6% for 45 min (15 min
      normoventilation; 15 min hyperventilation; 15 min normoventilation with nitrous
      oxide replaced by oxygen). Enflurane (1.7% for 30 min and 3.4% for 45 min) was
      given to another 17 patients; 17 other patients received isoflurane (1.2% and
      2.4%). Mean arterial pressure (MAP), nasopharyngeal temperature, end-tidal carbon
      dioxide concentration, inspired and end-tidal anaesthetic agent concentrations,
      haemoglobin concentration, PVC and TCD variables were measured at the end of each
      15 min period. After recovery from anaesthesia, TCD variables were measured
      again. There were no intergroup differences in changes in MAP, nasopharyngeal
      temperature, haemoglobin concentration and PCV. Halothane, enflurane and
      isoflurane at low doses and normoventilation had little influence on TCD
      variables compared with awake values. In large concentrations with nitrous oxide
      in oxygen and normoventilation, there were differences between the volatile
      agents. Halothane increased blood flow velocities, but enflurane and isoflurane
      caused little change. Hyperventilation always decreased blood flow velocities and
      increased pulsatility.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1642918
TI  - Rapid administration of crystalloid preload does not decrease the incidence of
      hypotension after spinal anaesthesia for elective caesarean section.
AB  - Twenty parturients undergoing elective Caesarean section were allocated randomly
      to receive crystalloid preload 20 ml kg-1 over either 20 min or 10 min before
      spinal anaesthesia. Significant hypotension (systolic arterial pressure less than
      100 mm Hg and less than 80% of baseline value) occurred in six of the 10 patients
      in the 20-min preload group and seven of 10 patients in the 10-min preload group
      (ns). Both groups had a significant (P less than 0.05) increase in central venous
      pressure during the preload period. The mean central venous pressure in the 10
      min group was 11.9 mm Hg (range 6-19 mm Hg), which was significantly greater (P
      less than 0.05) than that in the 20-min group (mean 7.3 mm Hg, range 2-13 mm Hg).
      Three patients in the 10-min group had clinically unacceptable increases in
      central venous pressure. This study has demonstrated that rapid administration of
      crystalloid preload before spinal anaesthesia did not decrease the incidence or
      severity of hypotension, and questions the role of crystalloid preload.

PMID- 1642919
TI  - Anaesthesia and the ventilatory system in infants and young children.

PMID- 1642920
TI  - Evaluation of a disposable patient-controlled analgesia device in children.
AB  - A disposable patient-controlled analgesia (PCA) device was evaluated in 20
      children after major abdominal, urological and orthopaedic surgery. All patients
      were given a high dependency level of nursing care in general wards. Efficacy (as
      assessed by hourly pain scores) was comparable to that achieved in a matched
      control group of 20 children who used the Graseby PCA system. Safety was
      confirmed by monitoring arterial oxygen saturation, sedation scores and
      ventilatory frequency. Morphine consumption was similar with the two techniques,
      but varied widely between patients. The disposable device has a complementary
      role to play in the provision of a comprehensive pain relief service for
      children.

PMID- 1642921
TI  - Stability of fentanyl, bupivacaine and adrenaline solutions for extradural
      infusion.
AB  - Fentanyl and bupivacaine were tested for their stability when diluted with 0.9%
      sodium chloride to 4 micrograms ml-1 and 0.1% respectively, in 100-ml polyvinyl
      chloride (PVC) bags, alone and in combination, with and without adrenaline
      1:200,000. Changes in drug concentration and pH were investigated for 56 days.
      The combination of fentanyl, bupivacaine and adrenaline was tested under varying
      environmental conditions of 35 degrees C, 4 degrees C, -18 degrees C, room
      temperature, darkness and after autoclaving. Fentanyl and bupivacaine were
      adsorbed onto PVC, resulting in reductions of 12.6% and 9.6% drug mass,
      respectively, at day 3, but remained stable thereafter. Adrenaline was
      progressively degraded to a maximum reduction of 37.3% at 35 degrees C by day 56.
      Solutions containing adrenaline became more acidic over 56 days. Fentanyl and
      bupivacaine were stable.

PMID- 1642922
TI  - Myocardial depressant effect of nitrous oxide after coronary artery bypass graft
      surgery.
AB  - We have studied the cardiovascular effects of nitrous oxide after cardiac
      ischaemia-reperfusion injury caused by aortic cross-clamping and unclamping
      during coronary artery bypass grafting (CABG). At the time of chest closure, 20
      patients were allocated randomly to receive oxygen and air (FIO2 = 0.5) or 50%
      nitrous oxide in oxygen in addition to anaesthesia with fentanyl. Nitrous oxide
      significantly decreased mean arterial pressure (P less than 0.01) and cardiac
      index (P less than 0.05), which suggests that nitrous oxide with fentanyl may
      significantly depress left ventricular performance after CABG. Although ischaemia
      reperfusion cardiac injury did not appear to increase the myocardial depressant
      effect of nitrous oxide, the use of nitrous oxide is not recommended immediately
      after CABG.

PMID- 1642923
TI  - Anaesthesia in a parturient with osteogenesis imperfecta.
AB  - A 20-yr-old primigravida at 38 weeks gestation with premature rupture of
      membranes and evidence of fetal distress required urgent Caesarean section. The
      diagnosis of osteogenesis imperfecta had been made 4 days earlier. The patient
      refused a regional anaesthetic. Difficulties in the administration of general
      anaesthesia to patients with osteogenesis imperfecta were recognized and managed
      accordingly. These problems are discussed and the importance of early antenatal
      assessment of such patients by the department of anaesthesia is emphasized.

PMID- 1642924
TI  - Change in cerebral blood flow velocity pattern during induced hypotension: a non
      invasive indicator of increased intracranial pressure?
AB  - A neurologically intact patient underwent spinal instrumentation under
      hypotensive anaesthesia 10 days after a mild closed head injury. Transcranial
      Doppler monitoring of the right middle cerebral artery revealed an abnormal flow
      pattern, suggesting increased intracranial pressure, impaired autoregulation, or
      both. Patients with a mild head injury may have altered intracranial
      haemodynamics and the time course of recovery from these changes is unknown.

PMID- 1642925
TI  - Extradural diamorphine for postoperative analgesia: audit of a nurse-administered
      service to 800 patients in a district general hospital.
AB  - We report the use of extradural diamorphine for postoperative analgesia as a
      nurse-based service on selected surgical wards in a district general hospital.
      Eight hundred patients received lumbar or thoracic extradural diamorphine
      analgesia for postoperative or traumatic pain. Diamorphine was administered in
      bolus form by suitably trained nursing staff. Satisfactory analgesia, recorded on
      a verbal rating scale at the conclusion of the service, was achieved in 94.6% of
      patients. The technique was considered by medical and nursing staff to be a safe
      and acceptable method of analgesia. Respiratory depression, defined as a
      ventilatory frequency of less than 10 b.p.m., occurred in seven patients
      (incidence of 0.9%). All occurred in the theatre recovery area or in the
      intensive care unit. Retrospectively, each was predictable and all responded to
      naloxone 0.4 mg.

PMID- 1642926
TI  - Overdose of opioid from patient controlled analgesia pumps.

PMID- 1642927
TI  - Combined spinal-extradural anaesthesia.

PMID- 1642928
TI  - Masseter spasm after suxamethonium.

PMID- 1642929
TI  - Tension pneumothorax--detection and incidence.

PMID- 1642930
TI  - Fresh gas utilization in the circle system.

PMID- 1642931
TI  - Collegiate developments.

PMID- 1642932
TI  - Liver disease and drug disposition.

PMID- 1642933
TI  - Effects of different hepatic pathologies on disposition of alfentanil in
      anaesthetized patients.
AB  - We have studied the influence of different hepatic pathologies on the disposition
      of alfentanil in 23 unpremedicated patients (six healthy control subjects, six
      patients with liver dysfunction of alcoholic aetiology and 11 patients with non
      alcohol related liver disease). All patients received a bolus of alfentanil 500
      micrograms i.v. as supplement to 67% nitrous oxide and isoflurane in oxygen
      anaesthesia. Plasma drug concentrations were measured in venous blood samples at
      intervals up to 24 h by radio-immunoassay and protein binding was determined by
      equilibrium dialysis. Kinetic estimates were determined using non-compartmental
      analysis. Patients with non-alcoholic liver disease had lesser plasma clearance
      (114.8 (range 66.8-213.5) ml min-1) than the alcoholic group (158.8 (100.0-220.7)
      ml min-1) or controls (187.4 (125.2-269.5) ml min-1). In all three groups, there
      was considerable intersubject variability, with a bimodal distribution in the non
      alcoholic group. This group also had a smaller apparent volume of distribution at
      steady state. Mean residence time was prolonged in the alcoholic group compared
      with controls (284.9 (217.8-362.2) min vs 226.8 (201.2-250) min). Protein binding
      was decreased in the alcoholic group compared with controls (84.9 (SD 4.2)% vs
      89.3 (2.1)%); this was attributable to a lesser plasma alpha 1-acid glycoprotein
      concentration (0.55 (0.18) g litre-1 vs 0.89 (0.21) g litre-1). Free drug
      clearance was reduced in both liver dysfunction groups compared with controls.

PMID- 1642934
TI  - Relationship between hypoxaemic and cardiac ischaemic events in the perioperative
      period.
AB  - We have used continuous and concurrent monitoring of arterial oxygen saturation
      (SpO2) and ECG to study the relationship between hypoxaemia and silent myocardial
      ischaemia in the perioperative period in 11 patients with cardiovascular disease.
      Ischaemic and hypoxaemic events occurred in all patients. Many events were
      shortlived and occurred independently of each other. However, our results suggest
      a close correlation between the duration of hypoxaemia and myocardial ischaemia.
      Ischaemia is more likely to occur if an episode of hypoxaemia is prolonged
      (beyond 5 min; P less than 0.01, chi square) and severe (SpO2 less than 85%; P
      less than 0.05, chi square).

PMID- 1642935
TI  - IV diclofenac in post-thoracotomy pain.
AB  - We have studied the efficacy of a continuous i.v. infusion of diclofenac 2 mg kg
      1/24 h given for 2 days after major thoracic surgery in 30 patients in a double
      blind, placebo-controlled, parallel-group design. The patients were able to
      obtain additional pain relief as on demand morphine boluses. In the diclofenac
      group, the consumption of morphine was reduced by 60% during the first and by 76%
      during the second day after operation compared with the control group. Overall,
      analgesia was also superior in the diclofenac group. Arterial oxygenation was
      significantly greater and the arterial PCO2 increased less during the first day
      after operation in the diclofenac group compared with the control group.
      Diclofenac had no significant effect compared with placebo on blood loss or on
      any bleeding or platelet test. Urine output was significantly less during the
      first day after operation in the diclofenac group compared with the control
      group, but was normal on the second day after operation; plasma creatinine
      concentrations were unchanged. I.v. diclofenac infusion combined with opioids
      delivered via a patient-controlled analgesia device seems a valuable method of
      pain relief after thoracic surgery in patients in whom more invasive techniques,
      such as extradural local anaesthetics and opioids, cannot be used. However, non
      steroidal anti-inflammatory drugs should be used cautiously, if at all, in
      patients who are at risk of acute renal failure.

PMID- 1642936
TI  - Effects of ketorolac trometamol on renal function.
AB  - We have compared the renal effects of ketorolac trometamol 10 mg administered 4
      hourly by intermittent i.m. injection or by continuous i.m. infusion with placebo
      in a double-blind study in 67 patients who had undergone upper abdominal surgery.
      Ketorolac was supplemented during the 48-h postoperative study period with bolus
      doses of morphine delivered by a patient controlled analgesia system. The only
      significant effect of ketorolac on renal function compared with patients who
      received placebo was reduced excretion of potassium. The overall changes caused
      by surgery alone were of much greater magnitude. Bleeding time was increased with
      ketorolac, but there were no adverse events related to this.

PMID- 1642937
TI  - Pharmacokinetics of propofol during and after long-term continuous infusion for
      maintenance of sedation in ICU patients.
AB  - The pharmacokinetics of propofol administered as long term infusions were
      determined in 12 intensive care unit patients (two female; mean age 58 yr, mean
      weight 66.9 kg) requiring sedation during mechanical ventilation. Patients were
      recruited after having been administered propofol for 24 h. Blood samples for
      analysis of propofol were taken during the infusion (mean duration 85.6 h; mean
      rate 2.58 mg kg-1 h-1) and for up to about 42 h after its termination. The median
      propofol total body clearance, derived from the apparent steady state propofol
      blood concentrations during infusion, was 2.11 litre min-1. One patient died
      during the infusion, from multi-organ failure secondary to a pre-existing
      septicaemia, and in one other patient no sampling was possible during the first
      30 min after infusion; full elimination data were obtained for 10 patients. After
      termination of the infusion, propofol blood concentrations declined rapidly, with
      an overall mean decrease of 50% over the first 10 min; thereafter the decline was
      more gradual. The elimination profile was triphasic in seven patients and
      biphasic in three patients. Mean half-lives for the three phases were 1.81 (n =
      10) min, 70.9 (n = 7) min and 1411 (n = 11) min. There was no apparent trend in
      the terminal phase half-life with the duration of sampling after infusion.

PMID- 1642938
TI  - Use of mivacurium chloride by constant infusion in the anephric patient.
AB  - Twenty anephric and 20 healthy patients received a bolus dose of mivacurium 150
      micrograms kg-1. When the first EMG response (T1) of the train-of-four had
      recovered to 5% of control (T0), an infusion of mivacurium 10 micrograms kg-1 min
      1 was started and adjusted to keep T1 at 5%. Ten patients in each group were
      given neostigmine 35 micrograms kg-1 when the infusion was stopped when T1/T0 had
      recovered to 20%; in the others recovery was spontaneous. After the bolus dose of
      mivacurium, mean (SD) depression of T1 was greater in the anephric group than in
      the normal group (98.4 (3.5) vs 96.8 (4.4)%; P less than 0.01) and recovery of
      T1/T0 to 5% was slower (15.3 (6.9) vs 9.8 (3.5) min; P less than 0.01). Anephric
      patients required a slower infusion rate (6.3 (1.9) vs 10.4 (2.8) micrograms kg-1
      min-1; P less than 0.001). Neostigmine hastened recovery of both T1/T0 and T4/T1
      in both groups. Spontaneous recovery of T1/T0 (from 25% to 75%) after the
      infusion was also slower in anephric patients (12.2 (8.2) vs 7.7 (1.2) min; P
      less than 0.05). Plasma cholinesterase activity was less in the anephric group
      (785 (207) vs 943 (217) iu litre-1; P less than 0.05) and there was a (negative)
      correlation overall between cholinesterase activity and time to 5% recovery of
      T1/T0 after the bolus dose (r = -0.42; P less than 0.02). We conclude that
      patients with chronic renal failure may require a reduced dose of mivacurium.

PMID- 1642939
TI  - Gastroduodenal dysfunction as a cause of gastric bacterial overgrowth in patients
      undergoing mechanical ventilation of the lungs.
AB  - We have studied 15 patients undergoing mechanical ventilation of the lungs for
      evidence of a relationship between gastroduodenal dysfunction and gastric
      bacterial overgrowth. Duodenal reflux was detected by quantitative measurement of
      conjugated bilirubin in gastric aspirate specimens. The pH and bacterial content
      of these specimens were analysed. A minority of specimens with pH less than 3.5
      contained measurable numbers of viable bacteria. The total bacterial count and
      the count of Gram negative bacteria correlated significantly with specimen pH in
      both cases (P less than 0.001, in both). In the 72 specimens of gastric aspirate
      with pH greater than 3.5, the presence of Gram negative bacteria was associated
      significantly with detectable bilirubin (P less than 0.001). The total bacterial
      count was greater also in specimens containing bilirubin (P = 0.009). These
      results suggest that gastroduodenal dysfunction may promote gastric bacterial
      overgrowth, contributing to the development of ventilator-associated pneumonia.

PMID- 1642940
TI  - Effect of low and high concentrations of alfentanil administered intrathecally on
      A delta and C fibre mediated somatosympathetic reflexes.
AB  - We have studied the effects of alfentanil administered intrathecally on
      somatosympathetic reflexes evoked by stimulation of radial and tibial nerves in
      10 anaesthetized and paralysed dogs. In five animals, alfentanil was administered
      in doses of 100, 100, 200 and 400 micrograms in 0.8 ml and 800 micrograms in 1.6
      ml prepared from the formulation of 500 micrograms ml-1. Five others received
      alfentanil (high concentration formulation, 5 mg ml-1) in doses of 500 and 2000
      micrograms in 0.5 ml and 5000 micrograms in 1 ml. C fibre tibial nerve reflexes
      were depressed by 100 micrograms and abolished with doses of 200-400 micrograms,
      but the A delta response remained unaffected. A delta responses were depressed
      also and abolished, respectively, by doses of alfentanil 2000 micrograms and 5000
      micrograms. At the larger, but not the smaller, concentration there was evidence
      of baroreflex sensitization probably caused by systemic absorption of the drug.

PMID- 1642941
TI  - Somatosensory and auditory evoked responses recorded simultaneously: differential
      effects of nitrous oxide and isoflurane.
AB  - Auditory (AER) and somatosensory evoked responses (SSER) were recorded
      simultaneously in eight patients under anaesthesia before surgery. We studied the
      effects of equi-MAC end-expiratory concentrations of isoflurane (0.65-0.75%) and
      nitrous oxide (60-65%). The anaesthetics were changed at random in three
      consecutive 10-min periods so that each patient received both drugs. From the AER
      recorded from the vertex and inion, Pa and Nb latency and amplitude were
      measured. N13, P20 latency and N13 amplitude were measured from SSER recordings
      from the neck and P15, N20, P25, N35, P45 latency and P15-N20, N20-P25, P25-N35
      and N35-P45 amplitude from the scalp over the hand area of the sensory cortex.
      Compared with nitrous oxide, isoflurane significantly increased the latencies of
      the AER waves Pa (P = 0.02) and Nb (P = 0.02), and the SSER waves N20 (P = 0.001)
      and P25 (P = 0.04). We were unable to demonstrate significant differences in Pa
      and Nb amplitude between isoflurane and nitrous oxide that we had seen
      previously. However, the amplitude of the SSER wave N20 was reduced significantly
      by nitrous oxide compared with isoflurane (P = 0.0004). This wave (N20) is
      thought to emanate from the thalamo-cortical radiations, and our findings may be
      explained by an analgesic effect of nitrous oxide mediated by endogenous opioids.

PMID- 1642942
TI  - Voltage fields surrounding needles used in regional anaesthesia.
AB  - Using a bench model, we have studied the voltage fields surrounding both
      insulated and uninsulated needles used in regional anaesthesia. The findings were
      compared with earlier computer predictions which suggested that the fields would
      be markedly different for the two types of needle. The results confirm that the
      fields differ markedly and suggest that the use of insulated needles may not
      necessarily improve the accuracy of nerve location and that uninsulated needles
      may be more appropriate.

PMID- 1642943
TI  - Arterial oxygen saturation during induction of anaesthesia and laryngeal mask
      insertion: prospective evaluation of four techniques.
AB  - In a prospective, randomized study of 87 patients, we have compared the incidence
      of hypoxaemia during induction of anaesthesia with subsequent Laryngeal Mask
      Airway (LMA) insertion in healthy adults when four different techniques were
      used: one without supplementary oxygen, and three with supplementary oxygen.
      Twelve patients did not receive supplementary oxygen before LMA placement, 25
      underwent partial denitrogenation by breathing oxygen from the start of injection
      of the induction agent, 25 underwent formal denitrogenation by breathing oxygen
      for 3 min, and 25 received five tidal volume breaths of oxygen by face mask using
      positive pressure immediately after induction of anaesthesia. Anaesthesia was
      induced with propofol 2.0 mg kg-1 and fentanyl 1 microgram kg-1. Additional
      propofol was given if required. Arterial oxygen saturation was measured by pulse
      oximetry. Desaturation occurred in 11 of 12 patients who did not receive
      supplementary oxygen, and in 19 of 25 patients who received manual ventilation
      with 100% oxygen after induction of anaesthesia before LMA insertion. Full
      denitrogenation and partial denitrogenation were equally successful in preventing
      desaturation. Failure to position the LMA successfully occurred in 3% of
      patients, and some difficulty was encountered in another 18%.

PMID- 1642944
TI  - Does glycine antagonism underlie the excitatory effects of methohexitone and
      propofol?
AB  - We have investigated the pharmacological basis of CNS excitation that occurs in
      association with general anaesthesia in mice. Propofol produced sustained clonic
      movements during anaesthesia. Methohexitone produced intermittent non-rhythmic
      jerking during anaesthesia. Ethanol and pentobarbitone produced anaesthesia
      without associated clonic movements. Doses of all anaesthetic drugs were
      equipotent. Surface EEG recordings showed paroxysmal discharges consistent with
      interictal manifestations of cortical seizures with methohexitone or propofol,
      but not with ethanol or pentobarbitone. Strychnine, a glycine antagonist without
      effects on the cerebral cortex, and bicuculline, a GABAA antagonist with effects
      on the cerebral cortex, were used in doses that were equipotent-0.5 log units
      less than the ED10 for clonic convulsions. Strychnine potentiated both excitatory
      behaviour and EEG paroxysmal discharges when given with methohexitone or
      propofol, but not with ethanol or pentobarbitone. Bicuculline did not affect
      either behaviour or EEG with any of the anaesthetic drugs. Our data show that
      methohexitone and propofol produced CNS excitation, while pentobarbitone and
      ethanol did not. We propose that the pharmacological basis of this excitation may
      be glycine antagonism occurring in subcortical structures.

PMID- 1642945
TI  - Esmolol hydrochloride for management of the cardiovascular stress responses to
      laryngoscopy and tracheal intubation.
AB  - In a double-blind, randomized, controlled prospective study, 30 grade ASA I/II
      patients received a continuous i.v. infusion of normal saline or esmolol
      hydrochloride before induction of anaesthesia and tracheal intubation. Arterial
      pressure and heart rate were measured to assess the pressor response to
      laryngoscopy and intubation. The heart rate decreased in the esmolol group before
      induction of anaesthesia. The pressor response to laryngoscopy was significantly
      less marked in the esmolol group.

PMID- 1642946
TI  - Reflective blankets used for reduction of heat loss during regional anaesthesia.
AB  - We have studied the ability of reflective blankets to reduce net loss of body
      heat during regional anaesthesia for total hip arthroplasty. Thirty patients were
      allocated randomly to either the study group (insulated with reflective blankets)
      or the control group (no reflective blankets). Surgical and operation room
      draping, theatre temperature and i.v. fluid administration were standardized for
      all patients. Total body heat was deduced from core temperature (aural canal) and
      mean skin temperature (four measuring sites). After 2 h of surgery, loss of body
      heat was reduced significantly in patients wrapped in reflective blankets (26 kJ)
      compared with those in the control group (95 kJ).

PMID- 1642947
TI  - Airway management in a case of neck impalement: use of the oesophageal tracheal
      combitube airway.
AB  - A patient presented with neck impalement after a traffic accident. Respiratory
      arrest demanded immediate tracheal intubation, which was impossible as a wooden
      splinter had partially obstructed the pharynx and prevented laryngoscopy. An
      oesophageal tracheal Combitube airway was inserted successfully and the patient's
      lungs were ventilated adequately until tracheotomy was performed.

PMID- 1642949
TI  - Peak serum bupivacaine concentration.

PMID- 1642948
TI  - Efficiency of the left ventricle assist device Hemopump in cardiac fibrillation.
AB  - We have examined in sheep the efficiency of the Hemopump during ventricular
      fibrillation. Circulatory arrest was induced by electrical stimulation and
      maintained for 30 min. Haemodynamic measurements were recorded continuously and
      blood samples were taken before, during and after fibrillation to determine total
      body and myocardial metabolic activity. All hearts were defibrillated
      successfully after 30 min of fibrillation. During fibrillation, the Hemopump
      sustained a mean arterial pressure of about 60 mm Hg with a blood flow rate of
      about 2.3 litre min-1. These perfusion conditions were sufficient for maintenance
      of aerobic myocardial metabolism, but with a borderline circulatory supply to the
      total organism.

PMID- 1642950
TI  - Papers presented at a symposium to honor Dr. Rudolf Nieuwenhuys' 65th birthday.

PMID- 1642951
TI  - Twenty-five years of comparative neuroanatomy in Nijmegen: homage to Rudolf
      Nieuwenhuys.

PMID- 1642952
TI  - Comparative aspects of cerebellar organization. From mormyrids to mammals.
AB  - Recent progress in the comparative analysis of the vertebrate cerebellar
      organization shows that the cerebella of different tetrapods have a basically
      similar intrinsic organization, whereas the cerebellum of fishes displays a
      number of fundamental differences in this respect. Clear examples of teleostean
      cerebellar specializations are present in the gigantocerebellum of mormyrids,
      including a valvula cerebelli, the absence of a parasagittal zonal organization,
      the presence of eurydendroid projection neurons instead of deep cerebellar
      nuclei, a precerebellar nucleus lateralis valvulae, olivocerebellar fibers that
      do not climb into the molecular layer, uni- and bilateral locations of granule
      cells, parallel fibers without a T-shaped bifurcation and with a coextensive
      distribution in the transverse plane, and different Purkinje cell arrangements
      including a dendritic palisade pattern. A theoretical exploration of the possible
      significance of these configurations suggests that they all might be involved in
      a single main cerebellar function, i.e. coincidence detection of parallel fiber
      activity by Purkinje cells.

PMID- 1642953
TI  - Brain and behaviour: morphological and functional aspects of the hypothalamus in
      the rat.
AB  - In a short historical overview some developments in the behavioural research of
      the hypothalamus of the rat are introduced. Especially the ventromedial and the
      lateral hypothalamus have received much attention in the past. Numerous different
      behavioural effects have been described as the result of some kind of activation
      or inactivation of parts of the hypothalamus in the rat. Questions concerning the
      topographical distribution and the specificity of the effects observed, are
      addressed in the later parts. These behavioural observations were very important
      for the comparison with our anatomical observations concerning the hypothalamus,
      including the topographical organization of some afferent and efferent
      relationships. Non-synaptic or paracrine communication may play an important role
      in the hypothalamic effects on the organization of behaviour.

PMID- 1642954
TI  - The emotional motor system.
AB  - A large number of new descending motor pathways to caudal brainstem and spinal
      cord have been recognized recently. Nevertheless all the new pathways seem to
      belong to one of three motor systems in the central nervous system (CNS). This
      survey gives an overview of the pathways belonging to the so-called emotional
      motor system or the third motor system as defined by Holstege. The similarities
      and differences with the core, median and lateral paracore areas of the CNS as
      defined by Nieuwenhuys are discussed.

PMID- 1642955
TI  - The morphology of the cerebellum the last 25 years.
AB  - Advances in our knowledge of the subdivision and the development of the
      cerebellum during the last 25 years are reviewed. It is concluded that the
      longitudinal subdivision of the cerebellum has become firmly established in
      studies of the morphogenesis, the connections and the chemoarchitecture of the
      cerebellum. A complicated relationship exists between the transverse, lobular
      subdivision of the cerebellum and the distribution of different mossy fiber
      systems.

PMID- 1642956
TI  - Development of motor systems: a comparative approach.
AB  - Anurans offer a unique opportunity to study the development of neuronal
      connections. Transition from the aquatic limbless tadpole to the juvenile occurs
      over a protracted period of time during which the animal is accessible for
      experimental studies. Moreover, tract-tracing studies have demonstrated that
      their descending brain stem pathways show remarkable similarities in origin,
      course and site of termination to those of mammals. A developmental sequence in
      the formation of descending pathways to the spinal cord has been shown implying
      that reticulospinal and vestibulospinal fibers innervate spinal segments very
      early in development, whereas the red nucleus projects spinalwards definitely
      later in development. In anurans, this developmental sequence parallels the
      changes observed in locomotor pattern. The ingrowth of descending pathways into
      the spinal cord possibly occurs along so-called 'pre-existing' tracts. Several
      hypotheses on guidance cues in axonal pathfinding will be discussed.

PMID- 1642957
TI  - Psychosocial predictors of "safer sex" behaviors in young adults.
AB  - This study tested a model of safer sex behavior using variables from social
      learning theory, the health belief model, the theory of reasoned action, and
      theories of cognitive coping style. Two types of safer sex behavior were
      measured: frequency of condom use and the discussion of AIDS and past partners
      with a sexual partner. The participants--275 undergraduate students--completed an
      anonymous written questionnaire. The variables (behavioral intention, perceived
      susceptibility, barriers, self-efficacy, monitoring, blunting, and social
      support) predicted 35% of the variance in condom use and 13% of the variance in
      discussion (adjusted R2s). Intention was the strongest predictor of both types of
      safer sex behavior. Perceived susceptibility and perceived barriers were
      associated with intention to use a condom; perceived barriers was inversely
      related to condom use. Self-efficacy was associated with the intention to discuss
      and reported discussion of AIDS and past partners with a sexual partner; social
      support was related to the intention to discuss. An information-avoiding coping
      style was negatively associated with condom use. Implications for future research
      and intervention efforts in the area of AIDS prevention are discussed.

PMID- 1642958
TI  - Factors associated with urban gay men's treatment initiation decisions for HIV
      infection.
AB  - While a public health emphasis on primary prevention of human immunodeficiency
      virus (HIV) infection continues, it is recognized that large numbers of
      individuals are already infected. Efforts at secondary prevention focus on early
      medical intervention and may be effective in slowing progression to a diagnosis
      of AIDS. Understanding the factors that promote or impede seropositive
      individuals from receiving prompt medical treatment and complying with treatment
      regimens is essential to prolonging survival. During unstructured interviews in
      an ongoing study of sexual decision-making, 55 urban, gay, seropositive men
      spontaneously offered information about their treatment choices for their HIV
      infection. Findings regarding their considerations in initiating, delaying, or
      rejecting medical treatment are presented.

PMID- 1642959
TI  - Targeting the audience for AIDS messages by actual and perceived risk.
AB  - Since there are many ways to segment an audience into target groups, we suggest
      that a productive strategy for AIDS education is to divide the audience by their
      actual and perceived risk. We provide an example in which we segmented an urban
      U.S. sample and make suggestions as to how messages appropriate for each group
      can be constructed. In our sample, the "unthreatened" accurately assessed their
      low risk of AIDS, and showed high knowledge and tolerance rates. The "panicked,"
      who included more women and Hispanics, inaccurately thought themselves at high
      risk because of misunderstandings about the causes of AIDS, and showed more
      intolerance of people with AIDS. "Deniers" continued to have multiple sexual
      partners and take precautions irregularly, despite seeing AIDS as a social
      problem and having more education and AIDS knowledge. In contrast, "gamblers"
      recognized their higher risk of AIDS and were most likely to have taken some
      action, although not enough to prevent sexual transmission of the HIV virus.

PMID- 1642960
TI  - AIDS education of college students: the effect of an HIV-positive lecturer.
AB  - Seventy-five introductory psychology students participated in an experiment to
      assess the effectiveness of 2 types of AIDS education. In the "disclosed" and
      "undisclosed" conditions, students were given a lecture about AIDS/human
      immunodeficiency virus (HIV) by a person who has been diagnosed with HIV disease.
      The lecturer revealed his HIV status in the disclosed but not in the undisclosed
      condition. A control group received no education. Significant differences were
      found in a 3 x 3 (Time x AIDS Education) analysis of variance. Knowledge and
      Attitude posttest scores were significantly higher than pretest scores. Students
      in the disclosed condition scored higher than students in the control condition
      on both Knowledge and Attitude posttests. For Behavioral Intent, students in the
      disclosed condition scored higher than students in the control condition.
      Subjective comments made by the students indicated that a lecturer with HIV
      disease had a dramatic impact on their perceptions about AIDS.

PMID- 1642961
TI  - Alternate forms of HIV prevention attitude scales for teenagers.
AB  - The purpose of this study was to develop valid, alternate-form scales to measure
      teenagers' attitudes toward prevention of the transmission of human
      immunodeficiency virus (HIV). Using a three-component attitude model, a two-way
      table of specifications was constructed as a theoretical framework for generating
      attitudinal items relevant to HIV and HIV prevention. Thus, a large pool of
      Likert-type items was generated, reviewed for clarity and content validity, and
      prepared for the preliminary scale with 50 items. The scale was administered to
      210 high school students. As a result of extensive analyses, two alternate forms
      with 15 items each were developed. The two forms were simultaneously administered
      to a sample of 600 high school students. The collected data were subjected to
      item analyses, factor analysis, and reliability estimation. The results of the
      analyses provided strong evidence of internal consistency, content validity, and
      comparability of both forms. The alternate reliability across the form was .82.
      The alpha reliability coefficients for forms A and B was .78 and .77 and the
      split-half .76 and .69, respectively. It is concluded that these alternate forms
      produce valid, reliable, and comparable results for measuring teenagers'
      attitudes toward HIV prevention. These forms are ideal for pretest/posttest
      designs used for evaluating educational approaches to HIV control.

PMID- 1642962
TI  - HIV risk behavior in drug users: increased blood "booting" during cocaine
      injection.
AB  - The practice of "booting" or "kicking," in which blood is drawn into the syringe
      and then injected, was assessed as a possible behavioral mechanism contributing
      to cocaine's association with increased human immunodeficiency virus (HIV)
      infection. Intravenous drug users (IVDUs) (N = 68) demonstrated (with an empty,
      needleless syringe) their usual style of injection of cocaine, heroin, and
      speedball, in random order. The experimenter recorded the injection procedures
      and the syringe volumes at each step. Total blood volumes and number of pumps of
      the syringe were each greater during simulated cocaine and speedball use than
      during heroin use (p less than .05); means for both cocaine and speedball were 2-
      to 3-fold greater than for heroin. Subjects also described the booting behavior
      of their needle-sharing partners; the percentage having partners who booted blood
      was significantly greater during cocaine use than during heroin use (p less than
      .05). These findings indicate that cocaine use is associated with a behavioral
      style of injection (increased blood booting) that is more likely to contaminate
      the injection equipment with blood. Thus, the practice of booting may warrant
      special attention in AIDS prevention interventions and risk assessments.

PMID- 1642963
TI  - Issue dedicated to the memory of John L. Martin, PhD, MPH (1953-1992).

PMID- 1642964
TI  - Stereoselective aliphatic hydroxylation of 6-n-propylchromone-2-carboxylic acid
      by female Dutch rabbits.
AB  - 6-n-Alkylchromone-2-carboxylic acids are metabolized solely by aliphatic
      oxidation. In the rabbit, the 6-n-propyl congener (PCCA) undergoes omega-1
      hydroxylation exclusively. Following administration of PCCA to female Dutch
      rabbits (500 mumol/kg), some 77% of the dose was excreted in the urine, 41% as
      PCCA and 36% as 6-(2'-hydroxy-n-propyl)chromone-2-carboxylic acid. Since this
      metabolite is chiral, we have examined the stereochemistry of the excreted
      material. Diastereoisomeric (as camphanate and alpha-methoxy-alpha-(trifluoro
      methyl)phenylacetate esters) and direct chiral HPLC and chiral lanthanide shift
      NMR have each shown the S:R ratio of the excreted metabolite to be 76:24. When
      rabbits were dosed with the racemic metabolite, excretion of the compound was not
      stereoselective. The regio- and stereo-selectivity of the aliphatic hydroxylation
      of PCCA are thus reflections of the selectivities of the enzyme systems
      responsible for its formation and suggest PCCA to be an appropriate probe
      compound for the study of prochiral-chiral hydroxylations.

PMID- 1642965
TI  - Stereoselective effect of phenprocoumon enantiomers on the binding of
      benzodiazepines to human serum albumin.
AB  - The effect of phenprocoumon enantiomers on the stereoselective binding of 3
      substituted 1,4-benzodiazepines to human serum albumin (HSA) was studied by
      chromatography on HSA-Sepharose column. (S)-Phenprocoumon exerts stereoselective
      allosteric interaction on the binding of benzodiazepines. The structural
      requirements of enhanced stereoselectivities are similar to those found
      previously with (S)-warfarin.

PMID- 1642966
TI  - Rootworm pheromones: the root of a stereochemical mixup.

PMID- 1642967
TI  - General features of systemic effects of murine leukemias on phosphate metabolism
      in liver studied by 31P NMR.
AB  - 31P NMR was used to study the systemic effects of a tumor on a host organism by
      monitoring the phosphate metabolite content in freshly excised mouse liver at 0-4
      degrees C and in ethanolic liver extracts of animals suffering from La, L1210 and
      P388 leukemias and Ehrlich ascites tumor (EAT). The progression of murine
      leukemia is characterized by increases in the intensities of the resonances of Pi
      and phosphomonoesters (PME), in particular, phosphorylethanolamine, in liver;
      phosphodiester (PDE) signals increase two- to four-fold during the period of
      rapid tumor growth and decline to undetectable levels in the terminal stage.
      There were no reliable alterations detected in the ATP content and intracellular
      pH throughout the course of the leukemia. The kinetics of intracellular
      phosphates are similar in various kinds of leukemia but quite different in EAT.
      The reduction of inoculum causes the appearance of maxima in the Pi and PME
      profiles in the latent period of La leukemia, but the profiles of liver PDE
      considered from the end of the latent period are independent of inoculum.
      Possible mechanisms for the changes in PDE concentrations and their biochemical
      role are discussed. NMR spectroscopy of liver may be used to indirectly monitor
      the progression of tumors unavailable for direct NMR assay.

PMID- 1642968
TI  - An in vivo 19F NMR study of isoflurane elimination as a function of age in rat
      brain.
AB  - In vivo 19F NMR at 4.7 T has shown that the biphasic elimination of the vapor
      anesthetic isoflurane from rat brain is ca 15% slower in old (23-24 months)
      animals compared with young (5-6 months) animals. The fast kinetic component has
      a t1/2 of ca 7-9 min and the slow event, 100-115 min. Gas chromatographic
      measurement of arterial blood elimination displays age attenuation to the same
      extent, although a monophasic kinetic process (6-7 min). The slow wash-out from
      brain is thought to involve elimination from intracranial fatty tissue as
      postulated by others in rabbit brain. Longitudinal relaxation time measurements
      show monoexponential recovery and essentially identical values for young (1.09 +
      0.11 s) and old (1.04 +/- 0.09 s) animals. For dipalmitoylphosphatidylcholine
      vesicles the monoexponential recovery also suggests rapidly exchanging averaged
      homogeneous lipid environments for the anesthetic, but the longer T1s (2.75 +/-
      0.25 s) imply less restricted mobility compared with brain. Single T2 values were
      obtained in vivo, indicating either a single compartment or rapid exchange
      between multiple environments. These measurements were inconsistent, undoubtedly
      as a result of B1 inhomogeneity. The age-attenuated elimination kinetics for
      isoflurane are consistent with poorer cardiopulmonary function, whereas the T1
      data suggest similar environments for the anesthetic in young and old brain
      tissue.

PMID- 1642969
TI  - 31P NMR spectroscopy of a xenografted hypopharynx carcinoma: effects of tumor
      growth and treatment with cisplatin on the tumor phosphorus metabolism, histology
      and cytokinetics.
AB  - A xenografted hypopharynx carcinoma growing subcutaneously in nude mice was
      studied by in vivo 31P NMR spectroscopy during uninfluenced growth and following
      treatment with cisplatin (CDDP). Parallel to the NMR experiments, the cytokinetic
      and histological changes in the tumor were investigated. The most significant
      change in the growing tumor was a decline in the level of phosphocreatine (PCr),
      whereas the tumor pH did not change. Following treatment with CDDP (4, 8 and 12
      mg/kg), a dose-dependent decrease in the level of phosphomonoesters (PME) took
      place, whilst no dose dependence could be observed for the increase of PCr. the
      pH shifted to alkaline only after administration of the highest CDDP dose. Tumor
      cytokinetics revealed a cell arrest at the G1/S boundary 24 h after chemotherapy.
      At this time, the histological sections showed a dilatation of capillaries,
      whereas first necroses appeared on day 3. The proliferative activity of the tumor
      showed a sharp decline 24 h after CDDP application, followed by a revival of cell
      proliferation that was proportional to the dose applied between days 5 and 7.
      This increase in proliferative activity was paralleled by a marked increase in
      the PME/phosphodiesters ratio. Thus, in the tumor investigated the PME were the
      best indicators of tumor response to therapy. A precise correlation between the
      cytokinetic data and the re-energization of the tumor was not possible because
      histological changes, which may contribute to improved tumor energy status took
      place at the same time.

PMID- 1642971
TI  - Threshold voltages for hyperbolic secant inversion pulses.
AB  - Spin inversion produced by hyperbolic secant RF pulses is independent of pulse
      amplitude once a threshold value is exceeded. A semi-empirical formula for these
      pulses has been derived by application of analytical solutions to the Bloch
      equations. This predicts the required coil voltages for inversion as a function
      of inversion bandwidth and side-to-width parameter mu, based on knowledge of a
      reference voltage for the loaded coil. The voltage required is shown to increase
      linearly with bandwidth but to fall with the mu, approximately as (1/mu)0.4.
      Experimental confirmation is presented, and factors affecting choice of pulse
      parameters are discussed.

PMID- 1642970
TI  - Quantitation of metabolites in NMR spectra from isolated tissues, using 14N
      spectroscopy and nitrate to determine tissue volume.
AB  - Quantification of metabolites is a goal of many biomedical NMR studies. To obtain
      absolute measurements of metabolite concentrations is often both difficult and
      time-consuming. In this paper a method for determining metabolite concentrations
      directly is described and validated. It is applicable to studies of amphibian
      muscles, and with suitable precautions, to other isolated organs and tissues. The
      method is based upon using 14N NMR and nitrate-containing solutions to determine
      what fraction (F) of the sensitive volume of the RF coil is occupied by tissue.
      As the concentration of nitrate is known it can be used to calibrate other 14N
      metabolites in the tissue. Moreover, once F is determined, it can be used to
      calibrate metabolites in spectra from other nuclei e.g., 31P or 31C. All that is
      required is that a spectrum from a standard for that nucleus is obtained. Thus
      this method does not require any 'internal' (intrinsic to the tissue) standard,
      and is extremely quick and simple to use.

PMID- 1642972
TI  - 31P NMR spectroscopy of perinatal hypoxic-ischemic brain damage: a model to
      evaluate neuroprotective drugs in immature rats.
AB  - Cerebral energy metabolism can be measured non-invasively in unanesthetized
      neonatal rats with 31P NMR spectroscopy. Using this technique, serial changes in
      high energy phosphates were determined from the right cerebral hemispheres of 7
      day postnatal rat pups during a hypoxic-ischemic insult known to produce focal
      brain injury. During 3 h of hypoxia-ischemia the concentration of ATP dropped to
      33 +/- 8% of prehypoxic (baseline) levels, phosphocreatine (PCr)/Pi decreased
      from 1.5 +/- 0.51 to 0.16 +/- 0.06, while pH decreased nominally by 0.2 units.
      After 2.5 h of recovery in air, ATP returned to 75 +/- 10% of baseline levels,
      PCr/Pi rose to 1.1 +/- 0.28, and pH returned to its normal value of 7.16 +/-
      0.06. This model was used to test the efficacy of the adenosine deaminase
      inhibitor, 2-deoxycoformycin (DCF) as a potential neuroprotective drug. The data
      for the drug- and saline-treated populations were analyzed by integrating ATP and
      Pi/PCr levels over specific time intervals, expressing it relative to baseline
      levels, and modeling it with cubic splines. Pretreatment with 500 micrograms/kg
      DCF shows a small, but statistically significant, preservation of both ATP and
      phosphorylation potential during hypoxia and initial recovery. Brain water
      content (edema) at 42 h recovery was apparently associated with both mean ATP and
      mean Pi/PCr in the last 2 h of hypoxia-ischemia. When ATP fell below 70% of
      baseline, brain edema was evident at 42 h of recovery. This methodology is
      suitable for extension to human infants.

PMID- 1642974
TI  - Acquired immunodeficiency syndrome (AIDS)--data as at 1 July 1992.

PMID- 1642973
TI  - Depth selective quantification of phosphorus metabolites in human calf muscle.
AB  - We have used phase modulated rotating frame imaging, a depth selective NMR
      technique, in conjunction with two methods of calibration, in order to determine
      the feasibility of quantifying phosphorus compounds in selected regions of a
      biological sample. In one method, we related peak areas obtained from a sample to
      the peak area of an external reference located within the receiver coil,
      previously calibrated against a standard. In the second method we measured peak
      areas from a standard separately and related them directly to the area of the
      sample peak. We examined the calf muscles of male volunteers, positioning the
      coil to obtain signal mainly from the gastrocnemius in the shallow slices and
      soleus in the deep slices. The concentrations of Pi, phosphocreatine and ATP (in
      mmol/kg tissue) were 3.0 +/- 0.5, 18 +/- 2 and 4.8 +/- 0.2 at 2 cm depth (mean +/
      SD; n = 5). These results are similar to published biopsy data. A comparison
      with published values obtained from other NMR quantification methods suggests
      that, while it is possible to obtain consistent results within one laboratory, it
      is not currently possible to obtain similar results between laboratories. This is
      evident from the fact that different laboratories report different
      phosphocreatine/ATP ratios, indicating that the techniques are limited by
      variations in the processes of data collection and peak area measurement.

PMID- 1642975
TI  - World AIDS cases: update.

PMID- 1642976
TI  - Insurance policies for health care workers with HIV infection.

PMID- 1642977
TI  - Thrush prophylaxis in AIDS and ARC.

PMID- 1642978
TI  - Skill mix. Value for money or dilution of care?

PMID- 1642979
TI  - Skill mix. Does fewer mean better?

PMID- 1642980
TI  - NHS reforms: blurring the boundaries.

PMID- 1642981
TI  - Ocular injuries in squash competitors.
AB  - Squash players are liable to suffer serious eye injuries if they do not take
      appropriate protective measures. The author presents a short case study which
      illustrates the type of injury that can be sustained, and argues that nurses and
      interested associations must become involved in health education activities to
      reduce the high incidence of injuries during squash matches.

PMID- 1642982
TI  - The current profile of the profession.

PMID- 1642983
TI  - Mental health: meeting needs with case management.
AB  - Present structures encourage a service-led provision of care. The purchaser
      provider split does have the advantage of targeting those most in need and of
      promoting an individualised service led by client needs. For those with a long
      term mental illness, however, a rigid split does not allow multiple needs to be
      met comprehensively, nor does it allow the work of engaging clients with
      appropriate services to be based on direct care. Case management is suggested as
      a flexible means of overcoming these problems.

PMID- 1642984
TI  - Reviewing options to hysterectomy.
AB  - The author reviews the options for women for whom hysterectomy has been advised.
      Nurses working in the community are identified as key personnel in offering such
      women skilled counselling and advice. This article provides nurses with
      information on the alternative treatment methods available.

PMID- 1642986
TI  - Studying at University of Birmingham.

PMID- 1642985
TI  - Open learning in occupational health.

PMID- 1642987
TI  - As nurses we must do all we can to identify with our patients.

PMID- 1642988
TI  - Computing: learning to love bytes.

PMID- 1642989
TI  - Psychiatry: observing the Italian job.

PMID- 1642990
TI  - Community care: suffering acts of omission.

PMID- 1642991
TI  - The Sister Susie column. Starting Susie's way.

PMID- 1642992
TI  - Ethics: killing or allowing to die?

PMID- 1642993
TI  - Social security benefits [continuing nursing education].
AB  - There is a wide range of benefits available for patients, clients and carers,
      and, in April this year two new benefits for disabled people were introduced
      together with new ways of claiming them. Is a knowledge of benefits necessary for
      a few nurse specialists only, or is it an integral part of professional practice
      for all?

PMID- 1642994
TI  - A healthy skin [continuing nursing education].
AB  - Nurses, midwives and health visitors often care for patients/clients with skin
      problems, so it is important they have the relevant knowledge and skills to
      deliver quality care in this sensitive area of practice.

PMID- 1642995
TI  - HIV/AIDS: approaching saturation point.

PMID- 1642996
TI  - Waving the flag for care. Interview by Alex Mathieson.

PMID- 1642997
TI  - Whistleblowing: whistling in the dark?

PMID- 1642998
TI  - Health screening for elderly people.

PMID- 1642999
TI  - Role and function of professional nursing.

PMID- 1643000
TI  - Malignant melanoma and sun exposure.
AB  - The awareness of 160 subjects about the dangers of over-exposure to the sun in
      relation to development of malignant melanoma was surveyed using a questionnaire.
      The survey found that despite wide acknowledgement of the dangers of ultraviolet
      radiation to the skin, the desire to get a suntan was still very strong and
      insufficient protection was being used. Advice continued to be required on all
      aspects of sun protection and on the importance of regularly examining the skin
      for changes in moles, a health education activity in which nurses have the skills
      to become fully involved.

PMID- 1643001
TI  - Perceptions of team midwifery.
AB  - This small study was conducted in a maternity unit which had implemented team
      midwifery one year previously. A period of non-participant observation of
      activities on a labour ward over ten shifts was followed by nine semi-structured
      interviews with midwives of various grades. While the initial aim of the study
      was to investigate the interpersonal aspects of collegial activity among
      midwives, the respondents gave many valuable comments on team midwifery. The
      general view was that team midwifery allowed them greater opportunities to
      develop a rapport with mothers and also provided more chances for personal and
      career development.

PMID- 1643002
TI  - Using peer audit in health visiting.
AB  - South Tees Health Authority is one of 12 pilot sites for quality assurance. Most
      staff in the community and mental health unit are involved with the setting of
      professional standards. This article describes health visitors' experience of
      peer audit, carried out on one of the standards set within their quality
      assurance standard setting group. The nine health visitors attached to general
      practices serving Redcar and the surrounding district set professional standards
      based on Donabedian's structure, process and outcome model. Standards were set in
      areas such as communication, immunisation, health promotion, and child health
      clinics.

PMID- 1643003
TI  - A hectic morning in a psychiatric nurse's life.

PMID- 1643004
TI  - Information technology: tomorrow's skills today.

PMID- 1643005
TI  - Tradimus. Student networks work.

PMID- 1643006
TI  - Tradimus. Student power: in search of a wise council.

PMID- 1643007
TI  - Tradimus. Project 2000: look back in danger.

PMID- 1643009
TI  - Tradimus. Student empowerment: double dealing with the media.

PMID- 1643008
TI  - Tradimus. Equal opportunities: defining equality.

PMID- 1643010
TI  - Tradimus. Placements: accent on emergencies.

PMID- 1643011
TI  - Tradimus. Ward placements: primary school.

PMID- 1643012
TI  - Cellular sites of extrarenal and renal erythropoietin production in anaemic rats.
AB  - The cellular origins of erythropoietin were investigated in the rat using a probe
      derived from a cloned rat erythropoietin cDNA. In anaemic-hypoxic rat liver, in
      situ hybridization detected erythropoietin mRNA primarily in hepatocytes and less
      frequently in nonparenchymal sinusoidal or perisinusoidal liver cells. An RNase
      protection assay was used to compare the erythropoietin mRNA contents of
      separated rat liver cell fractions and also suggested that hepatocytes are the
      major source of extrarenal erythropoietin with nonparenchymal liver cells
      contributing less than 1% to total hepatic erythropoietin production. In kidney,
      in situ hybridization localized erythropoietin mRNA in nonepithelial cells, as
      yet of undefined lineage, in the cortical and outer medullary interstitium. These
      results indicate that, in the rat, the primary sources of erythropoietin in liver
      and kidney are different types of cells.

PMID- 1643013
TI  - Interferon-alpha therapy during pregnancy in chronic myelogenous leukaemia and
      hairy cell leukaemia.
AB  - Interferon-alpha is an effective agent in the treatment of chronic myelogenous
      leukaemia and hairy cell leukaemia. Because interferon-alpha does not inhibit DNA
      synthesis, we have used it to treat these diseases during pregnancy. We report
      here two patients with chronic myelogenous leukaemia and two patients with hairy
      cell leukaemia managed with interferon-alpha during pregnancy. Interferon-alpha
      was well tolerated, and the pregnancies proceeded without complications. All four
      infants were apparently normal at birth, and all four have enjoyed normal growth
      and development. Interferon-alpha may represent relatively safe therapy during
      pregnancy, because of its lack of inhibition of DNA synthesis. Nevertheless,
      recommendations regarding the use of interferon-alpha to treat chronic leukaemias
      during pregnancy must await further experience with this agent in this setting.

PMID- 1643014
TI  - A randomized study of intermediate versus conventional-dose cytarabine as
      intensive induction for acute myelogenous leukaemia.
AB  - The optimal dose of cytarabine for induction chemotherapy is unknown. Most
      studies have utilized doses of 100-200 mg/m2/d, although higher doses have been
      proposed to increase the concentration of the active metabolite ara-CTP within
      leukaemia cells. To address this question 101 adults with newly diagnosed acute
      myeloid leukaemia were randomized to receive treatment with daunorubicin and
      either conventional-dose cytarabine (200 mg/m2/d by continuous infusion) or an
      intermediate-dose of cytarabine (500 mg/m2 every 12 h). 36/51 (71%) patients
      assigned to conventional-dose cytarabine achieved complete remission compared to
      37/50 (74%) who achieved remission with intermediate-dose cytarabine (P = 0.9).
      Patient age significantly affected remission rate. 8/17 patients age greater than
      60 assigned to conventional-dose cytarabine and 10/17 assigned to intermediate
      dose cytarabine achieved complete remission compared to 27/33 patients under age
      60 assigned to the conventional dose and 28/34 patients assigned to the
      intermediate dose arm (P = 0.004). Actuarial 4-year disease-free survival for
      patients assigned to conventional-dose cytarabine was 20 +/- 16% versus 28 +/-
      17% for patients assigned to intermediate-dose cytarabine (P = 0.9). We conclude
      that intermediate dose cytarabine did not substantially improve results of
      induction chemotherapy for acute myeloid leukaemia.

PMID- 1643015
TI  - The immunophenotype in infant acute lymphoblastic leukaemia: correlation with
      clinical outcome. An Italian multicentre study (AIEOP).
AB  - A detailed analysis of immunophenotype of 112 infants aged less than 18 months
      with acute lymphoblastic leukaemia (ALL) was performed. Patients were divided
      into three groups on the basis of age at presentation (under 6 months: group 1: 6
      12 months: group 2; 13-18 months: group 3). There were three cases of T-ALL
      (2.6%). The proportion of other subtypes was: common ALL in 59 patients (52.68%),
      pre-B ALL in 15 patients (13.3%), pre-pre-B ALL in 27 (24.1%) and acute
      undifferentiated leukaemia (AUL) in eight patients (7.14%). In non-T ALL,
      positivity to CD10 (corresponding to C-ALL and pre-B ALL) was distributed in the
      three age groups as follows: 38.88% (group I) 65.38% (group II) and 86.36% (group
      III). Conversely, immature phenotypes (pre-pre-B and AUL) were found more often
      in the younger patients of groups I and II, as well as anomalous phenotypes, such
      as the presence of myeloid antigens (MyAg) and of CD7. Prognostic significance
      was evaluated as event-free survival (EFS) by statistical analysis. A better
      outcome in CD10-positive ALL than in CD10-negative ones (48% v. 25% of long-term
      survivors) was demonstrated in all infants. Similarly, EFS was significantly
      better in MyAg-negative than in MyAg-positive cases. These results were confirmed
      also when adjusting for white blood cell count. This allowed the identification
      of CD10-negative, MyAg-positive ALL, which were relatively more frequent in
      infants and had a poorer clinical outcome with the current therapies. This study
      stresses the prognostic relevance of the immunological study in infant leukaemias
      and its utility in choosing different therapeutic modalities for poor risk
      phenotypes.

PMID- 1643016
TI  - Non-radioactive in situ hybridization for the detection and monitoring of trisomy
      12 in B-cell chronic lymphocytic leukaemia.
AB  - Non-radioactive in situ hybridization (NISH) with a chromosome 12-specific alpha
      satellite probe was performed on 20 patients with chronic lymphocytic leukaemia
      (CLL) with normal karyotype (15 cases) or with inadequate mitotic yield (5 cases)
      from mitogen-stimulated cultures. All patients had over 70% lymphocytes
      coexpressing the CD5/CD23 antigens. While less than 1% interphase nuclei showed
      three fluorescent spots in 16/20 patients, evidence of trisomy 12 in 15-25%
      interphase cells was detected in four patients. According to the FAB
      classification the diagnosis in these patients was typical B-CLL, stage III
      (Rai's staging system) in one case, CLL/PLL, stage II and III in two cases, PLL,
      stage III in one case. In order to confirm these results, NISH was repeated after
      1 month in one patient and after 2 years in three patients. All patients had been
      treated with chemotherapy in the period between the two NISH experiments. In all
      cases a 1.8-3-fold increase of percentage of trisomic interphase cells was
      detected. These findings suggest that in B-CLL clones with trisomy 12 may have
      proliferative advantage over clonal B-lymphocyte without +12 and, possibly, that
      they may be more resistant to chemotherapy. We conclude that NISH is a sensitive
      technique allowing for the detection and monitoring of trisomy 12 in a fraction
      of B-CLL patients with normal karyotype or with no analysable mitoses despite
      employment of polyclonal B-cell mitogens.

PMID- 1643017
TI  - Mini-BEAM followed by BEAM and ABMT for very poor risk Hodgkin's disease.
AB  - High dose chemotherapy and autologous bone marrow transplantation (ABMT) is an
      effective form of salvage therapy in patients with relapsed or resistant
      Hodgkin's disease. Patients with large tumour masses at the time of ABMT have a
      poorer prognosis and we have therefore administered intermediate dose BCNU,
      etoposide, cytarabine and melphalan (mini-BEAM) prior to high dose therapy with
      the same agents (BEAM) and ABMT in such patients. In addition we have used the
      same strategy in patients with bone marrow infiltration at the time of relapse in
      an attempt to clear the bone marrow for transplant. A total of 23 patients
      received mini-BEAM and 21 proceeded to BEAM and ABMT. Platelet engraftment was
      delayed compared to BEAM recipients who had not received mini-BEAM (P = 0.008)
      but there was only one procedure related death. Responses to BEAM and ABMT were
      not predicted by the response to mini-BEAM indicating a dose response effect at
      the upper end of the dose intensity spectrum. At 2 years, the overall survival
      and progression free survival are 61% and 46% respectively for this group of
      Hodgkin's patients with extremely poor prognosis.

PMID- 1643018
TI  - Chromosome 11q rearrangements in B non Hodgkin's lymphoma.
AB  - The clinical features, morphology and immunophenotype of 20 cases of B non
      Hodgkin's lymphoma (B-NHL) with chromosome abnormalities involving 11q13-14 were
      studied, to determine if this abnormality was closely associated with a specific
      sub-type of B-NHL. A t(11;14)(q13;q32) was found in 11 cases of intermediately
      differentiated lymphocytic lymphoma (IDLL). A breakpoint in the major
      translocation cluster of the BCL-1 locus was found in six of these cases. These
      patients were male with lymphomatous involvement of the bone marrow, marked
      splenomegaly and frequently had mucosa associated lymphoid tissue involvement.
      One patient with IDLL had a t(8;11)(p21;q13) and a rearranged BCL-1 locus,
      suggesting that this may be a variant of t(11;14)(q13;q32). Diagnoses of IDLL,
      chronic lymphocytic leukaemia, lymphoplasmacytic lymphoma and monocytoid B cell
      lymphoma were made in all but one of the remaining cases. These cases had either
      a translocation involving 11q13-14 and various partner chromosomes or an 11q13
      deletion. This study demonstrates that 11q abnormalities occur mainly in a group
      of low-grade B-NHL of non follicle centre cell lineage.

PMID- 1643019
TI  - Measurement of free kappa and lambda chains in serum and the significance of
      their ratio in patients with multiple myeloma.
AB  - An inhibition enzyme-linked immunoassay technique using commercially available
      antibodies has been developed for the quantitation of both kappa and lambda light
      chains in the serum of patients with B-cell malignancies. Assay conditions were
      selected to enable measurement of free light chains in the concentration range
      between 0.1 and 20 mg/l. The normal range for free lambda chains in serum was
      found to be 0.4-4.2 mg/l and for free kappa chains it was 1.6-15.2 mg/l. At
      diagnosis the serum of most patients with multiple myeloma contained increased
      levels of the malignant free light chain and in some cases there was also
      elevation of the non-malignant light chain. The absolute level of the malignant
      light chain at diagnosis did not correlate with survival nor with laboratory
      parameters such as IgM or creatinine. A correlation with beta 2 M and serum
      paraprotein levels was evident only in cases of IgA myeloma. Although the
      absolute level of free serum light chain had no value as a prognostic indicator,
      the ratio of kappa:lambda chains closely followed the clinical assessment of
      disease status, being near the normal range (1.2-9.1) in plateau phase or stable
      disease. During periods of progressive disease this ratio ranged from 19 to 460
      (n = 14) in patients with kappa myeloma, and 0.0013-0.14 (n = 9) in patients with
      lambda myeloma. Determination of the ratio of free light chains in the serum may
      allow effective monitoring and earlier warning of disease progression in patients
      with multiple myeloma.

PMID- 1643020
TI  - Mutations of the p53 tumour suppressor gene in haematologic neoplasms.
AB  - Mutations of the p53 tumour suppressor gene have frequently been observed in
      several types of solid tumours and are believed to be implicated in the
      development of these tumours. To determine the relevance of p53 mutations in
      haematologic neoplasms, we performed polymerase chain reaction-single strand
      conformation polymorphism analysis on the p53 gene in 45 patients with various
      types of haematologic neoplasms. In exons 5-8 containing highly conserved
      regions, mobility shifts indicating sequence alterations were detected in four of
      the 45 patients, and subsequent sequencing was performed. A point mutation
      resulting in a novel stop codon was detected at codon 213 in one of 23 cases of
      chronic myelogenous leukaemia (one of five cases of blast crisis). Point
      mutations causing amino acid substitutions were detected in one of four cases of
      myelodysplastic syndrome at codon 195, one of three cases of adult T-cell
      leukaemia at codon 281, and one of eight cases of acute lymphoblastic leukaemia
      at codon 281, and these missense mutations were accompanied by loss of the wild
      type allele. Patients harbouring these nonsense and missense mutations were in
      advanced disease stages. These findings suggest that mutational inactivation of
      the p53 gene is infrequent but is involved in the tumorigenesis of several types
      of haematologic neoplasms at least in some cases.

PMID- 1643021
TI  - Studies on macromolecular activators of phagocytosis from platelets (MAPPs) using
      anti MAPP murine monoclonal antibodies.
AB  - 1-MAPP(290 kD) and s-MAPP(150 kD) are glycoproteins which have been shown to be
      involved in released products from platelets (PRPr) and to activate monocyte and
      neutrophil phagocytosis via the Fc receptors. Three IgG 2a (kappa) murine
      monoclonal antibodies against 1-MAPP and nine IgG1 (kappa) antibodies against s
      MAPP have been raised. By affinity chromatography using these monoclonal
      antibodies, active MAPPs were obtained from the supernatant of outdated platelet
      concentrates in the presence of 60% saturated ammonium sulphate and from PRPr
      rich medium, and substantial amounts of non-functioning immunoreactive MAPPs were
      obtained from the precipitate. Fab fragments of one of the two anti 1-MAPP and of
      two of the four anti s-MAPP monoclonal antibodies inhibited the function of their
      corresponding MAPPs, but none of them could inhibit the other MAPPs. 1-MAPP and s
      MAPP in the platelets were visualized by indirect fluorescent antibody technique
      using Fab fragments of the antibodies.

PMID- 1643022
TI  - The relationship between increased platelet count and megakaryocyte size in
      bronchial carcinoma.
AB  - This study investigates megakaryocyte size in bronchial carcinoma and its
      relationship to platelet count, mean platelet volume and platelet function, the
      latter determined in vivo by measurement of the cutaneous bleeding time.
      Measurements were performed in 19 patients with bronchial carcinoma and 11
      patients with a hiatus hernia (controls). Platelet count (335 +/- 123 v. 241 +/-
      72 x 10(9)/l) and megakaryocyte total area (772 +/- 135 v. 666 +/- 105 microns 2)
      (mean +/- standard deviation) were both significantly increased in patients with
      bronchial carcinoma when compared to controls whilst the bleeding time was
      shorter in the patient group (253 +/- 116 v. 321 +/- 80 s). Patients with
      bronchial carcinoma were older (60.2 +/- 8.4 v. 48.8 +/- 13.2 years) and smoked
      more heavily (760 +/- 511 v. 92 +/- 175 cigarette years) than controls.
      Megakaryocyte size, platelet count and bleeding time all correlated with smoking
      habit (r = 0.395, P = 0.031; r = 0.622, P less than 0.001; r = 0.515, P = 0.004
      respectively). There were no statistically significant differences between the
      groups with respect to gender or mean platelet volume. When considering all
      patients, significant correlations existed between platelet count and
      megakaryocyte area (r = 0.400, P = 0.029), and bleeding time and megakaryocyte
      area (r = -0.365, P = 0.047). The megakaryocyte nuclear and cytoplasmic areas
      were positively correlated (r = 0.855, P less than 0.001). This study suggests
      that the elevated platelet count in patients with bronchial carcinoma is mediated
      by an increase in the size of bone marrow megakaryocytes although the results are
      compounded by the association between smoking and megakaryocyte/platelet
      parameters.

PMID- 1643023
TI  - Electrophoretic and functional characteristics of the von Willebrand factor in
      human fetal plasma.
AB  - Although the haemostatic role of von Willebrand factor (vWF) in adults is well
      known, there is little information currently available about its possible
      contribution to in utero haemostasis. We have investigated the distribution of
      vWF multimers in 27 pure fetal platelet-poor plasma (FP) samples aged from 20 to
      greater than 36 weeks, by using electrophoresis in both low- and high-resolution
      agarose gels in the presence of sodium dodecyl sulphate. Our data confirm that
      most FP samples contain higher molecular weight (HMW) vWF multimers than those
      present in normal adult plasma, the proportion of these HMW forms being lower in
      FP samples aged greater than 36 weeks. However, we found that the multimeric unit
      and the protomeric form of vWF were similar in normal fetal and adult plasma.
      Functional assays of vWF were performed on three pooled FP samples. In all cases,
      fetal vWF was able to interact with factor VIII and to bind to GP Ib platelet
      receptor in the presence of ristocetin and to types I and III collagen. These
      results indicate that plasma vWF has already acquired in fetal life the
      functional activities required for its role in both coagulation and primary
      haemostasis.

PMID- 1643024
TI  - Factor VIII gene deletions in haemophilia A patients in Czechoslovakia.
AB  - Genomic DNA from 90 Czechoslovak haemophilia A patients from 81 pedigrees was
      analysed by Southern blotting and hybridization with factor VIII cDNA probes.
      Three partial deletions of the factor VIII gene were identified and
      characterized: a 4.8 kilobase (kb) deletion eliminating exon 10 in one patient
      with severe haemophilia A without inhibitor, a 6.1 kb deletion eliminating the 3'
      part of intron 13 and the 5' part of exon 14 in two related severe haemophiliacs,
      but only one of them produced inhibitor, and a 4.6 kb deletion eliminating the 3'
      part of intron 13 and the 5' part of exon 14 in a severe haemophiliac with high
      titre inhibitor. Besides these three deletions, three different restriction site
      variants without apparent loss of DNA sequence were found.

PMID- 1643025
TI  - Rapid detection of a protein C gene mutation present in the asymptomatic and not
      in the thrombosis-prone lineage.
AB  - The presence of mutations in the serine protease domain of protein C was
      investigated by temperature gradient gel electrophoresis of PCR products in five
      patients with protein C deficiency and thrombosis. Molecules with an altered
      melting behaviour were detected in one subject with a history of venous and
      arterial thrombosis. Direct sequencing showed that a G deletion, present in the
      heterozygous state, caused a reading frame shift at Trp 300 and subsequently a
      premature termination at the codon 335. The resulting suppression of the protein
      C catalytic function explains the reduction of protease activity to half. In
      addition the mutation caused a reduction of the antigen level in plasma.
      Temperature gradient gel electrophoresis enabled the rapid detection of the gene
      alteration in the family of the propositus. Several members of the paternal
      lineage had had severe thrombotic episodes. Unexpectedly the mutation was found
      to be inherited from the clinically asymptomatic maternal lineage, thus
      suggesting that an additional unknown defect from the paternal lineage is present
      in the thrombosis-prone propositus.

PMID- 1643026
TI  - A beta-thalassaemia phenotype not linked to the beta-globin cluster in an Italian
      family.
AB  - This paper describes a family of Central Italian origin in which three patients
      in two generations had either thalassaemia intermedia or a late presenting form
      of thalassaemia major. Sequence analysis of the patients' DNA revealed that only
      one of the beta-globin genes was affected by a beta-thalassaemia mutation (the
      codon 39 nonsense mutation), the other being completely normal, apart from the
      complex rearrangement (-T +ATA) at position -530 5' to the CAP site of the beta
      globin gene, which has uncertain clinical significance. Haematologically, all
      these patients were characterized by unusually low HbF levels (1.8-7.3%) for a
      beta-thalassaemia major or intermedia phenotype. The mother of the two patients
      with thalassaemia intermedia was heterozygous for beta-thalassaemia (codon 39
      nonsense mutation), while the father had thalassaemia-like red cell indices, an
      increased alpha/non alpha chain synthesis ratio, a slight increase of HbF and a
      low HbA2 level, but showed entirely normal beta-globin gene sequences, apart from
      the complex rearrangement (-T +ATA) at position -530 5' to the CAP site. One of
      the thalassaemia intermedia patients married a normal woman and they had a child
      with thalassaemia major who inherited only the codon 39 nonsense mutation but not
      the complex rearrangement at position -530. The clinical phenotype of
      thalassaemia-intermedia or major in the patients from this family may be
      explained by postulating the inheritance of the double heterozygous state for
      beta-thalassaemia and for a mutation in a gene coding for an erythroid-specific
      DNA binding protein which may impair the function of the normal beta-globin gene.
      Heterozygosity for this postulated mutation (father of the patients with
      thalassaemia intermedia) may result in the production of a beta-thalassaemia
      carrier state with normal HbA2 level.

PMID- 1643027
TI  - The effect of macrophage colony-stimulating factor on haemopoietic recovery after
      autologous bone marrow transplantation.
AB  - Macrophage colony-stimulating factor (M-CSF) is active in the late stages of
      monocyte maturation, activates mature monocyte-macrophages and enhances their
      production of various other cytokines. We have examined the effects of a 21 d
      course of escalating doses of M-CSF purified from human urine (hM-CSF) on
      recovery following autologous bone marrow transplantation (ABMT) in 20 patients
      with malignant lymphomas. Four patients were treated at each dose level of 4, 8,
      16, 32 and 64 x 10(6) U/m2/d and results compared to 46 concurrent controls.
      There was no significant difference in recovery to an absolute neutrophil count
      (ANC) of 0.5 x 10(9)/l (median 20 d in hM-CSF group versus 22 in controls) or in
      recovery of platelets to 50 x 10(9)/l (32 d versus 39 d, 0.05 less than P less
      than 0.1); hM-CSF patients received a median of 81 platelet units following ABMT
      (controls 112 units, P = NS). hM-CSF patients had a median of 5.5 d with fever
      greater than 37.5 degrees C (control 8, P = NS), received parenteral antibiotics
      for 14.5 d (control 17, P = NS) and had a 50% incidence of bacteraemia (control
      48%). hM-CSF treated patients were discharged by a median of day 29 following
      transplantation (control 33, P less than 0.05). Platelet and neutrophil recovery
      correlated significantly with the number of marrow mononuclear cells (MNC)
      reinfused in the hM-CSF group (P = 0.05 and P = 0.014 respectively) but not in
      controls. Subgroup analysis showed that hM-CSF patients receiving greater than 2
      x 10(8) MNC/kg body weight reached an ANC of 0.5 x 10(9)/l by a median of day
      16.5 (control 18.5, NS), became platelet transfusion independent by day 17
      (control 29, P less than 0.05) and reached a platelet count of 50 x 10(9)/l by
      day 21 (control 40, P less than 0.05). No significant toxicity attributable to hM
      CSF treatment was seen. These results suggest that hM-CSF accelerates platelet
      recovery following ABMT and that relatively large marrow innocula are required to
      see this effect.

PMID- 1643028
TI  - Trisomy 8 detection in granulomonocytic, erythrocytic and megakaryocytic lineages
      by chromosomal in situ suppression hybridization in a case of refractory anaemia
      with ringed sideroblasts complicating the course of paroxysmal nocturnal
      haemoglobinuria.
AB  - Paroxysmal nocturnal haemoglobinuria (PNH) was diagnosed in a 20-year-old male
      patient who suffered from anaemia since the age of 11. Eighteen years after
      diagnosis, PNH transformed into refractory anaemia with ringed sideroblasts
      (RARS). Trisomy 8 was observed in 27%, 45% and 53% of the bone marrow metaphase
      cells analysed in 1987, 1988 and 1990 respectively. In order to determine which
      bone marrow cell lineages were affected by trisomy 8 and at which stage of stem
      cell differentiation, MAC (Morphology, Antibody, Chromosomes) and CISS
      (Chromosomal In Situ Suppression) hybridization techniques were combined. The MAC
      technique enables karyotypic analysis of morphologically and immunologically
      classified mitotic cells. CISS hybridization makes it possible to detect
      individual chromosomes and chromosome aberrations using recombinant DNA libraries
      from sorted human chromosomes. Trisomy 8 was detected in granulomonocytic
      (50.6%), erythrocytic (67.2%) and megakaryocytic (one megakaryocyte with trisomy
      8, one normal) lineages, providing evidence for the occurrence of trisomy 8 in
      early haematopoietic cell precursors, at the GEMM or pluripotent level.
      Cytogenetic and clinical data suggest that the sideroblastic clone originated
      from a mutation affecting a cell of the PNH clone, progressively replaced by the
      PNH/RARS clone, due to proliferative advantage.

PMID- 1643029
TI  - Trace levels of factor VIII in substrate plasma.

PMID- 1643030
TI  - t(8;9)(p11;q32) in atypical chronic myeloid leukaemia: a new cytogenetic
      clinicopathologic association?

PMID- 1643031
TI  - Autoimmune processes terminating 24 years later in Hodgkin's disease.

PMID- 1643032
TI  - Disappearance of spontaneous erythroid colonies in patients with
      myeloproliferative disorders treated by alpha-interferon.

PMID- 1643033
TI  - In vitro proteolysis of red cell membrane in hereditary spherocytosis.

PMID- 1643034
TI  - Bone marrow transplantation for dyskeratosis congenita.

PMID- 1643035
TI  - A comparative spectroscopic study of tryptophan probes engineered into high- and
      low-affinity domains of recombinant chicken troponin C.
AB  - The spectral properties of three tryptophan-substituted mutants of recombinant
      chicken troponin C are compared. Site-specific mutagenesis was used to introduce
      a tryptophan residue into the high-affinity (Ca2+/Mg2+) domain of troponin C at
      residue position 105, thereby creating the mutant phenylalanine-105 to tryptophan
      (F105W). The spectral properties of F105W and a double mutant, F29W/F105W, were
      compared with the mutant phenylalanine-29 to tryptophan (F29W). Since wild-type
      chicken troponin C does not naturally contain either tyrosine or tryptophan
      residues, the tryptophan substitutions behaved as site-specific reporters of
      metal ion binding and conformational change. The residues that occupy positions
      29 and 105 are at homologous locations in low-affinity and high-affinity domains,
      preceding the first liganding residues of binding loops I and III, respectively.
      Mutant proteins were examined by a combination of absorbance and fluorescence
      methods. Calcium induced significant changes in the near-UV absorbance spectra,
      fluorescence emission spectra, and far-UV circular dichroism of all three mutant
      proteins. Magnesium induced significant changes in the spectral properties of
      only F105W and F29W/F105W proteins. Tryptophan substitutions allowed Ca(2+)
      specific and Ca(2+)/Mg(2+) sites to be titrated independently of one another.
      Results indicate that there is no interaction between the two binding domains
      under conditions where troponin C is isolated from the troponin complex.
      Magnesium-induced changes in the environment of the tryptophan reporter at
      position 105 were significantly different from those induced by calcium. This
      suggests that calcium and magnesium differ in their influence on the conformation
      of the high-affinity, Ca(2+)/Mg(2+) sites.

PMID- 1643036
TI  - Europium(III) luminescence and tyrosine to terbium(III) energy-transfer studies
      of invertebrate (octopus) calmodulin.
AB  - The effects of minor differences in the amino acid sequences between a vertebrate
      (bovine testes) and an invertebrate (octopus) calmodulin on metal ion binding
      were investigated via laser-induced Eu3+ and Tb3+ luminescence. Amino acid
      substitutions at residues which are coordinated to the metal ion do not produce
      any detectable changes in the 7F0----5D0 excitation spectrum of the Eu3+ ion
      bound to octopus calmodulin relative to bovine testes calmodulin; only minor
      differences in the excited-state lifetime values in D2O solution are observed.
      The dissociation constants for Eu3+ (1.0 +/- 0.2 microM) and Tb3+ (5 +/- 1
      microM) from the weak lanthanide binding sites (III and IV, numbered from the
      amino terminus) of octopus calmodulin were measured using luminescence
      techniques. Both values agree well with those reported previously for bovine
      testes calmodulin [Mulqueen, P. M., Tingey, J. M., & Horrocks, W. D., Jr. (1985)
      Biochemistry 24, 6639-6645]. The measured dissociation constant of Eu3+ bound in
      the tight lanthanide binding sites (I and II) is 6 +/- 2 nM for octopus
      calmodulin and 12 +/- 2 nM for bovine testes calmodulin. The distances between
      sites I and II (12.4 +/- 0.5 A) and sites III and IV (11.7 +/- 0.8 A) were
      determined from Forster-type energy transfer in D2O solutions of octopus
      calmodulin containing bound Eu3+ donor and Nd3+ acceptor ions. Forster theory
      parameters for nonradiative energy transfer between Tyr138 and Tb3+ ions bound at
      sites III and IV of octopus calmodulin were comprehensively evaluated, including
      a dynamics simulation of the orientation factor kappa 2. This theory is found to
      account quantitatively for the observed energy-transfer efficiency as evaluated
      from the observed sensitized Tb3+ emission.

PMID- 1643037
TI  - Solution structure of the EcoRI DNA octamer containing 5-fluorouracil via
      restrained molecular dynamics using distance and torsion angle constraints
      extracted from NMR spectral simulations.
AB  - The self-complementary DNA octamer [d(GGAATUFCC)]2, containing the EcoRI
      recognition sequence with one of the thymines replaced by 5-fluorouracil (UF),
      was synthesized. Proton homonuclear two-dimensional nuclear Overhauser effect (2D
      NOE) and double-quantum-filtered correlation (2QF-COSY) spectra, as well as one
      dimensional spectra at different temperatures, were recorded for the octamer.
      Consequently, all proton resonances were assigned. The thermally induced
      transition from the duplex to single strands has been followed, demonstrating the
      stability of the duplex containing 5-fluorouracil. Simulations of the 2QF-COSY
      cross-peaks by means of the programs SPHINX and LINSHA were compared with
      experimental data, establishing scalar coupling constants for the sugar ring
      protons and hence sugar pucker parameters. The deoxyribose rings exhibit a
      dynamic equilibrium of N- and S-type conformers with 75-95% populations of the
      latter. Two programs used for complete relaxation matrix analysis 2D NOE spectra,
      CORMA and MARDIGRAS, were modified to account for the influence of the fluorines
      on dipolar interactions in the proton system. Quantitative assessment of the 2D
      NOE cross-peak intensities for different mixing times, in conjunction with the
      program MARDIGRAS, gave a set of interproton distances for each mixing time. The
      largest and smallest values of each of the interproton distances were chosen as
      the upper and lower bounds for each distance constraint. The distance bounds
      define the size of a flat-well potential function term, incorporated into the
      AMBER force field, which was employed for restrained molecular dynamics
      calculations. Torsion angle constraints in the form of a flat-well potential were
      also constructed from the analysis of the sugar pucker data. Several restrained
      molecular dynamics runs of 35 ps were performed, utilizing 284 experimental
      distance and torsion angle constraints and two different starting structures,
      energy-minimized A- and B-DNA. Convergence to similar structures with a root-mean
      square deviation of 1.2 A was achieved for the central hexamer of the octamer,
      starting from A- and B-DNA. The average structure from six different molecular
      dynamics runs was subjected to final restrained energy minimization. The
      resulting final structure was in good agreement with the structures derived from
      different molecular dynamics runs and showed a substantial improvement of the 2D
      NOE sixth-root residual index in comparison with classical and energy-minimized B
      DNA. A detailed analysis of the conformation of the final structure and
      comparison with structures of similar sequences, obtained by different methods,
      were performed.

PMID- 1643038
TI  - Comparison of the dynamical structures of lipoamide dehydrogenase and glutathione
      reductase by time-resolved polarized flavin fluorescence.
AB  - Time-resolved polarized fluorescence spectroscopy has been applied to the bound
      FAD in the structurally related flavoproteins lipoamide dehydrogenase from
      Azotobacter vinelandii (LipDH-AV) and glutathione reductase (GR) from human
      erythrocytes. The fluorescence parameters as obtained from the maximum entropy
      analysis differ considerably in both enzymes, reflecting the unique properties of
      the flavin microenvironment. Three conformational substates are revealed in LipDH
      AV and five in GR. Almost 90% of the population of GR molecules has a
      fluorescence lifetime in the order of 30 ps which originates from efficient
      exciplex formation with Tyr197. Equilibrium fluctuations between conformational
      substates are observed for LipDH-AV on a nanosecond time scale in the temperature
      range 277-313 K. Interconversion between conformational substates in GR is slow,
      indicating that large activation barriers exist between the states. In agreement
      with these results, a model is postulated which ascribes a role in catalysis to
      equilibrium fluctuations between conformational substates in GR and LipDH-AV.
      From time-resolved fluorescence anisotropy as a function of temperature,
      distinction can be made between flavin reorientational motion and interflavin
      energy transfer. In both proteins intersubunit energy transfer between the
      prosthetic groups is observed. Furthermore, it is revealed that only the flavin
      in glutathione reductase exhibits rapid restricted reorientational motion.
      Geometric information concerning the relative orientation and distance of the
      flavins can be extracted from the parameters describing the energy-transfer
      process. The obtained spatial arrangement of the flavins is in excellent
      agreement with crystallographic data.

PMID- 1643039
TI  - Molecular relaxation spectroscopy of flavin adenine dinucleotide in wild type and
      mutant lipoamide dehydrogenase from Azotobacter vinelandii.
AB  - The temperature dependence of the fluorescence emission spectra of flavin adenine
      dinucleotide bound to lipoamide dehydrogenase from Azotobacter vinelandii shows
      that the protein matrix in the vicinity of the prosthetic group is rigid on a
      nanosecond time scale in a medium of high viscosity (80% glycerol). The active
      site of a deletion mutant of this enzyme, which lacks 14 C-terminal amino acids,
      is converted from a solid-state environment (on the nanosecond time scale of
      fluorescence) into a state where efficient dipolar relaxation takes place at
      temperatures between 203 and 303 K. In aqueous solution, fast dipolar
      fluctuations are observed in both proteins. It is shown from fluorescence
      quenching of the flavin by iodide ions that the prosthetic groups of the mutant
      protein are partially iodide accessible in contrast to the wild type enzyme. A
      detailed analysis of the temperature dependence of spectral energies according to
      continuous relaxation models reveals two distinct relaxation processes in the
      deletion mutant, which were assigned to solvent and protein dipoles,
      respectively. From the long-wavelength shifts of the emission spectra upon red
      edge excitation, it is demonstrated that the active site of the wild type enzyme
      has high structural homogeneity in comparison to the deletion mutant. In
      combination with results obtained by X-ray diffraction studies on crystals of the
      wild type enzyme, it can be concluded that the C-terminal polypeptide of the A.
      vinelandii enzyme interacts with the dehydrolipoamide binding site, thereby
      shielding the flavins from the solvent.

PMID- 1643040
TI  - 19F-NMR spin-spin relaxation (T2) method for characterizing volatile anesthetic
      binding to proteins. Analysis of isoflurane binding to serum albumin.
AB  - This paper characterizes the low-affinity ligand binding interactions of a
      fluorinated volatile anesthetic, isoflurane (CHF2OCHClCF3), with bovine serum
      albumin (BSA) using 19F-NMR transverse relaxation (T2). 19F-NMR spectra of
      isoflurane in aqueous BSA reveal a single isoflurane trifluoromethyl resonance,
      indicative of rapid exchange of isoflurane between protein-bound and aqueous
      (free) environments. The exchange is slow enough, however, that the chemical
      shift difference between bound and free isoflurane (delta omega = 0.545 ppm)
      contributes to the observed isoflurane T2. The contribution of delta omega to T2
      can be minimized by shortening the interval between 180 degrees refocusing pulses
      in the Carr-Purcell-Meiboom-Gill pulse sequence used to monitor T2. Analysis of
      the dependence of T2 on interpulse interval additionally allows determination of
      the T2 (6.2 ms) and the average lifetime (tau b = 187 microseconds) of bound
      isoflurane molecules. By use of a short interpulse interval (less than 100
      microseconds), T2 measurements can readily be used to analyze equilibrium binding
      of isoflurane to BSA. This analysis revealed a discrete saturable binding
      component with a KD = 1.4 mM that was eliminated either by coincubation with
      oleic acid (6 mol/mol of BSA) or by conversion of BSA to its "expanded" form by
      titration to pH 2.5. The binding was independently characterized using a gas
      chromatographic partition analysis (KD = 1.4 mM, Bmax = 3-4 sites). In summary,
      this paper describes a method whereby T2 measurements can be used to characterize
      equilibrium binding of low-affinity ligands to proteins without the confounding
      contributions of chemical shift.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643041
TI  - Role of proline residues in human lysozyme stability: a scanning calorimetric
      study combined with X-ray structure analysis of proline mutants.
AB  - It has been shown that protein stability can be modulated from site-directed
      mutations that affect the entropy of protein unfolding [Matthews, B. W.,
      Nicholson, H., & Becktel, W. J. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 6663
      6667]. However, the effect of a specific amino acid replacement on stability
      highly depends on the location of the mutation site and its environment in the
      protein structure [Yutani, K., Hayashi, S., Sugisaki, Y., & Ogasahara, K. (1991)
      Proteins Struct., Funct., Genet. 9, 90-98). To clarify the role of specific
      proline residues in the thermostability of human lysozyme (h-lysozyme), a series
      of proline mutants were investigated by means of scanning calorimetry and high
      resolution X-ray crystallography. The thermodynamic properties of the mutant and
      wild-type h-lysozymes are compared and discussed on the basis of their three
      dimensional structure. h-Lysozyme contains two proline residues at positions 71
      and 103. The Pro71----Gly substitution was found to destabilize h-lysozyme by
      decreasing the entropic contribution of unfolding by about 2 kcal/mol at 68.8
      degrees C. This is consistent with the theoretical expectations for such a
      substitution. However, the same substitution at position 103 (Pro103----Gly) does
      not affect h-lysozyme stability, and the thermodynamic properties of the
      P71G/P103G and P71G mutants are essentially the same. Pro71 which is conserved
      among lysozymes from other species, appears to be important for stability,
      whereas Pro103, which is not conserved, does not. These differences are explained
      in terms of residue accessibility to the solvent and crystallographic B-factor,
      which reflects the amino acid mobility.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643042
TI  - Role of the B-ring substituent in the fluorescence of colchicinoid-tubulin and
      allocolchicinoid-tubulin complexes.
AB  - Fluorescence spectra of several B-ring derivatives of allocolchicine in a variety
      of solvents have been obtained. The quantum yields of the allocolchicine
      derivatives decreased with amine substitution at the C-7 position [R = H greater
      than NH2 much greater than NHCH3 greater than N(CH3)2]. The relative fluorescent
      intensities of the aminoallocolchicinoids [R = NH2, NHCH3, N(CH3)2] bound to
      tubulin were significantly less than the fluorescent intensities of tubulin-bound
      allocolchicine (R = NHCOCH3) and deacetamidoallocolchicine (R = H). The low
      fluorescent intensities of the aminoallocolchicinoids in solvents and bound to
      tubulin could be explained by exciplex formation between the lone pair of
      electrons on the nitrogen and the allocolchicinoid pi-system, which leads to
      quenching of the allocolchicinoid fluorescence. Direct evidence for exciplex
      formation between the C-7 amine nitrogen and the allocolchicinoid pi-system was
      found in the emission spectrum of N-methyldemeallocolchicine [R = N(CH3)2] in
      dioxane. The quantum yields of the aminoallocolchicinoids in glycerol were higher
      than would be predicted on the basis of solvent dielectric effects. Glycerol
      appears to increase the quantum yields of the aminoallocolchicinoids through both
      viscosity and hydrogen-bonding effects. The latter effect serves to sequester the
      lone pair of electrons on the nitrogen, decreasing its ability to interact with
      the pi-system of the allocolchicinoid. It is concluded that the fluorescent
      properties of colchicinoids and allocolchicinoids in glycerol are not reliable
      indicators of the fluorescent properties of the molecules bound to
      tubulin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643043
TI  - NMR structural characterization of the reaction product between d(GpG) and the
      octahedral antitumor complex trans-RuCl2(DMSO)4.
AB  - The reaction between the antitumor octahedral complex trans-RuCl2(DMSO)4 and
      d(GpG) leads to the formation of a stable compound characterized by a covalent
      bifunctional coordination of the bases to the metal center. The structure of the
      compound has been fully characterized by NMR and molecular modeling studies,
      showing the presence of two N7-coordinated guanine moieties in a head to head
      conformation, two dimethyl sulfoxide molecules, and one halogen atom in the
      coordination sphere of the ruthenium. The glycosidic chi angles are essentially
      in the anti range, the sugar puckering of the 5'G is 3'-endo (100% N), whereas
      that of the 3'G is more flexible but mainly in 2'-endo conformation (85% S), the
      two bases are strongly destacked. The compound shows structural features which
      are surprisingly similar to those exhibited by the corresponding cisplatin
      complex, indicating that such a way of interaction with DNA is not exclusive to
      Pt or to metals with square planar coordination geometries.

PMID- 1643044
TI  - Crystal structure of a pentamidine-oligonucleotide complex: implications for DNA
      binding properties.
AB  - The crystal structure of the complex formed between the dodecanucleotide
      d(CGCGAATTCGCG)2 and the drug pentamidine, which is active against the
      Pneumocystis carinii pathogen in AIDS patients, has been determined to a
      resolution of 2.1 A and an R-factor of 19.4%. Analysis of the structure has shown
      the drug to be bound in the 5'-AATT minor groove region of the duplex, with the
      amidinium groups H-bonded to adenine N3 atoms in an interstrand manner. The drug
      molecule adopts an extended conformation, and the immediate binding site spans
      four base pairs. Structural details of the drug-DNA interactions are discussed,
      and comparison is made with the dodecamer complex of the structurally similar
      berenil ligand.

PMID- 1643045
TI  - DNA packaging induced by micellar aggregates: a novel in vitro DNA condensation
      system.
AB  - Evidence for a conceptually novel DNA packaging process is presented. X-ray
      scattering, electron microscopy, and circular dichroism measurements indicate
      that in the presence of positively charged micellar aggregates and flexible
      anionic polymers, such as negatively charged polypeptides or single-stranded RNA
      species, a complex is formed in which DNA molecules are partially embedded within
      a micellar scaffold and partially condensed into highly packed chiral structures.
      Based on studies of micelle-DNA and micelle-flexible anionic polymer systems, as
      well as on the known effects of a high charge density upon the micellar
      organization, a DNA packaging model is proposed. According to this model, the DNA
      induces the elongation of the micelles into rodlike aggregates, forming a closely
      packed matrix in which the DNA molecules are immobilized. In contrast, the
      flexible anionic polymers stabilize clusters of spherical micelles which are
      proposed to effect a capping of the rodlike micelles, thus arresting their
      elongation and creating surfactant-free segments of the DNA that are able to
      converge and collapse. Thus, unlike other in vitro DNA packaging systems, in
      which condensation follows encounters between charge-neutralized DNA molecules, a
      prepackaging phase where the DNA is immobilized within a matrix is proposed in
      this case. Cellular and nuclear membranes have been implicated in DNA packaging
      processes in vivo, and negatively charged polyelectrolytes were shown to be
      involved in the processes. These observations, combined with the basic tenets of
      the DNA condensation system described here, allow for the progression to the
      study of more elaborate model systems and thus might lead to insights into the
      nature and roles of the intricate in vivo DNA-membrane complexes.

PMID- 1643046
TI  - The human colipase gene: isolation, chromosomal location, and tissue-specific
      expression.
AB  - The digestion of dietary triglycerides occurs in the duodenum through the action
      of triglyceride lipase, a pancreatic exocrine protein. The activity of pancreatic
      lipase is inhibited by the bile salts normally found in the gut lumen. Another
      pancreatic exocrine protein, colipase, restores the lipolytic activity of
      triglyceride lipase. The synthesis and secretion of both triglyceride lipase and
      colipase is increased by dietary fats and secretin. An increase in mRNA
      accompanies the increased activity, suggesting that the genes for triglyceride
      lipase and colipase contain nucleotide elements responsive to dietary fats or
      secretin or both. To study the regulation of colipase expression, we have first
      isolated the gene for human colipase from a cosmid library with a cDNA probe. The
      gene was localized to chromosome 6 and is organized into three exons contained in
      a single 3.3-kb BamHI fragment. The 5'-flanking region of the gene contains a
      TATA box, a GC box, and a 28-bp region with homology to the rat pancreatic
      specific enhancer. This region directs the tissue-specific expression of the
      chloramphenicol acetyltransferase gene in a transfected rat pancreatic acinar
      cell line, AR42-J. The same construct is inactive in HEPG2, C2C12, and COS-1
      cells. These results demonstrate that the isolated gene for human colipase
      contains tissue-specific promoter activity in the 5'-flanking DNA. The 28-bp
      region specifically binds to a factor in nuclear extracts.

PMID- 1643047
TI  - Energy transduction during catalysis by Escherichia coli DNA photolyase.
AB  - Native DNA photolyase from Escherichia coli contains 1,5-dihydroFAD (FADH2) plus
      5,10-methenyltetrahydropteroylpolyglutamate. Quantum yield and action spectral
      data for thymine dimer repair were obtained by using a novel multiple turnover
      approach under aerobic conditions. This method assumes that catalysis proceeds
      via a (rapid-equilibrium) ordered mechanism with light as the second substrate,
      as verified in steady state kinetic studies. The action spectrum observed with
      native enzyme matched its absorption spectrum and an action spectrum simulated
      based on an energy transfer mechanism where dimer repair is initiated either by
      direct excitation of FADH2 or by pterin excitation followed by singlet-singlet
      energy transfer to FADH2. The quantum yield observed for dimer repair with native
      enzyme (phi Native = 0.722 +/- 0.0414) is similar to that observed with enzyme
      containing only FADH2 (phi EFADH2 = 0.655 +/- 0.0256), as expected owing to the
      high efficiency of energy transfer from the natural pterin to FADH2 [EET = 0.92].
      The quantum yield observed for dimer repair decreased (2.1-fold) when the natural
      pterin was partially (68.8%) replaced with 5,10-CH(+)-H4folate (phi obs = 0.342
      +/- 0.0149). This is consistent with the energy transfer mechanism (phi calc =
      0.411 +/- 0.0118) since a 2-fold lower energy transfer efficiency is observed
      when the natural pterin is replaced with 5,10-CH(+)-H4folate (EET = 0.46) (Lipman
      & Jorns, 1992). The action spectrum observed for 5,10-CH(+)-H4folate-supplemented
      enzyme matched a simulated action spectrum which exhibited a small (5 nm)
      hypsochromic shift as compared with the absorption spectrum (lambda max = 385
      nm).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643048
TI  - Activity and spectroscopic properties of the Escherichia coli glutamate 1
      semialdehyde aminotransferase and the putative active site mutant K265R.
AB  - Glutamate 1-semialdehyde aminotransferase (glutamate 1-semialdehyde 2,1
      aminomutase; EC 5.4.3.8; GSA-AT) catalyzes the transfer of the amino group on
      carbon 2 of glutamate 1-semialdehyde (GSA) to the neighboring carbon 1 to form
      delta-aminolevulinic acid (ALA). To gain insight into the mechanism of this
      enzyme, possible intermediates were tested with purified enzyme and the reaction
      sequence was followed spectroscopically. While 4,5-dioxovaleric acid (DOVA) was
      efficiently converted to ALA by the pyridoxamine 5'-phosphate (PMP) form of the
      enzyme, 4,5-diaminovaleric acid (DAVA) was a substrate for the pyridoxal 5'
      phosphate (PLP) form of GSA-AT. Thus, both substances are reaction intermediates.
      The purified enzyme showed an absorption spectrum with a peak around 338 nm.
      Addition of PLP led to increased absorption at 338 nm and a new peak around 438
      nm. Incubation of the purified enzyme with PMP resulted in an additional
      absorption peak at 350 nm. The reaction of the PLP and PMP form of the enzyme
      with GSA allowed the detection of a series of peaks which varied in their
      intensities in a time-dependent manner. The most drastic changes to the spectrum
      that were observed during the reaction sequence were at 495 and 540 nm. Some of
      the detected absorption bands during GSA-AT catalysis were previously described
      for several other aminotransferases, indicating the relationship of the
      mechanisms. The reaction of the PMP form of the enzyme with DOVA resulted in a
      similar spectrum as described above, while the spectrum for the conversion of
      DAVA by the PLP form of the enzyme indicated a different mechanism.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1643049
TI  - A proteolytically sensitive region common to several rat liver cytochromes P450:
      effect of cleavage on substrate binding.
AB  - Limited proteolysis of rat liver microsomes was used to probe the topography and
      structure of cytochrome P450 bound to the endoplasmic reticulum. Three
      cytochromes P450 from two families were examined. Monoclonal antibodies to
      cytochrome P450 forms 1A1, 2B1, and 2E1 were used to immunopurify these
      proteolyzed cytochromes P450 from microsomes from rats treated with 3
      methylcholanthrene, phenobarbital, and acetone, respectively. Electrophoretic and
      immunoblot analysis of tryptic fragments revealed a highly sensitive cleavage
      site in all three cytochromes P450. N-Terminal sequencing was performed on the
      fragments after transfer onto poly(vinylidene difluoride) membranes and showed
      that this preferential cleavage site is at amino acid position 298 of P450 1A1,
      position 277 of P450 2B1, and position 278 of P450 2E1. Multiple sequence
      alignment revealed that these positions are at the amino terminal of a highly
      conserved region of these cytochromes P450. The important functional role implied
      by primary sequence conservation along with the proteolytic sensitivity at its
      amino terminal suggests that this region is a protein domain. Comparison with the
      known structure of the bacterial cytochrome P450cam predicts that this
      proteolytically sensitive site is within an interhelical turn region connected to
      the distal helix that partially encompasses the heme-containing active site.
      Substrate binding to the cleaved cytochromes P450 was examined in order to
      determine whether the newly added conformational freedom near the cleavage site
      functionally altered these cytochromes P450. Cleavage of P450 2B1 abolished
      benzphetamine binding, which indicates that the cleavage site contains an
      important structural determinant for binding this substrate. However, cleavage
      did not affect benzo[a]pyrene binding to P450 1A1.

PMID- 1643050
TI  - Identification of the sterol- and actin-binding domains of plasma vitamin D
      binding protein (Gc-globulin).
AB  - The mammalian plasma vitamin D binding protein (DBP), or Gc-globulin, is
      recognized to have at least two functional properties: sterol binding and G-actin
      sequestration. Affinity labeling of the sterol binding site with the radioactive
      electrophilic ligand, 3 beta-(bromoacetoxy)-25-hydroxycholecalciferol, followed
      by limited proteolysis, permitted the isolation and identification of three
      overlapping peptides in the amino terminus of the molecule. When G-actin affinity
      chromatography was applied to other proteolytic fragments, two fragments from the
      carboxy terminus of the molecule were isolated and identified. Another, large,
      tryptic fragment displayed both sterol- and actin-binding properties. The amino
      terminal assignment of the sterol-binding domain was confirmed by demonstrating
      sterol-specific binding by an in vitro transcribed and translated product of a
      mutated rat DBP cDNA encoding a protein truncated in its carboxy terminus. The
      sterol-binding domain was localized to the region between the first-amino
      terminal disulfide bond, and the actin-binding domain was found between residues
      350 and 403. A high degree of sequence conservation in these regions was found
      among human, rat, and mouse DBP's. These functional domain assignments confirm
      the apparent independence of these two binding activities and help to explain the
      observed triprotein complex of DBP-actin-DNase I and the competition between DBP
      and profilin for G-actin binding. Our findings should facilitate more precise
      delineation of the binding domains by site-directed mutagenesis experiments.

PMID- 1643051
TI  - Lateral diffusion and percolation in two-phase, two-component lipid bilayers.
      Topology of the solid-phase domains in-plane and across the lipid bilayer.
AB  - Fluorescence recovery after photobleaching (FRAP) has recently been used to
      examine the percolation properties of coexisting phases in two-component, two
      phase phosphatidylcholine bilayers [Vaz, W. L. C., Melo, E. C. C., & Thompson, T.
      E. (1989) Biophys. J. 56, 869-876]. We now report the use of FRAP to study two
      additional problems in similar systems. The first is the effect of solid-phase
      obstacles on the lateral diffusion in the fluid phase. The second is the question
      of whether or not, in a single bilayer, solid-phase domains in one monolayer are
      exactly superimposed on solid domains in the apposing monolayer. To address the
      first problem, the lateral diffusion of N-(7-nitrobenzoxa-2,3-diazol-4-yl)-1
      palmitoyl-2-oleoylphosp hatidylethanolamine (NBD-POPE), a probe soluble only in
      the fluid phase when solid and fluid phases coexist, has been studied in the
      mixture N-lignoceroyldihydrogalactosylceramide
      (LigGalCer)/dipalmitoylphosphatidylcholine (DPPC). Percolation of the fluid phase
      occurs at a high mass fraction of solid phase. This indicates that the solid
      domains have a centrosymmetric shape, a characteristic which makes this a good
      experimental system to test theoretical simulations of diffusion in an
      archipelago. It is shown that agreement between theory and experiment is poor, a
      result that had already been observed when the obstacles were integral membrane
      proteins. We develop an effective-medium model for diffusion in two-phase systems
      which explains both our results and those obtained with integral proteins. The
      distinctive feature of the model is the consideration of an annular region around
      the obstacles where the lipids are more ordered than in the bulk fluid phase. The
      diffusion coefficient is then calculated by extending the free area model to two
      phase systems, taking these annuli into account. The second question, the
      organization of the solid-phase domains across the lipid bilayer, is examined in
      the systems LigGalCer/DPPC and dimyristoylphosphatidylcholine
      (DMPC)/distearoylphosphatidylcholine (DSPC) by comparing the diffusion of a fluid
      phase-soluble, gel-phase-insoluble lipid derivative which spans the two
      monolayers of a bilayer (NBD-membrane-spanning-phosphatidylethanolamine, NBD
      msPE) with that of a probe which is restricted to a single monolayer. In
      LigGalCer/DPPC, 20:80, the distribution of solid domains in one of the monolayers
      is independent of the distribution in the apposing monolayer. In contrast, in
      DMPC/DSPC, 50:50, the solid domains in one monolayer are exactly superimposed
      upon the solid domains existing in the apposing monolayer.

PMID- 1643052
TI  - Resolving conflict.

PMID- 1643053
TI  - The old 'doctor-nurse game'--today's professional nurses decide to quit playing.

PMID- 1643054
TI  - Illegal sexual harassment violations: are you a victim?

PMID- 1643055
TI  - Is the glass half full or half empty?

PMID- 1643056
TI  - Growth and development of regional units in the head and face based on
      anthropometric measurements.

PMID- 1643057
TI  - Anthropometric growth study of the head.
AB  - Five measurements of the head were taken between 1 year and 18 years of age in
      1,537 North American Caucasians. By 1 year of age, the circumference (87.5%) and
      length (87.1%) of the head showed the highest levels of developmental level
      compared with their adult size. By 5 years, the developmental level of all
      measurements in head width, head length, and circumference increased, closely
      approaching maturation. Head length reached full maturation at 10 years in
      females (182.7 mm), and at 14 years in males (189.2 mm). In females, head width
      showed the most advanced maturation at 14 years (142.7 mm). In males, most of the
      head measurements matured at 15 years of age. Adult head height was approached at
      13 years in both sexes (113.3 mm in males and 109.8 mm in females). Early rapid
      growth in head height and head length took place between 1 and 4 years of age,
      and between 1 and 6 years in forehead width. The head width and head
      circumference showed continuous but mild growth rates throughout this period.

PMID- 1643058
TI  - Growth patterns of the face: a morphometric study.
AB  - Age-related growth changes in the face and the relationships between its parts
      were calculated by using three vertical, two horizontal, and two projective
      surface measurements from 1,594 healthy North American Caucasians between 1 and
      18 years of age. By 1 year, the width of the mandible was highly developed
      (80.2%) while its height reached only 66.6% of the eventual adult size. The
      mandible's height and width showed significant development between 1 and 5 years,
      while the face height, upper face height, face width, and the two face depth
      measurements exhibited continuous gradual growth after 5 years of age. In
      general, the face matured between 12 and 15 years in males and 2 years earlier in
      females. At 12 years, the upper face height, the mandible height, and the width
      of the face reached their mature size in females. At 15 years, the face height,
      mandible height, face width, and the depth of the mandible reached maturity in
      males.

PMID- 1643059
TI  - Growth patterns in the orbital region: a morphometric study.
AB  - Data for analysis of age-related changes in growth in the intercanthal (en-en)
      and biocular (ex-ex) widths were obtained from 1,594 healthy North American
      Caucasians in age groups from 1 to 18 years, divided equally between males and
      females. At 1 year, the degree of development of the intercanthal width reached
      84.1%, and that of the biocular width 85.9% of adults in both sexes. The levels
      of growth achieved by 5 years of age rose to 93.3% in the intercanthal width and
      88.1% in the biocular width, in both sexes. The average total growth increments
      achieved between ages 1 and 18 years were 5.2 mm in the intercanthal width and
      12.5 mm in the biocular. The intercanthal width showed very little growth after 1
      year of age; in contrast, the biocular width showed significantly greater growth
      increments both before and after 5 years of age. Rapid growth was observed
      between 3 and 4 years in the intercanthal width of both sexes. The age-related
      growth observed in the biocular width was small but continuous up to maturation
      time. The intercanthal width reached full maturation at 8 years in females and 11
      years in males, and the biocular width at 13 years in females and 15 years in
      males.

PMID- 1643060
TI  - Growth patterns of the nasolabial region: a morphometric study.
AB  - Age-related growth changes in the nasolabial region were analyzed through six
      measurements taken between 1 year and 18 years of age in 1,593 North American
      Caucasians. By 1 year of age, the length of the cutaneous portion of the upper
      lip and the width of the nose showed the highest levels of development compared
      with their adult size, 80.3 and 79.5%, respectively. By 5 years, the
      developmental level of the nasolabial region except nasal tip protrusion
      approached their maturation level. Our nasal measurements indicated that growth
      of the nose between 5 and 18 years was significantly greater than that of the
      upper lip, which revealed significantly greater growth increments between 1 and 5
      years of age. The cutaneous upper lip height reached its adult size in 3-year-old
      females (12.7 mm) and 6-year-old males (14.4 mm). Nose width and height were
      fully developed in females by age 12 and in males by age 14 or 15. Rapid growth
      occurred in the upper lip, nose height, and nasal tip protrusion between the ages
      of 1 and 4 years. Knowledge of these age-related morphologic variations within
      the nose and upper lip may be useful in planning the time and type of
      reconstructive surgery and in anticipating further change in the operated regions
      after the surgical reconstruction.

PMID- 1643061
TI  - Anthropometric growth study of the ear.
AB  - Age-related growth changes in the ear were analyzed by measuring the width and
      length of ears in 1,590 North American Caucasians between 1 year and 18 years of
      age. By 1 year, ear width reached 93.5% of adult size in both sexes, only 2.3 mm
      less than the mean value at 18 years. In contrast, ear length attained a
      developmental level of only 76.4% by 1 year in both sexes, requiring an increment
      five times greater (12.3 mm) to reach the size of the ear at 18 years of age. At
      5 years, the developmental level in width (96.7%) was almost equal to that of an
      adult, while the length reached 86.6% in both sexes, and requires 8.2 additional
      millimeters to attain adult size. Annual growth increments in ear width are
      small, interrupted with a few periods of no growth. Ear length in males showed an
      early rapid growth rate (between 2 and 3 years); subsequent growth was generally
      limited, interrupted with short periods of no changes. The same growth pattern
      appeared in females. Ear width reached its mature size in males at 7 years and in
      females at 6 years; ear length matured in males at 13 years and in females at 12.
      At the time of maturation, the ear was shorter than at 18 years by a mean of 1.1
      to 1.4 mm.

PMID- 1643062
TI  - A preliminary study of nasal airway patency and its potential effect on speech
      performance.
AB  - The relationship between nasal airway size and articulatory performance was
      studied in a group of cleft palate patients. Articulation analysis revealed that
      children with bilateral cleft lip and palate were nearly twice as likely to
      manifest compensatory articulations as children with unilateral cleft lip and
      palate or with cleft palate only. When subjects were grouped according to speech
      performance, aerodynamic assessment indicated that children with compensatory
      articulations had significantly larger nasal cross-sectional areas than children
      without compensatory articulations. The findings suggest that children with
      comparatively large nasal airways may be at increased risk for developing
      abnormal speech patterns. If these findings are confirmed by further research,
      such children may be candidates for relatively early palate repair.

PMID- 1643063
TI  - Is nasal airway size a marker for susceptibility toward clefting?
AB  - Johnston and Hunter (1989) reported that in monozygotic twins discordant for
      cleft lip +/- palate, the noncleft twins demonstrated what appeared to be a
      bimodal distribution of nasal cavity width. Two thirds showed reduced airway size
      and one third showed normal or slightly greater airway size. They suggested that
      the two-thirds group may represent reduced size of the medial nasal prominences
      and the other may represent underdevelopment of the maxillary prominence. We were
      particularly interested in the findings because the difference in distribution
      may represent differences in pathogenesis and therefore have etiologic
      significance. With this in mind we assessed nasal cross-sectional areas in 37
      subjects with cleft lip or cleft lip +/- palate using the pressure-flow technique
      during breathing. A group of 72 noncleft individuals served as controls. As
      expected, the data revealed that subjects with clefts had a significantly reduced
      nasal airway (p = .0001). More important, the distribution of nasal airway size
      in the cleft group was similar to that reported by Johnston and Hunter (1989).
      This comparability suggests that it may be possible to assign most cleft lip +/-
      palate patients to a particular group. Since heredity may differ among the two
      groups (Chung et al., 1986), we may have a simple technique to assess the risk of
      occurrence for cleft lip +/- palate.

PMID- 1643064
TI  - Soft palate reflex: technical requirements and first results.
AB  - The present study describes technical prerequisites for soft palate reflex
      measurements and first results. Reflex measurements can be done using standard
      electromyographic methods. The data-processing system that records and processes
      the electromyographic signals was activated when the soft palate was stimulated
      by a newly developed device. The first results of objective soft palate reflex
      measurements in 15 healthy subjects show that the musculus levator veli palatini
      reacts to a mechanical stimulation of the soft palate with a contraction that can
      be measured electromyographically. The response latencies were constant in the
      individual subjects. In 12 subjects a minimum of 30 ms and a maximum of 61 ms was
      recorded. In one healthy subject, the reflex was activated only after 167 ms. No
      reflex could be evoked in two subjects. The stimulus was always supraliminal.
      Reaction time was longer following surface anesthesia of the oral mucosa.

PMID- 1643065
TI  - Correspondence between nasalance scores and listener judgments of hypernasality
      and hyponasality.
AB  - The relationship between nasalance scores and perceptual judgments of
      hypernasality and hyponasality was examined for 74 subjects (51 with cleft palate
      and 23 noncleft controls). Twenty-nine of the 51 subjects with cleft palate had
      received pharyngeal flap surgery. Predictive analyses were performed to assess
      the sensitivity, specificity, and efficiency of the Nasometer as a screening
      instrument. The overall relationship between perceptual judgments of
      hypernasality and nasalance scores was good for the nonflap subjects when a
      nasalance cutoff score of 26 was used. A sensitivity coefficient of 0.87 and a
      specificity coefficient of 0.93 were obtained. Ninety-one percent of the
      nasometry-based classifications accurately reflected listener judgments of
      hypernasality. The correspondence between nasalance scores and clinical judgments
      of hyponasality was also good for the nonflap subjects when a nasalance cutoff
      score of 50 was used. Ninety-one percent of these classifications were consistent
      with the listener judgments. Efficiency of nasometry was poorer for the flap
      subjects.

PMID- 1643066
TI  - Self-perception, social skills, adjustment, and inhibition in young adolescents
      with craniofacial anomalies.
AB  - This study examines the relationships between self-perception, social skills,
      overall adjustment, and social inhibition in 45 young adolescents with
      craniofacial anomalies (CFA). Self-perception, social skills, and inhibition
      scores are within the normal range while the average adjustment is 1.5 SD below
      the average. Regression analyses were conducted. Social skills and athletic
      competence are the best predictors of adjustment and accounted for 73.5% of the
      variance in adjustment. Adjustment of adolescents is associated with degree of
      inhibition, with more poorly adjusted adolescents displaying greater inhibition.
      Self-esteem did not predict to adjustment. The theoretical and clinical
      implications of these findings are discussed.

PMID- 1643067
TI  - Periodontal status of teeth adjacent to nongrafted unilateral alveolar clefts.
AB  - The purpose of this study was to compare the periodontal condition of teeth
      adjacent to the cleft with contralateral teeth in adult subjects with a
      nongrafted unilateral alveolar cleft. Periodontal parameters were evaluated in 18
      subjects who had at least one tooth immediately adjacent to the cleft. For each
      tooth investigated, plaque index, gingival index, and probing depth were recorded
      and each tooth was assigned a mobility score. Width of attached gingiva and
      extent of recession was measured. Bone level was assessed using standardized
      magnified radiographs and a computerized digitizing system. The overall findings
      of this study support those of other studies and indicate that in individuals
      with a nongrafted alveolar cleft, teeth adjacent to the defect show signs of
      gingivitis but not of periodontal disease. The anatomic defect, eruption pattern,
      orthodontic tooth movements, and the presence of restorations appear to
      contribute to the reduced bone level on the central incisor adjacent to the cleft
      and to the presence of gingivitis.

PMID- 1643068
TI  - Fetal kleeblattschadel cranium: morphologic, radiographic, and histologic
      analysis.
AB  - The kleeblattschadel deformity is a rare craniofacial condition typified by its
      trilobed, cloverleaf skull. The pathophysiology of this process is controversial.
      The morphologic, radiographic, and histologic abnormalities identified in the
      cranial base of an 18-gestational-week fetus with kleeblattschadel skull have not
      been described previously. Recently, the intrauterine diagnosis of
      kleeblattschadel was established by serial ultrasonography and, based on this
      evidence, the fetus was aborted. The fetus was studied extensively. Standard
      radiographs and high-resolution CT scans were obtained. Three-dimensional,
      reformatted contour surface images were constructed from the CT scan data. The
      cranial base was examined grossly, radiographically, and histologically.
      Histologic microanatomic study concentrated on structures of the mid-sagittal
      cranial base from the occiput to the mid maxilla. The distorted cranial
      architecture in kleeblattschadel deformity has, in the past, been attributed
      largely to the cranial base deformity which secondarily distorts the developing
      brain. Our study, however, suggests that the calvarium itself may be the primary
      focus of abnormal events leading to synostosis. The findings in this study seem
      to be inconsistent with earlier theories about the abnormal development of
      craniodysostoses.

PMID- 1643069
TI  - Mandibular morphology and spatial position in patients with clefts: intrinsic or
      iatrogenic?
AB  - Lateral cephalometric films of operated (Op) and non-operated (Nop) patients with
      cleft lip and alveolus, cleft lip and palate or cleft palate only, were compared
      to determine whether the shape or position of the mandible is affected by lip
      and/or palate surgery. The sample included 204 adult cleft patients, Caucasians
      of both sexes with one of the following three cleft types: complete unilateral
      lip and alveolus (n = 50), complete unilateral lip and palate (n = 68), and
      isolated palate (n = 86). The comparison involved 113 cleft patients operated at
      the conventional timing and 91 cleft patients who had received no surgical or
      orthodontic treatment. Comparison was done in order to ascertain if the surgery
      performed had had any influence upon mandibular growth. The results indicated
      that, in all three cleft types, the surgery did not induce significant changes in
      the mandibular growth.

PMID- 1643070
TI  - Maxillary lateral incisor of subjects with cleft lip and/or palate: Part 1.
AB  - As a pilot study, dental casts of 30 patients with unilateral cleft lip and
      palate were selected and examined from the longitudinal data in the Department of
      Orthodontics, Kyushu University Dental Hospital. Dental casts of the anterior
      teeth were sectioned at right angles to the long axis of the tooth 2 to 3 mm
      below the incisal edge. The teeth were differentiated according to their cross
      sections. They were classed as lateral incisors or other types by the ratio of
      labiolingual diameter to mesiodistal diameter and the flatness labiolingually.
      Dental casts of 309 additional patients with cleft alveolus were examined
      subjectively based on above findings. In primary dentition, 183 of 184 teeth on
      the cleft side were incisal type. One tooth was canine type. In permanent
      dentition, 42 of 78 teeth on the cleft side were conical type, 20 teeth were
      intermediate type, and 16 teeth were incisal type. As a conclusion, the tooth on
      the cleft side is almost certain to be a lateral incisor, not a supernumerary
      canine tooth. As well, their form was normal in the majority of the primary
      dentition, but malformed in the permanent one.

PMID- 1643071
TI  - Maxillary lateral incisors of subjects with cleft lip and/or palate: Part 2.
AB  - Maxillary lateral incisors on the alveolar cleft were investigated in 431 cleft
      children registered in the Department of Orthodontics, Kyushu University Dental
      Hospital. The majority of primary maxillary lateral incisors were located on the
      distal side of the alveolar cleft in both unilateral cleft lip and alveolus
      (UCLA) and unilateral cleft lip and palate (UCLP) subjects. Permanent teeth in
      UCLA tend to be located distally, but in UCLP they tend to be congenitally absent
      (p less than .01). The majority of primary teeth had normal shapes; the majority
      of permanent teeth were of intermediate type or were missing congenitally. One
      third of the UCLA and one half of the UCLP subjects who had primary maxillary
      lateral incisors were not followed by permanent replacements. The location of the
      majority of permanent maxillary lateral incisors tallied with that of the primary
      ones except in four UCLA, ten UCLP, and two bilateral cleft lip and palate (BCLP)
      subjects. Four UCLA and ten UCLP subjects who had primary lateral incisors on the
      distal side were followed by their permanent successors on the mesial side. Three
      UCLP and one BCLP subjects had permanent maxillary lateral incisors even though
      they had no temporary predecessors.

PMID- 1643072
TI  - Association between adenoidectomy, velopharyngeal incompetence, and submucous
      cleft.

PMID- 1643073
TI  - Energy metabolism in islets of Langerhans.

PMID- 1643074
TI  - Amino acid transport System L in muscle cells: biochemical properties and its
      relation to protein synthesis.
AB  - Objectives were to characterize mechanisms and biochemical properties of
      transport systems responsible for the uptake of branched-chain amino acids
      (BCAAs) in muscle cells. Rat omega myoblasts (RMo) were grown to confluency and
      allowed to differentiate prior to conduct of transport assays. Myotubes
      concentrated cycloleucine (cLeu) in a sodium (Na)-free medium. The Na gradient
      independent transporter possessed high affinity (Km = 0.12 mM) and high capacity
      (Vmax = 6.4 nmol cLeu/mg protein per min). Cycloleucine transport was strongly
      inhibited by nonpolar neutral amino acids but not by alpha-aminoisobutyric acid
      or lysine. Myotubes possessed a Na gradient-independent trans-exchange mechanism.
      Hence, myotubes possess a System L-like transporter. In the second part of the
      study we determined that various inhibitors (KCN, oligomycin, iodoacetamide and
      cycloheximide) increased leucine transport. Their actions were not mediated by
      reductions in ATP concentration but were instead associated with changes in
      protein synthesis. Hence, regulation of muscle protein synthesis may also
      influence transporter activity.

PMID- 1643075
TI  - Changes in the nature of calcium transport systems on the porcine sperm plasma
      membrane during epididymal maturation.
AB  - Comparative studies of 45Ca(2+)-transport across the plasma membrane were
      performed using porcine caput, corpus and cauda epididymal sperm. The Ca(2+)
      uptake is dependent on the presence of the substrates for respiration and is
      sensitive to verapamil. The Ca(2+)-efflux is mediated by both Na(+)-dependent and
      -independent systems. In the immature sperm in caput epididymis, Na(+)
      independent efflux is predominant, but it is gradually replaced by Na(+)
      dependent efflux during the epididymal transit. The net activity of Ca2+
      accumulation into sperm increases with the epididymal maturation.

PMID- 1643076
TI  - Double helix formation of phosphatidylcholine myelin figures.
AB  - Double helix formation of phosphatidylcholine myelin figures has been studied by
      use of optical microscopy. The winding of the double helices was looser than a
      geometrically possible one and the pitch was related proportionally to the outer
      radii of helical myelin figures. The regularity in the winding was explained in
      terms of the intermembrane binding energy and the bending elastic energy.

PMID- 1643077
TI  - Dual effects of calcium on ATP-sensitive potassium channels of frog skeletal
      muscle.
AB  - The block of ATP-sensitive K+ channels by ATP were studied in inside-out patches
      of frog toe muscles. Seal formation within Ca(2+)-free Ringer induces many open
      channels which can be irreversibly blocked by subsequent addition of Ca2+.
      However, such Ca(2+)-blocked and ATP-blocked channels can be influenced by the
      addition of ATP and Ca2+: the block by ATP is partially but irreversibly
      cancelled.

PMID- 1643078
TI  - The essential role of specific Halobacterium halobium polar lipids in 2D-array
      formation of bacteriorhodopsin.
AB  - The mechanism whereby bacteriorhodopsin (BR), the light driven proton pump from
      the purple membrane of Halobacterium halobium, arranges in a 2D-hexagonal array,
      has been studied in bilayers containing the protein, 1,2-dimyristoyl-sn-glycero-3
      phosphocholine (DMPC) and various fractions of H. halobium membrane lipids, by
      freeze fracture electron microscopy and examination of optical diffractograms of
      the micrographs obtained. Electron micrographs of BR/DMPC complexes containing
      the entire polar lipid component of H. halobium cell membranes or the total lipid
      component of the purple membrane, with a protein-to-total lipid molar ratio of
      less than 1:50 and to which 4 M NaCl had been added, revealed that trimers of BR
      formed into an hexagonal 2D-array similar to that found in the native purple
      membrane, suggesting that one or more types of the purple membrane polar lipids
      are required for array formation. To support this suggestion, bacteriorhodopsin
      was purified free of endogenous purple membrane lipids and reconstituted into
      lipid bilayer complexes by detergent dialysis. The lipids used to form these
      complexes are 1,2-dimyristoyl-sn-glycerol-phosphocholine (DMPC) as the major
      lipid and, separately, each of the individual lipid types from the H. halobium
      cell membranes, namely 2,3-di-O-phytanyl-sn-glycero-1-phosphoryl-3'-sn-glycerol
      1'-phosphate (DPhPGP), 2,3-di-O-phytanyl-sn-glycero-1-phosphoryl-3'-sn-glycerol
      1'-sulphate (DPhPGS), 2,3-di-O-phytanyl-sn-glycero-1-phosphoryl-3'-sn-glycerol
      (DPhPG) and 2,3-di-O-phytanyl-1-O-[beta-D-Galp-3-sulphate-(1----6)-alpha-D- Manp
      (1----2)-alpha-D-Glcp]-sn-glycerol (DPhGLS). When examined by freeze-fracture
      electron microscopy, only the complexes containing 2,3-di-O-phytanyl-sn-glycero-1
      phosphoryl-3'-sn-glycerol- 1'-phosphate or 2,3-di-O-phytanyl-sn-glycero-1
      phosphoryl-3'-sn-glycerol-1'-sulphate, at high protein density (less than 1:50,
      bacteriorhodopsin/phospholipid, molar ratio) and to which 4 M NaCl had been
      added, showed well defined 2D hexagonal arrays of bacteriorhodopsin trimers
      similar to those observed in the purple membrane of H. halobium.

PMID- 1643079
TI  - Effect of the unsaturation of phospholipid acyl chains on leucine transport of
      Lactococcus lactis and membrane permeability.
AB  - The effect of the degree of unsaturation of the phospholipid acyl chains on the
      branched-chain amino acid transport system of Lactococcus lactis was investigated
      by the use of a membrane fusion technique. Transport activity was analyzed in
      hybrid membranes composed of equimolar mixtures of synthetic unsaturated
      phosphatidylethanolamine (PE) and phosphatidylcholine (PC) in which the number of
      cis double bonds in the 18-carbon acyl chains was varied. The accumulation level
      and initial rate of both counterflow and protonmotive-force driven transport of
      leucine decreased with increasing number of double bonds. The reduction in
      transport activity with increasing number of double bonds correlated with an
      increase in the passive permeability of the membranes to leucine. The membrane
      fluidity was hardly affected by the double bond content. It is concluded that the
      degree of lipid acyl chain unsaturation is a minor determinant of the activity of
      the branched chain amino acid transport system, but effects strongly the passive
      permeability of the membrane.

PMID- 1643080
TI  - Repulsive interactions and mechanical stability of polymer-grafted lipid
      membranes.
AB  - Liposome membranes containing lipids with covalently attached poly(ethylene
      glycol) (PEG-lipid) are currently being developed as drug delivery systems.
      These, so called, 'Stealth' liposomes have a relatively long half life
      (approximately 1 day) in blood circulation and show an altered biodistribution in
      vivo. The extended lifetime appears to result from a steric stabilization of the
      liposome by the grafted polymer. In order to characterize the surface structures
      that promote steric stability in such polymer-grafted lipid bilayer systems, we
      have used X-ray diffraction to measure the structural organization and
      interbilayer repulsion for lipid/cholesterol (2:1) bilayers incorporating 4 mol%
      of a PEG-lipid in which the molecular weight of the PEG moiety was 1900 g/mol. At
      this concentration, applied pressure versus interbilayer distance relations
      showed that the grafted polymer moiety extended approximately 50 A from the lipid
      surface and gave rise to a strong, slowly decaying repulsive pressure between
      membranes that opposed their close approach. Also, the pressure vs. distance
      relations were only modestly altered by changing the ionic strength of the medium
      (1 mM NaCl and 100 mM NaCl). Therefore, even though the PEG-lipid headgroup bears
      a negative charge, the long range pressure cannot be due primarily to an
      electrostatic double layer pressure. Measurements of lipid bilayer elasticity
      using micropipet manipulation showed that PEG-lipid did not change the cohesive
      properties of lipid/cholesterol liposomes which was consistent with the X-ray
      structural data showing that the PEG-lipid did not change the normal structure of
      the bilayer interior. From these data we conclude that the repulsive barrier
      properties of lipid-grafted PEG polymer chains originate mainly from a steric
      pressure and that this simple polymer steric stabilization is the basis for the
      extended in vivo circulation times observed for polymer-grafted liposomes.

PMID- 1643081
TI  - A sequential mechanism for the formation of aqueous channels by amphotericin B in
      liposomes. The effect of sterols and phospholipid composition.
AB  - The kinetics of formation of amphotericin B (AmB) aqueous pores in ergosterol
      containing DMPC or egg-PC liposomes was investigated using a stopped-flow method.
      The formation of aqueous pores by AmB occurred very rapidly (in milliseconds to
      seconds depending of the AmB concentration), and it was always preceded by the
      formation of transient, non-aqueous pre-pore structures. As anticipated, these
      non-aqueous pre-pore structures made the liposomes more permeable to urea without
      at the same time leading to a decrease of the reflection coefficient of urea or
      to an enhancement of glucose permeability. However, when liposomes were composed
      of egg-PC and cholesterol, the formation of non-aqueous and aqueous channels by
      AmB occurred after a lag time of several minutes. Such a time lag for AmB action
      was not observed in cholesterol-containing DMPC liposomes, an indication that the
      phospholipid composition is an important parameter in the formation of non
      aqueous channels by AmB. Both non-aqueous and aqueous channels were always formed
      at lower concentrations of AmB in liposomes containing ergosterol while higher
      concentrations were needed in cholesterol-containing liposomes. Measurements of
      the permeabilizing effect of AmB on liposomes prepared without sterols indicate
      that non-aqueous channels were formed in DMPC (but not in egg-PC) at polyene
      concentrations identical to that found for cholesterol-containing liposomes. No
      evidence of the formation of aqueous channels by AmB was found in pure DMPC
      liposomes. These data are consistent with the concept that AmB forms non-aqueous
      channels without the direct participation of sterol molecules. The initially
      formed non-aqueous channels subsequently interact with the sterols in the
      membrane to form aqueous channels, having an enlarged diameter. This sequential
      mechanism for the formation of AmB aqueous pores in liposomes provides a
      rationale for the understanding of the effect of both the phospholipid
      composition and type of sterol in the interaction of AmB with natural membranes
      and artificial bilayers.

PMID- 1643082
TI  - Site-directed antibodies as topographical probes of the gastric H,K-ATPase alpha
      subunit.
AB  - Gastric acid is secreted by an ATP-driven H+ and K+ exchanger (H,K-ATPase), an
      integral apical membrane protein of parietal cells. Although the primary
      structure of the enzyme is known, its higher order structure is uncertain. In
      order to acquire topographical probes of native, microsomal H,K-ATPase, synthetic
      peptides corresponding to the 17 amino-terminal (N-peptide) and 16 carboxyl
      terminal (C-peptide) residues of pig gastric H,K-ATPase alpha-subunit were
      coupled to keyhole limpet hemocyanin (KLH). Rabbits were immunized with peptide
      KLH conjugates and their sera were tested for specificity by enzyme-linked
      immunosorbent assay (ELISA), immunoblotting, and immunocytochemistry. All sera
      showed high ELISA reactivities with synthetic peptides, peptide-BSA conjugates,
      and microsomal H,K-ATPase adsorbed to microtiter wells (some titers greater than
      1:10(4)). Immunoblots of H,K-ATPase resolved by SDS-PAGE showed both N-peptide
      and C-peptide antibodies reacting with a single 94 kDa band. All sera selectively
      stained parietal cells in pig gastric mucosal sections. Preimmune sera gave
      negative or weak signals in all assays. In competition ELISAs, N-peptide
      antibodies, but not C-peptide antibodies, were displaced from the corresponding
      bound synthetic peptides by added microsomal H,K-ATPase. One of the N-peptide
      antibodies inhibited H,K-ATPase activity by more than 50%; binding of this
      antibody was decreased when ATP or K+ were bound to the enzyme. These results
      indicate a cytoplasmically-oriented alpha-subunit N-terminus which may
      participate conformationally in the H,K-ATPase catalytic cycle, and suggest that
      antibodies against synthetic H,K-ATPase peptides are potentially useful probes of
      native microsomal H,K-ATPase topography.

PMID- 1643083
TI  - Electrical transients produced by the toad bladder in response to altered serosal
      composition at constant osmolality.
AB  - The effects of step-changes in the ionic composition of the serosal medium
      bathing the toad urinary bladder under voltage-clamped conditions have been
      studied. A decrease in the K+ concentration from 4 to 3 mmol/l in the serosal
      fluid increased transiently the transepithelial current which after 30 min
      returned to the initial value. The peak current was reached after 3 min. The
      current response of the bladder to the reverse step in K+ concentration, from 3
      to 4 mmol/l was much smaller. Surprisingly, the partial replacement of Cl- with
      gluconate produced a transient increase in current. It is suggested that
      secondary active transport plays an important role in this phenomenon and leads
      to an increased apical Na+ conductance. The second phases of the biphasic
      responses to Na/K+ and Cl-/gluconate substitutions have been interpreted as
      osmotic effects. Since the exchange of solutions in these studies was isoosmotic
      but not necessarily isotonic, experiments were also performed with osmotic
      changes in the serosal fluid for the purpose of comparison.

PMID- 1643084
TI  - Triiodothyronine binding sites in the rat erythrocyte membrane: involvement in
      triiodothyronine transport and relation to the tryptophan transport System T.
AB  - The binding of L-triiodothyronine (T3) to rat erythrocyte membranes (ghosts and
      peripheral protein-depleted vesicles) was studied under equilibrium conditions.
      Ghosts contained high-affinity T3 binding sites whose dissociation constant (21
      nM) was similar to the equilibrium-exchange Michaelis constant of T3 transport
      measured in ghosts. Each ghost contained about 8.10(3) high-affinity binding
      sites. The high-affinity T3 binding was stereospecific and was inhibited by L
      tryptophan (Trp) but not by L-leucine. The iodothyronine and amino acid
      specificity of binding is therefore similar to that of System T, the erythrocyte
      T3/Trp transporter. These Trp-inhibitable high-affinity T3-binding sites were
      also present in peripheral protein-depleted membrane vesicles, indicating that
      they are integral part of the membrane. Ghosts prepared from human erythrocytes,
      which have very low System T transport activities, contained no detectable Trp
      inhibitable high-affinity T3-binding sites. In rat erythrocyte ghosts, N
      ethylmaleimide inactivated both the binding and the transport of T3. This
      inactivation was blocked by T3 and Trp with similar efficiencies. Phenylglyoxal,
      an arginine residue modifier, also inhibited both high-affinity T3 binding and
      System T transport activity. It is concluded that the Trp-inhibitable high
      affinity T3-binding sites in the rat erythrocyte membrane are likely to be
      associated with System T.

PMID- 1643086
TI  - Identification of a novel beta-turn-rich repeat motif in the D hordeins of
      barley.
AB  - The amino acid sequence of the C-terminal part of a barley D hordein seed protein
      was deduced from the nucleotide sequence of a partial cDNA. It showed high
      homology with the HMW glutenin subunits of wheat, both proteins consisting
      predominately of repeated sequences. Whereas the wheat repeats are based on tri-,
      hexa- and nonapeptides that are rich in glycine, proline and glutamine, the D
      hordein also contains eleven copies of a novel unrelated motif: Thr-Thr-Val-Ser.
      The repeated sequences in the wheat glutenin subunits have been demonstrated to
      form an unusual spiral supersecondary structure based on beta-turns.
      Conformational analysis of the Thr-Thr-Val-Ser motif by secondary structure
      prediction and by circular dichroism spectroscopy of an 18 residue synthetic
      peptide demonstrates that it also forms beta-turns. Thus, D hordein may also have
      a spiral structure like that of HMW glutenin, despite the presence of a different
      repeat motif. This conservation of protein conformation in D hordein and the
      wheat glutenin subunits may indicate a structural role, perhaps in packing of the
      proteins within the protein bodies of the developing grain.

PMID- 1643085
TI  - Steroid-induced perturbations of membranes and its relevance to sperm acrosome
      reaction.
AB  - The interaction of progesterone, 17-alpha-hydroxyprogesterone, testosterone and
      estradiol with membrane vesicles prepared from phosphatidylserine (PS), from the
      total lipids of human and hamster spermatozoa, from the lipids of hamster
      spermatozoal plasma and acrosomal membrane and with the native membranes of
      hamster spermatozoa have been investigated by 90 degrees light scattering and
      fluorescence spectroscopy. The results indicate that progesterone decreases the
      fluidity of membranes, aggregates membrane vesicles, induces fusion of membrane
      vesicles and also renders them permeable to hydrophilic molecules like
      carboxyfluorescein. But, testosterone and estradiol at the same concentration had
      very little effect on membrane fluidity, membrane aggregation, fusion and
      leakage. The above membrane perturbing activities of the steroids is discussed in
      light of the recent findings that progesterone induces acrosome reaction in human
      and hamster spermatozoa [11,18].

PMID- 1643087
TI  - Lipases from different sources vary widely in dependence of catalytic activity on
      water activity.
AB  - We have measured the rates of esterification in hexane catalysed by suspended
      immobilised lipases (triacylglycerol acylhydrolase, EC 3.1.1.3), with pre
      equilibration to known thermodynamic water activity (a(w)). There were important
      differences between the enzymes from five different microbes in their retention
      of activity at low a(w). That from Rhizomucor miehei showed over 40% maximal
      activity at an a(w) of 0.12, and that from Rhizopus niveus was also fairly active
      at low a(w). Lipases from other sources required higher a(w) values to show good
      activity, increasing in the sequence Humicola sp., Candida rugosa and Pseudomonas
      cepacia. The behaviour was generally similar to two very different support
      materials, anion-exchange resin and macroporous polypropylene. Comparison of the
      sequences of the homologous enzymes from Rh. miehei, Rh. niveus and Humicola sp.
      suggests that changes in charged residues in the 'hinge and lid' region of the
      structure may be significant in low a(w) tolerance.

PMID- 1643088
TI  - Regulation of the GM1-galactosidase supramolecular structure and catalytic
      activity in vitro.
AB  - Regulation of the supramolecular organization and the catalytic activity of GM1
      galactosidase (EC 3.2.1.23) and neuraminidase (EC 3.2.1.18) from human kidney was
      studied in a system of hydrated reversed micelles of Aerosol OT in octane. It was
      shown that both the catalytic activity and the oligomeric structure of the GM1
      galactosidase in reversed micelles depend on the [H2O]/[Aerosol OT] molar ratio
      (w(o)). GM1-galactosidase 64-67 kDa monomers, 260 kDa tetramers, and 660 kDa
      octamers were obtained in systems with w(o) = 0-20, 25-30 and 30-40,
      respectively. The association of GM1-galactosidase monomers into an octamer
      results in the cooperative increase in enzymatic activity. 'Protective protein',
      a component of the GM1-galactosidase-neuraminidase native complex, was found to
      improve this association significantly.

PMID- 1643089
TI  - X-ray diffraction studies on human tendon show age-related changes in collagen
      packing.
AB  - In this report, X-ray diffraction on native hydrated tendon is established as a
      monitor of human aging. X-ray diffraction patterns were recorded on toe extensor
      tendons of persons ranging from 1.6 years to 87 years old. All patterns show a
      set of 67 nm meridional reflections derived from the collagen fibril axial
      repeat, and the ratio of the intensities of the 16:17 orders showed a linear
      increase with age. The spacing of the equatorial maximum, which relates to the
      lateral packing of molecules in collagen fibrils, was also greater in older
      tendons. The observed changes in X-ray parameters follow those seen for rat-tail
      tendons subjected to in vitro non-enzymatic glycosylation. Age-related increases
      reported for the fluorescence of Maillard products and the concentration of the
      sugar-derived cross-link pentosidine are similar to the trends in X-ray
      parameters reported here. Our results support the cumulative nature of non
      enzymatic glycosylation in connective tissues during the human lifespan and
      indicate that structural changes accompany the chemical alterations. The X-ray
      parameters show a large degree of scatter for ages older than 60 years,
      suggesting other complicating factors are present. Studies on a small number of
      diabetic tendons show small, but not significant, increases compared to age
      matched controls.

PMID- 1643090
TI  - Histone H1a subtype presents structural differences compared to other histone H1
      subtypes. Evidence for a specific motif in the C-terminal domain.
AB  - Following a previous isolation by reverse-phase HPLC of five histone H1 subtypes
      from adult rat liver, purity of three of them, H1a, H1b and H1d (according to
      Lennox's nomenclature), was achieved. Structural features of these three subtypes
      were investigated. Partial cleavage of these subtypes by endoproteinase Glu-C
      showed a different behavior of the H1a subtype when compared to the H1b and H1d
      subtypes. Under the conditions used in this work, the H1b and H1d subtypes
      present three major sites accessible to the endoproteinase Glu-C, while the H1a
      subtype presents only one major site accessible to the proteinase. Partial N
      terminal sequence of the different fragments obtained after proteolysis indicated
      that the two H1b and H1d subtypes were cleaved inside the globular domain (Glu
      54,-75) and between the globular domain and the C-terminal one (Glu-116). The H1a
      subtype was only cleaved between the globular domain and the C-terminal tail (Glu
      116), though Glu-54 and Glu-75 sites were present. These results would suggest
      some differences in the conformation of these proteins. Furthermore, the partial
      determined sequences of H1b and H1d showed 85% similarity to each other (the main
      differences were threonine residues instead of alanine residues in the C-terminal
      domain) while H1a was only 60% similar to H1b and H1d, for the sequences which
      aligned. The strongest differences between the H1a subtype and the two other
      subtypes were observed in the first amino acid residues of the C-terminal domain.
      The 117-126 amino acid residues (SKASTTKVTV) of H1a were quite different from
      those of H1b and H1d. This sequence, which showed a number of serine and
      threonine residues, was not found in any other histone sequence, after
      consultation with data bases. This H1a subtype was a minor component in adult
      liver (2.4%). As it was described in testis as a major component, testis histone
      H1 proteins were fractionated onto reverse-phase HPLC under the same conditions
      as those used for histone H1 proteins from liver. The pure testis H1a fraction
      was submitted to the endoproteinase Glu-C digestion. The pattern digestion was
      the same as that observed for liver H1a. The two 44-76 and 117-126 determined
      amino acid residues of H1a from testis were strictly identical to those of liver
      H1a. We demonstrate that H1a is the same protein in liver and testis and we give
      evidence for a specific motif SKASTTKVTV (117-126 residues) in the sequence of
      the C-terminal domain.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1643091
TI  - Enzymatic methylation of heterogeneous nuclear ribonucleoprotein in isolated
      liver nuclei.
AB  - Protein N-methyltransferase activity has been studied in the rat liver nuclei,
      using recombinant heterogeneous nuclear ribonucleoprotein particle protein A1 and
      histone as the methyl acceptors. The hydrolysates of these two enzymatically
      [methyl-3H]-labeled proteins, however, yielded different patterns of methylated
      amino acids on HPLC analysis: NG-monomethylarginine (92%) and NG-NG-dimethyl
      (asymmetric) arginine (6.5%) were the major methylated amino acids identified in
      the protein A1, whereas epsilon-N-methylated lysine derivatives constituted a
      predominant portion (71%) of the methylated amino acids in histone. When liver
      extracts isolated from rats fed a methyl deficient diet were assayed, the methyl
      accepting activity of protein A1 increased 64% over the control (rats fed normal
      diet), while that of histone increased 260%. Partial hepatectomy induced a 7.9
      fold and 2.3-fold increase in the protein A1 methylase activity after 24 and 48 h
      of regeneration, respectively. These results, together with the fact that myelin
      basic protein-specific protein methylase I does not significantly methylate
      protein A1, indicate the presence of an enzyme in the rat liver nuclei which
      methylates the protein A1.

PMID- 1643092
TI  - A variety of catalases and bromoperoxidases in genus Pseudomonas and their
      characterization.
AB  - A survey of bromoperoxidase in some Pseudomonas strains revealed that they
      contain different types of bromoperoxidase, catalase-bromoperoxidase and
      catalase. Although all Pseudomonas strains exhibited catalase activity, the
      enzyme isolated from P. pyrrolnitrica was named catalase-bromoperoxidase, because
      it catalyzed not only a catalase reaction, but also the bromination of
      monochlorodimedone. Except heme-type catalase-bromoperoxidase, this strain
      contained four isoenzymes of general nonheme bromoperoxidase, and their molecular
      weights were about 73,000. On the other hand, P. putida and P. aeruginosa had the
      usual heme-type catalase, but they differed in molecular weight and pI value.
      Both strains also had a nonheme bromoperoxidase which catalyzed the bromination
      of monochlorodimedone and aniline, and the molecular weight of each enzyme was
      68,000 for P. putida and 86,000 for P. aeruginosa. Considering the results
      reported by Van Pee et al. [1] and Weisner et al. [2], regarding the
      haloperoxidases of Pseudomonas, the genus was revealed to contain a wide variety
      of bromoperoxidase and catalase.

PMID- 1643093
TI  - Conformational studies of the 'RGD' containing peptide echistatin and close
      analogs by circular dichroism and fluorescence.
AB  - Echistatin, one of the smallest and most active natural disintegrins, and its
      [Trp13]echistatin, [Trp27]echistatin, [Phe13,Trp31]echistatin analogs have been
      investigated by far-UV circular dichroism spectroscopy and fluorescence
      spectroscopy. All analogs inhibited ADP-stimulated platelet aggregation with EC50
      values between 30 and 50 nM. The analogs were related closely, both in the CD
      spectral properties, characteristic of turn conformations, and in the location of
      isodichroic points connected to conformational transitions upon temperature
      increase. The low fluorescence quantum yield for Trp13 of 0.018, which could be
      enhanced 2.7-fold by DTT reduction of the peptide, is ascribed to a close
      proximity of this Trp13 residue to a disulfide bond. Calculation of the
      efficiency of fluorescence resonance energy transfer (FRET) yielded distances of
      11.5 +/- 0.8 A for Tyr31-Trp27 in [Trp27]echistatin, and more than 15 A for Tyr31
      Trp13 in [Trp13]echistatin, in good agreement with the structure of echistatin
      deduced from earlier NMR-molecular modeling studies. Both Trp13 and Trp27 in the
      respective analogs were quenched effectively by acrylamide with bimolecular
      quenching constants of 3.36 x 10(9) M-1 s-1 and 3.72 x 10(9) M-1 s-1,
      respectively. Iodide anion had negligible quenching effect on Trp13, despite high
      exposure of this residue to water, but was only 2-fold less efficient than
      acrylamide in quenching Trp27 fluorescence. Steady-state fluorescence anisotropy
      data, together with mean fluorescence lifetimes of 1.25 ns for Trp13 and 3.84 ns
      for Trp27 derived from full fluorescence lifetime decay analyses, yielded long
      rotational relaxation times of 1.39 +/- 0.18 and 1.35 +/- 0.17 ns, respectively,
      for these residues comparable to the expected overall rotation time of the
      peptides. The 'RGD'-containing loop appears to be restricted in movement on the
      nanosecond timescale with respect to the compact core of the peptide.

PMID- 1643094
TI  - Purification and characterization of major glycoproteins, PAS-6 and PAS-7, from
      bovine milk fat globule membrane.
AB  - Two major glycoproteins (PAS-6 and PAS-7) from bovine milk fat globule membrane
      were selectively extracted with urea and KCl, co-purified by repeated gel
      filtration on Sephacryl S-200 and then separated by affinity chromatography on
      concanavalin A-agarose column. The two purified glycoproteins showed a single
      band by SDS-PAGE, and their molecular masses were estimated to be 50 kDa for PAS
      6 and 47 kDa for PAS-7. Both PAS-6 and PAS-7 were resolved several variants by
      analytical isoelectric focusing. These were shifted to a single band at pI 6.2
      for PAS-6 and at pI 6.5 for PAS-7 by neuraminidase. PAS-6 contained 7.1% and PAS
      7 5.5% of carbohydrate; the molar ratio of fucose:mannose:galactose:N-acetyl
      galactosamine:N-acetyl glucosamine:sialic acid was 1.0:3.0:2.0:6.1:5.0:1.3 for
      PAS-6 and 1.0:3.1:2.2:0:4.1:1.1 for PAS-7. Mild alkaline treatment and affinity
      to various lectins indicated that PAS-6 had O- and N-linked oligosaccharide
      chains, while PAS-7 had only the N-linked type. The major amino acid residues of
      PAS-6 were Glu, Ser and Gly, and those of PAS-7 were Asp, Glu, Gly and Leu. The N
      terminal amino acids of both glycoproteins were blocked. PAS-6 and PAS-7 digested
      with trypsin had a different peptide map, two major peptides having the same
      retention time on HPLC and being common to PAS-6 and PAS-7 having the same amino
      acid sequences of H-Gln-Ser-Gly-Asn-Lys-Asn-Pro-Ser-Glu-Ile-Ser-OH and H-Ile-Phe
      Pro-Gly-Asn-Met-Asp-Asn-Ser-His-Lys-OH.

PMID- 1643095
TI  - Identification of the histidine residue in Escherichia coli isocitrate lyase that
      reacts with diethylpyrocarbonate.
AB  - Escherichia coli isocitrate lyase was inactivated by diethylpyrocarbonate in a
      pseudo-first-order process. The enzyme was completely inactivated by modification
      of a single histidine residue, but slower modification of further residues also
      occurred. The substrate, isocitrate, and products, glyoxylate and succinate,
      protected against inactivation by diethylpyrocarbonate but this was not simply
      due to binding at the active site. Treatment of the inactivated enzyme with
      hydroxylamine led to only partial recovery of activity. Diethylpyrocarbonate also
      reacted with sulphydryl groups in isocitrate lyase, as judged by titrations with
      Nbs2, but this reaction was not responsible for the failure of hydroxylamine to
      reactivate the enzyme fully. The reactivity of isocitrate lyase to
      diethylpyrocarbonate declined with pH, following a titration curve for a group of
      pKa 6.1. Isolation and sequencing of ethoxyformylated peptides showed that the
      major site of modification by diethylpyrocarbonate was histidine residue 306.

PMID- 1643096
TI  - Concentration and distribution of apolipoproteins A-I and E in normolipidemic,
      WHHL and diet-induced hyperlipidemic rabbit sera.
AB  - Two sandwich-type enzyme immunoassays have been developed to measure
      apolipoproteins A-I and E in rabbit serum. Specific goat antibodies were purified
      by affinity chromatography and used both for coating and for preparing antibody
      peroxydase conjugates. The sensitivity of these assays is sufficient to allow
      studies of apo A-I and E distribution in lipoproteins fractionated by gel
      filtration from 50 microliters of serum. In WHHL rabbits, apo A-I is 5-fold lower
      (5.2 +/- 2.5 mg/dl) and apo E is 8-fold higher (9.9 +/- 3.5 mg/dl) than in
      normolipidemic rabbits (29 +/- 4.3 mg/dl and 1.3 +/- 0.5 mg/dl, respectively). In
      hyperlipidemic rabbits, fed 2 months on a 0.5% cholesterol diet, the apo A-I
      level was similar (32 +/- 12 mg/dl) to that of normolipidemic rabbits, but the
      apo E level is 12-fold higher (15.1 +/- 5.5 mg/dl). In addition, HDL particles
      were enriched with cholesterol and apo E. The bulk of apo E and cholesterol is
      located in large beta-VLDL in diet-induced hyperlipidemia, whereas they are
      mainly located in smaller size beta-VLDL in WHHL rabbits. In normolipidemic
      rabbits apo E occurs mainly in HDL, and cholesterol is distributed in the main
      three lipoprotein fractions VLDL, LDL and HDL. Interestingly, HDL of WHHL rabbit
      are deficient in apo A-I. These results are compatible with profound
      perturbations of lipoprotein composition and metabolism in atherogenic
      hyperlipidemia.

PMID- 1643097
TI  - Peroxidation and phospholipase A2 hydrolytic susceptibility of liposomes
      consisting of mixed species of phosphatidylcholine and phosphatidylethanolamine.
AB  - The relationship between lipid peroxidation and phospholipase A2 (PLA2)
      hydrolytic activity was studied using unilamellar vesicles (liposomes) as model
      membranes. Hydrolytic specificity was examined using vesicles prepared with pure
      bovine heart phosphatidylcholine (PC), bovine heart phosphatidylethanolamine
      (PE), or mixtures of these phospholipids, using two preparative procedures, i.e.,
      sonication or extrusion. Lipid peroxidation was induced by incubating vesicles
      with cumene hydroperoxide and hematin at 37 degrees C. Determinations of the
      extent of peroxidation by means of diene conjugate content derived from second
      derivative spectra or by polarographic measurement of oxygen consumption rates
      provided a basis for comparing the extent of peroxidation of each phospholipid
      species to their subsequent hydrolysis by PLA2 (from Crotalus adamanteus). The
      extent of hydrolysis was determined through the release of arachidonic acid from
      either PC or PE. The PE distribution among the outer vs. inner leaflet of the
      membrane bilayer was nearly equal in sonicated vesicles, whereas most of the
      phospholipid was incorporated into the inner leaflet in extruded vesicles. The
      proportion of PE found in the inner leaflet progressively increased as the ratio
      of PE to PC increased in both sonicated and extruded vesicle preparations. Lipid
      peroxidation had no effect on PE distribution under the conditions examined.
      There was a clear preference for PC peroxidation for all vesicle compositions
      tested and PC was preferentially hydrolyzed by PLA2. This effect is proposed to
      result from a perturbation of membrane structure following peroxidation with
      assimilation of PC into PLA2-susceptible domains whereas PE peroxidation and
      hydrolysis is less affected in mixed PC/PE vesicles. Lipid peroxidation imposes
      an additional hydrolytic susceptibility over the effects exerted through the
      mixing of these phospholipids which is based on structural changes rather than
      formation of specific substrates for PLA2.

PMID- 1643098
TI  - Tea catechins decrease micellar solubility and intestinal absorption of
      cholesterol in rats.
AB  - A(-)-epicatechin (EC) and (-)-epigallocatechin (EGC) mixture and a mixture of
      their gallates (ECG and EGCG, respectively) markedly lowered lymphatic
      cholesterol absorption in rats with a cannulated thoracic duct. A mixture of ECG
      and EGCG was more effective in reducing cholesterol absorption than the EC and
      EGC mixture. These catechins also tended to decrease lymphatic absorption of
      triacylglycerols, although not so pronounced as in cholesterol absorption. An in
      vitro study on micellar solubility of cholesterol showed that these catechin
      mixtures precipitated cholesterol solubilized in mixed bile salt micelles in a
      dose-dependent manner. A mixture of ECG and EGCG more effectively precipitated
      micellar cholesterol than a mixture of EC and EGC. When purified EC, EGC, ECG and
      EGCG were used, EGCG was more effective in precipitating micellar cholesterol
      than ECG. The effect of EC and EGC was comparable and weaker than their gallate
      esters. The bile acid concentration in the micelles was not affected by these
      catechins. A positive correlation was observed between the amount of
      coprecipitated EGCG and cholesterol. These results clearly show that tea
      catechins, in particular their gallate esters, effectively reduce cholesterol
      absorption from the intestine by reducing solubility of cholesterol in mixed
      micelles. The observation accounts for the hypocholesterolemic effect of tea
      catechins.

PMID- 1643099
TI  - Lower levels of lipid peroxidation in human platelets incubated with
      eicosapentaenoic acid.
AB  - The modulatory effects of eicosapentaenoic acid (EPA) on platelet arachidonic
      acid (AA) metabolism were applied to an in vitro model of oxidant stress.
      Unstimulated normal human blood platelets were first treated with a thiol
      oxidizing agent, azodicarboxylic acid bis(dimethylamide) (diamide) (1 microM),
      and then incubated with a low concentration of EPA (100 nM). Diamide treatment
      led to a lower alpha-tocopherol content compared to control. Formation of MDA, a
      marker of the overall lipid peroxidation, as well as formation of 12
      hydroxyeicosatetraenoic acid (12-HETE), the 12-lipoxygenase end-product of AA,
      were both higher in diamide-treated platelets. Subsequent incubation of diamide
      treated platelets with EPA counteracted the effects of oxidant stress induced
      pharmacologically by diamide. Interestingly, EPA prevented the alpha-tocopherol
      level from falling and the overall lipid peroxidation from increasing as it did
      during diamide treatment. In particular, incubation of diamide-treated platelets
      with EPA led to significantly lower amounts of 12-HETE. Conversely, preincubation
      of platelets with 100 nM EPA protected cells from oxidizing effects induced by
      diamide treatment, either on the level of lipid peroxides or on the antioxidant
      status. These results indicate that, in this particular model, EPA permitted
      platelets to have control levels of tocopherol, MDA and 12-HETE despite diamide
      treatment. Low concentrations of EPA might have prevented the increase of lipid
      hydroperoxides and especially the transient accumulation of 12
      hydroperoxyeicosatetraenoic acid (12-HPETE).

PMID- 1643100
TI  - Glycosylation of lipoprotein lipase in human subcutaneous and omental adipose
      tissues.
AB  - Human adipose tissues from the abdomen (subcutaneous), thigh (subcutaneous) and
      omentum were incubated for 2 h with [35S]methionine. Then glycosylation of
      lipoprotein lipase (LPL) was analyzed by sodium dodecylsulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) of endoglycosidase H (endo H)-digested subunits of the
      35S-labeled lipase. Adipose tissues from the abdomen, thigh, and omentum all
      synthesized LPL subunits with Mr = 57,000 composed of two types of subunits. One
      type was partially endo H-sensitive yielding a product with Mr = 55,000,
      indicating that it had one endo H-resistant and one endo H-sensitive
      oligosaccharide chain. The other type of subunit was totally endo H-sensitive
      yielding a product with Mr = 52,000. Subcutaneous adipose tissues contained
      nearly equal amounts of partially and totally endo H-sensitive subunits of LPL,
      whereas omental adipose tissues contained mainly partially endo H-sensitive
      subunits of LPL.

PMID- 1643101
TI  - Observation of the inverted hexagonal phase of lipids by scanning tunneling
      microscopy.
AB  - Scanning tunneling microscopy (STM) has been used in direct observations of the
      inverted hexagonal phase of several lipids, such as cardiolipin (CL) in the
      presence of Ca2+, soybean PE, DOPE and a binary system of CL and DMPC as well.
      Single tube-like structures, bundles of tubes and the cross-sectional view of the
      HII phase can clearly be seen at room temperature in a near natural state of
      these lipids. The success of this study shed some light on the applicability of
      STM in the investigation of lipid polymorphism and its role in the function of
      biological membranes.

PMID- 1643102
TI  - Glucocorticoids inhibit TNF alpha-induced cytosolic phospholipase A2 activity.
AB  - The cytosolic phospholipase A2 (PLA2) was characterized in the human epithelial
      carcinoma cell line HEp-2 by its apparent molecular mass (about 80 kDa); its in
      vitro activation by micromolar concentrations of calcium; and its calcium
      dependent association with cellular membranes. The activity of this enzyme was
      induced by an overnight incubation with tumor necrosis factor alpha (TNF alpha).
      Glucocorticoids only moderately reduced PLA2 activity in control cells, but
      completely inhibited the TNF alpha-induced increase in the activity of the high
      molecular-weight cytosolic PLA2.

PMID- 1643103
TI  - Fibric acid derivatives: effects on the synthesis of isoprenoid lipids in
      cultured human lymphocytes.
AB  - Fibric acid derivatives have been demonstrated to reduce circulating lipoprotein
      and triacylglycerol concentrations and to inhibit hydroxymethylglutaryl CoA
      reductase, a key regulatory enzyme of cholesterol biosynthesis. This study
      describes the effect of four fibric acid derivatives on the biosynthesis of
      isoprenoid products from acetate and mevalonate in Molt-4 cells, a human leukemic
      T-lymphocyte cell line. The isoprenoids analyzed were cholesterol as well as
      dolichol and ubiquinone, alternative products of the branched isoprenoid
      biosynthetic pathway. None of the fibric acid derivatives showed significant
      effects on the synthesis of cholesterol from acetate or mevalonate and there was
      little change in the flux of these metabolites into either dolichol and
      ubiquinone compared to cells grown in drug-free medium. Therefore, in contrast to
      the reported inhibitory effects of fibric acids on hepatic sterol synthesis in
      rats and humans and on hydroxymethylglutaryl CoA reductase activity in human
      nonmalignant lymphocytes, our results show that these drugs do not significantly
      affect any of the post-reductase enzymes in the branched metabolic pathways
      leading from acetate to dolichol, ubiquinone and cholesterol in short term
      culturing of human malignant lymphocytes.

PMID- 1643104
TI  - The visceral yolk sac--an important site of synthesis and secretion of
      apolipoprotein B containing lipoproteins in the feto-placental unit of the rat.
AB  - Rat fetuses exhibit a high serum LDL concentration at term. Delivery caused a
      marked decrease of the LDL apolipoprotein (apo) B concentration independent of
      whether this occurred on days 21, 22 or 23 of gestation. The interruption of the
      yolk sac circulation by a ligature in situ for 6 h led to the same alterations of
      the LDL-apo B concentration as Caesarean section. Immunoelectronmicroscopic
      studies provided evidence that the epithelial cells of the visceral yolk sac
      exhibited electron dense LDL-sized and apo B containing particles which were
      localized over the compartments of the Golgi complexes, endoplasmatic reticulum,
      secretory vesicles and intercellular spaces, but not over the cell nuclei,
      mitochondria or lysosomes. ApoB containing LDL-sized particles could be obtained
      by ultracentrifugation from the disrupted material of the microsomal fraction of
      yolk sac homogenates. Isolated segments of the yolk sac membranes were capable to
      secrete apoB containing lipoproteins floating in the d less than 1.020 g/ml as
      well as in the d = 1.020-1.064 g/ml fraction with a 10-fold higher amount of apoB
      in the higher density class. Incorporation experiments with [35S] methionine gave
      evidence that these lipoproteins were at least partially provided with newly
      synthesized apoB predominantly found in the LDL fraction. The size of the
      negatively stained particles in the d = 1.020-1.064 g/ml fraction secreted from
      yolk sac segments corresponded to that of LDL from fetal rat serum. In contrast
      their acylglycerol content was significantly higher, whereas the percentage
      contribution of total cholesterol and protein was markedly reduced in comparison
      with serum LDL of the fetus. In summary, biochemical and ultrastructural studies
      provide clear cut evidence that the rat yolk sac is able to synthesize and to
      deliver apo B containing lipoproteins in the density ranges of VLDL, IDL and
      particular of LDL thus contributing to the supply of serum lipoproteins in the
      rat fetus. By recalculation of recent tracer kinetic data (Plonne et al. (1990)
      J. Lipid Res. 31, 747) using a mathematical step function model it was possible
      to assess the contribution of the rat yolk sac to the LDL influx into the fetal
      serum.

PMID- 1643105
TI  - Calorimetric studies of lipid tubule formation from ethanol-water solutions.
AB  - We have used differential scanning calorimetry to systematically investigate the
      thermal formation of hollow cylindrical crystalline microstructures or 'tubules'
      upon cooling a diacetylenic phosphatidylcholine (1,2-bis(10,12-tricosadiynoyl)-sn
      glycero-3-phosphocholine) dispersed in varying volume fractions of ethanol/water.
      Tubule formation is characterized by a large exothermic event, observed upon
      cooling the lipid in 60-80% ethanol. The enthalpy of the transition was observed
      to be highest in this window of tubule formation (128-138 J/g) which is
      significantly higher than previously reported values for the enthalpy of tubule
      formation in water (90 -95 J/g). The enthalpy associated with the formation of
      tubules in 70% ethanol was also found to be strongly dependent on the efficiency
      of tubule formation and decreased as the number density of tubules decreased. A
      significant decrease in tubule number density could be brought about by
      increasing the lipid concentration of the 70% ethanol solution. Tubule number
      density was maximized at lipid concentrations between 0.5 and 2 mg/ml in 70%
      ethanol. Examination of the C-H stretch region from infrared spectra of the lipid
      below the phase transition, indicate that the intramolecular chain order-disorder
      is similar, regardless of the fraction of ethanol. The higher transition enthalpy
      for the melting of tubules in 60-80% ethanol (compared to water) implies that the
      high-temperature phase from which the tubules form in ethanol is more disordered
      than the lamellar liquid crystalline phase from which tubules form in water.

PMID- 1643106
TI  - Use of specific polyclonal antibodies to detect heterogeneous lipases from
      Geotrichum candidum.
AB  - Geotrichum candidum CMICC 335426 was previously shown to produce two lipases
      termed lipase A and lipase B, lipase B being highly specific for hydrolysis of
      esters of cis-delta 9 fatty acids. We now describe the isolation of polyclonal
      antibodies specific for lipase A and lipase B. These antibodies were used in
      Western blotting techniques to detect the appearance of the lipases during the
      course of the fermentation of G. candidum CMICC 335426. A and B were found to be
      produced simultaneously in the extracellular medium at the start of the growth
      phase. The two lipases were always present at similar levels in the medium. The
      specific antibodies were then used to detect the presence of A- and B-like
      lipases in crude lipase samples from other strains of G. candidum. The lipases
      were found at different levels in all these samples, and the specificities of the
      crude lipases varied significantly from one strain to another. Differences in
      specificity could therefore be explained by different levels of specific (B-type)
      and non-specific (A-type) lipases in the medium. This was verified by purifying A
      and B-type lipases from the G. candidum strain ATCC 34614.

PMID- 1643107
TI  - cDNA sequence and alternative mRNA splicing of surfactant-associated protein C
      (SP-C) in rabbit lung.
AB  - An 784 base pair (bp) copy DNA (cDNA) for the low molecular weight hydrophobic
      surfactant-associated protein C (SP-C) has been isolated from a lambda gt11 cDNA
      library constructed from fetal rabbit lung mRNA. The cDNA, which coded for a 193
      amino-acid proprotein with 6 bp 5' and 193 bp 3' untranslated segments, possesses
      considerable nucleic acid and predicted amino-acid homology with previously
      reported SP-C cDNAs. The predicted amino-acid sequence of the 35 amino-acid
      mature polypeptide shares 94-97% identity with human, rat and mouse SP-C and is
      88-91% homologous to the mature proteins from bovine, porcine and canine lung.
      The last 12 amino acids of mature SP-C are highly hydrophobic and invariant.
      Alignment of the rabbit and human nucleic acid sequences required introduction of
      a 27 bp gap in the rabbit sequence at a site corresponding to the exon-intron
      junction of the 5th exon of the human genomic sequence. Since previous studies
      have identified differential splicing at the 5' and 3' ends of the human 5th
      exon, we investigated the potential existence of alternative splicing of rabbit
      SP-C mRNA. Reverse transcription (RT) of total RNA followed by polymerase chain
      reaction (PCR) was used to establish the relative abundance of alternative
      splicing products from fetal and adult lung and from rabbit kidney, placenta and
      liver. The relative abundance of the 250, 280 and 350 bp bands observed was the
      same in lung and other tissues. PCR amplification of genomic rabbit DNA indicated
      that the 350 bp fragment corresponds to the unspliced nascent transcript. The
      lack of developmental or tissue-specific abundance patterns implies the absence
      of secondary influences on SP-C mRNA polymorphism. Indeed, free energy of
      formation calculations predicted the presence of hairpin structures favouring
      formation of the more abundant 250 bp form. These observations plus the absence
      of any effect of alternative splicing on SP-C protein structure led us to
      conclude a physiological role is unlikely.

PMID- 1643108
TI  - Reversibility of the activation of soluble phospholipase A2 on lipid bilayers:
      implications for the activation mechanism.
AB  - The time-courses of hydrolysis of large vesicles of
      dipalmitoylphosphatidylcholine were compared using four species of phospholipase
      A2 (Agkistrodon piscivorus piscivorus, Crotalus adamanteus and Naja naja venoms
      and porcine pancreatic). In all four cases, the hydrolysis rate suddenly
      increases 10 to 100-fold at the time (tau) when a specific mole fraction of
      reaction products has accumulated. The intrinsic fluorescence emission of the
      three venom enzymes also increases suddenly at time tau. Both the activation and
      the fluorescence change are reversible with a half-time of about 50 s for the
      activity and 2 to 6 s for the fluorescence. These reversal rates and the vesicle
      concentration dependence of tau are considered for monomer and dimer enzyme
      activation models. Apparently, at least three states of the enzyme exist beyond
      the initial unbound state: (1) inactive and bound, (2) inactive with high
      fluorescence and (3) active. The dimer model already contains the necessary
      number of states but requires that the activation rate be much lower than the
      reversal rate to account for the vesicle concentration dependence of tau. Success
      of the monomer model requires an enzyme state additional to those proposed
      previously. Although these results do not exclude either the monomer or dimer
      models conclusively, they do impose important constraints on each model.

PMID- 1643110
TI  - Molecular cell research.

PMID- 1643109
TI  - Characteristics and regulation of ganglioside-induced elevation of free
      cytoplasmic Ca2+ in human blood platelets.
AB  - We have found that gangliosides GD3 and GM3 induced rapid, reversible elevation
      of free cytoplasmic Ca2+ in fura-2-loaded human blood platelets. The effect
      persisted in Ca(2+)-free medium, indicating that gangliosides stimulated
      mobilization of intracellular stores. The action of gangliosides was
      concentration-dependent with EC50 of about 1 microM. The Ca(2+)-mobilizing
      effects of gangliosides were potentiated by epinephrine and inhibited by
      substances inducing activation of protein kinase C and cAMP-dependent protein
      kinases. Acidic phospholipids partially mimicked the Ca(2+)-mobilizing effects of
      gangliosides indicating that lipid head charge is essential for this activity.
      While the elevation of [Ca2+]i produced by arachidonic acid was almost completely
      blocked by aspirin pretreatment, the effects of gangliosides were diminished only
      2-fold, indicating that gangliosides activate both aspirin-sensitive and aspirin
      insensitive mechanisms of [Ca2+]i elevation.

PMID- 1643111
TI  - Hydroxyurea induces apoptosis and regular DNA fragmentation in a Burkitt's
      lymphoma cell line.
AB  - Hydroxyurea (HU) is an S-phase-specific cytotoxic drug used in the clinical
      treatment of haematological malignancies. HU treatment has been shown to lead to
      accumulation of short DNA fragments which show direct correlation with
      cytotoxicity. Specific regular DNA fragmentation is a biochemical feature of
      apoptosis (programmed cell death) in some systems. We investigated the effect of
      HU on a neoplastic (Burkitt's lymphoma) cell line (BM13674) in vitro to determine
      the role of apoptosis in HU action. HU produced growth inhibition and cell death
      by apoptosis in BM13674 cells. Low dose HU (66 and 131 mumol/l) gave a growth
      inhibition effect only with no apoptosis being induced. Higher doses (0.66-13
      mmol/l) induced apoptosis in a dose-dependent manner. Regular DNA fragmentation
      was detected by agarose gel electrophoresis of DNA and this correlated in time
      with the onset of apoptosis detected by light and electron microscopy. The
      results do not exclude the possibility that HU directly induces DNA strand
      breaks, which then initiate apoptosis and accompanying regular fragmentation of
      DNA in the apoptotic cells.

PMID- 1643112
TI  - Expression of chondroitin sulfate as a unique type of proteoglycan on the cell
      membrane of multipotential and committed hemopoietic progenitor cells.
AB  - Proteoglycans are increasingly implicated as a major factor in the regulation of
      hemopoiesis. They are generally synthesized by stromal cells and released to the
      extracellular matrix. More recently the ability of hemopoietic progenitor cells
      to synthesize proteoglycans has come into focus. In the present study we
      maintained 3 cloned factor-dependent hemopoietic progenitor cells (B6 and F-mix
      which are multipotential and F-2 which is bipotential) in liquid culture. The
      cells were pulse-labeled with 35SO4 which becomes incorporated into the glycan
      side-chains of proteoglycans. We then studied subcellular distribution and
      chemical characterization of the newly synthesized proteoglycans. All 3 cell
      lines synthesized chondroitin sulfate as a unique type of proteoglycan as
      identified by gel filtration on a Sepharose CL-4B column followed by
      chondroitinase ABC cleavage of its glycosaminoglycan. This single type of
      proteoglycan was compartmentalized into intracellular, membrane-associated and
      extracellular pools. Its density on the membrane appeared to be a function of the
      differentiation state of the cell. The functional significance of membrane
      associated proteoglycan in hemopoietic progenitor cells appears to be
      underestimated and requires further investigation.

PMID- 1643113
TI  - A thousand and two protein tyrosine phosphatases.

PMID- 1643114
TI  - 1,25-(OH)2D3 and 24,25-(OH)2D3 regulation of arachidonic acid turnover in
      chondrocyte cultures is cell maturation-specific and may involve direct effects
      on phospholipase A2.
AB  - Previous studies have shown that 1,25-(OH)2D3 stimulates phospholipase A2 (PA2)
      activity in growth zone chondrocytes (GC), but has no effect on the resting zone
      chondrocyte (RC) enzyme activity. 24,25-(OH)2D3 inhibits the RC enzyme but has no
      effect on the GC. This study examined whether the vitamin D metabolites affect
      arachidonic acid turnover in their contra-target cell populations. Incorporation
      and release of [14C]arachidonate was measured at various times following addition
      of hormone. Acylation and reacylation were measured independently by incubating
      with p-chloromercuribenzoate. The results demonstrated that 1,25-(OH)2D3 has no
      effect on arachidonic acid turnover in RC, but stimulates turnover in GC. In
      contrast, 24,25-(OH)2D3 stimulates arachidonic acid turnover in RC, but inhibits
      both incorporation and release in GC. To determine whether direct interaction
      with PA2 is one mechanism by which 1,25-(OH)2D3 and 24,25-(OH)2D3 regulate
      arachidonic acid release, snake venom (Niger niger) PA2 was incubated with the
      vitamin D metabolites. Enzyme specific activity was inhibited by 24,25-(OH)2D3
      and stimulated by 1,25-(OH)2D3 in a time- and dose-dependent manner. These
      results suggest that at least part of the direct effect of vitamin D3 metabolites
      on cell membranes may be related to changes in PA2 activity. The regulation is
      related to the stage of differentiation of the target cell population. Changes in
      fatty acid acylation and reacylation may be one mode of vitamin D3 action in
      cartilage.

PMID- 1643115
TI  - Diphosphorylation of platelet myosin ex vivo in the initial phase of activation
      by thrombin.
AB  - We prepared anti-platelet 20-kDa myosin light chain (MLC-20) antibody and
      demonstrated diphosphorylation of MLC-20 in platelets ex vivo in the initial
      phase of activation by thrombin. Our results are as follows. (1) By Western
      blotting, using anti-MLC-20 antibody, both mono- and diphosphorylated myosin were
      seen in the initial phase of aggregation of platelets by thrombin. The peak of
      the diphosphorylation was later than that of monophosphorylation and the degree
      of both mono- and diphosphorylation reduced in the process of aggregation. (2) ML
      7 (a synthetic inhibitor of MLCK) inhibited both mono- and diphosphorylation of
      myosin and also blocked aggregation of thrombin-activated platelets. However, H-7
      (an inhibitor of protein kinase C) had little effect on either the
      (di)phosphorylation of myosin or the aggregation of thrombin-activated platelets.
      (3) Arg-Gly-Asp-Ser (RGDS) peptide, a synthetic anti-adhesive peptide, inhibited
      aggregation of thrombin-activated platelets in a dose-dependent manner (100-200
      microM). However, it had little effect on either mono- or diphosphorylation of
      myosin in the process of the platelet aggregation stimulated by thrombin. From
      these results, we conclude that mono- and diphosphorylation of myosin by MLCK
      play a role in the initial phase of activation of thrombin-stimulated platelets
      in vivo and that mono- and diphosphorylation of myosin by MLCK precedes the
      secondary signal mediated by GPIIb/IIIa.

PMID- 1643116
TI  - Pathways for arachidonic acid mobilization in zymosan-stimulated mouse peritoneal
      macrophages.
AB  - Resident peritoneal macrophages release arachidonic acid when challenged by
      zymosan, a phagocytosable particle. The present study was designed to investigate
      the pathways for arachidonic acid mobilization in zymosan-stimulated macrophages.
      Experiments were conducted with [3H]arachidonic acid-labeled macrophages to
      establish the relative contribution of acyltransferases, phospholipase A2, and
      diacylglycerol lipase to overall arachidonic acid release. Upon zymosan
      stimulation, [3H]arachidonic acid incorporation into phospholipids was
      significantly enhanced. Stimulus-induced activation of arachidonic acid
      incorporated was not observed immediately, but was found 5 min after cell
      challenge. On the other hand, the results indicated a rapid accumulation of
      intracellular free [3H]arachidonic acid that paralleled the appearance of both
      [3H]glycerol-labeled lysophosphatidylcholine and [3H]glycerol-labeled
      lysophosphatidylinositol, the by-products of phospholipase A2 action on
      phosphatidylcholine and phosphatidylinositol, respectively. A transient
      accumulation of [3H]arachidonate-carrying diacylglycerol was also observed.
      However, no appreciable alterations in the levels of [3H]monoacylglycerol were
      found. The phospholipase A2 inhibitor nordihydroguaiaretic acid substantially
      prevented the zymosan-induced arachidonic acid release. In contrast, RHC 80267, a
      diacylglycerol lipase inhibitor, though preventing diacylglycerol breakdown, did
      not have any effect on [3H]arachidonic acid release From these results, it is
      concluded that: (1) the phospholipase A2 pathway controls arachidonic acid
      release upon zymosan stimulation; (2) the diacylglycerol lipase pathway appears
      not to be involved in arachidonic acid release by stimulated cells; (3) the
      acyltransferases play a remarkable role in controlling free arachidonic acid
      levels, but they do not participate in the increase of free fatty acid levels
      observed upon cell stimulation.

PMID- 1643117
TI  - The activation of inactive membrane-associated protein kinase C is associated
      with DMSO-induced erythroleukemia cell differentiation.
AB  - The rapid redistribution of cytosolic protein kinase C (PKC) to membranes and its
      subsequent proteolytic activation to PKM have been implicated in the DMSO/HMBA
      induced differentiation of murine erythroleukemia (MEL) cells. However, DMSO was
      found not to induce detectable changes in PKC distribution in a MEL cell subline
      (MEL1) which differentiated normally in response to the agent. Nevertheless, the
      differentiation of MEL1 cells appeared dependent on an early PKC-related event
      because hemoglobinization was partially blocked by the PKC inhibitor H-7 added to
      cells within the first 2 h after DMSO induction. Indeed, a rapid (15-60 min)
      increase in membrane PKC activity was detected in DMSO-treated MEL1 cells using a
      novel method which quantitates the amount of 'active' PKC in intact membranes.
      This transient PKC increase resulted from the activation of 'inactive' enzyme
      already associated with membranes, and not from the translocation of cytosolic
      PKC. Conventional PKC assays cannot distinguish between active and inactive
      membrane PKC pools. DMSO also activated inactive membrane PKC in HL-60 cells, but
      not in S49T-lymphoma and WEHI-231 B-lymphoma cells which do not differentiate in
      response to DMSO. The results suggest that a rapid and transient increase in
      membrane PKC activity may be an important early step in DMSO-induced
      differentiation of erythroleukemia cells.

PMID- 1643118
TI  - Chick embryo heart cells with high and low intracellular calcium concentrations
      respond differently to ouabain.
AB  - In cell cultures of 10-day-old chick embryo hearts, we found two cell
      populations, one with high intracellular calcium concentration ([Ca2+]i) of 116
      +/- 34 nM (S.E., high [Ca2+]i cells, n = 154) and another one with low [Ca2+]i of
      46 +/- 14 nM [Ca2+]i (S.E., low [Ca2+]i cells, n = 171), as revealed by fura-2
      digital imaging fluorescence microscopy. The proportion of the high [Ca2+]i cells
      varied as a function of the cell density from 10-60% of all cells. Histochemical
      staining of the cells showed that cells with high and low [Ca2+]i did not
      represent differences between muscle and non-muscle cells. When the cells were
      exposed to different concentrations of ouabain, the high [Ca2+]i cells showed a
      half maximal effect at 2.10(-9) M ouabain, but only a small increase in [Ca2+]i
      of 30%. The low [Ca2+]i cells reached their half maximal increase in [Ca2+]i at
      4.10(-8) M ouabain. A second increase in [Ca2+]i in this cell type was observed
      between 10(-6) and 10(-5) M ouabain. Toxic concentrations of ouabain produced an
      excessive increase in [Ca2+]i in low [Ca2+]i cells, whereas high [Ca2+]i cells
      showed morphological degeneration due to their higher sensitivity to ouabain. In
      conclusion, we demonstrate that chick embryo heart contains cells with high and
      low [Ca2+]i which show differences in the sensitivity of their sodium pumps to
      cardiac glycosides.

PMID- 1643119
TI  - Report different results in esophageal perforation patients.

PMID- 1643120
TI  - Virginia's athletic exam form: results and revisions.
AB  - In followup of the expanded preparticipation physical exam form introduced by the
      Virginia High School League in 1989, the author finds substantial evidence of
      beneficial effects: 1) Perception by school administrators, parents, and students
      of distinctly improved physical evaluations. 2) Demonstration of previously
      unrecognized historical and physical findings of significance. 3) Newfound
      interest in the relationship of health, fitness, and sports among students,
      coaches, and physicians. 4) Recognition of Virginia's leadership in promoting
      safety among high school athletes. Suggestions from the medical community
      generated revisions in the form, which creates a more effective form and gives
      the physician more flexibility.

PMID- 1643121
TI  - Virginia's EMS-DNR Order: rules of usage.

PMID- 1643122
TI  - Virginia's advance medical directive.

PMID- 1643124
TI  - Screening children for lead poisoning: new guidelines.

PMID- 1643123
TI  - Severe hypoglycemia in diabetic pregnancy.
AB  - Our results are presented to reemphasize that strict glucose control in pregnant
      Type I diabetic patients carries not only significant benefits but risk as well.
      Despite careful attention, self glucose monitoring, multi-shot/pump insulin,
      diabetic team management and obstetrical expertise, pregnant Type I diabetic
      patients are at increased risk for hypoglycemic episodes.

PMID- 1643125
TI  - Ethics programs at community hospitals in Virginia.

PMID- 1643126
TI  - What kind of fiscal medicine are we practicing?

PMID- 1643127
TI  - The lost art.

PMID- 1643128
TI  - Dr. Blanton's moving word picture.

PMID- 1643129
TI  - [Evaluation of 5 methods for the diagnosis of infections by respiratory syncytial
      virus].
AB  - BACKGROUND: To compare and evaluate four different rapid methods of respiratory
      syncytial virus antigen detection with the isolation of the virus in cell
      culture. METHOD: Ninety-eight nasopharyngeal swabs were studied, for respiratory
      syncytial virus isolation in Hep-2 cell line and for RSV antigen detection using
      direct immunofluorescence and three ELISA methods: Abbot RSV EIA (ELISA-1), RSV
      Antigen Detection System (ELISA-2) and Directigen RSV (Directigen). RESULTS: Of
      all 98 samples studied using the five mentioned methods, 42 (43%) were positive
      for respiratory syncytial virus. The most sensitive methods were ELISA-1 (82%)
      and immunofluorescence (82%). The most specific ones were direct
      immunofluorescence (86%) and Directigen (84%). The higher percentage of
      concordant positive results with respiratory syncytial virus culture were direct
      immunofluorescence (84%) and Directigen (82%). CONCLUSIONS: Rapid diagnostic
      methods for respiratory syncytial virus infection can not substitute the
      isolation method using cell line culture. We believe that respiratory syncytial
      virus isolation in cell culture combined direct with direct immunofluorescence or
      Directigen methods are the first choice diagnostic techniques for achieve a
      higher number of positive results in respiratory syncytial virus infected
      patients.

PMID- 1643130
TI  - [Hospital personnel who are nasal carriers of methicillin-resistant
      Staphylococcus aureus. Usefulness of treatment with mupirocin].
AB  - BACKGROUND: The evaluation of health care workers role in methicillin-resistant
      Staphylococcus aureus outbreaks and the efficacy of mupirocin as a topical agent
      for nasal carriers. METHOD: Microbiologic study of nasal microflora of 1547
      health care workers from the San Carlos University Hospital and 108 health care
      workers from related hospitals while an outbreak of methicillin-resistant
      Staphylococcus aureus nosocomial infections is in progress at San Carlos
      University Hospital. Assessment of the efficacy of mupirocin nasal ointment for
      nasal carriers using microbiologic controls of nasal and pharyngeal swabs at the
      end of treatment and two weeks after. RESULTS: In San Carlos University Hospital
      a total of 53 health care workers with nasal carriage of methicillin-resistant
      Staphylococcus aureus were found. That figure represents a 3.4% of all health
      care workers studied and also a 15.4% of methicillin-resistance among all S.
      aureus isolated. Among health care workers from related hospitals, only one nasal
      carrier was found. Forty-seven of all 53 methicillin-resistant Staphylococcus
      aureus isolated from San Carlos University Hospital health care workers and the
      strain isolated from the related hospitals health care worker were similar to the
      epidemic strain responsible for the outbreak. Mupirocin, as nasal ointment, was
      useful in eliminating nasal colonization in all cases. CONCLUSIONS: When a
      nosocomial outbreak of methicillin-resistant Staphylococcus aureus infections is
      detected, health care workers are one of the most important reservoirs. Topical
      treatment with mupirocin (nasal ointment) is useful for eliminating the nasal
      carrier status.

PMID- 1643131
TI  - [Rapid diagnosis of Chlamydia trachomatis using a DNA probe in a population with
      low risk of infection].
AB  - BACKGROUND: To assess the efficacy of a newer diagnostic technique for Chlamydia
      trachomatis and its usefulness as screening method in populations at low-risk for
      Chlamydia trachomatis infection. METHODS: Open comparative trial between the EIA
      technique (Abbott Laboratories) and DNA gene probe (Gen Probe Diagnostic). A
      total of 1683 individuals (1630 women and 53 men) were screened with the two
      different techniques using samples obtained simultaneously. RESULTS: Among women,
      66 give a positive result either by one or another technique. The prevalence was
      4.04%. Sensitivity of DNA probe when compared with EIA assay was 64% and
      specificity was 98.9%. CONCLUSIONS: The DNA probe technique is faster than actual
      techniques and easy to do without major laboratory equipment. However, its price
      is high and its sensitivity poor in low-risk populations.

PMID- 1643132
TI  - [Diarrhea and eosinophilia in a Spanish man from Equatorial Guinea].

PMID- 1643133
TI  - [Recurrent erythema and fever].

PMID- 1643134
TI  - [Infection of an axillo-femoral vascular prosthesis by Candida albicans].

PMID- 1643135
TI  - [Acute cholecystitis caused by Candida albicans].

PMID- 1643136
TI  - [Tuberculous spondylitis caused by Mycobacterium bovis].

PMID- 1643137
TI  - [Is bacteremia caused by Salmonella non-typhi an early complication in HIV
      infection?].

PMID- 1643138
TI  - [Isolation of Moraxella catarrhalis in a case of postoperative mediastinitis].

PMID- 1643139
TI  - [Disseminated actinomycosis and hepatic abscess caused by Arachnia propionica].

PMID- 1643140
TI  - [Identification of diphtheroids in the laboratory: when and how].

PMID- 1643141
TI  - [Hybridization techniques and mycobacteria. Evaluation in hospital practice].
AB  - BACKGROUND: Commercially DNA probes procedure for identification of M.
      tuberculosis complex and M. avium complex isolates were evaluated, for accuracy
      and applicability, for use in the clinical laboratory. METHODS: Gen-Probe culture
      confirmation tests for M. tuberculosis complex and M. avium complex were
      performed on 94 mycobacterial isolates. RESULTS: Results were expressed as
      absolute percent hybridization, with values greater than or equal to 10%
      considered positive. The M. tuberculosis complex probes correctly identified 71
      of 75 isolates, with 4 false-negative, for a sensitivity of 94.6% and a
      specificity of 100%. After repeat testing, all isolates were correctly
      identified, for a sensitivity of 100% and specificity of 100%. The M. avium
      complex probes correctly identified all M. avium-intracellulare isolates. There
      were no false-positives with 16 other mycobacteria. The mean percent
      hybridization (+/- the standard deviation) of M. tuberculosis complex isolates
      was 33.5 +/- 10.6; and for M. avium complex was 49.1 +/- 2.3. Among the isolates
      non M. tuberculosis and non M. avium complex, the percent hybridization range was
      0.9 to 4.6. Overall, there were 4 discrepant M. tuberculosis results after repeat
      testing, being necessary to repeat it if the percent hybridization is between 10
      and 5. CONCLUSIONS: GenProbe kits are highly sensitive and specific for use in
      identifying M. tuberculosis complex and M. avium complex isolates and will be
      useful in the clinical laboratory with a representative number of isolates.

PMID- 1643142
TI  - [Quantification of the levels of p24 antigen and antibodies in human
      immunodeficiency virus infection].
AB  - BACKGROUND: Quantification and clinical evaluation of p24 antigen and anti-HIV
      antibody levels. METHODS: Follow up of 13 HIV infected patients (53 sera) by
      determination of p24 antigen, total anti-HIV antibodies, anti-p24 and anti-env
      antibodies by ELISA and their semiquantitation. IgG and IgM class antibody
      determination by immunoblot techniques. RESULTS: The highest levels of p24 have
      been found in WR 1 and WR 6 stages. Commonly accepted serologic pattern has not
      been found in 100% of our cases. Western-blot is more sensitive for the detection
      of anti-p24 antibodies. CONCLUSIONS: p24 antigen appearance and a decrease in
      anti-p24 antibody level is related to a worse clinical prognosis. p24 antigen
      quantification is a usefull test for monitoring AZT therapy in patients suffering
      from AIDS.

PMID- 1643143
TI  - [Meningitis in pediatrics. Clinical and epidemiological study of 173 cases].
AB  - BACKGROUND: To know the incidence, clinical presentation, differential diagnosis
      and resistance level to antibiotics in pediatric meningitis. METHODS: 173 cases
      of meningitis (bacterial: 69, viral: 104) have been prospectively followed during
      1988 according to a previously established clinical and laboratory protocol.
      RESULTS: Meningitis attack rate was 60 cases/100,000 children younger than 15
      years per year (meningococcal: 25/100,000, Haemophilus: 2/100,000). Mortality was
      1.4%. 40% of bacterial meningitis received previous antibiotic treatment.
      Sensitivity of culture, Gram stain, and direct antigen detection by latex and EIA
      was 79%, 61.7%, 20.5% and 34%, respectively. Bacterial and viral differential
      diagnosis, by the application of Boyer's score was 95% sensitive and 98%
      specific. Four out of six cases of Haemophilus meningitis were ampicillin and
      chloramphenicol resistant; 39% of meningococcus had their penicillin
      susceptibility decreased between 2 and 8 times, although no therapeutic failures
      were seen. CONCLUSIONS: Laboratory parameters might not separate bacterial and
      viral meningitis at early stages of illness. Gram stain is an excellent and
      sensitive method of bacterial detection in CSF. Moderate resistance to penicillin
      in meningococcus is very frequent but clinical failures are not yet present.

PMID- 1643144
TI  - [Antimicrobial resistance in strains of Salmonella enterica isolated in the
      Hospital de Basurto (Bilbao) from 1987 to 1990].
AB  - BACKGROUND: Rate development of antimicrobial resistance of Salmonella strains in
      Hospital Basurto of Bilbao from 1987 to 1990 and to study their resistance
      mechanism. METHODS: The antimicrobial resistance for all strains isolated (1201
      strains) was performed by means of a agar-diffusion test. We selected 32 multi
      resistant strains for additional study (MIC, conjugation, IEF, and plasmid
      profile). RESULTS: The most frequent isolated serotypes were S. enteritidis
      (79.01%), S. typhimurium (8.5%) and Salmonella serogroup C1 (6.9%). The
      resistance to one or more of 17 antimicrobial rose significantly: 9.6% in 1987;
      10.25% in 1988; 16.45% in 1989 and 13.73% in 1990. The percentage of resistant
      serotypes were: S. typhimurium (40.2%); Salmonella serogroup B (31.8%);
      Salmonella serogroup C1 (16.8%); Salmonella serogroup D1 (13.04%); Salmonella
      serogroup C2 (9.09%) and S. enteritidis (8.4%). In 27 multi-resistant strains and
      their transconjugants, beta-lactamase bands with a pl: 5.4 and/or 5.6 compatible
      with TEM-1 and/or TEM-2 were observed. Also, these strains carried a plasmid of
      high molecular weight (125 MD). CONCLUSIONS: Although, the resistance of
      Salmonella is not a serious problem in our environment this situation is raising
      progressively with a greater number of strains with plasmid mediated beta
      lactamases. So, the antimicrobial policy will be more severe and righ in both
      hospital and extrahospital surrounding.

PMID- 1643146
TI  - Musings on the struggle--Part I: The "phonebook".

PMID- 1643145
TI  - [Cryptococcal meningitis and AIDS. Clinical description of 10 patients].
AB  - We have studied 10 patients with cryptococcal meningitis and AIDS. Nine of them
      were intravenous drug users and four have been previously diagnosed of AIDS. In
      60% of them cryptococcal meningitis was the first opportunistic infection, and as
      group represented only 6.3% of our 158 patients with AIDS on the same period. The
      most common symptoms were: malaise (100%), headache (80%), fever (60%), meningeal
      signs (50%). Two of them had focal neurological disease. CSF culture and serum
      cryptococcal antigen test were positive in 90%, the Indian ink in 77% and blood
      cultures in 30% of the cases, while indian ink preparation did it in 77%. MRI
      showed bilateral small lesions, deeply located, in 3 cases; it was also useful to
      prove optical tract lesions in a patient with blindness as a result of
      cryptococcal meningitis. We had treatment successes in 80% of the cases, all
      patients being treated with amphotericin B, alone in 4 and amphotericin B plus
      fluorocytosine in 6. Two patients died within the first 2 weeks. Maintenance
      therapy with fluconazole was effective and well tolerated, with 3 patients dying
      from causes other than cryptococcal meningitis. We recorded a survival rate over
      12 months in 33% of patients.

PMID- 1643147
TI  - Gene transfer in vivo with DNA-liposome complexes: safety and acute toxicity in
      mice.
AB  - DNA can be introduced into a variety of cell types after formation of liposomal
      complexes with cationic lipids. In this report, conditions have been established
      to optimize the production of DNA-liposome complexes that efficiently transfect
      cells. The safety and toxicity of this method of gene delivery have been assessed
      after in vivo administration, either by intravenous or direct intratumor
      injection. Nine to eleven days after intravenous injection, DNA was found
      primarily in heart and lung tissue by PCR analysis. No abnormalities were evident
      from histologic examination of tissue, examination of tissue-specific serum
      enzymes, routine biochemical parameters, or electrocardiographic monitoring. DNA
      liposome complexes can therefore be used for the delivery of recombinant genes in
      vivo with minimal toxicity.

PMID- 1643148
TI  - The greatest rewards and the heaviest penalties.

PMID- 1643149
TI  - Resource needs for institutional programs in human gene therapy.

PMID- 1643150
TI  - Retroviral-mediated gene transfer of bone marrow cells during autologous bone
      marrow transplantation for acute leukemia.

PMID- 1643151
TI  - Phase I study of cellular adoptive immunotherapy using genetically modified CD8+
      HIV-specific T cells for HIV seropositive patients undergoing allogeneic bone
      marrow transplant. The Fred Hutchinson Cancer Research Center and the University
      of Washington School of Medicine, Department of Medicine, Division of Oncology.

PMID- 1643152
TI  - Abstracts of the VIth Congress of the International Society for Peritoneal
      Dialysis. Thessaloniki, Greece, October 1-4, 1992.

PMID- 1643153
TI  - Thymidine kinase: a tumor marker with prognostic value for non-Hodgkin's lymphoma
      and a broad range of potential clinical applications.
AB  - Thymidine kinase (TK) is a cellular enzyme which is involved in a "salvage
      pathway" of DNA synthesis. It is activated in the G1/S phase of the cell cycle,
      and its activity has been shown to correlate with the proliferative activity of
      tumor cells. Additionally, certain viruses are able to induce cellular TK
      production and activity. Clinical studies have reported elevated serum TK levels
      in a variety of neoplasias. The majority of these studies concerned hematologic
      malignancies. TK seems to be a useful marker in non-Hodgkin's lymphoma, where it
      correlates with clinical staging and provides significant prognostic information
      on (progression-free) survival. Preliminary results in acute myeloid leukemia
      indicate that pretreatment serum TK values may predict the response to the first
      induction chemotherapy. Moreover, serum TK appears to have some clinical value in
      such solid tumors as prostate cancer, breast cancer, and small-cell lung cancer,
      whereas it is not a reliable marker of non-small-cell lung cancer and brain
      tumors.

PMID- 1643154
TI  - Differential expression of cell surface integrins on human mast cells and human
      basophils.
AB  - Integrins are multifunctional recognition molecules and are expressed on various
      hematopoietic cells. In the present study expression of integrins on the cell
      surface of human mast cells and human basophils was investigated by using
      monoclonal antibodies (mAbs) and indirect immunofluorescence. Human mast cells
      were obtained from lung (n = 5), uterus (n = 5) and skin (n = 4). Human blood
      basophils were obtained from normal donors (n = 2). In addition, HMC-1 cells
      (human mast cell line) and KU-812 cells (a basophil cell line) were analyzed.
      Primary mast cells were found to react with mAbs directed against the common beta
      chain of beta 1 integrins (CD 29), the alpha chain of VLA-4 (CD 49 d) and VLA-5
      (CD 49 e), the beta chain of beta 3 integrins (CD 61), and the alpha chain of the
      vitronectin receptor (VNR) (CD 51). Mast cells were not recognized by mAbs to
      beta 2 integrins (CD 18, CD 11 a, CD 11 b, CD 11 c), the alpha chain of VLA-2 (CD
      49 b), and VLA-6 (CD 49 f). No differences in expression of integrins on human
      mast cells obtained from different organs were found. HMC-1 cells and primary
      mast cells expressed an almost identical pattern of integrins. Human basophils
      and KU-812 cells were found to react with mAbs directed against beta 1-integrins
      (CD 29, CD 49 b, CD 49 d, CD 49 e) and beta 2-integrins (CD 18, CD 11 a, CD 11 b,
      CD 11 c). Together, mast cells and blood basophils express a unique pattern of
      integrins. These cell surface structures may be involved in the distribution of
      basophils and tissue mast cells and their accumulation and function in inflammed
      tissues.

PMID- 1643156
TI  - Effects of a preformed extracellular matrix on long-term serum-free bone marrow
      culture.
AB  - The extracellular matrix (ECM) produced by the stromal layer plays a key role in
      the regulation of commitment and differentiation of hematopoietic cells. Long
      term bone marrow culture (LTBMC) allows analysis of the stromal microenvironment.
      Recently, serum-free LTBMC has been described, but the formation of a classical
      adherent layer was never observed under these conditions. We have evaluated the
      effect(s) of a chemically well defined ECM on serum-free and serum-dependent
      LTBMC. In serum-dependent cultures ECM did not induce a significant increase of
      hematopoiesis. In serum-free conditions, a marked improvement of hematopoiesis
      was observed, both in terms of CFU-GM and BFU-E yield and in duration of
      cultures. A confluent stromal layer was observed only in the presence of ECM. The
      present results indicate that the addition of ECM to serum-free cultures provides
      a standardized culture condition, while improving progenitor cell recovery and
      allowing formation of a confluent stromal layer. Moreover, ECM+LTBMC may provide
      a model to study the effect(s) of adhesive proteins and hematopoietic growth
      factors normally present in serum.

PMID- 1643155
TI  - Ph-negative and bcr-negative atypical chronic myelogenous leukemia: biological
      features and clinical outcome.
AB  - We report the clinical, hematologic, cytogenetic, and molecular characteristics
      of 13 patients with Philadelphia-negative (Ph-), bcr-negative atypical chronic
      myelogenous leukemia (CML). In the majority of cases, the phenotypic features at
      presentation resembled those of typical CML. However, these patients presented
      with a higher median age, lower median hemoglobin levels, and lower leukocyte and
      platelet counts than patients with Ph-positive CML. Cytogenetic analysis showed
      an abnormal karyotype in only one case. Southern blot investigation, using probes
      exploring the entire M-bcr region, demonstrated the absence of genomic bcr-abl
      rearrangements. The assessment of clonality in five patients (study of X
      methylation patterns in females heterozygous at the DXS255 locus) indicated the
      proliferation of a monoclonal cell population. Disease evolution was mostly
      characterized by bone marrow failure, extramedullary infiltrates, and poor
      response to chemotherapy, without evidence of overt acute transformation. Our
      observations suggest that some hematologic and clinical features and the
      modalities of disease progression are presently the most helpful factors in
      distinguishing these bcr/abl-negative patients from those with typical bcr+CML.
      The differences existing also with chronic myelomonocytic leukemia (CMMoL), allow
      the consideration of ph-/bcr- CML as a separate entity, the nature of which
      remains to be elucidated.

PMID- 1643157
TI  - Increase in Ara-C sensitivity in Ara-C sensitive and -resistant leukemia by
      stimulation of the salvage and inhibition of the de novo pathway.
AB  - In this study the hypothesis that inhibition of the de novo pathway results in
      stimulation of salvage pathway activity was tested. The key enzyme in the balance
      between these two pathways is ribonucleotide reductase (RR), which can be
      inhibited by hydroxyurea (HU). The metabolism of 1-beta-D
      arabinofuranosylcytosine and 5-Aza-2 deoxycytidine (Aza-dC), which are activated
      via the salvage pathway, was evaluated in cells from Ara-C-sensitive and 
      resistant myelocytic leukemia cell line (BNML-Cl/0 and BNML-Cl/Ara-C). The
      combination of HU and Ara-C caused as much as a threefold increase of Ara-CTP; it
      significantly increased the incorporation of Ara-C into DNA and induced
      synergistic cytotoxicity, as evaluated in a colony assay. Even in the
      deoxycytidine (CdR) kinase-deficient Ara-C-resistant cell line, HU was partially
      able to restore sensitivity to Ara-C and Aza-dC. dCTP levels are reduced during
      the first 10 h after incubation with HU, but this effect vanishes at the time
      when phosphorylation is maximal. Increased CdR kinase activity in cell-free
      extracts could explain the enhanced synthetic salvage pathway activity, which is
      likely due to the fact that more enzyme is present (Vmax has increased by Km
      unchanged). RR inhibition combined with Ara-C might provide a means of
      eliminating leukemic cells with suboptimal anabolic salvage pathway activity,
      which otherwise survive Ara-C chemotherapy.

PMID- 1643158
TI  - Cyclosporin A in aplastic anemia--report of a workshop.
AB  - The management of aplastic anemia continues to challenge clinical investigators.
      With bone marrow transplantation or immunosuppression the prognosis of the
      patient with aplastic anemia has improved remarkably. For patients who are not
      eligible for bone marrow transplantation, antilymphocyte globulin has become the
      standard treatment. There is growing evidence that some patients also respond to
      immunosuppression with cyclosporin A. Further data suggest that combination of
      cyclosporin A with antilymphocyte globulin or androgens might be beneficial. An
      international workshop summarized the data on cyclosporin A treatment in aplastic
      anemia and attempted to create guidelines for the use of cyclosporin A in the
      management of aplastic anemia.

PMID- 1643159
TI  - A monoclonal antibody-linked immunoassay for hemoglobin H disease.
AB  - A murine monoclonal antibody (mAb) was generated that recognizes hemoglobin (Hb)
      H, the tetrameric form (beta 4) of human beta-globin chains. The antibody beta 4
      1 (gamma 1, kappa) does not react with Hbs A, F, Bart's, or isolated beta chains,
      indicating that the antibody recognizes an epitope comprised of multiple beta
      chains. A simple, rapid, and sensitive enzyme immunoassay was established to
      detect and quantitate Hb H in hemolysates from subjects with Hb H disease. The
      delta globin level in these patients was also measured using the monoclonal
      antibody delta-1, which is specific for delta chains of Hb A2. With these assays,
      20 hemolysates from subjects with Hb H disease' ten from normal adults and ten
      from newborn babies were analyzed. The percent of Hb H ranged from 1.5% to 25% in
      Hb H patients. There was a significant average reduction (32%) in delta chains in
      these samples as compared with the normal average adult value. The decreased
      expression of alpha chains thus results in a reduction of the levels of normal
      Hbs A and A2 and accumulation of beta 4, causing Hb H disease.

PMID- 1643160
TI  - Anti-phospholipid antibodies bind to platelet microparticles in idiopathic
      (autoimmune) thrombocytopenic purpura.
AB  - We recently reported that IgM antibody-related microparticles exist in some
      patients with idiopathic thrombocytopenic purpura (ITP) [14]. In this study, we
      investigated the relationship between antiphospholipid (cardiolipin and
      phosphatidylinositol) antibodies and microparticles in 56 ITP patients. We used
      an ELISA to detect anti-phospholipid antibodies. IgG antibodies against
      cardiolipin and phosphatidylinositol were detected in 13 and 12 patients,
      respectively. The titers of IgG antibodies against these phospholipids did not
      correlate with the platelet-associated IgG level or the platelet count. Next, we
      investigated the binding of anti-phospholipid antibodies to platelets and
      microparticles. Microparticles were obtained by incubating washed platelets with
      collagen plus thrombin. ITP plasma containing IgG-class anti-phospholipid
      antibodies showed significantly increase binding to microparticles compared with
      plasma without such antibodies (p less than 0.001). Our results suggest that anti
      phospholipid antibodies could affect the function of platelet microparticles in
      ITP.

PMID- 1643161
TI  - TNF induces cytoplasmic vesicles in actinomycin D-treated K 562 cells.
AB  - We report here that tumor necrosis factor alpha (TNF) induces peculiar
      cytoplasmic vesicles in the human erythromyeloid leukemia cell line K 562,
      sensitized to the cytotoxic action of TNF by a treatment with the inhibitor of
      transcription actinomycin D. These vesicles are well delineated
      ultrastructurally. The formation of these vesicles is characteristic for the
      combination of actinomycin D with TNF and precedes the changes of apoptosis and
      cellular disintegration. These vesicles correspond to an intermediate step in the
      cytotoxicity caused by TNF and may indicate that reactive metabolites are
      involved in the mechanism of action of TNF.

PMID- 1643162
TI  - Lymph node histology simulating T-cell lymphoma in adult-onset Still's disease.
AB  - A patient with adult-onset Still's disease (AOSD) underwent lymph node biopsy as
      part of initial evaluation for fever of unknown origin. The lymph node histology
      showed a massive, diffuse immunoblastic hyperplasia, simulating T-cell lymphoma.
      This nodal histology differs from rheumatoid arthritis, where mostly a follicular
      B-cell reaction predominates. Evaluating fever of unknown origin when one is
      unacquainted with this massive immunoblastic hyperplasia can lead to the wrong
      diagnosis of T-cell lymphoma in patients with AOSD.

PMID- 1643164
TI  - Reversible bone marrow aplasia induced by naproxen.
AB  - We report a case of reversible bone marrow aplasia related to the use of
      naproxen. A 71-year-old women developed severe pancytopenia after she had been
      treated with naproxen for more than 8 weeks. Bone marrow examination showed
      marked hypocellularity compatible with aplastic anemia. Full recovery of the
      pancytopenia and bone marrow was observed when naproxen was discontinued. Absence
      of exposure to other drugs and lack of underlying disorders known to cause bone
      marrow aplasia makes this case unique.

PMID- 1643163
TI  - Sweet's syndrome as the presenting symptom of hairy cell leukemia with
      concomitant infection by Mycobacterium kansasii.
AB  - A patient with Sweet's syndrome and leukopenia is reported. Hematological
      evaluation revealed hairy cell leukemia (HCL). The clinical picture was dominated
      by persistent fever, which is a common feature of both Sweet's syndrome and HCL.
      Since fever frequently reflects concomitant infection in HCL, a thorough search
      for infectious disease was performed. Blood cultures grew Mycobacterium kansasii.
      The patient recovered after treatment with recombinant interferon-alpha (r-IFN
      alpha) and tuberculostatic drugs. Remarkably, the skin lesions completely
      regressed within 1 week after the start of r-IFN-alpha. In the literature,
      Sweet's syndrome is rarely mentioned as a feature of HCL. Mycobacterial disease,
      especially atypical mycobacteria, is relatively often seen in HCL.

PMID- 1643165
TI  - Immunohistochemical and histopathological study of experimental rabies infection
      in mice.
AB  - An immunohistochemical and histopathological study using the ABC technique was
      carried out to examine time-sequential virus spread in the central nervous system
      (CNS) of mice after inoculation with the CVS strain of fixed rabies virus by
      different routes; intracerebral (ic), intraocular (io), intranasal (in),
      intramuscular (im) and subcutaneous (sc). Only the ic and io inoculations caused
      fatal infections, so that detailed analysis was conducted on mice inoculated by
      these two routes. In ic-inoculated mice, viral antigens were detected mainly in
      neurons in the cerebral cortex and in the pyramidal cells and granular cells of
      the hippocampus. After io inoculation, viral antigen was first detected in the
      trigeminal nerve ganglia, following which it spreads to the cerebral cortex and
      cerebellum. In the hippocampus only a few cells were viral antigen-positive at
      the early stage after io inoculation. There were no inflammatory lesions or Negri
      bodies in the CNS of mice infected by either route. This suggests that clinical
      signs such as ataxia or depression leading to death may be due to the direct
      effect of the virus on the functions of neural cells, but not to inflammatory
      reactions. The ABC method will be useful for the early diagnosis of suspected
      patients or animals to have the disease when conventional histopathological and
      immunofluorescent antibody techniques can not detect lesions or viral antigens.

PMID- 1643166
TI  - Relationship between halftime for sulfobromophthalein clearance and post-surgical
      prognosis in cows with abomasal displacement.
AB  - In 47 dairy cows with abomasal displacement, 34 (72%) cows were confirmed to have
      the lipid infiltration in liver by biopsy examinations. The pathological degree
      of the lipid infiltration was significantly higher in the cows with left abomasal
      displacement than in those with right one. The halftime for sulfobromophthalein
      clearance (BSP-T1/2) was markedly increased in nonrecovered cows with left
      abomasal displacement. In left abomasal displacement cases, cows with the T1/2
      less than 11 min recovered regardless of the degree of liver lipid infiltration,
      but those with the T1/2 longer than 11 min showed a significantly lower recovery
      rate (44%). Therefore, it was concluded that the BSP-T1/2 was one of valuable
      parameters for predicting the prognosis of this disease.

PMID- 1643167
TI  - Equine haptoglobin: isolation, characterization, and the effects of ageing,
      delivery and inflammation on its serum concentration.
AB  - Haptoglobin (Hp) was isolated from equine serum by ammonium sulphate
      precipitation, anion-exchange chromatography and gel filtration. Equine Hp which
      migrated to the alpha 2-globulin region in electrophoresis, contained 2 fractions
      with molecular weights (NW) of 108,000 and 105,000, and each fraction consisting
      of 2 subunits. Quantitative measurement of Hp in equine serum was performed by
      the single radial immunodiffusion method using anti-equine Hp serum. In
      clinically normal horses, the highest concentration of serum Hp was found in
      newborn foals and a high value was maintained until 12 months of age. The
      concentration then decreased with age. Normal Hp values were 5.25 +/- 2.36 mg/ml
      in foals (less than or equal to 12 months old), 2.19 +/- 1.54 mg/ml in adult
      horses (greater than or equal to 18 months old) and 3.62 +/- 0.81 mg/ml in all
      horses. Serum Hp concentration in mares during the perinatal period in comparison
      with the normal adult female was high for 4 months pre-partum, a passing increase
      at delivery, and then decreased at 2 weeks post-partum returning to normal within
      1 month of delivery. In horses with experimentally-induced inflammation, serum Hp
      concentration began to increase immediately after treatment and reached the
      highest value, 1.5 to 9 times higher than those of pre-treatment at 2 to 5 days,
      then decreased within 4 weeks. It was also elevated in most cases of horses with
      clinically inflammatory signs.

PMID- 1643168
TI  - Production of the vacuolation factor of Bacillus cereus isolated from vomiting
      type food poisoning.
AB  - Vacuole response in HEp-2 cells was induced with culture supernatants of Bacillus
      cereus strains isolated from outbreaks of vomiting- and diarrheal-type food
      poisoning grown in rice flour and laboratory media. High vacuole response was
      obtained with culture supernatants of B. cereus strains isolated from vomiting
      type food poisoning grown in cooked rice suspension or on a cooked rice plate,
      whereas no response was obtained with those of the same strains grown in brain
      heart infusion and trypto-soya broth media. The vacuole activity appeared only
      after spore formation of B. cereus. The activity was stable to proteolytic
      enzymes, heating, and exposing to pH 2.0 and 11.0. Of 124 strains isolated from
      B. cereus food poisoning that were tested, the vacuole activity was observed by
      68 of 110 (61.8%) of the strains isolated from the vomiting-type food poisoning
      but not by all strains (14 strains) from diarrheal-type ones. Moreover, the
      vacuole response in the HEp-2 cells was found to be induced by 56 of 76 (73.7%)
      of the serotype H-1 strains isolated from vomiting-type food poisoning.

PMID- 1643169
TI  - Morphological changes of epiphyseal plate in the long bone of chondrodysplastic
      dwarfism in Japanese brown cattle.
AB  - A total of 20 cases of disproportionate calves on Japanese Brown cattle were
      examined morphologically. Investigation of 5 affected calves revealed that the
      insufficiency of endochondral ossification was confined only to the long bones of
      the limbs and was not accompanied by other associated changes. On the basis of
      the histological changes of epiphyseal plate and the affected site, this
      condition may be called chondrodysplasia of the rhizomelic type. Therefore, this
      disorder was defined as a bovine dwarfism. From three dimensional image analysis
      and histological changes of the tibial proximal portion in the other 15 cases,
      deformity and shortness of the tibia were related to the state of distribution
      and the degree of damages of the epiphyseal plate. In the affected cartilage
      matrix, cystoid degeneration, fibrous striation, bone spicule, necrotic foci and
      rent were found. Inadequate metachromasia suggests the abnormal staining of
      sulfated glycosaminoglycans and alcian blue stainability may be attributable to
      the abnormal interactions between proteoglycan and other matrix components. At
      the interface of cartilage and bone, irregular calcification, fibrotic scar and
      sealing by osseous tissue with relation to vascularity were found. These changes
      in this study indicated the failure of modeling on the epiphyseal plate, showing
      disturbance of chondrocytic differentiation and abnormal formation of the matrix.

PMID- 1643170
TI  - Prevalence of Listeria (spp.) in wild rats captured in the Kanto area of Japan.
AB  - In the Kanto area a total of 245 wild rats were captured. All rats captured in
      Ikebukuro (110 rats) and 9 out of 41 rats in Yokohama were Rattus rattus, and all
      other 126 rats were Rattus norvegicus. In Kashima and Ikebukuro, listeria was
      isolated from 28 rats (77.8%) and 27 rats (24.5%), respectively, but in the other
      4 areas listeria was isolated from 0-7% rats. Listeria monocytogenes was isolated
      from 12 rats (10.9%) captured in Ikebukuro and 2 rats in Kashima and Numazu. The
      frequent isolation of L. monocytogenes in buildings suggests the possibility of
      R. rattus as a reservoir of L. monocytogenes and the continual environmental
      contamination in buildings by L. monocytogenes.

PMID- 1643171
TI  - Activation of bovine peripheral blood monocyte and its suppressive effect on
      parasitemia in Theileria sergenti infected calves.
AB  - Activation of bovine peripheral blood monocytes and its suppressive effect on
      parasite growth was examined in Theileria sergenti-infected calves by using a
      rosette assay that detects changes in Fc receptor expression and by luminol
      dependent chemiluminescence response. Monocyte activation preceded the peak of
      parasitemia but was depressed parallelly with the growth of the parasites. When
      four calves were treated with prednisolone, three showed a good correlation
      between the suppression of monocyte activity and an increase of parasitemia.

PMID- 1643172
TI  - Cardiac musculature of the cranial and caudal venae cavae and the pulmonary vein
      in the fowl.
AB  - The cardiac musculature of cranial and caudal venae cavae and pulmonary vein was
      examined to clarify its distribution pattern in the fowl using both light and
      electron microscopies. The musculature was distributed from the heart to the root
      of subclavian vein in the cranial vena cava, to the cranial margin of the liver
      in the caudal vena cava, and to the left and right distal pulmonary veins in the
      pulmonary vein, respectively. Judging from the morphology and distribution
      pattern in the venous wall, the cardiac musculature in the fowl is thought to
      share the same phylogenic origin with that in mammals. The ultrastructure of
      cardiac myocytes including transitional cells in the cranial vena cava and the
      pulmonary vein resembled that of atrial myocytes. While, the typical specialized
      myocytes such as Purkinje fiber were found in the caudal vena cava of the fowl.

PMID- 1643173
TI  - Disseminated mycoses in cattle. A study on nine autopsy cases.
AB  - Nine cases affected with disseminated mucormycosis (1.3% of all autopsy cases and
      20.0% of systemic mycosis) were found among bovine systemic mycosis examined from
      1975 to 1985. The disseminated lesions were found in the lungs (3 cattle), heart
      (2 cattle), liver (2 cattle), spleen (1 beef cattle), kidneys (1 cattle), central
      nervous system (1 cattle) and lymph node (1 cattle). Histological examination
      revealed granulomatous lesions, necrotic foci including infarcts, and
      thromboangiitis with the hyphae of a member of the Zygomycetes and neutrophil
      reaction. Granulomatous lesions with asteroid bodies were found in the liver.
      Metastatic foci were established from the primary lesions found in the alimentary
      organ (4 from the forestomach or abomasum and 1 from the tongue). One case
      resulted from uterine mucormycosis, and no primary lesion was found in the other
      3 cattle. Complicated infection with respiratory aspergillosis occurred in 4
      cases with alimentary mucormycosis. All of the 9 cattle had predisposing
      disorders. Six cattle had been manifested with prolonged debilitating conditions.
      Anemia was present in 4, leukopenia in 2 and lymphopenia in 1 cattle.

PMID- 1643174
TI  - Immunohistochemical observations on pneumonic lesions caused by Rhodococcus equi
      in foals.
AB  - An immunohistochemical analysis of Rhodococcus equi-induced pneumonia in 10 foals
      was performed by biotin-streptavidin system. The detection of R. equi was more
      sensitive in immuno-stain using anti-R. equi serum than in Gram's stain. This
      bacteria also reacted to anti-BCG serum. Lysozyme and alpha 1-antitrypsin were
      detectable in macrophages. A particularly intense staining was observed in
      association with intracellular bacteria. Though a degree of reaction for alpha 1
      antichymotrypsin was very low in comparison with lysozyme and alpha 1
      antitrypsin, it was also demonstrated in macrophages ingesting R. equi. These
      bacteria were almost intact under an electron microscope. Therefore, the surface
      components of R. equi may play important roles of protection from intracellular
      enzymes of macrophages. The cells containing intracytoplasmic IgM, IgG or IgA
      were a few in number and scattered predominantly around the pneumonic lesion. It
      is considered that the bactericidal activity by immunoglobulins may be weak in
      comparison with phagocytosis by macrophages.

PMID- 1643175
TI  - Comparison of the distribution of carbonic anhydrase isozymes (CA-I, CA-II, CA
      III) in the rat gastrointestinal tract.
AB  - The present paper described the immunohistochemical distributions of carbonic
      anhydrase (CA) isozymes. CA-I, CA-II and CA-III, in the epithelium lining the rat
      gastrointestinal tract, with rabbit antibodies to equine CA-I, CA-II and CA-III.
      Prior to the immunohistochemical examinations, the crossreactivities of these
      antibodies to the rat-antigens were confirmed in this study. In the stomach,
      surface epithelial cells and parietal cells of the glandular region showed an
      immunoreactivity only to CA-II. In the large intestine, each immunoreactivity to
      CA isozyme (CA-I, CA-II and CA-III) was localized in the upper portion of
      intestinal glands, and decreased toward the distal digestive tract, but absent in
      the small intestine. The present histological findings suggested that the CA
      isozymes might play a role in the ion-transportation during the water absorption
      in the rat large intestine.

PMID- 1643176
TI  - Annual changes of testis size, seminiferous tubules and plasma testosterone
      concentration of wild Sika deer (Cervus nippon yesoensis Heude, 1884) in
      Hokkaido.
AB  - Testis size, seminiferous tubules and plasma testosterone concentrations showed
      conspicuous annual changes in Sika deer of Hokkaido, Japan. The onset of the
      spermatogenic process occurred in July or August. Spermatogenic activity had
      already reached its height in late October, at the beginning of the rutting
      season, and had begun to decline in late December. Spermatogenesis had stopped in
      February or March. Plasma testosterone concentrations showed very high levels in
      late October and early November, but was almost at the basal level in February,
      March, June and December. The wide individual variation of the plasma levels in
      October suggest pulsatile secretions of testosterone.

PMID- 1643177
TI  - An improved method for extraction and cleanup of aflatoxin B1 from liver.

PMID- 1643178
TI  - Unilateral optic nerve aplasia in an F344 rat with special reference to
      pathomorphological changes of the optic nerve pathways.

PMID- 1643179
TI  - Bovine cases of urolithiasis treated with traditional herbal medicine, P-3.

PMID- 1643180
TI  - Glucose utilization in cats, dogs and cows measured by euglycemic insulin clamp
      technique.

PMID- 1643181
TI  - Whole-mount preparation of renin-containing cells in hydronephrotic mice.

PMID- 1643182
TI  - Fc receptor expression and immune phagocytosis in chicken monocytic cell lines.

PMID- 1643183
TI  - Effect of proteolytic enzyme on experimental infection of mice with Pseudomonas
      aeruginosa.

PMID- 1643184
TI  - An occurrence of vitamin A deficiency in chickens in Zambia.

PMID- 1643185
TI  - Inhibition of germinal vesicle breakdown of isolated cumulus-free mouse oocytes
      in culture by a calcium inhibitor, TMB-8.

PMID- 1643186
TI  - Fine structure of spreading hemocytes of an estuarine gastropod mollusc, Clithon
      retropictus.

PMID- 1643187
TI  - Recent advances in the growth and isolation of primitive human haemopoietic
      progenitor cells.

PMID- 1643188
TI  - N-methylformamide effects on cell proliferation and antigenic pattern in HT-29
      colon carcinoma cell line.
AB  - The effects of the differentiating agent N-methylformamide (NMF) on cell
      proliferation and antigenic pattern of HT-29 colon carcinoma cells have been
      investigated. The cell line was cultured in the presence, or absence, of 1% NMF
      and tested for the above mentioned characteristics, both in vitro and after
      injection into nude mice. The percentage of cells in the various cell cycle
      compartments was estimated by flow cytometry. The presentation on the cell
      surface of molecules such as tumour associated antigens (TAAs), HLA class I
      molecules and epidermal growth factor receptor (EGF-R) was analysed by ELISA,
      flow cytometry and immunohistochemistry. Results demonstrate that NMF impairs HT
      29 cell proliferation with a remarkable accumulation in the G0/G1 phases, as well
      as inducing a modification of the membrane antigenic pattern. The presence of NMF
      in the culture medium decreases the TAAs and EGF-R whereas HLA antigen maintains
      the same level of positivity in the two cell lines. These alterations are
      consistent with a different behaviour in vivo of the tumours originated from NMF
      treated and untreated cells. Tumours derived from NMF treated cells show a delay
      in the appearance and low levels of immunodetectable carcinoembryonic antigen
      (CEA) molecules.

PMID- 1643189
TI  - Nuclear and chromosomal replication patterns in chorionic villi cells by
      bromodeoxyuridine labelling and DNA flow cytometry.
AB  - Cell kinetics of chorionic villi (CV) were studied by BrdUrd-incorporation
      detected by fluorescence-plus-Giemsa and BrdUrd-antibody techniques, and by DNA
      flow cytometry. Growth characteristics of long-term cultures of CV resembled
      fibroblasts with a total cell cycle time of 26 h, final S phase of 9 h,
      penultimate S phase of 16 h and G2/M phase of 3-4 h. Especially useful for a
      quick routine diagnostic approach, Ultroser RG, a commercially available serum
      supplement, significantly increased cell proliferation and stabilized cell cycle
      lengths to a total cell cycle time of 14 h, final S phase of 7 h, penultimate S
      phase of 6 h and G2/M phase of 4 h. Moreover, mitotic activity steadily increased
      in cultured CV, when studying six successive subculturings. This reflects
      adaptation to the culture conditions rather than an inherent response of cultured
      CV cells of increasing passage numbers. Native villi exposed to BrdUrd
      immediately after biopsy show lower rates of uptake than do aliquots after
      overnight incubation. As shown by BrdUrd-pulse labelling studies, more than 7 h
      are required to overcome the proposed 'biopsy stress'. This correlates with
      routine diagnostic techniques, in which many more metaphase cells are observed in
      short-term cultures than in direct preparations.

PMID- 1643190
TI  - Plasma cell proliferation in the chicken harderian gland.
AB  - Studies to examine the percentages of proliferating plasma cells (PPC) in the
      Harderian gland (HG) were carried out in chicks between 5 and 12 weeks of age.
      Two methods, 5-bromo-2'-deoxyuridine (BrdUrd) incorporation into DNA and flow
      cytometric analysis of propidium iodide (PI) stained cells, were employed in
      control and emetine dihydrochloride treated birds. Flow cytometric analysis of PI
      stained cells showed the percentages of plasma cells in S phase were highest
      between 6 and 8 weeks of age. After this period of time, the number of S phase
      plasma cells decreased and remained low through 12 weeks of age. The lowest
      percentages of plasma cells in G0 + G1 were found at 6 and 8 weeks of age, and
      all ages had equal percentages of plasma cells in G2 + M phase. After
      administration of the protein synthesis inhibitor emetine dihydrochloride a
      common pattern of plasma cell depletion and repopulation in the HG was observed.
      At 3 and 5 days post-treatment the plasma cell population in the gland decreased
      and by 7 days post-treatment repopulation of the gland with plasma cells had
      taken place. Anti-BrdUrd staining of frozen sections revealed that the number of
      PPC were decreased at 3 days after emetine treatment but were as high as, or
      higher than, controls at 5 and 7 days post-treatment. Flow cytometric analysis
      indicated that some birds were more severely affected by emetine. Namely, the
      percentages of plasma cells in S phase were lower at 3 and 5 days post-treatment.
      Even though most birds were severely affected by emetine treatment during the
      experiments, they possessed a cell population with the proliferative capacity to
      quickly repopulate the HG by 7 days post-emetine treatment.

PMID- 1643191
TI  - Chromosomal influence on hybrid cell proliferation.
AB  - When normal cells and cancer cells (usually from the same species) are
      experimentally fused the resultant hybrid cells show loss of the tumorigenic
      phenotype. To examine the phenotypic phenomenon of growth suppression in hybrid
      cells in vitro, we examined the doubling times of somatic cell hybrids which
      contained single or multiple chromosomes derived from another species (inter
      species hybrids). In all of the hybrid lines examined, the presence of
      transferred chromosomes prolonged the cell population doubling times in
      proportion to the number of such chromosomes found in the hybrid lines. These
      findings provide additional evidence to support the hypothesis that increasing
      the genetic burden of cells may reduce the division potential of cells cultured
      in vitro.

PMID- 1643192
TI  - Sensory gating in rats depleted of dopamine as neonates: potential relevance to
      findings in schizophrenic patients.
AB  - Based on a recent hypothesis of reduced subcortical dopaminergic tone, evidence
      of early neurodevelopmental deviation, and acoustic startle abnormalities in
      schizophrenia, we examined acoustic startle in adult animals depleted of dopamine
      (DA) as neonates. Male rat pups received intracerebroventricular injections of
      either 6-hydroxydopamine (6-OHDA, 100 micrograms) or its vehicle on postnatal day
      3. At 60 days of age, baseline startle and prepulse inhibition (PPI) of startle
      were assessed in a no injection condition, with all other animals receiving
      injections of saline or the DA agonist, apomorphine. Acoustic startle was
      elicited using 120 db white noise bursts alone or preceded by prepulses of 75,
      80, and 85 db. Animals treated with 6-OHDA exhibited a 93% depletion of striatal
      DA compared to vehicle-treated controls. Whereas DA depleted animals did not
      differ from controls in the no injection condition, they showed greater baseline
      startle and reduced PPI compared to controls after saline injections. Depleted
      animals also showed exaggerated responses to apomorphine, with greater increases
      in baseline startle, loss of habituation, and decreased PPI compared to controls.
      Findings indicate that neonatal DA depletions lead to increased baseline startle
      and impaired sensory gating in adulthood after saline injections and dopamine
      agonists compared to controls. These findings may be relevant to a subgroup of
      psychotic patients that exhibit similar startle abnormalities as well as signs of
      hypodopaminergic function.

PMID- 1643193
TI  - Variability of TRH test responses in depressed and normal elderly subjects.
AB  - Thyrotropin releasing hormone (TRH) tests were conducted in 33 elderly patients
      with Major Depressive Disorder and 99 normal elderly volunteers. A wide range of
      thyrotropin-stimulating hormone (TSH) responses to TRH injection was revealed. A
      gender effect was found such that men had significantly diminished TSH responses
      to TRH relative to women (p = 0.008). However, there were no significant
      differences noted between depressed patients and normal elderly subjects of
      either gender. It appears that the wide range of TSH responses to TRH found in
      normal elderly men and women blurs any measurable differentiation between
      depressed patients and normal subjects and thereby limits the usefulness of the
      TRH test in the study of depressive disorder in elderly patients.

PMID- 1643194
TI  - Neural development is regulated by classical neurotransmitters: dopamine D2
      receptor stimulation enhances neurite outgrowth.
AB  - The classical neurotransmitters serotonin and dopamine are thought to be involved
      in the etiology or treatment of a variety of psychiatric disorders. Recent
      studies suggest that these neurotransmitters may also have roles as neural
      morphogens during brain development. Previously, we have demonstrated that
      stimulation of serotonin 5-HT1A receptors selectively inhibited neurite branching
      in an in vitro system (Sikich et al 1990). In the present study, the
      developmental role of dopamine D2 receptors in the control of neurite outgrowth
      has been investigated by quantitating the morphological response of cortical
      neurons to agonist stimulation in vitro. Cultures of fetal rat frontal, cortical
      neurons were shown to express both alternatively spliced forms of D2 receptor
      messenger RNA (mRNA). The larger mRNA form predominated (D2A444:D2A415 ratio of
      about 6:1). In a small but significant percentage of these neurons, culture in
      the presence of the D2 receptor selective agonist, quinpirole, resulted in a
      three-to ten-fold increase in the length of neurites and in the number of branch
      points per neurite. These effects were blocked by the D2 receptor antagonists
      eticlopride and spiperone. Early abnormalities in the stimulation of dopamine or
      serotonin receptor subtypes could lead to the types of neuroanatomical changes
      observed in studies of schizophrenia, bipolar affective disorder, and autism.
      These morphogenic effects of classical transmitters could unite
      neurodevelopmental and neurotransmitter theories of the etiology of severe
      psychiatric disorders.

PMID- 1643195
TI  - Behavioral response to diazepam in a residential laboratory.
AB  - Two groups of three healthy adult male volunteers without histories of sedative
      or other drug abuse participated in 15-day residential studies. Each day
      consisted of a private work period (10 AM to 4:30 PM), during which subjects
      participated in traditional laboratory performance tasks, and a social period (5
      to 11:30 PM), during which subjects had access to recreational activities
      available under social or private conditions. Tobacco cigarettes and food were
      available throughout each day (9 AM to 12 PM). Diazepam (5 or 10 mg/70 kg) or
      placebo was administered orally twice daily in alternating three-consecutive-day
      intervals. Dosing order varied between groups. Diazepam had no effect on the
      total amount of time subjects spent in social conditions; however, the low dose
      increased verbal interaction, while the high dose decreased verbal interaction.
      Both doses disrupted performance on a second-order repeated-acquisition task but
      produced no effects on the other performance measures. Five of six subjects
      increased caloric intake following at least one dose, with the largest increases
      observed in subjects with the lowest baseline intake. Increases in subject
      reports of dose "Potency" and "Sedated" were also observed following the high
      dose. Diazepam doses routinely used in clinical settings influenced a variety of
      behaviors that are observed in the natural ecology, but not performance on
      accepted laboratory tasks.

PMID- 1643196
TI  - The interaction of motor, memory, and emotional dysfunction in Wilson's disease.
AB  - Measures of the degree of motor, psychiatric, and declarative memory disability
      were made in neurologically impaired and neurologically asymptomatic patients
      with Wilson's disease. All three types of disability were significantly greater
      in the neurologically impaired than in the asymptomatic patients. There was no
      significant interaction between these disabilities in the impaired patients
      suggesting that motor, psychiatric, and memory symptoms are three relatively
      independent sequelae of the copper-induced central nervous system (CNS) damage
      that underlies Wilson's disease.

PMID- 1643197
TI  - The effects of nicotine plus haloperidol compared to nicotine only and placebo
      nicotine only in reducing tic severity and frequency in Tourette's disorder.
AB  - We studied the effects of chewing nicotine gum on tic frequency and severity in
      10 patients with Tourette's disorder (TD) on haloperidol, versus 9 untreated TD
      patients; placebo gum was administered to 5 of these untreated patients.
      Videotapes of patients during a 2-hr period of 30 min baseline, 30 min gum
      chewing, and two 30-min postgum-chewing periods were utilized. For those TD
      patients on haloperidol, significant reductions occurred in tic frequency and
      severity during the gum-chewing and the two postgum-chewing periods. Nicotine gum
      alone caused a decrease in tic frequency only during gum-chewing and one postgum
      chewing period, while placebo gum showed no effect. In this study, nicotine
      markedly potentiated haloperidol effects in treating TD, and showed lesser
      effects on TD when used alone.

PMID- 1643198
TI  - Season of birth and electrodermal activity in functional psychoses.
AB  - The present study examined the association between electrodermal activity (EDA)
      and season of birth in a sample of first-episode patients with schizophrenia,
      schizophreniform disorder, and affective disorder with psychotic features, and in
      a normal control group. Patients with schizophrenia who were born during the
      season of excess risk (January-April) were less responsive than those born during
      other times of the year. They had lower skin-conductance levels and fewer skin
      conductance responses. No such effects were found in patients with
      schizophreniform or affective disorder, or in the normal subjects. When compared
      with the control group, winter-born schizophrenics showed significantly more
      evidence of hyporesponsivity. In contrast, nonwinter-born patients did not differ
      from normal subjects in skin-conductance level or number of skin-conductance
      responses. Schizophreniform patients born during the other seasons of the year
      were more likely to be hyporesponsive. The above results provide supporting
      evidence for the validity of the season of birth phenomenon. We hypothesize that
      a viral infection, or some other perinatal complication associated with winter
      and early spring births, leads to temporal lobe damage and consequent
      dysregulation of electrodermal activity in patients with schizophrenia.

PMID- 1643199
TI  - Thyroid hormones, body temperature, and antidepressant treatment.

PMID- 1643200
TI  - Effects of platelets and plasma on fibrinolysis.
AB  - The effects of various concentrations of platelets and plasma on in vitro t-PA
      induced fibrinolysis were investigated. At t-PA levels between 30 and 70 ng/ml,
      fibrinolysis proceeded faster in platelet-rich plasma (PRP) than in platelet-poor
      plasma (PPP). When PRP was serially diluted with PPP and the rate of fibrinolysis
      compared to PPP, higher platelet counts (up to 300 x 10(9)/l) were associated
      with increased enhancement of lysis. However, lysis was inhibited when platelets
      were added to plasma diluted with buffer. Thus, platelets enhance fibrinolysis in
      undiluted plasma but inhibit lysis in diluted plasma. This is probably because
      platelets provide a catalytic surface for fibrinolysis but also release
      inhibitors of fibrinolysis. In undiluted plasma, there would be sufficient
      fibrinogen and plasminogen to overcome the effect of the platelet inhibitors, but
      in diluted systems, the inhibitors would predominate, retarding fibrinolysis.

PMID- 1643201
TI  - Physiological inhibitors of coagulation in fulminant hepatic failure.
AB  - To study the effect of the severe loss of hepatic synthetic function on the
      inhibitors of coagulation we have measured protein S (total and free), protein C,
      heparin cofactor II and antithrombin III in 30 patients with fulminant hepatic
      failure. The results showed severe reduction in all inhibitor levels with mean
      (+/- SE) values of: protein S, 0.26 +/- 0.03 U/ml; protein C, 0.26 +/- 0.03 U/ml;
      heparin cofactor II, 0.12 +/- 0.02 U/ml and antithrombin III, 0.21 +/- 0.02 U/ml.
      Heparin cofactor II was significantly lower than the other inhibitors (P less
      than 0.01). Although the reduction in free protein S was significant in fulminant
      hepatic failure as compared to normal subjects (0.40 +/- 0.05 U/ml compared to
      1.02 +/- 0.08 U/ml, P less than 0.001), the ratio of free to total protein S was
      significantly increased (0.67 +/- 0.02 compared to 0.40 +/- 0.04, P less than
      0.01). Prothrombin time (INR) was significantly inversely correlated with total
      protein S (r = -0.56, P less than 0.001) and free protein S (r = -0.48, P less
      than 0.01), but not with the ratio of free to total protein S. No significant
      correlation between the different coagulation inhibitors and other measures of
      hepatic function could be detected. Although the loss of hepatic synthetic
      function appears to be the major cause of the loss of coagulation inhibitors,
      other effects such as increased consumption and rate of clearance may play a
      role. The balance of these will be reflected in the circulating levels of the
      coagulation inhibitors.

PMID- 1643202
TI  - Protein S negates the activated protein C inhibitory activity of plasma.
AB  - The inactivation of factor Va by the natural anticoagulant, activated protein C
      (APC) is subject to a number of regulatory mechanisms. This report examines the
      efficacy of APC in plasma and evaluates the role of the APC cofactor protein S in
      this milieu. The ability of protein S to enhance the anticoagulant effects of
      activated protein C was demonstrated using a factor Xa recalcification time of
      Al(OH)3 adsorbed plasma. At a set concentration of APC, increasing concentrations
      of protein S resulted in a linear and saturable potentiation of the activity of
      APC. This result was not reflected in a purified component assay, where the
      extent of factor Va inactivation by APC was only marginally augmented by protein
      S. The efficacy of the cofactor was not affected by variations in the
      concentration of factor Va. Similarly, increasing the protein S:APC molar ratio
      of 200:1 resulted in only a trivial enhancement of APC activity. To directly
      examine the proteolysis of factor Va by APC in plasma, a novel assay system
      containing Al(OH)3 adsorbed, factor V deficient plasma supplemented with purified
      human factor Va was developed. The addition of APC in varying concentrations to
      this system consistently yielded factor Va inactivation rates inferior to those
      seen in a purified component assay. This finding is consistent with the presence
      of APC inhibitory activity in plasma. When protein S was added to the plasma
      system, factor Va inactivation by APC was restored to a similar level to that
      observed in the purified system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643203
TI  - An ELISA for tissue factor using monoclonal antibodies.
AB  - Whereas tissue factor, a high-affinity cell-surface receptor and essential
      cofactor for the serine protease factor VII is constitutively present in certain
      tissues such as epithelial tissue, brain and placenta, it is not normally
      expressed by cells within the vasculature. However, the stimulation of monocytes
      and endothelial cells by a variety of inflammatory and immunological reactions
      results in the induction of cell surface tissue factor (TF) expression. TF is
      also expressed on tumour cells, and may play a role in tumour growth and
      metastasis formation. To examine the role of TF in these processes we developed
      monoclonal antibodies to human tissue factor apoprotein. The antibodies were
      characterized by neutralization of the procoagulant activity and by
      immunoblotting. With two of these monoclonal antibodies a sandwich ELISA was
      developed for the rapid quantitation of TF. The sensitivity of the assay permits
      extensive studies involving the modulation of TF expression on small numbers of
      cells. The results are comparable to the functional clotting assay as evaluated
      with unpurified TF and with the tumour cell line MCF-7. For certain applications,
      monitoring of cellular TF expression by ELISA using anti-TF monoclonal antibodies
      is preferable because it is not influenced by other coagulation factors or by
      inhibitors of procoagulant activity on the cells.

PMID- 1643204
TI  - Increased hydrogen peroxide formation in platelets of patients affected with
      essential thrombocythaemia (ET).
AB  - The basal platelet level of reactive oxygen species and their enhancement
      following stimulation by different agonists were determined in a selected group
      of patients with essential thrombocythaemia (ET). Activated platelets had lower
      levels of superoxide anion and higher intracellular concentrations of hydrogen
      peroxide than controls. Higher levels of lipid peroxidation induced by N
      ethylmaleimide were also observed. Measurement of the most important enzymes
      generating and scavenging these reactive oxygen species revealed increased
      specific activities of NADPH-cytochrome c reductase and superoxide dismutase and
      a decrease in platelet catalase activity in patients with ET. Since an abnormal
      production of oxygen radicals seems to be implicated in various pathological
      conditions and aging processes, the increased amount of hydrogen peroxide found
      in platelets of patients could be involved in some of the platelet alterations
      described in ET.

PMID- 1643205
TI  - Fibrin clots obtained from plasma containing heparin show a higher sensitivity to
      t-PA-induced lysis.
AB  - Although heparin is currently used in concomitance with thrombolytic agents to
      improve their efficacy, its effect on fibrinolysis is controversial. We have
      evaluated the sensitivity to t-PA-induced lysis of clots prepared from plasma
      preincubated in vitro with therapeutic concentrations of heparin. The extent of t
      PA-induced lysis was significantly increased by preincubation of plasma with 0.5
      and 1.0 U/ml heparin. The concentration of t-PA required to give similar lysis
      rates were reduced by up to five times after adding 1.0 U/ml heparin to plasma
      prior to clot formation. Heparin added to the t-PA-containing medium after clot
      formation did not exert any significant effect. The effect of heparin was not
      mediated by the inhibition of thrombin as preincubation of plasma with hirudin
      did not modify clot sensitivity to t-PA. We also found that heparin significantly
      modified fibrin assembly and clot structure as assessed by a turbidimetric assay.
      Pre-incubation of fibrinogen with heparin caused an increase in the speed of
      fibrin fibre polymerization and in the turbidity of the final fibrin gel; changes
      known to be associated with the formation of thicker fibrin fibres. Thus the
      effect of heparin on clot sensitivity to lysis appears to be due to an increased
      permeability of these clots to fibrinolytic components. This may contribute to
      the antithrombotic activity and to the haemorrhagic risk of heparin. These
      findings could be particularly important for clinical thrombolysis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1643206
TI  - The preparation of a sensitive partial thromboplastin reagent from bovine brain.
AB  - Commercial partial thromboplastin reagents markedly differ in their sensitivity
      to factor deficiency, heparin, or the lupus anticoagulant. These differences may
      be partly due to the variable phospholipid content of different commercially
      available reagents. For over 15 years, we have routinely used a partial
      thromboplastin prepared from human brain. In the past four years, we have been
      using a similarly prepared bovine partial thromboplastin reagent. This report
      describes the preparation of our partial thromboplastin reagent, as well as an
      analysis of the phospholipid composition of both the human and bovine
      thromboplastin reagents. Four separate brain preparations produced consistent
      percentages of the anionic phospholipids, phosphatidylserine, and
      phosphatidylinositol. The bovine reagent was also compared with commercial
      partial thromboplastin reagents in the detection of coagulation factor
      deficiency, heparin, and the lupus anticoagulant.

PMID- 1643207
TI  - Study of the protein S system in HIV-infected patients: acquired protein S
      deficiency or unsuitable assays?
AB  - The plasma protein S (PS) system was studied in 120 HIV seropositive patients
      (CDC classification: group II: n = 35; group III: n = 6; groups IVA, IVC2 or IVE,
      n = 38; groups IVB, IVC1 or IVD, n = 41). Total PS antigen and C4b-binding
      protein (C4b-BP) values were not significantly different from control values.
      Free protein S levels assessed by an immunological method in the supernatant of
      PEG-precipitated plasma samples (PEG-fPS) were below the normal limit in 85
      patients, lower values being found in patients with advanced HIV disease. No
      correlation was found between PEG-fPS levels and C4b-BP or total PS levels. At
      least 25 patients had a low functional PS value. Low functional levels of PS were
      found in each clinical group although there was no difference in the distribution
      of functional PS values among groups. Crossed immuno-electrophoresis showed an
      abnormal distribution of PS in some patients, but failed to confirm the marked
      decrease of free PS in patients with very low PEG-fPS. An impairment of the
      protein S system is observed in HIV-infected patients. However, the discrepancies
      found in some patients among the results of the various PS-related assays should
      lead to a cautious interpretation concerning the incidence of PS deficiency in
      HIV-infected patients.

PMID- 1643208
TI  - A one-step enzyme immunoassay for the determination of total tissue-type
      plasminogen activator (t-PA) antigen in plasma.
AB  - A reproducible and sensitive one-step enzyme immunoassay (EIA) was developed to
      determine total tissue-type plasminogen activator (t-PA) antigen in plasma. The
      EIA comprises two monoclonal catching antibodies and a polyclonal (goat) tagging
      antibody conjugated with horseradish peroxidase. There is an equal reactivity
      towards the several physiological t-PA forms, i.e., single-chain t-PA, two-chain
      t-PA and t-PA in complex with its naturally occurring inhibitor plasminogen
      activator inhibitor-type 1 (t-PA/PAI-1 complex). Additionally, the EIA does not
      discriminate between human melanoma t-PA and recombinant t-PA (Activase). The
      assay has a lower detection limit of approximately 0.5 ng t-PA per ml plasma,
      with a time-to-result of only 3.5 h.

PMID- 1643209
TI  - Increased lipopolysaccharide-induced tissue factor activity and tumour necrosis
      factor production in monocytes after intake of aspirin: possible role of
      prostaglandin E2.
AB  - To determine how aspirin intake might influence lipopolysaccharide (LPS)-induced
      tissue factor (TF) activity and tumour necrosis factor (TNF) in human blood
      monocytes, we collected blood before and at various times after intake of 300 mg
      aspirin in 25 healthy volunteers. Aspirin intake reduced LPS-induced thromboxane
      B2 and PGE2 production in whole blood by 50% and 65% respectively, measured 1 h
      after aspirin intake. Subsequently, a 95% rise in LPS-induced TF activity in
      monocytes was seen as compared to a 26% rise in TNF. The rise in TF activity was
      maximal within 1 h after aspirin intake and no further rise was observed 3, 4 or
      24 h after aspirin intake. In contrast, TF activity induced by incubating whole
      blood in the absence of LPS fell rapidly after the intake of aspirin. In separate
      experiments, a dose-dependent inhibition by PGE2 was observed in LPS-induced TF
      activity in monocytes. It is proposed that the increased LPS-induced TF activity
      and TNF production following aspirin intake may be due to suppressed PGE2
      formation. The more pronounced rise in TF activity compared to TNF production may
      be due to an enhancement of the platelet lipoxygenase pathway that has been shown
      to be important for LPS-induced TF activity in monocytes.

PMID- 1643210
TI  - Antithrombin and its deficiency states.
AB  - Antithrombin is the most important physiological proteinase inhibitor of thrombin
      and other coagulation proteinases. It is a single chain glycoprotein of MW 58,200
      which has sequence homology with alpha 1-antitrypsin and other members of the
      serpin superfamily of inhibitors. Two functional domains of importance have been
      identified, the reactive centre that interacts with the proteinase and a heparin
      binding domain. Failure to maintain an adequate level of functional antithrombin
      in plasma results in an increased risk of thromboembolism: deficiency can be
      inherited or acquired. There is still uncertainty regarding the prevalence of
      inherited deficiency and the prevalence of thrombosis in affected individuals.
      The production of antithrombin is under the control of a single gene which is
      localized on chromosome 1q 23-25. Characterization of the coding sequence, which
      is distributed over seven exons, has allowed the analysis of the molecular basis
      for inherited antithrombin deficiency. To date more than 100 cases have been
      successfully investigated at the gene and/or protein sequence level and 40 novel
      mutations have been identified. Mutations causing amino acid substitutions solely
      affecting the heparin binding site have thus far been located primarily at the N
      terminal region of the molecule, residues 7-129; this region has been postulated
      to align as a positive groove in the molecule that forms the primary contact
      region for the essential antithrombin binding pentasaccharide of heparin. Not all
      the residues in which substitutions have been found are basic and some serve to
      maintain the conformation of nearby basic regions. Examples of this are provided
      by the Pro-41 to Leu mutation and a recently investigated mutant, Leu-99 to Phe.
      The reactive site defects are an interesting group, including those that alter
      P1, P1' and P12-P10 residues. Perhaps more remote mutations can also be included
      such as Pro-429 to Leu. The P1 and P1' mutations directly block interaction of
      the proteinase with anti-thrombin, while P12-P10 mutants (which have mutations
      affecting serpin strand s4A) enable the substrate reaction to proceed to
      completion, i.e. the antithrombin-thrombin complex is not stabilized and the
      mutant inhibitor is transformed into a substrate. The effect of the Pro-429 to
      Leu substitution is impairment of the reactive site and heparin binding, and the
      finding that this variant is not completely recognized by some MAbs implies a
      conformational change at the C terminus. Another group (nine cases) of
      interesting mutations is emerging, that has its primary defect in or near serpin
      strand 1C, amino acid sequence 402-407.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1643211
TI  - A programmable stimulator for electrophysiological studies.
AB  - We report on the design and construction of a programmable stimulator for use by
      neuroscientists. The stimulator is small, lightweight, and low powered. It
      generates positive, negative, or positive and negative pulses with widths and
      periods programmed by the user. The stimulator has ten parallel outputs to enable
      it to drive ten preparations at one time. It operates from 50-60 Hz, 115 v AC or
      230 v AC and had a nominal peak-to-peak output of 30 volts. A liquid crystal
      display was used for the user interface and the timing was software-generated by
      a mincrocontroller.

PMID- 1643212
TI  - Physiological monitoring techniques for home health care.
AB  - Practical techniques of nonconstrained physiological monitoring which are
      acceptable in daily life have been attempted, and obtained preliminary results:
      Successive records of temperature profile on a bed provide information such as
      body movement, and sleep hours. ECG can be recorded automatically in a bathtub
      with electrodes on the inside wall of the tub. Heart rate can be measured by ECG
      taken at a toilet seat. Proposed techniques do not require any effort of
      measurement procedure to the subject, and thus it is expected that physiological
      data can be accumulated automatically even though subjects never aware the
      monitoring procedure.

PMID- 1643213
TI  - Automated situational analysis for operating room anesthesia monitoring.
AB  - The hospital operating room (OR) is an environment that requires up-to-the
      minute, reliable information on a patient's state. Data is usually provided by a
      heterogeneous mixture of independent monitors that, due to their isolated nature,
      give complex and sometimes erroneous presentations of a patient's state. This
      complex presentation introduces the possibility of operating room personnel
      overlooking data items that indicate certain pending patient states, such as
      cardiac arrest. A computer based system that collects the various monitor data,
      summarizes its content, and provides concise discourse on a patient's state
      (including potential life threatening situations), would be beneficial.

PMID- 1643214
TI  - Development of a microcomputer-based system to quantify the effective dose of
      drug through epithelial cells.
AB  - It is well documented that the rate-limiting step of pharmaceutical investigation
      is the amount of drug absorbed through the epithelial cells, not the total dose
      taken. To date, the only measure of the effective dose of medication is by
      measuring the circulating level of the ingested medication. This mode of
      measurement is neither accurate nor practical in determining the active
      ingredient required. However, a more efficient method of testing which
      constitutes simplicity and practically is desired. The aim of this project was
      the design of a microcomputer-based system for detecting and quantifying steroid
      hormones taken up by mucosal intestinal cells in vitro, for eventual in vivo
      application in animals and humans. A microcomputer-based system capable of
      controlling and monitoring four cell membranes simultaneously has been designed,
      consisting of a microcomputer system and a data acquisition subsystem. The data
      acquisition subsystem consists of instrumentation amplifiers with an analog-to
      digital converter and digital-to-analog converter. This subsystem converts the
      ionic exchanges first to electrical signals, and then to digital format, to be
      processed and stored by the microcomputer. Subsequently, the stored information
      can be clinically interpreted. Due to the complexity of membrane behavior
      (nonlinear) in response to feedback control signals, software development was
      difficult. Therefore, a unique scheme was developed to control various
      unexcitable tissues in order to reach the predetermined values very rapidly, and
      then to collect cell membrane data periodically.

PMID- 1643215
TI  - Biocompatibility of ferric calcium phosphorous oxide ceramics.
AB  - The objective of this investigation was to ascertain the biocompatability of a
      ferric calcium phosphorous oxide ceramic (FECAP). The FECAP ceramic was
      fabricated from stock powders combined in a ratio of 46:40:14 by weight of
      Fe2O3:CaO:P2O5. The composite oxides were mixed for homogeneity, pressed into a
      20g block, and calcined in a crucible at 1100 degrees C for 12 hours. The
      calcined ceramic was then ground in a ball mill before separation into particle
      sizes of 38-45 microns and 63-75 microns, by an automatic siever and shaker.
      Calcined powders of each particle size were mixed with polyvinyl alcohol binder
      (0.025g PVA/1.0g of FECAP), and pressed into 0.5g pellets in a 5/16" (internal
      diameter) die at a 1820 kilogram load using a Carver hydraulic press. FECAP
      pellets were then sintered at 1100 degrees C for 12 hours. For this
      investigation, sixty albino (Sprague-Dawley) rats weighing 125-425 g each, were
      distributed into four groups: non-operated controls, sham-operated controls, and
      two groups subcutaneously implanted with ceramics 38-45 microns and 63-75 microns
      FECAP ceramics, respectively. Three rats from each group were sacrificed at
      three, five, seven, and twenty-one days post-surgery. Morphologic examination of
      the implant and implant site as well as hematocrit data indicate that this ferric
      calcium-phosphorous oxide ceramic is biocompatible. Data obtained todate suggest
      that sintered FECAP should have a wide variety of dental and medical
      applications, especially where iron deficiency is a concern.

PMID- 1643216
TI  - Characterization of ceramic drug delivery devices: the effect of various
      temperature of incubation on the delivery of biologicals.
AB  - The objectives of this study are: (i) to determine the effect of temperature on
      the release rate of steroids and proteins from ceramic drug delivery devices
      (CDDD), and (ii) to examine the effect of polylactic acid (PLA) impregnation of
      tricalcium phosphate (TCP), and alumino-calcium-phosphorous oxide (ALCAP) ceramic
      capsules on the release of small and large molecular weight compounds, and (iii)
      to investigate the interaction of molecular weight and various incubation
      temperatures (25, 37 and 50 degrees C) on the rate of delivery from CDDD. The
      CDDD were prepared using standard laboratory protocols. Eight of 16 ALCAP and TCP
      ceramic capsules were impregnated with PLA and the remainder fabricated without
      PLA. Fourteen ceramic capsules were loaded with either 40 mg of testosterone or
      40 mg of bovine serum albumin (BSA), and nothing was added to the two remaining
      capsules. All capsules were then sealed at both ends with Dow Corning Type A
      Silastic Medical Adhesive. Single capsules were suspended in serum bottles
      containing either 100 ml of 50% wt/vol aqueous ethanol solution (steroid
      containing capsules) or 100 ml of phosphate buffered saline (pH 7.4) (protein
      containing capsules). The bottles were then placed in one of three metabolic
      shaker baths that had been previously adjusted at 25, 37, or 50 degrees C and
      were oscillating at a frequency of 100 rpm. Testosterone release was measured
      spectrophotometrically at 245 nm and BSA by a colorimetric procedure.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1643217
TI  - Numerical study of arterial flow during sustained external acceleration.
AB  - A computer model of the human arterial tree based upon the one-dimensional flow
      equations is used to study the effects of sustained acceleration (+Gz) on eye
      level arterial pressure and flow. Steady-state physiological compensatory
      mechanisms are modelled using human centrifuge data found in the literature.
      Cases investigated include the supine and standing human (+1 Gz), the application
      of resistive and occlusive anti-G suits, and the occurrence of a stenosis
      proximal to the carotid bifurcation. Results indicate that the simulated eye
      level pressures and flows satisfactorily correspond with those found in the
      literature.

PMID- 1643218
TI  - Virtual instrumentation for frequency analysis of carotid sinus responses.
AB  - An advanced microcomputer based process control and instrumentation system was
      developed for real time frequency analysis of the viscoelastic relationships
      between the carotid sinus wall and indwelling baroreceptors. A 486 based AT bus
      microprocessor running data acquisition and visualization software was customized
      providing a virtual instrument for data collection, display, and recording. A
      full complement of signal processing algorithms was developed for the collection
      of large time sampled data sets and their conversion to the frequency domain for
      analysis. Polynomial curve fitting procedures were used for transfer function
      estimation of wall viscoelastic properties. Simulated in situ sinus data was
      collected and analysis was used to test the methodology.

PMID- 1643219
TI  - Design: a voice activated thermostat.
AB  - The voice activated thermostat was designed so the temperature in a house could
      be set without having to touch the thermostat. This is especially useful for a
      quadriplegic who would like to change the temperature of the room he is in. For
      simplicity, it was designed using VCP200 speaker-independent word recognizer
      chip. This chip comes pre-programmed with a limited number of words, so
      programming of words was not necessary. Every time the activation word is said
      the digital thermostat changes by one degree.

PMID- 1643220
TI  - Mathematical modelling of post-exercise heart rate recovery in ponies.
AB  - Using a recently developed nonlinear algorithm which identifies reference points
      on left ventricular pressure waveforms and other waveforms, we analyzed heart
      rate recovery in ponies after strenuous treadmill exercise. Each pony performed
      exercise tests with and without premedication with atropine methyl nitrate.
      Resting and exercise heart rates were 54 +/- 3 and 209 +/- 6 beats/min,
      respectively, without premedication and 85 +/- 8 and 212 +/- 5 beats/min,
      respectively, following atropine premedication. Post-exercise heart rate recovery
      without premedication was best described by a biexponential curve with a rapid
      initial period (duration = 55 +/- 6 sec, Tl/e = 15 +/- 2 sec) and a slower
      secondary period (duration = 267 +/- 5 sec, Tl/e = 455 +/- 78 sec). After
      atropine premedication, heart rate recovery followed a monoexponential curve
      (Tl/e = 174 +/- 46 sec) in 4 ponies, but remained biexponential (Part 1 duration
      = 74 sec, Tl/e = 20 sec; Part 2 duration = 243 sec, Tl/e = 342 sec) in the other
      ponies. The calculated time required for heart rate to return to resting levels
      after atropine premedication was 11.3 +/- 2.2 min, compared to 26.3 +/- 3.9 min
      without premedication. However, without premedication, only 6.6 +/- 1.6 min were
      required to reach the post-atropine resting heart rate, indicating that the time
      difference was due to the higher resting heart rate after atropine premedication.
      Thus, heart rate recovery in the non-premedicated pony follows a biexponential
      curve similar to that observed in other species.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643221
TI  - Determining the efficacy of edge detection algorithms.
AB  - Edge detection is an important process in the interpretation of image data. Four
      types of edge detection algorithms (the Local Variance, Correlation, Laplacian
      and Frequency Peak algorithms) are compared for their ability to discriminate the
      edges present in an image with precisely defined edges. The variety of techniques
      are discussed in terms of their sensitivity to the presence of edges and their
      sensitivity to the applied noise. Both computational and empirical analyses are
      presented, and the relative merits of each discussed in terms of signal-to-noise
      ratio, sensitivity and computational difficulty. It is shown that local variance
      edge detection is an acceptable method for edge detection which simplifies the
      computation needed for image convolution. The means through which to devise more
      sophisticated edge detection algorithms is outlined, and the use of difference
      images to discriminate edges in an image is discussed. The results are also
      discussed in terms of the implementation of edge detection algorithms as part of
      a computer visual system which has an architecture modeled after the mammalian
      visual system.

PMID- 1643222
TI  - Endothelial vasoactive influence simulated by exponential feedback.
AB  - We hypothesized that results from rabbit carotid sinus wall and baroreceptors
      could be simulated using exponential feedback in a viscoelastic model. Wall and
      baroreceptor were each modeled by second order differential equations.
      Coefficients for viscosity, elasticity and feedback were estimated from
      experimental data. Feedback of model wall distension (y1) on viscosity (C) was
      expressed by the transfer function: C/y1 = RW/(s tau W + 1). With gain (RW) =
      52.5E6 N(s)/m2 and tau W = 34 sec, this feedback resulted in simulation of wall
      response for sinuses with intact endothelium. Model receptor required no (or
      negative gain) feedback to simulate baroreceptors.

PMID- 1643223
TI  - Insulin delivery by zinc calcium phosphate ceramics.
AB  - Zinc-calcium-phosphorous oxide (ZCAP) ceramics were developed to deliver insulin
      in vivo in rats. Thirty-nine Sprague-Dawley male albino rats (Holtzman Co.,
      Madison, WI), weighing 260 +/- 15 g each, were randomly distributed into six
      groups: normal controls (3), sham controls (3), diabetic controls (6) and three
      diabetic experimental groups each consisting of nine rats. Diabetes was induced
      in rats by an intravenous injection of Streptozotocin (75 mg/kg body weight).
      Rats in the three diabetic experimental groups were implanted subcutaneously with
      two ZCAP capsules, each containing 10, 15, or 20 mg of insulin. Blood glucose
      measurements were taken at least twice a week over a six week period. Plasma
      insulin levels were measured at two, four, and six weeks by a radioimmunoassay
      using 125I labeled insulin. Normoglycemia was maintained for three weeks in rats
      implanted with ZCAP capsules containing a total of 20 mg of insulin. Plasma
      insulin levels correlated with the normal blood glucose levels in these rats.
      Thus, ZCAP capsules could be used to deliver insulin and maintain normoglycemia
      in diabetic rats.

PMID- 1643224
TI  - Zinc sulfate calcium phosphate (ZSCAP) composite for repairing traumatized bone.
AB  - The objective of this investigation was to evaluate the suitability of zinc
      sulfate calcium phosphate ceramic composites as bone substitutes. ZSCAP ceramics
      were fabricated from stock powders of zinc sulfate, zinc oxide, calcium oxide,
      and phosphorous pentoxide in a ratio of 15:30:30:25 by weight of
      ZnSo4:ZnO:CaO:P2O5. The three oxides and zinc sulfate were mixed for 10 minutes
      in a blender and then calcined in a crucible at 650 degrees C for 24 hours. The
      calcined powder was ground in a ball mill for 0.5 hours and separated into
      particle sizes of 38-45, 45-63, and 65-75 microns by an automatic siever and
      shaker. One hundred male, albino, Sprague-Dawley rats, weighing 250-300 g each,
      were used to conduct the investigation. The treatments (10 rats per treatment)
      were as follows: Group I, non-operated controls, Group II, sham-operated
      controls, and Groups III, IV and V, experimental animals. In situ hardening ZSCAP
      ceramic particulate powders or pastes of 38-45 microns (Group III), 45-63 microns
      (Group IV) or 65-75 microns (Group V) were implanted in a 2.0 mm defect in the
      femur of each rat. Radiographic and morphologic examination of the implant site
      indicated that the implant was biocompatible and firmly entrenched in the
      traumatized bone defect up to 90 days post-implantation. Since ZSCAP ceramics set
      like plaster of Paris and have all the beneficial properties of resorbable
      calcium phosphate, they should provide the surgeon with a non-toxic, resorbable,
      fast setting ceramic (in situ) for use as a hard tissue substitute in
      orthopaedic, dental, and maxillofacial surgeries.

PMID- 1643225
TI  - Electronic ECG simulator.
AB  - This paper describes the design of an ECG simulator which outputs both normal and
      abnormal waveforms. Both heart rate and signal amplitude may be controlled.
      Applications include a test signal source for repair/maintenance of ECG
      monitoring equipment, and as a laboratory simulation device for student
      educational use.

PMID- 1643226
TI  - Stimulus presentation using a programmable signal generator.
AB  - Event related potential experiments frequently require the presentation of
      complicated stimulus patterns to the subject. As the complexity and number of
      different types of stimuli presented to the subject increase there is a
      corresponding increase in the amount and complexity of the equipment required to
      generate the stimuli. Software was developed for complex stimulus presentation
      which uses a programmable arbitrary/function generator. The various stimulus
      patterns are stored in digital form in the memory of the signal generator and can
      be recalled by number. Prior to presentation of a particular stimulus pattern the
      number of that pattern is sent by the control program to the generator for recall
      from memory. The signal generator is set to operate in external trigger mode and
      at the proper time for stimulus presentation the generator is triggered by the
      control program. The use of the programmable signal generator allows replacement
      of the typical stimulus presentation equipment such as gates, signal generators,
      and attenuators by this the programmable generator and provides getter
      flexibility as to the type and complexity of stimuli which can be generated.

PMID- 1643227
TI  - Selecting a stimulus signal for linear systems analysis of the vestibulo-ocular
      reflex.
AB  - We evaluated 3 types of stimulus signals for use in estimating the transfer
      function of the vestibulo-ocular reflex. We used individual sine-wave, sum-of
      sine, and pseudorandom stimuli. Five normal human subjects were tested 5 times
      each using each of the 3 stimulus types. Frequency domain techniques were used to
      estimate the transfer function at 0.01, 0.03, and 0.05 Hz. The most consistent
      estimates were obtained using individual sine-wave stimuli. The pseudorandom
      signal yielded the most variable estimates. A sum-of-sine stimulus composed of 3
      sine-wave signals provided estimates slightly more variable than the individual
      sine-wave stimuli, but much less variable than the pseudorandom stimulus. The
      redundency of the sine and sum-of-sine stimuli seems to be an advantage by
      providing stable estimates of the transfer function in the presence of noise.

PMID- 1643228
TI  - Template matching techniques for electrophysiologic signals: a practical, real
      time system for detection of ventricular tachycardia.
AB  - Time domain template matching morphology techniques have been proposed for
      inclusion in implantable cardioverter defibrillators (ICDs) for the detection of
      ventricular arrhythmias from intraventricular electrograms (IVEGs). However, ICDs
      have limited battery capacity which necessitate the use of low current drain
      algorithms. Although more computationally efficient template matching algorithms
      have been developed, none have incorporated the limitations inherent in current
      ICDs. An external ICD sensing prototype system was developed which filters,
      digitizes, and analyzes IVEGs during electrophysiology studies. Two template
      matching IVEG metrics, amplitude normalized area of difference and signature
      analysis, are calculated. These metrics are being tested clinically for their
      accuracy in differentiating ventricular tachycardia and sinus rhythm IVEGs.

PMID- 1643229
TI  - Comparison of the frequency spectra of surface electromyographic signals from the
      soleus muscle under normal and altered sensory environments.
AB  - The vestibular, proprioceptive and visual senses of the body are all affected by
      alterations of the normal sensory environment during weightlessness. This study
      was designed to observe muscle activation characteristics when a single component
      of the sensory environment was altered. Partially immersing a subject in a water
      pool provided a buoyant force upon the lower body, "unloading" the muscles,
      similar to the effect on the muscles in weightlessness. Surface EMG from the
      soleus was obtained during the performance of a constant-force isometric
      contraction. The mean and median characteristic frequencies were calculated from
      the power spectrum of each trial. Six of ten subjects showed a difference in the
      characteristic frequencies between the two environments. It appears that for some
      individuals there are changes in muscle activation characteristics due to
      influences of the proprioceptive system when exposed to an altered sensory
      environment.

PMID- 1643230
TI  - EEG dynamics. Brain processing of sensory and cognitive information.
AB  - The EEG oscillations and resonances before sensory stimulation are variable;
      unstable frequencies and amplitudes. The EEG time-coherency is variable and tends
      to be incoherent preceding sensory stimulation. The phase angle of the EEG
      between brain structures tends to be random and coherence between various brain
      structures is low before the stimulus. Following sensory stimulation, the
      frequency is stabilized and the amplitude is greatly enhanced. These responses
      are considered to be related to coupling of neural oscillators and nuclear
      resonance. The shift to a time-coherent state is considered to be related to a
      probabilistic harmonic oscillators. The phase angle after the stimulus is zero
      phase in the brain rhythm channels in all brain structures as noted in the phase
      spectra. In the post stimulation period there is a change to high coherency
      between brain structures in the inherent frequencies of their brain rhythms.
      Internal evoked potentials shown in all the brain nuclei studied. All the
      frequencies in the evoked potential responses are dependent on spontaneous EEG
      activities prior to the stimulus.

PMID- 1643232
TI  - Intersegmental elbow joint load during pushup.
AB  - Intersegmental loading pattern on the elbow joint during a push-up exercise was
      investigated. Electromagnetic motion sensors and a piezoelectric force plate were
      used to simultaneously record upper extremity motion and forces on nine healthy
      male subjects during push-ups in six different hand positions. Peak axial forces
      exerted on the elbow joint averaged 45 percent of the body weight. Peak torque to
      produce elbow flexion was 2305.9 N-cm, or 56 percent of maximal isometric
      extensor torque. The results of this analysis give insight to the biomechanics of
      a normal elbow and to its load carrying capacity.

PMID- 1643231
TI  - Brain states--brain rhythms--brain responses.
AB  - Oscillation and resonance of electrical activity of certain sets of neurons in
      the brain and spinal cord is an important factor in the organization of those
      properties of connectivity that must be tuned by function. Once connectivity has
      reached some degree of specificity important biological and chemical events must
      occur to stabilize synaptic inputs and localize excitable sites to particular
      areas of the cell surface. It has been proposed that intrinsic
      electroresponsiveness generates internal computational states that serves as a
      reference frame or context for incoming information. The intrinsic activity is
      proposed to be a part of the vectorial coordinate space that sensory and motor
      transformations occur in context of a particular functional state such as
      attention and expectation that can modify the relevance of a given sensory input.
      The most significant mechanism in generation of oscillation properties of the
      brain are the intrinsic properties of individual neurons. This concept presents a
      shift of emphasis from properties of circuits to properties of single neurons.
      Feedback circuits and synchronization of single oscillators into sets of coupled
      oscillators which in turn generates field potentials such as (EEG) and evoked
      response (ER).

PMID- 1643233
TI  - An integrated approach to rehabilitation engineering education: the development
      of a new masters programme at Brunel University.
AB  - We report on a new multidisciplinary course at Master's Level; a joint venture
      between the Department of Design at Brunel University. U.K. and Brunel Institute
      for Bioengineering. The Bachelor of Science degree in Industrial Design at Brunel
      includes an important proportion of technological courses such as mechanics and
      electronics. The MSc course, which is modular, continues to embrace a wide range
      of disciplines but it also seeks to bring together graduates from traditional
      engineering backgrounds in addition to those from arts based design courses.
      Appropriate elements are offered in order to allow access into unfamiliar
      disciplines. One novel and valuable aspect of the course is the way in which
      graduates from diverse backgrounds, having complementary experience and skills
      will be studying and developing projects alongside one another. Although much of
      the academic content will be through the department of Design and the Faculty of
      Technology, the Brunel Institute for Bioengineering will play a major role in the
      provision of modules in Rehabilitation Studies and in the generation and
      supervision of projects. This project work will therefore be carried out within
      the Rehabilitation Engineering Unit at Brunel Institute for Bioengineering. The
      course to be discussed has been developed at Brunel University in the department
      of Design in conjunction with The Brunel institute for Bioengineering.

PMID- 1643234
TI  - Learning to count.
AB  - The "Learning to Count" is a microprocessor controlled device constructed to help
      teach a developmentally disabled individual to learn to count to ten. The device
      has ten buttons, each with two numerical seven-segment LED's displaying a random
      number 1 through 10. The game's objective is for the student to press the ten
      buttons in numerical order. A microprocessor and integrated circuits carry out
      the device's internal operations. The microprocessor controls the generation of
      the random numbers, the assigning of the random numbers to a button position, and
      the analysis of the button input. The integrated circuits transfer the
      information from the microprocessor to the displays and from the input buttons to
      the microprocessor.

PMID- 1643235
TI  - The next generation of students, are you ready?
AB  - School administrators across the country are under pressure from parents,
      community leaders and politicians to improve the public education system for the
      average student. As a result, several new programs are being studied, developed
      and implemented in grades K through 12. These programs will impact several areas
      at the public school building level from K through 12: 1) Goals for multicultural
      learning; 2) The grade structure and objectives at the elementary, middle and
      high school levels; 3) The use of technology in all subjects; 4) Open and direct
      teaching of critical thinking skills in all courses; 5) Methods of assessment
      which include self assessment and portfolios as well as standardized tests; and
      6) The incorporation of the guaranteed high school diploma.

PMID- 1643236
TI  - Contractile wire biomechanical actuators.
AB  - Several metal alloys have been discovered which, when fabricated into wire,
      contract strongly when heated and relax with cooling. The contractile force can
      be modulated under microcomputer control to produce a compact, powerful and
      durable mechanical actuator. This technique has a number of advantages over motor
      driven servos in robotics and medicine. This paper reviews previous applications
      of contractile wire, then presents two types of biomechanical actuators built by
      the author.

PMID- 1643237
TI  - An evaluation of two commercially available noninvasive blood pressure monitors
      in the canine.
AB  - The objective of this experiment was to evaluate whether two commericially
      available noninvasive blood pressure monitors could be adapted for animal use,
      specifically, in the dog. Five dogs were anaesthetized and had femoral canulas
      surgically implanted into the left rear leg to record invasive blood pressure. A
      blood pressure cuff was placed on the right leg and connected to a commonly used
      noninvasive blood pressure monitor. Hyper- and hypotensive states were induced
      pharmaceutically. Invasive and noninvasive measurements were compared under
      normal, hyper- and hypotensive states.

PMID- 1643238
TI  - Differential features for a neural network based anesthesia alarm system.
AB  - We have developed a neural network based alarm system that identifies 19 specific
      faults in the anesthesia breathing circuit, such as "Inspiratory Hose Leak," or
      "Y-Piece Disconnection." CO2, pressure, and expired flow waveforms, along with
      ventilator settings, were sampled by a personal computer. Fifty-two features,
      such as "maximum CO2" or "minimum pressure", were extracted from each breath,
      converted to "differential" features, normalized, and used as the inputs of a
      three layered feed-forward neural network. The network was trained, using
      backward error propagation with momentum, to classify each breath as normal or
      containing one of 19 faults. To collect the neutral network training set, seven
      dogs were anesthetized and ventilated using controlled ventilation. Each of 19
      faults were created over a range of ventilator settings and fresh gas flows. The
      neural network correctly identified 83.1% of 550 events presented to it during
      testing. These preliminary results are an encouraging example of neural network
      applications in the field of clinical monitoring.

PMID- 1643239
TI  - Molecular motions and thermotropic phase behavior of triacylglycerols and
      cholesteryl esters in herpesvirus-infected arterial smooth muscle cells: a
      deuterium nuclear magnetic resonance study.
AB  - The physical state of lipids in arterial smooth muscle cells (SMC) may contribute
      to lipid accumulation following injury. We have previously demonstrated that
      herpes simplex virus (HSV) infection alters the physical state of the neutral
      lipid accumulating in arterial SMC, as determined by differential scanning
      calorimetry (Biochem. J. 268 (1990) 693-697). To more precisely determine the
      molecular packing of neutral lipids in HSV-infected cells, the influence of HSV
      infection on the thermotropic and phase-behavior of the lipids in intact arterial
      smooth muscle cells and in cell-free lipid extracts was evaluated using [2H]-NMR,
      employing U-[2H]-oleic acid incorporated into cells. Inspection of the [2H]-line
      widths indicate that the lipid of HSV-infected cells exhibited more restricted
      motion or a greater chemical shift dispersity than lipids from uninfected cells,
      as evidenced by significant broadening of the -CD = CD- signals at 25 degrees C
      and 45 degrees C. Fatty acid compositional analysis of the neutral lipids of
      control and HSV-infected cells following C18:1 supplementation (an amount added
      similar to the NMR experiments) reveals that: (1) there is approximately 55-fold
      more triacylglycerols (TG) than cholesteryl esters (CE) in control cells and 40
      fold more TG than CE in the HSV-infected cells; (2) HSV infection significantly
      increases the C18:1 content of CE, and C18:3 and C20:4 in TG; and (3) HSV
      infection does not alter the ratio of TG to CE. These data support the hypothesis
      that the greater restriction of the neutral lipids in HSV-infected cells may be
      due to the rigidifying effects of C18:1 on lipid mobility. Thus, alterations in
      the physical state of neutral lipids in HSV-infected cells may lead to reduced CE
      hydrolysis which, in turn, may contribute to or exacerbate lipid accumulation.

PMID- 1643240
TI  - DNA associations: packing calculations in A-, B-, and Z-DNA structures.
AB  - A detailed theoretical study has been carried out to examine the modes of DNA-DNA
      interactions on the basis of hard-sphere contact criteria. Two helices of
      identical structure and length are oriented side-by-side and their relative
      positions are controlled by translations along and rotations about specific axes.
      Short atomic contacts between pairs of atoms in the structures are assessed and
      contact-free configurations are compiled. The computed contact-free arrangements
      of A, B, and Z double helices are found to be remarkably similar to the packing
      motifs observed in DNA crystals and stretched fibers. Equally interesting in the
      study are the broad ranges of sterically acceptable arrangements that preserve
      the overall packing morphology of neighboring duplexes: Among the most notable
      morphological features in the helical complexes are extended "super" major and
      minor grooves which might facilitate the wrapping and packaging of DNA chains in
      supramolecular assemblies. The hard-sphere computations, however, are
      insufficient for quantitative interpretation of the packing of DNA helices in the
      solid state. The results are, nevertheless, a useful starting point for energy
      based studies as well as relevant to the analysis of long-range interactions in
      DNA supercoils and cruciforms.

PMID- 1643241
TI  - Biochemical correlates with myocardial aging.
AB  - Both contraction and relaxation times are prolonged in cardiac muscle of
      senescent animals. This is in part explained by an alteration of excitation
      contraction coupling due to an increased duration of the action potential,
      reduced biosynthesis of the Ca(2+)-stimulated ATPase pump of sarcoplasmic
      reticulum, and prevalence of the V3 isoform of myosin with slow ATPase activity.
      The response to catecholamine decreases with aging because of a defective
      transmission of alpha and beta adrenergic stimulation mediated respectively by
      phosphoinositide hydrolysis and adenylate cyclase. Cardiac energetics is also
      impaired in the aged myocardium, since ATP and creatine phosphate levels are
      reduced by about 20%. This reduction seems in part the consequence of defective
      mitochondrial function, especially in fatty acid oxidation and ATP translocation
      to the cytoplasm. In this paper we have discussed the possibility that oxygen
      free radicals may be a cause of myocardial senescence, by damaging the nuclear
      and mitochondrial genomes as well as membranes and other cellular components.

PMID- 1643242
TI  - Reduction of myocardial damage by cloricromene during ischemia-reperfusion in the
      rabbit.
AB  - We studied the effect of cloricromene on myocardial damage during ischemia and
      reperfusion. The left anterior descending coronary artery was occluded in 20
      rabbits and cloricromene (6.2 micrograms/kg/min) (n = 10) or placebo (n = 10)
      were continuously infused. After 10 minutes of occlusion, a first biopsy was
      obtained from the apex. After 30 minutes, the artery was reopened and after 10
      minutes a second biopsy was taken. Both samples were used for chemiluminescence
      and electron microscopy. The group given placebo showed displacement of the ST
      segment throughout the ischemic period and arrhythmias during reperfusion; while,
      in the group given cloricromene, there were transient ST segment elevations in 5
      animals, which reverted as the infusion was increased. The chemiluminescence
      values were 7100 +/- 1300 cpm/mg protein and 14900 +/- 2300 (p less than 0.01)
      for the first and second biopsies of the control group and 5900 +/- 900 and 6100
      +/- 900 (NS) for the first and second biopsies of the cloricromene-treated group.
      In the group given placebo, the second biopsy showed early signs of irreversible
      myocyte injury and infarction, whereas samples from the group given cloricromene
      showed a preservation of myocyte architecture. During ischemia, the percentage of
      normal mitochondria was lower in the placebo group (p less than 0.0001); and, on
      reperfusion, the percentage of severely damaged mitochondria was increased in the
      placebo group (p less than 0.0001). The direct addition of cloricromene in vitro
      to myocardial homogenates did not reduce hydroperoxide-induced chemiluminescence.

PMID- 1643243
TI  - 1- and 3-nitro-6-azabenzo[a]pyrenes and their N-oxides: highly mutagenic nitrated
      azaarenes.

PMID- 1643244
TI  - Mouse skin tumor initiating activity of fluorinated derivatives of 1,2,3,4
      tetrahydro-7,12-dimethylbenz[a]anthracene.

PMID- 1643245
TI  - Microsomal metabolism of cyclopenta[cd]pyrene. Characterization of new
      metabolites and their mechanism of formation.
AB  - Oxidation of cyclopenta[cd]pyrene (CPP) by mouse and human liver microsomes was
      used to produce several previously undescribed metabolites, which were separated
      and isolated by reversed-phase HPLC. Three of these, 3,4-dihydroCPP-c-3,4-diol, 4
      hydroxy-3,4-dihydroCPP, and 4-oxo-3,4-dihydroCPP, were fully characterized by GC
      MS and UV spectroscopic analysis as well as by total synthesis. Two additional
      pairs of metabolites were identified as isomeric tetrahydrotetrols and
      dihydrotriols by GC-MS analysis of their trimethylsilyl derivatives. Their UV
      spectra were recorded and found to agree with the structure assignments. The
      tetrahydrotetrols were further characterized by the fact that either 3,4- or 9,10
      trans-dihydrodiol could serve as their precursor, indicating that they are the
      two diastomeric 3,4,9,10-tetrahydroCPP-t-3,4-t-9,10-tetrols. The dihydrotriols
      were shown to possess t-3,4-dihydrodiol functionality. As found previously using
      rat liver microsomes, the most abundant metabolite was 3,4-dihydroCPP-t-3,4-diol.
      It was produced with one enantiomer in severalfold excess over the other, and the
      major enantiomer was shown to have 3R,4R configuration by exciton chirality
      circular dichroism. Microsomal oxidation of [4-2H]CPP, which was synthesized for
      this study, was used to determine the mechanisms of formation of 4-oxo- and 4
      hydroxy-3,4-dihydroCPP. The ketone was produced without detectable retention of
      deuterium label, eliminating the NIH shift as a possible mechanism. The alcohol
      was shown to arise by NADPH-dependent reduction of both the ketone and another
      intermediate presumed to be the 3,4-epoxide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643246
TI  - NADPH-dependent oxidation of reduced ebselen, 2-selenylbenzanilide, and of 2
      (methylseleno)benzanilide catalyzed by pig liver flavin-containing monooxygenase.
AB  - The selenazole ring-opened metabolites of ebselen, 2-selenylbenzanilide and 2
      (methylseleno)benzanilide, are substrates for flavin-containing monooxygenase
      from pig liver. The Km values were 25 and 3 microM, respectively, measured at 37
      degrees C, pH 7.4, in the presence of 1 mM GSH. The Vmax values were 390 mU/mg of
      protein, similar to those obtained with methimazole or other substrates for FMO1.
      Although ebselen also appears to be a substrate in the absence of GSH, it
      progressively inactivates the enzyme, apparently by binding covalently to
      essential enzyme thiols. The oxidation products of the selenol and methylseleno
      derivatives are rapidly reduced by GSH, regenerating the parent substrates. Rapid
      reduction of the selenide oxide by GSH was unexpected and suggests that, unlike S
      oxidation of sulfides, Se-oxidation of selenides may be a route for
      bioactivation. The data show that in the presence of FMO1 micromolar amounts of
      either of these ring-opened metabolites establish a futile cycle catalyzing the
      oxidation of GSH to GSSG by NADPH and oxygen.

PMID- 1643247
TI  - Arylamination and arylation of 4,4,4-trifluoro-1-phenyl-1,3-butanedione with N
      acetoxy derivatives of 2-aminofluorene.
AB  - The present study investigated the reaction of carcinogenic electrophiles with
      beta-diketones which possess an active methylene group. N-Acetoxy-2
      (acetylamino)fluorene bound to tRNA at 37 degrees C, pH 7.0, and this reaction
      was inhibited by 4,4,4-trifluoro-1-phenyl-1,3-butanedione or 2
      thenoyltrifluoroacetone. N-Acetoxy-2-(acetylamino)fluorene reacted with these
      active methylene compounds to form transitory 3-substituted 2
      (acetylamino)fluorene intermediates, which, following cleavage of the
      trifluoroacetyl group, yielded 3-phenacyl-2-(acetylamino)fluorene or 3-(2
      thenoylmethyl)-2-(acetylamino)fluorene. N-Acetoxy-2
      [(trifluoroacetyl)amino]fluorene reacted with 4,4,4-trifluoro-1-phenyl-1,3
      butanedione to yield two products, N-phenacyl-1-(trifluoroacetyl)-2-aminofluorene
      and N-phenacyl-3-(trifluoroacetyl)-2-aminofluorene. The ratio of these two
      products was approximately 1:2. The same N-phenacyl products were produced by
      incubation of the beta-diketone, N-hydroxy-2-(acetylamino)fluorene, and rat liver
      cytosol which catalyzed the formation of N-acetoxy-2-aminofluorene. Thus, the
      inhibitions by beta-diketones of nucleic acid-binding and bacterial mutagenesis
      of carcinogens are likely due to their trapping of the carcinogens.

PMID- 1643248
TI  - Oligomerization of indole-3-carbinol in aqueous acid.
AB  - Indole-3-carbinol [I3C, also called 3-(hydroxymethyl)indole] is a naturally
      occurring modulator of carcinogenesis with a biological activity that is at least
      partially dependent on its conversion to active substances in acidic media. We
      compared the identities of the major oligomeric products of I3C produced under
      conditions approximating those found in gastric juice with the reported
      identities of products of 3-substituted indoles produced under enzymatic and
      other nonenzymatic conditions. After a 10-min treatment in aqueous HCl solution,
      I3C was converted in 18% yield to a mixture of acetonitrile-soluble products, the
      major components of which (as determined by HPLC) were diindol-3-ylmethane
      (5.9%), 5,6,11,12,17,18-hexahydrocyclononal[1,2-b:4,5-b':7,8-b"]triindo le
      (2.0%), and [2-(indol-3-ylmethyl)indol-3-yl]indol-3-ylmethane (5.9%). Tentative
      assignments were made for 3,3-bis(indol-3-ylmethyl)indolenine (0.59%), a
      symmetrical cyclic tetramer (0.64%), and a linear tetramer (1.1%). Indolo[3,2
      b]carbazole (ICZ) was formed slowly in aqueous acidic solutions in low yields
      (2.0 ppm) which increased to greater than 90 ppm following addition of an organic
      solvent [tetrahydrofuran (THF) or dimethylformamide (DMF)] to a neutralized
      solution. Relative yields of trimers vs dimer increased with decreasing pH and
      with decreasing starting concentration of I3C. Evidence is presented that ICZ
      formation may not involve radical intermediates as is characteristic of
      photodynamic processes. A mechanistic rationale is presented for the formation of
      the identified products.

PMID- 1643249
TI  - Flavin-containing monooxygenase-dependent stereoselective S-oxygenation and
      cytotoxicity of cysteine S-conjugates and mercapturates.
AB  - The metabolism of cysteine S-conjugates of both cis- and trans-1,3
      dichloropropene in the presence of rat kidney microsomes and purified flavin
      containing monooxygenase from hog liver was investigated in vitro. Preliminary
      studies with isolated rat kidney cells demonstrated that cysteine S-conjugates
      were quite toxic to the cells in a process which was consistent with a role of
      the flavin-containing monooxygenase in the bioactivation of the nephrotoxins.
      Putative S-oxide metabolites of cysteine S-conjugates were chemically
      synthesized, and diastereomers were separated and identified by spectroscopic
      means. The metabolic products of cysteine S-conjugates were identified by
      comparing the chemical properties of the metabolites with authentic synthetic
      cysteine S-conjugate S-oxides. Surprisingly, S-conjugate S-oxygenase activity was
      not observed with rat kidney microsomes but was present when cysteine S
      conjugates were incubated with the highly purified flavin-containing
      monooxygenase from hog liver. The kinetic parameters indicated that considerable
      S-oxygenase stereoselectivity and structural selectivity was observed: cis
      cysteine S-conjugates were preferred substrates and N-acetylation of cysteine S
      conjugates decreased substrate activity. S-Oxygenation was considerably
      diastereoselective and diastereoselectivity was much greater for cysteine S
      conjugates with higher Vmax values. Cysteine S-conjugate S-oxides were not
      indefinitely stable, and under certain conditions, the S-oxides underwent a [2,3]
      sigmatropic rearrangement to acrolein. Formation of acrolein or other
      electrophilic products from S-(chloropropenyl)cysteine conjugate S-oxides may
      contribute to the renal effects observed for S-(chloropropenyl)cysteine
      conjugates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643250
TI  - Oxidation of aflatoxins and sterigmatocystin by human liver microsomes:
      significance of aflatoxin Q1 as a detoxication product of aflatoxin B1.
AB  - Aflatoxin Q1 8,9-oxide was synthesized and found to yield lower levels of N7
      guanyl adducts than obtained from aflatoxin B1 8,9-oxide when mixed with calf
      thymus DNA or Salmonella typhimurium TA 98 cells. However, when S. typhimurium TA
      98 was treated with the (analogous) epoxides of aflatoxin B1, aflatoxin G1,
      aflatoxin Q1, or sterigmatocystin, the ratios of revertants to N7-guanyl DNA
      adducts were similar. Aflatoxin Q1 and aflatoxin B1 8,9-oxide (trapped here as
      the glutathione conjugate) are the major oxidative products formed from aflatoxin
      B1 at all substrate concentrations in human liver microsomes, and cytochrome P
      450 (P-450) 3A4 appears to be the dominant enzyme involved in both oxidations, as
      judged by studies involving correlation of activities in different liver samples,
      chemical inhibition, immunoinhibition, and reconstitution with purified hepatic
      and yeast recombinant P-450 3A4. Aflatoxin Q1 is not appreciably oxidized in
      human liver microsomes and is not very genotoxic. The postulated formation of
      both aflatoxin Q1 and aflatoxin 8,9-oxide from aflatoxin B1 can be rationalized
      by a model in which P-450 3A4 binds the substrate in either of two different
      configurations. This is further demonstrated by the dichotomous effect of 7,8
      benzoflavone--this flavone stimulates 8,9-epoxidation while inhibiting the 3
      alpha-hydroxylation reaction to form aflatoxin Q1. Thus, the 3 alpha
      hydroxylation of aflatoxin B1 to aflatoxin Q1 is viewed as a potentially
      significant detoxication pathway.

PMID- 1643251
TI  - Mechanism of metabolic activation of the potent carcinogen 7,12
      dimethylbenz[a]anthracene.
AB  - The DNA adducts of 7,12-dimethylbenz[a]anthracene (DMBA) previously identified in
      vitro and in vivo are stable adducts formed by reaction of the bay-region diol
      epoxides of DMBA with dG and dA. In this paper we report identification of
      several new DMBA-DNA adducts formed by one-electron oxidation, including two
      adducts lost from DNA by depurination, DMBA bound at the 12-methyl to the N-7 of
      adenine (Ade) or guanine (Gua) [7-methylbenz[a]anthracene (MBA-12-CH2-N7Ade or 7
      MBA-12-CH2-N7Gua, respectively]. The in vitro systems used to study DNA adduct
      formation were DMBA activated by horseradish peroxidase or 3-methyl-cholanthrene
      induced rat liver microsomes. The biologically-formed depurination adducts were
      identified by high-pressure liquid chromatography and by fluorescence line
      narrowing spectroscopy. Stable DMBA-DNA adducts were analyzed by the 32P
      postlabeling method. Quantitation of DMBA-DNA adducts formed by microsomes showed
      about 99% as depurination adducts: 7-MBA-12-CH2-N7Ade (82%) and 7-MBA-12-CH2
      N7Gua (17%). Stable adducts (1.4% of total) included one adduct spot that may
      contain adduct(s) formed from the diol epoxide (0.2%) and unidentified adducts
      (1.2%). Activation of DMBA by horseradish peroxidase afforded 56% of stable
      unidentified adducts and 44% of depurination adducts, with 36% of 7-MBA-12-CH2
      N7Ade and 8% of 7-MBA-12-CH2-N7Gua. Adducts containing the bond to the DNA base
      at the 7-CH3 group of DMBA were not detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643252
TI  - Formation of mitochondrial phospholipid adducts by nephrotoxic cysteine conjugate
      metabolites.
AB  - Nephrotoxic cysteine conjugates derived from a variety of halogenated alkenes are
      enzymatically activated via the beta-lyase pathway to yield reactive sulfur
      containing metabolites which bind covalently to cellular macromolecules.
      Mitochondria contain beta-lyase enzymes and are primary targets for binding and
      toxicity. Previously, mitochondrial protein and/or DNA have been considered as
      molecular targets for cysteine conjugate metabolite binding. We now report that
      metabolites of nephrotoxic cysteine conjugates form covalent adducts with rat
      kidney mitochondrial phospholipids. Rat kidney mitochondria were incubated with
      the 35S-labeled conjugates S-(1,1,2,2-tetrafluoroethyl)-L-cysteine (TFEC), S-(2
      chloro-1,1,2-trifluoroethyl)-L-cysteine (CTFC), S-(1,2-dichlorovinyl)-L-cysteine,
      and S-(1,2,3,4,4-pentachlorobutadienyl)-L-cysteine. Quantitation of metabolite
      binding to whole mitochondria and to mitochondrial protein and lipid fractions
      revealed that as much as 42% of the 35S-label associated with the mitochondria
      was found in the lipid fraction. Total lipids were also extracted from 35S
      treated mitochondria and separated by thin-layer chromatography. 35S-Containing
      metabolites were found in the lipid fractions from mitochondria treated with each
      of the conjugates. Lipids from both [35S]CTFC- and [35S]-TFEC-treated
      mitochondria contained major 35S-labeled lipid adducts which had similar mobility
      by thin-layer chromatography. Fatty acid analysis, 19F and 31P NMR spectroscopy,
      and mass spectrometric analyses confirmed that the major TFEC and CTFC adducts
      are thioamides of phosphatidylethanolamine.

PMID- 1643253
TI  - Comparative tumorigenicity of dimethylchrysenes in mouse skin.
AB  - In previous studies, we have observed unexpected structure-tumorigenicity
      relationships among the dimethylchrysenes. Thus, 5,6-dimethylchrysene and 5,7
      dimethylchrysene were only weakly tumorigenic and were significantly less active
      than 5-methylchrysene. These results were surprising in view of the known route
      of metabolic activation of 5-methylchrysene via its 1,2-diol 3,4-epoxide. In this
      paper, we extended our studies of structure-tumorigenicity relationships among
      the dimethylchrysenes. We synthesized 5,7-, 5,8-, 5,9-, and 5,10-dimethylchrysene
      via photochemical ring closure reactions. The tumor-initiating activities of
      these dimethylchrysenes on mouse skin were compared with those of 5
      methylchrysene and 5,6-dimethylchrysene. 5-Methylchrysene and 5,9
      dimethylchrysene were highly tumorigenic and were significantly more active than
      5,6-, 5,7-, 5,8-, and 5,10-dimethylchrysene. The results of these studies, taken
      together with those reported in the subsequent two papers, suggest that the
      molecular shapes of dimethylchrysenes influence the balance between metabolic
      activation and detoxification pathways.

PMID- 1643254
TI  - Metabolism and DNA binding of 5,6-dimethylchrysene in mouse skin.
AB  - 5,6-Dimethylchrysene (5,6-diMeC) is a weaker tumor initiator on mouse skin than 5
      methylchrysene (5-MeC). To investigate the reasons for the unexpectedly low
      activity of 5,6-diMeC, we have studied its metabolism and DNA binding in mouse
      skin, particularly with respect to metabolic activation via its anti-1,2-diol 3,4
      epoxide. The metabolism of 5,6-diMeC was first examined with liver 9000g
      supernatant from Aroclor 1254 pretreated rats. Three major metabolites were
      identified as 1- or 7-hydroxy-5-(hydroxymethyl)-6-MeC, 1,2-dihydroxy-1,2-dihydro
      5,6-diMeC (5,6-diMeC-1,2-diol), and 1-hydroxy-5,6-diMeC. The formation of 5,6
      diMeC-1,2-diol was then assessed in mouse epidermis, following topical
      application of [3H]5,6-diMeC. Levels of 5,6-diMeC-1,2-diol in epidermis exceeded
      those of 5-MeC-1,2-diol formed from 5-MeC under similar conditions. The binding
      of [3H]5,6-diMeC and that of [3H]5-MeC to mouse epidermal DNA were then compared.
      5,6-DiMeC-deoxyribonucleoside adducts were prepared as markers by reaction of
      anti- and syn-5,6-diMeC-1,2-diol 3,4-epoxide with calf thymus DNA. HPLC analysis
      of enzymatic hydrolysates of mouse epidermal DNA, isolated 18 h after topical
      treatment with [3H]5,6-diMeC or [3H]5-MeC, demonstrated the formation from
      [3H]5,6-diMeC of two major adducts produced by reaction of its anti-1,2-diol 3,4
      epoxide with deoxyguanosine and deoxyadenosine, respectively, while the major
      adduct formed from [3H]5-MeC resulted from reaction with deoxyguanosine, in
      agreement with previous results. Total DNA binding of [3H]5-MeC as well as
      formation of deoxyguanosine adducts exceeded that of [3H]5,6-diMeC by 3-4
      fold.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643255
TI  - Dimethylchrysene diol epoxides: mutagenicity in Salmonella typhimurium,
      tumorigenicity in newborn mice, and reactivity with deoxyadenosine in DNA.
AB  - In contrast to 5-methylchrysene and 5,9-dimethylchrysene, 5,6-dimethylchrysene
      and 5,7-dimethylchrysene are weak tumor initiators on mouse skin. In order to
      investigate the basis for this, we have evaluated the mutagenic activities toward
      Salmonella typhimurium TA 100 and reactivity with DNA of (+/-)-anti-1,2-dihydroxy
      3,4-epoxy-1,2,3,4-tetrahydro-5,6-dimethyl-ch rys ene (anti-5,6-diMeC-1,2-diol 3,4
      epoxide) and anti-5,7- and anti-5,9-diMeC-1,2-diol 3,4-epoxide. The tumorigenic
      activities of anti-5,6- and anti-5,7-diMeC-1,2-diol 3,4-epoxides in newborn mice
      were also investigated. anti-5,9-diMeC-1,2-diol 3,4-epoxide was the most
      mutagenic of the three diol epoxides. anti-5,6-diMeC-1,2-diol 3,4-epoxide was
      highly tumorigenic in newborn mouse lung, with activity significantly greater
      than that of either anti-5-MeC- or anti-5,7-diMeC-1,2-diol 3,4-epoxide. Although
      the amounts of total binding of the diol epoxides to calf thymus DNA were
      similar, anti-5,6-diMeC-1,2-diol 3,4-epoxide bound extensively to deoxyadenosine
      residues. High binding to deoxyadenosine is related to the presence of a
      sterically hindered bay or fjord region as present in 5,6-diMeC, 7,12
      dimethylbenz[a]anthracene, benzo-[g]chrysene, and benzo[c]phenanthrene. The
      conformations of the anti- and syn-diol epoxides of 5,6-diMeC and
      benzo[c]phenanthrene were similar, with both having pseudodiequatorial hydroxyl
      groups, in contrast to less sterically crowded diol epoxides. The high
      tumorigenicity of anti-5,6-diMeC-1,2-diol 3,4-epoxide in newborn mice is of
      interest with respect to its high deoxyadenosine binding.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1643256
TI  - Covalent cross-linking of proteins by carbon disulfide.
AB  - Carbon disulfide is known to react with amino groups of proteins to generate
      dithiocarbamates (2). We observed covalent cross-linking of dithiocarbamate
      derivatized proteins under physiological conditions which may occur through
      several mechanisms. Evidence for the structure of these covalent bridges and the
      reactive intermediate was obtained using 13C NMR spectroscopy in conjunction with
      specific isotopic labeling. On incubation at 37 degrees C oxidative coupling of
      dithiocarbamates generated bis(thiocarbamoyl) disulfides (3) which were reduced
      by cysteine. In addition, an electrophilic isothiocyanate (4) was generated from
      decomposition of the dithiocarbamate. Nucleophilic addition of sulfhydryl and
      amine moieties to the isothiocyanate produced dithiocarbamate ester (5) and
      thiourea linkages (6), respectively. Evidence for the presence of inter- and
      intramolecular cross-links was obtained using denaturing polyacrylamide gel
      electrophoresis under reducing conditions. The formation of isothiocyanate in
      neutral solution, through elimination of sulfhydryl ion, was correlated with
      increased pKa values of the parent amine of amino acids. Dithiocarbamates derived
      from terminal amino groups of proteins did not appear to generate isothiocyanate
      or form thiourea or dithiocarbamate ester. Both the thiourea and the
      dithiocarbamate ester were stable at reduced pH, whereas in alkaline media the
      thiourea was stable but dithiocarbamate ester was hydrolyzed. Although the
      disulfide and ester linkages were formed more rapidly than the thiourea,
      generation of the latter appeared to be irreversible, leading to its gradual
      accumulation over a longer period of time. Generation of isothiocyanate by CS2
      derived dithiocarbamates and subsequent covalent cross-linking of proteins may
      provide a molecular mechanism for CS2-induced axonopathy.

PMID- 1643257
TI  - Experimental and theoretical study on the redox cycling of resorufin by
      solubilized and membrane-bound NADPH-cytochrome reductase.
AB  - The present study describes both experimental and theoretical data on the redox
      cycling of resorufins catalyzed by NADPH-cytochrome reductase. At 1-5 microM
      concentrations at physiological pH, the redox cycling of ethoxy- and
      pentoxyresorufin was shown to be far more efficient than the redox cycling of
      their product from the cytochrome P-450 dependent O-dealkylation, resorufin (7
      hydroxyphenoxazone). This was shown to result from the fact that (i) the
      protonated form of the resorufin is a much better substrate for redox cycling
      than the deprotonated resorufin O-anion and (ii) at physiological pH the redox
      cycling active protonated form is present at only 1-4% of the total amount of
      resorufin. In addition to experimental data, AM1 molecular orbital computer
      calculations provided evidence for the difference in redox cycling capacity
      between the resorufin O-anion and its protonated form. The energy of the lowest
      unoccupied molecular orbital (ELUMO) of the resorufin O-anion is higher than the
      ELUMO value for the protonated form. This low ELUMO value of the protonated form
      can be taken as a parameter for its easier reduction. Furthermore, computer
      calculations demonstrated one-electron reduction of the protonated form to be
      energetically favorable by 363.5 kJ/mol, compared to one-electron reduction of
      the deprotonated O-anionic form. Additional AM1 molecular orbital computer
      calculations indicated that the one-electron-reduced resorufin will become
      protonated at the O-atom of the intramolecular semiquinone imine moiety before
      reduction by a second electron becomes likely. Finally, redox cycling of
      resorufin by solubilized and membrane-incorporated NADPH-cytochrome reductase
      provided evidence that membrane surroundings increase the concentration of the
      protonated form of resorufin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643258
TI  - Effect of bovine serum albumin on the extent of ortho rearrangement of N
      (sulfooxy)-2-fluorenylacetamide and of enzymatically activated N-hydroxy-2
      fluorenylacetamide and on the binding of reactive esters to nucleic acids.
AB  - We have investigated the effect of the bovine serum albumin (BSA)-catalyzed ortho
      rearrangement of synthetic and enzymatically generated N-(sulfooxy)-2
      fluorenylacetamide (NSF) to the O-sulfate esters on the binding of NSF to
      transfer ribonucleic acid (tRNA) and to deoxyribonucleic acid (DNA). Binding of
      synthetic NSF to tRNA and DNA decreased approximately 90 and 70%, respectively,
      in the presence of BSA. Under these conditions, the ortho rearrangement, a minor
      reaction in the absence of BSA, was nearly quantitative. The decrease of adduct
      formation to nucleic acids was not attributable to the competitive binding of NSF
      to BSA. Binding of NSF, generated by cytosolic sulfonation of the arylhydroxamic
      acid, N-hydroxy-2-fluorenylacetamide, to tRNA, was diminished approximately 97%
      in the presence of BSA while the ortho rearrangement of the sulfonated substrate
      increased from less than 0.5% to approximately 50%. Adduct formation of DNA with
      N-hydroxy-2-fluorenylacetamide, activated by enzymatic sulfonation, was inhibited
      approximately 90% in the presence of BSA. In these experiments, the catalytic
      effect of BSA on the ortho rearrangement of enzymatically sulfonated N-hydroxy-2
      fluorenylacetamide was of the same order as observed in the experiments with
      tRNA. The data obtained on the covalent interaction of DNA with enzymatically
      activated N-hydroxy-2-fluorenylacetamide indicate that, in addition to NSF,
      another electrophilic species accounts for binding of activated N-hydroxy-2
      fluorenylacetamide to DNA. The data support the view that the reactive
      electrophile is N-acetoxy-2-fluorenamine, resulting from the N,O-transacetylation
      of N-hydroxy-2-fluorenylacetamide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643259
TI  - Characterization of the glucuronide conjugate of cotinine: a previously
      unidentified major metabolite of nicotine in smokers' urine.
AB  - Recent studies in our laboratories have confirmed that a major unidentified
      metabolite of nicotine in smokers' urine was susceptible to enzymatic degradation
      by beta-glucuronidase to afford (S)-(-)-cotinine. In order to establish the
      identity of this metabolite, the quaternary ammonium conjugate, viz., (S)-(-)
      cotinine N-glucuronide, was synthesized. Reaction of methyl 2,3,4-tri-O-acetyl-1
      bromo-1-deoxy-alpha-D-glucopyranuronate with (S)-(-)-cotinine at 60 degrees C for
      3 days affords the fully protected conjugate as the bromide salt. Deprotection
      was accomplished in 1 M NaOH overnight at 25 degrees C. The deprotected inner
      salt was isolated by Dowex-50W cation-exchange chromatography. Electrospray mass
      spectra of the inner salt revealed the presence of ions with m/z 353 (M + H)+,
      375 (M + Na)+, and 391 (M + K)+ as well as ions resulting from loss of water and
      cleavage of the glycosidic bond. Proton and carbon nuclear magnetic resonance
      spectra established that the position of glucuronidation was the pyridyl
      nitrogen. The magnitude of the coupling between H1" and H2" of the sugar ring
      (8.71 Hz) and nuclear Overhauser enhancements were consistent with the beta
      isomer of the glucuronide conjugate. The synthetic (S)-(-)-cotinine N-glucuronide
      was susceptible to enzymatic hydrolysis by beta-glucuronidase to afford (S)-(-)
      cotinine. Application of a cation-exchange high-performance liquid
      chromatographic method enabled the collection of a fraction containing (S)-(-)
      cotinine N-glucuronide from a smoker's urine. The electrospray mass spectrum of
      this fraction contained ions consistent with the presence of (S)-(-)-cotinine N
      glucuronide. The concentrated fraction was subjected to enzymatic hydrolysis by
      beta-glucuronidase to afford (S)-(-)-cotinine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643260
TI  - Epoxide ring opening and related reactivities of cyclopenta polycyclic aromatic
      hydrocarbons: quantum mechanical studies.
AB  - A series of 13 cyclopenta polycyclic aromatic hydrocarbons have been studied
      using quantum mechanical methods. The three-dimensional molecular structure of
      each carbocation that might result from the opening of a protonated epoxide ring
      formed between the carbon atoms completing the cyclopenta ring was computed with
      AM1. AM1 and ab initio calculations, using a split valence basis set, were then
      used to predict the direction of ring opening and obtain information about the
      reactivity of the carbocation. These calculations have shown that for all
      carbocations studied the cationic charge is well distributed throughout the
      molecule. The largest CH group charges are approximately 0.3 electron. If the
      protonated epoxide ring can open so that the nominal charge is on a CH group that
      is attached to the central ring of an anthracenic core, that carbocation will be
      greatly favored. For carbocations of this type, the unoccupied alpha' position
      (the CH group opposite the position of attachment to the anthracenic core) has as
      much or more of the cation charge as the nominally charged CH position. The group
      charges, and other properties related to electrostatic reactivity, clearly favor
      addition of nucleophiles at the unoccupied alpha' position over addition at the
      nominally charged position. However, when the addition of small nucleophiles at
      both of these positions is modeled for two such examples, the results favor
      addition at the nominally charged position in one case and are equivocal in the
      other case. The group charges and other reactivities considered characterize the
      electrostatic part of the interaction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643261
TI  - Model adducts of benzo[a]pyrene and nucleosides formed from its radical cation
      and diol epoxide.
AB  - Reference adducts formed by reaction of deoxyribonucleosides with the ultimate
      carcinogenic forms of benzo[a]pyrene (BP), BP radical cation and BP diol epoxide,
      are essential for identifying the structures of adducts formed in biological
      systems. Electrochemical oxidation of BP in the presence of dG or dA produces
      adducts from BP radical cation. When 8 equiv of charge are consumed, four adducts
      are formed with dG: 7-(BP-6-yl)Gua, 8-(BP-6-yl)Gua, N2-(BP-6-yl)dG and 3-(BP-6
      yl)dG. With 2 equiv of charge, however, only 7-(BP-6-yl)Gua and 8-(BP-6-yl)dG (BP
      6-C8dG) are formed. Anodic oxidation of BP-6-C8dG affords 8-(BP-6-yl)Gua. Anodic
      oxidation of BP in the presence of dA produces 7-(BP-6-yl)Ade. Reaction of BP
      diol epoxide with dG yields 10-(guanin-7-yl)-7,8,9-trihydroxy-7,8,9,10
      tetrahydroBP, whereas reaction with dA affords three adducts, 10-(adenin-7-yl)
      7,8,9-trihydroxy-7,8,9,10-tetrahydroBP and two isomers of 10-(deoxyadenosin-N6
      yl)-7,8,9-trihydroxy-7,8,9,10-tetrahydroBP . On the basis of comparative kinetic
      studies among adducts of aromatic hydrocarbons and dG or G, only BP-6-C8dG easily
      loses the sugar moiety, providing a basis for a mechanism of hydrolysis of the
      glycosidic bond.

PMID- 1643262
TI  - Identification and quantitation of benzo[a]pyrene-DNA adducts formed by rat liver
      microsomes in vitro.
AB  - The two DNA adducts of benzo[a]pyrene (BP) previously identified in vitro and in
      vivo are the stable adduct formed by reaction of the bay-region diol epoxide of
      BP (BPDE) at C-10 with the 2-amino group of dG (BPDE-10-N2dG) and the adduct
      formed by reaction of BP radical cation at C-6 with the N-7 of Gua (BP-6-N7Gua),
      which is lost from DNA by depurination. In this paper we report identification of
      several new BP-DNA adducts formed by one-electron oxidation and the diol epoxide
      pathway, namely, BP bound at C-6 to the C-8 of Gua (BP-6-C8Gua) and the N-7 of
      Ade (BP-6-N7Ade) and BPDE bound at C-10 to the N-7 of Ade (BPDE-10-N7Ade). The in
      vitro systems used to study DNA adduct formation were BP activated by horseradish
      peroxidase or 3-methylcholanthrene-induced rat liver microsomes, BP 7,8
      dihydrodiol activated by microsomes, and BPDE reacted with DNA. Identification of
      the biologically-formed depurination adducts was achieved by comparison of their
      retention times on high-pressure liquid chromatography in two different solvent
      systems and by comparison of their fluorescence line narrowing spectra with those
      of authentic adducts. The quantitation of BP-DNA adducts formed by rat liver
      microsomes showed 81% as depurination adducts: BP-6-N7Ade (58%), BP-6-N7Gua
      (10%), BP-6-C8Gua (12%), and BPDE-10-N7Ade (0.5%). Stable adducts (19% of total)
      included BPDE-10-N2dG (15%) and unidentified adducts (4%). Microsomal activation
      of BP 7,8-dihydrodiol yielded 80% stable adducts, with 77% as BPDE-10-N2dG and
      20% of the depurination adduct BPDE-10-N7Ade. The percentage of BPDE-10-N2dG
      (94%) was higher when BPDE was reacted with DNA, and only 1.8% of BPDE-10-N7Ade
      was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643263
TI  - Perturbation of peptide conformations induced in anisotropic environments.
AB  - Reversed-phase high performance liquid chromatography (RP HPLC) has been found to
      be a convenient and powerful tool for the study of the secondary structure of
      peptides. Here, the ability of proline to perturb the secondary structures of
      peptides induced at aqueous-lipid interfaces and the induced conformation of
      polyproline peptides were investigated by means of RP HPLC. For these studies,
      four different complete sets of substitution analogues of model peptides expected
      to have specific induced conformations were used. In the first two studies, a
      single lysine was "walked" through two 18-residue polyproline sequences (one N
      acetylated, the other not). In the remaining two studies, a proline was "walked"
      through two different sequences that had been found earlier to be induced into an
      alpha-helical conformation during RP HPLC (an 18-residue polyalanine sequence and
      the amphipathic 14-residue sequence Ac-LLKLLKKLLKKLKK-NH2). Sixty-eight
      individual analogues were synthesized for this study and the effect of the
      respective substitutions on retention times was determined. The results are
      consistent with the concept that, upon interaction with the C-18 of the
      stationary phase during RP HPLC, polyproline is induced into a type II helical
      conformation, polyalanine into an alpha-helical conformation, and Ac
      LLKLLKKLLKKLKK-NH2 into an amphipathic alpha-helical array. In an extension of
      this study, the antimicrobial activities of Ac-LLKLLKKLLKKLKK-NH2 and its 18
      proline substitution analogues were found to be inversely correlated with their
      RP HPLC retention times.

PMID- 1643264
TI  - Heavy metal binding to heparin disaccharides. I. Iduronic acid is the main
      binding site.
AB  - As model compounds for Ni(II)-binding heparin-like compounds isolated from human
      kidneys (Templeton, D.M. & Sarkar, B. (1985) Biochem. J. 230 35-42.), we
      investigated two disaccharides--4-O-(2-O-sulfo-alpha-L-idopyranosyluronic acid)
      2,5-anhydro- D-mannitol, disodium salt (1a), and 4-O-(2-O-sulfo-alpha-L
      idopyranosyluronic acid)-6-O- sulfo-2,5-anhydro-D-mannitol, trisodium salt (1b)-
      that were isolated from heparin after nitrous acid hydrolysis and reduction. The
      monosulfate (1a) was active whereas the disulfate (1b) was inactive in a high
      performance liquid chromatography (HPLC) binding assay with the tracer ions
      63Ni(II) 54Mn(II), 65Zn(II), and 109Cd(II). This result is in accord with the
      isolation of two 67Cu(II) and 63Ni(II) binding fractions from a complete pool of
      nitrous-acid-derived heparin disaccharides using sulfate gradients and a MonoQ
      anion exchange column on an FPLC system. One was identified as compound (1a) and
      the other as a tetrasulfated trisaccharide by high resolution FAB-MS, NMR and
      HPLC-PAD. Similarly, two synthetic disaccharides-methyl, 2-O-sulfo-4-O-(alpha-L
      idopyranosyluronic acid)-2-deoxy-2-sulfamide-alpha-D-glucosamine, trisodium salt
      [IdopA2S(alpha 1,4)GlcNS alpha Me, 2a], and 2-O-sulfo-4-O-(alpha-L
      idopyranosyluronic acid)-2-deoxy-2-sulfamide-6-O-sulfo- alpha-D-glucosamine,
      tetrasodium salt [IdopA2S (alpha 1,4)GlcNS6S alpha Me, 2b]--were shown to bind
      tracer amounts of 63Ni and 67Cu using chromatographic assays. Subsequently, 1H
      NMR titrations of 1a, 1b, 2a, and 2b with Zn (OAc)2 were analyzed to yield 1:1
      Zn(II)-binding constants of 472 +/- 59, 698 +/- 120, 8,758 +/- 2,237 and 20,100
      +/- 5,598 M-1, respectively. The values for 2a and 2b suggest chelation. It is
      suggested that the idopyranosiduronic acid residue is the major metal binding
      site. NMR evidence for this hypothesis comes from marked 1H and 13C chemical
      shift changes to the iduronic acid resonances after addition of diamagnetic
      Zn(II) ions.

PMID- 1643265
TI  - Heavy metal binding to heparin disaccharides. II. First evidence for zinc
      chelation.
AB  - To map out the heavy metal binding sites of iduronic acid containing
      oligosaccharides isolated from human kidneys, we studied Zn(II) binding by
      nuclear magnetic resonance (NMR) and molecular modeling to two disaccharides
      isolated after nitrous acid depolymerization of heparin and two synthetic
      disaccharides representative of the heparin structure, namely, IdopA2S (alpha
      1,4)AnManOH, 1 alpha, IdopA2S (alpha 1,4)AnManOH6S, 1b, IdopA2S-(alpha 1,4)GlcNS
      alpha Me, 2a, and IdopA2S (alpha 1,4)GlcNS6S alpha Me, 2b (see previous article
      in this series). A conformational analysis of the metal free and metal bound
      solutions was made by comparing calculated [(NOE)]s, [T1]s, and [J]s to
      experimental values. The 1C4, 4C1, and 2S0 conformations of the L
      idopyranosiduronate ring and the 4E and 4T3 of the anhydro-D-mannitol ring are
      evaluated as are rotations about the C5-C6 hydroxymethylene of the AnManOH(6S) or
      GlcNS (6S) residues. The NOE between IdopA2S H1 and H3 and the known NOE between
      H2 and H5, as well as the T1 of IdopA2S H3, are introduced as NMR observables
      sensitive to the IdopA2S ring conformation. Similarly, a NOE between IdopA2S H5
      and AnManOH(6S) or GlcNS(6S) H3 was observed that directly restricts the allowed
      interglycosidic conformational space. For all disaccharides, the Zn(II) bound
      spectral data are consistent with models in which these motions are partially
      "frozen" such that the 1C4 conformation of the IdopA2S is stabilized along with
      the 4T3 conformation of the AnManOH(6S) ring. The interglycosidic conformation is
      also stabilized in one of two minima. Electrostatic potential energy calculations
      gave the best overall agreement with experiment and suggest metal binding
      conformations with the carboxylate and ring oxygen of the IdopA2S residues (1C4
      conformation) and either O3 of the GlcNS(6S) residues or the sulfate oxygens of
      the 6-sulphate for 2b providing additional chelating sites. These chelation
      models concur with the observation of marked 13C and 1H NMR chemical shifts for
      the IdopA2S resonances and of GlcNS H3 for 2 alpha and GlcNS6S C6 for 2b. This
      study of model compounds implicates the IdopA2S(alpha 1,4)GlcNS6S group as part
      of the heavy metal binding site in biologically important acidic oligosaccharides
      such as heparin.

PMID- 1643266
TI  - A molecular mechanical study of the structure of poly(alpha-aminoisobutyric
      acid).
AB  - A molecular mechanical study has been carried out to determine the most favorable
      conformation of poly(Aib) both in solution and in the solid state. An energetic
      approach to the packing has been carried out by studying the stability of pairs
      of poly(Aib) chains. The study reveals a higher stability of a 3(10)-helix when
      forming part of a dimer whereas in isolated molecules the alpha-helix structure
      seems to be more stable depending on the length of the chain and dielectric
      constant of the environment.

PMID- 1643267
TI  - Crystal structure of a helical oligopeptide model of polyglycine II and of other
      polyamides: acetyl-(glycyl-beta-alanyl)2-NH propyl.
AB  - We synthesized and solved the crystalline structure of the oligopeptide acetyl
      (glycyl-beta-alanyl)2-NH propyl. The crystal is formed by layers of helical
      molecules with the same chirality; however, right-handed layers alternate with
      left-handed ones. Inside every layer, the packing of helices is pseudohexagonal
      with hydrogen bonds between neighbor molecules. The structure found affords
      direct support for the model proposed by Crick and Rich for polyglycine II and
      also provides an interpretation for the structure of a newly found family of
      polyamides that do not form sheets as observed in most nylon structures.

PMID- 1643268
TI  - Solution structures of cyclic and dicyclic analogues of growth hormone releasing
      factor as determined by two-dimensional NMR and CD spectroscopies and constrained
      molecular dynamics.
AB  - Solution structures were determined for a linear analogue of growth hormone
      releasing factor (GRF), and cyclic and dicyclic analogues in which the side
      chains of aspartyl and lysyl residues spaced at positions i-(i + 4) were joined
      to form a lactam. The four analogues were [Ala15]-GRF-(1-29)-NH2 and its cyclo8
      12, cyclo21-25, and dicyclo8-12;21-25 derivatives. The peptides were studied in
      two solvent systems: 75% methanol/25% water at pH 6.0; and 100% water at pH 3.0.
      CD spectroscopy was used to assess the overall alpha-helical content. Nuclear
      magnetic resonance spectroscopy was used to determine the structures in more
      detail. Nearly complete proton resonance assignments were made for each of the
      peptides, in both solvents. Nuclear Overhauser effects were converted into
      distance constraints and applied in the molecular dynamics program CHARMM to
      evaluate the range of low-energy structures that satisfied the nmr data. In 75%
      methanol, all of the peptides are comprised of a single alpha-helical segment
      with fraying of one to three residues at each end. The linear analogue has a
      tendency to kink. In water, the analogues have two helical segments with flexible
      regions between them and at the termini of the peptides. The linear analogue is
      helical at residues 7-14 and 21-28. In the cyclo8-12 analogue, the N-terminal
      helical region extends to include residues 7-19, while the other helical region
      is slightly shortened. In the cyclo21-25 analogue, the C-terminal helical region
      is extended to include residues 19-28, while the N-terminal helical region is
      destabilized. The dicyclic analogue has the largest N-terminal helix, spanning
      residues 7-20, but its helical segment at residues 21-28 is not well ordered. All
      of the analogues exhibit substantial biological activity. The cyclic and dicyclic
      analogues show dramatically increased resistance to degradation during incubation
      with human plasma. The i-(i + 4) lactam, therefore, appears to be a synthetic
      means of stabilizing a local alpha-helical conformation, which may be of general
      use in the design of active, stable peptides.

PMID- 1643269
TI  - Protein: nucleic acid interactions. I. Electronic structures of cytosine, indole,
      and guanine complexes.
AB  - Low singlet transition energies and line strengths were calculated for the
      cytosine:indole:guanine complex by the INDO/1S-CI method. The chromophores were
      arranged in three sets of 270 intercalating geometries. Calculations were
      executed in the supermolecule model with single excited configurations. Errors
      due to basis set extension and incomplete configuration representation were
      assessed, for all chromophore pairs, by full BSSE correction calculations and
      inclusion of double-excited configurations. The intercalation-induced
      perturbations of the principal transitions are characterized by but not limited
      to (a) a decrease in strength of [pi*,pi] transitions, (b) increase in strength
      in [pi*,n] transitions, (c) splitting of [pi*,pi] transitions into components of
      unequal strength, and (d) energy and strength dependence in mixed transitions on
      rise and shift movements of the nucleic acid bases. These predictions are in
      accord with absorption, fluorescence emission, and scattering, and resonance
      Raman spectroscopic data on oligonucleotides and analogous aromatic complexes.
      The calculations suggest that major differences in intercalating coordinations
      are discernible in the near-uv spectroscopic domain of proteins and nucleic
      acids.

PMID- 1643270
TI  - The nature of folded states of globular proteins.
AB  - We suggest, using dynamical simulations of a simple heteropolymer modelling the
      alpha-carbon sequence in a protein, that generically the folded states of
      globular proteins correspond to statistically well-defined metastable states.
      This hypothesis, called the metastability hypothesis, states that there are
      several free energy minima separated by barriers of various heights such that the
      folded conformations of a polypeptide chain in each of the minima have similar
      structural characteristics but have different energies from one another. The
      calculated structural characteristics, such as bond angle and dihedral angle
      distribution functions, are assumed to arise from only those configurations
      belonging to a given minimum. The validity of this hypothesis is illustrated by
      simulations of a continuum model of a heteropolymer whose low temperature state
      is a well-defined beta-barrel structure. The simulations were done using a
      molecular dynamics algorithm (referred to as the "noisy" molecular dynamics
      method) containing both friction and noise terms. It is shown that for this model
      there are several distinct metastable minima in which the structural features are
      similar. Several new methods of analyzing fluctuations in structures belonging to
      two distinct minima are introduced. The most notable one is a dynamic measure of
      compactness that can in principle provide the time required for maximal
      compactness to be achieved. The analysis shows that for a given metastable state
      in which the protein has a well-defined folded structure the transition to a
      state of higher compactness occurs very slowly, lending credence to the notion
      that the system encounters a late barrier in the process of folding to the most
      compact structure. The examination of the fluctuations in the structures near the
      unfolding----folding transition temperature indicates that the transition state
      for the unfolding to folding process occurs closer to the folded state.

PMID- 1643271
TI  - The use of Flory-Huggins theory in interpreting partitioning of solutes between
      organic liquids and water.
AB  - Solute partitioning data for dilute solutions have almost invariably been
      interpreted by equating experimental values of -RT in Kx (wherein Kx is the mole
      fraction partition coefficient) to delta mu infinity, the standard Gibbs energy
      change for solute transfer from one solvent to another. Recently, it has been
      alleged that this relation is insufficiently general. Instead, the statistical
      mechanical Flory-Huggins (FH) theory has been recommended for use, because it is
      designed to account for disparities in molecular size between solute and solvent.
      Our examination of the thermodynamics of partitioning shows that: (1) The
      customary interpretation is not only entirely correct (providing only that the
      solute is dilute), but is model-independent. (2) The dilute limit of the FH
      theory is seen to agree entirely with the usual interpretation of -RT in Kx, once
      certain misnomers are cleared away. (3) The use of FH theory being urged upon us
      in fact serves only to extract from delta mu infinity (the latter quite correctly
      determined as -RT in Kx) the contact part of delta mu infinity in order to obtain
      information on hydrophobic interactions. Some caveats are cited concerning such
      use of the FH statistical mechanical model.

PMID- 1643272
TI  - Existence of lipid vesicles containing platelet-activating factor in endothelial
      cell lysate.
AB  - Platelet aggregation activity due to platelet-activating factor (PAF) was
      detected at high molecular weight (HMW) and low molecular weight fractions after
      gel-filtration chromatography of cell lysate of endothelial cells. [3H]PAF added
      to the cell lysate was similarly distributed after chromatography. The
      radioactivity associated with HMW fraction was not reduced by digesting the
      lysate with trypsin, suggesting that PAF was not making complexes with proteins
      but was included in lipid vesicles in cell lysate. Further evidence showed that
      an unknown specific factor(s) was needed to form these PAF-containing lipid
      vesicles. Radioactivity was not found in HMW fraction when [3H]PAF was mixed with
      cell lysate of vascular smooth muscle cells. When monomeric PAF was added to
      endothelial cell lysate, the specific activity of aggregation decreased to the
      level exerted by endogenous PAF-containing lipid vesicles due to incorporation
      into lipid vesicles. PAF in the form of lipid vesicles was more stable in plasma
      than monomeric form.

PMID- 1643273
TI  - Insulin antagonizes the phagocytosis stimulating action of histamine in
      Tetrahymena.
AB  - Histamine increased specifically the phagocytic activity of the unicellular
      Tetrahymena, whereas insulin had no influence on it. Insulin antagonized the
      phagocytosis stimulating action of histamine after simultaneous exposure and
      after preexposure two days earlier as well, although in the latter case to a
      lesser degree. Double exposure to a combination of histamine+insulin didn't
      influence the phagocytic activity at all, demonstrating the histamine
      antagonizing effect of insulin in this model.

PMID- 1643274
TI  - Inhibition of protein N-glycosylation has no effect on the binding of acetyl LDL
      to J774 cells.
AB  - Acetyl-LDL (Ac-LDL) bound to transformed mouse macrophage J774 cells in a high
      affinity, saturable and specific manner. When cells were cultured for 24h in the
      presence of tunicamycin such that incorporation of N-linked sugars into protein
      but not protein synthesis itself was inhibited significantly, the binding
      characteristics of Ac-LDL to the cells were unaltered. In this respect the Ac-LDL
      receptor of J774 cells is similar to the asialoglycoprotein receptor of HepG2
      cells.

PMID- 1643275
TI  - Changes in alanine and glutamine transport during rat red blood cell maturation.
AB  - Alanine and glutamine transport have been studied during red blood cell
      maturation in the rat. Kinetic parameters of Na(+)-dependent L-alanine transport
      were: Km 0.43 and 1.88 mM and Vmax 158 and 45 nmoles/ml ICW/min for reticulocytes
      and erythrocytes, respectively. During red cell maturation in the rat there is a
      loss of capacity and affinity of the system ASC for L-alanine transport. The
      values for Na(+)-dependent L-glutamine transport in reticulocytes were Km 0.51 mM
      and Vmax 157 nmoles/ml ICW/min. On the other hand, a total loss of L-glutamine
      transport mediated by both N and ASC systems is demonstrated in mature red cells.
      This seems to indicate that during rat red cell maturation the system N
      disappears. Furthermore, the system ASC specificity in mature cells changes, and
      glutamine enters the red cell by non-mediated diffusion processes.

PMID- 1643276
TI  - Surface heterogeneity of rat sperm during maturation.
AB  - Rat sperm isolated from the caput and caudal epididymis and the vas deferens were
      subjected to multiple partition in aqueous two-phase systems. The technique was
      used to reveal heterogeneity of a sperm population with respect to particular
      surface properties. Sperm from all three regions gave broad distributions
      indicative of heterogeneous cell populations. Greatest heterogeneity was observed
      for cauda sperm with caput and vas sperm producing similar distributions.
      Following multiple partition sperm from different regions of the distribution
      profiles were immunostained with three antibodies known to recognise maturation
      antigens. The results show that some antigens are acquired during epididymal
      transit whilst others are present throughout. The partition (surface
      heterogeneity) seen cannot therefore be explained solely by the distribution of
      the antigens recognized by 2D6, 6B2 and 3D5.

PMID- 1643277
TI  - 2-Ketoisocaproate transport in insulin-secreting cells.
AB  - The transport of the nutrient secretagogue 2-ketoisocaproate (KIC) was studied in
      isolated rat pancreatic islets and in the HIT-T15 insulinoma cell line using an
      oil-filtration technique. In both islets and HIT-T15 cells, KIC uptake was a slow
      process, not reaching equilibrium within 10 min KIC transport was not dependent
      upon Na+ in the medium, was not inhibited by alpha-cyano-4-hydroxycinnamate nor
      by 2-amino-2-norborane carboxylic acid (BCH) and did not appear to be
      electrogenic. Evidence was obtained to suggest that KIC uptake occurred via
      passive diffusion into the cell of the undissociated acid species. This
      possibility was supported by the apparent unsaturability of KIC uptake in HIT-T15
      cells. Addition of 10-30 mM KIC to dispersed islets cells or HIT-T15 cells
      produced a rapid intracellular acidification. In islets, the rate of transport of
      10 mM KIC was comparable with oxidation rate of the keto-acid suggesting that
      uptake could be rate-limiting factor for KIC oxidation and thus stimulated
      insulin release. However, in HIT-T15 cells, the rate of uptake of KIC greatly
      exceeded the oxidation rate. The low rate of KIC oxidation could explain the poor
      secretory response of HIT-T15 cells to KIC.

PMID- 1643278
TI  - Site-specific oligodeoxynucleotide binding to maize Adh1 gene promoter represses
      Adh1-GUS gene expression in vivo.
AB  - There is a 36 bp tract of extreme homopurine/homopyrimidine (PuPy) asymmetry in
      the maize Adh1 gene promoter (from -44 to -79) that is S1-hypersensitive in
      plasmids under supercoil tension. Oligodeoxynucleotides corresponding to the PuPy
      tract were designed to examine the secondary structure of the region and address
      the possible role of the tract in gene regulation. On the basis of
      oligodeoxynucleotide band-shift and DNase I footprinting analyses, it was
      concluded that the homopyrimidine oligodeoxynucleotide can form a triple helix
      with the duplex PuPy tract in vitro. Transient assays in protoplasts, suspension
      cells, and seedling roots show that the homopyrimidine oligodeoxynucleotide is
      also capable of repressing Adh1-GUS gene expression during co-transformation,
      presumably by the formation of a triple helix with the PuPy tract in vivo. The
      complementary homopurine oligodeoxynucleotide would not form a triple helix in
      vitro, nor would it repress Adh1-GUS in vivo. We propose that triple helix
      formation is a potential regulatory phenomenon in vivo, and that an intraregion
      triple helix could occur within the Adh1 promoter via the formation of H-DNA.

PMID- 1643279
TI  - Sequence of the fourth and fifth Photosystem II type I chlorophyll a/b-binding
      protein genes of Arabidopsis thaliana and evidence for the presence of a full
      complement of the extended CAB gene family.
AB  - A second locus (Lhb1B) encoding Photosystem II Type I chlorophyll a/b-binding
      (CAB) polypeptides was identified in Arabidopsis thaliana. This locus carries two
      genes in an inverted orientation. The predicted sequences of the polypeptides
      encoded by these two genes show substantial divergence in their amino termini
      relative to each other and to the proteins encoded by the three Lhb1 CAB genes
      previously characterized [10], but little divergence within the predicted primary
      structure of the mature protein. DNA probes derived from seven additional types
      of tomato CAB genes, encoding chlorophyll a/b-binding polypeptides of several
      antenna systems of the photosynthetic apparatus, were tested against A. thaliana.
      Each of these hybridized in Southern blots to unique DNA fragment(s),
      demonstrating the existence of each of these different types of CAB genes in the
      genome of A. thaliana. The number of genes encoding each CAB type in A. thaliana
      was estimated to be similar to that of tomato.

PMID- 1643280
TI  - Acidic and basic class III chitinase mRNA accumulation in response to TMV
      infection of tobacco.
AB  - Complementary DNA clones encoding acidic and basic isoforms of the class III
      chitinase were isolated from Nicotiana tabacum. The clones share ca. 65%
      identity, are equally homologous to the class III chitinases from cucumber and
      Arabidopsis, and are members of small gene families in tobacco. An acidic class
      III chitinase was purified from the intercellular fluid of tobacco leaves
      infected with tobacco mosaic virus (TMV). Partial amino acid sequencing of the
      protein confirmed that it was encoded by one of the cDNA clones. The mRNAs of the
      class III chitinases are coordinately expressed in response to TMV infection,
      both in infected and uninfected tissue. The acidic and basic class III chitinases
      constitute previously undescribed pathogenesis-related proteins in tobacco.

PMID- 1643281
TI  - Molecular analysis of the plant gene encoding cytosolic phosphoglucose isomerase.
AB  - The gene encoding a cytosolic isozyme of phosphoglucose isomerase (PGI, EC
      5.3.1.9) was isolated from Clarkia lewisii, a wild flower native to California,
      and the structure and sequence of the entire coding region determined. PGI
      catalyzes an essential step in glycolysis and carbohydrate biosynthesis in
      plants. Spanning about 6 kb, the gene has 23 exons and 22 introns, the highest
      number yet reported in plants. The exons range in size from 43 to 156 nt and
      encode a protein of 569 amino acids. The protein is about 44-46% identical to the
      inferred protein sequences of pig, Escherichia coli and Saccharomyces cerevisiae.
      All of the introns are bordered with the consensus 5'-GT...AG-3' dinucleotides.
      The longest intron includes a large stem-loop structure bounded by a perfect 9 nt
      direct repeat. We cloned the PGI gene from a genomic library prepared from a
      single plant of known PGI genotype. The locus and allele of the clone were
      identified by matching restriction fragments to fragments from genetically
      defined genomic DNAs by Southern hybridization.

PMID- 1643282
TI  - Identification and characterisation of cDNA clones encoding cinnamyl alcohol
      dehydrogenase from tobacco.
AB  - Cinnamyl alcohol dehydrogenase (CAD, EC 1.1.1.195) is an enzyme involved in
      lignin biosynthesis. We have previously isolated pure CAD enzyme as two closely
      related polypeptides of 44 and 42.5 kDa from tobacco stems. In this paper, we
      report partial amino acid sequences of these two polypeptides. Based on the
      peptide sequences mixed oligonucleotides were used to screen a tobacco stem cDNA
      library and CAD cDNA clones encoding the two polypeptides were identified. DNA
      sequence comparisons indicate very high sequence identity between these clones
      both in the coding and in the 5' and 3' untranslated sequences. The close
      similarity between the two CAD genes leads us to suggest that they do not
      represent different isoforms but are the same gene from each of the two parental
      lines of Nicotiana tabacum cv. Samsun. Sequence comparisons with alcohol
      dehydrogenase 1 (ADH1) from yeast shows sequence similarities of ca. 30%, while
      comparisons with maize, barley and potato ADH1 sequences show similarities of not
      more than 23%.

PMID- 1643283
TI  - The function of vacuolar beta-1,3-glucanase investigated by antisense
      transformation. Susceptibility of transgenic Nicotiana sylvestris plants to
      Cercospora nicotianae infection.
AB  - Vacuolar class I beta-1,3-glucanases (EC 3.2.1.39) are believed to be important
      in the induced defense reaction of plants to fungal infection. We used antisense
      transformation to test this hypothesis and to identify other possible
      physiological functions of this enzyme. Nicotiana sylvestris plants were
      transformed with antisense constructions containing the region from position 27
      to 608 of the coding sequence of the basic, vacuolar beta-1,3-glucanase gene GLA
      of tobacco regulated by cauliflower mosaic virus 35S RNA expression signals.
      Plants homozygous for this transgene showed a marked, ca. 20-fold reduction in
      the constitutive expression of class I beta-1,3-glucanase antigen in their
      leaves. RNA blot analysis indicated that the antisense plants expressed low
      levels of the sense transcript of the host beta-1,3-glucanase gene and the
      antisense transcript of the transgene. Immune blot analysis of plant extracts
      indicated that only expression of the N. sylvestris homologue of class I tobacco
      beta-1,3-glucanase and not the acidic, class II isoforms of the enzyme was
      blocked in the antisense plants. Class I isoforms of beta-1,3-glucanase and
      chitinase were coordinately induced in leaves of untransformed and empty-vector
      transformed N. sylvestris plants treated with ethylene or infected with the
      fungal leaf pathogen Cercospora nicotianae. In antisense plants, chitinase but
      not beta-1,3-glucanase was induced under these conditions indicating that
      antisense transformation effectively blocks constitutive as well as induced
      expression of class I beta-1,3-glucanase. Under greenhouse conditions, antisense
      plants developed normally and were fertile. The plants did not exhibit increased
      susceptibility to C. nicotianae infection. These results suggest that expression
      of the beta-1,3-glucanase isoform blocked by antisense transformation is not
      necessary for 'housekeeping' functions of N. sylvestris nor defense against the
      fungal pathogen tested.

PMID- 1643284
TI  - Regulation of lysine synthesis in transgenic potato plants expressing a bacterial
      dihydrodipicolinate synthase in their chloroplasts.
AB  - The essential amino acid lysine is synthesized in higher plants by a complex
      pathway that is predominantly regulated by feedback inhibition of two enzymes,
      namely aspartate kinase (AK) and dihydrodipicolinate synthase (DHPS). Although
      DHPS is thought to play a major role in this regulation, the relative importance
      of AK is not known. In order to study this regulation, we have expressed in the
      chloroplasts of transgenic potato plants a DHPS derived from Escherichia coli at
      a level 50-fold above the endogenous DHPS. The bacterial enzyme is much less
      sensitive to lysine inhibition than its potato counterpart. DHPS activity in
      leaves, roots and tubers of the transgenic plants was considerably higher and
      more resistant to lysine inhibition than in control untransformed plants.
      Furthermore, this activity was accompanied by a significant increase in level of
      free lysine in all three tissues. Yet, the extent of lysine overproduction in
      potato leaves was significantly lower than that previously reported in leaves of
      transgenic plants expressing the same bacterial enzyme, suggesting that in
      potato, AK may also play a major regulatory role in lysine biosynthesis. Indeed,
      the elevated level of free lysine in the transgenic potato plants was shown to
      inhibit the lysine-sensitive AK activity in vivo. Our results support previous
      reports showing that DHPS is the major rate-limiting enzyme for lysine synthesis
      in higher plants, but they suggest that additional plant-specific regulatory
      factors are also involved.

PMID- 1643285
TI  - Molecular characterization of tobacco cDNAs encoding two small GTP-binding
      proteins.
AB  - We have isolated two cDNAs encoding small GTP-binding proteins from leaf cDNA
      libraries. These cDNAs encode distinct proteins which show considerable homology
      to members of the ras superfamily. Np-ypt3, a 1044 bp long Nicotiana
      plumbaginifolia cDNA, encodes a 24.4 kDa protein which shows 65% amino acid
      sequence similarity to the Schizosaccharomyces pombe ypt3 protein. The N-ypt3
      gene is differentially expressed in mature flowering plants. Expression of this
      gene is weak in leaves, higher in stems and roots, but highest in petals, stigmas
      and stamens. Nt-rab5, a 712 bp long Nicotiana tabacum SR1 cDNA, encodes a 21.9
      kDa protein which displays 65% amino acid sequence similarity to mammalian rab5
      proteins. The expression pattern of the Nt-rab5 gene is very similar to that of
      the Np-ypt3 gene. The Nt-rab5 gene is virtually not expressed in leaves, higher
      in stems and roots, and highest in flowers. Both the Nt-rab5 and Np-ypt3 proteins
      were expressed in Escherichia coli and shown to bind GTP.

PMID- 1643286
TI  - Functional elements of the Arabidopsis Adh promoter include the G-box.
AB  - The alcohol dehydrogenase (Adh) gene of Arabidopsis is expressed constitutively
      in immature seedlings and cells in suspension, and may be induced by hypoxic
      stress only in roots of mature plants. Deletions and G-box mutations of the Adh
      promoter were assayed in Arabidopsis protoplasts by PEG-mediated transient
      expression. Sequence domains necessary for full gene activity are confined to the
      384 bp immediately 5' to the transcription start site, and deletion to -177
      results in greater than 90% reduction in promoter activity. Site-specific
      mutations of G-box bases result in greater than 60% reduction in activity and
      disrupt G-box factor binding in vitro.

PMID- 1643287
TI  - Isolation and characterization of a cDNA clone encoding the TATA box-binding
      protein (TFIID) from wheat.
AB  - We isolated a complementary DNA (cDNA) encoding the TATA-binding factor 'TFIID'
      from a wheat seedling cDNA library. The wheat TFIID transcript of 1.2 kb poly(A)+
      RNA was expressed at a low level early in germination, but gradually increased as
      the seedlings developed. In vitro binding experiments showed that the bacterially
      expressed wheat TFIID protein could specifically bind to the TATA boxes of the
      cauliflower mosaic virus (CaMV) 35S, wheat histone H3 and adenovirus major late
      genes with different affinity. A comparison with Arabidopsis TFIID showed the
      presence of a plant-specific region consisting of 13 amino acids at the divergent
      amino terminus and a conserved region (182 amino acids) at the carboxy terminus
      longer than that observed in yeasts (180 amino acids) and animals (181 amino
      acids).

PMID- 1643288
TI  - cDNA sequence of a sunflower oleosin and transcript tissue specificity.
AB  - Oleosins (oil body membrane proteins) of 20.5 and 18 kDa have been purified from
      sunflower (Helianthus annuus) seeds and polyclonal antibodies raised against
      them. The precipitated rabbit immunoglobulin fraction was purified by affinity
      chromatography on cyanogen bromide-activated Sepharose and specifically
      recognised polypeptides of 18 and 20.5 kDa in sunflower homogenate and oil body
      fractions assayed by western blotting. A near-full-length cDNA clone was isolated
      for the 20.5 kDa oleosin. The 694 bp cDNA contained an open reading frame of 534
      bp, followed by an untranslated region of 81 bp and a poly(A) region of 70 bp.
      The open reading frame encoded a polypeptide of 19.8 kDa. Study of transcript
      localisation revealed message to be abundant in the embryo during the later stage
      of development and still present in the dry seed. No signal was observed in RNA
      prepared from expanding leaves.

PMID- 1643289
TI  - Cloning and sequence analysis of the glucose-6-phosphate dehydrogenase gene from
      the cyanobacterium Synechococcus PCC 7942.
AB  - The glucose-6-phosphate dehydrogenase (EC 1.1.1.49) gene (zwf) of the
      cyanobacterium Synechococcus PCC 7942 was cloned on a 2.8 kb Hind III fragment.
      Sequence analysis revealed an ORF of 1572 nucleotides encoding a polypeptide of
      524 amino acids which exhibited 41% identity with the glucose-6-phosphate
      dehydrogenase of Escherichia coli.

PMID- 1643290
TI  - Nucleotide sequence of cDNA encoding beta-luffin, another ribosome-inactivating
      protein from Luffa cylindrica.

PMID- 1643291
TI  - The evidence for interleukin-6 as an autocrine growth factor in malignancy.
AB  - Interleukin-6, IL-6, is a pleiotropic cytokine which plays a central role in
      defense mechanisms, including the immune response, acute phase reaction and
      hematopoiesis. Abnormal expression of the IL-6 gene has been suggested to be
      involved in the pathogenesis of a variety of diseases, especially rheumatoid
      arthritis, Castleman's disease, mesangial proliferative glomerulonephritis,
      multiple myeloma and Kaposi's sarcoma. In the case of multiple myeloma and
      Kaposi's sarcoma, the existence of an IL-6-IL-6 receptor autocrine loop has been
      implicated in the oncogenesis process. On the other hand, IL-6 has a potent anti
      tumor activity against certain types of tumors. This anti-tumor effect is
      mediated by in vivo induction of tumor specific cytotoxic T cells and in part by
      a growth inhibitory activity of IL-6.

PMID- 1643292
TI  - Tumour necrosis factor: roles in cancer pathophysiology.
AB  - Tumour necrosis factor (TNF) is a pleiotropic cytokine with activities that
      extend beyond its antitumour effect. There is now increasing evidence that TNF
      can be either constitutively produced or induced in human tumours. Tumour cells
      may also lead to TNF induction in normal cells. Experimental studies implicate
      TNF in processes that contribute to cancer progression. These range from
      stimulation of cancer growth and metastasis, to metabolic and haematological
      disturbances, e.g. cancer cachexia, anaemia, and hypercalcaemia. Future cancer
      therapies may therefore involve neutralisation of TNF activity in cancer
      patients.

PMID- 1643293
TI  - Transfection of interferon-gamma gene in animal tumors--a model for local
      cytokine production and tumor immunity.
AB  - After retrovirus-mediated interferon (IFN)-gamma gene transfer, tumor cells
      constitutively produce IFN-gamma and subsequently increase their surface
      expression of class I major histocompatibility complex antigens. Such cells are
      useful for evaluating the comprehensive anti-tumor activity of IFN-gamma in vivo
      in the mouse. When implanted, the IFN-gamma-producing tumor cells usually lose
      their tumorigenicity due to specific and/or nonspecific immune responses against
      the tumor which are probably augmented by the tumor-derived IFN-gamma. This
      specific immunity is mediated by CD8+ effector cells, i.e. cytotoxic T
      lymphocytes. Other in vivo effects due to IFN-gamma gene transfer vary with
      different types of tumor. These results imply a promising potential of tumor-cell
      targeted IFN-gamma gene therapy against cancer.

PMID- 1643294
TI  - A comparative serological study of antigenic glycolipids from Mycobacterium
      tuberculosis.
AB  - Two fractions of antigenic diacyl trehaloses (DAT1 and DAT2) were isolated from
      the type strain of Mycobacterium tuberculosis (H37Rv). Phenolic glycolipid (PGL)
      and polar glycolipid antigens (C1-C4) were isolated from an unusual smooth so
      called 'Canetti' strain of M. tuberculosis. These lipids were analyzed by enzyme
      linked immunosorbent assay (ELISA) using antisera against a range of mycobacteria
      and sera from 50 tuberculosis patients and 25 healthy blood donors. All the
      lipids gave strong reactions with homologous mycobacterial antisera, except the
      least polar 'Canetti' polar glycolipid (C4). The phenolic glycolipid (PGL) from
      the 'Canetti' strain gave only a very weak response with antisera against M.
      tuberculosis H37Rv. The diacyl trehaloses (DAT) from H37Rv gave only weak
      reactions with the antisera against the 2 Canetti strains of M. tuberculosis. The
      3 most polar glycolipid antigens (C1-C3) from the Canetti strain gave strong
      responses with serum against M. tuberculosis H37Rv. None of the lipids was able
      to discriminate between patient and control sera at a level suitable for a
      serodiagnostic test. A combination of results from several lipids appears to be
      of greater value in this respect. Thus, PGL, DAT2 and C2 were the best
      combination, reacting with all but 4 of the patient sera and with only 1 of the
      control sera.

PMID- 1643295
TI  - Primary and acquired drug resistance in adult black patients with tuberculosis in
      South Africa: results of a continuous national drug resistance surveillance
      programme involvement.
AB  - Drug resistance is a major problem in the treatment of tuberculosis, and
      monitoring programmes are essential in control of this disease. The extent of
      primary resistance in a community is an important indication of the effectiveness
      of treatment schedules. Since 1965 the Tuberculosis Research Institute (TBRI) of
      the South African Medical Research Council has performed 25 annual surveys of
      drug resistance in adult black tuberculosis patients where the disease is most
      prevalent. Methodology for patient selection, specimen collection, laboratory
      procedures and criteria for drug resistance were strictly adhered to. All
      specimens were processed in a central laboratory supervised by the same two
      technologists. Between 1965 and 1988 a total of 33,111 strains of Mycobacterium
      tuberculosis were isolated from new cases and 19,134 from old cases. Both primary
      and acquired resistance to the 5 major antituberculosis drugs has decreased
      dramatically. Sex and age do not influence resistance rates, while patients'
      ethnic origin and geographical location do. The results indicate that current
      tuberculosis treatment practices are satisfactory. The prevalence of primary drug
      resistance in black South Africans is now intermediate between those countries
      where eradication of tuberculosis is well advanced and those where the disease
      remains a public health problem. Also, it can be shown that comparable and
      clinically significant data can be obtained from a central laboratory employing
      unsophisticated and inexpensive drug susceptibility testing procedures.

PMID- 1643296
TI  - High rate of rifampicin resistance of Mycobacterium tuberculosis in the Taif
      region of Saudi Arabia.
AB  - This retrospective study was undertaken to determine the prevalence and pattern
      of resistance to antituberculosis drugs among patients with sputum-proven
      pulmonary tuberculosis who were seen in Taif Chest Hospital over 24 months
      (between June 1986 and May 1988). The overall prevalence was 22.6% and the
      majority (53%) were resistant to two drugs. Resistance to streptomycin was most
      frequent (16%) followed by rifampicin (15%). Resistance to isoniazid was
      surprisingly low (6.5%). 23.3% of the resistant group had previously received
      antituberculosis drugs as against 15.4% in the sensitive group. There was a
      significant association between previous therapy and resistance to
      antituberculosis drugs. Recommendations to reduce the problem of resistance and
      to improve compliance are discussed.

PMID- 1643297
TI  - Activity of two long-acting rifamycins, rifapentine and FCE 22807, in
      experimental murine tuberculosis.
AB  - The efficacy of the long-acting rifamycins, rifapentine (RPE) and FCE 22807 (FCE)
      in experimental murine tuberculosis was studied by counting viable bacilli in
      spleens. At 2 weeks after infection with Mycobacterium tuberculosis, strain
      H37Rv, treatment with isoniazid 25 mg/kg, rifampicin 10 mg/kg and pyrazinamide
      150 mg/kg was given daily for 6 weeks. The mice were then divided into groups
      given RPE or FCE at intervals of 1, 2 or 3 weeks with spleen counts after 18 and
      24 weeks of chemotherapy. The first experiment showed the great effect of the
      size of the dose of RPE, which, in once-weekly regimens, caused rapid
      sterilization at 16 mg/kg, less rapid sterilization at 10 mg/kg and incomplete
      activity at 6.25 mg/kg. Regimens of RPE given every 2 or 3 weeks were less
      effective, though 16 mg/kg fortnightly was as good as 6 mg/kg once-weekly. The
      second experiment compared RPE and FCE each given at 12 or 8 mg/kg. The results
      were similar though, at 8 mg/kg every 2 or 3 weeks, FCE was slightly more
      effective than RPE. Serum assays showed that the levels with 8 and 12 mg/kg FCE
      were lower than those produced even by 6.25 mg/kg RPE, suggesting that FCE would
      be a better drug than RPE if its bioavailability could be improved, and that the
      levels following 16 mg/kg RPE were similar to those found in man after 8 mg/kg
      RPE taken with a fat-rich meal, suggesting good prospects for effective once
      fortnightly human treatment. The potential for long-acting rifamycins in the
      management of pulmonary tuberculosis is discussed.

PMID- 1643298
TI  - Pustular vasculitis complicating BCG vaccination.

PMID- 1643299
TI  - Tuberculosis forgotten?

PMID- 1643300
TI  - Microepidemics of tuberculosis: the stone-in-the-pond principle.
AB  - In a low prevalence country with no systematic BCG vaccination and a low
      frequency of environmental mycobacterial infections, for each recognized case of
      tuberculosis or infection with M. tuberculosis source detection should be
      undertaken. Sometimes this search will lead to discovery of a microepidemic. The
      extent of contact screening in a microepidemic can easily be determined if
      observed group prevalences are compared to expected group prevalences. The
      described method illustrates this search for contacts in concentric circles
      around the source case: the stone-in-the-pond principle.

PMID- 1643301
TI  - Deaths in tuberculosis patients in British Columbia, 1980-1984.
AB  - Records of all 1884 newly notified tuberculosis cases, over the 5-year period
      1980-1984 in British Columbia, Canada, were reviewed and 201 deaths were
      identified, including 48 diagnosed only after death, and 153 who died while on
      treatment; 56 of unrelated causes, 67 in whom tuberculosis was a contributing
      cause, and 30 in whom it was the principal cause. Significant predictors of death
      while on treatment (specific to tuberculosis) were the extent of disease, history
      of previous disease and sputum smear-positive for acid-fast organisms.
      Significant predictors of failure of diagnosis, in patients who died, were the
      presence of disseminated disease and the absence of a history of previous
      disease. The presenting features were not different in those dying, in whom the
      diagnosis was made before, as compared with after, death. The most frequent mode
      of death due to tuberculosis was respiratory failure, followed by multiple organ
      system failure and haemoptysis. The case fatality rate was low (1.6%) and did not
      change over 10 years. One-half of patients whose death was due to tuberculosis
      were diagnosed only after death and this had not changed over 10 years. We
      conclude that death due to tuberculosis is uncommon in patients while on
      treatment and that the main reason for death due to tuberculosis is that some
      patients are not diagnosed, and therefore not treated, before they die of the
      disease.

PMID- 1643302
TI  - Rising case fatality of bacteriologically proven pulmonary tuberculosis in The
      Netherlands.
AB  - Analysis of registration cards from the Tuberculosis Control Program (TCP) showed
      a four-fold increase in case fatality of bacteriologically proven pulmonary
      tuberculosis in Dutch patients in the period 1973-1984. Registered data of 125
      deceased patients whose primary cause of death was pulmonary tuberculosis were
      analyzed. Increased case fatality predominantly occurred in the elderly. Elderly
      patients presented often with other, less specific, complaints than coughing, but
      had a shorter combined patient's and doctor's delay than younger patients. The
      elderly were more often treated with 3 tuberculostatic drugs (INH, pyrazinamide,
      rifampin). Bacterial resistance was found in only 2%. Probably the most important
      factor concerning the raised case fatality in the elderly is the decline in
      immune response, due to ageing of the Dutch population. An effective response to
      tuberculostatic drugs needs a reasonably intact immune response. Declining
      immunity of the elderly group will increase incidence and mortality of pulmonary
      tuberculosis in this group.

PMID- 1643303
TI  - Sensitivity to PPD tuberculin and M. scrofulaceum sensitin in schoolchildren BCG
      vaccinated at birth.
AB  - OBJECTIVE: To determine the degree of and variation in sensitivity to PPD RT 23
      tuberculin and M. scrofulaceum sensitin RS 95 at school age in children BCG
      vaccinated at birth. DESIGN: Double-testing by applying standard WHO Mantoux
      tests and inspecting BCG scars. SETTING AND PARTICIPANTS: Urban and rural schools
      in Southwest Finland, 1091 children aged 11-13 years. MAIN OUTCOME MEASURES: Size
      of tuberculin and sensitin indurations and BCG scar (mm). RESULTS: The mean size
      of tuberculin indurations was 7.2 mm, sensitin indurations 8.1 mm and BCG scars
      7.9 mm. The reaction to sensitin was significantly larger than to tuberculin (95%
      confidence interval 0.58-1.10 mm) and the zero reactions to sensitin were fewer.
      Correlation between tuberculin and sensitin indurations was significant (r =
      0.75, 95% confidence interval 0.72-0.77). There were induration greater than or
      equal to 15 mm to tuberculin in 16% and to sensitin in 14%. Sensitin indurations
      exceeded those of tuberculin by 4 mm or more in 14% of the children with at least
      5 mm tuberculin indurations. CONCLUSIONS: High tuberculin sensitivity in healthy
      schoolchildren may be partially maintained by contact with environmental
      mycobacteria. Our data do not prove but very probably indicate that children have
      protective immunity. In view of the current incidence of tuberculosis in Finland
      and the likelihood that lymph node infections and sensitivity to environmental
      mycobacteria will increase, continued BCG vaccination at birth is recommended.

PMID- 1643304
TI  - Determinants of tuberculin sensitivity in a child population covered by mass BCG
      vaccination.
AB  - A cross-sectional survey of 701 Indian children aged 1-15 in five northern
      Canadian communities showed that 82% had a documented history of BCG vaccination
      while only 78% had a visible scar. The prevalence of 5 mm or more induration on
      Mantoux testing varied from 6 to 26%. Multiple logistic regression indicated that
      community, age, past use of isoniazid and time since the last Mantoux test were
      positive predictors of sensitivity. The presence of a BCG scar and the number of
      past vaccinations were not significantly associated but the elapsed time since
      the last BCG was negatively associated with a positive reaction. Overcrowding,
      nutritional status and past history of household and community contact with an
      active case of tuberculosis were also investigated but their independent effect
      could not be demonstrated. Despite the presence of mass BCG vaccination in this
      population, tuberculin testing is still a useful tool in assessing the risk of
      infection.

PMID- 1643305
TI  - The same genomic region is disrupted in two transgene-induced limb deformity
      alleles.
AB  - Mutations of the mouse limb deformity locus, ld, map to Chromosome (Chr) 2 and
      result in defects in the morphogenesis and patterning of the limb and kidney.
      Complementation studies have defined the existence of five recessive ld alleles.
      Remarkably, two of these, ldTgHd and ldTgBri, are transgene-induced mutations.
      Recovery of the first transgene insertional allele, ldTgHd, facilitated the
      molecular cloning of a large (greater than 200 kb) candidate gene at the ld
      locus. This gene is broadly transcribed and encodes a set of novel protein
      isoforms, termed formins. Here we present characterization of the ldTgBri
      mutation that supports the molecular identification of the ld gene. We show that
      the ldTgBri fails to complement both the ldTgHd and the ldOR alleles and that it
      has undergone a genomic deletion that disrupts the cloned ld gene and its
      transcripts. Curiously, the ldTgBri deletion encompasses the same 11-kb interval
      in which the ldTgHd insertion occurred and in which a chromosomal rearrangement
      has been identified in a third allele, ldIn2. These findings suggest that this
      region of the ld gene is a preferential site for illegitimate recombination.

PMID- 1643306
TI  - Intracisternal A-particle-specific oligonucleotides provide multilocus probes for
      genetic linkage studies in the mouse.
AB  - Oligonucleotide probes representing distinct intracisternal A-particle (IAP)
      subfamilies were derived from the long terminal repeats (LTRs) of
      transcriptionally active IAP genes in normal mouse cells. These probes were used
      to examine the distribution of IAP proviral elements in the genomic DNA of
      several inbred mouse strains. Each oligonucleotide probe identified multiple
      polymorphisms between the different strains. The distribution of polymorphic
      restriction fragments among the CXB set of recombinant inbred (RI) strains
      demonstrates the feasibility of using these probes for chromosome mapping. These
      and other subset-specific IAP probes can provide a useful series of multilocus
      markers for genomic mapping and genetic analysis in the mouse.

PMID- 1643307
TI  - Estimation of microsatellite mutation rates in recombinant inbred strains of
      mouse.

PMID- 1643308
TI  - Linkage analysis of 84 microsatellite markers in intra- and interspecific
      backcrosses.

PMID- 1643310
TI  - The mouse homolog to the ras-related yeast gene YPT1 maps on chromosome 11 close
      to the wobbler (wr) locus.

PMID- 1643309
TI  - Localization of the interleukin-3 gene to rat chromosome 10 by linkage analyses
      with a variable number of tandem repeats (VNTR).

PMID- 1643311
TI  - Map positions of four dinucleotide repeats in the mouse t complex.

PMID- 1643312
TI  - Respiratory medicine.

PMID- 1643313
TI  - Diagnostic pulmonary imaging.
AB  - This article examines four common but often confusing radiologic problems: the
      normal thoracic radiograph (performed when clinical suspicion of pulmonary
      disease is high), the solitary thoracic mass, loss of organ margination, and the
      mixed pulmonary pattern. Through the use of case examples, a systematic approach
      to each of the four problems is taken. Contrast and positional radiography,
      scintigraphy, ultrasonography, and computed tomography are discussed to
      demonstrate their applications in pulmonary imaging. A brief review of image
      formation and interpretation of alternate techniques will be provided. The
      discussion identifies some of the limitations of the radiographic examination,
      shows why they exist, and illustrates ways of overcoming them.

PMID- 1643314
TI  - State-related changes in breathing. Are we missing sleep-disordered breathing
      syndromes in veterinary patients?
AB  - In recent decades, treatment of sleep disorders has developed rapidly. Prevalent
      and severe sleep disorders affecting respiration have been discovered in clinical
      sleep disorders centers. Although sleep studies are not currently, and may never
      become, a clinical tool for veterinarians, evidence from investigative work shows
      that dogs, at least, can suffer from "sleep-disordered breathing" syndromes
      similar to those affecting humans. The physiology and pathophysiology of sleep
      and breathing are strikingly similar in dogs and humans.

PMID- 1643315
TI  - Lung infections and infestations. Therapeutic considerations.
AB  - This article discusses two common causes of lung disease in the dog and cat:
      tracheobronchitis and bacterial pneumonia. Information about parasitic
      infestation of the trachea, bronchi, and lung parenchyma is summarized. Data are
      also presented regarding the sensitivities of bacterial infections of the
      respiratory tract to antibiotics.

PMID- 1643316
TI  - Primary ciliary dyskinesia in the dog.
AB  - A disorder caused by congenital ciliary dysfunction occurs in dogs. Most of the
      clinical signs are directly or indirectly attributable to immotile or dyskinetic
      cilia and spermflagella. Due to severely impaired mucociliary clearance, a
      continuous mucoid nasal discharge and intermittent sneezing and coughing are
      typically observed during the neonatal period. Recurrent bacterial rhinosinusitis
      and bronchopneumonia usually start within a few weeks of birth. Hypoplastic nasal
      sinuses and atresia of the frontal sinuses are variable features of the disease
      that may be caused by neonatal colonization of these structures by specific
      bacteria. Bronchiectasis is an acquired lesion resulting from chronic
      inflammation and obstruction of airways. A secretory otitis media is caused by
      dysfunction of the cilia in the middle ear, and is manifested in some dogs by
      sclerotic tympanic bullae. Male infertility is caused by live, but immotile to
      hypomotile spermatozoa; however, unexplained oligospermia and azoospermia have
      been reported. Hydrocephalus and situs inversus are common but variable features
      of the disease; the genesis of these lesions has not yet been determined. The
      probable mode of inheritance is autosomal recessive, but dominant mutations
      cannot be excluded. The diagnosis can be confirmed by demonstrating the absence
      or near absence of nasal or tracheal mucociliary clearance and the presence of a
      specific ultrastructural lesion in a large percentage of cilia from multiple
      sites (airways, middle ear, or oviduct). The ultrastructure of sperm flagella
      should mirror that of the cilia. Not all dogs have ultrastructural ciliary
      lesions, and in these cases, results of in vitro analysis of ciliary activity may
      be highly suggestive, if not diagnostic. In dogs without mucociliary clearance in
      which structural and functional analysis of cilia are not diagnostic,
      confirmation of congenital ciliary dysfunction can be established only by ruling
      out other diseases with similar signs (e.g., congenital immunodeficiency
      syndromes). The clinical course in an longevity of affected dogs are highly
      variable. Appropriate antibiotic treatment and pulmonary physical therapy may
      result in prolonged survival, although cor pulmonale and reactive systemic
      amyloidosis are potential sequelae of chronic hypoxia and chronic bacterial
      infection of the airways, respectively.

PMID- 1643317
TI  - Chronic lower airway disease in the dog and cat.
AB  - The most common form of lower airway disease (LAD) in dogs is chronic bronchitis,
      whereas in cats a syndrome resembling chronic bronchial asthma in humans is
      commonly reported. In most cases, the cause(s) of LAD remains unproven. The
      primary symptom of LAD in dogs and cats is chronic cough, although many cats are
      free of symptoms between episodes of acute, life-threatening bronchoconstriction.
      Diagnosis is based on a careful history, physical examination, and diagnostic
      tests designed to rule out other causes of cough and dyspnea such as pneumonia,
      heartworm infestation, and congestive heart failure. More sophisticated tests,
      such as bronchoscopy, flow volume loops, and radioisotope ventilation scans are
      available to define the extent of the disease process better. Glucocorticoids
      remain the mainstay of chronic therapy for most dogs and cats with LAD.
      Bronchodilators are indicated for most cats with symptoms of acute
      bronchoconstriction, whereas a smaller number of dogs may respond to
      bronchodilator administration and demonstrate an increase in exercise capacity
      and a decrease in cough frequency. LAD in dogs and cats is a progressive
      disorder, and prognosis is guarded. Nevertheless, with aggressive medical
      management many of these animals can live relatively symptom-free lives.

PMID- 1643318
TI  - Respiratory complications of endocrine disorders.
AB  - This article provides an overview of the respiratory manifestations of endocrine
      disorders. The patient with endocrine disease may present with various clinical
      signs referable to the respiratory system. Furthermore, such respiratory problems
      may complicate patient management. Therefore, it is important for the clinician
      to be cognizant of alterations in pulmonary function associated with disorders of
      the endocrine system.

PMID- 1643319
TI  - Chemotherapy for intrathoracic cancer in dogs and cats.
AB  - The thoracic cavity contains numerous tissue types from which tumors may arise.
      Broadly speaking, the cavity is comprised of the pleural surfaces, the
      mediastinum and its enclosed viscera, and the lungs. Neoplasms arising from these
      structures are frequently advanced at the time of diagnosis, and surgery is
      rarely curative for malignant processes. Although reports describing anticancer
      chemotherapy use in dogs and cats for tumors of the thoracic cavity largely have
      been anecdotal, as advances are made in the chemotherapeutic management of
      comparable tumors in human cancer patients and as veterinarians become familiar
      with these compounds, use of antineoplastics as an adjunct to, or in place of,
      local treatment modalities should increase. This article reviews the
      epidemiology, clinical features, and diagnosis of pulmonary neoplasia;
      mediastinal neoplasia, particularly thymoma; and pleural neoplasia, with emphasis
      on mesothelioma. In addition, options for chemotherapy, derived from both the
      human and veterinary literature, are given for each tumor type.

PMID- 1643320
TI  - Respiratory complications in the critically ill animal.
AB  - Respiratory dysfunction in a critically ill animal is a life-threatening
      complication that often presents a challenge to patient management. In the
      critical care setting, the most severe respiratory complications include
      nosocomial pneumonia, pulmonary thromboembolism (PTE), and acute respiratory
      distress syndrome (ARDS). Successful treatment of acute respiratory failure,
      although difficult, can be enhanced by recognition of predisposing factors,
      knowledge of underlying pathophysiologic mechanisms, and early prophylactic and
      therapeutic intervention.

PMID- 1643321
TI  - Alternative treatment of heartworm disease.
AB  - Conventional adulticidal therapy may cause acute death due to embolism in major
      pulmonary arteries resulting in severe infarction of the lung. To avoid this
      problem removing a significant number of worms with flexible alligator forceps
      prior to adulticidal therapy is recommended. Before surgery, an accurate
      diagnosis and critical evaluation of the patient is mandated for proper choice
      and sequence of treatment.

PMID- 1643322
TI  - Medical management considerations for upper airway disease.
AB  - The conducting airways, also commonly referred to as the upper airways, provide
      for the passage of air to and from the atmosphere and lungs. Anatomical
      components include the nasal passages, pharynx, larynx, trachea, and mainstem
      bronchi. Clinical problems involving the conducting airways can be manifested by
      relatively mild clinical signs of stertorous breathing, by life-threatening
      dyspnea, or by chronic bouts of inspiratory stridor and cough. Concurrent disease
      of the lower respiratory system (ie, chronic bronchitis) as well as other organ
      systems (ie, cardiovascular, nervous, endocrine) may significantly contribute to
      the etiology and pathophysiology of upper airway disease. Diagnosis of the
      diseases of the conducting airways is primarily based on history and physical
      examination. The dynamic nature of some conditions, related to the phases of
      respiration, can make diagnosis more difficult. In addition to direct
      visualization, radiographic and endoscopic evaluation are often useful. Many
      upper airway problems, especially congenital conditions, lend themselves to
      surgical palliation that should be performed as early in life as possible.
      Medical management is often directed at treating underlying diseases and the
      relief of clinical signs. Historically, the use of variety of drugs have been
      advocated and frequently include decongestants, cough suppressants,
      bronchodilators, glucocorticoids, and antibiotics. However, their use may be
      detrimental and contraindicated. In addition, therapy for some conditions (ie,
      laryngeal paralysis and intrathoracic tracheal collapse) may be better directed
      at increasing airway muscle tone in order to stabilized airway patency.
      Therapeutic agents that may be useful include aspirin and digitalis. The overall
      objective to medical management must be to balance potential therapeutic benefit
      against untoward effects in order to minimize clinical signs and to improve the
      animal's quality of life.

PMID- 1643323
TI  - [Public health and citizen involvement--guidelines and general practice in
      Herne].
AB  - Health problems cannot be solved only by expanding medical and other systems of
      service. Limitations of these services are not only set by costs, but also by the
      disease patterns themselves. The traditional role of the patient must be
      redefined. It is necessary to develop personal health-coping strategies outside
      medical care, and for the citizen to participate in improving conditions of
      health in general. The public health system has the specific duty of initiating
      and establishing these new approaches to health promotion and coping with
      disease. A model for these new municipal health policies is presented with
      reference to medical practice in the city of Herne in the Ruhr area of Germany.

PMID- 1643324
TI  - [Ecology--health--medicine--ecologic health strategy].
AB  - Ecological problems call for a revolution in medical thinking. The basic ideas of
      research methodology and social application of traditional forms of medicine in
      society are beginning to falter, have to be examined, replaced, elaborated or
      made more precise. The article analysis the methodological barriere of
      medical/ecological research and the necessity for ethics of prevention. A basic
      introduction is presented with regard to the metabolic concept of the interaction
      between Man and Nature and the creation of a social environment from a
      theoretical scientific and ethical perspective. The concept of medicine as a
      natural Science is criticised.

PMID- 1643325
TI  - [Procedures of the public health office during an outbreak of infectious
      enteritis in community institutions].
AB  - On the occasion of a local epidemic of infectious enteritis in a Community
      centre, the Public Health Office had an opportunity to develop a procedure to
      deal with such outbreaks. Models for the tasks of Public Health Offices are
      suggested. These consist of investigation, control measures, documentation of the
      epidemic and assessment of the chosen procedures. Typical problems include
      pressure of time due to the large number of cases, the dilemma between the need
      to inform the population vs. professional secrecy, and the dual role of the
      Public Health Office in providing assistance in both medical consultation and
      epidemic control measures.

PMID- 1643326
TI  - [Claims and reality of public health expert assessment using legal public health
      guidelines].
AB  - The following article deals with the discrepancy between legal pretension and the
      practice of medical expertise in examinations for engagement, fitness for service
      or courses of medical treatment. To avoid injustice to the patients and conflicts
      for the experts, clear-cut general directions for the practice of medical
      expertise are demanded.

PMID- 1643327
TI  - [Waste prevention and recovery of valuable raw materials in the hospital].
AB  - Quite a number of the diseases with which Public Health services are concerned
      are due to environmental factors. It is our aim that especially the Public Health
      staff should tackle with efficiency and dispatch all the problems connected with
      damage caused by such factors. Environmental protection is in fact Medical
      Science. The volume of the waste deposits has been exhausted to the full. Burning
      of refuse is not the proper alternative: natural science tells us that it is
      definitely no solution of the problem. The best kind of waste is not to waste
      anything, i.e. waste that does not arise at all. The belief that disposable or
      throwaway goods improve hygiene, is totally erroneous and a misconception. All
      persons engaged in Public Health must unanimously demand from industry the
      production of high-quality, well sterilisable and easy-to-clean package items for
      repeated use. Active environmental protection motivates the staff and enhances
      the reputation of their work.

PMID- 1643328
TI  - [Effects of prednisolone on energy metabolism in patients with pulmonary
      tuberculosis and pneumonia].

PMID- 1643329
TI  - [Prognostic significance of cytochemical tests in peptic ulcer].
AB  - The paper is concerned with evaluation of the activity of the intracellular
      enzymes of lymphocytes--succinate dehydrogenase and alpha-glycerophosphate
      dehydrogenase of mitochondria, in patients with peptic ulcer running a different
      course to define their importance in the disease prediction. Aggravation of
      peptic ulcer was found to result at first in marked activation of lymphocyte
      energy supply including that at the expense of the formation of new cellular
      populations. Later the count of lymphocytes with a high enzymatic activity was
      found to decline together with a reduction of enzymatic activity. The retention
      of the indicated changes after ulcer healing serves a prognostically unfavourable
      sign of the further disease course.

PMID- 1643330
TI  - [Results of clinical care of children in contact with HIV-infected persons].

PMID- 1643331
TI  - [Somatogenic toxic-circulatory encephalopathies with pseudotumorous course].
AB  - A progredient course of cerebral circulatory disorders in grave-condition somatic
      patients may present a clinical picture of toxic dyscirculatory encephalopathy
      with brain symptoms of mass lesions. Pseudotumorous run of a chronic vascular
      process requires a sound clinical analysis and adjuvant methods of examination to
      rule out primary tumor or brain metastases.

PMID- 1643332
TI  - [Yersiniosis].

PMID- 1643333
TI  - [Current methods of treatment of infection].

PMID- 1643334
TI  - [Segmental vegetative disorders].

PMID- 1643335
TI  - [Early repolarization syndrome as a marker of additional conduction pathways in
      ischemic heart disease].

PMID- 1643336
TI  - [Treatment of congestive heart failure with sodium nitroprusside infusions in
      association of chronic obstructive lung diseases and postinfarct
      cardiosclerosis].

PMID- 1643337
TI  - [A differential approach to cavinton and finoptin treatment of patients with
      circulatory encephalopathies].

PMID- 1643338
TI  - [Short-term results of the treatment of patients with breast cancer using various
      laser units as a laser scalpel].

PMID- 1643339
TI  - [Surgical treatment of renal artery occlusion].

PMID- 1643341
TI  - [Associated chronic diseases in workers of poultry farms].

PMID- 1643340
TI  - [Radiotherapy of prostatic cancer and its administration in the prehospital
      period of patient management].

PMID- 1643342
TI  - [Study of factors influencing the time of detection of gastric cancer].

PMID- 1643343
TI  - [A case of Buschke-Lowenstein condyloma of the face in immunodeficiency state and
      effects of cryosurgery].

PMID- 1643344
TI  - [Pseudotumorous brain stem encephalitis of herpetic etiology in adults].

PMID- 1643345
TI  - [Ventricular ejection fraction in oxygen therapy of patients with pulmonary
      tuberculosis].
AB  - Radionuclide study of ejection fraction of the right heart ventricle was carried
      out in lung tuberculosis patients with respiratory insufficiency and cor
      pulmonale. Oxygen therapy was found to promote reduction of right ventricle heart
      failure in effective treatment of lung tuberculosis. The greatest reduction of
      heart failure was recorded in cases where oxygen therapy was combined with
      cardiac glycosides. As the tuberculosis process progresses, oxygen therapy does
      not decrease right ventricle heart failure. The treatment by antibacterial agents
      alone without using oxygen does not lead to the rise of ejection fraction of the
      right ventricle of the heart.

PMID- 1643346
TI  - [Occurrence of rectal polyps in patients with uterine myoma].

PMID- 1643347
TI  - [Diabetes mellitus and cancer].
AB  - There is evidence on infrequent cases of combined occurrence of cancer and
      diabetes mellitus (DM). The latter is likely to inhibit malignant growth (W.
      Rhomberg, G. Jorns, M. A. Kunitsina) as shown by reduced number of metastases and
      recurrences, especially in noninsulin-dependent DM, longer survival. Presence of
      cancer, in its turn, diminishes DM manifestations. Radical removal of the tumor
      promoted rapid DM decompensation. Cancer prognosis in DM presence is dependent on
      the anatomo-morphological pattern of the lesion and DM type.

PMID- 1643348
TI  - [Several indicators of hormonal homeostasis (hypophysis--gonads) in patients with
      hypertension].
AB  - One hundred and sixty-three male patients with essential hypertension (EH) stage
      I (68 subjects) and II (95 subjects) were compared to healthy controls by
      concentrations of renin, aldosterone, LH, FSH, prolactin and estradiol assessed
      by means of radioimmunoassay. The findings show that unlike healthy controls EH
      patients have low levels of LH and testosterone, high prolactin and unchanged FSH
      and estradiol concentrations. The involutional dynamics is similar for patients
      and controls: dissociation in the levels of hypophyseal hormones and
      testosterone. An age-specific trend in prolactinemia was related to EH severity.

PMID- 1643349
TI  - [Diagnosis of trophologic insufficiency].
AB  - Nutrition is a very important factor in maintenance of human health. Defects in
      nutrition may become the main "killer" and "pathogen" in current human society.
      Malnutrition can modify host defenses, influence the disease patterns and
      outcomes. The paper introduces the notion "trophologic status" as an indicator of
      human health. The definition is presented. Assessment of the trophologic status
      can be conducted by various methods useful for different medical institutions in
      early diagnosis of trophologic insufficiency in patients.

PMID- 1643350
TI  - [Detection of the pathology of the major cerebral arteries in transient disorders
      of cerebrovascular circulation using Doppler ultrasonography].
AB  - One hundred and six males aged 40-59 were examined generally, neurologically and
      using ultrasonic dopplerography within one month following an emergency call for
      transitory ischemic attacks, hypertensive cerebral crises. Ultrasound signs of
      arterial lesions were recorded in 79.2% of the examinees. Hemodynamic
      disturbances occurred most frequently (50.9%). Arterial stenosis was diagnosed in
      27.4% of cases. With growing number of risk factors, the incidence of major
      arteries lesions was on the increase.

PMID- 1643351
TI  - [Results of x-ray studies on the development of giant cell tumors in the tubular
      bones].
AB  - Giant cell tumor definition is still a debatable problem in medicine. The disease
      is referred to as giant cell tumor, osteoblastoclastoma, local fibrous
      osteodystrophy. X-ray follow-up of more than twenty patients gave the author
      arguments in favour of the disease belonging to fibrous osteodystrophy.
      Roentgenologically, it is characterized by two phases: destructive with typical
      structureless defects and restorative with typical cellular structures of the
      affected bone site. For the most part, the disease is benign, rare cases of
      malignant transformation are attributed to adverse factors.

PMID- 1643352
TI  - [Chronic disseminated lung diseases: diagnostic and therapeutic tactics].

PMID- 1643353
TI  - [Computerized tomography in emergency states].

PMID- 1643354
TI  - [Rare neoformations of the adrenal glands].

PMID- 1643355
TI  - [Characteristics of autoimmune process in melanoma of the uveal tract].

PMID- 1643356
TI  - [Ultrasonic diagnosis in the 1st trimester of pregnancy].

PMID- 1643357
TI  - [Effects of laser therapy on microstructure of the blood serum of patients with
      ischemic heart disease].

PMID- 1643358
TI  - [Effectiveness of the use of zaditen and leakadin in recurrent erysipelas].

PMID- 1643359
TI  - [Prevention of postoperative thrombotic complications by a combination of small
      doses of heparin and digitamin in oncologic patients].

PMID- 1643360
TI  - [Oxyprogesterone capronate in the treatment of menstrual epilepsy].

PMID- 1643361
TI  - [Effects of caloric value of parenteral nutrition on the effectiveness of
      cytostatics and ribonucleases in the treatment of patients with acute
      pancreatitis].

PMID- 1643362
TI  - [Treatment with calcium antagonist nifedipine in pathology of the preliminary
      period].

PMID- 1643363
TI  - [Use of anabolic steroid retabolil in patients with inflammatory diseases of the
      uterus and its appendages].

PMID- 1643364
TI  - [Scope of surgery in severe craniocerebral trauma].

PMID- 1643366
TI  - [Medicine of disasters and their differentiation according to severity].

PMID- 1643365
TI  - [Koshevnikoff's epilepsy in a child].

PMID- 1643367
TI  - [Possibilities of the use of health status indicators as criteria of adaptation
      to expedition-duty work].

PMID- 1643368
TI  - [Remission of Itsenko-Cushing disease after treatment with nizoral].

PMID- 1643369
TI  - [Clinico-morphological characteristics of hemochromatosis].

PMID- 1643370
TI  - Nurses' role in relation to substance misuse.

PMID- 1643371
TI  - Discontent among enrolled nurses.

PMID- 1643372
TI  - Preoperative nursing intervention to relieve stress.
AB  - Stress and anxiety produce physiological and psychological distress which impedes
      recovery postoperatively. Nurses can facilitate patient independence
      preoperatively through a combination of sensory stimulation techniques,
      communication and counselling.

PMID- 1643374
TI  - Use of music in therapeutic care.
AB  - Nursing is currently examining issues that relate to quality of care. One way in
      which nurses can provide higher standards is by improving the environment and
      patient care with the use of piped, background music.

PMID- 1643373
TI  - Partnership in care: paediatric nursing model.
AB  - In 1988, Casey developed her partnership in care model for use within the
      paediatric healthcare setting as she felt that other models did not recognize or
      emphasize concepts that she deemed essential for effective paediatric care. This
      has now been adopted by the Hospitals for Sick Children as the model of care.

PMID- 1643375
TI  - Implementing problem-solving approaches in clinical practice.
AB  - When analysing any nursing problem or situation, different approaches are always
      possible. A knowledge of the possible angles of approach can make nurses into
      more flexible problem-solvers. This article explores the holistic and
      reductionist approaches to patient care.

PMID- 1643376
TI  - Hyperosmolar non-ketotic hyperglycaemia.
AB  - Thorough assessment of the patient and good understanding of potential
      complications enhance patient care and safety. Correction of volume depletion and
      maintenance of a strict fluid balance chart is essential to avoid complications
      of congestive cardiac failure, cerebral or pulmonary oedema, renal failure and
      further dehydration. Careful monitoring of electrolytes and administration of
      supplements should be undertaken to prevent instability. Regular monitoring of
      blood glucose levels and careful insulin administration should be undertaken to
      prevent fluctuations in blood glucose levels. Any possible source of infection
      should be identified and treated as prescribed. Good basic nursing care for the
      patient and support and counselling for the patient and his family are essential
      components of holistic care.

PMID- 1643378
TI  - Nurses have rights too.

PMID- 1643377
TI  - Advances in clinical practice.

PMID- 1643379
TI  - HIV/AIDS: the ethical and legal dilemmas.
AB  - Regardless of personal feelings and fears, all healthcare practitioners have a
      duty to uphold the rights of HIV/AIDS patients. Dilemmas arise when the
      practitioner's responsibilities are split between upholding these rights and
      enforcing those of other at-risk individuals.

PMID- 1643380
TI  - Preparing for an interview.
AB  - Selection interviews provoke fear in many confident nurses and are among the most
      stressful situations nurses experience. Thorough preparation can assist you in
      achieving a positive outcome. This article considers the preparatory stages and
      recommends how you should conduct yourself to achieve success.

PMID- 1643381
TI  - The process of change in nursing audit.
AB  - This article reviews the current literature on change in nursing audit in order
      to develop a strategy for nursing staff. It suggests that the model for change
      will affect the nature of the measurement phase of audit, and proposes that an
      open systems model be adopted and a change agent incorporated to manage the audit
      cycle.

PMID- 1643382
TI  - Healthcare in Finland.
AB  - Finland has nearly the highest suicide rate and mortality from cardiovascular
      disease in the world. Healthcare needs are varied and create challenges for
      nursing practice.

PMID- 1643383
TI  - Chiral separation by high performance liquid chromatography. I. Review on
      indirect separation of enantiomers as diastereomeric derivatives using
      ultraviolet, fluorescence and electrochemical detection.
AB  - The increased attention on the therapeutic implications of stereoisomerism has
      provided an impetus for the development of analytical methods for enantiomeric
      separation. The indirect method of separation of enantiomers as diastereomers
      using high performance liquid chromatography (HPLC) has emerged as an efficient
      and versatile approach. This is due mainly to the availability of numerous chiral
      derivatization reagents (CDRs). This article reviews CDRs useful for the
      development of an indirect HPLC method using ultraviolet, fluorescence and
      electrochemical detection. In addition, factors crucial for the development of
      the indirect method are discussed.

PMID- 1643384
TI  - Determination of intraperitoneal mitoxantrone in the serum of cancer patients
      using a high performance liquid chromatograph coupled to an Advanced Automated
      Sample Processor (AASP).
AB  - A study has been carried out on 10 patients with ovarian cancer treated by
      intraperitoneal mitoxantrone. The serum concentration was determined by high
      performance liquid chromatography with spectrophotometric detection. The
      extracted analyte on the cartridge was injected and eluted on-line into the
      analytical column by the mobile phase. This improved the signal and sample
      processing rate, without significant loss in analytical performance. Excellent
      linearity (r greater than 0.9994) was observed for the calibration curve over the
      range 1-2000 ng/mL, along with a precision within-day and between-day estimated
      as 1.5% and 5.6%, respectively. Sensitivity was an order of magnitude higher than
      that of the comparison method. From a clinical point of view, these preliminary
      results have shown that intraperitoneal administration is more beneficial than
      intravenous therapy. Low serum levels (1-30 ng/mL) with a maximum at the first or
      second hour are revealed.

PMID- 1643385
TI  - Multimodal liquid chromatographic separation methods in the study of ethimizol
      metabolism in man.
AB  - The metabolism of ethimizol in the human body has been investigated. Focus was on
      the detection and demonstration of the regioselective pathway of metabolic
      demethylation of ethimizol by determining the presence of the corresponding
      metabolites in blood, saliva and urine. Isolation, purification and
      identification of the metabolites present in the biological samples was achieved
      by applying a combination of the following methods: solid phase extraction, high
      performance liquid chromatography, high performance thin layer chromatography,
      nuclear magnetic resonance and mass spectrometry. The suggested chemical
      structures were definitely established by comparing the physicochemical
      characteristics of the ethimizol metabolites obtained from the individual
      biological fluids with the characteristics of synthetized authentic derivatives.

PMID- 1643386
TI  - Non-labelled benzodiazepines partitioned into synaptosomal membranes: their
      extraction and quantification by high performance liquid chromatography.
AB  - A method for the extraction and quantification by high performance liquid
      chromatography (HPLC) of non-labelled benzodiazepines partitioned into biological
      membranes has been developed. The benzodiazepine (BZD) was partitioned in a
      synaptosomal membrane-buffer system. The membranous pellet was separated by
      centrifugation and from this pellet, previously submitted or not to a proteolytic
      treatment and resuspended in the same buffer, the BZD was extracted by the
      addition of the proper volume of ethyl acetate, i.e. that capable of extracting
      at least 99.5% of the total drug in the aqueous phase. Optimal conditions for
      maximum proteolysis were: incubation of membranes at a final concentration of 1
      mg protein/mL in the presence of 0.08 mg of Protease type I per mL for 90 min. at
      45 degrees C. Although the efficiency of the proteolysis was demonstrated not
      only by kinetic but also by electrophoretic evidence, recovery of BZD in the
      organic solvent was not increased by the enzymatic treatment at a mass
      BZD/protein ratio in the range 4-4.6 10(-5) micrograms BZD/mg protein. For the
      HPLC quantification a reversed phase ODS column was used with methanol:water
      (1:1) plus 3.5% acetic acid as the mobile phase at a constant pressure and 1
      mL/min flow rate. The UV detector was calibrated at 265 nm. Calibration curves
      were constructed by plotting peak height or peak area vs. nmoles BZD and adjusted
      to straight lines by a regression analysis by the least squares method. The peak
      height was selected as the detection method. Intra- and inter-assay precision did
      not exceed 10% and the total recovery was 100%.

PMID- 1643387
TI  - Simultaneous determination of pseudouridine and creatinine in urine of normal
      children and patients with leukaemia by high performance liquid chromatography.
AB  - A reversed phase high performance liquid chromatographic method for the
      simultaneous determination of pseudouridine (PU) and creatinine (Cr) in urine is
      described. The mobile phase was 0.01 mol phosphate buffer (pH 6.1) containing 2.5
      mmol octanesulphonic acid as the ion pairing agent. UV detection was set at 250
      nm. Variation in pH value affected the retention time of PU and Cr significantly;
      Their separation from interfering peaks was also affected. The recoveries of PU
      and Cr were 89.93% and 90.35%, respectively. The standard deviation of the method
      for PU was 48.69 +/- 0.063 (nmol/mumol Cr, mean +/- SD, n = 5). The urine samples
      from 233 normal children of different ages and 119 patients with leukaemia were
      analysed by this method. The normal reference value was appraised by comparison
      with the percentage of immature cells in the bone marrow. The results showed that
      the sensitivity of the method was 94.12%, the specificity was 95.86%, the
      accuracy was 95.50%, the positive predictive value was 82.05% and the negative
      predictive value was 98.78%. The method can be used to evaluate the state of the
      leukaemia, and to monitor the effect of treatment.

PMID- 1643388
TI  - One-step preparation of Hageman factor fragment concentrate.
AB  - The Hageman factor fragment (HFf) concentrate was prepared from acetone and
      dextran sulphate activated human plasma by chromatography on a CM-Sephadex
      column. The preparation was free of the main kallikrein inhibitors--Cl
      inactivator, alpha 2-macroglobulin, antithrombin III and alpha 1-antitrypsin. The
      HFf concentrate can serve as an activator of prekallikrein in patient plasma.

PMID- 1643389
TI  - TLC separation of certain tetracycline and amino glycopeptide antibiotics.
AB  - The separation of tetracycline and amino glycopeptide antibiotics was achieved on
      silica gel thin layers. Tetracycline antibiotics were resolved on a Co+2 (1.0%)
      impregnated silica gel layer using ethanol:acetic acid:water (10:6:6, v/v/v) as
      the mobile phase. Amino glycopeptide antibiotics were separated on an untreated
      silica gel layer using the mobile phase n-butanol:formic acid:water (6:5:7,
      v/v/v). The spots of these antibiotics were located by exposing the chromatoplate
      to iodine vapours.

PMID- 1643390
TI  - Liquid chromatographic determination of hyoscine (scopolamine) in urine using
      solid phase extraction.
AB  - A sensitive method for the determination of hyoscine (scopolamine) in urine is
      described. After concentration and "clean-up" on C18 and CN solid phase
      extraction columns, hyoscine was quantified by high performance liquid
      chromatography with coulometric detection (oxidation at +0.9 V). The limit of
      detection was 5 ng per sample and the precision for 5 mL samples containing 2
      ng/mL was 12.3%. The method was applied to urine samples collected from 12
      volunteers wearing Scopoderm TTS patches. The mean excretion rate of
      unmetabolized hyoscine was 0.45 micrograms/h and 87% of the total hyoscine was
      present as conjugates. Apohyoscine (aposcopolamine) was identified as a urinary
      metabolite. The significance of this with regard to hyoscine assays is discussed.

PMID- 1643391
TI  - An improved method for isolation and identification of Zn-metallothionein from
      cadmium-induced rat liver.
AB  - Zn-metallothioneins (MT-1 and MT-2) were isolated and purified from Wistar rat
      liver induced by subcutaneous injection with cadmium chloride over a short time.
      Instead of Sephadex G-50 and DEAE Sephadex A-50, new chromatographic media
      produced by Pharmacia, Sephacryl S-200, S-100 and DEAE Sepharose Fast Flow were
      used in the purification of metallothioneins. The time required for purification
      with the new method was only 1/3 that required with the usual method and had the
      same purification effect and rate of recovery. The number of mercapto groups
      measured with modified Ellman's reagent and cysteine as standard is 20 in MT
      molecules. Zn and Cd concentrations in each fraction were measured by single
      sweep polarography rather than atomic absorption spectrophotometry. MT-1 and MT-2
      contained 6 gram atoms of zinc, but no cadmium. Purified MT-1 and MT-2 were shown
      by high performance liquid chromatographic analysis to be highly homogeneous and
      had an amino acid composition similar to that of Cd-MT.

PMID- 1643392
TI  - Isolation of human haemopexin in apo-form by chromatography on S-Sepharose Fast
      Flow and Blue Sepharose CL-6B.

PMID- 1643393
TI  - Depressed affect as a predictor of increased desire for alcohol in current
      drinkers of alcohol.
AB  - Male drinkers (n = 45) were asked to rate their desire for a drink of alcohol
      when presented with the sight, smell and taste of their preferred alcoholic
      beverage and of a lemon cordial drink. The subjects' level of depressed affect on
      that day and their average daily consumption of alcohol over the last 30 days
      were measured prior to exposure to these cues. Both level of depressed affect and
      log of mean daily alcohol consumption predicted increased desire for alcohol when
      alcohol cues were present, accounting for 40% of the variance in desire. When
      presented with the lemon cordial cues only 14% of the variance in desire for
      alcohol was explained by these variables. Also, Spearman's rank order
      correlations were calculated between heavy drinkers' (n = 19) ratings of self
      efficacy to resist drinking and desire for alcohol in the presence of the alcohol
      cues. There were significant negative correlations between desire for alcohol and
      self-efficacy ratings on the 'urges and temptations' and 'positive social
      situations' subscales of the Situational Confidence Questionnaire-39. Several
      alternative accounts of these findings are discussed.

PMID- 1643394
TI  - Reversibility of alcohol-induced immune depression.
AB  - Alcohol abusers have suppressed cellular immune function. The aim of the study
      was to investigate the time of sobriety required to normalize immune function.
      Delayed hypersensitivity was investigated during disulfiram controlled abstinence
      in ten heavy alcoholics and in seven moderate drinkers without liver diseases.
      For comparison a control group of eight previous drinkers was tested. The skin
      test responses were modest initially with a median area of response of 12 mm2
      (range 0-31) in the heavy alcoholics and 3 mm2 (0-15) in the moderate drinkers.
      It improved significantly in both groups after two weeks of sobriety. The
      responses stabilized after 8 weeks at 74 mm2 (54-102) in the heavy alcoholics and
      after 9 weeks at 63 mm2 (42-76) in the moderate drinking group. The control group
      had skin test responses of 70 mm2 (46-87), not different from the responses of
      the alcohol groups after two months of abstinence. The results suggest that while
      2 weeks of abstinence from alcohol will improve the depressed cellular immunity,
      2 months of sobriety is necessary to normalize it.

PMID- 1643395
TI  - Drinking context and other influences on the drinking of 15-year-old New
      Zealanders.
AB  - This study investigated the influence of the situational characteristics of the
      drinking setting and a number of parental, personal and demographic variables on
      adolescents' alcohol use. The sample were 15-year-old participants in a
      multidisciplinary longitudinal study carried out in New Zealand. Measures of
      alcohol consumption were self reported amount of alcohol consumed on the most
      recent drinking occasion and amount usually consumed. All of the situational
      variables investigated had an effect on the amount of alcohol consumed on the
      most recent occasion. Greater amounts of alcohol were consumed if the alcohol was
      obtained from peers or by the 15-year-olds themselves, if the drink was consumed
      away from their own home, in the presence of peers only, and during the evening.
      More money to spend each week and lower SES were also associated with reports of
      greater alcohol consumption on the most recent drinking occasion. Adolescents
      with female friends who approved of drinking reported greater amounts of alcohol,
      the effect of female friends was most marked in the lower amounts reported by
      males who had female friends that disapproved of drinking. For amount of alcohol
      usually consumed, reports of larger amounts of alcohol were associated with more
      money available to spend each week and with lower SES. Furthermore, both males
      and females reported greater usual amounts if their male friends approved of
      drinking; female friends' approval was associated with greater amounts of alcohol
      usually being consumed, this effect was strongest for males. Sixty-eight per cent
      of the 15-year-olds indicated that they thought they definitely or probably would
      get drunk in the future.

PMID- 1643396
TI  - Increased desire to smoke during acute stress.
AB  - Conditions which promote smoking urges, or desire to smoke, are believed to be
      important in maintaining smoking behaviour, yet little controlled research has
      examined acute situational factors which increase desire to smoke. In this study,
      16 male and 16 female smokers either smoked or sham-smoked with an unlit
      cigarette after brief abstinence during two sessions, one involving a stressful
      computer task and the other a non-stress task. Desire to smoke was greater during
      the stress vs. non-stress task for sham-smokers (p less than 0.01). Furthermore,
      although smoking desire decreased markedly after smoking in the smoking smokers
      (p less than 0.001), even this group tended to report greater desire to smoke
      during stress (p less than 0.10). There were no differences between males and
      females. These findings indicate that exposure to stressors increases desire to
      smoke, and suggest that such situations may be influential in maintaining smoking
      behaviour in smokers not attempting to quit.

PMID- 1643397
TI  - Drug and alcohol medical education: evaluation of a national programme.
AB  - In recognition of inadequacies in drug and alcohol medical education, funds were
      allocated to all Australian medical schools in 1988 to appoint co-ordinators to
      develop and implement drug and alcohol curricula. This programme was broadly
      modelled on the Career Teacher Programme successfully implemented in North
      America in the 1970s and early 1980s. During 1989 all but one of Australia's 10
      medical schools made drug and alcohol co-ordinator appointments. Appointees came
      from diverse backgrounds including general practice, psychiatry, internal
      medicine, psychology and social work. The present study is a process evaluation
      and forms the first examination of the programme. Overall, findings indicated the
      programme to have achieved a 158% increase in drug and alcohol teaching hours, a
      383% increase in the number of electives and a 109% increase in student places
      for electives. These effects occurred even though the average duration of co
      ordinators' appointments was only 15 months. Implications of these recent
      developments are discussed in terms of teaching strategies, clinical experience
      and the inclusion of key educational issues such as early intervention.
      Recommendations are made for a continuation of the programme and for future
      outcome evaluation.

PMID- 1643398
TI  - Treatment dependence: preliminary description of yet another syndrome.
AB  - The last decade has witnessed an expansion of treatment services and research
      into alcoholism and addiction. As so often happens when attempting to find
      solutions to pressing individual and social problems, the solutions have come to
      acquire an importance of their own, obscuring the problems they were intended to
      solve. Many programmes are characterized by stereotyped approaches to treatment,
      which seem more in line with the needs of the staff than with the problems of the
      clients. The hopes that treatment for addictions will solve some of the problems
      of contemporary society have given treatment a salience which cannot be justified
      in terms of results. Frustrated at the results of treatment, clinic staff
      intensify their efforts and attribute the shortcomings of treatment to a lack of
      client motivation. There are disconcerting parallels between these behaviours in
      clinicians and the behavioural changes of the Alcohol Dependence Syndrome. The
      label 'Treatment dependence syndrome' is proposed to characterize a pattern of
      individual and institutional behaviour which is both self-perpetuating and self
      defeating.

PMID- 1643399
TI  - Obstacles to effective alcohol policy in the workplace: a case study.
AB  - Based on a case study of an assembly plant in a large US corporation, this paper
      reports on cultural and environmental influences on the form and process of
      workplace alcohol policy. Utilizing both ethnographic and survey methods,
      research findings indicate that although alcohol policies are in place,
      management and union leaders are unclear about their source and content, and the
      general employee population perceives alcohol availability and on-job drinking as
      poorly controlled. In grounded theory fashion, two conceptual themes are employed
      for organizing empirical explanations of the weakened policy and under-controlled
      drinking. These are: (1) the dual alcohol policy dilemma, and (2) the union
      management debate over authority to discipline. The ambivalent nature of alcohol
      policy and organizational mechanisms involved in its implementation become risk
      factors for developing workplace-related alcohol problems.

PMID- 1643400
TI  - Drug abuse related emergency room episodes in the United States.
AB  - Drug-related hospital emergency room cases provide one measure of the morbidity
      associated with drug abuse. Over time, they indicate if problems associated with
      particular drugs are increasing or decreasing. These trends may be influenced by
      a number of factors including increased prevalence of use, increased dosages,
      increased potency, increased frequency of use, the aging of drug addicts, the use
      of more dangerous routes of administration, and the combined use of two or more
      drugs. The primary source of this information in the United States is the Drug
      Abuse Warning Network (DAWN). This paper will present statistics on the drug
      related emergencies reported to the DAWN system for 1989 and 1990. In addition to
      numbers of drug-related emergencies, this paper includes the population based
      rates for drug-related emergencies in 1990.

PMID- 1643401
TI  - Cocaine users in Amsterdam.

PMID- 1643402
TI  - Opium-tea and prevalence of HIV-1 infection among intravenous drug users in
      Vienna, Austria, 1986-1991.

PMID- 1643403
TI  - International comparisons of drink units.

PMID- 1643404
TI  - Tobacco advertising bans cut smoking.

PMID- 1643405
TI  - The Fifth Thomas James Okey Memorial Lecture: research and practice: the
      necessary symbiosis.
AB  - What relationship should exist between research and practice in the field of
      addictive behaviour? Are the perspectives essentially independent, or is there a
      necessary interaction? The extent of productive interaction is considered in
      three examples; (i) detoxification, (ii) stable abstinence, and (iii) goals other
      than abstinence. Changes are occurring in the drugs being used, the extents and
      types of associated co-morbidity, the levels of public and professional concern,
      and the explanatory paradigms which are dominant; and so it will be increasingly
      important for both practitioners and researchers to be sensitive and reactive to
      these changing circumstances. The most productive state for both research and
      practice will exist when they both feed off, and feed into each other--when there
      is indeed a necessary symbiosis.

PMID- 1643406
TI  - Providing drug injectors with easier access to sterile injecting equipment: a
      description of a pharmacy based scheme.
AB  - In this short paper we describe the operation of a pharmacy-based scheme
      operating in Glasgow to provide injecting drug users with sterile injecting
      equipment. The operation of the scheme is described under a number of headings:
      its physical location, the policy of selling injecting equipment, the return of
      previously used equipment, counselling and referral, and, the style of working of
      pharmacy staff. It is shown that while retail pharmacies may be an important
      point of contact with injecting drug users it should not be assumed that pharmacy
      staff already possess the requisite skills for working in this area. There is a
      need for pharmacists' and their staff to be able to draw upon the experience of
      colleagues working in this area in order to benefit from a pool of common
      experience. In addition there is a need to provide staff with access to
      appropriate back-up and support services.

PMID- 1643407
TI  - Life-style factors and social circumstances of syringe sharing in injecting drug
      users.
AB  - Measures taken to reduce HIV risk by injecting drug users have been reported in
      many countries, but a minority of injectors continue to engage in risky
      practices. In an ongoing cohort study, 207 drug injectors were interviewed and
      anonymously tested for HIV antibodies in saliva in 1989. Injectors reporting
      recent syringe sharing were compared with those not recently sharing; injecting
      events where sharing did and did not take place were examined. Those recently
      sharing syringes differed significantly from the non-sharers on several factors,
      including: use of heroin, dihydrocodeine and temazepam; injection of heroin,
      temazepam and prescribed methadone; accommodation and contact with other
      injectors; means of financial support and recent involvement in crime; secondary
      sources of injecting equipment and unsafe disposal; employment of HIV protective
      strategies; treatment contact with general practitioners; number of sexual
      partners and injecting status of sexual partners. The two groups were not
      significantly different in terms of attendance at syringe-exchange schemes and
      self-reported HIV antibody status. Syringe sharing would appear to be related to
      social circumstances and life-style factors rather than just individual choices
      and motivation.

PMID- 1643408
TI  - Diversity in primary structure and function of neuronal nicotinic acetylcholine
      receptor channels.
AB  - Neuronal nicotinic acetylcholine receptors are oligomeric protein complexes whose
      component subunits are each encoded by a family of homologous genes. The current
      challenge is to determine the functional contributions of the related subunits to
      the receptor-linked ion channels they compose and to uncover the physiological
      impact of the distinct channel classes expressed in vivo. In the past year, new
      approaches to the analysis of these receptors have yielded important insights
      into their stoichiometry, pharmacology and functional properties.

PMID- 1643409
TI  - G-protein-coupled receptors: the new dopamine receptor subtypes.
AB  - The family of genes encoding G-protein-coupled dopamine receptors continues to
      grow with the recent cloning of a fifth member. The availability of these clones
      has revolutionized the dopamine receptor field. Expression of individual dopamine
      receptors is permitting the detailed analysis of their pharmacology and coupling
      to second messenger systems, while probes based on the receptors' nucleotide
      sequences are being used to gain new insights into their tissue distribution and
      genetics.

PMID- 1643410
TI  - The olfactory multigene family.
AB  - A novel multigene family has been identified that is likely to encode odorant
      receptors on olfactory sensory neurons. Further studies on this gene family are
      likely to shed light on the molecular mechanisms underlying information coding in
      the mammalian olfactory system. This review is also published in Current Opinion
      in Genetics and Development 1992, 2:467-473.

PMID- 1643411
TI  - Neuronal Ca2+ signalling takes the local route.
AB  - The past year has seen several sets of experimental results demonstrate that
      fast, large and highly localized rises in intracellular Ca2+ concentration can
      occur in neurons. These results confirm previous theoretical predictions of acute
      spatial compartmentalization of Ca2+ signalling, and document a form of
      signalling that may occur whenever rapid and local signal processing is the goal.
      The dimensions involved present severe challenges for attempts to directly
      measure these signalling events.

PMID- 1643412
TI  - Exocytosis and its control at the synapse.
AB  - Several new approaches have given fresh insight into the mechanism and control of
      exocytosis. Electrophysiological and morphological studies show that many or all
      of the intramembrane particles at presynaptic active zones are voltage-gated Ca2+
      channels. The sensitivity and time resolution of voltammetry allow the time
      course with which a single vesicle releases transmitter to be studied. Membrane
      proteins of the cell surface and synaptic vesicles have been shown to interact,
      and may join to form the fusion-pore complex.

PMID- 1643413
TI  - Neuromodulation.
AB  - The ability of the nervous system to respond to the environment and to learn
      depends upon the tuning of neuronal electrical activity, loosely called
      neuromodulation. The substrates for electrical activity and, therefore,
      neuromodulation are ion channels which may be either synaptic or extrasynaptic.
      Neuromodulation is dynamic and most frequently involves neurotransmitters and
      hormones acting via G-protein-coupled pathways.

PMID- 1643415
TI  - Signalling mechanisms.

PMID- 1643414
TI  - Synaptic plasticity: long-term potentiation in the hippocampus.

PMID- 1643416
TI  - Analysis by in situ hybridization of cells expressing mRNA for tumor-necrosis
      factor in the developing thymus of mice.
AB  - We have used in situ hybridization to investigate the expression of TNF-alpha
      genes by thymic cells during fetal development in mice. In 14-day-old fetal
      thymuses, very scarce cells produce TNF-alpha mRNA. A second phase of cytokine
      gene expression starts on day 16. The density of positive cells progressively
      increases up to day 20. Thymuses at 15 days of gestation and after birth do not
      express detectable cytokine mRNA. In an attempt to identify the nature of the TNF
      alpha mRNA-producing cells, acid phosphatase activity, which is characteristic of
      the macrophage lineage, was studied in the same thymuses. Acid phosphatase
      positive cells only appear on day 15. Their frequency increases up to birth.
      However, no correlation can be established between acid phosphatase--and TNF
      alpha mRNA--positive cells. The results indicate that a small subset of thymic
      cells is responsible for TNF-alpha mRNA production during ontogeny: These cells
      are not yet identified. The possible role of TNF-alpha in thymic ontogeny is
      discussed.

PMID- 1643417
TI  - Susceptibility of thymocytes for infection by chicken anemia virus is related to
      pre- and posthatching development.
AB  - To investigate the age-dependent mechanism of susceptibility for chicken anemia
      virus (CAV) infection, we inoculated embryos and chickens of ages between day 9
      of embryonic development and day 28 after hatching with CAV. Chicken embryos
      inoculated at days 9 and 11 of development showed no CAV-infected cells in the
      thymus, nor in other lymphoid organs. Many CAV-infected cells were detected in
      the thymic cortex of all chicken embryos inoculated at days 13 and 16 of
      development and of all chickens inoculated 1, 3, and 7 days after hatching. All
      embryos and chickens that contained CAV-infected cells in the thymus also
      contained CAV-infected cells in the bone marrow, but not in the bursa of
      Fabricius or the spleen. In chickens inoculated at days 14 and 21, only few CAV
      infected cells were detected in the thymus, whereas these cells were not detected
      in thymi of 28-day-old inoculated chickens. Depletion of the thymic cortex was
      only detected in chickens inoculated from day 16 of embryonic development till
      day 21 after hatching. Only hematocrit values of the chickens inoculated 1 and 3
      days after hatching were below normal. The rationale for the simultaneous
      susceptibility of cells of the T-cell lineage and cells of the erythrocyte
      lineage is discussed. As far as the thymus is concerned, the absence of clinical
      and microscopical signs of CAV infection in older chickens and the inability of
      CAV to infect embryos at days 9 and 11 of embryonic development may be caused by
      a lack of susceptible thymocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1643418
TI  - Interferon gamma alters the phenotype of rat thymic epithelial cells in culture
      and increases interleukin-6 production.
AB  - Rat thymic epithelial cells (TEC) in long-term culture were characterized by
      anticytokeratin monoclonal antibodies (mAbs) and electron microscopy. Phenotypic
      analysis performed by a large panel of mAbs showed that the highest percentage of
      these cells was of the subcapsular/medullary type. Recombinant rat interferon
      (IFN)-gamma up-regulated class-I and class-II MHC expression by TEC in culture as
      confirmed by immunohistochemistry and flow cytometry, but did not significantly
      alter other cell markers. TEC supernatants of IFN-gamma-treated cultures showed
      higher interleukin-6 (IL-6) activity, compared to the control, as determined by
      proliferation of the IL-6-sensitive B9-cell line. Increased IL-6 activity was
      probably not a consequence of increased TEC number in IFN-gamma-treated cultures
      because IFN did not significantly stimulate TEC proliferation in vitro. In
      contrast, IL-6 significantly stimulated TEC proliferation, indicating that this
      cytokine is not only a regulatory molecule for T-cell proliferation, but could
      also be an autocrine growth factor for thymic epithelium.

PMID- 1643419
TI  - A novel adhesion molecule in the murine thymic microenvironment: functional and
      biochemical analysis.
AB  - The rat monoclonal antibody (mAb) 4F1, raised against mouse thymic stromal cells,
      recognizes cortical epithelium in tissue sections of mouse thymus; however, in
      flow cytometry, activated leucocytes (T cells, B cells, and macrophages) and
      transformed thymocytes are also positive for the 4F1-antigen (4F1-Ag). Western
      blotting, under both reducing and nonreducing conditions, demonstrates that the
      molecule to which 4F1 binds is expressed in four forms, 29, 32, 40, and 43 kD,
      all of which carry N-linked carbohydrate; and that the structure is identical on
      epithelium and lymphocytes. The 4F1-Ag on cortical epithelium is partially
      sensitive to PI-PLC treatment, whereas on transformed epithelial and lymphoid
      cell lines, it was resistant to this enzyme. The molecule, therefore, may exist
      in both transmembrane and phosphoinositol-linked forms. In functional blocking
      experiments, mAb 4F1 gave inhibition of both T-cell proliferation in MLR and of
      cytotoxic T-cell killing of alloantigenic targets; it also blocked adhesion of
      transformed thymocytes to thymic epithelial cells in vitro. These molecular and
      functional characteristics suggest that the 4F1-Ag is a novel adhesion molecule
      that may be involved both in intrathymic T lymphocyte differentiation and in
      peripheral T-cell function.

PMID- 1643420
TI  - Pathogenetic significance of fetal-type acetylcholine receptors on thymic myoid
      cells in myasthenia gravis.
AB  - To investigate the role of thymic myoid cells in the pathogenesis of myasthenia
      gravis (MG), mRNA of nonneoplastic thymuses from eight MG patients was analyzed
      by dot blot hybridization for the occurrence of acetylcholine receptor (AChR)
      subunit transcripts, using the five AChR-subunit cDNAs (alpha, beta, gamma,
      delta, and epsilon) as probes. Attention was particularly paid to the gamma- and
      epsilon-subunit transcripts that specify fetal- or adult-type AChR. In all eight
      thymuses, transcripts of the alpha-, beta-, gamma-, and delta-subunit genes were
      detected. Relative autoradiographic signal intensities correlated with the
      frequencies of thymic myoid cells as determined by immunostaining with anti-AChR
      monoclonal antibodies. In only one of these thymuses were transcripts of the
      epsilon-subunit gene detected in addition to those of the other subunit genes.
      Four MG-associated thymomas without myoid cells were devoid of any AChR-subunit
      mRNA. Our findings imply that fetal-type AChR is expressed in MG thymuses as a
      rule, whereas adult-type AChR is coexpressed with it only in a minority of cases.
      A similar pattern of cotranscription is known to occur at certain stages of
      muscle development, and can be found in human rhabdomyosarcomas with an
      intermediate stage of myogenesis. Because the serum autoantibodies of MG patients
      exhibit preferential reactivity with fetal AChRs, the presence of fetal AChRs in
      the thymus provides circumstantial evidence for an active involvement of thymic
      myoid cells in the autoimmune process.

PMID- 1643421
TI  - Synthesis and cytotoxic properties of new N-substituted 4-aminophenol derivatives
      with a potential as antimelanoma agents.
AB  - New tyrosinase-targeted compounds based on structural variants of the prototype
      unit 4-aminophenol have been synthesized and screened for their potential as
      antitumour agents against malignant melanoma. Cytotoxicity assays showed that N-4
      hydroxyphenylglycine (NHPG) and its alpha-methyl derivatives methylphenylglycine
      and dimethylphenylglycine exhibit significant antiproliferative effects on
      pigmented human melanoma cell lines (HBL), with inhibitory concentrations at 50%
      (IC50) around 80 micrograms/ml. A marked increase in cytotoxicity was observed
      with morpholine-containing 4-aminophenols, e.g. N-(2-morpholinoethyl)-4
      aminophenol, which showed an IC50 of 20 micrograms/ml of HBL cells. Much more
      pronounced was the effect of the diacetoxy-derivative, DiAcMoAc, which showed an
      IC50 of 15 micrograms/ml on HBL cells and as low as 2 micrograms/ml on tyrosinase
      containing, non-pigmented human melanoma cells (LND1), with a toxicity response
      of the same order of magnitude as that of melphalan. These results open
      interesting perspectives in the design of new targeted pro-drugs against
      malignant melanoma.

PMID- 1643422
TI  - Role of asparagine-linked carbohydrates in pulmonary metastasis of B16-F10 murine
      melanoma cells: implication through glycosylation inhibition by nojirimycin.
AB  - N-linked oligosaccharide moieties of cell surface glycoconjugates may be involved
      in the metastatic potential of tumour cells. Many studies have examined the anti
      metastatic properties of inhibitors of carbohydrate synthesis or processing in
      vitro. However, there has so far been little evidence of such inhibitory factors
      on metastasis in vivo because of the general high toxicity of the inhibitors. In
      this study, we found nojirimycin (NM) to be a substantially non-toxic
      carbohydrate synthesis inhibitor that inhibited the experimental metastasis of
      B16-F10 melanoma cells not only in vitro but also in vivo. When NM was
      administered intraperitoneally to syngeneic C57BL/6 mice, the inhibition was dose
      dependent, with 40-75% suppression of pulmonary colonization observed after 5
      days exposure to NM (at 0.4 or 4 mg/day). An in vitro lectin sensitivity assay
      showed that NM-treated B16-F10 cells were less susceptible to the lectin
      concanavalin-A, suggesting alteration or decrease of high mannose-type
      carbohydrate moieties on the cell surface. Further in vitro analysis of
      adhesiveness between B16-F10 cells and endothelial cells demonstrated that NM
      treatment causes reduced binding of B16-F10 cells to endothelial cells. We have
      also studied the effect of NM on natural killer (NK) cells in mice. NM treatment
      elicited no substantial increase in the cytotoxic activity of splenic NK cells
      against YAC-1 target cells. These results indicate that NM acts on the process of
      adhesion and that specific structures of the cell surface carbohydrate moieties
      may be involved in the colonization phase of metastasis in vivo.

PMID- 1643423
TI  - Topical retinoic acid augments ultraviolet light-induced melanogenesis.
AB  - Melanin, the natural pigment found in human skin, absorbs and protects against
      the ultraviolet (UV) components of sunlight. Melanin production (melanogenesis)
      is increased by exposure to sunlight, causing a darker skin colour which is
      regarded as aesthetically pleasing by many humans, who therefore expose
      themselves to large amounts of potentially damaging sunlight. We have found that
      topically applied all-trans retinoic acid, a metabolic derivative of vitamin A,
      greatly enhances UV light-induced melanogenesis: the same preparation on its own
      had no effect on skin pigmentation. An orally administered retinoid, temarotene,
      did not have this effect. These observations were made using a lightly pigmented
      mouse strain, HRA: Skh-2, and confirmed in 2 human volunteers. This is the first
      time that metabolic derivatives of vitamin A have been shown to augment UV light
      induced melanogenesis, suggesting a role for vitamin A in this process.

PMID- 1643424
TI  - Induction of interleukin-2, natural killer cell activity and anti-melanoma
      antibodies resulting from immunization of mice with formalinized extracellular
      antigens (FECA) of murine melanoma.
AB  - Extracellular products from melanoma cells may play an important role in the
      pathogenesis of metastatic melanoma. Studies were designed to evaluate the effect
      of vaccination with formalinized extracellular antigens (FECA) of murine melanoma
      cells (MMM B16-F10) on survival and immune response of C57BL/6 mice. The cellular
      immune response was evaluated by assessing interleukin-2 (IL-2) production and
      natural killer cell activity, whereas the humoral immune response was examined by
      measuring the production of specific antibodies to extracellular antigens (ECA).
      IL-2 production by the splenocytes from immunized animals was significantly
      higher (4.7 U/ml and 3.7 U/ml) than that of controls (1.38 U/ml). The splenocytes
      from immunized mice revealed significantly higher natural killer cell activity.
      Similarly, immunized animals responded by producing specific antibodies against
      the extracellular melanoma antigens as detected by ELISA. The peak production of
      antibodies against ECA was observed on the 21st day post-immunization. These
      results suggest that FECA are immunogenic and may enhance active cellular and
      humoral anti-melanoma immunity.

PMID- 1643425
TI  - Effect of epidermal Langerhans cells from melanoma patients on
      lymphoproliferative responses.
AB  - Langerhans cells (LC) are potent antigen-presenting dendritic cells essential for
      cutaneous immune responses. LC are reduced in number in the epidermis adjacent to
      primary melanomas and increase in number in the lymphoid infiltrate that
      accumulates in the dermis deep to such tumours. The present study was undertaken
      to assess whether the reduction in epidermal LC was accompanied by alterations in
      their functional competence. We evaluated the capacity of LC from melanoma
      patients to augment lymphocyte responses to phytohaemagglutinin (PHA), tetanus
      toxoid and melanoma-associated antigens. Using a panning method to bind Fc
      receptor positive (FcR+) cells we separated LC-enriched (FcR+) and depleted (FcR
      ) fractions of epidermal cells. Lymphocyte responses to PHA and tetanus toxoid
      were increased in the presence of LC-enriched cell populations, but not in the
      presence of LC-depleted epidermal cells. In preliminary experiments LC-enriched
      cell populations did not help initiate detectable in vitro lymphoproliferative
      responses to autologous metastatic melanoma cell lines, allogeneic HLA-DR+
      metastatic melanoma cell lines, or a 180-190 kD melanoma tumour-associated
      antigen. Future studies will investigate the capacity of LC to augment responses
      to melanoma-associated antigens on autologous primary melanomas.

PMID- 1643426
TI  - A comparison of heat sensitivity, radiosensitivity and PLDR in four human
      melanoma cell lines.
AB  - Comparison of the heat sensitivity and radiosensitivity of four human melanoma
      cell lines in culture revealed a large variation in sensitivity amongst the four
      cell lines. Three of the four cell lines had large shoulders on the survival
      curves when exposed to hyperthermia (44 degrees C or 45 degrees C). These three
      cell lines also had demonstrable shoulders on the acute radiation dose response
      curves. The most radiosensitive cell line did not show a shoulder region in the
      heat or radiation survival curves (HT-144, Dq = 0.2 Gy). Despite this consistency
      in the presence or absence of shoulder, there was no correlation between heat and
      radiation sensitivity in the four melanoma cell lines. Furthermore, regardless of
      radiosensitivity, all four lines studied showed competent repair of potentially
      lethal damage. The recovery ratios at a surviving fraction of 0.001 ranged from
      5.7 to 7.6. All four lines had a similar cell cycle distribution at the time of
      treatment, hence the variation observed in the response of these four lines to
      radiation and heat was not due to differences in cell cycle kinetics. Preliminary
      results of DNA polymerase-alpha and -beta activities do not demonstrate a clear
      correlation between cellular levels of these two enzymes and radiosensitivity.

PMID- 1643427
TI  - Multiple primary melanomas in a patient with familial-type DNS during clomiphene
      induced pregnancy.
AB  - A 35-year old woman developed six primary cutaneous melanomas during her third
      pregnancy. She had received clomiphene treatment for nearly 2 years previously.
      She developed two more primary melanomas 15 and 21 months after giving birth. All
      melanomas were histologically associated with preexisting dysplastic naevi. The
      patient showed the characteristic phenotype of the dysplastic naevus syndrome; a
      cousin and an aunt were treated for malignant melanoma and the patient's brother
      had histologically confirmed dysplastic naevi. The course of her first two
      pregnancies was not complicated by the development of melanomas. We suggest that
      clomiphene may have played a role in the activation or progression of these
      'precursor lesions' into malignant melanoma.

PMID- 1643428
TI  - Malignant melanoma of the nasal cavity and nasopharynx treated with cisplatin and
      accelerated hyperfractionated radiation.
AB  - Primary malignant melanoma of the nasal cavity and paranasal sinuses is an
      uncommon disease, accounting for only 0.5-2% of all malignant melanomas. The
      primary treatment has been surgery. The frequency of local recurrence is high and
      recurrence is also the major determinant of treatment failure. Here we report on
      six patients with locally advanced disease, four of whom were too advanced for
      surgery, who were treated with accelerated hyperfractionated radiation in
      combination with cis-platinum. Three of four patients treated for local recurrent
      disease achieved a local cure and died of disseminated disease after 9-21 months.
      One patient given preoperative cisplatin and radiation is still alive with no
      evidence of disease 34 months after the completion of treatment. The present
      protocol may be a useful approach to obtain local control with the possibility of
      long-term cure.

PMID- 1643429
TI  - Modulation by interferon alpha and gamma of the expression of a melanoma
      associated antigen detected by autologous antibody.
AB  - Interferons (IFN) are known to alter the expression of histocompatibility and
      tumour-associated antigens. We have reported the isolation and purification of a
      66-kD melanoma-associated antigen (MAA) that is recognized by the host.
      Competitive binding with MAA reduced autologous antibody binding to five melanoma
      cell lines, suggesting that a similar antigen is detected by other patients with
      melanoma. Nine melanoma cell lines were incubated for 3 days with 0.01-100
      units/ml of interferon alpha (IFN-alpha) or interferon gamma (IFN-gamma) and the
      maximum titre of autologous antibody reactivity was determined by protein A
      haemadsorption. Incubation with IFN-alpha or IFN-gamma resulted in a decrease in
      maximum titre of autologous antibody reactivity directed against all melanoma
      cell lines. A 3-day incubation of three melanoma cell lines with IFN-gamma
      augmented the expression of HLA-DR, as has been reported by others. Incubation
      with spent media from autologous melanoma cells exposed to IFN-alpha inhibited
      autologous antibody binding less than control media from melanoma cells to which
      no IFN was added, indicative of decreased production or internalization of MAA.
      Conversely, incubation with spent media obtained after exposure to IFN-gamma
      inhibited autologous antibody binding to a greater degree than control spent
      media, consistent with increased shedding of antigen. These results suggest that
      IFN-alpha and IFN-gamma down-regulate the expression of MAA detected by
      autologous antibody by different mechanisms of action.

PMID- 1643430
TI  - Defect of insulin receptor in insulin-resistant variants of Cloudman S91 mouse
      melanoma cells.
AB  - To study the mechanisms by which insulin regulates proliferation, we have
      compared wild-type Cloudman melanoma cells, whose growth in inhibited by insulin
      (insinh) to variant lines that were genetically selected for resistance to
      insulin (insres). Scatchard analysis of insulin binding to five insres) lines and
      six insres variants revealed a marked reduction in the number of high-affinity
      binding sites for insulin in the insres lines, and insres lines displayed an
      abnormal beta-subunit of the insulin receptor. During autophosphorylation of the
      wheat germ agglutinin-purified receptor, the beta-subunit apparently underwent
      proteolytic degradation. This proteolysis was ATP-dependent and was prevented by
      bovine pancreatic trypsin inhibitor, and phenylmethylsulphonyl fluoride, but not
      by aprotinin or leupeptin. Receptor proteolysis was not observed in wild-type
      lines. The results suggest that insulin resistance in the mutant Cloudman
      melanoma cells is apparently due to proteolysis of the beta-subunit of insulin
      receptor which, in turn, alters insulin binding capacity of the cells and blocks
      their anti-proliferative response to the hormone.

PMID- 1643431
TI  - Can oncogene (RAS) activation predict susceptibility of human melanoma to
      activated lymphocytes and, therefore, the clinical response of such neoplasms to
      adoptive immunotherapy?
AB  - The expression of activated ras oncogenes was found to be associated with that of
      tumour-specific transplantation antigens in mouse tumours, which can be cured by
      adoptive immunotherapy with T lymphocytes and interleukin-2 (IL-2). A similar
      association is here proposed to exist between RAS oncogene activation (mutation)
      in human melanoma and susceptibility of these tumours to the lytic action of
      activated lymphocytes (both lymphokine-activated killers and cytotoxic T cells)
      which have been used, along with IL-2, in the adoptive immunotherapy of advanced
      melanomas. The limited clinical response (15-25%) of melanoma patients to
      different immunological therapies is, therefore, considered to be due to a
      similar frequency of immunogenic, RAS+ melanomas. The authors thus suggest that
      RAS activation might be a marker of immunogenicity and that only the subset of
      melanoma cells expressing activated RAS will in turn possess tumour antigens
      which can be the target of immunotherapeutic, activated lymphocytes. It is then
      predicted that RAS+ melanomas will be more susceptible to adoptive immunotherapy
      than RAS-counterparts.

PMID- 1643432
TI  - Are advanced malignant melanoma cells hybrids between melanocytes and
      macrophages?

PMID- 1643433
TI  - Keystone symposium. Melanoma and biology of the neural crest. Taos City Hall,
      Taos, New Mexico, USA, 1-8 February 1992.

PMID- 1643434
TI  - Risk factors for melanoma: site variation in minimal erythema dose.
AB  - Skin types 1 and 2, increased numbers of moles, and excessive intermittent sun
      exposure are known risk factors for cutaneous melanoma, but the inter
      relationship between UV radiation exposure, moles and melanoma remains unclear.
      There is a noteworthy site variation in melanoma, it being more common on the
      lower leg in women and on the back in men. In order to determine whether this
      site variation could provide further clues to the pathogenesis of melanoma, we
      examined site variation in photosensitivity and its relationship to other known
      melanoma risk factors (number of moles, skin type and skin colour) in 25 healthy
      volunteers. A marked site variation in photosensitivity was found. The pale skin
      of the volar aspect of the forearm was markedly less photosensitive than the
      darker skin of the back. Females were more photoresistant than males on the lower
      legs even though this is the more common site for melanoma in women. There was
      some correlation between the number of moles and photosensitivity at the two
      sites.

PMID- 1643435
TI  - The prognostic significance of histologic regression in cutaneous melanoma.
AB  - A retrospective evaluation of 201 stage I cutaneous melanomas was performed to
      investigate the prognostic significance of histological regression (present in 67
      cases). Thin melanomas showed regression more frequently than thick lesions (48%
      less than or equal to 0.75 mm vs 12% greater than 3 mm). The mean disease-free
      interval was 33.53 months in regressing tumours and 19.9 in non-regressing
      tumours (p = 0.07): differences between the survival curves were not significant
      (p = 0.61). Metastases developed in 13 (19.40%) patients with regressing tumours
      and by 40 (29.85%) patients with non-regressing tumours. Although we observed a
      higher frequency of regression in thin melanomas we could not demonstrate an
      influence of regression on disease-free interval and survival.

PMID- 1643436
TI  - The tape stripping toluidine blue (TSTB) method in the diagnosis of malignant
      melanoma: an investigator-blind study.
AB  - The cytological investigation of the skin surface with the simple, non-invasive
      tape-stripping toluidine blue (TSTB) method has been proposed to improve the
      clinical diagnosis of many dermatological disorders. We carried out an
      investigator-blind study to estimate the sensitivity and specificity of the
      procedure for the diagnosis of malignant melanoma. One hundred and fifty
      pigmented lesions were tested. Positive results were obtained in 22 out of 32
      malignant melanomas (sensitivity 68.7%), with three false negatives (two cases of
      lentigo maligna in premalignant phase and one early melanoma in situ) and seven
      non-significant findings. Negative results were found in 88 out of 118 non
      melanoma conditions (specificity 74.5%), with three false positives (two Spitz's
      naevi and one dysplastic naevus) and 27 non-significant findings. Thus the TSTB
      method may be a helpful diagnostic tool, in addition to the ABCDE rule, for the
      early detection of malignant melanoma.

PMID- 1643437
TI  - Characterization of isoforms of the major allergen Phl p V by two-dimensional
      immunoblotting and microsequencing.
AB  - Timothy pollen extract was separated by 2D PAGE blot for further characterization
      of the major allergen Phl p V. Using pooled patient serum, we demonstrated that
      Phl p V consists of 4 components at 32 kD and 4 components at 38 kD, each
      differing in their pIs. The primary structure and the amino acid composition of
      the 8 proteins were determined form the blotted samples. Proteins of the same
      molecular weight did not differ in the 20 N-terminal amino acid residues, whereas
      the 32- and 38-kD proteins showed only 60% sequence identity. Furthermore, the
      results of the amino acid analyses suggest differences in their protein
      structure. Therefore, it might be possible that both proteins express different
      IgE-reactive epitopes.

PMID- 1643438
TI  - Detection of house dust mite (HDM)-specific IgE antibodies on nasal mast cells
      from asthmatic patients whose skin prick test and RAST are negative for HDM.
AB  - Mast cells are found in nasal smears of pediatric patients with perennial
      bronchial asthma whose skin prick test and radioallergosorbent test (RAST) are
      negative for inhalant allergens. IgE antibodies were demonstrated on these mast
      cells by monoclonal anti-human IgE antibodies, whereas IgG antibodies were not
      detected by monoclonal anti-IgG antibodies. In order to pursue the causative
      allergen for asthma in these patients, binding potential between IgE antibodies
      on nasal mast cells and house dust mite (HDM), the most prevalent aeroallergen,
      was examined by an immunochemical technique. Out of 9 patients whose skin prick
      test and RAST were negative for HDM, 7 were found to have HDM-specific IgE
      antibodies on their nasal smear mast cells. None of these 7 patients had IgE
      antibodies to cedar pollen, a negative control aero-allergen, on their mast
      cells. Specific binding of HDM on the mast cells was further confirmed by the
      fact that nasal mast cells from patients with egg allergy bound egg white but not
      HDM on their surface. Preincubation of mast cells with anti-IgE antibodies
      inhibited binding of HDM on the mast cells, indicating that HDM was bound to
      surface IgE antibodies on the mast cells. These experiments enabled us to
      expeditiously identify sensitization to an inhalant allergen, such as HDM, in
      young asthmatic patients whose allergen cannot be found by conventional
      laboratory diagnostic procedures.

PMID- 1643439
TI  - Expression of the calcium-binding proteins MRP8 and MRP14 by early infiltrating
      cells in experimental contact dermatitis.
AB  - The immune response to an allergen is not only dependent on the inflammatory
      stimulus, but also on the genetic disposition of the individual. Important
      effector cells in the immune response are myelomonocytic cells in their various
      differentiation stages. We recently described the expression of MRP8 and MRP14,
      two calcium-binding proteins of the S-100 family, by these cells during
      inflammatory activation. Here, we investigated whether their expression in murine
      contact dermatitis is dependent on the stimulus by which dermatitis is elicited,
      and if it is related to the genetic constitution of different inbred strains of
      mice. Therefore we performed immunohistochemical studies on the distribution of
      MRP8- and MRP14-positive cells during experimentally induced allergic (ACD) and
      irritant contact dermatitis (ICD). Both forms of dermatitis were elicited in
      BALB/c and C57B1/6 mice. BALB/c mice were found to react with a more intense
      inflammatory response in both ACD and ICD (high responders) than C57Bl/6 mice
      (low responders). The expression of MRP8 and MRP14 in both forms of dermatitis
      correlated with the early influx of macrophages and with the cell density of the
      infiltrate. Also the percentage of MRP8- and MRP14-positive cells in the
      infiltrate during ACD or ICD was higher in the more intense inflammatory reaction
      of BALB/c mice compared to C57Bl/6 mice. We conclude that MRP8 and MRP14 define a
      differentiation stage of inflammatory macrophages and that their expression
      correlates with the activity of inflammatory processes.

PMID- 1643440
TI  - Modulation of anti-tumor cytotoxicity of cultured mast cells by metabolic
      inhibitors.
AB  - IL-3-dependent, murine mast cell lines derived from embryonic yolk sac precursors
      display a tumoricidal activity that is blocked by antibodies against tumor
      necrosis factor-alpha, indicating that this cytokine is the major mediator
      involved in the cytotoxic activity of the cultured mast cell lines. Further,
      cholera toxin strongly inhibits the cytotoxic activity of mast cells as well as
      their IL-3-induced DNA synthesis response but not IgE-mediated serotonin release.
      Cyclosporin A diminished cytotoxicity and serotonin release, but not DNA
      synthesis. Actinomycin D markedly suppressed the cytotoxicity of one mast cell
      line but only slightly suppressed that of another, whereas the IL-3-induced
      proliferation of both mast cell lines was strongly inhibited. Thus, our studies
      indicate that the cytotoxic function of mast cells is relatively independent of
      their degranulation and proliferation and may utilize different signalling
      pathways.

PMID- 1643441
TI  - Human gut mucosal mast cells: ultrastructural observations and anatomic variation
      in mast cell-nerve associations in vivo.
AB  - One hundred and seventeen coded intestinal biopsy specimens were examined by
      electron microscopy. All surgical biopsies were obtained from uninvolved sites of
      patients with two inflammatory bowel diseases (ulcerative colitis or Crohn's
      disease) and from patients with preneoplastic and neoplastic diseases
      (adenocarcinoma, rectal polyp, familial polyposis). Biopsy sites included normal
      ileum, colon, and rectum as well as conventional ileostomies and continent
      pouches constructed from the ileum. The data reported here describe the
      ultrastructural anatomy of human gastrointestinal tract mucosal mast cells in
      vivo and their anatomic associations with enteric nerves.

PMID- 1643442
TI  - Long-term cultured mouse mast cells: ultrastructure, histamine and leukotriene
      levels.
AB  - Interleukin 3 (IL3), dependent cells were obtained from bone marrow (9/10
      experiments) and spleen cells (4/5 experiments), but not from the thymus. These
      cells were similar to mucosal mast cell toluidine blue staining and electron
      microscopy. They had heterogenous metachromatic granules, and some had large
      scroll-like structures. They also contained histamine (200-800 ng/10(6) cells)
      for the first 2-5 weeks, whose level diminished to less than 30 ng/10(6) cells by
      10 weeks of culture. They also generated leukotriene (LT) C4/D4 (10-40 ng/10(6)
      cells) and LTB4 (2-5 ng/10(6) cells) for over 100 days of culture. In one
      experiment, bone marrow-derived mast cells after 150 days of culture began to
      produce an IL3-like substance and proliferated exponentially without exogenous
      IL3.

PMID- 1643443
TI  - N-terminal amino acid sequence homologies of group V grass pollen allergens.
AB  - In an earlier study, we presented data regarding the immunoaffinity purification
      and N-terminal sequencing of a major pollen allergen from orchard/cocks-foot
      grass (Dactylis glomerata), now identified as the group V allergen Dac g V. In
      this paper, we have extended our investigations to include group V allergens from
      other grass species. Our data confirm the presence of group V-restricted
      characteristic N-terminal amino acid sequences containing a high alanine and
      hydroxyproline (P') rather than proline (P) content, and based upon two conserved
      elements (ADAGY and TPA/TP'A).

PMID- 1643444
TI  - Recombinant allergens: biological, immunological and practical aspects.
AB  - Molecular and biochemical characterization of atopic allergens has made
      considerable progress since the application of cDNA cloning techniques. A number
      of mite allergens, a hornet venom allergen (Dol V), tree pollen allergens, grass
      pollen allergens and allergens from ragweed were cDNA cloned and sequenced. For
      the mite allergens Der p I and Der f I, a thiol protease activity can be assumed
      on the basis of sequence similarities with plant thiol proteases. The major birch
      pollen allergen, Bet v I, is highly homologous to a group of plant pathogenesis
      related proteins, suggesting a similar function of the pollen allergen for the
      birch tree. Finally, the minor birch pollen allergen, Bet v II was shown by
      sequence comparison and biochemical properties to represent the actin-binding
      protein profilin, a protein found in all eukaryotic cells.

PMID- 1643445
TI  - Profilin is a cross-reactive allergen in pollen and vegetable foods.
AB  - Sera with IgE antibodies against grass pollen often contain IgE against vegetable
      foods. We investigated the role of the ubiquitous protein profilin in this cross
      reactivity. Profilin was purified from Lolium perenne grass pollen by means of
      affinity purification with Sepharose-coupled poly(L-proline). This solid phase
      was also used as capturing agent for profilin from pollen and food extracts for
      application in a radioallergosorbent test. It was shown that profilin is an
      allergen in grass pollen and in a wide range of vegetable foods, like potato and
      celery. Within a grass-pollen-sensitive population, patients with IgE to
      vegetable foods have a high incidence of antibodies against profilin. IgE
      antibodies against grass pollen profilin were shown to be cross-reactive with
      respect to vegetable foods.

PMID- 1643446
TI  - For all the saints.

PMID- 1643447
TI  - A case for exit exams.

PMID- 1643448
TI  - Research priorities in rheumatology.

PMID- 1643449
TI  - Kinins--key mediators in inflammatory arthritis?
AB  - Recent evidence suggests an important role for kinins in the generation of pain,
      swelling and the cellular damage associated with inflammatory joint disease.
      Kinins are considered to be pro-inflammatory peptides for a variety of reasons.
      They stimulate c fibres in the synovium to cause pain and increase extravasation
      of fluid to produce swelling. Kinins possess the capacity to release
      neurotransmitters (substance P, acetylcholine) and a second wave of mediators
      (interleukin-1, tumour necrosis factor, interleukin-8, prostaglandins,
      leukotrienes). The steady levels and turnover of kinins is regulated by formation
      (enzymic action of kininogenases on endogenous substrates called kininogens) and
      by metabolism (kininases, peptidases that hydrolyse kinins). These components of
      the kinin system can enter the synovial joint space either by transudation from
      the plasma or from degranulating neutrophils chemotactically attracted into the
      synovium from which they migrate into the synovial fluid. If kinins are involved,
      one would expect neutrophil derived mediators of the system to dominate in
      rheumatoid arthritis and psoriatic arthritis and plasma derived products to be
      more important in osteoarthritis and gout. But, the question whether any of the
      functions attributed to each component of the system can be considered to be a
      primary factor in the cellular pathology of inflamed joints remains to be
      established. Future investigations, including therapeutic trials with kinin
      antagonists and kallikrein inhibitors, will need to address the differential role
      of the kallikreins and kinins in the different types of synovitis, on symptoms of
      inflammation and on any remedial effects on the progression of tissue damage
      within the joint.

PMID- 1643450
TI  - The prevalence of palpable finger joint nodules in diffuse idiopathic skeletal
      hyperostosis (DISH). A controlled study.
AB  - The presence of clinically palpable finger joint nodules (Heberden's and
      Bouchard's nodes) was documented in 123 consecutive cases with diffuse idiopathic
      skeletal hyperostosis (DISH) of the thoracic spine and 191 matched DISH negative
      controls. The prevalence of palpable finger joint nodules was almost twice as
      frequent in cases with spinal DISH compared to controls (46% versus 31%, chi 2 =
      7.67, P less than 0.01; multivariate adjusted odds ratio OR = 1.84; 95% CI: 1.14
      2.98). This increase was most marked at the proximal interphalangeal joint, in
      males and in patients up to the age of 65 years. In addition and independent of
      other variables such as hyperostotic features, age and sex, the prevalence of
      palpable finger joint nodules was about twice as high in probands with a history
      of physically heavy work compared to those without (43% versus 26%, chi = 9.18, P
      less than 0.005; multivariate adjusted odds ratio OR = 2.10; 95% CI: 1.26-3.52).
      From these results we conclude that DISH should be considered as an independent
      risk factor in the development of finger joint nodules.

PMID- 1643451
TI  - Cystic fibrosis arthritis. A report of five cases.
AB  - In a retrospective study of 206 patients with cystic fibrosis (CF), five cases of
      CF arthritis were recorded. This is a frequency of 2.5% and of 4.5% in patients
      aged over 10. Four patients had episodic arthritis, which was related to the
      course of pulmonary disease in two cases. In three patients, synovial fluid
      examination revealed minimal evidence of inflammation. In one of these three
      cases, synovial biopsy revealed a mild and non-specific synovitis. The fifth
      patient had chronic arthropathy and was positive for rheumatoid factor, but did
      not fulfil the criteria for rheumatoid arthritis. There were no radiographic
      abnormalities in any of these cases. CF arthritis is a rare syndrome of unknown
      pathogenesis.

PMID- 1643452
TI  - Abnormal temperature control suggesting sympathetic dysfunction in the shoulder
      skin of patients with frozen shoulder.
AB  - In view of the possibility that sympathetically mediated pain could be
      responsible for frozen shoulder symptoms we compared shoulder skin vasomotor
      control in 11 patients with frozen shoulder and 17 similarly aged normal subjects
      without shoulder pain. Using computer-assisted thermography the shoulder skin
      temperature was assessed before and following a 'cold challenge' which consisted
      of a 15 degrees C cold pack being held against the skin for 60 sec. Both prior to
      and immediately following the cold challenge shoulder skin temperatures tended to
      be lower in the patients. During a 10-min rewarming phase, however, the between
      group temperature difference increased and became significant at the 0.05 level.
      These abnormalities of temperature control in patients clearly suggest
      sympathetic dysfunction in the dermatome subserving pain sensation from the
      affected shoulder. Whether these abnormalities are primary or secondary remains
      unresolved.

PMID- 1643453
TI  - Gastrointestinal accumulation of indium-111 labelled granulocytes in reactive
      arthritis.
AB  - Six patients with reactive arthritis (ReA) were examined for gastrointestinal
      accumulation of Indium-111 labelled granulocytes. Abnormal scintigrams were found
      in three of six patients all of which showed early (less than 4 h) accumulation
      of indium-111 labelled granulocytes which may represent small intestinal
      inflammation. Our findings may indicate that the small intestine is involved in
      ReA, and that indium-111 granulocyte scintigraphy is a useful method for
      demonstrating inflammatory changes in the small intestine in reactive arthritis
      (ReA).

PMID- 1643454
TI  - A case of haemochromatosis arthritis.

PMID- 1643455
TI  - Transverse myelitis in systemic lupus erythematosus: two cases with magnetic
      resonance imaging.
AB  - Transverse myelitis is one of the most serious neurological complications
      occurring in the course of systemic lupus erythematosus. We describe two lupus
      patients, with transverse myelitis, one of whom had associated optic neuritis. In
      both, magnetic resonance imaging of the spinal cord showed an abnormal signal. In
      one case a good response to steroid and immunosuppressive therapy was observed;
      the other case failed to improve despite the therapy applied.

PMID- 1643456
TI  - Pseudoarthroplastic' hand in arthritis mutilans.
AB  - A 46-year-old man with arthritis mutilans and hand radiographic appearance
      suggestive of previous surgery is described. We propose the term
      'pseudoarthroplastic' hand for this radiological finding.

PMID- 1643457
TI  - Anticardiolipin antibodies and a severe subset of systemic lupus erythematosus.

PMID- 1643458
TI  - The use of intranasal calcitonin in the treatment of algodystrophy.

PMID- 1643459
TI  - Confusional syndrome as the presenting form of calcium pyrophosphate dihydrate
      deposition disease.

PMID- 1643460
TI  - Short of a length:Streptococcus sanguis knee infection from dental source.

PMID- 1643461
TI  - Two cases of diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis.

PMID- 1643462
TI  - Non-traumatic Clostridium septicum arthritis in a patient with caecal carcinoma.

PMID- 1643464
TI  - Dual publication--again.

PMID- 1643463
TI  - Vertebral osteoporosis in rheumatoid arthritis patients: effect of low dose
      prednisone therapy.

PMID- 1643465
TI  - Vanishing bile duct syndrome.

PMID- 1643466
TI  - Improving practice: the clinician's role.

PMID- 1643467
TI  - Prognostic factors in colorectal cancer.
AB  - The prognostic power of the extent of tumour invasion is indisputable; Dukes'
      classification has repeatedly been proven to be strongly correlated with patient
      survival. Modifications have led only to confusion, resulting in caution being
      required in the classification of patients with Dukes' A tumours. In the UK, the
      American tumour node metastasis and Australian clinicopathological systems are
      frequently considered too complex for routine clinical use. Meanwhile, Jass's
      classification may be complicated by observer variation between pathologists, and
      recent evidence suggests that it offers no advantage over that of Dukes. All the
      conventional staging systems also fail to take the skill of the surgeon into
      account when determining outcome. Attempts at quantifying tumour structure have
      not heralded the expected major advance. For instance, the expense and uncertain
      prognostic value of tumour DNA content assessed by flow cytometry are likely to
      restrict widespread use of this technique. It may soon be possible, however, to
      provide optimum treatment for patients based on individual tumour doubling times.
      Classification using knowledge of how a small number of cells in the tumour have
      the ability to invade locally, enter blood vessels and metastasize would also
      provide important prognostic information on which treatment could be based. Until
      then, the ease of use and high prognostic power of Dukes' classification ensure
      that, after 60 years, it is still the 'gold standard' against which all other
      prognostic classifications in colorectal cancer should be assessed.

PMID- 1643468
TI  - Nutrition and malignant disease: implications for surgical practice.
AB  - Malignant disease is often associated with weight loss and malnutrition.
      Nutritional support is frequently provided to patients with cancer in an attempt
      to improve nutritional status and reverse weight loss, with the aim of reducing
      morbidity and mortality rates. This review evaluates the effect of supplemental
      nutrition on morbidity and mortality in patients with malignancy undergoing
      treatment with surgery, chemotherapy or radiotherapy. It also assesses the effect
      nutritional supplementation has on host defence mechanisms and how nutrients
      affect tumour cell growth. The evidence suggests that perioperative nutritional
      support, if given for at least 10 days, reduces morbidity and mortality in
      patients with biochemical evidence of severe malnutrition, manifest as a low
      serum albumin concentration and excessive weight loss. In contrast, there is no
      evidence that parenteral nutritional support benefits patients undergoing
      chemotherapy or radiotherapy, in terms of either an increased tumour response
      rate or prolongation of survival. Current research on malignant disease is
      highlighting the role of specific nutrients (amino acids, essential fatty acids
      and polyribonucleotides) as key regulators of both anticancer host defence
      mechanisms and the control of nitrogen metabolism and tumour growth. Arginine,
      essential fatty acids and ribonucleotides have all been demonstrated to stimulate
      antitumour host defence mechanisms and some also modulate tumour cell metabolism.
      Dietary manipulation offers exciting possibilities for the innovative management
      of malignant disease.

PMID- 1643469
TI  - Use of Teflon stents for lymphovenous anastomosis.
AB  - The treatment of lymphoedema is difficult; conservative and surgical management
      show variable results. Lymphovenous anastomoses (LVAs) in experimental animals
      and patients give poor results in the treatment of primary lymphoedema and
      variable results in that of secondary lymphoedema. Conventional sutured LVAs were
      compared with anastomoses using polytetrafluoroethylene (Teflon) stents; 32
      sutured and 21 stented LVAs were constructed in 16 rabbits with normal
      lymphatics. Anastomoses were assessed for quality and patency at 1-16 weeks by
      direct exposure; 27 cases were further assessed using lymphangiography. Patency
      in stented and sutured LVAs was 71 and 38 per cent at 1 week, and 38 and 8 per
      cent at 3 weeks, respectively. After 4 weeks all anastomoses were occluded. The
      quality of stented LVAs seemed to be higher than that of sutured LVAs. Stented
      LVAs are feasible and probably superior to conventional sutured LVAs. However,
      the patency of LVAs is of short duration because of the disadvantageous pressure
      gradient from lymphatics to veins, and this limits their clinical application.

PMID- 1643470
TI  - Abdominal aortic aneurysm, glaucoma and deafness: a new familial syndrome.
AB  - Several reports have suggested a genetic basis for the distribution of abdominal
      aortic aneurysm (AAA) in some families. The familial clustering of this disease
      is further demonstrated in this report of ten siblings, five of whom have
      confirmed AAA. This is the largest cluster so far reported. The majority of
      patients in this family group also have glaucoma and/or deafness.

PMID- 1643471
TI  - Selective use of a right retroperitoneal approach to abdominal aortic aneurysm.
AB  - The repair of infrarenal abdominal aortic aneurysm by right retroperitoneal
      dissection using a standard midline transperitoneal incision has previously been
      described but its clinical application has not been evaluated. Over a 14-year
      period 144 elective abdominal aortic aneurysm grafts were performed by a single
      surgical firm. Of these, 11 were carried out by a right retroperitoneal exposure
      (seven men and four women, aged 63-81 (median 70) years). The indications were to
      improve access for large juxtarenal aneurysms (n = 6) and because of dense
      abdominal adhesions (n = 3), horseshoe kidney (n = 1) and retroperitoneal
      fibrosis (n = 1). In each instance, good proximal control of the aorta was
      achieved. There were no major operative or postoperative complications and all
      patients were discharged from hospital (median stay 15 days). Follow-up (median
      29 months) has revealed no procedure-related complications.

PMID- 1643472
TI  - Distribution of aortic diameter in a screened male population.
AB  - Between September 1990 and August 1991, 2291 men aged 65 years were invited for
      ultrasonographic screening of the aorta in the Gloucestershire aneurysm screening
      programme; 1748 (76.3 per cent) attended. An aortic diameter less than or equal
      to 2.5 cm was found in 1547 (88.5 per cent); 174 (10.0 per cent) had diameters in
      the range 2.6-4.0 cm, and 26 (1.5 per cent) had diameters greater than 4.0 cm.
      The mean(s.d.) aortic diameter was 2.1(0.55) cm and 97.5 per cent of patients had
      a diameter less than or equal to 3.3 cm. Any man over the age of 65 years with an
      aortic diameter greater than 3.3 cm has an aortic aneurysm.

PMID- 1643473
TI  - Thoracoscopic enucleation of leiomyoma of the oesophagus.

PMID- 1643474
TI  - Delayed surgery for congenital diaphragmatic hernia.
AB  - Between January 1987 and December 1990, 67 neonates were treated for congenital
      diaphragmatic hernia, symptomatic within 6 h of birth. The mortality rate was 33
      per cent. Preoperative stabilization was achieved in 47 patients, all of whom
      survived initial treatment, although two died later. Stabilization could not be
      achieved in 20 neonates, all of whom died within 3 days of birth, 18 without
      undergoing operation and two after early repair. Intensive resuscitation with
      controlled, delayed operation for congenital diaphragmatic hernia gives long-term
      results similar to those of urgent operative repair. This approach avoids
      operation in the majority of those who subsequently die.

PMID- 1643475
TI  - Mirizzi syndrome managed by endoscopic stenting and laparoscopic cholecystectomy.

PMID- 1643476
TI  - Effect of biliary decompression on reticuloendothelial function in jaundiced
      rats.
AB  - The recovery of reticuloendothelial system (RES) function following decompression
      of obstructive jaundice was studied using a rat model with bile duct ligation and
      side-to-side choledochoduodenostomy. Histopathological changes in the liver were
      still present 5 weeks after relief of jaundice, while results of liver function
      tests had returned to normal. RES function evaluated by the blood clearance and
      organ uptake of radiolabelled Escherichia coli using a corrected phagocytic index
      gradually returned to normal following biliary decompression. The severely
      impaired RES activity noted 1 week after operation may explain the increased
      incidence of sepsis and renal insufficiency in the early period after biliary
      surgery in jaundiced patients.

PMID- 1643477
TI  - Treatment of common bile duct stones using mono-octanoin.
AB  - A retrospective analysis of 48 patients undergoing mono-octanoin infusion via
      nasobiliary catheter following failure of endoscopic extraction of common bile
      duct stones is reported. Among 35 patients who received a complete course of
      treatment, nine (26 per cent) had duct clearance by the completion of the
      infusion and a further eight on subsequent endoscopic retrograde
      cholangiopancreatography (ERCP) (total 49 per cent). Two patients had a
      successful stone extraction after enlargement of the sphincterotomy (total non
      surgical clearance rate 54 per cent). None of five patients with stones greater
      than 2 cm in diameter had stone clearance at the completion of the infusion and
      only one at subsequent ERCP. Among 13 patients receiving an incomplete course of
      treatment seven had clear ducts on repeat ERCP (54 per cent). Mono-octanoin
      infusion via a nasobiliary catheter is of limited value in the management of this
      difficult group of patients, although it may be successful in some.

PMID- 1643478
TI  - Risk factors and classification of acute suppurative cholangitis.
AB  - A prospective study was performed in 1282 patients with common bile duct stones
      to determine the clinical and laboratory parameters that could predict
      cholangitis, and the factors associated with greater severity of cholangitis.
      Patients were divided into two groups, with or without acute cholangitis,
      depending on the macroscopic appearance of bile aspirated from the common bile
      duct during surgery. Acute cholangitis was diagnosed when the aspirated fluid was
      turbid or clearly pus; the typical Charcot's triad was present in only 22 per
      cent of patients with acute cholangitis. Several clinical and laboratory
      parameters were significantly more common in these patients and, depending on
      their number, the probability of acute cholangitis increased significantly. The
      operative mortality rate was 1.2 per cent for patients without cholangitis and
      11.9 per cent for patients with cholangitis. Depending on the number of factors
      present, patients with cholangitis were divided into three groups: mild acute
      cholangitis without mortality; moderate acute cholangitis with a mortality rate
      of 5.6 per cent; and severe acute cholangitis with a mortality rate of 27.5 per
      cent. The present classification allows the group of patients needing prompt
      endoscopic or surgical drainage to be identified.

PMID- 1643479
TI  - Identification of the regional lymphatic system of the gallbladder by vital
      staining.
AB  - In 21 patients with biliary tract cancer dye was injected into the lymphatic
      system of the gallbladder to determine the extent of its regional lymph nodes. A
      volume of 0.1-0.3 ml 1 per cent indigo carmine solution was injected directly
      into lymphatic vessels of the gallbladder in eight patients and into lymph nodes
      (cystic node or pericholedochal nodes) in 13 patients during radical surgery for
      biliary tract cancer. The lymphatic system was visualized in a total of 14
      patients. The dye descended around the bile duct, flowed into the cystic node,
      the pericholedochal nodes and the lymph nodes posterior to the head and neck of
      the pancreas, and finally reached the interaortocaval nodes adjacent to the left
      renal vein. The stained lymphatic tissue was regarded as the regional lymphatic
      system of the gallbladder. These nodes should be completely resected during
      radical surgery for gallbladder cancer.

PMID- 1643480
TI  - Bile duct stents in the management of hepatolithiasis with long-segment
      intrahepatic biliary strictures.
AB  - Biliary stricture represents a challenging problem in the treatment of
      hepatolithiasis because of its association with treatment failure and stone
      recurrence. The long-segment type of stricture is difficult to manage and is
      likely to recur. To investigate the necessity for biliary stenting after balloon
      dilatation therapy, 20 consecutive patients with long-segment strictures who had
      22 stents (group 1) were compared with ten patients who refused stenting (group
      2). The long-segment strictures in group 1 were located on the right side in 80
      per cent of patients, on the left side in 10 per cent, and were bilateral in 10
      per cent. The stents, varying from 8 to 12 Fr, were retained for at least 6
      months. They were inserted through the routes of a matured T tube track (five
      cases), percutaneous transhepatic track (14 cases), a jejunal limb (two cases)
      and a fistula (one case). Complications of stenting consisted of dislodgement
      (one case), haemobilia (two cases), cholangitis (two cases) and intrahepatic
      abscess (one case). The cumulative probability of stricture recurrence in group 1
      was 10 per cent, 15 per cent and 21 per cent at 2, 3 and 4 years, respectively,
      whereas in group 2 it was 80 per cent at 2 years (P less than 0.003). The results
      suggest that intrahepatic biliary stenting after balloon dilatation appears
      necessary and helpful in the management of hepatolithiasis with long-segment
      biliary strictures.

PMID- 1643481
TI  - Bilateral pancreaticopleural fistulae treated by distal pancreatectomy.

PMID- 1643482
TI  - Vascular inflow exclusion and hepatic resection.
AB  - Seventy-nine patients undergoing hepatic resection without manipulation of the
      vena cava were divided into three groups. Group 1 consisted of 32 patients in
      whom hepatic hilar vascular exclusion was not performed. Group 2 (20 patients)
      had vascular inflow exclusion performed at the operative site only (right or left
      unilateral exclusion). Group 3 (27 patients) had total inflow exclusion during
      hepatic resection. There were no significant differences between the groups in
      blood loss or blood transfusion requirement. On the third day after operation,
      the serum glutamic-pyruvic transaminase level in group 3 was significantly higher
      than that in group 1 (P less than 0.01). Vascular inflow exclusion may not be
      essential for successful hepatic resection.

PMID- 1643483
TI  - Potential candidates for small bowel transplantation.
AB  - The number of potential candidates for small bowel transplantation in the UK is
      unknown. Potential recipients are those with irreversible small intestinal
      failure, including those treated with permanent parenteral nutrition. This study
      of one of the largest groups of patients receiving such nutrition identified ten
      of 25 adult patients as possible recipients. The remaining 15 were considered
      unsuitable, mainly because of multiple previous abdominal operations or
      abscesses. Extrapolation of these data to national figures on the incidence of
      irreversible small intestinal failure suggests that each year up to 20 new adult
      patients in the UK might benefit from small bowel transplantation.

PMID- 1643484
TI  - Perforation of the bowel by suction drains.

PMID- 1643486
TI  - Mesosigmoplasty as a definitive operation for sigmoid volvulus.
AB  - In a prospective study, 126 patients with sigmoid volvulus were treated by
      mesosigmoplasty during a 12-year period. Patients with sigmoid volvulus with no
      clinical evidence of gangrene were selected for study, and all were given a trial
      of non-operative reduction by proctoscopy and passage of a rectal tube. Reduction
      was achieved in 48 patients (38 per cent), who were subsequently treated by
      mesosigmoplasty as an elective procedure 1-2 weeks later. For the remaining 78
      patients (62 per cent) who were not relieved by the non-operative method,
      emergency mesosigmoplasty was performed. There was one death in the emergency
      group, and two patients had a recurrence after 2 and 6 months respectively in the
      elective group, in whom resection was carried out. In the other 123 patients
      during a maximum follow-up of 12 (mean 8.2) years no recurrence was detected.
      Mesosigmoplasty has the advantage of low rates of mortality, morbidity and
      recurrence; it can be carried out as either an emergency or an elective
      procedure.

PMID- 1643485
TI  - Flush aortic tie versus selective preservation of the ascending left colic artery
      in low anterior resection for rectal carcinoma.
AB  - The effects of two methods of colonic vascular ligation were studied in 143
      consecutive patients who underwent low anterior resection with total mesorectal
      excision and full mobilization of the splenic flexure. Either the ascending left
      colic artery (ALCA) was selectively preserved (n = 52) or a flush aortic ligation
      was performed (n = 91). In those with a protective colostomy, the radiological
      leak rate was 12 per cent when the ALCA was preserved (n = 41) and 10 per cent
      when a flush aortic tie was performed (n = 60) (P greater than 0.95; 95 per cent
      confidence interval (c.i.) for difference -10 to +15 per cent). In those without
      a colostomy, the clinical leak rates of 9 per cent when the ALCA was preserved (n
      = 11) and 19 per cent when a flush aortic tie was performed (n = 31) were not
      significantly different (P greater than 0.10; 95 per cent c.i. for difference -12
      to +32 per cent). Proportional hazards analysis showed no association between the
      method of vascular ligation and the risk of tumour recurrence and death.
      Anastomotic leak rates, tumour recurrence and survival were not related to the
      method of vascular ligation.

PMID- 1643487
TI  - Primary versus staged resection for acute obstructing colorectal carcinoma.
AB  - The management of 115 patients with complete neoplastic obstruction of the colon
      was studied retrospectively. Primary resection was carried out in 40 patients, 22
      with right-sided and 18 with left-sided tumours. Staged resection was planned in
      48 patients and actually performed in 40. Creation of a stoma only was carried
      out in 25 patients because of advanced disease. There were no differences between
      primary and staged resection regarding the patients' general condition,
      concurrent disease, tumour stage according to Dukes' classification,
      postoperative complications, or mortality. The postoperative mortality rate was
      10 per cent after primary and 15 per cent after staged resection (P not
      significant). The median hospital stay was 18 and 45 days, respectively. The 5
      year survival rate was 38 per cent after primary and 29 per cent after staged
      resection. All primary resections but one were performed by qualified surgeons,
      while trainees created stomas as emergency treatment. The similarity in outcome
      suggests that in future this condition should, where possible, be treated by
      primary resection, by surgeons experienced in colorectal operations.

PMID- 1643488
TI  - Pouch advancement and neoileoanal anastomosis for anastomotic stricture and
      anovaginal fistula complicating restorative proctocolectomy.

PMID- 1643489
TI  - Brighton modification of the DeBakey aortic clamp.

PMID- 1643490
TI  - Estimation of small bowel transit time following colectomy and ileal reservoir
      construction.
AB  - A study was carried out to evaluate the breath hydrogen test as a method of
      estimating small bowel transit in patients with an ileal pouch and to determine
      whether gut transit time influenced functional outcome. Twelve patients with an
      ileal reservoir and ten control subjects ingested a test meal of 400 ml chicken
      soup, 20 g lactulose and 50 ml dilute barium solution. Concurrent breath hydrogen
      testing and radiological screening was carried out until the head of the test
      meal reached the ileal pouch or caecum. At the time that the test meal arrived in
      the pouch, faecal anaerobic bacterial counts were obtained. Pouch compliance,
      functional capacity and anal sphincter pressures were also measured. While there
      was an excellent correlation between radiological and breath hydrogen measures of
      orocaecal transit time in controls (P less than 0.001), no such relationship was
      found for oropouch transit. Four of the 12 patients with a pouch produced no
      hydrogen after test meal ingestion, while in two other such patients breath
      hydrogen peaks occurred when the head of the meal was in the jejunum. The
      magnitude of the breath hydrogen rise in patients with an ileal pouch correlated
      well with faecal anaerobic bacterial counts (P less than 0.01). The median (95
      per cent confidence interval) radiological small bowel transit time was more
      rapid in patients with a pouch than in control subjects: 28 (23-33) versus 72 (46
      86) min (P less than 0.01). Increased 24-h frequency of defaecation was
      associated with more rapid small bowel transit after ileal reservoir construction
      (P less than 0.01) but correlated with neither pouch capacity nor compliance.
      These data show that small bowel transit time may be a determinant of ileal pouch
      function but that breath hydrogen estimation of gut transit time in patients with
      an ileal reservoir is unreliable.

PMID- 1643491
TI  - Subcutaneous rectal stump closure after emergency subtotal colectomy.
AB  - Subtotal colectomy with preservation of the rectum is now the procedure of choice
      for patients with severe colitis requiring emergency surgery. The use of
      subcutaneous 'rectal closure' when the retained distal bowel is placed at the
      caudal end of the abdominal incision in the subcutaneous or fascial layer is
      studied. An anal catheter may be placed to drain the rectum. Thirty-two patients
      (14 men, 18 women) of mean age 33 (range 17-77) years with severe inflammatory
      bowel disease (29 ulcerative colitis, one Crohn's disease, one indeterminate
      colitis, one Campylobacter colitis) underwent emergency colectomy with
      subcutaneous rectal stump closure. Twenty-three stumps were closed with staples,
      four sutured and five by both staples and sutures. Complications developed in
      seven patients (22 per cent), of which two required surgical intervention. One
      significant wound infection was treated successfully with a course of
      antibiotics. Three minor wound infections did not require specific treatment. The
      rectal stump was always readily located at the time of restorative surgery. This
      technique is recommended as a simple and safe alternative to an open mucus
      fistula provided that surgeons adhere to standard surgical principles; in
      particular the distal bowel should not be brought out into the wound under
      tension.